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Uworld4 Flashcards

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1
Q

what is a common heart problem after viral myocarditis

A

dilated cardiomyopathy

- dilated ventricles and diffuse hypokinesia

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2
Q

what causes eccentric hypertrophy

A

chronic volume overload

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3
Q

what causes concentric hypertrophy

A

chronic pressure overload

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4
Q

What is the most common malignancy diagnosed in patients exposed to asbestos

A

bronchogenic carcnioma

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5
Q

what are the most common causes of secondary digital clubbing

A

Lung malignancies
cystic fibrosis
right-to-left cardiac shunts

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6
Q

clinical features of mixed cryoglobulinemia

A 
fatigue
palpable purpura 
arthralgias 
renal disease
peripheral neuropathies
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7
Q

Lab values for mixed cryoglobulinemia

A

hypocomplementemia
positive rheumatoid factor
elevated transaminases
kidney injury

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8
Q

What is required to diagnose Community-acquired pneumonia

A

presence of a lobar, interstitial, or cavitary infiltrate on chest x-ray.

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9
Q

when is sputum and blood cultures not required for CAP

A

outpatient setting, empiric oral abs are almost always curative

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10
Q

does hypoventilation cause alveolar-arterial oxygen gradient

A

no

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11
Q

what causes alveolar-arterial oxygen gradient

A

right-to-left intrapulumonary shunting
V/Q mismatch
interstitial lung disease

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12
Q

What scenario is decreased cardiac contractility observed in

A

systolic heart failure

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13
Q

what is the initial step for toxic megacolon?

A

abdominal x-ray

Surgery is only for pts not responding to medical therapy

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14
Q

What are other causes of cirrhosis other than alcohol

A
  1. viral hepatitis
  2. nonalcoholic fatty liver disease
  3. hemochromatosis
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15
Q

what causes pancreatitis complicated by hypotension

A

intravascular volume loss secondary to local and systemic vascular endothelial injury –> vasodilation, increased vascular permeability,

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16
Q

BUN levels greater than what typically causes uremic pericarditis

A

60

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17
Q

What medications can be used for patients who exercise daily with exercise asthma

A

inhaled corticosteroids or antileukotriene agents

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18
Q

Patients with severe bladder outlet obstruction due to BPH can develop what? next step?

A

acute kidney injury

renal U/S to assess hydronephrosis

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19
Q

Stain with Congo red and demonstrates an apple-green birefringence under polarized light of kidney.

A

amyloidosis

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20
Q

What is the most common cause of AL amyloidosis

A

multiple myeloma

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21
Q

What is the most common cause of AA amyloidosis

A

rheumatoid arthritis

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22
Q

Crescent formation on light microscopy

A

rapidly progressive glomerulonephritis

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23
Q

Hyalinosis that affects both afferent and efferent arterioles

A

hypertension

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24
Q

normal light microscopy

A

minimal change disease

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25
how does pH change with aspirin poisoning
respiratory alkalosis anion gap metabolic acidosis normal pH, low bicarb, low PaCO2
26
What is the next step if someone has painless hematuria as an adult (age>35)
CT urogram and cystoscopy
27
What is the most common cause of abnormal hemostasis in patients with chronic renal failure? lab values? treatment?
platelet dysfunction normal PT, PTT, and platelet count bleeding time prolonged Desmopressin
28
Most common cause of death in dialysis patients
cardiovascular
29
what leads to cyanide toxicity?
sodium nitroprusside prolonged infusion, especially if patient has chronic kidney disease
30
how do you treat lithium-induced nephrogenic DI
salt restriction and discontinuation of lithium
31
Initial choice of treatment for blacks with hypertension
Thiazide or CCB, alone or in combination
32
Initial treatment of choice for ethnicities with chronic kidney disease for hypertension
ACEI or ARB
33
What is the earliest renal abnormality seen in diabetic nephropathy
1. glomerular hyperfiltration 2. thickening of glomerular basement membrane 3. Mesangial expansion 4. Nodular sclerosis
34
what is the preferred method for urine microablumin
Spot urine collection and timed urine collection
35
What is the most common cause of nephrotic syndrome in adults, particularly African Americnas
Focal segmental glomerulosclerosis
36
Which kidney thing associated with HIV and heroin use
Focal segmental glomerulosclerosis
37
Which kidney thing is associated with Hep B and C
Membranoproliferative glomerulonephritis
38
what are 3 causes of astreixis
1. hepatic encephalopathy 2. uremic encephalopathy 3. hypercapnia
39
What are urgent indications for dialysis
AEIOU 1. Acidosis (pH <7.1) 2. Electrolyte abnormality (K>6.5) 3. Ingestion 4. Overload, volume 5. Uremia
40
treatment for uremic encephalopathy
dialysis
41
What is a risk factor for Hepatorenal syndrome
advanced cirrhosis with portal hypertension and edema
42
what is one indication for hepatorenal syndrome
no improvement in renal function with fluids | decrease in GFR
43
Why does hepatorenal syndrome occur?
1. splanchnic arterial dilation 2. decreased vascular resistance 3. local renal vasoconstriction
44
Name 6 medications that cause hyperkalemia
1. Beta blocker 2. ACE i 3. ARB 4. Spinolactone 5. digoxin 6. NSAIDs
45
Treatment for acute hyponatremia encephalopathy?
3% saline
46
What makes IgA nephropathy different from postinfectious glomerulonephritis
IgA nephropahty: within 5 days of URI. young adult men. | normal serum complements
47
Interstitial cystitis
Bladder pain that is worsened by filling and relieved by voiding. Dyspareunia, urinary frequency and urgency can also be present.
48
What is intersittial cystitis associated with?
psychiatric disorders and fibromyalgia
49
Side effect of Rifampin
red urine
50
What acid base values give you the best picture
pH and CO2
51
When do you use steroids to treat hypercalcemia
excessive vitamine D uptake Sarcoidosis lymphomas
52
what abs causes hyperkalemia
Trimethoprim
53
EKG changes for hyperkalemia
1. peaked t waves 2. PR prolongation 3. QRS widening
54
Most common renal vascular lesions seen in hypertension are
arteriosclerotic lesions of afferent and efferent renal arterioles and glomerular capillary tufts
55
acidosis does what to potassium
hyperkalemia
56
What is the difference between vomiting and Diuretic abuse/Bartter's syndrome
Vomiting: low urine chloride concentration | Diuretic abuse/Bartter's syndrome: positive urine chloride is high
57
Risk factor for correcting low sodium to normal
central nervous system osmotic demylination syndrome
58
Risk factor for correcting high sodium to normal
cerebral edema
59
what will show up in urine for diuretic abuse
urinary sodium and potassium will be elevated
60
What causes membranoproliferative glomerulonephritis
persistent activation of the alternative complement pathway
61
What acid base disturbance occurs after tonic-clonic seizure? treatment?
metabolic acidosis | resolves without treatment within 90 minutes following resolution of seizure activity
62
What is normal anion gap
6-12
63
MUDPILES
``` methanol uremia DKA Paraldehyde Isoniazid/INH Lactic Acidosis Ethylene glycol Salicylates ```
64
Appropriate compensation for metabolic acidosis?
PaCO2 = 1.5 (serum HCO3-) +8 +/- 2
65
What's a good way to distinguish between saline responsive metabolic alkaosis and saline resistant
saline resistant: a disease like hyperaldosteronism, cushing, saline responsive: diuretic/laxative abuse. vomiting
66
Patients with nephrotic syndrome have increased risk of what
1. atherosclerosis (due to hyperlipidiemia) | 2. arteriovenous thrombosis
67
Unfavorable metabolic side effects of thiazide
hyperglycemia increased LDL cholestrol and plasma triglyceride increased hyeruricemia
68
Electrolyte abnormalities of thiazide
hypo- Na, K, Mg | Hyper - Ca
69
Treatment for patients with hypertension and renal artery stenosis?
ACE or ARB | - surgery is reserved for resistant hypertension or recurrent pulmonary edema
70
What is radiolucent? type of stone?
Uric acid stones (acid stones) | may be seen on U/S or CT scan
71
treatment for uric acid stones
oral potassium citrate to alkalinze the urine
72
Absorption of what is increased in Crohn?
oxalate
73
Do you need a detailed metabolic evaluation for a first tine renal stone
no
74
what size stone passes spontaneously with conservative management
less than 5 mm
75
Drug used for kidney stone
alpha-1 receptor blocker | Tamsulosin
76
Unilateral varicoceles that fail to empty when a patient is recumbent raise suspicion for?
underylying mass pathology (renal cell carcinoma)
77
Who usually gets type 4 renal tubular acidosis
poorly controlled diabetics
78
Type 4 renal tubular acidosis
hyperkalemic renal tubular acidosis non-anion gap metabolic acidosis persistent hyperkalemia mild-to-moderate renal insufficiency
79
Electrolyte distrubance with laxative abuse
hypokalemia | non-anion gap metabolic acidosis
80
U/A for rhabdomyalsis
large amount of blood but no RBC on urine microscopy
81
severe hyponatremia for SIADH treatment
3% saline
82
Urgency incontinence? txt
sudden overwhelming or frequent need to void | anti-muscarinic (oxybutynin)
83
Overflow incontinence? txt?
``` constant involuntary dribbling cholinergic agonists (Bethanechol) ```
84
What does positive urine leukocyte indicate?
pyruia
85
what does positive urine nitrate indicate?
presence of bacteria
86
Treatment for uncomplicated cystitis
Nitrofurantoin Trimethoprim-sulfamethoxazole Fofomycin
87
Treatment for complicated cystitis
Fluoroquinolones
88
What lab values should you get before starting them on lithium
``` baseline metabolic calcium pregnancy test thyroid function test U/A ```
89
What are long term side effects of lithium
nephrogenic diabetes inspidus chronic kidney disease Hyperparathyroidism with hypercalcemia thyroid dysfunction
90
What is MRI of HIV patient
Diffuse increase in intensity in white matter
91
Advance sleep phase syndrome
inability to stay awake in the evening (usually after 7pm)
92
When is melatonin the first line treatment for insomnia
delayed sleep-wake phase disorder ( wake and sleep times different than conventional times)
93
MOA for metoclopramide
dopamine antagonist
94
MOA hyroxyzine
antihistamine
95
MOA ondansetron
Serotonin antagonist
96
severe MDMA intoxication
hyperthermia
97
Trastuzumab treats what
HER-2 positive breast carcinoma
98
Side effect of Trastuzamab
cardiotoxicity
99
side effect of Bleomycin
pulmonary fibrosis
100
treatment for urge incontinence
oxybutynin

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