Usmleworld Test 1 Step2

Front 1

Most common cause of rhabdomyolysis

Back 1

alcoholism

Front 2

What lab tipoff tells you rhabdomyolysis is going on?

Back 2

Urine dipstick is positive for blood, but there's hardly any RBCs on microscopic review. Also, creatinine levels rise disproportionately higher than BUN.

Front 3

Treatment of rhabdomyolysis?

Back 3

Hydration, alkalinization of urine. Diuresis with mannitol is sometimes needed.

Front 4

triad of renal cell cancer?

Back 4

dull flank pain, hematuria, fever.

Front 5

Predisposing factors for aortic dissection?

Back 5

Marfan's, HTN, Ehlers-Danlos, Turner's, coarctation of the aorta, bicuspid aortic valve

Front 6

which bisphosphonate should you give to bedridden pts?

Back 6

pamidronate IV, it doesn't cause esophageal irritation like the others.

Front 7

Define Reiter's syndrome

Back 7

Arthritis, conjunctivitis, and urethritis.

Front 8

Skin lesions associated with Reiter's syndrome

Back 8

keratoderma blenorrhagicum found on palms and soles. These are clear vesicles on red bases that evolve into macules and papules. Also, circinate balanitis, which are painless shallow ulcers on the glans penis or urethral meatus

Front 9

Causes of Dupuytren's contracture.

Back 9

cigarette smoking, diabetes, alcoholism

Front 10

three reasons why pts get post-op cholestasis

Back 10

1. increased pigment load from transfusion
2. decreased liver function from hypotension
3. decreased renal bilirubin excretion (from tubular necrosis)

Front 11

when does post-op cholestasis show up?

Back 11

post-op day 2-3

Front 12

what kinds of labs do you see in post-op cholestasis?

Back 12

AST and ALT are normal or slightly elevated, while Alk phos is markedly elevated.

Front 13

What tells you that pts have acute liver failure?

Back 13

prolonged PT and neuro si/sx of encephalopathy, decreased albumin levels.

Front 14

what happens to LES tone in scleroderma?

Back 14

the tone is decreased-->reflux

Front 15

what does esophageal spasm look like on barium swallow?

Back 15

cork-screw pattern

Front 16

What can cause chronic thrombocytopenia?

Back 16

lupus, CMV, toxoplasma, hepatitis, HIV, hematological diseases that cause decrease in bone marrow activity.

Front 17

What's the best measurement of lung involvement in Guillain-Barre?

Back 17

serial measurements of vital capacity.

Front 18

What is membranoproliferative glomerulonephritis type 2 called?

Back 18

dense deposit disease

Front 19

What causes dense deposit disease?

Back 19

IgG antibodies against C3 convertase of the alternate complement pathway (C3 nephritic factor) cause activation of the alternate complement pathway at the glomerular basement membrane.

Front 20

What does membranoproliferative glomerulonephritis type 2 (dense deposit disease) look like under the microscope?

Back 20

dense intramembranous deposits that stain for C3.

Front 21

cavitary lung lesions in HIV pts.

Back 21

Tuberculosis, atypical mycobacterium, nocardia, gram-negative rods, anaerobes, coccidioides

Front 22

how do you treat nocardia?

Back 22

TMP-SMX

Front 23

Causes of acute GI hemorrhage in the elderly

Back 23

angiodysplasia, diverticulosis, PUD

Front 24

si/sx of erhlichiosis

Back 24

headache, nausea, vomiting, malaise, myalgia

Front 25

lab finding in erhlichiosis

Back 25

thrombocytopenia, leukopenia, elevated LFTs.

Front 26

treatment of erhlichiosis

Back 26

doxycycline

Front 27

si/sx of acute angle closure glaucoma

Back 27

blurred vision, eye pain, nausea, vomiting, red eye, fixed dilated pupil, hazy cornea

Front 28

how do you reverse an overdose of calcium channel blockers?

Back 28

calcium chloride, fix hypotension with normal saline, insulin and glucose may be needed for severe poisoning

Front 29

why isn't ABO incompatibilty such a big deal during pregnancy?

Back 29

because ABO antibodies don't cross the placenta

Front 30

what does sodium cromolyn do?

Back 30

it stabilizes mast cells, good for asthma and atopy.

Front 31

how do you quickly reverse warfarin?

Back 31

fresh frozen plasma

Front 32

what is myerson's sign

Back 32

in Parkinson's, repetitive tapping of the chin produces prolonged blinking.

Front 33

what antibodies are assoc with celiac sprue?

Back 33

anti-endomysial antibodies

Front 34

describe the arthritis assoc with lyme disease?

Back 34

intermittent, tends to involve the knee, warmth, swelling, effusion, restriction of movement, the episodes gradually disappear in about ten years if untreated.

Front 35

define arrest of dilation

Back 35

no cervical change in 4 hours (and cervix is greater than 2cm dilated)

Front 36

define arrest of descent

Back 36

no change in descent in over an hour

Front 37

when would you give a pt a yellow fever vaccine?

Back 37

if they're going to sub-saharan africa or equatorial south america

Front 38

si/sx of intrahepatic cholestasis of pregnancy

Back 38

intense pruritus, worse on palms and soles, worse at night,

Front 39

si/sx of posterior urethral injury

Back 39

blood at urethral meatus, scrotal hematoma, high riding prostate,

Front 40

first step in management of posterior urethral injury?

Back 40

retrograde urethrogram (then you do a delayed repair)

Front 41

how do you diagnose bladder injury?

Back 41

retrograde urethrogram with post void films

Front 42

first step in management of anterior urethral injury

Back 42

immediate surgical repair

Front 43

why do liver failure pts get respiratory alkalosis?

Back 43

progesterone stimulates respiratory center

Front 44

what kind of corneal ulcers do pts with herpes zoster ophthalmicus get?

Back 44

dendriform ulcers

Front 45

what kind of corneal ulcers do pts with herpes simplex ophthalmicus get?

Back 45

dendritic ulcers

Front 46

what embryologic cells do wilm's tumors arise from?

Back 46

metanephros

Front 47

what does the metanephros give rise to?

Back 47

renal parenchyma

Front 48

what's the first step in management of preterm labor?

Back 48

bed rest and hydration

Front 49

define preterm labor

Back 49

between 20 and 37 weeks--the presence of 4 contractions in 20 minutes, effacement of 80%, or cervical dilation of 2cm or more.

Front 50

what are the syndromes assoc with lacunar infarcts?

Back 50

1. pure motor hemiparesis
2. pure sensory stroke
3. dysarthria-clumsy hand syndrome
4. ataxic hemiparesis

Front 51

si/sx of anterior cerebral artery stroke?

Back 51

contralateral motor and/or sensory deficits, worse in lower limb, urinary incontinence, gait apraxia, primitive reflexes, abulia, paratonic rigidity.