Usmleworld Test7 Step2

Front 1

why do OCPs cause HTN in some pts?

Back 1

because they cause an increase in the synthesis of angiotensinogen by the liver

Front 2

treatment of delayed labor because of mid-pelvic contraction?

Back 2

C-section (there is a pelvic obstacle)

Front 3

what do you do if you suspect a tear in a knee ligament, but the MRI is negative or inconclusive?

Back 3

get arthroscopy

Front 4

what is elevated in anorexics that gives them an orange tinge?

Back 4

carotene

Front 5

treatment of dermatitis herpetiformis?

Back 5

dapsone

Front 6

most common cyanotic congenital heart defect?

Back 6

tetrology of fallot

Front 7

si/sx of tetrology?

Back 7

pan-systolic murmur, single S2, cyanotic spells, can present early or late in the first four years

Front 8

what do urate crystals look like

Back 8

needle shaped negatively birefringent

Front 9

treatment of anorexia

Back 9

hospitalization

Front 10

test of choice for renal stones in a pregnant woman

Back 10

ultrasound!

Front 11

which glomerulonephritis is assoc with hepatitis B

Back 11

membranous

Front 12

which glomerulonephritis is assoc with hep c

Back 12

membranoproliferative

Front 13

which glomerulopathy is assoc with hodgkin's

Back 13

minimal change disease

Front 14

most common cause of blindness worldwide

Back 14

trachomatis

Front 15

si/sx of torsades de pointes

Back 15

polymorphic ventricular tachycardia, usually with prolonged QT

Front 16

common drugs that cause torsades de pointes

Back 16

quinine, procainamide, tricyclics, disopyramide, low potassium, calcium, and magnesium can also cause it

Front 17

treatment of torsades

Back 17

correct electrolyte abnormalities, especially magnesium, ventricular pacing, infusing isoproterenol, at last cardioversion

Front 18

what is the defect when a baby's umbilical cord is delayed in falling off?

Back 18

leukocyte adhesion defect, this is an immunodeficiency with normal WBC counts and normal immunoglobulins, but WBCs can't stick where they need to

Front 19

what's a good way to tell CMV retinitis from HSV keratitis?

Back 19

CMV is painless

Front 20

what is a q wave infarct?

Back 20

it's a transmural infarct. Q waves preceed ST segment elevations.

Front 21

How long does it take cardiac enzymes to become positive in an MI?

Back 21

4-12 hours

Front 22

EKG changes in a subendocardial infarct?

Back 22

ST depression

Front 23

what does unstable angina look like on EKG?

Back 23

ST depression,

Front 24

a pt is diabetic and hyperkalemic, why is he acidotic?

Back 24

Renal tubular acidosis type 4, his kidneys aren't excreting ammonium like they should

Front 25

is the pneumococcal vaccine for old folks a peptide or a polysaccharide vaccine?

Back 25

polysaccharide

Front 26

how do you treat fracture of the mid-shaft of the humerus?

Back 26

closed reduction with immobilization in a hanging arm cast. Radial nerve damage does not need repair

Front 27

what vaccines are contraindicated if a pt has a severe egg allergy?

Back 27

flu and yellow fever

Front 28

what vaccines should CF pts get?

Back 28

flu vaccine, they don't necessarily need prevnar because they are rarely infected with strep pneumo

Front 29

three complications of ventilation with high PEEP?

Back 29

alveolar damage, tension pneumo, ventricular failure

Front 30

treatment of cryptococcal meningitis?

Back 30

IV ampotericin plus oral flucytosine. These are then DC'd and oral fluconazole is started for life

Front 31

most common presenting sx of nasopharyngeal carcinoma?

Back 31

painless neck mass

Front 32

findings in scleroderma ds of esophagus

Back 32

absent peristaltic waves in the lower 2/3 of the esophagus, decreased LES sphincter tone

Front 33

treatment of central diabetes insipidus?

Back 33

nasal vasopressin

Front 34

treatment of SIADH?

Back 34

demeclocycline

Front 35

treatment of HELLP syndrome?

Back 35

if greater than 34 weeks OR if there's any fetal distress, give magnesium and induce labor. If it's earlier in the pregnancy, and the pts are stable, then give IV steroids and observe in the hospital. Vaginal delivery is always preferred

Front 36

treatment of black widow spider bites?

Back 36

calcium gluconate for abd cramps, nitroprusside for HTN, clean wound, tetanus shot, give dantrolene or diazepam to relieve muscle cramps

Front 37

treatment of brown recluse spider bites?

Back 37

dapsone BUT screen for G6PD deficiency first!