Uworld Step 2 Ck Cards 1-50

Front 1

side effects of atypical antipsychotics, like olanzapine

Back 1

weight gain, hyperglycemia, dyslipidemia, and HTN

Front 2

pt with foul smelling sputum after upper GI edoscopy must be suspected of having what?

Back 2

an anaerobic infection, treatment must have anaerobic coverage, like clindamycin

Front 3

OCPs cause what in 5% of pts?

Back 3

HTN
look to d/c OCP to correct the BP

Front 4

treatment of a-fib

Back 4

lone AF without other risk factors treat just with aspirin

if they have any risk factors treat with warfarin, these include previous TIA/stroke, DM, HTN, HF, age >75, or valve disease

Front 5

live vaccines generally not given in HIV pts

Back 5

BCG, anthrax, oral typhoid, intranasal influenza, and oral polio

Front 6

live vaccines that can be given to HIV pts

Back 6

MMR and varicella, as long as CD4 > 200 and no history of AIDS defining illness

Front 7

S/S of malignant otitis externa

Back 7

severe pain, otorrhea, and granulation tissue in the ear canal

MCC is Pseudomonas aeruginosa

Front 8

what is suspect in a pt with anemia and vitiligo

Back 8

pernincious anemia
suspect this in any pt with anemia and other autoimmune disorder (vitiligo, autoimmune thyroid, MS, etc)

Front 9

treatment of refractory hepatic hydrothorax

Back 9

transudative effusions in pts with cirrhosis and no cardiopulm disease

refratory is treated with TIPS (transjugular intrahepatic portosystemic shunt)

Front 10

polyuria and polydipsia with dilute urine and elevated serum osm

Back 10

diabetes insipidus

usually from defective ADH production

Front 11

polyuria and polydipsia with both plasma and urine diluted

Back 11

primary polydipsia

previously called psychogenic polydipsia

Front 12

polyuria and polydipsia with low serum osm and inappropriately high urine osm

Back 12

SIADH

Front 13

1st step in treatment after strong alkaline ingestion (like lye)

Back 13

early upper GI endoscopy to access damage

neutralization, vomiting, or charcoal are contraindicated as they do NOT improve outcome and complicate mgmt

Front 14

hyperosmolar hyperglycemic state

Back 14

seen in Type 2 DM
S/S are AMS, decreased consciousness, blurry vision, fatigue

can be precipitated by stressors that increase cortisol and catecholamine lvls, examples are stress and infection

Front 15

how to diff peritonsilar abscess from epiglotitis

Back 15

peritonsilar abscess can have a deviated uvula and unilateral lymphadenopathy

treatment includes aspiration, drainage, and IV antibiotics

Front 16

diabetic neuropathy effect on urination

Back 16

diabetic neuropathy leads to denervated bladder and therefore detrusor weakness

this causes urinary retetnion and overflow incontinence

Front 17

cauda equina syndrome (CES)

Back 17

1-23

Front 18

secondary amyloidosis

Back 18

frequently from chronic systemic inflammation seen in autoimmune disorders, chronic infections, IVDU

caused by deposition of acute phase reactants like serum amyloid A

can cause nephrotic syndrome, hepatomegaly, cardiomegaly, and/or peripheral neuropathy

Front 19

in a study, selecting pts with same age, race, or other demo is called what and reduces what problem

Back 19

it is called matching and reduces confounding

Front 20

portion of the spine most commonly affected by RA

Back 20

cervil spine

can result in C1-C2 instability subaxial subluxation

Front 21

things that increase warfarin activity

Back 21

P450 inhibitors

EtOH, Vit E, garlic, ginko biloba, St Johns Wort

Front 22

p450 inducers

Back 22

x

Front 23

p450 inhibitors

Back 23

x

Front 24

use of BAL (bronchoalveolar lavage)

Back 24

samples cell during bronchoscopy, used in eval of malignancy or opportunistic infection of interstitial lung disease

NOT useful in other forms of interstitial pulmonary fibrosis, sarcoid, or other connective tissue diseases

Front 25

leukemoid rxn

Back 25

a marked increase in leukocytes due to severe infection or inflammation

looks a lot like CML blast crisis, but the luekemoid rxn will have a HIGH LAP (leukocyte alkaline phosphatase score) and it will be low in CML

Front 26

reaction formation

Back 26

transformation of unwanted thoughts or feelings into their opposite

Front 27

best way to evaluate chronic pancreatitis

Back 27

US in pts with jaundice

CT of abdomen has a higher sensitivity in suspected pancreatic cancer

Front 28

presentation of cavernous sinus thrombosis

Back 28

often headache, low grade fever, periorbital edema, and cranial nerve palsies

usually secondary to infection, treat with IV antibiotics then possible anticoag, glucocorticoids, or surgery

Front 29

prophylaxis of malaria is sub-saharan Africa and India

Back 29

these areas have endemic choroquine resistant falciparum

prophylaxis is with mefloquine

Front 30

2-18

Back 30

x

Front 31

PAP smear guidelines

Back 31

start at 21 and have one every 2 years until 30

after 30 have a PAP every 3 years as long as they are neg

Front 32

HPV guidellines

Back 32

males and females aged 9-26, most effective if given prior to the start of sexul activity

Front 33

next step after suspected squamous cell carcinoma of head or neck

Back 33

a panendoscopy needs to be done to detect the primary tumor

panendoscopy is a triple endoscopy including esophagoscopy, bronchoscopy, and laryngoscopy

Front 34

HSV esophagits description and treatment

Back 34

seen in HIV, HSV esophagitis has multiple, small and well circumscibed ulcers that are small and deep "volcano-like"
cells have ballooning degen and esosinophlic intranuclear inclusions

treat with acyclovir

Front 35

CMV esophagitis description and treatment

Back 35

CMV esophagitis is seen in HIV and has large, irregular, linear, shallow, superficial ulcers

cells have intranuclear and intracyto inclusions

treat with ganciclovir

Front 36

HSV vs CMV lesions in esophagous

Back 36

HSV is multiple, small, deep, well circumscribed with intranuclear inclusions

CMV is large, irregular, shallow ulcers with intranuclear and intracyto inclusions

Front 37

1st, 2nd, and 3rd line treatment of SIADH

Back 37

1st line: fliud restriction

2nd line is hypertonic saline

3rd line is democlocycline that reduces ADH response at the collecting tube

Front 38

treatment of symptomatic hypercalcemia

Back 38

saline hydration

Front 39

spinal cord compression

Back 39

has s/s of UMN dysfunction of weakness, hyperreflexia, and babinski

it is a medical emergency dx with spinal MRI

Front 40

treatment of dermatitis herpetiformis

Back 40

dapsone is first line

as it is associtated with Celiac's, prevention is glutten free diet

Front 41

pulsus paradoxus: description and causes

Back 41

diff of >12 mm Hg in SP during inspiration

caused by cardiac tamponade, tension pneumo, and severe asthma

Front 42

1st step in eval and mgmt of ARK or AKI due to retention

Back 42

foley catheterization

post-op urinary retention is common in men > 50 and seen as oliguria (less than 250 mL in 12 hr), and increase in BUN and Cr

Front 43

use of dihydroppyridine ca channel blockers in STEMI

Back 43

dihydropyridien ca chanel blockers are CONTRA in STEMI as they cause peripheral vasodilation and reflex tachy worsening pt. These include nifedipine and nicardipine

Front 44

organ effects in amyloidosis

Back 44

as the amyloid can deposit in various organs, you can see:
restrictive cardiomyopathy with symmetrical thickened vents
proteinuria leads to edema from kidney deposits
easy bleeding from decreased coag factors from liver involvement

Front 45

S/S of cor pulmonale

Back 45

isolated right heart failure usually due to pulmonary disease
has JVD, S3, right vent heave, hepatomegaly, ascites, and dependent edema

NO signs of pulmonary congestion

Front 46

treatment of WPW

Back 46

when in a-fib with rapid vent rate, treat with cardioverion or procainamide

other AV blockers like beta blockers, ca channel blockers, digoxin, or adenosine are CONTRA because they increase the conductance through the accessory path

Front 47

precipitating factors in PACs

Back 47

tobacco, alcohol, caffine, and stress

Front 48

treatment for uncomplicated UTI

Back 48

TMP-SMX

Front 49

treatment of hordeolum (aka: stye)

Back 49

it is a staph abscess of the eyelid and painful

treat with warm compress, if no resolution in 48 hours, then I&D

Front 50

cause of UTI with alkaline urine

Back 50

Protues, as it makes urease which alkalizes the urine