Uworld Step 2 Ck Cards 151-250

Front 1

manifestations of hypercalcemia

Back 1

severe constipation, anorexia, weakness, neuro abdnormalities

Front 2

acid-base status and tonic clonic

Back 2

lactic acidosis that resolves in 60-90 minutes post seizure;
repeat the labs in 2 hours to reassess

Front 3

lupus anticoag

Back 3

= antiphospholipid anitbody
artefectually prolongs PTT
+RVV test

Front 4

brain death

Back 4

absent CN reflexes, fixed/dilated pupils, no spont breaths

no medical causes that can mimic brain death, temp > 32C, and must be agreed upon by 2 docs

Front 5

immunity needed to clear molluscum contagiosum

Back 5

cellular immunity

Front 6

what does an ateriovenous fistula do to circulation

Back 6

cardiac preload is increased
will lead to high outpt failure as oxygen demands cannot be met

Front 7

Charcot's joint

Back 7

damage to joints from repeated joint trauma, seen in diabetics due loss of nerve sensation

also called neurogenic arthopathy

will occur in weight bearing joints and will show as deformity, DJD, loose bodies, and osteophytes on imaging

Front 8

complicated effusion definition

Back 8

complicated effusion listed as pH < 7.2, glucose < 60, or positive Gram stain or culture; complicated require chest tube and drainage

Front 9

MCC of foot drop

Back 9

neuropathy, L5 radiculopathy, and traumatic damage

Front 10

pica for ice

Back 10

called pagophagia, and is often seen in pt with Fe def anemia

Front 11

kidney disease seen in pt with active HBV ifx

Back 11

poolyarteritis nodosa, membranoproliferative glomerulonephritis, and membranous glomerulonephritis

Front 12

1st line treatment in OA

Back 12

acetaminaphen

Front 13

s/s of Waldenstrom's macroglobulinemia

Back 13

hyperviscosity do to excess IgM which will show as a spike on the SPE, increased spleen, liver, and LNs, tiredness, HA, neuropathies

Front 14

what to do with newly dx Lupus pt

Back 14

renal biopsy
SLE renal disease is one of the leading causes of mortality, up to 40-75% of pts

Front 15

ways that cancer can cause hypercalcemia

Back 15

nonmetastatic tumors via PTHrP
metastatic solid tumors via cytokines
Hodgkin's via calcitrol

Front 16

drugs used in stress testing when exercise is not an option

Back 16

dobutamine or dipyridamole

Front 17

Somogyi effect in diabetics

Back 17

hyperglycemia in the early morning from bedtime insulin causing excess counterregulatory hormones overnight

Front 18

treatment of Tourettes

Back 18

typical antipsychotics like haldol or pimozide

Front 19

Hawthorne effect

Back 19

when the study pop changes outcomes since they know they are being studied

Front 20

treatment of Paget's disease of bone

Back 20

only treat if symptomatic
use Bisphosphonates

Front 21

how to treat acute renal transplant rejection

Back 21

high dose IV steroids

Front 22

triad of Meniere's disease

Back 22

dizziness, hearing loss, and tinnitus

Front 23

what electrolyte is bad prognostic factor in CHF

Back 23

hyponatremia = high level of the RAAS system attempting to compensatin for low CO

Front 24

renal complication seen in Hodgkin's lymphoma

Back 24

minimal change disease

Front 25

s/s of glucagonma

Back 25

necrolytic migratory erythema, diarrhea, hyperglycemia

Front 26

Gilbert's vs Crigler Najjar (check)

Back 26

Gilbert's is symptomatic
Crigler Najjar 1: bili<20,
Crigler Najjar 2: v. high bili, severe sx

Front 27

treatment of cancer induced anorexia

Back 27

progestins like medasterol (megase)

Front 28

effect of current or previous dx of anorexia on preg

Back 28

increased risk for miscarriage, premie, small for gest age, hyperemesis gravidarum, postpartum depression

Front 29

trichinellosis

Back 29

suspect in pt with GI issues followed by triad of periorbital edema, myositis, and eosinophilia

can also have splinter and retinal hemorrhages

Front 30

podophyllin

Back 30

an antimitotic agent leading to cell death, used in condylomata acumiata caused by HPV

Front 31

treatment of HPV warts

Back 31

chemical agents: 5-FU, podophyllin

immune therapy: imiquimod, interferon alpha

surgery: cyro, laser, excisional

Front 32

SAAG

Back 32

SAAG of 1.1 or greater shows transudative process consistent with portal HTN

Front 33

isoniazid and the liver

Back 33

liver injury with histology that looks like viral hepatitis
NOT dose dependent

Front 34

what causes anion gap metabolic acidosis with an osmolar gap

Back 34

ethylene glycol, methanol, and ethanol intox

Front 35

Duke's criteria for infective endocarditis

Back 35

must have 2 major, one major and 3 minor, or 5 minor

major: 2 positive blood cultures, endocardial involve on echo, new murmur
minor: predispising condition, fever > 38C, septic emboli, immunologic phenom, one pos blood culture

Front 36

homocystenuria and pyridoxine (check)

Back 36

x

Front 37

what causes the pain in a pulmonary embolism?

Back 37

associated pulmonary infarctions

Front 38

colonoscopy recommendations in ulerative colitis pts

Back 38

start screen 8 years after the dx, then repeat every 1-2 years after

note: some say you can extend the 1st window if only the left colon is involved

Front 39

treatment of herpes zoster

Back 39

valacyclovir or acyclovir

postherpetic neuralgia can be treated with TCAs like amitriptyline

Front 40

UA results

Back 40

leukocyte esterase indicates pyuria

nitries indicate Enterobacteriaceae, like E. coli, the MCC of UTI

Front 41

tick-borne paralysis

Back 41

isolated rapid ascending paralysis (hours to days)
remove tick ASAP

Front 42

recommened screening mammograms

Back 42

every 2 years for women 50 and older

Front 43

DeQuervain tenosynovitis

Back 43

inflammation of abd pollicis and extensor pollicis when mothers hold newborns with their thumbs outstretched

Front 44

blastomycosis s/s

Back 44

pulmonary infection with fever, sweats, productive cough, and weight loss

if it becomes systemic it can lead to ulcerated skin lesions and bone lesions

Front 45

disseminated histoplasmosis s/s and dx

Back 45

palatal ulcers, hepatoslpenomegaly, and pancytopenia

Front 46

primidone use and side effect

Back 46

antiseizure that is converted to phenobarbital
2nd line for essential tremor
SE is acute intermittent porphyria with abd pain, neuro and psych abnls

Front 47

causes of acalculous cholecystitis

Back 47

extensive burns or severe trauma
prolonged TPN or fasting
mechanical ventilation

Front 48

cause of mortality (& tx) in SAH

Back 48

vasospasm that induces infarction
prevent with Ca channel blockers like nimodipine

Front 49

treatment of uric acid renal stones

Back 49

treat by alkalinization of the urine to pH > 6.5 with oral potassium bicarb or potassium citrate

Front 50

causes of renal colic that do not show on xray

Back 50

radiolucent stones like uric acid
Ca stones less than 3mm
obstuction via tumor or clot

Front 51

potassium citrate - use

Back 51

used to alkalize the urine as it is metabolized into bicarb by the liver

Front 52

MCCs of epiglottitis

Back 52

H. influ and strep pyogenes

Front 53

treatment of Lyme disease

Back 53

doxycycline
if pt is preg it is contra so use amoxicillin

Front 54

dx of ARDS

Back 54

acute onset resp distress in setting of predisposing condition

PaO2/FiO2 ratio < 200

bilateral infiltrates and a normal PCWP (<18)

Front 55

electrolytes in OSA

Back 55

hypoxia
hypercapnia causing resp acidosis

renal compensation increases bicarb and decreases chloride reabsorption

Front 56

thalamic stroke

Back 56

damage of the VPL causing contralateral pain syndrome

Front 57

role of digoxin and furosemide in CHF

Back 57

they reduce symptoms and hospitalizations, but do NOT improve survivial

Front 58

psoriatic arthritis

Back 58

usually involves the DIP of the hand, morning stiffness, dactylitis (sausage digit)
+ nail involvement

Front 59

MCC of suspected brain abscess

Back 59

aerobic and anaerobic strep as well as Bacteroides (also anaerobic)
staph is only responsible for 15%

Front 60

electrolytes in Conn's

Back 60

primary hyperaldosteronsism leads to increased Na, decreased K, increased bicarb causing metaboic alkalosis

Front 61

risk of having bipolar disorder

Back 61

general population: 1%
if pt has 1st degree relative, risk is 5-10%
if both parents are, 60%

Front 62

ethylene glycol poisoning - electrolyte disturbance

Back 62

calcium oxalate in the kidneys oxalate binds Ca, causing hypocalcemia

treat with fomepizole or ethanol to reduce further metabolism of ethylene glycol

Front 63

indication for removal of pleual fluid

Back 63

if the pH < 7.2 or glucose < 60, it is suggestive of empyema and needs to be drained via thoracostomy