Pance Comprehensive , UWorld

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464 Terms

1
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Risk factors for COPD

- Smoking

- Alpha-1 antitrypsin deficiency

2
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Decreased breath sound, increased AP diameter, cachetic and non-cyanotic breather. Dx?

- Emphysema

3
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Gold standard to dx COPD

- PFT with obstructive pattern

4
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Criteria to consider Chronic Bronchitis

- Productive cough x3 mo/yr x2 yr

5
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3 cardinal sisx in Chronic Bronchitis

- chronic cough

- sputum production

- dyspnea

6
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EKG rhythm associated with COPD

- Multifocal atrail tachy

7
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Indication of O2 in COPD

- Condition

- O2 sat

- PaO2 level

- Cor Pulmonale

- O2 sat < 88%

- PaO2 < 55 mmHg

8
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Gold Stand for CF

- Sweat Chloride test

9
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common cause of bronchiectasis

- CF

- Recurrent lung infx - Pseudomonas, H. Influenzae

10
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- Test of choice & Gold standard for Bronchiectasis

- CT scan

- PFT

11
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Samter's TRIAD

- Asthma

- Nasal Polyps

- ASA/NSAID sensitivity

12
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Atopic's TRIAD

- Asthma

- Atopic dermatitis

- Allergic rhinitis

13
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Dx tool of asthma in office setting

- PFT with reversible obstruction

- Methacholine challenge follow by bronchodilator challenge with FEV1 increase > 12%

14
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how to assess asthma exacerbation severity?

- Peak expiratory flow rate

- discharge pt if PEFR > 70%

15
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Beta agonist side effect (albuterol, salmeterol, formoterol)

- Tachycardia,arrhythmias

- Muscle tremors

- CNS stimulation

16
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Supplement for someone who is on long-term corticosteroid

- Calcium

- Vit D

17
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Bilateral hilar lymphadenopathy on C-Xray

- Sarcoidosis

18
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Erythema nodosum, lupus pernio, maculapapular rash

Uveitis

joint pain

bilateral hilar LAD

- Sarcoidosis

19
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Sarcoidosis

- Restrictive or obstructive pattern on PFT

- Restrictive

20
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Lab - increased ACE level. dx

- sarcoidosis

21
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Most accurate dx for sarcoidosis

- Tissue biopsy - non-caseating granulomas

22
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Caseating vs Non-caseating granulomas

- Caseating = TB

- Non-caseating = Sarcoidosis

23
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Cystic fibrosis vs pulmonary fibrosis

- Cystic fibrosis = over secretion of the lungs d/t abnormal chloride/water transport

- Pulmonary fibrosis = progressive scarring of the lungs

24
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Occupation: Quarry work with granite. sandblasting. What pneumoconiosis?

- Silicosis

25
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Round nodular opacity in the upper lobes. What Pneumoconiosis

- Silicosis

26
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Work in Aerospace, electronics. What pneumoconiosis?

- Berrylliosis

27
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Construction in old building, ship yards, insulation. What pneumoconiosis?

- Asbestosis

28
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Which region of lungs involved in Asbestosis?

- Lower lobes

29
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What lung dz associated with Asbestosis

- Bronchogenic carcinomas

30
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Contradiction to Flu vax

- pt with GBS

- Infatn < 6m of age

31
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Vax schedule for DTaP

- 2-4-6 mo, 15-18 mo, 4-6 yr

- 5 doses

32
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cause of epiglottitis is unvax pt

- H. Influenzae

33
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cause of epiglottitis in vax pt

- GAS --> S. pneumoniae

34
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Gram + diplococci. what pathogen for PNA

- S. pneumoniae

35
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gram (+) cocci in cluster. what pathogen for PNA

- S. aureus

36
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Common pathogen for HAP

- Pseudomonas, MRSA

37
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Criteria to dx for HAP

- Sisx of PNA onset AFTER 48hr of hospital stay

38
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Criteria to dx for CAP

- Sisx of PNA onset BEFORE 48hr of hospital stay

39
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Risk factor for Histoplasmosis

- Inhalation of what?

- HIV with what CD4 count?

- Inhalation of soil with bird or bat dropping

- HIV with CD4 count < 150

40
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Risk factor for PCP

- HIV with what CD4 count

- CD4 < 200

41
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Where is the location of infiltration in the case of re-activation TB?

- apex/upper lobe with cavitation lesions

42
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How many sputum acid fasting staining and cultures needed for TB

- 3 samples on 3 consecutive days

43
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Thrombocytopenia and orange colored urine is AE of what med

- Rifampin

44
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Pt has lupus, hepatitis and peripheral neuropathy. what TB med?

- Isoniazid

45
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Photosensitive dermatologic rash cause by what TB med

- Pyrazinamide

46
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Ototoxicity and nephrotoxicity cause by what TB med

- Streptomycin

47
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tested (+) for PPD, what next?

- Get CXR or Interferon Gamma Release Assay

- pt most likely have Latent TB, even if it is BCG vax, still rec tx

48
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incidential finding of lung nodule on CXR, what next?

- CT chest to determine malignancy

49
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Periodic diarrhea, flushing, tachy, and bronchoconstriction. what dx?

- Carcinoid syndrome

50
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Lung CA screening

- Annual low-dose CT for 55-80 y/o with 30 PPY smoking hx who current smoke or quit within 15 yrs

51
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Location of adenocarcinoma of the lung

- Peripheral

52
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Central lesion on xray, cavitation, hypercalcemia, pancoast syndrome

- Squamous cell lung CA

53
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which long CA has worst prognosis

- small cell carcinoma

54
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Dx test for lung CA

- CXR for location

- CT guide biopsy or bronchoscopy biopsy for central lesions

- Aspiration biopsy for non-central lesion

55
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- Cushing syndrome

- SIADH

- Lambert-eaton myasthenic syndrome

- SVC syndrome

what lung cancer

- Small cell carcinoma

56
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- Horner syndrome

- shoulder and arm pain

- atrophy of muscle of the hand

- Pancoast tumor syndrome

57
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Gold standard Dx for Pulm HTN

- right heart catheterization

58
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initial confirmatory dx test for PE

- Helical CTA

59
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When to use V/Q scan to dx PE instead of CT

- Preggo

- Increased creatinine

60
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Gold standard for PE dx

pulmonary angiography

61
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indication for IVC filter in PE management

- anticoagulation is contraindicated

- anticoagulation is unsuccessful

- If RV dysfunction is seen on Echo

62
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When to use Wells' criteria for PE

- to determine probability of PE

63
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When to use PERC

- when PE probability is low from Wells. use to rule out PE

64
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What anti-hypertension medication can induce asthma

- ACE-I

65
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- Chronic non-productive cough WORSE at night

- Absent of wheezing and rhonchi

- Cough triggered by exercise, allergens, or forced exhaling

What Dx

- Cough-variant asthma

66
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Common cause of COPD exacerbation

- viral > bacterial infx

67
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- Nasal congestion, cough

- wheezing/crackle

- retraction, nasal flaring

- Pt< 2 y/o

- Bronchiolitis

68
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- Pancreatic insufficiency

- chronic sinusitis

- nasal polyps

- chronic bronchitis

What dz are these associated with?

- Cystic fibrosis

69
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What pathogens are CF pt at risk of getting

- Pseudomonas (common in adult)

- H. influenzea

- S. Aureus

70
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When to do emergent thoracotomy vs tube thoracostomy in hemothorax

- when initial bloody output > 1500 ml

- persistent hemorrhage > 200 ml/hr

71
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- Decreased breath sound

- hypoxic

- severe distress

- (+) transillumination on the affected side, with mediastinal deviation

- Ped pt

what dx

- tension ptx

72
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Initial tx of choice for chronic osteomyelitis

- surgical debridement + cultures

73
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MCC of Osteomylitis

- S. aureus > S. pyogenes

74
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MCC of osteomyelitis in puncture wounds

- Pseudomonas

75
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MCC of osteomyelitis in sickle cell dz

- Salmonella

76
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MCC of osteomyelitis in prosthetic joint placement

- S. Epidermis

77
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Dx tests for osteomyelitis

- Initial?

- Most sensitive?

- Gold Standard?

- initial = xray

- most sensitive = MRI

- Bone aspiration

78
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Joint x-ray

- asymmetric joint narrowing

- osteophytes

- subchondral bone sclerosis

- OA

79
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Joint x-ray

- symmetric joint narrowing

- osteopenia

- Bone and joint erosions

- RA

80
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Complications from pelvis fx

- DVT

- Sciatic nerve damage

- Vascular injury

81
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Most common type of hip fx

- femoral neck fx

82
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Worrisome complication from hip fx and hip dislocation

- Avascular necrosis

83
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Initial tx for Legg-calve-perthes

- Observation with therapy and brace/cast

84
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Dx test for ALC

- Initial

- Test of choice

- initial = Xray

- Test of choice = MRI

85
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What xray view for patella fx

- sunrise view + cross table lateral view

86
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Low riding patella with knee pain, inability to extend knee. What dx

- quadriceps tendon rupture

87
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High riding patella with knee pain, inability to extend knee. what dx

- patellar tendon rupture

88
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Worrisome complication from knee dislocation

- popliteal artery injury --> need to do ateriography or duplex

89
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When to get xray of the ankle and foot for ankle sprain?

- pain along both malleolus and foot

- cant walk > 4 steps

90
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What position to splint for Achilles tendon rupture

- Plantar flexion

91
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Spiral fx of proximal fibular and distal medial malleolar fx. What dx?

- Maisonneuve fx

92
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- Inferior heel pain, worse AFTER waking up. Pain better during the day, worse with prolong standing, worse with dorsiflexion of toes

- Planter fasciitis

93
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Compression of posterior tibial nerve cause what foot syndrome?

- Tarsal Tunnel Syndrome

94
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Tx for Jones fx

- Non weight-bearing with short leg cast X 6-8 wk

95
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Jones vs Pseudojones fx?

- Which one involve diaphysis

- which one involve the base of 5th metatarsal

- Diaphysis = Jones

- Base of metatarsal = Pseudojones

96
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x-ray findings - sunburst appearance and Codman's triangle. what dx?

- Osteosarcoma

- Chondrosarcoma

- Ewing sarcoma

- Osteosarcoma

97
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x-ray findings - Punctate or ring appearance calcification

- Osteosarcoma

- Chondrosarcoma

- Ewing sarcoma

- Chondrosarcoma

98
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x-ray findings - Periosteal reaction "onion skin" or :moth-eaten" appearance

- Osteosarcoma

- Chondrosarcoma

- Ewing sarcoma

- ewing sarcoma

99
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Tenderness > 11/18 trigger points, extreme fatigue, numbness. Dx?

- Fibromyalgia

100
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- Pain and stiffness of shoulders and hip joints

- NO muscle weakness

Dx?

- Polymyalgia rheumatica