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usmleworld test7 step2


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why do OCPs cause HTN in some pts?
because they cause an increase in the synthesis of angiotensinogen by the liver
treatment of delayed labor because of mid-pelvic contraction?
C-section (there is a pelvic obstacle)
what do you do if you suspect a tear in a knee ligament, but the MRI is negative or inconclusive?
get arthroscopy
what is elevated in anorexics that gives them an orange tinge?
treatment of dermatitis herpetiformis?
most common cyanotic congenital heart defect?
tetrology of fallot
si/sx of tetrology?
pan-systolic murmur, single S2, cyanotic spells, can present early or late in the first four years
what do urate crystals look like
needle shaped negatively birefringent
treatment of anorexia
test of choice for renal stones in a pregnant woman
which glomerulonephritis is assoc with hepatitis B
which glomerulonephritis is assoc with hep c
which glomerulopathy is assoc with hodgkin's
minimal change disease
most common cause of blindness worldwide
si/sx of torsades de pointes
polymorphic ventricular tachycardia, usually with prolonged QT
common drugs that cause torsades de pointes
quinine, procainamide, tricyclics, disopyramide, low potassium, calcium, and magnesium can also cause it
treatment of torsades
correct electrolyte abnormalities, especially magnesium, ventricular pacing, infusing isoproterenol, at last cardioversion
what is the defect when a baby's umbilical cord is delayed in falling off?
leukocyte adhesion defect, this is an immunodeficiency with normal WBC counts and normal immunoglobulins, but WBCs can't stick where they need to
what's a good way to tell CMV retinitis from HSV keratitis?
CMV is painless
what is a q wave infarct?
it's a transmural infarct. Q waves preceed ST segment elevations.
How long does it take cardiac enzymes to become positive in an MI?
4-12 hours
EKG changes in a subendocardial infarct?
ST depression
what does unstable angina look like on EKG?
ST depression,
a pt is diabetic and hyperkalemic, why is he acidotic?
Renal tubular acidosis type 4, his kidneys aren't excreting ammonium like they should
is the pneumococcal vaccine for old folks a peptide or a polysaccharide vaccine?
how do you treat fracture of the mid-shaft of the humerus?
closed reduction with immobilization in a hanging arm cast. Radial nerve damage does not need repair
what vaccines are contraindicated if a pt has a severe egg allergy?
flu and yellow fever
what vaccines should CF pts get?
flu vaccine, they don't necessarily need prevnar because they are rarely infected with strep pneumo
three complications of ventilation with high PEEP?
alveolar damage, tension pneumo, ventricular failure
treatment of cryptococcal meningitis?
IV ampotericin plus oral flucytosine. These are then DC'd and oral fluconazole is started for life
most common presenting sx of nasopharyngeal carcinoma?
painless neck mass
findings in scleroderma ds of esophagus
absent peristaltic waves in the lower 2/3 of the esophagus, decreased LES sphincter tone
treatment of central diabetes insipidus?
nasal vasopressin
treatment of SIADH?
treatment of HELLP syndrome?
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
treatment of black widow spider bites?
calcium gluconate for abd cramps, nitroprusside for HTN, clean wound, tetanus shot, give dantrolene or diazepam to relieve muscle cramps
treatment of brown recluse spider bites?
dapsone BUT screen for G6PD deficiency first!

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