Uworld 9

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pszurnicki
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218154
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Uworld 9
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2013-05-09 10:12:38
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Uworld 9
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  1. what kind of antibody does the polyvalent pneumococal and heptavalent pneumococcal vaccine produce ?
    what population gets what?
    • polyvalent--t cell independent
    • adults get poly valent

    • heptavalent--t cell dependent
    • kids get heptavalent
  2. what vaccines should hiv pts get?
    • strep pneumo
    • hep b
    • hep a
    • influenza
  3. how often is lipid screening?
    pap smear?
    • every 5 years
    • from 21 to 65 , after 30 every 2-3 years
  4. when do u suspect hit?
    platelts drop by at least 50%
  5. most feared complication of hit?
    hypercoagulability
  6. intubation in asthma exacerbation?
    • cant maintain pao2
    • respiratory muscle failure
    • cant speak bc of breathing
    • altered mental status
  7. presentation of androgen insensitivity?
    • normal appearing female
    • short vagina
    • no uterus
    • no ovaries, no fallopian tubes
    • testicles in the labia majora
    • high testosterone, lh and estrogen
  8. ocp for lactating woman?
    • progestin only
    • depot--medroxyprogesterone
  9. aica and pica supplies what part of the brain?
    cerebellum
  10. occlusion of pica causes?
    • loss of pain and temp or ipsi face
    • loss of pain and temp or contra body
    • cerebellar defects
  11. 2 caues for romberg sign?
    interruption of dorsal columns or vertibular apparatus
  12. most common site of an aneurysm in circle of willis?
    • anterior communicating
    • posterior communicating
  13. contralateral hemiballismus?
    subthalamic
  14. lesion of what produces poor repetition?
    arcuate fasiculus
  15. what artery perfuses wernickes. brocas and arcuate fasiculus?
    middle cerebral
  16. dysarthia?
    agraphia acalculia?
    • cerebellar vermis
    • left parietal
  17. most common cause of meningitis from 1 month to 60 years?
    • strep neumo
    • meningitis
    • h. influenza
  18. how old is child to give steroids for meningitis?
    6 months
  19. when do u give steroids prior to or after antibiotics?
    prior to
  20. rx for fungal meningitis/
    intrathecal amphotericin
  21. cause of encephalitis causing a rash?
    west nile
  22. what animals have rabies?
    • bats
    • skuns
    • dogs
    • foxes
    • not rats
  23. muscle weakness + encephalitis?
    polio
  24. difference between meningitis vs encephalitis?
    encephalitis-- mental status change
  25. what headaches are associated with menstrual cycles?
    migraine
  26. migraine with aura, cant give what contraceptive?
    ocp
  27. head made worse by eating tyramine containging foods?
    migraine
  28. jaw muscle pain when chewing headache?
    temporal arteritis
  29. periorbital pain with ptosis and miosis headache?
    cluster
  30. photophobia/phonophobia?
    migraine
  31. bilateral frontal or occipital pressure?
    tension
  32. lacrimation and rhinorrhea?
    cluster
  33. elevated esr headache?
    temporal arteritis
  34. worst headache of my life?
    subarachnoid hemorrhage
  35. headache + extraocular muscle palsies?
    cavernous sinus thrombosis
  36. sciniillating scotomas prior to headache?
    migraine
  37. responsive to 100% oxygen?
    cluster
  38. trauma to the heachage and it wont go away?
    subdural headache
  39. vomiting preceding headache or headache during sleep or right after awakening?
    tumor
  40. most srious complication of pseudotumor cerebri?
    vision loss
  41. what can cause pseudotumor cerebri?
    • reitnoids
    • tetracycline
    • steroid withdrawal
  42. fasiculations and spastic paralysis?
    aml
  43. impaired prioprioception + pupils do not react to light?
    tertiary syphilis
  44. bilateral loss of pain and temp below the lesion and hand weakness?
    syringomyelia
  45. bilatearl loss of vibration sense and spastic paralysis of legs then arms?
    vit b 12 def
  46. carotid endartectomy indications?
    • 70-99%
    • 50-69% in men
    • asymptomatic 80%
  47. anticoagulant for first tia?
    afib?
    tia and cad?
    tia while on aspirin?
    • aspirin
    • warfarin
    • clopidogrel
    • aggrenox or clopidogrel
  48. lacunar strokes
    • pure motor
    • pure sensory
    • ataxic hemiparesis
    • sensory motor stroke
    • dysarthia clumsy hand syndrome
    • absent cortical signs**
  49. what meds must be started withing 2 days of an ischemic stroke?
    • aspirin
    • statin
  50. parenchymal hemorrhages require the use of what to prevent seizures?
    anticonvulsants
  51. what 2 coniditions are associated with berry anerusm?
    • marfans
    • pckd
  52. rx for htn in sah?
    • labetalol
    • nimodipine

    avoid nitroglycerin
  53. if sah is suspected and ct is negative, next step?
    LP
  54. which hematoma in the brain, u can perform an lp?
    subarachnoid
  55. normal pressure hydrocephalus occurs secondary to waht?
    pathologies in the subarachnoid space--meningitis, sah
  56. in terms of regions of brain involved, what is the difference between simple partial and complex partial?
    simple partial--focal region of the cortex

    complex partial--focal region of temporal lobe
  57. 3 cycle per second spike and wave?
    absence
  58. second drug of choice for absence seizures?
    valproate
  59. blood dyscrasia?
    • carbamezapine
    • ethosuximide
  60. which febrile seizures have increased risk of epilepsy?
    atypical
  61. anticonvulsants causing low folate?
    • carbamezapine
    • valproate
  62. spastic cp is caused by what?
    while dyskinetic cp is caused by what?
    • pyramidal tract lesions
    • extrapyramidal tract lesions
  63. what drugs cause depression?>
    • methyldopa
    • interferon
    • antipsychotics, metoclopromide, prochlorathiazine
    • steroids
    • stimulant withdrawal, antihistamines, etoh,benzo
  64. what antibiotics can cause serotonin sydnrome?
    linezolid
  65. difference between serotonin syndrome and nms?
    nms--lead pipe rigidity

    serotonin syndrome--myoclonus
  66. serotonin withdrawal is the worst with?
    paroxetine
  67. withdrawal + neuropathic pain?
    • snri
    • tca
  68. how long does hypomania have to last?
    4 days
  69. digfast?
    • distractibility
    • insomnia
    • grandiosity
    • flight of ideas
    • activity
    • speech
    • taking risks
  70. episodes of mania in 10 years?
    4
  71. doc for rapid cyclers in bipolar?
    valproate or carbamezapine
  72. if an adjustement disorder lasts more than 6 months, what is it called?
    chronic adjustement disorder
  73. drug for benzo or etoh withdrawal?
    chlordiazepoxide
  74. stage fright is what kind of phobia?
    social phobia
  75. rx for ocd?
    ssri
  76. difference between greif vs adjustement disorder?
    • grief--still functional
    • adjustement disorder--not functional
  77. cradle cap?
    • seborheic dermatitis
    • selenium sulfide
  78. what can be used to rescue a sudden akinetic episode in parkinsons?
    apomorphine
  79. rx for als?
    riluzole--decreased glumatate excitatory toxicity
  80. rx for huntingtons?
    • dopamine antagonists
    • tetrabezanine
  81. symptoms of als?
    asymmetric limb weakness
  82. most accurate way to tell alzheimers from multiinfarct vascular dementia?
    mri
  83. injury to the afferent optic nerve causing inability to constrict the affected eye, this is called?
    marcus gunn pupil
  84. rx for gbs?
    • plasmapheresis
    • or
    • IVIG
  85. symptoms of complex regional pain syndrome?
    rewiring of nerve fibers is aberrant--sympathetics rewiring--you get sweating and hypersensitivity
  86. benzos and etoh increase what stage and decrease what stage of sleep?
    • increase stage 2
    • decrease 3 and 4
  87. night terror and sleep walking occur during what stage?
    3 and 4
  88. depressed patients have more of what stage of sleep?
    elderly have less of what stage?
    rem and get quicker to rem

    rem and takes longer to reach rem
  89. what effect does benzo have on osa?
    worsen it
  90. rx for narcolepsy?
    narcolpesy + cataplexy?
    stimulatans

    ssri
  91. sleep aid used for long term?
    eszopiclone
  92. what clue points to syncope vs seizure as for reason for passing out?
    • syncope--light headedness or dizziness
    • seizure--aura
  93. causes of syncope?
    • reflex--vasovagal--emotional
    • situational--micturition, defacation, 
    • orthostatic
    • cardiogenic
    • cerebrovascular
    • carotid sinus hypersensitivity
  94. can leg jerking be part of syncope?
    yes
  95. what is the reaction of the eyes if the cerebrum is damaged and water is poured into the rt ear?

    brain stem damage and the water is poured into the rt ear?

    normal reaction of nystagmus
    eyes look towards the rt ear, no nystagmus

    eyes do not move

    psychogenic coma
  96. rx for calcium phosphate stones?
    rx for cysteine and struvite stones?
    citrate

    acetazolamide
  97. uveitis is caused by what?
    • iris
    • choroids
    • ciliary bodies
  98. different between anterior uveitis and posterior uveitis?
    anterior--keratin deposits

    posterior--retinal deposits
  99. red eye that has preauricular lymph nodes?
    viral conjunctivitis
  100. red eye with dryness?
    keratoconjunctivits
  101. red eye with colored halos or shallow anterior chamber?
    acute angle closure glaucoma
  102. red eye with corneal ulceration
    herpes keratitis
  103. red eye with collagen vascular disease or hla-b27 disease?
    uveitis
  104. difference between chalazion and hordeolum?
    anterior blepharitis?
    rx for each?
    • chalazian is infection of internal sebaceous (whole eyelid swelling) and hordeolum is infection of the external sebaceous glands(eyelid margin swelling)
    • anterior blepharitis-- eye lid infection + dandruff(lid margin + dandrfuff)
    • chalazion--sx or steroids
    • hordeolum--warm compress and then abx
  105. most effective rx for glaucoma?
    laser iridiotomy
  106. most common cause of bilateral vision loss?
    macular degenration
  107. cherry red spot in fovea?
    • retinal artery occlusion
    • nieman picks
    • tay sachs
  108. rx for retinal artery occlusion?
    thrombolysis
  109. problems driving at night?
    cataract
  110. most common cause for bullous myringitis?
    mycoplasma
  111. symptoms of mastoidis?
    dx?
    • displaced external ear, erythema behind the ear
    • ct
  112. difference between vestibular neuritis and labirynthitis?
    vestibular neuritis--vertigo, no hearing loss

    labiryntitis--vertigo, hearing loss
  113. what two entities have vertigo, hearing loss, tinninute?
    • shwannoma
    • menieres
  114. rx for menieres?
    salt restiriction and diuretics

    • gentamycin
    • labirenthoctomy
    • vestibular neurocetomy
  115. most common cause of conductive hearing loss?
    otosclerosis
  116. causes of vertigo?
    • meniere
    • shwanoma
    • labiryntitis
    • cholesteatoma
    • vestibular neuritis
    • bppv
  117. most common cause of sensineuronal hearing loss
    presbyscusis
  118. 3 causes of hearing loss and vertigo?
    • meniere
    • shwannoma
    • labiryntitis
  119. ramsay hunt synrome?
    herpes zoster oticus
  120. rx for pagets/.
    bisphosphantes
  121. rx for alcohol withdrawal?
    benzos
  122. alcohol addiction rx?
    • aa
    • disulfiram
    • topiramate
    • naltrexone
    • acamprosate
  123. rx for benzo and alcohol withdrawal?
    benzo
  124. refeeding syndrome?
    • switch from carb to fat resulting in
    • HYPOPHOSPHATEMIA
    • CArdiovascular collapse
    • siezures
    • rhabdomyolysis
  125. whivh one is treated better with antidepressants, anorexia or bulimia?
    bulimia
  126. rx for hypochondriasis?
    frequent doctor visits
  127. how can pain disorder be diagnosed?
    when opiods fail to relieve the pain
  128. most common causes of delirium?
    undiagnosed uti

    drugs-anticholinergic
  129. rx for elderly agitation?
    haloperidol
  130. alternative to stimulants for adhd?
    • tca
    • bupropion
    • alpha 2 agonists
  131. what neurological disorder is contraindiated with stimulants in adhd?
    tourettes
  132. what side effect does atomoxetine have for adhd/
    increased suicide risk
  133. rx for tourettes?
    antipsychotics and tetrabenazine
  134. 3 uses of stimulants?
    • adhd
    • narcolepsy
    • weightloss
  135. physical signs and symptoms of pregnancy but not really pregnant?
    pseudocyesis

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