04 APR 2017 1258 MIX Flashcards Preview

ZZ - step 3 - UWorld 2017 > 04 APR 2017 1258 MIX > Flashcards

Flashcards in 04 APR 2017 1258 MIX Deck (23)
Loading flashcards...
1
Q

what is the pathophysiology of ARDS? what are the implications for lung physiology?

A
  • fluid / cytokine leakage into alveoli

- impaired gas exchange, decreased lung compliance, PHTN

2
Q

bilateral lung opacities (pulmonary edema) NOT due to CHF / fluid overload?

A

ARDS

3
Q

in ARDS there is hypoxemia with a PaO2/FiO2 ratio equal to or less than ______ mm Hg - why?

A
  • 300 mm Hg

- decreasing PaO2 leads to higher FiO2 requirement

4
Q

what should you consider in hypoxemia with a PaO2/FiO2 ratio equal to or less than 300 mm Hg?

A

ARDS

5
Q

why is lung compliance decreased in ARDS?

A
  • loss of surfactant

- increased elastic recoil of edematous lungs

6
Q

ARDS causes shunting with an ______________ (decreased / increased) A-a gradient

A

increased

7
Q

_________________ (sympathetic / parasympathetic) fibers are located on the periphery of the oculomotor nerve, which means that compression would cause __________________

A
  • parasympathetic

- mydriasis

8
Q

when do you do a workup for neonatal hydration / dehydration?

A

if infant has lost more than 7% of body weight

9
Q

when can formula supplementation be recommended for infants?

A

infants who have lost over 7% of birth weight despite optimization of breastfeeding

10
Q

why should water never be given to infants under 6 months?

A

due to the immature kidneys of infants, it can dilute the blood, resulting in hyponatremia and seizures

11
Q

what are the first and second line medications for bipolar disorder?

A
  • first line: lithium, valproate

- second line: quetiapine, lamotrigine

12
Q

how does digoxin toxicity present?

A
  • nausea
  • vomiting
  • decreased appetite
  • confusion
  • weakness
  • scotoma
  • blurry vision / color changes
13
Q

elevation of peak and plateau pressures indicates a process causing ____________ (decreased / increased) pulmonary compliance, such as pulmonary edema, atelectasis, pneumonia, or right mainstem bronchus

A

decreased

14
Q

what type of drug is raloxifene? what is the MOA? what is the indication?

A
  • SERM
  • estrogen agonist activity on BONE
  • decrease post-menopausal osteoporosis in patients who cannot tolerate bisphosphonates or are at high risk for invasive breast cancer
15
Q

SERMs have estrogen _____________ (agonist / antagonist) activity in the breast, estrogen ______________ (agonist / antagonist) activity in the bone, and estrogen _________________ in the uterus

A
  • breast: antagonist
  • bone: agonist
  • uterus: antagonist
16
Q

what is the treatment for acute bronchitis?

A

SYMPTOMATIC TREATMENT

17
Q

in a suspected ectopic pregnancy in a hemodynamically stable patient, what is the course of action after an equivocal transvaginal US?

A
  • serum BhCG
  • if over 1500 repeat BhCG level and transvaginal US in 2 days
  • if under 1500 repeat BhCG level in 2 days

BhCG should increase every 2 days in viable pregnancies but rise at a slower rate in ectopic and nonviable pregnancies

18
Q

in a woman over 35, infertility is considered when there is lack of conception after ____ months due to _____________

A
  • 6

- diminished ovarian reserve

19
Q

wide complex tachycardia with 2 fusion beats is diagnostic for:

A

sustained monomorphic ventricular tachycardia

20
Q

enterococci are a common etiology of bacterial endocarditis following what type of infection?

A

nosocomial infections (e.g. UTI)

21
Q

what are the 3 first line abx for asymptomatic bacteriuria?

A
  • cephalexin
  • amoxicillin-clavulanate
  • nitrofurantoin
22
Q

TMP-SMX is safe to use during which trimester? why cant it be used during the other trimesters?

A
  • 2nd trimester
  • 1st trimester: interferes with folate metabolism
  • 3rd trimester: neonatal kernicterus
23
Q

what is the explanation for the large oxygen saturation gap seen in methemoglobinemia?

A
  • metHb absorbs light at distinct wavelengths, so pulse oximetry is commonly around 85% regardless of the true oxygen saturation
  • in parallel, blood gas analysis frequently returns a falsely elevated result for oxygen saturation as it provides an estimate based on only the PaO2 and not on effective Hb-oxygen binding