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Step 2 UWORLD SIM 1 + 2

Terms in this set (199)

Greatest Risk factor of Parenteral Nutrition?
Central line associated blood stream infections.
Must be administered through central line due to high osmotic load.

Most common bacterial organisms: Coagulase-Negative Staph and Staph Aureus.

Cholestasis is a risk factor for patients on Parenteral Nutrition for >2 weeks.
Ecthyma Gangrenosum
Small erythematous macular to larger, nontender nodule with necrosis.
Caused by gram Negative organisms like Pseudomonas.
-Seen in immunocompromised patients (chemotherapy)
Thready pulses over both radial arteries that disappear with inspiration
Pulsus Paradoxus - Cardiac Tamponade
ACTH
Polypeptide Hormone - Produced from the cleavage of POMC (proopiomelanocortin) with also yields MSH (Melanocyte-stimulating hormone).

Cortisol is a steroid. ACTH is a polypeptide.
Labor Protraction
Cervical change slower than expected, with or without inadequate contractions.

Treatment: Oxytocin

Uterine contractions are considered adequate when they are forceful and come every 2-3min.
Labor Arrest
-No cervical change in >4 hours with adequate contractions
-No cervical change in >6 hours without adequate contractions

Treatment: C-section
CHADSVASC Score > 2
Anti-cogualation in treatments with A.Fib. If score of 1 give Aspirin.

Treat with:
-Warfarin or:
-Nonvitamin K antagonist oral anticoagulants - Rivaroxaban, Dabigatran, Apixaban
Tuberculosis Exudative Effusion
Exudative
-Lymphocyte predominance
-Low Glucose
-Mild Leukocytosis (1000s)

Compared to bacterial, which has largely elevated leukocytosis (50000), and neutrophil predominance.
Aspiration Pneumonia
Can be prevented by lifting the head of the bed, oral care, and diet modification.

NG tubes increase the risk of Aspiration pneumonia. But Jejunal tubes can decrease risk. Impaired consciousness and cough reflex also increase risk.
Bullous Phemphigoid
Autoantibodies: Hemi-desmosomes
-SUBEPIDERMAL CLEAVAGE
-Linear IgG basement membrane
-Tense bullae
-Oral Lesions - LESS COMMON
Prodrome: Pruritic eczematous or urticarial lesions.

Treatment: High potency steroids.
Pemphigus Vulgaris
Autoantibodies: DESMOSOMES
-INTRAEPIDERMAL CLEAVAGE
-Intact blisters are rare
-Oral Lesions - MORE COMMON
ALS
Upper motor signs - Babinski, Hyper-reflexes, etc.

Lower motor signs - Muscle wasting, fasciculations, etc.

Preserved SENSTATION
Secondary Parathyroidism
Secondary to Chronic Kidney disease, leaving to decreased Ca reabsorption and decreased Phosphorus excretion
-Low Ca, High Phosphorus, High PTH
-Leads to Parathyroid hyperplasia.

Renal Osteodystrophy - Increased bone resorption, from increased levels of PTH, leading to pain and increased risk of fracture.
Neurogenic Bladder
Longstanding diabetes mellitus leading to OVERFLOW incontinence - incomplete emptying, persistent dribbling, nocturia, frequent small voids, etc. Caused by detrusor underactivity.

-High post void residual volumes (>150 in women, >50 in men)

Treatment: Bethanechol - Muscarinic AGONIST in order to void more.
Dialated cardiomyopathy
Can occur secondary to MYOCARDITIS - From Coxsackie B infection

-Signs and symptoms of heart failure: Shortness of breath, PND, pitting edema, displaced point of max impulse, etc.
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