UWorld venxilinapsee.tk - Download as PDF File .pdf), Text File .txt) or read online . USMLE Step1 Uworld Notes pdf venxilinapsee.tk How do I get an offline UWorld for USMLE Step 1 ? Can I get a good score if I only study the UWorld material and not FA’s, for my USMLE step 1 preparation? How can I get an UWorld Qbank offline for STEP 2 CK?.
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Uworld Download. Uworld (pdf). Download. Uworld Algorithm. Download. UW Tables and pics (Usmle Grassroots). Download. UWORLD Notes By. In this part of the article, you will be able to access venxilinapsee.tk file of UWorld for USMLE Step 1 PDF by using our direct links. We have uploaded UWorld for . Virtually every medical student who has prepared for Step 1, Step 2 CK, or Step 3 has used UWorld (sometimes called “UW”). Formerly known as “USMLE.
Steps to Approach Questions: Mistakes to Avoid 1. Read the question first. Read all the answers. Read explanations sociation with each answer—whatever for the correct AND incorrect answer choices comes to mind.
Ask yourself: Complete correct answer? Utilize timed blocks to 3. Read the stem, and eliminate answers prepare for the exam.
Focus on the ma- terial in a focused study environment. Mentally create alternate stems that would have made other answers correct. UWorld Download. Flag for inappropriate content. Related titles. Jump to Page. Search inside document. Marion Sanchez. Alex Ivan Chen Tejada. Kia Garcia. Rachel Searcy.
Mariane G Valencia. Jay KJ. Jobnel Tineo bueno. Neha Gupta. Gaurav Patel. Ernesto Prado. Romina Gomez. Rafael Basa. Mustafa Thaier Alkaraghouli. Analgesic nephropathy is the most common form of drug-induced chronic renal failure. Patients with chronic analgesic abuse are also more likely to develop premature aging, atherosclerotic vascular disease, and urinary tract cancer.
Muddy brown granular cast -Acute tubular necrosis RBC casts - Glomerulonephritis WBC casts - Interstitial nephritis and pyelonephritis Fatty casts - Nephrotic syndrome Broad and waxy casts - Chronic renal failure The common presentation of cryoglobulinemia includes palpable purpura, glomerulonephritis, non-specific systemic symptoms, arthralgias, hepatosplenomegaly, peripheral neuropathy, and hypocomplementemia.
Most patients also have Hepatitis C. Dipsticks are commercially available kits that detect the presence of leukocyte esterase and nitrite in the urine of patients with suspected UTI. Positive leukocyte esterase signifies significant pyuria and positive nitrites indicate the presence of Enterobacteriaceae. Uncomplicated cystitis commonly occurs in otherwise healthy patients and has a low risk of treatment failure.
Urinalysis confirms the diagnosis. Patients can be treated without a urine culture, which may be done later in those who fail initial therapy. Collapsing focal and segmental glomerulosclerosis is the most common form of glomerulopathy associated with HIV. Typical presentation of focal segmental glomerulosclerosis includes nephrotic range proteinuria, azotemia, and normal sized kidneys.
Cystinuria is an inherited disease causing recurrent renal stone formation. Look for a personal history of recurrent kidney stones from childhood and a positive family history. The characteristic stones are hard and radioopaque. Urinalysis shows typical hexagonal crystals. The urinary cyanide nitroprusside test is widely used as a qualitative screening procedure. Interstitial cystitis painful bladder syndrome is an idiopathic, chronic condition characterized by bladder pain that is worsened by filling and relieved by voiding.
Dyspareunia, urinary frequency and urgency can also be present. Focal segmental glomerulosclerosis FSGS and membranous nephropathy are the most common causes of nephrotic syndrome in adults in the absence of a systemic disease. Initial hematuria suggests urethral damage.
Terminal hematuria indicates bladder or prostatic damage, and total hematuria reflects damage in the kidney or ureters. Clots are not usually seen with renal causes of hematuria. Discontinuing the offending agent is the treatment of drug-induced interstitial nephritis. Aspirin intoxication causes a mixed respiratory alkalosis and metabolic acidosis.
Respiratory alkalosis is due to increased respiratory drive. Metabolic acidosis is due to increased production and decreased renal elimination of organic acids eg, lactic acid, ketoacids.
CT scan of the abdomen is the most sensitive and specific test for diagnosing RCC. Drugs with anticholinergic properties can cause acute urinary retention by preventing detrusor muscle contraction and urinary sphincter relaxation.
The treatment involves urinary catheterization and discontinuing the medication. Saline hydration helps to restore intravascular volume and promote urinary calcium excretion. Calcitonin also reduces serum calcium concentration within hours and should be administered along with saline hydration. Bisphosphonates are recommended for long-term management in addition to treatment of the underlying cause. Agents used to shift potassium intracellularly include insulin and glucose, sodium bicarbonate, and beta-2 agonists.
Lung malignancies, cystic fibrosis, and right-to-left cardiac shunts are the most common causes of secondary digital clubbing. Chronic obstructive pulmonary disease with or without hypoxemia does not cause digital clubbing, and the presence of clubbing should prompt a search for occult malignancy. Hypertrophic osteoarthropathy refers to digital clubbing along with painful joint enlargement, periostosis of longbones, and synovial effusions.
Right mainstem bronchus intubation is a relatively common complication of endotracheal intubation. It causes asymmetric chest expansion during inspiration and markedly decreased or absent breath sounds on the left side on auscultation. Repositioning the endotracheal tube by pulling back slightly will move the tip between the carina and vocal cords and solve the problem.
For this form of asthma, only a PRN albuterol inhaler is required. Daily controller corticosteroids are reserved for persistent asthma.
Recurrent bacterial infections in an adult patient may indicate a humoral immunity defect. Quantitative measurement of serum immunoglobulin levels helps to establish the diagnosis. Undiagnosed pleural effusion is best evaluated with thoracentesis, except in patients with clear-cut evidence of congestive heart failure.
Of the main cell types of lung cancer, adenocarcinoma is the most common in both smokers and nonsmokers. It accounts for most of the primary lung cancer in nonsmokers. It is usually located peripherally and may present as a solitary nodule, with or without symptoms. Stage at diagnosis is the most important prognostic factor, with survival determined primarily by resectability.
In patients with acute asthma exacerbation, an elevated or even normal arterial partial pressure of carbon dioxide suggests decreased respiratory drive likely due to respiratory muscle fatigue and impending respiratory failure.
In these patients, treatment involves endotracheal intubation and mechanical ventilation,inhaled short-acting betaagonist, inhaled ipratropium, and systemic corticosteroids.
Idiopathic pulmonary fibrosis is due to excessive collagen deposition in peri-alveolar tissues. Patients have impaired gas exchange resulting in reduced diffusion capacity of carbon monoxide and increased alveolar -arterial gradient. Granulomatosis with polyangiitis Wegener's is a vasculitis affecting small and mediumsized arteries. Patients present with a combination of glomerulonephritis and upper and lower respiratory tract disease.
Diagnosis is made by c-ANCA positivity and tissue biopsy. Treatment involves high-dose corticosteroids and cy1otoxic agents. ARDS is due to impaired gas exchange, decreased lung compliance stiff lungs ,and increased pulmonary arterial pressure pulmonary hypertension. Mitral stenosis is most commonly due to rheumatic heart disease and presents with gradual and progressively worsening dyspnea or orthopnea.
Atrial fibrillation is a common complication and can cause rapid decompensation in previously asymptomatic patients.
Longstanding mitral stenosis can cause severe left atrial enlargement leading to an elevation of the left main bronchus on chest radiograph. Indicators of a severe asthma attack include normal to increased Pco2 values, speech difficulty, diaphoresis,altered sensorium, cyanosis, and 'silent' lungs.
UWCK 2018 USMLEWORLD STEP 2 CK
Warfarin dosing should be adjusted to maintain a goaiiNR appropriate for the condition being treated. Malignancy is the most common cause of SVC syndrome. When the history and physical examination are suggestive, chest x-ray is warranted.
The kidney compensates for respiratory alkalosis by preferentially excreting bicarbonate in the urine. The result is an alkalinized urine increased urine pH.
When the pH of the pleural fluid is less than 7. Infected pleural space is usually initially drained with a chest tube. Short-acting beta-adrenergic agonists administered 20 minutes before exercise are the firstline treatment for isolated exercise-induced asthma. The inciting trigger in exercise-induced asthma is rapid ventilation of cold,dry air. Physical examination in patients with pleural effusion usually shows decreased tactile fremitus, dullness to percussion, and decreased breath sounds over the effusion.
In the U. Sarcoidosis also typically affects the skin protean manifestations, most commonly erythema nodosum and the eyes uveitis. Theophylline toxicity can manifest as central nervous system stimulation eg, headache, insomnia, seizures ,gastrointestinal disturbances eg, nausea, vomiting , and cardiac toxicity arrhy1hmia. Inhibition of the cy1ochrome oxidase system by other medications, diet, or underlying disease can alter its narrow therapeutic window.
Blood in the chest, if it is not evacuated, can get infected. The majority of patients will present with a low-grade fever, dyspnea, and chest pain. Surgery is required to remove the clotted blood and fibrinous peel. A negative D-dimer is very helpful in excluding the diagnosis of pulmonary venous thromboembolism in low-risk patients.
A positive D-dimer, however, is far from diagnostic and must be followed by more specific studies. Secondary malignancy is common in patients with Hodgkin lymphoma treated with chemotherapy and radiation.
The most common secondary solid tumor malignancies are lung especially in smokers , breast,thyroid, bone, and gastrointestinal eg, colorectal, esophageal, gastric tumors. In all patients with COPD, the two modalities that have been shown to decrease mortality are home oxygen therapy and smoking cessation.
It is most often seen in patients with a history of asthma or chronic rhinosinusitis with nasal polyposis. AERO is characterized by bronchospasm and nasal congestion following aspirin ingestion. Bilateral diffuse interstitial infiltrates beginning in the perihilar region is a characteristic finding on chest x-ray. COPD is characterized by progressive expiratory airflow limitation which causes air trapping, decreased VC and increased total lung capacity.
FEV1 is disproportionately decreased as compared to VC. Patients with a history of recent orthopedic surgery followed by bed rest are at risk of developing lower extremity deep venous thrombosis and pulmonary embolism.
An elevated A-a gradient is commonly seen in patients with pulmonary embolism.
Bronchogenic cysts are usually found in the middle mediastinum. Thymoma is usually found in the anterior mediastinum. All neurogenic tumors are located in the posterior mediastinum. The 3 most common causes of chronic cough are upper-airway cough syndrome postnasal drip , asthma,and gastroesophageal reflux disease. The diagnosis of upper -airway cough syndrome is confirmed by the elimination of nasal discharge and cough with the use of H1 histamine receptor antagonists.
Acute massive pulmonary embolism can present initially with syncope and shock. Right heart catheterization in patients with massive pulmonary embolism will show elevated right atrial and pulmonary artery pressures,along with normal pulmonary capillary wedge pressure.
The first step in the initial ventilator management of ARDS is usually to decrease the Fi02 to relatively non-toxic values i. PEEP may be increased as needed to maintain adequate oxygenation after the Fi02 is lowered. Normal pleural fluid pH is approximately 7. Transudative fluid is usually due to systemic factors eg,increased hydrostatic pressure or hypoalbuminemia and has a pleural fluid pH of 7. Exudate is usually due to inflammation with a pleural fluid pH of 7. Bronchiectasis presents with cough, mucopurulent sputum, and hemoptysis that often antibiotics.
Chest x-ray is frequently abnormal but is not as sensitive or specific as highresolution computed tomography scan for definitive diagnosis. Blastomycosis is a pulmonary fungal infection endemic to the Great Lakes, and Mississippi and Ohio River basins. Systemic Blastomycosis may cause skin and bone lesions in addition to pulmonary manifestations.
Broad-based budding yeast grown from the sputum confirm the diagnosis. The modified Wells criteria can assess pretest possibility of acute pulmonary embolism PE as it can have variable presentations. Patients with likely PE based on these criteria should be further evaluated with computed tomography angiography CTA. Know the complications of ventilation with a high PEEP: alveolar damage, tension pneumothorax and hypotension. Tension pneumothorax may present with sudden-onset shortness of breath, hypotension,tachycardia, tracheal deviation, and unilateral absence of breath sounds.
Patients with impaired consciousness, advanced dementia, and other neurologic disorders are predisposed to aspiration pneumonia due to impaired epiglottic function. Bronchiectasis can be identified on CT by the presence of dilated bronchi with thickened walls.
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It can occur in any patient where there is pulmonary infection accompanied by either decreased airway drainage or impaired immune defense. Hemoptysis is a potential complication of bronchiectasis. Histoplasma capsulatum is a common and usually asymptomatic infection in endemic areas like Mississippi and Ohio River valleys and Central America.
It is usually found in soil with a high concentration of bird or bat guano droppings. Patients with massive pulmonary embolism usually present with signs of low arterial perfusion eg,hypotension, syncope and acute dyspnea, pleuritic chest pain, and tachycardia. The thrombus increases pulmonary vascular resistance and right ventricular pressure, causing right ventricular hypokinesis and dilation, decreased preload, and hypotension. Germ cell tumors typically affect young patients and display aggressive biologic behavior.
Nonseminomatous germ cell tumors typically produce both alpha fetoprotein and human chorionic gonadotropin tumor markers. Antipsychotic medications can cause hyperprolactinemia secondary to their dopamine blockade effect.
Some of the more serious adverse effects associated with lithium include nephrogenic diabetes insipidus,hypothyroidism, and Ebstein's anomaly in the fetus. The antidepressant of choice for depressed patients who do not respond to first-line treatment with a selective serotonin reuptake inhibitor is another medication in the same class.
Neuroleptic malignant syndrome is a potentially life-threatening condition that can occur after administration of antipsychotic medications. Symptoms include fever, rigidity, altered mental status, and autonomic instability. The most effective strategy to prevent firearm injuries is to remove all firearms from the home. Families who choose to keep firearms in the home should be advised to store unloaded firearms and ammunition in separate, locked containers.
Unlike patients with anorexia nervosa, patients with bulimia nervosa maintain a normal body weight and are not amenorrheic. Patients who are an acute threat to themselves should be hospitalized involuntarily, if necessary for treatment and stabilization. This principle also applies to minors, even without parental or guardian consent.
The mechanism of action of antipsychotic medications primarily consists of dopamine receptor blockade. The added serotonin receptor binding of atypical antipsychotics reduces the likelihood of extrapyramidal side effects. Risperidone is a dopamine and serotonin antagonist that can cause weight gain and hyperprolactinemia, the latter of which can lead to amenorrhea and galactorrhea.
Delusional disorder involves one or more delusions and the absence of other psychotic symptoms in an otherwise high-functioning individual. Benzodiazepines are used for the acute treatment of panic attacks. Patients who have experienced 2 episodes of acute mania should be considered for longterm years , if not lifetime, maintenance treatment with lithium, especially if the episodes were severe or there is a family history. Patients with a history of 3 or more relapses are recommended to have lifetime maintenance therapy.
Visual hallucinations and intensified perceptions are hallmarks of LSD use. Acute dystonia is a type of extrapyramidal symptom associated with antipsychotic treatment. It is most commonly seen with high-potency typical antipsychotics and is best treated with anticholinergics benztropine or antihistamines diphenhydramine. Patients may have concurrent medical illness, or the symptoms may represent normal bodily function.
Schizoaffective disorder is characterized by a significant mood episode depressive or manic with concurrent psychotic symptoms in addition to a period of psychosis without mood symptoms of at least 2 weeks. Most antidepressants must be taken for weeks before they provide symptomatic relief. Minimizing conflict and stress in the home decreases the risk of relapse in patients with schizophrenia. Family psychosocial interventions are indicated for patients with a recent psychotic episode who have significant ongoing contact with family members.
Panic disorder is frequently associated with other psychiatric illnesses, including agoraphobia, major depression, bipolar disorder, and substance abuse. It is also linked to a higher rate of suicide attempts or suicidal ideations. Antipsychotic medications are first-line treatment for psychosis. Second-generation antipsychotics are generally preferred due to a comparatively lower risk of extrapyramidal side effects and tardive dyskinesia.
Due to the risk of agranulocytosis, clozapine is reserved for patients who have failed at least 2 antipsychotic trials.
The dissociative disorders are characterized by forgetfulness and dissociation. Dissociative fugue is the only condition within this group that is associated with travel. Generalized social anxiety disorder is characterized by anxiety and fear of scrutiny in social situations,resulting in avoidance, distress, and social-occupational dysfunction. The preferred pharmacological treatment is a selective serotonin reuptake inhibitor or serotonin norepinephrine reuptake inhibitor.
Cognitive behavioral therapy can also be used as first-line treatment.
Classification of psychiatric illnesses by phase is necessary to determine the appropriate pharmacotherapy. Cognitive-behavioral therapy focuses on reducing automatic negative thoughts and avoidance behaviors that cause distress. It is effective as monotherapy or in combination with medication for a wide range of psychiatric disorders. Hoarding disorder is responsive to treatment with selective serotonin reuptake inhibitors and cognitive behavioral therapy.
Persistent depressive disorder dysthymia refers to a depressed mood lasting most days for at least 2years. Symptoms of a major depressive episode may occur concurrently or intermittently in persistent depressive disorder. Vs Patients with avoidant personality disorder desire social interaction but shy away due to feelings of inadequacy or fear of criticism, failure, or rejection.
This patient's fear of rejection by women relates to his mood symptoms low self-esteem and not general avoidance of social situations.
Neuroleptic malignant syndrome NMS is an unusual but potentially lethal side effect from the use of antipsychotics neuroleptics. It is treated primarily with dantrolene sodium and supportive care.
Cancer patients often have a depressed mood secondary to normal grieving. However, major depression should be considered in patients with prominent somatic symptoms of depression, guilt, feelings of hopelessness, or suicidal thoughts.
There should be a low threshold for beginning a selective serotonin reuptake inhibitor given the low risk of side effects and large potential benefit to the patient. The treatment of choice for adjustment disorder is cognitive or psychodynamic psychotherapy. Schizophreniform disorder is differentiated from schizophrenia by the duration of symptoms.
The diagnosis of schizophreniarequires symptoms to be present for at least 6 months. Serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are first-line medications for treating generalized anxiety disorder that can also potentially treat comorbid major depression.
Benzodiazepines should be reserved for nondepressed patients without a history of substance abuse who fail to respond to or cannot tolerate antidepressants. Disorganized speech is common in schizophrenics. Patients with a circumstantial thought process deviate from the original subject but eventually return to it, while those with a tangential thought process drift away without ever returning to the subject.
Because symptoms of hypochondriasis usually develop during periods of stress, patients suffering from the condition should be asked about their current emotional stressors and then referred for brief psychotherapy.
The extrapyramidal side effects of antipsychotics can be treated with anticholinergic medications like benztropine. Suspect heroin withdrawal in patients with pupillary dilatation, rhinorrhea, muscle and joint aches, abdominal cramping, nausea, and diarrhea.Germ cell tumors typically affect young patients and display aggressive biologic behavior.
Since I was using Anki, I knew the answer without reading the question. Ultimately, your preparations and how you use these resources will depend on what you believe the test to be about, and what you believe it takes to get a high score.
Benzodiazepines are used for the acute treatment of panic attacks. Mistakes to Avoid 1. Disorganized speech is common in schizophrenics. As a result, pupil examination is not as reliable as the recognition of bradypnea in opioid intoxication. Day one of testing includes multiple-choice items divided into 6 blocks of 42 to 43 items; 60 minutes are allotted for completion of each block with 7 hours of total test session including 45 minutes of break time and a 5-minute optional tutorial.
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