uworld 11

Question 1

Si/sx of rubella?

Answer 1

low grd fever, conjunctivitis, coryza, cervical LAD, head to body spread of blanching maculopapular rash, lasts less than 3 days

Question 2

Risk fx of endocarditis?

Answer 2

Poor dentition, cardiac probs (congenital dx, valvular abnormalities/ repair), IV catheters, IV drug use

Question 3

Lab/imaging findings w/ infective endocarditis?

Answer 3

+ blood cx, leukocytosis or nml WBC, glomerulonephritis signs on UA, septic emboli

Question 4

What is gold standard for dx of infective endo?

Answer 4

TEE is gold std, 100% specific

Question 5

How tx I.E.?

Answer 5

Start w/ vanc, then adjust based on cx

Question 6

What is alternate test to dx vertebral osteomyelitis?

Answer 6

can do bone scan w/ gallium if MRI contraindicated

Question 7

Causes of constrictive pericarditis?

Answer 7

idiopathic or viral pericarditis, cardiac surgery or radiation tx, TB pericarditis

Question 8

Px of constrictive pericarditis?

Answer 8

fatigue + dyspnea, periph edema, JVD, ascites, may hear pericardial knock

Question 9

JV wave signs of constrictive periccarditis?

Answer 9

prominent x and y descents

Question 10

What are P/E findings of pulmo htn?

Answer 10

widely split s2 and incrsd intensity of P2

Question 11

What is px of polymyositis?

Answer 11

slowly progressive prox muscle weakness of lower>upper extrem, cannot get out of chair, climb stairs, muscles of mastication and facial expession typically spared

Question 12

How best diagnose polymyositis?

Answer 12

do muscle biopsy — get mononuclear infiltrate surrounding necrotic and regenerating muscle fibers

Question 13

when should amiodarone be avoided?

Answer 13

Can cause pulm toxicity and should be avoided in pts w/ preexisting lung disease, can cause chronic interstitial pneumonia, organizing pneumonia, ARDS.

Question 14

How empirically tx patient <50 y/o for meningitis?

Answer 14

vanc + 3rd gen cephalosporin

Question 15

HOw empirically tx >50 y.o w. meningitis?

Answer 15

vanc + 3rd gen ceph + ampicillin. If immunocomp use cefepime instead of 3rd gen cephalo

Question 16

What is INR goal of anticoag after unprovoked DVT?

Answer 16

want 2.0-3.0 for 6-12 mo if unprovoked

Question 17

What is INR goal in pt w/ mechanical valve?

Answer 17

2.5-3.5

Question 18

Lab findings with tumor lysis syndrome?

Answer 18

incrsd uric acid, incrsd PO4 and K, dcrsd Ca

Question 19

Most common cause of hyperPTH?

Answer 19

80% due to parathyroid adenoma

Question 20

Other effects of hyperPTH?

Answer 20

htn, arrhythmias, ventric hypertrophy, vascular/ valvular calcificiation

Question 21

Causes of exudative pleural effusion?

Answer 21

infxn, malignancy, PE, connective tissue dx, iatrogenic

Question 22

when do papillary muscle ruptures occur?

Answer 22

classically w/ posteroseptal MIs, can occur rarely w/ anteromedial MIs

Question 23

SI/sx of Guillan Barre syndrome?

Answer 23

ascending lower extrem weakness, areflexia, can develop respiratory failure

Question 24

How manage resp failure in GBS?

Answer 24

serial VC measurements, risk for resp failure when VC < 15

Question 25

What is ddx for anterior knee pain?

Answer 25

patellofemoral syndrome, patellar tendonitis, osgood-schlatter syndrome

Question 26

How diagnose PFS?

Answer 26

based on clinical sx, do PF compression test --- reproduces pain of squatting

Question 27

How chronic exposure of lead px?

Answer 27

same as acute but with fatigue, insomnia, htn, neuropsych sx, nephropathy, reproductive probs

Question 28

Acute exposure of lead posioning sx?

Answer 28

ab pain, constipation, HA, periph neuropathy, joint pain, muscle aches, anemia, basophillic stippling, anorexia

Question 29

What can cause cauda equina syndrome?

Answer 29

disc herniation, rupture, spinal stenosis, tumors, infxn, hemorrhage, iatrogenic

Question 30

How does conus medullaris px?

Answer 30

sudden onset svr back pain, perianal hypo/anesthesia, symmetric motor reflexes, hyperreflexia, bowel and bladder dysfxn

Question 31

What is sympathetic opthalmia?

Answer 31

immune mediated inflamm of one eye following injury to other eye, px w/ floating spots and blurred vision in non injured eye.

Question 32

Si/sx of hereditary hemochromatosis?

Answer 32

lethargy, fatigue, malaise, skin pigmentation, joint probs/ arthralgia, incrsd LFTs, cirrhosis/ HCC risk, DM, hypogonadotropic hypogonadism, restrictive/dilated HF, cndxn probs

Question 33

Infxns risk for hereditary hemochromatosis?

Answer 33

incrsd risk of listeria, vibrio, yersinia

Question 34

Environ risk for pancreatic cancer?

Answer 34

smoking greatest, also chronic pancreatitis, obestiy, lack of physical activity

Question 35

How does dipyramidole dx angina?

Answer 35

dilates coronary arts distal to obstructed arteies, already max dilated --- other vessels dilate and pull blood from obstructed vessels--- ischemia

Question 36

How asses signs of adrenal insufficiency?

Answer 36

Do cosyntropin test

Question 37

Cosyntropin findings w/ primary adrenal insufficiency?

Answer 37

basal cortisol low, ACTH high w/ minimal respons of cortisol to cosyntropin