Uworld 3

Question 1

complete contralateral sensory loss =
right side of the face and right side of body
(often with severe proprioceptive defeacts that lead to unsteady gait and falls)

Answer 1

lesion to VPL or VML thalamic nuclei

thalamic syndrome!

Question 2

lesions frontal cortex lesions

Answer 2

deficits in higher brain function: alters patterns of spontaniety, creativity, social behavior, sexual interst

Question 3

lesion in internal capsule

Answer 3

motor deficiet

Question 4

lesion to pons

Answer 4

coma, bilateral paralysis, pinpoint lesions, rigidity, death

Question 5

lesion to caudate nucleaus

Answer 5

transient hemiparesis + frontal lobe symptoms (eg. inattentiveness, abulia, forgetfullness)

Question 6

primary causes of lacunar infarcts

Answer 6

lipohyalinosis and microatheromas

Question 7

common causes of lipohyalinosis and microatheromas?

Answer 7

hypertension and DM

Question 8

how do varicose veins happen?

Answer 8

prolonged increases in intraluminal pressure or loss of vessel wall tensile strength ==> causes venous dilation ==> retrograde flow from incompetant valves ==> venous stasis/ congestion with lower extremity edema.

Question 9

what are common complications of varicose veins?

Answer 9

from poor blood flow, painful thromboses, stasis dermatitis, skin ulcerations, poor wound healing, superficial infections

Question 10

what is phlegmasia alba dolens and what is it caused by?

Answer 10

“painful white leg” from iliofemoral venous thrombosis in preggers
because DVTs ==> from uterine pressure on the deep pelvic veins (causing venous stasis) and incr hypercoag

Question 11

dmg to central portion of spinal cord

Answer 11

syringomyelia

Question 12

dmg to dorsal columns and dorsal roots of spinal cord

Answer 12

tabes dorsalis (neurosyphilis) –lateral corticospinal tract NOT involved

Question 13

dmg to upper and lower motor neurons

Answer 13

ALS

Question 14

dmg to anterior horn of spinal cord

Answer 14

poliomyleitis

Question 15

bilateral loss of DCML, hyperreflexia, babinski +, numbness

Answer 15

B12 deficiency –> degeneration to dorsal columns, lateral corticospinal tracts, perpipheral axonal degeneration

Question 16

bilateral pain and temp loss, flaccid paralysis and atrophy of intrinsic hand muscles

Answer 16

syringomyelia

Question 17

loss of position and vibration, ataxia, pain and paresthesias of extremities

Answer 17

tabes dorsalis

Question 18

spasticity and hyperreflexia, flaccid paralysis, atrophy, fasiculations

Answer 18

ALS

Question 19

lower motor neuron weakness …progressive?

Answer 19

poliomyelitis

Question 20

complete loss of strength below level of injury with loss of pain and temp, but vibratory intact

Answer 20

anterior spinal artery syndrome! (compression of artery running along front of spinal cord)

Question 21

high PTT, normal PT, platelet count, bleeding time

Answer 21

Hemohilia A or B

Question 22

high bleeding time, normal or high PTT, normal PC and PT

Answer 22

von Willebrand factor deficiney

Question 23

high PT, PTT, bleeding time, and decreased platelets

Answer 23

DIC

Question 24

high bleeding time, normal PC, PT, PTT

Answer 24

Uremic platelet dysfunction (HUS?)

Question 25

high PTT, normal PT, PC, Bleeding time

Answer 25

Heparin

Question 26

high PT, super weak incr PTT, normal platelets, and bleeding time

Answer 26

warfarin

Question 27

high bleeding time, low platelets, normal PT and PTT

Answer 27

Immune thrombocytopenia

Question 28

what does vWF do?

Answer 28

promotes platelets adhesion by binding and crosslinking GP1b with exposed collagen under the damaged endothelum.

Question 29

what does protein C do?

Answer 29

acts with protein S to inactivate the activated forms of factors 5 and 8.

Question 30

when is heme: alpha 2, delta 2 found?

Answer 30

normal variant. makes hemoglobin A2. makes up 2-5 % of hemoglobin

Question 31

when is heme: zeta 2, epsilon 2?

Answer 31

earliest hb. from yolk sac.

Question 32

recurrent cyanotic spells counteracted by squatting

Answer 32

tetralogy of fallot --> to increase the amount going through the stenotic pulm valve

Question 33

-prils do what to GFR?

Answer 33

decr it!

Question 34

Have strep. bovis. what's the next step?

Answer 34

Check for colon CA!!

Question 35

mitral stenosis with low grade fevers neg. blood cultures

Answer 35

acute rheumatic fever

Question 36

fatigue and exertional dyspnea 3 weeks after a tooth extraction

Answer 36

Strep viridans subacute bacterial endocarditis

Question 37

repeated negative blood cultures with a small mitral vegetation on transesophageal echocardiogram

Answer 37

culture negative endocarditis

Question 38

what are the culture negative endocarditis organisms?

Answer 38

bartonella, coxiella, mycoplasma, histoplasma, chlamydia, HACEK organism ==> H flu, actinobacillus, cardiobacterium, eikenella, kingella

Question 39

persistent fever with trcuspid vegetations and tricuspid regurg on echo

Answer 39

IV drug use--> S. aureus

Question 40

Legionella culture

Answer 40

buggered charcoal yeast extract (BCYE) agar supplemented with L-cysteine and iron

Question 41

budding yeast that form germ tuebs at 37 degrees C.

Answer 41

Candida alibcans

Question 42

presence of candida in sputum...what is it?

Answer 42

normal...contaminant. upt o 40% of population has it in GI tract (and oral cavity)...so it will contaminate sputum cultures. doesn't indicate disease

Question 43

what are the receptors in the carotid sinus innervated by?

Answer 43

baroreceptors in carotid sinus (and carotid body chemosensors) travel up the glossopharyngeal nerve to brainsem.

Question 44

what are the receptors in the aortic arch innervated by

Answer 44

baroreceptors in aortic arch and chemor. in aortic body travel up vagus! to brainstem

Question 45

drug or HTN/ tia causes mouth ulcers and fever

Answer 45

TIclopidine causes neutropenia. monitor complete blood count biweekly for the first 3 months.

Question 46

antiplatelet drug with mechanism: block formation of ligands

Answer 46

asprin. decr. thromboxande A2

Question 47

antiplatelet drug with mech: ADP antagonists

Answer 47

clopidogrel and ticlopiine

Question 48

antiplatelet drug mech: incr cAMP by decr phosphodiesterase activity

Answer 48

cilostazol and dipyridamole

Question 49

hyperthermia, extreme generalized rigidity, autonomic instability, altered mental status

Answer 49

neuroleptic malighnant syndrome

Question 50

anaerobic bacteria in alcoholics with pneumonia

Answer 50

bacteroides, prevotella, fusobacterium, peptostreptococcus