Uworld 8/19

Question 0

What is reye syndrome?

Answer 0

• encephalopathy +/- liver disease caused by giving aspirin to a child for influenza or varicella infection
• pathophysiology: microvesicular fatty infiltration & hepatic mitochondrial dysfunction

Question 1

What can aspirin cause in a child when given to them for influenza or varicella infection?

Answer 1

-reye syndrome = encephalopathy and/or liver failure

Question 2

What is the only time aspirin should be given to a child?

Answer 2

-kawasaki disease!!

Question 3

What is more common in blunt trauma: esophageal or tracheobronchial rupture?

Answer 3

-tracheobronchial rupture!

Question 4

When does false labor usually occur?

Answer 4

-last 4-8 wks of pregnancy

Question 5

Describe the contractions of false labor?

Answer 5

• they are lower in the abdomen
• irregular
• interval does not shorten or increase in intensity
• NO cervical changes
• relieved by sedation

Question 6

What is the best initial test to do with any complaints of trouble swallowing?

Answer 6

-barium swallow study!

Question 7

What is the best way to help prevent kidney damage when a contrast CT scan is needed?

Answer 7

-use non-ionic contrast agent

Question 8

Microbio of pseudomonas?

Answer 8

-gram-neg rod

Question 9

Dx of malaria?

Answer 9

-thick and thin blood smears

Question 10

2 non-vasculitis conditions that have positive p-ANCA too!

Answer 10

1. Ulcerative colitis
2. Ankylosing spondylitis
   * *both HLA-B27

Question 11

Can relative risk be calculated from case-control studies?

Answer 11

• NO!

- only the odds ratio can be determined

Question 12

4 Common drugs that are ototoxic?

Answer 12

1. Aminoglycoside antibiotics
2. Chemotx
3. Aspirin
4. Loop diuretics (ex furosemide)

Question 13

What tx of graves dz can cause a worsening of opthalmopathy?

Answer 13

• radioiodine ablation –> bc releases more TH at first

- these effects are usually mild and transient, but can be given glucocorticoid tx prophylactically

Question 14

What is the only tx that is effective in reducing the risk of early reccurance of an ischemic stroke?

Answer 14

-aspirin!

Question 15

What 3 things can trigger vasovagal syncope?

Answer 15

1. Emotional stress
2. Painful stimuli
3. Prolonged standing

Question 16

Dx of vasovagal stroke?

Answer 16

• usually a clinical dx, with no other testing needed

- tilt test if clinical presentation is unclear

Question 17

Tx of mucormycosis?

Answer 17

-surgical debridement + amphotericin

Question 18

What type of bias is it when you lose a lot of subjects to follow-up?

Answer 18

-attrition bias = a selection bias

Question 19

Recurrent nose bleeds, oral lesions, and clubbing?

Answer 19

• think: osler-weber-rendu syndrome = hereditary telangiectasia
• develop multiple av malformations
• these pts can develope pulmonary AVMs that cause R–>L shunts

Question 20

What grade is a “flow murmur”? What should be done for murmurs that are > grade?

Answer 20

• grade I/II = innocent flow murmur of childhood, usually from VSD that will close on their own
• higher than grade II should have echo to determine size, severity, and location of defect

Question 21

“Stuck on” skin lesion?

Answer 21

-seborrheic keratosis!!!!!!

Question 22

Potassium in DKA and Hyperosmolar Hyperglycemic State (HHS)?

Answer 22

• serum levels might measure as normal or even high, but ther is actually a total body defecit
• bc insulin def and hyperosmolarity cause the mvmnt of potassium OUT of the cells and into the extracellular space

Question 23

What is a marker of poor prognosis in CLL?

Answer 23

-thrombocytopenia!

Question 24

A baby with vomiting, bloody stools, and abdominal distention?

Answer 24

-think: necrotizing entercolitis!

Question 25

Tx of choice for duodenal hematoma?

Answer 25

-NG suction + parenteral nutrition

Question 26

When are duodenal hematomas commonly seen?

Answer 26

-with blunt abdominal trauma, esp in kids

Question 27

When does a febrile non-hemolytic rxn to a blood transfusion usually occur?

Answer 27

-within 1-6 hrs of transfusion

Question 28

Tx for viral myocarditis?

Answer 28

-diuretic + inotropes

Question 29

What are 2 specific signs of CHF and increased cardiac filling pressures?

Answer 29

1. Elevated BNP

2. Audible S3

Question 30

Etiology if sudden vision changes in a diabetic?

Answer 30

• hyperosmolarity

- diabetic retinopathy is a chronic gradual change

Question 31

What is one love vaccine that is not contraindicated in an HIV pt?

Answer 31

• MMR!

- as long as CD4 is > 200 and no-AIDS defining illnesses are present

Question 32

What disease used to be the most common cause for adrenal insufficiency?

Answer 32

-tuberculosis!

Question 33

What is the bronchoalveolar lavage test best at diagnosing?

Answer 33

1. Suspected malignancy

2. Opportunistic infections

Question 34

Best dx test for PCP?

Answer 34

-bronchiolar lavage

Question 35

What is the most common cause of cor pulmonale in the the US?

Answer 35

-COPD

Question 36

Tx for supraventricular tachy?

Answer 36

-tx: adenosine = interrupts AV nodal reentry circuit

Question 37

Atrophic (glossy) tounge, vitiligo, thyroid dz, and neurologic abnormalities?

Answer 37

-think: pernicious anemia

Question 38

Arthritis in a pt with hemophilia?

Answer 38

• called: hemophilic arthropathy
• consequence of recurrent hemarthroses
• hemosiderin deposition leads to synovitis and fibrosis within the joint