Uworld Questions

Question 1

What is paradoxical vocal fold motion?

Answer 1

When the vocal cords close while trying to breathe in.

Question 2

How can doctors diagnose paradoxical vocal fold motion?

Answer 2

By looking at a flow-volume loop and performing a laryngoscopy.

Question 3

What is the treatment for paradoxical vocal fold motion?

Answer 3

Supportive care during acute episodes and speech therapy or counseling for long-term care.

Question 4

What is acute radiation pneumonitis?

Answer 4

A condition that can develop in patients receiving thoracic or neck irradiation, presenting with antibiotic-nonresponsive pneumonia.

Question 5

When does acute radiation pneumonitis typically present?

Answer 5

1-3 moths after radiation exposure.

Question 6

What is the treatment for acute radiation pneumonitis?

Answer 6

Prednisone for 2 weeks, followed by a gradual taper over 3-12 weeks.

Question 7

What is massive hemoptysis?

Answer 7

A life-threatening emergency frequently caused by bronchiectasis, aspergilloma, necrotizing pneumonia, and rarely, bronchogenic carcinoma.

Question 8

What is the initial management for massive hemoptysis?

Answer 8

Airway protection and resuscitation.

Question 9

What is the procedure of choice for managing massive hemoptysis?

Answer 9

Rigid bronchoscopy if a skilled physician is available.

Question 10

What characteristics are found in pleural fluid with low pH and very low glucose levels?

Answer 10

Typically found in empyema or rheumatoid pleurisy.

Question 11

What does pleural fluid in empyema appear like?

Answer 11

Purulent with a high cell count (>50,000/µL) and neutrophilic predominance.

Question 12

What is chronic respiratory acidosis characterized by?

Answer 12

A near-normal pH due to renal compensation.

Question 13

What symptoms are associated with cryoglobulinemic vasculitis?

Answer 13

Dyspnea, cough, and isolated proteinuria.

Question 14

What is the best method for obtaining tissue samples when diagnosing a suspected disease?

Answer 14

From the easiest-to-reach area, like lymph nodes or skin lesions.

Question 15

What does erythema nodosum not show even when linked to sarcoidosis?

Answer 15

Noncaseating granulomas.

Question 16

What is the first step for lymph node samples in the chest?

Answer 16

Endobronchial ultrasound (EBU) with nodal aspiration.

Question 17

When is mediastinoscopy with lymph node biopsy performed?

Answer 17

If EBU with nodal aspiration does not work, especially if lymphoma is suspected.

Question 18

What is required to diagnose sarcoidosis?

Answer 18

Symptoms, imaging tests, and a biopsy of the affected tissue.

Question 19

What are the staging indicators for pulmonary sarcoidosis?

Answer 19

Stage III and IV patients do not have the usual swollen lymph nodes in both lungs.

Question 20

What is auto-positive end-expiratory pressure (PEEP)?

Answer 20

When air stays in the lungs due to incomplete emptying during mechanical ventilation.

Question 21

When do doctors prescribe antifungal medicine for Candida?

Answer 21

For sick patients or those with a weakened immune system.

Question 22

What is the main treatment for excessive daytime sleepiness in narcolepsy?

Answer 22

Modafinil.

Question 23

What is the role of an ECHO in ARDS?

Answer 23

To definitively exclude hydrostatic pulmonary edema in patients without ARDS risk factors.

Question 24

What autoimmune conditions can be linked to pulmonary arterial hypertension (PAH)?

Answer 24

Rheumatoid arthritis and scleroderma.

Question 25

What is the most common cause of pulmonary hypertension in the US?

Answer 25

Left-sided heart disease.

Question 26

What history is typical for lung disease/hypoxemia linked to pulmonary hypertension?

Answer 26

History of lung disease or signs of sleep-disordered breathing.

Question 27

What occurs in chronic thromboembolic pulmonary hypertension (CTEPH)?

Answer 27

Blood clots become scarred into the artery walls, causing chronic blockages.

Question 28

What is extrathoracic dynamic obstruction?

Answer 28

Airway blockage outside the chest causing the flow-volume loop to flatten during inhalation.

Question 29

What can sudden worsening of COPD symptoms indicate?

Answer 29

Pneumonia, heart failure, or a pulmonary embolism (PE).

Question 30

How is pulmonary hypertension linked to diastolic heart failure managed?

Answer 30

By carefully managing volume status and left ventricular function.

Question 31

What condition is indicated by severe shortness of breath during exertion and an enlarged heart with left ventricular hypertrophy?

Answer 31

Heart failure with preserved ejection fraction (HFpEF) ## Footnote HFpEF is characterized by the heart's inability to properly fill with blood during relaxation.

Question 32

What is the normal range for mean pulmonary arterial pressure?

Answer 32

≤20 mm Hg ## Footnote A mean pulmonary arterial pressure above 20 mm Hg indicates pulmonary hypertension.

Question 33

What was the patient's mean pulmonary arterial pressure measured during right-sided heart catheterization?

Answer 33

39 mm Hg ## Footnote This measurement is consistent with pulmonary hypertension.

Question 34

What does a high pulmonary capillary wedge pressure indicate?

Answer 34

High left atrial pressure ## Footnote Normal range for pulmonary capillary wedge pressure is ≤15 mm Hg.

Question 35

What type of pulmonary hypertension is the patient likely experiencing?

Answer 35

Postcapillary PH-HFpEF (WHO group 2) ## Footnote This type is related to heart failure and occurs when the left atrium does not fill properly.

Question 36

What are the normal values for right atrial pressure and cardiac output in this patient?

Answer 36

Normal ## Footnote This indicates that the right ventricle is functioning well.

Question 37

What is the primary goal of treating PH-HFpEF?

Answer 37

Improve fluid balance and address underlying health problems ## Footnote Conditions like high blood pressure or heart disease can lead to left ventricular dysfunction.

Question 38

Which medications are commonly prescribed for PH-HFpEF?

Answer 38

* Diuretics * Antihypertensive medications * Aldosterone receptor antagonists (e.g., spironolactone) * Sodium-glucose cotransporter 2 (SGLT2) inhibitors (e.g., dapagliflozin) ## Footnote These medications help reduce heart workload and improve filling during relaxation.

Question 39

What are the effects of aldosterone receptor antagonists and SGLT2 inhibitors on the heart?

Answer 39

* Reduce overall workload on the heart * Improve heart's ability to fill during relaxation * Slow down growth of heart muscle * Help retain enough fluid through diuretic effects ## Footnote These effects are beneficial for managing HFpEF.

Question 40

Which pulmonary vasodilators are used for pulmonary arterial hypertension (WHO group 1)?

Answer 40

* Tadalafil * Bosentan ## Footnote These medications are not recommended for PH-HFpEF due to the risk of sudden lung swelling.

Question 41

True or False: Pulmonary vasodilators are safe for use in patients with PH-HFpEF.

Answer 41

False ## Footnote They can cause sudden swelling in the lungs if blood flow increases too quickly.