UWORLD random 3/18b

Question 1

pupillary light reflex defect

Answer 1

contralateral lesion in optic tract

Question 2

optic tract lesion

Answer 2

contralateral homonymous hemianopia

Question 3

Meckel’s diverticulum layers

Answer 3

true diverticulum

has all 3 parts of intestinal wall - mucosa, submucosa, muscularis

Question 4

Henoch Schonlein purpura

Answer 4

most common systemic vasculitis in children

3-10

Question 5

HSP pathophys

Answer 5

IgA-antigen immune complex deposition in small vessels and renal mesangium

follows URI

type III hypersensitivity

Question 6

HSP sx

Answer 6

palpable purpura
arthralgia
abdominal pain
renal disease with hematuria

self limited

Question 7

xeroderma pigmentosum

Answer 7

photosensitivity
poikiloderma
hyperpigmentation in sun-exposed areas
sq cell carcionma

AD

defect in nucleotide excision repair
UV-specific endonuclease

Question 8

turner syndrome underlying mechanism

Answer 8

meiotic nondisjunction

Question 9

porcelain gallbladder

Answer 9

due to chronic cholecystitis, multiple gallstones

dystrophic intramural deposition of calcium salts during chronic inflammation

+ risk of gallbladder adenocarcinoma

Question 10

IL-10

Answer 10

anti-inflammatory

inhibit TH1
reduce MHCII
suppress activated macrophages and dendritic cells

protective in Crohn’s

Question 11

pregnant women with HIV

Answer 11

2 NRTIs

+ 3rd drug (protease inhibitor, NNRTIs, integrase inhibitors)

Question 12

asplenic sepsis

Answer 12

impairment of systemic bacterial clearance

Question 13

primary M tuberculosis infection

Answer 13

Ghon complex = lower lobe lung lesion + ipsi hilar adenopathy/calcified node

Question 14

secondary M tuberculosis infection

Answer 14

apical cavitary lesion

Question 15

diabetic microvascular complications - what builds up?

Answer 15

sorbitol

increases osmotic pressure –> influx of water

Question 16

vWF labs

Answer 16

prolonged PTT, bleeding time
normal PT, TT

most common inherited bleeding disorder
AD

Question 17

prolonged PTT

Answer 17

defect in intrinsic pathway

Question 18

bleeding time

Answer 18

test platelet function

Question 19

sickness after drinking alcohol - drug?

Answer 19

metronidazole

Question 20

ulnar neuropathy

Answer 20

injured at hook of hamate (guyon’s canal)

sensory loss, weakness in wrist, finger, flexion of 4th-5th digits
flattened hypothenar eminence

Question 21

G6PD deficiency

Answer 21

Pentose phosphate pathway

x-linked R

hemolytic anemia after tx sulfonamids, antimalarials, infections

heinz bodies

Question 22

primary hyperaldosteronism tx

Answer 22

spironolactone

eplerenone

Question 23

hypocalcemia after blood transfusion

Answer 23

chelation with citrate anticoagulant

also can lead to hypomagnesemia

paresthesias

Question 24

hypercalcemia sx

Answer 24

weakness, constipation, confusion, polyuria/dipsia

Question 25

hypercalcemia in other diseases

Answer 25

granulomatous diseases = sarcoidosis, tuberculosis PTH independent conversion to active calcitriol also seen in hodgkin & some non-hodgkin lymphomas

Question 26

hydrocephalus complications

Answer 26

``` macrocephaly poor feeding muscle hypertonicity hyperreflexia (UMN injury) ``` seizures developmental delays

Question 27

healthy excess copper removal

Answer 27

hepatic excretion into bile --> stool ceruloplasmin is 90-95% circulating copper

Question 28

wolf-parkinson white syndrome ECG

Answer 28

short PR widened QRS slurred/broad upstroke up QRS (delta wave)

Question 29

WPW cause

Answer 29

AV accessory pathway that bypasses AV noce to cause early excitation of ventricles

Question 30

superficial inguinal lymph nodes

Answer 30

cutaneous lymph from umbilicus down anus below dentate line except glans penis and posterior calf = deep inguinal

Question 31

stress incontinence etiology

Answer 31

++ intraabdominal pressure after pregnancy

Question 32

urge incontinence etiology

Answer 32

detrusor overactivity

Question 33

spherocytes

Answer 33

slightly smaller than RBCs more densely hemoglobinized at periphery lack zone of central pallor

Question 34

hereditary spherocytosis

Answer 34

AD hemolytic anemia RBC membrane defect splenomegaly jaundice

Question 35

restless leg syndrome tsx

Answer 35

dopamine agonists

Question 36

INH ADR

Answer 36

hepatotoxicity hepatitis (fever, anorexia, nausea) peripheral neuropathy unless admin with pyridoxine

Question 37

oppositional defiant disorder vs conduct disorder

Answer 37

conduct disorder is worse

Question 38

bloom syndrome

Answer 38

AR mut BLM gene = DNA helicase growth retardation, facial anomalies, photosensitive rash, immunodeficiency

Question 39

afferent carotid sinus innervation

Answer 39

glossopharyngeal

Question 40

efferent carotid sinus innervation

Answer 40

vagus also afferent aortic arch baroreceptors

Question 41

estrogen activity --> thyroid hormones

Answer 41

increase total T4 pool via increased TBG

Question 42

esophageal SCC pt

Answer 42

men >50 smoking alcohol solid food dysphagia weight loss

Question 43

esophageal SCC histology

Answer 43

solid nests of neoplastic squamous cells abundant eosinophilic cytoplasm distinct borders keratinization intercellular bridges