UWORLD random 3/19a

Question 1

polyhydramnios cause

Answer 1

impaired fetal swallowing
- GI obstruction, anencephaly

increased fetal urination
- high cardiac output (anemia, parvovirus, hemorrhage)

Question 2

prenatal anti-epileptic use

Answer 2

++ fetal neural tube defects like anencephaly

Question 3

acute rheumatic fever

Answer 3

sydenham chorea
pancarditis (mitral regurg)
migratory arthritis

mitral stenosis

Question 4

___ supplementation bypasses folate deficiency

Answer 4

thymidine

Question 5

sickle cell mutation

Answer 5

glu –> val at position 6

GAA–>GTA
GAG–> GTG

Question 6

PKU inheritance

Answer 6

AR

Question 7

pentose phosphate pathway

oxidative vs nonoxidative

Answer 7

reversible

ribulose 5 phosphate

non-reversible

Question 8

NRTI inhibits ___ in viral genome replication

Answer 8

3’-5’ phosphodiester bond formation

Question 9

refractory severe asthma tx

Answer 9

anti-IgE antibodies

omalizumab

Question 10

highest urine osmolarity in setting of low ADH - where in nephron?

Answer 10

bottom of loop of henle

Question 11

___ down regulate gastric acid secretion

Answer 11

intestinal influences

after a meal

Question 12

nitroprusside infusion ADR

Answer 12

cyanide toxicity = confusion, lethargy, altered mental status, seizures, CV collapse, lactice acidosis, bright red venous blood

Question 13

cyanide tox tx

Answer 13

direct binding of cyanide ions (hydroxocobalamin), induce methemoglobinemia (sodium nitrite), dexotifying sulfur donors (sodium thiosulfate)

Question 14

immunoflorescence of PSGN

Answer 14

granular
deposits of IgG, IgM, C3

starry sky

Question 15

EM of PSGN

Answer 15

subepi humps = antigen-antibody complexes

Question 16

RANK-L

Answer 16

stimulate mature multinucleated osteoclasts

increase osteoclast activity

blocked by osteoprotegerin (via estrogen)

Question 17

ADHD tx

Answer 17

increase release of NE/dopa, block NE/dopa reuptake

Question 18

internal hemorrhoids blood supply

Answer 18

mid/superior rectal veins

internal iliac and inferior mesenteric veins

Question 19

external hemorrhoids blood supply

Answer 19

inferior rectal vein
internal pudendal
internal iliac

Question 20

bite cells

Answer 20

G6PD

Question 21

cancer tx + oliguria

Answer 21

tumor lysis syndrome

Question 22

uric acid crystals in kidneys

Answer 22

precipitates in acidic environment

distal tubules, collecting ducts = low pH

Question 23

thrombotic thrombocytopenic purpura sx

Answer 23

neuro sx (sensory loss due to lacunar stroke), anemia with schistocytes, thrombocytopenia, AKI

Question 24

TTP cause

Answer 24

deficiency of ADAMTS13 (vWF cleaving protease)

diffuse microvascular thrombosis

Question 25

rifampin ADR

Answer 25

GI, red orange body fluids, rash

Question 26

isoniazid ADR

Answer 26

neurotox, hepatotox

Question 27

pyrazinamide ADR

Answer 27

hepatotox, hyperuricemia

Question 28

ethambutol tox

Answer 28

optic neuropathy

Question 29

Listeria elimination from body depends on…

Answer 29

cell-mediated immunity

intracellular

neonates up to 3mo are vulnerable

Question 30

intracellular bacteria

Answer 30

chlamydia
legionella
listeria
mycobacterium
neisseria
nocardia
rickettsia
salmonella typhi

Question 31

intracellular fungi

Answer 31

cryptococcus
histoplasma
pneumocystis

Question 32

intracellular protozoa

Answer 32

plasmodia

toxoplasma

Question 33

COPD lung fxn tests

Answer 33

+ RV
TLC
RV/TLC

• FEV1
  FVC
  FEV1/FVC

Question 34

carcinoid syndrome tx

Answer 34

octreotide

analog of stomatostatin

Question 35

portavacal anastamoses

Answer 35

esophageal varices
l gastric –> esophageal

hemorrhoids sup rectal –> mid/inf rectal

caput madusae paraumb –> sup/inf epigastric

Question 36

muscles used when sitting up from supine

Answer 36

external ab obliques
rectus abdominis
hip flexors

** iliopsoas = psoas major, minor & iliacus

Question 37

enlargement of gastric folds

Answer 37

zollinger-ellison

gastrinoma with parietal cell hyperplasia

Question 38

uncal herniation sx

Answer 38

ipsi fixed and dilated pupil

ipsi paralysis of oculomotor muscles

contra/ipsi hemiparesis

contra homonymous hemianopsia with macular sparing

Question 39

uncal herniation

Answer 39

medial temproal lobe herniates through gap between crus cerebri and tentorium