UWorld_6.21

Question 1

Bath salts presentation

Answer 1

• bath salts = amphetamine
• severe agitation, combativeness. delirium
• tachycardia, elevated BP, myoclonus
• prolonged duration (can last several days)

Question 2

Pseudocyesis presentation

Answer 2

• psych d/o
• woman who desires pregnancy presents w/typical sx of pregnancy
• p/w weight gain, morning sickness, amennorrhea, + preg. test @ home
• in office: preg. test -, normal endometrial stripe

Question 3

Medulloblastoma common location

Answer 3

posterior fossa ==> ataxia + obstructive hydrocephalus sx

Question 4

Non-pharm interventions for new HTN

Answer 4

(from most to least impact)

1. weight loss if obese
2. DASH
3. exercise
4. decrease dietary sodium
5. decrease alcohol

Question 5

Physical exam in pyloric stenosis

Answer 5

• signs of dehydration

- “olive-shaped” mass in

Question 6

Most common cause of afib

Answer 6

ectopic foci w/in pulmonary veins

Question 7

most common cause of atrial flutter

Answer 7

reentrant circuit around tricuspid annulus

Question 8

PE in adenomyosis

Answer 8

boggy, tender, UNIFORMLY enlarged uterus

Question 9

MEN Type I

Answer 9

• primary hyperparathyroidism
• enteropancreatic tumors
• pituitary tumors

Question 10

MEN Type 2A

Answer 10

• Medullary thyroid
• Pheochromocytoma
• Parathyroid

Question 11

MEN Type 2B

Answer 11

• MTC
• Pheo
• Other: mucosal/intestinal neuroma, marfanoid habitus

Question 12

Tx for patients w/penicillin susceptible endocarditis

Answer 12

IV penicillin G vs. IV ceftriaxone for 4 WEEKS

Question 13

Most common cause of sudden cardiac arrest in setting of MI

Answer 13

reentrant ventricular arrhythmias (e.g. vfib)

Question 14

Risk for Mg toxicity

Answer 14

renal insuffiency

Question 15

Most common pathogen causing PNA in nursing homes

Answer 15

S. pneumo

Question 16

Sensitive vs. Specific

Answer 16

• “Sensitive & Truly Positive”; TP/TP+FN; SnOUT

- “Specifically Negative”; TN/TN+FP; SpIN

Question 17

Pneumococcal vaccine rx in patients age 19-64yo

Answer 17

• healthy patients: no vaccine
• PPSV23 @: chronic heart/lung/liver dz, or DM, smokers, EtoH
• PVC13 + PPSV23 @ high-risk pts: CSF leaks, cochlear implants; sickle cell/asplenia, immunocompromised, CKD

Question 18

Presentation of prolapsing leiomyoma uteri

Answer 18

• dark, red round mass @ cervical os
• labor-like pain
• prolonged/heavy menstrual bleeding

Question 19

Hormonal influences on prolactin production

Answer 19

• stimulated by serotonin & TRH

- inhibited by dopamine

Question 20

Can you remove pt. from ventilator in case of brain death?

Answer 20

yes

Question 21

Clinical manifestations of hemochromatosis

Answer 21

• skin: hyperpigmentation
• MSK: athralgia, arthropathy, chondrocalcinosis
• GI: elevated LFTs/hepatomegaly, cirrhosis, HCC
• Endocrine: DM
• cardiac: cardiomyopathy
• infections: increased susc. to listeria, yersinia

Question 22

Trousseau’s syndrome presentation

Answer 22

• hypercoagulable d/o assoc. w/unexplained superficial venous thrombosis/thrombophlebitis @ arm/chest
• associatied w/occult visceral malignancy e.g. pancreatic, stomach, lung, or prostate carcinoma

Question 23

Actinomyces vs. Nocardia

Answer 23

• actinomyces = branching gram + rod, anaerobic, NO ACID fast staining
• Nocardia = branching gram + rod, aerobic, partially ACID FAST

Question 24

ABG findings in PE

Answer 24

elevate A-a gradient