Rapid Review 2 Uworld/Rx

Question 1

Normacytic anemia and hypercalcemia. Bone biopsy shows the cell type shown. Dx?
What would you find on x-ray?

Answer 1

Add pics FA pg 419

Bone marrow with >30% plasma cells is diagnostic for Multiple Myeloma.
Punched out lytic lesions

Question 2

Stacks of RBC and increased ESR?

Answer 2

Multiple myeloma:

Rouleaux formation

Question 3

What is the pathophysiology behind the lytic bone lesions seen in Multiple Myeloma?

Answer 3

Neoplastic cells secrete IL-1 (osetoclast activating facotr) and IL–6
This leads to bone re-absorption

Question 4

Pregnant woman with nauseo and lightheadedness at bed time. What is the pathophysiology behind her symptoms?

Answer 4

She has supine hypertension syndrome:

Compress IVC–> decrease in venous return–> reduced preload–> decreased cardiac output–> hypertension

Question 5

Impaired ornathine transport requires what type of dietary restriction?

Answer 5

Protein.

Question 6

Treatment for rabies

Answer 6

inactivated vaccine

Question 7

The presence of odynophagia is indication of what ? How does it rule out Barrets?

Answer 7

pain with swolloging indicated an errosive process and ulcer formation. Barrett’s intestinal metaplasia occurs without pain but with dysphagia and weight loss.

Question 8

History of heartburn with acute odynophagia will indicate formation of what?

Answer 8

Ulcer

Question 9

What cells are a product of the immune response against TB?

Answer 9

CD5 Th1 helper cells.

Question 10

Oxidase negative, Non lactose fermenting gram negative rods that forms acid (not oxygen) during glucose fermentation. Ferment glucose without gas production, do not generate hydrogen sulfide when grown on tripple sugar iron agar and can not replicate with refrigeration temperatures.

Answer 10

Shigella. If it produces H2s then Salmonella

Question 11

Initially watery diarrhea that turns bloody.

Answer 11

Shigella

Question 12

E. coli that does not ferment sorbitol or produce glucuronidase. MOA of toxin?

Answer 12

Inactivates ribosomal subunits

Question 13

toxin that leads to increase intracellular cyclic GMP

Answer 13

ETEC (ST) and Yersenia (enerotoxin)–> watery diarrhea and electrolyte loss

Question 14

Toxin that disrups cytototocin via actin depolymerization leading to diarrhea and pseudomembranous colitis

Answer 14

C Diff toxin B

Treat with Metronidazole and Vanco

Question 15

Toxins that lead to increase in intracellular cAMP

Answer 15

1. LT ETEC
2. Bordetella pertussis
   and C. Jejuni enterotoxin

Question 16

Toxin that uses EF-2 via catalyzation of ADB ribosylation

Answer 16

C. Dip–> pseudomembranes

Pseudomonas –> death

Question 17

45 yr old female pt with heavy painful period. Uniformly enlarged uterus and secretory endometrium

Answer 17

Adenomyosis with endometrial tissue into uterine myometrium

Question 18

Hyperplastic growth of endometrial glands and stroma

Answer 18

endometrial polys

Question 19

Young, asymptomatic patient with soft ejection murmur at the right secong intercostal space. What pathology results in this?

Answer 19

Bicuspid Aortic Valve

Question 20

Hypoglycemia after prolonged fasting with inappropriately low ketones

Answer 20

impaired beta oxidation–>Medium Chain FA