USMLE Concepts

Question 1

Classic strong risk factor for developing infective endocarditis?

Answer 1

Indwelling cath (eg, pt in ICU with central line, Foley)

Question 2

30M p/w prodrome of cough, fever, post-tussive emesis, CXR normal. Rx?

Answer 2

Azithromycin for atypical PNA

Question 3

Child s/p Varicella Zoster IG due to exposure, after 10d p/w multi-joint pain, skin rash, etc. Dx?

Answer 3

Serum sickness (classically presents with fever, rash, polyarthritis or polyarthralgias)

Question 4

Ex-military back from deployment for routine exam, last PPD non-reactive 1 yr ago, no sxs atm, PPD 15 mm induration at visit? MANS?

Answer 4

Isoniazid tx for latent TB

Question 5

HIV+ male started on emtricitabine-tenofovir-efavirenz, otherwise nl, labs show low serum HCO3, UA with +1 glucose, no protein, no infection. Cause?

Answer 5

General failure of proximal tubule to reabsorb

Question 6

19F with positive Chlamydia, no NG. Complication pt may develop?

Answer 6

Ectopic pregnancy

Question 7

Young female with vaginitis (pH 4.5), taking minocycline, sexually active, inconsistent condoms, takes OCP. What predisposed to infection?

Answer 7

OCP use

Question 8

Male with acute epididymitis. What predisposed?

Answer 8

Sexual activity

Question 9

Old male p/w watery diarrhea, finished prostatitis abx course 6 wks ago. Cause of diarrhea?

Answer 9

Toxin-mediated epithelial injury

Question 10

Military female, rural Mexico trip, had nonbloody diarrhea/gas unresolved after taking cipro. Dx?

Answer 10

Giardia

Question 11

Neonate with SMN1 gene mutation, other physical exam findings?

Answer 11

Tongue fasciculations (LMN lesions)

Question 12

African-immigrant female with hoarseness x2 yr, smooth lobulated mass palpable on anterior neck, breathing difficult, VSS, CXR nl. Cause?

Answer 12

Invasion of recurrent laryngeal nerve

Question 13

20F presenting after rape 3 days ago, best mgmt for pregnancy prevention?

Answer 13

Oral levonorgestrel (emergency contraception)

Question 14

Infant getting tx with topical benzocaine c/o blue-ish discoloration of face, trunk, limbs. Mechanism?

Answer 14

Methemoglobinemia 2/2 decreased cytochrome B5-reductase enzyme (Dapsone, -caines, anti-malarials, nitroglycerin, TMP-SMX, reglan, isosorbide, ciproflox)

Question 15

How to check HIV in infant born to HIV+ mom?

Answer 15

HIV DNA PCR

Question 16

Male p/w dry cough, inc SOB x1 yr, hemoptysis, 5 kg weihgt loss in 6 mo, lower appetite. Hx sandblasting and smoking, cachectic and wheezing? Best dx test?

Answer 16

High resolution CT chest

Question 17

Anterior cleft palate. Defect in what caused?

Answer 17

Failed fusion of lateral palatine shelves (palate)
Failed fusion of maxillary and merged medial nasal process (lip)

Question 18

22M p/w SOB with sports, flow-volume loop before/after albuterol looks like?

Answer 18

Question 19

Lipid screen guidelines if high risk?

Answer 19

30-35 in females, 25-30 in males if high risk (HTN, DM, FamHx)

Question 20

40M has controlled HTN and lipid profile shows

250 total chol

160 LDL

54 HDL

450 trigs

Answer 20

Increased risk MI 2/2 elevated TG

Question 21

Graves dz treatment in 1st trimester pregnancy?

Answer 21

PTU

Question 22

Elderly male p/w chronic hip pain, also with HA and hearing loss, XR radiolucency and irregular radiopaque grossly deformed hip, labs show?

Answer 22

Elevated alk phos

Question 23

Tx for BPPV?

Answer 23

Repositioning