UW 3

Question 1

von Hippel- Lindau sd (5)

Answer 1

Autosomal dominant
Hemangioblastoma (high vacularity) in retina, brain stem, cerebellum, spine
Angiomatosis: eg. cavernous hemagiomas in skin, mucosa organs
Bilateral renal cell carcinoma
Pheochromocytoma

Question 2

Migraines tx in pregnancy

Answer 2

0. Rest, dark room, heat
1. Acetaminphen
2. add low potency opiod (codeine or antiemetic)
3. NSAIDs (second trimester only)
4. High potency oioid (oxycodone)

Question 3

Todler’s fracture

Answer 3

Spiral fracture of the distal tibia
twisting injury from low impact fall
Common in walking children <3
If child is not walking, think abuse if other sings are present

Question 4

Characteristics of urate crystals on joint aspiration

Answer 4

Needle shaped
Negatively birefringent (yellow when rays are parallel, blue when perpendicular)

Question 5

Calcium pyrophosphate dihydrate depositon

Answer 5

Psuedogout

romboid shaped
Weakly positivele birefringent

Question 6

B-hCG funtions in pregnancy (3)

Answer 6

Maintenance of the corpus luteum
Promotion of male sexual differentiation
Stimulation of maternal thyroid gland

Question 7

Nephrotic sd associated with:

a. Heb B infection
b. HIV

Answer 7

a. Membranous nephritis

b. FSGN

Question 8

Most common nephroritc sd in children

Answer 8

Minimal change (preadolescent)

Question 9

Labs of sideroblastic anemia

Answer 9

Microcytic anemia

High iron levels, Low TIBC

Question 10

Causes of sideroblastic anemia (6)

Labs

Answer 10

Defect in heme synthesis

Alcohol (most common)
Lead, zinc copper poisoning
Isoniazid, Pirazinamida, chloramphenicol
B6 deficiency
Malignancy

Increased iron, normal or low TIBC, basophilic stippling

Prussian blue: ring sideroblast is diagnostic

Question 11

HPV vaccine

Answer 11

<15yoa: 2 dosis
>15 yoa: 3 dosis

Start at 11-12 years administer 6 months apart

Question 12

Lynch Sd.

Answer 12

Colon cancer
Encometrial cancer
Ovarian Cancer

Question 13

Familial adenomatous polyposis

Othe associated tumors

Answer 13

Colorectal cancer
Desmoids and osteomas
Brain tumors

Question 14

Acute liver failure definition

Labs

Answer 14

Acute liver injury without previous liver disease

Elevated LFTs >1000
Synthetic liver dysfuntion (prolong PT with INR >1.5)
Hepatic encephalopathy

Increase in creatinine

Tx: liver transplant needs to be considered

Question 15

Labs suggesting the need of liver transplant

Answer 15

Hepatic encephalopathy III or IV
PT >100
Creatine >3.5

Question 16

Leukoplakia

Answer 16

White lession on mucosa
Biopsy
If new symptoms/changes occur, biobsy again even if previous was negative.
Risk of malignant transformation

Question 17

Osteoporosis screening

Answer 17

All women >65 or <65 with risk factor

one time dexa scan

Question 18

Lung cancer screening

Answer 18

Anual low dose CT:

> 30 pack-year smoking hx
Currently smocking or quit <15years ago

55-80years of age

Question 19

Osteoporosis risk factors (15)

Answer 19

Non-Modifiable:
advanced age, postmenopausal, low body weight, Asian or white ethnicity, hyperthyroidism, hyperparathyroidism, hypercortisolism

Modifiable: smoking, sedentary lifestyle, alcohol intake (low calcium, low vitamin D, glucocorticoids, anticonvulsants, estrogen deficiency

Question 20

Endometrial thickness that increases risk of cancer

Answer 20

> 4mm