UWorld

Question 1

Diagnosis and Treatment of infant with:

1. History of conjuctivitis
2. Persistent cough: series of short dry coughs
3. after nasal congestion for multiple weeks,
4. rales, and hyperinflation on CXR

Answer 1

Chlamydial pneumonia, spread by vaginal contact during delivery

Treat with 14 days of oral erythromycin (watch out for pyloric stenosis)

Question 2

Diagnosis with:

1. Narrow complex tachycardia
2. VFib after treatment with adenosine
3. Delta waves

Answer 2

WPW

Adenosine is correct treatment, but sometimes causes VFib

Question 3

Does a retroverted uterus cause increased risk of abortion

Answer 3

No

Question 4

Laboratory findings in Exogenous hyperthyroidism (taking thyroid hormone)

Answer 4

Low TSH, high T4, Low radioiodine uptake, low thyroglobulin (measure of thyroid inflammation)

Question 5

Type of bias that occurs when using a gold standard selectively to confirm a positive or negative test and result.

Answer 5

Verification bias which causes overestimates of sensitivity

Question 6

Cause of renal failure in patient with chronic back pain and kidney stone with WBC casts and elevated BUN/Cr

Answer 6

Analgesic nephropathy (WBC casts). Unilateral kidney stone does not cause elevated BUN/Cr

Question 7

Diagnosis and what to test for in patient with new onset erythematous plaque with greasy scales an dandruff

Answer 7

Seborrheic dermatitis, need to test for HIV

Question 8

Extraarticular management of Ankylosing Spondylitis

Answer 8

Acute anterior uveitis, aortic regurg, apical pulmonary fibrosis, IgA nephropathy and restrictive lung disease

Question 9

Treatment for person with erythema nodosum and CXR with bilateral hilar fullness but normal lungs

Answer 9

Nothing, asymptomatic pulmonary sarcoid have a high rate of spontaneous remission, just needs follow up

Question 10

Complication which needs to be screened for in patients with Primary Biliary Cirrhosis

Answer 10

Osteoporosis

Question 11

Mechanism to initial approach of symptoms management in Acute decompensated CHF

Answer 11

Lower preload with diuretics and/or vasodilators (nitro), but do not give vasodilator with signs of shock

Question 12

Antibiotics for mamallian bites and what it is covering

Answer 12

Amox/Clav because it covers oral flora (including eikenella)

Question 13

Treatment for photoaging (rough, wrinkles, hyperpigmented facial skin)

Answer 13

Tretinoin

Question 14

Management of goiter causing compression symptoms

Answer 14

Surgery, iodine ablation may make it larger

Question 15

Antibiotic associated with infantil pyloric stenosis

Answer 15

Macrolides (esp erythromycin)

Question 16

Treatment of toxic megacolon

Answer 16

Test for Cdiff (treat if positive) and try medical management with steroids. Avoif ASA compounds and opioids.

Question 17

Diet for acute stroke patients

Answer 17

NPO, especially with dysarthria, until bedside swallow eval can be performed

Question 18

Dose of heparin to give ischemic stroke patients and why

Answer 18

Low dose to prevent DVTs, full dose can cause hemorrhagic transformation

Question 19

Blood pressure parameters for stroke patients

Answer 19

220/120 for non-thrombolytic patients

185/105 for thyombolysis patients

Question 20

Medications to discontinue prior to surgery

Answer 20

Estrogens (including SERMS) increase risk of VTE

ACE inhibitors for non-CHF patients

Diuretics hold the morning of

Question 21

Antibiotics for endometritis

Answer 21

Clinda and gent (metronidazole is contraindicated in breast feeding moms)

Question 22

Steps to stop epistaxis

Answer 22

1. Nostril pinching
2. topical vasoconstrictor
3. Cauterization/nassal packing
4. Surgery

Question 23

Evaluation of breast mass by age

Answer 23

<30 - ultrasound, if something concerning, will get mammogram

>30 mammogram +/- ultrasound

Question 24

Presentation and treatment of alopecia areata

Answer 24

Smooth distinct area of hair loss

treat with intralesional or topical corticosteroids

Question 25

Threshold to treat PCP with steroids

Answer 25

Aa gradient >35 or arterial O2 <70

Question 26

Next step after diagnosis of Multifocal Atrial Tachycardia

Answer 26

MAT is usually seconday to something else, including hypoxia, CPOD< hypokalemia, hpomagnesemia, coronary/valvular disease or medications

First check O2 sats

Question 27

Next step when patient has bilateral or right varicocele, or one that does not disappear in the supine position

Answer 27

CT abdomen to rule out process that is obstructing the IVC