Uworld Flashcards
1
Q
Fixed false belief against cultural norm
A
Delusion (grandiose; increased self importance) 4195
2
Q
Pain in groin radiates to upper thigh
A
Osteoarthritis of hip 4564
3
Q
Forceful abduction and external rotation of arm, nerve injury?
A
anterior shoulder dislocation (block bball shot), axillary nerve injury (deltoid, teres minor and lateral UE sensation) 4604
4
Q
Newborn cyanosis aggrevated by feeding, relieved by crying
A
Choanal atresia 3872
5
Q
Painless hematochezia
A
Meckel’s diverticulum 4838
6
Q
Pregnancy hypertension
A
> 140 / >90
Before 20 wks - chronic hypertension
After 20 wks w/o end organ damage or proteinuria - gestational HTN
After 20 w/ end organ - preeclampsia
7
Q
hypertension in pregnancy risks
A
superimposed preeclampsia, placental abruption, FGR, preterm labor, stillbirth
8
Q
Normal skin at birth, gradual progression to dry scaly skin over extensor surfaces
A
Ichthyosis Vulgaris 2754
9
Q
Sickle cell disease: Severe anemia Low retic count and no splenomegaly
A
Aplastic crisis (due to parvo B19 likely) 3838
10
Q
Screening and confirmatory tests for lead
A
Capillary (screening), Venous (confirmatory) 4837
11
Q
Hypertrophic cardiomyopathy maneuver worsening murmur?
A
Valsalva, abrupt standing and Nitro (all decrease preload)
Murmur is due to decreased LVOT 2691
12
Q
Supp O2, COPD increase or decrease pCO2? How?
A
Increase, more v/q mismatch leading to more dead space, increase haldane effect, decrease respiratory drive
4718
13
Q
Hip pain with chronic steriod use dx and imaging of choice
A
Avascular necrosis (osteonecrosis) Xray typically normal, MRI better: 4565
14
Q
Antihypertensive causing insulin resistence
A
Thiazide diuretic 4171
15
Q
type 2 diabetic, AMS/polyuria/volume depletion
A
Hyperosmolar hyperglycemic state (HHS) (no ketosis)
4289
16
Q
Sensation innervation to cornea
A
Trigeminal nerve (CN V1) 4461
17
Q
Addison disease metabolic abnormalities
A
Primary adrenal insufficiency (decrease Mineralcortioid): Hyponatremia (Most Common) Hypokalemia Hypercholermic acidosis (less common) 4420
18
Q
upper gi bleed bun/cr ratio?
A
elevated, lower GI bleed not. 4303
19
Q
CP most common risk factor
A
Prematurity 2443
20
Q
Treatment of histoplasmosis
A
Itraconazole 4939
21
Q
Aspirin intoxication acid/base disorder
A
Mixed respiratory alkalosis (increase resp drive) and AG metabolic acidosis 2820
22
Q
Bipolar with euvolemic hyponatremia
A
Diabetes insipidus (taking lithium) 4425
23
Q
Cysts in liver of person from mexico, job? Bug?
A
Sheep breeder, echinococcus granulosis (tapeworm) 3789
24
Q
Child, fever, cough, conjunctivitis, rash, lesions in mouth
A
Measles (Cough, Coryza, Koplik spots, conjunctivitis) 2431
25
Tourette syndrome comorbidities
ADHD (60%), OCD (27%) 3760
26
Types of HIT
Type 1: 50% drop in 5-10 days, antibody mediated platelet activation 4316
27
young person, immobile mass on midline of hard palate
Torus palatinus, congenital defect 3427
28
thyroid nodule with increase uptake only in nodule, elevated T4/T3
Toxic adenoma 4318
29
vertigo 20 min to 24 hours, ear fullnuss, tinnitus, disease and 1st line treatment
Meniere's disease, salt restriction 4376
30
Hypercalcemia in pt after car accident weeks later. Cause?
Immobilization: increased osteoclast activity 4309
31
most common predisposing factor for bacterial sinusitis
Upper respiratory viral infection 4850
32
Skin cancer of lower lip
Most common: Squamous cell 4319
33
Pt with dilated colon (with haustral markings), bloody diarrhea
Toxic megacolon 3834
34
STD screening for anyone 15-65?
HIV (p24 antigen and antibody testing) 10301
35
Sexually active, polyarticular arthyralgias (without vaginal discharge or other symptoms)
Gonococcal infection 3153
36
fever, arthralgias, uticarial rash after treated strep pharyngitis
Serum sickness 4584
37
teenager with nasal mass and epistaxis
angiofibroma 2640
38
rheumatoid arthirits predisposition for which nephrotic syndrome?
Amyloidosis 3997
39
Contraindication for use of succinylcholine (Metabolic abnormality)
Hyperkalemia 4428
40
Painless third trimester bleeding? 2 kinds
Placental and Vasa previa 2533
41
Concrete worker with knee pain
Prepatellar bursitis 11976
42
Chronic steroid abrupt stop, low or high ACTH, Cortisol, aldosterone
Low acth, low cortisol and normal aldosterone 4325
43
What other disorder can be confused with menopause?
Hyperthyroidism 4136
44
Most common cause of anemia of preterm infants? Reason?
Anemia of prematurity, decreased EPO. 3774
45
Kid with elevated HVA/VMA in urine. What kind of cancer, arise from what kind of cell?
Neuroblastoma, neural crest cells 3824
46
Infection of submandibular/sublingual glands?
Ludwigs Angina 3530
47
Myocardial profusion scans, dipyrimidole and adenosine do what?
Vasodilate coronary arteries: coronary steal if CAD is present 4054
48
Antibiotics for immunocompromised bacterial meningitis? Bugs?
Vancomycin, Cefepime, Ampicillin. 3245
49
Treatment for narcolepsy? Class?
Modafinil, stimulant
50
Complications of placental aburption
DIC and hypovolemic shock 2528
51
Bird breeder with dry cough, fever, malaise. Disease? Treatment?
Hypersensitive Pneumonitis. Avoid antigen (birds) 3016
52
Pneumonia with leukocytosis with mainly lymphocytes and lymphadenopathy, test for diagnosis
CLL, Flow cytometry 2887
53
SIADH, treatment if can't treat underlying cause
Fluid restriction 2636
54
Indications for steroid use with PCP infection
PaO2 35 (3938)
55
Neurological features, self mutilation, gout in kid (dx and mechanism)
Lesch nyhan, HGPT deficency 3817
56
Heart failure in 35 yo with history of megacolon
Chaga's disease (trypanosoma cruzi, protazoa) 3065
57
Bullae and skin redness after starting anticoagulation
Warfarin induced skin necrosis 2772
58
Reccurent cutaneous abscess and pulmonary abscess that grow staph, aspergillus, serratia, burkholderia. Disease, diagnostic tests?
Chronic granulomatous Disease (all organisms catalase positive). Nitroblue tetrazolium test or Dihydrorhodamine 123 test 4495
59
Acute monoarticular arthitis with chondrocalcinosis on Xray. Diagnosis of joint? Condition associated with that?
CPPD cyrstal deposition (pseudogout). Herediatary hemochromatosis. 2880
60
Infant, failure to thrive, poor feeding, bilateral cateracts, jaundice, hypoglycemia. Disease and mechanism?
Galactosemia, galactose-1-phosphate uridyl transferase deficiency 3193
61
Polyarticular arthritis, symmetrical. Non-specific rash. Around kids
Parvo B19 3172
62
Hypopigmented patch of skin, decreased sensation. Muscle atrophy. Dx?
Mycobacterium leprae 3425
63
Most common cause of sudden cardiac arrest immediately post infarction
Re-entrant ventricular tachycardia
| 4093
64
Manic episode, no history of depression. Dx?
Bipolar I 2510
65
Patient with suspected PE, next 3 steps.
1. Stabilize (O2/fluids) 2.Anticoagulation (without contraindications) 3.Diagnostic test (CTA) 3717
66
Minor trauma, erythema, swelling, Pain out of proportion, fever/hypotension, crepitus
Nec fasc 2749
67
Fetus no movements felt and no pulses found on doppler, next steps
Ultrasound (absence of fetal movement and no cardiac activity = IUFD), Autopsy fetal parts and placenta 4775 and 4776
68
Carpopedal spasms in patient with PE. Reason?
Increase of pH due to respiratory alkalosis causing increase of calcium bound to albumin (more H+ ions disociate from albumin) causing decreased levels of ionized Ca+2 (3099)
69
Illicit drug cauing vertical nystagmus? Other clinical finding? Treatment for severe findings?
PCP, also causes disociative feelings, pyschosis, agitation, severe hypertension, hyperthermia. Benzos treat 2653
70
Pelvic pain exacerbated by exercise
Endometriosis 2546
71
Fragile X, genetic lesion?
Triplet repeat of CGG on FMR1 gene 2441
72
Joint fluid of osteoarthritis? Xray findings
Appearance: Clear, WBC: 200-2000, PMNs: 25%, Gram stain: negative. Xray: Narrowing of joint space, osteophytes 3148
73
Ventilator control. What controls oxygenation (PaO2) and what controls PaCO2?
PaO2: FiO2 and PEEP (adjust FiO2 first)
PaCO2: Pulmonary minute ventilation (RR and TV)
4536
74
Rapidly progressive dementia and myoclonus
Creutzfeldt-Jakob disease 2990
75
APGAR, score for resuscitation?
Appearance, Pulse (100), Grimace, Activity/tone, respiratory effort
76
Next step. Pt with hypogonadism, gynecomastia, low testosterone, normal FSH/LH
Prolactin level then MRI if elevated
| 3595
77
Palpable purpura, hematuria, abdominal pain. Pathogenesis
Henoch - Schonlein purpura. IgA mediatied leukocytoclastic vasculitis
3554
78
Acromegaly, test of choice
IGF-1
| 4323
79
Adduction of anterior foot, convex lateral border, concave medial border. Active and passive movement overcorrect into abduction. Dx? Tx?
Dx: Metatarsus Abductus
Tx: Reassurance (if motion can't correct then orthosis or casts)
3684
80
Chronic analgesic abuse, most common kind of nephropathy?
Chronic tubulointersitial nephritis and papillary necrosis
| 4007
81
Schizoaffective vs Mood with psychosis
Schizoaffective: periods of hallucination without mood symptoms. Mood symptoms are majority of illness
3376
82
Test to monitor DKA (two)
Beta hydroxybutaryate and Anion Gap
| 2189
83
3 screening tests for all prenatal pregnant women
HIV, Syphillis, hep B
| 4530
84
difference between benzo and alcohol/phenytoin overdose
Benzo does not have nystagmus
| 2664
85
Fetal risk in preeclampsia
fetal growth restriction (small for gestational age, oligohydramnios) due to chronic placental insufficiency
12064
86
Boy 4-10 with hip/knee pain, with antalgic gait
Legg-Calve-Perthes disease (osteonecrosis of femoral head)
| 3404
87
Herniated disc with BPH. Urinary retention without saddle anasthesia and anal sphincter intact. Why retention?
Inability to valsalva due to pain (BPH requires him to valsalva to urinate)
4615
88
Tests for primary adrenal insuffiency (two step)
Plasma 8am cortisol levels and ACTH stimulation test (cosyntropin)
2174
89
Bulging fontenelle, seizures, focal neuro signs, hypotension, bradycardia in an infant (specifically premee)
Intraventricular hemorrhage
| 3657
90
Most likely cause for a non reactive nonstress test?
Fetal sleep cycle
| 12017
91
First line treatment for chronic stable angina (med)
beta blocker
| 4127
92
Pelvic pain with bladder filling and relieved by voiding. Also dysparuenia/urinary frequency/urgency are present
Intersitial cystitis
| 4807
93
Prone to infection with lytic bone lesions
```
Multiple Myeloma (plasma cell discryasia)
4466
```
94
Nodular infiltration with cavitation in lung in person with HIV positive and IVDU
Tricuspid infective endocarditis causing septic emboli to lung (Staph Aureus)
4388
95
Kid falls with toothbrush in mouth, stroke symptoms
Carotid artery dissection 4117
96
INcrease sinopulmonary and gastrointestinal infection. Whats the problem?
X-linked agammaglobinemia --> abnormal b-cell maturation
| 2134
97
Pulmonary edema, would oxygen reverse hypoxemia? lung compliance high, normal or low? A-a gradient high or normal?
Yes, low, high
| 2303
98
Patient with headache, blurry vision, occasional falls. Vision gets worse when leaning forward. Dx?
Intracranial hypertension
| 4708
99
Laxity in knee when forced abduction
MCL tear (Valgus stress test) 3569
100
Triad of symptoms for arterial occulsion in bifurcation of aorta into the common iliacs
Bilateral hip, thigh and buttock claudication
Impotence
Symmetric atrophy of bilateral lower extremities
4508
101
```
Definitions for:
Threatened abortion
Incomplete abortion
Complete abortion
Inevitable abortion
```
Threatened: hemmorhage before 20 wks of live fetus, cervix closed, no fetal passage
Incomplete: Evacuation of some fetal tissue, cervix open
Complete: Whole fetus passes, cervix closes
Inevitable: Bleeding, open cervix. Dead fetus
4804
102
Threatend abortion management?
Reassurance 4805
103
Untreated hyperthyroid, long term consequences?
Osteoporosis - (increased osteoclast activity)
Cardiac tachyarrythymias
4307
104
Side effects of tamoxifen
Hot flashes, VTE, endometrial hyperplasia
| 2606
105
Definition and first step in primary amenorrhea workup
Absence menarche by 15 years old. Pelvic ultrasound 9566
106
Pt with chronic renal failure with dx of PE. WHat kind of anticoagulation to use?
Unfractionated heparin bridging to warfarin (easy to monitor both)
4629
107
Treatment for cancer related anorexia/cachexia syndrome
Progesterone analogue or steroids
| 2546
108
Infant normal at birth, gradual apathy, hypotonia, large tongue, sluggish movements, abdominal bloating, umbilical hernia, dx?
Congenital hypothyroidism
| 3662
109
Short term managment in severe hypercalcemia
Normal saline hydration
| 2633
110
Progessive dyspnea on exertion, nocturnal cough, occasional hempotysis with acute a fib symptoms
```
Mitral stenosis (due to rheumatic fever likely)
2701
```
111
Step wise treatment of ascites (4 steps)
1. Salt and water restriction
2. Spironolactone
3. Loop diuretic (
112
Steps in treating DKA (4 steps)
1. NS to replete intravascular volume
2. Regular insulin (human) to reverse hyperglycemia
3. Correct electrolyte abnormalities (especially K)
4. Treat underlying cause (abx for infection)
2184
113
Most common site for ulnar nerve impingment
Elbow at medial epicondylar groove
| 4170
114
Psychosis, tachycardia, agitation, combativeness, lasting several days
Bath salts intoxication
| 11815
115
Uncal herniation, most likely cranial nerve compromised
Oculomotor (III)
| 4552
116
Kid, head injury, loss of consciousness initially then had period of lucidity with progressive symptoms after that
Epidural hematoma
| 3297
117
Blunt trauma to abdomen in kid --> duodenal hematoma. Tx?
NG suction and parenteral nutrition
| 3851
118
Seizure with are adducted and internally rotated
Posterior shoulder dislocation
| 2372
119
Management of caustic ingestion (after securing airway)
Upper GI Endoscopy
| 2377
120
Signs of TCA overdose and antidote
Widened QRS, anticolinergics effects. Sodium bicarb for cardiotoxicity
4035
121
Acute, unilateral lymphadenitis in kid. Bugs
Staph aureus/strep pyogenes
122
HIV patient with subacute fever, headache, increased ICP
Cryptococcus meningitis 9885
123
Young, obese woman with headache and vision changes and pulsatile tinnitus. MRI shows empty sella. Next step for diagnosis and what is dx?
LP with opening pressure. Idiopathic intracranial hypertension
3162
124
Nocardia treatment
Tmp/smx
| 4417
125
Recurrent oral and genital ulcers. Die by thrombosis
Behcet syndrome
| 3815
126
Anal fissure treatment
Topical lidocaine and nifedipine (vasodilator)
| 4111
127
Diagnostic requirements for acute liver failure (3)
Severe acute liver injury (high ALT and AST)
Signs of hepatic encephalopathy
Synthetic liver dysfunction (INR >1.5)
2900
128
Treatment of Myasthenic Crisis
Plasmapheresis or IVIG and corticosteroids
| 3727
129
Subluxation of radial head treatment
(Nursemaids elbow) closed reduction, Hyperpronate arm
| 3416
130
Other term for disease with cirrhosis, neuropsych symptoms, green brown deposits in eye
```
Hepatolenticular degeneration (Wilson's disease)
2895
```
131
Knee pain, X-ray expansile and eccentrically placed lytic lesions in epiphysis of distal femur
Giant cell tumor
| 2618
132
Giant Cell Arteritis complications
Aortic dissection, blindness
| 4460
133
Kallman syndrome karyotype
46 XX or 46 XY
| 3912
134
Bedwetting is normal before age ___
5
| 2433
135
Abnormal BPP and why
4 or less, fetal hypoxia, placental dysfunction
| 9985
136
Absence Seizures comorbidities
ADHD, anxiety
| 2279
137
Absolute Contraindications for combined hormonal contraception
```
Migraine with aura
Cigarettes
Age >35
Htn
VTE
Stroke/heart disease
Breast cancer
Cirrhosis
Surgery
```
138
Nitrates predominant mechanism for pain relief
Decrease preload
| 3945
139
Most common nephrotic syndrome associated with carcinoma. And then with hodgkin lymphoma
Membranous nephropathy
Minimal change disease
3966
140
Triad for wiskott aldrich syndrome and cellular defect?
Eczema, Microthrombocytopenia, recurrent infections
Cytoskeleton defect
4847
141
Cryoglobinemia most common cause
Hep C
| 2958
142
Multiple small bowel ulcers recurrent. Test of choice
Serum gastrin concentration (gastrinoma)
| 3591
143
Older child intussupception, cause?
Meckel's
| 2463
144
Recurrent and migratory superficial thrombophlebitis (Trousseau's syndrome) Associated with what?
Occult visceral malignancy
| 2624
145
Nail puncture wound causing osteomyelitis. organism
Psuedomonas Aeruginosa
| 4257
146
Hereditary Spherocytosis test
Acidfied glycerol lysis test
eosin-5-maleimide binding test
2870
147
Common side effect of trastuzumab (HER2 positive breast cancer)
Cardiac toxicity
| 2608
148
Bronchiolitis complications in infant
Apnea
| 3553
149
Pulmonary complication of systemic sclerosis
interstitial fibrosis
| 4014
150
Chronic diarrhea in AIDS patient with CD4
Cryptosporidium
| 3590
151
Recommendations for screening for bladder cancer?
Don't
| 4502
152
Fever, jaundice, RUQ pain
| Sign on ct scan?
```
CBD dilation (acute cholangitis)
2978
```
153
Kidney stones, hexagonal crystals, hereditary.
Cystinuria, defect in amino acid transporter
154
Ipsilateral facial pain/temp loss, contralateral trunk/extremeties. vestibulocerebellar weakness, horner's syndreom. where is stroke?
Lateral medullary infarct
| 4269
155
Treatemtent of choice for hairy cell leukemia
Cladribine
| 2893
156
Post traumatic, weakness and sensory loss in cape like distribution, with preserved vibration and light touch
Syringomyelia
| 4698
157
Osteophyte formation in DIP and PIP joints
OA
| 11923
158
Knee pain in adolescent male athlete. What is mechanism?
Traction apophysitis of tibial tubercle
(Osgood-Schlatter disease)
4849
159
Adolescent with nephrotic syndrome and hepatitis b
Membranous nephropathy
160
Tuberculosis causing endocrine disorder
Primary adrenal insufficiency
| 2817
161
Hiv patient, altered mental status, ring enhancing lesion, ebv dna in csf
Primary cns lymphoma
162
Tuberculosis causing endocrine disorder
Primary adrenal insufficiency
| 2817
163
Abdominal pain with hip extension
"Psoas sign", psoas abscess
164
Pt with nephrotic syndrome now with gross hematuria and abd pain.
Renal vein thrombosis from loss of anti thrombin III, more commonly in membranous glomerulopathy
2243
165
Start warfarin get skin necrosis, what is deficient?
Hereditary protein c deficiency 2658
