Uworld Exam 8

Question 1

What does this picture show? In what disease, do you famously see this?

Answer 1

Reactive CD8 T cell Lymphocytes; EBV

Question 2

MIF Inhibits?

Answer 2

Female Internal Structures: Tubes Uterus Cervix, 1/3 of vagina

Question 3

How do you calculate Relative Risk?

Answer 3

Incidence of the exposed/Incidence of unexposed

Question 4

ECG shows HR 120 beats/min, irregular rhythm, narrow QRS complexes and no P waves. What is the problem?

Answer 4

Atrial Fibrillation

Question 5

Acyclovir MOA? EBV/CMV vs HSV/VZV?

Answer 5

MOA: Guanosine analog that is activated into active triphosphate form via Thymidine kinase

In HSV and VZV, this kinase is produced but in EBV and CMV=>it is not produced

Question 6

IL-4’s function?

Answer 6

Class switching for IgE and IgD

Question 7

Why is there only a modest increase in BP when a patient exercises?

Answer 7

vasodilation within muscles

Question 8

In an eukaryotic cell, if there is a DNA molecules that resemble bacterial chromosomes, you should think it is from?

Answer 8

mitochondria

Question 9

Hyperphagia and obesity, what nucleus?

Answer 9

ventromedial

Question 10

How would PO2, % saturation, and O2 content change with anemia, CO poisoning and polycythemia?

Answer 10

Anemia: PO2 and % saturation=Normal; O2 content=decreased

Polycythemia: PO2 and % saturation=Normal; O2 content=increased

CO Poisioning: PO2=Normal; % saturation and O2 content decreased

Question 11

Patient has ABG of pH 7.59, pCO2 49 mmHg, and pO2 85? What kind of an acid base disorder does this patient have? What is the next best test of choice?

Answer 11

Metabolic Alkalosis, Check Urine chloride

Question 12

A Patient has flushing, purple vascular lesions, watery diarrhea, bronchospasm w/abdominal tumor in the small intestine. Elevated Urine 5 HIAA. What is the Dx? and Tx?

Answer 12

Metastatic Carcinoid Tumor

Tx: Octreotide-Somatostatin Analog

Question 13

Mortality Cancer in US for men and women?

Answer 13

men=LBC

women=LPC

Question 14

MC inherited hypercoagulable (thrombophilic) disease?

Answer 14

Factor Leiden V

Question 15

1 week old boy is vomiting and poorly feeding. The boy is dehydrated. Na+ 122 mEq/L. What is the mostly likely Dx?

Answer 15

Congenital Adrenal hyperlasia

Question 16

MC Congenital Adrenal Hyperplasia? What symptoms do you see in this disease?

Answer 16

21 hydroxylase def.=>Latter number=1=>increase in androgen synthesis

Cortisol, aldosterone synthesis decreased

17 progesterone elevated

serum ACTH elevated

Question 17

What do you see in a patient with 17 hydroxylase def.?

Answer 17

Normal Kids with severe HTN.

Question 18

In a female patient with 21 hydroxylase def., what do you see?

Answer 18

Increased virilization

Question 19

Glucagon MOA in myocytes?

Answer 19

Increased cAMP and increased Ca2+ in cardiac myocytes

Question 20

What will you see in the lumbar puncture of a patient with Cryptococcus? TOC for acute and long term?

Answer 20

Low Glucose, and increased protein, usually grown on sabouraud agar

TOC acute: amphotericin B

Long Term: Azole

Question 21

Hypoxathine is converted to Uric Acid by? What drug inhibits this?

Answer 21

Xanthine Oxidase; Allopurinol

Question 22

Long Term Drugs for Gout?

Answer 22

Uricosuric agents: Probenicid or sulfinpyrazone

Xanthine Oxidase Inhibitors: Allopurinol

Question 23

Probenecid MOA? Use? AE?

Answer 23

MOA: inhibits reabsorption uric acid in the proximal convoluted tubules

Use: Chronic Gout in patients with good renal function

AE: Uric Acid Stones (Caliculi)

Question 24

Allopurinol MOA? Use?

Answer 24

MOA: Xanthine Oxidase Inhibitor

Use: Chronic Gout

Question 25

MC prosthetics, shunt placement and catheter bug?

Answer 25

Staph Epidermidis

Question 26

What Immunoglobulin cannot cross the placenta?

Answer 26

IgM

Question 27

What disease is a benign epidermal tumor that presents as a tan to brown, round, flat coin-like lesion that looks like it can be scrapped off (stuck on appearance)?

Answer 27

Seborrheic Keratosis

Question 28

IV drug user with high grade fever, fatigue and dyspnea with hemmorhagic infarc in the lungs. Dx?

Answer 28

Tricuspid Endocarditis by S. Aureus

Question 29

Okazaki fragments are put together by?

Answer 29

DNA Ligase

Question 30

Pencillin and Cephalosporin MOA? Resistance?

Answer 30

MOA: Binds to PBP **irreversibly** and inhibits transpeptidases Resistance: Through Protein structural change

Question 31

HBcAg makes what kind of proteins? And where is it?

Answer 31

Core protein=\>hepatocytes

Question 32

Glycoprotein that forms spheres and tubules that is about 22 nm in diameter that poorly correlates with viral replication is associated with what antigen?

Answer 32

HBsAg

Question 33

With Statins, MC adverse effect and what should you check?

Answer 33

Rhabdomyolysis and LFTs

Question 34

Sudden, painless, onesided blindness with cherry red macula. Dx?

Answer 34

Central retinal artery occlusion

Question 35

Alpha 1 adenergic stimulation can cause reflex?

Answer 35

bradycardia

Question 36

Flattened Face, epicanthal folds and endocardial cushion defect. MOA?

Answer 36

Down Syndrome: Nonmeiotic disjunction

Question 37

Chewing difficulty, persistent headaches, and tenderness over the temples. Dx?

Answer 37

Temporal Giant Cell arteritis

Question 38

Hemoglobin of 9.0 g, increased LDH and indirect bilirubin increased.

Answer 38

hemolyic anemia

Question 39

RBCs incubated hypotonic saline, hemoglobin is released. What test is it? and what is specific for? MOA of the disease?

Answer 39

Positive osmotic fragility Test; Hereditary Spherocytosis (AD) MOA: Spectrin and ankrin def.

Question 40

With any hemolytic anemia, the patient is at an increased risk of developing what?

Answer 40

Pigmented Gallstones

Question 41

MC neurological complication of VZV?

Answer 41

Post Herpetic Neuralgia

Question 42

Asbestos workers are more likely to get what kind of cancer?

Answer 42

Bronchogenic Carcinoma\>Mesothelioma

Question 43

Female with exertional dyspnea has inherited condition. Mostly likely MOA of her disease?

Answer 43

BMPR2=\>Vascular smooth muscle proliferation

Question 44

Hypotensive, tachycardic, hypoglycemic, with vomiting and weight loss you should think? DOC?

Answer 44

Adrenal Crisis (b/c of adrenal insufficiency) DOC: Glucocorticoids

Question 45

Hx of travel, Anorexia, nausea, dark urine, low grade fever and mild right upper abd. quadrant tenderness suggests? A Bx is likely to show which of the following?

Answer 45

Acute Viral Hepatitis, Bx: Diffuse Ballooning degeneration, mononuclear cell infiltrates, and councilman bodies

Question 46

What is the haldane effect and where does it occur? What is opposite to this effect and where does that occur?

Answer 46

Haldane effect=\>increases in O2 leads to CO2 and H+ unloading; in the lungs Bohr Effect=\>peripheral tissues

Question 47

Primary Ammenorhea in a patient with fully developed secondary sexual characteristics suggests the presence of? MCC of this presence is?

Answer 47

Anatomic defect MC=\>imperforated hymen