UWorld Incorrect

Question 1

presentation of hyperparathyroidism

Answer 1

Osteitis fibrosa cystica is the most characteristic skeletal manifestation of primary hyperparathyroidism.

• boen pain
• subperiosteal erosions affecting phalanges of the hand
• salt and pepper skull
• Brown tumor bone cysts

Question 2

how does epinephrine get made?

Answer 2

from norepinephrine by PNMT (phenylethanolamine-N-methyltranfserase) whose transcription is increased by cortisol which is highly present b/c venous drainage of adrenal cortex goes through adrenal medulla.

Question 3

function of MAO

Answer 3

metabolizes epinephrine and norepinephrine to dihydroxymandelic acid

Question 4

function of COMT

Answer 4

metabolizes epinephrine to metanephrine

metabolizes norepinephrine to normetanephrine

Question 5

insulin and glucagon affect glycolysis and gluconeogenesis how?

Answer 5

Glucagon phosphorylates the bifunctional enzyme (PFK2/fructose 2,6-bisphosphatase). This inactivates kinase and activates phosphatase.

Insulin dephosphorylates the bifunctional enzyme (PFK2/Fructose 2,6-bisphosphatase). This activates kinase and inactivates phosphatase.

Question 6

treatment of hirsutism in PCOS

mechanism

next line?

Answer 6

OCPs

work by suppressing LH secretion from pituitary decreasing ovarian androgen production. also increases Sex hormone binding globluin synthesis by the liver

next line is antiandrogens like 5alpha-reductase inhibitors (finasteride) and testosterone receptor antagonists (spironolactone)

Question 7

Theophylline intoxication

Answer 7

Seizures (major cause of death and morbidity)

Tachyarrhythmias (but not QT prolongation)

Vomiting

Diarrhea

Question 8

iron poisoning

Answer 8

hematemesis and melena (upper GI bleeding) b/c iron directly toxic to gastric mucosal cells)

Question 9

beta blocker toxicity

antidote?

Answer 9

brady cardia
hypotension
CV collapse

treat with glucagon (b/c increases intracellular cAMP and cardiac contractility)

Question 10

opoioid intoxication

treatment?

Answer 10

severe sedation
respiratory depression
constricted pupils

tx:
general supportive care
Naloxone/Naltrexone/Nalmefene are opioid antagonists you can use

Question 11

Acetaminophen toxicity

tx

Answer 11

liver dmg after a latent period

NAC is treatment by glutathione donor

Question 12

MAOI used when

Answer 12

atypical depression

Treatment resistant depression

Question 13

What is atypical depression vs. normal?

Answer 13

atypical depression is different b/c patients will get positive about positive things.

typical major depression, positive events will not result in a change in mood