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1 Mega Step 1 Deck > UWorld Incorrects > Flashcards

UWorld Incorrects Flashcards

1
Q

label the structures seen on a chest CT

A

*esophagus courses between the trachea and vertebral bodies; is typically collapsed with no visible lumen
*trachea is radiolucent (dark) due to air in the structure

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2
Q

anatomy of the femoral triangle (lateral to medial)

A

femoral NERVE (lateral)
femoral ARTERY
femoral VEIN (medial)

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3
Q

absolute risk reduction (ARR)

A

*percentage indicating the actual difference in event rate between control & treatment groups
*ARR = control rate - treatment rate

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4
Q

relative risk reduction (RRR)

A

*percentage indicating relative reduction in the treatment event rate compared to the control group
*RRR = ARR / control rate

recall: ARR = control rate - treatment rate

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5
Q

relative risk (RR)

A

*ratio of the probability of an event occurring in the treatment group compared to the control group
*RR = treatment rate / control rate

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6
Q

number needed to treat (NNT)

A

*number of individuals who need to be treated to prevent a negative outcome in 1 patient
*NNT = 1/ARR

recall: ARR = control rate - treatment rate

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7
Q

positive predictive value (PPV)

A

*represents the probability of truly having a given disease, given a positive test result
*varies with disease prevalence
*PPV = true positive / total # of positives

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8
Q

Trisomy 18 (Edwards syndrome) - classic findings

A

“PRINCE” Edward:
P - prominent occiput
R - rocker bottom feet
I - intellectual disability
N - nondisjunction
C - clenched fists with overlapping fingers
E - low set Ears

*other: micrognathia (small jaw), congenital heart disease (eg. VSD), omphalocele, myelomeningocele
*death usually occurs by age 1

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9
Q

Trisomy 13 (Patau syndrome) - classic findings

A

*severe intellectual disability
*rocker bottom feet
*microphthalmia
*microcephaly
*cleft lip/palate
*holoprosencephaly
*polydactyly
*cutis aplasia
*congenital heart disease
*polycystic kidney disease

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10
Q

Trisomy 21 (Down Syndrome) - class findings

A

*intellectual disability
*flat facies
*prominent epicanthal folds
*single palmar crease
*incurved 5th finger
*DUODENAL ATRESIA
*congenital heart disease (AVSD)
*associated with early onset Alzheimer disease

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11
Q

social anxiety disorder

A

*exaggerated fear of embarrassment in social situations (eg. public speaking, using public restrooms)
*treatment: CBT, SSRIs, SNRIs

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12
Q

maintenance dose formula

A

maintenance dose = (steady-state plasma concentration) x (clearance) x (dosing interval)

*clearance of the drug determines the dose rate required to maintain a given steady state plasma concentration

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13
Q

Enterobius vermicularis

A

*aka pinworm
*causes anal pruritus, worse at night
*most common in children aged 5-10
*dx made by visualizing eggs via tape test
*transmission = fecal-oral
*treatment: bendazoles (albendazole, mebendazole), pyrantel pamoate

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14
Q

duodenal atresia

A

*due to failure of duodenal recanalization or failure to recanalize lumen from solid cord stage
*X-ray shows double-bubble (dilated stomach, proximal duodenum)
*associated with DOWN SYNDROME

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15
Q

foscarnet

A

*viral DNA/RNA polymerase inhibitor and GIV reverse transcriptase inhibitor
*binds to pyrophosphate-binding site of enzyme
*does not require any kinase activation
*ADEs: nephrotoxicity, multiple electrolyte abnormalities can lead to seizures

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16
Q

brief psychotic disorder

A

*1 or more psychotic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) lasting > 1 day and < 1 month with eventual return to premorbid functioning

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17
Q

schizophreniform disorder

A

*1 or more psychotic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) lasting > 1 month but < 6 months

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18
Q

schizophrenia

A

*1 or more psychotic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) lasting > 6 months

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19
Q

acute stress disorder

A

*characterized by symptoms of intrusion (eg. flashbacks), negative mood, dissociation, avoidance, and arousal (ie. PTSD symptoms) that lasts between 3 days and 1 month after exposure to a life-threatening traumatic inciting event

note - PTSD requires > 1 month for dx

20
Q

adjustment disorder

A

*emotional or behavioral sx (anxiety, outbursts) that occur within 3 months of an identifiable psychosocial stressor (eg. divorce, illness) lasting < 6 months once the stressor has ended

21
Q

conversion disorder

A

*unexplained loss of sensory or motor function (eg. paralysis, blindness, mutism) often following an acute stressor
*patient may be aware of but indifferent toward symptoms
*more common in females, adolescents, and young adults

22
Q

somatic symptom disorder

A

*1+ bodily complains (eg. abdominal pain, fatigue) lasting months to years
*associated with excessive, persistent thoughts and anxiety about symptoms
*may co-occur with medical illness

23
Q

illness anxiety disorder

A

*preoccupation with acquiring or having a serious illness, often despite medical evaluation and reassurance; minimal to no somatic symptoms

24
Q

Streptococcus pneumonia

A

*gram-positive, lancet-shaped organism that grows in pairs (diplococci)
*major virulence factor = thick polysaccharide capsule which impedes phagocytosis and complement binding

25
Q

biliary atresia

A

*fibro-obliterative destruction of bile ducts → cholestasis
*obstruction of extrahepatic bile ducts
*associated with absent or abnormal gallbladder on ultrasound
*often presents as a newborn with persistent jaundice after 2 weeks of life, darkening urine, acholic stools, hepatomegaly
*labs: increased DIRECT bilirubin and GGT

26
Q

common complications of congenital CMV

A

chorioretinitis
sensorineural deafness
microcephaly

27
Q

medications used for pregnancy termination

A
  1. methotrexate:
    -used for ECTOPIC pregnancy
    -folic acid antagonist (inhibits dihydrofolate reductase)
    -preferentially destroys proliferating fetal cells
  2. mifepristone:
    -used for abortion
    -partial progesterone agonist (acts as progesterone antagonist during pregnancy)
    -promotes placental separation and uterine contractions
  3. misoprostol:
    -used for abortion or for inducing labor
    -prostaglandin E1 agonist
    -stimulates uterine contractions
28
Q

measles - clinical presentation

A

presents with:
-fever
-cough
-rhinorrhea
-conjunctivitis
-maculopapular rash that starts on the face and spreads downward
-Koplik spots (pathognomonic for measles) are characterized by tiny white, blue, or gray lesions on buccal mucosa

29
Q

antimicrobial prophylaxis for HIV patients, based on CD4 counts

A

1) CD4 < 200: prophylaxis with trimethoprim-sulfamethoxazole for Pneumocystis jirovecii
2) CD4 < 100: prophylaxis with TMP-SMX for Toxoplasma gondii
3) CD4 < 50: prophylaxis with azithromycin for Mycobacterium avium complex

30
Q

mechanical complications of acute MI: acute or within 3-5 days

A
  1. papillary muscle rupture/dysfunction:
    -usually due to right coronary artery occlusion
    -severe pulmonary edema, respiratory distress, new early systolic murmur (acute MR) hypotension/cardiogenic shock
  2. interventricular septum rupture:
    -chest pain, new holosystolic murmur, hypotension/cardiogenic shock, step up in O2 level from RA to RV
31
Q

mechanical complications of acute MI: within 5 days or up to 2 weeks

A
  1. free wall rupture:
    -usually due to LAD occlusion
    -chest pain, distant heart sounds, shock with rapid progression to cardiac arrest
32
Q

mechanical complications of acute MI: up to several months later

A
  1. left ventricular aneurysm:
    -heart failure, angina, and ventricular arrythmias
33
Q

ventilation/perfusion (V/Q) ratios in the regions of the lungs

A

*both perfusion and ventilation are highest in the BASE of the lung and lowest in the APEX
*however, the variability in perfusion is greater than that of ventilation
*causing V/Q ratio to be LOWEST IN BASE and HIGHEST IN APEX

34
Q

fulminant hepatitis in pregnant women

A

*classically associated with Hepatitis E infection
*hep E is an unenveloped, single-stranded RNA virus spread through fecal-oral route

35
Q

for life-threatening disease, is it more important to have high sensitivity or high specificity of the screening test?

A

*high SENSITIVITY ensures that most patients with the disease will have a positive test result, so fewer cases of disease are missed
*given a test with high sensitivity, a negative result would have to rule out a diagnosis (SnNout)

36
Q

common ALCOHOL withdrawal symptoms

A

*tremors, agitation, anxiety, delirium, psychosis
*exam findings: seizures, tachycardia, palpitations

37
Q

common BENZODIAZEPINE withdrawal symptoms

A

*tremors, anxiety, perceptual disturbances, psychosis, insomnia
*exam findings: seizures, tachycardia, palpitations

38
Q

common OPIOID withdrawal symptoms

A

*nausea, vomiting, abdominal cramping, diarrhea, muscle aches
*exam findings: dilated pupils, yawning, piloerection, lacrimation, hyperactive bowel sounds

39
Q

common STIMULANT (cocaine, amphetamine) withdrawal symptoms

A

*increased appetite, hypersomnia, intense psychomotor retardation, severe depression (“crash”), vivid dreams

40
Q

common NICOTINE withdrawal symptoms

A

*dysphoria, irritability, anxiety, increased appetite

41
Q

common CANNABIS withdrawal symptoms

A

*irritability, anxiety, depressed mood, insomnia, decreased appetite

42
Q

odds ratio calculatin

A

*the odds of an event is related to the probability of that event: odds = P / (1 - P)
*odds ratio = odds of exposure in cases / odds of exposure in control

43
Q

stroke volume

A

*absolute volume of blood ejected from the left ventricle with each contraction
*SV = LVEDV - LVESV

44
Q

ejection fraction

A

*relative volume of blood ejected from the left ventricle with each contraction (stroke volume divided by LVEDV)
*EF = (LVEDV - LVESV) / LVEDV

45
Q

cardiac output

A

*the volume of blood ejected into the aorta per unit time
*estimated by multiplying stroke volume (LVEDV - LVESV) times heart rate

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