UWorld Incorrects Flashcards by Kyra Porter

label the structures seen on a chest CT

*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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anatomy of the femoral triangle (lateral to medial)

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

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absolute risk reduction (ARR)

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

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relative risk reduction (RRR)

*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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relative risk (RR)

*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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number needed to treat (NNT)

*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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positive predictive value (PPV)

*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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Trisomy 18 (Edwards syndrome) - classic findings

“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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Trisomy 13 (Patau syndrome) - classic findings

*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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Trisomy 21 (Down Syndrome) - class findings

*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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social anxiety disorder

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

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maintenance dose formula

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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Enterobius vermicularis

*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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duodenal atresia

*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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foscarnet

*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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brief psychotic disorder

*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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schizophreniform disorder

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

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schizophrenia

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

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acute stress disorder

*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

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adjustment disorder

*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

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conversion disorder

*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

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somatic symptom disorder

*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

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illness anxiety disorder

Study These Flashcards

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

Streptococcus pneumonia

Study These Flashcards

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

biliary atresia

*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**

common complications of congenital CMV

chorioretinitis sensorineural deafness microcephaly

medications used for pregnancy termination

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

measles - clinical presentation

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

antimicrobial prophylaxis for HIV patients, based on CD4 counts

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

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

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

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

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

mechanical complications of acute MI: up to several months later

1. **left ventricular aneurysm:** -heart failure, angina, and ventricular arrythmias

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

*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**

fulminant hepatitis in pregnant women

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

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

*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)

common ALCOHOL withdrawal symptoms

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

common BENZODIAZEPINE withdrawal symptoms

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

common OPIOID withdrawal symptoms

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

common STIMULANT (cocaine, amphetamine) withdrawal symptoms

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

common NICOTINE withdrawal symptoms

*dysphoria, irritability, anxiety, increased appetite

common CANNABIS withdrawal symptoms

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

odds ratio calculatin

*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

stroke volume

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

ejection fraction

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

cardiac output

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

cytochrome P450 inducers

*carbamazepine *barbiturates *phenytoin *rifampin *griseofulvin *St. John's wort *modafinil *cyclophosphamide

cytochrome P450 inhibitors

*amiodarone *cimetidine *fluoroquinolones *clarithromycin *azole antifungals *grapefruit juice *isoniazid *ritonavir

brain areas associated with various types of aphasia

pulsus paradoxus

*significant variation in systolic blood pressure related to the respiratory cycle (**exaggerated drop in systolic BP during inspiration**) *typically present in CARDIAC TAMPONADE (associated with pericardial effusion)

false negatives & positives related to specificity and sensitivity

*rate of **false negatives** is the complement of sensitivity (**1 - sensitivity**) *rate of **false positives** is the complement of specificity (**1 - specificity**)

osmolarity in the segments of the nephron

***ADH present (dehydrated pt): lowest osmolarity in the DCT** *ADH absent (hydrated pt): lowest osmolarity in the distal collecting duct (excreting dilute urine)

type I & type II errors related to power and statistical significance

***statistical significance** is the probability of a **type I error (probability of REJECTING a TRUE null hypothesis)** *the **inverse of power** is the probability of a **type II error (finding NO EFFECT when there IS A REAL EFFECT)**

effects of SRY, testosterone & DHT on male sexual differentiation

*SRY gene: produces the TESTES *AMH: causes regression of female internal genitalia (uterus, fallopian tubes) *testosterone: produces INTERNAL male genitalia (epididymis, vas deferens) *DHT: produces EXTERNAL male genitalia

musculocutaneous nerve (brachial plexus)

*from C5-C7 *supplies sensory innervation to the LATERAL forearm *supplies **motor innervation to the FLEXORS of the forearm (biceps)**

radial nerve (brachial plexus)

*from C5-T1 *supplies sensory innervation to the posterior arm and part of hand *supplies motor innervation to the muscles that **EXTEND the FOREARM (triceps)** and fingers and SUPINATE the forearm ***vulnerable with a fracture of the shaft of the humerus**

median nerve (brachial plexus)

*from C5-T1 *supplies **sensory innervation to the thenar aspect of the hand (thumb, index, and middle finger)** *supplies **motor innervation to the forearm pronators, the wrist/finger FLEXORS**, and several finger muscles *vulnerable with a supracondylar fracture of the humerus or entrapment of the carpal tunnel

ulnar nerve (brachial plexus)

*from C8-T1 *supplies sensory innervation to the medial digits and palm *supplies motor innervation to medial wrist and finger flexors and intrinsic muscles of the hand on the medial side

UWorld Incorrects Flashcards

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