UWorld Medicine

Question 1

initial fibromyalgia tx

Answer 1

• pt education
• regular aerobic exercise
• good sleep hygeine
• next step = Pharmacotx
• – 1st: TCAs (ex amitriptyline)
• – Alternate: SNRIs, pregabalin

Question 2

blastomycosis geography

Answer 2

south/south-central states, mississippi & ohio river valleys, upper midwest states, great lakes states & canadian provinces

Question 3

presentation of blastomycosis

Answer 3

• lung: PNA
• cutaneous: well-circumscribed verrucous nodules and blaques that progress to microabscesses
• Bone: osteomyelitis
• GU: Prostatitis, epididymo-orchitis
• CNS

Question 4

electrolyte/volume status in SIADH pt

Answer 4

hypotonic hyponatremia in a euvolemic patient

Question 5

presentation of esophageal perforation

Answer 5

severe restrosternal pain, dyspnea, subcutaneous emphysema, odynophagia, and signs of sepsis
– surgical emergency

Question 6

PFTs for asthma

TLC, FEV1/FVC, DLCO

Answer 6

TLC normal/Increased
FEV1/FVC decreased (with positive bronchodilator response)
DLCO normal/increased

Question 7

PFTs for copd

TLC, FEV1/FVC, DLCO

Answer 7

TLC increased
FEV1/FVC decreased
DLCO decreased (normal in early COPD)

Question 8

PFTs for interstitial lung dz

TLC, FEV1/FVC, DLCO

Answer 8

TLC decreased
FEV1/FVC normal
DLCO decreased

Question 9

PFTs for pulmonary arterial HTN

TLC, FEV1/FVC, DLCO

Answer 9

TLC normal
FEV1/FVC normal
DLCO decreased

Question 10

PFTs for restrictive chest wall dz

TLC, FEV1/FVC, DLCO

Answer 10

TLC decreased
FEV1/FVC normal
DLCO normal

Question 11

presentation of idiopathic pulmonary fibrosis

Answer 11

slowly progressive dyspnea, dry cough, and fine crackles

- commonly in pts 50-70yo

Question 12

what is a hydrogen breath test look for?

Answer 12

rise in measured breath hydrogen level after ingestion of lactose, indicating bacterial carbohydrate metabolism

positive for lactose intolerance

Question 13

most common source of symptomatic PE clot

Answer 13

proximal deep leg veins (ex femoral v, popliteal v, deep femoral v)

Question 14

importance of size of solitary pulmonary nodules

Answer 14

<0.6cm are unlikely to be malignant

>0.8cm require additional management or surveillance

Question 15

brain location for alzheimers dementia

Answer 15

temporal and parietal lobes

— most prominent in the medial temporal lobes and hippocampi

Question 16

how to tell frontotemporal dementia vs alzheimers dementia

Answer 16

• memory: Alz presents initially with memory impairment vs in FT this is usually mild in the initial stages of dz
• age: FT has earlier age of onset (usually 50-60yo)
• brain location: Alz is temp and parietal. FT is temp and frontal.
• sx: FT primarily has personality changes and loss of social inhibition. Alz mainly memory impairment, word-finding difficulty, loss of executive function

Question 17

pt predisposed to AERD

Answer 17

• AERD = Aspirin-exacerbated respiratory disease`

- most often seen in pts with hx of asthma or chronic rhinosinusitis with nasal polyposis

Question 18

risk factors for carpal tunnel

Answer 18

include (but not limited to):
female
obese
hypothyroidism