Uworld Mix 10/3/2018

Question 1

What symptoms do you see if they obviously have congestive heart failure, and are very SPECIFIC

Answer 1

BNP levels, dyspnea, 3rd heart sounds

Question 2

Would you see wheezing in CHF?

Answer 2

sometimes, but not specific

Question 3

Manifestation of Bartonella Henselae and who has it, how do you treat

Answer 3

Vascular Cutaneous Lesion - possibly bleed
B-like symptoms,
HIV aids in cd4<100
tx is Doxycycline or erythromycin, and anti

Question 4

45 m has sudden onset skin rash, oral lesions with fever. He cant eat or drink due to pain in his mouth and throat. He also had joint pains prior to the skin lesion.s He was given TMP-SMX 5 days ago. 101F, 110/80 mmHG. Conjunctiva both inflamed. Theres erythmatous desquamating rash with scattereed on the trunk and proxumal thighs. IMage looks like skin layer is peeling after a little burn. Dx?

Answer 4

Steven Johnson Syndrome

Question 5

SJS features

Answer 5

4-28 days after exposure to trigger
acute flu like symptoms BEFORE
Rapid onset macules, vesicles, and bullae
Mucosal involvement - ulcers and PEELING SKIN IN THE MOUTH

Question 6

SJS vs TEN?

Answer 6

TEN involves >10-30% of the body. SJS doesnt

Question 7

Drugs that can cause SJS

Answer 7

Allopurinol, ABx, anticonvulsants, NSAIDs, Sulfasalazine

Question 8

Patient with aids has pain with swallowing, fluconazole didnt ork. has linear irregular ulcers, and biopsy shows intranuclear and intracytoplasmic inclusions. WHat med you give

Answer 8

Ganciclovir, NOT acyclovir. They have CMV esophagitis - large linear ulcerations.

Question 9

How would you describe ulcers from HSV esophagitis, and how do you treat.

Answer 9

multiple, small and well circumscribed round appearance. Has eosinophilic intranuclear inclusions. use ACYCLOVIR

Question 10

MEN 1 vs MEN2

Answer 10

MEN1 - Pituitary, Parathyroid, Pancreas
Look for Primary hyperPTH, gastrinoma, VIPoma, Insulinoma, glucagonoma

MEN 2 - if you see Parathyroid symptoms, look for Medullary Thyroid Cancer

Question 11

How do you confirm Parkinsons

Answer 11

Physical Exam

Question 12

What is causing Parkinsons

Answer 12

accumilation of alpha synuclein within the neurons of the substantia nigra

Question 13

What do you see in CT of Parkinsons

Answer 13

NOTHING. NOTHING DAMMIT> NOTHING COMFIRMATORY

Question 14

What prescreening is needed if you are about to start trastuzamab therapy for a HER2 positive breast cancer

Answer 14

Echocardiography - Cardiotoxicity is a known adverse affect of trastuzamab, so if theres already an issue, they can get heart failure

Question 15

What would you screen or if you are about to start Aromatase inhibitors in a ER positive breast cancer patient

Answer 15

Bone density scan, since it can cause osteoperosis

Question 16

If you are screening for FVL disease before giving a drug, what drug are you giving?

Answer 16

Tamoxifen