Uworld questions

Question 1

what is the Initial Evaluation for Hyperkalemia?

Answer 1

ECG
Acute therapy such as (CALCIUM GLuconate, Insulin with Glucose) is reserved for a patient with ABNORMAL ECG findings with a Potassium levels > or equal to 7.0MEq/L without characteristic ECG changes AKA a NORMAL ECG

Question 2

what are the most common cause of hyperkalemia

Answer 2

Acute and Chronic Kidney disease, medication that impairs RASS system.

Next best step for managing a patient with hyperkalemis is to review current medications.

Question 3

A patient with a pulsatile abdominal mass above the umbilicus suggesting Abdominal aortic aneurysm, what is the best next test to evaluate the abdominal mass?

Answer 3

Abdominal Ultrasound is the IMAGing of Choice for AAA. (100% sensitivity and specificity)

Question 4

what test of imaging do you use to screen for Renal Artery stenosis

Answer 4

Duplex Doppler Ultrasound

Question 5

what are the test that should be performed in a patient diagnosed with Secondary hypertension

Answer 5

a) Urinaliisis for occult hematuria and urine protein/creatine ratio
B) Chemistry panel
C) Lipid Profile
D) Baseline electrocardiogram

Question 6

Painless purple mottling of the skin is associated with what pathology?

Answer 6

Cholesterol Emboli (painless mottling of both feet refers to Levido Reticularis)

occurs in patient undergoing coronary angiogram or catheter placement. this cause emboli formation

Cholesterol embolization is associated with subacute renal failure, levido reticular, Blue toe syndrome, Cerebral or intestinal ischemia and HollennHorst plaque.

Question 7

What are Hollenhorst plaque

Answer 7

Common retinal finding in older patients. Patients are visually asymptomatic and present with retinal emboli and PLAQUe Ulceration in the Internal Carotid artery

Carotid Duplex is imaging of choice

Question 8

Inferior wall MI is associated with 3 things

Answer 8

AV block, hypotension and bradycardia

Question 9

what test is recommended to a patient that has a symptomatic carotid stenosis of 70%-99%?

Answer 9

Carotid Endarterectomy

Note if carotid stenosis is <50% annual duplex ultrasounds are used to monitor the patient and treat with anti platelet agents and statins

Question 10

When is Nasal Biopsy done?

Answer 10

In Mucormycosis (Sinusitis, tissue necrosis, Ketoacidosis)

Question 11

Shortness of Breath, Hypoxia and Unilateral Breath sounds on one side of the lungs

Answer 11

Think Secondary Spontaneous Pneumothorax.

Question 12

Severe asthma exacerbation that does not respond to albuterol, steroids and ipratropium. what is the next best step?

Answer 12

Endotracheal Intubation & mechanical ventilation to prevent lungs collapse

Question 13

alpha -1- antitrypsin deficiency should be considered in what two scenarios

Answer 13

Patient with COPD less than or equal to 45
COPD with minimal or no smoking history/ a family history of liver disease.

diagnosis: measurement of Serum AAA and pulmonary function testing

Question 14

what are the initial presentation of pulmonary embolism

Answer 14

syncope and shock

Right heart cauterization will show elevated right atrial and pulmonary pressures with a NORMAL PCWP

Question 15

what are the causes of Obstructive sleep Apnea and what is used to aid the diagnosis?

Answer 15

TOnsilar hypertrophy, excess soft tissue and a short mandible

Diagnose OSA using Nocturnal polysomnography
It determines the abnormal ventilation that occurs during sleep

Question 16

what is the most common complication for endotracheal intubation?

Answer 16

Right mainstream bronchus intubation. It causes asymmetric chest expansion during inspiration and a DECREASED BREATH SOUNDS on the LEFT SIDE on auscultation.

How do you solve the problem?

Reposition the endothelial tube

Question 17

what pathology is associated with displacement of left main stem bronchus in xray

Answer 17

Mitral stenosis associated with Rheumatic heart disease and they develop AFIb

Question 18

Complication associated with Mechanical ventilation used to treat ARDS is?

Answer 18

Alveolar damage, Pneumothorax( Cause absent breath sounds on affected side), hypotension

Remember UNILATERAL ABSENCE BREATH SOUNDS Suggest Pneumothorax

Question 19

When do you Consider alpha 1 anti tripsin deficiency as the diagnosis?

Answer 19

1) COPD @ a young age (less than/equal to 45 years)
2) COPD with minimal or no smoking history
3) Basilliar predominant COPD
4) History of unexplained liver disease