UWorld-Rapid Review

Question 1

ptosis, weakness of face muscles (i.e. mastication, EOMs), diplopia that worsens with use suggests what condition and what associated neoplasm

Answer 1

myasthenia gravis;

thymoma

Question 2

shortened 4th and 5th digits; short stature; round face

Answer 2

pseudohypoparathyroidism (end-organ resistance to PTH, TSH, LH/FSH) aka Albright hereditary osteodystrophy

Question 3

stained red by safranin-O

Answer 3

collagen, mast cell granules, or mucin

Question 4

adult structure that runs through inguinal canal (in man, in woman) and its embryologic derivative

Answer 4

spermatic cord in men (note: processus vaginalis disappears); round ligament in women
both are derived from gubernaculum (note: ovarian ligament also derives from gubernaculum, but doesn’t run through inguinal canal)

Question 5

expected pH, pCO2 and pO2 for pulmonary embolism

Answer 5

respiratory alkalosis (hyperventilation due to V/Q mismatch driven hypoxemia)=> high pH, low pCO2, low O2

Question 6

brown colored patches/spots, flesh-colored papules, intertriginous freckling

Answer 6

Neurofibromatosis (von Recklinghausen’s) chromosome 17

Question 7

antibiotic for which histamine release increases proportional to infusion rate

Answer 7

vancomycin (Red man syndrome)

Question 8

heavy menses, pelvic pressure/pain, palpable pelvic mass in an African American woman

Answer 8

leiomyoma

Question 9

pain passing stools, bloody in stool, Hx of vascular or heart disease (diminished pulses, past MI)

Answer 9

ischemic colitis:

on histology= mucosal hemorrhage and patchy necrosis

Question 10

fasting hypoglycemia and hypoketonemia

Answer 10

Acyl-CoA dehydrogenase deficiency or another defect in beta-oxidation pathway

Question 11

how many ATP produced per: NADH, FADH2, GTP

Answer 11

3 ATP per NADH, 2 ATP per FADH2, 1 ATP per GTP

Question 12

how much net ATP produced in anaerobic (glycolysis) vs. aerobic metabolism

Answer 12

net 2 ATP produced in glycolysis;

net 38 ATP produced in anerobic metabolism

Question 13

leukoplakia vs. lichen sclerosis

Answer 13

leukoplakia= white thickening of mucosal surfaces (i.e. oral) often due to EBV
lichen sclerosis= white thinning of squamous surfaces (i.e. labia majora or perineal skin) due to autoimmune disease (anti-ECM1)

Question 14

is acute tubular necrosis typically in the cortex or the medulla of the kidney

Answer 14

medulla: less blood supply than cortex so more prone to ischemia

Question 15

atrophy of villi in the small bowel on histology

Answer 15

Celiac’s (check for dermatitis herpetiformis)

Question 16

notable toxicities of TCA’s

Answer 16

QRS prolongation and arrhythmia, anticholinergic effects, agitation, seizure, coma

Question 17

sudden onset back pain, hematuria, oliguria and metabolic acidosis

Answer 17

ethylene glycol:

• causes anion gap metabolic acidosis
• causes calcium oxalate stones (along with Chron’s and vitamin C)

Question 18

sickle cell patient develops sepsis: what’s the microbe

Answer 18

most likely streptococcus (strep pneumo)

Question 19

recurrent lobar hemorrhages in an elderly patient

Answer 19

cerebral amyloid angiopathy (beta-amyloid deposition in cerebral arterial walls, not associated with systemic amyloidosis)

Question 20

a patient presenting with diabetes mellitus, necrolytic erythema and anemia likely has what condition

Answer 20

glucagonoma

Question 21

air in the biliary tree suggests what condition/complication

Answer 21

gallstone ileus; fistula formation between gallbladder and intestines allows stone to enter small intestines and get lodged in the ileocecal valve

Question 22

persistent disseminated mycobacterial and fungal infections suggest what immunologic defect

Answer 22

low IFN-gamma, needed to promote macrophage destruction of mycobacteria/fungi;
IL-12 receptor deficiency

Question 23

periodic, non-peristaltic contractions of the esophagus leading to crampy pain that resembles angina pectoris

Answer 23

diffuse esophageal spasm

Question 24

moldy grains can have what carcinogen and what associated cancer risk

Answer 24

aspergillus aflatoxins => HCC

Question 25

a patient treated for leukemia or lymphoma develops symptoms of renal failure (high BUN or Cr): what’s the problem and how could it have been prevented

Answer 25

tumor lysis syndrome; prevent with allopurinol/febuxostat or with rasburicase (turns uric acid into allantoin)

Question 26

a patient with lung cancer starts developing ataxia: explain the etiology

Answer 26

paraneoplastic cerebellar degeneration: anti-Yo, anti-P/Q, and anti-Hu antibodies to the tumor cross-react with Purkinje cells in the cerebellum leading to degeneration

Question 27

necrolytic erythema in the groin, abdominal pain, cheilosis, stomatitis can be the result of what condition

Answer 27

glucagonoma

Question 28

how can you differentiate partial central DI from complete central DI?

Answer 28

osmolarity increase of >10% after ADH= partial

osmolarity increase of >50% after ADH=complete

Question 29

what does danazol treat (2 things)

Answer 29

danazol=synthetic androgen that treats endometriosis and hereditary angioedema

Question 30

patient complains of fatigue, mild weight gain and has elevated creatinine kinase; what’s the next appropriate step in his care?

Answer 30

hypothyroid myopathy

-check serum TSH

Question 31

antiphospholipase A2 antibodies are associated with what renal condition

Answer 31

membranous glomerulonephropathy

Question 32

if you give your patient acyclovir, what side effect must you act to prevent

Answer 32

with acyclovir: hydrate your patient! acyclovir has a side effect of crystalline nephropathy and acute renal failure

Question 33

mother has a rash that starts at the head and moves down as well as arthralgia and postauricular LAD; what will baby present with

Answer 33

this is rubella:
fetal classic triad= PDA, cataracts, sensorineural deafness
(may also see blueberry muffin rash similar to CMV)

Question 34

which two infections in the mother can cause hydrops fetalis

Answer 34

parvovirus B19 and syphilis

Question 35

your patient has achalasia and you suspect it has been caused by infection; what pathogen do you suspect and what would you treat with if the infection was ongoing

Answer 35

Trypanosoma cruzi;

treat with benznidazole or nifurtimox

Question 36

what are p bodies and what do they do

Answer 36

p bodies are proteins found in the cytoplasm of eukaryotic cells that regulate translation by binding mRNA and storing them to release later

Question 37

what is the function of HER-2

Answer 37

HER-2 is an epidermal growth factor receptor that has intrinsic tyrosine kinase and it promotes epidermal cell proliferation and differentiation

Question 38

patients with adult-type coarctation are at increased risk of having what other condition

Answer 38

congenital berry aneurysms

Question 39

what’s the difference between scalded skin syndrome and toxic epidermal necrolysis

Answer 39

in scalded skin syndrome attachments between keratinocytes in the stratum granulosum are destroyed; in toxic epidermal necrolysis the epidermis-dermis junction is destroyed

Question 40

what characteristic should a drug that is hepatically cleared have

Answer 40

high lipophilicity so it can be absorbed by the hepatocytes (in the kidney it would filter out and get reabsorbed right back so this would be unfavorable for kidney clearance)