UWorld Sim 2

Question 1

peutz-jeghers syndrome

Answer 1

AD

• numerous hamartomas throughout the GI tract
• hyperpigmented macules on mouth, lips, hands, genitalia
• associated with increased risk of breast and GI cancers (colorectal, stomach, small bowel, pancreatic)

Question 2

FAP or lynch syndrome + malignant CNS tumor (medulloblastoma, glioma)

Answer 2

turcot syndrome

Question 3

FAP + osseous and soft tissue tumors, congenital hypertrophy of retinal pigment epithelium, impacted/supernumerary teeth

Answer 3

gardner syndrome

Question 4

anisocoria

Answer 4

unequal pupil size

Question 5

job syndrome

Answer 5

hyper-IgE syndrome

-recurrent skin and lung infections

Question 6

colorectal, endometrial, and ovarian cancer

Answer 6

lynch syndrome (MSH2, MLH1, MSH6, PMS2)
-problem with mismatch repair

Question 7

what two immunosuppressants are nephrotoxic

Answer 7

cyclosporine and tacrolimus

Question 8

what drug is contraindicated in parkinson disease

Answer 8

metoclopramide
-can exacerbate or cause de novo parkinsonian symptoms and trigger extrapyramidal reactions due to its antagonistic effect on dopamine receptors

Question 9

alkaptonuria findings

Answer 9

AR

• bluish-black connective tissue, ear cartilage, and sclerae (ochronosis), urine turns black on prolonged exposure to air
• may have debilitating arthralgias (homogentisic acid toxic to cartilage)

Question 10

if the pt is a professional athlete what should be on your radar

Answer 10

GnRH suppression

Question 11

pathogenesis of proptosis

Answer 11

glycosaminoglycan accumulation

Question 12

infant with painless compressible mass that transilluminates

Answer 12

cystic hygromas (lymphangiomas)

• cystic lymphatic malformation when the lymphatics dont properly link up to the venous system
• most often found on left side of head and neck
• most commonly associated with chromosomal aneuploidy (turner syndrome and trisomies)

Question 13

disinhibited behavior (hyperphagia, hypersexuality, hyperorality, visual agnosia, placidity, amnesia)

Answer 13

Kluver-Bucy syndrome

HSV encephalitis and traumatic brain injury are both potential causes

Question 14

what is the predominant cell type in psoriasis

Answer 14

dendritic cells and you will also see hyperkeratosis

Question 15

xerosis (gross scaly picture)

Answer 15

asteatotic dermatitis (winter itch)

• usually in older people during winter months when heaters make the house less humid and skin more dry
• just make sure the pt moisturizes after taking lukewarm showers and doesnt use alkaline soaps

Question 16

explain the structure of G protein coupled receptors

Answer 16

7 transmembrane domain with a hydrophobic core in alpha-helical secondary structure

Question 17

probenecid

Answer 17

• inhibits reabsorption or uric acid in proximal convoluted tubule
• inhibits secretion of penicillin
• can precipitate uric acid caliculi

Question 18

stimulation of what nerve causes reflex coughing or vomiting

Answer 18

auricular branch of the vagus nerve

Question 19

what causes syncope when someone is coughing

Answer 19

decreased venous return to the heart

Question 20

what are cutaneous neurofibromas made of

Answer 20

proliferation of schwann cells

Question 21

if a woman under 40 looks like shes in the early stages of menopause what do you think of

Answer 21

primary ovarian insufficiency

• presents with amenorrhea and elevated FSH
• may result from follicular depletion through accelerated atresia –> apoptotic process

Question 22

explain the agglutination inhibition pregnancy test

Answer 22

agglutination –> negative test result (she is NOT pregnant)

no agglutination –> positive test result (she IS pregnant)

Question 23

why do you add sirolimus to stents

Answer 23

inhibition of intimal hyperplasia

-prevents restenosis and scar tissue growth over the stent

Question 24

heel of foot

Answer 24

common peroneal nerve

Question 25

inheritance of MCAD deficiency

Answer 25

autosomal recessive

Question 26

if you see a young pt with vzv reactivation what should you be worried about

Answer 26

immunosuppression… maybe they have HIV. CHECK!!!

Question 27

what part of the eye does copper accumulate in wilson disease

Answer 27

cornea

Question 28

benign breast mass in pregnant woman that gets smaller after delivery of the baby

Answer 28

fibroadenoma

Question 29

hypertensive pt with widening of the mediastinum

Answer 29

aortic dissection

Question 30

repeated leucine residues every 7th position

Answer 30

leucine zipper dimerization (transcription factor)

-use southwest blot

Question 31

where does de novo purine and pyrimadine synthesis occur

Answer 31

first in the cytosol then in the mitochondria

• CPS2 is in the cyTWOsol
• CPS1 is in the m1tochondria

*note that glutamine + CO2 are in the first step of pyrimidine base production (requires aspartate)

Question 32

two strongest risk factors for MI

Answer 32

severe dislipidemia (usually genetic) and smoking

Question 33

maturity onset of diabetes is usually due to what and why

Answer 33

due to deficiency of glucokinase (preferentially in liver and pancreas)
-raise glucose threshold for insulin to be secreted

Question 34

sickle cell pt with osteomyelitis

Answer 34

salmonella (hydrogen sulfide producer)

Question 35

neoplastic cells promote what type of edema involving the crossing of the BBB

Answer 35

vasogenic edema

Question 36

construction worker with jaw pain

Answer 36

c. tetani