UWorld Test 5/26/2014

Question 1

hCG is structurally similar to what?

Answer 1

TSH, FSH, LH

Question 2

Cord factor and sulfatides in mycobacteria correlate to what?

Answer 2

Cord factor - virulence. Sulfatides inhibit fusion of lysosomes to phagosomes.

Question 3

Patients with primary polydipsia (psychogenic dipsia) respond how to water deprivation test?

Answer 3

Demonstrate appropriate significant increase in urine osmolality. Also, patients wil lhave low sodium serum levels (due to excess water drinkin) and low osmolality. Restriction of water intake normalizes urine output in patients with polydipsia.

Question 4

What are the retroperitoneal structures?

Answer 4

SAD PUCKER - suprarenal glands (adrenals), aorta and ivc, Duodenum (2nd through 4th), pancreas except tail, uterus, colon (descending and ascending), kidneys, esophagus (lower 2/3), rectum (partial)

Question 5

Thickened bronchial walls, NEUTROPHILIC infiltration, mucus gland enlargement, patchy squamous metaplasia of the bronchial mucosa are features of>

Answer 5

Chronic bronchitis

Question 6

What is responsible for the development of the greenish pigment that develops in ecchymoses?

Answer 6

Heme is broken down by heme oxygenase to biliverdin and and carbon dioxide. Biliverdin is then reduced to bilirubin

Question 7

When the de novo process of dTMP synthesis is imparied, what salvage pathway tries to compensate?

Answer 7

Thymidine kinase. Activation of this pathway with thymidine supplementation can partially compensated for reduced dTMP synthesis.

Question 8

What drug is used to assist in the prevention of cerebral vascular spasm following SAH?

Answer 8

Calcium channel blockers like nimodipine

Question 9

What is the most likely presentation for hyperchylomicronemia (hypertriglyceridemia)?

Answer 9

Acute abdominal pain (pancreatitis). Patients with this disorder are NOT at an increased risk for premature coronary artery disease. Tubular/tendon xanthomas are seen in patients with hypercholesterolemia not hypertriglyceridemia. CAD is increased with hypercholesterolemia.

Question 10

Patients with adult type coarctation of the aorta usually die from?

Answer 10

hypertension associated conditions like ruptured dissecting aortic aneurysm, intracranial hemorrhage, left ventricular failure. These patients have increased incidence of congenital berry aneurysms at the circle of willis and elevated aortic hypertension

Question 11

What is NF-kappa B

Answer 11

Transcription factor responsible for cytokine production in the immune response to pathogens. Crohn’s disease is a/w increased NF-kappa B activity.

Question 12

Dantrolene MOA?

Answer 12

Prevents the release of Ca2+ from SR. Used to prevent malignant hyperthermia and neuroleptic malignant syndrome

Question 13

What is the most common indolent non-Hodgkin lymphoma?

Answer 13

Follicular lymphoma. Non-tender lymph node enlargement or abdominal discomfort from abdominal mass. Indolent clinical course marked by remissions and recurrences.

Question 14

What is a positive whiff test? What does it detect?

Answer 14

Production of a fishy odor on addition of potassium KOH to vaginal discharge - bacterial vaginosis caused by Gardnerella vaginosis. Clue cells on saline wet mount also suggest this dx

Question 15

Henoch-Scholein Purpura triad?

Answer 15

1)Skin: purpura 2) Arthralgias, GI: abdominal pain, melena. Vasculitis secondary to IgA complex deposition