uworld4

Question 1

treatment for profound hypotension due to right ventricular MI

Answer 1

IV saline bolus

Question 2

what do you do in terms of rabies treatment if domesticated dog bites you?

Answer 2

quarantine dog for ten days and see if it develops rabies

only give prophylaxis if positive- it’s painful and intense

Question 3

management for patient with intense variceal bleeding and hemetemesis who’s altered mentally and minimally responsive to crystalloids

Answer 3

endotracheal intubation because fear of aspiration

abx ppx for spontaneous bacterial periotonitis

somatostatin analogue to reduce variceal bleeding

Question 4

most common liver malignancy is

Answer 4

metastasis from another source

Question 5

labs with a man taking anabolic steroids

Answer 5

ex androgens–> decreased LH, FSH

T may look nl because assay picks up exogenous androgen

elevated Hgb, choelstasis, dyslipidemia, slightly high Cr

Question 6

most common source of clot to form PE

Answer 6

femoral vein

Question 7

thrombi originiating from renal vein most likely in patients with

Answer 7

nephrotic syndrome

Question 8

thrombi originitating in RA most common in patients with

Answer 8

intracardial devices

Question 9

how does CKD cause secondary hyperparathyroidism

Answer 9

• phosphate retention
• decreased vit D–>less Calcium absorbed

both stimulate PTH

Question 10

complication of untreated hyperthyroidism

Answer 10

rapid bone loss from osteoclast activity–> osteoporosis

Question 11

sialadenosis presentation

Answer 11

nontender enlargement of submandibular glands- benign

Question 12

sialadenosis is common in what conditions

Answer 12

advanced liver disease (alcoholic and non-alcoholic cirrhosis)

malnutrition (bulimia, DM)

Question 13

mild vs moderate vs severe hypothermia presentation

Answer 13

mild- 90-95: shivering

moderate: 82-90: bradycardia, arrythmias
severe: <82: CV collapse

Question 14

mild vs moderate vs severe hypothermia treatment

Answer 14

mild: passive external warming-remove wet things,
blankets

moderate: active external warming- heating pads, warm baths
severe: active internal rewarming- warmed pleural irrigation, warmed humidified oxygen

Question 15

how does blood transfusion cause hypocalcemia?

Answer 15

citrate in transfused blood chelates ionized calcium

Question 16

hypertensive urgency vs emergency

Answer 16

urgency: >180/120 without end organ damage

emergency: with end organ damage
- malignant: papilledema, retinal hemorrhages, exudates
- encephalopathy: cerebral edema, neuro signs

Question 17

management for viral conjuctivitis

Answer 17

supportive care- self limiting

Question 18

treatment for TCA overdose

Answer 18

supplemental O2, intubation, IVF

activated charcoal if w/in 2 hrs of ingestion

if QRS>100 : IV sodium bicarbonate

Question 19

what is this: watery diarrhea, flushing, muscle cramps, hypokalemia, hypercalcemia, mass in pancreatic tail

Answer 19

VIPoma

Question 20

where are most carcinoid tumors?

Answer 20

small intestine

Question 21

is fluconazole for candiadiasis prevention needed in HIV patients with CD4<50?

Answer 21

no- adds drug resistance

Question 22

what prophylactic abx should HIV patient be on at various CD$ counts (200, 150, 100, 50)?

Answer 22

200- PJP- bactrim
150- histoplasma- itracanazole
100- toxo- bactrim
50- MAC_-azithromycin

Question 23

are isolate PVC’s associated with syncope?

Answer 23

no

Question 24

if someone has sinus rhythm and increased PR interval, do they have a bradyarrythmia?

Answer 24

yes apparently