UWorld_2.26

Question 1

Hip drops as ipsilateral foot is lifted ==> ?

Answer 1

• Trendelenburg gait (gluteus medius gait)
• results from injury to contralateral superior gluteal nerve or gluteus medius muscle

Question 2

Safe places for injections in buttocks region

Answer 2

• preffered = anterolateral
• safe = superolateral
• superomedial ==> risk of superior gluteal n. injury ==> trendeleburg gait
• superomedial, inferomedial, inferolateral ==> risk of sciatic n. injury

Question 3

Basic psych interviewing techniques

Answer 3

• facilitation = “and then what happened?
• reflection = repeat back
• confrontation = draw attn to discrepancies in responses
• empathy = understanding of patients experience (“I can imagine…”)
• support = express concern/interest w/out claiming understanding/empathy
• silence, direct or indirect questioning

Question 4

Proteases and Anti-proteases @ alveoli

Answer 4

• proteinases
  
  • elastase <== macs/PMNs
  • cathepsin G
  • matrix metallo-proteases
• anti-proteases
  
  • alpha-antitrypsin ==I PMN elastase
  • a2-macroglubulin
  • TIMPs (tissue inhibitors of MMPS) ==I Mac elastase

Question 5

Body fat correlated w/insulin resistance

Answer 5

• visceral fat [not subq fat]
• visceral fat is measured by waist-to-hip ratio
• increased W2H ratio indicates insulin resistance

Question 6

Neonatal manifestations of Turner’s

Answer 6

• abnormal lymphatic outflow ==>

1. lymphedema ==> swollen hands and feet
2. cystic hygroma
   
   1. commonly @ neck (esp. @ posterior triangle)
   2. cystic spaces separated by connective tissue rich in lymphoid aggregates

Question 7

Special fat-type found in newborns

Answer 7

• brown adipose tissue
  
  • contain several intracytoplasmic fat droplets + many mitochondria vs. white adipose cells
• fxn = produce heat
  
  • uncouple oxidative phosphorylation with protein thermogenin
  • ==> energy released by electron transport is dissipated as heat

Question 8

Kartagener presentation

Answer 8

• chronic respiratory infections
• ==> situs inversus (reversal of positioning of interal organs)
  
  • e.g. dextrocardia
• infertility

Question 9

Lyme disease characteristics

Answer 9

• Ixodes tick bite ==> Borrelia burgdorferi infection
• classic = erythema migrans ==> “bulls-eye rash”