UWorld_7.27

Question 1

Sudden lower limb signs of arterial occlusion w/hx of recent MI ==> dx?

Answer 1

arterial embolism (from L heart s/p MI or atria w/afib)

Question 2

Arterial thrombosis presentation

Answer 2

• insidious/gradual onset of sx of ischemia

- pulses usually diminished bilaterally

Question 3

B-thalassemia minor presentation/management

Answer 3

• asx
• mild anemia + high RBC count
• low MCV
• Hb > 10
• no management needed

Question 4

Delayed complication after blunt trauma/MVC

Answer 4

• diaphragmatic rupture; L>R

- ==> dilated loops of bowel in chest

Question 5

Physiologic cause of sx of cardiac tamponade

Answer 5

• cardiac tamponade/pericardial effusion ==> shift of interventricular septum towards left ventricle
• ==> reduced left ventricular preload ==> reduced stroke volume/cardiac output

Question 6

Older pt. w/bone pain, elevated alk phos, normal Ca ==> dx?

Answer 6

paget disease of bone

Question 7

Paget disease of bone cause/sx

Answer 7

• 2/2 osteoclast dysfxn ==> increased bone turnover
• bone pain/deformity
• @ skull: H/A. hearing loss
• @ spine: spinal stenosis, radiculopathy
• @ long bones: bowing, fx, arthritis

Question 8

Imaging in paget disease of bone

Answer 8

• XR: osteolytic vs. lytic/sclerotic lesions

- bone scan: focal uptake increased

Question 9

Tx of paget disease of bone

Answer 9

bisphosphonates

Question 10

Colon cancer screening in IBD

Answer 10

• 8yrs post-dx

- colonoscopy q1-2 yrs

Question 11

Colon cancer screening in FAP

Answer 11

• colonoscopy 10 years b4 age dx of relative or @ 40

- repeat q3-5 yrs

Question 12

Preconception initial screening for thalassemia

Answer 12

• non-african descent: CBC

- african descent: CBC + Hb electrophoresis

Question 13

Digitalis/Digoxin toxicity arrhythmia

Answer 13

• digoxin ==> increased ectopy and vagal tone

- ==> atrial tachycardia w/AV block

Question 14

Peripheral smear in sickle cell pt.

Answer 14

Howell Jolly bodies

Question 15

Howell Jolly bodies ==> ?

Answer 15

asplenia (fxnl or actual)

Question 16

Tx of ventricular tachycardia

Answer 16

• stable ==> IV amiodarone

- unstable ==> cardioversion

Question 17

High-yield interventions that improve transitions of care

Answer 17

interventions that target PHARMACY PERSONNEL & HIGH-RISK PATIENTS

Question 18

Cause of thrombocytopenia in SLE

Answer 18

immune-mediated peripheral destruction

Question 19

Management of prolactinomas

Answer 19

• asx/micro ( no tx
• sx/macro(>10mm) ==>
  1. DA agonists: cabergoline, bromocriptine
  2. resection: if >3cm or increase in size while on tx

Question 20

Primidone: MOA, use

Answer 20

• barbituate

- anticonvulsant, tx of essential tremor

Question 21

Trihexyphenidyl: MOA, use

Answer 21

• MOA = anticholinergic

- tx of parkinsons; particularly in younger pt. w/tremor as primary sx

Question 22

Evaluation of rapidly expanding head circumference in infant

Answer 22

• 6mo: CT vs. sedated MRI to spare radiation

Question 23

Urine collection in children

Answer 23

• clean catch if out of diapers

- infants/toddlers in diapers ==> straight catheterization

Question 24

anti-topoisomerase I ab association

Answer 24

systemic sclerosis

Question 25

anti-mitochondrial ab association

Answer 25

primary biliary cirrhosis

Question 26

ANCA association

Answer 26

polyangiitis (wegener's) = granulomatous vasculitis

Question 27

Anti-smooth m. ab association

Answer 27

autoimmune hepatitis

Question 28

Pulmonary edema impact on lung fxn

Answer 28

- ==> V/Q mismatch, increased A-a gradient, low lung compliance - moderate supplemental o2 improves status

Question 29

Presentation of hereditary angioedema

Answer 29

- noninflammatory edema of the face, limbs, and genitalia - laryngeal edema ==> life threatening - edema of intestines ==> colicky abdominal pain - episodes follow infection, dental procedure, or trauma

Question 30

Cause of hereditary angioedema

Answer 30

- C1 inhibitor deficiency, dysfxn, or destruction | - ==> elevated C2b and bradykinin

Question 31

Bowel sounds in SBO

Answer 31

high-pitched

Question 32

SBP vs. SBO

Answer 32

- SBP ==> vague abdominal pain, decreased bowel sounds, AMS (abnormal connect-the-numbers) - SBO ==> N/V, high-pitched bowel sounds

Question 33

RAIU in toxic multinodular goiter

Answer 33

patchy distribution

Question 34

Language development @ 12 mo, 18 mo, 2 yrs

Answer 34

- 12 mo: mama, dada + few other first words - 18 mo: 10-25 words - 2 yrs: 50+ words

Question 35

Imaging in Alzheimer's disease

Answer 35

atrophy prominent @ temporal and parietal loves

Question 36

dysphagia + regurgitation + chest pain w/emotional stress ==> dx?

Answer 36

- diffuse esophageal spasm/esophageal motility disorder | - relieved by nitrates

Question 37

Features of intracerebral hemorrhage stroke

Answer 37

- hx uncontrolled HTN, coag, drug use - sx progress @ min - hours - focal neuro sx, then sx of ICP (vomiting, H/A, AMS)

Question 38

Evaluation of ovarian mass + thickened endometrial stripe

Answer 38

-endometrial biopsy for concomitant malignancy

Question 39

Tactile fremitus in pleural effusion

Answer 39

decreased

Question 40

Tactile fremitus in consolidation

Answer 40

increased

Question 41

Theophylline toxicity presentation

Answer 41

- CNS: H/A, insomnia, seizures - GI: N/V - cardiac arrhythmia

Question 42

S. bovis bacteremia ==> ?

Answer 42

colonoscopy to evaluate for colon cancer

Question 43

Pellagra

Answer 43

diarrhea, dermatitis, dementia

Question 44

Ppx for varicella exposure in child

Answer 44

- immunized ==> observation - unimmunized, immunocompetent ==> varicella vaccine - unimmunized, immunocompromised ==> VZIG w/in 10 days of exposure