UWorld_7.28

Question 1

Labs to check before starting Li

Answer 1

creatinine

Question 2

Peripheral smear in lead poisoning

Answer 2

basophilic stippling

Question 3

Risk factor for clear cell adenocarcinoma of cervix/vagina

Answer 3

DES exposure in utero

Question 4

DES exposure in utero consequences

Answer 4

• clear cell adenocarcinoma of cervix/vagina
• structural anomalies of reproductive tract: hooded cervix, T-shaped uterus, small uterine cavity, vaginal septae
• pregnancy problems
• infertility

Question 5

Amox-clav coverage

Answer 5

• gram +
• gram -
• anearobes

Question 6

Abx for human bite

Answer 6

amox-clav; also for dog bites

Question 7

First line tx of idiopathic intracranial HTN

Answer 7

acetazolamide (inhibits choriod plexus carbonic anhydrase) +/- furosemide

Question 8

Evaluation of renal colic in pregnant patients

Answer 8

• US = first line

- low dose CT urography can be considered in 2nd/3rd trimesters

Question 9

Management of kidney stones in pregnancy

Answer 9

1. conservative measures
2. uterocsopy or nephrostomy if refractory
3. shockwave lithotripsy is contraindicated

Question 10

HCM inheritance

Answer 10

autosomal dominant

Question 11

Dx of carpal tunnel syndrome

Answer 11

nerve conduction study

Question 12

Main cause of acute interstitial nephritis

Answer 12

drugs: PCNs, TMP-SMX, cephalosporins, NSAIDs

Question 13

Presentation of acute interstitial nephritis

Answer 13

• maculopapular rash
• fever
• new drug exposure
• +/- arthralgias
• AKI
• pyuria, hematuria, WBC casts
• eosinophils @ urine

Question 14

Best long-term tx of graves

Answer 14

radioactive iodine therapy

Question 15

Anion gap =

Answer 15

Na - (Cl + HCO3) > 16

Question 16

DDx of AGMA w/elevated serum lactic acid

Answer 16

lactic acidosis/hypoperfusion

Question 17

DDx of AGMA w/hx of drug ingestion

Answer 17

• salicylates (early resp. alkalosis)
• isoniazid
• iron

Question 18

DDx of AGMA w/osmolal gap

Answer 18

• ethylene glycol ==> urinary calcium oxalate crystals (rectangular, envelope-shaped)
• methanol ==> blindness
• propylene glycol

Question 19

AGMA + urine calcium oxalate crystals ==> dx?

Answer 19

ethylene glycol ingestion

Question 20

AGMA + blindness ==> dx?

Answer 20

methanol ingestion

Question 21

Osmolal gap calculation

Answer 21

OG = measured - calculated (normal

Question 22

Patellofemoral pain presentation

Answer 22

• young female athletes
• subacute pain; increased w/squatting, running, stairs, prolonged sitting
• • patellofemoral compression test

Question 23

Patellar tendonitis presentation

Answer 23

• athletes (“jumpers knee”)
• episodic
• tenderness @ inferior patella

Question 24

CHF impact on renal physiology

Answer 24

-CHF ==> decreased effective arterial volume ==> activation of RAAS ==> increased AgII ==> vasoconstriction of efferent renal arterioles (in order to maintain adequate intraglomerular pressure/GFR)

Question 25

Characteristics of leukemoid reaction

Answer 25

• response to severe infection ==> WBCs > 50,000
• high alk phos
• greater metamyelocytes vs. myelocytes (Myelocytes > metamyelocytes @ CML)
• no absolute basophilia (vs. + @ CML)

Question 26

Milk-alkali pathophysiology and sx

Answer 26

• excess intake of Ca & absorbable alkali
• renal vasoconstriction ==> decreased GFR
• renal loss of sodium/H2O; reabsorption of HCO3
• N/V, constipation
• polyuria, polydipsia
• neuropsych sx

Question 27

Lab findings in milk-alkali syndrome

Answer 27

• hypercalcemia
• metabolic alkalosis
• AKI
• suppressed PTH

Question 28

Tx of milk-alkali

Answer 28

• d/c causative agent

- isotonic saline + furosemide

Question 29

Vitamin A toxicity presentation

Answer 29

• abdominal pain
• dry skin, H/A, blurred vision
• hypercalcemia

Question 30

Future vaccinations in prev. febrile sz. w/DTaP vaccine

Answer 30

• give DTap

- tylenol does not prevent febrile sz