UWorld_6.20

Question 1

Evaluation of hemoptysis

Answer 1

-mild/moderate ==> workup +/- CT +/- broncoscopy if needed -massive (600/24hr or 100/hr) ==> intubate/secure airway -bleeding stops ==> workup -bleeding continues ==> bronchoscopy

Question 2

Bilateral renal agenesis of fetus ==>

Answer 2

incompatible with life

Question 3

Lower intestinal pathology assoc. w/Down’s

Answer 3

Hirschsprung

Question 4

Causes of precocious puberty

Answer 4

-central ==> high FSH & LH -peripheral ==> low FSH & LH (e.g. excess peripheral conversion, estrogen-producing ovarian cyst, CAH)

Question 5

NF1 features

Answer 5

-cafe-au-lait -macrocephaly -feeding problems -short stature -learning disabilities ==> fibromas, neurofibromas, other tumors

Question 6

Fluid for correction of hypernatremia in infants

Answer 6

NS

Question 7

Causes of precocious puberty

Answer 7

• central ==> high FSH & LH
• peripheral ==> low FSH & LH (e.g. excess peripheral conversion, estrogen-producing ovarian cyst, CAH)

Question 8

NF1 features

Answer 8

-cafe-au-lait -macrocephaly -feeding problems -short stature -learning disabilities ==> fibromas, neurofibromas, other tumors

Question 9

Fluid for correction of hypernatremia in infants

Answer 9

NS

Question 10

Definition of precocious puberty

Answer 10

secondary sex characteristics @ :

girls < age 8

boys < age 9

Question 11

Evaluation of precocious puberty

Answer 11

1. bone age
   
   1. normal ==> premature thelarche (breast development) vs. premature adrenarche (pubic hair development)
   2. advanced ==> basal LH
2. basal LH
   
   1. high ==> central
   2. low ==> GnRH stimulation test
      
      1. low LH ==> peripheral
      2. high LH ==> central

Question 12

Neurologic deficits in B12 deficiency

Answer 12

• loss of distal vibration sense & proprioceptive sense
• memory loss, irritability, dementia

Question 13

Tx of megaloblastic anemia w/folic acid alone ==>

Answer 13

• if 2/2 B12 deficiency, folic acid will correct anemia but accelerate neurologic sx of B12 deficiency

Question 14

Evaluation of gastric adenocarcinoma

Answer 14

• may be discovered by biopsy during endoscopy
• stage w/CT scan

Question 15

Most common cause of constrictive pericarditis in Africa, India, China = ?

Answer 15

TB

Question 16

Management of placenta previa

Answer 16

C-section @ 36-37 weeks

Question 17

Cause of increased homocysteine level?

Answer 17

• folic acid deficiency
• B12 deficiency

Question 18

Cause of increased methylmalonic acid level?

Answer 18

B12 deficiency only

Question 19

Paget disease presentation

Answer 19

• osteoclast dysfxn ==> increased bone turnover
• may be asx
• can lead to fx, bone pain, skeletal deformities
• can lead to H/As and hearing loss if bones of head/ear involved

Question 20

Vaccines recommended for adults w/HIV

Answer 20

• HAV
  
  • liver dz
  • MSM
  • IVDU
• HBV
• HPV
  
  • age 9-26
• Influenza
• Menigococcus
  
  • age 11-18
  • college students/military recruits/incacerated pt.s
• Pneumococcus
  
  • PCV13 once + PCV23 after 2 mo.
  • PCV23 every 5 years
• Tdap every 10 years

Question 21

Prologed PPI use ==> risks?

Answer 21

C. diff infection