UWorld_6.27

Question 1

Management of lactational mastitis

Answer 1

• pain control
• frequent breastfeeding/pumping (direct feeding w/both breasts is best way to completely drain milk ducts
• abx (dicloxacillin or cephalexin)

Question 2

Cause of lactational mastitis

Answer 2

s. aureus

Question 3

Atrial fibrillation in pt. w/WPW

Answer 3

• avoid AV nodal blocking: adenosine, beta-blockers, ca-channel blockers (promotes conduction through accessory pathway)
• use antiarrhtymic: procainamide

Question 4

Extrapulmonary manifestation of mycoplasma PNA

Answer 4

• mycoplasma PNA = atypical PNA

- ==> erythema multiforme

Question 5

Management of drug-induced interstitial nephritis

Answer 5

stop offending drug

Question 6

Contraindication to MMR vaccine in HIV pt.

Answer 6

• administer only if CD4 >200 and no hx of AIDS illness

- absence of ART is NOT a contraindication

Question 7

Giant cell tumor presentation

Answer 7

• GCT = benign, local skeletal neoplasm
• ==> pain, swelling, decreased ROM @ site
• p/w osteolytic lesions; classic “soap bubble” on XR
• typically @ knee; @ epiphyseal regions

Question 8

Osteoid osteoma presentation

Answer 8

• sclerotic, cortical lesion w/central lucency on imaging

- pain @ night; unrelated to activity; improved w/NSAIDs

Question 9

Osteitis fibrosa cystic presentation

Answer 9

• rare; usually 2/2 hyperparathyroidism
• osteoclast resorption of bone replaced w/fibrous tissue
• XR: subperiosteal bone resorp.

Question 10

Donepezil: MOA, use

Answer 10

• ACh-i

- used to slow Alzheimers

Question 11

Adhesive capsulitis vs. Rotator cuff pathology

Answer 11

• adhesive capsulitis ==> >50% reduction in active AND passive ROM
• RC tear ==> decreased active ROM only

Question 12

Dietary rx in pt. w/renal calculi

Answer 12

• increase fluid intake
• decreased sodium
• normal calcium

Question 13

Presentation/dx of diffuse esophageal spasm

Answer 13

• intermittent chest pain
• dysphagia for solids & liquids
• dx: corkscrew pattern on esophagram & simultaneous contractions on manometry

Question 14

Tx of diffuse esophageal spasm

Answer 14

Ca-channel blockers (diltiazem)