UWorld_7.15

Question 1

Precipitating factors of hepatorenal syndrome

Answer 1

• reduced renal perfusion (GI bleed, vomiting, sepsis, diuretics, SBP)
• reduced glomerular pressure/GFR, e.g. NSAID use

Question 2

Dx of hepatorenal syndrome

Answer 2

• FeNa hypoperfusion
• absence of tubular injury (no RBC, protien, or granular casts)
• no improvement in renal fxn with fluids

Question 3

Tx of hepatorenal syndrome

Answer 3

• address precipitating factors
• splachnic vasodilators = midodrine, ocreotide, norepi
• liver transplant

Question 4

McCune-Albright presentation

Answer 4

• 3 Ps:
• prec. puberty
• pigmentation
• polyostotic fibrous dysplasia
• cushing’s assoc. w/M-A

Question 5

Peutz-Jeghers sydnrome presentation

Answer 5

• GI tract polyposis
• mucocutaneous pigmentation
• +/- estrogen secreting tumor

Question 6

Bacterial causes of dacrocystitis

Answer 6

• s. aureus

- beta-hemolytic strep

Question 7

Complications of pancreatitis

Answer 7

• pleural effusion
• ileus
• pancreatic pseudocyst/abscess/necrosis
• ARDS

Question 8

Leydig cell tumor presentation

Answer 8

• peripheral prec. puberty w/low LH that remains low after GnRH stimulation
• unilateral testicular enlargement/testicular mass

Question 9

Most common galactosemia

Answer 9

galactaose-1-phosphate uridyl transferase deficiency

Question 10

Length of mania @ bipolar I vs. bipolar II

Answer 10

• bipolar I ==> mania = >1wk w/severe impairment

- bipolar II ==> hypomania = >=4 days, no psychotic ft.

Question 11

Fat necrosis presentation

Answer 11

-firm, irregular mass w/out nipple d/c

Question 12

Damage to lateral ST tract ==>

Answer 12

contralateral loss of pain and temperature beginning @ two levels below level of lesion

Question 13

Urgent indications for dialysis

Answer 13

• AEIOU
• Acidosis = metabolic acidosis of pH6.5 or sx
• Ingestion = toxic alcohols, salicylate, lithium, sodium valproate, carbamazepine
• Overload
• Uremia = sx encephalopathy, pericarditis, bleeding

Question 14

HUS + penetrating wound ==> ?

Answer 14

laparotomy

Question 15

Chronic hep C presentation

Answer 15

• asx vs. nonspecific fatigue and arthralgias/myalgias
• waxing/waning LFTs
• extrahepatic: mixed cryoglubulinemia, porphyria cutanea tarda, MPGN

Question 16

Esophageal manomentry in achalasia

Answer 16

• increased LES pressure

- impaired LES relaxation

Question 17

Small papules w/central umbilication ==> dx?

Answer 17

molluscum contagiosum 2/2 poxvirus