UWorld_7.19

Question 1

Tx of lichen sclerosis

Answer 1

high-potency vaginal steroids

Question 2

Tx of atrophic vaginitis

Answer 2

low-dose vaginal estrogen

Question 3

Causes of bilious emesis @ neonate

Answer 3

• meconium ileus
• hirschsprung disease
• malrotation
• duodenal atresia

Question 4

Bilious emesis @ neonate + gasless abdomen on abd. xr ==> evaluation?

Answer 4

• upper GI series:

- if ligament of treitz on right side ==> malroation

Question 5

Evaluation of dilated loops of bowel on abd. XR

Answer 5

• constrast enema
• @ microcolon ==> meconium ileus
• @ rectosigmoid transition zone ==> hirschsprung

Question 6

Double bubble sign ==> dx?

Answer 6

duodenal atresia

Question 7

blunt chest trauma + hemorrhagic shock + tracheal deviation ==> dx?

Answer 7

hemothorax

Question 8

Cause of urinary retention in older person w/sciatica

Answer 8

pain prevents valsalva (esp. if also BPH present)

Question 9

Indications for cystoscopy

Answer 9

• gross hematuria w/out evidence of glomerular disease or infection
• microscopic hematuria w/risk for malignancy
• recent UTIs
• obstructive sx w/suspicion for stricture/stone
• irritative sx w/out urinary infection

Question 10

Risk factors for bladder cancer

Answer 10

• smoken
• occupation: pains, metal workers
• chronic cystitis
• cyclophosphamide exposure
• pelvic radiation

Question 11

Furuncle presentation

Answer 11

• skin abscess
• usually 2/2 s. aureus
• painful pustule/nodule draining purulent material

Question 12

Myxoma presentation

Answer 12

• constitutional sx: fever, weight loss, raynauds
• CV
• embolization
• lung invasion

Question 13

Loss of peripheral vision + cupping of optic disc ==> dx?

Answer 13

open-angle glaucoma

Question 14

Justification for anti-depressants in teens

Answer 14

risk for suicide from untx depression outweighs risk of suicide from taking meds

Question 15

Mechanism of amenorrhea in female athletes

Answer 15

-decreased GnRH and LH ==> decreased estrogen

Question 16

Risks for aspiration PNA

Answer 16

• poor dentition
• upper GI instrumentation
• GERD
• dysphagia
• impaired consciousness

Question 17

Hyperthyroidism w/low radioiodine uptake

Answer 17

• silent/painless thyroiditis

- subacute/de Quervain’s thyroiditis

Question 18

Mesenteric ischemia presentation

Answer 18

• rapid onset periumbilical pain (severe)
• pain OUT OF PROPORTION to exam
• hematochezia (late complication)

Question 19

Papilledema impact on vision

Answer 19

• caused by increased ICP
• transient vision loss for seconds w/changes in head position
• req. urgent evaluation b/c canc lead to vision loss

Question 20

rapid correction of hypernatremia ==> ?

Answer 20

cerebral edema

Question 21

rapid correction of hyponatremia ==>

Answer 21

osmotic demyelination

Question 22

Presentation/tx of bacillary angiomatosis

Answer 22

• bright red, firm, friable exophytic nodules
• caused by bartonella
• tx = oral erythromycin

Question 23

Succinylcholine SE/contraindication

Answer 23

• depolarizing m. relaxant

- can lead to K+ release; contraindicated @ hyperkalemia