UWorld_7.20

Question 1

Management of prepatellar bursitis

Answer 1

• prepatellar bursitis = “housemaid’s knee” often 2/2 s.aureus
• aspiration of bursal fluid for cell count/gram stain
• negative ==> anti-inflam. + activity modification
• positive ==> drainage + abx

Question 2

5-alpha reductase deficiency presentation

Answer 2

• cannot convert testosterone to dihydrotestosterone

- ambiguous genitalia @ birth + internal male genital tract

Question 3

Beckwith-Wiedmann syndrome presentation

Answer 3

• deregulation of imprinting @ 11p15 ==>
• fetal macrosomia, rapid growth
• omphalocele/umbilical hernia
• macroglossia
• hemihyperplasia
• wilms tumor
• hepatoblastoma

Question 4

hemihyperlasia in infant ==> ?

Answer 4

beckwith-wiedmann syndrome

Question 5

Type I RTA

Answer 5

• poor H+ secretion into urine

- distal

Question 6

Type II RTA

Answer 6

• poor bicarb resorption

- proximal

Question 7

Type IV RTA

Answer 7

• aldosterone resistance

- hyperkalemia

Question 8

Tx of restless legs

Answer 8

-supplement iron @ ferritin

Question 9

Presentation of right ventricular infarct

Answer 9

• hypotension
• JVD
• clear lung fields

Question 10

Type of radiation used for recurrence after radical prostatectomy

Answer 10

salvage

Question 11

Anion gap metabolic acidosis

Answer 11

• methanol
• uremia
• dka
• polyethylene glycol
• isoniazid
• lactic acidosis
• ethylene glycol
• salicylate

Question 12

BAT + LUQ pain radiating to shoulder ==> dx?

Answer 12

suspect splenic injury

Question 13

Evaluation of nonbloody nipple d/c w/out lumps

Answer 13

• pregnancy test
• guiac test
• serum prolactin, TSH
• consider pituitary MRI

Question 14

Splenectomy ==> impaired _____?

Answer 14

phagocytosis

Question 15

MALT (mucosa-assoc. lymphoid tissue) tumor management

Answer 15

• tx H. pylori

- omeprazole + clarithromycin + amoxicillin

Question 16

Vaccines after splenectomy

Answer 16

• PCV13, meningococcal, h. flu @ 14 s/p splenectomy
• PPSV23 next + 5 years later + @ 65yo
• Mening. q5yrs

Question 17

Henoch-Schonlein purpura presentation

Answer 17

• palpable purpura
• arthritis/arthralgia
• abdominal pain/intussusceptions
• renal dz ~ IgA nephropathy

Question 18

+ TB skin test in healthy patient

Answer 18

> 15mm

Question 19

+ TB skin test in non-healthy/special populations

Answer 19

• > 5mm @: HIV+, immunosuppressed, known TB

- >10mm @: “high-risk” e.g. immigrants, healthcare workers, IVDU

Question 20

Aortic regurgitation murmur

Answer 20

• early diastolic
• high pitched, blowing @ left sternal border
• louder on expiration

Question 21

Most common clotting disorder

Answer 21

Factor V Leiden

Question 22

Uveitis presentation

Answer 22

• blurred vision with moderate pain
• conjunctival injection
• constricted pupils just

Question 23

Von-Gierkes disease presentation

Answer 23

• G6-phosphatase deficiency
• 3-4 mo. w/hypoglycemia, lactic acidosis, hyperuricemia, hyperlipidemia
• doll-like face
• thin extremities
• short
• protuberant abdomen

Question 24

“brick dust” in neonate diapers = ?

Answer 24

• uric acid crystals

- not concerning if growing/feeding well

Question 25

Pulmonary nodule high-risk characteristics

Answer 25

- older, w/long smoking hx, irregular margins | - surgical excision

Question 26

Biliary atresia presentation

Answer 26

- @ 1-8wks: - jaundices - pale stools/dark urine - hepatomegaly - conj. hyperbili - mild elevated LFTs

Question 27

Breast milk jaundice presentation

Answer 27

- unconj. hyperbili | - @ week 2 of life