UWorld_7.23

Question 1

Inconclusive fast ==> ?

Answer 1

dx peritoneal lavage

Question 2

Back pain red flags

Answer 2

• age > 50
• hx cancer
• constitutional sx
• nighttime pain ==> interrupted sleep
• pain > 1 mo.
• no response to prev. therapy
• neuro sx

Question 3

Anticholinergic poisoning sx

Answer 3

• dry mouth.skin (“dry as a bone”
• blurry vision/mydriasis (“blind as a bat”)
• hyperthermia (“hot as a hare”)
• urinary retention (“full as a flask”)
• decreased bowel sounds
• cutaneous vasodilation (“red as beet”)
• AMS (“mad as a hatter”)

Question 4

Tx anticholinergic poisoning

Answer 4

physostigmine = cholinesterase inhibitor

Question 5

Laryngomalacia improves w/…

Answer 5

prone

Question 6

Vascular ring presentation

Answer 6

-presents @

Question 7

Management of infat/neonate meningitis

Answer 7

• 3rd ge. cephalosporins (cefotaxine @ neonates, ceftriaxone @ older infants) + vancomycin
• dexamethasone ==> less SN hearing loss

Question 8

Euthyroid sick syndrome presentation

Answer 8

• “low T3 syndrome”
• decreased total/free T3
• normal T4
• normal TSH
• occurs in pt.s w/ acute/severe illness

Question 9

CGD mechanism/dx

Answer 9

• PMN/phagocyte dysfxn

- dx: nitroblue or dihydrorhodamine 123 test

Question 10

Wiscott-Aldrich syndrome presentation

Answer 10

• X-linked R
• eczema
• thrombocytopenia
• recurrent infections

Question 11

Schistocytes indicate ?

Answer 11

• microangiopathic hemolytic anemia (e.g. DIC, TTP, HUS)

- not assoc. w/splenomegaly

Question 12

Presentation of autoimmune hemolytic anemia

Answer 12

• normocytic anemia
• reticulocytosis
• splenomegaly
• jaundice
• elevated indirect bili, LDH, and decreased hapto
• peripheral smear = spherocytes
• (+) direct antiglobulin (Coombs) test w/IgG ==> warm
• -(+) direct antiglobulin (Coombs) test w/IgM ==> cold

Question 13

Causes of warm agg. AIHA

Answer 13

• drugs (e.g. penicillin)
• viral infections
• autoimmune (e.g. SLE)
• immunodeficiency
• lymphoproliferative (e.g. CLL)

Question 14

Tx warm agg. AIHA

Answer 14

• steroids

- splenectomy if refractory

Question 15

Causes of cold agg. AIHA

Answer 15

• infections: MAC PNA, mono

- lymphoproliferative (e.g. CLL)

Question 16

Tx of cold agg. AIHA

Answer 16

• avoid cold temp.

- rituximab +/- fludarabine

Question 17

Hypercalcemia sx

Answer 17

• fatigue
• **constipation
• depression

Question 18

Leukoreduced RBC purpose/use

Answer 18

• chronic transfusions
• CMV at-risk pts
• potential transplant recipients
• prev. FEBRILE NONHEMO transfusion rxn

Question 19

Washed RBC purpose/use

Answer 19

• IgA def.
• complement-dep./cold AIHA
• allergic rxns

Question 20

Rash on face + periorbital edema + proximal muscle weakness ==> dx?

Answer 20

dermatomyositis

Question 21

Dermatomyositis presentation

Answer 21

• cutaneous findings: facial rash, periorbital edema, chest/lateral neck rash
• gottron’s papules = violaceous, slighlty scaly papules over joints
• proximal m. weakness + elevated CPK
• anti-Jo and anti-Mi-2

Question 22

PTU SE

Answer 22

agranulocytosis

Question 23

methimazole SE

Answer 23

agranulocytosis

Question 24

N/V after eating rice

Answer 24

bacillus cereus

Question 25

Lab findings in PCV

Answer 25

- elevated Hb - leukocytosis, thrombocytosis - low EPO - JAK2 mutation +

Question 26

Friedrich Ataxia

Answer 26

xxxxxx

Question 27

Most common cause of intermittent tachy arrhythm. in non-structural heart dz?

Answer 27

- paroxysmal supraventricular tachycardia | - accessory conduction through the AV node

Question 28

Self-management of PSVT

Answer 28

-vagal maneuvers: valsalva, carotid massage, immersion in cold water ==> slowing @ AV node

Question 29

Med management of PSVT

Answer 29

adenosine = short-acting AV node block

Question 30

Early complications of STEMI

Answer 30

- reinfarct (hours - 2 days) - septal rupture (hours - 1 week) - free wall rupture (hours - 2 weeks) - post-infarct angina (hours - 1mo.)

Question 31

Late complications of STEMI

Answer 31

- Papillary m. rupture (2 days - 1 week) - pericarditis (1 day - 3 mo.) - L. ventricular aneurysm (5 days - 3 mo.) ==> HF