UWorld_7.26

Question 1

Lacunar stroke presentation

Answer 1

• common syndromes include:
• pure motor hemiparesis
• pure sensory stroke
• ataxic hemiparesis
• dysarthria-clumsy hand

Question 2

Lacunar stroke lesions

Answer 2

• basal ganglia
• subcortical white matter (internal capsule, coronoa radiata)
• pons

Question 3

Timing for alcohol withdrawal seizures

Answer 3

12-48 hours after last drink

Question 4

Cyanide toxicity presentation

Answer 4

• AMS
• lactic acidosis
• seizures
• coma

Question 5

Anterior mediastinal mass ddx

Answer 5

• “4 Ts”:
• thymoma
• teratoma (mixed germ cell tumor)
• thyroid
• terrible lymphoma

Question 6

Evaluation of suspected androgen-producing tumor

Answer 6

DHEA-S (hehydroepiandrosterone-sulfate)

Question 7

First trimester anomaly screening options

Answer 7

-@ 9-13 weeks: triple test (PAPP A, bHCG, nucal translucency) 10 wks: cell free fetal DNA 35 yo)

Question 8

ipratropium MOA, use

Answer 8

• MOA: anti-muscarinic (anti-cholinergic)

- use = sx of COPD

Question 9

Tx of young cystic fibrosis pt. w/PNA

Answer 9

vancomycin

Question 10

Most severe mutation types

Answer 10

• nonsense

- frameshift

Question 11

Tx of PCP pneumonia in HIV pt.

Answer 11

TMP-SMX + corticosteroids

Question 12

First line therapy for angina pectoris

Answer 12

• ASA
• B-blockers (metoprolol)
• sublingual nitro PRN

Question 13

Cause of ED after pelvic fracture

Answer 13

nerve injury and disruption of arterial supply

Question 14

Morton neuroma presentation

Answer 14

• MN = mechanically induced degenerative neuropathy

- numbness, aching, burning @ distal forefoot from metatarsal heads to third/fourth toes

Question 15

Tarsal tunnel syndrome presentation

Answer 15

• 2/2 compression of tibial n. as it passes through ankle (usually 2/2 fractures around ankle)
• burning, numness, aching @ distal plantar surface of foot/toes +/- radiation to calf

Question 16

Prevent progression of diabetic nephropathy

Answer 16

-strict BP control w/target = 130/80

Question 17

Characteristics of dipyridamole cardiac testing

Answer 17

• injected during myocardial perfusion scanning
• reveals areas of restricted myocardial perfusion
• “steal syndrome” = redistribution of blood to non-diseased areas induced by injection

Question 18

Tx of reactive arthritis

Answer 18

NSAIDs

Question 19

Reactive arthritis

Answer 19

“can’t pee, can’t see, can’t climb a tree”

urethritis, conjunctivitis, arthritis

Question 20

OCD tx

Answer 20

• SSRIs

- CBT/exposure therapy

Question 21

Patau’s syndrome

Answer 21

xx

Question 22

Cause of osteomylitis 2/2 nail puncture wound

Answer 22

pseudomonas

Question 23

Complication of uncontrolled infection of facial skin

Answer 23

cavernous sinus thrombosis

Question 24

Presentation of cavernous sinus thrombosis

Answer 24

• can occur in setting of uncontrolled infection of face, sinuses, orbit
• H/A
• periorbital edema
• binocular palsies

Question 25

Dx/Tx of cavernous sinus thrombosis

Answer 25

- MRI | - IV abx/prevent herniation

Question 26

UGI bleed unusual lab findings

Answer 26

- low Hb | - elevated BUN and BUN/Cr ration

Question 27

Cooling in heat stroke

Answer 27

ice water immersion preferred

Question 28

Thiazide diuretic SEs

Answer 28

- hyperglycemia (worse in pt.s w/DM) - increased LDL/TGs - hyperuricemia - electrolytes: hyponatremia, hypokalemia, hypomg, hyperca

Question 29

Ovarian torsion tx

Answer 29

- laparoscopy w/detorsion - ovarian cystectomy - oophorectomy if necrosis/malignancy

Question 30

Behcet disease presentation

Answer 30

- recurrent, painful oral apthous ulcers - genital ulcers - eye lesions/uveitis - skin lesions - thrombosis

Question 31

Dx of Behcet disease

Answer 31

- pathergy = skin ulceration w/minor trauma (e.g. needlestick) - biopsy ==> nonspecific vasculitis of different-sized vessels

Question 32

Pulmonary nodule w/halo sign ==> dx?

Answer 32

aspergillosis

Question 33

Steroids skin SE

Answer 33

steroid-induced folliculitis ==> monomorphous, erythematous follicular papules

Question 34

Management of solid testicular mass

Answer 34

- ochiectomy | - avoid FNAB/transscrotal biopsy to avoid spillage of cancer cells

Question 35

Blastomycosis presentation

Answer 35

- Great Lakes, Mississippi river, Ohio river (WI is highest) - pulmonary: productive cough - skin and bone lesions - broad budding yeast from sputum

Question 36

Cause of calcium phosphate stones

Answer 36

- primary hyperparathyroidism | - renal tubular acidosis

Question 37

Most common kidney stones

Answer 37

calcium oxalate

Question 38

cysteine stones cause

Answer 38

- congenital error of metabolism | - fhx of stones

Question 39

struvite stones cause

Answer 39

- proteus infection (urease-producing) | - assoc. w/hx of recurrent UTIs

Question 40

Types of conditions that lead to digital clubbing

Answer 40

- intrathoracic neoplasms - intrathoracic suppurative diseases (e.g. CF, abscessn bronciectasis) - lung disease (except COPD) - cyanotic congenital heart disease

Question 41

RA typical joint involvement

Answer 41

- MCP and proximal PIPs initially - MTPs of toes - wrists - cervical spine ==> spinal sublux/cord compression