Uworld 8

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Uworld 8
2013-05-05 18:18:36

Uworld 8
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  1. Management of a tension pneumothorax that is diagnosed clinically?
  2. prophylaxis with rabies iv should be given to patients who were bitten by what kind of animals?
    carnivores like bats, skunks, foxes
  3. rx for minimal change disease?
  4. horseshoe kidneys are seen in what 2 conditions?
    • Turners
    • Patau
  5. hypermobility, blue sclera, dentinogenesis imperfecta are all a part of what syndrome?
    Osteogenesis Imperfecta
  6. first step after placement of a central venous catherer guided by ultrasound?
  7. most common presentation of renal papillary necrosis?
    painless hematuria
  8. management of a solitary metastatic nodule from a lung cancer tot he brain?
    multiple metastatic nodules?
    resection and whole brain irradiation

    multiple--palliative care with whole head radiation
  9. rx for an abcess in the pleura of the lungs--( empyema)
    surgery and drainage
  10. 3 indications for oxygen therapy in copd?
    • SaO2--88
    • PaO2--55
    • pulmonary htn and PaO2--60
    • signs of cor pulmonale
    • hematocrit->55%
    • pao2 60 and sao2 90 if nocturnal hypoxia
  11. cause of lymphedema in turners?
    dysgenesis of lymphatic networks
  12. what two conditions have non pitting edema?
    • turners--lymphadema
    • hypothyrodism--increased glycosaminoglycans
  13. congenital causes of high unconjugated bilirubin?
    conjugated bilirubin?
    • gilbert
    • crigler-naiglar 

    • conjugated--dubin and rotor
    • both have normal alp
  14. best initial rx for acute and chronic anal fissures?
    rx for refractory cases?
    stool softener, diet modification and local anesthetic

    lateral sphincteroctomy
  15. 3 complications of nephrotic syndrome?
    • loss of anti tthrombin 3 leading to hypercoagubility
    • increased infections
    • high lipids--atherosclerosis
  16. fluid in abdomen and hemodynamically unstable, next step?
  17. most common presenation of sickle cell patient?
    • painless hematuria
    • inability to concentrate urine
  18. side effect of carbamezapine?
    aplastic anemia
  19. 1st line rx for hcm?
    • bb
    • or ccb like diltiazem or verapamil
  20. inheritance of hcm?
    autosomal dominant
  21. dm most commonly produces what kind of neuropathy/.
    distal symmetrical polyneuropathy
  22. itching rash?
  23. best initial rx for stye caused by s. auresu?
    warm compress if doesnt resolve after 48 hours, I and D
  24. rx for chalazion?
    incision and curettage
  25. cause of cholesterol emboli syndrome?
    disruption of an atherosclerotic plaque leading to livedo reticularis and acute renal failure
  26. lab finidings in cholesterol emboli syndrome?
    • eosinophilia
    • low complement levels
  27. most common cause of idiopathic cirrhosis?
    • alcohol abuse
    • chronic infection iwth hep b
  28. duration of rx for bipolar after 1 episode?
    duration of rx for bipolar after 3 relapses?
    1 year and taper

  29. best diagnostic test for fat embolism?
    • fat droplets in urine
    • fat deposits in the arterioles on fundoscopy exam
  30. chest pain, abdominal pain thats worse with palpation?
  31. managment of refractory cases of myesthenia gravis?
    • <60---thymectomy
    • >60--- prednisone
  32. components of metabolic syndrome?
    • insulin resistance
    • htn
    • high tg
    • low hdl
    • increased waist size
  33. what causes metabolic syndrome---
    insulin resistance
  34. dry silvery plaques in the eye, what vitamin def?
    vitamin a
  35. poor adaptation to darkness, dry cornea, dry conjunctiva, silvery plaques in the eyes?
    vitamin a deficiency
  36. rx for bipolar with impaired kidney function?
  37. rx for patients with scfe?
  38. what in jelewery causes contact dermatitis?
  39. dheas is specific to what organ?
  40. what drugs causes hyperkalemia?
    • bb
    • digitalis
    • aceI, ARB
    • K sparing
    • tmp smx
    • nsaid
    •  cyclosporine
    • heparin
    • succinylcholine
  41. diagnostic criteria for kawasaki?
    • fever of 5 days +
    • mucous changes
    • conjunctivitis
    • limb changes
    • nodes
    • scantiliform rash
  42. best initial test for as?
    most accurate?

  43. difference in presenation between alzeheimers and normal pressure hydrocephalus?
    alzheimers--memory problems then incontinence

    normal pressure hydrocephalus--incontinence and gait problems first and then memory
  44. Riley Day syndrome(familial Dysautonomia) vs shy-drager syndrome (Mutliple System atrophy)
    • Shy drager-occurs with parkinsons
    • riley day occurs in jews
  45. adults still disease?
    • fever
    • rash
    • arthritis
  46. causes of hypoparathyroidism?
    • digeorge syndrome
    • apecd syndrome
  47. difference between preseptal or periorbital and septal or orbital cellulitis?
    orbital cellulitis has opthalmoplegia including double vision and tenderness with eye movement
  48. difference for periorbital cellutlitis vs orbital cellulitis?
    • periorbital--oral antibiotics
    • orbtial--iv antibiotics
  49. what happens to the levels of thyroxine with ocp?
    icp decrease levels of thyroxine by increased TBG
  50. what happens to the height of an infant as he reaches 1 year?
    4 years?
    13 years?
    • increased by 50%
    • doubled by 4
    • tripled by 13
  51. cause of varcocele?
    • dilated pampiform plexus
    • patent tunica vaginalis
    • dilated epidydimal duct
  52. cause of dilated small and large bowel?
    aparalytic ileus
  53. rx for paralytic ileus?
    rest supportive care
  54. 2 causes for paralytic ileus?
    • retroperitoneal hemorrhage
    • post surgery
  55. electric alternans is specific for what?
    cardiac tamponade
  56. midcycle pain or mittelshmertz, what is the cause of it?
    how does it present?
    • ovulation
    • 2 weeks after last menstruation, no other symptoms such as tach, fever, pain radiating anywhere
  57. what is the quadruaple screen pattern for down syndrmoe?
    • beta hcg is high
    • Inhibin is high

    • msafp is low
    • estriol is low
  58. rx for neuroleptic malignant syndrome?
    • dantrolene
    • bromocriptine
    • amantadine
  59. obesity associated hypoventilation or pickwickian syndrome vs obstructive sleep apnea?
    • in pickwickian--fat prevents movement of the chest wall and abdomen leading to low SaO2
    • vs in osa where SaO2 is normal
  60. rx for active genital hsv infection?
    c section
  61. most common primary  brain tumor in kids?
    second most common?
    • astrocytoma
    • medulloblastoma
  62. Rx for enterobius vermicularis?
  63. aport syndrome vs thin basement  membrane dz?
    • both lead to hematuria and proteinuria
    • but 
    • alports--kids
    • thin basement membrane--in adults
  64. recurrent pneumonia in the right lower lung with foul smelling sputum/.?
    aspiration pneumonia
  65. 3 reasons to replace aortic valve?
    • symptomatic--syncope, angina, dyspnea
    • pt is undergoing gabg
    • low ejection fraction<55% or LVH
  66. 3 p's of maccune albright syndrome?
    • pigmentation
    • precocious puberty
    • polyostic fibrous dysplasia
  67. Mccune albright syndrome usually occurs with what other syndrome?
  68. in any patient that is somnolent or near loss of consciesness, consider?
    intubation so as to prevent aspiration
  69. trazodone indication?
    sleep aid
  70. sumatriptans contraindication?
    • pregnancy
    • prinzmetal
  71. ekg findings with pericarditis?
    • diffuse st elevation
    • pr elevation
  72. what does uremia cause?
    • pericarditis
    • coagulopathy
    • encephalopathy
  73. indications for hemodialysis?
    • acidosis
    • electrolyte disorders like high K
    • Intoxication with methanol 
    • Overload or p. edema refractory to diuretics
    • Uremia--pericarditis, encephalopathy, coagulopathy
  74. 1st line rx for primary biliary cirhosis?
    definitive rx for primary biliary cirhosis?
    • ursedeoxycholic acid
    • liver transplant
  75. 3 occasionas when ursodeoxycholic acid is used?
    • primary biliary cirhosis
    • symptomatic cholelithiasis
    • pregnancy induced cholestasis
  76. when do u transplant in pbc?
    if cirhosis sets in
  77. best initial test for allerghic rhinitis?
    nasal cytology for eosinophils
  78. contraindication to sumatriptans?
    • uncontrolled htn
    • cad
    • prinzmetal
    • ischmic stroke
    • basilar migraine
    • hemiplegic migraine
    • pregnancy
  79. dx of melanoma?
    basal cell carcinoma?
    • full thickness biopsy
    • punch biopsy
    • shave biopsy
  80. best initial analgesic rx for oa?
    • tylenol
    • nsaids
    • capsacin cream
    • intraarticular steroids
    • joint replacements
  81. rx for human and dog/cat biutes?
    amoxicilian/clavulanic acid
  82. most common side effects of ssri?
    • impotenece
    • decreased libido
    • impaired ejaculation
  83. management of a fetus with major congenital disorder that renders it icompatible with life?
    vaginal delivery
  84. best initial rx for spinal cord compression with neurological deficits?
  85. rx for angioedema?
    • abc
    • epinephrine
    • tracheostomy
  86. management of terminal malignancy pain?
    • nsaids
    • short term opiods
    • long term opiods
  87. what kinds of vessels supply the internal capsule?
    small vessels--ie. lacunar infarcts
  88. what causes hypocalcemia and hypomagnesemia post transfusion?
    the chelating agent citrate in the packed RBC
  89. when do you treat pid as inpatient vs outpatient?
    inpatient--nausea and vomiting- cant take anything by oral

    outpatient--cant take oral antibiotics
  90. hiv pt with esophagitis symptoms, next step?
    • trial of fluconazole
    • if fails to improve
    • biopsy
  91. progressing stroke symp[toms usually imply what kind of pathology?
    intracerebral hemorrhage leading to increased ICP
  92. after treatment for cin 2 and 3 what is the screening recommendation?
    • pap smear with or without colposcopy untill 3 negative tests are obtained
    • then regular screening
  93. genotype xx and no uterus, cause?
    genotype xy and no uterus?
    mulllerian agensis

    • androgen insensitivity
    • alpha 5 reductase deficiency
  94. hydantoin syndrome caused by?
    phenytoin and carbamezapine
  95. presentation of hydantoin syndrome?
    think hypoplasia
    • microcephaly
    • facial hypoplasia
    • digital hypoplasia
    • lip and palate hypoplasia--cleft lip and palate
  96. difference between fetal alcohol syndrome and hydantoin syndrome?
    fas--no cleft palate and no digit hypoplasia

    hydantoin syndrome--has cleft palate and digit hypoplasia
  97. best initial test when suspecting pad?
    abi if unequivical

    do pre exercise, exercise and post excercise abi
  98. new onset hirsuitism or virilization with pregnancy?
    next step?
    • ultrasound
    • if unilateral solid--laparotomy to r/o malignancy
    • if bilateral solid-reassurance pregnancy luteoma
    • if bilateral cystic-- theca lutein cyst r/o w/ bhcg
  99. presentation of a meniscal tear?
    popping and locking of knee on extension and flexion
  100. what causes the following pathology of the liver?
    balloon degeneration
    panlobular mononuclear infiltration and portal necrosis with bridging fibrosis
    inflammatory desterction of small intrahepatic biliary tracts?
    fatty vacuolization?
    • alcohol
    • hepatitis virus
    • primary biliary cirhosis
    • rye--aspirin induced
  101. ear pain worse with chewing and a history of grinding teeth in sleep?
    tmj dysfunction
  102. ramsay hunt syndrome?
    shingles affecting the ear
  103. best initial rx for tmj dysfunction?
    bite guard
  104. most specific sign for opiod intoxication?
    decreased respiratory effort
  105. 2 conditions that have hyperextensible joints?
    marfans and ehlers danlos
  106. how early do the symptoms of extrapyramidal patter began with antipsychotic therapy?
    • 4 hours--dystonia
    • 4 days-akinesia
    • 4weeks- akathesia
    • 4 months-- tardive dyskinesia
  107. how can respiratory failure be followed in gbs?
    vital capacityu
  108. unequivical sweat chloride test, next step?
    genetic testing
  109. most common cause of erysepalas?
    groub a
  110. most common drug cause iron deficiency anemia?
  111. 1st line rx for pseudotumor cerebri?
  112. most common cause of primary adrenal insufficiency in developing countries?
    developed countries?
    • tb
    • autoimmune
  113. what causes adrenoleukodystrophy?
    deposition of very long chain fatty acids
  114. normal contractions in pregnancy occur how often?
    1 every 5 minutes
  115. when the fetus is how many weeks are steroids given?
    between 24 and 34 weeks
  116. which of the causes of conjugated hyperbilirubeniemia has dark pigments in the hepatocytes?
  117. best initial rx for dubin johnson?
    confirmatory test/?
    • high conjugated bilirubin with normal lfts
    • urinary corproporphyrin I
  118. difference on physical exam between empyema and consolidation?
    • empyema--no bronchial breath sounds
    • consolidation--bronchial breath sounds
  119. perinauds or pinelaoma presents how?
    precocioius puberty and opthalmoplegia
  120. dacrocystitis is ?
    inflammation of the lacrimal glands in the medial canthal fold
  121. which of the infection sof the eye causes purulent discharge?
  122. presentation of fetal alcohol syndrome?
    • long filtrum
    • thin upper lip
  123. most common complication of meningitis?
    what complications arise from meningtis?
    most common is hearing loss

    • all compliations occur--cognitive dysfunction
    • spasticity
  124. inverted champainge glasses look of the legs is seen in ?
    charcot marie tooth disease
  125. when does candida cause pneumonia?