UWorld 6

neguwota's version from 2016-07-06 18:13


ContentOpacitypHMicroscropic Apperance
Calcium OxalateYesNormalOctahedron(Square with "X" in the center)
Calcium PhosphateYes>7.0Elongated wedge shaped/ Form Rosettes
Magnesium Monophosphate(Struvite)Yes>7.0Rectangular prism(Coffin lids)
Uric acidNo<7.0Yellow or red-brown diamond or rhombus
Cystine(Amino acid) Yes <7.0Flat, yellow, Hexagonal
Infective endocarditis(Rheumatic fever) initiating pathophysiologyFibrin Deposits
Erythema Multiforme -> Sever cases affects oral mucosa -> In HSV, Mycoplasma <img src="">



Visual defects

2Right Nasal Hemianopia
3Bitemporal Hemianopia(Chiasmal lesion)
4Left Homonymous Hemanopia(Optic Tract)
5Left Homonymous inferior quandrantopia(Lower Optic radiation)
6Left Homonymous superior quandrantopia(Upper Optic radiation) <">
7 Left homonymous hemianopia with macular sparing
Central Scotoma -> Small yellow retinal lesions in macula


Question Answer
Fat9 calories per gram
Ethanol7 calories per gram
Protein & Carbohydrate4 calories per gram


: Osmolarity
Question Answer
Acute Gi Hemorrhage & DiarrheaLow Volume(ECF only), Normal Osmolarity
Adrenal InsufficenyLow volume(ECF), Low osmolarity
Diabetes Insipidus & SweatingLow volume, High Osmolarity
Hypertonic SalineHigh volume, High Osmolarity
Primary PolydipsiaHigh volume, Low osmolarity


RifampinGrapefruit Juice
Ethanol (chronic alcohol)Isoniazid


: Lymph Nodes
Question Answer
Glans Penis & Cutaneous of posterior calfDeep Inguinal Lymph Nodes
Anus, Scrotum, External Genitalia, UmbilicusSuperficial Inguinal Lymph Nodes
Superior BladderExternal Illiac Nodes
Inferior Bladder, ProstateInternal Illiac Nodes
Surgical Neck fracture of humerusPosterior Circumflex artery
Midshaft fracture of the humerusDeep Brachial Artery -> Radial Nerve defect(Wrist extension)
Subracondylar fracture of humerusBrachial Artery


Question Answer
SchizoidWants to live alone
SchizotypalWants to live alone + Magical thinking
SchizophrenicWeirder than schizotypal
SchizoaffectivePsychotic sx + bipolar or depressive mood


Question Answer
FabryAccumulation of Globotriasylceramide
Tay sachsAccumulation GM2 ganglioside
GaucherAccumulation Glucocerebroside
krabbeAccumulation Galactocerebroside


Question Answer Column 3
OslerWeberRendu SyndromeTelangiectasis in skin, mucousmembranes lips, Respiratory Tract, GI, UrinarySx - Epistaxis, Gi bleeding and hematuria
SturgeWeberPort wine stains, v1 distribution, leptomeningeal angiomas, pheochromocytomasGlaucoma, seizures, hemiparesis, mentral retardation,Tram track calcifications
Tuberous SclerosisHamartomas, Adenoma sebaceum, Mitral regurg, Ashleaf spots, RhabdomyomaAD, Mental retardation, Angiomyolipoma, Seizures
Neurofibramatosis Type I(Von Recklinghausen diseaseCafe-au-lait, Lischnodules(iris), opticgliomas, pheochromocytoma, 100%penetrantMutated NF1 (17)
Nf2Schwanomas & Medial meningomaAutosomal Dominant
VHLPort wine stains, v1 distribution, leptomeningeal angiomas of cerebelum, RENAL CYSTSDifferential between SturgeWeberSyndrome(familial teleangiectasis)
JAK Mutation aka Cytoplasmic tyrosine kinase aka Non-receptor mutationPolycythemia vera -> High RBC, headache, sweating, shower pruritus, facial plethora, splenomegaly, gouty arthritis(Increased RBC turnover)


Question Answer
Postpartum Hemorrhage can be stoppedBilateral ligation of Internal Illiac artery
IL2 effect on tumor cellsEnhance the activity of Natural Killer cells
Thyroid Ectopy(Breathying difficulty Hoarsness, Bright red lingual mass, dysphagia)Migration Failure
Acute stress disorder3Days to 1 week
PTSDOne month and more
Pt has trauma to leg and sever pain and worsening swelling in the injured leg with creptiusClostridium perfringens -> Similar condition is food pisioning -> Transient watery diarrhea and abdominal discomfort
Dystrophin geneDeletion of this gene through frame shift mutation leads to DMD
Endomysial inflammatory infiltratePolymyositis
Endoneural Inflammatory infiltrateGuillianBarre syndrome
Turner SyndromeStreak Ovaries same as Atrophy of ovaries
Young boy with normal growth till 6 months develops many episodes of otits media and has Giardia. Lab work up shows low levels off all immunoglobulinsX gammaglobulinemia -> Tyrosine Kinase gene mutation -> Lack of Cd19&Cd20
Sarcoidosis High Cd4 T cells & CD4/CD8 ratio 2:1 in bronchoalveolar lavage fluid for diagnosis
Pt with history of hypertension, hypercholestrolemia, who presents with hard time speaking, weakness of arm and resolves within 20 minsTransient Ischemic Attack -> Tx Aspirin -> Sx Gi bleeding
Pt has not eaten for 34 hrs and glucose level normal is due toOxalacetate-> phosphoenolpyruvate -> Enzyme PHOSPHOENOLPYRUVATE CARBOXYKINASE(Gluconeogenesis)
Pt has not eaten for 12 hrs and glucose is normal is due toGlycogen -> Glucose-1 phosphate
Increased A-fetaprotein, liver mass in a HBV carrier ptHepatocellular Carcinoma due to Viral DNA integration into the host genome
Resting membrane potential of muscle cellsNa & K
Resting membran potential of cardiomyocytesCa & K
CMV and EBV tx drugs cant be used with Herpes and varicella virus due toDrug phosphorylation rate
Active TB never treat alone but INSTEADRIPE due to -> Resistance Selective survival of bacterial cells secondary to gene mutation
Pt has water deprivation test and urine osmolarity is 200(low), after ADH administration it goes up to 750 osmolarity DiagnosisCentral Diabetes Insidious problem is at the Hypothalamus and NOT Posterior pituitary
Pt has water deprivation test and urine osmolarity is 200(low), after ADH administration it increases little 300 osmolarity DiagnosisNephrogenic Diabetes Insidious problem is at the kidney
Clasp knife rigidity(initial resistance follow by sudden release of tension as extension is continued), motor weakness, slurred speechUpper motor neuron problem Internal capsule
Pt with hypertension presents to ER "obtunded and bradycardia"Beta blocker overdose -> Treat with Glucagon -> Increase cAMP in cardiac myocytes
Diastolic Heart failureDecreased Ventricular compliance, Increased LV filling pressure, Normal Left ventricular ejection fraction & LV end-diastolic pressure
Inhibit funny Na channels during Phase 4 -> Decreasing HR but NO effect on contractility or relaxationIvabradine
S penumonia, H Influenza, N isseriaHas the ability to take the up DNA from environment -> Lead to lysing of and killing cells -> Transformation
Young pt with history of no vaccinations, presents with inspiratory stridor"leaning forward and making a lud hard shound with every inspiration", swollen and erythematous epiglottisHaemophilus Influenzae -> Virulence Factor - Polyribosylribitol phosphate
LecithinaseClostridum perfringens
M proteinStreptococcus
Protein AS.Aureus
Trehalose DimycolateM.Tuberculosis
Colicky upper abdominal pain, nausea, vomiting, dark brown, soft, primarily of calcium bilirubinate with small or little amounts of cholesterolGallstones from infection(e.coli, ascaris lumbricoides, clonorchis) of biliary tract -> Release of Beta-Glucuronidase by injured hepatocytes & Bacteria
Higher BMIHigher Leptin -> which are released from adipocytes to make you stop eating -> Mutation leads to more eating
Pt with obstructive sleep apnea leads to increased HematocritDue to the kidney production of Hematocrit
Pt with Alzhemizers expect to see in brainAmyloid(Neuritic)Plaques -> Same as senile plaque, neurofibillary tangles(Hyperphosphorylated Tau proteins)
Boy 4 yr old with high testosterone, high 17-hydroxyprogesterone, manly hair, manly smell21 Hydroxylase deficiency Adrenal cortical Hyperlasia TX Suppress ACTH
RED Neurons -Cytoplasmic eosinophil loss of nissl substance12-24hrs
p53 & RB & Mantle cell lymphomaG1 to s phase regulators
Burkitt lymphomaTranscription activation
Follicular lymphomaApoptosis inhibiton
Brca 1 & 2Dna repair problem
BCR-ABL-> CMLTyrosine Kinase
Chrons disease associated with ca oxalate stone due to impaired bile acid reabsorption at the terminal ileumReduced intestinal calcium oxalate binding -> Stones
COPD Pt has increasedIncreased functional residual volume & decreased elastic recoil
Fever cough rihnorhhea, conjunctivitis, koplick spots"Tiny white or blue grey lesions on buccal mucosa"Measles -> Rash presents later from head to toe
Buprenorphine is a partial opoid receptor agonistPrecipitate withdrawal
Progressive sever pain of the ear, moving or touching the pinna produces extreme pain, G- rodOtits Externa -> Psuedomonas -> ~G- Rod NonLactose fermenter & Non motile
Rheumatoid factor high specifictyCitrullinated peptides AKA anti-CCP
Rheumatoid factor High sensitivityFc portion of Human IgG
Pt having incontinence due to detrusser instability. DOCGO -> Glycopyrulate & Oxybutynin -> Antagonism of Muscarinic Cholinergic receptors
Auer rods -> Linear purple red linesAML-> Fatigue & Easy bruising/No Lymphadenopathy
Intralveolar HemorrhageEmphysema -> A1 Anti Trypsin deficiency -> COPD(Reduced expiratory flow velocity, increased residual volume, limitation of tidal volume)
Pt presents with bulky, foul smelling, loose stools, loss of weight. Best management optionStool test with SUDAN III stain most sensitive for malabsorption
Elderly pt presents with flank discomfort & red urine. Afew weeks ago pt had stroke and hemiplegia, lactate dehydrogenase levels elevated(Cell necrosis), rbc in urine, wedge shaped infarct on kidneysRenal infarction due to emboli from atrial fibrillation due to history of stroke
Pt nausea resistant to ondansteron and is given a new drugNeurokinin 1 antagonists -> Aprepitant, Fosaprepitant
Recall BiasInability to recall past exposure due to lack of memory
Selection BiasNot a selecting issue but instead ~inability to follow up pts after a period of time leading to in balance amount of participants left in exposed vs Non exposed group. Prevention - Try to achieve high pt followup
Cystic fibrosisFrame shift mutation
Bicep ReflexC5-C6
Tricep ReflexC7-C8
Shoulder shrugC4
Deltoid abductionC5
Wide fixed splitting of the second heart soundASD -> NO repair leads to -> Eisenmenger syndrome -> Pulmonary vessel hypertension
Neprilysn InhibitorsSacubitril -> Prevents breakdown of ANP -> Used in Heart failure pts
Vasopressin(ADH)Urea reabsorption in the collecting tubules
SpirnolactoneSpare K and hydrogen ions
Young boy present with respiratory infections with lack IL12 txIFN-y - IL 12 receptor deficency
T-tubules in skeletal muscleUncoordinated contraction of myofibrils
Pt presents with heavy painful menstrual bleeding, sexually active and had bilateral tubual ligation, Uterus is enlargedAdenomyosis ->Endometrial tissue in the myometrium
Folate deficiency leads to Erythroid precursor cell apoptosis ReticulocyteInhibiton of Erythroid precursor cell apoptosis is ~Thymidine
Genetic condition of K ion channel defect, decreased outward K flow with deafnessJaervell & Lange-nilsen syndrome
Reyes SyndromeLight microscopy of liver -> Microvesicular Steatosis
Chronic smoker, Trachieal deviation towards the right affected sideAtelectasis -> Obstructive lesion the right mainstem bronchus due to central lung tumors
Most effective in lowering blood pressure without worsening or affecting heart conduction or ECG readingsNifedipine, Amlodipine, Felodipine
Pt with history of hypertension and hypercholestrolemia, presents with firm mass is palpated in the right upper quadrant, calcification around the gall ballderPorcelain gallbladder Risk of gall bladder adenocarcinoma
Follicular lymphomaT(14:18) -> Bcl 2 over expression
Glioblastoma MultiformeGross- Areas of necrosis & hemorrhage, Light Microscopy- Pseudopalisading tumor cells
Low murmur, holosystolic murmur that is worse during hand grip maneuver(increased afterload)VSD
High Incidence and Low PrevalanceDeadly disease where many people are getting affected and not survivng
Trendelenburg sign + ->PT LEANS TO RIGHT SIDE SIDE WHEN WALKING and when standing on right leg the left hip goes downSuperior Gluteal Nerve injury(Injections,hip surgery)
Pt who presents with acute knee pain with redness, swelling, severe pain of right knee with 3 similar episodes and has a history of polycythemia veraGout due to high uric acid in blood due to cell turnover OR kidney conditions-lack of excretion of uric acid
Celiac DiseaseIgA transglutaminase Duodenal and Jejunal Biopsy
Clue cells(Epithelial cells covered with gram variable rods)Bacterial Vaginosis
Baby presenting with diarrhea, stetorrhea, lack of growth vitamin deficiency and duodenal biopsy shows pearly crypts and atrophic villous is suggestive ofCeliac disease ~Elevated IgA anti-endomysial & anti-tissue transglutaminase