UWorld 9

zomovefa's version from 2017-10-13 01:01


Question Answer
Celiac arteryStomach to proximal duodenum, liver, gallbladder, pancreas, spleen
SMADistal Duodenum to proximal 2/3 of transverse colon
IMADistal 1/3 transverse colon to upper portion of rectum, splenic flexure is a watershed region
A CHF pt on hydralazine and isosorbide dinitrate. ContraindicationSildenafil
Pt with a history of Rheumatoid Arthritis presents with intermittent sharp pain, which is exacerbated by deep breathing and can be decreased by leaning forwardPericarditis
Pt with high triglycerides and the MOA for the vitamin used for TX isAntagonize VLDL Cholesterol Secretion
Fibrate MOAIncreases catabolism of LDL-cholesterol
Minimal Alveolar concentration of an anesthetic has to do withPotency
Blood Gas partition coefficientSolubility and rate of absorption into CNS
Lower Blood gas partition coefficientFaster onset
Higher Blood gas partition coefficientSlower Onset and need more drugs
Roundworm Ascaris LumbricoidesFeces contaminated soil
Pt with DM 2 presents with erythema of the mid calf, edema, exquisite tenderness of the ankle, after cutting his R foot, along with High Leukocyte count. reaction is due toLeukotriene
Drug X alone has decreased BP but Drug X + Angiotensin II increased the bp slightly meansDrug X is partial agonist at Angiotensin II receptors
Pt with a history of Prostate cancer and had an orchiectomy later presents a few weeks later for a followup and showsProstate with scattered shrunken cells due to lack of testosterone from the Testes
Herpes Simples viral enzyme isDNA polymerase
Despite Chloroquine administration what survives?P.Vivax & P.Ovale because you also NEED Primaquine
PTT prolonged in a pt leads to coagulation factors abnomal and inflammatory factor abnormal isKallikrenin (Also works with brady kinin and plasmin)
Hepatits C liver biopsy shows lymphocytic infiltration and collagen deposition is due toChronic Inflammation (lymphocytes is the primary immune reaction)
Non Selective antagonist blocks a1 & b-adrenoreceptorsLabetalol Dx - Hypertension
Pink rods and blue cocciG- and Outer membrane are characteristic
Pudendal nerve respnsible forEjaculation
Hypogastric NerveEmission
Ilioinguinal NervePhysical contact leads to erection for a short period of time
Pt with severe abdominal pain with nausea, vomiting, which the pain originates in the left flankand radiates to the groin with high blood pressure, with tenderness of the left flank and the let lower quadrant of the abdomenUreteral Calculus
Horseshoe Kidney Pt with aneurysm abdominal complicationAbnormal Origins of multiple renal arteries to each kidney
Ligament of the spineLigamentum Flavum
Damage to what structure is very common during the removal of prostatePelvic Parasympathetic Nerves
25-year-old man with severe pain of his low back that radiates down his left leg. He tried to lift a bar loaded with 91 kg (200 lb) from the ground to over his head. The pain began immediately after this attempt. Most likely cause of this patients pain?Rupture of the inter-vertebral disc
Infrapinatus & teres minorRotate the head of humerus outward/ external/ or lateral rotation
SubscapularisMedial(Internal) Rotation & Adduction
Superior Orbital FissureCN III, IV, V1, VI
Foramen RotundumCN V2 Maxillary Branch
Foramen OvaleCN V3 Mandibular Branch
Internal Auditory MeatusCN VII, XII
Jugular ForamenCN IX,X,XI
Foramen SpinosumMiddle Meningeal Artery
Pt who presents with a history of chronic atrophic gastritis complains of lethargy, dizzines, decreased vibratory senses, and HIGH MCV Diagnosis?B12 deficiency due to Parietal cells missing from chronic atrophic gastritis
Release of Hydrogen ionParietal cell Fried egg appearance
SarcoidosisHigh calcium, Low sodium
Cigarette SmokingMucus secretion & Macrophage function GOES UP, Activity of airrway cilia GOES DOWN
6wk-old boy with homozygosity for hemoglobin S(Sickle cell). Daily Rx with penicillin decreases risk of infx from which organism?Most common Streptococcus pneumoniae
Giardia VS Chagas (DO NOT CONFUSE SPECIMEN)Nifurtimox
Pt present with abdominal pain, bloody diarrhea after kenya trip, stool specimen shows throphozoites dysplaying erythrophagocytosis RBC's in the cytoplasmEntamoeba histolytica
Filamentous g + rodNocardia Species
Pt who is going through chemotherapy for ALL Immnocompromised is having lung infiltrates and they are stained with PAS Stain Fungal. DOC?Amphotericin B
45-year-old fever chills, dysuria and a tender, enlarged prostate. Organism?Escherichia Coli
Pt who is alcoholic is collapsed and coughing on park bench.Halitosis, missing teeth, dental caries Chest exam shows increased fremitus, dullness to percussion, and tubular breath sounds over the right lower lung field Pneumonia Sputum shows purulence, gram-positive cocci in chains, and gram-negative bacilli. CXR shows cavitation of right lower lung lobe. Diagnosis?Aspiration Pneumonia -> Normal oral flora NOT supposed to be in lungs
Woman with 1-week history of fever and chills. 4.5-kg weight loss, 5-year hx of chronic sinusitis Temp 102.2 F Has markedly diminished nasal septa. Chest x-ray shows multiple pulmonary nodules Serologic studies show presence of antibodies against proteinase 3 Dx?Wegener Granulomatosis
30yr old man develops hemoptysis, dyspnea, weakness, and hematuria Diffuse pulmonary hemorrhages bilaterally. Renal biopsy shows focal glomerular necrosis with crescent formation and linear deposition of IgG and C3 in glomerular capillary loops Pathogenic mechanisms responsible?RPGN -> Goodpasture Syndrome - Autoantibodies against host cell basement membranes
SarcoidosisEpitheloid macrophages produce High Vitamin D(1,25-Dihydroxycholecalciferol) BUT LOW PTH
Neurotransmitter for PainSubstance P
Bringing body temeprature down is dueEvaporation of sweat
45yr old with congestive heart failure. Two 1st degree relatives died in 40s with dilated cardiomyopathy and cirrhosis Genetics Has cardiac enlargement and generalized hyperpigmentation Glucose is 320. Histologic exam of endomyocardial tissue is most likely to show an excess of?Hemochromotosis -> Iron
24-year-old African American M with 3-mo Hx of red bumps on his face and chin, istchy and painful. Hyperpigmented papules over the cheeks, jawline, and neck~ Dx?Pseudofolliculitis Barbae (Razor Rash)
Menopause confirmed byIncreased Follicular Stimulating Hormone
CT angiography shows large embolism occluding blood flow to the right lower lobe. Which describes ventillation-perfusion relationship in right lower lobe?Dead space
27yr f with 3-week hx of episodes of left-sided chest pain and tenderness radiating to the back and exacerbated when reaching over her head or back. No SOB, sweating, or light-headedness Tenderness to palpation 2 cm lateral to the midline and 10 cm below the clavicle on the left CXR and ECG normal. Dx?Costochondritis (Inflammation of the Ribs)
Charcot Leyden Crystals and eosinophilsAsthma -> Pathogenesis involves Leukotriene C4
24yr old M with nasal congestion, discharge, and sneezing. Happen each spring Which drugs is most effective in relieving these sx in the SHORT TERM?Alpha-adrenergic agonist(Phenylphrine, Midodrine, Epinephrine)


Question Answer
Anerobic glycolysisMetabolic acidosis with High anion gap
Beta-oxidation of fatty acidsKetones
Citric acid cycleMore CO2, FADH2, NADH


Question Answer
Distal esophagusAdenocarcinoma
Proximal esophagusSquamous cell carcinoma
No Alcohol associationAdenocarcinoma
Gerd associationAdenocarcinoma
Obesity associationAdenocarcinoma
No obesity associationSquamous
No GERD association Squamous
Alcohol associationSquamous
Smoking associationAdenocarcinoma & Squamous


Question Answer
Relationship between the amount of time in weeks spent studying for USMLE and score that the person makes on the examPearson correlation
Unintentional injuries reported between children age 5-9 10-14 15-19 years ageAnalysis of variance
Association between daily smokers and daily coffee drinkersChi-square analysis
Trial and error process in researchPDSA model plan, do, study, act
Understand the steps involved in delivery of patient careFlowcharts
Large proportion of quality problems being caused by a small number of casesPareto charts


Question Answer
Sudden unilateral painless visual lossCentral retinal artery occlusion
Missing areas centrally with normal peripheral vision with pigmentary changes in the maculae of both eyesAge related macular degeneration
Loss of progressive peripheral visual field loss cuppingOpen angle glaucoma


Question Answer
Northern blotsUsed to determine whether a particular gene is expressed in a tissue or in several tissues
Southern blotsCompare DNA samples for genetic relatedness, and for indirect mutation analysis within families with a genetic disease.
Western blotsIdentify proteins based on their ability to bind to specific antibodies
Southwestern blotsDetect DNA-binding proteins and the specific motifs in the genomic DNA to which they bind.

MCC Causes

Question Answer
#1 Cause of Abdominal painPancreatitis
MCC IUD InfectionActinomyces Israelli
MCC of free radicalsInfections due to virus or Neutrophils due to NADPH enzyme
Increase ICP#1 Mass Worst -> Nonctrast to make sure if it is a bleed #2 Infection Lumbar puncture
X-linked Dominant conditions dad gives it to all daughtersVitamin D resistant rickets & Pyruvate dehydrogenase deficiency
MC vitamin deficiency in the worldVitamin D obesity
MCC of folate deficiencyOvercooked vegetables
MCC of Vit b12 deficiency in USAPernicious anemia
MCC of Vit K deficiencyBabies due to lack of gut flora
Movement disorder in middle aged manHuntingtion -> AD, Trinucleotide repeat -> Tx anti-psychotics domaine blockers
MCC of myositisHypothyroidism, Cushings, Drugsfat soluble, Trichnell spirallis Bear meat, Tanes Solium, Jo 1 autoimmune
MCC of newborn hypothyroidism in USAHashimotos Anti-microsomal, anti-peroxidase
MCC of Pancreatitis in children1 Trauma, 2 Infection, 3 Increased Triglycerides, 4 Increase Calcium
MCC of Pancreatitis in Adult1 Alcohol, 2 Gallstone, 3 Increased Triglycerides, 4 Increase Calcium
MCC of CRF in kidsHUS
MCC of CRF in adults1 Hypertension 2 DM
MCC of Iron deficiency in 0-21Inadequate intake in diet NOT heavily menstruating teenage girls
MCC of Iron deficiency in 20-40Inflammatory disease CHRONS
MCC of Iron deficiency 40+Mucosal bleeding -> gi bleed
MCC of Mental retardation?FAS~smooth philthrum, Fragile X, Down syndrome
MCC collagen disease?MarFan
MC arthritis to affect middle aged womenRheumatoid Arthritis followed by 2 SLE
MC drugs to prevent mortality or heart remodelingACE, B-blocker, K sparing diuritics
MCC of death in SLERenal failure -> due to dsDNA
Massive Splenomegaly hinting forBONE MARROW Wiped out -> 1 Aplastic Anemia(EBV), 2 Pagets Disease, 3 Osteopetrosis, 4 Myelofibrosis(cancer)


Question Answer
Climbs stairs without assistance2yr
Rides bicycle6yr
Copies Circle/Stacks nine3yr
Copies Square4yr
Copies Triangle6yr
Uses two words12 months
Two word phrases2yr
Almost all speech intelligible4yr
Anxiety when separated12mo
Hand 2 hand play / stopping momentarily when said NO6mo
Say mama9mo
Plays along side / two step command18mo
Cooperative play4yr

Lysosomal storage

Question Answer
Signs of high TriglyceridesXanthelasma(fat pads on eyelids, shoulder), Pancreatitis
Askenazi Jews lysosomal Gaucher or Tay Sachs
Gargoyle feature lysosomal Gaucher, Hurler
X linked recessive lysosomalHunters, Fabrys
Cataracts lysosomalFabrys, hurler
Cherry red macula lysosomalTay sach, Nieeman Pick, Sand offs
Macrophages look like crumpled up paper with fat calfGauchers
Early renal diseaseFabrys a-galatocerebrosidase
Macrophages swollen like a globe(globoidbodies)Krabbes B-galactocerebrosidase
Irregular areas of myelin(zebra bodies)Nieman pick Sphingomyelinase