USMLE Practice Exam 100% solved

Results of a normal nonstress test: - ANSWER 20 minutes of doppler monitoring that shows fetal HR 110-160 with at least two accelerations of 15bpm that last 15s Ecthyma gangrenosum= - ANSWER Pseudomonal skin infxn w/ erythematous halo and black, necrotic center. Associated w/ immunodeficiency. CSF findings in HSV encephalitis: - ANSWER ↑ protein, WBCs, RBCs ↔ sugar Normal FEV1 and FEV1/FVC values - ANSWER FEV1 80-120% of predicted is considered normal FEV1/FVC of 80% is considered normal FEV1/FVC in obstructive vs restrictive disease - ANSWER Obstructive: 80% to 40% (severe disease) Restrictive: 75% ('normal', b/c it decreases proportionally to the decrease in FVC). Pseudo claudication - ANSWER Pain in legs w/ walking that doesn't appear when just standing. Hallmark: worse walking downhill. From spinal stenosis -- back extension -- exacerbate radiculopathy. Difference between protraction and arrest of labor: - ANSWER Protraction=slower dilation than expected (1cm/hr) versus complete arrest during active stage Tx for labor protraction and/or arrest: - ANSWER First latent stage (0-3cm): Pelvic rest, amniotomy, oxytocin First active stage (3cm-10cm): Amniotomy, oxytocin, csxn if arrest Second stage (descent of fetus): Forceps/vacuum, csxn Pleural effusion w/ LOTS of protein is usually.. - ANSWER TB. 4g/dL (glucose will only be slightly decreased) When do HIV positive pts get anti-retroviral therapy? Prophylactic abx? - ANSWER ARVT: CD4 350 Abx: CD4 200 When to give pneumococcal to HIV pts: - ANSWER Anytime their CD4 ct is 200 (so they can mount an appropriate response) Bullous pemphigoid affects which body parts? - ANSWER FLexor surfaces (knee pits, axillae, groin) Brain tumors in adults are usually... - ANSWER metastases Polymyositis labs versus polymyalgia rheumatica: - ANSWER Polymyositis↑ LDH, CPK, autoAbs Polymyalgia rheumatica just has ↑ ESR, CRP (PM has WEAKNESS; PR has pain/stiffness) What drug do you give w/ wide-complex VT? - ANSWER Amiodarone What drug do you give with SVT? - ANSWER Slow the *AV* node w/ adenosine (verapamil or metoprolol if that doesn't work) What drug do you give for supraventricular tachyarrhythmias? - ANSWER (Afib, etc). Digoxin Feared complication of esophageal dilatation for achalasia: - ANSWER Esophageal perforation. Presents w/ hematemesis, L-sided pleural effusion, SOB, mediastinitis (can ppt sepsis and death) Pancreatic calcifications on CT suggest... - ANSWER Chronic pancreatitis (alcoholism) Conn's syndrome - ANSWER Primary hyperaldosteronism from singular adenoma (causing HTN, hypokalemia) MOA and tx for Conn's syndrome: - ANSWER Aldosterone-producing adenoma Tx: Spironolactone (ARB) Gallstone prophylaxis in gastric bipass pts: - ANSWER Ursodeoxycholic acid (40% to 2%!) Hematuria w/ and w/o proteinuria: - ANSWER W/: Glomerular cause. W/o: Extraglomerular cause. The two most common causes of hematuria post-URI: - ANSWER IgA nephropathy and post-streptococcal glomerulonephritis ESRD and parathyroid gland: - ANSWER High phosphate and low vitamin D both stimulate secretion of PTH→hyperplasia of the parathyroids Sharp, localized abdominal pain: - ANSWER Somatic (not visceral!) Neurogenic bladder tx: - ANSWER Bethanechol Probenecid MOA: - ANSWER Decreases uric acid reabsorption in the kidney (acts on OAT transporter??) so you pee out more urate. Good for undersecretors (the majority)! SBP dx: - ANSWER Ascitic fluid w/ 250WBCS/mm3 Pathogens responsible for SBP: - ANSWER Gram po