UWSA 1 Exam Comprehensive
Questions and Solutions
Graded A+
this type of alcohol toxicity causes hematuria, flank pain, and calcium oaxalate crystals
methanol
ethylene glycol
isopropyl
alcohol - Answer: ethylene glycol
this is the only alcohol toxicity that does not cause an increased anion gap metabolic acidosis
alcohol
methanol
ethylene glycol
isopropyl - Answer: isopropyl alcohol
this alcohol toxicity can cause vision blurring, central scotomata, and afferent pupillary defect
alcohol
methanol
ethylene glycol
,isopropyl - Answer: methanol
What is considered a reactive nonstress test? - Answer: >2 accelerations
that are >15 bpm above baseline
last >15 seconds each
when to do a biophysical profile? - Answer: non-reactive stress test
ie <2 accelerations that are not >15 bpm above baseline that do not last >15 seconds each
Pt on chemo presents with a painless ulcer with a black center on his foot. Tx?
Antistaph penicillin
Antipseudomonal PCN - Answer: anti pseudomonal
Is myocarditis a/w pulsus paradoxus in the same way cardiac tamponade due to viral pericarditis
is? - Answer: No!
35yo M presents to Er with two episodes of syncope today. Last week had sore throat and dry
cough. Has bee having vague midchest pain and left sided neck pain. He has thready pulses over
both radial arteries that disappear with deep inspiration. Dx?
Acute myocarditis
Cardiac tamponade
Aortic disease
HOCM - Answer: cardiac tamponade
,he has signs of pulsus paradoxus (radial pulses that disappear) and decreased cardiac output
following a viral infection!
what are the characteristics CSF findings in herpes simplex virus encephalitis? - Answer:
increased lymphocytes
increased RBCs (due to hemorrhage of frontotemporal lobes)
elevated protein
*normal* glucose
what type of infection affects the frontotemporal region of the brain? - Answer: herpes simplex
virus encephalitis
36yo F presents to ER with 2 days of confusion, agitation, not sleeping, wandering around the
house. She has a temp of 100.7, is not oriented to time or place. No skin abnormalities. EEG
shows high amplitutde slow waves over the left temporal and frontal lobes. Likely etiology?
Bacterial meningits
Herpex simplex encephalitis
tuberculous meningitis
toxoplamosis - Answer: HSV encephalitis
increased capillary wedge pressure occurs in what heart condition? - Answer: CHF
this reflects an elevated L atrial pressure
Alveolar hypoventilation is seen in what type of lung diseases? - Answer: Extrinsic restrictive
lung disease:
, Obesity hypoventilation
Neuromuscular weakness
pt with back pain that is worse with walking downhill and better with walking uphill is an
indication of what type of claudication?
neurogenic
peripheral vascular - Answer: neurogenic claudication usually due to spinal stenosis
cushing syndrome - Answer:
60yo M presents with fatigue, HA, easy bruising. His BP is 180/120. Exam shows increased
pigmentation in palmar creases and scattered LE ecchymoses with symmetric proximal mm
weakness. CT scan shows 3 cm mediastinal mass. What is the likely dx? - Answer: Cushing
Syndrome due to ectopic ACTH production from small cell lung cancer!
*remember ACTH can cause hyperpigmentation by binding MSH receptors
if there is no change in the active phase of labor for 2 hours with contractions occurring every 5-
7 minutes, what is the next step in management?
C section
Operative vaginal delivery
Oxytocin infusion
Misoprostol - Answer: oxytocin infusion
to increase contraction frequency and strength
Questions and Solutions
Graded A+
this type of alcohol toxicity causes hematuria, flank pain, and calcium oaxalate crystals
methanol
ethylene glycol
isopropyl
alcohol - Answer: ethylene glycol
this is the only alcohol toxicity that does not cause an increased anion gap metabolic acidosis
alcohol
methanol
ethylene glycol
isopropyl - Answer: isopropyl alcohol
this alcohol toxicity can cause vision blurring, central scotomata, and afferent pupillary defect
alcohol
methanol
ethylene glycol
,isopropyl - Answer: methanol
What is considered a reactive nonstress test? - Answer: >2 accelerations
that are >15 bpm above baseline
last >15 seconds each
when to do a biophysical profile? - Answer: non-reactive stress test
ie <2 accelerations that are not >15 bpm above baseline that do not last >15 seconds each
Pt on chemo presents with a painless ulcer with a black center on his foot. Tx?
Antistaph penicillin
Antipseudomonal PCN - Answer: anti pseudomonal
Is myocarditis a/w pulsus paradoxus in the same way cardiac tamponade due to viral pericarditis
is? - Answer: No!
35yo M presents to Er with two episodes of syncope today. Last week had sore throat and dry
cough. Has bee having vague midchest pain and left sided neck pain. He has thready pulses over
both radial arteries that disappear with deep inspiration. Dx?
Acute myocarditis
Cardiac tamponade
Aortic disease
HOCM - Answer: cardiac tamponade
,he has signs of pulsus paradoxus (radial pulses that disappear) and decreased cardiac output
following a viral infection!
what are the characteristics CSF findings in herpes simplex virus encephalitis? - Answer:
increased lymphocytes
increased RBCs (due to hemorrhage of frontotemporal lobes)
elevated protein
*normal* glucose
what type of infection affects the frontotemporal region of the brain? - Answer: herpes simplex
virus encephalitis
36yo F presents to ER with 2 days of confusion, agitation, not sleeping, wandering around the
house. She has a temp of 100.7, is not oriented to time or place. No skin abnormalities. EEG
shows high amplitutde slow waves over the left temporal and frontal lobes. Likely etiology?
Bacterial meningits
Herpex simplex encephalitis
tuberculous meningitis
toxoplamosis - Answer: HSV encephalitis
increased capillary wedge pressure occurs in what heart condition? - Answer: CHF
this reflects an elevated L atrial pressure
Alveolar hypoventilation is seen in what type of lung diseases? - Answer: Extrinsic restrictive
lung disease:
, Obesity hypoventilation
Neuromuscular weakness
pt with back pain that is worse with walking downhill and better with walking uphill is an
indication of what type of claudication?
neurogenic
peripheral vascular - Answer: neurogenic claudication usually due to spinal stenosis
cushing syndrome - Answer:
60yo M presents with fatigue, HA, easy bruising. His BP is 180/120. Exam shows increased
pigmentation in palmar creases and scattered LE ecchymoses with symmetric proximal mm
weakness. CT scan shows 3 cm mediastinal mass. What is the likely dx? - Answer: Cushing
Syndrome due to ectopic ACTH production from small cell lung cancer!
*remember ACTH can cause hyperpigmentation by binding MSH receptors
if there is no change in the active phase of labor for 2 hours with contractions occurring every 5-
7 minutes, what is the next step in management?
C section
Operative vaginal delivery
Oxytocin infusion
Misoprostol - Answer: oxytocin infusion
to increase contraction frequency and strength
