Answer the question above you and post a new one

No idea.

A patient comes in and complains of fever. She says the fever is worse during the day, but her temperature goes down significantly at night. It occurs everyday for the past few months.

What is the likely organism?

How is it contracted?

brucella - unpasteruized milk, gram negative pleomorphic

i'll use my DIT high yield question - five categories of drug treatment for glaucoma, go

glaucoma drugs off the top of my head..hopefully I remembered it right
-a agonist - epinephrine (only for open angle)
-b blocker - timolol
-choniomimetics - carbachol, pilocarpine etc
-diuretics - acetozolaminde and mannitol
-pgf lantoprostol - bonus, makes your eyelashes grow

HYQ: woman with history of rheumatoid arthritis develops reactivation TB. What drug was she most likely taking?

.

cushie said:

Infliximab.

A teenager presents with stumbling and gait incoordination. On physical exam he has high plantar arches. What vitamin deficiency mimics this genetic disease?

Click to expand...

Vitamin E. He has Friedrich's ataxia.


Q: Medical student is studying for boards. He says he has been mostly sitting at his desk on his office chair for the past 3.5 weeks. He feels pain on his right hamstrings. Also tingling sensations occur from time to time down his right leg and notable on the sole of his right foot. What nerve is likely involved?

badasshairday said:

Vitamin E. He has Friedrich's ataxia.

Click to expand...

I read this on UWorld. But how come First Aid says Vit B12 neuropathy mimcs Friedrich's ataxia. Do they both mimic it? Or am I missing something?

sswang00 said:

I read this on UWorld. But how come First Aid says Vit B12 neuropathy mimcs Friedrich's ataxia. Do they both mimic it? Or am I missing something?

Click to expand...

Yes, you missed something.

Tibial Nerve.

What disease is associated with advanced paternal age?

jimmyboi said:

Tibial Nerve.

What disease is associated with advanced paternal age?

Click to expand...

Achondroplasia (FGF 3 problems).


What is the most common cause of pneumonia in various age groups? I'm having a hard time coming to an absolute consensus on this.

.

DrTacoElf said:

Achondroplasia (FGF 3 problems).


What is the most common cause of pneumonia in various age groups? I'm having a hard time coming to an absolute consensus on this.

Click to expand...

uhh

group B for newborns

RSV for under 6 months

mycoplasma pneumoniae for the rest until you get 40

strep pneumo for the rest



i think uworld got this next question wrong:

Your homeboy has smelly armpits. What mechanism of secretion do these glands use?

DrTacoElf said:

Achondroplasia (FGF 3 problems).


What is the most common cause of pneumonia in various age groups? I'm having a hard time coming to an absolute consensus on this.

Click to expand...

Not really sure if the pneumonias are broken up into cut-and-dry age groups like meningitis -- I would think that presentation factors would help: acute vs insidious, fever (high or low), productive (any blood/pus) vs non-productive cough, nosocomial or community acquired, etc... I'll let someone else comment on that one

Q: Which class(es) of anti-arrhythmics prolong QT? Which are most used immediately post-MI and why?

1st Q: SCID. RAG is responsible for VDJ recombination, so if you lose it you lack both cell mediated and humoral immunity.

2nd to last is budding off vesicles into the lumen for apocrine glands.

last Q: class Ia and III antiarrhythmics prolong QT. lidocaine, a class Ib, post MI. i think it was something about binding the inactivated receptors in rapidly firing cells, which makes it very effective for ischemic heart tissue that's more depolarized than normal. correct me if that's wrong though.

how do you tell the difference between 11OHase and 21OHase deficiencies? why does this difference exist?

pseudorosette said:

1st Q: SCID. RAG is responsible for VDJ recombination, so if you lose it you lack both cell mediated and humoral immunity.

2nd to last is budding off vesicles into the lumen for apocrine glands.

last Q: class Ia and III antiarrhythmics prolong QT. lidocaine, a class Ib, post MI. i think it was something about binding the inactivated receptors in rapidly firing cells, which makes it very effective for ischemic heart tissue that's more depolarized than normal. correct me if that's wrong though.

how do you tell the difference between 11OHase and 21OHase deficiencies? why does this difference exist?

Click to expand...

Bonus is the amiodarone is the only class III to NOT predispose to tosades de pointes.

11-OH deficiency has hypertension and hypokalemia because 11-deoxycorticosterone is a weak mineralocorticoid.

Straight from my test (two separate questions): Kid has hypoglycemia and hypoketonemia after fasting. What's the enzyme(s) deficient? What's the pathway?

MCAD-fatty acid synthesis

was the q straightforward or tricky?

jimmyboi said:

MCAD-fatty acid synthesis

was the q straightforward or tricky?

Click to expand...

It's fatty acid oxidation, not synthesis. One question gave a whole clinical scenario and had you pick MCAD. The other gave a less detailed history and had you pick the pathway.

rem6775 said:

It's fatty acid oxidation, not synthesis. One question gave a whole clinical scenario and had you pick MCAD. The other gave a less detailed history and had you pick the pathway.

Click to expand...

Just a quick clarification question (anyone can jump in)... does MCAD and Carnintine Shuttle mutation present any differently? I mean, basically, they both present with hypoglycemia and decreased ketones with fasting, correct?
(aka they shouldnt bot show up as an answer choice?)

FutureDoc4 said:

Just a quick clarification question (anyone can jump in)... does MCAD and Carnintine Shuttle mutation present any differently? I mean, basically, they both present with hypoglycemia and decreased ketones with fasting, correct?
(aka they shouldnt bot show up as an answer choice?)

Click to expand...

Correct. They were not both there on my test.

lol oh ya oxidation.

I knew that

What bug causes TCC of the bladder?

jimmyboi said:

lol oh ya oxidation.

I knew that

What bug causes TCC of the bladder?

Click to expand...

Honestly, I don't know of any bugs that cause TCC of the bladder....the only one I know is Schistosoma hemabiticus (causing squamous cell of the bladder)


Name the organism that causes pruritus in the anal region (seen often in children) and can be "seen" by the "tape" technique + treatment?

jimmyboi said:

lol oh ya oxidation.

I knew that

What bug causes TCC of the bladder?

Click to expand...

Do you mean SCC of bladder? schistosoma hematobium

which wrist bone is most commonly dislocated?

FutureDoc4 said:

Honestly, I don't know of any bugs that cause TCC of the bladder....the only one I know is Schistosoma hemabiticus (causing squamous cell of the bladder)


Name the organism that causes pruritus in the anal region (seen often in children) and can be "seen" by the "tape" technique + treatment?

Click to expand...

pinworm, "the male and female take a trip down to your anus and mate there, the most perverted worm - goljan"

treat pinworm aka eteribus with mebendazole or PP (pyrantol pamoate, don't quote me on spelling any of this correctly)

kryptik said:

Do you mean SCC of bladder? schistosoma hematobium

which wrist bone is most commonly dislocated?

Click to expand...

lunate. most commonly frx is scaphoid, by FOOSH.

which inguinal hernia is more common in women than men? which inguinal hernia is common in baby boys, and why?

Women= Femoral hernia
INfants= INdirect hernia. Why? Failure of processus Vaginalis to close.

Name 2 diseases that cause pseudorosettes?

meerak said:

Women= Femoral hernia
INfants= INdirect hernia. Why? Failure of processus Vaginalis to close.

Name 2 diseases that cause pseudorosettes?

Click to expand...

Ependymoma and neuroblastoma?

Multi-part question, very high yield:

The ureter runs beneath two important structures, over one, and medial to another what are they? (btw know the entire course of the ureter and its relation to just about everything)

meerak said:

Women= Femoral hernia
INfants= INdirect hernia. Why? Failure of processus Vaginalis to close.

Name 2 diseases that cause pseudorosettes?

Click to expand...

ewings sarcoma and medulloblastoma

Beneath the uterine artery "water under the bridge" and vas deferens.
Over the genitofemoral nerve.
Medial to ovarian/testicular artery

not too sure though.

What is the most common infection transmitted by blood transfusion?

IMGUSMLEStep1 said:

Beneath the uterine artery "water under the bridge" and vas deferens.
Over the genitofemoral nerve.
Medial to ovarian/testicular artery

not too sure though.

What is the most common infection transmitted by blood transfusion?

Click to expand...

HCV

Describe the results of the Rinne and Weber tests with a Right Ear Conduction deafness.

IMGUSMLEStep1 said:

What is the most common infection transmitted by blood transfusion?

Click to expand...

A:HBV

Q: what other organism besides E. Coli can cause HUS (and why)

InTheMaking said:

HCV

Describe the results of the Rinne and Weber tests with a Right Ear Conduction deafness.

Click to expand...

most common infection transmitted by blood transfusion is CMV
(HCV is the most common cause of post-transfusional hepatitis)

This is straight from Goljan's audio.

IMGUSMLEStep1 said:

most common infection transmitted by blood transfusion is CMV
(HCV is the most common cause of post-transfusional hepatitis)

This is straight from Goljan's audio.

Click to expand...

True that

Next Q: What three drugs undergo zero order kinetic elimination at high levels?

InTheMaking said:

True that

Next Q: What three drugs undergo zero order kinetic elimination at high levels?

Click to expand...

Phenytoin, Ethanol, Aspirin "PEAZ"

What 2 related bugs are commonly associated with food poisoning from seafood?

IMGUSMLEStep1 said:

Phenytoin, Ethanol, Aspirin "PEAZ"

What 2 related bugs are commonly associated with food poisoning from seafood?

Click to expand...

vibrio parahemolyticus and vibrio vulnificus.

shigella dysenteriae also causes HUS because it makes shigatoxin. both shigatoxin and e coli shiga-like verotoxin are vascular endothelium killers, causing underlying collagen to be exposed --> platelet aggregation --> microangiopathic hemolysis, brain and kidney dysfunction.

right ear conduction deafness: weber is louder on the right due to lack of background noise in an ear with conduction deafness. rinne shows greater bone conduction than air conduction on the right; greater air conduction than bone conduction on the left.

Q: woman with breast cancer undergoes radical mastectomy with full axillary lymph node dissection. what nerve may be damaged, and how would you tell that it's damaged? what secondary malignancy could she get a few years down the line as a result of the axillary node dissection?

pseudorosette said:

vibrio parahemolyticus and vibrio vulnificus.

shigella dysenteriae also causes HUS because it makes shigatoxin. both shigatoxin and e coli shiga-like verotoxin are vascular endothelium killers, causing underlying collagen to be exposed --> platelet aggregation --> microangiopathic hemolysis, brain and kidney dysfunction.

right ear conduction deafness: weber is louder on the right due to lack of background noise in an ear with conduction deafness. rinne shows greater bone conduction than air conduction on the right; greater air conduction than bone conduction on the left.

Q: woman with breast cancer undergoes radical mastectomy with full axillary lymph node dissection. what nerve may be damaged, and how would you tell that it's damaged? what secondary malignancy could she get a few years down the line as a result of the axillary node dissection?

Click to expand...

Long thoracic nerve, innervates serratius anterior muscle. Presents with ipsilateral 'winged scapula' and inability to abduct arm horizontally beyond 90`(first 90' are done by deltoid and supraspinatus muscles). Blockage of lymphatics in upper limb can predispose to malignant lymphangiosarcoma.

Q: Antipsychotic side effects:
a. causes agranulocytosis
b. retinal deposits
c. tardive dyskinesia, akinesia, etc

mq123 said:

Long thoracic nerve, innervates serratius anterior muscle. Presents with ipsilateral 'winged scapula' and inability to abduct arm horizontally beyond 90`(first 90' are done by deltoid and supraspinatus muscles). Blockage of lymphatics in upper limb can predispose to malignant lymphangiosarcoma.

Q: Antipsychotic side effects:
a. causes agranulocytosis
b. retinal deposits
c. tardive dyskinesia, akinesia, etc

Click to expand...

a. clozapine.
b. thioridazine.
c. high-potency typical antipsychotics, like haloperidol and fluphenazine. mxn is supposedly upregulation or hypersensitivity of dopamine receptors in the basal ganglia. you can treat EPS with diphenhydramine, because it's an anticholinergic and i guess it balances out the dopamine blockade.

what and where is the problem in pemphigus vulgaris? pemphigus foliaceus? bullous pemphigoid?

pemphigus vulgaris - anti desmosome - epidermis comes off easily (+nikolsy)

bullous pemphigoid- anti hemidesmosome - @demis/epidermis junction more blisters

pemphigus foliaceus - anti desmoglein btw cell-cell junctions not really sure of the sx?


q: Epilepsy drugs
-Mechanism of Action for the drug of choice in absence seizures
-Safe for a pregnant woman who has epilepsy
-Also used to treat bipolar disorder
-Also used to treat trigeminal Neuralgia

PokerDoc said:

Make them high yield and not absurd if possible.. but try to pick something people might have overlooked:


ok here goes nothing, my question:


Mutation in RAG-1 gene most likely causes: ?

Click to expand...

I think it causes a type of SCID ????????

sswang00 said:

pemphigus vulgaris - anti desmosome - epidermis comes off easily (+nikolsy)

bullous pemphigoid- anti hemidesmosome - @demis/epidermis junction more blisters

pemphigus foliaceus - anti desmoglein btw cell-cell junctions not really sure of the sx?


q: Epilepsy drugs
-Mechanism of Action for the drug of choice in absence seizures
-Safe for a pregnant woman who has epilepsy
-Also used to treat bipolar disorder
-Also used to treat trigeminal Neuralgia

Click to expand...

- Ethosuximide MOA blocks Calcium channels in thalamus
- Gabapentin but not so sure
- Carbamazepine valproic acid
- Carbamazepine

Pt with essential fructosuria still able to convert Fructose to Glucose Which Enzyme?

Doc176 said:

Pt with essential fructosuria still able to convert Fructose to Glucose Which Enzyme?

Click to expand...

whew.. you got me. no idea. Can you enlighten us?

What's the mechanism of hypocalcemia causing tetany?

Doc176 said:

Pt with essential fructosuria still able to convert Fructose to Glucose Which Enzyme?

Click to expand...

Hexokinase.

Some random questions from my exam:
1. 5 year-old overdoses on loperamide. Treatment?
2. Abnormal passive abduction at knee indicates injury to what?
3. A man has difficulty swallowing both solids and liquids. If it's due to an infection, what's the bug?

rem6775 said:

Some random questions from my exam:
1. 5 year-old overdoses on loperamide. Treatment?
2. Abnormal passive abduction at knee indicates injury to what?
3. A man has difficulty swallowing both solids and liquids. If it's due to an infection, what's the bug?

Click to expand...

1. Not really sure, either activated charcoal or maybe oral naloxone/naltrexone?
2. MCL
3. Chagas disease - trypanosoma cruzi (not motivated enough to even look up the spelling)

(edit) Crap forgot my own question...

A patient with metastatic breast cancer is brought in by her husband because she is only able to tell what objects are by putting them in her mouth, and she is trying to have sex with everything.

Name of disease?
What structure/structures are damaged?
What's the term for a patient with this condition being unable to recognize things in the mouth?

Nesiritide said:

A patient with metastatic breast cancer is brought in by her husband because she is only able to tell what objects are by putting them in her mouth, and she is trying to have sex with everything.

Name of disease?
What structure/structures are damaged?
What's the term for a patient with this condition being unable to recognize things in the mouth?

Click to expand...

1.Kluver Bucy
2.bilateral lesion of amygdala
3.no clue

Hyperorality?

What's the one disease in children where it's recommended to give aspirin? (Hint = it's a Vasculitis)

PokerDoc said:

Kawasaki's disease




What disease has anti-platelet antibodies?

Click to expand...

Immune thrombocytopenias, such as ITP and SLE

A 15 year old girl ingests 30 tablets of aspirin in an attempt to kill herself. What would be the typical arterial blood gas values for this patient?

Nesiritide said:

1. Not really sure, either activated charcoal or maybe oral naloxone/naltrexone?
2. MCL
3. Chagas disease - trypanosoma cruzi (not motivated enough to even look up the spelling)

(edit) Crap forgot my own question...

A patient with metastatic breast cancer is brought in by her husband because she is only able to tell what objects are by putting them in her mouth, and she is trying to have sex with everything.

Name of disease?
What structure/structures are damaged?
What's the term for a patient with this condition being unable to recognize things in the mouth?

Click to expand...

Naloxone.