UWSA 2 Step 2 Exam UPDATED Exam
Questions and CORRECT Answers
pseudomonas can cause what skin lesion?
"PAINLESS ULCER WITH A BLACK CENTER"
what drug to give? - CORRECT ANSWER - ecthyma gangrenosum
Anti-psuedomonal penicillin! IMMUNOCOMPROMISED STATE
Preterm labor in an Infant of Diabetic mother is at greatest risk of what? - CORRECT
ANSWER - FETAL LUNG IMMATURITY. (RDS)
Pt. with midline deviation of trachea + decreased breath sound on right-side + hypotension.
EKG SHOWN: sinus rhythm.
Solution to the problem? - CORRECT ANSWER - INCREASE VENOUS RETURN:
placement of a large bore needle at the 2nd intercostal space midclavicular border and
decompress the pneumothorax to increase venous return!
erythematous, edematous, then develops into a bulla surrounded by erythema, once the bulla
ruptures leaving a *painless ulcer* with a *black center* - CORRECT ANSWER -
ecythma gangrenosum - typically the lesions will progressive rapidly from small erythematous
,macule to larger nontender nodules with necrosis --> invasion occurs through the tunica media
and adeventitia of blood vessels.
retrosternal chest pain that radiates to left arm and shoulder with episodes of syncope following
URI symptoms - CORRECT ANSWER - cardiac tamponade secondary to viral URI -->
difference between this and viral myocarditis is that syncope is NOT a common feature. Viral
myocarditis will cause pulsus paradoxus and signs of cardiogenic shock
large decrease in systolic blood pressure on inspiration - CORRECT ANSWER - pulsus
paradoxus
-pericardial tamponade
-Acute Asthma
-COPD
*in pericardial tamponade - right atrial filling is impaired with results in an *increase* in
systemic venous pressure - remember that the lung remains clear to auscultation because there is
NO backup of blood into the pulmonary circulation*
when does cardiac filling occur in pericardial tamponade? - CORRECT ANSWER -
during deep inhalation when the negative intrathoracic pressure allows for a pressure difference
between the vena cava and the right atrium
Tension pneumothorax - recognize on Chest X-ray! - CORRECT ANSWER - ON
IPSILATERAL SIDE:
Retraction of the pleural viscera - forming a white line to which no pulmonary vascular markings
are seen.
CONTRALATERAL SIDE:
- mediastinal shifting towards the right side
pt presents with fever, headache, seizures, confusion, stupor, and twitching of upper extremities.
Pts can also experience anosmia, gustatory hallucinations, and bizzare or psychotic behavior -
CORRECT ANSWER - temporal lobe encephalitis - Herpes simplex virus
,What will EEG look like in herpes encephalitis? - CORRECT ANSWER - high amplitude
slow waves over the left temporal and frontal lobes
what will CSF look like in HSV encephalitis - CORRECT ANSWER - WBC = 25
% neurtrophil = 5
Glucose = Normal
RBC count = INCREASED
Protein = 120 (increased)
what is common cause of spinal stenosis - CORRECT ANSWER - osteoarthritis of the
spine
what are common degenerative changes in the spine in elderly pts? - CORRECT
ANSWER - -bulging of intervertebral discs
-facet joint hypertrophy
-hypertrophy of the ligamentum flavum
presentation for spinal stenosis - CORRECT ANSWER - pseudoclaudication "neurogenic"
--> refers to lower extremity pain with both walking and prolonged standing that is particularly
evident when walking downhill.
what is the most effective treatment to decrease the risk of stroke in pts with atrial fibrillation? -
CORRECT ANSWER - warfarin
what cancer are associated with Peutz Jehgers? - CORRECT ANSWER - GI cancer NOT
colon - more likely to be pancreas, HCC, ect.
what are causes of exudative effusions - CORRECT ANSWER - empyema
malignancy (breast cancer, small cell, NSCL)
what type of pleural effusion is characterized by hemorrhagic - CORRECT ANSWER -
pulmonary infarction
what pleural effusions are characterized by elevated amylase? - CORRECT ANSWER -
esophageal rupture
pancreatitis
pleural: serum protein ratio is <0.5 - CORRECT ANSWER - transudative
>0.5 is exudative
How often do you need to receive PCV when HIV positive? - CORRECT ANSWER -
PCV13 (conjugate) once then PPSV (polysaccharide) 23 8 wks later then every *5 years*
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