STEP 2 UWSA 2 assessment answers complete exam study ahead
2024 update
Pt with COPD and signs of pulmonary HTN develops worsening renal failure. Received
Furosemide. What is likely cause - correct answerPrerenal AKI; which occurs d/t
decreased renal perfusion
Look for BUN:Creatinine ratio >20:1
Initial treatment for R sided heart failure with lasix will improve cardiac function by
decreased R ventricular end diastolic volume (preload) but pts with R ventricular
dysfunction are *pre-load dependent* and therefore sensitive to excessive volume loss
Look for distended neck veins that become *flat* after treatment
Pt with yeast looking rash under breasts, hasn't seen a doc in years, BMI 36
What would like be seen on micro exam - correct answerCulture growing budding
yeasts
Candida intertrigo; satellite lesions, KOH prep of fungal culture, pseudohyphae
c/c w tinea cruris which is also KOH prep but shows *septate hyphae*
1 day old with petechiae, jaundice, minimal prenatal care for mom, mom had fever and
sore throat during 2nd trimester
baby is small, diffuse petechial rash, jaundice to face and trunk, and HSM - correct
answerCMV
parvo just presents as a swollen fetus and severe neonatal anemia!
remember, CMV is the *most common congenital infection*
also assoc with *periventricular calcifications and microcephaly*
Pt with acute gout but he's on anticoagulants bc he just had a drug eluting stent placed
and now he's in the hospital for CHF
What drug do you treat him with - correct answerNSAIDS are commonly used BUT they
may increase the risk of bleeding in pts on anticoagulants AND *can acutely worsen
heart failure*
so give him *colchicine*
inhibits polymerization of beta tubulin into microtubules, preventing migration and
activation of neutrophils. adverse effects include nausea, abd pain and diarrhea; *don't
use in elderly with severe renal dsyfunction*
, STEP 2 UWSA 2 assessment answers complete exam study ahead
2024 update
Basal ganglia hemorrhage herniation - correct answerUncal herniation
mass effect pushes part of temporal lobe (uncus) laterally and downward against the
tentorium cerebelli
compresses third cranial nerve and results in dilated, nonreactive ipsilateral pupil
further displacement causes midbrain compression with contralateral extensor
posturing, coma, and respiratory compromise
Differentiating neuroleptic malignant from serotonin syndrome - correct answerNMS-
rigidity and bradyreflexia
SS- prominent neuromuscular hyperreactivity (tremor, hyperreflexia, myoclonus)
Tramadol is serotonergic !
Tx for mycoplasma - correct answerMacrolide like azithromycin or resp fluoroquinolone
Intervention to prevent post op pneumonia for COPD pt - correct answerpre-operative
physical therapy (eg aerobic exercise, inspiratory muscle training)
polysomnography of narcolepsy - correct answershortened REM sleep latency
Generalized spike and wave of 3hz - correct answerabsence seizures
Job syndrome - correct answerHyper IgE syndrome
Rare, recurrent skin and lung infections in addition to a pruritic rash similar to eczema;
thrombocytopenia is NOT seen
Chediak-Higashi syndrome - correct answerimpaired phagolysosome formation.
Pathophys: Microtubule polymerization disorder means the "tracks" to get around the
cell are broken, as such transport of phagosomes is deficient.
albinism, peripheral neuropathy, recurrent skin and soft tissue pyogenic infections
Thromboangiitis obliterans (Buerger disease) - correct answerInflammation of the
medium-sized arteries and veins because of thrombotic occlusion, resulting in ischemia
and gangrene
clinical: age <45, ongoing or recent smoking history, distal limb ischemia, gangrene,
ulceration due to nonatherosclerotic occlusion, thrombosis
2024 update
Pt with COPD and signs of pulmonary HTN develops worsening renal failure. Received
Furosemide. What is likely cause - correct answerPrerenal AKI; which occurs d/t
decreased renal perfusion
Look for BUN:Creatinine ratio >20:1
Initial treatment for R sided heart failure with lasix will improve cardiac function by
decreased R ventricular end diastolic volume (preload) but pts with R ventricular
dysfunction are *pre-load dependent* and therefore sensitive to excessive volume loss
Look for distended neck veins that become *flat* after treatment
Pt with yeast looking rash under breasts, hasn't seen a doc in years, BMI 36
What would like be seen on micro exam - correct answerCulture growing budding
yeasts
Candida intertrigo; satellite lesions, KOH prep of fungal culture, pseudohyphae
c/c w tinea cruris which is also KOH prep but shows *septate hyphae*
1 day old with petechiae, jaundice, minimal prenatal care for mom, mom had fever and
sore throat during 2nd trimester
baby is small, diffuse petechial rash, jaundice to face and trunk, and HSM - correct
answerCMV
parvo just presents as a swollen fetus and severe neonatal anemia!
remember, CMV is the *most common congenital infection*
also assoc with *periventricular calcifications and microcephaly*
Pt with acute gout but he's on anticoagulants bc he just had a drug eluting stent placed
and now he's in the hospital for CHF
What drug do you treat him with - correct answerNSAIDS are commonly used BUT they
may increase the risk of bleeding in pts on anticoagulants AND *can acutely worsen
heart failure*
so give him *colchicine*
inhibits polymerization of beta tubulin into microtubules, preventing migration and
activation of neutrophils. adverse effects include nausea, abd pain and diarrhea; *don't
use in elderly with severe renal dsyfunction*
, STEP 2 UWSA 2 assessment answers complete exam study ahead
2024 update
Basal ganglia hemorrhage herniation - correct answerUncal herniation
mass effect pushes part of temporal lobe (uncus) laterally and downward against the
tentorium cerebelli
compresses third cranial nerve and results in dilated, nonreactive ipsilateral pupil
further displacement causes midbrain compression with contralateral extensor
posturing, coma, and respiratory compromise
Differentiating neuroleptic malignant from serotonin syndrome - correct answerNMS-
rigidity and bradyreflexia
SS- prominent neuromuscular hyperreactivity (tremor, hyperreflexia, myoclonus)
Tramadol is serotonergic !
Tx for mycoplasma - correct answerMacrolide like azithromycin or resp fluoroquinolone
Intervention to prevent post op pneumonia for COPD pt - correct answerpre-operative
physical therapy (eg aerobic exercise, inspiratory muscle training)
polysomnography of narcolepsy - correct answershortened REM sleep latency
Generalized spike and wave of 3hz - correct answerabsence seizures
Job syndrome - correct answerHyper IgE syndrome
Rare, recurrent skin and lung infections in addition to a pruritic rash similar to eczema;
thrombocytopenia is NOT seen
Chediak-Higashi syndrome - correct answerimpaired phagolysosome formation.
Pathophys: Microtubule polymerization disorder means the "tracks" to get around the
cell are broken, as such transport of phagosomes is deficient.
albinism, peripheral neuropathy, recurrent skin and soft tissue pyogenic infections
Thromboangiitis obliterans (Buerger disease) - correct answerInflammation of the
medium-sized arteries and veins because of thrombotic occlusion, resulting in ischemia
and gangrene
clinical: age <45, ongoing or recent smoking history, distal limb ischemia, gangrene,
ulceration due to nonatherosclerotic occlusion, thrombosis
