USMLE Practice Exam
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 positive cocci and GNRs
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 positive cocci and GNRs
