Term
| A 25-year-old man complains of a scrotal mass and pain made worse by coughing or sneezing. A scrotal exam reveals a palpable scrotal protrusion with Valsalva. What type of hernia is this patient experiencing? What type of hernia protrudes through Hesselbach’s triangle? What structures form Hesselbach’s triangle? |
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Definition
Inguinal hernia
Direct hernia protrudes through Hesselbach’s triangle, made of inguinal ligament, lateral margin of rectus sheath, inferior epigastric vessels |
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Term
| A 30-year-old African-American woman develops heavy menses and develops fatigue as a result. She is found to have anemia, and further work-up reveals an abnormality in her uterus. What is the most common gynecologic neoplasm? What is the typical histological pattern? Is it benign or malignant? |
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Definition
Leiomyoma (fibroid)
Smooth muscle bundles in different directions (whorled pattern)
Benign |
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Term
| What are the different paranasal sinuses? |
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Definition
Maxillary sinuses
Fronto sinuses
Ethmoid sinuses
Sphenoid sinuses |
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Term
| A 24-year-old woman reports having two miscarriages over the past 6 months and has been trying to become pregnant over the past year. What embryological structural abnormalities might account for her multiple miscarriages? What structures arise from the paramesonephric ducts? What other name is given to the paramesonephric ducts? |
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Definition
Bicornate uterus: incomplete fusion of the paramesonephric ducts
Paramesonephric ducts: Fallopian tubes, uterus, upper 1/3 of vagina
Mullerian ducts |
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Term
What is the adult remnant of the following fetal structures?
1. Gubernaculum (female):
2. Processus vaginalis (male):
3. Foramen ovale:
4. Notochord: |
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Definition
1. Gubernaculum (female): Ovarian ligament + round ligament of uterus
2. Processus vaginalis (male): Tunica vaginalis
3. Foramen ovale: Fossa ovalis
4. Notochord: Nucleus pulposus |
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Term
| A 24-year-old G1P0 complains of shortness of breath and chest pain. You are concerned that she might have a pulmonary embolism because she has an elevated D-dimer. She is a poor candidate for a pulmonary CT angiography because she is allergic to contrast dye. The patient undergoes a V/Q scan to determine if the cause of her symptoms is due to a pulmonary embolism. If it is determined that she does have a pulmonary embolism, what is the standard treatment? |
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Definition
Anticoagulation: IV heparin or low-molecular weight heparin
Don’t use TPA
Can use Lepirudin or bivalirudin |
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Term
| A patient crashed his bicycle on a mountain trail. During the crash he landed on the lateral aspect of his leg. Now he has foot drop. Which nerve was injured? |
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Definition
| Common peroneal nerve (common fibular nerve): branch off of sciatic nerve off of L5/S1 |
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Term
| A 43-year-old man presents with visual difficulties and decrease in libido. The patient reports that he is unable to see in the outer half of both sides of his visual fields. A brain MRI reveals a tumor. Would you expect the patient’s GnRH to be decreased or increased? This tumor will often cause infertility. What is the role of LH and FSH in spermatogenesis? What is an easy way to remember which cells LH and FSH stimulate during spermatogenesis? |
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Definition
Pituitary adenoma
Excess prolactin inhibits production of GnRH, decrease in GnRH
LH stimulates Leydig cell testosterone production, FSH stimulates Sertoli cells to produce androgen-binding protein, which keeps testosterone levels high
Also Sertoli cells stimulated to produce inhibin
LH – Leydig cells
FSH – Sertoli cells |
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Term
| The body uses both the cell-mediated and humoral immune response to fight infection. Which T cell type regulates the humoral response? |
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Definition
Th2 cells augment humoral response, generate IL-4 and 5 which promote growth and differentiation of B cells
Th1 cells generate IL2 and Ifn gamma, augment cell mediated immune response, suppress humoral response
Humoral response mediated by macromolecules |
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Term
Which antifungal drug fits the following description?
1. swish and swallow for oral candidiasis (thrush)
2. side effect: nephrotoxicity
3. deposits in keratin-containing tissue (nails)
4. used for cryptococcal meningitis in AIDS
5. side effect: teratogenic, carcinogenic: |
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Definition
1. swish and swallow for oral candidiasis (thrush): Nystatin
2. side effect: nephrotoxicity: Amphotericin B
3. deposits in keratin-containing tissue (nails): Griseofulvin
4. used for cryptococcal meningitis in AIDS: Amphotericin B, Flucanazole
5. side effect: teratogenic, carcinogenic: Griseofulvin |
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Term
| A 43-year-old man complains of excessive daytime sleepiness. The patient complains of having hallucinations just before sleep onset. The patient has normal polysomnography testing. You are concerned this patient might have narcolepsy. What are some other features seen with narcolepsy? What is the treatment for narcolepsy? |
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Definition
Excessive daytime sleepiness
Hypnagogic/hypnopompic hallucinations
Wakeful state directly to REM
Cataplexy
Treatment: Modafinil, Amphetamines, Sodium oxybate (GHB) |
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Term
| A 40-year-old man arrives at your clinic for his first physical in twenty years. He reeks of cigarette smoke and you notice his jacket bears the logo of his favorite tobacco company. He proudly informs you that he got this great jacket by redeeming his cigarette cartons. At what stage of change in overcoming his smoking habit is this man? |
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Definition
Precontemplation (no recognition that change needs to be made)
(Contemplation, Preparation, Action, Maintenance) |
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Term
| What is the initial medical treatment for the arrhythmia known as torsades de pointes? |
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Definition
Wide QRS complex, sinusoidal
Magnesium and Potassium dysregulation involved
IV magnesium sulfate |
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Term
| A newborn is noted to have cyanosis, which prompts echocardiography that reveals transposition of the great vessels. What substance should be given when a newborn is diagnosed with transposition of the great vessels to maintain a shunt? |
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Definition
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Term
| In regard to seizures, what do the terms partial, simple, complex, and generalized mean? |
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Definition
Partial: one part of brain has seizure (usually temporal lobe)
Simple: Consciousness not impaired
Complex: Consciousness impaired
Generalized: Diffuse involvement |
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