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UWorld High-Yield Clinical Vignettes Flashcards

6 cards from real UWorld practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 UWorld High-Yield Clinical Vignettes flashcards as text

  1. A 67-year-old male presents with progressive dysphagia to solids then liquids, significant weight loss, and a barium swallow showing an irregular narrowing in the distal esophagus. He has a 30-year history of GERD. What is the most likely diagnosis?

    Answer: Esophageal adenocarcinoma arising from Barrett's esophagus

    Chronic GERD leads to Barrett's metaplasia, which is the major risk factor for esophageal adenocarcinoma, typically occurring at the gastroesophageal junction.

  2. A 55-year-old woman presents with bone pain, fatigue, and lab results showing: calcium 11.5, creatinine 2.1, total protein 10 g/dL, and a spike on serum protein electrophoresis. Urinalysis shows Bence Jones proteins. What is the diagnosis?

    Answer: Multiple myeloma

    Multiple myeloma presents with the CRAB criteria: Hypercalcemia, Renal failure, Anemia, and Bone lesions, along with an M-protein spike and Bence Jones proteinuria.

  3. A newborn male fails to pass meconium within the first 48 hours. Rectal exam causes explosive release of stool. Biopsy of the rectal wall shows absence of ganglion cells. What is the diagnosis?

    Answer: Hirschsprung disease (congenital aganglionic megacolon)

    Hirschsprung disease results from failed neural crest cell migration, leaving an aganglionic segment of bowel that cannot relax, causing functional obstruction relieved by rectal exam.

  4. A 22-year-old male college student presents with fever, severe sore throat, cervical lymphadenopathy, and splenomegaly. Monospot test is positive. He is prescribed amoxicillin for presumed strep throat by an urgent care provider. What rash does he develop?

    Answer: Diffuse maculopapular rash due to EBV-associated reaction to amoxicillin

    EBV (infectious mononucleosis) causes a characteristic diffuse maculopapular rash when aminopenicillins (ampicillin, amoxicillin) are administered, a hypersensitivity reaction specific to active EBV infection.

  5. A 45-year-old female presents with proximal muscle weakness, difficulty rising from a chair, and a heliotrope rash with Gottron's papules over the knuckles. CK is markedly elevated. What is the most likely diagnosis?

    Answer: Dermatomyositis

    Dermatomyositis is distinguished from polymyositis by its characteristic skin findings: heliotrope rash around the eyes and Gottron's papules over the dorsal metacarpophalangeal joints.

  6. A 58-year-old male with hypertension is started on a new antihypertensive. He develops a dry, persistent cough 2 weeks later. What class of medication most likely caused this side effect?

    Answer: ACE inhibitor

    ACE inhibitors cause a dry, persistent cough in approximately 10–15% of patients due to bradykinin accumulation; switching to an ARB eliminates the cough while maintaining similar blood pressure control.