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
A 55-year-old male with chest pain radiating to the left arm, diaphoresis, and ST elevation in leads II, III, and aVF presents to the ER. What is the most likely diagnosis?
Answer: Inferior STEMI
ST elevation in leads II, III, and aVF localizes ischemia to the inferior wall of the left ventricle, most commonly from right coronary artery occlusion.
A 28-year-old woman presents with fatigue, cold intolerance, weight gain, constipation, and a TSH of 12 mIU/L with low free T4. What is the most appropriate next step?
Answer: Start levothyroxine therapy
Elevated TSH with low free T4 confirms primary hypothyroidism, and first-line treatment is oral levothyroxine replacement to normalize thyroid hormone levels.
A 70-year-old male smoker with a 50 pack-year history presents with hemoptysis, weight loss, and a central lung mass on chest X-ray. Biopsy shows small cells with necrosis. What is the most likely diagnosis?
Answer: Small cell lung carcinoma
Small cell lung carcinoma classically presents as a central mass in a heavy smoker with neuroendocrine features on biopsy and is strongly associated with paraneoplastic syndromes.
A 35-year-old woman presents with a butterfly rash, joint pain, fatigue, and a positive ANA with anti-dsDNA antibodies. Urinalysis shows hematuria and proteinuria. What is the most likely diagnosis?
Answer: Systemic lupus erythematosus with lupus nephritis
The combination of butterfly rash, polyarthritis, positive ANA, anti-dsDNA antibodies, and renal involvement is classic for SLE with lupus nephritis.
An 8-year-old boy presents with sudden onset periorbital edema, proteinuria (>3.5g/day), hypoalbuminemia, and hyperlipidemia. Kidney biopsy shows normal light microscopy with effacement of podocyte foot processes on electron microscopy. What is the diagnosis?
Answer: Minimal change disease
Minimal change disease is the most common cause of nephrotic syndrome in children, characterized by normal light microscopy but diffuse foot process effacement on electron microscopy.
A 45-year-old male presents with severe epigastric pain radiating to the back, nausea, vomiting, and a serum lipase three times the upper limit of normal after a weekend of heavy alcohol use. What is the most appropriate initial management?
Answer: IV fluid resuscitation, bowel rest (NPO), and pain management
Acute pancreatitis is initially managed with aggressive IV fluid resuscitation, NPO status, and analgesics; surgery is reserved for complications such as infected necrosis.