Repeated USMLE Questions Step 1- Review- 72

Q- Waterhouse-Friderichsen syndrome is characterized by which of the following conditions?

A- Abdominal pain, diarrhea and leukocytosis

B- Adrenal insufficiency, hypotension and disseminated intravascular coagulation

C- Back pain, fever and night sweats

D- Chest pain, pericardial effusion and persistent fever

B- Adrenal insufficiency, hypotension and disseminated intravascular coagulation- Bacterial infection with some organisms such as Neisseria meningitides can lead to sepsis and massive bleeding into one or both adrenal glands. Hypotension and multiple organ failures may follow.   



Q- 1-α-Hydroxylase activity is increased in which of the following conditions?

A- Hypocalcemia and hypophosphatemia

B- Hypoglycemia and ketonuria

C- Hypercalcemia and hyperphosphatemia

D- Hyperglycemia and acidosis

A- Hypocalcemia and hypophosphatemia- 1-α-Hydroxylase is located at the proximal tubule, skin, immune cells and bone. It catalyzes the hydroxylation of calcifediol into calcitriol which is the bioactive form of vitamin D.



Q- Which one of the following tests is highly diagnostic of systemic lupus erythematosus (SLE)?

A-Anti-citrullinated protein antibodies

B- Anti-double stranded DNA (Anti-dsDNA)

C- Anti-RNP antibodies

D- Anti-SSA/Ro autoantibodies

B- Anti-double stranded DNA (Anti-dsDNA)- This is the only test on the list that is highly specific to systemic lupus erythematosus.



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