UWorld > 7.3.16 > Flashcards

7.3.16 Flashcards

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1
Q

what is: nondisjunction in meiosis II

A

sister chromatids fail to sep

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2
Q

what is: pulm cap wedge pressure

A

indirect measure of the left atrial pressure

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3
Q

hyaline arteriolosclerosis: cause

A

long-standing:

  • benign HTN
  • DM
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4
Q

Kaposi sarcoma: cell of origin

A

primitive mesenchymal cells

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5
Q

inhibin: fx? secreted by?

A

Sertoli cell –> inhibin –> inh FSH

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6
Q

basal ganglia –> direct pathway: what is?

A

excitatory pathway –> facilitate mvmt:

1) cortex –> (dopamine –> D1 receptor) –> stim striatum
2) striatum -> release GABA
3) disinh thalamus (via globus pallidus internus)

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7
Q

hyperplastic arteriolosclerosis: cause? appearance?

A

malig HTN –> SM hyperplasia –> “onion-skin”

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8
Q

ganciclovir: what will increase risk of neutropenia?

A

co-admin:

  • zidovudine
  • TMP/SMX
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9
Q

what worsens hypertrophic cardiomyopathy?

A

decrease preload/afterload –> decrease LV vol –> worsen dynamic LV outflow tract obstruction:

  • vasodilator: DHP CCB, nitrate
  • diuretic
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10
Q

when do you suspect hypertrophic cardiomyopathy?

A
  • FHx of premature sudden death

- systolic murmur that accentuates w standing from supine position

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11
Q

hepatocell CA: #1 cause

A

HBV

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12
Q

diastolic heart fail: cause? gross appearance?

A

HTN heart dz

  • concentric V hypertrophy
  • decreased LV chamber size
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13
Q

DKA: tx? results in what lab changes?

A

IV normal saline + insulin

insulin:
- utilize glucose –> decrease glucose
- decrease ketone syn –> increase HCO3
- drive K into cell –> decrease K

hydration:
- normalize Na –> increase Na
- decrease serum osmolality

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14
Q

what is: secretin

A

hormone from duodenum –> released in response to acid/fat in small intest:

  • pancreas: secrete HCO3
  • gastric G cell: inh gastrin release
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15
Q

6-mercaptopurine: how activated? inactivated?

A
  • activate: hypoxanthine-guanine phosphoribosyl transferase (HGPRT)
  • inactivate: xanthine oxidase, thiopurine methyltransferase (TMPT)
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16
Q

what indicates a mononucleosis-like synd?

A
  • fever
  • fatigue
  • splenomegaly
  • atypical lymphocytosis

pharyngitis, LAD less common w CMV

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17
Q

JAK2 mutation: pathophys

A

cytoplasmic tyrosine kinase –> constitutively actie –> activate signal transducers and activators of transcription (STAT) proteins –> JAK-STAT signaling pathway

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18
Q

pure motor hemiparesis –> indicates damage to?

A
  • post limb of internal capsule

- basal pons

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19
Q

nocardia –> affects?

A

immunocomp:
- lung –> cavitary infiltrates –> cavitary pneumonia (look like TB)
- brain –> brain abscess
- skin

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20
Q

disinfectant –> iodine –> MOA?

A

halogenate proteins & nucleic acids

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21
Q

hereditary fructose intolerance: enzyme def

A

aldolase B

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22
Q

disinfectant –> chlorhexidine –> MOA?

A
  • disrupt cell membrane

- coag of cytoplasm

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23
Q

Charcot-Bouchard aneurysm: pathophys

A

chronic HTN –> lenticulostriate A –> hyaline arteriolosclerosis –> weak wall –> Charcot-Bouchard microaneurysm

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24
Q

glucagonoma: ssx

A
  • DM
  • necrolytic migratory erythema
  • anemia
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25
how do you test for Strep pyogenes infection?
pyrrolidonyl-arylamidase (PYR) + --> has replaced the bacitracin test (not very specific for S pyogenes)
26
putamen: location
pizza crust
27
ovarian torsion: pathophys
lrg adnexal mass --> heavy --> ovary twist around infundibulopelvic lig --> occlude blood & N supply to ovary --> severe acute pelvic pain, ovarian ischemia
28
thrombotic thrombocytopenic purpura: tx
plasma exchange (plasmapheresis) --> remv autoAb from blood
29
classic galactosemia: enzyme def
galactose 1 phosphate uridyl transferase
30
number needed to trt (NNT): calc
1/absolute risk reduction (ARR)
31
lead poisoning --> blood findings
- microcytic anemia w normal iron studies | - PBS: basophilic stippling
32
what is: necrolytic migratory erythema
elevated painful & pruritic rash --> usu face, groin, extremities --> gradually coalesce --> lrg lesion w central clearing of bronze induration
33
loop diuretic: stim what?
PG release --> increase renal blood flow --> increase GFR --> enhance drug delivery
34
GVHD: ssx
- skin: diffuse maculopapular rash --> predilection for palms, soles --> may desquamate in severe cases - liver: increase LFT - GI: diarrhea
35
dysarthria-clumsy hand synd --> indicates damage to?
- genu of internal capsule | - basal pons
36
fibrate --> gallstone: pathophys
inh bile acid syn --> decrease chol solubility --> gallstone
37
acute intermittent porphyria: enzyme? ssx?
porphobilinogen deaminase 5 P's: - painful abd - portwine urine - polyneuropathy - psych disturbance - precipitated by drugs, alcohol, starve
38
Parkinson dz --> intractable ssx --> tx?
high freq deep brain stim --> globus pallidus, subthalamic nucleus --> inh firing --> increase activity of downstream nuclei --> thalamo-cortical disinh --> improve mobility
39
infundibulopelvic lig: aka
suspensory lig of the ovary
40
lacunar infarct: what is? cause?
HTN --> small penetrating arterioles --> arteriolosclerosis --> deep brain (basal ganglia), subcortical white matter (internal capsule, corona radiata) --> small ischemic infarct
41
Charcot-Bouchard aneurysm: comp
intracerebral hemorrhage --> usu basal ganglia
42
branched chain aa --> metab to?
propionyl CoA --> methylmalonic acid
43
PKU: pathophys
deficient phenylalanine hydroxylase --> cannot convert Phe to tyrosine --> Phe accum in body fluids, CNS
44
PKU: clinical presentation
normal at birth --> gradually dev: - severe intell disability - sz - musty body odor - hypopigment: skin, hair, eyes, catechoaminergic brain nuclei
45
ataxia-hemiplegia synd --> indicates damage to?
- post limb of internal capsule | - basal pons
46
RVMI: clinical presentation
- hypotension - distended jugular veins - clear lungs
47
persistent gallbladder outflow obstruction --> leads to?
1) lysolecithin --> disrupt mucosa 2) bile salt --> irritate luminal epithelium 3) transmural inflamm, PG 4) gallbladder hypomotility 5) increase intraluminal pressure --> ischemia 6) bact invasion
48
porphyria cutanea tarda: enzyme? ssx?
uroporphyrinogen decarboxylase - blistering cutaneous photosens - tea color urine
49
RVMI --> what happens to: - RA pressure - central venous pressure - PCWP - cardiac output
- RA pressure: increase - central venous pressure: increase - PCWP: decrease - cardiac output: decrease
50
caudate nucleus: location
inferolat to ant horn of lat ventricle
51
LRT: what contributes most to airway resistance?
1st 10 gen of bronchi
52
when suspect lead poisoning?
microcytic anemia + constipation + mental status change in setting of construction work
53
what is: 3rd deg AV block
complete block of conduction from atria to ventricles: - SA node --> atrial contract - AV node --> ventricle contract --> narrow QRS ==> complete desynchronization bw P waves & QRS complexes
54
familial retinoblastoma: increased risk of?
2ndary tumors --> esp osteosarcoma
55
how damage ACL?
sport --> extended knee: - sudden decelerate - pivot
56
lead poisoning: features
LEAD Sucks: - Lead Lines in gums - Encephalopathy, Erythrocyte basophilic stippling - Abd colic, sideroblastic Anemia - Drops: wrist & foot drop - Dimercaprol, EDTA --> 1st line tx - Succimer --> chelation for kids
57
basal ganglia --> indirect pathway: what is?
inhibitory pathway --> inh mvmt: 1) cortex --> (dopamine --> D2 receptor) --> stim striatum 2) striatum --> disinh subthalamic nucleus (via globus pallidus externa) 3) STN --> stim GPi 4) inh thalamus
58
theca cell, granulosa cell: fx
LH --> theca interna --> androgen FSH --> granulosa cell --> androgen to estradiol theca externa cell: CT support struct for follicle
59
Zollinger-Ellison synd: ssx
- peptic ulcer --> esp distal duodenum - heartburn - diarrhea
60
what is: lentiform
putamen + globus pallidus
61
pure sensory stroke --> indicates damage to?
thalamus: - ventropostlat - ventropostmed
62
what is: acute calculous cholecystitis
acute inflamm of gallbladder initiated by gallstone obstruction of cystic duct
63
hereditary fructose intolerance: ssx
- after ingest fructose: hypoglycemia, vomit - failure to thrive - liver, renal fail
64
methadone: what is? use?
mu-opioid receptor agonist --> maintenance tx for opiod abuse --> suppress cravings & withdrawal ssx for >24hr
65
resistant schizophrenia: tx
clozapine
66
essential fructosuria: enzyme def
fructokinase
67
prolactin --> inh?
GnRH release
68
what is: glucose oxidase dipstick test
detect glucose in urine
69
globus pallidus: location
pizza --> inner part
70
JAK2 kinase: location
cytosol NOT nucleus
71
what is: striatum
putamen + caudate
72
thrombotic thrombocytopenic purpura: hallmarks
- microangiopathic hemolytic anemia | - thrombocytopenia
73
lactose intolerance: confirmatory test?
stool pH --> low bact --> ferment lactose --> short chain ffa --> lower pH
74
middle cerebral A occlusion --> leads to
- contralat hemiplegia of face & UE --> LE relatively preserved - aphasia (if dominant hemis affected (usu L))
75
what is: human multidrug resistance (MDR1) gene
codes for P-glycoprotein --> transmembrane ATP-dep efflux pump --> broad specificity for hydrophobic cmpds --> reduce drug influx & increase efflux from cytosol --> prevent axn of ctx agents
76
Klinefelter synd: clinical features
- 1ary hypogonad - long LE - small firm testes - azoospermia
77
sporicidal disinfectant
- hydrogen peroxide | - iodine
78
acute mitral regurg --> what happens to: - preload - afterload - contractile fx - ejection fraction - stroke vol
- preload: increase increase - afterload: decrease (decreased cardiac output --> severe hypotesion) - contractile fx: normal - ejection fraction: increase increase (increased preload, decreased afterload) - stroke vol : decrease
79
how do you get lead poisoning?
occupational exposure: - lead paint - battery - ammunition - construction
80
1ary myelofibrosis: pathophys
atypical megakaryocyte hyperplasia --> stim fibroblast prolif --> progressive replace marrow space by extensive collagen deposition
81
what is: INF-gamma assay
test for latent TB: expose to Mycobact tuberculosis antigens --> measure amt of IFN-gamma released by Tcells
82
Kallmann synd: pathophys
impaired GnRH syn by hypo: - 1ary amenorrhea - no 2ndary sex charact - olfactory sensory defect
83
Klinefelter synd: hormone changes
1ary hypogonad: - low testosterone - elevated FSH, LH - low inhibin
84
what is: nondisjunction in meiosis I
homologous chrom fail to sep
85
JAK2 mutation --> seen in
chronic myeloprolif disorders: - polycythemia vera - essential thrombocytosis - 1ary myelofibrosis
86
lightning injury: most common COD
- fatal arrhythmia | - resp fail
87
odd chain ffa --> metab to?
propionyl CoA --> methylmalonic acid
88
hematogenous osteomyelitis: what org? who?
``` children --> long bones (2ndary to bacteremic event): #1) staph aureus #2) S pyogenes ```
89
how do you dx essential fructosuria?
copper reduction test: detect reducing sugar
90
how do you dx gastrinoma vs other causes of hypergastrinemia?
admin exogenous secretin --> stim gastrin release from gastrinoma --> increase gastrin instead of decrease
91
polycythemia vera: ssx
- nonspecific ssx: HA, weak, diaphoresis - aquagenic pruritis - facial plethora - splenomegaly
92
disinfectant --> alcohol --> MOA?
- disorg lipid struct in membranes --> leaky - denature cellular proteins ==> bactericidal, tuberculocidal, fungicidal, virucidal --> but not destroy bact spores
93
aminolevulinic acid synthase requires what cofactor?
vitB6
94
basophilic stippling: seen in
Basically, ACiD alcohol in LeThal: - Anemia of Chronic Disease - alcohol abuse - Lead poisoning - Thalassemia
95
how do you acquire sideroblastic anemia?
- alcoholism: mito poison - lead poisoning: inh ALAD, ferrochelatase - vitB6 def: required cofactor for ALAS
96
ethanol --> hypoglycemia: pathophys
ethanol metabolism --> reduce NAD to NADH --> increase NADH/NAD ratio --> no NAD for gluconeogenesis
97
how does pancreatitis lead to ARDS?
release large amt of inflamm cytokine, pancreatic enzyme --> activate neutrophils in alveolar tissues --> interstial & intraalveolar edema, inflamm, fibrin deposition --> alveoli --> waxy hyaline membranes
98
systolic heart fail: cause? gross appearance?
- ischemic heart dz - dilated cardiomyopathy dilated ventricle
99
what is normal tracheal pO2? alveolar pO2?
tracheal pO2 = 150mmHg alveolar pO2 = 104
100
saccular aneurysm: what is? comp?
aka berry aneurysm --> thin walled saccular outpouching that lack media layer --> usu at ant comm A branch point subarachnoid hemorrhage
101
sideroblastic anemia is d/t?
defective protoporphyrin syn
102
1ary myelofibrosis: ssx
- pancytopenia - HSM - teardrop RBC
103
imperforate hymen: ssx
- 1ary amenorrhea - normal 2ndary sex charact - cyclic abd/pelvic pain d/t accum of menstrual blood in vagina/uterus (hematocolpos)
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