UWorld > 7.4.16 > Flashcards

7.4.16 Flashcards

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1
Q

gluconeogenesis: unique enzymes

A
  • pyruvate decarboxylase
  • phosphoenolpyruvate carboxykinase (PEPCK)
  • fructose 1,6 bisphosphatase
  • glucose 6 phosphatase
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2
Q

choriocarcinoma: ssx

A
  • abnormal vag bleed
  • uterine enlrg
  • sig increased B-hCG
  • hematogenous spread –> lung –> dyspnea, hemoptysis
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3
Q

what can increase incidence of statin-induced myopathy?

A

concomitant admin of drug that inh CYP450 –> inh statin metab

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4
Q

heme oxygenase: rxn

A

degrade heme to biliverdin –> green color of bruise

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5
Q

Chiari type I vs II

A

I: relatively benign –> adult –> occipital HA, cerebellar dysfx
- II: more severe –> neonate –> assoc w lumbar myelomeningocele, hydrocephalus

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6
Q

what is: Lambert-Eaten myasthenic synd

A

NM disorder presenting w:

  • proximal muscle weak
  • CN involvement
  • autonomic ssx
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7
Q

abd/pelvic trauma: comp

A

retroperitoneal hematoma

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8
Q

what releases IL-5?

A

TH2

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9
Q

ulnar N: sensory fx

A

mid ring –> pinky

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10
Q

tRNA –> 3’ CCA tail: fx

A
  • recog seq by proteins

- its terminal -OH grp serves as aa binding site

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11
Q

how does chronic kidney dz lead to renal osteodystrophy?

A

hyperphosphate –> hypocalc –> 2ndary PTH

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12
Q

migraine: acute tx

A

triptan –> abortive tx

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13
Q

how is S3 best heard?

A

L lat decubitus at end expiration

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14
Q

ectopic preg: RF

A

scarring:
- PID
- endometriosis

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15
Q

membranous nephropathy: nephritic or nephrotic?

A

nephrotic

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16
Q

subdural hematoma: CT scan

A

crescent-shaped mass

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17
Q

ulnar N injury: location

A
  • medial epicondyle of humerus (funny bone)

- Guyon’s canal: near hook of hamate, pisiform

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18
Q

essential tremor: mode of inheritance

A

AD

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19
Q

when does neurosyphilis occur?

A

any stage of infect

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20
Q

what is: myopia

A

nearsighted: can’t focus on far object –> image focus in front of retina

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21
Q

measles: neuro comp

A
  • w/in days: encephalitis
  • wks: acute disseminated encephalomyelitis
  • yrs: subacute sclerosing panencephalitis
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22
Q

what drug prolongs QT but has low risk of torsades?

A

amiodarone

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23
Q

intercostal V/A/N: location

A

subcostal groove on lower border of rib

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24
Q

SLE w Cushing synd –> died of LCA thrombus –> what increased risk of CAD?

A

cushing synd & lupus both increase risk of CAD

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25
SLE: most common renal dz
diffuse prolif GN
26
amatoxin: MOA
poison from mushroom (Amanita phalloides, death cap) --> inh RNA pol II --> halt mRNA syn
27
what is: Chiari malformation
congenital disorder: post fossa underdev --> cerebellum, medulla --> herniate thru foramen magnum
28
piriformis: passes thru what?
greater sciatic foramen
29
what can cause a subdural hematoma in the young? elder? how does it present?
- young: fall, motor vehicle accident --> gradual onset HA, confuse - elder: minor trauma --> variety of neuro ssx
30
what are the parts of tRNA?
- acceptor stem - 3' CCA tail - D loop - anticodon loop - T loop
31
ulnar N: motor fx
- finger adduct - finger abduct (except thumb) - digit 4 & 5: flex - wrist: flex, adduct
32
ectopic preg: classic presentation
lower abd pain few weeks after missed period
33
bipolar disorder --> tx --> why not use antidep?
risk of precipitating mania
34
hepatic encephalopathy: precipitating factors
- drugs - hypovol - excessive N load - infect
35
hypoxic ischemic encephalopathy: pathophys
profound systemic hypotension (cardiac arrest, shock) --> disminish blood supply to entire brain --> global cerebral ischemia: - in 5-10 sec --> syncope - 4-5min --> permanent brain damage
36
choriocarcinoma is commonly preceded by?
normal preg but can occur following any preg (molar, ectopic, aborted)
37
Lambert-Eaten myasthenic synd: pathophys
Ab against presynaptic Ca channel of NMJ --> can't release ACh
38
what is: Crigler-Najjar synd
AR --> no UGT --> no bile glucuronidation --> unconjugated hyperbilirubin --> kernicterus --> death
39
what is: RPGN
nephritic synd that progress to renal fail in wks-mos
40
what is: skin rhytides
skin wrinkle
41
RPGN: what disorders?
- Goodpasture synd - PSGN - diffuse prolif GN - Wegener granulomatosis - microscopic polyangiitis - Churg-Strauss synd
42
enterobius vermicularis: tx
1st line: albendazole | preg: pyrantel pamoate
43
where should you perform thoracentesis?
bw parietal & visceral pleura: - midclavicular line: bw rib 6-8 - midaxillary: 8-10 - paravertebral: 10-12
44
idiopathic membranous nephropathy: possible pathophys
IgG4 Ab to phospholipase A2 receptor found in high conc in glomerular podocytes --> immune deposition in glomerulus
45
what is: attrition bias
form of selection bias: disproportionate loss to FU bs exposed & unexposed grps
46
membranous nephropathy: assoc dz
- HBV - HCV - solid tumor - SLE - drugs --> NSAID, penicillamine
47
piriformis: fx
hip: ext rot
48
mucormycosis: classic clinical picture
paranasal sinus involvement in diabetic or immunosupp pt
49
A-fib: EKG
- irreg irreg rhythm - no organized P waves - varying R-R intervals - f (fibrillatory) waves bw QRS complexes --> irreg, low amp --> rep chaotic atrial activation
50
Lambert-Eaten myasthenic synd: assoc dz
malig --> classically small cell lung CA
51
S3: indicates
- healthy YA: normal | - >40yo: V enlargement
52
when should you suspect inherited causes of hypercoag?
53
androgenetic alopecia: pathophys
polygenic --> but dihydrotestosterone is 1ary pathogenic factor
54
membranous nephropathy: prognosis
poor response to steroids --> progress to chronic renal fail
55
muscles: 2 fiber types? fx?
1) slow twitch (Type 1): axns requiring low level sustained force --> postural maintenance 2) fast twitch (Type II): rapid forceful pulses of mvmt
56
T cell maturation --> neg selection: what is? where?
thymus --> medulla --> eliminate T cells that bind to self MHC or self Ag with overly high affinity
57
essential tremor: ssx
- slowly progressive symm postural/kinetic tremor --> usu UE - improve w alcohol
58
nephritic synd: charact
immune complex --> inflamm --> bleed: - oliguria/azotemia - salt retention --> periorbital edema, HTN - RBC casts
59
what is: choriocarcinoma
malig gestational trophoblastic dz --> anaplastic cytotrophoblasts & syncytiotrophoblasts --> no villi
60
what is the best test to dx 1ary hypothyroid?
serum TSH --> most sensitive screening test
61
retroperitoneal organs
SAD PUCKER: - suprarenal glands - aorta, IVC - duodenum (1st part) - pancreas (head & body) - ureter, bladder - colon (ascending & descending) - kidney - esophagus - rectum (mid-distal)
62
what is the most common inherited cause of intell disability?
fragile X synd
63
Type I & II muscle fibers --> where do they get their ATP?
I: aerobic --> high myoglobin (O2 storage), mito IIa (fast twitch): aerobic metab IIb: anaerobic glycogenolysis --> glycolysis
64
what is: piriformis synd
piriformis muscle --> injury, hypertrophy --> compress sciatic N in greater sciatic foramen --> sciatica like ssx --> pain, tingle, numb --> buttocks, N distribution
65
what is the most common mvmt disorder?
essential tremor
66
age related change can lead to what eye condition? pathophys?
presbyopia lens --> struct proteins denature --> lose elasticity
67
what is a pulm lab finding specific for PE?
vent-perfusion scan: sig mismatched defect
68
membranous nephropathy: who?
white adult
69
what is: bupropion
1st line antidep w amphetamine-like properties
70
membranous nephropathy: histology
- thick BM - granular IF - subepi deposit --> spike & dome
71
how can GI bleed lead to hepatic encephalopathy?
1) bleed --> more N (Hb) in gut 2) enterocyte --> convert to ammonia 3) into blood --> liver 4) liver cannot degrade to urea --> ammonia buildup
72
rhabdomyolysis: comp
acute renal fail
73
what is the most common cause of inherited hypercoag state?
factor V leiden
74
migraine: prophylactic tx
- BB - antidep: amitriptyline, venlafaxine - anticonv: valproate, topiramate
75
gluconeogenesis: initial 2 steps
1) pyruvate decarboxylase: pyruvate --> oxaloacetate | 2) phosphoenolpyruvate carboxykinase (PEPCK): oxaloacetate --> PEP
76
PE --> leads to? how?
- hypoxemia - resp alk vent (air) but no perfusion (blood flow) --> hypoxemia --> stim resp drive --> hypervent --> hypocapnia --> resp alk
77
MI --> 12 days after --> sudden cardiac death --> most likely cause?
V arrhythmia
78
membranous nephropathy: cause
usu idiopathic
79
hepatic encephalopathy: clinical presentation
- confuse, disorientation - lethargy - asterixis - stigmata of chronic liver dz: jaundice, edema/ascites, palmar erythema, telangiectasia, caput medusae
80
what muscle passes thru the greater sciatic foramen
piriformis
81
factor V leiden: pathophys
mutated factor V --> can't be deactivated by protein C/S --> excess factor V activity
82
cerebral watershed infarct: gross appearance
bilat wedge of necrosis over cerebral convexity, parallel & adj to longitudinal cerebral fissure
83
S3: cause
sudden limitation of V mvmt during rapid passive V filling
84
what is: presbyopia
can't focus on near objects --> image focuses behind retina
85
fragile X synd: cytogenetic abnormality
X chrom --> long arm --> fragile X mental retardation 1 (FMR1) gene --> oocyte meiosis --> CGG trinucleotide repeats expand --> >200 repeats --> hypermethylation --> FMR1 inactivation
86
subdural hematoma: results from?
rupture of cortical bridging vein
87
what is: gumma
3ary syphilis: necrotizing granuloma --> skin, mucosa, subQ tissue, bone, other organs
88
S3, S4: diastolic or systolic?
S3: diastolic S4: systolic
89
nephrotic synd: charact
proteinuria (>3.5g/day): - hypoalbumin --> pitting edema - hypoIg --> infect - hypercoag - hyperlipid/chol --> fatty cast
90
hepatic encephalopathy: pathophys
chronic liver fail --> impaired detoxification ability --> ammonia, other neurotoxins accum --> cross BBB: - increase inh neurotransmission - impair excitatory NT release
91
how can hyperTB lead to acute pancreatitis?
pancreas --> lipase --> metab TG to ffa --> toxic & inflamm effects on pancreas
92
who could develop a unilat cerebral watershed infarct?
severe carotid A stenosis
93
essential tremor: tx
propranolol (nonspec B-adrenergic ant)
94
MLF: location
pons --> dorsal --> paramedian
95
hydrops fetalis: ssx
- severe anemia - HF - pleural effusion - pericardial effusion - ascites
96
how do macrophage reduce plaque stability?
secrete metalloproteinase --> degrade extracell matrix proteins (collagen)
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