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U-World > 12 > Flashcards

12 Flashcards

1
Q

What do mesonephric ducts differentiate into ?

ductal stage

A

epididymis, ductus deferens, seminal vesicle

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2
Q

Mullerian (paramesonephric) give rise too?

ductal stage

A

uterine tubes, uterus, cervix and upper vagina under the maternal influence of estrogen

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3
Q

gives rise to glans penis in males and glans clitoris in females

A

genital tubercle

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4
Q

urogenital folds

A

ventral aspect of penis and the labia minora (chicks)

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5
Q

beomes scrotum in males and the labia majora in females

A

genital swellings

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6
Q

Urogenital sinus (males)

A

bladder urethra prostate and bulbourethral glands

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7
Q

Females urogenital sinus

A

bladder, urethra, lower vagina and Bartholin glands

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8
Q

DHT is adult male

A

secondary sexual characteristics

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9
Q

HIV DNA synthesis from the RNA template is impaired by reverse transcriptase inhibitors, which terminate viral DNA elongation by competitive or allosteric inhibition

A

NRTI: competitive nucleoside/tide RT inhibitor
NNRTI: Allosteric

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10
Q

Defect in the fusion of prechordal mesoderm- affects growth of midface, eyes and forebrain

A

Patau syndrome (13)

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11
Q

holoprosencephaly, microcephaly, microphthalmia, cleft lip, cleft palate, omphalocele

A

Patau syndrome (13)

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12
Q

Maturation of ovarian follicles, ovulation, and formation of corpus luteum

A

LH

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13
Q

Trophic to leydig cells in males and stimulates testosterone production

A

LH

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14
Q

Time Line of 4

A

4hours= Acute dystonia
4days= Akathisia
4weeks=bradykinisia
4months= tardive dyskinesia

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15
Q

Nasal flu vaccine

A

live attenuated

(MHC I and CD8+) Cell mediated

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16
Q

Injection flu vaccine

A

inactivated/killed

(induces neutralizing antibodies against HA) HUMORAL

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17
Q

who should be immunized for flu

A

everyone over 6mo old

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18
Q

Pericardial knock

A

earlier in diastole that S3

Constrictive pericarditis reduces ventricular compliance via an external force

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19
Q

A loud P2

A

Pulmonary hypertension

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20
Q

Restrictive pericarditis (positive Kussmal sign) why?

A

JVP should go down on inspiration but a fibrotic pericardium can not handle the increased VR so JVP pressure goes up.

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21
Q

CYP450 enzymes are heme containing proteins that are resposible for the majority of drug metabolism (mostly in liver). name the major subtypes

A

CYP3A, CYP2D, CYP2C

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22
Q

Prodrug metabolized by CYP2D to its active metabolite, endoxifen.

A

Tamoxifen

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23
Q

Woman with poor CYP2D on tamoxifen

A

exposed to decreased levels of drug’s active metabolite and have a higher risk of relapse

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24
Q

Downstream signal transducer that activates TFs to promote cell growth. Mutations associated with development of colorectal and lung cancers

A

KRAS

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25
Q

Decreased activity of hepatic N-acetyltransferase (wow)

A

decreased metabolism and increased toxicity of isoniazid and sulfonamides

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26
Q

Deficient thiopurine methyltransferase

A

6-MP cant be metabolized…becomes toxic

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27
Q

multidrug resistance in tumor cells

A

OVEREXPRESSION of P-glycoprotein (efflux)

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28
Q

Southwestern blots

A

identify and isolate proteins that bind DNA (ex: c-Jun and c-Fos, TFs, nucleases and histones)

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29
Q

S-100 ( neural crest marker)

A

homodimeric calcium-binding proteins (similar to calmodulin). Protein phosphorylation and cell growth and differentiation

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30
Q

cryptococcus neoformans

A

meningoencephalitis in HIV patient

Pneumonia is RARE

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31
Q

Autosomal recessive disorder of tyrosine metabolism

A

Alkaptonuria (tyrosine cant be turned into fumarate due to deficiency in homogentisic acid dioxygenase)

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32
Q

ochronosis

A

blue black pigment most evident in the ears, nose, and cheeks in alkaptonuria (AR) patients. (ochronotic arthopathy also a thing) ADULTHOOD manifestations usually

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33
Q

Inferior MI causes bradycardia…why?

A

RCA perfuses the SA and AV nodes

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34
Q

Blocks vagal influence on SA and AV nodes. Increases HR in patients with inferior MI

A

Atropine

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35
Q

People with disease of interest (cases) and people without the disease of interest (controls)

A

Case-control study

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36
Q

Median survival

A

calculated in cohort or clinical trials

compare median survival time in two or more groups of patients

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37
Q

LAD alone is occluded by atherosclerotic plaque

A

USE LEFT INTERNAL MAMMARY (thoracic) artery

*Superior patency rates

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38
Q

If multiple coronary arteries or vessels other than just LAD occluded

A

Use Great saphenous vein graft

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39
Q

Popliteal artery and vein course through popliteal fossa with tibial nerve. Common medical issues?

A

Popliteal artery aneurysms (majority of peripheral artery aneurysms.
Synovial (Baker’s) Cyst- associated with arthritis

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40
Q

Psychogenic or non-epileptic seizures can be seen in

A

conversion disorder

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41
Q

La belle indifference (incongruous lack of concern about symptoms) can be seen in

A

conversion disorder

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42
Q

Permanent CENTRAL DI

transient would be due to post. pituitary

A

Loss of hypothalamic vasopressinerginc neurons (supraoptic and paraventricular) due to trauma, surgery, or infiltrative disease (histiocytosis X) will lead to permanent DI

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43
Q

crescendo-decrsendo systolic ejection murmur at right sternal boarder.

A

Classic aortic stenosis

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44
Q

three major causes of valvular aortic stenosis

A

congenitally abnormal valve calcification (bicuspid valve)
calcified normal valve
RHD (MC in developing world…two above in US)

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45
Q

Marfan heart

A

aortic root disease that results in (aneurysmal dilation, aortic regurgitation (diastolic murmur), and aortic dissection)

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46
Q

where is aortic stenosis heard best?

A

right second intercostal space with radiation to the carotids

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47
Q

Primary biliary cholangitis

A

middle aged women and autoimmune diseases (sjogren and rheumatoid)

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48
Q

Ab in PBC

A

antimitochondrial

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49
Q

Granulomas and bile staining of hepatocytes (lymphocytic infiltration and intrahepatic bile duct destruction)

A

PBC

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50
Q

Most commonly affected organs in GVHD

A

Liver, GI, Skin

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51
Q

Post viral child with panlobular microvesicular steatosis

A

Reyes Syndrome

52
Q

subepidermal, nonacantholytic blisters

A

Bullus Pemp (anti-hemidesmosomes)

53
Q

Acute allergic contact dermatitis biopsy

A

spongiosis (abnormal accumulation of edema in fluid in the intercellular spaces between keratinocytes) and lymphocytic perivascular infiltrates

54
Q

A competitive antagonist of endothelin receptors used for tx of idopathic pulmonary arterial HTN

A

Bosentan

55
Q

Pulm HTN

A 
medial hypertrophy (smooth muscle)
intimal fibrosis
Luminal narrowing
Most severe: interlacing tufts of sm. vascular channels call plexiform lesions.
56
Q

Inactivating mutation in pro-apoptotic BMPR2 gene–> increase endothelial and smooth muscle cell proliferation leading to vascular remodeling, elvevated pulm. vascular resistance and PTH

A

Familial PAH (primary pulmonary hypertension)

57
Q

Family history w/ dyspnea and exercise intolerance in women 20-40

A

Familial PAH

58
Q

red blood cells with small rings called trophozoites and BANANA-shaped gametocytes

A

P. Falciparum infection

59
Q

Tx for ascariasis, trichuriasis, hookworm and pinworm

A

Mebendazole

60
Q

Prophylaxis and tx for P. Jirvocecii in HIV patient. Also used in african sleeping sickness and leishmaniasis

A

Pentamidine

61
Q

Require primaquine to treat liver hypnozoites

A

P. Vivax and P. Ovale

62
Q

Forchheimer spots on soft palate

A

rubella

63
Q

Unvaccinated close contacts of Hep A infection

A

immune globulin or vaccine

64
Q

Hep A vaccine (inactivated) for high risk including…

A

living or travel to endemic areas, chronic liver disease or coag disorders, men having sex with men

65
Q

Initiation of gene transcription: Binding of TFs to regulatory protein of the gene.

A

TF II D binds to TATA promotor sequence located about 25 BP upstream of coding region of the gene.

66
Q

Transcription produced a pre-mRNA molecule containing introns and exons. Post-transcriptional modification in which INTRONS are removed via

A

snRNPs

67
Q

Ciliated mucosal epithelium in lungs

A

trachea to proximal portions of respiratory bronchioles

68
Q

Mucus-secreting cells are present to the level of the larger bronchioles, after which _______ cells become the prominent secretory cell type

A

Club

69
Q

During thyroid surgery, nerve may be damaged do to close location of inferior thyroid artery

A

Recurrent laryngeal (branch of vagus)

unilateral: hoarseness
bilateral: inspiratory stridor and respiratory distress do to complete vocal cord paralysis

70
Q

Foreign viral protein synthesis can be inhibited by __________, which induce synthesis of antiviral proteins that promote degradation of RNA and halt protein translation in virally infected cells only

A

alpha and beta interferon

71
Q

Most common location of ectopic pregnancy (tubal ligation is actually a risk factor)

A

ampulla of fallopian tube (presents as adnexal mass on US)

72
Q

Uterine specimen reveal decidualized endometrium only, dilated coiled endometrial glands and vascularized edematous stroma

A

ectopic pregnancy (absent chorionic villi)

73
Q

molar prego or spontaneous abortion

A

Chorionic villi are enlarged and avascular edematous stroma

74
Q

Inflammatory endometrial infiltrate (infection of decidua); Uterine tenderness, fever, tachycardia

A

endometritis

75
Q

Straight short endometrial glands and compact stroma

A

proliferative phase (ex. day 7)

76
Q

Gonorrhea Tx (FQNs no longer first line due to resistance)

A

3rd generation cephalosporin + azithromycin or doxycycline (cover chlamydia)

77
Q

Drugs with high hepatic clearance have

A

HIGH LIPOPHILICITY and high volume of distribution

78
Q

Low volume of distribution

A

good for excretion into urine unchanged and less hepatic metabolism

79
Q

Supply the medial portion of the 2 hemispheres (frontal and parietal lobes)

A

Anterior cerebral artery (occlusion can cause contralateral motor and sensory deficits of lower extremities, behavior changes, and urinary incontinence)

80
Q

First area to be damaged in global cerebral ischemia

A

Hippocampus

81
Q

AIHA very similar to HS (indirect hyperbilirubinemia, elevated LDH, spherocytes) except

A

AIHA is not heritable, has positive direct coombs test, and propensity to develop other autoimmune diseases (SLE)

82
Q

Complications of HS

A

pigmented gallstones and parvoB19 aplastic crisis

83
Q

progressive HA with confusion

A

Hypertensive encephalopathy

84
Q

Lacunar infarcts (small ischemic infarcts) are most commonly due to

A

hypertensive arteriolosclerosis of small, penetrating arteries

85
Q

Hemosiderin-laden macrophages in pulmonary alveoli indicated chronic elevation of pulmonary capillary hydrostatic pressures most commonly due to

A

Left-sided heart failure

86
Q

Secrete a secretory protein and surfactant components and also help to detoxify inhaled substances (smoke) by CYP450 mechanism

A

Club cells (Clara)

87
Q

Incomplete fusion of urethral folds and presents as a ventrally located urethra (bottom)

A

Hypospadias

88
Q

Rotation of testicals around spermatic cord

A

testicular torsion

89
Q

Trauma or congenitally horizontal positioning of testes (bell clapper deformity)

A

Facilitates torsion

90
Q

Wall thickening, pericholecystic fluid on US

A

acute cholecystitis (mc due to gallstones obstructing the cystic duct)

91
Q

Cholescintigraphy

A

can be used to assess cystic duct patency and make diagnosis when US for acute cholecystitis is unclear

92
Q

HCM (large transverse diameter of myocytes and haphazardly arranged myocytes)

A

AD mutations in sarcomere proteins (thick and thin filament components) MC = beta-myosin heavy chain

93
Q

Chronic anemia

A

dilated cardiomyopathy

94
Q

Hypersensitivity myocarditis

A

drugs caused, mononuclear infiltrate and eosinophils

95
Q

Contact dermatitis, granulomatous inflammation, PPD skin test, and candida extract skin rx are examples of

A

type four hypersensitivity (occur 48-72 hours after antigen exposure) this is why you wait to read PPD

96
Q

Exclusively ketogenic AAs

A

Lysine and leucine (great for pyruvate dehydrogenase deficiency)

97
Q

Heberden and bouchard nodes w/ joint pain peeking in afternoon or evening after activity

A

Osteoarthritis (fingers, knees, hips, and spine MC)

98
Q

Combo of genetic, metabolic and mechanical factors that result in defects in articular cartilage

A

osteoarthritis

99
Q

Reactive arthritis bugs

A

salmonella, shigella, campy, chlamydia

100
Q

involvement of lower extrimity joints accompanied by enthesitis (infammation at insertion of tendons)

A

Reactive arthritis

101
Q

Blue black deposits in cartilage. Adults have sclerae and ear cartilage hyperpigmentation along with osteoarthropathy of large joints and spine

A

Alkaptonuria (AR)

102
Q

Neucloside monophosphate (ie nucleotide) that requires only cellular kinases for activation. great for HIV patient with mutated viral thymidine kinase HSV infection

A

Cidofovir

103
Q

Treatment of friends and family should be limited to

A

emergency situations when no other physician is available

104
Q

Gold standard for diagnosing Hirschsprung disease (congenital aganglionic megacolon)

A

Rectal suction biopsy

105
Q

Hydrogen breath test

A

used to diagnose lactose intolerance

106
Q

Annovulation (ex: PCOD) is a common cause of infertility. how do you treat this infertility?

A

Menotropin (human menopausal gonadotropin) acts like FSH and triggers formation of dominant follicle. Ovulation can then be induced by admin of beta-HCG which mimics LH surge via its similar alpha subunit

107
Q

Paraventricular tumors (ex: floor of fourth ventricle) w/ perivascular rosettes

A

Ependymomas

108
Q

Hypercellular areas of atypical astrocytes bordering regions of necrosis (pseuodo-palisading)

A

GBM

109
Q

benign tumors that involve cerebellum of children and young adults). Esosinophillic granular bodies and elongated hairlike processes (rosenthal fibers)

A

Pilocytic astrocytomas

110
Q

Spindle cells with palisading nuclei arranged around verocay bodies composed of eosinophilic cores (Antoni A pattern)

A

Schwannomas

111
Q

pregnancy and oral contraceptives predispose to

A

gallstone formation (female fat forty fertile)

112
Q

Reduces bile acid secretion and slows gallbladder emptying

A

progesterone

113
Q

Estrogen induced hypersecretion of cholesterol and progesterone-induced gallbladder hypomobility are responsible for

A

cholelithiasis (gallstones) in women who are pregnant or using oral contraceptives

114
Q

Over-expression of this oncogene leads to increased sensitivity of of cells to mitogenic stimuli

A

Ras (signal transducer for MAP-kinase pathway)

115
Q

Erb-B2 gene (proto-oncogene) overexpression =breast and ovarian cancer

A

Tyrosine Kinase activity related to epidermal growth factor receptor

116
Q

Hyperplastic arteriolosclerosis (onion-like concentric thickening)

A

laminated SMCs and reduplicated basement membranes

117
Q

homogeneous deposition of hyaline material in the intima and media of small arteries and arterioles (acellular thickening of arteriolar walls)

A

HTN (lower levels than hyperplastic)

118
Q

Trigeminal neuralgia (tic douloureux)

A

electric-shock like or stabbing pain in V2 and V3 distrubution. Carbamazepine = DOC (monitor CBC due to risk of aplastic anemia)

119
Q

saline microscopy

A

wet mount

120
Q

Inhibits phagocytosis and compliment activation, mediates bacterial adherence and is the target of type-specific humoral immunity to S. pyogenes

A

M protein

121
Q

Bortezomib (binds and inhibits 26S proteasome). USE?

A

In multiple myeloma it can facilitate apoptosis of neoplastic cells by preventing degradation of pro-apoptotic factors

122
Q

46 XY adolescent who appears phenotypically female but has primary amenorrhea due to the absence of an internal female reproductive tract and the presence of cryptochid testes

A

Androgen Insensitivity Syndrome

123
Q

The platelet function analyzer (PFA-100) test is abnormal in

A

NSAID use
Thrombocytopenia
Von Williebrand disease

124
Q

CALMs in MAS vs CALMS NF1

A 
NF1= smaller bilateral and smooth boarder (coast of cali)
MAS= large unilateral with an irregular boarder (Coast of Maine)
125
Q

MAS triad

A

CALMs (first)
Fibrous dysplasia of bone
Endocrine abnormalities

126
Q

results from an activating mutation in the G protein/CAMP/AC signaling pathway

A

MAS (mosaic somatic mutation)

U-World (16 decks)

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