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UWORLD first pass- week2 > 2/11 UWORLD test # 12 > Flashcards

2/11 UWORLD test # 12 Flashcards

1
Q

Q 1. Adrenal gland histology: which layer characteristically shows eosinophilic (pink)

A

zona reticularis
Right before medulla
Think this pink line as borderline landmark before medulla

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2
Q

Q 1. Each layer of adrenal gland is stimulated by what?

  • zona glomerulosa
  • zona fasiculata
  • zona reticularis
  • medulla chromaffin cells
A
  • G: AngII
  • F: ACTH
  • R: ACTH
  • medulla chromaffin: Ach (N), preganglionic sympathetic
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3
Q

Q 3. In female genital embryology, remnant mesonephric duct gives rise to what structure?

A

Gartner ducts

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4
Q

Q 3. In genital embryology, urogenital sinus gives rise to what structures- male? female?

A

Male: prostate gland, bulbourethral gland

Female: Bartholin gland, urethral/paraurethral gland

urogenital sinus-> all glands!

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5
Q

Q 4. cleft lip/palate: possible causes

A
  • maternal phenytoin
  • Patau syndrome
  • DiGeorge
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6
Q

Q 4. cleft lip/palate, thin scalp tissue, omphalocele: what is going on?

A

Patau (13 tisomony)

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7
Q

Q 7. Posterior communicating artery aneurysm: what CN is compressed? What about ACA?

A
  • Post. communicating: CN3

- ACA (anterior cerebral artery): optic chiasm -> bitemporal hemianopia

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8
Q

Q 8. What is legal term “capitation”?

A

payer ( patient self, employer, or goverment) pays FIXED amount of money

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9
Q

Q 8. What is legal term “global payment” ?

A

insurer pays single payment of all amount

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10
Q

Q 9. What is dexrazoxane? What is it used for? mechanism of action?

A

To reverse doxrubicin induced dilated cardiomyopathy. Iron chelator to reduce oxygen free radical

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11
Q

Q 10. Impact of lead poisoning on

  1. neurologic
  2. hematologic
  3. renal
  4. GI
A
  1. neurologic- foot drop, encephalopathy
  2. hematologic- sideroblastic anemia, basophlic stripping
  3. renal- interstitial nephritis
  4. GI- abdominal pain
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12
Q

Q 10. key from patient history that suggest possible lead poisoning

A

moving into old house (paint/dust are lead rich)

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13
Q

Q 12. onset of postpartum blues? when does it resolve?

A

2-3 days after delivery. Resolve within 14 days

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14
Q

Q 12. onset of postpartum depression?

A

within 4 weeks

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15
Q

Q 13. Legionella pneumoniae vs. mycoplasma pneumoniae: similarities (2) and differences (2)

A

Similarities

  • may present with mild productive cough
  • poor gram stain (legionella- requires silver stain, mycoplasma- lack cell wall)

Differences

  • legionella: high fever, mycoplasma: mild fever
  • legionella: community acquired pneumonia, mycoplasma: atypical pneumonia
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16
Q

Q 14. Gram negative sepsis: what abnormality would be seen on smear? mechanism?

A

Gram negative- LPS endotoxin

Endotoxin damage endothelium, forming microthrombi
-> schistocyte

  • This is exact mechanism of HUS by EHEC
17
Q

Q 15. Ureter obstruction results in what change in filtration fraction? explain physiology

A

Reduced

GFR decreased due to opposing hydrostatic pressure.

Decreased GFR -> AngII -> efferent constriction -> decreased RBF.

BUT, GFR decreases greater extent than RBF. Thus overall, FF=GFR/RPF decreases

18
Q

Q 16. What ethnic population is the least susceptible for osteoporosis? why?

A

African

higher bone density

19
Q

Q 18. In which situation does normal S2 splitting occur? Explain physiology

A

Inspiration

Increased venous return -> delayed P2 closure

20
Q

Q 18. What is fixed S2 splitting? (why is it called fixed?) In which situation does fixed S2 splitting occur? Explain physiology

A

Regardless of breath, splitting always occurs (thus fixed)

Increased blood volume in right side can cause this
such as ASD

21
Q

Q 19. male, urinary incontinence, osteoblastic lesions in vertebrae. What is going on? Which vessels (2) are involved in this process?

A

prostate cancer metastasizes to vertebrae

Hematogenous spread from prostatic venous plexus to vertebral venous plexus

22
Q

Q 20. esophageal varices in patient with cirrohosis: through what vessel?

A

Left gastric vein

23
Q

Q 21. Most common infection for fatal sporadic encephalitis? What would be a finding on CT?

A
  • HSV-1

- CT: hemorrhage

24
Q

Q 22. consequences of group A strep can be either PSGN (puffy face/hematuria) or rheumatic heart disease (murmur). Under what situation each of this consequence follows?

A
  • impetigo/ strep skin infection -> PSGN

- strep throat -> rheumatic heart disease

25
Q

Q 23. What is delta agent infection? What is special about this infection?

A

HepD infection

co-infection with HepB

26
Q

Q 23. What is definition of fulminant viral hepatitis?

A

severe/ sudden onset viral hepatitis

commonly by HepE, usually affect pregnant (Expecting baby) women

27
Q

Q 25. What is macrosomia? How diabetic mom commonly results in macrosomia of fetus? What about infant blood glucose level after delivery? Explain physiology

A

big fetus
Diabetic mom -> high glucose transferred to baby via placenta. Fetus is hyperglycemic & hyperinsulinism
-> islet beta cell hyperplasia

28
Q

Q 25. Does maternal insulin cross placenta?

A

No. It is degenerated by placenta.

Fetal insulin is produced from fetus

29
Q

Q 26. Which structure of heart is the most anterior?

A

RV

30
Q

Q 28. PT/PTT value in HUS?

A

normal
microthrombi formation - no activation of coagulation

HUS/ TTP are considered as primary homeostasis defect

31
Q

Q 28. Blood smear on DIC?

A

fragmented RBC (IDK why uwrold said it..)

32
Q

Q 28. PT/PTT value in von-willebrand disease?

A 
normal PT
elongated PTT (factor 8)
33
Q

Q 28. Plasma fibrinogen level in

  • von-willebrand disease
  • ITP
  • HUS
  • DIC
A
  • von-willebrand disease: no change
  • ITP: no change
  • HUS: no change
  • DIC: decrease
34
Q

Q 31. What is the mechanism of one side effect of metronidazole that mimics intoxication?

A

disulfiram like reaction

metronidazole inhibits acetaldehyde dehydrogenase
-> accumulation of acetaldehyde, causing alcohol intoxication effect

35
Q

Q 34. What is side effect of IV norephinephrine? antidote?

A

severe vasoconstriction and tissue necrosis

can be reversed by phentolamine (alpha antagonist)

36
Q

Q 36. Name 4 drugs that cause drug-induced SLE

A
  • INH
  • phenytoin
  • procainamide
  • hydralazine
37
Q

Q 37. What is mean corpuscular hemoglobin concentration (MCHC) in spherocytosis?

A

increase

spherocytosis is kinda condensed due to cytoskeleton loss while Hb is maintained. Thus more dense

38
Q

Q 38. What is physiological role of zinc finger motif? which receptors (3) contains it?

A

DNA binding motiff in transcription activator

Steroid receptor, thyroid hormone (T3/T4), vitamin D

39
Q

Q 40. What is consequence of endotracheal intubation in patient with long standing rheumatoid arthritis?

A

long standing rheumatoid arthritis involves vertebrae and thus may result in subluxation (vertebral misalignment)

Endotracheal intubation worsens subluxation, resulting in compression of spinal cord

UWORLD first pass- week2 (6 decks)

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