2/25 UWORLD test # 24 Flashcards
Q 1. biceps reflex is mediated by what nerve root?
C5, C6
Q 1. Musculocutaneous nerve is derived from which nerve root? What functions are lost with musculocutaneous n. injury?
- C5, C6
- bicep reflex, forearm flexion, lateral forearm sensation, and supination
Pancreas embryology: Each structure gives rise to what?
- ventral pancreatic bud
- dorsal pancreatic bud
- ventral: head and uncinate process of pancreas, main pancreatic duct
- dorsal: body and tail of pancreas, accessory pancreatic duct
Q2. Annular pancreas
- Which embryological defect?
- symptoms
- clinical finding
- abnormal migration of ventral pancreatic bud
- abdominal pain, non-villious vomiting, pancreatitis (obstruction of pancreatic duct). Mostly asymptomatic
- narrowed duodenum
Pancreas divisum
- Which embryological defect?
- symptoms
- failure of fusion of ventral pancreatic bud with dorsal pancreatic bud
- abdominal pain, pancreatitis, mostly asymptomatic
Q 4. polyuria, polydipsia, fruity odor to breath or urine. Diagnosis?
DKA
Q 5. Compare: cross-sectional vs. Ecological study
They both randomly select samples and evaluate exposure & outcome.
Cross-sectional: individual
Ecological: population
Q 6. T cell development: explain brief picture of what is happening in each structure
- bone marrow
- thymus
- secondary lymphoid tissues (lymph node- paracortex / spleen- PALS)
- bone marrow: T cell production
- thymus: T cell maturation- CD4+ T cell and CD8+ T cell
- Secondary lymphoid tissues: T cell activation ( Th becomes Th1, Th2, Th3 & CD8 cell becomes killer T cell)
Q 6. T cell maturation: describe what is happening in thymus
- before thymus: bone marrow - CD4-/CD8- double negative
- cortex: positive selection, CD4+/CD8+ double positive
=> majority of T cell get killed during positive selection - medulla: negative selection, single positive (either CD4+ or CD8+)
Q 7. Inheritance pattern of G6PD deficiency?
X-linked recessive
Q 7. Two reactions (oxidative & non-oxidative) of HMP shunt
- which rxn is reversible? which is irreversible?
- key enzymes
- what are reactant and product?
- oxidative: irreversible, first couple of rxns
non-oxidative: reversible, final couple of rxns - oxidative: G6PD
non-oxidative: transketolase (B1 dependent) - oxidative: G6P ->->->5P-ribosulase+ NADPH
- no-oxidative: 5P- ribosulase Ribose 5-P, F6P, Glyceraldehyde-3P
Q 8. What are three symptoms of Hodgkin lymphoma? How these symptoms are collectively called? (there is fancy word for it) Another medical condition that results in these symptoms?
B signs
- fever
- night sweat
- weight loss
These B signs may also be seen in TB
Q 9. Which cells undergo clonal expansion by TSS toxin from S.aureus?
T cell
TSST works as supraantigen that leads to polyclonal T cell exapansion
Q 9. Which toxin is made by C.perfringens? What does it do?
alpha toxin
disruption of phospholipid membrane
Q 10. Define intellectualization
using fact and logic to put emotional distance from situation
- focusing only on survival rate after cancer diagnosis
Q 10. Define passive aggression
indirect expression of emotion
Q 10. Define projection
attributing unacceptable internal impulse to another person
Q 10 . Define regression
INVOLUNTARILY going back to premature state UNDER STRESSFUL SITUATION, commonly seen in kids
- kids urinating in bed when they are stressed
Q 11. In a non-emergency situation, where should physician contact to report impaired colleagues? What if such a body does not exist?
physician health program
state licensing board if physician health program does not exist
Q 13. After period of starving, patient develops hypoketotic hypoglycemia: what is going on? what enzyme is most likely missing?
inability to undergo beta-oxidation for ketogenesis
Either cartine acyltransferase or acyl-coA dehydrogenase may be deficient
Q 13. What is role of carnitine in beta- oxidation? what are phenotypes for carnitine deficiency?
to shuttle long chain (over 14 carbons) fatty acyl-coA into mitochondria, where further steps in beta oxidation occurs
with carnitine deficiency, hypoketotic hypoglycemia after fasting
Q 14. How are PaO2 and PaCO2 during exercise in healthy people?
generally well maintained due to adjusted ventilation, V/Q
Q 15. Define nature of mutation in factorV laiden.
coagulability state? inheritance pattern?
resistance against protein C -> hypercoagulable state
gain of function so autosomal dominant
Q 16. How diet should be modified in celiac disease?
no grains (wheat, barly, rye)
