2/26 UWORLD test # 25 Flashcards
Q 2. Duodenal atresia
- pathphysiology
- presentation
- x-ray finding
- other associated medical condition
- failure of recanulation (makes duodenum lumen hollow during 9 weeks of gestation)
- bilious or non-bilious vomiting
- double bubble on x-ray (due to dilation of stomach and duodenum), polyhydramnios
- Associated with Down syndrome
Q 2. Jejunum/ ileum atresia
- pathophysiology
- presentation
- clinical finding
- vasocclusion leading to ischemia
- bilious vomiting
- spiral configuration of distal ileum around blood vessel- apple peeling
Q 2. Pathophysiology of tracheoesophageal fistula?
- Failure of tracheoesophageal septum to PARTITION the forgut into esophagus and trachea
partition: devision
Q 4. Somatic mosaicism vs. Germline mosaicism
somatic mosaicism: somatic mutation from parents can not pass affected gene (mosaicism needs to be in germ cells to pass next generation)
germline mosaicism: multiple siblings with variable disease manifestation from NORMAL parents. Germline mutation from normal parents can pass mutant.
Q 5. What is H. influenzae B vaccine made of? when should it be given?
- polysacchride capsule antigen conjugated to diptheria toxoid (inactivated toxin)
- 2-18 months
Q 5. Describe immune response to encapsulated bacteria vaccines
exogenous antigen presented to CD4 T cells
- > Th cell activation
- > B cell activation/ plasma cell
- > antibody production
It is antibody mediated immune response
Q 6. Describe the timeline regarding HBV serologic markers. Which one peaks disappears first? which one appears next? How can this time line explains window period?
- HBsAg
- HBeAg
- anti-HBsAg
- anti-HBeAg
- Anti-HBc IgG
- Anti-HBc IgM
- Both HBsAg and HBeAg arises, but HBeAg disappears first, followed by Anti-HBeAg productin
- HBsAg then disappear later, follwed by Anti-HBsAg production
- These processes above are still considered as acute infection, thus Anti-HBc IgM
- In window period, only Anti-HBeAg is positive (because it is synthesized earlier). Anti-HBc IgM will be detected
Q 8. Describe pathophysiology of secondary hyperparathyroidism/ renal osteodystrophy in CKD
CKD -> impaired 1-alpha hydroxylase
- > impaired (1.25)-OH vitamin D production
- > impaired gut Ca2+ absorption -> increased PTH
- > increased bone resorption, osteodystrophy
Q 9. Explain the mechanism in which opioid cause RUQ abdominal pain
opioid constricts oddi sphincter of bile duct, causing increased bile duct pressure
-> biliary colic like symptom
Q 10. Which cancer is associated with chronic postmastectomy lymphedema?
Angiosarcoma
Q 11. Which cell releases cholecystokinin? How does total parenteral nutrition (say after bowel surgery) results in gallstone?
I cells in duodenum and jejunum
parenteral nutrition will deplete enteral stimulation, causing less cholecystokinin release
- > less gallbladder emptying
- > stasis -> gall stone
Amitryptiline
- drug class, mechanism of action
- side effects (what is special about this drug compared to to other drugs in same class)
- TCA, block reuptake of serotonin and NE
- tertiary amine: more anti-muscarinic effect than secondary amine, like nortriptyline
- also QT prolongation, and cardiotoxicity by Na+ channel blocker. Cardiotoxicity can be reversed by NaHCO3
Q 13. Which complex mediates mRNA intron splicing? where in the cell does it occur?
snRNP
intron splicing occurs in nucleus
Q 13. What is P bodies? where is it located?
mRNA quality control (turnover)
cytoplasm
Q 14. sproatic colorectal cancer vs. colitis associated colorectal cancer
- From which cell does it arise?
- grade: which one is more aggressive?
- molecular pathogenesis
- distribution
Sporatic CRC
- arise from polyps
- less aggressive, lower grade
- APC mutation -> KRAS mutation -> COX-2 overexpression -> p53 mutation
- focal
Ulcerative colitis associated CRC
- arise from flat lesion
- more aggressive, higher grade
- early p53 mutation, followed by APC mutation
- multi-focal
Q 15. Where does bronchial vein drain to? How does it explain difference of pO2 between pulmonary vein and systemic artery?
pulmonary vein
Due to mixture of deoxygenated blood, systemic pO2 drops little bit compared to pulmonary venous pO2
Q 16. Injury to what structure will most likely impair common peroneal nerve?
fibular head
Q 18. Which nerve injury leads to wrist drop?
radial n.
Q 18. Damage to which artery should be concerned for humeral midshaft fracture?
deep brachial artery
it runs posteriorly with close proximity to radial nerve
Q 19. Up to which point can lung/pleura is located?
lung/pleura extends above clavicle!
Q 22. How does bordetella toxin works?
inhibition of Gi by Adenylylcyclase ribosylation
- > increased cAMP
- > edema & phagocyte dysfunction
Q 22. What does streptolysin O from group A strep do?
hemolysis
Q 23. Rotavirus
- RNA structure
- enveloped?
- what medical condition? to what population?
- dsRNA
- naked
- # 1 cause of diarrhea in kids
Q 24. Wound contraction
- when & what phase of wound healing does it happen?
- mediated by which mediator?
- proliferative phase, day 3 - weeks
- myofibroblast
