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UWORLD first pass- week 5 > 2/27 UWORLD test # 26 > Flashcards

2/27 UWORLD test # 26 Flashcards

1
Q

Q 1. In what structure does hydrocele forms? What fluid is this and how does hydrocele form?

A

tunica vaginalis

peritoneal fluid, leaking through patent processus vaginalis

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2
Q

Q 2. Which ethical value should be considered for treating friends for informal medical care?

A

maleficience (causing harm due to lack of medical information)

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3
Q

Q 3. Elastase in pulmonary secretion

  • what is elastase
  • which two cells secrete this?
  • what are counter-regulatory enzymes to balance action of elastase
  • what disease occurs if this balance is interupted?
A
  • protease
  • alveolar macrophage and neutrophil
  • alpha-antitrypsin, tissue inhibitors of metalloproteinase
  • emphysema
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4
Q

Q 3. What is name of surfactant produced by type 2 pneumocytes?

A

dipalmatoyl phosphatidylcholine

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5
Q

NRDS (neonatal respiratory distress syndrome)

  • what two maternal conditions/ delivery procedure can cause this? why?
  • why therapeutic supplemental O2 is contraindicated? (3)
A
  • maternal diabetes: insulin inhibits surfactant synthesis
    C section: lack of cortisol (cortisol produces surfactant)
  • supplemental O2 contraindicated for three reasons
    1. retinopathy
    2. bronchopulmonary dysplasia
    3. intraventricular hemorrhage
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6
Q

Q 4. What is general role of SAM (S-adenosyl-methionine) in many metabolic pathways and DNA modification?

A

methyldonor

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7
Q

Q 4. Fragile X syndrome

  • inheritance pattern
  • which gene is affected? how is it affected?
  • phenotypes (5)
A
  • x-linked recessive
  • FMR1 (Fragile x Mental Retardation)
  1. large testis
  2. large jaw/ long face
  3. MVP
  4. mental retardation
  5. autism
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8
Q

Q 6. Attributable risk percentage

  • definition
  • calculation from a,b,c,d table
  • calculation from relative risk
A
  • definition: % of cancer patients are attributable to smoking
  • % cancer among smokers - % cancer among non smokers
  • (1-1/RR) * 100
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9
Q

Q 7. What is PAS stain looking for?

A

polysaccharides within tissue

- ex: glycogen, glycolipids, mucin

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10
Q

Q 7. Pompe disease

  • defective enzyme
  • affected organs (3)
  • phenotypes (3)
A
  • lysosomal alpha-1,4 glucosidase
  • liver, muscle, heart

liver- hepatomegaly
muscle- muscle weakness
heart- cardiomegaly

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11
Q

Q 9. Neuronal defects in Brown-Sequard

A
  • ipsilateral DC/ML: at & below the level
  • Both contralateral/ ipsilateral spinothalmic: at the level
  • contralateral spinothalmic: below the level
  • ipsilateral UMN: at & below the level
  • ipsilateral LMN: at the level only
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12
Q

Q 11. Which two hormones are associated with difference in insulin release in response to oral glucose vs. IV glucose

A

GLP-1 (glucagon like peptide) and GIP (gastric inhibitory peptide)

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13
Q

Q 13. Is HDL medication (niacin) indicated for prevention of cardiovascular disease?

A

HELL NO.

ONLY STATIN is proven for effectiveness in reducing cardiovascular disease

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14
Q

Q 13. statin is proved for what kind of diseases (3) prevention?

A
  • risk of cardiovascular disease: MOST EFFECTIVE among all other lipid drugs
  • mortality of peripheral artery disease
  • mortality in high risk diabetes
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15
Q

Q 14. Describe how pressure changes as catheter passes following structures

  • SVC/ RA
  • RV
  • main pulmonary artery
  • pulmonary capillary
A
  • SVC/ RA: pressure is about 1-5 mmHg
  • RV: pressure is ~25/5 mmHg
  • main pulmonary artery: pressure is ~25/10 mmHg
    => increase in diastolic pressure due to resistance in pulmonary artery (narrower space)
  • PCWP: ~4 -12 mmHg
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16
Q

Q 16. What proteins (3) are encoded by pol gene in HIV?

A
  • reverse transcriptase
  • protease (for protein modification)
  • integrase (viral DNA integration to host genome)
17
Q

Q 16. Mutation on pol gene in HIV develops which two types of resistance?

A
  • drug resistance against NRTI & NNRTI

- drug resistance against protease inhibitor

18
Q

Q 16. Mutation on env gene develops what kind of resistance?

A

evade from host humoral immune response

host respond by antibodies, which target against gp120

19
Q

Q 18. Anatomy- Left side: gonadal artery vs. gonadal vein

Each of these are originated from which vessel?

A
  • gonadal artery: abdominal aorta

- gonadal vein: renal vein

20
Q

Q 20. Describe histologic findings (3) of duodenum in celiac disease

A
  • villous atrophy
  • crypt hyperplasia
  • intraepithelial lymphocytes
21
Q

Q 20. What is skin manifestation in celiac disease? Describe gross appearance

A
  • dermatitis herpetiformis

- bilateral, symmetrical pruritic erythematous papules, vesicles, bullous in extensor area, buttocks, and upper back

22
Q

Q 22. Describe how gp120 and gp41 from env gene is synthesized and transported to plasma membrane (trafficking pathway)

A

env gene encodes gp160

gp160 is then glycosylated and proteolytically cleaved into gp120 and gp41, which are transported to golgi, where they are targeted to plasma membrane

23
Q

Q 23. What is Glyburide? MOA?

A
  • sulfonylurea

- induces synthesis of ENDOGENOUS (thus will see increase in C-peptide) insulin

24
Q

Q 24. What does herbal supplement ephedra do? What side effect leads to banned from market by FDA?

A
  • weight loss and energy booster

- serious side effects of ephedra are cardiovasular complications

25
Q

Q 25. Which lab test will help categorizing metabolic alkalosis in two groups? How does this grouping helps for potential treatment?

A
  • urine chloride test
  • low urine chloride: vomiting, saline (chloride supplementation) responsive
  • high urine chloride
    1. thaizide (volume contraction leads to alkalosis due to aldo compensation)- saline responsive
    2. Barrters/ Gitelman - saline nonresponsive
    3. cushings (cortisol cross react on MR)- saline nonresponsive
    4. ectopic ACTH
    5. hyperaldosteroinsm- saline nonresponsive
26
Q

Q 26. AV conduction tract bypassing AV node

  • what is this?
  • ECG finding?
A
  • Wolf-parkinson white syndrome

- delta wave

27
Q

Q 26. Reentry circuit around the tricuspid valve annulus

  • what is this?
  • ECG finding?
A
  • atrial flutter

- sawtooth

28
Q

Q 26. Rapid electrical impulses originating from pulmonary vein

  • what is this?
  • ECG finding?
A
  • atrial fib

- irregularly irregular rhythm

29
Q

Q 27. Where is site for transection in vasectomy? what can possibly happen first month after surgery?

A

vas deferans (proximal to epididymis)

initial sperm leak for first few days

30
Q

Q 28. Chlorthalidone

  • what is this medication?
  • serum level of which ions/molecules (5) can be changed? how are they changed?
A
  • thiazide
  • hypercalcemia
  • hyperlipidemia
  • hypokalemia
  • hyperuricemia
  • hyperglycemia
31
Q

Q 29. chloramphenicol

  • mechanism of action
  • what is special about usage of this drug?
  • side effet
A
  • blocks peptidyltransferase at 50S ribosome
  • no longer used in U.S, but still used in developing country due to cheap cost
  • gray baby syndrome
32
Q

Q 30. Where is supinator canal? what nerve pass through it?

A
  • between superficial and deep parts of supinator muscle

- radial nerve

33
Q

Q 31. What gene mutation is associated with achondroplasia?

A

FGFR3

34
Q

Q 32. What is biliary sludge? what causes it?

A
  • viscous, concentrated bile: formation of biliary sludge predisposes gallstone
  • biliary hypomobility can cause it
35
Q

Q 32. What are two types of pigment gallstone? what is associated with each type?

A
  • black (Ca2+, radiopaque): hemolysis

- brown: infection

36
Q

Q 33. What two joints are most commonly involved in rheumatoid arthritis?

A
  • cervical spine

- hand (MCP, PIP)

37
Q

Q 34. Cherry hemangioma vs. strawberry hemangioma

A
  • cherry hemangioma: adult
  • strawberry hemangioma: infant

kids like strawberry more than cherry!

38
Q

Q 36. What makes mycobacteria acid-fast stain positive?

A

mycolic acid

UWORLD first pass- week 5 (8 decks)

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