2/27 UWORLD test # 26 Flashcards
Q 1. In what structure does hydrocele forms? What fluid is this and how does hydrocele form?
tunica vaginalis
peritoneal fluid, leaking through patent processus vaginalis
Q 2. Which ethical value should be considered for treating friends for informal medical care?
maleficience (causing harm due to lack of medical information)
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?
- protease
- alveolar macrophage and neutrophil
- alpha-antitrypsin, tissue inhibitors of metalloproteinase
- emphysema
Q 3. What is name of surfactant produced by type 2 pneumocytes?
dipalmatoyl phosphatidylcholine
NRDS (neonatal respiratory distress syndrome)
- what two maternal conditions/ delivery procedure can cause this? why?
- why therapeutic supplemental O2 is contraindicated? (3)
- 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
Q 4. What is general role of SAM (S-adenosyl-methionine) in many metabolic pathways and DNA modification?
methyldonor
Q 4. Fragile X syndrome
- inheritance pattern
- which gene is affected? how is it affected?
- phenotypes (5)
- x-linked recessive
- FMR1 (Fragile x Mental Retardation)
- large testis
- large jaw/ long face
- MVP
- mental retardation
- autism
Q 6. Attributable risk percentage
- definition
- calculation from a,b,c,d table
- calculation from relative risk
- definition: % of cancer patients are attributable to smoking
- % cancer among smokers - % cancer among non smokers
- (1-1/RR) * 100
Q 7. What is PAS stain looking for?
polysaccharides within tissue
- ex: glycogen, glycolipids, mucin
Q 7. Pompe disease
- defective enzyme
- affected organs (3)
- phenotypes (3)
- lysosomal alpha-1,4 glucosidase
- liver, muscle, heart
liver- hepatomegaly
muscle- muscle weakness
heart- cardiomegaly
Q 9. Neuronal defects in Brown-Sequard
- 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
Q 11. Which two hormones are associated with difference in insulin release in response to oral glucose vs. IV glucose
GLP-1 (glucagon like peptide) and GIP (gastric inhibitory peptide)
Q 13. Is HDL medication (niacin) indicated for prevention of cardiovascular disease?
HELL NO.
ONLY STATIN is proven for effectiveness in reducing cardiovascular disease
Q 13. statin is proved for what kind of diseases (3) prevention?
- risk of cardiovascular disease: MOST EFFECTIVE among all other lipid drugs
- mortality of peripheral artery disease
- mortality in high risk diabetes
Q 14. Describe how pressure changes as catheter passes following structures
- SVC/ RA
- RV
- main pulmonary artery
- pulmonary capillary
- 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
Q 16. What proteins (3) are encoded by pol gene in HIV?
- reverse transcriptase
- protease (for protein modification)
- integrase (viral DNA integration to host genome)
Q 16. Mutation on pol gene in HIV develops which two types of resistance?
- drug resistance against NRTI & NNRTI
- drug resistance against protease inhibitor
Q 16. Mutation on env gene develops what kind of resistance?
evade from host humoral immune response
host respond by antibodies, which target against gp120
Q 18. Anatomy- Left side: gonadal artery vs. gonadal vein
Each of these are originated from which vessel?
- gonadal artery: abdominal aorta
- gonadal vein: renal vein
Q 20. Describe histologic findings (3) of duodenum in celiac disease
- villous atrophy
- crypt hyperplasia
- intraepithelial lymphocytes
Q 20. What is skin manifestation in celiac disease? Describe gross appearance
- dermatitis herpetiformis
- bilateral, symmetrical pruritic erythematous papules, vesicles, bullous in extensor area, buttocks, and upper back
Q 22. Describe how gp120 and gp41 from env gene is synthesized and transported to plasma membrane (trafficking pathway)
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
Q 23. What is Glyburide? MOA?
- sulfonylurea
- induces synthesis of ENDOGENOUS (thus will see increase in C-peptide) insulin
Q 24. What does herbal supplement ephedra do? What side effect leads to banned from market by FDA?
- weight loss and energy booster
- serious side effects of ephedra are cardiovasular complications
Q 25. Which lab test will help categorizing metabolic alkalosis in two groups? How does this grouping helps for potential treatment?
- 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
Q 26. AV conduction tract bypassing AV node
- what is this?
- ECG finding?
- Wolf-parkinson white syndrome
- delta wave
Q 26. Reentry circuit around the tricuspid valve annulus
- what is this?
- ECG finding?
- atrial flutter
- sawtooth
Q 26. Rapid electrical impulses originating from pulmonary vein
- what is this?
- ECG finding?
- atrial fib
- irregularly irregular rhythm
Q 27. Where is site for transection in vasectomy? what can possibly happen first month after surgery?
vas deferans (proximal to epididymis)
initial sperm leak for first few days
Q 28. Chlorthalidone
- what is this medication?
- serum level of which ions/molecules (5) can be changed? how are they changed?
- thiazide
- hypercalcemia
- hyperlipidemia
- hypokalemia
- hyperuricemia
- hyperglycemia
Q 29. chloramphenicol
- mechanism of action
- what is special about usage of this drug?
- side effet
- blocks peptidyltransferase at 50S ribosome
- no longer used in U.S, but still used in developing country due to cheap cost
- gray baby syndrome
Q 30. Where is supinator canal? what nerve pass through it?
- between superficial and deep parts of supinator muscle
- radial nerve
Q 31. What gene mutation is associated with achondroplasia?
FGFR3
Q 32. What is biliary sludge? what causes it?
- viscous, concentrated bile: formation of biliary sludge predisposes gallstone
- biliary hypomobility can cause it
Q 32. What are two types of pigment gallstone? what is associated with each type?
- black (Ca2+, radiopaque): hemolysis
- brown: infection
Q 33. What two joints are most commonly involved in rheumatoid arthritis?
- cervical spine
- hand (MCP, PIP)
Q 34. Cherry hemangioma vs. strawberry hemangioma
- cherry hemangioma: adult
- strawberry hemangioma: infant
kids like strawberry more than cherry!
Q 36. What makes mycobacteria acid-fast stain positive?
mycolic acid
