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UWORLD first pass- week 5 > 2/28 UWORLD test # 27 > Flashcards

2/28 UWORLD test # 27 Flashcards

1
Q

Q 1. What breast disease is the most common cause of nipple discharge (serous or bloody)? What is histologic finding?

A
  • intraductal papilloma: can be serious and bloody

- projection of papillary cells with fibrovascular core

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2
Q

Q 1. Is fat necrosis associated with bloody nipple discharge? What is commonly associated with it? What is histologic finding?

A

HELL NO.

  • fat necrosis is commonly associated with trauma
  • calcification (saponification)
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3
Q

Q 1. What breast disease is associated with apocrine metaplasia? Is it associated with bloody nipple discharge?

A

fibrocystic changes

NO DISCHARGE

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4
Q

What breast diseases (3) are associated with nipple discharge? characteristics of discharge for each?

A
  • Intraductal papilloma: bloody/serous discharge
  • mammary duct ectasia: green-brown discharge
  • acute mastitis: purulent discharge
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5
Q

Q 4. ST elevation in leads I and aVL: where is infarct? which coronary artery occlusion?

A
  • lateral side

- left circumflex

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6
Q

Q 4. ST elevation in leads II,III, and aVF: where is infarct?which coronary artery occlusion?

A
  • inferior

- right coronal artery

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7
Q

Q 4. ST elevation in lead V7-V9: where is infarct? which coronary artery occlusion?

A
  • posterior

- posteior descending artery

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8
Q

Q 4. ST elevation in lead V1, V2: where is infarct? which coronary artery occlusion?

A
  • anteroseptal

- proximal left anterior descending artery

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9
Q

Q 4. ST elevation in lead V3, V4: where is infarct? which coronary artery occlusion?

A
  • anteroapical

- distal left anterior descending artery

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10
Q

Q 4. ST elevation in lead V5, V6: where is infarct? which coronary artery occlusion?

A
  • anterolateral

- left circumflex or left anterior descending

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11
Q

Q 4. ST DEPRESSION in V1-V3 with tall R wave: where is infarct? which coronary artery occlusion?

A
  • posterior

- posterior descending artery

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12
Q

Q 6. What cell mediates inflammation in sarcoidosis? What lab values (3) can be used?

A

CD4+ T cell

  1. elevated CD4/CD8 ratio
  2. hypercalcemia
  3. elevated ACE
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13
Q

Q 7. diplopia, intact upward gaze, problem with downward gaze (reading). Which CN is impaired?

A

trochlear (CN 4)

superior oblique is the only muscle that does depression (and intorsion as well)

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14
Q

Q 8. Define borderline disorder

A
  • mood instability, self-injury, marked impulsity

- splitting common for ego self-defence

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15
Q

Q 8. Define disruptive mood dysregulation disorder

A

persistent irritability with frequent temper outburst

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16
Q

Q 8. What adolescence behaviors are considered to be normal? How can it be differentiated by other psychological disorder?

A
  • transient emotional outburst is considered to be normal

- severity, DURATION, FREQUENCY are keys

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17
Q

Q 9. Where does amino acid binds to tRNA? Explain nature of chemical bond

A

3-OH

Ester bond

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18
Q

Q 10. Through what pathway are odd number fatty acids, branched chain amino acids, methionine, and threonine metabolized? what are metabolic intermediates (4)?

A

Propionyl-CoA-> methylmalonyl-CoA -> Succinyl coA

19
Q

Q 10. Describe how these are altered in methlymalonic acidemia

  • glucose
  • ketone
  • ammonia
A
  • acidosis: accumulation of methylmalonic acid
  • hyperammoniemia: acid prevent urea cycle
  • hypoglycemia
  • high ketone
20
Q

Q 12. repetitive behavior and lack of social engagement. Diagnosis?

A

Autism spectrum disorder

21
Q

Q 14. What is the most common cause of mitral valve stenosis?

A

prior rheumatic carditis

22
Q

Q 15. macrophage vs. ciliated cell: both are responsible for clearing of foreign material in respiratory system. what is the main difference?

A

LOCATION

macrophage: alveolar and distal respiratory bronchiole (as ciliated cuboidal cell becomes squamous)

ciliated cell: from bronchi to proximal respiratory bronchiole

23
Q

Q 20. Catheter insertion through what vessels are recommended? Which vessel has the highest infection rate?

A
  • subclavian & internal jugular

- femoral vein has the highest infection risk.
Because groin area is dirty!

24
Q

Q 20. Will frequent change of catheter helps reducing infection risk?

A

NO

Taking out catheter ASAP when no longer needed is much more effective in reducing infection risk

25
Q

Q 21. What is cancer drug, monoclonal antibody that targets EGFR? Mutation on what gene can cause resistance to anti-EGFR therapy? why?

A
  • cetuximab

- KRAS mutation will lead to constitutive activation of EGFR downstream signaling

26
Q

Q 23. vesicles on lips, hard palate and enlarged/tender lymphadenopathy. Which infection is most likely?

A

HSV-1

VESICLES is key word

27
Q

Q 24. Which two cell types express beta-1 receptor?

A
  • JGA (JuxtaGlomerular Appratus)

- cardiomyocyte

28
Q

Q 25. overactivity of which enzyme is associated with increased cancer development upon exposure to carcinogen? why?

A
  • cytochrome P-450 (microsomal monooxygenase)
  • most carcinogens enter the system as a pro-carcinogen (inactive form), which then is metabolized by P-450 to become active carcinogen
29
Q

Q 30. Canagliflozin

  • mechanism of action
  • indication
  • side effects
  • contraindication, why?
A
  • SGLAT1 inhibitor -> limit glucose reabsorption at PCT
  • type 2 DM
  • UTI
  • moderate to severe renal dysfunction. With renal dysfunction, it may increase risk of UTI
30
Q

Q 26. What is landmark for appendectomy?

A

Teniae coli

31
Q

Q 31. What is Ranibizumab?

A

VEGF inhibitor

32
Q

Q 31. age-related macular degeneration can be treated with what medication? why?

A

VEGF inhibitors (Ranibizumab, Bevacizumab)

: Macular degeneration is caused by neovasculization in macular-> newly synthesized vessels become leaky and cause macular hemorrhage

33
Q

Q 32. Ribavirin

  • mechanism of action
  • indication
  • example of drug that acts by same mechanism, but has different indications. what are indications for this drug?
A
  • inhibition of GMP synthsis
  • anti-Hepatitis C
  • Mycophenolate also inhibits GMP synthesis. Indicated for transplant rejection prophylaxis or lupus nephritis
34
Q

Q 32. Which anti-viral medication works by impairing uncoating?

A

Amentadine

  • note: it is no longer used. It is now indicated for parkinson (by promoting dopamine release/ inhibiting dopamine reuptake)
35
Q

Q 34. What cytokine mediates septic shock? how?

A

TNF-alpha

it increased vascular permeability, recruits WBC

36
Q

Q 35. What is clinical significance of CEA (Carcinoembryonic Antigen)?

A

not diagnostic due to low specificity

But good indicator for recurrence & monitoring after treatment

37
Q

Q 36. lingual thyroid

  • what is it?
  • pathophysiology
  • symptoms (3)
A
  • thyroid in lingual region within oral cavity
  • abnormal descending of thyroid during development
  • dysphagia, dyspnea (airway obstruction), dysphonia
38
Q

Q 37. High Arteriovenous gradient indicates what property of inhaled analgestics? explain physiology and principle

A

High arteriovenous gradient => high tissue solubility. Tissue/capillary is taking up more analgestic, meaning that it takes longer to saturate and exerts effect on CNS
=> SLOWER ONSET

MORE SOLUBILITY, takes longer to saturate, thus SLOWER ONSET

39
Q

Q 39. CA-125 is marker of what cancer?

A

ovarian cancer

40
Q

CA 19-9 is marker of what cancer?

A

pancreatic adenocarcinoma

41
Q

Q 39. Is long-term OCP use beneficial or harming for development of ovarian cancer? why?

A

beneficial

OCP (estrogen/progesterone) -> inhibits FSH/LH -> less estrogen stimulation

42
Q

Q 39. Is long-term use of antioxidant helpful for delaying cancer progression? What is example of anti-oxidant?

A

NOPE

  • vitamin C works as anti-oxidant
43
Q

Q 40. Findaxomicin

  • mechanism of action
  • indication
A
  • inhibition of sigma subunit of RNA polymerase

- recurrent C. Difficle

UWORLD first pass- week 5 (8 decks)

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