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UWORLD first pass- week 1 > 2/4 UWORLD test #6 > Flashcards

2/4 UWORLD test #6 Flashcards

1
Q

Q 2. Draw nuceli, nerve tracts, in internuclear opthalmoplegia

A

First aid p.490

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2
Q

Q 19. Explain the difference between “effect modification” and “confounding”

A

Effect modification
- ex: smokers tend to have less lung cancers with a drug, but in non-smokers, there is no difference of effect on drug on lung cancer development.
=> Adding smoking (one factor) modifies the effect of drug (another factor) for outcome

confounding
- ex: smokers tend to have more lung cancer compared to non-smokers, but smokers also tend to drink more alcohol.
=> factor confuses the effect of exposure on outcome

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3
Q

Q 22. What is first-line medication for treating DVT for pregnant? why?

A

heparin and LMWH ( ex: Endoxaparin, -parin)

Heparin does not cross placenta

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4
Q

Q 26. what is aldosterone escape?

A 
In PHA (primary hyperaldosteronism), 
Na+ level is normal as it is controlled due to enhanced natriuresis by ANP (atrial natriuresis peptide)
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5
Q

Q 39. How each cranial nerve of solitary nucleus is responsible for taste of different regions?

A
  • CN7: anterior 2/3 tongue
  • CN9: posterior 1/3 tongue
  • CN 10: supraglottic region
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6
Q

Q 1. What is key difference between status epilepticus and tonic-clonic seizure? What is first line of each?

A
  • status epilepticus
    : sustained (>5 min) & repetitive (epilepsy) seizure
    First line is BDZ
  • tonic-clonic seizure
    : brief contraction and movement
    First line is Valporic acid or Phenytoin
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7
Q

Q 1. What is mechanism of benzodiazepine?

A

Increase frequency of Cl- influx by binding to GABA-A receptor

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8
Q

Q 2. Where does MLF (Medial Longitudinal Fasiculus) is located?

A

dorsal pons

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9
Q

Q 2. How convergence will be affected with INO (Internuclear opthalmoplegia) ?

A

Convergence is normal.
only horizontal gaze will be affected

This makes sense: INO is bridge between CN6 and CN3, so only when CN6 is needed (horizontal gaze), CN3 function will be impaired. Convergence doesn’t require CN6 action, so CN3 can fire independently to CN6

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10
Q

Q 4. What is genetic abnormality in fragile X syndrome?

A

(CGG)n repeat in x chromosome, leading to hyper-methylation and suppression of FMR1 (Fragile x Mental Retardation 1)

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11
Q

Q 4. What are symptoms of fragile X syndrome? (5)

A
  • mental retardation
  • post-pubertal macroorchidism
  • long face, large jaw
  • autism
  • MVP (mitral valve prolapse)
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12
Q

Q 4. What is genetic imprinting? What diseases are example of imprinting (2)?

A

Imprinting means silencing of gene from only one side of parent. If inherited gene (from one parent) is deleted/mutated, disease occur

  • examples:
    1. Prader-Willi disease: maternal imprinting. Paternal inherited gene is mutated
    2. AngelMan syndrome: paternal imprinting. Maternal inherited gene is mutated
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13
Q

Q 5. What is key difference between conductive disorder and oppositional defiant disorder?

A

Conductive disorder actually cause cruel harm to people or animal.
Oppositional defiant disorder may violate some rules, but does not physically harm people or animal

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14
Q

Q 7. What is mechanism of action of omeprazole?

A

H+/K+- ATPase inhibitor

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15
Q

Q 7. What is mechanism of action of tetrodotoxin?

A

Tetrodotoxin is from puff fish

It inhibits voltage-gated Na+ channel

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16
Q

Q 7. What is dofetlide? (mneomic from sketchy?)

A 
class iii anti-arrhythmic 
"TILL I DIE" (-tilide) in sketchy (Ibutilide) is another one
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17
Q

Q 8. During DNA replication, what enzyme is responsible for RNA primer synthesis? As DNA replication proceeds, how is it removed and replaced by DNA?

A

RNA primers attaches to DNA and initiates transcription.
It is synthesized by primase.
As DNA replication proceeds, it will be digested by 5->3 endonuclease activity of DNA polymerase 1, and replaced with DNA

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18
Q

Q 9. How Vitamin C is involved in collagen synthesis

Deficiency of vitamin C can lead to?

A

Hydroxylation of proline and lysine

Vitamin C deficiency -> scurvy

19
Q

Q 11. What is legal term “malpractice” ?

A

Low quality of care (below accepted standard) is provided

20
Q

Q 11. What is “near miss” ?

A

When correction is happened before harm is done

21
Q

Q 11. What is “Sentinel event” ?

A

unexpected serious medical condition. needs immediate medical investigation

22
Q

Q 14. What cardiac abnormality causes head bobbing and bounding femoral pulse?

A

aortic regurgitation
with AR, systolic pressure will vary.
Low systolic pressure due to blood leaking back, while next systolic pressure for next round will be higher due to more blood buildup

23
Q

Q 17. What is endotoxin? What does ENDOTOXINS mneomic stand for?

A

LPS on gram negative, spread as cell lyse or blebbing of plasma membrane (vs. exotoxin, which is secreted)

E- Edema
N- Nitric oxide
D- DIC
O- Outer membrane
T- TNF-alpha
O- O antigen
X- eXtremely heat stable
I- IL-1 and IL-6
N- Neutrophil chemotaxis
S- septic shock
24
Q

Q 20. By when does implantation happen after fertilization?

A

6-7 days

25
Q

Q 20. By when blastocyst forms after fertilization?

A

4-5 days

26
Q

Q 20. To what structure does blastocyst transform after implantation? What does it secrete?

A

Syncytiotrophoblast

It secretes beta-HCG, initially. Placenta then takes over and beta-HCG level peaks at 8-10 weeks

27
Q

Q 23. Auer rod is seen on blood smear in what disease? translocation marker? what is pathophysiology for this translocation? treatment?

A

AML (myleoblasts have MPO, which aggregates to form Auer rod)

For APL (acute promyelocytic leukemia),
t(15;17) -> Retinoic acid receptor function is blocked

tx: ATRA

28
Q

Q 24. Sirolimus: mechanism of action? what is clinical use?

A

blocks mTOR -> inhibition of IL-2 signaling response

IL-2-> mTOR -> cell growth & proliferation

Sirolimus is used for kidney transplant

29
Q

Q 24. Bortezomib: mechanism of action? what is clinical use? (not on FA)

A

inhibits 26S proteasome -> inhibits degradation of pro-apoptotic factors-> more apoptosis of cancer cells

Bortezomib is used for multiple myeloma

30
Q

Q 25. Pathophysiology of Zenker diverticulum?

A

weakness of cricopharyngeal and inferior pharyngeal constrictor muscles

31
Q

Q 28. In primary adrenal insufficiency, what is bicarbonate level?

A

low

no aldo -> no H+ secretion -> less HCO3- reabsorption

32
Q

Q 29. What is naproxen?

A

NSAID

33
Q

Q 30. CT finding in metastatic hepatic cancer?

A

multifocal hypodense masses

34
Q

Q 31. Which nerve is most likely to be injured by stretch injury during delivery? What is common consequence?

A

pudendal nerve

fecal incontinence

35
Q

Q 32. What is formula of maintenance dose?

A

maintenance dose = CL x Cp/F

36
Q

Q 32. What is formula of loading dose?

A

loading dose = Vd x Cp/F

37
Q

Q 32. What is formula of half life (with given Vd and CL)>

A

half-life: 0.7xVd/CL

38
Q

Q 34. What is heteroplasmy? example?

A

variability within offspring due to different amount of mitochondrial genome.

It is seen in disease with mitochondrial inheritance pattern- ex: mitochondrial encephalopathy

39
Q

Q 34. How pedigree look like for mitochondrial inheritance pattern?

A

All childs from affected mom will have disease. None will have disease from affected dad.
Only maternal mitochondrial gene is passed to offsprings

40
Q

Q 34. What is uniparental disomy? What are two subtypes?

A

Only gene from one parent is passed

Heterodisomy- meiosis 1 error
Homodisomy- meiosis 2 error

41
Q

Q 35. What is Milrinone? mechanism of action?

A

PDE-3 inhibitor
accumulation of cAMP= same effect as Gs
-> Cardiac muscle: positive inotropy (more intracellular Ca2+)
-> Smooth muscle: vasodilation

42
Q

Q 36. What is St. Jones Wort? its effect on CYP450

A

herbal medicine: anti-inflammatory effect

CYP450 inducer

43
Q

Q 37. osteogenesis imperfecta: pathophysiology? symptoms? (3)

A

Impaired type 1 collagen synthesis
-> abnormal bone / retina

  1. easy fracture
  2. blue sclera- translucent connective tissue in sclera: visible blue blood vessels
  3. hearing loss- impaired ossicles
44
Q

Q 39. What are other functions of facial nerve other than facial movement? (4)

A
  1. taste
  2. lacrimation (parasympathetic)
  3. salivation (parasympathetic)
  4. auditory volume modification: innervates stapedius and prevents excessive movement for noise reduction

UWORLD first pass- week 1 (4 decks)

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