2/5 UWORLD test # 7 Flashcards
Q 1. What are deposits of crescentic glomerulonephritis (2)? vs. FSGN?
- IgG
- C3
These two are opsonins! - Fibrin
vs. FSGN: hyaline (not inflammatory)
Q 1. Which complement generally deposits in nephritic/nephrotic syndromes? why? Can other complements be deposited?
C3
C3b is the only opsonin in complement. Apart from C1 (which can be seen in FSGN), none of other complements are seen
Q 4. What are two GI defects in Down syndrome?
- Duodenal atresia
- Hirschsprung
Q 4. What is omphalocele? Due to what specific embryologic defect?
omphaloSEAL.
: GI organs are extruded out belly but sealed by peritoneum
Due to failure in lateral fold closure
Q 4. What abnormality can be found on ultrasonography in Down syndrome?
nuchal translucency
Q 5. For Down syndrome, what are results of the second- trimester quad screen in pregnant mom?
- increased beta-hCG
- increased inhibin A
- decreased AFP
- decreased estriol
Q 7. What are three possible routes of transmission of Campylobacter jejuni infection?
- poultry
- pet
- fecal oral
Q 7. What is route of transmission of Shigella?
fecal oral
Q 9. What signaling pathway does prolactin stimulate?
JAK-STAT
Q 9. What signaling pathway does growth hormone stimulate?
JAK-STAT
Q 9. What receptor does Insulin stimulate?
Tyrosine kinase
Q 9. What receptor does IGF-1 stimulate?
Tyrosine kinase
Q 10. IL-3 stimulates what?
bone marrow stem cell
Q 10. IL-4 stimulates what?
IgG and IgE
Q 10. IL-5 stimulates what?
IgA and eosinophil
Q 10. IL-2 stimulates what?
Differentiation/ growth for CD4/CD8/regulatory T cells, NK cells
Q 11. What are derivatives of each aortic arch?
- 1st
- 2nd
- 3rd
- 4th
- 5th
- 6th
- 1st aortic arch: maxillary artery
- 2nd: Stapedial artery (this artery normally regress)
- 3rd: common carotid, proximal part of internal carotid
- 4th: aortic arch, proximal part of right subclavian
- 5th: regress
- 6h: proximal part of pulmonary artery, ductus arteriosus
Q 13. Why OCPs are contraindicated in smokers?
OCPs increase risk for DVT and CAD
Q 14. What is Midodrine? Its effect on - Cardiac contractility - HR - Vascular resistance
alpha 1 agonist
- decreased contractility (reflex)
- decreased HR (reflex)
- increased vascular resistance
Q 14. What are two non-selective alpha antagonist?
Indications?
- Phentolamine (reversible): tyramine (cheese/wine) intake while taking MAOI- hypertensive crisis
- Phenoxybenzamine (irreversible): pheochromocytoma
Q 14. What is Clonidine? Its effect on -Cardiac contractility -HR -Vascular resistance
alpha2 agonist
- decreased contractility
- no change in HR
- decreased vascular resistance
Q 14. alpha1 blocker vs, beta1 blocker: which one causes orthostatic hypotension? What is patient’s complain for orthostatic hypotension
alpha blocker
orthostatic hypotension: standing up (increasing peripheral blood circulation) leads to syncope due to cerebral hypopefusion
Q 15. What is CSF protein level in viral infection?
increased (so does bacterial)
Q 17. What is signaling pathway for insulin
- binds to what receptor?
- metabolic pathway: what signaling molecules?
- growth pathway: what signaling molecules?
Insulin
- tyrosine kinase -> autophoshorylation
- metabolic pathway: P13K -> protein phospohtase (dephosphorylation)
- growth pathway: MAPK/RAS
Q 18. In what lung volume does total pulmonary vessel resistance is the lowest?
What about alveolar vessel resistance?
Explain physiology
- total pulmonary vessel resistance is lowest at FRC
- alveolar vessel resistance is lowest at RV
- physiology: At RV (residual volume), where lung is maximally shrinked due to forced exhalation, alveolar vessel resistance is lowest due to alveolar shrinkage effect. However, extra-avelolar blood vessel resistance will be increased due to loss of blood volume to alveolar vessel
At FRC (Functional residual capacity), balance between alveolar vessel resistance and extra-alveolar vessel resistance is the lowest. So total pulmonary vessel resistance is lowest
Q 18. What happens to resistance of extra-alveolar vessel in pulmonary circulation as lung volume increases? Explain physiology
extra-alveolar vessel resistance decreases as lung volume (opposite with alveolar vessel resistance) increases due to alveolar stretch effect.
As alveolar is stretched, less blood will be in alveolar vessel, resulting in more blood volume in extra-alveolar vessel -> dilation of extra-alveolar vessel -> decreased resistance
Q 20. What information does inferior colliculus carry?
auditory
Q 21. What is the most common microbial that causes meningitis in adult? What is the second most common cause?
most common: strep. pneumoniae (MOPS)
second most common: Nisseria meningiditis
Q 23. What are general (non-specific) symptoms of anal squamous cell carcinoma? What is the most common infection associated with it?
bleeding (might mimic hemorrhoids)
Ulcer (more indicative than bleeding)
HPV (16, 18, 31, 33)
Q 25. With increased risk for gallstone formation, what are levels of below:
- cholesterol
- bile salt
- phosphatidylcholine
- High cholesterol
- low bile salt
- low phosphatidylcholine
Bile salts and phosphatidylcholine BOTH increase solubility of cholesterol, decreasing gall stone
Q 27. What enzyme is responsible for initiation of autodigestion in actue pancreatitis
tripsinogen (zymogen) -> tripsin
Q 29. What are three As in terms of symptoms of serotonin syndrome? What are examples for each category?
- Agitation
- Autonomic: diaphoresis, hyperthemia, hypertension
- Activity: ankle clonus, hyperreflexia, seizure
Q 29. What is antidote for serotonin syndrome?
Cyproheptadine
Q 32. What organ is surrounded by 12th rib?
kidney
Q 33. Which two vitamins are not included in breastmilk?
Vitamine D and K
Q 34. What is mechanism of action for piogilatazone? side effects?
PPAR- gamma, which binds to transcriptional factor to up-regulates adiponectin, which will increase insulin sensitivity
side effects: hepatotoxicity, weight gain, HF
Q 35. Hepatitis serologic test for person who was vaccinated against HepB?
Anti-Hbs positive
Anti-Hbe & Anti-HBc negative: key difference from recovery)
Q 35. Hepatitis serologic test for chronic infection with high infectivity HepB?
HBsAg positive
HbeAg positive
Anti-HBc IgG (chronic)
Q 35. Hepatitis serologic test for chronic infection with low infectivity HepB?
HbsAg positive
HbeAg negative
Anti-Hbe postivie
Anti-HBc IgG
Q 35. Hepatitis serologic test for acute hepatitis B infection?
HBsAg positive
HbeAg positive
Anti-HBc IgM (acute- key difference from chronic infection with high infectivity)
Q 35. Hepatitis serologic test for person who is recovering from previous hepatitisB infection?
Anti-Hbs positive
Anti-Hbe positive
Still Anti-HBc IgM
Q 35. Hepatitis serologic test for a person who is in window period of Hep B infection
Anti-HbC IgM
Anti-Hbe postivie
Window period is short time after infection (basically very initial period of recovery).
During this period, HBsAg/HBeAg str negative, while Anti-HBs is also negative (not enough time to build antibodies in significant amount)
Only Anti-HBe is positive, meaning there is no actively replicating virus (not high infectivity), but it still has a potential to infect others. It is still considered to be an acute phase (Anti-HBc IgM)
Q 37. What is myocardial hibernation?
Heart muscles adjust to decreased cardiac perfusion (CAD) so that they decrease contractility to avoid ischemic injury due to maintenance of cardiac workload.
After coronary artery bypassing surgery, heart retain some contractility.
Q 40. What is physiology of skin wrinkles?
Skin wrinkles are due to age processing. Aging of skin (multiple exposure to UV) leads to decreased synthesis of collagen fibrils, resulting in wrinkles
