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UWorld > 2 > Flashcards

2 Flashcards

1
Q

in pernicious anemia, ?? may be increased

A

gastrin release is increased in response to decreased gastric acid production (from autoimmune destruction of the gastric mucosa)

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2
Q

acanthosis nigricans is assoc. with insulin resistance and obesity, but also ??

A

malignancy of GIT or lungs (sudden appearance)

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3
Q

long-term management of mechanical heart valve pts to reduce risk of thromboembolism

A

Warfarin

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4
Q

glycoprotein IIb/IIIa inhibitors

A

eptifibatide, abciximab, tirofiban

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5
Q

P2Y12 receptor blockers

A

clopidogrel, ticagrelor, prasugrel

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6
Q

PCSK9 inhibitor

A

alirocumab; increase degradation of hepatic LDL receptors

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7
Q

how will vasopressin levels change in nephrogenic DI?

A

increased serum vasopressin (ADH) due to vasopressin resistance in the renal collecting ducts

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8
Q

any unilateral visual pathway lesion beyond the optic chiasm can cause ?? from infarction of ??

A

homonynous hemianopsia

MCA, PCA, Anterior choroidal arteries

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9
Q

presentation of acute leukemia: pancytopenia results in these symptoms

A

decreased RBCs: anemia (fatigue)

leukopenia: opportunistic infections (candida)
thrombocytopenia: bleeding complications (retinal hemorrhages)

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10
Q

chronic alcoholism may affect the spleen how?

A

can cause portal HTN–>splenomegaly–>expansion of red pulp of spleen (blood congestion in sinuses and cords)

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11
Q

Cytochrome P-450 inducers (decrease dependent drug concentrations)

A 
"Guinness, Coronas, and PBRS induce Never-ending Chronic Alcoholism"
Griseofulvin
Carbamazepine
Phenytoin
Barbiturates
Rifampin
St. John's Wort
Nevirapine
Chronic Alcoholism
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12
Q

Cytochrome P-450 inhibitors (INCREASE dependent drug concentrations-reduce metabolism)

A 
CRACK AMIGOS
Cimetidine
Ritonavir
Amiodarone
Ciprofloxacin
Ketoconazole
Acute alcohol abuse
Macrolides (exc. azithromycin)
INH
Grapefruit juice
Omeprazole
Sulfas
(also Quinidine)
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13
Q

Fragile X: trinucleotide repeat in CGG leading to ??

A

^ gene methylation leading to inactivation of FMR1

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14
Q

episodic vertigo, tinnitus, hearing loss, think ?? caused by ??

A

Meniere disease
increased volume and pressure of endolymph in the vestibular apparatus

In contrast, a schwannoma will present similarly but will be more persistent/progressive

also, labyrinthitis (inflammation of vestibular nerve) causes acute-onset vertigo, N/V; typically a single episode, post-virus

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15
Q

positive selection of T cells occurs in the ??

negative selection occurs in the ??

A

thymic cortex (interaction of T cells w. thymic cortical epithelial cells)

thymic medulla (T cells- thymic medullary epithelial and dendritic cells)

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16
Q

characterisitic histo finding in HIV-associated dementia

A

microglial nodules, groups of activated macrophages/microglial cells rormed around small areas of necrosis that may fuse to form multinucleate giant cells

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17
Q

the mixing of genomic segments of segmented viruses that infect the same host cell is ??

this is in contrast to ?? in which gene exchange occurs thru crossing over of 2 dsDNA molecules

A

reassortment, (genetic shift); progeny of nonpathogenic strain can be pathogenic if their parent was coinfected alongside a pathogenic strain

recombination: progeny can have recombined genomes w. traits not present simultaneously in either parent virus

18
Q

small circular DNA resembling bacterial chromosome, code for proteins, tRNA and rRNA

A

mitochondrial DNA (mtDNA)

19
Q

chronic tic disorder vs tourettes

A

chronic tic disorder involves 1+ motor OR verbal tics (not both) for >= 1 year

tourettes has multiple motor AND at least 1 vocal tic, also >= 1 year

20
Q

etoposide inhibites ??
vs irinotecan and topotecan which inhibit ??
and FQs which inhibit ??

A

topoisomerase II
topoisomerase I

prokaryotic topoisomerase II and IV

21
Q

worsening dizziness, ataxia, dysarthria and visual disturbances in the setting of malignancy, think ??

A

paraneoplastic cerebellar degeneration: autoimmune response against tumor cells that cross-react with Purkinje neuron Ags (anti-Yo, anti-P/Q, anti-Hu)
-seen in small cell lung ca, breast, ovarian, and uterine malignancies

22
Q

a 46, XY with no Sertoli cells with present how?

A

male external genitalia, BOTH internal genitalia

  • no mullerian-inhibiting factor (MIF) produced–> female internal genitalia
  • Leydig cells still working and produce testosterone–>male internal genitalia
  • SRY gene on Y chromosome–>testes-determining factor (TDF)–>gonadal differentiation into testes
23
Q

while ACTH is the major trophic hormone of the zona fascitculata and reticular is, the zonal glomerulosis is prim. regulated by ??

A

angiotensin II

24
Q

prolonged ACTH stimulation causes ?? of the zona fasciculata and reticularis

A

hyperplasia (only limited hypertrophy)

25
Q

Aspergillus is not a leading opportunistic pathogen in HIV pts, why?

A

most likely because HIV pts have relatively intact phagocytic functions despite T cell dysfunction

26
Q

carotid massage does what??

A

stimulates baroreceptors and increases firing rate form carotid sinus, leading to an increase in parasympathetic output and w.drawal of sympathetic output to heart and peripheral vasculature, leading to slowing of HR and AV (also prolongs AV node refractory period) conduction, and decrease in SVR

27
Q

fever, pruritic skin rash, arthragias, vasculitis w. fibrinoid necrosis after infliximab administration, think ??
will also see low ??

A

Type II hypersensitivity reaction to nonhuman proteins (serum sickness)

low C3 and C4 complement levels

28
Q

structures that arise from neural crest cells

A 
"MOTEL PASS"
melanocytes
odontoblasts
tracheal cartilage
enterochromaffin cells
laryngeal cartilage, parafollicular cells of thyroid adrenal medulla and all ganglia
Schwann cells
spiral membrane
29
Q

pyruvate kinase deficiency causes ??

how does this affect the spleen?

A

hemolytic anemia due to failure of glycolysis, so can’t generate enough ATP to maintain RBC structure
-splenic red pulp hyperplasia occurs due to increased work of removing damaged RBCs from circulation

30
Q

what is “coronary steal” ?

what meds can cause it?

A

arteriolar vasodilation in nonischemic areas causes decreased blood flow in ischemic areas
adenosine and dypyridamole: selective vasodilators of coronary vessels
-can lead to hypoperfusionand worsening of existing ischemia

31
Q

what would cause the steepest decline in worldwide hepatocellular carcinoma?

A

univeral vaccination against HBV

32
Q

this protein ?? can both reduce the influx of drugs into cytosol and increase influx out, thereby preventing action of chemo agents

A

human multi drug resistance gene (MDR1) codes for P-glycoprotein, a transmembrane ATP-dependent efflux pump protein

33
Q

drugs with anticholinergic effects block ?? receptors

examples?

A

MUSCARINIC

atropine, TCAs, H1 rec antagonists (diphenhydramine), neuroleptics, antiparkinsonian drugs

34
Q

what is the most common predisposing condition for native valve infective endocarditis in developed nations??

A

MVP

In contrast: rheumatic heart disease is a common cause in developing nations
also, mitral annular calcification refers to degeneration and prog. calcium deposisiton typically seen in older adults and does not predispose to IE

35
Q

intracranial hemorrhage in infant with “natural” newborn period, consider ???

A

impaired clotting factor carboxylation due to not receiving postpartum vitamin K shot

36
Q

risk factors for transitional cell bladder cancer

A

Pee SAC: Phenacetin, Smoking, Aniline dyes, and Cyclophosphamide. (UWorld: rubber factory)

37
Q

an RTA presents with ??

A

hyperchloremic acidosis with normal anion gap and near normal GFR
if K+ high: RTA-IV
urine pH lower than 5.5: RTA-II
HCO3- decreased: RTA-II, normal RTA-I

38
Q

RTA I

A

can’t excreted H+ ions in collecting tubule, so increase in K+ excretion (hypokalemic) and elevation of H+ in blood
-associated with calcium kidney stones due to alkaline urine

39
Q

RTA-II

A

can’t reabsorb HCO3- in proximal tubule

40
Q

RTA-IV

A

deficient activity of Na+/K+ ATPase in collecting tubule (related to aldosterone deficiency)
-hyperkalemia

UWorld (8 decks)

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