2/6 UWORLD test #8 Flashcards
Q 2. What phospholipid in amniotic fluid can be used for what abnormal fetal condition?
dipalmitoyl phosphotidylcholine
ARDS
Q 2. What can be measured in amniotic fluid to screen neural tube defect?
Alpha-fetoprotein
Q 6. low leukocyte with infection symptoms. What is it?
non bacterial infection (viral)
Q 6. Histologic finding of CMV infection?
eosinophilic intranuclear inclusion (owl eye)
Congenital Toxoplasma gondii vs. Congenital CMV?
Both of them are ToRCHeS infection
They have similar, but different clinical manifestations
- Toxoplasma gondii \: ring shaped contrast on MRI intracranial calcification retinitis Hydrocephalus \+/- Blueberry muffin rash
- CMV \: periventricular calcification seizure hearing loss Blueberry muffin rash
What are two possible ways to get CMV infection?
- organ transplant
- sexual
Q 7. Explain how squatting helps alleviating cyanosis in tetralogy of Fellot
increased blood flow into pulmonary circulation due to increased pre-load and after-load (less deoxygenated blood will go to aorta)
Q 9. Key phenotype difference between fructokinase deficiency (essential fructosuria) vs. Adolase B deficiency (Fructose intolerance) ?
- essential fructosuria: benign, excess fructose will pee out
- Fructose intolerance: accumulation of toxic metabolite (1P-Fructose)
- Hypoglycemia (less phosphate available for gluconeogenesis)
- liver toxicity (cirrhosis), jaundice
Cataract will NOT be seen (this is only for galactose and sorbitol)
Q 10. What drugs can cause serum sickness?
- non protein drugs: penicillin
- chimeric monoclonal antibodies: rituximab
Q 10. What are symptoms (3) of serum sickness?
- fever
- pruritic skin rash
- arthralgia
Q 10. What will be seen in terms of complement level in serum sickness?
decreased C3 due to complement fixing by antibody (IgG/IgM)- drug complex
Q 11. What is the requirement for referring a patient for hospice care?
prognosis <6 months
Q 12. What is key difference between factitious disorder and malingering?
factitious disorder: goal is to meet psychological (internal) need- absence of obvious reward
malingering: goal is to achieve external reward
Q 13. What is conversion disorder?
unexplained neurologic complain, often acute onset with stress
Think like this: stress is CONVERTED to neurologic symptoms
Q 13. What is somatic symptom disorder?
unexplained generalized somatic symptoms (fatigue, pain) + excessive anxiety due to those symptoms
Q 15. What is argatroban?
What is its indication?
direct factor 2a (thrombin) inhibitor
Indicated for HIT (Heparin Induced Thrombocytopenia)
Q 19. What is area postrema? Where is it located? What is special for this structure?
chemoreceptor trigger zone- vomiting center, located in dorsal medulla
no BBB so that plasma material can freely move into area postrema -> chemoreceptor trigger for toxic material -> vomiting
Q 20. What is transmission pathways (3) for congenital toxoplasmosis gondii
- Congenital: vertical transmission
- Cat feces
- meat
Q 20. What is intrapartum infection?
Infection during delivery
Q 21 Which cells express MHC1? What about MHC2?
MHC1: most nucleated cells except erythrocyte - this makes sense that CD8 basically kills any virally infected cells. Needs nucleus that can express viral genome
MHC2: APCs (macrophage, B cells, Langerhan cells)
Q 21. What kind of antigen is presented in MHC1? What about MHC2?
MHC1: endogenously synthesized antigen, viral
MHC2: exogenous antigen, bacterial
Q 21. MHC1 vs MHC2: structural difference?
MHC1: heavy chain + beta 2- microglobulin
MHC2: alpha and beta chains
Q 22. Therapeutic measurement efficiency: Formula for absolute risk reduction?
% disease without medication - % disease with medication
Q 22. Therapeutic measurement efficiency: Formula for number needed to treat? What is its definition?
1/ARR
number of people to treat with medication to reduce one person from getting disease
