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UWORLD first pass- week2 > 2/9 UWORLD test # 10 > Flashcards

2/9 UWORLD test # 10 Flashcards

1
Q

Q 2. What is sublingual tablet used for antianginal therapy?

A

nitrates

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2
Q

Q 2. What are four mechanism of actions of antianginal therapy? Example of drugs for each mechanism?

A
  • Reduce HR: beta blocker, non-dihydropyridines CCB
  • Reduce pre-load (less stretch -> less cardiac workload): nitrate
  • Increase cardiac perfusion: dihydropyridines CCB,
    non-dihydropyridines CCB & nitrate (mild)
  • Reduce after-load (less cardiac workload): dihydropyridines CCB
    NOTE: hydralizine is NOT indicated
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3
Q

Q 3. What is Colchicine? mechanism of action?

A

Acute anti-gout drug

MOA: destabilize actin, inhibition of neutrophil chemotaxis -> reducing gouty inflammation

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4
Q

Q 4. Findings of sarcoidosis?

  • X ray
  • lung histology
  • other symptoms: SARCOID
A
  • X ray: bilateral hilar lymphadenopathy
  • Lung histology: non-caseating granuloma
- other symptoms
S: Skin- Erythema nodosum
A: Arthritis
R: Respiratory
C: Cardiac-pericarditis & Cranial- Bell's palsy
O: Occular- uveitis
I: ILD
D: vitamin D- hypercalcemia
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5
Q

Q 4. Describe histologic difference between caseating vs. non-caseating granuloma

A

non-caseating: multinuclear giant cells in the middle

caseating: apoptotic cell in the middle (just vague pink)

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6
Q

Q 5. Name of nephrologic complication of SLE?

LM/EM/IF findings? nephrotic or nephritic?

A

Diffuse proliferative Gromerulonephritis

LM: wire-looping
EM: IC deposit
IF: granular

Both nephrotic & nephritic

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7
Q

Q 5. What is cardiac complication of SLE?

  • Name
  • morphological characteristics
A

Libman-sacks endocarditis

vegetation (small/sterile) on both sides of valve

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8
Q

Q 7. What is Langerhans cell? morphology under microscopy?

A

APC (antigen presenting cell): dendritic cells in skin/mucosal membrane
tennis racquet

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9
Q

Q 9. What are 3Ds in pellagra?

A

Dementia
Dermatitis: photosensitive
Diharrea

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10
Q

Q 9. Niacin is precursor for what moleclues (2)? For what these molecules are used?

A

NAD: catabolic- glycolysis
NADP: anabolic- gluconeogensis

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11
Q

Q 9. What three enzymes require NAD as a cofactor in TCA cycle? mnemonic for this?

A

IMaK

  • I: Isocitrate dehydrogenase
  • M: Maltose dehydrogenase
  • aK: alpha-ketoglutarate dehydrogenase

All of them are dehydrogenase, which makes sense that NAD will be reduced and converted into NADH, while reactant will be oxidized (dehydrogenation)

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12
Q

Q 10. What is mnemonic for hemoglobin electrophoresis? What each letter stands for and what is characteristics of each type of hemoglobin?

A

A Fat Santa Claus
From anode (+) to cathode (-)
usually electrophoresis runs from (-) to (+)
so A will be the most distal to origin

A- HbA: normal Hb
F- HbF: fetal HB (gamma chain smaller in size)
S- HbS: sickle cell (valine mutation -> neutral)
C- HbC: lysine mutation -> positive

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13
Q

Q 10. Missense mutation vs. nonsense mutation. What is difference?

A

missense mutation: nucleotide change leading to amino acid change

nonsense mutation: stop codon insertion -> truncated protein
STOP NONSENSE!

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14
Q

Q 10. What are two phenotypes of HbC disease?

A

typically asymptomatic but sometimes,

  • mild normocytic hemolytic anemia
  • splenomegaly
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15
Q

Q 11. mom: 1/a disease carrier frequency & dad: 1/b disease carrier frequency. What is probability to have a child with disease?

A

1/(4ab)

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16
Q

Q 12. Signs of infection in patient who underwent VP shunt (ventriculoperitoneal shunt) for hydrocephalus. What would be a most likely pathogen?

A

S. epidermis

VP shunt device is foreign device that S.epidermis loves to attach biofilm

17
Q

Q 12. How S.epidermis forms biofilm on foreign body?

A

extracellular polysaccharide matrix

18
Q

Q 14. What are three phases of wound healing. Describe each phase by: phase duration, mediators, characteristics

A
  • inflammatory phase: up to day 3, neutrophils/macrophages
  • proliferative phase: day 3- weeks, endothelial cells/fibroblast/myofibroblast, type 3 collagen, granulation tissue, angiogenesis
  • scarring phase: weeks- months, fibroblast/ Zn2+ dependent collagenase: type 3 collagen-> type 1 collagen
19
Q

Q 14. Keloid is characterized by excessive what type of collagen?

A

type 3

20
Q

Q 15. cytosolic ribosome vs. ER attached ribosome: How protein product is different?

A

cytosolic ribosome: cytoplasmic protein

ER attached ribosome: proteins that will be further processed to Golgi -> vesicles -> membrane protein or secretory protein

21
Q

Q 15. Through what molecule does ribosome attaches to ER?

A

translocon

22
Q

Q 16. What is stridor in physical exam finding? What infectious organism should I think when see “stridor”?

A

hard breathing sound

Croup- parainfulenza virus

23
Q

Pulsus paradoxus- 2 cardiac conditions and 2 respiratory conditions and 1 respiratory infection. What are they?

A

Cardiac conditions

  • Cardiac temponade
  • pericarditis

Respiratory conditions

  • obstructive sleep apnea
  • asthma

Respiratory infection
- croup

24
Q

Q 17. Indirect hernia vs. Direct hernia: Difference regarding involvement of 1. type of inguinal ring 2. spermatic facial layers

A

Direct hernia

  • superficial inguinal ring
  • only external spermatic facial layer

Indirect hernia

  • deep inguinal ring
  • all three layers of external spermatic facial layer
25
Q

Q 17. Weakness of what structure is most common cause of direct hernia?

A

transversalis fascia

26
Q

Q 18. 4 phenotypes of Gerstmann syndrome? which brain lesion is associated with it?

A
  1. agraphia
  2. finger agnosia
  3. acalculia
  4. left right disorientation
  • dominant parietal
27
Q

Q 19. What is the most common site of gastric ulcer? Excess ulcer might rupture what blood vessel?

A

lesser curvature: transition zone- between acid secreting epithelium (parietal cells) in corpus of body and gastrin producing epithelium (G cells) in antrum

Left gastric vessel is susceptible to rupture

28
Q

Q 20. What ligament needs to be ligated to prevent excess bleeding during hysterectomy? This ligament connects what to what? why?

A

cardinal ligament
connects cervix to side wall of pelvis
it houses uterine vessels

29
Q

Q 21. Describe two histological findings of chronic bronchitis

A
  • increased mucin gland (or goblet cells), reid index

- squamous metaplasia

30
Q

Explain pathophysiology of cor pulmonale in COPD

A

pulmonary HTN -> right HF and right ventricular hypertension

31
Q

Q 21. What is role of goblet cells in respiratory tract? Where are they located?

A

mucous production

location: trachea -> bronchi before bronchiole

32
Q

Q 21. What is role of club cells in respiratory tract? Where are they located?

A

repair damage & detoxify irritants

location: bronchiole -> respiratory bronchiole before alveolar sac

33
Q

Q 22. What is genetic anticipation? What diseases (4) are highly associated with it?

A

Onset in young with progressive worsening of disease as age: All trinucleotide diseases present this pattern

  • Huntington (CAG)
  • Fragile X syndrome (CGG)
  • Friedreich ataxia (GAA)
  • myotonic dystrophy (CTG)
34
Q

Q 23. What toxin from staph.aureus cause scalded skin syndrome?

A

exfoliatin

35
Q

Q 25. What is the major site of inflammation in chronic rejection after lung transplant? what about renal transplant?

A
  • lung transplant: bronchioles- bronchiole obliterans

- renal transplant: vasculature- vascular obliterans

36
Q

Q 26. Treatment options for wilson’s disease

  • two chelators
  • metal ion (why?)
A

Chelator

  • trientine
  • penicillamine

Metal ion: inhibit Cu absorption
- Zn2+

37
Q

Q 34. What is specific phobia? How is it different from panic disorder? What is treatment for specific phobia?

A

specific phobia: fear to specific situation

vs. panic disorder: no unexpected attacks in specific phobia
tx: behavioral therapy

38
Q

Q 35. What are side effects of niacin? What is the mechanism?

A

flushing/ hypotension

Activation of prostaglandin

UWORLD first pass- week2 (6 decks)

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