3/15 UWORLD test # 43 Flashcards
Q 1. Where does N.menigitidis localize? What structure of bacteria is required for this?
- nasopharynx mucosal surface
- bacterial pili (fimbriae) mediates its attachment to mucosal epithelium of nasopharynx
Q 4. middle third of rectum drain into what lymph node? what approximate portion of rectum is above or below pectinate line?
internal iliac lymph node
down to lower third drains to internal iliac lymph node
*pectinate line is pretty below (like just lower third)
Q 5. Apart from its use for anticonvulsant, valporate can also be used for treatment of what diseases (2)?
- bipolar disorder
- migrane prophylaxis
Q 5. Apart from its use for anticonvulsant, topiramate can be used for what?
prevention of migraine
- like valporate!
Q 6. Presentation of maturity onset diabetes of the young (MODY)? Mutation on which enzyme is associated with it?
atypical presentation, thin type 2 diabetes-like: hyperglycemia that worsens with pregnancy induced insulin resistance
- mutation on glucokinase is associated with it.
Q 7. compare pathophysiology of man infertility in cystic fibrosis vs. Kartagener syndrome
Cystic Fibrosis: absence of vas deferans
Kartagener: immobile sperm
Q 8. diagnosis criteria of premature ejaculation? What psychiatric condition is associated with it?
ejaculation/ loss of orgasm in LESS THAN ONE MINUTE
of penetration for more than 6 months
- anxiety
patient often do not have issue with premature ejaculation during masturbation. It is anxiety that triggers it.
Q 9. Which step is required prior to admission for advance care?
asking whether patient has advanced directives
Q 10. kidney transplant rejection: acute rejection
- time period?
- histologic finding
- less than 6 months
- dense interstitial lymphocytic infiltrate
Q 10. kidney transplant rejection: chronic rejection
- time period?
- histologic finding
- months to years (more than 6 months)
- obliterative vascular FIBROSIS
Q 10. kidney transplant rejection: hyperacute rejection
- time period?
- histologic finding
- within minutes
- iscehmia/ necrosis
Q 12. Phenelzine: mechanism of action?
MOA inhibitor, non-selective: both MOA-A and MOA-B
Q 14. Describe morphologic of each spinal cord section
- cervical
- Thoracic
- lumbar
- sacral
UWORLD TEST # 43 - Q 14.
Q 15. glomerulonephropathy: immune deposits
- subendothelial (2)
- mesangial (1)
- intramembrane (1)
- subepithelial (2)
- subendothelial: - proliferative
1. type 1 membrenoproliferative
2. diffuse proliferative - mesangial: IgA nephropathy
- intramembrane: type 2 membrenproliferative
- subepithelial: - weried morphologies
1. PSGN: bumps/humps
2. membranous nephropathy: dome/spike
Q 17. lactose non-fermenting, oxidase negative, non-motile gram negative bacteria
- what is this bug?
- what is virulence factor?
- Salmonella
- Samlonella has special capsule called Vi antigen. This antigen prevents phagocytosis & OPSONIZATION
Q 19. What hematologic disorder can cause femoral avascular necrosis?
sickle cell
Q 21. What medication for CAD can redistribute blood away from ischemic areas? explain mechanism
selective coronary arteriole dilator.
blood flow will increase to non-artherosclerotic plaque region.
Q 22. What is pulmonary manifestation of gestational choriocarcinoma? how?
choriocarcinoma can spread hematogenously (one of exception of carcinomas), going into pulmonary circulation -> lung metastasis. may present with hemoptysis
Q 23. pain around eye with visual disturbance & intention tremor. Diagnosis? etiology of this disease
multiple sclerosis
- optic neuritis + cerebellar dysfunction
etiology of MS is believed to be autoimmune
: increased IgG level in CSF
Q 25. Head trauma with cerebral edema. How does maintaining pCO2 with ventilator helps?
CO2 is potent vasodilator in CNS
by maintaining pCO2, it prevents vasodilation, reducing blood flow thus reducing ICP
Q 29. Explain how phenylephrine works as decongestant
phenylephrine is alpha 1 agonist (it also binds to alpha2, but lesser degree compared to alpha 1)
-> vasoconstriction -> reduced nasal mucosa edema
Q 29. What is tachyphylaxis? example?
Decreased effectiveness of drug after several usages due to body’s compensatory regulatory mechanism
ex: decongestants (phenylephrine) show reduced response after several days of use, as stimulation of alpha1 reduces endogenous epinephrine via negative feedback -> relative vasodilation -> may lead to nasal bleeding
Q 30. tender thyroid with decreased iodine uptake
- diagnosis?
- histologic finding of thyroid
- subacute granulomatous thyroiditis (de Quervain)
- non-caseating granuloma
: mixed, cellular infiltration with occasional multinucleated cells
Q 30. What two antibodies may be detected in Hashimoto?
anti-TPO (thyroid peroxidase)
anti- thyroglobulin
Q 30. histologic finding of Hashimoto?
lymphoid aggregated with germinal centers
Q 31. What does anti-Jo1 target?
histidyl tRNA synthetase
Q 32. In duodenal ulcer, where does H.pylori reside?
Gastric antrum, prepyloric space: few gastric secreting parietal cells
Regardless of what ulcer is (gastric ulcer, duodenal ulcer), H.pylori reside in gastric antrum
Q 33. Which pneumoconioses show calcified region?
Asbestosis
Q 36. Leptospira interrogans
- morphology under microscope
- patient history to note?
- symptoms?
- question mark
- water sports- surfers in Hawai.
Leptospira interrogans is transmitted by water contaminated with animal urine - jaundice, conjunctivae, azotemia (renal failure)
Q 38. Define each statistical tests
- t-test
- ANOVA
- chi-square
- T-test: comparing mean from Two groups
- ANOVA: comparing mean from three or more groups
ANalysis Of VAriance - chi-square: comparing % of members of two or more ethnic groups
