3/15 UWORLD test # 43 Flashcards

1
Q

Q 1. Where does N.menigitidis localize? What structure of bacteria is required for this?

A
  • nasopharynx mucosal surface

- bacterial pili (fimbriae) mediates its attachment to mucosal epithelium of nasopharynx

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2
Q

Q 4. middle third of rectum drain into what lymph node? what approximate portion of rectum is above or below pectinate line?

A

internal iliac lymph node
down to lower third drains to internal iliac lymph node

*pectinate line is pretty below (like just lower third)

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3
Q

Q 5. Apart from its use for anticonvulsant, valporate can also be used for treatment of what diseases (2)?

A
  • bipolar disorder

- migrane prophylaxis

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4
Q

Q 5. Apart from its use for anticonvulsant, topiramate can be used for what?

A

prevention of migraine

  • like valporate!
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5
Q

Q 6. Presentation of maturity onset diabetes of the young (MODY)? Mutation on which enzyme is associated with it?

A

atypical presentation, thin type 2 diabetes-like: hyperglycemia that worsens with pregnancy induced insulin resistance

  • mutation on glucokinase is associated with it.
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6
Q

Q 7. compare pathophysiology of man infertility in cystic fibrosis vs. Kartagener syndrome

A

Cystic Fibrosis: absence of vas deferans

Kartagener: immobile sperm

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7
Q

Q 8. diagnosis criteria of premature ejaculation? What psychiatric condition is associated with it?

A

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.

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8
Q

Q 9. Which step is required prior to admission for advance care?

A

asking whether patient has advanced directives

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9
Q

Q 10. kidney transplant rejection: acute rejection

  • time period?
  • histologic finding
A
  • less than 6 months

- dense interstitial lymphocytic infiltrate

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10
Q

Q 10. kidney transplant rejection: chronic rejection

  • time period?
  • histologic finding
A
  • months to years (more than 6 months)

- obliterative vascular FIBROSIS

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11
Q

Q 10. kidney transplant rejection: hyperacute rejection

  • time period?
  • histologic finding
A
  • within minutes

- iscehmia/ necrosis

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12
Q

Q 12. Phenelzine: mechanism of action?

A

MOA inhibitor, non-selective: both MOA-A and MOA-B

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13
Q

Q 14. Describe morphologic of each spinal cord section

  • cervical
  • Thoracic
  • lumbar
  • sacral
A

UWORLD TEST # 43 - Q 14.

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14
Q

Q 15. glomerulonephropathy: immune deposits

  • subendothelial (2)
  • mesangial (1)
  • intramembrane (1)
  • subepithelial (2)
A
  • 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
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15
Q

Q 17. lactose non-fermenting, oxidase negative, non-motile gram negative bacteria

  • what is this bug?
  • what is virulence factor?
A
  • Salmonella

- Samlonella has special capsule called Vi antigen. This antigen prevents phagocytosis & OPSONIZATION

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16
Q

Q 19. What hematologic disorder can cause femoral avascular necrosis?

A

sickle cell

17
Q

Q 21. What medication for CAD can redistribute blood away from ischemic areas? explain mechanism

A

selective coronary arteriole dilator.

blood flow will increase to non-artherosclerotic plaque region.

18
Q

Q 22. What is pulmonary manifestation of gestational choriocarcinoma? how?

A

choriocarcinoma can spread hematogenously (one of exception of carcinomas), going into pulmonary circulation -> lung metastasis. may present with hemoptysis

19
Q

Q 23. pain around eye with visual disturbance & intention tremor. Diagnosis? etiology of this disease

A

multiple sclerosis
- optic neuritis + cerebellar dysfunction

etiology of MS is believed to be autoimmune
: increased IgG level in CSF

20
Q

Q 25. Head trauma with cerebral edema. How does maintaining pCO2 with ventilator helps?

A

CO2 is potent vasodilator in CNS

by maintaining pCO2, it prevents vasodilation, reducing blood flow thus reducing ICP

21
Q

Q 29. Explain how phenylephrine works as decongestant

A

phenylephrine is alpha 1 agonist (it also binds to alpha2, but lesser degree compared to alpha 1)
-> vasoconstriction -> reduced nasal mucosa edema

22
Q

Q 29. What is tachyphylaxis? example?

A

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

23
Q

Q 30. tender thyroid with decreased iodine uptake

  • diagnosis?
  • histologic finding of thyroid
A
  • subacute granulomatous thyroiditis (de Quervain)
  • non-caseating granuloma
    : mixed, cellular infiltration with occasional multinucleated cells
24
Q

Q 30. What two antibodies may be detected in Hashimoto?

A

anti-TPO (thyroid peroxidase)

anti- thyroglobulin

25
Q

Q 30. histologic finding of Hashimoto?

A

lymphoid aggregated with germinal centers

26
Q

Q 31. What does anti-Jo1 target?

A

histidyl tRNA synthetase

27
Q

Q 32. In duodenal ulcer, where does H.pylori reside?

A

Gastric antrum, prepyloric space: few gastric secreting parietal cells
Regardless of what ulcer is (gastric ulcer, duodenal ulcer), H.pylori reside in gastric antrum

28
Q

Q 33. Which pneumoconioses show calcified region?

A

Asbestosis

29
Q

Q 36. Leptospira interrogans

  • morphology under microscope
  • patient history to note?
  • symptoms?
A
  • question mark
  • water sports- surfers in Hawai.
    Leptospira interrogans is transmitted by water contaminated with animal urine
  • jaundice, conjunctivae, azotemia (renal failure)
30
Q

Q 38. Define each statistical tests

  • t-test
  • ANOVA
  • chi-square
A
  • 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