3/15 UWORLD test # 44 Flashcards
Q 1. most common intra-abdominal organ that is susceptible to get injured by trauma?
spleen
Q 1. Spleen is derived from what embryological structure?
mesoderm
Q 2. Turner syndrome
- ovary?
- palate?
- kidney?
- chest?
- ovarian dysgenesis: streak ovary -> primary amenorrhea
- palate: high arched palate
- kidney: horseshoe
- shield chest: broadened & widely apart nipples
Q 3. Which organ is the most susceptible for embolic infarction? why?
kidneys
high perfusion rate to maintain GFR
Q 3. most common cause of
- systemic embolism
- pulmonary embolism
- systemic embolism: left side of heart, so atrial fibrillation (stasis -> emboli formation). systemic embolism also can be caused by endocarditis or MI
- PE: embolus entering right side heart, so DVT is the most common cause
Q 4. Primary spontaneous pneumothorax
- definition
- describe how it happens
- commonly affected group
- spontaneous formation of pneumothorax without underlying lung disease
- sudden increase in pressure -> break in visceral pleura
- > apical alveoli forms bleb -> bleb spontaneous ruptures through viscera
- thin, tall male. smokers
Q 5. Niemann-Pick disease
- what is big category of this disease
- missing enzyme
- accumulated substrate
- phenotypes (3)
- histologic finding
- lysosomal storage disease (LSD)
- sphingomyelinase
- sphingomyelin
- neurodegenration
- hepatomegaly
- cherry-red spot on macula
- foam cells (lipid laiden macrophage)
Q 6. Sudden onset of erectile dysfunction, followed by persistent erectile dysfunction. what is the most likely cause?
emotional stress
- buzz word: sudden onset. happens suddenly at one night
Q 7. Pulsus paradoxus: ECG finding
beat to beat variation QRS amplitude
Q 10. Repaglinide
- MOA
- name of another drug that works with same mechanism?
- blocks ATP dependent potassium channel in pancreatic beta cell membrane-> deplorization-> insulin release
: binding site is different from sulfonylurea - Nateglinide
Q 11. How ischemic damage occurs in subarachnoid hemorrhage?
- vasospasm-> vasoconstriction-> ischemic infarct
Q 11. What medication is proven for decreasing morbidity and mortality by reducing post subarachnoid hemorrhage vasospasm?
nimodipine (CCB)
Q 12. Compare symptoms of rupture: saccular aneurysm vs. Charcot-Bouchard aneurysm
- Saccular aneurysm: sudden onset of headache
- Charcot-Bouchard aneurysm: progressive neural deficit, headache may follow
Q 13. Effect of phenylephrine on
- vascular resistance
- Systolic pressure
- pulse pressure
- HR
phenylephrine: alpha agonist
- increased vascular resistance: vasoconstriction
- increased systolic pressure: increased afterload
- decreased pulse pressure: less stroke volume due to reflex
- decreased HR: reflex bradycardia
Q 15. Stool finding of vibrio cholrae infection? why?
sloughed epithelial cells & flecks of mucus
cholera is not inflammatory
Q 15. Stool finding of shigella? why?
lots of leukocytes-PMN, with (or w/o) red blood cells,
Dysentery
Q 15. Stool finding of salmonella typhi vs. salmonella spices?
salmonella typhi: leukocytes- PMN
salmonella spp.: leukocytes- mononuclear leukocytes.
Q 16. What is adenomyosis?
extension of endometrium into myometrium
Q 16. fibroid (reproductive)
- what is another fancy word
- what is it
- estrogen sensitive?
- histologic finding
- leiomyoma
- as leiomyoma suggests, it is benign smooth muscle tumor
- estrogen sensitive: may grow in size during pregnancy
- whorled pattern of smooth muscle bundles with well demarcated border
Q 17. Anatomy: where is iliacus? where is psoas major?
-
Q 18. Pancoast tumor
- most common location
- sensorimotor defects? (3) why?
- apex of lung
- weakness upper limb, ipsilateral shoulder pain, areflex of upper limb
Q 20. Following gastrotecomy, which nutrition should be given?
B12
water soluble vitamin
Q 21. Explain mechanism regarding rapid onset of propofol
propofol initially distributes to highly vascularized structure- brain
Q 21. Explain mechanism regarding rapid recovery from anesthetic action of propofol
site of anesthetic action of propofol is brain
As time goes by, propofol becomes redistributed to peripheral tissue/organ (less vascularized)
–> propofol is reduced in brain -> recovery
