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UWORLD first pass- week 7 > 3/15 UWORLD test # 44 > Flashcards

3/15 UWORLD test # 44 Flashcards

1
Q

Q 1. most common intra-abdominal organ that is susceptible to get injured by trauma?

A

spleen

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2
Q

Q 1. Spleen is derived from what embryological structure?

A

mesoderm

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3
Q

Q 2. Turner syndrome

  • ovary?
  • palate?
  • kidney?
  • chest?
A
  • ovarian dysgenesis: streak ovary -> primary amenorrhea
  • palate: high arched palate
  • kidney: horseshoe
  • shield chest: broadened & widely apart nipples
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4
Q

Q 3. Which organ is the most susceptible for embolic infarction? why?

A

kidneys

high perfusion rate to maintain GFR

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5
Q

Q 3. most common cause of

  • systemic embolism
  • pulmonary embolism
A
  • 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
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6
Q

Q 4. Primary spontaneous pneumothorax

  • definition
  • describe how it happens
  • commonly affected group
A
  • 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
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7
Q

Q 5. Niemann-Pick disease

  • what is big category of this disease
  • missing enzyme
  • accumulated substrate
  • phenotypes (3)
  • histologic finding
A
  • lysosomal storage disease (LSD)
  • sphingomyelinase
  • sphingomyelin
  1. neurodegenration
  2. hepatomegaly
  3. cherry-red spot on macula
  • foam cells (lipid laiden macrophage)
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8
Q

Q 6. Sudden onset of erectile dysfunction, followed by persistent erectile dysfunction. what is the most likely cause?

A

emotional stress

  • buzz word: sudden onset. happens suddenly at one night
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9
Q

Q 7. Pulsus paradoxus: ECG finding

A

beat to beat variation QRS amplitude

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10
Q

Q 10. Repaglinide

  • MOA
  • name of another drug that works with same mechanism?
A
  • blocks ATP dependent potassium channel in pancreatic beta cell membrane-> deplorization-> insulin release
    : binding site is different from sulfonylurea
  • Nateglinide
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11
Q

Q 11. How ischemic damage occurs in subarachnoid hemorrhage?

A
  • vasospasm-> vasoconstriction-> ischemic infarct
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12
Q

Q 11. What medication is proven for decreasing morbidity and mortality by reducing post subarachnoid hemorrhage vasospasm?

A

nimodipine (CCB)

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13
Q

Q 12. Compare symptoms of rupture: saccular aneurysm vs. Charcot-Bouchard aneurysm

A
  • Saccular aneurysm: sudden onset of headache

- Charcot-Bouchard aneurysm: progressive neural deficit, headache may follow

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14
Q

Q 13. Effect of phenylephrine on

  • vascular resistance
  • Systolic pressure
  • pulse pressure
  • HR
A

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

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15
Q

Q 15. Stool finding of vibrio cholrae infection? why?

A

sloughed epithelial cells & flecks of mucus

cholera is not inflammatory

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16
Q

Q 15. Stool finding of shigella? why?

A

lots of leukocytes-PMN, with (or w/o) red blood cells,

Dysentery

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17
Q

Q 15. Stool finding of salmonella typhi vs. salmonella spices?

A

salmonella typhi: leukocytes- PMN

salmonella spp.: leukocytes- mononuclear leukocytes.

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18
Q

Q 16. What is adenomyosis?

A

extension of endometrium into myometrium

19
Q

Q 16. fibroid (reproductive)

  • what is another fancy word
  • what is it
  • estrogen sensitive?
  • histologic finding
A
  • 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
20
Q

Q 17. Anatomy: where is iliacus? where is psoas major?

A

-

21
Q

Q 18. Pancoast tumor

  • most common location
  • sensorimotor defects? (3) why?
A
  • apex of lung

- weakness upper limb, ipsilateral shoulder pain, areflex of upper limb

22
Q

Q 20. Following gastrotecomy, which nutrition should be given?

A

B12

water soluble vitamin

23
Q

Q 21. Explain mechanism regarding rapid onset of propofol

A

propofol initially distributes to highly vascularized structure- brain

24
Q

Q 21. Explain mechanism regarding rapid recovery from anesthetic action of propofol

A

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

25
Q

Q 22. intellectual disability- homocystinuria or Marfan? or both? or neither?

A

intellectual disability is only in homocysteinuira

26
Q

Q 22. Cardiac manifestations of Marfan syndrome (2)

A

medial necrosis of aorta
:aortic incompetence/ dissecting aortic aneurysm

floppy mitral valve

27
Q

Q 23. How hemosiderin looks like in microscope (not Prussian blue stained)

A

yellowish brown pigment

28
Q

Q 25. Which pneumoconioses is visible on polarized microscopy?

A

silica
bifringement particle surrounded by fibrous collagen

*buzzword: FIBROUS & BIFRINGEMENT

29
Q

Q 26. Which two carcinogens can cause hepatic angiosarcoma?

A
  • arsenic

- vinyl chloride

30
Q

Q 26. molecular marker of hepatic angiosarcoma?

A

CD 31 (PECAM)

31
Q

Q 27. What muscular irregularity may be seen in narcolepsy? what is it called?

A

cataplexy
(cata-: destructing)

sudden loss of muscle tone precipitated by strong emotion (laughter)

32
Q

Q 28. In patient who is currently on long term opioid therapy, what does buprenorphine do in terms of withdrawal effect?

A

buprenorphine works as partial agonist with strong affinity.

Thus with presence of other opioid agonists, buprenorphine will bind and trigger weaker response (partial agonist), PRECIPITATING withdrawal effect

33
Q

Q 28. For patient who was taking opioid, but not taking currently, what does buprenorphine do in terms of withdrawal effect?

A

buprenorphine can be useful for relieving withdrawal effect

34
Q

Q 28. Either buprenorphine or methadone can be used to treat opioid withdrawal symptoms. What is difference?

A

buprenorphine: long acting partial agonist

methadone: long acting FULL agonist.
Thus methdone will NOT precipitate withdrawal symtoms when given with other opioids

35
Q

Q 29. Describe histologic feature of carcinoid tumor cells

From what cell is carcinoid tumor cells derive from?

A

uniform, oval/round shaped big nuclei
(check image from test # 44- Q29)

  • neuroendocrine cells
36
Q

Q 30. True vs. false diverticulum

A

true: all layers including MUSCULARIS
false: only mucosa & submucosa

37
Q

Q 30. What is key term that describes pathogenesis of false diverticulum. what does this term mean?

A

pulsion

increased intraluminal pressure pushing (rePULSION) mucosa and submucosa outward

38
Q

Q 31. What does “white microcytes” on blood smear mean?

A

hypochromic microcytic RBC

39
Q

Q 31. What can cause iron deficiency anemia in postmenopausal, well nourished woman?

A

occult bleeding

  • occult means hidden, so no apparent visual bleeding., still can’t rule out occult GI internal bleeding even though stool doesn’t seem to contain blood
40
Q

Q 33. Mechanism of hepatocyte damage by HepB

A

Cytotoxic T cell killing HepB virus on hepatocyte cell surface can also damage hepatocyte cell surface.

HepB does NOT have virulence factor that DIRECTLY DAMAGES hepatocyte

41
Q

Q 34. Effect of opioid on blood pressure? explain physiology

A

hypotension

opioid promotes histamine release

42
Q

Q 35. What is Cushing’s ulcer?

A

acute gastritis caused after brain injury
brain injury -> increased ICP -> direct vagal stimulation
-> increased HCl release

43
Q

Q 37. two bugs found on dental carries?

A
  • Strep. virdian

- actinomycoses

UWORLD first pass- week 7 (12 decks)

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