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UWORLD first pass- week 7 > 3/16 UWORLD test # 46 > Flashcards

3/16 UWORLD test # 46 Flashcards

1
Q

Q 2. Empiric use of penicillin for bacterial pharyngitis in developing country: may also reduce what?

A

cardiac disease

  • remember Group A strep
    pharyngitis -> rheumatic fever
    vitiligo -> PSGN
  • also another buzz word: DEVELOPING COUNTRY
    Acute rheumatic fever is prevalent in developing country
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2
Q

Q 2. Two good medications for group A strep?

A

penicilin

clindamycin: for severe infection

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3
Q

Q 2. Can empiric use of penicillin reduce PSGN occurrence?

A

NO.

penicillin is proven for reducing rheumatic fever, but not PSGN

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4
Q

Q 4. Three possible mechanisms for trisomy in Down syndrome?

A
  • meiotic non-disjunction: either meiosis 1 or 2
  • translocation: t(14;21)- long arm of 21 (functional 21) is translocated to 14
  • mosaicism
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5
Q

Q 4. Define uniparental disomy.
Which step of meiosis has error in
- heterozygous
- homozygous

A

receiving two chromosomes from one parent only

  • heterozygous: meiosis 1 error
  • homozygous: meiosis 2 error
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6
Q

Q 6. Can psoriatic arthritis cause deformity?

A

YES.

pencil-in-cup deformity is classic

It can present very similarly as rheumatoid arthritis

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7
Q

Q 6. Is psoriasis associated with pulmonary fibrosis?

A

NOPE

In fact, pulmonary fibrosis is NOT associated with any of seronegative spondyloarthritis

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8
Q

What rheumatologic diseases are associated with pulmonary fibrosis (3)?

A
  • sarcoidosis: pulmonary manifestation (ILD, pulmonary HTN) is the most common cause of death in sarcoidosis
  • scleroderma
  • RA
  • no SLE, no seronegative spondylitis
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9
Q

Q 7. low grade fever, RUQ pain upon palpation, dark urine. Patient came back from traveling to Mexico. What is going on?

A

Acute Hepatitis A

mild acute presentation

  • HepA is the most common cause of acute viral hepatitis in young adults who just returned from endemic region
  • buzz word: MEXICO- endemic region of HepA
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10
Q

Q 7. Describe histologic findings (3) of liver biopsy of HepA

A
  • hepatocyte swelling: ballooning degeneration with cytoplasmic emptying
  • monocyte infiltration
  • eosinophilia (Councilman bodies)

check image of test #46-Q7

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11
Q

Describe histologic finding of liver biopsy of HepB.

This change is mediated by what cell?

A

eosinophilic groundglass appearance

mediated by cytotoxic T cells

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12
Q

Q 8. Describe morphology of plasma cell in blood smear.

A

wagon wheel, giant nuclei.
cell looks similar to blast, but nuceli is huge

  • check image of test #46-Q8
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13
Q

Q 9. Kid, fever, conjunctival injection, bright red tongue, non-pitting edema on hands/foots. Diagnosis?

A

Kawasaki

  • buzz words
  • bright red tongue: strawberry tongue
  • non-pitting edema on hands/foots: abnormal hand/foot. Erythema is also common
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14
Q

Q 9. Serious complication of Kawasaki disease?

A

coronary artery aneurysm

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15
Q

Q 10. 5 symptoms of cocaine withdrawal

A
  • hyperphagia: binge eating
  • hypersomina
  • vivid dreams
  • depression
  • fatigue
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16
Q

4 symptoms of Marijuana withdrawal

A
  • decrease appetite
  • insomnia
    Above two are main difference with cocaine withdrawal
  • irritability
  • anxiety
  • withdrawal
  • cocain: you can’t sleep, eat like crazy
  • marijuana: so sleepy, not interested in eating. I will just sleep
17
Q

Q 12. Is PTH associated with renal calcium handling? If so, how?

A

YES

PTH works not only on phosphate clearance, but it also stimulates Ca2+ reabsorption from urine via Ca2+/Na+ channel on apical side at DCT

18
Q

Q 14. PML (progressive multifocal leukoencephalopathy ): infection to what virus? what viral family? DNA?RNA? envelope?

A

JC virus
(Junky Cerebrum)

polyomavirus
dsDNA, not enveloped

19
Q

Q 14. Apart from infulenza virus, what another virus family also encodes hemagglutinin. what is its function?

A

paramyxovirus
(infuenza virus is orthomyxovirus, so MYXOVIRUS expresses hemagglutinin)

  • hemagglutinin mediates viral attachment to membrane
20
Q

Q 14. CNS complication of measles virus? symptoms?

A

subacute sclerosing panencephalitis (SSPE)

21
Q

Q 15. Urea reabsorption at kidney is mediated by what hormone? at which segment of nephron?

A

ADH

medullary collecting duct: important for maintaining high medullary concentration gradient

  • This makes sense, it only water is being reabsorbed, concentration gradient will not be maintained. It needs solute. and that solute is urea
22
Q

Q 16. thalamic nucleus: what information relays through it?

  • VPL
  • VPM
  • Lateral geniculate
  • Medial geniculate
  • VL
A
  • VPL: primary somatosensory
  • VPM: primary sensory for trigeminal (Masking=face)
  • LG: visual (Light)
  • MG: auditory (Music)
  • VL: primary motor
23
Q

Q 17. What does brain cavity with clear fluid suggest?

A

liquefactive necrosis

brain: fatty -> liquefactive necrosis mostly due to brain infarcts

24
Q

Q 17. lacunar infarct

  • definition
  • common site
  • most common etiology
A
  • infarct in small vessel
  • deep brain structure
  • lipohyalinosis -> vasocclusion
25
Q

Q 19. Menstural cycle in PCOS? why?

A

irregular mestural cycle

High LH -> androgen from theca interna -> estrone -> decreased FSH -> less follicle stimulation ->anovulation

26
Q

Q 20. Clomiphene

  • MOA
  • indication
  • side effects (2)
A
  • selective estrogen receptor antagonist (SERM)
    at hypothalamus
    -> inhibition of negative feedback from estrogen -> more LH/FSH
  • PCOS, infertility due to anovulation
  • side effects: hot flashes (estrogen), ovarian enlargement
27
Q

Q 23. Vancomycin resistance on bacterial cell wall?

A

D-ala-D-ala –> D-ala-D-lac

28
Q

Q 27. Three complications of enterococci infection

A
  • endocarditis
  • UTI
  • biliary tract infection (bile resistant)
29
Q

Q 29. what class of drug is oxycodone?

A

opioid

30
Q

Q 30. Kid, sore throat, restless/involuntary jerking. what is going on?

A

Rheumatic fever

restless/involuntary jerking: Sydenham chorea

31
Q

Q 30. Early dementia: associated with what disease?

A

Down syndrome

amyloid-Beta is in chromosome 21

32
Q

Q 32. etiology of diffuse esophageal spasm?

A

impaired inhibitory innervation on esophageal myenteric plexus

33
Q

Q 34. Why drug free interval is necessary when taking nitrate? (1 in morning, 1 in afternooon, and no in night)

A

to avoid tolerance development

34
Q

Q 35. Inheritance pattern of G6PD deficiency

A

X- linked recessive

only men eat bites of Fava bean with Heinz ketchup!

35
Q

Q 36. DRESS syndrome

  • definition
  • drugs (5) that can cause it
  • clinical presentations (4)
  • lab finding
A
  • Drug Reaction with Eosinophilia and Systemic Symptoms
  • phenytoin, carbamazepine, vancomycin, sulfasalazine, allopurinol
  • fever, diffuse/mobile rash, facial swelling, lymphadenopathy
  • eosinophilia
36
Q

Q 37. How long should depressive symptoms last to meet major depressive disorder diagnosis criteria? how many for SIGECAPS

A

> 2 weeks

> 5 or more SIGECAPS symptoms

37
Q

Q 37. SIGECAPS for major depressive disorder?

A 
S- sleep disturbance
I- loss of Interest
G- guilt
E- energy loss
C- concentrate
A- appetite
P- psychomotor retardation or agitation
S- suicidal ideation
38
Q

Q 38. pathophysiology of pancreatic insufficiency in cystic fibrosis?

A

production of thick mucus -> obstruction & inflammation of pancreatic duct

39
Q

Q 39. What is normal Aa gradient?

A

10-15mmHg

UWORLD first pass- week 7 (12 decks)

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