3/16 UWORLD test #47 Flashcards
Q 1. Two factors that predispose testicular torsion?
trauma
bell clapper deformity (congenitally horizontal positioning of testis)
Q 1. complication of hydrocele?
indirect hernia
- why indirect?
indirect hernia is only hernia that can pass through deep inguinal ring. Organs may pass through deep inguinal ring, migrate down to spermatic cord and to scrotum
(If patent processus vaginalis is big enough, organs)
Q 1. How Valsalva maneuver does change size of hydrocele? why?
valsalva maneuver -> decreased venous return
-> more blood hanging out in the vein (including spematic veins) -> enlargement of hydrocele
Q 3. Define viral recombination
Exchange of partial genomes via recombination between viral strains. Progenies will maintain altered genome information.
- buzz word: If drug resistance is acquired by recombination, subsequent progeny also maintain the resistance as genome is changed
Q 3. Define viral phenotype mixing. How does it differ from viral recombination?
While MAINTAINIG genome, one viral strain obtain envelop or nucelocapsid proteins from another viral strain when mixed together.
Progenies will essentially lose these new protein as genome is unchanged
vs. recombination, where genome is changed and maintained in subsequent progenies
Q 5. What compound inhibits carnitine acyl transferase (CAT) in beta oxidation?
malonyl-coA
Q 6. Diagnosis
- hemoglovin: 8.5 (man: 13.5-17.5)
- serum creatinine: 2.2 (0.6-1.2)
- Serum Ca2+: 10.6 (8.4-10.2)
anemia, renal disease, slight hypercalcemia
-> multiple myeloma
anemia- plasma cells infiltrate bone marrow
renal disease- amlyoidosis (immunoglobin light chain)
hypercalcemia- osteoclast activating factors released by tumor cells
Q 6. Bortezomib
- composition
- MOA
- indication
- boronic acid containing dipeptide
- proteosome inhibitor
- multiple myeloma:
impaired proteosomal degradation of irregular immunoglobulins -> apoptosis
Q 8. Danzaol
- MOA
- indication
- side effect
- synthetic androgen receptor agonist
- endometriosis: suppression of estrogen via negative feedback against gonadotropin
- androgenic effect: hirshitism, virlization
Q 10. How PAH is renally handled? What if PAH concentration is high? PAH clearance is good estimation for what?
- 100% excretion
: filtration + secretion (carrier enzyme mediated process)
=> because secretion requires carrier enzyme, which can be saturated, at hight level of PAH, it can get saturated and PAH will not be 100% excreted
- renal plasma flow
Q 12. femoral neck & head is supplied by what artery?
medial femoral circumflex
check FA p.427
Q 13. Acute phase reactant production is mediated by what interleukin?
IL-6
Q 13. What molecule is associated with severity of Giant cell arthritis
IL-6!
Q 14. cresendo-decresendo systolic murmur at apex that increases while standing up. What heart condition is this? What medications (2) needed to be avoided
APEX/ attenuated murmur with decreased venous return
-> HCM
Drugs that decrease venous return should be avoided
- nitrates
- diuretics
Q 15. Flaccid bullae vs. bullous
flaccid means: hanging loosely
Thus flaccid bullae: bullae hainging loosely so that it can easily get ruptured (positive Nikolsky sign)
-> pemphigus vulgaris
bullous: negative Nikolsky sign -> Bullous pemphigoid