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UWORLD first pass- week 7 > 3/17 UWORD test # 49 > Flashcards

3/17 UWORD test # 49 Flashcards

1
Q

Q 1. embryological origin of spleen?

A

mesoderm

  • spleen is weird. it is derived from mesoderm, but receives blood supply from foregut origin (splenic artery)
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2
Q

Q 1. most of intrabdominal organs are derived from endoderm. What four structures are exception? From what embryological structures are they derived from?

A

adrenal cortex
spleen
kidney
ureter

ASKU! - they are ALL derived from mesoderm

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3
Q

Q 1. embryological origin of testes/ovaries?

A

mesoderm

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4
Q

Q 2. what abnormal findings in stool & breath in lactose deficiency? explain mechanism

A

incomplete lactose digestion

  • > short chain fatty acid
  • > acidic stool & acidic breath
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5
Q

Q 4. Explain why isoniazid causes peripheral neuropathy

A

isoniazid is structurally similar to B6.

It can compete with B6 during synthesis of multiple neurotransmitters, yielding defective neurotransmitters

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6
Q

Q 5. Triad symptoms of ataxia telangiectasia

A
  • ataxia
  • Teleangiectasia (superficial blanching nest of disintended capillaries)
  • IgA deficiency -recurrent sinupulmonary infection
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7
Q

Q 5. Defective gene in ataxia telangiectasia? What is function of this gene?

A

ATM
double strand DNA break

  • remember this gene from XJ’s summer rotation?
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8
Q

Q 6. What is the most common elbow injury in young kid (age 1-4)? What ligament is injured? what is gross appearance of arm?

A

radial head subluxation

annular ligament

extended arm, while forearm is protonated

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9
Q

Q 7. What is growth pattern of diffuse type gastric cancer cell?

A

infiltrative growth WITHIN GASTRIC WALL

well demarcated

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10
Q

Q 7. What is growth pattern of intestinal type gastric cancer cell?

A

well demarcated rapid growth of cell IN GASTRIC LUMEN

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11
Q

Q 10. Dyspnea with recent history of calf swelling. What is most likely happening?

A

PE

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12
Q

Q 10. With acute onset of respiratory alkalosis due to hyperventilation, how long does it take to have reduction in HCO3- in response to metabolic compensation?

A

48 hours

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13
Q

Q 11. What is common route of transmission of entamoeba histolytica?

A

cyst in water

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14
Q

Q 11. By what route does Staph.aureus cause hepatic abscess?

A

hematogenous route

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15
Q

Q 11. By what route does E.coli, klebsiella cause hepatic abscess?

A

ascending biliary tract or portal vein

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16
Q

Q 12. suprapubic tenderness, burning urination. Diagnosis?

A

UTI

17
Q

Q 12. most common cause of UTI in general population? what about sexually active women?

A
  • general population: E.coli

- sexually active women: Staph. saprophyticus

18
Q

Q 12. Symptoms of each UTI

  • urethritis
  • cystitis
  • pyelonephritis
A

urethritis: pain with urination
cystitis: suprapubic pain
pyelonephritis: flank pain, pain in costovertebral angle

19
Q

Q 13. Mycoplasma pneumoniae grows on which agar? What is special about this agar?

A

Eaton agar
This agar is cholesterol rich. Mycoplasma requires cholesterol as their cell membrane is cholesterol rich

  • sketchy: “do not EAT ON ice” sign, net with cholesterol structure
20
Q

Q 14. Compare signaling pathway for glycogen regulation of each hormone

  • glucagon
  • epinephrine
  • insulin
A
  • glucagon
    glucagon receptor -> adenylate cyclase -> cAMP
    -> PKA -> activation of glycogen phosphorylase
  • epinephrine
    Beta receptor -> adenylate cyclase ->-> same as glucagon
  • insulin
    tyrosine kinase -> P13K -> protein phosphatase
    -> dephosphorylation of PKA -> activation of glycogen synthase
  • glucagon/epinephrine: phosphorylation
  • insulin: dephosphorylation
21
Q

Q 16. Role of cortisol in glucose metabolism?

A

cortisol is counter-regulatory hormone
: gluconeogensis (like glucagon/epinephrine)

cortisol is steroid hormone so it uses intracellular receptor to regulate gene expression for enzymes in gluconeogenesis

22
Q

Q 17. TTP (thrombotic thrombocytopenic purpura) causes what type of anemia?

A

microangiopathic HEMOLYTIC ANEMIA

  • seriously, why did I miss this question?
23
Q

Q 18. Does HSV-2 cause inguinal lymphadenopathy

A

sure.

*sketchy: hermes wearing lace dress

24
Q

Q 19. What is pituitary apoplexy? what is common underlying medical condition?

A

sudden hemorrhage into pituitary gland

often happens in the presence of existing pituitary adenoma

25
Q

Q 20. phrenic nerve irritation may present as pain on where? what nerve root is phrenic nerve?

A

referred pain to shoulder

C3-C5

26
Q

Q 22. Li-Fraumeni syndrome

  • what cancers(5) are associated with it
  • what gene mutation?
  • inheritance pattern?
A
  1. sarcoma
  2. breast cancer
  3. adrenocortical carcinoma
  4. leukemia
  5. brain tumor
  • these cancers may concurrently happen (kinda like multiple endocrine tumor)

p53 mutation
autosomal dominant

27
Q

Q 24. Describe how different level of dopamine can stimulate different receptors

A

at low dose, dopamine binds to dopamine receptors
(D1>D2)

at high dose, dopamine binds to adrenergic receptors
(beta>alpha)

Thus, dopamine administration with increasing dose results in increased renal flow first (D1) and then increased cardiac output (beta) later

28
Q

Q 25. testosterone injection induces what changes to hematocrit? why?

A

testosterone can increased hematocrit

as testosterone stimulates RBC production

29
Q

Q 26. Pathogenesis of fatty liver disease in alcoholic liver?

A

alcohol metabolism -> increased NADH/NAD+ ratio

  • > depletion of NAD+ -> limited beta oxidation
  • > accumulation of fat
30
Q

Q 27. columnar mucin secreting cells in alveolar space without invasion

  • what cancer is this?
  • benign or malignant?
A
  • adenocarcinoma in situ

- Although it is not invasing, in situ cancer is considered as malignant as it can progress to invasive form

31
Q

Q 28. Kid CNS tumor, calcification with cholesterol cyst. what cancer is this?

A

craniopharyngioma

32
Q

Q 30. What heart sound indicates severity of mitral stenosis?

A

time between S2 and opening snap
The closer time is, the more severe the stenosis is.

close time between S2 and OS means that more pressure is building up in LA, opening mitral valve more forcefully.

severity of murmur is basically all about how much fluid is passing through impaired valve

33
Q

Q 31. histologic findings of GERD?

A
  • basal zone hyperplasia

- elongation of lamina propria papillae with eosinophils and neutrophils

34
Q

Q 32. Jimson weed poisoning exerts what effect on nerve system? treatment?

A

anti-muscarinic effect (very similar as atropine overdose)

physostygmine (cholinesterase inhibitor)

35
Q

Q 38. What CNS tumor shows parasagittal mass?

A

meningioma

36
Q

Q 40. What occupational exposures (2) can cause transitional cell carcinoma of bladder? what about medication?

A

rubber & aniline dyes

cyclophosphamide

UWORLD first pass- week 7 (12 decks)

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