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UWORLD first pass- week 8 > 3/19 UWORLD test #52 > Flashcards

3/19 UWORLD test #52 Flashcards

1
Q

Q 2. What is the most common outcome of HepB infection?

A

acute hepatitis with complete resolution

> 95%

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2
Q

Q 3. impaired adduction of eye to contralateral gaze. where is lesion? what disease?

A

MLF

multiple sclerosis

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3
Q

Q 3. Young adult experiencing episodic CNS dysfunction that partially or fully resolves. what should I suspect?

A

multiple sclerosis

repeating recovery & relapsing

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4
Q

Q 3. What is saltatory conduction? What disease manifests decreased saltatory conduction

A

electrical signal transduction along axon by jumping.

multiple sclerosis

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5
Q

Q 4. Very severe burst of coughing. sometimes so severe, causing vomiting afterward coughing. What bug should I think?

A

whoping cough

Bordetella pertussis

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6
Q

Q 4. Bordetella pertussis: Gram stain? shape?

A

gram negative cocobacilli

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7
Q

Q 4. X-ray finding of Bordetella pertussis?

A

normal chest X-ray

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8
Q

Q 4. What patient history is clue for Bordetella pertussis

A
  • long cough duration (over 100 days)

- took a vaccine when young, but didn’t get any vaccination since then: absence of booster Tdap vaccine

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9
Q

Q 5. compare motor symptoms: serotonin syndrome vs. neuroleptic malignant syndrome

A
  • serotonin syndrome
    : more like clonus, hyperreflexia
  • neuroleptic malignant syndrome
    : rigidity, bradyreflexia
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10
Q

Q 6. How CO poisoning affects methamoglobin level? what about PaO2?

A

NO affect on both methemoglobin & PaO2

methemoglobin
PaO2: oxygen dissolve in blood

oxygen CONTENT (oxygen bound to Hb+ oxygen dissolved in blood) is lowered in CO poisoning

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11
Q

Q 8. How does kidney responds to acidic urine?

A

renal ammoniagenesis

generate ammonia and send it to buffer acid

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12
Q

Q 9. Renal ammoniagenesis uses what amino acid as a precursor of ammonia?

A

glutamine

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13
Q

Q 10. How does protein M works as virulence factor in group A strep?

A

inhibits phagocytosis and complement activation

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14
Q

Q 11. What is the most common cause gram positive bug of sepsis in sickle cell disease patients?

A

strep.pneumoniae

sickel cell: asplenic -> increased susceptibility to encapsulated bacteria

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15
Q

Q 13. What is reticulocyte? describe how its level changes with vitamin B12 injection therapy for vitamin B12 deficiency anemia

A

reticulocyte is immature RBC

with vitamin B12 injection, reticulocytes are synthesized and released in blood stream. After about 1 week, reticulocyte level drops, as it becomes mature RBC

It takes about 8 weeks to fix anemia with vitamin B12 injection for erythropoiesis induction

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16
Q

Q 15. Wild, large-amplitutde, flinging jerk characterizes what kind of tremor? which nucleus is impaired?

A

hemiballismus

subthalmic nucleus

  • one side leg & arm jerk may not be explicitily mentioned in question. In question, it may say like wild jerk movements so that patient throw beer can involuntarility, things like that.
17
Q

Q 16. increased RBC, leukocytes, platelet: what should I think?

A

myeloproliferative disorders
depending on which one is more siginificantly increased than others, it can be
PV or ET

18
Q

Q 16. What gene mutation is associated with myeloproliferative disorders? what is function of this gene?

A

JAK2 mutation

JAK2: cytoplasmic tyrosine kinase for JAK-STAT pathway

EPO binds to EPO receptor, intracellular JAK2 binds to EPO receptor and activates JAK-STAT signaling pathway
Mutated JAK2 leads to abnormal growth signling

19
Q

Q 18. Systemic mastocytosis

  • associated with what gene
  • excess secretion of what compound
  • complication
A
  • KIT gene mutation
  • excess mast cells –> excess histamine
  • histamine -> may also stimulate parietal cell –> excess gastric acid secretion
20
Q

Q 18. Cimetidine

  • MOA
  • indication
  • side effects
A
  • H2 blocker -> less gastric acid secretion from parietal cells
  • gastriitis, GERD
  • side effects
    1. potent CYP-450 inhibitor
    2. anti-androgen effects (gynecomastia, impotence, decreased libido)
21
Q

Q 20. Why serum ferritin is high in hereditary hemochromatosis?

A

HFE gene -> increased intestinal iron absorption

22
Q

Q 23. What is first line for acute gout?

A

NSAID

23
Q

Q 25. heart manifestation of Turner?

A

coarctation

24
Q

Q 25. heart manifestation of tuberous sclerosis?

A

valvular obstruction by rhabdomyoma

25
Q

Q 26. Brown adipose tissue

  • where is it located
  • gross appearance
  • function
A
  • around kidneys and adrenal glands
  • brown pigmented tan-fat containing tissue
    ( increased mitochondria within adipose tissue gives tan color)
  • heat generation
26
Q

Q 27. Why anti-depressants should be avoid in bipolar disorder?

A

anti-depressatns may induce mania

27
Q

Q 28. What is the location of pancoast tumor?

A

superior sulcus: apex of lung, grove formed by subclavian vessels

  • in fact, pancoast tumor is also called as superior sulcus tumor
28
Q

Q 29. How mitral regurgitation changes below? explain

  • preload
  • afterload
  • ejection fraction
A
  • preload: increased
    As blood regurging back to LA, more diastolic LV pressure
  • afterload: decreased
    more LV filled, less resistance for LV ejecting blood
  • ejection fraction: increased
    more LV filled, more forceful ejection
29
Q

Q 30. What does grapefruit juice do on CYP-450?

A

CYP450 inhibitor

30
Q

Q 30. Is CYP-450 exist in the gut wall?

A

yes.

major location of CYP450 is hepatocyte for sure. but gut wall also contains CYP450. This is why drinking grapefruit juice can inhibit CYP450

31
Q

Q 31. MRI finding: similarities and differences between pilocytic astrocytoma vs. medulloblastoma

A

Similarity: pilocytic astrocytoma an medulloblastoma BOTH commonly arise from cerebellum

Difference:
- pilocytic astrocytoma: combination of cyst + solid

  • medulloblastoma: solid
32
Q

Q 33. dietary restriction for fructose intolerance?

A

fructose and sucrose

sucrose -> metabolized to fructose

33
Q

Q 34. Is APC activated or inactivated in FAP?

A

inactivated

34
Q

Q 34. Is BRCA1 tumor suppressor gene? or oncogene? How mutation alters BRCA1 in breast cancer? What is its normal function?

A

BRCA1- neither tumor suppressor or oncogene
it mediates DNA repair

In breast cancer, loss of function mutation of BRCA1 leads to cancer development. BRCA1 mutation is example is incomplete penetrance, not all individuals with BRCA1 mutation will develop breast cancer

35
Q

Q 37. breast cancer with dimpling. What is dimpling? Existence dimpling suggest cancer cells invade through what structure?

A

dimpling is skin retraction.

That is, skin gets shallow underneath the mass, meaning cancer cells invade through suspensory ligament

36
Q

Q 38. Apart from SSRI and SNRI, what other drug may be useful for treating panic disorder?

A

BDZ

37
Q

Q 39. What is the primary mechanism of development of stress incontinence during pregnany?

A

increased intra-abdominal pressure

38
Q

Q 40. What are three most common underlying conditions that predisposes to subacute infective endocarditis?

A

MVP, prosthetic valve, valvular sclerosis

pre-damaged valve -> more likely damaged by infection

*historically rheumatic heart disease was also considered as common cause for bacterial endocarditis, but nowadays in developed countries, the association drops due to increased recognition to group A strep

UWORLD first pass- week 8 (11 decks)

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