3/19 UWORLD test # 53 Flashcards
Q 1. pancreatitis- > what pulm complication? explain pathophysiology
ARDS
pancreatitis -> release of cytokines & inflammatory mediators into circulation
-> infiltration into pulmonary interstitium and alveolar
Q 2. What tissue is being degenerated in mitral valve prolapse?
MVP is considered as myxomatous degeneration (connective tissue degeneration)
- think valve leaflet and chordate tendineae as connective tissue
Q 3. Define tertiary prevention
treating established condition with a goal of minimizing its progression or complications
Define primary prevention. what about secondary prevention?
primary prevention: prevent before disease occur- vaccination
secondary prevention: screen early for and manage existing but asymptomatic disease (ex: pap smear for cervical cancer)
Q4. which colonic polyp is neoplastic? What is two types of this polyp? which type is more aggressive
adenomatous polyp is malignant polyp
serrated polyp is pre-malignant
Villous adenomatous polyp is more aggressive than tubular form
Q 5. Kid infected with Diptheriae with no previous vaccination? what is the best treatment? antibiotics? or passive immunity?
passive immunity (injecting anti-toxin antibody) is much more effective than antibiotics.
Q 6. What are four primary strains of HPV that are associated with cervical cancer? What is primarily infection route of it?
HPV 16, 18, 31, 33
sexual route
Q 6. What is vaginal douching? This will increase risk for what?
cleaning showering vagina after mens or intercourse bacterial vaginosis ( gardenella will grow out)
Q 7. What are two acid buffers in urine? How DKA will change these concentration
NH3 + H+ ==> NH4+
HPO4-+ H+ ==> H2PO4
DKA -> more acid in urin -> increased NH4+ and H2PO4
Q 8. which cell mediates immune response against polysaccharide-toxoid conjugated vaccine?
T cell
Q 10. Coxiella burnetii
- gram?
- symptom: what is fancy word for this? what is classic triad?
- transmission route
- lab findings (2)
- gram negative
- Q fever
1. headache (retrorbital)
2. fever
3. pneumonia: lobular condensation on chest X ray - aerosols, farm animals (sheep)
- hepatotoxcity (elevated liver enzymes) , thrombocytopenia
Q 11. What is fontanel?
space between baby skull bones
baby’s skull bone is still growing to fill this empty space
Q 11. Vitamin K deficiency in infants
- why is baby’s susceptible to vitamin K deficiency?
- clinical manifestations (3)
- gut flora (vitamin K synthesizer) is not well established
+ breast milk has very low vitamin K in it. - intracranial hemorrhage -> altered mental status, large head circumference, bulging fontanel
- should not have trauma: different from abusive trauma that also can lead to increased ICP
Q 14. two cardiac manifestations of Turner?
- bicuspid aortic valve
- coractation of aorta
Q 15. Where does ductal carcinoma in-situ arise from?
arise WITHIN ductal LUMEN.
For invasive carcinoma, cancer cell outgrowth, penetrating basement membrane
Q 16. What electrical disturbance is primarily responsible for symptoms of dehydration?
hyponatremia
with CTFR mutation, Cl- is not able to INTRACELLUARLY transported and so does sodium.
=> excess wasting of chloride and sodium
*hypochloermia is also noticed with CF, but it is usually asymptomatic. it is SODIUM that causes sign of dehydration
Q 18. history of DVT, cerebral infarct: what heart defect may exist?
paradoxical embolism: somehow emboli from DVT bypass pulmonary circulation and enters to systemic. how?
=> ASD & foramen ovale!!
Q 19. Patient with ST elevation ECG, died suddenly. what is most likely going on?
severe hypotension due to cardiac wall rupture
Q 19. true ventricular aneurysm vs. pseudo ventricular aneurysm. what is difference? Which one can cause ventricular rupture?
true ventricular aneurysm: happens after extensive fibrosis.
pseudo ventricular aneurysm: happens during 3-14 days, all layers are sticking out -> easily get ruptured
Q 22. Cidofovir
- MOA
- indication
- side effect
- inhibits viral DNA polymerase. does not require phosphorylation by viral kinase
- CMV retinitis, gancyclovir resistance HSV, VZV
- nephrotoxicity
Q 24. buzzword for multiple sclerosis brain MRI?
periventricular plaques
Q 26. What is pathogenesis of paraneoplastic cerebellar degeneration?
autoimmune antibody attacking cerebellar nerve fibers
Q 27. where is piriform recess located? what nerve runs behind it? what reflex does this nerve mediate?
side of laryngeal orfice
internal laryngeal nerve (branch of vagus) runs behind it
internal laryngeal nerve mediates cough reflex (cough when upper respiratory tract is irritated)
Q 28. End stage renal disease: what hematologic disorder may be seen? why?
end stage renal disease -> uremic toxin
uremic toxin prevents platelet aggregation
-> primary homeostasis defect
- it is called uremic bleeding
