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UWORLD first pass- week 8 > 3/19 UWORLD test # 54 > Flashcards

3/19 UWORLD test # 54 Flashcards

1
Q

Q 1. what is 95% confidence for whole population? what about sample size of n? what about 99%?

A

95% confidence interval

  • whole population: mean +/- 1.96 SD
  • sample size n: mean +/- 1.96 SD/(square root n)

99% confidence interval

  • whole population: mean +/- 2.58 SD
  • sample size n: mean +/- 2.58 SD/ (square root n)
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2
Q

Q 2 What is difference between chronic transplant rejection vs. graft-versus- host response?

A

chronic transplant rejection: recipient T cell attacking donor’s organ
=> necrosis LIMITED to donor’s oran

graft- versus-host response: donor T cell attacking host organs -> would see diffuse destruction THROUGHOUT recipient’s body

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3
Q

Q 4. Pathophysiology of diabetic optic neuritis?

A

nerve ischemia

thick sugar blocks blood supply

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4
Q

Q 8. Accumulation of what compound causes infantile cataracts in impaired galactose metabolism?

A

galactokinase deficiency

classic galactosemia

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5
Q

Q 9. Menopause

  • diagnostic criteria
  • pathophysiology
  • changes in hormones (3)
  • symptoms (6) (hint: remember pneumonic?)
A
  • amenorrhea for 1 yr
  • age related degeneration of ovarian follicles
  • really high FSH, high LH, high GnRH
    : hormones increased to stimulate non-responsive (or very few responding) follicles
- HAVOCS
H: hotflashes
A: atropy of vagina, amenorrhea
V: vaginal dryness 
O: osteoporosis
C: coronary artery disease- estrogen increases HDL, lowers LDL
S: sleep disturbance
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6
Q

Q 9. Hot flashes is caused by what hormonal change?

A

low estrogen

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7
Q

Q 9. Apart from hot flashes, another sign of hypoestrogenic state?

A

vaginal dryness

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8
Q

Q 10. Extreme hypertension (diastolic pressure higher than 120), what vascular pathology is associated with it?
histologic finding?

A

hyperplastic arteriolosclerosis

onion-like concentric thickening of walls of arterioles

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9
Q

Q 11. testicular mass with hyperthyroidism. what tumor is this? what is marker?

A

choriocarcinoma

beta-HCG

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10
Q

Q 12. Signs of aseptic menigitis

  1. physical exam findings (2)
  2. CSF analysis
A

nuchal rigidity
NORMAL TEMPERATURE

CSF analysis

  • high/normal protein
  • NORMAL GLUCOSE
  • increased LYMPHOCYTES
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11
Q

Q 12. most common infectious organism for aseptic meningitis?

A

enterovirus

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12
Q

Q 12. Name three enteroviruses

RNA/DNA? naked/enveloped?

A
  • coxsackie virus
  • polio
  • Echo

positive single strand RNA, naked

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13
Q

Q 13. two branches of artery that eventually becomes retinal artery?

A

internal carotid -> opthalmic -> retinal

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14
Q

Q 14. What each ovarian vein drains into?

  • Right ovarian vein
  • left ovarian vein
A
  • R ovarian vein: IVC
  • L ovarian vein: renal vein
  • This is exactly same with testicular vein
    => why left varicocele is much more common on left side
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15
Q

Q 15. tumor lysis syndrome: what kidney stone may form?

which part of nephron? why?

A

uric acid

collecting duct, due to acidic urine

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16
Q

Q 16. patient unconscious, no advance directive on file. who is in charge of making decision?

A

family member. usually spouse

17
Q

Q 18. community acquired pneumonia: what makes sputum green color?

A

neutrophil myeloperoxidase

=> makes pus green color

18
Q

Q 19. What is retinol? what skin conditions (2) can it be used for treatment? why?

A
  • vitamin A derivative
  • acne and wrinkle
  • vitamin A acts as transcription factor. It down regulates keratin/ sebum synthesis
  • vitamin A, Acne
19
Q

Q 19. women considering isotretinon therapy for acne. what test should be performed in advance before medication initiation?

A

beta-HCG

pregnancy test should be performed in advance as retinol is teratogenic

20
Q

Four teratogenic effects of isotretinon

A
  • microcephaly
  • hydrocephalus
  • thymic hypoplasia
  • small ears
21
Q

Q 21. strongyloids stercoralis infection: what finding in stool?

A

rhabditiform larvae in stool

22
Q

Q 23. 5 symptoms of PICA stroke

A
  • horseness
  • dysphagia
  • horner (ptosis, myosis)
  • loss of facial and body temp/pain sensation (vs. AICA, which is facial drop)
  • ataxia/dysmetria
  • note: examiners can be bitchy and may not present classic hoarsness/dyphagia in question
23
Q

Q 25. pathophysiology of exopthalmos? what medication is indicated?

A

TSI (thyroid stimulating immunoglobulin) binds to its receptor at retro-orbital space
-> activation of T cell -> cytokines -> activation of fibroblast -> osmotic swelling

  • it is inflammatory process. So glucocorticoid can be used to treat it
24
Q

Q 26. granulosa cell tumor. Describe histologic feature. what hormone does it secret?

A

microfollicles surrounded by pink, eosinophilic center

granulosa cells secrete estrogen

  • SGLT
    sertoli- granulossa
    Leydig - theca interna
25
Q

Q 27. propofol

  • what is it
  • side effect
A
  • rapid induction of anasthetia

- excess vasodilation leading to hypotension

26
Q

Q 27. Desflurane

  • what is it
  • side effect
A
  • halogenated gas anesthetic

- hepatic necrosis

27
Q

Q 27. side effects (3) of succinylcholine?

A
  • malignant hyperthermia
  • hyperkalemia
  • hypocalcemia
  • hypocalcemia & malignant hypertnermia: succinylcholine is polarizing neuromuscular blocker -> excess stimulation of muscle may result in depletion of extracellular calcium and malignant hyperthermia due to prolonged contraction
  • hyperkalemia: excess intracellular calcium entry into muscle -> excess potassium pumping out to balance electric potential
28
Q

Q 30. what microscopic finding is abnormal in minimal change nephropathy

A

EM of glomeruli unit

LM is not sensitive enough. It looks totally normal in LM (thus minimal change)

29
Q

Q 31. two possible negative consequences of uncorrected cryptorchidism?

A
  • infertility

- testicular cancer: cancer loves to grow in warm temperature!

30
Q

Q 32. what two nuclei are over-activated in Parkinson’s disease? High frequency deep stimulation can do what on these two nuclei?

A
  • Gi and subthalmic
  • high frequency deep brain stimulation –> inhibition of neuron firing on these two nuclei
  • easy way to remember
31
Q

Q 34. increased calcium deposition on soft tissue of hands, ulcers at finger tips, telangiectasia. Diagnosis? what additional findings (2) may be present?

A
  • CREST
  • dysphagia due to atropy and fibrous replacement of LES of esophagus
  • also sclerodactylyl: thickening/tightening of skin
32
Q

Q 36. pregnant women who had previous C-section is delivering baby. She is heavily bleeding. What possible conditions (2) should I suspect?

A
  • placenta accreta/ increta/ percreta
  • placenta previa
  • buzzword: previous C-SECTION
    C-section => more likely to form fibrous tissue within uterus
33
Q

Q 38. pancreatic pseudocyst

  • what disease causes it as a complication
  • cellular composition?
A
  • acute pancreatitis
  • granulation tissue (NO EPITHELIAL CELLS)
    : accumulation of pancreatic enzyme -> inflammation -> new vasculature and cellular recovery: granulation tissue

UWORLD first pass- week 8 (11 decks)

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