3/21 UWORLD test #57 Flashcards
Q 2. Name 5 possible conditions associated with carpal tunnel syndrome. Explain pathophysiology for each
- pregnancy -> volume overload: median n. compression
- rheumatoid arthritis -> inflammation
- diabetes-> connective tissue thickening
- hypothyroidism-> glycosaminoglycan build up
- dialysis -> amyloidosis resulting in compression
Q 3. Why TB test needs to be done before etanercept?
TNF-alpha is required to sequester mycobacteria within granuloma
- It is TNF-alpha that push mycobacteria into and limited in granuloma
Q 4. How does pyruvate kinase deficiency results in hemolysis of RBC? what kind of hemolysis?
defective PK -> no ATP -> electrolyte imbalance and loss of water -> cell lysis
- intravascular hemolysis + extravascular as well (spleen removing damaged RBC)
Q 4. What part of spleen is responsible for removal of damaged RBC? what cells mediate this?
reticuloendothelial cells within red pulp
- Red pulp =Rbc
Q 5. Somatic symptom disorder: what is the best approach?
scheduling regular outpatient visit
: not symptomatic driven, but more like regular visits
=> office visits should focus on functional improvement, rather than symptom elimination
- referring to psychiatrist is not an ideal as it will not help alleviating patient’s symptom well.
Q 7. Primary vs. secondary hyperaldosteronism
- etiologies
- lab findings
- Etiology
primary: adrenal cortex issue
(* primary: site of aldo production= adrenal cortex)
secondary: most likely JGA issue - Labs
primary: only aldo up, renin down
secondary: BOTH renin and aldo up
Q 9. Name three pathways where BH4 is needed
- phenylalanine -> tyrosine
- tyrosine -> DOPA
- tryptophan -> serotonin
Apart from BH4, what else is needed for serotonin synthesis from tryptophan?
B6
BOTH B6 and BH4 are required for serotonin synthesis
Q 10. Which doparminergic pathway is associated with prolactin? Decrease or increase of this pathway leads to decrease or increase prolactin?
tuberoinfundibular pathway
decreased tuberoinfundibular pathway
- > increased prolactin
- > subsequent amenorrhea and decreased libido
Q 10. Which doparminergic pathway is associated with positive symptom? decrease or increase?
mesocortical
decreased mesocortical
-> negative symptoms
- easy way to remember:
mesoCortical= neCative
(simillar with weCner=C-anca)
Q 10. Which doparminergic pathway is associated with negative symptoms? decrease or increase?
Mesolimbic
increased mesolimbic -> positive symtpom
- Mesolimbic is only pathway that is associated with increased activity that causing disease. All rest is decreased activity.
- easy way to rembmer: positive symptom, positive means adding more, so increased activity
Q 10. Which doparminergic pathway is associated with parkinsonism?
nigrostriatal
decreased nigrostriatal -> parkinsonism
Q 10. Antipsychotic drugs mostly targets which doparminergic pathway?
mesolimbic
antipsychotic drugs have limited activity against mesocortical
Q 11. spongiosa filling medullary canals with no mature trabeculae: description of bone for what disease?
osteopetrosis
*buzzword: FILLING, NO MATURE
Q 11. subperiosteal thinning with subperiosteal erison: description of bone for what disease?
primary hyperparathryoidism
PTH mediated bone absorption -> subperiosteal ( or cortical bone)
- buzzword: SUBPERIOSTEAL
Q 12. infectious endocarditis vs. rheumatic fever:
how valvular manifestaions are different?
- infectious endocarditis: vegetations
- rheumatic fever: fibrous stenosis
Q 14. How to distinguish between: gout vs. pseudogout on bifringe scope picture?
shape
- gout: needle, uric acid
- pseudogout: rhomboid, calcium pyrophosphate
- don’t go by color on image it is confusing.
Question might just ask in text for that case, - yellow: uric acid, negative bifringe
- blue: calcium pyrophosphate, positive bifringe
Q 15. What is portal triad? what ligament houses it?
hepatoduodenal ligament
hepatic artery, hepatic portal vein, common bile duct
Q 18. fungal pneumonia: buzz signs?
- candida
- cryptococcus
- jivroceii
- aspergilos
- candida: very uncommon
- cryptococcus: immunocompromised, other clues (pigeon, dimorphic, india ink, latex agglutination)
- jivroceii: immunocompromised, other clues (diffuse ground glass chest x ray)
- aspergilos: immunocompromised, hemoptysis (invasive)
Q 19. ACE mediates what reaction in RAAS
angiotensin 1 –> angiotensin 2
Q 19. Pregnant mom with multiple anti-hypertensive drugs. baby born with potter syndrome. why?
maternal ACEI use
ACE is important for fetal renal development
Q 21. Which two bacteria are most common source for intraabdominal infection?
- Bacterioides fragilis
- E.Coli
- in fact, bacteriodes fragilis is more common dominant flora than E.coli in colon
Q 26. What is usage of meta- analysis?
epidemiologic method to pull data from several studies
*buzzword: SEVERAL STUDIES
Q 26. Chai-squiare is used for differences in two or more group for what two values?
- percentage
- outcome (not mean, which is for ANOVA)
- thus simple 2x2 table analysis (in which outcomes are listed, again not mean value) is suited for Chai-square test
