3/21 UWORLD test # 58 Flashcards
Q 1. left eye pain that is attenuated by ocular movement, episodes of numb and tingling of hands. most likely diagnosis?
MS
Of answer choices, if neurologic symptoms shows some random pattern, and regress/relapsing pattern, think MS in a differential
Q 2. two mediums for growth of diptheria
- cystine-tellurite agar
- Loeffler
Q 5. increased EPO in response to hypoxia is mediated by what cells? what organ?
peritubular cells in kidney
Q 4. sensorineuronal hearing loss and conductive hearing loss: compare findings of rinne test (mastoid) and weber test (vibrating in middle)
Rinne test
- sensorineural hearing loss: normal, not detectable (AC>BC)
- conductive hearing loss: abnormal to affected side (BC>AC)
Webertest
- sensorineuronal hearing loss: lateralize to unaffected side
- conductive hearing loss: lateralize to affected size
- Both Rinne and weber need to be done to know whether it is sensorineural or conducvite. Weber alone does not tell whether it is sensorineural or conductive
Q 6. which LSD accumulates alpha-galactosidase A?
Fabry
- Fabry first on FA table, thus alpha (1st)
Q 6. phenotypes of Fabry
- early
- late (2)
- early: acroparesthesias- pain in palm and sole
- late
1. renal failure
2. cardiovascular disease
Q 7. What is pulmonary response to DKA? what can happen in severe DKA?
- hyperventilation
- for severe DKA, respiratory failure can happen
Q 8. which antibiotic can cause serotonin syndrome?
linezolid
- sketchy: smile balloons in museum
Q 8. What are side effects of vancomycin?
- nephrotoxicity
- ototoxicity
- thrombophlebitis: vein thrombosis
- redman syndrome: diffuse flushing
Q 8. How redman syndrome with vancomycin can be revesred? (2 ways)
- slow infusion
- infusion with anti-histamine
Q 9. Which nerve pass through obturator canal? what part of leg does it innervate?
obturator nerve
medial thigh
Q 11. What is the only cranial nerve that is compressed by herniation syndrome? what herniation can compress this neuron? what brain structure does this herniation involve?
CN3
uncal herniation
uncal herniation involves tentorium cerebelli
uncus compress through tentorium cerebelli
- uncal herniation is also called as transtentorial herniation
Q 11. uncal herniation also can compress which vessel?
PCA
-> homonymous hemianopia with macular sparing
Q 12. increased central venous pressure due to pulmonary conjestion, yet no signs of peripheral edema. by what compensatory mechanism?
increased lymphatic drainage
more fluid -> more hydrostatic pressure -> more fluid forced into lymphatic drainage.
- when fluid leaking is so severe and thus lymphatic drainage can not keep up with it, then peripheral edema will occur
Q 13. What is molecular target of cycrosporin or tacrolimus? what does this molecule normally do?
calcineurin
calcineurin dephosphorylates NFAT. Dephosphorylated NFAT then migrates into nucleus, binds to IL-2 promoter region and induces transcription
- remember this was Beck’s project at OHSU?
Q 14. which anatomical structure is the most commonly injured during hysterectomy? what will be symptom?
- ureter: ureter runs right posteriorly to uterine arteries (housed by cardinal ligament)
- present with flank pain
- normally no issue with urination as another ureter is intact (bilateral ureter injury is very uncommon)
Q 15. What is presentation of dengue fever? What can cause more severe symptoms? what are severe symptoms?
- primary infection is normally not severe and self-limited
- secondary infection WITH DIFFERENT VIRAL SEROTYPE can lead to severe symptoms, including high fever, muscle pain, elevated liver enzymes, thrombocytopenia/leukocytopenia
Q 18. recent history of abortion followed by septic shock symptoms. what is going on?
septic abortion
After abortion, remnant products of conception can cause infection
Q 18. What are two most common infectious organisms for septic abortion?
- E.coli
- Staph.aureus
Q 19. pyruvate carboxylase: enzyme for which reaction? what cellular compartment does it occur?
pyruvate –> OAA: first step of gluconeogenesis
occurs in mitochondria!
once OAA becomes malate and malate leaves mitochondria, then rest of gluconeogenesis reaction is in cytosol
Q 19. HMP shunt pathway happens in what cellular compartment? oxidative and non-oxidative?
BOTH at cytosol
Q 19. What three main metabolic pathways occur in cytoplasm?
- glycolysis
- HMP shunt
- fatty acid synthesis
- gluconeogenesis, beta-oxidation are kinda mixed
Q 22. filtration at glomeruli: filtration at each part is based on what? albumin is filtered by what compartment?
- basement membrane (what molecule specifically mediates this barrier)
- endothelium
- GBM: charge based, heparan sulfate (negatively charged)
- endothelium: size based, fenestrated
albumin is filtered by negatively charged GBM
* albumin is small enough to pass through fenestrated endothelium
Q 21. Describe two different lymphatic drainage pathway in lower extermities
- lateral pathway: lateral side -> popliteal -> ingunial
- medial pathway: bypass popliteal, directly drain into inguinal
