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UWORLD first pass- week 8 > 3/23 UWORLD test #61 > Flashcards

3/23 UWORLD test #61 Flashcards

1
Q

Q 1. African kid, severe swelling in hands and feet. What should I suspect?

A

sickle cell disease

  • dactylitis: vasocclusive phenotype
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2
Q

Q 2. What anti-HIV drugs needed to be screened for hypersensitivity? What needs to be screened? What type of hypersensitivity

A

Abacavir

  • sketchy: abracadabra wizard, where he is reading book titled as HLA-B*5701
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3
Q

Q 3. Two watershed area that is susceptible for ischemic colitis?

A
  • splenic flexure

- rectosigmoid colon

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4
Q

Q 4. Describe reactions of respiratory burst. What is enzyme for each reaction

A

O2 –> O2 radical : NADPH oxidase

O2 radical –> H2O2: superoxide dismutase
*O2 radical here is also called reactive oxygen species

H2O2 –> HClO radical: myeloperoxidase

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5
Q

Q 5. Alkaptouria

  • defective gene, inheritance pattern, accumulated product
  • phenotypes (3)
A
  • homogenestic acid dioxygenase -> accumulation of homogenestic acid
    autosomal recessive
  • phenotypes
    1. blue-black spots on sclerae and connective tissue
    2. arthralgia
    3. urine turns dark after air exposure (homogenestic acid)
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6
Q

Q 6. abdominal pain, reddish urine. what disease is this?

A

acute intermittent porphyria

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7
Q

Q 8. What two electrolyte imbalance can amphorecin B cause?

A

hypokalemia

hypomagnesemia

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8
Q

Q 9. What is eczema?

A

atopic dermatitis

: type 1 hypersensitivity rxn, IgE dependent

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9
Q

Q 9. What is dyskeratosis? example?

A

abnormal (dys-) keratinization

-> squamous cell carcinoma

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10
Q

Q 9. What is Acanthosis? examples (2)?

A

epidermal hyperplasia due to increased startum spinosum (spinosoum - desmosome, which connects keratinocytes)

-> psoriasis (hyperplastic epidermis pilling off), acanthosis nigrans

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11
Q

Q 9. What is spongiosis? example?

A

epidermal accumulation of fluid

-> atopic dermatitis (eczema)

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12
Q

Q 10. sensitivity vs. specificity: what is used for screening? another one is used for what?

A

SCREENING: rule out disease, so sensitivity

CONFIRMATION of disease with positive from screening: rule in, so specificity

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13
Q

Q 11. key phenotypic difference between antipsychotic drugs induced parkinsonism vs. neuroleptic malignant syndrome

A

parkinsonism: no fever, no autonomic instability (tachy, hypertension)
- NES: high fever, autonomic instability
* muscle rigidity/stiffness can be shown in both cases, so it is not a good phenotype to differentiate between two

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14
Q

Q 11. First line treatment for antipsychotic induced parkinsonism?

A

benztropine

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15
Q

Q 11. Can Levodopa be for antipsychotic induced parkinsonism? why or why not?

A

NO

Levodopa can induce psychosis

  • sketchy: van goh picture
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16
Q

Q 12. DLCO in emphysema?

A

decreased

  • Although it seems like alveoli surface area is increased, it is floppy useless alveoli. Discussed this with Andy
17
Q

Q 14. Reticulocyte

  • size compared to mature RBC
  • Wright-Giemsa stain: appearance? what is stained?
A
  • immature RBC, bigger than mature RBC

- blue color, ribosomal RNA is stained by Wright-Giemsa stain

18
Q

Q 20. Turner syndrome: will develop secondary sexual characeristics?

A

no

streak ovary- very low estrogen

19
Q

Q 20. Imperforate hymen

  • what is it
  • phenotypes (2)
  • development of secondary sexual characeristics
A
  • incomplete degeneration of fibrous tissue bands that surround walls of vagina: imperforable, nothing discharges from uterus to vagina
  1. amenorrhea (no exit, blood trapped within uterus)
  2. cyclic abdominal pain/distention
  • ovary and all internal sexual organ is intact. It is that fibrous tissue blocking way from uterus to vagina. So normal secondary sexual characteristics
20
Q

Q 21. hypotension when supine, BP resolves with standing up.

  • what is diagnosis?
  • Most commonly seen in what pt group? explain physiology
A
  • supine hypotensive syndrome
  • preganant women >20wks gestation
    : enlarged uterus compress IVC, decreasing venous return. When supine or lateral decubitus position, uterus compression effect is much less.
21
Q

Q 22. What antibiotic is used to treat S.epidermis?

A

vancomycin

  • most S.epidermis is methicilin resistant. needs to be treated like MRSA
22
Q

Q 23. molecular target of ceftriaxone?

A

same as
transpeptidase

  • Don’t get confused with cell wall glycoprotein. It it D-ala D-ala analogue that binds to transpeptidase in cell wall. NOT CELL WALL GLYCOPROTEIN
23
Q

Q 26. What is general rule of thumb in terms of side of neuronal defect with cerebellar lesion?

A

IPSILATERAL side defect

24
Q

Name of 4 nuclei in cerebellum (from lateral to medial, remember mnenomic?)

A

Dont Eat Greasy Food

D- Dendate
E- Emboliform
G- Globose
F- Fastigius

25
Q

Q 26. Define intention tremor. Associated with lesion at where?

A

same as dysmetria, tremor during movement toward a target (INTENTIONALLY moving toward TARGET)

cerebellum lesion

26
Q

Q 26. Define dysdiadochokinesia

A

disorganized movement during rapid alternating movement (PE- hand flipping)

27
Q

Q 28. When it comes to talk about hereditary colorectal cancer, what should I find a first to distinguish between two big categories?

A

polyps? or no polyps?

polyps- FAP, Gardner, Turcot, Putez-Jeghers, Juvenile polyposis

no polyps- Lynch

  • In question stem, if they explicitly mentioned “no polyps”, then go with Lynch syndrome for sure
28
Q

Q 29. Most common primary cardiac tumor? where is the most prevalent location of tumor? Gross appearance?Describe histologic finding of this tumor? heart sound finding?

A
  • myxoma
  • left atrium, pedunculated mass
  • scattered cells within mucopolysaccharide STROMA
  • early diastolic tumor plop sound (during diastolic phase, pudenculated tumor flops and makes sound)
29
Q

Q 30. What two lung cancers can present paraneoplastic syndrome? What types of hormones are secreted from each?

A
  • small cell lung cancer
    1. ACTH
    2. SIADH
  • squamous cell cancer
    : PTHrP -> hypercalcemia
30
Q

Q 31. Aplastic anemia vs Myelodysplastic syndrome

  • similarity
  • difference
A
  • similarity
    : Both show pancytopenia (decreased level of every kind of blood cell)
  • note: aplastic anemia is dismonomer, it causes not only anemia, but also thrombocytopenia, leukopenia as well.

Difference

  • Aplastic anemia: dry bone marrow tap
  • myelodysplastic syndrome: hypercellular bone marrow (yet immature cells)
31
Q

Name three hematologic disorders that yield dry tap bone marrow

A
  • aplastic anemia
  • hairy cell leukemia
  • myelofibrosis
32
Q

Q 34. Quadriceps muscle is innervated by what nerve? what is the best site for analgestic injection to knock down this nerve?

A

femoral nerve

inguinal crease (lateral border of femoral artery)

33
Q

Q 38. Patient come in with joint pain. Kid was seen by physician for facial rash and fever before. what is going on?

A

possible Parvovirus B19 infection

  • adult mainfestation: arthritis (RA like)
  • kid manifestation: erythema infectiosum (slapped cheeks rash, which migrates down)
34
Q

Q 38. What is treatment for parvovirus induced arthritis in adult?

A

NSAID for pain relief

usually arthritis itself is self-resolving

35
Q

Q 39. Budd-chiari vs. hepatic portal vein embolism: differences (2)?

A

Budd-chiari

  1. embolism at hepatic vein
  2. liver cirrhosis

Hepatic vein embolism

  1. embolism at HPV
  2. varicies (ex-esophageal varicies), no liver cirrhosis (liver biopsy should be normal)
36
Q

Q 40. what is meconium ileus? which disease is associated with it?

A

ileum obstruction by meconium (first stool in infant), causing bowel distention and emesis

cystic fibrosis

37
Q

Q 40. What is fatal cause of death in cystic fibrosis?

A

pneumonia

UWORLD first pass- week 8 (11 decks)

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