3/3 UWORLD test # 31 Flashcards
Q 2. What are side effects of TCAs on heart? ECG findings? Pathophysiology? antidote?
arrythmia, enlarged QRS, prolonged QT
Blockade of Na+ channel
can be reversed by NaHCO3
Q 3. What is gross appearance of angiomyolipoma in kidney? Which neurocutaneous disease is associated with it? What others are associated with it? (remember mneomic in FA 495)
- mass containing blood vessel, muscle, fat
- tuberous sclerosis
H- Hamartoma A- Ash-leaf spot on skin (hypopigmented skin with leaf shape) M- Mitral regurgitation A- Angiofibroma R- Rhabdomyoma T- Tuberous sclerosis O- autosomal dOminant M- Mental retaradation A- Angiomyolipoma
Neurocutaenous disease: NF1 vs. NF2
- mutated gene/ chromosome number / which protein
- manifestations
- NF1: neurofibromin, negative regulator of RAS on chromosome 17
=> cafe-au-lait spots, pheocytochroma, cutaneous fibromas (think about gross appearance), Lisch noduels (pigmented iris) - NF2: NF2 gene on chromosome 22
=> bilateral schwannoma, juvenile cataracts, meningioma
von Hippel-Lindau disease
- what gene/ chromosome
- what cancers (4)
-
- VHL gene on chromosome 3
- bilateral RCC, pheocytochroma, hemangioblastoma (high vascularity with hyperchromic nuceli), angiomatosis
Sturge-Weber syndrome
- what gene
- findings (5)
- activating mutation on GNAQ gene
S-port-wine Stain T- tram track calcification of opposing gyrion CT U- unilateral R- retardation G- glaucoma/ GNAQ E- epilepsy
Q 5. Gross appearance of tinea versicolor? which infection? microscopy characteristic?
- hypopigemeted (and/or) pink patches
- Malassezia
- meatball sphaghetti
Q 7. Granulomatous destruction of interlobular bile ducts: what is this disease?
primary biliary cholangitis
Q 7. What hepatic condition is associated with ulcerative colitis?
primary sclerosing cholangitis
Q 7. What are clinical symptoms (5) of PBC (primary biliary colangitis) ?
cholestasis (jaundice, pale stool, dark urine)
hypercholesteroliemia: biliary obstruction limits elimination of cholesterol
hepatosplenomegally
fatigue
pruritus: accumulation of bile salts
Q 8. What is another fancy word for B12?
cobalamin
Q 8. What is another fancy word for B6?
pyridoxine
Q 8. What is another fancy word for B2?
Its usage in what TCA cycle rxn?
deficiency symptoms (2)
riboflavin
succinate dehydrogenase: succinate –> fumarate
Cheilosis, corenal vasculization (2 Cs)
Q 8. What kind of heart failure is seen in wet beriberi? describe physical exam findings
high output cardiac failure (thus WET)
displaced apical impulse at PMI
collapsing carotid pulses
S3
Q 8. Clinical presentations of dry beriberi
peripheral neuropathy
symmetrical muscle wasting -> eventually inability to walk
With B1 deficiency, dry beriberi may coexist with wet beriberi
Q 9. Sudden onset of heart failure can be caused most likely by what conditions (2)? Would Aortic stenosis present sudden onset of HF?
- acute atrial fibrilation or acute MI
- In case of aortic stenosis, onset of heart failure is usually gradual. not suddenly
Q 10. Facial drop vs. Facial numbness: what would most likely happen with parotid gland enlargement. why?
Facial drop
trigeminal nerve is deep so it is unlikely compressed by parotid gland, while facial nerve is superficial
FACIAL=superFICIAL
Q 11. Diagnostic criteria for cyclothymic disorder
MORE THAN 2 YEARS of alternating episodes of hypomanic and mild depression
Q 11. Define key difference: manic vs. hypomanic
manic: DIG FAST severe enough to interfere with occupational/social life
hypomanic: asl DIG FAST, but not severe enough to cause marked impairment in social/occupational functioning
Q 12. Patient ask physician out for a date. What is the physician’s appropriate response?
Tell patient that it is unethical
Q 13. What is protruding in femoral hernia? What is complication of femoral hernia? why is this?
- most commonly bowel protrudes through femoral ring
- Femoral vein/artery serve as lateral landmark! It is NOT femoral vessels that protrude.
- Malabsorption, nausea, vomiting, abdominal pain/distention, fever)
: Because femoral ring is small, femoral hernia can cause incarceration (protruding tissue become trapped and no longer be pushed back) or strangulation (impaired blood flow -> ischemia-> fever)
Q 15. Amiodarone side effects on
- skin
- eye
- blue/green skin deposits with photosensitive dermatitis
- corneal deposits
Q 16. Which cranial nerve mediates tongue movement? Left side defect on this CN results in what?
- hypoglossal
- tongue deviation to left
Q 16. Which CN mediates gag reflex
- sensory
- motor
- sensory: glossopharnyngeal
- motor: vagus
Q 16. glossopharyngeal nerve
- sensory
- motor
- parasympathetic
sensory: posterior 1/3 tongue, tonsil, carotid sinus/ body
motor: stylopharyngeus muscle only. elevation of pharynx/larynx during swallowing
parasympathetic: salivation
