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UWORLD first pass- week 6 > 3/6 UWORLD- test #34 > Flashcards

3/6 UWORLD- test #34 Flashcards

1
Q

Q 14. What cephalosporins (2) treat pseudomonas?

A

Third gen: Ceftazidime

Fourth gene: Cefepime

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2
Q

Q 14. What drugs treat pseudomonas? (6 drug classes)

A
  • cephalosporins (ceftazidime, cefepime)
  • aminoglycosides
  • fluoroquinolone
  • monobactem (aztreonam)
  • carbapenems (-penem)
  • broadspectrum penicilins (piperacilin, ticarcilin)
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3
Q

Q 1. suspensory ligament of ovary houses ovarian vessel. what is fancy word for this ligament? This ligament connects what?

A

infundibulopelvic ligament

connects ovary with lateral pelvic wall

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4
Q

Q 2. Which immune cells mediate killing of tumor cells ? Which cytokine mediates this?

A

NK cells

IL-2

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5
Q

Q 2. Which immune cells secrete IL-2? What cells does it stimulate for growth?

A

primarily from Helper T cells

Stimulates all sorts of T cells (helper, cytotoxic, regulatory) + NK cells

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6
Q

Q 3. What is glial fibrilary acidic protein? What cells show immunoactivity for this protein? What CNS tumors (2) will be positive?

A
  • GFAP
  • astrocytes
  • glioblastoma multiforme & pilocytic astrocytoma
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7
Q

Q 3. What is synaptophysin? Which cells (3) will show immunoactivity for this protein?

A
  • transmembrane glycoprotein in presynaptic vesicles

- neuron, neuroendocrine, neuroectoderm

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8
Q

Q 4. What determines severity of tetralogy of Fellot?

A

RVOT (right ventricle outflow tract) obstruction
-> will cause irreversible damage to pulmonary artery

  • right ventricular hypertrophy could be reversible
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9
Q

Q 5. How AV shunt changes hemodynamics?

A

Arterioles bypass capillary and directly enters venous

-> thus it will increase venous return & preload

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10
Q

Q 6. When does beta thalessemia major become symptomatic? why?

A

After 6 month of child birth

Before 6 months, gamma globulin chain will be predominant form. So Fetal hemoglobin (HbF, two alpha, two gamma) will be normally functioning.

As Fetal hemoglobulin drops after 6 months, newborn baby cannot produce normal HbA, becoming symptomatic.
This rule applies to other beta globulin disorder (sickle cell disease)

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11
Q

Q 7. characteristics/functions of tRNA

  • trinucleotide sequence in 3’end?
  • D arm (dihydrourine)?
  • T arm (ribothymidine, pseudouridine, cytidine)?
A
  • 3’ end CCA
  • D arm (dihyrdourine): tRNA recognition by correct aminoacyl-tRNA synthetase
  • T arm (ribothymidine, pseudouridine, cytidine): tRNA ribosome binding
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12
Q

Q 7. Function of aminoacyl-tRNA synthetase? what part of tRNA ensure integrity of this enzyme’s reaction?

A

transfer of aminoacid to 3’OH end of tRNA

pairing of right aminoacyl-tRNA is mediated by D arm (dihydrourine)

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13
Q

Q 9. MRI finding of loss of grey-white matter with sulcal effacement suggests what?

A

hypoxic brain injury

possibly due to acute MI

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14
Q

Q 9. nuclei for eye: function? location?

  • Edinger-westphal nucleus
  • pretectal nucleus
  • lateral geniculus nucleus
A
  • Edinger-westphal nucleus: ipsilateral efferent CN3, located in upper midbrain
  • pretectal nucleus: receives afferent CN2, sends BILATERALLY to Edinger-westphal nucleus, located in upper midbrain
  • lateral geniculus nucleus: receives afferent CN2, sends ipsilaterally to calcarine sulcus for vision, located in thalamus
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15
Q

Q 9. Draw how CN2/CN3 are interconnected for pupillary light reflex

A

FA. 487

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16
Q

Q 10. Define psychologic term “avoidance”

vs. “schizoid”?

A

not socialize due to fear of criticism / rejection

Schizoid is voluntary withdrawal from socializing.
In avoidance, affect/repectfulness are intact, while schizoid is not.

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17
Q

Difference between antisocial vs. conduct disorder?

A

Disrespectful, violation of rights of others

  • antisocial: > 18 yo
  • conduct disorder: <18 yo
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18
Q

Q 10. Define 4 characteristics of boarderline disorder

A
  • emotional instability
  • suicidality & self-mutilation
    (don’t confuse this with depression)
  • emptiness
  • impulsivility
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19
Q

Q 13. What tissue has maximal blood flow during ventricular diastole & minimal blood flow during ventricular systole? explain physiology. How is this different from all other tissues?

A
  • left ventricular myocardium
  • stretch/ compression
    during contraction, muscles compress coronary artery
    also, myocardium stretch coronary vessel, making it thinner => less blood supply
  • other tissues are opposite. They receive the most volume during systole!
20
Q

Q 16. compare “somatic symptom disorder” vs. “conversion disorder”

A

somatic symptom: unexplained, generalized body complaints (fatigue, pain) + excessive anxiety

conversion disorder: unexplained NEUROLOGIC symptoms

  • think like this: some pains get CONVERTED to NEUROLOGIC pain.
21
Q

Q 16. compare “somatic symptom disorder” vs. “illness anxiety disorder”

A

Like somatic symptom disorder, illness anxiety disorder also shows excessive anxiety of having/or acquiring disease.

But, somatic symptoms are MINIMUM

22
Q

Q 17. Where is germinal matrix? what is consequence of germinal matrix hemorrhage?

A

close proximity to lateral ventricle

germinal matrix hemorrhage can lead to intraventricular hemorrahge

23
Q

Q 19. ACEI vs. ARB: affect on

  • aldosterone
  • bradykinin
A

ACEI
- aldosterone: decrease

  • bradykinin: increase -> angioedema with c1 esterase inhibitor deficiency

ARB
- aldosterone: decrease (remember AngII binds to AngII receptor on adrenal cortex to stimulate aldo secretion)

  • bradykinin: no change (it is ACE that mediates bradykinin breakdown, not AngII)
24
Q

Q 20. What hematoma is associated with skull fracture?

A

epidural

25
Q

Q 20. epidural hematoma is associated with rupture of what artery? This artery is branch of what artery?

A

middle meningeal artery

branch of maxillary artery

26
Q

Q 21. Definition of intrapartum?

A

during labor and delivery

27
Q

Q 22. Draw and explain physiology regarding how breathing frequency & breathing work graph is affected in:

  • asthma
  • pulmonary fibrosis
A

Note p.26

28
Q

Q 23. Pulsus paradoxus & hypotension shortly week after upper respiratory infection. what is diagnosis?

A

cardiac temponade

NOT acute pericarditis: it can also cause pulsus paradoxus, but not hypotension. Also, it would take longer (months) to develop pericarditis after infection

29
Q

Q 23. 4 etiologies of cardiac temponade

A
  • infection
  • radiation
  • connective tissue disease (inflammation)
  • malignancy
30
Q

Q 25. pathophysiology: vitiligo vs. albinism

A

vitiligo: complete absence of melanocytes
albinism: impaired melanin production due to reduced tyrosinase activity (tyrosinase: DOPA -> melanin)

31
Q

Q 27. Hypertriglyceridemia (>1000mg/dL): what disease should I think first?

A

actue pancreatitis

32
Q

Q 28. MOA for bisphosphonate?

A

inhibition of osteoclast ACTIVITY

bisphosphonate binds to HYDROXYAPATITE on bone surface, inhibiting binding of osteoclast on bone

33
Q

Q 31. spreading pattern of maculopapular rash in rubeola (measles)?

A

starting from face, spread to trunk and extremities.
normally spares hands/feet.

DOWNWARD spread

34
Q

What is SSPE (subacute sclerosing panencephalitis)?

A

severe complication of measles that may present with seizure, myoclonus, personality changes, ataxia, and comma.

Normally seen in immigrant kids with no history of MMR vaccination.

35
Q

Q 32. How does bronchial obstruction causes lung collapse? unilateral lung collapse due to bronchial obstruction will show what findings on chest X-ray?

A

bronchial obstruction -> air trapped -> lung volume loss as air slowly diffuse into blood -> essential aveloar collapse

X-ray: hemithorax on affected side
deviation of trachea TOWARD affected side

*think like this: in normal settings trachea is in the middle with well balanced tension. With lung collapse on one side, the tension on affected side is decreased and structures will deviated TOWARD collapsed (weak) side.

36
Q

Chest x-ray with pneumothorax. what should I find first?

A

TRACHEA

trachea/direction of trachea deviation
& side of pneumothorax

Once find a direction of trachea deviation, then figure out etiology

  • trachea deviating TOWARD hemithorax: lung collapae due to alveolar obstruction
  • trachea deviating AWAY from hemithorax: tension pneumothorax (air within pleural space is accumulating and can’t get out -> air pressure builds up, pushing structures toward unaffected side
37
Q

Q 33. What is Trousseau syndrome? What medical condition is associated with it? How does it present clinically?

A

migratory thrombophlebitis

visceral cancer (pancreatic, colon, lung adenocarcinoma)

erythematous/tender thrombophlebitis showing migration pattern (extending forearm to elbow, for example)

38
Q

Q 33. What is Trousseau sign? What does it indicate?

A
  • blood pressure cuff- > carpal spasm

- hypocalcemia

39
Q

Q 34. genetics: what is in-frame deletion?

A

deletion of 3x nucleotides. no frameshift

40
Q

Q 35. elevated orotic acid in urine

  • what are two possible diseases?
  • compare these two diseases in terms of
    1) missing enzyme
    2) clinical presentation
A
  • hereditary orotic aciduira
    1) UMP synthase defect
    2) megaloblastic anemia, no hyperammonemia
  • ornithine transcarbamylase deficiency
    1) ornitine transcarbamylase in urea cycle
    2) encephalopathy due to hyperammonemia,
    no magaloblastic anemia
41
Q

Q 36. What is HbA2? Under what condition is it increased?

A
  • 2 alpha globulin + 2 delta globulin
  • increased in both beta thalessemia major/ minor

> 3.5% on electrophoresis can be diagnostic for beta thalessemia minor, which is usually asymptomatic

42
Q

Q 38. What three medications are used for first line regimen for long-term bipolar management?

A
  • lithium
  • valporate (or lamotrigene)
  • quetiapine (atypical antipsychotics)
43
Q

Apart from anti-epileptic usage, in what other two conditions can valporate be used?

A
  • bipolar disorder (long term management)

- prophylaxis for migraine

44
Q

Q 39. cytokeratin

  • what is it?
  • For which disease can it be used as marker?
A
  • keratin-containing intermediate filaments that make up cytoskeleton of EPITHELIAL cells
  • cytokeratin can be used a marker for epithelial cell derived tumor (squamous cell carcinoma)
45
Q

Q 40. HER2

  • encodes for what type of receptor/ function
  • marker for what diseases (2)
  • prognosis indicator?
  • which drug target HER2?
A
  • tyrosine kinase receptor for EPIDERMAL growth/proliferation
  • breast cancer, gastric cancer
  • HER2 positive breast cancer has worse prognosis than HER2 negative
  • trastuzumab

UWORLD first pass- week 6 (6 decks)

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