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UWorld Review > 4/18/19 > Flashcards

4/18/19 Flashcards

1
Q

amniotic fluid high in AFP and/or acetylcholinesterase

A

failure of fusion of neural tube

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2
Q

Failure for rostral neuropore fusion

A

anencephaly

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3
Q

Failure of caudal neuropore fusion

A

spina bifida

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4
Q

Colitis-associated colorectal cancer tumors are

A

multifocal, flat lesions
more aggressive
more likely to have high histopathological grade
younger patients

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5
Q

sporadic colorectal cancer tumors are

A

singular, polypoid

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6
Q

Complement binding site for IgG and IgM for C1

A

Fc portion of the heavy chain closer to the hinge region

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7
Q

solitary, painless ulcer

A

primary syphilis

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8
Q

painless progressive red serpiginous ulcerative lesions without LAD, biopsy shows donovan bodies

A

granuloma inguinal by klebsiella granulomatous

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9
Q

deep, purulent, painful ulcers w/matted/supurative lypmhadenitis

A

H. ducreyi

chancroid

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10
Q

multiple painful superficial vesicles or ulcerations with erythematous base

A

HSV

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11
Q

What slows the progression of hemochromatosis in women

A

physiology iron loss from menstruation and pregnancy

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12
Q

Klinefelter syndrome labs

A

Increased LH and FSH
decreased testosterone
no sperm

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13
Q

Mutation in GNAS gene
constant G protein activation
Hormone overproduction

A

McCune-Albright

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14
Q

Symptoms of McCune Albright

A

peripheral precocious puberty
irregular cafe-au-lait spots
polyostotic fibrous dysplasia (multiple osteolytic lesions in hip and pelvis)

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15
Q

complications of McCune Alright

A

Thyrotoxicosis
Acromegaly
Cushing syndrome

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16
Q

Beta thalassemia is a defect in

A

transcription, processing, translation of beta-globing mRNA

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17
Q

Disorders in heme synthesis are

A

porphyrias

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18
Q

Treatment for BPH that also decreases prostate volume

A

Finasteride

5-alpha-reductase inhibitor

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19
Q

Griseofulvin effects

A

fungal mitosis

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20
Q

Flucytosine effects

A

fungal DNA and RNA synthesis

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21
Q

Capsofungin effects

A

fungal cell wall

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22
Q

Amphotericin B, nystatin bind

A

ergosterol in fungal cell membrane

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23
Q

azoles inhibit synthesis of

A

ergosterol in fungal cell membrane

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24
Q

Made from remnants of Rathke’s pouch (anterior pituitary)

A

craniopharyngioma

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25
Q

Supersellar tumor in children composed of calcified cysts containing cholesterol crystals

A

craniopharyngioma

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26
Q

Treatment for carcinoid syndrome

A

Octreotide

synthetic analog of somatostatin with longer half life

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27
Q

MC complication of fibrinolytic therapy for acute MI

A

intracerebral hemorrhage

why PCI is preferred

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28
Q

Cortisol levels show no change (continues to be elevated) with high dose dexamethasone suppression test

A

ectopic ACTH secretion

adrenal adenoma/carcinoma

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29
Q

Cortisol levels decrease with high dose dexamethasone suppression test

A

pituitary adenoma

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30
Q

Decreased transverse tubules in muscle fibers

A

causes uncoordinated contraction of myofibrils within affected muscle fibers

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31
Q

lipids absorbed in small intestine cannot go to blood and accumulate in intestinal epithelium resulting in enterocytes w/clear or foamy cytoplasm

A

Abetalipoproteinemia

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32
Q

Procalcitonin rises with

A

bacterial toxins

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33
Q

Procalcitonin decreases with

A

viral infections

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34
Q

Positive acute phase reactants

rise in acute inflammatory states

A 
fibrinogen
CRP
ferritin
hepcidin
ceruloplasmin
haptoglobin
VWf
complement
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35
Q

Negative acute phase reactants

fall in acute inflammatory states

A

albumin
transferrin
transthyretin (prealbumin)

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36
Q

Primary Tb infection affects

A

Ghon complex

lower lobe and ipsilateral hilar lymph node

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37
Q

Secondary Tb infection affects

A

If walls of the granuloma weaken, M. tuberculosis can escape bronchogenically and cause reactivation secondary disease

apical cavitary lesions

MC in immunosuppression

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38
Q

Miliary tuberculosis

A

hematogenous dissemination of bacteria to multiple organs like liver

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39
Q

Antioxidant enzymes

A

superoxide dismutase
glutathione peroxidase
catalase
convert ROS to water and oxygen

40
Q

Bruises change from blue to green by

A

Heme oxygenase in macrophages

heme into biliverdin, CO, and ferrous iron

41
Q

Bruises change from green to yellow by

A

biliverdin reductase (reducer)
biliverdin to bilirubin
bilirubin in transferred to liver bound to albumin

42
Q

Obstructed right brachiocephalic (innominate) vein

A

possibly from apical lung tumor
redness and edema on one side of the face
engorgement of subcutaneous veins

43
Q

Meningioma histology

A

whorled pattern of cell growth that forms nests

may calcify into round eosinophilic laminar structures (psammoma bodies)

44
Q

Ebstein anomaly associated with what drug

A

lithium

45
Q

Nightmares occur during

A

REM
muscle paralysis
final third of the night

46
Q

Gerstmann syndrome

A

Agraphia
Acalculia
Finger agnosia
left-right disorientation

47
Q

What is affected in Gerstmann syndrome

A

acute ischemic stroke to angular gyrus of dominant parietal lobe

supplied by middle cerebral artery

48
Q

Sterile platelet rich thrombi on mitral valves

A

nonbacterial thrombotic endocarditis (marantic)

underlying hyper coagulable state

49
Q

nonbacterial thrombotic endocarditis is associated with

A 
advanced malignancy esp. mutinous adenocarcinoma
SLE (Libmann-sacks endocarditis)
antiphospholipid syndrome
DIC
extensive burns
50
Q

Myocardial stretch stimulates release of

A

ANP and BNP

51
Q

ANP and BNP are broken down by

A

neprilysin (metalloprotease)

52
Q

Sacubitril is used for

A

chronic heart failure
neprilysin inhibitor
enhances ANP and BNP effects

53
Q

ANP and BNP MOA

A

activate guanylate cyclase
form cGMP
stimulates diuresis and peripheral vasodilation

54
Q

interferon alpha is made by

A

leukocytes
antiviral
anti-tumor activity

55
Q

cachexia is caused by

A

TNF-alpha
suppressing appetite
increasing basal metabolic rate

56
Q

Transient hemolytic anemia from M. pneumoniae resolves as

A

IgM antibody titers decline (6-8 weeks)

fading immune response against bacteria

57
Q

Haemophilus needs both

A

X factor hematin

V factor NAD+

58
Q

Standard HF treatment that improve survival

A

ACE inhibitors
Beta blocker
mineralocorticoid receptor antagonist

59
Q

Brain area associated with emotion and personality

A

orbitofrontal cortex

60
Q

Kluver-Bucy syndrome

A 
behavioral changes
apathy
hyperorality
hyper sexuality
visual agnosia
temporal cortex injury
61
Q

Cromolyn and nedocromil are

A

mast cell stabilizing agents

inhibit mast cell degranulation

62
Q

36 yo female with arthalgias and nodules on her legs

bilateral hilar adenopathy

A

Sarcoidosis

63
Q

biopsy of sarcoidosis

A

noncaseating granulomas that stain negative for fungi and acid fast bacilli

64
Q

Rheumatoid factor is

A
  • antibody (typically IgM) specific for Fc compartment of IgG
  • binds IgG and ACPAs
  • forms immune complexes that deposit of synovium and cartilage
65
Q

Anorexic girl with no periods, her labs show

A

decreased LH and FSH

decreased estradiol

66
Q

HPV likes to affect what kind of epithelium

A

stratified squamous
true vocal cords
cervix
anus

67
Q

migratory thrombophlebitis should raise suspicion of

A

visceral cancer
pancreas, colon, lung
“Trosseau sign”

68
Q

S3/S4 is best heard at

A

the apex in LL decubitus at end expiration

69
Q

S3/S4 has decreased intensity with

A

valsalva

decreases preload

70
Q

MCC of transtentorial herniation

A

hemorrhage

brain tumor

71
Q

first sign of uncle herniation

A

fixed and dilated pupil on side of the lesion

72
Q

presentation of uncle herniation may be

A
  • ipsilateral paralysis of CN III muscles
  • contralateral or ipsilateral hemiparesis
  • contralateral homonymous hemianopsia with macula sparing
73
Q

Dog bite

mouse like odor

A

pasteurella multocida

tx with augmentin

74
Q

depolarizing (succinylcholine) anesthetic will have what kind of TOF stimulation

A

phase I: constant but diminished

phase II: fade (seen in prolonged exposure to succinylcholine or abnormal plasma cholinesterase activity)

75
Q

non depolarizing (vecouronium) anesthetic will have what kind of TOF stimulation

A

Fade throughout

76
Q

Birth control pills work by

A

decreasing serum gonadotropin levels
decreased GnRH in hypothalamus
decreased FSH and LH in anterior pituitary
inhibits ovulation

77
Q

Progestin only pills cause

A

impairment of embryo implantation by thinning uterine lining

78
Q

Progestin only and IUD levonorgestrel prevent pregnancy by

A

thickening cervical mucus
prevents sperm from accessing uterus
continue to have periods

79
Q

Clomiphene MOA

A

selective estrogen receptor modulator
stimulates FSH and LH production
stimulation of follicle development in ovaries

80
Q

copper IUD works by

A

creating intrauterine environment that is toxic to sperm

81
Q

hyperprolactinemia treated with

A

dopamine agonists
bromocriptine
cabergoline
decreases prolactin secretion by binding DA receptors

82
Q

Treatment for coagulase negative staph should initially include

A

vancomycin

83
Q

Bilateral pitting LE edema, flank mass, and tortuous abdominal veins is concerning for

A

IVC obstruction by renal cell carcinoma with extension to IVC

84
Q

Classic triad of RCC

A

flank pain, palpable mass, hematuria

85
Q

Common paraneoplastic syndrome with RCC

A

erythrocytosis

hypercalcemia from PTH-rp

86
Q

CREST syndrome stands for

A 
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
87
Q

Antibodies against what is found in CREST

A

Anti-centromere

Anti-DNA topoisomerase (scl-70) highly specific for systemic sclerosis (diffuse scleroderma)

88
Q

Anti-dsDNA is specific for

A

SLE

89
Q

Anti-histone Abs are found in

A 
drug induced lupus
procainamide
hydralazine
isoniazid
D-penicillamine
90
Q

Anti-Ro/SSA and anti-La/SSB are found in

A

Sjogren’s

91
Q

Sjogren’s disease is associated with

A

non-Hodgkin lymphomas

92
Q

Beurger disease (thromboangiitis obliterates) is characterized by

A

segmental vasculitis extending into contiguous veins and nerves

93
Q

histology for Beurger disease

A
  • highly cellular inflammatory intraluminal thrombi with neutrophils and multinucleate giant cells in arteries and veins
  • sparing of vessel wall and internal elastic lamina
94
Q

Karyotype of partial mole

A

69 XXX or XXY

maternal or paterna DNA

95
Q

Karyotype of complete mole

A

46 XX or XY

paternal DNA only

96
Q

immunochemistry of partial mole

A

p57 positive

97
Q

immunochemistry of complete mole

A

p57 negative

UWorld Review (35 decks)

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