Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

UWorld mixed > #5 3/9 > Flashcards

#5 3/9 Flashcards

1
Q

Histology of (1) zona glomerulosa (2) zona fasiculata (3) zona retiularis (4) adrenal medulla

A

(1) rounded/arched cluster (2) foamy-appearing cells in columns (3) basophilic cells in anastomosing cords (4) basophilic cytoplam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Adrenal medulla releases…

A

80% Epi, 20% Norepi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Aldosterone secretion from zona glomerulosa regulated by… (2 things)

A

(1) Angiotensin II (2) extracellular K+ levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

TNF-alpha inhibitors treat…

A 
Rheumatoid arthritis (STUDY MORE)
etanercept, inflixamab & adalimumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

First-line drug for established rheumatoid arthritis

A

methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

NSAID side effects (3)

A

GI ulcer and bleeding, fluid retention (block prostaglandin-mediated vasodilation of afferent arteriole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Kallmann’s syndrome

A

Failure of GnRH-secreting neurons to migrate from olfactory lobes to hypothalamus (migration problem)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thyroid development

A

(1) lower end of pharynx (2) migration along thyroglossal duct, from foramen cecum on dorsal surface of tongue to superior border of thyroid isthmus (can become sublingual if impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Parafollicular C-cells originate from

A

ultimobranchial bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical presentation of hypothyroidism in children

A

lethargy, feeding problems, constipation, macroglossia, umbilical hernia, large fontanels, dry skin, hypothermia, prolonged jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does an enzyme speed up the reaction rate?

A

reduce the energy of the transition state (activation energy); cannot alter Gibbs free energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

deltaG describes..

A

direction of a chemical rxn & concentrations of reactants and products at equilibrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

deltaG0 describes..

A

change in free energy that accompanies formation of 1 mol of products from substrate under standard condition
exothermic = -deltaGo (spontaneous)
endothermic = +deltaGo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Differentiate mucor/rhizopus from aspergillus on microscopy & affected population

A

irregular BROAD non-septate hyphae branching at WIDE angles (vs. septate hyphae that branch at 45 degrees).

Aspergillus: chronic granulomatous disease & immunocompromised
Mucor/Rhizopus: diabetic ketoacidotic & leukemic

Both can cause sinusitis in immunosuppressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dimorphic Fungi

A

Body Heat Changes Shape: blastomycoses, histoplasma, coccidiomycoses, sporothrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Thyrotoxicosis on serum calcium

A

hypercalcemia due to increased bone resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Familial hypocalciuric hypercalcemia (inheritance and defect)

A

autosomal dominant, defective calcium-sensing receptor on parathyroid cells & kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hydrochlorothiazide electrolyte abnormalities:

A

elevated: glucose, lipid, uric acid, calcium
decreased: potassium, magnesium, sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hypothyroid effect on skeletal muscle

A

myopathy: pale muscle fibers, decreased striation, deposition of mucinous material. atrophy or type II muscle fibers (increase in creatine kinase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Elevated creatinine kinase isoform localize: CK-MB, CK-BB, CK-MM

A

CK-MB: cardiac muscle
CK-BB: nervous system
CK-MM: skeletal muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Common causes of elevated creatine kinase (4)

A

hypothyroidism, HMG-CoA reductase (statins), autoimmune disease (polymyositis, dermatomyositis), muscular dystrophy (Duchenne)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

evolution of EPS side effects & Rx

A

4 hr: acute dystonia (muscle spasm, stiff, oculogyric crisis) rx: diphenhydramine
4 day: akathisia rx: propanolol
4 wk: bradykinesia rx: benztropine
4 mo: tardive dyskinesia rx: discontinue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

localize thyroid hormone receptor

A

inside nucleus (also, retinoids, peroxisomal proliferating activated receptors, and fatty acids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

resistance to rifampin

A

genetic mutation in DNA-dependent RNA polymerase (RAPID when monotherapy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
use of rifampin (3)
(1) prophylactic monotherapy for H. flu and N. meningitidis; combo: (2) mycobacterium TB (3) leprosy
26
Rx: MAC
macrolide (clarithromycin or azithromycin) rifampin ethambutol
27
Rx: penicillin-resistant pneumococcus
ceftriaxone & vancomycin combination
28
Rx: staphylococcal endocarditis
IV penicillin & rifampin or aminoglycoside (synergistic)
29
Use of colchine & mechanism of action
rx: for acute gout & prophylaxis binds & stabilizes tubulin, inhibiting leukocyte chemotaxis and degranulation also reduces LTB4
30
- 1st line Rx: acute gout | - preferred Rx in elderly/renal failure
- NSAID (anti-inflammatory, analgesic, anti-pyretic) | - intra-articular glucocorticoids
31
Side effect of colchine
GI
32
Use of leukotriene modulators (zileuton, montelukast, zafirlukast)
preventing recurrent of asthma & allergic rhinitis
33
ADH signal transduction
V2 receptor on principal cells in collecting duct -> increased cAMP -> fusion of endosomes with aquaporin 2 to luminal side -> increased water reabsorption
34
- highest & lowest tubular fluid osmolarity location (in presence of ADH? in absence?) - osmolarity in PCT
highest: bottom of loop of henle (1200mOsm when ADH is high) lowest: DCT (100mOsm) PCT equivalent to serum (300mOsm) in absence of ADH, most dilute in collecting ducts (as low as 50mOsm)
35
Cause of focal brain lesions in HIV+patients | & other causes in any pt
toxoplasma, CNS lymphoma (B cell; related to latent EBV infxn) & primary brain tumor (globlastoma multiforme), metastatic carcinoma, abcesses (cryptococcus, TB)
36
Irreversible neuronal damage (neuronal shrinkage, eosinophilic cytoplasm) leads to
glial hyperplasia; reactive gliosis (NOT fibroblast)
37
Vertebral level: bifurcation of abdominal aorta | & common iliac vein merge to IVC
L4
38
vertebral level: renal vein entering IVC
L1-2
39
interomediolateral nucleus (lateral horn) levels
T1-L2
40
appetite suppressants (fenfluramine, phentermine, dexfenfluramine) for >3 months causes..
pulmonary HTN -> cor pulmonale -> sudden death from arrhythmia
41
cerebral berry aneurysm associated with which genetic disorders?
ADPKD and Eherlos-Danlos
42
medial calcinosis (affected vessels and prognosis)
calcific deposits in muscular artery >50y/o. affects femoral, tibial, radial, ulnar. and arteries to genital tract. do not narrow lumen, so asymptomatic
43
prominent finding in neonate/fetus with Turner (45X,O) along with others (think: lymph, cardiac, kidney)
- lymphedema of hands and feet - abnormal nuchal lymphogenesis (subcutanoue nuchal edema and cystic hydroma) - webbed neck/low posterior hairline - cardiac abnormalities: coarctation of aorta, bicuspid aortic valve - horseshoe kidney
44
adult presentation of Turner syndrome
(45 X,O) short stature, broad shield-like chest, webbed neck, primary ovarian failure -- streaked)
45
fetus with Down Syndrome
trisomy 21; flat face, abnormal ears, slanted palpebral fissures, redundant skin at nape of neck, hypotonia, pelvic dysplasia, single transverse palmar crease
46
Edwards syndrome
trisomy 18; edwards: prominent occiput, micrognathia, small mouth, low-set and malformed ears, rocker-bottom feet. CHARACTERESTIC: clenched hands with index overriding the middle finger, 5th overriding 4th
47
1st most common autosomal trisomy in liveborn infants? 2nd? 3rd?
trisomy 21, downs trisomy 18, edwards trisomy 13, patau (most severe)
48
Patau syndrome
trisomy 13; patau: holoprosencephaly, microcephaly, polydatyl, rocker-bottom feet. mult facial abnormalities (hypotelorism, micropthalmia, cleft lip, cleft palate, absent or malformed nose)
49
47 XXX
clinically silent, decreased IQ, no increase risk of stillbirth
50
Klinefelter syndrome
47 XXY; mild mental retardation or normal intelligence. tall male with gynecomastia, small testes, and infertility. no increase risk of stillbirth
51
glucose-6-phosphate dehydrogenase catalyzes what rxn?
glucose-6-phosphate --> 6-phosphogluconate (with NADP+ --> NADPH. rate limiting step in HMP shunt
52
glucose through hexose monophosphate (HMP) shunt creates...
(1) oxidative: NADPH as a reducing equivalent - requires glucose-6-phosphate (2) reductive: ribose 5-phosphate for nucleotide synthesis & intermediates for glycolysis - requires transketolase (thiamine-dependent)
53
How do RBCs protect against oxidative injury?
HMP shunt, generates NADPH to maintain glutathione in a reduced state (via gluathione reductase)
54
G6PD histology & precipitants
X-linked; Heinz bodies (denatured hemoglobin from oxidative damage), destroyed in spleen PAINS: primaquine, aspirin, isoniazid nifuratoin, sulfonamides
55
Ascorbic acid
vitamin C; hydroxylation of proline and lysine residues in collagen: CT maintenance and wound-healing
56
Clinical presentation of orotic aciduria and Rx
impaired de novo pyrimadine synthesis: hypochromic megaloblastic anemia, neurologic abnormalities, growth retardation, excretion of orotic acid in urine; uridine supplementation, inhibit carbamoyl phosphate synthetase II
57
Resting potential of skeletal myocytes? cardiac myocytes?
- 75mV for skeletal | - 90mV for cardiac (reduced risk of arrhythmia)
58
Plataeu phase of cardiac myocyte action potential
phase 2: opening of L-type DHP-sensitive Ca++ channels and closure of some K+ channels
59
Orchiectomy vs. Orchipexy
removal of abdominal testes vs. surgery that allows descent
60
Effect of having one testicle on (1) androgen levels (2) inhibin B levels
(1) androgen not effected (compensation) | 2) inhibin decrease (FSH increase
61
High levels of cortisol on GnRH secretion
hypogonadotropic hypogonadism (suppressed GnRH hormone)
62
Lipofuscin pigment
'wear and tear' pigment; finely granular yellow brown pigment granules composed of lipid containing residues of lysosomal degradation (part of normal aging: heart, liver, kidney...)
63
Pathologic ventricular hypertrophy is characterized by... (2)
(1) morphologic changes (increased sarcomere content & volume of myocyte) and (2) gene transcription changes, i.e: ANP
64
ANP vs. BNP (who secretes it, in response to what)
ANP: secreted by atria & sometimes hypertrophic BNP: predominately ventricles both in response to volume overload --> natriuesis & diuresis
65
Laplace's law
distending pressure (pressure required to keep a sphere open) proportional to surface tension and inversely proportional to radius P= 2T/r as the radius of a sphere with constant ST decreases, pressure increases
66
Surfactant (2 effects)
prevent smaller airways from collapsing during expiration & regulates alveolar expansion (all at similar rates)
67
Chlamydia trachomatis cell wall
Lacks peptidoglycan in cell wall (muramic acid) and has cysteine residues instead (does have a cell wall, but can't be treated with penicillin/cephalosporins)
68
(2) organisms that lack a cell wall
Ureaplasma urealyticum & mycoplasma (increased cholesterol)
69
causes of urethritis
gonococcal & (NGU) chlamydia trachomatic, ureaplasma urealyticum, mycoplasma, trichomonas. Rx: NGU: azithromycin
70
chlamydia anomaly
chlamydia has PBPs and genes for peptidoglycan synthesis, but does not have peptidoglycan on cell wall
71
MRSA survives penicillin by..
modification of PBPs
72
Class IA antiarrhythmics (procainamide) are good for what type of arrhythmia
arising from centers of normal automaticity (rather than areas demonstrating abnormal automaticity)
73
Class IV antiarrhythmics (verapamil) are good for...
atrial tachycardia (i.e. supraventricular tachycardia, bc slows conduction through AV node) BAD for ventricular tachycardia; exacerbates
74
use of adenosine
paroxysmal supraventricular tachycardia
75
digoxin as an antiarrythmic
slow conduction through AV node
76
Labetolol mechanism & use
blocks alpha and beta adrenergics (decreased PVR, HR, contractility, slow AV conduction). used for refractory HTN, hypertensive urgency / emergency, and patients with pheo
77
Rx: ventricular tachycardia
amiodarone (class III) (used to be lidocarine class IB)
78
Niacin/nicotinic acid/B3 side effects...
acute flare of gouty arthritis (hyperuricemia), facial flushing (cutaneous vasodilation Rx: aspirin) hyperglycemia (acanthosis nigricans) heptatitis
79
Mechanism of Niacin/nicotinic acid/B3
decrease hepatic synthesis of TGs and VLDL, increasing HDL
80
Drugs that increase risk of gouty attacks
HCTZ, cyclosporine, pyrazinamide, Niacin
81
Statin side effects
hepatitis, myopathy
82
First-line Rx: hypertriglyceridemia & side effects
fibrates; gallstones & myopathy (worse w/ statins)
83
Ezetimibe effect
inhibit intestinal absorption of cholesterol
84
Bile acid-binding resins (cholestyramine) side effects
GI upset Hypertriglyceridemia malabsorption
85
Acute monoarticular arthritis in septic arthritis vs. gout / pseudogout
septic arthritis (gonococcus) has high WBC (100,000) while gout / pseudogout has <20,000
86
MDD diagnosis vs. Dysthymic
5 symptoms of SIG-E-CAPS for at least 2 wks w/ depressed mood or anhedonia vs. dysthmic disorder: depressed mood for >2yrs w/ 2 symptoms both respond to antidepressants
87
Borderline personality disorder
instability in relationships and marked impulsivity splitting: swing from scorning to idealizing suicidal / self-mutilating
88
Manifestation of transplant rejection - hyperacute - acute - chronic
- vascular fibrinoid necrosis; neutrophil infiltrate; thrombosis; infarction - dense interstitial T-cell infiltrate (cell-mediated) OR vasculitis (Ab: in between hyperacute/chronic) - obliterative intimal smooth muscle hypertrophy and fibrosis
89
Lung mass w/ hyponatremia =
SIADH, EUVOLEMIC | transient subclinical hypervolemia --> production of natriuretic peptides --> excretion of sodium
90
Hyponatremia urine osmolarity DDx (2)
- inappropriately concentrated >100mOsm = SIADH | - maximally dilute <100mOsm = polydypsia (appropriately low ADH)
91
Course of adult polycystic kidney disease
asymptomatic; progressively worsening uremia. has renal, pancreatic, and hepatic cysts
92
Risk during pelvic surgery (esp hysterectomy)
ligation of ureter, which runs posterior to uterine artery (ligated during hysterectomy for invasive cervical cancer)
93
Vesicoureteral reflex can occur after what surgeries (2)
prostatectomy or bladder surgery
94
Differentiate (3) Lambert-Eaton from Myasthenia Gravis
LEMS has... (1) hyporeflexia or areflexia (2) autonomic symptoms (dry mouth, impotence) (3) better with stimulation / at the end of the day
95
Myasthenia gravis is associated with what endocrine abnormality, and how does MG happen?
thymoma / thymic hyperplasia | MG is NOT inherited acquired autoimmune disease
96
Polymyositis (3 characterizations)
idiopathic inflammatory myopathy characterized by (1) bilateral proximal muscle weakness (2) elevated creatinine kinase (3) electromyographic abnormalities
97
Polymyalgia rheumatica (PMR) (2 characterestics)
sudden onset of stiffness, pain, and tenderness of musculature (esp shoulders, hips, neck, torso) - classically elevated ESR
98
Amyotrophic lateral sclerosis
(1) upper motor neuron disease -- hyperreflexia, spasticity | (2) lower motor neuron disease -- atrophy, fasiculation
99
Guillain-Barre syndrome; onset and progression
acute post-infectious polyneuropathy (often after Campylobacter jejuni). progressive ascending paralysis
100
Half of all LEMs have...
malignancy (small cell carcinoma usu)
101
Localized amyloidosis in cardiac atria (isolated atrial amyloidosis; form of senile cardiac amyloidosis)
Natiuretic peptide IAA risk increases w/ age ( >90% by 90) senile cardiac amyloidosis: transthyretin, also in brain
102
primary systemic amyloidosis deposits
immune globulin light chains (primarily lambda); in mesodermal tissue (heart, muscle, tongue)
103
BRCA-1 gene location and action
AD, chr. 17, tumor supressor; control cell cycle & role in gene repair & transcription
104
APC gene mutation associated w/..
decreased expression of D-cadherin adhesion molecule
105
genome recombination
two defective virus co-infect same host cell yielding cytopathic wild-type genome. exchange of genes between two chromosomes via crossing over within homologous regions
106
viral reassortment
exchange of whole genome sequences
107
transformation
uptake of naked DNA by prokaryotic cell
108
phenotypic mixing
co-infection of a host cell by two viral trains, resulting in a virion w/ nucleocapsid proteins from one strain and genome of other strain (alters infectivity)
109
viral interference
one virus inhibits the replication/release of a second virus infecting the same cell
110
sign of NE extravasation & antidote
cold, hard, pale IV site --> intense alpha-1 vasoconstriction --> local tissue necrosis. infuse phentolamine (reversible alpha-1 blocker)
111
lidocaine is less effective in...
acidic, ischemic tissue (becomes charged)

UWorld mixed (60 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions