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Review / Wrong Answers > 6/17 UWorld > Flashcards

6/17 UWorld Flashcards

1
Q

What is the damage caused to DNA by UV light

A

Thymine dimers

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2
Q

What is first line treatment for BPH?

Do they affect size of prostate

A

Alpha-1 antagonists (“-zosin”)

Do not change size of prostate

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3
Q

Which drug is used to decrease size of prostate

A

5-a reductase inhibitors (e.g. Finasteride)

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4
Q

Diagnostic criteria of pre-eclampsia

A

HTN

+

Protenuria OR signs of end-organ damage

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5
Q

Describe presentation of Neurofibromatosis type 1

A
  • Neurocutaneous disorder characterized by café-au-lait spots, cutaneous neurofibromas, optic gliomas, pheochromocytomas, Lisch nodules (pigmented iris hamartomas)
  • Neurofibromas consist of proliferation of Schwann cells, fibroblasts, and neurites
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6
Q

What is the most common renal stone?

A

Calcium stone

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7
Q

What are the 2 radioopaque kidney stones (seen on X-ray)

A

Calcium

Ammonium magnesium phosphate

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8
Q

What are the 2 radiolucent (not seen on XR) stones?

A

Uric acid

Cysteine

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9
Q

In internuclear ophthalmoplegia, is the affected eye (the one that cannot adduct) ipsilateral or contralateral to the MLF lesion?

A

Ipsilateral

  • E.g. if there is a lesion of the right MLF, when you look L, the R eye will not be able to look medially
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10
Q

What is the MOA and uses of Cilostazol

A
  • Inhibition of phosphodiesterase leads to increases cAMP within the platelet which will activate protein kinase A, and impairing platelet function and aggregation n
    • = sign UP for cAMP = increased camp
  • Causes arteriole vasodilation (due to increased cAMP)
    • =dilated red sleeves
  • Can treat symptoms of claudication due to peripheral artery disease
    • = dirt clods hitting leg
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11
Q

Adverse effect of Cilostazol

A
  • Can cause coronary steal
    • = stolen heart base
  • When there is stenosis in an artery, the body is already vasodilating, try to restore blood to that area
  • So if you give a vasodilator, all the other normal vessels will dilate even more, leading to even less blood going to the stenotic area, exacerbating ischemia
    • = dilated red hat crown = coronary artery vasodilation
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12
Q

Most commonly affected area in Crohn’s

A

Terminal ileum

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13
Q

AST and ALT indicate function of what organ?

A

Liver

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14
Q

Adverse effects of Methotrexate

A
  • Folate deficiency
  • Megaloblastic anemia
  • Myelosuppression and Pancytopenia
  • Increased risk of infection due to immunosuppression
  • _Pulmonary fib_rosis (restrictive lung disease)
  • Hepatotoxicity (should monitor LFTs)
  • Alopecia
  • Mucositis/oral ulcerations
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15
Q

What is the effect of an arteriovenous shunt on preload and afterload

A

Increased preload and decreased afterload due to shunting of blood out of arteries and into veins, bypassing arterioles

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16
Q

Presentation of Pick disease

A

Aka frontotemporal dementia

  • Early = Behavior/personality changes (frontal lobe) and/or aphasia (temporal lobe)
  • Late = Dementia
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17
Q

Lesion of subthalamic nucleus

A
  • Hemiballismus (involuntary flailing of limbs)
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18
Q

What nucleotide binds to what (A, G, T, C)

A

A binds to T with 2 bonds

G binds to C with 3 bonds

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19
Q

How do you get fromc cytosine (in DNA) to uracil (in RNA)

A

Uracil is a deaminated cytosine

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20
Q

Do purines/pyrimidines synthesis start with a base or ribose sugar

A

Purine starts with a sugar

Pyrimidine starts with a base

21
Q

Rate limiting step in pyrimidine synthesis

A

Carbamoyl phosphate synthetase II (in cytosol)

Vs. CPSI used in urea cycle in mitochondria

22
Q

What is the cause of megaloblastic anemia that does not respond to B12 or folate

A

Orotic aciduria

  • Failure to thrive
  • Developmental delay
  • Megaloblastic anemia refractory to folate and B12
  • No hyperammonemia
23
Q

What is the enzyme responsible for GMP/IMP salvage, preventing the formation of uric acid

A

Hypoxanthine-guanine phosphoribosyl transferase (HGPRT)

  • Deficient in Lesch Nyhan
24
Q

What is a common cause of SCID

A

Adenosine deamine deficiency

  • Increased dTAP = toxicity to lymphocytes
25
Describe mismatch repair What disorder is it defective in
Occurs during synthesis Mismatch is recognized and removed, along with everything downstream of the mismatch; and then starts over Defective in Lynch syndrome
26
Describe the steps in base excision repair
1. Glycosylase removes base, creating empty nucleotide 2. Endonuclease removes the empty nucleotide 3. DNA polymerase fills the gap 4. Ligase seals it
27
What is the only DNA repair that causes double-strand repair
Non-homologous end-joining
28
What is the defect in Ataxia telangiectasia
Mutated ATM gene = defective nonhomologous end-joining
29
What are the Gram + bugs covered by 1st gen and 2nd gen Cephalosporins
* 1st gen - PEcK * Proteus, E. Coli, Klebsiella (UTI bugs) * 2nd gen = HENS PEcK * H. Flu, Enterobacter, Neisseria, Serratia + PECK
30
31
What are the stop codons
UGA, UAA, UAG * U Go Away * U Are Away * U Are Gone
32
What causes removal of repressor protein and activation of transcription factor in lac operon
No glucose = activation of transcription factor (CAP) Lactose present = removal of repressor protein
33
Where does transcription and translation occur
* Transcription occurs in the nucleus to mature mRNA * Only 5' capped, 3' tail, and spliced mRNA can leave the nucleus * Translation occurs in the cytosol
34
What is the signal for Poly-A polymerae to add a tail
AAUAAA
35
Does aminoacyl tRNA synthesis work at the 5' or 3' end of tRNA, and what codon is at that end
3' end with a CCA sequence THINK: CCA = Can carry amino acids
36
Where are ribosomes synthesized
Nucleus
37
What is the functino of initiation factors
Part of translation Assembe the smaller RNA subunit with tRNA IF's are released when the larger RNA subunit attaches
38
What acid-base disorder (resp/met alk/acid) will occur during high altitude? Will you see high or low: * pH * pO2 * pCO2 * HCO3
Respiratory alkalosis (body starts hyperventilating in order to compensate for low O2) * pO2 = low (due to altitude) * pCO2 = low (due to hyperventilation) * pH = high (due to respiratory alkalosis) * HCO3 = low (due to compensation for alkalosis)
39
What is the purpose of V(D)J recombination
Antibody diversity
40
What is the presentation of galactokinase deficiency
* Deficiency in galactokinase = mild condition * Leads to accumulation of galacticol * Symptoms: * · Infantile cataracts * · Galactosemia and galactosuria
41
Describe the deficiency and presentation in Classic galactosemia
* Classic galactosemia – severe condition * Deficiency in galactose-1-phosphate uridyltransferase * Symptoms: * · Infantile cataracts * · Failure to thrive * · Jaundice * · Vomiting * · Hepatomegaly * · Renal dysfunction * · Intellectual disability * · E. Coli sepsis
42
What is Rett syndrome (inheritance, presentation)
* X-linked dominant, almost exclusively in females (males die in utero) * Symptoms become apparent between 1-4 y/o * Regression: loss of development, loss of verbal abilities, intellectual disability, ataxia, stereotyped hand-wringing
43
What inheritance pattern do most enzyme deficiencies follow?
Autosomal recessive E.g. Classic galactosemia
44
Will there be neutrophil or lymphocytic predominance present in the stool of a patient with V. cholera?
Neither - Vibrio is non-invasive Toxin activated adenylate cyclase to increase cAMP, enhancing Cl- efflux and decreased Na+ reabsorption Stool microscopy will show flecks of mucus and sloughed epithelial cells because toxin induces mucus ejection from goblet cells
45
Inserts of the ACL and PCL
ACL = originates on the lateral femoral condyle and courses anteriorly and medially to insert on the anterior intercondylar area of the tibia PCL = originates from medial condyle of femur and courses posteriorly to insert into posterior head of tibia
46
What disorder presents with diplopia that worsens with use?
Myasthenia gravis * Clinical features: * Ptosis, diplopia, weakness * Worsens with muscle use
47
What is the formula for Fick's Principle for cardiac output?
* CO = (Rate of O2 consumption) / (arterial O2 content – venous O2 content)
48
Compression of what nerve causes Saturday night palsy
Radial Recall that presentation includes inability to extend wrist
49
What nerve is responsible for arm flexors (biceps, coracobrachialis)
Musculocutaneous

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