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Review / Wrong Answers > 6/8 UWorld > Flashcards

6/8 UWorld Flashcards

1
Q

What is orthopnea

A

SOB while lying flat

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2
Q

What is the only cardiac abnormality that INCREASES with valsalva maneuver

A
  • Valsalva maneuver
    • This increases intrathoracic pressure, thus decreasing preload (opposite of inspiration)
    • Decreases all murmurs except increases S4 heard in hypertrophic cardiomyopathy
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3
Q

What is pleiotropy

A

When one gene mutations contributes to multiple phenotypic effects, often in different organ systems

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4
Q

What is effect modification

A
  • When the effect of the main exposure on the outcome is modified by the presence of another variable
    • E.g. Experimental drug has a significant effect in non-smokers but insignificant effect in smokers
  • Effect modification is not a bias
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5
Q

What is relative risk and its equation?

A
  • Probability of getting disease in exposed group vs. probability of getting disease in unexposed
    • Calculated from cohort studies
  • Equation:
    • RR = [a/(a+b)] / [c/(c+d)]
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6
Q

What is odds ratio and its equation

A
  • Odds that group with disease (case) was exposed to a risk factor vs. odds that group without disease (control) was exposed
    • Calculated from case-control studies
  • Equation:
    • OR = [(a/c) / (b/d)] = ad/bc
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7
Q

Occlusion of what artery will cause Wernicke’s aphasia?

A

Middle cerebral

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8
Q

Occlusion of what artery will cause Broca’s aphasia?

A

Middle cerebral

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9
Q

What dietary substance other than fructose should be avoided in aldolase B deficiency?

A

Sucrose (disaccharide that breaks down into fructose)

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10
Q

In what 3 steps of the citric acid cycle is ribaflavin (B2) necessary?

A

Pyruvate dehydrogenase (TLCFN)

Alpha-ketoglutarate dehydrogenase (TLCFN)

Succinate dehydrogenase (FAD –> FADH2)

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11
Q

What is the sublingual drug given to patients with angina

A

Nitroglycerin

  • Venodilation = decreased preload
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12
Q

What are the symptoms of Gerstmann Syndrome

A
  • Aka defect in dominant parietal lobe
  • Symptoms:
    • Agraphia (inability to write)
    • Acalculia (inability to calculate)
    • Finger agnosia (inability to identify individual fingers)
    • Left-right disorientation
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13
Q

What is the MOA of phenelzine

A

Sketchy = wine funnel

  • MOA: Monamine oxidase inhibitor (MAOI)
    • Increases serotonin, NE, and DA
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14
Q

What is the main characteristic of atypical depression

A
  • Mood reactivity - improved mood in response to positive events
  • Others:
    • Vegetative symptoms (increased sleep and appetite)
    • Leaden paralysis
    • Sensitivity to rejection
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15
Q

What disorders are associated with basophilic stippling

A
  • Small dots in the periphery of erythrocytes = visualization of ribosome aggregation in cytoplasm of RBCs
  • Seen in:
    • Lead poisoning
    • Thalassemias
    • Myelodysplastic syndrome
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16
Q

Describe the function of Dynein and Kinesin

A
  • Are both microtubule-associated motor proteins that transport cargo from one end of microtubule to another
  • Dynein:
    • Transports from (+) to (-) end of microtubule
    • Retrograde transport towards the nucleus
      • THINK: Negative end Near Nucleus
    • Defect in Kartagener syndrome
  • Kinesin:
    • Transports from (-) to (+) end of microtubule
    • Anterograde transport away from nucleus
      • THINK: Positive end Points to Periphery
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17
Q

MOA of Polyethylene glycol

A

Osmotic laxative

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18
Q

MOA of Psyllium

A
  • Bulk-forming laxatives:
    • Is an indigestible hydrophilic colloid = will absorb water = distention = peristalsis
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19
Q

MOA of Docusate

A
  • Stool surfactant agents (stool softener)
    • Facilitate the penetration of stool by water and lipids
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20
Q

What is Meniere disease

A
  • Increased pressure and volume of endolymph
  • Features:
    • Recurrent vertigo
    • Ear fullness/pain
    • Unilateral hearing loss and tinnitus
21
Q

Describe presentation of Vestibular neuritis

A
  • Vestibular neuritis (labyrinthitis):
    • Inflammation of vestibular nerve
    • Features:
      • Single episode that can last days
      • Severe vertigo but no hearing loss
22
Q

Is HLA-DR3 and HLA-DR4 associated with Type I or Type II DM

A

Type I DM

23
Q

MRI findings in multiple sclerosis

A

Periventricular plaques (areas of oligodendrocyte loss and reactive gliosis)

24
Q

Describe the MOA of glucagon as a treatment for beta blocker toxiciy

A

\

  • Glucagon acts on G-protein coupled receptors, increasing intracellular cAMP, and thus increasing release of intracellular calcium during muscle contraction
  • This increases heart rate and cardiac contractility
25
Q

How does hepatitis D use Hep B to cause infection

A
  • Hepatitis D antigen must be coated with Hepatitis B surface antigen (HBsAg) in order to penetrate the hepatocyte to cause infection and multiply
26
Q

Where are the different parts of the stomach (fundus, cardia, antrum, body)

A
27
Q

Cause of gastric varices within the fundus

A

Portal HTN

Splenic vein thrombosis (often due to pancreatitis, pancreatic cancer, or abdominal tumors - splenic vein runs posterior to pancreas)

28
Q

Describe isolation (psych)

A
  • Separating feelings from ideas and events
  • E.g. Describing murder in detail without an emotional response
29
Q

Describe sublimation (psych)

A
  • Consciously replacing an unacceptable wish with a similar but acceptable course of action
  • E.g. Redirection of aggression towards father into sports
  • Vs. Reaction formation -
    • Unconsciously replacing warded-off feelings by emphasis on its opposite
30
Q

What drugs can be used for nocturnal enuresis

A
  • Imipramine:
    • TCA
    • Decreases Non-REM N3
    • Short-term treatment
  • Desmopressin
    • Decreases urination
  • Indomethacin:
    • Decreases renal blood flow, thus decreasing urine formation
31
Q

What structures are contained in the cavernous sinus

Describe the presentation of cavernous sinus syndrome

A
  • Collection of venous sinuses on either side of pituitary
  • Contains CNs III, IV, V1, VI, and occasionally V2, + internal carotid
  • Cavernous sinus syndrome:
    • Can be due to pituitary tumor, infection
    • Presentation:
      • Ophthalmoplegia (CN II, IV, VI)
      • Decreased corneal sensation (CN V1)
      • Horner syndrome
      • Decreased maxillary sensation (CN V)
32
Q

Describe each stage of the sleep cycle

A
  • To remember EEG waves THINK: BATS Dream Big
  • Awake (eyes open)
    • Beta waves
  • Awake (eyes closed)
    • Alpha waves
    • Meditating
  • Non-REM N1
    • Theta waves
    • Light sleep
  • Non-REM N2
    • Sleep spindles and K complexes
    • Bruxism (teeth grinding)
  • Non-REM N3
    • Delta waves (lowest frequency)
    • Deepest sleep
    • Sleep-walking, night terrors, bed wetting
  • REM sleep
    • Beta waves
    • Loss of motor tone
    • Dreaming
33
Q

Describ embryology of brain formation

A
  • Prosencephalon à forebrain
    • Telencephalon
      • Walls à cerebral hemisphere
      • Cavities à lateral ventricles
    • Diencephalon
      • Walls à thalamus, hypothalamus
      • Cavities à third ventricle
  • Mesencephalon à midbrain
    • Mesencephalon
      • Walls à midbrain
      • Cavity à aqueduct
  • Rhombencephalon à hindbrain
    • Metencephalon
      • Walls à pons, cerebellum
      • Cavity à upper 4th ventricle
    • Myelencephalon
      • Walls à medulla
      • Cavity à lower 4th ventricle
34
Q

Supraoptic nucleus of the hypothalamus

A
  • Produces ADH to be stored in posterior pituitary
  • THINK: Eyeball cup filled with water
35
Q

Paraventricular nucleus of the hypothalamus

A
  • Produces oxytocin to be stored in posterior pituitary
  • THINK: near valleys filled with love and happiness
36
Q

Pre-optic area of the hypothalamus

A
  • Secretes GnRH à stimulates release of LH and FSH
  • THINK: Before you even see (pre-optic), the person for who they really are you start secreting sex hormones
37
Q

Dorsomedial nucleus of the hypothalamus

A
  • Stimulates GI
  • Stimulation = savage behavior and obesity
  • THINK: green monster on your back making you angry and eating out of jealousy
38
Q

Arcuate nucleus of the hypothalamus

A
  • Releases dopamine and GHRH
  • Regulates hunger and satiety
  • THINK: a smile is an arc so the arcuate nucleus gives you the dopey smile you get when you see delicious dessert
39
Q

What tumors show rosenthal fibers

A
  • Pilocytic astrocytoma
  • Rosenthal fibers – eosinophilic corkscrew fibers
    • THINK: Chris Rossman (Rosenthal) putting the star (astrocytes) on the top of a child’s (tumor of children) christmas tree, so it has a swirly base (corkscrew fibers)
40
Q

What tumor shows perivascular pseudorosettes

A
  • Ependymoma
  • Perivascular pseudorosettes (tumor cells surrounding vessel)
    • THINK: Ependymoma = tumor surrounding ventricles; ventricles are open spaces containing body fluids; pseudorosettes is surrounding a vessel which contains body fluids
41
Q

What tumor shows pseudopalisading (surrounding area of central necrosis)

A
  • Glioblastoma multiforme
  • THINK:
    • Pseudopallisading looks like a star = astrocyte
    • Central area is necrotic/dead so this must be an old people tumor – astocyte tumor of adults = glioblastoma multiforme
42
Q

What enzyme catalyzes the formation of ribose sugars in the HMP shunt pathway

A

Transketolase

43
Q

Treatment of pyruvate dehydrogenase deficiency

A

§ Ketogenic diet (high fat, low carb diet with moderate levels of protein)

§ This forces the production of ketone bodies to fuel the body in place of glucose, so less pyruvate is generated via glycolysis

§ Lysine and leucine are exclusively ketogenic amino acids and cannot be metabolized to pyruvate

44
Q

Compare and contrast conduction aphasia vs. global aphasia

A
  • Conduction aphasia
    • Damage to arcuate fasciculus (connection between Broca’s and Wernicke’s area)
    • Broca and Wernicke’s area are intact = fluent speech with intact comprehension
    • No connection between what you hear and what you say = impaired repetition
  • Global aphasia:
    • Both Broca and Wernicke area affected
    • Influent speech and impaired comprehension
45
Q

What are the 3 C’s to remember about toxicity of TCA’s?

A

Cardiac, coma (anti-H1), convulsions (anti-GABA)

46
Q

Compare Parkinson’s to Lewy body dementia

A
  • Lewy body:Early onset dementia + Lewy bodies
    • Vs. Parkinson’s which has late onset dementia + Lewy bodies
  • Lewy bodies within the cortex (aggregates of a-synuclein)
    • Vs. Parkinson’s which affects the substantia nigra
  • Characterized by dementia and visual hallucinations, followed by Parkinsonian features
47
Q

Presentation of Creutzfeldt-Jakob disease

A
  • Rapidly progressive dementia + ataxia + startle myoclonus
48
Q

Cause and presentation of homocystinuria

A
  • Causes:
    • o Cystathionine synthase deficiency
    • o Decreased affinity of cystathionine synthase for B6
    • o Methionine synthase deficiency
  • Presentation:
    • o Homocysteine in urine
    • o Marfanoid habitus
    • o Ocular changes (downward and inward lens subluxation – vs. Marfan which is upward)
    • o CV effects
      • Homocysteine is prothrombotic, which may lead to premature acute coronary syndrome
    • o Kyphosis
    • o Intellectual disability
49
Q

Cause and presentation of phenylketonuria

A
  • Due to:
    • Deficiency in phenylalanine hydroxylase, or
    • Deficiency in tetrahydrobiopterin cofactor (BH4)
  • Tyrosine becomes an essential amino acid
  • Presentation:
    • o Intellectual disability
    • o Growth retardation
    • o Seizures
    • o Fair skin = inability to make melanin
    • o Eczema
    • o Must body odor

Review / Wrong Answers (140 decks)

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