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uworld > 6.22.16 NBME Form 16 > Flashcards

6.22.16 NBME Form 16 Flashcards

1
Q

How do somatostatinomas cause cholelithiasis?

A

Somatostatin inhibits CKK action on the gallbladder

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2
Q

What is HELLP syndrome?

A

Preeclampsia with thrombotic microangiopathy involving the liver

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3
Q

what lifestyle modification will most likely decrease risk for additional fractures?

A

wt-bearing exercise

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4
Q

how else could you describe zero order eliminatino?

A

capacity-limited elimination

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5
Q

What is preeclampsia? What causes it?

A

Pregnancy-induced HTN, proteinuria, and edema in the 3rd trimester, d/t abnormality of maternal-fetal vascular interface in placenta

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6
Q

CASE: 45yo M –> fever, chills, dysuria, tender enlrged prostate –> what infect?

A

E coli

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7
Q

what disorder has paternal imprinting?

A

Angelman synd

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8
Q

Why is there peripheral neuropathy with Chediak-Higashi syndrome?

A

Inability to traffic nutrients to the periphery

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9
Q

what maneuvers enhance MR?

A

increase TRP –> squat, hand grip

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10
Q

highly increased FSH: indicates?

A

menopause

low estrogen –> lose neg feedback on FSH

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11
Q

Why are there giant granules in leukocytes in Chediak-Higashi syndrome?

A

Inability to distribute granules produced by the golgi

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12
Q

Why is there neutropenia in Chediak-Higashi syndrome?

A

No way to separate cells d/t defective microtubules

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13
Q

what is: leukomoid response

A

increased white blood cell count, or leukocytosis, which is a physiological response to stress or infection (as opposed to a primary blood malignancy, such as leukemia)

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14
Q

What are the labs that are elevated with HELLP syndrome? (3)

A

Hemolysis
Elevated LFTs
Low platelets

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15
Q

Which are most common, primary or mets to bone?

A

Mets

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16
Q

mutate/delete chrom 15 –> dx?

A

Prader-Willi or Angelman synd

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17
Q

what disorder has maternal imprinting?

A

Prader-Willi synd

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18
Q

what struct must be protected during surg remval of ovary?

A

ureter –> pass inf to ovary

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19
Q

what produces a continuous murmur?

A

PDA

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20
Q

What is the effect of VIP on gastric acid secretion?

A

Inhibits

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21
Q

stroke-like episodes, ragged red fibers: what dz?

A

mito inherited dz

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22
Q

Marfan synd: what organ systems does it affect?

A
  • skeleton
  • heart
  • eyes
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23
Q

what is: heteroplasmy

A

presence of both normal & mutated mtDNA –> variable expression in mito inherited dz

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24
Q

what are the systolic murmurs?

A
  • MR
  • TR
  • AS
  • VSD
  • MVP
  • ASD
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25
Q

Prader-Willi synd: most common cause

A

maternal uniparental disomy –> 2 maternally imprinted genes, no paternal gene

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26
Q

differentiate: schizophreniform disorder vs schizophrenia

A

1-6mo

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27
Q

carrier freq: calc

A

2pq

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28
Q

What are the s/sx of an insulinoma?

A

Episodic hypoglycemia with mental status changes and are relieved by glucose

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29
Q

What causes the hemolysis with HELLP?

A

Platelet deposition in the blood vessels leading to schistocyte formation

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30
Q

clomiphene: drug class

A

SERM

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31
Q

how does CN V exit skull?

A

Standing Room Only:
V1 - sup orbital fissure
V2 - rotundum
V3 - ovale

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32
Q

name: holosytolic, high pitched blowing murmur

A
  • MR

- TR

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33
Q

What are the GI findings of a somatostatinoma?

A
  • Achlorhydria (inhibition of gastrin)

- Cholelithiasis and steatorrhea (inhibition of CCK)

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34
Q

ondansetron: use

A

prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, or surgery

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35
Q

Prader-Willi synd: which gene is missing?

A

paternal

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36
Q

what is: 0-order elimiatino

A

constant rate of elimination (regardless of serum [drug])

37
Q

CASE:

wt-lifter –> lifts 200lb bar –> immed pain in low pain –> radiate down leg –> what is cause of pain?

A

rupture of intervertebral disc –> impinge on sciatic

38
Q

what is: psychosis

A

distorted perception of reality –> charact by –> delusions, hallucination, disorg thinking

39
Q

what are the diastolic murmurs?

A
  • AR
  • MS
  • PR
40
Q

CASE: run a marathon –> temp of 101.5F –> how will temp return to normal?

A

sweat evaporate

41
Q

what is: schizophrenia

A

> 6mo:

  • delusion
  • hallucination
  • disorg speech
  • disorg, catatonic beh
  • neg ssx
42
Q

What are the components of the BAILIN mnemonic for Chediak-Higashi syndrome?

A
  • Bleeding disorders
  • Albinism
  • Infections
  • Leukopenia
  • Infiltrative lymphohistiocytosis
  • Neuropathy
43
Q

What is Chediak-Higashi syndrome? Inheritance pattern?

A

AR Protein trafficking defect, characterized by impaired phagolysosome formation

44
Q

What are the two metastatic tumors of bone that are osteoblastic?

A

Prostate

Breast

45
Q

what is: transformation

A

ability to take up naked DNA

46
Q

what is: 1st order elimination

A

constant fraction of drug eliminated

47
Q

What is eclampsia?

A

seizure induced by HTN from baby

48
Q

Why is there defective primary hemostasis with Chediak-Higashi syndrome?

A

Loss of platelets d/t loss of movement out of megakaryocytes

49
Q

What are the findings of a VIPoma? (2) What electrolyte disturbance?
—–

A
  • Watery diarrhea
  • Hypokalemia
  • Achlorhydria
50
Q

what is: neg ssx

A
  • flat affect
  • social withdrawal
  • lack of motivation
  • lack of speech, thought
51
Q

first order elimination: what happens to serum [drug] (Cp)?

A

decrease exponentially with time

52
Q

glyceraldehyde 3 phosphate deH: rxn

A

glycolysis: glyceraldehyde 3 phosphate –> 1, 3-bisphosphoglycerate

53
Q

how else could you describe 1st order elimination?

A

flow-dep elimination

54
Q

Marfan synd: heart ssx

A
  • cystic medial necrosis of aorta –> aortic incompetence, dissecting aortic aneurysms
  • floppy mitral valve
55
Q

Marfan synd: eye ssx

A

lens subluxation –> up & out

56
Q

LP: go thru what layers?

A

1) skin
2) fascia, subQ fat
3) supraspinous lig
4) infraspinous lig
5) ligamentum flavum
6) epidural space & fat
7) dura

57
Q

What are the levels of the following in an insulinoma:

  • Glucose
  • insulin
  • C-peptide
A
  • Decreased glucose
  • Increased insulin
  • Increased C-peptide
58
Q

Marfan synd: skeletal ssx

A
  • tall w long extremities
  • pectus excavatum
  • hypermobile joints
  • arachnodactyly
59
Q

schizotypal personality: ssx

A
  • paranormal/superstitious beliefs
  • isolation, discomfort in social sit
  • odd thinking, beh
60
Q

disorg schizophrenia: ssx

A
  • disorg speech
  • inapprop affect
  • inapprop laugh
  • poor hygiene
  • sloppy appearance
61
Q

what is: contemplation

A

acknowledge there is a problem but not ready/willing to change

62
Q

what is: precontemplation

A

not yet acknowledge there is a problem

63
Q

What is a VIPoma?

A

Tumor that causes and excessive vasoactive intestinal peptide to be produced

64
Q

what are the hormonal changes found in menopause?

A
  • low estrogen
  • high high FSH
  • high LH
  • high GnRH
65
Q

what is: delusional disorder

A

> 1mo: fixed, persistent untrue belief system

66
Q

What is seen in the vessels of the placenta with preeclampsia?

A

Fibrinoid necrosis

67
Q

CASE:
cross-sectional area of aneurysm = 2cm^2
mean velocity of blood flow thru aneurysm = 20cm/sec

what is the flow rate (L/min) thru the aneurysm?

A 
flow rate = area X velocity
Q = VA = (20cm/sec)(2cm^2) 
= 40cm^3/sec 
= 2400cm^3/min (1cm^3 = 1ml) 
= 2400ml/min 
= 2.4L/min
68
Q

What is the effect of VIP on potassium levels?

A

Lowers

69
Q

clomiphene: use

A

induce ovulation

70
Q

what is: schizoaffective disorder

A

> 2wk: psychosis + MDE/mania

71
Q

CASE:

muscle weak & cramp after exercise –> lactate not increase after exercise –> dx?

A

McArdle Dz –> deficient glycogen phosphorylase –> can’t break down glycogen

72
Q

pudendal N: fx in M

A

M sexual response: ejaculation

73
Q

differentiate: brief psychotic disorder vs schizophrenia

A
74
Q

Pancreatic endocrine tumors are often a component of what genetic malignancy? What other malignancies are associated with this?

A

-MEN1

  • Parathyroid hyperplasia
  • Pituitary adenoma
  • Pancreatic tumors
75
Q

what is: maternal imprinting

A

maternal gene: silent

paternal gene: deleted, mutated

76
Q

What cells do pancreatic endocrine tumors arise from?

A

Islet cells

77
Q

Angelman synd: which gene is missing?

A

maternal

78
Q

Are most mets to bone osteolytic or osteoblastic?

A

Osteolytic

79
Q

What is the difference between osteolytic and osteoblastic lesions?

A

Osteolytic produces punched out appearance, while osteoblastic causes sclerosis of the bone

80
Q

CASE:
ATNII: increase BP
Drug X: increase BP
ATNII + X: no change in BP

what is Drug X?

A

partial agonist at ATN II receptor

partial agonist in presence of full agonist acts as antagonist

81
Q

zero order elimination: what happens to serum [drug] (Cp)?

A

decrease linearly with time

82
Q

What is Zollenger-Ellison syndrome?

A

gastrinoma that produces gastrin to increased HCl from parietal cells

83
Q

Why is there albinism with Chediak-Higashi syndrome?

A

Melanocyte cannot transfer melanin to the keratinocytes d/t crappy microtubules

84
Q

what struct is at greatest risk for injury during prostatectomy?

A

pelvic parasym nerves

85
Q

fibrillin-1 gene mutation –> dx?

A

Marfan synd

86
Q

MR: common cause

A
  • ischemic heart dz
  • MVP
  • LV dilation
87
Q

CASE: F can’t conceive –> tx?

A

clomiphene

88
Q

what maneuvers enhance TR?

A

increase RA return –> inspiration

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