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UWorld > 6.24.16 > Flashcards

6.24.16 Flashcards

1
Q

Tay Sachs dz: mode of inheritance

A

AR

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2
Q

mass in 3rd part of duodenum: may compromise?

A

SMA

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3
Q

caudal regression synd: charact

A

sacral agenesis:

  • LE paralysis
  • urinary incontinence
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4
Q

bacterial vaginosis: tx

A
  • metronidazole

- clindamycin

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5
Q

what binds thyroid hormone?

A

thyroxine-binding globulin (TBG)

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6
Q

dx: mild intell disability, 47 chrom

A

Klinefelter synd

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7
Q

osteogenesis imperfecta: pathophys

A

defective syn of collagen I –> impaired bone matrix formation

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8
Q

femoral N injury: ssx

A
  • weak quadriceps
  • lose patellar reflex
  • lose sensation: ant/med thigh, med leg
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9
Q

how do cells adhere to ECM?

A

integrin: bind fibronectin, collagen, laminin

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10
Q

Dx: proximal muscle pain, weak. Fatigue, wt gain. High CK

A

hypothyroid myopathy

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11
Q

Klinefelter synd: ssx

A
  • tall
  • small, firm testes
  • azoospermia
  • gynecomastia
  • mild intell disability
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12
Q

S4: cause

A

decreased LV compliance

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13
Q

portal HTN: hemorrhoids –> d/t what vessel?

A

sup rectal V

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14
Q

sirolimus: MOA

A

cyto –> bind immunophilin FK-506 binding protein (FKBP) –> form complex –> bind & inh mTOR –> block IL-2 signal transduction –> prevent cell cycle progression –> prevent lymphocyte prolif

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15
Q

Dx: infant –> flaccid lower extremities, absent ankle reflexes bilat. Poorly dev lumbar spine & sacrum

A

caudal regression synd

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16
Q

chi square test: use

A

test assoc bw 2 categorical variables

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17
Q

increase estrogen –> increase TH –> effect on pt?

A

normal free TH ==> euthyroid

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18
Q

ID spinal level: fasciculus gracilis & cuneas

A

above T7: both

below: only gracilis

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19
Q

5-HT3 receptor ant: drug

A

ondansetron

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20
Q

selective estrogen receptor modulator: MOA

A

competitive inh estrogen binding to estrogen receptor

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21
Q

low hepcidin: effect?

A
  • intestine –> increase absorb iron

- macrophage –> release iron

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22
Q

Dx: progressive proximal muscle weak & atrophy. No pain. Normal CK

A

glucocorticoid-induced myopathy

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23
Q

increase estrogen –> effect on thyroid hormone

A

estrogen –> increase TBG syn –> transient increase TSH –> increase TH syn –> increase total T4, total T3

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24
Q

Dx: shoulder, neck, pelvic girdle –> muscle pain & stiff. Worse in AM & with activity. Normal CK

A

polymyalgia rheumatica

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25
Q

net filtration pressure: calc

A

hydrostatic pressure gradient - oncotic pressure gradient

= (Pc-Pi) - (oc-oi)

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26
Q

caudal regression synd: RF

A

poorly ctrled maternal diabetes

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27
Q

prenatal screen for GBS: when?

A

35-37wks

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28
Q

ID spinal level: shape

A

as mv up –> more oval

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29
Q

acute viral hepatitis: histology

A
  • “spotty necrosis”
  • ballooning degen (hepatocyte swelling w wispy/clear cyto)
  • Councilman bodies (eosinophilic apoptotic hepatocytes)
  • mononuclear cell infiltrates
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30
Q

hepcidin: fx

A

central regulator of iron homeostasis

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31
Q

lat dorsi: fx

A

humerus:
- extend
- adduct
- med rotate

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32
Q

what is: dead space

A

air that is inhaled but has no role in gas exchange

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33
Q

vestibular nausea: tx

A
  • antihist

- antichol

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34
Q

Dx: 8mo F –> normal dev –> now can’t sit, roll over. Macrocephaly. Bright red fovea centralis. Normal abd exam

A

Tay Sachs

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35
Q

ID spinal level: gray matter

A

as mv up –> decrease gray matter

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36
Q

tamoxifen: what is it? use?

A

SERM

trt estrogen receptor+ breast CA

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37
Q

femoral N injury: cause

A
  • pelvic fracture

- compression from mass on iliopsoas, iliacus

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38
Q

muscle bx –> mid-size artery –> transmural inflamm w areas of homogeneous, eosinophilic arterial wall necrosis –> dx?

A

polyarteritis nodosa

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39
Q

acute synovitis, fever, leukocytosis –> next step in management?

A

synovial fluid analysis (R/O septic arthritis –> emergency!):

  • xl analysis
  • cell count
  • Gram stain
  • culture
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40
Q

tamoxifen: effect on breast

A

anti-estrogen

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41
Q

portal HTN: caput medusae –> d/t what vessel?

A

paraumbilical V

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42
Q

two sample t test: use

A

compre 2 group means

43
Q

acute hep A: ssx

A
  • prodrome: fever, malaise, anorexia, N/V, RUQ pain

- cholestasis: jaundice, pruritis, dark urine, clay stool

44
Q

lat dorsi: N

A

thoracodorsal

45
Q

Tay Sachs dz: key clinical features

A
  • progressive neurodegen

- cherry red macula

46
Q

what controls iron storage & release by other cells involved in iron homeostasis?

A

hepcidin

47
Q

ID spinal level: ventral horn

A

Large:

  • lower cervical
  • lumbosacral
48
Q

elevated creatine kinase: common causes

A
  • hypothyroid
  • autoimmune dz (polymyositis, dermatomyositis)
  • muscular dystrophy
  • med (HMG CoA reductase inh)
49
Q

polyarteritis nodosa: charact

A

transmural inflamm w fibrinoid necrosis

50
Q

calcineurin: fx

A

activate IL-2 –> T cell growth, prolif

51
Q

calcineurin inh: use

A

immunosupp in transplant pts

52
Q

polyarteritis nodosa: ssx

A

may affect almost any system –> ssx d/t ischemia of involved organs

53
Q

how do you diagnose RA?

A

clinically

anti-cyclic citrullinated peptide Ab –> helpful for confirm

54
Q

ID spinal level: white matter

A

as mv up –> increase white matter

55
Q

anti-CCP –> dx?

A

RA

56
Q

glomerular cap hydrostatic pressure = 45
glomerular cap oncotic pressure = 27
bowman capsule hydrostatic pressure = 10
bowman capsule oncotic pressure = 2

what is net filtration pressure?

A

= (45-10) - (27-2)

= 10

57
Q

why is alveolar ventilation lower than minute ventilation

A

dead space

58
Q

sirolimus: use

A

immunosupp –> prevent transplant rejection

59
Q

cardiac pacemaker cell: what is responsible for phase 4?

A
  • close repolarizing K channel
  • funny channel –> slow Na influx
  • open T-type Ca channel
60
Q

CYP450 effect on tamoxifen?

A

metab tamoxifen to active metabolite endoxifen

61
Q

Niemann-Pick dz: clinical features

A

infant:
- HSM
- neuro regression
- cherry red spot

62
Q

Klinefelter synd: pathophys

A

meiotic nondisjunction –> 47, XXY

63
Q

analysis of variance (ANOVA): use

A

compare means of >2 grps

64
Q

what is the most common liver malig?

A

metastasis from other primary site

65
Q

what can be the 1st manifestation of hypothyroid?

A

hypothyroid myopathy –> elevated CK

66
Q

RA: charact

A
  • symm polyarthritis (MCP & PCP)

- morning stiff >30min

67
Q

visceral nausea: cause

A

GI insult:

  • gastroenteritis
  • ctx
  • gen anes
68
Q

Dx: defective collagen I

A

osteogenesis imperfecta

69
Q

CASE: various missionary trips –> liver bx –> spotty hepatocyte necrosis, inflamm cell infiltration –> dx?

A

acute hep A

70
Q

what subst activates IL-2?

A

calcineurin

71
Q

Dx: proximal muscle weak. Skin rash, inflamm arthritis. High CK

A

inflamm myopathy (polymyositis, dermatomyositis)

72
Q

lateral horns of spinal cord: what level?

A

T1-L2

73
Q

what lowers hepcidin?

A
  • hypoxia

- increased erythropoiesis

74
Q

osteogenesis imperfecta: clinical findings

A
  • h/o fractures from minimal trauma
  • blue sclera
  • small, malformed teeth
75
Q

adenosine: MOA

A

activate A1 receptors –> activate K channel –> increase K conductance –> membrane potential stay neg longer

76
Q

why does antagonizing 5-HT3 receptor reduce N/V?

A

GI irritation –> increase mucosal serotonin release –> activate 5-HT3 receptors on vagal & spinal afferent N –> relay impulse to medullary vomiting center –> emesis

77
Q

Dx: proximal muscle pain, weak. Started statin 2 mos ago. High CK

A

statin-induced myopathy

78
Q

visceral nausea: tx

A

5-HT3 receptor ant

79
Q

what is: minute ventilation

A

total vol of new air that enter resp pathways per minute

80
Q

tamoxifen: effect on uterus

A

estrogen agonist effect –> endometrial hyperplasia –> CA

81
Q

what increases hepcidin?

A
  • high iron

- inflamm

82
Q

IL-2: fx

A
  • T cell activation, prolif
  • NK, macrophage activity
  • B cell growth
83
Q

Niemann-Pick dz: def?

A

sphingomyelinase –> accum sphingomyelin

84
Q

different drug efficacy & toxicity among indiv –> cause?

A

CYP450 polymorphism

85
Q

Dx: 18mo M –> normal dev til 5mo –> now can’t sit, poor head ctrl. Large spleen, liver. Hypotonic. Red macula

A

Niemann-Pick dz

86
Q

IL-2: produced by?

A

T cell

87
Q

portal HTN: esophageal varices –> d/t what vessel?

A

L gastric V

88
Q

differentiate: Tay Sachs vs Niemann-Pick

A

Tay Sachs: no HSM

89
Q

what is: alveolar ventilation

A

vol of new air reaching the gas exchange areas per minute

90
Q

metastasis to liver: CT

A

mult nodules

91
Q

S4: assoc dz

A
  • restrictive cardiomyopathy

- LV hypertrophy

92
Q

polyarteritis nodosa: assoc dz

A

HBV

93
Q

Listeria –> resistant to what abx? how?

A

cephalosporin

altered PBP

94
Q

migraine w nausea: tx

A

dopamine ant

95
Q

prolong phase 4 –> effect?

A

reduce rate of spontaneous depolarization –> decrease sinus rate, AV conduction –> decrease HR

96
Q

total peripheral resistance of vessels arranged in parallel: calc

A

1/TPR = 1/R1 + 1/R2 + 1/R3 + …

97
Q

thiazolidinedione: MOA

A

activate PPAR-gamma –> upreg GLUT4, adiponectin –> decrease insulin resistance

98
Q

3rd part of duodenum: location

A

L3: across abd aorta & IVC

99
Q

calcineurin inh: drugs

A
  • cyclosporine

- tacrolimus

100
Q

what subst prolong phase 4 of nodal tissue?

A
  • Ach

- adenosine

101
Q

synovitis: charact

A
  • pain
  • erythema
  • swelling
  • reduced ROM in jt
102
Q

osteogenesis imperfecta: mode of inheritance

A

AD

103
Q

Tay Sachs dz: pathophys

A

B-hexosaminidase A def –> accum GM2 ganglioside

104
Q

ID spinal level: lat gray matter horns

A

thoracic & early lumbar

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