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UWorld > 6.26.16 > Flashcards

6.26.16 Flashcards

1
Q

obstructive sleep apnea: pathophys

A

sleep –> upper airway –> recurrent obstruct –> reduce ventilation –> transient hypercapnia, hypoxemia:

  • reflexive systemic & pulm vasoconstrict
  • sym cardiac stim
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2
Q

differentiate: class IA vs IB antiarr –> preferentially bind?

A

IC: open Na channel –> areas of normal automaticity
IB: inactivated Na channel –> areas of ischemia –> rapidly depolarize

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3
Q

class IA antiarrh: MOA

A

1) block Na channel –> depress phase 0 depolarization
2) moderate block K channel –> prolong repolarization
==> increase AP duration

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4
Q

injure cervical symp ganglia –> manifestation?

A

Horner synd

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5
Q

heroin withdrawal: key ssx

A
  • dilated pupil
  • yawn
  • lacrimation
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6
Q

alcohol withdrawal w adv liver dz –> tx?

A

benzo without active metabolites –> lorazepam, oxazepam, temazepam

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7
Q

absence + tonic clonic sz –> tx?

A

valproate

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8
Q

what is: permissiveness

A

hormone allow another to exert its max effect

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9
Q

Dx: “bunches of grapes”

Caused by?

A

complete mole

trophoblast prolif

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10
Q

Dx: low LPL

A

familial chylomicronemia synd

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11
Q

how is copper eliminated?

A

secrete into bile –> excreted in stool

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12
Q

absence + tonic clonic sz –> tx –> ethosuximide?

A

no –> does not suppress tonic clonic sz

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13
Q

what is: celecoxib

A

selective COX2 inh

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14
Q

spasticity: clinical presentation

A
  • muscle stiff
  • painful muscle spasm
  • scissoring gait
  • lack of dexterity
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15
Q

T/F: familial hyperchol –> premature coronary artery dz?

A

T

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16
Q

dystrophin: fx

A

allow interaxn bw extracell CT & intracell contraction apparatus

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17
Q

what hormone exerts permissiveness?

A

cortisol

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18
Q

alcohol/benzo withdrawal: key ssx

A

sz

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19
Q

nitrate: MOA

A

vasc smooth muscle relax –> systemic vasodilate –> decrease LVEDV, wall stress –> decrease preload –> decrease myocardial O2 demand –> relieve angina ssx

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20
Q

what cytokines are produced in response to viral infect?

A

IFN a & B

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21
Q

suspensory lig of ovary: contains?

A

ovarian A, V, N, lymphatics

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22
Q

How do IFN a & B halt protein syn in virus infected cells?

A

signalling –> transcribe antiviral enzymes that can halt protein syn –> become active only in presence of dsRNA ==> inh protein syn only in virus infected cells

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23
Q

radial N injury: cause

A

repetitive pressure/trauma at axilla

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24
Q

huntingtin protein –> expand CAG trinucleotide repeats: effect?

A

gain of fx –> increase histone deacetylation –> repress transcription (silence) –> no neurotrophic factors –> neuron cell death

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25
Q

what is: lipid A

A

toxic component of LPS

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26
Q

difrerentiate: Duchenne vs Becker musc dystrophy –> type of mutation?

A

DMD: deletion –> frameshift
BMD: deletion –> no frameshift

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27
Q

2ndary bact pneumonia: 3 most common org

A 
#1 strep pneumo
#2 staph aureus 
#3 H flu
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28
Q

UV damaged DNA: repair mechanism?

A

nucleotide excision repair

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29
Q

renal A stenosis: who?

A
  • elder (atherosclerosis)

- F of childbearing age (fibromusc dysplasia)

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30
Q

alcohol withdrawal –> tx?

A

benzo

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31
Q

“-cept” suffix: what kind of drug?

A

receptor mole

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32
Q

complete mole: karyotype?

A

46 XX or XY (paternal DNA only)

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33
Q

patella fracture: ssx

A
  • acute swollen knee
  • focal patella tender
  • can’t extend knee against gravity
  • palpable gap in extensor mechanism
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34
Q

complete mole: immunohist? why?

A

p57-

absence of maternal genome

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35
Q

ant cmpt of leg –> acute compartment synd –> will affect what struct?

A
  • deep peroneal (fibular) N

- ant tibial A & V

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36
Q

infraorbital N injury: ssx

A

paresthesia:
- upper cheek
- upper lip
- upper gingiva

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37
Q

T/F: familial dysbetalipoproteinemia –> premature coronary artery dz?

A

T

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38
Q

septic shock: ssx

A
  • fever
  • hypotension
  • diarrhea
  • oliguria
  • vasc compromise
  • DIC
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39
Q

CT: location of esophagus

A
  • bw trachea & vertebral bodies

- typically collapsed w no visible lumen

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40
Q

what type of dyslipidemia: tendon xanthoma

A

hyperchol

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41
Q

what can damage iliohypogastric N?

A

abd surg –> appendectomy

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42
Q

antipsychotics –> block CNS D2 receptor –> AE?

A

disrupt tuberoinfundibular pathway –> hyperprolactinemia –> galactorrhea, amenorrhea

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43
Q

what are the hydrophobic aa?

A
  • alanine
  • valine
  • leucine
  • isoleucine
  • phenylalanine
  • tryptophan
  • methionine
  • proline
  • glycine
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44
Q

colchicine: MOA

A

bind tubulin –> inh microtubule formation –> impair neutrophil mitosis, chemotaxis

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45
Q

complete mole –> treated –> must monitor what? why?

A

B-hCG

high risk for malig transformation –> invasive mole, choriocarcinoma

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46
Q

“-nib” suffix: what kind of drug?

A

kinase inh

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47
Q

norovirus gastroenteritis: ssx

A
  • vomit

- watery diarrhea

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48
Q

decreased V compliance –> leads to?

A

diastolic heart fail

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49
Q

Dx: unilat kidney atrophy

A

renal A stenosis

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50
Q

diastolic heart fail –> effect on: LVEF, LVEDV, LV filling pressure

A
  • LVEF: normal
  • LVEDV: normal
  • LV filling pressure: increased
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51
Q

lactose intolerance: pathophys

A

lactase def

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52
Q

heroin is what type of subst?

A

opioid

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53
Q

Duchenne musc dystrophy: who?

A

2-5yo M

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54
Q

pernicious anemia: pathophys

A

autoimmune –> CD4+ T cells –> destroy parietal cell

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55
Q

IFN a & B: role in viral infect

A

suppress viral replication:
- halt protein syn
- promote apoptosis of infected cells
==> limit virus ability to spread

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56
Q

baclofen: MOA

A

GABA-A receptor agonist –> decrease excitability of spinal reflexes

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57
Q

radial N injury: motor findings

A

weak extensors:

  • forearm
  • hand
  • finger

==> wrist drop, absent triceps reflex

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58
Q

direct frontal trauma to orbit –> fractures what?

A

orbital floor

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59
Q

name a microsomal monooxygenase

A

CYP450

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60
Q

cortisol –> permissiveness –> effect?

A
  • increase glucose release by liver in response to glucagon

- increase vasc & bronchial SM reactivity to catecholamines

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61
Q

dystrophin gene: location

A

X chrom p21

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62
Q

what mutation causes mast cell prolif?

A

KIT

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63
Q

norovirus outbreaks: where?

A

school, cruise ship, nursing homes

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64
Q

CYP450 –> role in carcinogen?

A

convert pro-carcinogen to active carcinogen

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65
Q

lipid A: pathophys

A

activate macrophage –> widespread IL-1, TNFa release –> septic shock

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66
Q

complete mole: US

A

diffuse echogenic material –> “snowstorm”

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67
Q

tuberoinfundibular pathway: fx

A

inh prolactin secretion

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68
Q

major basic protein: where? fx?

A

eosinophil granules –> help defend against parasite

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69
Q

X chrom p21 mutation –> dx?

A

DMD or BMD

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70
Q

complete mole: high B-hCG –> leads to?

A
  • hyperemesis gravidarum

- theca lutein cysts (d/t stim ovarian growth)

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71
Q

direct impact to ant aspect of knee –> leads to?

A

patella fracture

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72
Q

what induces CYP450?

A
  • carbamazepine
  • barbiturates
  • phenytoin
  • rifampin
  • griseofulvin
  • St John’s wort
  • modafinil
  • cyclophosphamide
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73
Q

etanercept: use

A

mod-severe RA –> adjunct to methotrexate if methotrexate alone not work

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74
Q

dx: wrist drop, absent triceps reflex

A

radial N injury

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75
Q

differentiate: alcohol vs benzo withdrawal

A

alcohol: delirium
benzo: no delirium

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76
Q

what type of dyslipidemia: acute pancreatitis

A

familial chylomicronemia synd

77
Q

radial N injury: sensory findings

A

sensory loss:

  • post arm, forearm
  • dorsolat hand
  • dorsal thumb
78
Q

Duchenne musc dystrophy: pathophys

A

dystrophin deletion

79
Q

skeletal muscle contraction: Ca2+ fx?

A

SR –> release Ca2+ –> bind troponin C –> allow actin to bind myosin

80
Q

what is: power

A

probability of seeing a difference when there is one

81
Q

what is: B-endorphin

A

endogenous opioid peptide

82
Q

how does sun exposure cause DNA damage?

A

UV –> create pyrimidine dimers

83
Q

Dx: dilated pupils, piloerection, hyperactive bowel sounds, lacrimation, yawning

A

opioid withdrawal

84
Q

nigrostriatal pathway: fx

A

regulates coordination of vol mvmt

85
Q

ipsilat shoulder pain, upper limb paresthesia, areflexic arm weak –> what struct is injured?

A

brachial plexus

86
Q

etanercept: MOA

A

decoy receptor for TNFa –> inh TNFa

87
Q

acute pancreatitis: 2 most common causes

A 
#1 gallstone
#2 alcohol abuse
88
Q

where is: cerebellopontine angle

A

bw cerebellum & lateral pons

89
Q

Dx: macrocytosis, AST:ALT >2

A

chronic alcohol use

90
Q

what type of dyslipidemia: eruptive skin xanthoma

A

hyperTG

91
Q

spasticity is a common problem in what dz?

A

mult sclerosis

92
Q

what stimulates gastric acid secretion?

A
  • histamine
  • ACh
  • gastrin
93
Q

acoustic neuroma: common location

A

cerebellopontine angle

94
Q

auer rod found in what cell?

A

myeloblast

95
Q

radical mastectomy w axillary lymph node dissection: comp

A

chronic lymphedema –> angiosarcoma

96
Q

what is: systemic mastocytosis

A

abnormal prolif of mast cells –> increase hist release

97
Q

acoustic neuroma: ssx

A
  • sensorineural hearing loss

- tinnitis

98
Q

chlordiazepoxide: drug class?

A

benzo

99
Q

Duchenne musc dystrophy: how does it manifest?

A
  • proximal muscle weak

- distal muscle enlarge

100
Q

acute compartment synd: most common location

A

ant cmpt of leg

101
Q

acute compartment synd: ssx

A
  • severe pain
  • myonecrosis
  • N injury
102
Q

protein –> mult a-helical regions –> composed of valine, alanine, isoleucine –> what is the fx of this region?

A

anchor to cell membrane

103
Q

complete mole: trophoblast secretes?

A

B-hCG

104
Q

contact dermatitis: what happens with chronic exposure?

A

lesions become less edematous –> stratum spinosum & corneum thicken

105
Q

status epilepticus: initial tx

A

IV lorazepam + phenytoin

106
Q

differentiate: opioid vs alcohol/benzo withdrawal: how serious?

A
  • opioid: non-life threatening

- alcohol/benzo: sz

107
Q

iliohypogastric N: fx

A

sensory:
- suprapubic
- gluteal

motor:
- ant-lat abd wall muscles

108
Q

orbital floor fracture –> why is vertical gaze impaired?

A

inf rectus M become entrapped

109
Q

compound nevus: lesion

A

slight raised papule –> uniform pigment, symm sharp border

110
Q

can HTN lead to hypertrophic cardiomyopathy?

A

no

111
Q

familial chylomicronemia synd: onset?

A

childhood

112
Q

Dx: Gower sign & calf enlargement

A

DMD

113
Q

what is the major blood supply to the ovary?

A

ovarian A

114
Q

carbamazepine: MOA

A

reduce Na channel ability to recover from inactivation –> inh neuronal high-freq firing

115
Q

phenytoin: MOA

A

Na channel –> decrease ability to recover from inactivation –> inh neuron high freq firing

116
Q

MI –> ventricular arrhythmia –> tx?

A

amiodarone

117
Q

high levels of what decrease risk for gallstone?

A

bile salt & phosphatidylcholine –> increase chol solubility

118
Q

carbamazepine: need to monitor what? why?

A

BM suppress –> monitor CBC

119
Q

what inflamm dz can cause 2ndary (acquired) lactose intolerance?

A

celiac dz

120
Q

what infection can cause 2ndary (acquired) lactose intolerance?

A

giardia

121
Q

obstructive hydrocephalus: ssx

A
  • papilledema
  • HA
  • vomit
122
Q

what type of dyslipidemia: xanthelasma

A

hyperchol

123
Q

what does proopiomelanocortin (POMC) produce?

A
  • B-endorphins
  • ACTH
  • MSH
124
Q

tachycardia, HTN, hyperthermia, diaphoresis, mydriasis –> intoxicated w what subst?

A

stimulant

125
Q

familial chylomicronemia synd: clinical manifestation

A
  • recurrent acute pancreatitis
  • hyperTG
  • lipemia retinalis
126
Q

what is: infliximab

A

monoclonal Ab –> irrev bind & inh TNF-a

127
Q

what is: Gower sign

A

use hands to get up –> compensate for proximal muscle weak

128
Q

defect in nucleotide excision repair –> leads to?

A

xeroderma pigmentosum

129
Q

nucleotide excision repair: MOA

A

1) endonuclease complex –> recog deformed helix –> single strand cleavage on both sides
2) damaged segment discarded
3) DNApol –> synthesize new segment
4) DNA ligase –> ligate gap

130
Q

dorsal midbrain (Parinaud) synd: charact

A
  • limited upward gaze
  • bilat eyelid retraction
  • light-near dissoc (pupil react to accommodation but not to light)
131
Q

what is: Stewart-Treves synd

A

chronic lymphedema –> predispose to angiosarcoma

132
Q

nicotine withdrawal: key ssx

A

increased appetite

133
Q

when is LPS released?

A

bacterial cell:

  • divide
  • lyse

LPS is NOT actively secreted!

134
Q

contact dermatitis: histology

A

spongiosis –> accumulation of edema fluid in intercell spaces of epidermis

135
Q

systemic mastocytosis: ssx

A
  • hypotension
  • flushing
  • pruritis
  • gastric hypersecrete
136
Q

germinoma: clinical presentation

A
  • obstructive hydrocephalus
  • dorsal midbrain (Parinaud) synd
  • endocrinopathy (if in suprasellar region –> pit/hypo dysfx)
137
Q

stimulant (cocaine, amphetamine) withdrawal: key ssx

A
  • intense psychomotor retardation

- severe depression (“crash”)

138
Q

what is the precursor to nitric oxide?

A

arginine

139
Q

contact dermatitis: gross findings

A

erythematous, papulovesicular, weeping lesions

140
Q

complete mole: composed of?

A

edematous hydropic villi –> “bunches of grapes”

141
Q

radial N: fx

A

motor: extensors –> forearm, hand, finger

sensory:
- post arm, forearm
- dorsolat hand
- dorsal thumb

142
Q

Dx: benign prolif of melanocytes –> dermis & epidermis

A

compound nevus

143
Q

giardia –> can lead to?

A

lactose intolerance

144
Q

acid a-glucosidase: fx

A

brkdown glycogen in lysosome

145
Q

lots of auer rods can be found in what dz?

A

acute promyelocytic leukemia

146
Q

IV lorazepam + phenytoin for initial tx of status epilepticus –> role of each?

A

lorazepam: stop sz
phenytoin: prevent sz recurrence

147
Q

signs of radial N injury but triceps brachii is spared –> dx?

A

distal radial N injury

148
Q

what nerve is found at the orbital floor?

A

infraorbital N

149
Q

what is: status epilepticus

A
  • 1 sz –> >5min

- mult sz –> incomplete recovery of consciousness bw episodes

150
Q

Pompe dz: ssx

A

early infancy:

  • cardiomegaly
  • macroglossia
  • profound musc hypotonia
151
Q

alcohol abuse: liver lab finding?

A

> 2 AST: ALT

152
Q

what is: spasticity

A
  • increase resistance to passive muscle mvmt

- velocity-dep increase in tonic stretch reflex

153
Q

2ndary (acquired) lactose intolerance: pathophys

A

inflamm, infect –> damage microvilli –> damage cells slough off –> immature cells replace –> low lactase

154
Q

brain, spinal cord dz –> spasticity –> tx?

A
  • baclofen

- tizanidine

155
Q

gamma-glutamyl transpeptidase (GGTP): use

A

GGTP predominantly present in hepatocytes & biliary epithelia –> determine whether elevated alk phos is of hepatic of bony origin

156
Q

acid a-glucosidase def –> leads to?

A

Pompe dz

157
Q

power: calc

A

1-B

B = type II error rate

158
Q

what is: auer rod

A

deformed azurophilic granules in myeloblast cyto –> stain positively for myeloperoxidase

159
Q

improperly fitted crutches –> lead to?

A

“crutch palsy” (proximal radial N injury)

160
Q

what is: eczematous dermatitis

A

grp of conditions charact by erythematous, papulovesicular, weeping lesions

161
Q

hypertrophic cardiomyopathy: pathophys

A

AD –> cardiac sarcomere –> severe myocardial hypertrophy

162
Q

Duchenne musc dystrophy: mode of inheritance

A

XR

163
Q

trigeminal neuralgia –> tx?

A

carbamazepine

164
Q

nitric oxide synthase: rxn

A

arginine –> nitric oxide

165
Q

what inh CYP450?

A
  • amiodarone
  • cimetidine
  • fluoroquinolone
  • clarithromycin
  • azole antifungal
  • grapefruit juice
  • isoniazid
  • ritonavir (protease inh)
166
Q

cryptococcus neoformans: most common manifestation

A

meningoencephalitis

167
Q

what is another name for the suspensory lig of ovary?

A

infundibulopelvic lig

168
Q

elder –> insomnia –> tx?

A

ramelteon

169
Q

acoustic neuroma: derived from?

A

vestibulocochlear N –> vestibular portion –> Schwann cell

170
Q

what is: suspensory lig of ovary

A

fold of peritoneum that attach ovary to pelvic sidewall

171
Q

what part of brain is responsible for inh prolactin secretion?

A

tuberoinfundibular pathway

172
Q

what is the major form of copper in the human body?

A

ceruloplasmin

173
Q

alcohol withdrawal: ssx

A
  • insomnia
  • tremulous
  • anxiety
  • autonomic hyperactivity
174
Q

dx: suprapubic region –> decrease sensation, burning pain

A

iliohypogastric N injury

175
Q

obstructive sleep apnea: comp

A
  • systemic HTN

- pulm HTN –> RH fail

176
Q

Pompe dz: muscle bx

A

lysosomes –> abnormal glycogen accumulation

177
Q

to avoid excessive bleed during oophorectomy, the surgeon should ligate what struct?

A

suspensory lig of ovary

178
Q

what is the most common pineal gland tumor?

A

germinoma

179
Q

T/F: familial chylomicronemia synd –> premature coronary artery dz?

A

F

180
Q

familial chylomicronemia synd: enzyme

A

lipoprotein lipase

181
Q

mesolimbic & mesocortical pathway: fx

A

regulate cognition, beh

182
Q

what are the major dopaminergic pathways in the brain?

A
  • mesolimbic & mesocortical
  • nigrostriatal
  • tuberoinfundibular
183
Q

angiosarcoma: RF

A

chronic lymphedema

184
Q

complete mole: classic clinical findings

A
  • 1st trimester –> vaginal bleed
  • enlarged uterus inconsistent w dates
  • extremely high B-hCG
185
Q

viral gastroenteritis: #1 cause?

A

norovirus

186
Q

acute compartment synd: cause

A

increased pressure in fascial compartment of limb –> impair perfusion

187
Q

E.coli –> septic shock –> what bacterial factor caused it?

A

lipid A

188
Q

Pancoast tumor: can involve what struct?

A
  • brachial plexus

- cervical sym ganglia

189
Q

Pompe dz: enzyme?

A

acid a-glucosidase

UWorld (28 decks)

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