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UWorld > 6.27.16 > Flashcards

6.27.16 Flashcards

1
Q

hypocretin: what is? fx?

A

hypocretin-1 (orexin A), hypocretin-2 (orexin B) –> neuropeptides produced in lat hypo

  • promote wakefulness
  • inh REM sleep-related phenomena
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2
Q

factitious disorder: key feature

A

intentional falsification or inducement of ssx to assume sick role

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3
Q

Dx: pseudopalisading tumor cells around areas of necrosis

A

glioblastoma multiforme

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4
Q

CA-125: use

A

cancer marker for epithelial ovarian CA –> dx & fu tx

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5
Q

varicose vein: comp

A
  • superficial venous thrombosis
  • venous stasis ulcer –> usu over medial malleolus

NOT thromboembolism

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6
Q

Meyer’s loop injury –> leads to?

A

contralat sup quadrantanopia

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7
Q

Dx: hypocretin-1 def

A

narcolepsy

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8
Q

illness anxiety disorder: key feature

A

fear of having serious illness despite few/no ssx + consistently neg evals

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9
Q

cancer antigen 125 (CA-125): assoc dz

A

epithelial ovarian CA

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10
Q

Hashimoto thyroiditis: histology

A
  • lymphocyte infiltrate w germinal centers

- Hurthle cells (eosinophilic epithelial cells)

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11
Q

ethylene glycol ingestion: clinical findings

A
  • anion gap metab acidosis
  • increased osmolar gap
  • calcium oxalate crystals in urine
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12
Q

what is: cataplexy

A
  • conscious, brief episodes of sudden bilat muscle tone loss –> precipitated by emotion (laugh, joke)
  • spont, abnormal facial mvmt w/out emotional trigger
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13
Q

Dx: pt from Central/South America –> sz

A

neurocystocercosis

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14
Q

what is: dorsal optic radiation

A

upper fibers of optic radiation –> carry info from upper retina (lower contralat visual field)

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15
Q

how is isoniazid metab?

A

by acetylation

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16
Q

what is the signifiance of glycerol kinase in DKA?

A

gluconeogenesis:
1) adipose –> brkdown TG –> glycerol
2) liver, kidney –> glycerol kinase –> glycerol –> glucose

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17
Q

Meyer’s loop: what route?

A

LGN –> temporal lobe –> lingual gyrus of striate cortex

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18
Q

what is another name for cobalamin?

A

vitB12

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19
Q

Dx: painless thyroiditis

A

Hashimoto thyroiditis

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20
Q

what is the most common urea cycle disorder?

A

ornithine transcarbamylase def

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21
Q

subacute granulomatous (de Quervain) thryoiditis: onset

A

following viral illness

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22
Q

congenital hypothyroid: cause

A
  • thyroid dysgenesis

- iodine def

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23
Q

cutaneous post calf: drains to what LN?

A

deep inguinal

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24
Q

spongiform encephalopathy: histology

A
  • vacuoles in gray matter

- no inflamm changes

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25
Q

interstitial lung dz: why increased expiratory flow rate?

A

fibrotic interstitial tissue –> decrease lung vol, increase lung elastic recoil –> increase radial traction (outward pulling) on airway –> airway widen –> decrease airflow resistance –> increase expiratory flow rate

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26
Q

Dx: hyperammonemia –> vomit, tachypnea, confuse/coma

A

urea cycle disorder

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27
Q

Blastomyces dermatitidis is endemic to?

A

SE USA

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28
Q

what is: myocardial stunning

A

reversible contractile dysfx

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29
Q

glioblastoma multiforme: gross appearance

A

areas of necrosis & hemorrhage

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30
Q

monoclonal Ab against PD-1: MOA

A

prevent PD-1 blind PD-L1 –> block T cell inh –> restore cytotoxic response –> tumor cell apoptosis

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31
Q

what is: Meyer’s loop

A

lower fibers of optic radiation –> carry info from lower retina (upper contralat visual field)

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32
Q

intracranial mass –> dx?

A

glioblastoma multiforme

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33
Q

hypoK: ssx

A
  • muscle weak
  • cramp
  • possible rhabdomyolysis
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34
Q

diabetes during preg –> neonatal comp –> transient hypoglycemia –> pathophys?

A

exposed to high maternal glucose levels in utero –> excessive fetal insulin production, islet hyperplasia –> hyperinsulinemia persist for several days after birth

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35
Q

epithelial ovarian CA: who?

A

postmenopause

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36
Q

what is another name for vitB12?

A

cobalamin

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37
Q

mitral stenosis: when do you hear the opening snap?

A

early diastole

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38
Q

glans penis: drains to what LN?

A

deep inguinal

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39
Q

conversion disorder: key feature

A

fxal neurologic symptom disorder:

  • neuro ssx incompatible w neuro dz
  • acute onset assoc w stress
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40
Q

Dx: eczema, intell disability, abnormal gait, musty body odor

A

PKU

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41
Q

tumor –> effect on PD-1?

A

increase expression of programmed death receptor 1 ligand (PD-L1) –> inh cytotoxic T cell –> downreg immune response against tumor cell

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42
Q

what is: optic radiation

A

LGN axons that project to striate (1ary visual) cortex

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43
Q

Tourette disorder: who?

A

6-15yo M

44
Q

epistaxis: most common location

A

ant nasal septum –> Kiesselbach plexus

45
Q

optic tract fibers go to?

A

lat genticulate nucleus

46
Q

what muscles are used to sit up from supine position?

A
  • external abd obliques
  • rectus abdominis
  • hip flexors
47
Q

congenital hypothyroid: comp

A

irrev intell disability

48
Q

Dx: hyponia, large ant fontanelle, lrg tongue, reducible umbilical hernia

A

congenital hypothyroid

49
Q

diabetes during preg –> neonatal comp –> what congenital malformation?

A
  • neural tube defect
  • CV anomaly
  • caudal regression synd
50
Q

dietary lipid: digested where?

A

duodenum via pancreatic enzymes

51
Q

rabies vaccine: what type?

A

inactivated

52
Q

diabetes during preg: neonatal comp

A
  • premature
  • fetal macrosomia
  • congenital malformation
  • resp distress
  • transient hypoglycemia
  • polycythemia & hyperviscosity
53
Q

Hashimoto thyroiditis: what Ab will you find?

A

TPO

54
Q

Hashimoto thyroiditis: cause

A

autoimmune

55
Q

superficial inguinal LN: drains to what LN?

A

deep inguinal

56
Q

what muscles make up the hip flexors?

A
  • rectus femoris
  • iliopsoas
  • tensor fascia lata
57
Q

what is: scolex

A

head of tapeworm w hooklets

58
Q

somatic ssx disorder: key feature

A

excessive anxiety & preoccupation w >1 unexplained ssx

59
Q

ornithine transcarbamylase def: charact

A
  • hyperammon (medical emergency!)

- elevated orotic acid in urine

60
Q

PD-1: location

A

surface of activated T cells

61
Q

what is most common ovarian malig?

A

epithelial ovarian CA

62
Q

vitB12 def –> trt w folate –> what happen?

A
  • mod improve Hb level

- can worsen neuro dysfx

63
Q

obstructive sleep apnea –> tx –> nerve stim –> what N? MOA?

A

hypoglossal N –> electrical stim –> tongue mv forward –> increase oropharyngeal airway diameter –> decrease freq of apneic events

64
Q

what is: cysticeri

A

neurocystocercosis: fluid-filled larval cysts surrounding the invaginated scolex

65
Q

malingering: key feature

A

falsification of exaggeration of ssx to obtain external incentives (2ndary gain)

66
Q

testes: drains to what LN?

A

abd para-aortic (retroperitoneal)

67
Q

how do you differentiate bw tuberculoid vs lepromatous leprosy?

A

lepromin skin test :
+ –> tuberculoid (strong CD4+ TH1 cell-med immune reponse to myco leprae)
- –> lepromatous (weak TH1 cell-med immune response)

68
Q

DHP CCB: AE

A
  • HA
  • flushing
  • dizzy
  • peripheral edema
69
Q

why is hyperammon a medical emergency?

A

ammonia –> neurotoxic:

  • episodes of vomit
  • confuse/coma
  • cerebral edema –> tachypnea –> hypervent, resp alk
70
Q

what occurs at Kiesselbach plexus?

A

anatomosis of:

  • ant ethmoidal A
  • sphenopalatine
  • sup labial
71
Q

what is: Anti-Rh immune globulin

A

IgG anti-D Ab –> opsonize Rh+ fetal RBC –> cleared by maternal reticuloendothelial macrophages –> prevent maternal Rh sensitization

72
Q

total myocardial ischemia: when is there loss of cardiomyocyte contractility?

A

60 sec

73
Q

what strongly suggests rabies encephalitis?

A

exposure –> w/in wks –> agitation & spasm –> progress to coma

74
Q

epithelial ovarian CA: histology

A
  • epithelial cell anaplasia
  • invasion of ovarian stroma
  • mult papillary formations w cell atypia
75
Q

congenital hypothyroid: onset

A

asymp at birth –> dev ssx after maternal T4 wanes

76
Q

superficial inguinal LN: drains what?

A

all skin from umbilicus down –> including anus (blow dentate/pectinate line)

Except: testes, glans penis, post calf

77
Q

amlodipine: drug class

A

DHP CCB

78
Q

Anti-Rh immune globulin: given to who? when admin?

A

Rh- F:

  • 28wk gestation
  • immed postpartum
79
Q

dietary lipid: absorbed where?

A

jejunum

80
Q

what drugs inh dihydrofolate reductase?

A
  • trimethoprim
  • methotrexate
  • pyrimethamine
81
Q

Dx: acute renal fail, proximal tubular cell ballooning, vacuolar degen

A

acute tubular necrosis

82
Q

temporal lobe lesion –> can damage what part of visual pathway?

A

Meyer’s loop

83
Q

neurocystocercosis: diagnostic findings

A
  • CT/MRI: cyst, scolex

- eosinophilia

84
Q

urea cycle: rate limiting enzyme

A

carbamoyl phosphate synthetase

85
Q

PKU: mode of inheritance

A

AR

86
Q

can cholescystectomy pt tolerate fatty food? why?

A

yes: no gallbladder ==> bile constant released into duodenum

87
Q

congenital hypothyroid: ssx

A
  • constipation
  • lethargy
  • hypotonia
  • macroglossia
  • umbilical hernia
  • lrg ant fontanelle
88
Q

what is the most important hip flexor?

A

iliopsoas

89
Q

subacute granulomatous (de Quervain) thryoiditis: histology

A

inflamm infiltrate w macrophage & giant cells

90
Q

obstructive sleep apnea: pathogenic mech

A

neuromusc weakness

91
Q

differentiate: vitB12 vs folate def

A

vitB12: megaloblastic anemia + neuro dysfx
folate: megaloblastic anemia

92
Q

acute tubular necrosis: histology

A

proximal tubule cells:

  • vacuolar degen
  • ballooning
93
Q

congenital hypothyroid: tx

A

levothyroxine by age 2wk

94
Q

thiazide diuretic: AE? how?

A

decrease intravasc fluid vol –> stim aldos –> increase excrete K, H –> hypoK, metab alk

95
Q

sex hormones –> effect on bone growth

A
  • bone growth

- epiphyseal plate closure

96
Q

pyrimethamine: use

A
  • malaria

- toxoplasmosis

97
Q

what is: CA-125

A

protein expressed by epithelial cells lining Mullerian organs (ovary, FT) & peritoneum

98
Q

what is: PrP

A

prion protein –> CJD, bovine spongiform encephalopathy

99
Q

DHP CCB: drugs

A

“-dipine” suffix: amlodipine, nifedipine

100
Q

PKU: ssx

A
  • intell disability
  • gait, posture abnormality
  • eczema
  • musty body odor
101
Q

dorsal optic radiation: what route?

A

LGN –> parietal lobe –> cuneus gyrus of striate cortex

102
Q

what is the main source of rabies in the USA?

A

bat

103
Q

glioblastoma multiforme: histology

A

pseudopalisading tumor cells around areas of necrosis

104
Q

Dx: painful thyroiditis

A

subacute granulomatous (de Quervain) thryoiditis

105
Q

differentiate: trimethoprim vs methotrexate vs pyrimethamine

A
  • trimethoprim: bact
  • methotrexate: human cell
  • pyrimethamine: some protozoa
106
Q

ornithine transcarbamylase def: pathophys

A

excess carbamoyl phosphate –> stimulate pyrimidine syn –> orotic acid accum

107
Q

differentiate: chronic tic disorder vs Tourette

A

chronic tic disorder: >1yr –> 1 or more motor or verbal tics (but not both)

Tourette: >1yr –> mult motor tics + at least 1 verbal tic

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