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UWorld > 6.30.16 > Flashcards

6.30.16 Flashcards

1
Q

hypervent –> leads to?

A

decrease arterial pCO2 –> hypocapnia –> cerebral vasoconstrict –> decrease cerebral blood flow

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2
Q

dev milestones: 12mo

A
  • gross motor: stand, walk first steps indep, throw ball
  • fine motor: 2 finger pincer grasp
  • lang: first words (not mama, dada)
  • social/cog: sep anxiety, follow 1 step command w gesture
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3
Q

hereditary hypothalamic diabetes insipidus: #1 etiology

A

pt mutation in neurophysin II –> insuff ADH release into systemic circ

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4
Q

endometriosis: ssx

A
  • asymptomatic

- dysmenorrhea, dyspareunia, infertile

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5
Q

dev milestones: 3yo

A
  • social/cog: imaginative play
  • lang: 3 word sentences
  • fine motor: copy a circle, use utensils
  • gross motor: ride a tricycle
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6
Q

Hodgkin lymphoma: histology

A

LN bx: Reed-Sternberg cell –> abundant cyto, bilobed/double nuclei, inclusion-like eosinophilic nucleoli

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7
Q

when is west nile virus usu transmitted?

A

summer

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8
Q

what is: thrombotic thrombocytopenic purpura

A

impaired ADAMTS13 (wWF cleaving protease) fx –> uncleaved multimers that are significantly more prothrombotic –> diffuse microvasc thrombosis –> microangiopathic hemolytic anemia, thrombocytopenia

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9
Q

total filtration rate: calc

A

GFR x plasma [A]

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10
Q

differentiate: TTP vs DIC

A
  • TTP: thrombosis –> increased bleeding time, normal PT/PTT

- DIC: thrombosis + bleed –> increased PT/PTT

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11
Q

thiazolidinedione: MOA

A

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

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12
Q

west nile virus –> how dx?

A

1) clinical findings

2) CSF –> anti-WNV Ab

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13
Q

Whipple dz: histology

A

small intestine mucosa containing enlarged, foamy macrophage packed w rod-shaped bacilli & PAS+ diastase-resistant granules

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14
Q

net renal excretion rate of subst: calc

A

total filtration rate - total tubular resorption rate

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15
Q

what is: acute rheumatic fever

A

autoimmune rxn following an untreated GAS pharyngitis

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16
Q

subarachnoid hemorrhage: tx

A

nimodipine (CCB) –> prevent cerebral vasc spasm –> decrease morbidity, mortality

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17
Q

acute promyelocytic leukemia: cytogenetic abnormality

A

t(15; 17)

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18
Q

dev milestones: 2yo

A
  • gross motor: stairs w both feet on each step, jump
  • fine motor: build 6-cube tower, copy a line, turn page
  • lang: 50+ vocab, 2word phrase
  • social/cog: follow 2step command, parallel play, begin toilet training
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19
Q

MEN1: clinical features

A
  • 1ary PTH –> hyperCa –> renal stone
  • pit tumor –> prolactin, bitemporal visual defect
  • pancreatic tumor –> usu gastrinoma
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20
Q

what are the mult endocrine neoplasias?

A
  • MEN1: 3 P’s –> tumors of pit, PTH, pancreas
  • MEN2A: medullary thyroid CA, pheo, PTH hyperplasia
  • MEN2B: medullary thyroid CA, pheo, mucosal neuroma/marfanoid habitus
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21
Q

dev milestones: 5yo

A
  • gross motor: skip, walk backward
  • fine motor: copy a triangle, tie shoelace, indep dress/bath, print letters
  • lang: count to 10, 5word sentence
  • social/cog: has friends, complete toilet training
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22
Q

streptomycin: use

A
  • TB
  • plague
  • tularemia
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23
Q

where do most gastric ulcers occur?

A

lesser curvature of stomach –> border bw acid-secreting & gastrin-secreting mucosa

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24
Q

subarachnoid hemorrhage: comp

A

vasospasm –> altered mental status, focal neuro deficits

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25
Q

leuprolide: MOA?

A

gonadotropin-releasing hormone analog –> transient increase in LH –> increase testosterone –> continuous leuprolide use –> suppress LH release –> decrease testosterone production

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26
Q

what is: granulosa cell tumor

A

sex cord stromal tumor of ovary that secrete estrogen –> endometrial hyperplasia

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27
Q

serum sickness: clinical findings

A
  • fever
  • pruritic skin rash
  • arthralgia
  • low serum C3, C4
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28
Q

DRESS synd: ssx

A
  • fever
  • gen LAD
  • facial edema
  • diffuse skin rash
  • eosinophilia
  • internal organ dysfx
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29
Q

what happens when severe aortic stenosis pts get A-fib?

A

sudden loss of normal atrial contraction that contribute to V filling:

  • decrease LV preload –> severe hypotension
  • blood build up in LA & pulm veins –> increase pulm venous pressure –> acute pulm edema
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30
Q

dev milestones: 18mo

A
  • gross motor: run, kick ball
  • fine motor: build tower of 2-4 cubes, remv clothing
  • lang: 10-25 word vocab, ID >1 body part
  • social/cog: understand “mine”, begin pretend play
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31
Q

west nile virus –> can lead to?

A

neuroinvasive dz:

  • encephalitis
  • meningitis
  • flaccid paralysis
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32
Q

differentiate: 1ary vs 2ndary hemostasis disorder –> clinical features

A
  • 1ary: skin & mucosal bleed –> epistaxis, menorrhagia, GI bleed, hematuria, easy bruise
  • 2ndary: deep tissue bleed into muscles & jts, rebleed after surg procedures
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33
Q

Dx: normal PT, normal aPTT, low platelet, increased bleeding time

A

immune thrombocytopenia

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34
Q

serum sickness: histology

A

small vessel vasculitis w fibrinoid necrosis & intense neutrophil infiltration

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35
Q

granulosa cell tumor: histology? gross?

A

gross: unilat yellow tumor –> lipid in theca cells
histology: Call-Exner bodies –> cells arranged in microfollicular/rosette pattern around a pink eosinophilic center; coffee bean nuclei

36
Q

streptomycin: what is? MOA?

A

aminoglycoside –> inactivate 30S ribosomal subunit –> inh protein syn

37
Q

dev milestones: 4yo

A
  • gross motor: balance & hop on 1 foot
  • fine motor: copy a square
  • lang: ID colors, speech 100% intelligible
  • social/cog: cooperative play
38
Q

fibroids: ssx

A
  • heavy menses w or w/out clots
  • constipation, urinary freq, pelvic pain/heaviness
  • irreg enlarged uterus
39
Q

endometriosis: pathophys

A

extrauterine endometrium –> bleed & shed –> blood collections in ectopic locations –> eventually hemolysis –> induce inflamm –> adhesion formation –> distort organ struct & fx:

  • adhesion interfere w ovulation & FT fx –> infertile
  • uterosacral lig –> fixed, retroverted uterus
  • post cul de sac –> painful intercourse
  • shed ectopic tissue –> dysmenorrhea
40
Q

Dx: normal PT, normal aPTT, normal platelet, increased bleeding time

A

uremic platelet dysfx

41
Q

damage lat corticospinal tract –> leads to?

A

spastic weakness

42
Q

why is there hyperCa in sarcoidosis?

A

activated macrophage –> form 1,25-dihydroxyvitD (indep of PTH) –> intestine –> increase absorb Ca

43
Q

what is: serum sickness

A

type III HSN to nonhuman proteins –> immune complex –> deposit in tissues –> vasculitis

44
Q

acute rheumatic fever: clinical manifestations

A
  • arthritis
  • carditis
  • Sydenham chorea
  • erythema marginatum
  • subcut nodules
45
Q

what are the hemodynamics of severe aortic stenosis?

A

1) severe stenosis impairs LV output
2) higher systolic pressure cause LV hypertrophy
3) atrial contraction necess for filling of stiffened LV

46
Q

RET mutation –> what thyroid CA?

A

medullary thyroid CA (MEN2)

47
Q

Thayer-Martin selective medium: what is? for what?

A

chocolate (heated blood) agar w:

  • vancomycin –> G+
  • colistin (polymyxin) –> G-
  • nystatin –> fungus
  • trimethoprim –> G-

used to isolate Neisseria from clinical cultures

48
Q

acute rheumatic fever: what Ab form? what do they do?

A

anti-group A strep Ab:

  • M protein: attack myosin (cardiac protein)
  • N-acetyl-beta-D-glucosamine: attack lysoganglioside (neuronal cell surface protein)
49
Q

what is: neurophysin

A

carrier protein –> carry oxytocin & vasopressin –> from site of production at hypo –> to site of release at post pit

50
Q

trauma, sustained pressure to neck of fibular –> leads to?

A

common peroneal N injury as it courses superficially & laterally to this struct

51
Q

vWF def: clinical presentation

A

lifelong h/o mucosal bleeding –> gingival bleed, epistaxis, menorrhagia

52
Q

what is: subacute cerebellar degen

A

paraneoplastic synd assoc w:

  • small cell lung CA
  • breast, ovary, uterine CA
53
Q

endometrial CA/hyperplasia: ssx

A
  • hx of obesity, nulliparity, or chronic anovulation
  • irreg, intermenstrual, or postmenopausal bleed
  • small, nontender uterus
54
Q

paraneoplastic cerebellar degen: ssx

A
  • progressively worsening dizzy
  • limb & truncal ataxia
  • dysarthria
  • visual disturb
55
Q

Dx: normal PT, normal/high aPTT, normal platelet, increased bleeding time

A

vWF def

56
Q

what can you use to estimate GFR? why?

A

inulin clearance –> neither secreted nor resorbed

57
Q

DRESS synd: cause

A
  • anticonvulsant –> phenytoin, carbamazepine
  • allopurinol
  • sulfonamide –> sulfasalazine
  • abx –> minocycline, vancomycin
58
Q

LE: superficial lymphatic system

A
  • medial track: superficial inguinal LN

- lateral track: popliteal –> deep inguinal

59
Q

Dx: increased PT, increased aPTT, low platelet, increased bleeding time

A

DIC

60
Q

what is: metrorrhagia

A

bleed at irreg intervals

61
Q

friedreich ataxia: degen of?

A
  • spinocerebellar tract

- dorsal column, DRG

62
Q

auer rod –> indicates?

A

acute myeloblastic leukemia

63
Q

what is: Whipple dz

A

rare systemic illness that involve small intest, jt, CNS caused by actinomycete Tropheryma whippelii

64
Q

what is: Sydenham chorea

A

non-rhythmic mvmts of hands, feet, face

65
Q

what is: transport maximum

A

kidney tubule: max rate at which subst can be resorbed

66
Q

common peroneal N injury: ssx

A

weak foot:

  • dorsiflexion
  • eversion

sensory loss:

  • dorsal foot
  • lat shin
67
Q

what is the M3 variant of AML?

A

acute promyelocytic leukemia

68
Q

p53 mutation –> what thyroid CA?

A

anaplastic thyroid CA

69
Q

Dx: normal PT, increase aPTT, normal platelet, normal bleeding time

A

hemophilia A & B

70
Q

what is: erythema marginatum

A

faintly erythematous, circular lesions w central clearing that come and go on trunk & extremities

71
Q

adenomyosis: ssx

A
  • dysmenorrhea, pelvic pain
  • heavy menses
  • bulky, globular & tender uterus
72
Q

DRESS synd: onset

A

2-8wk after exposure to drug

73
Q

paraneoplastic cerebellar degen: pathophys

A

immune response against tumor cells –> cross react w Purkinje neuron antigens –> acute onset rapid cerebellar degen

74
Q

granulosa cell tumor: who?

A

postmenopause

75
Q

what is: menometrorrhagia

A

prolonged or excessive uterine bleeding occurs irregularly and more frequently

76
Q

what is: infliximab

A

chimeric monoclonal antibody biologic drug that works against tumor necrosis factor alpha (TNF-α) and is used to treat autoimmune diseases

77
Q

gastric ulcers can penetrate what BV?

A

L & R gastric A

78
Q

RAS mutation –> what thyroid CA?

A
  • follicular thyroid CA

- some follicular adenomas

79
Q

hepatic encephalopathy: pathophys

A

adv liver fail –> can’t metabolize N waste products –> hyperammonemia –> cross blood-brain barrier –> taken up by astrocytes –> ammonia + glutamate –> glutamine –> increase intracell osmolarity –> astrocyte swell –> can’t release glutamine –> no glutamine for neurons –> no glutamate –> disrupt excitatory neurotransmission

80
Q

prostate cancer: tx

A

androgen deprivation tx:

  • surgical orchiectomy
  • pharm suppression of testosterone production –> leuprolide
81
Q

thiazolidinedione: onset of axn

A

several days - few weeks: bc dep on alter gene expression & subseq protein syn

82
Q

what is: menorrhagia

A

heavy flow

83
Q

Dx: normal PT, increased aPTT, normal platelet, normal bleeding time

A

heparin admin

84
Q

what is: adiponectin

A

cytokine secreted by fat tissue:

  • increase # of insulin-responsive adipocytes
  • reg ffa oxidation
85
Q

what are the Ab involved in paraneoplastic cerebellar degen?

A

anti-Yo, anti-P/Q, anti-Hu Ab

86
Q

Dx: increased PT, increased aPTT, normal platelet, normal bleeding time

A

warfarin use

87
Q

friedreich ataxia: ssx

A
  • cerebellar ataxia
  • loss of position/vibration sense
  • kyphoscoliosis
  • hypertrophic cardiomyopathy
  • foot abnormal
  • DM

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