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UWorld > 7.3.16 > Flashcards

7.3.16 Flashcards

1
Q

what is: nondisjunction in meiosis II

A

sister chromatids fail to sep

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2
Q

what is: pulm cap wedge pressure

A

indirect measure of the left atrial pressure

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3
Q

hyaline arteriolosclerosis: cause

A

long-standing:

  • benign HTN
  • DM
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4
Q

Kaposi sarcoma: cell of origin

A

primitive mesenchymal cells

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5
Q

inhibin: fx? secreted by?

A

Sertoli cell –> inhibin –> inh FSH

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6
Q

basal ganglia –> direct pathway: what is?

A

excitatory pathway –> facilitate mvmt:

1) cortex –> (dopamine –> D1 receptor) –> stim striatum
2) striatum -> release GABA
3) disinh thalamus (via globus pallidus internus)

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7
Q

hyperplastic arteriolosclerosis: cause? appearance?

A

malig HTN –> SM hyperplasia –> “onion-skin”

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8
Q

ganciclovir: what will increase risk of neutropenia?

A

co-admin:

  • zidovudine
  • TMP/SMX
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9
Q

what worsens hypertrophic cardiomyopathy?

A

decrease preload/afterload –> decrease LV vol –> worsen dynamic LV outflow tract obstruction:

  • vasodilator: DHP CCB, nitrate
  • diuretic
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10
Q

when do you suspect hypertrophic cardiomyopathy?

A
  • FHx of premature sudden death

- systolic murmur that accentuates w standing from supine position

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11
Q

hepatocell CA: #1 cause

A

HBV

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12
Q

diastolic heart fail: cause? gross appearance?

A

HTN heart dz

  • concentric V hypertrophy
  • decreased LV chamber size
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13
Q

DKA: tx? results in what lab changes?

A

IV normal saline + insulin

insulin:
- utilize glucose –> decrease glucose
- decrease ketone syn –> increase HCO3
- drive K into cell –> decrease K

hydration:
- normalize Na –> increase Na
- decrease serum osmolality

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14
Q

what is: secretin

A

hormone from duodenum –> released in response to acid/fat in small intest:

  • pancreas: secrete HCO3
  • gastric G cell: inh gastrin release
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15
Q

6-mercaptopurine: how activated? inactivated?

A
  • activate: hypoxanthine-guanine phosphoribosyl transferase (HGPRT)
  • inactivate: xanthine oxidase, thiopurine methyltransferase (TMPT)
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16
Q

what indicates a mononucleosis-like synd?

A
  • fever
  • fatigue
  • splenomegaly
  • atypical lymphocytosis

pharyngitis, LAD less common w CMV

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17
Q

JAK2 mutation: pathophys

A

cytoplasmic tyrosine kinase –> constitutively actie –> activate signal transducers and activators of transcription (STAT) proteins –> JAK-STAT signaling pathway

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18
Q

pure motor hemiparesis –> indicates damage to?

A
  • post limb of internal capsule

- basal pons

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19
Q

nocardia –> affects?

A

immunocomp:
- lung –> cavitary infiltrates –> cavitary pneumonia (look like TB)
- brain –> brain abscess
- skin

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20
Q

disinfectant –> iodine –> MOA?

A

halogenate proteins & nucleic acids

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21
Q

hereditary fructose intolerance: enzyme def

A

aldolase B

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22
Q

disinfectant –> chlorhexidine –> MOA?

A
  • disrupt cell membrane

- coag of cytoplasm

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23
Q

Charcot-Bouchard aneurysm: pathophys

A

chronic HTN –> lenticulostriate A –> hyaline arteriolosclerosis –> weak wall –> Charcot-Bouchard microaneurysm

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24
Q

glucagonoma: ssx

A
  • DM
  • necrolytic migratory erythema
  • anemia
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25
Q

how do you test for Strep pyogenes infection?

A

pyrrolidonyl-arylamidase (PYR) + –> has replaced the bacitracin test (not very specific for S pyogenes)

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26
Q

putamen: location

A

pizza crust

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27
Q

ovarian torsion: pathophys

A

lrg adnexal mass –> heavy –> ovary twist around infundibulopelvic lig –> occlude blood & N supply to ovary –> severe acute pelvic pain, ovarian ischemia

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28
Q

thrombotic thrombocytopenic purpura: tx

A

plasma exchange (plasmapheresis) –> remv autoAb from blood

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29
Q

classic galactosemia: enzyme def

A

galactose 1 phosphate uridyl transferase

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30
Q

number needed to trt (NNT): calc

A

1/absolute risk reduction (ARR)

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31
Q

lead poisoning –> blood findings

A
  • microcytic anemia w normal iron studies

- PBS: basophilic stippling

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32
Q

what is: necrolytic migratory erythema

A

elevated painful & pruritic rash –> usu face, groin, extremities –> gradually coalesce –> lrg lesion w central clearing of bronze induration

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33
Q

loop diuretic: stim what?

A

PG release –> increase renal blood flow –> increase GFR –> enhance drug delivery

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34
Q

GVHD: ssx

A
  • skin: diffuse maculopapular rash –> predilection for palms, soles –> may desquamate in severe cases
  • liver: increase LFT
  • GI: diarrhea
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35
Q

dysarthria-clumsy hand synd –> indicates damage to?

A
  • genu of internal capsule

- basal pons

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36
Q

fibrate –> gallstone: pathophys

A

inh bile acid syn –> decrease chol solubility –> gallstone

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37
Q

acute intermittent porphyria: enzyme? ssx?

A

porphobilinogen deaminase

5 P’s:

  • painful abd
  • portwine urine
  • polyneuropathy
  • psych disturbance
  • precipitated by drugs, alcohol, starve
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38
Q

Parkinson dz –> intractable ssx –> tx?

A

high freq deep brain stim –> globus pallidus, subthalamic nucleus –> inh firing –> increase activity of downstream nuclei –> thalamo-cortical disinh –> improve mobility

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39
Q

infundibulopelvic lig: aka

A

suspensory lig of the ovary

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40
Q

lacunar infarct: what is? cause?

A

HTN –> small penetrating arterioles –> arteriolosclerosis –> deep brain (basal ganglia), subcortical white matter (internal capsule, corona radiata) –> small ischemic infarct

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41
Q

Charcot-Bouchard aneurysm: comp

A

intracerebral hemorrhage –> usu basal ganglia

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42
Q

branched chain aa –> metab to?

A

propionyl CoA –> methylmalonic acid

43
Q

PKU: pathophys

A

deficient phenylalanine hydroxylase –> cannot convert Phe to tyrosine –> Phe accum in body fluids, CNS

44
Q

PKU: clinical presentation

A

normal at birth –> gradually dev:

  • severe intell disability
  • sz
  • musty body odor
  • hypopigment: skin, hair, eyes, catechoaminergic brain nuclei
45
Q

ataxia-hemiplegia synd –> indicates damage to?

A
  • post limb of internal capsule

- basal pons

46
Q

RVMI: clinical presentation

A
  • hypotension
  • distended jugular veins
  • clear lungs
47
Q

persistent gallbladder outflow obstruction –> leads to?

A

1) lysolecithin –> disrupt mucosa
2) bile salt –> irritate luminal epithelium
3) transmural inflamm, PG
4) gallbladder hypomotility
5) increase intraluminal pressure –> ischemia
6) bact invasion

48
Q

porphyria cutanea tarda: enzyme? ssx?

A

uroporphyrinogen decarboxylase

  • blistering cutaneous photosens
  • tea color urine
49
Q

RVMI –> what happens to:

  • RA pressure
  • central venous pressure
  • PCWP
  • cardiac output
A
  • RA pressure: increase
  • central venous pressure: increase
  • PCWP: decrease
  • cardiac output: decrease
50
Q

caudate nucleus: location

A

inferolat to ant horn of lat ventricle

51
Q

LRT: what contributes most to airway resistance?

A

1st 10 gen of bronchi

52
Q

when suspect lead poisoning?

A

microcytic anemia + constipation + mental status change in setting of construction work

53
Q

what is: 3rd deg AV block

A

complete block of conduction from atria to ventricles:

  • SA node –> atrial contract
  • AV node –> ventricle contract –> narrow QRS

==> complete desynchronization bw P waves & QRS complexes

54
Q

familial retinoblastoma: increased risk of?

A

2ndary tumors –> esp osteosarcoma

55
Q

how damage ACL?

A

sport –> extended knee:

  • sudden decelerate
  • pivot
56
Q

lead poisoning: features

A

LEAD Sucks:

  • Lead Lines in gums
  • Encephalopathy, Erythrocyte basophilic stippling
  • Abd colic, sideroblastic Anemia
  • Drops: wrist & foot drop
  • Dimercaprol, EDTA –> 1st line tx
  • Succimer –> chelation for kids
57
Q

basal ganglia –> indirect pathway: what is?

A

inhibitory pathway –> inh mvmt:

1) cortex –> (dopamine –> D2 receptor) –> stim striatum
2) striatum –> disinh subthalamic nucleus (via globus pallidus externa)
3) STN –> stim GPi
4) inh thalamus

58
Q

theca cell, granulosa cell: fx

A

LH –> theca interna –> androgen
FSH –> granulosa cell –> androgen to estradiol

theca externa cell: CT support struct for follicle

59
Q

Zollinger-Ellison synd: ssx

A
  • peptic ulcer –> esp distal duodenum
  • heartburn
  • diarrhea
60
Q

what is: lentiform

A

putamen + globus pallidus

61
Q

pure sensory stroke –> indicates damage to?

A

thalamus:
- ventropostlat
- ventropostmed

62
Q

what is: acute calculous cholecystitis

A

acute inflamm of gallbladder initiated by gallstone obstruction of cystic duct

63
Q

hereditary fructose intolerance: ssx

A
  • after ingest fructose: hypoglycemia, vomit
  • failure to thrive
  • liver, renal fail
64
Q

methadone: what is? use?

A

mu-opioid receptor agonist –> maintenance tx for opiod abuse –> suppress cravings & withdrawal ssx for >24hr

65
Q

resistant schizophrenia: tx

A

clozapine

66
Q

essential fructosuria: enzyme def

A

fructokinase

67
Q

prolactin –> inh?

A

GnRH release

68
Q

what is: glucose oxidase dipstick test

A

detect glucose in urine

69
Q

globus pallidus: location

A

pizza –> inner part

70
Q

JAK2 kinase: location

A

cytosol NOT nucleus

71
Q

what is: striatum

A

putamen + caudate

72
Q

thrombotic thrombocytopenic purpura: hallmarks

A
  • microangiopathic hemolytic anemia

- thrombocytopenia

73
Q

lactose intolerance: confirmatory test?

A

stool pH –> low

bact –> ferment lactose –> short chain ffa –> lower pH

74
Q

middle cerebral A occlusion –> leads to

A
  • contralat hemiplegia of face & UE –> LE relatively preserved
  • aphasia (if dominant hemis affected (usu L))
75
Q

what is: human multidrug resistance (MDR1) gene

A

codes for P-glycoprotein –> transmembrane ATP-dep efflux pump –> broad specificity for hydrophobic cmpds –> reduce drug influx & increase efflux from cytosol –> prevent axn of ctx agents

76
Q

Klinefelter synd: clinical features

A
  • 1ary hypogonad
  • long LE
  • small firm testes
  • azoospermia
77
Q

sporicidal disinfectant

A
  • hydrogen peroxide

- iodine

78
Q

acute mitral regurg –> what happens to:

  • preload
  • afterload
  • contractile fx
  • ejection fraction
  • stroke vol
A
  • preload: increase increase
  • afterload: decrease (decreased cardiac output –> severe hypotesion)
  • contractile fx: normal
  • ejection fraction: increase increase (increased preload, decreased afterload)
  • stroke vol : decrease
79
Q

how do you get lead poisoning?

A

occupational exposure:

  • lead paint
  • battery
  • ammunition
  • construction
80
Q

1ary myelofibrosis: pathophys

A

atypical megakaryocyte hyperplasia –> stim fibroblast prolif –> progressive replace marrow space by extensive collagen deposition

81
Q

what is: INF-gamma assay

A

test for latent TB: expose to Mycobact tuberculosis antigens –> measure amt of IFN-gamma released by Tcells

82
Q

Kallmann synd: pathophys

A

impaired GnRH syn by hypo:

  • 1ary amenorrhea
  • no 2ndary sex charact
  • olfactory sensory defect
83
Q

Klinefelter synd: hormone changes

A

1ary hypogonad:

  • low testosterone
  • elevated FSH, LH
  • low inhibin
84
Q

what is: nondisjunction in meiosis I

A

homologous chrom fail to sep

85
Q

JAK2 mutation –> seen in

A

chronic myeloprolif disorders:

  • polycythemia vera
  • essential thrombocytosis
  • 1ary myelofibrosis
86
Q

lightning injury: most common COD

A
  • fatal arrhythmia

- resp fail

87
Q

odd chain ffa –> metab to?

A

propionyl CoA –> methylmalonic acid

88
Q

hematogenous osteomyelitis: what org? who?

A 
children --> long bones (2ndary to bacteremic event): 
#1) staph aureus
#2) S pyogenes
89
Q

how do you dx essential fructosuria?

A

copper reduction test: detect reducing sugar

90
Q

how do you dx gastrinoma vs other causes of hypergastrinemia?

A

admin exogenous secretin –> stim gastrin release from gastrinoma –> increase gastrin instead of decrease

91
Q

polycythemia vera: ssx

A
  • nonspecific ssx: HA, weak, diaphoresis
  • aquagenic pruritis
  • facial plethora
  • splenomegaly
92
Q

disinfectant –> alcohol –> MOA?

A
  • disorg lipid struct in membranes –> leaky
  • denature cellular proteins

==> bactericidal, tuberculocidal, fungicidal, virucidal –> but not destroy bact spores

93
Q

aminolevulinic acid synthase requires what cofactor?

A

vitB6

94
Q

basophilic stippling: seen in

A

Basically, ACiD alcohol in LeThal:

  • Anemia of Chronic Disease
  • alcohol abuse
  • Lead poisoning
  • Thalassemia
95
Q

how do you acquire sideroblastic anemia?

A
  • alcoholism: mito poison
  • lead poisoning: inh ALAD, ferrochelatase
  • vitB6 def: required cofactor for ALAS
96
Q

ethanol –> hypoglycemia: pathophys

A

ethanol metabolism –> reduce NAD to NADH –> increase NADH/NAD ratio –> no NAD for gluconeogenesis

97
Q

how does pancreatitis lead to ARDS?

A

release large amt of inflamm cytokine, pancreatic enzyme –> activate neutrophils in alveolar tissues –> interstial & intraalveolar edema, inflamm, fibrin deposition –> alveoli –> waxy hyaline membranes

98
Q

systolic heart fail: cause? gross appearance?

A
  • ischemic heart dz
  • dilated cardiomyopathy

dilated ventricle

99
Q

what is normal tracheal pO2? alveolar pO2?

A

tracheal pO2 = 150mmHg

alveolar pO2 = 104

100
Q

saccular aneurysm: what is? comp?

A

aka berry aneurysm –> thin walled saccular outpouching that lack media layer –> usu at ant comm A branch point

subarachnoid hemorrhage

101
Q

sideroblastic anemia is d/t?

A

defective protoporphyrin syn

102
Q

1ary myelofibrosis: ssx

A
  • pancytopenia
  • HSM
  • teardrop RBC
103
Q

imperforate hymen: ssx

A
  • 1ary amenorrhea
  • normal 2ndary sex charact
  • cyclic abd/pelvic pain d/t accum of menstrual blood in vagina/uterus (hematocolpos)

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