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UWorld > 7.5.16 > Flashcards

7.5.16 Flashcards

1
Q

what inh prolactin release?

A

dopamine secretion from hypo

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2
Q

AL amyloidosis: histology

A
  • eosinophilic extracell deposit

- apple green birefringence w Congo red stain under polarized light

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3
Q

what is: lesser omentum

A

double layer of peritoneum that extend from liver to lesser curv of stomach & beginning of duodenum –> 2 parts:

  • hepatogastric lig
  • hepatoduodenal lig
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4
Q

acute rheumatic fever: comp

A

chronic valvular dz –> mitral regurg, stenosis

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5
Q

fidaxomicin: gen charact

A
  • macrocyclic abx
  • bacteriocidal
  • oral admin
  • minimal systemic absorption
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6
Q

when should you suspect SIADH?

A

hypoNa + lung mass

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7
Q

what is: alpha-1 antitrypsin

A

major serum inh of neutrophil elastase

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8
Q

plasma cell: charact appearance

A
  • abundant basophilic cyto
  • eccentrically placed nucelus
  • “clock face” distribution of nuclear chromatin
  • perinuclear pale zone
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9
Q

what is: acute acalculous cholecystitis

A

acute inflamm of gallbladder in absence of gallstones

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10
Q

Goodpasture synd: pathophys

A

autoAb against BM collagen –> inflamm destruction:

  • renal glomeruli
  • lung alveoli
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11
Q

what can cause hyperprolactinemia?

A

decreased dopamine:

  • antipsych, antidep –> block dopamine D2 receptors
  • suprasellar, infundibular lesion –> disrupt dopaminergic pathway
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12
Q

exclusively ketogenic aa

A
  • lysine

- leucine

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13
Q

when should you suspect ASA intoxication?

A

triad:
- fever
- tinnitis
- tachypnea

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14
Q

when should you suspect mucormycosis?

A

DKA –> face pain, HA, black necrotic eschar in nasal cavity

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15
Q

NOD2 mutation –> leads to?

A

decrease activity of NF-kB –> reduce cytokine production –> impair innate barrier fx of intestinal mucosa –> intestinal microbe –> exagg response by adaptive immune system –> chronic GI inflamm

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16
Q

what hormone is necess for maintenance of preg?

A

progesterone

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17
Q

what stimulates renal ammoniagenesis?

A

acidosis

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18
Q

how induce hemostasis in a pt w hemophilia?

A

admin thrombin

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19
Q

abdominal aortic aneurysm: pathophys

A

transmural inflamm –> chronic –> proteases degrade elastin & collagen:

  • lose elastin
  • lose smooth muscle
  • collagen –> abnormal remodeling & crosslinking –>

==> weaken wall

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20
Q

external auditory canal: sensory innervation

A
  • post wall: vagus N –> small auricular br

- rest: trigeminal N –> mandibular division

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21
Q

what is: ventromedial nucleus

A

center of satiety

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22
Q

idiopathic pulm fibrosis: CT

A

patchy involvement –> usu subpleural, paraseptal spaces:

  • dense fibrosis
  • “honeycomb” changes (formation of cystic spaces)
  • fibroblastic foci
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23
Q

duodenal peptic ulcer: cause

A

H pylori

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24
Q

what is: chronic myelogenous leukemia

A

unctrled mature granulocyte production –> mostly neutrophils, but also basophil, eosinophil

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25
Q

what is: vasovagal syncope

A

stim vagus N –> parasym outflow –> decrease HR, BP –> syncope

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26
Q

what is: Osler-Weber-Rendu synd

A

AD –> telangiectasias –> skin & mucus membrane:

  • lips
  • oronasopharynx
  • resp tract
  • GI
  • urinary
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27
Q

chronic hemolysis can lead to?

A

iron deposition in kidney (hemosiderosis)

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28
Q

paroxsymal nocturnal Hburia: pathophys

A

mutated phosphatidylinositol glycan class A (PIGA) gene –> cannot syn glycosylphosphatidylinositol (GPI) anchor protein –> can’t attach CD55 decay acclerating factor blood cells –> can’t inh C3 convertase –> can’t inactivate complement –> unctrled complement-med hemolysis

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29
Q

mult myeloma –> infect –> pathophys

A

increased monoclonal Ab –> lack antigenic diversity –> infection

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30
Q

diphtheria vaccine: MOA

A

induce production of circulating IgG against exotoxin B subunit

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31
Q

lesion to ventromedial nucleus –> leads to?

A

hyperphagia –> obesity

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32
Q

orbital blowout fracture –> inferior orbital wall –> can lead to herniation into?

A

maxillary sinus

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33
Q

mesothelioma: #1 RF

A

asbestos exposure

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34
Q

what is: ristocetin test

A

cause vWF bind GP1b –> induce platelet aggregation

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35
Q

cryptoorchidism: what happens to leydig cell?

A

nothing –> normal fx –> normal 2ndary sex charact, sex performance

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36
Q

differentiate: CML vs leukemoid rxn

A
  • leukemoid rxn: normal/elevated leukocyte (neutrophil) alk phos
  • CML: decreased
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37
Q

mult myeloma –> hyperCa –> pathophys

A

activate osteoclast

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38
Q

hypoNa: ssx

A

altered mental status

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39
Q

mifespristone: what is? use? MOA?

A

MOA: progesterone ant –> block progesterone receptor –> apoptosis & necrosis of uterine decidua

use: + misoprostol (PGE1 agonist) –> terminate 1st trimester preg

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40
Q

mult myeloma –> anemia –> pathophys

A

BM infiltration –> suppress normal hematopoiesis –> normocytic, normochromic anemia

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41
Q

musculocutaneous N: nerve roots

A

C5-7

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42
Q

growth factors that promote angiogenesis

A
  • vascular endothelial GF (VEGF)

- fibroblast GF (FGF)

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43
Q

enteropeptidase def: ssx

A

protein & fat malabsorption:

  • diarrhea
  • fail to thrive
  • hypoproteinemia –> edema
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44
Q

what area of the brain has greatest atrophy in Alzheimer’s dz?

A

hippocampus

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45
Q

carcinoid tumor: histology

A

islands or sheets of uniforms cells:

  • eosinophilic cyto
  • oval to round stippled nuclei
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46
Q

pericardial knock: seen in?

A

constrictive pericarditis

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47
Q

vWF: fx

A

1) bind glycoprotein (GP) 1b recetpors on platelet –> mediate platelet aggregation & adhesion to subendo collagen
2) carrier for factor VIII –> prolong its halflife

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48
Q

what causes centriacinal emphysema?

A

heavy smoking

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49
Q

how can Crohn’s dz lead to gallstones?

A

terminal ileum involved –> can’t resorb bile acid –> supersat bile w chol –> gallstone

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50
Q

pilocystic astrocytoma: histology

A

well-differentiated neoplasm:

  • spindle cells w hair-like glial processes –> assoc w microcysts
  • Rosenthal fibers (thick eosinophilic processes of astrocytes) + granular eosinophilic bodies
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51
Q

idiopathic pulm fibrosis: features

A
  • progressive exertional dyspnea, dry cough
  • restrictive profile on pulm fx test
  • interstitial fibrosis w cystic air space enlrgment
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52
Q

GERD: histology

A
  • basal zone hyperplasia
  • elongation of lamina propria papillae
  • scattered eosinophils
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53
Q

brain MRI –> what highly suggests Alz dz?

A

hippocampus atrophy

54
Q

when is a result considered statistically sig?

A

95% CI does not cross null value

55
Q

myoglobin: O2-dissociation curve

A

hyperbolic

56
Q

trauma or strenuos UE exercise –> can injure what?

A

brachial plexus –> upper trunk (C5-7) –> affecting the musculocut N (derived from C5-7)

57
Q

seminiferous tubule: fx

A

spermatogenesis

58
Q

L colon CA: clinical manifestation

A

infiltrate intestinal wall –> encircle lumen:

  • constipation
  • ssx of intestinal obstruction
59
Q

Sertoli cell: location

A

they form the epithelium of the seminiferous tubule

60
Q

misoprostol: what is? MOA?

A

PGE1 agonist –> cervical softening, uterine contract –> expulsion of preg

61
Q

hyperCa: ssx

A
  • mental status change
  • muscle weak
  • constipation
  • polyuria/polydipsia
  • dehydrate
62
Q

what is structurally analogous to myoglobin?

A

indiv subunits of Hb mole

63
Q

renal blood flow: calc

A

RPF/(1-Hct)

64
Q

when should you suspect a pilocystic astrocytoma?

A

cystic tumor in cerebellum of child

65
Q

pyruvate decarboxylase: rxn

A

pyruvate –> acetyl CoA

66
Q

chronic nonhealing ulcer: most likely what type of org?

A

necrosis, diminished blood supply –> anaerobe

67
Q

thionamide: drug

A
  • methimazole

- propylthiouracil

68
Q

mult myeloma –> AL amyloid –> pathophys

A

increased monoclonal Ig light chains

69
Q

acute acalculous cholecystitis: who?

A

critically ill pt (sepsis, severe burn, trauma, immunosupp) –> gallbladder stasis, ischemia

70
Q

paroxsymal nocturnal Hburia: classic triad

A
  • hemolytic anemia (Hburia)
  • pancytopenia
  • thrombosis at atypical sites –> hepatic, portal, cerebral V
71
Q

what can decrease effects of radioactive iodine tx? how?

A

perchlorate, pertechnetate –> iodide isotypes –> sodium-iodide symporter –> uptake to thyroid –> reduce uptake of other iodine (radioactive iodine) thru competitive inh

72
Q

persistent lymphedema: comp

A

lymphangiosarcoma

73
Q

Osler-Weber-Rendu synd: ssx

A

telangiectasia –> rupture –> epistaxis, GI bleed, hematuria

74
Q

cryptoorchidism: what happens to the seminiferous tubules?

A

high temp –> damage seminiferous tubule –> atrophy, hyalinization:

  • decrease sperm count
  • decrease inhibin
75
Q

renal plasma flow: calc

A

= PAH clearance

= (urine PAH)(urine flow)/(plasma PAH)

76
Q

acute acalculous cholecystitis: ssx

A
  • fever
  • RUQ pain
  • leukocytosis
77
Q

Kussmaul sign –> seen in? why?

A

constrictive pericarditis

78
Q

what hormone is necess for implantation?

A

progesterone

79
Q

what is: bacteroides fragilis

A

G- anaerobic rod that can produce B-lactamase

80
Q

what drugs are used for preg termination?

A
  • misoprostol
  • mifepristone
  • methotrexate
81
Q

mult myeloma –> bone resorption –> pathophys

A

activate osteoclast –> lytic, punched out bone lesions –> esp vertebrae, skull

82
Q

CML: findings

A
  • elevated WBC
  • increase in precursor forms (bands, metamyelocyte, myelocyte)
  • decrease leukocyte alk phos
  • myelocytic bulge (more myelocytes than the more mature metamyelocyte)
  • basophilia
  • eosinophilia
83
Q

pyruvate decarboxylase complex def: tx? MOA?

A

ketogenic diet:

  • fat, ketogenic aa –> acetyl CoA –> ketones –> energy
  • no glucose –> decrease pyruvate syn –> decrease lactate
84
Q

orbital blowout fracture –> medial orbital wall –> can lead to herniation into?

A

ethmoid sinus

85
Q

what is: NF-kB

A

pro-inflamm TF –> increase cytokine production

86
Q

Syndenham chorea: when?

A

months after GAS infect

87
Q

portal V: location on CT

A
  • medial to R liver lobe

- ant to IVC

88
Q

what is responsible for the vast majority of renal acid excretion in chronic acidotic states?

A

renal ammoniagenesis

89
Q

how can mitral stenosis lead to hoarseness?

A

mitral stenosis –> LA dilation –> impinge L recurrent laryngeal N –> L vocal cord paresis –> hoarse

90
Q

Graves dz: tx

A

ablating doses of radioactive iodine

91
Q

what poses a physical barrier to neovascularization?

A

laminin in BM

92
Q

what is: Syndenham chorea

A

face, arms, legs –> invol rapid irreg jerking mvmts

93
Q

ASA intoxication –> 4-5hrs later –> what kind of acid/base disturbance? what will ABG show?

A

mixed resp alk + metab acid:

  • normal pH
  • low PaCO2
  • low HCO3
94
Q

mesothelioma: histology

A

tumor cells:

  • long slender microvilli
  • abundant tonofilaments
95
Q

leydig cell: location

A

adj to seminiferous tubule

96
Q

what changes does a neuron undergo w irrev injury?

A

12-24hr after injury –> red neuron:

  • cell body shrink
  • eosinophilic cyto
  • nucleus pyknosis
  • lose Nissl subst
97
Q

Ras exists in what 2 states?

A
  • inactive GDP-bound

- active GTP-bound

98
Q

How is Ras activated? what happens when Ras is activated?

A

growth factor –> bind receptor tyrosine kinase –> –> Ras remv GDP –> bind GTP –> active Ras

Ras-MAPK signal transduction pathway: active Ras –> phosphorylation cascade –> activate mitogen-activated protein kinase (MAPK) –> enter nucleus –> gene transcription

99
Q

methacholine: MOA

A

muscarinic cholinergic agonist:

  • contract bronchial SM
  • increase bronchial mucus production
100
Q

C. diff infection: tx

A
  • 1st line mild-mod: metronidazole
  • 1st line severe: vancomycin
  • recurrent C diff: fidaxomicin
101
Q

what estimated renal plasma flow?

A

PAH clearance

102
Q

what is: constrictive pericarditis

A

chronic condition –> normal pericardial space –> replaced by thick fibrous shell –> restrict V vol –> eventually HF

103
Q

what is: lymphangiosarcoma

A

rare malig neoplasm of endothelial lining of lymphatic channels

104
Q

vascular dementia: typical presentation

A

sudden/stepwise cog decline in pts w CV risk factors, ischemic stroke

105
Q

how do you dx a malabsorptive disorder?

A

Sudan III stain –> detect fat in stool

106
Q

acute rheumatic fever: #1 COD

A

severe pancarditis

107
Q

what is: renal ammoniagenesis

A

renal tubular epithelial cell –> metab glutamine to glutmate –> generate ammonium + bicarb:

  • excrete ammonium in urine
  • absorb bicarb –> buffer acids in blood
108
Q

pyruvate decarboxylase complex def: pathophys

A

pyruvate accum –> shunt to lactate –> lactic acidosis

109
Q

musculocutaneous N: fx

A

motor:
- major forearm flexors: biceps brachii, brachialis
- coracobrachialis

sensory: lat forearm

110
Q

how can pro-inflamm cytokines promote angiogenesis?

A

increase VEGF expression

111
Q

what type of amyloid deposition will be seen in Alzheimer’s dz?

A
  • neuritic plaque: extracell core of AB amyloid + entangled neuritic processes
  • cerebral amyloid angiopathy
  • neurofibrillary tangle: intracell aggregates of fibers composed of hyperphos tau
112
Q

why is matching used in case-ctrl studies?

A

to ctrl confounding

113
Q

enteropeptidase: what is? fx?

A

jejunum –> brush border enzyme –> responsible for activating trypsinogen to trypsin

114
Q

Osler-Weber-Rendu synd: aka

A

hereditary hemorrhagic telangiectasia

115
Q

SIADH: lab findings

A
  • euvolemic hypoNa: normal body fluid vol, low plasma Na & osmolality
  • inapprop concentrated urine
116
Q

coracobrachialis muscle: fx

A

flex & adduct arm

117
Q

how do you dx mucormycosis?

A

tissue bx –> histologic exam

118
Q

pyruvate decarboxylase complex def: ssx

A
  • lactic acidosis

- neuro defects

119
Q

AAT def –> leads to?

A

panacinar emphysema –> affects lower lobes more severely

120
Q

how do you dx mult myeloma?

A

BM bx –> >30% plasma cells

121
Q

lactate deH: rxn

A

pyruvate –> lactate –> pyruvate

122
Q

cryptoorchidism: comp

A
  • damage to seminiferous tubules

- testicular CA

123
Q

R colon CA: clinical manifestation

A

exophytic mass –> occult bleed –> iron def anemia

124
Q

Kussmaul sign: what is? cause?

A

normally: JVP drop during inspiration

Kussmaul sign: JVP increase during inspiration
RV –> vol restricted –> cannot accomodate inspiratory increase in venous return

125
Q

95% CI corresponds to what pvalue?

A

less than 0.05

126
Q

what is the most common congenital cardiac anomaly in Down synd?

A

complete AV canal defect

127
Q

how do you dx paroxysmal nocturnal Hburia?

A

flow cytometry –> lack of CD55 (DAF) on blood cells

128
Q

mesothelioma: clinical features

A
  • hemorrhagic pleural effusion

- pleural thickening

129
Q

what mutation is assoc w Crohn dz?

A

NOD2

130
Q

what is: complete AV canal defect

A

1) atrial septal defect
2) V septal defect
3) common AV valve

131
Q

mult myeloma: ssx

A
  • anemia
  • bone resorption
  • hyperCa
  • infection
  • AL amyloid
  • renal fail
132
Q

thionamide: MOA

A

inh thyroid peroxidase –> inh iodine organification, coupling of iodotyrosines –> decrease TH syn

PTU: also decrease peripheral conversion of T4 to T3

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