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UWorld > 7.7.16 > Flashcards

7.7.16 Flashcards

1
Q

atherosclerosis: most common vessels involved

A 
#1) abd aorta
#2) coronary A
#3) popliteal A
#4) internal carotid A
#5) circle of Willis
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2
Q

which has lower pressure: R vs L heart

A

R heart d/t lower resistance in pulm vasc

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3
Q

which has lower pressure: RV vs pulm A

A

RV bc pulm A has resistance to flow from the pulm circ

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4
Q

what is normal diastolic pressure in the RV? RA? central venous? pulm A?

A

central venous, RA, RV: 1-6mmHg

pulm A: 6-12

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5
Q

what nerves are involved in the pupillary light reflex?

A

afferent limb: CN II

efferent: CN III

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6
Q

what nerves open/close eye?

A

CNIII: open
CNVII: close

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7
Q

tibial N: motor fx

A
  • foot: plantarflex, inversion

- toe flex

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8
Q

tibial N: sensory fx

A

plantar foot

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9
Q

where/how can you injure tibial N?

A

level of popliteal fossa d/t deep penetrating trauma, knee surg

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10
Q

AV node: location

A

endocardial surface of RA –> near:

  • septal leaflet of tricuspid valve
  • orifice of coronary sinus
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11
Q

global cerebral ischemia: what struct is damaged first?

A

hippocampus

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12
Q

global cerebral ischemia: what cells are most susceptible to damage?

A
  • pyramidal cells of hippocampus & neocortex

- Purkinje cells of cerebellum

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13
Q

metronidazole + alcohol –> leads to?

A

disulfiram-like rxn (d/t acetaldehyde accum):

  • abd cramp
  • nausea
  • HA
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14
Q

adrenal crisis: ssx

A
  • severe hypotension
  • abd pain
  • vomit
  • weak
  • fever
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15
Q

adrenal crisis: tx

A
  • aggressive fluid resuscitation

- glucocorticoid

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16
Q

what is: 1ary biliary cholangitis

A

chronic autoimmune liver dz –> charact by:

  • lymphocytic infiltrates
  • destruction of small & mid-sized intrahep bile ducts
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17
Q

spironolactone: AE

A

antiandrogenic effects:

  • gynecomastia
  • decrease libido
  • impotence
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18
Q

benzodiazepine: MOA

A

enhance GABA effect at GABA-A receptor –> increased Cl- influx, suppress AP firing

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19
Q

what is: bioavail

A

fraction of admin drug that reach systemic circ in a chemically unchanged form

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20
Q

bioavail: calc

A

(area under oral curve)(IV dose) / (area under IV curve)(oral dose)

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21
Q

tetralogy of Fallot: major determinant of severity

A

degree of RV outflow tract obstruction –> determines degree of R–>L shunting & resulting cyanosis

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22
Q

increased activity of what cell is involved in pathogenesis of Crohn’s dz?

A

TH1 –> IL2, IFNgamma, TNF –> intestinal injury

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23
Q

noncaseating granuloma: Crohn’s or UC?

A

Crohn’s

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24
Q

what is special about GLUT4?

A

it is the only GLUT that is responsive to insulin

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25
Q

what is: lamellar body

A

organelles in type II pneumocytes that store & transport surfactant to cell surface

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26
Q

SLE: pathophy

A

loss of immune self-tolerance –> produce autoAb against nuclear antigens –> bind self-Ag –> form immune complex:

  • deposit in tissues
  • activate complement –> decrease complement levels
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27
Q

what Ab are assoc w SLE?

A
  • ANA
  • anti-dsDNA
  • anti-Sm
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28
Q

minimal change dz: histology

A

EM: foot process effacement

LM, IF: normal

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29
Q

minimal change dz: tx

A

corticosteroid

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30
Q

nephrotic synd: ssx

A
  • edema
  • hyperlipid
  • hypoalbumin
  • proteinuria
31
Q

costochondritis: cause? type of chest pain?

A

repetitive activity

pain:
- reproducible w palpation
- worse w mv, change position

32
Q

deep intracranial hemorrhage: #1 cause

A

HTN vasculopathy involving small penetrating br of cerebral arteries (Charcot Bouchard aneurysms)

33
Q

Q fever: who? ssx?

A

farm workers exposed to waste from cattle, sheep

  • retro-orbital HA
  • pneumonia
  • thrombocytopenia
34
Q

what is the most common thyroid cancer?

A

papillary thyroid CA

35
Q

papillary thyroid CA: histology

A

large cells w nuclei containing finely dispersed chromatin w ground glass appearance (Orphan Annie eye)

36
Q

ADH: what part of nephron has highest [] tubular fluid? lowest?

A
  • highest: collecting duct

- lowest: thick ascending limb, DCT

37
Q

familial dysbetalipoproteinemia: pathophys

A

AR –> defect in ApoE3, ApoE4 –> decreased clearance of chylomicrons, VLDL remnant –> high chol, TG –> xanthoma, premature atherosclerosis

38
Q

acute viral hepatitis: histology

A

hepatocyte necrosis & apoptosis w mononuclear infiltration:

  • necrosis: cell swell & cytoplasmic empty
  • apoptosis: cell shrink, councilman bodies (eosinophilic dying hepatocyte)
39
Q

Goodpasture synd: pathophys

A

autoAb to alpha3 chain of type IV collagen (anti-GBM Ab):

  • glomerular BM –> rapid prog GN
  • alveolar hemorrhage –> SOB, hemoptysis
40
Q

Goodpasture synd: histology

A
  • LM: crescent

- IF: linear deposition of IgG, C3

41
Q

Goodpasture synd: who?

A

YA M

42
Q

what is the most common cause of spontaneous lobar hemorrhage? most common site?

A

cerebral amyloid angiopathy

  • occipital lobe
  • parietal
43
Q

dapsone: AE

A

hemolytic anemia –> esp G6PD def

44
Q

what is the most common cause of calcium kidney stone dz?

A

idiopathic hypercalciuria

45
Q

calcium nephrolithiasis: RF

A
  • hypercalciuria
  • hyperoxaluria
  • hyperuricosuria
  • low urine vol
  • hypocitraturia
46
Q

what reduces peripheral metab of levodopa?

A
  • DOPA decarboxylase inh –> carbidopa

- catechol-O-methyltransferase inh –> entacapone

47
Q

what is the most common lung cancer? location? histology?

A

adenocarcinoma –> esp F, nonsmoker

peripheral

glandular or papillary struct

48
Q

preg, OCP –> cholelithiasis –> pathophys?

A
  • estrogen: induce chol hypersecrete

- progesterone: induce gallbladder hypomotility

49
Q

IV drug –> bioavail fraction?

A

1

50
Q

maintenance dose: calc

A

(steady state plasma []) x (clearance) / (bioavail fraction)

51
Q

half life: calc

A

(vol of dist) X (0.7) / (clearance)

52
Q

loading dose: calc

A

(vol of dist) X (steady state plasma []) / (bioavail fraction)

53
Q 
IV abx --> 1st order kinetics: 
- Vd = 70L
- CL = 0.5L/min
- steady state 4mg/L
how much should be admin 6hr to maintain steady state?
A 
maintenance dose = Cpss x CL / [bioavail fraction]
= (4mg/L)(0.5L/min)/1
= 2.0mg/min 
= 2.0mg/min x (60min/hr) x 6hr
= 720mg q6hr
54
Q

renal, hepair impairment –> how should you adjust dosing?

A
  • loading dose: no change

- maintenance dose: decrease

55
Q

neonatal intraventricular hemorrhage: what is? where?

A
  • common comp of prematurity that can lead to longterm neurodev impairment

germinal matrix

56
Q

ARDS –> what changes will be seen:

  • pulm cap permeability
  • lung compliance
  • work of breathing
  • vent: perfusion matching
  • PCWP
A
  • pulm cap permeability: increased –> interstitial & alveolar edema, exudate formation
  • lung compliance: decreased
  • work of breathing: increased
  • vent: perfusion matching: mismatched
  • PCWP: normal
57
Q

how does HBV increase risk for hepatocell CA? how does this differ from HCV?

A

HBV:

  • integrate DNA into host genome –> continue transcribe HVx protein (oncogenic viral protein) –> inactivate p53
  • active hepatitis infect –> cause regenerative hyperplasia –> increase # of cell divisions –> increase chance for genetic mutation

HCV –> RNA virus w no reverse transcriptase –> not integrate into host genome

58
Q

what is: CD14

A

surface marker for monocyte-macrophage cell lineage

59
Q

inhalation anes: AE

A
  • increase cerebral blood flow
  • myocardial depression
  • hypotension
  • resp dep
  • decreased renal fx
60
Q

PSGN: histology

A
  • LM: enlrg, hypercell glomeruli
  • IF: lumpy-bumpy granular deposits of IgG, C3
  • EM: subepi humps
61
Q

vitiligo: charact by?

A

loss of epidermal melanocytes

62
Q

minor –> can consent to:

A
  • prenatal care
  • STD dx/tx
  • contraception
  • drug/alcohol rehab
63
Q

CREST synd: manifestation

A
  • calcinosis
  • Raynaud’s phenomenon
  • esophageal dysmotility
  • sclerodactyly
  • telangiectasia
64
Q

what Ab is assoc w CREST synd?

A

anti-centromere Ab

65
Q

what Ab is highly specific for systemic sclerosis (diffuse scleroderma)?

A

Anti-DNA topoisomerase I (Scl-70) Ab

66
Q

systemic sclerosis: 2 types

A
  • diffuse scleroderma: diffuse skin & visceral involvement
  • CREST synd: localized skin involvement, more benign
67
Q

Aspergillus:

  • colonization –> leads to?
  • invasion –> leads to?
A
  • colonization: aspergilloma (mycetoma)

- invasion: pulm aspergillosis

68
Q

aspergilloma: features

A
  • fungus ball that shifts when pt change position

- asymptomatic or cough/hemoptysis

69
Q

aspergillus –> leads to?

A
  • immunosupp, neutropenic: opportunistic infect –> invasive pulm aspergillosis
  • preexisting lung cavity: aspergilloma
  • asthma: lung HSN –> allergic bronchopulm aspergillosis
70
Q

ant portion of medial pons –> infarct –> leads to?

A
  • dysarthria

- contralat ataxic hemiparesis

71
Q

trigeminal N: arises from?

A

level of middle cerebellar peduncle at lat aspect of mid-pons

72
Q

asbestos exposure –> leads to what malig?

A 
#1) bronchogenic carcinoma 
#2) mesothelioma
73
Q

asbestos exposure –> leads to?

A
  • asbestosis: diffuse pulm fibrosis + asbestos bodies
  • pleural dz:
  • malig: bronchogenic CA, mesothelioma

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