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Uworld Jornal > All Subjects > Flashcards

All Subjects Flashcards

1
Q

PSGN light microscopy

A

hypercellular glomeruli (leukocyte infiltration)

mesangial and endothelial cell proliferation

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2
Q

PSGN immunofluorescence

A

granular deposits (IgG, IgM, C3) in BM and mesangium

“starry sky”

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3
Q

PSGN EM

A

subepithelial humps

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4
Q

PKU

A

AR deficiency of phenylalanine hydroxylase

fair complexion (excess phenylalanine inhibits tyrosinase necessary for production of melanin), intellectual disability, musty odor

pallor of substantia nigra, locus ceruleus, and vagal nucleus dorsalis

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5
Q

Linkage disequillibrium

A

2 genetic locci and alleles inherited together more or less often than expected give allele fequencies

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6
Q

Langerhans cell histology

A

stellar cells
intracytoplasmic granules that replicate tennis racquet (birbeck granule)

act as dendritic cells and present antigens to T cells

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7
Q

Accumulation effect of studies

A

exposure to risk or risk modifiers must sometimes occur for long periods before clinically significant effect is detected

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8
Q

ankle sprain

A

most likely damage to anterior talofibular ligament (pain on anterolateral aspect of ankle)

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9
Q

Wilsons disease neuro changes

A

atrophy of basal ganglia after copper leaks from damaged hepatocytes

decreased ceruloplasmin

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10
Q

Viral gastroenteritis outbreaks

A

most likely norovirus in developed countries

(rotavirus immunization)

Sx: vomiting and watery diarrhea

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11
Q

CAAT and TATA

A

promoter of transcription in eukaryotic genome

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12
Q

Enhancer sequences

A

bind activator proteins that facilitate bending of DNA

Silencers have opposite effect

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13
Q

Effect of slow acetylators

A

slow metabolism of isoniazid, dapsone, hydralazine, and procainamide

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14
Q

Prevalence

A

incidence * duration of disease

Prevalence is increased with factors that prolong disease duration (decreased mortality, higher quality of care, etc.)

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15
Q

Risks associated with prostatectomy

A

injury to prostatic plexus can cause erectile dysfunction

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16
Q

Cremasteric reflex

A

L1-L2 genitofemoral nerve

damage seen with testicular torsion

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17
Q

Embryology of uteric bud

A

forms collecting system of kidney

  1. collecting tubules and ducts
  2. major and minor calyces
  3. renal pelvis
  4. ureters
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18
Q

Embryology of metanephric mesoderm

A
  1. glomeruli
  2. bowman’s space
  3. proximal tubules
  4. loops of henle
  5. distal convoluted tubles
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19
Q

Tamoxifen

A

SERM used in tx of estrogen receptor positive breast cancer

antagonist at breast, agonist at endometrium

prodrug metabolized by CYP2D to active metabolite, endoxifen

CYP polymorphisms change concentration of active metabolite in serum

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20
Q

INH moa

A

activated by mycobacterial catalase peroxidase and requires specific protein sequence in enzyme target

resistance by non-expression of catalase-peroxidase enzyme or genetic modification of INH binding site on mycolic acid synthesis enzyme

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21
Q

Analysis of variance

A

used to determine whether there are significant differences in the means of several independent groups

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22
Q

Chi square tests

A

used to evaluate association between 2 categorical variables

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23
Q

Multiple logistic regression

A

used to predict probability of binary outcome based one 1 or more independent variables

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24
Q

Pearson correlation coefficient

A

measure of the strength and direction of linear relationship between 2 quantitative variables

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25
Q

CMV torches

A 
chorioretinitis
sensorineural deafness
seizure
jaundice
hepatomegaly
splenomegaly
microcephaly
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26
Q

Surface marker of macrophages

A

CD14

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27
Q

Klinefelter Syndrome

A

Path: nondisjunction of sex chromosomes (47XXY)

Clinical: primary hypogonadism, tall, gynecomastia, mental retardation

Labs: low testosterone, high FSH, LH (loss of feedback inhibition), high estradiol

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28
Q

Gynecomastia with exogenous steroid use

A

increased androstenedione levels

Also see acne, male-pattern baldness, short stature, aggression

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29
Q

Triad of congenital rubella

A
  1. congenital cataracts (white pupils)
  2. Sensory-neural deafness
  3. PDA
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30
Q

Bulimia

A

binge eating with compensatory behaviors to prevent weight gain (nl to high BMI)

vs. anorexia (significantly low BMI <18.5)

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31
Q

Major depressive disorder

A

> 2 week

> 5 SIGECAPS

No history of mania or hypomania
Not due to another condition

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32
Q

Goodpastures Syndrome

A

anti-glomerular basement membrane (type Iv collagen) + and lung basement membrane

linear immuno

see glomerular crescents with proliferating parietal cells, monocytes, and macrophages on EM

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33
Q

JGA

A

Release renin in response to hypoperfusion of kidney

smooth muscle cells in afferent afteriole

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34
Q

Clasp knife spasticity

A

initial resistance to passive extension followed by sudden release

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35
Q

Internal capsule stroke

A

pure motor weakness of contralat arm, leg and lower face

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36
Q

Methionine cycle

A

methionine -> homocysteine -> cystein

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37
Q

Homocystinuria

A

cystathione synthase deficiency

Homocysteine is prothromtoic therefore see hypercoag, thromboembolic occlusion, ACS

ectopia lentis and intellectual disability can also be seen

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38
Q

2 year old speech development milestones

A

50-200 words

2 work phrases

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39
Q

inulin

A

compound with no tubular resorption, used to model the glucose clearance with inhibition of sodium-coupled transport of glucose

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40
Q

Paraaminohippuric acid (PHA)

A

clearance of PAH used to calculate renal plasma flow

amount excreted > filtered load

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41
Q

Pellagra

A

vitamin B3 (niacin) deficiency

photosensitive dermatitis, diarrhea, dementia

Important in citric acid cycle as cofactor

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42
Q

Cholesteatomas

A

collections of squamous cel debris behind tympanic membrane that form pearly mass

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43
Q

Primaquine

A

eradicates hynozoites (latent forms of malaria) to prevent disease relapse

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44
Q

Kiesselbach plexus

A

anastamoses and highly vascular mucosa in anterior nasal septum (common cause of nose bleeds)

  1. Anterior ethmoidal
  2. sphenopalatine
  3. superior labial artery
    all anastomose in this region
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45
Q

lead time bias

A

apparent increase in survival time among patients undergoing a screening when they have an unchanged prognosis

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46
Q

rituximab

A

monoclonal ab used in lymphoma immunotherapy that targets the CD20 surface IG

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47
Q

Infliximab

A

IgG1 monoclonal ab to TNFalpha

tx of RA, ankylosing spondylitis, and fistulizing crohn’s disease

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48
Q

IL-2

A

cytokine that regulates activation and differentiation of t cells (tumor destruction)

used in tx of renal cell carcinoma and melanoma

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49
Q

Imatinib

A

inhibits BCR/ABL fusion gene

tx of CML

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50
Q

Abciximab

A

ab against GP IIb/IIIa receptor

blocks final step in platelet aggregation used to tx ACS

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51
Q

Odds ratio

A

measure of association

OR=odds of exposure in case/odds of exposure in controil

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52
Q

T cell ALL

A

fever, fatigue, pallor, petechia, bleeding, lymphadenopathy, HSM, bone pain

large anterior mediastinal mass that can compress superior vena cava (SVC syndrome) or compress the esophagus (dysphagia)
and trachea (dyspnea and stridor)
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53
Q

Churg-Strauss

A

Eosinophilic granulomatosis with polyangitis

small-med vessel vasculitis with asthma, rhinosinusitis, eosinophilia

asymmetric neuropathy (wrist drop)

anti neutrophil myeloperoxidise (p-ANCA)

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54
Q

Warfarin toxicity bleeding

A

Vit k (takes a few days)

FFP (immediately effective)

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55
Q

Heparin toxicity bleeding

A

protamine

heparin specific antidote

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56
Q

Acute dystonia

A

due to D2 antagnoism in nigrostriatal pathway

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57
Q

Patent urachus

A

straw colored urine discharge from umbilicus

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58
Q

Reverse t3

A

From peripheral conversion of T4

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59
Q

Axillary nerve

A

shoulder abduction (deltoid muscle)

sensory over upper lateral arm

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60
Q

Trousseau syndrome

A

migrating thrombophlebitis due to visceral cancer

adenocarcinoma produces thromboplastin like substance

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61
Q

Desmopressin (DDAVP)

A
  1. hemophilia A and vWF disease: increases circulating factor VIII and endothelial secretion of vWF to stop bleeding
  2. centrai DI: binds V2 receptors in renal tubular cells leading to increased aquaporin channels, increased water reabsorption and decreased urine output
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62
Q

Pleiotrophy

A

multiple, unrelated phenotypic manifestations as a result of a single gene defect

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63
Q

Transferance

A

unconscious shifting of emotions or desires from a person of the past to another person in the present

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64
Q

displacement

A

person expresses unacceptable feelings meant for someone in their present life toward a different, “safer” person

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65
Q

Projection

A

misattributing ones own unacceptable feelings to another person

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66
Q

Reaction formation

A

uncomfortable feelings are transformed into their opposites

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67
Q

Tibial nerve

A

plantar flexion, inversion, toe flexion

sensory to plantar foot

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68
Q

Risk of second hand smoke exposure

A
  1. prematurity, low birth weight
  2. SIDS
    3 middle ear infection
  3. asthma
  4. URI
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69
Q

PAH

A

Intimal hyperplasia, fibrosis, and medial hypertrophy with formation of capillary tufts

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70
Q

Hearing tests in conductive hearing loss

A

BC>AC in rinne test and weber test lateralizes to affected ear

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71
Q

Hearing tests in sensorineural hearing loss

A

AC>BC in rinee and weber test lateralizes to unaffected ear

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72
Q

Factitious disorder

A

intentional falsification or inducement of symptoms with goal to assume sick role

ex: deceptive reporting of symptoms, manipulating lab samples, ingesting substances, altering medical records, inducing illness

Malingering includes a secondary gain

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73
Q

Buspirone

A

partial agonist of 5HT receptor used for GAD

slow onset of action, no muscle relaxant or anticonvulsant properties

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74
Q

Hemolytic disease of the newborn

A

maternal anti-fetal erythrocyte antibodies cause a type II HSR

Maternal A and B antibodies are IgM and do not cross placenta and cause disease

maternal O ab are IgG and can cross the placental to cause fetal hemolysis

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75
Q

Lactotrophs

A

release prolactin

Prolactinomas present with hypogonadism, infertility, galactorrhea and amenorrhea

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76
Q

Corticotrophs

A

secrete ACTH

ACTH secreting tumors present with Cushing’s disease

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77
Q

Somatotrophs

A

Secrete GH

tumor: acromegaly or gigantism

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78
Q

Thyrotrophs

A

secrete TSH

tumor: thyrotoxicosis

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79
Q

Gonadotrophs

A

secrete LH and FSH

tumor: hipopituitarism or mass effect

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80
Q

Selegiline

A

MAO B inhibitor

used to delay progression of parkinsons disease

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81
Q

Biotin as a cofactor

A

B7

1. Gluconeogenesis
pyruvate to oxaloacetate (pyruvate carboxylase)
2. FA syntehsis 
Acetyl CoA to malonyl CoA (acetyl CoA carboxylase)
3. Fatty acid oxdation 
propionyl Co-
A to methylmalonyl CoA 
(propionyl CoA Carboxylase)
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82
Q

Biotin deficiency

A

rare
poor diet
excessive egg white consumption (biotin binding avidin)
congenital disorders

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83
Q

C peptide

A

measure of endogenous beta cell insulin secretion

Increased with sulfonylrueas and melitnides

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84
Q

Acarbose

A

inhibits alpha glucosidease in intestinal brush border and decreases postpradial glucose absorption

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85
Q

Thyroid dermopathy

A

stimulation of fibroblasts by TRAb and t cells leads to excess production of glycosaminoglycans and adipogenesis

induration and thickening of skin over shins (pretibial myxedema)

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86
Q

lipofuscin

A

yellow, brown finely granular perinuclear pigment

product of free radical injury and lipid perosidation

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87
Q

Anthracosis

A

carbon or coal dust taken up by macrophages within lung perenchyma

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88
Q

Fetal effects of maternal diabetes

A

congenital malformations (cardiac, ntd)

asphyxia
growth restriction
polycythemia

Increased fetal insulin (hyperplasia of beta cells):
macrosomia
hypertrophic cardiomyopathy
hypoglycermia after delivery

glucose can pass to fetus, but insulin is catabolized by placenta

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89
Q

Glucocorticoid induced myopathy

A

progressive proximal muscle weakness and atrophy WITHOUT pain

lower extremitys more invovled

normal creatinine kinase

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90
Q

Polymyalgia rheumatica

A

muscle pain and stiffness in shoulder, neck, and pelvic giirdle

worse in morning and with activity

normal creatinine kinase

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91
Q

Inflammatory myopathies

A

polymyositis and dermatomyositis

proximal muscle weakness, skin rash and inflammatory arthritis possible

high creatinine kinase

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92
Q

Statin-induced myopathy

A

proximal muscle weakness and pain weeks to months after starting a statin

increased creatinine kinase

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93
Q

Hypothyroid myopathy

A

muscle pain, crams and weakness in proximal muscles

delayed tendon reflexes and myoedema

increased CK

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94
Q

Features of cushings

A 
central obesity 
skin atrophy and purple stria
proximal muscle weakness
hypertension
glucose intolerance
skin hyperpigmentation (ACTH excess)

dg: 24 hour urinary cortisol, late night salivary cortisol, dexamethasone suppression test

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95
Q

Small intestinal bacterial overgrowth

A

overproduction of vitamin k and folate with nausea, bloating, abdominal discomfort, and malabsorption

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96
Q

Piriformis syndrome

A

piriformis passes through greater sciatic foramen and is involved in external hip rotation

compression of sciatic nerve can cause piriformis syndrome (pain, tingling, and numbness in buttocks and posterior thigh)

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97
Q

High alpha fetaprotein

A
  1. Ntd
  2. ventral wall defects (omphalocele, gastroschisis)
  3. multiple gestation
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98
Q

Down syndrome lab rsults

A

low AFP and low unconjugated estradiol

increased beta hcg and inhibin A

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99
Q

Incretins

A

GI hormones
glucagon like peptide 1 (GLP1)
Gastric inhibitory peptide (GIP)

stimulates pancreatic insulin secretion in response to ingestion of foods

why more insulin is released from oral than iv glucose

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100
Q

delta agent infeciton

A

Hep D infection

Can only occur with concominant hep B infection (encapsulated with HBsAg

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101
Q

Chronic lung rejection

A

bronchiolitis obliterans

obstructive lung disease with lymphocytic infiltration, and ultimately fibrosis scarring and obliteration of small airways

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102
Q

hepatic encephalopathy

A

increased levels of ammonia increase glutamine production and release disrupting excitatory neurotransmission

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103
Q

Genital lesions of syphillis

A

Primary: chancre

Secondary: Condyloma lata

tertiara: gumma

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104
Q

PAS stain

A

stains glycoprotein

used to diagnose trpheryma whippelii

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105
Q

Trypheryma Whipelli

A

gram positive actinomycete

abdominal discomfort, loose stool, weight loss

dg with PAS stain

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106
Q

Contact dermatitis

A

Type Iv HSR (t cell mediated)

characterized histologically by spongiosis (accumulation of edema fluid in intracellular spaces of epidermis) perivascular lymphocytes and eosinophils

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107
Q

Acyclovir nephrotoxicity

A

When acyclovir in collecting duct exceeds solubility, crystallization, and rental tubular damage can occur

Can be prevented (and treated) with adequate hydration and reduction in rate of drug infusion

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108
Q

Congenital Long QT syndrome

A

Mutation in K+ channels that decrease outward potassium flow and predispose to syncope, seizures, and sudden cardiac death due to arrhythmia (tDP)

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109
Q

Plegoticase

A

Urate oxidase that converts uric acid into soluble allantoin which promotes excretion

can cause hemolysis in G6PD deficiency (bit cells)
anaphylaxis
administered IV

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110
Q

Common medical conditions with polygenic inheritance

A
  1. androgenic alopecia
  2. epilepsy
  3. glaucoma
  4. hypertension
  5. ischemic heart disease
  6. schizophrenia
  7. Type II DM
111
Q

Causes of polyhydraminos

A
  1. fetal GI obstruction
    (esophageal, duodenal, intestinal atresia, enencephaly
  2. high fetal cardiac output (alloimmunization, parvovirus infection, fetomaternal hemorrhage)
112
Q

Abx against cell wall of bacteria

A
  1. penicillins
  2. cephalosporins
  3. vancomycin
113
Q

Step pyogenes M protein

A

alpha helical coiled protein

shares structural homology with tropomyosin and myosin

prevent phagocytosis by inhibiting complement binding, also aids in epithelial attachment

114
Q

Scapular winging

A

due to long thoracic nerve damage and paralysis of serratus anterior muscle

common with axillary lymph node dissection

weakness in abduction above horizontal due to impaired rotation of scapula

115
Q

Acute parotitis

A

RF: dehydration, intubation, decreased salivary flow (anticholinergics), salivary flow obstruction and recent teeth cleaning

often s. aureus

Ductal inflammation and abscess and elevated serum amylase without pancreatitis and normal serum lipase

116
Q

Serum marker of osteoclast activity

A
  1. tarate-resistant acid phosphatase
  2. urinary hydroxyproline
  3. urinary deoxypyridinoline (most reliable)
117
Q

Streptomycin

A

binds 30s ribosomal subunit and prevents protein synthesis

118
Q

perianal fistulas

A

Crohn disease
mouth to anus
spares rectum
full thickness inflammation

119
Q

Suspensory ligament of ovary

A

contains ovarian artery

120
Q

Transverse cervical ligament

A

Contains uterine artery

121
Q

Carotid sinus reflex

A

afferent limb: baroreceptors to glossopharyngeal nerve

efferent limb: parasymp via vagus nerve

122
Q

Virulence of diptheria

A

Exotoxin AB

acquired via phage mediated infection with Tox gene (lysogenization)

123
Q

Tetralogy of Fallot

A

Anterior and cephalad deviation of infundibular septum during embryologic development

124
Q

Pulsus paridoxus

A

measured via Korotkoff sounds

decrease in systolic blood pressure > 10 mmHg with inspiration

Cardiac tamponade, severe asthma, COPD, constrictive pericarditis

125
Q

Treatment of COPD

A

Beta 2 agonist

Gs couples increase intracellular cAMP

126
Q

Signs of constrictive pericarditis

A
  1. increased JVP
  2. Kussmaul sign (paradoxical rise in JVP with inspiration)
  3. Pulsus paradoxus
  4. pericardial knock
127
Q

Kussmaul sign

A

rise in JVP with inspiration

seen in constrictive pericarditis

128
Q

Third degree heart block

A

P and QRS are not related

SA node causes contraction of atria
AV node causes contraction of ventricles

129
Q

Drugs that improve survival in systolic HF

A
  1. ACE inhibitors
  2. ARBs
  3. aldosterone antagonists
    4 beta blockers
130
Q

Hyperplastic arteriolosclerosis

A

Diastolic pressures >130

onion-like concentric thickening of walls

Renal and ophthamologic symptoms

131
Q

Osler Weber Rendu syndrome

A

hereditary hemorrhagic telangiectasia

132
Q

Von ricklinhausen disease

A

NF1

neurofibromas, optic gliomas
lisch nodules
cafe au lait spots

133
Q

NF2

A

b/l CN VIII schwanoma and meningioma

134
Q

Strug Weber

A

cutaneous facial angiomas
leptomeningeal angioma

metal retardation
seizures
hemiplegia
skull radiopacities (tram track appearance)

135
Q

Resistance to penicillins

A

Beta lacatamse
mutated PBP
mutated porin protein

136
Q

Resistance to vancomycin

A

mutated cell wall

impaired influx/increased efflux

137
Q

Resistance to quinolones

A

mutated DNA gyrase

impaired influx/ increased efflux

138
Q

Resistance to aminoglycosides

A

mutated ribosomal subunit protein
mutated porin protein
aminoglycoside-modifying enzymes

139
Q

Tetracyclines resistance

A

impaired influx/increased efflux

inactivated enzyme

140
Q

Resistance to rifamycin

A

mutated RNA poll

141
Q

PBP

A

transpeptidase

142
Q

Thayer martin agar

A

chocolate sheep blood agar infused with vancomycin (inhibit gram positive bacteria), colistin and trimethoprim and nystatin (inhibits yeast growth)

143
Q

C. perfringens

A

gas gangrene of penetration injuries (alpha toxin lecithinase)

late-onset food poisoning with transient watery diarrhea (toxin produced inside body,

144
Q

Blunt aortic injury

A

most likely occurs at aortic isthmus (after subclavian artery branch)

145
Q

Treatment of bacteroides infection

A

piperacillin (extended specturm penicillin)+Tazobactam (beta lactamase inhibitor)

146
Q

pyrrolidonyl arylamindase test (PYR)

A

test to determine s. pyogenes

S pyogenes are PYR positive

147
Q

Keloid

A

excess TGF beta leads to excess, disorganized collagen formation

148
Q

Stop codons

A

UAG
UAA
UGA

149
Q

Hypertrophic cardiomyopathy

A

AD
mut in beta-myosin heavy chain or myosin binding protein
c

150
Q

Male embryonic sex development

A

MIF: regression of mullerian ducts that give rise to female internal genitalia

Testosterone: development of male internal genitalia

DHT: development of male external genitalia

151
Q

Depersonalization/Derealization disorder

A

depersonalization(feelings of detachment from or being outside ones self)

derealization (experiencing surroundings as unreal)

intact reality testing

152
Q

Dissociative amnesia

A

inability to recall important personal information (usually stressful nature)

not explained by other disorder

153
Q

dissociative identity disorder

A

discontinuity in identity and loss of agency with fragmentation into >2 distinct personality states

(severe trauma/abuse)

154
Q

Calcium sensing receptors

A

G protein coupled receptors that regulate secretion of PTH in response to changes in calcium concentration

155
Q

Familial hypocalicuric hypercalcemia

A

AD
defect in CaSR i PTH and kidney

higher serum Ca levels required to suppress PTH secretion

Mild Asx hypercalcemia
Reduce urinary excretion of Ca
High PTH

156
Q

Chronic interstitial nephritis

A

Chronic NSAID use

patchy inflammation and papillary necrosis with scarring
Calcium deposits

157
Q

Gigantism

A

HyperGH secretion, secretion of IGF-1 from hepatocytes and activation of JAK-STAT pathway

158
Q

G6PD

A

rate limiting step of pentose phosphate pathway

X linked recessive

Increased oxidative stress with animalarials and sulfonamides

159
Q

Lateral epicondyltis

Tennis elbow

A

elbow pain worse with activity

attachment point of extensor carpi radialis brevis (wrist extension)

160
Q

Who is eligible for medicare?

A

individuals >65 and older who have a work history and younger individuals with disbilities

161
Q

Frameshift mutations

A

deletion or insertion of bases not divisible by 3

162
Q

Conduct disorder

A
  1. aggression towards people or animals
  2. destruction of property
  3. serious violation of rules
  4. decietfulness of theft
163
Q

Cleft lip

A

failed fusion of intermaxillary segment and maxillary prominence

164
Q

Cleft palate

A

palatine shelves fail to fuse with each other or primary palate

165
Q

Factor V leiden mutation

A

inherited coagulability

Factor Va resistance to inactivation by protein C

166
Q

BRCA

A

Tumor suppressor gene

in charge of DNA repair genes

167
Q

Suicide risk factors

A
  1. previous attempts
  2. psych disorder
  3. single
  4. live alone
  5. elderly white man
  6. unemployed or unskilled
  7. physical illness
  8. family history
  9. access to firearms
  10. substance abuse
168
Q

Polycythemia Vera

A

uncontrolled erythrocyte production

mutation in JAK2 cytoplasmic tyrosin kinase associated with erythropoietin receptor

169
Q

Hypercalcemia

A
  1. Exogenous Vit D excess
  2. granulomatous disease (sarcoid, TB
  3. hodgkin and non-hodgkin lymphoma
170
Q

Attrition bias

A

form of selection bias in which loss to follow up occurs disproportionately to expose and unexposed groups

171
Q

PCOS

A

Androgen excess
ovarian dysfunction
insulin resistance
obesity

Increased risk of endometrial carcinoma

increased activity of 17alpha hydroxylase, 17,20 lyase and 3 beta hydroxysteroid dehydrogenase

172
Q

Morphological characteristics of osteoporosis

A

Trabecular thinning and perforation with loss of interconnecting bridges

173
Q

Thiazolidinediones (TZD)

A

bind PPAR gamma

Upregulate
GLUT4 (insulin responsive glucose transporter on adipocytes and muscles)

Upregulates adiponectin (cytokine secreted by fat and increases number of insulin-responsive adipocytes and regulates FA oxidation)

174
Q

Diseases transmitted via direct contact

A
  1. mono
  2. lymphogranuloma venereum
  3. RSV, rhinovirus, norwalk virus
175
Q

Diseases transmitted via Droplet

A
  1. influenza
  2. meningococcus
  3. andenovirus, pertussis
176
Q

Diseases transmitted via airborn

A
  1. TB
  2. Measels
  3. chicken pox
  4. small pox

N95 mask!!

177
Q

Diseases transmitted via mosquito

A
  1. malaria
  2. dengue fever
  3. chikungunya
178
Q

Diseases tranmitted via ticks

A
  1. lime disease
  2. Rickettsia
  3. Babesiosus
179
Q

Glucagon

A

increases hepatic glucose production via glycogenolysis and gluconeogenesis

stimulate G proteins receptors on hepatocytes increasing cAMP and activating protein kinase A

180
Q

Tetracycline effect on fetus during pregnancy

A

Stained teeth

181
Q

Chloramphenicol effect on fetus during pregnancy

A

“gray baby” syndrome

182
Q

Trimethoprim/sulfa effect on fetus during pregnancy

A

NTD

183
Q

Aminoglycosides effect on fetus during pregnancy

A

ototoxicity, vestibulotoxicity

184
Q

Rheumatoid Arthritis

A
  1. pain and swelling
  2. morning stiffness
  3. small joints (spares DIP)
  4. fever, weight loss, anemia
  5. cervical spin involvement

labs:
1: RF
Anti CCP antibodies
(Anti-cyclic citrullinated peptide )

  1. C reactive protein and ESR

XRay: soft tissue swelling, joint space narrowing, bony erosions

185
Q

Granuloma formation

A

Macrophages release TNF alpha and pro-inflamm cytokines (IL6, IL1, IL12) that promotoe macrophage and Th1 cell differentiation

Th1 produce IL2 and IFN gamma to promote further inflammation

186
Q

Fetal Hydronephrosis

A

most common site of obstruction is ureteropelvic junction

newborns with palpable abdominal mass and enlarged kidney

187
Q

Prophyria cutanea tarda

A

uroporphyringoen decarboxylase deficiency (UROD) of porphyrin synthesis

causes photosensitivity due to accumulation of porphyrinogens that react with oxygen on excitation by UV light

188
Q

Labs in Klinefelters syndrome

A

Increase LH and FSH

decreased testosterone

189
Q

LH and FSH in male

A

LH -> test

FSH -> inhibin

190
Q

Turner Syndrome

A

1 coarctation of aorta

  1. bicuspid aortic valve
  2. horseshoe kidney
  3. streak ovary
narrow, high arched palate
low hairline
webbed neck
broad chest/widely spread nipples
cubitus valgus 
short stature
191
Q

piriformis recess

A

superior laryngeal nerve damage (cough reflex)

192
Q

Acute hemolytic tranfusion reaction

A

Type II HSR against pre-existing anti-ABO abs

Complement reaction that causes erythrocyte lysis, vasodilation and shock

193
Q

IL4

A

produced by TH2

facilitates b cells and Th2

abs isotype switching to IgE

194
Q

paranoid personality

A

suspicious, distrustful, hypervigilant

195
Q

Schizoid personality

A

prefers to be alone, detatched, unemotional

196
Q

Schitzotypal personality

A

eccentric, odd thoughts, perceptions, behavior

197
Q

Antisocial personality

A

disregard and violation of others

198
Q

Borderline personality

A

chaotic relationships, sensitivity to abandonment, labile mood, impulsie, inner emptiness, self harm

199
Q

histrionic personality

A

dramatic, superficial, attention seeking

200
Q

narcissistic personality

A

grandiosity, entitlement, lack of empathy

201
Q

avoidant personality

A

avoidance due to fears of criticism and rejection

202
Q

dependent personality

A

submissive, clingy, needs to be taken care of

203
Q

Rett syndrome

A

normal development until 5-18 months then loss of motor and language skills, stereotypic hand movements, deceleration of head growth

de novo mut in x linked MECP2 gene

204
Q

pramipexole

A

direct dopamine agonist

205
Q

APL

A

Auer rods

15;17

206
Q

tubular fluid with low ADH

A

highest osm: bottom of loop of henle

207
Q

Vasopressin

A

increases water permeability within cortical and medullary collecting duct

activates urea transporters in medullary collecting duct increasing urea reabsorption

208
Q

Cyanide poisoning

A

Inhibits cytochrome c. oxidase in mitochondria

red skin, tachypnea, headache, tachy, n/v, confusion

tx: inhaled amyl nitrite oxidizes Fe2+ to Fe3+ with greater affinity for cyanide (sequesters cyanide and keeps it from binding cytochome oxidase)

209
Q

G6PD

A

increased oxidative stress due to lack of NADPH

210
Q

Glutathion reductase

A

uses NADPH to reduce glutathione

211
Q

Prognosis of PSGN

A

poor: age, pre-existing kidney disease

212
Q

PSGN tx

A

anithypertensives, salt/water restriction, diuretic

213
Q

Metabolic alkalosis diganosis

A

Need urine chloride

214
Q

hemochromatosis

A

HFE (hepatocytes and enterocytes)mutation interacts with transferrin receptor
decreased hepcidin and DMT1 leads to iron overload

increased risk for cirrhosis and hepatocellular carcinoma

215
Q

Gonadal arteries

A

arise from abdominal aorta

torsion can lead to ischmia

216
Q

Osteoblastic bone metastasis

A
  1. prostate
  2. small cell lung
  3. hodgkin lymphoma
217
Q

Osteolytic bone metastasis

A
  1. multiple myeloma
  2. non small cell
  3. non hodkin
  4. renal cell carcinoma
  5. melanoma
218
Q

Cavernous Hemangioma

A

most common benign liver tumor

cavernous blood filled vascular spaces of variable size lined by single epithelial layer

219
Q

Gram negative sepsis

A

LPS release from cell during division of lysis

Lipid A activates Macrophages leading to widespread release of IL-1 and TNR alpha leading to septic shock

220
Q

Methotrexate

A

Dihydrofolate reductase inhibitor

death of all rapidly dividing cells (GI, bone marrow)

tx of toxicity: folinic acid

221
Q

Radial nerve injury

A

hyperextension injury (supracondylar humerus fracture with anterolateral displacement)

wrist drop and loss of sensory of posterior forearm/dorsolateral hand

222
Q

radial nerve

A

hand/finger extensor

sensory to posterior forearm and dorsolat hand

223
Q

Ulnar nerve injuries

A

hyperflexion injuries (falling on fixed elbow) posterior displacement of proximal humerus or fracture of medial epicondyle

sensory loss over medial 1.5 digits and weaness of flexion of 4th and 5th digits and wrist

224
Q

ulnar nerve

A

wrist flexion and 4th and 5th finger flexion

225
Q

Mature mRNA

A
  1. 5’ cap (7-methyl-guanosine)
  2. poly-A tail at 3’ end
  3. Splicing (GU at 5’ and AG at 3’ splice site
226
Q

Cyclosporine

A

inhibits calineurin activation (necessary for activation of IL-2, which promotes growth and differentiation of T cells

227
Q

Tacrolimus

A

inhibits calcineurin activation

228
Q

Which part of kidney is most susceptible to ischemic injury

A

Renal medulla (esp proximal tubule and thick ascending lim of henle) due to active transport (ATP) depending of ions

229
Q

Acute Tubular Necrosis

A

decreased renal perfusion

increased creatinine and BUN with normal BUN/cr ration and oliguria

Histo: flattening of proximal tubular epithelial cells with loss of brush border, and cell necrosis of basement membrane

Muddy brown casts

230
Q

Muddy Brown Casts

A

ATN

231
Q

Uric acid kidney stones

A

often occur in distal tubules or collecting duct due to low pH

(tumor lysis syndrome)

232
Q

Etoposide

A

chemotherapy agent that inhibits sealing of topoisomerase II

double stranded DNA breaks seen

233
Q

Smooth ER

A

Detox
Steroid hormone synthesis
lipid synthesis
carb metabolism

234
Q

Latanoprost

A

topical prostaglandin used in tx of closed angle glaucoma

increase outflow of aqueous humor

235
Q

HER2

A

transmembrane glycoprotein with intrinsic tyrosine kinase activity (eGFR)

236
Q

ER and PR

A

intracellular receptors

increase cellular proliferation

237
Q

Papillary muscle rupture

A

anterolat papillar muscle: LAD

Posteriomed pap muscle: posterior descending

238
Q

Follicular lymphoma

A

non-Hodgkin lymphoma

t(14;18) Bcl2 over expression
anti-apoptotic effects

239
Q

Ataxia Telagiectasia

A
  1. Ataxia
  2. Telangiectasias
  3. Sinopulmonary infections
240
Q

Chediak-Higashi Syndrome

A
  1. Oculocutaneous albinism
  2. pyogenic infections
  3. Progressive neurologic dysfunction
241
Q

Chronic granulomatous disease

A
  1. severe bacterial and fungal infections

2. granuloma formation

242
Q

DiGeorge Syndrome

A
  1. Congenital Heart Disease
  2. Dysmorphic facies
  3. hypocalcemia
  4. hypoplastic thymus
  5. hypoplastic parathyroid causing hypocalcemia

Complete DGS is a type of SCID

243
Q

SCID

A
  1. severe bacterial and viral infections in infancy
  2. Chronic diarrhea
  3. Mucocutaneous candidiasis

thymic aplasia

244
Q

Terminal complement deficiency (MAC)

A

Recurrent Neisseria infections

245
Q

Wiskott-Aldrich syndrome

A
  1. Recurrent infections that worse with age
  2. Easy bleeding (thrombocytopenia)
  3. eczema
246
Q

Common variable immunodeficiency

A

B and T cell dysfunction

hypogammaglobulinemia

recurrent infections in children and adults

cell mediated immunity is not as impaired

247
Q

X-linked agammaglobulinemia

A

insufficient mature B cells

  1. infection with encapsulated pyogenic bacteria
248
Q

Patau Syndrome

A

Trisomy 13

Microcephaly
cutis aplasia
micrphthalmia
cleft lip/palate
umbilical hernia/omphalocele
rocker bottom feet
renal defects
cardiac defects
polydactyly

impaired fusion of prichordal mesoderm

249
Q

Edward’s Syndrome

A

Trisomy 18

fetal growth retardation
hypertonia
micrognathia
congential heart defects
clenched hands with overlapping fingers
Meckel's diverticulum 
malrotation
250
Q

Idiopathic intracranial hypertenison

A

Young obese women
H/A
Papilledema
transient visual disturbances worse with valsava

251
Q

TX of BPH

A
  1. alpha antagonsits (terazosin, tamsulosin
  2. 5-alpha-reductase inhibitor (finasteride, dutasteride)
  3. antimuscarinic (tolterodine)
252
Q

finasteride

A

inhibits conversion of testosterone to dihydrotestosterone

reduces prostate gland size

SE: decreased libido, ED

253
Q

Tumor suppressors

A
  1. APC
  2. BRCA1
  3. RB
  4. TP53
254
Q

APC

A

tumor suppressor in Adenomatous polyposis syndrome

colon cancer

255
Q

BRCA1

A

TS responsible for dna repair

breast and ovarian cancers

256
Q

RB

A

Tumor suppressor that regulates transition from G1 to S

257
Q

TP53

A

Tumor supressor gene

p53 inhibits proliferation of cells with genetic abnormalities

258
Q

Sickle cell

A

Substitution of valine (hydrophobic) for glutamic acid (hydophilic)

259
Q

Nitroprusside toxicity

A

Cyanide toxicity

tx: sodium nitrate (methemoglobin formation),
sodium thiosulfate (sulfur donor), hydroxocobalamin (cobalt binds cyanide)
260
Q

Burkitt Lymphoma

A

Associated with EBV

t(8;14)
cmyc (transcription activatior)

261
Q

Mantle cell LYmphioma

A

t(11;14) cyclin D1

promoter of g1 to S transition

262
Q

CML

A

BCR-ABL (9;22)

inhibits apoptosis and promotes mitogenesis and increased tyr kinase activity

263
Q

Alkaptonuria

A

AR disorder of tyrosine metabolism

urine turns black
black pigment in ears, nose and cheeks

264
Q

Akathisia

A

Subjective restlessness and inability to sit still

symptom of antipsychotics (Extrapyramidal)

265
Q

IgA Nephropathy

A

Painless hematuria 5-7 days after URI

Mesangial hypercellularity and IgA deposits

With extra renal symtpoms AKA Henoch Schonlein purpura

266
Q

Alport syndrome

A

Defective type IV collagen

Lamellated appearance of BM

267
Q

Recombination

A

gene exchange that occurs through crossing over of 2 double stranded DNA molecules

268
Q

Reassortment

A

Mixing of genome segments in segmented viruses that infect same host cell

269
Q

DNA Pol III

A

5’-3’ DNA synthesis and 3’-5’ exonuclease (proofreading)

270
Q

DNA pol 1

A

Same as pol III

also removed RNa primer (5’-3’ exonuclease)

271
Q

Granulosa Cell Tumor of Ovary

A
  1. increase in estrogen (endometrial hyperplasia, precocious puberty)
    2 Increased inhibin

Call exner bodies (cuboidal granulosa cells in rosette pattern with coffee bean nuclei)

Yellow theca cells with lipid

272
Q

DIC in pregnancy

A

due to release of tissue factor from placental trophoblasts following placental injury

273
Q

Multiple myeloma

A

Bone marrow with >30% plasma cells

  1. normocytic normochromic anemia
  2. Bone resorption due to Il-1 and IL-6 activation of osteoclasts
  3. hypercalcemia
  4. increases susceptibility to infection
  5. al amyloid in kidneys, heart, tongue and CNS
  6. Rena fialure

Uworld Jornal (5 decks)

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