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usmle > bichemistry and tests > Flashcards

bichemistry and tests Flashcards

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USMLE® Step 1 flashcards
1
Q

what is the problem with chorinoic villous sampling

A

10• 14 weeks

• Risk of miscarriage, bleeding, infection

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2
Q

why hg electophoreis more significant test for scd

A

involves separation of proteins

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3
Q

when is karyotype used

A

A karyotype is a visual analysis of all the chromosomes in a cell ordered by size and stained to reveal chromosomal bandin

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4
Q

name me cyto p450 inducers

A

CYP450 inducers, griseofulvin, rifampin, antiepileptics, EtOH and smokin

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5
Q

explain role of estrogen in association of thyroid hormones

A

Estrogen (eg, pregnancy, oral contraceptives) causes increased production of TBG, which lowers free thyroid hormone levels. A brief rise in TSH subsequently increases production of thyroid hormone to saturate the increased TBG binding sites, and the patient returns to a euthyroid state.

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6
Q

how is lactation suppressed in pregnant woman

A

progestrone binds to receptors preventing prolacting from binding so when it is lowered there is binding of progestrone

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7
Q

what is congenital torticallis

A

Develops by 24 weeks of age
• MCC by birth trauma or malposition of head in utero (macrosomia or oligohydramnios) > sternocleidomastoid injury and fibrosis
• Palpable soft mass in inf 1/3 of SCM
• Associated with hip dysplasia, metatarsus adducts and talipes equinovarus (clubfoot)

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8
Q

what are the symotoms of adrenal crisis in terms of epinephrine/norepinephrine

A

Cortisol is also necessary for the synthesis of epinephrine in the adrenal medulla; the consequent reduction in circulating epinephrine leads to a compensatory increase in norepinephrine to increase vascular tone in an effort to maintain blood pressure.

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9
Q

why is total cortisol low in liver cirrhosi

A

decrease in cortisol binding protein

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10
Q

which change in physiologiocal condition elevates cortisol

A

dehydration and hf

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11
Q

why in ectopic acth production aldestrone is low

A

it is suppressed because cortisol and other stress hormones have some mineralcorticoid activity

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12
Q

unilateral mlf lesion

A

Unilateral MLF lesions typically occur in older patients with lacunar strokes in the dorsal pons or midbrain (pontine artery distribution) and result in impaired adduction of the ipsilateral eye during horizontal gaze, causing diplopia

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13
Q

explain hepatic hydrothorax

A

fluid movement across diphragm due to increase in intradbdominal pa

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14
Q

explain mechanism of parapneumonic effusion and inflammatory disease effusion

A

disruption of visceral pleura causes bacteria to move from alveoli to pleura, rheumatologic effusion is also due to increased inflammation

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15
Q

coponents of bacterial cell wall/which drug resistant

A

Mycoplasma

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16
Q

why we have pelvic cramping and vaginal bleeding ine ctopic pregnancy

A

ectopic pregnancy causes high vasuclarization draws blood from surrounding structures=ischemic injury and potentially rupture

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17
Q

icthyosis vulgaris

A 
dry sin--->diffuse scaly pattern
abnormal kertanization
mutation in flaggarin skin
trunk and extensor surfaces of extremeties--->palmarhyperlineraity
important in seasonal variation
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18
Q

what are the clinical features of testicular torsion

A

testicular inguinal or abdominal pain

inadequate fixation of testis to. lower portion of tunca vaginalis

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19
Q

bulging of groin or scrotum is?

A

inguinal hernia absent high riding prostate and if inaacerated acute scrotal pain

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20
Q

what does the supraclavicular lymph node drain

A

chest and abdomen unlilkely to be casused by childhood infections

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21
Q

anterior/post cervical ln

A

Anterior and posterior cervical lymphadenopathy is common with upper respiratory infections because these nodes drain the neck and oropharyn

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22
Q

submental and submandibular lymphnodes

A

enlarged oral cavity inf,dental inf,cocksacike virus inf

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23
Q

what is the tox gene in corynebacterium diphtheria

A

This phage inserts the tox gene into the C diphtheriae genome, which results in the bacterial expression of the diphtheria AB toxin.

24
Q

what part of the male stores sperm prior to maturation

A

epidydimis

25
Q

peniorre disease is due to

A

excessive collagen in tunica albugenia which causes pain

26
Q

a patient has ileostomy and chronic diarrhea what complication can she have

A

chronic diarrhea or those who have had a colectomy have reduced bicarbonate reabsorption from the gut, leading to a state of chronic metabolic acidosis. The kidneys compensate by increasing the excretion of hydrogen ions (H+) and reabsorption of bicarbonate in the collecting ducts. This lowers urine pH (acidic urine), increasing the conversion of soluble urate ion into insoluble uric acid.

27
Q

pathogensis of migrain

A

cortical spreading depression trigeminal afferents in the meninges causes the release of vasoactive neuropeptides, including substance P and calcitonin gene–related peptide (CGRP),

28
Q

how do triptans work

A

5-hydroxytryptamine 1B/1Dagonists that directly counter migraine headaches by binding to trigeminal serotonin receptors and inhibiting CGRP release from the trigeminal neurons
causes intracranial vc

29
Q

how does calciphylaxis present in patients

A

This usually occurs in patients with end-stage renal disease receiving hemodialysis and presents with extremely painful nodules, plaques, and ulcers.

30
Q

how does tinea versiclaor cause

A

macular rash on trunk

31
Q

how does hypothyrodism present on skin

A

dermal hickening and induration deposition of glycosaminoglycasn ( thyroid dermopathy

32
Q

what is the manifestation of agammaglobulinemia

A

sinopulmonary infections

33
Q

what is the problem with cgd

A

impaired nadph oxidase impaired phagocytes therefore impaired catale =
osteomyletis and sepsis

34
Q

how to test a person whether he has t cell fuck up what is the failure of response called

A

insert candida antigen if induration t cell okay if not it is fucked up it is called naergy

35
Q

peristent tunica vaginalis can lead to what two pathologies

A

if opening small=communicating hydrocele

if opening big hernia

36
Q

what is ingional hernia covered by

A

spermaic fascia

37
Q

primary nocturnal enuresis

A

Awareness of bladder filling
Suppression of bladder contractions by the cerebral cortex
Coordination of sphincter/detrusor function in the pontine micturition cente

THERE IS BRAIN MATURATION DELAY

38
Q

maxillary sinisitus spreads to

A

Maxillary sinusitis can spread contiguously to the orbit and cause periorbital or orbital cellulitis and abscess.

39
Q

peritonsillar abseceses

A

Peritonsillar abscess usually presents with fever, sore throat, and a muffled voice. Complications include airway obstruction and spread of the infection to the deep neck spaces or mediastinum.

40
Q

clinical exam findings of strep throat

A

abrupt onset of fever and sore throat ( differnetial would be measels

41
Q

how to diagnose them

A

RADT therapy and throat swab testf

actor that coats the surface of GAS, provide protective immunity against future infections with a particular GAS strain

42
Q

how does zidovuidine work

A

binds to reverse transcriptase > incorporated into viral geneome (as thymidine) > prevents 3’• 5’ phosphodiester bond (azido instead of hydroxyl in 3’) preventing elongation

43
Q

how does doxirubicin work

A

Intercalate between bases causing defective base pairing and splitting of DNA fucks up the hydrogen bond formation

44
Q

risk factor of preclampsia

A

dm cocain previous htn and multiple gestation(increased placental mass)

45
Q

why preclampsia causes widespread vasospasm

A

antiangiogenic factors that cause widespread maternal endothelial cell damage. The resulting capillary leakage is responsible for third spacing of fluid (eg, facial edema, weight gain) and leakage of protein into the urine (ie, proteinuria). In addition, disrupted endothelial control of vascular tone causes hypertension and widespread vasospasm, resulting in end-organ hypoperfusion

46
Q

why secondary infection of dengue severe

A

Secondary infection with different serotype is more severe, Ab dependent enhancement of infectiondue to antibody-dependent enhancement of infection, enhanced immune complex formation, and/or accelerated (not blunted) T-lymphocyte responses

47
Q

the only way to dy/dx b/w asperigillus mucor

A

acute septate/ is the only way

48
Q

reactive thrombocytosis

A

infection—>high il6 high TPO reactive thrombocytosis seen in malignancy,rheumatology and burns and noninflammatory–>miron deficiency hemolysis and blood loss
MCC spelnectomy
also hepcidin released which casues decrease fe absoprtion

49
Q

essential thrombocytopenia

A

essential thrombocytopenia triad of symotoms

-thrombocytosis,vasomotor and increased risk of thrombosis

50
Q

how elevated the srum marker of calcium should be to suggest malignancy

A

greater than 13 mg.dl

51
Q

MOA of calcineurin and drugs used

A

calcineurin-activated upon stimulation
moa
dephosphyrulation of NFAT =enters nucleus binds to IL2 promotes synthesis
cyclosporine and tacrolimus inhibit this activation

52
Q

MCAD deficency

A

Carnitine deficiency impairs FA transport from the cytoplasm into mitochondria, preventing β- oxidation of FAs into acetyl-CoA. This leads to cardiac and skeletal myocyte injury (lack of ATP from TCA) and impaired ketone body production by the liver during fasting periods.

53
Q

glutathione

A

Glutathione is a tripeptide that can be synthesized from amino acids (glutamate, cysteine, and glycine).

54
Q

cofactors of homocystenine conversion

A

cysteine (pyridoxine) or recycled into methionine (cobalamin)

55
Q

where is palmitate synthesized

A

Palmitate is a fatty acid that can be ingested or synthesized from carbohydrates. Palmitate synthesis occurs in the cytosol and would not be affected by carnitine deficiency

usmle (38 decks)

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