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UWorld > Block 2 > Flashcards

Block 2 Flashcards

1
Q

What is the equation for Vd?

A

Vd = (amount of drug given)/(plasma concentration of drug)

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2
Q

What are the averages for total body water, extracellular fluid, and plasma volume?

A

average total body water: 41 L

extracellular fluid: 14 L

plasma: 3 L

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3
Q

What properties contribute to a low volume of distribution?

A

low Vd: high molecular weight, high polarity, high binding to plasma proteins

drugs that have low molecular weight and are uncharged can cross cell membranes and reach intracellular compartments, so they have a high Vd

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4
Q

What is the typical timing for a positive B-hCG result in the urine?

in the serum?

A

urine: 14 days after ovulation
serum: 8 days after oovulation

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5
Q

on which day does the multicellular morula enter the uterus as a 2-8 celled embryo?

A

3-4 days post ovulation

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6
Q

how long after fertilization does implantation occur?

A

6-12 days

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7
Q

when is the first dose of the Hib vaccine given?

A

at 2 months of age

before 2 months, humoral immunity is received from maternal IgG

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8
Q

what is the capsule of H influenzae composed of?

A

polyribosyl-ribitol-phosphate (PRP)

antiboodies to PRP facilitate complement-dependent phagocytosis and killing through opsonization

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9
Q

What do you see in Von Hippel-Lindau?

A

autosomal dominant, chromosome 3p deletion

  • cerebellar hemangioblastomas
  • clear cell renal carcinomas
  • pheochromocytomas
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10
Q

What are the 3 causes of Down Syndrome?

A

trisomy 21 (95%)

unbalanced Robertsonian translocations (extra arm of chr 21): 2-3%

mosaicism (pts have 2 cell lines: 1 normal, 1 w/ trisomy 21)

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11
Q

which drugs have been clearly shown to slow the progression of diabetic neuropathy in Type 1 and Type 2 diabetes both prior and after proteinuria?

A

ACE inhibitors, ARBs

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12
Q

what brain changes do you see in Huntington disease?

A

bilateral atrophy of the caudate nucleus and putamen (which form the striatum)

caudate atrophy leads to typical dilation of the frontal horns of the lateral ventricles

loss of GABA-containing neurons leads to decreased GABA

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13
Q

where are the leads placed in a 3-lead pacemaker?

A

the first 2 leads are placed in the right atrium and right ventricle

the 3rd lead paces the left ventricle

the lead enters the right atrium –> coronary sinus (which resides in the atrioventricular groove on the posterior aspect of the heart) –> lateral venous tributary

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14
Q

what is the reason that gram-positive organism are now a more frequent cause of nosocomial bloodstream infections?

A

increasing use of intravascular devices shifting the microbiology

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15
Q

what drug is used in patients who have had a transient ischemic attack to prevent primary and secondary coronary artery events/strokes

A

low dose aspirin

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16
Q

what is specificity?

A

(number of true negatives)/(total number of patients without disease)

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17
Q

what is sensitivity?

A

(number of true positives)/(total number of pts with disease)

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18
Q

how to calculate false positives?

A

(1-specificity)*number of patients without disease

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19
Q

S4 heart sound

A

sign of diastolic dysfunction, occurs when there is a sudden rise in the end-diastolic ventricular pressure caused by atrial contraction against a ventricle that has reached its elastic limit (aortic stenosis, hypertrophic cardiomyopathy)

20
Q

what is the biggest cause of wrinkles?

A

decrease in collagen fibril production, decreased dermal collagen and elastic fibers –> sagging, wrinkles

21
Q

what disease shows proximal muscle weakness, increased CK, increased anti-Jo, CD8+ T cells

A

polymyositis

22
Q

what lung cancers are associated with smoking?

A

squamous cell carcinoma, small cell carcinoma

23
Q

most common lung cancer?

A

adenocarcinoma, frequently in women/nonsmokers

24
Q

how can small cell carcinomas be distinguished from non small cell carcinomas?

A

small cell is distinguished by its aggressive behavior and is treated with chemo and radiation

nonsmall cell carcinomas can be treated w/ surgery if localized

25
Q

What does a negative Gibbs free energy number mean?

A

G = -RT(ln Keq)

If Gibbs is negative, Keq will be greater than 1, meaning the concentration of products will exceed that of substrates

26
Q

what happens to atropines half life in the elderly?

A

atropine’s half-life may be prolonged from its usual 3 hours to up to 10-30 hrs due to decreased clearance –> toxicity

27
Q

what is coarctation of the aorta associated with?

A

other cardiac anomalies or with berry aneurysms of the Circle of Willis

these berry aneurysms are prone to rupture. Coarctation of the aorta –> increased hypertension in the brances of the aortic arch proximal to coarct –> subarachnoid hemorrhage

28
Q

Which component of HIV binds to CD4 and CCR5 chemokine receptors, leading to HIV entry from fusion with the cell membrane?

A

HIV viral outer envelope protein gp120

If cells don’t express CCR5 on membrane, HIV binds to CD4 but is unable to enter the cell

29
Q

What are Nef and Tat?

A

Nef and Tat are HIV genes

TAT gene product plays a role in viral replication

Nef decreases expression of MHC class I proteins on the surfaces of infected cells

30
Q

What cells of the adrenal medulla receive sympathetic input and are stimulated by ACh released by preganglionic neurons to secrete NE and Epinephrine directly into the blood stream (80% epi, 20% NE)?

A

chromaffin cells

31
Q

What can be a limiting factor when initiating ACE inhibitors and what other drugs can potentiate that factor?

A

first dose hypotension

thiazide loop diuretics can cause hypovolemia and hyponatremia, thus potentiating the effects of 1st dose hypotension

32
Q

which “swish and swallow” agent binds to ergosterol molecules in the fungal cell membrane, causing pores and leakage of fungal cell contents?

given as an oral agent to treat thrush

A

nystatin

33
Q

what are asthma patients who take oral or inhaled steroids at risk for?

A

candidiasis

34
Q

why are ritodrine and terbutaline used to defer premature labor?

A

they are B2 agonists

adrenergic receptors of the uterus belong to the B2 group whose stimulate leads to uterine RELAXATION

35
Q

Winter’s formula

A

PaCO2 = 1.5 * HCO3- + 8 (+/-)2

36
Q

What is unique about S. bovis in addition to its association with colonic malignancy?

A

Causes endocarditis but the majority of cases are in patients with no preexisting valvular abnormality

37
Q

Caucasian boy brought to clinic because face is “puffy” in morning and he has proteinuria

A

Minimal change disease

38
Q

What happens when Ca2+ binds to troponin C?

A

tropomyosin shifts to expose the actin binding sites for myosin, allowing contraction to occur

39
Q

what is the gold standard for diagnosis of mesothelioma?

A

electron microscopy

EM will show tumor cells with numerous, long, slender microvilli and abundant tonofilaments

adenocarcinoma have short, plump microvilli

40
Q

in what disease will an EM show tumor cells with numerous, long, slender microvilli and abundant tonofilaments?

A

electron microscopy

41
Q

what is the triad seen in fat embolism syndrome?

A

acute onset neurologic symptoms

hypoxemia

petechial rash

42
Q

how does a fat embolism cause ARDS?

A

fat globules occlude microvessels in lung –> release of fatty acids from globules causes local toxic injury to endothelium –> ARDS

43
Q

why do fat embolisms causes thrombocytopenia and petechiae?

A

platelets adhere to and coat the fat microglobules

44
Q

how do fat emboli cause acute onset neurologic symptoms?

A

some fat globules escape lungs and occlusion can happen in the CNS

45
Q

what does hypothermia due to the oxygen hemoglobin saturation curve?

A

shifts curve to the left

lower temperatures help to stabilize the bonds between oxygen and hemoglobin

UWorld (6 decks)

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