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Uworld assessment 2 > block 3 > Flashcards

block 3 Flashcards

1
Q

Chlamydia trachomatis does not have a cell wall. What do we use to treat?

A

1 dose azithromycin - macrolide (inhibit protein synthesis by blocking translocation; bind to the 23S rRNA of the 50S ribosomal unit)

more complicated infections, use doxycylcine (tetracycline) which is bacteriostatic, binds to 30S and prevents attachment of aminoacyl tRNA; limited by CNS penetration

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2
Q

Probenecid inhibits renal tubular secretion of penicillins, most chephalopsorins and other weak organic acids

A

-prolonging the action of these agents by slowing elimination

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3
Q

Imipenem is a carbapenem b-lactam antibiotic

combined with?

A

cilastatin an agent that prevents proximal renal tubular brush border hydrolysis of imipenem by dehydropeptidase (dipeptidase) thereby prolonging the antibacterial effect of imipenem

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4
Q

retinoid agents

A

-especially retinate, can accumulate in the adipose tissue and cause birth defects. craniofacial defects and cardiac defects and most commonly observed

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5
Q

Hyperstrogenemia in liver disease

A 
present:
spider angiomas (spider telangiectasias), palmar erythema, gynecomastic, testicular atrophy and decreased body hair and dyputrens conctractures

cirrhosis: decreased metabolism of estrogen by failing liver, decreased production of sex hormone binding globulin by the liver (which causes increased free sex hormone levels) and decreased metabolism of adrogens, which are converted peripherally to estrogens by aromatase

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6
Q

Neurofibromatosis type 1 (von Rencklinghausen disease)

A
  • autosomla dominant disorder associated with a mutation in the NF gene on chromosome 17qll
  • multiple neurofibromas
  • multiple pigemented lesions such as cafe au lait
  • axillary freckling (crowes sign)
  • pigmented iris hamartomas (lisch nodules)
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7
Q

neurofibromas

A

consist of loos and disoranized proliferations of Schwann cells (elongated, wavy cells with spindly nuclei), fibroblasts and neurites

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8
Q

68/95/99 rule

A

1 standard deviation of the mean 68 %
2 standard deviation of the mean 95%
3 standard deviations 99.7%

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9
Q

leucovorin

A

is a reduced form of folic acid that is used in treating overdosage of folic acid antagonist such as methotreaxate.

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10
Q

colchicine

A

reduces leukocyte motility and phagocytosis though inhibition of microtuble formation in addition to other mechanisms of action. it is a second-line agent for gout

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11
Q

niacin effects?

A
  • increased HDL
  • decrease LDL
  • decrease TG

how? impair hepatic production of VLDL and thereby decreases LDLD which is formed form VLDL by lipoprotein lipase, It also inhibits hormones sensitive lipase in adipose tissue and in which reduced triglyceries. It also inhibits triglyceride biosynthesis in the liver.
-limits the cholesterol transfer of HDL to VLDL and by slowing HDL clearance –> increased HDL

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12
Q

Follicular atresia

A

without sufficient FSH exposure, oocyte and granulosa cells within primordial follicles undergo apoptosis.

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13
Q

latex agglutination inhibition reactions

A
  • limited amount of anti-antigen antibodies
  • urine may have the antigen or may now
  • latex bound to antigen
  1. add your urine to the anti-antigen antibodies, if you have the antigen like bhCG then they will bind
  2. you added the latex-antigen particles, if there is not antigen in the urine, the latex antigen particles with bind to the antibody and cause a latex agglutination. Thus agglutination means you dont have the antigen, if no agglutination happened that means you had the antigen in your urine
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14
Q

amitriptylines (Tricyclic antidepressents)

side effects

A
  • affinity for muscarinc receptors
  • produce adverse anticholinergic effects such as hyperthermia, flushing, mydriasis, dry mouth, and alpha antagonistic properties that would cause vasodilation and thereby contribute to inducing tachycadia
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15
Q

Adverse effects of SSRI

A

-GI upset and anorgasmia

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16
Q

side effects of antieleptic carbamazepine?

A

cutaneous hypersensitivity reactions, hepatotoxicity, agranulocytosis and aplastic anemia

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17
Q

Restriction fragment length polymorphism (RFLP)

A

The prodedue is carried out first by treating DNA with bacteria restriction enzymes, which function by cleaving DNA at specific DNA sequences. This will result in the production of numerous restriction fragments of DNA. Genetic variation in the DNA sequence will result in restrict of fragments of differing lengths. which can then be separated by size on Gel.
Single base pair change –> restriction enzymes depend on the recognition of a specific sequence of base pairs in order to cleave DNA. A change will result in RF of differing lengths

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18
Q

Pleiotropy

A

phenomenon where a single gene can cause multiple phenotypic traits. RFLP can not determine if a specific gene exhibits pleiotropy.

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19
Q

uniparental disomy

A

inheritance of both copies of a single chromosome from a single parent

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20
Q

Drugs commonly used to coat drug-eluting stents include: paclitaxel and sirolimus

A

Paclitaxel is an antineoplastic agent that functions by binding b-tublin and preventing microtubule breakdown, thus causing arrest of the cell cycle in the M phase, –> inhibit cellular division and prevent stent restenosis by preventing intimal hyperplasia

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21
Q

All RNA virus replicate in the cytoplasm except?

A

Influenza virus and retroviruses like HIV which replicated in the nucleus.

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22
Q

Influenza virus, an orthomyxovirus with negative-sense single-stranded RNA genome

A

-fevers, chills, malaise, couch, sore throat, upper respiratory congestion, arthralgias and myalgias of acute onset

23
Q

Paramyxovirus are ss -ve sense RNA

A

RSV –> pneumonia in infants

Parainfluenza virus –> causes croup and brochiolitis in childen and bronchitis in adults

24
Q

Adenovirus

A
  • dsDNA
  • replicates in nucleus
  • URI
  • conjunctivitis
25
Q

Insulin and glyclysis

A
  • inactivates Protein kinase A, which can no longer phosphoylate PFK2
  • PFK2 in its dephosphorylate state is active and increases levels of f-2,6,bisphosphonate
  • f-2,6-BP stimulates PFK1 –> glycolysis over gluconeogenesis
26
Q

How does insulin drive K into cells?

A

-activates the Na/K/ATPase leading to more K entering the cell

27
Q

The deltoid and the trapezius muscles attach to the lateral end of the clavicle

A

-the deltoid will draw a fracture distal clavicular fragment inferolaterally while the trapezius will tend to draw such a fragment superomedially.

28
Q

The sural nerve is purely sesory nerve

A

-innervates the skin of the posterolateral leg and lateral foot

29
Q

tibial nerve is a branch of the sciatic nerve

A

-it provides motor innervation to the posterior compartment of the lower leg as well as to the plantar flexors of the foot. It provides sensory innervation to the sole of the foot

30
Q

deep peroneal

A
  • branch of the common peroneal nerve
  • first webspace of foot
  • anterior compartment of lower leg muscles
31
Q

saphenous nerve

A

sensory nerve that supplies the medial leg and foot

32
Q

ornothine transcarbamoylase deficience is the most common defect of the urea cycle

A

this ezyme converts carbamoyl phosphate to citrulline

  • hyperammonemia
  • accumulation of carbamoly phosphate–> converts to orotic acid’
33
Q

Transduction

A

bacterial DNA is transported from one bacterium to another by a virus (bacteriophage)

34
Q

Uncal herniation

A

uncus ( the most medial part of the parahippocampal gyrus) is pressed though the tentorium cerebelli into the infratentorial space

  • the herniated temperoal lobe exerts pressure on the CNIII
  • resulting in a fixed and dilated pupil on the ipsilateral side due to interruption of the parasympathetic fibers innervation the iris (recall they are the outmost portion)
35
Q

conversion disorder

A

presence of symptoms that are unexplained by any medical condition and are preceded by psychological stresoor. The symptom is not intentionally produced and causes impairement of normal functioning

36
Q

somatization disorder

A

is characterized by multiple physical complaints including four pain symptoms, two GI, one sexual and one pseudoneurological symptomb begninng before 30

37
Q

CAG repeat in huntingtons codes for what amino acid??

A

glutamine

38
Q

variable expression

A

-variation in the clinical features exhibited by individuals with the same gene alteration

39
Q

penetrance

A

is a percentage of individuals with a specific genotype who exhibit the associated phenotype

40
Q

genetic heterogeneity

A

-different mutation in a variety of different genes elicit a similar phenotype

41
Q

pleitrophy

A

when a single gene influences multiple phenotypic traits

42
Q

MCAD medium chain acyl Coenzyme A dehydrogenase deficiency

A

autosomal recessive

  • inability to degrade medium length fatty acids (6-12 carbons) by beta oxidation
  • suffer fasting hypoglycemia because acetyl Coa is consumed in synthesis but not recovered in beta oxidation
  • lower Coa inhibits oxaloacetate to pyruvate and inhibits gluconeogenesis
43
Q

Urea

A

-the nitrogen atoms are derived from free ammnoia and aspartate the carbone atom is derived from CO2

44
Q

patients taking high doses of loop diuretics are predisposed to hypokalemia and contraction alkalosis

A

early signs:

muscle weakenss, cramps, myalgias and fatigue

45
Q

psoas major

A

originates at the T12-L4 vertebrae, passes below the inguinal ligament over the ala of the ilium and attaches to the lesser trochanter of the femur. Spread of the pus along the psoas muscle may lead to formation of an abscess in the GROIN and pain referred to that region.

46
Q

mutations in DNA mismatch repair enzymes can result in microinstability

A

like HNPCC

47
Q

MEN 1 vs MEN II

A

MEN I MENIN tumor supressor genes

MEN II and III are RET protooncogene

48
Q

endometriosis and infertilitiy

A

adhesions and endometriomas can cause infertlity by distorting the pelvic anatomy and impairing transport through the oviduct

49
Q

HIV patient – CMV colitis

A

CMV is the most common opportunisitic viral infection affecting the GI tract
-CMV colitis is the seoncd most common reactivation syndrome after CMV retinitis
presents:
chills, fever, anorexia, wt loss, abdominal pain
colonoscopy: mucosal erythema, erosions ulcerations
histo: acute and chronic inflammatory changes, vasculitis and giant cells with large ovoid nuclei containing centralized intranuclear inclusions

50
Q

cyptosporidium is a protozoan parasite

A

that causes watery diarrhea in both immunocompromised and immunocompetent patients. The organism is confined to the microvilli of the small intestine and biopsy will show basophillic parasites attached to mucosal brush border

51
Q

Enfuvirtide is a HIV fusion inhibitor

A

binds to viral gp41 and prevents fusion between the viral and host cell membranes

52
Q

obstruction of the IVC

A
  • often due to a renal tumor

- produces lower extremity edema and often prominently visible abdominal wall collateral venous circulation

53
Q

renal cell carcinoma

A
  • triad of flank pain, flank mass and hematuria

- inappropriate EPO production by the tumor may result in assoc. erythrocytosis

Uworld assessment 2 (4 decks)

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