Daily UWorld Qs Flashcards
Antibodies found in celiac disease
- IgA anti-endomysial
- anti-gliadin
- anti-tissue transglutaminase
instetinal biopsy findings of celiac disease
- Villi atrophy
- crypt hyperplasia
- intraepithelial lymphocyte infiltration
Regions most affected by celiac disease b/c of highest concentration of gluten
duodenum and proximal jejunum
A vascular malformation that occurs in brain parenchyma and increase the risk of intracerebral hemorrhage and seizure
Cavernous hemangioma
The most common side effect of opioids
opioid-induced constipation (OIC)
Tx for OIC
Methylnaltrexone (peripheral u-opioid receptor antagonist)
Under normal circumstances, pulmonary capillary wedge pressure is equal to
LA pressure
pulmonary capillary wedge pressure increases when
LA pressure increases (mitral stenosis)
Endocarditis that is characterized by mitral valvular deposition of platelet-rich thrombi without bacterial infection
Nonbacterial thrombotic endocarditis associated with malignancy or lupus
Hyperuricemia that predisposes to gout can be idiopathic or due to increased urate production such as
- Myeloproliferative/lymphoproliferative disorders
- Tumor lysis syndrome
Hyperuricemia that predisposes to gout can be idiopathic or due to decreased clearance of monosodium urate crystals such as in
- CKD
- Thiazide/loop diuretics
asymptomatic thrombocytopenia during pregnancy is
gestational thrombocytopenia
asymptomatic thrombocytopenia during pregnancy is caused by
plasma volume expansion (hemodilution) & increased platelet sequestration/consumption in placenta
Normally, inspiration increases venous return to the right side of the heart and _____ JVP
lowers/decreases
Paradoxical rise in JVP during inspiration is known as _____
Kussmaul sign
Pericardial knock and Kussmaul sign is associated with _____ and _____ by encasing the heart and restricting ventricular filling
- Constrictive pericarditis (thick/fibrous tissue in the pericardial space)
- Cardiac tamponade
A pause elicited by pain during inspiration while physician deeply palpates the RUQ is known as
+ Murphy sign
- CN V1 (ophthalmic nerve) exits through ____
- CN V2 (maxillary nerve) exits through ____
- CN V3 (mandibular nerve) exits through ____
- Superior Orbital fissure
- Foramen Rotundum
- Foramen Ovale
“ORO”
Appendicitis initially starts with dull pain at the umbilicus and then the pain progresses to McBurney’s point (2/3 distance from the umbilicus to anterior superior iliac spine) because of
irritation of the parietal peritoneum by appendix
serum sickness is an example of type __ hypersensitivity
III
Type 3 hypersensitivity is resolved/cleared by
mononuclear phagocyte system (macrophages)
firm, shiny, round flesh-colored papules with central umbilication
molluscum contagiosum
molluscum contagiosum is caused by___ and is spread through
poxvirus; sexual contact
Raw or steamed shellfish (oyster, shrimp) is the common culprit for hepatitis __
Hepatitis A
An autoimmune disorder caused by autoantibodies against postsynaptic nicotinic ACh receptors; progressive WORSENING after exercise or with muscle use; spared reflexes
Myasthenia gravis
An autoimmune disorder caused by autoantibodies against presynaptic ca+2 channel (decreased Ach release); progressive improvement after exercise or with muscle use; hyporeflexia
Lambert-Eaton Syndrome
Myasthenia gravis is associated with what disease?
Thymoma, thymic hyperplasia
Lambert-Eaton Syndrome is associated with what disease?
Small Cell Lung Cancer
Tx for Myasthenia Gravis
Cholinesterase inhibitor (pyridostigmine)
Cholinesterase inhibitor (pyridostigmine) side effects
muscarinic overstimulation due to increase ACh –> DUMBELS
Cholinergic toxicity symptoms (DUMBELS)
D: diarrhea/diaphoresis U: Urination M: Miosis B: Bronchospasm E: Emesis L: Lacrimation S: Salivation
Tx for cholinergic toxicity
Muscarinic antagonists (glycopyrrolate)
Pediculus humanus capitis is aka
head lice (egg casings in hair)
Pulsus paradoxus (>10 mm Hg drop in systolic BP with inspiration) can be seen in what 2 diseases?
- cardiac tamponade
2. COPD
What’s Beck’s triad seen in cardiac tamponade?
- Hypotension (decreased diastolic filling and CO)
- Distant heart sounds (decreased PMI)
- JVD
In cardiac tamponade, right side heart SIZE (atrium & ventricle) ____ but right side PRESSURE ____
Decreases (compressed); increases
The most nephrotoxic antifungal medication
Amphotericin B
What is achalasia?
absence of peristalsis in esophagus and loss of fx in lower esophageal sphinter
What parasite causes achalasia due to destruction of the submucosal (Meissner) and myenteric (Auerbach) plexus?
Trypanosoma cruzi (U shaped flagellated parasite)
- Chagas disease
What is the vector for chagas disease?
kissing bug (Triatoma and not a tick)
Chagas disease can present with what other physical manifestations (heart and GI)?
Heart: dilated cardiomyopathy
GI: Megaesophagus or Megacolon
All mitochondrial myopathies will have what muscle biopsy finding?
Red ragged (blotchy red) muscle fibers
A mitochondrial myopathy with myoclonic epilepsy with ragged red fibers is known as
MERRF
A mitochondrial myopathy with encephalopathy with stroke-like episodes and lactic acidosis is known as
MELAS
Hepatic encephalopathy (altered mental status) is due to excess ___ in cases of liver injury, disease, or cirrhosis
ammonia
Tx for hepatic encephalopathy that increases conversion of ammonia to ammonium
Lactulose
Tx for hepatic encephalopathy that decreases intraluminal ammonia production
Rifaximin
Both afferent and efferent nerves of JAW JERK REFLEX is mediated by
trigeminal nerve (V3)
Amniotic fluid with elevated AFP and polyhydramnios indicate
anencephaly (no drinking center)
A vascular malformation in which blood courses directly from arteries to veins (w/o passing capillary bed) that occurs in brain parenchyma
Cerebral arteriovenous malformation (AVM)
Microscopy finding of AVM
A tangle of abnormal vessels with thickened walls
Explain how Nitrates (NO) work on ED
Nitrates are converted to NO by endothelial cells –> NO increase intracellular cGMP –> cGMP induce vascular smooth muscle relaxation (vasodilation) –> improves ED
Explain how PDE inhibitors work on ED
Normally, cGMP is degraded by phosphodiesterase –> PDE inhibitors inhibit this enzyme from degrading cGMP –> increased cGMP –> vasodilation –> improves ED
The activation of “cytotoxic” T cells requires what 2 stimulatory signals?
- CD8+ T cell must bind to a specific antigen on MHC I of an APC
- The bound T cell must be costimulated by an interaction between the T cell surface receptor CD28 and the APC cell surface ligand CD80/86
T cells (regardless of type) binds to antigen-MHC I or II complex through what receptor on its surface?
TCR (T-cell receptor)
CD 80/86 is aka.
B7
T cells that bind an antigen on an APC but are not costimulated undergo what form of anergy?
peripheral immune tolerance
calculated by dividing the number of fatal cases of a disease or condition by the total number of people with that disease or condition.
Case-fatality rate
Alpha 1 blockers that can treat both BPH and HTN
- zosin
doxazosin, prazosin, and terazosin
Alpha 1 blockers that can treat only BPH (uroselective)
- Tamsu”losin”
the most common primary bone malignancy. Histology shows pleomorphic, spindle-shaped cells that produce new osteoid and bone.
Osteosarcoma
the second most common malignant bone tumor of childhood (after osteosarcoma); Histopathology is characterized by uniform, small, round, cells; fibrous septae; and patches of necrosis and hemorrhage.
Ewing sarcoma
is characterized by overuse of wrist extensor muscles (eg, extensor carpi radialis, extensor digitorum), leading to pain at their attachment on the lateral epicondyle
Lateral epicondylitis (ie, tennis elbow)
is characterized by overuse of wrist flexor muscles, leading to pain at their attachment on the medial epicondyle
Medial epicondylitis (ie, golfer’s elbow)
the most common subtype of renal cell carcinoma and is composed of large, rounded, or polygonal cells with clear cytoplasm. These tumors are often detected incidentally at an advanced stage; the lung is the most common site for metastasis
Clear cell carcinoma
year-round infection that causes the acute onset of fever, cough, congestion, pharyngitis, and conjunctivitis; occur in outbreaks among those living in close quarters (eg, camp dormitories, military barracks)
Adenovirus
Describe adenovirus
nonenveloped, ds DNA
