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Step 1 UWorld > Deck 10 > Flashcards

Deck 10 Flashcards

1
Q

What environmental exposure is associated with tuberculosis?

A

Silicosis: impairs macrophage effector arm

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2
Q

What causes TCAD overdose cardiac symptoms? Tx? What receptors are affected?

A

Blockage of cardiac fast channel Na channels; Tx = sodium bicarb; other receptors = muscarinic, histamine, alpha-1

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3
Q

Tx for status epilepticus?

A
  1. IV lorazepam (increased GABA activation) - rapid onset 2. the phenytoin (block Na channels) as long lasting - prevention
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4
Q

COX-2 is an inducible enzyme that is stimulated by what?

A

IL-1, TNF-a by infiltrating cells

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5
Q

What med should be given for pain in patients with reflux or ulcer disease?

A

COX-2 selective inhibitors (celecoxib) - COX1 has “housekeeping” roles like gastric mucosal protection

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6
Q

How are CD8 Tcells activated?

A

IFN-gamma & IL-2 by Th1

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7
Q

Pneumonia with diarrhea, high fever… what do you think of?

A

Legionnaires disease

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8
Q

What causes straw colored urine discharge to come from umbilical cord?

A

Patent urachus (from the allantois)

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9
Q

What causes tender umbilical cord with erythema and purulent discharge?

A

Urachal sinus (failure of distal urachus - from allantois - to close)

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10
Q

Morphology of hep E?

A

Unenveloped ssRNA

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11
Q

What are risk factors for infant vitamin K deficiency? What are symptoms?

A

Born with low stores > parental refusal of vit K prophylaxis, exclusive breastfeeding, cystic fibrosis; BLEEDING (intracranial, GI, cutaneous, umbilical, surgical site)

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12
Q

Chest pain radiating to neck or shoulders, worse with inspiration, helps to lean forward?

A

Pericarditis

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13
Q

In what condition do you see serositis (Pleurisy, pericarditis, peritonitis)?

A

SLE

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14
Q

Describe histo of reticulocytes?

A

Slightly larger and bluer (Wright Giemsa stain) because lacks nucleus, but retains basophilic reticular network of ribosomal rRNA

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15
Q

MOA of colchicine?

A

inhibiting microtubular polymerization: disrupts chemotaxis, phagocytosis, degranulation

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16
Q

Immune deficiency, large granules in phagocytes?

A

Chediak Higashi: failure of phagosome lysosome fusion in neutrophil (also albinism & neuro defects)

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17
Q

Why should you not take nitrates at night?

A

Avoid tolerance development- need a nitrate free interval

18
Q

What organs can utilize ketones? Which can’t?

A

Brain, kidneys, cardiac/ skeletal muscle; NOT in erythrocytes (no mitochondria) & liver (lacks thiophorase)

19
Q

What signals are activated in autoimmune MS response?

A

Helper T cells react to antigens in myelin (oligo) and release IFN-gamma and other cytokines to promote macrophages/microglia and leukocytes

20
Q

How to differentiate schizoaffective vs major depressive with psychotic?

A

In MDwP there will be mood symptoms- but can still have hallucinations and delusions

21
Q

What is an irreversible alpha agonist? Uses?

A

Phenoxybenzamine- used in treatment of pheo

22
Q

What does the exfoliatin exotoxin do? How?

A

Scalded skin syndrome: blisters only in superficial epidermis; act as proteases to cleave desmoglein in desmosones

23
Q

What is rasburicase used for?

A

Tumor lysis syndrome: converts uric acid to soluble metabolites

24
Q

A person with gout undergoing chemo…?

A

Tumor lysis syndrome- large number of cells are destroyed and release K, P, and nucleic acids&raquo_space; uric acid accumulation in kidneys; give allopurinol or rasburicase

25
Q

What is major basic protein?

A

Released from eosinophils; a potent anti-helminthic toxin

26
Q

What do you give in treatment resistant schizophrenia?

A

Clozapine

27
Q

Hypercoagulable state that’s resistant to protein C?

A

Factor V mutation (leiden); factor Va is usually inactivated by protein C

28
Q

What causes pigment stones?

A

Ca salts of unconjug bilirubin from bacterial/helminth infection of biliary tree (releases beta-glucuronidase) or extravascular hemolysis

29
Q

What occurs in vit D deficiency from Crohns?

A

Decreased Ca (and P) absorption&raquo_space; rickets or osteomalacia (adults); PTH will be up

30
Q

Consequences of syringomyelia?

A

Loss of upper extremity pain/ temp, weakness, hyporeflexia; LE loss of weakness, pain/temp, hyperreflexia; kyphosis

31
Q

What is mutated in AR polycystic kidney disease?

A

fibrocystin (PKHD1 gene): found in epithelial cells of renal tubules and bile ducts&raquo_space; dilation of these structures

32
Q

What would you expect with fetus with autosomal recessive PKD?

A

oligoghydramnios symptoms- flattened face, limb deformities, pulm hypoplasia

33
Q

What can long term RA do to cervical spine?

A

joint destruction with vertebral malalignment (subluxation)

34
Q

What is / is not found in terminal bronchioles?

A

Yes = ciliated cuboidal cells, Club cells; No = goblet cells, submucosal mucous lands, & macrophages clear debri from alveoli

35
Q

What can cause isolated systolic hypertension?

A

Increased arterial stiffness, incr CO from from aortic regurg or systemic causes (hyperthyroid or anemia)

36
Q

Language regression, anemia, impoverished kid…?

A

Lead poisoning (RBC’s show basophilic stippling, microcytic anemia)

37
Q

What enzyme is deficient with photosensitivity, tea colored urine (w high uroporphyrinogen levels)?

A

Uroporphyrinogen decarboxylase (porphyria cutanea tarda)

38
Q

What enzyme is deficient with acute painful abd, neuropsych, red brown urine?

A

Porphobilinogen deaminase (acute intermittent porphyria)

39
Q

What heme synth enzymes are inhibited by lead poisoning?

A

d-ALA & Ferrochelatase

40
Q

What makes you think conduct disorder vs oppositional defiant disorder?

A

More aggression and cruelty towards humans, animals, destruction of property, stealing etc.; antisocial is diagnosed after 18 y/o

Step 1 UWorld (16 decks)

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