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Step 1 UWorld > Deck 12 > Flashcards

Deck 12 Flashcards

1
Q

What makes you think of fibromuscular dysplasia?

A

Women 20-30, renal artery stenosis, string of beads appearance of renal arteries

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2
Q

What is defect in paroxysmal nocturnal hemoglobinuria?

A

Mutation in PIGA gene that synthesizes Gpi anchor protein: lack CD 55, CD 59; hemolytic anemia (low haptoglobin, incr bilirubin, LD), thrombosis, iron deposition in kidney (hemosiderosis)

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3
Q

What muscle can get an abscess from appendix, hip joint, vertebral bodies?

A

Psoas: fever, flank or back pain, difficulty walking, +psoas sign

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4
Q

How long does a patient need symptoms to diagnose with major depressive disease?

A

2 weeks

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5
Q

What are three cranial nerve abnormalities that present first with botulism?

A

Diplopia, dysphagia, dysphonia with descending paralysis

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6
Q

What medications prevent dihydrofolate reductase and prevent reduction of folic acid to THF?

A

Trimethoprim (bacteria), methotrexate (humans), pyrimethamine (some protozoa)

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7
Q

What fracture is suspected with pain in anatomical snuffbox?

A

scaphoid

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8
Q

What is a paradoxical embolism? What would you find?

A

Embolism that originates from venous side but passes through cardiac defect (PFO, ASD, VSD, AV malformation) to arterial side to cause stroke; ASD would cause wide splitting of S2- Qid 189

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9
Q

What two components make up an MHC class I?

A

heavy chain, B2-microglobulin

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10
Q

Which cranial nerves do preganglionic parasympathetic nerves come from?

A

III, VII, IX, X

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11
Q

Where do most interventricular hemorrhages from premature delivery arise from?

A

Germinal matrix: subventricular zone with thin vessels and lacks glial support, becomes less prominent by 32 weeks

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12
Q

Where is most common location of medulloblastoma?

A

Cerebellar vermis

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13
Q

How can isoniazid cause microcytic anemia?

A

Decreased activity of d-ALA synthetase (prevents conversion of Vit B6 cofactor)&raquo_space; blocks rate limiting step of heme synthesis&raquo_space; sideroblastic anemia

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14
Q

What does the Her2 oncogene do?

A

Codes for human epidermal growth factor receptor w TYROSINE KINASE activity > increased proliferation

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15
Q

What causes the clear cytoplasm in the rounded polygonal cells in renal cell carcinoma?

A

lipid and glycogen accumulation

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16
Q

What does liver biopsy show in hepatitis?

A

anlobular lymphocytic infiltrate, ballooning hepatocytes, necrosis and apoptosis

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17
Q

What are councilman bodies?

A

Apoptotic hepatocytes that form round acidophilic bodies

18
Q

Phosphoribosyl pyrophosphate synthetase (PPRP) mutation leads to what?

A

Gout: PRPP is necessary for purine synthesis&raquo_space; increased purines = increased gout

19
Q

What cell types are responsible for inflammatory response in gout?

A

Neutrophils

20
Q

Why do myocytes swell in myocardial ischemia?

A

Switch to anaerobic&raquo_space; can’t maintain ATP levels&raquo_space; membrane ATPases fail leading to incr Ca and Na in cell&raquo_space; attract free water

21
Q

Oxalate crystals in tubular lumen is suggestive of what?

A

Ethylene glycol poisoning

22
Q

Proximal tubule cell ballooning and vacuolar degeneration is suggestive of what?

A

Acute tubular necrosis

23
Q

What is the cause of bruise colors? Explain process.

A
  1. Hemoglobin-containing erythrocytes escape into tissue = blue/purple; 2. Heme oxygenase breaks down heme to biliverdin = green; 3. Biliverdin reductase reduces to bilirubin = yellow&raquo_space; travels to liver with albumin to get conjugated
24
Q

What detects tension in muscle and prevents injury? How?

A

Golgi tendon organs: connected in series at junction of tendon; with resistance sensory 1b fibers > inhibitory interneuron&raquo_space; stop contraction

25
Q

Patient with HIV, seizures, multiple ring enhancing lesions…? Tx?

A

Toxoplasmosis; Pyrimethamine & sulfadiazine

26
Q

What does ventral posterior medial nucleus of thalamus do?

A

Receive input from trigeminal (stroke = loss of sensation of ispi face)

27
Q

What are the most common cause of lacunar infarcts?

A

Lipohyalinosis & microatheromas- Qid 2077

28
Q

What nerve passes through supinator canal?

A

Radial - weakness of fingers and thumb from excessive pronation/supination movement

29
Q

What is not improved by atropine with organophosphate poisoning? What can help?

A

Muscle weakness: atropine doesn’t have effect in nicotinic receptors; Pralidoxime works at both

30
Q

What cytokine is particularly important for severity of temporal arteritis? What Tx?

A

IL-6; can give IL-6 monoclonal antibody tocilizumab

31
Q

What’s similar/ different between curling/ cushing ulcer?

A

Stress-related mucosal disease; Curling: from burns/ trauma&raquo_space; ischemia; Cushing: cranial trauma&raquo_space; vagal stimulation&raquo_space; hypersecretion of acid

32
Q

What stimulates B cells?

A

IL-4 from Th2

33
Q

What will the vessels of the lung do when hypoxic?

A

Vasoconstrict to dilate blood to better ventilated areas: unique hypoxic vasoconstriction!

34
Q

What lab findings have poor prognosis for cirrhosis?

A

PT time, hypoalbuminemia, elevated bilirubin

35
Q

What kind of hypertrophy occurs with mitral insufficiency?

A

Eccentric (incr cavity size- not wall): regurgitant flow increases the amount of blood returned to LV during diastole

36
Q

Describe the process of interferon-gamma signaling in tuberculosis…

A

Infected Mx secrete IL-12&raquo_space; Tcells & NKs: secrete IFN-g&raquo_space; IFN-g leads to activation of JAK1/2&raquo_space; nuclear signaling via STAT1 & transcription of protecting/killing genes

37
Q

What is X-linked agammaglobulinemia and what infections do they get?

A

Reduced mature B cell production: deficient in all immunoglobulins&raquo_space; lower respiratory tract infections and Giardia

38
Q

What nucleotides are on 3’ end of tRNA?

A

CCA: 3’ end with OH- that binds to AA

39
Q

What nerves are involved in vagal maneuvers?

A

Afferent = CN IX (carotid baroreceptors > vagal nucleus & medullary centers); Efferent = vagus nerve (to SA and AV node)

40
Q

What squamous keratin debris in middle ear can cause conductive hearing loss?

A

Cholesteatomas

Step 1 UWorld (16 decks)

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