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Step 1 UWorld > Deck 13 > Flashcards

Deck 13 Flashcards

1
Q

What areas are most affected by aspiration pneumonia?`

A

Supine = post right upper/ superior right lower; Standing = basilar (right)

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2
Q

What is milrinone? Why is it used for systolic HF?

A

PDE-3 inhibitor&raquo_space; incr cAMP: Cardiac = incr inotropy; smooth muscle = vasodilation

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3
Q

What is the process of infective endocarditis?

A

Disruption of endocardial surface > adherence of platelets/fibrin (sterile fibrin/platelet nidus)&raquo_space; microorganisms colonize

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4
Q

What helps distinguish alcoholic pancreatitis vs other causes?

A

Macrocytosis

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5
Q

Histo for acute tubular necrosis?

A

Flattened epithelial cells, loss of brush border, necrosis, denudation of BM, MUDDY BROWN CASTS

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6
Q

What sections of kidney are most susceptible to ischemic injury?

A

Proximal tubule (straight portion), thick ascending loop: participate in active transport and have high O2 demand

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7
Q

Who can get hydrocephalus ex-vacuo?

A

AIDS dementia, AZ: cortical atrophy > expansion of ventricles w normal CSF pressure

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8
Q

What do you give in life-threatening warfarin toxicity?

A

FFP: restores all clotting factors (II, VI, IX, X & proteins)

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9
Q

What is cryoprecipitate used for?

A

Factor VIII, XIII, vWF, fibrinogen

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10
Q

What conditions could give you ataxia, loss of position/ vibration, loss of deep tendon reflex…?

A

Vitamin E deficiency, Friedrich ataxia, Vit B12- Qid 671

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11
Q

How do each of psoriasis Tx work: topical Vit D, cyclosporine, etanercept, MTX? (Qid 8569)

A

Vit D = vit d receptor is nuclear TF that inhibits keratinocyte prolif; Cyclo = inhibits NFAT (inhibiting IL-2); Etanercept = Binds TNF-a; MTX = inhibits purine & thimidylic acid synthesis in rapidly proliferating skin epithelial cells

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12
Q

What causes bronze diabetes?

A

Hemochromatosis

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13
Q

What is mechanism of fibrinolytics (alteplase)?

A

binds fibrin in clot and converts entrapped plasminogen to plasmin

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14
Q

What does primary HSV-1 result in?

A

Herpetic gingivostomatitis; usually come in to doctors for dehydration

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15
Q

Where is the renal vein in relation to renal artery?

A

Crosses anterior to aorta and renal arteries

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16
Q

What is the sweat like in CF? Why?

A

Hypertonic w high sodium/ Cl: CFTR usually reabsorbs chloride and Na/ H2O follow in ducts of eccrine glands&raquo_space; risk of hyponatremia (give salt supplementation to infants)

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17
Q

Episodic HA, tachycardia, diaphoresis…?

A

Pheo

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18
Q

In coronary artery disease, what else should be given if can’t take aspirin?

A

Clopidogrel: blocks ADP receptors and prevents aggregation; just as effective as aspirin

19
Q

Pancytopenia w/o splenomegaly…?

A

Aplastic anemia (dry tap w hypocellular marrow, fat & stromal cells)! Also B12/ folinic, acute leukemia, myelodysplastic syndrome

20
Q

What is characteristics biochemical feature of Huntingtons?

A

Loss of GABA (containing neurons)

21
Q

How and where does shigella get into intestinal cells?

A

Invade M cells as base of villi within a Peyer Patch via endocytosis

22
Q

What regulates transition from G1 > S? How does it regulate?

A

RB protein: active when hypophosphorylated; cell stimulation by growth factor > Activation of cyclin D, cyclin E, CD4 & 6&raquo_space; hyperphosph RB is inactivated & releases E2F transcription factor&raquo_space; pass through checkpoint

23
Q

Why is hypernatremia & edema rarely seen in primary hyperaldosteronism?

A

Aldosterone escape: Aldo increases intravascular volume&raquo_space; incr RBF&raquo_space; increased Na excretion & limited net sodium retention

24
Q

What do antibodies against phospholipase a2 receptor cause in kidney?

A

Membranous nephropathy

25
Q

What virus causes aplastic crisis in sickle cell patients?

A

Parvovirus

26
Q

What organism has polyribosylribitol phosphate (PRP) as virulence factor?

A

H. flu: part of polysaccharide capsule - protects against phagocytosis and complement by binding factor H (control protein that prevents complement on host cells_

27
Q

What can chronic lymphedema cause? Ie. 10 years after women has breast cancer removal…?

A

Lymphangiosarcoma

28
Q

Cause of prolonged PTT & BT?

A

vWD

29
Q

What causes the maldevelopment of thymus/ parathyroid gland in Di George?

A

Defective neural crest migration into derivatives of 3rd and 4th pharyngeal pouches

30
Q

Recurrent respiratory infections caused by Pseudomonas, diarrhea, failure to thrive.? Tx?

A

Cystic fibrosis; Pancreatic lipase supplementation will help with nutrient absorption - Qid 808

31
Q

What causes heparin induced thrombocytopenia? Tx?

A

HIT = thrombosis from antibodies to heparin and platelet factor IV; stop heparin and give direct thrombin inhibitors (argatroban, lepirudin, hirudin)

32
Q

Which areas of brain cause parkinsons? Where do you target for deep brain stimulation?

A

Excessive stimulation of globus pallidus internus by subthalamic nucleus&raquo_space; excessive inhibition of thalamus; Target Gpi or sTn

33
Q

Vasculitis of lower leg/ arm associated with tobacco?

A

Buergers disease: can extend into surrounding arteries, nerves, veins; Tx: smoking cessation

34
Q

Fever, rash, renal problems weeks after starting medications? What kind of reaction?

A

Acute interstitial nephritis (interstitial edema & leukocyte infiltration); IgE-mediated hypersensitivity or cell-mediated (type IV) reaction depending on drug? Qid 835

35
Q

Patient with osteolytic lesions, precocious puberty, café-au-lait spots? What is mechanism?

A

McCune Albright syndrome; Mosaic somatic mutation during embryogenesis of stimulatory a subunit of G protein: constituitive activation of Gs pathway > gain of function in cells: melanocytes (café-au-lait macules), early puberty, activation of osteoclasts

36
Q

In healing process, what cytokines control fibroblast proliferation & function?

A

TGF-b (stimulates connective tissue remodeling); also platelet derived growth factor

37
Q

What expresses 1-a-hydroxylase in sarcoidosis and other granulomatous disorders?

A

Activated macrophages

38
Q

Which hypothalamic nuclei is responsible for jet lag and circadian rhythms?

A

Suprachiasmatic (remember that it takes stimuli from retina)&raquo_space; sends stimuli to other nuclei to regulate temp, cortisol, melatonin

39
Q

What intracellular/ extracellular processing occurs with collagen synthesis?

A

Intracellular = cleave signal sequence > hydroxylation of Pro/lys > glycosylation > assemble triple helix; Extracellular = terminal peptides cleaved (N/ C peptidases) > collagen molecules spontaneously assemble > covalent crosslinks by lysyl oxidase

40
Q

What condition from defect in collagen synthesis?

A

Ehler-Danlos: defect from procollagen peptidases (cleaves terminal ends extracellularly

41
Q

Signs of tuberous sclerosis?

A

Auto dom: hamartomas, facial angiofibromas, angiomyolipoma, ash-leaf patches, rhabdomyomas (cardiac), mitral regurg

42
Q

Foamy macrophages in intestinal mucosa with rod shaped bacilli, PAS positive,diastase-resistant granules?

A

Whipple disease: middle aged caucasians with malabsorption, diarrhea, weightloss

43
Q

Which would you give post-MI with COPD?

A

Metoprolol (cardioselective if COPD)

44
Q

How can you get bradykinin-associated angioedema?

A

C1 inhibitor deficiency; symptoms = facial swelling (no urticaria), laryngeal edema, GI problems- Qid 11667

Step 1 UWorld (16 decks)

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