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Step 1 UWorld > Deck 14 > Flashcards

Deck 14 Flashcards

1
Q

Where is the site of attachment of immunoglobulins?

A

Fc portion = constant region of heavy chain

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2
Q

What do you do if you suspect asthma but spirometry is normal?

A

Methacholine (or histamine, exercise, cold air) challenge: try to illicit symptoms (causes bronchoconstriction

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3
Q

What is the result of the mutation CFTR gene in CF?

A

Impaired post-translational processing&raquo_space; targeted for degradation, preventing it from reaching the surface

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4
Q

The greatest risk of dying from Friedrich Ataxia is from what?

A

Cardiomyopathy

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5
Q

What is most serious side effect of amphotericin B?

A

Nephrotoxicity

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6
Q

Small cell carcinomas stain for neuroendocrine markers, such as…?

A

Neural cell adhesion molecule, neuron-specific enolase, chromogranin, synaptophysin

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7
Q

What is vimentin and what malignancy is it seen in?

A

Intermediate filament in mesenchymal-origin cells; mesenchymal (sarcomas) and others (see FA pg. 60)

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8
Q

Describe replication of Hep B?

A

Partially DsDNA&raquo_space; ssRNA to either translate proteins or&raquo_space; reverse transcriptase to ssDNA intermediate then partially DsDNA again

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9
Q

Vitamin supplementation with what may help with MSUD? Enzyme?

A

Thiamine; a-ketoacid dehydrogenase

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10
Q

Who requires arginine as essential amino acid?

A

Disorders of urea cycle

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11
Q

What murmur increases with inspiration?

A

Tricuspid regurgitation

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12
Q

Where is K absorbed?

A

2/3rds in proximal tubule; 25-30% in ascending loop; 5-10% DCT; Hyperkalemia = secreted by principal cells in collecting duct (5-100+%) or Hypokalemia = K absorption of a-intercalated cells

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13
Q

What s the cause of spontaneous pneumothorax in thin/ tall individuals or smokers?

A

Apical subpleural bleb rupture - Qid 490

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14
Q

What does TNF-a cause?

A

Cachexia (muscle wasting, anemia, also called cachectin btw), fever, symtpoms of septic shock, causes hepatic release of acute phase reactants (C-peptide, fibrinogen)

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15
Q

Leser-trelat sign?

A

Suddent onset of multiple seborrheic keratosis: indicative of underlying carcinoma of GI tract

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16
Q

Difference between 23 valent/ 13 valent pneumococcal vaccine?

A

23 = polysaccharide capsule > protects against wider range of serotypes & not immunogenic, but shorter immunity; 13 = conjugate vaccine (with diphtheria protein) > boosts immunity through T cell recruitment&raquo_space; development of memory B cells, higher antibody levels, herd immunity

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17
Q

Tx for narcolepsy?

A

First line = Modafinil (non-amphetamine stimulant); second line = amphetamines

18
Q

What drug causes R atrial ventriculization in fetus?

A

Lithium&raquo_space; Ebsteins anomaly

19
Q

Hemangiomas in brain, angiomatosis in skin, and renal cell carcinoma or pheo?

A

Von hippel lindau

20
Q

Cutaneous facial/ leptomeningeal angiomas, skin involvement in V1-V2 trigem, tram track opacities in skull..?

A

Sturge Weber

21
Q

Which sequelae of endocarditis results from immune complex lesions and not microemboli?

A

Osler nodes (nodes seen on fingertips and toes) & Ruth spots (retina)

22
Q

What are DNA methyltransferases used for?

A

Imprinting

23
Q

Cause of waxing and waning painless lymph node enlargement?

A

Follicular lymphoma, t(14:18) translocation- overexpression of bcl-2 oncogene

24
Q

Characteristics of Bells palsey?

A

Functions of CN VII: sudden unilateral facial paralysis, decreased tearing, hyperacusis (sensitivity to sound), loss of sensation/taste of anterior 2/3 of tongue

25
Q

Most commonly affected areas in charcot-bouchard aneurysm (from hypertension) deep intracerebral hemorrhage?

A

Basal ganglia/putamen (lenticulostriate arteries), cerebellar nuclei, thalamus

26
Q

Characteristics of basal ganglia hemorrhage?

A

Usually involves adjacent internal capsule&raquo_space; contralateral hemiparesis, hemianesthesia & ICP symptoms

27
Q

Venous drainage of internal/ external hemorrhoids?

A

Internal = middle > internal iliac & superior rectal veins > inferior mesenteric; External = inferior rectal vein > internal pudendal > internal iliac

28
Q

Difference in decerebrate vs decorticate posturing?

A

Decerebrate = extensors predominate (below red nucleus [loss of rubrospinal tract, unopposed vestibulospinal]); Decorticate = flexors predominate (above red nucleus [loss of descending inhibition of red nucleus])

29
Q

What causes the decreased Ach in alzheimers? Where?

A

Deficiency of choline acetyltransferase most notably in basal nucleus of Meynert (projects to neocortex)

30
Q

What does inactivated X chromosone look like on microscopy?

A

Condensed heterochromatin = compact body at periphery of nucleus (Barr body); heavily methylated DNA and deacytelated histones

31
Q

What cancer is associated with pure red cell aplasia? What infection can cause it?

A

Thymoma; Parvovirus B19

32
Q

What processing of mRNA only occurs in cytoplasm?

A

Interaction with P bodies (regulation, storage, turnover)

33
Q

What is cause of familial hypocalciuric hypercalcemia?

A

Defective Ca-sensing receptor (G-protein that helps mediate release of PTH)

34
Q

What does MacConkey agar grow?

A

Gram negative (bile salts and crystal violet prevent gram +); if ferment lactose&raquo_space; turns pink red, non lactose remains colorless

35
Q

What are available treatments for AZ?

A
  1. Donepezil (cholinesterase inhibitor) 2. Vit E aka a-tocopherol (prevents oxidative damage 3. Memantine (NMDA antagonist)
36
Q

External auditory canal is innervated by what?

A

Mostly CN V mandibular branch; Posterior part, concavity of concha is CN X, VII

37
Q

Symptoms of arsenic poisoning and Tx?

A

Garlic breath, vomiting, watery diarrhea, QT prolongation; Tx; dimercaprol

38
Q

Mechanism of arsenic poisoning?

A

Binds sulfhydryl groups and impairs cell respiration via pyruvate dehydrogenase, gluconeogenesis, glutathione metabolism

39
Q

What translocation is associated with Burkitt lymphoma?

A

c-Myc gene on chromosone 8 to heavy chain of 14 = t(8;14)

40
Q

In what malignancy is there overexpression of antiapoptotic BCL2?

A

Follicular lymphoma, t(14;18)

41
Q

What is statistical power?

A

1- b (b is the possibility of commiting type II error) = studies ability to detect a difference when one really exists

42
Q

What are features of a glucagonoma?

A

DM, necrolytic migratory erythema: painful pruritic rash in face, groin, extremities that coalesce to to large, indurated plaques with a central clearing that appears brown or bronze

Step 1 UWorld (16 decks)

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