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Step 1 UWorld > Deck 15 > Flashcards

Deck 15 Flashcards

1
Q

What is polyarteritis nodosa?

A

Segmental, transmural, necrotizing inflammation of medium to small size arteries in any organ EXCEPT lungs; most commonly kidneys, heart, GI; bead-like aneurysm formation

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2
Q

What does carbon tetrachloride do?

A

Free radical injury in liver: centrilobular necrosis, fatty change

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3
Q

How do you know if someone has thrombocytopenic thrombotic purpura- hemolytic anemia?

A

Pentad of fever, neuro symptoms, renal failure, anemia, thrombocytopenia in setting of GI illness; Normal PT & aPTT

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4
Q

Symptoms of neonatal abstinence syndrome? Tx?

A

Neurologic (irritability, jitteriness, hypertonia), GI (diarrhea, vomiting), autonomic (sweating,s ; Tx = methadone, morphine

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5
Q

What med increases activity of azathioprine?

A

Allopurinol: xanthine oxidase catalyzes AZ inactivating pathways

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6
Q

What lesion can cause pure motor hemiparesis?

A

Lacunar infarct - small penetrating arterioles of INTERNAL CAPSULE

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7
Q

What can cause a pure sensory stroke?

A

Lacunar infarct - small penetrating arterioles of VP or VPN thalamus

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8
Q

Describe development of prion disease?

A

Prion protein (PrP) is normally a-helical > if converted to b-pleated sheet, protein becomes resistant to proteases > accumulation in grey matter leads to prion disease

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9
Q

What area of lungs are most often damaged in chronic and acute rejection of allograft?

A

Chronic = small bronchioles, Acute = pulmonary/ bronchiole vessels (perivascular infiltration with lymphocytes, macrophages, plasma cells)

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10
Q

What is the mechanism of uric acid stones in person with dehydration?

A

Diarrhea = reduced bicarb excretion > metabolic acidosis > increase H excretion > makes soluble urate solutes insoluble uric acid

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11
Q

What causes RBCs to sediment at faster rate? How?

A

Fibrinogen: causes RBCs to form stacks; Part of acute phase reactants stimulated by TNF-a, IL-1, IL-6

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12
Q

Firm coarse itchy rash (peau de orange) and breast swelling?

A

Inflammatory breast cancer: Cancer cells blocking lymph drainageafter spread to dermal lymphatic spaces

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13
Q

What do you give for NE extravasation?

A

Phentolamine: reverses NE a1 vasoconstriction/ ischemia of local tissue

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14
Q

Epigastric pain an hour after eating, weight loss, eating aversion…?

A

Chronic mesenteric ischemia

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15
Q

What is the best indicator of severity of mitral stenosis?

A

Presence of S3: indicates increased rate of LV filling due to large volume of regugitant flow entering ventricle during mid diastole

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16
Q

What is cause of disproportionate loss of pain & temp in hands/ arms?

A

Syringomelia: cavity enlarges pushing against ventral white commissure

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17
Q

How does pyruvate kinase deficiency manifest?

A

Hemolytic anemia in newborns (insufficient ATP > disrupted gradient > disrupted membrane)

18
Q

What is the immunologic test that uses cardiolipin, lecithin, cholesterol?

A

Rapid plasma reagent test (RPR) => syphilis

19
Q

What is the central regulator of iron homeostasis? How?

A

Hepcidin: synthesized by liver; inversely related to iron levels: binds and degrades ferroportin, decreasing iron absorption

20
Q

What is vanillymandelic acid?

A

Biproduct of NE, EPI detected in neuroblastoma/ other neural crest tumors

21
Q

What can cause urine to turn black overnight and blue black (ochronosis) of ears, cheeks, nose)? What pathway is inhibited?

A

Alkaptanuria: blocks homgentisic acid dehydrogenase; Blocks conversion of tyrosine > fumarate (tyrosine metabolism)

22
Q

What are dextrans and what do they adhere to?

A

Extracellular polysaccharides (Strep viridians): adhere to fibrin and platelets which are deposited during endothelial trauma

23
Q

What are most common organisms in secondary bacterial pneumonia (after getting flu)?

A

Strep pneumo, Staph, H. flu

24
Q

Dx of women with recent pregnancy with respiratory symptoms, elevated b-HCG?

A

Gestational choriocarcinoma: arises from trophoblast; vaginal bleeding, bulky white intrauterine mass, necrosis, hemorrhage; lungs are common metastasis

25
Q

What is the only abnormal test you will see on minimal change disease?

A

Electron microscopy: diffuse podocyte foot process effacement and fusion

26
Q

Which ligament contains ovarian artery, vein, nerve, lymphatics?

A

Suspensory ligment (infundibulopelvic)

27
Q

What is most likely cause of widened pulse pressure, large LV SV?

A

Aortic regurg

28
Q

What causes paraneoplastic cerebellar degeneration?

A

Autoimmune response against tumor cells (small cell lung, breast, ovarian, uterine) that cross reacts with Purkinje neurons; Abs = anti-Yo, anti-P/Q, anti-Hu

29
Q

When is KRAS active? What does it trigger?

A

When bound to GTP&raquo_space; RAF&raquo_space; MAP kinase and then transcription factors

30
Q

What genetic defect causes increased iron?

A

Hereditary hemochromatosis: missense mutation in HFE gene (interacts with tranferrin receptor on cell) > reduced cell iron uptake leads to&raquo_space; increased intestinal absorption, decreased hepcidin

31
Q

Abdominal trauma (splenic rupture, peritonitis, hemoperitoneum) causes referred pain to where?

A

Shoulder (C3 - C5)

32
Q

What condition is associated with migratory thrombophlebitis?

A

Pancreatic cancer (and some other GI): Trosseau syndrome

33
Q

What is a selective antimuscarinic agent that only targets cholinesterase at muscarinic receptors (not nicotinic muscles)?

A

Scopolamine

34
Q

What is the function of c-myc? On what chromosone is it found?

A

Transcription activator; Chromosone 8 (Burkitt lymphoma = [8;14] translocation)

35
Q

What nerves provide general sensation of tongue?

A

Ant 2/3: mandibular CN V, Post 1/3: CN IX, Posterior tongue root: CN X

36
Q

What nerves provde gustatory sensation of tongue?

A

Ant 2/3: chorda tympani (CN VII), Posterior 1/3: CN IX, Post tongue root and upper esophagus: CN X

37
Q

What does the CFTR protein do in the respiratory/ intestinal epithelia vs the sweat glands?

A

(Opposite effect in CF): Respiratory = secretes Cl, decreases Na/H20 reabsorption (through ENaC); Sweat = absorbs luminal Cl, increases reabsorption of Na/ H20

38
Q

What nuclei produces serotonin?

A

Raphe nuclei

39
Q

Histo of hep B?

A

finely granular, homogenous pale pink cytoplasm in hepatocytes

40
Q

Tx for hypertensive crisis?

A

Nitroprussid (incr cGMP), fenoldopam (D1 agonist)

41
Q

What nerve is damaged in uncal/transtentorial herniation?

A

CN III: Ipsilateral fixed dilated pupil, ipsi paralysis of oculomotor muscles, contralateral homonymous hemaniopsia

42
Q

What chromosone is RB tumor suppressor gene on?

A

13

Step 1 UWorld (16 decks)

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