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Step 1 UWorld > Deck 2 > Flashcards

Deck 2 Flashcards

1
Q

What are the different stop codons? Start codon?

A

UAG, UAA, UGA; AUG

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2
Q

What serum marker is produced by epithelial ovarian cancers?

A

CA-125 (protein expressed epithelial cells lining mullerian structures

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3
Q

What causes reperfusion injury?

A

Oxygen radical generation, mitochondrial damage, and inflammation

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4
Q

What form of glucose is selected by transmembrane transporters? Difference - GLUT 4 & GLUT 2?

A

D-glucose (not L glucose). GLUT4 = insulin dependent in muscle/ adipose cells. GLUT2 = exports glucose into circulation in liver, small intestine, kidney

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5
Q

Why is cilostazol used in peripheral arterial dz (what does it do)?

A

Is a PDE inhibitor (increases cAMP) which inhibits platelet aggregation + direct arterial vasodilator

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6
Q

What allows a bacteria to survive boiling? Examples?

A

Spore-forming. Ie: Bacillus anthracis, Clostridium

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7
Q

In what time is a patient more susceptible to left ventricular wall rupture?

A

5-14 days after MI due to weakening of inflammation and necrosis

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8
Q

What results from orbital floor fracture?

A

Damage to infraorbital nerve = numbness and paresthesias of upper lip, cheek, gingiva

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9
Q

What results from aldolase B deficiency? What does this enzyme do?

A

Hereditary fructose intolerance; It metabolizes fructose-1-phosphate (a toxic product of fructose metabolism)

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10
Q

What drugs have antimuscarinic effects?

A

atropine, TCADs, H1 antagonists (diphenhydramine), neuroleptics, antiparkinson drugs

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11
Q

What drugs are metabolized by acetylation (in liver)?

A

Isoniazid, dapsone, hydralazine, procainamide

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12
Q

3 mitochondrial inherited diseases?

A

Leber hereditary optic neuropathy (bilateral vision loss), myoclonic epilepsy with red ragged fibers (myoclonic seizures and myopathy associated w exercise), Mitochondrial encephalomyopathy with lactic acidosis and stroke like episodes (MELAS)

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13
Q

What are the two main cytokines that stimulate B cells after exposure to antigen? Difference?

A

IL-4 & IL-5: 4 is responsible for B cells growth and isotope switching, stimulates secretion of IgE (type 1 rxns), and Th0 -> Th2; 5 is responsible for B cell differentiation, stimulates IgA production and eosinophil activity (parasitic)

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14
Q

What does the Fas receptor do? What problems with defect?

A

Initiates extrinsic pathway of apoptosis (through FADD aka death domain in cytoplasm). Defect = prevents apoptosis and autoreactive lymphocytes

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15
Q

What 2 things are needed for osteoclast differentiation?

A

M-CSF and NF-kB (RANK-ligand)

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16
Q

What would suggest Gilbert syndrome?

A

No apparent liver dz but mildly elevated unconjugated bilirubin provoked by stressor, exercise, etc; From reduced production of UDP glucuronyl transferase

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17
Q

How is Dubin Johnson different from Gilbert?

A

Elevated conjugated bilirubin

18
Q

What nerve passes through posterior triangle of neck? What muscles? What happens if injured?

A

Spinal accessory; Trapezius & sternocleidomastoid- causes impaired abduction, shoulder droop, winging of scapula

19
Q

What forms the fibrous cap in atherosclerotic plaques?

A

Vascular smooth muscles cells

20
Q

What is a complication of long lasting meds for asthma

A

Oral candidiasis (low dose inhaled corticosteroids); So patients should prophylactically rinse mouth

21
Q

What are the main adverse effects of nitrates?

A

headaches, cutaneous flushing, lightheadedness, hypotension, reflex tachycardia

22
Q

In what ways does propanalol help with thyroid storm (thyrotoxicosis)?

A

Reduce sympathetic (HR, anxiety, etc) and peripheral conversion of T4 - T3 by inhibiting iodothyronine deiodinase

23
Q

What meds alter thyroid hormone synthesis?

A

PTU (inhibits thyroid peroxidase + 5’-deiodinase) & Methimazole (only thyroid peroxidase)

24
Q

Difference between dynein and kinesin?

A

Dynein causes retrograde, kinesin causes anterograde

25
Q

Mechanism of action of metformin? SE? Contraindications?

A

Decreases hepatic gluconeogenesis (inhibits 1st enzyme in ECT) and increases peripheral glucose use; SE= lactic acidosis- increased in renal problems, hepatic problems, avoid in CHF & alcoholism (increased lactic acidosis)

26
Q

Proximal muscle weakness in legs and arms- difficulty lifting things, etc? Describe findings

A

Polymyositis- biopsy shows endomysial mononuclear inflammatory infiltrate and patchy muscle fiber necrosis. ANA and Anti-Jo-1 antibodies (anti-histidyl-trna-synthetase; May be paraneoplastic for Adenocarcinoma

27
Q

Antimitochondrial Abs? Anti-smooth muscle Abs?

A
  1. PBS 2. Autoimmune hepatitis (middle aged women)
28
Q

What is finasteride used for? Mechanism of action?

A

BPH and androgenic alopecia. Inhibits 5-alpha-reductase- decreases peripheral conversion of testosterone to DHT

29
Q

What is the order of conduction velocity of cardiac tissues?

A

Fast to slow = Park AT Venture Avenue: purkinje, Atrial muscle, ventricular muscle, AV node

30
Q

Describe cardiac and renal complications of SLE?

A

Cardiac = accelerated atherosclerosis, small vessel necrotizing vasculitis, pericarditis, Libman-sacs endocarditis (small, sterile vegetations); Renal = diffuse proliferative glomerulonephritis with “wire-loop” structures due to subendothelial immune complex deposits

31
Q

What characterizes myotonic dystrophy? Inheritence?

A

Abnormally slow muscle relaxation: inability to let go of door handle/ loosen grip. Cataracts, frontal baldness, gonad atrophy. Type 1 muscle fibers. AUTO DOMINANT- CTG repeats

32
Q

What do anti-Smith abs in SLE target?

A

Smith proteins- combine with snRNA to form snRNP (splice RNA)

33
Q

What lab test is specific for drug-induced lupus?

A

Anti-histone Abs

34
Q

What effect does hepatic encephalopathy have on neurotransmitters? What is Tx?

A

Increase inhibitory (GABA) and decrease excitatory; Tx = Lactulose: Bacterial action on lactulose acidifies colon -> traps ammonia in non-absorbable ammonium ions and is excreted in stool

35
Q

MOA of ethosuximide? Phenytoin?

A

Ethosuximide: Blocks T-type Ca channels in thalamic neurons; Phenytoin blocks Na channels in cortical neurons

36
Q

Where does most water absorption occur in kidney?

A

Proximal tubule

37
Q

What 2 conditions cause congenital QT prolongation?

A

Romano Ward (autosomal dom) & Jervell and Lange Nielsen syndrome (autosomal recessive w neurosensory deafness)

38
Q

What does cholesterol 7-a hydroxylase do? What blocks it?

A

Catalyzes rate limiting step in bile acid formation. Inhibited by fibrates -> less cholesterol solubility = more cholesterol stones

39
Q

What is rate limiting step in cholesterol formation?

A

HMG-CoA -> mevalonate (HMG-CoA reductase)

40
Q

What receptor do antipsychotics block?

A

D2 receptor- disinhibit prolactin

Step 1 UWorld (16 decks)

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