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Step 1 UWorld > Deck 3 > Flashcards

Deck 3 Flashcards

1
Q

Difference between class 1 and class 2 HLA proteins?

A

Class 1 (B): expressed in all nucleated cells and present to CD8 T lymphs. Class II (DR, DP, DQ): expressed by antigen presenting cells (Mx, dendritic cells) and present to CD4 Th

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2
Q

Examples of class 1 HLA?

A

HLA B27- PAIR = seronegative spondyloarthropathies (because of absence of rheumatoid factor ie IgM against IgG)

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3
Q

What is buspirone used for?

A

GAD- not panic disorder because of slow onset of action (1-2 weeks); no sedation, addiction, good with alcohol; “I’m always anxious the BUS will be ON time”

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4
Q

What things happen in herniation from temporal lobe lesions?

A

Uncal hernation: Transtentorial herniation of uncus -> ipsilateral 3rd nerve palsy (fixed dilated pupil) and compression of cerebral peduncles (corticospinal tract injury with hemiplegia)

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5
Q

What things happen in central herniation?

A

Abducens palsy

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6
Q

Which polymerase has 5’- 3’ exonuclease activity?

A

Only DNA polymerase 1 (in addition to having 5-3 polymerase, and 3-5 exonuclease activity)- remove primer and fix damaged sequences

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7
Q

What is MOA of opiates on pre and post synaptic cells

A

Bind mu receptor- Pre = closure of voltage gated Ca channels (reduced Ca influx / neurotrans release from presynaptic); Post = mu binds K channels and hyperpolarization from K efflux

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8
Q

What drugs inhibit renin release?

A

Bblockers- block stimulation of beta-1 receptors located on juxtaglomerular cells

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9
Q

What effect does dropping Co2 have in brain?

A

Vasoconstriction

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10
Q

Jaundice, pruritis, dark urine, light stools, B symptoms, indicative of what?

A

Adeno of head of pancreas blocking bile duct

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11
Q

How does ribavirin work? What is it used for?

A

Hep C and RSV: nucleoside antimetabolite that interferes with duplication of viral genetic material

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12
Q

Cheyne stokes breathing seen in what?

A

CHF

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13
Q

What antiarrythmics prolong cardiac cycle (QT interval)? Which one doesn’t cause Torsades?

A

Class 1A, III; Amiodarone doesn’t cause torsades

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14
Q

What three main vessels supply blood to GI?

A

Celiac trunk, SMA, IMA

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15
Q

What meds for hypoPTH patient with hypocalcemia?

A

Calcitriol (active vit D)- Calcidiol has to be converted by PTH

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16
Q

Symptoms of neuroleptic malignant syndrome?

A

Diffuse muscle rigidity, high fever, autonomic instability (BP, tachy), altered sensorium, high CK (rhabdo)

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17
Q

What causes NMS? Tx?

A

From antipsychotics (block dopamine); Give dantrolene or bromocriptine (dopamine antagonist)

18
Q

Which SERM is used for Tx of breast cancer? For osteoporosis?

A

BC = tamoxifen; Osteoporosis = Raloxifene (antagonist action in breast/ uterus)

19
Q

Difference between type 1 and type 2 error?

A

Type 1: conclude there’s a difference when there isn’t. Type 2: conclude no difference when there is

20
Q

What accounts for adverse effects of Fabry’s?

A

Deficiency of a-galactosidase- breaks down Gp3 or ceramide trihexidase; This accumulates in vascular smooth muscle cells, glomerular cells, cardiac myocytes, DRG and autonomic ganglion

21
Q

What medications dilate coronary arteries and can cause coronary steal syndrome?

A

Adenosine and dipyridamole

22
Q

What does IF microscopy show in PSGN?

A

Granular deposits of IgG, IgM, and C3 in mesangial and basement membranes

23
Q

Which amino acids are exclusively ketogenic?

A

Lysine, leucine

24
Q

Symptoms of pyruvate dehydrogenase deficiency? Why?

A

Lactic acidosis, neuro deficits; Pyruvate can’t become Acetyl coA- build up of pyruvate shunts to lactate –> Lactic acidosis

25
Q

The liver converts D2,3 to 25,hydroxyvitamin D with 25-hydroxylase- what converts to 1,25-dihydroxy?

A

Kidney- with 1-a-hydroxylase (stimulated by PTH, decreased by Ca)

26
Q

What makes you think adrenal crisis? What Tx?

A

Severe hypotension, shock, abd pain, vomiting, weakness, fever-Hx of autoimmune endocrinopathies, weight loss, hyperpigmentation (addison); Tx: fluids with glucocorticoid supplementation (hydrocortisone, dexamethasone)

27
Q

What activates/ inactivates 6-mercaptopurine? What precautions should you take?

A

Activated by HGPRT, inactivated by xanthine oxidase (and thiopurine methyltransferase). PRECAUTION: reduce 6-MP dose if giving allopurinol! (XO inhibitor)

28
Q

What medication raises HDL and cause trigger gout? What other SE?

A

Niacin- reduces clearance of HDL; decreases renal excretion of uric acid. Other SE: flushing, hyperglycemia, hepatotoxicity

29
Q

What receptors does dopamine stimulate? What effect on heart/ kidneys?

A

D1 receptors in kidney = Incr GFR, renal BF, Na excretion. B1 in heart = Incr contractility, SBP, HR (***At higher doses can stimulate a1)

30
Q

How does diphenoxylate help with diarrhea?

A

opioid - mu receptors in GI and slows motility (to discourage abuse- combined with atropine)

31
Q

What medication can reduce craving of alcohol? Target?

A

Naltrexone- blocks mu-opioid receptor

32
Q

What genes encode DNA transcription factors important in segmental development of embryo (along cranio-caudal axis)?

A

Homeobox or Hox genes

33
Q

What are the segmented viruses that can undergo antigenic shift?

A

Orthomyxovirus, Reovirus, bunyavirus, arenavirus

34
Q

What is the role of ubiquitin?

A

Tag that attaches to protein and marks them for destruction (by proteasome)

35
Q

What does VIP do (a VIPoma)? What counters it?

A

Stimulates pancreatic bicarb and Cl, and incr cAMP of intestinal epithelium causing loss of Na, Cl, and water => secretory diarrhea. VIPoma: watery diarrhea, hypokalemia, achlorhydria.

36
Q

What inhibits VIP?

A

Somatostatin (octreotide) inhibits VIP

37
Q

What does octreotide inhibit?

A

Decreases production of VIP, gastrin, glucagon, CCK

38
Q

How can you diagnose anti-phospholipid syndrome?

A

SLE, prolonged PTT, history of thrombosis, spontaneous abortions, falso positive syphilis tests

39
Q

Symptoms of pineal gland mass?

A

Obstrucive hydrocephalus (papilloedema, HA, vomiting) and Parinaud syndrome (limited upward gaze from compression of tectum)

40
Q

What lab is elevated in pineal tumor??

A

B-HCG: most commonly germinomas

Step 1 UWorld (16 decks)

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