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Step 1 UWorld > Deck 6 > Flashcards

Deck 6 Flashcards

1
Q

What heart complication does the rubicin chemo agents cause? Tx?

A

Dilated cardiomyopathy; swelling of sarcoplasmic reticulum is first sign then myocyte loss; prevent with dexrazoxane (iron chelating agent that prevents free radicals)

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2
Q

Which cytokine mediates formation of pus?

A

IL-8: Mx and endothelial cells secrete to recruit neutrophils to site of infection & induces phagocytosis

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3
Q

What Tx for drug (antipsychotic) induced parkinsonism?

A

Centrally acting antimuscarinic (trihexyphenidyl, benztropine)

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4
Q

What are examples of multifactorial inheritence?

A

Spina bifida, cleft lip and palate, DM, CAD, HTN

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5
Q

What are most common non-cardiac causes of pulsus paradoxis?

A

Asthma & COPD- incr intrathoracic pressure transmitted to extrathoracic structures and leads to excessive drop in blood pressure with inspiration

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6
Q

How is hereditary PAH transmitted?

A

Autosomal dom - BMPR2 mutation: dysfunctional endothelium and smooth muscle proliferation

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7
Q

How can you distinguish MAC from tuberculosis? What prophylaxis Tx in HIV?

A

MAC = anemia, hepatoSPM, elevated alk phos/ lactate dehydrogenase, grows better at 41 C; give azithromycin for prophylaxis in HIV

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8
Q

What causes decrease in systolic pressure in pulsus paradoxis?

A

Inspiration: incr venous return expands into restricted LV and decreases EDV and SV

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9
Q

What is the cause of Turner XO?

A

Paternal meiotic nondisjunction (loss of parental X chromosone in sperm)

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10
Q

What causes diastolic HF? What are diagnostic findings?

A

Decr ventricular compliance from impaired relaxation (ischemia, HCM) or incr stiffness (amyloid, HCM); Incr end-diastolic pressure, NORMAL end-diastolic volume and LV ejection fraction

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11
Q

Vascular lesion w IgA and C3 deposition, rash on legs, abd pain, arthralgias…?

A

Henoch-Schonlein Purpura

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12
Q

What incr risk of squamous cell of esophagus?

A

Smoking, alcohol, achalasia

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13
Q

Describe Friedrich Ataxia- inheritance? Symptoms? Population?

A

Aut recessive- kids 5-15; difficulty walking (ataxia), HCM, kyphoscoliosis, foot abnormalities, DM

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14
Q

What causes S-100 immunoreactivity?

A

Neural crest origin: Schwannoma (schwann cells), melanoma

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15
Q

Histo of schwannoma?

A

Biphasic pattern with areas of dense elongated cells with oval nuclei (Antoni A) + less dense myxoid region (Antoni B);

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16
Q

What nerve is not affected in schwannoma? Most common site?

A

All but CN II (Oligo covered); most common = cerebropontine angle @ CN VIII -> bilateral acoustic neuroma

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17
Q

How does body compensate for incr fluid in HF?

A

Shunted to lymph system; when overwhelmed -> edema

18
Q

What happens in lesion of dominant parietal lobe (Gertsmann syndrome)?

A

Agraphia (can’t write), acalculia, left-right disorientation, inability to identify fingers on hand

19
Q

What happens in lesion of Lateral medulla?

A

Wallenburg (PICA): loss of pain/ temp of ipsi face/ contra body, ipsi bulbar weakness (nucleus ambiguus), vertigo (vestib nuclei), ipsi limb ataxia (inf cerebellar peduncle), Horners

20
Q

What happens in lesion of Medial medulla?

A

(anterior spinal artery) = contra hemiparesis (lat corticospinal), contra hemisens loss (lat dorsal column medial lemniscus), ipsi tongue paralysis (XII nucleus)

21
Q

What exacerbates HCM? What meds should you avoid/ give?

A

Worsens with decr LV volume (decr preload or SVR) because outflow obstruction; avoid vasodilators & diuretics; Tx: negative inotropics (reduce LVOT obstruction) = BBs, nondihydropyrodine CCBs (verap, dilt)

22
Q

What would cause resistance to anti-EGFR therapy

A

KRAS mutation (proto-oncogene that encodes transducer) Qid: 12049

23
Q

Difference between LGN & MGN?

A

MmmmmmGN: auditory & LoookGN is visual (in thalamus- recieves optic tract)

24
Q

Where do dihydropyridine CCBs act?

A

Arterial smooth muscle- little cardiac activity = safe in arrythmias (vs. verap/ dilt)…. Can cause reflex tachy

25
Q

Which LE lymph tract bypasses popliteal nodes to inguinal?

A

Medial

26
Q

What happens in Wolf-Parkinson-White? EKG changes?

A

AV accessory pathway (random palpitations)- Short PR, Widened QRS, delta wave (slurred, broad upstroke of QRS)

27
Q

Back up Tx for CMV? Complications?

A

Foscarnet: pyrophosphate analog; can cause hypocalcemia (can chelate Ca) and hypomagnesia

28
Q

What causes scarlet fever? Symptoms?

A

GAS; fever, malaise, abd pain, sore throat, red strawberry tongue… then blotchy rash, “sandpaper like rash” (sunburn with goose pimples)

29
Q

What damage causes hemiballismus?

A

Subthalamic nucleus (commonly lacunar stroke)

30
Q

Winters formula? Tells you what?

A

Tells you if appropriate CO2 compensation = (1.5 x HCO3) + 8 +- 2

31
Q

What is prinzmetal angina? Possible triggers?

A

Transient attack of coronary vasospasms; Triggers = cig smoke, cocaine/ amphetamines, ergot alkaloids

32
Q

What is CREST syndrome?

A

Systemic sclerosis from collagen: Calcinosis, Raynouds, Esophageal dysmotility, Sclerodactyly (skin thickening/ tightening over fingers), Telangiectasias

33
Q

What catalyzes first step in B-oxidation and is most common deficient enzyme?

A

Acyl Coa synthase

34
Q

Which pneumocytes act as progenitor/ stem cells?

A

Type II

35
Q

What serological testing is positive in celiacs?

A

Elevated IgA, anti-endomysial, anti-TTG antibodies

36
Q

What muscles are most commonly affected in myasthenia gravis?

A

Extraocular, bulbar (chewing, dysphagia)

37
Q

Cause and presentation of polymyositis?

A

CD8 lymph mediated damage to muscles; symmetric proximal muscle weakness

38
Q

What often accompanies lambert eaton? What is cause?

A

Often involves small cell lung cancer; autoantibodies against presynaptic Ca channel; proximal weakness that improves with use

39
Q

What is cause/ symptoms of lymphogranuloma venereum?

A

Chlamydia serotypes L1-L3; initially painless small ulcer followed by swollen painful coalescing lymph nodes (buboes), intracytoplasmic inclusion bodies

40
Q

What ligament is injured in valgus stress injury?

A

MCL

Step 1 UWorld (16 decks)

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