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Step 1 UWorld > Deck 9 > Flashcards

Deck 9 Flashcards

1
Q

How can you suspect CML? Qid 1569

A

Elevated WBC (>50,000), increase in precursor forms

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2
Q

How can you distinguish leukemiod rxn from CML?

A

CML = decreased leukocyte alk phosph (aren’t planning on fighting), increased basophils

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3
Q

Laboratory findings of PSGN?

A

Low C3 & elevated anti-strep antibodies (anti-streptolysin O, anti-Dnase B, anti-cationic proteinase)

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4
Q

What germ cell does prolactinoma arise from?

A

Surface ectoderm (anterior lactotrophs) Qid8702

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5
Q

What two agents are important for NAD production? Qid 1064

A

Niacin + tryptophan; in pellagra can use tryptophan to make NAD; niacin can be consumed or made endogenously through tryptophan

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6
Q

Describe Call-Exner bodies in ovarian cancer? What do they secrete?

A

Cuboidal granulosa cells in rosette pattern with pink eosinophilic center & coffee bean nuclei; Estrogen (can have endometrial hyperplasia); a sex-cord stromal tumor

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7
Q

What is the possible cause of milder Turner syndrome?

A

Somatic mosaicism

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8
Q

What does the GU tract come from (embryonically)?

A

Metanephric blastema + ureteric bud

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9
Q

What is the last thing to canalize in GU tract?

A

utereropelvic junction

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10
Q

What suppresses lactation in pregnancy?

A

Progesterone

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11
Q

What is the most abundant amino acid in collagen?

A

Glycine: occupies every third spot in each of three alpha chains

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12
Q

Cause of elevated creatine kinase, fatigue, myalgia, myoedema

A

Hypothyroid myopathy

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13
Q

Where does angiotensinogen, ang I, ang II come from?

A

Angiotensinogen = liver; Ang I = converted from angiotensinogen in systemic circulation by renin; Ang II = converted from Ang I by endothelial bound ACE in pulmonary vessels

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14
Q

Whats wrong with high nitroprusside dose, altered mental status, seizures, lactic acid, bright red blood? What Tx?

A

Cyanide toxicity; Sodium thiosulfate (gives sulfates to rhodanse to form less toxic thiosulfate), hydroxycobalamin, sodium nitrite

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15
Q

What enzyme is deficient in familial chylomicronemia syndrome (type 1 hyperlipoproteinemia)? How can it be measured?

A

LPL: normally bound to heparin sulfate moieties- can be measured when administered heparin…. Pancreatitis!

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16
Q

What med is teratogenic - required for renal development and can cause oligohydramnios symptoms?

A

ACEI’s

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17
Q

What is most common cause of viral meningitis?

A

Enteroviruses

18
Q

What are possible causes of hyperosmotic volume contraction?

A

Diabetes insipidus (vassopressin doesn’t lose NaCl like aldosterone), dehydration,, profuse sweating (due to hypotonic nature of sweat)

19
Q

Second hand smoke increases chances of what in kid?

A

Sudden infant death syndrome, otitis media, asthma, other resp illnesses

20
Q

Symptoms of PKU? Inheritance?

A

Intellectual disability, gait/ postural abnormality, eczema, musty body odor; auto recessive

21
Q

Carcinoembryonic antigen is elevated in what?

A

Colorectal cancer

22
Q

In complete mole, what does microscopy, immunochemistry, blood show?

A

Micro = large, edematous hydropic villi; Immuno = negative P57 (absent maternal genome); Blood = elevated b-HCG

23
Q

In what condition do you see decreased ADAMST13?

A

Thrombotic thrombocytopenia purpura: normally degrades vWF&raquo_space; clotting

24
Q

What muscles are used for shoulder abduction?

A

Supra + deltoid to horizontal; Traps + serratus anterior rotate glenoid superiorly after that

25
Q

What compounds are triggered by insulins tyrosine kinase?

A

Phosphorylates IRS1 (insulin receptor substrate) > PI3K (metabolic: more GLUT4, glycogen & fat synth) + RAS/ MAP kinase (mitogenic: DNA synth & cell growth)

26
Q

What acetylcholinesterase inhibitor crosses BBB?

A

Physostigmine

27
Q

What is bosentan used for?

A

Pulmonary arteriole hypertension: endothelin-1 receptor antagonist (vasodilation)

28
Q

Chiari I vs Chiari II congenital malformations?

A

I = benign, low lyring cerebell tonsils, paroxysmal HA in early adulthood, dizziness, ataxia; II = more severe and in young kids, vermis, tonsils, and medulla through foramen magnum, non communicating hydroceph, medulla problems (dysphagia, stridor, apnea), lumbar myelomeningocele

29
Q

Characteristics and findings of Pick disease?

A

Frontotemporal dementia - changes in behavior, slurred speech; frontotemp atrophy, Pick bodies (aggregates of cytoplasmic tau protein seen in silver stain)

30
Q

Trosseau sign?

A

Carpal spasms with inflation of blood pressure cuff- hypocalcemia… DiGeorge?

31
Q

What cells are in ovary?

A

Simply cuboidal that divide and proliferate rapidly to repair

32
Q

Characteristics of Wiskott Aldrich? Whats wrong?

A

Eczema, recurrent infections, thrombocytopenia (WATER); X linked mutation with thrombocytopenia and immunodeficiency: combined B cell (incr pyogenic infections- capsule) & T cell (incr opportunistic)

33
Q

Which UV rays absorb in upper dermis and cause sunburn and malignancy?

A

UVB

34
Q

Which UV rays penetrate deeper and causes photaging? How?

A

UVA; ROS activate receptors & TF’s to DECREASE COLLAGEN FIBRIL PRODUCTION and increased MMP degradation

35
Q

What makes you think SCID? Labs? Tx?

A

Defective T cell development & B cell dysfunction; Risk for infections of virus, fungi, protozoa, sinopulmonary bacteria; LABS: lymphopenia & hypogammaglobinulinemia; Tx: stem cell transplant

36
Q

What is Tx from defect in ornithine transport?

A

(Urea cycle) = limit protein consumption - no excess amino acids being converted to urea (which can’t be excreted)

37
Q

What ribs overlie the spleen? The kidney?

A

Spleen = 9, 10, 11; Kidney = 12

38
Q

If a patient has general malabsorption with normal labs & exams, what is best next test?

A

Stool microscopy with Sudan III stain - looks for fats in stool (first nutrients to not be absorbed well)

39
Q

What other condition should you expect with endocarditis w strep gallolyticus aka bovis (group D)?

A

Associated with colon cancer

40
Q

In global ischemia of brain (cardiac arrest) what are most vulnerable areas to go first?

A

Hippocampus (pyramidal cells); also vulnerable = purkinje cells of cerebell & neocortex

Step 1 UWorld (16 decks)

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