export_uworld qbank Flashcards
VIP GAL Valine Isoleucine Proline Glycine Alanine Leucine
Non-Polar Aliphathic Hydrophobic Amino Acids
Try Trippin with Pheynyoin Tyrosine Tryptophan Phenilalanine
Aromatic Hydrophobic Amino Acids
halothane (inhaled anesthetic) hepatotoxicity
- fulminant hepatitis - rapid atrophy and centrolobular hepatcyte necrosis - inflammation of the portal tracts and parenchyma - S/S: fever, anorexia, nausea, myalgias, arthralgias, rash, tender hepatomegaly, jaundice - labs: increased ALT, AST, PT. Leukocytosis and eosinophila. normal albumin (makrer of chronic liver failure) - very high mortality rate
Type 3 Hypersensitivity
Neutrophils and complement activation. * Fibrinoid Necrosis * Neutrophil Infiltration * Hypocomplementemia
Leuprolide Use in “leu” of GnRH
* Use: fertility (pulsatile release) and cancer chemotherapy (continuous) * pulsatile release stimulates sustained release of FSH and LH and results in ovulation * continuous desensitizes GnRH receptors on anterior pituitary leading to suppression of FSH and LH release “medical castration”
beta-glucuronidase
* This enzyme contributes to the hydrolysis of bilirubin glucuronides and increases the amount of unconjugated bilirubin in bile * infx in biliary tract –> release of by injured hepatocytes and bacteria * **seen in pigment bile stones (mostly asia/africa)
Phentolamine
nonselective alpha antagonist Blocks vasoconstriction at alpha 1 and feedback inhibition of NE release at alpha 2 which causes increased HR and contractility (Beta 1 not blocked) prevention/control of HTN pheocromocytoma (adrenal tumor)
Zidovudine Zombie Dove
Deoxythymidine analogue Used in HAART for HIV treatment Nucleoside reverse transcriptase inhibitor Neutropenia
cromolyn
prevent release of mediators from mast cell. Prophylaxis against asthma. Not affective during acute attacks.
adenocarcinoma
most common form of lung cancer in women and in people under 45 Form glandular configurations Peripheral portion of lung with a scar like area. Common among non smokers
Subacute granulomatous thyroiditis
* 3-5x in female, 30-50y/o * Seasonal incidence, peaking in summer, most common cause of thyroid pain * Pathogen: viral infection or post inflamm response: ( Coxsackie, mumps, measles, adeno, others ) * Viral induced tissue damage, release of ‘antigen’, tim of cytotoxic T cells limited
Dobutamine Dough Buddha
* Mech: Predominant Beta1 agonist. CV effect: Increases Contractility(pure inotrope)–> increase CO, decrease SVR and increase HR moderately, * Indication: Heart failure, MI. * Pharm: t1/2 = 2 min. * Chronic continuous infusion can lead to desensitization; inhibited by beta-blockers
Zollinger-Ellison syndrome
A gastrinoma (often in pancreas and associated with MEN 1, a tumor of pancreas, pituitary, and parathyroid, 3 P’s) causes gastrin hypersecretion which increases gastric HCl, which leads to severe peptic ulceration. * Uncommon, but a possible cause of PUD, GERD, and fatty diarrhea(bc not alkalinized enough to activate pancreatic enzymess
Erythrocyte Sedimentation Rate.
*This lab value* should be determined if temporal arteritis is suspected. It will be increased.
HOT T-bone stEAk
IL1 - fever and osteoclast activating factorIL2 - T cells IL3 - like GM-CSF IL4 - class switching to IgE and IgG IL5 - IgA and eosinophils IL-6 - acute phase reactants
Clomipramine
TCA that treats OCD
flurazepam
long-acting BZD
TOM Triazolam Oxazepam Alprazolam
Short acting benzodiazepines
NF-κB
Transcription factor * induces production of TNF-α and other inflammatory cytokines Inhibited by corticosteroids
Nevirapine
Non-Nucleoside Inhibitor of Reverse Transcriptase Skin Rash Lactic Acidosis
Ritonavir
Anti-HIV (protease inhibitor)
ramipril
* class: ACE inhibitor * use: hypertension, CHF, MI * MOA: blocks conversion of angiotensin I to angiotensin II (a vasoconstrictor) and suppresses aldosterone, limiting sodium re-uptake in the kidney * ADE: hypotension, HA, cough, bradykinin accumulation, dizziness, vision changes
Hashimoto’s thyroiditis
* Gross: pale, firm, rubbery, tan or white. * Micro: lymphocyte and plasma cell infiltration w/ germinal centers and fibrosis. variable amount of parenchymal atrophy: small follicles, w/ scant colloid and pink, plump, granular oxyphil epithelial cells (aka Askanazy or Hurthle cells), and desquamated epi cells in follicular lumens. Slightly increased risk of thyroid lymphoma and papillary thyroid carcinoma.
Granulosa Cells
Androgens released from theca interna cells migrate to *these cells* which contain aromatase to convert androgens to estradiol
pseudomonas aeurginosa
* opportunistic G- rod * strict aerobe * non-fermenter * oxidase + * pigment producing * Hot Tub folliculitis
Agranulocytosis
Major side effect of thionamides such as propylthiouracil and methimazole
Lidocaine
Class IB- Na blocker Use: Ventricular fibrillation; IV Short-acting, emergency act mostly on inactivated ischemic tissues
Medial femoral circumflex artery
Vessel that is vulnerable to damage from femoral head fractures
Dofetilide
Class III antiarrhythmic Potassium channel blocker Used for Atrial Flutter
Gemfibrozil
Best treatment for acute pancreatitis due to severe hypertriglyceridemia
Seborrheic keratosis
Thickened areas of pigmentation that look dark and greasy; develop in unexposed and sun exposed areas
-pril
ending used for angiotensin converting enzyme (ACE) inhibitor, antihypertensive (causes vasodilaiton)
Renal papillary necrosis
*This Conditon* can be caused by chronic analgesic abuse, diabetes mellitus, sickle cell trait or disease, severe acute pyelonephritis
Nonmalignant hypertension Diabetes
2 conditons that can cause Homogenous deposition of eosinophilic hyaline material in intima and media of small arteries and arterioles
Henoch-Schonlein Purpura
* Small-vessel vasculitis * MC childhood systemic vasculitis * URI, then triad of palpable purpura, arthralgia, and GI (abd pain, melena, lesions same age) * Path: IgA complex deposition, vasculitis * Assoc: IgA nephropathy
Rotavirus
-sudden onset w short incubation, ab pain/fever, lasts 3-8 days -fecal oral, winter peak, dehydration in kids -death(6-24 mths) -segs of dsDNA capable of reassortment- infects & kills enterocytes- loss of microvilli- replaced by immature cells cannot absorb nutrients and water -vaccine: 5 live strains
Parvovirus B19
* 5th disease * Slapped cheek disease (erythema infectosium) in children
Ondansetron
5HT3 antagonist Antiemetic
cidofovir
* synthetic acyclic purine nucleotide * treats: CMV retinitis in AIDS patients * mode of action: cidofovir diphosphate inhibits viral DNA synthesis * Doesn’t need virally encoded kinase
Budd-Chiari syndrome
* Liver infarction secondary to hepatic vein obstruction * Present with painful hepatomegaly and ascites
CML
Increased white blood cell count Many immature cells, few blasts Low leukocyte alkaline phosphatase
HMP shunt
This metabolic process provides a source of NADPH and ribose for nucleotide synthesis (from glucose-6-P via glucose-6-P dehydrogenase)
Transketolase Transaldolase
two enzymes which are part of reversible phase of HMP shunt
Burkitt’s lymphoma
This type of lymphoma demonstrates translocation of c-myc oncogene
C-MYC and N-MYC
- nuclear transcription factor oncogene - translocation (of C-MYC)= Burkitt’s lymphoma - amplification (of N-MYC)= neuroblastoma - most common nuclear transcription factor mutation in human tumors
MRP2
A ATP-dependent, uni-directional transporter - transports Conjugated Bilirubin against its concentration gradient RLS
Peptic Ulcer Disease
Selective Cox2 inhibition using drugs such as celecoxib is useful for pain management with people with which condition?
Candida albicans
* Opportunistic fungal infxn * Yeast w/ pseudohyphae in culture at 20°, Germ tubes at 37° * Oral/esophageal thrush in IC (neonates, roids, AIDs, DM), vulvovaginits (high pH, Abx, DM), diaper rash, endocarditis in IV drug users, disseminated candidiasis, cmc * Nystatin for superficial infxn, Amphotericin B for systemic
Anaplastic Tumor
Type of Tumor that is * Pleomorphism * Hyperchromatic (dark) * Nuclear/Cytoplasmic ratio 1-1 * Giant cells, prominent nucleoli * Atypical (tri or quadri polar) mitosis *not specific for diagnosis
Pilocytic Astrocytomas
* Grade I tumor * Children, young adults * usu. in cerebellum (& other midline structures) * or spinal cord if adult patient slow-growing tumors that can be cut out
Hemosiderin
Hemoglobin derived aggregates of partially denatured ferritin within lysosomes. Prussian blue stain is positive. Localized accumulation follows hemorrhage (bruise)
Cytochrome P450
General name for a large class of enzymes that play a significant role in drug metabolism.
Desmopressin
Drug that is used to treat mild caes of hemophilia A. Causes temporary increase in plasma factor VIII levels by two to three fold. vWF is also increased
Protamine
Antidote for heparin overdose
Fibronectin
A type of large glycoprotein that is found on the surface of cells and mediates cellular adhesion, control of cell shape, and cell migration
T-cell ALL
Which lineage of Acute Lymphoblastic Leukemia (ALL) is more likely to result in mediastinal mass that can compress trachea?
Multiple Myeloma
Which type of Plasma cell disorder results in Primary AL amyloidosis?
Amifostine Amy Frost. Cold like platinum
Prevents nephrotoxicity of platinum-based chemotherapeutic agents
erythrocyte
red blood cell. there are about 5 million per microliter
reticulocyte
a young RBC characterized by a network of granules within the cell membrane
Foscarnet
- Synthetic pyrophosphate analog - Prevents viral DNA replication - Binds viral DNA polymerase - Drug of choice during acyclovir resistance - HSV, VZV, CMV, HIV-1
Foscarnet
“Fox cARRR net” If you catch foxes in a net, they won’t reproduce (this drug is a stage 3 inhibitor). ARRR… it inhibits RNA polymerase and Reverse transcriptase to block Reproduction. You’re going to put the foxes into a car that’s made out of bones (this drug binds to bones and decreases Ca2+ and Mg2+). Also, a foxy lady is HOT (this drug will cause a fever) and never wear fox urine to hunt (this is excreted in the kidney and causes renal insufficiency).
Valine, Leucine & Isoleucine Muscles LIVe Fast
- branched chain amino acids - bulky non polar R group (hydrophobic so on the interior of proteins)
BRAF
Q.id: 7707 ONCOGENE : Melanoma (Serine/threonine kinase)
valproate
generalized tonic-clonic seizures partial seizures generalized seizure absence seizure myoclonic seizure
Phenytoin
MOA: use dependent Na-channel blocker; prolongs refractory period First like for partial and generalized seizures Tox: nystagmus, ataxia, dyplopia, sedation, gingival hyperplasia , p450 induction
CREST syndrome
Calcinosis Raynaud’s phenomen Esophageal dysmotility Sclerodactyly (thickening and tightness of skin of fingers and toes) Telangiectasia (small dilated blood vessels near surface of skin and mucosa, usually seen around nose, cheeks and chin)
adenocarcinoma in situ
tumor that lines glands preserving glandular structure non-invasive but can lead to invasive carcinoma muscin preserved
Type I diabetes
Q.ID 921 Increased thirst, increased hunger dry mouth, frequent urination unexplained weight loss fatigue blurred vision labored, heavy breathing loss of consciousness
permissive
Q.id: 551 -need one hormone to have full effect of another hormone e.g Cortisol with Norepinephrine
Status Epilepticus
Q..ID 353 Treatment of this conditon 1. DOC is Benzodiazepines 2. Phenytoin if no response (beware cardiotoxicity) 3. Phenobarbital is the DOC in pediatric patients
Anti-centromere
Q.id: 340 Type of antibody found in CREST scleroderma * C - Calcinosis/Centromere * R - Raynauds * E - Esophageal dysmotility * S - Sclerodactyly * T - Telangiectasia
Left Anterior Descending
Q.ID: 10467 Occlusion of this artery leads to ST elevation in leads V1-V3
Helicase
Q.ID 1436 This enzyme unwinds DNA at the replication fork.
Poly Arteritis Nodosa
Necrotizing Med Vessel Vasculitis of Rena, coronary Messenteric Arteries Spares Pulmonary Arteries Asct with HBsAg & Middle aged men Nodosa: Nodes: Focal Vasculitis produces aneurysms RUN Angiogram to Confirm Organ infarctionin Kidneys (renaal failure), heart (acute MI), bowels (bloody diarrhea), skin (ischemic ulcer) testicle (testicular pain)
Pilocytic astrocytoma
Q.ID 457 * MC in children * 5C’s: C ystic, C hildhood, C ontrast-enhancing, C alcification, C ircumscribed * Biphasic, dense, loose appearance, Rosenthal fibers, eosinophilic granules * 40% cerebellum and 25% optic nerve
delusional disorder
Q.ID 2046 a condition in which a person has a non bizarre delusion, no other psychotic symptoms, and few changes in overall functioning other than the behaviors immediately surrounding the delusion
Schizophreniform disorder
Q.ID 2046 a disorder in the schizophrenic spectrum characterized by symptoms of schizophrenia for less than 6 months, less social dysfunction than schizophrenia, and a more likely recovery
Tryptophan
An amino acid that can be converted to niacin in the body.
PSGN
Discrete subepithelial humps on electron microscopy consisting of IgG and C3
Cilostazol
MOA : phosphodiesterase III inhibitor; increases cAMP (usually metabolized by phosphodiesterase) in platelets, thus inhibiting platelet aggregation; vasodilator Use : intermittent claudication, coronary vasodilation, prevention of stroke or TIAs (combined with aspirin), angina prophylaxis; superior to aspirin in peripheral arterial disease Toxicity : nausea, headache, facial flushing, hypotension, abdominal pain
CA-125
serum marker for ovarian surface epithelial tumors
t1/2= (Vd × 0.7) /CL
Formular for half life
Lambert-Eaton Myasthenic Syndrome
Flaccid - Weakness is greatest at the initiation of muscle use or with slow rates of stimulation. Pre-synaptic side of neurotransmission. Mostly in men with small cell lung carcinoma
Trousseau Syndrome
tumor-associated release of procoagulants cause migratory thrombophlebitis usually associated with pancreatic adenocarcinoma Non-Bacterial thrombotic endocarditis can also be seen.
Reye syndrome
Microvesicular steatosis of hepatocytes without inflammation.
EBV
Associated with which virus? Primary CNS lymphoma arising mostly from B-cells. (Diffuse large B-cell lymphoma)
Descending Aorta
When TEE probe is faced posteriorly in mid esophageal position, what structure will be best imaged in this position?
Echinococcus granulosus
Q.ID: 61 Rapidly growing mass in liver which has this gross appearance. Due to infection by? Eggshell calcification
Propanolol
Q.ID: 1364 This medication can counteract effect of epinephrine by blocking both beta 1 and beta 2 receptors
Gallstone ileus
Q.ID: 88 Hard high cholesterol mass obstructing ileocecal valve and air in biliary tree is most consistent with?
CREST scleroderma
Q.ID: 825 Calcinosis, raynaud’s, esophageal dysmotility, sclerodactyly, and telangiectasia. Microvascular injury of pulmonary arterioles leads to narrowing of lumen and increased pressure in pulmonary circulation
HNPCC (Hereditary Non-polyposis colon cancer)
Q.ID: 429 Occurence of colonic adenocarcinoma at
axonal reaction
Q.ID: 494 Term used to describe following histologic change Cell body has edema, and nucleus displaced to periphery; Nissl substance disperse around the cytoplasm (central chromatolysis)
Submocosa Narrow Part
Q.id: 331 Barium anema shows narrow rectum and rectosigmoid area, and large proximal dilation close to narrow area. Sampling of which area and layer would be most useful for diagnosis?
