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Uworld > June 1st Exam > Flashcards

June 1st Exam Flashcards

1
Q

Drugs that block Folate :

= NTDs

A
  1. Methotrexate (RA and cancer)
  2. Sulfasalazine (RA , IBD)
  3. Trimeterene ( HCTZ diuretic, edema and HTN)
  4. Trimethoprim (Cystitis , pneumocystis) + Sulfanethoxalate

= inhibit dihydrofolate reductase (1st tri, limit precursors for DNA synthesis of cell growth)

  1. Valproic Acid, Carbamazepine, Phenytoin (Bipolar and Seizure disorders)
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2
Q

Retinoids and Vit A and preg

A

How genes blocking

= brachial arch problems ( CNS, Thymic, Craniofacial defects)

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3
Q

ACE inh and preg

A

In 2nd + 3rd tri

= Renal Dysplasia (pulm hypoplasia, limb contractions, growth restriction, cord compression)

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4
Q

Sacral agenesis in preg occurs in who

A

DM pts

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5
Q

Pregnancy and :

  1. Syphilis
  2. CMV
  3. Rubella
  4. Hepes
A
  1. Syphilis = bone lesions and defects, Hutchinson teeth, periostitis, osteochondritis, RASH (palms /soles) , rhinorrhea
  2. CMV = hearing probs, microcephaly, periventricular calcifications
  3. Rubella = hearing probs , cataracts, PDA
  4. Hepes= vesicular, ulcer rash (intrapartum meningitis)
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6
Q

TB drugs : side effect

  1. Rifampin
  2. Isoniazid
  3. Pyrazinamide
  4. Ethambutol
A
  1. Rifampin = rash, red/orange body fluids, Cytopenia, GI probs
  2. Isoniazid = X VIT B6, hepatotoxic
  3. Pyrazinamide = hyperuricemia, hepatotoxic
  4. Ethambutol = optic neuropathy
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7
Q

TB drugs : MOA

  1. Rifampin
  2. Isoniazid
  3. Ethambutol
A
  1. Rifampin = inhibit bacterial DNA- dependent RNA Polymerase
  2. Isoniazid = Inhibit Mycolic Acid synthesis
  3. Ethambutol = Inhibit Arabinosyl transferase
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8
Q
  1. Iliohypogastic nerve innervates
  2. Ilioingunal nerve
  3. Genitofemoral N
A
  1. Iliohypogastic nerve : suprapubic + gluteal sensation (anterolateral abd wall muscles) ,can get injured in appendectomy and cause suprapubic burning
  2. Ilioingunal nerve : upper + medial thigh + external genitalia
  3. Genitofemoral N : Upper anterior thigh + motor genitalia
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9
Q

P bodies are what

A

In cytoplasm bind to mRNA and prevent them from being translated ( decapping, miRNA silencing, exonucleases, mRNA storage and release when ready)

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10
Q

AAUAAA means

A

Cleave the mRNA there and add the polyA tail after it (3’end)

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11
Q

5’ end mRNA capping is done by what

A

Guanine 7-methyltransferase adding the methyl group to guanine cap

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12
Q

Drugs for Primary Adrenal insufficiency

A
  1. Hydrocortisone : increase cortisol ( increasing vasoconstriction)
  2. Fludrocortisone : increase MINERALCORTIcoIds ( aldosterone) = increase BV volume and vasoconstriction
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13
Q

Aldosterone acts on what cells

A

Principal cells CT kidney

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14
Q

Desmopressin

A
  1. ADH given in DI

2 increase F8 and vWF

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15
Q

What other things happen in Graves’ disease that is specific to this disease and no other type of hyperthyroidism

A

DX with TRAb (Thyrotropin ABs)

  1. Pretibial myxedema (thickening and induration of skin over shins)
  2. Opthalmopathy ( retro-orbital tissues causing proptosis)

= TSH stimulation can happen in other parts of the body leading to glycosaminoglycan accumulation in these areas

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16
Q

Cholestyramine MOA

A

Increase hepatic cholesterol and bile acid synthesis (MOA = increase excretion of cholesterol + bile acids)

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17
Q

Ileum absorbs what

A

IF + bile acid

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18
Q

What causes hyperglycemia in stress situations

A

Hepatic glycogenolysis + gluconeogenesis (from secretary cortisol, catecholamines, glucagon, and inflammatory cytokines)
+ increase GLUT1 in CNS (increase brain glucose uptake)

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19
Q

GH uses what pathway and 3 others that use this pathway

A 
JAK STAT ( causing IGF-1 making ) 
( cytokines, EPO, G-CSF)
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20
Q
  1. What uses adenylyl cyclase Gprotein , cAMP, PKA

2. What uses Gprotein, phospholipase C, DAG + IP3, PKC

A
  1. PTH, ACTH, TSH, ADH (V2)

2. GnRH, TRH, Angiotensin 2, ADH (V1)

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21
Q

V1 vs V2 ADH

A 
V1 = vasopressin vasoconstriction 
V2 = kidney water absorption
22
Q

Dilated cardiomyopathy causes problems in what

A

Contraction dysfunction

23
Q

Sertoli cells are activated by and secrete

A

FSH —> Sertoli cells —-> Inhibin B (seminiferous tubules)

24
Q

LH does what in males

A

Activate Leydig cells —» testosterone

25
Q

Multiple Myeloma causes what blood thing and cytokine

A
  1. IL6 = bone mineralization
  2. Rouleaux formation (from elevated circulating proteins (monoclonal paraproteins = Igs)
    ( also seen in Waldenström macroglubulinemia)
  3. Renal Insuffieciency = Ig light chain cast nephropathy ( M-spike)
26
Q

Cold Agglutinin does what to blood and what infection causes this

A

Clumps it into clumps ( cross reactive IgMs)

= Mycoplsma Pneumonia

27
Q

Hypersegmented N seen in

A

VIT B12 def

28
Q

E. COli have what properties

A
  1. Gram - bacilli, MacConkey agar, Eosin-methylene blue agar (green metallic color)
  2. Beta hemolysis on blood agar
29
Q

E.Coli virulence factor backed on disease :

  1. Bacterimia / sepsis
  2. Neonatal meningitis
  3. bloody D
  4. Watery D
  5. UTI
A
  1. Bacterimia / sepsis : Lipopolysaccharides Lipid A (Macrophages) + Lipid O
  2. Neonatal meningitis : K1 capsular polysaccharide (prevent complement and phago)
  3. bloody D : shiga toxin (inactivates 60S = cell death)
  4. Watery D : heat stable (cGMP) + heat labile (cAMP) enterotoxin
  5. UTI : P-fimbriae (adhesion in bladder)
30
Q

PPAR-gamma MOA

PPAR-alpha MOA

A
  1. Decrease insulin resistance (Thiazolidinediones : nuclear receptors : -glitz)
    = increase GLUT4 (insulin glucose uptake) , Adioponectin (FFA oxidation in fat cells) -> fat mass increase
  2. Lower TAGs, (Fibrates : Fenofibrate, Gemfibrozil)
31
Q

Most common site of thrombus formation in heart

A

LA appendage (usually from Atrial fib)

32
Q

Hookworm causes what in blood

A

Anemia chronic IDA + eosinophilia

33
Q

Schistoomiasis 3 things that can happen

A
  1. Hematuria, dysuria, bladder cancer, hydronephrosis, pylo
  2. GI ulcers = IDA
  3. Periportal fibrosis + portal HTN in portal veins (esophageal Varices, hepatomegally,)
34
Q

Trauma to superior orbital fissure

A

CN3,4,6, + CN5 injured

CN V1= corneal reflex (pons)

35
Q

Mastoid process hematoma causes

A

Battle sign, periorbital bruising, clear otorrhea = BASIAllAR SKULL FRACTURE

36
Q

Fracture to temporal bone or Zygomatic orbit fracture causes

A

CN 7 damage

37
Q

CN from midbrain, pons , medulla

A

MIDBRAIN : 3-4 (x memory, vision ,hearing)
PONS : 5-8 (diplopia, dizzy, X balance, X swallowing, numbness, nystagmus )
MEDULLA : 9-12

38
Q

Atrial Fib not responding to BB due to

A

Artiea structural remodeling ( stretching and dilation ) = happens with age

39
Q

Phenytoin + carbamazepine MOA

What transports NT to axon) (CA role

A

Block NA voltage gates = disrupts AP in neurons
(Kinesin)
(CA= fusion and release of NTs)

40
Q 
HIV and :
1. Cryptococcus neoformans 
2. Isospora belli 
3 .HSV
4. CMV
5. Candida
A
  1. Meningitis
  2. Profuse D
  3. Punched out ulcers in esophagus _ COWDRY type A (multi nuclear squamous cells)
  4. Linear esophageal ulcers (cytoplasmic inclusions)
  5. Pseudomembranes in esophagus, psuedohyphae
41
Q

CCB in AV/SN node and cardiomyocytes

A
  1. Slows spontaneous depolarizations (phase 0) = treat PSV tachy
  2. Decrease excitation and contraction coupling
42
Q

Burkitt Lymphoma

(Chr, histo, gene, sx and mutation cause) associated with what

A

Chr14/CHR8 translocation heavy Ig chain , starry sky (macrophages) , MYC overexpression = transcription activator*

  1. Kids with mandibular or maxillary mass
  2. Associated with EBV
43
Q
  1. Follicular Lymphoma
  2. MAntel cell lymphoma
  3. CML
A
  1. Follicular Lymphoma : Chr 18/Chr 14 translocation = BCL2 overexpression
  2. MAntel cell lymphoma : CHR 11/14 translocation = cyclin D1 overproduction = G1–>S
  3. CML : BCR/ABL = CHR9/22 translocation = Tyrosine Kinase increased —I apoptosis
44
Q

Chlamydia

  1. Urine and gram culture
  2. TX
A
  1. None , need nucleic acid amplification (due to no pepridoglycan in cell wall)
  2. Azithromycin + Doxycycline
45
Q

Gonorrhea

  1. Urine and gram culture
  2. TX
A
  1. Gram stain only gram - diplococci THAYER MARTIN AGAR (+ purulent urethral fluid)
  2. Ceftriaxone
46
Q

E. Coli + Klebsiella Pneumonia

1. Urine and gram culture

A
  1. Both
47
Q

NKC activated by and markers

A

CD16, CD56
IL12, INF-gamma
(Kill cells with low MHC 1 expression)

48
Q

Thorecentesis below what can injury abd structures

A

below rib 9
Around rib 10 = injure right hepatic lobe

  1. Midclavicular 6th rib
  2. Midaxillary 8th
  3. Paravertebral 10th rib
    * SHOULD BE DONE*
49
Q

Inheritance :

  1. Rett syndrome (neurodegenerative hand movement in F, males die inutero)
  2. HD
  3. Hemophilia B
  4. Galactosemia classic (jaundice, Hepatomegaly, V, X Galactose-1phosphate uridyl transferase)
A
  1. X link
  2. AD
    3/ X -link
  3. AR
50
Q

REason you give Chloroquine + Primaquine

A 
Chloroquine = in infected RBCs (trophozoites) 
Primaquine = dormant in liver (hypnozoites) (Vivax + Ovale strains)

MALARIA ( Giemsa stain, paroxysms fever

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