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Uworld > June 2nd Examm > Flashcards

June 2nd Examm Flashcards

1
Q
A

Noncommunicative Hydrocephalus, obstruction (aqueduct stenosis, Arnold Chiari) ventricles proximal to obstruction are enlarged

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2
Q
A

Normal Pressure HYdrocephalus (communicating hydrocephalus = X CSF absorption)

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3
Q
A

Hydrocephalus Ex-vacuo (AIDS or dementia) cortical atrophy causing this

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4
Q
A

Hydrocephalus Ex-vacuo

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5
Q

Pseudotumor cerebri

A

Intracranial HTN with no ventricular enlargement (young females)

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6
Q

3 things reducing liver gluconeogenesis

A
  1. Sepsis chronic inflammation
  2. BB
  3. Heavy alcohol
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7
Q

Achondroplasia

  1. Inheritance ‘
  2. Mutation in
  3. Sx
A
  1. AD, homozygous is leathal, Heterozygous live
  2. FGFR3 mutation
  3. Short limbs , dwarfism
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8
Q

Neurofibromatosis
1, inheritance
2. Gene mutation
3. Cells its made of and embryo logic origin

A
  1. AD
    2 . NF1 TSG
  2. Schwann cells = NCC
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9
Q

NCC origin

A
  1. Skull bones
  2. Schwann cells
  3. Septum aorticpulmonary
  4. Melanocytes
  5. Bone/cartilage
  6. Adrenal Medualla
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10
Q

NT origins

A
  1. Retina
  2. Brain / spinal cord
  3. Pineal gland
  4. PP gland
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11
Q

Mesoderm origin

A
  1. Muscles , bone cartilage
  2. Heart , lymph
  3. Spleen, kidney , ureter
  4. Adrenal Cortex
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12
Q

Endoderm origin

A
  1. GI, bladder, urethra, liver. Pancreas
  2. Lungs
  3. Thyroid, parathyroid, thymus
  4. Middle ear
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13
Q

Injury to 1 eye can cause

A

T- cells that attack that cell due to injury and clearing infections , some can start attacking the other eye = bilateral blindness
(Same in testes) = immune privilege (have self antigens)

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14
Q

Vesicoureteral Reflux what happens and location and what can happen as a result

A

Ureter enters bladder in perpendicular way (instead of oblique) allowing urine back up to ureter = chronic pylo (lower and upper lobes due to compound papillae-open- are found) = renal scarring/atrophy and dilation = Secondary HTN

Middle kidney = simple papillae : closed

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15
Q

Multicystic dysplastic kidney

A

Many non-communicating cysts and if bilateral causing renal insufficiency due to no normal kidney tissue

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16
Q

Posterior Urethral Valves

A

Valve forms from Wolffian duct malformation in urethra = urine back up into bladder up to kidney = hydronephrosis (bilaterally)

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17
Q

Lesion in

  1. Midbrain
  2. Pons
  3. Medulla
A
  1. Dilated down and out pupil (CN3) = PCA infarct
  2. Nystagmus (CN4/CN5/6,CN7/CN8) , facial weakness, spacial hearing and seeing loss, vertigo
  3. Tongue deviation to effected side
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18
Q

Nystagmus due to what CN

A

CN8

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19
Q

Inferior cerebellar peduncle

A

Ataxia

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20
Q

TLC increases then what has to increase

A

RV

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21
Q

Restrictive

Obstructive

A
  1. R : low TLC/RV, + low FVC, low FEV1, HIGH -normal FEV1/FVC,
  2. O : high TLC/RV , low FEV1, normal FVC, low FEV1/FVC
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22
Q

Homocysteinuria

  1. SX, casue of death
  2. What is the cause + inheritance
  3. What to give them
A
  1. Lens dislocation , intellectual probs, MARFAN sx , HIGH THROMBOEMBOLIC events
    (Cause of death)
  2. AR X cystathionine B-synthase (NEEDS vit B6) [homocysteine —x—> Cysteine]
  3. Don’t eat Methionine, give VIT B6
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23
Q

VIT C cofactor for

A

Proline + Lysine hydroxylation (can cause curly hair and perifolicular hemorrhage = IMPAIRED COLLAGEN fibers)

24
Q

Carinitine

A

Long - chain FA transportation into mitochondria = FA oxidation problems in cardiac and skeletal muscles

25
Q

TX crytococcus neoformans + always answer for what

A 
Amphotericin B (headache fever, meningitis + immunosuppressive pts)
= Sabouraud Agar stain + India ink Stain 
= has think polysaccharide capsule
26
Q

CMV tx and can cause

A 
Ganciclovir ( inhibit viral DNA) 
CMV meningoencephalitis (PCR to dx)
27
Q
  1. Ceftriaxone

2. PNC can treat what meningitis

A
  1. Pneumococcal , H. Influenzae

2. Listeria

28
Q

Pneumonia from traveling cruise or hotel (contaminated water)

  1. Sx
  2. LABS
  3. Dx in
A

Legionellosis Pneuomnia (GRAM - bacilli)

  1. Fever, ha, dry cough, Lower lobe crackles + WATERY D
  2. Hyponatremia
  3. Gram = only N, Urine = organism Ag seen
29
Q

Mycoplasma pneumonia

A

Walking , atypical
= cold Agglutinins
= young pt, Tracheobronchitis 9milkd bilateral infiltrates

30
Q

What increases GLUT4

A
  1. Insulin
  2. Exercise
    = in muscles
31
Q

Where is GLUT2

A

Liver and pancreas B-cells insulin independent glucose uptake

32
Q

Glucokinase and G6-phosphorylase role

A
  1. Glukokinase : phosphorylates glucose ——> G6P
  2. G6-phosphorylase remove P : G6P ——> Glucose

= in liver

33
Q

G protein GTP goes into (Growth Factors)

A

GF attack to Tyrosine Kinase

  1. GTP activates KRAS
  2. MAPkinase
34
Q

What does IP3 use

A

GTP activates IP3 (bring Ca)+ DAG (activate PKC with CA)

35
Q

HB seen in :

  1. Normal people
  2. SC trait
  3. SC Anemia
  4. SC Anemia + Hydroxurea tx
  5. Hemoglobin SC Disease
A
  1. Normal people : HbA/ HbA
  2. SC trait : HbA /HbS
  3. SC Disease : HbS/HbS
  4. SC Disease + Hydroxurea tx : HbS + HbF
  5. Hemaglobin SC Disease : HbS + HbC
36
Q

SCD what mutation

Hemaglobin SCD mutation

A
  1. Valine to glutamine position 6

2. Valine to glutamine position 6 + Glutamate to Lysine position 6

37
Q

What is in the hepatoduodenal ligament + when do you clamp this ligament

A
  1. Common bile duct
  2. Portal Vein
  3. Hepatic Artery

= clamp it during bleeding from liver (if bleeding continuous its from IVC)

38
Q

2 painful genital lesion causes and biopsy finding

A
  1. HSV : Multinucleated giant cells,

2. Haemophilus Ducreyi : deep ulcers, clumps in parallel strands

39
Q

3 NONpainful genital lesion causes and biopsy finding

A
  1. Chlamydia : inclusions bodies + PAINFUL LAD
  2. Syphilis : Corkscrew organism (dark field microscopy) + NONpainful LAD
  3. Klebsiella : Gram - Donovan body cysts , no lad
40
Q

21Hydroxylase deficiency causes what and converts what+ DX feature

A
  1. Progesterone —> 11-Deoxycorticosterone
  2. 17-Hydroxyprogesterone —> 11-Deoxycorticol

= causes congenital Adrenal Hyperplasia (HIGH ANDROGENS female with male genital formations)

= DX : high 17-Hydroxyprogesterone

41
Q

17a-Hydroxylase deficiency causes

A

NO cortisol no androgens , HIGH MINERALCORTIcoids (HTN)

42
Q

5a-reductase DEF

A

Testosterone —> DIEA ( male with ambiguous genitals)

43
Q

Diabetic meds MOA :

  1. -gliptin
  2. -gliflozin
  3. -gitazone
  4. -tide
  5. Sulfaureas (Glyburide) / Meglitinides
  6. Acarbose
A
  1. Increase GLP + GIP (DPP4 inhibitors)
  2. Increase glucose renal excretion (SGLT2 inhibitor)
  3. PPAR-g : lower insulin resistance (HF, WG)
  4. Increase glucose dependent insulin secretion + DELAY gastric emptying (WL, pancreatitis) (GLP-agonists)
  5. Insulin secreation by B-cells Katp channels (WG, hypoglycemia)
  6. X glucose GI absorption ( prevent post mean spike)
44
Q

MOA of

  1. Omalizumab
  2. Glucocorticoids
  3. Cromoglycates
  4. Zileuton
  5. Montelukast / Zafirlukast
  6. UV light therapy
A
  1. Omalizumab : anti -IgE (lower IL4, IL13)
  2. Glucocorticoids *: prevent Phospholipase A2 transcription (can become leukotriene + PGE)
  3. Cromoglycates : prevent Histamine release
  4. Zileuton ( block arachidonic acid —> Leukotriene + PGE)
  5. Montelukast / Zafirlukast : BLOCK CysLT1 receptor that Leukotriens bind to (prevent asthma mucous build up and edema + bronchoconstiction)
  6. Keratin apoptosis (tx psoriasis )
45
Q

Posttransplant lymphoproliferative Disorder

A

EBV causing mono-like sx with hepatomegally + LAD = Atypical B-cells

46
Q
  1. Differential medium
  2. Enrichment Medium
  3. Selective Medium
A
  1. MacConkey + Eosin methylene blue ()
  2. Need Factors like H. Influenzae needs factor X and V, Clostridium
  3. Neisseria : Thayer MArtin VCN (Vanco, Colistin/ Nyastatin)
47
Q

Sudden upward jerk of arm causes

A

Lower Brachial Plexus injury (C8, T1) Median + Ulna nerve = Klumpke palsy

48
Q

NE injects through IV can cause what and TX

A

NE Extravasation = so much local vasoconstriction through a1 that there is necrosis by IV site , pale cold indurated, hard

TX : a1 antagonist Phentolamine

49
Q
  1. H1 antagonist SX

2. M1 antagonist SX

A
  1. H1 : drowsiness

2. M1 : dilated pupils, flushed cheeks, Hot, dry mouth, Tachy (atropine, scalopime)

50
Q

MecA encodes what

Resistant to and TX needed

A

PNC binding Protein (PBP) 2A = allows the bacteria to grow in PNC + B-lactams (cephalosporins)
MRSA

TX: vanco (—-I peptidoglycans) , TMP-SMZ,Clindamycin (—-I S50) , Tetracyclins (Doxycycline —-I S30)

51
Q

Chronic Granuloaous Disease :

  1. Cause and mutation
  2. high risk of what infections
  3. Biopsy
  4. DX
A
  1. NADPH oxidase mutation x-link (no ROS in N)
  2. S. Aureus , Burkholderia, Serratia, Nocardia ,Aspergilus (CATALASE + infections)
  3. diffuse granuloma formation
  4. Dihydrorhodamine flow cytometry (low N superoxide)
52
Q

Liver is this when

  1. Fibrinoid necrosis
  2. Coagulative necrosis
  3. Liquefactive necrosis
  4. When HEP causes HCC
  5. What does acute HEP casue
A
  1. Immune vasculitis , malignant HTN
  2. Several viral Hep
  3. Entamoaeba Histolytica
    4 . HEP B/C, aflatoxin B
  4. Hepatocyte swelling , mononuclear cell infiltration (Acute hep =A or E)
53
Q
  1. What interacts with immune cells (region 3) + complement (region 2) on the ABs
  2. What interacts with
A
  1. Heavy chain constant region (Fc part, CD16)

2. Fab fragment on Light chain variable region

54
Q

Steatosis happens how

A

TAG accumulation due to low FFA oxidation

= alcohol makes NADH = inhibits FFA oxidation + TAG synthesis + inhibits gluconeogenesis

55
Q

Crohn’s Disease has what features

A

WL, Fistulas, , Abscess, Fibrotic Strictures, Transmural inflammation , Cobblestone, Perianal tags , fissures

56
Q

Components in :

  1. B-thalassemia HB
  2. HbA
  3. a-thalassemia intermedia (HbH)
  4. A-thalassemia major (Barts Hb)
A
  1. HbF : a2g2
  2. a2B2
  3. B4
  4. G4

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