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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
TX crytococcus neoformans + always answer for what
``` Amphotericin B (headache fever, meningitis + immunosuppressive pts) = Sabouraud Agar stain + India ink Stain = has think polysaccharide capsule ```
26
CMV tx and can cause
``` Ganciclovir ( inhibit viral DNA) CMV meningoencephalitis (PCR to dx) ```
27
1. Ceftriaxone | 2. PNC can treat what meningitis
1. Pneumococcal , H. Influenzae | 2. Listeria
28
Pneumonia from traveling cruise or hotel (contaminated water) 1. Sx 2. LABS 3. Dx in
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
Mycoplasma pneumonia
Walking , atypical = cold Agglutinins = young pt, Tracheobronchitis 9milkd bilateral infiltrates
30
What increases GLUT4
1. Insulin 2. Exercise = in muscles
31
Where is GLUT2
Liver and pancreas B-cells insulin independent glucose uptake
32
Glucokinase and G6-phosphorylase role
1. Glukokinase : phosphorylates glucose ——> G6P 2. G6-phosphorylase remove P : G6P ——> Glucose = in liver
33
G protein GTP goes into (Growth Factors)
GF attack to Tyrosine Kinase 1. GTP activates KRAS 2. MAPkinase
34
What does IP3 use
GTP activates IP3 (bring Ca)+ DAG (activate PKC with CA)
35
HB seen in : 1. Normal people 2. SC trait 3. SC Anemia 4. SC Anemia + Hydroxurea tx 5. Hemoglobin SC Disease
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
SCD what mutation | Hemaglobin SCD mutation
1. Valine to glutamine position 6 | 2. Valine to glutamine position 6 + Glutamate to Lysine position 6
37
What is in the hepatoduodenal ligament + when do you clamp this ligament
1. Common bile duct 2. Portal Vein 3. Hepatic Artery = clamp it during bleeding from liver (if bleeding continuous its from IVC)
38
2 painful genital lesion causes and biopsy finding
1. HSV : Multinucleated giant cells, | 2. Haemophilus Ducreyi : deep ulcers, clumps in parallel strands
39
3 NONpainful genital lesion causes and biopsy finding
1. Chlamydia : inclusions bodies + PAINFUL LAD 2. Syphilis : Corkscrew organism (dark field microscopy) + NONpainful LAD 3. Klebsiella : Gram - Donovan body cysts , no lad
40
21Hydroxylase deficiency causes what and converts what+ DX feature
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
17a-Hydroxylase deficiency causes
NO cortisol no androgens , HIGH MINERALCORTIcoids (HTN)
42
5a-reductase DEF
Testosterone —> DIEA ( male with ambiguous genitals)
43
Diabetic meds MOA : 1. -gliptin 2. -gliflozin 3. -gitazone 4. -tide 5. Sulfaureas (Glyburide) / Meglitinides 6. Acarbose
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
MOA of 1. Omalizumab 2. Glucocorticoids 3. Cromoglycates 4. Zileuton 5. Montelukast / Zafirlukast 6. UV light therapy
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
Posttransplant lymphoproliferative Disorder
EBV causing mono-like sx with hepatomegally + LAD = Atypical B-cells
46
1. Differential medium 2. Enrichment Medium 3. Selective Medium
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
Sudden upward jerk of arm causes
Lower Brachial Plexus injury (C8, T1) Median + Ulna nerve = Klumpke palsy
48
NE injects through IV can cause what and TX
NE Extravasation = so much local vasoconstriction through a1 that there is necrosis by IV site , pale cold indurated, hard TX : a1 antagonist Phentolamine
49
1. H1 antagonist SX | 2. M1 antagonist SX
1. H1 : drowsiness | 2. M1 : dilated pupils, flushed cheeks, Hot, dry mouth, Tachy (atropine, scalopime)
50
MecA encodes what | Resistant to and TX needed
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
Chronic Granuloaous Disease : 1. Cause and mutation 2. high risk of what infections 3. Biopsy 4. DX
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
Liver is this when 1. Fibrinoid necrosis 2. Coagulative necrosis 3. Liquefactive necrosis 4. When HEP causes HCC 5. What does acute HEP casue
1. Immune vasculitis , malignant HTN 2. Several viral Hep 3. Entamoaeba Histolytica 4 . HEP B/C, aflatoxin B 5. Hepatocyte swelling , mononuclear cell infiltration (Acute hep =A or E)
53
1. What interacts with immune cells (region 3) + complement (region 2) on the ABs 2. What interacts with
1. Heavy chain constant region (Fc part, CD16) | 2. Fab fragment on Light chain variable region
54
Steatosis happens how
TAG accumulation due to low FFA oxidation | = alcohol makes NADH = inhibits FFA oxidation + TAG synthesis + inhibits gluconeogenesis
55
Crohn’s Disease has what features
WL, Fistulas, , Abscess, Fibrotic Strictures, Transmural inflammation , Cobblestone, Perianal tags , fissures
56
Components in : 1. B-thalassemia HB 2. HbA 3. a-thalassemia intermedia (HbH) 4. A-thalassemia major (Barts Hb)
1. HbF : a2g2 2. a2B2 3. B4 4. G4

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