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Dedicated Study > Missed UWorld Questions > Flashcards

Missed UWorld Questions Flashcards

1
Q

Onset of aspiration pneumonia vs chemical pneumonitis

A

Onset of aspiration pneumonia is more delayed,

more delayed than….

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2
Q

How can you reduce recurrence of HSV?

A

Daily Valacyclovir, prevents recurrence of….

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3
Q

Most common point of entry for enteroccocus infection?

A

GU procedures, ex cystoscopy

Most common cause of what infection?

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4
Q

What nerve runs with the superior thyroid artery? What does it innervate?

A

Superior laryngeal nerve, innervates cricothyroid muscles

What artery does it run with?

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5
Q

Most common cause of death in diabetes?

A

MI, CAD

Most common cause of death in….

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6
Q

Pre-tibial myxedema is seen in….

A

Graves disease

Physical findings…

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7
Q

Histologic findings in Medullary Thyroid CA

A

Nest s of cells, stain with Congo red

Histologic findings in….

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8
Q

What part of bone is affected by hyper-PTH?

A

Compact bone, causes subperiosteal errosions

Findings in….

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9
Q

What part of bone is affected by osteoporosis?

A

Trabecular bone

Degraded in…..

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10
Q

What behavioral change has greatest reduction in MI risk?

A

Smoking

Greatest behavioral change to prevent……

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11
Q

What is the greatest risk for cervical cancer?

A

Immunosuppression

greatest risk for what cancer?

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12
Q

What drug can improve fertility in PCOS?

A

Estrogen Receptor Modulator: Clomiphene

Improves fertility in…..

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13
Q

What can improve fertility in Turner Syndrome?

A

Give Estrogen and Progesterone to grow decidua then do IVF (60%) success rate
Improves fertility in….

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14
Q

What hormone/molecule is required for normal fetal renal function?

A

Angiotensin II

Important for what part of fetal development?

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15
Q

What vitamins are not in breast milk?

A

D and K

Are they in breast milk?

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16
Q

How many kcal/gram in protein, carb, fat, and alcohol?

A

Protein and carb = 4kcal/gram
Fat = 9 kcal/gram
Alcohol = 7 kcal/gram?

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17
Q

Ulcers in mid or distal duodenum. More likely H Pylori or ZE?

A

Zollinger Ellison syndrome.

More likely to cause ulcers where?

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18
Q

Gallstone ileus is more likely to lodge where?

A

Terminal ileum, smallest caliber

What could lodge here?

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19
Q

Pneumobilia is suggestive of….

A

gallstone illeus

Physical exam finding?

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20
Q

Crohn patients have increased risk of gallstones. Why?

A

Reduced bile acid reabsorption.

Causes gallstones in…..

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21
Q

Gastrin has trophic effects on what cells?

A

Gastric Parietal cells

Trophic factor includes…..

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22
Q

Epiethelial cell type of true vocal cords

Increases infection by…..

A

Stratified squamous epithelium
HPV
What structure is this?

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23
Q

Where do herpes viruses get their envelope?

A

Host cell membrane

Source of envelope for what viruses?

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24
Q

Sorbitol is typically metabolised into……

A

Fructose

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25
Q

What is the purpose of Neisseria IgA protease?

A

Increases adherence which increases infection

What bacteria has IgA Protease?

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26
Q

Causes of Polyhydramnios?

A

Impaired swallowing: GI obstruction, anencephaly

These fetal defects cause…..

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27
Q

Grave’s disease treatment can cause……

A

Agranulocytosis

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28
Q

What is a Pyrrolidonyl Arylamidase Test?

A

Replaces bacitracin test for strep pyogenes

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29
Q

What cells does Parvovirus infect for replication?

A

Erythrocyte precursors

Site of replication for…..

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30
Q

Infertility in CF and Kartagners is caused by…..

A 
CF = absent ductus deferens 
Kartageners = defective sperm motility
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31
Q

What treatment for pregnant mothers with risk of tetanus?

A

Vaccinate pregnant mother, don’t give ABs to newborn

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32
Q

Where does SMA cross over duodenum?

A

3rd portion of duodenum.

Which artery crosses here?

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33
Q

Findings with Meckel Diverticulum?

A

Painless bleeding, possible intussusception in <2yr old

Findings in…..

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34
Q

What tests show liver injury? Dysfunction?

A

Injury markers are AST, ALT, GGT, ALP

Dysfunction are PTT, Albumin, Bilirubin

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35
Q

What increases cholesterol solubility in bile?

A

Bile acids and phosphatidylcholine

Purpose in bile?

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36
Q

Causes of Zenker Diverticulum vs Achalasia

A

Zenker: Cricopharyngeal motor dysfunction
Achalasia: Myenteric nerve dysfunction

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37
Q

Cancer mutation sequence in Crohn, UC

A

Early P53, Late APC

Carcinoma sequence in…..

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38
Q

How do fibrates cause gallstones?

A

Reducing bile acid synthesis by inhibiting 7alpha-hydroxylase

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39
Q

How does Crohn disease increase risk of kidney stones?

A

Reduced fat absorption causes calcium to bind FAs in gut, calcium cannot bind oxalate in gut so more oxylate is absorbed.
What disease and what risk?

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40
Q

Type of inflammation in primary biliary cirrhosis vs biliary cholangitis?

A

Biliary Cirrhosis: Granulomatous

Biliary Cholangitis: Autoimmune inflammatory

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41
Q

Necrotising Enterocolitis findings and associations

A

Air in the bowel wall
Associated w/ prematurity and reduced immune function
Disease is……

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42
Q

Adenomyosis vs Endometrial Hyperplasia

A

Adenomyosis: painful, heavy irregular bleeding
Hyperplasia: painless, irregular bleeding

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43
Q

What causes dimpling of breast tissue in CA?

A

Invasion of suspensory ligament

Causes what physical finding in breast CA?

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44
Q

Causes of Down Syndrome?

A

95% nondisjunction, 2-3% translocation, <2% mosaicism

Causes of what disease?

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45
Q

What vitamin is needed for amino acid transamination or decarboxylation?

A

B6, Pyridoxime

Needed for what biochemical reactions?

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46
Q

GI bleeding leads to increased what in blood?

A

Increased ammonia from increased nitrogen absorption

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47
Q

Are syphilis gummas painful?

A

No

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48
Q

What viruses can undergo genetic shift?

A

BOAR segmented viruses
Bunya, Orthomyxo, Arena, Rio
All can undergo what?

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49
Q

What bacteria produces H2S?

A

Salmonella, turns TSI agar black

What causes this?

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50
Q

What makes up cutaneous nodules in NF-1?

A

Schwann cells, neural crest derived

Makes up cutaneous nodules in what disease?

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51
Q

What do you give to reduce vasospasm after hemorrhage?

A

CCBs, specifically Nimodipine

Given to after what event?

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52
Q

What causes Narcolepsy?

A

Low CSF Hypocretin-1

Seen in…..

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53
Q

What causes intraparenchymal hemorrhages in brain?

A

Hypertension, lenticulostriate vessels

Can lead to…..

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54
Q

What type of incontinence is associated with DM-1?

A

Neuropathy leads to overflow incontinence

What disease?

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55
Q

What is source of energy in first 12=18 hours of fasting?

A

Glycogenolysis

How long does it provide energy in fasting?

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56
Q

Recombination vs Phenotypic Mixing

A

crossing over between coinfected viruses

Swapping genome and capsules w/ co-infection

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57
Q

Reye syndrome liver histology/pathology

A

Microvesicular steatosis of liver

Seen in what disease?

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58
Q

How does Neisseria reach the meninges?

A

Blood not lymph

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59
Q

Where are VLC fatty acids oxidized?

A

Peroxisomes

Site of oxidation of which fatty acids?

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60
Q

Pathogenesis of Huntington disease, intracellular

A

Gain of function, histone deacetylation

Causes what disease?

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61
Q

Median nerve enters hand between what muscles?

A

Flexor digitorum profundus and flexor digitorum superficalis

What nerve passes between these muscles?

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62
Q

Does choriocarcinoma have chorionic villi?

A

NO

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63
Q

What cells can’t use ketones for energy?

A

Erythrocytes

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64
Q

When does vertical transmission of HepB typically occur?

A

During delivery

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65
Q

Mother with respiratory arrest after delivery, what does she have?

A

Amniotic fluid embolism

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66
Q

If patient can’t have metronidazole, what do you give for Garnerella?

A

Clindamycin

Given as second line treatment for what STD…..

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67
Q

How do you tell if respiratory compensation is appropriate?

A

Winters Formula: (1.5 HCO3) + 8 +/- 2

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68
Q

BH4 deficiency decreases synthesis of what hormones?

A

Serotonin (also causes PKU)

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69
Q

Essential Tremor, treatment and inheritance

A

Treat with Alcohol and beta blocker. Autosomal Dominant

What disease?

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70
Q

What are P bodies?

A

mRNA-ribosome complexes in cytoplasm

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71
Q

How do eosinophils kill parasites?

A

Antibody-mediated release of granules

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72
Q

How are osteocytes connected?

A

Gap junctions

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73
Q

What cytokine is important in giant cell arteritis?

A

IL-6

important in the pathogenesis of what disorder?

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74
Q

What is Neprilysin?

A

A metalloprotease that cleaves natriuretic peptides

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75
Q

How is copper removed from the body?

A

In bile

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76
Q

What artery causes femoral head necrosis?

A

Medial Circumflex

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77
Q

Transthyretin Amyloidosis

A

Can cause restrictive cardiomyopathy; form of senile anyloidosis

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78
Q

Ureters pass anteriorly to what arteries?

A

Internal Iliac Arteries

Pass posteriorly to…..

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79
Q

Causes of hereditary pulmonary hypertension?

A

BMPR2 mutation, increases smooth muscle proliferation.

Causes….

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80
Q

AV Shunt

A

Bypasses arterioles, causes increased preload and decreased afterload

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81
Q

Palpable, non-tender gallbladder with associated weightloss and obstructive jaundice

A

Suggests pancreatic adenocarcinoma at head of pancreas

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82
Q

Does Amiodarone or type IA anti-arrythmics have lower risk of torsades?

A

Amiodarone has lower risk of torsades

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83
Q

Increased serine phosphorylation reduces…..

A

Tryosine kinase activity

Is reduced by…….

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84
Q

Caudal Regression syndrome, complication of…..

A

Maternal Diabetes, sacral-lumbar agenesis

What is it?

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85
Q

Stimulation of what nerve can improves obstructive sleep apnea?

A

Hypoglossal nerve.

Stimulation can improve…..

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86
Q

What type of receptors are calcium-sensing receptors on Parathyroids?

A

G-protein coupled receptors, defective in familial hypocalciuric hypercalcemia

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87
Q

Histology of acute viral hepatitis

A

hepatocyte necrosis with cellular swelling

Characteristic of…..

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88
Q

Nitroprusside overdose

A

Increased cyanide, give sulfur donors and hydroxycobalamin

Treatment for…..

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89
Q

Centriacinar Emphysema causes and histology

A

Smoking

increased macrophages and PMN proteases

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90
Q

Charcot-Bouchard aneurysm

A

HTN-associated aneurysm in central gray matter structures

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91
Q

Normal alveolar-arterial gradient

A

5-15

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92
Q

Role of lactate in anaerobic glycolysis

A

Replenishes NAD+ to allow for more glycolysis

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93
Q

Glucagonoma physical exam findings

A

necrolytic migratory erythema; plaques with brown center on face, groin, extremities
Finding suggests…..

94
Q

Post-abortion septic infections caused by…..

A

Staph Aureus

95
Q

What structure is damaged in hemiballismus?

A

Subthalamic nucleus

96
Q

What point in spirometry is pulmonary vascular resistance the lowest?

A

At functional reserve capacity, low point of tidal volume

97
Q

Chorioretinitis is caused by what infection?

A

CMV, causes what eye finding in newborns?

98
Q

Mast cell granules contain…..

A

Histamine and Tryptase

Contents of…..

99
Q

2nd most common valve affected by rheumatic heart disease?

A

Aortic

100
Q

What part of airway has highest resistance?

A

Medium bronchi

101
Q

Scotoma

A

A small visual field defect secondary to retina or optic nerve damage

102
Q

Alkaptonuria

A

Black urine, no tyrosine to fumarate conversion

Homogentisate deficiency

103
Q

Idiopathic membranous nephropathy typically caused by…..

A

IgG4 to PLA2R

104
Q

What cytokine is needed to differentiate TH into cytotoxic TH1s?

A

IL-12 and IFN-gamma

Needed for what cell differentiation?

105
Q

H Flu capsule composition and function

A

Polyribosylribitol Phosphate, binds factor H and prevents phagocytosis

106
Q

Treatment for Neuropathic Malignant Syndrome?

A

Danrolene

107
Q

Opacified CXR with tracheal deviation to same side is caused by…..

A

Mainstem bronchus block

CXR findings?

108
Q

What bacteria is indole positive?

A

E Coli

Indole test?

109
Q

What signaling increases glycogenolysis in liver and muscle?

A 
Liver = increase cAMP
Muscle = increased calcium
110
Q

Where do you cut for emergency airway?

A

Cut deep cervcial fascia and cricothyroid membrane

Between cricoid and thyroid cartilage

111
Q

Hilar adenopathy, increased ACE, Hypercalcemia, Non-caseating granulomas

A

Sarcoidosis

Findings?

112
Q

Middle meningeal artery is branch of…..

A

Maxillary artery

113
Q

Effects of aging on lung volumes?

A
  • TLC, Low expiratory reserve, low vital capacity, high functional residual capacity, high residual volume
114
Q

Stomach erosion vs ulcer

A

Erosions stop in the mucosa and don’t breach muscularis

Ulcers pass muscularis into sub-mucosa

115
Q

What nerve runs in piriform recess?

A

Internal superior laryngeal nerve, needed for cough reflex

Where does it run?

116
Q

Where does Sciatic nerve run? What muscle runs with it?

A

Through sciatic foramen with piriformis

117
Q

Effect of arteriovenous shunt

A

Decreased peripheral resistance (passes arterioles) and increases cardiac output (increased preload)

118
Q

Meiosis I vs II nondisjunction

A

Meiosis I results in 2 different extra chromosomes from same parent
Meiosis II results in 2 same extra chromosomes from same parent

119
Q

Contact Dermatitis is what hypersensitivity?

A

Type IV

120
Q

Arsenic and Polyvinyl chloride cause…..

A

Liver Angiosarcoma

Caused by…..

121
Q

Migratory Thrombophlebitis is suggestive of…..

A

Visceral cancer, typically gastric

Skin finding is……

122
Q

Small cell lung cancer paraneoplastic syndromes (4)

A

ACTH, ADH, Lambert-Eaton, Anti-neuron ABs

123
Q

Mean, Median, and Mode with Skews

A

Mean shifts the most, Mode shifts the least

124
Q

What hypertrophies in renal artery stenosis?

A

JGA and Maculodensa (smooth muscle of afferent arteriole)

Hypertrophy with……

125
Q

What stimulus is required for osteoclast differentiation and survival?

A

RANK expression and stimulation

126
Q

What symptoms don’t recover in Wernicke-Korsacoff?

A

Memory and learning (Korsakoff portion)

Ataxia is slow to recovery but improves

127
Q

What bug grows in highly alkaline media

A

Cholera

128
Q

Symptoms of VIPoma

A

WDHA: watery diarreha, hypokalemia, achlorhydia

129
Q

What murmur is not detected at birth?

A

VSD –> pulmonary resistance is still high

130
Q

Symptoms of primary carnitine deficiency

A

myopathy, cardiomyopathy, hypoketoic hypoglycemia

131
Q

Pathogenesis of ARDS

A

Endothelial damage by neutrophil toxins, protein fluid leakage into alveoli, hyaline membranes in alveoli

132
Q

Direct Inguinal Hernia

A

Breaks through weak transversalis fascia through Hesselbach’s triangle, medial to inferior epigastrics

133
Q

What does high arteriovenous concentration difference mean for anesthetics?

A

High partitioning into peripheral tissues

134
Q

2 main opsonins for phagocytosis

A

IgG and C3b

135
Q

What vertebrae have lateral horns?

A

T1-L2

136
Q

Ehler Danlos vs Marfan

A

Collagen issue, no eye symptoms

Fibrillin glycoprotein issue, lens issues

137
Q

Learning disorder

A

Poor performance in a major academic category, might see restlessness or anixety issues with that subject

138
Q

What characteristics keep a drug in the plasma compartment? (4L of volume of distribution)

A

Large, High protein binding, Highly charged (hydrophilic)

139
Q

3 Effects of high oxygen supplementation in chronic COPD patients

A

Increased physiologic deadspace (sudden vasodilation)
High pCO2 from rapid CO2 dissociation from hemoglobin (Haldane effect)
Reduced minute ventilation from reduced chemoreceptor stimulation.

What causes these effects?

140
Q

Which structures should be targeted with deep brain stimulation in parkinson disease?

A

Constant stimulation of Globus Palidus or Subthalamic nucleus prevent firing
This can be used to treat…..

141
Q

Morbidity and Mortality in Neisseria Meningititis infections are directly associated with serum concentrations of……

A

LOS (endotoxin like LPS but w/o repeating O antigen)

Levels are associated w/ mortality and morbidity in….

142
Q

Multiple change disease is characterized by……

A

selective albuminuria. Increased selective filtration of albumin due to T-cell release of glomerular permeability factor that fuses podocytes together.

143
Q

Two causes of hypoxemia with normal A-a gradient

A

Hypoventilation and High Altitude

144
Q

Findings in Rett Syndrome

A

Normal development followed by loss of milestones and gain of hand-wringing movements, deceleration of head growth
more common in girls

145
Q

What drug should be used in treatment-resistant schizophrenia?

A

Clozapine

146
Q

Pathogenesis of neurotoxicity in hyper-ammonemia

A

Ammonia is taken up by astrocytes and converted to glutamine which causes an osmotic imbalance. This impairs normal glutamine release which is typically converted to glutamate for excitatory signaling

147
Q

Normal degenerative arthritis of the spine leads to hypertrophy of what ligament? Symptoms improve with…..

A

Ligamentum flavum hypertrophy. Symptoms improve with bending forward (spinal flexion)

148
Q

What nerve passes through obturator canal? What muscle function does it innervate?

A

Obturator nerve. What does it pass through?

It provides adductor muscle innervation

149
Q

Intestinal Atresia is caused by what intrauterine process?

A

Vascular occlusion

Causes what deformation in utero?

150
Q

What is the body’s natural attempt to correct heart failure? (3)

A

Low cardiac output causes: sympathetic stimulation, RAAS activation, and ADH secretion
All of these are a natural response to what condition?

151
Q

Most common cause of death in tricyclic overdose?

A

Arrhythmia caused by sodium channel inactivation and QRS prolongation.
most common cause of death in overdose of what med?

152
Q

Hyperacusis (increased sensitivity to everyday sounds) is caused by damage to what cranial nerve?

A

Facial nerve, stapedius branch

Paralysis of this muscle can cause?

153
Q

Neutralizing antibodies to influenza recognize what epitope?

A

Hemagluttinin

This is the epitope recognized by neutralizing antibodies to what bug?

154
Q

What role do sertoli cells play in sexual differentiation?

A

Secrete AMF to regress mullerian ducts

155
Q

What is a Kussmal sign on physical exam?

A

Suggests constrictive pericarditis; right ventricle can’t take increased venous return on inspiration so JVD increases

156
Q

What amino acid is required for nitric oxide synthesis in endothelial cells?

A

Arginine

Used to produce what in endothelial cells following ACh stimulation?

157
Q

Zinc motif in a receptor, what does it do?

A

See Zinc, think Zinc finger and DNA binding. Probably an intracellular hormone receptor that moves to nucleus

158
Q

What are the 2 history findings in anti-phospholipid syndrome?

A

Recurrent miscarriages and increased clotting (DVT, PE, ect)

These are signs of……..

159
Q

What are the lab findings in anti-phospholipid?

A

VDRL positive, elevated PTT

160
Q

Half life equation

A

thalf = (0.7 * Vd) / Cl

161
Q

Left vs Right frontal lobe lesion symptoms

A

Left = apathy
Right = disinhibition
Lesions to which part of brain?

162
Q

Intra-Scalene anesthetic administration can also paralyze what nerve?

A

Phrenic C3-C5

Can be accidentally paralyzed in what anesthetic administration?

163
Q

Which test is most specific for diagnosing gallbladder obstruction?

A

Nucleotide scan is more specific than ultrasound

For determining obstruction in what condition?

164
Q

Pseudopalasading necrosis is seen in what brain tumor?

A

Glioblastoma Multiforme

Major histologic finding?

165
Q

What mutation can cause polycythemia vera?

A

Jak-Stat mutation

This can cause what disease?

166
Q

What type of signal transducer is Jak-Stat?

A

Cytoplasmic Tyrosine Kinase

What signal transducer is this?

167
Q

Aspiration pneumonia lobes upright and supine

A

Upright aspiration: basilar segments of lower right lobes

Supine: posterior segment of right upper or superior segment of right lower

168
Q

What is a genetic risk factor for reactive arthritis?

A

HLA-B7

In addition to ank spond and psoriatic arthritis, what else does this put you at risk for?

169
Q

Main lab results seen in primary hyperaldosteronism?

Na, K, Bicarb

A

Normal Na (aldosterone escape)
Hypo K
High Bicarb

170
Q

What is the treatment for pyruvate dehydrogenase deficiency?

A

Ketogenic diet, Leucine and Lysine

Treatment for?

171
Q

Patients with severe aortic stenosis are reliant on what to keep good systolic function?

A

Heavily reliant on atrial contraction for ventricle filling due to low ventricle compliance. A loss in atrial function (ex Afib) can causes severe hypotension and possible pulmonary edema

172
Q

Wilson Disease: where does copper accumulate?

A

Copper accumulates in Liver (hepatotoxic), cornea, and basal ganglia (neurologic symptoms)
What disease?

173
Q

What drug is given to severely immunocompromised patients (CD4 <50) for Mycobacterium prophylaxis?

A

Azithromycin

Used as prophylaxis for what disease in what patients?

174
Q

What can lead to isolated loss of erythocyte precursors with normal myeloid precursors? (3)
Pure Red Cell Aplasia

A

Parvovirus B19
Autoantibodies (Lymphocytic leukemia)
Cytotoxic T Cells (thymoma)
These can cause…..

175
Q

What is the single greatest risk factor for aortic dissection?

A

Hypertension

176
Q

Pneumonic for shifts in hemoglobin oxygen curves

A 
ACE BATs right handed
Acid
CO2
Exercise
2,3-BPG
Temperature
177
Q

Effect of acute mitral regurgitation on preload, afterload, and ejection fraction

A

Increased Preload, Decreased Afterload, and Increased ejection fraction. However, less blood is moving forward, causing hypotension

178
Q

Landmark for lumbar puncture?

A

Iliac crests

Landmark for?

179
Q

What does Romberg test assess?

A

Proprioception

180
Q

Reduced blood pressure by 10mmHg only during inspiration is suggestive of?

A

Pulsus Paridoxus, suggestive of pericardial disease (ex cardiac tamponade)

181
Q

Treatment for acute COPD exacerbation?

A

Beta Blocker

182
Q

First line treatment of gout?

A

NSAIDs

183
Q

Fibrates mechanism of action

A

Induce PPAR which reduces VLDL from liver and increases LPL in periphery

184
Q

Hemosiderin-laden macrophages in alveoli are indicative of….

A

Heart Failure cells

Where do you see these? How do you visualize them?

185
Q

What drug do you give for muscle spasms?

A

Baclofen

186
Q

What artery changes are seen in claudication?

A

Atherosclerosis, lipid plaque

187
Q

What is most common predisposing condition to Strep Viridans mitral valve endocarditis in developed countries?

A

Mitral valve prolapse in developed
Rheumatic heart disease in developing
These predispose to….

188
Q

Histological development of AAA?

A

Transmural inflammation, inflammatory cells releasing metaloproteases and elastases. Weakens AAA wall and leads to aneurysm formation

189
Q

What nerve innervates the lattisimus dorsi? What are its actions?

A

Thoracodorsal (C6-8)

Internal rotation, adduction, and extension of shoulder

190
Q

What is the pathogenesis of fatty liver disease?

A

Reduced free fatty acid oxidation

This causes…..

191
Q

Decompensated heart failure after viral infection, what does heart look like?

A

Dilated ventricles

Acutely occurs due to heart failure caused by….

192
Q

What else does ADH reabsorb other than water?

A

Urea, helps to concentrate renal medulla

Absorption from urine is stimulated by….

193
Q

Alpha Helix vs Beta Sheet is determined by what sort of bonds?

A

Hydrogen bonds

194
Q

What part of ear does noise-induced hearing loss effect?

What about presbycusis?

A

Organ of Corti Damage, damage to stereociliated cells.

Loss of hair cells at cochlear base, high frequency sound
Damaged in what pathologies?

195
Q

Pain in external hemorrhoids is sensed by what nerve?

A

Pudendal nerve

196
Q

3 kinds of osteoblastic bone mets
2 kinds of mixed bone mets
Rest are lytic bone mets

A

3 blastic = prostate, small cell lung, Hodgkin Lymphoma
2 mixed = breast and GI
Rest are lytic tumors

197
Q

What chemical is a competitive inhibitor of the sodium-iodine symporter in the thyroid gland?

A

Potassium Perchlorate and Pertechnitate

Competitive inhibitors of…..

198
Q

What is CD55?

What does deficiency cause?

A

Decay Accelerating Factor (complement)
Causes paroxsymal nocturnal hemoglobinuria
What CD marking?

199
Q

Dilated Cardiomyopathy = Systolic Dysfunction
(Ischemia and DCM)
Hypertrophic Cardiomyopathy = Diastolic Dysfunction
(HTN and HCM)

A

Copyright (c) UWorld, Please do not save, print, cut, copy or paste anything while a test is active.

200
Q

Terminal Ileum damage in Crohn Disease can lead to what deficiency?

A

Loss of bile acid reabsorption = fat malabsorption = vitamin K deficiency = bleeding disorder
Can be caused by what disease?

201
Q

What is coronary steal? What 3 drugs cause it?

A

Selective vasodilation of cardiac vessels worsens ischemia by disrupting the arterial pressure gradients created to deliver collateral blood supply to ischemic tissue.
Caused by adenosine, cilostosol, dipyridamole

202
Q

3 most common brain tumors in kids

A

Pilocytic Astrocytoma (cerebellar or hemisphere, cystic and solid on imaging)
Medulloblastoma (cerebellar, solid only)
Ependymoma (4th ventricle)

203
Q

Accumulation of uremic toxins in severe renal disease can lead to what changes in hemodynamics?

A

Prolonged bleeding (platelet dysfunction) with everything else normal (PT, PTT, Platelet Count)

204
Q

Oxalate Crystals in renal tubules is suggestive of what cause of AKI?

A

Toxic from ethylene glycol. What would the kidney look like?

205
Q

Physical symptoms of Alkaptonuria

Usually benign but what can it cause?

A

Black urine
Black-Blue spots on sclera
Darkening of auricular cartilage

Can cause severe myalgias from cartilage toxicity.

What disease?

206
Q

Water Hammer pulse; head bobbing; bounding femoral and carotid pulses with left sternal murmur. Suggestive of?

A

Aortic Regurgitation.

What would you see on exam? Why?

207
Q

Which muscle is needed to abduct the shoulder past 90 degrees and to stabilize the scapula? What innervates it? When is it typically injured?

A

Serratus anterior, innervated by long thoracic, injured during mastectomy with axillary lymph node removal.
Symptoms?

208
Q

Cholestatic diseases can cause what serum and dermatologic findings?

A

Hyperlipidemia and Xanthomas

What form of GI diseases can cause these findings?

209
Q

Findings in acute fulminant hepatitis (ex halothane toxicity)

A

Elevated Aminotransferases and Prolonged PT
NO change in serum albumin (half life is too long)

These symptoms are seen in….

210
Q

Wheals are formed by edema to what part of skin? What about eczematous dermatitis?
What is the deepest form of edema called?

A

Wheals are due to edema in the superficial dermis
Eczematous dermatitis has edema in epidermis (spongiosis)
Deep dermal edema is termed angioedema

211
Q

Signs of occlusion after an invasive vascular procedure (ex PCI) is suggestive of…….
What is most common presenting symptom?

A

Atheroembolism; cholesterol-containing clots breaking off and lodging in small vessels
Most commonly presents with acute kidney injury
When is this seen?

212
Q

Which symptoms do you see in SIADH: pulmonary congestion, peripheral edema, high JVP….

A

None of these, SIADH is apparent euvolemia (high volume with natriuresis = euvolemic hyponatremia)

213
Q

Silicosis creates an increased risk for what? Why?

A

Increased risk for TB. It impairs macrophage function.

What disease?

214
Q

What is Anastrazole? (think Anastasia, Aromatase)

A

Chemotherpeutic in hormone positive breast cancer that prevents aromatase from making more estrogen

215
Q

What is first line treatment for Nacrolepsy? Why?

What is second line treatment?

A

First line treatment is Modafinil, daytime psychostimulant
Second line are amphetamines
What disease?

216
Q

Bone/Calcium markers in Multiple Myeloma (PTH, VitD, Urinary Ca, Serum Ca, PHrP)

A

Low PTH (calcium sensing)
Low vitamin D (renal damage, low 1-alpha-hydroxylase)
High urinary Ca (low PTH)
High serum Ca (bone resorption)

What disease?

217
Q

C1 esterase inhibitor deficiency, symptoms

A

Angioedema from lots of kallikrein-bradykinin conversion
Will see low C4
What disease?

218
Q

Carotid massage reflex: afferent and efferent are?

A

Afferent is Glossopharyngeal
Efferent is Vagus
What reflex is this?

219
Q

Why is calcium elevated in Sarcoidosis?

A

Macrophages express 1-alpha-hydroxylase and cause PTH-independent increases in vitamin D
What disease? What finding?

220
Q

Findings in Patau Syndrome

A

Micrcephaly, Cleft Lip/Palate, Omphalocele, Polydactyly, Renal Issues, Cutis Aplasia (Incomplete skull closure on top), Rocker bottom feet

221
Q

Nicotine in Pregnancy

A

Placenta issues (previa and abrupta) and prematurity

222
Q

Appendicitis Pain: Why does it change?

A

Lumen distention activates general visceral autonomic fibers (superior mesenteric plexus, T10). Further infection causes inflammation of the parietal paritoneum which is more localized.

223
Q

What vascular syndrome is associated with polymyalgia rheumatica?

A

Giant cell arterities

What rheumotologic disease is this associated with?

224
Q

Examples of true diverticula? of Pseudodiverticula?

A 
True = Appendix, Meckel's
Pseudo = Zenker
225
Q

Aortic Aneurysm development vs Aortic Dissection

A

Aortic Aneurysm is caused by long term HTN weakening and possibly autoimmune proceses.
Dissection is due to HTN plus shear stress

226
Q

How does the adrenal cortex impact Epinephrine synthesis?

A

Cortisol increases the activity of phenylethanolamine-N-methyltransferase which converts NE to Epi

227
Q

What murmur is heard best when sitting up and leaning forward?

A

Aortic Regurgitation

When is this murmur heard best?

228
Q

What lab findings are seen in SLE?

A

Anti-nuclear ABs, Anti-ds-DNA ABs, Anti-SNR ABs

Low complement levels (C3 and C4)

229
Q

What disease has Anti-Jo ABs? What is an anti-Jo AB?

A

Polymyositis; AB to histidyl-tRNA synthetase

What is another name for this AB?

230
Q

What causes of Cushing Syndrome produce elevated ACTH? Which can be suppressed with dexamethasone?

A

High ACTH Cushing syndrome is caused by pituitary adenomas and paraneoplastic ectopic ACTH (squamous lung CA)
Only pituitary adenomas can be suppressed; with high levels dexamethasone

231
Q

Temporal lobe masses can cause what visual symptoms?

A

Contralateral upper quadrant loss of vision (myers loop runs in temporal lobe but dorsal optic radiation does not)
Lesions in myers loop causes……

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