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Uworld > Mixed Block Notes 11 > Flashcards

Mixed Block Notes 11 Flashcards

1
Q

Xanthomas are most characteristic of

A

Hypercholesterol or Hypertriglyceride

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2
Q

Familial hypercholesterolemia etiology

A

LDL Receptor

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3
Q

Peutz-Jeghers mutation

A

Serine/Threonine kinase 11 (STK11) on 19

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4
Q

Peutz-Jeghers manifestations

A

Skin lesions within first few years, intestinal polyposis follows

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5
Q

Buccal mucosa pigmented lesions

A

Pathognomonic for Peutz-Jeghers

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6
Q

Histology of Rhabdomyoma

A

Fascicles of polygonal cells with vacuolated cytoplasm and peripherally placed nuclei

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7
Q

Where do Rhabodmyomas occur

A

Head and neck of younger males

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8
Q

Dermoepidermal junction autoantibodies to type VII collagen

A

Epidermolysis Bullosa Acquisita

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9
Q

Clomiphene is best used to

A

Achieve fertility in women with ovulatory failure who are normogonadotrophic, normoprolactinemic, euthyroid

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10
Q

hCG therapy can be used to trigger

A

ovulatory cascade in an oocyte donor when her follicles are deemed mature

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11
Q

HOCM murmur is louder/softer with

A

Louder with decreases in Preload or Afterload; Softer with increases

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12
Q

IgA deficiency can lead to incr incidence of

A

Atopic, Autoimmune disease

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13
Q

Excise RNA primers and replace with DNA

A

DNA Polymerase I

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14
Q

AFP is associated with what repro malignancy

A

Yolk Sac tumors

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15
Q

Classic AE’s with Prednisone

A

Avascular necrosis of femoral head, Insomina, Psych

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16
Q

Glyburide

A

Sulfonylurea

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17
Q

Cytoplasmic what accumulation is a hallmark of ischemic injury

A

Ca2+

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18
Q

Tamm-Horsfall

A

Exclusively secreted by renal tubular epithelial cells in ascending LOH (Prerenal azotemia and low urine flow rate –> Accumulation to form hyaline casts)

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19
Q

Findings in homocysteinuria

A

Marfanoid, Lens down and in, Thrombosis, Athersclerosis, Osteoporosis

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20
Q

Warfarin embryopathy

A

Midfacial hypoplasia, Chondrodysplasia punctata, Hemorrhage, Organ hypoplasia, CNS

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21
Q

Changing of pili in neisseria

A

Phase variation (on-off) and Antigenic variation

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22
Q

Complementation

A

Production of distinct phenotypic trait resulting from homozygous mutations in more than on egene

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23
Q

Important finding NOT found in McArdle’s

A

Hypoglycemia (liver glycogen phosphorylase intact)

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24
Q

Glycogen synthase deficiency

A

Infancy = Hypoglycemia, Ketosis, Metabolic acidosis, Growth delays

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25
Q

Effects of beta blocker on K

A

Hyperkalemia

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26
Q

EKG signs of hyperkalemia

A

Peaked T, Loss of p, Prolonged PR, Widen QRS, Slow HR

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27
Q

EKG signs of hypokalemia

A

QT prolongation, U waves, ST depression –> Torsades

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28
Q

EKG signs of Hypo vs Hypercalcemia

A

Hypo causes QT prolongation; Hyper causes QT shortening

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29
Q

In general, a medullary lesion would result in

A

Contralateral spastic paresis, Ipsilateral CN XII defect

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30
Q

Phenylephrine

A

Selective alpha 1 agonist

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31
Q

Dobutamine

A

Mostly Beta 1 agonist - little effects on PVR

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32
Q

Isoproterenol

A

Non-selective beta agonist; Incr HR/CO/PP, Decr PVR

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33
Q

Epinephrine effects on HR and PVR

A

Incr HR, Decr PVR

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34
Q

CAAT box

A

Promoter - binding site for RNA polymerase II

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35
Q

Promoters/Binding sites for RNA polymerase II

A

CAAT, TATA

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36
Q

Enhancers are unique in that

A

they can be located very far away

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37
Q

Sublimation

A

Converting unacceptable feelings or drives into socially acceptable ones

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38
Q

Hepatic sinusoidal endothelial cells are unique in that

A

Fenestrated, Lack BM

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39
Q

Stellate cells

A

Vit A storage; Diff into myofibroblast upon injury –> Fibrosis

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40
Q

Block 23S rRNA of 50S

A

Macrolides, Clindamycin

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41
Q

Inhibition of 50S peptidyltransferase

A

Chloramphenicol

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42
Q

Decreasing [Kin]

A

Increases likelihood of neuronal depolarization w/out altering AP amplitude

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43
Q

Increasing [Kin]

A

Hyperpolarize neuron without altering AP amplitude

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44
Q

Mechanism for age-related lactase deficiency

A

Decr gene expression

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45
Q

Cyclosporine MOA

A

Binds cyclophilin –> inhibits calcineurin –> Inhibit calcium-dependent promotion of IL2 transcription

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46
Q

Basiliximab, Daclizumab MOA

A

mAb that blocks IL-2R

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47
Q

Tacrolimus MOA

A

Binds FKBP –> inhibits calcineurin –> inhibit calcium-dependent promotion of IL-2 transcription

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48
Q

Sirolimus (Rapamycin) MOA

A

Binds FKBP –> Blocks mTOR –> Prevents IL-2 response

49
Q

Tardive Dyskinesia mechanism

A

Upregulate D receptors; Concomitant decr in cholinergic activity in Striatum

50
Q

The plateau phase of cardiomyocyte AP corresponds to

A

ST segment (isoelectric)

51
Q

Virus that carries its own DNA-dep RNA polymerase

A

Pox

52
Q

What can decrease glomerular capillary filtration coefficient

A

Chronic HTN, DM –> Drop in GFR

53
Q

Calcipitriol

A

Vit D analog for treatment of Psoriasis (topically)

54
Q

Antibiotic efflux pumps are found in what type of bugs

A

Typically gram negative

55
Q

Orlistat MOA

A

Lipase inhibitor

56
Q

McArdle’s disease severity

A

Typically begin in young adulthood –> Muscle cramps, Fatigue, Transient myoglobuinuria –> normal lifespan

57
Q

Lipofuscin is produced when

A

ROS –> Membrane Lipids

58
Q

Cholesterol Ester Storage disorder

A

Partial defect in lysosomal acid lipase –> Accumulation of cholesterol ester, TG’s –> Hepatic fibrosis, Premature atherosclerosis

59
Q

Clinical manifestations of Cryptosporidium

A

Mild enterocolitis with water, non-bloody diarrhea

60
Q

Toxoplasmosis in immunocompetent

A

Nonspecific –> Fever, headaches, myalgia, lymphadenitis

61
Q

Nephrotic Syndrome in adults

A

Membranous Glomerulonephritis

62
Q

Methenamine silver stain showing thickening of glomelar BM

A

Membranous Glomerulonephritis

63
Q

CCB’s in pregnancy

A

Limb loss - decreased placental perfusion

64
Q

BB’s in pregnancy

A

Generally safe

65
Q

Incr in endothelium-bound LPL activity

A

Insulin resistance

66
Q

Increased cholesteryl ester storage in hepatocytes and endothelial cells

A

Cholesteryl Ester Storage disease - Lysosomal acid lipase defect

67
Q

Insulin effect on Adipocyte vs Endothelial LDLR’s

A

Upregulate on hepatocytes, Downregulate on endothelial cells

68
Q

Complicated non-gonoccocal urethritis

A

Epididymitis –> 2 wks of doxy or 1 wk azithromycin

69
Q

Probenicid and Penicillin

A

inhibits renal tubular secretion of penicillins, most cephalosporins,

70
Q

Cilastatin and Imipenem

A

Prevent proximal tubular brush border hydrolysis of imipenem by dehydropeptidase

71
Q

Stimultion of auricular branch of vagus nerve

A

Reflex coughing or vomitting

72
Q

Bloom syndrome

A

Photosensitivity, Short stature, Erythema, Telangiectasias - Defect in DNA helicase gene – Predisposed to lymphoproliferative and gastrointestinal malignancies

73
Q

ATM gene is important for

A

DNA repair following ionizing radiation - Telangiectasias in eyes and ears, Lymphoproliferative malignancies

74
Q

Tumors in Li Fraumenia

A

Breast cancer, Soft tissue sarcoma

75
Q

Location of Lynch syndrome polyps

A

proximal

76
Q

Histology of Follicular Lymphoma

A

Effacement; Small cleaved cells (centrocytes), Larger non-cleaved cells w/ multiple nucleoli (centroblasts)

77
Q

Presentation of Sporadic Burkitt’s

A

Ascites and abdominal mass from ileum, cecum, or mesentery

78
Q

Manifestations of hyperestrogenism in cirrhosis

A

Spider angiomas, Palmar erythema, Dupuytren’s, Decr body hair

79
Q

Niacin MOA

A

(1) Impair VLDL production; (2) Inhibit Hormone Sensitive Lipase –> Decr TG; (3) Incr HDL by limiting cholesterol transfer form HDL to VLDL, slowing HDL clearance

80
Q

intestinal Kaposi

A

Hemorrhagic nodules by endoscopy

81
Q

Most common cause of Restriction Fragment Length Polymorphism

A

SNPs

82
Q

RNA virus that replicates in nucleus

A

Influenza

83
Q

High blood ammonia and Increased urinary orotic acid

A

OTC deficiency (Increased Carbamoyl Phosphate shunted to Orotic Acid)

84
Q

Uncal herniation findings

A

CNIII, Contralateral muscle paresis (cerebral peduncle)

85
Q

Somatic Symptom Disorder vs Illness Anxiety Disorder

A

Minimal or no actual physical symptoms in Illness Anxiety

86
Q

Pseudodementia

A

Cognitive dysfunction that occurs in patients with severe psych illness

87
Q

Why hypoglycemia in MCAD

A

Acetyl-CoA is consumed by medium chain fatty acids that accumulate –> Low concentrations of AcetylCoA inhibit conversion of pyruvate to OAA (inhibiting gluconeogenesis

88
Q

Anti-SRP antibodies

A

Autoimmune Myositis

89
Q

MHC II pathway is particularly important for generating helper T response against

A

Extracellular and Intracellular membrane-bound pathogens

90
Q

T lymphocyte antigen recognition is determied by

A

Specificity of TCR for both MHC variant allele and peptide fragment bound to it

91
Q

Positive T lymphocyte selection

A

Thymic cortex - Responsible for generating T cells compatible with person’s HLA haplotype

92
Q

Individuals with HLA haplotypes that cannot bind certain polypeptide fragments

A

will not be able to mount T cell dependent immune response against these antigens

93
Q

Most common opportunistic viral infection affecting GI tract of HIV patients

A

CMV - Ulcers, Mucosal erosions, Large cells with basophilic intranuclear & intracytoplasmic inclusions

94
Q

Biopsy in HIV Cryptosporidium diarrhea

A

Organism confined to microvilli - basophilic parasites attached to mucosal brush border

95
Q

Microsporidium diarrhea in HIV

A

Distortion of villous architecture w/out inflammation; Small spores with diagonal or equatorial belt-like structure

96
Q

MAC diarrhea in HIV

A

Necrotizing and Non-necrotizing granulomas; Acid fact staining bacilli

97
Q

HIV protease cleaves

A

gag and pol products

98
Q

Carboxyhemoglobin

A

HbCO –> Loss of cooperativity, Unable to unload O2

99
Q

Sclerosing Adenosis

A

Incidental finding (rarely palpable mass) –> Slight incr risk, Must biopsy

100
Q

Mammary duct ectasia

A

Skin retraction, Thick creamy or bloody discharge, Palpable periareolar mass

101
Q

Fibroblasts in a cartwheel or storiform pattern

A

Dermatofibrosarcoma protuberans

102
Q

Dysplastic Nevus syndrome

A

CDKN2A on 9p21

103
Q

LV End systolic volume, End diastolic volume and pressure in exercise

A

End systolic volume decreased, End diastolic volume up, End diastolic pressure same

104
Q

Metencephalon –>

A

Pons and Medulla

105
Q

Three vs Five embryonic vesicles

A

Pros, Mes, Rhomb –> Tel, Di, Mes, Met, My

106
Q

Short a-helix with leucine resides at every seventh position

A

Leucine zipper dimerization domain –> TF’s known as Basic Zipper Proteins

107
Q

DNA-binding motifs

A

(1) Zinc finger; (2) Helix-loop-helix; (3) Leucine zipper dimerization domain

108
Q

First reaction of Pyrimidine synthesis

A

Glutamine, CO2, 2 ATP –> Carbamoyl Phosphate in Cytosol

109
Q

Peroxisome function

A

Lipid metabolism (beta oxidation), Oxidative reactions, Purine catabolism

110
Q

Cellular location of G-6-Phosphatase

A

Smooth ER

111
Q

CYP inhibition/induction effects on Warfarin

A

Inhibits incr Warfarin effect (decr inactivation)

112
Q

2 most common sites for hypertension-related intracerebral hemorrhage

A

Thalamus, Putamen

113
Q

Hyptertensive hemorrhage in pons

A

(1) Pinpoint pupils; (2) Loss of horizontal gaze; (3) Decerebrate posturing; (4) Coma

114
Q

mechanisms of incr ICP in brain tumors

A

(1) Obstruction; (2) Disrupt BBB = vasogenic edema

115
Q

Cutaneous findings in Reiter’s

A

Keratoderma blenorrhagica, Balanitis circinata

116
Q

Causes of nephrogenic diabetes insipidus

A

(1) Hypercalcemia; (2) Hypokalemia; (3) Post-obstructive diuresis; (4) Lithium, Amph B, Gentamicin, Cisplatin

117
Q

Eptifibatide

A

Gp Iib/IIIa inhibitor that inhibits platelet aggregation by binding fibrinogen site

118
Q

Effect of CYP inhibitors/inducers of Clopidogrel

A

Must be activated, so inhibitors decr drug levels

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