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Uworld > Mixed Block Notes 2 for import > Flashcards

Mixed Block Notes 2 for import Flashcards

1
Q

Laplace’s Law

A

P=2T/r

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2
Q

Uptake of unconjugated bililrubin occurs via

A

Organic Anion Transporting Polypeptide (OATP) - passive

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3
Q

Conjugated bilirubin is secreted from hepatocytes via __? This is blocked in __?

A

MRP2 (active organic anion transporter) - Criggler-Najjar, Rotor

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4
Q

Concentration of Bicarb along Proximal Tubule

A

Actively reabsorbed due to Carbonic Anhydrase –> Acetazolamide causes excretion

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5
Q

How to differentiate MAC from MTB in HIV patient

A

MAC has anemia, HSM, incr ALP/LAD due to widespread involvement of RES; Also grows well at 41degC

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6
Q

Prophylaxis and treatment of MAC

A

Proph with Azithromycin; Tx with Azith + Ethambutol or Rifampin

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7
Q

Absence of ganglion cells in colonic wall causes

A

affected segment to narrow (can’t relax)

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8
Q

Which parts of GI tract are always involved in Hirschprung

A

Since NCC’s migrate caudally, rectum always involved

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9
Q

How does metabolism of drug relate to drug-induced lupus?

A

Slow acetylators more likely (hydralazine, procainamide)

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10
Q

Most liver hydrolysis involve what enzymes

A

Amidase, Esterase

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11
Q

When is Exenatide used?

A

(GLP-1) Suboptimal glucose control in patients already on Metformin and Sulfonylureas

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12
Q

Ventricular response to AF is dependent on

A

Transmission through AV node

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13
Q

What types of viral genomic material can be individually infective?

A

Positive Linear ssRNA

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14
Q

Interstitial pneumonia in transplant patient

A

CMV

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15
Q

Treatment of C. diphtheria

A

Antitoxin –> Penicillin or Erythromycin –> DPT vaccine

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16
Q

Most common cause of death from C diph

A

Cardiomyopathy

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17
Q

Features of Cutaneous Neurofibromas

A

Rubbery, Buttonholing

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18
Q

Features of Wiskott-Aldrich

A

Thrombocytopenic Purpura, Eczema, Recurrent infections

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19
Q

Acute Narrow Angle Glaucoma is often precipitated by

A

Anticholinergics –> Anterior chamber narrows, obstructing trabecular meshwork

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20
Q

Confirmatory test for calculus cholecystitis

A

HIDA scan (not ultrasound)

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21
Q

Stool osmotic gap? What increase?

A

Colonic fermentation products –> Increased when poorly absorbable substances present (lactose)

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22
Q

Nonpolar Aliphatic Hydrophobic AA

A

VIP GAL - Valine, Isoleucine, Proline, Glycine, Alanine, Leucine

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23
Q

Aromatic Hydrophobic AA

A

Try Trippin w/ Phenytoin - Tyrosine, Tryptophan, Phenilalanine

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24
Q

Basic/Positive AA’s

A

Shallow HAL is positive - Hystidine, Arginine, Lysine

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25
Q

Acidic/Negative AA’s

A

Glutamate, Aspartate

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26
Q

Hydrophilic uncharged AA’s

A

Come, Take My GAS! - Cysteine, Threonine, Methionine, Glutamine, Asparaine, Serine

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27
Q

When is Arginine essential?

A

During + nitrogen balance

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28
Q

Non-lactose fermenting, Oxidase negative organism in Sickle Cell Osteomyelitis

A

Salmonella

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29
Q

Oxidase Positive bugs

A

Vibrio, Pseudomonas, Campylobacter, Helicobacter, Neisseria, Moraxella, Legionella

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30
Q

Main virulence factor of S aureus in osteomyelitis

A

Adhesion to collagen

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31
Q

Apo E4 predisposes to

A

Late-onset familial Alzheimer’s

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32
Q

Hypertrophic CM trait

A

AD - Beta myosin heavy chain

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33
Q

MOA and use of Dezrazoxane

A

Iron chelating agent to prevent cardiotoxicity from Anthracyclines

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34
Q

Location of 5-HT3 receptors implicated in chemo n/v

A

Peripherally in presynaptic nerve terminals of vagus in GI, Centrally in CTZ and Solitary nucleus/tract

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35
Q

Loop diuretics stimulate release of

A

Prostaglandins –> incr renal BF

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36
Q

Most common benign tumor of breast

A

Fibroadenoma (<35, often bilateral, cyclinc)

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37
Q

Fibroadenoma histology

A

Cellular, often myxoid stroma that encircles and sometimes compresses epithelium-lined glandular and cystic spaces

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38
Q

Function of vWF

A

Platelet adhesion by crosslining GpIb with exposed collagen underneath damaged endothelium

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39
Q

Secondary role of vWF

A

Carrier protein for factor VIII

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40
Q

Proteins C and S act to inactivate

A

V and VIII

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41
Q

Thrombin is produced from Prothrombin by

A

Activated Factor X

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42
Q

Growth Hormone binds to a __ receptor

A

JAK-STAT

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43
Q

Lecithin-Sphingomyeline Ratio is a marker for

A

Lung maturity (>1.9 = mature)

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44
Q

Mechanism of methicillin resistance

A

Alterations in PBP2a (also affects cephalosporins)

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45
Q

Immunity to reinfection by influenza is mediated by

A

Circulating antibodies against Hemagluttinin

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46
Q

Tumor originating from collecting duct cells

A

Renal Oncocytoma

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47
Q

Transitional cell tumors of pelvis are often what morphology

A

Papillary

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48
Q

Niacin-induced flushing is mediated by

A

Prostaglandins

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49
Q

___ reduces pain by decreasing level of substance p in PNS

A

Capsaicin

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50
Q

Clinical uses of Valproate

A

Anticonvulsant (absence, myoclonic, grand mal) AND mood stabilizer (acute mania, bipolar)

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51
Q

Anticonvulsants used as mood stabilizers in bipolar

A

Valproate, Carbamazepine, Lamotrigene

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52
Q

Carbamazepine indications

A

Trigeminal Neuralgia, Manic episodes, Partial and generalized seizures

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53
Q

MOA and use of Olanzapine

A

second gen antipsychotic

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54
Q

QT interval reflects

A

Myocyte AP duration

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55
Q

Two congenital syndromes that cause QT prolongation

A
  1. Jervell Lange-Nielson (AR, neurosensory deafness); 2. Romano-Ward (AD, no deafness)
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56
Q

Mutations affecting cardiac cell cytoskeletal proteins or mitochondrial enzymes of ox phos are though to cause

A

Genetic Dilated CM’s

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57
Q

Mutations of calcium-binding SR protein might underly

A

Arrhythmogenic RV Cardiomyopathy –> Progressive fibrofatty replacement of RV

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58
Q

Extramedullary hematopoesis is most frequently associated with

A

Chronic Hemolytic Anemias (eg beta thal)

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59
Q

Pentazocine

A

Opioid narcotic designed to produce analgesia with little to no abuse potential (weak antagonist at mu)

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60
Q

Short-acting benzos

A

ATOM - Alprazolam, Triazolam, Oxazepam, Midazolam

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61
Q

Long-acting benzos

A

Choose Carefully Due to Falls - Chlordiazepoxide, Chlorazepate, Diazepam, Flurazpam

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62
Q

Malabsorption, Diarrhea, PAS-positive granules in intestinal macrophages

A

WHIPPLES DISEASE - Tropheryma whippelii

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63
Q

Recurrent infections with Strep pneumo, H flu, and Moraxella indicate

A

Humoral immunodeficiency

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64
Q

Pneumocystis and chronic mucocutaneous candidiasis indicate

A

T cell deficiency

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65
Q

Immotile cilia syndrome presents in newborn period with

A

Respiratory distress –> Recurrent Otitis Media, Bronchitis, Sinusitis (opprotunistic infections like PCP unusual)

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66
Q

Agammaglobulinemia means susceptible to

A

Extracellular, encapsulated bacteria

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67
Q

Exchange of viral dna in coinfection by non-segmented viruses

A

Recombination

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68
Q

Viral phenotypic mixing

A

Coinfection leads to one virus with nucleocapsid protein from another

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69
Q

AE’s of TZD’s

A

Weight gain, edema, CHF

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70
Q

Damage to the Caudate is associated with

A

Transient hemiparesis and frontal lobe symptoms such as inattentiveness, abulia, forgetfulness

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71
Q

Compression fracture in elderly woman –> Calcium and PTH?

A

Normal

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72
Q

Driver of respiratory function in COPD vs normal

A

pO2 in COPD vs pCO2 normally –> Supplementary O2 in COPD will lead to respiratory suppression and coma

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73
Q

Main toxin of C perf

A

Lecithinase (phopholipase C, alpha toxin)

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74
Q

Insular cortex is associated with

A

Integrating body states w/ emotions (limbic); ANS control; Conscious experience of visceral sensations

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75
Q

Damage to internal vs external Globus Pallidus

A

Internal –> Excessive movement; External –> Decreased

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76
Q

Role of D arm of tRNA

A

Dihydrouracil residues –> Helps facilitate correct tRNA recognition by proper Aminoacyl tRNA synthetase

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77
Q

Role of T arm of tRNA

A

Binding tRNA to ribosomes

78
Q

Only RNA that contains thymidine

A

T RNA

79
Q

NE to Epinephrine requires

A

SAM - PNMT enzyme

80
Q

BH4 is required for synthesis of

A

Tyrosine, DOPA, Serotonin, Prolactin

81
Q

Winter’s Formula

A

PaCO2 = (1.5*HCO3) + 8 +/- 2

82
Q

Media for growing V cholerae

A

Alkaline - extremely acid sensitive organism

83
Q

Mechanism of hepatocyte damage in Hep B

A

CD8 response to viral antigens on cell surface

84
Q

Regulatory HIV genes required for replication

A

Tat, Rev

85
Q

Structural HIV genes

A

Gag, Pol, Env

86
Q

Products of Gag, Pol, Env genes in HIV

A

Gag - p24, p7; Pol - RT, Integrase, Protease; Env - gp120, gp41

87
Q

Function of HIV nef gene? Rev? Tat?

A

Nef - Downregulate CD4 and MHC 1; Rev - Transport of unspliced viral transcripts out of nucleus; Tat - Protein that transcriptionally activates other viral genes

88
Q

Features of Colitis-associated CRC vs sporadic

A

(1) younger; (2) Flat or non-polypoid dysplastic precursor; (3) Mucinous and/or signet ring morphology; (4) early p53 and late APC - opposite of sporadic; (5) proximal colon; (6) Multifocal

89
Q

MOA of Varenicline

A

Partial agonist at nicotinic ACh receptor

90
Q

Pentamidine is used for

A

Prophylaxis and tx of PCP

91
Q

Nifurtimox is used for

A

Chagas treatment

92
Q

Normal alveolar pO2

A

104 mmHg (if higher, poor perfusion)

93
Q

When is O2 equilibration diffusion-limited

A

Emphysema, Fibrosis, Very high blood flow (ie exercise)

94
Q

A, I, and H bands

A

A is thick myofilament, I is Actin only, H is Myosin only

95
Q

Pharmacodynamic Drug Antagonism

A

Drug can antagonize or prevent effect of another drug or endogenous substance

96
Q

Pharmacokinetic drug interaction

A

eg CYP inducers

97
Q

Treatment of recurrent C diff colitis

A

Fidaxomicin

98
Q

MOA of Fidaxomicin

A

Inhibits sigma subunit of RNA polymerase; Less effect on normal flora; Poor oral

99
Q

Most common cystic fibrosis mutation and result

A

dF508 –> Impaired post-translational processing and results in proteasome degradation

100
Q

AA’s with three titratable protons

A

Acidics, Basics, CT = Glutamate, Aspartate, Histidine, Arginine, Lysine, Cysteine, Tyrosine

101
Q

Salicylate acid base disorder

A

(1) Rapid respiratory depression causing alkalosis; (2) A few hours later metabolic acidosis

102
Q

Effect of ANP on kidney, Adrenals, BVs

A

Dilates afferent arterioles, Inhbitis Na reabsorption, Restrict aldosterone secretion, cGMP-mediated veno- and arteriodilation

103
Q

Type of MI usually associated with Bradycardia

A

Inferior - SA/AV nodal branch block

104
Q

ANS drug that can cause Glaucoma

A

Atropine –> Midriasis –> Narrowing of anterior chamber

105
Q

Anti-mitochondrial Ab’s

A

Primary biliary cirrhosis

106
Q

Anti-Smith Ab’s

A

Anti-snRNP = Specific for SLE

107
Q

Rapid atrophy and shrinkage of liver on autopsy

A

Halone-induced liver failure

108
Q

Shortest half life pro-coagulant factor

A

Factor VII (PT)

109
Q

What enzyme produces urea in Urea cycle

A

Arginase (Arginine –> Urea + Ornithine)

110
Q

Excessive amounts of Orotic acid are usually found in

A

OTC deficiency, Citrullinemia, Arginosuccinate aciduria

111
Q

Low levels of C1 esterase inhibitor

A

Hereditary Angioedema

112
Q

Mechanisms of C1 esterase inhibitor

A

Inhibit C1 –> Activated C1; Inactivates Kallikrein (which converts Kininogen to Bradykinin)

113
Q

16S rRNA function

A

Component of 30S subunit –> Expresses sequence complementary to Shine-Dalgarno in all prokaryotic mRNA

114
Q

23S rRNA function

A

Peptidyltransferase - Peptide bond formation

115
Q

Pontiac Fever

A

Legionella –> Acute, flu-like, self-limited disease

116
Q

Features of Legionnaire’s Disease

A

Recent expsoure to contaminated water, Pneumonia, High Fever; Sometimes GI, Relative bradycardia, neurologic

117
Q

Most common lab finding in Legionnaire’s

A

Hyponatremia

118
Q

Bilateral ACA occlusion

A

LE motor, Behavioral (abulia), Urinary incontinence

119
Q

Spread of H flu vs N meningitidis to meninges

A

H flu uses lymphatics, N men is hematogenous, Both from Pharynx

120
Q

MOA of Organophosphates

A

AChE inhibitors

121
Q

Bromoacetylcholine MOA

A

Inhibits Choline Acetyltransferase

122
Q

Nicotininc receptor antagonists

A

Pancuronium, Tubocurarine

123
Q

Hemicholinium MOA

A

Choline import into presynaptic terminal

124
Q

Train of Four seen in Non-depolarizing blockade

A

eg Tubocurarine - Slanted within group, Group increases each 4

125
Q

Train of Four seen in Depolarizing blockade

A

Equal within group, Group increases each four (phase 1) –> Resembles slanting of non-depolarizing in phase 2

126
Q

Neostigimine in Phase 1 vs 2 of Succinylcholine NMB

A

Augments blockade in Phase 1, Reverses it in Phase 2

127
Q

Duration of Succinylcholine action depends on

A

Diffusion out of NMJ and metabolism by plasma cholinesterase

128
Q

Nitrate with best bioavailability

A

Isosobide Mononitrate

129
Q

Hep B Window Period

A

Time lag betwee HBsAg disappearing and Anti-HBs appearing

130
Q

Most specific marker for diagnosis fo acute Hep B

A

Anti-HBc IgM –> Present in window period

131
Q

Vitamin E deficiency manifestations

A

Neuromuscular disease (myopathy, ataxia, pigmented retinopathy, dorsal column) and Hemolytic anemia

132
Q

Vitamin E primarily serves to

A

Protect fatty acids from oxidation –> Neurons and erythrocytes most susceptible

133
Q

Vitamin C excess

A

Nausea, Abdominal pain, Diarrhea, Stones

134
Q

Physostigmine vs Neostigmine and Edrophonium

A

Neostigimine and Edrophonium are Quaternary Amines and can’t cross BBB

135
Q

Tarry stool and fatigue are seen with what CT agents

A

Alkylating agents (upper GI bleed)

136
Q

Abdominal pain and jaundice may be seen with what CT agent

A

Mercaptopurine (cholestasis and hepatitis)

137
Q

Flagellate skin discoloration is seen with what CT agent

A

Bleomycin (along with pulmonary fibrosis)

138
Q

Nitroblue Tetrazolium testing

A

Properly functioning PMNs produce ROS that reduce yellow NBT to dark blue formazan that precipitates within the cells

139
Q

DHR flow testing

A

NADPH oxidase shows decr fluorescence

140
Q

NBT and DHR testing in MPO deficiency

A

Normal

141
Q

Pyruvate kinase deficiency is a common cause of

A

Chronic Hemolytic Anemia

142
Q

Ortner Syndrome

A

Mitral Stenosis –> LA enlargement –> Impingement on Recurrent Laryngeal N

143
Q

Location of Glut-2

A

Regulation of Insulin Release –> Hepatocytes, Beta cells, Renal tubular cells, Small intestine

144
Q

Location of Glut-3

A

Placenta, Neurons

145
Q

What is commonly found regarding uterus on vaginal vaginal examination in Endometriosis

A

Nodularity of uterosacral ligaments, Fixed retroversion of uterus

146
Q

Ectopic endometrial tissue secretes

A

PG’s –> Interfere with ovulation and tubal function –> Infertility

147
Q

Adenomyosis

A

Presence of endometrial glands w/in uterin myometrium (presents with bleeding, painful menses, and enlarged uterus unlike endometriosis)

148
Q

When to give Ribavirin with RSV?

A

Confirmed, severe RSV at risk for dz progression (immunodeficiency, prematurity, cardiopulmonary disease)

149
Q

Mechanism of Shiga-like toxin

A

AB - A subunit prevents binding of tRNA to 60S ribosomal subunit

150
Q

Bactrim is drug of choice for

A

Pneumocystis jiro, Toxoplasma, Nocardia

151
Q

Hyoscyamine

A

Anti-muscarinic to counteract AChEi in Myasthenia Gravis

152
Q

Side effects of Thiazide Diuretics

A

Hyper Glycemia Lipidemia Uricemia Calcemia

153
Q

Medication-induced fat redistribution

A

Corticosteroids, HAART (Protease inhibitors)

154
Q

Chronic Eosinophilic Bronchitis in asthmatics involves

A

Bronchial wall infiltration by numerous activated eosinophils in response to IL-5 by allergen-activated TH2 cells

155
Q

Class 3 Anti-arrhythmics

A

Amiodarone, Ibutilide, Dofetilide, Sotalol

156
Q

Which vitamin supplement should be given to child with Measles

A

Vitamin A - Reduces time to recovery from pneumonia and diarrhea, as well as risk of death

157
Q

Which HIV drug to give to pregnant women

A

Zidovudine

158
Q

Protein secondary structure is due to

A

Hydrogen bonds (Tertiary due to ionic bonds, hydrophobic interactions, hydrogen bonds, and disulfide bonds)

159
Q

E coli aquired ability to form pili via

A

Conjugation

160
Q

Strep pneumo aquired capsule via

A

Transformation

161
Q

Function of Thyroid Peroxidase

A

Oxidize inorganic iodide to organic iodine; Formation of monoiodotyrosine and diiodotyrosin; Coupling of these to iodotyrosines

162
Q

Lab studies in HUS

A

Only bleeding time elevated

163
Q

Bacitracin MOA

A

Prevents mucopeptide transfer into growing cell wall

164
Q

Trimpethroprin, Methotrexate, and __ inhibit DHFR

A

Pyrimethamine

165
Q

Important Bactrim AE’s

A

Hyperkalemia, Megaloblastic Anemia

166
Q

Serotonin Syndrome effects

A

HARM - Hyperthermia, ANS instability, Rigidity, Myoclonus

167
Q

Drugs that precipitate Serotonin Syndrome

A

TTYL - Tramadol, Triptans, trYcyclics, Linezolid

168
Q

Features of Myotonic Dystrophy

A

Frontal balding, Gonadal atrophy, Arrhythmia (My toupe, my testicles, my ticker); sustained grip, type 1 fiber loss

169
Q

Most important signalers in Coronary autoregulation

A

Adenosine, NO

170
Q

What causes NO release in coronaries

A

Pulsatile stretch, Flow shear stress

171
Q

What subtype not stimulated by NE

A

Beta 2

172
Q

Skeletal Muscle Depolarization –>

A

L-type channel-RyR mechanical coupling (no significant flux of Ca across L-type Ca channel) –> RyR1 opening –> Binds Troponin C

173
Q

Cardiac Muscle Depolarization –>

A

L-type Ca influx on PM –> RyR2 opening

174
Q

Smooth Muscle Depolarization –>

A

v-gated L type Ca influx –> Calmodulin (no troponin) –> Myosin light chain kinase –> P-lation of myosin

175
Q

Nonselective beta blocker with a1 blocking activity

A

Labetolol

176
Q

Systemic sequelae with Diphtheria

A

Myocarditis, Heart Failure, Neurotoxicity

177
Q

EKG leads for LAD

A

V1-V3

178
Q

Type 3 collagen is found in

A

Granulation tissue, Skin, Lungs, Blood vessels

179
Q

Bell vs Diaphragm

A

Bell = Low freq; Diaphragm = High

180
Q

S3 on end expiration

A

More audible, Heart closer to chest wall

181
Q

Localized amyloidosis confined to cardiac atria

A

ANP-derived (elderly)

182
Q

Prolyl Hydroxylase –>

A

Proline on Procollagen –> Stable triple helix

183
Q

Lysyl Hydroxylase –>

A

Stronger

184
Q

Bepridil

A

CCB - Second line anti-anginal drug

185
Q

Loud P2 =

A

Pulmonary hypertension

186
Q

Kussmaul =

A

Paradoxical rise in JVP during inspiration

187
Q

Don’t use DPH-CCB with

A

Acute Coronary Syndrome (reflex tachycardia)

188
Q

Digoxin toxicity

A

Hyperkalemia, Vision, N/V/D

189
Q

Afib with RVR: tx –>

A

CCBs, BBs, then Digoxin second line

190
Q

Lidocaine is for what arrhythmias

A

Ventricular, not Atrial

191
Q

Mechanism of Fibrates

A

Peroxismal Proliferator-Activated Receptor Alpha –> LPL activity increase –> Decr TB, Raise HDL

192
Q

How do assess severity of Mitral Regurg

A

Presence of S3 gallop

Uworld (16 decks)

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