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UWorld QBank > Random Facts > Flashcards

Random Facts Flashcards

1
Q

Cleft lips

A

Failure of the midline intermaxillary segment (fused medial nasal prominence) to fuse with the maxillary prominences - occurs more commonly on the left.

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2
Q

NSAID-induced nephropathy

A

Concentrates in the medulla; decreased prostaglandin synthesis causes vasoconstriction of the medullary vasa recta and papillary necrosis; also uncouples the mitochondria to cause direct cellular damage. Chronic interstitial nephritis

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3
Q

Papillary necrosis

A

Elevated serum creatinine Fanconi syndrome Mild proteinuria Colicky pain Gross hematuria Tissue fragments on urinalysis

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4
Q

S. epidermidis antibiotics sensitivity

A

Often not sensitive to methicillin-class antiotics; first line treatment is vancomycin or rifampin

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5
Q

Beta-thalassemia cause

A

Usual mutations affect mRNA splicing and premature translational termination

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6
Q

Courvoisier’s sign

A

1) Palpable nontender gallbladder 2) Weight loss 3) Obstructive jaundice Together they mean adenocarcinoma at the head of the pancreas.

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7
Q

Risk factors for pancreatic adenocarcinoma

A

1) Age 2) Smoking 3) Diabetes 4) Chronic pancreatitis 5) Genetic predisposition

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8
Q

Production of propionic acid

A

Isoleucine Valine Threonine Methionine Cholesterol Odd-chain fatty acids

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9
Q

Glucagonoma

A

Hyperglycemia (diabetes diagnosis) Stomatitis Cheilosis Abdominal pain Necrolytic migratory erythema

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10
Q

E. coli virulence factor for meningitis

A

K-1 capsular antigen Inhibits complement and phagocytosis Antibodies against capsule are protective

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11
Q

Anaplasia

A

Neoplastic cells that completely lack any signs of differentiation (pleomorphism, large N/C ratios, loss of polarity, mitotic figures and multinucleated giant cells)

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12
Q

Cerebellar Purkinje cell degeneration paraneoplastic syndrome

A

Anti-Yo (ovarian and breast) Anti-P/Q (lung) Anti-Hu (lung)

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13
Q

PABA sunscreen protection

A

PABA protects against UVB only Zinc oxides protects against UVB and UVAI & UVAII Avobenzone protects against UVAI & UVAII only

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14
Q

Neutrophil chemotaxis

A

1) Margination (histamine & prostaglandin vasodilation) 2) Rolling (Sialyl Lewis X & Selectins) 3) Activation (Chemokines) 4) Crawling (CD18 b2 integrins MAC-1 or LFA-1 & ICAM1) 5) Transmigration (PECAM-1 at intercellular junctions)

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15
Q

Thioridazine

A

Retinal deposits (looks like retinitis pigmentosa)

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16
Q

Chlorpromazine

A

Corneal deposits

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17
Q

Quetiapine

A

HAM blockage and cataracts

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18
Q

Pulmonary embolism ABG/Chem

A

Hypoxemia > increased respiration > respiratory alkalosis Serum bicarb takes time to decrease to compensate

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19
Q

Low serum C1 esterase inhibitor

A

Autosomal dominant hereditary angioedema Painless, non-pitting, well-circumscribed edema Face, neck, lips, tongue and internal organs Respiratory obstruction is fatal GI tract is abdominal pain, N/V and diarrhea C1 esterase inhibitor -| kallikrein Kallikrein catalyzes kininogen to bradykinin and plasminogen to plasmin DO NOT use ACE inhibitors

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20
Q

Aflatoxin mechanism

A

G-T transversion in p53 causing hepatocellular carcinoma

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21
Q

Porcelain gallbladder

A

Intramural calcification due to chronic inflammation 11-33% chance of gallbladder carcinoma

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22
Q

Differentiate vibrio vs. campylobacter

A

Both comma-shaped, gram-negative, and oxidase-positive Only vibrio grows on alkalinized media

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23
Q

Atherosclerosis spots

A

Abdominal aorta > coronary > popliteal > internal carotid > circle of willis

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24
Q

Parvo arthritis

A

Symmetric inflammation of PIP, MCP, wrist, knee and ankle like RA but resolves spontaneously in < one month\

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25
Q

Reversible vs. irreversible change

A

Disaggregation or aggregation of nuclear elements is REVERSIBLE Mitochondrial vacuolization is irreversible

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26
Q

First line pharmaco-intervention for gestational diabetes

A

Insulin

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27
Q

Most common cause of MS and MR

A

MS: rheumatic fever MR: myxomatous degeneration

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28
Q

Osteoporosis PTH vs. Ca2+

A

DEXA scan over 2.5 SD of normal Normal PTH and Ca2+ balance in serum

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29
Q

Components of cystathionine

A

Homocysteine and serine via B6 condensation Then cystathionase (B6) to cysteine

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30
Q

Pure red cell aplasia (PRCA)

A

Inhibition of erythropoietic precursors by IgG autoantibodies or cytotoxic T cells. Associated with thymomas and lymphocytic leukemias. Also could be from Parvo B19 infection.

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31
Q

EPO-producing tumors

A

Uterine fibroids Cerebellar hemangioblastomas Renal cell carcinomas Hepatocellular carcinoma

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32
Q

Test for lipoprotein lipase activity

A

Heparin causes vascular endothelium release of LPL which is negative in congenital deficiencies. Shows eruptive skin xanthomas, HSM and pancreatitis

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33
Q

Hypercholesterolemia vs. Hyperlipidemia

A

Arcus senilis vs. lipemia retinalis Tendinous xanthomas and xanthelasma vs. eruptive cutaneous xanthomas Coronary artery disease vs. pancreatitis

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34
Q

Livedo reticularis

A

Aggravated by cold and found on lower extremities 1) Polyarteritis nodosa 2) SLE 3) RA 4) Dermatomyositis 5) Pancreatitis 6) Amantadine 7) Cryoglobulinemia 8) Arteriosclerosis (cholesterol emboli) #1 causes is idiopathic in young women during winters

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35
Q

Glucokinase deficiency

A

MODY and gestational diabetes

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36
Q

Most common tumor of the pineal gland

A

Germinomas - Precocious puberty - Parinaud syndrome - Aqueductal compression w/ hydrocephaly

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37
Q

Serum marker for mast cell degranulation

A

Tryptase

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38
Q

Gastric structure

A

Gastric pit connects to multiple gastric glands 1) Upper glandular layer contains parietal cells 2) Lower glandular layer contains chief cells

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39
Q

T-ALL

A

More likely to form large anterior mediastinal mass that compresses surrounding structures

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40
Q

Coin lesions in non-smoker lung

A

Hamartoma (pulmonary chondroma)

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41
Q

Polyarteritis nodosa sparing

A

Spares the pulmonary arteries and rarely involves the bronchial arteries

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42
Q

Post-strep RPGN

A

More severe in adults and progress to chronic forms

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43
Q

Metyrapone

A

Blocks 11-b-hydroxylase in adrenal cortex to test HPA axis Should see increase in urinary 17-hydroxycorticosteroids

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44
Q

Halothane-associated hepatitis

A

Type 1: elevated AST and ALT but mild or no symptoms Type 2: rapid atrophy of bladder w/ centrilobular necrosis and inflammation of the portal tracts. Marked increase in AST and ALT and prolonged PT. Thought to be hypersensitivity reaction to drug leading to autoimmune attack on hepatocytes

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45
Q

Pituitary apoplexy

A

Bleeding into a pre-existing pituitary adenoma leading to ACTH dysregulation and insufficient stress response and severe hypotension

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46
Q

Pilocytic astrocytomas

A

Cystic and nodular component on MRI Rosenthal fibers pathomnemonic

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47
Q

Brain CT

A

Hemorrhage = hyperdense Ischemia = hypodense

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48
Q

Turner’s heart problems

A

Most common = bicuspid aortic valve Second most = aortic coarctation Non-damaged bicuspid AV still has early systolic ejection high frequency click over the cardiac apex

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49
Q

Foul-smelling sputum

A

Abscess formation

50
Q

Green color of sputum

A

Myeloperoxidase is green in color because it is a heme based protein

51
Q

TImeline of neuronal ischemia

A

12-48 hours = red neurons (eosinophilic, pyknotic, loss of Nissl substance) 48-72 hours = necrosis and neutrophilic infiltration 3-5 days = macrophage infiltration and clean up 1-2 weeks = reactive gliosis and vascular proliferation (liquefactive necrosis w/ soft area) > 2 weeks = glial scar (cystic area surrounded by gliosis)

52
Q

Early changes in myocardial infarction

A

0-4 hours = no change 4-12 hours = edema, wavy fibers, hemorrhage, necrosis 12-24 hours = coagulative necrosis, contraction bands

53
Q

Depth limit on gastric erosion

A

Erosions cannot extend beyond the muscularis mucosa; further becomes ulcers

54
Q

Bronchoalveolar carcinoma

A

Looks like pneumonia consolidations and arises on the periphery of the lung Arises from alveolar epithelium and is well-differentiated Minimally invasive of the vasculature or stroma

55
Q

germ cell tumors and hyperthyroidism

A

Germ cell tumors secrete hCG that is structurally related to FSH, LH and TSH and can stimulate the TSH receptor. FSH cannot.

56
Q

Primary cause of lacunar infarcts

A

Chronic hypertension resulting in arteriolar sclerosis

57
Q

Cavernous hemangioma of the brain and viscera

A

Associated w/ von Hippel Lindau syndrome Blue in color because of dermis (deep) location

58
Q

Cholecystenteric fistula treatment

A

Surgical removal of the stone at ileocecal valve Typically does not require cholecystectomy or fistula repair

59
Q

Common peroneal nerve damage

A

Foot inversion and plantarflexion (Equinovarus) Foot drop Anterolateral leg loss of sensation

60
Q

Meningioma origins

A

Arachnoid villi

61
Q

Sciatic nerve contributions

A

L4 to S3

62
Q

Splenium of corpus callosum lesion

A

Alexia without agraphia

63
Q

Supraspinatus testing

A

Empty can supraspinatus test 1) Abduct arm to 90 2) Flex arm to 30 3) Point thumbs down 4) Apply downward force on the arm

64
Q

Aortic rupture location

A

Isthmus of the aortic arch after the left subclavian

65
Q

Spleen

A

Intraperitoneal Derived from the mesoderm

66
Q

Superior laryngeal nerve innervation

A

Cricothyroid muscle Sensory innervation above the vocal cord

67
Q

Favorite location of schwannomas

A

Cerebellopontine angle Affects CN V, VII and VIII

68
Q

Nursemaid’s elbow

A

Radial head subluxation Traction while elbow is pronated and extended Children hold their arms in this position to stop hurting Reduction achieved by supination and flexion

69
Q

Delineation of the anterior 2/3 to posterior 1/3 tongue

A

Terminal sulcus which contains the foramen cecum

70
Q

Infancy hydrocephalus

A

Typically due to congenital malformations like Arnold-Chiari and aqueductal stenosis Can lead to hyperreflexia and spasticity due to pyramidal tract stretching

71
Q

Parotid gland nerve pathway

A

Inferior salivatory nucleus - IX - otic ganglion - auriculotemporal (V) - parotid gland

72
Q

Submandibular gland nerve pathway

A

Superior salivatory nucleus - VII chorda tympani - lingual - submandibular ganglion

73
Q

Prepatellar bursitis

A

Housemaid’s knee (common in roofers, carpeters, plumbers and gardeners) Prepatellar bursitis between skin and prepatellar tendon

74
Q

Lung and pleura locations

A

Left and right are the same PARIETAL PLEURA Mid-clavicular = 7 Mid-axillary = 10 Para-vertebral = 12 LUNGS Lungs are always 2 spaces above

75
Q

Superior mesenteric artery syndrome

A

SMA compression of transverse duodenum against the aorta Caused by low body weight, weight loss and lordosis (from scoliosis surgery)

76
Q

External ear canal innervation

A

External canal and outer membrane = mandibular V3 (auriculotemporal branch) Posterior part of external canal = small auricular of X Inner membrane = tympanic of IX

77
Q

Reflex levels (lower extremity)

A

Anal = S2-S4 Knee = L3-L4 Achilles = S1-S2

78
Q

Lacunar infarct causes

A

Lipohyalinosis and microatheromas (Diabetes and hypertension)

79
Q

What structures lie posterior to the duodenal bulb

A

Common bile duct Portal vein Gastroduodenal artery (damaged by posterior ulcer)

80
Q

Piriform recesses

A

Small cavities beside the epiglottis on the esophageal side - food tend to get stuck here Underneath is the internal laryngeal (X) of the superior laryngeal (X) and is responsible for sensation above the vocal cords - afferent of the cough reflex

81
Q

Body’s smallest bone and skeletal muscle

A

Stapedius (VII) and stapes

82
Q

V3 somatic motor

A

Muscles of facial expression and tensor tympani

83
Q

Lower trunk of brachial plexus

A

C8 and T1 and contributes to median and ulnar - all intrinsic muscles of the hand

84
Q

Intraventricular hemorrhage in newborns

A

Associated with prematurity ( < 32 weeks) and/or low birth weight (< 1500 g), and almost always occurs within 5 days of birth. Due to rupture of the germinal matrix - highly cellular and vascular region w/o glial support of blood vessels in the subventricular zone (SVZ).

85
Q

Cardinal sign of CHF in the lung

A

Batwing opacity and Kerley B lines

86
Q

Most common shoulder dislocation

A

Anterior is most common - falling onto outstretched hands The axillary nerve is often damaged

87
Q

Sensory component of the phrenic nerve

A

Diaphragmatic and mediastinal pleura referring to C3-5 (shoulder and neck) All other pleural sensory is done by the intercostal nerve

88
Q

Sensory location of musculotaneous nerve

A

Lateral forearm

89
Q

Urethral segments

A

Posterior (prostatic -> membranous) Anterior (bulbous -> penile) The joining component is the weakest and can be damaged by pelvic trauma

90
Q

Intracytoplasmic P bodies

A

Site of mRNA storage and degradation Contains microRNA apparatus and other nucleases that affects mRNA stability and half life

91
Q

Linkage disequilibrium

A

Two alleles inherited together more than chance alone would dictate 1) Proximity on the same chromosome 2) Selection pressure for them to be together

92
Q

Polyol pathway

A

Aldose reductase reduces glucose into sorbitol with NADPH, which cannot leave the cell and increases the osmolarity of the cytoplasm Polyol dehydrogenase, which has lower activity, converts sorbitol into FRUCTOSE 1) Seminal vesicles 2) Lens

93
Q

Myelin electrical properties

A

DECREASE capacitance INCREASE length constant (distance until 1/e old amp) DECREASE time constant (time until 1-1/e new amp)

94
Q

Pro-collagen formation

A

Disulfide bond formation between the C-terminal propeptides of 3 a-chains brings them into formation for triple helix formation

95
Q

Mitochondrial disorders

A

1) Leber hereditary optic neuropathy 2) Myoclonic epilepsy w/ ragged red fibers 3) Mitochondrial encephalomyopathy w/ lactic acidosis and stroke like episodes

96
Q

Etoposide

A

Topoisomerase II inhibitor (double-stranded breaks)

97
Q

Irinotecan Topotecan

A

Topoisomerase I inhibitor (single-stranded breaks)

98
Q

MEN I

A

Mutation: Menin Parathyroid Pancreatic Pituitary

99
Q

MEN IIA

A

Mutation: RET Parathyroid Pheochromocytoma Medullary carcinoma of the thyroid

100
Q

MEN IIB

A

Mutation: RET Pheochromocytoma Medullary carcinoma of the thyroid Marfanoid habitus and mucosal neuromas

101
Q

Methods of acquiring CJD

A

1) Corneal transplants 2) Neural implants 3) Bovine growth hormones

102
Q

CJD

A

Spongiform degeneration Myoclonic seizures and rapidly progressive dementia Cytoplasmic vacuoles Long incubation period but rapidly progressive NO inflammatory changes

103
Q

Paget’s disease complication

A

Affected bone has increased fibrosis and vascularity Proliferation of fibroblasts and endothelial cells due to cytokine release by osteoclasts - AV shunting and HIGH OUTPUT HEART FAILURE - High density but fragile bone leading to fractures - Increased risk of osteosarcoma

104
Q

Renal acid secretion

A

Minimum pH is approximately 4.5 Increase bicarbonate absorption Increase titratable acid secretion (HPO4 and NH3)

105
Q

HEV

A

Hepevirus ssRNA+ noneveloped icosahedral structure

106
Q

Adenovirus in close quarters

A

Pharyngoconjunctival fever

107
Q

Femoral nerve

A

Comes out between psoas and iliacus From roots L2-L4 Weakness in quadriceps group (knee buckling) Loss of sensation anterior medial thigh and leg Diminished patellar tendon reflex (L3-4 mostly 4)

108
Q

Dopamine

A

Low = D1 activation = UP RBF, UP GFR, UP sodium excretion, UP mesenteric flood flow Med = B1 activation = UP contractility, UP systolic blood pressure, SAME diastolic blood pressure HIGH = A1 activation = UP vasoconstriction

109
Q

Polymyositis

A

Unknown antigen stimulates autoimmunity against muscle Macrophage and CD8 T cell infiltration of the endomysium Symmetric proximal muscle weakness of the arm and leg Anti-Jo1 antibody Increased MHC I expression on sarcolemma Increased general risk of malignancies

110
Q

Trihexyphenidyl

A

Centrally acting anti-cholinergic (like benztropine)

111
Q

GLUT3 expression pattern

A

Brain Kidney Placenta

112
Q

Platelet factors that induce atherosclerosis

A

PDGF: SMC migration and proliferation TGB-b: SMC migration and collagen synthesis

113
Q

Theca interna products

A

LH induced testosterone and progesterone production

114
Q

Carotid sinus syncope

A

Hypersensitivity of carotid sinus (internal carotid) w/ afferent through the Hering’s nerve (IX) causing increased inhibition (increased firing) in the solitary nucleus in the medulla, leading to decreased HR and vasodilation and decreased BP

115
Q

Monomeric insulins

A

Aspart (Novolog), Lispro (Humalog), Glulisine (Apidra) Starts 15 min - peaks 60 min - lasts 4 hours

116
Q

Regular insulin

A

Regular insulin Starts 30 min - peaks 2 hours - lasts 8 hours

117
Q

Intermediate insulin

A

NPH (Neutral protamine Hagedorn) Starts 2 hours - peaks 8 hours - lasts 16 HOURS Lente (Novalin) Starts 1.5 hours - peaks 6 hours - lasts 24 hours

118
Q

Long acting insulin

A

Detemir Starts 2 hours - peaks 8 hours - lasts 24 hours

119
Q

Peakless insulin

A

Glargine (Lantus) (low pH and forms microprecipitate) 24 hours peakless

120
Q

Factors causing acne

A

1) Follicular epidermal hyperplasia 2) Excessive sebum production 3) Inflammation 4) Propionibacterium acnes

121
Q

Aging skin histology

A

1) Thinning of the dermis and epidermis 2) Flattening of the dermoepidermal junction 3) Decreased number of fibroblasts 4) Reduced synthesis of collagen and elastin

UWorld QBank (2 decks)

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