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My Uworld > Random (Nov-Jan) > Flashcards

Random (Nov-Jan) Flashcards

1
Q

Ventricular wall thickness is increased globally in

A

Hypertensive heart disease

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2
Q

Gottron sign is seen in

A

Dermatomyositis

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3
Q

Chest pain from GI/esophageal cause

A

Non exertional
Relieved by antacids
Ass with regurgitation, nausea, dysphagia
Nocturnal pain

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4
Q

Most common lab abn in legionellosis

A

Hyponatremia

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5
Q

Statins and fibrates adverse effects

A

Myopathy

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6
Q

features of radial nerve injury

A

weakness on finger and thumb extension (finger drop)

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7
Q

criteria for narcolepsy

at least 1 of

A

cataplexy (brief loss of consciousness ppt by strong emotions laughter etc)
low CSF hypocretin-1
shortened REM sleep latency

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8
Q

Absent seizure features

A

Brief loss of consciousness (eg blank stare)
May have automatisms
Usually no postictal state

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9
Q

Eczematous dermatitis histology

A

Spongiosis

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10
Q

Other features of congenital torticollis

A 
Hip dysplasia
Metatarsus adductus (adduction of forefoot)
Talipes equinovarus (club foot)
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11
Q

% saturation of O2 is decreased in

A

CO poisoning

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12
Q

Bicuspid aortic valve

A

Turner syndrome (susceptible to infectious endocard)

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13
Q

Side effects of colchicine

A

Nausea
Abdominal pain
Diarrhea

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14
Q

PICA ischemia leads to

A

Lateral medullary (wallenberg) syndrome

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15
Q

Overuse of diphenoxylate leads to

A

Euphoria and physical dependence

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16
Q

hPL stimulates production of which hormone

A

Insulin in pancreatic beta cells

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17
Q

Gram positive anaerobic bacteria
Colonize mouth colon vagina
In dental caries and margins of gums

A

Actinomyces

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18
Q

Contraindications of colchicine

A

Elderly

Severe renal dysfunction

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19
Q 
Tremors 
Anxiety 
Delirium 
Psychosis 
Withdrawal symptoms of
A

Alcohol

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20
Q

Complex focal seizure

A

Loss of consciousness and post ictal state

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21
Q

Excessive daytime sleepiness
Snoring
Gasping are features of

A

Obstructive sleep apnea

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22
Q

Most common form of adrenal hyperplasia

A

21 hydroxylase deficiency

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23
Q

Humoral component of type 4 hypersensitivity rxn

A

None

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24
Q

candida vaginitis xtic

A

thick, cottage cheese discharge

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25
Q

Maternal virulization is commonly seen in

A

Aromatase deficiency

Transfer of excess androgens in2 maternal circulation

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26
Q

incr methylmalonylcoA inv deficiency of

A

B12

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27
Q

Lamotrigine is used for

A

Bipolar depression

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28
Q

Cause of BPPV

A

Otoliths in semicircular canals

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29
Q

Enlarged uterus inconsistent with dates is seen in

A

Complete hydatidiform mole

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30
Q

Chest pain from coronary artery disease

A

Substernal
Radiates to arm, shoulder, or jaw
Ppt by exertion
Relieved by rest or nitroglycerin

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31
Q

Total oxygen content is decreased in

A

CO poisoning

Anemia

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32
Q

Affected newborn girls in aromatase deficiency have

A

Normal internal genitalia

Ambiguous or male-type external genitalia (clitoromegaly)

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33
Q

Teratogenic effects of warfarin

A

Nasal hypoplasia

Stippled epiphysis

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34
Q

low Urine chloride metabolic acidosis

causes:

A

vomiting/ nasogastric aspiration

prior diuretic use

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35
Q

Side effects of methylphenidate

A

Decr appetite

Weight loss

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36
Q

Abnormal premature keratinization of individual kerayocytes below stratum granulosum ? Term?

A

Dyskerayosis

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37
Q

Diagnosis of allergic bronchopulmonary aspergillosis

A

Eosinophilia
+ve aspergillus specific IgG
Incr aspergillus specific and total IgE
+ve skin test for aspergillus

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38
Q

Serum sickness
Lupus nephritis
PSGN hypersensitivity type

A

Type 3

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39
Q

Diabetes insipidus

A

Incr osm
Decr ICF
Decr ECF
Hyperosmotic volume contraction

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40
Q

Clozapine class

A

Antipsychotic

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41
Q 
Epicanthal folds
Upslanting palpebral fissures
Protruding tongue
Excessive skin at nape of neck 
Hyptonia
Weak startle (moro) reflex seen in
A

Down syndrome

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42
Q

Bupropion is used for

A

Major depression

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43
Q

Nicotine withdrawal symptoms

A

Dysphoria
Irritability
Anxiety
INCREASED APPETITE

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44
Q

CMV occurs in

A

Transplant pts
HIV
Fetuses (congenital infections)

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45
Q

Common causes of vertigo

A

Meniere disease
BPPV
Vestibular neuritis (labyrinthitis)

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46
Q

Fecal/embryonic tissue in complete hydatidiform mole?

A

Absent

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47
Q

High pitched blowing decrescendo murmur

A

Aortic regurgitation (diastolic murmur)

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48
Q

Double bubble sign on XRAY

A

Duodenal atresia

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49
Q

Pulmonary compliance in emphysema is

A

Increased

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50
Q

Motor features of tourette disorder

A

Facial grimacing
Blinking
Head/neck jerking
Tongue protrusion, sniffing

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51
Q

Serum sickness hypersensitivity

A

Type 3 hypersensitivity rxn to non human proteins—> vasculitis from tissue deposition of circulating immune complexes

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52
Q

Colchicine disrupts

A

Chemotaxis
Phagocytosis
Degranulation

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53
Q 
abd pain
vomiting
diarrhea
hypotension
garlic breath due to
A

arsenic poisoning

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54
Q 
Incr appetite 
Hypersomnia
Intense psychomotor retardation 
Severe depression
Withdrawal symptoms of
A

Stimulants (cocaine, amphetamine)

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55
Q

Risk of bupropion is greater with preexisting

A

Seizure disorder or eating disorder (anorexia or bulimia)

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56
Q

Mnemonic of features of Manic episode

A 
DIGFAST
D- distractibility
I- impulsivity
G- grandiosity
F- flight of ideas
A- incr activity
S- decr need for sleep
T- talkativeness
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57
Q

Teratogenic effects of ACE inhibitors

A

Renal dysgenesis

Oligohydramnios

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58
Q

bacterial vaginosis org

A

gardnerella vaginalis

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59
Q

Warfarin inhibits

A

Vitamin K dependent clotting factors esp VII

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60
Q

Teratogenic effects of lithium

A

Nephrogenic DI
Ebstein anomaly
Hypothyroidism

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61
Q

Gestational HTN

A

New onset incr bp at 20wks gestation

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62
Q

variable uterine dev
no upper vagina
primary amenorrhea
normal ovaries (reg dev of secondary sexual xtics)

A

mullerian aplasia /
vaginal agenesis
Mayer Rokitansky Kuster Hauser syndrome

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63
Q

incr homocysteine inv deficiency of

A

folate and B12

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64
Q

Teratogenic effects of valproate

A

Neural tube defects

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65
Q

Ebstein anomaly leads to

A

Decreased right ventricular volume

Atrialization of right ventricle

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66
Q

Features of obesity hypoventilation syndrome

A 
Obesity
Chronic fatigue 
Dyspnea
Difficulty concentrating 
Incr paCO2
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67
Q

K and H wasting at distal nephron is caused by

A

Aldosterone

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68
Q

Side effects of lamotrigine

A

Rash
Steven Johnson synd

Is an anticonvulsant

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69
Q

Brief jerking movements are seen with

A

Myoclonic generalized seizure

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70
Q

most common cause of alarming bloody nipple discharge

A

intraductal papilloma

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71
Q 
Vaginal bleeding
INCREASED beta hCG
Hyperemesis gravidarum
Preeclampsia
Hyperthyroidism 
Theca lutein cysts
A

Complete hydatidiform mole

46 XX or XY

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72
Q

other sources of arsenic poisoning

A

pressure-treated wood
minjg
glass making
pesticides

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73
Q

Simple focal seizure

A

No loss of consciousness or postictal state

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74
Q

Target INR

A

2-3

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75
Q

gerstmann syndrome

affected lobe

A

dominant parietal lobe

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76
Q

Vasodilator in chemical cardiac stress tests

A

Adenosine

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77
Q

Gottron sign

A

Raised violaceous scaling eruption of knuckles

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78
Q

Causes of erectile dysfunction

A

Psychogenic stressors (rapid onset)morning erections present
Performance anxiety or depression
Medications (SSRIs, sympathetic blockers-clonidine, methyldopa)
Vascular or neurological impairment
Genitourinary trauma

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79
Q

Management of placenta accreta diagnosed during prenatal care

A

Cesarean delivery followed by hysterectomy

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80
Q

Causes of right shift in O2-Hb dissociation curve

A

Incr temperature
Decr pH
Incr 2,3 BPG

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81
Q

Teratogenic effects of methotrexate

A

Neural tube defects
Limb and craniofacial abn
Abortion

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82
Q

Cyt P450 inducers

A 
Decr warfarin effect
Decr in efficacy 
Carbamazepine, Phenytoin
Ginseng, St John's wort
OCP
Phenobarbital 
Rifampin
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83
Q

% occlusion for positive inducible ischemia

A

80 and 60% occlusion of R&L CA

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84
Q

Transepithelial potential difference test in cystic fibrosis

A

Saline applied to nasal mucosa

Incr Na absorption in CF patients causes a more negative nasal transepithelial potential difference

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85
Q

Maternal features of rubella

A

Low grade fever
Maculopapular rash with cephalocaudal progression
Postauricular and suboccipital lymphadenopathy

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86
Q

Kallman syndrome?

A

Impaired synthesis of GnRH by hypothalamus

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87
Q

Incr incidence of cholelithiasis in pregnancy and OCP use is associated with

A

Estrogen-induced cholesterol hypersecretion

Progesterone-induced gallbladder hypomotility

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88
Q

Folic acid antagonist that inhibits DHF reductase

A

Methotrexate

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89
Q

Diffusion capacity for carbon monoxide in chronic bronchitis is

A

Normal

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90
Q

Hypersensitivity type in myasthenia gravis

A

Type 2

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91
Q

basal ganglia atrophy is seen in

A

Wilson dx

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92
Q

Posterior limb of internal capsule carries which fibers?

A

Corticospinal motor and somatic sensory fibers + visual and auditory fibers

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93
Q

Specificity calculation

A

d/b+d
TN/TN+FP

Rules into normal population (SPIN)

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94
Q

Useful meds in atypical subtype of major depression and treatment resistant depression

A

Monoamine oxidase (MAO inhib)
Phenelzine
Tranylcypromine
Selegiline

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95
Q

HPV imfection is associated with which cancers

A

Anogenital squamous cell carcinomas and precursors

Squamous intraepithelial lesions

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96
Q

Pigment that causes greenish color to develop in bruises several days after an injury

A

Biliverdin

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97
Q

Deficiency of aromatase

A

AR
Early manifestation in embryo
Incr androgen and decreased estrogen levels in female fetus

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98
Q

Ataxia telang gene responsible for

A

DNA break repair

DNA is hypersensitive to xray causing multiple chromosomal breaks

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99
Q

FEV1 and FVC in chronic bronchitis and emphysema

A

Decreased

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100
Q

Cl and Na in cystic fibrosis

A

Decr Cl secretion and incr Na absorption by respiratory epithelia resulting in dehydrated mucus

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101
Q

Thickening of stratum corneum

A

Hyperkeratosis

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102
Q

Phase 2 nonpacemaker cell blocked by

A

Class IV Antiarrhythmics

Verapamil, Diltiazem

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103
Q

Key enzyme involved in steroidogenesis

A

Aromatase

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104
Q

Specific phobia meaning and duration

A

Marked anxiety about specific object or situation (flying, heights, animals, injections, blood)
Common (10% population)
> 6 months

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105
Q

ADHD treatment

A

Methylphenidate

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106
Q

AML features

A

Peroxidase +ve granules (auer rods)

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107
Q

radial nerve passes through

injury can also occur due to

A

supinator canal

direct trauma or dislocation of radius

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108
Q

pancreatic insufficiency is a cause of which vitamin deficiency

A

vitamin A

chronic pancreatitis or cystic fibrosis

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109
Q

ACE-I and statins and impotence

A

Not shown to cause impotence

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110
Q

Features of meniere disease

A

Recurrent vertigo
Ear fullness/pain
Unilateral hearing loss and tinnitus

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111
Q

Location of caudate nucleus

A

Inferolateral wall of anterior horn of lateral ventricle

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112
Q

IL-10 function

A

Anti-inflammatory
Immunomodulatory
Esp in pathogenesis of inflammatory bowel disease

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113
Q

Chronic HTN in pregnancy

A

> = 140/90 prior to conception or 20wks gestation

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114
Q

radial nerve injury due to

A

due to repetitive pronation and supination of forearm

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115
Q

Young black woman
Non caseating granulomas
Cough dyspnea chest pain
Macules/plaques/erythema nodosum

A

Sarcoidosis

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116
Q

Atrophy of caudate is seen in

A

Huntington’s disease

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117
Q

trichomoniasis org

A

trichomonas vaginalis

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118
Q

Partial pressure of oxygen in nitrites poisoning?

A

Unchanged

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119
Q

Excessive alveolar elastin degradation is seen in

A

Alpha 1 antitrypsin def

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120
Q

In aromatase deficiency, At puberty impaired ovarian estrogen synthesis leads to

A

Primary amenorrhea
Osteoporosis
Tall stature (low estrogen delays fusion of epiphysis)

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121
Q

Measles and rubella pattern of spread

A

From head and neck spread downward

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122
Q

Late presentation of salt wasting or precocious puberty is seen in

A

21 hydroxylase deficiency

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123
Q

Common causes of non-valvular heart failure

A

IHD
Dilated cardiomyopathy
Hypertensive heart disease
Hypertrophic cardiomyopathy

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124
Q

Findings in colonic atresia

A

Constipation

Abd distension

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125
Q

Insulin causes activation of

A

PFK 2

Incr glycolysis

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126
Q

Conduction SPEED order in heart from slow to fast

A
  1. AV node (0.05m/sec)
  2. Ventricular muscle
  3. Atrial muscle
  4. Purkinje system (2.2 m/sec)
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127
Q

meds fr pregnancy termination

A

misoprostol -prostag E1 agonist
mifepristone -progest antag
methotrexate - folic acid antag

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128
Q

RV FVC and TLC in aging

A

Incr RV
Decr FVC
Unchanged TLC

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129
Q

Diagnosis of methylmalonylcoA mutase deficiency

A

Elevated urine methylmalonic acid and propionic acid

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130
Q

clomilphene

A

selective estrogen receptor modulator

prevents negative feedback inhibition in hypothalamus and pituitary by circulating estrogen

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131
Q

risk factors for epithelial ovarian cancer

A 
FAM hx
infertility
nulliparity
endometriosis
PCOS
lynch syndrome
post men hormone therapy
BRCA 1 or 2 mutation
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132
Q

Total O2 content (dissolved and attached to Hb) is increased in

A

Polycythemia

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133
Q

hyperkeratosis
night blindness
growth retardation
severe eye dryness and corneal ulceration

A

vitamin A deficiency

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134
Q

Most common indicators in obesity related restrictive lung dx

A

Decr ERV and FRC

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135
Q

one ureter injury during hysterectomy

voiding in pt

A

can void normally
flank pain
fever

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136
Q

Autoantibodies ANA, anti Jo-1 can be seen in

A

Polymyositis

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137
Q

Botulinum toxin mechanism

A

Blocks Ach release into NM synapse

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138
Q

Parvovirus description

A

Non enveloped SS DNA virus

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139
Q

Causes of hypoxemia with elevated A-a

A 
R-L shunt (septal defects, pulmonary edema)
V/P mismatch (PE, COPD)
Impaired diffusion (interstitial lung dx)
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140
Q

Dermatomyositis main features

A

Autoimmune
Prox muscle weakness
Violaceous discol of upper eyelids (heliotrope rash)
Elevated CPK levels

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141
Q

Tryptase is found in

A

Mast cell —– anaphylaxis

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142
Q

accumulated HCO3 causes compensatory

A

decrease in ventilation

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143
Q

metabolic alkalosis
pH
HCO3

A

arterial pH > 7.45

bicarb > 24mEq/L

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144
Q

Stage 3 of sarcoidosis

A

Disappearance of hilar lymphadenopathy

CXR shows lung infiltrates only

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145
Q

Features of BPPV

A

Brief episodes brought on by head movement

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146
Q

metronidazole for

A

gardnerella and trichomonas

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147
Q

Patient with history of irregular menses at risk for

A

Inaccurate pregnancy dating (dating error)

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148
Q

androgen excess
hirsutism
acne
androgenic alopecia

A

PCOS

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149
Q

Emesis in duodenal atresia

A

Billous or non billous

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150
Q

Lithium used in pregnancy causes

A

Ebstein anomaly

Apical displacement of tricuspid valve leaflets

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151
Q

Biliverdin (green color) is converted to UC bilirubin by

A

Biliverdin reductase

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152
Q

Ribavirin MOA

A

Interferes with duplication of viral genetic material

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153
Q

Main distinguishing xtic in atypical depression

A

Mood reactivity (feeling better in response to positive events)

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154
Q

First step in pathogenesis of coronary artery disease involves which cells

A

Endothelial cells

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155
Q

Diagnosis of biliary atresia

A

Liver biopsy

Intrahepativ bile duct prolif, portal tract edema and fibrosis

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156
Q

FSH level incr during transition to menopause due to

A

resistant ovarian follicles

lack of feedbck from inhibin

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157
Q

Cause of meniere disease

A

Incr pressure and volume of endolymph

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158
Q

Genetic influence on short arm of chromosome 20, or X and Y chromosomes is seen in

A

Androgenic alopecia

Some are therefore X-linked recessive others are autosomal dominant

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159
Q

Generalized seizures involve

A

Both hemispheres at onset

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160
Q

albendazole is used for

A

tapeworm (cestodes)

echinococcus cysts in liver

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161
Q

Tourette disorder definitive features

A

Multiple motor and >= 1 vocal tics

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162
Q

Fibrin deposits in Bowman’s space seen in

A

Rapidly progressive glonerulonephritis

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163
Q

Initial drug of choice regardless of etiology for status epilepticus

A

IV benzodiazepines eg lorazepam

Due to its efficacy and rapid onset of action

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164
Q

Abn in men with aromatase deficiency

A

No genital abnormality

Tall stature and osteoporosis present

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165
Q

MOA of colchicine

A

Inhibits microtubular polymerization

Binds to tubulin protein that helps form microtubules, prevents aggregation

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166
Q

Esmolol MOA

A

Short acting cardioselective B1 antagonist
Decr heart rate and myocardial contractility
Not a vasodilator
Does not increase renal perfusion

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167
Q

Sheehan syndrome

A

High estrogen during pregnancy—> enlargement of pituitary gland without proportional increase in blood supply— ischemia

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168
Q

Ataxia telangiectasia mutated gene
Type of infections
Type of immune def

A

Sinopulmonary

IgA immune deficiency

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169
Q

HPV proteins E6 and E7 inhibit

A

p53 and Rb tumor suppressor genes respectively

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170
Q

most common enteric parasite in US and canada

A

Giardia

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171
Q

Early systolic high frequency click over R 2ICS

A

Aortic ejection sound (turner syndrome)

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172
Q

Preeclampsia

A

New onset incr bp at 20 wks gestation and proteinuria or signs of end organ damage

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173
Q

risk factors for post partum hemorrhage

A

prolonged labor

twin gestation

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174
Q

The genu of internal capsule carries

A

Corticobulbar fibers

And lies between anterior and posterior branches

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175
Q

treatment of prolactinoma

A 
dopamine agonist 
(bromocriptine)
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176
Q

Jejunum/ileum atresia associated with

A

Gastroschisis

177
Q

Landmark for appendectomy

A

Teniae coli

178
Q

Fever in legionella

A

> 39 degrees (102.2F)

179
Q

Neonatal features of rubella

A

Sensorineural deafness
Cataracts
Cardiac malformations (PDA)

180
Q

treatment of wiskott Aldrich syndrome

A

HLA-matched bone marrow transplantation

181
Q

MOA of sulfonylureas and meglitinides (eg glyburide)

A

Incr secretion of insulin and C-peptide from pancreas

182
Q

Cellular components of type 2 hypersensitivity

A

NK cells
Eosinophils
Neutrophils
Macrophages

183
Q

Diphenoxylate is combined with what to discourage abuse

A

Atropine

Induces adverse effects if taken in high doses

184
Q

Nitrites effect on heme

A

Convert heme Fe 2+ to oxidized ferric iron Fe3+

Fe 3+ (methemoglobin)

185
Q

Umbilical hernia is associated with

A

Down syndrome

Hypothyroidism

186
Q

prolactinoma features

A 
headache
visual field defects
decr bone density
galactorrhea
infertility ,decr libido, impotence in men
187
Q

Other features of atypical depression

A 
Leaden paralysis (arms and legs feel extremely heavy)
Rejection sensitivity (overly sensitive to slight criticism)
Increased sleep and appetite
188
Q

Humoral component of type 1 hypersensitivity

A

IgE

189
Q

Severe hypertension features

A 
Acute coronary syndrome
Intracranial or SAH
Aortic dissection 
Papilledema
Retinal hemorrhage or exudates
Encephalopathy (confusion)
Pulmonary edema
AKI (incr creatinine)
190
Q

Bilateral nodular hyperplasia and hyperfunctioning adrenal adenoma are xtic of

A

Primary hyperaldosteronism

191
Q

Fetal/emb tissue in partial hydatidiform mole?

A

Present

192
Q

Cellular component of type 4 hypersensitivity

A

T cells CD8+

Macrophages

193
Q

Deposition of inhaled corticosteroids on oral mucosa can be avoided by using

A

A spacer and rinsing mouth after inhalation

194
Q

Symptoms of neonatal abstinence syndrome

A 
Irritability 
Hypotonia
Jittery movements
Diarrhea 
Vomiting
Feeding intolerance
Sweating
Sneezing
Pupillary dilation
195
Q

Risk groups for legionellosis

A 
Elderly
Immunocompromised
Smokers
Alcoholics
Pts with COPD
196
Q

cyanide toxicity can occur in pts treated with

A

nitroprusside

197
Q

Mnemonic for LV pressure volume loop

A

MAAM
COCO

Mitral valve -close Isovol contraction (A-B)
Aortic valve -open ventricular ejection (B-C)
Aortic valve-close isovol relaxation (C-D)
Mitral valve-open vent filling (D-A)

198
Q

Treatment of absent seizure

A

Ethosuximide

199
Q

NSAIDS for acute gouty arthritis CI in PUD, alternative med?

A

Colchicine

200
Q

Screening for GBS in pregnancy

A

Weeks 35-37

Vaginal-rectal culture

201
Q

Hydralazine function

A

Direct arteriolar vasodilator

No significant effect on renal perfusion or natriuresis

202
Q

Malignant transformation of neuroendocrine cells is ass with

A

Carcinoid tumors

Eosinophilic cytoplasm, oval to round stippled nuclei

203
Q

presence of S 3 gallop

A

severe mitral regurg best indicator

204
Q

Marijuana is metabolized in

A

Liver
Distributed and stored in lipophilic tissues and slowly released

Detected in urine up to 30 days after daily use cessation

205
Q

hyperhomocystinemia is related to deficiency of

A

B12, B6, folic acid

206
Q

Prolonged untreated obstructive sleep apnea can cause

A

Pulmonary hypertension and RHF

207
Q

Converts androstenedione to estrone

And testosterone to estradiol

A

Aromatase

208
Q

Mesalamine is used for

A

Crohn’s disease

209
Q

common sources of arsenic poisoning

A

insecticides

contaminated water

210
Q

Midgut malrotation position of cecum

A

RUQ instead of RLQ

211
Q

affected patients in intraductal papilloma have no

A

associated breast mass or skin changes

212
Q

Jejunum/ileum atresia is due to

A

Vascular injury

213
Q

Duodenal atresia is due to

A

Failure of recanalization at 8-10 wks gestation

214
Q

Age of onset of Tourette syndrome

A

< 18

215
Q

In type 1 hypersensitivity there is Interaction with pre existing IgE bound to

A

Basophils and

Mast cells

216
Q

Duodenal atresia associated with

A

Down syndrome

217
Q

Diffusion capacity for carbon monoxide in emphysema is

A

Decreased

218
Q

Progesterone inhibits

A

Prolactin (negative feedback on anterior pituitary)

219
Q

Preventive measure for GBS

A

Intrapartum penicillin

220
Q

Verapamil MOA

A

Slowing phase 4 depolarization

221
Q

Candida contributes normal flora in

A

Skin
Mouth
Vagina

222
Q

Decrease uptake of iodine isotopes due to competitive inhibition

A

Perchlorate amd pertechnetate

223
Q

Side effects NOT seen with bupropion

A

No weight gain or sexual side effects

224
Q

Hypoaldosteronism can lead to

A

Type 4 renal tubular acidosis

225
Q

Heme is converted to biliverdin by

A

Heme oxygenase

226
Q

MOA of fenoldopam

A

Short acting
Selective
Peripheral dopamine 1 agonist (act adenylyl cyclase and incr cAMP) vasodil arterial beds, decr BP
Little effect on alpha 1 or beta receptors

227
Q

Hyperaldosteronism presenting signs

A

Decr plasma renin activity
Hypertension
Hypokalemia
Metabolic alkalosis

228
Q

Antibiotic for actinomyces

A

Penicillin

229
Q

Incr susceptibility to pyogenic bacteria, enteroviruses and Giardia lamblia in

A

X linked agammaglobulinemia

230
Q

Most common cause of post partum hemorrhage

A

Uterine atony (failure to contract adequately after delivery)

231
Q

Enzyme in elastin for extensive cross linking

A

Lysyl oxidase

232
Q

Low or absent circulating CD 19 and 20 B cells and panhypogammaglobulinemia in

A

X linked agammaglobulinemia

233
Q

Teratogenic meds

A 
Phenytoin
Lithium
Valproate 
Methotrexate 
ACE inhibitors
Isotretinoin
Warfarin
234
Q

Decr cerebral Perfusion in panic attacks leads to

A

Neurological symptoms

235
Q

vessels to ligate in mgt of post partum hemorrhage

A

internal iliac arteries (hypogastric arteries)

236
Q

What is neonatal abstinence syndrome

A

Withdrawal from transplacental opiates by mother

237
Q

Fewer side effect aldosterone antagonist

A

Eplerenone (use when spironolactone not tolerated)

238
Q

in treponemal serologic test (RPR) patient’s serum is mixed with solution of

A

cardiolipin
cholesterol
lecithin

detect antibodies to human cellular lipids released in2 bloodstream after destructio. by treponema

239
Q

CXR essential for diagnosis of

A

Sarcoidosis

240
Q

MOA of lorazepam

A

Incr influx of negatively charged Cl- ions in response to GABA binding
Leads to hyperpol of post syn neuron and suppression of action potential firing

241
Q

Features of vestibular neuritis

A

Single episode that can last days

Severe vertigo but no hearing loss

242
Q

Cystic medial degeneration is?

Seen in?

A

Myxomatous changes with pooling of proteoglycans in media layer of large arteries

Young individuals with Marfan syndrome

243
Q

Atypical antipsychotics with greatest risk

A

Olanzapine and clozapine

244
Q

Features of chest pain from chest wall/musc cause

A

Persistent/prolonged pain
Worse with movement or change in position
Often follows repititive activity

245
Q

mifepristone

receptor

A

progesterone antagonist

246
Q

Teratogenic effects of isotretinoin

A

Microcephaly
Small ears
Thymic hypoplasia
Hydrocephalus

247
Q

Chest pain from aortic cause

A 
Sudden
Severe tearing pain 
Radiates to back
Elderly men
HTN and risk factors of atherosclerosis
248
Q

Accumulation of edema fluid in intercellular spaces of epidermis

A

Spongiosis

249
Q

Affected systems in wegener’s

A

Vessels -Systemic vasculitis (small and medium sized)
URT -sinusitis, epistaxis, otitis
Hemoptysis
Kidneys (RPGN)

250
Q

nitroprusside is converted to

A

nitric oxide and cyanide ions

251
Q

MOA of diphenoxylate

A

Opiod antidiarrheal agent
Structure related to meperidine
Binds to mu opiate receptors in GI and slows motility

252
Q

Cervicofacial abscess

Filamentous orgs

A

Actinomyces

253
Q

Erythematous papulovesicar weeping lesions

A

Acute allergic contact dermatitis

254
Q

gardnerella vaginalis xtic

A

thin off white discharge + fishy odor
no inflammation

positive whiff test (amine odor)

255
Q

Fast acting antiarrhythmic for acute SVT

Short acting

A

Adenosine

256
Q

Stage 4 of sarcoidosis

A

Lung fibrosis

257
Q

heavy menstrual bleeding

uniformly enlarged uterus

A

adenomyosis

258
Q

pH in bacterial vaginosis and trichomoniasis

A

> 4.5

259
Q

Allergic bronchopulmonary aspergillosis ass history

A

Asthma

Cystic fibrosis

260
Q

Fas receptor is expressed on

A

T lymphocytes

Plays impt role in patho of cancer and autoimmune dx like SLE

261
Q

MOA of bupropion

A

Inhibits reuptake of NE and dopamine

262
Q

Krukenberg tumor

A

Primary gastric cancer metastasis to ovary

Nests of signet ring cells

263
Q

Chest pain from pulmonary cause

A

Sharp/stabbing pain
Worse with inspiration
Pericarditis (worse when lying flat)
Pneumothorax (resp disress, hypoxia)

264
Q 
Ring-enhancing lesion 
Respiratory symptoms 
Fever 
Headache
Acid fast beaded branching filaments
A

Nocardia

265
Q

deposition of copper in cornea and basal ganglia

A

Wilson dx

266
Q

Peptide hormone secreted by syncytiotrophoblast that leads to insulin resistance

A

Human placental lactogen (hPL)

267
Q

vaginitis with vaginal inflammation present

A

trichomoniasis

candida vaginitis

268
Q

Lip smacking may be seen in

A

Complex focal seizure

269
Q

ADH is synthesized in

A

Paraventricular and supraoptic nuclei of hypothalamus

270
Q

Drug ass with reflex sympathetic activation resulting in increased heart rate and contractility, Na and fluid retention

A

Hydralazine

271
Q

Side effect of clozapine

A

Agranulocytosis

272
Q

Second generation (atypical) antipsychotics adverse effects

A

Metabolic!!!
Weight gain, dyslipidemia, hyperglycemia
Incr risk of DM

273
Q

Warfarin not given alone. Why?

A

Warfarin decreases protein C while still having higher level of other procoagulants
Protein C half life = factor VII half life; short
As it acts against coagulation factors, also decr protein C
Leads to transient hypocoag

274
Q 
bicuspid aortic valve
broad chest
cubitus valgus
low hairline
narrow high arched palate
A

turner syndrome

275
Q

Initial empiric treatment of coagulase-negative staph should include

A

Vancomycin

If susceptibility results indicate methicillin sensitivity switch to Nafcillin or oxacillin

276
Q

> 200 CCG trinucleotide repeats in fragile X leads to

A

FMR1 hypermethylation

277
Q

Treatment of specific phobia

A

Cognitive behavioral therapy with exposure
Acute - short acting benzodiazepines (alprazolam , lorazepam, oxazepam -slow onset)
Alorazolam is xanax
Lorazepam is ativan

278
Q

placenta accreta

A

Placenta abnormally adherent to myometrium

279
Q

vaginal / vulvar itching and redness, thick white discharge

A

candida vaginitis

280
Q

Focal seizure

A

Involves 1 cerebral hemisphere at onset

281
Q

Serum sickness can occu with admin of non human proteins like

A

Chimeric monoclonal antibodies (rituximab, Infliximab)

Or non human Igs eg venom antitoxins

282
Q

histopath findings in intraductal papilloma

A

papillary cells with fibrovasc core

283
Q

Causes of increased maternal serum AFP

A

Open neural tube defects (anencephaly, open spina bifida)
Ventral wall defects (omphalocele, gastroschisis)
Multiple gestation

284
Q

decr pCO2 is seen in

A

respiratory alkalosis

<40 mmHg

285
Q

pH in candida vagjnitis

A

normal

286
Q

Neonatal complications of diabetes during pregnancy

A 
Premature delivery
Fetal macrosomia
Congenital malf (neural tube defects, CVS anomalies, caudal regression syndrome)
Respiratory distress
Transient hypoglycemia 
Polycythemia and hyperviscosity
287
Q 
irregular menses
glucose intolerance/ diabetes
metabolic syndrome
obesity
acanthosis nigricans
A

PCOS

288
Q

Causes of left shift in O2 -Hb dissociation curve

A

Decr temperature
Incr pH (decr H+)
Decr 2,3 BPG

289
Q

patient with idiopathic intracranial htn usually a

A

young obese woman

with pseudotumor cerebri

290
Q

Preformed mediators in mast cells

A

Histamine

Tryptase

291
Q

Medical conditions with polygenic inheritance (variable expressivity)

A 
Androgenic alopecia
Glaucoma
Epilepsy
Schizophrenia 
Hypertension 
Ischemic heart disease
Type 2 DM
292
Q

Germ tubes at 37 degrees for 3hrs seen with

A

Candida

293
Q 
Tremors
Anxiety 
Perceptual disturbances
Insomnia
Psychosis 
Withdrawal symptoms of
A

Benzodiazepines

294
Q

Diffuse muscle contractions of limbs followed by rhythmic jerking seen in

A

Tonic clonic generalized seizure

295
Q

Treatment of hypertensive emergency

A

Fenoldopam

296
Q

CO2 a potent cerebral vasodilator exerts most significant effect in

A

Panic attacks

297
Q

Jejunum/ileum atresia emesis

A

Billous emesis

Abd distension seen

298
Q

First line treatment of acute gouty arthritis

A

NSAIDS eg Indomethacin

299
Q

21 hydroxylase catalyzes conversion of

A

Progesterone to 11 deoxycorticosterone

300
Q

Side effect of carbamazepine and valproate

A

Bone marrow abn

301
Q

Good pasture syndrome hypersensitivity type

A

Type 2

302
Q

Myoclonic generalized seizure

A

No loss of consciousness or post ictal state

303
Q

Complete hydatidiform mole is p57

A

Negtive

304
Q

MOA of desmopressin

A

Incr circulating factor 8 levels

Stimulates vWF secretion from endothelial cells

305
Q

Differentials of chest pain

A 
Coronary artery disease 
Pulmonary/pleuritic(pleurisy, pneumonia, pericarditis, PE)
Aortic (dissection, intramural hematoma)
GI/esophageal
Chest wall/musc
306
Q

Partial pressure of O2 is normal in

A

CO poisoning
Anemia (low Hb)
Polycythemia

307
Q

Med for exacerbations of crohn’s disease

A

Prednisone

308
Q

Hemophilia A responds to which med

A

Desmopressin (DDAVP)

309
Q

MCC of congenital torticollis

A

Birth trauma

Malposition of head in utero (4rm macrosomia or oligohydramnios)

310
Q

Features of serum sickness

A

Fever
Pruritic skin rash
Low serum C3 and C4 levels

311
Q

Absolute risk reduction calculation

A

ERcontrol - ERtreatment

ER - event rate

312
Q

Ectopic pregnancy with no evidence of rupture

Treatment

A

Single dose methotrexate

313
Q

Marijuana use symptoms

A 
Tachycardia 
Conjuctival injection
Incr appetite 
Dry mouth
Inappropriate laughter
Mild euphoria
314
Q

treatment of arsenic poisoning

A

dimercaprol

DMSA (succimer)

315
Q

Presence of cANCA is typical in

A

Wegener’s (granulomatosis with polyangitis)

316
Q

Modt common opportunistic mycosis

A

Candida

317
Q

Principal cause of high RBC chloride content in venous blood

A

Chloride shift

HCO3 diffuse out of RBC in2 plasma and cl diffuse into RBC to maintain electrical neutrality

318
Q

Vocal tics of tourette disorder

A 
Grunts
Snorts
Throat clearing
Barking
Yelling
319
Q

Immediate and long term treatments of panic disorder

A

Immediate - benzodiazepines

Long term- SSRI / SNRI and/or CBT

320
Q

Other indicators in obesity related restrictive lung disease

Residual volume?

A

Decr FEV1
Decr FVC
Decr TLC

RV is normal

321
Q

Contractile function is decreased in which non valvular heart disease?

A

IHD

Dilated cardiomyopathy

322
Q

Treatment of juvenile myoclonic epilepsy

A

Broad spectrum anticonvulsant (eg valproic acid)

323
Q

Which org develop in old lung cavities

A

Aspergillus

324
Q

associated features of narcolepsy

A

hypnagogic or hypnopompic hallucinations

sleep paralysis

325
Q

Cyt P450 inhibitors

A 
Incr warfarin effect 
Incr bleeding risk
Acetaminophen, NSAIDs
Antibiotics/Antifungals eg metronidazole 
Amiodarone 
Cimetidine 
Cranberry juice, Ginkgo biloba, Vitamin E
Omeprazole
Thyroid hormone
SSRIs eg Fluoxetine
326
Q

common org in septic abortion

A

s.aureus

gram neg bacilli

327
Q

Most common elbow injury in children

A

Radial head subluxation (nursemaid’s elbow)

Mostly 1-4 yr olds

328
Q

Screening for gestational diabetes is more accurate in

A

3rd trimester

329
Q

gap junctions important during

A

labour and delivery

require coordination of individual myometrial cells

330
Q

clindamycin to substitute metro in

A

bacterial vaginosis (gardnerella)

331
Q

Increased septal thickening is present in

A

Hypertrophic cardiomyopathy

332
Q

Hypertensive urgency

A

> = 180/120

333
Q

Deposition of inhaled glucocorticoids on oral mucosa in asthma leads to

A

Oropharyngeal candidiasis

334
Q

Lab findings of biliary atresia

A

Incr conjugated bilirubin and

Gamma glutamyl transferase

335
Q

Phase 3 blocked by

A

Class 3 Antiarrhythmics
Amiodarone
Sotalol
Dofetilide

336
Q

Panic disorder is

A

Recurrent

Unexpected panic attacks + >= 4 of the list of features

337
Q

narcolepsy meaning

A

recurrent relapses into sleep or naps

min 3 times/WK for 3 months

338
Q

Panic attack xtic

A 
Hyperventilation
Decr pCO2 (hypocapnia)
339
Q 
Nausea
Vomiting
Abd cramping
Muscle aches 
Withdrawal symptoms of
A

Heroin

340
Q

2 Features of polymyositis

A

Symmetrical proximal muscle weakness

Incr diff climbing stairs, getting up 4rm chair, carrying heavy obj

341
Q

Mast cell high affinity IgE receptor

A

FCERI

342
Q

Drugs with high intrinsic hepatic clearance have

A

High lipophilicity and high volume of distribution

343
Q

Features of fragile X syndrome

A

Macroorchidism
Dysmorphic facies
ADHD
ASD (delayed language acquisition and poor social skills)

344
Q

CAG trinucleotide repeats are seen in

A

Huntington’s disease

345
Q

Partial hydatidiform mole is p57

A

Positive

346
Q

Complications of polymyositis

A

Interstitial lung dx

Myocarditis

347
Q

Partial pressure of oxygen is

A

Amount if oxygen dissolved in plasma

348
Q

incr HCO3 is seen in

A

metabolic alkalosis

> 40 mmHg

349
Q

Radial head subluxation occurs from

A

Pull on the hand while forearm is pronated and elbow extended

350
Q

Tonic clonic generalized seizure

A

Loss of consciousness and post ictal state

351
Q

Acute myelogenous leukemia is associated with

A

Down syndrome

352
Q

Causes of hypoxemia with normal Alveolar to arterial gradient (A-a)

A

Hypoventilation (OHS, neuromusc disorders)

Low inspired fraction of O2 (high altitude)

353
Q

Colonic atresia associated with

A

Hirschsprung dx

354
Q

Hypertensive emergency is

A

Severe hypertension with end organ damage

355
Q

Dobutamine MOA

A 
Beta 1 agonist
Gs protein
Adenylyl cyclase
Incr cAMP
Ca2+ activation
356
Q

Vivid dreams
Depression
Fatigue
Are findings in withdrawal of

A

Stimulants

357
Q

Chemicals released from degranulation of cells in type 1 hypersensitivity

A

Histamine

Heparin

358
Q

Med for gouty arthritis that reduces formation of LTB4

A

Colchicine

359
Q

Aortic regurg best heard where?

Patient position?

A

Along left sternal border at 3rd and 4th ICS while sitting up and leaning forward

360
Q

Legionellosis symptoms

A

High fever
Confusion, headache
Diarrhea

361
Q

primary risk factor for ectopic pregnancy

A

Tubal scarring

Prior N.gonorr and C.trach infection

362
Q

Incr AFP level is seen in

A

Fetal neural tube defect
Twin gestation
Abd wall defects
Underest of gestational age

363
Q

confirmatory test for treponema

A

FTA-ABS

364
Q

Features of primary hyperaldosteronism

A

Incr aldosterone
Incr sodium
Decr k reabs
Decr H reabs

365
Q

Secondary oocytes arrest at

A

Metaphase of meiosis 2 until fertilization

366
Q

idiopathic intracranial htn symptoms

A

daily headache
bilateral papilledema
transient visual disturbance
symptoms worsen during valsava (cough, bending) due to incr ICP

367
Q

Features of methemoglobin (Fe3+)

A

Binds tightly to cyanide
Causes dusky skin discoloration
Cannot carry O2

368
Q

Most common inherited cause of intellectual disability

A

Fragile X syndrome

369
Q

Features of biliary atresia

A

Jaundice with first 2 months of life
May appear healthy at birth
Dark urine
Acholic stools (pale or clay colored)

370
Q

Carcinoid tumor on e-microscopy

A

Multiple dense core granules in cytoplasm which contain vasoactive molecules eg Serotonin, histamine, bradykinin and hormones eg gastrin

371
Q

Robertsonian translocation is seen in

A

Down syndrome

46 XX t(14;21)

372
Q

uses of loperamide

A

some cases of traveler’s diarrhea

no fever or blood in stool

373
Q

med for infertility prob in PCOS

A

clomiphene

374
Q 
Contaminated water
Cruise ships
Spas
Hospitals
Air conditioned hotels
Orgs?
A

Legionella

375
Q

Features of PICA ischemia

A

Vertigo/nystagmus (vestibular nucleus)
Ataxia (inferior cerebellar peduncle)
Loss of pain and temperature in ipsilat face and contralat body
Ipsilat horner syndrome (sympathetic fibers inn head)

376
Q

cervical intraepithelial neoplasia features

A

atypical squamous cells

expansion of immature basal cells to epithelial surface

377
Q

Sensitivity calculation

A

a/a+c
TP/TP+FN
Rules out of the normal population (SNOUT)

378
Q

Fas receptor pathway

A

Extrinsic pathway of apoptosis

379
Q

Biliary atresia is

A

Progressive
Complete or partial obstruction of extrahepatic bile ducts
Normal biliary tree at birth

380
Q

cyanide antidotes

A 
hydroxocobalamin (directly binds cyanide)
sodium nitrite (methemoglobinemia induction)
sodium thiosulfate (detoxifying sulfur donors)
381
Q

Nitroglycerin function

A

Rapid acting vasodilator

Decrease preload and CO

382
Q

Med to prevent hemorrhagic disease of newborn

A

Vitamin K

383
Q

Metabolic acidosis
Hypertension
Hypokalemia are present in

A

Primary hyperaldosteronism

384
Q

presentation of septic abortion

A 
fever
chills
lower abd pain
bloody or purulent discharge
boggy and tender uterus + dilated cervix
385
Q

Treatment of generalized seizure

A 
Broad spectrum 
Lamotrigine 
Levetiracetam (keppra)
Topimarate
Valproic acid
386
Q

Unconjugated bilirubin is converted to conjugated bilirubin by

A

Glucuronyl transferase

387
Q

Types of ALL

A

Precursor B cell and T cell types
Bcell -CD 19 and CD 10 +ve
T cell - CD 1,2,5 +ve

388
Q

Risk factor for placenta accreta

A

Scar tissue from previous surgery (C-delivery) can result in malformed or absent decidual layer between placenta and myometrium

389
Q

Eclampsia

A

Preeclampsia + new onset grand mal seizures

390
Q

Contact dermatitis

Type of hypersens?

A

Type IV (delayed)

391
Q

Average hPL incr with increasing

A

Gestational age

392
Q 
male
eczema
recurrent infections
thrombi cut open is
B and T cell deficiency
A

wiskott Aldrich syndrome

393
Q

med that inhibits microtubules of roundworms (ascaris, ancylostoma, enterobius)

A

mebendazole

394
Q

Thickening of stratum spinosum

A

Acanthosis

395
Q

Humoral component of type 3 hypersensitivity

A

Deposition of Ag-Ab complexes

396
Q

V/P in pulmonary embolism

A

V/P mismatch

Hypoxemia

397
Q

kallman syndrome features

A

primary amenorrhea
absent secondary sexual xtics
olfactory sensory defect

398
Q

normal vaginal pH

A

3.8 to 4.5

399
Q

Features of congenital torticollis

A

Head tilted toward affected muscle
Contracted SCM muscle
Chin points away from contracted muscle

400
Q

Ambiguous (virilized) genitalia at birth in females and normal genitalia in males

A

21 hydroxylase deficiency

401
Q

Contact dermatitis

Hypersensitivity type

A

Type 4

402
Q

Treatment of tourette syndrome

A

Antipsychotics
Alpha 2 adrenergic agonists
Behavioral therapy

403
Q

69 XXX or XXY
Normal to high beta hCG
Normal uterine size
Seen in

A

Partial hydatidiform mole

404
Q

Globus pallidus and putamen are separated from thalamus by

A

Posterior limb of internal capsule

405
Q

Panic disorder involves 4 or more of the following

A 
Chest pain , palpitations, SOB, choking
Dizziness, paresthesias
Trembling, sweating, nausea, chills
Derealization, depersonalization
Fear of losing control or dying
Worry about additional attacks, avoidance behavior
406
Q

Elevated muscle enzymes CK and aldolase are seen in

A

Polymyositis

407
Q

Cause of vestibular neuritis

A

Inflammation of vestibular nerve

Labyrinthitis

408
Q

treatment of PCOS

A

weight loss
combination contraceptives
metformin

409
Q

Radial head subluxation results in

A

Injury/tear to annular ligament attached to radial neck

By age 5 annular ligament bcms thick and strong, decrd likelihood of tear

410
Q

IVF to achieve pregnancy in

A

turner syndrome

411
Q

Two-sample t test for

A

Means of 2 populations

412
Q

loperamide class

A

opiate antimotility drug

413
Q

Raised, scaly plaques are from

A

Thickening of spinosum and corneum

414
Q

TLC in chronic bronchitis is

A

Normal

415
Q

Treatment of focal seizure

A 
Narrow spectrum 
Carbamazepine 
Gabapentin
Phenobarbital 
Phenytoin
416
Q

FRC in chronic bronchitis is

A

Increased

417
Q

Immunological finding in polymyositis

A

Incr expression of MHC 1 on sarcolemma
leads to autoantigens to CD8 cells
Then myocyte destruction

418
Q

Bethanechol use

A

Post op urinary retention (music agonist)

419
Q

Caspofungin MOA

A

Targets cell wall

CASpofungin (case)

420
Q

Diastolic function is decreased in

A

Hypertensive heart disease

Hypertrophic cardiomyopathy

421
Q

Cellular component of type 1 hypersensitivity

A

Basophils

Mast cells

422
Q

Aldosterone antagonists are

A

Spironolactone

Eplerenone

423
Q

Humoral component of type 2 hypersensitivity

A

IgG and IgM autoantibodies

Complement activation

424
Q

Which IL inhibits TH1 cytokines
Reduces MHC 2 expression
Suppresses activated macrophages and dendritic cells

A

IL 10

425
Q

Decreased Maternal serum AFP is seen in

A

Aneuploidies

Trisomy 18 and 21

426
Q

Choriocarcinoma

A

Malignant form of gestational trophoblastic disease composed of anaplastic cytotrophoblasts and syncytiotrophoblast without villi

427
Q

Before using warfarin, start with

A

Heparin/LMWH which will decrease the procoag forces transiently until other coagulation factor levels fall

428
Q

Amniotic fluid embolism histology

A

Pulmonary artery branch with swirls of fetal squamous cells

429
Q

presentation of cyanide toxicity

A 
altered mental status
seizures
CVS collapse
lactic acidosis
bright red venous blood
430
Q

Cholesteatoma

A

Collection of squamous cell debris that form round pearly mass behind tympanic membrane in middle ear

431
Q

Treatment of neonatal abstinence syndrome

A

Opiod therapy eg
Morphine
Methadone

432
Q

Dyskeratosis

Found in? DX?

A

Squamous cell carcinoma

433
Q

Screening for malabsorptive disorders

A

A qualitative assay of stool with sudan III stain

434
Q

Another name for aldosterone-producing adrenal adenoma

A

Conn syndrome

435
Q

Primary oocytes arrest at

A

Prophase of meiosis 1 until ovulation

436
Q

ALL features

A

TdT +ve

PAS +ve material

437
Q

Severity of manic episode may include

A

Psychotic features (hallucinations, delusions)

438
Q

TLC is emphysema is

A

INCREASED

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