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UWorld QBank > Self Assessment > Flashcards

Self Assessment Flashcards

1
Q

Stages of ARDS

A

Also called diffuse alveolar damage but starts with perialveolar endothelial damage

1) Exudative phase (fluids damage alveolar walls)
2) Proliferative phase (edema resolution and type II pneumocytes proliferation)
3) SOMETIMES fibrotic phase (diffuse pulmonary fibrosis and cyst formation)

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2
Q

Cardiac conduction speeds

A

His-Purkinje > atrial > ventricular > AV nodal

AV node located at interatrial septum near the right AV orifice

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3
Q

Osteosarcoma location and radiological findings

A

Femur > tibia > humerus

Sunburst pattern and Codman triangle

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4
Q

Globus hystericus

A

SAME as globus sensation
Feeling of difficulties swallowing despite negative radiological and endoscopic findings of dysfunction
Linked to emotional stress, psych disorders and GERD

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5
Q

Why gout causes flairs

A

Monosodium urate crystals normally covered with ApoE or ApoB protective coating
Fluctuation or trauma causes uncoating and antigenic exposure - > neutrophil activation and inflammation

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6
Q

Germline mosaicism

A

Suspect when disease present in offsprings but not the parents
Involves genetic mutations early in embryonic development

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7
Q

Osteogenesis imperfecta inheritance pattern

A

Autosomal dominant

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8
Q

Molluscum contagiosum infection

A

Children - through fomites (face, neck, trunk, axilla)
Adults - sexually transmitted (trunk, anogenital)
Immunocompromised - prolonged course and widely distributed papules numbering in the hundreds

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9
Q

Knee dislocation injury

A

Popliteal artery because it is closest to the articular surface and is bound proximally and distally by the adductor magnus and the soleus respectively
Penetrating injuries more likely to damage the tibial nerve

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10
Q

Most common bacteria in postpartum endometritis

A

Bacteroides species

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11
Q

Post-nephretomy recovery

A

Initial drop of 50% total GFR but quickly recovers to 80%

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12
Q

Vasomotor rhinitis

A

Chronic nasal congestion triggered by abrupt changes in temperature, humidity or strong odors (also comes with headache and sinusitis occasionally)

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13
Q

Nummular eczema

A

Associated with xerosis (dry skin) and exacerbated by environmental irritants
Typically presents as coin-shaped pruritic erythematous eruptions

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14
Q

Cocaine abuse

A 
Atrophic nasal mucosa
Nasal septal thinning 
Chronic nasal discharge
Nasal septal perforations
Osteolytic sinusitis
Headaches
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15
Q

HSV encephalitis

A

Tends to affect the temporal lobe
Unique features include olfactory hallucinations, anosmia, personality changes, aphasia, delirium, bizarre behaviors, temporal lobe seizures and hemiparesis

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16
Q

AIP Inheritance pattern

A

Autosomal dominant
Defect in hydroxymethylbilane synthase (AKA porphobilinogen deaminase)
Urine darkens upon exposure to sunlight but person does not experience cutaneous photosensitivity

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17
Q

Diagnosis on the causes of pleural effusion

A

Light’s criteria (must mean at least one of three)
1) Ratio of pleural protein to serum protein > 0.5
2) Ratio of pleural LDH to serum LDH > 0.6
3) Pleural LDH is above 2/3 upper limit of serum LDH
Minor criteria
Pleural to serum albumin difference > 1.2 g/dL

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18
Q

Osmotic fragility testing for RBCs

A

Increased fragility in hereditary spherocytosis (due to decreased surface area to volume ratio)
Decreased fragility in thalassemias and sickle cell (due to

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19
Q

Echinocytes vs acanthocytes

A

Burr cells vs Spur cells
Echinocytes have smaller and more uniformly distributed spicules all around the perimeter of the RBC
Acanthocytes have bigger, fewer and more irregular spikes that are unevenly distributed on the RBC surface

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20
Q

Echinocytes

A

Usually a laboratory artifacts due to sample preparation
But can be associated with disease
1) Uremia
2) Pyruvate kinase deficiency

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21
Q

B12 and folate deficiency

A

Both are susceptible to depletion in alcoholics and elderly
B12 depleted over the course of years
Folate depleted over the course of weeks
While hematological abnormalities are reversible, B12-related neurological issues are IRREVERSIBLE
Folate supplementation alone without B12 when patient is B12 deficient can actually worsen demyelination and cause abnormal myelin synthesis

22
Q

Multiple sclerosis shock

A

Lhermitte phenomenon

Shock-like sensation shooting down the spine radiating to the feet upon neck flexion

23
Q

Paraneoplastic myasthenias

A

Myasthenia gravis = 60% thymic hyperplasia and 10% thymoma
Lambert-Eaton myasthenic syndrome = small-cell lung carcinoma (more extremities weakness vs axial/girdle and also typically older patient with smoking history)

24
Q

Infective arthritis organisms by group

A

Children < 2 y/o = Hemophilus influenza B
Adolescents = Staph aureus
Teenagers and adults = Neisseria gonorrhoeae
Elderly = Staph aureus
Sickle-cell patients = Salmonella

25
Q

DKA electrolytes

A

Glucose UP
Potassium UP
(Decreased insulin to drive K+ into cells; H+/K+ increased exchange in a-intercalated cells in the CCT; H+K+ increased exchange at cell membranes)
Sodium DOWN
(Despite hypovolemia and body trying to preserve sodium and water, the osmotic diuresis from glucose drags sodium and water out of the body; for every 100 mg/dL glucose increase, Na+ decreases 1.6 mEq/L)

26
Q

Dandy-Walker syndrome

A

Cerebellar vermis absence or hypoplasia leading to trunk ataxia and abnormal coordination
Fourth-ventricular cyst leading to hydrocephalus and macrocephaly
Abnormally enlarged posterior fossa; can be associated with polydactyly, urogenital malformations and cardiac defects

27
Q

Allelic vs genetic vs phenotypic heterogeneity

A

Allelic heterogeneity = different mutations in the same gene cause similar but different phenotypes
Genetic heterogeneity = mutations in different genes cause similar phenotypes
Phenotypic heterogeneity = mutations in the same gene causes different phenotypes

28
Q

Bronzing in hemochromatosis

A

Autosomal recessive
Disease is usually not observed until over 20g total iron
Dermal hemosiderin deposits provides skin with bronze
Impotence, arthropathy, cardiac enlargement/dysfunction

29
Q

Achondroplasia

A

Autosomal dominant inheritance pattern
Mutation in FGFR3 on Chr 4 (gain-of-function)
FGFR3 normally inhibits chondrocyte proliferation

30
Q

Exceptions to the sympathetic postganglionic rule

A

1) Sweat glands (acetylcholine)
2) Arrector pilorum muscle (acetylcholine)
3) Renal vasculature (dopamine)
4) Adrenal medulla (acetylcholine)

31
Q

Secretion mechanisms

A 
Eccrine = merocrine (vesicular content release)
Mammilary = apocrine (apical buds)
Sebaceous = holocrine (entire cell buds off)
32
Q

Platelet activating factor (PAF)

A 
High doses
1) Vasoconstriction
2) Bronchoconstriction
3) Platelet aggregation and microthrombi formation
Low doses
1) Vasodilation
2) Leukocyte adhesion and diapedesis
3) Degranulation and oxidative burst
Acts through Gq and increases IP3
33
Q

Red man syndrome

A

Rapid vancomycin infusion causes nonspecific mast cell degranulation that is NOT IgE dependent

34
Q

Blue sclera

A

1) Osteogenesis imperfecta
2) Menkes syndrome
3) Progeria

35
Q

Bile acid alternative function

A

Because they are amphipathic, bile salts also function to disrupt plasma membranes and is bactericidal
Patients with chronically blocked common bile ducts can develop bacterial overgrowth

36
Q

Eukaryotic ribosomal subunits

A

80S total
60S = 28S, 5.8S and 5S
40S = 18S
28S+18S+5.8S transcribed from a single gene by RNA polymerase I and 5S transcribed separately by RNA polymerase III

37
Q

Prokaryotic ribosomal subunits

A

70S total
50S = 23S and 5S
30S = 16S

38
Q

Delusional disorder

A

Presence of “non-bizarre” delusions for more than one month. Non-bizarre delusions are those that are strange but nonetheless possible. Person has preserved social and occupational functioning.
If another person of close relation also has the same set of delusions, then it would be diagnosed as shared psychotic disorder.

39
Q

Peripheral insulin resistance vs. impaired glucose tolerance

A

1) Peripheral insulin resistance means tissues respond poorly to insulin but increased pancreatic release is able to keep the blood glucose levels normal
2) Impaired glucose tolerance means that despite max pancreatic insulin secretion, blood glucose can rise to abnormally high levels

40
Q

Lichen sclerosus and atrophicus

A

White plaques surrounding the vulvular area and skin thinning; caused by autoimmune inflammatory condition involving autoantibodies against ECM components
Pruritis, dyspareunia, pain on defecation
Can lead to disfigurement and squamous cell carcinoma
Treat with high-dose corticosteroids

41
Q

ATN nephrotoxins

A

1) Aminoglycosides
2) Heavy metals
3) Radiocontrast
4) Amphotericin B
5) Myoglobin/hemoglobin
6) Bence-Jones protein

42
Q

Prader-Willi syndrome

A

P = you NEED the paternal allele of chromosome 15

1) Hyperphagia
2) Neonatal hypotonia
3) Short stature
4) Small hands and feet
5) Hypogonadism

43
Q

Dermatitis herpetiformis pathophysiology

A

Anti-gliadin IgA and IgG cross-reacts with reticulin, a component of fibrils needed to anchor the epidermis to the superficial dermis
Neutrophil recruitment leads to inflammation, edema and destruction at the dermal papillary tips and micro-abscess formation -> coalesce into subepidermal blisters

44
Q

Callus layer

A

Callus is restricted to the stratum corneum

45
Q

Puromycin

A

Aminonucleoside antibiotic

Mimics aminoacyl-tRNA and accepts the growing polypeptide chain and dissociates

46
Q

Alternative causes of acanthosis nigricans

A

Benign conditions include insulin resistance and obesity
If the acanthosis has the following characteristics:
1) Sudden onset
2) Rapid spread
3) Affects mucosal surfaces and/or the palms and soles
The likelihood of an underlying GI tract malignancy or lung cancer is high (stomach, liver, intestinal etc)

47
Q

Gaucher disease

A

Most common lysosomal storage disease
Most common genetic disorder in Ashkenazi jews
Autosomal recessive mutation in glucocerebrosidase

48
Q

Aspergillus morphology

A

Acute angle septated hyphae

Occasionally forms “broom-like” structures called conidiophore project

49
Q

Hand-food-genital syndrome

A

Mutation in HoxA13

1) Clinodactyly
2) Short thumbs
3) Small feet
4) Short great toes
5) Genitourinary defects (female: GU tract duplication; male: hypospadias)

50
Q

Waardenburg syndrome

A

Mutation in Pax3

1) Heterochromia irides (different iris colors)
2) Poliosis (white patches of head hair, eyebrow or lash; also present in 60% of tuberous sclerosis)
3) Dystopia canthorum (lateral displacement of the medial canthus, giving the appearance of wide nose)
4) Deafness

51
Q

Why maxillary sinus is the most commonly infected

A

The path of drainage for the maxillary sinus is above the floor of the sinus and thus unaided by gravity

UWorld QBank (2 decks)

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