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UWorld > Set 3 (Derm, MSK, Hep) > Flashcards

Set 3 (Derm, MSK, Hep) Flashcards

1
Q

Secrete membrane bound vesicles into hair follicles rather than directly onto skin

A

Apocrine gland

Smelly

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2
Q

Achondroplasia: inheritance

A

Sporadic 85%

Autosomal DOMINANT 15%

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3
Q

Asboe-Hansen sign

A

bullae spread laterally w/ pressure

Seen in pemphigoid vulgaris

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4
Q

Nikolsky sign

A 
new bullae form w/ gentle traction
(Seen in pemphigoid vulgaris)
or 
Skin slipping off w/ gentle pressure 
(Seen in SSSS)
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5
Q

Connexin defects underlie some specific forms of?

A

Palmoplantar keratoderma

Deafness-associated ichthyosis

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6
Q

What has PTH receptors?

A

Osteoblasts

Which produce M-CSF, RANK-L

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7
Q

Glycogen degradation is coupled w/?

A

Skeletal muscle contraction

due to calcium-mediated myophosphorylase activation

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8
Q

Fever, urticaria, arthralgias, GN, LAD, LOW serum C3 5-10d after intravascular exposure to antigen

A 
Serum sickness (Type 3 hypersensitivity)
(complement-fixing immune complexes, vasculitis)
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9
Q

Liver sulfate conjugation

A

into more POLAR drug for excretion

Ex: phenol, chloramphenicol

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10
Q

Liver hydroxylation

A

CYP 450 oxidation rxn –> LESS lipid soluble

Ex: Pentobarbital, phenobarbital

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11
Q

Liver hydrolysis

A

Involve: esterase, amidase
Ex: Procaine, lidocaine, ASA

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12
Q

Plasma hydrolysis

A

Inactivate drug rapidly

Ex: Succinylcholine, tetracine, remifantanil

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13
Q

Drug-induced lupus: what type of liver metabolism?

A

N-acetylation

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14
Q

Thiazide: A/E

A

HYPOkalemic metabolic ALKalosis
HYPERuricemia (hypovolemia stimulates absorptino)
HYPERlipidemia
HYPERglycemia (decrease insulin secretion)

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15
Q

Main toxin produced by C. perfringens

A

Lecithinase (Alpha toxin):

degrades lecithin (phospholipid membranes) –> cell death and widespread necrosis/hemolysis

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16
Q

T cell and macrophage infiltration of peripheral NERVOUS tissue causing segmental demyelination

A

Guillain-Barre syndrome

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17
Q

Autoantibody binding causes _______to receptors

A

Complement-mediated destruction

Ex: myasthenia gravis

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18
Q 
Osteoporosis
Amenorrhoea
Enlarged parotid gland
Lanugo (fine downy body hair)
Bradycardia, HYPOtension
Cardiac atrophy
A

Anorexia nervosa (binge/purge type)

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19
Q

Branched-chain ketoacid dehydrogenasse deficiency

A

Maple syrup urine disease

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20
Q

homogentisic acid oxidase deficiency

A

Alkaptouria (AR)

pigments deposits in CT throughout body

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21
Q

Perifollicular hemorrhage

Coiled (corkscrew) hairs

A

Scurvy

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22
Q

Vitamin C and collagen synthesis

A

Post-translational modification in RER (hydroxylation)

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23
Q

Thymidine kinase-deficiency VZV: tx

A

Foscarnet (pyrophosphate analog viral DNA polymerase inhibitor)
or
Cidofovir (nucleotide, only cellular kinases required for activation)

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24
Q

deposition of UNmineralized osteoid

A

VitD deficiency (osteomalacia, or rickets)

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25
Q

Subperiosteal thinning

A

Hyperthyroidism

Resorption of CORTICAL bones

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26
Q

Irregular sections of lamellar bones linked by cement line

A

Paget’s disease of bone

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27
Q

Persistence of primary, unmineralized spongiosa in medullary canals

A

Osteopetrosis

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28
Q

“Currant jelly” sputum

A

Klebsiella

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29
Q

Influenced by disease prevalence

A

PPV, NPV

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30
Q

Annular scaling plaque w/ well-demarcated, raised erythematous borders and central clearing

A

Tinea corporis

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31
Q

Tx of dermatophytosis

A

Terbinafine

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32
Q

Terbinafine: MOA

A

Inhibit synthesis of ergosterol by suppressing enzyme squalene epoxidase

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33
Q

Amphotericin B and Nyastatin: MOA

A

Polyene antifungals: binds to ergosterol

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34
Q

Caspofungin: MOA

A

Echinocandin antifungals
Blocks synthesis of Beta (1,3)-D-glucan
(main component of Candida and Aspergillus cell wall)

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35
Q

Griseofulvin: MOA

A

Binds ot pomerized MT and disrupts fungal mitotic spindle (prevent mitosis)

ONLY effective in dermatophytosis

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36
Q

Flucytosine: MOA

A

Antimetabolite antifungal
(transform into 5-FU –> inhibit protein synthesis by replacing uracil)
(for SYSTEMIC fungal infections)

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37
Q

Femoral head and neck; blood supply

A

Inferior and superior gluteal artery
Medial and lateral femoral circumflex

(Medial is largest contributor; vulnerable to damage due to close a/w posterior femoral neck)

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38
Q

Acanthosis

A

Increase in thickness of stratum spinosum

Psoriasis

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39
Q

Dyskeratosis

A

Abnormal premature kertinization of keratinocyte
Strongly eosinophlic
(Squamous cell carcinoma)

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40
Q

Hyperparakeratosis

A

Retention of nuclei in stratum corneum

ex: actinic keratosis; normal in mucous membranes

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41
Q

Hypergranulosis

A

Excessive granulation in stratum granulosum

Ex: lichen planus

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42
Q

Spongiosus

A 
Intercellular epidermal edema (increase in width btwn cells)
Eczematous dermatitis (contact dermatitis)
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43
Q

Seborrheic dermatitis
Glossitis
Peripheral neuropathy

A

Pyridoxine deficiency (B6)

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44
Q

VitB12 necessary for?

A

Synthesis of methionine

Synthesis of succinyl CoA

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45
Q

Soft tissue and joint hemorrhages

A

Hemophilia A

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46
Q

Musculocutaneous n.

A

C5-C7
Flexors of UPPER arm
Sensory innervation to LATERAL forearm

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47
Q

Sjogren syndrome is a/w?

A

Parotid gland enlargement.

Increased risk of non-HL.

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48
Q

Paradoxically increased in SLE patients despite propensity twd thrombosis.

A

PPT

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49
Q

Systemic sclerosis: antibody

A

Anti-DNA topoisomerase I (Scl-70)

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50
Q

____degrade intracellular protein.

____degrade extracellular protein.

A

Proteasome: intracellular.
Lysosome: extracellular.

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51
Q

High PTH

Low calcium

A

Renal failure
or
VitD deficiency

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52
Q

Osteoporosis: labs

A

NORMAL!

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53
Q

Contact dermatitis vs. Atopic dermatitis: hypersensitivty

A

Contact: type 4

Atopic dermatitis: type 1

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54
Q

Sarcoidosis: hypersensitivity

A

Type 4

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55
Q

Hypersensitivity pneumonitis: hypersensitivity

A

Type 3

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56
Q

Sustained, involuntary muscle contractions, which force certain parts of body into abnormal, sometimes painful movements or postures

A

Dystonia

impaired fxn of basal ganglia

57
Q

spasmodic torticollis

A

Focal dystonia (cervical)

58
Q

blepharospasm

A

Involuntary forcible closure of eyelids
(initial sx: uncontrollable blinking)

Example of focal dystonia.

59
Q

Pathologic myoclonus (sudden, brief, sometimes severe muscle contraction)

A

Epilepsy

Creutzfeldt-Jakob disease

60
Q

Contralateral injury in or near subthalamic nucleus

A

Hemiballism

61
Q

Weakness of quadriceps muscle
Loss of patellar reflex
Loss of sensation over anterior and medial thigh and medial leg

A

femoral nerve injury

difficulty w/ stairs, “knee buckling”

62
Q

Gram negative rod
Oxidase +
NON-lactose fermenting

A

Pseudomonas aeruginosa

63
Q

Tx: P. aeruginosa

A

CefePIME
CeftaziDIME
(use penny and dime to treat “air”)

Ticarcillin, Pipercillin

Certain aminoglycoside, fluoroquinolone (cipro, levo), carbapenems (imi, mero)

64
Q 
DOC for:
Pneumocystis jiroveci
Toxoplasma gondii
Nocardia
Stenotrophomonas maltophilia
A

TMP-SMX

65
Q

Lichenification in flexural distribution

A

Atopic dermatitis

66
Q

Hallmark of atopic dermatitis

A

Intense pruritis

67
Q

Midsystolic click

late systolic murmur

A

MVP

68
Q

Pretibial myxedema
Thinning of hair
Alopecia areata
Hyperhidrosis

A

Hyperthyroidism (cutaneous manifestations)

69
Q

Peptid ulcer disease can be a/w

A

MEN1

Wermer syndrome

70
Q

Xanthelasma occur in a/w?

A 
Primary or Secondary hyperlipidemia
Cholestatic conditions (ex: PBC)
71
Q

Dactylitis

A

Painful swelling of hands and feet

Common presentation in Sickle cell disease in YOUNG children –> DECREASED haptoglobin

72
Q

Median nerve: location

A

w/ brachial artery in groove between biceps and brachialis

Btwn humeral and unlar heads of pronator teres

Btwn flexor digitorum superficialis and flexor digitorum profundus

73
Q

Loss of thenar eminence

“Ape hand” deformity

A

median n. injury @ wrist

74
Q

Btwn flexor carpi ulnaris and flexor digitorum profundus

A 
Ulnar nerve
(injury= "claw hand" due to paralysis of intrinsic m. of hand)
75
Q

Bisphosphonate: MOA

A

Structural analogues of pyrophosphate (component of hydroxyapatite) –> make hydroxyapatite more insoluble.

Decrease bone resorption by interfering w/ osteoclasts.

76
Q

Bisphosphonate: use.

A

Osteoporosis.
Paget’s disease of bone
Malignancy-induced HYPERcalcemia.

(fasting state w/ plenty of water due to poor bioavailability, upright to prevent reflux esophagitis)

77
Q

Unmineralized osteoid matrix
Widened osteoid seams
Harrison’s sulci
Craniotabes (softening of skull)

A

Rickets

78
Q

Hematogenous osteomyelitis

A

m/c in children

Metaphysis of long bone (slower blood flow, capillary fenestrae)

79
Q

Upper respiratory infection followed by diarrhea

A

Rotavirus

80
Q

Tx of ascites 2/2 cirrhosis

A

Restriction of Na intake

Furosemide + spironolactone

81
Q

Factor 9 deficiency

A

hemophilia B

X-linked recessive

82
Q

Hypoxanthine phosphoribosyltransferase deficiency

A

Lesch-Nyhan syndrome
(X-linked recessive)
(hypoxanthine –> IMP, and guanine –> GMP; purine salvage)

83
Q

Leber hereditary optic neuropathy: inheritance

A

Mitochondrial

84
Q

Galactose-1-phosphate uridyltransferase gene affeted

A 
Classical galactosemia
(autosomal recessive)
85
Q

Antibodies in celiac disease cause clinical dz by?

A

x-reacting w/ reticulin (anchoring fibrils of epidermal BM)

86
Q

STD

White, umbilicated papule on penis, vulva, groin

A

Molluscum contagiosum (poxvirus)

87
Q

Erythema multiforme: classic target lesions suggests this as m/c etiology

A

Herpes simplex infection

88
Q

2 eukaryotic promotors

A

1) TATA (Hogness) box: 25 nucleotides upstream.

2) CAAT box: 70-80 bases upstream

89
Q

anti-HBsAg

A

When hepatitis B infection begins to resolve

90
Q

Anti-HBcAg: protective?

A

NO

91
Q

Hepatocellular carcinoma: which hepatitis virus is most associated?

A

HepB

92
Q

Acneiform eruptions: what drugs can cause this?

A

Methyltestosterone
EGFR inhibitors
Lithium

93
Q

Ephedrine

A

Sympathomimetic for:
Bronchial asthma
Stimulant, appetite suppressant, decongestant.

94
Q

k-RAS mutations are common in?

A

Pancreatic malignancies.

95
Q

N-myc

A

Transcription factor

96
Q

Protein kinase A regulates target protein activity via?

A

Phosphorylating SERINE and THREONINE.

97
Q

DNA glycosylase

A

Base excision repair.

98
Q

Southwestern blot

A

DNA-bound protein

99
Q

Northern blot

A

mRNA

100
Q

Hepatitis B viral genome replication

A

dsDNA –> + RNA (template) –> dsDNA (progeny)

101
Q

Poliovirus viral genome replication

A

+ssRNA –> -ssRNA (template) –> +ssRNA (progeny)

102
Q

Viral genome replication:
Influenza
Measles
Rabies

A

-ssRNA –> +ssRNA (template) –> -ssRNA (progeny)

103
Q

Parvovirus B19 viral genome replication

A

ssDNA–> dsDNA (template) –> ssDNA (progeny)

104
Q 
viral genome replication:
papvavirus
adenovirus
herpesvirus
poxvirus
A

dsDNA –> dsDNA (template) –> dsDNA (progeny)

105
Q

Lipodystrophy
HYPERglycemia
P450 INhibitor

A

A/E of all protease inhibitor (anti-retrovirals)

106
Q

Zidovudine

A

Nucleoside reverse transcriptase inhibitor (NRTI)
(Suppression of DNA synthesis from viral RNA)

A/E: bone marrow toxicity –> anemia

107
Q

MAC infection in HIV: tx

A

Azithromycin

108
Q

CMV infection in HIV: tx

A

Foscarnet

A/E: nephrotoxicity, electrolyte disturbances (HYPOcalcemia, HYPOmagnesemia, HYPOkalemia)

109
Q

m/c/c of death in patient with TCA poisoning

A

Cardiac arrythmias

tx: sodium bicarbonate

110
Q

Barbiturate poisoning: tx

A

Diuretic

Urinary alkalinization

111
Q

Acetominophen toxicity: tx

A

N-acetyl cysteine

112
Q

Hypoglycemia following fructose ingestion

A

Aldolase B deficiency

113
Q

GALT defciency

A

Classic galactosemia

vomiting, lethargy, failure to thrive after breastfeeding begins

114
Q

Galactosemia can result in?

A

Impaired liver fxn
HYPERchloremic metabolic ACIDosis
Aminoaciduria

115
Q

Galctokinase dficiency: m/c manifestation

A

Cataract

116
Q

t1/2=

A

0.7Vd/CL

117
Q

Glycogen accumulation in lysosomal vesicles

A 
Acid maltase (alpha glucosidase) deficiency
(Type II: Pompe's disease)
118
Q 
Hepatomegaly, Cardiomegaly
Macroglossia, HYPOtonia
Mental retardation
Glycogen accumulation in lysosomes
NORMAL blood sugar levels
A 
Acid maltase (alpha glucosidase) deficiency
(Type II: Pompe's disease)
119
Q

Hepatomegaly
HYPOglycemia, Lactic acidosis
Hyperlipidemia, Hyperuricemia
Increased glycogen storage but NORMAL structure

A

Glucose-6-Phosphate deficiency
(Type 1: Von Gierke’s disease)
(involves ONLY liver b/c NOT present in muscle)

120
Q

Poor exercize tolerance
Muscle cramping, pain, rhabdomyolysis during exercise
No rise in blood lactate after exercize
HIGH level of glycogen in muscle

A

Muscle glycogen phosphorylase deficiency

Type 5: McArdle’s disease

121
Q 
Hepatomegaly
Growth retardation
HYPOglycemia
HYPERlipidemia
Muscle weakness
A

Debranching enzyme deficiency

Cori or Forbes disease

122
Q

Galactokinase deficiency: main manifestation

A

Cataract

123
Q

Chronic hemolytic anemia
Splenomegaly
Poor exercize tolerance

A

Pyruvate kinase deficiency

124
Q

Production of larger protein w/ altered fxn but preserved immune reactivity

A

Splice site mutation

125
Q

Can hepatocyte utilize ketone bodies?

A

NO, lack succinyl-CoA-acetoacetate CoA transferase (thiophorase)

(other cells that cannot utilize ketones: cells w/o mitochondria: erythrocytes)

126
Q

PolyA tail is transcribed from DNA?

A

NO, added as post-transcriptional modification downstream of consensus sequence (AAUAAA)

127
Q

TPN-induced gallstones

A

1) biliary stasis (2/2 decreased CCK release)

2) ileal resection: distrubance of enterohepatic bile acid circulation

128
Q

Hepatic adenoma

A

Women + lengthy history of OCP use.
Abdominal pain
Can rupture and cause intra-abdominal bleeding

129
Q

Reye’s syndrome is characterized histologically by?

A

Micovesicular steatosis

130
Q

Serious acetominophen overdose: histology

A

Centrilobular necrosis (that can extent to ENTIRE lobe)

131
Q

Interlobular bile ducts: florid duct lesion

granulomatous inflammation

A

Primary biliary cirrhosis

132
Q

Acantholysis

A

Loss of cohesion btwn keratinocytes in epidermis or adnexal structures
(Ex: Eczematous dermatitis)

133
Q

Urticaria is characterized by?

A

Superficial DERMAL edema, lymphatic channel dilation

NO epidermal changes

134
Q

reddish-pink
periodic acid-Schiff-positive granules
resist digestion by diatase

A

A1AT

135
Q

Myoglobinemia
Weakness following exercize
Elevated muscle TG
HYPOketonemia

A

Skeletal muscle carnitine deficiency

136
Q

Hypoglycemia

Hypoketonemia

A

Median chain acyl-CoA dehydrogenase deficiency

MCAD deficiency

137
Q 
Elevated ALP
NORMAL GGTP (gamma-glutamyl transpeptidase)
A

Problem with BONE

NOT in liver; since GGTP is is liver, NOT bone

138
Q

Followup of moderately elevated ALP of unclear etiology

A

GGTP

UWorld (17 decks)

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