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UWORLD facts > test A > Flashcards

test A Flashcards

1
Q

MOA of physostigmine

A

cholinesterase inhibitor

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2
Q

Atropine MOA and where does it work

A

competitive inhibitor of acetylcholine-like agents that acts at the muscarinic receptors of smooth muscle cells

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3
Q

Anticholinergic syndrome symptoms

A

fever, dry skin and mucous membranes, flushing, mydriasis and cycloplegia (blurred vision) and altered mental status.

hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter

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4
Q

jimson weed acts similarly to what drug

A

Atropine (both are anticholinergic)

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5
Q

What cell type produces IL-2

A

exclusively produced by antigen-stimulated T lymphocytes

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6
Q

what chromosomal translocation is commonly seen in APL?

A

t(15;17)

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7
Q

what is the treatement for APL

A

all trans retinoic acid

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8
Q

in what neoplasm are auer rods seen

A

APL

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9
Q

what is the translocation in Burkitt lymphoma

A

t(8;14)

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10
Q

what is the translocation in CML

A

t(9;22)

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11
Q

what is the translocation seen in ALL

A

t(12;21)

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12
Q

what is the translocation seen in follicular lymphoma

A

t(14;18)

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13
Q

which cells are responsible for binding epithelial cells together?

A

cadherins

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14
Q

what are desmosomes made of

A

cadherins

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15
Q

what is extracelluar domains of cadherins depended on

A

calcium (lack of calcium will lead to dissociation of cadherin mediated junctions causing loss of cell-cell adhesion)

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16
Q

what is responsible for cell adhesion to the basement membrane

A

hemidesmosomes (which rely on integrins and are calcium independent)

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17
Q

what does a biopsy of mulliscum contagiosum show

A

epidermal hyperplasia + molluscum bodies (large eosinophilic cytoplasmic inclusions made of virus particles)

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18
Q

what artery is commonly injured during an ACL or PCL tear

A

popliteal artery

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19
Q

what is the defense mechanism sublimation

A

channeling impulses into socially acceptable behaviors (channeling rage into a sport)

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20
Q

what is the defense mechanism reactive formation

A

responding in a manor that is opposite to ones actual feelings

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21
Q

what do Craniopharyngiomas form from and what major symptom may this cause

A

Rathke’s pouch reminants (the ectodermal orgain of the anterior pituitary)

cause bitemporal hemianopia (loss of peripheral vision)

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22
Q

what muscle and nerve injury can lead to a winged scapula

A

long thoracic nerve (via penetrating trauma or surgical procedures (axillary lymph node drainage) leads to paralysis of the serratus anterior muscle

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23
Q

what test diagnosis hereditary spherocytosis

A

osmotic fragility test - blood samples are exposed to decreasing strengths of saline solution and the degree of hemolysis is measured. RBCs in pts with hereditary spherocytosis have increased susceptibility to HYPOtonic saline compared to normal due to the decreased surface area to volume ratio. (therefore they will have a higher percentage of hemolysis)

24
Q

what are the main features of hereditary spherocytosis and how do you treat it

A

splenomegaly, jaundice and bilirubin gallstones

treat with a splenectomy to decrease hemolysis which occurs in the spleen

25
Q

what are common presenting signs of Mysthenia gravis

A

ptosis, diplopia, dysarthria, dysphagia and fatiguable chewing

26
Q

what thyroids problems are common in pts with mysthenia gravis

A

hyperplastic thyroids and thyoma (rarely), thymectomy may benefit the pts

27
Q

what are the common clinical symptoms of DiGeorges syndrome

A

Conotruncal cardiac defects (tetralogy of Fallot, truncus arteriosus, interrupted aortic arch)
abnormal facies
thymic hypoplasia/aplasia (T-cell deficiency)
craniofacial deformities (cleft palate)
hypocalcemia/hypoparathyroidism

28
Q

what is the pathogenesis of DiGeorges syndrome

A

chromosome 22q11.2 deletion causing defective development of pharyngeal pouches

29
Q

what happens to sodium and potassium during DKA

A

loss of sodium causes hyponatremia and the lack of insulin and acidemia causes hyperkalemia

30
Q

what drug should be used pre-operatively for a pheochromocytoma and how does it work

A

Phenoxybenzamine - an irreversible long acting, a-adrenergic blocker (prevents peripheral vasoconstriction and hypertensive crisis during surgery)

31
Q

what causes intraventricular hemorrhage in newborns

A

weak vascular network of the germinal matrix

32
Q

what is Misoprostol used to treat and its mechanism

A

treats peptic ulcer disease by acting as a PGE1 analog (receptor agonist) to stimulate gastric epithelial cell mucus production

33
Q

what is palmitoylation

A

process in which fatty acids are covalently anchored to plasma membrane cysteine residues to increase the hydrophobicity of a protein

34
Q

what is the purpose of a N-terminal peptide sequence

A

it indicates for a protein to directed to the RER (without it the protein would accumulate in the cytosol)

35
Q

what compound is found in the urine of a child with maple syrup urine disease? what is the acid base status?

A

keto-acids are in the urine, the pt has a metabolic acidosis

36
Q

what enzyme is deficient in maple syrup urine disease? and what cofactor does it require

A

branched chain alpha-keto acid dehydrogenase complex therefor they are unable to degrade branched chain alpha-amino acids.

requires thiamine pyrophosphate (vit B1)

37
Q

which amino acids are unable to be degraded in maple syrup urine disease

A

leucine, isoleucine and valine and must be avoided in the diet

38
Q

what kind of hemoglobin is seen in alpha-thalassemia major

A

hemoglobin Barts (4 gamma chains) leads to hydrops fetalis

39
Q

how does alpha-thalassemia minor appear on blood smear

A

hypochromatic and microcytic due to decreased hemoglobin and an imbalance of globin chains

40
Q

what protein maintains the high concentration of testosterone in the testes? what type of cell produces it?

A

androgen-binding protein produced by the sertoli cells in response to FSH

41
Q

what cell types are stained by Red safranin O

A

cartilage, mast cell granules, and mucin

42
Q

what are 2 types of catecholamine-secreting tumors

A

pheochromocytoma (adrenal medula) and a paraganglioma (aorta)

43
Q

what is the break down product of catecholamines

A

vanillylmandelic acid (VMA)

44
Q

what enzyme is deficient in medium chain acyl-CoA dehydrogenase deficiency

A

Acyl CoA dehydrogenase (the first step of beta oxidation that provides acetyl-CoA to the TCA and cycle and to ketone production)

45
Q

what is the rate limiting enzyme of fatty acid synthesis

A

Acetyl-CoA carboxylase

46
Q

how does medium chain acyl-CoA deficiency typically present?

A

in the first few years of life with N/V, seizures, liver dysfunction and hypoketotic hypoglycemia after prolonged fasting

47
Q

what drug can reduce the secretion of bioactive peptides by a carcinoid tumor reducing symptoms of flushing and diarrhea? and what is its MOA

A

octreotide - a somatostatin analog

48
Q

what is the method of internal ribosome entry and when is it used

A

its an alternative method of translation initiation that functions without eukaryotic initiation factors (eIFs). It allows for binding of the ribosome to the mRNA during apoptosis when eIFs are degraded

49
Q

describe the corse of the right and left recurrent laryngeal nerves

A

they come off of the vagus nerve. The right loops below the right subclavian. The left loops under the aortic arch. They both then course superiorly to the intrinsic muscles of the larynx

50
Q

which muscles does the recurrent laryngeal artery innvervate

A

posterior cricoarytenoid, lateral cricoarytenoid, oblique arytenoid, transverse arytenoid, thyroarytenoid

51
Q

where can you find unmyelinated neurons

A

postganglionic autonomic nervous system axons, afferent neurons that conduct heat sensation, afferent neurons that transmit dull, bunring or visceral pain, and first order bipolar sensory neurons of olfaction

52
Q

describe the course of reactive arthritis

A

genitourinary infection followed 2-6 weeks later by acute back pain, monoarthritis, and conjunctivitis. The joint aspirates are sterile since the disease is caused by immune complexes not disseminated infection (infectious agent is Chlamydia trachomatis)

53
Q

describe the inheritance of Prader-Willi syndrom vs Angelman syndrome

A

Prader-willi syndrome results from a loss of paternal genes from chromosome 15q11-13

Angelman syndrome results from a loss of maternal genes at the same spot on chromosome 15q11-13

both can be due to either a microdeletion (detected via FISH) or uniparental disomy

54
Q

describe the clinical features of Prader-Willi vs Angelmans

A

Prader-Willi - neonatal hypotonia, hyperphagia/obesity, short stature, small hands & feet, hypogonadism, dysmorphic facies, intellectual disability

Angelmans - Epilepsy/seizures, ataxic gait/tremors, poor motor and language development, inappropriate laughter/smiling, intellectual disability

55
Q

what are the affects of pilocarpine

A
  • contracts the ciliary muscle increasing aqueous humor outflow
  • accommodation of the lens (becomes more round)
  • activates the sphincter pupillae to cause pupil constriction
    (its a cholinomimetich)
56
Q

what is the enzyme defect in Gauchers disease

A

B-glucocerebrosidase

57
Q

what are the clinical signs of Gauchers disease

A

Hepatosplenomegaly, pancytopenia, bone pain/osteopenia

UWORLD facts (7 decks)

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