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Uworld > Test May 29th > Flashcards

Test May 29th Flashcards

1
Q
A

Kaposi Sarcoma HHV-8
= usually immunosuppressive or corticosteroid use
= skin red papules + pulmonary disease nodular cheery red

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2
Q
A

Adenocarcinoma pulmonary

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3
Q
A

Pneumocystis Jirovecii

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4
Q
A

Carcinoid Tumor pulmonary

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5
Q

Small Cell Carcinoma

  1. Type of cells
  2. Associated diseases
A
  1. Sheets of small blue cells, neuroendocrine markers (NCAM, Neural cell adhesion molecule CD56, Chromogranin)
  2. SIADH, Cushing, Lambert Eaton (proximal muscle weakness improves by day or stimulation)
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6
Q

Epidermal GF receptor gene mutation

  1. Causes what
  2. Responds to what drug
A
  1. Non small cell cancer ADENOCARCIOMA

2. Responsiveness to Tyrosine kinase inh. (Erlotinib, Afatinib)

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7
Q

1, Vimentin

2. KRAS

A
  1. Sarcoma

2. Prostate or colorectal cancer

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8
Q

2 types of gout

A
  1. Ca Pyrophosphate ( square, + bifringent)

2. Monosodium urate (needle like , - bifringent)

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9
Q
A

Ca Oxalate crystal

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10
Q

HIV :

  1. Attachment
  2. Bind to T-cell
  3. Fusion
  4. Tat, Rev, Nef, Vpu, Vpr, Vif
A
  1. gp120
  2. CCK5 + CHEMOKINE RECEPTOR **
  3. gp41
  4. Tat = viral transcription, REv = unsliced viral transcription from nuc to cyto, Nef = down reg CD4 cells recognition, Vpu = viral assemble release, VPR = nuclear enters + stop division, VIF = increase viral infectivitity
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11
Q

HIV : drugs

  1. Block CCK5 chemokine receptor
  2. Block GP 41
  3. Protease inh.
  4. Integrase Inh.
  5. Reverse Transcriptase Inh.
  6. Non-reversible Transcriptase inh.
A
  1. Maraviroc = inhibit fusion
  2. Enfuviritide = inhibit fusion
    • navir (hyperglycemia, Cushing like), Darunavir
      4 . -gravir , Raltegravir
  4. Abacavir = hypersensitivity, Emtricitabine (macular rash palms soles) , Zidovidine (anemia, BM toxic)
  5. Efavirenze + Nevirapine ( Steven Johnson syndrome, Epidermal necrosis)
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12
Q

Paroxysmal supraventricular Tachy due to

A

No organized AV conduction = reentrant circuit formed (from slow circuit not getting blocked by fast circuit)

  1. Hypotension = ventricular diastole shortens = less filling
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13
Q

Atria remodeling causing

A

Atrial fib, (ectopic foci in pulmonary vein ostia)

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14
Q
  1. Sick sinus syndrome

2. Delayed repolarization pf ventricular cardiomyocytes can casue

A
  1. SN node degeneration,

2. Torsades

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15
Q

Long QT syndrome

A

Abnormal K+ channels outward flow,

= die from ventricular arrhythmias and torsades

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16
Q

HCM mutations

A 
Sarcomere genes (myosin binding protein C, Beta myosin heavy chain gene) 
AD
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17
Q

Dilated cardiomyopathy mutation + 3 other causes

A

Titin mutation ,

can also happen from chagas, doxyrubicin , coxsackie virus

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18
Q

Drug against PD-1
Drug against Poly-ADP ribose polymerase (repairing single stranded dna breaks)
Rituximab moa

A
  1. Pembrolizumab
  2. Olaparib
  3. Against B-cells
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19
Q

Innervation to glut max and glut med/min

A
  1. Glut max = Inferior Gluteal N ( X climb stairs or rising from chair)
  2. Glut men/min = Superior glut N (trendelenburg sign)
20
Q

Antifungals

  1. Cell membrane
  2. Cell wall
  3. Dna
A
  1. a = inhibit ergosterol synthesis (AZOLES + they also uppers P450)
    B= bind to ergosterol ( Amphotericin B, Nystatin + cause pore /cell lysis)
  2. -Fungins, (prevent 1,3-beta D GLUCAN synthesis
  3. Flucytosine ( increases Amphotericin B = Cryptococcal meningitis)
21
Q

Desmopressin MOA 2 of them

A
  1. Increase vWF + F8

2. Bind to V2 on renal tubular cells, increasing aquaporin channels (DI and nocturnal enuresis) = helps reabsorb water

22
Q

Laryngeal obstruction = tripod posture means

A 
Inspiratory stridor **
Expiratory stridor ( Tracheomalacia, treachery construction)
23
Q
  1. Phenylketonuria
  2. Alkaptonuria
  3. Cystinuria
  4. Maple syrup syndrome
A
  1. X phenylalanine Hydroxylase ( Phenalalanine —x—> Tyrosine) intellectual probs, (can also be due to dihydropteridine reductase = no BH4 —> BH2)
  2. X Homogenrisic Acid Dioxygenase (Tyrosine —x—> Fumarate) Homogentisic acid accumulation happens giving BLACK color and black urine
  3. X renal cystine transport ( flank pain and kidney stones child, or itching lysine arginine also) , tx: alkaline urine
  4. X break down branched AA ( Leucine, Isoleucine, VAline) , sweet urine sweat, seizures cerebral edema
24
Q

Plt rich thrombi on heart valves due to

A

Malignancy ( Mucinous. Adenocarcinoma ) burns, Anti-phospholipid syndrome, DIC

25
Q

Giant cell arthritis risk of

A

Venous thromboembolic disease (Temporal A)
+ Anterior ischemic optic neuropathy ( CN2 ischemia supplying posterior ciliary As)

TX : glucocorticosteroids

26
Q

CN 1-12 (where it comes from and foramen)

A

CN1. Cribiform plate
CN2. . Optic canal
CN3 . MIDBRAIN, Superior Orbital fissure (asym pupils)
4 = MIDBRAIN , Superior Orbital fissure (vertical diplopia)
5 = PONS V1(Superior Orbital fissure) V2 (foramen rotundum) V3 (foramen ovale)
6= PONS, Superior Orbital fissure
7= PONS, Internal Auditory Meatus , facial canal
8= PONS Internal Auditory Meatus ( head position stabilize gaze and movement NYSTAGMUS causing)
9 = MEDUALLA Jugular Foramen
10 = MEDUALLA Jugular Foramen
11 = MEDUALLA Jugular Foramen
12 = MEDUALLA Hypoglossal canal

27
Q

Least oxygenated area vessel in entire body

A

Coronary sinus draining coronary As into RA ( only increases coronary BF can increase heart coronary A oxygenation)

28
Q

DM causes

A

Metabolic Acidosis

29
Q

Group A vs Group B strep

A

Group A : Complete hemolysis = beta hemolytic, expresses cytolysins (Streptolysin O) (M- protein virulence factor) , TX : AMOXICILLIN
Group B : incomplete hemolysis

30
Q

HPV causing warts and what do you check next

A
  1. HPV 6, 11

2. Check HIV

31
Q

Condylomata Lata what and DX how

A
  1. Syphilis , dense lymphoplasmacyic infiltrate

2. Dark field Microscopy

32
Q

Trisomy 21 proteins

A

APP (Amyloid Precursor Protien )*** = causes AD (chr 21 has this gene)
Amyloid Beta plaques

33
Q

CAG gene repeats

A

HTT (huntingtin)

34
Q

Apolipoprotein E epsilon 4

A

High risk of late onset AD

35
Q

Black gallstones cause

A

Increase bilirubin
= B-glucuronidase increased = increase in unconjugated bilirubin = CA biliruinate precipitaion ( infection or hemolytic anemia)

36
Q

Fibrates

A

Inhibit 7a-Hydroxylase = cholesterol —> bile acids, increase cholesterol stones risk (nonpigmented gallstones)

37
Q

Low bone density and high calcium = anemia

A

Malignancy or osteoclasts (multiple myeloma) = lower OPG which increases RANK activity

38
Q

Osteomyelitis DX how

A

MRI gold standard ( staph aureus usually)

39
Q 
MESSENGERS 
A1
A2
B1
B2
M2
M3
A

A1 : increases IP3 (vasoconstrict, pupil dilation, urethral constriction)
A2 : decrease cAMP (de GI motility + insulin)
B1 : increase cAMP (In HR, renin)
B2 : increase cAMP (bronchodilate, vasodilate)
M2 : decrease cAMP (de HR)
M3 : increase IP3 (bronchoconstrict, INC GI motility + insulin, pupil dilation)

40
Q

Mycophenolate

A

Inh inosine 5-monophosphate dehydrogenase (X de novo purines) = prevent lymphocyte proliferation

AD EF: lymphopenia, D

41
Q

Allopurinol and Febuxostat

A

Xanthine Oxidase inhibitor (inh cellular proliferation with 6-mercaptopurine accumulation)

42
Q

Tacrolimus and Cyclosporine

A

Inhibit IL2 transcription ,

43
Q

Glucocorticoids (prednisone) MOA

A

Inhibit NF-kB = low IL2 and other cytokine transcription

44
Q

Siroliumus MOA

A

mTOR inhibition (rapamycin) interruption IL2 signaling transduction

45
Q

Tumor Lysis Sydnrome TX

A

Allopurinol (only prevent further crystals) , if uric acid is over 8 give Rasburicase (gets rid of current crystals)
= give fluids

46
Q

Anti bacterial inh 50s and 30s

A
  1. 50s MACROLIDES

2. 30s TETRACYCLINES

Uworld (7 decks)

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