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Uworld > Test May 30th > Flashcards

Test May 30th Flashcards

1
Q

sarcoidosis findings and labs

A 
(Can happen in young AA, cough,sob) 
Bilateral hilar adenopathy****
1. Elevated ACE = elevated VitD = elevated Ca+2
2. Non-caseating granuloma 
3. CD4+ cells involved activating M
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2
Q

Insulin activates what pathways

A
  1. PI3K (glycogen/lipid/protein synthesis) : Protein phosphatase - glycogen making (dephospholylaed glycogen synthase)
  2. RAS/MAPK (growth, dna synthesis)
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3
Q

JAK kinase used for

A

GH, prolactin, cytokines

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4
Q

Lipoxygenase

A

Arachidonic acid metabolism - synthesis of LEukotriens

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5
Q

Phospholipids C does what

A

Activated by G protein /IP3/ Ca+2

PLC degrades phospholipids to IP3 + Diacylglycerol ( DAG and Ca+2 activated PKC)

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6
Q

PKA used for

A

Glycogen breakdown when glucagon binds

= glycogen phosphorylase activated

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7
Q

LIVER metabolism of

  1. Fructose
  2. Mannose
  3. Galactose
  4. Glucose
A
  1. . Fructose = fructose 1-phosphate by fructokinase and then done
  2. Enters as M6P —> F6P into glycolysis
  3. Enters as G1P—> G6P into glycolysis
  4. Enters glycolysis as G6P
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8
Q

Classical PAthway
Alternative Pathway
Lectin pathway

A
  1. Bacteria + IgG/IgM = C1(q,r,s) = C2, C4 = C3 (Common for SLE)**
  2. C3 = C3a + C3b = Factor B/D and C3B = C3
  3. Mannose rich + C1 like complex (MBL, MASP) = C2, C4 = C3
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9
Q

CREST :

Ca, Raynauds, Esophageal dysmobility, Sclerodactyly, Telangiectasia

A

Esophageal dysmobility = atrophy and fibrous replacement of Muscularis in Lower Esophagus , dilating LES = heartburn

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10
Q

Diffuse Esophageal spasm

A

Contractions of LES from impaired inhibitory innervation in myenteric plexus = dysphagia and CP (food not going down to stomach right)

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11
Q

Microtubule drugs

A
  1. Vinca alkaloids (veincristiene + Vinblasteine ) = bind to monomers = no mitosis separation
  2. TAxanes (Paxlitaxel) = microtubule dysfunction
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12
Q

Podophyllin

A

Treat genital warts

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13
Q

Methotrexate

A

Inhibits dihydrofolate reductase

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14
Q
  1. Etoposide

2. Irinotecan + Topotecan

A
  1. Inhibit Topoisomerase 2

2. Inhibit Topoisomerase 1

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15
Q

Sofosbuvir + Ledipasvir

MOA and use

A 
HepC
Inhibits viral genome replication and assembly 
1. Sofosbuvir = inhibit RNA polymerase 
2. Ledipasvir = inhibit NS5A 
3 . Simeprevir = inhibit protease
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16
Q

Olsetavir MOA

A

Prevent Viron release from infected cells

= tx flu

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17
Q

Pancreas

  1. Secretin secretes what
  2. Trypsinogen secreted by what stimulation
A
  1. HCO-3 = lowering Cl-

2. CCK and Ach increases this

18
Q

O2 and CO2 pressures remain same and HR + CO increased when

A

Exercise

19
Q

Pregnancy
Elevated AFP
Lowered AFP

A
  1. High AFT : tri 13, tri 18 (NTD, Ventral wall probs like omphalocele) + holoprosencepaly (tri13)
  2. Low AFT : tri 21, Duodenal atresia (recanalization problem) + Hirschprungs (NCC, rectum, ) , T1D, VSD/ASD, early AD (APP), hypothyroid, atlantoaxial instability
20
Q

Brachial Plexus pneumonic of ends

A

MARMU (musculocutaneous, axial, radial, medial, ulnar)
1. Radial = humoral shaft injury, wrist and fingers down extend
2. Medial = pronation , first 3 fingers, thumb opposition
3, Ulnar = thumb abduction, finger abduction and abduction(not thumb)

21
Q

what is increased in ACE inh that causes cough

A

Bradykinin

22
Q

Kidney action

  1. BB
  2. ACE inh
  3. ARBs
A
  1. BB = block renin
  2. Blocks ACE (increasing renin and angiotensin 1) (decreasing angiotensin 2 and aldosterone)
  3. Blocks Angiotensin 2 (increase Angiotensin 2, angiotensin 1, renin) (decrease aldosterone)
23
Q

What nerves beyond splenic FLEXURE

A

S2-S4

External sphincter - puededal nerve branch

24
Q

Acute pericarditis causes

A
  1. Viral MOST COMMON

2. .autoimmune (SLE, RA)

25
Q

What INCREASED in COPD And Bronchitis And Emphysema

A

Function Residual Capacity, Residual Volume, TLC

26
Q

UV light and Dietary vitD and liver does what and kidney

A
  1. UV = 7-dehydrocholesterol —> Vit D2 /Vit D3
  2. Diet = VitD2/ VitD3
  3. Liver D3 /D2 —>25-hydroxyvitD (25-Hydroxylase)
  4. Kidney : 1a-hydroxylase : 25-hydroxyvitD—> 1,25- dihydroxyvitD
27
Q

Meningitis in immunocompromised

A 
Cryptococcal meningitis (cryptococcal neoformans) 
= yeast + polysaccharide capsule 
= Meningioencephalitis 
= India ink
= Amphotericin B
28
Q

Germ tubes

A

Candida , true hyphe
= oval budding yeast
= normal oral flora

29
Q

Aortic Arches

A 
1 = Maxillary A 
2 = Hyoid A, Stapedial A
3 = common carotid + proximal internal carotid 
4 = left : aortic arch , right : proximal right subclavian A
6 = PDA, proximal pulmAs
30
Q

PDA closure drug

A

Indomethacin (PGE2 synthase inhibitor)

31
Q

Pseudomonas

A

Gram - bacilli , Oxidase + , green pigment Pyocyanin (oxidase - = BARTONELLA Henselae, car scratch )

Red itchy rash from hot tubs

32
Q

Sevelamer + lanthanum

A

Reduce phosphorous GI absorption (usually in CKD = cant excrete it)
1. Increases serum phosphate with low CA = secondary hyperthyroidism

33
Q

TX:

  1. Vestibular N (motion sickeness)
  2. Nausea with migraine
  3. Normal N
  4. Carcinoid D
A
  1. H1 antagonist (diphenhydramine/ meclizine)+ anti-Ach (scopolamine)
  2. Dopamine antagonist (metoclopramide, prochlorperazine)
  3. 5HT antagonists (Odensetron)
  4. Somatastatin agonist (octreotide)
34
Q

Hereditary Hemochromatosis

A

HFE gene inactivating mutation = X hepcidin ( Fe is always let into BVs from GI)

35
Q

ARDS risk factors

A

Pancreatitis
Pneumonia , sepsis
Trauma
= high N

36
Q

ARDS what happens

A

Inflammation causing alveolar cap leakage (NEUTROPHILS** ROS and proteases) , il1, il6, TNF-a
= pulm edema (intrapulmonary shunting)
= LOW functional residual Volume (helped by + end expiratory pressure ventilation which opens closed alveoli)

37
Q
  1. Long thoracic nerve innervates

2. Thoracodorsal Nerve

A
  1. Axilary LN dissection, Serratur Anterior (winging of scapula)
  2. Altissimo dorsi (shoulder extension adduction and internal rotation)
38
Q

Histo

A

Ovoid yeast narrow based budding

= pneumonia

39
Q

CD40 is seen

A
  1. APC presented to Th1 CD4 cell

2. B cell presented to Th2 CD4 cell = class switch

40
Q
  1. AML markers
  2. Hodgkin lymphoma markers
  3. ALL
A
  1. CD33, CD13, auer rods (myeloid)
  2. CD15, CD30 + Mediastinal MASS
  3. Child : Bcells, Adult : Tcells ( CD3, Tdt+) + Mediastinal MASS
    Tdt = immature T cells and B cells
41
Q 
Thrombotic Microangiopathy (Thrombocytopenic Thrombotic Purpura) TTP 
PENTAT
A
  1. plt activation (thrombocytopenia)
  2. Microvascular thrombosis (renal failure)
  3. Fever + lethargy
  4. Anemia
  5. Schistocytes

= LONG Bleeding time only Normal. PT/PTT

42
Q

Toxoplasmosis neonate SX

A
  1. Chorioretinitis, Hydrocephalus, intracranial Calcifications

Uworld (7 decks)

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