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U World Questions Flashcards

1
Q

Blotchy red muscle fibers on Gomori stain are characteristic of

A

Mitochondrial myopathies
Abnormal mitochondria accumulate under the sarcolemma of muscle fibers –> fibers have an irregular shape and size on cross-section

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2
Q

Delayed separation of the umbilical cord;
recurrent cutaneous infections without pus formation;
poor wound healing;
dx?

A

defect in CD18 - Leukocyte adhesion deficiency

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3
Q

HTN classes that reduce mortality in patients with HF

A

ACE inhibitors
ARBs
Prevent cardiac remodeling

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4
Q

Common causes for Candida vaginitis (5)

A 
Antibiotic use
high estrogen levels ie during pregnancy
systemic corticosteroid therapy
uncontrolled DM
immunosuppression ie HIV
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5
Q

What vascular beds develop the highest burden of atherosclerosis?

A

lower abdominal aorta

coronary arteries

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6
Q

Excess phenylalanine inhibits:

A

tyrosinase, required for the downstream production of melanin;
lack of melanin - fair complexion seen in PKU (deficiency of phenylalanine hydroxylase)

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7
Q

Intellectual disability by 6 months;
Seizures
Eczema
Light skin/hair

A

PKU (also musty body odor)
inability to convert phenylalanine to tyrosine
tx with tyrosine in diet, restrict phenylalanine in diet

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8
Q

Name the branched chain amino acids:

A

Leucine
Isoleucine
Valine
elevated in MSUD - deficiency of branched-chain alpha-ketoacid dehydrogenase complex

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9
Q 
Feeding difficulties
Seizures
Cerebral edema
Sweet odor of urine
Dx?
A

MSUD

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10
Q

The C5-C6 spinal nerves mediate what reflexes?

A

Biceps and brachioradialis (elbow)

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11
Q

C4 Myotome

A

Shoulder/scapula elevation

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12
Q

C5 myotome

A

Shoulder ABduction

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13
Q

C5-C6 myotome

A

elbow flexion

wrist extension

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14
Q

C7 myotome

A

elbow extension

finger extension

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15
Q

C8 myotome

A

wrist flexion

finger flexion

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16
Q

T1 myotome

A

finger ABduction

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17
Q

C7-C8 reflexes

A

triceps reflex

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18
Q

SIADH drug causes:

A

Carbamazepine
SSRIs
Cyclophosphamide

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19
Q

Vasopressin and oxytocin are synthesized within the neurons found in what nuclei?

A

Paraventricular and supraoptic nuclei;
Neurophysins are involved in the posttranslational processing and stabilization of oxytocin and vasopressin within the neurosecretory vesicles during transport to the posterior pituitary

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20
Q

The internal iliac vein (lower rectum) drains to

A

the caval system

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21
Q

The superior rectal vein (upper rectum) drains to

A

the portal system

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22
Q

The venous component of internal hemorrhoids drains into:

A

the middle and superior rectal veins, which communicate with the internal iliac and inferior mesenteric veins

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23
Q

The venous component of external hemorrhoids drains to:

A

External hemorrhoids drain via the inferior rectal vein into the internal pudendal vein, which communicates with the internal iliac veins

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24
Q

Bacterial mRNA can be polycistronic, meaning:

A

that one mRNA codes for several proteins. Example = lac operon in E. Coli - the transcription and translation of the bacterial proteins is regulated by a single promoter, operator, and set of regulatory proteins;
Eukaryotic mRNA is rarely polycistronic

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25
Q

Effect of 2,3 BPG

A

decreases hemoglobin’s affinity for oxygen;

in the presence of lower blood oxygen concentrations, higher 2,3-BPG enable O2 delivery in the peripheral tissues

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26
Q

How is 2,3-BPG produced?

A

Glycolysis pathway
Glucose –> Glucose 6P –> Fructose 6P –> Fructose 1,6P –> Glyceraldehyde 3P –> 1,3 BPG

Instead of continuing in glycolysis, 1,3 BPG –(mutase in RBCs) –> 2,3 BPG

2,3 BPG can also return to the glycolysis pathway –(phosphatase)–> 3-phosphoglycerate –> 2-phosphoglycerate –> phosphoenolpyruvate –> pyruvate

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27
Q

What intermediate step in glycolysis produces ATP?

A

1,3-BPG –(phosphoglycerate kinase)–> 3-phosphoglycerate

28
Q

Satiety center in the brain

A

Ventromedial nucleus of the hypothalamus

29
Q

Where do ependymomas arise?

A

walls of the ventricles
can hamper CSF flow and cause hydrocephalus;
cells for gland-like structures called “rosettes”

30
Q

Where are medulloblastomas found?

A

cerebellum, often at the vermis;
sheets of small, blue cells;
poorly differentiated/poor prognosis

31
Q

Medulloblastomas and what other kind of tumor are found in the cerebellum?

A

Pilocytic astrocytoma - most common brain tumor in childhood;
contain pilocytic astrocytes and rosenthal fibers

32
Q

Indapamide

Class and MOA

A

Thiazide diuretic
Blocks Na/Cl symporters in the distal tubules
can cause hypokalemia

33
Q

K+ sparing diuretics (3)

A

Amiloride
Triamterene
Spironolactone

Block the epithelial sodium channel or aldosterone receptor

34
Q

How can beta-blockers cause hyperkalemia?

A

Interfere with beta-2-mediated intracellular potassium uptake

35
Q

How can ACE inhibitors cause hyperkalemia?

A

Inhibition of angiotensin II formation with subsequent decrease in aldosterone secretion

36
Q

How can cardiac glycosides (ie digoxin) cause hyperkalemia?

A

Inhibition of the Na/K pump

37
Q

How can ARBs cause hyperkalemia?

A

Block the AT1 receptor, thus decreasing aldosterone secretion

38
Q

How can NSAIDs cause hyperkalemia?

A

Impaired local prostaglandin synthesis reduces renin and aldosterone secretion

39
Q

MOA Shiga-like toxin

A 
Halts protein synthesis by disabling the 60s ribisomal subunit, leading to intestinal epithelial cell death and diarrhea;
AB toxin (active A and binding B)
encoded by a plasmid transmitted by a bacteriophage
40
Q

MOA Tocilizumab

A

monoclonal antibody to IL-6

treatment of giant cell arteritis, for which IL-6 is an important marker of disease severity

41
Q

Which Prostaglandins are pro-inflammatory, and cause bronchoconstriction?

A

TXA2
PGD2
PGF2alpha

42
Q

Which prostaglandins are anti-inflammatory and cause bronchodilation and vasodilation?

A

PGI2

PGE2

43
Q

What enzyme catalyzes the formation of arachadonic acid from membrane phospholipids?

A

Phospholipase A2 (corticosteroids inhibit)

44
Q

Prolonged, untreated obstructive sleep apnea can cause:

A

pulmonary HTN and RHF

45
Q

Sodium nitroprusside

Use

A

Management of acute heart failure due to severe hypertension

IV vasodilators

46
Q

Right sided colon cancers are more likely to ______ while left-sided colon cancers are more likely to ______.

A

Right-sided colon cancers, ie ascending colon, are more likely to:
bleed, grow as large bulky masses

Left-sided colon cancers are more likely to:
infiltrate the wall of the colon, be smaller, cause obstruction

47
Q

What are the protective factors against epithelial ovarian carcinoma?

A

oral contraceptive use;
multiparity, breastfeeding
tubal-ligation or salpingo-oophorectomy
all reduce the # of times the epithelium of the ovary has to get repaired

48
Q

Warfarin inhibits

A

epoxide reductase, which converts vitamin K to reduced vitamin K

49
Q

Failure of PT to correct with vitamin K treatment indicates:

A

liver disease (reflecting factor VII deficiency)

50
Q

Superior sulcus tumors are aka

A

Pancoast tumors
lung apex
cause shoulder pain due to compression of the brachial plexus

51
Q

Integrins bind to what ECM components?

A

Fibronectin
Collagen
Laminin

52
Q

“HALT” - diseases that involve target cells

A

HbC disease
Asplenia
Liver disease
Thalassemia

53
Q

Bleeding time is a test of

A

platelet function

54
Q

Platelets contain (4 main things)

A

vWF
thromboxane A2
fibrinogen
COX

55
Q

Autoaintibodies to GpIIb-IIIa

Dx?

A

Immune thrombocytopenic purpura (ITP)

56
Q

Deficiency of metalloprotease ADAMS-TS13

Dx?

A

Thrombotic thrombocytopenic purpura –> microangiopathic hemolytic anemia

57
Q

Hemolysis
Uremia
Thrombocytopenia
Dx?

A

HUS

58
Q 
Hemolysis
Uremia
Thrombocytopenia
Neurologic symptoms
Fever
A

Thrombotic thrombocytopenic purpura –> microangiopathic hemolytic anemia
“Nasty Fever Torched His Kidneys”

59
Q

How is von WIllebrand disease a mixed platelet and coagulation disorder?

A

vWF is needed to stabilize factor VIII;
also binds GpIb to subendothelial collagen

Tx: DDAVP (desmopressin) - forces release of vWF from storage cells

60
Q

“STOP Making Thrombi” - causes of DIC

A 
Sepsis
Trauma
OB complications
Pancreatitis
Malignancy
Transfusion
61
Q

Clopidogrel
Ticlopidine
Ticagrelor
Prasugrel

A

ADP receptor inhibitors

ADP binds ADP receptor –> induces GpIIb-IIIa on the surface of platelets

62
Q

Abciximab
Tirofiban
Eptifibatide

A

Direct GpIIb-IIIa inhibitors;

use in NON-ST elevation MI

63
Q

Maximum life span of platelet

A

8-10 days

64
Q

NSAIDs inhibit

A

Thromboxane A2

65
Q

MOA Enoxaparin

A

LMWH - inhibits factor Xa

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