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UWorld mixed > usmle2: block 3 > Flashcards

usmle2: block 3 Flashcards

1
Q

most common cause of epididymitis in heterosexual male

A

c. trachomatis

homosexual: colon bacterias

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2
Q

what drug can be given w/ penicillin to inhibit metabolism / secretion

A

penicillin + probenicid

prevents reabsorption of uric acid
prevents secretion of penicillin

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3
Q

bloom syndrome

A

photosensitivty, short stature, erythema, teleangiectasia

defect in DNA helicase RecQL3

predisposed to lymphoproliferative & GI malginancy

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4
Q

where does heriditary nonpolyposis colon cancer usu arise

A

microsatellite instability
mismatch repair defect

usu proximal bowel

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5
Q

waxing & waning lymphadenopathy

A

follicular lymphoma
bcl-2 t(14,18)

small cleave w/o nucleoli &
large cell w/ mult nucleoli

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6
Q

burkitt lymphoma in industrialized country location

A

ascites & abdominal mass

distal ileum, cecum, mesentary

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7
Q

Dupuytren’s contractures

A

fixed flexion of fingers

physical manifestation of high estrogen in cirrhotic patients

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8
Q

what are lisch nodules

A

pigmented iris hamartomas

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9
Q

what’s in a neurofibroma

A

schwann cells, fibroblasts, neurites

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10
Q

niacin mechanism

A

block hormone sensitive lipase –> reduce formation of VLDL and triglyerides

increases HDL
decrease TG

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11
Q

possible niacin side effects

A

prostaglandin mediated:

flushing, pruitis, headache

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12
Q

how many of the oocytes we are born w/ remain at puberty?

A

25%
of that, only 400 will be ovulated normally
rest = atesia

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13
Q

describe follicular atresia (oocytes)

A

outside basal lamina: THECA cells dedifferentiate & return to poor of ovarian interstitial or stromal cells

in basal lamia: OOCYTE & GRANULOSA cells = apoptosis

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14
Q

which antibiotics are teratogen (2)

A

aminoglycoside “a mean guy hit the baby” CN VIII toxicity

tetracycline: discolored teeth

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15
Q

which antiseizure drugs are teratogen (3)

A

carbamazepine, phenytoin, valproate (inhibit folate reabsporption

PVC

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16
Q

which anti-thyroid drug is a teratogen

A

methimazole

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17
Q

loss of heterozygosity

A

relevant to oncogenesis

person born w/ single defective copy of tumor supressor gene does not develop malignancy until some cells spontaneously mutate other gene

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18
Q

reason diff alleles have different cuts on restriction enzyme digestion?

A

single nucleotide polymorphisms at restriction enzyme cleavage site

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19
Q

how does paclitaxel in a drug-eluting stent work?

A

prevents intimal hyperplasia

major cause of restenosis

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20
Q

after placing a coronary stent, what is the major cause of restenosis?

A

intimal hyperplasia
prevent w/ paclitaxel / sirolimus
freeze cells in metaphase

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21
Q

anti-platelets post stent?

A

given LONGER w/ drug-eluting stents (paclitaxel) bc the rate of endolthelium reformation delayed.

less time w/ bare metal stents

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22
Q

which RNA viruses replicate in nucleus?

A
  • retroviruses (HIV, HTLV)

- influenza

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23
Q

where does influenza replicate

A

nucleus! (+ HIV) all other rna virus = cytoplasm

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24
Q

most common cause of pneumonia in infant

A

RSV

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25
croup & bronchiolitis in children | bronchitis in adult
parainfluenza birus
26
which GLUT is insulin dependent? which tissues
GLUT 4: muscle & adipocytes
27
what 2 muscles pull on acromial-end of clavicle? medial portion (3)
lateral: 1. deltoid 2. trapezius medial 1. pec major 2. sternocleidomastoid 3. sternohyoid
28
Ras is downstream
GTP-binding protein downstream RTK -single transmembrane, dimerize on binding (not GPCRs)
29
differential of orotic aciduria?
1. if also hyperammonia: OTC build up of carbamoyl phosphate --> shunt to de novo pyridamine synthesis --> orotic acid temp base 2. w/o hyperammonia --> orotic aciduria
30
steps of collagen formation
``` in ER: hydroxylation of proline/lysine glycosylation of some lysine assembly of triple helix = PROCOLLAGEN --requires 1. H bonding of hydroxylated groups & 2. disulfide bonding w/ C-terminals ``` secrete procollagen into golgi -> out of cell in ECM cleave N & C terminus -> collagen fibril crosslink via lysyl oxidase
31
most common amino acid in collagen
glycine Gly-X-Y (other: proline, lysine)
32
absence of proline hydroxylation results in
cannot form pro-collagen in ER bc triple-helix will be abnormal.
33
what is procollagen
formed in ER -triple helix (thanks to hydroxylation of proline/lysine) and disulfide bonds of C terminal groups ultimately secreted by cell
34
presentation of transtentorial herniation
uncal -fixed and dilated pupil on ipsilateral side -can produce ipsilateral or contralateral hemiparesis (cerebral peduncle) (compress external parasympathetics) ipsilateral hemiparesis: kernohan phenomenon - due to shifting of entire brainstem, compresses contralateral cerebral peduncle against rim of tentorium
35
MLF
links nuclei of CN VIII proprioception from inner ear w/ nuclei for eye movements also allows for conjugate lateral gaze, communication between also: CNVI and CNIII nuclei when CNVI nucleus activates lateral rectus, will also activate CNIII for medial rectus --> conjugate movement damaged in multiple sclerosis
36
internuclear opthalmoplegia
lesion to MLF problem w/ conjugate lateral gaze CNVI nuclei fails to tell contralateral CNIII to contract medial rectus (while telling ipsilateral lateral rectus) will see nystagmus in abducting eye (overstimulation by CN VI)
37
conversion
conversion: symptoms unexplained by medical condition. preceeded by psychological stressor not intentionally produced; cause impairment of normal fxn.
38
somatizatin disorder
multiple physical complaints before age 30 - 4 pain symptoms: 2 GI, one sex, one neuro - unexplained by general medical condition - not artificially produced - causing significant impairment
39
what neurological disease makes a protein w/ excess glutamine residues
huntington's! | CAG repeats are translated --> polyglutamine
40
4 trinucleotide repeat diseases
1. huntington 2. myotonic dystrophy 3. fragile X syndrome 4. friedrich's ataxia
41
confabulation
unintentionally fabricates memories that he believes to be true
42
wernicke-korsakoff vs. alzheimers & pseudodementia etc..
wernicke-korsakoff may also have ataxia (cerebellar degeneration) alzheimers, pseudodementia, etc = NORMAL GAIT. more cortical / cognitive issues
43
normal pressure hydrocephalus vs. wernicke-korsakoff
both have gait problems no confabulation in NPH
44
succinyl-CoA and glycine are starting products for..
heme synthesis in mitochondria via ALA synthase (w/ B6)
45
starting substrates for pyrimidine de novo synthesis
glutamine + CO2 also need aspartate + PRPP
46
from where are the nitrogen atoms in urea derivived from
ammonia & aspartate
47
patient complaining of fatigue, myalgia, muscle cramps, weakness over a week w/ lots of urination. due to furosemide or statin?
furosemide! worry about electrolyte abnormalities! -hypokalemia statins can cause rhabdomyolysis, but will be ACUTE: generalized weakness, muscle pain, dark urine
48
fatigue, myalgia, muscle cramp, weakness over a week
hypokalemia!
49
psoas muscle originates from? how does it enter femur
T12-L4 combines w/ illiacus forms common tendon to attach to lesser trochanter of femur (medial aspect) travels below inguinal ligament. pus can form near groin.
50
3 effects of angII
1. direct Na+ retention 2. aldosterone production 3. vasoconstrition
51
HLA codes for
``` MHC class I and II antigen presentation ``` ``` class I: HLA A, B, C class IIL HLA DP, DQ, DR ```
52
CD40-CD40L
CD40 on B cell CD40L on T cell needed for B cell activation: class switching
53
CD28-B27
CD28 on T cell B27 on B cell costimulatory molecule w/ TCR & MHC interaction w/o this: T cell -> anergy
54
in what type of arthritis is carpometacarpal joint irritated
osteoarthritis (w/ DIP and PIP) repeated mechanical trauma see: joint space narrowing, subchondral sclersosis, eburnation, cyst formation, osteophytes can feel crepitus on exam
55
chondrosarcoma on X-ray
bony destruction at tumor site
56
mechanical ventillation implies fixed (2)
- total minute ventilation (TV x RR) | - FiO2
57
generally, atelactasis results in..
right-to-left shunt -> hypoexemia but will have hyperinflation of remaining non-collapsed alveoli, so physiologic dead spaced only increased slightly
58
with fixed ventillation, how can hypercapnea develop
increase in pathologic deadspace (i.e. diffusion barrier)
59
microsatellite instability
abnormal lengthening or shortening of macrosatellite repeats related to HNPCC
60
MEN I gene? MEN II and II gene?
MEN I: inactivating mutation in menin tumor supressor MEN II and II: activating mutation in RET proto-oncogene
61
common presentation of endometriosis (3)? long term consequence?
dysmenorrhea pelvic pain dyspareunia can have infertility: pelvic adhesions, fibrosis. distort pelvic anatomy and impair transport to oviduct. if in bowel/bladder wall, can have painful defecation/urination too.
62
CMV colitis
2nd most common CMV manifestation after CMV retinitis in HIV patients. fever, anorexia, weight loss, abdominal pain. mucosal erythema, erosion, ulcer giant cells w/ large ovoid nucleus w/ centralized intranuclear inclusions "Cowdry". like one big owel eye.
63
gag codes for..
p24 capsid
64
env codes for ..
``` gp120 (attachment) gp 41 (fusion) ``` from cleavage of gp160
65
pol codes for..
reverse trancriptase, aspartate protease, integrase
66
mobile flank mass that produces a bruit
think: renal cell carcinoma! | which can obstruct IVC and cause ascities / peripheral edema
67
consider IVC obstruction in..
any patient w/ sudden lower extremity edema

UWorld mixed (60 decks)

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