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UWorld/FA Questions > UW 2/23 to 3/1 > Flashcards

UW 2/23 to 3/1 Flashcards

1
Q

<p>What type of cell mediates delayed hypersensitivity reactions?</p>

A

<p>TH1</p>

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2
Q

<p>What is the most common cause of bloody discharge from the nipple?</p>

A

<p>Intraducal Papilloma</p>

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3
Q

<p>Which breast diseases are characterized by the following descriptions:

1. Atypical cells infiltrating the nipple skin
2. Cysts lined by metaplastic apocrine cells
3. Liquefactive necrosis of adipocytes w hemorrhage
4. Stromal proliferation compressing the ducts to slits</p>

A

<p>1. Pagets

2. Fibrocystic Change
3. Fat Necrosis
4. Fibroadenoma.</p>

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4
Q

<p>What is Acute Intermittent Porphyria? What is the presentation? Treatment?</p>

A

<p>AIP= deficiency in the Porphobiligen Deaminase enzyme leading to inc levels of d-ALA and PBG

~~~
Presentation:
Painful abdomen
Port wine Urine
Polyneuropathy (tingling)
Pyschological changes
Precipitated by drugs (p450 inducers), OH, low calorie diet, progesterone (activate ALA synthase)
~~~

Treat, Glucose and Heme to inhibit ALA synthase.</p>

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5
Q

How is Delusional Disorder characterized clinically?

A

1 or more delusions for more than 1 month.

Able to function “normally” in society. No other major psychological issues.

Behavior is not “obviously bizzare”

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6
Q

How is Delusional Disorder different from Schizophrenia?

A

Schizophrenia has other psychotic symptoms present (hallucinations, disorganization, negative symptoms etc.)

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7
Q

Which personality disorders are on the differential for someone with suspected delusions?

A

Paranoid (suspiciousness- someone out to get them)

Narcissistic (if they have delusions of grandiosity)

Schizotypal (if they have odd beliefs/behaviors, or persistent false, fixed beliefs)

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8
Q

When conducting a study, matching study subjects with a control group (people of similar age, race etc), what research flaw is trying to be controlled?

A

Confounding variables.

Often used in case control studies.

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9
Q

Connexins make up which type of cell junction? Claudins?

A

Gap Junctions- connexins

Claudins- Tight junctions

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10
Q

What is the blood pH in someone with an acute PE? Why?

A

Respiratory Alkalosis! (not acidosis) w/ no metabolic compensation

Dyspnea. Dec pO2 due to VQ mismatch. Results in hyperventilation. CO2 loss. Alkalosis

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11
Q

What is the most common cause of hydronephrosis in a fetus?

A

Ureteropelvic junction obstruction

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12
Q

What disease is associated with a balanced 15:17 translocation? What is the defective gene produced?

A

Acute Myelogenous Leukemia.

PML-RARA (Promyelocytic leukemia gene and Retinoic Acid Receptor Alpha)

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13
Q

What is the function of the obturator nerve?

A

Thigh adductor muscles (Longus, brevis, magnus). And sensation over distal medial thigh (inner knee)

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14
Q

A 18 month old patient comes in with hepatosplenomegaly, neurological regression, and a cherry-red macular spot. What is the pathophysiology of this disease? Which disease is similar and often mistaken for the above presentation?

A

This is Niemann Pick Disease.
Caused by sphingomyelinase deficiency.
Sphingomyelin begins to accumulate in neurons, liver, and retina leading to damage.

Tay-Sachs is similar but w/o HSM.

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15
Q

What enzyme is deficient in Tay Sachs? What is the product that accumulates in neurons?

A

B-Hexosaminidase A

GM2 ganglioside accumulates in neurons.

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16
Q

When diagnosing anxiety, what must be on the differential?

A

General Anxiety Disorder
Anxiety due to general medical conditions (i.e. Hyperthyroidsm, Pheo, Hypoglycemia, Hypercortisolism, Arrhythmias, and SUBSTANCE USE)

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17
Q

Where is Histoplasma Capsulatum found?

A

Bird and Bat droppings in Mississippi and Ohio river basins.

History of pt often includes cave exploration or cleaning bird cages.

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18
Q

What is the histological findings in Histoplasma Capsulatum infection?

A

Light Microscopy show small intracellular oval bodies.

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19
Q

Which fungus has Hyphae, pseudohyphae?

A 
Hyphae= Aspergillus 
Pseudohyphae= Candida
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20
Q

Which TB drug targets mycolic acid synthesis?

A

Isoniazid.

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21
Q

Cold sores are reactivations of HSV1 when this virus is transported to the periphery via what process and protein?

A

Anterograde transport via Kinesin

My AK-47 is REaDY to go
Antero-Kinesin

Retro: Dynein

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22
Q

What causes supernormal expiratory flow rates in patients with restrictive lung diseases?

A

Pulmonary fibrosis leads to increased lung elastic recoil and airway widening.

“Inc radial traction on airway walls” means fibrosis forces airways closed.

Obstructive disease decreases radial traction on airway walls

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23
Q

Which blood problem is associated with recurrent blistering that heal with hyperpigmentation due to photosensitivity?

A

Porphyria cutanea tarda. (most common porphyria)

Caused by Uroporphyrinogen decarboxylase (UROD) def.

24
Q

With respect to porphyrin synthesis, how do early enzymatic deficiencies present differently from late steps?

A

Early= neuropsychiatric manifestations

Late=photosensitivity.

25
Q

What are the characteristics of Rheumatoid Arthritis? How is it diagnosed?

A 
Bilateral morning stiffness
Small Joints (spares DIP joint)

Serology: +Rheumatoid Factor (IgM that is anti-IgG to Fc component)
and Anti-CCP abs.

26
Q

What is the probability of a child getting a AR disease if the chances his mom is a carrier are 1/50 and his dads chances for carrier status are 1/10?

A

=1/2000

1/50x1/10 x 1/4 (both recessive genes passed on)

27
Q

What is the presentation of NF1 mutations? What is the inheritance pattern?

A

AD on chromosome 17

Presents as:
Café Au lait spots
Neruofibromas (Bumps/leisions that can be everywhere!)
Lisch Nodules (pigmented hamartomas of iris)

Also associated with brain tumors.

28
Q

What are the Steps of PCR?

A
  1. Denature DNA
  2. Add Primer to match nucleotides before desired sequence
  3. Extend with Taq pol.
29
Q

What is the name of a dendritic cell commonly found in skin and mucous membranes?

A

Langerhans Cells.

They have tennis racquet shaped granules. (only found in Langerhans cells)

30
Q

Most common type of kidney stone

A

Calcium

31
Q

True or false: CD8 is found on NK cells?

A

False

CD8 = cytotoxic T cells

32
Q

Hyperuricemia, self mutilating behavior, developmental delays in a young boy
What is this?
What enzyme has INCREASED function in this disease? Inheritance?

A

Lesch Nyhan syndrome (HGPRT def) . XR

This leads to dec purine salvad and activation of purine synthesis enzymes. PRPP AMIDOTRANSFERASE activity increases.

33
Q

Why does HPV attack the true vocal cords and not false vocal cords in pts who give blow jobs?

A

True is lined with stratified squamous and HPV likes that

hence why it infects the anus/external genitalia.

34
Q

Which 2 drugs prolong phase 4 of pacemaker cardiomyocytes? MOA?

A

Adenosine and AcH.

Adeonsine increases potassium conductance and hyperpolarizes the cell. It also inhibits L type Ca channels.

This leads to slowing of sinus rate. AcH has similar MOA

35
Q

Is it considered “normal behavior” for a child to see/talk to a dead parent that passed away a month ago?

A

Yes.

This is NOT acute stress disorder (3days-1mo) or PTSD (>1mo), which occur after a actual or threatened death experience

36
Q

Where are the 2 most common sites for aortic dissection in the thorax?

A

Type A: near the sinotubular junction (aortic root)

Type B: L. Subclavian (descending aorta)

Both types occur near curvature and are affected by increases in rate of rise of pressure and shearing forces.

37
Q

What is the first line treatment for Rheumatoid Arthritis?

A

Methotrexate.

However, this takes weeks to take effect. Use Predinsone for bridging relief.

38
Q

If a pt has elevated ESR, which interleukin is responsible for induction of the process?

A

IL-6

Hot TBone Steak
1- Fever
2-Tcells
3-Bone Marrow
4-IgE
5 IgA
6-aKute phase reactants

IL6 is seen in Giant Cell Arteritis.

39
Q

Which test is used to test the means of 2 variables? 3 variables?

A

Two-Sample T test=2

ANOVA (analysis of variance)=3

40
Q

What bacteria are generally responsible for ascending cholangitis?

A

Enterics (e coli, klebsiella)

41
Q

What are the causes of hepatic abscesses?

A

Staph A via blood
Entamoeba histolytica by food and poor sanitation.
Enteric Bacteria (ascending cholangitis)

42
Q

Name some drugs that prolong QT interval:

A

QT3=
Quinidine
Thioridazine (antipsychotics, haloperidol)
TCAs
Class Three Antiarrhythmic (sotolol and quinidine)

Also Macrolides and Flouroquinolones

43
Q

Which is associated with pancreatic cancer, smoking, moderate EtOH use, or both?

A

Smoking is the most important environmental risk factor for PC.

However, EtOH–> Chronic pancreatitis–>adenocarcinoma

44
Q

Why is stool pH decreased in lactose intolerant patients?

A

Lactose is fermented by enteric bacteria–> dec pH (lactic acid production) AND in H2 Breath content

45
Q

Does spironolactone cause or treat gynecomastia?

A

Cause.

Tamoxifen can help men with gynecomastia on androgen depravation therapy (GnRH treatment)

46
Q

What happens if B-blockers and verapamil (or diltiazem) are used together? Would the same effect be seen if BB and Nitrates were taken?

A

Hypotensive Bradycardia.

W/ nitrates this would not happen as nitrates cause reflex tachycardia.

47
Q

What is CREST syndrome?

A 
Calcinosis (anti-CENTROMERE ab)
Reynoud, 
Esophageal Dysomtility
Sclerodactyly (thickening of skin on hands and feet. Non pitting edema is beginning) 
Telangiectasis (
48
Q

Administration of leuprolide in a patient with BPH has what effect on Testosterone and DHT

A

Initial Spike in both followed by decline.

DHT follows Testosterone levels because leuprolide has no effect on 5 Alpha reductase.

49
Q

MOA Dobutamine

A

B- Agonist. Gs agonist.

50
Q

How long after MI does Dressler syndrome happen? What is Dresslers?

A

Autoimmune pericarditis weeks to months post MI

51
Q

True or False: Antibodies are not effective against fighting TB.

A

True. M Tuberculosis is facultative intracellular.

52
Q

How do you treat drug induced parkinsonism?

A

With Anticholinergics like Benztropine or Trihexyphenidyl.

This controls the shakes by decreasing Ach at neuromuscular junctions.

53
Q

Match Each of the following with their respective deficiencies:

  1. Bacterial
  2. Fungal
  3. Opportunisitc Infections
  4. Viral
Agammaglobulinemia
CGD
CF
SCID
Primary Ciliary dyskinesia
Terminal Compliment deficiency (MAC)
A

Agamma- Bacterial infections (sinopulmonary)
CGD- Fungal and Bacterial
CF- Bacterial (respiratory)
SCID- Bacterial, fungal, OI, Viral (think of HIV like symptoms)
PCD- Bacterial (sinopulmonary)
TCD- Neisseria infection

54
Q

Dilated pupilas are indicative of what type of withdrawal?

A

Heroine/opiate (constriction in overdose)

55
Q

What 2 reasons are beta blockers prescribed for in thyroid toxicosis?

A

Dec sympathetic response of adrenergic impulses.

* Reduce peripheral conversion from T4–>T3

UWorld/FA Questions (4 decks)

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