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UWorld Review > UW wrong 2 > Flashcards

UW wrong 2 Flashcards

1
Q

Beta blockers help in hyperthyroidism by

A

decreasing tachycardia

decreases peripheral conversion of T4 to T3

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2
Q

Increased acetylcholinesterase and AFP in amniotic fluid means

A

neural tube defects

fusion of edges of neural plate

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3
Q

nightmares are part of what of sleep

A

REM sleep

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4
Q

REM sleep is characterized by

A

muscle paralysis

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5
Q

social anxiety disorder should be treated first with

A

SSRI or SNRI

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6
Q

sterile platelet rich thrombi on the mitral valve is characteristic of

A

nonbacterial endocarditis

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7
Q

nonbacterial endocarditis is most associated with

A

malignancy

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8
Q

the MC presentation of nonbacterial endocarditis is

A 
systemic embolization (stroke, acute limb ischemia)
otherwise asymptomatic
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9
Q

Failed low dose dexamethasone test with suppressed cortisol with high dose dexamethasone is

A

cushing syndrome d/t pituitary adenoma

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10
Q

in primary osteoporosis, levels of calcium, phosphate, and PTH are typically

A

normal

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11
Q

Tay-sachs disease is caused by

A

beta-hexoaminidase A deficiency

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12
Q

a beta-hexoaminidase A deficiency in Tay-Sachs causes a build up of

A

GM2 ganglioside (cell membrane glycoprotein) within lysosomes

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13
Q

normal early development that suddenly regresses (neurologic deterioration), weakness, hypotonia, seizures, blindness, macrocephaly, abnormal startle reflex, cherry red macula

A

Nieman-pick

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14
Q

progressive neurodegeneration
peripheral neuropathy
optic atrophy

A

Krabbe disease

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15
Q

In Krabbe disease you get a build up of

A

galactocerebroside

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16
Q

globotriaosylceramide accumlation

A

Fabry disease

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17
Q

angiokeratomas
peripheral neuropathy
glomeropathy
that typically present in adulthood

A

Fabry disease

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18
Q

buildup of sphingomyelin

A

Nieman-pick disease

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19
Q

diseases with cherry red macula

A

Gaucher
Niemann-Pick
Tay-sachs

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20
Q

beta-glucocerebroside accumulation

A

Gaucher disease

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21
Q

build up of sulfatides

A

metachromatic leukodystrophy

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22
Q

difference between tay-sacks and niemann-pick

A

tay sach’s has no hepatosplenomegaly

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23
Q

BCR-ABL is an oncogene that codes for

A

fusion protein with constitutive tyrosine kinase activity
stimulates proliferation of granulocytic precursors
development of CML

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24
Q

c-myc is a

A

nuclear phosphoprotein that functions as a transcription activator

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25
Q

penicillins and cephalosporins function by

A

irreversibly binding to penicillin binding proteins such as transpeptidases

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26
Q

vancomycin works by

A

binds to d-ala-d-ala residues on cell wall glycoproteins

prevents transpeptidases from forming cross-links

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27
Q

NE affects BP by

A

stimulation of alpha 1

vasoconstriction via increased IP3 second messenger pathway

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28
Q

NE affects the heart by

A

stimulation of beta 1 in heart
increase contractility, conduction, HR
via increase cAMP through Gs mediated rec

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29
Q

acute ureteral constriction or obstruction causes

A

decreased GFR and FF

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30
Q

hormones that use the PIK system

A

oxytocin
ADH
GNRH

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31
Q

hormone that uses JAK/STAT path

A

erythropoietin

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32
Q

brain tumors of neuron origin stain with

A

synaptophysin

protein found on presynaptic vesicles of neurons

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33
Q

brain tumors of glial cell origin stain with

A

GFAP

astrocytomas, ependymomas, oligodendrogliomas

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34
Q

the most deoxygenated blood in the body is from

A

cardiac venous system in coronary sinus

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35
Q

noise induced hearing loss from trauma to

A

stereociliated hair cells of organ of corti

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36
Q

low frequency sound is registered in the

A

distal cochlea

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37
Q

Auer rods in AML stain for

A

myeloperoxidase

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38
Q

propionyl-CoA is derived from metabolism of

A 
valine
isoleucine
methionine
threonine
odd chain FA
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39
Q

propionic acidemia presents as

A 
lethargy 
poor feeding
vomiting
hypotonia 
1-2 weeks after birth
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40
Q

Entacapone is a

A

COMT inhibitor for Parkinsons

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41
Q

MOA of entacapone

A

decrease peripheral metabolism of levodopa

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42
Q

what drug enhances the effect of endogenous dopamine

A

amantadine

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43
Q

end plate potential for MG

A

reduced amplitude

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44
Q

treat cholinergic toxicity in medicated MG patients with

A

antimuscarinics
glycopyrrolate
hyoscyamine
propantheline

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45
Q

liver changes in sarcoidosis

A

scattered granulomas

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46
Q

cancer resistance to meds MOA

A

human multi-drug resistance gene codes P-glycoprotein
transmembrane ATP dependent efflux protein
broad specificity for hydrophobic compounds

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47
Q

reverse transcriptase PCR is used to detect

A

mRNA

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48
Q

Build up of arginine
progressive spastic diplegia
growth delay
abnormal movements

A

arginase deficiency

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49
Q

arginase is used in what cycle

A

urea cycle

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50
Q

diabetic neuropathy is caused by

A
  • diabetic microangiopathy leading to nerve ischemia

- accumulation of sorbitol leading to osmotic nerve injury

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51
Q

endoneural inflammatory infiltration of peripheral nerves is characteristic of

A

Guillain-Barre syndrome

also see segmental demyelination

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52
Q

mutation of myelin protein gene

A

Charcot-Marie-Tooth disease

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53
Q

Symptom of Charcot-Marie-Tooth disease

A

weakness of foot dorsiflexion d/t common perineal nerve

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54
Q

severe bacterial and viral infections in infancy
chronic diarrhea
mucocutaneous candidiasis
possible absent thymus

A

severe combined immunodeficiency

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55
Q

recurrent infections that worsen with age
easy bleeding
eczema

A

wiskott-aldrich syndrome

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56
Q

severe bacterial and fungal infections

granuloma formation

A

chronic granulomatous disease

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57
Q

oculocutaneous albinism
pyogenic infections
progressive neurologic dysfunction

A

chediak-higashi syndrome

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58
Q

ataxia
telangiectasis
sinopulmonary infections

A

ataxia-telangiectasia

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59
Q

ions with negative equilibrium potential

A

potassium or chloride

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60
Q

ions with positive equilibrium potential

A

sodium of calcium

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61
Q

JAK kinase second messenger system

A

growth hormone
prolactin
interferon
interleukin

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62
Q

surface receptor for insulin is a

A

transmembrane protein with intrinsic tyrosine kinase activity in its cytoplasmic domain

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63
Q

Insulin promotes mitogenic functions like DNA synthesis and cell growth via

A

MAP kinase pathway

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64
Q

insulin promotes metabolic functions such as translocation of GLUT-4 to cell membrane, glycogen synthesis, fat synthesis via

A

PI3K activation –> activates protein phosphatase

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65
Q

what does protein phosphatase do in glycogen synthesis

A

dephosphorylates glycogen synthase

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66
Q

afferent limb of gag reflex via

A

CN IX

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67
Q

efferent limb of gag reflex via

A

CN X

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68
Q

nerve that mediates cough reflex

A

internal laryngeal nerve (branch of superior laryngeal nerve, CN X)

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69
Q

Damage to left piriformis recess damages what nerve

A

internal laryngeal nerve (CN X)

70
Q

histology of interstitial lung disease

A 
lymphoplasmacytic infiltrates
focal fibroblastic proliferation
areas of dense fibrosis
honeycombing
hyperplasia of type 2 pneumocytes (idiopathic)
71
Q

therapy for interstitial lung disease directed at

A

slowing progression of fibrosis

inhibit TGF-beta and other fibrogenic growth factors (PDGF, fibroblastic growth factor, VEGF)

72
Q

Pirfenidone is a

A

antifibrotic agent

inhibits TGF-beta

73
Q

acute decompensated HF d/t dilated cardiomyopathy (doxorubicin) causes what changes in RA and LVED pressures

A

both increased

74
Q

right atrial pressure is synonymous with

A

central venous pressure

75
Q

virally infected cells secrete

A

type I interferon alpha and beta

76
Q

what does type I interferon alpha and beta do to infected viral cells

A

transcription of antiviral enzymes to halt protein synthesis

only happens in presence of dsRNA which forms in infected cells from viral replication

77
Q

pressure of the RA

A

<5

78
Q

pressure of right ventricle

A

25/5

79
Q

pressure of pulmonary artery

A

25/10

80
Q

pressure of aorta

A

120/80

81
Q

pressure of LA

A

<10

82
Q

pressure of LV

A

120/10

83
Q

how does propranolol work to stop essential tremors

A

prevents interaction of epi and NE interaction with receptors at adrenergic synapses

dampens sensitivity of muscle spindles/smooths out force of contraction

84
Q

MC CFTR gene mutation

A

3 bp deletion of phenylalanine at AA position 508 (deltaF508)

causes impaired post-translational processing of CFTR that is detected by ER

85
Q

once delta F508 mutation found my ER what happens

A

abnormal protein targeted for proteosomal degradation preventing it reaching cell surface

86
Q

what FA can’t undergo mitochondrial beta oxidation

A

very long chain FA
certain branched chain FA (phytanic acid)

undergo beta and alpha oxidation in peroxisomes instead

87
Q

what are two peroxisomal diseases

A

Zellwegger syndrome

X-linked adrenoleukodystrophy

88
Q 
widened sutures
large anterior fontanelle
hepatomegaly
hypotonia/seizures/developmental delay
death within months of initial presentation
A

Zellweger syndrome

peroxisomal disease

89
Q

defective transport of VLCFA into peroxisomes

A

X-linked adrenoleukodystrophy

90
Q

childhood or adulthood neurological deterioration

adrenal insufficiency

A

X-linked adrenoleukodstrophy

91
Q

protein modification

sorting/transport

A

golgi

92
Q

digestion of cellular debris and pathogens

A

lysosomes

93
Q

TCA cycle
FA oxidation
E transport chain (ATP synthesis)
Apoptosis

A

mitochondria

94
Q

oxidation of VLCFA and branched FA

hydrogen peroxide degeneration

A

peroxisomes

95
Q

degradation of ubiquitinated proteins

A

proteasomes

96
Q

synthesis of integral membrane and secretory proteins

A

rough ER

97
Q

drug detox

lipid, phospholipid, steroid synthesis

A

smooth ER

98
Q

watery diarrhea stool findings

A

no leukocytes or RBC

99
Q

dysentery of inflammatory diarrhea stool findings (shigella, salmonella, campylobacter, EIEC, yersinia, clostridium, entamoeba)

A

PMN

with or without RBC

100
Q

enteric fever stool findings (salmonella typhi)

A

mononuclear leukocytes

101
Q

isoniazid must be processed by

A

mycobacterial catalase peroxidase

102
Q

accessory conduction pathway

atrioventricular conduction tract bypassing the atrioventricular node

A

WPW syndrome

103
Q

drug directed at CD20

lymphoma

A

rituximab

104
Q

CML

drug that inhibits proliferation of BCR/ABL expressing cells without inducing apoptosis

A

Imatinib

105
Q

chimeric (human/murine) IgG1 monoclonal Ab to TNF-alpha

A

Infliximab

use in RA, AS, fistulizing Crohn’s

106
Q

IL-2 is used for

A

RCC

melanoma

107
Q

chimeric mouse-human Ab against platelet GpIIb/IIIa receptor

A

Abciximab

administered during angioplasty in patients w/ACS

108
Q

treatment for hemophilia A or B

A

thrombin

109
Q

hemophilia A and B lead to

A

failure to convert prothrombin into thrombin and deficient thrombus formation

110
Q

Treatment of bradycardia from infer MI

A

atropine

111
Q

atropine MOA

A

blocks vagal influence on SA and AV nodes

increases HR

112
Q

Atropine is contraindicated in

A

patients with glaucoma

muscarinic receptor blockade
mydriasis = narrowing of anterior chamber angle, diminished outflow of aqueous humor
cause closed angle glaucoma

113
Q

base excision repair steps

A 
glycosylase 
endonuclease
lyase
polymerase 
ligase

“GELPL”

114
Q

glycosylate cleaves

A

the altered base leaving an AP site (first step)

115
Q

endonuclease cleaves

A

5’ end (2nd step)

116
Q

lyase cleaves

A

3’ end (3rd step)

117
Q

DNA polymerase does what in base excision repair

A

fills single nucleotide gap (4th step)

118
Q

Ligase does what

A

seals the nick (5th step)

119
Q

hypertensive hemorrhage at posterior rostral pons near lateral flow of fourth ventricle

A

locus ceruleus

NE

120
Q

pigmented chemical made in the midbrain

A

DA

substantia nigra

121
Q

NE is converted into Epi primarily in the

A

adrenal medulla

122
Q

bursitis d/t repetitive or prolonged kneeling

A

prepatellar bursitis

123
Q

bursitis in those with OA or inflammatory joint disease

A

popliteal bursitis

124
Q

bursitis d/t direct blue to distal thigh or prolonged/repetitive quad activity (running)

A

supra patellar bursitis

125
Q

increased orotic acid in urine
kid with increased blood ammonia levels
sleepiness, vomiting, fever
tachypnea

A

ornithine transcarbamylase deficiency

126
Q

what will build up in ornithine transcarbamylase deficiency

A

orotic acid in urine

carbamoyl phosphate

127
Q

where does ornithine transcarbamylase work

A

mitochondria

128
Q

self-mutilation and hyperuricemia is characteristic of

A

Lesch-Nyan

HGPRT deficiency

129
Q

GAS is

A

PYR positive

bacitracin sensitive

130
Q

in sickle cell disease sicking of cells will cause

A

permanent deformation
premature RNC destruction by macrophages
mechanical stress

intra and extravascular hemolysis

131
Q

sickle cell disease will show what changes to indirect bilirubin and LDH

A

Increased both

decrease haptoglobin

132
Q

what does haptoglobin do

A

binds circulating Hgb and reduces renal excretion of free Hgb

preventing tubular injury

133
Q

motion sickness
vertigo
treat with

A 
H1 or M1 receptor antagonist
(vestibular cause)
diphenhydramine
meclizine
scopolamine
134
Q

mechanical and chemical irritants to Gi tract nausea treat with

A

5-HT3 receptor antagonist

zolfran

135
Q

cancer drug vomiting treat with (central nausea)

A

D2 receptor antagonist
metoclopramide
prochlorperazine

136
Q

Ejection fraction

A

EDV-ESV/EDV

137
Q

Crohn’s disease people get what kind of kidney stones

A

oxalate stones

reduced intestinal calcium oxalate formation from malabsorption, ends up in urine

138
Q

what kind of kidney stones do people with myeloproliferative disease and hemolytic anemia

A

uric acid stones

139
Q

hyper acute renal transplant reaction

min to hours

A

preformed antibodies

140
Q

acute renal transplant reaction

less than 6 months

A

exposure to donor antigens induces (host T-cell sensitization) humoral/cellular activation of naive immune cells

141
Q

chronic renal transplant reaction

months to years

A

chronic low grade immune response refractory to immunosuppressants

142
Q

superior vena cava syndrome is caused by

A

mediastinal mass

143
Q

with TCA overdose, widened QRS interval or ventricular arrhythmia are an indication for

A

sodium bicarbonate

144
Q

cardiac symptoms from TCA overdose are d/t

A

blockage of cardiac fast sodium channels

145
Q

lesions of the macula cause

A

central scotomas

146
Q

first step of infective endocarditis

A

disruption of normal endocardial surface

followed by formation of sterile fibrin-platelet nidus

147
Q

stool findings for strongyloides stercoralis

A

rhabditiform larvae

148
Q

detection of parasite eggs in stool is used to diagnose

A

schistosomiasis

mansion or japonicum

149
Q

dorsal pancreatic bud forms

A

majority of pancreas
body
tail
most of head

150
Q

ventral pancreatic bud makes

A

precursor of uncinate process
inferior/posterior portion of head
major pancreatic duct

151
Q

low back pain relieved with leaning forward due to

A

spinal stenosis
intervertebral disc herniation
ligamentum flavum hypertrophy
osteophyte formation affecting facet joints

152
Q

Fabry disease is at most risk for development of

A

renal failure
TIA/stroke
cardiac disease (LVH)

153
Q

burning pain in hands and soles
hypohidrosis
exacerbated by exercise or stress

A

Fabry disease

154
Q

dermatomyositis and polymyositis is associated with

A

being paraneoplastic syndrome with adenocarcinoma (ovary, lung, pancreas)

155
Q

HER2 is a

A

transmembrane tyrosine kinase

156
Q

what makes salmonella typhi worse than salmonella enterica

A

extensive intra-phagocytic multiplication

blunted neutrophil response d/t capsular antigen Vi

157
Q

inactivated viral vaccines primarily generate

A

humoral immune response against extracellular viral antigens

prevents viral entry into cell

158
Q

live attenuated viral vaccines generate

A

strong cell-mediated immune response that can kill virally infected cells in addition to providing humoral immunity

159
Q

kinesin is a

A

microtubule motor protein

160
Q

what does kinesis do

A

anterograde transport of intracellular vesicles and organelles toward the plus ends of microtubules

161
Q

nitrates relieve chest pain by increasing cGMP that lead to

A

myosin light chain dephosphorylation resulting in vascular SM relaxation

162
Q

Paget disease starts with increased activity of

A

osteoclasts

163
Q 
initially healthy baby with dark urine
gray stools
elevated direct bilirubin and GGT
jaundice
firm hepatomegaly
A

biliary atresia

164
Q

biopsy of biliary atresia would show

A

intrahepatic bile duct proliferation
portal tract edema
fibrosis

165
Q

Clomiphene is A

A

estrogen receptor modulator

166
Q

osmolarity of renal proximal tubule

A

300

167
Q

osmolarity of descending limb

A

400-1000

168
Q

osmolarity of ascending limb

A

200-800

169
Q

osmolarity of DCT

A

100

170
Q

osmolarity of collecting tubule

A

300-1200

171
Q

in bacteria, RNA primers are removed by

A

DNA polymerase I

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