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zz - step 4 - uworld > UW10 > Flashcards

UW10 Flashcards

1
Q

Watery diarrhea, headache, confusion, recent travel

A

Legionella (dx with urine antigen test)

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2
Q

Labs for legionella

A

hyponatremia, gram stain with many neutrophils but few or no organisms

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3
Q

Pulmonary infiltrates, bronchiectasis with eosinophilia. Elevated IgE. Hx of athsma

A

allergic bronchopulmonary aspergillosis (ABPA)

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4
Q

small, bright-red papuplar lesions in adult. Sharply circumscribed areas of congested capillaries and post-capillary venules in papillary dermis

A

Cherry Hemangioma

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5
Q

dilated vascular spaces with thin walled endothelial cells. Soft blue, compressible masses up to a few cm in size

A

Cavernous hemangioma

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6
Q

Cavernous hemangioma of the brain and viscera are associated with what disease

A

Von Hippel Lindau

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7
Q

lymphatic cysts lined by endothelium

A

cystic hygroma

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8
Q

Cystic Hygromas are associated with what diseases

A

Turner sydrome and Down syndrome

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9
Q

what are some risk factors for gallbladder hypomotility

A

pregnancy, rapid weight loss, prolonged TPN, octreotide, high spinal cord injuries

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10
Q

what is biliary sludge

A

bile precipitation containing cholesterol monohydrate crystals, calcium bilirubinate, mucus. Precursor to stones.

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11
Q

Brown pigment stones

A

Biliary tract infection

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12
Q

Black pigment stones

A

Intravascular hemolysis

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13
Q

Mechanism of type IV HSR

A

antigen is taken up by DC and presented to T cells. TH1 cells release IFN-g and recruit macrophages

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14
Q

Neutrophils can be falsly elevated in what patients?

A

Corticosteroids. Cause demargination (release from vascular walls)

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15
Q

Café au lait, neurofibromas, lisch nodules

A

NF-1 ( chr 17)

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16
Q

Hypersensitive to rejection, desires relationship with others

A

Avoidant personality

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17
Q

Pattern of distrust and suspiciousness of others

A

Paranoid personality

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18
Q

Detachment from social relationships, self absorbed, little pleasure in intimacy

A

Schizoid personality

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19
Q

what channels open when the cell membrane of skeletal muscles are depolarized

A

Opens L type ca channels in T-tubule system

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20
Q

What causes release of ca from intracellular stores in the sarcoplastic reticulum in skeletal muscle

A

L type calcium-RyR mechanical coupling

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21
Q

Does skeletal muscle require ca to enter from extracellular space to cause ca release in the cell?

A

no. this is why CCB do not effect skeletal muscles.

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22
Q

What does ca bind to in a depolarized skeletal muscle cell?

A

Binds to troponin C

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23
Q

What does ca-troponin C binding cause?

A

moves tropomyosin out of the way. Myosin releases ADP leading to power stroke

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24
Q

what causes ca influx in cardiac cells?

A

Depolarization causes L type Ca chennels to open and allow extracellular ca to enter and activae RYR2 channels (CICR)

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25
What is the mechanism of smooth muscle contraction
Ca influx (L type) leads to CICR. Ca binds to calmodulin which activates myosin light chain kinase leading to phosphorylation of myosin (binds to actin)
26
T tubules are present in what types of muscle cells
Skeletal and cardiac. Not smooth muscle
27
why is skeletal muscle resistant to effects of ca channel blockers
L type- RyR mechanical coupling (does not relay on extracellular ca for excitation-contraction coupling)
28
What types of muscle cells depend on extracellular ca for excitation-contraction coupling
Cardiac and smooth muscle (Targets of Verapamil)
29
How does aldosterone affect K and H+ secretion
Increases secretion leading to a loss of K+ and H+
30
Perifollicular hemorrhages and coiled hairs
vitamin C deficiency
31
Loss of sensation of right upper and lower extremities and right side of face
Thalamic syndrome (damage to VPN and VPL) leads to complete sensory loss. Proprioception is affected leading to falls
32
5-6mm cavities in deep structure of the brain filled with clear fluid
Lacunar stroke (hipohyalinosis, microatheroma)
33
spindle cells with hair like glial processes associated with microcytes. Rosenthal fibers and granular eosinophilic bodies
Pilocytic astrocytoma
34
brain tumor in subcortical white matter that spreads across the corpus callosum. Pleomorphic astrocytic cells with necrosis and microvascular proliferation
Glioblastoma multiforme
35
small blue cells with Homer Wright rosettes
Medulloblastoma
36
Tumor with Pseudorosettes arising in 4th ventricle
Ependymoma
37
small round blue cells with neuropil (neuritic process)
Neuroblastoma (adrenal medulla- N-myc)
38
Required co-factor for urea cycle
Carbamoyl phosphate synthase I requireds N-acetylglutamate
39
budding yeast with pseudohyphae
Candida
40
Defense against Candida
T cells: prevent superfician Candida infection. Neutrophils prevent hematogenous spread of Candida
41
What is fluoxetine used for
SSRI for panic disorder, social phobia, generalized anxiety, OCD
42
DOC for generalized anxiety disorder
Buspirone ( 5HT1A) agonist
43
in artherosclerotic plaques what promotes the migration of smooth muscle cells from the media into the intima
PDGF secreted platelets, endothelial cells, macrophages
44
Young, pregnant mother in Asia with fulminant hepatitis
Hep E (unenveloped RNA virus)
45
Flutamide
competitive inhibitor of testosterone receptor
46
Theophylline intoxication
Abdominal pain, vomiting, seizures. Tx: gastric lavage, activated charcoal, cathartics
47
intoxication causing bradycardia, hypotension, cardiovascular collapse
Beta blocker. Reverse with glucagon
48
intoxication causing severe sedation, respiratory depression, constricted pupils
Opiods, reverse with naltrexone, naloxone
49
Intoxication causing liver damage following a latent period
Acetaminophen. Reverse with N-acetylcyseine (glutathione donor)
50
side effect of nitrates
Headaches due to vasodilation
51
diuretic that can precipitate gout attacks
Thiazide
52
Drugs associated with Raynauds
Beta blockeres and ergotamine (headaches)
53
oval yeast forms in macrophage
Histoplasma
54
spherule filled with endospores
coccidiodies
55
Mutation associated with melanoma
BRAF (valine to glutamate)
56
Neurophysins
carrier proteins for oxytocin and vasopressin
57
what enzyme is inducible in states of inflammation?
COX-2
58
viral hepatitis that causes cytoplasm of hepatocyte to take on a granular eosinophilic appearance (ground glass)
Hep B ( filled with HBsAg)
59
tumors of eosinophilic cytoplasma and oval stippled nuclei. No variation in shape or size of tumor. From enterochromaffin cells
carcinoid tumor
60
Prevent dilated cardiomyopathy caused by doxorubicin
Dexrazoxane
61
Mutation in hypertrophic cardiomyopathy
Beta myosin heavy chain
62
fracture at neck of fibula
lateral compartment (everts), sensory to the dosum of foot
63
Ras
GTP binding protein. Oncogene. Cholangiocarcinoma, pancreatic adenocarcinoma
64
MYC
Transcription factor (Burkitt)
65
ERBB1 (EGFR)
Receptor tyrosine kinase. Oncogene. (lung adenocarcinoma)
66
ERBB2 (HER2)
Receptor tyrosine kinase (Breast cancer) Oncogene
67
ABL
non receptor tyrosine kinase (CML). Oncogene
68
BRAF
RAS signal transduction (hairy cell leukmenia, melanoma). Oncogene
69
BRCA1 &2
Tumor suppressor. DNA repair genes (breast and ovarian cancer)
70
APB/ Beta-catenin
Tumor suppressor. WNT signaling. FAP
71
p53
tumor supressor. Li Fraumeni
72
RB
tumor suppressor. Retinoblastoma, Osteosarcoma
73
WT1
tumor supressor. Urogenital differentiation. Wilms tumor
74
VHL
Tumor suppressor. RCC
75
Concentric hypertrophy of ventricular wall
narrowing of ventricular cavity seen in elevated ventricular pressures (HTN or aortic stenosis)
76
Eccentric hypertrophy
Dilation of the ventricle with increased chamber size due to volume overload (aortic or mitral regurgitation, dilated cardiomyopathy)
77
what does the anti-Rh(D) ig consist of
IgG anti-D antibodies. Binds to Rh+ RBCs that enter an Rh- mother. Give at 28 weeks
78
Perfusion not matched by ventilation
Occluded blood flow (PE)
79
Ventilation not matched by perfusion
Lung collapse or consolidation
80
what is the Na level in hyperaldosteronism?
normal due to aldosterone escape. Increased sodium excretion. Increased volume also increases ANP causing natriuresis
81
How does the hypokalemia in hyperaldosteronism present?
Profound muscle weakness
82
orthopnea, crackles
Left sided heart failure
83
Hypoxia induced vasoconstriction leading to pulmonary hypertension
Chronic obstructive pulmonary disease
84
when is K+ excretion seen
High extracellular K, increased aldosterone, alkalosis, volume expansion, high Na intake, diuretic use
85
Dizygotic twins ( 2 different oocytes by 2 different sperm)
Dichorionic/ Diamniotic
86
Monozygotic twins 0-4 days
Dichorionic/Diamniotic
87
Monozygotic twins. 4-8 days
Morula (1 chorion, 2 amnion)
88
Monozygotic twins. 8-12 days
Blastocyst (1 chorion, 1 amnion)
89
pleuritic chest pain that decreases with pt sits up and leans forward
pericarditis
90
Kussmaul sign
paradoxical increase in jvd when inspiration. Seen in constrictive pericarditis
91
pericardial knock
heard shortly after S2 in patients with constrictive pericarditis
92
Torticollis, tongue protrusions, opisthotonus, oculogyric cirsis ( elevation of eyes)
Acute dystonia (4hrs to 4 days after antipsychotic use)
93
how can N. gonorrhoeae evade the immune system?
IgA protease that degrades IgA in mucosal secretions
94
wbc \>100,000 in synovial fluid analysis without crystals
Septic arthritis (consider gonococcus)
95
Wheezing, diarrhea, facial flushing
carcinoid tumor. Tx: octreotide
96
Methyltesterone
Anabolic steroids. Promotes epidermal hyperproliferation and excessive sebum (acne)
97
symptoms or deficients of neurological deficits without explanation after traumatic event
conversion disorder
98
Numerous physical complaints over years for which no physical explanation can be found
Somatization disorder
99
odds ratio
probabilty of an event/ (1-probability of that event)
100
Enoxaparin
low weight molecular heparin. Binds and inactivates AT III
101
Antithrombin III
binds and inactivates factor Xa and stops it from converting prothrombin to thrombin
102
Potency of a drug
dose required to produce a given effect. Higher affinity= higher potency. ED50
103
Efficacy
Max effect
104
Hypertension, low renin, weakness, parathesia
Primary mineralcorticoid excess (hyperalodsteronism)
105
Why is there a metabolic alkalosis in hyperaldosteronism
increase excretion of H+ and K+ leads to reactive increase in bicarb production and absorption
106
Hypotension, hyponatremia, hyperkalemia, metabolic acidosis
Primary adrenal insufficiency (addison)
107
Hyponatremia, hypokalemia, metabolic alkalosis
Loop or thiazide (contraction alkalosis) due to urinary Na/K loss and increase HCO- absorption
108
Hyperkalemia and metabolic acidosis
Mineralcorticoid receptor antagonist. Decrease excretion of K+ and H+
109
Mutation associated with polycythemia vera
JAK2
110
mild pleocytosis and positive VDRL is associated with what skin lesion
Gumma (tertiary)! Not chancre (primary)

zz - step 4 - uworld (18 decks)

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