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Uworld > UW12 > Flashcards

UW12 Flashcards

1
Q

fever, malaise, weight loss, clubbing, leukocytosis, coupious foul smellig sputum

A

Lung Abscess

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2
Q

Aspiration when supine

A

Posterior segment of R. upper lobe. Superior segment of R. lower lobe

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3
Q

Aspiration when upright

A

Basal segment of R. lower lobe

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4
Q

Risk for aspiration

A

Altered consciousness (alcoholism, seizure, dementia), Immunosuppression (steroid, old age, long hospitalization), Poor dental hygiene, dental infections

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5
Q

Abnormal uterine bleeding, endometrial hyperplasia (or precocious puberty), right sided adnexal mass

A

Granulosa cell tumor

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6
Q

Ovarian tumor with small follicle like structures filled with eosinophilic secretions

A

Call-Exner bodies (Granulosa cell tumor)

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7
Q

Ovarian tumor that does not make estrogen. Sheets of “fried cell” cells

A

dysgerminoma

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8
Q

A type of ovarian tumor that contain skin and cartilage, can also produce what hormone

A

Dermoid cyst (teratoma) can produce thyroid hormone (struma ovarii)

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9
Q

Surface ectoderm

A

anterior pituitary ( Rathke’s pouch), lens, cornea, sweat and mammary glands, epidermis

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10
Q

Neuroectoderm

A

Brain, spinal cord, Posterior piuitary, retina (CNS)

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11
Q

Neural crest

A

PNS (sensory ganglia, schwann cells, endocardial cushions, branchial arch, skull bones, melanocytes, adrenal medulla

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12
Q

Mesoderm

A

muscles, connective tissue, serosal linings, CV system, spleen, kidney, ureters, adrenal cortex

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13
Q

Endoderm

A

GI tract, liver, pancreas, thymus, parathyroid, thyroid follicular cells, bladder, urethra

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14
Q

“claw hand”

A

ulnar nerve damage at the medial epicondyl of the humerous. Loss of flexion of wrist and medial fingers. Cant extend pinky

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15
Q

Difficulty with fine motor control of thumb

A

Carpal tunnel (median nerve compression)

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16
Q

Radial head subluxation

A

Deep branch of radial nerve (weakness of muscles in extensor compartment)

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17
Q

Innervation of the coracobrachialis

A

Musculocutaneous n

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18
Q

Fracture of the surgical neck of humerous

A

axillary nerve ( paralysis of deltoid)

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19
Q

psychotic episodes that last

A

Brief psychotic disorder

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20
Q

anxiety, depression, disturbed behavior that develops within 3 months of an identifiable stressor. Last no more than 6 months after stressor ends

A

Adjustment disorder

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21
Q

How do you manage somatic symptom disorder?

A

Regular visits with the same provider. Limit unnecessary workup and referrals. Mental health referral once physician-patient relationship is well established

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22
Q

what ethnicities are at an increased risk for osteoporotic fractures

A

white, hispanic, asian

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23
Q

First line agents for anti-convulsant therapy

A

Benzodiazepines ( diazepam, lorazepam, midazolam)

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24
Q

DOC for complex partial seizures

A

Carbamazepine

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25
Q

Phenobarbital can be used for what types of seizures

A

Partial and generalized tonic-clonic

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26
Q

What are some mood stabilizers for bipolar disorder?

A

Lithium, valproate, carbamzepine, Lamotrigine

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27
Q

Lithium

A

Manic and depressive episodes. SE: Diabetes insipidus, hypothyroidism, Tremor, Ebstein’s

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28
Q

Valproate

A

Manic episodes. Also absence, generalized tonic-clonic, myotonic seizures. SE: hepatotoxic, neural tube defects

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29
Q

Carbamazepine

A

Manic episodes. Also partial and generalized seizures and trigeminal neuralgia. CYPE inducer. SE: agranulocytosis, SIADH, Neural tube defects

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30
Q

Lamotrigine

A

Depressive episodes. Focal seizures. SE: Stevens Johnson syndrome

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31
Q

What drugs should be avoided in treating bipolar disorder?

A

SSRIs because they can induce mania

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32
Q

Lesion of the lateral hypothalamic nuclei

A

Anorexia

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33
Q

Lesion of the ventromedial hypothalamic nuclei

A

Hyperphagia, aggressive

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34
Q

Lesion of the Supraoptic hypothalamic nuclei

A

Decreased ADH synthesis

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35
Q

Lesion of the supraventricular hypothalamic nuclei

A

Decreased oxytocin synthesis

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36
Q

Lesion of the Anterior hypothalamic nuclei

A

Uncontrolled hyperthermia and death

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37
Q

Suprachiasmatic nuclei regulates

A

circadian rhythmn

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38
Q

Lesion of the posterior hypothalamic nuclei

A

Hypothermia ( cold)

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39
Q

increased contractility and strove volume causes what change in a pressure volume loop?

A

Increased ejection volume and higher systolic pressure

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40
Q

how does increased preload change a pressure volume loop?

A

increased EDV

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41
Q

How does increased afterload change a pressure volume loop?

A

increased left ventricular pressures. Decreased SV

42
Q

How does systolic dysfunction change a pressure volume loop?

A

Decreased contractility leads to decreased stroke volume

43
Q

Substrate level phosphorylation step in TCA

A

Succinyl-CoA to Succinate (Succinyl-CoA Synthetase). Makes GTP

44
Q

Substrate level phosphorylation steps in gycolysis

A

1,3 BPG –> 3PG (phosphoglycerate kinase). PEP –> Pyruvate (pyruvate kinase). Makes ATP

45
Q

Which steps in gluconeogenesis requires GTP?

A

Oxaloacetate –> PEP

46
Q

Where is pyruvate carboxylase located?

A

Mitochondria ( used for gluconeogenesis)

47
Q

Where is Phosphoenolpyruvate Carboxykinase located

A

Cytoplasm (gluconeogenesis)

48
Q

Where is Glucose 6 phosphatase located?

A

ER of Liver. (gluconeogenesis)

49
Q

neurological abnormalities, hypoxemia, petechial rash with long bone fracture

A

Fat embolism syndrome

50
Q

Cisplatin

A

Forms reactive free radicals that crosslinks DNA. SE: nephrotoxic so give with Amifostine or chloride diuresis (keeps cisplatin in nonreactive state due to high Cl concentration)

51
Q

Amifostine

A

Free radical scavenger that decreases nephrotoxicity d/t cisplatin

52
Q

N-acetylcysteine

A

increases glutathione production and conjugation of toxic NAPQI metabolite. Used as a mucolytic agent in patients with bronchitis. Prevents radiocontrast induced nephropathy

53
Q

Fomepizole

A

antidoe for methanol or ethylene glycol poisoning (preventes conversion into toxic metabolites)

54
Q

Dexrazoxane

A

Iron chelating agent that prevents anthracycline-induced cardiotoxicity

55
Q

What organism is pyrrolidonyl arylamidase (PYR) positive

A

S. pyogenes

56
Q

How does nitroglycerin work?

A

venodilator ( decreases preload)

57
Q

what is the volume of distribution

A

Volume into which the administered amount of drug will need to be uniformly distributed to produce the observed plasma concentration (amount of drug/plasma concentration)

58
Q

which properties decrease a drugs volume of distribution

A

large molecular weight, bound extensively or is highly charged

59
Q

pathogenesis of alcoholic hepatic steatosis

A

increased NADH causes decrease in fatty acid oxidation

60
Q

what is formed when methyl-THF donates a methyl group to homocystine? What co-factor is required.

A

Forms Methionine and THF. Requires B12

61
Q

What vitamin is required for conversion of methylmalonyl CoA to succinyl CoA?

A

Vitamin B12

62
Q

What is elevated in Vit B12 deficiency

A

Methylmalonyl CoA

63
Q

What is elevated in folic acid and B12 deficiency?

A

Homocysteine

64
Q

What does pleuritic pain that increases with swallowing and radiates to the neck, fever tell you?

A

Pleuritic= pericardial. Swallowing= posterior pericardium. Radiation= inferior pericardium (adjacent to phrenic nerve). Fever= inflammatory

65
Q

Brain tumor: soft, poorly defined with areas of necrosis and hemorrhage

A

Glioblastoma multiforme

66
Q

Phenoxybenzamine

A

irreversible non-selective alpha blocker

67
Q

Phentolamine

A

reversible non-selective alpha blocker ( used for pts on MAOi that eat tyramine containing foods)

68
Q

Prazosin

A

alpha 1 blocker (HTN, BPH)

69
Q

When are waxy casts een in the urine?

A

Chronic renal failure. (shiny, translucent casts formed in dilated tubules)

70
Q

polyuria, polydipsia, polyphagia with fatigue and weight loss

A

Type I DM

71
Q

which rash spreads faster? Rubella or rubeola?

A

Rubella (blueberry muffin rash) that does not darken or coalesce

72
Q

floppy baby, poor feeding, jaundice, macroglossia, constipation and umbilical hernia

A

congenital hypothyroidism (cretinism)

73
Q

at risk of injury during thyroidectomy

A

superior laryngeal (courses deep to the superior thyroid artery)

74
Q

Brain tumor: elongated cells with regular, oval nuclei, biphasic pattern of growth with areas of dense cellularity interspersed with myxoid regions

A

Schwannoma

75
Q

tumors that are S-100 +

A

Scwannoma, melanoma

76
Q

Brain tumor: pseudopalisading necrosis

A

Globlastoma

77
Q

elongated, or corkscrew intracytoplasmic eosinophilic bundles

A

Rosenthal fibers

78
Q

Preferred anticonvulsants for focal seizures

A

Carbamazepine, gabapentin, Phenobarbital, phenytoin

79
Q

Preferred anticonvulsants for generalized seizures

A

Lamtotrigine, Levetiracetam, Topiramate, Valproic acid

80
Q

Sudden onset jerking movements involving both arms, occurs within first hour of waking and provoked by sleep deprivation

A

myoclonic seizure

81
Q

abdominal pain, vaginal bleeding, hemorrhagic shock, tachycardia, cold clammy extremities, hx of amenorrhea

A

Ectopic pregnancy

82
Q

What type of reaction is methylmalonyl CoA –> Succinyl CoA

A

Isomerization

83
Q

which bacteria can cause gastroenteritis with only 10-500 cells

A

Shigella

84
Q

anorexia, nausea, dark urine, low grade fever, RUQ pain

A

Viral hepatitis

85
Q

diffuse ballooning degeneration, councilman bodies, mononuclear cell infiltrates

A

acute viral hepatitis

86
Q

What does Antithrombin inhibit?

A

Factor Xa and thrombin

87
Q

Enoxaparin

A

LMWH that inhibits Xa (not thrombin)

88
Q

What do you use to treat restless leg syndrome

A

Dopamine agonist ( pramipexole)

89
Q

What is P-glygoprotein?

A

ATP dependent efflux pump

90
Q

how can pyogenic bacteria gain access to the liver?

A

Ascending cholangitis, portal vein pyemia, hepatic artery (systemic seeding), direct invasion or penetrating trauma

91
Q

contralateral homonymous hemianopia, with macular sparing indicates an infarct in what artery?

A

PCA

92
Q

treatment of choice for ectopic pregnancy

A

methotrexate

93
Q

46XY, normal leydig cells. No sertoli cells

A

Male and female internal genitalia and male external genitalia

94
Q

No sertoli cells

A

no MIF. Retain mullerian duct (female internal genitalia)

95
Q

What cell produces MIF

A

Sertoli cells

96
Q

Male external genitalia in genetically female fetus

A

Congenital adrenal hyperplasia

97
Q

blue lesion under nails, tender to touch. What tumor?

A

Glomangioma. Glomus bodies shunt blood for thermoregulation

98
Q

what is crucial to defense against mycobacterial diseases?

A

INF-y

99
Q

when are black pigment stones seen?

A

increased extravascular hemolysis (increased unconjugated bilirubin)

100
Q

what is the enzymatic defect in XP?

A

nucleotide excision repair (ENDOnuclease deficiency)

101
Q

enzyme defect in HNPCC

A

Mismatch repair (3- -5’ EXONnuclease)

Uworld (18 decks)

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