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zz - step 4 - uworld > UW13 > Flashcards

UW13 Flashcards

1
Q

What does the VRDL, RPR evaluate for?

A

Presence of cardiolipin, a byproduct of treponemal infection

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2
Q

Low dose vs High dose ASA

A

Low doses: inhibits COX-1, high doses: inhibits COX-1 and COX-2

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3
Q

How does COX-1 inhibition lead to GI bleeding?

A

inhibition of TXA2 mediated platelet aggregation and impairment of PGE2 and PGI2 dependeant protection of GI mucosa

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4
Q

PGI2

A

inhibits platelet aggregation, vasodilation, inhibits proliferation of smooth muscle cells

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5
Q

Vertigo, tinnitus, hearing loss with asa

A

high dose asa causes salicylism. Stimulates respiratory drive= hyperpnea causing respiratory alkalosis and metabolic acidosis

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6
Q

ovaries with connective tissue and no follicles

A

Streak ovaries (Turners)

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7
Q

Turner Syndrome

A

High arched palate, low set ears, coarctation of the aorta, bicuspid valve, streak ovaries, short stature, horseshoe kidney, broad chest with widely spaced nipples, webbed neck, low hairline

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8
Q

Most common childhood brain tumor

A

Pilocytic astrocytoma

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9
Q

Most common location of a pilocytic astrocytoma

A

Cerebellum

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10
Q

which childhood tumor has solid and cystic components

A

Pilocytic Astrocytoma

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11
Q

Recurrent sinopulmonary and GI infections that develops an anaphylactic reaction after transfused blood

A

IgA deficiency

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12
Q

how does salicylate cause metabolic acidosis

A

increases lipolysis, uncouple oxidative phosphorylation, inhibits TCA causing an increase in ketoacids, lactate and pyruvate

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13
Q

What does acute transplant rejection cause

A

Vascular damage (vasculitis) 1-2 weeks after transplant due to Host immune response (CD8T) against donor

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14
Q

dyspnea, nonproductive cough, wheezing months after lung transplant

A

Brochiolitis obliterans: inflammation of small bronchioles

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15
Q

characteristic finding in acute transplant rejection

A

perivascular infiltration

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16
Q

Glucocorticoids

A

Increase gluconeogenesis, glycogenesis, increase muscle and fat break down,inhibits fibrobast proliferation, immunosuppressant, decrease bone mass

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17
Q

Dephosphorylation of glycogen synthase

A

activates protein and increases glycogen synthesis

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18
Q

Dephosphorylation of 1,BPatase

A

inactivates enzyme to inhibit gluconeogenesis

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19
Q

“knee buckling”

A

Femoral Nerve L2-L4 (flexion of thigh and extension of leg)

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20
Q

Femoral nerve compression

A

weakness of quadriceps, loss of patellar reflex, loss of sensation over anterior and medial thigh and medial leg

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21
Q

Superior gluteal

A

thigh abduction

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22
Q

Inferior gluteal

A

thigh extension

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23
Q

Obturator

A

thigh adduction (anterior hip dislocation)

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24
Q

Peau d’orange

A

Cooper’s ligament infiltration by invasaive breast cancer. Seen often in inflammatory breast cancer

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25
Q

How is SLE managed?

A

Glucocorticoids. Risk for Cushing’s syndrome

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26
Q

What can lead to diffuse adrenal hyperplasia?

A

Chronic hypersecretion of ACTH (Cushing Disease)

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27
Q

Alendronate

A

Bisphosphoate analog of pyrophosphate. Inhibits bone resorption. Tx for osteoporosis d/t corticosteroid use

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28
Q

how does lowering a cutoff value affect the sensitivity of a test?

A

Increases sensitivity. Increase in FP, decreases PPV, and decrease FN. Specificity= TN/(TN+FP)

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29
Q

Sensitivity

A

ability of a test to rule out those with disease. High sensitivity identifies most patients with the disease

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30
Q

Specificity

A

test to exclude those without the disease. High specificity= low false positive rate

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31
Q

How can you prevent reccurent HSV infections?

A

continuously daily valcyclovir

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32
Q

Ulceration and necrosis in a hospitalized pt with ANC

A

Ecthyma grangrenosum (P aeruginosa bacteremia)

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33
Q

Most common cause of gram negative sepsis after UTI

A

E. Coli

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34
Q

Risk for pseudomonas infections

A

neutropenia, hospitalized, burns, indwelling catheters

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35
Q

What drug decrease the activity of platelet phosphodiesterase to prevent platelet aggregation

A

Cilostazol (also a vasodiltor), Dipyridamol

36
Q

lung tumor seen as hilar mass (arising from major bronchi). Synaptophysin and chromogranin positive

A

Small cell lung cancer

37
Q

How does dobutamine change a cardiac pressure volume loop

A

increases contractility. Higher pressures would be reached during ventricular ejection, increase in SV

38
Q

How does clamping the aortic change a pressure volume loop?

A

increase in afterload leading to increase pressures and decrease SV

39
Q

How would loss of myocardial mass change a pressure volume loop?

A

decreased contractility. Decrease in ventricular ejection and decrease SV

40
Q

Pioglitazone

A

binds to PPAR-gamma to increase transcription of adiponectin to decrease insulin resistance

41
Q

Glipizide

A

Sulfonylurea that close K(ATP) channel that causes insulin release

42
Q

Repaglinide and Metaglinide

A

non-sulfonylurea that act by binding K(atp) and increase insulin release (shorter acting)

43
Q

Exenatide, Liragluide

A

incretin (increases insulin secretion) TIIDM

44
Q

Loss of pain and temperature involving arms and hands. Preserved touch, vibration and position sense

A

Syringomyelia (ventral white commissure)

45
Q

What is TGF-B involved in?

A

Growth factor in Tissue regeneration and repair

46
Q

What does interferon gamma do?

A

Activate macrophages

47
Q

Differntial cyanosis in a child

A

PDA

48
Q

Corkscrew esophagus

A

periodic non-peristaltic esophageal muscle contractions seen in diffuse esophageal spasm

49
Q

Hx of headache decreased libido. B/l loss of temporal visual fields. Hypotensive and loses consciouness

A

Pituitary apoplexy (cardiovascular collapse due to loss of ACTH)

50
Q

High orotic acid

A

OTC deficiency, citrullinemia

51
Q

What is a short acting benzodiazepine?

A

Triazolam (

52
Q

Dyspnea, hypotension, tachycardia after Beta lactam

A

Anaphylatic shock. Give Epinephrine. DUH.

53
Q

Myastenia gravis is associated with what tumor

A

thymoma or thymic hyperplasia

54
Q

Eczema, immunodeficiency, thrombocytopenia

A

Wiskott-aldrich syndrome (WATER)

55
Q

colicky flank pain, gross hematuria, passage of tissue fragments in urine

A

Papillary necrosis

56
Q

Hypertension, proteinura, edema in pregnancy

A

pre-eclampsia

57
Q

Treatment for depression leading to QRS prolongation

A

TCA

58
Q

Treat TCA overdose

A

sodium bicarbonate

59
Q

initial resistance to passive extension followed by sudden release ( Clasp-knife spasticity)

A

UMN lesion

60
Q

Pure motor neuron weakness affecting arm, leg, lower face

A

Internal capsule

61
Q

Strongyloides diagnosis

A

larvae in the stool

62
Q

Schistosoma diagnosis

A

Eggs in the stool

63
Q

T. Solium (other tapeworms) diagnosis

A

Proglottids in the stool

64
Q

Giardia diagnosis

A

Cysts and trophozoites in stool

65
Q

Cast of leg causing weakness in inversion and dorsiflexion

A

Common peroneal at the neck of the fibula

66
Q

Lateral compartment of the leg is innervated by

A

Superficial peroneal

67
Q

Anterior compartment of the leg is innervated by

A

Deep peroneal

68
Q

what structures course through the popliteal fossa?

A

tibial nerve, popliteal artery and vein

69
Q

Main site of lipid absorption

A

jejunum

70
Q

key landmark for locating trigeminal nerve

A

middle cerebral peduncle

71
Q

what are some causes of B12 malabsorption

A

Pancreatic insufficiency, intestinal bacterial overgrowth, ileal disease

72
Q

Trabecular thinning with fewer interconnections

A

Osteoporosis

73
Q

Subperiosteal resorption with cystic degeneration

A

Hyperparathyroidism

74
Q

Persistence of primary unmineralized spongiosa in medullary canals

A

Osteopetrosis

75
Q

Infertility, oligomenorrhea, hyperandrogenism

A

PCOS. Usually starts in teenage years

76
Q

Amenorrhea, hypoestrogenism, increased gonadotrophin levels.

A

Premature ovarian failure

77
Q

Triptans

A

Serotonin AGONISTS

78
Q

Polycystic kidney disease

A

think berry aneurysms. Nimodipine shown to decrease cerebral vasospasms

79
Q

positive copper reduction test but negative urine dipstick

A

Essential Fructoseuria (defective fructokinase)

80
Q

acid a-glucosidase deficiency

A

Pompe disease (cardiomyopathy, muscle weakness, hypotonia)

81
Q

galactosemia is caused by a defect in what enzyme

A

Galactose 1 phosphate uridyl transferase

82
Q

What medications are contraindicated in mania?

A

SSRI (precipatate mania)

83
Q

Tx for acute mania

A

Valproic acid, lithium, or carbazepine

84
Q

Blowing, holosystolic murmur over cardiac apex with radiation to the axilla

A

Mitral regurgitation

85
Q

Mid systolic ejection mumur heard over r. second intercostal space with radiation to the neck

A

Aortic stenosis

86
Q

Opening snap at diastolic with low pitched mid diastolic rumble

A

Mitral stenosis

87
Q

most common cause of spontaneous lobar hemorrhage in elderly

A

Cerebral amyloid angiopathy (occipital and parietal lobes)

zz - step 4 - uworld (18 decks)

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