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UW3 Flashcards

1
Q

Reversal of opiod

A

Naloxone

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2
Q

loss of coordination, nystagms and acute brain syndrome (disorientatin, poor judgement, memory loss). Associated with trauma

A

Substance induced psychosis from PCP abuse

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3
Q

endocardial cushion defect (ASD, regurgitant AV valves) is seen in what developmental disorder

A

Down syndrome

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4
Q

Hypertrophic cardiomyopathy is seen in what developmental defect

A

Friedreich ataxia

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5
Q

Situs inversus

A

Kartagener

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6
Q

Cystic medial necrosis (aortic dissection), Mitral valve prolapse

A

Marfan

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7
Q

valvular obstruction due to cardiac rhabdomyoma

A

Tuberous sclerosis

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8
Q

Aortic coarctation and bicuspid valve

A

Turner syndrome

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9
Q

difficulty rising from chairs and combing hair are examples of

A

Proximal muscle weakness

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10
Q

bilateral stiffness of shoulder and pelvic girdle muscles, fever, weight loss and increased sed rate. Associated with temporal arteritis

A

Polymyalgia Rheumatica

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11
Q

Drug abuse: violent, dissociations, nystagmus, ataxia

A

PCP

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12
Q

Drug abuse: visual hallucinations

A

LSD

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13
Q

Drug abuse: Chest pain, seizures, mydriasis

A

Cocaine

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14
Q

Drug abuse: violent, psychosis, choreiform movements, tooth decay

A

Methamphetamine

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15
Q

Drug abuse: increased appetite, impaired time perception, conjuctival injection

A

Marijuana

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16
Q

Drug abuse: Depressed mental status, Miosis, Respiratory depression

A

Heroin

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17
Q

course of the Median nerve in the forearm

A

Between the flexor digitorium superficialis and flexor digitorum profundus

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18
Q

Denervation of Median nerve leads to what deformity

A

loss of thenar eminence and “ape hand”

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19
Q

Course of the musculocutaneous nerve

A

Between the biceps brachi and coracobrachialis. Injury results in inability to flex

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20
Q

Course of the ulnar nerve

A

Between the flexor carpi ulnaris and flexor digitorium profundus in forearm. Between olecranon and medial epicondyle of humerus

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21
Q

Injury to ulnar nerve

A

claw hand deformity due to paralysis of intrinsic hand muscles

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22
Q

Course of the radial nerve

A

through the supinator near the head of the radius. Injury causes wrist drop (loss of extensors)

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23
Q

Number of people who must be treated before an adverse event occurs

A

Number needed to harm= 1/attributable risk

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24
Q

Attributable risk

A

Event rate of treatment - control

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25
Q

How is flow related to the radius in a vessel?

A

Inversly proportional raised to the 4th power

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26
Q

Mechanism of Digoxin

A

Block NaK ATPase and decrease AV nodal conduction by increased PS tone (vagal)

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27
Q

Low plasma sodium and osmolality, inappropriately concentrated urine, increased urinary sodium and normal body volume ( RAS intact)

A

SIADH ( small cell lung cancer)

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28
Q

What can be used to determine if malabsorption is due to pancreatic or intestinal pathology?

A

D-xylose (can be absorbed without amylase)

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29
Q

What does the deep peroneal nerve innervate?

A

Extensors and great dorsiflexors

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30
Q

What does the superficial peroneal n. innervate?

A

Peroneal muscles and skin of the toes

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31
Q

Compression or leg fracture causing foot drop

A

Damage to the common peroneal n ( crosses lateral neck of fibula)

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32
Q

Damage to femoral nerve

A

Loss of knee jerk

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33
Q

Damage to tibial nerve

A

Loss of plantar flexion (motor to popliteus and flexors of the foot)

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34
Q

Overflow incontinence

A

Impaired detrusor contractility or bladder outlet obstruction

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35
Q

Stages of lobar pneumonia

A

Congestion (24 hr), Red hepatization (2-3 days), Gray hepatization ( 4-6 dyays), resolution

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36
Q

High doses of ACHEi with no improvement with edrophonium

A

Cholinergic Crisis

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37
Q

What is the mechanism of cholinergic crisis?

A

High doeses of ACHEi increases AcH in synapases causes excessive stimulation that results in muscles that are refractory to future impulses. Presents as muscle weakness that does not improve with edriphonium

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38
Q

vitamin deficiency that appears similar to B12 but without megaloblastic anemia, hypersegmented neutrophils or increased serum methylmalonic acid

A

Vitamin E

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39
Q

PKU

A

Phenylalanine hydroxylase. Requires BH4

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40
Q

Maple syrup urine disease

A

branched chain ketoacid dehydrogenase

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41
Q

Alkaptonuria

A

Deficiency of homogentisic acid oxidase

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42
Q

splitting of S2 that does not change with respiration

A

ASD

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43
Q

Systolic ejection murmur that increases with standing

A

Hypertrophic cardiomyopathy ( decreased in size of left ventricular outflow tract)

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44
Q

Splitting of S1 accenutated on inspiration

A

delayed closure of tricuspid. Seen in Right BBB or tricuspid stenosis

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45
Q

Power of a study

A

Ability to detect a difference between groups when a different truly exists. Increases when sample size

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46
Q

Full bladder sensation and inability to pass a foley

A

Urethral injury

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47
Q

Autoregulation of BP in coronary arteries is mostly controlled by

A

Nitric oxide and adenosine

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48
Q

Impaired balance, difficulty speaking with elevated transaminases

A

Wilsons disease. Kayser Flesicher ring

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49
Q

Treatment of DKA

A

Insulin and normal saline ( drops potassium due to intracellular shift of K)

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50
Q

Mitochondrial diseases display variability in clincal findings. What explains this?

A

Heteroplasmy ( condition of having different organellar genomes in a single cell)

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51
Q

Monoclonal antibody that binds IgE

A

Omalizumab

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52
Q

Monoclonal antibody that binds TNF

A

Infiximab, adalimumab

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53
Q

Decoy TNF receptor

A

Etanercept

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54
Q

Monoclonal antibody that binds HER2/neu

A

Trastuzumab

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55
Q

Hydrocephalus, intracranial calcifications and chorioretinitis

A

Congential Toxoplasma

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56
Q

What determines the potency of an anesthetic?

A

Minimal alveolar concentration (MAC) percentage that renders 50 percent of patients unresponsive to stimuli

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57
Q

What determines the onset of action for an anesthetic?

A

Blood/gas partition

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58
Q

SE of statins

A

hepatitis and myopathy

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59
Q

SE of niacin

A

cutaneous vasodilation, hyperglycemia (acanthosis nigricans), hyperuricemia, Hepatitis

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60
Q

SE of Fibric acid

A

Gallstones, myopathy

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61
Q

Bile acid binding resins

A

GI upset, Hypertrigyceride, malabsorption

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62
Q

peripheral displacement of nuclei, dispersion of Nissl substance in neurons indicate

A

Axonal regeneration

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63
Q

Burkitt lymphoma is a proliferation of what type of cells?

A

B cell proliferation. EBV can increase c-myc translocation (8,14)

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64
Q

Atrophic skin changes, cold induced vasospasm

A

CREST Syndrome (sclerodactylyl and Raynaud)

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65
Q

CREST Syndrome

A

Calcinosis, Raynaud, Esophageal dysmotility, Sclerodactyly, Telangietasia (anti-centromere antibody)

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66
Q

What does an accented heart sound over left sternal border suggest

A

pulmonary coponent of second heart sound suggests increase in pulmonary artery pressure and pulmonary hypertension

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67
Q

Diffuse injury to pulmonary microvasculature or alveolar epithelium, resulting in increased pulmonary capillary permeability and leaky alveolocapillary membrane

A

ARDS

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68
Q

ARDS

A

increased pulmonary capillary permeability leads to interstitial and alveolar exudate and edema. Decreases lung compliance, increases work of breathing and V/Q mismatch. Normal capillary wedge pressure.

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69
Q

tall stature, gynecomastia and small, firm teste

A

Klinefelter

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70
Q

Arachnodactyly, scoliosis, aortic root dilation

A

Marfan

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71
Q

Short broad fingers, transverse palmar crease

A

Down Syndrome

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72
Q

Macrosomia, large jaw, large ears, thin face, macroorchidism, mental retardation

A

Fragile X (CGG)

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73
Q

If the 95% CI for the mean difference between 2 variables includes 0

A

Null hypothesis is not rejected so there is no significant difference

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74
Q

If the Cl between 2 groups overlap, is there a significant difference?

A

no

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75
Q

If 95% CI for a RR or OR includes 1 is the null hypothesis rejected?

A

no

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76
Q

Percentage indicating the actual difference in event rate between control and treatment groups

A

Absolute risk reduction

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77
Q

Percentage indicating relative reduction in treatment event rate compared to control

A

Relative risk reduction (ARR/ control rate)

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78
Q

Ratio of the probability of an event occurring in the treatment group compared to the control group

A

Treatment rate/ Control rate

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79
Q

number of individuals that need to be treated to prevent a negative outcome in one patient

A

Number needed to treat (NNT= 1/ARR)

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80
Q

treat anemia due to chronic renal failure

A

Epo

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81
Q

Koilonychia

A

Spoon nails seen in iron deficiency

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82
Q

polyuria, polydipsia, volume depletetion, hyperglycemia, low bicarb, high anion gap, decrease sodium

A

DKA

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83
Q

What electrolyte must you monitor in DKA?

A

Potassium

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84
Q

Plantar flexion

A

Tibial (Gastrocnemius, soleus, plantaris)

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85
Q

Inversion of the foot

A

Tibal n (tibialis posterior)

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86
Q

Tibial nerve innervates

A

Flexors of the lower leg, flexors of the toes and skin of the sole of the foot

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87
Q

Course of the tibial nerve

A

Branch of the sciatic that goes through the popliteal foxxa

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88
Q

Key findings of DIC

A

Prolonged PT and PTT, Thrombocytopenia, microangiopathic hemolytic anemia, low fibrinogen, elevated fibrin split products, low factor 5 and 8

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89
Q

Penetrating injury to the second intercostal space at L. sternal border

A

Pulmonary trunk

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90
Q

Penetrating injury to the 4th intercostal space in the midclavicular line

A

left lung and left ventricle

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91
Q

stab would to the back immediate right of the vertebral body

A

IVC

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92
Q

penetrating injury at left sternal border at 4th intercostal space

A

Right ventricle

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93
Q

Gastric erosions

A

Do not penetrate the muscularis mucosa

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94
Q

Gastric ulcer

A

Extend into the submucosal layer and the muscularis propria

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95
Q

Basement membrane splitting

A

Membranoproliferative GN and alport syndrome

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96
Q

Diffuse thickening of glomerular capillary walls

A

Membranous glomerulopathy

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97
Q

Linear IgG and C3 deposits on IF

A

Goodpasture

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98
Q

narrow, high arched palate, low hairline, low set ears, bicuspid aortic valve, horseshoe kidney, cubitus valgus

A

Tuners Syndrome

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99
Q

individual inherits 2 copies of a chromosome from one parent and no copies from the other

A

Uniparental disomy (Prader Willi and Angelman)

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100
Q

Infection + hypotension, tachycardia, tachypnea and temperature

A

Septic shock

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101
Q

Early sepsis

A

Increased cardiac output, peripheral vasodilation and warm extremities

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102
Q

stimulates neutrophil migration to site of inflammation

A

Leukotriene B4

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103
Q

Stimulates growth and differentiation of stem cells in bone marrow

A

IL 3

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104
Q

Stimulates growth of B cells and increases TH2 t helper T cel

A

IL 4

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105
Q

Anti-inflammatory cytokine produced by macrophages and TH2 helper T cell

A

IL 10

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106
Q

Produced by T cells and recruits leukocytes and activate phagocytosis

A

INF gamma

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107
Q

Function of the 16s rRNA

A

initiation of protein synthesis. Binds Shine Dalgarno sequence in mRNA and allow mRNA and 30 risomal subunit to bind

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108
Q

Midshaft humerus fracture

A

Deep brachial artery and radial nerve

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109
Q

Short acting BZD

A

Alprazolam, Triazolam, Oxazepam

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110
Q

Medium acting BZD

A

Estazolame, Lorazepam, Temazepam

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111
Q

Long acting BZD

A

Chlordiazepoxide, clorezepam, Diazepam, Flurazepam

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112
Q

Transference

A

unconscious shifting of emotions associated with one person to another

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113
Q

Acting out

A

unconcious wishes or impulses are expressed through actions

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114
Q

Projection

A

misattributing ones own unacceptable thoughts and feelings to another

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115
Q

Pancreatitis with respiratory distress

A

ARDS from diffuse injury to pulmonary microvasculature and kealy alveolocapillary membranes ( exudate and necrotic tissue make up hyaline membrane)

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116
Q

Crackles (rales)

A

Alveolar edema and atelectasis

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117
Q

Cytokeratin is used as IHC marker for what cells

A

Epithelial cells

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118
Q

MPO is used as a marker for what type of cells?

A

Myeloid cells

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119
Q

Vimentin is used as a marker for what type of cell?

A

Vimentin

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120
Q

Chromogranin is used as a marker for what type of cell?

A

Neuroendocrine

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121
Q

stimulated by decrease in pH of CSF ( increased paCO2) increases respiration

A

Central chemoreceptors

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122
Q

Senses PaO2 and stimulated by hypoxemia

A

Peripheral chemoreceptor

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123
Q

C fibers that regulate duration of inspiration depending on degree of lung distension to prevent from hyperinflation

A

Pulmonary stretch receptors (Hering Bruer reflex)

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124
Q

TCA toxicity

A

sodium bicarbonate

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125
Q

Barbituate poisoning

A

Diuretic with urinary alkalization

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126
Q

Salicylate (asa)

A

alkalinization

127
Q

Unique histology of duodenum

A

Brenner’s glands (secrete alkaline mucus), cryts of lieberkuhn

128
Q

unique histolory of jejunum

A

plicae circulares

129
Q

unique histology of ileum

A

peyers patches

130
Q

unique histology of colon

131
Q

Obesity, hirsutism, oligomenorrhea

132
Q

Ambiguous genitalia, hypotension, hyponatremia

A

21 hydroxylase deficiency

133
Q

Mechanism of action of terbinafine

A

Squalene epoxidase inhibitor

134
Q

Mechanism of action of amphotericin B and Nystatin

A

Binds to ergosterol

135
Q

Mechanism of action of caspofungin

A

blocks synthesis of Beta D-glucan (Candida and Aspergillus)

136
Q

Mechanism of Griseofulvin

A

binds polymerized microtubules and discupts fungal mitotic spindle to prevent mitosis

137
Q

Where is secretin secreted from?

A

S cells in duodenum in response to acid. Increases bicarb secretion from pancreas

138
Q

What hormones are secreted by the pancreas

A

Insulin, glucagon, somatostatin

139
Q

Characteristics of anaplasia

A

Loss of cellular polarity with disruption of normal architecture. Pleomorphism. High N to C ratio. Mitotic figures. Giant Multinucleated tumor cells

140
Q

Role of HIV gp120

A

viral adherence

141
Q

Role HIV gp41

142
Q

Unilatera hearing loss with facial numbness and weakness

A

Intracranial schwannoma (cerebellowpontin angle)

143
Q

Obstructive hydrocephalus ( headache, vomiting, AMS) and Parinaud syndrome (upward gaze palsy)

A

Pineal tumor ( dorsal midbrain)

144
Q

Dermatitis, diarrhea, dementia

A

Pellagra (Niacin deficiency)

145
Q

Phenylalanin derivatives

A

Tyrosine, Dopa (melanin), Dopamine, NE, Epi

146
Q

Tryptophan derivatives

A

Niacin, Serotonin

147
Q

Glycine derivative

A

Porphyrin, Heme

148
Q

Arginine derivatives

A

Creatinine, Urea, Nitric oxide

149
Q

Cofactor in Heme synthesis for ALAS

A

B6 pyridoxine

150
Q

17a hydroxylase deficiency

A

no androgens, hypertension

151
Q

21a hydroxylase deficiency

A

lots of androgens, low sodium

152
Q

hyperdensity in sulci on CT with headache

A

Subarachnoid hemorrhage

153
Q

Mechanism of action of thiazolidinediones

A

Bind to PPAR-y which increases expression of adiponectin and increase lipid metabolism and increase insulin sensitivity in tissues

154
Q

which DNA polymerase inhibitor does not require phosphorylation by viral kinase?

155
Q

How do you calculate power?

A

1- Beta ( type II error) No difference even though one exists

156
Q

Type I error

A

probability of seeing a difference when no difference exists ( p- value)

157
Q

Accumulation found in Tay Sach

A

GM2 ganglioside, no hepatosplenomegaly

158
Q

palpable swelling in newborn that is only comfortably when held sideways. Favors looking in one direction

A

Congenital Torticollis

159
Q

Angiokeratoma, painful neuropathy, cardiovascular, renal disease

A

Fabry disease, a-galactosidase, ceramide trihexoside

160
Q

Gaucher cells, hepatosplenomegaly, pancytopenia, severe bone and joint pain

A

Gaucher disease, B-glucocerebrosidase, Glucocerebroside

161
Q

Gargoylism, corneal clouding, hepatosplenomegaly, developmental delay

A

Hurler syndrome, a-L-iduronidase, Dermatan and heparan sulfate

162
Q

Gargoylism, NO corneal clouding, hepatosplenomegaly

A

Hunter syndrome, Induronate sulfatase. Dermatan and heparan sulfate

163
Q

Hepatosplenomegaly, cherry-red spot in macula, foam cells, progressive neurodegeneration

A

Niemann Pick, sphingomyelinase. Shpingomyelin

164
Q

Cherry red spot, progressive neurodengeration, NO hepatosplenomegaly

A

Tay sachs. B-hexosaminidase A. GM2 gangliside

165
Q

Progressive neurodegeration, optic atrophy

A

Krabbe disease, Galactocerebrosidase. Galactosylsphingosine and galactocerebroside

166
Q

Muscle wasting, dementia, ataxia

A

Metachromatic leukodystrophy. Arylsulfatase A. Cerebroside sulfate

167
Q

which cancer drug can cause burning on urination and urgency?

A

Cyclophosphamide

168
Q

Which cancer drug can cause leg swelling and orthopnea?

A

Doxorubicin associated CHF

169
Q

Which cancer drug can cause dry cough and exertional dyspnea?

170
Q

Which cancer drug can cause tarry stool and fatigue?

A

alkalating agents

171
Q

which cancer drug can cause abdomina pain and jaundice?

A

mercaptopurine

172
Q

What percentage of values lie within 1 standard deviation?

173
Q

what percentage of values lie within 2 standard deviations?

174
Q

what percentage of valules like within 3 standard deviations

175
Q

non-rhythmic conjugate eye movements associated with myoclonus

A

opsoclonus-myoclonus syndrome

176
Q

opsoclonus, 2 year old, hypotonia, myoclonus, abdominal mass

A

Neuroblastoma

177
Q

teenagers, malignant bone tumor

A

Ewing sarcoma

178
Q

2 year old, palpable flank mass. Tumor that resembles primitive metanephric tissue

A

Wilms tumor

179
Q

2 yr old, brain tumor, gait and limb ataxia

A

Medulloblastoma

180
Q

type of sensitivity in acute hemolytic transfusion reaction

A

Type II antibody mediated (complement mediated cell lysis)

181
Q

type of sensitivity reaction in Rh incompatibility

A

Type II antibody mediated

182
Q

urticaria or itching after transfused blood

A

Allergic reaction (type I) IgE mediated. Seen in IgA deficient patients with anti-IgA antibodies

183
Q

Mutations associated with early alzheimer

A

APP on chr 21, Presenilin 1 (chr 14) and presenilin 2 ( chr 1)

184
Q

Mutations associated with late onset familial alheimer

A

E4 allel on apoE

185
Q

Mutation in hyptrophic cardiomyopathy

A

Beta myosin heavy chain

186
Q

Findings in cholestasis

A

acholic stools and dark urine ( obstruction of biliary tree)

187
Q

Juandice, unconjugated hyperbilirubinemia, positive combs test, hemolytic anemia

A

Rh+ born to Rh - mothers

188
Q

liver biopsy shows oval to round intracytoplasmic hepatocyte inclusions that appear eosinophilic and PAS positive

A

Alpha 1 antitrypsin

189
Q

centrilobar necrosis (hepatic vein)

A

drugs, ischemic injury, toxins, hepatitis

190
Q

periportal hepatitic fibrosis

A

chronic viral hepatitis

191
Q

which nerves are affected in saddle anesthesia

192
Q

Low back pain radiating to one or both legs, saddle anesthesia, loss of anocuaneous reflex, bowel or bladder dysfunction and loss of ankle jerk reflex with plan flexion weakness of feet

A

Cauda equina syndrome

193
Q

anesthesia or parathesias in the glutea region inferior to the iliac crest and anteriorly on the thigh inferior to the femoral triangle and inguinal ligment

194
Q

Decreased knee jerk reflex and patellar reflex. Paresthesias and weakness over anterior thigh

A

L3-4 lesion

195
Q

loss of sensory or parethesias over posterior leg and thigh

A

S1-2 (sciatic nerve) loss of achilles reflex

196
Q

Bone pain, elevated alk phos. Biopsy showing lamellar bone

A

Paget disease

197
Q

MEN 1

A

parathyroid, pancreas, pituitary

198
Q

MEN 2A

A

Medullary carcinoma of thyroid, pheo, parathyroid

199
Q

MEN 2B

A

Medullary carcinoma of thyroid, pheo, mucosal neuroma

200
Q

MEN 2A and 2B are associated with what mutation

A

RET proto-oncogene affecting neural crest cells

201
Q

Primary cells responsible for inflammatory response in gout

A

neutrophils

202
Q

Ulcers on the anterior wall of the duodenum are more like to cause

A

Perforation

203
Q

Ulcers on the posterior wall are more likely to cause

A

Hemorrhage (erosion into GDA)

204
Q

From which artery does the common hepatic arise from?

A

celiac trunk and bifurcates into proper hepatic and GDA

205
Q

the inferior pancreacticoduodenal artery is a branch of

A

the SMA. Supplies the lower duodenum and head of pancreas

206
Q

Metheamine silver or mucicarmine stains are use for what organism

A

Cryptococcus

207
Q

TB like pulmonary disease. Dimorphic fungi found intracellularly in macrophages

A

Histoplasma

208
Q

large, thick walled spherules that contain endospores

A

Coccidioides

209
Q

bronchiectasis with eosinophilia

A

Aspergillus

210
Q

Crescents in IF of renal biopsy

A

Rapidly progressive GN

211
Q

Diffuse granular pattern of IgG and C3 in capillary walls and mesangium

A

Post strep GN

212
Q

Linear deposits of IgG and C3

A

Goodpasture (type I RPGN)

213
Q

down and out gaze with normal light and accommodation

A

Diabetic mononueropathy

214
Q

Where is the area postrema located?

A

Dorsal medulla

215
Q

Intraepidermal vesicles, superficial epidermal hyperkeratosis producing scales, epidermal hyperplasia (ancanthosis) or chronic inflammatory infiltrate

A

Active eczema

216
Q

what are the local cutaneous adverse effects of chronic topical corticosteroid administration?

A

atrophy, thinning of dermis associated with loss of dermal collagen (drying, cracking or tightening of skin, telangiectasia and ecchymoses)

217
Q

what is the polyadenylation signal?

218
Q

how can you tell if a cell is a blast cell?

A

large cell size (compared to RBC) with high nucleus to cytoplasm ratio

219
Q

What is the criteria for diagnosing AML?

A

>20% blast cells

220
Q

Spike and dome on EM

A

Membranous glomerulopathy

221
Q

hypercellular glomeruli

A

membranoproliferative

222
Q

Painless hematuria after URI with IgA deposits

A

Berger disease

223
Q

Effacement of foot processes

A

Minimal change and FSGN

224
Q

Hypertrophic cardiomyopathy is associated with which murmur?

A

Mitral regurgitation

225
Q

what enzyme contributes to pigment stones?

A

Beta glucuronidase

226
Q

small cells with dark, round nuclei and small rim of cytoplasm

A

Lymphocytes

227
Q

asthmatic with wrist drop, eosinophils,anti neutrophil myeloperoxidase

A

Churg strauss

228
Q

Eosinophils, elevated IgE and IgG antibodies to aspergillus

A

Allergic bronchopulmonary aspergillosis

229
Q

Direct thrombin inhibitors

A

Lepirudin and agatroban

230
Q

primary use for lepirudin and agatroban

A

heparin induced thrombocytopenia

231
Q

Inhibits ADP mediate platelet aggregation

A

Ticlopidine and clopidogrel

232
Q

Use for Ticlopidine and clopidogren

A

unstable angina and non-Q wave MI

233
Q

Mechanism of finbrinolysis agents

A

Covert plasminogen to plasmin

234
Q

Use for TPA

A

acute MI, PE and arterial thrombosis

235
Q

mechanism for aspirin

A

irreversibly acetylates platelet COX-1 to decrease formation of TXA2

236
Q

what part of the heart does the RCA perfuse?

A

Sinoatrial and AV node

237
Q

How can inferior MI change heart rate?

A

Bradycardia due to decreased perfusion of SA and AV node

238
Q

What is an effective treatment for inferior MI?

A

atropine due to vagal influence on SA and AV nodes increases heart rate (inferior MI can cause bradycardia due to decreased SA and AV node perfusion)

239
Q

Why can atropine result in glaucoma?

A

Mydriasis results in narrowing of anterior chmaber angle and decreased outflow of aqueous humor

240
Q

Scopolamine

A

Anticholinergic used for motion sickness. SE: sedation

241
Q

Benztropine

A

Anticholinergic for Parkinsons

242
Q

oxybutynin

A

anticholinergic for neurogenic (spastic) bladder

243
Q

Ipratropium

A

Anticholinergic for Asthma and COPD (bronchodilation)

244
Q

ground glass infiltrates diagnosis with silver staining of fluid collected during bronchoscopy

A

Pneumocystis jiroveci

245
Q

Requires L-cysteine to grow

A

Legionella

246
Q

Renal angiomyolipoma, seizures, patches of skin that lack pigment

A

Tuberous sclerosis (brain hamartoma, ash leaf spot)

247
Q

Neurofibroma, optic glioma, pigmented nodules of iris (Lisch nodules), café au lait

A

Neurofibromatosis type I

248
Q

Cerebellar hemangioblastima, retinal hemangioma, liver cysts

A

Von Hippel Lindau

249
Q

Port wine stain, leptomeningeal capillary venous malformation

A

Sturge Weber

250
Q

Hemorrhagic telangiectasia with recurrent GI bleed

A

Osler Rendu Weber

251
Q

at what age do children understand the finality of death?

252
Q

Recurrent otitis medi, chronic diarrhea, pneumocystis

A

SCID (humoral and T cell deficiency)

253
Q

Reccurent infections with extracellular, encapsulated organisms

A

Agammaglobulinemia

254
Q

recurrent cutaneous abscesses

A

Phagocytic defects (chronic granulomatous disease)

255
Q

Increased susceptibility to Neisseria

A

Complement deficiency ( associated with lupus like syndrome)

256
Q

cells in cell mediated immunity

A

CD4, CD8, NK, macrophages

257
Q

what is anergy?

A

lack of response to foreign substances

258
Q

components of humoral immunity

A

antibodies, B cells

259
Q

pulses paradoxus, arterial hypotension

A

cardiac tamponade

260
Q

cardiogenic shock

A

Cardiac output becomes insufficient to provide necessary oxygen to patient’s tissues

261
Q

Paloating radial pulse that disappears with inspiration

A

cardiac tamponade

262
Q

Beat to beat variation in magnitiude of pulse pressure in presence of regular cardiac rhythm

A

Pulsus alternans in pts with left ventricular dysfunction

263
Q

two distinct peaks during systole and diastole palpated in carotid arteries in pts with severe systolic function

A

Dicrotic pulse

264
Q

Low magnitude pulse with delayed peak of aortic stenosis

A

Pulsus Parvus et tardus

265
Q

rapid ejection of large stroke volume against decreased afterload seen in high output conditions (PDA) or AV fistula

A

Hyperkinetic pulse

266
Q

Ferments mannitol

267
Q

Novobiocin resistance

A

S. saprophyticus

268
Q

Prolonged QT with neurosensory deafness, autosomal recessive

A

Jervell and Lange-Nielsen

269
Q

Prolonged QT no deafness, autosomal dominant

A

Romano-ward

270
Q

sudden syncopal episode

A

sudden cardiac arrhythmia

271
Q

mutations in dilated cardiomyopathy

A

cardiac cell cytoskeletal proteins or mitochondrial enzymes

272
Q

Mutations in hypertrophic cardiomyopathy

A

cardiac sarcomere proteins

273
Q

Vasopressin increases permeability to what substances in the collecting duct?

A

water and urea

274
Q

Biopsy shows central collecting of epithelioid macrophages surrounded by rim of mononuclear cells

A

Non-caseating granuloma

275
Q

Bronchial challenge testing

A

Methacholine assesses bronchial hyperreactivity

276
Q

Forceful blow to lateral kneed while low extremity is fully extended and foot is planted

A

ACL, MCL, meniscal tear

277
Q

Forceful blow to medial knee while leg is extended

A

Lateral (fibular) collateral ligament

278
Q

Abnormal pressur gradient between LV and aorta

A

Aortic stenosis

279
Q

holosystolic heard at apex that radiates to axilla

A

Mitral regurgitation

280
Q

ventricular volumne overload is associated with what mumur?

A

Mitral regurgitation

281
Q

S3 is an indicator of

A

large regurgitant volume (CHF)

282
Q

Fever for 5 days, bilateral nonexudative conjunctivitis, mucositis, coronary artery aneurysm, swelling an erythema of palms and soles, cerival lymph node

A

Kawasaki Disease

283
Q

What enzyme catalyzes translocation?

A

Elongation factor 2

284
Q

What enzyme catalyzes peptide bond formation

A

Peptidyl transferase

285
Q

Mutation in thalassemia intermdia

A

Kozak sequence of beta globin chain causing hypochromic, microcytic anemia

286
Q

which enzyme in glyconeogenesis is only present in liver cells?

A

Glu 6 phosphatase ( muscles don’t make glucose!)

287
Q

What enzyme is deficiency in McArdle’s syndrome

A

Glycogen phosphorylase leads to decreased breakdown of glycogen during exercise

288
Q

muscle cramping, pain and myoglobinuria during exercise

A

McArdles failure of glycogenolysis (glygocen phosphorylase deficiency)

289
Q

Early systolic, high frequency click over right second interspace

A

Bicuspid aortic valve

290
Q

cardiac anomalies in down syndrome

A

ASD, VSD, complete Atrioventricular canal

291
Q

cardic mumur in Maran

A

Mitral prolapase (mid systolic click)

292
Q

insufficiently cooked boiled eggs

A

Salmonella

293
Q

Side effets which diuretic: hypokalemia, hypomagnesemia, hypocalcemia, volume depletetion, hyponatremia, decreased GFR, hypotension, ototoxicity

A

Loop diuretic

294
Q

Side effects of which diuretic: hypokalemia, hyponatremia, hypomagnesemia, hypotention, volume depletion and hypercalcemia

295
Q

Side effects of which diuretic: hyperkalemia

A

Spironolactone

296
Q

Side effect of which diuretic: nausea, vomiting, headache and hypernatremia

297
Q

Side effect of which diuretic: somonolence, parethesias and urine alkalinization

A

acetazolamide

298
Q

caput medusae and esophageal varices, acites

A

portal hypertension

299
Q

secretory diarrhea

A

Bacterial toxins or VIPoma

300
Q

which viruses do not produce thymidine kinase?

A

CMV and EBV

301
Q

Acyclovir, famciclovir and valaciclovir are effective in which viruses

A

HSV and VZV which encode thymidine kinase

302
Q

What is use dependence

A

affinity for activated and inactivated channels and little affinity for resting sodium channels

303
Q

Lichtenberg figure

A

fern leaf pattern on skin pathognomonic of lightening strike

304
Q

severe nosebleeds, pink spider like lesions in oral and nasal mucosal, face and arms

A

Osler weber Rendu

305
Q

cutaneous facial angioma, leptomeningeal angioma, metal retardation, hemiplegia, skull radiopacities. Tram track calcification

A

Sturge weber

306
Q

recurrent nephrolithiasis, hexagonal shaped crystals

A

Cystinuria, cystine stones

307
Q

stones that are octahedron with x in center

A

Calcium oxalate

308
Q

stones that are rectangualar prisms

A

Struvite stones

309
Q

Stones that are rhombus or diamond

310
Q

Stones that are hexagonal

311
Q

How does an AV shunt change pressure volumne loop

A

Increase preload and decrease afterload

312
Q

Increase preload on Pressure Volume loop

A

Increase end diastolic volume and increase stroke volume

313
Q

Increase Afterload on pressure volumn loop

A

decrease stroke volume, increase end systolic volume

314
Q

Increase contractility on pressure volume loop

A

Increase stroke volume, increase ejection fraction and decrease End systolic volume

Uworld (18 decks)

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