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zz - step 4 - uworld > UW5 > Flashcards

UW5 Flashcards

1
Q

Which regulatory genes of HIV are required for replication?

A

Tat and rev

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2
Q

what does the HIV gag protein encode?

A

Structural genes for viron assembly, nucleocapside proteins p24 and p7

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3
Q

What does the HIV pol protein encode?

A

Reverse transcriptase

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4
Q

What does the HIV env protein encode

A

envelope glycoproteins gp 120 and gp 41

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5
Q

what are homeobox genes important for?

A

Sequential development of organs and tissues during embryogenesis

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6
Q

muscle stiffness and cyanotic skin mottling after inhaled anesthetic

A

Malignant hyperthermia which causes fever and severe muscle contractions after inhaled anesthetics and succinylcholine

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7
Q

Treatment for malignant hyperthermia

A

Dantrolene which acts on ryanodine receptor to prevent further release of Ca into cytoplasm of muscle fibers

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8
Q

when does acute organ transplant occur?

A

1 to 4 weeks after transplant. Rejection is mediated by T cell sensitization against graft MHC

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9
Q

Perivascular infiltrate with abundant eosinophil on endomyocardial biopsy after intiation of a new drug

A

hypersensitivity myocarditis

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10
Q

Scant inflammatory cells and intersitial fibrosis on endomyocardial biopsy

A

Chronic transplant rejection mediated by lymphocytes and antibodies months to years after transplant

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11
Q

Dense mononuclear lymphocytic infiltrate with cardiac myocyte damage on endomyocardial biopsy

A

Acute transplant rejection

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12
Q

Vitamin required to maintain differentialize of specialized epithelia (mucus secreting columnar epitheium, conjunctivia, respiratory and urinary tract and exocrine glands)

A

Vitamin A

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13
Q

Deficiency in Vitamin E

A

Infertility and decrease in serum phospholipids

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14
Q

Deficiency in Vitamin D

A

Rickets in children and osteomalacia in adults

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15
Q

Mutation in Wilms tumor

A

WT-1 or 2

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16
Q

Corkscrew esophagus on esophagogram

A

Diffuse Esophageal spasm

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17
Q

Pleuritic chest pain, dyspnea, cough, hemoptysis

A

Consider pulmonary embolism

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18
Q

ACTH stimulation does not increase serum cortisol

A

Primary adrenal insufficiency

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19
Q

Labs in primary adrenal insufficiency

A

Hyponatremia, hyperkalemia, hyperchloremia, non-anion gap metabolic acidosis

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20
Q

fever, nucal rigidity after neurosurgery

A

Staphylococcus meningitis

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21
Q

Rinne and weber in conductive hearing loss

A

Rinne: abnormal bone >air. Localized to affect ear

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22
Q

Sensorineural Rinne and weber test

A

Normal rinne, weber localizes to unaffected ear

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23
Q

brain tumor with concentrically arranged cells and psammoma bodies

A

meningioma (commonly in parasagittal region)

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24
Q

brain tumor causing tinnitus and unilateral hearing loss

A

acousting neuroma or tumors in cerebellopontine angle

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25
Q

mechanism of action for Lamotrigine

A

Blocks voltage gated Na Channel to treat partial and gneralized seizures

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26
Q

Side effect of Lamotrigine

A

Stevens Johnson Syndrome or TEN characterized by extensive cutaneous and mucosal lesions.

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27
Q

drugs associated with SJS/TEN

A

Lamotrigine, Carbamazepine, phenobarbital, phenytoin

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28
Q

function of peroxisome

A

catabolism of very long chain fatty acids, branched chain fatty acids and amino acids

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29
Q

Zellweger syndrome

A

unable to form myelin leading to hypotonia, seizures, mental retardation

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30
Q

Refsum disease

A

defect in peroxisomal alpha oxidation leads to accumulation of phytanic acid. Tx by avoiding chlorophyll

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31
Q

Functions to degrade uneeded or improperly formed intracellular proteins

A

proteosomes

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32
Q

organelle that contain an acidic fluid for degrading fatty acid, carbohydrates, proteins and nuclei acids

A

Lysosomes

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33
Q

fall on outstretched hand leading to flattening of deltoid muscle

A

Anterior dislocation of the humerus causes injury to axillary nerve

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34
Q

Which bacteria do polymyxin/ Colistin inhibit

A

Gram negative

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35
Q

which bacteria does vancomycin inhibit?

A

Gram positives only

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36
Q

enzyme responsible for green pigment in a bruise

A

Heme oxygenase

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37
Q

Enzyme defect in porphyria cutanea tarda

A

Uroporphyrinogen decarboxylase

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38
Q

what drugs inhibit warfarin metabolism

A

Cimetidine, amiodarone, TMP-SMX

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39
Q

CYP P450 inducers

A

Chronic alcoholic, Modafinil, St. Johns wort, phenytoin, phenobarbital, nevirapine, Rifampin, Griseofulvin, Carbamazepine

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40
Q

CYP P450 inhibitors

A

Acute alcohol abuse, Gemfibrozil, Ciprofloxacin, Isoniazid, Grapefruit juice, Quinidine, amiodarone, ketoconazole, macrolides, sulfonamides, cimetidine, ritonavir

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41
Q

which antibiotic has weak MAOi activity?

A

Linezolid which can precipitate serotonin syndrome in pts taking MAO inhibitors

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42
Q

What drugs can induce serotonin syndrome when used with serotonin agonists

A

Tramdol, ondansetron, linezolid

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43
Q

Side effect of TMPSMX

A

hemolysis (G6PD deficiency), hyperkalemia, megaloblastic anemia

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44
Q

Side effect of doxycycline

A

Photosensitivity, pill induced esophagitis. Enamel hypoplasia or tooth discoloration in children

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45
Q

Side effect of vancomycin

A

Red man syndrome: flushing erythema, pruritus

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46
Q

Interviewing: Support

A

expressing concern and interest. Does not claim to personally understand how the pt feels

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47
Q

Interviewing: Facilitation

A

encourages pt to talk more about experiences

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48
Q

Interviewing: Empathy

A

expression of interviewer’s understanding of pts experiences

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49
Q

Interviewing: Reflection

A

interviewer repeats what the pt is telling him

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50
Q

Interviewing: confrontation

A

draw pt to discrepancies in responses

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51
Q

Mechanism of Amantadine

A

dopaminergic agent, anticholinergic

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52
Q

Selegiline

A

MOA-B inhibitor that prevent degradation of dopamine

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53
Q

COMT inhibitor

A

Decrease break down of levodopa in peripheral disease and increase amount of levodopa to cross BBB

54
Q

Drugs for drug induced parksinsonism

A

Trihexyphenidyl and benztropine

55
Q

ANP

A

secreted by cardiomyocytes in response to atrial stretch. Activates adenylate cyclase to dilate afferent arterioles (increases GFR) and increases sodium and water excretion. Decreases aldosterone secretion. Relaxes vascular smooth muscle in arteriles and venules

56
Q

sharp pleuritic chest pain relieved by sitting up and leaning forward. Scratchy sound on auscultation when leaning forward

A

Pericarditis

57
Q

Failure of neural crest migration is responsible for which congenital heart diseases?

A

Tetralogy, Truncus arteriosus and transposition of great vessels

58
Q

failure of urethral folds to close

A

hypospadias

59
Q

faulty positioning of genital tubercle

A

epispadias

60
Q

Philadelphia chromosome is associated with which cancer

A

Chronic myelogenous leukemia t(9:22)

61
Q

Kartagener syndrome

A

Immotile cilia, autosomal recessive, bronchiectasis, situs inversus

62
Q

Macroorchidism, mental retardation

A

Fragile X

63
Q

Eczema, recurrent infections and thrombocytopenia

A

Wiskott aldrich syndrome (x linked, combined B and T lymphocyte disorder)

64
Q

hemolytic anemia, thrombocytopenia, acute renal failure

A

HUS

65
Q

Oculocutaneous albinism, peripheral neuropathy, immunodeficiency

A

Chediak Higashi (dysfunction of pahgocyte pahgolysosome-lysosome fusion)

66
Q

progressive ataxia and telangietasia and immunodeficiency

A

Ataxia-telangiectasia syndrome. Defect in ATM gene. IgA deficiency

67
Q

N-myc

A

neuroblastoma, small cell carcinoma

68
Q

BCR-ABLE rearrangement

A

CML and some ALL, increases tyrosine kinase activity

69
Q

overexpression of BCL2

A

t(14;18) follicular lymphoma

70
Q

which part of the bone does osteomyelitis usually affect in children

A

Metaphysis

71
Q

most common location for hematogenous osteomyelitis in adults

A

vertebral body

72
Q

paradoxical rise in JVP during inspiration

A

Kussmaul sign seen in constrictive pericarditis

73
Q

increase JVP, Kussmaul sign, pulsus paradoxus, pericardiac knock

A

Constrictive pericarditis

74
Q

Loud P2

A

pulmonary hypertension

75
Q

Pericardial knock

A

Constrictive pericarditis reduces ventricular compliance

76
Q

S3 heart sound

A

Restrictive cardiomyopathy. Due to sudden deceleration of incoming blood as the ventricle reaches its elastic limit

77
Q

Quinidine

A

IA antiarrhythmic. Phase 0 and 3

78
Q

Lidocaine

A

IB antiarrhythmic. Blocks Na channels on rapidly depolarizing cells

79
Q

Flecainide

A

IC antiarrhythmic. Blocks Na and acts by slowing phase 0

80
Q

Esmolol

A

class II antiarrhythmic that slows phase 4

81
Q

ST elevation in V1-V3

A

LAD

82
Q

ST elevation in V4-V6

A

LAD or LCX

83
Q

ST elevation in I, AVL

A

LCX

84
Q

ST elevation in II, III, AVF

A

RCA

85
Q

non-cyanotic congenital heart disease

A

ASD, VSD, PDA, COA

86
Q

Cyanotic congenital heart disease

A

Truncus arteriosis, Transposition, Tricuspid atresia, TOF, TAPVR

87
Q

mediators of the BBB

A

tight junctions (zona occludens)

88
Q

Rasburicase

A

recombinant urate oxidase that converts uric acid to allantoin to preven hypuricemia and renal manifestations of tumor lysis syndrome

89
Q

Denosumab

A

MAB that prevents osteoclast activation by binding RANK L to decrease bone loss and fracture in pts with bone metastasis

90
Q

N-acetylcysteine

A

Acetaminophen overdose for enhancing glutathionne production and conjucation of toxic NAPQI metabolite. Also used as a mucolytic agent for patients in CF and for prevention of radiocontrast induced nephropaty in pts with renal failure

91
Q

beta error

A

conclusion that is is no difference when a difference truly exists

92
Q

Foscarnet

A

Pyrophosphate analog that directly inhibits DNA polymerase and RT. Used for acyclovir reesistant HSV or Ganciclovir resistent CMV

93
Q

Acyclovir

A

requires conversion by thymidine kinase

94
Q

Lamivudine

A

cytosine analog (NRTI)

95
Q

Ganciclovir

A

guanine nucleoside analog that requires conversion by viral kinase

96
Q

Amatidine

A

binds to M2 channel protein to block viral uncoating

97
Q

Oseltamivir

A

silalic analog inhibitor of neuraminidase

98
Q

Fru 2,6 BP

A

inhibits gluconeogenesis and promotes glycolysis (induces PFK1)

99
Q

insulin

A

Dephosphorylates

100
Q

Glucagon

A

phosphorylates

101
Q

which antibody crosses the placenta

A

IgG

102
Q

what can cause crescentic GN

A

Goodpasture, granulomatosis with polyangiitis, microscropic polyangiitis

103
Q

BM splitting

A

Alport syndrome and MPGN

104
Q

nephritis, deafness and eye problems

A

alport syndrome

105
Q

uniform, diffuse capillary wall thickening on renal biopsy

A

Membranous glomerulopathy

106
Q

segmental sclerosis and hyalinosis on renal biopsy

A

Focal segmental glomerulosclerosis

107
Q

Pulmonary hemorrhages, rapidly progressive GN

A

Goodpasture. Anti-GBM against a3 chain of collagen type IV

108
Q

what can help prevent renal calculi formation

A

increased citrate an high fluids

109
Q

how do ACE inhibitors affect GFR

A

Decrease GFR be causing vasodilation of efferent arterioles

110
Q

tremor when posture is maintained

A

Essential tremor, tx with propranolol

111
Q

Benztropine

A

Anti-cholinergic used to treat tremor in Parkinson

112
Q

Clozapine

A

atypical antipsychotic that blocks serotonin

113
Q

coffee ground emesis

A

Upper GI bleed

114
Q

1st line therapy for chronic asthma

A

Fluticasone, beclomethasone (systemic corticosteroids)

115
Q

Albuterol

A

short acting beta 2 agonist for acute asthma

116
Q

Theophylline

A

inhibits phosphodiesterase to increase cAMP causing bronchodilation

117
Q

Ipratropium

A

antimuscarinic that decreases mucus production

118
Q

thrombocytopenia, ecchymoses, petechia, mucosal bleeding

A

ITP

119
Q

Thrombocytopenia with decrease fibrinogen and elevated PT

A

DIC (widespread activating of clotting factors (sepsis, Trauma, OB, acute pancreatitis, malignancy, nephrotic syndrome, Transfusion)

120
Q

hyaline arteriolosclerosis

A

nonmalignant HTN or diabetes. Leakage of plasma against endothelium and excessive extracellular matrix production by smooth muscle cells

121
Q

onion-like concentric thickening of walls of arterioles

A

Malignant hypertension (laminated SMC and reduplicated BM)

122
Q

Granulomatous inflammation of media

A

Temporal (giant cell) arteritis

123
Q

Suppression

A

Voluntary withholding of unpleasant thoughts from ones mind

124
Q

Identification

A

Modeling ones behavior after someone who is perceived to be more powerful

125
Q

repression

A

removal of disturbing psychological material from conscious awareness (more thorough than supression)

126
Q

Displacement

A

transfer of an impulse or desire towards a safer and less distressful object

127
Q

Projection

A

Transplantation of ones unacceptable impulses or behavior onto another person or situation

128
Q

Succinylcholine

A

Strong ACH receptor agonist that produces SUSTAINED depolarization and prevents muscle contraction

129
Q

Reversal of succinylcholine

A

Phase I (prolonged depolarization) has no antidote. Phase II (repolarized but blocked– use neostigmine to reverse

130
Q

Dantrolene

A

Malignant hyperthermia and neuroleptic malignant syndrome

131
Q

Pancuronium, tubocurarine

A

competative Ach agonists. Train of 4 responses always show fading pattern. Reverse with neostigmine

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