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Uworld > UW6 > Flashcards

UW6 Flashcards

1
Q

high uric acid levels, dystonic movements,tendency to bite own lips

A

Lysch Nyhan (HGPRT deficiency)

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2
Q

What enzyme is increased in lysch-nyhan syndrome

A

PRPP aminotransferase (due to accumulation of PRPP and in creased de novo purine synthesis) Xanthine oxidase increases due to degradation of xanthine and guanine to uric acid

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3
Q

Disorganized ( insight, abstract reasoning, planning), Disinhibited (judgement, inappropriate social behavior), apathetic (motivation, personality)

A

Frontal lobe syndrome

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4
Q

spatial and visual perception, writing and calculation, left to right differentiation, object identification

A

Parietal lobe damage

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5
Q

Language, difficulty with sensory interpretation, impaired memory

A

Temporal lobe damage

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6
Q

Pertussis adenylate cyclase toxin

A

functions as adenylate cyclase,increases cAMP levels causing edema and phagocyte dysfunction

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7
Q

tetany, aortic arch abnormalities, underdeveloped madible

A

DiGeorge ( 3rd pharyngeal pouch)

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8
Q

branchial cleft cyst

A

Second branchial cleft (pharyngeal groove)

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9
Q

gives rise to tissues innervated by 9th cranial nerve ( glossopharyngeal), stylopharyngeus m, hyoid bone, posterior 1/2 of tongue

A

3rd branchial arch

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10
Q

gives rise to tissues innervated by the superior laryngeal branch of vagus n and most muscles of the soft palate and pharynx

A

4th branchial arch

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11
Q

Criteria for schizoprenia

A

2 or more symptoms for >6 month of at least 1 positive symptom of delusions, hallucinations or disorganized speech. Negative symptoms: flat affect, lack of speech or thought, social withdrawal

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12
Q

Criteria for Manic episode

A

elevated, expansive or irritable mood for at least 1 week. At least 3 of the following: grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, psychomotor agitation

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13
Q

Bipolar I

A

Manic episode + major depressive episode

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14
Q

Bipolar II

A

hypomanic episode and depressive episode

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15
Q

cyclothymic disorder

A

Dysthymia and hypomania lasting 2 years

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16
Q

Respiratory distress, AMS, seizures, petechial rash over head, neck, thorax, axillae

A

Fat embolism

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17
Q

Cleft plalet, polydactylyl, rocker bottom feet

A

Patau (trisomy 13)

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18
Q

single palmar crease, endocardial cushion defect, duodenal atresia

A

Down syndrome, increased risk for AML, ALL, early alzheimer

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19
Q

TTX blocks which channels

A

voltage gated sodium channels

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20
Q

What channels does lidocaine block?

A

voltage gated sodium channels of sensory neurons, purkinje fibers and ventricular cells (anaesthetic and Class IB antiarrhythmic)

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21
Q

Autoantibodies in Pemphigus Vulgaris

A

Desmosomal proteins (desmoglein 3)

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22
Q

Autoantibodies in epidermolysis bullosa acquisita

A

Cutaneous basement membrane proteins

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23
Q

Autoantibodies in bullous pemphigoid

A

Hemidesmosomal proteins (intact bullae) and mucosal involvment uncommon

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24
Q

What happens when baroreceptors are stimulated?

A

stimulated by stretch and increased BP leads to increased number of signals leading to decreased baroreceptor signaling

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25
Q

what is carotid sinus syncope

A

external pressure causes baroreceptors to react as if there was a systemic BP increase causing hypotension leading to syncope

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26
Q

Which nerve is responsible for carrying signals from the carotid sinus?

A

Glossopharyngeal

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27
Q

Which nerve is responsible for carrying signals from the aortic arch?

A

Vagus

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28
Q

when are glycogen stores depleted?

A

12-18 hours after fasting

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29
Q

Pyruvates to PEP

A

Pyruvate carboxylase

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30
Q

Oxaloacetate to PEP

A

Phosphoenolpyruvate carboxykinase (PEPCK)

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31
Q

acetyl coA to palmitate

A

Fatty acid produced during lipogeneisis

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32
Q

acetoacetyla Coa to 3hydroxy3methyglutaryl coA

A

Cholesterol synthesis

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33
Q

Daptomycin use and side effects

A

Used for Gram positive, MRSA ( disrupts cell membrane) causes myopathy and CPK elevation. Not effective in treating pneumonias because it is inactivated by pulmonary surfactant

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34
Q

Linezolid Use and side effects

A

Used for MRSA (binds to 23rRNA on 50S to prevent formation of intiation complex), Can cause thrombocytopenia, optic neuritis and risk for serotonin syndrome

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35
Q

Common drugs for MRSA

A

Vancomycin, Daptomycin, Linezolid

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36
Q

Papilledema, dry skin, hepatosplenomegaly, visual difficulties

A

Vitamin A toxicity

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37
Q

widespread musculoskeletal pain, fatigue, tender points, normal inflammatory markers

A

Fibromyalgia

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38
Q

progressive pain and stiffness of spine, scaroiliitis

A

Ankylosing spondylitis

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39
Q

Bilateral pain and morning stiffness in shoulders and hips, elevated sed rate, associated with giant cell arteritis

A

Polymyalgia rheumatica

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40
Q

Side effect of thiazides

A

HYPER: uricemia, calcemia, glycemia, lipidemia. HYPO: kalemia, tension

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41
Q

gradula onset dyspnea, end-inspiratory crackles at lung bases, decreased FEV1 and FVC, increased ratio and decreased diffusion capacity

A

Pulmonary fibrosis

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42
Q

Post strep glomerulonephritis is seen after a strep skin infection or phayngitis or both?

A

Both

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43
Q

Rheumatic fever is seen after strep pharyngitis, skin infection or both?

A

only with throat infection

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44
Q

Amino acid formula of collagen

A

GLY-X-Y where X and Y are proline or lysine

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45
Q

recombination

A

exchange of genes between two chromosomes via crossing over in non-fragmented, ds DNA genome

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46
Q

Transformation

A

uptake of naked DNA or uptake of viral DNA into host cell chromosome

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47
Q

Phenotypic mixing

A

coinfection of a host by two viral strains results in virion that contains nucleocapside proteins from one and genome of other strain

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48
Q

Interference

A

inhibition by one virus of the replication or release of second virus in same cell

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49
Q

Factor Xa inhibitors

A

Direct: Rivaroxaban, Apixaban. Indirect: Fondaparinux

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50
Q

Direct thrombin inhibitor

A

Argatroban, Bivalirubin, Dabigatran

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51
Q

how do Xa inhibitors affect PT, PTT and thrombin time

A

Prolongs PT, PTT and does not change thrombin time

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52
Q

contraindications of OCP

A

Prior history of stroke, hx of estrogen dependant tumor, smoker over 35, hyperTG, decompensated liver disease, pregnancy

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53
Q

painless hematuria 2-3 days after URI, IF shows electron dense material in mesangium

A

IgA nephropathy

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54
Q

purpura on extensor surface, Abdominal pain, vomiting, IgA nephropathy

A

Henoch Schonlein diease

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55
Q

Necrotizing vaculitis of small dermal vessels and areas of subepidermal hemorrhage of purpuric skin leions

A

IgA nephropathy

56
Q

when does IgA nephropathy present after an URT infection?

A

2-3 days (vs PSGN which is seen after 2 weeks)

57
Q

Treatments for A-fib

A

Calcium channel blockers, beta-blockers, digoxin

58
Q

Side effect of digoxin

A

AV block and ventricular tachyarrythmia. Hyperkalemia in toxicity but hypokalemia can increase susceptilibity to toxic effects

59
Q

Mechanism of digoxin

A

inhibits NaK ATPase slows conduction through the AV node by stimulatig the vagus nerve

60
Q

Activity of Ciprofloxacin

A

Gram negative (legionella, pseudomonas)

61
Q

Activity of Ceftriaxone

A

Gram negative bacilli (Hib, Neisseria, Serratia)

62
Q

Activity of azithromycin

A

chlamydia, mycoplasma, H. influenze, Morazella

63
Q

Activity of vancomycin

A

Gram Positive (MRSA, MRSE, C. diff)

64
Q

adverse effects of succinylcholine

A

malignant hyperthermia ( esp. halothane), severe hyperkalemia in patients with burns,myopaties, crush injuries, dennervation

65
Q

Succinylcholine is contraindicated in which patients?

A

Pts with burns, myopathies, crush injuries, denervating injuries because these states cause an upregulation of nACHR leading to a release of potassium and casing hyperkalemia ( arrythmia)

66
Q

Pelvic surgery loss of thigh adduction

A

Obturator L2-L4

67
Q

pelvic fracture or hematoma of iliopsoas, loss of flexion of thigh, extension of leg

A

Femoral L2-4

68
Q

Fibula neck fracture, Loss of foot eversion, dorsiflexion, Lose sensation to dorsum of foot

A

Common peroneal L4-S2

69
Q

Trauma to the knee causing loss of foot infersion, plantar flexion. Lose sensation to sole

A

Tibial L4-S3

70
Q

Foot drop (plantarflexed and inverted). Steppage gait

A

Peroneal nerve injury

71
Q

What criteria determine the malignant potential of adenomatous polyps?

A

Degree of dysplasia, villous adenomas are more likely to undergo malignant transformation than tubular. Size (>4cm)

72
Q

Types of non-neoplastic polyps

A

Hyperplastic, Hamartomas (Peutz Jeghers or juvenile polyposis), Inflammatory (UC, Crohns), Lymphoid

73
Q

Avascular necrosis is associated with which conditions?

A

Sickle cell, SLE (due to vasculitis), high dose steroids, and alcoholism

74
Q

groin pain exacerbated by weight bearing. Painful and restricted movement in affected joint. No swelling, erythema or temperature change

A

Osteonecrosis (avascular necrosis)

75
Q

chronic, intermittent pain in groin area that radiates to lateral thigh. Pain increased with pressure on the affected hip and with walking. No restriction in joint movement

A

Trochanteric bursitis

76
Q

Malformation of the mandible, maxilla, malleus, temporal bone.

A

First arch syndrome

77
Q

pruritis after showering, facial plethora, splenomegaly.

A

Polycythemia vera

78
Q

Mutation in Polycythemia vera

A

JAK2 (cytoplasmic tyrosine kinase)

79
Q

which factors bind to receptors with intrinsic tyrosine kinase activity

A

insulin, growth factors

80
Q

capillary hemangioblastoma in the retina or cerebellum, cysts in the kidney, liver, pancreas

A

Von Hippel Lindau (AD)

81
Q

neurofibroma, optic nerve glioma, Lisch nodules, café au lait spots

A

Von Recklinghausen (NF 1)

82
Q

Cranial nerve 7 Schwannomma and meningioma

A

NF type 2

83
Q

facial angioma, mental retardation, hemiplegia, skull radiopacities, tram track calcifications on xray

A

Sturge Weber

84
Q

Kidney, liver, pancreatic cyst, cortical and subependymal hamartoma, renal angiomyolipoma, cardiac rhabdomyoma

A

Tuberous sclerosis

85
Q

Telangiectasia that rupture to cause recurrent epistaxis, Gi bleeding

A

Osler weber rendu

86
Q

Fever, hypotension, diarrhea, oliguria, vascular compromise, DIC

A

Septic shock

87
Q

What is responsible for the toxic properties of LPS in gram negative sepsis

A

Lipid A of LPS activates macrophages and granulocytes to make IL1 and TNF

88
Q

Hypercellular glomeruli

A

Post strep glomerulonephritis

89
Q

Round basophilic bodies in the nucleus

A

Nucleolus

90
Q

Function of the nucleolus

A

site of rRNA transcription. RNA pol I transcribes rRNA

91
Q

Dopamine dose dependant effects

A

Low dose: acts on D1 receptors on renal vaculature and increases glomeruar filtrate rate. Med: B1 increaes contractility and BP. Higher doses stimulates alpha1 causing vasoconstriction

92
Q

mutation in HFE protein

A

Primary hemochromotosis leading to iron accumulation due to increased expressiosn of divalent metal transporter protein and decreased hepcidin synthesis

93
Q

Micronodular cirrhosis, diabetes mellitus and skin pigmentation

A

Primary hemochromatosis

94
Q

Superficial inguinal lymph nodes

A

external genitalia and anus up to pectinate line

95
Q

Deep inguinal lymph nodes

A

glans penis and clitoris

96
Q

Radial nerve innervates

A

Extensors, skin on dorsum of the hand

97
Q

Wrist drop

A

Radial head subluxation (nursemaid elbow)

98
Q

Carpal tunnel

A

Median nerve

99
Q

weakness in intrinsic muscles of the hand

A

Ulnar nerve

100
Q

Fracture of the surgical neck of humerous

A

Axillary nerve

101
Q

afferent limb of light reflex

A

Optic nerve

102
Q

efferent limb of light reflex

A

occulomotor nerve

103
Q

IL1

A

neutrophil and macrophage migration. Acute phase reactants, fever and shock

104
Q

IL2

A

T cell activation and proliferation

105
Q

IL3

A

Hematopoiesis

106
Q

IL4

A

TH2 cell differentiation, B cell growth, Isotype switching to IgE

107
Q

IL5

A

Differentiation of eosinophil, IgA isotype switching

108
Q

IL6

A

T and B cell growth. Osteoclast activity. Acute phase reactant and fever

109
Q

IL8

A

neutrophil activation and chemotaxis

110
Q

IL 10

A

Decrease TH1 differentiation, decrease cell mediated and APC activity. Increase B cell function

111
Q

IL12

A

TH1 differentiation, increase NK cell and CD8 activity

112
Q

TGFB

A

decrease immune cell function, increase matrix synthesis and angiogenesis

113
Q

TNFa

A

increase inflammation , acute phase reactants, fever and shock

114
Q

LTC4, LTD4, LTE4

A

vasocontriction, increased vascular permeability and bronchospasm

115
Q

Oculomotor dysfunction, ataxia, mental status change (disorientation, aptahy and decreased attention span

A

Thiamine deficiency

116
Q

damage to the anterior and dorsomedial thalamic nuclei

A

memory loss and confabulation in Korsakoff syndrome (inability to form new memories)

117
Q

excitation-contraction coupling

A

Ca released from sarcoplasmic reticulum. Ca binds troponin C, tropomyosin shifts to exposed actin binding sides for myosin to allow contraction

118
Q

Progressive ataxia, hypertrophic cardiomyopathy, kyphoscoliosis, pes cavus, DM

A

Friedreich ataxia (AR)

119
Q

rapidly spreading, pruritic rash with erythematous papules and excoriation on flexor surfaces. Worse at night

A

Scabies

120
Q

Bisphosphonates

A

analog of pyrophosphate (important for hydroxyapatite) used for osteoporosis, Paget’s, malignancy of hypercalcemia

121
Q

why should you not use non-selective beta blockers in diabetics

A

mask symptoms of hypoglycemia

122
Q

cheilosis, stomatitis, glossitis, dermatitis, corneal vascularization

A

Riboflavin deficiency B2

123
Q

Cheilosis, glossitis, dermatitis, peripheral neuropathy

A

Pyridoxine B6 deficiency

124
Q

Acrodermatitis enteropathica, growth retardation and infertility

A

Zinc deficiency

125
Q

gradual vision loss, subretinal inflammation with abnormal extracellular matrix formation that appear as drusen deposits

A

Dry Age related macular degeneration

126
Q

Acute vision loss with metamorphosia. Funduscopy show grayish green subretinal discoloration

A

Wet age related macular degeneration

127
Q

myotonia, cataracts, frontal balding, gonadal atrophy

A

myotonic dystrophy (CTG repeats)

128
Q

nausea, vomiting, changes in color vision, arrythmia

A

Digoxin toxicity

129
Q

mutation in hereditary PAH

A

BMPR II

130
Q

apocrine glands

A

secrete sweat into hair follicles rather than directly to skin

131
Q

Holocrine glands

A

found in association with sebaceous glands. Discharge of entire secretory cells that undergo breakdown to release secretory product

132
Q

Eccrine (merocrine) glands

A

Present in skin (except lips) and secretes sweat directly to skin surface

133
Q

approximately how much of filtered urea is reabsorbed by PT?

A

50.00%

134
Q

how much of filtered sodium is reabsorbed?

A

99.00%

135
Q

how is glucose handled at low and high filtered loads?

A

at low filtered loads: all is reabsorbed. At high loads: increasing fractional excretion. Increases beyond saturation point do not result in increased absorption

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