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Uworld > UW7 > Flashcards

UW7 Flashcards

1
Q

What is the length constant of a neuron?

A

how far along an axon an electrical impulse can propagate. Distance at which the originating potential decreases to 37% of its original amplitude

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2
Q

temporal summation

A

sequential impulses from the same same neuron over time

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3
Q

Spatial summation

A

simultaneous impulses from several different neurons

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4
Q

Time constant of a neuron

A

how long it takes for a change in membrane potential to achieve 63% of a new value. Lower time constants allow quicker changes in membrane potential, thus increasing axonal conduction speed

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5
Q

failure of obliteration during development leads to an abnormal connectionb etween the scrotum and the peritoneal cavity?

A

Processes vaginalis

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6
Q

what allows reassortment in viruses

A

segmented genomes (orthomyxo, rotavirus)

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7
Q

what does frothy, foamy urine indicate

A

Proteinuria or bile salts in urine

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8
Q

how does loss of protein in urine change fluid dynamics?

A

decrease plasma oncotic pressure (leads to edema)

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9
Q

how does a decrease in capillary hydrostatic pressure change fluid dynamics?

A

Decrease net plasma filtration

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10
Q

how does aldosterone levels change in nephrotic syndrome?

A

plasma oncotic pressure is decreased so effective circulating intravascular volume is decreased leading to an increased aldosterone level

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11
Q

macrpphages release what cytokines in septic shock

A

Il1 and TNFa

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12
Q

fever, rash, shock

A

Toxic shock syndrome mediated by TSST-1, exfoliative toxin or enterotoxin that brings MHC and TCR in close proximity to cause widespread acitivation of T cells leading to release of IL2 (Tcell) and IL1 and TNFa from macrophages

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13
Q

Where should thoracentesis be preformed?

A

between the 7th ribs along the midclavicular line, the 9th ribs along the midaxillary line and 11th ribs along the paravertebral line. Along the upper border of the rib

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14
Q

What are the borders of the pleura?

A

midclavicular: 7th, Midaxillary: 10th, Paravertebral: 12

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15
Q

Where do the intercostal vein, artery and nerve lie along the ribs

A

the lower border

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16
Q

Collagen type I

A

Dermis, bone, tendons, ligaments, dentin, cornea, blood vessels, scar tissue

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17
Q

Collagen type II

A

cartilage, vitreous humor, nucleus pulposus

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18
Q

Collagen type III

A

Skin, lungs, intestines, blood vessels, bone marrow, granulation tissue

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19
Q

Collagen type IV

A

Basement membranes

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20
Q

Nomal pCO2

A

40

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21
Q

Normal HCO3

A

24

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22
Q

normal pH

A

$7.40

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23
Q

pH 40

A

Respiratory acidosis. Renal compensation is slow and takes 3-5 days to have max effect (HCO3

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24
Q

pH 7.3, CO2=70, HCO3= 26

A

compensated respiratory acidosis (chronic)

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25
Q

low pH, low HCO3, low PCO2

A

diabetic ketoacidosis with respiratory compensation ( kussmaul breathing)

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26
Q

high pH, high HCO3, high pCO2

A

contraction alkalosis. Overuse of diuretics loss leads to compensatory aldosterone production which leads to loss of potassium and hydrogen ions by kidneys. Metabolic alkalosis

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27
Q

high pH, low pCO2 and slightly low HC03

A

panic attack ( acute so no compensatory response)

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28
Q

vagal efferent activity on bronchial smooth muscle

A

bronchial smooth muscle contraction (muscarinic M3 receptors) and increased mucous secretions

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29
Q

Anti-cholinergic drugs that cause bronchodilation

A

Tiotropium and ipratropium

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30
Q

lymphatic drainage of scrotum

A

superficial inguinal lymph nodes

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31
Q

lymphatic drainage of testis, glands penis

A

Deep inguinal lymph nodes

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32
Q

Lymphatic drainage from testes

A

Para-aortic lymph nodes

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33
Q

dyspnea, distended neck veins, distant heart sounds, pulsus paradoxus

A

pericardial effusion

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34
Q

headache, facial plethora, dilated veins of neck and upper torso

A

Superior vena cava syndrome (SCLC)

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35
Q

Degeneration of the putamen is seen in what disease

A

Wilson’s disease (medial to the insula and lateral to the GP)

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36
Q

Which brain structure is affected in Huntington’s disease

A

Caudate

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37
Q

Fibrous intimal thickening with endocardial plaques limited to the right heart

A

Carcinoid heart disease

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38
Q

5 hydroxyindoleacetic acid is a metabolite of

A

Serotonin

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39
Q

VMA is a metabolite of

A

Epinephrine and norepinephrine

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40
Q

elevated phenylalanine in urine

A

PKU (phenylalanine hydroxylase deficiency)

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41
Q

subendothelial immune complex deposition leads to thickening and thinning of the glomerular BM “tram track”

A

membranoproliferative GN

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42
Q

Subepithelial immune complex deposition leads to “spike and dome” on EM

A

Membranous GN

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43
Q

sclerotic changes in some portions of some glomeruli

A

Focal segmental glomerulosclerosis. Secondary to HIV infection, heroin abuse, severe obesity

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44
Q

proliferation of lymphocytes, endothelial cells within capillary loops

A

Diffuse proliferative GN

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45
Q

Catabolism of what amino acids leads to formation of proprionic acid

A

Valine, Isoleucine, threonine, methionine

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46
Q

What enzyme deficiency is responsible for propionic acidemia

A

proprionyl coA carboxylase ( conversion of proprionyl coA to methylmalonyl CoA)

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47
Q

what vitamin is given as an IM injection at birth?

A

K

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48
Q

What drugs cause vasodilation of arterioles in nonischemic regions leading to decreased perfusion in ischemic areas?

A

adenosine and dipyridamole (coronary steal)

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49
Q

What part of the stomach does H. pylori affect

A

antrum

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50
Q

which part of the stomach does autoimmune chronic gatritis affect

A

body of the stomach ( destruction of parietal cells)

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51
Q

Solitary ring enhancing lesion on Brain MRI in HIV pt

A

Primary central nerveous system lymphoma

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52
Q

pupillary dilator muscle has which adrenergic receptors

A

alpha 1 ( phenylephrine is selective alpha agonist for pupil dilation)

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53
Q

adrenergic receptors on the uterus

A

Beta 2 (uterine relaxation; terbutaline is a B2 agonist)

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54
Q

Adrenergic receptors on the bladder

A

alpha 1 (contraction of internal urethral sphincter)

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55
Q

adrenergic receptors on the lungs

A

Beta 2 (bronchodilation)

56
Q

Pathophysiologic basis of depression

A

dysregulation of monoamine (serotonin, NE, dopamine)

57
Q

what drug inhibits inositol monophosphat e

A

Lithium

58
Q

What is nafcilin used to treat

A

skin and soft tissue infections ( folliculitis, abscesses) due to S. aureus

59
Q

What antibiotic is used to treat lung abscesses in alcoholic patients

A

Clindamycin (coveres anaerobic)

60
Q

Side effect of low potency anti-psychotics

A

Chlorpromazine, Thioridazine (Sedation, anti-cholinergic, orthostatic hypotension)

61
Q

Side effect of high potancy anti-cholinergic

A

Haloperidol and Fluphenzine (extrapyramidal sxs)

62
Q

High doses of nitroprusside caninduce what toxicity

A

Cyanide

63
Q

AMS, sizures, cardiovascular collapse, lactic acidosis, bright red venous blood

A

Cyanide toxicity

64
Q

How do you manage CN toxicity

A

Sodium nitrate: promotes metHb formation which binds to CN. Sodium thiosulfate: acts as ao sulfur donor to convert CN to thiocyanate to be excreted. Hydroxycobalamine binds to CN which can be excreted

65
Q

Dose dependent increase in cardiact contractiliy and dose dependent decrease in vascular resistance

A

Isoproterenol. Low dose: B2 causes relaxation of vascular smooth muscle. No alpha effects

66
Q

Early virilization and accelerated linear growth in boys. Ambiguous genitalia in girls

A

21 hydroxylase deficiency (adrenal hyperplasia)

67
Q

What is the treatment for congenital adrenal hyperplasia?

A

Exogenous steroids to decrease ACTH

68
Q

bronchoalveolar lavage in sarcoidosis

A

predominance of CD4 T cells (high CD4/CD8 ratio)

69
Q

bronchoalveolar lavage in hypersensitivity pneumonitis (bird handling)

A

predominance of CD8 T cell

70
Q

Surface markers for pre-B cell

A

CD10, CD19, CD20

71
Q

surface markers for pre T cells

A

CD2, CD3, CD4, CD5, CD7, CD8

72
Q

fever, malaise, bleeding, bone pain, hepatosplenomegaly with blast cells

A

B - ALL

73
Q

dysphagia, superior vena cava syndrome, blast cells

A

T- ALL

74
Q

Treatment of Arsenic poisoning

A

Dimercaparol

75
Q

Treatment for lead or mercury poisoning

A

EDTA

76
Q

Treatment for CN poisoning

A

Amyl nitrite

77
Q

Treatment for iron poisoning

A

Deferoxamine

78
Q

treatment for metHb

A

Methylene blue

79
Q

Stomach pains, vomiting, delirium, garlic odor

A

Arsenic poisoning

80
Q

Tunnel vision in low ambient light ddx

A

toxic retinopathy due to phenothiazides, chloroquine, Vit A deficiency, congenital rubella, diabetic retinopathy

81
Q

Pupillary light reflex

A

Afferent: II Efferent: III

82
Q

Corneal reflex

A

Afferent V1 Efferent: VII (close eyelids)

83
Q

Jaw jerk

A

Afferent V3 Efferent V3 (massert contraction)

84
Q

Vestibuloocular reflex

A

Afferent: VIII Efferent III, IV, VI

85
Q

Carotid sinus reflex

A

Afferent IX Efferent X (decrease HR and BP)

86
Q

Cough reflex

A

Afferent and efferent X

87
Q

Gag reflex

A

Afferent IX and Efferent X (contraction of phayngeal constrictor muscles)

88
Q

What is effect modification

A

Effect of main exposure is modified by the presence of another variable. Not a bias. Can be confused with confounding

89
Q

inactivated influenza virus induces antibodies against what antigen

A

Hemagglutinin ( prevents viral entry)

90
Q

Labs in anorexia

A

decreased FSH, LH, Estradiol

91
Q

Enzyme defect in Maple syrup urine disease

A

Branched chain alpha ketoacid dehydrogenase

92
Q

Thiamine, Lipoate, CoA, FAD and NAD are required by which enzymes

A

Branched chain alpha ketoacid dehydrogenase, pyruvate dehydrogenase and alpha keto glutarate dehydrogenase

93
Q

When is pyridoxine supplmentation required

A

Sideroblastic anemia and hyperhomocysteinemia

94
Q

PKU can result from a deficiency of in which cofactor for phenylalanine hydroxylase

A

Tetrahydrobiopterin (required for phenylalanine hydroxylase)

95
Q

Before starting treatment for RA, what should be tested?

A

TB (TNFa blocker can predispose pts to infections)

96
Q

Drugs that cause drug induced lupus

A

Hydralazine, procainamide, isoniazid (positve ANA)

97
Q

SE: Thyroid dysfunction, lung fibrosis, liver toxicity, blue, gray discoloration of skin

A

amiodarone

98
Q

SE: negative inotrophy, constipation, gingival hyperplasia

A

Verapamil

99
Q

SE: chest burning, flushing, transient hypotension

A

Adenosine

100
Q

Leaking of urine with coughing, sneezing, laughing, lifting

A

loss of urethral support and intraabdominal pressure exceeds sphincter pressure

101
Q

Sudden, overwhelming or frequent need to empty bladder

A

Detrusor overactivity

102
Q

Constant involuntary dribbling or urine and imcomplete emptying

A

impaired detrusor contractility or bladder outlet obstruction

103
Q

Mifepristone

A

progesterone antagonist that acts as an abortifacient (leads to decidual necrosis and expulsion of products of conception)

104
Q

Misoprostol

A

Prostaglandin E1 analog causes uterine contraction

105
Q

Diazepam

A

anxiolytic (GAD and panic attacks), Sedative-hyponotic (insomnia), Anticonvulsant (status epilepticus), muscle relaxant

106
Q

Chlorpheniramine

A

anti-histamine that can penetrate BBB and lead to sedation by blocking H1 receptors

107
Q

Loratadine

A

anti-histamine that blocks peripheral H1 receptors does not cross BBB

108
Q

Ranitidine

A

Inhibits gastric acid secretion by blocking H2 receptors

109
Q

CD for macrophages

A

CD14

110
Q

69XXX

A

partial mole

111
Q

46XX

A

complete mole

112
Q

elevated hCG after molar pregnancy

A

Choriocarcinoma

113
Q

vaginal bleeding, hypertonic uterus, intense painful contractions in 3rd trimester

A

Abruptio placentae

114
Q

Diseases transmitted by tick bites

A

Leishmaniasis, plasmodium, chagas (reduviid bug), lyme (Ixodes)

115
Q

first line treatment for acute gout

A

NSAIDS

116
Q

Why are xanthine oxidase inhibitors not given in acute gout?

A

can exacerbate acute arthritis

117
Q

ataxia, dysarthria, loss of position and virbration sense

A

seen in Friedreich ataxia, vitamin E deficiency

118
Q

Difference between topoisomerase I andII

A

I induces single stranded nicks to relieve negative supercoiling while II makes double stranded breaks to relieve both positive and negative supercoiling

119
Q

What drugs inhibit topoisomerase I

A

Irinotecan and topotecan

120
Q

what drugs inhibit topoisomerase II

A

Etoposide

121
Q

cough, hemoptysis, sinusitis, mucosal ulceration, rapidly progressive GN

A

Wegnener granulomatosis with polyangiitis

122
Q

Posterior Cruciate Ligament

A

attaches to the lateral surface of the medial condyle

123
Q

Anterior Cruciate ligament

A

Attaches to the medial surface of the lateral condyle

124
Q

hepatomegaly, cardiomegaly, macroglossia, hypotonia, mental retardation, glycogen accumulation

A

Acid maltase deficiency

125
Q

Normal blood sugar, severe cardiomegaly, glycogen accumulation

A

Pompe (a glucosidase deficiency)

126
Q

weakness and fatigue with exercise. Little or no rise in blood lactate levels after exercise

A

Glycogen phosphorylase deficiency (McArdle)

127
Q

Hepatomegaly, fasting hypoglycemia, lactic acidosis, hyperuricemia

A

Glu6 phosphatase deficiency (von Gierke)

128
Q

Beta thalassemia

A

mutation that results in defective transcription, processing and translation of beta globin mRNA

129
Q

Example of protein folding defect

A

Z mutation in alpha antitrypsin

130
Q

Hypothalamus: ventromedial

A

Satiety (stimulated by leptin)

131
Q

Hypothalamus: Lateral

A

Hunger (inhibited by leptin)

132
Q

Hypothalamus: anterior

A

Heat dissapation

133
Q

Hypothalamus: posterior

A

Heat conservation

134
Q

Hypothalamus: arcute

A

secretion of dopamine, growth hormone releasing hormone and gonadotropin

135
Q

Hypothalamus: paraventricular

A

AND, CRH, oxytocin,TRH

136
Q

Hypothalamus: supraoptic

A

ADH and oxytocin

137
Q

Hypothalamus: suprachiasmatic

A

Circadian rhythm and pineal gland function

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