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Uworld > UW8 > Flashcards

UW8 Flashcards

1
Q

what L/S ratio indicates that the lung is mature?

A

>2

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2
Q

When do you sample amniotic fluid for AFP?

A

fetal neural tube defect (elevated in spina bifida)

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3
Q

When do you sample amniotic fluid for bilirubin?

A

Erythroblatosis fetalis

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4
Q

dense pigments composed of epinephrine metabolites in lysosomes on liver biopsy

A

Dubin Johnson

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5
Q

how does erythromycin affect cytochromes

A

inhibits 3A4

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6
Q

Cyp Inducers

A

Carbazepine, Phenobarbitol, Phenytoin, Rifampin, Griseofulvin

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7
Q

Cyp inhibitors

A

Cimetidine, Ciprofloxacin. Errythromycin, Azoles, Grapefruit juice, isonizid, Ritonavir

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8
Q

chronic giardia infection

A

IgA deficiency, X-linked agammaglobulinemia, Common variable

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9
Q

Ataxia, Telangiectasia, sinuopulmonary infections

A

Ataxia-telangiectasia

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10
Q

Oculocutaneous albinism, pyogenic infections, progressive neurologic dysfunction

A

Chediak Higashi

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11
Q

Severe bacterial and fungal infections, granuloma formation

A

Chronic granulomatous disease

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12
Q

congenital heart disease, dysmorphic facies, hypocalcemia

A

DiGeorge

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13
Q

Severe bacterial and viral infections, Chronic diarrhea, candidiasis

A

SCID

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14
Q

Recurrent infections that worsen with age, easy bleeding, eczema

A

Wiskott Aldrich syndrome

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15
Q

Absent thymic shadow

A

Digeorge, SCID

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16
Q

What is the difference between HUS and DIC?

A

DIC the coagulation system is activated so PT and PTT are elevated

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17
Q

conjunctival injection, tachycardia, increased appetite and dry mouth

A

Marijuana intoxification (THC acts on CB receptors which causes euphoria, sedation, slow reflexes, distorted perceptions)

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18
Q

Drug intoxication: nystagmus

A

PCP

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19
Q

Drug intoxidation: miosis

A

Opiate (pinpoint pupil)

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20
Q

Drug intoxidation: mydriasis

A

cocaine

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21
Q

4 phases of menstrual cycle

A

Follicular, ovulatory, luteal, menstruation

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22
Q

Tx of anovulation

A

Menotropin (menopausal gonadotropin that acts like FSH) and hCG (acts like LH)

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23
Q

Plueral plaques along lower lungs and diaphragm

A

asbestos

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24
Q

Risk for gastric carcinoma

A

H. pylori, nitrosamines, smoking

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25
Q

Risk for bladder cancer

A

Aniline dyes, rubber industry

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26
Q

drugs with low volume of distribution tend to be confined to bloodstream why?

A

highly plasma protein bound and hydrophilic

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27
Q

Chest pain, seizures, mydriasis

A

Cocaine intoxication

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28
Q

violent behavior, psychosis, tooth decay, choreiform movements

A

Methamphetamines

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29
Q

increased appetite, impaired time perception, conjunctival injection

A

Marijuana

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30
Q

Depressed mental status, miosis, repiratory depression

A

Heroin (opioid)

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31
Q

Visual hallucinations, euphora, panic

A

LSD (hallucinogen)

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32
Q

Violent bheavior, hallucination, amnesia, nystagmus, ataxia

A

PCP

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33
Q

mechanism of cocaine

A

inhibits presynaptic uptake of monoamines. Potent vasoconstrictor

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34
Q

Entacapone and tolcapone

A

COMT inhibitors that prevent degradation of catecholamines

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35
Q

location of the heart

A

Apex is covered by Left lung beind the 5th intercostal space at the left midclavicular line. Anterior surface is mainly the RV. Inferior surface is LV and RV. Posterior surface is mainly LA

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36
Q

vomiting, lethargy, failure to thrive after initiation of breast feeding

A

Galactosemia due to Galactose 1 phosphate uridyl transferase (GALT) deficiency

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37
Q

bilateral cataracts

A

Galactokinase deficiency. Excess galactose is converted to galactitol (aldose reductase)

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38
Q

Deficient enzyme in fructose intolerance

A

Aldolase B

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39
Q

Hypoglycemia, lactic acidosis, hepatomegaly, hypertriglyeridemia

A

Von Gierke (glucose 6 phosphatase deficiency)

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40
Q

CN poisoning syndrome

A

Cutaneous flushing, tachypnea, headache, tachycardia, nausea, vomiting, weakness

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41
Q

CN antidote

A

Nitrates, Sodium thiosulfate

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42
Q

Increased white count, immature cells, and few blast cells. Low leukocyte alk phos.

A

Chronic myelogenous leukemia ( dx requires demonstration of t(9;22)

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43
Q

Eye down and out

A

CN III lesion

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44
Q

Eye deviated upward

A

CN IV (superior oblique)

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45
Q

Eye deviated medially

A

CN VI (lateral rectus)

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46
Q

Bulbus cordis

A

smooth portion of left and right ventricles

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47
Q

Widening of the pulse pressure

A

aortic regurgitation

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48
Q

M1 receptor

A

Brain (Gq) memory formation and cognitive functioning

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49
Q

M2 receptor

A

Heart (Gi): decreases HR and atrial contraction

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50
Q

M3 receptors (Lung, bladder, eyes, GI, Skin)

A

Gq: Bronchocontriction, detrusor contraction, miosis, ciliary m. contraction ( accomodation), peristalsis, gastric secretions, increased sweat)

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51
Q

angular stomatitis, cheilitis, glossitis, seborrheic dermatitis, keratitis, corneal neovascularization, anemia

A

Riboflavin deficiency (Succinate dehydrogenase)

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52
Q

t(9:22)

A

BCR-ABL tyrosine kinase activity leads to proliferation of granulocytic precursor (CML)

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53
Q

t(8:14)

A

Burkitt lymphoma makes c-myc (transcription activator)

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54
Q

t(14:18)

A

Follicular lymphoma causes overexpression of BCL2 (anti-apoptotic)

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55
Q

t(11;14)

A

Cyclin D1 on Ig heavy chain leads to increase cyclin D (mantle cell lymphoma)

56
Q

endocardial cushion defect

A

Downs (ASD)

57
Q

Ataxia, falling, loss of DTR

A

Friedreich ataxia

58
Q

What is the cardiac problem in Friederich ataxia?

A

Hypertrophy cardiomyopathy

59
Q

Cardovascular defect in Marfans

A

Cystic medial necrosis of aorta

60
Q

3 cytogenic abnormalities in Down Syndrome

A

Trisomy 21, unbalanced Robertsonian translocations, Mosaicism (2 cell lines)

61
Q

Uniparental diosmy

A

fetus inherits 2 copies of homologous chromosomes and no copy from the other parent. Paternal disomy exists in complete hydatidiform mole

62
Q

vaginal bleeding with fundal size greater than dates

A

Hydadiform mole

63
Q

young female with infertility, acne, hirsuitism, insulin resistance, central obesity

A

Polycystic ovary disease

64
Q

elevated alk phos. What next?

A

Gamma-glutamyl transpeptidase to determine bone vs heptic origin (GGTP not present in bone)

65
Q

What reactions require NADPH

A

anabolic reactions for fatty acid, cholesterol, steroid synthesis (electron donor= reducing agent) and is used to reduce glutathione for repairing oxidative damage

66
Q

coin lesion with popcorn calcifications

A

lung hamartoma on cxr (contain mature hyaline cartilage, fat, smooth muscule, clefts lined by respiratory epithelium)

67
Q

lung lesion along periphery along alveolar septae without invasion

A

Bronchoalveolar carcinoma (adenocarcinoma)

68
Q

Abdominal pain, fever, diarrhea, shock in a patient with UC

A

Toxic megacolon. Get an X eay

69
Q

What are some circumstances where minors do not require consent

A

Emergency care, Sexually transmitted infections, substance abuse, prenatal care

70
Q

clock face chromatin, eccentrically placed nuclei, basophillic cytoplams

A

plasma cell

71
Q

anemia, hypercalcemia, increased susceptibility to infection, AL amyloid, renal failure

A

Multiple myeloma

72
Q

Chronic hypertension, intraparenchymal hyperdensity on CT

A

Charcot Bouchard aneurysm (deep brain structures)

73
Q

Hypertensive arteriolosclerosis of deep brain structures and internal capsule, corona radiata are a risk for

A

Lacunar infarct

74
Q

Nodular densities, eggshell calcifications of hilar nodes

A

Silicosis

75
Q

electrical impulses generated by SA node

A

60-100 bpm

76
Q

electrical impulse generated by AV node

A

45-55 bpm

77
Q

electrical impulses below the AV node

A

can be as slow as 20 bpm and will show abnormal QRS due to aberrant impulse through ventricles

78
Q

Mechanism of Fenoldopam

A

Dopamine D1 receptor agonist. Stimulates Gs increaes cAMP and Causes vasodilation in renal, mesenteric and coronary beds. Increased sodium and water excretion

79
Q

What drug is used for hypertensive crisis in a patient with renal failure

A

Fenoldopam (vasodilator that increase renal perfusion and increases naturiesis)

80
Q

what is the mutation in PKU

A

phenylalanine hydroxylase due protein misfolding

81
Q

mutation In marfan

A

defect in fibrillin prevents normal formation of microfibrils

82
Q

mutation in Friedreich’s ataxia

A

Frataxin gene codes for mitochondrial protein. GAA repeat disrupts transcription

83
Q

fever, malaise, dark urine, n/v with ballooning degeneration of hepatocytes

A

viral hepatitis

84
Q

prolonged pruritis and fatigue

A

primary sclerosing cholangitis

85
Q

Upper GI bleed and ascities

A

portal hypertension

86
Q

acholic stools and bone pain

A

primary biliary cirrhosis

87
Q

course of the ureters

A

cross over the common/ external iliac vessels and under the gonadal (uterine) vessels. Anterolateral to the internal iliac and medial to the ovarian vessels.

88
Q

PaO2, Oxygen saturation, total O2 content in CO poisoning

A

Normal PaO2, decrease O2 sat. decrease total O2 content

89
Q

what is a maneuver that can improve symptoms of paroxysmal supraventricular tachycardia

A

Carotid sinus massage and the valsalva maneuver can slow heart rate by slowing conduction through the AV node (abolishes re-entrant circuit)

90
Q

tx for PSVT

A

adenosine

91
Q

when do neurotube defects occur?

A

4th week

92
Q

Signs of neural tube defects in amniocentesis

A

increased AFP and acetylcholinesterase

93
Q

Reverse beta blocker overdose

A

Glucagon (works through Gs)

94
Q

half life

A

Vd x0.7/ clearance)

95
Q

RA

A

Symmetric polyarthritis (MCP and PIP), morning stiffness >30 min

96
Q

collagen synthesis

A

procollagen synthesized in ER (flanked by globular extensions) Transported to golgi apparatus and released into extracellular space where it is converted into tropocollagen by procollagen peptidases which then self assembly into collage fibrils that are crosslinked by lysyl oxidase

97
Q

what affects liklihood ratios

A

sensitivity and specificity (not prevalence)

98
Q

What do liklihood ratios indicate

A

how a positive or negative test result influences the probability of having a disease. LR>1 presence of disease and

99
Q

LR +

A

Sensitivity (1-specificity)

100
Q

LR-

A

1-sensitivity/ specificity

101
Q

JVP: x descent

A

relaxation of right atrium

102
Q

JVP: y- descent

A

abrupt decrease in R atrial pressure during early diastole after tricuspid opens

103
Q

JVP: a-wave

A

atrial contraction

104
Q

JVP: C wave

A

RV contraction ( closed tricuspid bulging into atrium)

105
Q

JVP: v- wave

A

increase right atrial pressue due to filing aginst a closed tricuspid valve

106
Q

thickening and calcification of pericardium

A

constrictive pericarditis

107
Q

5’ to 3’ exonuclease activity

A

DNA polymerase I (can be used to remove RNA primer and repair DNA)

108
Q

how do BZD affect cl- channels?

A

increased fequency of opening

109
Q

Diphenhydramine

A

reversible inhibition of H1 receptor

110
Q

TCA

A

inhibit NE and serotonin reuptake

111
Q

Barbiturates

A

increase the DURATION of GABA receptor Cl channel

112
Q

Serotonin is synthesized from what amino acid

A

tryptophan

113
Q

Spindle shaped tumor cells with small vessel proliferation on biopsy. Small reddish/violet maculopapular rash on colonoscopy

A

Kaposi sarcoma

114
Q

inflammatory infiltrate involving mucosa and submucosa with crypt abscesses on biopsy

A

Ulcerative Colitis

115
Q

hypertension, hypokalemia, metabolic alkalosis and decreased plasma renin

A

hyperaldosterone (Conn Syndrome)

116
Q

Treatment for thyrotoxicosis

A

PTU (inhibit thyroid peroxidas), Beta blockers (decrease sympathethic outflow and decrease peripheral conversion of T4 to T3 by inhibiting iodothyronine deiodinase)

117
Q

Hemorrhoids

A

Superior rectal — middle and inferior rectal veins

118
Q

Caput medusae

A

Paraumbilical veins– superficial and inferior epigastric veins

119
Q

signet ring carcinoma

A

diffuse involvement of stomach wall, plaque like appearance and cause a leather bottle stomach (gastric adenocarcinoma)

120
Q

stomach cancer that causes a polypoid mass that can become ulcerated

A

intestinal type gastric adenocarcinoma

121
Q

Rugal thickening with acid hypersecretion

A

Zollinger Ellison Syndrome

122
Q

Mechanism of Neisseria meningitis

A

Pharynx, blood, choroid plexus, meninges

123
Q

Mechanism of H. flu meningitis

A

Pharynx, lymphatics, meninges

124
Q

risk of untreated prolactinoma

A

increased prolactin dereases GnRH which decreases estrogen (leading to an increase in bone loss)

125
Q

MEN I

A

Parathyroidism (hyper), Peptic ulcer (gastrin secreting tumor in Pancreas), Pituitary adenoma

126
Q

interstitial myocardial granuloma with macrophages that have slender chromatin ribbons

A

Aschoff bodies and Anitshow cells seen in Acute Rheumatic Carditis

127
Q

Medial band like calcification

A

Monckeberg’s medial calcific sclerosis (medial Calcinosis)

128
Q

Homogenous acculluar thickening of arteriolar walls

A

Deposition of hyaline material is seen in hypertension

129
Q

Granulomatous inflammation of the media

A

Giant cell arteritis

130
Q

Transmural inflammation of arterial wall with fibrinoid necrosis

A

Polyarteritis nodosa

131
Q

Enzyme defect in albinism

A

Tyrosinase

132
Q

Reduced transfer of melanin to keratinocytes

A

post inflammatory hypopigmentation

133
Q

increased melanosome aggregates in melanocyte cytoplasm

A

Café au lait

134
Q

benign linear melanocytic hyperplasia

A

Lentigo

135
Q

Loss of epidermal melanocyte

A

Vitiligo

136
Q

foul smelling, bulky, floating stool

A

Malabsorption. Sudan III stool stain to assess for fat in stool

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