uWorld 13 Flashcards

1
Q

elastase in the lungs is released from what cells

A

macrophages (in lysosomes)

neutrophils (azurophilic (primary) granules)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

when is beta-hCG first detectable in the serum

A

8 days after fertilizations
6 days at the earliest b/c that is when IMPLANTATION OCCURS
beta-hCG is produced by the SYNCYTIOTROPHOBLAST after implantation

detectible in urine 14 days after fertilization (less sensitive than serum pregnancy test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is a crossover study

A

subjects are randomly allocated to a sequence of 2 or more treatment given consecutively
simplest model is AB/BA type of study in which subjects are allocated to the AB study arm receive treatment A followed by treatment B and vice versa in the BA arm

allows PATIENTS TO SERVE AS THEIR OWN CONTROLS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a disadvantage of crossover studies and how is it limited

A

principle drawback is that effects of one treatment may “carry over” and alter the response to subsequent treatments
to limit this a washout (no treatment) period is often added b/w consecutive treatments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is a case series

A

a descriptive study that tracts patients with a known condition (a particular exposure, risk factor, or disease) to document natural history or response to treatment
a qualifying study that cannot quantify statistical significance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

a left shift in the hemoglobin curve causes what sequelae in the a patient

A

ERYTHROCYTOSIS (compensatory to maintain normal oxygen delivery)
hint: hypoxia (low tissue O2 from the left shift and less unloading at the tissues) causes ERYTHTROYCYTOSIS b/c the kidneys sense the low tissue O2 and synthesize ERYTHROPOIETIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the pre-contemplation stage of change (transtheoretical) model

A

no thinking about behavior modification

denial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the contemplation stage of change (transtheoretical) model

A

thinking about behavior modification

acceptance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the preparation stage of change (transtheoretical) model

A

planning behavior modification

panning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the action stage of change (transtheoretical) model

A

putting plan into action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the maintenance stage of change (transtheoretical) model

A

maintaining new behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what kind of drug is fenoldopam and what is it used for

A

DOPAMINE-1-RECEPTOR AGONIST (little or no effect on alpha or beta-adrenergic receptors)

used in hypertensive emergency especially when there is ACUTE KIDNEY INJURY b/c fendolopam has prominent RENAL VASODILATION effects and thus INCREASES RENAL PERFUSION
INCREASES NATRIURESIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is homocysteinuria and what is the most common cause

A

condition that leads to HYPERCOAGULABILITY and THROMBOEMBOLIC OCCLUSION
premature acute coronary syndrome, ECTOPIA LENTIS (DOWN and OUT displacement), and INTELLECTUAL DISABILITY

MCC = CYSTATHIONE SYNTHASE defect

cysteine is essential in diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what does IL-3 do

A

promotes growth and differentiation of bone marrow stem cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what promotes class switching to IgE

A

IL-4

IL-13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is seen histologically in high-grade CIN

A

expansion of immature basal cells to the epithelial surface

17
Q

what cells in the bone form from mononuclear phagocytic cell lineage and are ultimately formed when several precursor cells fuse to create a multinucleated mature cell
what factors are essential for the differentiation of these cells

A

osteoclasts
macrophage colony-stimulating factor (M-CSF)

receptor for activated nuclear factor kappa-B ligand (RANK-L)

18
Q

what is osteoprotegerin (OPG)

A

physiologic decoy receptor that decreases binding of RANK-L to RANK

19
Q

middle meningeal artery is a branch off of what

A

MAXILLARY ARTERY

20
Q

the PTH receptor and calcium-sensing receptors (CaSR) are what kind of receptors

A

transmembrane G-protein0 coupled (metabotropic) receptors

21
Q

what use transmembrane ligand-gated ion channels (inotropic receptors)

A

acetylcholine
serotonin
NMDA
GABA

22
Q

what use transmembrane receptors that recruit Janus Kinase

A

GH
prolactin
erythropoietin

23
Q

true aneursyms of the ventricular wall are bound by scarred myocardium is seen when after a large transmural infarct

A

late complication (greater than 1 month)

can cause thrombus, arrhythmias, and HF but rarely rupture

24
Q

what are signs and symptoms of ventricular free wall rupture seen within 5-14 days of an MI

A

hemoperricardium and cardiac tamponade
profound hypotension
shock
rapid progression to pulseless electrical activity and death

25
what causes an S4 in older adults
age-related decrease in left ventricular compliance (relatively benign finding) the louder it gets the more pathologic it is- like left ventricular hypertrophy following prolonged hypertension or restrictive cardiomyopathy
26
what is the second most common cause of ring-enhancing lesions with mass effect (seizures) in HIV pts
Primary Central Nervous System Lymphoma (PCNSL) | b-cell origin from epstein-barr virus
27
lymphadenopathy behind the ears is indicative of rubella or rubeola
rubella | rash of rubella typically spreads faster and does NOT DARKEN or COALESCE
28
what drug competitively inhibits iodine transport
potassium perchlorate or pertechnetate
29
what TB drug requires intracellular catalase peroxidase activity to be activated
Isoniazid (INH)- inhibits mycelia acid synthesis but needs to be processed by mycobacterial catalase peroxide for the drug to be activated within the bacteria
30
how does cyanide work
potent mitochondria toxin that binds Fe3+ in CYTOCHROME C OXIDASE inhibiting the electron transport chain and halting aerobic respiration in the cell
31
tonofiliaments, long slender microvilli in proliferation of epithelioid-type cells that are joined by desmosomes is indicative of what lung cancer
mesothelioma | pancytokeratin immunohistochemical marker is helpful
32
what is seen in the bladder of a MS patient
bladder hypertonia w/ increased urinary frequency and urge incontinence
33
what characterizes primary biliary cirrhosis
chronic autoimmune liver disease infiltrate of macrophages, lymphocytes, plasma cells, and eosinophils that results in granulomatous destruction of INTRAHEPATIC, INTERLOBAR BILE DUCTS ("florid duct lesion")
34
primary biliary cirrhosis presents in who
insidiously in middle-aged women FATIGUE and PRURITITS (usually worse at night) are usually first symptoms hepatosplenomegaly and CHOLESTASIS (jaundice, pale stool, dark urine) XANTHELASMA formation
35
what is seen in disseminated HSV infection
primarily in immunocompromised ppl and presents with diffuse vesicles on an erythematous base NO erythema multiform