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Level 1/Step 1 > UWorld > Flashcards

UWorld Flashcards

1
Q

Cancer pt experiencing
1. in-patient diarrhea when should obtain

a latex agglutination of viral antigen vs PCR for a bacterial toxin gene

A

latex agglutination of viral antigen = Rotavirus → nonbloody diarrhea + vomiting + fever in less than 48 hours

PCR for a bacterial toxin gene = C. difficile → watery diarrhea + ab pain w/ hospital stay 2+ days

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2
Q

​​​​​​​ alpha-synuclein protein aggregation

A

Lewy Body Dementia = Parkinsons

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3
Q

Pts w/ ​​​​​​​uterine enlargement + heavy menses

A

Adenomyosis

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4
Q

impaired myelination in the ascending dorsal columns + spinocerebellar tracts = diminished position/vibration sense + ataxia

Impaired myelination descending lateral corticospinal tracts = muscle weakness + spastic paresis

A

Vitamin B12 (cobalamin) deficiency
Or Vitamin E deficiency

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5
Q

Tremor

Dystonia = involuntary (unintended) muscle contractions

Parkinsonism

Ataxia

Chorea which are associated with dysphagia, dysarthria and drooling

A

Wilson Disease

Dx: Slit Lamp (Kayser-Fleischer rings)

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6
Q

Startle myoclonus (rapidly progressive)
Dementia (rapidly progressive)
Sharp waves on EEG
Increase 14-3-3 proteins in CSF

A

Creutzfeldt-Jakob disease = Prion misfolding beta-pleated sheets (PrPsc)

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7
Q

Pt w/ multiple syncope episodes while wearing a tight (tie, shirt collar)

A

Carotid sinus hypersensitivity via overstimulation of CN9 (glossopharyngeal)

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8
Q

Female
Tetracycline
Obesity
Vitamin A excess
Danazol (androgen agonist)

A

Idiopathic Intracranial HTN = pseudotumor cerebri

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9
Q

B1 deficiency → issues w/ APT-B

A
  • A-ketoglutarate dehydrogenase (TCA-cycle)
  • Pyruvate dehydrogenase (glycolysis → TCA)
  • Transketolase (HMP shunt) – RBC activity decrease
  • Branched-chain ketoacid dehydrogenase
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10
Q

Dopamine metabolite

A

Homovanillic acid & when low in CSF → Parkinson disease

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11
Q

Leptin = produced primarily by fat cells + long-term adequacy of fat stores → during fasting ______

A

Falls

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12
Q

Clara cells =

A

glycosaminoglycans to protect the lining of bronchioles

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13
Q

DLCO increases w/

A

asthma

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14
Q

DLCO decreases w/

A

COPD

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15
Q

R → L shunt =

A

decrease alveolar ventilation

BLOCKAGE present

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16
Q

Increased V/Q

A

reduced perfusion (Pulmonary embolism)

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17
Q

Decreased V/Q

A

decreased oxygenation of the alveoli (lung pathology)

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18
Q

Pulmonary HTN
Right Heart failure
Normal PCWP

A

Cor pulmonale + Eisenmenger syndrome

Etiology: pulmonary fibrosis (CREST syndrome + radiation)

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19
Q

Benign paroxysmal positional vertigo (BPPV)
Spinning + no vomiting
Nystagmus beating to 1 side

A

Otolith = Posterior semicircular canal

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20
Q

When do you obtain a ECG stress test

A

Arterial insufficiency

If they have BBB then echo

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21
Q

Medial malleolus ulcer
Leg color change

A

Chronic venous insufficiency

Dx: duplex US

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22
Q

Punched-out ulcer on foot
Intermittent claudication

A

Arterial Insufficiency = Peripheral vascular disease

Dx:
1. Ankle-brachial indices (ABI)
2. Doppler US or arteriography

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23
Q

Cold → increased a-1 agonism =

A

myogenic reflex
Central Blood volume increases
ADH decreases
ANP increases

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24
Q

CONCENTRIC hypertrophy

________ heart failure is associated with
due to _________ overload

A

Diastolic heart Failure
S4 sound = pressure overload
normal ejection fraction

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25
Q

ECCENTRIC hypertrophy

________ heart failure is associated with
due to _________ overload

A

Systolic heart Failure
S3 sound = volume overload
decrease ejection fraction

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26
Q

______ increase right-sided murmurs
______ increases left-sided murmurs

A

Inspiration = right-sided

Exhalation = left-sided

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27
Q

Increased intrathoracic pressure

A

Valsalva + Exhalation

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28
Q

Decreased intrathoracic pressure

A

Inhalation

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29
Q

Blood related conditions (sickle cell + anemia)
Increased HR
Normal BP
Mid-systolic murmur at URSB (upper right sternal border)

A

Transient functional flow murmurs

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29
Q

MVA or fall
Widening mediastinum on CXR

A

Rupture aorta (thoracic)

GET a arteriography

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30
Q

Damage to the ______ → Diabetes Insipidus

A

hypothalamic nuclei

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31
Q

Low _______ → lowers a1 receptors on arterioles → low BP

A

Cortisol

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32
Q

Viral infection
Vertigo

A

Vestibular neuritis

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33
Q

Viral infection
Tinnitus
Vertigo
+/- neurosensory hearing loss

A

Labyrinthitis

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34
Q

Dilute urine + low serum sodium

A

Psychogenic polydipsia

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35
Q

Where does Aldosterone work

A

Cortical collecting ducts

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36
Q

Where does ADH work

A

Medullary Collecting ducts

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37
Q

Renal tubular acidosis 1

A

DCT
– bilateral stones linked to Sjogren syndrome

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38
Q

Renal tubular acidosis 2

A

PCT
- Fanconi (carbonic anhydrase inhibitors + expired tetracyclines)

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39
Q

Renal tubular acidosis 4

A

Collecting ducts
(resembles Addison but has HYPOKALEMIA)

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40
Q

Who gets Ca++ oxalate stones

A
  1. Intestinal malabsorptive disorders
    Why = increased intrasinstainal binding of fat to Ca++ → less Ca++ to bind to oxalate intraluminally → increased Oxalate absorption
  2. Diets w/ low Citrate
    Why = Citrate helps prevent Ca++ Oxalate compounds by binding to free Ca++
  3. High Na+ diets = decrease Ca++ reabsorption
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41
Q

What can cause K+ wasting (increased K+ secretion)

A

MI w/ LBP

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42
Q

C. tetani causes disease by producing a potent ___________ (tetanospasmin)

A

metalloprotease exotoxin

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43
Q

​​​​​​​ increased serotonin release contributes to the extreme fluid _______ seen in ________

A

secretion
cholera

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44
Q

Type 4 hypersensitivity rxn

A

MS = t-cell destruction of oligodendrocytes = in demyelination of the cCNS

Hashimoto = t-cell destruction of thyroid tissue

DM1 = t-cell destruction of β cells

Acute rejection = host attacks donor

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45
Q

Type 3 hypersensitivity rxn

A

antibody-antigen immune complex deposition → to complement activation + neutrophil recruitment

Arthus rxn = pre-sensitized individuals receiving a toxoid vax booster → local edema, inflammation, and fibrinoid necrosis

Polyarteritis nodosa (PAN) = vessels

Poststreptococcal glomerulonephritis = post strep infection IgG & C3 deposits on kidney

Fibrinoid necrosis = HTN + vasculitis (Leaking of proteins (fibrin) into vessels → bright pink staining)

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46
Q

middle-aged men
Fever + weight loss + abdominal pain
Melena = Dark stools
HTN
renal dysfunction
Biopsy samples = fibrinoid necrosis + renal microaneurysms (a string of pearls)

A

Polyarteritis nodosa

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47
Q

An ______ Coombs test will identify if a woman has Rh antibodies in her serum

A

indirect

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48
Q

Type 2 hypersensitivity rxn

A

Pemphigus vulgaris = IgG antibodies against desmoglein-1 or desmoglein-3.

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49
Q

cytotoxic Type 2 hypersensitivity rxn

A

Autoimmune hemolytic anemia (AIHA)

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50
Q

Type I hypersensitivity rxn → _____ binding to allergens → mast cell degranulation of _______

A

IgE (Th2 w/ B-cells)
histamine + leukotrienes + tryptase

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51
Q

__________ = Th1 cell-mediated response to Ag. Skin: well-demarcated lesions with central hypopigmentation via granulomatous inflammation

A

Tuberculoid

52
Q

Th2-mediated humoral response to Ag → inhibiting Th1 response Skin: poorly demarcated nodular lesions on cool regions of the body (skin, mucous membranes, genitalia, nerves) → invasion of these structures by the bacilli = Damage

A

Lepromatous

53
Q

Inability to make new memories (anterograde amnesia)

A

Global cerebral ischemia

54
Q

Chiari 2 malformation

A

Herniation of 2 structures = Cerebellum + Medulla
Associated w/ myelomeningocele

Dysphagia + stridor + apnea + limb weakness

55
Q

Tracheal deviation towards dysfunctional side

A

Atelectasis

56
Q

Albinism is associated w/ the following genetic changes

A

Epistasis = 1 gene affects the phenotype expression of another gene

Locus heterogeneity = mutation at different loci → same disease

57
Q

Frameshift mutation = deletion/insertion of nucleotide → which disorders

A

Duchenne muscular dystrophy
Tay-Sachs Disease

58
Q

PLAIN ole Chediak

A

Progressive neurodegeneration

Lymphohistiocytosis

Albinism

Infections – recurrent pyogenic

Neuropathy – peripheral

Chediak-Higashi Syndrome

59
Q

CRITOE

A

Capitellum
radial head
internal (medial) epicondyle
Trochlea
Olecranon
external (lateral) epicondyle

Order of ossification

60
Q

Seizures
mild intellectual disability
history of a cardiac rhabdomyoma
hypopigmented macule (“ash leaf” spots)
angiofibroma

A

tuberous sclerosis = TSC1 or TSC2 genes (AD)

60
Q

______________ → Gagging + Cyanosis w/ Feeding & Normal XR

A

Tracheoesophageal Fistula

61
Q

Bacillus Anthracis morphology

A

Spore Forming Gram Positive Rod

62
Q

Hepcidin Inhibits Intestinal Iron Absorption in

A

Anemia Of Chronic Disease

63
Q

Which of the following correctly describes the passage of light from the environment to the retina?

A

Cornea → aqueous humor → pupil → lens → vitreous body → retina

64
Q

Nephrotic syndrome sx
Phospholipase A2 receptor Ab (linked to clots)

A

Membranous nephropathy

65
Q

p-ANCA Ab

A

Anti-myeloperoxidase (anti-MPO)

66
Q

c-ANCA Ab

A

Anti-proteinase 3 (anti-PR3)

67
Q

Signs of Nephritic syndrome
Fibrin crescents + C3b + Leukocytic infiltrates
ANAC +

A

Rapidly progressive glomerulonephritis (RPGN)

68
Q

Capillary looping
Joint pain
Blood in urine

A

Diffuse proliferative glomerulonephritis

69
Q

lesions on butt or thighs
Arthralgias = joint pain
Ab pain
Red urine

A

HSP → IgA deposits

70
Q

Sore throat
Blood in urine weeks laters

A

PSGN

71
Q

Sore throat or viral infection or GI infection
Blood in urine 1-3 days laters

A

IgA nephropathy

72
Q

Nephritic syndrome findings =

A

Hematuria
Oliguria
Azotemia = high nitrogen compounds in the blood (BUN)
HTN

73
Q

If on biopsy subendothelial deposits are discovered

A

Pt has either
Membranoproliferative
Diffuse proliferative

74
Q

Dilated renal pelvis

Dilated collecting system = calyces + collecting ducts

Ureters NOT dilated

A

Incomplete recanalization of proximal ureter

75
Q

Which ligament is folded peritoneum enclosing FT

A

Broad ligament

75
Q

Past viral infection

Multiple bruises + Petechiae + Bleeding gums

anti-GpIIb/IIIa Ab (type II hypersensitivity rxn)

Increased megakaryocytes - BM biopsy

Decrease Platelet count

A

Idiopathic thrombocytopenic purpura

76
Q

AD syndrome associated with a variety of tumors:

  1. hemangioblastoma (cerebellum and spine)
  2. retinal angiomas
  3. clear-cell RCC (adenocarcinoma)
  4. Pheochromocytoma
  5. serous cystadenomas
  6. neuroendocrine tumors of the pancreas
  7. papillary cystadenomas of epididymis + broad ligament
A

Polycystic kidney disease = Von Hippel-Lindau syndrome (VHL)

77
Q

Low levels of hypocretin-1 in CSF
shortened REM sleep

A

Narcolepsy

78
Q

Mitral stenosis → ______ LA pressure + ______ pulmonary artery pressure (_________)

A

Increased pressures

Pulmonary edema

79
Q

Amyloid deposition in cortical blood vessels
Congo red staining plaques in hippocampus

A

Alzheimer dementia = slow progressive memory loss

80
Q

64M
Vertebral artery = retrograde flow
dx

A

Subclavian steal syndrome

81
Q

TIBC low means

A

iron is bound = abnormal iron utilization

82
Q

55M
watery diarrhea
Stool Ziehl-Neelsen stain = acid-fact organism

A

Cryptosporidium parvum

83
Q

Ziehl-Neelsen stain

A

Carbol fuchsin = Acid fast bacteria

Mycobacteria = mycolic acid in cell wall in disseminated infection

Nocardia = mycolic acid in cell wall

Cryptosporidium = protozoa oocytes (stool)

84
Q

Infant w/ edema + Turners syndrome

A

lymphedema due to lymphatic network dysgenesis

85
Q

Tetrahydrobiopterin BH4 =

A

cofactor = Dopamine + Serotonin

Phenylalanine hydroxylase deficiency = hypopigmented

Tyrosine hydroxylase = mood + appetite + sleep + muscle contraction changes

86
Q

Bevacizumab

A

binds to vascular endothelial growth factor (VEGF)

87
Q

26F prego
PE
LMWH therapy
renal vein thrombosis

A

HITT = Ab against platelet factor 4 (IgG)

88
Q

14monthM
difficulty sitting unsupported
megaloblastic anemia
Orotic acid crystals in urine
Tx

A

Hereditary orotic aciduria (AR) = UMP synthase deficient

tx = Uridine supplementation

89
Q

Mifespristone

A

partial progesterone agonist = placental separation + uterine contractions

90
Q

Misopreostol

A

Prostaglandin E1 agonist = uterine contractions

91
Q

Intracellular pathogens are eliminated by

A

cell-mediated immune responses

92
Q

Some
Nasty
Bugs
May
Live
FacultativeLY

A

Some = Salmonella
Nasty = Neisseria
Bugs = Brucella
May = Mycobacterium
Live = Listeria
FacultativeLY = Francisella +Legionella + Yersinia

93
Q

Coxiella’s
Really
Chilling
inside

A

Coxiella’s = Coxiella
Really = Rickettsia
Chilling = Chlamydia
Inside = Obligate intracellular

94
Q

PPRP synthetase gene caues

A

increases in purines = joints being affected

95
Q

NSAIDs given to acute gouty arthritis

A

directly inhibits neutrophils

95
Q

p-glycoprotein efflux pump

A

ATP-dependent transportor

96
Q

Recurrent epistaxis
Cutaneous telangiectasias
S2 ULSB

dx

A

Hereditary hemorrhagic telangiectasia = Rendu-Osler-Weber syndrome

AD = TGF-b mutation

causes HF + pulmonary htn + paradoxic embolism + iron deficiency anemia

97
Q

62M
Focal UE weakness
Sx resolve spontaneously
Smoking history
140/84

dx
tx

A

TIA = transient ischemia attack = resembles a stoke

tx: Statin = helps reduce artherosclerotic plaque formation

98
Q

Pt w/ GCA are at an increase risk of blindness b/c

A

ischemic optic neuropathy = GCA affects medium + small vessels –> ischemia

99
Q

TATA box

A

promoter resion = RNA poly 2 knows where to start transcription

100
Q

Hospice care is an option for pt w/

A

a prognosis of less than 6 months

101
Q

Organisms resistant to PBP thus resistant to Cephalosporins

A

Listeria
MRSA
Enterococci

102
Q

Chlorpheniramine

A

1st generation antihistamine = easily penetrates the CNS

103
Q

-trozole

A

aromatase inhibitors = suppressions ovarian estradiol production

104
Q

Cilostazol

A

Phosphodiesterase inhibitor

inhibits platelet aggregation + direct arterial vasodilation

105
Q

Argatroban

A

tx = heparin-induced thrombocytopenia

direct thrombin inhibitor

106
Q

28M
anesthesia
muscle rigidity
130/min
Tachycardia

dx
tx

A

Malignant hyperthermia

Tx: inhibit sarcoplasmic Ca++ release in skeletal muscles (Dantrolene)

107
Q

Phenoxybenzamine

A

irreversible a1 & a2 receptors
stop NE

108
Q

DRESS = rash + swelling caused by

A

Anticonvulsants
Sulfonamides
Abx
Allopurinol

109
Q

Phentolamine

A

a blockers = vasodilation

110
Q

65M = new-onset confusion + lack of urine output

BPH
HTN
Hyperlipidemia
DM2
Insomnia

which med could cause sx

A

TCA = insomnia + adjunctive pain management

111
Q

Rx reduces
1. Uterine contractions + serum K+ levels

A

B2 agonist

Beta agonist = pushes K+ into the cell
B2 = found on smooth muscles –> relaxation

112
Q

Milrinone

A

PDE3 inhibitor = increased cAMP = positive inotropy = vasodilation (reduces preload + afterload)

112
Q

Isoproterenol

A

B1 & B2 agonist

decrease TPR & positive inotropy

113
Q

Labetalol

A

nonselective beta blocker = vasodilation affecting heart

alpha1 blocker = decrease TPR

114
Q

Metolazone

A

Thiazide

115
Q

Etomidate

A

GABA agonist = sedation + amnesia

adrenocortical suppressive by inhibiting cortisol production

116
Q

Propofol

A

GABA agonist = lipophilic

increases TG + lipase & vasodilation

117
Q

Rapid onset of action + short duration anesthesia

A

Propofol = GABA agonist

Etomidate = GABA agonist

Ketamine = NMDA antagonist

118
Q

Ketamine

A

NMDA antagonist –>
stimulation of catecholamines (SANS) =
1. bronchodilation
2. tachy
3. Positive inotrophy
3. Cerebral blood flow

119
Q

IgM agglutinin in the cold & has low affinity IgM Ab in 37C

A

Mycoplasma pneumoniae

120
Q

ST elevation + PR segment depression
children + viral infection
Chest pain worsens in recumbent position

A

Pericardial inflammation

121
Q

Deficiency in factor 8 = Hemophilia A –> bleeding following minor trauma or _______

A
  1. bleeding into joint
  2. bleeding in CNS
  3. bleeding in retroperitoneal = retroperitoneal hematoma
122
Q

Bile acid sequestrant –>

A

diverting additional cholesterol = Cholesterol to cholate

123
Q

Tachycardia =

A

decrease time for filling =
1. low EDV
2. decrease length in diastole
3. low SV
4. low CO

124
Q

Blocking Na+ channel blockade =

A

Level 1/Step 1 (15 decks)

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