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Step Rx incorrect answers > Uworld 2 > Flashcards

Uworld 2 Flashcards

1
Q

what are the paranasal sinuses lined with?

A

ciliated, pseudostratified, columnar, mucus-secreting epithelium

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2
Q

what is the laryngeal vestibule lined with?

A

upper airway…so ciliated, pseudostratified, columnar, mucus-secreting epithelium

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3
Q

what is the trachea lined with?

A

ciliated, pseudostratified, columnar, mucus-secreting epithelium

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4
Q

what is the false vocal cords lined with?

A

upper airway…so ciliated, pseudostratified, columnar, mucus-secreting epithelium

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5
Q

what are the true vocal cords lined with?

A

stratified squamous epithelium

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6
Q

small DNA virus that has an affinity for stratified squamous epithelium

A

HPV –> causes warty growths on true vocal cords –> hoarseness and possible stridor (with upper airway obstruction)

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7
Q

what are the oropharynx, laryngopharynx, anterior epiglottis, and upper half of the posterior eppiglottis lined with?

A

stratified squamous

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8
Q

woman btwn 20-40 presents with dyspnea and exercise intolerance. +fam hx

A

idiopathic pulmonary htn

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9
Q

idiopathic pulm htn gene mutation

A

inactivating mutation in pro-apoptotic BMPR2 gene

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10
Q

pathogenesis of idiopathic pulm htn

A

endothelial and SM proliferation ==> vascular remodeling, elevated pulm vascular resistance, and progressive pulm htn

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11
Q

Definitive treatmet for idiopathic pulm htn?

A

lung transplant

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12
Q

intermediate treatment for idiopathic pulm htn? (while waiting for a transplant)

A

Bosentan- endothelin receptor antagonist. so blocks effects of endothelin which is a potent vasoconstrictor and stimulates endothelial proliferation

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13
Q

what does Bosentan do?

A

blocks effects of endothelin which is a potent vasoconstrictor and stimulates endothelial proliferation

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14
Q

what does clopidogrel do?

A

inhibits ADP- induced platelet aggregation

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15
Q

what is clopidogrel used in?

A
  1. atherosclerotic ischemic dz

2. prevent acute stent thrombosis following percutanous coronary interventions

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16
Q

What is enalapril

A

ITS A PRIL!

its an ACE inhibitor

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17
Q

what is enalapril used in?

A

CHF, htn, diabetic nephropathy

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18
Q

what is used by neutrophils to roll?

A

L selectin

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19
Q

what is used by endothelial cells to make pmns roll?

A

e- or p- selectins

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20
Q

what allows tight adhesion and crawling?

A

neutrophils tightly attach by binding of CD 18 beta 2 integrins (MAC-1 and LFA-1) to intracellular adhesion molecule 1 (ICAM 1) on endothelial cells

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21
Q

what allows transmigration?

A

integrin attachments to PECAM-1 ==> only found in the peripheral intercellular junctions of endothelial cells

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22
Q

what is LAD type 1?

A

deficient CD 18

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23
Q

what happens if you have an absence of CD 18?

A

can’t tight adhesion, crawling, transmigration.

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24
Q

symptoms: recurrent skin infections without pus formation, delayed detachment of umbilical cord, poor wound healing.

A

LAD type 1. no CD 18

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25
Q

posterior drawer test does what?

A

if pcl is messed up

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26
Q

where does pcl originate and insert?

A

anterolateral surface of medial femoral condyle

and inserts into posterior intercondylar area of tibia

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27
Q

prognosis of colorectal adenoCA is related to what?

A

STAGE!

not grade!

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28
Q

what is stage of a tumor?

A

extent of tumor expansion

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29
Q

what is grade of a tumor?

A

degree f tumor differentiation

well diff->anaplastic

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30
Q

what is the function of the mesolimbic-mesocortical pathway?

A

regulates behavior

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31
Q

what is the dz associated with the mesolimbic-mesocortical pathway?

A

schizophrenia

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32
Q

what is the function of the nigrostriatal pathway?

A

coordination of voluntary movements

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33
Q

what is the dz associated with the nigrostriatal pathway?

A

parkinsons

34
Q

what is the function of the tuberoinfundibular pathway?

A

controls prolactin secretion

35
Q

what is the dz assoc with tuberoinfundibular ptwy?

A

hyperprolactinemia

36
Q

inferior thyroid surgery. what’s injured?

A

recurrent layrngeal

37
Q

superior thyroid surgery. what’s injured?

A

superior laryngeal. branch of the vagus

38
Q

what is the ansa cervicalis?

A

loop of the cervical plexus. from C1,2,3 . loops around the internal jugular. innervates the sternohyoid, sternothyroid, omohyoid muscles…

39
Q

high blood and tissue ammonia. neuro problems as a result. increased urine orothic acid.

A

ornithine transcarbamyolase deficiency

40
Q

how does hep c evade the immune system?

A

has a lot of variety in the virus envelope proteins! host immunity can’t keep up!

41
Q

Does pO2 = PaO2 ever?

A

yes. by the time it passes through the first 3rd of the alveolar capillaries.

42
Q

how do you measure the A-a gradient if given the pO2 and the PaO2?

A

subtract PaO2-pO2

43
Q

How do you measure physiologic dead space?

A

Vd= Vt x ((PaCO2-PeCO2)/PaCO2)

the taco, paco, peco, paco

44
Q

How do you calculate alveolar ventilation?

A

Va= (Vt-Vd) x RR

45
Q

what is a normal A-a gradient?

A

10-15

46
Q

what are the causes of a low pO2, with a normal A-a?

A

alveolar hypoventilation or inspiration of air with a low pO2.

47
Q

2 diff mech causes of hypoventilation

A
  1. surpressed central respiratory drive (sedative OD, sleep apnea)
  2. decr in inspiratory capacity (Mysthenia gravis, obesity)
48
Q

what are the 4 major causes of hypoxemia? (low PaO2)

A

alveolar hypoventilation, V/Q mismatch, difusion impairment, right to left shunting

49
Q

which causes of hypoxemia would you see a high A-a gradient?

A

V/Q mismatch, difusion impairment, right to left shunt?

50
Q

How does a GI bleed lead to high ammonia?

A

a gi bleed will incr nitrogen delivery to the gut as Hb, which is then converted to ammonia and absorbed. The ammonia is then delivered to the liver to be detoxified to urea. If there is liver dysfunction, the ammonia won’t be converted…..

51
Q

how does high ammonia cause encephalopathy?

A

impaired metabolism and decr cerebral glucose metabolism.

leads to incr in inhibitory (GABA) and decr in excitatory (glutamate, catecholamines)

52
Q

What do you give for hepatic encephalopathy?

A

lactulose, rifaximin, get rid of precipitating cause

53
Q

how does lactulose work as tx of incr ammonia?

A

bacterial action will acidify the colonic contents==>
ammonia converted to inabsorbable ammonium==>
traps ammonium in stool. incr fecal nitrogen excretion.

54
Q

a decr in albumin would do what to capillary beds?

A

lowers plasma oncotic pressure and increases net plasma filtration. EDEMAAAA

55
Q

do turner syndrome pts have normal uterus(es)?

A

YESSS.

endometrial response to estrogen and progesterone is normal. so they can get pregnant after IVF or donor oocytes

56
Q

are gonadotropins high or low in turner?

A

HIGH. because problem in ovaries. can’t make estrogen. LH and FSH will be sups high.

57
Q

which bacteria don’t have a peptoidoglycan wall?

A

MYCOPLASMA!!! D=

58
Q

chronic lymphedema predisposes to the development of what?

A

angiosarcoma (stewart-treves syndrome)

59
Q

facial pain, headache, black eschar in nasal cavity of person with DKA

A

mucormycoses (caused by Mucor or Rhizopus)

60
Q

how does diffuse type gastric adeno CA grow?

A

linitis plastica. infiltrates the stomach wall. signet ring cells

61
Q

cxr: fibrocalcific parietal pleural plaques in the posterolateral mid- lung zones and over the diapharam

A

asbestosis

62
Q

thiazolidinediones work how? (TZDs) (for DM)

A

glucose lowering effect by decreasing insulin resistance by binding PPAR-gamma

63
Q

what does PPAR - gamma do? (4)

A

incr adiponectin, fatty acid transport protein, insulin receptor substrate, GLUT 4

64
Q

what do you give to treat acute thyrotoxicosis (from hyperthyroid) before surgery?

A

beta blockers

65
Q

what is exophthalmos?

A

in hyperthyroid. incr soft tissue mass within body orbit. enlargement of the extraocular muscles and incr fibroblast proliferation and ground substance production.

66
Q

most common cause of adrenal insufficiency

A

depression of the entire hypo-pit-adrenal axis by glucocorticoid therapy

67
Q

what dopamine receptor do dopamine agonist used to treat parkinson’s stimulate?

A

D2 preference

68
Q

what are the ergot dopamine agonists?

A

bromocriptine and pergolide

69
Q

what are the non-ergot dopamine agonists?

A

pramipexole and ropinerole

70
Q

drug to quickly convert people out of proxysmal supraventricular tachy

A

adenosine!

71
Q

side effects of adenosine

A

flushin, chest burning (due to bronchospasm)

72
Q

what can cause malignant hyperthermia

A

inhalation anesthetics (esp. halothane) and muscle relaxant succinylcholine –> in genetically susceptable ppl

73
Q

how do you treat malignant hyperthermia?

A

dantroline!

74
Q

dantroline mechanism?

A

blocks ryanodine receptors and prevents release of Ca into the cytoplasm of skeletal muscle fibers

75
Q

what is the relationship between GFR and serum creatinine

A

rule of thumb: every time GFR halves, the serum creatinine doubles.

(when normal) large decr in GFR= small incr in creatinine
(when GFR sups low) small decr in GFR= large changes in creatinine

76
Q

whats most important stimulator for insulin release by Bcells

A

glucose (gets in via GLUT 2) goes through glycolosis and makes ATP, which then closes the potassium ATP channel.

77
Q

how is insulin normally released

A

glucose–> glycolysis–> incr ATP–> incr in ATP/ ADP ratio –> closes potassium ATP channel –> depol–> opens Ca++ channel –> incr in intracellular CA++ –> insulin exocytosed.

also the GLP1 receptor increases cAMP–> exocytosis of insulin

78
Q

what’s different in MRSA that makes it resistant to all B-lactam antibiotics (even the Blactamase resistant ones)

A

altered penicillin binding protein. doesn’t bind b-lactams effectively

79
Q

how far down does the mucociliary clearance go?

A

down to the terminal bronchioles

80
Q

how far down to the goblet cells go? (in the bronchial tree)

A

to the larger bronchioles. then later goes to surfactant containing fluid secreted by the club cells

Step Rx incorrect answers (10 decks)

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