Uworld 3 Flashcards
What is the treatment of Graves ophthalmopathy?
Glucocorticords improve Graves ophthalmopathy by decreasing the severity of inflammation and reducing the excess extraocular volume.
Recurrent sinopulmonary infections and exocrine gland fibrotic atrophy in a young patient are suggestive of what disease?
Cystic fibrosis
Cystic fibrosis can lead to what manifestations?
Pancreatic insufficiency, fal malabsorption, and a deficiency of vitamins DEAK.
Vitamin A maintains what? Deficiency causes?
Vitamin A maintains orderly differentation of specialized epithelia, including the mucus-secreting columnar epithelia of the ocular conjunctiva, respiratory and urinary tracts, and pancreatic and other exocrine ducts.
Avitaminosis A can cause squamous metaplasia of such epithelia to a keratinizing epithelium.
What is the gold standard for syphilis diagnosis?
Patients with early syphilis (eg, chancre) often have false-negative initital serologic testing.
Direct visualization of the orgranism (Treponema pallidum) by dark-field microscopy or fluorescent antibody testing is the gold standard for diagnosis but is not widely available.
What nerves enter the orbit via the superior obital fissure?
CNIII: oculomotor
CNV1: opthalmic
CNIV: trochlear
CNVI: abducens
How long can patients have viable sperm after a vasectomy?
Following vasectomy, viable sperm remain in the portion of the vas deferens distal to the transection.
Patients can still have viable sperm in the ejaculate for up to 3 months and at least 20 ejaculations after the procedure.
What is seen in sertoli-leydig cell tumors?
Sertoli-Leydig cell tumors of the ovary arise from the sex cord stroma and secrete testosterone.
Therefore, patients typically have signs and symptoms of hyperandrogenism, including rapid-onset virilization (eg, hirsutism, clitoromegaly, voice deepening) and amenorrhea.
What is purulent pericarditis caused by? Which organism is most common?
Purulent pericarditis is usually caused by hematogenous dissemination from distant infection or direct extension from an adjacent infection or chest wall trauma.
Staph aureus is the most common pathogen, particularly in the setting of a portal from the skin to the bloodstream (eg, catheter) or pericardium (eg. recent chest surgery, penetrating injury)
What is the most common cause of death in patients with diabetes mellitus?
Coronary heart disease
Patients with what disease are at the same risk of cardiovascular events (eg myocardial infarction, stroke) as patients with known coronary heart disease?
Patients with noncoronary atherosclerotic disease, diabetes mellitus, or chronic kidney disease.
What is the disease inheritance pattern for classical galactosemia?
Autosomal recessive
Autosomal recessive disorders affect what percentage of offspring?
Affect 25% of offspring of asymptomatic heterozygous carrier parents
How does classical galactosemia presents?
classical galactosemia is the most common and severe galactosemic disorder and presents within days of birth with jaundice, vomitting, and hepatomegaly.
What is hereditary angioedema due to?
Hereditary angioedema is characterized by recurrent episodes of cutaneous and/or mucosal swelling due to C1 inhibitor deficiency.
What is low in hereditary angioedema?
C4 levels are low due to uninhibited cleavage of C4 by excess activated C1.
High-output heart failure results from what?
High-output heart failure results from markedly decreased systemic vascular resistance (eg, large arteriovenous fistula) that leads to increased venous return and increased cardiac output.
Despite a sustained increased in cardiac output, the left ventricle is unable to keep up with the increased venous return, and decompensated heart failure develops.
What are the most common bacterial causes of acute otitis media?
The most common bacterial causes are respiratory colonizers: strep pneumo, haemophilus influenzea, and moraxella catarrhalis
What is the pathogenesis of acute otitis media?
Acute otitis media usually occurs after a viral upper respiratory infection causes obstruction of the eustachian tube. This obstruction leads to the accumulation of secretions, which encourages bacterial growth.
Aminoglycoside (eg, gentamicin) resistance is most commonly due to what?
Most commonly due to antibiotic-modifying enzymes. These enzymes add chemical groups to the antibiotic, which diminishes its ability to bind to the 16S ribosomal RNA within the 30s ribosomal subunit.
What is the most common diaper rash and the treatment?
Irritant contact diaper dermatitis is the most common diaper rash and is characterized by skin barrier breakdown as a result of exposure to fecal bacteria that causes increased local skin pH.
Treatment is with a barrier ointment that prevents skin contact with urine and stool.
What can be used to treat bradyarrhythmias?
Conduction impairment is common with acute inferior wall myocardial infarction.
Sinus bradycardia often occurs due to nodal ischemia and an increase in vagal tone triggered by infarction of myocardial tissue; the enhanced vagal tone can be counteracted by the anticholinergic effects of atropine.
What is the MOA of beta blockers?
Beta blockers inhibit release of renin from renal juxtaglomerular cells through antagonism of beta-1 receptors on these cells.
Inhibition of renin release prevents activation of the renin-angiotensin-aldosterone pathway, which results in decreased vasoconstriction and decreased renal sodium and water retention.
Fructose 2,6 bisphosphate (F2,6BP) activates what?
Activates phosphofructokinase-1 (increasing glycolysis)