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Step Rx incorrect answers > Uworld 3 > Flashcards

Uworld 3 Flashcards

1
Q

complete contralateral sensory loss =
right side of the face and right side of body
(often with severe proprioceptive defeacts that lead to unsteady gait and falls)

A

lesion to VPL or VML thalamic nuclei

thalamic syndrome!

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2
Q

lesions frontal cortex lesions

A

deficits in higher brain function: alters patterns of spontaniety, creativity, social behavior, sexual interst

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3
Q

lesion in internal capsule

A

motor deficiet

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4
Q

lesion to pons

A

coma, bilateral paralysis, pinpoint lesions, rigidity, death

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5
Q

lesion to caudate nucleaus

A

transient hemiparesis + frontal lobe symptoms (eg. inattentiveness, abulia, forgetfullness)

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6
Q

primary causes of lacunar infarcts

A

lipohyalinosis and microatheromas

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7
Q

common causes of lipohyalinosis and microatheromas?

A

hypertension and DM

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8
Q

how do varicose veins happen?

A

prolonged increases in intraluminal pressure or loss of vessel wall tensile strength ==> causes venous dilation ==> retrograde flow from incompetant valves ==> venous stasis/ congestion with lower extremity edema.

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9
Q

what are common complications of varicose veins?

A

from poor blood flow, painful thromboses, stasis dermatitis, skin ulcerations, poor wound healing, superficial infections

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10
Q

what is phlegmasia alba dolens and what is it caused by?

A

“painful white leg” from iliofemoral venous thrombosis in preggers
because DVTs ==> from uterine pressure on the deep pelvic veins (causing venous stasis) and incr hypercoag

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11
Q

dmg to central portion of spinal cord

A

syringomyelia

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12
Q

dmg to dorsal columns and dorsal roots of spinal cord

A

tabes dorsalis (neurosyphilis) –lateral corticospinal tract NOT involved

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13
Q

dmg to upper and lower motor neurons

A

ALS

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14
Q

dmg to anterior horn of spinal cord

A

poliomyleitis

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15
Q

bilateral loss of DCML, hyperreflexia, babinski +, numbness

A

B12 deficiency –> degeneration to dorsal columns, lateral corticospinal tracts, perpipheral axonal degeneration

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16
Q

bilateral pain and temp loss, flaccid paralysis and atrophy of intrinsic hand muscles

A

syringomyelia

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17
Q

loss of position and vibration, ataxia, pain and paresthesias of extremities

A

tabes dorsalis

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18
Q

spasticity and hyperreflexia, flaccid paralysis, atrophy, fasiculations

A

ALS

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19
Q

lower motor neuron weakness …progressive?

A

poliomyelitis

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20
Q

complete loss of strength below level of injury with loss of pain and temp, but vibratory intact

A

anterior spinal artery syndrome! (compression of artery running along front of spinal cord)

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21
Q

high PTT, normal PT, platelet count, bleeding time

A

Hemohilia A or B

22
Q

high bleeding time, normal or high PTT, normal PC and PT

A

von Willebrand factor deficiney

23
Q

high PT, PTT, bleeding time, and decreased platelets

A

DIC

24
Q

high bleeding time, normal PC, PT, PTT

A

Uremic platelet dysfunction (HUS?)

25
Q

high PTT, normal PT, PC, Bleeding time

A

Heparin

26
Q

high PT, super weak incr PTT, normal platelets, and bleeding time

A

warfarin

27
Q

high bleeding time, low platelets, normal PT and PTT

A

Immune thrombocytopenia

28
Q

what does vWF do?

A

promotes platelets adhesion by binding and crosslinking GP1b with exposed collagen under the damaged endothelum.

29
Q

what does protein C do?

A

acts with protein S to inactivate the activated forms of factors 5 and 8.

30
Q

when is heme: alpha 2, delta 2 found?

A

normal variant. makes hemoglobin A2. makes up 2-5 % of hemoglobin

31
Q

when is heme: zeta 2, epsilon 2?

A

earliest hb. from yolk sac.

32
Q

recurrent cyanotic spells counteracted by squatting

A

tetralogy of fallot –> to increase the amount going through the stenotic pulm valve

33
Q

-prils do what to GFR?

A

decr it!

34
Q

Have strep. bovis. what’s the next step?

A

Check for colon CA!!

35
Q

mitral stenosis with low grade fevers neg. blood cultures

A

acute rheumatic fever

36
Q

fatigue and exertional dyspnea 3 weeks after a tooth extraction

A

Strep viridans subacute bacterial endocarditis

37
Q

repeated negative blood cultures with a small mitral vegetation on transesophageal echocardiogram

A

culture negative endocarditis

38
Q

what are the culture negative endocarditis organisms?

A

bartonella, coxiella, mycoplasma, histoplasma, chlamydia, HACEK organism ==> H flu, actinobacillus, cardiobacterium, eikenella, kingella

39
Q

persistent fever with trcuspid vegetations and tricuspid regurg on echo

A

IV drug use–> S. aureus

40
Q

Legionella culture

A

buggered charcoal yeast extract (BCYE) agar supplemented with L-cysteine and iron

41
Q

budding yeast that form germ tuebs at 37 degrees C.

A

Candida alibcans

42
Q

presence of candida in sputum…what is it?

A

normal…contaminant. upt o 40% of population has it in GI tract (and oral cavity)…so it will contaminate sputum cultures. doesn’t indicate disease

43
Q

what are the receptors in the carotid sinus innervated by?

A

baroreceptors in carotid sinus (and carotid body chemosensors) travel up the glossopharyngeal nerve to brainsem.

44
Q

what are the receptors in the aortic arch innervated by

A

baroreceptors in aortic arch and chemor. in aortic body travel up vagus! to brainstem

45
Q

drug or HTN/ tia causes mouth ulcers and fever

A

TIclopidine causes neutropenia. monitor complete blood count biweekly for the first 3 months.

46
Q

antiplatelet drug with mechanism: block formation of ligands

A

asprin. decr. thromboxande A2

47
Q

antiplatelet drug with mech: ADP antagonists

A

clopidogrel and ticlopiine

48
Q

antiplatelet drug mech: incr cAMP by decr phosphodiesterase activity

A

cilostazol and dipyridamole

49
Q

hyperthermia, extreme generalized rigidity, autonomic instability, altered mental status

A

neuroleptic malighnant syndrome

50
Q

anaerobic bacteria in alcoholics with pneumonia

A

bacteroides, prevotella, fusobacterium, peptostreptococcus

Step Rx incorrect answers (10 decks)

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