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Qbank > Uworld 3,4 > Flashcards

Uworld 3,4 Flashcards

1
Q

What characteristic pathologic changes are seen in Alzheimer dementia?

A

Intracellular Neurofibrillary tangles and extracellular amyloid-beta plaques

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2
Q

What are neurofibrillary tangles composed of?

A

Tau proteins - component of intracellular microtubules

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3
Q

What happens to Tau proteins in alzheimer dementia?

A

Hyperphosphorylated, causing microtubule structures to collapse into tangles

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4
Q

The APP gene is located on what chromosome?

A

21

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5
Q

Zidovudine is what type of analog?

A

Thymidine analog - without 3’OH group, making 3’-5’ phosphodiester bond formation impossible

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6
Q

What hormones are responsible for glucose homeostasis during prolonged fasting?

A

Growth hormone and cortisol

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7
Q

What hormones are responsible for increasing blood glucose due to a rapid drop in glucose?

A

Glucagon is primary, with Epi acting as a backup

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8
Q

Growth hormone receptors are found where, and what activate what pathway?

A

Receptors are membrane-bound, result in JAK-STAT pathway

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9
Q

What cells produce the inflammatory response seen in gout?

A

Neutrophils

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10
Q

What is the best option for rapid reversal of warfarin?

A

Fresh frozen plasma

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11
Q

What is protamine used for?

A

Heparin reversal

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12
Q

The basal ganglia are supplied bu what arteries?

A

Lenticulostriate arteries

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13
Q

What valvular lesion is commonly seen in Turner syndrome? What other common vascular defect is seen?

A

Bicuspid aortic valve; coarctation of the aorta

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14
Q

What are the gynecologic complications of Turner syndrome?

A

Streak ovaries, amenorrhea, infertility

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15
Q

What is the site of protrusion for direct inguinal hernia?

A

Hesselbach triangle

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16
Q

What is the site of protrusion for an indirect inguinal hernia?

A

Deep inguinal ring

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17
Q

Is an indirect inguinal hernia above or below the inguinal ligament?

A

Above; the inguinal ligament makes up the lower border

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18
Q

Is a direct inguinal hernia above or below the inguinal ligament?

A

Above; the inguinal ligament makes up the lower border

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19
Q

Is a femoral hernia above or below the inguinal ligament?

A

Below

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20
Q

Why do indirect inguinal hernias occur?

A

Failure of the processus vaginalis to obliterate, allowing adb contents to protrude through deep inguinal ring

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21
Q

What is the location of an inguinal hernia in regards to the inferior epigastric vessels?

A

Inguinal hernia is lateral to the inferior epigastric vessels

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22
Q

What is the location of a direct inguinal hernia in regards to the inferior epigastric vessels?

A

Direct inguinal hernia is medial to the inferior epigastric vessels

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23
Q

What type of inguinal hernia can continue into the scrotum?

A

Indirect inguinal hernia

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24
Q

Deep palpation of the external inguinal ring reveals a hernia, what type of hernia is it most likely to be?

A

Indirect inguinal hernia

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25
Q

What is the equation for NPV?

A

TN/ (TN + FN)

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26
Q

What is the equation for specificity?

A

TN/ (TN + FP)

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27
Q

What is the equation for positive likelihood ratio?

A

LR+ = sensitivity / (1-specificity)

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28
Q

What is the positive likelihood ratio?

A

A ratio representing the likelihood of having the disease given a positive result

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29
Q

What is the equation for the negative likelihood ratio?

A

LR- = (1- sensitivity) / specificity

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30
Q

How do patients with partial nephrogenic DI respond to water deprivation test?

A

Slow but steady rise in urine osmolality with increasing serum osmolality after water deprivation; there is no further increase in urine osmolality with DDAVP

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31
Q

Where is the MLF located in the brainstem?

A

Dorsal pons

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32
Q

Where does the frontal eye field project to in conjugate horizontal eye movement?

A

Projects to contralateral paramedian pontine reticular formation

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33
Q

In internuclear ophthalmoplegia, the lesion occurs on which side, in regards to the affected eye?

A

Ipsilateral

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34
Q

Patient has internuclear ophthalmoplegia with a lesion on the left side MLF, what eye is unable to adduct? What eye is unable to abduct?

A

Left eye unable to adduct during right conjugate horizontal gaze, contralateral (right) eye abducts with nystagmus

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35
Q

What is first line treatment for toxoplasmosis in patient with HIV?

A

Pyrimethamine and sulfadiazine (or clindamycin in case of sulfa allergy); may add leucovorin (folinic acid)

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36
Q

What gene is effect in achondroplasia?

A

FGFR3 gene; point mutation causes exaggerated inhibition of chondrocyte proliferation

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37
Q

What channel do class IC antiarrhythmics block? What effect do they have on the ECG?

A

Sodium channels; prolong QRS duration with minimal effect on QT interval

38
Q

What type of antiarrhythmic is procainamide?

A

Class IA

39
Q

What effect do Class IA antiarrhythmics have on the ECG?

A

Prolong QRS and the QT interval due to moderate K channel blocking

40
Q

What channels do Class IA antiarrhythmics block?

A

Na and moderate K channel block

41
Q

What type of antiarrhythmic is lidocaine?

A

Class IB

42
Q

What type of antiarrhythmic is flecainide? Propafenone?

A

Both Class IC

43
Q

What is an important virulence factor of E coli causing neonatal meningitis?

A

K1 capsule

44
Q

Fever and a sore throat in a patient with hyperthyroidism treated with medical therapy should raise concern for what?

A

Thionamide-induced agranulocytosis

45
Q

What are the AEs of thionamides?

A

Agranulocytosis; methimazole: 1st trimester teratogen, cholestasis; PTU: hepatic failure, ANCA-associated vasculitis

46
Q

What is the MOA of celecoxib?

A

Selective COX-2 inhibitor

47
Q

What is the MOA of rifaximin?

A

Nonabsorbable antibiotic that alters GI flora and decreases intestinal production and absorption of of ammonia

48
Q

What is the MOA of lactulose?

A

Increased conversion of ammonia to ammonium by lowering colonic pH

49
Q

What effect does high urine citrate have on renal stone formation?

A

Has stone-preventing effects; citrate binds to free (ionized) calcium, preventing its precipitation and facilitating its excretion

50
Q

Patients with hypocitraturia are at increased risk for what?

A

Calcium oxalate precipitation and stone formation

51
Q

What effect doe higher dietary calcium have on renal stone formation?

A

Decreases it; calcium binds oxalate in intestine, decreasing absorption of oxalate, and therefore decreasing the amount of oxalate needing to be excreted

52
Q

At what pH do magnesium ammonium phosphate stones precipitate?

A

Higher pH

53
Q

What chromosome is the RB tumor suppressor gene on?

A

13

54
Q

What gene is the WT-1 tumor suppressor gene on? What is it associated with?

A

Chromosome 11; Wilms tumor

55
Q

What chromosome is c-Myc on? What is it associated with?

A

Chromosome 8; associated with Burkitts lymphoma

56
Q

What chromosome is NF-1 on? What is it associated with?

A

Chromosome 17; associated with neurofibromatosis type 1

57
Q

Renal blood flow x (1- Hct) calculates what?

A

Renal plasma flow

58
Q

How is renal plasma flow calculated using renal blood flow and Hct?

A

Renal blood flow x (1-Hct)

59
Q

How is filtration fraction calculated?

A

GFR/RPF

60
Q

When creating a DDx for metabolic alkalosis, what is an important test to differentiate the causes?

A

Urine chloride

61
Q

In unilateral renal artery stenosis, what is seen on CT?

A

Atrophy of the affected kidney, while contralateral kidney becomes enlarged

62
Q

How does acute hemolytic transfusion reaction present?

A

Fever, hypotension, tachypnea, tachycardia, flank pain, hemoglobinuria

63
Q

What is the cause of acute hemolytic transfusion reaction?

A

IgM antibodies to transfused ABO blood, resulting in complement activation

64
Q

What type of HSR is acute hemolytic transfusion reaction?

A

Type II HSR

65
Q

What are the AEs of thiazide diuretics?

A

Hypokalemia, metabolic alkalosis, hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia. Sulfa allergy.

66
Q

What effect do loop diuretics have on calcium?

A

Loops increase calcium excretion; hypocalcemia

67
Q

What are the AE of acetazolamide?

A

Hypokalemia, metabolic acidosis (proximal renal tubular acidosis), sulfa allergy, NH3 toxicity, paresthesias

68
Q

Gram negative rod, non-lactose fermenting, causing UTI in patient with indwelling catheter

A

P aeruginosa

69
Q

Gram negative rod that is lactose-fermenting and causes nosocomial UTI infections

A

Enterobacter cloacae

70
Q

What is the MOA of sirolimus?

A

Binds immunophilin FKBP in cytoplasma, forming a complext that inhibits mTOR; inhibition of mTOR inhibits IL-2 signal transduction

71
Q

What is the most dangerous AE of amphotericin B?

A

Nephrotoxicity - can cause damage and result in hypokalemia

72
Q

How do uric acid stones appear?

A

Yellow or red brown, diamond/rhombus formation

73
Q

Uric acid crystals precipitate at what pH?

A

Low pH

74
Q

In PSGN, what are the immune complex depositions comprised of?

A

IgG, IgM, C3

75
Q

In repidly proliferative crescentic GN, the deposits are comprised of what?

A

Fibrin

76
Q

In type 1 membranoproliferative GN, the deposits are comprised of what?

A

C1q

77
Q

Subendothelial C1q deposits are characteristic of what renal disease?

A

Type 1 membranoproliferative GN

78
Q

Basement membrane splitting is seen in what renal disease?

A

Alport syndrome and membranoproliferative glomerulonephritis

79
Q

Uniform, diffuse thickening of glomerular capillary walls on LM is seen in what renal disease?

A

Membranous glomerulopathy

80
Q

What drug can be used to treat ganciclovir-resistant CMV?

A

Foscarnet

81
Q

What are the AEs of foscarnet use?

A

Hypocalcemia and hypomagnesemia which can cause seizures

82
Q

Hyperproteinemia has what effect on GFR?

A

Increased oncotic pressure in the glomerular capillary, therefore decreased GFR

83
Q

Urea passively diffuses into what part of the tubule?

A

Thin ascending limp of the loop of henle

84
Q

Where is UT1 found? What controls it? What is its function?

A

Found in medullary collecting tubule; ADH increases expression of UT1; UT1 allows for reabsorption of urea (increasing interstitial concentration and therefor promoting water reabsorption)

85
Q

Where is UT2 found? What is its function?

A

UT2 is found on thin ascending limb of the loop of Henle; it allows for secretion of urea (allowing for dilution of the tubular fluid)

86
Q

What is minimal change disease?

A

Most common cause of pediatric nephrotic syndrome; see massive proteinuria (selective)

87
Q

Erythropoiesis-stimulating agents increase the risk for what?

A

Hypertension an thromboembolic events

88
Q

What is a urachus?

A

Remnant of the allantois that connects the bladder with the yolk sac

89
Q

What effects doe beta-adrenergic antagonists have on renin secretion?

A

Inhibits renin release

90
Q

What substance can be used to calculate renal plasma flow?

A

Para-aminohippuric acid

91
Q

Acute rejection of an organ is seen in what timeframe?

A

Usually < 6 months

92
Q

Secondary hyperparathyroidism due to CKD results in what characteristic lab findings?

A

Hyperphosphatemia, low 1,25 Vit D, hypocalcemia, increased PTH

Qbank (33 decks)

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