uWorld 33 Flashcards
the COLA transporter is fucked in what
CYSTINURIA
what is seen in Cystinuria
COAL transporter fucked (free cysteine, ornithine, lysine, and arginine can’t be absorbed)
no amino acid deficiencies because absorbed as oligopeptides in gut
high urinary cystine concentration leads to CYSTINE KIDNEY STONES (FLAT, YELLOW, HEXAGONAL “SIX”tine for the 6 sides)
risk facts are LOW URINE pH, the presence o a preexisting CRYSTAL NIDUS, and URINE SUPERSATURATION
what is found to be SODIUM CYANIDE NITROPURRSIDE TEST positive
CYSTINURIA
what is SERTRALINE
SSRI
causes sexual dysfunction
how do influenza vaccines work
introduce NEUTRALIZING ANTIBODIES against he HEMAGGLUTININ ANTIGEN in select viral strains
what kind of vaccines strongly stimulates MCH class I antigen-processing pathway and can great CD8+ T cells that kill infected cells
LIVE-ATTENUATED
BOUNDING FEMORAL and CAROTID PULSES (marked by abrupt dissension and quick collapse (“water hammer” pulses) due to wide pressure pulses and HEAD BOBBING with CAROTID PULSATIONS (de MUSSET SIGN) due to momentum of left ventricle stroke volume to the head and neck is seen in what
AORTIC REGURGITAION (diastolic decrescendo murmur)
what is the cause of phenylketonuria if both hyperphenylalanemia and elevated prolactin are present, why
DIHYDROBIOPTERIN REDUCTASE (produces the cofactor TETRAHJYDROBIOPTERIN (BH4))
BH4 is required for PHENYLALANINE HYDROXYLASE (turns phenylalanine into TYROSINE) and also for TYROSINE HYDROXYLASE (converts tyrosine to DOPA)
without DOPA, dopamine cannot be produced via DOPA decarboxylase
with lower dopamine levels prolactin isn’t inhibited as well as normal
how can you tell von Willebrand and Bernard Soulier appart
both have abnormal ristocetin but in Bernard Soulier since vWF levels are normal the addition of normal plasma will not correct the aggregation
in vWD addition of normal plasma corrects the ristocetin test
what does ristocetin do
activates Gp1b receptors on platelets and makes them available for vWF binding
what is first line treatment for females with menorrhagia due to von Willebrand Disease
combined oral contraceptives
desmopressin may be used too
what is seen in congenital deficiency of factor XII (hangman factor)
prolonged PTT without bleeding diathesis
tendency for thromboembolic complications
any suprasellar mass with 3 components (solid, cystic, calcified) is highly suggestive of what
craniopharyngioma
present in childhood with visual defects and mass effect (hypopituitarism)
what causes DECEREBRATE (extensor) posture
lesion AT or BELOW the RED NUCLEUS (midbrain TEGMENTUM, PONS)
due to loss of descending excitation of the upper limb flexors (via rubrospinal tract) and extensor predominance (due to unopposed vistublospinal tract output)
what causes DECORTICATE (flexor) posturing
lesions ABOVE the RED NUCLEUS (cerebral hemisphere)
due to loss of descending inhibition of the red nucleus and subsequent hyperactivity of upper-extremity flexor muscles
damage to the cerebellar vermis does what
fucks up balance and coordination of the axial/proximal limb muscles, resulting in gait and truncal ataxia
maybe nystagmus and vertigo
damage to the internal capsule typically results in in what
contralateral motor/sensory deficits
cortical signs (aphasia, agnosia, neglect, apraxia, hemianopsia) are classically absent
damage to the dorsal midbrain (tectum) usually results in what
vertical gaze palsy (inability to look up) due to its proximity to the superior colliculus
may also cause light-near dissociation (pupils constrict for accommodation but not light)
bilateral damage to the thalamus can result in what
coma
what drug is a motilin receptor agonist used for gastroparesis
ERYTHROMYCIN
what 5 receptors regulate vomiting reflex
M1 muscarinic D2 dopamine H1 histamine 5-HT3 serotonin- good for chemo neurokinin 1 (NK1)- good for chemo
what is a CHOLESTEATOMA
collections of SQUAMOUS CELL DEBRIS that form a round, PEARLY MASS behind the tympanic membrane in the middle ear
cause painless OTORRHEA
primary- a result of chronic negative pressure in the middle ear causing retraction pockets int he tympanic membrane that become cystic
secondary- occur after squamous epithelium migrates to or is implanted in the middle ear (“skin in the wrong place”)