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zz - step 3 - uworld > uWorld 48 > Flashcards

uWorld 48 Flashcards

1
Q

high doses of folate can antagonize what drug

A

PENYTOIN- can precipitate seizures in a select group of patients

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2
Q

what are signs suggestive of self induced vomiting in bulimia

A

pharyngeal erythema, PAROTID ENLARGEMENT, hypokalemia, and hyperamylasemia, erosion of dental enamel

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3
Q

describe junctional, compound, and intradermal nevi

A

junctional: aggregates at dermoepidermal junction, FLAT, black- to brown pigmented macules with darker coloration in the CENTER than periphery, preserved skin markings
compound: aggregates extend INTO DERMIS, RASIED papule with UNIFORM brown pigment
intradermal: EPIDERMAL NESTS of nevus cells have been LOST, dermal cells lose TYROSINASE activity and produce little to no pigment, skin- to take-colored, dome-shaped, and sometimes pedunculated

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4
Q

what are fibrillary waves (f waves)

A

seen in some patients with atrial fibrillation

irregular, low-amplitude waves b/w the QRS completes that represent the chaotic atrial activation

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5
Q

what is “holiday heart syndrome”

A

A fib in people after extensive alcohol consumption

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6
Q

what is neuropeptide y

A

polypeptide neurotransmitter found in the central and autonomic nervous systems

though tot play a role in appetite and pain perception

NPY antagonists have been investigated as potential anti obesity drug

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7
Q

how do you visualize trichamoniasis

A

wet mount (saline microscopy)

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8
Q

daytime sleepiness and naps that are NON-RESTORATIVE are seen in what

A

OBSTRUCTIVE SLEEP APNEA

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9
Q

what is obesity hypoventilation syndrome (PICKWICKIAN SYNDROME)

A

caused by restricted expansion of the chest wall due to severe obesity

leads to hypoventilation and chronically elevated PCO2 and decreased PO2

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10
Q

damage to the common peroneal (for drop and loss of sensation to dorsum of foot and lateral shin) happens where

A

FIBULAR NECK

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11
Q

what nerve gets injured from compression of the popliteal fossa

A

TIBIAL

  • innervates skin of posterior calf and lateral foot
  • tissues of knee joint
  • muscles of plantar flexion and inversion (gastrocnemius, soleus, tibialis posterior)
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12
Q

antibodies to alpha3-chain of collagen type IV are seen in what

A

GOOD PASTURE SYNDROME

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13
Q

what is the VALSALVA maneuver

A

increase VAGAL TONE and can be used to abolish paroxysmal supraventriucalr tachycardia

RECTUS ABDOMINIS is most important muscle in achieving the increased intraabdominal and intrathoracic pressure of the Valsalva maneuver

done by FORCIBLE EXHALING against CLOSED GLOTTIS

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14
Q

thin stratum granulosum and prominent parakeratotic status corneum with occasional foci of neutrophil accumulation

A

PSORIASIS

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15
Q

describe psoriasis

A

salmon-colored rounded plaques covered in loosely adherent, silvery scale

elbows, knees, gluteal cleft, lumbrosacral area, glans penis, and scalp

caused by CD4 cells activation CD8 cells in the epidermis after interacting with antigen presenting cells in the skin
-results in production of cytokines and keratinocyte growth factors

HYPERPARAKERATOSIS, ACANTHOSIS, ELONGATION of RETE ridges, mitotic activity above epidermal basal cell layer, reduced or absent stratum granulosum

AUSPITZ SIGN- bleeding when you scratch at the scaly surface

MUNRO MICROABSCESSES- neurophils mat form spongiotic clusters in the superficial dermis and the parakeratotic stratum corneum

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16
Q

what property of methadone makes it good at what it do

A

LONG HALF LIFE (surpasses trains and withdrawal for over 24 hours)

17
Q

what is synthesized by most human cells in response to viral infections

A

TYPE I INTERFERONS (ALPHA and BETA)

results in transcription of antiviral enzymes capable of HALTING PROTEIN SYNTHESIS, such as RNase L and protein kinase R
-enxymes are only active in presence of dsRNA (selectivity for virally infected cells)

PROMOTES APOPTOSIS

include MHC class I expression on cells (stimulates NK and CD8 killing)

18
Q

fluid filled cavity in liver in conjunction with fevers, chills, and right upper quadrant pain

A

HEPATIC ABSCESS

developed countries: BACTERIAL INFECTION

underdeveloped countries: PARASITIC INFECTION (enamoeba, echinococcal)

19
Q

how do pyogenic bacteria gain access to liver

A

BILIARY TRACT INFECTION (ascending cholangitis- GRAM NEG like e coli or klebsiella)
PORTAL VEIN PYEMIA (bowel or peritoneal sources- gram neg and enterococci)
hepatic artery (systemic hemorrhagic seeding)
direct invasion form an adjacent source (peritonitis, cholecystitis)
penetrating trauma or injury (mixed anaerobic and aerobic)

20
Q

CA 19-9 is a marker for what

A

pancreatic cancer

21
Q

what is seen in REYES SYNDROME

A 
MITOCHONDIRA fucked (aspirin metabolites fuck up beta oxidation by reversible inhibition of mitochondria enzymes)
MICROVESICULAR STEATOSIS
hypoglycemia
vomiting
hepatomegaly
coma

ENCEPHALOPATHY from HYPERAMMONEMIA

22
Q

apoptosis of hepatocytes, acinar necrosis and periportal mononuclear inflammatory infiltration are characteristic LM finding of what

A

VIRAL HEPATIITS

23
Q

bile duct destruction, periductal granulomatous inflammation and bile duct proliferation are seen in what

A

primary biliary cirrhosis

24
Q

what is a pure motor nerve that passes through the POSTERIOR TRIANGLE OF THE NECK

A

SPINAL ACCESSORY NERVE (CN XI)

25
Q

what does the trapezius do

A

elevate scapula, rotate it upward, stabilize shoulder

originates from the spinous processes and ligaments of the cervical and thoracic vertebra down to T12 and then inserts on lateral 1/3 of clavicle, acromion, and spine of scapula

if its FUCKED: DROPPING of SHOULDER, impaired ABduction of arm ABOVE HORIZONTAL, and winging of scapula

26
Q

injury to the deltoid fucks up abduction of the arm when

A

blow horizontal

C5-C6 axillary nerve

27
Q

what does serratus anterior do

A

ortingates on first 8 ribs and inserts on medial border of scapula
rotates scapula upward, allowing abduction of the arm over the head

innervated by long thoracic nerve

injury: impaired abduction and winging of scapula

28
Q

what are the hallmark sings of acute viral hepatitis historically

A

hepatocyte necrosis- CELLULAR SWELLING and CYTOPLASMIC EMPTYING (“BALLOONING DEGENERATION”)

apoptosis- CELLULAR SHRINKAGE and nuclear fragmentation with intense EOSINOPHILIA (COUNCILMAN BODIES)

Mononuclear infiltrate- presence of virally infected and dying hepatocytes promotes mononuclear inflammation in the sinusoids and portal tracts

29
Q

amebic liver abscesses caused by ENTAMOEBA histolytica infection can produce what kind of necrosis

A

LIQUIFACTIVE

30
Q

if events are independent, the probability that all events will turn out the same is the product of the separate probabilities for each even. the probably of at least 1 event turning out differently is given as

A

1 - P(all events being the same)

so if test is negative in 95% of patients who dont have disease, the odds of getting a positive result in a group of 8 people withOUT the disease is:
(1-(0.95)^8)

31
Q

how is copper normal excreted

A

hepatic excretion into the bile

32
Q

when does presbyopia star

A

40-50

33
Q

what are skin rhytides

A

WRINKLES

directly causes by chronological aging (with a contribution form the harmful effects of UV light)

with aging skin becomes atrophic and fragile, with reduced elasticity and subdemral fat

dermal and epidermal thinning, flattening of dermoepidermal junction, a decreased number of fibroblasts, reduced synthesis and increased breakdown of collagen and elastin

34
Q

patients with MYOPIA (increased eye axial length so image focuses before retina) see improvements with aging why

A

PRESBYOPIA compensates for the myopia by displacing the image backward

35
Q

what causes presbyopia

A

denaturation of structural proteins in lens

loss of lens elasticity

36
Q

acute lesion of the cerebellar vermis cause what

A

trucnal and gait ataxia (impaired modulation of medial-descding motor systems)

involvement of lower vermis and flocculonoudlar lobe causes vertigo/nystagmus due to dysregulation of vestibular nuclear complex

zz - step 3 - uworld (62 decks)

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