Uworld 5

Question 1

immune response to TB

Answer 1

macrophage phagocytosis
antigen presentation to T lymphcites
CD4+ TH1 cells stimulate macrophages (WITH IFN-GAMMA) to kill intracellular M tuberculosis organisms and form langhans giant cells (multiple nuclei organized in the shape of a horseshoe peripherally)- granulomatous

Question 2

in male, non-fusion of the urethral folds –>

Answer 2

hypospadias

Question 3

lots of smooth ER means

Answer 3

phospholipid synthesis, like corticosteroids

Question 4

digoxin MOA

Answer 4

increased parasymp tone

Question 5

what impacts acne development in athletes?

Answer 5

anabolic steroids: methyltestosterone

Question 6

arsenic poisoning

Answer 6

disrupts cellular respiration (binds to sulfhydryl groups)

in pesticides/ contaminated water/ treated wood

acute: garlic breath, vomiting, watery diarrhea, QT prolongation
chronic: hypo/ hyperpigmentation, hyperkeratosis, stocking-glove neuropathy

treat with Dimercaprol

Question 7

rasburicase MOA

Answer 7

converts uric acid into more soluble metabolites (during chemotherapy)

Question 8

virulence of rabies

Answer 8

binds to nACH receptors

Question 9

CNS cells that stain positive for synaptophysin and negative for GFAP are what?

Answer 9

originate from neurons

Question 10

HIV receptor

Answer 10

CD4 protein and CCR5

Question 11

RX for generalized anxiety disorder

Answer 11

SSRI such as citalopram

Question 12

what happens to c peptide?

Answer 12

storage in secretory granules, sent into circulation

Question 13

what does ubiquitin do?

Answer 13

labels proteins for degradation

Question 14

how do we usually get rid of copper?

Answer 14

hepatic excretion into bile

Question 15

K+ sparing diuretics

Answer 15

amiloride
triamterene
spironolactone

Question 16

failure of obliteration of the processus vaginalis –>

Answer 16

hydrocele or indirect inguinal hernia

Question 17

blood supply to ureters

Answer 17

proximal- renal
middle- gonadal

distal- common iliac, internal iliac, and then vesical artery

Question 18

how does sarcoidosis lead to hypercalcemia?

Answer 18

activated macrophages –> increased 1,25 dihydroxyvitamin D

Question 19

dx for pseudomonas aeruginosa

Answer 19

cefepime (cephalosporin)

ceftazidime

Question 20

what part of the nephron is impermeable to water regardles of ADH?

Answer 20

ascending loop of henle, thick and thin,

and early distal convoluted tubule

Question 21

caspofungin target

Answer 21

cell wall of fungus

Question 22

the cardiotoxicity of doxorubicin

Answer 22

dilated cardiomyopathy

Question 23

collateral circulation for descending colon?

Answer 23

SMA and IMA

Question 24

triggers of prinzmetal angina

Answer 24

dihydroergotamine
smoking
cocaine/ amphetamines
triptans

Question 25

Reid index

Answer 25

ration of thickness of mucous gland layer to the thickness of the bronchial wall between the respiratory epithelium and bronchial cartilage

Question 26

pneumonia stages

Answer 26

congestion- first 24 hours. vascular dilatation, alveolar exudate contains mostly bacteria red hepatization- 2-3 days. Red, firm lobe (liver-like)- alveolar exudate contains erythrocytes, neutrophils, and fibrin Gray hepatization- 4-6 days- gray-brown firm lobe. RBCs disintegrate. Alveolar exudate contains neutrophils and fibrin Resolution- restoration of normal architecture. Enzymatic digestion of the exudate

Question 27

urine crystals

Answer 27

calium oxalate octahedron - square with X in center calcium phosphate- elongated, wedge-shaped, forms rosettes Mg ammonium phosphate (struvite or triple phosphate)- rectangular prism. "coffin lids" uric acid- yellow or red-brown diamond or rhombus cystine- hexagonal

Question 28

gastric varices are associated with

Answer 28

splenic vein thrombosis | portal hypertension

Question 29

antipsychotics cause acute dystonic reaction (spasmodic torticollis) how?

Answer 29

D2 antagonism- nigrostriatal pathway

Question 30

what mimics Friedrich ataxia?

Answer 30

vitamin E deficiency

Question 31

H flu virulence factor

Answer 31

``` polyribosylribitol phosphate (PRP) capsule binds factor H ```

Question 32

animal waste, retroorbital headaches, pneumonia and thrmobocytopenia

Answer 32

Q fever caused by cxiella burnetii

Question 33

gastric bypass and vitamins

Answer 33

B12, A, D and E and iron are down | folic acid and vitamin K are up

Question 34

adults with rubella develop what?

Answer 34

polyarthralgia

Question 35

Zidovudine (AZT) MOA

Answer 35

nucleoside reverse transcriptase inhibitor interrupts 3'-5' phosphodiester bond formation

Question 36

rx of invasive ductal breast carcinoma with Estrogen receptor and HER2 positivity

Answer 36

trastuzumab prevents activation of transmembrane tyrosine kinase

Question 37

sickle cell inheritance

Answer 37

autosomal recessive but phenotype is autosomal dominant (under certain circumstances- sickle cell crisis)

Question 38

fenofibrate MOA

Answer 38

reduces hepatic VLDL production

Question 39

HNPCC underlying pathology

Answer 39

DNA mismatch repair

Question 40

diabetes med that has risk of hypoglycemia

Answer 40

sulfonylureas like Glyburide

Question 41

hemolytic uremic syndrome etiology

Answer 41

shiga toxin-producing bacteria (E coli, shigella) antecedent diarrheal illness (often bloody) Hemollytic anemia with schistocytes thrombocytopenia acute kidney injury microthrombi in small blood vessels

Question 42

significan renal hypoperfusion-->

Answer 42

compensatory increase in renin secretion by JG cells (located walls of afferent arteriole; modified smooth muscle cells) --> ang system -->

Question 43

pre-eclampsia

Answer 43

proteinuria OR signs of end-organ damage

Question 44

Prader willi pathogenesis

Answer 44

loss of correct chromosomal imprinting

Question 45

Reyes syndrome- microscopy of liver will show

Answer 45

microvesicular steatosis

Question 46

what makes interferon gamma

Answer 46

T lymphocytes a test for latent TB infection

Question 47

base codon at 3' end of tRNA

Answer 47

CCA (posttranscriptional modification)

Question 48

class of drugs causing renal failure

Answer 48

aminoglycosides

Question 49

class of drugs causing vestibular disturbances

Answer 49

aminoglycosides (ototoxicity)

Question 50

in diabetic ketoacidosis, triglycerides are metabolized to glycerol by

Answer 50

glycerol kinase

Question 51

glucagon receptor type

Answer 51

protein kinase A

Question 52

what bacterial toxin works against 60 S subunit of eukaryotic RNA?

Answer 52

shigella dysenteriae- shiga toxin

Question 53

G6PD is the rate-limiting step for what change?

Answer 53

Glucose-6-phosphate to 6-phosphogluconate

Question 54

start codon

Answer 54

AUG

Question 55

cataracts and hyperglycemia. What pathogenesis?

Answer 55

aldose recutase conversion of glucose to sorbitol happening too fast --> accumulation --> osmotic pressure in tissues and stimulates influx of water usually sorbitol gets turned into fructose for secretion

Question 56

beta thalassemia

Answer 56

target cells and acanthocytes most common: splice-site error look for a tool that would help with checking out RNA, like northern blot

Question 57

Fragile X

Answer 57

X-linked dominant CGG repeat (methylation--> reduced expression of gene) very common form of inherited mental retardation

Question 58

gene associated with holoprosencephaly

Answer 58

sonic hedgehog

Question 59

environmental causes of holoprosencephaly

Answer 59

alcohol | hyperglycemia in pregnancy