uWorld 5 Flashcards
what is the most common cause of bronchitis
tobacco smoke (not occupational exposure)
what causes tetralogy of fallot
anterior and cephalic deception of the INFUNDIBULAR SEPTUM during embryologic development
abnormal neural crest cell migration
cyanosis due to Right Ventricular Outflow Tract obstruction (pulmonary stenosis)- harsh systolic ejection murmur over the mid-to-left upper sternal border
how can cancer cells evade apoptosis via FasR-Fas pathway
SPLICE OUT a particular exon that codes the TRANSMEMBRANE DOMAIN of the FasR which allows them to EVADE APOPTOSIS
fibrinolytics (tPA, reteplace, tenecteplace) can cause what on arterial re-opening
reprofusion arrhythmia accelerated idioventricular (AIVR) rhythm is a common reprofusion arrhythmia
what part of the lung is affected by aspiration while eating on back
posterior segment of the right upper lobe and superior segments of the lower lobes
(right lobe always more common b/c more vertically oriented)
what part of the lung is affected in patients who aspirate in upright (or semi-recumbent) positions
basilar segments of the right lower lobe
right lobe always more common b/c more vertically oriented
what is acute intermittent porphyria
defect in porphobilinogen deaminase
acute attacks of abdominal pain, neuropsychiatric symptoms and RED OR BROWN URINE
what is porphyria cutanea tarda (PCT) (most common porphyria)
defects in uroprophyrinogen decarboxylase
chronic photosensitivity with blistering in areas of sun exposure and elevated levels of uroporphyrinogen in urine
when would one see elevated zinc protoporphyrin levels
lead poisoning
b/c ferrocheletase cannot incorporate iron to form heme it incorporates zinc instead
what medication selectively decreases the heart rate but has no effect on myocardial contractility or relaxation
IVABRADINE- used in chronic HF w. reduced ejection fraction and persistent symptoms- reduces risk of hospitalization
affects the FUNNY SODIUM CHANNELS thereby prolonging the slow depolarization phase (phase 4)
what is Murphy sign and what does it signify
inspiratory pause elicited by pain during deep palpation of right upper quadrant
seen in acute calculus cholecystitis
what does lecithin hydrolysis and mucosal damage do in cholecystitis and what causes it
gallbladder outflow obstruction causes it
persistent obstruction promotes hydrolysis of luminal lecithins to lysolechitihins which disrupts protective mucosal layer
what happens if loop diuretics are used with NSAIDs
decreased diuretic response
what drugs would increase QRS complex but but have little effect on QT interval and what ion channel they fuckgin with
Class 1C antiarrhymics (flecainide) by clocking the sodium channels
QRS complex corresponds to ventricular depolarization and phase 0 of the myocardial action potential
pancreatic juice is what type of secretion (iso, hypo, hyper-tonic) and what ions are in the same concentrations as plasma and what ions are differnet
isotonic secretion
Sodium and potassium are in the same concentrations as found in the blood
BICARD is INCREASED in pancreatic juice
CHLORIDE is DECREASED in pancreatic juice
as pancreatic flow rates increase bicarb goes up and chloride goes down in the pancreatic juice
what is the only heart chamber to lie lateral to the midclavicular line
left ventricle
all other chambers are medial to MCL
patients with IL-12 deficiency suffer from what and how can this be treated
severe mycobacterial infections due to the inability to mount a strong cell-mediated granulomatous immune response
treated with IFN-gamma
in a patient with flank pain, hematuria, elevated lactate dehydrogenase (cell necrosis) and a wedge shaped infarct (coagulative necrosis) on CT- think RENAL INFARCT, what causes this?
systemic thromboembolism from ATRAIL FIBRILLATION- irregular heart contractions can lead to clot formation
MI and endocarditis can cause this too
how do external hemorrhoid drain
inferior rectal vein into the internal pudendal vein which communicates with the internal iliac vein
the superior vesicle artery supplies what
bladder
ductus deferens
the left colic artery is a branch off what and supplies what
branch off IMA
suppers transverse and descending colon
what disinfectant works by coagulation of cytoplasm and disruption of cell membranes
chlorhexidine (not sporicidal)
what disinfectant works by denaturation of proteins and disruption of cell membranes
alcohols (not sporicidal)
what disinfectant works by halogenation of proteins and nucleic acids
iodine (SPORICIDAL)
how is hydrogen peroxide a disinfectant
produces destructive free radicals that oxidize cellular components (SPORICIDAL)
what is the most common cause of turner syndrome
paternal meiotic nondisjunction
loss of SHOX gene which is responsible for long bone growth
what vitamin is necessary of transamination and decarboxylation of amino acids (for gluconeogeneiss and other essential biochemical pathways)
pyridoxine (B6)
transamination reactions typically occur between what
amino acid and alpha-leto acid
amino group is transferred to the alpha-kets acid from the amino acid making the alpha-leto acid an amino acid
what is a cofactor for all 4 carboxylase enzymes (pyruvate, acetyl-coe, propionyl-CoA, 3-methylcrotonyl-CoA)
biotin (B7)
what vitamin is an important coenzyme for a number of important dehydrogenase enzymes (transketolase, alpha-ketoglutarate dehydrogenase, pyruvate dehydrogenase)
Thiamine (B1)
what is listerolysin-O
pore-forming toxin of listeria that is selectively activated within acidified phagosomes
allows listeria to lyse the vacuolar membrane
how is listeria removed from the body in a healthy person
cell-mediated immunity
what characteristics of drugs make them more susceptible to hepatic metabolism and clearance (when non-renal clearance is desired)
highly lipophilic and high volume of distribution
(highly lipophilic drugs tend to be poorly eliminated in the kidney as these agents rapidly cross tubular cell membranes after filtration to reenter the tissues
the right middle lobe of the lung lies immediately adjacent to what structure
right border of the heart which on a PA chest x-ray corresponds to the RIGHT ATRIUM
what are specific features of hyperthyroidism due SPECIFICALLY to GRAVES disease
pretrial myxedema and exophthalmos
both due to build up of GAGs within the affected tissues
