uWorld 50 Flashcards
what would be one measure to most likely cause a steep decline in the incidence of hepatocellular carcinoma worldwide
universal vaccination of children against HBV
in Korea, Tiawan, Mozambique, and china there are hight rates of HCC usually do to chronic HBV acquired through vertical transmission at childbirth
what is found in the medullary cords and sinuses
cords: B cells, plasma cells, and macrophages
sinuses: reticular cells and macrophages
both with mild intellectual ability has a long and narrow face, prominent mandible, and large testes.
HYPERLAXITY in his finger and thumb joints
FRAGILE X Snydrome
also have large ears
NEUROPSYCHIATRIC FEATURES: anxiety, ADHD
Ehlers danlos is most commonly due to what
Type V collagen defect- CLASSICAL TYPE (joint and skin symptoms)
Hypermobility type is most common type- joint hyper flexibility
(the vascular type is type III collagen- berry aneurysms and shit)
what is the inheritance patter of marfan
AD
autopsy findings of PLATELET-RICH THROMBI attached to the MITRAL VALVE LEAFLETS is characteristic of what
NONBACTERIAL THROMBOTIC ENDOCARDITIS (NBTE) aka MARANTIC ENDOCARDITIS
most commonly associated with ADVANCED MALIGNANCY, as well as chronic inflammatory disorders like antiphosphlipid syndrome, SLE, and DIC in patients with sepsis
often seen with MUCINOUS ADENOCARCINOMA
WHITE THROMBUS: strands of fibrin, immune complexes, and mononuclear cells
vegetation can dislodge and are MORE LIKELY TO EMBOLIZE (than infective endocarditis) causing infarction
what is binge eating disorder
recurrent episodes of binge eating w/ NO COMPENSATORY BEHAVIORS
lack of control during eating
what are signs of bulimia nervosa in people who vomitit regularly
hypotension tachycardia dry skin MENSTRUAL IRREGULATIEIS erosion of dental enamel PAROTID HYPERTRPHY electrolyte imbalances (hypokalemia, hypochloremia, metabolic alkalosis)
what is body dimorphic dorder
intense preoccupation with previewed defect in physical appearance leading to significant functional impairment
NOT DIAGNOSED if the preoccupation is WEIGHT GAIN and the people MEETS the CRITERIA for an EATING DISORDER
whats stress incontinence
loss of urethral support and intraabdominal pressure exceeds urethral sphincter pressure
leaking with coughing sneezing, laughing, lifting
COMMON in PREGNANCY
what is urge incontinence
detrusor overactivity
sudden, overwhelming, or frequent need to empty bladder
what is overflow incontinence
impaired detrusor contractility, bladder outlet obstruction
constant involuntary dribbling of urine and incomplete emptying
what muscles function with the urethral valve to maintain continence
LEVATOR ANI
COCCYGEOUS
(during pregnancy hormones decrease urethral tone and relax these pelvic floor muscles)
what can improve symptoms of stress urinary incontinence
KEGEL EXERCISES0- strengsten pelvic floor muscles (elevator and and coccyges)
what wild thing can be seen with KLUMPKE’s PALSY (sudden upward jerking of arm causing injury to lower trunk- total claw hand)
HORNER’ SYNDROME- from involvement of T1 nerve room proximal to the sympathetic trunk
TNF alpha is a proinflammtory cytokine that induces insulin resistance how
activation of SERINE KINASES, which then phosphorylate serine residues on the beta subunits of IR and IRS-1
this inhibits tyrosine phosphorylation of IRS-1 by IR and subsequently hinder downstream signaling, reusing in resistance to the normal actions of insulin
phosphorylation of threonine resides has same effect
CATECHOLAMINES
angiotensin II and GnRH work through what kind of receptor
Gq
what is seen microscopically in a Schwannoma
Antoni A: BIPHASIC with highly cellular areas
-spindle cells that form palisading patterns with interspersing nuclear-free zones called VEROCAY BODIES
Antoni B: MYXOID regions of low cellularity
S-100 positive
what are the risk factors for epithelial ovarian cancer
infertility (ovarian dysfunction), nulliparity (repeated ovulation)
endometriosis
genetics (BRCA1 or 2, HNPCC)
postmenopausal age
what are the protective factors for epithelial ovarian cancer
oral contraceptives
multiparty, breastfeeding
tubule ligation, salpingo-oophorectomy
(less repair at the ovarian surface due to reduced lifetime ovulation frequency)
what is granuloma inguinal (DONOVANOSIS)
KLEBSIELLA GRANULOMATIS
PAINLESS, progressive, red serpiginous, ulcerative lesions WIHTOU LYMPHADENOPATHY
gram stain and culture (difficult)
biopsy (DONOVAN bodies)
how does chancroid present
purulent ulcers with “ragged” borders and suppurative lymphadenopathy
gram (-) rods in a “SCHOOL OF FISH” chain
what is a special feature found onion the thoracic and early lumbar spinal levels (T1-L2
LATERAL HORNS (intermediolateral cell columns)- sympathetic preganglionic neurons
what is something found only above the T7 spinal level
CUNEATE FASCICULI
only gracile fascicule is present below T7 (both are present above0
development of respiratory distress, diffuse neurological impairment (confusion), and upper body peteachail rash (due to thrombocytopenia) within days of long bone fractures is characteristic of what
FAT EMBOLISM SYNDROME
multiple fat emboli occluding the pulmonary microvasculature STAIN BLACK with OSMIUM TETROXIDE
may have numerous platelets but platelet stain (wright’s stain) is purple
metabolism of 1 gram of protein or carbs gives you how many calories
FOUR (4) thats FOUR YOU FUCKTARD
fat will give you 9, ethanol will give you 7
what tumor of SMALL ROUND CELLS is gna be found in the appendix
CARCINOID TUMOR
usually in the tip and can cause obstruction and appendicitis
what is seen microscopically in a carcinoid tumor
ISLANDS or sheets of uniform cells with eosinophilic cytoplasm and oval-to-round stippled nuclei
on EM can see multiple dense-core granules (serotonin, bradykinin, histamine, gastrin)
what is the Shine-Delgtarno sequence
in PROKARYOTES ONLY
found upstream from AUG codon, which recognizes N-formylmethionine-tRNA
allows 30S binding to mRNA and this N-formylmethionin-tRNA (forming the prokaryotic 30S INITIATION COMPLEX)
dilation of sinusoids and perivenular hemorrhage are associated with what
acute venous outflow obstruction within the liver (BUDD-CHIARI)
granulomatous destruction of bile ducts is seen nwhat
primary biliary cirrhosis
CD79a is found on what
B-cells in CNS lymphomas
what is seen microscopically in thromboangiitis obliterans (Buerger’s Disease)
SEGMENTAL VASCULITIS extending into continuous veins and nerves
principally tibial and radial artery inolvemtn
acute and chronic inflammation of the arterial walls, often with thrombosis of the lumen, which can undergo organization and recanilzation
intermittent claudication, superficial nodular phlebitis, cold sensitivity (Raynaud’s)
transmural inflammation of the arterial wall with fibrinoid necrosis
PAN
what does the lepromin skin test tell me
its positive in patines with TUBERCULOID LEPROSY as they exhibit a strong CD4+ Th1 cell-mediated response
lepromatous leprosy will test negative due to their weak Th1 cell-mediated immune response (they have Th2)
a person with T2DM has the highest risk of DYING from what
CORONARY HEART DISEASE (MCC of death in T2DM)
patients with NONCORONARY ATHERSCLEROITC DISEASE, DM, or CHRONIC KIDNEY DISEASE are at the same risk of cardiovascular events (MI, stroke) as patines with known coronary heart disease
what particular strain of E coli does not ferment sorbitol and does not produce a GLUCORONIDASE
EHEC 0157:H7
what can succinylcholine cause other than malignant hyperthermia
significant POTASSIUM RELASE from cells (HYPERKALEMIA) and life threatening arrhythmias in patients with burns, myopathies, crush inures, and denervation
bradycardia from parasympathetic stimulation or tachycardia from sympathetic simulation
