uWorld 51 Flashcards by Lucas Bracero

involuntary head bobbing is a sign of what and seen in what

WIDENED PULSE PRESSURE

seen in AORTIC REGURGITATION (unusually large LV stroke volumes and a heart murmur with the widened pulse pressure)

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palpitations usually result from what implying what

result from forceful ventricular contractions ejecting LARGE STROKE VOLUMES (high stroke volume meaning wider pulse pressure)

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if HBeAg persists for several months and host anti-HBeAg remain low or undetectable levels, suspect

CHRONIC HEPATITIS B infections with HIGH INFECTIVITY

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the recurrent laryngeal muscle innervates what muscles

posterior cricoarytenoid
lateral cricoarytenoid
obligue arytenoid
transverse arytenoid
thyroarytenoid

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the superior laryngeal nerve (cur at the superior pole of the thyroid lobe due to proximity of superior thyroid artery and vein) innervates what

supraglottic sensation (internal laryngeal branch)

CRICOTHYROID (external laryngeal branch)- TENSES VOCAL CORDS resulting in hoarseness

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PE is an example of what kind of shunt

RIGHT-to-LEFT intrapulmonary shunt (often results in HYPOXEMIA)

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under normal conditions how do astrocytes regulate neurotransmission

takin up glutamate present in the synapse, preventing excessive neuronal excitation
using glutamine synthetase, glutamate undergoes condensation reaction with AMMONIA to from GLUTAMINE (a non-neuroactive compound)
glutamine is then released by the astrocytes, teen up by neurons, converted back into glutamate to be used as a neurotransmitter

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EXCESS AMMONIA in the blood from cirrhosis causes elevation of what in astrocytes

GLUTAMINE

extra glutamine in the astrocytes leads to intracellular osmolarity, causing astrocyte swelling and impaired glutamine release

decreases amount of glutamine available for conversion to glutamate in neurons, resulting in DISRUPTION of EXCITATORY NEUROTRANSMISSION

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what happens to levels of alpha-ketoglutarate in hyperammonemia

they are depleted because ammonia is detoxified into glutamate via glutamate dehydrogenase- this causes impaired energy metabolism in the brain

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what are the signs of primary carnititne deficiency

muscle weakness
cardiomyopathy
HYPOKETOTIC hypoglycemia
elevated muscle triglycerides

caused by deficit in protein responsible for carinitine transport across the plasma membrane- w/o carnitine, FAs can’t be transported from cytoplasm INTO MITOCHONDRIA as acyl-carnitine

mitochondria therefore cannot beta-oxdize the fact acids into acetyl CoA, the carbon substrate for the TCA cycle

cardiac and skeletal muscle cannot generate ATP from fatty acids and the liver is unable to synthesize KETONE BODIES wen glucose levels are low

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what are signs of medium chain acyl CoA dehydrogenase (MCAD) deficiency

hypoglycemia

HYPOKETOTIC hypoglycemia

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15 year old girl w/ gait instability, kyphoscoliosis, res caves, bilateral lower extremity ataxia
joint position and vibration sense are impaired
she has an inherited disease what is it and whats she gna die from

FREIDREICH ATAXIA
death by CARDIOMYOPATHY

DORSAL COLUMNS, DRG, LATERAL CORTICOPANIAL, SPINOCEREBELLAR all fucked

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what is the inheritance of wilson disease

AR
aka hepatolenticular degeneration

liver failure, movement abnormalities, psychiatric symptoms

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localized amyloidosis confined to cardiac atria (isolated atrial amylodiossi)

beta-pleated ANP-derived proteins

incidence increases with age

this form of senile cardiac amyloidosis may INCREASE RISK of ATRIAL FIB

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localized amyloid to thyroid gland is due to what

abnormally folded CALCITONIN-derived peptides

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localized amyloid to pituitary gland is due to what

abnormally folded PROLACTIN-derived peptides

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localized pancreatic amyloidosis is due to what

islet amyloid protein (AMYLIN)

found in the pancreas of more than 90% of patients with TYPE 2 DIABETES

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what is the MCC complication of VZV infection

POSTHERPETIC NEURALGIA- persistent local pain

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what is COSTOSTERNAL SYNDROME aka COSTOCHONDRITIS aka ANTERIOR CHEST WALL SYNDROME

occurs after repetitive activity and involves the upper costal cartilage at the costochondral or costosternal junctions

pain is typically REPRODUCED WITH PALPATION and WORSENED with MOVEMENT or CHANGES in POSITION (horizontal arm flexion)

typically DO NOT HAVE palpable warmth, swelling or erythema

how is septic abortion treated and what are complciaotns

broad-spectrum antibiotics and promo SURGICAL EVACUATION to remove the nidus of infection and prevent severe complications such as sepsis, multi-organ failure, and death

long term complications include SYNECHIAE (adhesions) int he uterine cavity that can lead to secondary amenorrhea and infertility (ASHERMAN SYNDROME)

how does a septic abortion oresent

fever, abdominal pain, uterine tenderness, FOUL-SMELLING discharge AFTER PREGNANCY TERMINATION

STAPH AUREUS, E. COLI, GBS are common causes

retinoblastoma is on what chromosome

13q14

active when hypophosphorylated

stroke to where would cause bilateral homonymous hemianopsia WITH MACULAR involvement

MCA

would also have contralateral UPPER LIMB loss of sensory and moroni

PICA occultation results in what

lateral medullary syndrome (Wallenberg)
CONTRALATERAL loss of PAIN AND TEMP
IPSILATERAL CN V, VIII, IX, X, XI deficits
HORNER’s snydrome

te maximum intensity of the murmur in aortic stenosis is directly related to what

magnitude of the left ventricle to aorta pressure gradient find the spot on the graph (if given one) where the two pressures are the furthest apart during systole

what is a choledochal cyst

congenital dilatation of the common bile duct that typically present during childhood (less than 10) with recurrent abdominal pain and jaundice

what is acute ACALCULOUS cholecystitis

acute inflammatory disorder of the gallbladder in the ABSENCE of GALLSTONES critically ill patients (sepsis, severe, burns, trauma, immunosupresse) due to gallbladder stats and ischemia fever, RUQ pain, leukocytosis

a highly soluble gas anesthetic (HIGH BLOOD/GAS partition coefficient) has what properties

blood SATURATES SLOWLY, leading to a delayed rise in partial pressure decreased pressure slowly brain saturation, increasing onset time (HALOTHANE) need a lot to saturate the blood, slow rise in partial pressure in the blood, slow equilibrium in the brain, slow onset of action

a poorly soluble gas anesthetic (LOW BLOOD/GAS partition coefficient) has what properties

blood SATURATES QUICKLY, leading to a fast rise in partial pressure increased pressure speeds brain saturation, decrying onset time (NITROUS OXIDE) need little to saturate the blood, rapid rise in partial pressure in the blood, rapid equilibrium in the brain, rapid onset of action

acyclovir can cause what ADR that makes creatinine go up

CRYSTALLINE NEPHOPATHY (nephrotoxicity) treat with ADEQUATE HYDRATION, slow rate of infusion, dosage adjustment better yet PREVENT IT with HYDRATION then when you give them IV acyclovir to avoid this shit

CFTR is what kind of channel

ATP-binding cassette transmembrane ion transporter that pumps chloride ions out of epithelial cells Chromosome 7

cGMP-gates sodium channels play a role in what

vision

what kind of receptor does VITAMIN D bind to

nuclear one

what the fuck is an ACORCHORDON

SKIN TAG | pedunculated outgrowth of normal skin the tare person on regions affected by acanthosis nigricans

type 1 collagen takes part in what for bone formation

bone matrix formation

osteogenesis imperfecta is transmitted how

AD for most patients

whats cool about hodgkin lymphoma

BIMODAL distribution of age 20s and 60s B SYMPTOMS (fevers, night sweats, weight loss) nontender lymphadenopathy REED-STERNBERG cells seen on biopsy

what is VEMURAFENIB

potenti inbhitior of mutated bFRAG significant anti-tumor effects with improved survival and long-term outcomes in advanced stage V600E-positive MELANOMA

what does the BRAF mutation V600E (valine to glutamic acid) do

greatly increased ACTIVATION of the signaling pathways for melanocyte growth, survival, and metastasis

if a patient has LOW SODIUM and urine osmolarity INCREASED DURING WATER DEPRIVATION but then does not further increase when ADH is added after 7 hours of water deprivation what do they have

PRIMARY POLYURIA treat with WATER RESTRICTION

what is the arcuate line

horizontal line located below the umbilicus that demarcates the lower limit of the posterior rectus sheath above arcuate line the rectus abdomens is surround b anterior and posterior sheaths below arcuate line the muscle is covered only by the anterior sheath

if RECTUS ABDOMINIS is TRANSECTED HORIZONTALLY what most be identified and ligated bilaterally to prevent bleeding complicaitons

INFERIOR EPIGASTRIC ARTERY b/c there is no SUPPORTING POSTERIOR SHEATH blow the arcuate line- can result in significant hemorrhage if cut

what does the lateral femoral cutaneous nerve do

travels UNDER the INGUINAL LIGAMENT and provides sensory innervation to the anterolateral thigh entrapment (MERALGIA PARESTHETICA) most commonly occurs in obese or pregnant peeps or those who were mad might clothes around hips

the PPAR family plays a significant role in what

METABOLCI SNYDROMES (obesity, HTN, dyslipidemia, and insulin resistance)

thiazolidinediones exert their glucose-lowering effect how

decreasing insulin resistance through PPAR-gamma