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zz - step 3 - uworld > uWorld 56 > Flashcards

uWorld 56 Flashcards

1
Q

what are the most important mitochondrial myopathyies

A

myoclonic epilepsy with ragged red fibers (MERRF- seizures are short lived and triggered by startle with proximal muscle weakness)

leber optic neuropathy (blindness)

mitochondria encephalopathy with stroke-like episodes and lactic acidosis (MELAS)

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2
Q

nephrotic syndromes are associated with a hyper coagulable state why

A

loss of ANTITHROMBIN III in urine leads to RENAL VEIN TROMBOSIS

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3
Q

patient with membranous nephropathy, flank pain, hematuria, and right-sided varicocele likely has what

A

RENAL VEIN THROMBOSIS from loss of ANTITHROMBIN III in urine causing hyper coagulable state

ELEVATED LACTATE DEHYDROGENASE, FLANK PAIN, HEMATURIA

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4
Q

ISOLATED RIGHT-SIDED VARICOCELE indicates what

A

IVC OCCLUSION

MALIGNANT TUMOR or THROMBUS

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5
Q

following IV administration, highly lipophilic drugs will be rapidly distributed to organs with high blood flow (brain, liver, kidneys, lungs), they are then REDESTRIBTED WHERE

A

tissues with relatively lower blood flow (SKELETAL MUSCLE, FAT, BONE)

seen in PROPOFOL USE (short duration of action)

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6
Q

vesicles, ulcers, then crusting in the genetialia or buttocks

A

HSV

INGUINAL LYMPHADENOPATHY

itchy, painful, vesciular

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7
Q

what is locomotor ataxia

A

seen in neurosphyillis due to tabes dorsalis

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8
Q

what is the Kehr sign

A

referred pain to C3-C5 shoulder region from any abdominal process (ruptured spleen, peritonitis, hemoperitoneum) irritating the phrenic nerve sensory fibers around the diaphragm

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9
Q

what are caspases

A

proteolytic enzymes that destroy cell components

contain cysteine and care able to cleave aspartic acid residues (Cysteine-ASPartic-acid-proteASES)

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10
Q

what are some complications of diphtheria

A

submucosal edema and pseudomembrane aspiration can obstruct respiratory tract, causing SUFFOCATION

systemic absorbed diphtheria toxin had prediction for brain and heart tissue:

  • MYOCARDITIS/HEART FAILURE
  • NEUROLOGIC TOXICITY
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11
Q

what is the most common cause of postpartum hemorrhage

A

UTERINE ATONY- failure of uterus to contract adequately after delivery

usually respond to utertotonic agent

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12
Q

removal of placenta in pieces manually after delivery and post part hemorrhage suggests what

A

PLACENTA ACCRETA

scar tissue from previous urger (c-section) can result in malformed or ABSENT DECIMAL LAYER b/w placenta and myometrium, allowing for direct MYOMETIRAL ATTACHMENT by the villous tissue and preventing normal placental separation after fetal delviery

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13
Q

what is Guyon’s canal

A

fibroosseous tunnel between HOOK of HAMATE and PISIFORM bone that the ULNAR NERVE (C8-T1) runs through

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14
Q

subluxation of the radial head can injury can fuck up what

A

deep branch of the RADIAL NERVE during its passage through the SUPINATOR CANAL

weakness during finger and thumb extension (“finger drop”)

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15
Q

what causes alcohol-induced hepatic statosis

A

decrease in free fatty acid oxidation secondary to excess NADH proaction by the 2 major alcohol metabolism enzymes alcohol dehydrogenase and aldehyde dehydrogenase

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16
Q

what is seen in Mockebergs

A

medial band-like calcifications

DOES NOT NARROW VESSEL LUMEN

seen on x-ray or as palpable mass

17
Q

what are c-Jun and c-Fos

A

nuclear transcription factors that directly bind DNA via a leucine zipper motif

18
Q

what is S-100

A

homodimeric calcium-binding proteins, similar in structure to calmodulin and important in intracellular functions such as protein phosphorylation and cell growth and differntiation

19
Q

elevated initial CEA levels indicates what

A

WORSE PROGNOSIS

20
Q

endoneurial inflammatory infiltration of peripheral neves is characteristic of what

A

guillian-barre syndrome

21
Q

mutation of a myelin protein gene is the pathogenesis of what

A

CHARIOT-MARIE-TOOTH disease (a neural form of muscular atrophy)

weakness of foot dorsiflexion due to involvement of the common peritoneal nerve

22
Q

what causes diabetic neuropathy

A

diabetic microangiopathy which leads to nerve ischemia

accumulation fo sorbitol, leading to osmotic nerve injury

23
Q

what is seen in OVARIAN VEIN THROMBOSIS

A

example of septic pelvis thombophelbitis, a complication that can occur via vaginal or cesarean birth

FEVER and LOCALIZED ABDOMINAL PAIN ONE WEEK after delivery

24
Q

what does the paraventricular nucleus of the hypothalamus do

A

ADH, CTRH, oxytocin, TRH secretion

25
Q

what doe the arcuate nucleus of the hypothalamus do

A

secretion of dopamine (inhibits prolactin), GHRH and GnRH

26
Q

what does the supraoptic nucleus of the hypothalamus do

A

ADH and oxytocin secretion

27
Q

what signifies irreversible injury in myosites

A

appearance of vacuoles and phospholipid-containing amorphous densities within mitochondria

implies permanent inability to generate further ATP via oxidative phosphorlyaiton

28
Q

what ulcers are rarely malignant and thus do not require biopsy

A

DUODNEAL

gastric ulcers can be associated with MALTOMA or gastric adenocarcinoma

29
Q

what is the most common benign liver tumor

A

CAVERNOUS HEMANGIOMA

congenital malformation that ELARGE by ECTASIA, not hyperplasia or hypertrophy

occur singly or in multiples and are well-circumscribed masses of spongy consistency, typically measuring less than 5cm in width

consist of cavernous, blood-filled vascular spaces of variable side lined by a single epithelial layer

collagenous scars or fibrous nodules may be seen in association with tomboys

abdominal pain and RUQ fullness moisture symptomatic though

30
Q

why dont you biopsy a suspected cavernous hemangioma of the liver

A

DO NOT BIOPSY A HEMANGIOMA it has been known to cause fatal hemorrhage and is of low diagnostic yield

31
Q

what are lightning related complications

A

cardiac: cardiac arrest, ARRYHTMIAS (FATAL)
neurologic: peripheral nerve damage, seizures, confusion, RESPIRATORY ARREST (FATAL), autonomic dysfunction
dermatologic: LICHTENBERG FIGURES (pathognomonic)- FERN LEAF PATTERN, superficial burns

MSK: rhabdo, bone fractures, compartment syndrome

other: cataracts, ruptures tympanicmembranes, curling ulcers

32
Q

bluish neoplasm under the nail bed

A

GLOMUS TUMOR (GLOMANGIOMA) or subungal melanoma

GLOMUS is modified SMOOTH MUSCLE CELLS that are used for THERMOREGULATORY- shunts blood away from skin surface in cold temperatures in order to prevent heat loss

33
Q

what are risk factors for pre-eclampsia

A

nulliparity
personal or family history of pre-eclampsia
obesity
chronic hypertension

34
Q

what is gestational HTN

A

new-onset elevated blood pressure at more than 20 weeks gratin

NO PROTEINURIA or END-ORGAN DAMAGE (this is seen in pre-eclampsia)

35
Q

what causes pre-eclampsia

A

abnormal placentation

abnormal planental vasculature leads to placental hypoxia and ischemia, which in turns results in release of antiangiogenic factors into material circulation- causes endothelial injury increasing permaibiltiy and causing proteinuria

36
Q

what is arteriovenous nicking

A

FUNDOYCOPIC finding in CHRONIC HYPERTENSION

an early manifestation of retinopathy

zz - step 3 - uworld (62 decks)

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