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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

nephrotic syndromes are associated with a hyper coagulable state why

A

loss of ANTITHROMBIN III in urine leads to RENAL VEIN TROMBOSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ISOLATED RIGHT-SIDED VARICOCELE indicates what

A

IVC OCCLUSION

MALIGNANT TUMOR or THROMBUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

vesicles, ulcers, then crusting in the genetialia or buttocks

A

HSV

INGUINAL LYMPHADENOPATHY

itchy, painful, vesciular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is locomotor ataxia

A

seen in neurosphyillis due to tabes dorsalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
what doe the arcuate nucleus of the hypothalamus do
secretion of dopamine (inhibits prolactin), GHRH and GnRH
26
what does the supraoptic nucleus of the hypothalamus do
ADH and oxytocin secretion
27
what signifies irreversible injury in myosites
appearance of vacuoles and phospholipid-containing amorphous densities within mitochondria implies permanent inability to generate further ATP via oxidative phosphorlyaiton
28
what ulcers are rarely malignant and thus do not require biopsy
DUODNEAL | gastric ulcers can be associated with MALTOMA or gastric adenocarcinoma
29
what is the most common benign liver tumor
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
why dont you biopsy a suspected cavernous hemangioma of the liver
DO NOT BIOPSY A HEMANGIOMA it has been known to cause fatal hemorrhage and is of low diagnostic yield
31
what are lightning related complications
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
bluish neoplasm under the nail bed
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
what are risk factors for pre-eclampsia
nulliparity personal or family history of pre-eclampsia obesity chronic hypertension
34
what is gestational HTN
new-onset elevated blood pressure at more than 20 weeks gratin NO PROTEINURIA or END-ORGAN DAMAGE (this is seen in pre-eclampsia)
35
what causes pre-eclampsia
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
what is arteriovenous nicking
FUNDOYCOPIC finding in CHRONIC HYPERTENSION an early manifestation of retinopathy