UWorld Flashcards
1
Q
“slapped cheek rash”
A
Parvo B19 replicates in erythrocytes
2
Q
car accident
A
asplenic sepsis
3
Q
Is Group B Strep bacitracin resistant?
A
YES
4
Q
pustular lesions with thick scabs
A
impetigo caused by s. aureus, s. pyogenes
5
Q
facial puffiness and hematuria
A
post-strep glomerulonephritis
6
Q
Gram+
Cat-
B-hemolytic
pyrrolidonyl arylamidase+
bacitracin-sensitive
A
GAS
7
Q
C diff precautions
A
Non-sterile gloves and gown
8
Q
benzodiazepines mech of action
A
increased frequency of chloride channel opening
9
Q
fragile x syndrome
A
226 CGG trinucleotide repeats on X chromosome gene methylation
Creates Giant Gonads
10
Q
locus ceruleus
A
posterior rostral pons near the lateral floor of the fourth ventricle pigmented nucleus produces norepinephrine
11
Q
rubeola
roseola
rubella
A
rubeola (aka measels) & rubella same rash (face –> trunk), both live attenuated vacc
rubeola = Koplik spots on buccal mucosa
rubella: Forchheimer spots on soft palate (congenital = cataracts, deafness, PDA)
roseola (aka HHV-6) rash starts on trunk –> face with high fever 3-5 days BEFORE, most common cause of febrile seizures
12
Q
A
histoplasma capsulatum
can survive intracellularly inside macrophages
13
Q
What bug can cause pneumonia with watery diarrhea? what lab finding is commonly associated?
A
legionella hyponatremia
14
Q
what is the most common cause of fatal sporadic encephalitis?
A
HSV-1
15
Q
What virus is a particularly common cause of pneumonitis in patients with organ transplants?
A
CMV
16
Q
foot drop can be caused by compression of which nerve?
A
common peroneal
17
Q
how does methylmalonic acidemia present, and what is the inheritance pattern?
A
AR
metabolic acidosis, hypoglycemia, ketones, hyperammonemia
(caused by methylmalonyl-CoA mutase deficiency)
18
Q
what is the mech of action of baclofen?
A
agonist at the GABA-B receptor
19
Q
most common cause of osteomyelitis in patients with sickle cell
A
SALMONELLA
20
Q
Reed Sternberg cells
A
Hodgkin’s lymphoma
21
Q
What media is used to isolate Neisseria species?
A
Thayer-Martin (chocolate agar + vancomycin, colistin, nystatin, trimethoprim)
22
Q
What bacteria is a major pathogen in burn patients?
A
Pseudomonas
23
Q
what pathogen causes woolsorters disease?
A
bacillus anthracis
24
Q
what does bacillus anthracis look like on microscopy?
A
long chains “serpentine” or “medusa head”
25
what is the major virulence factor of bacillus anthracis?
antiphagocytic capsule containing D-glutamate (instead of polysaccharide)
26
what is the virulence factor of salmonella?
capsule that protects it from opsonization and phagocytosis
27
what are the DNA viruses?
HHAPPPPy Hepadna, Herpes Adeno Pox, Parvo, Papilloma, Polyoma
28
What cells does EBV commonly infect?
B-cells
29
How is EBV infection diagnosed?
Heterophile antibody test
30
What drug is used for recurrent c. diff and what is its mech of action?
fidaxomicin macrocyclic antibiotic that inhibits RNA polymerase
31
klebsiella
encapsulated lactose-fermenting
32
what is a common cause of pneumonia in alcoholics?
klebsiella
33
currant jelly sputum
klebsiella
34
what virus acquires envelope from nuclear membrane
herpesvirus
35
What disease does Hib cause most commonly? what is Hib's major virulence factor?
meningitis polyribosylribitol phosphate (PRP)
36
primary central nervous system lymphoma is typically composed of cells of what type?
B-lymphocytes
37
How does shiga-like toxin work? what bacteria produce it?
inactivate the 60s ribosomal subunit shigella EHEC
38
what bacteria can cause hepatic abscess via hematogenous seeding of the liver?
staph aureus
39
what bacteria can cause hepatic abscess via ascending the biliary tract, portal vein pyemia, or direct invasion from adjacent area (cholecystitis)
enteric bacteria (e. coli, klebsiella, enterococci)
40
what is the mech of action of bacillus anthracis edema factor? a toxin produced by what other bacteria is similar?
adenylate cyclase that causes massive increases in intracellular cAMP
bordatella pertussis
cholera
41
what is the most common cause of bacterial meningitis in adults of all ages?
streptococcus pneumoniae
42
pseudomonas
oxidase-positive non-lactose-fermenting
43
does cryptococcus neoformans have a yeast form?
NO
44
is staph epidermidis sensitive to novobiocin?
YES
45
after what type of strep infection can you get acute rheumatic fever?
pharyngitis
46
what do nocardia species cause?
pulmonary, CNS, or skin disease in immunocompromised patients
47
what pathogens are most often responsible for secondary bacterial pneumonia?
strep pneumo, staph aureus, h. flu
48
what medications cause drug-induced parkinsons
D2 receptor blockers (1st generation antipsychotics)
49
what is the mech of action of benztropine?
antimuscarinic
50
what is polycythemia?
when you have a lot of hemoglobin
51
what do Hb concentration, O2 sat, PaO2, and total O2 content look like in:
CO poisoning
Anemia
Polycythemia
Cyanide poisoning
High altitude
CO poisoning: nl Hb, v SaO2, nl PaO2, v O2 content
Anemia: v Hb, nl SaO2, nl PaO2, v O2 content
Polycythemia: ^ Hb, nl SaO2, nl PaO2, ^ O2 content
Cyanide poisoning: all normal
High altitude: all low
52
what are the 3 variables that affect the total O2 content of blood?
Hb concentration, SaO2, PaO2
53
what cytokines induce/repress Th1 response?
induce: IL-12, IFN-y
repress: IL-4, IL-10
54
what cytokines induce/repress Th2 response?
induce: IL-2, IL-4
repress: IFN-y
55
what cytokines induce Th17 response?
TGF-B, IL-6
56
What cytokines induce Treg response?
TGF-B
57
What do Th1 cells do? What cytokines to they secrete?
activate macrophages + Tc-cells
IL-2, IFN-y, lympotoxin B
58
What do Th2 cells do? What cytokines do they secrete?
activate B-cells
IL-4, 5, 10, 13
59
facial and periorbital edema, mild-moderate HTN, in a patient with hematuria are suggestive of ... ?
nephritic syndrome / poststreptococcal glomerulonephritis (when occur after a strep infection)
60
the deposits in the glomerular basement membrane in patients with PSGN are made up of what immune complexes?
IgG, IgM, C3
61
what are the major constituents of surfactant? at how many weeks gestation do they increase?
dipalmitoyl phophatidylcholine (lecithin, L), 30 weeks phosphatidylglycerol, 36 weeks
62
should the amniotic fluid sphingomyelin level remain approximately constant during the 3rd trimester?
YES!
63
asplenic patient (surgical or auto e.g. sickle cell)
encapsulated microbes (SHiN = s. pneumo, Hib, n. meningitidis)
64
branching rods in oral infection
actinomyces israelii
65
sulfur granules
actinomyces israelii
66
chronic granulomatous disease
catalse + microbes (esp s. aureus)
67
dog or cat bite
pasteurella multocida
68
facial nerve palsy
borrelia burgdorferi (Lyme disease)
69
health care provider
HBV (from needlestick)
70
neutropenic patients
candida albicans (systemic), aspergillus
71
PAS +
tropheryma whipplei
72
pediatric infection
h. flu (including epiglottitis)
73
pneumonia in CF, burn infection
pseudomonas aeruginosa
74
pus, empyema, abscess
s. aureus
75
rash on hands and feet
rickettsia rickettsii
coxsackie A
syphillus
76
sepsis/meningitis in newborn
GBS
77
surgical wound
s. aureus
78
traumatic open wound
c. perfringens
79
how does diphtheria exotoxin inhibit host cell protein synthesis?
catalyzing ADP-ribosylation of host cell EF-2
80
does diphtheria stain with aniline dyes?
YES
81
immunization with diphtheria toxoid induces production of circulating ___ against the exotoin ___ subunit?
IgG
B
82
what are the 4 ways genital herpes can be diagnosed?
PCR, direct fluorescence Ab testing, viral culture, Tzanck smear
83
does neisseria meningitidis have a capsule?
hell yeah
84
can parvo cause arthritis in adults?
YES
85
what is the essential pathogenic mechanism for Shigella infection?
mucosal invasion
86
clue cells, vaginitis
gardnerella
87
is the rabies vaccine inactivated?
YES
88
What are 2 causes of painful genital lesions?
chancroid (haemophilus ducreyi)
genital herpes (HSV 1 or 2)
89
What are 3 causes of painless genital lesions?
granuloma inguinale (klebsiella granulomatis, multiple lesions, no lymphadenopathy)
syphillis (treponema pallidum, single lesion)
lymphogranuloma venereum (chlamydia trachomatis, small shallow ulcers, inguinal lymphadenopathy)
90
what organism can cause otitis externa? what can cause otitis media?
pseudomonas
Hib
91
riboflavin (B2) is a co-factor for what enzyme?
succinate dehydrogenase
92
how do urate crystals appear under polarized light?
needle-shaped and negatively birefringent
93
what conditions increase urate production?
idiopathic gout
myeloproliferative/lymphoproliferative disorders
tumor lysis syndrome
hypoxanthine guanine phosphoribosyl transferase deficiency
94
what are causes of decreased urate clearance?
chronic kidney disease
thiazide/loop diruetics
95
what causes the majority of overdose deaths in the US?
opiods
96
what drains to the superficial inguinal lymph nodes?
cutaneous lymph from the umbilicus down, including the anus below the dentate line
97
when is PVR lowest?
at functional residual capacity
98
what should you give an infant born prematurely \<32 weeks gestation?
corticosteroids! surfactant production
99
what are common findings in acute hemolytic transfusion reaction?
fever, hypotension, chest and back pain, hemoglobinuria
100
what are P bodies?
cytoplasmic P bodies are distinct foci found within eukaryotic cells that are involved in mRNA regulation and turnover
101
what causes wrinkles?
decreased collagen fibril production
increased degradation of type I and III collagen and elastin
102
linear deposits of immunoglobulin along the glomerular basement membrane
anti-GBM disease (IgG and C3), form glomerular crescents
103
hyperammonemia and elevated urinary orotic acid =
ornithine transcarbamylase deficiency
104
eczema, recurrent infections (encapsulated organisms, due to T and B cell deficiency), and thrombocytopenia =
Wiskott-Aldrich syndrome
105
what is secreted in the urine in acidotic states?
urinary acids (mainly NH4+ and H2PO4-)
106
cherry red epiglottis
Hib
107
how are meningococci transmitted?
respiratory droplets
(pilus attaches to epithelial cells in the pharynx --\> colonaize --\> invade vasculature --\> spread hematogenously)
108
can CMV be spread by blood transfusion?
yes
109
is initial lesion caused by chlamydia painful?
NO
110
what is the toxin of c. perfringens?
lecithinase (aka PLC or alpha toxin, catalyzes the splitting of phospholipid molecules --\> cell lysis
111
pertussis & cholera toxins both cause an increase in \_\_\_\_\_\_\_
cAMP
112
diptheria toxin and pseudomonas exotoxin A inactivate \_\_\_\_\_\_
EF-2 via ribosylation --\> inh host cell protein synthesis
113
what bacteria have capsules?
strep pneumo, h. flu, neisseria meningitidis
114
if it looks like EBV, but the question stem tells you it's not, then what is it?
CMV
115
what e. coli virulence factor allows adhesion to uroepithelium, causing UTIs?
P fimbriae
116
lysteria produces a narrow zone of __ hemolysis on blood agar
B
117
what is staphylococcal scalded skin syndrome?
epidermal sloughing and erythema due to exotoxin exfoliatin (staph), occurs in infants and children
118
what conditions/pathogens are associated with cold agglutinins
mycoplasma pneumoniae, EBV, hematologic malignancies
119
what conditions are associated with an umbilical hernia?
Down syndrome
Hypothyroidism
Beckwith-Wiedemann syndrome
120
failure of extraembyronic gut to return to the abdominal cavity can result in \_\_\_\_\_\_\_
omphalocele or gastroschisis
121
embryonic malrotation of the midgut prior to physiologic reduction into the abdominal cavity can result in \_\_\_\_\_
volvulus --\> ischemia --\> necrosis
122
the superficial inguinal ring is a physiologic opening in what anatomic structure?
external abdominal oblique aponeurosis
123
the deep inguinal ring is a physiologic opening in what anatomic structure?
transversalis fascia
124
what enzyme deficiency causes hereditary fructose intolerance?
aldolase B (F-1-P --\> DHAP + glyceraldehyde)
125
normal pressure in the SVC and RA is
1-6 mmHg
126
normal RV systolic pressure is
15-30 mmHg
127
normal PA diastolic pressure is
6-12 mmHg
128
normal PCWP is ___ and is equal to what other pressure?
6-12 mmHg, PA
129
which ion is responsible for pacemaker action potential in cardiac pacemaker cells?
Ca
130
tyramine-containing foods can cause a hypertensive emergency because their degradation is blocked by what class of drugs?
MAO inhibitors (aged cheeses, cured meats, draft beer are tyramine-contining foods)
131
what is the universal start codon?
AUG
132
what are the 3 stop codons?
UAA, UAG, UGA
133
LH --\>
leydig cells --\> testosterone
134
FSH --\>
sertoli cells --\> inhibin B
135
what virus has a predilection for stratified squamous epithelium? what can this cause in infants?
HPV (anal canal, vagina, cervic, true vocal cords)
respiratory papillomatosis
136
which second-generation antipsychotics carry the greatest risk for metabolic syndrome?
olanzapine, clozapine
137
what second-generation antipsychotic can cause agranulocytosis?
clozapine
138
caudal regression syndrome can be caused by
maternal diabetes
139
list the classic demographic and pathophysiolgy of:
indirect inguinal hernia
direct inguinal hernia
femoral hernia
indirect: male infants, patent processus vaginalis
direct: older men, weakness of transversalis fascia
femoral: women, weakness of proximal femoral canal
140
what causes intestinal atresia distal to the duodenum?
vascular occlusion
141
what dermatologic finding is associated with pseudomonas infection in neutropenic patients?
ecthyma gangrenosum
142
what cytokines are secreted by TH1 cells
IL-2, IFN-y
143
what is sarcoidosis and what is the classic histological finding
dysregulated cell-mediated immune response to unidentified antigen --\> formation of multiple non-caseating granulomas characterized by a central collection of tightly custered epithelioid macrophages surrounded by a rim of mononuclear cells
144
how do thiazolidinediones lower glucose in treatment of T2DM
binds PPAR-y --\> up-regulates transcription of genes that regulate glucose and lipid metabolism (esp adiponectin) --\> increases insulin sensitivity
145
CD20 is a \_\_\_-cell marker
B
146
what are each of the following biologic response modifiers (BRMs) used for?
rituximab
infliximab
IL-2
imatinib
abciximab
rituximab: B-cell lymphoma (binds CD-20)
infliximab: ankylosing spondylitis, fistulizing Crohn's disease
IL-2: renal cell carcinoma, melanoma
imatinib: CML (BCR/ABL philadelphia chromosome)
abciximab: during angioplasty in patients with acute coronary syndrome (blocks platelet aggregation)
147
what is usually the cause of an S3 sound?
increased left ventricular end-systolic volume (LV failure)
148
what makes up an MHCI molecule?
heavy chain + B2-microglobulin
149
during what step in the TCA cycle is GTP produced?
succinyl-CoA --\> succinate (succinyl-CoA synthetase)
150
what is freely filtered at the glomerulus and neither reabsorbed nor secreted by the renal tubules (and therefore commonly used to calculate GFR)?
inulin
151
what type of insulin should be used in patients presenting with DKA
regular insulin (lasts 5-8 hours)
152
what chamber of the heart is closest to the esophagus?
LA
153
what pharyngeal/brancial pouch(es) are affected in DiGeorge syndrome?
3 (inferior parathyroid and thymus) and 4 (superior parathyroid)
154
light microscopy of a liver biopsy from a child with Reye syndrome shows what
microvesicular steatosis (small fat vacuoles in the cytoplasm) of hepatocytes without inflammation
155
what causes diastolic heart failure?
decreased ventricular compliance
HTN, obesity, and infiltrative disorders (transythyretin-related amyloidosis, sarcoidosis) are important causes
156
how is peripheral artery disease (PAD) managed
graded exercise and cilostazol (PDE inhibitor that inhibits platelet aggregation and acts as a direct arterial vasodilator)
157
what is the most common cause of retinitis in HIV-positive patients, and how is it treated?
CMV
ganciclovir
158
what are the acute effects of corticosteroids on the white blood cell count?
increased neutrophils (due to demargination)
decreased everything else
159
what is the most common mutation in the CFTR protein in patients with CF and what does it do?
deltaF508
causes protein misfolding --\> proteasome degradation --\> no CFTR proteins on the membrane
160
what cranial nerves pass through the jugular foramen?
IX
X
XI
161
all ______ cells contain a well-developed smooth ER
steroid-producing
162
what osmotic diuretic can cause pulmonary edema?
mannitol
163
which organs are most frequently affected in graft-vs-host-disease?
skin
liver
GI
164
fever
pharyngitis
sandpaper-like rash
circumoral pallor
strawberry tongue
scarlet fever (caused by GAS --\> RF or PSGN)
165
what conditions cause increased/decreased maternal serum AFP
increase: NTDs, ventral wall defects, multiple gestation
decrease: aneuploidy
166
what vitamins can be produced by enteric bacteria?
vitamin K
folate
167
which vessels are most heavily involved in development of atherosclerotic plaques (in order of most-least)
abdominal aorta \> coronary a \> popliteal a \> internal carotids \> circle of Wiliis
168
what antibiotic can lead to bone marrow suppression
chloramphenicol
169
absorption of which vitamins may be impaired after gastric bypass procedures?
iron
B12
golate
fat-soluble (EDAK)
170
koilocytes on pap test are a sign of ____ infection
HPV
171
what intrauterine exposure can lead to VSD?
alcohol
172
what heart defect can be caused by congenital rubella?
PDA
173
what heart defect is associated with down syndrome?
ASD
174
what congenital heart defect is associated with maternal diabetes?
transposition of the great vessels
175
what heart defect is associated with Marfan syndrome?
aortic dissection
176
When I say "Ebstein anomaly," you say "\_\_\_\_\_"
Also, what is an Ebstein anomaly?
intrauterine Lithium exposure
problem with the leaflets of the tricuspid valve --\> tricuspid regurgitation and RHF
177
When I say "coarctation of the aorta," you say, "\_\_\_\_\_\_"
What other heart defect is associated with \_\_\_\_\_?
Turner syndrome
bicuspid aortic valve
178
what heart defect is associated with William's syndrome?
supravalvular aortic stenosis
179
what heart defect is associated with 22q11 syndromes?
truncus arteriosus, tetralogy of Fallot (DiGeorge)
180
"string of beads" appearance of renal artery
fibromuscular dysplasia
181
182
183
184
