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UWorld > UWorld > Flashcards

UWorld Flashcards

1
Q

What 2 cell types are responsible for the proliferation of an atherosclerotic plaque?

A

Platelets and macrophages

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2
Q

What is the most common genetic combination for a complete molar pregnancy?

A

Empty egg + 1 sperm, then 1 sperm duplicates

90% 46, XX

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3
Q

By what mechanism does mutated huntingtin protein cause transcriptional repression?

A

Histone deacetylation

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4
Q

How is the uterine fundus normally formed embryologically?

A

Lateral fusion of paramesonephrine ducts

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5
Q

How do you differentiate between a septate and bicornuate uterus?

A

On MRI, septate has normal uterine contour whereas bicornuate does not.

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6
Q

What does the presence of HBsAg mean?

A

Active infection - acute or chronic

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7
Q

What does the presence of HbeAg mean?

A

High infectivity

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8
Q

What key intermediate regulates the balance between fatty acid synthesis and degradation?

A

Malonyl-CoA

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9
Q

What determines coronary dominance?

A

The coronary that supplies the PDA (which supplies the AV node) determines dominance, mostly right-dominant

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10
Q

In areas with chloroquine-resistant malaria, what are the treatments of choice?

A

Mefloquine or atovaquone + proguanil

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11
Q

What part of the brain is injured in hemiballimus?

A

Subthalamic nucleus

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12
Q

What is underlying etiology in a patient with blue-black spots on sclerae, connective tissue hyperpigmentation, and severe arthritis?

A

Alkaptonuria

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13
Q

What factors precipitate sickling in sickle cell anemia?

A

Low O2, high altitude, acidosis (deoxygenated)

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14
Q

What do RBCs rely on for ATP production?

A

Lactic acid fermentation

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15
Q

What is most of the ATP in RBCs used for?

A

Membrane maintenance and structural integrity

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16
Q

What is associated with caudal regression syndrome?

A

Maternal diabetes

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17
Q

What can cause paresthesias following massive blood transfusion?

A

Hypocalcemia (from citrate mixed into blood before storage)

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18
Q

What arteries supply the lesser curvature of the stomach?

A

Gastric arteries

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19
Q

What are the 3 most common cancers in women (other than skin cancers)?

A

Breast, lung, colon

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20
Q

What microbial component has the closest correlation with disease severity in meningococcus meningitis?

A

LOS protein

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21
Q

Biopsy of sinus mucosa reveals wide angle, non-septate hyphae in an immunocompromised individual. What is the organism?

A

Mucor or Rhizopus

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22
Q

Bartonella henselae is responsible for which 2 diseases?

A

Cat scratch disease and bacillary angiomatosis

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23
Q

Dx for young, obese woman with transient vision loss worsened with bending forward or lifting things and a persistent headache?

A

Pseudotumor cerebri

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24
Q

What is the etiology of S4?

A

HOCM

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25
Q

What is the only antibody that crosses the placenta?

A

IgG

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26
Q

What biochemical marker is elevated in hydatidiform moles and what malignancy is it correlated with?

A

b-HCG, choriocarcinoma

27
Q

What is the difference between somatic and gonadal mosaicism?

A

Somatic mosaicism cannot be passed on, gonadal mosaicism has family history and can be passed on

28
Q

What is the treatment of choice for patients with acute MI and history of lung disease?

A

B1-specific blocker ??

29
Q

What nerve can be damaged by lateral fibular damage?

A

Common peroneal nerve

30
Q

How do osteocytes communicate with each other?

A

Through processes in canaliculi, via gap junctions

31
Q

What is the pathophysiology of HSP?

A

IgA immune complex-mediated vasculitis (type III hypersensitivity)

32
Q

What causes apple-peel deformity?

A

Vascular occlusion/ischemia

33
Q

What enzyme is responsible for changing bilirubin to biliverdin?

A

Heme oxygenase

34
Q

What organism is stained red by mucicarmine?

A

Cryptococcus neoformans

35
Q

Nitrites are given to treat toxicity from what compound?

A

Cyanide - increases hemoglobin affinity for cyanide to keep it bound so it can’t be toxic

36
Q

What brain mass gives rise to papilledema and Parinaud syndrome?

A

Pinealoma - papilledema from obstructive hydrocephalus, Parinaud from compression of the tectum

37
Q

What is Parinaud syndrome?

A

Compression of the tectum resulting in limited upward gaze, upper eyelid proptosis, pseudo-Argylle-Robertson pupils

38
Q

What vein drains the head, neck, and upper extremity?

A

Brachiocephalic vein (IJ + EJ + SC)

39
Q

How does potassium iodide prevent thyroid damage after exposure to iodine-131?

A

Competes with I-131 for uptake into thyroid so the more benign iodine there is, the less radioactive I-131 the thyroid takes in

40
Q

Dx for patient with diplopia that worsens throughout the day?

A

Myasthenia gravis

41
Q

In a patient with myasthenia gravis, what are the 2 causes for an acute crises?

A

Myasthenic crisis - undertreated, will improve with edrophonium
Cholinergic crisis - overtreated, will not improve with edrophonium

42
Q

Dx for patient with hx of asthma and recurrent, migratory lung infiltrates?

A

Aspergillosis - ABPA

43
Q

What is the MOA of pioglitazone?

A

Binds PPARy (intracellular) –> alters transcription –> change lipid and glucose metabolism

44
Q

What is the difference between 21-hydroxylase deficiency and 11b-hydroxylase deficiency?

A

No mineralocorticoid in 21-deficiency –> hypotension and increased renin
Increased weak mineralocorticoid in 11-deficiency (11-DOC) –> hypertension and decreased renin

45
Q

What is compliance?

A

change in volume/change in pressure

46
Q

What movement is the supraspinatus responsible for?

A

Arm abduction

47
Q

What is the effect of nitrites on hemoglobin?

A

Induces methemoglobinemia

48
Q

What is the difference in the role of Ca2+ influx during contract between skeletal muscle and cardiac/smooth muscle?

A

Skeletal - mechanical coupling between L-type Ca2+ channels and RyR on SR (verapamil-resistance)
Cardiac/smooth - Ca2+-dependent Ca2+ release from SR (verapamil works)

49
Q

1 week after an ischemic brain injury, what do you expect to see histologically?

A

Microglia have phagocytosed myelin from dead nuclei, will stain red with lipid stain

50
Q

Dx of pt with expressive aphasia and hemiplegia, CT hypodensity in brain 1 week after?

A

Stroke/ischemic disease of brain

51
Q

What are the two exceptions the general scheme of the sympathetic nervous system?

A

General scheme: ACh from short preganglionic - nAChR, adrenergic from long postganglionic to target
Exceptions:
1) adrenal medulla - AChR, direct release of NE/epi into blood
2) eccrine sweat glands - AChR, then ACh to mAChR on sweat glands

52
Q

In areas with chloroquine-resistant malaria, what are the treatments of choice?

A

Mefloquine or atovaquone+proguanil

53
Q

What are the risk factors for black gallstones?

A

Chronic hemolysis, increased enterohepatic cycling of bilirubin

54
Q

What are the risk factors for brown and cholesterol gallstones?

A

Biliary tract infection - releases microbial b-glucuronidases

55
Q

What does homogentisic acid dioxygenase deficiency cause?

A

Alkaptonuria

56
Q

What effects do alpha-1 agonists have on PVR, blood pressure, pulse pressure, and heart rate?

A

Increases PVR
Increases blood pressure
Decreases pulse pressure
Decreases heart rate (vagal reflex to vasoconstriction)

57
Q

What part of the spleen is involved in removing damaged RBCs?

A

Red pulp

58
Q

What causes urge incontinence?

A

Uninhibited bladder contractions (detrusor instability)

59
Q

Where is PAH concentration the lowest in the kidney?

A

Bowman’s space

60
Q

What’s the difference between 21-hydroxylase and 11-hydroxylase deficiency?

A

21-hydroxylase: no mineralocorticoid produced = hypotension, decreased Na+, increased K+
11-hydroxylase: weak mineralocorticoid produced = hypertension, increased Na+, decreased K+

61
Q

Dx for patient with pruritis after showering?

A

Polycythemia vera

62
Q

What is the treatment of choice for patients with acute MI and history of lung disease?

A

A-M beta blockers (metoprolol)

63
Q

What are the 3 biggest risk factors for coronary heart disease?

A

Atherosclerosis, diabetes mellitus, CKD

64
Q

Which are the only 2 insulins that are human recombinant without any amino acid modifications?

A

Regular insulin and NPH

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