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UWorld Flashcards

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1
Q

Primary site of ribosome synthesis and assembly

A

Nucleolus

* all ribosomal RNA except 5S rRNA is transcribed in the nucleolus

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2
Q

Nephrogenic diabetes insipidus

Etiology

A 
Lithium 
Demeclocycline 
⬆️Ca++
⬇️K+
ADH receptor mutation
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3
Q

Prolonged bleeding following procedures ^ spontaneous hemorrhages into the joints

A

Hemophilia

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4
Q

Riboflavin deficiency

Enzyme impaired?

A

Cofactor in redox reactions

Succinate dehydrogenase

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5
Q

Primary carnitine deficiency (4)

A

Muscle weakness
Cardiomyopathy
Hypoketotic hypoglycemia
⬆️muscle TGS

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6
Q

Brainstem lesions typically result in…

A

Crossed signs
Ipsilateral cranial nerve palsies
Contralateral hemiparesis
Vertigo ^ ataxia

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7
Q

Xeroderma pigmentosum

A

Nucleotide excision repair of DNA

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8
Q

Patients w/aortocavitary fistulas. Doppler will demonstrate:

A

Continuous blood flow from the higher pressure aortic root to the lowest pressure right ventricle.
Continuous murmur

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9
Q

Which substance act in the most similar manner to IgG antibodies to facilitate phagocytosis ?

A

Complement C3b

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10
Q

Ras protein

2 states:

A

Inactive GDP-bound state

Active GTP-bound state

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11
Q

Iron deposition in the kidney

Name ?

A

Hemosiderosis

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12
Q

Iron deposition in the kidney

Name ?

A

Hemosiderosis

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13
Q

PNH triad

A

Hemolytic anemia (hemoglobinuria)
Pancytopenia
Thrombosis at atypical sites

chronic hemolysis can cause Iron deposition in the kidney

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14
Q

PNH

Etiology?

A

Gene defect (PIGA A) that leads to uncontrolled complement-mediated hemolysis

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15
Q

Common peroneal nerve damage presents w/

A

Equinovarus posture

Loss of sensation to the anterolateral leg and dorsum of the foot

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16
Q

Organ supplied by an artery of the foregut ?

The organ itself is not a foregut derivative

A

Spleen: mesoderm

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17
Q

N gonorrhoeae can be cultured on

A

Thayer Martin VCN selective medium

Vanco, colistin, nystatin, TMP

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18
Q

Treatment of absence seizures

A

Ethosuximide: 🚫 R-type Ca++ channel in thalamic neurons

Valproate

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19
Q

Schizoaffective disorder

A

Delusions or hallucinations >= 2 wks in the absence of major depressive or manic episode

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20
Q

Bipolar disorder and major depression w/psychotic features

A

The psychotic symptoms occur exclusively during manic or depressive episodes

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21
Q

Main side effect of thiazolidinediones

A

Fluid retention
⬆️Na++ reabsorption in the renal collecting tubules
Adipose weight gain

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22
Q

Type B dissections

Origin?

A

Left subclavian artery

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23
Q

Diverticulosis

  1. Morphology
  2. Pathogenesis
A
  1. True vs FALSE (no muscularis included)

2. Traction vs PULSION (⬆️intraluminal pressure)

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24
Q

POMC

Produce?

A

Beta endorphins
ACTH
MSH

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25
Q

Cholinesterase inhibitors

Tertiary amines

A

Physostigmine
Galantamine
Donepezil
Rivastigmine

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26
Q

Imparts black color to fat

A

Osmium tetroxide

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27
Q

Flaccid bullae

Mucosa and trunk

A

Pemphigus vulgaris

Desmosomes

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28
Q

Volume of distribution

Formula

A

Vd (L)= amount of drug given / plasma concentration of drug

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29
Q

Drug in the plasma compartment
Low Vd
Characteristics?

A

⬆️molecular weight
⬆️plasma protein binding
⬆️charge
Hydrophilicity

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30
Q

Aromatase deficiency

A

Female fetus:⬆️androgen, ⬇️estrogen levels

Maternal virilization

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31
Q

B1 adrenergic receptors are found in:

A

Cardiac tissue

Renal juxtaglomerular cells

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32
Q

Within the true pelvis the ureters lie:

A

Anterior to the internal iliac artery
Medial to the ovarian vessels
The uterine artery crosses over the anterior surface of the ureter 🌉

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33
Q

Anterior humerus dislocation

A

Flattening of deltoid muscle
Acromial prominence
Loss of sensation over the lat shoulder
Axillary nerve injury

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34
Q

Ketogenic aminoacids

A

Lysine

Leucine

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35
Q

PDH deficiency

A

Failure to thrive
Lactic acidosis
Seizures
🏥:Ketogenic diet

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36
Q

Febrile maculopapular rash taht begins on the face and spreads to the trunk ^ extremities

A

Rubeola (measles)

Rubella (german measles)

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37
Q

Febrile maculopapular rash that spreads to the trunk ➕ POSTAURICULAR LYMPHADENOPATHY ?

A

RUBELLA (GERMAN MEASLES)

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38
Q

What is the next step if there is suspicious for child abuse ?

A

Ask permission to interview the child alone

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39
Q

Saphenous vein can be accessed at which site?

A

Inferolateral to the pubic tubercle

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40
Q

GFR is dependent on

A

Angiotensin II

Mediated efferent arteriolar vasoconstriction in renal art. Stenosis

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41
Q

PSGN

most important poor proognostic factor ?

A

Increased age

42
Q

Effect modification vs confounding

A

Stratified analysis

With confounding there is usually no significant difference between the strata

43
Q

Cerebellar Hemisphere Lesion

A

Disdiadochokinesia
Limb dysmetria
Intention tremor

44
Q

Enzymes that metabolize 6-MP

A

Xanthine oxidase ^ thiopurine methyltransferase: INACTIVE metabolites

HGPRT: active metabolites

45
Q

Acute mitral regurgitation

A

Afterload ⬇️
Preload ⬆️
LV EF ⬆️

46
Q

⬇️ renal plasma flow

⬆️ filtration fraction

A

FF= GFR/RPF

Constriction of the efferent arteriole

47
Q

Mitochondrial diseases

A

Heteroplasmy

48
Q

DOC for insomnia in elderly

A

Ramelteon: melatonin agonist

Avoid: BZD, antihistamines, sedative antidepressants

49
Q

Muscle that passes through the greater sciatic foramen ?

A

Piriformis muscle

50
Q

Sciatic foramen is divided into a greater and lesser sciatic foramina by

A

The sacrospinous ligament

51
Q

Structures runing above and below piriformis nerve ?

A

Above: sup gluteal vessels, sup gluteal nerve
Below: inf gluteal vessels, internal pudendal vessels, sciatic nerve

52
Q

Scurvy in children

A

Hemorrhages
Bone deformities
Subperiosteal and joint hematomas

53
Q

Pyelonephritis

A

Hematura w/ casts

WBC casts

54
Q

Tertiary syphilis

A

Vasa vasorum endarteritis and obliteration

Thoracic aortic aneurysm

55
Q

Panic attack

In a young healthy patient

A 
Chest pain 
Tachycardia 
Sweating 
Shortness of breath 
Tremulousness 
NORMAL EKG
56
Q

Colchicine

A

2nd line agent to treat acute gouty arthritis

Prevent tubulin polymerization into microtubules

57
Q

Dopamine

A

D1 renal Blood flow
B1⬆️ ♥️ contractility
A1 vasoconstriction

58
Q

Methylphenidate

A

⬇️ appetite, weight loss

59
Q

Coumarin ^ warfarin toxicity

A

IV FRESH FROZEN PLASMA

60
Q

Aplastic anemia

Pathogenesis

A

Bone marrow failure due to hematopoietic stem cell deficiency (CD34)

Pancytopenia + absence of splenomegaly

61
Q

Drug that inhibit primary active transport ?

A

Omeprazole

62
Q

Primary active transport ?

A

Na/K ATPase
H/K ATPase
Ca ATPase

63
Q

Most common benign vascular tumors in adults

A

Cherry hemangiomas

64
Q

Drug that can precipitate withdrawal in opioid-tolerant patients w/chronic pain?

A

Buprenorphine

Partial opioid agonist w/ low intrinsic activity

65
Q

Cough reflex impaired by ?

A

Foreign bodies lodged in the piriform recess

66
Q

Vessels w/highest burden of atherosclerosis?

A

Lower abdominal aorta

Coronary arteries

67
Q

Cholesteatoma

A

Squamous cell debris

68
Q

Acute macular degeneration

Wet AMD

A

VEGF INHIBITORS: Ranibizumab, bevacizumab

69
Q

Side effects of corticosteroids on immune system?

A

Neutrophilia

70
Q

Rabies
Reservoir?
Vaccine ?

A

Bats

Inactivated vaccine

71
Q

Changes after administration of T3 in a hypothiroid patient ?

A

⬇️TSH
⬆️T3
⬇️T3r
⬇️T4

72
Q

HORMONE SENSITIVE LIPASE

A

Enzyme found in adipose tissue that catalyzes the mobilization of stored TGS into:
Free fatty acids ➡️ ketones
Glycerol ➡️ glucose

73
Q

Treatment-resistant schizophrenia ?

A

Clozapine

74
Q

Garlic odor, pesticides/insecticides, abdominal pain , QT prolongation, watery diarrhea

A

Arsenic poisoning

Dimercaprol

75
Q

GLUT responsive to insulin ?

A

GLUT 4 : skeletal muscle ^ adipose tissue

76
Q

Nicotinic (diplopia, disphagia) muscarinic blockade (dry mouth)

A

Strongly suggestive of food poisoning w/ Clostridium botulinum toxin

77
Q

Telomerase

A

Reverse transcriptase

Add TTAGGG repeats to the 3’ end of chromosomes

78
Q

Anaplastic tumors

Features ?

A
  1. Loss of cell polarity
  2. Giant, multinucleated tumors cells
  3. Abnormal mitotic figures
  4. Cellular ^ nuclear pleomorphism
  5. High nucleus to cytoplasm ratio
79
Q

Fibrates (gemfibrozil) should be avoided in patients w/?

A

Gallstones

80
Q

Patophysiology of acne ? (4)

A
  1. Sebum production
  2. Folicular epidermal hyperproliferation
  3. P. Acnes
  4. Inflammation
81
Q

Significant first dose hypotension in patients w/ volume depletion (diuretics) or heart failure.
Drug ?

A

ACE inhibitors

82
Q

Gastric bypass cause small inyestinal bacterial overgrowth.

Causes?

A

⬇️vit A, B12, D, E, Zn

⬆️Folic acid, vit K

83
Q

Romberg test is a test of?

A

Proprioception

84
Q

Organic acidemia

A

Lipids: Odd chain fatty acids, cholesterol
AA: Valine, methionine, isoleucine, threonine
Pyrimidine: uracil, thymidine

85
Q

ADHD

Treatment ?

A

Stimulant drugs
Methylphenidate
⬆️release of D and NE

86
Q

Tibial nerve sensory loss?

A

Over the sole

87
Q

Part of the nephron impermeable to water?

A

Ascending limb of the loop of Henle

88
Q

Haloperidol, fluphenazine

Side effects ?

A

Akathisia
Acute dystonia
Parkinsonism

89
Q

Sotalol

Adverse effect ?

A

Torsades de pointes
QT prolongation
Excessive B blockade

90
Q

Paralysis of the stapedius muscle produces hyperacusis.

CN injured ?

A

Facial

91
Q

Tetrahydrobiopterin is a cofactor in the synthesis of ?

A

Serotonin
Tyrosine
DOPA

92
Q

Neuro (gait disturbance, parkinsonism, dysarthria)
Hepatic (ALF, chronic hepatitis, cirrhosis)
Psychiatric (depression, personality changes)
⬇️ CERULOPLASMIN

A

Wilson disease

Treatment: D-penicillamine, Zn

93
Q 
Febrile neutropenia (n<500)
Microorganisms
A

Aspergillus

Candida spp

94
Q

Most common indicator of obesity-related restrictive lung disease ?

A

⬇️ expiratory reserve volume ERV

95
Q

Causes of angioedema ?

A

Mast cell activation (+pruritus/urticaria)➡️Type 1 hypersens. Reaction, mast cell activation

Excess bradykinin (NO pruritus/urticaria)➡️ACEI, C1 inhib deficiency

96
Q

Multiple myeloma

A 
Fatigability 
Constipation (⬆️Ca++)
Bone pain 
⬆️ serum protein 
Renal failure
97
Q

Hox gene code for ?

A

TRANSCRIPTION FACTORS

98
Q

Irreversibly inhibits COX-1 ^ COX-2

A

ASPIRIN

99
Q

Lynch syndrome

Gene ?

A

MSH2, MLH1, MSH6, PMS2

100
Q

Abdominal aortic aneurysm

Pathology?

A

Chronic transmural inflammation

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