uWorld 9 Flashcards
what causes coordinated, synchronous labor contraction
increase in GAP JUNCTIONS b/w myometrial cells due to ESTROGEN increases myometrial excitability
increase in UTEROTONIC (OXYTOCIN) receptors due to estrogen which mediate claim transport though ligand-activated calcium channels
what kind of murmur is aortic regurgitation
decrescendo diastolic murmur that begins (and PEAK INTENSITY) immediately after A2 (AORTIC VALVE CLOSURE)- when pressure gradient b/w aorta and left ventricle is at its maximum
loss of dicrotic notch, high peaking left ventricular and aortic pressures during systole, steel diastolic decline in aortic pressure (resulting in wide pulse pressure)
best heard along the left sternal border at the third and fourth intercostal spaces while the patient is siting up and leaning forward with his breath held at end-expiration
what kind of vaccine is the rabies vaccine (what other vaccines are like this)
inactivated (killed) vaccine "RIP Always" Rabies (inactivated by beta-propiolactone) Influenza (injected) Polio (Salk) HAV
what vaccines are subunit vaccines
HBV (antigen = HBsAg)
HPV (types 6, 11, 16, 18)
PPSV23 step pneumo
what could bind a repeated sequence of deoxythymine residues fixed to latex beads
POLY-A TAIL of MATURE mRNA
what is telemorase
Rna-Dependent DNA polymerase that makes telomeres that contain TTAGGG repeats
how is carbon dioxide carried in the blood
as carbamate in hemoglobin
bicarb in the plasma
chloride shift makes high RBC chloride content in venous blood (maintain electroneutrality b/c of bicarb leaving cell)
what is Asherman syndrome
causes secondary amenorrhea via obstruction from carrying of the uterine cavity
typically sequela of uterine infection (postpartum endometritis) or procedures (dilation and curettage)
what is an imperforate hymen
obstructive lesion caused by incomplete degeneration of the central portion of the fibrous tissue band connecting the walls of the vagina
at birth, vaginal secretions stimulated by the mother’s estrogen can cause mucocolpos (accumulation of mucus in the vaginal canal), may manifest as building intriitus
what are the signs and symptoms of imperforate hymen
PRIMARY AMENORRHEA and normal secondary sexual characteristics with CYCLIC abdominal or PELVIC PAIN due to accumulation of menstrual blood int he vagina and uterus (HEMATOCOLPOS)
vaginal budge or mass palpated anterior to the rectum
secondary sexual characteristics are normal
what is seen in endometriosis
severe dysmenorrhea (nor amenorrhea) with lower abdominal cramps 1-2 days BEFORE MENSES common site is endometrial implants is he pouch of Douglas, which presents as painful defecation, dyspareunia, and palpable nodularity on rectovaginal examination
what is kallman syndrome
impaired synthesis of gonadotropin-releasing hormone by the hypothalamus
presents as primary amenorrhea, absent secondary sexual characteristics, and an OLFACTORY SENSORY DEFECT
what nerve is fucked up in gluteal gait
superior gluteal (gluteus medius and minimus, tensor fascia lata) caused by pelvic trauma or iatrogenic damage occurring during hip surgery or buttocks injections
when STANDING pelvis SAGS to UNAFFECTED (contralateral) side when patient stands on the affected leg
when WALKING patients LEAN towards the AFFECTED SIDE to compensate for the hip drop (GLUTEUS MEDIUS LURCH)
what is seen if the inferior gluteal nerve is injured
gluteus maximus is injured (extension and external rotation of thigh at the hip fucked up)
difficulty raising leg from a seated position and climbing stairs
femoral nerve innervates what and injury to it results in what
muscles responsible for flexion of the thigh at the hip (iliac and sartorius muscles) and extension of the leg at the knee (quadriceps femurs)
sensory to skin on the anterior thigh and medial leg
injury results in KNEE BUCKLING and LOSS of PATELLAR REFLEX
injury to the obturator nerve results in what
impaired thigh adduction and medial thigh sensory loss
the sciatic nerve innervates what
muscles in the posterior compartment of the thigh (hamstrings)
divides into tibial and common fibular/common peritoneal nerves (motor and sensory to leg and foot)
bilateral lens opacities (cataracts) with large amounts of galactose in urine, otherwise asymptomatic. Enzyme contributing to this?
aldose reductase which converts galactose to galacticol (causes cataracts)
this is galactokinase deficiency, a form of glactosemia that has cataracts and hepatocellular manifestations
what is classic galactosemia
galactose-1-phosphate uridyl transferase (GALT) deficiency
vomiting, lethargy, and failure to thrive soon after feeding is begun
impaired liver function, hyperchloremic metabolic acidosis, and aminoaciduria
severe symptoms after initiation of breast feeding
what is responsible for HIV protease variants that are resistant to standard protease inhibitors
Pol gene mutations
also responsible for structural changes in HIV-1 reverse transcriptase that render the enzyme resistant to standard nucleoside and non-nucleoside reverse transcriptase inhibitors