Uworld Flashcards
where does lichen planus normally occur
wrists and ankles
pathogenesis of lichen planus
T cell mediated response to cells along junction of dermis and epidermis
gross appearance of lichen planus
pruritic, pink papule and plaques
how does ionizing radiation (for cancer) cause cell damage
1) DNA double strand breaks
2) generation of reactive oxygen species
in a patient with a fib, what is the most likely source of a thrombus formation?
left atrial appendage
a small saclike structure in left atrium that is particularly susceptible to thrombus formation
direct and indirect hernia - where do they lie in relation to the inferior epigastric vessels
direct: abdominal contents protrude MEDIAL to the vessels
indirect: abdominal components protrude LATERAL to the vessels
acute angle closure glaucoma occurs in what patients
those w/ predisposing narrow chamber angle
acute angle closure glaucoma can occur after taking what medications
those that cause pupillary dilation, such as alpha adrenergic agonists and drugs with anticholinergic effects
dilation of pupil in susceptible individuals causes iris to press against the anterior surface of the lungs –> limits flow of aqueous humor through the pupil –> causes iris to bulge forward
according to epidemiological data, overdose with what drugs cause the majority of OD deaths in the US
opioids
most common cause of pericarditis/pericardial effusion
viral infection
how to calculate half life
(0.7 x volume of distribution) / clearance rate
in first order kinetics, how many half lives elapse before 75% of the drug is eliminated?
2 half lives
in first order kinetics, what percentage of the drug is eliminated after:
- 1 half life
- 2 half lives
- 3 half lives
- 4 half lives
- 5 half lives
1: 50%
2: 75%
3: 87.5%
4: 93.75%
5: 96.875%
positive psychotic symptoms in schizophrenia are thought to be caused by what
an excess of dopamine in the mesolimbic dopamine pathway
characteristics of ADHD
inattentive (forgetful, disorganized, loses things)
hyperactive/impulsive symptoms (difficulty staying seated, interrupts other)
why do multiple myeloma patients have more infections
neoplastic plasma cells crowd the bone marrow –> impairs normal hematopoiesis (particularly B cell development)
*limits the generation of targeted immunoglobulins against infectious agents –> recurrent bacterial infections
coarctation of the aorta can be associated with what
other congenital cardiac anomalies or with berry aneurysms of the circle of willis
side effects of theophylline OD
seizures and tachyarrhythmias
histology of Ewing sarcoma
uniform, small, round cells with clear scant cytoplasm separated by fibrous septa and patches of necrosis/hemorrhage
what connect the dermal-epidermal junction
hemidesmosomes
MOA beta blockers
prevent interaction of epinephrine and norepinephrine with receptors at adrenergic synapses
first line therapy for essential tremor
b blocker
function of 3’ to 5’ exonuclease
removing mismatched nucleotides
prokaryotes have 3 types of DNA polymerase (I, II, III) and they have all ______ activity
only DNA polymerase I has _____ activity
all have 3’ to 5’ exonuclease (proofreading) activity
only DNA polymerase I has 5’ to 3’ exonuclease activity
MOA staph bullies impetigo
exfoliative toxin A that targets desmoglein 1 in superficial epidermis
what is the Hawthorne effect
tendency of study subjects to change their behavior as a result of their awareness that they are being studied
metastatic cancer in the liver most likely spread how
through the portal circulation
MOA anemia of chronic disease
TIBC levels?
chronic inflammation leads to release of hepcidin –> binds and inhibits iron channels –> reduced iron absorption
decreased TIBC due to suppression of transferrin
imiquimod MOA
topic immunomodulatory drug
upregulates TLR-7 which unregulates NF-kB –> initiates immune response
what disease processes have osteoBLASTIC bone lesions
- prostate cancer
- small cell lung cancer
- hodgkin lymphoma
what disease processes have osteoCLASTIC bone lesions
- multiple myeloma
- non-small cell lung cancer
- non hodgkin lymphoma
- renal cell carcinoma
- melanoma
what kind of pleural effusion occurs with heart failure
transudative
describe protein and lactate dehydrogenase levels in transudative effusions
low protein
low lactate dehydrogenase
describe protein and lactate dehydrogenase levels in exudative effusions
high protein
high lactate dehydrogenase
what is a “consensual response” when light is shined in one eye
shining light in one eye causes pupillary constriction of the other eye
- indicates CN II is functional in the ipsilateral eye, since it caused the other eye to constrict
function of calcineurin
inhibiting calcineurin can be of what use
calcium and calmodulin dependent serine/threonine protein phosphatase that activates T cells of the immune system
inhibition of calcineurin blocks T cell proliferation
what drugs inhibit calcineurin
cyclosporine and tacrolimus
hyperprolactinemia from use of anti-psychotics is due to dopamine blockage in what pathway
tuberoinfundibular
you want to block the dopamine in the mesolimbic pathway, but adverse effects can occur when the tuberoinfundibulnar pathway is involved
how must the p value change when doing an experiment with 100,000 study subjects
decrease the p value to decrease the # of false positives
describe the phases of Paget disease
initial: osteolytic
mixed phase
final: osteoblast-dominated
in wegener disease, what are the antibodies against
neutrophils
anti-neutrophilic cytoplasmic antibodies
what stage of sleep does sleep walking occur
non-REM stage 3
deep, slow wave sleep - delta waves
when in the sleep cycle do you see theta waves
non-REM sleep stage 1 and 2
when in the sleep cycle do you see sleep spindles and K complexes
non-REM sleep stage 2
when in the sleep cycle do you see occasional sawtooth patterns
REM sleep
what causes keloids
excessive collagen formation
compare TTP and HUS
both:
- triad of thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury
- normal PT and PTT
TTP:
- triad + fever + neurologic symptoms
HUS:
- triad + bloody diarrhea
what is the treatment in an emergency setting for rapid relief of symptoms in panic disorder
benzos
what does carbon tetrachloride do
causes free radical injury –> causes lipid peroxidation
what tests can you do to determine the relationship between two qualitative variables
chi square
logistic regression
what tests can you do to determine the relationship between two quantitative variables
correlation
linear regression
what tests can you do to determine the relationship between a qualitative independent variable and a quantitative dependent variable
t-test
ANOVA
linear regression
what tests can you do to determine the relationship between a quantitative independent variable and a qualitative dependent variable
logistic regression
first line treatment for psoriasis
topical corticosteroids and vitamin D analogs
why do you give vitamin D analogs for psoriasis
they activate the vitamin D receptor –> inhibition of T cell and keratinocyte proliferation
(anti-inflammatory)
first line treatment for PTSD
SSRI or SNRI
why give epinephrine with lidocaine
prolongs duration of action because lidocaine remains at site of injection
also decreases local bleeding
what enzyme causes bruises to green
heme oxygenase
degrades heme into biliverdin
what are some complications of varicose veins in the LEs
stasis dermatitis
skin ulcerations
poor wound healing
why are magnesium and aluminum hydroxide combined when treating GERD
mangesium salts cause osmotic diarrhea
aluminum hydroxide causes constipation
they reduce the adverse effects of each other
what is fanconi syndrome
generalized reabsorption defect in the PCT
leads to increased excretion of amino acids, glucose, HCO3-, and PO43-
what acid base disturbance can come from fanconi syndrome
what anion disturbances
metabolic acidosis
hypophosphatemia
what is barterr syndrome
reabsorption defect in the thick ascending loop of Henley
affects Na/K/2Cl cotransporter
what acid base disturbance can come from barterr syndrome
what anion disturbances
metabolic alkalosis
hypokalemia, hypocalciuria
what is gitelman syndrome
reabsorption defect of NaCl in DCT
what acid base disturbance can come from gitelman syndrome
what anion disturbances
metabolic alkalosis
hypokalemia, hypertension, decreased aldosterone
what is liddle syndrome
gain of function mutation in ENaC channels in collecting tubule
increases Na+ reabsorption in collecting tubules
what acid base disturbance can come from liddle syndrome
what anion disturbances
metabolic alklaosis
hypokalemia, hypertension, decreased aldosterone
what is syndrome of apparent mineralocorticoid excess (SAME)
cortisol activates mineralocorticoid receptors
cortisol tries to be the SAME as aldosterone
what acid base disturbance can come from SAME syndrome
what anion disturbances
metabolic alkalosis
hypokalemia, hypertension, deceased serum aldosterone
what causes fanconi anemia
autosomal recessive DNA repair defect causing bone marrow failure –> aplastic anemia
DQ2 and DQ8
celiac
