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Uworld Added 3 Flashcards

1
Q

Mechanism of Edema and Lethal factors (anthrax)

A

Edema = cAMP; Lethal = Protease that inhibits MAPK

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2
Q

Bordatella pertussis toxins

A

Pertussis = Gi ribosylation –> cAMP; AC toxin = AC –> cAMP

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3
Q

Location and symptoms of Germinomas

A

Pineal –> (1) Precocious puberty, (2) Obstructive hydrocephalus, (3) Parinaud

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4
Q

Functions of Thyroid Peroxidase

A

(1) Oxidation of iodide to iodine; (2) Iodination of thyroglobulin tyrosine residues; (3) Iodotyrosine coupling to form T3 and T4

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5
Q

Anti-TPO

A

Hashimoto’s

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6
Q

Chronic lymphedema is a risk for developin what skin tumor

A

Angiosarcoma

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7
Q

Spongiosa filling medullary canal with no mature trabeculae

A

Osteopetrosis

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8
Q

Squatting vs Passive leg raise

A

Squatting increases both Preload and Afterload, while Passive leg raise just Preload

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9
Q

How to decrease MVP murmur

A

Decr LV volume, bringing valve leaflets into a more normal anatomic arrangement

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10
Q

In severe MVP, the murmur becomes more

A

Holosystolic

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11
Q

Histology of MVP

A

Attenuation of fibrosa (collagen) layer; Thickening of spongiosa layer thru deposition of mucoid (myxomatous) material; Thinning of collagenous core of chordae tendineae

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12
Q

Chromium deficiency

A

Glucose intolerance (GLUT cofactor), Peripheral neuropathy

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13
Q

Selenium deficiency

A

Muscle pain and weakness, Dilated CM

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14
Q

Copper deficiency

A

Microcytic anemia (ferrochetolase), Aortic dissection (elastic tissue), Poor wound healing (lysyl oxidase)

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15
Q

Only bile acid that is not reabsorbed in the terminal ileum

A

Lithocholic acid

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16
Q

Magnesium def

A

Hypocalcemia with Tetany, Tachycardia

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17
Q

Magnesium excess

A

Neuromuscular depression, Bradycardia

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18
Q

Congenital defect in Cytochrome b5 reductase

A

This reduces ferrous hb to ferric in methemoglobinemia

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19
Q

Free radicals from drugs and alcohol-related fatty change affect which zone of liver

A

III

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20
Q

Ubiquinated cytokeratin intermediate filament in hepatocytes in alcoholic liver disease

A

Mallory bodies

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21
Q

Nephrocalcinosis

A

Metastatic calcification of renal tubules –> Diabetes insipidus

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22
Q

Chemo regimen for Hodgkin

A

Adriamycin, Bleomycin, Vinblastine, Dacarbazine

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23
Q

AE of Dacarbazine

A

Azospermia

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24
Q

Ecthyma gangrenosum is strongly associated with

A

P aeruginosa

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25
Q

Virulence factors of Pseudomonas in Ecthyma gangrenosum

A

Exotoxin A (protein synthesis), Elastase, PLC, Pyocyanin (ROS)

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26
Q

Exposure to bats or bird droppins in Ohio or Mississippi area

A

Histo (resembles tuberculosis)

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27
Q

Chlorthalidone

A

Thiazide diuretic

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28
Q

Holocrine glands

A

Associated with sebaceous - entire cells secreted

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29
Q

Apocrine vs Eccrine

A

Apocrine secretes into hair follicles, Eccrine directly onto skin

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30
Q

Rapid y descent that becomes deeper and steeper during inspiration

A

Constrictive pericarditis

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31
Q

Timeline of T cell response to MTB

A

2-4 weeks after infection

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32
Q

Most dangerous complication of UC

A

Toxic Megacolon

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33
Q

Sacral micturation center

A

S2-S4 - parasympathetic fibers travel with pelvic nerves

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34
Q

Pontine Micturation Center

A

Pontine Reticular Formation

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35
Q

Medium chain acyl-CoA DH deficiency causes

A

Hypoglycemia, Hypoketonemia

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36
Q

Each round of FA beta oxidation produces

A

1 NADH, 1 FADH2, 1 AcetylCoA

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37
Q

During rapid beta oxidation, the TCA cycle is overwhelmed –>

A

Shunting acetyl-CoA toward production of ketone bodies

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38
Q

Acetyl-CoA Carboxylase

A

RLS - first step in FA synthesis

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39
Q

Anti-cholesterol meds that should be used with caution in patients with pre-existing GB disease

A

Bile acid resins, Fibrates

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40
Q

Parvovirus binds what antigen

A

Erythrocyte P antigen

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41
Q

EBV envelope glycoprotein gp350 binds what

A

C3d complement component (CR2 or CD21)

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42
Q

Hydrocephalus, Intracranial calcifications, Chorioretinitis

A

Congenital Toxo

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43
Q

What type of enzyme is telomerase

A

RNA-dependent DNA polymerase (RT)

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44
Q

Rifampin monotherapy

A

Exposure to H flu or N meningitidis

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45
Q

Tx of MAC

A

Macrloide + Rifampin + Ethambutol

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46
Q

Hurthle Cells

A

Hashimoto’s

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47
Q

Beta-Galactosidase

A

Lactose –> Glucose + Galactose

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48
Q

Lac operon

A

Lack of glucose increases cAMP, Presence of Lactose binds repressor

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49
Q

FFA’s and insulin resistance

A

Increase resistance, also decrease insulin secretion

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50
Q

Pyogenic granuloma

A

Polypoid form of capillary hemangioma - Resemble hypertrophic granulation tissue

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51
Q

Cystic hygroma

A

Endothelium-lined lymph spaces beneath epidermis - Differ from cavernous hemangiomas by absence of luminal vessels

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52
Q

Liver hemangiosarcomas are associated with

A

Arsenic (pesticides), Thorotrast (contrast), Polyvinyl chloride

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53
Q

Diet recommended for PDH deficiency

A

Ketogenic (Leucine, Lysine)

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54
Q

Glucogenic AA’s

A

Methionine, Valine, Histidine (met sugary valiant hunk)

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55
Q

Glucogenic/Ketogenic AA’s

A

Phenylalanine, Isoleucine, Threonine, Tryptophan

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56
Q

Ketogenic AA’s

A

Leucine, Lysine

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57
Q

Mutation of Myelin protein gene

A

Charcot-Marie-Tooth (weakness of foot dorsiflexion)

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58
Q

Additional manifestations of Polycythemia Vera

A

Peptic ulceration, Pruritis, Gouty arthritis

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59
Q

Measure of fetal lung maturity

A

Incr ratio of phosphatidylcholine (lecithin) to sphingomyelin ratio

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60
Q

Primary abnormality in Paget’s

A

Excessive osteoclastic bone resorption

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61
Q

Phenazopyridine

A

Urinary analgesic - provides symptomatic relief of dysuria, urinary frequency, urgency

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62
Q

Ascorbic acid accelerates what reactions

A

Hydroxylation, Amidation

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63
Q

Workup of all patients with gastrinoma should include

A

Serum calcium, PTH, and Pituitary hormones - MEN-1

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64
Q

Anti-MTB drug that requires acidic intracellular environment

A

Pyrazinamide

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65
Q

INH MOA

A

Synthesis of mycolic acid

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66
Q

Ethambutol MOA

A

Blocking Arabinosyl Transferase

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67
Q

Segmented viruses

A

Reovirus (rota, colti), Orthomyxo, Arena, Bunya

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68
Q

Excessive rise in left atrial systolic pressure (v wave) is characteristic for

A

Mitral Regurgitation

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69
Q

Differentiate bone-specific ALP

A

Easily denatured by heat (bone = boil)

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70
Q

Urinary hydroxyproline and deoxypyridinolin excretion

A

Osteoclast activity (most common measures), also TRAP

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71
Q

Antipsychotic most notorious for causing prolonged QT

A

Ziprasidone

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72
Q

Cardiac medication that can cause hypothyroidism

A

Amiodarone

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73
Q

Clozapine acts on what receptors

A

D4

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74
Q

Prevent intracelllular dehydration in sickle cell

A

Gardos channel blockers (ca-dep K channel)

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75
Q

Specificity of tPA

A

Can only bind plasminogen strongly in presence of fibrin = clot-specific

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76
Q

Most common elbow injury in children

A

Radial Head Subluxation = Tear of annular ligament

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77
Q

Blanching of vein into which NE is being infused + induration and pallor

A

NE extravasation –> a1 vasoconstriction –> Phentolamine

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78
Q

Respiratory muscarinic antagonists

A

Ipratropium, Tiotropium, Glycopyrrolate

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79
Q

Eye muscarinic antagonists

A

Atropine, Homatropine, Tropicamide

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80
Q

GI muscarinic antagonists

A

Hyoscyamine, Dicylomine

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81
Q

GU muscarinic antagonists

A

Oxybutynin, Solifenacine, Tolterodine

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82
Q

Flunisolide

A

Inhaled GC for prophylactic treatment of asthma (bronchial)

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83
Q

Calcific Tendonitis

A

Deposits of calcium hydroxyaptite crystals in periarticular soft tissues (esp tendons, rotator cuff)

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84
Q

Anti-EGFR Ab

A

Cetuximab

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85
Q

Muromonab

A

Anti-CD3 (acute rejection treatment for liver, kidney, heart)

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86
Q

Most common bugs causing sepsis in sickle cell

A

Pneumococcus, H flu

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87
Q

How does radiation kill cells

A

DNA ds break, ROS

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88
Q

Secretin stimulates pancreas to release

A

Bicarb rich, Cl poor fluid (Cl to produce NaCl)

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89
Q

High levels of what increase ESR

A

Fibrinogen stimulted by Acute Phase Reactants

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90
Q

Pure Red Cell Aplasia is associated with

A

Parvo B19, Thymoma, Lymphocytic Leukemias

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91
Q

Invasive Mole vs Choriocarcinoma

A

Hydropic villi and proliferated trophoblast vs Atypical cytotrophoblastic and syncytiotrophoblastic cells w/ foci of hemorrhage and necrosis

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92
Q

Pulsus alternans

A

LV dysfunction - Beat to beat variation in magnitude of pulse pressure in presence of regular rhythm

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93
Q

Dicrotic pulse

A

Two distinct peaks - Severe dystolic function

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94
Q

Pulsus parvus et tardus occurs in

A

Aortic stenosis

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95
Q

Hyperkinetic pulse

A

Rapid ejection of large stroke volume against decr afterload

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96
Q

Paget disease of nipple

A

DCIS spreads to nipple skin without having crossed basement membrane

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97
Q

Ductal dilation, Inspissated breast secretions, Chronic granulomatous inflammation in the periductal and interstitial areas

A

Mammary Duct Ectasia

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98
Q

Most common benign tumor of esophagus

A

Esophageal Leiomyoma

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99
Q

Adenosine MOA

A

AV node - slows conduction and decreases automaticity by hyperpolarizing cells

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100
Q

Usefulness of Methacholine challenge

A

High sensitivity, Low specificity

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101
Q

UG Sinus vs Wolffian Ducts in males

A

UG sinus = Bladder, urethra, prostate, bulbo’s; Wolffian = Epididymis, Ductus, Seminal vesicles

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102
Q

In a healthy individual, airway resistance is smallest when

A

lungs are inflated - radial traction of pulmonary tissue on conducting airways

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103
Q

Repetitive ischemia of cardiomyocytes or persistent hypoperfusion –>

A

Hibernation - Chronic but reversible loss of function

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104
Q

Myocardial stunning

A

Less severe form of ischemia-induced reversible loss of contractile function than hibernation (from brief ischemic episodes)

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105
Q

Long term lithium requires monitoring of

A

Thyroid and Renal function

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106
Q

PCWP =

A

LA EDP, which should equal LVEDP

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107
Q

Regulatory step for Pyrimidine synthesis

A

ATP, CO2, Glutamine –> Carbamoyl Phosphate

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108
Q

Treatment of Orotic Aciduria

A

Can’t for UMP, so supplement with uridine (–> UMP)

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109
Q

Presentation of Orotic Aciduria

A

Hypochromic megaloblastic anemia, Neuro, Growth

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110
Q

Hydroxyurea inhibits

A

Ribonucleotide Reductase

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111
Q

Leflunomide blocks formation of

A

Orotic Acid

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112
Q

Peptide YY

A

Ileum and Colon –> ECL –> Inhibit gastrin-stimulated histamine release from ECL’s

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113
Q

Bladder lymph drainage

A

Superior to External Iliac, Inferior to Internal

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114
Q

Traction diverticula

A

Due to inflammatino and scarring –> True (eg mediastinal lymphadenitis, periesophageal scarring)

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115
Q

Pathophys of aortic dissection from hypertension

A

Medial hypertrophy of aortic vasa vasorum –> Reduced BF for aortic media –> Medial degeneration

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116
Q

PABA esters block

A

UVB (290-320)

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117
Q

UV what is major cause of sunburn, photo-aging, and carcinogenesis

A

UVB

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118
Q

Avobenzone

A

UVAI and UVAII

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119
Q

Zinc Oxide sunscreen

A

UVB, UVAI, UVAII

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120
Q

Stomatitis in treatment of RA

A

MTX (supplement folic acid)

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121
Q

Serious potential AE of Hydroxychloroquine

A

Permanent retinal damage

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122
Q

Lack of GC’s means response to what will be limited

A

Vasopressors

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123
Q

Strong predisposing factor to Mallory Weiss

A

Hiatal hernia

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124
Q

Which MEN has marfanoid habitus

A

MEN2b

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125
Q

Which lung cancer is not surgically approached

A

Small cell

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126
Q

Primary mechanism of combination OCP’s

A

Suppression of FSH, LH (no midcycle LH spike for ovulation); Secondary mechanism is blocking sperm and preventing implantation

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127
Q

Neuro-endocrine markers

A

Neuron-specific enolase, Chromagranin, Synaptophysin

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128
Q

Vimentin is used to dx

A

Sarcoma (mesenchymal origin)

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129
Q

Thrombin Time

A

Fibrinogen to Fibrin

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130
Q

Chronic HTN causes what microvascular changes in brain

A

Lipohyalinosis, Microatheroma

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131
Q

Lacunar infarct in Base of Pons

A

Ataxia-Hemiplegia; Dysarthria-Clumsy Hand syndrome

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132
Q

Lacunar infarct in Genu of Internal Capsule

A

Dysarthria-Clumsy Hand Syndrome

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133
Q

Initial presentation of Charcot Bouchard vs Lacunar Infarct

A

Charcot Bouchard would show hemorrhage on initial CT

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134
Q

First sign of puberty

A

Testicular and breast enlargement

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135
Q

What causes LV outflow obstruction in HCM

A

Abnormal systolic anterior motion of anterior leaflet of mitral valve toward hypertrophied IV septum

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136
Q

Garlic odor after poisoning

A

Arsenic –> Dimercaprol (which itself causes nephrotoxicity and HTN)

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137
Q

EDTA is used for

A

Lead and Mercury poisoning

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138
Q

Well-developed smooth ER

A

Steroid-producing cells (eg adrenals, gonads, liver); Detoxification

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139
Q

Most specific marker for dx of acute HepB

A

Anti-HBc IgM

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140
Q

All females with Mullerian defects should undergo

A

Renal ultrasound (coexisting urologic abnormality)

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141
Q

Relative speed of conduction in cardiac components

A

Purkinje > Atrial Muscle > Ventricular Muscle > AV node (Park At Ventura Avenue)

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142
Q

Why do cryptorchid testes not secrete Inhibit

A

Temperature degenerates seminiferous tubules selectively

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143
Q

Chronic gastritis with antral sparing vs antral-predominant

A

Autoimmune spares antrum; H pylori mostly affects antrum

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144
Q

Most common bening vascular tumors in adults

A

Cherry Hemangiomas (do not regress)

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145
Q

Superficial Hemangioma

A

Infantile, Capillary, Strawberry - Grow rapidly and regress

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146
Q

B1 is a cofactor for

A

Pyruvate DH, a-KG DH, Transketolase

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147
Q

QRS complex in exercise

A

Normally decr; If prolonged –> 1c anti-arrhythmic (use-dependent)

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148
Q

Use dependence of Class III anti-arrhythmics

A

Reverse use-dependence = Slower heart rate means more QT prolongation

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149
Q

Digoxin and K

A

Toxicity causes HyperK, but can be exacerbated by HypoK

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150
Q

Citrullination

A

Tissue inflammation –> Arginine enzymatically converted to citrulline

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151
Q

GABAa vs GABAb

A

A = Cl influx; B = GPCR (K efflux, decr Ca influx, inhibit AC)

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152
Q

Clinical manifestations of Chronic Interstitial Nephritis

A

(1) Modest elevation in creatinine; (2) Evidence of tubular dysfunction - polyuria, nocturia; (3) Fanconia syndrome - Aminoaciduria, Glycosuria, Hypophosphatemia, Hypouricemia

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153
Q

NSAID-associated chronic renal injury is morphologically characterized by

A

Papillary Necrosis; Chronic Interstitial Nephritis

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154
Q

Myelofibrosis

A

Atypical Megakaryocytic Hyperplasia –> Activate fibroblast prolifation

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155
Q

Myelodysplastic syndromes - BM bx

A

BM bx shows disordered differentiation affecting all non-lymphoid lineages, Ringed siderblasts, Megaloblastoid maturation

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156
Q

Myelophthisic anemia

A

Space-occupying lesion sof bone marrow - All lines affected (pancytopenia)

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157
Q

Most common causes of Myelophthisic anemia

A

Infiltration by met carcinomas w/ associated fibrosis; Also granulomas

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158
Q

Ergot Dopamine agonists

A

Bromocriptine, Pergolide

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159
Q

Non-ergo Dopamine agonists

A

Pramipexole, Ropinirole

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160
Q

CEA is a marker for

A

Colon, Pancreatic

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161
Q

CA-125

A

Maligant ovarian carcinoma

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162
Q

Congenital Long QT and Sensorineural deafness

A

Jervell and Lange-Nielsen (AR)

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163
Q

Congenital Long QT, pure cardiac

A

Romano-Ward

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164
Q

Virus with lipid solubule envelope are susceptible to

A

Diethyl Ether, Chloroform, 50% trichlorofluoroethane

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165
Q

Most common benign lung tumor

A

Hamartoma (Pulmonary chondroma) - Coin lesion

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166
Q

Lung lesion with alveolar growth pattern along alveolar septae without fascular or stromal invasion

A

Bronchioalveolar Carcinoma

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167
Q

Sporicidal compounds

A

Hydrogen Peroxide, Iodine (not alcohols or chlorhexidine, which disrupt membrane)

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168
Q

Chlorhexidine works by

A

Destabilizing cell membranes and coagulating intracellular constituents

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169
Q

Formaldehyde and Glutaraldehyde work by

A

Alkylating and cross-linking DNA and proteins

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170
Q

Matching is used to control

A

Confounding

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171
Q

Viruses that cleave one polyprotein via protease

A

NAME?

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172
Q

BH4 is cofactor for synthesis of

A

Tyrosine, DOPA, Serotonin, NO

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173
Q

Xanthomas are most characteristic of

A

Hypercholesterol or Hypertriglyceride

174
Q

Familial hypercholesterolemia etiology

A

LDL Receptor

175
Q

Peutz-Jeghers mutation

A

Serine/Threonine kinase 11 (STK11) on 19

176
Q

Peutz-Jeghers manifestations

A

Skin lesions within first few years, intestinal polyposis follows

177
Q

Buccal mucosa pigmented lesions

A

Pathognomonic for Peutz-Jeghers

178
Q

Histology of Rhabdomyoma

A

Fascicles of polygonal cells with vacuolated cytoplasm and peripherally placed nuclei

179
Q

Where do Rhabodmyomas occur

A

Head and neck of younger males

180
Q

Dermoepidermal junction autoantibodies to type VII collagen

A

Epidermolysis Bullosa Acquisita

181
Q

Clomiphene is best used to

A

Achieve fertility in women with ovulatory failure who are normogonadotrophic, normoprolactinemic, euthyroid

182
Q

hCG therapy can be used to trigger

A

ovulatory cascade in an oocyte donor when her follicles are deemed mature

183
Q

HOCM murmur is louder/softer with

A

Louder with decreases in Preload or Afterload; Softer with increases

184
Q

IgA deficiency can lead to incr incidence of

A

Atopic, Autoimmune disease

185
Q

Excise RNA primers and replace with DNA

A

DNA Polymerase I

186
Q

AFP is associated with what repro malignancy

A

Yolk Sac tumors

187
Q

Classic AE’s with Prednisone

A

Avascular necrosis of femoral head, Insomina, Psych

188
Q

Glyburide

A

Sulfonylurea

189
Q

Cytoplasmic what accumulation is a hallmark of ischemic injury

190
Q

Tamm-Horsfall

A

Exclusively secreted by renal tubular epithelial cells in ascending LOH (Prerenal azotemia and low urine flow rate –> Accumulation to form hyaline casts)

191
Q

Findings in homocysteinuria

A

Marfanoid, Lens down and in, Thrombosis, Athersclerosis, Osteoporosis

192
Q

Warfarin embryopathy

A

Midfacial hypoplasia, Chondrodysplasia punctata, Hemorrhage, Organ hypoplasia, CNS

193
Q

Changing of pili in neisseria

A

Phase variation (on-off) and Antigenic variation

194
Q

Complementation

A

Production of distinct phenotypic trait resulting from homozygous mutations in more than on egene

195
Q

Important finding NOT found in McArdle’s

A

Hypoglycemia (liver glycogen phosphorylase intact)

196
Q

Glycogen synthase deficiency

A

Infancy = Hypoglycemia, Ketosis, Metabolic acidosis, Growth delays

197
Q

Effects of beta blocker on K

A

Hyperkalemia

198
Q

EKG signs of hyperkalemia

A

Peaked T, Loss of p, Prolonged PR, Widen QRS, Slow HR

199
Q

EKG signs of hypokalemia

A

QT prolongation, U waves, ST depression –> Torsades

200
Q

EKG signs of Hypo vs Hypercalcemia

A

Hypo causes QT prolongation; Hyper causes QT shortening

201
Q

In general, a medullary lesion would result in

A

Contralateral spastic paresis, Ipsilateral CN XII defect

202
Q

Phenylephrine

A

Selective alpha 1 agonist

203
Q

Dobutamine

A

Mostly Beta 1 agonist - little effects on PVR

204
Q

Isoproterenol

A

Non-selective beta agonist; Incr HR/CO/PP, Decr PVR

205
Q

Epinephrine effects on HR and PVR

A

Incr HR, Decr PVR

206
Q

CAAT box

A

Promoter - binding site for RNA polymerase II

207
Q

Promoters/Binding sites for RNA polymerase II

A

CAAT, TATA

208
Q

Enhancers are unique in that

A

they can be located very far away

209
Q

Sublimation

A

Converting unacceptable feelings or drives into socially acceptable ones

210
Q

Hepatic sinusoidal endothelial cells are unique in that

A

Fenestrated, Lack BM

211
Q

Stellate cells

A

Vit A storage; Diff into myofibroblast upon injury –> Fibrosis

212
Q

Block 23S rRNA of 50S

A

Macrolides, Clindamycin

213
Q

Inhibition of 50S peptidyltransferase

A

Chloramphenicol

214
Q

Decreasing [Kin]

A

Increases likelihood of neuronal depolarization w/out altering AP amplitude

215
Q

Increasing [Kin]

A

Hyperpolarize neuron without altering AP amplitude

216
Q

Mechanism for age-related lactase deficiency

A

Decr gene expression

217
Q

Cyclosporine MOA

A

Binds cyclophilin –> inhibits calcineurin –> Inhibit calcium-dependent promotion of IL2 transcription

218
Q

Basiliximab, Daclizumab MOA

A

mAb that blocks IL-2R

219
Q

Tacrolimus MOA

A

Binds FKBP –> inhibits calcineurin –> inhibit calcium-dependent promotion of IL-2 transcription

220
Q

Sirolimus (Rapamycin) MOA

A

Binds FKBP –> Blocks mTOR –> Prevents IL-2 response

221
Q

Tardive Dyskinesia mechanism

A

Upregulate D receptors; Concomitant decr in cholinergic activity in Striatum

222
Q

The plateau phase of cardiomyocyte AP corresponds to

A

ST segment (isoelectric)

223
Q

Virus that carries its own DNA-dep RNA polymerase

224
Q

What can decrease glomerular capillary filtration coefficient

A

Chronic HTN, DM –> Drop in GFR

225
Q

Calcipitriol

A

Vit D analog for treatment of Psoriasis (topically)

226
Q

Antibiotic efflux pumps are found in what type of bugs

A

Typically gram negative

227
Q

Orlistat MOA

A

Lipase inhibitor

228
Q

McArdle’s disease severity

A

Typically begin in young adulthood –> Muscle cramps, Fatigue, Transient myoglobuinuria –> normal lifespan

229
Q

Lipofuscin is produced when

A

ROS –> Membrane Lipids

230
Q

Cholesterol Ester Storage disorder

A

Partial defect in lysosomal acid lipase –> Accumulation of cholesterol ester, TG’s –> Hepatic fibrosis, Premature atherosclerosis

231
Q

Clinical manifestations of Cryptosporidium

A

Mild enterocolitis with water, non-bloody diarrhea

232
Q

Toxoplasmosis in immunocompetent

A

Nonspecific –> Fever, headaches, myalgia, lymphadenitis

233
Q

Nephrotic Syndrome in adults

A

Membranous Glomerulonephritis

234
Q

Methenamine silver stain showing thickening of glomelar BM

A

Membranous Glomerulonephritis

235
Q

CCB’s in pregnancy

A

Limb loss - decreased placental perfusion

236
Q

BB’s in pregnancy

A

Generally safe

237
Q

Incr in endothelium-bound LPL activity

A

Insulin resistance

238
Q

Increased cholesteryl ester storage in hepatocytes and endothelial cells

A

Cholesteryl Ester Storage disease - Lysosomal acid lipase defect

239
Q

Insulin effect on Adipocyte vs Endothelial LDLR’s

A

Upregulate on hepatocytes, Downregulate on endothelial cells

240
Q

Complicated non-gonoccocal urethritis

A

Epididymitis –> 2 wks of doxy or 1 wk azithromycin

241
Q

Probenicid and Penicillin

A

inhibits renal tubular secretion of penicillins, most cephalosporins,

242
Q

Cilastatin and Imipenem

A

Prevent proximal tubular brush border hydrolysis of imipenem by dehydropeptidase

243
Q

Stimultion of auricular branch of vagus nerve

A

Reflex coughing or vomitting

244
Q

Bloom syndrome

A

Photosensitivity, Short stature, Erythema, Telangiectasias - Defect in DNA helicase gene – Predisposed to lymphoproliferative and gastrointestinal malignancies

245
Q

ATM gene is important for

A

DNA repair following ionizing radiation - Telangiectasias in eyes and ears, Lymphoproliferative malignancies

246
Q

Tumors in Li Fraumenia

A

Breast cancer, Soft tissue sarcoma

247
Q

Location of Lynch syndrome polyps

248
Q

Histology of Follicular Lymphoma

A

Effacement; Small cleaved cells (centrocytes), Larger non-cleaved cells w/ multiple nucleoli (centroblasts)

249
Q

Presentation of Sporadic Burkitt’s

A

Ascites and abdominal mass from ileum, cecum, or mesentery

250
Q

Manifestations of hyperestrogenism in cirrhosis

A

Spider angiomas, Palmar erythema, Dupuytren’s, Decr body hair

251
Q

Niacin MOA

A

(1) Impair VLDL production; (2) Inhibit Hormone Sensitive Lipase –> Decr TG; (3) Incr HDL by limiting cholesterol transfer form HDL to VLDL, slowing HDL clearance

252
Q

intestinal Kaposi

A

Hemorrhagic nodules by endoscopy

253
Q

Most common cause of Restriction Fragment Length Polymorphism

254
Q

RNA virus that replicates in nucleus

255
Q

High blood ammonia and Increased urinary orotic acid

A

OTC deficiency (Increased Carbamoyl Phosphate shunted to Orotic Acid)

256
Q

Uncal herniation findings

A

CNIII, Contralateral muscle paresis (cerebral peduncle)

257
Q

Somatic Symptom Disorder vs Illness Anxiety Disorder

A

Minimal or no actual physical symptoms in Illness Anxiety

258
Q

Pseudodementia

A

Cognitive dysfunction that occurs in patients with severe psych illness

259
Q

Why hypoglycemia in MCAD

A

Acetyl-CoA is consumed by medium chain fatty acids that accumulate –> Low concentrations of AcetylCoA inhibit conversion of pyruvate to OAA (inhibiting gluconeogenesis

260
Q

Anti-SRP antibodies

A

Autoimmune Myositis

261
Q

MHC II pathway is particularly important for generating helper T response against

A

Extracellular and Intracellular membrane-bound pathogens

262
Q

T lymphocyte antigen recognition is determied by

A

Specificity of TCR for both MHC variant allele and peptide fragment bound to it

263
Q

Positive T lymphocyte selection

A

Thymic cortex - Responsible for generating T cells compatible with person’s HLA haplotype

264
Q

Individuals with HLA haplotypes that cannot bind certain polypeptide fragments

A

will not be able to mount T cell dependent immune response against these antigens

265
Q

Most common opportunistic viral infection affecting GI tract of HIV patients

A

CMV - Ulcers, Mucosal erosions, Large cells with basophilic intranuclear & intracytoplasmic inclusions

266
Q

Biopsy in HIV Cryptosporidium diarrhea

A

Organism confined to microvilli - basophilic parasites attached to mucosal brush border

267
Q

Microsporidium diarrhea in HIV

A

Distortion of villous architecture w/out inflammation; Small spores with diagonal or equatorial belt-like structure

268
Q

MAC diarrhea in HIV

A

Necrotizing and Non-necrotizing granulomas; Acid fact staining bacilli

269
Q

HIV protease cleaves

A

gag and pol products

270
Q

Carboxyhemoglobin

A

HbCO –> Loss of cooperativity, Unable to unload O2

271
Q

Sclerosing Adenosis

A

Incidental finding (rarely palpable mass) –> Slight incr risk, Must biopsy

272
Q

Mammary duct ectasia

A

Skin retraction, Thick creamy or bloody discharge, Palpable periareolar mass

273
Q

Fibroblasts in a cartwheel or storiform pattern

A

Dermatofibrosarcoma protuberans

274
Q

Dysplastic Nevus syndrome

A

CDKN2A on 9p21

275
Q

LV End systolic volume, End diastolic volume and pressure in exercise

A

End systolic volume decreased, End diastolic volume up, End diastolic pressure same

276
Q

Metencephalon –>

A

Pons and Medulla

277
Q

Three vs Five embryonic vesicles

A

Pros, Mes, Rhomb –> Tel, Di, Mes, Met, My

278
Q

Short a-helix with leucine resides at every seventh position

A

Leucine zipper dimerization domain –> TF’s known as Basic Zipper Proteins

279
Q

DNA-binding motifs

A

(1) Zinc finger; (2) Helix-loop-helix; (3) Leucine zipper dimerization domain

280
Q

First reaction of Pyrimidine synthesis

A

Glutamine, CO2, 2 ATP –> Carbamoyl Phosphate in Cytosol

281
Q

Peroxisome function

A

Lipid metabolism (beta oxidation), Oxidative reactions, Purine catabolism

282
Q

Cellular location of G-6-Phosphatase

283
Q

CYP inhibition/induction effects on Warfarin

A

Inhibits incr Warfarin effect (decr inactivation)

284
Q

2 most common sites for hypertension-related intracerebral hemorrhage

A

Thalamus, Putamen

285
Q

Hyptertensive hemorrhage in pons

A

(1) Pinpoint pupils; (2) Loss of horizontal gaze; (3) Decerebrate posturing; (4) Coma

286
Q

mechanisms of incr ICP in brain tumors

A

(1) Obstruction; (2) Disrupt BBB = vasogenic edema

287
Q

Cutaneous findings in Reiter’s

A

Keratoderma blenorrhagica, Balanitis circinata

288
Q

Causes of nephrogenic diabetes insipidus

A

(1) Hypercalcemia; (2) Hypokalemia; (3) Post-obstructive diuresis; (4) Lithium, Amph B, Gentamicin, Cisplatin

289
Q

Eptifibatide

A

Gp Iib/IIIa inhibitor that inhibits platelet aggregation by binding fibrinogen site

290
Q

Effect of CYP inhibitors/inducers of Clopidogrel

A

Must be activated, so inhibitors decr drug levels

291
Q

Nomal post-void residual volume

292
Q

Oxybutynin

A

Anti-muscarinic for urge incontinence

293
Q

Histology of Hep B vs C

A

B = Ballooning, Necrosis, Portal inflammation, GROUND GLASS; C = Lymphoid aggregates w/in portal tracts, Focal areas of macrovesicular steatosis

294
Q

Most common meds that cause ED other than SSRIs

A

Clonidine, Methyldopa, BB’s

295
Q

COMT inhibitors vs Carbidopa

A

Both peripheral work peripherally; Carbidopa on DOPA decarboxylase

296
Q

Entacapone vs Tolcapone

A

Entacapone is peripheral only (can’t Enter the CNS); Tolcapone associated with haptotoxicity

297
Q

MOA of Ropinerole

A

DA agonist

298
Q

Carrier vs Channel proteins

A

Carrier proteins undergo conformational changes as substrate is transported

299
Q

Uptake of cholesterol occurs via

A

Receptor-mediated endocytosis

300
Q

Transport of Glucose by Glut4 is

A

Carrier-mediated transport (co-transport in GI tract, renal tubule)

301
Q

Blank requirements are lower in adrenal insufficiency

302
Q

Chloride in primary adrenal insufficiency

A

Increased to maintain electroneutrality of extracellular fluid

303
Q

Secondary/Tertiary adrenal insufficency vs primary

A

Can still release aldosterone in response to AgII –> No electrolyte

304
Q

Isolated hyperkalemia can be caused by

A

Insulin deficiency; Diet; Cell lysis; B1 antagonists

305
Q

Side effects of Flutamide

A

Hot flashes, Gynecomastia, Impotence (androgen depletion)

306
Q

GnRH agonists

A

Leuprolide, Goserelin, Nafarelin, Histrelin

307
Q

Cyproterone MOA

A

Androgen receptor blocker (like Flutamide)

308
Q

IL-2 is approved for treatment of

A

RCC, Melanoma

309
Q

Translocation is catalyzed by blank and requires blank

A

EF2, GTP hydrolysis

310
Q

Type of anemia in beta thal minor

A

Hypochromic, microcytic

311
Q

Most common cell type in pituitary

A

Somatotroph

312
Q

How to prevent HSV2 recurrences

A

Daily treatment with Acyclovir, Valacyclovir, Famciclovir

313
Q

Close contact prophylaxis for Hep A

A

Ig, Vaccine for high risk

314
Q

Vaginal Adenosis

A

Glandular metaplasia due to DES –> Clear cell adenocarcinoma

315
Q

Blutn Aortic Injury ocurs most often at

A

Isthmus (attched to Ligamentum Arteriosum)

316
Q

Fall on outstretched, dorsiflexed hand

A

Lunate discloation

317
Q

Onset of Otosclerosis

A

middle age

318
Q

AE’s of Ganciclovir

A

Pancytopenias, Renal

319
Q

Major AE of Zidovudine

A

BM suppression

320
Q

Foscarnet AE

A

Electrolytes, Renal

321
Q

AE’s common to all NNRTI’s

A

Rash/SJS, Hepatotoxicity

322
Q

MOA of Nitroglycerin

A

Dilate large veins –> Decr preload

323
Q

Primary site of hormonal regulation of systemic BP

A

Small arteries and arterioles

324
Q

Control of precapillary sphincters

A

NE, Epi, Local regulators

325
Q

Rhabditiform Larvae in stool

A

Strongyloides –> Ivermectin

326
Q

Parasite eggs in stool

A

Schistosoma mansoni or japonicum –> Praziquantel

327
Q

Proglottids in stool

A

Tapeworms = Taenia, Diphyllobothrium

328
Q

Trophozoites and Cysts in stool

A

Protozoa = Giardia lamblia, Entamoeba histolytica

329
Q

Strongyloides infection

A

Skin penetration –> Alveoli –> Pharynx –> Intestine –> Autoinfection

330
Q

a-Glucosidase inhibitors

A

Acarbose, Miglitol

331
Q

Th in Cronhn’s vs UC

A

Th1 in Crohn’s, Th2 in UC

332
Q

First 5 years of diabetic nephropathy

A

Glomerular hypertrophy, Increase GFR!

333
Q

Gouty nephropathy

A

Chronic tubulointerstitial nephritis

334
Q

First line for Wilson’s

A

Penicillamine, Trientene

335
Q

Vitamin store longevity for A, D, Folate, B12

A

A for 6 months, D for 3 months, Folate for 3 monts, B12 for 3-4 years

336
Q

Storage of water soluble vitamins

A

All flushed easily except folate and B12

337
Q

Anti-psychotics more likely to cause anti-cholinergic effects

A

Traditional low-potency (eg chlorpromazine, thiordazine)

338
Q

Alleviation of negative symptoms of schizophrenia is thought to be due to

A

Inhibition of 5-HT2a (atypical anti-psychotics)

339
Q

Common symptoms for sickle cell traint

A

Hematuria, Inability to concentrate urine

340
Q

Lab indications of sickle cell trait

A

sickling test positive, all else negative

341
Q

Dubin-Johson = absence of

342
Q

Deconjugation of bile acids

A

Anaerobes, S aureus –> Less soluble –> Less able to form miscelles –> Lipid malabsorption

343
Q

Lower border of parietal pleura

A

7th –> 10th –> 12th

344
Q

Where should thoracentesis be performed

A

5-7 (midclavicular) –> 7-9 (midaxillary) –> 9-11 (paravertebral)

345
Q

Unlike ACh, Succinylcholine is not

A

degraded by AChEsterases

346
Q

Succinylcholine Phase 1 vs 2

A

1 is depolarized, 2 is non-depolarized

347
Q

Relaxant for intubation –> Hyperkalemia

A

Succinylcholine

348
Q

AE’s of Succinylcholine

A

(1) Malignant hyperthermia; (2) Severe hyperkalemia; (3) Bradycardia

349
Q

Who gets hyperkalemia with Succinylcholine

A

Burns, Myopathies, Crush injuries, Denervation

350
Q

Atracurium releases

A

Histamine –> Fall in BP, Bronchoconstriction

351
Q

Sensory from inner tympanic membrane, eustachian tube

352
Q

Noninfective envelope glycoprotein that forms spheres and tubules 22 nm in diameter

353
Q

Milrinone

A

PDE 3 inhbitor –> Incr cAMP –> Ca conductance –> + Inotropy

354
Q

Dipyridamole, Cilostazol

A

Decr platelet PDE –> Incr cAMP –> Decr platelet aggregation; Cilastazol also directly vasodilates

355
Q

Ticlopidine, Clopidogrel MOA

A

Block ADP receptor –> Decr Gp Iib/IIIc receptor

356
Q

Ingestion of undercooked shellfish

A

V cholera, Norwalk virus, Hep A

357
Q

VPM receives input from

A

Superior Olivary Nucleus, Inferior Colliculus of Pons

358
Q

Subacute Cerebellar Degeneration

A

Small cell, Female repo cancers –> Anti-Yo, -P/Q, -Hu –> Cross-react with cerebellar purkinje neurons

359
Q

Post-viral Cerebellar Ataxia

A

Within 3 weeks of Varicella, Measles, EBV in children –> Self-resolving

360
Q

Clinical associations with Adenocarcinoma

A

Clubbing, Hypertrophic osteoarthropathy

361
Q

Location and clinical associations with Large cell carcinoma of lung

A

Peripheral; Gynecomastia, Galactorrhea

362
Q

Carcinoid syndrome is associated with decreased

363
Q

Liver histology Reye’s syndrome

A

Microvesicular steatosis w/out inflammation

364
Q

Most adults in US with Anti-HAV IgG

A

Have never experience icteric illness

365
Q

Icterus in HAV infection depends on

A

Age (children typically anicteric)

366
Q

Petechiae, Purpura, Ecchymoses

A

Pupurua 5mm to 1cm

367
Q

Stones in IBD

A

Calcium binds to lipids instead of oxalate –> more Oxalate absorbed –> Stones

368
Q

Volume depletion after activity in CF

A

Can’t reabsorb Cl or Na in sweat

369
Q

Direct and Indirect Factor Xa inhibitors

A

Direct = Rivaroxaban, Apixaban; Indirect = Fondaparinux

370
Q

Direct Thrombin Inhibitors

A

Argatroban, Bivalirudin, Dabigatran

371
Q

HBx –>

A

Activates synthesis of IGF-2, and IGF-1 receptors –> Cell proliferation

372
Q

Acetyl CoA Carboxylase catalyzes

A

FA synthesis (–> Malonyl CoA) in cytosol

373
Q

ATP citrate lyase

A

Converts Citrate –> OAA and Acetyl CoA in cytosol

374
Q

Liver-specific enzyme serving as bridge b/t TG breakdown and Gluoneogenesis

A

Glycerol Kinase (Glycerol –> Glycerol-3-P)

375
Q

Prevent Prolactin-mediated lactation in pregnancy

A

Estrogen, Progesterone

376
Q

hCG in second half of pregnancy

377
Q

Binds 30S subunit and inhibits binding of Aminoacyl-tRNAs

A

Tetracyclines

378
Q

MacConkey agar

A

Bile and salt containing; Inhibits gram positives; Grows enterics

379
Q

Blood agar with saline and bile grows

A

Enterococci (Strep bovis grows in bile but not hypertonic saline)

380
Q

Fever is caused by

A

PGE2 increasing set point in anterior hypothalamus

381
Q

CNS cells especially sensitive to heat damage

A

Purkinje cells in cerebellum

382
Q

First line for Legionella

A

Erythromycin

383
Q

Arcuate nucleus of Hypothalamus

A

DA (inhibits prolactin), GHRH, Gonadotropin

384
Q

Bacterial DNA Polymerase with 5->3 exonuclease activity

A

DNA Polymerase I

385
Q

Fornix

A

Projection from Hippocampus to Mamillary Body

386
Q

Dorsal vs Anterior Thalamus

A

Dorsal relays from spinal cord to cortex; Anterior part of Papez circuit

387
Q

Lesions of Splenium of Corpus Callosum

A

Alexia without Agraphia

388
Q

How can dietary fructose be used for glycolysis in Fructokinase deficiency?

A

Hexokinase (Fructose –> Fructose-6-P)

389
Q

Aldose Reductase

A

Glucose –> Sorbitol

390
Q

Where does intron splicing occur

391
Q

P bodies

A

Foci involved in mRNA regulation and turnover

392
Q

Porcelain gallbladder

A

Risk of GB cancer

393
Q

LM changes in first 24 hours after MI

A

4-12 = Coag necrosis, Edema, Hemorrhage, Wavy; 12-24 = Coag necrosis, Contraction band

394
Q

Neutrophil and Macrophage infiltration after MI

A

PMNs 1-5 days; Macrophages 5-10 days

395
Q

When does granulation tissue form after MI

A

10-14 days w/ neovascularization

396
Q

Fluid/Osmolarity changes after acute GI hemorrhage

A

Isotonic loss from ECF is only change

397
Q

Fluid/Osmolarity changes after Adrenal Insufficiency

A

Hypertonic fluid loss = Decr osm, Decr volume, Water shifts intracellularly

398
Q

Fluid/Osmolarity changes after Hypertonic Saline

A

Inc osmolarity, Fluid shifts from intracellular to extracellular

399
Q

Fluid/Osmolarity changes after Primary Polydipsia

A

Fluid shifts intracellularly = Incr in intra and extracellular volume with decr in osmolarity

400
Q

Cholesterol in bile is solubilized by

A

Bile salts, Phosphatidylcholine

401
Q

Fracture of 12th rib injures

A

Left Kidney

402
Q

Spleen borders what ribs

403
Q

Ribs overlying Liver

A

8, 9, 10, 11

404
Q

Most common manifestation of Botulism

A

Diplopia, Dysphagia, Dysphonia 12-46 hours after consumption

405
Q

Superior infectivity due to unique binding site on intestinal M cells

406
Q

DMD histology

A

Widespread necrosis, Angulated fibers

407
Q

Charcot-Marie-Tooth

A

Myelin synthesis defect –> Decr nerve conduction –> Presents with foot drop

408
Q

Microabscesses at tips of dermal papillae

A

Dermatitis Herpetiformis

409
Q

Positive straight leg raise test

A

Sciatic nerve root irritation (eg intervertebral disc herniation)

410
Q

Cryoprecipitate vs FFP

A

FFP contains all factors, Cryoprecipitate contains only cold-soluble (VIII, Fibrinogen, vWF, Vitronectin)

411
Q

Nedocromil MOA

A

Inhibit mast cell degranulation (like cromolyn)

412
Q

Zileuton

A

Lipoxygenase inhibitor

413
Q

Claudication is almost always result of

A

athersclerosis of larger, named arteries

414
Q

Calories per gram of Ethanol, Carbs, Fat

A

7 for Ethanol, 4 for carbs, 9 for fat

415
Q

Mechanism of reversing opioid tolerance

A

NMDA antagonism (activation of NMDA is though to enhance tolerance)

416
Q

Blank is required for activation of NMDA

A

Glycine and Glutamate

417
Q

Anticonvulsants and Osteoporosis

A

Induce CYP –> Incr Vit D metabolism –> Decr Ca

418
Q

PPI’s and Osteoporosis

A

Decr Ca absorption (need acid to absorb)

419
Q

Heparin, Thiazolidinediones and Osteoporosis

A

Decr bone formation

420
Q

Pseudobulbar Palsy

A

Central Pontine Myelinolysis - CN IX, X, XI

421
Q

Rapid correction of hypernatremia

A

Cerebral edema

422
Q

Labetalol

A

Antagonist of a1, B1, B2 with minor B2 agonist activity

423
Q

Diabetic retinopathy fundoscopy

A

Cotton wool, Aneurysms, Dot anb blot hemorrhages

424
Q

Amourosis Fugax

A

Painless, transient, monocular vision loss caused by small embolus (few seconds)

425
Q

45yo female with long history of pruritis and fatigue who developed pale stool and xanthelasma

A

Primary Biliary Cirrhosis - Destruction by granulomatous inflmmation, Heavy portal tract infiltration

426
Q

Bile tract disease associated with UC

A

Primary Sclerosing Cholangitis

427
Q

Vit E deficiency may closely mimic

A

Friedreich’s Ataxia - Ataxia, Dysarthria, Loss of position and vibration sense

428
Q

Fever w/ relative bradycardia

A

Salmonella Typhi

429
Q

Gastric Erosion

A

Limited to mucosa

430
Q

Gastric Ulcers

A

Extend into submucosal layers

431
Q

Limitation of chest expansion in Ankylosing Spondylitis is due to

A

Enthesopathy of Costovertebral and Costosternal junctions –> Hypoventilation

Uworld (16 decks)

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