Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Step 1 (Let's Do This)! > UWorld- Aug '15 > Flashcards

UWorld- Aug '15 Flashcards

1
Q

What is coronary steal syndrome? Which drugs can cause in coronary vesserls?

A

Phenomenon where blood flow to ischemic areas is reduced due to arteriolar vasodilation in nonischemic areas.
Coronary vessel specific dilators can trigger: Adenosine and Dipridamole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

If a coronary vessel is blocked, what is compensatory response?

A

Collateral circulation allows flow to mocardium distal to blocked vessel. Coronary artery distal occlusion is DILATED, so blood can reach ischemic site.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Effect of dilation of:

  • systemc veins
  • systemic arteries
  • mixed artery and vein
A
  • veins: ↓ventricle vol, ↓ventricle wall tension→↓O2 demand by myocrdium
  • ateries: ↓afterload, same effect.
  • Dilation of both also same effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MCC of Sudden Cardiac death? Presentation and demographic

A

V. fib in patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sudden cardiac death in elderly MCC?

A

80% coronary atheroschlerosis; CAD (70%).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is hybernating myocardium?

A
  • Chronic persistent ischemia due to contraction inhibition by NOS and TNF-α
  • Reversible
  • less severe form of Myocardial stunning (brief ischemic episodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you treat Hibernating myocardium?

A

Revascularization w/ CABG or Balloon angioplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Ischemic Preconditioning?

A

MI resistance due to episodes of non-lethal ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you access fetal lung maturity?

A

L/S ≥2 (amniotic fluid), lungs mature. Surfactant assessment.
Lecithin (phosphatidylcholin): Sphingomyelin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How to measure fetal neural tube defect?

A

Alpha-Fetoprotein (AFP) elevated (amniotic fluid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Suspect Erythroblastosis fetalis. What do you measure?

A

Fetal bilirubin!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Detect fetal adrenal gland dysfunction?

A
  • measure amniotic 17-hydroxyprogesterone levels
  • gene linkage of HLA region for Ch 6
  • Molecular probe for abnormal gene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Neural tissue ischemia presentation for

A

3-6hrs: Nothing seen

12-48 hrs: “red neurons”- eosinophili cyto, pyknotic nuclei, loss of Nissl substance

24-72hrs: Necorosis and Neutrophil infiltration

3-5days: macrophage infiltration

Nothing macro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which cells make surfactant and when? Describe cells

A

Type II pneumocyte: Cuboidal and clustered. Also a precursor cell to Type I, and more Type II.

SUrfactant mae 26wks, reaching mature levels at 35wks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does neural tissue presents after 1 week of ischemia?

A

1-2wk: Reactive gliosis and vascular proliferation around necrotic area. Gross: liquifactive necrosis

> 2wks: Glial scar.

> 1 month: Gross: Cystic area surrounded by gliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Common cause of falling of elderly? Give examples

A

Medication can increase risk of falling:
Antipsychotics, Anti-depressents, and Benzo
-Amlodipine and Ibuprofin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What activates NK cells and what is their mechanism?

A

-Target cells w/ reduced or absent MHC I expression-Use -perforin create hole in membrane, and granzymes induce apoptosis
IFN-gamma, IL-12 activate. Enhanced by IFN alpha, beta. and IL-12.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Only lymphocyte part of innate immune system? Other unique qualities as a lymphocyte?

A
  • NK cell
  • Do not require thmus for maturation, present in athymic pts, and have no Ag-specific activities (do not need AG exposure for activity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Surface marker if NK cells?

A

CD16 or CD56

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe Korsakoff psychosis

A

Anterograde and retrograde amnesia, apathy, confabulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What structure most frequently damaged in Wernicke encephalopathy? Result of what deficiency?

A

Mamillary Body

acute deficiency of Thiamine (B1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Alcoholic w/ B1 deficiency Tx?

A

Alcoholic or malnourished receive IV B1 before IV dextrose, because dextrose w/o thiamine can precipitate Wernicke encephalopathy

23
Q

Clinical presentation of Wernick encephalopathy?

A

Ataxia
Nystagmus
Opthalmoplegia
Anterograde amnesia

24
Q

What increases Statin S/E on muscles? Describe S/E

A

Myopathy: muscle pain w/ serum CK more than 10X the upper limit of normal

It increaes when statin given w/ Fibrates (i.e. Gemfibrozil)

25
Describe shift in fluid compartments w/ 1) Infusion of isotonic saline 2) Diarrhea or GI hemorrhage
Osmolarity unchanged for both 1) ECF vol↑ → ↓Hct, ↑BP 2) ECF vol↓ → ↑Hct, ↓BP
26
Describe fluid shift w/ excessive Nacl intake
Serum Osm↑ Water shifts from ICF→ECF (∴ECF↑,ICF↓) Protein and Hct↓ due to ECF↑
27
Describe fluid shift w/ sweating in a dessert
Sweat is Hypotonic. ∴Serum (ECF) osm↑, ECF vol↓ ICF↓ [Protein]↑ Hct unchanged. H2O shifted out of RBCs)
28
SIADH effect on water movement from compartments
Hypotonic volume expansion Excess H2O: Osmolarity ↓, ECF↑, water shifts to ICF↑ [protein]↓. Hct same.
29
Adrenocortical insufficiecy (NaCl loss) effect of fluid shift
Osmolarity drops ECF↓, ICF↑ Protein and Hct↑
30
Most potent mediator of coronary vascular dilation in large arteries and pre-arteriolar vessels? How is it made?
Nitric Oxide Made by Arginine and O2 by Endothelial cells. Causes vasodilation via cGMP. Adenosine vasodilates small coronary arterioles
31
Physician priority encountering Intimate Partner Violence?
- Ensure patient's safety w/ referrals and an emergency safety plan. - Be nonjudgemental. Ask if patient feels safe.
32
Describe values of statistical significance that can strengthen Relative Risk results
Confidence internal must NOT have a nul value. When 95% CI has no null value, means that p-value less than 0.5
33
Describe path of median nerve
- Lateral and medial cords of BPlexus - Runs w/ brachial artery between biceps brachii and brachialis - Courses between humeral and ulner heads of pronator teres - Travels beween flexor digitorum superficialis and flexor digitorum profundus - enters wrist w/n Flexor retinaculum and Carpal tunnel
34
Sensory and mechanical innervation of median nerve
``` Thumb flexion/opposition Flexion of 2nd, 3rd digits Wrists flexion/ABduction Sensory: Thumb, digit 2,3, and; 1/2 4 (palm side). posterior of digit 2 and 3 ```
35
Classic sign of Median nerve injury (proximal)? When is this seen. What median nerve damage does not present?
Preachers hand- weakness of thenar and flexor digitoru muscles of 2nd, 3rd digit. Seen w/ humerus fracture of entrapment between pronator teres. Pts w/ Carpal tunnel, suicide attempt do not present w/ this, branches responsible for this more proximal.
36
How to osteocytes communicate w/ one another in the bone matrix?
Gap junctions via cytoplasmic processes, that lye within canaliculi. Send signals, exchange nutrients and waste products.
37
Describe Haversian system. | Stimulation of osteocytes.
Osteocytes located in bone matrix space, Lacuna. Processes from osteocytes extend out w/n canaliculi. Layers are lamallae, centered on Central (Haversian) canal. Osteocytes: maintain bone matrix, and short term Ca release. Plasma [Ca] directly effects, PTH and calcitonin indirectly influence metabolic activity.
38
Layers of epidermis
Stratum: - Corneum (Keratin) - Lucidum - Granulosum - Spinosum (spines= desmosomes) - Basale (stem cell sites) "Chicagoans Love Giordanos, Sears towers, and daa Bears!"
39
What are epidermal glands?
Sebaceous- holocrine. Associated with hair follicle. Eccrine- secretes sweat. Everywhere on body. Apocrine- makes milky, viscous fluid. Presents after puberty. Located at axillae, genitals, and areolae. Odor due to bacteria.
40
Fx and structure of Zonula Occludens?
Tight junctions Prevents para cellular movement of solutes Composed of Claudins and Occludins. @ apices
41
What epithelial junction promotes metastasis if lost? | Describe location, Fx, structure
Zonula adherens Below tight junctions Forms belt connecting actin cytoskeletons of neighboring cells w/ Cadherins (Calcium dependent adhesion proteins)
42
What structure maintains basement membrane of epithelium?
Integrins. Bind to laminin in BM
43
What is targeted I Pemphigus vulgaris, and how. Location.
Desmosomes (macula adherens) - supports via keratin. Part of Stratified Sqm Epi. IgG against desmoglein.
44
What is targeted in bullous pemphigoid?Describe Fx and structure
AutoAbs against Hemidesmosomes Connects keratin in basal cells to underlying BM.
45
Describe structure that allows cardiac myocyte Action potential spread.
Gap junctions-protein connexon channels permit electrical and chemical communication between cells. Also how Osteocytes communicates via their cytoplasmic processes w/n canaliculi.
46
Cause of cat scratch disease? Associated diseases with same bug
Bartonella henselae, gram neg - Cat scratch: Lymphadenopathy, low fever - Endocarditis - Bacillary angiomatosis (immuno-weak): red/purple papular skin or viscera lesions.
47
Stages of membrane action potential (muscle, nerves). Describe ionic flow, and membrane potential (mV)
``` Resting potential (-70): high permeability to K, efflux via non gated leak channels. Depolarization: opening of Na, voltage gated channels, influx. Overshoot, MAX value reached. (+35) Repolarization: closing of Na channels, opening of K voltage gated-channels Hyper polarization (-85): after repolarization reached, membrane shortly more negative due to K channels remaining open. Returns to resting after K voltage channels close ```
48
Label Action potential diagram
Depolarization, overshoot, depolarization, hyper polarization, threshold, Pg. 385
49
Injury of Musculocutaneous nerve presents how (sansory and movement)?
Paralysis of elbox flexors (biceps, brachialis, coracobrachialis) Loss of sensation over lateral forearm
50
Fx and sensaory loss w/ ulnar nerve damage?
MSensation loss of medial 1.5 digits Weakness on wrist flexion/ADduction Finger ABduction/ADduction Flexion of 4th, 5th diit
51
Ulnar nerve physical path?
- Between olecranon and medial epicondyle of humerus | - enters forearm. Lies between flexor carpi ulnaris and flexor digitorum profundus
52
Radial nerve path?
-through supinator muscle near head of radius
53
Fx and sensory loss of radial nerve damage?
``` Wrist drop (extensors of wrist at forear) Sensation loss: posterior arm, forwarm, dorsolateral hand, dorsal thumb ```

Step 1 (Let's Do This)! (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions