UWorld cheat sheet 13-21 (Monday) Flashcards
1
Q
Most important mediator of coronary vascular dilation [Qid: 1516]
A
NO
2
Q
MC congenital cardiac anomaly ass w/ T21 [Qid: 188]
A
Complete AV canal defect
3
Q
Hepatic GH stimulations causes activation of what? [Qid: 224]
A
JAK-STAT pathway
4
Q
Released from the liver following stimulation of hepatic GH receptors [Qid:224]
A
IGF-1
5
Q
Hormones using JAK-STAT signaling [FA16: 316]
A
PIGGlET:
- Prolactin
- Immunomodulators (Cytokines, IL-2, IL-6, IFN)
- Growth Hormone
- G-CSF
- Erythropoietin
- Thrombopoietin
6
Q
Fn of IGF-1 [Qid: 224]
A
Binds specific TK recceptors and stimulates growth in bone, cartilage, muscle, etc.
7
Q
Infl mꬾ in the intima may reduce plaque stability by secreting ____________________, which degrade ____________________. [Qid: 447]
A
metalloproteinases / ECM proteins (eg, collagen)
8
Q
What is an Aschoff body? Where is it found? What does it contain? [Qid: 240]
A
Interstitial myocardial granulomas (Aschoff bodies) are found in myocarditis due to acute rheumatic fever. They contain plump mꬾ w/ abundant cytoplasm and central, slender ribbons of chromatin (Anitschkow, or caterpillar, cells).
9
Q
Late-onset food poisoning characterized by transient watery diarrhea caused by a toxin formed when a large quantity of spores are ingested. [Qid: 1394]
A
Clostridium Perfringens
10
Q
Hemorrhagic cystitis during therapy w/ cyclophosphamide or ifosphamide is caused by the urinary excretion of toxic metabolite _____________________. It can be prevented by aggressive hydration, bladder irrigation and administration of _____________________, a sulfhydryl compound that binds acrolein in the urine. [Qid: 1816]
A
Acrolein / Mesna
11
Q
Alcohols function by _____________________, causing them to be leaky, and by _____________________. They are bacteriocidal, tuberculocidal, fungicidal, and virucidal, but do not destroy bacterial spores. [Qid: 8593]
A
disorganizing the lipid structure in membranes / denaturing cellular proteins
12
Q
In LVHF, fluid accumulation causes swelling of affected tissue leading to _____________________ [Qid: 1585]
A
Decreased lung compliance
13
Q
Tumor lysis syndrome can develop during _____________________ (3) [Qid: 8542]
A
during chemo for cancers w/ rapid cell turnover (eg, poorly differentiated lymphomas/leukemias), ↑ tumor burden or ↑ sensitivity to chemo
14
Q
Prevention of TLS often involves hydration and the use of ____________________. [Qid: 8542]
A
hypouricemic agents such as allopurinol and rasburicase.
15
Q
TLS labs: - Ca++ - PO4--- - K+ - Uric Acid [Qid: 8542]
A
TLS labs: ↓ - Ca++ ↑ - PO4- ↑ - K+ ↑ - Uric Acid
16
Q
Northeastern US [Qid: 11524]
A
- Babesiosis
- Lyme
17
Q
What would babesiosis show in a blood slide? [Qid: 11524]
A
Maltese cross and ring form inclusions
18
Q
Tacrolimus and cyclosporine inh ____________________.
Sirolimus inh ____________________
Pathway?
[Qid: 1155]
A
Tacrolimus/Cyclosporine —| Calcineurin.
Sirolimus —| mTOR.
TCR Calcineurin NFAT IL-2 transcription IL-2
IL-2 IL2receptor mTOR Cell proliferation and differentiation.
19
Q
CD4+ counts
A
- <50
- Azithromycin
20
Q
↓ - Serum glucose ↑ - Urine ketones ↑ - Serum ammonia ↑ - Urine propionic acid Def of \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ S&S: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ [Qid: 1341]
A
- Methylmalonic academia (AR)
- Def of methylmalonyl-CoA mutase
- Lethargy, vomiting and tachypnea in newborn.
- Diagnosis by ↑ urine methylmalonic acid and propionic acid.
21
Q
Major manifestation: - Acute pancreatitis Protein defect? Elevated lipoproteins: - Chylomicrons [Qid: 782]
A
Familial chylomicronemia (Type I) - lpl, ApoC-II
22
Q
Major manifestation: - Premature CAD Protein defect? Elevated lipoproteins: - LDL [Qid: 782]
A
Familial cholesterolemia (Type II A) - LDL R, ApoB-100
23
Q
Major manifestation: - Premature CAD and peripheral vasc dz Protein defect? Elevated lipoproteins: - Chylomicron and VLDL remnants [Qid: 782]
A
Familial dysbetalipoproteinemia (Type III) - ApoE
24
Q
Major manifestation: - ↑ pancreatitis risk and ass w/ obesity and insulin resistance Protein defect? Elevated lipoproteins: - VLDL [Qid: 782]
A
Familial hypertryglyceridemia (Type IV) - ApoA-V
25
Central regulator of iron hemostasis [Qid: 787]
Hepcidin
26
Cells that secret a substance that controls iron storage and release [Qid: 787]
Hepatic parenchymal cells
27
____________________ and ____________________ increase the synthesis of hepcidin. ____________________ and ____________________ act to lower hepcidin levels [Qid: 787]
- High iron levels / inflammatory conditions (APR)
| - Hpoxia / increased erythropoiesis
28
NO is synthesized from ____________________ by ____________________. [Qid: 8563]
- Argenine
| - NO synthase
29
Which structure limits the ascent of the horseshoe kidney during fetal development? [Qid: 2]
Inferiro mesenteric aa
30
Retain the carbolfuchsin dye and resist decoloration by an acid-alcohol decolorizing agent. [Qid: 1309]
Mycolic acids
31
Specifically inh the synth of mycolic acids, an essential component of the unique mycobacterial peptidoglycan cell wall. [Qid: 1309]
INH
32
Wide, fixed splitting of the second heart sound that does not change with respiration [Qid: 201]
ASD
33
Peptic ulcers in the distal duodenum [Qid: 305]
Z-E S
34
Gastrinomas located in the small intestine/pancreas [Qid: 305]
Z-E S
35
↑ gastrin levels that rise in response to exogenous secretin administration [Qid: 305]
Z-E S
36
Rare but serious side effect of trazodone is ____________________, T/t for ____________________ [Qid: 707]
Priapism / Insomnia
37
Fracture to the orbital floor causes damage to the ____________________ [Qid: 11742]
Infraorbital nn (Maxillary branch)
38
Primary gastric cancer that metastasizes to the ovary [Qid: 127]
Krukenberg tumor
39
Krukenberg tumor has ____________________ on histology [Qid: 127]
Signet ring cells
40
Peptic ulcers in the distal duodenum [Qid: 305]
Z-E S
41
Ras/MAPK signal transduction pathway is regulated by ____________________. [Qid: 790]
GTP
42
Potent, long-acting opioid agonist with good bioavailability
and can be given in once-daily oral dosing [Qid: 1287]
Methadone
43
CNS tumors from neuronal origin frequently stain positively for ____________________ on immunohistology [Qid: 880]
Synaptophysin
44
CNS tumors from glial origin frequently stain positively for _____________________ on immunohistology [Qid: 880]
GFAP
45
Histones within core and histone outside core [Qid: 1472]
Within:
- H2A, H2B, H3, H4
Outside:
- H1
46
Endomysial mononuclear inflammatory infiltrate and patchy mm fiber necrosis on biopsy w/ anti-Jo-1 (anti-histidyl-tRNA synthetase) autoantibodies. [Qid: 11646]
Polymyositis
47
Prolonged thrombin time [Qid: 2133]
Unfractioned heparin & direct thrombin inhibitors
48
Direct thrombin inhibitors [Qid: 2133]
- Argatroban
- Bivalirudin
- Dabigatran (Oral)
49
Immediately deep to the tip of the left 12th rib [Qid: 1700]
Left kidney
50
Non-expression of the catalase-peroxidase enzyme [Qid: 1223]
Mycobacterial resistance to INH
51
Genetic modification of the binding site on the mycolic acid synthesis enzyme. [Qid: 1223]
Mycobacterial resistance to INH
52
↓ secretion of aqueous humour by ciliary epithelium [Qid: 1363]
- β-blockers (Timolol)
- α2-AR agonists
- CAIs (Acetazolamide)
53
↑ uveoscleral outlow of aqueous humor [Qid: 1363]
Prostaglandin F2α agonists:
- Latanprost
- Travoprost
54
↑ trabecular outlow of aqueous humor [Qid: 1363]
Cholinomimetics:
- Pilocarpine
- Carbachol
55
Glutamate --> Valine [Qid: 1470]
HbS
56
Glutamate --> Lysine [Qid: 1470]
HbC
57
Which will be closer to the cathode (-) HbS or HbC? [Qid: 1470]
HbC
58
Haemophilus influenzae requires what factors for growth? Can be accomplished in the presence of what other microbe? [Qid: 963]
- H.Flu is a "blood loving" organism that requires X (hematin) and V (NAD+) factors for growth.
- Staph Aureus
59
All pts beginning T/t w/ TNF-α inhs should be evaluated for _____________________ due to TNF-α's ability to _____________________. [Qid: 720]
Latent Tb / Impair cell-mediated immunity
60
High-grade fever, headache, retro-orbital pain, bleeding, diffuse macular rash, muscle and joint pain, leukopenia, thrombocytopenia, elevated liver enzymes [Qid: 11395]
Dengue viruses (ssRNA virus' w/ 4 diff serotypes)
- Primary inf: lifelong immunity against that serotype
- Secondary inf: if w/ a diff viral serotype, can cause a more severe illness
61
Hypothermia shift O-dissociation curve to the ____________________ [Qid: 1385]
Left
62
Patellar reflex tests ____________________ [Qid: 1692]
L4
63
Achilles reflex tests ____________________ [Qid: 1692]
S1
64
Vertical diplopia [Qid: 1933]
Trochlear nn (eg, stairs)
65
Horizontal diplopia [Qid: 1933]
Abducens nn (eg, driving)
66
Main causes of HIV-ass esophagitis [Qid: 283]
- Candida (MC)
- CMV
- HSV
67
Patches of adherent, grey/white pseudomembranes on erythematous mucosa. LM --> pseudohyphae [Qid: 283]
Candida albicans
68
Small vesicles --> "punched-out" ulcers. Eosinophilic intranuclear inclusions (Cowdry type A) in multinuclear squamous cells at ulcer margins [Qid: 283]
HSV-1
69
Linear ulcerations in distal esophagus w/ intranuclear & cytoplasmic inclusions [Qid: 283]
CMV
70
Red polysaccharide capsule on mucicarmine stain [Qid: 117]
Cryptococcus neoformans
71
What shows in the plasmodium blood slide? [Qid: 1908]
Plasmodium falciparum
- Banana shaped gametocytes
- Ringed shaped trophozoites
72
- MCC of rotator cuff syndrome
- Test to isolate function
[Qid: 1732]
- Supraspinatus tendinopathy
| - Empty can test
73
Left atrial enlargement can sometimes cause ____________________ n impingement. Neurapraxia resulting in left vocal cord paresis and hoarseness may result. [Qid: 236]
Left recurrent laryngeal
74
Induces transient breaks in both DNA strands simultaneously to relieve (+) & (-) supercoiling [Qid: 2018]
Topoisomerase II
75
____________________ and ____________________ specifically inh topo II's ability to seal the strand breaks it induces, causing them to accumulate and eventual cell death [Qid: 2018]
Etoposide / Podophyllin
76
Inh topo II and T/t for testicular cancer and small cell lung cancer [Qid: 2018]
Etoposide
77
Inh topo II and T/t for genital warts [Qid: 2018]
Podophyllin
78
Critically ill pts (sepsis, severe burns, trauma, and immunosuppression). Clinical findings: fever, right upper quadrant pain, and leukocytosis. [Qid: 81]
Acute acalculous cholecystitis--> acute infl of the gallbladder in the absence of gallstones. Typically occurs in critically ill pts --> due to gallbladder stasis and ischemia.
79
Pt with acute pancreatitis is most likely to have history of what? [Qid: 440]
Gallstones or alcholism (Acc for 80%)
80
Pulmonary arterial hypertension follows a 2-hit hypothesis. An abnormal ____________________ gene acts as the first insult and predisposes to excessive ____________________ proliferation. [Qid: 530]
BMPR2 / endothelial and sm cell
81
Common sources of arsenic [Qid: 841]
Insecticides / Contaminated water
82
Abdominal pain, vomiting, watery diarrhea, hypotension and a garlic odor on the breath [Qid: 841]
Arsenic poisoning
83
Chelating agent of choice for arsenic poisoning [Qid: 841]
Dimercaprol
84
Persistence in bleeding post-Pringle maneuver indicates ____________________. [Qid: 10583]
Injury to the IVC or hepatic veins
85
Pts can develop what secondary condition after inflammatory (eg, celiac) or infectious (eg, giardiasis) processes damage the microvilli of the SI. [Qid: 1072]
Secondary lactase def
86
Gram (+) cocci, coagulase (-), novobiocin resistant [Qid: 678]
Staph saprophyticus
87
Gram (+) cocci, coagulase (-), novobiocin sensitive [Qid: 678]
Staph Epidermitis
88
Sodium channel binding strength among Class 1 antiarrythmics [Qid: 159]
1C > 1A > 1B
89
GnRH --> FSH --> Sertoli cells --> Inhibin B --| ____________________. [Qid: 216]
FSH
90
Digital clubbing is often ass w/ ____________________. [Qid: 820]
Prolonged hypoxia
91
Hypercalcemia in sarcoidosis is caused by PTH-independent formation of ____________________ by ____________________ due to mꬾ expression of ____________________. [Qid: 984/1065]
1,25-dihydroxyvitamin D / mꬾ / 1-α-hydroxylase
92
↑ in total thyroid hormone levels, but NL levels of free thyroid hormone can be found what conditions? Due to what? [Qid: 772]
- Preggo/Post-meno estrogen-replacement therapy
| - Due to an ↑ in estrogen activity
93
SLE T/t? --> Cushings --> ____________________ (Adrenal change seen) [Qid: 928]
Glucocorticoids / Bilateral adrenal atrophy
94
Produced by most human cells in response to viral infections [Qid: 1468]
Interferons α & β
95
Interferons α & β bind to type 1 IFN receptors resulting in transcription of antiviral enzymes capable of ____________________. [Qid: 1468]
Halting protein synthesis
96
Spliceosomes remove introns containing _____ at the _____ splice site and _____ at the _____ splice site/ [Qid: 2038]
- GU / 5'
| - AG/ 3'
97
Supracondylar fracture resulting in anterolateral displacement of the proximal fracture fragment --> ____________________. [Qid: 11855]
Radial n inj
98
Supracondylar fracture resulting in anteromedial displacement of the proximal fracture fragment --> ____________________. [Qid: 11855]
Median n and brachial a inj
99
Short PR interval, delta wave, widening of QRS [Qid: 11797]
WPW syndrome ∆
100
Short PR interval, delta wave, widening of QRS [Qid: 11797]
WPW syndrome ∆
101
WPW syndrome is due to... [Qid: 11797]
...an accessory pathway that bypasses the AV node and directly connects the atria and ventricles.
102
MC pineal gland tumor [Qid: 1261]
Germinomas
103
Obstructive hydrocephalus and upward gaze limitation with downward gaze preference, bilateral eyelid retraction, and light-near dissociation [Qid: 1261]
Pineal gland tumor w/ perinaud syndrome
104
Very tender, small, red-blue lesion under the nail bed [Qid: 467]
Glomus tumor
105
↑ of what in diet can provide ε for PDH def pt w/out ↑ lactate? [Qid: 998]
Lysine and leucine (Exclusively ketogenic AAs)
106
- ANP is released in response to?
- ∴ effect on kidney, adrenal and BV?
[Qid: 1978]
- ↑ blood volume
| - limits Na reab and renin secr, restricts ald sercr and relaxes sm in arterioles
107
Neprilysin effect?
| Neprilysin inh? [Qid: 1978]
- Degrades ANP/BNP (as well as bradykinin, glucagon, enkephalins)
- Sacubitril
108
CF w/ eosinophilia and recurrent infiltrates (eventual bronchiectasis) [Qid: 665]
ABPA
- Also in asthmatics
- Elevated IgE
109
Branching pseudohyphae w/ blastoconidia [Qid: 11633]
Candida
110
Central venous catheter and receipt of parenteral nutrition are risk factors for which fungus? [Qid: 11633]
Candida
111
Acute-onset confusional state characterized by a fluctuating level of consciousness with deficits in attention, memory, and executive function. [Qid: 2122]
Delirium (Reversible)
112
Gradual-onset confusional state with deficits in attention, memory, and executive function [Qid: 2122]
Dementia (Irreversible)
113
Allergic symptoms caused by the release of histamine [Qid: 173]
Rhinorrhea, itchy eyes and nose, urticaria
114
- 1st gen antihistamines?
- Receptor blockade?
[Qid: 173]
- Chlorpheniramine, Diphenhydramine
| - Antihistmine, antimuscurinic, anti-α adrenergic, and anti-serotonergic
115
Benzo MOA?
| [Qid: 937]
- Positive allosteric modulation of GABA-A receptors
116
Effects of chronic opioid use?
| [Qid: 1257]
Tolerance to S/Es except constipation and miosis
117
Drugs that induce hemolytic anemia in G6PD def pts.
Pain IN the PRIMARY PYRAMID requires 3 elements (nitro, chlor, sulf)
```
Pain=ASA, ibuprofen
IN=INH
PRIMARY=primaquine
PYRAMID=pyrimethamine
3 elements=nitrofurantoin, chloramphenicol, sulfonamides
```
118
What part is always involved in Hirschsprung dz? and why? [Qid: 330]
Rectum cuz NC cells migrate caudally
119
Why is there hemolytic anemia in PK def? What results from the hemolytic anemia? [Qid: 1020]
- due to failure of glycolysis and resultant failure to generate ATP to maintain erythrocyte structure
- Splenic hyperplasia (Red pulp)
120
HSV-1 encephalitis can lead to temporal lobe necrosis resulting in ___________________ & ___________________ in addition to classic features. [Qid: 907]
Personality changes / Aphasia
121
CHF due to dilated cardiomyopathy causes ___________________ dysfn. [Qid: 92]
Systolic
122
HTN heart Dz *-->* Hypertrophic cardiomyopathy *-->* ___________________ dysfn. [Qid: 92]
Diastolic
123
Ergot alkaloids?
Nonergot alkaloids?
MOA?
[Qid: 703]
- Bromocriptine
- Pramipexole, ropinirole
- Dopamine agonists
124
Where does ADH act in the nephron? [Qid: 1161]
Principal cells of the medullary segment of the collecting duct
125
What occurs with an interscalene block? [Qid: 11744]
- Anesthetizes the brachial plexus
| - Transient ipsilateral diaphragmatic paralysis due to C3-5 involvement
126
Repetitive or prolonged kneeling resulting in anterior knee pain [Qid: 1491]
Prepatellar bursitis
127
- Pharyngeal arch CN derivations
- Aortic arch derivatives
[Qid: 1750]
+ 5, 7, 9, 10 (Sup), 10 (Recurrent)
- 1st arch is MAXimal (Maxillary)
- Second = Stapedial
- C is third letter (Carotid)
- 4th arch = 4 limbs (systemic)
- 6th = Pulmonary
128
Adenoma-carcinoma sequence
| [Qid: 421]
APC --> KRAS --> P53
129
Sarcoid granulomas produce ___________________ and ___________________. [Qid: 796]
1, 25-dihydroxycholecalciferol / ACE
130
Predominant type of lymphocyte found in sarcoid granulomas [Qid: 796]
- CD4+ T-helper cells
| - ↑CD4/CD8 T-cell ratio in bronchopulmonary lavage fluid
131
Mycoplasma genus (incl Ureaplasma) are resistant to what antibiotics? [Qid: 1677]
Penicillins, cephalosporins, carbapenems and vacomycin (No cell wall)
132
β-lactamase, ESBL [Qid: 1000]
Penicillin resistance
133
Mutated PBP [Qid: 1000]
Penicillin resistance
134
Mutated peptidoglycan wall [Qid: 1000]
Vancomycin resistance
135
Mutated DNA gyrase [Qid: 1000]
Quinolone resistance
136
____________________-modifying enzymes [Qid: 1000]
Aminoglycoside / Aminoglycoside resistance
137
Mutated RNA polymerase [Qid: 1000]
Rifamycin resistance
138
Symmetric peripheral neuropathy [Qid: 1046]
Dry beriberi (Thiamine def)
139
CHF w/ symmetric peripheral neuropathy [Qid: 1046]
Wet beriberi (Thiamine def)
140
Green discoloration of pus or sputum seen in bacterial inf is due to ____________________. [Qid: 1910]
presence of MPO
141
Difference in meiotic nondisjunction on RFLP blot [Qid: 8328]
Meiosis 1 = 1 band matching the father (NL) & 2 bands matching the mother (AbNL)
Meiosis 2 = 1 band matching the father (NL) & 1 *THICKER* band matching the mother (AbNL)
142
IF microscopy shows granular deposits of IgG, IgM, and C3 in the mesangium and BMs. [Qid: 8]
PSGN
143
Abn huntingtin causes ↑ ____________________, silencing the genes necessary for neuronal survival. [Qid: 840]
histone deacetylation
144
Hypoberic hypoxia is the primary cause; it leads to an inc RR w/ development of resp alk. [Qid: 12024]
High-altitude sickness
145
Fn of IL-12 [Qid: 762]
Stimulates the differentiation of naïve T-cells to TH1 subpopulation
146
Pts def. in IL-12 would be T/t w/ ____________________ because it also stimulates Th1 differentiation. [Qid: 762]
IFN-γ
147
Within the true pelvis, ureters lie anterior to the ____________________ and medial to the ____________________. The ____________________ crosses over the anterior surface of the ureter ("water under the bridge"). [Qid: 1804]
Internal iliac a / Ovarian vessels / Uterine a
148
Direct indicator of alveolar ventilation status [Qid: 528]
Arterial PaCO2 (Hypocapnia implies ongoing alveolar hyperventilation)
149
Glycerol produced by the degradation of TGs in adipose tissue can be used by ____________________ in the liver and kidney to synthesize glucose during gluconeogenesis. [Qid: 1889]
Glycerol kinase
150
____________________ oxygen extraction exceeds that of any other tissue in the body. This is met by a proportionate ↑ in ____________________. [Qid: 2009]
Myocardial / coronary blood flow (∴ coronary sinus has least O2 content)
