UWorld cheat sheet 22-29 (Tuesday) Flashcards

1
Q

An apparent inc in survival in pts diagnosed with a new test [Qid: 1170]

A

Lead-time bias (actually have an unchanged prognosis)

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2
Q

Rate of O2 consumption ÷ arteriovenous O2 content difference [Qid: 1529]

A

CO

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3
Q

Causes crystalline nephropathy if adequate hydration is not also provided [Qid: 1642]

A

Acyclovir

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4
Q

Reduced gallbladder contractility, due to decreased CCK secretion is responsible for ____________________ in pts w/ ____________________. [Qid: 601]

A

biliary stones / somatostatinomas

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5
Q

Obstructive sleep apnea is ass w/ systemic hypertension. Prolonged OSA can also cause ____________________ and ____________________. [Qid: 1985]

A

Pulm HTN / RHF

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6
Q

____________________ is characterized by dysphagia (esophageal web formation) and iron deficiency anemia. Findings ass w/ ____________________ include koilonychias (spoon-shaped nails) and shiny red tongue. Most symptoms resolve following iron supplementation. [Qid: 1075]

A

Plummer-Vinson syndrome / Iron deficiency

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7
Q

PYR-positive, beta-hemolytic. [Qid: 8857]

A

Strep Pyo

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8
Q

Corynebacterium diphtheria A/B exotoxin:
_____ (think: binding) subunit allows penetration of the _____ (think: active) subunit into the cell to ___________________. [Qid: 1092]

A

A / B / Inhibit ribosome function

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9
Q

____________________ –> AR disorder of de novo pyrimidine synth –> defect in UMP-synthase –> Pres w/ mental retardation, megaloblastic anemia, and large amounts of urinary orotic acid. ____________________ suppl can improve symptoms. [Qid: 2066]

A

Orotic aciduria / Uridine

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10
Q

In children age <6, ____________________ inf is most often (>80%) silent or subclinical (“anicteric”). Unlike hep B or C, ____________________ is a self-limiting disease that is not ass w/ an asymptomatic carrier state. [Qid: 373]

A

Ornithine transcarboxylase def

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11
Q

Failure to thrive, hyperammonemic encephalopathy within the first few weeks of life.

A

HAV / HAV

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12
Q

Acidosis stimulates renal ____________________, a process by which renal tubular epithelial cells metabolize glutamine to glutamate. ____________________ (excreted in the urine) & ____________________ (absorbed into the blood) [Qid: 11939]

A

Ammoniagenesis / Ammonium / Bicarbonate

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13
Q

The pO2 in the left atrium and ventricle is ____________________ than in the pulmonary capillaries due to mixing of oxygenated blood from the pulmonary veins w/ deO2 blood from the ____________________ and ____________________. [Qid: 1542]

A

Lower / bronchial circ / thebesian veins

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14
Q

Anovulation is a CC of infertility. ____________________ is a T/t option that acts like FSH and triggers the formation of a dominant ovarian follicle. Ovulation is then induced by administration of ____________________, which mimics LH surge (Same α subunit). [Qid: 207]

A

Menotropin / hCG

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15
Q

L. Monocytogenes produces a very narrow zone of _____-hemolysis on blood agar, shows tumbling motility at _____⁰C, and can be cultured at temperatures as low as 4⁰C. Intact ____________________ immunity is essential for elimination of bacterium from the body. Neonates up to 3 months of age are especially vulnerable as their ____________________ immunity is not yet fully developed. [Qid: 1391]

A

β / 22 / cell-mediated / cell-mediated

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16
Q

Location of AV node [Qid: 11956]

A

Near the insertion of the septal leaflet of the tricuspid valve and the orifice of the coronary sinus

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17
Q

Occurs in the fragile germinal matrix and inc in fre w/ dec age and birth weight [Qid: 8564]

A

Neonatal intraventricular hemorrhage

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18
Q

Complications of prematurity [Qid: 8564]

A
  • BP* IN RR:
  • Bronchopulm dysplasia
  • PDA
  • Intraventricular hemorrhage
  • Necrotizing enterocolitis
  • Respiratory distress syndrome
  • Retinopathy of prematurity
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19
Q

In viridians strep –> ____________________ facilitate streptococcal adherence to fibrin. [Qid: 1003]

A

Dextrans

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20
Q

↑ Cholestrol = _____ in likelihood of gallstone formation.
↑ bile salts and ↑ phosphatidylcholine = _____ risk for gallstones and _____ cholesterol solubility.
[Qid: 78]

A

↑ / ↓ / ↑

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21
Q

Alcoholic cardiomyopathy, doxorubicin therapy, selenium deficiency and viral myocarditis dilated cardiomyopathy w/ LV systolic dysfunction characterized by inc LV volume
Shift in P/V curve to the right

A

Diastolic HF is caused by decreased ventricular compliance which can lead to decreased LVED₽ at the same LVED volumes. HTN, obesity and infiltrative disorders (eg, transthyretin-related amyloidosis, sarcoidosis) are important causes of DHF.
Shift in P/V curve that goes upward and to the left
Alcoholic cardiomyopathy, doxorubicin therapy, selenium deficiency and viral myocarditis dilated cardiomyopathy w/ LV systolic dysfunction characterized by inc LV volume

Shift in P/V curve to the right

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22
Q

↓ ventricular compliance / ↓ LVED₽ / LVED volumes

A

Diastolic HF is caused by ____________________ which leads to ↓ ____________________ at the same ____________________. [Qid: 93]

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23
Q

Important causes DHF [Qid: 93]

A

HTN, obesity and infiltrative disorders (eg, transthyretin-related amyloidosis, sarcoidosis)

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24
Q

Shift in P/V curve that goes upward and to the left [Qid: 93]

A

Hypertrophic cardiomyopathy

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25
Important causes of SHF [Qid: 93]
Alcoholic cardiomyopathy, doxorubicin therapy, selenium deficiency and viral myocarditis
26
Important causes of dilated cardiomyopathy [Qid: 93]
ABCCCD: - Alcohol abuse - Beriberi - Coxackie B - Chronic cocaine use - Chagas Dz - Doxorubicin therapy
27
Shift in P/V curve to the right [Qid: 93]
Dilated cardiomyopathy
28
Symptoms of alcohol withdrawal [Qid: 350]
- Insomnia - Tremulousness - Anxiety - Autonomic hyperactivity
29
T/t for visceral nausea [Qid: 10999]
5HT3 receptor antagonists
30
T/t for vestibular nausea [Qid: 10999]
Antihistamines and anticholinergics
31
T/t for nausea ass w/ migraines [Qid: 10999]
Dopamine antagonists
32
Bilateral carpal tunnel syndrome in pt w/ hx of hemodialysis, dx? MOA? [Qid: 1264]
Deposition of β2-microglobulin in the carpal tunnel causing median nn compression
33
Rare and serious adverse effect of ACE inh therapy? ACE inh ↑ ____________________ levels, which increase vasc perm. [Qid: 949]
Angioedema / bradykinin
34
Diffuse, large cell non-Hodgkins lymphoma of B-cell origin that usually occurs as a late complication of HIV inf. EBV is identified in almost all cases. [Qid: 2083]
PCNSL (Primary CNS lymphoma)
35
MC due to a toxic effect or autoimmune response causing apoptosis of pluripotent stem cells. BM biopsy reveals hypocellularity with an abundance of fat cells. [Qid: 1787]
Aplastic anemia --> Pancytopenia
36
Aplastic anemia is MC due to a toxic effect or autoimmune response causing apoptosis of ____________________ (pancytopenia). [Qid: 1787]
pluripotent stem cells
37
- BM biopsy will be hypercellular w/ abnormally differentiated cells [Qid: 1787] - Due to? - Progress to?
- Myelodysplastic Syndromes (MDS) - De novo mutation / Env exp (chemo) - AML
38
Inherited cause of AA that presents w/ short stature and absent thumbs and is ass w/ an increased risk of malignancy. [Qid: 1787]
Fanconi anemia
39
Antioxidant enzymes [Qid: 11916]
- Superoxide dismutase - Glutathione peroxidase - Catalase
40
Abnormal spasm or diminished relaxation of the cricopharyngeal mm during swallowing is thought to be the underlying mechanism of ____________________. ↑ oropharyngeal intraluminal ₽ eventually results in herniation of the pharyngeal mucosa through a zone of m weakness in the post. hypopharynx (Killian triangle). [Qid: 279]
Zenker diverticulum
41
Decrease in systolic BP of >10mmHg w/ inspiration. MC in ____________________ dz. [Qid: 2099]
- Pulsus paradoxus | - MC in pericardial dz, (i.e, cardiac tamponade)
42
MFC of pulsus paradoxus in the absence of significant pericardial dz. [Qid: 2100]
Asthma and COPD exacerbation
43
Used w/ misoprostol (a prostaglandin-E1 agonist) to terminate a first-trimester pregnancy. [Qid: 583]
Mifepristone (progesterone antagonist)
44
GBS after camp jejuni inf has an immune-mediated pathogenesis; antibodies against infectious agents are thought to cross-react w/ the myelin of the spinal roots and peripheral nn. ____________________ and ____________________ are seen on LM. [Qid: 1058]
Segmental demyelination / endoneural infl infiltrate
45
The pathogenesis of AAA is characterized by... [Qid: 463]
...transmural aortic wall infl, abnormal collagen remodeling and cross-linking, and loss of elastin and sm cells
46
Manifestations of Vit B12 def (4) [Qid: 64]
- ↑ methylmalonic acid (MMA) & homocysteine - Dorsal columns (You break your back in MMA) - SACD (You get sacked in MMA) - Megaloblastic anemia (You bleed in MMA).
47
Hydrocephalus, intracranial calcifications and chorioretinitis in newborn [Qid: 1038]
Congenital toxoplasmosis' classic ∆
48
Why can't you give ACE inh to pts w/ hereditary angioedema? [Qid: 1612]
Pts w/ hereditary angioedema have a def in C1 esterase inh which is an enzyme that suppresses the activation of C1 as well as inactivate kalikrein (∴ bradykinin accumulation). The action of ACE on bradykinin is to inactivate it; ∴ with ACE inh you also further accumulate bradykinin leading to angioedema exacerbation.
49
HPV has a tropism for ss epithelium which lines the ____________________ (3). Infants can acquire respiratory papillomatosis via passage through a HPV-infected birth canal. [Qid: 483]
true vocal cords, cervix, and anus
50
``` Neprilysin is an example of what? What does it do? Inhibition is beneficial in what condition? Example of Neprilysin inh? [Qid: 11746] ```
- Metalloproteinase - Inactivates BNP - HF - Sacubitril
51
Nitrites T/t cyanide poisoning due to its ability to induce ____________________. [Qid: 1415]
Methemoglobin
52
Hemorrhagic lymphocytic pleocytosis w/ inc protein and NL glucose in CSF. Abn MRI signaling in the bilateral temporal lobes. T/t w/ IV ____________________. [Qid: 11729]
HSV encephalitis / Acyclovir
53
Diarrhea, weight loss, and epigastric calcifications in a pt w/ chronic alcoholism suggest ____________________ w/ resulting ____________________ and ____________________. [Qid: 1547]
Chronic pancreatitis / pancreatic exocrine insuf / malabsorption
54
Structural alteration in enzymes involved in RNA synthesis [Qid: 1310]
Rifampin resistance
55
↓ Activity of bacterial catalase-peroxidase [Qid: 1310]
Isoniazid resistance
56
↑ Activity of enzymes involved in cell wall polysaccharide synthesis [Qid: 1310]
Ethambutol resistance
57
Altered structure of bacterial ribosomal proteins [Qid: 1310]
Streptomycin resistance
58
Anterior humerus dislocation [QID: 1924]
Axillary n inj
59
MC CV manfifestation ass w/ SLE [Qid: 1040]
Pericarditis
60
Could limit chest wall expansion due to involvement of costovertebral/sternal jxns. Other important complications include ascending aortitis and anterior uveitis. [Qid: 753]
Ankylosing spondylitis (Characterized by ankylosis and enthesitis)
61
Conn syndrome [Qid: 454]
Primary hyperaldosteronism due to an aldosterone-producing adenoma
62
Conn syndrome can cause muscle weakness and paresthesias due to ____________________. [Qid: 454]
Hypokalemic alkalosis
63
Tinnitus, vertigo and sensorineural hearing loss [Qid: 308]
Ménière dz ∆
64
Ménière dz is caused by... [Qid: 308]
↑ ₽ & volume of endolymph
65
Maternal serum α-fetoprotein screening (MSAFP) is ↓ in ____________________. ↑ in ____________________(3). [Qid: 312]
Aneuploidies / Open NTDs, VWDs and multiple gestations
66
Crescent formation on LM [QID: 24]
RPGN (IF microscopy image is created by fluorescently tagged antibody that specifically binds fibrin)
67
Crescent in RPGN consists of ____________________(4) [QID: 24]
parietal cells, monocytes, mꬾ and abundant fibrin
68
Feednack system for mm length [Qid: 8266]
Mm spindle system
69
Feedback systems for mm force. [Qid: 8266]
Golgi tendon system
70
Symmetrical enlargement of the ventriculi is characteristic of ____________________ which occurs secondary to dyfunction or obliteration of ____________________. This is usually a sequelae of meningeal infection or subarachnoid/intraventricular hemorrhage. [Qid: 15]
Communicating hydrocephalus / subarachnoid villi (arachnoid granulations)
71
Immune dysregulation and overproduction of glomerular permeability factor --> damages podocytes and ↓ the anionic properties of the glomerular BM [Qid: 385]
MCD
72
Selective albuminuria (as opposed to other nephrotic syndrome forms) [Qid: 385]
MCD
73
- Sertoli cells --> ____________________ --> Müllerian duct involution - Sertoli cells --> ____________________ --> Spermatogenesis - Leydig cells --> T2 --> ____________________ (Wolffian) - Leydig cells --> T2 --> DHT --> ____________________ [Qid: 1449]
- Anti-mullerian hormone (AMH) - ABP - Internal male organs (Wolffian) - External male reproductive organs
74
Damage below the Red nuke --> ____________________ Damage above the Red nuke --> ____________________ [Qid: 11574]
Decerebrate (Extensor) / Decorticate (Flexor)
75
Necrolytic migratory erythema (face, groin, extremeties), DM, GI symptoms. Diagnosis: markedly elevated glucagon levels. [Qid: 585]
Glucagonoma
76
____________________ commonly infects B cells, stimulating them to proliferate continuously --> immortalization. [Qid: 1594]
EBV
77
The heterophile antibody test (IgM) is sensitive and highly specific for ____________________ infections. [Qid: 1594]
EBV
78
PCP presents as ____________________ on CXR [Qid: 11637]
diffuse, bilateral interstitial infiltrates
79
Systemic mastocytosis --> Mast cell proliferation is ass w/ mutations in ____________________. Excessive histamine release from degranulation of mast cells mediates many of the symptoms of the disease --> syncope, flushing, hypotension, pruritus, urticaria. ____________________ --> Gastric acid secretion --> Gastric ulceration. [Qid: 306]
KIT receptor tk / Histamine
80
Flushing, watery diarrhea, bronchospasm, dyspnea, weezing. T/t is resection, ____________________ for symptomatic pts. [Qid: 309]
Carcinoid syndrome / Octreotide
81
Octreotide is a synthetic analog of ____________________ --> inh secretion of many hormones. (Also used to inh secretory diarrhea in VIPomas.) [Qid: 309]
somatostatin
82
Neuropathic pain and angiokeratomas --> Glomerular, cardiac and cerebrovascular complications develop in adulthood. [Qid: 1989]
Fabry dz
83
T/t for glaucoma, ↑ trabecular outflow [Qid: 11841]
Muscurinic agonists
84
T/t for glaucoma, ↑ uveoscleral outflow [Qid: 11841]
PG agonists
85
T/t for glaucoma, ↓ aqueous humor inflow (3) [Qid: 11841]
β-blockers, α2-agonists, CAIs
86
Appears as disorganized non-peristaltic contractions on esophageal manometry and "corkscrew" esophagus on barium esophagogram. Pathogenesis likely involves impaired inhibitory NTssion w/in the esophageal myenteric plexus. [Qid: 280]
Diffuse esophageal spasm (DES)
87
Lenticular accumulation of ____________________ in the lenses of pts w/ galactosemia (____________________ def) can cause osmotic damage and development of ____________________. Cataracts may be the only manifestation of ____________________ deficiency.
galactitol / galactokinase / cataracts / galactokinase
88
(+) test for reducing substance in the urine but no cataracts [Qid: 1074]
Galactossemia
89
(+) test for reducing substance in the urine w/ cataracts [Qid: 1074]
Essential Fructosuria
90
Anti-CCP have a high specificity for ____________________ [Qid: 8802]
RA
91
____________________ --> proliferation of papillary cells in a cyst or duct that may contain focal atypia. [Qid:11890]
Intraductal papilloma
92
MCC of bloody nipple discharge and typically presents without breast masses or skin changes. [Qid: 11890]
Intraductal papilloma
93
Patients w/ severe ____________________ can have anaphylaxis during transfusion of blood products that contain small amounts of ____________________. [Qid: 1130]
IgA def / IgA
94
Uric acid is soluble at physiologic pH, but it can precipitate in the normally ____________________ environment of distal tubules and collecting ducts. [Qid: 1050]
Acidic
95
Prevention of TLS [Qid: 1050]
Urine alkalinisation and hydration
96
Transmission of Hep A occurs through ____________________ and is common in areas of overcrowding and poor sanitation. Outbreaks frequently result from contaminated water or food, and or raw or steamed shellfish is a common culprit in the US. [Qid: 372]
fecal oral route
97
AR ATP7B mutation
Wilson Dz
98
Clinical findings: - Hepatic (↑Transaminases) - Neurologic (parkinsonism, gait disturbance, dysarthria) - Psychiatric (depression, personality changes) Diagnosis : - ↓ Ceruloplasmin & ↑ Urinary copper excretion
Wilson Dz
99
T/t Wilson Dz
D-Penicillamine
100
How does HBV increase the risk for hepatocellular carcinoma [Qid: 58]
Integrates its DNA into the host genome, thereby increasing the risk for hepatocellular carcinoma
101
The crycothyrotomy incision passes through what layers? [Qid: 8631]
The superficial cervical fascia, pretracheal fascia, and the cricothyroid membrane
102
Median nn runs between? [Qid: 1749]
The flexor digitorum superficialis and the flexor digitorum profundus.
103
Vomiting is reflex regulated mainly by which 5 receptors? Which are useful for chemo induced vomiting? [Qid: 11728]
M1 muscurinic, D2 dopaminergic, H1 histaminic, 5-HT3 and NK1 receptors. The last 2 are particularly useful for chemotherapy induced vomiting
104
____________________, a melatonin agonist, is safe and effective in reducing time to sleep onset in the elderly. [Qid: 348]
Ramelteon
105
Heparin induced thrombocytopenia (HIT) is T/t w/? [Qid: 1078]
Direct thrombin inhibitors (DTI’s) such as argatroban, hirudin & lepirudin.
106
Why do glucocorticoids cause hyperglycemia? [Qid: 548]
They increase hepatic gluconeogenesis and glycogenesis. This, along with peripheral antagonism of insulin --> hyperglycemia. [Qid: 548]
107
Effects of glucocorticoids? [Qid: 548]
Glucocorticoids are predominantly catabolic, causing muscle weakness, skin thinning, impaired wound healing, osteoporosis, and immunosuppression.
108
Presents w/ gradually progressive dyspnea and bilateral reticulonodular opacities on CXR. [Qid: 653]
Pulmonary fibrosis
109
Lab tests used in evaluation of hepatobiliary dz to asses liver: functionality [Qid: 99]
eg, PT, bilirubin, albumin, cholesterol
110
Lab tests used in evaluation of hepatobiliary dz to asses liver: structural integrity and cellular intactness [Qid: 99]
eg, transminases
111
Lab tests used in evaluation of hepatobiliary dz to asses liver: biliary tract [Qid: 99]
eg, alkaline phosphatase, γ- glutamyl transpeptidase - GGTP