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Step 1 - Elise > UWorld, Day Four > Flashcards

UWorld, Day Four Flashcards

1
Q

Increased ADH = increased reabsorption of what (other than Na)

A

urea

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2
Q

Define T-tubules

A

they are invaginations of the muscle cell membrane - they have VGCaC (DHPs), so they transmit depolarization signals to the SR, resulting in Ca release.

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3
Q

25 hydroxycholecalciferol —(___)—> 1,25 dihydroxycholecalciferol (active)

what is the enzyme and what is the location?

A

1-alpha-hydroxylase (stimulated by PTH)

in the kidney (this step impaired in CKD)

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4
Q

What vessel holds venous blood with the least amount of oxygen?

A

coronary sinus

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5
Q

definition of carboxyhemoglobin
define PaO2
define methemoglobin

What changes occur in CO poisoning

A

increased - CO bound to Hb
normal - PaO2 is the amount of O2 dissolved in plasma
normal - occurs when ferrous (Fe2+) is oxidized into ferric iron (Fe3+)

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6
Q

What does prednisone do to the HPA-axis? (CRH, ACTH, cortisol)

A

suppresses all

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7
Q

wide splitting

A

delayed RV emptying (i.e. pulmonic stenosis… dt possible eisenmenger (L->R that turned R–>L with pulmonary artery thickening)

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8
Q

fixed split

A

ASD

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9
Q

what synapses on an inhibitory interneuron from a skeletal muscle?
what is tested during a DTR?

A

golgi tendon organ

muscle spindle (they mediate stretch/myotactic reflex)

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10
Q

a woman gave birth a few weeks ago in which she had ongoing vaginal bleeding. she presents now with dyspnea and hemoptysis. endometrial curretage shows proliferation of cytotrophoblasts and syncytiotrophoblasts. what is it?

A

choriocarcinoma

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11
Q

what is this (in uterus):

  • B9 tumor of bundles of smooth muscle cells
  • diffusely hydropic chorionic villi
  • fetal tissue with triploid karyotype
  • diffusely hydropic chorionic villi with diffusely enlarged trophoblasts with myometrial invasion
A
  • myoma (fibroid)
  • complete mole
  • partial hydatidiform mole
  • invasive mole
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12
Q

HA, visual and muscular disturbances, enlarged temporal artery, elevated ESR and IL-6

A

Giant cell arteritis (temporal arteritis)

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13
Q

Female with proximal muscle weakness.

Female with proximal muscle weakness and inflammatory involvement of skin.

A

polymyositis

dermatomyositis - associated with paraneoplastic syndrome of cancers of lung, ovary, colorectal, or NHL

both are anti-Jo1/mito2/SRP

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14
Q

IGF-1 is associated with what state?

What type of signaling pathway and where is IGF-1 made?

A

Gigantisim - hypersecretion on GH from ant pit, inducing liver’s IGF-1 - involved in JAK-STAT

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15
Q

At person presents with polyuria and polydipsia. Think what three DDx:

  1. elevated plasma sodium and no urine osm change in response to water deprivation test
  2. high blood glucose
  3. hyponatremia and low initial urine osm
A
  1. DI (central - no ADH, or nephrogenic - decreased response to ADH)
  2. DM
  3. Primary (psychogenic) polydipsia
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16
Q

hypotension, elevated jugular pressure, muffled heart sounds. hear drop in pulse amplitude with inspiration

A

beck triad - cardiac tamponade

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17
Q
  • what two drugs stop levodopa degradation by COMT to 3-OMD, thus potentiating levodopa’s effects
  • what drug stops levodopa degradation into dopamine in the PERIPHERY
A

entacapone and tolcapone

cabidopa

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18
Q

64 year old female wtih sudden right arm weakness and difficulty speaking that resolves on its own in 20 min. What is this and give what med?

AE at high doses of this med?

A

TIA

give NSAID (low dose ASA)

at high dose ASA, can get vertigo, tinnitus, hearing loss, hyperapnea (stim resp drive)

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19
Q

MOA of med given for panic attack.

A

Benzo - binds allosterically to Cl- channel, potentiating GABA effects in frequency of opening.

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20
Q

tx of idiopathic Pulmonary ARtery HTN

A

bosentan - endothelin receptor antagonist

21
Q

use what antihistamine (H1) in elderly?

A

second generation - loratidine and cetirizine

22
Q

What drug causes bronchiodilation by blocking action of ACh at muscarinic receptors?

A

ipratroprium (atropine derivative)

23
Q

Use what drug class in restless leg syndrome?

Use what drug class in antipsychotic induced akithisia?

A

RLS - use dopamine agonist

Akithisia - use B-antagonist (i.e. propranolol) - this occurs because of antipsychotic antidopaminergic MOA

24
Q

An AE of levodopa admin in PD patients that persists, even after carbidopa admin.

A

Agitation and anxiety.

25
Q

What is an agonist at GABA-B receptor? For spastiity (i.e. dt MS)

A

baclofen or tizanidine

26
Q

Vd x 0.7 / CL = ?

A

half life

steady state concentration is achieved in 4-5 half lives

27
Q

Cpss x CL / bioavailability fraction = ?

Cpss = concentration in plasma at steady state

A

maintenance dose

for IV administration, bioavailability = 1

in renal or hepatic impairment, LD is unchanged, but MD is decreased

28
Q

Cpss x Vd / bioavailability fraction = ?

Cpss = concentration in plasma at steady state

A

loading dose

in renal or hepatic impairment, LD is unchanged, but MD is decreased

29
Q

Three benzos used for people with hepatic dysfunction.

A

LOT - lorazepam, oxazepam, temazepam

30
Q

Where do most RCCa (polygonal cells with abundant clear cytoplasm) originate?

MC renal cancer arising from the renal pelvis

A

proximal renal tubules

transitional cell carcinoma

31
Q

2-sample t-test measures?

ANOVA measures?

chi-square measures?

A

Any difference between MEAN OF TWO GROUPS

Any differences in MEANS OF >2 GROUPS.

Determine if an association exists between two variables in a given outcome.

32
Q

What is this: a complication of acute pancreatitis, collection of fluid rich in enzymes and inflammatory debri surrounded by GRANULATION tissue and FIBROSIS

A

pancreatic pseudocyst

33
Q

Always choose what option on a santiation precaution question:

A

HAND HYGEINE

34
Q

Always choose what option on a santiation precaution question:

A

HAND HYGEINE

35
Q

CXR: well defined coin like lesion “popcorn calcification”. Often contain islands of mature hyaline cartilage, fat, smooth muscle, and clefts (cartilage, fibrous, and adipose tissue).

A

hamartoma - overgrowth of tissue correct for the organ

36
Q

What PANS nerve goes to carotid chemoreceptors?

What goes to aortic arch chemoreceptors?

A

Carotid - glossopharyngeal (9)

Aortic - vagus (10)

37
Q

MOA of triptans

A

5HT-1B/1D agonists; acute migraine (during attack)

38
Q

Recombinant humanized IgG1 monoclonal ab that binds with IgE to inhibit action of IgE

A

omalizumab, for people with SEVERE allergic asthma

39
Q

CCA

AUG and UAG

A

CCA is the 3’ end of tRNA

AUG and UAG are start and stop mRNA codons

40
Q

What vessels does NO act on?

A

large veins

41
Q

Right dominant heart (70%) is defined by ____ supplying the Posterior Descending Artery.
Left dominant heart (10%) is defined by ____ supplying the Posterior Descending Artery.

A

Right dominant - Right Coronary Artery
Left dominant - Left circumflex artery

(Posterior Descending Artery supplies AV branch - supplies the AV node).

42
Q

Optimal location to insert needle for femoral nerve blcok.

A

At the inguinal crease, just lateral to the femoral artery.

43
Q

Dialysis pt with bleeding from cath site:

A

think uremic toxicity, a QUALITATIVE platelet disorder increased bleeding time. (PT, PPT, Platelets normal)

44
Q

murmur during sitting up and leaning over. high pitched, blowing decrescendo diastolic murmur immediately after AV closure.

A

AR

45
Q

old man with crescendo, decrescendo systolic murmur

A

AS or PS

46
Q

interstitial and alveolar edema and exudate formation in acute respiratory distress syndrome results in… ____
see: dec lung compliance, work of breathing, worsened V/Q. PCWP normal.

A

ARDS - increased pulmonary capillary permeability.

47
Q

ANTIDOTE for:

  • benzo overdose (CNS toxicity and respiratory depression
  • opioid overdose (resp depression, miosis, vomiting, constipation, seizure, sedation)
  • BBlocker overdose (bradycardia, heart block, hypotension, bronchospasm)
  • alcohol (hyperventilation and visual disturbance)
  • iron (child)
A
  • benzo - flumazenil
  • opioid - naloxone
  • BB - glucagon
  • alcohol - fomepizol
  • iron - deferoxamine
48
Q

5 disease that must be reported to CDC

A

gonorrhea, chlamydia, hep B, hep C, HIV

Step 1 - Elise (30 decks)

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