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usmle > uworld deck 9 > Flashcards

uworld deck 9 Flashcards

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USMLE® Step 1 flashcards
1
Q

why anus preffered in drug 1st pass metabolism

A

the veins below pectinate line basically drain into the systematic circulation-internal iliac and internal pudenal internal iliac gives to rise to middle rectal
internal pudenal gives rise to inf rectal

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2
Q

which part of the intestine has greates blood flow

A

related to metabolic acitivyt, duodenum has hig active transport more blood flow therefore more absorption
greater BF means high Concentration gradient

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3
Q

why rectum has low absorption of drug vs small intestine

A

surface area

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4
Q

sacroptes scaiebei

A

Rapidly spreading, pruritic rash with erythematous papules, small crusted red papules
• Hands and wrists
• Mite burrows into skin (linear pattern)

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5
Q

which antiviral drug is associated with myopathy

A

integrase inhibtiors

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6
Q

whipplei patients develop what conditon

A

hyperpigmentation

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7
Q

type 2 dm

A

velvety patches of brownish discoloration affecting the neck and skinfolds.

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8
Q

shoulder dislocation

A

Most commonly anterior
• Flattening of deltoid, protrusion of acromion
• Damaged axillary nerve

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9
Q

crocoid process frac

A

hotgun or rifle related activities have the highest chance of coracoid

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10
Q

midshaft fx

A

Radial nerve or deep brachial artery damage

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11
Q

head and neck cancer

A

dysphafgia ,base tounge mass, cervical LADo human papillomavirus (HPV), which may be seen in younger, nonsmoking patients. smoking is also a reason

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12
Q

dissoicative disorders

A

Dissociative amnesia

Inability to recall personal information, usually of a traumatic or stressful nature
Dissociative identity disorder

Fragmentation into ≥2 distinct personalities
Discontinuity in identity & personal agency

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13
Q

murmur of asd

A

asd defect murmur
early peaking systolic wide s2
increased pulmonary flow =early peaking systolic murmur 2nd ic space
tricuspid flow=rumble at LLS

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14
Q

avasular necrosis presentation

A

Avascular necrosis typically presents with pain and limited mobility but not pathologic fractures.

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15
Q

which disease enchondral ossification imparied

A

Endochondral ossification involves the deposition of hyaline cartilage by chondrocytes and is impaired in achondroplasia,

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16
Q

premotor frontal cortex lesion

A

abnormal posturing or repetitive movements but not an action tremor.

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17
Q

toical steroid

A

Telangiectasias, ecchymoses from mild trauma, and atrophic striae may also be found. troubles with corticosteorid use
dermal atrophy as well

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18
Q

why no IGm phagocytosis

A

here are no receptors on macrophages for the Fc portion of IgM

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19
Q

what is l selectin

A

L-selectin is an adhesion molecule that aids entry of lymphocytes from the blood into lymphoid tissue

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20
Q

which cells express high telomeres

A

stem cells

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21
Q

t lymphocytes and neutrophils both cause candida

A

t cells-superficial

neutrophils-disseminated

22
Q

primary mechanism of atypical antipsychotics

A

Dopamine D2 receptor antagonism

Serotonin 2A receptor antagonism

23
Q

qid 1522

A

large A-a gradient should always be 10

24
Q

why give thiamine with glucose

A

Always give thiamine with glucose > if only glucose you will further deplete thiamine

25
Q

pathophys of photoaging

A

hinning of epidermis and flattening of rete ridges > increased crosslinking of collagen + desiccation of corneum = wrinkles

26
Q

exposure to UVa

A

produces ROS > increased inflammatory receptors and transcription factos > decreased collagen fibril production and increased MMP and collagenase > degradation of type 1 and 3 collagen

27
Q

creatinine as abiomarker

A

Therefore, uncorrected creatinine clearance overestimates the GFR by approximately 10%-20%. Creatinine clearance has further limitations in patients with low muscle mass (eg, malnutrition, lower extremity amputation) or high- or low-protein diets.

28
Q

how would increased cyp metabolism ijncrease bioavaliability drug

A

Enhanced CYP enzyme induction by the blue formulation would cause increased drug metabolism over time as additional enzymes are synthesized, leading to decreased serum drug levels.

29
Q

appearance of a finely granular, diffusely homogeneous, pale eosinophilic cytoplasm ( is what]

hemochromatosis

A

ground glass appearnecegold-yellow hemosiderin granules in the cytoplasm

30
Q

pathophys of dot and flame hemorrhage

A

Severe hypertension in retinal precapillary arterioles causes endothelial disruption, leakage of plasma into the arteriolar wall, and fibrinous necrosis. The necrotic vessels can then bleed into the nerve fiber layers, causing dot- and flame-shaped hemorrhages.

31
Q

pure sensory branch of the medial leg =

A

saphenous nerve

32
Q

osteoporosis in glucortiocids mechanism

A

mechanism of glucorticoids induced osteoporosis

decreased proliferation and differentiation of osteoblast precursor cells.

33
Q

homeobox genes

A

80 nucleotide DNA sequence
• Code for transcription factors that bind to regulatory reions of DNA, altering expression of gene involved with segmental organization of the embryo.
• Hox gene mutation > skeletal malformations and improperly positioned limbs and appendages

34
Q

side effects of antihistamines

A

anticholinergic =glaucoma
alpha blockade=postural hypotension
serotonin blocker= weight gain

35
Q

why coronary vc in cocaine intoxication

why fever

A

Arterial vasoconstriction, including coronary vasoconstriction, is also enhanced (alpha-1 effect), leading to a decrease in myocardial oxygen supply.
impaired heat loss due to peripheral vc

36
Q

how bzd help reduce cocaine symtpoms

A

reduce psymotor agitation,reduce symp outflow

37
Q

PE causes what

A

pulmonary infarction, pleuritic chest pain

38
Q

waht contributes to insulin resistance

A

RAndalls phenomenon

39
Q

Define preclampsia

A

new onset of htn Diastolic>90 or systolic >140

40
Q

classic px of preclampsia

A

headache and visual changes:
dysregulated cerebral blood flow, brain ischemia, and/or capillary leakage resulting in cerebral ed

isual changes include blurry vision, photopsia (seeing “sparks”), and scotomata (partial vision loss [blind spots]) and are due to retinal artery vasospasm and optic nerve ischemia

41
Q

choroidal neovasuclarizaiton

A

typicall y unilateral affects one eye first

42
Q

px of acute glaucoma

A

mid dilated poor light response

43
Q

heamophilis duceryi

A

Multiple & deep ulcers
Base may have gray to yellow exudate
Organisms often clump in long parallel strands (“school of fish”)Multiple & deep ulcers
Base may have gray to yellow exudate
Organisms often clump in long parallel strands (“school of fish”)

44
Q

klebseilla granulomatosis

A

Extensive & progressive ulcerative lesions without lymphadenopathy
Base may have granulation-like tissue
Deeply staining gram-negative intracytoplasmic cysts (Donovan bodies)

45
Q

chalmydia

A

Extensive & progressive ulcerative lesions without lymphadenopathy
Base may have granulation-like tissue
Deeply staining gram-negative intracytoplasmic cysts (Donovan bodies)

46
Q

clinical features of chinkguinya

A

Initial MFx incl self-limited fever, severe polyarthralgia, and rash. Relapsed or chronic arthralgias, polyarthritis (e.g. wrist, fingers, ankles), or tenosynovitis occur in >50% of infected individuals.

47
Q

how do benzos work

A

they work as positive allosteric modulators that promote an increased frequency of channel openings in response to GABA stimulation.

48
Q

what cells predominate in hypersensitivity pneumonitis

A

cd8

49
Q

explain mechanism of levothyroxine

A

levothyroxine is basically T4 so when it is exogenous it is converted by peripheral tissues to t3

50
Q

subclinical thyrodism

A

Subclinical hyperthyroidism is characterized by a mildly suppressed TSH with normal thyroid hormone levels

51
Q

euthyroid sick sydrome

A

euthyroid sick syndrome

hypothyrodid state, normal t4, decrease in t3( because 5 deiodinase fucked) more conversion of t3-rt3

52
Q

what is anaplastic tumor

A

inability to resemble previous tissue

usmle (38 decks)

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