Uworld discreet facts Flashcards
What clotting factors are in fresh frozen plasma?
all coal factors and other proteins: Factors II, VII, IX, X
used in the warfarin (or rodenticide) toxicity
Vitamin K given in warfarin toxicity when
PTT and PT are prolonged but no bleeding
Coag factors in cryoprecipitate?
Factors VIII, XIII, vWF, fibrinogen
Why is desmopressin used in the context of hemophilia A or von willebrand disease?
It increases plasma levels of vWF and Factor VIII
What is a common finding in gallstone lieus (mechanical obstruction of cholesterol gallstone that erode into the intestinal lumen?)
Pneumobilia (air in the biliary tract)
What adrenergic receptor when stimulated inhibits uterine contractions?
Beta 2
Drugs: Isoproterenol, Terbutaline, Ritodrine
flow of fetal circulation
umbilical vein–>liver–>inferior vena cava–>heart–>pulm/shunted to the left side via foramen ovale–>some might bypass the pulm circuit via shunting through the ductus arteriosus then go into the descending aorta–>
What does the prenatal quadruple test consist of
alpha fetoprotein
unconjugated estriol
beta-hCG
Inhibin A
When do you see an increase in alpha fetoprotein on a prenatal quadruple test?
Open neural tube defects
ventral wall defects
multiple gestation
Decrease in alpha fetoprotein is see in
Aneuploidies–>Trisomy 21
Decerebrate posturing is from damage at or below the level of the
red nucleus (midbrain tegmentum, pons) because the red nucleus controls the flexors so a lesion here would cause the vestibulospinal tract to dominate (this means the extensors predominate)
Decorticate is from
a lesion above the red nucleus in the cerebral cortex or the internal capsule causes decorticate posturing because that usually inhibits the red nucleus so flexors and extensors predominate and the arms curl up
Where does DNA ligase exert the most work?
On the Okazaki fragments to join the gaps together, also requires repetitive action of the DNA primase to start and stop the segmental joining
Someone withdrawing who is yawning a lot w/ lacrimation and dilated pupils is withdrawing from
heroin
PCP is a NMDA agonist or antagonist
NMDA antagonist
NMDA agonists
glutamate, aspartate, D-cycloserine
Acetylcholine, shear stress, and bradykinin exerted on the vascular endothelium leads to increased
increased calcium which increases eNOS which facilitates Arginine and oxygen to be converted to NO and citrulline. The NO dissipates into the smooth muscle and causes guanylate cyclase to convert GTP into cGMP this dissipates into the vascular lumen to cause vasodilation
Rinne test where you bang the tuning fork and place it behind the ear and then in front of the acoustic meatus is normal when which sound is detected?
When you bring the tuning fork off the bone and close to the ear and the person can still hear it despite not being able to hear it on the mastoid–> that is normal. If you can’t hear it in front of your ear then you have conductive hearing loss. if you can’t hear it on the bone it is sensorneural
The Weber test lateralizes sensorineural hearing loss to the unaffected ear and conductive hearing loss to the
affected ear because the conductive hearing loss makes it so that you can’t hear the ambient room noise so you hear the tuning fork on your head best.
What immune cells are in the :
paracortical
germinal center
paracortical: dendritic cells and T cells
germinal centers and primary lymphoid follicles: mature B cells
What must be ligated to prevent excessive bleeding of the ovary during an oophorectomy
The suspensory ligament of the ovary. The ureter is close to this ligament and must be identified before ligation.
Which cholesterol drug lowers LDL significantly?
statins
which cholesterol drug lowers serum triglycerides significantly
Fibrates (fenofibrate, gemfibrozil) PPARgamma activators
mainly used to prevent pancreatitis
most effective at Increasing HDL
Niacin (B3)
associated with hyperglycemia and flushing
usually used when other drugs have failed
slight decrease in LDL by inhibiting cholesterol uptake in the GI tract
Exetimibe
used in patients who can’t take statins because of hepatotoxicity or myopathy or who have high levels of LDL despite statin tx
exercise and weight loss has its main effect on what aspect of lipid lowering
Triglycerides
Cationic exchange resins used in the tx of cholesterol lowering interfere with
enterohepatic circulation of bile acids
Meyer’s loop (damage to is can cause upper quadrantanopia) is located in the
temporal lobe
The optic tract synapse in the ______ but also projects to the
Lateral geniculate nucleus and then go on to the meyer’s loop and the dorsal optic radiation
Also projects to the superior colliculus for reflex gaze
pretectal area for light reflex
suprachiasmatic nucleus to regulate circadian rhythm
beta blockers decrease blood pressure via the kidneys via
blocking renin release
stages of lyme disease
Early localized phase days to weeks following exposure–flu-like symptoms and target lesion
Early disseminated phase: weeks of months later, CNS (facial palsy), cardiac block (AV nodal block)
Late lyme disease: months to years; asymmetric arthritis, encephalopathy (decreased memory, somnolence, mood changes)
Tx of lyme disease
Doxycycline or ceftriaxone
Where does the facial nerve (CNVII) exit
Stylomastoid foramen
A tumor of the parotid would cause facial drooping because
It could impinge upon the motor nerve CN VII
Branches of the facial nerve
Temporal, zygomatic, buccal, mandibular, cervical
Psoriasis is associated with
nail pitting
psoriatic arthritis
In psoriasis there is an increased in and decrease in stratum ________
Increase in stratum corneum
Decrease in stratum Granulosum
there are still nuclei within the stratum corneum; acanthosis w/ parakeratotic scaling, munro microabscesses.
single layer of epithelial cells with cavernous blood filled vascular spaces
the most common benign liver tumor–> cavernous hemangioma
which vessels are spared in the small to medium vessel vasculitis polyarteritis nodosa?
Pulmonary arteries and bronchial arteries
segmental, transmural, necrotizing inflammation of the arteries
Kidneys, heart, liver GI typically affected and pt/s present with livedo reticularis purplish network of discoloration
synaptophysin is found in
transmembrane glycoprotein found on presynaptic neurons, neuroendocrine, neuroectodermal cells
GFAP positive brain neoplasms
Astrocytomas, oligodendrogliomas, ependymomas (gliomas)
Brain tumors of adults vs children
adults= supratentorial (above the cerebellum) children= below the tentorium (below the cerebellum)
types of kidney stones
calcium oxalate, phosphate
Magnesium Ammonium Phosphate
Uric Acid
Cystine
octahedron kidney stones
calcium oxalate, phosphate
Kidney stones that are elongated, wedge shaped, form rosettes
calcium phosphate
Kidney stones that are rectangular, form coffin lids
Magnesium ammonium phosphate (struvite or triple phosphate)
Yellow or red-brown, rhombus/diamond
uric acid
cystine
flat, yellow, hexagonal
test to detect the presence of urinary cystine (other dibasic amino acids such as lysine, ornithine and arginine are soluble in urine and don’t form crystals)
this will detect aminoaciduria and the test is sodium cyanide-nitroprusside
Treatment of cystinuria
Acetazolamide–>alkalinizing the urine
hypercalciuria can be from
sarcoidosis
hyperoxaluria can be from
Crohn’s disease
hyperuricosuria can be from
Gout
Hypocitraturia can be from
distal renal tubular acidosis
confirmatory test for Type I diabetes mellitus
Fasting glucose or HgbA1C
