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UWorld Facts > UWorld Facts 1 > Flashcards

UWorld Facts 1 Flashcards

1
Q

Muscles used when sitting up from supine position

A

external abdominal obliques
rectus abdominis
hip flexors: psoas major, psoas minor, iliacus

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2
Q

distal complications of FOOSH

A

dislocation of lunate
fracture of scaphoid
fracture of distal radius

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3
Q

Anterior dislocations of humerus

A

most common shoulder dislocation
get flattening of deltoid
axillary nerve most commonly injured with this - innervates deltoid and teres minor and provides sensation to skin overlying lateral shoulder

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4
Q

Achondroplasia - most common defect

A

activating mutation of FIBROBLAST GROWTH FACTOR RECEPTOR-3 at the epiphyseal growth plate - inhibits growth at epiphyseal growth plate

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5
Q

Churg-Strauss: eosinophilic granulomatosis with polyangiitis

A

small vessel vasculitis

symptoms: asthma, sinusitis, skin nodules or purpura, peripheral neuropathy
antibodies: MPO-ANCA, P-ANCA, increased IgE

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6
Q

Complications of PSORIASIS

A

psoriatic arthritis, uveitis and nail pitting

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7
Q

Osgood-Schlatter disease

A

overuse injury of secondary ossification center (apophysis) of tibia tubercle
pain and swelling over tibia tubercle - insertion point of patellar ligament

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8
Q

Main indicator for total alveolar ventilation

A

PaCO2
if high PaCO2 - hypoventilation
if low PaCO2 - hyperventilation

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9
Q

Most common risk factor for chronic bronchitis

A

Tobacco

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10
Q

Chi-squared test tests for?

A

tests for an association between two CATEGORICAL variables (ex: gender and smoking status)

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11
Q

Fibular neck fractures damage which nerve?

A 
Common peroneal (fibular) nerve 
causes: weakness of dorsiflexion, eversion of foot and loss of sensation of dorsum of foot
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12
Q

Antiphospholipid syndrome - findings

A

elevated aPTT prolongation in vitro BUT cause hyper coagulable state in vivo

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13
Q

Renal clearance increases, decreases or stays unchanged with increasing age?

A

DECREASES - adjust dose of medications

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14
Q

Renal Excretion of X (freely filtered and absorbed) =

A

(GFR)(Plasma concentration of A)-(Tubular reabsorption of substance A)

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15
Q

A-a gradient concentration

A

PAO2 = 150 - (PaCO2)(0.8)

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16
Q

Lithium induced diabetes insipidus

A

Lithium antagonizes ADH in collecting tubules - causes polyuria, polydipsia (cannot decrease urine output even if low volume - i.e. after 8 hours of water restriction)

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17
Q

Hartnup disease

A

defective absorption of TRYPTOPHAN (precursor for serotonin, nicotinic acid and melatonin) —> leads to NIACIN (B3) deficiency —> signs of Pellagra and ataxia

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18
Q

SCID - clinical presentation

A
  • Infections from bacterial, fungi, viruses, opportunistic pathogens
  • Failure to thrive and diarrhea in first year of life
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19
Q

anti-GBM (Goodpasture’s) targets what?

A

alpha-3 chain of collagen type IV

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20
Q

Uremic platelet dysfunction - lab characteristics

A

normal PT, aPTT, platelet count
INCREASED bleeding time
renal dysfunction leads to increased uremic toxins in circulation - toxins impair platelet aggregation and adhesion - QUALITATIVE PLATELET DISORDER - do dialysis to get rid of toxins

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21
Q

Power of study - definition and formula

A 
Power = the ability (probability) of a study to detect a difference between groups when such a difference truly exists 
Power = 1- beta
beta = TYPE II ERROR = probability there is no difference between groups when there is a difference
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22
Q

IgA protease - role

A

cleaves secretory IgA at the hinge region —> facilitates mucosal adherence of bacteria (IgA normally binds and inhibits pili and other cell surface antigens used for adherence and penetration)

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23
Q

Treatment of panic attacks

A

Immediate - benzodiazepines

long term - SSRIs/SNRIs and or cognitive therapy

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24
Q

Phentolamine - class

A

Alpha 1 antagonist - vasodilation (more subcutaneous tissue?)

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25
Q

Bloom syndrome

A
  • mutations in BLM gene encoding HELICASE
  • AR
  • get growth retardation, facial abnormalities, photosensitive skin rash, and immunodeficiency due to chromosomal instability and breakage
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26
Q

DNA polymerase I has _____ exonuclease activity

A

5’—>3’

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27
Q

DNA polymerase III has _____ exonuclease activity

A

3’—>5’

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28
Q

Ehlers Danlos Syndrome - genetic defect

A

Pro-collagen peptidase deficiency —> get impaired cleavage of terminal pro peptides in extracellular space

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29
Q

Ventromedial nucleus of hypothalamus

A

mediates SATIETY - destruction leads to HYPERPHAGIA (always wants to eat)

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30
Q

Lateral nucleus of hypothalamus

A

mediates HUNGER - destruction leads to ANOREXIA

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31
Q

Coronary steal phenomenon

A

blood flow to ischemic areas of heart is decreased due to coronary ARTERIOLAR VASODILATION that brings more blood flow to normal areas of heart and less to ischemic areas

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32
Q

Langerhans cells

A

Dendritic cells in skin

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33
Q

Langerhans cells histiocytosis - hallmarks

A
  • lytic bone lesions

- birbeck granules - tennis rackets

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34
Q

Treatment of insomnia in ELDERLY

A

Ramelteon - Melatonin agonist

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35
Q

Treatment of acute asthma and COPD exacerbations (offers immediate relief)

A

Beta-adrenergic agonists (beta 2) - causes bronchial smooth muscle relaxation via increased intracellular cAMP

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36
Q

Warfarin toxicity treatment

A
  • fresh frozen plasma - contains all blood clotting factors and proteins - IMMEDIATE
  • Vitamin K - takes days
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37
Q

Rodenticides (rat poisoning) causes . . .

A

depletion of Vitamin K clotting factors —> BLEEDING (throw up blood, poop with blood and bruising)

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38
Q

microscopic changes 12-24 hours after ISCHEMIC STROKE

A

RED NEURONS - eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance

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39
Q

Ionizing radiation induces what kind of DNA damage?

A

DNA double stranded breaks (and formation of oxygen free radicals)

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40
Q

Non-ionizing (UV) radiation induces what kind of DNA damage?

A

thymine dimers

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41
Q

Donepezil - class/use

A

Cholinesterase inhibitor

- used in Alzheimer’s disease (ACh which is important for memory and learning is decreased in Alzheimer’s)

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42
Q

Treatment of Alzheimer’s

A
  • Cholinesterase inhibitor (donepezil)
  • Antioxidants (Vit E)
  • NMDA receptor antagonists (memantine)
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43
Q

Osler-Webber-Rendu Syndrome (Hereditary Hemorrhagic Telangiectasia)

A
  • Autosomal dominant
  • disorder of blood vessels - get telangiectasias in skin and mucous membranes
  • nose bleeds, GI bleeds, hematuria
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44
Q

Venous blood content during exercise

A
  • decreased O2 (increased O2 consumption)
  • increased CO2
  • decreased pH
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45
Q

Arterial blood content during exercise

A

O2, CO2 and pH near normal resting values due to homeostatic regulation

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46
Q

Henoch-Schonlein purpura - clinical presentation

A

Skin: purpura on buttocks/legs
Arthralgias - large joints, lower extremitites
GI: abdominal pain

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47
Q

Myasthenia gravis is associated with abnormalities of the ____

A

Thymus

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48
Q

What arises from the 3rd pharyngeal pouch?

A

Thymus and INFERIOR parathyroid glands

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49
Q

Side effects of chochicine

A

diarrhea, abdominal pain, nausea

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50
Q

Acute tubular necrosis most commonly affects which renal structures?

A

Proximal tubules and thick ascending limp of Henle’s loop because participate in active transport of ions and have HIGH OXYGEN DEMAND

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51
Q

Clopidogrel - class/use

A
  • irreversibly blocks P2Y12 component of ADP receptors on platelet surfaces and prevents platelet aggregation
  • use in people with STABLE ANGINA with aspirin allergy to prevent cardiovascular events
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52
Q

Confidence intervals

A

OR/RR - not significant if it includes 1

Mean difference between two groups - not significant if it includes 0

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53
Q

How to treat STATUS EPILEPTICUS

A
  1. IV LORAZEPAM (benodiazepine) - faster onset
  2. Give PHENYTOIN simultaneously to prevent recurrence of seizures - decreases Na current in cortical neurons - inhibit neuronal high-frequecy firing by reducing the ability of Na+ channels to recover from inactivation
  3. If still seizing, give PHENOBARBITAL
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54
Q

Primary amenorrhea - definition

A
  • Absence of menses by age 15 in someone who has normal growth and secondary sex characteristics
  • Absence of menses at age 13 in someone who does not have secondary sex characteristics
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55
Q

Central retinal artery occlusion

A

clinical presentation - sudden, permanent, MONOCULAR blindness
funduscopic exam:
- cherry red macula
- pale retina

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56
Q

Epithelial ovarian cancer - Marker

A

CA-125

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57
Q

Measure of osteoblast activity

A

alkaline phosphatase

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58
Q

Measure of osteoclast activity

A
  • urinary deoxypyridinoline - most reliable
  • urine hydroxyproline
  • tartrate-resistant hydroxyproline
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59
Q

cytoplasmic P bodies

A
  • regulate mRNA translation (represses it) and turnover

- also stores mRNA until ready to be translated

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60
Q

Down syndrome - most common GI abnormality

A

duodenal artresia - “double bubble sign” - dilated stomach and proximal duodenum

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61
Q

Anterior compartment of leg - nerve

A

Deep peroneal nerve

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62
Q

Lateral compartment of leg - nerve

A

Superficial peroneal nerve

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63
Q

Imperforate anus are associated with what other kind of congenital abnormality?

A

Urogenital tract abnormalities

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64
Q

Periodic acid-Schiff stains for what?

A

things with sugar - oxidizes carbon-carbon bonds

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65
Q

metanephric mesoderm gives rise to:

A

glomerulus, bowman’s capsule, proximal tubules, loop of henle and distal convoluted tubules

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66
Q

prophylaxis treatment of MAC (mycobacterium avium complex)

A

Azithromycin

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67
Q

How does citrate acid help prevent calcium stones?

A

binds to FREE CALCIUM —> prevents calcium precipitation and promotes excretion

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68
Q

Multiple myeloma - CRAB

A 
hyperCalcemia
R - renal involvement 
A - anemia 
B - bone lytic lesions/back pain 
Also elevated serum protein from M spike
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69
Q

How does acute ureteral constriction or obstruction affect GFR, RPF and FF?

A 
decreases GFR - greater hydrostatic pressure in Bowman's capsule 
decreases RPF - efferent arteriole constriction due to decreased GFR
decreased FF (GFR/RPF) - GFR repressed to a greater extent that RPF
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70
Q

Renal Blood Flow equation

A 
RBF = (RPF)/(1-Hematocrit) 
RPF = PAH clearance = (Urine flow rate X Urine [PAH])/plasma [PAH]
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71
Q

Paget’s disease is associated with which bone tumor

A

Osteosarcoma

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72
Q

Globus sensation

A
  • feeling of “lump in my throat”: feels like foreign body, tightness or fullness in throat
  • worse when swallowing saliva, better with food or liquid
  • NO ABNORMALITIES ON PHYSICAL, ENDOSCOPIC OR RADIOLOGICAL EXAM
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73
Q

GOUT - synovial fluid findings

A
  • needle shaped crystals
  • NEGATIVELY BIREFRINGENT: yellow and blue
  • neutrophils
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74
Q

Endometriosis

A
  • presence of endometrial glands and stroma outside of the nucleus
  • most common location is the OVARIES —> dysmenorrhea
  • pathology: CHOCOLATE CYSTS
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75
Q

DNA laddering (DNA fragments in multiples of 180 base pairs on gel electrophoresis) is a sensitive indicator of what?

A

APOPTOSIS

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76
Q

Anticholinergic syndrome: side effects of too little cholinergic activity

A

“HOT as a hare, DRY as a bone, RED as a beet, BLIND as a bat, MAD as a hatter”

  • Fever
  • dry skin and mucous membranes
  • flushing
  • blurred vision
  • altered mental status
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77
Q

Presence of AUER RODS signifies which malignancy?

A

Acute myelogenous leukemia (AML)

  • t(15:17)
  • give ALL TRANS RETINOIC ACID
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78
Q

IL-2 is exclusively produced by which cell?

A

T-lymphocytes

- stimulate growth and proliferation of T cells, NK cells, B cells and macrophages

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79
Q

Molluscum contagiosum - clinical presentation

A

FLESH-COLORED PAPULES with UMBILICATED CENTERS on skin and mucosal membranes

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80
Q

Post partum endometritis

A
  • polymicrobial uterine infection
  • clinical presentation: fever, uterine tenderness, foul smelling vaginal discharge, leukocytosis
  • risk factors: C-SECTION (most important), prolonged labor, preterm, etc
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81
Q

Craniopharyngioma causes which kind of visual defect?

A

biTEMPORAL hemianopia - compresses OPTIC CHIASM

82
Q

Benefits of splenectomy in hereditary spherocytosis

A

DECREASES CELL TRAPPING AND HEMOLYSIS IN SPLEEN

  • improves anemia
  • decreases jaundice
  • decreases incidence of bilirubin gallstones
83
Q

Phenoxybenzamine - class

A

IRREVERSIBLE, long acting alpha adrenergic blocker

84
Q

Side effects of cisplatin/carboplatin (chemotherapy agents)

A
  • ototoxicity

- nephrotoxicity

85
Q

Misoprostol - class, use

A

PGE1 (prostaglandin) analog, binds to membrane prostaglandin receptors

  • stimulates mucous secretion and decrease parietal cell acid secretion
  • used to prevent and treat NSAID induced peptic ulcers
  • PGE1 helps maintain the mucosal lining of GI
86
Q

Palmitoylation

A

Process in which protein receptor carboxyl tails are anchored to cysteine residues in plasma membrane —> increases hydrophobicity of protein

87
Q

Allelic heterogeneity

A

Different mutations in SAME GENE cause similar phenotypes

88
Q

Montelukast - class, use

A
  • Blocks leukotriene receptors

- good for asthma

89
Q

Skin infection with yellow “honey” crust - disease, bugs

A

IMPETIGO

  • staph aureus: bullae can form due to toxin production
  • strep pyogenes
90
Q

Burton agammaglobulinemia

A
  • X-linked disorder that results in a defective Burton TYROSINE KINASE
  • without the signaling, B cells cannot exit the bone marrow to enter circulation —> antibodies are not produced —> INFECTIONS!
  • See normal number of T cells but low B cells
91
Q

Maple syrup urine disease - enzyme deficiency

A

branched chain alpha-keto acid dehydrogenase complex

- need Thiamine (B1) as cofactor

92
Q

Enzymes that need thiamine (B1) as cofactor

A
  • branched chain alpha-keto acid dehydrogenase complex (MSUD)
  • thioketolase
93
Q

Red safarin O stains for?

A

Collagen, mast cell granules and mucin

94
Q

Glucagon is coupled to which receptor?

A

Gs

95
Q

Insulin is coupled to which receptor?

A

tyrosine kinase

96
Q

Diagnosis of catecholamine-producing tumors (pheochromocytomas and paraganglioma)

A
  • increased urine METANEPHRINE AND NORMETANEPHRINE —> increased urine vanillylmandelic acid
97
Q

How does an increase in enzyme affects Vmax and Km?

A
  • increases Vmax

- same Km (affinity for substrate)

98
Q

Risks for osteoarthritis

A
  • AGE: most important

- obesity, female sex, occupational joint loading, past trauma and abnormal joint alignment

99
Q

How to treat carcinoid tumor

A

OCTREOTIDE - somatostatin analog, inhibits release of bioactive peptides by the carcinoid tumor

100
Q

Thiazolidinediones - class, action

A

Oral ANTIDIABETIC medication

  • decrease insulin resistance by increasing transcription of insulin responsive genes
  • Glucose transporter 4: increases glucose transport into cells
  • adiponectin
101
Q

Crohns disease

A
  • involves TERMINAL ILEUM

- abdominal pain, fever, diarrhea, APHTHOUS ULCERS ON MOUTH and PERIANAL DISEASE

102
Q

CIMETIDINE - affect on CYP450

A

INHIBITS CYP450 - decreases metabolism

103
Q

Treatment of hepatic encephalopathy

A

want to acidify the intestinal contents
use LACTULOSE
- nonabsorbable disaccharide that is degraded by colonic bacteria to form lactic acid and acetic acid
- GI contents becomes ACIDIFIED and ammonia (NH3) is converted to ammonium (NH4+)

104
Q

Papillomaviruses - structure

A

small, non enveloped, icosohedral viruses with double stranded DNA genomes

105
Q

Which nerve fibers are unmyelinated?

A
  • POSTganglionic autonomic nervous system axons

- Primary sensory afferent nerve fibers responsible for slow pain, heat sensation and olfaction

106
Q

Reiter syndrome

A

reactive arthritis, urethritis and conjunctivitis (can’t see, can’t pee, can’t climb tree)
- caused by IMMUNE COMPLEXES involving bacterial antigens, not disseminated infection

107
Q

Prader- Willi - etiology, clinical symptoms

A
  • etiology: loss of PATERNALLY inherited genes from chrm 15 due to: paternal micro deletion or maternal uniparental disomy (both chrms from mom)
  • clinical symptoms: neonatal HYPOTONIA, HYPERPHAGIA, HYOGONADISM
108
Q

Angelmans - etiology, clinical symptoms

A
  • etiology: loss of MATERNALLY inherited genes from chm 15 due to: maternal microdeletion or paternal uniparental disomy (both chrms from dad)
  • clinical symptoms: epilepsy/seizures, ataxic gain/tremor, INAPPROPRIATE LAUGHTER/SMILING
109
Q

Varicoceles

A
  • dilations of spermatic vein pampiniform plexus
  • more common on L side: longer vein, higher pressure
  • ENLARGE WITH STANDING, REGRESS WITH LYING DOWN (blood returns to systemic circulation)
110
Q

Associations with acanthosis nigricans

A
  • benign: insulin resistance, obesity

- malignant: cancer in GI tract or lungs if appear suddenly and spread quickly

111
Q

Treatment of prostate cancer

A
  • surgery

- androgen deprivation therapy (ex: leuprolide) —> decrease testosterone

112
Q

Leuprolide: MOA, use

A
  • GnRH analog: continuous stimulation decreases LH and decreases testosterone production in Leydig cells
  • used in prostate cancer, precocious puberty and endometriosis
113
Q

Gaucher disease - enzyme deficiency

A

beta-glucocerebrosidase - glucocerebroside accumulates

114
Q

Gaucher disease - distinguishing features

A
  • “wrinkled tissue paper” on electron microscopy
  • heptosplenomegaly —> breaks down blood —> pancytopenia
  • bone pain/osteopenia
115
Q

Anti-TNF-alpha agents are:

A
  • infliximab: monoclonal AB to TNF-alpha

- etanercept: a recombinant TNF receptor fusion protein

116
Q

FSGS is associated with?

A

HIV, heroin use and sickle cell disease

117
Q

Collapsing glomerulopathy

A
  • a variant of FSGS with poor prognosis
  • characteristic of HIV-associted nephropathy
  • typical FSGS lesions with collapse and sclerosis of whole glomerular tuft
118
Q

Hand-foot-genital syndrome

A
  • mutation: HOXA13 - homeobox gene
  • clinical presentation: distal limb defects (HYPOPLASTIC FIRST DIGITS) and genitourinary malformations (MULLERIAN FUSION ABNORMALITES —> miscarriages)
119
Q

Metastasis from stomach cancers involve which lymph node?

A

Left supraclavicular lymph node - VIRCHOW’S NODE

120
Q

Vascular invasion is associated with which organism?

A

Aspergillus

121
Q

Affects of liver failure and portal hypertension on SPLEEN

A
  • causes congestion of blood in spleen (splenic vein drains into portal system) —> ENLARGED SPLEEN from expansion of RED PULP
122
Q

Superficial inguinal ring is formed by?

A

External oblique aponeurosis

123
Q

Deep inguinal ring is formed by?

A

Transversalis fascia

124
Q

Route of descent for testes

A

Descend through scrotum by passing through the DEEP inguinal ring to INGUINAL CANAL and then through SUPERFICIAL inguinal ring to exit canal

125
Q

Gingivostomatitis

A
  • HSV-1 infection
  • 6 months to 5 years of age
  • starts with fever, malaise, chills
  • then get PAINFUL vesicles on lips and gingiva, palate, tongue or oropharynx —> can form ulcers and then resolve
126
Q

Which hormone prevents lactation in pregnancy?

A

Prolactin

- decreases after pregnancy and allows prolactin to stimulate lactation

127
Q

Why is essential fructosuria (fructokinase deficiency) benign?

A

Because fructose can be metabolized by HEXOKINASE to yield glucose-6-phosphate that enters the glycolysis cycle

128
Q

Pathophys of diabetic neuropathy

A
  1. Non enzymatic glycosylation of proteins
    - leads to increased thickness, hyalinization and narrowing of walls of arteries —> get ischemic damage to nerves
  2. Osmotic damage due to sorbitol accusation from excess glucose —> water influx —> damages axons and schwann cells
    - glucose is broken down to sorbitol by aldolase reductase, then to fructose by sorbitol dehydrogenase
129
Q

Amino acids in collagen

A
  • alpha chains are made up of repeating Gly-X-Y sequence
  • Glycine: most abundant
  • X = proline usually: induces kinks in structure increasing rigidity of helical structure
  • Y = hydroxyproline or hydroxylysine: hydroxylysine contributes to the TENSILE strength of collagen
130
Q

Damage to supraspinatus muscle/tendon leads to pain with which arm movement?

A

ABduction

131
Q

What is the most common injury to the rotator cuff?

A

Injury to tendon of supraspinatus muscle —> impairs ABduction of arm

132
Q

Communicating Hydrocele (congenital)

A

Benign PAINLESS swelling of scrotum

  • have patent processus vaginalis —> fluid from peritoneum accumulates in the TUNICA VAGINALIS
  • get transilluminating swelling
  • common in infants
133
Q

Acquired hydrocele

A

Benign swelling of scrotum secondary to trauma, tumor and infection

134
Q

Second gen antipsychotics - side effects

A

Metabolic adverse effects

  • weight gain, dyslipidemia, hyperglycemia, increased risk of diabetes
  • require routine monitoring of metabolic parameters
  • worse with Clozapine and Olanzapine
135
Q

Etanercept - class, use

A

TNF-alpha inhibitor: acts as decoy receptor to reduce activity of TNF-alpha
- used in RA in patients who have failed methotrexate therapy

136
Q
  • mab
A

Monoclonal antibody

137
Q
  • nib
A

kinase inhibitor

138
Q
  • cept
A

receptor molecule

139
Q

Pterion

A

Where frontal, temporal, parietal, and sphenoid bones meet

140
Q

Middle meningeal artery is a branch of which artery and enters the brain in which foramen?

A

Maxillary artery, enters in foramen spinosum

141
Q

Prophylaxis agents for N. meningitidis

A

Rifampin (most common), ciprofloxacin and IM ceftriaxone
- need to do antibiotic chemoprophylaxis to close contacts because spread through respiratory secretions or aerosolized droplets and disease can be fast onset

142
Q

Causes of bloody discharge from nipple:

A
  • Intraductal PAPILLOMA: most common

- CARCINOMA

143
Q

Haloperidol, Fluphenazine - class

A

HIGH dose first gen antipsychotics

- associated with more extrapyramidal side effects due to potent D2 antagonism

144
Q

Chlorpormazine, Thioridazine - class

A

LOW dose first gen antipsychotics
- associated with side effects due to histaminergic (sedation), cholinergic (anticholinergic) and noradrenergic blockade (orthostatic hypotension)

145
Q

Phenelzine - class

A

MOAI - monoamine oxidase inhibitor: inhibits oxidative deamination (degradation) of serotonin, NE and dopamine

146
Q

MOAI - use

A

Treatment resistant depression and ATYPICAL depression

147
Q

Treacher Collins syndrome

A
  • abnormal development of first and second pharyngeal arches

- have craniofacial abnormalities and conductive hearing loss

148
Q

Flucytosine - class, MOA

A

Antifungal

  • inhibits synthesis of both DNA and RNA in fungi
  • used mainly as synergistic agent with amphotercin B
149
Q

Caspofungin - class, MOA

A

Antifungal

- block polysaccharide synthesis needed for fungal cell wall

150
Q

Griseofluvin - class, MOA

A

Antifungal

- enters cells and binds microtubules, inhibiting mitosis

151
Q

Consequence of prostatectomy

A

Erectile dysfunction

  • prostatic plexus lies within the prostatic fascia and innervates corpus cavernosa of penis which facilitates penile erection
  • can damage the post-ganglionic parasympathetic nerves
152
Q

Cardiac tamponade - clinical findings

A

Cardiac tamponade = compression of heart by fluid

  • see Beck triad: distended neck veins (JVD), distant heart sounds and hypotension
  • increased HR
  • pulsus paradoxus: decreased systolic BP > 10 mmHg during inspiration
153
Q

Phospholipase C is part of which pathway?

A

Gq pathway: hydrolyzes PIP2 to yield IP3 and DAG

154
Q

Pseudogout

A
  • commonly involves knee

- crystals: RHOMBOID shaped made up of CALCIUM PYROPHOSPATE, POSITIVELY birefringent ( opposite of gout)

155
Q

Organisms resistant for Cephalosporins

A
  • Resistant penicillin binding proteins: Listeria, MRSA, enterococci
  • No cell wall: Mycoplasma, chlamydia
156
Q

What to use to treat Listeria

A

Ampicillin in kids, immunocompromised (gastroenteritis is usually self limited)

157
Q

Which muscle is most important for achievement in Valsalva maneuver?

A

Rectus abdominis: needed to achieve intraabdominal and intrathoracic pressure of Valsalva maneuver

158
Q

Inferior colliculi and medial geniculate body is associated with which sense?

A

Auditory

159
Q

Lateral geniculate body is associated with which sense?

A

Vision

160
Q

Xeroderma Pigmentosum - pathyphys

A
  • AR mode of inheritance
  • defect in nucleotide excision repair (usually deficient ENDOnuclease) —> very sensitive to UV damage —> hyper pigmentation, increased susceptibility to skin cancer
161
Q

Hairy cell leukemia

A
  • indolent B cell neoplasm
  • Middle aged men
  • bone marrow failure —> PANCYTOPENIA —> DRY TAP
  • extramedullary hematopoesis —> SPLENOMEGALY
  • TRAP positive
162
Q

Treatment of bulimia

A
  • SSRI: First line! - Fluoxetine
  • Nutritional rehabilitation
  • Cognitive behavior therapy
    Note: Pharmacotherapy is not first line for anorexia
163
Q

DRESS syndrome - drug reaction with eosinophilia and systemic symptoms

A
  • 2-8 weeks after exposure to high risk drugs: anticonvulsants, allopurinol, sulfonamides, and antibiotics
  • get fever, lymphadenopathy, facial edema, diffuse skin rash, eosinophilia, and internal organ dysfunction
164
Q

Accessory nipple: cause

A

Failure of mammary ridge to involute

165
Q

Parvovirus B19 - main clinical presentation in kids and adults

A

Kids: erythemia infectiosum (fifth disease) - bright red rash on cheeks
Adults: acute arthritis - involves hands, knees, ankles, wrists

166
Q

Tryptase

A
  • enzyme that is specific to MAST CELLS

- increased serum levels seen in anaphylaxis

167
Q

What triggers vasoactive substance release from mast cells and basophils?

A

AGGREGATION of IgE receptors on surface
- Multivalent antigen binds multiple IgE —> become cross-linked —> IgE receptors aggregate —> activate non-receptor tyrosine kinases —> trigger intracellular cascade that leads to mast cell and basophil degranulation

168
Q

What do you use for a measurement in cohort studies (retrospective or prospective study)?

A

RR

169
Q

What do you use for a measurement in case-control studies?

A

OR

170
Q

Derivatives of POMC

A

POMC = propionmelanocortin

- enzymatic cleavage of POMC yields beta-endorphins, ACTH and MSH

171
Q

Effects of glucagon injection

A
  • increases HEPATIC gluconeogenesis and glyogenolysis

- stimulates insulin release from pancreas

172
Q

Effects of Epi on glucose homeostatsis

A

Has effect on skeletal muscle, kidneys and adipose tissue

  • skeletal muscle: decreases glucose uptake, increases alanine release which is a source of gluconeogenesis in liver
  • renal cortex: increases gluconeogenesis
  • adipose tissue: promotes breakdown of triglycerides —> yields fatty acids and glycerol for gluconeogenesis
173
Q

Temporal (Giant) Cell Arteritis - Marker of severity

A

IL-6

174
Q

Cause of BICORNUATE uterus

A

Incomplete lateral fusion of Paramesonephric ducts

  • get abnormal uterine contour
  • indentation in center of fundus
175
Q

B12 deficiency - spinal cord lesion symptoms

A

Subacute combined degeneration

  • dorsal column: bilateral loss of position and vibration sense, sensory ataxia
  • lateral corticospinal tracts: UMN lesion
  • axon degeneration of peripheral nerves: numbness or paresthesias
176
Q

Lacunar infarctions

A
  • SMALL VESSEL occlusions in DEEP STRUCTURES

- are small, cavitary lesions

177
Q

Cushing triad

A
  • Bradycardia
  • Bradypnea
  • Hypertension
178
Q

Side effects of chronic TOPICAL corticosteroid use

A

DERMAL ATROPHY

  • drug decreases production of extracellular matrix collagen and glycosaminoglycans
  • get loss of dermal collagen, drying, cracking, and/or tightening of skin
179
Q

Cancers associated with Dermatomyositis

A

Ovarian, colorectal and lung cancers

180
Q

Clue cells seen on PAP smear is indicative of?

A

Gardnerella vaginosis

181
Q

Koilocytes seen on PAP smear is indicative of?

A

HPV infection

182
Q

Adenomyosis

A
  • presence of endometrial glandular tissue within myometrium
  • heavy menstrual bleeding and dysmenorrhea
  • UNIFORMLY enlarged uterus with normal appearing endometrial tissue
183
Q

Polyenes: drug names and MOA

A
  • Amphotercin B (systemic) and nystatin (topical)

- bind to ergosterol molecules, creating pores and causing lysis

184
Q

Triazoles: MOA

A
  • inhibit synthesis of ergosterol
185
Q

Echinocandins: drug names and MOA

A
  • capsofungin and micafungin

- inhibit synthesis of GLUCAN, a component of fungal cell wall

186
Q

Pyrimidines: drug names, MOA

A
  • Flucytosine

- converted to 5-fluorouracil within fungal cell wall and interferes with fungal RNA and protein synthesis

187
Q

Griseofluvin - MOA

A
  • antifungal

- interacts with fungal MT, inhibiting mitosis

188
Q

Most common source of bleeding for epistaxis (nose bleeds)

A

Kiesselbach plexus in ANTERIOR nasal septum: where ethmoidal, sphenopalantine, and superior labial arteries anastomose

189
Q

Germinoma

A
  • Pineal gland tumor
  • obstructive hydrocephalus: papilledema, headache, vomitting
  • dorsal midbrain (Parinaud) syndrome: paralysis of upward gaze, ptosis and pupillary abnormalities
190
Q

Lesions in temporal lobe produces what kind of vision defect?

A

Affects Meyer’s loop —> get contralateral superior quandrantanopia

191
Q

Which hormone should be monitored after COMPLETE hydatidiform mole?

A

beta-HCG due to significant risk of malignant transformation - persistently elevated or rising levels may signify development of invasive mole or choriocarcinoma

192
Q

Most common cause of subarachnoid hemorrhages

A

Saccular (berry) hemorrhages

193
Q

Signs of marijuana intoxication

A
  • conjunctival injection (red eyes)
  • tachycardia
  • increased appetite
  • dry mouth
194
Q

Injection to superomedial part of the buttock risks injury to which nerve?

A

Superior gluteal nerve - can cause Trendelenburg gait

195
Q

Injection to superolateral, inferomedial, and inferolateral parts of buttock risks injury to which nerve?

A

Sciatic nerve

196
Q

Beta blockers and diabetics

A
  • Avoid using non-selective beta blockers: inhibit Epi compensatory mechanisms for hypoglycemia, beta 2 inhibits hepatic gluconeogenesis and peripheral glycogenolysis and lipolysis
  • Use beta-1 blockers instead if needed
197
Q

Transference - definition

A

Unconscious shifting of emotions or desires associated with a person of the PAST to a person of the PRESENT

198
Q

Reactive arthritis

A
  • ASYMMETRIC arthritis of LARGE joints following infection (chlamydia, campylobacter, shigella, salmonella, yersinia, or bartonella)
  • HLA-B27 positive individuals
  • Joint aspirates are STERILE (not infectious, is reactive)
199
Q

Interferon alpha and gamma - role in viral infection

A
  • produced by VIRUS-infected cells
  • bind to type I interferon receptors on neighboring cells —> get transcription of antiviral enzymes that HALT PROTEIN SYNTHESIS
  • enzymes only active when cells are infected so “primes” cells for viral defense
200
Q

Antibody in CREST syndrome

A

Anti-centromere

UWorld Facts (12 decks)

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