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
2
Q
distal complications of FOOSH
A
dislocation of lunate
fracture of scaphoid
fracture of distal radius
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
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
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
6
Q
Complications of PSORIASIS
A
psoriatic arthritis, uveitis and nail pitting
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
8
Q
Main indicator for total alveolar ventilation
A
PaCO2
if high PaCO2 - hypoventilation
if low PaCO2 - hyperventilation
9
Q
Most common risk factor for chronic bronchitis
A
Tobacco
10
Q
Chi-squared test tests for?
A
tests for an association between two CATEGORICAL variables (ex: gender and smoking status)
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
12
Q
Antiphospholipid syndrome - findings
A
elevated aPTT prolongation in vitro BUT cause hyper coagulable state in vivo
13
Q
Renal clearance increases, decreases or stays unchanged with increasing age?
A
DECREASES - adjust dose of medications
14
Q
Renal Excretion of X (freely filtered and absorbed) =
A
(GFR)(Plasma concentration of A)-(Tubular reabsorption of substance A)
15
Q
A-a gradient concentration
A
PAO2 = 150 - (PaCO2)(0.8)
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)
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
18
Q
SCID - clinical presentation
A
- Infections from bacterial, fungi, viruses, opportunistic pathogens
- Failure to thrive and diarrhea in first year of life
19
Q
anti-GBM (Goodpasture’s) targets what?
A
alpha-3 chain of collagen type IV
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
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
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)
23
Q
Treatment of panic attacks
A
Immediate - benzodiazepines
long term - SSRIs/SNRIs and or cognitive therapy
24
Q
Phentolamine - class
A
Alpha 1 antagonist - vasodilation (more subcutaneous tissue?)
25
Bloom syndrome
- mutations in BLM gene encoding HELICASE
- AR
- get growth retardation, facial abnormalities, photosensitive skin rash, and immunodeficiency due to chromosomal instability and breakage
26
DNA polymerase I has _____ exonuclease activity
5'—>3'
27
DNA polymerase III has _____ exonuclease activity
3'—>5'
28
Ehlers Danlos Syndrome - genetic defect
Pro-collagen peptidase deficiency —> get impaired cleavage of terminal pro peptides in extracellular space
29
Ventromedial nucleus of hypothalamus
mediates SATIETY - destruction leads to HYPERPHAGIA (always wants to eat)
30
Lateral nucleus of hypothalamus
mediates HUNGER - destruction leads to ANOREXIA
31
Coronary steal phenomenon
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
32
Langerhans cells
Dendritic cells in skin
33
Langerhans cells histiocytosis - hallmarks
- lytic bone lesions
| - birbeck granules - tennis rackets
34
Treatment of insomnia in ELDERLY
Ramelteon - Melatonin agonist
35
Treatment of acute asthma and COPD exacerbations (offers immediate relief)
Beta-adrenergic agonists (beta 2) - causes bronchial smooth muscle relaxation via increased intracellular cAMP
36
Warfarin toxicity treatment
- fresh frozen plasma - contains all blood clotting factors and proteins - IMMEDIATE
- Vitamin K - takes days
37
Rodenticides (rat poisoning) causes . . .
depletion of Vitamin K clotting factors —> BLEEDING (throw up blood, poop with blood and bruising)
38
microscopic changes 12-24 hours after ISCHEMIC STROKE
RED NEURONS - eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance
39
Ionizing radiation induces what kind of DNA damage?
DNA double stranded breaks (and formation of oxygen free radicals)
40
Non-ionizing (UV) radiation induces what kind of DNA damage?
thymine dimers
41
Donepezil - class/use
Cholinesterase inhibitor
| - used in Alzheimer's disease (ACh which is important for memory and learning is decreased in Alzheimer's)
42
Treatment of Alzheimer's
- Cholinesterase inhibitor (donepezil)
- Antioxidants (Vit E)
- NMDA receptor antagonists (memantine)
43
Osler-Webber-Rendu Syndrome (Hereditary Hemorrhagic Telangiectasia)
- Autosomal dominant
- disorder of blood vessels - get telangiectasias in skin and mucous membranes
- nose bleeds, GI bleeds, hematuria
44
Venous blood content during exercise
- decreased O2 (increased O2 consumption)
- increased CO2
- decreased pH
45
Arterial blood content during exercise
O2, CO2 and pH near normal resting values due to homeostatic regulation
46
Henoch-Schonlein purpura - clinical presentation
Skin: purpura on buttocks/legs
Arthralgias - large joints, lower extremitites
GI: abdominal pain
47
Myasthenia gravis is associated with abnormalities of the ____
Thymus
48
What arises from the 3rd pharyngeal pouch?
Thymus and INFERIOR parathyroid glands
49
Side effects of chochicine
diarrhea, abdominal pain, nausea
50
Acute tubular necrosis most commonly affects which renal structures?
Proximal tubules and thick ascending limp of Henle's loop because participate in active transport of ions and have HIGH OXYGEN DEMAND
51
Clopidogrel - class/use
- 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
52
Confidence intervals
OR/RR - not significant if it includes 1
| Mean difference between two groups - not significant if it includes 0
53
How to treat STATUS EPILEPTICUS
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
54
Primary amenorrhea - definition
- 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
55
Central retinal artery occlusion
clinical presentation - sudden, permanent, MONOCULAR blindness
funduscopic exam:
- cherry red macula
- pale retina
56
Epithelial ovarian cancer - Marker
CA-125
57
Measure of osteoblast activity
alkaline phosphatase
58
Measure of osteoclast activity
- urinary deoxypyridinoline - most reliable
- urine hydroxyproline
- tartrate-resistant hydroxyproline
59
cytoplasmic P bodies
- regulate mRNA translation (represses it) and turnover
| - also stores mRNA until ready to be translated
60
Down syndrome - most common GI abnormality
duodenal artresia - "double bubble sign" - dilated stomach and proximal duodenum
61
Anterior compartment of leg - nerve
Deep peroneal nerve
62
Lateral compartment of leg - nerve
Superficial peroneal nerve
63
Imperforate anus are associated with what other kind of congenital abnormality?
Urogenital tract abnormalities
64
Periodic acid-Schiff stains for what?
things with sugar - oxidizes carbon-carbon bonds
65
metanephric mesoderm gives rise to:
glomerulus, bowman's capsule, proximal tubules, loop of henle and distal convoluted tubules
66
prophylaxis treatment of MAC (mycobacterium avium complex)
Azithromycin
67
How does citrate acid help prevent calcium stones?
binds to FREE CALCIUM —> prevents calcium precipitation and promotes excretion
68
Multiple myeloma - CRAB
```
hyperCalcemia
R - renal involvement
A - anemia
B - bone lytic lesions/back pain
Also elevated serum protein from M spike
```
69
How does acute ureteral constriction or obstruction affect GFR, RPF and FF?
```
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
```
70
Renal Blood Flow equation
```
RBF = (RPF)/(1-Hematocrit)
RPF = PAH clearance = (Urine flow rate X Urine [PAH])/plasma [PAH]
```
71
Paget's disease is associated with which bone tumor
Osteosarcoma
72
Globus sensation
- 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
73
GOUT - synovial fluid findings
- needle shaped crystals
- NEGATIVELY BIREFRINGENT: yellow and blue
- neutrophils
74
Endometriosis
- presence of endometrial glands and stroma outside of the nucleus
- most common location is the OVARIES —> dysmenorrhea
- pathology: CHOCOLATE CYSTS
75
DNA laddering (DNA fragments in multiples of 180 base pairs on gel electrophoresis) is a sensitive indicator of what?
APOPTOSIS
76
Anticholinergic syndrome: side effects of too little cholinergic activity
"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
77
Presence of AUER RODS signifies which malignancy?
Acute myelogenous leukemia (AML)
- t(15:17)
- give ALL TRANS RETINOIC ACID
78
IL-2 is exclusively produced by which cell?
T-lymphocytes
| - stimulate growth and proliferation of T cells, NK cells, B cells and macrophages
79
Molluscum contagiosum - clinical presentation
FLESH-COLORED PAPULES with UMBILICATED CENTERS on skin and mucosal membranes
80
Post partum endometritis
- polymicrobial uterine infection
- clinical presentation: fever, uterine tenderness, foul smelling vaginal discharge, leukocytosis
- risk factors: C-SECTION (most important), prolonged labor, preterm, etc
81
Craniopharyngioma causes which kind of visual defect?
biTEMPORAL hemianopia - compresses OPTIC CHIASM
82
Benefits of splenectomy in hereditary spherocytosis
DECREASES CELL TRAPPING AND HEMOLYSIS IN SPLEEN
- improves anemia
- decreases jaundice
- decreases incidence of bilirubin gallstones
83
Phenoxybenzamine - class
IRREVERSIBLE, long acting alpha adrenergic blocker
84
Side effects of cisplatin/carboplatin (chemotherapy agents)
- ototoxicity
| - nephrotoxicity
85
Misoprostol - class, use
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
Palmitoylation
Process in which protein receptor carboxyl tails are anchored to cysteine residues in plasma membrane —> increases hydrophobicity of protein
87
Allelic heterogeneity
Different mutations in SAME GENE cause similar phenotypes
88
Montelukast - class, use
- Blocks leukotriene receptors
| - good for asthma
89
Skin infection with yellow "honey" crust - disease, bugs
IMPETIGO
- staph aureus: bullae can form due to toxin production
- strep pyogenes
90
Burton agammaglobulinemia
- 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
Maple syrup urine disease - enzyme deficiency
branched chain alpha-keto acid dehydrogenase complex
| - need Thiamine (B1) as cofactor
92
Enzymes that need thiamine (B1) as cofactor
- branched chain alpha-keto acid dehydrogenase complex (MSUD)
- thioketolase
93
Red safarin O stains for?
Collagen, mast cell granules and mucin
94
Glucagon is coupled to which receptor?
Gs
95
Insulin is coupled to which receptor?
tyrosine kinase
96
Diagnosis of catecholamine-producing tumors (pheochromocytomas and paraganglioma)
- increased urine METANEPHRINE AND NORMETANEPHRINE —> increased urine vanillylmandelic acid
97
How does an increase in enzyme affects Vmax and Km?
- increases Vmax
| - same Km (affinity for substrate)
98
Risks for osteoarthritis
- AGE: most important
| - obesity, female sex, occupational joint loading, past trauma and abnormal joint alignment
99
How to treat carcinoid tumor
OCTREOTIDE - somatostatin analog, inhibits release of bioactive peptides by the carcinoid tumor
100
Thiazolidinediones - class, action
Oral ANTIDIABETIC medication
- decrease insulin resistance by increasing transcription of insulin responsive genes
- Glucose transporter 4: increases glucose transport into cells
- adiponectin
101
Crohns disease
- involves TERMINAL ILEUM
| - abdominal pain, fever, diarrhea, APHTHOUS ULCERS ON MOUTH and PERIANAL DISEASE
102
CIMETIDINE - affect on CYP450
INHIBITS CYP450 - decreases metabolism
103
Treatment of hepatic encephalopathy
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
Papillomaviruses - structure
small, non enveloped, icosohedral viruses with double stranded DNA genomes
105
Which nerve fibers are unmyelinated?
- POSTganglionic autonomic nervous system axons
| - Primary sensory afferent nerve fibers responsible for slow pain, heat sensation and olfaction
106
Reiter syndrome
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
Prader- Willi - etiology, clinical symptoms
- 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
Angelmans - etiology, clinical symptoms
- 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
Varicoceles
- 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
Associations with acanthosis nigricans
- benign: insulin resistance, obesity
| - malignant: cancer in GI tract or lungs if appear suddenly and spread quickly
111
Treatment of prostate cancer
- surgery
| - androgen deprivation therapy (ex: leuprolide) —> decrease testosterone
112
Leuprolide: MOA, use
- GnRH analog: continuous stimulation decreases LH and decreases testosterone production in Leydig cells
- used in prostate cancer, precocious puberty and endometriosis
113
Gaucher disease - enzyme deficiency
beta-glucocerebrosidase - glucocerebroside accumulates
114
Gaucher disease - distinguishing features
- "wrinkled tissue paper" on electron microscopy
- heptosplenomegaly —> breaks down blood —> pancytopenia
- bone pain/osteopenia
115
Anti-TNF-alpha agents are:
- infliximab: monoclonal AB to TNF-alpha
| - etanercept: a recombinant TNF receptor fusion protein
116
FSGS is associated with?
HIV, heroin use and sickle cell disease
117
Collapsing glomerulopathy
- a variant of FSGS with poor prognosis
- characteristic of HIV-associted nephropathy
- typical FSGS lesions with collapse and sclerosis of whole glomerular tuft
118
Hand-foot-genital syndrome
- mutation: HOXA13 - homeobox gene
- clinical presentation: distal limb defects (HYPOPLASTIC FIRST DIGITS) and genitourinary malformations (MULLERIAN FUSION ABNORMALITES —> miscarriages)
119
Metastasis from stomach cancers involve which lymph node?
Left supraclavicular lymph node - VIRCHOW'S NODE
120
Vascular invasion is associated with which organism?
Aspergillus
121
Affects of liver failure and portal hypertension on SPLEEN
- causes congestion of blood in spleen (splenic vein drains into portal system) —> ENLARGED SPLEEN from expansion of RED PULP
122
Superficial inguinal ring is formed by?
External oblique aponeurosis
123
Deep inguinal ring is formed by?
Transversalis fascia
124
Route of descent for testes
Descend through scrotum by passing through the DEEP inguinal ring to INGUINAL CANAL and then through SUPERFICIAL inguinal ring to exit canal
125
Gingivostomatitis
- 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
Which hormone prevents lactation in pregnancy?
Prolactin
| - decreases after pregnancy and allows prolactin to stimulate lactation
127
Why is essential fructosuria (fructokinase deficiency) benign?
Because fructose can be metabolized by HEXOKINASE to yield glucose-6-phosphate that enters the glycolysis cycle
128
Pathophys of diabetic neuropathy
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
Amino acids in collagen
- 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
Damage to supraspinatus muscle/tendon leads to pain with which arm movement?
ABduction
131
What is the most common injury to the rotator cuff?
Injury to tendon of supraspinatus muscle —> impairs ABduction of arm
132
Communicating Hydrocele (congenital)
Benign PAINLESS swelling of scrotum
- have patent processus vaginalis —> fluid from peritoneum accumulates in the TUNICA VAGINALIS
- get transilluminating swelling
- common in infants
133
Acquired hydrocele
Benign swelling of scrotum secondary to trauma, tumor and infection
134
Second gen antipsychotics - side effects
Metabolic adverse effects
- weight gain, dyslipidemia, hyperglycemia, increased risk of diabetes
- require routine monitoring of metabolic parameters
- worse with Clozapine and Olanzapine
135
Etanercept - class, use
TNF-alpha inhibitor: acts as decoy receptor to reduce activity of TNF-alpha
- used in RA in patients who have failed methotrexate therapy
136
- mab
Monoclonal antibody
137
- nib
kinase inhibitor
138
- cept
receptor molecule
139
Pterion
Where frontal, temporal, parietal, and sphenoid bones meet
140
Middle meningeal artery is a branch of which artery and enters the brain in which foramen?
Maxillary artery, enters in foramen spinosum
141
Prophylaxis agents for N. meningitidis
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
Causes of bloody discharge from nipple:
- Intraductal PAPILLOMA: most common
| - CARCINOMA
143
Haloperidol, Fluphenazine - class
HIGH dose first gen antipsychotics
| - associated with more extrapyramidal side effects due to potent D2 antagonism
144
Chlorpormazine, Thioridazine - class
LOW dose first gen antipsychotics
- associated with side effects due to histaminergic (sedation), cholinergic (anticholinergic) and noradrenergic blockade (orthostatic hypotension)
145
Phenelzine - class
MOAI - monoamine oxidase inhibitor: inhibits oxidative deamination (degradation) of serotonin, NE and dopamine
146
MOAI - use
Treatment resistant depression and ATYPICAL depression
147
Treacher Collins syndrome
- abnormal development of first and second pharyngeal arches
| - have craniofacial abnormalities and conductive hearing loss
148
Flucytosine - class, MOA
Antifungal
- inhibits synthesis of both DNA and RNA in fungi
- used mainly as synergistic agent with amphotercin B
149
Caspofungin - class, MOA
Antifungal
| - block polysaccharide synthesis needed for fungal cell wall
150
Griseofluvin - class, MOA
Antifungal
| - enters cells and binds microtubules, inhibiting mitosis
151
Consequence of prostatectomy
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
Cardiac tamponade - clinical findings
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
Phospholipase C is part of which pathway?
Gq pathway: hydrolyzes PIP2 to yield IP3 and DAG
154
Pseudogout
- commonly involves knee
| - crystals: RHOMBOID shaped made up of CALCIUM PYROPHOSPATE, POSITIVELY birefringent ( opposite of gout)
155
Organisms resistant for Cephalosporins
- Resistant penicillin binding proteins: Listeria, MRSA, enterococci
- No cell wall: Mycoplasma, chlamydia
156
What to use to treat Listeria
Ampicillin in kids, immunocompromised (gastroenteritis is usually self limited)
157
Which muscle is most important for achievement in Valsalva maneuver?
Rectus abdominis: needed to achieve intraabdominal and intrathoracic pressure of Valsalva maneuver
158
Inferior colliculi and medial geniculate body is associated with which sense?
Auditory
159
Lateral geniculate body is associated with which sense?
Vision
160
Xeroderma Pigmentosum - pathyphys
- 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
Hairy cell leukemia
- indolent B cell neoplasm
- Middle aged men
- bone marrow failure —> PANCYTOPENIA —> DRY TAP
- extramedullary hematopoesis —> SPLENOMEGALY
- TRAP positive
162
Treatment of bulimia
- SSRI: First line! - Fluoxetine
- Nutritional rehabilitation
- Cognitive behavior therapy
Note: Pharmacotherapy is not first line for anorexia
163
DRESS syndrome - drug reaction with eosinophilia and systemic symptoms
- 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
Accessory nipple: cause
Failure of mammary ridge to involute
165
Parvovirus B19 - main clinical presentation in kids and adults
Kids: erythemia infectiosum (fifth disease) - bright red rash on cheeks
Adults: acute arthritis - involves hands, knees, ankles, wrists
166
Tryptase
- enzyme that is specific to MAST CELLS
| - increased serum levels seen in anaphylaxis
167
What triggers vasoactive substance release from mast cells and basophils?
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
What do you use for a measurement in cohort studies (retrospective or prospective study)?
RR
169
What do you use for a measurement in case-control studies?
OR
170
Derivatives of POMC
POMC = propionmelanocortin
| - enzymatic cleavage of POMC yields beta-endorphins, ACTH and MSH
171
Effects of glucagon injection
- increases HEPATIC gluconeogenesis and glyogenolysis
| - stimulates insulin release from pancreas
172
Effects of Epi on glucose homeostatsis
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
Temporal (Giant) Cell Arteritis - Marker of severity
IL-6
174
Cause of BICORNUATE uterus
Incomplete lateral fusion of Paramesonephric ducts
- get abnormal uterine contour
- indentation in center of fundus
175
B12 deficiency - spinal cord lesion symptoms
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
Lacunar infarctions
- SMALL VESSEL occlusions in DEEP STRUCTURES
| - are small, cavitary lesions
177
Cushing triad
- Bradycardia
- Bradypnea
- Hypertension
178
Side effects of chronic TOPICAL corticosteroid use
DERMAL ATROPHY
- drug decreases production of extracellular matrix collagen and glycosaminoglycans
- get loss of dermal collagen, drying, cracking, and/or tightening of skin
179
Cancers associated with Dermatomyositis
Ovarian, colorectal and lung cancers
180
Clue cells seen on PAP smear is indicative of?
Gardnerella vaginosis
181
Koilocytes seen on PAP smear is indicative of?
HPV infection
182
Adenomyosis
- presence of endometrial glandular tissue within myometrium
- heavy menstrual bleeding and dysmenorrhea
- UNIFORMLY enlarged uterus with normal appearing endometrial tissue
183
Polyenes: drug names and MOA
- Amphotercin B (systemic) and nystatin (topical)
| - bind to ergosterol molecules, creating pores and causing lysis
184
Triazoles: MOA
- inhibit synthesis of ergosterol
185
Echinocandins: drug names and MOA
- capsofungin and micafungin
| - inhibit synthesis of GLUCAN, a component of fungal cell wall
186
Pyrimidines: drug names, MOA
- Flucytosine
| - converted to 5-fluorouracil within fungal cell wall and interferes with fungal RNA and protein synthesis
187
Griseofluvin - MOA
- antifungal
| - interacts with fungal MT, inhibiting mitosis
188
Most common source of bleeding for epistaxis (nose bleeds)
Kiesselbach plexus in ANTERIOR nasal septum: where ethmoidal, sphenopalantine, and superior labial arteries anastomose
189
Germinoma
- Pineal gland tumor
- obstructive hydrocephalus: papilledema, headache, vomitting
- dorsal midbrain (Parinaud) syndrome: paralysis of upward gaze, ptosis and pupillary abnormalities
190
Lesions in temporal lobe produces what kind of vision defect?
Affects Meyer's loop —> get contralateral superior quandrantanopia
191
Which hormone should be monitored after COMPLETE hydatidiform mole?
beta-HCG due to significant risk of malignant transformation - persistently elevated or rising levels may signify development of invasive mole or choriocarcinoma
192
Most common cause of subarachnoid hemorrhages
Saccular (berry) hemorrhages
193
Signs of marijuana intoxication
- conjunctival injection (red eyes)
- tachycardia
- increased appetite
- dry mouth
194
Injection to superomedial part of the buttock risks injury to which nerve?
Superior gluteal nerve - can cause Trendelenburg gait
195
Injection to superolateral, inferomedial, and inferolateral parts of buttock risks injury to which nerve?
Sciatic nerve
196
Beta blockers and diabetics
- 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
Transference - definition
Unconscious shifting of emotions or desires associated with a person of the PAST to a person of the PRESENT
198
Reactive arthritis
- 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
Interferon alpha and gamma - role in viral infection
- 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
Antibody in CREST syndrome
Anti-centromere
