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UWorld Facts Flashcards

1
Q

What do you initially treat Coag Negative Catalase + staph with?

A

Vanco - assume resistance

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2
Q

What is the normal value in ARDS?

A

Pulmonary wedge pressure - an elevated pressure would be indicative of cardiogenic pulmonary edema

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3
Q

A bimodal curve in the concentration of a drug indicates what?

A

Slow/fast Acetylation - I.E. Isoniazid

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4
Q

How do nitrates relieve chest pain in patients with stable angina?

A

Vasodilate veins

Decrease LV volume/Preload

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5
Q

A man who thinks the neighbors are poisoning him despite no proof has what?

A

Delusional

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6
Q

What are the two types of congenital QT?

A

Romano-Ward (AD) Cardiac only

Jervell and Lange-Nielson - (AR) + sensorineural deafness

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7
Q

What is the major pathophysiologic abnormality seen with prolonged NSAID use?

A

Chronic Interstitial nephritis and papillary necrosis

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8
Q

When treating someone with amphotericin B what might you need to supplement?

A

K and Mg - Inc. distal tubular membrane permeability

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9
Q

Desmosine cross-linking between 4 lysines via lysyl-hydroxylase forms what?

A

Elastin

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10
Q

Menkes disease

A

Impaired copper absorption and decreased activity of lysyl oxidase - kinky/brittle hair - growth retardation - hypotonia

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11
Q

Osteogenesis imperfecta

A

Dec. synthesis of normal Type 1 collagen - impaired matrix formation - blue sclera

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12
Q

What stage of collagen formation occurs extracellularly?

A

Cleavage of disulfide terminal regions of procollagen

Covalent lysine|hydroxylysine cross-linking - lysyl oxidase (Cu)

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13
Q

Granulomas in the GI tract

A

Crohns (Th1 response)

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14
Q

UC w/ pANCA

A

Primary sclerosing cholangitis - onion skinning, hyper IgM, inc. risk for 2 biliary cirrhosis and cholangio

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15
Q

Why is htere an incrased risk of gallstones with Crohn’s disease

A

Decreased reuptake of bile salts/acids - cholesterol stones fall out of solution

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16
Q

β-glucuronidase

A

Bacterial enzyme that deconjugates bilirubin - pigment stones

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17
Q

Ingestion of the “death cap mushroom” leads to what?

A

Bind to RNA Pol II - block mRNA synthesis

Abdominal pain, vomiting, diarrhea

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18
Q

Increased volume of endolymph in inner ear

A

Meniere’s Disease

Tinnitus, vertigo, sensorineural hearing loss

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19
Q

Knocking out the ACA can lead to what

A

Contra motor/sensory problems of the lower extremities
Urinary incontinence
Behavioral changes

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20
Q

Mitochondrial vacuolization indicates what?

A

Irreversible injury/cell death

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21
Q

What disease can cause cystic degeneration of the putamen?

A

Wilsons Disease

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22
Q

What layers will you pass thru during a cricothyrotomy

A

Superficial cervical fascia

Cricothyroid membrane

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23
Q

What causes the flushing after a dose of niacin?

A

Prostaglandins

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24
Q

What is the most common cause of elevated AFP?

A

Dating error

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25
Q

Lung Bx: Spherules packed with endospores

A

Coccidioides immitis

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26
Q

Acute acalculous cholecystitis

A

Acute inflammation of the GB in the absence of stones - hospitalized and severely ill

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27
Q

How does doxycycline and the other tetracyclines act?

A

Block A site tRNA binding

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28
Q

How can you diagnose a thiamine deficiency

A

Measure erythrocyte transketolase levels (decreased)

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29
Q

The mean arterial pressure remains fairly stable during exercise due to an adaptive decrease in what?

A

Systemic Vascular Resistance

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30
Q

What is the major long-term hemodynamic compensatory response to volume overload of Aortic Regurg?

A

Inc in preload

LV end-diastolic volume (eccentric LVH)

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31
Q

Analyzing associations of dietary habits (i.e. Vitamin D intake) and prevalence of a disease is an example of what?

A

Ecological study - analyzing population

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32
Q

Analyzing exposures and outcomes of interest in an individual at a given point in time is called what?

A

Cross-sectional survey

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33
Q

What are the 3 effects of ANP

A
  1. Dilate afferent arterioles, limit Na resorption (PT, IMCD), inhibit renin secretion
  2. Restricts aldosterone secretion
  3. Relaxes vascular SM
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34
Q

What is the action of hypophosphorylated Rb?

A

Active Rb - prevents G1/S transition

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35
Q

What are preterm newborns at risk for?

A

Vitamin K deficiency - Hemorrhagic disease of the newborn

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36
Q

An erosion can extend into, but not through what layer?

A

Muscularis mucosa

*Once it enters the submucosa it is an ulcer

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37
Q

What is the most common location to find colon cancer?

A
  1. Rectosigmoid colon

2. Ascending colon

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38
Q

Pathogenesis of EtOH-induced hepatic steatosis is due to what?

A

Decreased FFA oxidation

2˚ to excess in NADH prodution

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39
Q

Eosinophils in the urine indicate what? What drugs can cause this?

A

Interstitial nephritis

NSAIDs, sulfonamides, rifampin, diuretics, β-lactam

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40
Q

Muscle Bx: Glycogen accumulating in lysosomes

A

Type II: Pompe Disease

Def in acid α-glucosidase

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41
Q

What amino acids are metabolized to propionyl CoA?

A

Threonine, Methionine

Valine, Isoleucine

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42
Q

What nerve and artery are at risk with a midshaft fx of the humerus?

A

Deep brachial artery

Radial nerve

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43
Q

A patient with hypertensive emergency after a eating tyramine containing foods is likely on what drug?

A

MAOIs

44
Q

What does N-acetylcystine do in acetaminophen toxicity?

A
  1. Glutathione substitute

2. Provide sulfhydryl group to enhance non-toxic sulfation elimination

45
Q

Permanent Central Diabetes insipidus is caused by damage to what structure?

A

Hypothalamus

46
Q

What are the 2 most immediate physical symptoms of marijuana?

A

Tachycardia and conjunctival injection

47
Q

Cold agglutinins (mycoplasma pneumonia)

A

Antigenic similarity between m. pneumo and erythrocyte membrane

48
Q

How do β-blockers help in thyrotoxicosis?

A

Inhibit peripheral iodothyronine deiodinase (conversion from T4 to T3)
Decrease sensitivity to catecholamines

49
Q

What is a central side effect of levodopa?

A

Anxiety and agitation

50
Q

Axonal reaction (post nerve injury - Wallerian degeneration)

A

Neuronal body: swollen, nucleus displaced to periphery, Nissl substance is fine and granular

51
Q

Leaving bed when not sleepy/using it only for sleep/sexual activity is an example of what?

A

Stimulus control

52
Q

True or False: Acute Hepatitis B is usually symptomatic while Hepatitis C is asymptomatic.

A

True

53
Q

What is the mutation seen in Burkittt Lymphoma

A

t( 8;14) - c-myc transcription factor

54
Q

How do you get schistosomiasis?

A

Snails

55
Q

S japonicum and S mansoni cause schistosomiasis in what two locations?
S. haematobium causes schistosomiasis in what location?

A

S. Japonicum and mansoni = intestinal and hepatic

S. haematobium = urinary

56
Q

Blanching of a vein in which NE is being infused is indicative of what?

A

NE extravasation - α1 mediated vasoconstriction

57
Q

Palpable but non-tender gallbladder, weight loss, obstructive jaundice?

A

Pancreatic AdenoCA - head

**smoking

58
Q

Hyperpyrexia

A

Body temp > 40
Cooling 1st
Antipyretics 2nd

59
Q

Synaptophysin in a brain tumor indicates what origin?

A

Neuronal

60
Q

PI3K/Akt/mTOR

A

Cell proliferation

mTOR is a transcription factor

61
Q

Non-expression of the mycobacterial catalase-peroxidase enzyme leads to resistance against what?

A

Isoniazid

62
Q

Waking up from barbiturates is due to what?

A

Tissue redistribution of the drug - not metabolism

63
Q

Ticlopidine can cause what serious side effect?

A

Neutropenia + fever + mouth ulcers

64
Q

What does a kid with cyanotic spell relieved by squatting have?

A

Tetralogy of Fallot

65
Q

What drugs are used to treat isolated systolic HTN?

A

Amlodipine & Nifedipine (dyhydro)

Thiazide

66
Q

What is a side effect of amlodipine?

A

Flushing and peripheral edema

67
Q

What can causes a sudden muscle relaxation in response to inc. stress/force?

A

Golgi tendon organs

68
Q

Painless 3rd trimester bleeding

A

Placenta previa - C section

69
Q

Abrupt, painful, 3rd trimester bleeding

A

Placental abruption

bloody maternal surface

70
Q

What increases the risk of placental abruption

A

Trauma, smoking, HTN, Preeclampsia and cocaine

71
Q

What causes preeclampsia

A

Maternal/fetal vascular interface problem - fibrinoid necrosis

72
Q

What is a common cause of death in Cervical CA?

A

Hydronephrosis with post renal failure - tumor invades thru anterior bladder blocking ureters

73
Q

What are secondary risk factors for cervical CA?

A

Smoking and immunodeficiency

74
Q

Absent cremasteric reflux

A

Testicular torsion

75
Q

incomplete closure of the process vaginalis can result in what?

A

Hydrocele

Indirect Inguinal hernia

76
Q

Thyroid hormone has β-adrenergic effects and increases the BMR - how does it do this?

A

Ιnc. β1 adrenergic receptors

Inc. Na/K-ATPase

77
Q

Why do you get hypocholesterolemia in hyperthyroidism?

A

Inc. LDL receptor expression

78
Q

What are teh causes of PTH independent hypercalcemia?

A

Malignancy
Granulomatous Disease
Vitamin D toxicity

79
Q

What mediates insulin resistance in DM2

A

Decreased insulin receptors

80
Q

What is the mechanism of a a CF kid who collapses while exercising?

A

Sodium loss with sweating

81
Q

What does CFTR do in the respiratory/gastric glands and the sweat glands?

A

R/G: CFTR secretes Cl and impairs ENaC - inc. Na/H20 in mucus
S: CFTR activates ENaC to increase Na/Cl absorption

82
Q

Patients with adult coarctation of the aorta are more likely to experience what complications?

A

HTN associated

  1. LV failure
  2. Ruptured dissecting aortic aneurysm
  3. Intracranial hemorrhage - ruptured berry aneurysms (Inc. risk) + HTN
83
Q

What is associated with exposure to arsenic, thorotrast, and polyvinyl chloride? What is a marker for this?

A

Liver angiosarcoma

CD31 = PECAM1 - leukocyte migration

84
Q

What are the causes of pure red cell aplasia?

A

Thymoma
Lymphocytic leukemia
Parvovirus B19

85
Q

Lung cancer can irritate which nerves?

A
  1. Phrenic (C3-C5): hiccups, dyspnea
  2. Brachial plexus (C8-T1/2)
  3. Recurrent laryngeal - hoarseness
  4. SVC syndrome - central/mediastinal
  5. Horners: Lung apex
86
Q

What is the most common muttiaon in Hypertrophic CM?

A

β-myosin heavy chain - cardiac sarcomere protein

87
Q

If a person has inherited dilated CM, what is the mutation?

A

1/3 are inherited

AD mutation of cardiac myocyte cytoskeletal proteins - dystrophin or mitochondrial enzymes

88
Q

What is the most common benign liver tumor?

A

Cavernous hemangioma

collagenous scars, and blood filled spaces

89
Q

A patient with hypothyroidism after taking a meds for mood swings and sleeping problems was likely on what?

A

Lithium

90
Q

What should you measure routinely in a patient on Lithium?

A

TSH (hypothyroidism)
Li - levels can build up
Renal function - Li can quickly build up

91
Q

Ergonovine

A

Ergot alkaloid = vasoconstriction

α and 5-HT agonist

92
Q

What would worsen an attack of Prinzmetal angina?

A

Vasoconstriction

93
Q

What viruses use a protease to cleave their viral products?

A

Picorna (PERCH) - ss, + non-segmented RNA virus

94
Q

What pH, PaO2 and PaCO2 would you expect to see in a patient at high altitude for 5 days?

A

Slight alkalosis
Dec PaO2, dec PaCO2
Dec in HCO3 - compensatory

95
Q

Pulmonary HTN and cor pulmonale are common complications of CREST - what is the mechanism?

A

Intimal thickening of pulmonary arteries

Inc. TGF-β - inc. collagen and ECM by matrix proteins and fibroblasts

96
Q

How do you medically treat a patient with MR?

A

Decrease afterload

Arterial vasodilators

97
Q

What is a weird potential side effect of ACE Inhibitors?

A

1st dose hypotension (block AT2)

Exacerbated with diuretics, hyponatremia, high renin/aldosterone levels, renal impairment and heart failure

98
Q

Vitiligo

A

Loss of melanocytes/melanin - autoimmune

99
Q

How does the liver use glycerol produced by breakdown of TGs?

A

Glycerol kinase –> Glycerol-3-P –> DHAP

100
Q

What are the 2 mechanisms of opioid signaling via μ-opioid receptors?

A

G-coupled receptors
Inc. K efflux out of cells
Block AC - decreased cAMP

101
Q

Dystonia

A

Sustained, involuntary muscle contractions - force body parts into abnormal/painful movements or positions

102
Q

Blepharospasm is an example of dystonia - what is it? What is another example of focal dystonia?

A
  1. Focal dystonia - involuntary forcible closure of eyelids
  2. Writers cramp
  3. Spasmotic torticollus - cervical dystonia - most common
103
Q

Myoclonus

A

Brief, sudden, shock-like jerk - falling asleep, epilepsy, Creutzfeldt-J disease

104
Q

Who might you see vitamin E deficiency in?

A

Fat malabsorption
Abetalipoproteinemia
Low birth weight infants

105
Q

What does vitamin E deficiency look like?

A

Mimics Friedreich Ataxia/B12 deficiency

Ataxia, dysarthria, loss of vibration/prop sense

106
Q

What are the characteristics of viral meningitis?

A

Normal glucose
Increased protein
90% lymphocytes

107
Q

Osteoid matrix accumulation around the trabeculae is indicative of what?

A

Vitamin D deficiency

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