uworld incorrect 2

Question 1

decreased chest wall compliance

Answer 1

chest wall compliance decreases in obesity hypoventalation/poor respiratory drive ,opiods and

Question 2

why does gastric bypass ause overgrowth of bacteria

Answer 2

Gastric bypass Sx can cause SIBO due to excessive bacterial proliferation in the blind-ended gastroduodenal segment.

Question 3

enteric bacteria

Answer 3

Enteric bacteria product Vit K and Folate
Bacterial overgrowth in duodenum > overproduction of Vit K and folate
Small Intestinal Bacteria Overgrowth
• Can cause B12 def
• Can cause Fe and Zn def injury by bacterial toxin
• Can cause Vit A, D and E def

Question 4

ataxia telnegctsasia

Answer 4

superficial blanching nests of distended capillaries) and sinopulmonary infection (IgA def)

Question 5

bare lymphocyte syndrome

Answer 5

MHC 2 deficiency

• No humoral respons

Question 6

gastroparesis

Answer 6

causes of gastroparesis
uremia,dm,hypothyrodisism
constipation early satiety and vomiting

Question 7

complement protein deficiences

Answer 7

reccurent infections /sle

Question 8

DBS in parkinson

Answer 8

x of Parkinson disease may benefit from high- freq deep brain stimulation of the globus pallidus internus (GPi) or subthalamic nucleus (STN) as it promotes thalamo-cortical disinhib w/ improved mobility

Question 9

where does the coronary sinus reside

Answer 9

in the AV groove
• 1 in RA, 1 in RV
• 1 in LV via the Ra > coronary sinus (via atrioventricular groove on posterior heart) > lateral venous tributaries into LV

Question 10

great saphenous vein course

Answer 10

The great saphenous vein is a superficial vein of the leg that originates on the medial side of the foot, courses anterior to the medial malleolus, and then travels up the medial aspect of the leg and thigh. It drains into the femoral vein w/i the region of the femoral triangle, a few cm inferolateral to the pubic tubercle

Question 11

small saphenous vein

Answer 11

mall saphenous vein: lateral foot to popliteal vein

Question 12

how does renal artery stenosis manifest in kidney

Answer 12

ischemia iffuse cortical thinning, tubular atrophy, interstitial fibrosis, and small crowded glomeruli. J

Question 13

non stenotic RAS

Answer 13

nonstneotic kidney exposed to high Bp=hypertensive enephrosclerosis
-arteriolar wall nthickening hyalinization and hyperplastic artheroscleoriss(due to high pa)

Question 14

function of protein titin

Answer 14

D mutations in the TTN gene, which encodes for the sarcomere protein titin, are the most common cause of familial DCM.

Question 15

function of protein titin

Answer 15

Titin is an elastic protein that anchors the beta-myosin heavy chain to the Z-discs and likely contributes to passive myocardial tension

Question 16

right arrythmogenic cardiomyopathy

Answer 16

Arrhythmogenic right ventricular cardiomyopathy is characterized by fibrosis and scarring of right ventricular myocardium, which predisposes to ventricular arrhythmias and sudden cardiac death

Question 17

cause of Right Arry cmo

Answer 17

mpaired desmosome function due to mutations in genes encoding desmosomal proteins (eg, plakoglobin, desmoplakin)

Question 18

HCMO

Answer 18

beta-myosin heavy chain or myosin-binding protein C

Question 19

electrolyte changes in intracellular myocardium

Answer 19

Low ATP > low Na/K pump and Ca SERCA pump > high Na and Ca inside cell causes swelling (also in mitochondria)
• Intracellular K will be low

Question 20

does hypovluemia increase uric acid absorption

Answer 20

Uric acid absorption is closely tied and directly related to sodium absorption in the proximal renal tubule; therefore, there is typically increased serum uric acid in the setting of hypovolemia

Question 21

why is ventricular edpa increased in hf

Answer 21

increased preload and afterload

Question 22

do nitrates reduce coronary perfusion pressure

Answer 22

define coronary perfusion pressure
between the end-diastolic aortic pressure and the left ventricular end-diastolic pressure nitrates reduce cornoary perfusion pressurea

Question 23

brown pigemnt on histopath

Answer 23

LHF leads to chronically ↑ pulm venous and capillary pressures, w/ resulting pulm oedema and extravasation of RBCs into the alveolar parenchyma. The Fe from RBCs is taken up by alveolar macrophages and stored as hemosiderin, appearing as brown pigment on histopathology.

Question 24

calcium regulation in cardiomyocytes

Answer 24

Ca efflux from cardiac cells prior to relaxation is primarily mediated via an Na/Ca exchange pump and SR Ca-ATPase pump.

Question 25

how do kortkoffs sound alter in cardiac cycle

Answer 25

Ca efflux from cardiac cells prior to relaxation is primarily mediated via an Na/Ca exchange pump and SR Ca-ATPase pump.

Question 26

patients with LV failure can have

Answer 26

pulsus alternans

Question 27

endomyocardial fibrosis

Answer 27

Endomyocardial fibrosis is a restrictive cardiomyopathy characterized by thickening and fibrosis of the apical endocardial surface.

Question 28

difference in cardiotoxicity of trastuzuman and doxirubicin

Answer 28

By binding to HER2, trastuzumab blocks downstream signaling that promotes cellular proliferation and thereby encourages malignant cell apoptosis.
cardiotoxicity decreaed myocardial contractility

however anthracycline induced cardiotixicy is due to free radical damage causing patchy necrosis

Question 29

HIV protein

Answer 29

The HIV genome contains 3 major structural genes that are translated as polyproteins and subsequently cleaved by host protease (env gene products) or viral protease (gag-pol gene products) into the individual proteins that compose the HIV virus.

Question 30

typhoid fever manifestation

Answer 30

yphoid fever is usually associated with a week of stepwise fever followed by a week of “rose spots” and abdominal pain and then possible complications such as abdominal bleeding/perforation and hepatosplenomegaly.

Question 31

what glands destoyed in sjorgen syndrome and hat are the symotoms histopath

Answer 31

. salivary, lacrimal, vagi

plus lymophcytic infiltrate of germinal centeres

Question 32

oral manifestation of crohns

Answer 32

aphtous ulcers

Question 33

pedriatric hiv cases developed by what age

Answer 33

age 2

Question 34

nasopharyngeal carcinoma symotoms

Answer 34

Nasopharyngeal carcinoma presents with a nasopharyngeal mass that may cause facial pain and associated weight loss. However, the tumor is typically unilateral, and the diagnosis is usually in patients age >50.

Question 35

MOA OF ifkb

Answer 35

TLR all activate IKB kinase causing degradation of IKB (via ubiquitin proteasome) > releasing Nf KB > transcription modification for immunity, inflammation and cell proliferation
g CSF
• Production of neutrophils TNFalpha
• Activated Nf KB (does not cause degradation of IKB)

Question 36

physiologic changes of clots in pregancny

Answer 36

pregnancy
increase clotting factor
decrease anticlotting
decrease fibrnolysis why ( activity of plasminogen activator inhibitor derived from placenta increases )

Question 37

lymoh node metastasis

Answer 37

External iliac
Cervix

Internal iliac
Vagina

Proximal: internal iliac
Distal: inguinofemoral
Vulva

Inguinofemoral
Ovaries

Paraaortic

Question 38

MOA of apoptosis by FAS l

Answer 38

pon binding Fas ligand (FasL), the receptors trimerize, allowing their death domains to form a binding site for an adapter protein called Fas-associated death domain (FADD). Receptor-bound FADD then stimulates the activation of initiator caspases (8 & 10) that begin an activation cascade culminating in the activation of executioner caspases (3 & 6)

Question 39

affinity maturation of b lymphi

Answer 39

affinity maturation of B lymphoc
hocytes undergo affinity maturation, cells that exhibit a stronger affinity for the antigen (which acts as a limited growth resource) are able to proliferate more than cells with lower affinity. This results in cells that are more efficient and accurate in binding to pathogens. Affinity maturation does not involve the Fas pathway.

Question 40

anergy

Answer 40

anergy=t lymph immune tolerance

self reactive t cells bind to mhc molecules without recieveing co stimulatory signal

Question 41

histopath of aspiration pneumonia

Answer 41

presence of giant cells

Question 42

why we have basophilic stippling

Answer 42

erythrocyte 5’ nucleotidase by lead results in ribosome aggregation due to inability to degrade RNA,

Question 43

define premature ejaculation medical condition

Answer 43

premature ejaculation
unwanted episodes of early ejactulation lack sense of control
within one minute of penetration for 6 months
prostatitis and DM