uworld incorrects Flashcards
Where does bile salt get absorbed ?
What diseases affect this part of the bowel?
Symptoms?
Terminal Ileum
Chrons
Diarrhea
What are DAMPS?
INTRAcellular components of released by host cells during states of inflammation that activate macrophages, dendritic cells, (innate immune system)
What are PAMPS?
Name a common PAMP
MICROBIAL components that activate the innate immune system (macrophages, dendritic cells)
LPS (lipopolysaccharide) a component of gram NEGATIVE bacterial cell walls
Which form of RNA contains high levels of modified bases dihydrouridine, ribothymidine, psudourine?
tRNA
What is detected in urine electrophoresis of MM patients?
lamba light chains
What does aminta phalloides (deathcap mushroom) inhibit?
Messenger RNA
What do RBCs look like when infected with Plasmodium falciparum?
They have multiple small rings – represent trophozoites
What is the first line treatment for Malaria? and what is given if there is resistance to it?
First line treatment is chloroquine if resistant use mefloquine or atovaquone/proguanil
What is the treatment for P vivax/ovale? What should you test for ?
primaquine. always test for G6PD deficiency
What is the most common cause of an elevated AFP level?
Incorrect dating. Especially if someone has a history of irregular menstrual cycles
What cardiac compensation develops due to chronic aortic regurgitation and why?
Eccentric hypertrophy because as blood leaks backwards into L.V. there is increase in LVEDV which triggers ventricular wall lengthening. this causes an increase in stroke volume which leaves aortic regurgitation asymptomatic for a long time
What is thayer martin media? and what is used for?
Thayer martin media is chocolate sheep blood agar infused with vancomyocin to inhibit gram positive.
It is used to identify Nesseria organisms
What causes impaired ADduction of the ipsilateral eye?
a lesion of Medial longitudinal fasciculus - medial rectus palsy
What causes impaired ABduction of the ipsilateral eye
a lesion of the abducens nerve- lateral rectus palsy
What test is used to determine VWF deficiency? Why?
Ristocetin cofactor assay and it is used because it activates GP1b receptors to make them active for binding. If there is lack of VWF then it will not respond appropriately even with risotocetin.
Hyperkalemia, hypotension, ambiguous genitalia in girls
21 hydroxylase deficiency
hypertension, hypokalemia, ambiguous genitalia in females
11 hydroxylase deficiency
hypertension, hypokalemia, absent puberty, ambiguous genitalia in boys
17 hydroxylase deficiency
Where is the SA node located?
junction of the R. atrium and Superior Vena Cava
Where is the AV node located?
R. atrium near septal cusp of the tricuspid valve?
What is monoamine oxidase? What are MAO inhibitors used for?
mitochondrial enzyme that breaks down monoamine neurotransmitters such as dopamine, epinephrine, serotonin.
they are used for treatment resistant depression
What should patients taking MAO inhibitors avoid?
Tyramine containing foods (cheese, meat, draft beer). it usually broken down by MOA, and if taken in large quantities can induce hypertensive crisis.
oncogene located on chromosome 8, associated with Burkitt Lymphoma and diffuse large B cell lymphoma
c-MYC
Tumor suppressor gene is located on chromosome 17. Associated with neurofibromatosis type 1
NF-1
Tumor suppressor gene located on chromosome 13 and associated with retinoblastoma and osteosarcoma
RB
What syndrome is associated with colorectal cancer, ovarian cancer, and endometrial cancer? What gene is involved?
Lynch Syndrome. Genes MSH2, MSH6, MLH 1, PMS2
What syndrome is associated with colorectal cancer, brain tumors, desmoids, and osteomas? What gene is involved?
Familial adenomatous polyposis. APC
What syndrome is associated with hemangioblastomas, clear renal cell carcinoma, and pheochromocytoma?
Von Hippel-Lindaue. VHL
What syndrome is associated with sarcomas, breast cancer, brain tumors, adrenocortical carcinoma, and leukemia? what gene is associated with it?
Li Fraumeni. TP53
what type of drug is glycopyrrolate?
selective muscarinic antagonist, can be used to treat cholinergic toxicity
Overexpression of what causes keloid formation during wound healing?
TGF beta (TGF b usually signals to fibroblasts to synthesize collagen)
which amino acids are exclusively ketogenic?
leucine and lysine
what is the treatment for pyruvate dehydrogenase deficiency?
diet of exclusively ketogenic amino acids to generate acetyl co-A without generating lactate
A young woman presents w/ hilar lymphadenopathy, elevated ACE levels, erythema nodosa, and hypercalcemia. What does she have
Sarcoidosis
what are the 3 bowel findings in celiac disease?
- increased intraepithelial lymphocytes
- crypt hyperplasia
- progressive villous atrophy
what are the 3 bowel findings in celiac disease?
- increased intraepithelial lymphocytes
- crypt hyperplasia
- progressive villous atrophy
Damage to what structure results in contralateral hemibalism
subthalamic nucleus
What is the MOST common presentation of dizygotic twins
Dichorionic Diamniotic
what is the most common presentation of monozygotic twins? What is the second most common
They split usually by days 4-8 and 75% are monochorionic (shared placenta) and diamniotic.
If they split earlier then they could be dichorionic diamniotic (25%)
what is the most common presentation of monozygotic twins? What is the second most common
They split usually by days 4-8 and 75% are monochorionic (shared placenta) and diamniotic.
If they split earlier then they could be dichorionic diamniotic (25%)
what is a nonsense mutation?
When a an amino acid gets replaced by a preamature stop codon
What is a missense mutation?
When the wrong amino acid gets placed
What is a frameshift mutation?
deletion/ insertion of a number of bases that is NOT divisible by 3.
What phase of meosis is an egg frozen at prior to PUBERTY?
meosis I in prophase
What phase of meosis is an oocyte arrested at prior to FERTILIZATION?
meiosis II metaphase
An apparent increase in survival rate, with an unchanged prognosis due to screening
lead time bias
slowly progressive forms of the disease are more likely to be detected than rapidly progressive forms
Length time bias
where are gallstones most likely to get stuck in the small bowel?
Illeum, duodenum and jejunum are usually wide enough to let them pass
what cells CANNOT utilize ketones for energy?
erthrocytes because they lack mitochondria
Name 3 physiologic changes that happen to lungs during aging
- lung compliance increases due to loss of elastin
- chest wall compliance decreases (stiff rib cage)
~overall total respiratory system compliance is decreased - increased physiologic deadspace
what happens during a pulmonary embolism? A. metabolic acidosis B. metabolic alkalosis C. pulmonary acidosis D. pulmonary alkalosis
D. Pulmonary alkalosis because of hyperventalation
What happens during vomitting? A. metabolic acidosis B. metabolic alkalosis C. pulmonary acidosis D. pulmonary alkalosis
B. Metabolic alkalosis due to loss of HCl, secondary respiratory acidosis to be expected
What are the two ways to manage HOCM?
- negative chronotropy - decrease heart rate to increase filling time (beta blockers)
- negative inotropy- decrease contractility to decrease amount of ventricular blood ejected (calcium channel blockers)
All this is to maintain a high blood volume
