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usmle > uworld incorrects > Flashcards

uworld incorrects Flashcards

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USMLE® Step 1 flashcards
1
Q

how does hep b vaccination prevent virus entry

A

These antibodies prevent infection by binding to the envelope of circulating virus and inhibiting viral entry.

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2
Q

how to dy.dx infected with vaccinated hep b

A

presence of hepcab

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3
Q

does hep b cause intf production

A

no because it is stealh virus blocks portion of immune system that causes release of intf

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4
Q

what are the contact precautions

A 
MRSA, VRE
• C Diff
• Scabies
• Soap and water handwash (for spores) • Nonsterile gloves
• Gown
• Private room
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5
Q

signs of patellar fracure

A

Signs include an acutely swollen knee, focal patella tenderness, inability to extend the knee against gravity, and a palpable gap in the extensor mechanism

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6
Q

what causes primary testicular failure

cause of euchnoid features

A

klienfelter syndrome
why?
testicular hyalinization
testosterone deficiency

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7
Q

Arachnodactyly, scoliosis, and aortic root dilation

A

marfans

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8
Q

what are janeway lesion

A

bacteria neutrophils and microabsceses

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9
Q

what is osler rendu nodes and pathogensis

A

Osler nodes are tender, violaceous nodules typically located in the pulp of fingers and toes. The pathogenesis of Osler nodes is immune-complex deposition in the skin.

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10
Q

primary infection of foot

A

sportorichosisSorbitol accumulation increases cellular osmotic and oxidative stress

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11
Q

how sorbitold damages cells

A

Sorbitol accumulation increases cellular osmotic and oxidative stress

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12
Q

germinoma

A

arise in gonass,mediastinum, and cns( suprasellar) (pineal)

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13
Q

where does the tirgeminal nerve exit

A

trigeminal nerve (CN V) exits the brainstem at the lateral aspect of the mid-pons at the level of the middle cerebellar peduncles (

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14
Q

where is the facila nucleus located

A

facial nucleus is located in the dorsolateral aspect of the caudal pons,

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15
Q

onidine curse

A

more appropriately known as congenital central hypoventilation syndrome, or CCHS—is a rare, severe form of sleep apnea in which an individual completely stops breathing when falling aslee

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16
Q

diphragm fatigue

A

Both Myasthia Gravis AND a restrictive lung disease can cause rapid diaphragm fatigue

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17
Q

metastatic disease to pericardium cause phrenic nerve compression

A

uniform weak diphragm contractions

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18
Q

KAT G mutation

A

KatG mutation decreasing catalase peroxidase expression

• Modification of protein target binding site for INH

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19
Q

when do we have decreased transport protein expression in cells in antibiotic therapy

A

Decreased transport protein expression at cell surface

• Resistance in fluoroquinolones, macrolides, aminoglycosides

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20
Q

where does histoplasama capsulatum disseminate

A

owever, those with impaired immunity (eg, advanced AIDS) are at risk for dissemination through the reticuloendothelial system due to the organism’s affinity for mononuclear phagocytic cel

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21
Q

where does blastomycosis disseminate

A

Blastomyces is a large yeast with thick walls and broad-based buds that disseminates primarily to the skin

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22
Q

where does cryptococcus disseminate

A

t can replicate within macrophages and cause pulmonary infection in patients with advanced AIDS. However, dissemination usually leads to meningoencephalitis

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23
Q

age related cataract

A

Gradual loss of visual acuity
Excessive glare, halos around bright lights
Myopic shift

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24
Q

mechanisms of cataracts

A

mechanism of catracts
nucler sclerosisNuclear sclerosis: new layers of epithelia form on the cortex of the lens, compacting older layers beneath

Photooxidative damage and cross-linking of crystallins causes brown/yellow pigmentary changes worsedned by uv exposure

Osmotic injury resulting in development of hydropic lens fibers acclerated in DM

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25
Q

pcp histopath

A

eosinophilic foamy alveolar material and cystic and trophic forms that can be stained with Giemsa or silver stain (producing a cup-in-saucer appearance

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26
Q

why beta blockers treat symotoms of HCM

A

eta blockers reduce heart rate, which lengthens diastolic filling time and increases the amount of blood that can enter the heart during each beat (increasing end-diastolic volume)

Beta blockers also reduce LV contractility, which reduces the amount of blood ejected during systole (increasing end-systolic volume)

27
Q

how beta blockers improve angina

A

increases perfusion gradient and reduces wall stress

28
Q

how would beta blockers reduces flow velocity in increase xsection area

A

low velocity = volumetric flow rate / cross-sectional area

29
Q

beta blockers and compensatory hypertrophy

A

redcues it evident aftr 4 weeks increases preload and reduces outflow obstruction
hcm is preload dependant

30
Q

critical collapse pressure of lung

A

There is a critical lung capacity (ie, closing capacity) at which some of the lung’s small airways collapse during expiration (due to decreased radial traction at lower lung volumes). When FRC drops below this critical capacity, alveoli supplied by the collapsed airways are without ventilation for part of the respiratory cycle, which contributes to intrapulmonary shunting and increases ventilation-perfusion mismatching. Increasing FRC minimizes the time spent below closing capacity and in doing so decreases ventilation-perfusion mismatching.

Because the FRC air volume remains in the lungs throughout the respiratory cycle, it acts as a store of oxygen that the body can pull from during brief periods of increased need. Therefore, increasing FRC increases the oxygen reserves in the lungs.

31
Q

what does peep do to the intrapleural pressure and why

A

increases exaplain the mechanism

32
Q

isminute volume changed in peep

A

no

33
Q 
mechanism of hyper kalemiain 
cyclosporine
heparin
nsaid
trimethoprim
A

Blocks aldosterone activity
Blocks aldosterone production
Decreases renal perfusion → decreased potassium delivery to the collecting ducts
Inhibits ENaC

34
Q

frontal lobe dysfunction

A

personality, language, motor fxns, and executive fxns (e.g. abstraction). Frontal lobe fxn may be Dx by testing abstraction ability (e.g. asking about the similarities b/w 2 related objects) on the MSE.

35
Q

why SVR increases in newborn

A

At the same time, umbilical cord clamping removes the low-resistance placenta from the systemic circulation, causing SVR to increase. decrease in pvr
hese pressure changes quickly lead to reversal of blood flow across the ductus arteriosus (ie, left-to-right), eliminating the right ventricular contribution to cardiac output.

36
Q

botulinism toxin

A 
Constipation, poor feeding, hypotonia
Oculobulbar palsies (eg, absent gag reflex, ptosis)

allergic proctolitis
dy/dx food groups+occult blood well and have diarrhea

37
Q

organic acidemia

A

AR mutation of methylmalonyL CoA mutase
• Ile, Val, Thr, Met, and odd chain FA form propionyl CoA • > MMA via methylmalonyL CoA mutase (required B12)
• Metabolic acidosis, elevated propionic acid, hypoglycemia, high ketones, and hyperammonemia

38
Q

why we have elevated MCV in extramedullary hematopoeis

A

xtramedullary erythropoiesis can occur in SCD and lead to an elevated reticulocyte count and MCV, as it is not produced in BM

39
Q

why liver failure results in macrocytosis what is the value of liver macrocytosis

A

Macrocytosis can occur in liver failure due to an increase in circulating phospholipids and cholesterol that adsorb onto erythrocytes, resulting in membrane expansion it is usualy mild less than 110

40
Q

what are beta blockers good for HF

A

what are beta blockers good for HF
lowers PVR? decreases renin/endothelin
only introduced after stabilization

41
Q

what is the function of nucleolus

A

Dense region in nucleus that contains ribosomal DNA and produces rRNA
unctions as the primary site of ribosome synthesis and assembly.

42
Q

what kinds of rrna is transcriped in the nucleolus

A

All ribosomal RNA except 5S rRNA is transcribed in the nucleolus.

43
Q

mitochondria rna

A

Mitochondria have their own ribosomes, but they are typically found within the mitochondrial matrix or boun

44
Q

what causes direct inhibition of vitamin D

3 mechanisms

A

FGF23 levels increase early in CKD, causing direct inhibition of 1-alpha-hydroxylase

Reduced glomerular filtration limits the delivery of 25-hydroxyvitamin D to proximal tubule cells

Reduced functional renal mass limits production of 1-alpha-hydroxylase

45
Q

how does reduced gfr affect vit d

A

decreased delivery to proximial tubule

46
Q

renal mass

A

decreases 1 alpha ohase

47
Q

how is klebsilla characterized

A

characterized by “currant-jelly” sputum and early abscess formation.

48
Q

what sets the RMP

A

K+ efflux is moderate • Na+ influx is minimal

• This is what sets the RMP

49
Q

what happens to the N c terminal in collagen synthesis

A

N and C terminals are cleaved off making tropocollagen > cross linked by lysyl oxidase

50
Q

pathophys of annular pancreas and divisim

A

annular pancreas= abnormal migration of ventral bud
rotates behind duodenum in 7th week
deriatives=unicinate process+main pancreatic duct
patholgy = adherence to dorsal bud
incomplete fusion=divism pancreas

51
Q

papilloma virus what are the different types
palms and soles
histpath

A

ow can cutaneus warts present as
skin coloured papules, circumscribed plaqyes and filiform lesions

palms and soles-tender disrupt skin stiae

dermascopy=rough /small black dots=thrombosed capillary

what is histopath of herpes infection
Multinucleated giant cells, plus ancantholysis

histopath of papillomaEpidermal hyperplasia (acanthosis) with eosinophilic inclusions and keratohyaline granules
Thickened stratum corneum (hyperkeratosis)
Papilloma formation
Perinuclear cytoplasmic vacuolization

52
Q

lateral epicondylitis

A

Attaches extensor carpi radialis brevis, extensor digitorum

• Excessive use can result in microtrauma of extensor carpy radialis brevis > angiofibroblastic tendinosis

53
Q

sensory innervation of the tounge

A

Anterior 2/3 of the tongue: mandibular branch of trigeminal nerve (CN V3)
Posterior 1/3 of the tongue: glossopharyngeal nerve (CN IX)
Posterior area of the tongue root: vagus nerve (CN X

54
Q

gustatory innervation of tounge

A

Gustatory innervation (taste buds) is as follows:
Anterior 2/3 of the tongue: chorda tympani branch of facial nerve (CN VII)
Posterior 1/3 of the tongue: glossopharyngeal nerve (CN IX)
Posterior area of the tongue root and taste buds of the larynx and upper esophagus: vagus nerve (CN X)

55
Q

3rd part of duodenum

A

Traps SMA and SMV between itself and pancreas

invasion of cancer injurs the sma

56
Q

course of common bile duct

A

he common bile duct courses inferiorly, posterior to the first part of the duodenum and within the head of the pancreas, to drain into the second part of the duodenum.

57
Q

totalmyocardial ischemia

A

Heart will stop beating in 60 seconds
• Although there is still ATP around, ATP in locations of high metabolic demand is rapidly depleted and causes heart to stop Ischemia less than 30 min > reversible damage

58
Q

myocardial stunning

A

rolonged dysfunction of myocardium, function returns within days

59
Q

clostridum septicium

A

lostridium septicum is a spore- forming, exotoxin-producing, Gram (+) organism that is the most common cause of spontaneous gas gangrene (eg, rapid-onset pain, hemorrhagic bullae, tissue crepitus). Underlying colonic malignancy is the greatest RFx for infection.

60
Q

how does herpes virus stay suppressed

A

t expresses latency-associated transcript, a non-protein coding RNA molecule that suppresses viral lytic genes and inhibits host cell apoptosis

61
Q

which virus must integrate into genome for replication

A

hiv

62
Q

why do aldoestrone antagonists prevent heart remodelling

A

These antagonists also block the deleterious effect of aldosterone on the heart, causing regression of myocardial fibrosis and improvement in ventricular remodeling.

63
Q

ghrelin

A

Ghrelin is produced primarily in the stomach in response to fasting; levels surge leading up to meals and fall after eating. Ghrelin stimulates appetite and promotes weight gai

Caloric restriction and falling fat stores lead to increased ghrelin levels (along with decreased leptin and insulin levels), which limits weight loss from dietary modification alone. H

64
Q

pancreatic reseve and what decreases it

A

exocrine pancreas has a significant secretory reserve, and >90% of the glandular tissue must be destroyed before a patient will develop clinical malabsorption. However, this patient likely has significant loss of pancreatic tissue at baseline due to chronic pancreatitis and is at increased risk for exocrine insufficienc

usmle (38 decks)

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