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PATH STORE > UWorld Key Points Wks 1-2 > Flashcards

UWorld Key Points Wks 1-2 Flashcards

1
Q

Pentose phosphate pathway end products (2)

A

NADPH and ribose 5 phosphate

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2
Q

SSx of polymyositis

A

Symmetrical proximal muscle weakness

+/- muscle aches (vs polymyalgia rheumatica)

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3
Q

Endomysial mononuclear infliltration is characteristic of which condition?

A

Polymyositis

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4
Q

3 antioxidant enzymes in the body

A

Superoxide dismutase
glutathione peroxidase
catalase

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5
Q

tetrahydrobiopterin is a cofactor for which 3 reactions

A

Serotonin synthesis
Phenylalanine –> Tyrosine
Tyrsone –> DOPA

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6
Q

What does retrograde arterial flow suggest

A

Steal syndrome (obstruction in vessel causes proximal hypotension –> branches distal to obstruction flow backwards)

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7
Q

2nd pharyngeal arch components (3)

A

Styloid process
lesser horn of hyoid
stapes

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8
Q

Number needed to Harm equation

A

NNH = 1/ARR

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9
Q

mechanism for nitrite therapy in Cyanide poisoning

A

Oxidize Fe2+ –> Fe3+ (methemoglobin) so that Hb has greater affinity for cyanide. This increases PaO2 and decreases free cyanide

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10
Q

Acid a-glucosidase deficiency

A

Pompe Disease

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11
Q

3 types of aspergilosis

A

Allergic (wheezing, patchy inflitrate)
Colonizing (aspergilloma)
Invasive (lung, brain, immunocompromised)

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12
Q

Northern blot

A

mRNA

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13
Q

Southern Blot

A

DNA

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14
Q

Western blot

A

Protein

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15
Q

lactose intolerance Stool pH and osmolarity

A 
Acidic pH (lactose metabolism by gut flora produces fatty acids)
Increased osmolality (increased lactose)
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16
Q

All cutaneous structures inferior to the umbilicus are drained by which lymph nodes

A

superficial cutaneous nodes

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17
Q

Kid with hyperkalemia, hyponatremia and hypotension

A

21 hydroxylase deficiency

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18
Q

Acute onset abdominal pain, brown urine that darkens over time

A

AIP

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19
Q

Acute intermittent porphyria Tx

A

Glucose (inhibit ALA synthase)

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20
Q

Most important cell and mediator in atherosclerosis

A

Platelets secreting PDGF

endothelial cells and foam cells produce PDGF too

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21
Q

dividing groups based on current risk factors then comparing disease prevalence at present time

A

Cross Sectional study

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22
Q

half life eq

A

t1/2= (0.7 x Vd)/CL

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23
Q

What inhibits beta oxidation of fatty acids, particularly the carnitine shuttle

A

Malanoyl CoA

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24
Q

CD14 is a unique surface marker for

A

Macrophages

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25
Q

Cancer that Trisomy 21 pts are at increased risk for

A

Acute Lymphoblastic Leukemia

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26
Q

Mechanism by which eosinophils kill parasites

A

Ab dependent cell mediated cytotoxicity

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27
Q

Ab dependent cell mediated cytotoxicity mechanism (2 steps)

A

Fc receptor on eosinophil binds IgE/IgG on the parasite –> triggers degranulation and release of Major Basic protein –> destroy the parasite

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28
Q

Patients with urea cycle disorders should rectrict eating

A

protein

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29
Q

Hyperphenylalanemia + hyperprolactinemia

A

Dihydrobiopterin reductase deficiency (increased phenylaline and decreased dopamine production)

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30
Q

Anterior cerebral artery supplies blood to which part of the sensory/motor cortex

A

Lower limb (medial aspect of each lobe)

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31
Q

2 most important factors to determine cause of metabolic alkalosis

A

Urine Chrloride

Volume status

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32
Q

Heart dominance

A

Whichever artery supplies the posterior descending

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33
Q

Which artery supplies the AV node?

A

Right dominant- right coronary

Left dominant- Circumflex artery

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34
Q

2 mechanisms by which DKA causes K loss in urine

A

1- osmotic diuresis (increases K gradient in DCT)

2- increase aldosterone secretion (from hypovolemia)

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35
Q

Cellular mechanism of HIV associated dementia

A

Activation of microglial cells –> microglial nodules

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36
Q

Serum sickness hypersensitity type

A

Type III

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37
Q

Type III hypersensitivity lab values and primary cell type

A

Low levels of Circulating C3

Neutrophils predominate

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38
Q

First line therapy for isolated hypertriglyceridemia

A

Fibrates (fenofibrate, gemfibrozil)

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39
Q

Adrenal medulla cells (type) are stimulated by which NT

A

Chromaffin cells are stimulated by Acetylcholine from SNS preganglionic neurons

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40
Q

Contents of inundibulopelvic ligament and clinical relevance

A

Ovarian n.a.v.

This is the site of injury in ovarian torsion

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41
Q

Chain of decision making for individual with no health care proxy

A

Spouse –> Family member –> close friend

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42
Q

Functional Mitral Regurgitation (Cause and Tx)

A

Seen in volume overloaded hearts where the mitral valve is stretched and the high LV EDV reguritates back into L atrium.

Tx is to reduce preload

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43
Q

Site in tubule of most concentrated urine in absence of ADH

A

Junction of descending and ascending loops of henle

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44
Q

Effects of steroid abuse on hematocrit

A

Increases

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45
Q

Most anterior portion of the heart and the one that gets pierced if the person is stabbed in the chest

A

Right ventricle

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46
Q

Cause of infertility in cystic fibrosis vs primary ciliary dyskinesia

A

CF - absence of the vas deferens = AZOSPERMIA

PCD- immotile spermatozoa = have sperm but they dont work

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47
Q

Hyponatremia with a normal water restriction test that doesn’t significantly change when ADH is given

A

Primary Polydipsia

DI would have hypernatremia and inability to concentrate urine

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48
Q

Destruction of misfolded proteins is mediated by which pathway

A

Ubiquitin and Proteosomes

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49
Q

Enzyme deficiency in Maturity-Onset Diabetes of the Young, and its normal function

A

Glucokinase. Normally converts glucose –> G6P in the pancreatic beta cells

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50
Q

Major risk of prescribing an antidepressant to a patient with a history or FHx of bipolar?

A

induction of a manic episode

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51
Q

During radical prostatectamy, the nerves surrounding the prostate are damaged. What are the nerves and what is the effect?

A

Prostatic plexus.

Erectile dysfunction b/c cavernous nerves come from prostatic plexus

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52
Q

Innervation below the dentate line (i.e. external hemorrhoids)

A

Inferior rectal nerve via the pudendal nerve

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53
Q

c-myc, n-myc, l-myc functions

A

nuclear regulators that faciliate mRNA translation

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54
Q

prophylactic treatment for neonatal GBS

A

INTRAPARTUM penicillin/ampicillin

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55
Q

Most important prognostic factor in determing severity of mitral regurg

A

Presence of S3 suggests heart is volume overloaded = severe mitral regurg.

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56
Q

At which point in the respiratory tree do cilia disappear and macrophages appear?

A

Resipratory bronchioles

terminal bronchioles have cilia and no macrophages

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57
Q

Why are vaccines with capsular antigens coupled with a protein/toxin conjugate?

A

To induce a T cell response and confer longer immunity (good in infants)

Polysaccharide capsules only confer a B cell response and don’t last long (not good in infants)

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58
Q

Most important mechanism of pathogen removal in the terminal bronchiole

A

Ciliated epithelial cells

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59
Q

Lateral nucleus of the hypothalamus

A

Hunger center (destruction = anorexia)

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60
Q

Ventromedial nucleus of hypothalamus

A

Satiety center (destruction = hyperphagia)

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61
Q

RIght vs Left frontal lobe lesions/trauma

A

Right = disinhibited behavior (impulsivity)

Left= apathy and depression

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62
Q

Histone H1 vs H2-H4

A

H2-H4 are central

H1 is external and links the DNA segments

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63
Q

Which enzyme is overactive in Fructokinase deficiency

A

Hexokinase

Fructose –> Fructose 6 Phosphate

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64
Q

Modified smooth muscle cells in the kidney

A

Juxtaglomerular cells and macula densa

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65
Q

Seizures + Myopathy + Ragged muscle fibers

A

Mitochondrial Myopathy

Maternal inheritance

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66
Q

Epithelial ovarian cancer tumor marker

A

CA 125

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67
Q

2 components of MCHII vs MHC1

A

MHC1 = Heavy chain + B2 globulin

MHCII = alpha chan + beta chain

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68
Q

Specific cause of papilledema in idiopathic intracranial HTN

A

Compression of optic nerve, impairing axoplasmic flow

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69
Q

Cellular target of C. diff Toxin A and B

A

inactivation of Rho-regulatory proteins –> destruction of actin and tight cell junctions

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70
Q

Why does tranfusion of packed RBCs lead to hypocalcemia?

A

It contains citrate, which chelates calcium

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71
Q

Rash on sun exposed areas + ataxia + neutral aminoaciduria

A

Hartnup Disease –> defective neutral aminoacid transporter

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72
Q

Tx for hartnup

A

Niacin

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73
Q

PCL origin and insertion

A

Origin- Anteriolateral surface of medial femoral condyle

Insert- Posterior intercondylar area of tibia

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74
Q

MCC genotype of complete molar pregnancy

A

46XX&raquo_space;> 46XY

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75
Q

Time frame for maintaining BGL during a fast (<18hrs and >18hrs)

A

<18 is maintained by glycogenolysis

> 18 is maintained by gluconeogenesis

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76
Q

Time course of salicylic acid RespAlk / Met Acidosis

A

Resp Alk occurs first then 12 HOURS LATER pateitns develop Met Acidosis

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77
Q

Positive vs Negative T cell selection

A

Positive selection occurs first- Keep T cells that bind self MHC

Negative selection - destroy T cells that bind self MHC too tightly

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78
Q

Location of positive vs negative selection

A 
Positive = thymic cortex
Negative = thymic medulla
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79
Q

2 Supplementation for homocystinuria

A

Pyridoxine B6 and Cysteine

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80
Q

Microsomal Monooxygenase function

A

Convert carcinogenic substances to their active forms

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81
Q

Most common toxin found in wild mushrooms and its mechanism

A

Amatoxins –> inhibit RNA Pol II –> decrease mRNA

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82
Q

Thyroid nodule. Biopsy shows cells with large nuclei and sparse chromatin

A

Orphan annie nuclei –> Papillary carcinoma

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83
Q

Vessels anterior and posterior to ureter

A

Anterior = Gonadal vein/a.

Posterior = INTERNAL iliac

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84
Q

2 holocrine glands, 1 apocrine gland

A

apocrine = breast

Holocrine = sebaceous and meibomian glands

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85
Q

Which process is most important in removing intracellular organisms from the body?

A

Cell mediated immunity via macrophages…NOT complement mediated lysis b/c intracellular organisms are “shielded” from complement and T cells

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86
Q

Ingestion of houshold substance, now has N/V/D and garlic breath. (overdose and antidote)

A

ArseNIC = garLIC breath

Dimercaprol –> binds sulfhydrl groups to inhibit cellular respiration

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87
Q

Most appropriate test for determining the presence of malabsorption in general…not necessarily a specific cause of malabsorption.

A

Stool microscopy with Sudan III Stain

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88
Q

Effect of excess ammonia in astrocytes

A

Increased ammonia = increased glutamine production –> astrocyte swelling –> impaired glutamine release

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89
Q

MCC site of aortic arch injuries (in car accidents)

A

Isthmus (just distal to the subclavian a) , b/c it is secured by the ligamentum arteriosum

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90
Q

Dihydrorhodamine flow cytometry test (use and positive result)

A

Used to assess for NADPH ox deficiency.

Normal neutrophils will produce a green flouresence. Cells lacking NADPH oxidase will not floursce as much

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91
Q

Which urea cycle disorder will present WITHOUT hyperammonemia?

A

Arginase deficiency

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92
Q

Main inhibitor of LACTATION in pregnancy

A

Progesterone

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93
Q

Calcium Sensing Receptor of PTH is coupled to which kind of receptor

A

GPCR

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94
Q

Sudden upward jerking of arm followed by weakness in all hand muscles. Injured structure?

A

Lower trunk of brachial plexus –> klumpkes palsy

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95
Q

Recurrent small lobar hemorrhages in an elderly individual without intraparenchymal hemorrhage. Cause?

A

Amyloid angiopathy

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96
Q

2 major examples of a true diverticulum. What layers are involved?

A

Meckels diverticulum and the appendix

Submucosa, mucsoa and muscularis propria

97
Q

After illness, child’s cardiac biopsy shows a granuloma and fibrosis. organism?

A

GAS –> acute rheumatic fever

98
Q

DOC for reducing inflammation both chronically and acutely in COPD/Asthma

A

Corticosteroids

99
Q

Study results show a perceived association between an exposure and an outcome, but that association can actually be explained by an outside, unaccounted for variable

A

Confounding

100
Q

2 major risk factors for Rhizopus infection

A

DKA

Immunosuppression

101
Q

Origin and insertion sites of ACL

A

Origin- Anterior intercondylar area

Insertion- Medila portion of the LATERAL condyle

102
Q

Patient was treated for a bacteremia a week ago, now presents with bone pain

A

Osteomyelitis

103
Q

Two lung cells that contain elastases/proteases

A

Neutrophils and Macrophages

104
Q

Ductus arteriosus is a derivative of which aortic arch?

A

6th

105
Q

Molecular mechanism by which the mutated huntingtin gene causes disease

A

Transcriptional repression –> causes histones to be DEacetylated –> impaired neuron survival

106
Q

Polyribosylribitol phosphate capusle…organism?

A

H. influenzae

107
Q

Tx for PCOS patients that still wish to get pregnant?

A

SERMs that block negative feedback of estrogen on pituitary –> improved FSH/LH production

108
Q

How do irreversible inhibitors affect kinetics?

A

Decrease Vmax

109
Q

ST elevation in leads I and aVL. Artery?

A

Left circumflex artery

110
Q

Mechanism by which M3 receptors cause vasodilation? most important amino acid?

A

Endothelium dependent vasodilation

ARGININE gets converted to NO which incresaes cGMP

111
Q

What process occurs in the nucleolus

A

Transcription of rRNA

112
Q

Progressive loss of hearing with + exposure to loud sounds. Imaging shows high frequency hearing loss. Site of damage?

A

Cilia on the hair cells are damaged

113
Q

Why is hypernatremia rarely seen in hyperaldosteronism>

A

Aldosterone escape

114
Q

What is aldosterone escape?

A

Increased Na reabsorption = increased water retention = incresaed RBF = increased Na FILTRATION to counteract the increased Na reabsorption

115
Q

Kinesin function

A

Anterograde transport towards + end of microtubule

from nucleus towards periphery

116
Q

2 substances that can be used to calculate GFR

A

Inulin

Creatinine

117
Q

Where is the area postrema located?

A

Dorsal midbrain at the level of the 4th ventricle

118
Q

Enoxaparin drug class

A

Low molecular weight heparin

119
Q

2 Main differences in function b/w DNA Pol I and DNA Pol III

A

DNA Pol I removes the okazaki fragments and has 5–> exonuclease activity

DNA Pol III has 3–>5 exonuclease activity

120
Q

2 cells affected by toxic shock syndrome toxin

A

Macrophages and T cells

121
Q

Respiratory side effect of mannitol

A

Pulmonary edema

122
Q

Cystic fibrosis patient with normal sweat chloride levels. What other ion defect could they have?

A

Increased Na reabsorption from the lumen = more water reabsorption = thick mucus

123
Q

Is the anterior pituitary more closely associated with the optic chiasm or the mammilary body?

A

Optic chiasm. Posterior pituitary is on the same side as the mammillary body

124
Q

Increased muscle contractions, weakness, cataracts, gonadal atrophy and frontal balding

A

Myotonic dystrophy

125
Q

Subendothelial space in arterioles shows homogenous substance that stains pink with PAS. What is the condition? MCC?

A

Hyaline arteriolosclerosis

DM and essential HTN

126
Q

Which type of immune response do inactivated vaccines induce? Live vacciens?

A

Induce antibodies against the pathogen (don’t enter host cells)

Live vaccines produce CD8T cell response b/c the vaccine enters cells and is expressed on MHCI

127
Q

Acute onset of neurologic disturbance, hypoxemia, shortness of breath and a petichial rash on the chest

A

Fat embolism (Fat causes local toxic injury to the endothelium –> petichae)

128
Q

Histologic difference between osteoblasts and osteoclasts

A

Osteoblasts are uninucleated

Osteoclasts have multiple nuclei…in pagets, they can have up to 100 nuclei!

129
Q

How to differentiate b/w myoclonic seizure and simple motor seizure?

A

Myoclonic is bilateral, simple motor seizure is unilateral

generalized seizures affect both hemispheres. Focal seizures affect one hemisphere

130
Q

Main difference in spirometry between pulmonary fibrosis and obesity?

A 
Fibrosis = decreased RV
Obesity = normal RV
131
Q

Which artery does polyarteritis nodosa spare?

A

Pulmonary artereis

132
Q

Hypertension, bradycardia, fixed dilated pupils with loss of light reflexes

A

Uncal herniation

133
Q

Drug used for preventing RECURRENCE of status epileptics

A

Phenytoin

134
Q

Flutamide MOA

A

Binds DHT/Testosterone receptor and inhibits its effects

135
Q

What is the reason for rapid onset and recovory from highly lipophilic drugs?

A

Quickly enters brain then redistributes to other body tissues

136
Q

Thyroid condition with mononuclear / lymphocyte infiltration with germinal centers

A

Hashimoto Thyroidits

137
Q

Pt rolled ankle and is tender over anterolateral aspect. Injured ligament?

A

Anterior talofibular ligament

138
Q

MSH2, MSH6, MLH1, PMS2 mutations

A

HPNCC (hereditary nonpolyposis colon cancer)

139
Q

Major complication of Etanercept if left unchecked?

A

REactivation of TB

140
Q

Specific site of osteomyelitis in children

A

Metaphysis of long bone

141
Q

Calories/Gram of Protein

A

4

142
Q

Cause of bicornuate uterus

A

Failed lateral fusion of paramesonephric ducts

143
Q

What 2 cellular processes on DNA and Histones reduce its ability to be transcribed?

A

DNA methylation completely silences transcription

Histone Methylation

144
Q

Where are barr bodies located?

A

In the periphery of the cell as heterochromatin

145
Q

What unique process do proteins targeted to the lysosomes undergo while in the Golgi?

A

Phosphorylation of mannose residues

146
Q

What is the histologic difference between Ischemic ATN and Toxic ATN?

A

Toxic ATN has oxalate crystals (probably from ethylene glycol)

Ischemic ATN has all the same vacuolization but no crystals

147
Q

Bloody diarrhea in an AIDS patient. Histology shows spindle shaped cells with vessel proliferation.

A

Kaposi Sarcoma

148
Q

Melanocytes are from which embryologic derivative?

A

Neural Crest

149
Q

What kind of immune response do Toxoid vaccines produce?

A

Ab against the toxin only

This means that they don’t activate complement and target the pathogen directly. (Vaccines against capsules will create this type of response)

150
Q

Child with bilateral papilledema, upward gaze paralysis, vomiting and headache. Where is the tumor?

A

Pineal gland mass

Constricts aqueduct causing hydrocephalus (headache, papilidema, vomiting).
Compresses dorsal midbrain (visual symptoms)

151
Q

Besides Dorsal columns and lateral corticospinal tracts, what other spinal pathway does B12 deficiency affect?

A

Spinocerebellar tract (contributes to the ataxia)

152
Q

Lung sputum grows on Sabraoud Agar. What is it?

A

Coccidoides immitis

153
Q

Hawthorne Effect

A

Subject changes their behavior once they know theyre being observed

154
Q

Most common site of male urethral injury in pelvic fracture/severe trauma

A

Bulbomembranous junction of the posterior urethra

155
Q

Most common site of male urethral trauma in straddle injuries

A

Bulbous segment

156
Q

Pt on a diuretic was given lisinopril then developed orthostatic hypotension. Why/

A

First dose HTN –> Patients on diuretics are usually volume contracted. ACE inhibitors will cause vasodilation and exacerbate volume contraction

157
Q

Normal HFE function

A

Senses serum Fe levels and releases hepcidin

158
Q

BMPR2 gene mutation (dz and pathogenesis)

A

Idiopathic Pulmonary Hypertension caused by smooth muscle proliferation

159
Q

What is the only glycogen storage disease strictly limited to skeletal muscle? why?

A

McArdle disease b/c glycogen phosphorylase is not present in liver or heart

160
Q

Importance of the kozak sequence

A

It is important in the initiation of translation. The ribosome initiaton complex binds upstreatm then “scans” until it finds the kozak sequence

161
Q

Which 2 cell types cannot use ketones as energy?

A

Erythrocytes

Hepatocytes

162
Q

Specific reason for splenomegaly in extravascular hemolytic anemia

A

Red Pulp hyperplasia

Increased hemolysis = increased work load for the splenic macrophages = hyperplasia

163
Q

Path of blood flow to retina

A

Internal carotid –> opthalmic –> retinal

164
Q

Which cellular mediator is responsible for keloid formation?

A

Excess TGFB

165
Q

Sporotrichosis histology

A

Granulomatous inflammation (its a fungus…so you expect granulomas)

166
Q

Speech, comprehension, repitition and other neurologic ssx of Broca Aphasia

A

non fluent speech
Fine comprehension
Poor repitition
Right sided hemiparisis (face and arm)

167
Q

High circulating levels of what substance are most important in the development and progression of DM II?

A

Free Fatty Acids

(Insulin insensitivity = increased liposlysis = increased FFA release = downregulation of insulin receptors even more = further insulin insensitivity)

168
Q

Landmark for the deep radial nerve as it enters forearm, and the nerve that it gets renamed to

A

It pierces the supinator muscle and becomes the posterior interosseous n

169
Q

Why is PaO2 slightly lower than PAO2 in a heatlhy individual?

A

Deoxygenated bronchial blood drains into the Pulmonary Vein

170
Q

Midhumerus fracture. Damaged nerve and artery

A

Radial nerve

Deep brachial a.

171
Q

Which Group A strep virulence factors allows it to be antiphagocytic? 2

A

M Protein and Hylaronic acid

streptolysin destroys RBCs and WBCs…it has nothing to do with the capsule

172
Q

How to determine if angioedema from lisinopril is from bradykinin or C1 esterase deficiency

A

Bradykinin is in all patients, especially the ones who have never had experience with angioedema

C1esterase pts normally present in childhood

173
Q

Cheyenne Stokes Breathing (who is it seen in and what is it)

A

Seen in CHF

Ossiliting patterns of increased tidal volume and decreased tidal volume. (See Uworld image)

174
Q

What is the toxic metabolite that induces abortion in MTX therapy

A

Dihydrofolate polyglutamate

when MTX is in the cell, everything gets polyglutamated

175
Q

2 reasons Sickle Cell patients can have a MACROcytic anemia

A

Extramedullary hematopoiesis –> increased retics

Folate deficiency (increased synthesis of RBCs = increased demand for folate)

176
Q

what is the first initiating step in infective endocarditis (non Staph aureus)?

A

Damaged valve induces formation of a fibrin platelet –> bacteria can then bind to that clot

177
Q

where in the cell is proinsulin cleaved to insulin and c-peptide?

A

Within the secretory granule

178
Q

what serum marker is most specific for Rheumatoid Arthritis?

A

anti-certrullinated peptide Ab (anti-CCP)

179
Q

Mnemonic for the 10 Neural Crest structures

A

MOTEL PASS

Melanocytes
Odonoblasts
Tracheal cartilage
Enterochromaffin cells
Laryngeal cartilage
Parafollicular cells of thyroid
Adrenal medulla and Ganglia
Schwann Cells
Spiral membrane
180
Q

Enteropeptidase is analagous to

A

Enterokinase

Converts tryspinogen to trypsin

181
Q

ACUTE V/Q defect (shunt or deadspace) pH, PaO2, PaCO2, HCO3

A 
Low PaO2 (V/Q mismatch causes hypoxemia)
Low PaCO2 (hypoxemia triggers hyperventilation)
High pH (hyperventilation = Resp Alkalosis)
nml/mildly low HCO3 (by mass effect of low CO2. Renal compensation takes several days)
182
Q

Hydrops fetalis definition and presentation

A

Heart failure in the fetus leads to fluid accumulation in multiple compartments

Pleural effusion, ascites, pericardial effusion etc.

183
Q

Which types of hormone receptors have zinc fingers? 3 examples

A

Intracellular receptors (Steroids, Fat soluble vitamins and THyroid hormone)

184
Q

First structure affected in alzheimers

A

Hippocampus

185
Q

Isolated cleft lip is a defect in

A

Fusion of the maxillary prominence and intermaxillary segment of the nasal prominence

186
Q

2 most important vasoactive metabolites in the coronary arteries

A 
Adenosine
Nitric Oxide (EDRF)
187
Q

Mechanism by which vitamin D analogs improve psoriasis

A

Bind intracellular receptor –> activates transcription –> inhibition of keratinocyte proliferation

188
Q

Calcipotriene, calcitriol, tacalcitol are examples of

A

Vitamin D analogs

189
Q

Which inflammatory pathway can be induced by IL 1? why?

A

COX 2 –> cox 2 is only active during episodes of acute inflammation. IL1 is the initatior of acute inflammation

190
Q

Why do microglial cells fill with lipid after an infarction?

A

THey consume all the dead nerve cells, which contain lots of myelin breakdown products

191
Q

Preterm premature rupture of membranes suggests premature delivery is iminent. What medication should be given to improve respiratory function for the baby?

A

Dexamethasone (cortisol increases surfactant production)

192
Q

Neonate who is unvaccinated with bulging fontanelle, downward looking eyes and an increased head circumference. Dx?

A

Intracranial hemorrhage due to Vitamin K deficiency

193
Q

Anterolateral displacement of a supracondylar ridge fracture suggests which side was fractured?

A

Lateral

(the fractured bone shifts to the direction in which it was fractured. Medial supracondylar ridge Fx has anteriomedial displacement)

194
Q

How does the CFTR channel get its energy?

A

ATP-mediated

195
Q

Which osteoporosis drug is structurally similar to pyrophosphate?

A

Bisphosphonates

so is foscarnet…but thtats not for osteo

196
Q

Effect of nitrate therapy on venous capacitance

A

Increases

C=V/P venodilation = increased volume in veins

197
Q

Fidaxomicin indication and mechanism

A

Used in conjunction with metronidazole and vancomycin for C. diff

Inhibits RNA polymerase

198
Q

Baby’s BGL after delivery from a mom with poorly controlled diabetes

A

Transient hypoglycemia

199
Q

2 Most important serum markers indicating PROGNOSIS for cirrhotics

A

Serum albumin, bilirubin and PT time

These all measure the functional capacity of the liver

200
Q

Basis of Sodium Cyanide Nitroprusside test

A

Put cyanide in urine to produce cysteine
Add nitroprusside which reacts with cysteine to cause red/purple color to urine.

Test is positive in cystinuria (too much cystine in urine = cyanide will have lots to react with)

201
Q

Most common bursa injured in people spending lots of time on their knees

A

Prepatellar

202
Q

Specifically, where is aqueous humor produced (cell and structure)

A

Epithelial cells of the ciliary body

203
Q

What is the major difference between an HMO and Point of Service plan?

A

HMO has lowest copay.

HMO < POS < PPO

204
Q

What are the 4 things that minors can consent to?

A

Prenaltal care (NOT ABORTION)
STD screening/testing
Contraception
Drug/Etoh rehab

205
Q

In a purely breast fed baby, what 2 things does the baby need to be supplemented with?

A 
Vitamin D
Vitamin K (usually given if at birth...only have to supplement if they received no vaccines)
206
Q

When does Iron need to be supplemented to a breast fed infant?

A

If they are low weight after 4months

207
Q

Elevated levels of which 2 substances in the serum increase risk for ACUTE pancreatitis

A

Triglycerides

Calcium

208
Q

Abdominal distention, bloody stool and vomiting in a PRETERM infant

A

Necrotizing Enterocolitis (Xray will show air in the bowel)

209
Q

Which cause of bacterial meningitis is resistant to ceftriaxone?

A

Listeria

210
Q

Oral Thrush, recurrent pneumonia, lymphopenia in an infant of a mother who received no prenatal care

A

Vertical transmission of HIV

211
Q

which inflammatory muscle condition can present as a paraneoplastic syndrome of visceral cancers?

A

Dermatomyositis

212
Q

Within the lamellae of bony matrix are osteocytes. Which type of cell junction connects them?

A

Gap junctions so they can exchange nutrients and waste products

213
Q

Linear, red, markings on extremities that seem to move around to different areas of the body and are painful. What is this sign?

A

Trousseau syndrome –> migratory thrombophlebitis

214
Q

Migratory thrombophlebitis is most ocncerning for

A

Visceral cancer

215
Q

Senile or Familial transthyretin deposition inthe heart will eventually cause which kind of heart failure?

A

Diastolic failure (decreased ventricular compliance)

216
Q

Which sulfonylurea is LEAST likey to induce hypoglycemi? Why?

A

Glipizide, because it is the shortest acting

217
Q

Neonate with a duodenum ending in a blind pouch, followed by an absent remainder of the small bowel. The colon is present but the terminal ileum appears tightly adhered to a blood vessel. Diagnosis?

A

Intestinal atresia of the midgut

218
Q

MCC of intestinal atresia of the midgut

A

Vascular occlusion in utero

219
Q

3 nerves affected by a tumor in the cerebellopontine angle

A

V (facial sensation, corneal reflex problems)
VII
VIII

220
Q

Most important immunologic distinguishing factor between Salk and Sabin vaccines

A

Sabin produces LUMINAL IgA

Both produce serum IgA but that isn’t helpful for polio

221
Q

Phenylcycladine MOA

A

NMDA receptor antagonist

222
Q

Menotropin use and MOA

A

FSH analog that triggers formation of a follicle

223
Q

Role of B-hCG supplements in treating infertility

A

B-HCG mimics LH surge required for ovulation…often given in conjunction with menotropin (which prepared the follice)

224
Q

What is the most severe, irreversible change that occurs in Eissenmenger syndrome of an ASD/VSD

A

Irreversible hypertrophy/fibrosis of the pulmonary artery

225
Q

When should an oral glucose tolerance test be used to screen for diabetes?

A

Only for gestiational DM and in CF patients

For normal pts, fasting glucose, random glucose or elevated A1C are best

226
Q

Fammily Hx of leukemia, adrenal tumors and brain cancer. Pt has a sarcoma and breast mass. Gene mutation?

A

p53 –> Li Fraumani syndrome

227
Q

3 intermediate benzodiazepines

A

Alprazolam
Lorazepam
Temazepam

228
Q

Besides T cells, macrophages and B cells, which other cell type does IL2 directly stimulate?

A

NK cells

229
Q

Labs of intravascular hemolysis (LDH, Haptoglobin, UCB,

A

High LDH
Low Haptoglobin
High UCB (elevated UCB isn’t only in extravascular hemolysis)

230
Q

Pt has muscle weakness, hypertension and a low renin. No edema noted. Diagnosis?

A

Primary hyperaldosteronism

Weakness = hypoK
HTN= hypernatremia
No edema = aldosterone escape

231
Q

Describe aldosterone escape

A

Increased aldosterone –> increased Na/H2O retention –> increased blood volume –> increased venous return to heart –> release ANP –> increase GFR and Na excretion

Essentially all the Na that aldosterone reabsorbed gets re-excreted so you don’t get edema

232
Q

Results of quadruple screen for Downsyndrome

A

Low AFP (most important)
Low unconjugated estriol
Increased BhCG
Increased Inhibin A

233
Q

Which colon cancer produces copious amounts of watery, mucus filled diarrhea?

A

Villous Adenoma

234
Q

Puncture wound superior to the clavicle, between mid clavicular and lateral sternal lines. Most likely structure to be damaged and the symptoms it causes

A

Lung pleura leading to a tension pneumothorax

hypotension due to increased intrathoracic pressure compressing the heart/decreasing CO

tachycardia and SOB

235
Q

Patient with cancer develops ataxia, dizziness, dysarithia. Most likely cause?

A

Subacute cerebellar degeneration

236
Q

Subacute cerebellar degeneration pathogenesis

A

Autoimmune! anti tumor Abs cross reacti with the cerebellar purkinje cells

237
Q

Subactue cerebellar degeneration serum Ab markers

A

Anti- Yo
Anti- P/Q
Anti-Hu

238
Q

Nephrotic syndrome assiciated with IgG against phospholipase A2 receptor

A

Membranous nephropathy

PATH STORE (24 decks)

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