UWorld-Mixed Deck from All Subjects

Question 1

anti-centromere antibodies are found in most patients with

Answer 1

CREST syndrome

Question 2

what the classic triad of reactive arthritis and what HLA gene is it associated with

Answer 2

asymmetric aseptic arthritis, conjunctivitis, urethritis (“can’t see can’t pee can’t bend my knee)

associated with HLA-B27 along with the other seronegative spondyloarthropathies

Question 3

what kind of drug are nafcillin, methicillin and oxacillin and what general kind of infection/ pathogen do they usually treat

Answer 3

penicillinase-resistant penicillins;

they treat S. aureus (except MRSA) and are often used for skin, soft tissue and follicle infections

Question 4

a child with intellectual disability and bilateral lens subluxation that dies of MI could have been treated with what

Answer 4

pyridoxine (vit B6) for homocysteinuria, most commonly caused by cystathione synthase deficiency, which is catalyzed by vitamin B6

Question 5

what are two reasons that niacin can cause increase side effects when given to a patient on anti-hypertensive therapy

Answer 5

niacin potentiates anti-hypertensive drugs by causing vasodilation

niacin can cause hyperuricemia as can thiazides

Question 6

winged scapula involves injury to what nerve

Answer 6

long thoracic nerve (innervation to serratus anterior)

Question 7

what is the normal A-a gradient and what respiratory conditions involve a normal A-a gradient

Answer 7

10-15mmHg;

hypoventilation and high altitude have normal A-a gradient

Question 8

ataxia, increased risk of sinopulmonary infections and telangiectasias are the classic triad for

Answer 8

ataxia telangiectasia

Question 9

what effect does COPD have on cerebral vasculature

Answer 9

COPD causes rising pCO2 and hypercapnia causes cerebral vasodilation

Question 10

what are entacapone and tolcapone, how do they work and what do they treat

Answer 10

COMT inhibitors;

they increase levodopa levels in the brain and are used to treat Parkinson’s

Question 11

what kind of UV do PABA esters absorb

what kind of UV do zinc oxide containing sunscreens absorb

Answer 11

PABA esters absorb UVB only;

zinc oxide containing sunscreens are broad-spectrum and absorb UVAI, UVAII and UVB

Question 12

what kind of UV does avobenzone absorb

Answer 12

UVAI and UVAII

Question 13

which DNA viruses are enveloped, which are naked

Answer 13

enveloped=herpes virus, hepadnavirus, and poxvirus

naked=picornavirus, adenovirus, papillomavirus, polyomavirus

Question 14

which DNA viruses are circular

Answer 14

papillomavirus, polyomavirus are circular and hepadnavirus is partially circular

Question 15

name two echinocandins and explain the mechanism of action

Answer 15

capsofungin and micafungin;

inhibit synthesis of beta-glucan, a component of fungal cell walls

Question 16

a smoker comes down with an acute illness involving very high fever, confusion, diarrhea and headache;
gram-stain shows no bacteria; what is the causal pathogen and the disease

Answer 16

Legionella pneumophila causes Legionnaire’s disease and often doesn’t show up on gram-stain

Question 17

what differentiates Tay Sachs (beta-hexosaminidase A deficiency) from Niemann-Pick (sphingomyelinase deficiency)

Answer 17

no hepatomegaly in Tay-Sachs

note: cherry red spot on macula and progressive neurodegeneration seen in both

Question 18

bilateral accoustic neuromas are associated with what condition and what chromosome is affected

Answer 18

neurofibromatosis 2

NF2 gene on chromosome 22

Question 19

streak ovaries (underdeveloped elongated ovaries) are a classic sign of what condition

Answer 19

Turner’s syndrome

Question 20

how do you calculate attributable risk percentage

Answer 20

ARP= (RR-1) / RR

Question 21

where is ACE produced

Answer 21

mainly in the endothelial cells of the pulmonary vasculature

Question 22

where is prostaglandin E1 produced and what does it do

Answer 22

prostaglandin E1 is a locally produced vasodilator produced by almost all tissues in the body

Question 23

pigmented gallstones are an indication of what process

Answer 23

hemolytic anemia

Question 24

which test models the relationship between a continuous dependent variable and continuous independent variable

Answer 24

linear regression

Question 25

what statistical test compares the means of two groups of continuous variables

Answer 25

t-test

Question 26

name three cardiac defects that produce a holosystolic murmur

Answer 26

VSD, tricuspid regurg. and mitral regurg.

Question 27

renal angiomyolipomas and ash-leaf patches are associated with what condition

Answer 27

tuberous sclerosis

Question 28

which DNA polymerase has 5’ to 3’ exonuclease activity

Answer 28

DNA polymerase I has both 3’ to 5’ and 5’ to 3’ exonuclease activity

Question 29

how do benzodiazepines work;

which other psych drugs have a similar mechanism of action

Answer 29

allosterically binding GABAa receptor to increase Cl channel opening (causing hyperpolarization)

Question 30

what kinds of receptors are GABAa, GABAb and GABAc

Answer 30

GABAa and GABAc are ion channels that increase Cl influx

GABAb is a G protein that (1) increases K+ efflux, (2) decreases Ca2+ influx and (3) inhibits adenylyl cyclase

Question 31

what effect do loop diuretics have on prostaglandins

Answer 31

loop diuretics increase prostaglandin release, which leads to increased renal blood flow –> increased GFR

Question 32

BMPR2 (bone morphogenic protein receptor type 2) predisposes to what condition

Answer 32

PAH (pulmonary artery hypertension)

Question 33

name 6 drugs that are metabolized by CYP450

Answer 33

warfarin, phenytoin, propranolol, metoprolol, quinidine, theophylline

Question 34

will a positive urease test show high or low pH

Answer 34

high;

urease converts urea to CO2 and ammonia

Question 35

what part of the lung is most affected in chronic rejection

Answer 35

the small bronchioles (bronchiolitis obliterans)

Question 36

what do Clara cells do

Answer 36

secrete clara cell secretory protein (which inhibits neutrophil recruitment and activation); precursors for goblet cells

Question 37

direct bilirubin fraction of over 50% suggests

Answer 37

Dubin-Johnson syndrome with otherwise normal liver profile

Question 38

what does ADH do to urea

Answer 38

ADH increases concentration of urea passive transporters in the inner medullary collecting duct

Question 39

name two direct (selective) arteriolar vasodilators and list their side effects

Answer 39

hydralazine and minoxidil;

since they only dilate arterioles and not the venous system they can cause reflex tachycardia and sodium retention

Question 40

most common side effect of inhaled glucocorticoids (fluticasone, beclomethasone, flunisolide)

Answer 40

oral candidiasis

Question 41

which medication helps decrease risk of adenomatous polyp formation and via what mechanism

Answer 41

aspirin;
COX-2 overexpression has been implicated in recurrence of adenomatous polyp formation so aspirin blocks COX-2, thereby reducing risk

Question 42

for what issues can a minor give consent for medical treatment without parental permission

Answer 42

pregnancy, birth control, STDs, alcohol or drug addiction

Question 43

which of the immune cells are acutely increased after glucocortiocoid administration

Answer 43

neutrophils; demargination of neutrophils that were previously attached to vessel walls is induced acutely by glucocorticoids
all other immune cells are decreased rather than increased during this time

Question 44

deficiency of what vitamin causes peripheral neuropathy, cardiomegaly, congestive heart failure and tachycardia

Answer 44

this is wet beriberi;

B1

Question 45

how does dextrans facilitate strep viridans infection

Answer 45

dextrans is synthesized by strep viridans and it allows the pathogen to adhere to fibrin

Question 46

name some symptoms you would expect from systemic mastocytosis

Answer 46

gastric acid hypersecretion, diarrhea, flushing, pruritus, rash (all the things H1 and H2 receptors mediate)

Question 47

how would you treat drug-induced parkinsonism vs. how would you treat Parkinson’s disease

Answer 47

drug-induced parkinsonism is caused by D2 antagonism by antipsychotics; treat with benztropine (antimuscarinic) not D2 agonists like levodopa or bromocriptine b/c they allow psychosis to reemerge

Parkinson’s is treated with levodopa/carbidopa or bromocriptine (as well as selegiline) and benztropine can also be used (to curb disinhibited ACh actvitity)

Question 48

bronchoaveolar lavage of the lungs of a patient with sarcoidosis will have an abnormal predominance of what cell type

Answer 48

CD4+ cells

Question 49

what are the relative values of calcium and PTH compared to normal in osteoporosis

Answer 49

both Ca2+ and PTH are normal;
the loss in bone density and interconnections is due to increased bone resoprtion/decreased bone formation due to other causes

Question 50

what kinds of molecules are c-Jun and c-Fos

Answer 50

nuclear transcription factors that bind DNA and promote oncogenic activity when mutated

Question 51

the oxidative part of the HMP shunt (involving G6PD-mediated generation of NADPH) is most important for what sites in the body

Answer 51

adrenal cortex, mammary glands, liver and RBCs (sites of fatty acid or steroid synthesis)

Question 52

cauda equina syndrome involves damage to what nerve roots

Answer 52

S2-S4

Question 53

anal wink reflex (anocutaneous reflex) is mediated by what nerve root

Answer 53

S4

Question 54

which drugs prolong QT?

of these drugs which has the lowest risk of torsades de pointe?

Answer 54

Class 1A (quinidine, procainimide, disopyramide) and Class III (amiodarone, ibutilide, dofetilide, and sotolol)

of these amiodarone is associated with a low incidence of Torsades

Question 55

BRAF is associated with what cancer

Answer 55

oncogene associated with melanoma

note: p16 is a tumor suppressor associated with melanoma

Question 56

you want to treat your patient for an allergic rash, but your patient has a medical history of poor vision and frequent falls; what would you use

Answer 56

second generation anti-histamines (fexofenadine, loratadine, desloratadine, and certirizine) have less antimuscarinic (blurry vision), less sedative, and less antiadrenergic (postural dizziness) effects