UWorld-Mixed Deck from All Subjects Flashcards
Q#1-27 from test #14
anti-centromere antibodies are found in most patients with
CREST syndrome
what the classic triad of reactive arthritis and what HLA gene is it associated with
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
what kind of drug are nafcillin, methicillin and oxacillin and what general kind of infection/ pathogen do they usually treat
penicillinase-resistant penicillins;
they treat S. aureus (except MRSA) and are often used for skin, soft tissue and follicle infections
a child with intellectual disability and bilateral lens subluxation that dies of MI could have been treated with what
pyridoxine (vit B6) for homocysteinuria, most commonly caused by cystathione synthase deficiency, which is catalyzed by vitamin B6
what are two reasons that niacin can cause increase side effects when given to a patient on anti-hypertensive therapy
niacin potentiates anti-hypertensive drugs by causing vasodilation
niacin can cause hyperuricemia as can thiazides
winged scapula involves injury to what nerve
long thoracic nerve (innervation to serratus anterior)
what is the normal A-a gradient and what respiratory conditions involve a normal A-a gradient
10-15mmHg;
hypoventilation and high altitude have normal A-a gradient
ataxia, increased risk of sinopulmonary infections and telangiectasias are the classic triad for
ataxia telangiectasia
what effect does COPD have on cerebral vasculature
COPD causes rising pCO2 and hypercapnia causes cerebral vasodilation
what are entacapone and tolcapone, how do they work and what do they treat
COMT inhibitors;
they increase levodopa levels in the brain and are used to treat Parkinson’s
what kind of UV do PABA esters absorb
what kind of UV do zinc oxide containing sunscreens absorb
PABA esters absorb UVB only;
zinc oxide containing sunscreens are broad-spectrum and absorb UVAI, UVAII and UVB
what kind of UV does avobenzone absorb
UVAI and UVAII
which DNA viruses are enveloped, which are naked
enveloped=herpes virus, hepadnavirus, and poxvirus
naked=picornavirus, adenovirus, papillomavirus, polyomavirus
which DNA viruses are circular
papillomavirus, polyomavirus are circular and hepadnavirus is partially circular
name two echinocandins and explain the mechanism of action
capsofungin and micafungin;
inhibit synthesis of beta-glucan, a component of fungal cell walls
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
Legionella pneumophila causes Legionnaire’s disease and often doesn’t show up on gram-stain
what differentiates Tay Sachs (beta-hexosaminidase A deficiency) from Niemann-Pick (sphingomyelinase deficiency)
no hepatomegaly in Tay-Sachs
note: cherry red spot on macula and progressive neurodegeneration seen in both
bilateral accoustic neuromas are associated with what condition and what chromosome is affected
neurofibromatosis 2
NF2 gene on chromosome 22
streak ovaries (underdeveloped elongated ovaries) are a classic sign of what condition
Turner’s syndrome
how do you calculate attributable risk percentage
ARP= (RR-1) / RR
where is ACE produced
mainly in the endothelial cells of the pulmonary vasculature
where is prostaglandin E1 produced and what does it do
prostaglandin E1 is a locally produced vasodilator produced by almost all tissues in the body
pigmented gallstones are an indication of what process
hemolytic anemia
which test models the relationship between a continuous dependent variable and continuous independent variable
linear regression
what statistical test compares the means of two groups of continuous variables
t-test
name three cardiac defects that produce a holosystolic murmur
VSD, tricuspid regurg. and mitral regurg.
renal angiomyolipomas and ash-leaf patches are associated with what condition
tuberous sclerosis
which DNA polymerase has 5’ to 3’ exonuclease activity
DNA polymerase I has both 3’ to 5’ and 5’ to 3’ exonuclease activity
how do benzodiazepines work;
which other psych drugs have a similar mechanism of action
allosterically binding GABAa receptor to increase Cl channel opening (causing hyperpolarization)
what kinds of receptors are GABAa, GABAb and GABAc
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
what effect do loop diuretics have on prostaglandins
loop diuretics increase prostaglandin release, which leads to increased renal blood flow –> increased GFR
BMPR2 (bone morphogenic protein receptor type 2) predisposes to what condition
PAH (pulmonary artery hypertension)
name 6 drugs that are metabolized by CYP450
warfarin, phenytoin, propranolol, metoprolol, quinidine, theophylline
will a positive urease test show high or low pH
high;
urease converts urea to CO2 and ammonia
what part of the lung is most affected in chronic rejection
the small bronchioles (bronchiolitis obliterans)
what do Clara cells do
secrete clara cell secretory protein (which inhibits neutrophil recruitment and activation); precursors for goblet cells
direct bilirubin fraction of over 50% suggests
Dubin-Johnson syndrome with otherwise normal liver profile
what does ADH do to urea
ADH increases concentration of urea passive transporters in the inner medullary collecting duct
name two direct (selective) arteriolar vasodilators and list their side effects
hydralazine and minoxidil;
since they only dilate arterioles and not the venous system they can cause reflex tachycardia and sodium retention
most common side effect of inhaled glucocorticoids (fluticasone, beclomethasone, flunisolide)
oral candidiasis
which medication helps decrease risk of adenomatous polyp formation and via what mechanism
aspirin;
COX-2 overexpression has been implicated in recurrence of adenomatous polyp formation so aspirin blocks COX-2, thereby reducing risk
for what issues can a minor give consent for medical treatment without parental permission
pregnancy, birth control, STDs, alcohol or drug addiction
which of the immune cells are acutely increased after glucocortiocoid administration
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
deficiency of what vitamin causes peripheral neuropathy, cardiomegaly, congestive heart failure and tachycardia
this is wet beriberi;
B1
how does dextrans facilitate strep viridans infection
dextrans is synthesized by strep viridans and it allows the pathogen to adhere to fibrin
name some symptoms you would expect from systemic mastocytosis
gastric acid hypersecretion, diarrhea, flushing, pruritus, rash (all the things H1 and H2 receptors mediate)
how would you treat drug-induced parkinsonism vs. how would you treat Parkinson’s disease
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)
bronchoaveolar lavage of the lungs of a patient with sarcoidosis will have an abnormal predominance of what cell type
CD4+ cells
what are the relative values of calcium and PTH compared to normal in osteoporosis
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
what kinds of molecules are c-Jun and c-Fos
nuclear transcription factors that bind DNA and promote oncogenic activity when mutated
the oxidative part of the HMP shunt (involving G6PD-mediated generation of NADPH) is most important for what sites in the body
adrenal cortex, mammary glands, liver and RBCs (sites of fatty acid or steroid synthesis)
cauda equina syndrome involves damage to what nerve roots
S2-S4
anal wink reflex (anocutaneous reflex) is mediated by what nerve root
S4
which drugs prolong QT?
of these drugs which has the lowest risk of torsades de pointe?
Class 1A (quinidine, procainimide, disopyramide) and Class III (amiodarone, ibutilide, dofetilide, and sotolol)
of these amiodarone is associated with a low incidence of Torsades
BRAF is associated with what cancer
oncogene associated with melanoma
note: p16 is a tumor suppressor associated with melanoma
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
second generation anti-histamines (fexofenadine, loratadine, desloratadine, and certirizine) have less antimuscarinic (blurry vision), less sedative, and less antiadrenergic (postural dizziness) effects
