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Step 1 Clues > uworld part 2 > Flashcards

uworld part 2 Flashcards

1
Q

a common underlying cause of massive hemoptysis is

A

brochiectasis

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2
Q

fatal massive hemoptysis is suggestive of

A

hemorrhage from bronchial arteries

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3
Q

bacteria escape from phagolysosome

A

listeria

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4
Q

resistant to phagosome-lysosome fusion

A

legionella
TB

involves activation of Th1, IFN-Y and IL2

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5
Q

SLE

prolong PT, low platelett low fibrinogen, bleeding

A

DIC
consumptive coagulopathy

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6
Q

vaginal bleeding, utering enlargement and markely increased B-hCG

no pregnancy

A

gestational choriocarcinoma

proliferation of cytotrophoblast and syncytiotrophoblast

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7
Q

potential complicaton of using chimeric antigen receptor to target CD19

A

Hypogammaglobulinemia

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8
Q

Reduced B-globin chain causes

microcytosis, hypochromic

A

B-thalassemia
precipitate unpaired alpha chain causing membrane damage

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9
Q

hypoglycemia with hi insulin hi c-peptide

A

sulfonylurea use

secretagogue or insulin-secreting tumor

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10
Q

MOA of dronate

A

kills osteoclast

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11
Q

MOA of denosumab

A

decrease bone resorption
bind RANKL

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12
Q

mutation for polycythemia vera

A

mutated JAK2 gene

non-receptr tyrosin kinase

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13
Q

increase physiologic dead space in

A

obese people

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14
Q

topical antifungal for dermatophytes

A

Miconazole
clotrimazole

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15
Q

Nystatin primarily use for

A

candida infection

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16
Q

metabolic alkalosis in loop diuretic therapy

treat with

A

acetazolamide

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17
Q

different bwt staph A. and other staph

A

coagulase neg

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18
Q

RA lab

A

anti citrullinated peptide
hi ESR/CRP

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19
Q

nonbezo hypnoti agent

A

zolpidem
eszopiclone

GABA receptor agonism

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20
Q

hyperphosphatemia induces

A

hypocalcemia

CKD pt

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21
Q

most devastating effect of fibrinolytic therapy

Pt with MI

A

intracerebral hemorrhage

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22
Q

Azathioprine is metabolized by

A

HGPRT

same MOA of allopurinol

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23
Q

trimethoprim inhibits

inhibit pyrimidine nucleotides

A

dihydrofolate reductase

disrupt folate metabolism

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24
Q

prevents IL-2 transcription

A

Tacrolimus

immune suppression

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25
Q

Inhibits inosine monophosphate dehydrogenase

shunting purine base to salvage pathway

A

mycophenolate

de novo purine synthesis

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26
Q

false guanosine(purine nucleotides) disrupting DNA synthesis

A

Ganciclovir

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27
Q

cerebral venous hypertension is an idiopathic cause of

A

elevated intracranial pressure

no mass or ventriculomegaly

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28
Q

bilateral papilledema with ventriculomegaly

A

aqueductal stenosis
increased production of cerebrospinal fluid

choroid plexus papilloma

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29
Q

gram-neg coccobacilli resembling closed safety pin

A

yersinia pestis

harbor by rodens/rats fleabites

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30
Q

inhibit topoisomerase I

A

irinotecan and topotecan

relieve neg supercoiling of DNA

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31
Q

inhibits sealing activity of topisomerase II

A

Etoposide and podophyllin

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32
Q

HbF contains

A

Y-globin instead of B-globin

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33
Q

sepsis lead to multiple organ dysfunction dt

A

defective mito oxidative respiration

low energy state…elevated venous O2 saturation

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34
Q

dermatomyositis..polymyositis with heliotorpe rash affects which muscle

A

straited muscle: perifascicular atrophy of
muscle in the proximal
esophageal muscularis propria

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35
Q

Lung transplant rejection

Hyperacute

A

minutes to hours
ABO or HLA
Neurophil with fibrinoid necrosis and thrombosis

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36
Q

Lung transplant rejection

Acute

A

less than 6 month
cell-mediated
perivascular and submucosal lymphocytic infiltrates

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37
Q

Lung transplant rejection

Chronic

A

Months to years
small airways: sbumucosal inflammation
granulation scaring
bronchiolitis obliterans

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38
Q

long face
large ears
large testes

A

Expansion repeat in FMR1gene
Fragile X syndrome

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39
Q

most common location for anal fissures is

A

posterior midline distal to the dentate line

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40
Q

autonomic instability, altered mental status
and neuromuscular irritability

A

serotonin syndrome

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41
Q

serotoning syndrome is caused by

A

antidepressant MAOI
non-antidepressant with MAOI activity
combine with SSRI or TCA

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42
Q

linezolid plus SSRI causes

A

serotonin syndrome

Linezolid is mild MAOI

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43
Q

conjugate vaccine activates

A

B and T cell response

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44
Q

treatment for dermatomyositis
heliotrope rash

antinuclear ab, anti-jo-1 ab

A

systemic glucocorticoids

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45
Q

motile aerobic G-pos rod, oxidase pos, pyocynin
endotoxin inhibit EF2
nonlactose fermenting

A

psuedo. A

3&4 gen cephalosporin, ticar & piperacillin, carbapenem, aminoglycoside

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46
Q

MOA of emphyema medication to improve chest tube drainage

A

activation of fibrin-bound plasminogen

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47
Q

severe chest pain radiating ot the back and widened mediastium consistant with

A

acute aortic dissection

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48
Q

MOA of Esmolol

A

decreases left ventricular contraction velocity

use for aortic dissection

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49
Q

reduced efficacy of Ig is dt

A

number of antigen epitopes recognized

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50
Q

infant

rash after abrut resolution of fever

A

HHV-6
Roseola infantum

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51
Q

small, causes obstruction, altered bowel habits, NV, abdomen distension, narrow lumen

location: left or right side colon cancer

A

left-sided rectosigmoid colon cancer

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52
Q

large, bulky mass protruding in colonic lumen

A

right-sided ascending colon cancer

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53
Q

severe muscle spasm post anesthesia, fever

A

malignant hyperthermia

treat: stop drug and dantrolene

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54
Q

type 1 hypersensitivity triggered by

A

cell surface-bound antibody linking by antigen

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55
Q

long-term use

how does PPI cause osteoporosis

like omeprazole

A

decrease ca++ absorption

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56
Q

osteoporosis

glucocorticoids and unfractionated heparin

MOA

A

decrease bone formation

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57
Q

osteoporosis

GnRH agonist MOA

A

decrease testosteron and Estrogen

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58
Q

osteoporosis

Aromatase inhibitor and medroxyprogesterone

A

decrease estrogen

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59
Q

osteoporosis

anticonvulsants that induces cytochrome P450

phenobarb, phenytoin, carbamazapine

A

increases vit D catabolism

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60
Q

malignant, intraepithelia adenocarcinoma cells are

A

Paget cell

Breast cancer

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61
Q

unilateral painful/pruritic, eczematous rash on nipple and areola

A

paget disease of the breast

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62
Q

Breat Paget biopsy

A

intraepithelial adenocarcinoma cells

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63
Q

unilateral bloody nipple discharge
no mass

A

intraductal papiloma

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64
Q

small firm mobile breast masses,
proliferating breast stroma and epithelium

A

Fibroadenomas

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65
Q

horseshoe kidney is problem with

A

metanepros
(metanephric blastema)

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66
Q

prostate procedure may damage

nerve

A

inferior hypogastric plexus–>prostate plexus–>cavernous nerves

cavernous nerves passes through prostate fascia

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67
Q

neutrophilic infiltrates and elongated dermal papilae

A

psoriasis vulgaris

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68
Q

full-thickness epidermal necrosis
subepidermal bullae is

A

Stevens-johnson syndrome
toxic epidermal necrolysis

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69
Q

homogenization of dermal collagen dt activation by TGF-beta

A

late stage radiotherapy injury

scaring, ulceration, telangiectasias

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70
Q

Anti-HBs

A

confrims longterm immunity
vaccination

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71
Q

anti-HBc IgG present

A

acute and chronic infection

not in vaccination

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72
Q

Anti-HBc IgM present in

A

acute and
during window phase

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73
Q

HBs Ag

A

acute and
persistence>6 month=chronic

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74
Q

binucleated cells in lymphocytic infiltrates
CD15/30

A

Reed-sternberg cells

Hodgkin lymphoma (owl’s eyes)

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75
Q

multiple peptic ulcer postbulbar duodenal and jejenal

A

gastrin secretin tumor

MEN1: ZES

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76
Q

pyruvate to Acetyl-CoA

enzyme

A

P.dehydrogenase

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77
Q

enzyme

pyruvate to Oxaloacetate

gluconeo

A

pyruvate carboxylase

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78
Q

white-yellow plaque on colonic mucosa

fibrin and inflammatory cells

A

pseudomembranes

C. diff

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79
Q

mito toxicity in virus treatment with aspirin in kids

A

Reye syndrome

Hi ammonia causing diffuse astrocyte swelling and cerebral edema

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80
Q

use for juve myoclonic epilepsy

A

valproic acid
levetiracetam

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81
Q

use for focal onset seizure

A

carbamazepine
phenytoin

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82
Q

cornea cloulding prominent forehead broad nose(coarse face)

enlarged heart, liver and spleen

A

Hurler syndrome
hi dermatan and heparan sulfate

iduronidase

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83
Q

melatonin agonist used in elderly insomnia

A

Ramelteon

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84
Q

opioids MOA

A

membrane hyperpolarization (K efflux)
closes voltage-gated ca++ channel(low Ca influx)

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85
Q

lamotrigine effect on kidney

A

hi Renal bld flow
Hi GFR
Low serum creatinine

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86
Q

Crohn Dz

bile acid wasting in terminal ileum causes

A

gallstone

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87
Q

acute hemolytic transfusion reaction

A

complement-mediated cell lysis

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87
Q

erythematous pruritic papules vesicles, bullae on extensors

crypt hyperplasia and villous atrophy, IgA, Celiac dz

A

dermatitis herpetiformis

increased intestinal intraepithelia lymphocyte

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88
Q

ddx

celiac dz, pneumonia, and tranfusion related reaction

may also have GI infection (giardia), skin condition

A

Selective IgA deficiencty

Normal IgG and IgM

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89
Q

Neutral amino acid

A

alanine
serine
threonine
valine
leucine
isoleucine
phenylalanin
tyrosine
tryptophan

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90
Q

neutral aminoacidura is seen in

A

Niacin deficiency
pellagra-like skin eruption
cerebella ataxia

Hartnup dx

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91
Q

LH surge triggers

A

oocyte release

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92
Q

progesterone endometrial action

A

proliferate and stabilizes for implantation

withdrawal causes menstration

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93
Q

heavy protracted mentrual period (7-10 day) in adolescent

A

Low & irregular GnRH pulses
low LH surge–>
low progesteron–>

immature hypothalamic-pituitary-ovarian axis –>

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94
Q

increased enzyme activity with lesch-Nyhan syndrome

A

PRPP (phosphoriboxyl pyrophospate amidotransferase

HGPRT defect

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95
Q

CFTR mutation is a

A

Frameshift mutation
Chrom 7 @ F508, missing phenylalanine

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96
Q

Ipsilateral Brachiocephalic vein drains into

A

ipsilateral jugular and subclavian veins

neck and face

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97
Q

Bilateral brachiocephalic veins forms

A

SVC

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98
Q

Bollous pemphigoid

A

deposition of IgG and complement at the dermal-epidermal junction

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99
Q

TMP-SMX risk in HTN pt taking ACE-I, potassium-sparing diuretic… and elderly

A

Hyper-K

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100
Q

segmental vasculitis extending into contiguous veins and nerves

A

Thromboangiitis obliterans(Buerger disease)

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101
Q

Transmural inflammation of the arterial wall with fibrinoid necrosis

A

Polyarteritis Nodosa (PAN)

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102
Q

Inflammatory infiltration and necrosis of peyers patches

A

Typhoid pass through

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103
Q

Rotavirus is

A

segmented nonenveloped, ds RNA virus

fecal-oral transmission

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104
Q

<5 yo acute self-limited fever and watery diarrhea causes

segmented nonenveloped, ds RNA virus

A

Blunting of the villi in the duodenum and proximal jejunum

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105
Q

extnesive colonic mucosal injury with yellow-white adherent layer

A

C. Diff

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106
Q

flask shaped ulcerations in the cecum and ascending colon

A

Entamoeba hystolytica

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107
Q

foamy macrophages in the small intestinal lamina propria

A

whipple dz(Tropheryma whipplei)

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108
Q

prevent degradation acetylcholine

A

physostigmine

release anticholinergic agents(atropine,scopolamine effect)

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109
Q

recurrent Ca nephrolithiasis and hypercalcemia

A

primary hyperparathyroidism (PHPT)

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110
Q

primary hyperparathyroidism (PHPT) effect on bone

A

subperiosteal resorption with cortical thinning

increased bone resorption

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111
Q

Benzo and phenobar MOA

A

Increase GABA A action

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112
Q

inhibits vesicle fusion by binding SV2A protein

A

Levetiracetam

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113
Q

Blocks NA+ and GABA transaminase

A

Valproic Acid

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114
Q

Blocks thalamic T-type Ca

A

Ethosuximide

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115
Q

seisures

Blocks Na+

A

Phenytoin
carbamazepine

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116
Q

Blocks Ca

A

Gabapentin

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117
Q

irreversible inhibition of GABA transaminase in CNS

A

Vigabatrin

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118
Q

neonatal opiod withdrawal treatment

A

morphine

119
Q

Granular deposition in PSGN

Posttreptococcal glomerulonephritis

A

IgG, IgM, and C3
on GBM and mesangium

119
Q

CKD with excessive bruising, normal platelet count
normal coagulation studies

A

platelet dysfunction

due to hi urea–:ammonia breakdown
product–>hi NO–>low adhesion

120
Q

jerky movement that flow b/t muscle groups

A

chorea

121
Q

sustained contraction resulting in abnormal posture

focal/generalized

A

Dystonia

122
Q

controls glucose entry into cells

A

glucokinase

123
Q

maternity onset diabetes of the young is mutation of

A

glucokinase
lower glucose affinity

non-obese pt and condition is non-progressive

124
Q

still born, exposed brain, (in bipolar woman)

A

valproate
folate effect on neural tube development

125
Q

multiple myeloma

demyelination causes

A

decrease signaling velocity by
Velocity= low length/hi time

length (space) constant

126
Q

TNF a

from macrophages

A

mediates systemic inflammatory response in sepsis

127
Q

leptospirosis

A

motile spirochet

corksrew-shape pathogen

128
Q

contaminated water with animal urine

A

leptospirosis

mild self-limited, flulike illness—>renal or hepatic failure

129
Q

low circulating iron and hi bone marrow iron

A

suggestive of anemia of chronic disease

130
Q

moa of sevelamer

used in CKD with hi phosphorus level

A

decrease intestinal absorption of phosphorus

131
Q

caloric restriction in fat people: leptin/insulin/ghrelin

A

lowers leptin and insulin
increase ghrelin

132
Q

low activity of which enzyme cause gallstone

A

cholesterol 7a-hydroxylase

133
Q

aluminum hydroxide causes

treatment in gastroesophageal reflux

A

constipation

134
Q

mg+ conbination with aluminum hydroxide rationale

A

reduce adverse effects
(constipation)

135
Q

heavy alcohol use effect on liver

A

intrahepatic neutrophil infiltration
hepatocellular ballooning
mallory bodies
steatosis

136
Q

normal torso and short limbs

A

chondrocytes defects
achondroplasia

137
Q

females

lo platelet
shistocytes, hi creatinine
neurologic(headach)
fever

A

decrease activity of von Willebrand factor-cleaving protease

ADAMTS-13

138
Q

amlodipine side effect

A

headache, flushing, dizziness, peripheral edema

139
Q

hypogonadism with pigmented skin

A

iron deposit in pituitary gland
hemochromatosis (endocrine)

140
Q

fluid given to septic pt

A

lactated Ringer solution

141
Q

Movement disorder with psychiatric symptoms

psychosis, dementia, irritability, anxiety, apathy, depression

A

Huntington Disease
Cytosine-adenine-guanine

AD

142
Q

Genetically predisposed individuals
with slow acetylator phenotype have greatest risk of

A

Drug-induced lupus erythematosus

143
Q

Hi Hb A2(alpha-2 delta-2) suggestive of

microcytic anemia

A

beta-thalassemia trait

144
Q

cause of Hi Hb A2

A

erroneous
mRNA processing
due to point mutations

145
Q

what mediates response to monoclonal antibody therapy

HER2 epidermal growth receptor

A

Natural killer cell and granzymes

146
Q

in utero CMV exposure

A

chorioretinitis
seizures
microcephaly

hepatospleno megaly and sensorineuro deafness

147
Q

RBC with no central pallor

anemia, hi reti count, hi indirect bili

A

hi MCHC

hereditary spherocytosis

148
Q

yersinia pestis: plague treatment

A

Aminoglycoside (30s )
prevent protein synthesis

149
Q

schistosomiasis treatment

contaminated snails freshwater transmission

A

praziquantel

affects mesenteric and bladder

150
Q

excessive vascular calcification occurs freequently in CKD due to

A

hyperphosphatemia
hypercalcemia

others: atherosclerosis and chronic inflammation

151
Q

Recurrent respiratory papillomatosis in a child

transmission

A

vertical

HHV 6 and 11

152
Q

Lab findings in legionella Pneumonia

A

Hypo Na
hi Neutrophils with few or no bug
in sputum

153
Q

legionella Pn symptoms

A

hi fever
cough
confusion
diarrhea

154
Q

malonly CoA inhibits carnitine acyltransferase causing

A

beta oxidation failure

155
Q

CD40L defect causes

A

impairs T-cell activation by B-cell
impairs T-cell-APC interaction

No secondary germinal center

156
Q

mid systolic click murmur disappears with squatting

A

MV prolapse

connective tissue problem

157
Q

MOA of bevacizumab

A

depletion of endothelial factors
of angiogenesis

inhibits angiogenesis

158
Q

when does motor symptom present in idiopathic parkinson

A

when 60% of dopaminergic neurons are lost

159
Q

postsynaptic compensatory effect of dopaminergic neuronal loss

A

upregulation of dopamine receptors

160
Q

Bug that directly damage dorsal columns

A

Reactive VDRL of CSF
neurosyphilis

tabes dorsalis

161
Q

associated with sensory ataxia, neurogenic urinary incontinence
hi incidence with HIV
DCML

treatment

A

Pen G(IV)

syphilis

162
Q

false Neg PPD may be due to

A

inadequate lymphocytic response

acid-fast bacilli on sputum

163
Q

strongest risk factors for A fib

A

Age, left atrial dilation
(htn, HF, MV disease)

164
Q

retrosternal burning and regur, raynaulds finger

antibodies

A

anti-centromere

CREST syndrome

165
Q

ACE inhibitor ARB moa

A

lower aldo secretion
inhibits ENaC

166
Q

C

cyclosporins moa

A

Blocks aldo activity

167
Q

Digitalis

A

ihibits Na+/K+-ATPase

168
Q

Heparin
Effect on aldosterone

A

Blocks aldo production

169
Q

Nonselective B-adrenergic blocker

A

decrease K uptake

170
Q

NSAID

A

decrease renal perfusion–>decrease K delivery to collecting ducts

171
Q

K sparing diuretic

Elperenone

A

inhibits ENaC or aldo receptor

172
Q

Trimethoprim

A

Inhibits ENaC

173
Q

accumulates in astrocyte with hyperammonemia

A

glutamine
Motor symptoms

174
Q

Biliary sludge seen with

A

incomplete gallbladder emptying

GB mobility stimulated by CCK

175
Q

ATM gene, cerebellar dysfunction, distended cappilaries

A

DNA break repair

176
Q

responsible for fibrous cap on plaque

A

smooth muscle cells

177
Q

pseudomonas aeruginosa mechanism of antibiotic resistance

A

beta lactamases, efflux pumps and
antiboitic modifying enzymes

178
Q

aminoglycoside (gentamicin) resistance in P. aeruginosa

A

antibiotic-modifying enzymes

179
Q

associated with poor prognosis of bladder cancer

A

invasion of muscularis propria layer

180
Q

cavity seen in TB is created by

A

aggregation of activated leukocytes

181
Q

prostate mets..treatment to reduce spread

A

ihibition of the 17-alpha-hydroxylase enzyme

abiraterone

182
Q

benign melanocytes grow involving the dermis and epidermis

A

compund nevi

183
Q

hi direct bili and Y-glutamyl transferase

A

biliary atresia
obstruction of extrahepatic bile ducts

184
Q

dialated chest, neck, face and upper trunk vein

A

Extrinsic compression of SVC
mediastinal mass

185
Q

erb-duchenne palsy

A

C5-C6

186
Q

Loop diuretics
furosemide high doses will cause

other ototoxic drugs

A

ototoxicity

when use with aminoglycosides, salicylates, cisplatin

187
Q

Anastrozole inhibits

estrogen receptor pos tumor

A

aromatase

decreased androgen aromatization

188
Q

liver fibrosis, myofibroblast response to hepatocyte injury and callagen deposit is due to

A

Stellate cell activation into myofibroblast

189
Q

SGLT-2 MOA causing additional effect

A

MOA: inhibit sodium glucose cotransporter
causing osmotic diuresis
lowering BP/mortality for Heart failure

190
Q

DRESS syndrome is a

A

Drug Reaction with eosinophilia and systemic symptoms

hi risk drugs: phenytoin, carbamezepine, sulfer, vanco, minocycline

191
Q

cognitive decline present with normal ADLs

A

Mild cognitive impairment

192
Q

cognitive decline interferes with ADLs

A

dementia

193
Q

uncomplicated parapneumonic effusions

A

movement of sterile exudate into the pleural space

low leukocyte count below 50k mm3

194
Q

complicated parapneumonic effusion involves

A

inflammatory disruption of visceral pleural membrane and bacterial translocation

195
Q

C. Perfringen alpha toxin moa

A

split phospholipid (lecithinase)

gas formation is due to carbohydrates metabolism

196
Q

c. Diffi cytotoxin B moa

A

Actin depolymerization
causing infectious diarrhea

197
Q

Plasminogen activator from exotoxin of

A

Strep. pyogenes

198
Q

causes of b12 defficiency

A

R protein cleavage defect due chronic pancreatitis
Type A gastritis-intrinci factor
absorption problem

199
Q

PDA causes lower Systemic vascular resistance

A

shunting causes lower resistance

200
Q

Delay in warfarin effect may be due to

A

clotting factors generated before warfarin initiation

201
Q

polyvinyl chloride causes

A

hepatic angiosarcoma

202
Q

BTK, X-linked agamma

Common infection becomes life threatening

A

Decrease circulating B cell

203
Q

Flutamide moa

A

impaired androgen-receptor interaction

204
Q

GnRH agonist (leuprolide) MoA

A

inhibit LH release from A. Pituitary

205
Q

Ketoconazole and spironolactone MOA

A

inhibit testosterone synthesis
Leydig cells

206
Q

conversion of testosterone to DHT inhibitor

A

finasteride
5-a-reductase inhibitor

207
Q

inhibit androngen receptor-binding

A

flutamide
cyproterone
spironolactone

208
Q

vulvovaginal candidiasis is the result of

A

decreased number of gram-positive bacteria

immune suppression: antibiotic, pregnancy, corticosteroid, diabetes

209
Q

possible nutritional deficiencies in vegan

A

B12, Vit D, Ca++
Iron, zinc

210
Q

infliximab is a

A

chimeric monoclonal antibody targeting
TNF-a

causes serum sickness: type III HS reaction

211
Q

infliximab reaction resolution is by

A

activation of the mononuclear phagocyte system

212
Q

anatomy

SVC is derived from

A

common cardinal veins

213
Q

cardiac temponade: becks triad

A

jugular venous distension
hypotension
pulsus paradoxus

214
Q

Aminoglycoside resistance

A

methylation of binding site

MOA 30s inhibition

215
Q

coupling of iodotyrosines is moa of

A

methimazole

216
Q

T4–T3 conversion inhibitor

A

Propylthiouracil
B-blocker
contrast agent(Ipodate)

217
Q

Thyroid peroxidase inhibitor(coupling of iodotyrosines)

A

propylthiouracil
methimazole

218
Q

binds to the thrombin active site

A

Argatroban

low platelett

219
Q

newborn Hi TSH and low T4

A

transplacental transfer of thyroxine

congenital hypothyroidism

220
Q

optochin sensitive and bile-soluble

A

Strep. Pneumo

221
Q

Bacitracin sensitive and PYR pos

A

strep. Pyo

B-hemolysis

222
Q

pre-eclampsia urinalysis

A

hi specific gravity
protein
no RBC

223
Q

acquire vWF deficiency risk

A

severe aortic stenosis
bleeding

224
Q

MM demyelination plaques is due to

A

perivenular inflammatory cells
T-c and MP

225
Q

young fm with optic nuritis
Broad-based gait
intnsion tremor

A

Demyelinating plaques
Multiple sclerosis

226
Q

Genetic mutation of ryanodine receptors =

Hypercabia & Rhabdomyolysis

A

malignant hyperthermia

227
Q

fever, muscle spasm post anesthesia

masseter muscle spasm

A

malignant hyperthermia

inhalational anesthetics and succinylcholine

228
Q

uregulated sarcoplasmic calcium release resulting in sustained muscle contraction

whidespread muscle contraction (rigidity)

A

malignant hyperthermia

Treatment: dantrolene

229
Q

antiepileptic drug that induces ADH production and incr renal sensitivitiy to ADH

SIADH

A

Carbamazepine

siezure/pain

230
Q

maraviroc is a chemokine receptor antagonist targeting

A

T-cell chemokine receptor=CCR5

mediates viral fusion

231
Q

Negative regulator of T-cell activation
antagonist are use in

A

melanoma treatment

232
Q

Myastenia gravis Pathophy

A

Reduce amplitude of motor end plate potential

decreases number of functonal acetylcholine receptors

233
Q

Glycopyrrolate an antimuscarinic agent use in

A

Myastenia gravis treatment

234
Q

UV damage causes

A

thymine or cytosine dimers
repaired by endonuclease nicking of damaged

Nucleotide excision repair

235
Q

MOA of Sulfonylureas

glipizide

A

inhibit ATP-sensitive K channel in beta cell membrane

membrane ion channels

236
Q

Risk of sulfonylurea

A

hypoglycemia

237
Q

Diabetic diarrhea patho

A

autonomic dysfunction
altered intestinal motility
increase secretions

238
Q

predominant cell in EBV

A

B-Cells

239
Q

HIV pt

2nd MCC of ring-enhancing lesion with mass effect

A

EBV
primary central nervous system lymphoma

multiple rings

240
Q

Single ring-enhancing lesion in HIV

A

Toxo

241
Q

PEEP used causes

A

Intrapulmonary shunt effect

242
Q

Amyotrophic lateral sclerosis die from

A

respiratory failure

243
Q

Presentation of ALS

A

UMN dysfunction
brisk reflexes, extensor plantar reflex

244
Q

ALS: lower motor neurons dysfunctions

A

fasciculations, muscle atrophy

245
Q

Arch

pulmonary arteries, ductus
arteriosus

A

arch 6
CN10 recurrent laryngeal

246
Q

ARCH

True aortic arch, subclavian arteries

A

4th
superior largngeal vagus

247
Q

arch

common carotid artery, proximal internal carotid artery

A

3rd
CN9

inte

248
Q

integrase inhibitor prevents

A

production of viral mRNA

249
Q

pathway

Ornithine transport defect

A

urea cycle

250
Q

urea cycle defect accumulates

A

ammonia
causing neurological damage

251
Q

nutritional restriction of ______________ improves urea cycle defect

A

protein

252
Q

MCC of Mallory-Weiss syndrome

A

increase of intraabdominal and intraluminal gastric pressure

retching and vomiting

253
Q

increase intestinal intraepithelial lymphocytes

seen in patient with

A

Dermatitis herpetiformis

rash on extensor surfaces

254
Q

Delay onset of HFE gene in women is dt

A

premenopausal menstrual bleeding

255
Q

Why is DM 1 with CKD having hypoglycemia

A

decreased renal insulin clearance

256
Q

path findings in alcoholic liver

A

marked intrahepatic neutrophill
steatosis
mallory-denk bodies
hepatocellular ballooning

257
Q

chronic lithium tox

drug interaction

A

gradual onset of neurologic symptoms
ataxia and tremor

thiazide, ACE and NSAID( NA reabsorption/lithium clearance)

258
Q

predisposing risk factor for lung abscess

A

condition the cases aspiration
alcoholism
drug abuse
seizure disorders
Stroke
dementia

259
Q

head injury causing transient DI

A

Posterior pituitary

260
Q

Head injury causing permanent DI

A

Hypothalamic

261
Q

Angioedema without urticaria

A

hi Bradykinin
hi activated C1(low C4)

hi C4 consumption = low C4 levels

262
Q

Dopamine receptor agonist are first line in

A

schizophrenia treatment

263
Q

preeclampsia occurs due to

A

abnormal placental development–>
hi-resistance, lo-perfusion and placental ischemia

264
Q

placental ischemia in preeclampsia triggers

A

endothelial dysfunction
dysregulated vascular tone
hi vascular permeability
low organ perfusion

265
Q

headaches and visual changes in preeclampsia due to

A

vascular dysregulation

266
Q

Mutation in HOX gene leads to

A

malpositioned body parts:
syndactyly/polydactyly

267
Q

MOA of HOX gene

A

binding DNA trasription regulatory regions

directly regulates body patterning

268
Q

androgenetic alopecia

inheritance

A

polygenic inheritance with
variable expressivity

MCC of hair loss in both gender

269
Q

TXA(tranexamic acid moa

A

stabilizes thrombi/clots
by innhibiting plasmin formation

prevent fibrin degredation

270
Q

pyruvate kinase defi causes

A

hemolytic anemia

dec ATP

271
Q

splenic hyperplasia(red pulp) seen with
pyruvate kinase dif

why?

A

splenic overworking to remove deformed
erythrocyte

272
Q

female

Theca interna synthesizes

A

Androgens from
cholesterol

stimulated by LH

273
Q

female

Granulosa Cell synthesizes

A

Estrogen(estradiol)
from androgen

Stimulated by FSH

274
Q

males

Leydic cells

A

Stimulated by LH to secrete testosterone

275
Q

risk factors for gastric adenocarcinoma

A

hi salt
n-nitroso-containing compounds
H.pylori
obesity
chronic atrophi gastritis

276
Q

histology of gastric adenocarcinoma

A

signet-ring cell
glandular structure
plaque-like infiltration
ulcerated mass with heaped-up edges

277
Q

recurrent nosebleed
spider-like lesions on oral/nasal mucosa, face and arms

A

osler-weber-Rendu syndromes

278
Q

Heat stroke can trigger DIC, How?

A

severe hyperthermia—hi O2 demand
shunts bld from central organs
cause ischemia/necrosis
release procoagulant protiens
=DIC

279
Q

Hematologic findings present in DIC

A

hi fibrinolysis
hi thrombin production
hi plasmin generation

280
Q

MC masses in the anterior mediastinum are the

A

thymoma
teratoma(& other germ cell tumors)
terrible lymphoma
thyroid neoplasm

4 Ts

281
Q

anterior mediastenum mass with hi AFP and B-hCG

A

nonseminomatous germ cell Tumor

yolk sac tumor, choriocarcinoma, embryonal carcinoma

282
Q

AFP and hCG are hi in teratomas

A

false

283
Q

Seminomas may have hi ______ but normal _________

A

hi hCG
normal AFP

284
Q

what are the key players in abcess formation

A

lysosomal enzyme from Neutrophils

285
Q

topical agent that acts as a tool-like receptor agonist to increase antiviral cytokine production

A

Imiquimod

286
Q

topical immunomodulator with antiproliferative effect

A

imiquimod
activates toll-like receptor 7

induce apoptosis and ihibits angiogenesis

287
Q

inhibits T-cell and keratinocyte prolifiration and stimulate differentiation

A

calcipotriene
Vit D analog

288
Q

treats atopic dermatitis(eczema) by blocking NFAT trannslocation

A

pimecrolimus

reduced IL-2 transcription

289
Q

major contributor to the development of centriacinar and panacinar emphysema

A

excess protease activity

neutrophil and macrophages elastase

290
Q

acute hepatitis C is characterized by

A

panlobular lymphocytic inflammation with hepatocyte injury and cell death

ballooning degeneration and councilman bodies

291
Q

chronic hep c leads to predominantly

A

portal lymphocytic infiltration, fibrosis, lymphoid follicle formation

292
Q

two approaches to RA treatment

A

DMARD and short-term anti-inflammatory(steriod/NSAID)

293
Q

DMARD

A

methotrexate
sulfasalazine
hydroxychloroquine
minocyline
TNF-a inhibitor

Step 1 Clues (27 decks)

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