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Step 1 Journal RC > Uworld Part 3 > Flashcards

Uworld Part 3 Flashcards

1
Q

what side effect of dopamine is central?

does carbidopa increase or decrease?

how to avoid?

A

anxiety and agitation is central effects.

carbidopa can increase thru increasing central availability by inhibiting peripheral conversion

decrease dose
use atypical antipsychotics like cloazpine

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2
Q

what can carbidopa help you avoid

A

peripheral effects of dopamine

  • postural hypotension
  • hot flashes
  • tachyarrhthmias
  • Nausea and vomiting
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3
Q

RNA polymerase I function

A

form ribosomal components

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4
Q

RNA polymerase II function

A

mRNA
snRNA
micro RNAa

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5
Q

RNA polymerase III fxn

A

tRNA

Component of 60S ribosomal subunit

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6
Q

selectivity for CCB

A

Verapamil most on heart

Nifedipine most on peripheral vasculature

Diltiazem in between

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7
Q

SE of verapamil

A

constipation
gingival hyperplasia
bradycardia
first/second/third degree AV nodal block

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8
Q

most acid labile piconravirus

A

rhinovirus

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9
Q

most acid stable piconravirus

A

enteroviruses

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10
Q

most common species for aspiration pneumoniae

A

fusobacterium
peptostreptoccus
bacteroides

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11
Q

16S rRNA fxn

A

complementary and binds to Shine Delgarno sequence in all prokarotic mRNA 10 bases upstream of AUG start.

mRNA and 30S ribosomal subunit bind, an initiator tRNA binds to AUG, the 50S ribosomal subunit joins and protein synth begins

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12
Q

23s rRNA

A

found in 50S, faciltates peptide bond formation in protein translation

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13
Q

isoniazid function

A

req. conversion to active compound by mycobacterial enzyme catalase-peroxidase

inhibits mycolic acid synthesis

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14
Q

rifampin function

A

imhibits DNA dependent RNA synthesis

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15
Q

50S antibiotics

A

chloramphenicol
clindamycin
linezolid
macrolides (erythromycin/azithromycin/clarithroycin)

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16
Q

30S antibiotics

A

tetracycline
doxycycline
aminoglycosides (gentamicin, streptomycin and others)

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17
Q

beta blocker function in thyrotoxicosis

A

Block increased sensitivity to catecholamines via thyroid hormone mediated upregulation of beta-adrenergic receptor expression

Decrease peripheral conversion of T4 to T3 by inhibiting iodothyronine deiodinase

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18
Q

G6PD genetic

A

X linked recessive

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19
Q

Hereditary spherocytosis genetic

A

autosomal dominant

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20
Q

vitamin D-resistant rickets genetic

A

x-linked dominant inheritance

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21
Q

oxidative phosphorylation mutations tend to be

A

mitochondrial diseases

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22
Q

autosomal dominant diseases

A 
ADPKD
FAP
Familial hypercholesterolemia
Hereditary hemorrhagic telangietasia
Heredtiary spherocytosis
Huntington disease
Marfan syndrome
MEN
Neurofibromatosis 1
Neurofibromatosis 2
Tuberous sclerosis
Von Hippel Lindau disease
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23
Q

autosomal recessive diseases

A 
Albinism
ARPKD
Cystic fibrosis
Glycogen storage diseases
hemochromatosis
Kartagener syndrome
Mucopolysaccharidoses (except hunter syndrome)
Phenylketouria
Sickle cell anemia
Sphingolipidoses (except Fabry disease)
Thalessemias
Wilson disease
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24
Q

xlinked recessive disorders

A

Be Wise, Fool’s GOLD Heeds Silly HOpe

Bruton agammaglobulinemia
Wiskott-Aldrich syndrome
Fabry disease
G6PD deficiency
Ocular albinism
Lesch-Nyhan syndrome
Duchenne (and Becker) muscular dystrophy
Hunter Syndrome
Hemophilia A and B
Ornithine transcarbamylase deficiency
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25
Q

Trinucleotide repeat expansion diseases and the trinucleotide repeats are

A

Huntington disease (CAG)

Myotonic dystrophy (CTG)

Friedreich ataxia (GAA)

Fragile X syndrome (CGG)

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26
Q

where does digestion of triglycerides occur

A

duodenum

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27
Q

where does absorption of triglycerides occur

A

jejunum

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28
Q

hemosiderin laden macrophages in pulmonary alveoli indicates

A

chronic elevation of pulmonary capillary hydrostatic pressures which is usually the result of left sided heart failure.

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29
Q

how to differentiate b/w lipofuscin or hemosiderin

A

prussian blue stain, detects intracellular iron, colorless potassium ferrocyanide converted by iron to blue black ferric ferrocyanide.

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30
Q

left ventricular leads in biventricular pacemakers courses through

A

coronary sinus residing in the atrioventricular groove on the posterior aspect of the heart.

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31
Q

vitiligo is caused by

A

loss of epidermal melanocytes

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32
Q

characteristic abnormality in huntingtons

A

bilateral atrophy of the caudate nucleus and putamen (striatum)

33
Q

characteristic abnormality in parkinsons

A

decreased dopamine in the substantia nigra and striatum

34
Q

what causes green sputum

A

myeloperoxidase, blue green heme based pigmented molecule in azurophilic granules of neutrophils that catalyzes the production of hypochlorous acid from chloride and hydrogen peroxide during phagocytic respiratory burst

35
Q

Polyarteritis nodosa affects what arteries

A

affects medium to small arteries in any organ. Kidneys, heart, liver, GI tract.

SPARES PULMONARY ARTERIES and rarely involves bronchial arteries.

36
Q

how does PAN affect the arteries

A

transmural inflammation of the arterial wall w/ fibrinoid necrosis

37
Q

mechanism of korsakoff

A

dmg to the anterior and dorsomedial thalamic nuclei resulting in memory loss and confabulation.

IMPAIRMENT IN MEMORY AND LEARNING IS USUALLY PERMANENT

38
Q

rapid correction of hypernatremia results in

A

cerebral edema

39
Q

rapid correction of hyponatremia results in

Mechanism

presents

A

Central pontine myelinolysis

Mech:
osmotic demyelination syndrome of the axons in the central part of the pons.

demyelination of corticospinal tracts and corticobulbar tracts of CN IX, X, XI (Pseudobulbar b/c nuclei of CN intact).

presents as spastic quadriplegia and pseudobulbar palsy

40
Q

what factors does H. influenzae require

A

X factor (exogenous hematin)

V factor (NAD+)

41
Q

blocking alpha2 adrenergic receptors results in

A

release of norepinephrine from nerve endings

insulin from pancreas

42
Q

D1 adrenergic (dopaminergic) receptors are located where and cause what

A

located in walls of renal, splanchnic, mesenteric blood vessels

Vasodilatation and increase in renal and splanchnic blood flow

43
Q

silicosis distinguished by

A

eggshell calcification of hilar nodes

birefringent silica particles surrounded by fibrous tissue

44
Q

asbestosis distinguished by

A 
calcified pleural plaques
ferruginous bodies (fusiform or beaded rods w/ a translucent asbestos center and coated w/ an iron containing proteinaceous material best seen w/ prussian blue staining)
45
Q

berylliosis and hypersensitivity may produce

A

noncaseating granulomas

46
Q

coal miners lung assoc w

A

perilymphatic accumulations of coal dust laden macrophages

47
Q

aortic arch baroreceptor transmits via… to…

to what does it respond

A

vagus nerve to solitary nucleus of medulla.

only responds to increase

48
Q

Carotid sinus baroreceptor transmits via… to…

to what does it respond

A

glossopharyngeal nerve (Hering branch) to solitary nucleus of medulla

responds to increase or decrease

49
Q

distinguish bullous pemphigoid from pemphigus vulgaris

A

bullous pemphigoidhave intact bullae (negative nikolsky sign) and mucosal involvement is uncommon

50
Q

CNS fried egg tumor cell appearance (nuclei w finely granular chromatin surrounded by clear cytoplasm)

A

oligodendroglioma

51
Q

presentation of meningiomas

mechanism

A

personality change
New onset seizures

(from frontal lobe compression)

52
Q

culture negative endocarditis causes

A 
Bartonella
Coxiella
Mycoplasma
Histoplasma
Chlamydia
HACEK 
-Haemophilus
-Actinobacillus
-Cardiobacterium
-Eikenella
-Kingella
53
Q

vitamin E deficiency results in what

what condition does it mimic?

How do they both present?

A

degneration of spinocerebellar tracts, dorsal column of the spinal cord, and peripheral nerves

mimics Friedrich ataxia

Ataxia
Dysarthria
Loss of both position and vibration sensation

54
Q

Lead intoxication presentation

A

irritability
loss of devo milestones/learning problems
GI issues

55
Q

Thiamine deficiency has what triad

A

ataxia
confusion
ophthalmoplegia

56
Q

Creutzfeldt jacob disease presents how

A

rapidly progressive dementia and myoclonic jerks of the extremities

57
Q

Acute intermittent porphyria presents how

A

acute abd pain
peripheral neuropathy
hyponatremia

58
Q

what atypical antipsychotic most likely to cause EPS?

A

Risperidone

59
Q

What atypical antipsychotic least likely to cause EPS?

A

Clozapine (but watch out for agranulocytosis)

60
Q

treatment of acute dystonia

A

antihistamines (diphenhydramine)

Anticholinergics (benztropine/Trihexyphenidyl)

61
Q

treatment of parkinsonism

A

anticholinergic (benztropine)

62
Q

presence of erythroid precursors in organs like liver and spleen is indicative of..

what causes it

A

extramedullary hematopoiesis

caused by severe chronic hemolytic anemias (beta thalessemia for example)

63
Q

visual impairment in HIV patient is caused by

A

secondary to CMV induced retinitis

64
Q

treatment for CMV induced retinitis

A

ganciclovir
foscarnet
cidofovir

65
Q

SE of foscarnet

why does this happen?

A

hypocalcemia and hypomagnesemia, both of which promote seizures.

mech:
calcium chelator, renal wasting of magnesium induced, reduction in release of parathyroid hormone

66
Q

lamivudine SE

A

peripheral neuropathy
lactic acidosis

(this is unusual compared to other NRTIs)

67
Q

B6 involved in

A

transamination and decarboxylation steps in amino acid metabolism

heme (ALAS) and neurotransmitter synthesis (L-DOPA to Dopamine)

68
Q

what uses TLCFN

A

branched chain alpha-ketoacid dehydrogenase

pyruvate dehydrogenase

alpha-ketoglutarate dehydrogenase

69
Q

acute irrev injury to neuron results in a what?

what signs?

A 
Red neuron
12-24 hr after
-shrinkage of cell body
-eosinophilia of the cytoplasm
-pyknosis of the nucleus
-loss of Nissl substance
70
Q

important prognostic factor in poststreptococcal glomerulonephritis

A

AGE
95% of affected children recover completely
60% of adults recover completely

71
Q

psoriasis is characterized by

A 
hyperparakeratosis
acanthosis
rete ridge elongation
mitotic activity above the epidermal basal cell layer
reduced or absent stratum granulosum

neutrophils may form spongiotic clusters in the superficial dermis and the parakeratotic stratum corneum (Munro microabcesses)

72
Q

diabetic mononeuropathy presents how?

A

predominantly central ischemia affecting somatic nerve fibers but sparing peripheral parasympathetic fibers

ptosis
down and out gaze
normal light and accommodation reflexes

73
Q

granulation tissue is comprised of what type of collagen

A

Type III collagen. this is replaced eventually by type 1 as the infarct matures.

74
Q

what benzodiazepines are not metabolized by liver

A

LOT

Lorazepam
Oxazepam
Temazepam

75
Q

confidence intervals z values

A

90%=1.645
95%=1.96
99%=2.57

76
Q

speed of transmission in the heart

A

park at ventura avenue

purkinje
atrial
ventricle
av node

77
Q

where do dna viruses replicate

A

all in nucleus except poxvirus

78
Q

where do rna viruses replicate

A

all in cytoplasm except

  • influenzae
  • retrovirus
79
Q

segmented viruses

A

BOAR

bunyavirus
orthomyxovirus (influenza)
arenavirus
reovirus

Step 1 Journal RC (9 decks)

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