UWORLD random 3/17

Question 1

DM I sx

Answer 1

polyuria
polydipsia
polyphagia

fatigue
weight loss

Question 2

delirium tx

Answer 2

haloperidol

Question 3

lesions that cause ONLY inguinal LAD

Answer 3

medial LE

Question 4

lesions that cause BOTH popliteal and inguinal LAD

Answer 4

lateral LE

Question 5

Western Blot

Answer 5

protein

Question 6

Southern Blot

Answer 6

DNA

Question 7

Northern Blot

Answer 7

mRNA

Question 8

Southwestern Blot

Answer 8

DNA-bound protein

Question 9

CML genes

Answer 9

BCR-ABL fusion gene

t(9;22)

Question 10

metabolism of v long fatty acid chains/branch chain at odd-numbered fatty acids

Answer 10

peroxisomes

Question 11

Zellweger syndrome

Answer 11

peroxisomal disease

unable to form myelin in CNS

hypotonia, seizures, hepatomegaly, mental retardation, early death

Question 12

refsum disease

Answer 12

peroxisomal disease

defect in a-oxidation

neuro disturbances from phytanic acid accumulation

tx = avoid chlorophyll

Question 13

glossopharyngeal nerve

Answer 13

IX

stylopharyngeus muscle (elevate larynx during swallowing)

parotid gland secretion

sensory = tympanic membrane, eustachian tube, posterior third of tongue, tonsillar region, upper pharynx, carotid body/sinus

taste = posterior third of tongue

Question 14

glossopharyngeal nerve lesions

Answer 14

loss of gag reflex

loss of sensation in upper pharynx, posterior tongue, tonsils, middle ear cavity

loss of taste in posterior 1/3 tongue

Question 15

when b-hcg is detectable in serum

Answer 15

6-8 days after fertilization

implantation 6 days after fertilization, syncytiotrophoblast starts secreting b-HCG

Question 16

when b-hcg is detectable in urine

Answer 16

14 days

Question 17

RA pressure

Answer 17

<5

Question 18

RV pressure

Answer 18

25/5

Question 19

Pulm artery pressure

Answer 19

25/10

Question 20

LA pressure

Answer 20

<12

capillary wedge

Question 21

LV pressure

Answer 21

130/10

Question 22

Aorta pressure

Answer 22

130/90

Question 23

PE acid/base disturbance

Answer 23

hypoxemia

respiratory alkalosis

Question 24

live attenuated oral poliovirus vaccine Sabin vs inactivated Salk

Answer 24

secretory IgA in intestinal lumen

Question 25

ischemia on CT

Answer 25

hypodense

poorly delineated from surrounding tissue

Question 26

post-ischemic brain injury timeline

Answer 26

48 h = red neurons

3-5 days = neutrophils
followed by monocytes

2 wks = cystic space replaces necrosis
gliosis (astrocytes form glial scar)

Question 27

lipids in microglia

Answer 27

phagocytosis of disintegrated neurons, myelin, necrotic debris

myelin breakdown products

Question 28

acute intermittent porphyria

Answer 28

AD

porphobilinogen deaminase deficiency (PBG –> HMB)

Question 29

AIP sx

Answer 29

mostly asx

acute attcks = abdominal pain, vomiting, peripheral neuropathy, neuropsycho sx, reddish-brown urine

Question 30

AIP tx

Answer 30

IV glucose or heme preps

downregulate ALA synthase activity (reduce toxic intermediate metabolites of heme synthesis)

avoid CYP450 inducers

Question 31

normal CD4+ lymphocyte count

Answer 31

> 500

Question 32

polymyositis sx

Answer 32

symmetrical prox muscle weakness

increased difficulty climbing stairs, getting up from chair, carrying heavy objects

Question 33

polymyositis pathology

Answer 33

+ muscle enzymes (CK, aldolase)

autoantibodies (ANA, anti-Jo-1)

MHC 1 antigens on sarcolemma with CD8+ cytotoxic T-cells, myocytes

Question 34

polymyositis biopsy

Answer 34

inflammation
necrosis
regeneration of muscle fibers

(patchy necrosis)

Question 35

Baclofen

Answer 35

agonist at GABA-B

monotherapy for spasticity 2/2 CNS disease

could also use Tizanidine (a2 agonist)

Question 36

essential tremor

Answer 36

most common movement disorder

slow, progressive, symmetric postural/kinetic tremor in UE

AD inheritance

tx propanolol