UWorld Review Flashcards
BRCA is what kind of gene and is located on what chromosome?
Tumor supressor gene. BRCA 1 is on Chr. 17. BRCA2 is on Chr 13.
Myasthenia Gravis
AutoAB against post synaptic AChR. Associated with thymoma.
Myasthenia Syndrome
Autonomic symptoms. Dry mouth.
Small cell lung carcinoma.
AutoAb to the presynaptic calcium channel.
Preclampsia
HTN, edema, and proteinuria. HTN after 20 weeks of gestation.
Unexplained HTN and proteinuria before 20 weeks may suggest molar pregnancy.
Increase vs decrease in alpha fetoprotein
Increase: NTD or liver cancer, or yolk sac cancer.
Decrease in alpha feto protein: chromosomal abnormalities.
Down Syndrome
Decrease in AFP. Increase in BHCG and inhibin.
All other chromosomal abnormalites. Decrease in everything else.
Basal Long Acting Insulin
NPH (18 hours day),
Glargine and Detemir (1 x day because 24 hours).
Postprandial, Short acting Insulin
Aspart, lispro, gli. –> best for post-prandial.
Regular –> 2-4 hours longs.
Does PaO2 and SaO2 associated with the amount of Hg?
Nope. Can be normal in the setting of anemia. Lower blood O2 content because of lower hemoglobin.
Osgood Schlatter Disease
Overuse injury at the tibial tubercle –> secondary ossification center.
Fibrates
Blocks 7a hydroxylase, reduces the synthesis of bile acids –> at risk for gallstones.
What kidney stones are radiopaque?
Calcium oxalate and ammonium phosphate.
Penicillin to a small baby before 2 months prevents what infection?
H. influenza. Can’t give vaccination until 2- 18 months.
Coronary Steal Syndrome
Treatment with vasodilators and coronary dilators (adenosine, diperidol- stress test) -> the other unclogged coronary arteries will steal blood from the other clogged artery making the ischemia in that area worse.
PCOS
Increase in testosterone, estrogen, and decrease in progesterone. At risk for endometriosis. Increase in LH: FSH ratio.
Clomiphene
Estrogen receptor antagonist to decrease the negative feedback on pituitary. Increase in LH and FSH surge.
What happens at the 6- 10 weeks gestation?
Midgut rotates counterclockwise around SMA.Failure leads to intestinal obstruction and midgut volvulus.
CKD effects on bones?
Osteodystrophy or osteitis fibrosa cystica -> increase bone resorption due to secondary hyperparathyroidism.
MODY (Maturity Onset Diabetes of Young)
Mutation in the glucokinase (insulin dependent; liver and pancreas B cells), cannot control glucose in the glycolytic pathway. Diabetes onset during pregnancy induced insulin resistance.
Pathway of Glucose Induced Insulin Release from Beta Cells
GLUT 2, glucokinase, increase ATP: ADP ratio, closure of ATP sensitive K+ channels -> depolarization -> opening of VG Ca2+ channels -> increase Ca2+ in and insulin release.
What is the prodrug of 6 mercaptopurine?
Azathioprine
Converting carbamoyl phosphate into orotic acid requires _____ as the cofactor?
Aspartate
Orotic Acid
Involved in pyrimidine synthesis (acts as a temporary base) and urea cycle.
Brachial Arch 4 and 6
Vagus: 4 (superior laryngeal- cricothyroid), 6 (recurrent laryngeal- all larynx)
Brachial 3
CN IX
CAP
Cleft is ectoderm, Arch is mesoderm, and Pouch is the endoderm.
What cell produces the MIF?
Sertoli.
Leydig Cells
Produces testosterone to help produce male pump system except the prostate.
Sertoli
Support sperm, inhibin (negative feedback on FSH at pituitary), and makes androgen binding protein to maintain high local concentration.
Sertoli temperature sensitive.
In glycolysis, which rxns require ATP?
glucose to glucose6P
fructose6P to fructose 1,6 P
Pyruvate dehydrogenase deficiency
Give leucine and lysine because highly ketogenic. Other wisee build up of lactic acid. Pyruvate cannot form Acetyl CoA.
Fructokinase deficiency?
No big deal. Essential fructosuria. AR. Since fructose is not trapped in the cells. It’ll just stay in the blood and urine.
Aldolase B deficiency
Bad. Furcose intolerance. Fructose 1 phospahte ends up accumulating causing a decrease in available phosphate, inhibits glycogenolysis and gluconeogenesis.
Presents with hypoglycemia, jaundice, and cirrhosis, and vomiting. Decrease intake of fructose and sucrose (glucose and sucrose).
Galactokinase Deficiency
Mild AR. Build up of galactitol. Cant’ track or have social smile.
Classic Galactosemia
Absence of galactose-1-phosphate uridyltransferase. Galactitol accumulates. Avoid galactose and lactose (galactose and glucose).
Ammonia is transported by which amino acids?
Alanine and Glutamate.
A 40-year-old alcoholic woman develops slurred speech and asterixis. What acute and long-term treatments do you recommend?
Acute treatment is benzoate or phenylbutyrate (bind amino acids), lactulose (acidifies GI tract, traps NH4+); long term, reduce protein
What is rifaximin?
rifaximin (reduces colonic ammoniagenic bacteria)
Cidofovir
DNA polymerase inhibitor. Does not have to be phosphorylated. Used for VZV.
Fenoldipam
Partial D1 agonist. Increase renal perfusion. Hypertensive emergency crisis.
Trouble Walking and Recurrent infections in a kid
Ataxia Telengiectasia.
Jimson Weed
Atropine. Tx with physostagmine.
Alveolar gas equation
PaIO2 (usually 150) - (PaCO2/ 0.8)
Methomoglobin
Oxidized Fe3+ does not hold onto oxygen well but can hold onto cyanide very well.
Cidofovir and Foscarnet
Tenofavir
does not need to be phosphorylated,
Does not need to be phosphorylated because already nucleotide.
Acute Intermittent Porphyria
Abdominal pain, neurological conditions, and pot wine urine.
Aortic baroreceptor
Carotid baroreceptor
Vagus- slow down heart rate.
Glossopharyngeal
Avoid thiaazides in diabetic. Why?
Hyperglycemia. (also hypercalcemia).
Rifaximin
decrease intraluminal ammonia production
An interesting zoo must have mammals
Actin in the I band binds to the Z line and Myosin in the H line binds to M line.
Nimodopine
prevent cerebral vasospasm after subarachnoid hemorrhage.
Increase in y-glutamyl transferase and alkaline phosphatase?
Hepatobiliary disease.
Metoprolol
Cardioselective. Safe to use in COPD. A and B blocker carvedilol and labetalol also safe to use with COPD.
Halothane
Fulminant hepatitis. Increase in AST, similar to acute hepatitis, and prolong PT because loss of Factor VII.
Increase in urinary deoxypyridonoline?
Increase in osteoclasts activity. Measure for Pagets.
VIPoma
WDHA syndrome –> watery diarrhea, hypokalemia, and achlorhydria.
C3 and C4 innervates what muscles?
Trapezius.
Lung cancer loves to go to the ________
Adrenals.
Ipratropium and Tiotropium
Block muscarinic ACh receptors, no bronchoconstriction.
Lambert Eaton
Small cell carcinoma, Ab blocks the Ca channels, symptoms improve with use.
PKU Causes
Phenylalanine hydroxylase deficiency and BH4 deficiency.
Hepcidin
a key regulator of the entry of iron into the circulation in mammals. In states in which the hepcidin level is abnormally high such as inflammation, serum iron falls due to iron trapping within macrophages and liver cells and decreased gut iron absorption
Abetalipoproteniemia
spur cells/ acanthocytes; ApoE.
Hartnup Disease
Can’t get niacin and serotonin from tryptophan. No trptophan apsorption from the PCT.