UWORLD review Flashcards
whats the difference between Bipolar 1 and Bipolar2?
bipolar 1 has MANIC epsiodes– (lasts>1 wk, has psychosis, or hospitalization)
bipolar 2 has HYPOMANIC episodes (remember this is STILL A MANIA but just less severe) it lasts >4 days and doesnt have psychotic features. there is no marked impairment or hospitalization needed
where is the most common NEONATE hemorrhage?
in the germinal matrix (next to lateral ventricle).. this is a matrix with numerous thin vessels and less glial support.
germinal matrix areas become less by 32 wks gestation.. so premie with IVH— think germinal matrix
what is CaSR
it is a transmembrane G-coupled protein (metabotropic) which senses Ca levels to inhibit PTH release if Ca2+ is high enough
Familial Hypercalcemia hypocaluria is a AD defect in this
melanoma has what embryological origin
NCC
if youve been exposed to a strain of influenza before or have been vaccinated for that strain, what will prevent infection?
antibodies against Hemagglutinin
Orotic Aciduria + hyperammonia= 1
vs
Orotic Aciduria + megaloblastic anemia=21
- ornithine transcarbamoylase deficiency (in the urea cycle, buildup of Carbamoyl phosphate causes shunting to Pyrimidine denovo syn pathway causing ornithine buildup)
- UMP synthetase deficiency
what electrolyte abnormalities are seen in Foscarnet use?
chelation of calcium
and renal magnesium wasting
what type of receptor does glucagon bind to ?
G-coupled membrane receptor (same like epi/NE)
what hormones are active in glucose conservation during fasting states?
- glucagon
- epinephrine
- cortisol
- GH
in relative afferent pupillary defect, if light is shone in the LEFT eye, and there is no constriction, what is damaged?
the damage is in the RIGHT optic tract or the LEFT optic nerve.
its the RIGHT optic tract b/c the nasal portion of the eye that contributes most to the pretectal nucleus
why would fibrates lead to more gallstones?
they block 7ahydroxylase
what are the causes of diastolic HF?
- htt
- obesity
- infiltrative disorder (sarcoid, transthyretin amyloid)
what does osteoprotegrin do?
acts as a decoy receptor for RANKL and inhibits RANK/RANKL binding, therefore decreasing osteoclast diff/prolif
(denosumab acts like OPG)
what ligament can compress the spinal cord?
ligamentum flavum
what drug for ischemia induced ventricular arrhythmia?
class II antiarrhythmic b/c it binds to inactivated sodium channels (seen in tissues post MI) and dissociate quickly
most commonly aborted fetus
trisomy 16 and XO
what happens when H Pylori colonizes gastric antrum?
gastric body?
gastric antrum— knocks out delta SST cells in antrum, causing increased gastric acid production— duodenal ulcer
gastric body — causes a gastric ulcer (with risk for GALT) due to inflammatory and toxic effects of HPylori
B1 is found on ?
cardiac myocytes
and JG cells
Left Frontal lobe lesion vs Right Frontal Lobe lestion
L= low: so apathy and depression R="racey"= disinhibition
Rheumatoid Arthritis (and treatment with MTX) is associated with what lung problem?
interstital lung disease= interstitial pneumonitis and fibrosis
what causes TH1 differentiation
what causes TH2 differentiation
IL12, INFy
IL4
large friable mass on valve= IE, what is the cause?
developed country= MVP
developING country= RHD
LYMPH
where does the prostate drain?
where does the skin below the umbilicus drain? what are the 2 exceptions?
prostate- drains to internal iliac nodes
skin below umbilicus- superficial inguinal nodes
exceptions: glans penis and posterior calf drain to deep inguinal nodes
what does the flu shot do? vs what does Tamiflu do?
flu shot: antibodies anti-HA (HA inds sialylated receptors and enters cells via endocytosis)– stops virus from entering cells
Tamiflu: anti NA- stops release of progeny
name whats RETROperitoneal?
SADPUCKER suprarenal/adrenal aorta/IVC duodenum (not 1st pt) Pancreas (body+ head) Ureters/bladder Colon (asc/desc) Kidneys Esophagus Rectum (mid-distal)
Whats up with the spleen of a SS patient?
discolored, shrunken + fibrotic! why? b/c repetitive infarction to spleen
dog has diarrhea, then you have diarrhea? whats the cause?
campylobacter
Dengue Fever
transmitted by Aedes aegyptii mosquito.
tropical regions
acute fever, headache/retroorbital pain, jt/m pain, petechia, thrombocytopenia and
(this mosquito also transmits chickingunya)
what does a virus have to be if its “purified” RNA but able to produce proteins
SS (+) RNA
you have multiple ring enhancing brain lesions (its not toxo) and EBV positive! whats going on?
Primary CNS lymphoma
(made of abnormal B cells— not T cells even though EBV+
escalating fever + diarrhea/constipation/abdominal pain+ hemorrhagic enteritis+ rash (rose colored spots) after a recent trip to endemic area?
Salmonella Typhi
aseptic (viral) meningitis most commonly caused by?
enteroviruses
how would you check for Mucormycosis
mucosal biopsy (note its NOT seen in the blood)
+ germ tube test at 37 degrees
Candida
gingivostomatitis + malaise vs mild perioral vesicles
primary HSV vs reactivation HSV
calcification of bladder wall?
schistosomiasis
-chronic cystitis with inflammation/fibrosis/granulomas that can lead to SCC
what are the light spots of Burkitt’s Lymphoma?
tingeable macrophages
apoptotic bodies
how does codeine work?
inactive on its own it must be converted by CYP enzymes in the liver to morphine
chimeric antibodies can cause?
serum sickness
Type IIIHS—- immune complexes
pubertal gynecomastia in males is??
NORMAL
how does N Fowleri get into the brain
via olfactory N and through cribiform plate
whats going on if both PaO2 and PaCO2 are low?
its most likely a PE or pneumonia that is causing a V/Q mismatch. Low O2 levels are telling you to breathe more, so you blow off more CO2, but you are still unable to get the O2 you need!
if you have nephritis 5 days after a URI, and it recurs now and then?
vs
if you have nephritis 1-3 wks after a URI and it doesnt recur
IgA Bergers
vs
PSGN
how does sirolimus work?
it blocks IL2 signal transduction
pure SVC syndrome w/o Horner’s or brachial plexus pain is most likely a mass where?
mediastinum
in a lung transplant what structures are affected by chronic rejection
small airways–
bronchiolitis obliteraans
what effects on the lungs can LV failure have?
- increased hydrostatic P
- – increased fluid in lung interstitium
- —– decreased compliance
in CF
there is reduced Cl secretion and increased Na reabsorption in the resp epithelia
you need a break with nitrates administration to prevent?
tolerance devpt
