UWorld SA Flashcards
Paget’s disease of the bone increases risk for what
osteogenic sarcoma, arising in the femur, tibia, humerus, or other bones.
Avascular necrosis assoc with
glucocorticoid use (high dose). RAdiographic findings include pathognomonic crescent sign (subchondral collapse)
What are the renal osteodystrophies
- Hyperthyroid bone disease
- Osteomalacia
- Mixed urine osteodystrophy
- Aplastic bone
PSeudobulbar is caused by conditions like
and presents
Multiple sclerosis
dysarthria, dysphagia, dysphonia, impaired movement of the tongue and facial muscles
What is Globus Hystericus
Sensation of lump in throat w/o accompanying physical, endoscopic, or radiologic findings of esophageal obstruction.
Emotions commonly trigger. also other disorders like GERD, upper esophageal sphincter abnorm, achalasia, psych disorder, stress
treatment of RSV
Humidified supplemental oxygen and sometimes aerosolized ribavirin
Oseltamivir use
mechanism
inhibitor of the neuraminidases of influenza A and B viruses. used to prevent and early treatment.
Sialic acid analogue. Prevents neuraminidase cleavage of terminal sialic acid residues and release of attached virions.
Histo of burkitts lymphoma
chromosomal translocation
Round nuclei w basophillic cytoplasm containing prominent lipid vacuoles
t(8;14)
translocation in B cell childhood Acute lymphocytic leukemia
t(12;21)
Follicular lymphoma histo and translocation
Malignant cells w/ notches or clefts (high N/C ratio
Desmosome relies on what
cadherins (Ca2+ dependent)
Hemodesmosomes rely on
integrins
Fibronectin is what
ecm glycoprotein that binds cell surface integrins, facilitating cell binding to the extracellular matrix
presentation of rosacea
easy flushing, then later with persistent erythema, telangiectasia, senstivity to sunlight or insults of a chemical or physical nature.
Injury to the ____ is the primary concern w/ both anterior and posterior dislocations of the knee joint.
Describe location
Popliteal artery
This vessel is fixed rigidly proximal and distal to the knee joint by the adductor magnus and soleus muscles respectively.
Most commonly isolated organism in endometritis
Bacteroides family
Aspirin intolerance is characterized by
Asthma
Nasal polyps
Aspirin sensitivity
levator scapulae
action
innervation
elevates the scapula and rotates the glenoid fossa inferiorly
innervated by dorsal scapular nerve w/ contributions from teh C3 through C5 spinal nerves
Pectoralis minor
Originates from what and attaches to what
Action
Innervation
Originates from anterior surface of 3rd-5th ribs and attaches to teh coracoid process of teh scapula
Draws the scapula anteriorly and inferiorly against the chest wall stabilizing it.
Innervated by the medial pectoral nerve
Trapezius
Action
Innervation
Elevates and retracts scapula. Can aslo rotate the scapula slightly for movement of the glendoid fossa superiorly
Innervated by teh spinal accessory nerve CN XI
what two primary tissues produce a bicarbonate rich fluid in response to stimulation
What do they respond to and what is this secreted by
Exocrine pancreas
Epithelial cells of teh biliary tract
MEdiated predominantly by secretin from S cells of the duodenal mucosa in response to acid
difference b/w acute stress disorder and ptsd
ptsd is greater than 1 month. otherwise the same.
most common viral encephalitis
Where does it tend to affect
presentation
tx
herpes simplex encephalitis caused by HSV-1 typically.
tends to affect the temporal lobe., ergo some unique
(along w normal meningitis signs)
- seizures
- personality changes
- psychosis
tx: acyclovir
paramyxoviridae includes
measles
mumps
RSV
parainfluenza
Acanthamoeba causes what
protozoal organism causing fatal ecephalitis in AIDS pt. and other chronically immunosuppressed.
cause of 3rd heart sound
cause of 4th heart sound
3rd heart sound-low pitched sound during rapid filling of teh ventricle in mid-diastole. From sudden deceleration of blood as teh elastic limits of the ventricular chamber are reached during rapid ventricular filling. Normal in children but indicates ventricular failure in adults. (cardiac failure either systolic or diastolic failure)
4th heart sound- forceful atrial contraction pushing blood into overfilled/stiffened ventricle.
Exudates demonstrate what (that transudates lack)
Pleural fluid protein/serum protein > 0.5
Pleural fluid LDH/serum LDH>0.6
Pleural fluid LDH more than 2/3 the upper limit of normal serum LDH
Target cells/codocytes seen in
liver disease
thalessemia
status post splenectomy
fragmented RBC seen in
microangiopathic hemolytic anemia Thrombotic thrombocytopenic purpura Hemolytic uremic syndrome DIC Prosthetic valve hemolysis
Echinocytes/burr cells (multiple surface projections) seen in
Uremia
Pyruvate kinase deficiency
how to tx hereditary spherocytosis
what improves
splenectomy
Improved anemia
Decreased hemolysis and jaundice
Reduced incidence of bilirubin gallstones
Intraventricular hemorrhage begins where for premature infants?
Germinal matrix (highly cellular and vascular int he subventricular region that generates neurons and glia during fetal development)
Cephalhematoma is what
HEmorrhage within the circular region of teh scalp that enters the lower uterus during childbirth.
assoc with
- sudden delivery
- disproportion b/w diameter of fetal head and birth canal
- inapprop forceps use
Procainamide SE
Reversible syndrome similar to SLE
Amiodarone SE
pulmonary fibrosis arrhythmias hepatic injury thyroid abnormalities ocular changes bluish-gray skin discoloration
Lidocaine SE
dose dependent CNS stimulation or depression
Cardiovascular depression
Sotalol SE
Torsades de pointes
Excessive beta blockade
What do
Acetylcholine
Histamine
Gastrin
bind to on parietal cells to stimulate gastric acid production
ACh: M3 receptor
Histamine:H2 receptor
Gastrin:CCK2 receptor
What leukotrienes mediate asthmatic bronchoconstriction
Leukotrienes C4,D4,E4 mediate asthmatic bronchoconstriction
pathogenesis of aspirin sensitive asthma
selective inhibition of COX in arachidonic acid metabolism promotes formation of bronchoconstrictive leukotrienes. (C4,D4,E4)
palmitoylation is what
where do you see it
fatty acids covalently anchored to plasma membrane cysteine residues therby increasing hydrophobicity of a protein
Many GPCRs have carboxyl tails palmitoylated on cysteine residues. V2 vasopressin receptor is a prime example.
Digeorge is caused by
hypoplastic third pharyngeal pouch
Hypercalcemia results in
painful bones, renal stones, abd groans, and psychic moans
allelic heterogeneity vs. genetic heterogeneity
Genetic heterogeneity is where mutations of different genes cause similar phenotypes
Phenotypic heterogeneity is mutations of the same gene result in different phenotypes
Polygenic disease is what. example?
result from defects in numerous often unrelated genes (type 2 diabetes, which has clearly heritable component but cannot be traced to any specific gene)
what receptor does histamine use for airway hyperresponsiveness
H4
chromosome 7 mutation associations
cystic fibrosis
Ehlers-Danlos syndrome
Osteogenesis imperfecta
chromosome 16 associations
Polycystic kidney disease
Tuberous sclerosis
Maple syrup urine disease has defect in what?
What is a coenzyme?
Branched chain alpha keto acid deydrogenase complex
(cannot break down leucine, isoleucine, valine)
Thiamine B1 is a coenzyme
Glucagon uses what receptor
Gs
Growth factors use what receptor
RTK
Insulin uses what receptor
RTK
Red safranin O stains what
Cartilage
Mast cell granules
Mucin
(turns them red)
Pulmonary embolism causes what in abg
Alkalosis, and decrease in both PaCO2 and PaO2
This is due to hyperventilation and ventilation/perfusion mismatch
neurofibroma is what
assoc with what
soft, flesh colored papule that is assoc with NF1
Dermatofibroma is what
firm hyperpigmented papule tethered to teh epidermis
how can you have dx of NF1
2 or more of following
- 6 or more cafe au lait spots (brownish spots)
- intertrigeinous freckling
- optic nerve glioma
- bony lesions-iris Lisch nodules
- First degree relative with NF1
Describe NF1’s genetics
autosomal dominant on chr 17. Has 100% penetrance and variable expressivity. Novel germine mutations can cause NF1 in families with no prior fam hx
intense holosystolic murmur heard best over the apex that radiates to the axilla
mitral regurgitation
loud, holosystolic murmur heard best along the left lower sternal border occasionally associated with a palpable systolic thrill
Interventricular septal defect (VSD)
High pitched decrescendo diastolic murmur best heard in the third intercostal space along the left sternal border
aortic regurgitation
blowing holosystolic murmur heard best along the lower left sternal border intensified during inspiration and reduce during standing
tricuspid regurgitation.
think of infective endocarditis in abusers of IV drugs
red man syndrome from vancomycin causes what
histamine release from mast cells but NOT IGE MEDIATED ALLERGIC REACTION. CAn be prevented using a slower rate of infusion
