UWorld Test 5/24/2014 Flashcards
Reassorment is? happens between?
Mixing of segment genetic material between segmented viruses
Recombination?
Gene exchange that involves crossing over between two double stranded DNA molecules.
Narcolepsy characterized by? Etiology?
Excessive daytime sleepiness, hypnagogic or hypnapompic hallucinations, nocturnal/narcoleptic sleep episodes, cataplexy loss of all muscle tone in some patients). Due to decreased production of orexin from lateral hyptohalamus
Tx for narcoplepsy
Modafinil (non-amphetamine stimulant), amphetamines in the daytime , sodium oxybate for nighttime
Classic triad of reactive arthritis?
Non-gonococcal urethritis, anterior uveitis/conjuctivitis, arthritis. Most common cause of asymmetric inflammatory arthritis in young males.
Reactive arthritis occurs after? Causes what in 20% of patients
Several weeks after GU (non-gonoccoal urethritis) or GI (bacterial enteritis) infection. Belongs to group of seronegative arthropathies. Sacroilitias.
What drugs are effective against pseudonomas
Few specific penicillins (ticarcillin, piperacillin), cephalosporins (ceftazidime, cefepime). Some aminoglycosides (amikacin, gentamicin, tobramycin), fluoroquinolones (ciprofloxacin, levovofloxacin), and carabanepams (impinem, meropenem), monobactams (aztreonam) are also effective.
Burkitt lymphoma is what translocation? What does it results in?
t(8;14) - translocation of c-myc (8) to heavy chain (14). Results in overexpression of c-myc - cell growth, differentiation, proliferation
Psamomma bodies are found in?
Core of dense calficiation with surrounding collagen bundle fibers. Found in 1) meningiomas (slow growing, well circumscribed benign tumors) 2) thryoid papillary carcinoma 3) serous papillary ovarian adenocarcinoma
Patient with signs of renal failure and toe gangrene or livedo reticularis (mottled vascular pattern) following invasive vascular procedure like has what? Light microscopy shows?
Atheroembolic renal disease. Light microscopy shows choleserol emboli (cholesterol crystals) blocking the renal arterioles
Synpatophysin stain, GFAP stains?
Synpatophysin - protein found in neurons, neuroectoderm, neuroectodermal tumors. CNS of neuronal origin stain + for synaptophysin. Neoplasms of GLIAL origin stain + for GFAP - astrocytomas, ependymomas, oligodendrogliomas
What are the short, mid, long acting benzodiazepines? Which ones have an increased risk for daytime drowsiness/falling?
Short: Alprazolam, triazolam, oxazepam Medium: Estrazolam, lorazepam, temazepam. Long: Chlordiazepoxide, diazepam, flurazepam. Long acting causes more severe daytime drowsiness and high risk of falling
Schizoaffective disorder criteria
Psychosis must occur in the ABSENCE of mood symptoms but must have mood symptoms for most of the illness. FA: at least 2 weeks of stable mood with psychotic symptoms plus a major depressive manic or both episode. 2 subtypes: bipolar/depressive
Elderly patients are at risk of what after an influenza infection?
Secondary bacterial pneumonia. Most common agents: 1) Strep pneumo 2) Staph aureus 3) H Influenza
What is dobutamine
Sympathomimetic. Beta1 receptor > beta2, and alpha receptor. Increases cardiac contractility (increased CO and decreased ventricular filling pressure) , increases HR, cardiac conduction velocity => increased O2 consumption
Pulmonary lung abscesses with suppruative destruction of lung parenchyma due to?
Release of lysosomal enzymes by neutrophils and macrophages.
What veins join to form the braciocephalic vein
Subclavian and Internal jugular. On the right side, the right thoracic duct drains into the right braciocephalic vein.
Obstruction of braciocephalic vein vs superior vena cava
Braciocephalic vein obstruction - uniliateral swelling sx. Superior vena cava - bilateral symptoms
What is Leuprolide? Effects on testosterone and DHT?
GnRH analog. Concordant increase and then decrease in testosterone and DHT levels.
What is heteroplasmy?
Presence of both normal and mutated mt DNA in an individual cell. Degree of disease depends on the ratio of normal to mutated mtDNA.
Caudal regression syndrome is characterized by? Due to?
Uncontrolled maternal diabetes. Sacral agenesis, lower extremity paralysis, and urinary incontinence. Dorslflexed contractures of the feet
What are the JG cells, where are they located. What happens to them in chronic renal hypoperfusion
Modified smooth muscle cells of the afferent arterial that synthesize and secrete renin. They undergo hypertrophy and hyperplasia
How does increased cAMP cause smooth muscle relaxation?
Usually in smooth muscle contraction, activated myosin light chain kinase phosphrylates Myosin-Action to Myosin-p-Actin=> contraction. Increased cAMP INHIBITS myosin light chain kinase, thereby INHIBITING contraction
What is ipratropium
Anti-muscarinic which inhibits bronchoconstriction
What is N meningitidis’ virulence factor?
Lipo-oligosaccharide (like gram negative LPS)
5-10% of patients who receive IV acyclovir can develop what? Prevent with what?
Nephrotoxicity. When acyclovir concentration in the collecting duct exceeds its solubility, cyrstallization, crystaluria, and renal tubular damage may result. Aggressive hydration
What presents in von Hippel Landau disease? What kind of inheritance
Cavernous hemangiomas in skin, organs, mucosa; congenital cysts/neoplasms of kidney, pancreas, liver; (bilateral) renal cell carcinoma, and HEMANGIOBLASTOMAS in retina, cerebellum, brain stem; pheochromocytomas. A/D.
What is Osler Weber Rendu Syndrome
Hereditary hemorrhagic telangiectasia - inherited disorder of blood vessels. Telangiectasia, recurrent epistaxis, skin discolorations, AVMs, BI bleeding, hematuria
Isosorbide mononitrate has what pharmacokinetic property?
Active metabolite of isosorbide dinatrate. Has 100% bioavailability after PO route, unlike nitroglycerin and isosorbide dinatrate which undergo considerable first pass metabolism
Extended consumption of appetite suppressants (what are examples?) leads to what?
Examples: fenfluramine, phentermine is a/w increased pulmonary hypertension, leading to right ventricular hypertrophy
Pantothenic acid ‘s active form is what
Coenzyme A
