UWorld_2.24 Flashcards
1
Q
Epithelial structure @ respiratory tract
A
- stratified squamous epithelium
- oropharynx
- laryngopharynx
- anterior epiglottis
- upper half of post. epiglottis
- vocal folds (true vocal chords)
- pseudostratified, columnar (mucous-secreting) epithelium
- nose
- paranasal sinus
- nasopharynx
- larynx
- tracheobronchial tree
2
Q
Tendons of rotator cuff + injuries
A
- Rotater cuff stabilizes glenohumoral joint w/ligaments of GH joint and biceps brachii tendon
-
SITS:
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
- supraspinatus = most common injury
- most superior muscle ==> 10-15 deg. of arm abduction
- tested by “empty can test”
- ==> pain with abduction + flexion
3
Q
Characteristics of the “delta agent”
A
- “delta agent” = hepatitis D virus
- replication-defective RNA virus
- only capable of causing infection when encapsulate w/HBsAg
- presentation
- acute coinfection w/Hep B
- superinfection of chronic HBV carrier
4
Q
Characteristics of fulminant viral hepatits
A
- rare
- can arise w/any hepatitis virus
5
Q
Impacts of efferent arteriole constriction
A
- efferent arteriole constriction ==> increase hydrostatic pressure @ capillaries ==> increased GFR
- GFR starts to fall from max increase after resistance increases > 2x normal
- efferent arteriole constriction ==> decrease in RBF
- efferent arteriole constriction ==> increase in FF
- FF = GFR/RBF
6
Q
Filtration fraction =
A
FF = GFR/RBF
7
Q
Langerhans cell characteristics
A
- dendritic cells found at skin and mucous membranes
- myeloid cell line
- myeloid stem ==> granulocyte-monocyte progenitor ==> dendritic
- antigen-presenting cell
- express MHC Class II + co-stimulatory B7 cell surface molecules
- interact w/T lymphocytes
- Birbeck granules = “racquet-shaped” intracytoplasmic granule
8
Q
Isoniazid side effects
A
- peripheral neuropathy (if given w/pyroxidine)
- hepatotoxicity
- usually mild ==> transient elevated AST, ALT
- elevated bilirubin
- fever, anorexia, nauseau
- severe ==> liver dysfxn, jaundice, bilirubinuria
9
Q
Hib vaccine + importance
A
- composed of polyribosyl-ribotol-phosphate (PRP) = component of Hib capsule
- [conjugated w/diptheria or tetanus toxoid]
- ==> lasting immunity against Hib in children
- H. flu ==> epiglottitis
10
Q
Incomplete obliteration of precessus vaginalis ==>
A
- hydrocele = connection between scrotum and abdominal cavity ==> fluid leakage into scrotum
- indirect inguinal hernia ==> protrusion of abdominal organs along inguinal canal
11
Q
Frameshift mutation
Missense mutation
Nonsense mutation
Conservative mutation
A
- frameshift = deletion/insertion ==> change in reading frame
- missense = substitution @ point ==> different aa
- nonsens = substitution @ point ==> premature stop codon
- conservative = missense where aa is similar ==> normal protein length and possible similar secondary structure and fxn
12
Q
PAH handling @ kidney
Inulin handling @ kidney
A
- PAH
- mostly filtered
- small amount excreted @ proximal
- no reabsorb
- inulin
- some filtration
- no excretion or reabsorbtion
13
Q
Sodium handling @ kidney
Glucose handling @ kidney
Urea handling @ kidney
A
- Sodium
- 99% of filtered sodium reabsorbed
- Glucose
- complete reabsorption @ low filtered loads
- increasing fractional excretion of glucose @ higher plasma concentrations
- Urea
- 40-50% of filtered urea is reabsorbed
- @ fixed GFR and euvolemia ==> constant fractional excretion
14
Q
vWD presentation
A
- lifelong history of mucosal bleeding, gingival bleeding
- epistaxis, menorrhagia
- normal platelet levels
- prolonged bleeding time due to impaired platelet fxn
15
Q
S1 injury ==>
A
- posterior thigh and leg pain
- weakness of plantar flexion
- diminished ankle jerk reflex
16
Q
L4 injury ==>
A
- impairment of knee-jerk reflex
17
Q
L5 injury ==>
A
- posterior and lateral thigh and leg pain ==> inner foot
18
Q
Sciatic nerve =
A
- L4 - S3 nerve roots
- sciatica = commonly L5 or S1 injury
19
Q
Raloxifene: MOA
A
- SERM
- estrogen agonist @ bone ==> prevention of osteoporosis
- estrogen antagonist @ breast ==> prevention of breast cancer
20
Q
Atenolol: MOA + effects
A
- B1 receptor antagonist
- @ cardiac tissue and JGA, but not @ vascular smooth muscle
- ==> decreased cAMP @ cardiac/renal
21
Q
Presentation/characteristics of McArdle’s syndrome
A
-
myophosphorylase deficiency:
- muscle glycogen ==> glucose-1-phosphate
- ==> failure of glycogenolysis
- ==> exercise intolerance + myoglobinuria + muscle pain w/activity
22
Q
Clinical presentation of organophosphate poisoning
A
- Organophosphate poisoning (e.g. pesticides) ==> irreversible inhibition of cholinesterase @ muscarinic & nicotinic cholinergic synapses
- muscarinic activation ==>
- Diarrhea; diaphoresis
- Urination
- Miosis
- Bronchospasm
- Bradycardia
- Emesis
- Lacrimation
- Salivation
- nicotonic activation ==>
- muscle fasciculations
- paralysis
- seizures
- CNS dperession
23
Q
Tx of organophosphate poisoning
A
- Atropine: reversal of muscarinic sx; no effect on nicotinic receptors
- pts still at risk for muscle paralysis
- Pralidoxime: reverses muscarinic and nicotinic effects of organophosphates
- effective only if given early after the exposure
24
Q
Metabolism of glucose @ RBCs
A
- no mitochondria or nucleus
- metabolism of glucose via glycolysis & HMP (hexose monophosphate) shunt
- glycolysis ==> energy fr survival
- HMP shunt ==> NADPH production to prevent ocidant damage
- G6PD helps produce NADPH
25
Causes of unregulated oxidative damage in RBCs
* G6PD deficiency ==\> no NADPH to prevent from oxidative damage
* Glutathione reductase deficiency
* H2O2 ==\> water via oxidation of glutathione
* NADPH is used by glutathione reductase to reduce oxidized glutathione
* glutathione can then be reused to reduce another molecule of hydrogen peroxide
