UWorld_3.15 Flashcards
1
Q
Characteristics of G6PD Pathway
A
- G6PD: G6P == …. ===> ribulose-5-P + 2 NADPH
- NADPH ==> oxidative processes
- FA, cholesterol
- steroid synth
- drug metabolism
- ribulose-5-p ==> nonox processes
- glycolytic
- aromatic aa synth
*
2
Q
HIV+ w/800 T cells + pneumo ==> causative agent?
A
s. pneumo
PCP common @ < 200 T cells
3
Q
Mycoplasma pneumo ==> dx?
A
atypical pneumo
4
Q
Characteristics of drugs w/various volume of distribution
A
- low Vd = 3-5 L
- highly bound
- charged
- hydrophillic
- high molecular weight
- Vd = 14-16L = plasma + interstitial fluid
- small molecular weight
- hydrophillic
- Vd = 41L = highest distribution
- lipophillic (or hdyro)
- uncharged
5
Q
Where is the majority of water reabsorbed at nephron?
A
- proximal tubule, regardless of patient hydration status
6
Q
Implications of folate deficiency
A
- thymidilate synthase: 5,10-MEtetrahydrafolate + dUMP ==> dihydrofolate + dTMP (deoxythymidine monophosphate)
- folate deficiency ==> megaloblastic anemia and promotes erythrocyte apoptosis
- supplementing with thymidine would decrease erythro apoptosis
7
Q
Most potent cerebral vasodilator [blood gas]
A
pCO2
8
Q
Aorta anterior and to the right of pulmonary artery ==> dx + embryologic cause?
A
- dx = transposition of the great arteries (vessels)
- due to failure of aorticopulmonary septum to spiral normally during septation of the truncus arteriosus
9
Q
Embryology:
- fail of proliferation ==>
- fail of obliteration ==>
- fail of migration ==>
- fail of apoptosis ==>
- fail of fusion ==>
A
- prolif ==> fibular aplasia
- obliteration ==> branchial cyst
- migration ==> hirschsprung
- apoptosis ==> overactive/autoreactive B/T cells ==> apoptosis
- fusion ==> hypospadia
10
Q
Factors used in the ddx of metabolic alkalosis
A
- urine chloride
- patient volume status
- low urine chloride ==>
- vomiting/ng aspiration
- prior diuretic use
- high urine chloride + hypo/euvolemia ==>
- current diuretic use
- barter or gittelman syndrome
- high urine chloride + hypervolemia ==>
- excess mineralocorticoids:
- Cushings
- ectopic ACTH
- primary hyperaldo
- excess mineralocorticoids:
11
Q
Isoniazid: MOA
A
- antimycobacterial
- inhibits mycolic acid synthesis
12
Q
Cell structure of mycobacteria that lead to acid-fastness
A
mycolic acids (loss of myc acid ==> loss of acid-fast)
13
Q
Buspirone: MOA/properties, use
A
- MOA: partial 5HTA1 agonist
- no muscle relaxant
- no anti-seizure
- little hypnosis/hallucinatory
- Use:
- anxiety
- esp. @ previous abusers of anxiolytics
- less addiction potential vs. benzos
14
Q
Consequences of Vit A abuse
A
- ==> acute, chronic, teratogenic
- acute = N/V
- vertigo
- blurred vision
- chronic
- alpecia
- skin changes, dry skin
- hepatomegaly
- intracranial HTN (pseudotumor cerebri) ==> papilledema
- vision difficulties
- teratogenic
- abortive
- microcephaly
- cardiac abnormalities
15
Q
Beck’s triad =
A
- hypotension
- JVD
- distant/muffled heart sounds
- ==> cardiac tamponade
