UWorld_3.17 Flashcards
1
Q
Blood testing in suscipicion of celiacs
A
- blood test for:
- IgA anti-endomysial
- Iga anti-tissue transglutaminase
2
Q
Transmural inflammation of arteries w/fibrinoid necrosis ==> dx?
A
- polyarteritis nodosa
3
Q
Characteristics of polyarteritis nodosa
A
- segmental, fibrinoid necrosis of small-med arteries
- Sx
- fever
- abdominal pain
- peripheral neuropathy
- weakness
- weight loss
- assoc. w/hep B in 10-30% of cases
4
Q
Most common point of occurence of intusseception
A
ileocecal jxn
5
Q
Characteristics of a transaminase reaction
A
- reaction between amino acid and an alpha-keto acid
- e.g. glutamate & oxaloacetate
- often occur to allow amino acids to enter TCA cycle/Urea cycle
- Vit B6 (Pyroxidine) = cofactor for transaminase and decarboxilation reactions
6
Q
TH1 cytokines (+ purpose) =
TH2 cytokines (+ purpose) =
A
- interferon-gamma, IL-2 ==> activate macs & attract CD8+ t cells
- TH2 ==> stimulate B cells [adaptive immunity]
- IL4 + IL13 ==> IgE from B cells
- IL5 ==> IgA + eosinophil
7
Q
“Red neurons” on histo section of brain
A
- ischemia/infaction within the past 12-24 hrs
8
Q
Characteristics of lynch syndrome
A
- hereditary nonpolyposis colon cancer
- due to defect in mismatch repair
- AD
- due to mutations @
- MSH2 ==> MutS
- MLH1 ==> MutL
9
Q
a. that runs with the radial n.
A
deep brachial
10
Q
anatomic structure that runs through the hepatoduodenal ligament
A
- portal triad = hepatic artery, portal vein, common bile duct
11
Q
Mechanism of relaxation of cardiac muscle
A
- calcium efflux preceeds relaxation
- accomplished via:
- Ca2+ ATP pump
- Na/Ca exchanger
12
Q
Most common cause of bronchiolitis + tx
A
- RSV
- 1st line = O2 or IV fluids
- in @ risk for progression, can give ribavirin:
- nucleoside analog
- active against RSV and hep C
13
Q
K+ in DKA
A
- total body decrease in K+
- decreased intracell stores of K+
- normal to increased serum K+
- K+ drawn out in exchange for H+; low insulin levels
- increased if hypovolemic
14
Q
HCV vs. HBV most common transmission
A
- HCV
- most common = blood transfusion or IV drug use
- possible, but less common = sexual transmission
- HBV
- blood contact (transfusion, needle stick, IV drug use) OR unprotected sex
15
Q
Strep infections that lead post-strep syndromes
A
- Impetigo (step skin infect) OR strep pharyngitis ==> APSGN
- ONLY strep pharyngitis ==> rheumatic fever
16
Q
Common cause of fluid filled cavity in liver + fever chills
A
- dx = hepatic abcess
- underdeveloped countries ==> parasitic infection (entamaeba histolytica)
- developed countries ==> bacterial infection
- biliary tract infection (asc. cholangitis)
- portal vein pyremia (bowel or peritoneal sources e.g. appecitis, peritonitis, enteric pathogens)
- hepatic artery (hemat spread from distant site)
- penetrating injury or trauma
17
Q
ST elevation @ V1-V3 ==> dx?
A
occlusion at left anterior descending coronary artery
18
Q
Riboflavin biochemical role
A
- Riboflavin + Pi ==> FMN = coenzyme
- FMN + Pi ==> FAD (i.e. FAD+) ==> oxidation/reduction reaction
- e.g. @ TCA cycle: succinate + FAD+ ==> fumarate + FADH2
19
Q
Palpaple, nontender gallbladder + jaundice ==> dx?
A
- palpable, nontender gall = “Courvosier’s sign”
- dx = adenocarcinoma of the head of the pancreas obstructing CBD
20
Q
Presentation and risks for adenocarcinoma of the head of the pancreas
A
- ==> courvosiers sign (palpable, distended, nontender gallbladder) + anorexia + obstructive jaundice
- obstructive jaundice = jaundice + dark urine + pale stools
- risks
- age > 50
- smoking
- DM
- chronic pancretitis
- genetic predisposition: HNP, FAP, MEN
21
Q
Ondansetron: MOA, use
A
- MOA
- central = 5HT3 inhibitor @ chemoreceptor trigger zone (medulla) & solitary nuceus
- periphery = inhibit vagus-mediated nausea
- use: post-chemo anti-nausea
22
Q
5HT3-inhibitors
A
- ondansetron
- granesetron
- dolasetron
23
Q
Rapid and complete relief in RA [short-term]
A
glucocorticoids, e.g. prednisone
24
Q
Methotrexate: MOA, use
A
- MOA: antimetabolite, antifolate
- use: RA, other autoimmune
25
Auer Rods ==\> dx?
* AML (/PML)
26
Nevirapine: MOA, similar drugs
* NNRTI
* inhibits reverse transcription, doesn't need phosphorylation to be active
* other drugs
* efavirenz
* delaviridine
27
Canagiflozin: MOA, use, SE
* MOA
* oral anti-diabetic
* = SGLT2 inhibitor ==\> decreased reabsorption of glucose @ proximal renal tubule
* ==\> urinary glucose loss
* SE
* renal effects \<== monitor Creatinine and BUN
28
Lithium toxicity antidote
hydrocholorthiazide ==\> trapping in urine
29
Cause of decreased gene transcription in Huntington's
* CAG repeats ==\> gain of fxn ==\> pathologic interactions w/trxn factors
* abnormal huntingtin ==\> histone deacetylation ==\> repressed trxn ==\> decreased production of neurotrophic factors ==\> impaired neuron survival
30
Causes of polyhydramnios
* decreased fetal swallowing
* intestinal atresia/obstruction
* anencephaly
* increased urine production
* twin-twin transfusion
* high CO due to anemia
31
Enhancer and inhibitor of morphine/opoid tolerance
* mechanism = ~ phosphorylation of receptors, increased cAMP
* glutamate ==\> increased NMDA receptor activity ==\> potentiation of tolerance
* ketamine ==I tolerance
32
RANK receptor fxn
* ==\> formation and differentiation of osteoclasts ==\> increased bone resorption
* ligands for RANK receptor =
* RANK ligand \<== osteoblast-produced
* MSC \<== osteoblast produced
* bone formation regulated by RANK/OPG (osteoprotegerin) balance
* OPG also produced by osteoblasts
33
Location of PTH receptors in bone marrow
osteoblasts
34
Ras protein type & association
* part of MAP kinase pathway ==\> cell growth and differentiation
* G protein; activated by GTP
