UWorld_3.21 Flashcards
Mutations associated with Alzheimer disease
- Early onset (<60 yo)
- Amyloid precursor protein (APP) @ chromosome 21
- Presenilin 1 @ chromo 14
- Presenilin 2 @ chromosome 1
- Late-onset
- Apolipoprotein E`4
Contraindications for use of OCPs
- Prior thromboembolic event/stroke
- hx of estrogen-dependent tumro
- women > 35 who smoke heavily ==> higher risk of CV events
- hypertriglyceridemia
- decompensated or active liver disease
- pregnancy
Gross painless hematuria @ older adult ==> dx?
- urothelial cancer until proven otherwise
- most common = clear cell carcinoma <== renal tubular cells
- high glycogen or lipid content on histologic prep
RCA occlusion ==> dx + EKG findings?
LAD occlusion ==> dx + EKG findings?
LCX occlusion ==> dx + EKG findings?
- RCA ==> transmural ischemia @ inferior wall of L ventricle ==> ST elevations @ II, III, aVF
- LAD ==> anteroseptal transmural ischemia ==> ST elevation @ V1-V4
- LCX ==> lateral wall transmural ischemia ==> ST elevation @ V5, V6 & possibly I and aVL
Locations of ovarian artery
Location of uterine artery
- ovarian a. w/in suspensory ligament
- uterine artery w/in transverse cervical ligament
Calculating A-a gradient @ sea levle
- A = PAO2 = 150 - (PaCO2/0.8)
- a = PaO2
- Normal A-a < 10-15
Risk factors for gallstone formation
- “fat, fertile, female, forty”
- OCPs/Pregnancy ==> increased estrogen and progesterone
- estrogen ==> upregulated HMG-CoA reductase activity ==> supersaturation of bile with cholesterol
- progesterone ==> gallbladder hypomotility
Pulsus Paradoxus ==> Ddx?
- = decrease in systolic BP > 10 mmHg w/inspiration
- acute cardiac tamponade
- constrictive pericarditis
- severe obstructive lung disease
- restrictive cardiomyopathy
Microbio characteristics of Corynebacterium
- gram (+) rods
- non-motile, unencapsulated
- clumps ~ chines letters or V- or Y-shaped chains
- cytoplasm has metachromatic granules that stain w/aniline dyes
RBF calculation
= PAH clearance / (1-Hct)
S. pyogenes microbio characteristics
- gram + cocci in chains
- b-hemolytic
- susc. to bacitracin
- pyrrolidonyl arylamidase (PYR) positive
Post-influenza bacterial pneumonia causes
- s. pneumo
- s. aureus
- h. influenzae
Role of “P bodies” in cell
- cytoplasmic proteins that play a role in mRNA translation regulation and mRNA degradation
Causes of exacerbation of mysathenia gravis
- myasthenic crisis = undertx <==ephodrium will improve sx
- cholinergic crisis = overtx <==ephodrium will not improve sx
Consequences of HCV infection
- acute hepatitis (+/-)
- chronic hepatitis
- slowly progressive to cirrhosis
Serotonin precursor amino acid
tryptophan
Glutamic acid ==> molecular product?
Histidine ==> molecular product?
Methionine ==> molecular product?
Tyrosine ==> molecular product?
- glutamic = GABA
- histidine = histamine
- methionine= cysteine, carnitine, taurine, lethicin
- tyrosine = thyroxine, dopamine, epinephrine, norepi, melanin
Antidote for serotonin syndrome
- cyproheptadine = antihistamine + anti-serotonergic properties
Verapamil: MOA, use, SE
- MOA = non-dihydropyriddine ca-channel blocker
- slows conduction through AV nodes
- use = rate control in afib w/rapid ventricular response
- SE
- constipation
- gingival hyperplasia
- bradycardia
- first, second, or third degree AV node block
Leoprolide impact @ male
- GnRH
- transient increase, then decrease in both T and DHT
Vancomycin: MOA vs. Ceftriaxone: MOA
- Vanc binds D-ala (glycoproteins @ cell wall of bacteria)
- Ceftriaxone binds PBPs
- PBPs = transpeptidases that cross-link peptidoglycan @ cell wall
Most common cause of nephrotic syndrome in children
- MCD = fusion of foot processes on EM
Watershed areas of the colon
- splenic flexure and distal sigmoid colon
- lie between major arteries ==> susc. to damage during hypotension/low perfusion states
Lead placement in biventricular pacemaker
- 2-3 leads used
- first two = @ RA and RV via subclavian/SVC
- left ventricle pacer lies @ atrioventricular groove
Characteristics of lac operon
- genetic sequence in E. Coli that codes for proteins requried for metabolism of lactose
- regulatory gene (i), promotor region (p), operator region (o) + three structural genes (z, y, a)
- z = beta-galactosidase ==> lactose ==> glucose + galactose
- y = transmembrane enzyme allows cell perm. to lactose
- i = repressor protein ==> w/out lactose binds operator and prevents RNA pol binding to promotor
- lactose assoc. w/repressor ==> release of repressor ==> trxn of lac operon
- glucose ==> decreased aden cyclase ==> decreased cAMP ==> decreased expression of lac operon genes
