UWorld_3.26

Question 1

Initial test for hypothyroidism

Answer 1

-TSH levels <== more sensitive than T4/T3 levels

Question 2

Major signal trasnduction systems

Answer 2

1. MAP-kinase 2. PIP3K/Akt/mTOR 3. cAMP 4. Inositol phospholipid 5. JAK/STAT

Question 3

Characteristics of PIP3K/Akt/mTOR pathway

Answer 3

-important in cell growth and proliferation -tyrosine kinase receptor autophosphorylates ==> PIP3K converts PIP2=>PIP3 ==> Akt activation ==> mTOR = trxn factor -PTEN inhibits mTOR activation: tumor suppressor that removes phosphate from PIP3

Question 4

Characteristics of thalamic stroke

Answer 4

-complete sensory loss on contralateral side of body -no motor deficits -loss of proprioception ==> difficulty ambulating

Question 5

Cause of lacunar infarcts

Answer 5

-lipohylanosis or atherosclerosis w/in penetrating vessels to deep brain structure

Question 6

Medium for growing Neisseria

Answer 6

-Thayer-Martin VCN (vanc/colistin/nystatin) agar = selective medium for Neisseria

Question 7

Neuronal cells vulnerable to global ischemia

Answer 7

1. hippocampus 2. purkinje cells of cerebellum

Question 8

Gram + cocci that produces yellow pigment

Answer 8

S. aureus (aureus = gold)

Question 9

Characteristics of digoxin toxicity

Answer 9

-nonspecific GI = N/V, abdominal pain, anorexia -neurologic = fatigue, confusion, weakness, sometimes: color vision changes -most serious complication = arrhythmias

Question 10

Drugs not to use with partially occluded coronary arteries

Answer 10

-coronary artery vasodilators -vasodilation of unoccluded arteries ==> reduced blood flow through collaterals to ischemic areas ==> worsening ischemia

Question 11

Virus: nonenveloped w/ssDNA

Answer 11

parvoviridae = parvovirus B19 ==> 1. erythema infectiousum (5th disease) 2. aplastic crisis in sickle cell 3. hydrops fetalis @ <20wks gestation

Question 12

Location to perform thoracocentesis

Answer 12

-between ribs 5-7 @ midclavicular (on upper border) -between ribs 7-9 @ midaxillary (on upper border)

Question 13

Location of intercostal neurovascular bundle

Answer 13

in subcostal groove @ lower border of rib

Question 14

Which of these drugs would cause bradycardia: -Nifedipine -Captopril -Verapamil -Isosorbide nitrate -Prazosin

Answer 14

-verapamil only -all others act peripherally

Question 15

Drugs with negative chronotropic effects @ heart

Answer 15

-B-blockers -non-dihydropyridine Ca-channel blockser (verapamil, diltiazem) -cardiac glycosides (digoxin) -Amiodarone and sotalol -Cholinergic agonists (pilocarpine, rivastigmine)

Question 16

Drug effect of sildanefil is similar to what naturally occuring hormones/mechanisms

Answer 16

1. NO 2. ANP all ==> increased cGMP

Question 17

Vegetation composition in bacterial endocarditis

Answer 17

fibrin & platelet deposition at sites of bacterial invasion due to exposure of TF

Question 18

Presentation of Kawasaki’s

Answer 18

-child w/ 1. fever 2. lymphadenopathy 3. bilateral conjuctivitis 4. cutaneous involvement -palate/tongue erythema -edema/erythema @ palms/soles = fingertip desquamation -general rash: extremities ==> trunk

Question 19

Renal consequence associated with Chron’s

Answer 19

-oxalate kidney stones -oxalate normally bound by calcium, but crohn’s ==> decreased Ca2+ absorption ==> oxalate precipitation

Question 20

Biopsy in paget disease of bone

Answer 20

mosaic pattern of lamellar bone

Question 21

Embryo: -deformation -malformation -disruption -sequence

Answer 21

-deform = change in fetal structure due to mechanical forces; e.g. clubbed feet, hip dislocation due to breach position -malform = primary defect/intrinsic abnormality; e.g. holoprosencephaly, congenital heart defect -disruption = disruption of previously normal tissue; e.g. amnio rupture ==> limb damage -sequence = key single problem ==> number of abnormalities; e.g. oligohydramnios/potter

Question 22

DDAVP: moa, use

Answer 22

-vasopressin analog -little affect @ V1 receptors ==> no vasoconstriction -use: 1. central DI 2. bleeding control: induces release of procoag proteins (e.g. vWF) and stabilized factor VIII (Hemo A)

Question 23

Substances that induce angiogenesis

Answer 23

-VEGF -FGF (fibroblast)