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BT_Step1_NTK > Uworld_NTK_Wk3 > Flashcards

Uworld_NTK_Wk3 Flashcards

1
Q

cyclic breasting in which apnea is wolowed by gradually increase then decreasing tidal volumes until the next apneic period. ?

A

Cheyne-Stokes breathing.

commonly associated with Advanced CHF

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2
Q

What is Cheyne-strokes breathing commonly associated with?

A

Advanced CHF

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3
Q

biofilms ~w/ what bug?

A

Staph epidermidis

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4
Q

What is the pathogenesis of alcohol-induced hepatic steatosis?

A

decrease in free fatty acid oxidation secondary to excess NAHD production by the 2 major alcohol metabolism enzymes, alcohol dehydrogenase and aldehyde dehydrogenase.

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5
Q

triglyceride accumulation within the hepatocellular system == ?

A

hepatic steatosis

lipids can be stained with oil-red-O or Sudan black.

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6
Q

Sudan black ?

A

stains for lipids

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7
Q

What is the Serum K+ levels in a pt. w/ DKA?

A

normal to increased serum K+, despite a total body K+ deficit.

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8
Q

gram-neg rod that does not gram stain?

A

Legionella

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9
Q

what reconizes stop codons (UAA. UAG, UGA) and terminated protein synthesis?

A

releasing factors

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10
Q

if you can’t find the appendix via palpation during an appendectomy, how else can you locate it?

A

follow the teniae col to their origin at the cecal base.

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11
Q

High temp and exercise can cause what in a CF pt?

A

HYPOnatremia d/t excessive sodium loss through sweat.

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12
Q

Transmission of Hepatitis A?

A

Oral-fecal.

~overcrowding, poor sanitation, contaminated water or food, raw or steamed shellfish

OYSTERS

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13
Q

double layer of peritoneum that extencs from the liver to the lesser curvatve of the stomach and the beginning of the duodenum.

A

less omentum; it is divided into the hepatogastric and hepatoduodenal ligaments.

Gastic bands pass through the lesser omentum

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14
Q

That drug therapy is ~w/ fat redistribution?

A

HAART.

redist. fat from face and extremities to trunk

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15
Q

what is the immediate precursor of dopamine and can cross the BBB?

A

levodopa;

dopamine cannot cross the BBB

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16
Q

func. of the drug entacapone?

A

to reduce the peripheral metabolism of levodopa —> increase levodopa bioavailablity to the brain.

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17
Q

_________ is a peripheral DPA decarboxylase inhibitor.

A

Carbidopa.

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18
Q

Acute bacterial arthritis in sexually active young pt. is caused by?

A

N. gonorrhoeae

wrist and elbow joint pain.

joint aspirate with high neutrophil count and intracellular organisms.

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19
Q

What are the diseases classified as microangiopathic hemolytic anemia?

A
  • HUS
  • thrombotic thrombocytopenia purpura (TTP)
  • DIC
  • malignant HTN
  • mets. carcinoma
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20
Q

What does a low Vol. of Distribution mean? V_d?

A

drug is trapped in plasma compartment.

means that drugs is:

  • high molecular wt.
  • high plasma protein binding.
  • high charge
  • hydrophilic
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21
Q

Benign tumors in peds, that appear in the first weeks of life, grow rapidly and disappear by age 5-8?

A

strawberry hemangiomas. (capillary hemangiomas)

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22
Q

common in pregos, pt. w/ liver diz, and in pt. taking OCP or estrogen supplements.

A

spider angiomas;

dilated cutaneous arterioles that present as central papule with radiating blanching capillaries.

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23
Q

small, bright red, cutaneous papules that appear in pt. during adulthood.

MC benign vascular proliferation in adults.

A

Cherry hemangiomas;

dilated caps and post-capillary venules in papillary dermis and do NOT regress spontaneously.

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24
Q

What is a DNA-dependent RNA polymerase that incorporates short RNA primers into replicating DNA?

A

Primase

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25
Q

elevated alk-Phos labs of unclear etiology should be followed up with what lab?

A

gama-glutamyl transpeptidase;

this enzyme is mainly in hepatocytes and biliary epithelia; uses to figure out with high AlkPhos is or HEPATIC or BONY origin.

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26
Q

Which of the “bleeding issues” labs asseses liver function?

A

PT time?

Vitamin K-dep factors are made in the liver. (

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27
Q

Which of the “bleeding issues” labs assesses liver function?

A

PT time?

Vitamin K-dep factors are made in the liver. (

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28
Q

DOC for the Tx of treatment-resistant schizophrenia?

A

Clozapine; 2nd generation anti-psychotic.

Clozapine has affinity for multiple DA and 5HT receptors, but precise MOA is unknown.

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29
Q

Omalizumab?

A

Anti-IgE antibodies.

DOC fot severe allergic asthma.

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30
Q

What drug are effective to Tx chronic urticarial and allergic Sx, but NOT effective in the Tx of asthma?

A

H1 receptor antagonist.

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31
Q

What is a proteasome inhibitor used in the Tx of multiple myeloma and Waldenstrom macroglobulinemia?

A

Bortezomib

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32
Q

In what pt. can ambiguous external genitalia be seen?

A

(46, XX) w/ congenital adrenal hyperplasia

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33
Q

In what diz do pt. have absent uterus and primary amenorrhea?

A

Mullerian agenesis

androgen insensitivity syndrome

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34
Q

Fibrotic fallopian tubes are sometimes seen in ?

A

pelvic inflammatory disease

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35
Q

What is the genetic mech. responsible for the clinical variability of MITOCHONDRIAL diseases called?

A

Heteroplasmy

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36
Q

What is the best medical Tx of gallstones?

A

Give hydrophilic bile acids (ursodeoxycholic acid) –> reduces cholesterol secretion and increases biliary bile acid concentration.

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37
Q

How do fibrates increase risk of gallstones?

A

increase cholesterol content in bile ==> increase gallstone formation

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38
Q

what does estrogen and progesterone do w.r.t. bile?

A

estrogen increase cholesterol secretion.

progesterone reduces bile acid secretion. –? stasis

think makes the bile supersaturated with cholesterol.

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39
Q

Digoxin is used for ventricular rate control in a-fib b/c it decreases AV nodal conduction by _______________________ tone.

A

Digoxin increases PNS vagal tone.

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40
Q

Pt. who desires relationships but fear rejection == ?

A

Avoidant personality disorders

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41
Q

Pt. w unstable relationships, impulsivity, mood lability, and self-harm == ?

A

Borderline personality disorder

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42
Q

pt. with long-standing pattern of eccentric behavior, odd beliefs, perceptual distortions, and social anxiety despite familiarity == ?

A

Schizotypal

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43
Q

wound –> motor neuron axons –> spinal cord.

is the infection pathway of ???

A

C. tetani

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44
Q

wound –> neuron axons –> salivary glands.

infection pathway of ??

A

Rabies virus

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45
Q

fibrous exudate –> systemic circulation –> cortical neurons.

infection pathway of ??

A

diphtheria toxin.

fucks with cardiac and cerebral cortical tissues.

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46
Q

food –> systemic circulation –> meninges.

infection pathway of ???

A

listeria monocytogenes

meningitis in neonates

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47
Q

food –> systemic circulation –> peripheral nerves.

infection pathway of ??

A

botulinum toxin.

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48
Q

insect bite that leads to encephalitis, meningitis, flaccid paralysis ???

A

West Nile Virus; pos-sense, single strand flavivirus

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49
Q

What is used to Tx cardiac toxicity that is ~w/ TCA overdose?

A

Sodium Bicarb.

50
Q

The Sx of TCA overdose is due to what?

A

TCA overdose ==> blockade of cardiac fast sodium ch. and inhibition of ACh, H, and alpha-1 receptors.

51
Q

What are the Sx of TCA overdose?

A
  • delirium
  • seizures
  • cardiac abn.
  • severe HTN
  • signs of anti-cholinergic tox
52
Q

What nerve do you stimulate to help with OSA?

A

stimulate hypoglossal nerve ==> increase diameter of the oropharyngeal airway and decrease freq. of apneic events.

53
Q

What func. does cilicosis impair in the lungs?

A

Macrophages; thus fucks with cell-mediated immunity, increases infection by mycobacteria.

54
Q

How do you Tx cyanide poisoning and what’s the MOA?

A

inhaled amyl nitrite.

nitrites are oxidizing agents that induce methemoglobinemia (Fe3+), which has high affinity for cyanide.

55
Q

where are the neurons that release serotonin loc. in the CNS?

A

raphe nuclei

56
Q

substantia nigra contains what type of neurons?

A

dopaminergic neurons; these are depleted in parkinsons.

57
Q

Where are the NE-secreting neurons loc. in the CNS?

A

Locus ceruleus

58
Q

What tracts are fucked in B12 def.?

A
  • dorsal columns
  • lateral corticospinal
  • spinothalamic
59
Q

non-selective beta-blockers exacerbate ____________ and mask’s its adrenergic symptoms mediated by NE and Epi.

A

hypoglycemia

60
Q

what enzyme is released by injured hepatocytes and bacteria hydrolyzes bilirubin glucuronides to unconjugated bilirubin?

A

Beta-glucuronidase

61
Q

What kind of drug is chlordiazepoxide?

A

benzo

62
Q

Disease that is confirmed by excessive amounts of NEUTRAL amino acids in the urine.

A

Hartnup Disease;

impaired transport of neutral amino acids in the small intestine and PCT.

Pellgra-like Sx and cerebellar ataxia, d/t niacin def.

63
Q

ADRs:

decreased GFR (increase in creatinine), hypokalemia, cough,

A

ACE inhibitors

64
Q

MC predisposing condition for native valve infective endocarditis in DEVELOPED nations?

A

mitral vale prolapse with regurg.

for developing nations, it is RHEUMATIC HEART DISEASE.

65
Q

What is the most Px indicator of malignant melanoma?

A

depth of invasion (Breslow Thickness)

66
Q

What is the confirmatory test for celiac’s disease?

A

Duodenal biopsy

67
Q
  • capillary hemangioblastoma in retina/cerebellum.
  • congenital cysts/neoplasms in kidney, liver, pancreas.
  • increased risk for renal cell carcinoma.

=== ???

A

VHL

68
Q

Von Recklinghausen’s disease =

A

aka: NF1

69
Q

bilateral CN8 schwannomas and multiple meningomas = ?

A

NF2

70
Q

presence of cutaneous facial angiomas and leptomeningeal angiomas == ???

A

Sturge-weber synd.

skin involvement overlies V!1 and V2 nerve.

skull x-ray shows “tram-track” calcifications.

71
Q

Osler-weber-Rendu ?

A

aka: hereditary hemorrhagic telangiectasia.

NO Cysts!!!

72
Q

What is the most important virulence factor that Uropathogenic E. coli expresses?

A

P. fimbraie; needed to bind to uroepithelial cells to infect UTI.

without it, the E. coli would just wash away

73
Q

What does HYPO-ventilation do to pCO2 and pH?

A

increase atrial pCO2 and decreases serum pH. [Resp. Acidosis]

74
Q

how do you get different proteins from the same DNA seq.?

A

alternative RNA slicing.

75
Q

What is the screening and confirmatory test for T. pallidum?

A

screening: RPR or VDRL.
Rapid Plasma Reagin (RPR) serum is mixed with solution of cardiolipin, cholesterol and lecithin.
Aggregation, or “flocculation” is a (+) test.

confirmatory: FTA-ABS.

76
Q

where does lymph from the umbilicus down, including the anus below the dentate line, drain to?

A

Superficial inguinal lymph nodes.

77
Q

pancreatic inflammation can cuase a blood clot within what vessel?

A

Splenic vein.

This can increase pressure in the short gastric veins and lead to gastric varices only in the FUNDUS

78
Q

Suppression of which hormones is responsible for billiary stone?

A

CCK;

b/c CCK normally increases gallbladder contraction.

79
Q

PPV and NPV depend on what statistic? .

A

prevalence

80
Q

Conc. of what increases as fluid runs along the proximal tubule?

A
  • PAH
  • creatinine
  • inulin
  • urea
81
Q

Conc. of what DECREASE as fluid moves along that PCT?

A
  • bicarb
  • glucose
  • amino acid

i.e. glucose and amino acids are readily reaborbed by the PCT.

82
Q

What subs. are reabsorbed in concentration approx. equal with water in the PCT?

A

Na+ and K+

83
Q

A pt. with oligomenorrhea, hirsutism, and is obese is at risk for what disease?

A

high risk of endometrial hyperplasia/carcinoma.

pt. has PCOS

84
Q

What drug is best for visceral nausea d/t to GI insults, chemoTx, general anesthesia?

A

5-HT3 antag. Odensetron

85
Q

DOC for vestibular nausea?

A

Anti-histamines and anticholinergics

86
Q

DOC for Nausea d/t to migraine?

A

DA antagonist.

87
Q

What mu-opioid receptor functions as an anti-motility agent?

A

Loperamide

88
Q

S/Sx of stimulant intoxication?

A
  • tachycardia
  • hypertension
  • hyperthermia
  • diaphoresis
  • mydriasis
89
Q

what disease can both finasteride (5-alpha reductase inhibitor) and tamsulosin (alpha-1-blocker) be used to Tx?

A

BPH

90
Q

ADRs of tricyclics?

A

STRONG anti-cholinergic!

  • confusion
  • constipation
  • urinary retention
91
Q

What lab can be used to monitor colon cancer recurrance, but CANNOT be used to dX colon cancer?

A

CarcinoEmbryonic Antigen (CEA)

92
Q

Pt. has S/Sx of hypoglycemia and elevated C-peptide, what does this indicate?

A

insulin secreatgogue like a sulfonylaurea.

or an insulin-secreting tumor.

93
Q

Virus that is ~w/ pharynconjunctivitis and coryza (runny, nose, nasal congestion)

A

Adenovirus

94
Q

MCC viral gastroenteritis?

A

norovirus.

~ outbreaks, schools, ships.
~ vomiting and watery diarrhea.
~ peds and adults

Rotavirus causes similar S/Sx and in outbreaks, but less common in developed and vaccinated populations.

95
Q

Chronic lymphedema increases risk of dev of what?

A

angiosarcoma (Stewart-Treves syndrome)

96
Q

DOC vs. Pseudomondas aeruginosa?

A

cefepime or ceftazidme.

Trimethoprim-Sulfamethoxazole does NOT have activity here.

97
Q

Polygenic inheritance: ?

A

some key genetic influence are inherited in x-linked manner,

others are in autosomal dom.

98
Q

Common conditions with polygenetic inheritance: (7)

A
  • androgenetic aplopecia
  • epilepsy
  • glaucoma
  • hypertension
  • ischemic heart disease
  • schizophrenia
  • DM2
99
Q

What bacterial infection is ~w/ bacillary angiomatosis?

A

Bartonella henselae; Cat-scratch disease.

G-neg endocarditis.

100
Q

what causes accessory nipple?

A

failure of regression of the mammary ridge in utero.

aSx, but can be tender along with regular breast tissue d/t hormonal fluctuation.

101
Q

Raised and can be hyperpigmented. d/t clonal proliferation of benign melantocytes in utero.

A

congenital melanocitic nevi.

102
Q

What is the defect in Ehlers-Danlos syndrome?

A

defective collagen synthesis.

def. in procollagen peptidase; enzyme that cleaves terminal propeptides from procollagen in the ECM space.

S/Sx: hyperextensible skin, fragile tissue w/ easy bruising, and poor wound healing.

103
Q

How do you Dx tentanus?

A

Clinical hX and P. exam.

104
Q

What diz is X-linked recessive and presents with intramuscular hemorrhage, hemarthroses and increased aPTT?

A

Hemophilia

105
Q

Gi diz w/:

transmural inflammation, stricture, fistulas ==> ?

A

Crohns

106
Q

in elderly, triad of

  • ataxic gait
  • urinary incontinence
  • dementia

==>

A

Normal pressure hydrocephalus ==> leads to distortion of periventricular white matter.

lost of coritical inhibition on teh sacral micturition center causes the develop of urge incontinence.

107
Q

What can cause acture pancreatitis if its serum levels are very high!?

A

triglycerides > 1000mg/dL

108
Q

What is a major complication that can arise 4 - 12 days after a subarachnoid hemorrhage?

A

Servere vasospasm, leading to weakness in the extermities. (major cause of death)

Tx with Nimodipine, selective CCB.

109
Q

Beta-Thal increases what Hb?

A

HbA2; increased to compensate for beta globin underproduction.

==> microcytic RBC that are prone to hemolysis!

INCREASED red cell turnover = FALSELY low HbA1c levels

110
Q

What is the biggest regulator of the removal of cholesterol-containing IDL and LDL particles from circulation>?

A

LDL receptor on the liver!

111
Q

Symmetrical enlargement of the venticals in the brain ==> ?

A

communiting hydrocephallus.

dysfunc. w/ arachnoid granulations

112
Q

_____1_____ tumors are composed of islands or sheets of uniformed cells with eosinophillic cytoplasm and oval-to-round stippled nuclei. they are derived from ______2_____ cells in the GI tract.

A
  1. carcinoid

2. nueroendocrine cells

113
Q

Ghon complex ~ ? (lower lung lesion)

A

primary infection by M. tuberculosis

114
Q

factor V leiden increases risk of what?

A

DVT,

b/c factor V leiden ==> HYPER-coag state.

115
Q

What diz id neuroimaging best for?

A

excluding causes of movement disorders;

  • tumors,
  • infarction,
  • demyelinating diseases
116
Q

IgE-med degranulation of mast cells increase permeability –> edema of superficial dermis ==> ?

A

Urticaria

117
Q

High peak in the gamma-globulin region = ?

A

M-protein

118
Q

M-protein ~ ?

A

overproduced monocloncal Igs == Multiple Myeloma (Plasma cell neoplasm)

119
Q

_____________ –> hematoma –> extend prox. & distally –> compression of major arteries and impair blood flow (STUPID HIGH BP)

A

Intimal tearing.

This is a Aortic Dissection.

120
Q

bridging veins ~

A

Subdural hem.

121
Q

Func. of NF-kB protein?

A

pro-Inflammatory Transcription factor.

BT_Step1_NTK (28 decks)

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