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NBME > UWSA 2 > Flashcards

UWSA 2 Flashcards

1
Q

A case where HIV viral isolates are resistant to nevirapine. Cause is?

Abacavir
Darunavir
dolutegravir
Efavirenz
Tenofovir

A

Abacavir - NRTI
Darunavir -PI
dolutegravir - Integrase -
Efavirenz - NNRTI
Tenofovir - NRTI

Idea here is if u previously used NNRTI, U will be resistant to another NNRTI too.

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2
Q

VHL synd?

A

Chr 3 mutation
AD

Triad:
CB and retinal Hemangioblastomas
Phechromocytoma
RCC

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3
Q

Right and left Hb shifts?

A

Left: dec H+, dec 2,3-BPG, dec Temp
Left is low - low unloading of O2

Right: inc H+, inc 2,3-BPG, inc temp

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4
Q

If a breast mass is there (even post trauma) and dec in size later on?

A

Not fat necrosis but fibroadenoma!

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5
Q

Skin lesions + CDKN2A mutation?

A

Melanoma

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6
Q

Inc HR
Dec LV end-systolic vol
Inc end-diastolic vol
LV end-diastolic pr unchanged

What cause?

LV systolic dysfn
Nl exercise

A

Inc SV happens when?

(EDV-ESV inc) –> Exercise

In DCM or diastolic dysfn - both end-diastolic vol and end-systolic vol inc

In HCM - systolic dysfn - both end-diastolic vol and end-systolic vol dec

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7
Q

Leucine zipper + arginine and lysine rich 2-alpha helical struc?

A

Transcription factors

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8
Q

Hydrophobic AA rich alpha/beta helical struc not rich in arginine, lysine or leucine

A

Transmemb proteins

(alanine, leucine, isoleucine, valine, tryptophan, methionine, proline, glycine, phenylalanine)

Basically anything apart from basic AA (Histidine, arginine, lysine) and acidic AA (Glutamate and aspartate)

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9
Q

Memorize all the Hs and Gq/Gs

A

like Glucagon works on Gs
and ACTH on Gq

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10
Q

Isotretoin MOA?

A

Dec cohesiveness of epi cells

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11
Q

CYP450 inhibitors?

A

Metronidazole
Macrolides
Amiodarone
Cimetidine
Grapefruit juice

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12
Q

CYP450 inducers?

A

Carbamezipine
Rifampin
Alcohol
Phenbarbitol
Griseofulvin
Phenytoin
St John’s wart

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13
Q

High ICP cause?

Hydrocephalus caused by tumor
Vasogenic edema

A

Hydrocephalus only when u see enlarged ventricles

If just mass arnd it necrotic area - its Vasogenic edema

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14
Q

Some1 ppt to the ER with jaw pain and difficulty swallowing. No past 10 yrs Hx. Touching the post pharynx causes spasm of muscles of jaw. Cause?

Vasculitis
Bacterial toxin

A

Bact toxin
Tetanus is common in ppl with improper vaccination Hx

not vasculitis as no fever

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15
Q

ARDS C/P, why pt has dec O2 Sat?

A

Its cus of R-L from non-ventilated alveoli

Copious sputum filled up in alveoli - V/Q mismatch and then shunting!

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16
Q

If HLA is defective, what is an issue?

A

Ag recognition by APCs

not Ag recognition by T-cells/B-cells

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17
Q

Where can abscess be formed once we know there is a psoas abscess?

A

Groin

(not post thigh)

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18
Q

Korshakoff synd?

A

Amnesia
Preserved LTM
Memory fabrication with no intention to lie (Confabulation)
Lack of insight

if pt is >65 and has only anterograde amnesia - think abt AD.

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19
Q

A pt’s father who has early neurodegerative issue has accumalation of proteins with Glutamine excess. What can be seen in kid?

A

Anticipation

Its CAG repeats - Huntington!

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20
Q

If bacteriophage cause lytic infection in bact CW.

A

It can inject into the bact but it cant produce progeny - Transduction

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21
Q

If Prolyl hydroxylase inhibitor is given. What step is defective?

A

Abnl 3x helix formation in ER.

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22
Q

ssRNA -ve sense virus that allows replication of its DNA in nucleus?

A

Infleunza!!!!

apart from retrovirus its only the one that uses nuclear process to multiply

23
Q

Stunts coated with sirolimus and everolimus. Why?

A

These are mTOR inhibitors that dec smooth muscle proliferation

24
Q

Villous atrophy, crypt hyperplasia and Ls intraepi?

A

Celiac

24
Q

Ls in lamina propria?

A

Celiac sprue

25
Q

Ns in mucosa

A

UC

26
Q

Multiple freckles, nodules and pigmented lesions?

A

NF 1 - Schwann cells

27
Q

pigmented macules or papules?

A

Melanoma

28
Q

Coughing ep causes syncope. How?

A

VasoVagal response

Inc VD and dec BP + dec HR

29
Q

Liver Bx shows spherical nodules within confines of fibrous septa. The cells inside the nodule?

A

Hepatocytes!!

stalette cells form the fibrous septae they are not in the nodule.

30
Q

Large doughy mass covered by skin abv left clavicle and lat to SCM. Mass transilluminates with light. Cause?

A

Chromosomal aneuploidy - Cystic hygroma of XO synd

31
Q

If some1 tries to fire another AP when MP is +40mV. Why it does the 2nd AP reach just +10mV?

A

think of eqlbm potential of all ions

Na - +60mV
K - -90mV
Cl - -75mV
Ca - +125mV

Na dec EC - as MP closer to its eqlbm potential

32
Q

An erythematous raised rash with linear streaks post exposure outside is what?

A

HSR!!

33
Q

Lactose intolerance cause?

A

Gene expression issue!

34
Q

Tardive dyskinesia C/P?

A

lip puckering and smacking
facial grimacing
Choreiform Movements

thus cause is upreg of D2 R

35
Q

If some1 has def of DA-Beta-Hydroxylase, C/P?

A

Obv low E/NE –> orthostatic hypotn

36
Q

Any dsDNA virus u see and its asked how they replicate?

Ex: Adenovirus, HSV, VZV etc (Except poxvirus)

A

They replicate using DNA-dependent- DNA polymerase.

37
Q

C/P: Fever, chills, Malaise and paresthesia
Hydrophobia + PHARYNGEAL SPASM + paralysis

A

Think abt Rabies - Bats and unvaccinated dog bite trasmit it

Bx: EOSINOPHILIC NEURNAL CYTOPLASMIC INCLUSIONS

38
Q

Cells active in psoariasis?

A

Epidermal hyperplasia - APCs + like Dendritic cells –> produce INF-alpha - activate T-cells –> Keratinocytes act and local inc proliferation

39
Q

RAS physio?

A

Okay so here we have

Dec RPF lets say in left RA - dec Cl- at DCT - adenosine inc - AA dilation + EA constriction inc GFR

Dec RPF + inc GFR ==> Inc FF

40
Q

Venous pr curve for A.fib?

A

Absent a-wave

Cannon a -wave for? AV dissociation

41
Q

If u see dry crusted skin. Managemnet?

A

MOISTURIZE

42
Q

Scabies like lesions?

A

Wash bedding and clothes more frequently

43
Q

Cells that regenerate in intestines are located where?

A

Stem cells are in crypts of lieburkuhn

44
Q

Why is warfarin preferred not to be given in pregnancy instead heparin is used?

A

Warfarin has low mol wt thus passes the placenta easily

Other ppy that cause drugs to move thru placenta:
Low albumin binding
Lipophilic

45
Q

Primer annealing in PCR where?

A

On the extreme left in upper strand and extreme right on lower strand post denaturing

Taq (DNA) polymerase helps make the extended version of the DNA strands in 5’ to 3’.

46
Q

If a yg athlete ppts with bone loss. Cause?

A

Amenorrhea + Bone loss due to less Ez and less GnRH

47
Q

Weird protein brownish close to DCT in Bx of kidney?

A

Renin

48
Q

Black stains on diaper + nothing lese in qn stem. Cause?

A

Homogentisic acid dioxygenase Def

  • AR
  • Inc pigmentation of skin, sclerae, urine and stool
  • Dx: Inc Homogentisic acid levels
49
Q

What AntiCa drug causes obliterative vasculopathy of the renal AA?

A

Tacrolimus (Calcineurin inhibitors) cause VC of the renal arterioles.

50
Q

DNA polymerase 3 vs DNA polymerase 1?

A

DP3 - 5’-3’ synthesis of complementary DNA post RNA primers are annealed at site
This DNA synthesis in continuous on leading strand but discontinuous on lagging strand.

thus lagging strand has RNA primers in btw DNA bps –> so these intervening RNA primers –> DNA polymerase 1 works to excise and replace these RNA primers with DNA

What makes the primers - RNA polymerase/Primase

51
Q

1 - specificity v/s sensitivity curve

A

False +ves vs True +ve curve - is parabolic and +ve

52
Q

Painful bullae + Nikolsky sign positive. Igs deposit where?

A

Btw keratinocytes - pemphiguc vulgaris - Igs agnst desmosomal jns proteins (desmoglein 1 n 3)

NBME (11 decks)

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