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UWORLD > Week 3 > Flashcards

Week 3 Flashcards

1
Q

_____ cellular rejection is associated with diffuse _____ infiltration

A

acute, lymphocytic

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2
Q

what murmur is heard best when the patient is sitting up and leaning forward with expiration?

A

aortic regurg

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3
Q

aortic regurg:

when does peak intensity occur?

A

immediately after aortic valve closure

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4
Q

inactivated viral vaccines primarily generate a ______ immune response. the influenza vaccine induces neutralizing Abs against the ____ antigen

A

humoral (vs cell-mediated);

hemagglutinin

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5
Q

primary TB infection = characterized by ghon complex, which consists of a _____ lobe lesion and ipsilateral ______ _____

A

lower;

hilar adenopathy

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6
Q

orotic aciduria:

causes a ______ anemia. due to defect in _____. treat with _____ supplementation

A

megaloblastic;
UMP synthase;
uridine

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7
Q

most common cause of death in acute rheumatic fever?

A

pancarditis –> HF

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8
Q

ovarian vein thrombosis:

often occurs ____partum. typically ____ sided and can extend into the ______

A

post;
RIGHT;

IVC

(L side can extend to renal vein)

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9
Q

inheritence of spina bifida?

A

multifactorial

same as clef lip/palate, diabetes, CAD, HTN

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10
Q

where cell layer are parietal cells found in?

A

upper glandular layer

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11
Q

what kind of transplant rejection is characterized by immediate mottling and cyanosis of the organ upon initial perfsion?

A

hyperacute

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12
Q

hyperacute rejection is mediated by _____ _____ _____. 2 examples =

A

preformed anti-donor Abs;

ABO, HLA

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13
Q

what nerve runs in the anterior compartment of the leg?

A

deep peroneal (also with anterior tibial artery)

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14
Q

embryological cause of transposition of great arteries?

A

failure of aorticopulmonary septum to sprial

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15
Q

S4:

heard in ____ diastole. associated with ventricular ______. 2 causes?

A

late;
noncompliance;

LVH, restrictive cardiomyopathy

represents atrial contraction

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16
Q

release of ____ ____ from ischemic neurons leads to liquefactive necrosis

A

lysosomal enzyymes

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17
Q

in anaerobic glycolysis, ____ is regenerated via conversion of pyruvate to _____ via _____ dehydrogenase

A

NAD+;

lactate, lactate

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18
Q

F-2,6-bisphosphate ______ PFK1 = ______ gycolysis. it also _____ F16-bisphosphatase = _____ gluconeogensis

A

stimulates, increases;

inhibits, decreases

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19
Q

interstitial lung disease:

associated with _____ lung elastic recoil caused by fibrosis–> _____ radial traction on airways

A

increased;
increased

leads to increased FEV1

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20
Q

celiac disease typically affects what part of the GI tract?

A

duodenum

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21
Q

phenoxybenzamine and phentolamine both inhibit ____. phenoxybenzamine is a _____ antagonist. phentolamine is a _____ antagonist

A

alpha 1, alpha2;

irreversible,
reversible

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22
Q

the lunate is the more ______ of the bones that articulates with the radius. what is the other bone?

A

medial;

scaphoid

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23
Q

in general what RNA are considered infectious? (ie act directly as mRNA)

A

single strand positive sense

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24
Q

infants born to ____-positive mothers have a high risk of aquiring perinatal HBV. typically present as ….?

A

HBeAG;

asymptomatic

but high risk for HCC, cirrhosis

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25
Q

diuretics, ACE inhibitors, and ARBs all _____ plasma renin activity

A

increase

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26
Q

strawberry hemangiomas:
present when?
grow rapidly or remain stable?
regress or no?

A

infancy, grow rapidly and then regress

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27
Q

mutations in what 2 sarcomeric proteins can cause hypertrophic cardiomyopathy?

A

beta-myosin heavy chain;

myosin binding protein C

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28
Q

parvovirus:
DNA or RNA?
ss or DS?
enveloped or naked?

A

ss DNA naked

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29
Q

S3:

associated with increased ______ _______ _____ volume. often occurs with?

A

increased LV End-systolic volumel

Left HF

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30
Q

what part of the body has the most deoxygenated blood?

A

coronary sinus

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31
Q

2 most important mediators of coronary vascular dilation?

A

NO, adenosine

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32
Q

what part of the urethra is most commonly damaged with pelvic fractures?
what about straddle injuries

A

posterior (ie membrnaous segment);

anterior (ie bulbous and penile)

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33
Q

2 most important risk factors for esophageal SCC?

A

smoking, alcohol;

see keratinization + intracellular bridges

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34
Q

MQs and monocytes can be identified by what CD marker?

A

CD14

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35
Q

disproportionate loss to follow up between exposed and unexposed groups is an example of _____ bias, a form of ____ bias

A

attrition;

selection

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36
Q

the rubber-like properties of elastin are due to ________ _____ between elastin monomers which is facilitated by ____ ____

A

extensive cross-linking;

lysyl oxidase

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37
Q

what region of the sarcomere contains only thick (myosin filaments)? what band only has thin filaments?

A

H band;

I band

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38
Q

HPV has predilection for what kind of epithelium?

what part of the respiratory tract has this epithelium?

A

stratified squamous;

true vocal cords

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39
Q

____ head sublaxation results from sudden traction on outstretched and pronated arm of child. what ligament is torn?

A

radial;

annular

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40
Q

either and organic solvents destroy virus infectivity by what mechanism?

A

dissolve lipid bilayer of envelope

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41
Q

femoral hernias:
____ to inguinal ligament;
____ to pubic tubercle;
medial to what vessel?

A

below;
lateral;
femoral vein

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42
Q

Guallain-Barre syndrome is characterized by _____ demyelination and _____ inflammatory infiltrate

A

segmental;

endoneural

43
Q

what kind of benign breast tumor is characerized by a cellular/myxoid stroma that encircles glandular/cystic spaces?

A

fibroadenoma (most common benign breast tumor)

44
Q

lactose intolerance:

____ stool pH, _____ hydrogen breath content, _____ stool osmolality

A

decreased, increased, increased

45
Q

what does Protein A produced by staph aureus do?

A

binds Fc portion of IgG –> impaired complement activation and phagocytosis

46
Q

______ hypersensitivity reaction is strongly associated with HLA-B57:01 allele

A

abacavir

47
Q

T cells:
positive selection occurs in the _____;
negative selection occurs in the ______

A

thymus cortex;

thymus medulla

48
Q

what can be used to reverse both CNS and peripheral symptoms of atropine overdose? is this a tertiary or quarternary amine?

A

physostigmine;

tertiary

49
Q

klinefelter:

_____ testosterone; ____ LH, ____ FSH, ____ estrogen

A

decreased, increased, increased, increased

50
Q

pneumococcal _____ vaccines produce both B and T cell recruitment. _____ vaccines cause a T-cell indepenedent respone

A

conjugate;

polysacharride

51
Q

(acidosis or alkalosis)? stimulates renal amniogenesis. what amino acid is required for this?

A

acidosis;

glutamine

52
Q

myasthenia gravis:

decreased ____ ____ potentials –> prevents ability to form _____ _____

A

end plate;

action potentials

53
Q

what 2 bacteria are pyrrolidonyl arylamidase-positive?

A

strep pyogenes; enterococci

54
Q

B1 receptors are found mainly in what 2 areas?

A 
heart;
renal JGA (increase renin release)

not vascular!

55
Q

equation for RPF

A

RBF * (1 - hematocrit)

56
Q

insulin promotes glycogen _____ by activating ____ _____

A

synthesis, protein phosphatase

57
Q

digoxin prevents sodium _____ and causes a _____ in intracellular sodium levels

A

efflux, increase;

= decreased Na/Ca exhanger = increased Ca in cell

58
Q

hartnup disease:

due to mutations in _____ ____ ____ transporters in PCT and intestine. causes symptoms due to _____ deficiency

A

neutral amino acid;
niacin

ie pellegra

59
Q

the live attenuated oral (_____) poliovirus vaccine produces a stronger ______ Ig___ response compared to the inactivated vaccine

A

Sabin;

mucosal IgA;

60
Q

acute transplant rejections can be _____ or _____ mediated. which is more common?

A

cellular, antibody;

cellular (ie T lymphocytes)

61
Q

what amino acid becomes essential in most patients with homocysteinuria?

A

cysteine;

see buildup in methionine as well

62
Q

buerger disease/thromboangiitis obliterans:
heavily associated with _____;
what kind of vasculitis?

A

smoking;

```
segmental thrombosing
which can extend into contiguous veins/nerves
~~~

63
Q

when do red neurons first appear with an ischemic stroke?

A

12-24 hours

64
Q

cryptococcal pneumonia is diagnosed by ______ staining of lung tissue and ______ _____

A

mucicarmine (stains red);

bronchoalveolar washings

65
Q

______ = PAH clearance

A

RPF

(urine conc x urine flow)/plasma conc

66
Q

equation for RBF in regards to PAH clearance

A

PAH clearance / (1 - hematocrit)

67
Q

what drug is indicated for treatment of visceral nausea due to gastroenteritis?

A

ondansetron

mostly for chemo tho

68
Q

what part of the basal ganglia is located directly lateral to the anterior horns of the lateral ventricles?

A

caudate

69
Q

shigella:

what is the key pathogenic mechanism that causes symptoms?

A

mucosal invasion

not toxin production

70
Q

atherosclerosis:
_____ produced locally by _____, endothelial cells, and MQs promotes migration of smooth muscle cells from media into intima –> proliferation

A

PDGF, platelets

71
Q

most carcinogens are converted into active metabolites by CYP450 systems. an example of an enzyme is ____ ____

A

microsomal monooxygenase

72
Q

reciting months of the year backwards is a test for _____

A

concentration

73
Q

following multi-step commands is a test for ____. drawing a clock at the correct time is a test for _____ function

A

comprehension;

executive function

74
Q

21 hydroxylase is responsible for concverstion of progesterone to _____.

A

11-deoxycorticosterone

75
Q

XY patients with no sertoli cells but normal leydig cells will have _____ internal reproductive organs and _____ genitalia

A

female and male;
male

(sertoli cells produce anti-mullerian hormone)

76
Q

in CML, leukocyte alkaline phosphatase levels are _____. what is it in leukemoid reactions?

A

decreased;

normal or increased

77
Q

INO: the affected eye is ____ to the lesion. it is unable to _____.

A

ipsilateral;
adduct

normal convergence, pupillary light reflex

78
Q

mitral stenosis:

loud S___, opening snap heard when?

A

loud S1;

OS after S2

79
Q

2 most common bacteria implicated in intra-abdominal abscesses?

A

Bacteroides, E. coli

80
Q

what must happen to the Hepatitis D virus before it can infect hepatocytes?

A

be coated by HbSAg

81
Q

in _____ order kinetics, a constant fraction of a drug is metabolized per unit time. in ____ order kinetics, a constant amount of drug is metabolized by unit time, independent of serum levels

A

first, zero

82
Q

what renal problem is seen in patients with sickle cell trait?

A

renal papillary necrosis

83
Q

B12 deficiency develops after absence of intake for how long?

A

4-5 years

due to large liver stores

84
Q

polyarteritis nodosa:

what kind of vasculitis?

A

transmural inflam with fibrinioid necrosis

85
Q

polyarteritis nodosa:

associated with what viral disease?

A

hep B

86
Q

what enzyme is responsible for pyruvate –> oxaloacetate?
what reaction is this a part of?
what vitamin is a cofactor?

A

pyruvate carboxylase;
gluconeogenesis;
B7

87
Q

in addition to pyruvate carboxylase, ____ is also a cofactor for Acetyl-Coa carboxylase, which is involved in _____ and propionyl-coa carboxylase, which is involved with ______

A

B7 (biotin);

FA synth;
FA ox

88
Q

_____ is an arrangement in which a payer pays a fixed, predetermined fee to provide all services required by a patient

A

capitation

89
Q

______ is when an insurer pays a provider a single payment to cover all expenses associated with an incident of care

A

global payment

ie elective surgeries`

90
Q

should thoracentesis needles be inserted at the upper border of a rib or the lower border of a rib?

A

upper border;

lower border is where Nerves, arts, and vessels are

91
Q

neonatal tetanus can be prevented by what?

A

immunizing pregnant women

92
Q

what is the main virulence factor of strep pyogenes? what does it do?

A

M protein;

inhibits phagocytosis and complement activation

93
Q

_____ is a selective estrogen receptor modulator that decreases negative feedback inhibition on the hypothalamus–> increased gonadotropin production. used to treat?

A

clomiphene;

Polycystic ovarian syndrome

94
Q

auer rods are seen in what kind of cancer?

A

AML

95
Q

which DNA polymerase has 5 to 3’ DNA synthesis and 3’ to 5’ exonuclease activity?

A

DNA polymerase 3

96
Q

which DNA polymerase has 5 to 3’ exonuclease activity? what is this used for?

A

DNA pol 1;

used to remove RNA primer synthesized by RNA primase

97
Q

_______ is characterized by rapidly progressive dementia and myoclonic jerks. multiple _____ are seen in the gray matter of the brain. due to prion.

A

Creutzfeldt-Jakob disease;

vacuoules (spongiform encephalopathy)

98
Q

lymph proximal to the dentate line drain to what 2 groups of lymph nodes?

A

internal iliac, inferior mesenteric

99
Q

damage to brainstem at or below the red nucleus (ie pons) results in _____ or ____ posturing;
damage above the red nucleus results in _____ or _____ posturing

A

decerebrate/extensor;

decorticate/flexor

100
Q

what ion is most responsible for the QRS complex? What about the QT interval?

A

Na (phase 0);

K (repolarization)

101
Q

residual volume is _____ in patients with COPD

A

increased

102
Q

what do you use to treat listeria meningitis?

A

ampicillin

it is resistant to cehpalosporins

103
Q

traumatic aortic rupture most commonly occurs where?

why here?

A 
aortic isthmus (right after L. subclav);
tethered by ligamentum arteriosum here
104
Q

which group of class 1 antiarythmics prolongs AP duration? which shortens it?

A

1A prolong;

1B shorten

UWORLD (6 decks)

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