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UWORLD > Week 4 > Flashcards

Week 4 Flashcards

1
Q

dizygotic twins (ie male and female) always have ____ amnion(s) and ____ chorion(s)

A

2, 2;

ie diamnionic, dichorionic

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2
Q

with monozygotic twins, it is most common to have ___chorion(s) and _____ amnion(s)

A

1, 2

ie monochorionic, diamniotic

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3
Q

excess malonyl-Coa inhibits what metabolic process?

A

beta oxidation (inhibits carnitine acyltransferase)

malonyl-coa is made in FA synth

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4
Q

all newborns should receive _____ prophylaxis to prevent ____ complications

A

vitamin K;

bleeding

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5
Q

nitrates:

activate _____, increasing intracellular levels of ____. this causes myosin light-chain _____

A

guanylate cyclase;
cGMP;
dephosphorylation

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6
Q

herpetic gingivostomatitis follows _____ infection with HSV1

A

Primary

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7
Q

_____ is when a bacterium takes up exogenous DNA fragments and is able to express the encoded proteins

A

transformation

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8
Q

what drug increases both PT and aPTT?

what is its effect on thrombin time?

A

direct factor Xa inhibitors (ie apixaban);

no effect

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9
Q

patients with trisomy 21 have 3 copies of _____ ____ _____ = increased risk of early onset Alzheimers

A

amyloid precursor protein (APP)

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10
Q

an alveolus with a smaller radius has a _____ collapsing pressure than one with a larger radius

A

higher;

ie as radius decreases, pressure increases (if no surfactant)

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11
Q

high altitude results in _____ O2 levels with ____ ____ (an acid base thing)

A

low (hypoxemia);
respiratory alkalosis

see low HCO3 levels in respone

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12
Q

what kind of capsue does HiB have?

A

polyribosyl ribitol phosphaste (PRP) capsule

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13
Q

LV leads in biventricular pacemakers course through the coronary sinus, which resides where?

A

AV groove on posterior aspect of heart

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14
Q

condyloma ____ is seen in ___ syphillis. condyloma ____ is caused by HPV

A

lata, secondary;

accuminata

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15
Q

what 2 endocrine drugs can cause agranulocytosis?

A

PTU, methimazole

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16
Q

_____ is a short acting sulfonylurea and has a _____ risk of causing hypoglycemia

A

glipizide;

lower

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17
Q

the lower trunk of the brachial plexus contains what nerve roots?
how is it damaged?

A

C8, T1;

sudden upward stretching ie grabbing tree branch when falling

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18
Q

what kidney disease is characterized by eiosinophila? whats a common cause?

A

interstitial nephritis;

beta lactams

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19
Q

a _____ ____ _____ is multiple malformations that occur secondary to an embryonic disturbance in an adjoining group of cells. what is an example?

A

developmental field defect;

holoprosencephaly

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20
Q

what neurotoxin impairs both muscarinic and nicotinic neurotransmission?

A

botulinum neurotoxin

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21
Q

inhibition of nicotinic or muscarinic transmission causes changes in CMAP?

A

nicotinic–see decreased compound muscle action potential (CMAP)

ie from botulinum

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22
Q

why do arteriolar vasodilators cause edema and fluid retention?

A

due to reflex RAAS activation

ie hydralazine

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23
Q

1st committed step of gluconeogenesis is conversion of pyruvate to _____ via ______. depends on what vitamin?

A

oxaloacetate;
pyruvate carboxylase;

B7 (biotin)

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24
Q

proteosome inhibitors such as ______ kill tumor cells by what mechanism?

A

bortezomib;

increase cell apoptosis (ie multiple myeloma)

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25
Q

_____ selectively inhibits funny sodium channels –> prolonging phase ___ –> _____ _____

A

ivabradine;
4;
slows HR (no effect on contractility)

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26
Q

cannulation of the femoral artery should be _____ the inguinal ligament to decrease the risk of _____ hemorrhage

A

below;
retroperitoneal
(increased risk of hemorrhage if above)

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27
Q

what ligament do the ovarian vessels, nerves, and lymphatics run in?

A

suspensory ligament of ovary (infundibulopelvic)

ligate these during ovary removal

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28
Q

what disinfectant causes coagulation of cell cytoplasm?
which forms free radicals?
which halogenates proteins and nucleic acids?

A

coag = chlorhexidine;

free rad = H2O2

halogenate = iodine

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29
Q

acyl-coa dehydrogenase deficiency causes ____ketotic ____glycemia when fasting (ie sick)

A

hypo;
hypo

vs glycogen storage disorders which are hyperketotic

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30
Q

Afib with aortic stenosis:

significantly reduces _____ –> decreased CO –> systemic hypotension. can also cause pulmonary ____

A

LV preload;

edema

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31
Q

uremia:

causes _____ bleeding time, _____ platelet count, _____ PT, ____ aPTT

A

prolonged;
normal, normal, normal

due to impaired platelet aggregation

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32
Q

which is longer lasting, regular insulin or NPH?

A

NPH

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33
Q

AV shunts:

____ preload, ____ afterload,

A

increase;
decrease

(decreased resistance to flow bc bypass arterioles)

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34
Q

what forms the clear spaces in Renal cell carcinoma?

A

glycogen and lipid accumulation

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35
Q

complete mole:

results when a _____ is fertilized by a ______. what is the genotype?

A 
empty ovum;
haploid sperm (that duplicates);

46, XX (only paternal DNA tho)

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36
Q

_____ withdrawal is characterized by acute severe depression, hyperphagia, hypersomnia, and vivid dreams

A

cocaine

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37
Q

milrinone inhibits what?
how does this effect the heart?
what about blood vessels

A

phosphodiesterase 3;

increase cAMP = increase Ca = increase contractility;

increase cAMP = systemic vasodilation

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38
Q

of the 3 types of muscle, which is not dependent on extracellular Ca?

A

skeletal (bc it is mechanically coupled)

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39
Q

what cell can produce pyruvate that sometime yields no ATP?

what is being produced?

A

erythrocytes;

producing 2,3-bisphospoglycerate

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40
Q

what is used to treat delirium?

A

low-dose antipsychotics (ie haloperidol)

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41
Q

overdose of what vitamin can cause intracranial hypertension, skin changes, and hepatosplenomegaly?

A

vitamin A

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42
Q

exercise:
_____ blood pressure;
_____ SVR

A

slightly increased;

decreased

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43
Q

what fungus is characterized as ovoid cells within MQs?

A

histoplasma

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44
Q

triad of portal vein thrombosis:

A

portal HTN, splenomegaly, varicosities

liver NOT changed on histology

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45
Q

people with blood group A or B typically have antibodies in the serum that are Ig____;
people with type O blood have antibodies in the serum that are Ig___

A

A or B = IgM;

O = IgG (can cross placenta–> fetal hemolysis)

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46
Q

Tay-Sachs:
what enzyme is defecient?
build up what?
causes progressive _____ and a cherry red spot on the _____.

A

Hexosaminidase A;
GM2 ganglioside;

neurodegeneration;
macula

NO HEPATOSPLENOMEGALY (vs Niemann Pick)

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47
Q

proteins destined for the _____ require phosphorlyation of mannose residue in the ____. this is deficient in what disease?

A

lysosomes;
golgi;

I-cell (N-acetylgluocsaminyl-1-phosphotransferase deficiency)

48
Q

I-cell disease:
where do proteins end up?
symptoms = ____ facies, ____ corneas

A

extracellular space;

coarse facies;
clouded

49
Q

VSD:
occurs when?
heard where?
____ in maneuvers that increase afterload (ie ____)

A

holosystolic;
left sternal border;
increases;
handgrip

50
Q

Mitral valve prolapse and Hypertrophic cardiomyopathy murmurs increase with maneuvers that ____ preload and ____ afterload

A

decrease, decrease;

and vice versa (ie decrease with increased preload)

51
Q

increased afterload (ie ____) causes a _____ in the aortic stenosis murmr

A

hand grip;

decrease

52
Q

carnitine deficiency:
impaired FA transport into _____, leading to ____ and ____ injury (lack of ATP from citric acid) and impaired _____ production during fasting

A

mitochondria;
skeletal muscle, myocyte;
ketone

53
Q

do central or peripheral chemoreceptors respond to changes in blood O2?
what are these called?

A

peripheral;

carotid bodies

54
Q

combining ganciclovir with TMP-SMX increases the risk of what side effect?

A

BM suppression (ie neutropenia)

55
Q

we are most worried about irreversible changes in _____ in patients with L–>R shunting (ie ASD)

A

pulm vessels (ie Pulm HTN)

56
Q

what 2 ligaments make up the lesser omentum?

A

hepatogastric, hepatoduodenal

57
Q

treatment of congenital adrenal hyperplasia focuses on suppressing what?

A

ACTH secretion (via corticosteroids)

58
Q

PAH is secreted from the blood into the tubular fluid by cells of the ______ via a ______ process

A

PCT;

carrier mediated

59
Q

what other nerve can be paralayzed with interscalene nerve block of the brachial plexus?
causes paralysis of what?

A

phrenic;

diaphragm

60
Q

orbital floor fractures can damage what nerve?

what muscle can become entrapped?

A

infraorbital (V2);

inferior rectus (decreased vertical gaze)

61
Q

what part of the respiratory tract provides the most airway resistance?

A

medium size bronchi

62
Q

what is characterized as a pearly mass behind the tympanic membrane that can cause hearing loss?

what is it made of?

A

cholesteatoma;

squamous cell debris

63
Q

mechanism of action for beta blockers in glaucoma treatment:

A

decrease aq humuor secretion by ciliary epithelium

64
Q

Juxtaglomerular cells are modified ____ _____ cellls of the ____ _____. undergo hyperplasia in response to _____

A

smooth muscle;
afferent arteriole;

hypoperfusion (long term)

65
Q

resistance to cephalospornis is caused by what?

A

change in PBP structure

66
Q

psoriasis:
____ stratum granulosum;
munro microabscessess, which are PMNs in the ____

A

decreased;

stratum corneum

67
Q

high levels of bile salts and phosphatidylcholine ____ cholesterol solubility and ____ risk of gallstones

A

increase, decrease

68
Q

umbilical hernias are due to a defect in the ____ _____; associated with what 2 conditions?

A

linea alba;

down, hypothyroidism

69
Q

skeletal muscle contraction causes an increase in intracellular ___ which activates ____ ____, stimulating glycogen phosphorylase and _____ glycogenolysis

A

Ca;
phosphorylase kinase;

increasing

(glucagon and epinephrine cause in increase in cAMP)

70
Q

what enzyme compensates for fructokinase deficiency?

A

hexokinase (converts fructose to F6P–>glycolysis)

71
Q

in what form of polycythemia is RBC mass normal?

A

relative polycythemia (ie fluid lose)

72
Q

which increases more from the apex of the lung to the base, ventilation or perfusion?

the ventilation/perfusion ratio _____ from apex to base

A

perfusion;

decreases (ie highest at apex)

73
Q

what 2 findings are essential to TTP diagnosis?

A

microangiopathic hemolytic anemia, thrombocytopenia

74
Q

obstruction of what causes unilateral symtpoms similar to SVC syndrome?

A

brachiocephalic vein

75
Q

which complement protein is decreased in PSGN?

A

C3

76
Q

myoglobin demonstrates a ______ oxygen-dissociation curve

A

hyperbolic

higher affinity than Hb

77
Q

severe hypertension in retinal vessels causes what?

A

flame hemorrhages

78
Q

sheehan syndrome:
high ____ levels during pregnancy cause enlargement of gland. peripartum hypotension can cause ____ _____ –> hypopituitarism

A

estrogen;

ischemic necrosis

79
Q

name 2 DNA binding domains

A

Zinc-finger;

leucine zipper

80
Q

sorbitol is formed by conversion of glucose via ____ _____. sorbitol is then metabolized into ____ by ____ ____

A

aldolase reductase;

fructose, sorbitol dehydrogenase

81
Q

____ can be used to treat patients who have a combination of tonic-clonic and absence seizures

A

valproic acid

82
Q

beta 2 activation causes _____ of the uterus;

which receptor causes pupillary dilation?

A

relaxation (tocolysis);

alpha 1

83
Q

which 2 tests are preferred for diagnosis of Type 1 DM?

A

HbA1C (more than 6.5);

fasting blood glucose (over 126)

84
Q

aminoglycosides inhibit _____ genetic code reading and protein synth by binding to the ____ ribosomal subunit

A

mRNA;

30S

85
Q

what are the three P’s of MEN1?

A

pituitary tumor, pancreatic endocrine tumor (ie gastrinoma), and parathyroid adenoma

86
Q

in endocarditis:
______ are due to microemboli.;

_____ are due to immune complex deposition

A

janeway lesions (painless)

osler nodes (painful)

87
Q

strongyloides infection can be diagnosed by finding _____ in the stool

A

rhabditiform larvae

88
Q

estrogen _____ levels of thyroxine-binding globulin. this ____ total thyroid levels. free levels of thyroid _____

A

increases;
increase;
stay the same

89
Q

alkaptonuria:

deficiency in _____ blocks the metabolism of _____

A

homogentisate oxidase;

tyrosine

90
Q

_____ disorder meets criteria for schizophrenia in addition to a major mood disorder. patients must have more than ____ of hallucinations/delusions _____ a major mood episode

A

schizoaffective;
2 weeks;
without (to differentiate from major mood disorder with psychotic features)

91
Q

findings in anemia:

_____ SaO2, ____PaO2, _____ total O2

A

normal, normal;

decreased (due to decreased Hb)

92
Q

hamartomas in the lung are made of _____ and _____

A

lung tissue, cartilage

93
Q

bilateral ligation of what can be used to control post partum hemorrhage?

A

internal iliac

94
Q

what determines the ventricular response in atrial fibrillation?

A

AV node refractory period

95
Q

incomplete fusion of the urethral folds results in ____, an abnormal opening of the urethra along the _____ shaft of the penis

A

hypospadias;

ventral

96
Q

what drug can be used to treat drug-induced parkinsonism?

what is it’s mechanism of action?

A

benztropine – anticholinergic

97
Q

familial hypocalciuric hypercalcemia:

defective ____ Sensing. causes ____ calcium levels , _____ PTH levels

A

Ca2+;

increased, normal to increased

98
Q

calcium efflux from cardiac cells prior to relaxation is mediated by what 2 methods?

A

Na/Ca exchanger and SR Ca-ATPase pump

99
Q

miRNA and siRNA basepair with complementary ____ sequences. this induces _____ ____ _____

A

mRNA;
post transcriptional gene silencing

ie, repressess translation

100
Q

megaloblastic anemias are due to defects in ______ synthesis.

A

DNA

101
Q

what is the etiology of bilateral wedge-shaped infarcts, parallel to the longitudinal fissure in the brain?

A

global hypoperfusion

102
Q

Myocardial ischemia:
loss of contractility occurs within _____;
if ischemia is less than _____, this is reversible dysfunction

A

60 seconds;

30 minutes

103
Q

obstructive sleep apnea:

due to relaxation of _____ muscle tone–>closure of airway. associated with ____ headaches. can cause ____ heart failure

A

pharyngeal;
morning;
right

104
Q

what are the 2 blood supplies to the liver?

A

hepatic artery, portal vein

less sussceptible to infarction

105
Q

primary biliary choloangitis:

characterized by _____ infiltration, _____, and destruction of ____ bile ducts

A

lymphocytic, granulomas;
intrahepatic;

antimitochondrial antibody

106
Q

methylmalonic acidemia:
due to deficiency of ____ ____;
characterized by metabolic ____, _____ hypoglycemia, and ____ammonemia

A

methylmalonyl-coa mutase;

acidosis, ketotic, hyperammoniaemia

107
Q

penicillin and cephalosporins cause _____ Vasculitis. characterized by what symptom?

A

leukocytoclastic;

palpable purpura of lower extremity

108
Q

the _____ pancreatic bud forms the uncinate process and contributes to the main pancreatic duct. everything else is formed by the _____ pancreatic bud

A

ventral;

dorsal

109
Q

pulmonary actinomycosis commonly follows _____ and can also be due to ___ ____

A

aspiration;

dental caries

110
Q

St. John;s Wort ____ CYP450. Grapefruit Juice ____ it.

A

induces, inhibits

111
Q

lesions of the ____ lower extremity can cause lymphadenopathy in both popliteal and inguinal areas

A

lateral

medial only causes inguinal lymphadenopathy

112
Q

triptans:

agonists or antagonists of what receptor?

A

5HT1b or 1d agonists

cause vasoconstriction of meningeal vessels

113
Q

what vitamin can be useful in the treatment of measles?

A

vitamin A

114
Q

patients with increased elastic resistance (ie _____) breath at ___ RR and ___ tidal volumes

A

pulm fibrosis;

high, low

(vs COPD, which breathe at lower rates due to increased airflow resistance)

115
Q

a high mitotic index is typical of what kind of lymphoma?

associated with what?

A

burkitt lymphoma;

EBV

116
Q

recurrent ______ is characterized by scarring at the upper and lower poles of the kidney. most often due to ____ _____ ( a structural abnormality)

A

pyelonephritis;

vesicoureteral reflux

117
Q

glycolysis, FA synth, and the pentose phosphate pathway occur where in the cell?

A

cytoplasm

beta ox, TCA, gluconeogenesis = in mitochondria

UWORLD (6 decks)

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