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UWORLD > Week 5 > Flashcards

Week 5 Flashcards

1
Q

_____ cells produce inhibin in response to ____.

A

sertoli;

FSH

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2
Q

impaired sertoli function:

_____ inhibin, ____ FSH, _____ testosterone, _____ LH

A

decreased, increased;

normal, normal

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3
Q

HCV lacks what proofreading enzyme that is responsible for its antigenic variation?

A

3–>5’ exonuclease

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4
Q

what pregnancy complication is due to impaired decidual layer?

how does it present?

A

placenta accreta;

post partum bleeding

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5
Q

____ ____ is defined by a decrease in systolic blood pressure of > 10 mm Hg with inspiration. seen in ?

A

pulsus paradoxus;

cardiac tamponade (also COPD, constrictive pericarditis)

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6
Q

which thyroid hormone decreases first in hypothyroidism?

A

T4

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7
Q

what do EPO levels do in patients with aplastic anemia?

A

increase

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8
Q

_____ ulcers are due mainly to increased gastric acid production; ____ ulcers are due to decreased mucosal production

A

duodenal;

gastric

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9
Q

intestinal malration occurs when the ____ fails to rotate completely around the ____ –> intestinal obstruction,____ bands

A

midgut;
SMS;
LADD (fibrous)

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10
Q

chronic NSAID use can cause what 2 kidney injuries?

A

interstitial nephritis;

papillary necrosis

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11
Q

HLA-A,B,C are the loci of the MHC ____ complex. HLA-DP, DQ-DR are the loci of the MHC ___ complex

A

1, 2

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12
Q

abdominal aortic aneurysm:

chronic ____ ____ –> extracellular matrix degradation –> weakening and expansion, typically ____ the renal arteries

A

transmural inflammation;

below

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13
Q

what has higher pressures, pulmonary artery or right ventricle?

A

pulm artery (around 25/10 vs RV, which is 25/5)

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14
Q

what fungal respiratory infection can complicate asthma? can cause recurrent ___ ____ and eventual ______ ( a lung disease)

A

aspergillosis (ie ABPA);

pulm infiltrates, bronchiectasis

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15
Q

brown adipose tissue (in newborns) function to produce heat by _____ oxidative phosphorylation with the protein ____

A

uncoupling;

thermogenin

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16
Q

abetalipoproteinemia:
inability to sythesize ____ –> can’t transport lipids into blood –> enterocytes with
____ cytoplasm

A

ApoB;

foamy

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17
Q

Mitral valve prolapse:
____ click;
murmur _____ with squatting

A

midsystolic;

decreases

due to myxomatous degeneration

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18
Q

methemoglobinemia can be caused by exposure to ____;

O2 content ____, O2 saturation _____, partial pressure O2 _____

A

nitrites;

decreases, decreases;

stays the same

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19
Q

what is an example of stimulus control in treatment of insomnia?

A

leaving bed if unable to sleep;

vs sleep hygeine (limit caffeine, alcohol, naps)

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20
Q

hepatitis E virus:
naked or enveloped?
DNA or RNA?
single or double strand?

A

naked, ss RNA

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21
Q

mullerian aplasia:

present with _____ vagina, ____ ovaries, ____ secondary sexual characteristics

A

short;
normal;
normal

variable uterine development

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22
Q

empiric treatment of staph epidermidis endocarditis?

A

vancomycin

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23
Q

increased intracranial pressure compresses optic nerves externally, impairing ____ ____ –> ____

A

axoplasmic flow;

papilledema

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24
Q

primary adrenal insufficiency:

_____ blood pressure, ____kalemia, metabolic _____, hyperpigmentation

A

decreased;
hyper;
acidosis

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25
Q

prophylaxis for Mycobacterium avium complex?

A

azithromycin

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26
Q

MAC (myco avium) grows best at _____ temperatures

A

high (vs Tb)

causes hepatosplenomegaly, anemia, increased ALP, increased LDH

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27
Q

how to differentiate between lacunar infarcts and charcot-bouchard aneurysms?

A

aneurysms rupture, cause hemorrhage which is visible on CT;

lacunar infarcts are small and often not initially seen on CT

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28
Q

where is meissner’s plexus located?

where is auerbach’s plexus?

A

submucosa (secretes fluid, regulates blood flow);

muscularis externa (motility)

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29
Q

translation of mRNA occurs in the ____ direction

A

5 to 3’

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30
Q

maximum flow to the ____ ventricle occurs during _____

A

left;
diastole

(RV = lower pressures=mostly constant perfusion)

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31
Q

what kind of lymphocytes are atypical lymphocytes seen in Mono?

A

CD8

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32
Q

benign liver tumors:
which is most common?

which can regress with stopping of OCPs?

A

cavernous hemangioma;

adenoma

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33
Q

where is this reabsorbed?

bile acids =
iron =
B12 =
Folate =

A

terminal illeum;
duodenum;
terminal illeum;
jejunum

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34
Q

aging:
____ chest wall compliance;
____ lung compliance;
____ elastic recoil

A

decreased;
increased;
decreased

causes increased RV, decreased FVC, normal TLC

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35
Q

2 most common symptoms in glucagonoma?

A

necrolytic migratory erythema + hyperglycemia;

also diarrhea

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36
Q

celiac disease most commonly affects the _____

A

duodenum

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37
Q

obstructive atelectasis:

unilateral pulmonary ____ + deviation of mediastinum toward _____-

A

opacification;

toward collapsed lung

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38
Q

what transfusion reaction is characterizedby fever, hypotension, chest/back pain, and hemoglobinuria? what kind of HSR is this?

A

acute hemoyltic transfusion reaction;

type II HSR (ie ABO incompatibility)

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39
Q

what is the embryological cause of tetralogy of fallot?

A

anterosuperior displacement of infundibular septum

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40
Q

alcohol abuse:
which liver enzyme is more increased?
what is seen on blood smear?

A

AST > ALT;

macrocytosis (e.g. folate deficiency)

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41
Q

what part of the spine is most commonly affected in RA?

A

cervical

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42
Q

order these in conduction velocity, from fastest to slowest:

atrial muscle, AV node, purkinje, ventricular muscle

A

Purkinje (fastest) > Atrial muscle > ventricular muscle > AV node

Park At Venture Avenue

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43
Q

injury to the temporal lobe can cause contralateral _____ quadrantanopia;

injury to the parietal lobe can cause contralateral _____ quadrantanopia

A

superior (pie in sky for Meyer’s loop);

inferior

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44
Q

prostatectomy can injure the _____ which lies in the fasica of the prostate. this can cause _____

A

prostatic plexus;

erectile dysfunction

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45
Q

HUS:

____ platelet count, ____ bleeding time, ____ PT, ___PTT, ____ LDH

A

decreased PC, increased BT;

normal PT and PTT;
increased LDH

46
Q

the neural tube is usually formed by ____ weeks

A

4

if not–>spina bifida

47
Q

besides the liver, what else can produce glucose during fasting?

A

kidney;

intestinal epithelium

48
Q

pernicious anemia:

____ gastric pH, ____gastrin, ____ parietal cells

A

increased, increased, decreased

49
Q

“on off” phenomenon with parkinson’s therapy is due to progressive ____ ___ –> decreased therapeutic window

A

progressive nigrostriatal degeneration

50
Q

equation for half life?

A

t = (0.7 * Vd)/CL

51
Q

why should you wait 2 weeks after stopping MAO inhibitors before starting SSRIs?

A

allow time for MAO regeneration

52
Q

what drug class can mask symptoms of hypoglycemia?

A

non-selective beta blockers

53
Q

equation for NNT

A

1/ARR

ARR = difference between control and experimental group event rates

54
Q

the electrolyte disorders seen in hyperaldosteronism cuase what 2 symptoms?

A

muscle weakness, paresthesias

55
Q

most common cause of bronchiolitis in kids?

A

RSV

see increased work of breathing, cough, tachypnea

56
Q

tetrodotoxin _____ depolarization;

ciguatoxin _____ depolarization

A

prevents (binds Na channels);

causes (opens Na channels)

57
Q

______ = tendency of study subjects to change behavior as they know they are being studied

A

hawthorne effect

58
Q

chancroid vs granuloma inguinale:
painful =
lymphadenopathy =
donovan bodies =

A

chancroid, chancroid;

granuloma inguinale

59
Q

what is JAK2?

A

cytoplasmic (non-receptor) tyrosine kinase

60
Q

what removes RNA primers in DNA replication?

A

DNA polymerase 1 (5 to 3’ exonuclease)

61
Q

which of the coagulation factors has the shortest half life?

A

factor 7

so, first to decrease in liver disease –> prolonged PT

62
Q

thoracic outlet syndrome is due to compression of the _____ trunk of the brachial plexus between a cervical rib and what?

A

lower;

scalene muscles

63
Q

a prominent left atrial “v wave” is a major finding for what valvular disorder?

A

mitral regurg;

represents LA filling during systole

64
Q

what is the toxic component of LPS?

A

Lipid A;

widespread release of IL1 and TNF alpha

65
Q

exposure to high temperature in patients with CF can cause what symptomatic electrolyte abnormality?

A

hyponatremia;

hypochloremia also occurs, but no symptoms

66
Q

effect on insulin release:

M3 =
Beta 2 =
Alpha 2

A

increase; increase;

decrease

67
Q

what is the equation for alveolar ventilation?

A

Va = (Vt - Vd) * RR

Vt = tidal volume, Vd = dead space

68
Q

arterial ____ is a direct indicator of alveolar ventilation status

A

PaCO2

ie hyperventilation = decreased Pa CO2

69
Q

nitrartes induce _____l ; can be used to treat ______

A

methemoglobinemia (Fe3+);

cyanide poisoning

70
Q

nitroprusside:
____ preload;
____ afterload;
_____ SV

A

decreased, decreased;
unchanged

arteriole AND venous dilator

71
Q

pituitary apoplexy is ____ of the pituitary and most often occurs secondary to ______

A

hemorrhage;

pituitary adenoma

72
Q

ventricular outflow obstruction in patients with HCM is due to which 2 structures?

A

mitral valve leaflet, IV septum

thiccc septum + anterior shifting of mitral leaflet toward aortic valve

73
Q

which 2 opioids are used as anti-diarrheals?

A

diphenoxylate (With atropine);

loperamide

74
Q

what is the best predictor of severity in a patient with mitral regurg?

A

presence of audible S3

75
Q

name a drug that binds K+ channels, increasing post-prandial insulin release

A

repaglinide (a meglitinide)

76
Q

the reid index is the ratio of the thickness of the mucosal gland layer to the thickness of what?

A

between resp epithelium and cartilage (ie not including cartilage)

77
Q

pulmonary vascular resistance is lowest at what?

A

functional residual capacity

78
Q

Myelination ____ the length constant and _____ the time constant –> improving axonal conduction speed

A

increases;

decreases

79
Q

which Glucose transporter is insulin dependent? what cells have this?

A

GLUT4;

adipose tissue, striated muscle

80
Q

what nerve runs between the Flexor digitorum profundus and superficialis? what runs between the 2 heads of the pronator teres>?

A

median, median

81
Q

what lipid lowering drug can slightly increase TG levels?

A

bile acid resins ie cholestyamine, colestipal

82
Q

unlike sporadic colorectal carcinoma, carcinomas associated with long standing ulcerative colitis are more likely to be what?

A

multifocal in nature;

also early p53 mutation, higher grade

83
Q

most common cause of sudden cardiac death in first 48 hours post acute MI?

A

ventricular fibrillation

84
Q

which RNA polymerase functions exclusively in the nucleolus?

A

RNA pol 1

85
Q

metyrapone ____ cortisol synthesis. in normal patients, causes a _____ in ACTH, a ____ in 11-deoxycortisol

A

inhibits (via inhibition of 11-beta-hydroxylase);

increase, increase

86
Q

which thyroid problem causes elevated creatine kinase?

A

HYPOthyroidism

87
Q

the external branch of the ____ ___ nerve can be injured during thyroidectomy due to proximity to the superior thyorid arter/vein; what muscle does it innervate?

A

superior laryngeal;

cricothyroid

(4th arch)

88
Q

11-beta hydroxylase deficiency:
____ blood pressure;
____ K+;
genitals?

A

increased;
decreased;

virilized (if XX)

89
Q

17-alpha hydroxylase deficiency:
____ blood pressure,;
___ K+;
____ sex hormones

A

increased;
decreased;

DECREASED

90
Q

21-hydroxylase deficiency:
_____ blood pressure;
____ k+;
____ sex hormones

A

DECREASED;
INCREASDED;

increased (ie virilized if XX)

91
Q

carotid sinus massage:

_____ afferent baroreceptor firing –> ____ –> decrease HR

A

increased;

prolonged AV refractory period

92
Q

insulin shifts K+ ____ the cell. beta agonists shift K+ ____ the cell

A

in, in

93
Q

how are cells infected with HBV characterized as?

A

granular eoisinophilic “ground glass” appearance (due to HbSAg accumulation)

94
Q

acetyl coa stimulates what enzyme in gluconeogenesis?

A

pyruvate carboxylase

95
Q

an elevated ALP of unclear etiology should be followed up with what test?

A

gamma-glutamyl transpeptidase

96
Q

infection, pain, and sleep deprivation cause ____glycemia;

exercise can cause ____glycemia

A

hyper;

hypo (by upregulating GLUT4 transporter)

97
Q 
aortic dissection:
type A (ascending aorta) usually orginiates where?

where does type B (descending aorta) originate?

A

sinotubular junction;

near origin of left subclavian vein

98
Q

what drug prevents the synthesis of HIV mRNA?

A

integrase inhibitors

ie raltegravir

99
Q

what nerve runs medial to the ischial spine, through the sacrospinous ligament?

A

pudendal nerve

i.e. for perineal anesthesia

100
Q

G6P dehydrogenase catalyzes the conversion of G6P to what?

A

6-phosphogluconate

and 6-phosphogluconate to ribulose 5-phosphate

101
Q

what drug is indicated in treatment of bradycardia that can also cause increased intraocular pressure and acute _____ glaucoma?

A

atropine–>acute closed angle

102
Q

what kind of channel is mutate in CF?

A

ATP-gated chloride channel

103
Q

spinal stenosis is characterized by ____ ____ hypertrohpy, disc herniation, and osteophyte formation affecting the ____ joints

A

ligamentum flavum;

facet

104
Q

Tb:
_____ establishes virulence thru PMN inhibition, TNF release, and mitochondrial destruction;

_____ inhibit phagolysosome fusion

A

cord factor;

sulfatides

105
Q

what ovarian tumor often secretes estrogen?

characteristic _____ _____ on histologyu

A

granulosa cell tumor;

Call-exner bodies

106
Q

erosions penetrate into the ____ ____ but do not extend all the way through. ulcers extend all the way into the ______

A

muscularis mucosa;

submucosa

107
Q

bilateral renal angiomyolipomas are associated with that disease?

A

tuberous sclerosis;

also seizures, angiofibromas, ash-leaf spots etc..

108
Q

drugs with LOW Vd have a ____ molecular weight, ____ plasma protein binding, ____ charge, and are hydro____

A

high;
high;
high;
hydrophilic

stay in plasma compartment

109
Q

what should be given to patients exposed to nuclear accidents to prevent the development of radiation induce thyroid carcinoma?

A

potassium iodide

110
Q

uric acid stones precipitate at a ____ urine pH, which can occur in the setting of chronic _____

A

low;
diarrhea

(diamond/rhomboid shaped crystals)

111
Q

the rER is invovled in transfer of proteins to the _______ and ______

A

cell membrane, extracellular space

UWORLD (6 decks)

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