Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Uworld > * Wrong Answers (Second Pass) > Flashcards

* Wrong Answers (Second Pass) Flashcards

1
Q

Antihypertensive emergency drug (IV):

  • arteriolar dilation
  • increases renal perfusion (only IV one!)
  • promotes natriuresis
A

Fendolopam

selective dopamine-1 agonist

(no effect on alpha or beta receptors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

antihypertensive that relaxes arterioles but not veins;

adverse effect?

A

Na and fluid retention

(reflex symp action –> tachycarida and edema)

(e.g. hydralazine and minoxidil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

bacteria makes dextrans from sucrose;

adherence site?

A

FIBRIN -platelet aggregates

viridans strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

nerves and vessels supplying ovary are in what ligament

A

suspensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

cancer cells resist chemo drugs with what type of surface glycoprotein

A

ATP-dependent transporter

efflux pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

zenker divrituculum cause

A

cricopharyngeal muscle dysfunction

diminshed relaxation of pharyngeal muscles during swallowing –> increased pressure –> mucosa herniates through wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

isolated diastolic HF;
LVEDP?
LVEDV?
LV EF?

A

LVEDP increased

LVEDV and EF are normal

(dyastolic HF = decreased ventricular diastolic compliance but normal contraction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q 
Hyperaldosteronism (primary mineral corticoid excess)
Renin?
Na?
K?
Bicarb?
Fluid status?
BP
A 
Renin- low
Na - NORMAL
K - low
Bicarb - high 
Euvolemic
HTN
  • H exretion –> incrased bicarb reabsob in alpha-intercalated cells
  • rise in volume causes ANP and increased pressure natiuresis –> compensates for Na and fluid effects of aldo)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3 effects of aldo

A
  • Increase ENaC (luminal - brings Na in)
  • Increase Na/K ATPase (basal - Na to blood)
  • Increase H pump (luminal - H out to urine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

aortic stenosis loudest at what point on cath tracing

A

peak of aortic pressure (intensity related to magnitude) LV/AS pressure gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

neurofibromas - cell type/embryologic origin

A

schwann cells

neural crest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

anti-CD20 med

A

rituximab

used for some lymphomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

anti-TNF alpha med

A

infliximab

used for RA, ank spon, fistulizing crohn’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

provides major proliferative stimuli for cellualr components of atherosclerotic plaques

A

platelets
endothelial cells
macrophages

(release PDGF –> sm muscle migrates from media into intima and prolif)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

least common site of malignancy in GI tract

A

duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

impairment of glucose –> ribulose-5-phosphate would inhibit what biochem pathways

A
  • cholesterol synth
  • FA synth
  • glutathione antiox mech

(all require NADPH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how to handle somatic symptom d/o pt

A

increase freq of outpatient visits (with same provider)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Parvo B19 virus description

A

DNA
single-stranded
non-env

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Bruise –> green

what enzyme

A

Heme oxygenase

heme –> biliverdin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

biotin reaction types

A

CO2 carrier

e.g. pyruvate to oxaloacetate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ziovudine mech

A

NRTI

  • binds to RT and is incorporated into genome
  • does NOT have a 3’-OH –> blocks 3’-5’ phospodiester bond formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

TB drug that causes cells to lose their acid-fast-ness

A

isoniazid

inhibits synth of mycolic acids (lose acid fast-ness) and stop muliplying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

1st gen antihistamines also have effects on what other receptors

A

anti- muscarinic
anti- alpha
anti -serotonin

(chorpehniramine and diphenhydramine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

diphenhydramine –> blurred vision

antagonism of what

A

acetylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

lung bx:

colmnar mucin-secreting cells that line the alveolar spaces w/o invading stroma or vessels

A

Malignant neoplasm:
Adenocarcinoma in situ (aka bronchioalveolar carcinoma)

pre-invasive
well differentiated dysplastic columnar cells arising from alveolar epithelium (w/ or w/o mucin)

possible aerogenous spread if not resected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q 
infant:
hypotonia
mild jaundice
enlarged tongue
umbilical hernia
A

hypothyroidism

(also poor feeding, lethargic, constipation, hoarse cry)

increased incidence of ASD/VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

hyperammonemia –> depletion of what in brain

A

depletes alpha-KG (–> inhib krebs cycle)

depletes glutaMATE (excititory) –> accumulation of glutaMINE –> astrocyte swelling and dysfx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Flow relation to radius

A

Flow is directly proportional to the radius to the FOURTH power (r^4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

chemotherapeutic agent that binds with viral-encoded enzymes (DNA pol, RNA pol, RT) that does not need intracellular activation

A

Foscarnet
(pyrophosphate analog)

binds DNA pol in herpes

binds RT in HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

General rule - what is NOT an effective way to kill bacteria transmitted fecal/oral

A

acid

they survive the stomach!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How to kill HAV on contaminated products

A
  • water chlorination
  • bleach (1:100 dilution)
  • formalin
  • UV
  • boiling to 85C for ONE MINUTE

( or autoclaving 120C for 20mins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

JAK kinase tyrosine receptor ligands

JAK/STAT pathway

A 
GH
PRL
IL-2
cytokines
Colony stim factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

receptor tyrosine kinase ligands

MAP-kinase –> Ras….

A

Growth factors
(EGF, PDGF, FGF, etc)
Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Enzyme that is defective in MSUD requires what cofactors

A

remember: branched chain alpha-ketoacid dehrogenase is like pyruvate dehydrogenase and alpha-KG dehdrogenase

TLC For Nobody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Some MSUD pts improve with what supplement

A

Thiamine (high dose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

apoptosis from folate deficiency would be somewhat helped with what supplementation

A

thymidine

folate def inhibits formation of dTMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

isolated systolic HTN after 50 from what?

(SBP >160 and DBP

A

age-related decrease in compliance of aorta and it’s proximal major branches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

COPD –> cerebral vascular resistance?

A

decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

genetic exchange b/w two virus strains that have non-fragmented dsDNA

A

recombination

other possibilities?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Group A Strep - virulence factor that protects against phagocytic killing

A

Protein M

  • major virulence factor
  • inhibits phagocytosis and activation of complement
  • cytotoxic to neutrophils in seurm
  • mediator of bacterial attachment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Streptolysin O

A
  • lyses erythrocytes and neutrophils
  • oxygen labile

(NOT antiphagocytic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

weak wrist extension

- where was the nerve injured

A

head of radius
“nursmaid’s elbow”

  • radial nerve divides at lateral epicondyle
  • superficial = pure sensory (radial half of dorsal hand except distal fingers)
  • deep branch = forearm extensor compartment –> dmg = wrist drop
    (no sensory)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

erythema of antral mucosa

bx: inflammatory cell infiltrates

A

type B chronic gastritis

  • aka H pylori associated
  • aka antrum predominate
  • inflammatory infl cell type distiguishes chronic vs acute
  • a/w risk of MALToma and gastric adenocarcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

gastritis a/w megaloblastic anemia

A

Type A
- aka autoimmune

  • body of stomach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

MCC of meningitis in adults

A

strep pneumo

lancet shaped gram pos cocci in pairs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Contribute to a low Vd (3-5L)

A

(things that trap it in plasma)

  • HIGH molecular weight
  • HIGH plasma protein binding
  • HIGH charge
  • hydroPHILLIC

note: Bioavailability is UNRELATED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Actions of nitroprusside

A

(must be IV)

  • short acting balanced venous AND arterial vasodilator
  • decreases both preload and afterload
  • stroke volume maintained
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Decreased preload on P/V loop

A

EDV decreases

- right edge of curve moves toward y axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Decreased afterload on P/V loop

A

Mean Systolic intraventricular pressure decreases

- top curve lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Bilateral renal masses composed of fat, smooth muscle, and blood vessels in young woman….

A

(renal angiomyolipomas)

a/w tuberous sclerosis
bilateral = 80-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Tuberous sclerosis features

A

Autosomal Dom

  • cortical tubers
  • subependymal hamartomas (brain)
  • seizures
  • mental retardation
  • cardiac rhabdomyomas
  • facial angiofibromas
  • ASH LEAF spots (depigmented)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Fragile X mech

A

increased CGG repeats on X –> hypermethylation of cytosine bases –> gene inactivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q
  • ambiguous external genitalia in XX

- maternal virilization

A

placental aromatase deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what catalyzes first step in beta-oxidation

A

Acyl-CoA dehydrogenase

most commonly deficient enzyme in that pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

holosystolic
apex
radiates to axilla

… best indicator of severity

A

presence of S3
- indicative of large volume of regurgitant flow –> increased rate of LV filling

(mitral regurg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

opening snap to S2 interval = diag of intensity of what

A

mitral STENOSIS

aburpt halting of valve leaflets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what shares an origin with endogenous opiods (endorphins, enkephalins, dynorphins)

A

ACTH
MSH

(POMC precursor for all)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Lithium induced nephrogenic DI - med tx?

A

hydrochlorathiazide

same for any nephrogenic DI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

viral glycoprotein that poorly correlates with viral replication

A

HBsAg,

which is a component of the ENVELOPE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

HBeAg

A
  • core component assembles virion w/in hepatocytes (like HBcAg)
  • precore component directs secretion into blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

von Willebrand factor binds to what

A

sub endothelial collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

bilateral wedge shaped strips of necrosis over cerebral convexity

A

ischemia in watershed areas
- hypoxic-ischemic encephalopathy

(global cerebral ischemia due to profound hypoperfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

taking exogenous glucocoricoids… post surgery levels of CRH, ACTH, and Cortisol compared to normal response

A

all decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

autoAb that have high specificity for RA

A

anti-citrullinated peptides (anti CCP)

RF factor = anti Fc portion of IgG, but they are not as specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

actions of interferon alpha and beta

A

activate cells to synthesize antiviral proteins that degrade intracellular mRNA —> halts protein synth

(activated by viral dsRNA)

produced by wide variety of cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

interferon gamma

A

produced mainly by NK and T cells

  • increases MCH II expression
  • promotes Th1 dfferentiation
  • activates macrophages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

“saddle anesthesia” + loss of anocutaneous reflex

A

cauda equina syndrome

- dmg to S2-S4 nerve roots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

viruses that bud through nuclear membrane

A

herpes viruses

e. g:
- cytomegalovirus
- HSV
- VZV
- HHV-8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

drug (3):

  • blocks synthesis of viral DNA from the RNA template
  • not phosphorylated intracellularly
  • structurally unrelated to nucleosides
A

nevirapine
efavienz
delavirdine

(NNRTIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

comedocarcinoma

A

DCIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

breast nodule

  • ducts distended by pleomorphic cells with prominent central necrosis
  • does not extend beyond ductal basal membrane
A

comedocarcinoma
(subtype of DCIS)

characterized by solid sheets of pleomorphic high grade cells w/central necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Paget disease of nipple

A

malignant cells spread from superficial DCIS into nipple skin w/o crossing basement membrane

  • unilateral erythema and scale crust around nipple
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

fibroadenoma histo

A

cellular often mixoid stroma that encircles and sometimes compresses epithelium-lined glandular cystic spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

common carotid - which aortic arch

A

3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

porphyria cutanea tarda - enzyme def

A

uroporphyrinogen decarboxylase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

increased ejection fraction on pressure volume loop

A

widening of graph
(isovolumetric relaxation line shifted toward y axis showing less volume remaining in ventricle after contraction complete)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

test that is specific for acute cholocystitis

A

failed gallbladder visualization on radionuclide biliary scan

(indicates obstx)

contrast given IV - normally goes from liver to gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

hematologic d/o a/w JAK/STAT pathway

A
  • essential thrombocytosis
  • polycythemia vera
  • primary myelofibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

pregnant w/ hypertension and leg swelling - other likely finding

A

proteinuria

Triad of pre-eclampsia:

  • HTN
  • edema
  • proteinuria

*can progress to HELLP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

hyperuricemia after an episode of arthritis - what’s the best long-term tx

A

xanthine oxidase inhib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

how does silicosis increase risk of TB

A

disrupts macrophage phagolysomes by internalized silica particles

(macrophage killing of intracellular mycobacteria by be impaired as a result)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

how is elastin able to recoil

A

crosslinking between four lysine residues on 4 different elastin chains

(extracellular lysyl hydroxylase crosslinks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

mech of DDAVP in hemophilia

A

induces release of vWF and factor VIII from ENDOTHELIAL cells

(temporarily increases factor VIII levels 2-3x)

NB: factor VIII made by liver and stored in endothelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q
  • mouth ulcers
  • fever
  • low WBC

(hx of TIA and HTN)

A

Ticlopidine induced neutropenia

1% of ppl - should monitor blood count biweekly for first 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Ticlopidine

A

ADP antagonist
(like clopidigril)

*risk of neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Mechanism to address in infertility tx for PCOS

A

Estrogen receptor modulaiton

  • tx with clomiphene or letrazole

(decreases negative feedback inhib on hypothalamus–> increases gonadotropin production)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

drug –> direct dilation of arteries and inhib of platelet aggregation

A

cilostazol

  • decreases activity of platelet phosphodiesterase (enzyme that breaks down cAMP) –> prevents platelet shape change/granule release
  • direct arterial vasodialtor

(used for intermittent claudication; better than asprin in peripheral arterial disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

argatroban

A

antithrombotic drug used in tx of heparin-induced thrompocytopenia

direct thrombin inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

kid w/

toe cyanosis and clubbing but no finger abnormalities

A

patent ductus arteriosus w/ late-onset reversal of shunt

  • PDA after branches from aorta to upper body
  • coartation does not typically cause cyanois, just differences in BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

IgA nephropathy (Berger’s)

A

IgA neph

  • followed by URI
  • present w/ painless hematuria
  • often subsides and returns every few months
  • IgA in MESANGIUM
  • dx = HSP if a/w extrarenal symp (e.g. abdominal pain, purpura)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

analgesic into epidural space - what’s the effect on postsynaptic neuron

A

Increases K efflux out of cell (one way)

Opiods

  • bind to mu receptors
  • g-protein coupled activation of K channels (efflux)
  • hyperpolarization of postynaptic cesll

or

inhibit adenyl cyclase, inhib calcium conductance, inhbib transmitter release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

biologically active form of pantothenic acid

A

Coenzyme A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

cofactor for oxaloacetate to citrate

A

Pantothenic acid (CoA)

first step in TCA cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

CoA important in synthesis of…

A
  • Vit A
  • Vit D
  • Cholesterol
  • Steroids
  • Heme A
  • FAs
  • AAs
  • Proteins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

RNA containing odd nucleosides

e.g. pseudouridine, thymidine, dihyrouracil

A

tRNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

3’ end of tRNA

A

(acceptor stem - binds AA)

CCA (- OH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Bacillus anthracis capsule

A

D-glutamate

instead of polysaccharide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

MAC prophylaxis

A

Azithromycin

(CD4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

HIV proph

A

CD4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

TB drug that requires acidic environment

A

Pyrazinamide (PZA)

*most bacterialcidal to intracellular bac that are in the macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q
  • Precocious puberty
  • Parinaud syndrome aka dorsal midbrain syndrome (paralysis of upward gaze/convergence)
  • obstructive hydrocephalus
A

Pineal germinomas

germ cell tumors histologically simialr to testicular seminomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

infant w/ meningitis - what are the bacteria + meds

A

Group B –> ceftriaxone

Listeria –> AMPicillin

Note:
ceftriaxone would also cover N. meningitidis, strep pneumo, and Hflu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

pt tx for arrhythmia (esp aFib w/vent tach) –> constipation, bradycardia, 2nd or 3rd degree heart block, gingival hyperplasia

SE of what drug?

A

Verapamil

note: digoxin –> diarrhea and n/v

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

excess 17-hyroxyprogesterone and testosterone

  • histo findings
A

adrenal cortical hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

passive extension —> initial resistance —> sudden release of tension

A

“clasp-knife” spasticity

UMN lesion - lack of UMN inhibition of stretch reflex

internal capsule, cortical spinal tracts, medulla, pons, midbrain

internal capsule stroke usually = pure motor (contralateral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Bleeding tests results for end stage renal disease

A

(uremia –> qualitative platelet d/o)

  • prolonged bleeding time
  • normal platelet count
  • normal PT and PTT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

hyperlipidemia drug that can trigger gout

A

Niacin

also can –> hyperglycemia/ancanthosis nigricans

108
Q

kid w/ involuntary jerking of face, arms legs

  • sore throat 3 mo ago
  • all vaccines up to date
A

rhumatic fever

molecular mimicry to cardiac and neuronal tissue

109
Q

env

A

gp 160

  • gp 41
  • gp 120

(Go Put the ENVelope in the mail)

110
Q

gag

A

p24
p7

(nucleocapsid)

111
Q

HIV pt w/ impaired vision–>

  • generalized seizures
  • hypocalcemic
  • hypomagnesemic

SE of what drug?

A

Foscarnet

  • chelates calcium
  • nephrotxic renal Mg wasting
tx for CMV retinitis
- gancyclovir =1st
(a/w neutropenia)
- foscarnet
- cidofovir
112
Q

dark gallstones w/ 7% cholesterol

- what enzyme contributed

A

Beta-glucuronidase
(2/2 infx of biliary tract injuring hepatocytes)
- hydrolysis of bilirubin glucuronides and increases amt of unconj biliurbin in bile

NB: pigment stones most common in rural Asian pop

113
Q

parasites that increase risk of pigmented gallstones

A 
Ascaris
Opisthorchis sinensis (liver fluke)

(also biliary infx w/ e coli)

114
Q
  • symmetric myeling layer vaculization
  • axonal degen
  • posterior columns
  • lateral corticospinal tracts
A

Vit B12 def

(subacute combined - i.e. ascendign and descending)

position/vibration,
ataxia,
spastic paresis

115
Q

dmg to dorsal columns and dorsal roots

A

tabes dorsalis

116
Q

exacerbates myocardial ischemia by redistributing blood away from ischemic areas

A

CORONARY artery dilation

  • ischemic arterioles are already dilated while others are not, increasing collateral flow; dilating decreases pressure in non-ischemic vessels, decreasing collateral flow
117
Q
  • shipyard
  • hemorrhagic pleural effusion
  • columnar cells joined by desmosomes
  • TONOFILAMENTS
  • long microvilli
A

(asbestos)

Mesothelioma

EM gold standard for dx
- tonofilaments and slender microvilli (vs short plump microvili of adeno)

118
Q

hypophysectomy –> decreased epinephrine from adrenals

what enzyme?

A

Phenylethanolamine-N-methyltransferase

  • stimulated by CORTISOL
  • NE –> E
119
Q

underlying issue in beta thalasemia

A

beta chain production via defects in

  • mRNA transcription
  • mRNA processing
  • mRNA translation

MC mt –> aberrant spicing of precursor mRNA or premature chain termination during translation

120
Q

hemorrhage in left temporal lobe and compression of anterior medial temporal lobe agains the free margin of tentorium cerebelli

A

UNCAL herniation
(transtentorial)

  • compression of CN III (oculomotor)
  • “down and out”
    (ipsilateral)
121
Q

first sign of uncal/transtentorial herniation

A

fixed dilated pupil on side of the lesion

ipsilateral paralysis of CN III

+/- contralateral homonymous hemianopsia w/macular sparing

122
Q

needs a viral protease

A

single stranded RNA
positive sense
nonsegmented

(e.g. picornaviruses - echo,etc)

123
Q

drug used in emergent tx of pts with acute coronary symptoms (decrease mortality)

  • what is an adverse effect
A

Beta-blockers
(work at level of receptor)

can –> bronchochonstriction and wheezing

124
Q

Odds Ratio

A

*write it out!

(a/B)/(c/D) = ad/bc
aka - across tx row

125
Q

tetrahydrobiopterin

A

cofactor in:

pheylalanine –>tyrosine

tyrosine –> dopa

tryptophan –> serotonin precursor

nitric oxide synth

126
Q

many of amphotericin B’s toxic effect are due to it’s binding of…

A

cell membrane cholesterol

127
Q

21 yr old w/ chronic headaches and ataxia found to have low-lying cerebellar tonsils extending into vertebral canal

A

arnold chiari type 1 malformation
(congenital)

usu asymptomatic in infants but manifests as adult w/ headaches and cerebellar symptoms (e.g. ataxia)

(type II more severe and usu presents in infancy; abnormally formed cerbellum and medulla –> myelomenigocele and hydroceph)

128
Q

mechanism of tissue damage in TB infx

A

delayed type hypersensitivity (type 4)

granulmatous inflammation and caseous necrosis

129
Q

eosinophil anti-hemilinth action

A
  • stimulated to destroy parasite via ANTIBODY dependent cell-mediated cytotoxicity with enzyme from their cytoplasmic granules
130
Q

7 alpha hydroxylase

A

converts cholesterol into bile acids

  • suppressed by fibrates –> increased cholesterol in bile –> risk of stones (esp w/ hypomobility)
131
Q

anti-mitochondrial abs…

dx and description

A

Primary biliary cirrhosis (PBC)

autoimmune destruction of intrahepatic bile ducts and cholestasis

“florid duct lesion”
- granulomatous infl

similar infiltrate to graft vs host

eventually liver grossly stained green and uniformly micronodular

132
Q

high fructose 2,6- bisphosphate will inhibit conversion of…

A

gluconeogenesis
via inhib fructose 1,6-bisphosphatase

e.g.
alanine –> glucose

NB: will NOT inhibit glycogen synth; in fact both are stim by insulin so often occur together

133
Q

lipid drug that increases TGs

A

cholestyramine

bile acid-binding resins

134
Q

TTP vs DIC

A 
TTP = thromotic thrombocytopenic purpura
(on same path with HUS)
- usually do NOT bleed
- only platelets activated
 - normal PT/PTT
- normal fibrinogen

DIC

  • bleed
  • coag cascade activated
  • PT/PTT long
  • low fibrinogen
  • high FDP (esp D-dimer)
135
Q

cecum fixed to right upper quadrant

A

failure of midgut rotation around SMA

136
Q

inhibition of lactate dehydrogenase in strenously exercising skeletal muscles would eventually inhibit glycolysis due to depletion of…

A

NAD+

137
Q

acute viral hepatitis symptoms

A 
dark urine (increased serum bilirubin)
n/v
fever malise
hepatomegaly
jaundice
138
Q

aspirin ingestion process

A

1 - resp alkalosis
(directly STIMULATE resp center –> increased ventilation)

2 - AG met acidosis shortly afterward
(increase lipolysis, uncouple oxidative phosphorylation, inhibit TCA cycle —> accum of organic ions in blood - ketoacids, lactate, pyruvate)

therefore usu present w/mixed acidosis/alkalosis

139
Q

aspirin ingestion labs

A

mixed resp alk/met acidosis

pH: in normal range
CO2: low
HCO3: low

note: CO2 will be lower than what it would be for compensation - means it is not due to comp alone (concurrent primary resp alkalosis)

140
Q
  • hypotension
  • tachycardia
  • JVD (increased central venous pressure)
  • pulsus paradoxus
A

cardiac tamponade

141
Q

hypercalcemia in sarcoidosis

A

increased extrarenal formation of 1,25-vit D by activated MACROPHAGES

(hypercalcemia suppresses PTH)

142
Q

resistance in parallel

A

1/R =
1/R1 + 1/R2 + 1/R#…

*remember the total is the reciprocal too!

143
Q

high fever
watery diarrhea
mildly productive cough

A

legionella

*will not gram stain (will see neutrophils)

144
Q

clubbing - bronchial ashtma or bronchiectasis

A

bronchiectasis

145
Q

hereditary spherocytosis (or any hemolytic anemia) at risk for…

A

pigmented gallstones

NOT splenic infarction

146
Q
  • normal CT at first
  • weeks later CT shows
    lake-like cavitary lesion in deep brain structures
A

hypertensive arteriolar sclerosis –> lacunar infarct

chronic htn (MCC) –>arterioles undergo lipohyalinosis –>microatheroma formation —> occlusion

(note: charcot-bouchard aneuysm would appear as a focus of intraparynchymal hyperdensity on intitial CT)

147
Q

Increased in CHF (CV measure)

A

arteriolar resistance

  • decreased CO –> renal flow –> activates RAAS
  • decreased CO –> sympathetic outflow

this increases afterload and exacerbates HF

148
Q

vegetations on heart of relatively young person w/o other risk factors

A

mitral valve prolapse

*MC cardiac abnormality predisposing to “native valve bacterial endocarditis” in 15-60 y/o in US

(rheumatic fever potential, but less common)

149
Q

Abx a/w serotonin syndrome

A

Linezolid

150
Q

Analgesic a/w serotonin syndrome

A

Tramadol

151
Q

directly supplies nitrogen to urea cycle

A

Aspartate

“TAke nitrogen from asparTAte”

(aspartate + citrulline —> arginosuccinate)

152
Q

infant w/ lethargy, vomiting, tachypnea soon after birth

met acidosis w/ large AG, ketosis, hypoglycemia

increased methylmalonic acid in urine and serum– what type of reaction is deficient

A

isomerization

pt has methylmalonic aciduria
- defect in isomerization reaction of meythylmalonyl CoA –> succinyl CoA (—> TCA)

(B12 cofactor in isomerization)

153
Q

TNF-alpha decreases glucose uptake via…

A

serine and threonine residue phosphorylation (via activation of kinases)

  • phosphorylation of serine/threo in beta subunit of insulin receptors hinders signalling
  • phosyphorylation of IRS-1 serine/threo residues inhibits tyrosine phosphyroyaltion by insulin
  • mech of insulin resistance in catecholamines, glucocorticoids, and glucagon (and FFAs)
154
Q

neonatal:

  • pupillary dilation
  • rhinorrhea
  • sneezing
  • nasal stuffiness
  • diarrhea
  • n/v
  • chills, tremors, jittery movements
  • rarely seizures
A

narcotic/optiate withdrawl

tx with opium tincture (orally)

155
Q

histo of hashimotos

A
  • intense mononuclear infiltration (lymphocytes and plasma cells)
  • germinal centers
  • Hurthle cells - large oxyphilic cells w/ granular cytoplasm (follicular epithelial cell metaplastic chanbe)
156
Q

drug for idiopathic pulmonary artery htn

A

bosentan

competitive antagonist of endothelin receptors

157
Q

post GU infx:

  • conjunctivitis
  • rt knee pain
  • vesicular rash on palms and soles
A

Reactive arthritis

also may a/w:

  • ethesitis
  • dactylitis
  • sacroiilitis (20%)
  • oral ulcers
158
Q

reactive arthritis
vs
secondary syph

(skin findings)

A

ReA

  • keratoderma blennorrhagicum = hyperkeratotic vesicles on palms and soles
  • circinate balantis = serpiginous annular dermatitis of glans penis

Syph:
- maculopapular or pustular (but NOT vesicular) rash that can involve palms and soles

NB: syph a/w POLYarthritis

159
Q

external branch of superior
laryngeal nerve

(innervates what muscle)

A

cricothyroid

*near SUPERIOR thyroid arter/vein

160
Q

alkaptonuria

what reaction pathway

A

tyrosine –> –> fumarate

enzyme:
homogentisate oxidase

161
Q

IgG against phospholipase A2 (on podocytes)

A

idopathic membranous nephropathy

162
Q
  • homonymous hemianopia
  • marcus gunn pupil
    (relative afferent pupillary defect)

(where’s the lesion)

A

Optic tract (contralateral)

*note: the nasal portion of the retina contributes more reflex (why contralateral damage of optic tract will decrease reaction)

163
Q

PAH lowest concentration where

A

bowman’s space

164
Q

vascular tumor a/w aresenic or PVC exposure

A

hepatic angiosarcoma

*express CD 31
endothelial cell marker

165
Q

Atypical lymphocytes seen in infectious mono

A

CD 8 cytotox T cells

B cells infected, but only ~5% of smear

Cytotoxic T-lymphocytes destroy virally infected B cells

166
Q

Abdomina aortic aneurysm begins with what

A

intimal streak

(atherosclerosis)

atheromas can progress to weaken underlying media

167
Q

fam hx of:
osteosarcoma
brain tumors
rhabdosarcoma

A

Li-Fraumeni
mt of p53

AD

cancers at young age (30s)

MC: breast, brain, adrenal cortex

168
Q

fibrous deposits around tricuspid and pulmonary valves

left chambers and valves normal

A

Carcinoid heart disease

a/w carcinoid syndrome

degree of endocardial fibrosis correlates w/ levels of serotonin and urinary excretion of -HIAA (serotonin metabolite)

limited to rt heart b/c serotonin and bradykinin in blood are inactivated by pulm vasculature endothelial MAO

169
Q

Osteomyelitis in SCD caused by salmonella

- what is the virulence factor most contributing

A

resistance to opsonization

  • asplenic/fucntionally asplenic pts at risk of infx by encapsulated organisms

NB: staph also common cause of osteomyelitis in SCD, so abx should be directed at both

170
Q

glycerol kinase

A

liver specific enzyme

uses triglyceride breakdown products for energy and glucose synth

glycerol -*-> glycerol-3-phospate (–> DHAP –> glycolysis or gluconeogenesis)

171
Q
  • trauma
  • acute onset neurologic abnormalities
  • hypoxemia
  • petechial rash
A

Fat embolism syndrome

trauma of long bones/pelvis

172
Q

Non-pupil-sparing CN 3 palsy

aneurysm of what artery

A
  • posterior cerebral
    (or)
  • superior cerebellar

(courses b/w them as it exits midbrain)

173
Q

Prinical site of uric acid precipitation

A

collecting ducts

due to low pH

174
Q

verapimil will slow what portion of AP

A

diastolic depolarization

175
Q

AML will stain for…

A

myeloperoxidase

often cells have Auer rods

176
Q

VSD heart sounds

A

holosystolic murmer loudest over left mid-sternal border

177
Q

bifid carotid pulse with brisk upstroke

A

hypertrophic obstuctive cardiomyopathy

a/w dynamic left ventricular outflow tract obstx

178
Q

14:18

A

Bcl2

follicular lymphoma

179
Q

indurated painless nodule on vulva

pleocytosis in CSF

A

tertiary syph

gummas
neurosyph

180
Q

drug for drug-induced parkinsonism (from antipsychotics)

A

BENZtropine
or
amantadine
(anti-cholinergics)

*do not use DA agonists (e.g. bromocriptine) b/c they can precipitate psychosis

181
Q

hemochromotosis issue with…

A

intestinal absorption

NB: gene on ch 6

182
Q

theophylline tox

A
  • abdominal pain
  • vomiting
  • seizures *main M/M
  • tachyarrhythmias (NOT qt elongation)
  • diarrhea
183
Q

loss of pain and temp in arms and hands (LE fine)

A

syringomyelia

compresses ventral white comissure - where lateral spinothalamic tract decussates

184
Q

xanthelasma a/w what other organ disease

A

chronic chosetatic processes:

  • primary biliary cirrhosis
  • obstx biliary lesions

NB: hypOthyroidism a/w hyperlipidemia

185
Q

Leukomoid reaction vs CML

A

Leukocyte alkaline phosphatase:

  • Nml/High in leukamoid
  • LOW in CML

NB: definitite diagnosis of CML requires t(9;22)

186
Q

Leukomoid reaction

A

over-exuberant white blood cell response

  • leuk >50,000
  • left shift
  • neutrophil alk phos levels norm or elevated
187
Q

E coli that

- does NOT ferment sorbitol - - does NOT invade intestinal mucosa

A

O157: H7

(80% of other ecoli do)

also does not produce glucuronidase (other ecoli do)

188
Q

bacteria that activate Guanylate cyclase

A

ETEC
(heat STABLE toxin)

Yersinia enterocolitica

189
Q

bacteria that activate Adenylate cyclase

A
  • ETEC
    (heat LABILE toxin)
  • B. Pertussis
  • B. antrhacis (edema factor)
  • Campylobacter
  • B. cereus (heat labile)
  • Cholera
190
Q

nucleoside analog anitviral that does not need to be phosphoyrlated

A

(Nucleotides)

  • cidofovir
  • tenofovir
191
Q

what part of the nephron does vasopressin act to increase urea absobtion

A

MEDULLARY segment of collecting duct

192
Q

nerve that runs under mucosa of piriform recess

A

internal laryngeal nerve
(branch of superior laryngeal nerve, from vagus)

mediates afferent limb of cough reflex

(larynx and epiglottis - stim stimulates cough not gag)

193
Q

gag reflex

A

afferent:
glossopharyngeal

efferent:
vagus

194
Q

cheyne stokes respirations a/w…

A
  • cardiac disease
    (congestive heart failure)
  • neurologic disease
195
Q

lyase

A

cleaves 3’ sugar

196
Q

order of enzymes in base excision repair

A

-glycosylase
(cleaves base)

  • endonuclease (5’) and lyase (3’)
    (cleave backbone)
  • polymerase
  • ligase
197
Q

sickle cell pt w/ sepsis

A

1) streptococcus pneumoniae

(at increased risk of encapsulated organisms)

198
Q

malignant otitis externa

A

pseudomonas

*typically seen in elderly diabetic patients

199
Q

alveolar cells with golden cytoplasmic granules that turn dark blue w/ prussian blue staining

A

(iron)

“heart failure cells” or “siderophages”

indicates episodes of pulmonary congestion
(a/w left ventricular dysfx)

200
Q

side effect of bupropion

A

seizures

201
Q

indication for an MAOI

A

atypical depression

treatment-resistant depression

202
Q

what distinguishes atypical depression from major depression

A

mood reactivity in atypical

will have improvemetn in mood in response to something positive

203
Q

adrenergic receptor in the eye

A

Alpha-1

contraction of pupillary dilator

204
Q

microangiopathic
hemoytic
anemias

A

TTP/HUS

DIC

205
Q

penicillins are structural analogs to…

A

D-Ala-D-Ala

bind transpeptidase

206
Q

Underlying event in death from TCA overdose

A

MCC of death is hypotension and cardiac arrhythmias

thought to be caused by inhib of fast sodium channels on heart

*fluid resuscitation w/ normal saline and hypertonic sodium bicarb crucial

207
Q

marker that should be monitored in cirrhotic pt

to watch for developing hepatocellular carcinoma

A

AFP
(alpha fetoprotein)

NB: level not correlated to stage, size, or prognosis

208
Q

occurs outside osteoblast during collagen synth

A

N- and C-terminal peptide removal

covalent crosslinks by LYSYL oxidase

209
Q

macrophages loaded with PAS-positive granules in intestinal lamina propria

A

Whipple’s disease
(tropheryma whippellii)

(tx w/ abx)

210
Q

erosion defined as….

A

mucosal defect that do not fully extend through the MUSCULARIS MUCOSA

(ulcers penetrate through to the SUBmucosal layer)

211
Q

regardless of hydration status, where does the majority of water reabsorption occur

A

proximal tubule

(passively with solutes)

PT >60%
LOH ~20%

212
Q

precipitating events for hepatic enceph (high ammonia)

A
  • Excessive nitrogen load
    (bleeding, constipation)
  • drugs (sedatives, narcotics)
  • hypovolemia or met disturbances
  • infections

**NOT a/w increased BUN (actually less BUN b/c can’t make urea well in liver failure)

213
Q
  • pt w/ asthma
  • recurrent transient pulmonary infiltrates
  • eosinophilia
  • proximal bronchiectasis

colonized with…

A

Aspergillus

NB: strongyloides not a/w bronchietasis

214
Q

adult intracranial mass

  • elongated cells w/ regular, oval nuclei
  • biphasic growth (dense/myxoid)
  • S-100
A

schwanomma

S-100 = neural crest

215
Q

rate of glycogen degradation in skeletal muscles increases after onset of contraction due to enzyme activation of…

A
  • Ca 2+
    (calcium-mediated myophosphorylase activation)

Also:

  • cAMP
  • AMP
216
Q

Cardiac ouput - increased
and
Venous return - increased

A

chronic arteriovenous fistula

217
Q

restriction of blood flow to kidney will —> hyperplasia and hypertrophy of…

A

modified smooth muscle cells of the afferent arteriole

JG cells

218
Q

main site of digestion and absorption of dietary lipids

A

digestion = duodenum

absorption = jejunum

219
Q

mitral regurg –> hoarsness

mech?

A

Left atrial enlargement –>

left recurrant laryngeal nerve impingement—>

left vocal cord paresis —> hoarseness

220
Q

produced by macrophages and —> neutrophil chemotaxis and phagocytosis

A

IL -8

221
Q

location of aortic rupture caused by rapid deceleration

A

aortic isthmus

  • tethered by ligamentum arteriosum
  • just past the 3 branches
222
Q

Thiamine cofactor reactions

  • useful for dx of deficiency
A
  • Transketolase
  • pyruvate dehydrogenase
  • alpha-KG dh
  • erythrocyte transketolase activity useful for dx
223
Q

side effect of mannitol

A

pulmonary edema

(caused by rapid rise in volume)

can also lead to dilutional hyponaturemia, met acidosis, hyperkalemia)

224
Q

route of cryptococcus infection

A

soil/pigeon droppings –>
yeast transmitted via resp route to lungs (primary site of entry)

can disseminate to CNS

225
Q

end stage cirrhosis

A
  • diffuse hepatic fibrosis

- regenerative parenchymal nodules

226
Q

charcot-bouchard aneurysm

A

hyperechoic spot in deep brain

saccular would be on outter edge and highlight sulci

227
Q

painful symmetrical swelling of hands and feet

A
  • common presentation of sickle cell in young children
  • due to vasooclusion
  • will also see low hapatoglobin levels due to the hemolysis of sickle cells
228
Q

RNA polymeryase I, II, III

A

I - rRNA

II - mRNA

III - tRNA

229
Q

mode of decreasing lap operator activity in presence of glucose

A

w/o glucose:
- cAMP binds to CAP (catabolite activator protein) —> binds upstream of promoter increases transciption

glucose decreases activity of adelylyl cyclase—> less cAMP –> less transcription

230
Q

riboflavin coenzyme in what enzyme

A

succinate dehydrogenase

(succinate –> fumarate in TCA)

*sucker snake fuming

231
Q
  • ulcer NOT in duodenal bulb
  • multiple ulcers refractory to tx
  • recurrence of ulcers after acid-reducing surgery
A

non-gastric neoplasm (2/3 malignant)

(Zollinger-ellison - hyper secretion of gastrin from pancreas tumor)

  • peptic ulcers (most pts)
  • diarrhea (inactivation of enzymes by excess acid)
232
Q

cells that directly produce intimal response of thickening and collagen depo in arteries

A

smooth muscle cells

  • migrate from media to intima and make collagen
233
Q

cellular protein goes from alpha-helix –> beta pleated sheet –> resistant to proteases –> intracellular accumulation

A

Prion disease
- PrP (prion protein)

–> spongiform transformation in gray matter

234
Q

stimulates angiogenesis

A

FGF
VEGF

(not EGF)

235
Q

K concentration along nephron (% of filtered)

A

Bowmans - 100% –>
[65% filtered K reab in PT]

PT - 35%

[ 25-30% filtered K reab in TAL of LOH]

early DT - 5-10%

[K secretion by principle cells in later DT - 5-100+% of filtered]

CD - 10-100+%

236
Q

mt –> protein larger with altered fuction but preserved immune reaction

A

splice site mt

NB: shorter nonfuntional proteins result from frame shift mt

237
Q

sudden upward stretching of arm at shoulder –> “right hand clumsiness”

A

damage to the lower trunk of the brachial plexus

  • C8 and T1
  • medial and ulnar nerves
  • innervate all the intrinsic muscles of the hand
238
Q

tx for TCA associated cardiac abnormalities

A

Sodium Bicarbonate

corrects QRS prolongation, reverse hypotn, tx ventricular dysrhythmia

239
Q

Ischemic ATN

- what part of nephron

A

Proximal tubules

TAL of LOH

240
Q

Digoxin clearance

A

kidneys

*careful in elderly (can have renal insufficiency in the presence of normal creatinine)

241
Q
  • loss of upper extremity pain/temp
  • UE LMN signs
  • +/- LE UMN signs
A

syringomyelia

esp in setting of scoliosis

242
Q

Sickle cell + macrocytosis

A

folic acid deficiency

predisposed due to high cell turnover

243
Q

important clue in cardiac tamponade

A

pulsus paradoxus

244
Q

digoxin mech for decreasing HR

A

increases parasympathetic tone

vagus nerve

245
Q

paradoxical embolism - what heart sounds

A

fixed spitting of S2

from ASD

246
Q

PRP (polyribosyl-ribitol-phosphate)

= component of what capsule

A

Hflu type B

Hib

247
Q

1st line med for juvenille myoclonic seizures

A

should use BROAD spectrum:

Valproate

  • narrow should be avoided in generalized epilepsy syndromes (may aggravate seizures)
  • e.g. carbamazapine, gabapentin, phenobarbital, phenytoin
248
Q

Juvenille Myoclonic Epilepsy

A
  • adolescents (poss familial)
  • generalized
  • no LOC
  • brief, involuntary jerking movements of both UEs
  • usu w/in first hour of waking
  • provoked by sleep deprivation
249
Q

presntation of mass in ASCENDING colon

A
  • symptoms of Fe deficient anemia and systemic symptoms
  • -> weight loss
  • ->progressive fatigue
  • -> palor

(ususally exophytic masses and rt larger caliber than left- so no obstx )

250
Q

Tx for restless leg syndrome

A

dopamine agonist

e.g. pramipexole

251
Q

lung mass + brain degen

mech?

A

automimmune

  • paraneoplastic syndrome
  • subacute cerebellar degeneration

(anti yo, anti p/q, anti hu)

(small cell lung, breat, ovarian, uterine)

252
Q

cells most susceptible to global cerebral ischemia

aka hypoxic-ischemic enceph

A
  • pyramidal cells of the hippocampus and neocortex
  • perkinje cells of the cerebellum

**hippocampus FIRST area damaged

253
Q

cutaneous + systemic symptoms

recently started a new med
2-8wks

A

DRESS syndrome:
“drug reaction with EOSINOPHILIA and systemic symptoms”

commonly a/w:
anticonvulsants
allopurinol
sulonamides
abx

sx:
fever, generalized lymphadenopathy, facial edema, diffuse mobilliofrm skin rash –> confluent erythema

organs affected:
liver, kidney, lung

254
Q

portal circulation of esophagus

A

left gastric vein

255
Q

enzyme that decreases plaque stability

A

mettaloproteinases

from macrophages

256
Q

high output heart failure + neurologic symptoms

what vitamin def

A

B 1
(thiamine)

Wet Beriberi

257
Q

PT still prolonged after Vit K injection

A

Factor VII def

  • shortest half life
  • part of EXtrinsic pathway

usu liver disease (so vit K doesnt help)

258
Q

V/Q from apex to base

A

V/Q - HIGHEST at APEX

(decreases towards base - LOWest at BASE)

  • blood flow (Q) increases linearly from apex –> base (highest at base)
  • ventilation increases exponentially from apex —> base (highest at base)

both are highest at base but ventilation changes much more

259
Q

HUS vascular finding

A

microthrombi in small blood vessels

260
Q

pruritis
rash
flushing
abdominal cramps

bx = mast cells in small bowel mucosa

A

Gastric hypersecretion due to systemic mastocytosis –> histamine

Gastric acid increase inactivates pancreatic enzymes –> diarrhea

261
Q
  • postprandial epigastric pain
  • food aversion/wt loss
  • atherosclerosis
A

chronic mesenteric ischemia

“intestinal angina”

atherosclerosis of mesenteric arteries –> decreased blood flow to intestine after meals

262
Q
  • pedunculated mass in left atrium
  • constitutional symptoms
  • mid-diastolic rumbling murmur heard best at apex
  • positional cardiovascular symptoms
A

atrial myxomoa

  • scattered cells w/in a mucopolysacccharide stroma
  • abnormal blood vessels
  • hemorrhaging

symptoms often position dependednt

263
Q

blood transfusion

  • –(mins to hrs)–>
  • fever/chills
  • chest/back pain
  • hemoglobinuria
A

acute hemolytic transfusion reaction

Ab-mediated (type II) hypersensitivity rx

—> complement mediated cell lysis

264
Q

lower lung fields
califications
pleural thickening

A

asbestos

265
Q

glucagon pathway

A

GCPR
adenylate cyclase
cAMP
protein kinase A

266
Q

unable to adduct + no corneal reflex

what hole

A

superior orbital fissure

III
IV
V-1
VI

(and superior opthalmic vein)

Uworld (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions