Brainscape's Knowledge GenomeTM

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


See full index

Uworld > #5 > Flashcards

#5 Flashcards

1
Q

Boy slanted palpebral fissures, epicentral folds, thick nuchal folds, single palmar crease

  • Large reducible midline abdominal protrusion covered by skin, more pronounced when he cries
  • Umbilical stump is at the center of the protrusion

Cause?

A

Incomplete closure of umbilical ring

- Down syndrome ‘’ congenital umbilical hernia’’

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

44 yo man type 2 DM

  • lost 7kg with occasional nausea, vomiting and sensation of fullness after eating
  • Previously taking metformin added new medication

If patient weight loss is due to new medication, which is it?

A

Glucagon like peptide 1 agonist

- Increase glucose -dependent insulin release. Enhance satiety and prolonged feeling of fullness

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

Enzyme possess 3’ to 5’ exonuclease activity .

What action does this has?

A

Removal of mismatched base pairs during DNA replication.

- Proofreading activity.

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

34 yo wo difficulty chewing, trouble speaking, symptoms worse after a long day.
- Symptoms reversible on administration of an acetylcholinesterase inhibitor

Pathogenesis similar to which disease?

A

Goodpasture syndrome
- Patient has myasthenia gravis
Type II hypersensitivity.

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

18 yo man hematuria and intermittent flank pain
- Compression of left renal vein between SMA and aorta.

What will develop because of this?

A

Varicocele ‘‘nutcracker effect’’

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

4 yo boy several episodes of vomiting

  • Found mushroom on kid hands
  • Poison stimulates muscarinic receptors

Effect of poison?

A

Nitric oxide synthesis

- Increase parasympathetic activity, relaxation and vasodilation.

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

23 yo fever, vomiting , diarrhea, temperature 39

  • Diffuse erythematous macular rash resembling sunburn
  • Tampon in the vagina

Responsible for condition?

A

Macrophages and T lymphocytes

- Toxic shock syndrome caused by staph aureus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Oxygen-hemoglobin dissociation curve, what would cause a shift to the left?

A

Hypothermia, decrease 2,3 BPG, increased pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

4 day old poor feeding and vomiting

  • exaggerated deep tendon reflexes and clonus
  • Impaired transport of ornithine from the cytosol to the mitochondria

Nutritional restrictions of which substance can improve this?

A

Proteins

- Ammonia accumulate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

45 yo man suicidal ideation

  • 4.5 kg weight loss
  • He is responsible for all the evil in the world, he has heard a voice for the past week

Diagnosis?

A

Major depressive disorder with psychotic features.

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

45 yo man severe dyspnea
- PaCO2 26 / PaO2 54
What is happening?

A

Alveolar hyperventilation

- acute pulmonary embolism causes hypoxemia

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

33 yo man plays loud the piano nonstop.
- His mood is terrific, he claims is related to the president
- Hears voices telling him he is going to be famous entertainer
- Secret cameras are monitoring him
- No mood symptoms
Diagnosis?

A

Schizoaffective disorder

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

52 yo wo, DM 6 months ago
- Metformin therapy is initiated
Physiological changes in hepatic gluconeogenesis / muscle glucose uptake / Endogenous insulin production?

A

Hepatic gluconeogenesis decreased
Muscle glucose uptake increased
Endogenous insulin production unchanged

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

28 yo wo cesarian delivery

  • intermittent sharp pain over well healed transverse scar
  • Abnormal axonal regeneration is suspected

Ion channel most likely upregulated?

A

Sodium ‘‘propagation of action potentials’’

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

38 yo right sided facial pain, knife stabbing my face
- Instigated by a meal or teeth brushing

Best initial treatment?

A

Carbamazepine

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

36 yo man gout treated with prednisone

  • Uric acid level is 13.5
  • Allopurinol is prescribed

This last drug will increase activity of which medication?

A

Azathioprine

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

95% confidence interval was 1.02 -1.85

Which p-values is most consistent with the results?

A

Either 5% or lower

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

26 yo wo when she chews she hears a clicking noise in right ear

  • She has been grinding her teeth at night
  • Spasms of which muscle?
A

Masseter and pterygoid muscle

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

35 yo man acute right knee pain and swelling

  • pain climbing stairs
  • Diarrheal illness 2 weeks before onset
  • Joint aspirate no bacteria

Most likely associated with symptoms?

A

Histocompatibility antigen HLA-B27
- Reactive arthritis occurs with chlamydia, campylobacter, salmonella, shigella or yersinia.
Deposition of Immune complexes

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

20 yo flattening of right deltoid muscle

  • most likely injury?
A

Anterior dislocation of the humerus

- Axillary nerve injury

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

45 motor vehicle accident

  • Unable to void, resistance encountered when catheter is inserted
  • Left hemothorax and pelvic fracture

Portion of urogenital tract damage?

A

Posterior urethra - membranous segment

  • Bulbous segment most common damage in straddle injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

6 yo girl abdominal pain

  • 2 episodes of non bilious emesis
  • erythematous macular rash over her legs and back
  • Urine blood and protein

Renal abnormality?

A

Mesangial deposition of IgA

- Henoch-Schonlein purpura

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

32 yo woman vaginal discharge
- cytology shows clue cells

Organism?

A

Anaerobic gram-variable rod

- Bacterial vaginosis ‘’ gardenerella vaginalis’’

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

78 yo man fever, cough shortness of breath

  • Living facilities owning several pets
  • Dullness to percussion and bronchial breath sounds
  • Left lower consolidation, gram negative diplococci

Most helpfull in preveting lung infection?

A

Vaccination with bacterial polysaccharide

- S pneumo most common

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

30 yo man dyspnea and hypoxia
- pulmonary angiography shows arteriovenous malformation

Cause of hypoxia?

A

Increased right-to left shunting

26
Q

baby with small head and eyes

  • cleft lip and palate, round punched out lesion with an overlying thin membrane on patient’s scalp
  • Bowel protrudes from patient’s abdominal midline

Responsible for condition?

A

Patau syndrome

- Cutis aplasia ‘‘membrane on scalp’’

27
Q

55 yo type II DM and obesity

  • bicarbonate is low
  • Normal anion gap

Likely diagnosis?

A

Renal tubular acidosis , severe diarrhea, excesive saline infusion.

28
Q

68 yo recurrent bacterial sinusitis, pneumonia and urinary tract infections

  • normocytic normochromic anemia
  • Bone marrow shows clock face cells

Cause of increased susceptibility to infections?

A

Decrease production of functional immunoglobulins

- Multiple myeloma

29
Q

73 yo severe pain and discharge from left ear

  • granulation tissue in left ear canal with scant amount of discharge
  • Culture grow gram-negative rod

Describe organism?

A

Motile and oxidase positive

- Pseudomonas aeruginosa

30
Q

66 yo shows 10cm perihilar mass in right lung

  • Results show non -small lung cancer
  • Plenty of people in the room

Physician should ask?

A

Is there anyone you would like to remain in the room while we talk about your results

31
Q

30 yo man sudden onset of severe headache and confusion

  • autosomal dominant polycystic kidney disease
  • Blood in subarachnoid space
  • New onset weakness in right arm and leg 5 day after admission

Medication could have prevented the complications?

A

Calcium channel blocker

improves outcome of cerebral vasospasm by inducing cerebral vasodilation

32
Q

ATP attaches to sarcomere, this causes?

A

Myosin head detachment from the actin filament

33
Q

6 yo girl itchy rash on face
- Rash began 3 weeks ago
- Tacrolimus is prescribed
MOA?

A

Inhibition of T-lymphocyte signaling

34
Q

6 yo boy bruises easily, appears pale

  • Massive splenomegaly, platelet count is low/ Hepatomegaly
  • Marrow shows wrinkled tissue paper appearance

Diagnosis?

A

Gaucher disease

- Lipid laden macrophages

35
Q 
41 yo 4 months history of fatigue, headache, weight loss, sweating
- Lid lag and fine hand tremor
- Enlargement of thyroid gland 
TSH 10
T4 is 3
T3 is 400

Cause of disorder?

A

pituitary tumor

Hyperthyroidism , elevated TSH pituitary adenoma

36
Q

What hormone level would increase at breakfast , lunch and dinner time?

A

Ghrelin

37
Q

40 yo wo malaise, fever, productive cough, pleuritic chest pain

  • HIV, injection drug
  • Lung examination reveal lancet shape image

Pathogenic factor that contributes to lung infection?

A

Antiphagocytic microbial capsule

- Strep pneumo

38
Q

35 yo genital warts on labia majora

- This could also infect?

A

True vocal cords

39
Q

65 yo wo episode of syncope after standing
- Advanced adenomatous changes in one polyp and adenocarcinoma in other

Responsible for transformation of advanced adenoma to carcinoma?

A

TP53

40
Q

Neural crest cell migration in human fetus is interrupted during the 12th week

This results in lack of innervation where?

A

Rectum

- Hirschsprung disease

41
Q

64 yo man severe abdominal pain, nausea, hypertension, MI, systolic heart failure
Respirations are 24/min
Sodium 136, bicarbonate 12, pH 7.2/ PaCO2 26/ lactic acid 6.2

Abdomen reveals distal ideal wall thickening and lack of enhancement

Decreased activity of which enzyme?

A

Pyruvate dehydrogenase
- Patient suffering from acute mesenteric ischema.
Inadequate O2 present in tissues, pyruvate is converted to lactate

42
Q

54 yo man, headaches and leg weakness
- Physical examination shows neurofibromas and cafe au last spot

Inheritance pattern?

A

Neurofibromatosis type I

- Autosomal dominant

43
Q

2 yo boy
- My boy is always sick, otitis media, skin infections, pneumonia, staph aureus

  • Testing shows absent CD18 antigen on surface of leukocytes

Associated with?

A

Persistent leukocytosis
- Leukocytes adhesion deficiency
CD18 necessary for formation of integrins
- Late umbilical cord separation

44
Q

52 yo enlarging neck mass, fatigue and weight loss

  • enlarged tonsils and splenomegaly
  • Large B cells have replaces normal tissue. + for Epstein Barr virus

Risk factor associated with condition?

A

Advanced HIV infection

- Non Hodgkin lymphoma , immune dysregulation

45
Q

Therapy X Standard

alive 1 year 40 51
Dead 1 year 60 69

Number need to harm for therapy regimen?

A

NNH = 1/ Absolute risk increase
Adverse in therapy: 60/100
Adverse in standard: 69/120

0.6 - 0.575 = 0.025 ( 2.5%)

1/0.025 = 40 persons

46
Q

65 yo man fevers and chills

  • Lives eastern massachusetts
  • enjoying gardening and swimming
  • Traveled to Thailand 2 years ago and to florida 2 months ago
  • Coarse crackles, palpable splenomegaly, nor rash or open wound

Exhibit shows intraerythrocytic ring inclusions

Diagnosis source?

A

Ixodes tick,

- Babesiosis

47
Q

1 week old boy recurrent vomiting
- Sunken fontanelle and dry mucous membranes

  • Sodium 122 / Potassium 5.7

Findings in cortisol / aldosterone/ serum ACTH / 17 hydroxyprogesterone?

A

Cortisol decrease
Aldosterone decrease
Serum ACTH increase
17 hydroxyprogesterone increase

COngenital adrenal hyperplasia due to 21 hydroxylase deficiency

48
Q

Ashkenazi jewish descent
- enzyme deficiency that results in decreased degradation of phospholipid substrate to ceramide which leads to buildup of phospholipid.

Clinical features of affected child?

A

Retinal opacification and splenomegaly

- Niemma pick disease deficiency of sphigomyelinase

49
Q

Blurred vision worse when he reads

  • Took diphenhydramine for allergies
  • Visual symptoms are due to blockade of which mediator?
A

Acetylcholine

- Anticholinergic effect of 1st generation antihistamine cause these symptoms

50
Q

28 yo insomnia

  • Hypersenstitive to loud sounds
  • Friend being blown up after step-in on a landmine
  • Anxious mood

Appropriate pharmacotherapy?

A

SSRI’s

51
Q

21 day old boy

  • Bulge in his neck
  • Looks toward right and cries then head is turned left
  • Mass on neck does not move when child swallows

Condition present prenatally?

A

Intrauterine malposition

  • Congenital torticollis
  • Sternocleidomastoid muscle injury
52
Q

35 yo man
respirations are 12/min
pH7.54 / PaCO2 49

What study would be helpful in determining patient acid-base abnormality?

A

Urine chloride

  • Metabolic alkalosis
  • Low CL impairs renal excretion of HCO3
53
Q

64 yo man dyspnea on exertion

  • Hypertension several years ago
  • Dullness to percussion and decreased breath sounds
  • Right sided pleural effusion
Pleuropulmonary changes are most likely in
Vascular permeability 
Vascular hydrostatic pressure
Vascular oncotic pressure
Lymphatic flow
A

Vascular permeability normal
Vascular hydrostatic pressure increase
Vascular oncotic pressure normal
Lymphatic flow increased

54
Q

24 yo motorcycle collision

  • Patient opens eyes spontaneously gazing around the room but does not track objects
  • Moves all 4 extremities, but movements are not purposeful

Diagnosis?

A

Persistent vegetative state

55
Q

Prostate adenocarcinoma, radical prostatectomy is done.
- Nerves within the fascia surrounding the gland are injured

Consequence?

A

Erectile dysfunction ‘‘prostatic plexus’’ innervates corpus cavernosa

56
Q

52 yo man right pupil is 3mm and left is 5mm.
Light is dimmed, anisocoria increases

  • Location of lesion?
A

Right oculosympathetic pathway

57
Q

12 yo rash posterior neck
- Pruritic with the cooler weather and patient scratch his neck

Cause of rash?

A

Genetically mediated skin barrier dysfunction

- Chronic atopic dermatitis , epidermal barrier dysfunction

58
Q

40 yo wo anemia

  • increasing heavy irregular menses
  • 24hs After transfusion of blood developed yellowing of the eyes and face but no hepatosplenomegaly

Antibody-antigen reaction?

A

Patient’s antibodies against the blood product minor red blood cell antigen
- Delayed hemolytic transfusion reactions.

59
Q

65 yo man pain, redness and swelling in his calf

  • Cellulitis and clindamycin
  • Watery diarrhea and abdominal cramps
  • Toxin responsible affects what component?
A

Cytoskeleton integrity

- C difficile

60
Q

35 yo man urethral discharge

  • neutrophils and intra gram negative diplococci
  • Infection resolves, but had similar 3 months ago

Reason for recurrence of infection?

A

High variability of microbial antigenic structure

Uworld (11 decks)

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