2/3 UWORLD test #5 Flashcards
(52 cards)
Q 1. In what medical condition is Polyethylene glycol (PEG) used?
Constipation
PEG is thick non-absorbable sugar that works as osmotic laxative
Q 1. What is lactase deficiency and its effect on GI?
Impaired lactose digestion -> effect similar to osmotic laxative (non-digested chunky sugar driving water into GI) -> diarrhea
Q 2. Medication options for BPH? (3)
- finasteride
- terazosin
- tadalafil
Q 2. What is tadalafil? mechanism of action? side effects?
PDE-5 (phospho diesterase type 5) inhibitor
increased NO-> vasodilation
hypotension, flushing, syncope
Q 3. Differential diagnosis of infectious vaginitis? (3)
Diagnostic test? treatment?
- bacterial: gardenella vaginalis, gray discharge, clue cell, KOH whiff test, pH >4.5 clindamycin or metronidazole
- protozoa: Trichomonas vaginalis, green/yellow discharge, pH >4.5 saline microscope, metronidazole
- fungal: Candida, thick white /cottage cheese discharge, normal pH (4-4.5), -azoles
Q 4. What is rett syndrome? hereditary pattern?
Developmental delay, intellectual disability, hand-wringing
X linked dominant
Q 4. In general, enzyme deficiency results in what type of hereditary pattern?
autosomal recessive
Q 4. In general, defective non-catalytic protein results in what type of hereditary pattern?
autosomal dominant
Q 4. What is classic galacotosemia? hereditary pattern?
Symptoms? tx?
- Galactose 1-P Uridyltransferase deficiency
- Autosomal recessive (all carbohydrate metabolism disease are AR)
- Juvenile cataracts, Liver failure, jaundice
: due to accumulation of galactitol, osmotically active - limit galactose & lactose (metabolized to glucose and galactose) on diet: diary
Q 4. What is Leber hereditary optic neuropathy? hereditary pattern?
- degeneration of retinal ganglion cells (RGCs) and their axons that leads to an acute or subacute loss of central vision
- mitochondrial inheritance
: all kids from affected mother
Q 6. What is duration/etiology of transplant rejections:
Hyperacute, Acute, Chronic
- Hyperacute; within minutes, preformed antibodies from receipient
- Actue: months ( < 6 mo), humoral/cell mediated response, mostly CD8+ T cells
- Chronic:, years, weak immune response, mostly CD4+T cells
Q 7. What maternal condition can cause NRDS (Neonatal respiratory distress syndrome)? Another cause of NRDS associated with delivery procedure?
Diabetic - hyperglycemia/insulin inhibits surfactant synthesis
C section- stressed induced cortisol triggers surfactant synthesis
Q 7. What medication can be used for infant survival in NRDS? What is the mechanism?
Dexamethasone
: cortisol helps surfactant synthesis
Q 7. When (gestation time) does surfactant synthesis start and by when fetus produces enough surfactant? How early premature gestation can cause NRDS?
begins at 26 weeks, normally mature in 35 weeks
less than 32 weeks of gestation is considered early, high chance to develop NRDS
Q 8. 1 week of focal deficits (hemiplegia, dysphagia) with evidence of brain ischemic injury. what do you expect to see in histology?
Reactive gliosis + microglial cells eating up necrotic cellular debris
Q 8. explain how ischemic brain injury proceeds
(time line: 12-48 hrs, 1-3days, 3-5 days, 1-2 wks, more than 2 weeks
12-48 hrs: red neuron 1-3 days: necrosis & neutrophils 3-5 days: microglia (macrophage of CNS) 1-2 wks: microgliosis >2 wks: fibrosis
Q 9. Is alpha-helix or beta-sheet secondary structure? or tertiary structure? what is the strongest chemical bond that determines its structure?
secondary structure
Hydrogen bond
Q 10. What are symptoms of acute intermittent porphyria? (5Ps?)
Painful abdomen Port-wine urine color Precipitated by drug (P450 inducers), alcohol Polyneuropathy Psychiatric symptoms
Q 10. what are two treatments for acute intermittent porphyria?
Heme, Glucose
Both inhibit ALAS
Q 12. Crohn’s can cause what type of kidney stone? what is mechanism?
Calcium Oxalate
Fat malabsorption -> Calcium binds to fat in the gut -> oxalate not bound to Calcium is not fecally excreted via calcium oxalate form -> more oxalate reabsorption into blood and enter to kidney
Q 15. What are features of secretory phase of endometrium during menstrual cycle?
- what hormone is secreted?
- what mucus is secreted?
- spiral artery? uterine wall?
- progesterone
- glycogen rich mucus
- tortious (more) spiral artery, edematous (thickened) uterine wall
Q 17. What is first line treatment for symptomatic relief of acute congestive HF?
Diuretics
Q 17. What are long-term medications for survival improvement in patient with congestive HF? (4)
- Beta blockers
- ACEI
- AngII receptor blocker
- spironolactone
Q 17. What is Amlodipine? Mechanism of action? Indications? Can this drug be useful for congestive HF?
- Dihydrophyridine CCB
- vasodilation of peripheral vessels
- hypertension, Raynaud phenomenon
- No. dihydrophyridine CCBs are more like peripheral blood vessel dilation- blood pressure control. Does not really have impact on preload and afterload
