2/9 UWORLD test # 10 Flashcards
(38 cards)
Q 2. What is sublingual tablet used for antianginal therapy?
nitrates
Q 2. What are four mechanism of actions of antianginal therapy? Example of drugs for each mechanism?
- Reduce HR: beta blocker, non-dihydropyridines CCB
- Reduce pre-load (less stretch -> less cardiac workload): nitrate
- Increase cardiac perfusion: dihydropyridines CCB,
non-dihydropyridines CCB & nitrate (mild) - Reduce after-load (less cardiac workload): dihydropyridines CCB
NOTE: hydralizine is NOT indicated
Q 3. What is Colchicine? mechanism of action?
Acute anti-gout drug
MOA: destabilize actin, inhibition of neutrophil chemotaxis -> reducing gouty inflammation
Q 4. Findings of sarcoidosis?
- X ray
- lung histology
- other symptoms: SARCOID
- X ray: bilateral hilar lymphadenopathy
- Lung histology: non-caseating granuloma
- other symptoms S: Skin- Erythema nodosum A: Arthritis R: Respiratory C: Cardiac-pericarditis & Cranial- Bell's palsy O: Occular- uveitis I: ILD D: vitamin D- hypercalcemia
Q 4. Describe histologic difference between caseating vs. non-caseating granuloma
non-caseating: multinuclear giant cells in the middle
caseating: apoptotic cell in the middle (just vague pink)
Q 5. Name of nephrologic complication of SLE?
LM/EM/IF findings? nephrotic or nephritic?
Diffuse proliferative Gromerulonephritis
LM: wire-looping
EM: IC deposit
IF: granular
Both nephrotic & nephritic
Q 5. What is cardiac complication of SLE?
- Name
- morphological characteristics
Libman-sacks endocarditis
vegetation (small/sterile) on both sides of valve
Q 7. What is Langerhans cell? morphology under microscopy?
APC (antigen presenting cell): dendritic cells in skin/mucosal membrane
tennis racquet
Q 9. What are 3Ds in pellagra?
Dementia
Dermatitis: photosensitive
Diharrea
Q 9. Niacin is precursor for what moleclues (2)? For what these molecules are used?
NAD: catabolic- glycolysis
NADP: anabolic- gluconeogensis
Q 9. What three enzymes require NAD as a cofactor in TCA cycle? mnemonic for this?
IMaK
- I: Isocitrate dehydrogenase
- M: Maltose dehydrogenase
- aK: alpha-ketoglutarate dehydrogenase
All of them are dehydrogenase, which makes sense that NAD will be reduced and converted into NADH, while reactant will be oxidized (dehydrogenation)
Q 10. What is mnemonic for hemoglobin electrophoresis? What each letter stands for and what is characteristics of each type of hemoglobin?
A Fat Santa Claus
From anode (+) to cathode (-)
usually electrophoresis runs from (-) to (+)
so A will be the most distal to origin
A- HbA: normal Hb
F- HbF: fetal HB (gamma chain smaller in size)
S- HbS: sickle cell (valine mutation -> neutral)
C- HbC: lysine mutation -> positive
Q 10. Missense mutation vs. nonsense mutation. What is difference?
missense mutation: nucleotide change leading to amino acid change
nonsense mutation: stop codon insertion -> truncated protein
STOP NONSENSE!
Q 10. What are two phenotypes of HbC disease?
typically asymptomatic but sometimes,
- mild normocytic hemolytic anemia
- splenomegaly
Q 11. mom: 1/a disease carrier frequency & dad: 1/b disease carrier frequency. What is probability to have a child with disease?
1/(4ab)
Q 12. Signs of infection in patient who underwent VP shunt (ventriculoperitoneal shunt) for hydrocephalus. What would be a most likely pathogen?
S. epidermis
VP shunt device is foreign device that S.epidermis loves to attach biofilm
Q 12. How S.epidermis forms biofilm on foreign body?
extracellular polysaccharide matrix
Q 14. What are three phases of wound healing. Describe each phase by: phase duration, mediators, characteristics
- inflammatory phase: up to day 3, neutrophils/macrophages
- proliferative phase: day 3- weeks, endothelial cells/fibroblast/myofibroblast, type 3 collagen, granulation tissue, angiogenesis
- scarring phase: weeks- months, fibroblast/ Zn2+ dependent collagenase: type 3 collagen-> type 1 collagen
Q 14. Keloid is characterized by excessive what type of collagen?
type 3
Q 15. cytosolic ribosome vs. ER attached ribosome: How protein product is different?
cytosolic ribosome: cytoplasmic protein
ER attached ribosome: proteins that will be further processed to Golgi -> vesicles -> membrane protein or secretory protein
Q 15. Through what molecule does ribosome attaches to ER?
translocon
Q 16. What is stridor in physical exam finding? What infectious organism should I think when see “stridor”?
hard breathing sound
Croup- parainfulenza virus
Pulsus paradoxus- 2 cardiac conditions and 2 respiratory conditions and 1 respiratory infection. What are they?
Cardiac conditions
- Cardiac temponade
- pericarditis
Respiratory conditions
- obstructive sleep apnea
- asthma
Respiratory infection
- croup
Q 17. Indirect hernia vs. Direct hernia: Difference regarding involvement of 1. type of inguinal ring 2. spermatic facial layers
Direct hernia
- superficial inguinal ring
- only external spermatic facial layer
Indirect hernia
- deep inguinal ring
- all three layers of external spermatic facial layer
