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UWORLD first pass- week 6 > 3/12 UWORLD- test # 37 > Flashcards

3/12 UWORLD- test # 37 Flashcards

1
Q

Q 1. ectoderm gives rise to what three EMBRYOLOGICAL structures?

A

surface ectoderm
neural tube
neural crest

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2
Q

Q 1. adenohypophysis (anterior pituitary) is derived from what embryological structure?

A

surface ectoderm

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3
Q

Q 1. mammary gland is derived from what embryological structure?

A

surface ectoderm

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4
Q

Q 1. pineal gland is derived from what embryological structure?

A

neuroectoderm

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5
Q

Q 1. Dermis is derived from what embryological structure? what about epidermis?

A

dermis: mesoderm
epidermis: surface ectoderm

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6
Q

Q 1. Adrenal cortex is derived from what embryological structure? what about adrenal medulla?

A

adrenal cortex: mesoderm

adrenal medulla: neural crest (A in motel pass)

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7
Q

Q 2. Two phases of type 4 hypersensitivity. What is happening and how long?

  • sensitization phase
  • elicitation phase
A
  • sensitization phase: when hapten (such as ivy) is first exposed. Takes 10-14 days, as it takes time to antigen presenting/ T cell activation
  • elicitation phase: when SAME hapten is exposed again Takes 2-3 days, as hapten-specific T cells are located in epidermis and dermis
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8
Q

Q 3. Describe how airway resistance changes from trachea to alveoli. Why is this pattern?

A

Airway resistance picks at medium sized bronchi and decreases as it travels down to alveoli

medium sized bronchi has the greatest turbulent flow. Resistance drop as airway branches more, because surface area becomes great

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9
Q

Q 4. Which cell mediates immune response to helminth?

A

eosionphil

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10
Q

Q 5. vitamin C overdose toxicity? (3)

A
  • calcium oxalate kidney stone (vitamin C is metabolized to oxalate)
  • GI (nausea, diarrhea, vomiting)
  • increased risk of iron toxicity
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11
Q

Q 5. Vitamin A overdose toxicity? (4As)

A
  • it is all A
  • Appearance (Alopecia, dry skin)
  • Ability to think (pseudomotor cerebri -> papilloedema)
  • Alcohol metabolizer (hepatic toxicity)
  • Arthralgias
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12
Q

Q 5. vitamin E overdose? what about deficiency (3)?

A

overdose
- hemorrhagic stroke: vitamin E inhibits coagulation factors

deficiency
- hemolytic anemia, acanthocytosis, neurologic degeneration due to oxdiative stress

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13
Q

Q 6. What is health maintenance organization

A

insurance program
low monthly cost, low co-payment
Good option for chronic disease (in chronic state, MAINTENANCE of health is important, so health MAINTENANCE organization)

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14
Q

Q 7. Internal hemorrhoids vs. external hemorrhoids

  • anatomical location
  • artery
  • vein drainage
  • lymphatic drainage
  • nerve innervation/painfulness
A

Internal hemorrhoids

  • above pectinate line
  • superior rectal a. (branch of inferior mesenteric)
  • superior rectal vein -> inferior mesenteric vein -> portal system
  • internal iliac lymph node
  • visceral nerve/ not painful

External hemorrhoids

  • below pectinate line
  • inferior rectal a. (branch of pudendal a.)
  • inferior rectal vein -> internal pudendal vein -> internal iliac vein -> common iliac vein -> IVC
  • superficial inguinal lymph node
  • somatic nerve/ painful
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15
Q

Q 8. Patient belives people are harming them (although it is not true). Paranoid personality disorder or delusional disorder?

A

delusional disorder

paranoid personality disorder is that patient does not TRUST people. which is not the same as believing that people are harming (that is not true) the patient.

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16
Q

Q 8. Diagnostic criteria for delusional diorder

A

one or more delusion for one ore more month

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17
Q

Q 9. Brief psychotic disorder vs. delusional disorder

A

Brief psychotic disorder is defined as one or more of positive symptoms (delusion is included), but less than one month (but more than one day)

18
Q

Q 10. Low carnitine content in muscle biopsy suggests what?

A

defect in fatty acid oxidation

19
Q

Q 10. What is palmitate?

A

fatty acid that can be ingested or synthesized from carbohydrates. Defect in fatty acid synthesis may result in low palmitate

20
Q

Q 10. What is acetoacetate?

A

ketone bodies

21
Q

Q 12. compare glucose tranport mechanism in

  • adipose/ liver/ muscle tissue
  • intestine/ renal tubule
A

Adipose/liver/muscle tissue
- GLUT mediated transport (carrier mediated facilitated diffusion: steroselective- D glucose is absorbed much faster than L-glucose)

intestine/ renal tubule
- Na+/glucose cotransporter

22
Q

Q 13. HIV associated dementia

  • CD4 T cell count?
  • pathogenesis?
A
  • CD4 <200

- inflammatory activation of microglial cells chewing up brain

23
Q

Q 14. Infection routes (2) for HIV?

A
  • sex

- needle stick

24
Q

Q 14. HIV positive pregnant should do what to decrease risk of transmission to baby?

A

antiviral medications (zidovudine)

There is no vaccine for HIV!

25
Q

Q 16. How homocysteine is converted to other metabolites in two different ways? Which vitamin is cofactor for each pathway?

A
  • homocysteine -> methionine: vitamin B12

- homocysteine -> cystathione -> cystine: both vitamin B6

26
Q

Q 18. Compare symptoms of frontotemporal dementia vs. Alzheimer disease

A

Fromtotemporal dementia: early stage shows changes in personality. As stage progresses, patients may have movement disorder (parkinsonism) and dementia

Alzheimer disease: slow/progressive memory loss

27
Q

Q 19. dog bite. what bug?

A

pasteurella multocida

28
Q

Q 20. what differentiates between staph. and strep.

A
  • catalase

- morphology: chain vs. cluster

29
Q

Q 21. shortness of breath/ chest pain. Drug is initiated. Then, wheezing & prolonged expiration developed. What drug is this? Explain what is going on.

A

beta blocker

CAD -> beta blocker to slow down heart rate -> B2 antagonistic effect -> bronchoconstriction

  • buzzing word: wheezing/ prolonged expiration: think about obstructive lung pathology
30
Q

Q 22. In the setting of chronic renal hypo-perfusion, which renal structure will undergo hyperplasia? explain physiology

A

JuxtaGlomerular cells (JG cells)

In the setting of hypo-perfusion,
low GFR -> chronic stimulation at JGA for renin release
-> JG cells undergoes hyperplasia

  • I initially thought it will be efferent arteriole due to chronic AngII stimulation. But remember, efferent arteriole undergoes vasoconstriction, NOT hyperplasia
31
Q

Q 27. Severe hypotension, vomiting, abdominal pain, hyperpigmentation. what is going on? what is treatment?

A
  • acute adrenal crisis (acute primary adrenal insufficiency)
  • treatment: IV fluid + immediate glucocorticoid => this treatment should be done immediately, without waiting for results.
  • buzzing word: hyperpigmentation, hypotension
32
Q

Q 28. How does beta blocker affects following? why?

  • Renin
  • AngI
  • AngII
  • Aldo
  • bradykinin
A

All RAAS components will be down, while no change in bradykinin (no effect on ACE activity)

JGA releases renin in response to beta1 adrenergic stimulation (beta 1 receptors are located on JGA)

33
Q

Q 29. Of all diabetic drugs, which one may cause significant hypoglycemia as side effect?

A

2nd generation sulfonylureas

- glyburide, glipizide

34
Q

Q 31. Difference in histologic finding between hepatic toxicity of acetoaminophen vs. reye syndrome by aspirin?

A

acetoaminophen
: centriloblular necrosis

reye syndrome by aspirin
: panlobular microvascular steatosis

35
Q

Q 33. List two myopathies with normal CK, and three myopathies with elevated CK

A

normal CK

  • polymyalgia rheumatica
  • glucorcorticoid myopathy

elevated CK

  • polymyositis/ dermatomyositis
  • inflammatory myopathy
  • hypothyroid myopathy
36
Q

Q 33. What features (2) of hypothyroid myopathy distinguish it from other type of myopathies

A
  • myoedema

- loss of reflex

37
Q

Q 35. Whipple disease

  • what infectious agent?
  • intestinal biopsy histologic finding
  • symptoms
  • treatment
A
  • T. whipplei
  • PAS positive, whipplei laiden macrophages@ lamina propria= foamy macrophages
  • foamy whipped CAN
    C- cardiac
    A- arthralgia
    N- neurologic
  • antibiotics for tx
38
Q

positive PAS (periodic acid schiff) stain: what two things should I remember?

A
  1. alpha-antitrypsin 1 deficiency: PAS postive granules in liver
  2. Whipple disease: multiple macrophages with PAS postive granules in lamina propria of intestine
39
Q

Q 36. Deficiency of which vitamin may result in squamous metaplasia to keratinizing epithelium

A

vitamin A

40
Q

Q 38. which drugs can induce IgE independent mast cell degranulation? (3)

A
  • opioid
  • radiocontrast agent
  • vancomycin
41
Q

Q 39. McCune-Albright syndrome

  • what gene is affected? function of gene? what type of mutation?
  • symptoms (3)
A

somatic mosaicism on GNAS gene, stimulating subunit of G protein -> constitutive activation of G protein receptor
-> overgrowth

3 symptoms

  1. precautious puberty
  2. fibrous dysplasia: fracture may be seen in x-ray
  3. cafe-au-lait spots

UWORLD first pass- week 6 (6 decks)

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