3/12 UWORLD- test # 39 Flashcards

1
Q

Q 5. achondroplasia

  • what gene is mutated?
  • inheritance pattern?
  • phenotype of heterozygous mutation? what about homozygous mutation?
A
  • FGFR3
  • autosomal dominant
  • short statue/ normal head size: heterozygous
    homozygous usually result in death shortly after birth
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2
Q

Q 2. What is best initial test for giant cell arteritis? what would be next for diagnosis?

A

serum inflammation marker- ESR, CRP
temporal artery biopsy- intimal thickening

  • Angiography will not be useful. Angiography is more for artery obstruction- stroke
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3
Q

Q 3. Intracellular adhesion molecule (ICAM-1) vs. Platelet endothelial cell adhesion molecule (PECAM-1)

  • where are located?
  • where do they bind to?
  • facilitate what step in neutrophil migration?
A

ICAM-1

  • located in endothelium
  • bind to PFA-1 (CD18) on neutrophil
  • facilitate adhesion (tight binding)

PECAM-1

  • endothelium
  • bind to PECAM-1 on neutrophil (both neutrophil and endothelium has same one)
  • diapedesis ( transmigration)
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4
Q

Q 4. What protein is affected in Marfan syndrome? what is function of that protein?

A

Fibrillin-1

- glycoprotein that forms a sheath around elastin

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5
Q

Q 5. bloody diarrhea, Gram negative, lactose-non permenting, H2S negative: what bug is this? What is the most important during pathogenesis?

A

Shigella

envasion: shigella invades through M cells (antigen presenting macrophage in the payer’s pouch), using M cells’ actin filament to migrate through intestine.

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6
Q

Q 9. Isotretinoin (vitamin A derivative) is teratogenic. What abnormalities can form? (4)

A
  • microcephaly
  • hydrocephalus
  • small ears
  • thymic hypoplasia
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7
Q

Q 11. What is trailing zeros? how can it cause error in prescription?

A

put 0 after decimal point. (ex, 2.0 instead of 2)
it may cause errors in dosage amount.
Asking physician not to do trailing zeros can reduce source of error

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8
Q

Q 13. cholecystokinin is released from what cells? Where are they located?

A

I cells, small intestine

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9
Q

Q 13. somatostatin is released from what cells? where are they located?

A

D cells, pancreatic islets

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10
Q

Q 13. GIP

  • full name?
  • function?
  • what cells secret it? where are they located?
A
  • Glucose dedependent Isulinotropic Peptide
  • insuline release in response to glucose: explains difference of insulin release from oral glucose vs. IV glucose
  • K cells, duodenum/jejunum
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11
Q

Q 15. How does biliary atresia result in color change in urine? what about stool?

A

dark urine- due to excessive renal excretion of bile

pale stool - due to lack of intestinal bile (bile duct is only way to get into intestine)

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12
Q

Q 14. carpal tunnel syndrome

  • compression on what nerve
  • Incision of which structure is performed during surgery?
A

median nerve

incision of transverse carpal ligament (flexor retinaculum) is performed to relieve pressure

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13
Q

Q 16. What is nulliparity? How is this associated with reproductive diseases?

A

no history of pregnancy

-> increased risk for endometrial/breast cancer

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14
Q

Q 16. Endometriosis

  • what is it?
  • complications (3) and physiology
A
  • non-neoplastic growth of endometrium outside of uterine
  1. heavy/painful mestural bleeding: ectopic endometrium also sheds/bleeds during mens
  2. infertility
  3. retroverted uterus
    2&3: ectopic endometrium shedding/bleeding-> blood trapped -> inflammation -> adhesion of urterus/ovary
    -> infertility & retroverted uterus
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15
Q

Q 17. What is embryological origin of anterior pituitary? what about posterior pituitary?

A
  • anterior pituitary: oral ectoderm (Rathke pouch)

- posterior pituitary: neuroectoderm

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16
Q

Q 18. McArdle disease is defect of what enzyme? what is its function?

A

glycogen phosphorylase

cut branch until 4 glucose molecules remain

17
Q

Q 19. Describe how tetanus toxin migrates

A

contaminated soil -> wound: bacteria releasing toxin -> toxin migrates retrograde along motor neuron-> toxin reside in spinal cord and medulla

18
Q

Q 20. What morphology does blastomyces look like in potassium hydroxide preparation

A

Blastomyces- Budding

19
Q

Q 21. Apart from visual issue/ headache, what medical conditions in MEN may happen in prolactinoma? (3)

A

prolactin -> suppression of GnRH

  1. libido
  2. infertility
  3. hypoganadism
20
Q

Q 25. side effect of colchicine?

A

GI effects (diarrhea, nausea, abdominal pain)

21
Q

Q 26. RSV in kid: what does it cause? physical exam finding?

A

bronchiolitis & pneumonia

wheezing

22
Q

Q 27. What DNA repair mechanism is messed up in Lynch syndrome?

A

mismatch repair

23
Q

Q 28. two locations of baroreceptor

A
  • aortic arch

- carotid sinus

24
Q

Cold temperature: what is the change of

  • cardiac output
  • ADH
  • Atrial natriuretic peptide

why? explain physiology

A
  • CO: increase
  • ADH: decrease
  • ANP: increase

cold temp -> peripheral vasoconstriction -> increased blood volume in heart -> increased CO (more ventricular stretch) -> stretching pressure sensed by baroreceptors -> decrease ADH/ increase ANP to tone pressure down

25
Q

Q 32. Burkitt lymphoma

  • transolcation?
  • what does this translocation result in? explain molecular physiology about what is going on
A

t (8;14)

fusion of heavy chain Ig & c-myc
high level expression of c-myc, transcription factor (oncogene)

26
Q

Q 32. CML

  • translocatoin?
  • what does this translocation result in? explain molecular physiology about what is going on
A

t (9;22): philadelphia chromosome

fusion of BCR-Abl
constitutive tyrosine kinase activity -> growth

27
Q

Q 36. Colon cancer may cause what anemia?

A

iron deficiency anemia

28
Q

Q 36. How colon cancer at two different sites present differently?

  • ascending colon
  • rectosigmoid colon
A
  • ascending colon
    : large/ bulky -> rupture -> hemorrahge -> iron deficiency anemia
  • rectosigmoid colon
    : small -> obstruction -> vomiting/abdominal distention
29
Q

Q 37. What two factors can cause angiogenesis during scar formation?

A

VEGF

FGF: fibroblast growth factor

30
Q

Q 38. Buerer disease

  • what is another fancy term?
  • most common cause
  • gross appearance (2)
  • histologic finding
A
  • thromboangitis obliterans
  • smoking
  • gangrene, raynaud
  • SEGMENTAL thrombosing vasculitis that often extend into continuous veins . & nerves
31
Q

Q 39. normal language development for 3yo

A

3 words sentence

32
Q

Q 39. normal fine motor development for 3yo

A

usage of utensils, copies circle