3/23 UWORLD test # 62 Flashcards
(30 cards)
Q 2. What general class of molecule cause of acute interstitial nephritis? examples of this molecule? (5) (hint: remember
drugs that work as haptogens
five Ps Pee (diuretics) Pain (NSAIDs) Proton pump inhibitor Penicilin, cephalosporins, also sulfonamide rifamPin
Q 2. Which hypersensitivity reaction mediates acute interstitial nephritis?
IgE mediated or even type 4
Q 2. What is treatment of acute interstitial nephritis?
AIN resolves almost simultaneously after withdrawal of offending reagents
Q 3. Which cell is main site for collagen synthesis? In what intracellular organelle of this cell?
fibroblast
rough ER (collagen will be exported to outside of cell essentially)
Q 3. which amino acid is most rich in collagen? (That is, which amino acid content best reflects collagen synthesis?)
glycine
Q 4. parasympathetic innervation on detrusor muscle?
contraction
remember: detrusor is surrounding muscle of bladder
- don’t get confused with trigon or
Q 4. parasympathetic innervation with vasoconstriciton or vasodilation? mechanism?
parasympathetic system INDIRECTLY mediates vasodilation by releasing NO
- If none of answer choices make sense for parasympathetic mediated response, pick vasodilation
Q 6. Define “permissiveness” between two drugs. What is example of permissiveness?
Effect of one drug becomes limited, but addition of another drug intensify the effect of first drug.
second drug does NOT have drug effect by itself
(vs. additive effect or synergistic effect)
ex: beta agonist + thryoid hormone.
=> thyroid hormone increases beta receptor availability, intensifying effect of beta agonist. thyroid hormone itself does not increase beta adrenergic effect
compare additive effect vs. synergistic effect between drugs
- additive effect: sum of two drugs is equal to addition of individual drug
- synergistic effect- sum of two drugs is greater than addition of individual drug
Q 8. Recurrent kidney stone, bitemporal visual field defect. What another cancer may be present?
pancreatic cancer
MEN1 !!
- this question is good one: If question seems to present MORE THAN TWO CANCERS, always think about MULTI ENDOCRINE NEOPLASIA
Q 12. How Hartnup disease is associated with niacin deficiency? inheritance pattern of Hartnup disease?
autosomal recessive
Hartnup disease:
PCT aminoacid transport is messed up
-> impaired amino acid reabsorption
-> waste of tryptophan -> niacin deficiency
Q 13. What if filter implantation for DVT? where is filter normally placed?
Filter is placed in IVC to prevent propagation of thrombi from DVT to pulmonary ciculation
Q 14. How mycoplasma infection can cause anemia? what kind of anemia? how this anemia can resolve?
mycoplasma triggers cold agglutinins (IgM), which binds to RBC and lyse it. (cold aggultination test can be performed to diagnosis of mycoplasma infection)
=> hemolytic anemia
as immune response fades (that is, cold IgM goes away), anemia resolves
Q 15. what three major muscles are used for sitting up from supine position?
- external abdominal obliques
- rectus abdominis
- hip flexors (ilopsoas = iliacus + psoas)
- SIT UP is not same as STAND UP
Q 16. African american, acute chest pain and abdominal pain that resolves with hydration with some weird thing going on spleen. What should be in differential diagnosis?
sickle cell disease
- acute chest pain is one of many manifestations of vaso-oclusive crisis. also called as acute chest syndrome
- dehydration is also cause of sickling. In fact, hydration is one of treatment options for sickle cell disease (as well as hydroxyurea)
Q 17. Describe histologic finding of epidermis of eczema (atopic dermatitis)
intraepidermal vesicles
=> spongiosis, epidermal fluid accumulation of edematous fluid
Q 17. What happen to skin after topical corticosteroid therapy for atopic dermatitis? explain mechanism
dermal atropy
corticosteroid can decrease extracellular matrix collagen
Q 18. What are two arteries branching off from splenic artery? which artery is susceptible
short gastric and left gastroepiploic
short gastric artery does not have anastomosis
=> susceptible for ischemic injury after splenic artery rupture.
L. gastroepiploic artery anastomoses with R. gastroepiploic
Q 19. What is target of isoniazid?
mycolic acid synthesis
Q 21. What electrolyte imbalance should be considered with succinylcholine? what serious complication is caused by this electrolyte imbalance?
hyperkalemia -> cardiac arrhythmia
succinylcholine is depolarizing muscle relaxant.
constant depolarization => hyperkalemia
Q 22. What is renal compensation to high altitude sickness? Within how many hours will renal compensation occur?
high altitude -> respiratory alkalosis
renal excretion of HCO3- (or decreased renal HCO3- reabsorption) to compensate
compensation occurs usually within 24-48 hrs
Q 23. Mass in lymph node. What needs to be checked to ensure that this mass is malignant?
key difference between simple hyperplasia and neoplasia is that hyperplasia is polyclonal expansion, while neoplasia is monoclonal expansion
- according to pathoma,
relative amount of Ig light chain isoforms (kappa:lamda) is normally 3:1. But in neoplasia ratio can bump up to 6:1, indicating monoclonal expansion. - Pathoma p.23 extensively covers this topic
Q 25. Pathophsiology of gait ataxia in Friedrich ataxia?
degeneration of spinocerebellar tract and lateral corticospinal tract
Q 27. Key difference between atopic dermatitis and dermatitis herpitiformis? what about similarity?
key difference is onset age
- atopic dermatitis: common in all age
- dermatitis herpiformis: as a complication of celiac, it happens at 40-50 age.
Both presents as pruritic rash
