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Uworld > Random Q set 2 > Flashcards

Random Q set 2 Flashcards

1
Q

Which enzyme can be defective & predispose a patient to diabetes, perhaps gestational diabetes?

A

glucokinase, b/c this is on pancreatic beta cells, & not in other tissues (hexokinase). Thus, it may not be able to sense that there is glucose there & that they should release insulin.

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2
Q

IV drug abuser is predisposed to staph aureus infective endocarditis, messed up tricuspid valve. What is a complication of this that could cause death?

A

throw blood clots to lungs. get hemorrhagic pulmonary infarcts.

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3
Q

What is Berkson’s bias?

A

selection bias when hospitalized patients are the control group

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4
Q

What is lead-time bias?

A

when you have a screening test, detect diseases much earlier than you would have normally

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5
Q

What is the Pygmalion effect?

A

researchers belief in the efficacy of the treatment may affect the outcome

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6
Q

What is the Hawthorne effect?

A

observer effect

study subjects change their behavior when they feel like they are being watched.

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7
Q

What are some examples of HIV drugs that require intracellular phosphorylation for activation?

A

nucleoside reverse transcriptase inhibitors (NRTIs)
zidovudine
zalcitabine

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8
Q

What are some examples of HIV drugs that do NOT require intracellular phosphorylation for activation?

A

non-nucleoside reverse transcriptase inhibitors (NNRTIs)
nevirapine
efavirenz
delavirdine

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9
Q

What is the MOA of ritonavir in HIV treatment?

A

inhibitor of HIV protease

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10
Q

MOA of enfuvirtide in HIV treatment?

A

inhibitor of HIV fusion

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11
Q

What are the common features of DOwn’s syndrome?

A 
flat face
flat nasal bridge
up-slanting palpebral fissures
epicanthal folds
small mouth
single palmar creases
MR
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12
Q

Usu Down’s syndrome is caused by trisomy, 21. In rare cases, what genetic defect can cause it?

A

Robertsonian translocation & mosaicism.

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13
Q

How do CD8+ cells recognize foreign antigens?

A

With MHC 1 presenting cells.

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14
Q

What are MHC I proteins composed of?

A

heavy chain + beta 2 micro globulin

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15
Q

What are the different types of organ rejection?

A

hyperacute
acute (1-4 weeks), host CD8 cells against foreign MHCI
chronic

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16
Q

What is the treatment for acute organ rejection?

A

calcineurin inhibitors–cyclosporine, tacrolimus

corticosteroids

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17
Q

What is the significance of ERB-B2 sensitivity?

A

aka Her-2/neu, determines if the breast cancer will respond to trastuzumab treatment

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18
Q

What is the significance of ER/PR positivity in breast cancer?

A

determines whether the breast cancer will respond to tamoxifen

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19
Q

What are the main features of chronic bronchitis? What is its leading cause?

A 
thick bronchial walls
neutrophil infiltration
mucous gland enlargement
patchy squamous metaplasia
**leading cause--smoking
20
Q

Which part of the heart is closest to the esophagus? posterior to the esophagus @ the same place?

A

left atrium

descending aorta

21
Q

Describe the conc’n of the tubular fluid in the kidney after the glomerulus.

A

PCT ~300 (isotonic w/ blood). Water & electrolytes are absorbed here.
Descending Limb –>1200 (only water reabsorbed)
Ascending Limb–>1200 b/c of ADH & water reabsorption

22
Q

When do you usu see a Mallory Weiss tear?

A

a tear in the gastric mucosa near the gastroesophageal junction
tight lower esophageal sphincter
often caused by repetitive vomiting
vomiting produces metabolic alkalosis

23
Q

What is cricopharyngeal motor dysfunction?

A

can’t relax your pharyngeal muscles when you’re swallowing
increased pressure–get a Zenker’s diverticulum
**get choking, coughing, dysphagia, aspiration

24
Q

When you add carbidopa to levodopa…which symptoms can increase?

A

the peripheral symptoms are reduced, but the central symptoms, such as anxiety & agitation are increased.

25
Q

How do you get osteomalacia from cholestasis?

A

can cause malabsorption & nutritional deficiencies of fat-soluble vitamins
Vit D deficiency=osteomalacia

26
Q

What is the major virulence factor for strep pyogenes that is antiphagocytic & prevents complement activation?

A

Protein M

27
Q

When IgA nephropathy includes abdominal pain & purpuric skin lesions what is it considered?

A

Henoch-Schonlein purpura

28
Q

When you have metabolic alkalosis…which types are saline-responsive?

A

vomiting, loop diuretic use
lose water & chloride
**hyperaldosteronism can cause non-saline responsive metabolic alkalosis

29
Q

What are some TCAs?

A

amitriptyline
imipramine
doxepin
clomipramine

30
Q

What are possible negative side effects of TCAs?

A

anticholinergic effects, can cause urinary retention in patients with BPH

31
Q

Mucopurulent cervicitis w/ cervical motion tenderness indicates what?

A

PID from N. gonorrhea or chlamydia

can cause scarring of fallopian tubes & infertility

32
Q

Talk a little about beta oxidation & what it produces.

A

Beta oxidation in mitochondria.
carnitine transfers thru the mitochondrial membranes.
produces acetyl coa for tca & ketone bodies, including acetoacetate.

33
Q

Tryptophan is a precursor to which substance?

A

serotonin

34
Q

What is serotonin syndrome?

A 
confusion
agitation
tremor 
tachycardia
HTN
clonus
hyperreflexia
hyperthermia
diaphoresis
35
Q

What can be used to treat serotonin syndrome?

A

cyproheptadine

antihistamine that has anti-serotnergic properties

36
Q 
Rate these in terms of sodium binding strength:
1A
1B
1C
Antiarrhythmics.
A

1C>1A>1B

37
Q

What is polycythemia vera?

A

clonal myeloproliferative disorder of pluripotent hematopoietic stem cells
increased RBC mass
increased plasma volume
decreased EPO level
JAK2 V617F mutation
**bone marrow has increased sensitivity to growth factors

38
Q

What does it take to improve the opthalmic symptoms of hyperthyroidism?

A

high dose glucocorticoids

39
Q

Glucagon should be used to treat patients who overdose on beta blockers. Why is this a good drug?

A

b/c it increases HR etc independent of adrenergic receptors

GPCR, activates adenylate cyclase, increases cAMP

40
Q

What are the 2 most common causes of subaranchnoid hemorrhage & the “worst headache of my life”?

A
  1. ruptured aneurysms

2. AV malformation

41
Q

Berry aneursym in the Circle of Willis are associated with which disease?

A

polycystic kidney disease

42
Q

Which nerve can be damaged during bladder surgery? Which foramen does it pass thru? Which action is compromised?

A

obturator nerve
passes thru the obturator foramen
adduction of the thigh

43
Q

When do you see air in the biliary tree?

A

when there is a fistula passing b/w the biliary tree & the small intestine
can develop this fistula from pressure from a large longstanding gallstone
*gallstone ileus-gallstone may pass into SI

44
Q

If you see a calcified gallbladder what do you think?

A

porcelain gallbladder
puts patients at higher risk for gallbladder carcinoma
cholecystectomy recommended

45
Q

What is the wobble phenomenon?

A

the fact that some tRNAs can bind multiple AA

Uworld (5 decks)

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