4/17 Uworld review Flashcards
(161 cards)
1
Q
non-membrane bound cytoplasmic lipid that shifts and sometimes causes scalloping of the nucleus.
-what am i describing?
A
liposarcoma.
2
Q
anisocoria
-define:
A
unequal size of pupils.
-can be benign or pathological.
3
Q
difficult swallowing & choking when drinking liquids.
-which nerve is possibly damaged?
A
vagus.
4
Q
HCM
-w/regard to preload & afterload, how do you reduce the murmur/outflow tract obstruction?
A
-Murmur is quieter w/increases in preload & afterload.
5
Q
IgA deficient pt getting blood products from normal person. Risk of what reaction?
A
anaphylaxis.
-type 1 HSR.
6
Q
DNA rep:
-which enzyme replaces RNA primers w/DNA?
A
DNA pol 1
7
Q
DNA rep:
-which enzyme replaces RNA primers w/DNA?
A
DNA pol 1
-only then does ligase join the DNA segments together.
8
Q
DNA rep:
-which enzyme replaces RNA primers w/DNA?
A
DNA pol 1
-only then does ligase join the DNA segments formed by DNA Pol 3 to the new segments formed by DNA Pol 1.
9
Q
(1-specificity) = __________ rate
A
(1-specificity) = false positive rate.
*specificity is about the true negatives. So true negatives + the false positives has to = 1.
10
Q
TP + TN / all obersvations =
A
accuracy
11
Q
(TP + TN) / all obersvations =
A
accuracy
12
Q
glyburide
-what is it?
A
sulfonylurea.
13
Q
alkaptonuria
-only non-benign Sx that can occur?
A
debilitating arthralgias.
14
Q
alkaptonuria
-only non-benign Sx that can occur?
A
debilitating arthralgias.
- due to deposition of the pigment in the joint cartilage.
- only happens once its built up a lot, so when pt is 40-50 yo.
15
Q
rigidity w/passive wrist flexion:
A
parkinsons
16
Q
cogwheel rigidity
-seen in what disease?
A
parkinsons
17
Q
foam stability test for fetal lung maturity
-what do you add to what?
A
ethanol + surfactant.
18
Q
What vertebral level is the pancreas?
A
L1
19
Q
why is heparin safer choice than warfarin during pregnancy?
A
heparin can not cross the placenta bc its water soluble.
- warfarin is lipid soluble & can cross the placenta.
- water soluble materials (ie. direct bilirubin) do not cross the placenta but lipophilic materials (ie. indirect bili) do.
20
Q
N. gonnorrhea
-virulence factor?
A
pili
-doesn’t have capsule like n. meningitidis.
21
Q
cotton-wool exudates on ophtho exam in AIDS pt?
A
CMV retinitis.
22
Q
recidivism
-define?
A
relapsing.
-ie. quitting smoking then starting back up again.
23
Q
Influenza: viral HA and NA proteins are coded by different segments.
A
good to know!
24
Q
Influenza: viral HA and NA proteins are coded by different segments.
-what does this predispose to?
A
allows genetic reassortment.
25
Influenza: viral HA and NA proteins are coded by different segments.
-what does this predispose to?
allows genetic reassortment which = antigenic shift.
26
phenotypic mixing
| -define:
when 2 viruses infect the same cell & progeny viruses exhibit coat or envelope proteins not coded for by their genetic material.
27
```
JVP tracing (aka RA pressures)
-a wave?
```
RA contraction.
28
JVP tracing (aka RA pressures)
- a wave?
- absent in which disease?
RA contraction.
| -absent in afib.
29
JVP tracing
- c wave?
- absent in which disease?
RV contraction pushes tricuspid in & causes inc in RA pressure.
-absent in tricuspid regurg (i believe).
30
nadir
| -define:
lowest point.
31
JVP tracing
- c wave?
- absent in which disease?
RV contraction pushes tricuspid in & causes inc in RA pressure.
32
JVP
- x descent
- absent in which disease?
- negative pressure as blood flows across from RV contraction.
- absent in tricuspid regurg.
33
Whats the only thing that will reverse the flow of a VSD?
Eisenmenger.
34
Damage to sup. colliculus
| -what sort of gaze palsy?
paralysis of conjugate vertical gaze.
| -parinaud syndrome.
35
How does phenylephrine dec. pulse pressure?
- reflex brady = dec. inotropy = dec. systolic.
| - arteriolar vasoconstriction = inc. diastolic.
36
does epinephrine vasoconstrict or vasodilate?
vasodilate
| -preferential action on beta-2 over alpha-1.
37
What is a TATA box?
part of DNA
| -promotes txn of the DNA into RNA.
38
What is a TATA box?
part of DNA
- promotes txn of the DNA into RNA.
- binding site of RNA Pol 2.
39
What is a TATA box?
part of DNA
- promotes txn of the DNA into RNA.
- binding site of RNA Pol 2.
- the TATA sequence itself is NOT transcribed.
40
what is a CAAT box?
same as TATA box.
41
what is a CAAT box?
same as TATA box.
| -initiates TXN.
42
defect in lysyl hydroxylase
| -which disease?
Ehlers Danlos.
43
stellate cell
- where is it found?
- aka?
- functions?
- liver
- ito cell
- vitamin A storage & can differentiate into myelofibroblast upon injury to liver & play big role in fibrosis of liver.
44
Which ABxs bind to 23s of 50s ribosome?
macrolides, clindamycin,
45
Cloramphenicol
| -mech:
Block peptidyltransferase at 50S ribosome.
46
Cloramphenicol
| -mech:
Block peptidyltransferase at 50S ribosome.
47
Which ABxs bind to 23s of 50s ribosome?
macrolides, clindamycin.
48
Which ABXs are neutralized by modifying the drug?
chloramphenicol & aminoglycosides.
49
spleen contains ~ 1/2 the total Ig producing B cells in the body.
-another reason why sickle cell w/splenic infarct get infections.
50
spleen contains ~ 1/2 the total Ig producing B cells in the body.
-another reason why sickle cell w/splenic infarct get infections - bc IgG = needed for opsonization.
51
Radiation exposure
| -leads to which cancers?
leukemia, papillary carcinoma of thyroid, sarcoma, breast cancer.
52
High serum albumin level
| -may indicate what?
hemoconcentration.
53
Mab vs IL-2 receptor:
basiliximab
54
tardive dyskinesia
- what causes it?
- Tx:
- long term use of typical anti-psychotics. these meds block D2 receptors, and tardive dyskinesia happens bc the D2 receptors are then upregulated (w/concomitant dec. in ACh).
- Tx: stop all anti-cholinergic meds & ween off the anti-psychotic.
*much less common if using atypical anti-psychotics.
55
tardive dyskinesia
- what causes it?
- Tx:
Long term use of typical anti-psychotics. These meds block D2 receptors, and tardive dyskinesia happens bc the D2 receptors are then upregulated (w/concomitant dec. in ACh).
-Tx: stop all anti-cholinergic meds & ween off the anti-psychotic.
* aka, hypersensitivity to D2.
* much less common if using atypical anti-psychotics.
56
dopamine => NE
| -which enzyme?
dopamine beta-hydroxylase.
57
respiratory Sxs is SVC syndrome
| -due to what?
laryngeal edema.
58
What enzyme used by RNA viruses to replicate their genome?
RNA dep. RNA polymerase.
59
painful pharyngeal muscular spasms & neuro problems
| -which bug?
rabies.
60
where are negri bodies found?
- purkinje cells of cerebellum.
| - hippocampus.
61
most common cause of human rabies in the USA?
bats
62
painful pharyngeal muscular spasms & neuro problems
| -which bug?
rabies.
| -hydrophobia results due to choking while drinking.
63
baroreceptor firing frequency & BP
- relationship?
- directly or inversely related?
directly related.
64
reflex tachy
| -mediated by which nerves?
- dec. vagal tone
| - inc beta-1 tone
65
are corticosteroids okay to use in pregnancy?
yes
| -they are category C - so they can be used.
66
sulfasalazine
| -can be used in which diseases?
IBD & RA.
67
Category A, B, C, D
| -can these be used in pregnancy?
yes
| *category D has risks but can be used in some cases.
68
Category X
| -can it be used in pregnancy?
no
69
orlistat
| -mech?
inhibit intestinal lipase.
70
blood from most pelvic organs drain into which vein?
internal iliac vein.
71
blood from most pelvic organs drain into which vein?
internal iliac vein.
* also from middle rectal vein.
* inf rectal vein => internal pudendal.
72
blood from most pelvic organs drain into which vein?
internal iliac vein.
* also from middle rectal vein.
* inf rectal vein => internal pudendal => internal pudendal.
73
Hydrophobic AAs:
glycine, alanine, valine, leucine, isoleucine, phenyalanine, tryptophan, methionine, proline.
74
Only sinus that receives blood from facial veins?
cavernous sinus.
75
Only sinus that receives blood from facial veins?
cavernous sinus.
| *acute infection of face could spread here.
76
which sinus drains finally into the IJ?
sigmoid sinus.
77
Is VSD ever going to cause cyanosis in an infant?
For our purposes, NO.
| -answer is probably going to be tetrology of fallot.
78
severe anemia does not usually result in cyanosis.
good to know.
79
amebiasis
- refers to infection w/what?
- why is it seen in homos?
entamoeba histolytica
| -can be spread oral-anal.
80
lumbar lordosis
| -which muscles are flexed too much?
hip flexors.
| *not extensors!
81
hypertensive woman that gives birth to baby w/congenital renal problems.
-you can assume the mother was on what meds?
ACE inhibitors.
82
Why do they call apoB-48 this?
its a truncated version of apoB-100.
| -its 48% of the size.
83
Lisch nodules
- which disease
- what is it? what exactly is pigmented?
- NF1
| - pigmented iris hamartomas.
84
niacin
| -mech:
- dec liver VLDL synthesis.
| - dec. HSL activity so less lipids are sent to bloodstream.
85
friable, inflamed mucosa in rectum + neutrophils in crypt lumina.
-which disease?
UC.
86
friable, inflamed mucosa in rectum + neutrophils in crypt lumina. multiple pseudopolyps.
-which disease?
UC.
87
Drug eluting stents
- which drugs typically used?
- for what purpose?
- paclitaxel or sirolimus.
| - to prevent intimal hyperplasia - so you dont get stenosis again.
88
herpesvirus
| -whats special about it w/regards to assembly?
- assembles in nucleus and has a nuclear envelope.
| - dsDNA virus.
89
Only RNA viruses that replicate in nucleus?
influenza & retroviruses.
90
Only DNA virus that replicates in cytoplasm?
poxvirus.
91
HHV-3
| -which virus is this?
herpes zoster
| -aka shingles.
92
Upon termination of insulin action, how is GLUT-4 taken back into the cell?
clathrin-coated pits.
93
saphenous nerve
| -pure motor or pure sensory?
pure sensory nerve.
94
saphenous nerve
- pure motor or pure sensory?
- for which part of body?
pure sensory nerve for medial leg & foot.
95
NF-kB
- what does it do?
- what are corticosteroid actions on it?
- its the txn factor that encodes inflammation. It induces production of TNF-alpha & other pro-inflammatory chemicals.
- corticosteroids inactivate NF-kB.
96
H-bonding btwn hydroxyproline residues stabilizes the triple helix structure (which is formed in the RER).
-good to know
97
lysyl oxidase
- what does it do?
- whats its cofactor?
- problem w/this = what disease?
- cross links extracellular collagen fibers via covalent bonds.
- copper
- problem w/cross-linking = Ehlers Danlos.
98
Generalized transduction
- can the virus w/bacterial DNA infect another cell?
- can it produce progeny?
- yes it can infect another bacteria.
| - no it can not produce progeny bc it has bacterial DNA in it, not its own viral DNA.
99
Huntingtons
| -whats the cause?
atrophy of the caudate.
100
Huntingtons
| -whats the cause?
atrophy of the caudate.
| -dec GABA & ACh.
101
Huntingtons
- whats the trinucleotide thats repeated?
- what amino acid does it code for?
- CAG
| - glutamine.
102
MCAD deficiency
- what is it?
- Sxs:
- inability to degrade medium chain FAs.
| - fasting hypoglycemia.
103
MCAD deficiency
- what is it?
- Sxs:
-inability to degrade medium chain FAs.
-fasting hypoglycemia (need acetyl-coa from FA oxid for gluconeo).
-
104
Any auto recessive enzyme deficiency.
- homozygous has no enzyme activity
- what about the heterozygous? does he have full? half?
- the heterozygous has half the enzyme activity.
- the enzyme is coded for on that allele, and he only has one working allele, which means he only makes half the amount of that enzyme.
105
blood CPK
| -whats cpk?
creatine phosphokinase.
106
does furosemide cause hypo or hyperkalemia?
| -how?
- hypokalemia
| - more Na delivered to collecting duct which means more aldo effect = wastes more H and K.
107
differentiating rhabdo from statins vs hypokalemia from furosemide:
- rhabdo = acute onset w/red urine.
| - furosemide induced hypokalemia = will happen over a week or so.
108
anti-SRP
| -which disease?
polymyositis/dermatomyositis.
109
young pt presenting w/herpes zoster
| -what should you test them for?
HIV (immunosuppression).
110
beta-1
| -inc or dec lipolysis?
inc. lipolysis
111
positive selection of T cells
- where in thymus does it happen?
- does this happen before or after negative selection?
- whats the selection process.
- cortex of thymus.
- before negative selection.
- testing T cells to see if they bind to MHC. If they dont, theyre disposed of.
112
negative selection of T cells
- where in thymus?
- does this happen before or after positive selection?
- whats the selection process?
- medulla
- after
- T cells binding too tightly to self MHC are disposed of.
113
RA morning stiffness
| -how long does it typically last?
almost over an hour.
114
RA morning stiffness
| -how long does it typically last?
~ 1 hr.
115
yellow under parallel light
| -gout or pseudogout?
GOUT.
116
microsatellite instability
| -due to what?
defects in DNA mismatch repair enzymes.
| -ie. HNPCC.
117
red/blue or yellow/brown nodules that involve the pelvic mucosal/serosal surfaces:
endometriosis.
118
dysmenorrhea & pelvic pain during periods
| -potential cause?
endometriosis.
119
dysmenorrhea & pelvic pain during periods w/random lesions in the peritoneal/pelvic cavity.
-potential cause?
endometriosis.
120
most common opportunistic pathogen invading GI tract of HIV pts?
CMV (a herpesvirus).
121
most common opportunistic pathogen invading GI tract of HIV pts?
CMV (a herpesvirus).
| -CMV colitis = 2nd most common reactivation syndrome after CMV retinitis.
122
most common opportunistic pathogen invading GI tract of HIV pts?
CMV (a herpesvirus).
-CMV colitis = 2nd most common reactivation syndrome after CMV retinitis.
*giant cells w/large ovoid nuclei containing central intranuclear inclusions (owl eyes).
123
Diarrhea in HIV pt
| -differential?
CMV
cryptosporidium
microsporidium
MAC
124
Diarrhea in HIV pt
| -differential?
- CMV
- cryptosporidium
- microsporidium
- MAC (will have granulomas & acid fast stain)
125
raltegravire
- what is it?
- mnemonic?
integrase inhibitor for HIV.
| -ralTEGRAvire = inTEGRAse inhibitor.
126
tortuous veins visible on lower abdominal wall
| -sign of what?
upstream blockage - whether it be portal HTN or IVC blockage.
127
carboxyHb
- Hb w/what attached?
- whats the O2 dissociation curve look like?
- carbon monoxide.
| - asymptotic instead of sigmoid.
128
Wilsons
| -where exactly is the copper deposited to get the kaiser Fleischer rings?
in the cornea.
129
- myeloperoxidase found where?
| - NADPH oxidase found where?
- myelo = inside lysosomes.
- NADPH oxidase = membrane protein present on phagosome.
*lysosome and phagosome will eventually fuse.
130
nests of nevomelanocytes w/hyperchromatic nuclei bridging w/nests in neighboring rete pegs:
dysplastic nevus.
131
nests of nevomelanocytes w/hyperchromatic nuclei bridging w/nests in neighboring rete pegs:
dysplastic nevus.
| -will become melanoma.
132
nests of nevomelanocytes w/hyperchromatic nuclei bridging w/nests in neighboring rete pegs:
dysplastic nevus.
| -can become melanoma.
133
most common skin cancer?
Basal cell carcinoma.
134
if they're going to describe basal cell carcinoma histologically, what will they most probably include?
nuclear palisading.
135
5 secondary brain vesicles
- what are they?
- mnemonic?
TDMMM
- telencephalon
- diencephalon
- mesencephalon
- metencephalon
- myelencephalon
136
telencephalon
| -becomes what?
cerebral hemispheres.
137
diencephalon
| -becomes what?
thalamus.
138
mesencephalon
| -becomes what?
midbrain.
139
myelencephalon
| -becomes what?
medulla.
140
Which ventricle goes through thalamus?
3rd ventricle.
141
aqueduct of sylvius goes thru what portion of brain?
midbrain.
142
alcoholic cerebellar degeneration
| -caused by degeneration of which cells?
purkinje cells.
143
alcoholic cerebellar degeneration
| -caused by degeneration of which cells?
purkinje cells.
| -cerebellum derived from rhombencephalon.
144
alcoholic cerebellar degeneration
- Sxs:
- caused by degeneration of which cells?
- ataxia, broad-based gait, truncal instability.
- purkinje cells.
- cerebellum derived from rhombencephalon.
145
leucine zipper
nucleic acid binding domain.
146
leucine zipper
nucleic acid binding domain.
| -like zinc-finger motif.
147
leucine zipper
nucleic acid binding domain.
-like zinc-finger motif.
*obvious not part of ligand binding domain bc every ligand binding domain will be unique.
148
gestational trophoblastic disease
- encompasses which diseases?
- which chemical is elevated?
- complete mole, partial mole, choriocarcinoma.
| - beta-HCG.
149
"tretin"
| -think what?
vitamin A.
150
dihydropyridines
| -selective for what?
-arteriolar smooth muscle.
151
how is galactose converted to glucose?
galactose => g-1-p => g-6-p then glucose-6-phosphatase converts it to glucose.
-unless of course the pt has von-gierkes, then g-6-p builds up & cant be converted to glucose.
152
how is fructose converted to glucose?
fructose => f-1-p => DHAP + glyceraldehyde => g-3-p...and eventually becomes g-6-p.
-glucose-6-phosphatase converts it to glucose, unless the pt has von gierkes, then g-6-p builds up.
153
why do you get lactic acidosis in von-gierkes?
Cori cycle: lactic acid made by muscle sent to liver.
- converted back to pyrvuate via LDH.
- pyruvate undergoes gluconeo and converts to glucose, & liver sends glucose back into blood.
- if you have von-gierkes, you cant do last step of gluconeo (no glucose-6-phosphatase) - so lactic acid builds up.
154
how is galactose converted to glucose?
galactose => g-1-p => g-6-p then glucose-6-phosphatase converts it to glucose.
-unless of course the pt has von-gierkes, then g-6-p builds up & cant be converted to glucose.
*built up g-6-p shunted to glycolysis & lactic acid prod.
155
how is fructose converted to glucose?
fructose => f-1-p => DHAP + glyceraldehyde => g-3-p...and eventually becomes g-6-p.
-glucose-6-phosphatase converts it to glucose, unless the pt has von gierkes, then g-6-p builds up.
*built up g-6-p shunted towrard glycolysis & lactic acid production.
156
What stains PAS (+)?
detects polysaccs like glycogen.
| -detects sugars!
157
Where is glycogen stored?
| -where is glycogen made?
- granules in the cytoplasm.
| - in the cytoplasm.
158
peroxisome beta-oxidation
| -what is the energy used for?
generate hydrogen peroxide.
159
high LH levels result in inc. conversion of testosterone to estradiol.
results in gynecomastia, for instance in klinefelters.
160
klinefelters
- whats the genotype?
- how did it occur?
- 47 XXY
| - materanl nondisjunction in meiosis.
161
klinefelters
- whats the genotype?
- how did it occur?
- 47 XXY
| - maternal nondisjunction in meiosis.
