Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Uworld > Test 29 > Flashcards

Test 29 Flashcards

1
Q

How does Nitroprusside work? how does it impact preload and afterload and stroke volume

A

short-acting balanced venous and arterial vasodilator

  • decreases both preload and afterload
  • same stroke volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Specific MOA of Nitroprusside

A

increase cGMP via direct release of NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Side effect of Nitroprusside

A

cyanide toxicity (releases cyanide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the role of carbonic anhydrase activity in erythrocytes

A

forms bicarbonate from carbon dioxide and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Explain chloride shift? what does this cause

A
  • bicarb diffuse out of RBC into plasma
  • maintain neutrality, Cl- diffuse into RBC
  • high RBC chloride content in venous blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is spectrin

A

structural component of membrane of RBC

-gives cell flexibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Role of 2,3-DPG

A

combines with hemoglobin

- decreases affinity for oxygen, facilitates oxygen delivery to tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is glucose-6-phosphate dehydrogenase enzyme found in the pathway

A

first enzyme in pentose phosphate pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how do glucose-6- phosphate deficiency pts present

A

episodic hemolysis induced by oxidant stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Abusive head trauma can be caused by vigorous shaking of an infant and results in what

A

subdural hemorrhage and retinal hemorrhages

  • injuries inconsistent with history or developmental age
  • posterior rib fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What gets torn in subdural hemorrhages

A

tearing of bridging veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does a child start rolling

A

by 6 months rolls and sits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what causes idiopathic thrombocytopenia purpura

A

platelet autoantibody formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

All newborns are deficient in what vitamin

A

K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the difference between shaken baby syndrome and vitamin K deficiency in child

A

no retinal hemorrhages seen in vitamin K deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is ocular exam for retinoblastoma

A

absence of “red reflex”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the most common ocular tumor of infancy

A

retinoblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

compare perfusion in the lung

A

increases from the apex of lung to the base

- base gets most perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

compare ventilation of the lung

A

increases slightly from apex to the base

- apex gets most ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the V/Q in the lung

A

ratio decreases in the lung from apex to base

- highest at apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the zones of perfusion

A

Zone 1, 2, 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Zone 1 of lung

A
  • apex of lung
  • alveolar pressure, arterial pressure, venous pressure
  • pulmonary capillaries collapsed
  • alveolar dead space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Zone 2

A
  • middle of lung
  • arterial pressure, alveolar pressure, venous pressure
  • pulsatile fashion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Zone 3

A
  • lower lung

- arterial pressure, venous pressure, alveolar pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

in pregnancy who secretes progesterone

A
  • corpus luteum

- then later by placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the [prolactin] during pregnancy? what inhibits prolactin from doing it’s job

A

increases as pregnancy progresses

- progesterone works at anterior pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

role of prolactin

A

peptide hormone promotes milk production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

where is prolactin released from

A

anterior pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what stimulates prolactin production

A

thyrotropin-releasing hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Who secretes Beta-hCG during first trimester

A

embryonic syncytiotrophoblast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

role of Beta-hCG

A
  • maintains corpus luteum until placenta assumes responsibility for estrogen and progesterone synthesis
  • hormones level drop as pregnancy continues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Fibrinolytic system causes what

A

reperfusion arrhythmia on arterial re-opening

- arrhythmias usually benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Strepktokinase

A

non-specific fibrinolytic durg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tisuse plasminogen activitor (tPA), reteplase, and tenecteplase are what

A

fibrin specific drugs

- act only on fibrin attached to recently formed clot without systemic activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Deficiency of vitamin B12 is associated with

A
  • megaloblastic anemia

- neurologic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Folate deficiency is associated with

A
  • megaloblastic anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

treatment of deficiency in vitamin B12 with folate and vice versa can improve what? treatment of B12 deficiency with folate alone can do what

A
  1. improve hemoglobin levels

2. worsen neurologic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

patient being treated with folic acid for anemia. Then experiences bilateral foot numbness. What vitamin is she deficient in

A

Vitamin B12 (Cobalamin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the relationship between folate and phenytoin? impact

A

high doses of folate may antagonize phenytoin

- precipitating seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the most important environmental risk factor for pancreatic cancer? other

A
  • smoking

- greater than 50, chronic pancreatitis, DM, MEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Courvoisier sign

A

palpable but nontender gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q
  1. Courvoisier sign
  2. weight loss
  3. obstructive jaundice ( associated with pruritus, dark urine, and pale stools)

these indicate what

A

adenocarcinoma at head of pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what patient would be put on a low-fiber diet

A

risk for colon adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

H. pylori increases the risk for what

A

gastric adenocarcinoma

gastric lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is sertoli-leydig cell tumors of the ovary

A

arise from sex cord stroma and secrete testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

clinical features of sertoli-leydig tumors of ovary

A
  • large ovarian mass

- virilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

histo for sertoli-leydig tumor of ovary

A
  • tubular structures lined by Sertoli cells

- surrounded by fibrous stroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is granulosa cell tumor

A

sex cord-stromal tumor

- produces excessive estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

hist for granulosa cell tumor

A

Call-exner bodies - small follicle-like structures filled with eosinophilic secretion that lined by granulosa cells containing coffee bean nuclei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

how does endodermal sinus (yolk sac) tumor present

A

abdominal pain due to ovarian torsion without virilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

histo for endodermal sinus (yolk sac)

A

Schiller-Duval bodies: glomerulus-like papillary structures with a central vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the most common benign germ cell tumor

A

mature cystic teratoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is mature cystic teratoma on histo

A

keratinized epithelial tissue with sebaceous glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the most common epithelial ovarian cancer

A

serous cystadenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

how does serous cystadenocarcinoma present

A
  • post-menopausal
  • adnexal mass
  • ascites without excess hormonal activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

autopsy for serous cystadenocarcinoma

A

Psoamma bodes: concentrically laminated, calcified spheric deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

A side effect of using inhaled glucocorticoids

A
  • oropharyngeal candidiasis

- dysphonia - myopathy of laryngeal muscles and mucosal irritation

58
Q

young Female patient with virilization, amenorrhea for 5 months, adnexal mass, large ovarian cyst

A

Sertoli-Leydig tumor

59
Q

increased alpha-fetoprotein is a serum tumor marker for what liver stuff

A

chronic viral hepatitis

hepatocellular carcinoma

60
Q

Serum tumor marker CA19-9

A

pancreatic

61
Q

serum tumor marker CA125

A

ovarian

62
Q

When is alpha-fetoprotein produced

A

fetal liver and yolk sac during gestation

63
Q

what should be suspected in young otherwise healthy patients with fatigue, progressive dyspnea, atypical chest pain or unexplained syncope

A

pulmonary hypertension

64
Q

pulmonary hypertension impact on heart

A

hypertrophy and/or dilation of the right ventricle (cor pulmonale)

65
Q

severe right ventricular hypertrophy in young women with progressive dyspnea suggests

A

pulmonary arterial hypertension

66
Q

what is the physical finding of PAH pulmonary arterial hypertension

A

intimal hyperplasia
fibrosis
medial hypertrophy
capillary tufts

67
Q

Wolff-Parkinson-White syndrome

A

electrophysiological abnormality of AV node conduction

histo: small accessory AV impulse conduction pathway anatomically separate from AV node

68
Q

when should a doctor suspect Wolff-Parkinson-White syndrome

A

sudden cardiac death in otherwise healthy young individual

69
Q

clinical presentation of tertiary syphilis

A
  • cardiovascular involvement

- gummas

70
Q

what is a guma

A

necrotizing granulomas occurring on skin, mucosa, subcutaneous tissue, and bones within other organs

71
Q

when does neurosyphilis occur

A

any stage of infection

72
Q

what is physical presentation of primary syphilis

A

chancre at the treponema pallidum inoculation site

  • 1-3 weeks after contact
  • resolves 3-6 weeks
73
Q

Secondary syphilis PE

A
  • macular rash on palms and soles

- Condylomata lata: large gray wart like growths

74
Q

Latent syphilis PE

A

asymptomatic

75
Q

Tertiary Late syphilis

A
  • Gummas
  • ascending aortic aneurysms ( calcifications seen on X-ray)
  • aortic valve insufficiency
76
Q

patients with granuloma inguinale, a sexually transmitted disease caused by what

A

Klebsiella granulomatis

77
Q

define cachexia

A 
anorexia
malaise
anemia
weight loss
generalized wasting
78
Q

role of tumor necrosis factor - alpha (TNF-alpha)

A
  • causes necrosis of some tumors in vitro
79
Q

who releases TNF-alpha

A

macrophages

80
Q

Where does TNF-alpha do?

A

hypothalamus, leading to appetite suppression

  • increases basal metabolic rate
  • fever
81
Q

Eaton-Lambert Syndrome

A

autoantibodies to voltage-gated calcium channels

82
Q

PE for eaton-Lambert syndrome

A
  • progressive, symmetric proximal muscle weakness ( rather than wasting)
  • Ocular and autonomic symptomts
83
Q

who synthesizes interferon-alpha

A

leukocytes

- anti viral and anti tumor

84
Q

who produces IL-3

A

activated CD4+ Th cells

- stimulates growth and differentiation of myeloid cells

85
Q

Transforming growth factor-beta function

A

inhibition of inflammatory response

- decreases T cell proliferation and cytokine production

86
Q

What does Thiazolidinediones bind to

A

peroxisome proliferator-activated receptor gamma (PPAR-gamma)

87
Q

what is peroxisome proliferator-activated receptor-gamma (PPAR- gama)

A

intracellular nuclear receptor

- transcriptional regulator of many genes involved in glucose and lipid metabolism

88
Q

one of the most important genes regulated by PPAR-gamma is one that codes for

A

adiponectin: cytokine secreted by fat tissue that enhances insulin sensitivity and fatty acid oxidation
- low in diabetics

89
Q

Diabetic drug target: intracellular mitochondrial enzyme

A

Metformin, reduces hepatic gluconeogenesis

90
Q

Diabetic drug target: membrane-bound enzymes

A

alpha-glucosidase inhibitors

91
Q

Diabetic drugs target: membrane ion channel

A

Sulfonylureas

92
Q

Diabetic drug target: surface adenylate cyclase-coupled receptor

A

Glucagon-like polypeptide-1 (GLP1-)

93
Q

Diabetic drug target: surface tyrosine kinase receptor

A

insulin

94
Q

what kind of drug is prioglitazone

A

thiazolidinediones

95
Q

MOA of fibrinolytic agents like alteplase

A
  • bind to fibrin in thrombus
  • activate plasmin
  • leads to thrombolysis
96
Q

most common adverse effect of thrombolysis

A

hemorrhage

97
Q

When is it advisable to give fibrinolysis

A

acute MI patients within 12 hours of symptoms

98
Q

which is preferred and why PCI vs. fibrinolysis

A

PCI: lower rates of intracerebral hemorrhage

99
Q

MOA of alteplase

A

binds fibrin in thrombus

  • converts entrapped plasminogen to plasma
  • plasmin hydrolyzes bonds in fibrin matrix
  • causing clot lysis
100
Q

signs of increased intercranial hemorrhage

A
  • decreased level of consciousness
  • asymmetric pupil
  • irregular breathing
101
Q

man comes in with MI, given Alteplase, then gets irregular breathing patterns and asymmetric pupils? what caused this condition

A

intracerebral hemorrhage

102
Q

what is the preferred disease-modifying treatment for patients with moderate to severe rheumatoid arthritis

A

Methotrexate

103
Q

adverse effects of Methotraxate

A

stomatitis
bone marrow suppression
liver function abnormalities

104
Q

middled- aged women with polyarthritis, morning stiffness , and systemic symptoms has what

A

Rheumatoid arthritis

105
Q

MOA for Methotrexate

A

folate antimetabolite

- halting purine and pyrimidine synthesis through irreversible binding of dihydrofolate reductase

106
Q

When is hydroxychloroquine used? toxicity

A

mild RA and systemic lupus erythematous

- irreversible retinopathy

107
Q

Minocycline MOA? toxicity

A

tetracycline antibiotic with weak antirheumatic activity

- photosensitivity dermatitis

108
Q

A women with RA, painful mouth ulcers and nausea. AST and ASP elevated. what drug is she taking

A

Methotrexate

109
Q

Ace inhibitors or angiotensin II receptor blockers cause what to arteries and GFR

A
  • efferent arteriolar vasodilation causes GFR to fall, may lead to acute kidney failure
110
Q

Atherosclerosis involving renal arteries can cause

A

bilateral renal artery stenosis

111
Q

reduced renal blood flow does what to GFR

A

decreased

112
Q

role of angtiotensin II on kidney

A

constricts the efferent arteriole

113
Q

difference between urethritis and cystitis

A
  • suprapubic pressure and tenderness more specific for cystitis
114
Q

where are pyuria and bacteriuria found in the urinary tract

A

both upper and lower urinary tract infections

115
Q

where are white blood cell casts found in urinary tract

A

form in renal tubules

116
Q

what does white blood cell casts with UTI indicate

A

acute pyelonephritis

117
Q

Sterile pyuria

A

WBC with no bacteria

118
Q

MOA of Rifamycin (Rifampin)

A

block action of bacterial DNA-dependent RNA polymerase

- inhibit transcription

119
Q

MOA for Isoniazid

A

inhibit mycolic acid synthesis

120
Q

side effect of rifamycins

A

harmless red-orange discoloration of body fluids

121
Q

what is the major cause of the morbidity and mortality from theophylline intoxication? other major concern

A

Seizures

- tachyarrhythmias

122
Q

how is theophyllin intoxication treated

A
  • activated charcoal: reduce GI absorption
  • beta blockers: cardiac tachyarrhythmias
    Benzodiazepines and barbiturates
123
Q

what can cause hematemesis and melena

A

iron poisoning

124
Q

what is used to treat acetaminophen toxicity

A

acetylcysteine

- glutathione donor

125
Q

severe sedation
respiratory depression
constricted pupils
what happened

A

opioid intoxication

126
Q

treatment for opioid intoxication

A

naloxone

127
Q

Cholesteatomas ? lead to?

A

collections of squamous cell debris that form a mass behind the tympanic membrane

  • may have hearing loss due to erosion into auditory ossicles
  • pearly mass
128
Q

A complete mole is composed of what ( reproductive)

A

multiple cystic edematous hydropic villi

- result from trophoblast proliferation

129
Q

what should be measured in complete mole?

A

Beta-hHCG

as increased levels may signify invasive mole or choriocarcinoma after uterine evacuation

130
Q

macroscopic appearance of complete mole

A

bunch of grapes

131
Q

What is the immunochemistry staining for complete moles

A

p57- negative

132
Q

classical clinical findings for complete mole

A

vaginal bleeding
hyperemesis gravidarum
theca-lutein cysts

133
Q

MOA for Baclofen ? impact?

A

agonist at GABA-B receptor at spinal cord level

- inducing skeletal muscle relaxation

134
Q

Duloxetine ? MOA? uses

A

norepinephrine reuptake inhibitor

- treat anxiety/depression

135
Q

what type of drug is Levetiracetam

A

anti-epileptic

136
Q

What type of drug is Nortriptyline? used for

A

tricyclic antidepressant

- treat neuropathic pain and migraine headaches

137
Q

MOA of Metformin

A
  • inhibits hepatic gluconeogenesis

- increases peripheral glucose utilization

138
Q

complication of metformin with a patient with underlying renal insufficiency

A

lactic acidosis

139
Q

What should be checked before placing someone on Metformin

A

serum creatinine

140
Q

3-hour glucose tolerance test used for

A

diagnose diabetes, esp. gestational diabetes

141
Q

Vanillylmandelic acid (VMA)? what is it. what is it used to screen

A
  • metabolite of catecholamines

- catecholamine-producing tumors ( pheochromocytoma_

Uworld (63 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions