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uWorld Flashies > uWorld 46 > Flashcards

uWorld 46 Flashcards

1
Q

what is the inheritance pattern of classical galactosemia

A

autosomal recessive

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2
Q

what is the inheritance pattern of Lesch-Nyhan syndrome

A

x-linked recessive

so is hemophilia B

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3
Q

what is tetanospasmin

A

protein toxin produced by C. tetani that can ravel by retrograde axonal transport into the CNS

binds GABA and GLYCINE receptors

TETANUS TOXOID (formaldehyde-inactivated tetanus toxin) vaccine- illicit HUMORAL IMMUNITY SPECIFIC for the TETANUS TOXIN

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4
Q

toxoid vaccines produce what kind of response

A

production of ANTITOXIN antibodies (active immunity)

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5
Q

immune defense against bacteria that the bacteria itself circulates causing infection produces what kind of response

A

antibodies that fix complement

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6
Q

regurgitant flow from the aorta into the left ventricle in chronic aortic regurgitation leads to an increase in left ventricular end-diastolic volume (preload) and wall stress, with resultant eccentric hypertrophy. Increases in left ventricular chamber size increases what that maintains the cardiac output

A

increases in STROKE VOLUME

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7
Q

nasal ulcerations, sinusitis, hemoptysis in setting of rapid progressive glomerulonephritis

A

Wegners

c-ANCA (targets neutrophil proteinase 3)

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8
Q

what are the first line medications or bipolar

A

lithium

valproate

quetiapine

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9
Q

squatting during Tet spells does what

A

increases SVR and decreases right-to-left shunting, thereby increasing pulmonary blood flow and improving oxygenation status

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10
Q

in the setting of low ADH where is the highest and lowest urine concentrations

A

highest: bottom of loop
lowest: distal convoluted tubules and connecting duct

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11
Q

beta thalassemia is due to what

A

mutations that result in defective transcription, processing, and translation of beta-globin mRNA

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12
Q

what buds are resistant to cephalosporins

A

LISTERIA (resistant PBPs)
MERSA (resistant PBPs)
ENTEROCOCCI (resistant PBPs)
Mycoplasma, Chlamydia (no cell wall)

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13
Q

what is the most common cause of meningitis in children over 28 days old

A

STREP PNEUMO

penicillin resistant so 3rd gen cephalosporin is first line

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14
Q

what drug is used to stop vasospasm after subarachnoid hemorrhage

A

calcium channel blocker No-mo-toppings NIMODIPINE

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15
Q

what is exaggerated sensitivity adverse drug reaction

A

predictable reaction occurring at lower than expected exposure

Tinnitus after single aspirin dose

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16
Q

what is idiosyncratic adverse reaction drug reactions

A

unpredictable reaction in certain patients

non immune hemolytic anemia with primaquine in G6PD deficiency

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17
Q

what is pierced in a suprapubic cystostomy

A

APONEUROSIS of the abdominal wall muscles, along with layers of the superficial fascias, transversals fascia, and exztraperitoneal fat

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18
Q

abduction of the thigh is done by what

A

gluteus medius and minimus (superior gluteal nerve)

tensor fascia lata

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19
Q

what does extension of the leg

A

quadriceps femrois muscle group

20
Q

what does extension of the thigh

A 
gluteus maximus (inferior gluteal nerve)
exits through greater sciatic foramen below the piriformis
21
Q

flexion of thigh is done by what

A

psoas, iliacus, and sartorial muscles

psoas innervated by lumbar plexus

iliacus is innervated by femoral nerve

22
Q

the major determinant of whether or not a coronary artery plaque will cause ischemic myocardial injury is what

A

the RATE at which it occludes the involved artery

this allows for the collaterals that could prevent myocardial necrosis

23
Q

the extent of tumor expansion is characterized by what

A

STAGE

not grade (degree of differentiation- well differentiated, mitotic figures)

24
Q

in meningococcal meningitis blood levels of what correlate closely with morbidity and mortality

A

lipooligosaccharide (LOS)

25
Q

decreased levels of consciousness, asymmetric pupils, and irregular breathing after alteplase administration

A

INTRA CEREBRAL HEMORRHAGE

26
Q

atrial fib is associated with increased risk of systemic thromboembolism, where does this form

A

left atrial appendage is most common site of thrombus formation

27
Q

what may contribute to the squamous metaplasia of the epithelial lining of pancreatic exocrine ducts

A

Avitaminosis A

vitamin A and its metabolite, retinoid acid, are required to maintain orderly differentiation of specialized epithelia, including mucus-secreting columnar epithelium

28
Q

xi in a monoclonal antibody means what

A

chimeric (human constant regions/ foreign variable regions)

29
Q

zu in a monoclonal antibody menas what

A

humanized (human constant and variable regions, except complementarity determining regions)

30
Q

what is CERTOLIZUMAB

A

humanized monoclonal antibody that targets TNF-alpha

used in treating autoimmune disorder associated with elevated levels of TNF-alpha

31
Q

imatinib treats what

A

philidelphia chromosome-positive CML

KIT-positive GIST

tyrosine kinase receptor inhibitor

32
Q

what is VITILIGO

A

relatively common condition

partial or COMPLETELY LOSS of epidermal MELANOCYTES

flat, well-circumscribed macule and patches of absent pigment, varying in size

loss of melanocytes and a complete absence of melanin pigment

33
Q

what is post inflammatory hypopigmentation

A

redistribution of existing melanin within the skin

may be associated with reduced transfer of melanin to keratinocytes

34
Q

what skin lesion shows increased melanosome aggregates within the melanocyte cytoplasm

A

CAFE AU LAIT SPOTS

35
Q

what are causes of polyhydramnios

A

Impaired Swallowing:

  • fetal GI obstruction (esophogeal, duodenal, or intestinal atresia)
  • anencephaly

Increased fetal urination:
-high fetal cardiac output (alloimmunization, parvovirus, fetomaternal hemorrhage)

maternal diabetes and multiple gestations can too but milder forms

36
Q

what seen in pemphigus vulgaris

A

antibodies to gesmoglein 3 and 3 (desmosomes)

INTRAEPIDERMAL cleavage
ACANTHOLYSIS (detached keratinocytes)
tombstone cells along basal layer

net like appearance of IgG on immunofluorescence

oral/mucosal involvement
FLACCID bull
nikolski sign positive

37
Q

what is seen in bulls pemphigoid

A

anti-bollous pemphigoid antigens 1 and 2 (hemidesmosomes)

SUBEPIDERMAL clevage
no pacantholysis

linear IgG at basement membrane on immunofluorescence

elderly
TENSE bull
rareoral/mucosal involvement

38
Q

adhesion of cells to the extracellular matrix involves integrin-meidated binding to what

A

FIBRONECTIN, COLLAGEN, and LAMININ

differential expression of integrin subtypes affects adhesion properties of individual cells, and has been found to create with malignant behavior in number of tumors

39
Q

what are examples of NMDA agonists

A

glutamate, aspartate, D-cycloserine

40
Q

what drugs are NMDA antagonsits

A

KETAMINE

PCP

41
Q

what are signs of PCP intoxication

A

dissociative and anesthetic effects but can cause psychosis and severe agitation leading to violent trauma
Ataxia, horizontal and vertical NYSTAGMUS, and delirium can be present

42
Q

what is the ESSENTIAL pathogenic mechanism for SHIGELLA infection

A

MUCOSAL INVASION of M cells overlying the Peyer’s patches

43
Q

what is silicosis

A

pneumoconioses

presents (10-20 years after initial exposure) with dyspnea on exertion and productive cough

nodular densities and calcifications of the rim of hilar nodes (eggshell calcification)

BIREFRINGENT SILCIA PARTICELS surrounded by fibrous tissue

APICAL LUNG regions

44
Q

what is seen in berylliosis

A

dyspnea and ill-defined nodular or irregular opacities on CXR

noncaseasting epithelia granulomas without obvious, assicaoted particels

45
Q

what is seen in coal workers pneumoconiosis

A

exertional dyspnea
nodular intertial opacities on CXR
nodal and perilymphatic lung tissue shows accumulations of coal dust-laden macrophages (coal macules)

46
Q

wha is hypersensitivity pneumonitis

A

inhalation of organic dusts

exertional dyspnea
diffuse nodular interstitial infiltrates on CXR

nodal tissue may reveal noncaseasting granulomas

47
Q

how is the diagnosis of tetanus made

A

history and physical examination

uWorld Flashies (62 decks)

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