Brainscape's Knowledge GenomeTM

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


See full index

uWorld Flashies > uWorld 49 > Flashcards

uWorld 49 Flashcards

1
Q

hyper IgM is inherited in what pattern

A

X-LINKED RECESSIVE

problem in class switching (CD40-CD40L interaction)

sinopulmonary, GI, and opportunistic infections (Pneumocystis, Cryptosporidium)

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

what changes in B cell class switching

A

SPACING out DNA coding for different types of the HEAVY CHAIN CONSTANT REGION until the desired isotope is reached. the VARIABLE REGION, and therefore the antigenic specificity of the antibody, the the same

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

exceptions to confidentiality include what

A

suspected child or elder abuse
knife or gunshot wounds
diagnosing reportable communicable disease
threats to hear self or others and reasonable ability to carry out the threat in the near future

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

what happens to hormone levels in menopause

A

FSH INCREASED due to resistant ovarian follicles and lack of feedback inhibition

menopause is lack of menses for 12 months (average age is 51)

associated with HYPOESTROGENIC SYMPTOMS (hot flashes, vaginal dryness)

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

what are the main factors influencing CEREBRAL BLOOD FLOW

A

SYSTEMIC BLOOD PRESSURE

  • above 150 causes ↑ cerebral BLOOD FLOW and ↑ ICP
  • below 50 causes hypo perfusion and potential cerebral ischemia

ARTERIAL BLOOD GASS LEVELS

  • DROP in PCO2 due to hyperventilation causes VASOCONSTRICTION, increasing VASCULAR RESISTANCE and reducing cerebral blood flow
  • lowering PCO2 is one of the measures to REDUCE ICP in MECHANICALLY VENTILATED patients with CEREBRAL EDEMA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

inducing sedation and therapeutic hypothermia can decreased BRAIN METABOLIC DEMAND, exerting what kind of effect

A

NEUROPROTECTIVE and improving ICP by reducing cerebral blood flow

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

what is the thecal sac

A

sheath of dura mater surrounding the spinal cord that contains CSF
increased ICP can cause displacement of CSP form the brain into the thecal sac

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

pCO2 has what effect on the brain

A

POTENT VASODILATOR of cerebral VASCULATURE

TACHYPNEA causes HYPOCAPNIA and cerebral VASOCONSTRICTION, thereby decreasing cerebral blood flow and intracranial pressure

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

what is seen histologically in reflux esophagitis

A

elongation of papillae

basal cell hypertrophy

intraepithelial eosinophils

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

fever, jaundice, anorexia, and IV drug use suggests what

A

VIRAL HEPATITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is seen histologically in viral hepatitis

A

pan lobular lymphocytic infiltrates, ballooning hepatocytes, hepatocyte necrosis and hepatocyte apoptosis

apoptotic heptoctes form round ACIDOPHILIC bodies known as COUNCILMAN BODIES or apoptotic bodies

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

whats the only specific therapy known to reduce pulmonary vascular resistance

A

NITRIC OXIDE

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

what is the only ligament of the uterus that extends posteriorly

A

UTEROSACRAL ligament

pelvic splanchnic nerves run on top of it

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

what causes infertility in CF patients

A

ABSENT VAS DEFERENS bilaterally (AZOOSPERMIA)

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

what could cause the liver to appear shrunken and atrophies on autopsy in a patient who recently had surgery in a foreign country

A

DRUG-INDUCED LIVER INJURY from inhaled anesthetic (HALOTHANE, used in foreign countries still)

HEPATOCELLULAR PATTERN OF INJURY0 can range from mild asymptomatic ↑ LFT to FULMINANT HEPATITIS (50% mortality rate)

extensive haptocellular damage can cause the liver to rapidly atrophy and appear SHRUNKEN on autopsy

widespread CENTRILOBULAR NECROSIS and inflammation of the PORTAL TRACTS and PARENCHYMA are obsessed, making the condition indistinguishable from fulminant viral hepatitis

thought to be a hypersensitivity reaction to the drug that causes and immune-mediated attack against hepatocytes

fever, anorexia, nausea, myalgia, arthralgias, ↑ LFTS, PROLONGED PROTHROMBIN TIME, leukocytosis, eosinophilia

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

what happens to albumin levels in acute liver injury

A

NOTHING (20 day half life)

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

what drugs are associated with osteoporotic fractures

A

anticonvulsants that induce CYP450 (phenobarbital, phenytoin, carbamazepine)- ↑ Vitamin D catabolism

aromatase inhibitors, medroxypregestrerone- ↓ estrogen

GnRH agonists- ↓ testosterone and estrogen

PPIs ↓ calcium absorption

glucocorticoids, unfractioned hep, thiazolidinediones- ↓ bone formation

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

what defines a pathologic fracture

A

fracture due to a force significantly less than that required to fracture a normal bone

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

PROXIMAL TUBULAR cell BALLOONING and VACUOLAR DEGENERATION in a patient with acute renal failure is consistent with what

A

ACUTE TUBULAR NECROSIS

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

presence of OXALATE CRYSTALS in the tubular lumen is highly suggestive of what

A

ETHYLENE GLYCOL poisoning thus the damage and renal failure is due to TOXIC RENAL INJURY

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

what is hepatorenal syndrome

A

advanced liver disease with portal hypertension and ascites may causing renal failure

hallmark of this condition is RENAL VASOCONSTRICTION

histologically the kidney is NORMAL and function goes back to normal once the liver is transplanted

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

what is seen in ethylene glycol poisoning

A

TOXIC, acute tubular necoriss with VACUOLAR DEGENERATION and BALLOONING of the PROXIMAL TUBULAR cells

high anion gap metabolic acidosis

increased osmolar gap

calcium OXYLATE CRYSTALS in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

MID-SHAFT humerus break will fuck up what nerve and artery

A

RADIAL NERVE

DEEP BRACHIAL ARTERY (aka profunda brachii artery)

24
Q

the radial nerve innervates what msucles

A

FOREARM EXTENSORS (TRICEPS)

HAND EXTENSORS at the wrist

extensors of the digits

BRACHIORADIALIS and SUPINATOR MUSCLES

25
Q

the brachial artery gets injured in what kind of injury

A

SUPRACONDYLAR FRACTURE (anteromedial displacement) or in the cubital fossa/distal humerus

with the MEIDAN NERVE

26
Q

injury to the SURGICAL NECK of the HUMERUS may damage what artery and nerve

A

ACILLARY NERVE and POSTERIOR CIRCUMFLEX ARTERY

27
Q

first pass elimination is based on what blood flow

A

LIVER BLOOD FLOW (not intestinal blood flow)

28
Q

in coronary steal pneomenon drugs like adenosine of DIPYRIDAMOLE do waht

A

selectively VASODILATOR CORONARY VESSELS

causes redistribution of blood flow through collateral micro vessels and coronary arterioles that can reduce collateral blood flow

arterioles within ischemic areas already maximally delated prior to drug admin so vasodilation occurs in nonischmic areas only causing MORE ISCHEMIA

29
Q

what kind of rash in seen in pseudomonas hot tub folliculitis

A

pruritic, papulopustuar rash

30
Q

etoposide is a derivative of what

A

plant alkaloid podophyllotixin, targets topoisomerase II

31
Q

whats the diff b/w topoisomerase I and II

A

topoisomerase I causes single-stranded nicks to relieve NEGATIVE supercoiling

topoisomerase II- induces transient breaks in BOTH DNA strands simultaneously to relive BOTH POSITIVE and NEGATIVE supercoiling

32
Q

what drug blocks thymidylate synthase

A

5-FU

it does not work on DHFR thats methotrexate

33
Q

irinotecan and topotecan do what

A

inhibit topoisomerase I (single-stranded breaks in DNA to relieve negative supercoiling

34
Q

PNEUMATOSIS INTESTINALIS (air in the bowel- curvilinear areas of lucency that parallel the bowel wall lumen) in an infant with abdominal distention and BLOODY STOOLS is diagnostic for what

A

NECROTIZING ENTEROCOLITIS (NEC)

one of most frequent GI emergencies in newborns (mainly PRETERM INTENTS secondary to GI and immunologic immaturity)

upon feeding bacteria proliferate excessively and impaired mucosal barrier function allows the bacteria to invade the bowel wall, causing inflammation and ischemic necrosis of terminal ileum and colon

bowel becomes congested and gangrenous with the formation o INTRAMURAL GAS COLLECTIONS

30% die but survivors at risk for STRICTURES and BOWEL OBSTRUCTION

35
Q

what type of epithelium is found in the different parts of the female reproductive tract

A

ovary- simple cuboidal i.e. germinal (rapidly proliferate to pre air ovulatory surface defects)

fallopian tube- simple columnar (ciliated cells transport egg/embryo, damage can cause infertility, hydrosalpinx, entropic pregnancy)

uterus- simple columnar (stratum FUCNTIONALIS sloughs off during menstruation, prolonged estrogen exposure prevents shedding- hyperplasia/malignacny)

vagina- stratified squamous non-keratinized (maintains acidic environment to prevent infection)

cervix:

  • ectrocervis: stratified squamous non-keratinized
  • endocervix: simple columnar
  • cervical glands secrete mucus- (thin and watery during ovulation, mucus plug in pregnancy)
  • HPV infraction predisposes to cervical malignancy
36
Q

what bugs are pyrrolidonyl arylamidase (PYR) positive

A

Strep progenes

enterococci

37
Q

describe HEREDITARY OROTIC ACIDURIA

A

AR disorder of de novo pyrimidine synthesis

defect in URIDINE 5’MONOPHOSPHATE (UMP) SYNTHASE

PHYSICAL and MENTAL RETARDATION (low height/weight, developmental milestones)

MEGALOBLASTIC ANEMIA

elevated urinary OROTIC ACID levels (also seen in ornithine transcarbamylase deficiency but they would also have failure to thrive and hyperammonemia encephalopathy from impaired urea synthesis)

TX: URIDINE SUPPLEMENTATION bypasses this enzymatic defect and improve symptoms as uridine is covered to UMP via nucleoside kinases

38
Q

rheumatoid arthritis affects what part of the spine

A

CERVICAL SPINE (leading to SPINAL INSTABILITY and potentially to radiculopathy and cord compression)

39
Q

arthritis in the thoracic and lumbar spine are usually due to what

A

thoracic: osteoarthritis or spondyloarthritis
lumbar: osteoarthritis

40
Q

what electrolyte changes are seen in PRIMARY ADRENAL INSUFFICIENCY (ADDISON)

A

HYPERKALEMAI
HYPONATREMIA
HYPERCHLOREMIA
non-anion gap METABOLIC ACIDOSIS

41
Q

horners syndrome can occurs from lesions where

A

lateral hypothalamus
hypothalamospinal tract
superior cervical ganglion (pan cost tumor)
internal carotid artery (carotid dissection)

42
Q

rubber, amine-containing dyes, textiles, leather industry work puts you at higher risk for what kind of cancer

A

BLADDER

43
Q

what are the risk factors for great cancer

A

early menarche
late menopause
NULLIPARITY
BRCA mutations

44
Q

charred or fried foods as well as obesity put you at risk for what cancer

A

COLORECTAL

so does HNPCC, FAP, IBD

45
Q

hemochromatosis put you at risk for what cancer

A

LIVER

so does Hep B and C, liver cirrhosis (any cause), aflatoxin

46
Q

what is WHIPPLES TRIAD (symptomatic hypoglycemia)

A

symptoms of hypoglycemia( tremor, diaphoresis, confusion)
low blood glucose level
relief of hypoglycemic symptoms when the blood glucose is increased

47
Q

what are brown and black pigment stones

A

BROWN: associated with biliary tract infections (microbes producing beta-glucoronidases)

BLACK: occur in setting of chronic hemolytic anemia (sickle cell disease) and increased enterohepatic cycling of bilirubin (Crohns disease)

48
Q

what is biliary sludge

A

due to gallbladder HYPOMOTILITY

biliary STASIS results in bile concentration, promoting bile precipiaiotn and at the accumulation of particulate material (cholesterol monohydrate crystals, calcium bilirubinate, mucus)

know precursor to stone formation (especially cholesterol stones) and may be complicated by biliary colic, acute cholecystitis, cholangitis, and pancreatitis

49
Q

what are risk factor for gallbaldder hypomotility and thus biliary sludge

A

pregnancy
rapid weight loss
high spinal cord injuries
prolonged use of total parenteral nutrition or octreotide

50
Q

what is intertrigo

A

well-defined erythematous plaques with satellite vesicles or pustules in warm, moist skin areas (axillae, groin, skin folds)

usually do etude candida

51
Q

what contributes to formation of PE

A

VIRCHOW TRIAD:
endothelial cell injury
venous statin

HYPER COAGULABLE STATE (particularly due to cancer)

52
Q

crutch or satruday night palsy fucks up what nerve

A

RADIAL (proximal injury)

weakness or paralysis or forearm, hand, and finger EXTENSOR MUSCLES (wrist drop, absent triceps reflex)

(mid shaft humerus breaks spare the triceps)

53
Q

a ventiatlion defect matched by a perfusion defect (matched defect) usually indicates what

A

lung collapse or consolidation

if its not matched (PE)

54
Q

how does mismatch repair work

A
  • starts with MutS homolog detecting mismatch on newly created daughter strand (done by creating nicks in the phosphodiester bonds)
  • MutL homolog then recruited and slides along the DNA until it finds one of the nicks in the daughter strait
  • EXONUCELASE 1 is then loaded onto and activated by the repair complex degrading the daughter strand BACKWARDS past the initial mismatch point, leaving a variable gap of ss-DNA the is stabilized by DNA-binding protein
55
Q

ionizing radiation fucks DNA up how, what fixes it

A

double stranded breaks

repaired via end joining mechanisms (non-homologous is prone to more mutations than homologous recombination)

56
Q

what is INSULITIS

A

infiltration of islet cells by inflammorty cells in early stages of T1DM

cell-mediated immunity causes destruction of beta islet cells not the antiboeis that are foudn

57
Q

what is maturity-onset diabetes of the young

A

AD disease caused b mutations in GLUCOSE SENSING and INSULIN SECRETION by pancreatic beta cells

no-insulin dependent diabetes at a tong age (less than 25)

uWorld Flashies (62 decks)

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