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Review / Wrong Answers > 6/17 UWorld > Flashcards

6/17 UWorld Flashcards

1
Q

What is the damage caused to DNA by UV light

A

Thymine dimers

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2
Q

What is first line treatment for BPH?

Do they affect size of prostate

A

Alpha-1 antagonists (“-zosin”)

Do not change size of prostate

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3
Q

Which drug is used to decrease size of prostate

A

5-a reductase inhibitors (e.g. Finasteride)

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4
Q

Diagnostic criteria of pre-eclampsia

A

HTN

+

Protenuria OR signs of end-organ damage

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5
Q

Describe presentation of Neurofibromatosis type 1

A
  • Neurocutaneous disorder characterized by café-au-lait spots, cutaneous neurofibromas, optic gliomas, pheochromocytomas, Lisch nodules (pigmented iris hamartomas)
  • Neurofibromas consist of proliferation of Schwann cells, fibroblasts, and neurites
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6
Q

What is the most common renal stone?

A

Calcium stone

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7
Q

What are the 2 radioopaque kidney stones (seen on X-ray)

A

Calcium

Ammonium magnesium phosphate

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8
Q

What are the 2 radiolucent (not seen on XR) stones?

A

Uric acid

Cysteine

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9
Q

In internuclear ophthalmoplegia, is the affected eye (the one that cannot adduct) ipsilateral or contralateral to the MLF lesion?

A

Ipsilateral

  • E.g. if there is a lesion of the right MLF, when you look L, the R eye will not be able to look medially
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10
Q

What is the MOA and uses of Cilostazol

A
  • Inhibition of phosphodiesterase leads to increases cAMP within the platelet which will activate protein kinase A, and impairing platelet function and aggregation n
    • = sign UP for cAMP = increased camp
  • Causes arteriole vasodilation (due to increased cAMP)
    • =dilated red sleeves
  • Can treat symptoms of claudication due to peripheral artery disease
    • = dirt clods hitting leg
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11
Q

Adverse effect of Cilostazol

A
  • Can cause coronary steal
    • = stolen heart base
  • When there is stenosis in an artery, the body is already vasodilating, try to restore blood to that area
  • So if you give a vasodilator, all the other normal vessels will dilate even more, leading to even less blood going to the stenotic area, exacerbating ischemia
    • = dilated red hat crown = coronary artery vasodilation
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12
Q

Most commonly affected area in Crohn’s

A

Terminal ileum

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13
Q

AST and ALT indicate function of what organ?

A

Liver

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14
Q

Adverse effects of Methotrexate

A
  • Folate deficiency
  • Megaloblastic anemia
  • Myelosuppression and Pancytopenia
  • Increased risk of infection due to immunosuppression
  • _Pulmonary fib_rosis (restrictive lung disease)
  • Hepatotoxicity (should monitor LFTs)
  • Alopecia
  • Mucositis/oral ulcerations
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15
Q

What is the effect of an arteriovenous shunt on preload and afterload

A

Increased preload and decreased afterload due to shunting of blood out of arteries and into veins, bypassing arterioles

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16
Q

Presentation of Pick disease

A

Aka frontotemporal dementia

  • Early = Behavior/personality changes (frontal lobe) and/or aphasia (temporal lobe)
  • Late = Dementia
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17
Q

Lesion of subthalamic nucleus

A
  • Hemiballismus (involuntary flailing of limbs)
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18
Q

What nucleotide binds to what (A, G, T, C)

A

A binds to T with 2 bonds

G binds to C with 3 bonds

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19
Q

How do you get fromc cytosine (in DNA) to uracil (in RNA)

A

Uracil is a deaminated cytosine

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20
Q

Do purines/pyrimidines synthesis start with a base or ribose sugar

A

Purine starts with a sugar

Pyrimidine starts with a base

21
Q

Rate limiting step in pyrimidine synthesis

A

Carbamoyl phosphate synthetase II (in cytosol)

Vs. CPSI used in urea cycle in mitochondria

22
Q

What is the cause of megaloblastic anemia that does not respond to B12 or folate

A

Orotic aciduria

  • Failure to thrive
  • Developmental delay
  • Megaloblastic anemia refractory to folate and B12
  • No hyperammonemia
23
Q

What is the enzyme responsible for GMP/IMP salvage, preventing the formation of uric acid

A

Hypoxanthine-guanine phosphoribosyl transferase (HGPRT)

  • Deficient in Lesch Nyhan
24
Q

What is a common cause of SCID

A

Adenosine deamine deficiency

  • Increased dTAP = toxicity to lymphocytes
25
Q

Describe mismatch repair

What disorder is it defective in

A

Occurs during synthesis

Mismatch is recognized and removed, along with everything downstream of the mismatch; and then starts over

Defective in Lynch syndrome

26
Q

Describe the steps in base excision repair

A
  1. Glycosylase removes base, creating empty nucleotide
  2. Endonuclease removes the empty nucleotide
  3. DNA polymerase fills the gap
  4. Ligase seals it
27
Q

What is the only DNA repair that causes double-strand repair

A

Non-homologous end-joining

28
Q

What is the defect in Ataxia telangiectasia

A

Mutated ATM gene = defective nonhomologous end-joining

29
Q

What are the Gram + bugs covered by 1st gen and 2nd gen Cephalosporins

A
  • 1st gen - PEcK
    • Proteus, E. Coli, Klebsiella (UTI bugs)
  • 2nd gen = HENS PEcK
    • H. Flu, Enterobacter, Neisseria, Serratia + PECK
30
Q
A
31
Q

What are the stop codons

A

UGA, UAA, UAG

  • U Go Away
  • U Are Away
  • U Are Gone
32
Q

What causes removal of repressor protein and activation of transcription factor in lac operon

A

No glucose = activation of transcription factor (CAP)

Lactose present = removal of repressor protein

33
Q

Where does transcription and translation occur

A
  • Transcription occurs in the nucleus to mature mRNA
    • Only 5’ capped, 3’ tail, and spliced mRNA can leave the nucleus
  • Translation occurs in the cytosol
34
Q

What is the signal for Poly-A polymerae to add a tail

A

AAUAAA

35
Q

Does aminoacyl tRNA synthesis work at the 5’ or 3’ end of tRNA, and what codon is at that end

A

3’ end with a CCA sequence

THINK: CCA = Can carry amino acids

36
Q

Where are ribosomes synthesized

A

Nucleus

37
Q

What is the functino of initiation factors

A

Part of translation

Assembe the smaller RNA subunit with tRNA

IF’s are released when the larger RNA subunit attaches

38
Q

What acid-base disorder (resp/met alk/acid) will occur during high altitude?

Will you see high or low:

  • pH
  • pO2
  • pCO2
  • HCO3
A

Respiratory alkalosis (body starts hyperventilating in order to compensate for low O2)

  • pO2 = low (due to altitude)
  • pCO2 = low (due to hyperventilation)
  • pH = high (due to respiratory alkalosis)
  • HCO3 = low (due to compensation for alkalosis)
39
Q

What is the purpose of V(D)J recombination

A

Antibody diversity

40
Q

What is the presentation of galactokinase deficiency

A
  • Deficiency in galactokinase = mild condition
  • Leads to accumulation of galacticol
  • Symptoms:
    • · Infantile cataracts
    • · Galactosemia and galactosuria
41
Q

Describe the deficiency and presentation in Classic galactosemia

A
  • Classic galactosemia – severe condition
  • Deficiency in galactose-1-phosphate uridyltransferase
  • Symptoms:
    • · Infantile cataracts
    • · Failure to thrive
    • · Jaundice
    • · Vomiting
    • · Hepatomegaly
    • · Renal dysfunction
    • · Intellectual disability
    • · E. Coli sepsis
42
Q

What is Rett syndrome (inheritance, presentation)

A
  • X-linked dominant, almost exclusively in females (males die in utero)
  • Symptoms become apparent between 1-4 y/o
  • Regression: loss of development, loss of verbal abilities, intellectual disability, ataxia, stereotyped hand-wringing
43
Q

What inheritance pattern do most enzyme deficiencies follow?

A

Autosomal recessive

E.g. Classic galactosemia

44
Q

Will there be neutrophil or lymphocytic predominance present in the stool of a patient with V. cholera?

A

Neither - Vibrio is non-invasive

Toxin activated adenylate cyclase to increase cAMP, enhancing Cl- efflux and decreased Na+ reabsorption

Stool microscopy will show flecks of mucus and sloughed epithelial cells because toxin induces mucus ejection from goblet cells

45
Q

Inserts of the ACL and PCL

A

ACL = originates on the lateral femoral condyle and courses anteriorly and medially to insert on the anterior intercondylar area of the tibia

PCL = originates from medial condyle of femur and courses posteriorly to insert into posterior head of tibia

46
Q

What disorder presents with diplopia that worsens with use?

A

Myasthenia gravis

  • Clinical features:
    • Ptosis, diplopia, weakness
    • Worsens with muscle use
47
Q

What is the formula for Fick’s Principle for cardiac output?

A
  • CO = (Rate of O2 consumption) / (arterial O2 content – venous O2 content)
48
Q

Compression of what nerve causes Saturday night palsy

A

Radial

Recall that presentation includes inability to extend wrist

49
Q

What nerve is responsible for arm flexors (biceps, coracobrachialis)

A

Musculocutaneous

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