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UWorld > 7.7.16 > Flashcards

7.7.16 Flashcards

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1
Q

atherosclerosis: most common vessels involved

A 
#1) abd aorta
#2) coronary A
#3) popliteal A
#4) internal carotid A
#5) circle of Willis
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2
Q

which has lower pressure: R vs L heart

A

R heart d/t lower resistance in pulm vasc

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3
Q

which has lower pressure: RV vs pulm A

A

RV bc pulm A has resistance to flow from the pulm circ

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4
Q

what is normal diastolic pressure in the RV? RA? central venous? pulm A?

A

central venous, RA, RV: 1-6mmHg

pulm A: 6-12

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5
Q

what nerves are involved in the pupillary light reflex?

A

afferent limb: CN II

efferent: CN III

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6
Q

what nerves open/close eye?

A

CNIII: open
CNVII: close

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7
Q

tibial N: motor fx

A
  • foot: plantarflex, inversion

- toe flex

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8
Q

tibial N: sensory fx

A

plantar foot

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9
Q

where/how can you injure tibial N?

A

level of popliteal fossa d/t deep penetrating trauma, knee surg

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10
Q

AV node: location

A

endocardial surface of RA –> near:

  • septal leaflet of tricuspid valve
  • orifice of coronary sinus
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11
Q

global cerebral ischemia: what struct is damaged first?

A

hippocampus

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12
Q

global cerebral ischemia: what cells are most susceptible to damage?

A
  • pyramidal cells of hippocampus & neocortex

- Purkinje cells of cerebellum

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13
Q

metronidazole + alcohol –> leads to?

A

disulfiram-like rxn (d/t acetaldehyde accum):

  • abd cramp
  • nausea
  • HA
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14
Q

adrenal crisis: ssx

A
  • severe hypotension
  • abd pain
  • vomit
  • weak
  • fever
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15
Q

adrenal crisis: tx

A
  • aggressive fluid resuscitation

- glucocorticoid

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16
Q

what is: 1ary biliary cholangitis

A

chronic autoimmune liver dz –> charact by:

  • lymphocytic infiltrates
  • destruction of small & mid-sized intrahep bile ducts
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17
Q

spironolactone: AE

A

antiandrogenic effects:

  • gynecomastia
  • decrease libido
  • impotence
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18
Q

benzodiazepine: MOA

A

enhance GABA effect at GABA-A receptor –> increased Cl- influx, suppress AP firing

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19
Q

what is: bioavail

A

fraction of admin drug that reach systemic circ in a chemically unchanged form

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20
Q

bioavail: calc

A

(area under oral curve)(IV dose) / (area under IV curve)(oral dose)

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21
Q

tetralogy of Fallot: major determinant of severity

A

degree of RV outflow tract obstruction –> determines degree of R–>L shunting & resulting cyanosis

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22
Q

increased activity of what cell is involved in pathogenesis of Crohn’s dz?

A

TH1 –> IL2, IFNgamma, TNF –> intestinal injury

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23
Q

noncaseating granuloma: Crohn’s or UC?

A

Crohn’s

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24
Q

what is special about GLUT4?

A

it is the only GLUT that is responsive to insulin

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25
what is: lamellar body
organelles in type II pneumocytes that store & transport surfactant to cell surface
26
SLE: pathophy
loss of immune self-tolerance --> produce autoAb against nuclear antigens --> bind self-Ag --> form immune complex: - deposit in tissues - activate complement --> decrease complement levels
27
what Ab are assoc w SLE?
- ANA - anti-dsDNA - anti-Sm
28
minimal change dz: histology
EM: foot process effacement | LM, IF: normal
29
minimal change dz: tx
corticosteroid
30
nephrotic synd: ssx
- edema - hyperlipid - hypoalbumin - proteinuria
31
costochondritis: cause? type of chest pain?
repetitive activity pain: - reproducible w palpation - worse w mv, change position
32
deep intracranial hemorrhage: #1 cause
HTN vasculopathy involving small penetrating br of cerebral arteries (Charcot Bouchard aneurysms)
33
Q fever: who? ssx?
farm workers exposed to waste from cattle, sheep - retro-orbital HA - pneumonia - thrombocytopenia
34
what is the most common thyroid cancer?
papillary thyroid CA
35
papillary thyroid CA: histology
large cells w nuclei containing finely dispersed chromatin w ground glass appearance (Orphan Annie eye)
36
ADH: what part of nephron has highest [] tubular fluid? lowest?
- highest: collecting duct | - lowest: thick ascending limb, DCT
37
familial dysbetalipoproteinemia: pathophys
AR --> defect in ApoE3, ApoE4 --> decreased clearance of chylomicrons, VLDL remnant --> high chol, TG --> xanthoma, premature atherosclerosis
38
acute viral hepatitis: histology
hepatocyte necrosis & apoptosis w mononuclear infiltration: - necrosis: cell swell & cytoplasmic empty - apoptosis: cell shrink, councilman bodies (eosinophilic dying hepatocyte)
39
Goodpasture synd: pathophys
autoAb to alpha3 chain of type IV collagen (anti-GBM Ab): - glomerular BM --> rapid prog GN - alveolar hemorrhage --> SOB, hemoptysis
40
Goodpasture synd: histology
- LM: crescent | - IF: linear deposition of IgG, C3
41
Goodpasture synd: who?
YA M
42
what is the most common cause of spontaneous lobar hemorrhage? most common site?
cerebral amyloid angiopathy - occipital lobe - parietal
43
dapsone: AE
hemolytic anemia --> esp G6PD def
44
what is the most common cause of calcium kidney stone dz?
idiopathic hypercalciuria
45
calcium nephrolithiasis: RF
- hypercalciuria - hyperoxaluria - hyperuricosuria - low urine vol - hypocitraturia
46
what reduces peripheral metab of levodopa?
- DOPA decarboxylase inh --> carbidopa | - catechol-O-methyltransferase inh --> entacapone
47
what is the most common lung cancer? location? histology?
adenocarcinoma --> esp F, nonsmoker peripheral glandular or papillary struct
48
preg, OCP --> cholelithiasis --> pathophys?
- estrogen: induce chol hypersecrete | - progesterone: induce gallbladder hypomotility
49
IV drug --> bioavail fraction?
1
50
maintenance dose: calc
(steady state plasma []) x (clearance) / (bioavail fraction)
51
half life: calc
(vol of dist) X (0.7) / (clearance)
52
loading dose: calc
(vol of dist) X (steady state plasma []) / (bioavail fraction)
53
``` IV abx --> 1st order kinetics: - Vd = 70L - CL = 0.5L/min - steady state 4mg/L how much should be admin 6hr to maintain steady state? ```
``` maintenance dose = Cpss x CL / [bioavail fraction] = (4mg/L)(0.5L/min)/1 = 2.0mg/min = 2.0mg/min x (60min/hr) x 6hr = 720mg q6hr ```
54
renal, hepair impairment --> how should you adjust dosing?
- loading dose: no change | - maintenance dose: decrease
55
neonatal intraventricular hemorrhage: what is? where?
- common comp of prematurity that can lead to longterm neurodev impairment germinal matrix
56
ARDS --> what changes will be seen: - pulm cap permeability - lung compliance - work of breathing - vent: perfusion matching - PCWP
- pulm cap permeability: increased --> interstitial & alveolar edema, exudate formation - lung compliance: decreased - work of breathing: increased - vent: perfusion matching: mismatched - PCWP: normal
57
how does HBV increase risk for hepatocell CA? how does this differ from HCV?
HBV: - integrate DNA into host genome --> continue transcribe HVx protein (oncogenic viral protein) --> inactivate p53 - active hepatitis infect --> cause regenerative hyperplasia --> increase # of cell divisions --> increase chance for genetic mutation HCV --> RNA virus w no reverse transcriptase --> not integrate into host genome
58
what is: CD14
surface marker for monocyte-macrophage cell lineage
59
inhalation anes: AE
- increase cerebral blood flow - myocardial depression - hypotension - resp dep - decreased renal fx
60
PSGN: histology
- LM: enlrg, hypercell glomeruli - IF: lumpy-bumpy granular deposits of IgG, C3 - EM: subepi humps
61
vitiligo: charact by?
loss of epidermal melanocytes
62
minor --> can consent to:
- prenatal care - STD dx/tx - contraception - drug/alcohol rehab
63
CREST synd: manifestation
- calcinosis - Raynaud's phenomenon - esophageal dysmotility - sclerodactyly - telangiectasia
64
what Ab is assoc w CREST synd?
anti-centromere Ab
65
what Ab is highly specific for systemic sclerosis (diffuse scleroderma)?
Anti-DNA topoisomerase I (Scl-70) Ab
66
systemic sclerosis: 2 types
- diffuse scleroderma: diffuse skin & visceral involvement - CREST synd: localized skin involvement, more benign
67
Aspergillus: - colonization --> leads to? - invasion --> leads to?
- colonization: aspergilloma (mycetoma) | - invasion: pulm aspergillosis
68
aspergilloma: features
- fungus ball that shifts when pt change position | - asymptomatic or cough/hemoptysis
69
aspergillus --> leads to?
- immunosupp, neutropenic: opportunistic infect --> invasive pulm aspergillosis - preexisting lung cavity: aspergilloma - asthma: lung HSN --> allergic bronchopulm aspergillosis
70
ant portion of medial pons --> infarct --> leads to?
- dysarthria | - contralat ataxic hemiparesis
71
trigeminal N: arises from?
level of middle cerebellar peduncle at lat aspect of mid-pons
72
asbestos exposure --> leads to what malig?
``` #1) bronchogenic carcinoma #2) mesothelioma ```
73
asbestos exposure --> leads to?
- asbestosis: diffuse pulm fibrosis + asbestos bodies - pleural dz: - malig: bronchogenic CA, mesothelioma

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