Daily UWorld Qs

Question 1

Antibodies found in celiac disease

Answer 1

• IgA anti-endomysial
• anti-gliadin
• anti-tissue transglutaminase

Question 2

instetinal biopsy findings of celiac disease

Answer 2

• Villi atrophy
• crypt hyperplasia
• intraepithelial lymphocyte infiltration

Question 3

Regions most affected by celiac disease b/c of highest concentration of gluten

Answer 3

duodenum and proximal jejunum

Question 4

A vascular malformation that occurs in brain parenchyma and increase the risk of intracerebral hemorrhage and seizure

Answer 4

Cavernous hemangioma

Question 5

The most common side effect of opioids

Answer 5

opioid-induced constipation (OIC)

Question 6

Tx for OIC

Answer 6

Methylnaltrexone (peripheral u-opioid receptor antagonist)

Question 7

Under normal circumstances, pulmonary capillary wedge pressure is equal to

Answer 7

LA pressure

Question 8

pulmonary capillary wedge pressure increases when

Answer 8

LA pressure increases (mitral stenosis)

Question 9

Endocarditis that is characterized by mitral valvular deposition of platelet-rich thrombi without bacterial infection

Answer 9

Nonbacterial thrombotic endocarditis associated with malignancy or lupus

Question 10

Hyperuricemia that predisposes to gout can be idiopathic or due to increased urate production such as

Answer 10

• Myeloproliferative/lymphoproliferative disorders

- Tumor lysis syndrome

Question 11

Hyperuricemia that predisposes to gout can be idiopathic or due to decreased clearance of monosodium urate crystals such as in

Answer 11

• CKD

- Thiazide/loop diuretics

Question 12

asymptomatic thrombocytopenia during pregnancy is

Answer 12

gestational thrombocytopenia

Question 13

asymptomatic thrombocytopenia during pregnancy is caused by

Answer 13

plasma volume expansion (hemodilution) & increased platelet sequestration/consumption in placenta

Question 14

Normally, inspiration increases venous return to the right side of the heart and _____ JVP

Answer 14

lowers/decreases

Question 15

Paradoxical rise in JVP during inspiration is known as _____

Answer 15

Kussmaul sign

Question 16

Pericardial knock and Kussmaul sign is associated with _____ and _____ by encasing the heart and restricting ventricular filling

Answer 16

• Constrictive pericarditis (thick/fibrous tissue in the pericardial space)
• Cardiac tamponade

Question 17

A pause elicited by pain during inspiration while physician deeply palpates the RUQ is known as

Answer 17

+ Murphy sign

Question 18

1. CN V1 (ophthalmic nerve) exits through ____
2. CN V2 (maxillary nerve) exits through ____
3. CN V3 (mandibular nerve) exits through ____

Answer 18

1. Superior Orbital fissure
2. Foramen Rotundum
3. Foramen Ovale

“ORO”

Question 19

Appendicitis initially starts with dull pain at the umbilicus and then the pain progresses to McBurney’s point (2/3 distance from the umbilicus to anterior superior iliac spine) because of

Answer 19

irritation of the parietal peritoneum by appendix

Question 20

serum sickness is an example of type __ hypersensitivity

Answer 20

III

Question 21

Type 3 hypersensitivity is resolved/cleared by

Answer 21

mononuclear phagocyte system (macrophages)

Question 22

firm, shiny, round flesh-colored papules with central umbilication

Answer 22

molluscum contagiosum

Question 23

molluscum contagiosum is caused by___ and is spread through

Answer 23

poxvirus; sexual contact

Question 24

Raw or steamed shellfish (oyster, shrimp) is the common culprit for hepatitis __

Answer 24

Hepatitis A

Question 25

An autoimmune disorder caused by autoantibodies against postsynaptic nicotinic ACh receptors; progressive WORSENING after exercise or with muscle use; spared reflexes

Answer 25

Myasthenia gravis

Question 26

An autoimmune disorder caused by autoantibodies against presynaptic ca+2 channel (decreased Ach release); progressive improvement after exercise or with muscle use; hyporeflexia

Answer 26

Lambert-Eaton Syndrome

Question 27

Myasthenia gravis is associated with what disease?

Answer 27

Thymoma, thymic hyperplasia

Question 28

Lambert-Eaton Syndrome is associated with what disease?

Answer 28

Small Cell Lung Cancer

Question 29

Tx for Myasthenia Gravis

Answer 29

Cholinesterase inhibitor (pyridostigmine)

Question 30

Cholinesterase inhibitor (pyridostigmine) side effects

Answer 30

muscarinic overstimulation due to increase ACh --> DUMBELS

Question 31

Cholinergic toxicity symptoms (DUMBELS)

Answer 31

``` D: diarrhea/diaphoresis U: Urination M: Miosis B: Bronchospasm E: Emesis L: Lacrimation S: Salivation ```

Question 32

Tx for cholinergic toxicity

Answer 32

Muscarinic antagonists (glycopyrrolate)

Question 33

Pediculus humanus capitis is aka

Answer 33

head lice (egg casings in hair)

Question 34

Pulsus paradoxus (>10 mm Hg drop in systolic BP with inspiration) can be seen in what 2 diseases?

Answer 34

1. cardiac tamponade | 2. COPD

Question 35

What's Beck's triad seen in cardiac tamponade?

Answer 35

1. Hypotension (decreased diastolic filling and CO) 2. Distant heart sounds (decreased PMI) 3. JVD

Question 36

In cardiac tamponade, right side heart SIZE (atrium & ventricle) ____ but right side PRESSURE ____

Answer 36

Decreases (compressed); increases

Question 37

The most nephrotoxic antifungal medication

Answer 37

Amphotericin B

Question 38

What is achalasia?

Answer 38

absence of peristalsis in esophagus and loss of fx in lower esophageal sphinter

Question 39

What parasite causes achalasia due to destruction of the submucosal (Meissner) and myenteric (Auerbach) plexus?

Answer 39

Trypanosoma cruzi (U shaped flagellated parasite) * Chagas disease

Question 40

What is the vector for chagas disease?

Answer 40

kissing bug (Triatoma and not a tick)

Question 41

Chagas disease can present with what other physical manifestations (heart and GI)?

Answer 41

Heart: dilated cardiomyopathy GI: Megaesophagus or Megacolon

Question 42

All mitochondrial myopathies will have what muscle biopsy finding?

Answer 42

Red ragged (blotchy red) muscle fibers

Question 43

A mitochondrial myopathy with myoclonic epilepsy with ragged red fibers is known as

Answer 43

MERRF

Question 44

A mitochondrial myopathy with encephalopathy with stroke-like episodes and lactic acidosis is known as

Answer 44

MELAS

Question 45

Hepatic encephalopathy (altered mental status) is due to excess ___ in cases of liver injury, disease, or cirrhosis

Answer 45

ammonia

Question 46

Tx for hepatic encephalopathy that increases conversion of ammonia to ammonium

Answer 46

Lactulose

Question 47

Tx for hepatic encephalopathy that decreases intraluminal ammonia production

Answer 47

Rifaximin

Question 48

Both afferent and efferent nerves of JAW JERK REFLEX is mediated by

Answer 48

trigeminal nerve (V3)

Question 49

Amniotic fluid with elevated AFP and polyhydramnios indicate

Answer 49

anencephaly (no drinking center)

Question 50

A vascular malformation in which blood courses directly from arteries to veins (w/o passing capillary bed) that occurs in brain parenchyma

Answer 50

Cerebral arteriovenous malformation (AVM)

Question 51

Microscopy finding of AVM

Answer 51

A tangle of abnormal vessels with thickened walls

Question 52

Explain how Nitrates (NO) work on ED

Answer 52

Nitrates are converted to NO by endothelial cells --> NO increase intracellular cGMP --> cGMP induce vascular smooth muscle relaxation (vasodilation) --> improves ED

Question 53

Explain how PDE inhibitors work on ED

Answer 53

Normally, cGMP is degraded by phosphodiesterase --> PDE inhibitors inhibit this enzyme from degrading cGMP --> increased cGMP --> vasodilation --> improves ED

Question 54

The activation of "cytotoxic" T cells requires what 2 stimulatory signals?

Answer 54

1. CD8+ T cell must bind to a specific antigen on MHC I of an APC 2. The bound T cell must be costimulated by an interaction between the T cell surface receptor CD28 and the APC cell surface ligand CD80/86

Question 55

T cells (regardless of type) binds to antigen-MHC I or II complex through what receptor on its surface?

Answer 55

TCR (T-cell receptor)

Question 56

CD 80/86 is aka.

Answer 56

B7

Question 57

T cells that bind an antigen on an APC but are not costimulated undergo what form of anergy?

Answer 57

peripheral immune tolerance

Question 58

calculated by dividing the number of fatal cases of a disease or condition by the total number of people with that disease or condition.

Answer 58

Case-fatality rate

Question 59

Alpha 1 blockers that can treat both BPH and HTN

Answer 59

- zosin | doxazosin, prazosin, and terazosin

Question 60

Alpha 1 blockers that can treat only BPH (uroselective)

Answer 60

- Tamsu"losin"

Question 61

the most common primary bone malignancy. Histology shows pleomorphic, spindle-shaped cells that produce new osteoid and bone.

Answer 61

Osteosarcoma

Question 62

the second most common malignant bone tumor of childhood (after osteosarcoma); Histopathology is characterized by uniform, small, round, cells; fibrous septae; and patches of necrosis and hemorrhage.

Answer 62

Ewing sarcoma

Question 63

is characterized by overuse of wrist extensor muscles (eg, extensor carpi radialis, extensor digitorum), leading to pain at their attachment on the lateral epicondyle

Answer 63

Lateral epicondylitis (ie, tennis elbow)

Question 64

is characterized by overuse of wrist flexor muscles, leading to pain at their attachment on the medial epicondyle

Answer 64

Medial epicondylitis (ie, golfer's elbow)

Question 65

the most common subtype of renal cell carcinoma and is composed of large, rounded, or polygonal cells with clear cytoplasm. These tumors are often detected incidentally at an advanced stage; the lung is the most common site for metastasis

Answer 65

Clear cell carcinoma

Question 66

year-round infection that causes the acute onset of fever, cough, congestion, pharyngitis, and conjunctivitis; occur in outbreaks among those living in close quarters (eg, camp dormitories, military barracks)

Answer 66

Adenovirus

Question 67

Describe adenovirus

Answer 67

nonenveloped, ds DNA