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UWorld Journal > Kaplan Qbank > Flashcards

Kaplan Qbank Flashcards

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1
Q

Produced in patients with Multiple Myeloma as seen in serum electrophoresis as the M spike

A

Kappa or lambda monoclonal immunoglobulin light chains (usually IgG or IgA) that are excreted in the urine as Bence Jones protein

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2
Q

Inflammatory process of the breast that presents as a discrete mass with calcifications on mammography and is usually associated with trauma to the breast.

A

Fat necrosis

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3
Q

Equation for Pulmonary Vascular Resistance

A

PVR = (P pulm artery - P L atrium)/CO

N=2-3 mmHg min/L

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4
Q

Cofactors and coenzymes used by Pyruvate Dehydrogenase

A 
Thiamine Pyrophosphate
Lipoic Acid
Coenzyme A
FAD
NAD
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5
Q

Presents as classic triad of Ataxia, Confusion, and Ophthalmoplegia + confabulation, personality change and memory loss. Caused by thiamine deficiency. Usually seen in alcoholics

A

Wernicke-Korsakoff Syndrome

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6
Q

Typical vs atypical antipsychotic medications

A
  • Typicals have more EPS than atypicals
  • High potency typicals (e.g. haloperidol, fluphenazine) have more EPS and less non-neurological side effects
  • Low potency typicals (e.g thioridazine, chlorpromazine) have less EPS and more non-neurological side effects
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7
Q

Pneumocystis jirovecii

A
  • Opportunistic infection in premature infants and patients with AIDS.
  • stains in methenamine silver as roughly spherical bodies with sharply outlines walls
  • Causes atypical pneumonia due to over-replication of type II pneumocytes and production of surfactant-rich exudates
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8
Q

Campylobacter jejuni

A

Gram-negative curved rod with polar flagella, oxidase +, microaerophilic, grows at 42deg. Feco-oral transmission via ingestion of undercooked contaminated poultry.

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9
Q

Polyarteritis nodosa

A
  • Systemic necrotizing vasculitis of small-medium vessels sparing the lungs.
  • Strongly associated with Hepatitis B infection
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10
Q

Plasmodium falciparum

A
  • Most serious malaria (malignant tertian)
  • May present with severe anemia, hgb <5
  • Parasitized RBCs occlude capillaries of the brain, kidneys and lungs.
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11
Q

First affected by Duchenne Muscular Dystrophy

A

Proximal muscles of the lower extremity - HIPS!

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12
Q

Unstable Angina

A

Chest pain at rest that does not resolve with nitroglycerine.
Without elevation in myocardial enzymes or ST changes in ECG

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13
Q

Heart Sounds

A

Blowing pansystolic murmur:

  • tricuspid regurg (radiates to the right side of the heart)
  • mitral regurg (radiates to the left side)

Midsystolic crescendo-decrescendo murmur:

  • aortic stenosis (right sternal border)
  • pulmonic stenosis (left sternal border)

S3 sound:
- right (look for tricuspid regurg) or left (look for mitral regurg) ventricular overload

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14
Q

McArdle Disease

A

Defect in muscular glycogen phosphorylase
Presents with exercise intolerance, cramping, which are alleviated with brief rest (“second wind” phenomenon)
Labs: myoglobinuria and elevated creatine kinase
Biopsy: accumulation of cytoplasmic glycogen granules in muscles

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15
Q

Polycystic Kidney Disease

A

Adult: autosomal dominant, mutation in PKD1 (Ch16) or PKD2 (Ch4); assoc with berry aneurysms, MVP, benign hepatic cysts

Infant: autosomal recessive; assoc with congenital hepatic fibrosis -> portal hypertension

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16
Q

Mycosis fungoides

A

Cutaneous T-cell lymphoma that presents with itchy, erythematous skin patches/plaques caused by malignant CD4 T cells that infiltrate the superficial dermis and epidermis (Pautrier abscess)

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17
Q

Beta blockers on patients with diabetes

A

Caution in giving this to these patients. BB may mask the signs of hypoglycemia.

Symptoms of hypoglycemia:
sweats, tremor, tachycardia, hunger, irritability, nervousness, seizures

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18
Q

Mycoplasma pneumoniae

A

Most common cause of atypical pneumonia in young adults (< 30 yrs)
Associated with cold agglutinins (IgM)
Macrolides, Doxycycline as treatment
Penicillins are ineffective due to their lack of cell walls

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19
Q

Polycystic Ovarian Syndrome

A
  • inc LH:FH ratio, inc androgens

- hirsutism, immature follicles

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20
Q

Aortic Stenosis

A

weak peripheral pulse, decrease S2

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21
Q

Some heart pathology

A

Heaves: LVH (apex) or RVH (left side)
Diastolic murmur: turbulence during ventricular filling (MS or AR)
Loud S3: rapid ventricular filling (mitral insufficiency, CHF)

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22
Q

Testosterone in plasma

A
  • bound to albumin: ~50%
  • bound to steroid hormone-binding protein: ~44%
  • bound to corticosteroid binding-globulin: ~4%
  • free testosterone: ~2%
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23
Q

Type I Diabetes Mellitus

Study These Flashcards
A
  • autoimmune destruction of B cells in pancreas usually directed against glutamic acid carboxylase
  • usually present in a child with glucosuria, polyuria, polydipsia, and weight loss
  • insulin deficiency, hyperglycemia, inc hba1c, inc serum osmolality, and dec C-peptide
24
Q

Acromegaly

Study These Flashcards
A
  • hypersecretion of growth hormones in adults
  • overgrowth of the bones in the head, hand, and feet
  • inc insulin-like growth factor-1, inc plasma insulin, impaired glucose tolerance, and failure of glucose administration to suppress GH
25
Cryptococcus neoformans
- Most common fungal meningitis of immunocompromised patients in US. - Budding encapsulated yeast acquired from pigeon droppings and urease-positive
26
Meckel's Diverticula
- caused by incomplete obliteration of the vitelline duct - true diverticula - may contain ectopic pancreatic or gastric mucosa - Rule of 2's: 2 inches long, within 2 feet of the ileocecal valve, 2% of the population, 2 years old, can contain 2 ectopic epithelium
27
Gag Reflex
Afferent: CN IX Efferent: CN X
28
Most common CNS tumor
Metastatic cancer. Commonly seen as multiple well-circumscribed tumors at GRAY/WHITE MATTER JUNCTION.
29
Psoas Major
- flex thigh at hip - attaches to transverse processes and the bodies of the 12th vertebra and all 5 lumbar vertebrae - infection can spread leading to psoas abscess
30
Psammoma Bodies
- laminated, concentric spherules with dystrophic calcification - Papillary carcinoma of thyroid - Serous papillary cystadenocarcinoma of ovary - Meningioma - Malignant Mesothelioma
31
Antidiabetic agent that is contraindicated in patients with heart failure
Thiazolidinediones - binds to PPAR-gamma leading to increase in insulin sensitivity - can cause worsening of heart failure symptoms, fluid retention leading to peripheral edema, and promotion of weight gain
32
Gastric acid regulation
Stimulate: Gastrin, Histamine, Acetylcholine Reduce: Somatostatin, Prostaglandin E2
33
Ixodes Tick
- vector of Bebesiosis and Lyme Disease
34
Lobular vs Ductal carcinoma of the breast
Lobular: - cancer cells appear in "single file" - no glands - usually bilateral - dec E-cadherin expression Ductal: - most common type - present as firm mass - small glands lined by pleomorphic cells surrounded by reactive, desmoplastic stroma
35
ADP-ribosylation bacterial toxins
``` E coli heat labile toxin -Gs Cholera toxin - Gs Pertussis toxin - Gi Pseudomonas toxin - eEF2 Diptheria toxin - eEF2 ```
36
Monozygotic twins
arise from 1 fertilized egg that splits in early pregnancy - Cleavage 0-4 days: separate chorion and amnion - 4-8 days: shared chorion - 9-12 days: shared amnion - >13 days: shared body (conjoined)
37
REM rebound
- increase in number and intensity of dreams for several days - occur with discontinuation of meds known to suppress REM * alcohol * barbiturates * stimulants * TCA * SSRI * lithium * MAO inhibitors
38
Transformation
SHiN - Streptococcus pneumonia - Haemophilus influenzae - Neisseria spp
39
Ataxia-Telangiectasia
- autosomal recessive - ataxia, spider angioma, IgA deficiency - defects in ATM gene -> failure to detect DNA damage
40
ATM gene (ataxia-telangiectasia)
- tumor suppressor gene -> DNA-dependent protein kinase | - recognizes and corrects DNA double strand breaks
41
Borders of the heart:
Right Border: Right Atrium Anterior: Right Ventricle Posterior: Left Atrium Left Border/Floor: Left Ventricle
42
Francisella tularensis
- etiologic agent for tularemia - facultative intracellular pathogen - small, pale-staining, slow-growing, aerobic, gram-negative coccobacilli that optimally grow at 35C - requires CYSTEINE for growth
43
RBF autoregulation
Effected primarily through AFFERENT arteriolar CONSTRICTION 2 principal mechanisms: - myogenic response - tubuloglomerular feedback Efferent arteriole does not regulation of RBF
44
Beck's triad
- see in cardiac tamponade Hypotension Distended neck veins Muffled heart sounds
45
Major salivary glands
Majority is mucous: SUBLINGUAL Mixed mucous & serous: SUBMANDIBULAR Majority is serous: PAROTID
46
Ticlopidine
Blocks ADP from binding to platelets | Side effect: Neutropenia
47
SNRI vs TCA
Both inhibit 5-HT and NE reuptake | TCA SE: antimuscarinic effects, alpha-adrenergic blockade, cardiotoxicity
48
Friedrich ataxia
trinucleotide expansion repeat (GAA) autosomal recessive mutation on frataxin gene on Ch9 age 5-15. Begin as gait ataxia and eventually spread to arms and trunk Hypertrophic cardiomyopathy Most die from cardiac causes
49
Neurofibromatosis 1
mutations on tumor suppressor gene, NF1 on Ch17 Cafe-au-lait spots (light-brown macules) Lisch nodules (pigmented iris hamartomas) multiple peripheral nerve tumors (neurofibroma)
50
Invasive Fungal Sinusitis
- Aspergillus - neutropenic patients | - Zygomycetes (Mucor) - diabetic and neutropenic patients
51
Recurrent Laryngeal n.
- branch of vagus n - supply all intrinsic muscle of the larynx except cricothyroid - vulnerable during thyroid surgeries -> hoarseness
52
Molecular motor that powers ciliary & flagellar beating and intracellular vesicle transport
Dynein
53
von Hippel-Lindau disease
Deletion of VHL gene at Ch3 Hemangioblastoma of in retina, brainstem, cerebellum, spine Angiomatosis bilateral Renal cell carcinoma Pheochromocytoma
54
Most common cause of sporadic encephalitis
Herpes simplex virus 1 | - has propensity for TEMPORAL lobes
55
Rb gene
Retinoblastoma and osteosarcoma

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