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Uworld > Mixed Block Notes 3 > Flashcards

Mixed Block Notes 3 Flashcards

(101 cards)

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1
Q
A
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2
Q

Defect in Chediak-Higashi

A

Phagosome-Lysosome fusion –> Recurrent pyogenic infections with Staph and Strep

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3
Q

Features of Chediak-Higashi

A

Immunodef, Albinism, Neurologic (nystagmus, cranial neuropathies)

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4
Q

Phosphorylation of NRTI’s vs NNRTI’s

A

NRTI’s must be phosphorylated

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5
Q

Most important mechanism of lead poisoning

A

Affinity for sulfhydryl groups –> Inhibition of d-ALA dehydratase and ferrochetolase

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6
Q

Formation of d-ALA

A

Succinyl-CoA and Glycine via Pyridoxal Phosphate cofactor

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7
Q

Cause and manifestation of acute serum sickness

A

Type 3 (IC deposition) –> Fever, Pruritic skin rash, Arthralgias, Fibrinoid necrosis, Hypocomplementemia

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8
Q

Serum sickness can be caused by

A

Chimeric monoclonal Ab’s, Nonhuman Ig’s, Nonprotein drugs (eg penicillin, cefaclor, bactrim)

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9
Q

Osteolytic phase of Paget’s is due to excess

A

RANK signaling, NFKB activation

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10
Q

Pattern of bone in Osteoblast phase of Paget’s

A

Dense, hypovascular, mosaic pattern of lamellar bone with irregular, haphazardly oriented sections separated by prominent cement lines

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11
Q

What stimulates Inhibin B secretion

A

FSH stimulation of Sertoli cells

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12
Q

MOA of trihexyphenidyl

A

centrally-acting anti-muscarinic

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13
Q

Anti-cholinergics such as benztropine and trihexyphenidyl should be avoided in elderly patients, esp with

A

BPH, Angle-Closure Glaucoma

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14
Q

S-100 protein function

A

Homodimeric calcium-binding proteins, important for protein p-lation, cell growth, and differentiation

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15
Q

S-100 marks what cells

A

Neural Crest (melanocytes, Schwann), Langerhans and other dendritic

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16
Q

DLCO depends on

A

Thickness and total SA of alveolar capillary membrane, Hematocrit, Total volume of pulmonary capillary blood

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17
Q

DLCO in emphysema vs chronic bronchitis

A

Reduced in Emphysema, Normal in CB

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18
Q

Mechanism of Bohr effect

A

CO2 –> H+ and HCO3+ –> H+ binds histidine side chains of Hb –> Stabilize deoxygenated form of Hb

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19
Q

What happens to H+ and HCO3 in RBC from CO2

A

H+ binds Hb; HCO3 exchanged for Cl (Cl enters)

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20
Q

Which step of Glycolysis utilizes NAD+

A

G3P –> 1,3-BPG

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21
Q

When is FADH2 produced

A

During conversion of succinate to fumarate

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22
Q

Synthesis of Carnitine

A

Lysine + Methionine via Vit C cofactor

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23
Q

Citrate is formed from

A

Condensation of Acetyl CoA w/ OAA

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24
Q

Heart Failure definition

A

(1) Cannot pump enough blood to meet demand; or (2) Can onliy do so from elevated ventricular filling pressure

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25
Diarrhea in pellagra results from
Columnar epithelium atrophy
26
NAD functions as a coenzyme for
Dehydrogenases involved in metabolism of fats, carbs, and amino acids
27
Niacin can be synthesized endogenously from
Tryptophan
28
Populations that primarily subsist on __ are prone to developing pellagra
Corn (niacin in corn is bound and unabsorbable)
29
Pellagra is less commonly seen in what patient populations
Carcinoid, Prolonged INH, Hartnup (more commonly in alcoholics and chronic disease)
30
Arginine is a precursor of
NO, Urea, Ornithine, Agmatine, Creatine
31
Orotic acid is a precursor of
Pyrimidine
32
Ab-dependent cellular cytotoxicity is defense against
Virus, Parasite
33
Function of MPO
Hypochlorite from H2O2 and Chlorine
34
Testicular feminization syndrome =
Complete Androgen Insensitivity = Absent Wolffian and Mullerian structures
35
Pulmonary hypertension is usually found in patients with
Scleroderma
36
H1 receptors are found in
Vascular endothelium, Bronchial smooth muscle
37
5 important classes of meds with Anti-muscarinic effects
Atropine, TCA's, H1 blockers, Neuroleptics, Anti-Parkinson - NATHA
38
MOA of Ribavirin
Nucleoside antimetabolite - (1) Lethal hypermutation, (2) Inhibit RNA polymerase and IMP DH (depleting GTP), (3) Defective 5'-cap formation on viral mRNA, (4) Modulating a more effective immune response
39
Bone turnover is regulated by ratio of
RANKL to OPG - incr when RANK-L high and OPG low
40
How does PTH activated Osteoclasts
Stimulates Osteoblasts to upregulate RANKL and secrete M-CSF --\> Osteoclast maturation
41
Function of Osteoprotegrin
Decoy RANK-L receptor
42
Arachnodactyly, Scoliosis, and Aortic Root Dilatation are signs of
Marfan
43
Macroorchidism, Large Jaw, and Intellectual disability are signs of
Fragile X
44
Top 3 causes of meningitis in neonates
GBS, E coli, Listeria
45
Courses between Biceps brachii and Coracobrachialis
Musculocutaneous
46
Courses between Flexor Carpi Ulnaris and Flexor Digitorum Profundus in forearm
Ulnar
47
Courses between Flexor Digitorum Profundus and Flexor Digitorum Superficialis
Media N
48
Substrate for PRPP synthetase
Ribose-5-Phosphate
49
Gout occurs with increased frequency in patients with activating mutations of
PRPP Synthetase
50
First line for Acute Gouty Arthritis
NSAIDs (Colchicine second)
51
How does pregnancy affect gallstones?
Estrogen-induced cholesterol hypersecretion (HMG CoA Reductase); Progesterone reduces bile acid secretion and slows gallbladder emptying
52
Fluid-filled cavitiy in liver + Fever, Chills, RUAbdominal Pain
Most likely bacterial abscess in developed nation
53
Pyogenic bacteria most commonly gain access to liver via
Biliary tract, Portal vein pyema, Hepatic artery
54
How does RBC carry CO2
15% as carbamate on Hb, Remained as bicarb ion w/in RBC
55
Diuretic often used in management of Cerebral edema and Incr ICP
Mannitol
56
Overaggressive treatment with osmotic diuretic therapy
Excessive volume depletion and eventual hypernatremia
57
Osmotic diuretics should be used cautiously in what patients
CHF, Pre-existing pulmonary edema
58
Spironolactone side effects
Hyperkalemia, Gynceomastia, Decr libido, Erectile dysfunction
59
The risk of statin myopathy is increased when
Fibrates and/or Niacin also used
60
Drugs that can cause myopathy
SGFC PHIN - Statins, GC's, Fibrates, Colchicine, Penicillamine, Hydroxychloroquine, IFNa, Niacin
61
MOA of Fenodolpam
Benazepine derivative of DA --\> Selective DA-1 agonist with no effect on alpha or beta receptors
62
Stimulation of DA receptors in kidneys
Improves RBF and Na and Water excretion
63
Fenoldopam is indicated for
Short term management of severe HTN
64
Use and risk of Nitroprusside
Most effective agent for most cases of HTN emergency --\> Cyanide toxicity
65
Vimentin is a marker for
Mesenchyme
66
Chromogranin A
Neuroendocrine tumors
67
Imperforate anus is most commonly associated with
GU malformation - VACTERL (vertebral, anal atresia, cardiac anomalies, TE fistula, esophageal atresia, renal anomalies, limb anomalies)
68
Fibrinous pericarditis is most commonly caused by
MI, RF, Uremia; Also viral
69
Pericardial knock
Brief, high frequency, precordial sound heard shortly after S2 in constrictive (chronic) pericarditis
70
Heme in the liver is synthesized for
CYP450 system
71
Acute Intermittent Porphyria can be precipitated by
Phenobarbital, Griseofulvin, Phenytoin, Low calorie diet, Alcohol --\> All decr hepatic heme --\> Incr ALA synthase activity
72
Heme synthesis enzymes inhibited by lead
ALA dehydratase, Ferrochetolase
73
Influenza vaccine induces
Neutralizing antibodies against Hemagglutinin
74
Why don't killed vaccines stimulate CD8 response
They don't enter host cell for MHC Class 1 presentation
75
Sensory nerve to parietal pleura
Phrenic to Diaphragmatic and Mediastinal; Intercostal to remainder
76
Superficial Inguinal Nodes drain
Nearly all cutaneous lymph from umbilicus to feet, including external genitalia and anus
77
Lymph from Glans penis and cutaneous portion of posterior calf drain into
Deep inguinal lymph directly (bypassing superficial)
78
Effect of cyanide poisoining
Inhibits cytochrome C oxidase - SaO2 of venous blood increases due to failure of oxygen unloading
79
Crescents of RPGN are composed of
Proliferated glomerular parietal cells, Monocytes, Macrophages, Fibrin
80
Inactivated HFE increases iron by
(1) Incr DMT1 on enterocytes; (2) Decr hepcidin --\> Incr ferroportin expression
81
Atypical antipsychotics most and least likely to cause EPS
Clozapine least likely, Risperidone most likely
82
Top 3 risk factors for Coronary Heart Disease
Noncoronary Athersclerotic Disease, Diabetes Mellitus, CKD
83
Pineal Tumors most commonly cause
Parinauds, Precocious puberty, Obstructive hydrocephalus
84
Short acting insulins
Lispro, Aspart, Glulisine
85
When to use regular insulin
DKA
86
What accounts for delayed onset of regular insulin
Dimer and hexamer formation (short acting are monomers)
87
NPH insulin works by
Crystalline suspension with protamine and zinc --\> Delays absorption
88
Detemir insulin works by
FA bound to lysine --\> Binds albumin and slowly dissociates
89
MAOi's
MAO Takes Pride In Shanghai = Tranylcypromine, Phenelzine, Isocarboxazid, Selegline (B selective)
90
SSRI's
Flashbacks Paralyze Senior Citizens = Fluoxetine, Paroxetine, Sertraline, Citalopram
91
SNRI's
Venlafaxine, Duloxetine
92
How quickly after ischemia does loss of contractility occur in cardiomyocytes?
60 seconds
93
At what timepoint is myocardial ischemia irreversible
30 minutes
94
Ligands for Receptor Tyrosine Kinase vs JAK/STAT
Growth Factors bind RTKs; JAK/STAT bound by Cytokines, Growth Hormone, Prolactin, IL-2, EPO
95
Microscopy of Membranous Glomerulopathy
LM - Mesangial proliferation; IF - Ig and C3; EM - Spike and Dome
96
T-ALL is most likely to present
Anterior Mediastinal mass that compresses great vessels and esophagus
97
EKG progression of Acute Transmural Infarct
Peaked T waves --\> STE --\> Q waves
98
Imaging in Gallstone Ileus shows
Intestinal gas (obstruction), Air in biliary tree
99
Boerhaave Syndrome
Transmural tear (vs Mallory Weiss which is mucosal)
100
Cricopharyngeal motor dysfunction occurs due to
Diminished relaxatin of pharyngeal muscles during swallowing
101
Renal consequences of Ethylene Glycol ingestion
Oxalate crystals, Tubular epithelial damage (ballooning and vacuolar degeneration mostly in PCT)

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