uWorld 15

Question 1

many progressive neurologic diseases may be associated with CYSTIC DEGENERATION of what?
this is especially seen in Wilson’s Disease

Answer 1

PUTAMEN (medial to insula and lateral to globus pallidus on coronal sections)
(globus palidus is medial to putamen)

Question 2

what separates the globes pallidus and putamen from the caudate nucelus

Answer 2

internal capsule

Question 3

what structures is found on the inferolateral walls of the anterior horns of the lateral venticles

Answer 3

CUASDATE NUCLEUS

Question 4

what causes an annular pancreas

Answer 4

abnormal MIGRATION of the VENTRAL pancreatic bud (during 7th or 8th week of development)
can be caused by adherence to either the dorsal bud or duodenum before rotation begins

usually asymptomatic but can present with duodenal obstruction or pancreatitis

Question 5

host defenses against mycobacterial infections depends on what

Answer 5

interactions b/w macrophages and T cells

INTERFERON GAMMA a pleitrophic Th1 cytokine is a key factor in the elimination of these infections

Question 6

autosomal recessive deficiencies of the IFN-gamma receptor (or other elements of this pathway) result in disseminated what

Answer 6

mycobacterial disease in infancy or early childhood, including disseminated infection by the BCG vaccine strain if administered

once identified, these pts require lifelong tx with continuous antimycobacterial antibiotics

Question 7

what do you give to someone who is having a panic attack

Answer 7

BENZO in emergency setting

give them SSRI for the long-term

Question 8

what is citalopram

Answer 8

an SSRI used to treat general anxiety disorder

Question 9

what are the different stages of Pagets Disease of the Bone

Answer 9

1. Osteoclastic (osteolytic phase)
2. Mixed phase (blastic/clastic)
3. osteoblastic (osteoclerotic phase)

Question 10

what part of the kidney is fucked in renal cell carcinoma

Answer 10

PROXIMAL RENAL TUBULES

risk factors are: smoking and obesity

Question 11

what is a renal oncocytoma

Answer 11

very rare tumors that originate from COLLECTING DUCT CELLS

well-differentiated neoplastic cells that contain numerous mitochondria

Question 12

what tumor is found in the renal pelvis lining

Answer 12

transitional cell carcinoma (responsible for 90% of the tumors involving the renal pelvis)
tends to be multifocal in nature
often forms papillary tumors composed of urothelium supported by a thin fibrovascular stalk

Question 13

where is ribosomal DNA coding for 28S, 5.8S, and 18S rRNA, NEWLY TRANSCRIBED rRNA in association with RIBOSOMAL PROTEINS that are translated in the cytoplasm from mRNA found in a cell

Answer 13

NUCLEOLUS- primary function is to synthesis and assemble immature 60S and 40S ribosomal stunts that are exported form the nucleus to fully mature in the cytoplasm

all ribosomal RNA except 5S rRNA is transcribed in the nucleolus

Question 14

what is porcelain gallbladder

Answer 14

potential manifestation of CHRONIC CHOLESCYSTITS and is often found in association with multiple gallstones
due to dystrophic intramural deposition of calcium salts in the setting of chronic inflammation
associated with ↑ risk of ADENOCARCINOMA of the gallbladder

pt presents with firm, palpable gallbladder (RUQ pain) but many are asymptomatic w/ findings detected incidentally on imaging (CALCIFICATION SEEN SURROUNDING ENLARGED THICK GALLBLADDER)

Question 15

what is acute ascending cholangitis

Answer 15

typically due to gram-negative infection of the intrahepatic biliary tree
consequence of biliary obstruction (choledocholithiaisis) and present with fever, RUQ pain, and jaundice

Question 16

how can non-pathogenic Corynebacterium cause severe pseudomembranous pharyngitis

Answer 16

acquiring the Tox gene via lysognization by a TEMPEATE BACTERIOPHAGE

Question 17

Strep pneumo gets its ability to produce capsules how

Answer 17

transformation

Question 18

what is conjugation and what bacteria uses it

Answer 18

direct transfer of plasmids from one bacterium to another through a sex pilus
E. Coli acquire ability to form pili via bacterial conjugation

genes for antibiotic resistance are often transmitted in this manner

Question 19

at higher levels of exercise what is responsible for most of the increase in CO

Answer 19

HR

Question 20

in exercising what hemodynamic and vasoregulatory adjustments are done to provide maximal blood flow to active muscles

Answer 20

simulation of mechano- and chemoreceptors in the exercising muscle causes sympathetic activation and withdrawn of vagal tone resulting in:
↑ HR
↑ SV
↑ overall CO

Question 21

what decreases during exercise

Answer 21

SYSTEMIC VASCULAR RESISTANCE
due to the substantial arteriolar vasodilation in active skeletal muscles, mediated by local release of:
adenosine, K+ ions, ATP, CO2, lactate

Question 22

what vessel courses anteriorly to the 3rd part of the duodenum

Answer 22

SUPERIOR MESENTERIC ARTERY (and vein)

close proximity to the uncinate process of the pancreas

Question 23

the 3rd part of the duodenum courses horizontally over what

Answer 23

L3
abdominal aorta
IVC

Question 24

what is the course of the common bile duct

Answer 24

inferiorly from the hepatoduodenal ligament region
posterior to the first part of the duodenum and within the head of the pancreas, to drain into the second part of the duodenum

Question 25

how does pulmonary fibrosis present

Answer 25

GRADUAL-ONSET DYSPNEA, first with exertion and then progressing to symptoms at rest
see bilateral and diffuse patter of small, irregular (RETICULONODULAR) opacities that are most pronounced in the lower lobes

Question 26

does Tay-Sachs or Niemann-Pick have hepatosplenomegaly

Answer 26

Niemann-Pick