UWORLD 2 Flashcards

(32 cards)

1
Q

patient with suspected lung cancer develops hiccups, shoulder pain, and dyspnea…affected nerve and vertebral origin?

A

phrenic
c3-c5

(c3,4,5 keeps diaphragm alive)

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2
Q

histopathologic finding in HIV associated dementia

A

microglial nodules (groups of activated macrophages/microgilal cells formed aorund small areas of necrosis tha tmay fuse to for multinucleated giant cells

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3
Q

gastric erosion vs ulcer

A

erosion - does not extend into MUSCULARIS MUCOSA (limited to mucosal layer)
ulcer - penetrate through the mucosal layer and extend into submucosal layer

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4
Q

histologic feature of acute eczematous dermatitis (eczema)

A

spongiosis (due to accumulation of eema fluid i tne intracellular space of epidermis)

with chronic exposure, lesions bcome less edematous with thikcening of stratum spinosum and stratum corneum (acanthosis and hyperkeratosis respectively)

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5
Q

what is the target of botulinum toxin

A

presynaptic exocytosis of ACh vesicles

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6
Q

painless genital ulcers that progress into painful inguinal lmyphadenopatyh (buboes) and ulceration, mild fever and malaise…cells scrapings show cytoplasmic inclusion bodies

A

chlamydia trachomatis

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7
Q

patient comes in with anemia but with normal WBC and platelet count and normal bone marrow…dx and associations

A

pure red cell aplasia (bone marrow failure of just pure erythroid elements) can be assocaited with inhibition of erythropoetic precursosrs by IgG autoantibodies or T lymphocytes associated with thymomas, lymphocytic leukemias and parvovirus b19

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8
Q

nongonoccal urethritis, arthritis, conjunctivits

A

reactive arthritis
assoc with keratoderma blennorhagicum (hyperkeratotic vesicles on palms and soles) and sacroilitiis
HLAb27

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9
Q

purpose of conjugating toxoid for Hib vaccine

A

since humoral immunity is immature in inffant younger than 2, conjugated toxoid induces T cell mediated immune response to help with formation of long term immunity via memory B cells

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10
Q

What substance is specific to mast cells that is useful in diagnosing anaphylaxis?

A

mast cells release HISTAMINE AND TRYPTASE…

tryptase is useful is diagnosing anaphylaxis

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11
Q

How do mast cells degranulate

A

aggregation of multiple IgE receptors brought together by multivalent antigen….this causes multiple IgE antibodies to become cross linked leading to degranulation

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12
Q

two mechanisms of fibrates

A

upregulate lipoprotein lipase which will increase TG clearance and activate PPARa to induce HDL synthesis…
also blocks cholesterol 7 alpha hydroxylase which will stop synthesis of bile acids and decrease cholesterol solubility in bile = CHOLESTEROL STONES adverse effect

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13
Q

difference between HLA class I and class II

A
class i - HLA A,B,C, expressed by all nucleated cells and prsesentendogenous to CD8
class 2 - HLA DP, DQ, DR
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14
Q

perifollicular hemhorrhage, myalgia, subperiosteal hematoma, gingivitis

A

scurvy

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15
Q

what two things need to be known before PCR

A

dNA template that includes target region to be amplified

olignonucleotide sequence of flanking regions must be known to make primers necesssary to start PCR

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16
Q

receptor on T cells that binds to tumor cells which will DOWNREGULATE response of T cells against tumor cells

A

PD-1…similar to CTLA4
so tumors that overexpress these PD1 receptors can bypass T cell apoptosis and continue to grow…antibodies designed to block these receptors can help to kill these pesky tumor cells

17
Q

What does the lagging strand need more of that the leading strand does not?

A

increased DNA primase and ligase activity (making and glueing together alot more fragments)

18
Q

cardiomegaly, hypotonia, macroglossia, hepatomegaly, normal glucose, glycogen accumulation in lysozomes
dx and deficient enzyme

A

pompe

deficienct in a glucosidase

19
Q

recurrent vertigo, ear fullness/pain, unilateral hearing loss and tinnitus

A

meniere dx

due to incerased volume of endolymph in inner ear

20
Q

MOA IL-2’s anter cancer effects

A

IL 2 producd by helper T cells and stimulateds growth of CD4 and CD8 T cells and B cells…also activates natural killer cells and monocytes which helps kill metastatic melanoma and RCC

21
Q

elderly woman presents with SBO with hard mass in ileocecal valve

A
gallstone ileus (from gallstone that has moved into intestinal lumen through colecystoenteric fistula)
associated with air in biliary tree
22
Q

Mechanism of cystic fibrosis genetic defect

A

most COMMONLY due to 3 base pair deletion at CFTR F508 position…mutation will impair post translational processing of CFTR resulting in shunting of CFTR toward proteasome

23
Q

hemolytic anemia due to failure of glycoysis and rigid erythrcyte structure associated with what

A

increased extravascular hemolysis which will cause splenic hyperplasia in red pulp (increased removal of deformed erythrocytes)

24
Q

MOA nitrate

A

primary venodilator with modest effects on decreasing systemic vascular resistance

all to reduce preload via guanylate cyclase cGMP system

25
dense fibrous deposits around tricuspid and pulmonary valves as well as moderate pulmonary valve stenosis WITH NORMAL LEFT HEART
metastatic carcinoid syndrome | associated with flushing, watery diarrhea, bronchospasm and elevated urine 5-hiaa
26
histologic hallmark in neutrophils during leukomoid reaction
remember luekocyte alkaline phosphatase is normal or increased in leukomoid reaction....peripheral smear shoes Dohle bodies (blue basophilic periphearl granules in neutrophils)...also associated with increased bands, toxic grnaulation, cytoplasmic granules
27
hereditary spherocytosis associated with increased risk of what GI complication
``` pigmented gallstones NOT AUTOSPLENECTOMY (THAT'S SICKLE CELL) ```
28
early MI, fibrinoid necrosis of arterioles, pericarditis, sterile valve vegetations on BOTH valvular surfaces, fibrino...wireloop changes and glomerular capillary basement membrane thickening
SLE
29
holosystolic murmur best heard at apex, radiating to axilla....how to tell severity
presence of s3 gallop | (severe mitral regurg will manifest sound indicating volume overload with increased
30
OD on something with garlic breath and profuse watery diarrhea...what is teh agent and antidote
arsenic | treat with dimercaprol and DMSA (succimer)
31
absence of ganglion cells in distal colon and rectum
hisrshsprung | failure of neural crest migration
32
how to dx hirschsprung
rectal SUCTION BIOPSY (because ganglion resides in submucosa and umuscular)