Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

uWorld Flashies > uWorld 31 > Flashcards

uWorld 31 Flashcards

1
Q

what is used as prophylaxis for mycobacterium avium complex in HIV patients with CD4 less than 50

A

AZITHROMYCIN in combo with rifabutin or ethambutol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is used as prophylaxis for histoplasma capsulatum in hIV patients with CD4 less than 150 in endemic areas (ohio and mississippi river valleys)

A

itraconazole

can be used as chemoprophylaxis for Coccidiodies too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

wha are the mitochondrial syndromes that are important

A

LEBER HEREDITARY OPTIC NEUROPATHY- leads to bilateral vision loss

MYOCLONIC EPILEPSY WITH RAGGED-RED FIBERS- myoclonic seizures and myopathy associated with exercise. skeletal muscle biopsy shows irregularly shaped muscle fibers (ragged red fibers)

MITOCHONDIRAL ENCEPHALOMYOPATHY with LACTIC ACIDOSIS and STROKE-LIKE EPISODES (MEALS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the function of EOSINOPHILS

A

PARASITIC DEFENSE:

  • stimulated by IL-5 (from Th2 and mast cells)
  • parasite gets coated in IgG and IgE antibodies that bind the Fc receptors located on eosinophil
  • degranulation happens and cytotoxic proteins (MAJOR BASIC PROTEIN) and ROS
  • ANTIBODY-DEPENDENT CELL-MEDIATED CYTOTOXICITY (ADCC)

TYPE I HYPERSENSITVITY REACTIONS (and chronic allergic reactions):
-LATE PHASE synthesis of PROSTAGLANDINS, LEUKOTRIENES, and CYTOKINES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does niacin cause flushing, warmth and itching and what is used to prevent it

A

PROSTAGLANDIN (PGD2 and PGE2)

use ASPIRIN (30 minutes before niacin) to inhibit prostaglandin synthesis and reduce this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does topical capsaicin work

A

causes release of substance P, resulting in burning pain in the area of application
prolongs use causes depletion of substance P, and the pain diminishes with time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

if pH is low (7.27) and PaCO2 is normal (40mmHg) and the patient is in diabetic ketoacidosis and has been for two days what the fuck is going on to cause the acid base disorder

A

patient IS NOT COMPENSATING for acidosis with BREATHING thus they must have RESPIRATORY FAILURE from pulmonary edema or significantly decreased mental function due to DKA

b/c PaCO2 is normal (ABOVE what we want to see for COMPENSATION) this means that there is SUPERIMPOSED RESPIRATORY ACIDOSIS that is interfering with the normal compensatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the appropriate compensation for metabolic acidosis

A

PaCO2 = 1.5(serum HCO3-) +8 +/-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the appropriate compensation for metabolic alkalosis

A

↑ PaCO2 by 0.7 mmHg for ever 1mEg/L rise in serum HCO3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the appropriate compensation for acute respiratory acidosis

A

↑ serum HCO3 by 1mEq/L for ever 10 mmHg rise in arterial PaCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the appropriate compensation for acute respiratory alkalosis

A

↓ serum HCO3 by 2 mE1/L for every 10mmHg decrease in arterial PaCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is seen in heroin withdrawal

A 
YAWNING
LACRIMATION
hyperactive bowel sounds
PILOERECTION
dilated pupils
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what can be used as a surgical landmark during surgery of the appendix

A 
TENIAE COLI 
(which are a layer of longitudinal muscle that surrounds the rectum just below the serosa, at the recmosigmid junction, this lacer condenses to form 3 DISTINCT LONGITUDINAL BANDS that travel on the outside of the entire colon before CONVERGING at the root of the vermiform APPENDIX)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are haustra

A

colonic sacculations causing the colon’s segmented appearance
occur when the teniae coli contract lengthwise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

where is cholecystokinin (CCK) secreted and in response to what

A

hormone responsible for gallbladder contraction, and increase pancreatic enzyme secretion, also decrease gastric emptying

produced by I cells from duodenum and jejunum when a FAT-PROTEIN-rich chyme enters the duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what doe secretin do

A

promotes bicarb secretion from pancreatic DUCTAL epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what does VIP do

A

produced in pancreas and stimulates intestinal water secretion, counteracts gastrin in the stomach, and promotes bicarb secretion for the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

complex atypical hyperplasia of the endometrium is associated with what

A

prolonged exposure to estrogen without opposing progesterone, which may develop form chronic anovulation over many years

most common in obese older women or those who receive estrogen without progesterone during hormone replacement therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

endometrial atrophy is an expected find in whom, what does it cause

A

post-menopausal women or women using certain types of hormonal contraception

can cause intermittent spotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when is anovulation common and what is seen

A

first several years after menarche and the last few years before menopause

marked menstrual cycle irregularity is seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when performing a midline episiotomy what is usually cut

A

vertical incision from the posterior vaginal opening to the PERINEAL BODY

transects the vaginal lining and the submucosal tissue (not the external anal sphincter or the rectal mucosa)

improper repair of a midline episiotomy may result in PELVIC ORGAN PROLAPSE or DYSPAREUNIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the perineal body

A

essental to the integrity of the pelvic floor

tendinous CENTER POINT of the PERINEUM separates the urogenital and anal triangles

blends anteriorly with the perineal membrane and superiorly with the rectovesical or rectrovesical septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what structures are anchored to the perineal body

A

bulbospongiosus muscle
external anal sphincter muscle
superficial and deep transverse perineal muscles
fibers from the external urethral sphincter, levator ani, and muscular coat of the rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the ischiocavernosus muscle

A

part of urogenital triangle

arises from the ischial tuberosities and the ischiopubic rami and inserts into the corpus cavernous

when CLITORIS is STIMULATED the ischiocavernosus muscle forces BLOOD into the vlitoris

25
Q

what is the transverse perineal muscle

A

art of the superficial perineal space (urogenital triangleO

arises form the ischial rami and tuberosities and inserts into the perineal body

muscle is out during MEDIOLATERAL EPISIOTOMY

26
Q

what muscle is cut during a mediolateral episiotomy

A

TRANSVERSE PERINEAL MSUCLE

27
Q

what is the virulence mechanism of Salmonella osteomyelitis in a Sickle cell patient

A

CAPSUL called the “Vi antigen” (Vi standing for virulence)

protects it from OPSONIZATION and PHAGOCYTOSIS

28
Q

what is the main virulence factor of Staph aureus causing OSTEOMYELITIS

A

adhesion to collagen

29
Q

when and how to the lip and the palate form

A

FIFTH-SIXTH WEEK of embryonic development

  1. first pharyngeal arch splits into he upper maxillary prominence and lower mandibular prominence
  2. fusion of the 2 medial nasal prominences form the midline INTERMAXILLARY SEGMENT. (intermaxillary segment becomes the PHILTRUM of the upper lip, the 4 medial maxillary teeth, and the PRIMARY PALATE)
  3. the left and right maxillary prominences then fuse with the midline inter maxillary segment to form the UPPER LIP and PRIMARY PALATE
30
Q

what happens if one of the maxillary prominences failures to fuse with the inter maxillary segment, what if both

A

UNILATERAL cleft lip

if both: BILATERAL cleft lip

31
Q

failure of the medial nasal prominence to fuse an form the inter maxillary seeming is associated with what

A

severe midline defects (like holoprocencephaly)

32
Q

what is seen in the Pierre-Robin Seqence

A

severe MICROGNATHIA results in POSTERIOR displacement of the tongue (GLOSSOPTOSIS) and prevents fusion of the secondary palate (CLET PALATE)

33
Q

what causes a cleft palate

A

failure of palatine shelves to fuse with one another (secondary palate) or with the primary palate

34
Q

catabolism of isoleucine, valine, threonine, methionine, cholesterol, and odd-chain fatty acids leads to the formation of what

A

PROPIONIC ACID, which is converted to METHYLMALONIC ACID by biotin-dependent carboxylation

isomerization of methylmalonyl CoA forms succinyl CoA, which then enters TCA cycle

35
Q

what is seen in congenital decificency of PROPIONYL CoA CARBOXYLASE

A

development of propionic academia, as propionyl CoA accumulates (can’t be converted to methylmalonyl CoA)

POOR FEEDING, VOMITING, LETHARGY, DEHYDRATIOn, anion gap ACIDOSIS

produced as intermediate in catabolism of BRANCHED CHAIN AMINO ACID (Val, Ile, Met, Thr), ODD-NUMBERED fatty acids, CHOLESTEROL SIDE CHAINS

36
Q

what is special about lysine

A

essential amino aid that is strictly KETOGENIC

unique metabolism in that it is NOT TRANSAMINATED as the initial step

37
Q

an increase in what will stop beta oxidation of fatty acids

A

MALONYL-CoA

it in habits CARNITINE ACYLTRANSFERAE, preventing the transfer of acyl groups into the mitochondria

38
Q

where does beta-oxidation happen and how does it get there

A

MITOCNONDRIAL MATRIX

membranes are impermeable to fatty acids dup to their negative charge, so a specialized membrane carrier (CARNITINE) must be used to shuttle them into the matrix

39
Q

in the WELL-FED STATE, the abundance of ATP in hepatocytes inhibits isocitrate dehydrogenase, leading to high levels of citrate int eh mitochondria. What does this citrate do

A

is transferred to the cytosol via the citrate shuttle and cleaved by ATP citrate lyase to form acetyl-CoA

high citrate levels (in addition to elevate insulin caused by high carbohydrate intake) causes upregulation of ACETYL-CoA CARBOXYLASE- a cytosolic enzyme that catalyzes the conversion of acetyl-CoA to malonyl-CoA in the rate-limiting step of FATTY ACID SYNTHESIS

40
Q

what is Burkholderia cepacia

A

a catalase-positive organism that is common cause of infection in Chronic Granulomatous Disease

so are (Serrate, Aspergillus, Nocardia, Staph A)

41
Q

how does latanoprost work in treating glaucoma

A

increased outflow of aqueous humor (via decreasing collagen content int eh uveoscleral outflow pathway)

42
Q

how do carbonic anhydrase inhibitors (dorzolamide) work in trading glaucoma

A

decerase formation of bicarbonate in the ciliary body, leading to decreased sodium and fluid transport

43
Q

who do alpha-adrenergic agonists (brimonidine) that glaucoma

A

inhibit production of aqueous humor via VASOCONSTRICTION in the CILIARY BODY

44
Q

how do beta blockers (Timolol) treat glaucoma

A

decrease aqueous humor production

45
Q

what is the order of compartments inhaled anesthetics must go through before they can reach the target organ (brain)

A

inhaled air → lungs → blood → brain

onset of anesthesia is transferred to the brain

46
Q

what is the arteriovenous concentration gradient of inhaled anesthetics

A

difference in the concentration of fas anesthetic in arterial blood and venous blood

solubility of the anesthetic in the peripheral tissues is a major factor in determining the size of the AV gradient

the more anesthetic absorbed into the tissue the more that needs to be replaced before it can get to the brain- HIGH AV gradient

47
Q

what is Marlin’s ulcer

A

an aggressive, ulcerating squamous cell carcinoma that presents in an area of previously traumatized, chronically inflamed, or scarred skin

malignant transformation often occurs long after initial trauma (like more than 10 years)

48
Q

if a patient has painful subcutaneous nodules in a location that days or weeks previously had SUTURES and you see a GRANULOMA, what caused it

A

reaction to FOREIGN BODY (retained sutures)

49
Q

what happens to QRS interval normally during exercise

A

REDUCED

50
Q

what drug for treating arrhythmias would cause an increase in QRS during exercise

A

TYPE IC anti-arryhtmic (flecainide)

USE-DEPENDENCE: phenomenon in which sodium-blocking effect intensifies as the heart rate increases due to less time between action potentials for the medication to dissociate form the receptor

51
Q

how do class 4 antiarrythmics work

A

calcium channel blockers which slow SA and AV nodal conduction
increases coronary blood flow and reduces myocardial oxygen demand, can mask ischemia during stress test

52
Q

what is a gallstone ileus

A

mechanical bowel obstruction caused when a large gallstone erodes into the intestinal lumen (through a CHOLECYSTOENTERIC FISTULA)
PNEUMOBILIA (air in the biliary tract) is a common finding

53
Q

what is seen in an ovarian dysgerminoma

A

malignant germ cell ovarian tumor that presents as a RAPIDLY GROWING mass or a RUPTURED OVARIAN CYST

common cause of ovarian cancer in PREGNANCY

vesicular cells with clear cytoplasm and large central nuclei due to increased N?C ratio (“fried egg cells”)

54
Q

what is seen in a endodermal sinus (yolk sac) tumor in a female

A

malignant germ cell tumor
abdominal pain due to ovarian TORSION without virilization

Schiller-Duval bodies (glomerulus like papillary structures with a central vessel)

55
Q

the metabolism of ethanol b alcohol dehydrogenase and aldehyde dehydrogenase consumes what and fucks up what ratio

A

consumes NAD+ causing an INCREASE in NADH to NAD+ RATIO

INHIBITS ALL PATHWAYS that REAUIRE NAD+ (citric acid cycle)

56
Q

thaimine is necessary for what

A

pyruvate dehydrogenase
alpha-keotglutarate dehydrogenase (alpha ketoglutarate to succinyl-CoA, produces NADH)
transketolase

57
Q

what perianal disease might be seen in Crohn’s

A

fistulas (enterocutanous (skin), enterovesical (bladder), enterovaginal (vag), eneroenteric (more bowel))
skin tags
fissures

58
Q

what is intergluteal pilonidal disease

A

acquired skin infection involving upper natal cleft of the buttocks
may present with draining sinus tracts in intergluteal region

no abdominal pain/tenderness or diarrhea

59
Q

what does actinomyces do

A

anaerobic bacteria
can form abscission in cervicofacial region or abdominal cavity

abscesses dont form as quick as B. fragilis (and actinomyces is less common of a cause of abscesses than B. fragilis)

uWorld Flashies (62 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions