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UWorld Flashcards

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1
Q

Furosimide SFx

A

hypokalemia, hyperuricemia, hypovolemia

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2
Q

Methotrexate SFx

A

hepatotoxicity, pulmonary fibrosis, bone marrow suppression

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3
Q

Metoprolol SFx

A

Selective B1-andrenergic blocker, few SFx

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4
Q

Penicillin SFx

A

hypersensitivity

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5
Q

What else to screen for with Major Depressive Disorder?

A

History of bipolar disorder (rule out unipolar disorder)
MDD = SIG E CAPS
multiple episodes, over last 6-12 mo, 5/9 following
*pt w/fast onset SSRI could be clue of mania

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6
Q

Pharyngeal Arches (and pouch/clefts) -rules

A 
mesoderm forms: muscle, vascular
neuroectoderm: bone, CT
-each arch innervated by own CN
*just think about arch number and associated place on upper body, with DIT rules, should be able to get there
Arch 1 = M and T
Arch 2 = S (stapes)
Arch 3 = pharyngeus everything
Arch 4 and 6 = Cricoid, thyroid, larynx
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7
Q

Antibody structure

A

Light chain = binds the antigen at FAB (fragment ag binding region)
Carboxy end of heavy chain = (farthest from LC is where Frc region) binds the Fc R on phagocytes
LC ag binding signals phagocytosis of ag

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8
Q

Neurophysin

A

Hypothalamus transports for OTC and VPN

Gene MT could lead to Central DI because no VPN/ADH will be released

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9
Q

Rapid glomerulonephritis with crescent formation

A

macrophages and t cells enter bowmans space, dmg capillaries, BM gets gaps, fibrin deposits and fibrosis occurs

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10
Q

Infection and risk of abscess at this muscle for HIV, DM, IV drug users

A

iliopsoas muscle (primary iliopsoas muscle abscess)

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11
Q

Fragile X syndrome

A

mild intellectual disability, CGG repeat, macrocephaly, long narrow face, macroorchidism
FMR1 gene
*small gap near tip of long arm of X chromosome (cytogenetic studies)

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12
Q

Oxygen-Hb Dissociation Curve (R/L Shift)

A 
Right shift (left shift is opposite) = Hb decrease affinity for oxygen
"ACE BATs right"
Increase:
Acid
CO2
Exercise
2,3 - BPG
Altitude
Temperature
If Hb has an increased affinity for oxygen (or decrease in above), less oxygen will be released, leading to errythrocytosis (via EPO release)
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13
Q

Withdrawal Sx for: alcohol, stimulants (cocaine, amphetamines), benzodiazepines, heroin, nicotine

A

alcohol: delirium,agitation, PE: tremor, seizure
stimulants: intense psychomotor agitation with severe depression, no PE
benzodiazipines: agitation, anxiety, tremor, PE: seizure
nicotine: increased appetite, no PE
Heroin: N/V, abd pain, PE: yawning, lacrimation, dilated pupils

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14
Q

Achondroplasia - genetics/heritability

A

Sporadic MT, AD heritable, MT Fibroblast GFR3 (FGFR3),

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15
Q

Krukenberg tumor met to ovaries - describe features of this malignant CA and met statistics

A

Tumor - primary GI tumor that met to the ovaries (#1 met to ovaries is GI CA), Histo: signet ring cells with large amounts of mucin displacing the nucleus. It spread by lymphatics and seeded the peritoneum
Px - weight loss, early satiety (met), epigastric pain

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16
Q

B Cell maturation including VDJ/VJ and Isotype

A

B Cells:
1 - proliferate/mature in bone marrow (go to lymphoid organs)
-VDJ (heavy chain) / VJ (light chain) rearrangement occurs via DNA rearrangement
2 - Ag exposure/activation (some go into blood with IgM specificity ST, some go on as plasma cells, others go to follicle of LN for further maturation)
3 - Follicle: Germinal center, cortex of LN - isotype switching (IgG to.. IgA). Activated B-cell expresses CD40 and connects with CD40L CD4+, CD4+ cytokines mediate isotype switching (IL 2/4/5/6, INF-gamma)
-subsequent Ag encounters by B cell release IgG (IgA for mucin)
*negative selection is T cells in the thymus

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17
Q

Heart pressures RA, RV, PA, LA, LV, Aorta

A

RA <5, RV 25/5, PA 25/10, LA <10, LV 120/10,

Aorta 120/80

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18
Q

Bacterial endocarditis - Aortocavitary fistula - where does blood flow?

A

because Aortic P&raquo_space;»» RV P,

blood with CONTINUOUSLY flow from aorta to the RV with a fistula between them

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19
Q

Where is most water absorbed in the nephron?

A

Proximal convoluted tubule (beginning), just like everything else, the rest of nephron is for lesser adjustments (electrolytes, acid/base dumping, water reabsorbing) and concentrating the urine

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20
Q

Mullerian aplasia/vagina agenisis/MRKH syndrome

A

variable uterine development, no upper vagina, primary amenorrhea, normal development of ovaries, regular development of secondary sexual characteristics (breasts, etc.)

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21
Q

Sexual development-Mullerian vs Wolfian

A

Mullerian is default, wolfian ducts will degenerate without anything. Male - testosterone will cause mullerian ducts to degenerate and wolfian ducts to grow

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22
Q

Vaginal adenosis

A

children of mothers who took diethylstilbestrol, causes replacement of the vaginal squamous epithelium with columnar, risk for vaginal clear cell carcinoma

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23
Q

Turner Syndrome

A

45X, premature ovarian failure (=high LH and FSH)(streak ovaries), no breasts or menses. Can also have bicuspid valve or coarctation of aorta

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24
Q

Relative Risk = ?

A 
Coronary event / No Coronary Event
ACEI
No ACEI
RR = (a/(a+b)) / (c/(c+d))
can remove the equalizer that joins both groups (here the Q was patient populations with DM)
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25
Failure in rotation of the midgut
omphacele or gastrochisis
26
Down syndrome has what abdominal abnormality?
uncomplicated hernia as a newborn (defect in linea alba)- failure of closure of the umbilical ring. Will likely resolve spontaneously
27
Failure of physiologic occlusion and subsequent recanalization of the midgut results in:
Duodenal atresia
28
Persistent processus vaginalis
Congenital inguinal hernia forms - processus vaginalis, an outpouching of the peritoneum, fails to obliterate, allowing a path for bowel contents to go into the inguinal canal
29
Delayed Hypersensitivity Reaction: tests, process
PPD test, Candida extract skin reaction, contact dermatitis, granulomatous inflamtion -T-lypmphocyte mediated (Th1). Dendrites in skin bring to T cell --> Th1 call macrophages with INF-y. 48-72hr.
30
Transplant reactions: hyperacute, acute, chronic
hyperacute (min-hr) - preformed Ab in recipient acute (less than 6 mo) - humoral, cellular response chronic (mo-yrs) - low grade immune response, thickening and fibrosis
31
neurocysticercosis
T. solium
32
Gastric cell layers (top->bottom) in gastric body (5)
simple columnar epithelial cells - secrete mucus upper grandular layer - parietal cells deeper aspect of gastric glands - chief cell (pepsinogen) muscularis mucosea - lamina from submucosa submucosa - vascular and CT
33
Number Needed to Harm - calculation
``` NNH = 1 / AR AR = Event rate (tx) - Event rate (placebo) ```
34
Huntington Dz impact on other genes - mech of action?
AD, CAG repeats -> results in gain of function of the huntington gene -> causes deacetylation of histones, will silence other genes/decrease gene expression
35
Resolving hematoma - blood breakdown path
Heme is broken down by heme oxygenase into: biliverdin (green), CO, ferrous iron biliverdin broken down to yellow pigment bilirubin, transported to liver by albumin
36
cauda equine syndrome
S2-S5 | pain low back to legs, saddle anesthesia, loss ancutaneous reflex (finger in rectum), bowel/bladder dysfunction
37
Rhuem A - test
anti-CCP present | arginine -> citruline in pr vimentin
38
Translocation Down Syndrome
46, XX t(14;21) | Robertson translocation - (nrm balanced) DS = unbalanced translocation - lose 2 short arms chrome
39
Non-modifiable risk factors for bone fracture
``` advanced age female white, Hispanic, asian (African americans protective) Fhx early bone fractures ```
40
Appendix identification for appendicitis
teniae coli - 3 separate smooth muscle ribbons travel longitudinally outside of the colon and converge at the root of the vermiform appendix
41
If have cavity from TB infection and Aspergillus settles forming an aspergilloma, what is this called?
colonization NOT INVASION!
42
CF - CFTR MT results in what? sweat test nasal transepithelial difference test
CF transmembrane conductance regulator normally secretes Cl to hydrate mucus (will dec Na/water absorption by ENaC *this is opposite in sweat glands (dec Cl secretion) MT - will flip Sweat test - (+) Na and Cl will be sweat out w/ Cl Nasal transepithelial difference test - when Na presented, Na will be absorbed
43
Beer's criteria
what not to give to old people (look up phone pic)
44
Filtration Fraction
= GFR/RPF RPF = renal plasma flow clearance GFR = use inulin or creatine clearance RPF = use PAH (all secreted into kidney goes urine) Clearance = (urine conc S x urine flow rate) / plasma conc of S = (Cr Cl / PAH Cl) x 100%
45
Lung elastase - what produces it?
neutrophils - in alpha granules (A1 antitrypsin inhibs) macrophages - in lysosomes (Tissue metaloprotinases inhibs-TIMPs) -make own types, can inhibit each others -excess elastase --> dmg and emphysema
46
Salmonella Typhi
``` watery diarrhea -> green -> become bloody (wk3) Salmon colored spots on abdomen fever hepatosplenomegaly intestinal invasion (wk 3) ```
47
classic galactosemia
AR disorder most common and severe galactosemic Ds deficiency enzyme: galactose-1-phosphate uridyl transferase newborns within days: Px - jaundice, vomiting, hepatomegaly
48
Mycoplasma pneumoniae
causes anemia - cold agglutinins (IgM cross-reactivity) resolves with infection cure (not due to return of cellular iron stores)
49
Chediak-Higashi syndrome
immodeficiency (failure phagosomal lysosomes fusing --get abn large lysosomal inclusions), albinism, neural defects (ex: nystagmus)
50
Cori Disease
debranching enzyme deficiency Px: hypoglycemia, hypotonia, hepatomegaly key feature: cytosolic accumulation of glycogen with abnormally short outer chains
51
Vitelline (omphalmesenteric) duct | -connects what to what and if not obliterated during 7th week embryogenesis, what can it cause?
midgut lumen with yolk sac cavity persistent VD - fistula, meconium out of umbilicus Meckel diverticulum - #1 vitelline sinus - partially patency at umbilicus vitelline duct cyst - connected w/ileum and abd wall *fibrous band attaches to everything, causes issue
52
cure Confounding Bias - how?
matching (match patient group to like age, race controls)
53
homeobox / HOX genes - code for what?
txn factors -- crainal to caudal spinal alignment
54
Adenomyosis = Px?
=endometrial glandular tissue into uterine myometrium pain, heavy bleeding, uniform fullness of uterus Bx - normal endometrium appearance (secretory endometrium)
55
opioids = #1 cause?
Most common cause of OD death (heroin or prescription) | respiratory failure, unresponsive
56
sarcomere
electron micro thin filaments + Z line = clear with black middle (I-band) thick filaments = dark with M-line (A-band)
57
Persistence of processus vaginalis in male - testicle descent
leaves opening between scrotum and the peritoneal cavity via the inguinal cavity small opening --> hydrocele large opening --> indirect inguinal hernia w/abd organs
58
Palpable mass anterior to recturn
imperforate hyman - obstruction | incomplete degeneration of the fibrous tissue band connecting the walls of the vagina
59
poison ivy = conctact dermatitis -how Px? what HSR?
Px -intensely pruritic erythematous papules, vesicles, or bullae in linear pattern (urishiol is the poison) Type 4 HSR - T lymphocyte mediated (bc poison ivy dermatitis is a contact allergic dermatitis)
60
Lupus Ab - against what?
Anti-smith = vs snRNPs, involved in removing introns with spliceosomes
61
bacterial IgA proteases are used to mainly do what? (think N. Meningitides invasion)
adherence to the mucosal wall (IgA binds bacterial pili and other prs that help it adhere) NOT MAINLY vs complement and phagocytosis
62
CF patients - most common gene MT
CFTR 3 base pair deletion of phenylalanine at position(deltaF508) - leads to impaired post-translational processing of CFTR --> ER notices, tags for peroxisomal degradation
63
Two sample T test - purpose:
to see if the mean of two populations are equal - need the 2 means, std deviation variances, and the sample sizes - calculate t score, derive p value - p value <0.05 = null hypothesis is true and both means are statistically different
64
HIV patients and Candida - what WBCs are more infected? superficial vs disseminated (candidemia)
superficial - will occur due to low T-cell count candidemia - will occur due to low neutrophil cout/neutropenia *therefore -superficial candida is more common in HIV patients, but candidemia is more common in neutropenic patients
65
SFx of 1st-line antipsychotic D2 blocker
-blockade on nigrostriatal pathway | extrapyramidal Sx -dyskinesia reactions, akathisia, parkinsonian
66
Prokaryotes - DNA replication, how many polymerases, what actions?
3 polymerases, all with 3'-5' proofreading activity however, DNA polymerase I can also excise RNA primer with 5'->3' exonuclease. used to repair damaged DNA. ex: E. Coli
67
What neurons produce these? | DA, dynorphin, E, His, NE, orexin, OTC, ADH/VPN
DA - VTA of substantia niagra pars compacta - midbrain dynorphin - opioid peptide - PAG, medulla, ant horn SC E - locus ceruleus (post rostral pons, floor 4th ventricle), arousal/RAS system NE - E->NE conversion in adrenal medulla His/orexin - posterior hypothal OTC/ADH - anterior hypothalamus
68
Major sites of metabolism in the cell (2) - what goes on there?
Mito - B oxidation FA, (TCA cycle) citric acid cycle, carboxylation of pyruvate (gluconeogenesis) Cystol - glycolysis, FA synthesis, pentose phosphate pathway Mixed - heme synthesis, urea cycle, gluconeogensis
69
Major Depressive Ds Criteria - also ask self what question when ruling out psych Ds?
``` great than or equal to 2 weeks 5/9 sx: SIG E CAPS Depressed mood Sleep disturbance Loss of Interest (anhedonia) Guilt with feelings of worthlessness Energy loss and fatigue Concentration problems Appetite/weight changes Psychomotor retardation or agitation Suicidal ideation Ask self - do they meet criteria? if they do, then they have it ```
70
Maternal serum alpha-feto pr levels: high vs low
High: open neural tube defects (anencephaly, open spina bifida), ventral wall defects (gastroschisis, omephacele), multiple gestation Low: aneuploidies (18, 21)
71
Golgi tendon organ
Sits at jcn between muscle and tendon, sense contraction against resistance (not muscle lengthening). If force is too great - will communicate with SC via interneurons and tell the muscle to be paralyzed to save skeletal structure
72
start and stop codons
start : AUG | stop: UGA, UAA, UAG
73
Male internal and external sex differentiation
Male bone XY SRY gene will allow testicle development From testicles get Sertoli and Leydig Cells Sertoli secrete AMH, F regression insues Leydig Cells produce testosterone = wolfian ducts go male, testosterone also made in (peripherally converted) DHT -> external development
74
Late Alzheimer's Disease MT
APO E4 (apolipoprotein) - believed to form senile plaques
75
MVC head injury - cause diabetes insipidis -> how px?
hyperosmotic blood - loss of free water - decrease in intracellular/extracellular fluid
76
Wilson Dz - which brain degeneration part?
putamen (lateral to globus pallidus)
77
Most important factors for auto-regulation of coronary blood flow: (2)
NO is #1 (from arginine and oxygen - works via guanylate-cyclase) adenosine (works small arteries) (auto regulation by local control mostly?) nervous system (NE via sympathetic nerves) has low input for coronary blood flow autoregulation
78
Diffusion speed across a semipermeable membrane (dialysis) - how to increase or decrease?
increase diffusion speed: higher molecular concentrations of gradients, large membrane surface area, increased solubility of diffusing substance decrease: increase membrane thickness, small pore size, high molecular weight, low temperatures
79
Congenital association(abnormalities)- connected without known cause - mnemonic and name them
``` VACTERL vertebral defects anal atresia cardiac defects TE fistula renal anomalies limb abnormalities ** ```
80
von Hippel-Lindau syndrome - 3 Px Sx and major gene deletion
Px - renal cell carcinoma, hemangioblastomas, pheochromocytoma Major gene deletion = chromosome 3 gene deletion
81
Whats made in Basal nucleus of Meynert
Acetylcholine
82
whats made in ventral tegmentum, SNpc
DA
83
whats made in nucleus accumbens
GABA
84
whats made in locus ceruleus
NE
85
whats made in raphe nucleus
SER
86
Blotting -mnemonic
SNoW DRoP Southern = DNA Northern = RNA Western = Protein
87
Read and understand the answer choices...
foramen ovale is in the atria... why did you pick some ventricle...
88
anti-Jo-1 =?
anti-Jo-1 = anti-histidyl-tRNA synthase seen in polymyositis and dermatomyositis (with rash)
89
``` Gential lesions - painful, not painful? Haemophilus Ducreyi HSV1/2 Klebsiella granulomatis Treponema pallidum Chlamydia trachomatis ```
``` Haem d - yes HSV1/2 - yes Kleb - no Treponema - no Chlamydia trach - no ```

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