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uWorld Flashies > uWorld 58 > Flashcards

uWorld 58 Flashcards

1
Q

13 month old with history of otitis media, pneumonia, and thrush w/ pneumocystis

failure to thrive, chronic diarrhea

A

SCID

TX: stem cell transplant

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2
Q

TYPE IV HYPERSENSITIVITY is mediated by what cells

A

Th1 and MACROPHAGES, CD8

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3
Q

failure to generate a response to candida antigen infection is referred to as what

A

ANERGY (expected in SCID)

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4
Q

what is seen 4-12 hours after MI

A

early coagulation necrosis
edema
hemorrhage
wavy fibers

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5
Q

what is seen 12-24 hours after MI

A

coagulation necrosis and marginal contraction band necrosis

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6
Q

G6PD is inherited how

A

X-linked recessive

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7
Q

PANCYTOPENIA WITHOUT HEPATOSPLENOMEGALY

A

APLASTIC ANEMIA

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8
Q

phosphoribosyl pyrophosphate (PRPP) synthetase does what

A

responsible for production of the activated ribose necessary for de novo synthesis of purine and pyrimidine nucleotides

over activation causes HYPERURICEMIA and GOUT

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9
Q

NSAIDS affect what cells

A

NEUTROPHILS

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10
Q

what does hepatitis B do to help hepatitis D

A

HBsAg provides coating of the viral particles

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11
Q

most common cause of meningitis in ADULTS OF ALL AGES

A

STREP PNEUMONIAE (lancet-shaped Gram-positive cocci are found in paris)

alcoholics, sickle cell anemia patients, splenic individuals, and those in generally poor health are at greater risk

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12
Q

what are bean-shaped gram-negative cocci in pairs

A

Neisseria meningitidis

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13
Q

what is a facultative intracellular, motile, gram positive rod

A

LISTERIA

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14
Q

infants with what are especially at risk for vitamin K

A

CYSTIC FIBROSIS (poor absorption)

PARETNAL REFUSAL OF PROPHYLAXIS (like if they dont have vaccines and other meds)

EXCLUSIVE BREAST FEEDING

infants without prenatal care are also at risk

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15
Q

how does monocyte relaxation happen

A

CALCIUM EFFLUX form the cytoplasm

intracellular calcium is removed primarily via Na+/Ca2+ EXCHANGE PUMP (NCX) and sarcoplasmic reticulum Ca2+-ATPase (SERCA)

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16
Q

elevates serum levels of what contributes to acanthosis nigricans

A

FREE FATTY ACIDs

insulin resistance from T2DM causes increased LIPOLYSIS (insulin inhibits lipolysis normally) causing elevated FFA levels which then contribute to insulin resistance by impairing insulin-dependent glucose uptake and increasing hepatic gluconeogenesis

17
Q

pro-carcinogens are metabolized by what

A

CYTOCHROME P450 MONOOXYGENASE- an enzyme system present in hepatic microsomes and the endoplasmic reticula of varied other tissues

18
Q

what causes a ZENKER diverticulum

A

abnormal spasm or diminished relaxation of the cricopharyngeal muscles during swallowing (CRICOPHARYNGEAL MOTOR DYSFUNCTION) is thought to be the underlying mechanism of formation

results in early OROPHARYNGEAL DYSPHAGIA with feeling of food obstruction at the level of the neck and coughing/choking

increased oropharyngeal intraluminal pressure eventually results in herniation of the pharyngeal mucosa through a zone of muscle through a zone of muscle weakness (FALSE DIVERTICULUM) in the posterior hypo pharynx (Killian Triangle)

food retention with HALITOSIS/REGURGITATION

PULMONARY ASPIRATION of diverticular contents may also lead to recurrent pneumonia

19
Q

fatiguability, weight gain, and myoedema (focal mounding of muscle following percussion)- what is the most likely cause of myopathy

A

HYPOTHYROIDISM

hypothyroidism myopathy may be one of the first manifestations (elevated creatinine kinase)

20
Q

what is bronchiolitis

A

lower respiratory tract infection that usually occurs before age 2

most commonly caused by RESPIRATORY SYNCYTIAL VIRUS (RSV)

hypoxemia, TACHYPNEA, and RETRACTIONS with diffuse WHEEZES and CRACKLES

21
Q

what gout mediation selectively binds to an INTERLEUKIN-1 INDUCIBLE ENZYME that is highly expressed by inflammatory cells and undetectable in the surrounding normal tissue

A

COX-2

22
Q

what is consciously faking sick to play the sick role

A

FACTICIOUS DISORDER

23
Q

what is MALINGERING

A

falsification or exaggeration of symptoms to obtain sternal incentives (SECONDARY GAIN)

24
Q

what is somatic symptom disorder

A

excessive anxiety and preoccupation with more than 1 unexplained symptoms

25
Q

what is the infundibulopelvic (IP) ligament

A

aka SUSPENSORY LIGAMENT OF THE OVARY

carries the blood supple to the ovary

ROTATION of the ovary around the IP ligament results in OVARIAN TORSION

26
Q

what are risk factors for OVARIAN TORSION

A

rotation of the ovary around the IP ligament

presence of a LARGE OVARIAN MASS (CYST, NEOPLASM)- weight of mass causes the ovary to TWIST and OCCLUDE the OVARIAN VESSELS and NERVES

27
Q

what happens to the ovary in blood flow is completely blocked in ovarian torsion

A

EDEMATOUS and ISCHEMIC

28
Q

what maintains the ante flexion of the uterus

A

round ligament

runs form the lower aspect of the uterus through the inguinal ring to the labia majora and is not connected to the ovaries

during pregnancy, a woman may experience intermittent sharp pain due to irritation from sudden movements of the stretching round ligament

29
Q

what does the uterosacral ligament do

A

connects the posterior aspect of the uterus to the anterior portion of the sacrum

hold the uterus in an anteverted or retroverted position; loss of this support contributes to uterine prolapse into the vagina

30
Q

Henoch-Schonlein Purpura (HSP) affects what

A

GI Tract- intermittent abdominal pain

Kidneys

Skin

JOINTS- self-limited migratory arthralgia and arthritis are most commonly seen in the large joints of the lower extremities (ankle and knee joints), possibly because of their dependent nature

31
Q

lipid looking shits in a biopsy of the UPPER EYELID of an elderly woman is seen in what

A

PRIMARY BILIARY CIRRHOSIS

XANTHELASMA

32
Q

patient with PANCREATITIS and subsequent respiratory failure likely has what

A

ACUTE RESPIRATORY DISTRESS SYNDROME

33
Q

hepatic angiosarcomas have what tumor marker

A

CD31

34
Q

what causes functional hepatic amenorrhea

A

reduced circulating LEPTIN levels as a result of diminished adipose tissue stores

decreases in leptin inhibits pulsatile GnRH release from the hypothalamus, causing decreased pituitary LH and FSH secretion, low circulating ESTROGEN levels, and amenorrhea

35
Q

what hormone stops lactation

A

PROGESTERONE

36
Q

guillain-barre syndrome is an acute demyelinating disease with an immune-mediated pathogenesis of what

A

ENDONEURAL INFLAMMATORY INFILTRATE causing SEGMENTAL DEMYELINATION

37
Q

in the CNS how long does Wallerian Degeneration

A

slow due to blood-brain barrier

slow removal of MYELIN DEBRIS can PERSIST for YEARS in eh degenerating tracts and SUPRESS AXONAL GROWTH via myelin-associated inhibitory factors

ASTROCYTES also release inhibitory molecules and proliferate in the weeks to months following injury, forming a GLIAL SCAR that act as a BARRIER to axon regeneration

uWorld Flashies (62 decks)

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