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UWorld Flashcards

1
Q

“slapped cheek rash”

A

Parvo B19 replicates in erythrocytes

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2
Q

car accident

A

asplenic sepsis

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3
Q

Is Group B Strep bacitracin resistant?

A

YES

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4
Q

pustular lesions with thick scabs

A

impetigo caused by s. aureus, s. pyogenes

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5
Q

facial puffiness and hematuria

A

post-strep glomerulonephritis

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6
Q

Gram+

Cat-

B-hemolytic

pyrrolidonyl arylamidase+

bacitracin-sensitive

A

GAS

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7
Q

C diff precautions

A

Non-sterile gloves and gown

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8
Q

benzodiazepines mech of action

A

increased frequency of chloride channel opening

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9
Q

fragile x syndrome

A

226 CGG trinucleotide repeats on X chromosome gene methylation

Creates Giant Gonads

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10
Q

locus ceruleus

A

posterior rostral pons near the lateral floor of the fourth ventricle pigmented nucleus produces norepinephrine

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11
Q

rubeola

roseola

rubella

A

rubeola (aka measels) & rubella same rash (face –> trunk), both live attenuated vacc

rubeola = Koplik spots on buccal mucosa

rubella: Forchheimer spots on soft palate (congenital = cataracts, deafness, PDA)

roseola (aka HHV-6) rash starts on trunk –> face with high fever 3-5 days BEFORE, most common cause of febrile seizures

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12
Q
A

histoplasma capsulatum

can survive intracellularly inside macrophages

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13
Q

What bug can cause pneumonia with watery diarrhea? what lab finding is commonly associated?

A

legionella hyponatremia

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14
Q

what is the most common cause of fatal sporadic encephalitis?

A

HSV-1

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15
Q

What virus is a particularly common cause of pneumonitis in patients with organ transplants?

A

CMV

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16
Q

foot drop can be caused by compression of which nerve?

A

common peroneal

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17
Q

how does methylmalonic acidemia present, and what is the inheritance pattern?

A

AR

metabolic acidosis, hypoglycemia, ketones, hyperammonemia

(caused by methylmalonyl-CoA mutase deficiency)

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18
Q

what is the mech of action of baclofen?

A

agonist at the GABA-B receptor

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19
Q

most common cause of osteomyelitis in patients with sickle cell

A

SALMONELLA

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20
Q

Reed Sternberg cells

A

Hodgkin’s lymphoma

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21
Q

What media is used to isolate Neisseria species?

A

Thayer-Martin (chocolate agar + vancomycin, colistin, nystatin, trimethoprim)

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22
Q

What bacteria is a major pathogen in burn patients?

A

Pseudomonas

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23
Q

what pathogen causes woolsorters disease?

A

bacillus anthracis

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24
Q

what does bacillus anthracis look like on microscopy?

A

long chains “serpentine” or “medusa head”

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25
Q

what is the major virulence factor of bacillus anthracis?

A

antiphagocytic capsule containing D-glutamate (instead of polysaccharide)

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26
Q

what is the virulence factor of salmonella?

A

capsule that protects it from opsonization and phagocytosis

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27
Q

what are the DNA viruses?

A

HHAPPPPy Hepadna, Herpes Adeno Pox, Parvo, Papilloma, Polyoma

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28
Q

What cells does EBV commonly infect?

A

B-cells

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29
Q

How is EBV infection diagnosed?

A

Heterophile antibody test

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30
Q

What drug is used for recurrent c. diff and what is its mech of action?

A

fidaxomicin macrocyclic antibiotic that inhibits RNA polymerase

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31
Q

klebsiella

A

encapsulated lactose-fermenting

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32
Q

what is a common cause of pneumonia in alcoholics?

A

klebsiella

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33
Q

currant jelly sputum

A

klebsiella

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34
Q

what virus acquires envelope from nuclear membrane

A

herpesvirus

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35
Q

What disease does Hib cause most commonly? what is Hib’s major virulence factor?

A

meningitis polyribosylribitol phosphate (PRP)

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36
Q

primary central nervous system lymphoma is typically composed of cells of what type?

A

B-lymphocytes

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37
Q

How does shiga-like toxin work? what bacteria produce it?

A

inactivate the 60s ribosomal subunit shigella EHEC

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38
Q

what bacteria can cause hepatic abscess via hematogenous seeding of the liver?

A

staph aureus

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39
Q

what bacteria can cause hepatic abscess via ascending the biliary tract, portal vein pyemia, or direct invasion from adjacent area (cholecystitis)

A

enteric bacteria (e. coli, klebsiella, enterococci)

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40
Q

what is the mech of action of bacillus anthracis edema factor? a toxin produced by what other bacteria is similar?

A

adenylate cyclase that causes massive increases in intracellular cAMP

bordatella pertussis

cholera

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41
Q

what is the most common cause of bacterial meningitis in adults of all ages?

A

streptococcus pneumoniae

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42
Q

pseudomonas

A

oxidase-positive non-lactose-fermenting

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43
Q

does cryptococcus neoformans have a yeast form?

A

NO

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44
Q

is staph epidermidis sensitive to novobiocin?

A

YES

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45
Q

after what type of strep infection can you get acute rheumatic fever?

A

pharyngitis

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46
Q

what do nocardia species cause?

A

pulmonary, CNS, or skin disease in immunocompromised patients

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47
Q

what pathogens are most often responsible for secondary bacterial pneumonia?

A

strep pneumo, staph aureus, h. flu

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48
Q

what medications cause drug-induced parkinsons

A

D2 receptor blockers (1st generation antipsychotics)

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49
Q

what is the mech of action of benztropine?

A

antimuscarinic

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50
Q

what is polycythemia?

A

when you have a lot of hemoglobin

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51
Q

what do Hb concentration, O2 sat, PaO2, and total O2 content look like in:

CO poisoning

Anemia

Polycythemia

Cyanide poisoning

High altitude

A

CO poisoning: nl Hb, v SaO2, nl PaO2, v O2 content

Anemia: v Hb, nl SaO2, nl PaO2, v O2 content

Polycythemia: ^ Hb, nl SaO2, nl PaO2, ^ O2 content

Cyanide poisoning: all normal

High altitude: all low

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52
Q

what are the 3 variables that affect the total O2 content of blood?

A

Hb concentration, SaO2, PaO2

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53
Q

what cytokines induce/repress Th1 response?

A

induce: IL-12, IFN-y
repress: IL-4, IL-10

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54
Q

what cytokines induce/repress Th2 response?

A

induce: IL-2, IL-4
repress: IFN-y

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55
Q

what cytokines induce Th17 response?

A

TGF-B, IL-6

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56
Q

What cytokines induce Treg response?

A

TGF-B

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57
Q

What do Th1 cells do? What cytokines to they secrete?

A

activate macrophages + Tc-cells

IL-2, IFN-y, lympotoxin B

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58
Q

What do Th2 cells do? What cytokines do they secrete?

A

activate B-cells

IL-4, 5, 10, 13

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59
Q

facial and periorbital edema, mild-moderate HTN, in a patient with hematuria are suggestive of … ?

A

nephritic syndrome / poststreptococcal glomerulonephritis (when occur after a strep infection)

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60
Q

the deposits in the glomerular basement membrane in patients with PSGN are made up of what immune complexes?

A

IgG, IgM, C3

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61
Q

what are the major constituents of surfactant? at how many weeks gestation do they increase?

A

dipalmitoyl phophatidylcholine (lecithin, L), 30 weeks phosphatidylglycerol, 36 weeks

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62
Q

should the amniotic fluid sphingomyelin level remain approximately constant during the 3rd trimester?

A

YES!

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63
Q

asplenic patient (surgical or auto e.g. sickle cell)

A

encapsulated microbes (SHiN = s. pneumo, Hib, n. meningitidis)

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64
Q

branching rods in oral infection

A

actinomyces israelii

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65
Q

sulfur granules

A

actinomyces israelii

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66
Q

chronic granulomatous disease

A

catalse + microbes (esp s. aureus)

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67
Q

dog or cat bite

A

pasteurella multocida

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68
Q

facial nerve palsy

A

borrelia burgdorferi (Lyme disease)

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69
Q

health care provider

A

HBV (from needlestick)

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70
Q

neutropenic patients

A

candida albicans (systemic), aspergillus

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71
Q

PAS +

A

tropheryma whipplei

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72
Q

pediatric infection

A

h. flu (including epiglottitis)

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73
Q

pneumonia in CF, burn infection

A

pseudomonas aeruginosa

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74
Q

pus, empyema, abscess

A

s. aureus

75
Q

rash on hands and feet

A

rickettsia rickettsii

coxsackie A

syphillus

76
Q

sepsis/meningitis in newborn

A

GBS

77
Q

surgical wound

A

s. aureus

78
Q

traumatic open wound

A

c. perfringens

79
Q

how does diphtheria exotoxin inhibit host cell protein synthesis?

A

catalyzing ADP-ribosylation of host cell EF-2

80
Q

does diphtheria stain with aniline dyes?

A

YES

81
Q

immunization with diphtheria toxoid induces production of circulating ___ against the exotoin ___ subunit?

A

IgG

B

82
Q

what are the 4 ways genital herpes can be diagnosed?

A

PCR, direct fluorescence Ab testing, viral culture, Tzanck smear

83
Q

does neisseria meningitidis have a capsule?

A

hell yeah

84
Q

can parvo cause arthritis in adults?

A

YES

85
Q

what is the essential pathogenic mechanism for Shigella infection?

A

mucosal invasion

86
Q

clue cells, vaginitis

A

gardnerella

87
Q

is the rabies vaccine inactivated?

A

YES

88
Q

What are 2 causes of painful genital lesions?

A

chancroid (haemophilus ducreyi)

genital herpes (HSV 1 or 2)

89
Q

What are 3 causes of painless genital lesions?

A

granuloma inguinale (klebsiella granulomatis, multiple lesions, no lymphadenopathy)

syphillis (treponema pallidum, single lesion)

lymphogranuloma venereum (chlamydia trachomatis, small shallow ulcers, inguinal lymphadenopathy)

90
Q

what organism can cause otitis externa? what can cause otitis media?

A

pseudomonas

Hib

91
Q

riboflavin (B2) is a co-factor for what enzyme?

A

succinate dehydrogenase

92
Q

how do urate crystals appear under polarized light?

A

needle-shaped and negatively birefringent

93
Q

what conditions increase urate production?

A

idiopathic gout

myeloproliferative/lymphoproliferative disorders

tumor lysis syndrome

hypoxanthine guanine phosphoribosyl transferase deficiency

94
Q

what are causes of decreased urate clearance?

A

chronic kidney disease

thiazide/loop diruetics

95
Q

what causes the majority of overdose deaths in the US?

A

opiods

96
Q

what drains to the superficial inguinal lymph nodes?

A

cutaneous lymph from the umbilicus down, including the anus below the dentate line

97
Q

when is PVR lowest?

A

at functional residual capacity

98
Q

what should you give an infant born prematurely <32 weeks gestation?

A

corticosteroids! surfactant production

99
Q

what are common findings in acute hemolytic transfusion reaction?

A

fever, hypotension, chest and back pain, hemoglobinuria

100
Q

what are P bodies?

A

cytoplasmic P bodies are distinct foci found within eukaryotic cells that are involved in mRNA regulation and turnover

101
Q

what causes wrinkles?

A

decreased collagen fibril production

increased degradation of type I and III collagen and elastin

102
Q

linear deposits of immunoglobulin along the glomerular basement membrane

A

anti-GBM disease (IgG and C3), form glomerular crescents

103
Q

hyperammonemia and elevated urinary orotic acid =

A

ornithine transcarbamylase deficiency

104
Q

eczema, recurrent infections (encapsulated organisms, due to T and B cell deficiency), and thrombocytopenia =

A

Wiskott-Aldrich syndrome

105
Q

what is secreted in the urine in acidotic states?

A

urinary acids (mainly NH4+ and H2PO4-)

106
Q

cherry red epiglottis

A

Hib

107
Q

how are meningococci transmitted?

A

respiratory droplets

(pilus attaches to epithelial cells in the pharynx –> colonaize –> invade vasculature –> spread hematogenously)

108
Q

can CMV be spread by blood transfusion?

A

yes

109
Q

is initial lesion caused by chlamydia painful?

A

NO

110
Q

what is the toxin of c. perfringens?

A

lecithinase (aka PLC or alpha toxin, catalyzes the splitting of phospholipid molecules –> cell lysis

111
Q

pertussis & cholera toxins both cause an increase in _______

A

cAMP

112
Q

diptheria toxin and pseudomonas exotoxin A inactivate ______

A

EF-2 via ribosylation –> inh host cell protein synthesis

113
Q

what bacteria have capsules?

A

strep pneumo, h. flu, neisseria meningitidis

114
Q

if it looks like EBV, but the question stem tells you it’s not, then what is it?

A

CMV

115
Q

what e. coli virulence factor allows adhesion to uroepithelium, causing UTIs?

A

P fimbriae

116
Q

lysteria produces a narrow zone of __ hemolysis on blood agar

A

B

117
Q

what is staphylococcal scalded skin syndrome?

A

epidermal sloughing and erythema due to exotoxin exfoliatin (staph), occurs in infants and children

118
Q

what conditions/pathogens are associated with cold agglutinins

A

mycoplasma pneumoniae, EBV, hematologic malignancies

119
Q

what conditions are associated with an umbilical hernia?

A

Down syndrome

Hypothyroidism

Beckwith-Wiedemann syndrome

120
Q

failure of extraembyronic gut to return to the abdominal cavity can result in _______

A

omphalocele or gastroschisis

121
Q

embryonic malrotation of the midgut prior to physiologic reduction into the abdominal cavity can result in _____

A

volvulus –> ischemia –> necrosis

122
Q

the superficial inguinal ring is a physiologic opening in what anatomic structure?

A

external abdominal oblique aponeurosis

123
Q

the deep inguinal ring is a physiologic opening in what anatomic structure?

A

transversalis fascia

124
Q

what enzyme deficiency causes hereditary fructose intolerance?

A

aldolase B (F-1-P –> DHAP + glyceraldehyde)

125
Q

normal pressure in the SVC and RA is

A

1-6 mmHg

126
Q

normal RV systolic pressure is

A

15-30 mmHg

127
Q

normal PA diastolic pressure is

A

6-12 mmHg

128
Q

normal PCWP is ___ and is equal to what other pressure?

A

6-12 mmHg, PA

129
Q

which ion is responsible for pacemaker action potential in cardiac pacemaker cells?

A

Ca

130
Q

tyramine-containing foods can cause a hypertensive emergency because their degradation is blocked by what class of drugs?

A

MAO inhibitors (aged cheeses, cured meats, draft beer are tyramine-contining foods)

131
Q

what is the universal start codon?

A

AUG

132
Q

what are the 3 stop codons?

A

UAA, UAG, UGA

133
Q

LH –>

A

leydig cells –> testosterone

134
Q

FSH –>

A

sertoli cells –> inhibin B

135
Q

what virus has a predilection for stratified squamous epithelium? what can this cause in infants?

A

HPV (anal canal, vagina, cervic, true vocal cords)

respiratory papillomatosis

136
Q

which second-generation antipsychotics carry the greatest risk for metabolic syndrome?

A

olanzapine, clozapine

137
Q

what second-generation antipsychotic can cause agranulocytosis?

A

clozapine

138
Q

caudal regression syndrome can be caused by

A

maternal diabetes

139
Q

list the classic demographic and pathophysiolgy of:

indirect inguinal hernia

direct inguinal hernia

femoral hernia

A

indirect: male infants, patent processus vaginalis
direct: older men, weakness of transversalis fascia
femoral: women, weakness of proximal femoral canal

140
Q

what causes intestinal atresia distal to the duodenum?

A

vascular occlusion

141
Q

what dermatologic finding is associated with pseudomonas infection in neutropenic patients?

A

ecthyma gangrenosum

142
Q

what cytokines are secreted by TH1 cells

A

IL-2, IFN-y

143
Q

what is sarcoidosis and what is the classic histological finding

A

dysregulated cell-mediated immune response to unidentified antigen –> formation of multiple non-caseating granulomas characterized by a central collection of tightly custered epithelioid macrophages surrounded by a rim of mononuclear cells

144
Q

how do thiazolidinediones lower glucose in treatment of T2DM

A

binds PPAR-y –> up-regulates transcription of genes that regulate glucose and lipid metabolism (esp adiponectin) –> increases insulin sensitivity

145
Q

CD20 is a ___-cell marker

A

B

146
Q

what are each of the following biologic response modifiers (BRMs) used for?

rituximab

infliximab

IL-2

imatinib

abciximab

A

rituximab: B-cell lymphoma (binds CD-20)
infliximab: ankylosing spondylitis, fistulizing Crohn’s disease

IL-2: renal cell carcinoma, melanoma

imatinib: CML (BCR/ABL philadelphia chromosome)
abciximab: during angioplasty in patients with acute coronary syndrome (blocks platelet aggregation)

147
Q

what is usually the cause of an S3 sound?

A

increased left ventricular end-systolic volume (LV failure)

148
Q

what makes up an MHCI molecule?

A

heavy chain + B2-microglobulin

149
Q

during what step in the TCA cycle is GTP produced?

A

succinyl-CoA –> succinate (succinyl-CoA synthetase)

150
Q

what is freely filtered at the glomerulus and neither reabsorbed nor secreted by the renal tubules (and therefore commonly used to calculate GFR)?

A

inulin

151
Q

what type of insulin should be used in patients presenting with DKA

A

regular insulin (lasts 5-8 hours)

152
Q

what chamber of the heart is closest to the esophagus?

A

LA

153
Q

what pharyngeal/brancial pouch(es) are affected in DiGeorge syndrome?

A

3 (inferior parathyroid and thymus) and 4 (superior parathyroid)

154
Q

light microscopy of a liver biopsy from a child with Reye syndrome shows what

A

microvesicular steatosis (small fat vacuoles in the cytoplasm) of hepatocytes without inflammation

155
Q

what causes diastolic heart failure?

A

decreased ventricular compliance

HTN, obesity, and infiltrative disorders (transythyretin-related amyloidosis, sarcoidosis) are important causes

156
Q

how is peripheral artery disease (PAD) managed

A

graded exercise and cilostazol (PDE inhibitor that inhibits platelet aggregation and acts as a direct arterial vasodilator)

157
Q

what is the most common cause of retinitis in HIV-positive patients, and how is it treated?

A

CMV

ganciclovir

158
Q

what are the acute effects of corticosteroids on the white blood cell count?

A

increased neutrophils (due to demargination)

decreased everything else

159
Q

what is the most common mutation in the CFTR protein in patients with CF and what does it do?

A

deltaF508

causes protein misfolding –> proteasome degradation –> no CFTR proteins on the membrane

160
Q

what cranial nerves pass through the jugular foramen?

A

IX

X

XI

161
Q

all ______ cells contain a well-developed smooth ER

A

steroid-producing

162
Q

what osmotic diuretic can cause pulmonary edema?

A

mannitol

163
Q

which organs are most frequently affected in graft-vs-host-disease?

A

skin

liver

GI

164
Q

fever

pharyngitis

sandpaper-like rash

circumoral pallor

strawberry tongue

A

scarlet fever (caused by GAS –> RF or PSGN)

165
Q

what conditions cause increased/decreased maternal serum AFP

A

increase: NTDs, ventral wall defects, multiple gestation
decrease: aneuploidy

166
Q

what vitamins can be produced by enteric bacteria?

A

vitamin K

folate

167
Q

which vessels are most heavily involved in development of atherosclerotic plaques (in order of most-least)

A

abdominal aorta > coronary a > popliteal a > internal carotids > circle of Wiliis

168
Q

what antibiotic can lead to bone marrow suppression

A

chloramphenicol

169
Q

absorption of which vitamins may be impaired after gastric bypass procedures?

A

iron

B12

golate

fat-soluble (EDAK)

170
Q

koilocytes on pap test are a sign of ____ infection

A

HPV

171
Q

what intrauterine exposure can lead to VSD?

A

alcohol

172
Q

what heart defect can be caused by congenital rubella?

A

PDA

173
Q

what heart defect is associated with down syndrome?

A

ASD

174
Q

what congenital heart defect is associated with maternal diabetes?

A

transposition of the great vessels

175
Q

what heart defect is associated with Marfan syndrome?

A

aortic dissection

176
Q

When I say “Ebstein anomaly,” you say “_____”

Also, what is an Ebstein anomaly?

A

intrauterine Lithium exposure

problem with the leaflets of the tricuspid valve –> tricuspid regurgitation and RHF

177
Q

When I say “coarctation of the aorta,” you say, “______”

What other heart defect is associated with _____?

A

Turner syndrome

bicuspid aortic valve

178
Q

what heart defect is associated with William’s syndrome?

A

supravalvular aortic stenosis

179
Q

what heart defect is associated with 22q11 syndromes?

A

truncus arteriosus, tetralogy of Fallot (DiGeorge)

180
Q

“string of beads” appearance of renal artery

A

fibromuscular dysplasia

181
Q
A
182
Q
A
183
Q
A
184
Q
A

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