UWorld Flashcards
(268 cards)
1
Q
Drug classes used to treat BPH
A
5-alpha reductase inhibs (finasteride) and alpha-adrenergic blockers (prazosin), antimuscarinics
2
Q
What are the humoral and cell components of Type III hypersensitivity?
A
Antibody-antigen complexes, complement; neutrophils
3
Q
E coli virulence factor in bloody diarrhea
A
Verotoxin (Shiga-like)
4
Q
What areas is drained by para-aortic nodes?
A
Testes, ovaries, kidneys, uterus
5
Q
Cofactors of branched chain alpha-ketoacid dehydrogenase, pyruvate dehydrogenase, alpha-ketoglutarate dehydrog
A
Thiamine (B1), FAD (B2), NAD (B3), Acetyl CoA (B5), lipoate
6
Q
Cancer of rectum below dentate metastasizes to
A
Lungs (enters systemic circ thru internal iliac)
7
Q
What’s in the carpal tunnel?
A
Flexor digitorum profundus tendons, flexor digitorum superficialis tendons, flexor pollicis longus tendon, median nerve
8
Q
anti-centromere
A
CREST
9
Q
What rxn is catalyzed by aldose reductase?
A
Glucose to sorbitol (sorbitol accums in DM)
10
Q
granular muddy brown casts
A
ATN
11
Q
Triceps reflex
A
C7, C8
12
Q
Toxic component of lipopolysaccharide
A
Lipid A
13
Q
Biceps/brachioradialis reflex
A
C5, C6
14
Q
Howell Jolly bodies
A
Basophilic nuclear remnant in RBCs (should have been removed by spleen). Occurs in sickle cell and post-splenectomy
15
Q
What enzyme is primarily responsible for NADPH pdtion?
A
G6PD
16
Q
painless, spontaneous lower GI bleeding in a child
A
Meckel diverticulum
17
Q
What causes a left shift in O2-hemoglobin curve?
A
Left shift=less O2 to tiss: decr H+ (high pH), decr 2,3 BPG, decr temp
18
Q
What’s the protein defect with elevated chylomicron and VLDL remnants?
A
ApoE
19
Q
Intestinal lipase inhibitor used for weight loss
A
orlistat
20
Q
lung cancer assoc with gynecomastia and galactorrhea
A
large cell carcinoma
21
Q
cAMP signal pathway
A
lots pituitary: FSH, LH, ACTH, TSH, CRH, hCG, ADH, MSH, PTH, calcitonin, GHRH, glucagon, histamine, epinephrine
22
Q
Lymph node that drains lower rectum to anal canal above pectinate
A
Internal iliac
23
Q
Infections with catalase positive bugs
A
Chronic granulomatous disease
24
Q
Ecthyma gangrenosum
A
P aurigonsa
25
Fetus with limb and craniofacial abnormalities, neural tube defects, abortion
MTX
26
Probenecid MOA
Blocks organic anion transporter in kidney to incr conc in serum (penicillin) or urine (urate)
27
Where's glucokinase?
Beta cells of pancreas and liver
28
CN for carotid sinus reflex
IX in, X out
29
Neuroleptic malignant syndrome symptoms
Hyperthermia, lead pipe rigidity, autonomic instability, altered mental status
30
Cell types seen in inflammatory diarrhea or dysentery
Leukoctyes +/- RBCs
31
Severe intermittent abdominal pain that presents with currant jelly stool
Intussusception
32
Niacin synth'd from (blank)
tryptophan
33
Drugs that inhibit NF-kB
Corticosteroids
34
What areas are drained by internal iliac nodes?
Rectum to anal canal, bladder, vagina, cervix, prostate
35
Solid, cystic, and calcified mass in brain
Craniopharyngioma
36
bilious emesis, abdominal pain and failure to pass meconium
Hirschsprung disease
37
Passes thru foramen magnum
Brainstem, spinal root of CN XI, vertebral arteries
38
Ketogenic aa's
Leucine and lysine
39
Screening test for fetal lung maturity
Lecithin-sphingomyelin ratio (<1.5 predictive of NRDS)
40
antiandrogen therapy that blocks androgen receptors
flutamide, spironolactone
41
Function of malonyl-CoA
Fatty acid synthesis and blocks beta oxidation thru inhib of carnitine acyltransferase
42
CML translocation and mutation
t(9;22); BCR-ABL inhibs apoptosis and promotes tyrosine kinase
43
waxy casts
ESRD
44
CN in medulla
IX, X, XI,, XII
45
Murmurs heard with handgrip
AR, MR, VSD
46
anti-Smith
specific for SLE
47
Injury to superior gluteal nerve
Motor: thigh abduction
48
Pre-existing recipient antibodies react to donor antigen
hyperacute transplant rejection
49
Type III collagen
reticulin--skin, blood vessels, uterus, fetal tiss, gran tiss
50
bronchiolitis obliterans, accelerated atherosclerosis, chronic graft nephropathy, vanishing bile duct
chronic transplant rejection
51
What are the CV defects associated with with Kartagener?
Situs inversus
52
projection
attributing one's own feelings to others (thinking someone is angry with you when you're angry with them)
53
vitamin deficiency with peripheral neuropathy and cardiac involement
wet beriberi from thiamine deficiency (wet involves heart)
54
antiandrogen therapy that blocks conversion of testosterone to DHT at peripheral tissues
5-alpha-reductase inhibs eg finasteride
55
Receptor tyrosine kinase signal pathway
MAP kinase growth factors: insulin, IGF-1, FGF, PDGF, EGF
56
Horizontal nystagmus, abducens palsy, ataxia, encephalopathy
Wernicke enceph (damage to mamillary bodies)
57
Marfinoid body habitus plus intellectual disability and thrombosis
Homocystinuria. Cystathione beta synthase mutation leads to buildup and methionine and homocysteine
58
fatty casts
nephrotic syndrome
59
Injury to tibial nerve
Sensory: Bottom of foot to lateral edge; Motor: foot inversion, plantar and toe flexion
60
Traverses foramen ovale
V3
61
Osteogenesis imperfecta mutation
Type I collagen
62
Cyanotic congenital heart disease
Tet of Fallot; truncus arteriosus; transposition; tricuspid atresia, total anomalous pulm venous connection
63
E coli virulence factor in bacteremia and septic shock
Lipopolysaccharide
64
What antibody protects from Giardia?
IgA
65
vasculitis of graft vessels with interstitial lymphocytic infiltrate
acute transplant rejection
66
DNA polymerase with 5' to 3' exonucleases activity that excises RNA primers on lagging strand
DNA polymerase I
67
Meds that can cause hyperkalemia
Nonselective beta-blockers, ACE-I, ARB, K+ sparing diuretics, Cardiac glycosides, NSAIDs
68
antimitochondrial Abs
PBC
69
Injury to common peroneal nerve
Sensory loss along lateral shin and dorsum of foot; Motor: Foot eversion, dorsiflexion, toe extension
70
Malrotation of midgut
Usually asymptomatic but can lead to ischemia and volvulus
71
Oxidase positive
P aeruginosa, Neisseria, Vibrio, Campylobacter, H pylori, Legionella
72
Granulomatous inflammation and destruction of intrahepatic, interlobular bile ducts
Primary biliary cirrhosis
73
Branches of celiac trunk
Common hepatic, splenic, left gastric
74
Cerebellar ataxia, telangiectasias, incr risk of sinopulmonary infections
Ataxia telangiectasia (mutation in gene responsible for DNA break repair)
75
Dyslipidemia with premature CAD, tendon xanthomas, xanthelasmas
Familial hypercholesterolemia. Defect in LDL receptor and ApoB
76
number needed to treat
NNT=1/ARR
77
Common causes of septic arthritis in sickle cell
S aureus, salmonella
78
Congenital heart dz, dysmorphic facies, hypocalcemia
DiGeorge
79
Halflife equation
.7*Vd/Cl
80
Genitofemoral nerve
Sensory: scrotum/labia majora; medial thigh; Motor: cremaster
81
Biochem processes exclusively in mito
Fatty acid oxidation, TCA, gluconeogenesis (pyruvate carboxylation)
82
Causes of osteomyelitis in sickle cell
Staph aureus, Salmonella
83
Type IV collagen
basement memb, basal lamina, lens
84
Causes of osteomyelitis in IVDU
Pseudomonas, candida, S aureus
85
Bite cells and Heinz bodies
G6PD deficiency
86
Fetus with Ebstein anomaly, nephrogenic diabetes insipidus, hypothyroidism
lithium
87
Injury to obturator nerve
Sensory loss on inner thigh; Motor: thigh adduction
88
pyuria without casts
acute cystitis
89
Upward gaze palsy from damage to..
Superior colliculus
90
Acidic aa's
Aspartate, glutamate
91
Treatment for organophosphate
Atropine (antichol) to counteract cholinesterase inhib
92
nephrotic syndrome in those with hepatitis
membranous nephropathy
93
Pudendal nerve
Sensory: perineum and external genitalia; motor: external urethral and anal sphincters
94
What's the function of micro RNA?
gene silencing and mRNA degradation
95
Drugs that prevent IL-2 txn
Cyclosporine and tacrolimus
96
Traverses foramen rotundum
V2
97
E coli virulence factor in infant meningitis
K1 capsular polysaccharide
98
Fetus with nasal hypoplasia, stippled epiphysis
Warfarin
99
MOA botulinum toxin
cleaves SNARE and blocks exocytosis of ACh NTs
100
Type II collagen
cartilage
101
lung cancer assoc with Cushing syndrome, Lambert-Eaton, SIADH
small cell carcinoma
102
What's the protein defect with elevated LDL?
LDL receptor, ApoB-100
103
donor T cells proliferate in immunocompromised host and reject host cells
graft vs host disease
104
What activates Th1? What inhibs Th1?
Activate: IL-12, IFN-gamma; Inhib: IL-4, 10
105
Nutrients that can contribute to serotonin syndrome
Tryptophan, omega 3 fatty acids
106
Hypoketotic hypoglycemia
Failure of fatty acid degradation from lack of carnitine or acyl-CoA dehydrog
107
Cell types seen in watery diarrhea
No inflammatory cells, just mucus and sloughed epithelial cells. Enterotoxin which is noninflamm
108
Enzyme defic in hereditary fructose intolerance
Aldolase B
109
Treatment for maple syrup disease
Restriction of valine, luceine, isoleucine; supplementation of thiamine
110
What are the CV defects associated with Down Syndrome?
Endocardial cushion defects: ASD, VSD, single AV node (ostium primum and regurge)
111
pacemaker rates
Fastest to slowest: SA, AV, bundle of his/Purkinje/ventricles
112
precursor of pyrimidine
orotic acid
113
E coli virulence factor in watery diarrhea
Heat stable/labile enterotoxin
114
Traverses jugular foramen
IX,X,XI, jugular vein
115
Arthralgias, skin findings, ACE elevation, hilar lymph nodes
Sarcoidosis
116
CN for gag reflex
IX in, X out
117
Symptoms of right sided vs left sided colon cancer
Right: bleeding and iron defic anemia; Left: obstruction
118
Follicular lymphoma
t(14;18); Bcl-2 is antiapoptotic
119
Failure of gut recanalization
Duodenal atresia
120
Lymph node that drains foot and calf
Popliteal
121
Burkitt lymphoma translocation and mutation
t(8;14); c-Myc is transcription activator
122
vasculitis common in patients with hepatitis
polyarteritis nodosa
123
What's the function of small nuclear RNA?
mRNA splicing and transciption regulation
124
Drugs that increase coronary vasodilation
CCBs (both di and nondi)
125
Type I collagen
bone, skin, tendon
126
What are the CV defects associated with DiGeorge?
3 Ts: tetrology of Fallot, truncus arteriosus, transposition of great arteries
127
Structures supplied by IMA
Distal 1/3 of transverse colon to upper part of rectum
128
Child with Intellectual disability, seizures, hypopigmentation
Phenylketonuria
129
cardiac tissue conduction velocity
Fastest to slowest: purkinje, atrial muscle, ventricular muscle, av node (mnemonic: park at venture ave)
130
Congenital toxo
Chorioretinits, cranial calcifications, hydrocephalus
131
Lateral gaze palsy from damage to
Frontal eye fields or abducens nerve in pons
132
Lymph node that drains anal canal below pectinate
Superficial inguinal
133
Cancer of rectum above dentate metastasizes to
Liver (enters portal circ thru inf mesenteric)
134
Structures supplied by celiac artery
Pharynx, lower esophagus to proximal duodenum, liver, gallbladder, pancreas, spleen
135
Enfuvirtide MOA
fusion inhib by binding to gp41
136
What's in the aortic hiatus of diaphragm?
aorta, thoracic duct, azygos vein
137
heterophile abs against sheep erythrocytes
Mono
138
absolute risk reduction
ARR=control rate - treatment rate
139
What are the humoral and cell components of type IV hypersensitivity?
No humoral; T cells and macrophages
140
Syringomyelia
Bilateral loss of pain and temperature. Occurs in Chiari I malformation
141
What does Th1 release?
IL-2, IFN-gamma, TNF-alpha
142
reaction formation
doing something that's the opposite of what you're feeling
143
RBC casts
glomerulonephritis, malignant HTN
144
Precursor of vit A
carotene
145
Enzyme that's deficient in lead poisoning
ALA dehydrotase or ferrochelatase
146
Anticholinergic toxicity
Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter, full as a flask (urinary retention), fast as a fiddle (tachycardia)
147
widespread thrombosis of graft
hyperacute transplant rejection
148
What antibody binds mast cells and basophils?
IgE
149
Albinism, pyogenic infections, progressive neuro dysfunction
Chediak-Higashi
150
lung cancer assoc with clubbing and hypertrophic osteoarthropathy
adenocarcinoma
151
Iliohypogastric nerve
Sensory: suprapubic; motor: abs and obliques
152
drugs that cause arterial dilation and decr afterload
dihydropyridines (nifedipine)
153
What are the CV defects associated with Marfan?
Aortic dissection and aneurysm, mitral valve prolapse
154
Drugs that prevent response to IL-2
Sirolimus
155
frontal bossing, macrocephaly, short arms and legs, midface hypoplasia
achondroplasia (FGFR3 mut)
156
Causes of agglute neg mono-like syndromes
CMV, HHV-6, HIV, Toxo
157
Bacterial and viral infections in infancy, chronic diarrhea, mucocutaneous candidiasis
Severe combined immunodeficiency disorder
158
Porphyria with blistering and photosensitivity
Porphyria cutanea tarda; uroporphyrinogen decarboxylase
159
IP3 signal pathway
GnRH, Oxytocin, ADH, TRH, Histamine, ang II, gastrin
160
sustained, involuntary muscle contractions
dystonia
161
CN for pupillary light reflex
II in, III out
162
IgM against Fc portion of IgG
Rheumatoid factor
163
CN in midbrain
III, IV
164
cGMP signal pathway
vasodilators: ANP, BNP, EDRF (NO)
165
Where's hexokinase?
Most tiss (not liver or pancreas)
166
Enzyme that's deficient in sideroblastic anemia
ALA synthase
167
Drug that inhibits pancreatic enzymes needed to digest complex carbs
Acarbose
168
What enzyme is deficient in homocystinuria and what builds up?
Defic of cystathione beta-synthase leads to high levels of homocysteine and methionine
169
Patellar reflex
L3, L4
170
Horizontal gaze center in
pons
171
Newborn with hyperammonemia
Ornithine transcarbamylase defic is most common. Presents with high orotic acid and low citrulline. Carbamoyl phos synthetase defic results in low orotic and citrulline
172
drugs that decrease HR
beta blockers and nondihydropyridines (verap and dilti)
173
Causes of myopathy with increased creatine kinase
Autoimmune (polymyositis), musc dystrophy, hypothyroid, statins
174
What's in the esophageal hiatus of diaphragm?
Esoph, vagus nerve, left gastric artery
175
What are the humoral and cell components of Type II hypersensitivity?
IgG, IgM and complement; NK cells, eos, neutrophils, macrophages
176
Glutamate is precursor of (2)
GABA, glutathione
177
Phosphorylation of mannose residues in Golgi send prot to...
lysosome
178
Difficulty swallowing, speaking and blurred vision
C botulinum
179
Murmurs that decrease with squatting and passive leg raise
MVP and HCM
180
Molecule necessary for glutathione antioxidant mech
NADPH
181
What's the only way for more oxygen to be delivered to the heart?
increase coronary blood flow
182
E coli virulence factor in UTIs
P fimbriae
183
Alport syndrome and Goodpasture mutation/autoab
Type IV collagen
184
Bacterial component that aids in attachment to epithelium
Pili
185
Traverses foramen spinosum
Middle meningeal artery and vein
186
What are the CV defects associated with turners?
Aortic coarctation, bicuspid aortic valve
187
Fetus with renal dysgenesis, oligohydramnios
ACE-I
188
CN for vestibulo-ocular reflex
VIII in; III, IV, VI out
189
Ehlers-Danols mutation
Type III collagen
190
Schistocytes
Microangiopathic hemolytic anemia: DIC, TTP/HUS, HELLP, mechanical trauma
191
relative risk reduction
RRR=ARR/control rate
192
CN for cough reflex
X in, X out
193
Enzyme defic in essential fructosuria
Fructokinase (excess fructose metab'd by hexokinase)
194
hyaline casts
nonspecific
195
What's the protein defect with elevated chylomicrons?
Lipoprotein lipase, ApoC-2
196
What recognizes toll-like receptors and PAMPS?
Cells of innate immunity
197
Mantle cell lymphoma translocation and mutation
t(11;14); cyclin D1 promotes G1 to S
198
Injury to inferior gluteal nerve
Motor: thigh extension
199
nephrotic syndrome in those with HIV or heroin use or sickle cess
focal segmental glomerulosclerosis
200
Neonatal hypotonia, hyperphagia, obesity, hypogonadism
Prader-Willi (loss of paternal allele)
201
Antiandrogen therapy that lowers testosterone synthesis
Leuprolide (GnRH agonist that suppresses LH when given continuously) and ketoconazole
202
Histidine is precursor of
histamine
203
Treatment for jinsonweed
Physiostigmine or other cholinesterase inhib to counteract antichol toxicity
204
What are the humoral and cell types in Type I hypersensitivity?
IgE; mast cells and basophils
205
Drugs that cause venodilation and decr preload
Nitrates
206
flailing of arm or leg
hemiballismus from lesion of CL subthal nucleus
207
Brown-Sequard (hemisection)
Lose all sensation at level of lesion, then IL dorsal column and CL spinothalamic. IL LMN signs at level of lesion, IL UMN signs below
208
Failure of extraembryonic gut to return to abdomen cavity
Omphalocele (covered by thin memb) or gastroschisis (not covered)
209
CD8+T cells against donor MHCs and development of antibodies
acute transplant rejection
210
sudden, brief, uncontrolled muscle contraction
myoclonus
211
Virulence factor that inhibits phagocytosis and complement activation
Protein M (S pyogenes)
212
epilepsy/seizures, ataxia, inappropriate laughter
Angelman (loss of maternal allele)
213
Porphyria with painful abdomen and port wine urine and polyneurophaty
Acute intermittent porphyria; porphobilinogen deaminase
214
CN in pons
V, VI, VII, VIII
215
Murmurs that decrease with handgrip
HCM and AS
216
Glycine is precursor of
prophyrin then heme
217
maculopapular rash, jaundice, diarrhea, hepatosplenomegaly
graft vs host disease
218
What activates and inhibs Th2?
Activate: IL-2,4; Inhib: IFN-gamma
219
WPW triad
short PR, wide QRS, delta wave
220
CN for corneal reflex
V1 in, VII out
221
Basic aa's
histidine, lysine, arginine (his lyes are basic)
222
What causes a right shift in O2-Hb curve?
Right shift=more O2 to tiss: incr H+ (low pH), incr 2,3-BPG, incr temp
223
Biochem processes exclusively in cyto
Glycolysis, fatty acid synth, pentose phosphate
224
Intracell receptor signal pathway
Progesterone, estrogen, testosterone, cortisol, aldosterone, t3/t4, vitamin D
225
What enzyme is deficient in galactosemia?
Galactose-1-phosphate uridyltransferase
226
What areas are drained by superficial inguinal nodes?
Anal canal, skin below umbilicus, scrotum, vulva
227
WBC casts
pyelonephritis, inflammation, transplant rejection
228
precursor of tyrosine
phenylalanine
229
Achilles/ankle reflex
S1, S2
230
G6PD precipitating factors
Infection, drugs (TMP-SMX, dapsone, antimalarials), DKA, fava beans
231
Fetus with neural tube defects, orofacial clefts, microcephaly, nail/digit hypoplasia
phenytoin, valproate (just tube defects)
232
lung cancer most common in women and nonsmokers
adenocarcinoma
233
Inflammation and onion skin fibrosis of large bile ducts and obstruction of small ducts
Primary sclerosing cholangitis
234
MOA tetanus toxin
cleaves SNARE in inhibitory interneuron preventing release of GABA and glycine NTs
235
Arginine is the precursor of
nitric oxide, urea, ornithine, creatine
236
What enzymes can't be broken down in maple syrup dz?
Leucine, isoleucine, valine (branched chain aa's)
237
Structures supplied by SMA
Distal duodenum to proximal 2/3 of transverse colon
238
CD4+T cells respond to recipient APCs
chronic transplant rejection
239
Murmurs heard during valsalva and abrupt standing
MVP and HCM
240
Target cell
HALT: Hb C, asplenia, liver disease, thalassemia
241
Dyslipidemia with acute pancreatitis, skin xanthomas, and hepatosplenomegaly
Familial chylomicronemia. Defect in LPL and ApoC
242
What are the CV defects associated with tuberous sclerosis?
valvular obstruction due to cardiac rhabdomyomas
243
Zinc-containing enzyme that degrades basement membrane and ECM
Metalloproteinase (proteolytic enzyme)
244
Disorder that causes black urine and can progress to arthritis (and pathophys)
Alkaptonuria. Mutation in homogentistic acid dehydrogenase which breaks down phenylalnine and tyrosine
245
Maraviroc
Inhibs viral entry by blocking gp120--CCR5
246
Cremasteric reflex
L1, L2
247
Serotonin syndrome symptoms
Hyperthermia, hyperreflexia, shivering, clonus, autonomic instability, altered mental status
248
Syndromes/cancers with mutation of DNA repair enzymes
Breast (BRCA), ovarian cancer, Lynch, xeroderma pigmentosum, Fanconi anemia
249
restlessness and urge to move
akithisia
250
relative risk
RR=treatment rate/control rate
251
Elevated alkaline phosphate
Hepatobiliary disease and elevated osteoblastic activity
252
Common causes of septic arthritis
S aureus, strep, N gonorrhea
253
CN for jaw-jerk reflex
V3 in, V3 out
254
formation of fibrous Ladd bands
malrotation of gut
255
Fetus with microcephaly, thymic hypoplasia, small ears, hydrocephalus
Isotretinoin
256
hematuria without casts
cancer, stones
257
Fetus with mental retardation, microcephaly, smooth philtrum, thin vermillion border, limb dislocation, heart defects
Fetal alcohol syndrome
258
Spherocyte
Spherocytosis, drug/infection induced hemolytic anemia
259
Tryptophan is precursor of (2)
Niacin, serotonin
260
lung cancer assoc with hypercalcemia
squamous cell carcinoma
261
ilioinguinal nerve
runs with spermatic cord; sensory to upper and medial thigh and external genitalia
262
Nonreceptor tyrosine kinase signal pathway
JAK/STAT: prolactin, immunomodulators (cytokines), GH, G-CSF, erythropoietin, thrombopoietin
263
sublimation
channeling impulses into socially acceptable manner
264
What are the CV defects associated with Friedreich ataxia?
Hypertrophic cardiomyopathy
265
What antibody is released into secretions and breast milk?
IgA
266
anti-dsDNA
specific for SLE
267
Injury to femoral nerve
Sensory loss from inner thigh down to ankle; Motor: thigh flexion, leg extension
268
anti-ANA
sensitive but not specific for SLE; also in pts with other conn tiss disorders
