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Flashcards in UWorld Facts Deck (107):
1

What do you initially treat Coag Negative Catalase + staph with?

Vanco - assume resistance

2

What is the normal value in ARDS?

Pulmonary wedge pressure - an elevated pressure would be indicative of cardiogenic pulmonary edema

3

A bimodal curve in the concentration of a drug indicates what?

Slow/fast Acetylation - I.E. Isoniazid

4

How do nitrates relieve chest pain in patients with stable angina?

Vasodilate veins
Decrease LV volume/Preload

5

A man who thinks the neighbors are poisoning him despite no proof has what?

Delusional

6

What are the two types of congenital QT?

Romano-Ward (AD) Cardiac only
Jervell and Lange-Nielson - (AR) + sensorineural deafness

7

What is the major pathophysiologic abnormality seen with prolonged NSAID use?

Chronic Interstitial nephritis and papillary necrosis

8

When treating someone with amphotericin B what might you need to supplement?

K and Mg - Inc. distal tubular membrane permeability

9

Desmosine cross-linking between 4 lysines via lysyl-hydroxylase forms what?

Elastin

10

Menkes disease

Impaired copper absorption and decreased activity of lysyl oxidase - kinky/brittle hair - growth retardation - hypotonia

11

Osteogenesis imperfecta

Dec. synthesis of normal Type 1 collagen - impaired matrix formation - blue sclera

12

What stage of collagen formation occurs extracellularly?

Cleavage of disulfide terminal regions of procollagen
Covalent lysine|hydroxylysine cross-linking - lysyl oxidase (Cu)

13

Granulomas in the GI tract

Crohns (Th1 response)

14

UC w/ pANCA

Primary sclerosing cholangitis - onion skinning, hyper IgM, inc. risk for 2 biliary cirrhosis and cholangio

15

Why is htere an incrased risk of gallstones with Crohn's disease

Decreased reuptake of bile salts/acids - cholesterol stones fall out of solution

16

β-glucuronidase

Bacterial enzyme that deconjugates bilirubin - pigment stones

17

Ingestion of the "death cap mushroom" leads to what?

Bind to RNA Pol II - block mRNA synthesis
Abdominal pain, vomiting, diarrhea

18

Increased volume of endolymph in inner ear

Meniere's Disease
Tinnitus, vertigo, sensorineural hearing loss

19

Knocking out the ACA can lead to what

Contra motor/sensory problems of the lower extremities
Urinary incontinence
Behavioral changes

20

Mitochondrial vacuolization indicates what?

Irreversible injury/cell death

21

What disease can cause cystic degeneration of the putamen?

Wilsons Disease

22

What layers will you pass thru during a cricothyrotomy

Superficial cervical fascia
Cricothyroid membrane

23

What causes the flushing after a dose of niacin?

Prostaglandins

24

What is the most common cause of elevated AFP?

Dating error

25

Lung Bx: Spherules packed with endospores

Coccidioides immitis

26

Acute acalculous cholecystitis

Acute inflammation of the GB in the absence of stones - hospitalized and severely ill

27

How does doxycycline and the other tetracyclines act?

Block A site tRNA binding

28

How can you diagnose a thiamine deficiency

Measure erythrocyte transketolase levels (decreased)

29

The mean arterial pressure remains fairly stable during exercise due to an adaptive decrease in what?

Systemic Vascular Resistance

30

What is the major long-term hemodynamic compensatory response to volume overload of Aortic Regurg?

Inc in preload
LV end-diastolic volume (eccentric LVH)

31

Analyzing associations of dietary habits (i.e. Vitamin D intake) and prevalence of a disease is an example of what?

Ecological study - analyzing population

32

Analyzing exposures and outcomes of interest in an individual at a given point in time is called what?

Cross-sectional survey

33

What are the 3 effects of ANP

1. Dilate afferent arterioles, limit Na resorption (PT, IMCD), inhibit renin secretion
2. Restricts aldosterone secretion
3. Relaxes vascular SM

34

What is the action of hypophosphorylated Rb?

Active Rb - prevents G1/S transition

35

What are preterm newborns at risk for?

Vitamin K deficiency - Hemorrhagic disease of the newborn

36

An erosion can extend into, but not through what layer?

Muscularis mucosa
*Once it enters the submucosa it is an ulcer

37

What is the most common location to find colon cancer?

1. Rectosigmoid colon
2. Ascending colon

38

Pathogenesis of EtOH-induced hepatic steatosis is due to what?

Decreased FFA oxidation
2˚ to excess in NADH prodution

39

Eosinophils in the urine indicate what? What drugs can cause this?

Interstitial nephritis
NSAIDs, sulfonamides, rifampin, diuretics, β-lactam

40

Muscle Bx: Glycogen accumulating in lysosomes

Type II: Pompe Disease
Def in acid α-glucosidase

41

What amino acids are metabolized to propionyl CoA?

Threonine, Methionine
Valine, Isoleucine

42

What nerve and artery are at risk with a midshaft fx of the humerus?

Deep brachial artery
Radial nerve

43

A patient with hypertensive emergency after a eating tyramine containing foods is likely on what drug?

MAOIs

44

What does N-acetylcystine do in acetaminophen toxicity?

1. Glutathione substitute
2. Provide sulfhydryl group to enhance non-toxic sulfation elimination

45

Permanent Central Diabetes insipidus is caused by damage to what structure?

Hypothalamus

46

What are the 2 most immediate physical symptoms of marijuana?

Tachycardia and conjunctival injection

47

Cold agglutinins (mycoplasma pneumonia)

Antigenic similarity between m. pneumo and erythrocyte membrane

48

How do β-blockers help in thyrotoxicosis?

Inhibit peripheral iodothyronine deiodinase (conversion from T4 to T3)
Decrease sensitivity to catecholamines

49

What is a central side effect of levodopa?

Anxiety and agitation

50

Axonal reaction (post nerve injury - Wallerian degeneration)

Neuronal body: swollen, nucleus displaced to periphery, Nissl substance is fine and granular

51

Leaving bed when not sleepy/using it only for sleep/sexual activity is an example of what?

Stimulus control

52

True or False: Acute Hepatitis B is usually symptomatic while Hepatitis C is asymptomatic.

True

53

What is the mutation seen in Burkittt Lymphoma

t( 8;14) - c-myc transcription factor

54

How do you get schistosomiasis?

Snails

55

S japonicum and S mansoni cause schistosomiasis in what two locations?
S. haematobium causes schistosomiasis in what location?

S. Japonicum and mansoni = intestinal and hepatic
S. haematobium = urinary

56

Blanching of a vein in which NE is being infused is indicative of what?

NE extravasation - α1 mediated vasoconstriction

57

Palpable but non-tender gallbladder, weight loss, obstructive jaundice?

Pancreatic AdenoCA - head
**smoking

58

Hyperpyrexia

Body temp > 40
Cooling 1st
Antipyretics 2nd

59

Synaptophysin in a brain tumor indicates what origin?

Neuronal

60

PI3K/Akt/mTOR

Cell proliferation
mTOR is a transcription factor

61

Non-expression of the mycobacterial catalase-peroxidase enzyme leads to resistance against what?

Isoniazid

62

Waking up from barbiturates is due to what?

Tissue redistribution of the drug - not metabolism

63

Ticlopidine can cause what serious side effect?

Neutropenia + fever + mouth ulcers

64

What does a kid with cyanotic spell relieved by squatting have?

Tetralogy of Fallot

65

What drugs are used to treat isolated systolic HTN?

Amlodipine & Nifedipine (dyhydro)
Thiazide

66

What is a side effect of amlodipine?

Flushing and peripheral edema

67

What can causes a sudden muscle relaxation in response to inc. stress/force?

Golgi tendon organs

68

Painless 3rd trimester bleeding

Placenta previa - C section

69

Abrupt, painful, 3rd trimester bleeding

Placental abruption
bloody maternal surface

70

What increases the risk of placental abruption

Trauma, smoking, HTN, Preeclampsia and cocaine

71

What causes preeclampsia

Maternal/fetal vascular interface problem - fibrinoid necrosis

72

What is a common cause of death in Cervical CA?

Hydronephrosis with post renal failure - tumor invades thru anterior bladder blocking ureters

73

What are secondary risk factors for cervical CA?

Smoking and immunodeficiency

74

Absent cremasteric reflux

Testicular torsion

75

incomplete closure of the process vaginalis can result in what?

Hydrocele
Indirect Inguinal hernia

76

Thyroid hormone has β-adrenergic effects and increases the BMR - how does it do this?

Ιnc. β1 adrenergic receptors
Inc. Na/K-ATPase

77

Why do you get hypocholesterolemia in hyperthyroidism?

Inc. LDL receptor expression

78

What are teh causes of PTH independent hypercalcemia?

Malignancy
Granulomatous Disease
Vitamin D toxicity

79

What mediates insulin resistance in DM2

Decreased insulin receptors

80

What is the mechanism of a a CF kid who collapses while exercising?

Sodium loss with sweating

81

What does CFTR do in the respiratory/gastric glands and the sweat glands?

R/G: CFTR secretes Cl and impairs ENaC - inc. Na/H20 in mucus
S: CFTR activates ENaC to increase Na/Cl absorption

82

Patients with adult coarctation of the aorta are more likely to experience what complications?

HTN associated
1. LV failure
2. Ruptured dissecting aortic aneurysm
3. Intracranial hemorrhage - ruptured berry aneurysms (Inc. risk) + HTN

83

What is associated with exposure to arsenic, thorotrast, and polyvinyl chloride? What is a marker for this?

Liver angiosarcoma
CD31 = PECAM1 - leukocyte migration

84

What are the causes of pure red cell aplasia?

Thymoma
Lymphocytic leukemia
Parvovirus B19

85

Lung cancer can irritate which nerves?

1. Phrenic (C3-C5): hiccups, dyspnea
2. Brachial plexus (C8-T1/2)
3. Recurrent laryngeal - hoarseness
4. SVC syndrome - central/mediastinal
5. Horners: Lung apex

86

What is the most common muttiaon in Hypertrophic CM?

β-myosin heavy chain - cardiac sarcomere protein

87

If a person has inherited dilated CM, what is the mutation?

1/3 are inherited
AD mutation of cardiac myocyte cytoskeletal proteins - dystrophin or mitochondrial enzymes

88

What is the most common benign liver tumor?

Cavernous hemangioma
collagenous scars, and blood filled spaces

89

A patient with hypothyroidism after taking a meds for mood swings and sleeping problems was likely on what?

Lithium

90

What should you measure routinely in a patient on Lithium?

TSH (hypothyroidism)
Li - levels can build up
Renal function - Li can quickly build up

91

Ergonovine

Ergot alkaloid = vasoconstriction
α and 5-HT agonist

92

What would worsen an attack of Prinzmetal angina?

Vasoconstriction

93

What viruses use a protease to cleave their viral products?

Picorna (PERCH) - ss, + non-segmented RNA virus

94

What pH, PaO2 and PaCO2 would you expect to see in a patient at high altitude for 5 days?

Slight alkalosis
Dec PaO2, dec PaCO2
Dec in HCO3 - compensatory

95

Pulmonary HTN and cor pulmonale are common complications of CREST - what is the mechanism?

Intimal thickening of pulmonary arteries
Inc. TGF-β - inc. collagen and ECM by matrix proteins and fibroblasts

96

How do you medically treat a patient with MR?

Decrease afterload
Arterial vasodilators

97

What is a weird potential side effect of ACE Inhibitors?

1st dose hypotension (block AT2)
Exacerbated with diuretics, hyponatremia, high renin/aldosterone levels, renal impairment and heart failure

98

Vitiligo

Loss of melanocytes/melanin - autoimmune

99

How does the liver use glycerol produced by breakdown of TGs?

Glycerol kinase --> Glycerol-3-P --> DHAP

100

What are the 2 mechanisms of opioid signaling via μ-opioid receptors?

G-coupled receptors
Inc. K efflux out of cells
Block AC - decreased cAMP

101

Dystonia

Sustained, involuntary muscle contractions - force body parts into abnormal/painful movements or positions

102

Blepharospasm is an example of dystonia - what is it? What is another example of focal dystonia?

1. Focal dystonia - involuntary forcible closure of eyelids
2. Writers cramp
3. Spasmotic torticollus - cervical dystonia - most common

103

Myoclonus

Brief, sudden, shock-like jerk - falling asleep, epilepsy, Creutzfeldt-J disease

104

Who might you see vitamin E deficiency in?

Fat malabsorption
Abetalipoproteinemia
Low birth weight infants

105

What does vitamin E deficiency look like?

Mimics Friedreich Ataxia/B12 deficiency
Ataxia, dysarthria, loss of vibration/prop sense

106

What are the characteristics of viral meningitis?

Normal glucose
Increased protein
90% lymphocytes

107

Osteoid matrix accumulation around the trabeculae is indicative of what?

Vitamin D deficiency