UWorld MQ1 Flashcards
(302 cards)
1
Q
HIV DRUG : NRTI
A
Zidovudine
Tenofovir
emtricitabine
2
Q
NRTI MOA
A
inhibits HIV DNA synthesis from RNA template by terminating DNA chain elongation
3
Q
NNRTI
A
EfaVIRenz
NeVIRapine
4
Q
NNRTI MOA
A
allosteric RT inhibits: terminate DNA chain enlongation
5
Q
PI drugs: Navir
A
Atazanavir
darunavir
ritonavir
indinavir
6
Q
PI MOA
A
inhibits HIV poly protein cleavage
7
Q
Integrase Inhibitor MOA
A
inhibits HIV DNA integration into host genome
8
Q
Fusion inhibitor: binds to HIV gp41
A
EnFUvirtide
9
Q
CCR5 antagonist: allosteric gp120 interaction
A
Maraviroc: blocking entry
10
Q
how is resistance developed to NNRTIs
A
point mutation in RT region of Pol gene
11
Q
gremlin mutation of VHL gene
A
AD
renal cell carcinoma
pheochrom
RB
12
Q
Kayser-Fleischer rings in Wilson dz
Incre copper, dec ceruloplasmin
A
Cornea deposition
Treat with zinc and chelation(D-penicillinamine)
13
Q
Breast fat necrosis clues
A
Post traumatic
Irregular mass
Central necrosis liquefactive fat
Neutrophil & macrophages
14
Q
Breast: solitary firm round mass with clear borders, fibrous capsules, tan/white on cross section
A
Fibroadenoma
15
Q
Cyclical premenstrual tender breast
Blue or brown fluid
A
Fibrocystic changes
16
Q
Dysplastic nevus syndrome mutation
A
CDKN2A (p16)
17
Q
multiple scattered skin lesions with irregular nuclear contours, round or spindle shape cells will develop
A
melanoma
18
Q
DNA synthesis reaction begins in
A
cytoplasm
carbamoyl phosphate synthetase II
19
Q
Antifungal: Cell wall
A
Caspofungin
20
Q
antifungal: mitosis
A
Griseofulvin
21
Q
anti fungal DNA& RNA synthesis
A
Flucytosine
22
Q
Antifungal Cell membrane
A
Amphotericin B &Nystatin bind ergosterol
Azoles inhibit synthesis of ergosterol
23
Q
single enlarged parathyroid
A
parathyroid adenoma
excess secretion of hormones causes hypercalcemia and neg feedback causing atrophy of other gland
24
Q
MOA of vit A analog alter gene expression to
A
normalizes keratinization
decreased epithelial cohesiveness
stimulated stem cell mitosis
25
strongest risk factor for MI
smoking
oxidize LDL=accelerate atherosclerosis
increase catecholamine =vasoconstriction
vasculitis and endothelial cell dysfunction
26
# pharm
Streptomycin
MOA
| aminoglycoside
inactivatinng the 30S(small) Ribosomal Subunit
| altered structure of bacterial ribosomal protient cause resistance
27
Rifampin MOA
Inhibition of bacterial DNA-dependent RNA polymerase
| SE: Red-orange body fluids, cytopenia, GI effects
28
Isoniazid MOA
Inhibition of mycolic acid synthesis
Niacin defi(skin rash)
| Neurotoxic(B6), hepatotoxicity
29
Pyrazinamide SE
| Unclear MOA
Hepatotoxicity
hyperuricemia
30
Ethanbutol MOA
inhibition of arabinosyl transferase
| Optic neuropathy
31
Increase activity of enzymes involved in cell wall polysaccharide synthesis
arabinosyl transferase
Ethambutol
32
Decreased activity of bacterial catalase peroxidase
| inhibition of mycolic acid
INH
33
Altered the structure of enzymes involved in DNA winding-unwinding
Rifampin
34
2 phases of Hep B progression
Proliferative phase and integrative phase
35
To activate MHC I, HepB present with
| CD 8 activation causes cytotoxic effect
entire virion, HBsAg and HBcAg on hepatocyte cell surface
36
appropriete med for long-term management of Bipolar
Lithium
| Nephrogenic Diabetis, hypothyroid, chronic interstitial nephritis
37
treatment option of bipolar maintenance
lithium,
valproate,
lamotrigine
| lithium may decr suicidal ideation
38
MALT Lymphoma may be cause by
chronic immune stimulation
39
mc trigger of gastric MALT lymphoma
H. pylori
40
# Ecoli V. factor & function
Lipopolysaccharide
activates macrophages to
release IL-1, IL-6, TNF-a
| septic shock/bacteremia
41
# Ecoli V. factor & function
K1 capsular polysaccharide
prevents phagocytosis and complement-mediated lysis
| Neonatal meningitis
42
# Ecoli V. factor & function
Shiga toxin
block 60S: protein synthesis/cell death
| Bloody diarrhea
43
# Ecoli V. factor & function
heat-stable/heat-labile enterotoxins
promotes fluid
electrolytes secretion from intestinal epithelium
| watery diarrhea
44
# Ecoli V. factor & function
P-frimbriae
adhesion to uroepithelium
| urinary tract infection
45
hi dose IL-2 MOA
| produced by activated CD4/8 & NK cells
enhance activity of natural killer cells
46
IL-2 effect of cd4
| proinflammatory
converts to T helper 1+--> IFN-Y/A, IL-2
47
IL-2 effect of CD8
expands pool of CD8 for cytotoxic killing
48
hypotension, tachycardia, dental erosion
electrolyte abnormalities
| low K, metabolic alkalosis
Bulimia nervosa
49
minimal change pathogenesis
T Cell- mediated injury to podocytes
50
first line treatment for candida
fluconazole
51
resistance to fluconozole
Mutations altering the enzyme of cell membrane ergosterol synthesis
52
resistance to azole
eflux pumps
increase 14-alpha-demethylase
mutate 14-a-demthylase
| 14-a dm covert lanosterol to ergosterol
53
in B12 deficiency you are missing
succinly-CoA and
Methionine/THF
54
what build up in B12 defi
methylmalonyl-CoA
Homosysteine
55
digoxin is fat or water soluble
water soluble
| cleared by kidney
56
inhibition of glycosyltransferase enzyme affects
Mycoplasma
57
function of bacterial glycosyltransferase enzyme
add glycan to peptidoglycan chain of cell wall
58
target mycoplasma with
tetracycline
macrolides
59
ubiquitinated TDP-43
| found in
Frontotemporal demetial
| altered executive function
60
difficulty moving post antipsychotic drug
HTN, fever
| NT affected
dopamine
61
# MOA
Benztropine
| antipsychotic
Block D2 Negrostiatal pathway
| drug-induced parkinsonism treat with anticholinergic medication
62
Disease progression in Ankylosis Spondy
| most helpful measurement
chest wall mobility
63
cardioinhibitory response in syncopy
increase parasympathetic to SA/AV node
64
# vasodepressor
vasodepressor response to syncopy
decreased sympathetic output to vascular smooth muscle causing dialation
65
cirrhosis pt with fluid in the lung
hepatic hydrothorax
| fluid moving across diaphragm
66
phthirus pubis treatment
| pubic louse
topical permethrin
66
function of aromatase
| Dificiency in the placenta
converts androgens to estrogen
hi androgen during pregnancy-->ambigous external genetalia
## Footnote
Maternal and female fetus verilization
67
# If pt can't use aspirin
alternate antiplatelet irreversible blocks P2Y-ADP receptor
clopidogrel
68
use to prevent cardiovascular event
Aspirin
clopidogrel
69
cilostazol moa
| treats?
phospodiesterase inhibitor
| claudication: peripheral vascular dz
70
cytocine deamination DNA repair sequenes
| base excision repair
glycosylase
endonuclease,
lyase,
polymerase
lygase
71
synergistic activity of simvastatin and cholestyramine
cholestyramine--- increase cholesterol syn
simvastatin---Inhibit cholestrol syn
| lowers cholesterol
72
what is Programmed-death receptor 1(PD-1)
used by cancer cells to downregulate
cytotoxic T-cell
73
MOA of Pembrolizumab
blocks PD-1
restore CD 8 T-cell killing ability
74
trisomy 21 Cardiac presentation
AV septal defect
VSD
ASD
75
trisomy 21 GI
duodenal atresia
hirschsprung dz
76
trisomy 21 oncology
acute leukemia
77
trisomy 21 orthopedic
atlantoaxial instability
78
trisomy 21 neuro
intelectual disability
alzheimer dz
79
Amiodaron
| Class III SE
Bradycardia
hepatic toxic
thyroid dysf
80
Metoprolol
| SE
Bradycardia
advanced AV block
81
Adenosine
| MOA hyperpolarize nodal pacer
flushing/Low BP
Bronchospasm
Hi-grade AV block
| initial PSVT treament
82
Digoxin
| SE
Bradycardic
Nausea & vomiting
yellow vision halo
83
Verapamil/diltiazem
| Ca+ Blocker
bradycard
AV blocker
low ventricular contraction
constipation
84
ibutilide/dofetilide/sotalol
| SE
Torsade de pointes
85
mc ectopic electrical foci causing A. Fib
pulmonary vein
| treat with ablation
86
Treat Warfarin OD with
Vit K
FFP
87
treat heparin OD with
Protamin sulfate
88
lack of ApoE3 and ApoE4, lipid-laden macrophages shows inpairment of
chylomicron remnat uptake by liver cells
89
misattributing undesired thoughts or feeling to another person
projection
90
incomplete obliteration of the vitelline duct
meckel diverticulum
| true diverticulum: mucosa, submucosa and muscularis
91
dz causing verying severity of maternal line
heteroplasmy
92
dz with AD patern causing varying severity
variable expression
93
Ecoli LPS bind to _______________-and activate NF-kB to transcribe _____________________
Toll-like receptor (PRR)
Proinflammatory (TNF-a, IL-1, IL-6, IL-12)
93
incident of spinal stenosis may result from enlargment of _____________ligament
ligmentum flavum
94
3 component of RAAS regulation
Macula densa
intrarenal baroreceptors
beta-adrenergic receptors
| B1 blocks renin release
95
when etiology of Met. alkalosis is unknow, assess
volume status
urine chloride
| low CL- impairs renal excretion of HCO3
96
primarily manic, may have depressive episodes
| hospitalizaiton or marked social impairment
Bipolar I
97
major depression,
Hypomanic >4 days,
observable change from functioning baseline
| no psychotic feature, no hospitilization
Bipolar II
98
responsible for wound reepithelization
keratinocytes
| contact inhibition controls growth
99
lack of facial expression and monotone voice + psychotic symp.
| neg symptom: flat affect
schizophrenia
100
pharyngitis and tonsillitis with grey-white pseudomembranes
| Treatment
Diphtheria antitoxin****
Antibiotic
101
moa of DT exotoxin
| booster vac. every 10 years
irreversibly inhibits host protein syn
| ADP-ribosylation of EF-2
102
spherules containing endospores describes
| parts of central and south America
coccidioides immitis
| dimorphic fungus:
103
disruption of tissue O2 delivery by oxidizing agents
| increase Lactic acidosis
Methemoglobinemia
(Nitrites, chloroquine)
104
cyanide tox of nitroprusside moa
blocks TCA electron trasport
105
pain in SI and pubic symphysis during pregnancy may be dt
relaxin prduction
| by corpus lutium and placenta
106
Histology of pulmonary edema
engorged capillaries and alveoli filled with acellular pick material
107
histology of lung of pt with heart failure demostrate
hemosiderin-laden macrophages
| leak from alveolar capillaries
108
presence of hi neutrophils in alveolar fluid
exudative alveolar
bacterial pneumonia
109
Goodpasture / vasculitides lung histology
| histology presentation
focal necrosis of alveolar walls
intra-alveolar hemorrhage
110
# Treatment
defective platelet surface glycoprotein receptor
| binds finbrinogen in platelet aggregation
abciximab
| Txt: unstable angina, acute coronary syndrome..: GP2b/3a antagonist
111
Defective outward K flow and prolongation of action potential causes ? Cardiac presentation
| Amiodarone, sotalol, dofetilide (K blocker)
ventricular Tach & sudden death
| congentital long QT syndrome
112
Which cytokines is proinflammatory
IL-12--> IFNy, IL-2, TNFa (Th1)
IL-17(Th17)
113
Anti-inflammatory cytokines
IL-4, IL-10(Th2)
Treg (IL-10, TGFb)
114
proinflammatory release from T helper 1
IFNy
TNFa
IL-2
115
association b/t exposure to risk modifier (treatmt) and outcome (disease course)
Exposed/non-exposed
| RR
116
why is barium constrast studies and colonoscopy contraindicated in toxic megacolon(UC)
Risk of perforation
117
children with limited Iron intake first show decrease in which lab findings
Ferritin
118
# parasite blood fluke infection
chronic hepatosplenomegaly, bladder cancer, anemia and hi eosinophile
| asia, subsahara Africca
schistosomiasis
119
# UTI
Nitrate reductase-producing bacterial
Ecoli,
Klebsiella,
proteus mirabillis
| Plus Urease=proteus mirabillis
120
# UTI
Bacteria incubation
| incease bacteria #: false neg with low bacterial count in UA
allow for Nitrite pos result
| accumulation of bacterial metabolites
121
common neoplastic colonic polyps is
sessiele serrated polyp
adenomatous (villous>tubular)
122
Non-neoplastic common colonic polyps is
Hyperplastic
inflammatory
Hamartomatous
123
attrition bias is a form of _________________ resulting from disporportionate loss of reseach subject in follow-up
selection bias
124
MCC of acute otitis media
Strep pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
| Bulging/ruptured TM with purulence in middle ear
125
agent that increase natriuresis and sustained decrease in serum AT II and aldo production
B-blockers
direct Renin inhibitor
ACE inhibitor
126
sphingomyelinase moa
| Niemann-pick
spingomyelin(phospholipid) to ceramide
| hepatosplenomegaly, foam cells cherry-red macula(retinal opacity)
127
progressive neurodegeneration, macula opacity, G m2(ganglioside)
B-Hexosaminidase
Tay-Sachs ds
128
hi dose dexa suppresses with ACTH hi
pituitary
129
All antidepressants carry risk of _______________.
inducing mania
| EG: Sertraline
130
predisposure to giardia result from
secretory IgA production
131
infant is diaphoretic with high-pitched cry, vomiting and loose stools
| exposure to which drug
Heroin
132
presentation of antigens processed in lysomoes
HLA-DR+ (MHC II)
| absence impairs B and T activation
133
Hi AChE in amniotic fluid
| Hi AFP
fusion of edges of neural plate
neural tube defect
134
low AFP and normal AChE levels in amniotic fluid
Down Syndrome
135
# Lab
hi IgE
eosinophil
normal leukocyte with low Th17
hyper-IgE syndrome
136
# pathogenesis
Hyper-IgE
AD
Defective JAK-STAT--low Th17
low neutrophil/chemotaxis
137
Hyper IgE present with
noninflammatory abscesses (cold)
recurrent sinopulmonary infection
chronic atopic dermatitis
138
# withdrawal
seizures, tachycardia, palpitations
| tremors, agitation, anxiety, delirium
alcohol & Benzo
139
# withdrawal
NVD, lacrimation, yawning, dialated pupil abdominal craping
opioids
140
# withdrawal
hyperphagia, psychomotor retardation, severe depression, hi appetite
stimulants
cocaine, amphetamines (ADHD)
141
prefers to be alone, detached, unemotional
schizoid
142
prefers to be alone for fear of criticism and rejection
avoidant
143
cresent formation on Renal biopsy on light microscopy is
anti-GBM, linear deposition of IgG, C3
144
Goodpasture syndrome
glomerulonephritis and pulmonary hemohrrage
145
aortic root dialation dt marfan syndrome
| best heard
right upper sternal border
| end of expiration w pt leaning forward
146
# best heard
Aortic regurgitation murmur dt valvular pathology
| bicuspid/rheumatic hrt dz
left third intercostal space
| end of expiration w pt leaning forward
147
beta-oxidation, TCA, carboxylation of pyruvate occurs in
mitochondria
148
Glycolysis, fatty acid synthesis, and pentose phosphate pathway occurs
in cytosol
149
contracted while cleaning animal waste from barn
| SOB, fatigue, myalgias, retroorbital headaches
coxiella burnetii
| Q fever from animal shit
150
dense DNA in nucleus
low transcription
heterochromatin
151
symptomatic management of alzheimer dz
NMDA receptor antagonist(memantine)
cholinesterase inhibitors(donepezil, galantamine)
152
Alzheimer disease pathogenesis
loss of cholinergic neurons--Memory
B-amyloid--diffuse cortical atrophy
153
Actinic keratoses histology
| sun-exposed region
atypical keratinocytes-hyperchromatic
scattered mitotic figures
154
infectious RNA molecure purified from virus capable of protein synthesis and gene replication is
pos sense single-stranded
| eg Rhinovirus
155
healthy 6 week old with frequent emesis with no PE finding
physiologic low tone of the LES
156
Tolcapon & Entacapon MOA
| Tolcapone is also central
anti COMT incr levodopa
| prevent levodopa breakdown in periphery
157
carbidopa MOA
anti DOPA decarboxylase
inhibit levodopa--->dopamine
158
cardiac auscultation in left decubitus position on full expiration =presystolic sound
left ventricular hypetrophy
| S4
159
# ecoli
Lipid A is also called
LPS
endotoxin
| septic shock
160
elbow pain dt pulling up childs arms cause by
radial head dislocation and impingement of the annular ligament
161
cervical posterial lymph node biopsy may affect
spinal accesory
trapezius & SCM
162
first-line pharm for moderate-to-severe alcohol use disorder
opioid antagonis naltrexone
| pt who need help dealing with cravings
163
pulsatile GnRH secretion during puberty may result in
increase estrogen-->precocious puberty
| shorter female
164
# pathogenesis
5-a reductase def
46 XY
impaired conversion of testosteron to DHT
| hi T and no DHT
165
5a-reductase presentation
teenage girl with primary amenorrhea
blind vagina
internal male sx organs
166
complete defect in androgen receptor function
| presentation
phenotypic female with absent internal female genital ducts
primary amenorrhea
internal male genital duct absent
gynecomastia expected
167
Drug involve with chelation resulting in decreased absorption
| cation effect
Tetracyclines
Fluoroquinolones
Levothyroxine
| Cation: Iron, Ca++, Mg++, Aluminum.....
168
single base substitution with normal Lysine for Histidine
Hemoglobin F
| less affinity for 2,3 BPG incr O2 affinity
169
Where are serotonergic neurons found
Raphe Nuclei of brainstem
170
Where is raphe nuclei located
midbrain, pons, medulla
with axon projection thoughout CNS
171
SSRI function of neurons found in
| Eg: Fluoxetine
Raphe nuclei
| Anxiety
172
acute and painless monocular vission loss is characteristic
Central retinal artery occlussion
| Cherry-red macula
173
abnomal presence of endometrial glands and stroma
adenomyosis
174
adenomyosis present in
multiparous pt with dysmenorrhea
heavy menses
uniformly enlarges uterus
175
benign myometial smooth muscle, heavy mensis nontender and irregularly enlarged uterus
Leiomyomas(uterine fibroids)
176
Risk factors of acute ARDS
Sepsis, pneumonia
Trauma
pancreatistis
177
Acute ARDS
| pathophysiology
insult--> cytokine release-->hi neutrophil--> hi capillary permeability--> alveolar fluid increase--wipeout surfactant--hyaline membrane formation
| increase functional residual capacity
178
pt with renal condition must avoid which opioid
Morphine
179
opioid tox in pt with renal condition is dt
accumulaton of morphine active metabolites that are renally cleared
180
# prokaryotes :ecoli
DNA pol 1 function
5' -3' enxonuclease that removes RNA primer
| inhibition impairs growth
181
very flexible body, contortionist, skin bruises and scar easily
| defect
collagen
182
defective fibrillin-a is a
AD
Marfan syndrome
183
hypermobile joint, overelastic skin, bruis, wound easy
Ehlers-Danlos syndrome
184
# M
Monoamine oxidase inhibitors (MAOIs)
Phenelzine
tranylcypromine
| antidepressant: inhibit oxidative deamination
185
MAOIs function
increase presynaptic
NorEpi
Dopamine
Serotonin
186
mood reactivity
leaden paralysis
rejections sensitivity
incre sleep/appetite
major depressive disorder with atypical features
187
MOAIs can be used to treat
treatment-resistant major depressive disorder
188
Organism that burrows in the epidermis
Scabies --human itch mites
| Treat: Topical permethrin
189
# MOA
effective treatment for pulmonary arterial hypertention
| Bosanten and ambrisentan
Blocking the endothelin receptor
190
name 2 growth factors involve in angiognensis in neoplastic/granulation tissue
VEGF and FGF
191
# growth factor
proinflammatory cytokines can also stimulate expression of
| IL-1 and INF-Y
VEGF
192
what may pose a physical barrier to sprouting new bld vessels
laminin in basement membranes
193
# MOA of
Programmed cell death protein -1 (PD-1)
Binds T, B and NK cell
down reg activity
| prevent T-cell exhaustion with PD-L1
194
when PD-1 bind receptor
it decrease IL-2
195
next step in pt with xantholasma
check serum lipids and blood glucose level
196
virus that cause neuroinvasive disease meningitis, encephalitis and flaccid paralysis
West Nile virus
197
cardic conduction speed
AV Node .05 m/sec
Ventricular m. 0.3m/s
Atrial m. 1.1m/sec
purkinje system 2.2m/s
198
# MOA of
TMP
methotrexate
Pyrimethamin
inhibit dihydrofolate reductase
| decrease formation of THF
199
CGG repeats in fragile X is
| what mechnism
Methylation-induced gene silencing
200
ethiology of prerenal acute kidney injury
anything the decrease renal perfusion (BP)
201
Which beta blocker is effective for pt with chest pain and COPD
| cardia selective
metoprolol, atenolol, bisoprolol, nebivolol
202
# pt with MI and COPD
why avoid non-cardioselective beta blockers
trigger bronchospasm
| propranolol, nadolol .....
203
complication of anorexia nervosa
osteoporosis
amenorrhea
hair loss
parotid hypertrophy
hypotention, hypothermia, bradicardia
cardiac atrophy, arrhythmias
204
damaged ipsilateral lateral geneculate body affect
ipsilateral temporal hemiretina
204
protease inhibitor defi
affecting elastin
| target
interchain cross-links involving lysine
| alpha-1 antitrypsin defi
205
thoracocentesis is typically performed bwt rib
6th and 8th midclavicular
8th & 10 midaxillary
10th 12th paravertebral
| below righ 9th risk penetrating the liver/abdominal organ
206
prolong use of B-blocker and withdrawer
upregulation of B-adrenergic receptor and enhance response
207
increase in left ventricular wall stress may result in
| incre O2 demand
slow-rising carotid pulse, mid-systolic murmur, large pressure gradient
| severe aortic stenosis
208
baby with subdural and retinal hemorrhage suspect
abusive head injury
209
early prenancy vaginal bleeding and no fetal cardiac activity
partial hydatidaform mole
| 69, XXX or XXY
210
duadenal ulcer primarily associate with
H. Pylori
| Gastric antrum
211
progressive loss of peripheral vision w hi intraocula pressure
open-angle glaucoma
212
# glaucoma pt
carbonic anhydrase inhibitor and Timolol targets
| nonselective beta blockers
ciliary epithelium
| decrease aqueous humor
213
# glaucoma pt
decrease eye presure and increase outflow of aqueous humor by
Pg F2a (lantanoprost, travoprost)
cholinomimetics (pilocarpine, carbachol)
214
to preseve left ventricular ejection fraction
| changes
Cardiomyocyte hypertophy
215
# Lung exam
Nomal lung
| Breath sounds, tactile fremitus and percussion
Normal
Normal
Resonance
216
# consolidation
Breath sounds,
tactile fremitus
percussion
Increased
increased
Dullness
217
# Pleural effusion
Breath sounds,
tactile fremitus
percussion
decreased/absent
Decreased
Dullness
218
# pneumothorax
Breath sounds
tactile fremitus
percussion
decreased/absent
Decreased
Hyperresonance
219
# Atelectasis
Breath sounds,
tactile fremitus
percussion
Decreased or absent
Decreased
Dullness
220
# Pt with DM1.
adrenal insufficiency
| what is the elctrolyte abnormalities
low NA
hi K
Hi Cl-
nonanion gap metabolic acidosis
| hypoaldo
221
# MG associated with thymus
Thymus and __________________ arise from third pharyngeal pouch
inferior parathyroid glands
222
# transplant patient
only fungus appearing red on mucicarmine stain and clear on india ink
cryptococcus neoformans
223
Hormones that binds zinc finger domaine
Thyroid and lipid-soluble like estrogen, aldo, cortisol and fat
224
Transudative effussion has *Low/Hi* LDH compare to Exudate
Low
225
painless solid testicular mass
| alway supect
cancer
226
Area under the PO curve divided by area under the IV curve =
Bioavailability
227
MOA of oxandrolone post burn
anabolic steroid use to protein synthesis
| decrease pt musce wasting due to increase metabolic rate
228
# surgery
damage to which structures will result in voice pitch limitation
superior laryngeal nerve invervating the cricothyroid ms
229
MOA of the systemic progestins
| combine hormonal contracptive
suppresses GnRH & pituitary
gonadotropin secretions
inhibiting ovulation
230
MOA of the locally-acting progestins
| progestin-only pill, Levonorgestrel IUD
Thickens cervical mucus
imparing sperm penetration
231
MOA of Copper IUD
causes chronic cytotoxic inflammed uteres, imparing sperm migration
232
# Enzyme defect?
infant with open anterior fontanelle and soft with overlying fine, white hair
abnormal optic nerve and foveal development
AR: Tyrosinase
oculocutaneous albinism
| impair melanin synthesis
233
chronic allergic contact dermatitis histology
| reaction nickle
intercellular epidermal edema with infiltration
of lymphocytes and eosinophil
234
complication of vesicoureteral reflux
acute pyelonephritis
Reflux nephropathy
| retrograde urine flow causing recurrent infection
235
MOA of death cap (amanita phaloides)
Amatoxin inhibites RNA pol. II
| directly inhibites mRNA
236
clinical association of atopic dermatitis in children
Allergic rhinitis
Asthma
Food allergy
| Lab: Hi IgE and eosinophils
237
Aspirin in children with viral infeciton causes
Reye syndrome
microvesicular steatosis
| PE: hepatomegaly, hi transaminase, may progress to seizure and coma
238
most common cause of unilateral hearing loss in adults
| cerebellopontine angle tumors
vestibular schwannnoma
| located bwt cerebellum and lateral pons
239
Bilateral vestibular schwannomas are associated
with
neurofibromatosis type 2
240
defective primary neurolation lab shows
increase AFP
241
What is the measure of potency of inhaled anesthetic
Minimal alveolar concentration (MAC)
| low MAC=high potency
242
# physiology of
ganglion cyst
(mucoid) degeneration of periarticular tissue
243
MOA of penecilamine therapy
binds copper and increase urinary copper excretion
244
location of RNA polymerase I
exclusively in the nucleolus
| transcribe 18S, 5.8S,and 28S rRNAs
245
function of RNA polymerase II
trascribe mRNA, snRNA and miRNA in the nucleus
246
hi ammonia and orotic acid
| enzyme
ornithine transcarbamylase
247
MOA of PCP
| superstrenght, hallucinaition and movement disorder
N-Methyl-D-aspartate receptor antagonist
may cause Dopamin disregulation
| and inhibit serotonin, dopamin and norepi reuptake
248
reactivation of CMV causes
colitis in HIV pt
biopsy: inflammaotry infiltrate, mucosal necrosis,
| ovoid nuclei with basophalic deposit
249
MOA of protease inhibitor
block viral protease from
cleaving gag-pol polyprotein
| produces immature virus
250
early marker for abnormal phosphate metabolism in pt with chronic reanal disease
increase serum fibroblast growth factor 23
| increase in response to hyperphos dt CKD
251
pathway of alkaptouria
Tyrosine to fumarate
252
homogentisic acid dioxygenase defect
build up : Homogentisate
253
indication of lithium
bipolar with Manic & deprssive features
| DI (arginine vasopressin restist) ebstein anomaly, tremor, lo thyroid
254
indication of valproate
bipolar with manic features
| SE: hepatotox and teratogenic
255
indication of carbamazepine
bipolar with manic features
| SAIDH, neural tube defect, aplastic anemia
256
indication of Lamotrigine
Bipolar with Depressive features
| benign rash, Steven-johnson syndrome
257
protrusion of the tongue
CN XII
258
horseness: muscle of larynx mostly innervated by
| vocal cord
CN 10
259
# Nerve
anterior 2/3 of tongue
parasympa: salivary gland secretion from submandibular and sublingual
corda tympani branch of CN 7
260
afferent of gag reflex and sensory to posterior 2/3 of tongue
CN9
261
general sensation to carotid body carotid sinus and tonsillar region
CN 9
262
# esophagus
a motility disorder caused by reduced numbers of inhibitory ganglion cells
Achalasia
| decreased amplitued of peristalsis and Incease LES tone
263
Reversible acute confusion, fluctuating levels of consciousness
delirium
264
# altered mental status
gradual progression irreversible (loss) of consciousness. spared remote memory;
dementia
265
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rigor mortis is failure to
relax
myosin head detachment from the actin filament
| calcium-and ATP -driven process: cross-bridge cycling
266
promising option pregnancy in Downs and turner syndrome
In Vitro fertilization
267
risk factor for vibrio
open wound in marine environment and Iron overload condition
| C. Jujuni, vibrio like Iron
268
short acting nonbenzodiazepin hypnotic agent
| GABA agonist
zolpidem,
zaleplon,
eszopiclone
269
absent elevation of the testicle with stroking of the ipsilateral thigh
testicular torsion
270
(ERBB2) HER2 expression indicate
aggressive disease
271
secondary reaction causing epithelia tissue damage from type 1 hypersensitivity
major basic protein initiated by IgE
| late phase
272
most common pediatric arrhythmia
| narrow QRS complexe
supraventricular tachycardia
| elevated heart rate regular rhythm
273
most likely cause of SVT
Shortening of the ventricular diastole
| less time for relaxation
274
preventing catheter related UTI
avoid unessesary use and remove promptly
275
rectal bleeding/pain with ulcerated or nodular anal mass
Human papilomavirus
| dark, irregular nuclei with keratinization
276
contact dermatitis
| pt with allergy due to hair product
type 4 H.sensitivity
277
# ```
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short acting B 2 agonist
albuterol
levalbuterol
278
long acting beta 2 agonist
salmeterol
formoterol
279
Renin level in primary hyperaldo
| adrenal adenoma
low
280
elevated aldo and renin suggest
2ndary hyperaldo
| enovascular disease and renin-secreting tumors
281
in-hospital Treatment for PE
Low-molecular-weight heparin
282
Thayer-martin selective medium contains
vancomycin, colistin, nystatin and trimethoprim
283
Thayer-martin medium is use
Neisseria organisms Identification
284
AIDs : CD4 :30, progressive motor deficite, confusion
| Reactivation of
JC virus
285
most effective drug for hypertriglyceridemia
Fibrates (fenofibrate)
286
Treatment of hi triglyceride causing pancreatis
| activate peroxisome PPAR-a
fenofibrate
| increse lipoprotein lipase..induces HDL syn
287
# 1.
cause of early cataracts formation
prednisone exposure
DM
ocular trauma
external radiation exposure
288
longterm use of Hydroxychloroquine
| For SLE
low central visual acuity
photopsia(flashing light)
central macular degeneration
289
Drugs associated with SAIDH
| ADH production & increase renal ADH sensitivity
carbamazepine
SSRI
chlorprapamide(antidiabetic)
recreational drugs(MDMA: ecstasy)
| Low serum na and osmo
290
Lithium renal effect
ADH resistance
| low urin osmo, high serum osmo and Na
291
nonpainful, nonpruritic skin colored lesion, cerrucious vulgaris
HPV
292
histologic description of HPV
thickening stratum cornneum
epidemal hyperplasia & papilloma formation
cytoplasmic vacuolization(koilocytosis)
293
pelvic fractures are frequently associated with
posterior urethra valve injury
bulbomembranous junction
high rising boggy prostate
urethra blood
294
fabrous band extending from cecum and right colon to retroperitoneum
| compressing duodenum
Ladd band
| midgut malrotation and intestinal fixation
295
MG pt may be resistant to which anesthetic
depolarizing agents (succinylcholine)
| competitive agonist of Nicotinic receptor. less receptor available
296
MG pt are extremely sensitive to which anesthetic
| removal of mediastinal mass
nondepolarizing agent (vecuronium, rocuronium)
less receptors available
| small does induces paralysis loss airway patency
297
greatest risk for multiple myeloma
Amyloidosis
deposition of insoluble Ig light-chain
298
atraumatic Splenic rupture is risk for
leukemia and lymphoms
| massive spleomegaly
299
use to detect and quatify mRNA in sample
RT-PCR
