uworld part 2 Flashcards
1
Q
a common underlying cause of massive hemoptysis is
A
brochiectasis
2
Q
fatal massive hemoptysis is suggestive of
A
hemorrhage from bronchial arteries
3
Q
bacteria escape from phagolysosome
A
listeria
4
Q
resistant to phagosome-lysosome fusion
A
legionella
TB
involves activation of Th1, IFN-Y and IL2
5
Q
SLE
prolong PT, low platelett low fibrinogen, bleeding
A
DIC
consumptive coagulopathy
6
Q
vaginal bleeding, utering enlargement and markely increased B-hCG
no pregnancy
A
gestational choriocarcinoma
proliferation of cytotrophoblast and syncytiotrophoblast
7
Q
potential complicaton of using chimeric antigen receptor to target CD19
A
Hypogammaglobulinemia
8
Q
Reduced B-globin chain causes
microcytosis, hypochromic
A
B-thalassemia
precipitate unpaired alpha chain causing membrane damage
9
Q
hypoglycemia with hi insulin hi c-peptide
A
sulfonylurea use
secretagogue or insulin-secreting tumor
10
Q
MOA of dronate
A
kills osteoclast
11
Q
MOA of denosumab
A
decrease bone resorption
bind RANKL
12
Q
mutation for polycythemia vera
A
mutated JAK2 gene
non-receptr tyrosin kinase
13
Q
increase physiologic dead space in
A
obese people
14
Q
topical antifungal for dermatophytes
A
Miconazole
clotrimazole
15
Q
Nystatin primarily use for
A
candida infection
16
Q
metabolic alkalosis in loop diuretic therapy
treat with
A
acetazolamide
17
Q
different bwt staph A. and other staph
A
coagulase neg
18
Q
RA lab
A
anti citrullinated peptide
hi ESR/CRP
19
Q
nonbezo hypnoti agent
A
zolpidem
eszopiclone
GABA receptor agonism
20
Q
hyperphosphatemia induces
A
hypocalcemia
CKD pt
21
Q
most devastating effect of fibrinolytic therapy
Pt with MI
A
intracerebral hemorrhage
22
Q
Azathioprine is metabolized by
A
HGPRT
same MOA of allopurinol
23
Q
trimethoprim inhibits
inhibit pyrimidine nucleotides
A
dihydrofolate reductase
disrupt folate metabolism
24
Q
prevents IL-2 transcription
A
Tacrolimus
immune suppression
25
Inhibits inosine monophosphate dehydrogenase
| shunting purine base to salvage pathway
mycophenolate
| de novo purine synthesis
26
false guanosine(purine nucleotides) disrupting DNA synthesis
Ganciclovir
27
cerebral venous hypertension is an idiopathic cause of
elevated intracranial pressure
| no mass or ventriculomegaly
28
bilateral papilledema with ventriculomegaly
aqueductal stenosis
increased production of cerebrospinal fluid
| choroid plexus papilloma
29
gram-neg coccobacilli resembling closed safety pin
yersinia pestis
| harbor by rodens/rats fleabites
30
inhibit topoisomerase I
irinotecan and topotecan
| relieve neg supercoiling of DNA
31
inhibits sealing activity of topisomerase II
Etoposide and podophyllin
32
HbF contains
Y-globin instead of B-globin
33
sepsis lead to multiple organ dysfunction dt
defective mito oxidative respiration
| low energy state...elevated venous O2 saturation
34
dermatomyositis..polymyositis with heliotorpe rash affects which muscle
straited muscle: perifascicular atrophy of
muscle in the proximal
esophageal muscularis propria
35
# Lung transplant rejection
Hyperacute
minutes to hours
ABO or HLA
Neurophil with fibrinoid necrosis and thrombosis
36
# Lung transplant rejection
Acute
less than 6 month
cell-mediated
perivascular and submucosal lymphocytic infiltrates
37
# Lung transplant rejection
Chronic
Months to years
small airways: sbumucosal inflammation
granulation scaring
bronchiolitis obliterans
38
long face
large ears
large testes
Expansion repeat in FMR1gene
Fragile X syndrome
39
most common location for anal fissures is
posterior midline distal to the dentate line
40
autonomic instability, altered mental status
and neuromuscular irritability
serotonin syndrome
41
serotoning syndrome is caused by
antidepressant MAOI
non-antidepressant with MAOI activity
combine with SSRI or TCA
42
linezolid plus SSRI causes
serotonin syndrome
| Linezolid is mild MAOI
43
conjugate vaccine activates
B and T cell response
44
treatment for dermatomyositis
heliotrope rash
| antinuclear ab, anti-jo-1 ab
systemic glucocorticoids
45
motile aerobic G-pos rod, oxidase pos, pyocynin
endotoxin inhibit EF2
nonlactose fermenting
psuedo. A
| 3&4 gen cephalosporin, ticar & piperacillin, carbapenem, aminoglycoside
46
MOA of emphyema medication to improve chest tube drainage
activation of fibrin-bound plasminogen
47
severe chest pain radiating ot the back and widened mediastium consistant with
acute aortic dissection
48
MOA of Esmolol
decreases left ventricular contraction velocity
| use for aortic dissection
49
reduced efficacy of Ig is dt
number of antigen epitopes recognized
50
# infant
rash after abrut resolution of fever
HHV-6
Roseola infantum
51
small, causes obstruction, altered bowel habits, NV, abdomen distension, narrow lumen
| location: left or right side colon cancer
left-sided rectosigmoid colon cancer
52
large, bulky mass protruding in colonic lumen
right-sided ascending colon cancer
53
severe muscle spasm post anesthesia, fever
malignant hyperthermia
| treat: stop drug and dantrolene
54
type 1 hypersensitivity triggered by
cell surface-bound antibody linking by antigen
55
# long-term use
how does PPI cause osteoporosis
| like omeprazole
decrease ca++ absorption
56
# osteoporosis
glucocorticoids and unfractionated heparin
| MOA
decrease bone formation
57
# osteoporosis
GnRH agonist MOA
decrease testosteron and Estrogen
58
# osteoporosis
Aromatase inhibitor and medroxyprogesterone
decrease estrogen
59
# osteoporosis
anticonvulsants that induces cytochrome P450
| phenobarb, phenytoin, carbamazapine
increases vit D catabolism
60
malignant, intraepithelia adenocarcinoma cells are
Paget cell
| Breast cancer
61
unilateral painful/pruritic, eczematous rash on nipple and areola
paget disease of the breast
62
Breat Paget biopsy
intraepithelial adenocarcinoma cells
63
unilateral bloody nipple discharge
no mass
intraductal papiloma
64
small firm mobile breast masses,
proliferating breast stroma and epithelium
Fibroadenomas
65
horseshoe kidney is problem with
metanepros
(metanephric blastema)
66
prostate procedure may damage
| nerve
inferior hypogastric plexus-->prostate plexus-->cavernous nerves
| cavernous nerves passes through prostate fascia
67
neutrophilic infiltrates and elongated dermal papilae
psoriasis vulgaris
68
full-thickness epidermal necrosis
subepidermal bullae is
Stevens-johnson syndrome
toxic epidermal necrolysis
69
homogenization of dermal collagen dt activation by TGF-beta
late stage radiotherapy injury
| scaring, ulceration, telangiectasias
70
Anti-HBs
confrims longterm immunity
vaccination
71
anti-HBc IgG present
acute and chronic infection
| not in vaccination
72
Anti-HBc IgM present in
acute and
during window phase
73
HBs Ag
acute and
persistence>6 month=chronic
74
binucleated cells in lymphocytic infiltrates
CD15/30
Reed-sternberg cells
| Hodgkin lymphoma (owl's eyes)
75
multiple peptic ulcer postbulbar duodenal and jejenal
gastrin secretin tumor
| MEN1: ZES
76
pyruvate to Acetyl-CoA
| enzyme
P.dehydrogenase
77
# enzyme
pyruvate to Oxaloacetate
| gluconeo
pyruvate carboxylase
78
white-yellow plaque on colonic mucosa
| fibrin and inflammatory cells
pseudomembranes
| C. diff
79
mito toxicity in virus treatment with aspirin in kids
Reye syndrome
| Hi ammonia causing diffuse astrocyte swelling and cerebral edema
80
use for juve myoclonic epilepsy
valproic acid
levetiracetam
81
use for focal onset seizure
carbamazepine
phenytoin
82
cornea cloulding prominent forehead broad nose(coarse face)
| enlarged heart, liver and spleen
Hurler syndrome
hi dermatan and heparan sulfate
| iduronidase
83
melatonin agonist used in elderly insomnia
Ramelteon
84
opioids MOA
membrane hyperpolarization (K efflux)
closes voltage-gated ca++ channel(low Ca influx)
85
lamotrigine effect on kidney
hi Renal bld flow
Hi GFR
Low serum creatinine
86
# Crohn Dz
bile acid wasting in terminal ileum causes
gallstone
87
acute hemolytic transfusion reaction
complement-mediated cell lysis
87
erythematous pruritic papules vesicles, bullae on extensors
| crypt hyperplasia and villous atrophy, IgA, Celiac dz
dermatitis herpetiformis
| increased intestinal intraepithelia lymphocyte
88
# ddx
celiac dz, pneumonia, and tranfusion related reaction
| may also have GI infection (giardia), skin condition
Selective IgA deficiencty
| Normal IgG and IgM
89
Neutral amino acid
alanine
serine
threonine
valine
leucine
isoleucine
phenylalanin
tyrosine
tryptophan
90
neutral aminoacidura is seen in
Niacin deficiency
pellagra-like skin eruption
cerebella ataxia
| Hartnup dx
91
LH surge triggers
oocyte release
92
progesterone endometrial action
proliferate and stabilizes for implantation
| withdrawal causes menstration
93
heavy protracted mentrual period (7-10 day) in adolescent
Low & irregular GnRH pulses
low LH surge-->
low progesteron-->
| immature hypothalamic-pituitary-ovarian axis -->
94
increased enzyme activity with lesch-Nyhan syndrome
PRPP (phosphoriboxyl pyrophospate amidotransferase
| HGPRT defect
95
CFTR mutation is a
Frameshift mutation
Chrom 7 @ F508, missing phenylalanine
96
Ipsilateral Brachiocephalic vein drains into
ipsilateral jugular and subclavian veins
| neck and face
97
Bilateral brachiocephalic veins forms
SVC
98
Bollous pemphigoid
deposition of IgG and complement at the dermal-epidermal junction
99
TMP-SMX risk in HTN pt taking ACE-I, potassium-sparing diuretic... and elderly
Hyper-K
100
segmental vasculitis extending into contiguous veins and nerves
Thromboangiitis obliterans(Buerger disease)
101
Transmural inflammation of the arterial wall with fibrinoid necrosis
Polyarteritis Nodosa (PAN)
102
Inflammatory infiltration and necrosis of peyers patches
Typhoid pass through
103
Rotavirus is
segmented nonenveloped, ds RNA virus
| fecal-oral transmission
104
<5 yo acute self-limited fever and watery diarrhea causes
| segmented nonenveloped, ds RNA virus
Blunting of the villi in the duodenum and proximal jejunum
105
extnesive colonic mucosal injury with yellow-white adherent layer
C. Diff
106
flask shaped ulcerations in the cecum and ascending colon
Entamoeba hystolytica
107
foamy macrophages in the small intestinal lamina propria
whipple dz(Tropheryma whipplei)
108
prevent degradation acetylcholine
physostigmine
| release anticholinergic agents(atropine,scopolamine effect)
109
recurrent Ca nephrolithiasis and hypercalcemia
primary hyperparathyroidism (PHPT)
110
primary hyperparathyroidism (PHPT) effect on bone
subperiosteal resorption with cortical thinning
| increased bone resorption
111
Benzo and phenobar MOA
Increase GABA A action
112
inhibits vesicle fusion by binding SV2A protein
Levetiracetam
113
Blocks NA+ and GABA transaminase
Valproic Acid
114
Blocks thalamic T-type Ca
Ethosuximide
115
# seisures
Blocks Na+
Phenytoin
carbamazepine
116
Blocks Ca
Gabapentin
117
irreversible inhibition of GABA transaminase in CNS
Vigabatrin
118
neonatal opiod withdrawal treatment
morphine
119
Granular deposition in PSGN
| Posttreptococcal glomerulonephritis
IgG, IgM, and C3
on GBM and mesangium
119
CKD with excessive bruising, normal platelet count
normal coagulation studies
platelet dysfunction
due to hi urea--:ammonia breakdown
product-->hi NO-->low adhesion
120
jerky movement that flow b/t muscle groups
chorea
121
sustained contraction resulting in abnormal posture
| focal/generalized
Dystonia
122
controls glucose entry into cells
glucokinase
123
maternity onset diabetes of the young is mutation of
glucokinase
lower glucose affinity
| non-obese pt and condition is non-progressive
124
still born, exposed brain, (in bipolar woman)
valproate
folate effect on neural tube development
125
# multiple myeloma
demyelination causes
decrease signaling velocity by
Velocity= low length/hi time
| length (space) constant
126
TNF a
| from macrophages
mediates systemic inflammatory response in sepsis
127
leptospirosis
motile spirochet
| corksrew-shape pathogen
128
contaminated water with animal urine
leptospirosis
mild self-limited, flulike illness--->renal or hepatic failure
129
low circulating iron and hi bone marrow iron
suggestive of anemia of chronic disease
130
moa of sevelamer
| used in CKD with hi phosphorus level
decrease intestinal absorption of phosphorus
131
caloric restriction in fat people: leptin/insulin/ghrelin
lowers leptin and insulin
increase ghrelin
132
low activity of which enzyme cause gallstone
cholesterol 7a-hydroxylase
133
aluminum hydroxide causes
| treatment in gastroesophageal reflux
constipation
134
mg+ conbination with aluminum hydroxide rationale
reduce adverse effects
(constipation)
135
heavy alcohol use effect on liver
intrahepatic neutrophil infiltration
hepatocellular ballooning
mallory bodies
steatosis
136
normal torso and short limbs
chondrocytes defects
achondroplasia
137
# females
lo platelet
shistocytes, hi creatinine
neurologic(headach)
fever
decrease activity of von Willebrand factor-cleaving protease
| ADAMTS-13
138
amlodipine side effect
headache, flushing, dizziness, peripheral edema
139
hypogonadism with pigmented skin
iron deposit in pituitary gland
hemochromatosis (endocrine)
140
fluid given to septic pt
lactated Ringer solution
141
Movement disorder with psychiatric symptoms
| psychosis, dementia, irritability, anxiety, apathy, depression
Huntington Disease
Cytosine-adenine-guanine
| AD
142
Genetically predisposed individuals
with slow acetylator phenotype have greatest risk of
Drug-induced lupus erythematosus
143
Hi Hb A2(alpha-2 delta-2) suggestive of
| microcytic anemia
beta-thalassemia trait
144
cause of Hi Hb A2
erroneous
mRNA processing
due to point mutations
145
what mediates response to monoclonal antibody therapy
| HER2 epidermal growth receptor
Natural killer cell and granzymes
146
in utero CMV exposure
chorioretinitis
seizures
microcephaly
| hepatospleno megaly and sensorineuro deafness
147
RBC with no central pallor
| anemia, hi reti count, hi indirect bili
hi MCHC
| hereditary spherocytosis
148
yersinia pestis: plague treatment
Aminoglycoside (30s )
prevent protein synthesis
149
schistosomiasis treatment
| contaminated snails freshwater transmission
praziquantel
| affects mesenteric and bladder
150
excessive vascular calcification occurs freequently in CKD due to
hyperphosphatemia
hypercalcemia
| others: atherosclerosis and chronic inflammation
151
Recurrent respiratory papillomatosis in a child
| transmission
vertical
| HHV 6 and 11
152
Lab findings in legionella Pneumonia
Hypo Na
hi Neutrophils with few or no bug
in sputum
153
legionella Pn symptoms
hi fever
cough
confusion
diarrhea
154
malonly CoA inhibits carnitine acyltransferase causing
beta oxidation failure
155
CD40L defect causes
impairs T-cell activation by B-cell
impairs T-cell-APC interaction
| No secondary germinal center
156
mid systolic click murmur disappears with squatting
MV prolapse
| connective tissue problem
157
MOA of bevacizumab
depletion of endothelial factors
of angiogenesis
| inhibits angiogenesis
158
when does motor symptom present in idiopathic parkinson
when 60% of dopaminergic neurons are lost
159
postsynaptic compensatory effect of dopaminergic neuronal loss
upregulation of dopamine receptors
160
Bug that directly damage dorsal columns
Reactive VDRL of CSF
neurosyphilis
| tabes dorsalis
161
associated with sensory ataxia, neurogenic urinary incontinence
hi incidence with HIV
DCML
| treatment
Pen G(IV)
| syphilis
162
false Neg PPD may be due to
inadequate lymphocytic response
| acid-fast bacilli on sputum
163
strongest risk factors for A fib
Age, left atrial dilation
(htn, HF, MV disease)
164
retrosternal burning and regur, raynaulds finger
| antibodies
anti-centromere
| CREST syndrome
165
ACE inhibitor ARB moa
lower aldo secretion
inhibits ENaC
166
# C
cyclosporins moa
Blocks aldo activity
167
Digitalis
ihibits Na+/K+-ATPase
168
Heparin
Effect on aldosterone
Blocks aldo production
169
Nonselective B-adrenergic blocker
decrease K uptake
170
NSAID
decrease renal perfusion-->decrease K delivery to collecting ducts
171
K sparing diuretic
| Elperenone
inhibits ENaC or aldo receptor
172
Trimethoprim
Inhibits ENaC
173
accumulates in astrocyte with hyperammonemia
glutamine
Motor symptoms
174
Biliary sludge seen with
incomplete gallbladder emptying
| GB mobility stimulated by CCK
175
ATM gene, cerebellar dysfunction, distended cappilaries
DNA break repair
176
responsible for fibrous cap on plaque
smooth muscle cells
177
pseudomonas aeruginosa mechanism of antibiotic resistance
beta lactamases, efflux pumps and
antiboitic modifying enzymes
178
aminoglycoside (gentamicin) resistance in P. aeruginosa
antibiotic-modifying enzymes
179
associated with poor prognosis of bladder cancer
invasion of muscularis propria layer
180
cavity seen in TB is created by
aggregation of activated leukocytes
181
prostate mets..treatment to reduce spread
ihibition of the 17-alpha-hydroxylase enzyme
| abiraterone
182
benign melanocytes grow involving the dermis and epidermis
compund nevi
183
hi direct bili and Y-glutamyl transferase
biliary atresia
obstruction of extrahepatic bile ducts
184
dialated chest, neck, face and upper trunk vein
Extrinsic compression of SVC
mediastinal mass
185
erb-duchenne palsy
C5-C6
186
Loop diuretics
furosemide high doses will cause
| other ototoxic drugs
ototoxicity
| when use with aminoglycosides, salicylates, cisplatin
187
Anastrozole inhibits
| estrogen receptor pos tumor
aromatase
| decreased androgen aromatization
188
liver fibrosis, myofibroblast response to hepatocyte injury and callagen deposit is due to
Stellate cell activation into myofibroblast
189
SGLT-2 MOA causing additional effect
MOA: inhibit sodium glucose cotransporter
causing osmotic diuresis
lowering BP/mortality for Heart failure
190
DRESS syndrome is a
Drug Reaction with eosinophilia and systemic symptoms
| hi risk drugs: phenytoin, carbamezepine, sulfer, vanco, minocycline
191
cognitive decline present with normal ADLs
Mild cognitive impairment
192
cognitive decline interferes with ADLs
dementia
193
uncomplicated parapneumonic effusions
movement of sterile exudate into the pleural space
| low leukocyte count below 50k mm3
194
complicated parapneumonic effusion involves
inflammatory disruption of visceral pleural membrane and bacterial translocation
195
C. Perfringen alpha toxin moa
split phospholipid (lecithinase)
| gas formation is due to carbohydrates metabolism
196
c. Diffi cytotoxin B moa
Actin depolymerization
causing infectious diarrhea
197
Plasminogen activator from exotoxin of
Strep. pyogenes
198
causes of b12 defficiency
R protein cleavage defect due chronic pancreatitis
Type A gastritis-intrinci factor
absorption problem
199
PDA causes lower Systemic vascular resistance
shunting causes lower resistance
200
Delay in warfarin effect may be due to
clotting factors generated before warfarin initiation
201
polyvinyl chloride causes
hepatic angiosarcoma
202
BTK, X-linked agamma
| Common infection becomes life threatening
Decrease circulating B cell
203
Flutamide moa
impaired androgen-receptor interaction
204
GnRH agonist (leuprolide) MoA
inhibit LH release from A. Pituitary
205
Ketoconazole and spironolactone MOA
inhibit testosterone synthesis
Leydig cells
206
conversion of testosterone to DHT inhibitor
finasteride
5-a-reductase inhibitor
207
inhibit androngen receptor-binding
flutamide
cyproterone
spironolactone
208
vulvovaginal candidiasis is the result of
decreased number of gram-positive bacteria
| immune suppression: antibiotic, pregnancy, corticosteroid, diabetes
209
possible nutritional deficiencies in vegan
B12, Vit D, Ca++
Iron, zinc
210
infliximab is a
chimeric monoclonal antibody targeting
TNF-a
| causes serum sickness: type III HS reaction
211
infliximab reaction resolution is by
activation of the mononuclear phagocyte system
212
# anatomy
SVC is derived from
common cardinal veins
213
cardiac temponade: becks triad
jugular venous distension
hypotension
pulsus paradoxus
214
Aminoglycoside resistance
methylation of binding site
| MOA 30s inhibition
215
coupling of iodotyrosines is moa of
methimazole
216
T4--T3 conversion inhibitor
Propylthiouracil
B-blocker
contrast agent(Ipodate)
217
Thyroid peroxidase inhibitor(coupling of iodotyrosines)
propylthiouracil
methimazole
218
binds to the thrombin active site
Argatroban
| low platelett
219
newborn Hi TSH and low T4
transplacental transfer of thyroxine
| congenital hypothyroidism
220
optochin sensitive and bile-soluble
Strep. Pneumo
221
Bacitracin sensitive and PYR pos
strep. Pyo
| B-hemolysis
222
pre-eclampsia urinalysis
hi specific gravity
protein
no RBC
223
acquire vWF deficiency risk
severe aortic stenosis
bleeding
224
MM demyelination plaques is due to
perivenular inflammatory cells
T-c and MP
225
young fm with optic nuritis
Broad-based gait
intnsion tremor
Demyelinating plaques
Multiple sclerosis
226
Genetic mutation of ryanodine receptors =
| Hypercabia & Rhabdomyolysis
malignant hyperthermia
227
fever, muscle spasm post anesthesia
| masseter muscle spasm
malignant hyperthermia
| inhalational anesthetics and succinylcholine
228
uregulated sarcoplasmic calcium release resulting in sustained muscle contraction
| whidespread muscle contraction (rigidity)
malignant hyperthermia
| Treatment: dantrolene
229
antiepileptic drug that induces ADH production and incr renal sensitivitiy to ADH
| SIADH
Carbamazepine
| siezure/pain
230
maraviroc is a chemokine receptor antagonist targeting
T-cell chemokine receptor=CCR5
| mediates viral fusion
231
Negative regulator of T-cell activation
antagonist are use in
melanoma treatment
232
Myastenia gravis Pathophy
Reduce amplitude of motor end plate potential
| decreases number of functonal acetylcholine receptors
233
Glycopyrrolate an antimuscarinic agent use in
Myastenia gravis treatment
234
UV damage causes
thymine or cytosine dimers
repaired by endonuclease nicking of damaged
| Nucleotide excision repair
235
MOA of Sulfonylureas
| glipizide
inhibit ATP-sensitive K channel in beta cell membrane
| membrane ion channels
236
Risk of sulfonylurea
hypoglycemia
237
Diabetic diarrhea patho
autonomic dysfunction
altered intestinal motility
increase secretions
238
predominant cell in EBV
B-Cells
239
# HIV pt
2nd MCC of ring-enhancing lesion with mass effect
EBV
primary central nervous system lymphoma
| multiple rings
240
Single ring-enhancing lesion in HIV
Toxo
241
PEEP used causes
Intrapulmonary shunt effect
242
Amyotrophic lateral sclerosis die from
respiratory failure
243
Presentation of ALS
UMN dysfunction
brisk reflexes, extensor plantar reflex
244
ALS: lower motor neurons dysfunctions
fasciculations, muscle atrophy
245
# Arch
pulmonary arteries, ductus
arteriosus
arch 6
CN10 recurrent laryngeal
246
# ARCH
True aortic arch, subclavian arteries
4th
superior largngeal vagus
247
# arch
common carotid artery, proximal internal carotid artery
3rd
CN9
| inte
248
integrase inhibitor prevents
production of viral mRNA
249
# pathway
Ornithine transport defect
urea cycle
250
urea cycle defect accumulates
ammonia
causing neurological damage
251
nutritional restriction of ______________ improves urea cycle defect
protein
252
MCC of Mallory-Weiss syndrome
increase of intraabdominal and intraluminal gastric pressure
| retching and vomiting
253
increase intestinal intraepithelial lymphocytes
| seen in patient with
Dermatitis herpetiformis
| rash on extensor surfaces
254
Delay onset of HFE gene in women is dt
premenopausal menstrual bleeding
255
Why is DM 1 with CKD having hypoglycemia
decreased renal insulin clearance
256
path findings in alcoholic liver
marked intrahepatic neutrophill
steatosis
mallory-denk bodies
hepatocellular ballooning
257
chronic lithium tox
| drug interaction
gradual onset of neurologic symptoms
ataxia and tremor
| thiazide, ACE and NSAID( NA reabsorption/lithium clearance)
258
predisposing risk factor for lung abscess
condition the cases aspiration
alcoholism
drug abuse
seizure disorders
Stroke
dementia
259
head injury causing transient DI
Posterior pituitary
260
Head injury causing permanent DI
Hypothalamic
261
Angioedema without urticaria
hi Bradykinin
hi activated C1(low C4)
| hi C4 consumption = low C4 levels
262
Dopamine receptor agonist are first line in
schizophrenia treatment
263
preeclampsia occurs due to
abnormal placental development-->
hi-resistance, lo-perfusion and placental ischemia
264
placental ischemia in preeclampsia triggers
endothelial dysfunction
dysregulated vascular tone
hi vascular permeability
low organ perfusion
265
headaches and visual changes in preeclampsia due to
vascular dysregulation
266
Mutation in HOX gene leads to
malpositioned body parts:
syndactyly/polydactyly
267
MOA of HOX gene
binding DNA trasription regulatory regions
| directly regulates body patterning
268
androgenetic alopecia
| inheritance
polygenic inheritance with
variable expressivity
MCC of hair loss in both gender
269
TXA(tranexamic acid moa
stabilizes thrombi/clots
by innhibiting plasmin formation
| prevent fibrin degredation
270
pyruvate kinase defi causes
hemolytic anemia
| dec ATP
271
splenic hyperplasia(red pulp) seen with
pyruvate kinase dif
| why?
splenic overworking to remove deformed
erythrocyte
272
# female
Theca interna synthesizes
Androgens from
cholesterol
| stimulated by LH
273
# female
Granulosa Cell synthesizes
Estrogen(estradiol)
from androgen
| Stimulated by FSH
274
# males
Leydic cells
Stimulated by LH to secrete testosterone
275
risk factors for gastric adenocarcinoma
hi salt
n-nitroso-containing compounds
H.pylori
obesity
chronic atrophi gastritis
276
histology of gastric adenocarcinoma
signet-ring cell
glandular structure
plaque-like infiltration
ulcerated mass with heaped-up edges
277
recurrent nosebleed
spider-like lesions on oral/nasal mucosa, face and arms
osler-weber-Rendu syndromes
278
Heat stroke can trigger DIC, How?
severe hyperthermia---hi O2 demand
shunts bld from central organs
cause ischemia/necrosis
release procoagulant protiens
=DIC
279
Hematologic findings present in DIC
hi fibrinolysis
hi thrombin production
hi plasmin generation
280
MC masses in the anterior mediastinum are the
thymoma
teratoma(& other germ cell tumors)
terrible lymphoma
thyroid neoplasm
| 4 Ts
281
anterior mediastenum mass with hi AFP and B-hCG
nonseminomatous germ cell Tumor
| yolk sac tumor, choriocarcinoma, embryonal carcinoma
282
AFP and hCG are hi in teratomas
false
283
Seminomas may have hi ______ but normal _________
hi hCG
normal AFP
284
what are the key players in abcess formation
lysosomal enzyme from Neutrophils
285
topical agent that acts as a tool-like receptor agonist to increase antiviral cytokine production
Imiquimod
286
topical immunomodulator with antiproliferative effect
imiquimod
activates toll-like receptor 7
| induce apoptosis and ihibits angiogenesis
287
inhibits T-cell and keratinocyte prolifiration and stimulate differentiation
calcipotriene
Vit D analog
288
treats atopic dermatitis(eczema) by blocking NFAT trannslocation
pimecrolimus
| reduced IL-2 transcription
289
major contributor to the development of centriacinar and panacinar emphysema
excess protease activity
| neutrophil and macrophages elastase
290
acute hepatitis C is characterized by
panlobular lymphocytic inflammation with hepatocyte injury and cell death
| ballooning degeneration and councilman bodies
291
chronic hep c leads to predominantly
portal lymphocytic infiltration, fibrosis, lymphoid follicle formation
292
two approaches to RA treatment
DMARD and short-term anti-inflammatory(steriod/NSAID)
293
DMARD
methotrexate
sulfasalazine
hydroxychloroquine
minocyline
TNF-a inhibitor
