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Flashcards in Uworld Part 3 Deck (79):
1

what side effect of dopamine is central?

does carbidopa increase or decrease?

how to avoid?

anxiety and agitation is central effects.

carbidopa can increase thru increasing central availability by inhibiting peripheral conversion

decrease dose
use atypical antipsychotics like cloazpine

2

what can carbidopa help you avoid

peripheral effects of dopamine
-postural hypotension
-hot flashes
-tachyarrhthmias
-Nausea and vomiting

3

RNA polymerase I function

form ribosomal components

4

RNA polymerase II function

mRNA
snRNA
micro RNAa

5

RNA polymerase III fxn

tRNA
Component of 60S ribosomal subunit

6

selectivity for CCB

Verapamil most on heart

Nifedipine most on peripheral vasculature

Diltiazem in between

7

SE of verapamil

constipation
gingival hyperplasia
bradycardia
first/second/third degree AV nodal block

8

most acid labile piconravirus

rhinovirus

9

most acid stable piconravirus

enteroviruses

10

most common species for aspiration pneumoniae

fusobacterium
peptostreptoccus
bacteroides

11

16S rRNA fxn

complementary and binds to Shine Delgarno sequence in all prokarotic mRNA 10 bases upstream of AUG start.

mRNA and 30S ribosomal subunit bind, an initiator tRNA binds to AUG, the 50S ribosomal subunit joins and protein synth begins

12

23s rRNA

found in 50S, faciltates peptide bond formation in protein translation

13

isoniazid function

req. conversion to active compound by mycobacterial enzyme catalase-peroxidase

inhibits mycolic acid synthesis

14

rifampin function

imhibits DNA dependent RNA synthesis

15

50S antibiotics

chloramphenicol
clindamycin
linezolid
macrolides (erythromycin/azithromycin/clarithroycin)

16

30S antibiotics

tetracycline
doxycycline
aminoglycosides (gentamicin, streptomycin and others)

17

beta blocker function in thyrotoxicosis

Block increased sensitivity to catecholamines via thyroid hormone mediated upregulation of beta-adrenergic receptor expression

Decrease peripheral conversion of T4 to T3 by inhibiting iodothyronine deiodinase

18

G6PD genetic

X linked recessive

19

Hereditary spherocytosis genetic

autosomal dominant

20

vitamin D-resistant rickets genetic

x-linked dominant inheritance

21

oxidative phosphorylation mutations tend to be

mitochondrial diseases

22

autosomal dominant diseases

ADPKD
FAP
Familial hypercholesterolemia
Hereditary hemorrhagic telangietasia
Heredtiary spherocytosis
Huntington disease
Marfan syndrome
MEN
Neurofibromatosis 1
Neurofibromatosis 2
Tuberous sclerosis
Von Hippel Lindau disease

23

autosomal recessive diseases

Albinism
ARPKD
Cystic fibrosis
Glycogen storage diseases
hemochromatosis
Kartagener syndrome
Mucopolysaccharidoses (except hunter syndrome)
Phenylketouria
Sickle cell anemia
Sphingolipidoses (except Fabry disease)
Thalessemias
Wilson disease

24

xlinked recessive disorders

Be Wise, Fool's GOLD Heeds Silly HOpe

Bruton agammaglobulinemia
Wiskott-Aldrich syndrome
Fabry disease
G6PD deficiency
Ocular albinism
Lesch-Nyhan syndrome
Duchenne (and Becker) muscular dystrophy
Hunter Syndrome
Hemophilia A and B
Ornithine transcarbamylase deficiency

25

Trinucleotide repeat expansion diseases and the trinucleotide repeats are

Huntington disease (CAG)

Myotonic dystrophy (CTG)

Friedreich ataxia (GAA)

Fragile X syndrome (CGG)

26

where does digestion of triglycerides occur

duodenum

27

where does absorption of triglycerides occur

jejunum

28

hemosiderin laden macrophages in pulmonary alveoli indicates

chronic elevation of pulmonary capillary hydrostatic pressures which is usually the result of left sided heart failure.

29

how to differentiate b/w lipofuscin or hemosiderin

prussian blue stain, detects intracellular iron, colorless potassium ferrocyanide converted by iron to blue black ferric ferrocyanide.

30

left ventricular leads in biventricular pacemakers courses through

coronary sinus residing in the atrioventricular groove on the posterior aspect of the heart.

31

vitiligo is caused by

loss of epidermal melanocytes

32

characteristic abnormality in huntingtons

bilateral atrophy of the caudate nucleus and putamen (striatum)

33

characteristic abnormality in parkinsons

decreased dopamine in the substantia nigra and striatum

34

what causes green sputum

myeloperoxidase, blue green heme based pigmented molecule in azurophilic granules of neutrophils that catalyzes the production of hypochlorous acid from chloride and hydrogen peroxide during phagocytic respiratory burst

35

Polyarteritis nodosa affects what arteries

affects medium to small arteries in any organ. Kidneys, heart, liver, GI tract.

SPARES PULMONARY ARTERIES and rarely involves bronchial arteries.

36

how does PAN affect the arteries

transmural inflammation of the arterial wall w/ fibrinoid necrosis

37

mechanism of korsakoff

dmg to the anterior and dorsomedial thalamic nuclei resulting in memory loss and confabulation.

IMPAIRMENT IN MEMORY AND LEARNING IS USUALLY PERMANENT

38

rapid correction of hypernatremia results in

cerebral edema

39

rapid correction of hyponatremia results in

Mechanism

presents

Central pontine myelinolysis

Mech:
osmotic demyelination syndrome of the axons in the central part of the pons.

demyelination of corticospinal tracts and corticobulbar tracts of CN IX, X, XI (Pseudobulbar b/c nuclei of CN intact).

presents as spastic quadriplegia and pseudobulbar palsy


40

what factors does H. influenzae require

X factor (exogenous hematin)

V factor (NAD+)

41

blocking alpha2 adrenergic receptors results in

release of norepinephrine from nerve endings

insulin from pancreas

42

D1 adrenergic (dopaminergic) receptors are located where and cause what

located in walls of renal, splanchnic, mesenteric blood vessels


Vasodilatation and increase in renal and splanchnic blood flow

43

silicosis distinguished by

eggshell calcification of hilar nodes

birefringent silica particles surrounded by fibrous tissue

44

asbestosis distinguished by

calcified pleural plaques
ferruginous bodies (fusiform or beaded rods w/ a translucent asbestos center and coated w/ an iron containing proteinaceous material best seen w/ prussian blue staining)

45

berylliosis and hypersensitivity may produce

noncaseating granulomas

46

coal miners lung assoc w

perilymphatic accumulations of coal dust laden macrophages

47

aortic arch baroreceptor transmits via... to...

to what does it respond

vagus nerve to solitary nucleus of medulla.

only responds to increase

48

Carotid sinus baroreceptor transmits via... to...

to what does it respond

glossopharyngeal nerve (Hering branch) to solitary nucleus of medulla

responds to increase or decrease

49

distinguish bullous pemphigoid from pemphigus vulgaris

bullous pemphigoidhave intact bullae (negative nikolsky sign) and mucosal involvement is uncommon

50

CNS fried egg tumor cell appearance (nuclei w finely granular chromatin surrounded by clear cytoplasm)

oligodendroglioma

51

presentation of meningiomas

mechanism

personality change
New onset seizures

(from frontal lobe compression)

52

culture negative endocarditis causes

Bartonella
Coxiella
Mycoplasma
Histoplasma
Chlamydia
HACEK
-Haemophilus
-Actinobacillus
-Cardiobacterium
-Eikenella
-Kingella

53

vitamin E deficiency results in what

what condition does it mimic?

How do they both present?

degneration of spinocerebellar tracts, dorsal column of the spinal cord, and peripheral nerves

mimics Friedrich ataxia

Ataxia
Dysarthria
Loss of both position and vibration sensation

54

Lead intoxication presentation

irritability
loss of devo milestones/learning problems
GI issues

55

Thiamine deficiency has what triad

ataxia
confusion
ophthalmoplegia

56

Creutzfeldt jacob disease presents how

rapidly progressive dementia and myoclonic jerks of the extremities

57

Acute intermittent porphyria presents how

acute abd pain
peripheral neuropathy
hyponatremia

58

what atypical antipsychotic most likely to cause EPS?

Risperidone

59

What atypical antipsychotic least likely to cause EPS?

Clozapine (but watch out for agranulocytosis)

60

treatment of acute dystonia

antihistamines (diphenhydramine)
Anticholinergics (benztropine/Trihexyphenidyl)

61

treatment of parkinsonism

anticholinergic (benztropine)

62

presence of erythroid precursors in organs like liver and spleen is indicative of..

what causes it

extramedullary hematopoiesis

caused by severe chronic hemolytic anemias (beta thalessemia for example)

63

visual impairment in HIV patient is caused by

secondary to CMV induced retinitis

64

treatment for CMV induced retinitis

ganciclovir
foscarnet
cidofovir

65

SE of foscarnet

why does this happen?

hypocalcemia and hypomagnesemia, both of which promote seizures.

mech:
calcium chelator, renal wasting of magnesium induced, reduction in release of parathyroid hormone

66

lamivudine SE

peripheral neuropathy
lactic acidosis

(this is unusual compared to other NRTIs)

67

B6 involved in

transamination and decarboxylation steps in amino acid metabolism

heme (ALAS) and neurotransmitter synthesis (L-DOPA to Dopamine)

68

what uses TLCFN

branched chain alpha-ketoacid dehydrogenase

pyruvate dehydrogenase

alpha-ketoglutarate dehydrogenase

69

acute irrev injury to neuron results in a what?

what signs?

Red neuron
12-24 hr after
-shrinkage of cell body
-eosinophilia of the cytoplasm
-pyknosis of the nucleus
-loss of Nissl substance

70

important prognostic factor in poststreptococcal glomerulonephritis

AGE
95% of affected children recover completely
60% of adults recover completely

71

psoriasis is characterized by

hyperparakeratosis
acanthosis
rete ridge elongation
mitotic activity above the epidermal basal cell layer
reduced or absent stratum granulosum

neutrophils may form spongiotic clusters in the superficial dermis and the parakeratotic stratum corneum (Munro microabcesses)

72

diabetic mononeuropathy presents how?

predominantly central ischemia affecting somatic nerve fibers but sparing peripheral parasympathetic fibers

ptosis
down and out gaze
normal light and accommodation reflexes

73

granulation tissue is comprised of what type of collagen

Type III collagen. this is replaced eventually by type 1 as the infarct matures.

74

what benzodiazepines are not metabolized by liver

LOT

Lorazepam
Oxazepam
Temazepam

75

confidence intervals z values

90%=1.645
95%=1.96
99%=2.57

76

speed of transmission in the heart

park at ventura avenue

purkinje
atrial
ventricle
av node

77

where do dna viruses replicate

all in nucleus except poxvirus

78

where do rna viruses replicate

all in cytoplasm except
-influenzae
-retrovirus

79

segmented viruses

BOAR

bunyavirus
orthomyxovirus (influenza)
arenavirus
reovirus