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STEP COPY > Uworld self assessment #2 > Flashcards

Uworld self assessment #2 Flashcards

1
Q

1 cause MS

A

Rheumatic fever

diastolic murmur at apex. Can cause pulm edema and hemoptysis

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2
Q

Peutz-Jeghers

A

AD disorder on chr 19, pigmented mucocutaneous macules and hammartomatous polyps in GI tract

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3
Q

Liposarcoma

A

partially composed of lipoblasts

See scalloping of the nuclear membrane

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4
Q

+ Nikolski sign

Flaccid Bulli

A

Pemphigus Vulgaris

Autoantibodies to desmoglien 1 and 3

Would see intercellular IgG and C3 deposition in chicken-wire pattern

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5
Q
  • Nikolski Sign

Tense Bullae

A

Bullous Pemphigoid

IgG Ab against hemidesmosomes

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6
Q

anisocoria

A

unequal pupils

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7
Q

chronic alcoholism w/ ataxia

A

damage to cerebellum

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8
Q

Lithium ADR

A

nephrogenic DI

Dysfunction of distal collecting tubule

Does not respond to ADH/DDAVP

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9
Q

Meckel Diverticulum

A

made up of gastric or pancreatic tissue (heteroplastic)

See anemia due to painless abd bleeding

incomplete obliteration of omphalomesenteric duct

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10
Q

S2 heart sound

A2/P2

A

S2 –> closure of aortic and pulmonic valves

Inspiratory split due to delayed closure of pulmonic valve (due to more volume in the RV)

also can be caused by AV heart block and Pulmonary stenosis (both things that keep the pulmonary valve open for longer)

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11
Q

CD40 Ligand deficiency

A

hyper IgM syndrome

inability of T cells to activate B cell switching

Significantly decreased IgG, IgA, IgE

Class switch defect

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12
Q

Removal of RNA primers and synthesis of new DNA in their place

A

DNA pol I

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13
Q

Tacrolimus

A

Calcineurin inhibitor, block FK506 prevent IL-2 transcription

ADR: NEPHROTOXIC

Also, cyclosporine is calcineurin inhibitor

Cyclosporine binds cyclop

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14
Q

cyclophosphamide

A

alkalating agent used to treat leukemia , lymphoma, myelosuppression

Can give mesna or N-acetylcystine (also CF, COPD, acetaminophen tox –> replenishes glutathione)

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15
Q

cyclosporine

A

calcineurin inhibitor

Blocks IL-2 transcription

used in transplant prophylaxis, PAIR

nephrotoxic, gingival hyperplasia

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16
Q

metaclopramide

A

D2 antagonist

gastroporesis

antiemetic

contraindicated in Parkinson

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17
Q

alkaptonuria

A

urine turn black on standing

AR

Homogentisic acid dioxygenase

Homogentisic acid accumulates in cartilage (orchonosis) –> can cause osteoarthropy (debilitating arthralgias)

skin can turn black as well

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18
Q

hallmark of ischemic injury

A

cytoplasmic accumulation of calcium

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19
Q

Foam stability index test

A

Test whether or not fetus has enough surfactant

Surfactant is a phospholipid

Look at the lectin:spingomyelin ratio (>2 indicates maturity)

Mix with ethanol (see ring around edges of test tube)

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20
Q

Marfanoid body habitus (3 things)

A

1. Marfan syndrome –> fibrillin-1, NORMAL intellect, upwards lens dislocation (looking at mars)

2. MEN2B –> pheo, meddulary carcinoma thyroid, mucosal neuromas

3. Homocystinuria –> defective CBS protein, intellectual disability, THROMBOSIS, downward lens dislocation

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21
Q

PCR requirements

A

make DNA 5’ –> 3’

need 3’ primers (need 2 of them on both strads) so that you can move in 5’ –> 3’ direction

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22
Q

Why is heparin safer than warfain in pregnancy

A

It is more WATER soluble (lipid soluble things cross membranes)

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23
Q

shift vs drift

A

shift is serious shit

Drift is minor changes (flu shot every year)

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24
Q

Pineal gland tumor

A

Upward gaze palsy, absent pupillary reflex, impaired convergence

Damage the midbrain (specifically the superior colliculus region)

Can cause obstructive hydrocephalus

Cause precocious puberty in males (b-hCG production)

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25
Q

cirrhotic liver primary cell

A

proliferating hepatocytes within the nodules (trying to regenerate itself)

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26
Q

Number one cause of infertility

A

PID (can be subclinical) if pt has unprotected sex with multiple partners

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27
Q

lactase deficiency

A

decrease in lactase gene expression (NOT protein synthesis)

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28
Q

most important risk factor for thyroid malignancy

A

ANY exposure to thyroid radiation (even in a child)

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29
Q

Kluver Bucy Syndrome

A

Amygdala lesion

inappropriate sexual activity

hyper-oral fixation

loss of normal anger and fear

most commonly associated with HSV-1 encephalitis or TBI

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30
Q

tardive dyskinesia

A

long term D2 blockers, lip smacking, constant movement due to upregulation of dopamine receptors

Tx is to reduce dose of antipsychotic or switch to second gen (clozapine, quetiapine)

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31
Q

skewed X inactivation

A

instead of 50-50, the pt inactivates something like 70-30.

If pt is heterozygous for a condition, they are more susceptible to displaying mutation

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32
Q

adenovirus

A

DS DNA virus

naked

replicates via DNA dependent DNA polymerase in nucleus

can cause pink eye, pneumonia, tonsilitis, URI, hemorrhagic cystitis

military recruits

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33
Q

negri bodies

A

rabies

eosinophilic cytoplasmic inclusions in hippocampal neurons

34
Q

renal artery stenosis

A

afferent dilation

efferent constriction to maintain GFR at all costs

FF increases

RBF decreases

FF=GRF/RBF

35
Q

membranous nephorpathy

A

most common nephrotic syndrome in adults

light microscopy jones stain shows thickened GBM

spike and dome appearance

nephrogenic presentation of SLE

36
Q

cancer distal rectum mets to –>

Cancer prox rectum mets to –>

A

distal –> drain to caval system to LUNGS

prox –> drain to liver

(Opposite of what you think)

37
Q

xerosis

A

itchy rash, dry cracked skin (winter itch) in old people

Put on lotion!

38
Q

insulin in general (also in DKA pt) (regulation of glycolysis)

A

increase Fructose 2-6-biphosphetate and activates PFK-1 to glycolyis

Glucagon DEGRADES fruc 2-6 bisphos

Fructose 2-6 biphosphate is PRO-glycolysis

39
Q

basic AA

A

HAL

histadine

arginine

lysine

40
Q

acidic AA

A

aspartate

glutamate

(have carboxylic acid R group)

41
Q

non polar aa

A

isoleucine, leucine, valine

alanine

phenylalanine

tryptophan

methionine

proline

glycine

42
Q

probenacid

A

inhibits organic anion transporters in renal tubules to keep PCN in circulation

43
Q

xeroderma pigmentosum

A

AR

nucleotide excision repair deficit

uv damage causes thyamine dimers, and fixed by nucleotide excisions

BIG risk for skin cancer

44
Q

t(14;18)

A

follicular lymphoma

increased BCL2

increased inhibiton apoptosis

waxing and waning LAD

45
Q

cirrhosis

A

leads to decreaed production sex hormone binding globulin leads to decreased T, increased ESTROGEN

hyper estogen –> telangectasias, gynecomastia, testicular atrophy, decreased body hair, palmar erythema,

46
Q

spider angiomata

A

vascular lesions that occur in the trunk, face or upper extremities

NOT specific for cirrhosis

47
Q

neurofibromatosis

A

proliferation of schwann cells and fibroblasts

48
Q

long term sequella of endometriosis

A

infertility due to scarring

49
Q

Paclitaxel in stents

A

microtubule inhibitor in M phase of cell cycle

used in stent placement to inhibit cellular division and prevent stent restenosis by preventing intimal hyperplasia

same family as vinblastine and vinchristine

50
Q

what pulls distal clavicle fx down

A

deltoid

51
Q

increased urinary orotic acid

A

ornithiene transcarcmoylase deficiency

52
Q

transduction

A

bacterial DNA is transferred from one bacteria to another via bacteriophage

generally happens when bacteriophage causes lytic infection

53
Q

somatic symptom disorder

A

excessive preoccupation with one or more somatic complaints

Real symptom that causes disproportionate distress/disruption of daily life

excessive, persistent thoughts about symptoms

54
Q

memory impairment with confabulation in alcoholic pt

A

Korsakoff

confabulation = unintentional lying

55
Q

Lynch syndrome

A

mismatch repair

predispose to microsattelite instability

This is what leads to cancer in these folks

56
Q

hypokalemia sx

A

muscle weakness, cramp, muscle fatigue, myalgia

on ECG –> see U waves

57
Q

ARDS

A

increased dead space formation

diffuse damage to lung parenchyma cause air spaces to fill with proteinaceous fluids, results in increased dead space and RIGHT to LEFT shunting resulting in hypoxemia and hypercapnia

58
Q

hemangioblastoma associated with what other cancers?

A

Renal Cell Carcinoma

Von-Hippel Lindau (chr 3)

Hemangioblastoma, Cysts in kidney and pancreas, pheochromocytoma, renal cell carcinoma

May also see polycythemia vera

59
Q

2-3 BPG

A

enahce Hgb ability to release O2 near tissue that need it most

increased, shift to the RIGHT (Bohr)

60
Q

conjunctiva (eyes)

A

lines sclera and covers inside of eyelids

(think pulling DOWN on eyes)

61
Q

Kayser Flescher Rings

A

deposit COPPER in Descement membrane of CORNEA

(in the Iris is Lisch Nodules)

62
Q

fibroadenoma

A

solitary round mass, firm with clear borders, mobile

Its epithelial is estrogen-sensitive, resulting in size increase during pregnancy and decrease after pregnacy

63
Q

dysplastic nevus syndrome

A

numerous dysplastic nevi in young adult. predispose to melanoma, esp if in family hx

melanoma has hyperchromasia, round/spindle shaped

Associated with CDKN28 on chr 9 (dysregulation of cell cycle g1 –>s)

75% chance of getting melanoma if first degree relative with this and you have mutation

64
Q

brain development sections

A
65
Q

leucine zipper

A

transcription factor composed of two alpha helix that form a dimer

basic AA plus leucine every 7th position in each alpha helix

66
Q

G protein that hydrolyzes membrane bound phospholipids

A

Gq

alpha subunit activates Phospholipase C hydrolyzes PIP2 and DAG

These then realse calcium from SR

67
Q

de novo pyrimidine synthesis begins where?

A

cytosol

carbamoyl phosphate synthase II is the RDS

68
Q
A
69
Q

p57 staining (pregnancy)

A

indicates presence of maternal expresssed (paternal imprinted)

Complete moles are p57 NEGATIVE

70
Q

most common cause of primary hyperthyroidism

A

parathyroid adenoma (usually of 1 of 4 parathyroids) so the other three atrophy as a result of negative feedback

sx are painful bones, psych moans, abd groans, and kindey stones

71
Q

retinoid acid for acne

A

acts to decrease sebum production and normalize epidermal differentiation. Retinoids increase cellular turnover and the shedding of cells from stratum corneum

**Normalize follicular keratinization**

This reduces hyperkeratinization, opens blocked pores, and prevents formation of comodones

72
Q

3 diaphragmatic holes

A
  1. esophageal hiatus –> esophagus, inferior posterior trunk of vagus
  2. aortic –> aorta, thoracic duct, azygos
  3. vena cava –> vena cava
73
Q

what does amlodipine do?

A

The dihydropyridines are more selective for smooth muscle than for cardiac muscle. These drugs are particularly selective for arteries.

They decrease systemic BP and therefore decrease afterload

74
Q

postprandial glucose is dealt with by hexokinase/glucokinase

A

glucokinase

It is preferentialy on B cells of pancreas and liver and plays an important regulatory role in insulin secretion

glucokinase has the higher Vm

75
Q

Gene mutation assocaiated with Maturity onset diabetes of the young (MODY)

A

Glucokinase

76
Q

Von Gierke Disease

A

defieincy of Glucose 6 phosphetase

severe fasting hypoglycemia with lactic acidosis

hepatomegaly (glycogen stuck in there)

Impairs the release of free glucose generated through glycogenolysis and gluconeogenesis

DOES NOT improve with fructose administration

77
Q

Pompe Disease

A

cardiomegaly, hypotonia, macroglossia

caused by defieincy in alpha-glucosidase

Cause glycogen to accumulate within lysosymes

78
Q

carbamezapime vs cimetidine cyp450

A

cimetidine –> INHIBITOR (cement inhibits)

carbamezapime –> Inducer

79
Q

H2S production

NO H2S production

A

H2S –> salmonella, proteus

NO H2S –> Shigella

80
Q

pontine hemorrhage

A

pinpoint pupils, quadraporesis, decerebrate posturing (extension), loss of horizontal gaze

STEP COPY (36 decks)

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