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STEP COPY > Uworld self assessment #2 > Flashcards

Uworld self assessment #2 Flashcards

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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
cirrhotic liver primary cell
proliferating hepatocytes within the nodules (trying to regenerate itself)
26
Number one cause of infertility
PID (can be subclinical) if pt has unprotected sex with multiple partners
27
lactase deficiency
decrease in lactase gene expression (NOT protein synthesis)
28
most important risk factor for thyroid malignancy
ANY exposure to thyroid radiation (even in a child)
29
Kluver Bucy Syndrome
**Amygdala lesion** inappropriate sexual activity hyper-oral fixation loss of normal anger and fear **most commonly associated with HSV-1 encephalitis or TBI**
30
tardive dyskinesia
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)
31
skewed X inactivation
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
32
adenovirus
DS DNA virus naked replicates via DNA dependent DNA polymerase in nucleus can cause pink eye, pneumonia, tonsilitis, URI, hemorrhagic cystitis military recruits
33
negri bodies
**rabies** eosinophilic cytoplasmic inclusions in hippocampal neurons
34
renal artery stenosis
afferent dilation efferent constriction to maintain GFR at all costs **FF increases** RBF decreases **FF=GRF/RBF**
35
membranous nephorpathy
most common nephrotic syndrome in adults light microscopy jones stain shows thickened GBM spike and dome appearance nephrogenic presentation of SLE
36
cancer distal rectum mets to --\> Cancer prox rectum mets to --\>
distal --\> drain to caval system to **LUNGS** prox --\> drain to **liver** (Opposite of what you think)
37
xerosis
itchy rash, dry cracked skin (winter itch) in old people Put on lotion!
38
insulin in general (also in DKA pt) (regulation of glycolysis)
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
basic AA
**HAL** histadine arginine lysine
40
acidic AA
aspartate glutamate (have carboxylic acid R group)
41
non polar aa
isoleucine, leucine, valine alanine phenylalanine tryptophan methionine proline glycine
42
probenacid
inhibits organic anion transporters in renal tubules to keep PCN in circulation
43
xeroderma pigmentosum
AR nucleotide excision repair deficit uv damage causes thyamine dimers, and fixed by nucleotide excisions BIG risk for skin cancer
44
t(14;18)
follicular lymphoma increased BCL2 increased inhibiton apoptosis waxing and waning LAD
45
cirrhosis
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
spider angiomata
vascular lesions that occur in the trunk, face or upper extremities NOT specific for cirrhosis
47
neurofibromatosis
proliferation of schwann cells and fibroblasts
48
long term sequella of endometriosis
infertility due to scarring
49
Paclitaxel in stents
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
what pulls distal clavicle fx down
deltoid
51
increased urinary orotic acid
ornithiene transcarcmoylase deficiency
52
transduction
bacterial DNA is transferred from one bacteria to another via bacteriophage generally happens when bacteriophage causes lytic infection
53
somatic symptom disorder
excessive preoccupation with one or more somatic complaints Real symptom that causes disproportionate distress/disruption of daily life excessive, persistent thoughts about symptoms
54
memory impairment with confabulation in alcoholic pt
Korsakoff confabulation = unintentional lying
55
Lynch syndrome
mismatch repair predispose to microsattelite instability This is what leads to cancer in these folks
56
hypokalemia sx
muscle weakness, cramp, muscle fatigue, myalgia on ECG --\> see U waves
57
ARDS
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
hemangioblastoma associated with what other cancers?
Renal Cell Carcinoma Von-Hippel Lindau (chr 3) Hemangioblastoma, Cysts in kidney and pancreas, pheochromocytoma, renal cell carcinoma May also see polycythemia vera
59
2-3 BPG
enahce Hgb ability to release O2 near tissue that need it most increased, shift to the RIGHT (Bohr)
60
conjunctiva (eyes)
lines sclera and covers inside of eyelids (think pulling DOWN on eyes)
61
Kayser Flescher Rings
deposit **COPPER** in Descement membrane of **CORNEA** (in the Iris is Lisch Nodules)
62
fibroadenoma
solitary round mass, firm with clear borders, mobile Its epithelial is estrogen-sensitive, resulting in size increase during pregnancy and decrease after pregnacy
63
dysplastic nevus syndrome
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
brain development sections
65
leucine zipper
transcription factor composed of two alpha helix that form a dimer basic AA plus leucine every 7th position in each alpha helix
66
G protein that hydrolyzes membrane bound phospholipids
Gq alpha subunit activates Phospholipase C hydrolyzes PIP2 and DAG These then realse calcium from SR
67
de novo pyrimidine synthesis begins where?
cytosol carbamoyl phosphate synthase II is the RDS
68
69
p57 staining (pregnancy)
indicates presence of maternal expresssed (paternal imprinted) ## Footnote **Complete moles are p57 NEGATIVE**
70
most common cause of primary hyperthyroidism
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
retinoid acid for acne
acts to decrease sebum production and normalize epidermal differentiation. Retinoids increase cellular turnover and the shedding of cells from stratum corneum ## Footnote **\*\*Normalize follicular keratinization\*\*** **This reduces hyperkeratinization, opens blocked pores, and prevents formation of comodones**
72
3 diaphragmatic holes
1. esophageal hiatus --\> esophagus, inferior posterior trunk of vagus 2. aortic --\> aorta, thoracic duct, azygos 3. vena cava --\> vena cava
73
what does amlodipine do?
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
postprandial glucose is dealt with by hexokinase/glucokinase
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
Gene mutation assocaiated with Maturity onset diabetes of the young (MODY)
Glucokinase
76
Von Gierke Disease
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
Pompe Disease
cardiomegaly, hypotonia, macroglossia caused by defieincy in alpha-glucosidase Cause glycogen to accumulate within lysosymes
78
carbamezapime vs cimetidine cyp450
cimetidine --\> INHIBITOR (cement inhibits) carbamezapime --\> Inducer
79
H2S production NO H2S production
H2S --\> salmonella, proteus NO H2S --\> Shigella
80
pontine hemorrhage
pinpoint pupils, quadraporesis, decerebrate posturing (extension), loss of horizontal gaze

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