UWorld_3.17 Flashcards Preview

Question 1

1

Blood testing in suscipicion of celiacs

Answer

blood test for:
- IgA anti-endomysial
- Iga anti-tissue transglutaminase

Question 2

2

Transmural inflammation of arteries w/fibrinoid necrosis ==> dx?

Answer

polyarteritis nodosa

Question 3

3

Characteristics of polyarteritis nodosa

Answer

segmental, fibrinoid necrosis of small-med arteries
Sx
- fever
- abdominal pain
- peripheral neuropathy
- weakness
- weight loss
assoc. w/hep B in 10-30% of cases

Question 4

4

Most common point of occurence of intusseception

Answer

ileocecal jxn

Question 5

5

Characteristics of a transaminase reaction

Answer

reaction between amino acid and an alpha-keto acid
- e.g. glutamate & oxaloacetate
often occur to allow amino acids to enter TCA cycle/Urea cycle
Vit B6 (Pyroxidine) = cofactor for transaminase and decarboxilation reactions

Question 6

6

T_H1 cytokines (+ purpose) =

T_H2 cytokines (+ purpose) =

Answer

interferon-gamma, IL-2 ==> activate macs & attract CD8+ t cells
TH2 ==> stimulate B cells [adaptive immunity]
1. IL4 + IL13 ==> IgE from B cells
2. IL5 ==> IgA + eosinophil

Question 7

7

"Red neurons" on histo section of brain

Answer

ischemia/infaction within the past 12-24 hrs

Question 8

8

Characteristics of lynch syndrome

Answer

hereditary nonpolyposis colon cancer
due to defect in mismatch repair
AD
due to mutations @
- MSH2 ==> MutS
- MLH1 ==> MutL

Question 9

9

a. that runs with the radial n.

Answer

deep brachial

Question 10

10

anatomic structure that runs through the hepatoduodenal ligament

Answer

portal triad = hepatic artery, portal vein, common bile duct

Question 11

11

Mechanism of relaxation of cardiac muscle

Answer

calcium efflux preceeds relaxation
accomplished via:
- Ca2+ ATP pump
- Na/Ca exchanger

Question 12

12

Most common cause of bronchiolitis + tx

Answer

RSV
1st line = O2 or IV fluids
in @ risk for progression, can give ribavirin:
- nucleoside analog
- active against RSV and hep C

Question 13

13

K+ in DKA

Answer

total body decrease in K+
decreased intracell stores of K+
normal to increased serum K+
- K+ drawn out in exchange for H+; low insulin levels
- increased if hypovolemic

Question 14

14

HCV vs. HBV most common transmission

Answer

HCV
- most common = blood transfusion or IV drug use
- possible, but less common = sexual transmission
HBV
- blood contact (transfusion, needle stick, IV drug use) OR unprotected sex

Question 15

15

Strep infections that lead post-strep syndromes

Answer

Impetigo (step skin infect) OR strep pharyngitis ==> APSGN
ONLY strep pharyngitis ==> rheumatic fever

Question 16

16

Common cause of fluid filled cavity in liver + fever chills

Answer

dx = hepatic abcess
underdeveloped countries ==> parasitic infection (entamaeba histolytica)
developed countries ==> bacterial infection
- biliary tract infection (asc. cholangitis)
- portal vein pyremia (bowel or peritoneal sources e.g. appecitis, peritonitis, enteric pathogens)
- hepatic artery (hemat spread from distant site)
- penetrating injury or trauma

Question 17

17

ST elevation @ V1-V3 ==> dx?

Answer

occlusion at left anterior descending coronary artery

Question 18

18

Riboflavin biochemical role

Answer

Riboflavin + Pi ==> FMN = coenzyme
FMN + Pi ==> FAD (i.e. FAD+) ==> oxidation/reduction reaction
- e.g. @ TCA cycle: succinate + FAD+ ==> fumarate + FADH₂

Question 19

19

Palpaple, nontender gallbladder + jaundice ==> dx?

Answer

palpable, nontender gall = "Courvosier's sign"
dx = adenocarcinoma of the head of the pancreas obstructing CBD

Question 20

20

Presentation and risks for adenocarcinoma of the head of the pancreas

Answer

==> courvosiers sign (palpable, distended, nontender gallbladder) + anorexia + obstructive jaundice
- obstructive jaundice = jaundice + dark urine + pale stools
risks
- age > 50
- smoking
- DM
- chronic pancretitis
- genetic predisposition: HNP, FAP, MEN

Question 21

21

Ondansetron: MOA, use

Answer

MOA
- central = 5HT3 inhibitor @ chemoreceptor trigger zone (medulla) & solitary nuceus
- periphery = inhibit vagus-mediated nausea
use: post-chemo anti-nausea

Question 22

22

5HT3-inhibitors

Answer

ondansetron
granesetron
dolasetron

Question 23

23

Rapid and complete relief in RA [short-term]

Answer

glucocorticoids, e.g. prednisone

Question 24

24

Methotrexate: MOA, use

Answer

MOA: antimetabolite, antifolate
use: RA, other autoimmune

Question 25

25

Auer Rods ==> dx?

Answer

AML (/PML)

Question 26

26

Nevirapine: MOA, similar drugs

Answer

NNRTI
inhibits reverse transcription, doesn't need phosphorylation to be active
other drugs
- efavirenz
- delaviridine

Question 27

27

Canagiflozin: MOA, use, SE

Answer

MOA
- oral anti-diabetic
- = SGLT2 inhibitor ==> decreased reabsorption of glucose @ proximal renal tubule
- ==> urinary glucose loss
SE
- renal effects <== monitor Creatinine and BUN

Question 28

28

Lithium toxicity antidote

Answer

hydrocholorthiazide ==> trapping in urine

Question 29

29

Cause of decreased gene transcription in Huntington's

Answer

CAG repeats ==> gain of fxn ==> pathologic interactions w/trxn factors
abnormal huntingtin ==> histone deacetylation ==> repressed trxn ==> decreased production of neurotrophic factors ==> impaired neuron survival

Question 30

30

Causes of polyhydramnios

Answer

decreased fetal swallowing
- intestinal atresia/obstruction
- anencephaly
increased urine production
- twin-twin transfusion
- high CO due to anemia

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UWorld_3.17 Flashcards Preview

USMLE Step 1 > UWorld_3.17 > Flashcards

Blood testing in suscipicion of celiacs

blood test for: IgA anti-endomysial Iga anti-tissue transglutaminase

Transmural inflammation of arteries w/fibrinoid necrosis ==> dx?

polyarteritis nodosa

Characteristics of polyarteritis nodosa

segmental, fibrinoid necrosis of small-med arteries Sx fever abdominal pain peripheral neuropathy weakness weight loss assoc. w/hep B in 10-30% of cases

Most common point of occurence of intusseception

ileocecal jxn

Characteristics of a transaminase reaction

reaction between amino acid and an alpha-keto acid e.g. glutamate & oxaloacetate often occur to allow amino acids to enter TCA cycle/Urea cycle Vit B6 (Pyroxidine) = cofactor for transaminase and decarboxilation reactions

TH1 cytokines (+ purpose) = TH2 cytokines (+ purpose) =

interferon-gamma, IL-2 ==> activate macs & attract CD8+ t cells TH2 ==> stimulate B cells [adaptive immunity] IL4 + IL13 ==> IgE from B cells IL5 ==> IgA + eosinophil

"Red neurons" on histo section of brain

ischemia/infaction within the past 12-24 hrs

Characteristics of lynch syndrome

hereditary nonpolyposis colon cancer due to defect in mismatch repair AD due to mutations @ MSH2 ==> MutS MLH1 ==> MutL

a. that runs with the radial n.

deep brachial

anatomic structure that runs through the hepatoduodenal ligament

portal triad = hepatic artery, portal vein, common bile duct

Mechanism of relaxation of cardiac muscle

calcium efflux preceeds relaxation accomplished via: Ca2+ ATP pump Na/Ca exchanger

Most common cause of bronchiolitis + tx

RSV 1st line = O2 or IV fluids in @ risk for progression, can give ribavirin: nucleoside analog active against RSV and hep C

K+ in DKA

total body decrease in K+ decreased intracell stores of K+ normal to increased serum K+ K+ drawn out in exchange for H+; low insulin levels increased if hypovolemic

HCV vs. HBV most common transmission

HCV most common = blood transfusion or IV drug use possible, but less common = sexual transmission HBV blood contact (transfusion, needle stick, IV drug use) OR unprotected sex

Strep infections that lead post-strep syndromes

Impetigo (step skin infect) OR strep pharyngitis ==> APSGN ONLY strep pharyngitis ==> rheumatic fever

Common cause of fluid filled cavity in liver + fever chills

ST elevation @ V1-V3 ==> dx?

occlusion at left anterior descending coronary artery

Riboflavin biochemical role

Riboflavin + Pi ==> FMN = coenzyme FMN + Pi ==> FAD (i.e. FAD+) ==> oxidation/reduction reaction e.g. @ TCA cycle: succinate + FAD+ ==> fumarate + FADH2

Palpaple, nontender gallbladder + jaundice ==> dx?

palpable, nontender gall = "Courvosier's sign" dx = adenocarcinoma of the head of the pancreas obstructing CBD

Presentation and risks for adenocarcinoma of the head of the pancreas

==> courvosiers sign (palpable, distended, nontender gallbladder) + anorexia + obstructive jaundice obstructive jaundice = jaundice + dark urine + pale stools risks age > 50 smoking DM chronic pancretitis genetic predisposition: HNP, FAP, MEN

Ondansetron: MOA, use

MOA central = 5HT3 inhibitor @ chemoreceptor trigger zone (medulla) & solitary nuceus periphery = inhibit vagus-mediated nausea use: post-chemo anti-nausea

5HT3-inhibitors

ondansetron granesetron dolasetron

Rapid and complete relief in RA [short-term]

glucocorticoids, e.g. prednisone

Methotrexate: MOA, use

MOA: antimetabolite, antifolate use: RA, other autoimmune

Auer Rods ==> dx?

AML (/PML)

Nevirapine: MOA, similar drugs

NNRTI inhibits reverse transcription, doesn't need phosphorylation to be active other drugs efavirenz delaviridine

Canagiflozin: MOA, use, SE

MOA oral anti-diabetic = SGLT2 inhibitor ==> decreased reabsorption of glucose @ proximal renal tubule ==> urinary glucose loss SE renal effects <== monitor Creatinine and BUN

Lithium toxicity antidote

hydrocholorthiazide ==> trapping in urine

Cause of decreased gene transcription in Huntington's

CAG repeats ==> gain of fxn ==> pathologic interactions w/trxn factors abnormal huntingtin ==> histone deacetylation ==> repressed trxn ==> decreased production of neurotrophic factors ==> impaired neuron survival

Causes of polyhydramnios

decreased fetal swallowing intestinal atresia/obstruction anencephaly increased urine production twin-twin transfusion high CO due to anemia

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blood test for:

IgA anti-endomysial

Iga anti-tissue transglutaminase

segmental, fibrinoid necrosis of small-med arteries

Sx

fever

abdominal pain

peripheral neuropathy

weakness

weight loss

assoc. w/hep B in 10-30% of cases

reaction between amino acid and an alpha-keto acid

e.g. glutamate & oxaloacetate

often occur to allow amino acids to enter TCA cycle/Urea cycle

Vit B6 (Pyroxidine) = cofactor for transaminase and decarboxilation reactions

T_H1 cytokines (+ purpose) =

T_H2 cytokines (+ purpose) =

interferon-gamma, IL-2 ==> activate macs & attract CD8+ t cells

TH2 ==> stimulate B cells [adaptive immunity]

IL4 + IL13 ==> IgE from B cells

IL5 ==> IgA + eosinophil

hereditary nonpolyposis colon cancer

due to defect in mismatch repair

AD

due to mutations @

MSH2 ==> MutS

MLH1 ==> MutL

calcium efflux preceeds relaxation

accomplished via:

Ca2+ ATP pump

Na/Ca exchanger

RSV

1st line = O2 or IV fluids

in @ risk for progression, can give ribavirin:

nucleoside analog

active against RSV and hep C

total body decrease in K+

decreased intracell stores of K+

normal to increased serum K+

K+ drawn out in exchange for H+; low insulin levels

increased if hypovolemic

HCV

most common = blood transfusion or IV drug use

possible, but less common = sexual transmission

HBV

blood contact (transfusion, needle stick, IV drug use) OR unprotected sex

Impetigo (step skin infect) OR strep pharyngitis ==> APSGN

ONLY strep pharyngitis ==> rheumatic fever

Riboflavin + Pi ==> FMN = coenzyme

FMN + Pi ==> FAD (i.e. FAD+) ==> oxidation/reduction reaction

e.g. @ TCA cycle: succinate + FAD+ ==> fumarate + FADH₂

palpable, nontender gall = "Courvosier's sign"

dx = adenocarcinoma of the head of the pancreas obstructing CBD

==> courvosiers sign (palpable, distended, nontender gallbladder) + anorexia + obstructive jaundice

obstructive jaundice = jaundice + dark urine + pale stools

risks

age > 50

smoking

DM

chronic pancretitis

genetic predisposition: HNP, FAP, MEN

MOA

central = 5HT3 inhibitor @ chemoreceptor trigger zone (medulla) & solitary nuceus

periphery = inhibit vagus-mediated nausea

use: post-chemo anti-nausea

ondansetron

granesetron

dolasetron

MOA: antimetabolite, antifolate

use: RA, other autoimmune

NNRTI

inhibits reverse transcription, doesn't need phosphorylation to be active

other drugs

efavirenz

delaviridine

MOA

oral anti-diabetic

= SGLT2 inhibitor ==> decreased reabsorption of glucose @ proximal renal tubule

==> urinary glucose loss

SE

renal effects <== monitor Creatinine and BUN

CAG repeats ==> gain of fxn ==> pathologic interactions w/trxn factors

abnormal huntingtin ==> histone deacetylation ==> repressed trxn ==> decreased production of neurotrophic factors ==> impaired neuron survival

decreased fetal swallowing

intestinal atresia/obstruction

anencephaly

increased urine production

twin-twin transfusion

high CO due to anemia