Uworld 8

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Uworld 8
2012-04-05 01:05:15

Uworld 8
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  1. Pan acinar emphysema vs centriacinar affects what part of the lung, apical or base?
    • pan acinar--base
    • Centriacinar--apical
  2. What is the mode of action of morphine?
    • inhibit ca influx
    • open K channels
    • inhibit -ACH, NE, 5HT, Glutamate, Substance P
  3. The coronary vasospasm following a subarachnoid hemorrhage is due to what?
    breakdown products of the blood clot
  4. Chemotherapy for testicular cancer?
    • Etoposide
    • Bleomycin
    • Cisplatin
  5. Etoposide drugs inhibit which topoisomerase I or II?
    topoisomerase II
  6. Irinotecan and topotecan inhibit what topoisomerase, I or II?
  7. Rx for orotic aciduria?
    Uridine which block CP II
  8. What does the marrow look like in aplastic anemia?
    hypocellular filled with fat cells and fibrotic stroma
  9. What is the most common outcome of HBV infected individuals?
    complete resolution
  10. What is the stool pH in lactose challenge?
    • low pH
    • high osmotic stool gap
    • high breath hydrogen content
  11. What are the Large vessel vasculitis?
    • Giant Cell Arteritis
    • Takayasu's Arteritis
    • Large vessel
  12. Medium vessel vasculitis?
    • PAN
    • Kawasaki's
  13. What happens to the PPV if the prevalence of the disease is high?
    PPV increases and NPV decreases
  14. Rx for Restless leg syndrome?
    • Dopamine agonists----
    • Pramiprexole
  15. What kind of bacteria can you get from rat bites?
    spirella minus
  16. What kind of bacteria can you get from puppy feces?
    yersinia enterocolitica
  17. MOA of atomoxetine?
    NE reuptake inhibitor
  18. RX for turettes?
    • fluphenazine
    • pimozide
    • tetrabenazine
  19. Lewy bodies are made up of what?
    alpha- synuclein defect
  20. High potency neuroleptics?
    • haloperidol
    • trifluperazine
    • fluphenazine
  21. Low potency neuroleptics?
    • thioridazine
    • chlorpromazine
  22. What receptors due typical low potency neuroleptics block?
    • muscarinic
    • histamine
    • alpha adrenergic
  23. 4 side effects of typical high potency neuroleptics/?
    • dystonie
    • akinesia
    • akathisia
    • tardive dyskinesia
  24. What receptors do atypical neuroleptics block?
    • 5HT
    • alpha
    • histamine
    • dopamine
  25. Antidepressants without sexual side effects?
    • Nefazodone
    • Bupropion
  26. What is use for WPW?
  27. WPW drugs?
    • amiodarone
    • procainamide
  28. What causes SVT?
    AV node firing too much
  29. When do you cardiovert a-fib?
    before 24 hrs
  30. RX for a-fib?
    • ccb
    • bb
    • digoxin
  31. HTN medication for aortic dissection?
  32. Crystal findings in gout?
    negatively birifringent--yellow and parallel
  33. What 2 things can cause peptic ulcers?
    • Ca
    • corticosteroids
  34. Placenta accreta?
    Placenta previa?
    Placenta abruptio?
    • accreta-- attached to myometrium--fails to seprate upon labor
    • previa--low lying placenta
    • abruptio-- detachment of placenta from implantation site
  35. Aromatase inhibitors?
    • anastrozole
    • exemestane
  36. WHat is the function of the following hypothalamic nuclei?
    Anterior and preoptic
    Anterior and preoptic
    Anterior and preoptic
    Posterior and lateral
    • circadian rhythm
    • regulates the pns
    • destruction leads to hyperthermia
    • regulates sns
    • produces adh
    • mediates oxytocin production
    • receives input from retina
    • savage behavior and obesity result from stimulation
    • savage behavior and obesity result from destruction
    • stimulates leads to eating and destruction leads to starvatio
    • regulates release of gonadotropic
    • mediates sweating and cutaneous vasodilation
    • mediates shivering and decrease cutaneous blood flow
    • destruction leads to neurogenic DI
    • destruction results in inability to stay warm
    • releases hormones affecting the anterior pituitary
  37. Cingulate (Subfalcine) herniation produces what?
    compression of anterior cerebral artery---leg paralysis
  38. Uncal herniation produces what?
    • CN III palsy
    • posterior cerebral artery--contralateral homonomys heminopsia
    • compression of crus cerebri
  39. Hereditary causes of ataxia?
    • Wilsons
    • Ataxia-telangiectasia
    • Friedrich's
    • Vit E
    • Metachromatic leukodystrophy
    • Lysosomal storage diseases
  40. Two reasons for pulmonary hypertesnion?
    • Primary---mutation in BMPR2 which normally inhibits proliferation
    • Secondary--due to COPD, restrictive lung diseases, hypoxia, vascular injury
  41. What is the mode of action or Thaliozidadones?
    • 1-increases the number of mature adipocytes by inducing differentiation from immature adipocytes
    • 2-Increases insulin sensitivity by increasing GLUT- 4
  42. What effect do bile salts have on bacteria?
    Bile salts disrupt the cell walls of bacteria
  43. What is the most significant risk factor for Osteoporosis?
    • Osteoporosis--Family History/Genetics
    • Osteoarthritis---Age
  44. Increasing enzyme concentration does what to the vmax?
    it decreases it
  45. Hypoglycemia and low ketone bodies during a fast suggest a deficiency of what enzyme?
    Hypoglycemia and normal level ketone bodies during a fast indicates what?
    • Medium chain acyl coa dehydrogenase
    • Glucose 6 Phosphatase deficiency
  46. 2 reasons for ischemic colitis?
    • hypoperfusion-during a cardiogenic shock/other shock
    • artherosclerosis--thrombosis
  47. African American women are more likely to experience what 2 conditions?
    • Sarcoidosis
    • Leyiomyoma
  48. Rationale for using lactulose to treat hepatic encephalopathy in cirhosis?
    lactulose acidifies the gut lumen absorbing NH3 from circulation and decreasing the encephalopathy
  49. Pharmacodynamic vs Pharmacokinetic effect?
    • Pharmacodynamic is the interaction of 2 substances at the tissue level
    • Pharmacokinetic has to do with one substance altering the metabolism of another substance
  50. What is deficient in osteomalacia/rickets?
    osteoids--they are unmineralized
  51. What are the 4 kinds of nerve fibers that arent myelinated?
    • olfaction
    • slow pain
    • heat sensation
    • autonomic post ganglionic
  52. During antigen processing of MHC II what is proteotically removed?
    invariant chain
  53. One gene has many phenotypic effects is called?
    WHen 2 genes produces the same phenotypic effects it is called?
    • Pleitropy
    • Genetic Heterogeneity
  54. White pruritic patches in the vagina are what?
    Lichen Sclerosus
  55. Pathogenesis of Lichen Sclerosus?
  56. What are the extrinsic and intrinsic toxins that cause ATN?
    • extrinsic--aminoglycosides, amphotericin b, vancomycin, cisplatin
    • intrinsic-myoglobinuria, hyperuriciemia, bence-jones proteins
  57. How are protein post translationally modified to enhance their hydrophobicity?
  58. What effect does nitroglycerin have on Heart Rate and End-systolic blood volume?
    Heart Rate increases as a compensatory mechanism and since ventricles have less time to fill, the end -systolic blood volume also increases
  59. What is Albright's hereditary Osteodystrophy characterized by?
    • Resistance to PTH, TSH, LH/FSH resulsting in
    • short stature, shortened 4th and 5th digits,, hypocalcemia, high LH/FSH, TSH
  60. Differentiate between Alleic, Genetic heterogeneity and pleitrophy?
    • Genetic--different genes cause similar phenotype
    • Alleic-- mutations in same gene can cause different phenotype
    • Pleitropy-- One gene causes many different phenotypes
  61. Epidermal infection with a "crust " is what?
    impetigo--bullous if caused by Staph
  62. What is the most common mode of antibiotic resistance?
    Pumping the drug out of the cell
  63. Polypeptide destined for RER is going to have what kind of signal molecule on what end? N or C end?
    N-terminal(hydrophobic sequence)
  64. 3 different causes of microcytic anemia?
    • iron deficiency
    • thalassemias
    • Lead/sideroblastic anemia
  65. How do sertoli cells maintain very high concentrations of testosterone in the semineforous tubules and epidydymys?
    sertoli cells synthesize Androgen Binding Proteins (ABP) which concentrate testosterone in the lumens or S.T and Epidydimys
  66. Red Safranin O stains what ?
    Oil Red O /Sudan Black stains what?
    • cartilage
    • Fat
  67. The round and suspensory ligaments are derived from what?
  68. What phospholipid and mineral activates caclium?
    PAF--Ca via activating Gq
  69. Prader-Willi Syndrome is caused by what?
    • microdeletion from paternal ch 15
    • inheritance of both maternal chromosomes 15
  70. Levels of what hormone are high in Pernicious Anemia?
    Gastrin because the negative feedback inhibition thru HCL is lost
  71. Which of the scrotal masses decreases when laying down?
  72. What anti-coagulant is used with mechanical heart valves?
  73. Mode of action of Leuprolide?
    • Leuprolide--GnRH agonist
    • Flutamide/cyproterone-- Androgen receptor antagonist
  74. What cardiac anomaly is present in DiGeorge Syndrome?
    Truncus Arteriosus
  75. Which residues are preferentially methylated?
  76. Which is the inducible/inflammatory responsive COX enzyme? COX1 or COX 2?
    COX 2
  77. Which fungus has classically fruting bodies?
  78. Mutation in what developmental genes causes the HFG syndrome?(Hand-Foot-Gential syndrome)?
  79. Which sinuses are most commonly affected in URI?
    maxillary due to poor drainage
  80. DOC for bleeding varicose veins?
  81. Lump in the throat without accompanying findings is called what?
    Globus Hystericus
  82. DIC is common with what leukemia?
  83. Anterior/posterior dislocation of the knee endangers what structure?
    popliteal artery
  84. Trauma to the lateral knee joint endangers what structure?
    Common Peroneal Nerve
  85. Infection of the uterus in the post-partum period is commonly what?
    What causes it?
    • endometritis
    • mixed flora--commonly Bacteriodes
  86. What is sublimation?
    channeling unacceptable feelings into socially acceptable activities
  87. What happens to GFR after Nephroctemy?
    initially reduced to 50% but with time to 80%
  88. What enzyme is deficient in Acute Intermittent Porphyria?
    Porphobilinogen Deaminase
  89. What enzyme is deficient in Porphyria Cutanea Tarda?
    Uroporphyrinogen decarboxylase
  90. Hallucinations +memory loss?
    Lewy Body Dementia
  91. 3 most common locations for Tophi?
    • external ear
    • Olecranon bursa
    • Achiles Tendon
  92. What 3 factors stimulate Gastrin release?
    • Phenylalanine
    • Tryptophan
    • Hypercalcemia
  93. M1 and M3 blockers rarely used for peptic ulcer treatment?
    • Pirenzapine
    • Propantheline
  94. Which antacid causes constipation?
    • Constipation--Aluminum
    • Diarrhea-- Magnesium
  95. 2 Most common benign salivary tumors?
    • Pleiomorphic
    • Warthin--heterotropic salivary tissue in l. node
  96. Malignant salivary Tumor?
    Mucoepidermoid Tumor
  97. What vitamin deficiency presents with stomatitis, glossitis and cheliosis?
    • B vitamin deficiency
    • iron deficiency
    • folate
  98. What decreases secretion of VLDL bc it inhibits lipolysis in adipose tissue?
  99. Vitamin b6 deficiency?
    • convulsions
    • irritability
    • peripheral neuropathy
    • anemia
  100. Where are cations and anions excreted in the nephron?
  101. What do the principal and intercalated cells do?
    • principal cells reabsorb water and excrete K
    • Intercalated cells excrete K and H/HCO3
  102. What are the effects of Aldosterone on the Principal and Intercalated cells?
    increases Na reabsorption and K secretion in Principal cells and increases H excretion in the intercalated
  103. Causes of metabolic acidosis with normal anion gap?
    • glue sniffing
    • diarrhea
    • hyperchloremia
    • RTA
  104. What 5 disorders produce Membrano-Proliferative Glomerulonephritis?
    • HBV
    • HCV
    • SLE
    • subacute bacterial endocarditis
    • Mixed Cryoglobulinemia
  105. What 3 conditions produce hypocomplemetemia with glomerular disease?
    • PSGN
    • Lupus nephritis
    • Membranoproliferative Type II
  106. Most common Leukemia in children?
  107. Most common Leukemia in adults?
  108. Most common lymphoma in US
    DIffuse large B- cell
  109. Reed-sternberg cells?
    Hodgkin's lymphoma
  110. AML a/w Down syndrome?
    M7 AML
  111. Leukemia with more mature cells and less than 5% blasts?
    Chronic leukemia
  112. AML that are CD 13 and CD33 +
    M0-M6 AML
  113. A/w long term celiac dz?
    Intestinal T-cell lymphoma
  114. Myeloproliferative disorders may progress to what?
  115. AML that is CD41 and CD61 +?
    M7 AML
  116. PAS + acute leukemia?
  117. Leukemia with a mediastinal mass??
  118. Leukemia presents with Bone pain?
  119. Numerous basophils, splenomegaly and negative for Leukocyte alkaline Phosphatase?
  120. Most common Neonatal Leukemia?
    M7 AML
  121. A/w Sjogrena, Hashimotos thyroditis, and H. Pylori?
    Marginal Cell MALToma
  122. Acute leukemia positive for peroxidase?
  123. Solid sheets of lymphoblasts in marrow?
  124. Presentation of Menier's disease?
    • Tinnitus
    • Vertigo
    • Sensineuronal hearing loss
  125. Cause of Menier's disease?
    increase endolymph in the inner ear
  126. Organisms using phase/antigenic variation?
    • Gonorrhea
    • Borrelia
    • Trypanosoma
    • Strep. Pneumoniae
  127. What do the 2 toxins of C. dif do?
    • Toxin A attracts neutrophils and causes inflammation
    • Toxin B causes actin depolymerization and disrupts cell integrity
  128. Hepatic uptake or secretion of Bilirubin is an active process?
    • secretion is active
    • uptake is passive
  129. What is the only class III antiarrhythmic with beta blocking abilities?
  130. What 2 growth factors mediate the formation of an atherosclerotic plaque?
    • PDGF
    • TGF-beta
  131. Cystic myxomatous degeneration of the media of the muscular arteries is seen in what genetic condition?
  132. CD16 on NK cells binds what?
    Fc region of Ig
  133. What is the CRAB of MM?
    • Calcemia--Hyper
    • Renal insufficiency
    • Anemia
    • Bone Lesions--Lytic
  134. What 2 immunomodulator drugs are affected by the cyt p450 system?
    • cyclosporine
    • Tacrolimus
  135. Subacute thyroditis vs Reidel's Thyroditis?
    • Subacute--due to inflammation, has granulomas
    • Reidels--replacement of thyroid wtih fibrous tissue
  136. What is the pathological description of brain in Prion disease vs SSPE?
    • Prion--spongiform vacuoles coalesce into cystic spaces
    • SSPE/
  137. DOC for listeria?
    • Amoxocillin
    • Ampicillin
  138. What 2 enzymes are needed to synthesize Ribose-5-Phosphate from the intermediates in glycolysis?
    • Transketolase
    • Transaldolase
  139. What is the main hemodynamic consequence of an A-V shunt?
    increased preload
  140. What are the effects of Dobutamine?
    • increases ionotropy--contraction
    • increased conduction velocity
  141. What 3 mediators increase gastric acid secretion?
    • Histamine on H2 receptors
    • ACH on M3 receptors
    • Gastrin from G cells on parietal cells and + ESL cells to secrete Histamine
  142. Which vaccine is made up of a polysaccharide conjugated to a diptheria toxoid?
    H. Influenza type B
  143. Use interferon alpha?
    • hepatitis B and C
    • kaposi sarcoma
    • Leukemia
    • malignant lymphoma
  144. Muscarinic antagonists used in cystitis and urge incontinence?
    • oxybuntin
    • glycopyrrolate
    • Tolteridine
    • Darifenacin
    • Trospium
    • Solifenacin
  145. DOC for reversing Neuromuscular blockade ?
  146. Anti-hypertensive DOC i aortic dissection?
  147. Drugs causing erectile dysfunction?
    • Dopamine blockers
    • beta blockers
    • H2 blockers
    • anti depressants
    • HCTZ
    • CCB