Uworld 9

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pszurnicki
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142615
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Uworld 9
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2012-03-28 00:24:02
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Uworld 9
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  1. 2 causes of Pure Red cell aplasia?
    • Thymoma
    • Parvo B19
  2. What is the most common complication of Ulcerative Colitis?
    Toxic Megacolon
  3. How do you diagnose Toxic Megacolon?
    Abdominal X-ray
  4. Glucocorticoid administration has what effect on the WBC count?
    all depressed except Neutrophils
  5. Presence of beta HCG in the plasma corresponds to what?
    Implantation of the blastocyst in the endometrium which occurs at about 7 days post conception
  6. What is the most common form of Non-Hodgkin Lymphoma?
    How does it present?
    • Follicular B cell lymphoma
    • presents as an indolent mass with remitting periods
  7. What is the pathogenesis of an aneurysm?
    intimal streak in atherosclerosis
  8. What is the pathogenesis of a dissecting aneurysm?
    intimal tear
  9. Which drugs decrease seizure threshold?
    • Bupropion
    • Cilistatin
    • Tramadol
    • INH without pyridoxine
  10. What are the side effects of Thiazides?
    • Hyper
    • Glycemia
    • Lipidemia--high LDL and cholesterol
    • Uricemia
    • Calcemia
  11. What are the growth factors that increase angiogenesis?
    • VEGF
    • FGF
  12. What produces degeneration of dosal columns and corticospinal tracts?
    Vitamin B12 deficiency
  13. What are the side effects of androgen abuse?
    • Erythrocytosis
    • Hypogonadism
    • Male Pattern Baldness
    • Acne
    • Hepatic adenomas
  14. What is the naturally derived peptide that causes dilations of the venous and arterial systems and increases diuresis?
    • BNP
    • ANP
  15. What nerve exits thrut he obturator foramen?
    obturator nerve
  16. Formation of which kidney stones is favored by alkaline pH?
    What about all other stones?
    • Ammonium Magnesium Phosphate--Struvite stones
    • All other stones are favored by an acidic pH
  17. The ventral pancreatic bud gives rise to what 3 structures?
    • uncinate process
    • main pancreatic duct
    • part of the head of pancreas
  18. Use of Sucralfate?
    • improves ulcer dealing
    • Traveler's diarrhea
  19. IL-12 has what function?
    it differentiates Th cells into Th1 subset
  20. Cromolyn and Nedocromil have what function?
    inhibit Mast cell Degranulation
  21. What is the only vitamin that is stored in the liver for several years?
    Vitamin B12
  22. 1st line Rx for status Epilepticus?
    Benzo--diazepam, Lorazepam
  23. 1st line Rx for absence seizures?
    ethosuxamide
  24. 1st line Rx for Tonic clonic or absence + tonic clonic?
    Valproate
  25. What is heteroplasmy?
    variable clinical expression of mitochondrial DNA producing various manifestations
  26. Rx for serotonin syndrome?
    Cyproheptadine
  27. Use of apettite suppressants such as phenfluramine and phenteramine causes what?
    pulmonary hypertension
  28. What is responsible for the green color of sputum associated with pneumonia?
    Myeloperoxidase enzyme found in the azurophilic granules of neutrophils
  29. With what hereditary thrombotic disorder does warfarin cause skin necrosis?
    Protein C deficiency
  30. What are the hereditary thrombotic dz's?
    • Protein C
    • ATIII
    • Prothrombin
    • Factor V Leiden
  31. What is the side effect of Chlorthiazine and Thioridazine?
    • Chlorthiazine--corneal deposits
    • Thioridazine--Retinal deposits
  32. What are the levels of the following in a down syndrome pregnancy?
    • Beta HcG--up
    • Inhibin--up
    • estriol-down
    • AFP -down
  33. What is the only antiarrhythmic that prolongs the QT interval but doesn not lead to Torsaides de Pointe?
    Amiodarone
  34. What histological changes are observed in ischemic myocardium post MI at
    1 day?
    5 days?
    10 days?
    15 days?
    • 1st day--neutrophils
    • 5th day--macrophages
    • 10th day--granulation tissue and neovascularization
    • 15th day--- collagen deposition
  35. In what 3 ways does pregnancy predispose to DVT?
    • increased estrogen--more clotting factors and less protein S
    • uterus pressing on teh IVC causes stasis leading to coagulopathy
  36. WHat allosterically activates Pyruvate carboxylase in gluconeogenesis?
    acetyl coa
  37. Membranous glomerulopathy is caused by what?
    antibodies to transmembrane proteins of podocytes
  38. Low levels of Ca, Na or K cause altered mental status?
    Na
  39. Low levels of Ca, Na or K cause muscle spasms?
    K
  40. Chagas disease can casue what?
    • megacolon
    • megaureter
    • megaesophagus
    • cardiomegaly
  41. What 2 conditions cause hemathrosis?
    • Vitamin C deficiency
    • Hemophilias
  42. 1st Branchial arch is innervated by what ?
    Trigeminal
  43. 2nd branchial arch is innervated by what?
    Facial nerve
  44. 3rd branchial arch is innervated by what?
    glossopharyngeal nerve
  45. 4th and 6th branchial arches are innervated by what nerve?
    Vagus
  46. Male pseudohermaphrodite is a genetically male XY but has female external secondary characteristics, this is due to?
    Androgen insensitivity syndrome
  47. Female pseudohermaphrodite is genetically XX but has male external secondary sexual characteristics, this is due to what?
    exposure to high testosterone could be due to CAH
  48. What 3 conditions cause phlebitis?
    • Vancomycin
    • Amphotericin
    • Pancreatic adenocarcinoma
  49. What 2 antifungals cause liver toxicity?
    • azoles
    • Griseofulvin
  50. Parasite + portal hypertension with granulomatous lesions is what?
    Schistosoma
  51. 2 causes of brain calcifications?
    • Toxo
    • Taenia Solium
  52. Rx of Resistant Malaria?
    • Mefloquine
    • Quinine and doxycycline
    • Sulfadoxine and pyrimethamine
  53. What antifungal depositis in keratin containing tissues?
    Griseofulvin
  54. Rx for pinworm, roundworm, hookworm?
    albendazole
  55. Rx for flukes and tapeworms?
    Praziquantel
  56. Phenobarbital is a derivative of what drug?
    Primidone
  57. What are the polymerases that produce rRNA, mRNA, tRNA?
    • mRNA--pol II
    • rRNA--pol I
    • tRNA--pol III
  58. Which class I antiarrhythmic is selective for rapidly depolarizing cells?
    IB
  59. What transcription factor is overexpressed in Crohn's disease leading to overstimulation of cytokine producing pathway?
    NF-kappa B via NOD receptor
  60. How is an S3 heart sound best heard?
    in the left lateral decubitus position and on exhalation
  61. Very long chain Fatty acids are metabolized where?
    Peroxisomes
  62. What 2 diseases present with inability to oxidize very long chain fatty acids in the peroxisomes and thus produce mental disturbances?
    • Zellweger
    • Refsum
  63. Most common amino acid in collagen?
    glycine
  64. What 2 post translational modifications occur in the cytosol and outside the cytosol in the synthesis of collagen molecule by a fibroblast?
    • inside the cytosol---hydroxylation and glycosylation
    • outside the cytosol- cleavage of terminal residues and crosslinking by lysyl oxidase
  65. How are viridans group able to adhere to teeth forming plaque and to prosthetic heart valves?
    by producing dextrans---extracellular polysaccharides
  66. What HBV component is produced during its replication in the hepatocyte that is disproportionately produced?
    HBs antigen
  67. How does INH cause Vit B6 deficiency?
    • INH competes with pyridoxine for enzymes resulting in non functional products
    • INH increases the excretion of pyridoxine
  68. What is the anti-depressant without sexual side effects?
    Buproprion
  69. Glucocorticoids increase protein synthesis only in what organ?
    Liver--enzymes involved in gluconeogenesis
  70. How do glucocorticoids produce muscle weakness?
    increase BUN
    • catabolism of protein
    • hypokalemia due to mineralcorticoid activity
  71. Increased BUN due to protein breakdown
  72. reverse or rT3 is produced how?
    from T4
  73. What does the Huntingtin protein do in Huntingtons disease?
    it hypermethylates histones effectively repressing their transcritption
  74. Hamartoma of the lung is composed of what kind of itssue?
    Cartilage
  75. Measles causing SSPE is missing what protein which allows it to escape immunological clearance?
    M protein
  76. Exposure to a DNA damaging agent needs what gene to be inactivated?
    tumor suppressor such as p53
  77. What enzyme most commonly converts pro-carcinogens to carcinogens?
    microsomal monooxygenase aka cyt p450
  78. Pudendal nerve block accomplishes what?
    • anesthesia to the perianal and genitals
    • urethral and anal sphincter tone is down
  79. Deficiency of what vitamin leads to increased oxidative stress in RBC and neurons?
    Vitamin E
  80. Vitamin E prevents oxidation of what compounds?
    fatty compounds--in neurons..bc of myeling so you get neuropathy in a deficiency
  81. What is urticaria(hives)?
    dermal edema due to mast cell degranulation either as Type I hypersensitivity or indiependent of antibody stimulation
  82. In order for nucleoside reverse Transcriptase inhibitors to be active what must be done?
    they must be phosphorylated by thymidine kinase like acyclovir and gancyclovir
  83. Which HIV drugs cause pancreatitis?
    • Ritonavir
    • Zalcitabine
    • Stavudine
    • Didanosine
  84. Which protease inhibitor causes nephrolithiasis?
    Indinavir
  85. What drug is a CCR5 antagonist?
    Maraviroc
  86. What is an integrase inhibitor?
    Rategravir
  87. What is used for WPW?
    • Procainamide
    • Amiodarone
  88. DOC in treating SVT?
    Adenosine
  89. What blocks effects of adenosine?
    Theophylline
  90. What drugs prolong QT interval?
    • Class I
    • Thioridazine
    • Haloperidol
    • Risperidone
    • Bepridil
    • Erythromycin
    • Fluoroquinolones
    • Class III
    • Methadone
    • Antimalarials
    • Protease Inhibitors
  91. what are the 6 actions of ATII?
    • 1- constricts blood vessels
    • 2- secretes aldosterone
    • 3-constricts efferent arteriole of glomerulus
    • 4-- stimulates thirst
    • 5-- secretes adh
    • 6--increases Na reabsorption at PCT
  92. DOC in vascular spasm pathologies like Prinzmetal angina or Raynauds' esophageal spasm?
    • Nifedipine
    • Bepridil
  93. Hypertension predisposes to what two aorta pathologies?
    • AAA
    • aortic dissection
  94. ST segment elevation in the following leads tells you which of the vessels is being infarcted?
    • V1-V5---LAD
    • aVL, V5--LCX
    • II, III, AVF--RCA-inferior wall MI
  95. Motor dysfunction of what pharyngeal muscle can cause a Zenker's diverticulum?
    cricopharyngeus
  96. What converts heme to biliverdin giving tissue a greenish color after a hematoma?
    heme oxygenase
  97. How do patients with SCID present?
    • infections with Bacteria, viruses, fungi
    • Chronic diarrhea
    • Failure to thrive
  98. What is Anergy?
    failure to generate a response to a common antigen
  99. 2 aldosterone antagonists?
    • eplerenone
    • spironolactone
  100. The anterior urethra is commonly injured how?
    THe posterior urethra is commonly injured how?
    • by falling on something
    • in a pelvic fracture
  101. All Class I antiarrhythimic prolong QRS but what do they individually do to AP and QT?
    • IA--prolongs AP and QT
    • IB-- shortens AP and QT
    • IC--no effect on AP and QT
  102. What environement is Legionella associated with?
    water--that is aeroselized
  103. which fungus colonizes old cavitary lesions formed by Tb?
    Aspergillus
  104. How long after ischemia does the myocardium stop contracting?
    How long after ischemia is the muscle injury irriversible?
    • 60 seconds
    • 30 minutes
  105. The most common cause of aspiration pneumonia results from aspiration of contents from what anatomical area?
    oropharynx
  106. Whether it is in a medical setting or not, hypglycemia is treated by administering dextrose or glucagon how?
    IV not IM
  107. MOA of ethambutol?
    stop polymerization of the cell wall
  108. MOA of pyrazinamide?
    acts in acidic phagolysosome of macrophages
  109. What vitamin may prevent neurodegeneration see in Alzheimers?
    vitamin E
  110. What tumors have psammoma bodies?
    • papillary thyroid carcinoma
    • serous adenocarcinoma of ovary
    • mesothelioma
    • meningioma
  111. What is the pathogenesis of Scleroderma?
    activated T cells stimulat fibroblasts to laydown excess collagen
  112. Coffee Ground Vomitus usually implies what origin of the bleed?
    Stomach
  113. What kind of environment worsens the symptoms of MS?
    Heat
  114. What is seen in Dermatomyositis?
    • Proximal muscle weaknes as in Poliomyosistis
    • +
    • Heliotrope rash
    • Gottron papules on the hands
  115. What should be the balance of cholesterol, bile acids and phosphotidylcholine in the gall bladder to minimize the formation of gall stones?
    Cholesterol should be low and biles acids and phosphotidylcholine levels should be high
  116. Radical mastectomy predisposes to what kind of malignancy?
    lymphoangiosarcoma
  117. Glucose administration without thiamine to a thiamine deficient patient will cause what?
    Wernicke's encephalopathy
  118. What are the 3 causes of metabolic alkalosis?
    and what are the levels of chloride in each?
    • getting rid of acid--causes low serum and urine chloride
    • Diuretics--cause low serum and high urine chloride
    • hyper-aldosteronism--low serum and high urine chloride
  119. HLA predisposition is present in DM type I or II?
    type I
  120. What causes the beta islet cell destruction in DM type II?
    amylin
  121. What 2 benzos are used for Delirium Tremens?
    • Chlordiazepoxide
    • Diazepam
  122. Why is the CNS excitability during etoh withdrawal?
    bc of downregulation of gaba during chronic etoh use..low gaba receptor number increased cns excitability
  123. What synthetic hormone is used for secretory diarrhea as seen in VIPoma?
    octeotride
  124. non Enveloped viruses are resistant or sensitive to organic solvents such as ether?
    resitant
  125. How doe CO cause hypoxia?
    • 1--CO binds to O2 binding sites on hemoglobin
    • 2--CO shifts the O2 dissociation curve to the left
  126. What is the normal A-a gradient?
    What is the normal anion gap
    • 10-15
    • 8-12
  127. What increases the A-a gap'?
    • diffusion defect--pulmonary fibrosis--restrictive disease/obstructive
    • right to left shunt
    • v/q mismatch---pneumonia, COPD, pulmonary embolus
  128. Where is there increased LDL, cholesterol and other lipids in nephrotic syndrome?
    • 1-increased synthesis of protein(including lipprotein) due to hypoalbumenemia
    • 2- decreased lipoprotein lipase in plasma leads to increased circulating levels of lipoproteins with lipids which leads to lipiduria
  129. Ehlers danlos results from faulty what?
    Marfans results from what?
    • fibrillar collagen
    • marfans--faulty glycoprotein fibrillin which makes up elastin
  130. Whats responsible for amenorrhea in anorexia nervosa?
    decreased GnRH
  131. Rabies are acquired most commonly from bites from what animals?
    • bat
    • skunk
    • racoon
  132. What antibiotics are safe in pregnancy?
    • penicillins/cephalosporins
    • macrolides
    • metronidazole after 1st trimester
  133. What antibiotics cause tinnitus?
    fluoroquinolones
  134. Gram negative rods with renal insuffiency or allergic to penicillin/cephalosporins are treated with?
    Aztreonam
  135. What 2 stains stain fat?
    • Oil Redo O
    • Sudan Black
  136. p53 acts thru what protein?\
    p53 induces apoptosis by activating what protein?
    • p21
    • BAX protein
  137. Yolk sac tumor is also called what?
    Endodermal sinus tumor
  138. AFP are elevated in what 2 cancers?
    • Hepatocellular carcinoma
    • Yolk Sac tumor--Endodermal sinus tumor
  139. WHat cancers can secret epo?
    • HHPR
    • hemangioblastoma
    • hepatocellular carcinoma
    • pheochromocytoma
    • Renal Cell carcinoma
  140. Vit D3 used in psoriasis?
    Calcipotriene
  141. WHere do K+ sparing diuretics work?
    Cortical Collecting duct
  142. 3 Side effects of Protease Inhibitors?
    • hyperglycemia
    • cytp450 inhibition
    • cushing like distribution
  143. What organism is commonly implicated in infections in asthmatics?
    Aspergillus
  144. What kind of abnormalities are turner's patients born with?
    • Cystic Hygroma
    • Lymphadema
  145. D ala-D ala has what significance?
    • penicllin is a structural analog of it
    • vancomycin binds to it
    • both inhibit cell wall synthesis
  146. Transmural inflammation of an arteriolar wall with fibrinoid necrosis is characteristic of what vasculitis?
    PAN
  147. Rosenthal fibers + cystic spaces and malignant cells with glial like processes are what?
    Pilocytic Astrocytoma
  148. What virulence factor of N. Meningitidis correlates wtih morbidity and mortality?
    LOS
  149. Osteoclasts are activated by Osteoblasts thru what 2 receptors?
    • RANK-L
    • M-CSF

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