USMLE2

Card Set Information

Author:
rere_girl4ever
ID:
293031
Filename:
USMLE2
Updated:
2015-02-01 23:39:49
Tags:
USMLE
Folders:

Description:
USMLE4
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user rere_girl4ever on FreezingBlue Flashcards. What would you like to do?


  1. What is Type V  glycogen storage disease?
    • McArdle disease (type V) 
    • Increased glycogen in muscle, but cannot break it down, leading to:
    • 1. Painful muscle cramps
    • 2. Myoglobinuria (red urine) with strenuous exercise
    • 3. Arrhythmia from electrolyte abnormalities
    • Deficient enzyme: Glycogen phosphorylase (myophosphorylase
    • Muscle glygogen --> Glucose-1-Phosphate
  2. What is McArdle disease? Which enzyme is deficient?
    • McArdle disease (type V glycogen storage disease) 
    • Increased glycogen in muscle, but cannot break it down, leading to:
    • 1. Painful muscle cramps
    • 2. Myoglobinuria (red urine) with strenuous exercise
    • 3. Arrhythmia from electrolyte abnormalities
    • Deficient enzyme: Glycogen phosphorylase (myophosphorylase
    • Muscle glygogen --> Glucose-1-Phosphate
  3. In this disease, there is increased glycogen in muscle which cannot be broken down.
    McArdle disease (type V glycogen storage disease)
  4. Glycogen storage disease in which there is a deficiency in glycogen phosphorylase.
    • McArdle disease (type V glycogen storage disease)
    • Deficient enzyme: Glycogen phosphorylase (myophosphorylase)
    • Muscle glygogen --> Glucose-1-Phosphate
  5. Glycogen storage disease in which there is a deficiency in myophosphorylase.
    • McArdle disease (type V glycogen storage disease)
    • Deficient enzyme: Glycogen phosphorylase (myophosphorylase) 
    • Muscle glygogen --> Glucose-1-Phosphate
  6. This enzyme converts glucose-6-phosphate to 6-phosphogluconolactone
    Glucose-6-phosphate dehydrogenase
  7. What is the function of glucose-6-phosphate dehydrogenase?
    Converts glucose-6-phosphate to 6-phosphogluconolactone
  8. What is an S3 heart sound? What pathology is it associated with?
    • Impact of inflowing blood against a distended/ noncompliant ventricle.
    • Occurs in early diastole during rapid ventricular filling phase.
    • Associated with mitral regurgitation and heart failure.
  9. What kind of heart sound is heard in mitral regurgitation?
    • S3- 
    • Increased rate of left ventricular filling due to large volume of regurgitant flow re-entering the ventricle during mid diastole.
  10. Where does a mitral heart murmur radiate?
    Loudest at apex and radiates toward axilla
  11. This type of heart murmur radiates toward the axilla
    Mitral
  12. This type of heart murmur is loudest at apex.
    Mitral
  13. A midsystolic click is characteristic of which heart murmur? What causes it?
    • Mitral valve prolapse
    • Tensing of the chordae tendineae.
  14. Differentiate between the types of holosystolic murmurs.
    • VSD- holosystolic, harsh-sounding murmur
    • Mitral/tricuspid regurgitation- holosystolic, high pitched "blowing murmur"
  15. What is the function of free ribosomes?
    Synthesize proteins for the cytosol and organelles.
  16. What is the function of ribosomes attached to the RER?
    Synthesize secretorymembrane-bound and lysosomal proteins.
  17. What is the function of the smooth endoplasmic reticulum?
    • Carbohydrate metabolism
    • Detoxification of drugs and poisons
    • Lipid synthesis
  18. Disease associated with gene deletion on chromosome 3.
    • von Hippel-Lindau disease
    • Renal cell carcinoma
  19. Renal cell carcinoma is associated with a gene deletion on which chromosome?
    Chromosome 3
  20. What diseases are associated with von Hippel-Lindau?
    • Cerebellar hemangioblastomas
    • Bilateral renal cell carcinomas
    • Pheochromocytomas
  21. Mutation of the Rb gene may lead to the development of which diseases?
    • Osteosarcoma
    • Retinoblastoma
  22. Mutation of the NF-1 gene is associated with which disease?
    Neurofibromatosis type 1
  23. Mutation of the BRCA1 is associated with?
    Breast and ovarian cancer
  24. Gene deletion on chromosome 11 is associated with which disease?
    Wilms tumor
  25. Which of the Benzodiazepines are short, intermediate and long acting?
  26. Which benzodiazepines are short acting (less daytime side effects)?
    • Alprazolam
    • Triazolam
    • Oxazepam
    • Midazolam
  27. What is lead -time bias?
    Early detection of a disease is confused with increased survival.
  28. What is observer bias?
    • Resaercher's belief in the efficacy of a  treatment changes the outcome of that treatment.
    • If observer expects treatment group to show signs of recovery, then he is more likely to document positive outcomes.
  29. Where does the Right gonadal vein drain into?
    Right ovaries/ testes -> Right gonadal vein -> IVC
  30. Where does the left gonadal vein drain into?
    Left ovaries/ testes -> Left gonadal vein -> Left renal vein -> IVC
  31. Where are varicoceles most common and why?
    • On the LEFT.
    • Because of the left spermatic/gonodal vein enters the left renal vein at a 90 degree angle, flow is less laminar.
  32. Evaluate this hysteogram.
    Normal uterus
  33. Evaluate this hysterogram.
    • Bicornurate uterus
    • Incomplete fusion of Paramesonephric/ Mullerian ducts.
  34. Evaluate the hysterogram below.
    • Septate uterus
    • Incomplete resorption of septum.
  35. Evaluate the image below.

    • Didelphys uterus.
    • Complete failure of fusion of the Paramesonephric/ Mullerian ducts.
    • Double uterus, vagina and cervix.
  36. Complete failure of fusion of the paramesonephric/ mullerian ducts result in?
    • Didelphys uterus
    • Double uterus, vagina and cervix
  37. Incomplete fusion of the Paramesonephric/ Mullerian ducts results in?
    Bicornurate uterus
  38. In which pathology is this cell type found?
    • Gardnerella vaginalis
    • Clue cells-/ vaginal epithelial cells
    • Vaginal squamous epithelial cells covered with multiple small, adherent bacteria
  39. This cell type is found in which pathology?
    • Gardnerella vaginalis
    • Clue cells- vaginal squamous epithelial cells covered with multiple small, adherent bacteria.
  40. Grayish-whitish vaginal discharge with a "fishy" odor?
    • Gardnerella vaginalis
    • Clue cells
  41. What can be used to diagnose Gardnerella vaginalis?
    Amine whiff test- mixing discharge with 10% Potassium hydroxide enhances odor
  42. Describe the vaginitis caused by Gardnerella vaginalis. How do we treat?
    • Greyish/white vaginal discharge
    • Fishy smell
    • Associated with sexual activity
    • Nonpainful
    • Tx: METRONIDAZOLE or CLINDAMYCIN
  43. Describe the vaginosis caused by Trichomonas vaginalis.
    • Foul smelling
    • Greenish/ yellow discharge
    • Itching and burning
    • Tx: Metronidazole (for patient and partner)
  44. This type of organism is found in which infection?
    • Trichomonas vaginalis
    • Motile, flagellated trophozoites on wet mount.
  45. Motile, flagellated trophozoites on wet mount are diagnostic of?
    Trichomonas vaginalis
  46. Label the diagram below.
    • 1- Abdominal aorta
    • 2- IVC
    • 3- Left Crus of diaphragm
    • 4- Liver
    • 5-Right Crus of diaphragm
    • 6- Spleen
    • 7- Stomach
  47. What is the function of single-stranded DNA binding proteins?
    Prevents strands from reannealing.
  48. In which direction is the leading strand synthesized with respect to the replication fork?
    Leading- towards the replication fork.
  49. In which direction is the lagging strand synthesized with respect to the replication fork?
    Lagging- away from the replication fork.
  50. In which direction does DNA synthesis occur on the leading strand/ lagging strand?
    DNA synthesis always occur in the 5'-3' direction on both strands.
  51. This enzyme removes the RNA primer and replaces it with DNA.
    DNA polymerase I
  52. What is the function of DNA polymerase I?
    • Prokaryotic only
    • Degrades RNA primer and replaces it with DNA
  53. What is the function of DNA polymerase III?
    Elongates leading and lagging strand.
  54. Which strand (leading/lagging) require RNA primers to initate DNA polymerization?
    Both strands. But the lagging strand uses more.
  55. How does sample size affect a study?
    The larger the sample size, the greater the ability to detect a difference when one truly exists.
  56. Statistical significance is acheived what what value of p?
    p<0.05= Statistical significance
  57. What is Berkson's bias?
    • Selecting hospital patients as control group.
    • They are less healthy than general population.
  58. CGG trinucleotide repeat expansions are found in which disease?
    Fragile X syndrome  -CGG
  59. GAA trinucleotide repeat expansions are found in which disease?
    Friedreich ataxia -GAA
  60. CAG trinucleotide repeat expansions are found in which disease?
    Huntington disease-  CAG
  61. CTG trinucleotide repeat expansions are found in which disease?
    Myotonic dystrophy - CTG
  62. Describe the findings of an Imperforate anus. What other defects are associated with it?
    • Manifests during the first days of life as inability to pass meconium.
    • Dimple instead of anal opening is found.
    • Meconium may discharge from urethra/ vagina if fistula is present.
    • Urinary tract defects is common.
  63. What is this protein structure shown below?
    IgA dimer
  64. What is the secretory form of IgA?
    • Dimer- 2 monomers, J chain, secretory component.
    • Monomer when in circulation.
  65. Stimulation of the V1 receptor causes?
    Vasoconstriction and increased prostaglandin release.
  66. Stimulation of V2 receptors causes?
    • Increased water permeability and reabsoroption in medullary collecting tubules in the kidney.
    • Inserts aquaporin channels.
  67. Which cells contribute to the development of centriacinar emphysema?
    Heavy smoing causes neutrophils and macrophages  to release proteases: elastase, cathepsins, matrix metalloproteinases which destroys elastic fibers.
  68. What is the function of Club/ Clara cells?
    • 1. Secrete component of surfactant
    • 2. Detoxify inhaled substances (eg tobacco smoke) by cytochrome P450 mechanism
  69. Label the diagram
  70. Which structures does the truncus arteriosus give rise to?
    Ascending aorta and pulmonary trunk
  71. What structure does the cardinal veins give rise to?
    • Superior vena cava
    • R.common and R.anterior cardinal vein
  72. Which embryonic structure gives rise to the SVC?
    R.common and R.anterior cardinal vein
  73. Which embryonic structure gives rise to the ascending aorta?
    Truncus arteriosus
  74. Which embryonic structure gives rise to the pulmonary trunk?
    Truncus arteriosus
  75. Describe the presentation of obstructive sleep apnea
    • Excessive daytime sleepiness (MCC)
    • Bed partners kept awake (snoring)
    • Morning headaches
    • Depression
  76. What causes obstructive sleep apnea?
    • In adults: excess parapharyngeal tissue
    • In children: adenotonsillar hypertrophy
    • Patient continues to contract the diaphragm in an attempt to breathe but airflow is impeded by upper airway obstruction

  77. What is obesity hypoventilation syndrome (aka Pickwickian syndrome)?
    • Obesity BMI>30 impeded the expansion of the chest and abdominal wall during breathing.
    • Underventilation of lungs during all  hours -> Chronically elevated PaCO2 during sleep and waking hours
    • Decreased PaO2
  78. What is central sleep apnea?
    CNS injury/ toxicity- no drive to initiate breathing
  79. The 47,XXY karyotype is diagnostic of?
    • Klinefelter syndrome
    • The extra chromosome is acquired due to meiotic nondisjunction.
  80. 45,XO karyotype is diagnostic of ?
    Turner syndrome
  81. Calcitonin is secreted by?
    Parafollicular or C cells of the thyroid
  82. What is the function of calcitonin?
    Decreased bone resorption of calcium (osteoclast inhibition)
  83. Label 1-4
  84. Describe the passage of a penetrating injury to the right ventricle.
    • Penetrating injury at the left sternal boarder at the level of the 4th intercostal space
  85. Describe the penetrating injury to the left ventricle.
    Penetrating injury t the 4th intercostal space in midclavicular line, only after passing through a bulk of the lung

  86. Describe the penetrating injury to the pulmonary trunk.
    • Penetrating injury to 2nd intercostal space at left sternal boarder
  87. At what level does the IVC penetrate the diaphragm?
    At T8
  88. How does HIV enter the target cell?
    • 1. gp120 binds CD4 and CCR5 ( on macrophages (early infection))/ CXCR4 (on T cells (late infection))
    • 2. The virus enters the cell by fusion with the cell membrane (gp41)
  89. What role does the CCR5 coreceptor play in HIV infection?
    gp120 binds CD4 as well as a coreceptor CCR5 on macrophages (early infection).
  90. What role does CXCR4 play in HIV infection?
    gp120 binds CD4 as well as coreceptor CXCR4 in T cells (late infection)
  91. Deletion of both alleles of the gene that codes for CCR5 indicates?
    Homozygous CCR5 mutation= immunity/ resistant to HIV
  92. What happens if cells do not express the CCR5 protein on their membrane?
    HIV binds CD4 but is unable to enter the cell.
  93. What is the importance of fibronectin?
    • High molecular weight glycoprotein that is synthesized in the liver and plays a role in wound healing.
    • Component of cryoprecipitate used to treat coagulation deficiencies involving fibrinogen and factor 8
  94. What are cadherins?
    • Calcium dependent adhesion proteins responsible for cellular adhesion.
    • Loss of E-cadherin promotes metastasis.
  95. Downregulation in the gene that codes for E-cadherin is implicated in?
    Cancer progression and metastasis
  96. What are calcium-dependent adhesion proteins?
    Cadherins- important for cellular adhesion
  97. What are the effects of ethanol (alcohol) on gluconeogenesis?
    • Ethanol metabolism increases the NADH/NAD ratio in the liver causing the conversion of:
    • Oxaloaxetate to malate (prevents gluconeogenesis -> Fasting hypoglycemia)

What would you like to do?

Home > Flashcards > Print Preview