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UWORLD incorrects week 3
Terms in this set (81)
What is treatment for Lung absess in alcoholic?
Covers anaerobic and aerobic gram +
How do you reverse the toxicity of Methotrexate?
Folinic acid= Leucovorin
" Luke to the rescue for all of the meth heads"
Increased activity of which of the following enzymes is most likely to promote recurrent adenoma dev?
Pts with ASA use regularly, lower incidence of adenoma
A red neuron represents what kind of change?
Irreversible cell injury
"Neuron is bleeding out- this is irrev"
What combination of lipid lowering agents increases risk of myopathy?
Stain + fibrates
Ulcer vs erosion
Erosion- dont fully extend through muscularis mucosa (limited to mucosal layer)
Ulcers- through mucosal layer and extend into submucosal layers
Layers from superficial to deep
In folic acid deprivation, what can you supplement to decrease erythroid precursor apoptosis? AKA what can you give to increase dTMP levels?
Salvage pathway with thymidine kinase that does 5-10% of dTMP synthesis
The ulnar nerve courses between what two muscles?
Flexor digitorum superficialis and flexor digitorum profundus
What does pulmonary capillary wedge pressure measure
Findings in strongyloides stercoralis
Rhabditiform larvae in stool
What is the treatment for restless leg syndrome?
What is clear/white part of renal clear cell carcinoma
Glycogen and lipid accumulation
In an alcoholic cirrhotic patient, what markers indicate poor prognosis?
These are all signs of liver failure
What could cause pure red cell aplasia?
Thymoma, lymphocytic leukemia, parvovirus B19
What is the cause of the rapid plasma decay of thiopental/Barbiturate like anesthetic agent?
Tissue redistribution of drug
What is the most sensitive marker for diagnosing hypothyroidism?
What nerve causes vertical diplopia?
What wouls you see in CSF od cryptococcus infxn?
Yeast form only
What does transketolase do?
Non oxidative rxn in HMP shunt
Can synthesize ribose from fructose6P and glycolytic intermediates
Need this for synthesis of nucleotides- All cells can do this
What type of drug is Etanercept? What do you need to check before you admin?
TNF a inhibitor
Check PPD for TB
Unenveloped RNA virus
Enteric- Fecal oral
Expectant mothers, epidemic
"Hep a and e- the vowels hit your bowels"
Treatment for absence + tonic clonic seizures?
PDA is in which aortic arch?
What is C1 esterase inhibitor deficiency? What drug should you avoid and why?
Avoid ACEI bc these patients already have increased bradykinin and cant have any more increase
What drug is Chlorpheniramine? SE?
First generation antihistamine
What is PTH and Ca level in osteoporosis?
Cecum fixed in the right upper quadrant
Midgut rotation around SMA
It is fixed with fibrous bands to the second portion of the duodenum
This can also cause intestinal obstruction
Treatment for acute mania
Lithium/valproate/carbamazepine + Atypical Antipsychotic
Total gastrectomy- what do you need to supplement with?
B12! Paraenteral bc no IF
Progressively worsening dizziness, ataxia, disarthria, visual disturbance
Mass in lung
Autopsy: cerebellar purkinje cell degeneration
Paraneoplastic cerebellar degeneration
Associated with small cell
Cerebellar degeneration is an immune reaction against purkinge neuron ag
What would cause the release of both ANP and BNP from ventricles? (as opposed to just BNP)
Hypertrophy and volume overload
Why do old people get increased Ditgoxin toxicity
Decreased renal clearence
When Rb protein is phosphorylated it is ____?
inactive- not stopping cell cycle continuation
Active= hypophosphorylated= stop g1 to S
What is p27 protein?
cell cycle inhibitor
Moldy grains in china cause what mutation? Increased risk for?
mt in p53- increase risk for liver ca
"Aflatoxin" from aspergillus
In infertility treatment- what does large dosage of bHCG stimulate?
Stimulate LH surge
What HIV drug causes hyperglycemia? What other SE do these drugs cause?
Other SE: Lipodystrophy, inhibit p450
Sickle cell disease with hematuria?
What is mechanism of toxicity of Carbon tetrachloride?
oxidized by p450 radical system --> formation of CCL3 --> lipid peroxidation, formation of free radicals
What aspect of thiamine deficiency may remain permanent, even after treatment?
Permanent memory loss, results in confabulation
How do you prevent HIV transmission to baby?
MOA: Competitively inhibit nucleotide binding to reverse transcriptase --> terminate DNA chain
INHIBIT REVERSE TRANSCRIPTASE
Brain biopsy shows psammoma bodies- diagnosis?
From cells of arachnoid villi
What is alveolar gas equation
PAO2= 150- (PaCO2/.8)
How does IL 2 exert anti cancer effect?
Increased activity of NK cells and T cells
What do you see on histology in subacute/Dequevains thyroiditis?
Mixed cellular infiltration with occasional multinucleate giant cells
What do you see in hashimotos thyroiditis?
Mononuclear parenchymal infiltration with well developed germinal centers
What is similar pathophys to hydrocele?
Indirect inguinal hernia
Failure of obliteration of the processus vaginalis can cause both
Exposure to arsenic- what Ca?
Patient has increased globoside ceramide trihexoside. Disease? risk of developing?
Risk of renal failure
What is pathophys in anorexia induced amenorrhea?
Loss of pulsatile GnRH release from hypothalamus
this results from body fat falling below a certain level
This causes decrease FSH and LH --> decrease estrogen
(think this is anorexia/eating disorder- they are MENTALLY ill, its all in their head)
Where are lipids abs?
"Iron Fist Bro"
Fist= Folate and FAT
What Ab are specific for Lupus?
Anti Smith and anti dsDNA
Anti Smith- Anti snrp
What is Endothelium derived growth factor? Where is it released from? What receptor stimulates its release?
Endothelial cell- muscarinic recepton
cGMP (Parasympathetic), Ca efflux. smooth muscle/vasodilation
Mifeprisone vs Misoprostol
Mifeprisone- Anti progestin
Misoprostol- PGE1 analog
NAD+ is derivative of what AA?
--> niacin (nad, nadp) and tryptophan
What is most susceptible region of brain to ischemia?
Pyramidal cells of hippocampus and purkinge cells of cerebellum
What mt is in Myelofibrosis?
What are syx?
Activation of JAK STAT pathway
Tx: Ruxolitnib- JAK2 inhibitor
Syx: Splenomegaly and hepatomegaly bc of extramedullary hematopoesis, early satiety bc of splenomegaly
high rate of radiation induced genetic mutation in 4 year old boy with difficulty walking and frequent resp infections
Ataxia telangiectasia- ionizing radiation causes dsDNA breaks
Cerebellar atrophy --> ataxia
Hypersensitivity to DNA cross links
How do you prevent tetanus in newborn?
Immunization o women who are pregnant or may become pregnant
IgG crosses placenta, immunize infants at 2 months old
Vaccine is inactivated tetanus toxin
What converts glucose to sorbitol? Sorbitol is then converted into?
Sorbitol and fructose increase H2O in tissues
Organophosphate poisening is reversed with atropine- what is still a risk in this patient?
Muscle paralysis because only muscarinic is reversed by atropine, not nictinic recepors
Pralidoxime- reverses at muscarinic and nicotinic
SE of ticlodipine? MOA?
ADP receptor blocker with clopidigrel
activates IL2 which does growth and differentiation of T cells
Inhibited by cyclosporin and tacrolimus
Defect in isomerization from methylmalonylcoa to succinyl CoA (cofactor=B12)
Celecoxib- MOA? When do you use this?
Selective COX 2 inhibitor
Little effect on platelet and GI irritation
Short acting BZD for "Mission critical position"?
Triazolam or alprazolam
Can prescribe in between SSRI and time it takes to be effective
In iron deficiency anemia- transferrin levels?
Increase bc liver increases production to scrounge for iron
Ulcers in jejunnum is specific for?
What three cytokines mediate the inflammatory response? How does this increase ESR?
Stimulate liver to release acute phase proteins like fibrinogen, this will increase ESR
What is Li Fraumeni Syndrome?
Mt in p53
Predispose to sarcomas of breast, brain and adrenal cortex
What is mt in Hemoglobin C?
Missense mutation: Glutamate --> Lysine
decrease in negative charge
How is MRSA resistant to B lactams?
Altered PBP in cell wall- doesnt bind B lactams as effectively
ETEC is similar to what? How?
LT- increase cAMP
ST- increase in cGMP
Used in atypical depression- mood reactivity, heavy arms and legs, rejection sensitivity, increased sleep and appetite
Mood reactivity- improvement in mood in response to something positive (not present in MDD)
How are tumor cells resistant to chemotherapy?
transmembrane protein that functions as ATP dependent efflux pump
Initial: Resp alkalosis- salicylates directly stimulate the medullary respiratory center, increasing ventilation
Late: AGMA with resp alkalosis
What does Hep B do for Hep D?
Coat Hep D before it can infect hepatocytes
HLA B27- Class I or Class II?
Class 2- DR, DP, DQ
MOA of ipratroprium
Blocks action of ACH at muscarinic receptors
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