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Albin Uworld 10

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maxonupi's version from 2016-07-28 01:46

Section

Question Answer
Celiac arteryStomach to proximal duodenum, liver, gallbladder, pancreas, spleen
SMADistal Duodenum to proximal 2/3 of transverse colon
IMADistal 1/3 transverse colon to upper portion of rectum, splenic flexure is a watershed region
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Question Answer
Most important factor in preventing influenza infectionAntibodies to Hemagglutinin(Humoral)
Invasion of InfluenzaAntibodies to Neuraminidase
Cryptoorchidism pathwayAbdomen -> Deep inguinal right -> enter inguinal canal -> SUPERFICIAL INGUINAL RING(External oblique muscle aponeurosis) -> Scrotum
Variation in bone mass is determined by1. Genetic aka Ethinicity / 2.Physical activity
Boy presents with pulmonary infections(IgA deficiency), gait is unsteady ataxia , childs eyes and head do not move smoothly when he is looking, blanching nests of distended capillaries on sun exposed areas of his skin TelangiectasiaATM gene -> DNA break repair
~Generalized hyperpigmentation over face,neck and dorsal hands, weight loss, hypotension, vomitingAcute adrenal crisis(Addison disease) due to no steriord production to stress -> TX -> Aggressive fluid hydration & Glucocorticoid supplementation(dexamethasone)
SarcoidosisActivated macrophages lead to Hypercalcemia / DO NOT confuse with independent PTH
Amino acid responsible for nitrogen disposal by transporting it to liverAlanine
Alanine in Liver is transaminated to pyruvate coverted toA-ketoglutarate to form glutamate -> converted to urea for the disposal of nitrogen
Insulin resistancePhosphorylation of serine & threonine of insulin receptor -> Induced by TNF-a, catecholamines, glucocorticoids and glucagon
Tumor cells become resistant to various chemo medication due toATP-dependent transporter
Black lady with left hip and pelvic pain, constant dull, achy pain exacerbated by movement of the hip or weight bearing. Hx of sickle cellAvascular Necrosis (Also seen in Glucocorticoids,Alcohol abuse, tramuatic fracture, Vasculitis)
Triad - Fatigue, weakness, pallor, decreased hemoglobin ANEMIA , bruising, ecchymoses without trauma THROMBOCYTOPENIA , lipid droplets on bone marrow aspirationAplastic Anemia -> Pancytopenia -> Leads to increased erythropoietin by kidney
Females 10-30 yr old with lower abdominal discomfort, hx of cigarette & alcohol, with right sided adnexal mass HISTOLOGY - Hair, Sebaceous gland, Epidermis & Dermis liningMature teratoma
Ovarian carcinomaAge 60 with cystic & solid components, with pseudoglandular spaces & papillae
Amphetamines - ADHDDecreased appetite & weight loss & insomnia
Anti-psychoticsIncreased appetite & weight gain
Drug induced parkinson txBenztropine-> Anti-muscarnic
Female with ambiguous genitalia - clitoral enlargement & High bp 11B-Hydroxylase
Female with normal genitalia & High Bp17A-Hydroxylase
Male with undervirilized -no puberty,& Highbp17A-Hydroxylase
Homeless man abdominal pain, acute confusion, nystagmus, bilateral lesions of mamillary bodies & periaqueductal gray matter Precipitated byGlucose infusion with Thiamine first -> Wernicke Encephalopathy
Pt develops cardiovascular collapse & bleeding from venipuncture siteWaterhouse-Friederichen syndrome -> Due to cortisol deficiency -> Adrenal Hemorrhage
Pt who presents with headaches, tremulousness and sweating with family hx of primary hyperparathyroidism, high bp, urinary metanephrines & catecholamines with right side adnexal mass has what common embryological origin?Pheochromocytoma -> Neural crest cells -> MOTEL PASS - Melanocytes, Odontoblasts, Trachea, Enterochromaffin cells, larynges, parafollicular cells of thyroid, adrenal medulla, Schwann cells, Spiral membrane
Most common hepatitsHepatitis B -> DNA
Acute Hepatitis B presents also asSerum sickness -> Joint pain, lymphadenopathy, pruritic rash, rightupper quadrant pain, hepatomegaly, elevated hepatic transaminase levels
Pt suddenly wild large amplitude, flinging movements, affecting the proximal muscles of the left armHemiballism -> Lesion of subthalamic nucleus due to lacunar stroke
TB granulomasInterferon-y, IL-12, TNF-a
Pt with no previous medical hx but presents with chestpain, palpitations, shortness of breath, and sweating, pt feels like he is going to die. TX?Panic disorder -> Benzodiazepine administration -> NOT SSRI because its take 2-4weeks
Pt is brought in by friend to the ER. Requires consent and states "pt has a sister but is unaware of when they last spoke"Attempt to contact the pt's sister for consent for intubate
A young pt who presents with chronic, mild dyspnea, fatigue, foggy mind, lives a sedentary lifestyle, smoked cigs, bp 140/85, bmi -obese, Partial pressure of oxygen - Low / Partial Pressure of carbon dioxide - High / Alveolar arterial oxygen gradient - Normal(5-15)Obesity hypoventilation syndrome -> Chronic Hypoventilation
Hypoxemia with NORMAL alveolar to arterial gradient causesObesity Hypoventilation, Neuromuscular respiratory problems or High altitude Low inspired fraction of oxygen
Hypoxemia with ELEVATED alveolar to arterial gradient causesR-L shunt Cardiac septal defects/Pulmonary edema , Impaired diffusion Interstital Lung disease , Ventilation perfusion mismatch pulmonary embolism, COPD
Claustrophobia leads to Panic attack which leads toHyperventilation(Breathing TOO fast) leading too Low PCO2 in the body(dizziness, weakness, blurred vision)
Viral drug that does not require intracellular activation and is known to bind in vitro with viral encoded enzymes such as DNA POLYMERASEFoscarnet
Pt who presents with muscle weakness high bp, low plasma renin. Overactivity of what?Conns syndrome Zona Glomerulosa of adrenals
Pt who presents with NO muscle weakness high bp, low plasma renin, metanephrines in urinePheochromocytoma Chromaffin cells of the adrenals
Neisseria, Haemophilus, S.Pneumoniea vaccine haveOuter polysaccharide covering
Recurrent granulamatous skin lesions, inactivating mutation of neutrophil oxidase enzymeChronic Granulomatous disease -> NAPD OXIDASE -> Catalase + -> S.Aureus, Burkholderia Cepacia Serratia Marcescens, Nocardia, Aspergillus
Staphylococall infections in blood increased due toIntravascular devices
Round or coin popcorn like lesion in the upper lung in asymptomatic non smokerHamartoma -> hyaline Cartilage,fibrous or fat tissue in the biopsy sample
Erythrocytes do not have & useMitochondria & Ketones
Not gaining weight, fatigue, polyuria, polydipsia, losing weight despite having foodDiabetes Type 1
Pt who presents with pain while swallowing, sub-sternal burning at night despite antacids, long time ger complication?Ulceration
Immediate treatment for bleedingFresh Frozen Plasma(Contains blood clotting factors and proteins) Dx- Warfarin Overdose or Rodent poisoning Vitamin K is NOT Immediate treatment
HUSElevated serum indirect bilirubin due to hemolysis
Coombs test +Auto-antibodies against red blood cells
Relative Risk -> 120 outof 400 taking ACE had coronary problems VS 100 out off 300 not taking ACE had coronary problems(120/400) / (100/300)
Odds Ratio -> 120 outof 400 taking ACE had coronary problems VS 100 out off 300 not taking ACE had coronary problems(120/200) / (100/280)
After drug infusion pt develops SOB, itching, dizziness, hypotension, bilateral wheezing. What is elevated in pt serum?Tryptase, Histamine due to mast cell & basophil degranulation
Cholera toxinApical ion transport defective
C.Perfringes Alpha toxin of lecithinaseCell membrane integrity defective
E.coli HUSDefective Ribosomal protein synthesis
Women who complains of pelvic pressure bulky, constipation, easier to defeacate with her fingers in her vaginal canal, NO Heavy or severe pain, irregularly enlarged uterus & normal rectal toneUterine Fibroid -> Subserosal Leiomyoma
dysmenorrhea, abdnormal uterine bleeding, chronic pelvic pain with uterine enlargementAdenomyosis
Feeling a bulge pressure or that something is falling out of the vagina, constipation, with NO uterine enlargementVaginal wall prolapse(Rectocele)
Alkalaline Phosphatase is elevated in Liver Y-glutamtransferase, Bone, Placenta
MyeloperoxidaseElevated in inflammation & infection NOT Acute allergic reaction
Allergic Reaction IgE trigger of vasoactive substance how?IgE Receptor aggregation on mast cell
TRNA Amino Acid bindingTop -> CCA Can Carry Aminoacid
TRNA Codon bindingBottom
Most common site of thrombus formationLeft atrial appendage
MAO Inhibitors(phenelzine,tranylcypromine)Increase synaptic monamine levels OR monamine degradation
MAO Inhibitors + WINE,CheeseTyramine Hypertension due to increased Monamine & Tyramine levels which are sympathetic
Left atrial enlargement leads toRecurrent laryngeal nerve impingement leading to hoarsness
Early stage diabetic nephropathy look forAlbumin
End stage kidney failureWaxy casts
Pt with hx of hypertension and high bp has Unilateral MLF lesion due toLacunar Stroke of pontine artery -> Lateral Pons -> CN VI
Bilateral MLFMultiple sclerosis
Drugs that cause pseudomembranous colitis watery diarrhea, abdominal crampCephalosporin, Clindamycin, Fluoroquinolones -> Overgrowth of C.Dificile leading to Damage to Cytoskeleton integrity of GI
Right angle branching hyphaeMucor
Pt with a catheter who presents with fevers, chills, with yeast infection is due toCatheter associated Candidemia -> Pseudohyphae with blastoconidia
Fetal highest oxygenated arteriesUmbilical vein, Ductus venosus, Inferior vena cava
pt who is started on isonazid with pyridoxine presents with fever, anorexia, nausea with mild abdominal discomfort is have a Sx DUE TOHepatocyte damage due to Isonazid
Pruified protein derivative test meansPPD TEST
Pt with a history of alcoholism presents with abdominal pain, nausea, elevated serum amylase & lipase(Pancreatitis), pt died from respiratiory failure due toARDS from pancreatits which shows Alveolar Hylaine membranes
Pt with a history of alcoholism presents with abdominal pain, nausea, elevated serum amylase & lipase (Pancreatitis, and with Hemoptysis died from respiratory failure due toARDS from pancreatitis which shows Intraalveolar hemorrhage
Generalized anxiety DisorderIndividuals expereince chronic worry about mutiple issues and DO NOT have recurrent unexpected panic attacks
Pt who presents no medical history, no drug or alcohol abuse, recurrent anxiety attacks while relaxing or from sleep, happen anywhere & anytime, worried about future attacksPanic attack
Conduct vs Social disorderLESS THAN 18 VS ABOVE 18 & diagnosed with conduct disorder before 18
2 major Allergic Asthma is caused byLeukotrienes(zafirlukast & montelukast) & Acetylcholine(Ipratroptium)
Pemphis Vulgaris presents as mouth involvement, flaccid bullae with erosions scattered over trunk & +Nikolsky sign, blisters spread laterally with pressure on uninvolved skin produces blistering is antibody againstDesmosomes
Bullous pemhigoid presents as bullae are tense & remain intact over the dermis & -Nikolsky sign and produces antibodies agianstHemidesmosomes
Cerebral vermis dysfunctionTruncal Ataxia and postural
Gardnella VaginosisMetrondiazole OR Clindamycin
Ribavrin MOAInterfering with the duplication of viral genetic material & Inhibit IMP(Inosine Monophosphate) dehydrogenase
What supplies the spleen, stomach, liver, abdominal esophagus, pancrease?Celiac trunk through proper hepatic artery
Breath hydrogen content testH.pylori
Asian or black with flatulance, crampy abdomnal pain, watery diarrhea, History of - Acute gastroeneteritisAcquired Lactase Deficency -> Bacteria Ferments lactose decreasing stool ph & hydrogen gas -> Flatulance
D-xylose Absorption testDifferentiate pancreatic from intestinal malabsorption
Women with fever, confusion/disoriented/somnolent/difficult to arouseDelirium, flushed skin, dry oral mucosa, dilated pupils, Decrease bowel soundsAnti-Cholinergic Toxicity -> Sympathetic sx
Anti-Cholinergic Toxicity SXFeverHot as sun, Flushingred as chile, Dry skin or mucousDry as bone, Nonreactive Mydrasisblind as bat, DeliriumMad, Urinary retentionfull as flask, Decreased bowel sounds, Tachycardia
Anti-Cholinergic Toxicity causing drugsAnti-HistaminesDiphenydramine, TCAAmitriptyline,Imipramine, Low potency antipsychoticchlorpromazine, Antipsychotic clozapine, Antiparkinson drugsbenztropine, Atropine
AmitriptylineNerve Pain & Anti-depressants
Pt with past sexual abuseThat sounds like an awful experience, are you comfortable talking about it?
A adnergic agonist(Phenylphrine,methoxamine)Increase BP & Reflexive LOW HR due -> Stimulation of baroreceptors of carotid sinus & aortic arch leading to a vagal stimulation of heart
What does B.Anthracis & B.petrussis have in common?Adenylate cyclase -> Edema factor leads to increase in intracellular cAMP leading to macrophage and neutrophil dysfunction AND EDEMA
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G- Stomach bugs

Question Answer
G- oxidase positive, grow in alkaline media, comma shapedVibrio -. Common in chronic omeprazole treatment pts
G- rod oxidase positive, Urease positiveH.Pylori
G- oxidase positive, Non lactose fermenterPseudomonas
G- Oxidase positive, grows in 42C, comma or S shapedCampylobacter jejuni
G- oxidase negative, non lactose fermenterShigella, Salmonella, Proteus
Gout -> NSAIDS & Colcheine contraindicated inRenal or liver dysfunction or elderly or peptic ulcer
Gout -> Glucocorticosteroids contraindicated inDiabetics due to increase blood glucose
Anti- HAV IgM+Acute Hepatits A -> From eating oysters
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Anti-HAV IgM- & Anti-HAV IgG + -> HAD Hepatits A infection or vaccinated but now is immune to it

Parkinson

Question Answer
COMT inhibitors / CarbidopaDecreasing peripheral levodopa degradation
Bromocriptine, Pramipexole, ropiniroleDirectly stimulating dopamine receptors
AmantidineEnhancing the effect of endogenous dopamine
Anti-cholinergics(benztropine,trihexyphenidyl) reduce tremorInhibiting central muscarnic receptors
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Statistics

Question Answer
The probability of a diseased person testing positiveSensitivity
The probability of a non-diseased person testing negativeSpecificity
The probability that disease is present given a positive resultPPV
The probability that disease is absent given a negative resultNPV
A ratio representing the likelihood of having disease given a positive resultPostive likelihood ratio
A ratio representing the likelihood of NOT having disease given a negative resultNegative likelihood ratio
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