UWorld 3

poxidicu's version from 2016-05-15 21:02


Question Answer
BuspironeAnxiety treatment. Slow onset of action 2weeks similar to SSRI Drugs
Collagen(Triple helical structure)Glycine is the most abundant amino acid in collagen(Gly-x-y)
Vitamin C deficiencyProline & Lysine hydroxylation
Prolonged fasting causes hypoketotic Hypoglycemia(vomiting, lethargy, mild hepatomegaly) -> Low ketone bodiesacyl-CoA dehydrogenase deficiency
Women, fever & HematuriaAcute pyelonephritis(Ascending urinary infection)/ Vesicuretral reflux
NorepinhrinecAMP increases in cardiac myocytes
Dysuria, vulvar pain, itching, inguinal lymphadenopathy. tender vesicular lesions, new sexual partnerHSV2 -> PT at risk of recurrent genital ulcers
Obese, day time sleepiness, not refreshed when waking up or have NO hallucinations before going to bed or waking upObstructive Sleep apnea
Double vision, difficulty walking down the stairs and up-close reading(vertical diplopia)/ No problemTrochlear nerve(CN4) -> Down and in toward nose
AbducensDown and middle of the nose
Vertical and horizontal diplopia, ptosis, enlarged/ non-reactive pupilsOcculomotor(CN3) -> Down and out
Horizontal eye movement and weak abduction of the affected eye & nystagmus of the contralateral eyeMLF
High grade fever, headaches, severe myalgias, joint pains, trip to mexico, retrorbital pain, rash(white islands in sea of red)Dengue fever(Break bone fever)
High grade fever, headaches, sever myalgias, joint pains, trip to mexico + Macuopapular rash, spontaneous bleeding, low bp, tachycardia, purpuric rash, thrombocytopenia, leukopenia, positive torniquet test(petechiae after syphgmamanometer cuff inflation)Dengue Hemorrhagic fever (Single stranded RNA virus)
Dengue fever Vs Hemorrhagic dengue feverinfection with a different viral serotype
Pt has IgG agianst Hep C but still as no immunity for infection due toEnveloped protein having variation in there antigenic structure
Angiotensin II will be higher in pulmonary vein OR artery?Pulmonary vein
Most common cause of viral enteritis in developed countries (vomiting & watery diarrhea, no blood or mucus, no travel history)Norovirus(Cruiseships, hospitals, nursing home, school)
Most common cause of viral enteritis in developed countries (vomiting & watery diarrhea, no blood or mucus, no travel history, NOT IMMUNIZED)Rotavirus
Liver cirrhosisHemochromotosis(Iron accumulation) -> Protein mutation on liver and GI -> Reduce endocytosis of the iron transferin complex -> Iron buildup in blood
Basal ganglia atrophyWilsons disease(Copper accumulation) / Hepatolenticular degeneration
Knee joint, rhomboid crystals(coffin)Psuedogout(calcium pyrophosphate)
First metatarsophalangeal joint, needle shapedGout(monosodium urate)
After 20 weeks of pregnancy pt has HYPERTENSION with PROTEINURIAPreeclampsia
After 20 weeks of pregnancy pt has HYPERTENSION with PROTEINURIA & SEIZURESEclampsia
After 20 weeks of pregnancy pt has HYPERTENSIONGestational Hypertension
Before 20 weeks of pregnancy pt has HYPERTENSIONChronic Hypertension
Right upper qudrant pain, nausea, recurrent fever(enlarged gallbladder), tenderness over the right subcostal area, history of necrotizing fascitis & sepsis(critically ill pts)Acalculous cholecystitis-> Inflamed and enlarged galbladder
Porcelain gallbladderDue to Chronic cholecystitis -> Increase risk of gall bladder carcinoma
Grayish white discharge, fishy odor worse with potassium hydroxide(whiff test), clue cellsBacterial vaginosis -> Anaerobic gram-variable rod
Pelvic surgery(hysterectomy), flank pain(right sided back pain), fever, NO problem voidingUnilateral Ureter damaged
myxomatous cystic degeneration of the medial layerAortic Aneurysm(Marfan)
ErythrocytesNO mitchondria -> No ATP. Instead glycolysis


Question Answer
Thiazide complicationNa and CL excreted leading to decrease volume -> Body turns on RAS system -> Aldosterone causes Na and Cl reabsorption and wasting of K
Degree of mitral stenosisA2(aortic) to opening snap time interval -> Shorter the interval worse the stenosis
Progressive exertion SOB, dry cough, interstitial fibrosis with cystic air space enlargement in the subpleural area, fibroblast proliferation, honey combineIdiopathic pulmonary hypertension Tx Lung transplantation & bosentan
Acute CholecystitisFailed gallbladder visualization on radionucleotide biliary scan due to obstruction by stone at the cystic duct
Alcoholics(fever,cough, weightloss), air fluid levels(Abcess), poor dentition(anaerobes)Aspiration Pneumonia -> Impaired gag reflex -> Bacteroides,Prevotella,Fusobacterium,Peptostreptococcus -> Tx Clindamycin(Also treat S.Pneumonia)
Asymptomatic parents with diseased childrenAutosomal recessive -> Classic galactosemia
Weakness, paresthesia, Super high BP, LOW plasma RENINConns Syndrome(Tumor of the adrenals) -> Sodium High, K Low, Ph low, Bicarb High (Metabolic Alkalosis)
Rheumatoid Arthritis affectsCervical Spine, PIP,MCP, MTP(feet), Cord compression
Osteoarthritis jointsThoracic spine, Lumbar spine, DIP, PIP, WRIST, Ankle
Ankylosing spondylitis, reactive arthritis, inflammatory disease arthritis, psoriartic arthritisSacroilliac joints(HLA b27)
AppendicitisStarts in the middle umblical area and as the inflammation gets worse it gets localized to McBurney point(Inflammation of the parietal peritoneum)
Biofilm organisms(S.epi, S.mutans, Pseudmoas, Viridans, Anthrax)Virulence -> Synthesis of an extracellular polysaccharide matrix
Spherules containing endosporesCoccidioides immitis
Kidney ischemic damage(Shock,sepsis, surgery)Proximal Tubules, Thick ascending limb,
Widespread musculoskeletal pain(Shoulder,back pain, muscle tenderness), Fatigue, Lack of concentration(Psychiatric disturbances)Fibromyalgia
Succinate to Fumarate -> Succinate Dehydrogenase cofactorRiboflavin FAD
Cholestrol to AndrogensTheca Interna
Androgens to EstradiolGranulosa
Worsening backpain, Localized bony pain(upper lumbar), low grade fever, recent staphlcoccal bactremia or endocarditis OR Neurological findings with or without back painVertebral osteomyelitis -> Blood cultures & MRI OF SPINE
Autosomal dominant
Autosomal recessive(Enzyme deficiency, present in childhood, 2 carrier parents -> 25%ofsspring affected)
X-linked recessive(No male to male)
X linked dominant(No male to male - All female offspring of affected father diseased)
Mitchondrial inheritance(Only female offsprings affected, heteroplasmy)
Autosomal Dominant(FFAANNTHHHOMM)Familial adenomatous polyposis, Familial hypercholestromlemia, Achondroplasia, ADPKD, NF1,NF2, vOn hippel lindu, MEN, Marfan syndrome
Autosomal recessiveAlbinism, ARPKD, Cystic fibrosis, glycogen storage disease, hemochromatosis, muucopolysaccharides(hurler), phenylketonuria, sickle cell anemia, thalaseemias, dubin johnson, spingolipidosis(Except fabrys)
X-linked recessive(Be Wise Fools GOLD Heeds Silly Hope)Brutons agammaglobuonemia, Wiskott-Aldrich, Fabrysdisease, G6PD, Ocular albinism, Lesch-Nyjhan syndrome, Duchennes muscular dystrphy, Hunter syndrome, Hemopilia A & B
X-linked dominantHypophosphatemic rickets -> Increase phosphate wasting in PCT leading to a rickets like presentation
Pt confidentialityNeither deny or agree the pt is yours - "No, I cannot say whether she is my patient"
Supine to sittingupRectus abdominis, external abdominal obliques, hip flexors(iliopsoas - psoas major, psoas minor, iliacus)
Small cell carcinoma biopsy showsNeural cell adhesion -> Tumor markers - Enolase, chromogranin, Synaptophysin
Bacitracin resistant G+GBS -> S Agalactiae -> Mothers with past history of babies with infection & and positive now -> Intrapartum ampicillin
Red rash on chest,firm itchy and feels rough(peau d orange), axillary lymphadenopathy, no massesInflammatory breast cancer(cancerous cells obstructing lymphatic drainage due to spread to the dermal lymphatic space)
Herpes pt viral strain lacks viral phosphorylating enzymeCidofovir, Tenofovir
Sertoli cell makesMIF -> Prevent female Internal organs in male
Leydig cells makesMale internal(Testosterone) and External genitalia(DHT)


Question Answer
ThionamidesMethimazole MOA - Coupling of Iodotyrosinase - inhibit thyroid peroxidase(Same as PTU but converison of t4 to t3)
Dry cough at night, sore throat and occasional epigastric discomfort, Obese and pt with Diabetes mellitusGERD causes Barretts esophagus -> High risk for Esophageal adenocarcinoma(distal part of esophagus)
Estrogen(pregnancy,oral contraception, postmenopausal estrogen treatment) effect on the thyroidElevated TBG levels -> Increase total T4 & T3 pools -> Normal free thyroid hormones so NORMAL
Aldose B vs Aldose Reductase deficiencyIncreased Fructose & sucrose VS Increased Galactose
CyclothymicMild hypomania and depressive moods fluctuate for two years
Gaba A receptor in the brainRegulates flow of - charged chloride in neuron(Hyperpolarize) -> -75
Sodium+60 in neuron
Potassium-90 in neuron
Calcium+125 in neuron
Hepatitis B surface antigen recombinant vaccine in a population can preventHepatitis D & NOT hepatocellular carcinoma because Hepatitis C can cause hepatocellular carcinoma
High concentrations of fructose 2-6 Bisphosphate levelInhibits gluconeogenesis -> Decreased conversion of alanine to glucose
PFK2 increases duringInsulin therapy
Pregnancy two antibodiesIgG(Hemolysis) & IgM(No hemolysis)
Blood type A & BIgM
Blood type OIgG
Aspirin Allergy(rhinitis, asthma, urticaria) drug of choiceClopidogrel -> Irreversibly block P2Y component of ADPreceptors
Supracondylar fracture of the humerus anterolateral displacementRadial nerve Injury
Supracondylar fracture of the humerus anteromedial displacementMedian nerve and Brachial artery injury
Accessory NippleFailed involution of the mammary line
Influenza vaccineInhibition of virus into cell
FibratesTreat TG
Bile acid resinsIncrease TG
Azoles InhibitLiver C-cyp450)
Left ventricular dysfunction signLung biopsy contains macrophages containing Golden cytoplasmic Granules that turn dark blue with Prussian blue stain(Hemosidrin macrophage) -> Heart failure cells
Beta blockers effect on RAS systemInhibits release of renin at the kidney -> DECREASES Rening, Angiotensin I, Angiotensin II, Aldosterone. NO CHANGE Bradykinin
Upper Gi hemorrhage(Mallory weiss), Liver picture full of nodules(Cirrhosis)Fibrosis & Nodular paranchymal regeneration -> Sign of liver cirrhosis
Adrenal medulla chromaffin cells(arise from neural crest) activated epi and norepinephrine byAcetylcholine
Phenotypic mixingTwo virus particles "share" coat proteins, therefore each has a similar assortment of identifying surface proteins, while having different genetic material
Tata promoter regionStarts transcription
Fever, myalgia, swollen lymph node in the neck behind ear(Lymphadenopathy), splenomegaly, Increased lymphocytesEBV(Saliva transmission)
Mysthania gravisReduced motor end plate potential (Thymoma linked to this condition)
ADHD DocAmphetamines -> Methylphenidate -> Increase availability of norepinephrine and dopamine
PCA injury findingsContralateral Homonymous Hemianopia with macular sparing
G+, diplococcus, a-hemolytic, grows in blood agar, fever, cough, consolidation(pneumonia)S.Pneumonia -> Virulence factor polysaccharide capsule(inhibits phagocytosis)
M protein virulence factorS.pyogenes


Question Answer
Diarrhea, wright loss, epigastric calcificationChronic Alcoholism -> Exocrine insufficiency and malabsorption
LOW CRH, ACTH & CortisolChronic prednisone treatment
Boy with headaches, cystic with solid areas, visual changes(Bitemporal hemaopia), Intracranial calcified mass with cystic space with rich cholesterol protein crystals brownish fluids(machine oil)Craniopharynigioma -> Anterior Pituatry formed same as the Rathkes pouch(surface ectoderm)
Common complication of acute pancreatits(4 weeks after epigastric pain and binge drinking)Pancreatic Pseudocyst -> Fibrous and granulation tissue epithelium
Industrial worker, Dizziness and palpation, flushed skin, redish discoloration without cyanosisCyanide -> Amyl Nitrate antidote
Osmolarity the same asConcentration(Loop of henle)
Painful urination,watery penile discharge(Urethritis), NEGATIVE gonococcal infection, few weeks presents with acute conjunctivitis, rightknee pain(osteoarthritis), vesicular rash on palms and solesReactive arthritis(Sero-negative arthritis) -> Sacroilitis(20%)
Supraspinatus functionAbduction problem
InfraspinatusExternal rotation
Teres minorAdduction & external rotation
SubscapularisAdduction & internal rotation
Most common cause of death in Diabetes MellitusMI
At/Below the Red nucleus(Midbrain tegmentum, pons)Decerebrate posturing -> Extension -> Loss of descending excitation
Above the red nucleus(Cerebral hemispheres)Decorticate posturing -> Flexion -> Loss of descending inhibition
You pt presents with fever, fatigue, poor appetite, holosystolic murmur, cardiac biopsy shows ashoff bodies(myocardial granuloma)Strep Pyogenes -> Untreated -> Acute Rheumatic Fever
Mitral Regurgitation hemodyanmicsIncrease Preload, Decrease Afterload(due to blood going onto left atrium), Increase Ejection fraction
Grow in 6.5% hypertonic saline & bileEnterococcal endocarditis -> Urinary tract catheterization(cytoscopy)
Does not grow in Grow in 6.5% hypertonic saline & bileS bovis -> Colonic cancer
Male children 3-11yrs, IgA & C3b depositionHenoch Schonlein purpura -> Skin rash(palpable purpura buttocks & legs), abdomnal pain & arthalgia
Etoposides inhibitTopoisomerase II and used in cancer by causing chromosomal breaks -> Death
Viridans streptococci(Extracellular dextran polysaccharides using sucrose)Fibrin-platelet aggregates -> Mitral valve prolapse
Pt having angina given sublingual nitroglycerineVenodilator-> Decrease left ventricularvolume and wall stress -> Decreased myocardial oxygen demand & relief of
Fever anorexia discomfort -> Hematocrit increased -> Multiple round lesions -> Lung has lesions on both lungs(lung metastasis), large polygonal cytoplasm clear due to high lipid and glycogen content
Flank pain, hematuria, palpable mass classic triadRenal cell carcinoma

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