Uworld 5

wewovino's version from 2017-03-25 20:07


Question Answer
Porphyria & PhotosensitivityUroporphyrinogen decarboxylase(Most common) deficiency
Children exposed to secondhand smoke exposure leads toPrematurity, low birth weight, sudden infant death syndrome, Otitis Media, Asthma, Bronchitis, pneumonia
Pt started on a new hypertensive drug, 3 weeks later presents with bilateral edema, Negative for proteinuria or creatineNormal kidneyCalcium channel blockers Sx Also Dizziness or lightheadness
Prolactinomas txDopamine Agonist-> Bromocriptine
Heparin OverDOSE Sx Sever headache, Unconsious, bleeding into tumorAntidote Protamine Sulfate/ Contraindicated FFP
Hepatitis C LacksRNA Virus last reverse transcriptaseProof reading 3-5 exo-nuclease activity
Unfractioned Heparin VS Low molecular heparin(Enoxaparin)Heparin binds to Xa & Thrombin VS Enoxaprin only binds to Xa
E.coli strand that does not ferment sorbitol or produce glucuronidaseEHEC -> HUS(thrombocytopenia, microangiopathic hemolysis, renal problems) Inhibits 60S ribosomal subunit leading to inhibition of protein synthesis
AML very similar to DIC15,17
Lesch-Nyhan Syndrome(Aggressively bite on fingers,hypotonia, involuntary movement, elevated serum uric acid, delayed development)Deficiency of HGPRT & Excess of PRPP amidotransferase
Medication selectively binds to Interleukin-1 inducible enzyme(COX2)Celecoxib-> Best use in pts with gastroduodenal problems
Umblical Hernia, Down syndrome baby present with reducible bulge at umbilicus while crying(Increased abdominal pressure)Incomplete closure of the umblical ring
Duodenal AtresiaIncomplete recanalization of the fetal intestinal tract
OmphaloceleUmblical cord at the apex with sac containing multiple organs & GastrochisisUmbilicus to the left of defect with no membrane coveringFailure of the extraembryonic gut to return to the abdominal cavity
Skeletal muscle contractionCalcium released from SR -> binds to troponin -> Binding of Actin and Myosin
Integrin expression meansIntegrin binds to fibronectin to bind to the collagen
Pancreatitis risk factor isARDS(SOB,Progressive hypoxemia, new bilateral opacities) -> Abnormal Capillary Permeability, Lung compliance, Work of breathy, V/p mismatch Normal Pulmonary capillary wedge pressure
Deaf translatorNecessary for Non emergency situation but No need for emergency situations
Diffuse muscle rigidity WITHOUT CLONUS, high fever, Hypertension, tachycardia, altered sensorium, Elevated Creatine KinaseDantolene -> Inhibiton of calcium ion release from sarcoplasmic reticulum of skeletal muscle-> Ryanodine receptors
Serotonin SyndromeVery similar to Neuorleptic Malignant Syndrome BUT NO Muscle rigidity -> With Clonus
History of tubual ligation & permanant ligation meansEctopic pregnancy -> Microscopy shows Dilated coiled endometrial glands and edematous stroma
Molar Pregnancy microscopyEnlarged chorionic villi and avascular edematous stroma
Central ChemoreceptorsIncreased PaCO2 increase in respiration in healthy people
Peripheral ChemoreceptorsCarotid & Aortic bodies -> Stimulated by hypoxemia in COPD -> Suppresed respiration if oxygen administration
CFTR Gene mutation in the respiratory or Gastric glandDecreased Chloride secretion / Increased Luminal sodium absorption
CFTR Gene mutation in the sweat glands "Sweat Test"Increased Chloride secretion
Low volume distribuiton 3-5LHigh moleculer weight, Hydrophilicity, High plasma protein binding, High charge
Total gasterectomyb12 DEFICIENCY need life long b12 because intrinsic factor is made in the parietal cells and is needed for absorption in the ileum
Rheumatoid ArthritisIgm Antibody specific for the Fc component of self IgG
Discharge from the umblicus, small reducible mass, minimal to clear straw-colored discharge(Urine)Persistence of the allantois remnant -> Failure of urachus to obliterate -> Patent urachus
Toddlers with painless GI bleeding due to ectopic gastric mucosaPersistance of omphalomesentric duct -> Failure of obliteration of vitelline -> Meckel Diverticulum
Abscence of neutrophil migrationLAD -> DECREASED b-2 integrins delayed separation of umblical cord
Mushroms have AmatoxinsInhibit RNA polymerase II -> Inhibiton of Messenger RNA
MalpractiseDr ladien wife injury or harm to pt
Preventable adverse eventPt presents with depression and hypothyroidsm. Physicans treats depression with out realizing that treating Hypothyroidism would treat depression also.
Non-preventable adverse eventPt or Docotor doesnt know allergy to a medication and ends up with allergic reaction
Tibial NerveDecreased sensation over the sole, Plantar flexion & Inversion
Common Peroneal nerveLateral leg & Decreased sensation over the sole, Dorsiflexion & Evertion
~Above the inguinal ligament artery damage due to coronary interventionRetro-peritoneal Blood accumulation
Plevic fracture or gynecologic complicationPelvic blood accumulation
Paracolic GutterAscending colon & abdominal wall space -> Blood,pus,bile accumulation
2yr old50-200words & 2 word phrases
RNA virus from nasal exudate of an animal and later mutated which then was able to affect human epithelial cells. Which protein is responsible for the attachment of the mutated virus?Surface Glycoprotein
Pt with recurrent vaginal candida,(Wet mount showing buddyin yeasts), weight loss, diarrhea,thrush. has HIVLatent EBV reactivation -> Ebv associated lymphomas
Epithelial ovarian cancer PROTECTIONOral contraceptive use, Multiparity, Breast feeding
Epithelial ovarian cancer RISKInfertility, nulliparity, Brca 1&2, Postmenopausal age
Pt with MRSA with vancomycin allergy treated with another drug presents with musclepain and elevated creatine phosphokinaseDaptomycin -> MOA- Maintenance membrane potential(Depolarizes cellular membrane by creating trans membrane channels -> SX myopathy
Syphilis ArteryVasa Vasorum endarteritis
Intimal Tear & Medial degenerationDissection aortic aneurysm
Diabetic Ketoacidosis txIV normal saline & Insulin -> Increase Serum Bicarbonate & Sodium, Decrease glucose, osmolarity & Potassium
Goodpasture VS Wegners Granulomatosis SxHemotpysis & Oliguria VS Nasal ulcer & Hematuria
Medial InflammationTakaysu & Giant cell arteritis
Mother has a baby but the baby is of a different fatherDo no tell father
Fatty acid oxidationCarnitine
Fatty acid synthesisMalonyl-CoA inhibits beta oxidation
Transamination(Making of amino acid) requires what cofactor in the liverB6 Pyridoxine
CarboxylationB7 Biotin
Dehydrogenase (NAD)B3 Niacin
Dehydrogenase (FAD)B2 Riboflavin
Serum SicknessType 3 hypersensitivity-> Fever pruritic rash,arthritis, Lymphadenopathy -> Small vessel vasculitis with fibrinoid necrosis and neutrophil deposition -> Caused by Infliximab, Rituxamab - Decreased C3 Levels
Tumer lysis syndrome -> Uric stonesCollecting ducts due to low urine pH
SIADH due to Small cell lung cancerLow plasma sodium & osmolarity, Normal BODY VOLUME(Peripheral edema, pulmonary crackles, elevated JVP NOT seen)
Pt overdose on anti depresssants presents with QRS prolongation & premature ventricular beats, dry mouth, low bp, cardio toxicity txTCA toxicity -> Antidote ->(Sodium bicarbonate)
aVRRight side of heart
I, aVL, v4-v6Left ventricle-> Left Circumflex Artery
v1-v4Left proximal anterior descending artery
v1-v2Left distal anterior descending artery
II, III, aVFRight coronary artery
ST elevationLeft main coronary artery
Alternative splicingIncludes or excludes different DNA coding regions -> Made FAS proteins which were shorter and lacked the transmembrane domain leading to NO apoptosis
IBD(Crohns or Ulcerative colitis) increase risk for colorectal carcinomaMultifocal, Proximal colon, younger pts, from flat & non polypoid dysplasia, signt ring morphology, early p53 & late APC gene mutation
G- rods, Nitrite & leukocyte estrase +, lactose fermenting and indole +E.Coli
G- rods, Nitrite & leukocyte estrase +, lactose fermenting and indole -Enterobacter colace
young pt with right sided chest pain worse with breathing, fever, needle marks in arms, holosystolic murmur(endocarditis)S.Areus endocarditis -> Septic embolism to the lungs
CricothyrotomySuperficial cervical fascia and cricothyroid membrane
Osteogensis imperfectaPrimary impairment in bone matrix formation
Lungs Hypoxic vasoconstricitonSmall muscular arteries divert blood from poorly ventilated areas to normal ventilated areas UNLIKE other organs
Prevention of Tetanus In babyVaccinate mother
Treatment of tetanus in babyImunnoglobulins or Anti-bacterial
Tetanus vaccination with diptheria/petrussisAge 2 months
Clenched hands -> One finger over another, Increased tone in extremeties, holosystolic murmurs, small jaw, renal defects(horseshoe kidney), Prominent occiput, rocker bottom feetEdwards syndrome
Midline facial defects, Polydactly, omphalcele, No overlapping fingersPatau Syndrome
Flat face, upslanting palapable fissures, epicanthal folds, simean crease, Excess skin around neck, tow distance wide, Burrowed tongues featureDown syndrome
M Protein peak in serum protein electrophoresis, anemia(Weakness,fatigue), lytic bone lesions(back-pain, fractures), renal insufficency(hypercalcemia, creatinine abnormality)Multiple Myeloma-> Plasma cell neoplasm
High fluid intake & CitrateUse to prevent calcium stones
CREST(Exertional dyspnea, fatigue, bluish discoloration of the fingers, tightening of skin over the fingers) pts tend to havePulmonary Hypertension ->Intimal thickening of pulmonaryarteriole
IV DextroseHospital setting tx for low glucose
Intramuscular GlucagonNon-clinical setting tx for glucose
Severe Skin & subcutaneous fat necrosis 2 days after initiating necrosisProtein C activity -> Decrease ability to inactivate factors V and VIII
Antibodies against thyroid peroxidase enzymeHashimotos Thyroiditis
Peroxidase enzyme functionThyroglobulin iodination
Inhalation AnestheticHigh tissue solubility -> Large arteriovenous concentration means -> slower onset of action More in blood & not brain
Potent anestheticsMinimal arteriolar concentration(MAC) is low NO EFFECT on arteriovenous concentration
Kid with sickle cell anemiaCongestion in the spleen
Adult with sickle cell anemiaScarring, atrophy, fibrosis of the spleen
Pyruvate Kinase deficiencyLack of atp generation for RBC -> Water/K Loss -> Defectiverbc membrane -> Hemolysis -> Spleen cleaning of damaged RBC with Redpulp -> Redpulp Hyperplasia
Nose picking leads to bleeding fromAnterior Nasal Septum
Meckel DiverticulumFailed obliteration of the vitelline omphalomesentric duct -> pt presents with dark red blood in tissue paper & Tc pertechnetate shows focal radiotracer accumulation in the right lower quadrant "Ileal outgrowth"
Hyperacute rejectionMottling & cyanotic kidney in the surgery by surgeon -> Due to Anitbody mediated hypersensitivity
Adequate Hydration, Dosage adjustment, IV infusion slowAcyclovir
Smoker with lung mass having weight gain, easy bruising, hyperpigmentation, peptic ulcer diseaseACTH by small cell
Graves disease proptosisInflammatory infiltration can be treated with glcuocorticoids
Cardiac Output(Rate of O2 consumption/Atriovenous 02 content difference)
CapitationDr provides service for employees for a company for a fixed monthly rate. Incentive for the provider and patient to reduce expenses by restriciting from going to other drs and avoid un-wanted tests and expenses
Primary Central Nervous Lymphoma VS Aids associated T cell lymphomaB VS T cells
Finasteride5-alpha reductase inhibitors -> Reduce prostate gland size
Auer rods for AML stain forMyeloperoxidase
CML stain forPlatelet derived growth factor
Bacteria fail to decolorize when treated with anline aka carbofuschin dyeMycobacteria-> mycolic acid
Paracortex of lymph nodeT cells
Meduala of lymph nodeLymphocytes, Plasma cells, macrophages
Cortex-Follicle-Germical centerB cells
Most common extracrnial childhood tumor, Non rythmatic eye movements in various directions Seizures, hypotonia, abdominal mass, dumbbell tumorNeuroblastoma -> Develops from adrenals -> Increased N-myc copies
Wilms tumorsNephoblastoma 2-4 yrs old, palpable flank mass while bathing the child
Cystostomy(A procedure to remove urine from bladder with a tube)Need to go through Anterior Abdominal Aponeuresis , Superfical fascia, transversalis fascia and extraperitoneal fat
Zinc fingerMade of cysteine & histidine -> Thyroid, coritsol, estrogen, aldosterone, steroids Fat soluble
Burnt Sugar smell urine in diaperMaple syrup urine disease -> Buildup of Isoleucine, Valine, Leucine -> Lack of a-ketoacid dehydrogenase -> Vit B1 Thiamine, Lipoate, Coenzyme A, FAD, NAD helps improve symptoms -> Tender Loving Care For Nancy
Decrease alveolar resistance is usually atEnd of normal expiration
Aspirin Toxicity AFTER 12HRSMixed Respiratory/Metabolic Acidosis -> Normal pH, low Bicarb and PCo2
Aspirin Toxicity BEFORE 12HRSRespiratory alkalosis -> High pH, low PCo2 & Bicarb
Lumbosacral radiculopathy -> Foraminal stenosis VS Herniated discL5 nerve compression VS S1 nerve compression
Foraminal stenosis -> L5 compressionBack pain radiates to leg,Decreased sensation of dorsum of the foot buttocks, lateral thigh & calf , postive straight leg test pain
Thoracocentesis - MidclavicularAbove 8th rib
Thoracocentesis - MidaxillaryAlong the 9th rib
Thoracocentesis - Posterior scapularAlong the 10-12th rib
Aortic Regurgitation sequeleIncreased in left ventricular end diastolic volume(preload) -> Eccentric hypertrophy means increase left chamber size -> Increased stroke volume causes better cardiac output
Cystic Fibrosis mother carrier and father affectedBaby has 33% or 1/3 of being affected
Iron is absorbed inDuodenum & proximal part of jejunum
LV pressure/volume curveA - Mitral closes B- Mitral opens C- Aortic closes D-Aortic opens
Nosocomical, silver stain, grows on chocolate agar, cysteine and ironLegionella Pneumonia -> Water system is where it is acquired from
DKA leads toTriglyceride breakdown in adipose tissue with the help of glycerol kinase


Question Answer
Proximal Lesser curvatureLeft Gastric
Distal Lesser curvatureRight Gastric
Proximal greater curvatureLeft gastroepiploic
Distal greater CurvatureRight gastroepiploic
Proximal grater curvature above the spleen or the fundusShort gastric
Proximal Part of duodenumGastroduodenal


Question Answer
Chi square test exampleSimvastatin therapy & No Simvastatin therapy with High or Normal fibrinogen 2X2 table
T testSimvastatin and amount of cholesterol in body
ANOVASimvastatin results among never exercise, exercise occasionally and exercise frequently
Meta AnalysisSeveral studies put together to make a big study