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UWorld 8

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yepugiga's version from 2016-07-07 15:16

Section

Question Answer
1. Choline -> CholineHemicholinium
2. Choline -> AcetylcholineBromoacetylcholine
3. Acetylcholine transportation into vesiclesVesamicol
4. Inhibition of acetylcholine vesicle into synapseBotulinum Toxin
5. Post synaptic receptor on the other end inhibited byAtropine for organophostate poisioning
6. Area between the synpases is where drugs such asOrganophosphates, Methacholine, carbachol (Cholineesterase Inhibitors-> Impaired break down of choline & Acetate)
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Question Answer Column 3
Pneumocystis JiroveciCD4 count less than 200TMP-SMX
Toxoplasma GondiiCD4 count less than 100TMP-SMX
Histoplasma CapsulatumCD 4 count less than 150Itraconazole
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Question Answer Column 3
Tight JunctionsClaudins, occludinGI Intestinal barrier
Adherens junctionsCadherins
DesmosomesCadherins(Desmogleins, desmoplakin)Oemohis vulgaris
HemidesmosomesIntegrinsBullous pemphigoid
Gap junctionsConnexinsHeart & Labor contractions
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Question Answer
Hypoglycemia, hypotonia, hepatosplenomegaly, ketoacidosis, hebatic fibrosis without fat accumulation, multiple branched polysaccharide with abnormal shorter outer chains within the cytosol of hepatocytesCori Disease-> Debranching Enzyme Deficiency(alpha1-6 or alpha1-4 deficiency)
Patellar Fracture -> Direct blow to the knee(Swollen Knee)Inability to extend the knee against the gravity
Lateral Rectus Abdomens muscle cut leads to damagingInferior Epigastric artery -> Bleeding complication
Bacillus AnthracisPathogenicity -> Anti-phagocytic D-GLUTAMATE capsule
Digoxin MOADecreased Sodium Efflux(Keep it inside) -> Increased intracellular calcium
Erythropoeisis-Stimulating agentsAre used in anemia pts with kidney disease or dialysis pts -> Sx - Increased risk of Hypertension or Thromboembolic events(stroke) Due to Increased blood viscosity & red cell mass
Hemoglobin two jobsCarry carbon dioxide to lungs and Oxygen to organs
To neutralize the acid content in your venous sideCarbonic anhyrdase shifts Cl to the venous side
Which area of nephron is normally impermeable to water(Most concentrated)Thick & Thin Ascending loop of Henle
Western Blot think ofmRNA Translation
Single amino acid substituition glutamine for arginineFactor V leiden mutation -> Leads to Hypercoagulabity -> DVT
Superficial Peroneal NerveSensory loss ONLY on the dorsum of the foot
Common peroneal NerveSensory loss of the dorsum of foot & lateral shin with evertion and foot droop
Aerobic exercise expect increase inCO2 content in the mixed venous blood
Tetralogy of Fallot, Systolic murmur with cyanosis getting better every time squattingEmbrological MOA -> Abnormal migration of neural crest cells leading to deviation of the infundibular septum
3 day history of headaches, intermittent blurring of vision on both eyes, stiffness in shoulders & Fatigue, Increased ESRGiant cell arteritis -> Polymyalgia Rheumatica -> InterLeukin-6 is linked with disease severity -> Tocilizumab
Antibodies for myeloperoxidase & proteinase 3C-ANCA, P-ANCA
PSGN Immunofluorecent Green & BlackC3b & IgG & IgM
RPGN Fibrin deposits Cresent Formation
Where do you see fibrinRPGN & Rheumatic fever valve leaflets
Primary Biliary Cirrhosis -> Liver biopsy extensive lymphocyte infiltration & granulamatous destruction of interlobular bile ductWomen with long history of pruritius worst at night, fatigue, with pale stool & dark urine(cholestasis) and xanthelsma(NO bile so acumulation of cholestrol), ADEK Malabsorption
Viral HepatitisMononuclear infiltration and balooning degneration and apoptosis Homeless man
Primary Sclerosing CholangitisDiffuseinflammation/fibrosis of the large intra and extra hepatic bile ducts onion skin fibrosis and obstruction of the small ducts Inflammatory bowel disease pts
Faty female fortyAcute cholecystitis(Gallstone)
Hypnotic,anxiolytic, muscle relaxant, and anticonvulsant USED IN INSOMNIABenzodiazepine -> Increased frequency of chloride channel opening
Henoch Schonlein Purpura( IgA Vasculitis) SxAbdominal pain, Bloody diarrhea GI , Bloody urine, RPGN Kidney , Purpura over buttocks Skin, Migratory Arthraglias Joint
Diabetic Ketoacidosis DOC insulinIV Regular insulin Lasts 5-8hrs Half life of 5 minutes peaks 2-4hrs -> 3 Times a day
Pt with AML immunocompromised comes with ulcers and multiple skin patches with occassional necrotic centers(Black spots - Ecthyma Gangrenosum)pSeudomonas -> Sepsis(Black lesions on skin)
Fatty streaks predominant cellsMacrophages
Epistaxis(Nosebleed), Eccyhmoses, Low platelets , High megakaryocytes & BTThrombocytopenia -> Idiopathic Thrombocytopenic prupura -> Immune destruction of platelets
VwfEpitaxis,easy bruising, with eccyhmoses Normal platelet count -> Dysfunction of platelet plug formation
Pt with post renal graft transplant immunocompromised, dysphagia, odonophagia, burning chest pain, fever, with linear shallow ulceration in the lower esophagusCMV Esophagitis common in transplant pts or HIV -> Histology shows Enlarged cells with intranuclear inclusions
pt with kidney transplant a yr ago presenting with meningitis and his CSF shows g+ rod with tumbling motility at room temperature and multiples in cold temperatureListeria Monocytogenes Meningitis -> Contaminated food
Pt intolerance of certain medication and presents with hemolytic anemia is due to G6PD which is an XR
Pt being aware of there own behavior being studiedHawthorne effect or Observer Bias
Choosing hospitalized pts has control groupBerkson bias(Selection bias)
Researcher thinks the outcome of the medication no matter what affects the outcomePygmalion effect
Chronic Cholelithiasss leads to a fistula between gall bladder and duodenum leading to stone passing till the ileum where it gets stuck in the ileocecal valveAir in the biliary tree and gall bladder with no jaundice, small bowel obstruction
Common bile duct obstructionDue to pancreatits and cholangitis, fever, right upper quadrant abdominal pain and jaundice NO SMALL bowel obstruction
Ehlers DanlosType 3 collagen -> Skin and joint hypermobility (Aortic rupture)
OsteogensisType 1 collagen -> Fragile bones(Derrick rose), blue sclera, hearing loss
marFanFibrillin (Large extracellular glycoprotein-> Microfibrils) -> Blood vessels, periosteum, ligaments, lens, aortic dissection(Cardiac arrest later)
Glucagon IM increasing glucagon through liver leads to cAMP activatesProtein Kinase A(TSH & PTH)
SupraopticADH
SuprachiamiticCircidan (Jet lag)
SarcoidosisTH1, IL-2, If-y Non-caseating granuloma
AV node whereBetween Coronary Sinus(Deoxygenated blood of the heart) & Interatrial Septum(septal leaflet of the tricuspid)
2 days old premature baby with cyanosis and tachypnea has decreased number of granules contain parallel stacks of membrane lamellae Type II surfactantNRDS -> Alveolar Atelactasis due to surfactant deficiency -> Increased tendency of lungs to collapse
Migrant ranch worker(Injury), painful paroxymal involuntary muscle contractions of jaw, neck and trunkClostridum Tetnaus -> Wound(Soil that contaminated injured tissue) -> Motor neuron axons -> Spinal Cord
Clostridum BotulismFood -> Systemic circulation -> Peripheral Nerves
Listeria Monocytogenes in neonates or ImunnocompromisedFood -> Systemic circulation -> Meninges
Meningiococcal PiliImportant bacterial attachment to epithelial surface -> Antibodies of the pili inhibit attachment of nasopharynx
Glossopharyngeal SensoryTympanic membrane, Upper pharynx, Posterior Tongue, tonsils,middle ear cavity
Glossopharyngeal reflexG a G
Glossopharyngeal MotorElevates Larynx while swallowing(Stylopharyngeus)
Glossopharyngeal GlandParotid
Boy presents with fever, fatigue, easy bruising, pallor, generalized lymphadenopathy, bone, tenderness, thrombocytopenia, leukocytosis, with atypical lymphoblasts is characteristic forALL
2nd line treatment for AnxietyBUSpirone & Do not get confused with Bupropion(TX depression)
1st line treatment for AnxietySSRI -> Citalopram
Pt with eye pain, blurred vision, 2 month history of weakness, increased mononuclear cells & oligoclonal bandingMultiple Sclerosis -> Destruction of Oligodendrocytes
Progressive difficulty walking, weakness and decreased muscle bulk of the lower extremities with diminished Patellar and Achilles tendon reflexesDemyelination of the corticospinal pathways(UMN)
Pt comes in asking for opiod drugs for pain because "Theyre the only medications that decrease my pain". What would you do?Determine which drugs have been prescribed for the patient in the past
Pt states "I know that i need to make some changes in how i live so that my heart can be healthier but i just dont have the willpower to quit smoking and drinking rightnow "Contemplation
18yr male hiding from intruders "from the other place." Has heard two male voices in his head for 2 weeks Dx?Brief Psychotic Disorder (Delusion & Hallucination) -> <1month stress related
Flesh-colored papules in the nasolabial folds accompanied by hypopigmented ash-leaf macules. MRI of brain shows subependymal nodulesTuberous Sclerosis
Pt unable to move right upper and lower extremities is significant forCorticospinal tract -> Ipsilateral CST damage(Below the pyrimidal decussation) / Contralateral CST damage(Above the pyrimidal decussation)
Unmotivated and pessimistic about the future, little energy for relationships or work. 2 yrs, No change in appetite or sleep, and able to continue to work. No suicidal thinking Dx?Dysthymic disorder
5-year-old boy with severe vomiting and increased sleepiness. Had flu-like illness she treated with aspirin. Prothrombin time is prolonged. Becomes comatose in hospital. Serum shows increased ammonia and lactate concentrations and increased transaminase activities. Cause of the patients coma?Reyes Syndrome -> Cerebral edema
12-year-old boy with 6 month history of difficulty walking and leg pain (Motor & Sensory Neuropathy). Mild atrophy of the lower extremities and hammer toes (Friedriech Ataxia-> Oligodenodrocytes demyelination) . High-stepping gait. Nerve biopsy will show?Charcot-Marie-Tooth disease -> Abnormal myelin sheaths
Mysthania GravisBinding of antibody to the acetycholine receptor
2-hour episode of loss of vision in his right eye 2 days ago. Underwent left femoral-popliteal bypass 3 months ago for peripheral vascular disease. Funduscopic exam shows cholesterol emboli. Cause is embolus in which arteriers?Right ophthalmic
18-year-old with anxiety and confusion for 6 hours. pulse 130/min, BP 180/110 Diaphoresis, pupillary dilation, and muscle weakness. Substance?Amphetamines
46-year-old with Retired professional boxer. Mask-like features, stooped posture, slow and rigid movements, shuffling gait, and resting tremor Which alterations in brain?Parkinson Disease -> Neuronal dopaminergic degeneration
56-year-old woman loss of pain and temperature sensation in both upper extremities and portion of her trunk from clavicles to just below the nipples Touch, vibratory sensation, and proprioception normal. Findings on MRI of head and spine?Syringomyelia -> Syrinx of the central region of the spinal cord from C-4 to T-5
6-week hx of sharp, stabbing pain on the left side of his face that occurs when he touches itTrigeminal V -> Rotundum
Flashing lights in her right visual field(photophobia), followed 20 minutes later by a unilateral throbbing headache accompanied by nausea and vomiting. occur around time of menses. Dx?Migraine
85yr woman is diagnosed with a fracture of the right femur and begins treatment with morphine. Three days later, her respirations are 6/min. Physical examination shows pinpoint pupils Her serum creatinine concentration is 1.8 mg/dL(Kidney function low) Which of the following best explains this patient's clinical deterioration after the initiation of morphine therapy?Morphine is metabolized to active metabolites that accumulate
Do weight bearing exercises for osteoporosisweight training, walking, hiking, jogging, climbing stairs, tennis, and dancing
Exercises that are not weight bearingswimming and bicycling
Greatest pre-disposing factor for decreased bone mineral density(Osteoporosis)Gender
40yo with gunshot wound to the abdomen. Develops ventricular fibrillation and dies 30 min later. Autopsy shows 3 L fresh blood in peritoneal cavity, liver and kidneys show centrilobular pallor and swelling of the hepatocytes and proximal convoluted epithelial cells(INFARCTION) Mechanism of renal findings?Decreased function of Na-K-ATPase
Vancomycin-resistant Mechanism of resistance?Substitution of d-lactate for d-alanine in peptidoglycan
18-month-old boy with lethargy for 3 hours due to prolonged fasting .Hepatomegaly. Serum: glucose, ketones, and carinitine decreased Urine ketones decreased, D-carboxylic acids present. Medium-chain triglycerides are administered daily for 6 months, which helps. Deficiency of which enzymes is cause?Long-chain acyl-CoA dehydrogenase
Genetic analysis shows null mutations in a gene for a protein that controls the traffic of vesicles into the Golgi complex Electron microscopy of cells will show?Dilated rough endoplasmic reticulum
Atrophy of muscle is a form ofpolyubiquitination ->Degradation of protein through proteases
After incubation of a nonencapsulated strain of S. pneumoniae with the lysate from heat-killed S. mitis, colonies of S. pneumoniae expressing the new capsular type are identified Mechanism causing transfer of genes encoding new capsular type?Transformation
Cystic FibrosisDefect in CFTR Protein Structure
Poliovirus mRNA lacks a 5' m7G cap but is translated by cellular ribosomes due toPresence of an internal ribosome entry site
Gs subunit of the tumor G proteins lack GTPase activity. The tumor cells most likely have an increased activity of which enzyme?Adenlyl cyclase
Gq subunit would have an increased activity ofPhospholipase C
Gi subunit would have decreased activity ofAdenylate cyclase & Phospholipase C
p53 & RB mutation leads toImpaired regulation of apoptosis -> G1 to S
Pt with persistent truncus arterosus & VSD is due to abscese ofEctodermal neural crest cells during development (Aorticopulmonary Septum)
Mitral area Systolic MumurMitral Regurgitation holosystolic high pitched blowing murmur loudest at apex and radiates to axilla
Mitral Areal Diastolic murmurMitral stenosis rumbling diastolic murmur heard best 2 cm left of the sternal border at the fourth left intercostal space
Indomethacin ends PDA MOAIs an NSAID that is a inhibits Cyclooxygenase
PDA Kept open with prostaglandins in conditions such asTransposition of Arteries
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