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q bank 2
uworld
| Question | Answer |
|---|---|
| Episiotomy- cuts between? | It is a posterior midline incision from vaginal opening to perineal body. it transects submocosal tissue. NOT RECTAL MUCOSA OR EXT, ANAL SPHINCTER |
| mesoderm derivatives? | Muscles, serosa, heart, lymphatics, internal genitalia, kidney ureters, spleen , connective tissue, adrenal cortex |
| SAD PUCKER? | Suprarenal, aorta, duodenum, pancreas, ureters , colon , esophagus, rectum |
| VHL GENE ASSOCIATED WITH? | chromosome 3 p (Von hippel-lindau) rare, AD, clear cell renal carcinomas, cerebellar hemangioblastoma, pheochromocytoma VHL INHIBITS HYPOXIA - INDUCIBLE FACTORS (OVEREXPRESSION OF VEGF/PDGF), SO ANGIOGENESIS |
| C-myc (burkitt lymphoma) and LDBCL? | Chromosome 8 |
| Neurofibromatosis type 1 | Chromosome 17 |
| Rb tumor___ retinoblastoma and osteosarcoma | chromosome 13 |
| WT-1 / wilms tumor | chromosome 11 |
| intracellular and extracellular organism immune response? | intracellular: cell-mediated (CD4 AND CD 8,cytotoxic t-cells, macrophages, cytokines) extracellular: humoral (b-cells and antibodies) and neutrophils |
| What are the intracellular bacteria types? | Obligate: Unable to generate ATP independent of host à Chlamydia, Rickettsia, Coxiella Facultative: Able to generate ATP independent of host à Mycobacterium, Listeria, Legionella, Yersinia, Neisseria, Salmonella, Brucella, Francisella |
| baby with recurrent sinusitis, otitis media and on antibiotic, has giardia, low IG for all types, dx? | X-linked agammaglobulinemia. mutation in Bruton tyrosine kinase so lack of development of mature b cells. lymph nodes lack germinal centers. |
| in obese person (BMI >30) use body weight lower than pt body weight. WHY? | for mainly narrow therapeutic drugs, drugs act on extracellular compartments so body clearance and volume of distribution are adjusted accordingly. the disproportionate amount of adipose tissue is not counted so hydrophillic drug dont enter adipose tissue |
| treatment for mild, moderate and severe hypoglycemia? | mild: oral glucose/ juice moderate: fast acting carbs, candy, sweetened juice severe: IV glucose/ (50% dextrose ampule) in medical setting. or IM glucagon (hepatic glycogenolysis and gluconeogenesis) , if both cant be done, give oral glucose stuff etc |
| sickle cell anemia? | point mutation of 6th codon in beta globulin, valine to glutamate forms HbS. |
| Esophagus and microorganisms? | Trypanosoma cruzi- mega colon, achalasia, cardiomyopathy HIV/ Immunocompromised- infectious esophagus candida albicans- exudative esophagus, concurrent oral thrush cytomegalovirus- ulcerative esophagitis, distal esophagus. |
| Perfusion limited and diffusion limited gas exchange difference? | Perfusion ltd: (its normal physio) equilibrium is maintained with N20, CO2, O2 Diffusion ltd: CO (bound to Hb none in blood) and O2 (in emphysema and fibrosis or high alt) equilibrium is not maintained. |
| menopause hormone elevation? | FSH!!! HYPOESTROGENIC SYMPTOMS FOLLOW |
| potter sequence causes? | mom may take Acei or ARBs during gestation causing lack of AT II so normal renal development is not occuring. |
| descending aorta lies? | posterior to esophagus and left atrium |
| COPD signs? | smoking hx, hyperinflated chest, SOB, flattened diaphragm and narrowed mediastinum. increased residual volume, |
| HCV and causes of hypervariable region with genetic mutation? | lack of proofreading from 3'-->5' exonuclease in RNA polymerase of envelope protiens. |
| most reliable indicator of mitral stenosis? | A2-OS interval |
| primary, secondary and miliary TB? | PRIMARY: lower lobe ipsilateral hilar lymph node, ghon focus-->ghon complex--> latent(secondary), resolved or progressive (miliary) SECONDARY: reactivation of previous tb in lungs MILIARY: Hematogenous spread to many organs |
| Why is it good to block PD-1 receptor? | This is done by monoclonal antibodies, like pembrolizumab and nivolumab (on t cells) or atezolizumab (cancer cells) this causes cytotoxic t-cell to BE ACTIVE and prevents t-cell exhaustion. |
| is it good or bad to show neoantigens? | Neoantigens are indicators of genetic mutations and are destroyed normally by cytotoxic t-cells, however cancer cells hide their neoantigens (decreased expression) . However, monoclonal antibodies are used to expose these antigens on cancer cells. GOOD. |
| HPV infects what type of cells ? | types 6 and 11. Stratified squamous epithelium(found in anal canal, vagina, cervix, true vocal cords) can be passed from mom to infant |
| stomach functions? what must be supplemented after gastrectomy? | reservoir for food (dumping syndrome after surgery), B-12 IF (supplemented), protiend digestion parietal and chief, |
| causes of acute pancreatitis? | gallstones and chronic alcohol (macrocytosis and ast>alt) alcohol causes spasms of sphincter of oddi and direct toxic effect on acinar cells. macrocytosis is due to folate def, liver toxicity or bone marrown toxicity |
| DNA-binding protein? | C-jun or c-fos (nuclear transcription factors) leucin zipper motif . oncogenes related. south western blotting. double stranded DNA used to detect histones, transcription factors, nucleases. |
| aspiration lying on back vs being upright? | posterior upper lobes and basilar lower lobes respectively. more likely to aspirate on the right (take a bite, goes down right) |
| Pathogenesis of Neisseria meningitidis? | nasopharynx> immune system/ blood> choroidal plexus>meninges |
| heparin antidote warfarin antidote | protamine sulfate for heparin (acute) ffp (immediate), vitk (time taking), prothrombin complex concentrates |
| turner down marfan and ehler danlos heart defects? | Bicuspid aortic valve ASD, VSD, complete AV canal mitral valve prolapse |
| diseases by non typeable and type B Hemophilus influenza? | non type: bacteremia, pneumonia, otitis media, epiglottitis b-type: MENINGITIS |
| Propranolol administered with epinephrine cause? | Since epinephrine is a1,a2,b,1,b2 mediator. Propranolol (non selective b blocker) will diminish Heart rate and a1 will soley increase DBP |
| Norepinephrine administered will cause? | Increase cAMP in cardiac muscle cells (B1)- used in septic shock. NE acts on a1,a2,b1 (vasocon, inc HR, dec insulin and GI motiliy) |
| Wolf Parkinson White syndrome? | Asymptomatic, delta wave AV node -caused by an accessory path called Bundle of Kent, associated with AVRT->palpitations early QRS and widened QRS |
| Short bowel syndrome? | multiple resections or extensive intestinal disease resulting in loss of absorptive area s vitamin deficiencies (B-12) with peripheral neuropathy, subacute combined degeneration, and macrocytic anemia. |
| How to correct met. Acidosis due to DKA? | IV INSULIN AND SALINE |
| Cluster headache ? | unilateral eye pain, sweating, flushing , pupillary changes |
| Heparin- Induced Thrombocytopenia 1 and 2? | HIT 1- mild thrombocytopenia, platelet clumping, heparin continued, HIT-2 - confromational change in platelet factor 4 so igG antibodies and splenic macrophages destroy these. happens 5-10 days after administering heparin. Switch to non-heparin anticoa |
| Opsonins? | IgG, C3b also mannose binding lectin and C-reactive protien |
| Pancreatice adenocarcinoma risk factors? | Age>65, SMOKING, chronic pancreatitis, genes signs_ wt loss, abdomen pain plus obstructive jaundice, migratory thrombophlebitis, hepatomegaly and ascites. |
Created by:
khulu
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