Bocock Uworld Week 5.1

Front 1

Skin lesions on lower abdomen+buildup of ceramide trihexoside+IR of renal failure

Back 1

Fabry's disease

Front 2

What enzyme is lacking in Fabry's disease?

Back 2

alpha galactosidase A

note: get a buildup of ceramide hexoside

Front 3

MC lysosomal Dx presents w/ aseptic necrosis of the femur+ MACS that look like crumpled tissue paper

Back 3

gaucher's disease

note: deficient in glucocerebrosidase

Front 4

What enzyme is missing in gaucher's disease?

Back 4

glucocerebrosidase

note: get a buildup of glucocerebroside

Front 5

MC cause of morbidity and death in pts recovering from SAH?

Back 5

vasospasm

Front 6

What is given to prevent vasospasm in pts with SAH?

Back 6

nimodipine

Front 7

Associated with neutrophilic inflammation into renal interstitium and white cell casts in the urine?

Back 7

acute pyelonephritis

Front 8

Most likely cause of acute pyelonephritis?

Back 8

gram - rods that ascend from the bladder

Front 9

Female infant w/ ambiguous genitalia + mom with masculinization

Back 9

aromatase deficiency

Front 10

Enzyme that converts androstenedione to estrone...and testosterone to estradiol?

Back 10

aromatase

Front 11

Leads to estrogen excess w/ gynecomastia in boys and precocious puberty in girls?

Back 11

increased aromatase levels

Front 12

Leads to decreased production of DHT in male fetus & feminized external genitalia at birth w/ virilization at puberty?

Back 12

5 alpha reductase deficiency

Front 13

Increased estrogen in cirrhotic pt causes what physical findings?

Back 13

(1) gynecomastia
(2) testicular atrophy
(3) spider angiomas
(4) decreased body hair

Front 14

MC site of aortic rupture from a motor vehicle accident?

Back 14

aortic isthmus

note: distal to where the left subclavian artery branches off of the aorta

Front 15

Hepatomegaly+cardiomegaly+a decrease in lysosomal alpha 1,4 glucosidase

Back 15

pompe's disease

Front 16

What enzyme is deficient in pompe's disease?

Back 16

lysosomal alpha 1,4 glucosidase

Front 17

RX for CMV retinitis in AIDS pts?

Back 17

gangciclovir

Front 18

Rx of cornybacterium diptheriae in order of importance?

Back 18

(1) diptheria antitoxin (passive immunity)
(2) penicillin or erythromycin
(3)DPT vaccine

Front 19

Amino groups off AA are transferred to this molecule to form glutamate?

Back 19

alpha ketoglutarate

Front 20

Blanching of a vein w/ pallor surrounding the IV injection site of NE

Back 20

NE extravasation

Front 21

RX for NE extravasation?

Back 21

alpha 1 blockers-phentolamine

Front 22

What characteristic does a drug need to undergo hepatic metabolism and to not be excreted by the kidney( Non renal clearance)?

Back 22

drug must be hyperphilic

Front 23

This drug is an opiate that can be used as an antidiarrheal agent to slow gut motility

Back 23

diphenoxylate

Front 24

Causes a prolongation of the QT interval but does not predispose to torsades de pointes?

Back 24

amiodarone

Front 25

First line therapy RX high cholestrol?

Back 25

statins

Front 26

Main 2 SEs seen with the statins?

Back 26

liver damage and myopathy

Front 27

What is the mneumonic for obligate aerobes?

Back 27

"Nagging Pests Must Breathe"
(1) nocardia
(2) pseudomonas
(3)mycobacterium TB
(3) bacillus

Front 28

Encapsulated bacteria that asplenic pts cannot opsonize?

Back 28

"SHIN SKiS"
(1)strep pneumo
(2)H inlfuenza type b
(3) N. meningitidis
(4)salmonella
(5) klebsiella
(6) Group B strep

Front 29

Catalase positive orgs that cause trouble for CGD pts?

Back 29

you need SSPACE for your CATs"
(1) Staph aureus
(2)serratia
(3)pseudomonas
(4)actinomyces
(5)candida
(6)Ecoli

Front 30

Presents w/ gray vaginal discharge with a fishy smell?

Back 30

gardnerella vaginalis

Front 31

Vaginal epithelial cells covered with bacteria-associated with gardnerella vaginalis?

Back 31

clue cells

Front 32

Presents with a bull's eye rash leading to bells palsy, av nodal blockade, and polyarthritis?

Back 32

Lyme disease

note: caused by borrelia burgdorferi

Front 33

Binge eating, +/- purging, with normal body weight?

Back 33

bulimia nervosa

Front 34

Excessive dieting, +/- purging, leading to BW< 85% of ideal BW?

Back 34

anorexia nervosa

Front 35

Pt CONSCIOUSLY creates physical -psychological sxs in order to assume sick role and to get medical attention?

Back 35

factitious disorder

Front 36

Preoccupation w/ minor or imagined defect in appearance...pt often seeks cosmetic surgery?

Back 36

body dysmorphic disorder

Front 37

Preoccupation w/ and fear of having a serious illness despite medical evaluation and reassurance?

Back 37

hypochondriasis

Front 38

What substance is placed in whole blood & can cause hypocalcemia in transfused pts?

Back 38

citrate

Front 39

Which cytokines inhibit inflammation?

Back 39

IL 10 and TGF beta

Front 40

Characterized by being hypersensitive to rejection, socially inhibited, timid, feelings of inadequacy, but desires relationships w/ others?

Back 40

avoidant personality

Front 41

voluntary social withdrawal, limited emotional expression & content w social isolation?

Back 41

schizoid

Front 42

Disregard for & violation of rights of others?

Back 42

antisocial personality

Front 43

Type of transplant rejection that occurs in months to years and is associated with obliterative vascular fibrosis?

Back 43

chronic transplant rejection

Front 44

Type of transplant rejection that occurs in weeks & is associated w/ vasculitis of graft vessels w/ dense interstitial lymphocytic infiltrate?

Back 44

acute rejection

Front 45

This is when grafted BM cells attack the host as foreign ag?

Back 45

graft vs host disease

Front 46

presents w/ sharp pain, aggravated by inspiration, and is relieved by sitting up and leaning forward?

Back 46

acute pericarditis

Front 47

presents w/ a loud friction rub?

Back 47

fibrinous acute pericarditis

Front 48

MC viral cause of acute hemorrhagic cystitis in children?

Back 48

adenovirus

Front 49

What is the abnormal process that takes place in cystic fibrosis?

Back 49

abnormal posttranslational processing

note: the TM receptor is degraded in the cytosol

Front 50

Mutations in this HIV gene is responsible for resistance to HIV RTVIs and PIs?

Back 50

pol gene

Front 51

mutations in this HIV gene enable escape from host neutralizing abs?

Back 51

env gene

Front 52

Renal papillary necrosis is associated with what 4 conditions?

Back 52

(1) DM
(2) acute pyelonephritis
(3) chronic phenacetin use
(3) sickle cell anemia and trait

Front 53

Abrupt onset of gross hematuria in a pt w/ a FH of sickle cell disease?

Back 53

renal papillary necrosis

Front 54

First sx of alcohol withdrawal?

Back 54

tremulousness (tremors)

Front 55

Unilateral chest pain+hyperresonance+absent breath sounds+decreased tactile fremitus

Back 55

pneumothorax

Front 56

MCC of spontaneous pneumothorax?

Back 56

rupture of apical blebs

note: trachea deviates TOWARD affected lung

Front 57

Parvovirus B19 has tropism for what tissue?

Back 57

bone marrow

Front 58

Virus which is highly tropic for erythrocytes in the BM?

Back 58

parvovirus B19

Front 59

Appearance of "slapped cheeks"

Back 59

erythema infectiosum-fifth disease

Note: causes by parvovirus B19

Front 60

What can slow the development of hemochromatosis in women?

Back 60

loss of iron through menstruation and pregnancy

Front 61

Rx for hemachromatosis

Back 61

phlebotomy or deferoxamine

Front 62

Sheets of basohilic lymphocytes w/ interspersed macrophages?

Back 62

burkitt lymphoma

Front 63

Associated w/ a jaw lesion in the endemic form...& the pelvis or abdomen in the sporadic form?

Back 63

burkitt lymphoma

Front 64

name 4 conditions associated with EBV?

Back 64

(1)mononucleosis
(2)hodgkins
(3)Burkitt lymphoma
(4) nasopharyngeal carcinoma

Front 65

Serotonin metabolite detected in the urine?

Back 65

5hydroxyindoleacetic acid

Front 66

RT sided valvular disease + 5HIAA in the urine

Back 66

carnicoid syndrome

Front 67

rupture of bridging veins+ CRESCENT shaped hemorrhage on CT?

Back 67

subdural hematoma

Front 68

Rupture of an aneurysm+worst HA of my life+risk of vasospasm 2-3 days later

Back 68

SAH

Front 69

Rupture of middle meningeal artery+ lucid interval

Back 69

epidural hematoma

Front 70

Occurs in infants b/c of failure of the processes vaginalis to close?

Back 70

indrect hernias and hydroceles

Front 71

Protrusion of peritoneum through the inguinal triangle covered by external spermatic fascia?

Back 71

direct inguinal hernia

Front 72

Type of hernia that is medial to the inferios epigastric artery?

Back 72

direct inguinal hernia

Front 73

Type of hernia that is lateral to the inferior epigastric artery?

Back 73

indirect inguinal hernia

Front 74

Flat facies+excess skin of posterior neck+transverse palmar creases+duodenal atresia

Back 74

trisomy 21

Front 75

Older BP medicine that blocks the storage of both NE and serotonin INTO vesicles & therefore can cause depression?

Back 75

reserpine

Front 76

Drug that ihibits the conversion of tyrosine----> DOPA

Back 76

metyrosine

Front 77

Inhibits the release of NE from from vesicles at the nerve terminal?

Back 77

guanethidine

Front 78

Sxs are identical to PTSD except sxs last for only four weeks?

Back 78

acute stress disorder

Front 79

CO poisoning has what two effects on oxygen?

Back 79

(1) decreases the oxygen carrying capacity in the blood-SaO2
(2)LFT shifts the hb-O2 dissociation curve

Front 80

What is the mechanism of rheumatoid factor associated with RA?

Back 80

IgM that binds to the Fc portion of IgG

Front 81

Defect in hepatic excretion of conjugated bilirubin+black liver+dense pigment of EPI metabolites within lysosomes?

Back 81

dubin johnson syndrome

Front 82

Occurs when the transverse portion of the duodenum is entrapped between the SMA and the aorta...leading to sxs of partial bowel obstruction?

Back 82

SMS syndrome

Front 83

What can cause SMA syndrome?

Back 83

diminished mesenteric fat (wt loss)

Front 84

Retrperitoneal hematoma in a stable MVA pt is most likely associated with what structure?

Back 84

pancreas

Front 85

Its long half life allows for prolonged effects to supress withdrawal sxs in heroin addicts

Back 85

methadone

Front 86

Enzyme increased in Lesch Nyhan syndrome?

Back 86

PRPP amidotransferase

note: due to increased de novo purine synthesis

Front 87

Hormone that promotes milk production/lactation?

Back 87

prolactin

Front 88

Which hormones inhibit lactation during pregnancy?

Back 88

progesterone and estrogen

Front 89

Where in the gut are LIPIDS digested and absorbed?

Back 89

digested--->duodenum

absorbed--> jejunum