Uworld 1/10-1/18

Front 1

Girl w garlic odor breathe and ingestion of arsenic insecticides what do you give?

Back 1

dimercaprol: antidote for mercury, arsenic, gold poisoning...

Front 2

How does demercaprol work?

Back 2

chelating agent..displaces arsenic ions and excretes them

Front 3

Most common SE of demarcaprol?

Back 3

nephrotoxcitiy & hypertension

Front 4

Patient with Chron's comes w left-sided pain & kidney/urether stones... why?

Back 4

Chron's disease causes malabsorption bc the bile isn't being reabsorbed due to the inflammation of ileum- calcium is binding to the extra lipids and excreting out body, oxalate gets absorbed when alone to kidney etc.

Front 5

Patient comes in with secretory diarrhea, which GI hormone would you want somatostatin to inhibit the most?

Back 5

VIP..incr intestinal water/electrolyte secretion...relax muscle and sphincters..incr w vagus, and VIPOma over stimulation from pancreas= WDHA watery diarrhea, hypokalemia, and achlorhydria

Front 6

WDHA

Back 6

watery diarrhea, hypokalemia, achlorhydria
non-alpha/beta pancreatic islet cells

Front 7

Recent traverler to mexico, sigmoid scope reveals yellow-white membrane plauqes on colon...probably cause by?

Back 7

antibiotic treatment disruption normal flora but C. dificile survives by making spores...2 toxins release (A& B)
A; alter fluid secretion= watery diarrhea
B= epithelial cell necrois and fibrin --> psueodmem colitis

Front 8

treatment for C. dificile

Back 8

metronidiazole

Front 9

Pt w bloody diarrhea presenting w symptoms of a bacteria that inhibits protein synthesis is most like?

Back 9

shiga-like toxin...enterohemorrhagic E.coli and shigella dysneterie do this..they have AB toxin A and 5 part B toxins inhibit 60s.. and tRNA

Front 10

What are the characteristics of an HIV pt w Candid albicans ?

Back 10

Patches of adherent grey/white pseudomembranes on eryhtmatous mucosa- microscopic findings: yeast and pseudohyphae...

Front 11

HSV-1 w HIV?

Back 11

epithelial punched out lesions microscope shows eosinophils

Front 12

CMV w HSV-1?

Back 12

in the nuclei of endothelial cells & fibroblasts linear ulcerations

Front 13

infectious esophagitis causes?

Back 13

Candida>CMV>HSV-1

Front 14

Pneumocystic pneumotitis most likely associated with?

Back 14

HIV-AIDS infection

Front 15

Shigella has specificity for which cells?

Back 15

M cells in epithelium peye'rs patch in ileum by endocytosis...then gains access and spreads laterally

Front 16

Pt w difficulty swallowing food, has a mass, and tumor shows kertain pearls and nests?

Back 16

Esophageal SCC #1= alcohol/tobacco use

Front 17

Serum carcinoembryognic antigen is used to measure what in colon cancer?

Back 17

the recurrence of the tumor

Front 18

Why is the CEA not specific to colon cancer?

Back 18

used for pancreas, lungs & many benign lesions

Front 19

histology of lactase-deficient pt?

Back 19

normal intestinal histology

Front 20

Back 20

carcinoid tumor: even looking cells, most common tumor of appendix

Front 21

Treating hypothyroidism with T3 should do what to the following levels of TSH, T3, reverse t3, T4

Back 21

decrease TSH, incr T3, decr reverse t3, decr t4
(reverse t3 is an inactive form also released by t4)

Front 22

Hypersosmotic volume contraction occurs with?

Back 22

Diabetes insipidus: lose more water than electrolytes
can also happen w profuse sweating

Front 23

Anorexia nervosa girls w amonrrhea what do you expect to see w FSH, LH, and estradiol levels?

Back 23

all will be low!

Front 24

A patient with point mutation in neurphysin is most likely at risk for what?

Back 24

Diabetis insipidus

Front 25

What does neurophysin do?

Back 25

It's a carrier protein for vasopresin and oxycytnin- by the paraventricular nuclei, neurphysin II has binding for vassopresin if mutated can lead to DI

Front 26

Describe Barret's esophagus

Back 26

intestinal metaplasia of esophagial epithelium

Front 27

Barret's esophagus is mostly associate with what disease?

Back 27

GERD--> Barret's esophagus--> Esophageal adenocarcinoma

Front 28

What are esophageal leiyomas?

Back 28

MCC benign tumor in esophagus

Front 29

What does this indicate?

Back 29

Barret's esophagus...see goblet cell (arrow)

Front 30

What is it called when a drug allows another drug to exert its full effect?

Back 30

Permissiveness

Front 31

Main site of digestion of dietary lipids?

Back 31

Duodenum

Front 32

Main site of lipid absorption?

Back 32

jejunum

Front 33

What is the main difference with fatty meals if someone has undergone cholecystectomy?

Back 33

They have less recycling of the bile and no storage of it, therefore can not eat huge fatty meals at once

Front 34

Where is VIP made?

Back 34

Pancreatic islet cells & GI mucosa

Front 35

What does VIP do?

Back 35

causes loss of Cl- which causes secretory diarrhea (water/K follows), also decreases H+ secretion, & causes Gi relaxation

Front 36

Fistulas & strictures are common characteristics of what disease?

Back 36

Chron's disease

Front 37

What kind of sugar is D-xylose? And how is it digested?

Back 37

monosaccarhide- so can be digested by small intestinal brush border (doesn't need pancreatic enzymes to digest)

Front 38

What drug is used to treat a carcinoid tumor-assoc symptoms?

Back 38

Octreotide- somatostatin analog, will inhibit enteroendocrine hormones (VIP) causing diarrhea etc. given pre-op