UWorld_3.20

Question 1

Antifungal that inhibits fungal cell wall synthesis

Answer 1

• Capsofungin
• inhibits synthesis of cell wall polysaccharide glucan

Question 2

HbA =

HbF =

Gower =

Answer 2

• A = alpha2-beta2
• F = alpha2-gamma2
• gower = zeta2-epilson2
  
  • @ embryonic sac, before liver produces HbF

Question 3

Phenytoin SE/toxicity

Answer 3

1. CNS effects ==> cerebeller defects/ataxia
2. gingival hyperplasia
   
   1. pheny ==> increased PDGF ==> stimulated macs to proliferate gingiva and alveolar bone
3. coarsening of facial features, hirstruism
4. interferes w/folic acid metabolism ==> megaloblastic anemia
5. induces P450
6. teratogen ==> fetal hydantoin syndrome

Question 4

Common bacteria found in alcoholics with pneumonia + tx?

Answer 4

• anaeorobic = bacteriodes, prevotella, fusobacterium + aerobic
• ==> abcesses and necrotizing infections
• clindamycin = covers anaerobes and gram positive (e.g s. pneumo)

Question 5

Benzodiazepine: duration of actions

Triazolam

Lorazepam

Diazepam

Flurazepam

Chlordiazepoxide

Answer 5

• T = short
• Lor = intermediate
• diaz = long
• flur = long
• chlor = long

Question 6

Common CNS-releated complication in premature neonates

Answer 6

• intraventricular hemorrhage @ germinal matrix ==> ventricular system
• ==> neurodevelopmenal impairment
• higher risk with earlier born and lower weight

Question 7

Secretin @ pancreas

Answer 7

bicarbonate secretion

Question 8

Maternal rubella ==> problems @ mom? problems @ baby?

Answer 8

• mom = head/neck rash ==> extremities + postauricular/occiital lymphadenopathy + polyarthritis/arthralgia
• fetal infection ==> sensorneural deafness, cataracts, cardiac malform (PDA)

Question 9

Folate vs. Vit B12 megaloblastic anemia

Answer 9

• homocysteine elevated in both
  
  • cobalamin (vit B12) and methyl tetrahydrofolate (folic acid) used to convert homocystein to methionine
• methylmalonyl CoA elevated ONLY in B12
• neurodegen in ONLY B12

Question 10

Major virulence factor of S. pyogens

Answer 10

M protein ==I phagocytosis and complement activated

Question 11

High levels of fructose-2,6-bisphosphate ==>

Answer 11

• induces glycolysis by inducing PFK-1
• inhibits gluconeogenesis

Question 12

Phenelzine: drug class, use, other similar drugs

Answer 12

• MAOIs
• Atypical depression = mood reactivity (to positive events), leaden fatigue, rejection sensitivity, increased sleep and apetite
• others
  
  • tranylcypromine

Question 13

Rare, serious side effect of ACE-i

Answer 13

• angioedema = face, lips, tonuge, eyelids, larygneal edema ==> difficulty breathing
• most likely due to elevated bradykinin levels

Question 14

SE: Orange/red body fluids ==> drug + MOA?

Answer 14

• Rifampin
• ihibits DNA-dependent RNA synthesis (bacterial RNA pol)

Question 15

Acute TB tx

Answer 15

• isoniazid
• pyrazinamide
• ethambutol and/or streptomycin

Question 16

Mechanism of PAH

Answer 16

• two-hit hypothesis
• abnormal BMPR2 gene = first insult; predisposes to pulmonary vasc disease
• second insult ==> disease process = vascular smooth musle proliferation ==> elevated pulm pressure

Question 17

Reticulotcyte appearance on staining

Answer 17

• immature RBC
• larger than RBC
• bluish <== residual ribosomal RNA

Question 18

Urticaria ==> histo findings?

Answer 18

dermal edema

Question 19

obturator n. = course + innervation

Answer 19

• only major n. through obturator foramen
• innervates adductor m. of thigh
• may be injured during pelvic surgery (e.g. lymph node dissection)