3RD UWORLD SET QUESTIONS AND ANSWERS 100%

24 year old patient come in with purulent arthritis of the knee, oligoarticular joint pain, and few vesicle/pustular lesions on her extremities. What is it? - ANSWERS-neisseria GONORRHEA can cause polyarthralgia, dermatitis, and tenosynovitis especially in young sexually active ppl septic arthritis common with this in young sexually active adults .ABG on advanced CKD? - ANSWERS-advanced is like creatinine above 3 ANION gap metabolic acidosis .Acute tubular necrosis with vacuolar degeneration and ballooning of proximal tubular cells? Oxalate crystals are seen. - ANSWERS-ethylene glycol intoxication .All patients with etanercept need to be tested for what? - ANSWERS-TB cuz its a decoy TNFa receptor thing -> can sequester TB in macrophages if its there .Anatomical landmark for doing lumbar puncture? - ANSWERS-iliac CREST -> highest points of iliac crest are at L4 vertebral body .CH50 and AH50 in MAC deficiency? - ANSWERS-LOW for both CH -> this is for CLASSICAL (even if it says complete) cuz both lead to MAC .Complications of EPO-stimulating agents? - ANSWERS-patients can develop HYPERTENSION and increased thromboembolic events or CLOTS .Describe CF diagnosis stuff? - ANSWERS-more sodium REABSORPTION for nasal transepithelial potential difference -> leads to CF diagnosis (more negative) nasal transepithelial potential difference -> cl cant go out (cuz CFTR is malfolded), so sodium (with water) come BACK INTO THE EPITHELIUM (this is abnormal, seen in CF) this leaves the lumen more NEGATIVE in skin -> CFTR is reversed. It absorbs Cl. So can't absorb, NaCl builds up and can be detected on sweat .Dude has hypoglycemia, but no symptoms of hypoglycemia except hes hungry. What happened? - ANSWERS-a non-selective Beta blocker like propanolol was used remember, in low glucose -> NE/E is ramped up (this is what causes tachy, tremors, anxiety/aroual) and B-blockers will block this still hungry due to ACh effects -> ACh causes the sweating, hunger, and paresthesias (due to muscle activate) .Early after an MI, where does the pericarditis occur? - ANSWERS-its called peri-infarction pericarditis -> 2-4 days after just develops overlying the necrotic myocardial segment dressler's is diffuse autoimmune attack of the entire pericardium (weeks to months after an MI) .Histology of HSP? - ANSWERS-perivascular neutrophilic inflammation small vessels with FIBRINOID NECROSIS leukocytoclastic vasculitis (nuclear debris) this disease presents with palpable purpura, ARTHRALGIAS (JOINT PAIN), and KIDNEY involvement .How can rhabdo effect the kidney? - ANSWERS-causes ATN!!!!! the heme pigement injuries the kidneys -> ATN .How do class 1a antiaryhtmics work and what are they? - ANSWERS-block sodium channel (some can block K too -> prolong AP) these are procainamaide, quinidine .How do class 1b antiarryhtmics work and what are they? - ANSWERS-LIDOCAINE block sodium channel .How do class 1c antiarrythmics work and what are they? - ANSWERS-block sodium channel flecainide .How do class 3 antiaryythrmics work and what are they? - ANSWERS-they block POTASSIUM channel outflow these are like AMIODARONE, sotafol, dofetilide .How do interferon a and b work in stopping virus? - ANSWERS-they HALT protein synthesis only in the presence of DOUBLE-STRANDED RNA (which is typical of viruses, so normal cells are chillin) also induce MHC1 -> so NK and CD8 can kill .How does adenosine affect cardiac AP? - ANSWERS-activates POTASSIUM channel conductance -> increases potassium outflow AV node delay .How does azathioprine effect B and T cell levels? - ANSWERS-drops BOTH side effect is pancytopenia .How does etanercept work? - ANSWERS-"cept" basically acts as a decoy receptor -> binds to Fc of IgG, sucking TNFa to the decoy receptor and preventing normal TNFa action .How does Wilson's disease present? - ANSWERS-accumulation of COPPER -> low serum CERULOPLASMIN in young ppl, LIVER and NEURO/PSYCH symptoms diagnose with SLIT lamp (on eye) for Kayser-Fleischer rings .How fast does loss of cardiomyocyte contractility occur with total ischemia? - ANSWERS-literally 60 seconds or a MINUTE after 30 minutes -> injury is irreversible .How motile is pseudomonas? - ANSWERS-its hella MOTILE .How to calculate CO? - ANSWERS-Ficks rate of O2 CONSUMPTION/arteriovenous O2 content DIFF .How to know biologics mechanism? - ANSWERS-"mab" -> monoclonal antibody ""cept" -> receptor molecule decoy thing "nib" is a KINASE inhibitor (like tyrosine for example) .How to treat BPH? - ANSWERS-Finasteride!!!! or prazosin tamsulosin .How to treat drug-induced parkinsonism? - ANSWERS-benztropine ("tropine" like atropine) like due to haloperidol give BENZTROPINE -> antimuscarinic (it says "tropine" like atropine) .If during pregnancy, posterior vagina is lacerated, what is torn? - ANSWERS-PERINEAL BODY .Impaired MAC formation leads to susceptible to what? - ANSWERS-its ENCAPSULATED bacterias in general but yeah N meningitidis comes up a lot, but can also see pneumonia due to to strep .Intermittent muscle spams triggered by sensory stimuli? - ANSWERS-TETANUS .Just foodborne illness and person gets better? How? - ANSWERS-staph aureus -> dude just ate the heat-stable enterotoxin itself (preformed toxin) mayonnaise-based chicken salads, dairy products, anything its the performed toxin tho .Major HIP flexors? - ANSWERS-rectus femoris, iliopsoas, and SARTORIUS (just think cross-legged position for its functions) .Most common heart thing in woman after giving birth? - ANSWERS-DILATED cardiomyopathy -> reduced EF .needle-like cholesterol clefts? - ANSWERS-this is atheroembolic event, most likely after a coronary surg like cardiac angiography -> dislodges it KIDNEY INJURY IS COMMON .Nice big yellow/gray ball tumor thing seen in the endometrium? well circumscribed - ANSWERS-it is a FIBROID leiomyoma .Once invading lamina propria of enterocytes, describe diff in typhi vs salmonella enteriditis? - ANSWERS-enteriditis -> gets phagocytosed by neutrophils and macrophages -> hella inflammation and neutrophils response. This inflammatory respnose is what causes gastroeneteritis typhi -> has capsular Vi antigen -> inhibits neutrophils recruitment and evades phagocytosis. Also inhibits respiratory burst in macrophages, so itll keep replicating inside PHAGOCYTES -> can disseminate through lymph and reticuloendothelial system to cause typhoid fever .Other than ptosis or diplopia, what other symptoms can MG patients have? - ANSWERS-they can have BULBAR sysmptoms -> like dysphonia, can't chew, face can DROOP .RBF and GFR in neonates vs adults? - ANSWERS-RBF and GFR are LOWER in neonates than adults neonates also have MORE TOTAL BODY WATER .SBP and DBP and PP during aerobic exercise? - ANSWERS-SBP goes UP DBP either unchanged or even goes DOWN due to this, PP goes UPPPP .Side effects of protease inhibitors? - ANSWERS-1. buffalo hump appearnce with more fat on back/abdomen 2. HIGH GLUCOSE 3. inhibits cytochrome p450 .Strong risk factor for Afib? - ANSWERS-AGE also anything that DILATES the left atria -> atrial remodelling .Symptoms in Turner's? - ANSWERS-1. HIGH ARCHED PALATE 2. WIDE spaced nipples 3. 4th metcarpal is SHORT 4. hairline is LOW 5. congenital lymphedema causes 1. horseshoe kidney 2. bicuspid AV 3. aortic dissections 4. STREAK ovaries -> atrophic ovaries