0527

Question 1

what is required to happen before hCG appears in maternal serum?

Answer 1

successful implantation, usually on day 6 after ovulation (hCG detected 8-11 days after ovulation)

Question 2

which antimycobacterial drug is not active against extracellular mycobacteria, including those in necrotic foci and tissue cavities?

Answer 2

pyrazinamide (requires acidic environment of macrophage phagolysosomes to be active)

Question 3

another name for lecithin…

Answer 3

phosphatidylcholine.

as in LECITHIN/sphingomyelin ratio measured to determine fetal lung maturity.

Question 4

major constituents of surfactant

Answer 4

1. dipalmitoyl phosphatidylcholine (lecithin).

2. phosphatidylglycerol.

Question 5

paroxysmal supraventricular tachycardia

Answer 5

heart palpitations.
tachycardic with regular rhythm.

relieved by vagal stimulation: carotid massage or Valsalva maneuver.

Question 6

fixed wide split

Answer 6

ASD

Question 7

what substances drive angiogenesis?

Answer 7

1. VEGF.

2. FGF.

Question 8

clozapine SE

Answer 8

atypical antipsychotic.
causes agranulocytosis
(and seizures).

Question 9

cryoglobulinemia

Answer 9

serum proteins that precipitate in cold.
contain Immunoglobulin.
assoc with HCV.

Question 10

EBV is an oncogenic virus that promotes production of…?

Answer 10

polyclonal B cells

and heterophil Abs

Question 11

what causes altered mental status in hepatic encephalopathy?

Answer 11

INCREASED activity of GABA system

Question 12

slow acetylators metabolize which drugs slowly?

Answer 12

isoniazid.
dapsone.
hydralazine.
procainamide.

all these will accumulate.

Question 13

lipofuscin results from?

Answer 13

free radical injury

and lipid peroxidation

Question 14

where is lipofuscin commonly found?

Answer 14

heart and liver of aging or cachectic/malnourished pts

Question 15

why is nifedipine useful for hypertensive pts with bradycardia?

Answer 15

it causes peripheral vasodilation while possibly leading to reflex tachycardia

Question 16

Kussmaul’s sign

Answer 16

paradoxical rise in height of JVP during inspiration.

due to increase in venous return that occurs with inspiration while right heart filling is restricted- seen with chronic constrictive pericarditis.

(normally JVP decreases with inspiration)

Question 17

nitrates primary action

Answer 17

VENOdilation- decrease cardiac work by decreasing LV filling volume (preload)

Question 18

elastic recoil limits what?

Answer 18

the max volume that can be expired… chest wall resists too much inward deformation during max expiration

Question 19

increased recoil means resp mm. have to…?

Answer 19

work harder during expiration to oppose the increased outward recoil that causes decreased expiratory flow rates

Question 20

reflex symp activation due to arterial dilators results in?

Answer 20

increased HR.
increased contractility.
increased renin (sodium and fluid retention).

Question 21

morphine tolerance

Answer 21

mediated by stimulatory glutamate at NMDA receptors.

reduce with ketamine or dextromethorphan admin.

Question 22

what is the only IV agent that decreases blood pressure while also improving renal blood flow?

Answer 22

fenoldopam- decreases syst vasc resistance via arteriolar dilation and natriuresis. improves renal perfusion.

Question 23

cofactor for transamination rxn

Answer 23

pyridoxal phosphate (B6)

*also important in DEcarboxylation rxns

Question 24

cofactor for carboxylation rxn

Answer 24

biotin

Question 25

skin/mucosal telangiectasias + recurrent nosebleeds =

Answer 25

Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia) rupture of telangiectasias may cause epistaxis, bleeding.

Question 26

familial retinoblastoma most likely to develop what secondary tumor?

Answer 26

osteosarcoma

Question 27

psammoma bodies in CNS

Answer 27

meningioma

Question 28

complications of prematurity

Answer 28

1. resp distress syndrome. 2. PDA. 3. bronchopulmonary dysplasia. 4. intraventricular hemorrhage. 5. necrotizing enterocolitis. 6. retinopathy of prematurity.

Question 29

congenital hypothyroidism

Answer 29

``` pale dry skin. myxedema. macroglossia (BIG TONGUE). UMBILICAL HERNIA. coarse facial features. increased cong heart defects. jaundice. poor feeding. constipation. muscle hypotonia. hoarse cry. ```

Question 30

T4 in infants is important for?

Answer 30

normal brain development and myelination

Question 31

most common mets TO brain

Answer 31

1. lung cancer. 2. breast cancer. 3. melanoma.

Question 32

lac operon regulated by...

Answer 32

1. negatively by repressor protein binding to operator locus. 2. positively by cAMP-CAP binding upstream from promoter region (glucose blocks this by decreasing cAMP).

Question 33

S3

Answer 33

imbalance between force with which bld is pushed into ventricle and ability of ventricle to accommodate this blood. assoc with: 1. forceful rapid filling of ventricle that has normal or elevated compliance. 2. normal or even decreased filling rates when vent compliance is low. 3. bld flowing into an overfilled ventricle with high ESV.

Question 34

O2 content of blood

Answer 34

amt dissolved in arterial bld (not that much) PLUS amt bound to Hb. depends on: 1. Hb concentration. 2. SaO2. 3. PaO2.

Question 35

akathisia

Answer 35

inner restlessness and inability to sit or stand in one position. often a complication of anti-psychotic tx.

Question 36

incomplete obliteration of processus vaginalias results in...

Answer 36

persistent connection between scrotum and peritoneal cavity: 1. hydrocele: small opening that only allows for fluid to leak through. 2. indirect inguinal hernia: larger opening that allows abd organs to protrude.

Question 37

complement is mainly produced in?

Answer 37

liver

Question 38

1. hemolytic anemia. 2. hypercoag state. 3. decreased blood counts.

Answer 38

suspect: paroxysmal nocturnal hemoglobinuria. without CD55 and 59, complement stays activated.

Question 39

CD55 and CD59 deficiency is diagnostic of?

Answer 39

paroxysmal nocturnal hemoglobinuria- unable to inactivate complement

Question 40

common SE of all nitrates

Answer 40

headaches and cutaneous flushing (vasodilation in meninges and skin)