16

Question 1

disseminated Histoplasmosis

Answer 1

HSM (with calcifications) and tongue lesions (often)

Lung nodules similar to TB

Question 2

complement fixation, immunodiffusion

Answer 2

serological tests to measure Abs

Question 3

young (otherwise healthy)
fatigue, progressive dyspnea, atypical chest pain, unexplained syncope.
leads to hypertrophy and/or dilation of right ventricle (cor pulmonale)
Look for thickened RV

Answer 3

PAH

Question 4

Birth defect study: women who had a baby with a birth defect are more likely to remember exposures than mothers who had a normal baby

Answer 4

Recall Bias

Question 5

Peyronie disease

Answer 5

excess collagen formation within tunica albuginea = pain and hook dick

Question 6

JAK2 Inhibitor approved for tx of primary myelofibrosis

Answer 6

Ruxolitinib

Question 7

Drugs that cause hypersensitivity myocarditis

Answer 7

diuretics (furosemide, HCTZ) and antibiotics (ampicillin, azithromycin)

Question 8

Alcohol fixed neutrophils…

Answer 8

think ANCA

Question 9

CD16 and CD56+
Do not require thymus for maturation and are present in athymic patients
Activated by INF-gamma and IL-12

Answer 9

NK cells

Question 10

SMA and IMA anastomosis

Answer 10

marginal artery (of Drummond)> mesenteric meandering artery (arc of Riolan)

Question 11

Vinyl chloride, arsenic or thorotrast exposure

Answer 11

hepatic angiosarcoma

Question 12

Results from failure of vitelline (or omphalomesenteric duct) to obliterate. Toddlers may have GI bleeding due to ectopic gastric mucosa

Answer 12

meckel diverticulum

Question 13

Well tolerated antirheumatic drug used in RA and SLE. ADR= irreversible retinopathy. Patients must have regular eye exams!

Answer 13

Hydroxychloroquine

Question 14

Tetracycline antibiotic with weak antirheumatic activity. ADR: photosensitivity

Answer 14

Minocycline

Question 15

Medical therapy Conn’s Syndrome

Answer 15

Aldosterone antagonist such as spironolactone or eplerenone

Question 16

SAH vasospasm

Answer 16

Autoregulation impairred. Do a Transcranial color doppler to see

Question 17

Most feared comp. of SAH

Answer 17

rebleed

Question 18

Proteasomes

Answer 18

degrade nuclear and cytoplasmic proteins

Question 19

Lysosomes

Answer 19

degrade cellular organelles and Extracellular proteins

Question 20

RNA interference (base pairing with complementary strands)

Answer 20

Posttranscriptional gene siliencing
Translation repressed (imperfect)
mRNA cleavage (perfect)
miRNA (mutations can cause cancers) and Si RNA (c-MYC therapy)

Question 21

Normal epithelium to early adenoma

Answer 21

APC mutation

Question 22

Early Adenoma–>Late (increase in size)

Answer 22

K-Ras Mutation (proto-onco) - uncontrolled cell proliferation

Question 23

Malignant transformation of adenoma in carcinoma

Answer 23

mutation of two genes required: DCC and p53 (anti-oncogene mutation)

Question 24

BRCA (anti-oncogene)

Answer 24

supresses cell cycle

Question 25

WT-1 (tumor suppressor/anti-onco)

Answer 25

Wilms tumor

Question 26

N-myc oncogene

Answer 26

Increased number of copies of gene (amplification) Neuroblastoma

Question 27

Colon cancer (diet that leads too)

Answer 27

high in cholesterol and carbs | low in fiber

Question 28

Protects fatty acids from oxidation

Answer 28

Vit. E

Question 29

Corneal softening

Answer 29

keratomalacia

Question 30

Abdominal pain diarrhea and nausea = acute | Chronic= calcium oxalate kidney stones

Answer 30

Vit. C overuse

Question 31

Acetylation (slow) of INH can have have toxic effects ---reduce dose

Answer 31

also actylate | Dapson, Hydralazine and procainamide

Question 32

Azathiprine and 6-MP biotransformation

Answer 32

methylation (fast and slow)

Question 33

Note:

Answer 33

Patients who take opioids on the reg...develop tolerance to respiratory depression very quickly Tolerance also developed to itching and N/V and i guess drowsiness

Question 34

When is aortic regurg heard best?

Answer 34

After closure of aortic valve (A2) along the left sternal boarder at the third and fourth intercostal spaces while the patient is sitting up and leaning forward with the breath held in end expiration

Question 35

Left shift in oxy-Hb curve

Answer 35

``` Lower P50 (partial pressure of O2 in blood at which Hb is 50% saturated)...Higher affinity saturates to 50% quicker thus lower P50 think left shift = lower P50 ```

Question 36

Very severe anemia, strenous workout would shift

Answer 36

curve to right

Question 37

DRESS SYNDROME DRUGS: fever, GAD, facial edema and diffuse morbilliform skin rash--> confluent erythema with follicular accentuation Labs: eosinophillia, atypical lymphocytes and elevated ALT

Answer 37

phenytoin and carbamazepine allopurinol Sulfonamides (sulfasalazine) Minocycline and vancomycin

Question 38

Essential for GBM diagnosis

Answer 38

Necrosis Common is prominent microvascular proliferation

Question 39

Neuritic process called a neuropil

Answer 39

Pathognomonic for neuroblastoma

Question 40

MYCN (N-MYC)

Answer 40

Chromosome 2 neuroblastoma NSE, chromogranin, synaptophysin and S-100 positive Elevated VMA and/or HVA

Question 41

Pulsion

Answer 41

pathogenesis of false diverticula (increased pressure) ex: in colon (strained bowel movements due to chronic constipation