3/25 - UW 24

Question 1

In what circumstances is 2,3-BPG production increased?

Answer 1

In hypoxic conditions, e.g. chronic lung disease, heart failure, and high altitudes

Question 2

Reye syndrome hepatolopathy shows what on light microscopy?

Answer 2

Microvesicular steatosis, NOT necrosis or inflammation

Question 3

What is the clinical presentation of Reye syndrome?

Answer 3

Vomiting and hepatomegaly, rarely see jaundice. Elevated ALT, AST, ammonia, bili, PT and PTT

Question 4

What light microscopy findings will you see in viral hepatitis?

Answer 4

Hepatocyte apoptosis, acinar necrosis, periportal mononuclear inflammatory infiltration

Question 5

Mitochondrial defects tend to cause what sequelae?

Answer 5

Lactic acidosis, and defects in tissues with high metabolic rates, e.g. neural and muscular tissue

Question 6

HIV+ mothers should be prophylaxed with what?

Answer 6

Nucleoside analog, Zidovudine (retroviral reverse transcriptase inhibitor)

Question 7

When should reverse transcriptase inhibitor (Zidovudine) prophylaxis be started in an HIV+ pregnant woman?

Answer 7

14 wks gestation, continued throughout labor, with IV ZDV during labor, and oral ZDV to the infant for 6 wks.

Question 8

Presence of multinucleated giant cells (Aschoff cells) in myocardium points to what pathology?

Answer 8

Acute rheumatic carditis

Question 9

NFT-1 is a tumor of what cells?

Answer 9

Schwann cells

Question 10

What embryological cell type produces Schwann cells (neoplasms of which are neurofibromas, e.g. NFT-1)?

Answer 10

Neural crest cells

Question 11

What are two common sites of ulnar nerve injury?

Answer 11

Posterior to the medial epicondyle, and between the hook of the hamate and the pisiform bone

Question 12

What enzyme is deficient in Cori disease?

Answer 12

Debranching enzyme

Question 13

How does Cori disease present?

Answer 13

Hypoglycemia, hypertriglyceridemia, ketoacidosis, hepatomegaly

Question 14

Of all the mediators of allergic asthma, what are the two that have pharmacologic roles?

Answer 14

Leukotrienes, ACh

Question 15

At what level does hypertriglyceridemia start to cause pancreatic acinar cell injury? How?

Answer 15

> 1000 mg/dL

By direct cytotoxicity

Question 16

What are some drugs that can cause acute pancreatitis?

Answer 16

Azathioprine
Sulfasalazine
Furosemide
Valproic acid

Question 17

What are some infections that cause acute pancreatitis?

Answer 17

Mumps
Coxsackie virus
Mycoplasma pneumoniae

Question 18

What are the two most common causes of acute pancreatitis?

Answer 18

Alcohol and stones

Question 19

What signaling pathway does GH use to activate IGF-1 release from the liver?

Answer 19

JAK-STAT

Question 20

What clotting factors are missing in hemophilia A and B?

Answer 20

Hemophilia A: factor VIII

Hemophilia B: factor IX

Question 21

What is urokinase? MOA?

Answer 21

Thrombolytic agent used for MI and PE

MOA: Converts plasminogen to plasmin (which degrades fibrinogen and fibrin)

Question 22

Deficiency in fructokinase causes what benign condition?

Answer 22

Essential fructosuria

Question 23

Which neoplasm is associated with tumors of the “3Ps”?

Answer 23

MEN 1: anterior Pituitary, Parathyroids, Pancreas

Question 24

What vessels does nitroglycerin work on?

Answer 24

Large veins

Question 25

How does nitroglycerin decrease angina?

Answer 25

Dilates large veins, decreasing preload, decreasing inotropy and cardiac oxygen demand

Question 26

anti-CCP ab confirms what dx?

Answer 26

RA

Question 27

What are the “4Cs” of measles?

Answer 27

Cough, coryza, conjunctivitis, Koplik spots

Question 28

DiGeorge originates from maldevelopment of what embryologic structures?

Answer 28

3rd and 4th pharyngeal pouches

Question 29

What DM medication increases endogenous insulin secretion?

Answer 29

Sulfonylureas (e.g. glyburide),

Question 30

What DM medications increase insulin sensitivity?

Answer 30

Metformin and rosiglitiazone

Question 31

What DM medication decreases intestinal glucose absorption?

Answer 31

Acarbose (alpha glucosidase inhibitors)

Question 32

What is the most common cause of Malignant Otitis Externa (MOE)?

Answer 32

Pseudomonas aeruginosa

Question 33

What is the best alternative to aspirin in prevention of thromboembolic disease?

Answer 33

Clopidogrel

Question 34

Canagliflozin MOA?

Answer 34

DM med, SGLT2 inhibitors (Sodium-glucose cotransporter 2), leading to glucosuria

Question 35

What is D-xylose used for?

Answer 35

Monosaccharide, for testing small intestinal brush border absorptive function

Question 36

What is pituitary apoplexy and how is it treated?

Answer 36

Acute hemorrhage into the pituitary gland, often from preexisting pituitary adnenomas. Neurosurg consult and GLUCOCORTICOIDS are the tx

Question 37

What diuretic to give to reduce calciuria?

Answer 37

HCTZ

Question 38

Gottron papules and heliotrope rash with proximal muscle weakess are specific for what pathology?

Answer 38

Dermatomyositis

Question 39

What are Gottron papules?

Answer 39

Red or violaceous, flat topped papules with light colored scale appearing over bony prominences, particularly the MCP, PIP, and DIPs

Question 40

What is a heliotrope rash?

Answer 40

Erythematous or violaceous edematous eruption on the upper eyelids and periorbital skin

Question 41

What autoantibodies are seen with dermatomyositis?

Answer 41

Anti-Jo1 (specific), anti-ANA (non-specific)

Question 42

The ureteric bud gives rise to what renal structures?

Answer 42

Everything from the collecting tubules to the ureters.

Question 43

The metanephric mesoderm (blastema) gives rise to what renal structures?

Answer 43

Glomeruli to DCT