3/28 - UW 28

Question 1

What Brodmann’s areas are 4 and 6?

Answer 1

Premotor and motor cortices

Question 2

What is the order of structures through which 1st order corticospinal (pyramindal) tracts travel through?

Answer 2

Premotor, motor cortex, internal capsule, midbrain, pons, decussate in the medulla, anterior horn

Question 3

What is the most common cause of post-duodenal small bowel atresia?

Answer 3

In utero vascular accidents

Question 4

In an infant with post-duodenal atresia, what etiology is indicated by a spiraling “apple peel” or “Christmas tree” deformity in the terminal ileum distal to the atresia?

Answer 4

SMA occlusion in utero, leading to blind-ending at the proximal jejunum

Question 5

What disease is caused by a failure of neural crest cells to migrate to the intestinal wall?

Answer 5

Hirschsprung disease, where the submucosal and myenteric plexi do not develop. Presents as intestinal obstruction with failure to pass stool.

Question 6

What congenital GI malformation is due to a failure of recanalization?

Answer 6

Duodenal atresia

Question 7

What are the basal, long acting insulins?

Answer 7

BID: NPH
QD: Glargine, Detemir

Question 8

What are the postprandial, short acting insulins?

Answer 8

IV: Regular insulin (takes 2-4 hours to work)

Post-prandial: Lispro, Aspart, Glulisine

Question 9

What are the two components of MHC I molecules?

Answer 9

Heavy chain

B2 microglobulin

Question 10

What are the two components of MHC II molecules?

Answer 10

Alpha and beta polypeptide chains

Question 11

What is conus medullaris syndrome?

Answer 11

Lesions at L2: flaccid paralysis of bladder and rectum, impotence, saddle (S3-5) anesthesia

Question 12

What are some causes of conus medullaris syndrome?

Answer 12

DIsk herniation, tumors, spinal fractures

Question 13

What is cauda equina syndrome?

Answer 13

Compression of 2+ of its 18 spinal nerve roots

Question 14

What causes cauda equina syndrome?

Answer 14

Typically from a massive rupture of an intervertebral disk, but can be from any trauma or space occupying lesion

Question 15

What is the main cause of death with PCP?

Answer 15

Trauma due to violent behavior

Question 16

Trendelenburg gait is due to injury to what nerve or muscle?

Answer 16

Nerve: superior gluteal
Muscle: gluteus medius

Question 17

What is the Alveolar gas equation at sea level?

Answer 17

PAO2 = 150 - (PaCO2/0.8)

Question 18

What two factors are important for osteoclast differentiation? What cells release it?

Answer 18

M-CSF and RANK-L from osteoblasts

Question 19

What is a Tzanck smear used for?

Answer 19

HSV or VZV dx by scraping epithelial cells from the base of a vesiculoulcerative lesion

Question 20

What process does EBV stimulate in B cells?

Answer 20

After infection of B cells, EBV stimulates “transformation” or “immortalization” where they proliferate continuously

Question 21

“-cyclovir/-ciclovir” drugs are what analogs? What do they need to be active?

Answer 21

NucleoSide analogs, requiring phosphorylation by VIRAL kinases, then another phosphorylation by CELLULAR kinases

Question 22

“-fovir” drugs are what analogs? When might they be used over “-cyclovir” drugs?

Answer 22

Nucleotide analogs, used when the virals lacks thymidine kinase (required to activate nucleoside analogs like cyclovir drugs)

Question 23

What are the only two vitamins that are NOT adequate from breast milk?

Answer 23

D and K

Question 24

How are vit D and vit K supplemented to infants? Which infants need this?

Answer 24

Exclusively breast fed infants need vit D and vit K.
Vit K is give IM at delivery to prevent hemorrhagic disease.
Vit D is given as an oral supplement.

Question 25

Why shouldn’t E. granulosus hydatid cysts be aspirated?

Answer 25

Anaphylactic shock! Really really quickly

Question 26

What is the preferred tx for narcolepsy?

Answer 26

Psychostimulants like Medafinil (non-amphetamine stimulant)

Question 27

What diseases cause combined restrictive and obstructive lung defects?

Answer 27

CF, bronchiectasis

Question 28

Why would you see an increase in diffusing capacity with asthma?

Answer 28

Increased pulmonary blood volume

Question 29

Congenital prolonged QT (Jervell and Lange-Nielsen syndrome) is associated with what other sx?

Answer 29

Congenital neurosensory deafness

Question 30

Triad of Kartagener’s?

Answer 30

Bronchiectasis, infertility, situs inversus

Question 31

What are the 3 mutations in the “adenoma to carcinoma” sequence?

Answer 31

Normal mucosa to small polyp: APC
Increased size of polyp: K-ras
Malignant transformation: p53 and DCC

Question 32

Increase of N-myc oncogene leads to what neoplasm?

Answer 32

Neuroblastoma

Question 33

What are Cushing ulcers?

Answer 33

Ulcers in the esophagus, stomach, duodenum in patients with high intracranial pressure

Question 34

What are Curling ulcers?

Answer 34

Ulcers in the proximal duodenum associated with severe trauma or burns

Question 35

What is the common etiology of antral gastritis? non-antral?

Answer 35

Antral: H. pylori (elevated risk of duodenal ulcers)

Non-antral: autoimmune (destruction of parietal cells, may get pernicious anemia)

Question 36

What is seen on small intestine biopsy in Celiac patients?

Answer 36

Villous blunting, chronic inflammatory infiltration of lamina propria

Question 37

What are the two factors that drive angiogenesis?

Answer 37

VEGF and FGF

Question 38

What is the most common cause of death in CF patients in the US?

Answer 38

Cardiorespiratory complications