4/2 - UW 41

Question 1

What is the first line treatment for benign essential tremor?

Answer 1

Primidone

Question 2

What are the metabolites of Primidone?

Answer 2

Phenobarbital and Phenylethylmalonamide

Question 3

What component of the dimeric, secretory IgA is not produced by plasma cells? What produces it?

Answer 3

The Secretory Piece is produced by epithelial cells

Question 4

In what form is IgA in the serum?

Answer 4

Monomer

Question 5

Which embryonic aortic arch derives the ductus arteriosus?

Answer 5

PDA = 6th aortic arch

Question 6

What are the derivatives of the third embryological aortic arch?

Answer 6

Common carotid, proximal internal carotid

Question 7

What are the derivatives of the fourth embryological aortic arch?

Answer 7

L: Aortic Arch
R: Proximal right subclavian artery

Question 8

What motion is the Obturator nerve responsible for?

Answer 8

Thigh adduction

Question 9

What motions is the Common Peroneal nerve responsible for?

Answer 9

Foot eversion, dorsiflexion, toe extension

Question 10

What joint pathology can be seen with Crohn’s disease?

Answer 10

Ankylosing spondylitis

Question 11

What is the most common area of the GI tract to be involved in Crohn’s disease?

Answer 11

Terminal ileum

Question 12

How does Crohn’s lead to increased oxalate kidney stones, B12 and folate deficiency, and gallstones?

Answer 12

Bile acids are normally reabsorbed in the terminal ileum, where Crohn’s affects most.

Loss of bile = gallstones
Poor fat absorption = lipids bind Ca, then excreted
Poor B12/folate absorption

Question 13

What percent of filtered Na is reabsorbed by the kidneys?

Answer 13

99%

Question 14

What percent of filtered urea is reabsorbed by the kidneys?

Answer 14

40-50%

Question 15

Where does the Inferior Mesenteric VEIN drain to?

Answer 15

IMV to Splenic V. to Portal Vein (of course! to go to the Liver!)

Question 16

What enteric organism requires very few cells to infect?

Answer 16

Shigella (as few as 10)

Question 17

Muscle tissue can be identified by staining for what?

Answer 17

actin, caldesmon, desmin

Question 18

What is the clinical presentation of Kallman syndrome?

Answer 18

Delayed puberty and anosmia (GnRH neurons fail to migrate from olfactory placode)

Question 19

Hilar lymphadenopathy with elevated ACE in African American female = ???

Answer 19

Sarcoidosis

Question 20

What is the most common liver biopsy finding in sarcoidosis?

Answer 20

Granulomas (portal triad area > lobular parenchyma)

Question 21

What are the most common causes of hepatic centrilobular necrosis?

Answer 21

(necrosis surrounding terminal hepatic vein)

R sided HF, drugs/toxins, fulminant hepatitis

Question 22

What causes periportal hepatic fibrosis?

Answer 22

Chronic viral hepatitis

Question 23

What is the most common treatment for agitation?

Answer 23

Haloperidol

Question 24

What drug is most commonly associated with Neuroleptic Malignant Syndrome (NMS)?

Answer 24

Haloperidol

Question 25

What are the 4 clinical features of Neuroleptic Malignant Syndrome (NMS)?

Answer 25

1. Hyperthermia
2. Muscle rigidity
3. Autonomic instability
4. Altered mental status

Question 26

How does Tardive dyskinesia present clinically?

Answer 26

Persistent lip smacking

Rhythmic tongue/chewing movements

Question 27

Ipratropium MOA?

Answer 27

Antimuscarinic, used for reversing vagally mediated bronchoconstriction in asthma

Question 28

Theophylline (and aminophylline) MOA?

Answer 28

Phosphodiesterase inhibitor, increasing cAMP and bronchial dilation

Question 29

What is Zileuton’s role in asthma therapy?

Answer 29

Prophylaxis (by inhibiting lipoxygenase pathway, reducing leukotriene production)

Question 30

What is WDHA syndrome and what causes it?

Answer 30

Watery Diarrhea, Hypokalemia, Achlorhydria (WHDA) caused by VIPoma

Question 31

What neurotransmitter modulates morphine tolerance?

Answer 31

Glutamate

Question 32

What is Ketamine used for? MOA?

Answer 32

Blocks morphine tolerance by blocking NMDA receptors, preventing glutamate from increasing tolerance.

Question 33

Aside from proximal muscle weakness, what other clinical presentations can occur with Lambert-Eaton (LEMS)?

Answer 33

Note: PROXIMAL muscle weakness

Cranial nerve involvement (esp oculobulbar): diplopia, ptosis, dysarthria, dysphagia
Autonomic: dry mouth, impotence
Malignancy: Small Cell Carcinoma of the lung (cause of LEMS)

Question 34

What molecules activate JAK-STAT pathway?

Answer 34

GH, Prolactin, IL-2, cytokines

Question 35

What is measured by the Ristocetin aggregation test?

Answer 35

vWF dependent platelet aggregation

Question 36

What are the 3 most common primary brain tumors in adults?

Answer 36

1. Glioblastoma multiforme (from astrocytes, cerebral, necrotic/hemorrhagic, poor prognosis)
2. Meningiomas (benign, attached to dura)
3. Acoustic neuromas (Schwannoma from Schwann cells of CN VIII, at cerebellopontine angle)

Question 37

How do Oligodendrogliomas appear? Glioblastoma multiforme?

Answer 37

Oligodendrogliomas are well circumscribed gray masses, with possible calcifications

Glioblastoma multiforme are soft, poorly defined, with areas of necrosis or hemorrhage

Question 38

What does prostacyclin do?

Answer 38

Inhibits platelet aggregation and adhesion to vascular endothelium, vasodilates, increases vascular permeability, stimulates leukocyte chemotaxis

Question 39

Where is prostacyclin released from?

Answer 39

Capillary endothelium

Question 40

What is the “opposite” of prostacyclin?

Answer 40

Thromboxane A2 (enhances platelet aggregation and vasoconstriction)

Question 41

What factor is Hageman factor?

Answer 41

Factor XII

Question 42

What does Kallikrein do?

Answer 42

Converts kininogen into bradykinin

Question 43

What vitamin maintains orderly differentiation of specialized epithelia (eg ocular conjunctiva, respiratory and urinary tracts, pancreatic and exocrine ducts)?

Answer 43

Vitamin A! That’s why it affects vision!