4

Question 1

Light microscopy PSGN

Answer 1

Hypercellular glomeruli (leukocytes), mesangial and endothelial proliferation

Question 2

IF PSGN (starry sky)

Answer 2

Granular deposits of IgG, IgM, and C3*(alternative pathway-no C1 or C4)

Question 3

EM PSGN

Answer 3

Sub-epithelial humps (Ab-Ag(exotoxinB) deposits)

Question 4

Subendothelial C1q deposits

Answer 4

Type 1 Membranoproliferative GN

Question 5

Lupis nephritis: IgE deposits in capillary wall

Answer 5

Poorer prognosis

Question 6

Cannulation of the femoral vein should occur where?

Answer 6

1cm below inguinal ligament and just medial to the femoral artery pulsation

Question 7

Variability in mitochondria disease expression is due to

Answer 7

herteroplasmy

Question 8

Name 3 mitochondria disease

Answer 8

1) LHON-bilateral vision loss
2) Myoclonic epilepsy with ragged-red fibers: myoclonic seizures and myopathy w/ exercise. Red ragged fibers on muscle biopsy
3) MELAS- mitochondrial encephalomyopathy with lactic acidosis and stroke like episodes

Question 9

Variable expressivity is seen in

Answer 9

AD disorders

Question 10

M3R in endothelial surface (muscarinic toxicity)

Answer 10

vasodilation/relaxtion (via NO–>hypotension). In other sights causes smooth muscle contraction

Question 11

M2 receptors (mostly in cardiac muscle)

Answer 11

G-protein decrease intracellular cAMP–>opens potassium channels to slow depolarization. Descreased inotropy (contractility) and chronotropy (HR)

Question 12

Endocardial cushion defects that result in ostium primum atrial septal defects and regurgitation atrioventricular valves

Answer 12

Down syndorme

Question 13

aortic valve incompetence, MVP, cystic medial necrosis of aorta

Answer 13

Marfan (AD)

Question 14

Pericarditis often follows what? Pain is worse when?

Answer 14

Upper respiratory viral syndrome.

Lying flat

Question 15

Blood pressure disparity btw arms (greater than 10mmHg) and tearing pain to back

Answer 15

aortic dissection

Question 16

occurs w/ repetitive activity; reproducible pain w/ palpation and worse with movement

Answer 16

costosternal syndrome (costochondritis)

Question 17

siezures in patient from rural or central south america

Answer 17

neurocysticercosis (Taenia solium - pork tape worm)

Question 18

Screening test for T.Pallidum

Answer 18

Rapid plasma reagin (RPR) test and VDRL

Question 19

Confirmatory test for T.Pallidum

Answer 19

FTA-ABS

Question 20

TTP (FAT-RN)…Differs from DIC because TTP has

Answer 20

NORMAL PT and aPTT

Question 21

Most common cause of coronary sinus dilation (know your anatomy fool)

Answer 21

elevated right-sided heart pressure secondary to PHTN (pulmonary hypertension)

Question 22

Low frequency sound commonly associated with increased left ventricular end-systolic volume (left ventricular systolic failure)

Answer 22

S3

Question 23

When is S3 best heard

Answer 23

Place bell over apex (midclavicular 5th intercostal space) with patient lateral decubitus position

Question 24

When do you hear an S3

Answer 24

Heart failure, dilated cardiomyopathy, mitral regurg.

Question 25

Cough reflex (afferent limb): can be damaged when sharpe shit (like fish bone) gets lodged in piriform recess

Answer 25

Internal laryngeal nerve (sensory and autonomic fibers)

Question 26

Gag reflex

Answer 26

Afferent: CN IX
Efferent: CN X

Question 27

KIT receptor tyrosine mutation (CD117)

Answer 27

systemic mastocytosis (expression of mast cell tryptase)

Question 28

Histamine mediated via degranulation of mast cells: syncope, flushing, hypotension, pruritis, urticaria, gastric acid secretion (phys.pic), diarrhea

Answer 28

Systemic mastocytosis (abnormal proliferation of mast cells and increased histamine release)

Question 29

Chronic lithium toxicity (confusion, ataxia, neuromuscular excitability) can be precipitated by volume depletion and drug interactions

Answer 29

thiazides, ACE inhibitors, NSAIDS

Question 30

How do human cell resist chemo therapy

Answer 30

MDR1 gene–> P-glycoprotein (prototype gene product)

Question 31

What is p-glycoprotein (product of MDR1 gene)

Answer 31

Transmembrane pump that functions at an ATP-dependent efflux pump. Normally expressed in intestinal and renal cells for elimination.

Question 32

What drugs have been shown to fuck w/ this lil shit head p-glycoprotein?

Answer 32

verapamil, diltiazam, and ketoconazole (all reduce the action of this multi-drug resistance protein

Question 33

Musculocutaneous nerve injury causes

Answer 33

trauma (shoulder dislocation) and strenuous upper extremity activity (baseball pitching)

Question 34

Where is the musculocutaneous nerve derived from? Innervations? Sensory?

Answer 34

C5-C7 of the lateral cord of brachial plexus…it innervates forearm flexors (biceps, brachialis) and coracobrachialis (flexes and adducts the arm). Sensory of skin of lateral forearm

Question 35

First dose hypotension (esp. in patients with volume depletion from diuretic, HF, etc)

Answer 35

ACE inhibitors (titrate up dose to prevent)

*note also no beuno in BILATERAL renal artery stenosis
Uni is “okay”

Question 36

Mucocutaneous canidiasis (and other infections), persistent diarrhea, failure to thrive, thymic hypoplasia or aplasia, low or absent CD3+ T-cells and hypogammaglobulinemia

Answer 36

SCID

Question 37

Brutons is a T or B issue?

Answer 37

B ONLY

Question 38

Most common disorder of heme synthesis?

Answer 38

Porphyria cutanea tarda (PCT) due to deficient Uroporphyrinogen decarboxylase