4/6&7 overall review Flashcards
1
Q
What is underlying pathophys of ARDS?
-what will CXR look like?
A
Damage to endothelial cells lining the pulm caps.
- results in leakage of fluids into alveoli.
- CXR will show “white out” of the lungs.
2
Q
Alveolar wall destruction
-which disease?
A
emphysema
3
Q
aneurysmal dilations
-usually have absent what?
A
internal elastic lamina.
4
Q
Cardiac tissue conduction velocity
- order?
- mnemonic:
A
Park At Ventura Ave.
- purkinje system = fastest
- atrial muscle
- ventricular muscle
- AV node = slowest
5
Q
Which chamber are SA and AV node located?
A
RA
6
Q
Conduction speed of atrial muscle vs ventricular muscle.
-which one faster?
A
atrial muscle faster than ventricular muscle.
7
Q
Paget disease of bone
-most often associated w/which bone tumor?
A
osteosarcoma.
8
Q
Age distribution in osteosarcoma?
A
bimodal.
9
Q
radiological findings in osteosarcoma:
A
- areas of mixed lysis & sclerosis = radioopaque & radiolucent areas.
- periosteal elevation.
- reactive new bone formation.
- lifting of cortex.
10
Q
Osteophytes
-RA or osteoarthritis?
A
osteoarthritis
11
Q
Trabecular bone
- aka?
- damaged preferentially in which disease?
A
- spongy, cancellous.
- osteoporosis.
12
Q
globus hystericus
-what is it?
A
“lump in your throat”.
13
Q
karyorrhexis
-what is it?
A
nuclear fragmentation - part of apoptosis.
-get 180 bp fragments.
14
Q
Blurred vision: think what mechanism?
A
-think a ciliary muscle/lens issue, NOT a pupillary size issue!
15
Q
Pleiotropy
A
Impact a single gene has on multiple phenotypes.
16
Q
tumor cell w/round nuclei and prominent lipid vacuoles.
A
Burkitt lymphoma
17
Q
t(12;21): which disease?
A
ALL
-better prognosis.
18
Q
IL-1 primarily released by which cell?
A
macros
19
Q
TNF-alpha primarily released by which cell?
A
macros
20
Q
GM-CSF
-stim prod of which cells?
A
granulocytes + monocytes
21
Q
What can cause dissociation of cadherins?
A
Removing Ca from extracellular fluid. Leads to loss of cell-to-cell adhesion.
-Cadherin intercellular interactions are Ca dependent.
22
Q
In post & ant dislocations of knee (so ACL/PCL injuries), which nerve or vessel is most likely to be injured?
A
Popliteal artery
- tibial n. in similar location but not as susceptible to this type of injury like pop. artery is.
- popliteal vein same location but superficial to artery. Also not as likely to be injured in this kind of injury.
23
Q
Psych: reflection is most similar to what other technique?
A
summarization
24
Q
Psych: facilitation
-what is it?
A
Encouraging the pt to talk more: “tell me how your drinking increased”.
25
What changes does cocaine cause to your nose area?
- atrophic nasal mucosa.
- chronic nasal discharge.
- thinning of nasal septum.
- oropharyngeal ulcers.
26
Hay fever
| -what is it?
Seasonal form of allergic rhinitis.
| -provoked by pollen from plants.
27
Which cell = primary player in asthma?
mast cell.
28
Long thoracic nerve
| -which nerve roots?
C5-C7
29
Is there bicarb in sweat?
not really.
30
PTSD
- by definition how long has it been going on?
- what do you call it if it hasn't been going on that long?
PTSD > 1 month.
| < 1 month (but > 3 days) = acute stress disorder.
31
Schizo Sxs < 1 mo: whats it called?
brief psychotic episode
32
Number needed to treat: equation?
1/ARR
* ARR = absolute risk reduction.
- so if 40% survived w/Tx, and 20% survived w/o Tx. Then ARR = 40-20 = 20%.
* 1/ARR = 1/.2 = 5.
33
Viral cause of kluber bucy?
| -explain:
HSV-1 encephalitis causes damage to temporal lobe.
- amygdala is in temporal lobe.
- damage to amydala => kluver bucy.
34
Acute intermittent porphyria
- what builds up?
- inheritance pattern?
- porphobilinogen.
| - auto-dom.
35
Porphyria cutanea tarda
| -what builds up?
uroporphyrinogen 3.
36
trinucleotide repeat diseases
| -all cause Sxs in which system?
CNS
37
Is penetrance an all or nothing thing?
ya
38
genetic heterogeneity
| -define:
mutations at diff genes cause same phenotype.
39
In adults, S3 usually heard in setting of what heart problem?
Heart failure - either systolic or diastolic.
40
Transudate vs Exudate:
| -pleural fluid LDH/serum LDH: > .6
Exudate.
| *transudates dont have LDH in them.
41
Osmotic fragility test: (+)
| -which disease?
Hereditary spherocytosis
| *pathognomonic.
42
Target cells:
- seen in which diseases?
- mnemonic:
HALT said the hunger to his target:
- HbC disease
- Asplenia
- Liver disease
- Thalassemia
43
Diabetic neuropathy of DM:
| -symmetrical/bilateral?
yes, symmetrical.
44
There will be a question where you have to differentiate LEMS vs MG:
- Associated w/which organ?
- Which one is more common?
- Which one more commonly presents w/eye weakness?
- Which one gets better w/more activity?
- MG = thymoma. LEMS = small cell lung cancer.
- MG = much more common.
- MG = more likely to get diplopia.
- LEMS = better w/increased use.
45
RB gene
- which chrom?
- can lead to which tumors?
- 13
| - retinoblastomas, osteosarcomas.
46
Neisseria
| -gram +/-?
gram (-)
47
DiGeorge: pouch or arch?
| -mnemonic?
Pouch.
| -George Foreman "punches".
48
serum sodium levels in DKA?
hyponatremia
| -Dilutional hyponatremia. Water shifted from intra to extracellular compartments due to the hyperosmolarity.
49
spina bifida cystica
| -aka?
myelomeningocele.
50
androgen insensitivity
| -why do they develop breasts?
free testosterone aromatized to estrogen.
- develop breasts.
* there is inc. LH & testosterone (& therefore Estrogen) bc LH has no neg. feedback bc test. receptors in hypoT insensitive as well.
51
Intraventricular hemorrhage:
| -happens in which pt population?
- Low birth weight babies (< 32 weeks).
| * most often occurs in the germinal matrix.
52
How are transmembrane proteins anchored inside the cytoplasm?
palmitoylation.
53
Nitroglycerin:
| -effect on HR?
reflex tachy.
| -so give it w/a beta blocker.
54
pseudohypoparathyroidism
- inheritance pattern?
- Sxs:
- auto-dom.
| - short stature, hypocalcemia, short 4th & 5th digit, PTH resistance.
55
Allelic heterogeneity
- define:
- example:
Different mutations in the same genetic locus cause similar phenotypes.
-ie. Duchenne MD vs Becker. Same gene, different mutation, similar phenotype.
* dont confuse w/genetic heterogeneity where mutations in different genes can cause similar phenotypes.
* dont confuse w/phenotypic heterogeneity where mutations in the same gene can result in different phenotypes.
56
lysyl oxidase
- whats it do?
- cofactor?
- which disease results in dec. absorption/transport of this cofactor?
- cross links collagen in extracellular space.
- copper
- Menke's disease
57
polydactyly
| -think what disease?
Patau
| -P & P.
58
In what situation would a legit female have serum karyotyping w/XY?
She gone bone marrow transplant from a male donor!
| *her peripheral blood cells will have XY, but rest of her tissues will obviously still have her own XX.
59
Signal sequences for SRP to take halt translation & take ribo+polypep to protein pore in RER:
-what type of AAs in that signal sequence?
hydrophobic.
60
Do sebaceous glands have sym inn?
No.
61
Safranin O
| -stains what red?
Cartilage, mast cell granules, & mucin.
62
H.pylori quadruple therapy:
PPI, bismuth subsalicylate, tetracycline, metronidazole.
63
Red man syndrome of vanc.
- mechanism?
- IgE mediated?
- prevention?
- Rapid infusion of vanc causes histamine release.
- Not IgE mediated!
- Slow infusion rate + pre-treatment w/anti-histamine.
64
leiomyoma
- Sxs:
- whos the pt?
- menorrhagia, miscarriage, palpable mass in lower abdomen, passing clots occasionally.
- black woman in her 30s or 40s (pre-menopausal).
65
Why are chlamydia resistant to penicillins?
1) They're intracellular.
| 2) They dont have cell wall. They have disulfide bonds in their outer membrane that give them stability instead.
66
Glitazones
- mech:
- tox:
- PPAR receptor agonist, inc. insulin receptor sensitivity.
- weight gain, edema, hepatotox, HEART FAILURE.
*PPAR receptor agonist = for instance, one action of that gene is to inc. GLUT4 receptors on adipocytes.
67
Biguanides: metformin
- mech:
- tox:
- dec gluconeo, inc. glycolysis, inc. peripheral insulin sensitivity.
- lactic acidosis, mild inc. in LFTs, GI upset.
68
Glyburide
- what is it?
- whats it do?
- Sulfonylurea.
- Closes K channel, causes influx of Ca, and release of insulin from pancreas.
*mimics normal action of ATP.
69
Pt shows up to ER w/asthma attack - if she's treat w/b-2 agonist, how long will it take on that nebulizer to experience significant relief?
Could be as long as 15-20 min.
| -this shit is not instantaneous!
70
MAP kinase
| -what does MAP stand for?
Mitogen Activated Protein kinase.
71
woven bone vs lamellar bone
| -which one is immature/pathologic?
woven is either immature or pathologic bone.
72
Only enveloped virus who gets its envelope from nuclear envelope?
herpesvirus
73
Only DNA virus that does NOT replicate in the nucleus:
poxvirus
74
Papovirus
| -what is it?
Includes papillomaviridae & polyomaviridae.
75
Lichen Planus
| -associated w/which virus?
hepC.
76
Duchenne
| -what type of mutation?
frameshift
77
Ego defense: intellectualization
- mature or immature?
- what is it?
- immature.
| - man intellectualizing his cancer Dx by researching it extensively & talking about it in a detached fashion.
78
G6PD def.
| -why do you get back pain?
Hb in urine = nephrotoxic.
| -back pain is from kidney pain.
79
Names some unmyelniated nerves:
- afferent for olfaction, heat, slow pain.
| - post-ganglionic autonomic neurons.
80
What can cause a marfanoid body habitus?
- Marfans.
- Homocystinuria.
- Men 2B.
81
genetic heterogeneity vs allelic heterogeneity.
| -which one deals w/1 gene and which one deals w/2 genes?
genetic heterogeneity = deals w/2 or more genes.
| -allelic deals w/1 gene.
82
Aerobic respiration: how many max ATP?
| Anaerobic: how many max ATP?
- 38
| - 2
83
leukoplakia
| -occurs on what type of tissue?
Only occurs on mucosal surfaces!
84
Reactive arthritis
| -what does this include?
- conjunctivitis/uveitis.
- urethritis.
- arthritis.
85
Callus
- inc. thickness of which layer of skin?
- whats the medical term for this?
- what other disease shows this?
- stratum corneum.
- hyperkaratosis.
- psoriasis.
86
Whats the regulatory protein that dictates the differentiation of a progenitor cell into a more specializes cell?
-growth factor? txn factor?
- transcription factor.
| * growth factors usually regulate synthesis of txn factors, but the answer here is txn factors.
87
Peutz-Jegher syndrome
| -inheritance:
auto-dom.
88
Can you refer to warfarin as a vitamin-k antagonist?
yes
89
Someone given a mechanical valve, which med do you give them to prevent clot formation. Life-long med.
warfarin.
| -NSAIDs wont cut it alone. You can add a daily low-dose aspirin though which will be useful.
90
Which Ig types are made w/o any class switching?
IgM & IgD.
91
CD40 receptor
| -is receptor on B cell or T cell?
B cell.
92
H__ is the only histone not in the nucleosome core.
H1
93
Most prevalent lysosomal storage disease:
Gaucher disease.
94
What % occlusion of coronary for stable angina?
| -how does it progress to unstable?
- 75%
| - Thrombus formation w/incomplete coronary occlusion = unstable angina. Someone w/unstable angina needs to be admitted.
95
COX-1 or COX-2
| -aspirin blockage of this inhibits platelet aggregation:
COX-1
96
TXA2 production: dep on COX-1 or COX-2?
COX-1
97
focal segmental glomerulosclerosis
- nephrotic or nephritic?
- mnemonic?
- nephrotic.
| - focal focal sounds like fuck. HIV pts are fucked and fucking got them their HIV.
98
```
Berger disease (IgA nephropathy)
-nephrotic or nephritic?
```
nephritic
99
Asthma exacerbation:
| -What will CXR show?
CXR is typically normal.
100
Spont. pneumothorax
| -trachea deviates toward or away from lesion?
toward.
101
Tension pneumothorax
| -trachea deviates toward or away from lesion?
away.
102
nephrogenic DI
| -Tx:
hydrochlorothiazide, indomethacin, amiloride.
103
Ethylene glycol
| -how does it result in kidney stones?
Its converted to oxalate.
104
Serum anion gap:
- equation?
- whats normal?
- anion gap = (Na) - (Cl + HCO3)
| - normal = 10-14
105
Ethylene glycol poisoning
| -presentation:
- anion gap metabolic acidosis
- gross hematuria, flank pain, oliguria.
* its toxic metabolite causes ATN.
106
How does Iron OD cause inc. anion gap metabolic acidosis?
Iron OD => ox. phos. uncoupler (like salicylates) => lactic acidosis => inc. anion gap metabolic acidosis.
107
PCR:
| -what happens during cooling (2nd step, after heating)?
Primers bind.
| *important to know that the primers are added in excess.
108
Coronal image
| -which side is the patients right side?
left side of image.
| -just like if a pt was lying down.
109
URI: which sinuses are most commonly affected?
| -why?
maxillary sinuses
-bc their path of drainage is located superior to the floor of the sinus. Thus, gravity does not favor drainage of these sinuses.
110
MCA territory infarct
- what sort of visual defect?
- why?
- homonymous hemianopsia.
| - can damage optic radiations.
111
Central scotoma
| -can it be caused by a vessel occlusion?
Not usually bc macula has more than 1 blood supply.
| -usually due to macular degeneration or optic neuritis.
112
Virchow node
| -which node?
left supraclavicular.
| *you know its left bc thoracic duct drains into it.
113
Sarcomere: what are its borders:
- extends from ______ to _______.
- whats attached to these borders?
Z line to Z line.
| -actin.
114
Sarcomere electron micrograph
| -whats the darkest portion called? perpendicular to actin/myosin.
Z line.
| -where actin attaches.
115
Z-lines
| -what overlies the Z-lines?
T tubules & terminal cisternae of SR overlie the Z lines and I bands.
116
Which band doesn't change length during muscle contraction?
A-band.
117
white patches on gingival and oral mucosa
| -what is it?
oral thrush most probably.
118
Acute leukemia
| -how can the thrombocytopenia present?
Bleeding complications like
- petechiae
- gingival bleeding
- retinal hemorrhages
119
Acute leukemia
| -how can the leukopenia present?
Opportunistic infections
- candida (oral thrush).
- aspergillosis
- bacterial pneumonia
- perirectal infection.
120
What is a prominent virulence factor of aspergillus that allows it to disseminate?
Vascular invasion.
121
expansion of red pulp in the spleen
| -one common cause?
cirrhotic liver leading to hepatosplenomegaly.
| -that excess blood backup in the spleen causes expansion of the red pulp sinusoids.
122
Red pulp of spleen
| -structure:
Blood filled sinuses and cords lined by macrophages.
123
esophageal varice hemorrhage
- Tx:
- mechanism?
octreotide
| -indirectly constricts splanchnic vasculature by inhibiting splanchnic vasodilators (VIP, glucagon).
124
ADP receptor inhibitors
| -which is the only one that is a reversible blocker?
ticagrelor
125
cutaneous anthrax
| -is the black eschar painful or painless?
painless
126
A positive ferric chloride test is strongly suggestive of:
An aspirin overdose (b/c phenols are used in production of aspirin and this test looks for phenols).
127
Which thyroid carcnioma spreads hematogenously?
follicular carcinoma
