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Question 1

mullerian aplasia

Answer 1

AKA mayer-rokitansky-kuster-hauser syndrome

variable uterine development, no vagina

primary amenorrhea

normal ovaries and secondary sex characteristics

Question 2

osler-weber-rendu syn

Answer 2

hereditary hemorrhagic telengstasia in skin and mucous membranes (lips, oropharnyx, GI, urinary tract)

rupture –> hematuria, GI bleeding, epistaxis

Question 3

most common cause of sudden cardiac death in a patient 48 hours after MI

Answer 3

ventricular fibrillation

Question 4

how does hyperammonemia lead to encephalopathy

Answer 4

NH3 crosses BBB –> NH3 + glutamate makes more glutamine production –> excess glutamine accumulates in astrocytes –> decreased glutamine able to be converted back to glutamate in neurons –> disrupt excitatory neurotransmission

Question 5

how does increasing preload affect heart

Answer 5

stretches myocardium- increases end-diastolic sarcomere length

–> increased SV and CO

Question 6

serious side effects of clozapine

Answer 6

agranulocytosis–> monitor neutrophil count!
seizures
myocarditis

Question 7

why are direct arteriolar vasodilators limited in their long term efficacy

Answer 7

baroreceptor reflex–> activate sympathetics –> R-A-A –> sodium and fluid retention —> tachycardia and edema

use with sympatholytics and diuretics

Question 8

type of breaths in COPD versus pulmonary fibrosis

Answer 8

COPD (high airflow resistance): deep slow breaths

fibrosis (elastic resistance): fast shallow breaths

Question 9

why is pus green

Answer 9

neutrophil myeloperoxidase- bue-green heme-based pigmented molecules within azurophilic granules of PMN

used in phagocytic respiratory burst

Question 10

medical therapy for gallstones (for people who dont want surgery)

Answer 10

hydrophilic bile acids - reduce cholesterol

Question 11

fenoldopam MOA and Rx

Answer 11

selective peripheral dopamine-1 agonist –> Gs –> vasodilation of arterial beds
and renal vasodilation good for kidney patients

rx: hypertensive emergency

Question 12

linkage disequilibrium

Answer 12

when alleles inherited together in the same gamete more or less often than expected by chance

often due to physical proximity

Question 13

atrial myxoma

Answer 13

primary cardiac neoplasm (often in LA)

composed of scattered cells within a mucopolysaccharide stroma (large pedunculated)

constitutional symptoms, mid-diastolic rumbling murmur at apex, positional SOB

Question 14

CD31

Answer 14

PECAM-1- leukocyte migration

expressed in hepatic angiosarcoma

Question 15

binding of opiates to pre-synaptic and post-synapse on mu receptors

Answer 15

pre-synapse: close Ca–> reduced Ca influx (decrease Ach, NE, Serotonin, gluatamate, substance P release)

post synapse: opens K channels–> K efflux

Question 16

which artery gives majority of supply to femoral head and neck

Answer 16

medial femoral circumflex artery

Question 17

stat test to evaluate 2 categorical variables association

Answer 17

chi-square test for independence

Question 18

tests to compare the means between groups

Answer 18

uses quantitative variables!

paired t- test: 2 groups

ANOVA: >2 groups

Question 19

menetrier disease

Answer 19

gastric hyperplasia of mucosa–> hypertrophic rugae (brain gryi-esq)

excess mucus production, loss of protein
parietal cell atrophy–> less acid

precancerous

Question 20

what is reabsorbed more in medullary collecting duct as a result of vasopressin

Answer 20

water and urea

Question 21

which infection is erythema multiforme associated with

Answer 21

HSV

Question 22

most frequent CNS tumor in someone with AIDS

Answer 22

primary CNS lymphoma

Question 23

methylmalonic acidemia

Answer 23

deficiency of methylmalonyl-CoA mutase

lethargy, vomiting, tachypnea in newborn

hyperammonemia, ketotic hypoglycemia, metabolic acidosis, elevated urine methylmalonic acid and propionic acid

Question 24

which hypoerthyroid drug helps opthalmopathy and how

Answer 24

high-dose glucocorticoids- antiinflammatory

Question 25

how is copper normally excreted

Answer 25

into bile, then excreted in feces

renal is 5-15%

Question 26

renal papillary necrosis

Answer 26

gross hematuria, flank pain, and sloughing of papillae into urine

seen in patients with sickle cell, diabetes, severe obstructive pyelonephritis, analgesic nephropathy

Question 27

Courvoisier sign

Answer 27

palpable but non-tender gall bladder

Question 28

signs of pancreas head adenocarcinoma

Answer 28

• courvoisier sign
• weight loss
• obstructive jaundice (dark urine, pale stools)

Question 29

CFTR mutation in respiratory/intestinal mucosa vs sweat in CF patients

Answer 29

resp/intestinal: reduced secretion of Cl, increased Na and H2O reabsorption –> thickened mucus

sweat: reduced absorption of Cl and Na–> increased Na and Cl in sweat

Question 30

what is insertion point for patellar ligament

Answer 30

tibial tuberosity

Question 31

Osgood-Schlatter disease

Answer 31

overuse of the secondary ossification center of tibial tuberosity –> impair quads

from young athlete doing repetitive quad contracting (jumps)

Question 32

which bacteria produces very narrow zone of beta hemolysis

Answer 32

listeria

Question 33

what part of immune system guards against listeria

Answer 33

cell-mediated immunity (cytokines)

Question 34

what factors make up low Vd

Answer 34

high charge
high molecular weight
hydrophilicity
high plasma protein binding

Question 35

aortic regurgitation has what effect on LV

Answer 35

increased SV from added volume and eccentric hypertrophy

Question 36

which lymphoma follow pharnygitis on initial presentation and then has waxing and waning lymph node enlargement

Answer 36

follicular lymphoma

Question 37

which type of depression is MAOIs good for

Answer 37

atypical depression- increased appetite and sleep, leaden paralysis, rejection sensitivity, mood reactivity

Question 38

what can help bypass apoptosis in folate deficiency

Answer 38

thymidine supplementation