5 Flashcards

1
Q

transtentorial/uncal herniation leads to ??

damages what nerve??

A

fixed and dilated pupil(ipsilateral)
CN III (oculomotor damage)
ipsilateral paralysis of oculomotor muscles, contra/ipsilat hemiparesis, contralat homonymous hemianopsia (possible)

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2
Q

ureteric bud gives rise to ??

A

collecting system: collecting tubules and ducts, major/minor calyces, renal pelvis, ureters

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3
Q

metanephric mesoderm gives rise to ??

A

glomeruli, Bowman’s space, proximal tubules, loop of Henle, distal convoluted tubules
(NOT collecting tubules- from ureteric bud)

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4
Q

H. pylori concentration is greatest where ??

A

in the pre pyloric area of the gastric antrum

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5
Q

stroke, intestinal and foot ischemia, renal infact, think ??

A

embolism, possibly from a-fib

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6
Q

milrinone and inamrinone are ??

A

PDE-3 inhibitors
increase IC cAMP–>Ca2+ influx–>^cardicac contractility
-also causes systemic vasodilation due to ^cAMP in vasc. smooth muscle (limited use in sev. hypotensive pts)

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7
Q

what must increase in Lesch-Nyhan syndrome??

A

de novo purine synthesis (PRPP amido transferase) to increase the lost bases
(HGPRT defect causes degradation of hypoxanthine and guanine–>uric acid)

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8
Q

“elfin” facies, supravalvular aortic stenosis, extroverted personality, think ??

A

Williams syndrome

think Will Ferrell in Elf

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9
Q

while the capsular polysaccharide of N. meningitides is an important virulence factor, ?? directly induces systemic inflammatory response, correlating with morbidity and mortality in meningitis/menigococcemia

A

LOS (menigococcal lipooligosaccharide)

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10
Q

what drug inhibits funny sodium channels, slowing depolarization of phase 4, slowing SA node firing (with no effect on cardiac contractility?)

A

Ivabradine

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11
Q

ovarian torsion typically involves ??

A

the infundibulopelvic ligament aka suspensory ligament of the ovary, resulting in decreased blood and neural supply to ovary

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12
Q

ataxia (spinocerebellar tract degeneration), loss of position and vibration sense (DC degen) and loss of deep tendon reflexes (peripheral nerve degen), think??

A

Friedrich ataxia and Vitamin E deficiency (free radical damage)

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13
Q

MM is sensitive to tx with ??

A

proteasome inhibitors such as bortezomib (boronic acid-containing dipeptide)
because the plasma cells are synthesizing large amounts of protein, so this inhibition–>apoptosis

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14
Q

most enveloped nucleocapsid viruses get their lipid bilayer by budding through the plasma membrane of the host cell except ??

A

herpesviruses (including CMV)- acquire envelope from host cell NUCLEAR membrane

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15
Q

most commonly deficient enzyme in B-oxidation of fatty acids

A

acyl-CoA dehydrogenase

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16
Q

If PaCO2 during metabolic acidosis is higher than predicted by Winter’s formula (??) consider a superimposed ??

A

respiratory acidosis (resp. failure) i.e. lungs are not hyperventilating enough to compensate for the metabolic acidosis

Winter’s formula: (1.5 x HCO3-) + 8 +/- 2

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17
Q

gastric ulcers can extend into ??

vs erosions ??

A

submucosal layer and muscularis propria

erosions do not fully penetrate the muscularis mucosa so do not reach the submucosa

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18
Q

colorectal, endometrial, ovarian cancer think ?? syndrome with ?? gene mutations

A

Lynch syndrome

MSH2, MLH1, MSH6, PMS2

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19
Q

the area of the brain demonstrating greatest degree of atrophy in Alzheimer’s disease??

A

hippocampus

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20
Q

poorly controlled maternal DM can lead to ?? in baby

A

caudal regression syndrome: sacral agenesis causing LE paralysis and urinary incontinence (also transposition of the great vessels)

21
Q

hormones that share alpha subunits

A

hCG, TSH, LH, FSH
(also hCG and TSH have similar beta subunits) this can cause hyperthyroid-like presentation in pt w. germ cell tumor or gestational trophoblastic disease (^hCG)

22
Q

how to calculate number needed to tx (NNT)

A

1/ARR

ARR=event rate in control group-event rate in tx group

23
Q

migratory thrombophelbitis, think??

A

cancer (adenocarcinomas of pancreas, colon, lung) paraneoplastic syndrome–>hyper coagulability–>superficial venous thromboses (Trousseau syndrome)

24
Q

the live attenuated oral polio vaccine (Sabin) produces a stronger ?? immune response then inactivated polio vaccine (Salk)

A

mucosal secretory IgA immune response (mucosal surfaces are directly stimulated by the antigen)

25
Q

thiazides raise levels of serum ?? and lower ??

A

calcium, uric acid, glucose, cholesterol, triglycerides

lower serum Na+, K+, Mg+

26
Q

how will SVR change during exercise??

A

will decrease due to vasodilation within active skeletal muscles (even tho sympathetic output–>splanchnic vasoconstriction causing mild ^ in BP)

27
Q

NRTIs and NNRTIs directly inhibit synthesis of ?? whereas integrate inhibitors prevent ??

A

complementrary DNA synthesis from HIV RNA template (RNA–>DNA inhibited)

integrase inhibitors integrate into host cell chromosomes and prevent cellular machinery from being used to synthesize HIV mRNA (DNA–>RNA)

28
Q

acute vs chronic liver disease

A

acute failure: ^LFTs and prolonged PT

chronic: decreased albumin (long half-life), caput medusa, as cities, palmar erythema, splenmeg (cirrhosis)

29
Q

meds to tx pulmonary arterial HTN

A

sildenafil, bosentan (endothelin-receptor antagonist), epoprostenol

bosentan is very different than bleomycin and busulfan, which CAUSE pulmonary fibrosis

30
Q

G6PD is the rate-limiting enzyme in the ?? which produces ?? needed for ??

A

pentose phosphate pathway (PPP), source of NADPH needed for reducing glutathione (prev. oxidative damage) and for the biosynthesis of cholesterol, fatty acids and steroids

31
Q

2 regions of the basal ganglia that can be ablated with DBT and will improve Parkinson’s symptoms

A

globus pallidus interna and subthalamic nucleus

-they are over activated and cause more tonic inhibition

32
Q

tx fibromyalgia with??

A

SSRIs, TCAs, anticonvulsants

33
Q

the ACL attachments vs PCL

A

ACL: anterior intercondylar tibia to posterior medial side of LATERAL femoral condyle (travels superioposterolaterally)
PCL: posterior intercondylar area of tibia to anterior lateral surface of medial epicondyle of femur (travels superioanteromedially)

34
Q

what sequence helps initiate translation at the start codon (AUG)?

A

the Kozak consensus sequence

gcc)gccRccAUGG (R is either adenine or guanine

35
Q

RPF = ??

how to calculate RBF from that??

A

RPF=(urine PAH x urine flow rate)/plasma PAH

RBF=RPF/(1-HCT)

36
Q

enterocytes with clear or foamy cytoplasm, think ??

A

abetalipoproteinemia: inability to synthesize apolipoprotein B (part of chylomicrons and VLDL)
- lipids absorbed by the small intestine cannot be transported into the blood and accumulate in the intestinal epithelium–>enterocytes w. clear or foamy cytoplasm

37
Q

post-transcriptional hnRNA processing that happens within the nucleus??
outside the nucleus in the cytoplasm??

A

adding 5’-guanosine triphos. cap, methylating the 5’ terminal guanine, adding the 3’ poly AAA tail, interaction with snRNPs to splice mRNA

in the cytoplasm: interact with ribosomes–>translation or certain mRNA complexes associate with proteins in P bodies; translation regulation and mRNA degradation

38
Q

DRESS syndrome

A

“drug reaction with eosinophilia and systemic symptoms”

  • 2-8 wks after exposure to certain drugs: anticonvulsants (phenytoin, carbamazepine), allopurinol, sulfonamides, abx (minocycline, vancomycin)
  • pts have fever, LAD, facial edema, skin rash, eosinophilia, internal organ dysfunction
39
Q

choriocarcinoma consists of ??

A

anaplastic cytotrophoblasts and synceytiotrophoblasts without villi
-may present with dyspnea/hemoptysis due to pulmonary mets from hematogenous spread

40
Q

attributable risk percent (ARP) can be calculated how?

A

ARP(exposed)= 100x ((RR-1)/RR)

41
Q

hypogonadism, long LEs, small, firm testes, gynecomastia, azoospermia, think??
what levels of LH, FSH, testosterone and sperm?

A

Klinefelter syndrome (47, XXY)
PRIMARY hypogonadism : destruction and hyalinization of seminiferous tubules
-decreased inhibit levels, low testosterone, loss of feedback–>elevated FSH, LH
-high estrogen due to ^aromatase activity
-azoospermia and infertility

42
Q

orotic aciduria is ??

what can improve symptoms??

A

AR disorder of de novo pyrimidine synthesis; defect in UMP synthase

  • physical/mental retardation, megblast anemia, ^urinary orotic acid
    tx: uridine supplementation, convertied to UMP by nucleoside kinases
43
Q

symptoms of right vs left-sided colon cancers

A

right/ascending colon: exophytic masses–>occult bleeding and iron-def. anemia
left/descending colon: infiltrate intestinal wall and encircle lumen–>constipation, intestinal obstruction
rectosigmoid: hematochezi

44
Q

the principle stabilizing force for secondary structure of proteins?
tertiary structure??

A

hydrogen bonds

tertiary structure: ionic bonds, hydrophobic interactions, hydrogen bonds, and disulfide bonds (help w.stand denaturing) (lots!)

45
Q

the liver on aspirin

A

(Reye’s)
microvesicular steatosis of hep cells WITHOUT inflammation
(also cerebral edema–>encephalopathy)

46
Q

the liver on viral hepatitis

A

apoptosis of hepatocytes, acinar necrosis and PERIPORTAL mononuclear inflammatory infiltrate

47
Q

the liver on RHF

A

centrilobular congestion

48
Q

the liver on PBC

A

bile duct destruction, periductal granulomatous inflammation and bile duct proliferation