6.28.16

Question 1

differentiate: schizoaffective disorder vs MDD/bipolar disorder w psychotic features

Answer 1

MDD/bipolar disorder w psychotic features: psychotic ssx occur exclusively during mood episodes

schizoaffective disorder: psychosis w/out mood episode

Question 2

hypoxemia, normal A-a gradient –> indicates? One cause?

Answer 2

alveolar & arterial PO2 –> both low

alveolar hypovent –> obesity hypovent synd

Question 3

Conn’s synd: tx

Answer 3

aldos ant: spironolactone, eplerenone

Question 4

Dx: mania, h/o delusions & hallucinations w/out mood episode

Answer 4

schizoaffective disorder

Question 5

what is: Rathke’s pouch

Answer 5

embryonic precursor of ant pit

Question 6

obesity hypovent synd: charact

Answer 6

• chronic fatigue
• dyspnea
• difficult concentrate
• evidence of hypovent (increased PaCO2)

Question 7

blast cells in peripheral blood –> strongly suggests?

Answer 7

leukemia

Question 8

what is: velocardiofacial synd

Answer 8

• cleft palate
• cardiac anomaly
• dysmorphic facies

Question 9

what is: Wilson dz (hepatolenticular degen)

Answer 9

AR –> excess copper –> toxic accum:

• liver
• basal ganglia –> parkinsonism
• cornea –> Kayser-Fleischer rings

Question 10

external br of sup laryngeal N: fx

Answer 10

innervate cricothyroid muscle

Question 11

DM: #1 COD

Answer 11

coronary heart dz

Question 12

what is: DiGeorge synd

Answer 12

• cardiac anomaly
• hypoplastic/absent thymus
• hypoCa

Question 13

11-hydroxylase def: clinical findings

Answer 13

early in life:

• F: ambiguous genitalia
• HTN
• hypoK

Question 14

hyperaldos: ssx

Answer 14

• HTN
• hypoK
• metab alk
• decrease renin

Question 15

autoAb against snRNP? who?

Answer 15

anti-Smith Ab

SLE

Question 16

Dx: chronic fatigue, dyspnea, difficult concentrate, increased PaCO2, obese

Answer 16

obesity hypovent synd

Question 17

what is: Conn’s synd

Answer 17

1ary hyperaldos

Question 18

what malig can arise from Rathke’s pouch?

Answer 18

craniopharyngioma

Question 19

femoral N block: optimal site

Answer 19

inguinal crease

Question 20

Wilson dz (hepatolenticular degen): tx

Answer 20

chelation tx w D-penicillamine –> remv excess loosely bound serum copper

Question 21

what is: Wallerian degen

Answer 21

process of axonal degen & brkdown of myelin sheath distal to site of injury

Question 22

snRNP: fx

Answer 22

essential component of spliceosomes –> remv introns from pre-mRNA to form mature mRNA

Question 23

chrom 22q11.2 microdeletion: leads to?

Answer 23

• DiGeorge synd

- velocardiofacial synd

Question 24

thyroidectomy: can injure what N?

Answer 24

external br of sup laryngeal N d/t proximity to sup thyroid A & V

Question 25

Wilson dz (hepatolenticular degen): lab findings

Answer 25

• elevated LFT

- low serum ceruloplasmin

Question 26

what is: schizoaffective disorder

Answer 26

• schizophrenia + mood episode
• h/o: >2wk –> delusion, hallucination without mood episode

mood ssx present for most of illness –> but psychosis occurs w/out mood ssx

Question 27

RNApol II: fx

Answer 27

synthesize:
- mRNA
- snRNA

Question 28

enterococcal endocarditis is assoc w?

Answer 28

GU instrumentation, catheterization

Question 29

TCA overdose: ssx

Answer 29

• mental status change
• sz
• prolonged QRS
• V arrhythmia
• antichol

Question 30

enterococcus can grow in?

Answer 30

• hypertonic (6.5%) saline

- bile

Question 31

11-hydroxylase def: pathophys

Answer 31

excess production:

• adrenal androgen
• mineralocorticoid (11-deoxycorticosterone)

Question 32

chronic mesenteric ischemia: pathophys

Answer 32

mesenteric A –> atherosclerosis –> diminish blood flow to intestines after meals –> postprandial epigastric pain (“intestinal angina”)

Question 33

DiGeorge synd: cause

Answer 33

chrom 22q11.2 microdeletion –> defective neural crest migration into derivatives of 3rd & 4th pharyngeal pouch

Question 34

T-cell ALL: presentation

Answer 34

mediastinal mass –> resp ssx, dysphagia, SVC synd

Question 35

why does axonal regen not occur in CNS?

Answer 35

• myelin debris that persist for years
• neuronal inh factors –> inh axon growth
• dense glial scar –> barrier to axon regen

Question 36

what is the gold standard for detecting a microdeletion?

Answer 36

fluorescence in situ hybridization

Question 37

what is the most common childhood malig?

Answer 37

acute lymphoblastic leukemia (ALL)

Question 38

A-a gradient: what is? what is normal?

Answer 38

difference in PO2 in alveoli & arterial blood

normal = 5-15 mmHg

Question 39

TCA overdose: tx? MOA?

Answer 39

sodium bicarb –> trt cardiac toxicity

MOA: increase serum pH & extracell Na –> alleviate fast Na channel blockade

Question 40

coronary heart dz –> cardiovasc event –> MI, stroke

who has same risk for cardiovasc event?

Answer 40

• noncoronary atherosclerotic dz
• DM
• chronic kidney dz

Question 41

coronary heart dz: highest RF

Answer 41

• noncoronary atherosclerotic dz
• DM
• chronic kidney dz

Question 42

femoral N block: effect?

Answer 42

anesthetize skin & muscles:

• ant thigh –> quadriceps
• femur
• knee

Question 43

what is: craniopharyngioma

Answer 43

child –> remnant of Rathke’s pouch –> suprasellar tumor –> composed of calcified cysts containing chol xls

Question 44

bipolar disorder: maintenance tx

Answer 44

mood stabilizer:

• lithium
• valproate

Question 45

small nuclear RNA (snRNA): fx

Answer 45

complex w specific proteins to form small nuclear ribonucleoprotein (snRNP)

Question 46

what is the most common type of ALL?

Answer 46

B-cell ALL