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Question 1

why is HBV required for HDV?

Answer 1

Coating of viral particles!!! before it can infect hepatocytes and multiply

Question 2

what does diphtheria immunity give you

Answer 2

immunization produces circulating IgG against exotoxin B subunit, effectively preventing disease

Exotoxin A think “Active” inhibits ribosome function
Exotoxin B think “bind” allows penetration of the A subunit

Question 3

distinguish the 2 strep pneumo vaccines

Answer 3

give children and elderly the conjugate vaccine:
it has polysaccharide protein-conjugate; it’s attached to inactivated diphtheria toxin
this protein conjugation induces active immunity via a T-cell-DEPENDENT B cell response, resulting in improved immunogenicity due to the formation of higher affinity antibodies and memory cells; IgG immunity

give adults the polysaccharid vaccine:
it contains capsular material; this vaccine induces a relatively T cell independent B cell response, making it less effective in young and elderly
IgM immunity

Question 4

what are depression, fatigue, hypersomnia, hyperphagia, and vivid dreams characteristic of for drugs

Answer 4

cocaine withdrawal

alcohol withdrawal you’ll see delirium, agitation, tremors, psychosis

Question 5

what should you think with:
fatigue (anemia)
constipation (hyperCa)
bone pain (osteoclast-activation)
elevated serum Protein (monoclonal proteins!!!)
renal failure

Answer 5

multiple myeloma

you’ll see large eosinophilic casts composed of Bence-Jones proteins in the tubular lumen in myeloma cast nephropathy

Question 6

what’s the most common cause of aseptic meningitis

Answer 6

Enteroviruses,

including coxsackievirus, echovirus, poliovirus

Question 7

injury to what causes hemiballism

Answer 7

Subthalamic nucleus,
which controls basal ganglia output

you could injure it w/ a lacunar stroke

Question 8

what is propofol’s route of elimination

Answer 8

they readily diffuse across membranes, since they’re highly lipophilic drugs

they quickly accumulate in tissues receiving high blood flow (rapid onset)

redistributed to organs receiving less blood flow (short duration of action)

Question 9

what drugs can cause hypoglycemia but not really show the classic adrenergic symptoms

Answer 9

non-selective beta blockers, like propranolol

Question 10

how does urine concentration in a water deprivation test change after vasopressin injection in normal, polydipsia, CDI, and NDI pts?

Answer 10

normal: no additional increase
pt has already maximally concentrated their urine

primary polydipsia: same as above (there’s nothing wrong with this pt)

Central DI: large increase (you’re just missing the ADH from the pituitary)

nephrogenic DI: small increase (kidney still can’t respond well to the vasopressin)

Question 11

which enzyme is deficient in Sideroblastic anemia

Answer 11

ALA-S

”s”ideroblastic = ala-“S”

Question 12

what is the triad for Henoch Schonlein Purpora???

Answer 12

ARTHRALGIAS
GI/abdominal pain
palpable purpura on buttocks

Question 13

what is a common childhood brain tumor that is in the cerebellum, often at vermis, and consists of sheets of small blue cells?

Answer 13

medulloblastoma

Question 14

what is AV conduction tract bypassing the AV node

Answer 14

Wolff Parkinson White syndrome

gives you heart palps and delta wave

Question 15

what will H2PO4- urine levels be in DKA

Answer 15

high

urine’s main way of excreting acid during acidosis is via NH4+ and titratable acids like H2PO4-

Question 16

where dos highest urine osmolarity occur in the nephron

Answer 16

deepest part of Loop of Henle

water has been passively reabsorbed the whole way down

Question 17

where in the nephron is urine most dilute / lowest osmolarity

Answer 17

distal convoluted tubule

Question 18

how do fibrates lower triglyceride levels

Answer 18

fibrates lower triglyceride levels by activating peroxisome proliferator-activated receptor alpha (PPAR-alpha), which leads to DECREASED VLDL PRODUCTION and increased LPL activity.

Question 19

what’s the most specific test for gallstones

Answer 19

“failed gallbladder visualization on radionuclide biliary scan”

Question 20

what’s the most specific test for gallstones

Answer 20

“failed gallbladder visualization on radionuclide biliary scan”

Question 21

what happens in sickle cell spleens?

Answer 21

repeated splenic infarctions that ultimately result in splenic atrophy and fibrosis

Question 22

suppression vs repression

Answer 22

suppression consciously chooses to ignore something

repression is involuntarily ignoring/forgetting something