7

Question 1

medial zone of cerebellum

Answer 1

proprioceptive and sensory signals

damage leads to ataxia and falls toward affected side

Question 2

lateral zone of cerebellum

Answer 2

controls planned limb movements

damage results in effort in force, speed, and amplitude of movement

Question 3

absence of CD18 Ags and recurrent skin/mucosal infections without pus

Answer 3

Leukocyte adhesion deficiency
can’t form integrins, failure of leak. chemotaxis
-other clinical features: delayed sep. of umbilical cord, persistent leukocytosis (not attached to endothelium)

Question 4

what enzyme converts NE to EPI in the adrenal medulla?

Answer 4

phenylethanolamine-N-methyltransferase (PNMT)

Question 5

restless leg syndrome tx with ??

Answer 5

dopamine agonists: ropinirole, pramipexole

Question 6

don’t use ?? with benzos

Answer 6

first gen antihistamines (H1-receptor antagonists): dephenhydramine, chlorpheniramine
-can cause significant sedation

Question 7

primary biliary cholangitis will look like what other condition (on liver histology) ??

Answer 7

hepatic GVH disease, because both have immune etiology

PBC: chronic AI disease; lymphocytic infiltrates and destruction of sm/med intrahepatic bile ducts

Question 8

what drug will cause a longer QRS duration when exercise is occurring?

Answer 8

class IC antiarrythmics, i.e. flecainide
strong use dependence, i.e. when heart is more active, more QRS prolonging occurs

Question 9

enzyme order in base excision repair

Answer 9

glycosylase(cleaves base)–>endonuclease(cleaves 5’ end)–>lyase(cleaves 3’ end)–>polymerase(fills gap)–>ligase(seals)

Question 10

proteinuria, serum IgG4 Abs to phospholipase A2 receptor (PLA2R), think ??

Answer 10

membranous nephropathy, NOT SLE

Question 11

main complication of varicose veins?

Answer 11

venous stasis ulcers (medial malleolus)

NOT DVTs/PEs as varicose veins are superficial (vs DEEP VT)

Question 12

elevated CK, muscle lumps with tapping, think ??

Answer 12

hypothyroid myopathy

-other causes of elevated CK: polymyositis, dermatomyositis, muscular dystrophies and statins

Question 13

even though PRL rises as pregnancy progresses, lactation is inhibited via ??

Answer 13

progesterone (corpus luteum, then placenta) via negative feedback on PRL in the anterior pituitary

Question 14

mechanism of Shiga/EHEC toxin

Answer 14

halts protein synthesis by disabling the 60s ribosomal subunit–>intestinal epithelial cell death and diarrhea

Question 15

INF-a and B produced in response to viral infection work by ??

Answer 15

halting protein synthesis and promote apoptosis of infected cells–>suppress viral replication and limit spread

Question 16

lung macrophages containing golden cytoplasmic granules that turn dark blue w. Prussian blue staining, think ?? caused by ??

Answer 16

hemosiderosis caused by left ventricular dysfunction
-LHF causes increased pulmonary cap pressure and pulmonary edema–>extravasation of RBCs and alveolar hemorrhage, RBCs phagocytksed by macrocytes and iron from HGB converted to hemosiderin

Question 17

what changes seen in mitral regurg??
preload
afterload
LV ejection fraction
forward SV
CO

Answer 17

preload increases
afterload decreases
LV ejection fraction is INCREASED, but since some of the blood is going back to LA, the forward SV and CO are decreased

Question 18

craniopharyngiomas arise from ??

Answer 18

Rathke’s pouch remnants in the ant pit

Question 19

ALS causes damage to ??

Answer 19

L-CST: UMN signs

anterior horn: LMN signs

Question 20

damage to posterior columns and L-CST, think ??

Answer 20

subacute combined degeneration (both ascending (DC) and descending (CST)) due to vitamin B12 deficiency
-lose position/vibration, have ataxia (DC) and spastic paresis (CST)

Question 21

aortic arch vascular derivatives

Answer 21

1: max artery
2: hyoid art, stapedial art
3: common carotid, proximal ICA
4: left: aortic arch, right: proximal R subclavian art
6: proximal pulmonary arteries, left: ductus arteriosus

Question 22

in the absences of ADH tubular fluid is most concentrated where ??

Answer 22

junction between descending and ascending limbs of the loop of Henle (only H2O is reabsorbed in descending limb, not solute–>becomes more concentrated)

• TAL: impermeable to water, Na/K/Cl reabsorbed here, diluting fluid
• DCT: NaCl reabsorbed (early DCT impermeable to H2O)–>more dilute
• most dilute in the collecting ducts, because ADH needed to reabsorb water, so only NaCl reabsorbed
• PCT: H2O passively reabsorbed w. active transport of solute–>isoosmotic with plasma

Question 23

pathological description of Beurger’s

Answer 23

segmental vasculitis extending into contiguous veins and nerves

Question 24

elevation of propionyl CoA think deficiency of what enzyme ??
propionyl CoA metabolized from what compounds?

Answer 24

deficiency of propionyl CoA carboxylase, need to convert propionyl ClA to methylmalonyl CoA

• leads to propionic acidemia and hypoglycemia
• derived from Valine, Isoleucine, Methionine, Threonine, odd FAs and cholesterol side chains

Question 25

necrolytic migratory erythema, DM, GI symptoms, anemia think ??

Answer 25

glucagonoma

Question 26

constipation, gallbladder stones, hyperglycemia, steatorrhea, abdomnial pain, think excessive secretion of ??

Answer 26

somatostatin

inhibits insulin, glucagon, gastrin, secretin, CCK

Question 27

diarrhea, hypokalemia, achlorhydria, hypotensive, think excessive secretion of ??

Answer 27

VIP

VIPoma

Question 28

rash, hypogonadism, azoospermia, hair loss, impaired fast, nigh blindness, impaired wound healing, think ??

Answer 28

zinc deficiency

Question 29

what is the problem with CFTR in CF??

Answer 29

3 base pair deleetion in the CFTR gene at F508
-impaire post translational processing of CFTR, resulting in shunting of CFTR toward proteasome w. complete absence of the protein in the apical membrane of affected epithelial cells

Question 30

what med may decrease adenomatous polyp formation? (which lead to colon adenocarcinoma)

Answer 30

COX inhibitors (ASA, celecoxib) as COX-2 has been linked to colonic adenocarcinoma

Question 31

activity of ?? causes intestinal injury in Crohn’s (non-caseating granulomas)

Answer 31

IL-2, IFN-y, TNF

Question 32

if bacteria die in hypotonic solution after tx with abx, what abx was it??

Answer 32

PCN, ceph, vancomycin because they disrupt the PTG cell wall and orgs can no longer survive osmotic stress

Question 33

odds ratio equation

Answer 33

OR=ad/bc (use in case-control study)
RR=(a/(a+b))/(c/(c+d))
(use in cohort study)

Question 34

levels in methemoglobinemia: PO2, % sat, total O2 content, partial pressure O2, oxygen delivery

Answer 34

PO2: decreased
%sat: decreased
total O2 content: decreased
partial pressure O2: NORMAL (measure of oxygen dissolved in plasma, unrelated to HGB function)
oxygen delivery: decreased

Question 35

CO poisoning levels:
PO2
%sat
total O2 content

Answer 35

PO2: normal
% sat: decreased
total O2 content: decreased

Question 36

anemia levels: PO2
%sat
total O2 content

Answer 36

PO2: normal
% sat: normal
total O2 content: decreased

Question 37

most adult brain tumors are ?? will look like what on gross exam ?

Answer 37

metastases from other cancers

appear as multiple, well-circumscribed masses at the junction of the gray and white matter

Question 38

joint pain, pruritic skin rash, areas of fibrinoid necrosis (skin) and neutrophil infiltration in small blood vessels (after initiating infliximab) think ??

Answer 38

serum sickness; type III hypersn reaction to nonhuman proteins
both TII and TIII hypersensitivity reactions activate complement, so C3 and C4 will be low