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1
Q

retinol/beta carotine

A

Vit A

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2
Q

Def: bitot spots, night blindness, dry skin, corneal ulceration

A

Vit A

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3
Q

Vit Teratogens

A

Vit A - cleft palate, cardiac defects

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4
Q

Thiamine

A

Vit B1

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5
Q

TPP (thiamine) is a cofactor for what rxns

A

Pyruvate dehydrogenase (TCA cycle), alpha-ketogluterate dehydrogenase (TCA cycle), Transketoase (hmp shunt), branche chain AA dehydrogenase

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6
Q

Wernicke-korsakoff, beriberi (wet- cardiac, dry - footdrop symmetrical muscle waisting) - brain and heart affected first. Seen in malnutrition and alcoholics

A

vit b1 def

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7
Q

Sxs: confusion, opthalmoplegia, ataxia (triad) + confabulation, personality change, memory loss (irreversible)

A

Wernicke-korsakoff

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8
Q

riboflavin

A

Vit B2

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9
Q

cofactor in oxidation and reduction

A

Vit B2 - riboflavin is a cofactor for FAD, FMN

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10
Q

cheilosis (agranular stomatitis - lip inflammation, scaling, fissures at corners of mouth), glossitis

A

Vit B2

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11
Q

niacin

A

Vit B3

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12
Q

constituant of NAD, NADPH - used in redox rxns. Derived from tryptophan.

A

Vit B3

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13
Q

Def: pallegra - diarrhea, dementia, dermatitis

A

Vit B3 (the 3 Ds)

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14
Q

Excess: facial flushing

A

Vit B3 - Niacin

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15
Q

pantothenate

A

Vit B5

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16
Q

pyridoxine

A

Vit B6

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17
Q

Def: convulsions, hyperirritability, peripheral neuropathy, inducible by isoniazid

A

Vit B6

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18
Q

biotin

A

vit b7

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19
Q

cofactor for carboxylation enzymes

A

vit b7 - biotin

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20
Q

folic acid

A

vit b9

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21
Q

converted to tetrahydrofolate, def in alcoholics and pregnancy

A

vit b9 - folate

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22
Q

cobalmin

A

vit b12

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23
Q

megaloblastic anemia + neuro problems

A

vit b12

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24
Q

ascorbic acid

A

vit c

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25
Q

needed for proline and lysine in collagen synthesis

A

vit c

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26
Q

swollen gums, hemarthrosis, poor wound healing

A

scurvy - vit c def

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27
Q

hypocalcemia, frontal bossing, rachitic rosary, pigeon chest, bone pain

A

rickets - vit d def

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28
Q

femoral neck and vertebral body fractures, bone pain, muscle weakness,

A

ostemalacia - vit d def adults

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29
Q

alpha tocopherol

A

vit e

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30
Q

def: inc fragility of rbcs, spinocerabellar tract demyelination (ataxia)

A

vit e

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31
Q

vit k def coags

A

10, 9, 7, 2, C, S. Babies need vit k - not in breast milk

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32
Q

def: delayed wound healing, acrodermatitis enteropathica (rash around eyes, mouth and anus), growth retardation, dec night vision, infertility

A

zinc def

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33
Q

Phenylalanine derivative

A

tyrosine, dopamine, NE, Epi

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34
Q

Tryptophan derivative

A

Niacin, seratonin ->melatonin

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35
Q

histadine derivative

A

histamine

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36
Q

gylcine derivative

A

porphyrine, heme

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37
Q

arginine derivative

A

creatine, urea, NO

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38
Q

glutamate derivative

A

GABA, Glutathione

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39
Q

macrophages filled with fungus, infiltrative granuloma, mississippi and ohio river valley, bird or bat droppings, pneumonia

A

histoplasmosis

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40
Q

east of mississippi, granulomatous nodules, broad based bud, heaped up boarders with microabscesses, skin lesions , inflammatory lung disease

A

blastomycosis

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41
Q

southwestern US (Cali, AZ) pneumonia and meningitis, spores in dust, spherules filled with endospores, barrel shaped, valley fever, desert bumps

A

coccidiodomycosis

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42
Q

latin america, budding yeast with captains wheel

A

paracoccidiodomycosis

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43
Q

elderly females, unilateral headache, jaw claudication

A

temporal arteritis

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44
Q

may lead to irreversible blindness, inc ESR

A

temporal arteritis

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45
Q

pulseless disease, asian females less than 40, weak upper extremity pulses, granulomatous thickening of aortic arch

A

takayasu arteritis

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46
Q

young adults, assoc with Hep B, relapsing and remitting, renal and visceral vessels, not pulmonary arteries, immune complex mediates, fibrinoid necrosis

A

polyarteritis nodosa

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47
Q

lesions of different ages

A

polyarteritis nodosa

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48
Q

asian children under 4, strawberry tongue, hand foot erythema, rash, may develop coronary aneurysm, MI, rupture

A

kawasaki - Tx w. aspirin

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49
Q

heavy smokers, males under 40, intermittent claudication, may lead to gangrene, autoamputation of digits, microabcesses, raynauds, tibial and radial a. involvement

A

buergers disease (thomboangiitis obliterans)

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50
Q

pauci-immune glomerulonephritis, lesions of same age, necrotising vasculitis involving lung, kidneys, skin, no granulomas, p-ANCA

A

microscopic polyangiitis

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51
Q

p-ANCA

A

microscopic polyangiitis, churg strauss

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52
Q

chronic sinusitis, perforation of nasal septum.

Triad: focal necrotizing vasculitis, necrotizing granulomas of lung, necrotizing glomerulonephritis c-ANCA

A

Wegners

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53
Q

Asthma, palpable purpura, peripheral neuropathy (wrist/foot drop), granulomas, necrotizing vasculitis with eosinophils. p-ANCA

A

churg-strauss

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54
Q

c-anca

A

wegners granulomatosis

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55
Q

most common childhood vasculits, follows URI, assoicated with bergers (IgA nephropathy)

A

henoch-schonlein purpura

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56
Q

Triad: palpable purpura on buttocks/legs, arthritis, abdominal pain/melena
seen in kids

A

henoch-schonlein purpura

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57
Q

t(9:22)

A

CML bcr-abl (tyrosine kinase)

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58
Q

t(8;14)

A

burkitts c-myc

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59
Q

t(11;14)

A

mantle cell cyclin D

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60
Q

t(14;18)

A

follicular bcl-2

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61
Q

t(15;17)

A

M3 type of AML - responds to Vit A

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62
Q

ingestion causes actue renal failure w/ muddy brown casts and hemorrhagic gastritis

A

mercury

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63
Q

ingestion causes pancytopenia w/ hypocellular bone marrow

A

benzene

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64
Q

ingestion disrupts ETC and is treated with sodium nitrate

A

cyanide

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65
Q

enzyme responsible for salt wasting in CAH

A

11-deoxycorticosterone

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66
Q

enzyme responsible for mineral corticoid excess in CAH

A

17-alpha hydroxylase

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67
Q

dark curtain falls over eyes, transient vision loss, vertigo, HTN

A

amaurosis fugax

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68
Q

alcoholic with massive hematemesis, may be fatal

A

esophageal varicies

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69
Q

alcoholic with hematemesis after violent retching

A

mallory weiss tears (longitudinal lacerations)

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70
Q

FAP + osteomas, hypertrophy of retinal pigment epithelium, desmoid tumors, lipomas, dental abnormalities

A

Gardners syndrome, chrom 5

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71
Q

harmatomas in GI tract + hyperpigmented lesions on lips and mouth

A

peutz-jeghers

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72
Q

FAP + glioblastomas, medulloblastomas

A

turcots

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73
Q

HNPCC + inc risk of cancer everywhere

A

lynch syndrome

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74
Q

macrocephaly, multiple GI harmatomas, inc risk of breast cancer, follicular thyroid cancer, endometrial cancer

A

Cowden syndrome

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75
Q

skin pigmentation, cirrhosis, diabetes

A

hemochromatosis (inc transferrin)

76
Q

diseases associated with erythema nodosa (rash on shins)

A

sarcoidosis, drug rxns, post-strep infection, thyroid disease

77
Q

involves intra and extra hepatic ducts

A

primary sclerosing cholangitis

78
Q

involves small intra hepatic ducts

A

primary biliary cirrhosis

79
Q

valsalva maneuver

A

dec CO and firing of baroreceptors at carotid sinus, dec HR

80
Q

location of Brocas area

A

inferior frontal gyrus

81
Q

location of wernickes area

A

superior temporal gyrus

82
Q

supplies motor to UE and brocas

A

MCA (brocas is in frontal lobe)

83
Q

supplies motor to LE and can cause hemiparesis

84
Q

young patient with venous thromboembolism

A

factor V leiden - protein C can’t bind to Va

85
Q

merkles nerve endings

A

in the fingertips and hair follicules

86
Q

free nerve endings

A

pain and temp

87
Q

meissners corpuscles

A

non-hairy regions - palms and soles, light touch

88
Q

pacinian corpuscles

A

deep touch, vibration

89
Q

ruffini corpuscles

A

change in position, responds to stretch

90
Q

blurred margins of optic disc

A

abducens nerve palsy - pseudotumor ceribri (fat women)

91
Q

type of shock: low preload, low CO, inc vascular resistance

A

obstructive (tension pneumothorax)

92
Q

type of shock: normal/low preload, high CO, dec vascular resistance

A

distributive (septic shock)

93
Q

type of shock: low preload, low CO, low vascular resistance

A

hypovolemic (bleeding, dehydrated)

94
Q

type of shock: high preload, low CO, normal vascular resistance

A

cardiogenic (heart attack)

95
Q

PT/PTT/Bleeding time in DIC

A

dec platelets, dec plasminogen, inc PT, PTT and BT

96
Q

most common dermatosis involving nail pitting, salmon patches (yellow/pink discoloration) and oncholysis

97
Q

EKG lead changes in V1-3 show MI in this location

A

Septum - LAD

98
Q

EKG lead changes in V3-4 show MI in this location

A

Anterior - LAD

99
Q

EKG lead changes in V5-6, I and aVL show MI in this location

A

lateral - left circumflex

100
Q

EKG lead changes in II, III and aVF show MI in this location

A

inferior - right coronary

101
Q

lift head, look to faces

A

1 month milestone

102
Q

smile responsively, follows objects past midline

A

2 month milestone

103
Q

grasps object, squeals, laughs, rolls over, eats soft foods

A

4 month milestone

104
Q

sit with support, jabber, feeds self

A

6 month milestone

105
Q

sits alone, begins pull to stand

A

9 month milestone

106
Q

wave, have 2 words, use cups, takes a few steps

A

12 month milestone

107
Q

walking, scribbling

A

15 month milestone

108
Q

use utensils for food, stacks two blocks, 3+ words

A

18 month milestone

109
Q

remove clothing, stack 4 blocks, kick ball

A

24 month milestone

110
Q

lung cancer: eosinophilic cytoplasm with keratin pearls

A

squamous cell CA

111
Q

most common cause of death under 1 year old

A

congenital anomalie

112
Q

most common cause of death 1-44

113
Q

most common cause of death 45-65

A

malignant neoplasm

114
Q

most common cause of death 65+

A

heart disease

115
Q

most common breast tumor in women under 25

A

fibroadenoma (tenderness with lump during menses)

116
Q

widening of the mediastinum, aortic regurg, asymmetrical UE pulses

A

aortic dissection - tearing of the intima

117
Q

gene fusion with inc tyrosine kinase activity

A

CML (9;22) bcr-abl

118
Q

tx for CML

119
Q

asherman syndrome- secondary amenorrhea due to

A

intrauterine adhesions and absent stratum basalis

120
Q

anti thyroid peroxidase and anti thyroglobulin abs

A

hashimotos

121
Q

treatment for kawasaki disease

A

immunoglobin

122
Q

hemisection of spinal cord (brown-sequard)

A

loss of motor and all senses on one side below the lesion but loss of pain and temp on the other side but crude touch will be preserved on same side of lesion.

123
Q

location of lesion that causes intention tremor

A

cerebellum

124
Q

def results in alopecia, dermatitis (perioral rash), muscle pain, depression, can be caused by raw eggs

125
Q

alcoholic with disorientation, change in personality

A

hepatic encephalopathy

126
Q

tx for hepatic encephalopathy

A

lactulose - acidifying the gut lumen to dec ammonia concentration

127
Q

first sign of phenotypic puberty

A

thelarche - development of breast buds

128
Q

RBBB vs LBBB

A

WiLLiaM MaRRoW - look at leads V1 and V6 - if it makes a W in 1 and M in 6 its LBBB, if it is a M in 1 and W in 6 its RBBB

129
Q

things you can’t do if a patient is DNR

A

CRP, cardiogenic shock, anti-arrhythmic meds

130
Q

memory loss, parkinsons like movement disorder, visual hallucinations

A

lewy body dementia

131
Q

Myasthenia vs lambert-eaton: improves with rest

A

myasthenia gravis

132
Q

Myasthenia vs lambert-eaton: improves with activity

A

lambert-eaton (ab to Ca ch) ALSO ASSOCIATED WITH SMALL CELL CA of lung

133
Q

elevated fibrin degradation products, elevated V/Q ration

A

PE ( dec perfusion so V/Q goes up)

134
Q

basophilic stippling and denaturing of ribonuclease

A

lead poisoning

135
Q

Vertebral level of celiac artery branching from aorta

136
Q

Vertebral level of SMA branching from aorta

137
Q

Vertebral level of renal artery branching from aorta

138
Q

Vertebral level of IMA branching from aorta

139
Q

Vertebral level of illiac branching from aorta

140
Q

breast mass that changes size/tenderness with menstruation

A

fibroadenoma if ONE mass

fibrocystic change if multiple masses

141
Q

greasy scale over erythematous patch

A

seborrheric dermatosis

142
Q

TAN HATS of things the hypothalamus controls

A

Thirst
adenohypophysis - ant pit
neurohypophysis - post pit

hunger and satiety
autonomics - bp and circadian rhythm
temp - ant part is cooling, post is heating
sex

143
Q

elevated hematocrit, leukocytes, thrombocytosis, DEC hematopoietin

A

polycythemia vera

144
Q

feeling of bugs crawling all over skin, high BP, HR, resps

A

cocaine OD

145
Q

brocas area of the brain

A

frontal lobe

146
Q

wernickes area of the brain

A

superior temporal lobe

147
Q

marker for hepatocellular CA

A

alpha-fetoprotein

148
Q

biochemical markers for RA

A

elevated ESR, CRP and rheumatoid factor

149
Q

cause of wheezing in asthmatic who ingests aspirin

A

leukotriene excess causing bronchoconstriction

150
Q

Tx for gestational diabetes

A

insulin - glyburide

151
Q

microcephaly, craniofacial abnormalities, nail hypoplasia

A

fetal hydantoin syndrome -phenytoin during pregnancy (inhibits gluatmate release)

152
Q

blood type associated with gastric cancer

153
Q

blood type associated with peptic ulcers

154
Q

collection of neutrophils in crypts of leiberkuhn

A

ulcerative colitis

155
Q

stimulate water and electrolyte secretion leading to massive diarrhea (tumor)

156
Q

proximal muscle weakness - can’t stand up from sitting in chair

A

polymyositis - cytotoxic destruction

157
Q

proximal muscle weakness plus rash on knuckles, elbows knees

A

dermatomyositis

158
Q

high dose dexamethasone will dec ACTH in what scenario

A

ACTH-secreting pituitary adenoma

159
Q

failure to thrive, hepatomegaly, mental retardation, elevated urine glucose, cataracts, infant exclusively fet breast milk

A

classic galactosemia - galactose-1-phophate uridyltrasferase deficiency
eliminate galactose and lactose from diet

160
Q

bladder extrophy is associated with what penile defect

A

epispadias (dorsal/superior opening)

161
Q

nucleoside excision repair defect

A

xeroderma pigmentosum - thymine dimers

162
Q

mismatch repair defect

A

hereditary nonpolyposis colorectal cancer

163
Q

Polycystic ovarian disease has inc risk for what

A

type 2 diabetes

164
Q

pruritic, oval, scaly plaque with central clearing

A

tinea corpis - KOH with many hyphae forms

165
Q

weight loss, diarrhea, bronze indurations on legs and trunk that blister and scale

A

glucagonomas - alpha cells of pancreas

166
Q

delta cells of pancreas secrete

A

somatostatin

167
Q

non-alpha, non-beta cell pancreatic tumor

A

VIPoma - cholera like diarrhea

168
Q

water deprivation test in polydipsia, polyuria

A

urine becomes concentrated if its psychogenic polydipsia (often seen in psychosis) it does not effect nephrogenic DI

169
Q

diplopia walking down stairs

A

superior oblique issue (trochlear nerve - CN IV)

170
Q

medical ethics answer that is almost always wrong

A

consult the hospital ethics committee

171
Q

mandated screening for these diseases required after birth

A

PKU, hypothyroidism, sickle cell, CAH

172
Q

Rhogam is administered to pregnant woman when

A

routine at 28 weeks, following chorionic villus sampling (or other invasive procedures), transplacental bleeding and 72 hours post delivery

173
Q

episodic biliary colic following meals

A

cholelithiasis

174
Q

fever, persistant RUQ pain with guarding with positive murphy sign

A

cholecystitis

175
Q

obstructive jaundice without fever

A

choledocholelithiasis

176
Q

muscle weakness, cramps, fatigue

A

hypokalemia

177
Q

CA 125 tumor marker

A

ovarian cancer

178
Q

CA 19-9 tumor marker

A

pancreatic cancer

179
Q

sunburst pattern and codmans triangle

A

osteosarcoma

180
Q

polycystic ovarian disease levels of LH, DHEA, FSH

A

elevated LH, elevated DHEA, decreased FSH. LH/FSH >3

181
Q

relative risk equation

A

a/(a+b) / c/(c+d)

182
Q

skin cancer with best prognosis

A

basal cell CA

183
Q

triad of cardiac tamponade

A

hypotension, distant heart sounds, JVD

184
Q

first sign of magnesium toxicity (tx for preeclampsia)

185
Q

carcinoid syndrome is associated with what heart defect

A

right sided valve defects - stenosis due to serotonin

186
Q

arthritis associated with giant cell arteritis

A

polymyalgia rheumatica

187
Q

basophilic stippling is seen in what diseases

A

beta thalassemia, lead poisoning, alcohol abuse, iron overload

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