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STEP Flash Cards > CBSSA 13 > Flashcards

CBSSA 13 Flashcards

1
Q

Man with longstanding DM type II and has anemia - how do you treat it?

A

It’s anemia of chronic disease - give EPO

Inflammation leads to inc. hepcidin which inhibits iron release from macrophages -

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2
Q

Acetaminophen toxicity & how alcohol facilitates this

A

Majority metabolized via glucuronidation to non-toxic metabolite.
Generation of NAPQI (N-acetyl-p-benzoquinoneimine) via P450 = MINOR PATHWAY
TOO MUCH = saturation of glucuronidation = more P450 metabolism

Alcohol induces P450 system

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3
Q

Deficiency in myeloperoxidase prevents _____________ which causes inc. susceptibility to infections

A

Inability to produce hydroxy-halide radicals

H2O2 converted to HOCl radical via MPO

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4
Q

Pseudomonas exotoxin A

A

Inactivates EF-2

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5
Q

Chronic pseudomonas infections characterized by…

A

BIOFILM formation

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6
Q

What produces fructose rich secretions found in semen

A

Seminal vesicles

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7
Q

Primary cause of hemochromatosis

A

Mutation in HFE gene leads to increased intestinal absorption of iron = inc. iron stores and serum iron

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8
Q

Non-acantholytic blister with sepearation of epidermis from basement membrane - autoantibodies against?

A

Hemidesmosomal proteins
Bullous pemphigoid - IgG Ab
Spares oral mucosa (less severe than pemphigus vulgaris)

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9
Q

Pemphigus vulgaris

A

Autoimmune IgG Ab against desmoglein 3 (part of desmosomes) - acantholysis
+ Niklosky sign

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10
Q

Visceral pleura of lungs receives blood supply from…

A

Bronchial artery branches

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11
Q

Parietal pleura of lungs receives blood from…

A

Intercostal arteries

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12
Q

Which receives more CO? Bronchial or pulmonary circulation?

A

Pulmonary. Duh.

High volume, low pressure

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13
Q

Young adult male presents with hematuria, hemoptysis, weight loss - has microcytic hypochromic anemia - most likely dx and findings on IF, LM, GBM, EM?

A 
Goodpasture's (RPGN)
IF: Linear deposition of anti GBM Ab's
LM: Glomerular crescents
GBM: linear IgG and C3 deposits
EM: no deposits
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14
Q

Role of RNA peptidyl transferase

A

Forms the peptide bonds between AA

Inhib by. chloramphenicol (on 50S subunit)

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15
Q

Trace path for glucagon/epinephrine mechanism to inc. glycogenolysis

A

Glucagon (from liver) or Epi (From liver & muscle) stim. adenylyl cyclase
Inc. cAMP
Activate PKA
Activate Glycogen phosphorylase kinase (adding Pi)
Activate glycogen phosphorylase
Activate glycogenolysis

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16
Q

Insulin effect on inhibiting glycogenolysis

A

Dimerize TK receptors
Activate protein phosphatase
INactivate glycogen phosphorylase kinase via removing Pi

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17
Q

How to become resistant to cirprofloxacin

A

DNA GYRASE MUTATION!!!!
Efflux pumps
Plasmid-mediated resistance

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18
Q

Characteristics of a VIPoma

A 
Watery diarrhea
Hypokalemia
Achlorhydria
Diarrhea will NOT get better fasting
Vasodilation (flushing)
Hyperglycemia
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19
Q

VIP function

A

Smooth muscle relaxation and sphincter relaxation

Inc. intestinal water and electrolyte secretion

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20
Q

If you add a base pair to 3’ end of tRNA and consequently shorten the C loop, what is the most likely effect on mitochondrial function?

A

Decreased protein synthesis - you’ll still have same mRNA stability but you won’t translate the protein (aka no synthesis)

21
Q

Define the ego defense of SUPPRESSION

A

Voluntary witholding of an idea or feeling from conscious awareness (vs. repression)
Ex: Choosing not to think about the fact that alcoholics anger you and choosing to deal with it more effectively

22
Q

Define reaction formation

A

IMMATURE/unhealthy ego defense
A warded-off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite

Ex: sex addicted thought person enters a monastery

23
Q

Define sublimation ego defense

A

MATURE/healthy
One replaces an unacceptable wish with a course of action that is similar but does not conflict with one’s value system

Ex: teen’s aggression towards father is redirected to performing well in sports

24
Q

Bupivacaine MOA

A

LOCAL ANESTHETIC
Decreased permeability to Na+ (prevents influx)
Inhib. depolarization

25
Q

Persistent nonbilious projectile vomiting; prominent peristalsis - mechanism for condition?

A

Congenital pyloric stenosis = hypertrophy of pyloric sphincter
Palpable olive mass in epigastric region
Often in males

26
Q

What type of hypersensitivity = wheal and flare eruptions/hives

A

Type 1 hypersensitivity/immediate

27
Q

Beta-2 agonist effects

A

Vasodilation, bronchodilation, uterine relaxation, ciliary muscle relaxation (pupillary constriction), increase insulin release

28
Q

Define loss of heterozygosity

A

If a pt inherits or develops a mutation in a tumor suppressor gene, the complementary allele must be deleted/mutated before cancer develops (ex: p53)

29
Q

Cohort observational vs. Cross-sectional study

A

Cohort: smaller group of individuals watched over long period of time (given exposure/risk factor and risk for a particular disease)

Cross-sectional: large population looked at a particular instance in time (determine disease frequency/prevalence)

30
Q

Describe staghorn calculus

A

Essentially take up the entire renal pelvis and calyces

31
Q

Enlarging neck mass on left side - painless, mobiel, soft, cystic

A

Persistent cervical sinus - incomplete fusion (from 2nd-4th clefts) it will be located on LATERAL neck (so a little bit in front of your SCM muscle)

32
Q

Fibrates + Statins combined side effect

A

Myopathies - cramping, pain, myalgias

Fibrates will inhibit P450 metabolism of statin

33
Q

Myasthenia gravis relating to lung disease

A

Causes RESTRICTIVE.
Will not hear any lung abnormalities
Dec. VC, Vt, ERV, normal RV
Has trouble taking a long, deep breath

34
Q

Sickle cell cause

A

Point mutation causes single AA replacement of beta chain Hb - in low oxygen states, you get sickling (polymerization of Hb and shape distortion)

35
Q

HIV protease MOA

A

Inhibition prevents maturation of new viruses because assembly of the virion depends on proteases (pol gene) to cleave the giant protein product into functional units

You don’t get a mature viral core

36
Q

Osteoporosis in post-menopausal women can show increased levels of…

A

IL-1 - IL-1A = osteoclast activating factor!

37
Q

MItochondrial myopathies

A

mutations affecting mitochondrial function - RAGGED RED FIBERS - inhibits oxidative phosphorylation

38
Q

MELAS

A

See increased lactic acid concentration
CNS and myopathy problems
Headaches, clumsiness, fatigue

39
Q

Metformin toxicity

A

Inc. lactic acid concentration

40
Q

Hydatidiform mole is a proliferation of…

A

Trophoblastic tissue

41
Q

Heroin withdrawal in baby

A

Sucking frantically, crying inconsolably, overreacts to stimuli, marked startle response

42
Q

Mesial temporal sclerosis

A

Most common cause of temporal lobe epilepsy

43
Q

Consequence of AVM

A

The most frequently observed problems related to an AVM are headaches and seizures

44
Q

Antiphospholipid antibody syndrome

A

Characterized by loss of pregnancy (lots of stillborns/spont abortions) and spontaneous clotting (DVTs leading to PE’s)
Check levels of lupus anticoagulant

45
Q

History of pregnancy losses?

A

THINK SLE

46
Q

Herpes establishes latency…

A

In sensory nerve cells (sacral ganglia)

47
Q

Transplant - 6 mo later see infiltrating T CD8 lymphocytes - most likely cause of rejection?

A

Direct cytotoxicity

48
Q

ARDS causes

A

Acute diffuse alveolar damage - see hyaline membranes of alveoli, inc. capillary perm.

STEP Flash Cards (14 decks)

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