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CBSSA Flashcards

0
Q

If I see an image of nucleated keratinocytes and a description of a red SCALY plaque in a sun exposed area, it is probably…

A

Actinic keratosis

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1
Q

Renal cell cancer is also known as

A

Renal Adenocarcinoma - highly vascularized – lower pole of kidney.

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2
Q

What is the most posterior portion of the heart that can cause compression of the esophagus and lead to dysphagia or hoarseness?

A

Left atrium

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3
Q

A widened aortic arch and diminished pulses in an extremity regardless of history including drug history is concerning for?

A

Dissecting aneurysm.

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4
Q

What is the physiologic correlate of STABLE angina?

A

It is ischemia to a vessel with greater than 60% occlusion.

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5
Q

What is the physiologic correlate to UNSTABLE ANGINA

Myocardial infarction - ACS?

A

Unstable angina: usually plaque disruption with clot formation and interrupted distal flow or vasoconstriction or mechanical occlusion or inflammation or increased myocardial oxygen demand

Myocardial infarction: Total occlusion of the coronary vessel

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6
Q

Full recovery in acute bacterial pneumonia can occur because

A

Alveolar exudate is lysed and absorbed. As long as there is no damage to vascular and endothelial tissue (including Basement membrane), there will be NO granulation tissue formed.

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7
Q

Type II pneumocytes are endodermal in origin.

A

Repeat

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8
Q

What is the characteristic peipheral blood smear result in HELLP.

A

It is a MAHA due to high velocity damage against damaged endothelial cells. SCHISTOCYTES.

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9
Q

What determines the tropism of leprosy (mycobacterium leprae) to the dermis as opposed to the viscera?

A

Temperature (cooler temp preferred). Note that the lion facies version of leprosy (lepromatous is a TH2 response)

While the tuberculoid form of leprosy with hypoesthetic plaques is a Th1 response.

Both are treated with dapsone and rifampin. Add clofazimine for tuberculoid form.

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10
Q

What is the mechanism of action of Bisphosphonates?

A

Bisphosphonates are pyro phosphate analogs. Bind hydroxyapatite in bone INHIBITING OSTEOCLAST activity.

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11
Q

Erythema with no blisters after being in the sun

A

First degree burn.

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12
Q

What are struvite stones made of?

A

Ammonium magnesium phosphate. Struvite is the name of these stones and they are a nidus for UTI infection

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13
Q

What is the most posterior chamber of the heart that can result in dysphagia? Or hoarseness?

A

Left atrium

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14
Q

Where is the MLF located?

A

It is located in the brainstem by the third ventricle.

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15
Q

What is agraphesthesia?

A

In ability to recognize a number or letter written on skin.

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16
Q

What is unique about Vaccinia?

A

It is a poxvirus. These are DNA viruses but they ONLY REPLICATE IN THE CYTOPLASM because they carry all their replication machinery with them.

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17
Q

Influenza is unique in that it is a single-stranded RNA virus that replicates in the…

A

Nucleus! The only other virus that does this is Hep D virus.

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18
Q

Peek-a-boo is a proxy for

A

Object permanence (7-9months). Finger feeding happens around the same time (6-12 months).

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19
Q

Any time umbilication is mentioned with a skin rash, just pick

A

Molluscum.

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20
Q

Type II pneumocyte touches the wall and looks like it has substances within it.

A

Repeat

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21
Q

What is Rathke’s pouch?

A

It is a diverticulum of the roof of the developing oral cavity.

22
Q

Amiodarone, Ibutilide, Dofelitide, and Sotalol are all…

A

Class III anti-arrhythmics that increase QT and predispose to TOrsades de pointes.

23
Q

What is the mechanism of action of cholestyramine?

A

Cholestyramine is a bile acid sequestrant. It can exchange chloride anions with anionic bile acids and bind strongly forming insoluble complexes.

24
Q

What cholesterol drug inhibits transport of cholesterol through the intestinal wall?

A

Ezetimibe – blocks absorption of cholesterol in the intestine!

25
Q

What is gemfibrozil? What is its mechanism of action?

A

Gemfibrozil is a fibrate. It works by up regulating Lipoprotein lipase to increase triglyceride clearance. It also activates PPAR-alpha (nuclear receptor) to induce HDL synthesis.

26
Q

What phase clinical trial involves a small number of healthy volunteers to determine safety and toxicity?

A

Phase 1

27
Q

What phase clinical trial involves only diseases people to see how drug works?

A

Phase 2

28
Q

What phase clinical trial involves post-marketing surveillance like examining long-term adverse effects

A

Phase 4

29
Q

What phase clinical trial compares the drug to standard of care?

A

Phase 3

30
Q

Cytochrome P450 2D6 demonstrates autosomal RECESSIVE inheritance for being a poor metabolizer of drugs. If someone is Cytochrome P450 2D4 alleles homozygous for example, that means they have two alleles (4), one inherited from each parent.

A

Repeat.

31
Q

How do Glucorticoids like prednisone act as anti-inflammatory drugs?

A

They INHIBIT NF-kappa B which suppresses BOTH T and B lymphocyte function.

32
Q

Thyroid hormone binds to…

A

NUCLEAR Retinoid X receptor.

33
Q

Which hormones bind to JAK STAT

A

Prolactin, cytokines, and Growth hormone.

34
Q

What hormones bind to cAMP?

A

FLAT ChAMP. FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2 receptor), MSH, PTH, Glucagon, Calcitonin

35
Q

What is the difference between variable expressivity and incomplete penetrance?

A

Variable expressivity means individuals with the same genotype can have different severities of disease. They are ALL affected. Just at a varied rate.

Incomplete penetrance on the other hand, means some people with the mutant allele DO NOT show the mutant phenotype.

36
Q

What does gonadal mosaicism mean?

A

Gonadal mosaicism means that there are genetically distinct cell lines that ARISE from MITOTIC errors AFTER fertilization that only exist in the gametes of the affected individual.

37
Q

What is the normal coverage of Ampicillin?

How do the gram negatives that achieve resistance to ampicillin acquire it?

A

It’s normal coverage includes gram negative rods like E. Coli, H. Flu, proteus.

The vast majority of gram negatives that develop resistance do so via a beta-Lactamase!!!

38
Q

Which bacteria establishes resistance to beta-lactam by ALTERING ITS PENICILLIN BINDING PROTEIN?

A

MRSA.

39
Q

What are the most common hematologic disorders in lupus?

A

Cytopenias - thrombocytopenia, leukopenia, anemia.

40
Q

In response to what is the carotid sinus Baroreceptor activity increased or decreased?

A

Hypotension REDUCES stretch of the carotid sinus baroreceptors. Reduced stretch REDUCES AFFERENT Baroreceptor firing leading to INCREASED efferent sympathetic firing and reduced parasympathetic firing which increases vasoconstriction, HR, contractility, and BP.

41
Q

How does regenerating muscle quickly increase its ATP concentration?

A

Creatine phosphate is hydrolyzed by myosin

42
Q

What is the inheritance pattern of osteogenesis imperfecta?

If a father has 2 kids with the disease and only 1 in 10 of his sperm actually have the defect, what is happening?

A

Autosomal dominant

Germline mosaicism. The mutation is present in only part of his germ cells and occurred via an error in mitotic division after fertilization.

43
Q

What drug promotes urination by acting as muscarinic AGONIST?

A

Bethanechol

44
Q

What is the impact of a central retinal artery occlusion?

A

Loss of retinal ganglion cells.

45
Q

What core issue underlies acetaminophen toxicity?

A

Decreased gluthathione. Acetaminophen ONLY becomes toxic when it exceeds the capacity of gluthathione to neutralize one of its metabolits formed by cytochrome P 450. The antidote is N -acetylcysteine

46
Q

Best thing to do to alleviate GERD is avoid caffeine and fatty foods.

A

Repeat.

47
Q

What does EPO do?

A

It stimulates ERYTHROID PRECURSORS.

48
Q

What is the major side effect of the Histamine 1 receptor antagonists?

A

Drowsiness, sedation, and anti-muscarinic effects.

49
Q

Although pralidoxime reverts both muscarinic and Nicotinic effects, the best drug to use in the setting of ACUTE organophosphate poisoning is???

A

Atropine!!!

50
Q

Insulin Upregulates transcription of glucokinase

A

Repeat.

51
Q

What is the antidote to methanol or ethylene glycol poisoning?

A

Ethanol or Fomepizole. Ethanol works by binding alcohol dehydrogenase more effectively while fomepizole works by COMPETITIVELY inhibiting alcohol dehydrogenase.

52
Q

Increased bHCG differential should be hyatidiform mole vs choriocarcinoma.

A

Repeat

53
Q

Edema that occurs subsequent to a bee sting occurs because histamine facilitates ENDOTHELIAL cells creating GAPS.

A

Repeat.

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