CPR - Unreviewed blocks

Question 1

Adenocarcinoma of the lung will often px with ___ production? And is often found in what part of the lung?

Answer 1

Mucin (watery sputum - bronchorrea)

Periphery (alveolar epithelium)

Question 2

Small cell lung cancer Histology?

Answer 2

Small blue cells, found mostly in the major bronchi

Question 3

Squamous cell carcinoma histology?

Answer 3

Squamous cells with intracellular bridges and keratin pearls

Question 4

S. pneumo is Bile soluble/insoluble and Optochin sensitive/insensitive?

Answer 4

Bile soluble

Optochin sensitive

Question 5

Polysaccride capsule in H. influenza which allows it to?

Answer 5

spread hematogenously and cause invasive disease

Question 6

Proximal ureter receives blood flow from?

Distal ureter receives blood from?

Answer 6

Renal artery

Superior vesical artery

Question 7

In methacholine challenge,what is indicative of asthma?

Answer 7

FEV1 reductions at lower doses than those without asthma (hyper-responsiveness to the stimulus)

Question 8

Vancomysin often causes ___ after a long course?

Answer 8

ATN

Question 9

Chemoreceptors and baroreceptors are located are located here?

Answer 9

Carotid body (CN 9)

Aortic arch (CN 10)

Question 10

The CFTR transmembrane protein that is dysfunctional in CF is a ____ gated channel?

Answer 10

ATP

Question 11

Malignant nephrosclerosis is usually as a result of ?

Answer 11

Severe hypertension (often HTN emergency - with end organ damage)

Question 12

Malignant nephrosclerosis is characterized by 2 hist patterns?

Answer 12

1. Fibrinoid necrosis of small arterial walls

2. Hyperplastic arteriosclerosis ( activate platelets release growth factors-> concentric hyperplasia.

Question 13

How does rhamdomyolysis cause Acute kidney injury?

Answer 13

Myoglobin degradation -> produce heme pigment -> directly cytotoxic to the kidney and causes vasoconstriction (ischemia) -> ATN

Question 14

Phospolipid testing during pregnancy is done to determine?

Answer 14

Lung maturity.

**lecithin/sphingomyelin ratio -> mature is >2

Question 15

The main culprits in the development of centriacinar emphysema are?

Answer 15

The activated neutrophils and macrophages. These release protease (elastase) that degrade the ECM and generate free oxygen radicals.

Question 16

What is the treatment fro Nephrogenic DI?

Answer 16

Thiazide diuretics and replacement of water losses. (paradoxical use of thiazide -> induces dehydration -> forcing the PCT to reabsorb more Na & water)

Question 17

Chronic rejection of transplant causes?

Answer 17

Bronchiolitis obliterans (lymphocytic infiltration -> fibrosis of small airways)

Question 18

In CKD what are the reasons for low calcium?

Answer 18

Phosphate clearance declines -> High phosphate binds free Ca2+
Kidney is unable to convert vitamin D into activated form

Question 19

Exposure to rubber, plastics, aromatic amines- containing dyes, textiles or leather increases risk for development of this cancer?

Answer 19

Bladder (urothelial) cancer

Question 20

Which of the diuretics is known for increasing calcium resorption?

Answer 20

Thiazides

Question 21

Fever, maculopapular rash and acute renal failure that occurs 1-3 weeks after beginning a new medication is highly suggestive of?

Answer 21

Acute interstitial nephritis

** will see eosinophilia, sterile pyuria, possible WBC casts

Question 22

Which drug class is often used to treat pulmonary HTN?

Answer 22

Endothelin receptor antagonists (bosetan, ambrisentan)

**Endothelin is a potent vasoconstrictor promotes smooth cell proliferatn

Question 23

What is the gene responsible for familial PAH?

Answer 23

BPR2.

** results in proliferative vasculopathy of pulmonary arteriolar smooth muscle

Question 24

Filtration fraction formula?

Answer 24

GFR/RPF. Where RPlasmaF is RBloodF *(1-Hematocrit)

Question 25

S. Pneumo vaccines. Polysaccharide vaccine features? Conjugate vaccine features?

Answer 25

T cell independent - B cell activation (moderate response, not effective for infants) T cell dependent B cell activation - generates higher affinity antibodies.

Question 26

In TB, which cell activate macrophages?

Answer 26

CD 4 -> T helper -> secrete IFN-gamma-> activate macrophages

Question 27

The polysaccaride capsule in H. influenza contain these polymers?

Answer 27

PRP (polyribosylribitol phosphate)

Question 28

Cardiac tissue conduction velocity. Fastest to slowest?

Answer 28

``` Park at Venture Avenue P- Purkinje A - Atrial M. V- Ventricular m A - AV node ```

Question 29

What is the cause of malignancy related hypercalcemia?

Answer 29

Production of PTHrp

Question 30

Pulmonary edema due to HF can often _____ lung compliance?

Answer 30

Decrease. Edema makes the lungs heavy and stiff

Question 31

Clear cell carcinoma of the kidney originates from? Risk? Histology?

Answer 31

epithelial cells of the proximal renal tubule Smoking and toxin exposure Golden yellow cells (high lipid content) & areas of focal necrosis & hemorrhage

Question 32

RCC often invades this structure?

Answer 32

The renal vein -> can extend to the IVC -> Px with symmetrical lower extremity edema and development of venous collateral.