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DIT and Random Flashcards

1
Q

Clinical manifestations of sarcoidosis

A

GRUELING

Granulomas

RA

Uveitis

Erythema nodosum

Lymphadenopathy

Idiopathic

Not TB

Gamma Globulinemia

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2
Q

What is seen in synovial asparate in gout?

Pseudogout?

A

Gout: - Birefringence with needle shaped crystals

Pseudogout: + birefringence with Rhomboid shapped crystals

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3
Q

Decreased AFP on amniocentesis

A

Trisomy 21

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4
Q

Psammoma bodies are observed in these patholigic conditions

A

Papillary adenocarcinoma of thyroid

Serous cystAdenocarcinoma of ovary

Meningioma

Mesothelioma

PSAMMoma

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5
Q

Parotid gland enlargement in a thin female?

A

Bulima/Anorexia nervosa

Parotid gland enlargement is evidence of purging

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6
Q

Which DNA polymerase has 5’–>3’ exonuclease activity?

A

DNA Polymerase I

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7
Q

Which prokaryotic polymerase has 3’–>5’ exonuclease activity?

A

DNA polymerase III to proofread

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8
Q

Dark urine upon exposure to light

A

Acute intermittant porphyria

Uroporphyrinogen I Synthase defect

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9
Q

Major lamotrigine use and side effect?

A

Partial refractory seizures

Steven-johnson syndrome

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10
Q

Major adverse effect associated with Ethosuxamide

A

Steven-johnson syndrome

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11
Q

Location of GLUT-1,2,3,4,5

A

GLUTE-1: RBC and Brain

GLUTE-2: Liver, B islet cells, Kidney

GLUTE-3: Neurons

GLUTE-4: Skeletal muscle and Adipose

GLUTE-5: Frutose trnasporter in the GI

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12
Q

What structures are derived from the first aortic arch?

A

The maxillary artery

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13
Q

Structure derived from the second aortic arch?

A

Stapedial artery

(Stapedial is Second)

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14
Q

Third aortic arch

A

Common carotid and proximal internal carotid

(C is the **3rd **letter of the alphabet)

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15
Q

Fourth aortic arch

A

Left: Aortic Arch

Right: proximal part of right subclavian

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16
Q

6th aortic arch

A

Proximal part of the pulmonary arteries

Ductus arteriosus

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17
Q

Which embryonic layer are the folling dervied from:

Branchial Clefts

Branchial arches

Branchial pouches

A

Clfects: eCtoderm

Arches: mesoderm (ARMESoderm)

Pouches: Endoderm

or CAP from outside to inside

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18
Q

Cartilage, muscles and nerves derived from the first branchial arch?

A

Meckel’s cartilage, Mandible, Malleus, Mandibular ligament

Muscles: Muscles of Mastication, Masseter, lateral and Medial pterygoid, myelohyoid, anterior belly of digastric and tensor tymapni and tensor veli palitini

Nerves: V2 and V3

The M’s

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19
Q

2nd branchial arch cartilage, muscles, and nerves

A

The S’s

Cartilage: Stapes, Styloid preocess, Stylohyoid ligament

Muscles: Facial expression, Stapedius and Stylohyoid

Nerves: CN VII (Seven=Smile)

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20
Q

3rd branchial arch cartilage, muscles and nerves

A

“Pharyngeal”

Catilage: greater horn of hyoid

Muscles: stylopharyngeus innervated by glossopharyngeal nerve (CNVIII)

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21
Q

Arches 4-6 cartilage, muscles, and nerves

A

Cartilage: thyroid, cricoid, and other laryngeal cartilage

Muscles: 4th: Pharyngeal constrictors, cricothyroid, levator veli palatini

Muscles: 6th: all intrinsic laryngeal except cricothyroid

Nerves: 4th: Superior laryngeal branch of CNX

Nerves: 6th: Recurrent laryngeal branch of CNX

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22
Q

Structures derived from the 3rd and 4th branchial pouches

A

3rd: inferior parathyroids and thymus
4th: **superior **parathyroids

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23
Q

Developes into the ascending aorta and pulmonary trunk

A

truncus areteriosis

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24
Q

forms the smooth part of the left and right ventricles

A

bulbus cordis

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25
Q

The primitive ventricle and primitive atria form

A

The trabeculated parts of the ventricles and trabeculated parts of the atria respectively

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26
Q

coronary sinus is formed by the

A

left horn of the sinus venosus

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27
Q

Right horn of the sinus venosus forms the

A

smooth part of the right atrium

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28
Q

SVC is formed by

A

the right common cardinal vein and the right anterior cardinal vein

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29
Q

What does HCV lack that makes it so prone to mutations?

A

3’–>5’ exonuclease activity

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30
Q

How is the fick principle used to calculate Cardiac Output?

A

CO= O2 consumption/(arterialO2-VenousO2)

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31
Q

These drugs are hypnotics that cause sedation and are also anxiolytics. What is their MOA?

A

BenZodiaZepines

Increase Cl channel frequenzzzzzz

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32
Q

What is the most common indolent non-hodgkin lymphoma in adults?

A

Follicular lymphoma

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33
Q

protein that regulates the G1–>S phase transition

How does it work?

A

Rb

Supresses transcription when in the hypophophrylated (active) state and is bound to EF2

When CyclinD and E and CDK4 and 6 (respectively) phophorylate Rb it becomes inactive and releases EF2 allowing transcription to take place

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34
Q

receptor that contains C and Adelta fibers and transmits pain and temperature

A

Free nerve endings

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35
Q

Sense pressure and deep static touch, are located in hair follicles…

What kind of fibers do they carry?

A

Merkel Discs

Carry large myelinated fibers and adapt slowly

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36
Q

Fine, light touch receptors that are located on hairless skin and adapt quickly…

What kind of fibers

A

Meisner corpuscles

Large myelinated fibers

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37
Q

Location, function, and fiber type associated with paccinian corpuscles

A

Large myelinated fibers

Deep skin, ligaments and joints

Sense vibration and pressure

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38
Q

Most common salivary glad tumor

A

Pleomorphic adenoma–> painless mobile mass composed of cartilage and epithelium and recurs frequently

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39
Q

Benign cyctic tumor with germinal centers found in the parotid gland

A

Warthin tumor

(papillary cystadenoma lymphomatosum)

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40
Q

msot common malignant salivary gland tumor

What is it composed of?

How does it present?

A

Mucoepidermoid carcinoma

–>mucinous and squamous components

–>presents as a painful mass and commonly involves the facial nerve

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41
Q

acute, fatty, foul smelling diarrhea

A

Giardia

(pear shapped nuclei with tumbling motility)

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42
Q

Tx for giaridia

A

Metronidazole

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43
Q

RBC inside of trophozoites with multiple nuclei

A

Entomoeba histolytica

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44
Q

DOC for entomoeba histolytica

A

–Trophozoites with Metronidazole and tinidazole

–Cysts with iodoquinol and paromycin

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45
Q

Bugs treated with metronidazole?

A

**GET GAP **on the Metro

Giardia

Entomoeba

Trichomonas

Gardnerella

Anerobic bacteria

Pylori (H. pylori)

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46
Q

Triad of conginital toxoplasmosis?

A

Choriretinitis

Hydrocephalus

Intracranial calcifications

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47
Q

Tx of toxoplasmosis

A

Sulfadiazine and pyrimethamine

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48
Q

Bug that causes african sleeping sickness

A

trypanosoma bruci (tsetse fly)

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49
Q

spiking fevers

hepatosplenomegaly

pancytopenia

Macrophages containing amastigotes

A

Leishmania donovani (sand fly)

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50
Q

Cutaneous ulcers that are slow to head after a bug bit?

A

Cutaneous leishmaniasis

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51
Q

Anopheles mosquito

A

Malaria

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52
Q

48 hr fever cycle

A

P. vivax and ovale

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53
Q

Malaria assocatied with irregular fever

A

P. falciparum

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54
Q

72hr fever cycle

A

P. malariae

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55
Q

Vivax and oval can remain dormant so must be treated with what drug

A

Primaqine

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56
Q

Bananna shapped gametocyte

A

P. falciparum

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57
Q

Tx for malaria

A

Start with Chloroquine

If resistant add Mefloquine

if Vivax/Ovale (48hr cycle) add primaquine

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58
Q

Tx for babesiosis

A

Quinine and azithromycin

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59
Q

Neomatodes that are trasmitted orally (either Fecal-oral or ingestion)

A

Enterbius (pinworm-scotch tape)

Asacaris (giant roundworm–Loeffler eosinophilic pneumonitis)

Trichinella (bears–> in the muscle)

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60
Q

Stongyloids transmission and Tx

A

Penetrate skin of feet–>venous–>lungs blahblahblah

Ivermectin or albendazole

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61
Q

Three worms from feet penetrations

A

Strongyloides

Ancylostoma

Necator

d

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62
Q

Cestode that causes neurocystercerosis

A

Tanea solium

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63
Q

Cysts from dog feces

A

echinococcus granulosus (ethanol injected to kill cysts before removal)

64
Q

Helminths with portal hypertension and splenomegaly

A

Schistosoma

65
Q

Top 3 most common cancers in men in US

A

Prostate

Lung

Colon

66
Q

Most common cancer in women in US

A

Breast

Lung

Colon

Uterus

67
Q

Men most mortalities from cancer

A

Lung

Prostate

Colon

(switch one and two most common)

68
Q

Most mortalities from cancer in women in US

A

Lung

Breast

Colon

(Switch first and second most common)

69
Q

What CDK and cycldin is involved in Rb protein phosporylation

A

Cyclin D activated CDK4–>Rb phosphorylation

Phosphorlated Rb detaches from EF2 and allows G1-S phase to continue

70
Q

Tumors associated with tuberous sclerosis?

Skin manifestation to TS?

A

-Cardiac rhabdomyoma, renal angiomyolipoma, astrocytoma

Ash Leaf spots

71
Q

Most common three drug regimin for testicular cancer?

A

Eradicate Ball Cancer

Etopiside

Bleomycin (can be replaced with Ifosfomide)

Cisplatin

72
Q

Cancer drug that stabilizes microtubules

A

Paclitaxel and taxols

TAXES stabilize society

73
Q

Side effects of glucocorticoid use

A

BAM CUSHINGOID

Buffalo Hump

Amenorrhea

Moon faces

Crazy (psychosis)

Ulcers

Skin changes

HTN

Infection

Necrosis of the femoral head

Galucoma and cataracts (hyperglycemia)

Osteoporosis

immunosuppression

Diabetes

74
Q

Patient with a recent subarachnoid hemorrhage (4-12d) develops similar symptomes (muscle weakness) as the original event. What is the most likely cause?

A

Cerebral vasospasm

Seen in >50% of SAH and will manifest with similar physical finidings and a negative non-contrast CT

75
Q

MOA of colchicine

A

Inhibits microtubule formation thereby affecting leukocyte migration and chemotaxis

76
Q

Etoposide inhibits….

A

Topoisomerase II

77
Q

Morphine acts by…

A

Inihbiting mu receptors and causing increase potassium efflux from the post-synaptic neuron.

78
Q

Paitient with a significant family Hx of early cancers of the brain, adrenal cortex, breast, leukemia and sarcomas. What is the mutation and what is the name of the disorder?

A

Li-Fraumeni Syndrome

Mutation in p53

79
Q

Mutation in pecam-1 would affect this step of leukocyte migration…

A

Transmigration

80
Q

A young child with difficulty walking, oral telangiextasias and recurrent infections

A

Ataxia-telangiectasia

ATM gene mutation

Cerebellar atrophy

81
Q

Hemosiderin laden macrophages in the lungs are indicative of this pathology

A

Left ventricular dysfunction

Heart failure cells

82
Q

This is supplemented in orotic acidurea

A

Uridine

83
Q

Pulmonary edema has what effect on lung compliance?

A

Reduces it

84
Q

Where does osteomyelitis most common occur?

A

Metaphysis of long bones

85
Q

What does hyperPTH look like on xray?

A

Subperiosteal thinning with cystic degeneration

86
Q

Selective proteinuria

A

Loss of albumin without loss of the bulkier proteins like IgG and IgM

87
Q

Why is albumin the predominant protein lost in minimal change disease?

A

Becuase mostly the negatively charged molecules are lost from the GBM in MCD and albumin is small enough to fit through pores.

Without charge exclusion from heparan sulfate and other proteoglycans, albumin leaks

88
Q

X-linked disorder consisting of excema, recurrent infections and thrombocytopenia

A

Wiscott-Aldrich syndrome

89
Q

Replicates in cold environment and exhibits tumbling motility. Almost exclusively seen in IC adults.

A

Listeria monocytogenes

90
Q

A 85 year old patient with focal motor deficits and hypertension.

CT of the head reveals a small cystic lesion in the brain. What is the cause of this lesion?

A

Lacunar infarct

–>Hyaline arteriolosclerosis

91
Q

What cholesterol lowering drugs cause hypertriglyceridemia? How?

A

Bile acid binding resins (cholecytyramine)

–>raise TGs by binding bile acids and forcing the liver to mobilize LDL and increase uptake to resynthesize bile acids

92
Q

What lipid lowering drug increases the toxicity of statins?

A

Gemfibrozil (fibrates)

Increased the myopathic toxicity

93
Q

Lobular strokes occuring in the cerebral hemisphere and not as severe as other strokes

A

Cerebral amyloid angiopathy

94
Q

Nitrogen in urea are derved from what two compounds?

A

NH3 and Aspartate

95
Q

antipsychotic that causes retinal deposits

A

ThioRidizine

Retinal deposits

96
Q

Findings in pulmonary silicosis

A

Eggshell calcification of hilar lymph nodes

Birefringent silica crystals

97
Q

What is the most potent echosinoid chemotactic agent?

Which of these are implicated in asthma related bronchospasm?

A

Leukotriene B4

Asthma: LTC4, D4 and E4

98
Q

Which of the anti-tuberculoid drugs have highest acticity at low pH (in the lysosmes)

A

Pyrazinamide

99
Q

Is KRAS an anti- or proto-oncogene?

A

Proto-oncogene

100
Q

What AAs should be restricted in a pt with MSUD

A

Isoleucine

Leucine

Valine

I Love Vermont maple syrup

101
Q

Enzyme defect in acute intermittant porphyria?

KNOW WHERE IN THE CYCLE THIS FITS

A

Porphobilinogen deaminase

AKA

Uroporphyrinogen I Synthase

102
Q

Hemophilia inheritance pattern?

A

X-linked recessive

103
Q

Myasthenia gravis pts will benefit from what surical procedure? Why?

A

Thymectomy

Most MG pts have hyperplastic thymic tissue producing the AChR auto antibodies (causing a type II hypersensitivity) and a small percentage of them also have thymoma

104
Q

Digeorge syndrome–> conginital aplasia of which structures

A

3rd (thymus and inferior parathyroids) and 4th (superior parathyroids) pharyngeal POUCHES

POUCHES

POUCHES

POUCHES

105
Q

Levels of serum pH, K, and Na in DKA

A

pH is low

K is high (relitively because total stores are low due to loss in urine)

Na is low (due to osmotic pressure of glucose and loss in urine)

106
Q

Anti-cancer agent that is extremely ototoxic

A

cisplatin

107
Q

Slowly progressive cough and dyspnea in a patient being Tx’ed for a ventricular arrythmia

A

Amiodarone

108
Q

Process by which fatty acids are anchored to the plasma membrane

A

polmitoylation

109
Q

mutations in the same gene presenting with varying degrees of disease

A

Allelic heterogenicy

110
Q

Point mutation in FGFR3

A

Achondroplasia

111
Q

Two enzymes that require thiamine (B1) as a cofactor.

A

Transketolase

Alpha-ketoacid decarboxylase (MSUD)

112
Q

Type and size of RBC seen in thalassemias

A

Microcytic

Target cells

113
Q

In females the gubernaculum persists as the

A

round ligament of the uterus

114
Q

PAF (platelet activating factor) causes what response through what receptor?

A

Vasoconstriction

Bronchoconstriction

Platelet activation and thrombus formation

Gq receptor mediated (IP3 and Ca)

115
Q

First step of FA oxidation is catalyzed by what enzyme?

A

Acetyl-CoA Dehydrogenase

Deficiency causes severe fasting hypoglycemia with decreased ketones

116
Q

Which of the tumor supporssor and proto-oncogenes is a transmembrane (rather than intranuclear) receptor?

A

Ras

MAP-kinase receptor

117
Q

In a lineweaver-burke plot, increased enzyme will have what effect on the graph

A

The y-intercept will decrease (Increased 1/vmax)

x-intercept (1/Km) will stay the same becuase the affinity of the receptor for the substrate has not changed

118
Q

Pt with apthous (oral) ulcers and perianal disease. What part of the GI tract is most likley affected?

A

Ileum

–> Most commonly area affected by crohns disease

119
Q

Which fibers are the only ones in the body that are unmyelinated

A

Postganglionic autonomic fibers

First order olefactory fibers

C fibers carrying slow pain and dull sense

120
Q

Entero viruses (coxsackie, polio, echo, entero, and hepatitis) are all part of what family of viruses?

A

Picornoviruses

121
Q

During antigen processing, what chain is processed by macrophages

A

invariant chain

122
Q

Different mutations in different genes causing similar phenotypes is called:

Different mutations in the same gene causing similar phenotypes is called:

Different mutations in the same gene causing different phenotypes is called:

A

Genetic heterogenicity

Allelic heterogenicity

Phenotypic heterogenicty

123
Q

Aminoglycosides, amphoterocin B, radiocontrast dyes and heavy metals are all toxic to the…

A

Kidney

124
Q

Leuprolide MOA

A

GnRH analogue which decreases LH and FSH when dosed continuously

Mimics endogenous GnRH when dosed in pusatile manner

125
Q

Only type of renal stone that does not show up on plain x-ray

A

Uric acid stones

126
Q

How does N-acetylcysteine tx the pulmonary sx of cystic fibrosis

A

N-acetylcysteine breaks the disulfide bonds of the mucus glycoproteins which leads to loosening of the mucus

127
Q

Polyarteritis nodosa is associated with what other disease

A

Hepatitis B

128
Q

TZDs should be monitored closely with what tests?

A

LFTs due to heptaotoxicity

129
Q

Should be given to reduce cisplatin toxicity

What toxicity is associated with cisplatin?

A

Amifostine

–>Nephrotoxicity

130
Q

2 year old child with non-rhytmic eye movements, myoclonus and an abdominal mass

A

Neuroblastoma

131
Q

Fist coagulation factor to decrease in chronic liver disease?

A

Factor VII

132
Q

C-myc serves what function?

In which neoplastic process is it dysfunctional?

A

Transcription activator

Burkitt Lymphoma t(8;14)

133
Q

Medical Tx of pulmonary HTN

A

Bosetan–> endothelian antogonist–> vasoconstriction and inhibition of endothelial cell proliferations

134
Q

Swish and swallow for oral cadidiasis

A

Nystatin

Not absorbed from the GI tract

Similar in action to amphertericin B

135
Q

Bonchiolitis obliterans

A

chonic lung transplant rejection

Obliteration of the small airways

136
Q

Patient treated for bradycardia now has eye pain

A

Atropine–> caused acute closed angle glaucoma

137
Q

Vincristine toxicity

A

neurotoxicity

138
Q

bradycardia and STEMI in II III and aVF, what artery

A

Right coronary artery

Supplies SA node (brady) and inferior heart (II, III, aVF)

139
Q

Migratory thrombophelbitis should make you think….

A

Cancer

140
Q

Councilman bodies

A

Acidophillic bodies on H&E stain indicating apoptosis

141
Q

Most common benign liver tumor

A

cavernous hemangioma

142
Q

endoneural inflammatory infiltrate present after upper respiratory tract infection

A

Guillian-barre

143
Q

Preferred location of biopsy in hirshprung Dz

A

Rectal suction biopsy

144
Q

Reactive arthritis marker

A

HLA-B27

145
Q

Besides a phepchromocytoma, what else would be on the differential of a person with maligant HTN and palpitations

A

Withdrawl from clonidine and B-blockers

146
Q

Purpose of bromodeoxuridine in tumor grading

A

Thymidine analogue

–> increased uptake into the tumor indicates many cells in the S-phase–>High grade and rapidly dividing

147
Q

Patient diagnosed with dibetes mellitus who has epidermal necrolysis of the lower extremity and abdominal pain

A

Glucagonoma

148
Q

Mitral valve deposits and MI in the setting of no coronary artery involvement

A

Libmann-Sachs endocarditis

caused by SLE and hypercoagulability

149
Q

Cofactor needed to convert glutamyl residues into y-carboxyglutamate

A

Vitamin K

150
Q

Increaed serum transaminases with dificulty speeking and ataxia

A

Wilson disease

Slip lamp exam for keiser fleischer rings

151
Q

What malignancy is likely to arise with retinoblastoma

A

Sarcomas

Specifically osteosarcoma

152
Q

Anti-Hu, Anti-Yu, and Anti-Pu Ab

A

Paraneoplastic degeneration of the cerebellum

153
Q

Disturbed color preception, nausea, vomiting and anorexia are caused by what medication

A

digoxin

154
Q

Comedocarcinoma is also known as a

A

Ductal carcinoma in situ

155
Q

Type of degeneration seen in hepatitis

A

Ballooning degeneration

156
Q

Foscarnet chelates this electrolyte

A

Calcium–>Tx of cmv retinitis can lead to neprotoxicity and seizures

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