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DIT Q's Flashcards

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1
Q

What effect might aminoglycosides have on a developing fetus?

A

Ototoxicity

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2
Q

What birth defect can result from the following agents:

Ace inhibitors

Folate antagonist

Tetracyclines

Lithium

A

Ace inhibitors - renal damage

Folate antagonist - neural tube defects

Tetracyclines - teeth discoloration

Lithium - Ebsteins anomaly

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3
Q

What molecule targets proteins in the ER for lysosomes?

A

Mannose-6-phosphate

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4
Q

What artery supplies…

medullary pyramids and medial lemnisculs in the medulla ?

inferior cerebellar peduncles, nuc ambiguus and lateral STT in teh medulla?

A

medullary pyramids and medial lemnisculs in the medulla ?

Anterior spinal artery

inferior cerebellar peduncles, nuc ambiguus and lateral STT in teh medulla?

PICA

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5
Q

Labs for hepatic cirrhosis?

A

AST > ALT (2:1)

“A Scotch and Tonic”

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6
Q

DDX for erectile dysfunction:

A
  • Hormonal disturbances (low T, hyperprolactinemia)
  • Depression
  • Diabetes
  • Psychological/Psyciatrical (performance anxiety)
  • Medication adverse side effects (beta blockers, SSRIs, neuroleptics, ethanol)
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7
Q

What is type I (alpha) error?

A

Study shows difference between two groups when there is no actual difference

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8
Q

What trace element is important for carbonic anhydrase and lactate dehydrogenase?

A

zinc!

impt also for protein folding

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9
Q

when do we see subluxation of the lenses?

A

Marfan syndrome

homocystinuria

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10
Q

Tuft of hair in the lower back?

A

spina bifida occulta

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11
Q

What occurs at the corto-medullary junction of the thymus?

A

positive and negative selection of T-cells

positively restrict MHC

MHC I - on most nucleated cells

MHC II - only on antigen presenting cells

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12
Q

What is the clinical definition of chornic bronchitis?

A

productive cough for at least 3 months, in at least 2 consecutive years

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13
Q

Local anesthesia:

A

lidocaine and other local anesthetics act by blocking sodium channels, preventing firing

small myelinated fibers blocked first

smaller before large

myelinated before unmyelinated

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14
Q

what meds used in

urge incotinence?

A

Anticholinergic drugs:

oxybutynin

tolterodine

darifenacin

solifenacin

tropsium

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15
Q

different RNAs?

A

prokaryotes only one RNA, makes everything

Eurkaryotes 3 RNAs

RNA I –> rRNA

RNA II –> mRNA

RNA III –> tRNA

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16
Q

which cells do not req insulin?

A

muscles and adipose require glut 4 need insulin

brain, RBC< intestines, cornea, kidney, liver DONT require insulin

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17
Q

Kallman syndrome?

A

sporadic or Xlinked

caused by defective development of GnRH-secreting cells in the hypothalams

men > women

dec FSH, dec LH, low test

fail 2nd sexual characteristics

low sperm counts

associated with anosmia (agensis or hypoplasia of olfactory bulb) and midline facial defects

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18
Q

how can NSAIDs make renal insufficiency worse?

A

Careful using NSAIDs in pt with renal insufficiency

NSAIDS inhibit COX block prostaglandins

recall prostaglandins DILATE, esp afferent arteriole of glolmerulus!! thus if the afferent arteriole of glomerulus is not dilating, you can low renal plasma flow, low GFR

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19
Q

INC infections of S. Aureus and E.coli? What immunity disfunction increases the risk?

A

Chronic granulomatous disease

due to a decrease in the NADPH oxidase deficiency

normally allows phagocytes to create oxygen free radicals and hydrogen periodize to kill bacteria in phagosomes

PREDISPOSES CATALASE POSITIVE bacterial infections

(catalase cat)

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20
Q

Causes of metabolic acidosis with increased anion gap?

A

MUD PILES

Methanol

Uremia

Diabetic ketoacidosis

Propylene glycol

Iron tables / Isoniazid

Lactic acidosis

Ethylene glycol

Salicylates (aspirins)

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21
Q

Attributable Risk

A

Attributable riks = difference between exposed and unexposed groups, porportion of diease caused by exposure

2X2

AR = (A / A+B) - (C / C+D)

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22
Q

leuprolide

A

GnRH agonist

binds to GnRH r in anterior pituitary –> not pulsatile! –> downregulation of receptors –> suppression of release of LH and FSH and reduced testosterone production –> helps slow the growth of prostate CA

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23
Q

Urea cycle enzyme deficiencies?

A

Ornithine transcarbamylase deficiency:

INC ammonia levels within the first days of life

X linked recessive

–> INC orotic acid in blood and urine (part of purine synthesis)

dec BUN, symptoms of hyperammonemia (neurological deficits)

Hyperammonemia: tremor, slurred speech, comnolence, vomiting, cerebral edema, blurred vision

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24
Q

Brachial cleft cyst vs thyroglossal duct cyst?

A

Branchia cleft cyst @ lateral neck, does NOT move with swallowing

Thyroglossal duct @ midline, MOVES with swallowing

remnant is foramen cecum

thyroid diverticulum arises form the flor of the primitive pharnyx and descents to the beck at foramen cecum –> thyroid remains connects to tongue by thyroglossal duct (if persists!!); if duct persist it becoems the pyramidal lobe of thyroid

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25
Q

clozapine major side effect

A

Cauess agranulocytosis

needs to monitor WBC weekly!!

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26
Q

anteiror shoulder dislocation vs a posterior shoulder dislocation?

A

ant dislocation:

external rotation, slight abduction

axillary artery, axillary nerve

scenarios - blow to the arm while abducted, externally rotated and extended

PE- prominent acromion process (if thin, loss of normal roundness of the shoulder, appears more angular

Posterior dislocation:

internal rotation, adduction, unable to externally rotate the arm

unusual to have any neurovascular compromise

scenario - seizure, electrocution

PE: bulge in the posterior shoulder area, anterior aspect of the shoulder is relatively flat

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27
Q

cyclosporine:

A

Use: immuno supp for transplat, psoriasis

MOA: binds to cyclophilin –> inhibits calcineurin

normally calcineurin activates nuclear factor of activated T-cells cytoplasmic (NFATc), which upregulated IL-2 (impt for T cell growth and differentiation)

–> inhibition of T-cell growth, activation and differentiation

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28
Q

central pontine myelinolysis:

A

when sodium is corrected too quickly

(such as in SIADH)

could cause: diplopia, dysarthria, paralysis, locked-in syndrome (pt alert and awkae up unable to move)

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29
Q

pericarditis casues?

A

idiopathic, coxackivirus a/b, tb, uremia, lupus, scleroderma, radioation of the chest, acute RF, dressler syndrome, cancer mets

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30
Q

Sx of fat-soluble vitamin deficiencies:

A

A: night blindness, dry skin

D: rickets, osteomalacia, hypocalcemium, tetany

E: fragile RBC, muscle weakness, demyelination of CNS

K: coagulation factor defects, osteoporosis, CAD

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31
Q

Meckles arches:

A

Meckles - 1st brachial arch

CN V2 and V3

Mesoderm - muscles and arteries

Neural crest - bones and cartilage

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32
Q

mean, median, mode relationship in normal, positive and left skewed graphs

A

normal

mean = mode = median

positive - shifted to the left, tail to the

mean > median > mode

negative- shift to the right, tail to the left

mode > median > mean

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33
Q

problems with mercury during pregnancy?

A

brain damage

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34
Q

rate order: zero vs first

A

zero order elimination = constant amt of drug eliminated per unit of time

  • linear graph
  • amt metabolized stays constant regardless of concentration

first order elimination = a constant fraction of the drug is metabolized per unit time

  • curved
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35
Q

what artery supplies distal colon vs proximal 2/3 of colon?

what structures are they derived from?

A

proximal 2/3: SMA

from midgut

distal 1/3: IMA

from hindgut

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36
Q

status epilepticus

acute vs prophylaxis

A

acute - stop seizure: benzos

once it has stopped, treat with anti-convulsant for further seizures: phenytoin first line

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37
Q

Treatment of asthmas …

A

chronic asthma - fluticasone, budesonide (corticosteroids)

acute exacerbations - albuterol, levalbuterol (b2 agonist)

narrow therapeutic index, drug of last resort - theophylline

blocks conversion of arachidonic acid to leukotriene - Zileuton

inhibits mast cell release of mediators, used for prophylaxis only - cromolyn

inhaled treatment that blocks muscarinic receptors - ipratropium, tiotropium

inhaled long-actin B2 agonist - salmeterol

blocks leukotriene receptors - montelukast, zafirlukast

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38
Q

hyperaldosteronism treatment and side effects

A

spironolactone, eplerone

hyperkalemia, spironolactone (adrogen antagonist –> gynecomastia in men, progesteron agonist –> menstrual irregularities in women)

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39
Q

neomycin

A

aminoglycoside

prevent bac from syn proteins by binding to the 30s subunit of the bac ribsomomes inhibitng formation of the initiation complex

toxicities: nephrotoxic, ototoxic, teratogenic

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40
Q

fluamide vs finasteride?

A

Flutamide:

for prostate CA;

competitive testosterone receptor inhibitor

Finasteride

BPH, male pattern baldness

inhibits 5 alpha reductase (T –> DHT)

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41
Q

bone injured when falling on an outstretch hand?

A

scaphoid bone is the most commonly injuryed

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42
Q

PCP intoxication

A

psychomotor agitation, impulsiveness, psychosis, belligerence, homicidality, aggression/violence, fever, tachy

*verticle and horizontal nystagmus*

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43
Q

interferon gamma

A

Th1 secreted

stimulates macrophages and inhibits T2 helper cells

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44
Q

benzo’s vs barbiturates?

A

Benzo increases the FREQUENCY of GABAa receptor Cl- channel opening

Barbiturates increases the DURATION of GABAa receptor Cl- channel opening

–> CNS depressive effects, respiratory (hypovent), CV depression (bradycardia)

NOT a good mixture with alcohol

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45
Q

Decompression sickness

A

when divers come up too quickly nitrogen gas forms bubbles in the blood

joint and muscle pain, neurologic sx (dizziness, syncope, paralysis), the chokes (sob, PE, death – occlusion in the lung)

could use carbonic anhydrase inhibitors (acetozolamide)

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46
Q

Clinical presentation:

resting tremor, postural instability, mask like facies

antiviral drug?

A

parkinsonisms

amantadine - causes increase release of dopamine

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47
Q

which anti-cancer drugs are responsible for restrictive lung disease

A

bleomycin – induces free radicals

methotrexate

busofin?

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48
Q

ACUTE medical treatment for esophageal varices

A

octreotide

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49
Q

antidote for digoxin tox?

A

digoxin immune Fab fragments (digiFab) - too expensive

most of the time give nl potassium and magnesium, give lidocaine for any arrhythmias…

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50
Q

What is related with a hydatiform mole?

A

2% of complete moles are associated with choriocarcinoma

tumor marker: b-hCG (make sure it goes down!)

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51
Q

incomplete paramesonephric ducts could lead to what clinical presentation?

A

-> bicornate uterus, which a women could present with frequent miscarriages

fallopian, uterus, upper portion of the vagina

aka: mullerian ducts

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52
Q

Crescent shaped hemorrhage?

A

Subdural hematoma

bridging veins

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53
Q

Test for hereditary spherocytosis?

A

Hereditary sperhocytosis is a defect in RBC cytoskeleton proteins such as spectrin, band 3, pallidin, ankyrin

Test: osmotic fragility test, or flow cytometry

keep putting RBC in increasing osmotic fluids, which are more fragile

Findings: microcytic, round with no central pallor, increase RDW, INC MCH

spleen –> extravascular hemolysis

negative coombs tests

Splenomegaly, gallstones, aplastic crises with stress

54
Q

nucleosome

A

8 histoproteins in nucleosome core with DNA surrounded around

lots of + charged dna around (lysine, arginine)

Histone H1 ties nucleosomes together

55
Q

Visual blackout G-force?

A

Visual black out

occurs at 4-6 Gs because G forces pulling blood down to the abdomen and legs and not enough going to the brain

56
Q

Dorsal root ganglia

A

neural crest derived from ectoderm

57
Q

Complements:

A

Which..

Opsonizes: C3b

Neutrophil chemotaxis: C5a

MAC: C5b, C6 -C9

58
Q

blood supply of the adrenals

A

superior adrenal artery arises from teh inferior phrenic artery

middle adrenal artery arises from the aorta

inferior adrenal artery arises from the renal artery

59
Q

Frequent neisseria infections?

A

C5-C9 deficiency

60
Q

frequent pyogenic respiratory tract infections?

A

C3

H. influ

61
Q

paroxysmal nocturnal hemoglobinuria

A

CD55, CD59, prevents the complement from attacking RBCs

K activating factor DAF

62
Q

increased frequency of type III hypersensitivity

A

C3 deficiency

(ie - glomerular nephritis)

63
Q
A

ACTH –> cushing syndrome – small cell lung CA

PTH- related peptide –> hypercalcemia – squamous cell lung CA

Erythropoietin –> polycythemia – renal cell CA, hemangioblastoma, HCC, pheochromocytoma

ADH –> SIADH – small cell lung CA, intracranial neoplasms

64
Q

Homan’s sign?

A

Pain in the calf upon dorsiflexion

Possible DVT

65
Q

Why do we see osmotic damage to some cells in diabetic pt?

A

glucose –> sorbitol via aldose reductase –> fructose via sorbitol dehydorgenase

Schwann cells, retina and kidneys don’t have sorbitol dehydrogenase; so the aldose reductase coverts glucose to sorbitol which then acts as an osmotic agent –> damage

66
Q

type II B error

A

study that shows no error when in fact there is error

67
Q

risk factors for osteosarcoma?

A

Bone infarcts, radiation, paget disease of hte bone, familial retinoblastoma, male sex, ages 10-20 yrs

68
Q

cotton wool spots in the retina

A

chronic HTN

diabetic retinopathy

aids lupus

temporal arteritis

wegnere glume

poly adeno.

69
Q

anovulation

A

elevated cortisol, central –> cushing syndrome

amenorrhea + hirstuism + obsesity –> PCOS

70
Q

T3 and T4 production

A

TSH stimulation causes the uptake of iodine with a I/Na+ cotransporter… Iodine then gets exported into the colloid, there it undergoes oxidation into I- by periodixase and then organification, with the addition of thyroglobulin –> MIT or DIT then condensation into T3 and T4 boud to TG…released into the blood stream after the proteolytic removal of TG (recycled)

Active = T3

Most that is made is actually T4 but converted in the periphery

71
Q

zollinger ellision syndrome

A

gastrinoma, gastrin secreting tumor

stimulates the release of acid into the stomach

does not respond to PPIs

duodenism or pancreas

72
Q

peptic ulcers (ZE) + kidney stones + hypogonadism??

A

MEN 1!

recall MEN 1 is: parathyroid, pituitary and pancreatic involvement

73
Q

PCOS

A
  1. adnrogen excess
  2. polycystic ovaries
  3. anovluation or oligoovualation

clomiphene = estrogen antagonist, blocking normal feedback –> increasing release of LH and FSH

–> induces ovulation

74
Q

when is consent NOT required by the patient

A
  1. emergency situations
  2. pt lacks decision making capacity –> can’t make consent thus power of attorney or spouce
  3. waiver giving conset to other
75
Q

Amiodarone…

what needs to be measured

A

PFTs, LFTs, TFTs

Pulmonary fibrosis, hepatotox, thyroid dysfunction (hypo or hyper)

corneal deposits, neuro probs, constipation, photsensitivity, blue gray skin discoloration since amiodarone is about 40% iodine by weight

76
Q

when is a fetus most susceptible to teratogens??

A

Embryonic perio weeks 3-8, when organs are formed!

77
Q

How is the body affected if stayed in space for too long?

A

DEC all of the following:

blood volume, RBC, muscle strength and work capacity, maximum cardiac output

LOSS of CALCIUM and PHOSPHATE from the bones –> loss of bone mass

78
Q

what is the most common gynecologic neoplasm?

A

leiomyoma = firboids

common

smooth muslce bundles in different dirrections - whorled pattern

benign

79
Q

polycythemia vera

A

myeloproliferative disorder bone marrow is making too many RBC

not cancerous, benign

inc plasma volume, inc red cell mass, normal O2 and decrease erythropoietin

80
Q

treatment for vWd?

A

Desmopressin - synthetic analog of ADH

releases vWF stored in endothelium

recall that AVP - factor 8, vWD, and pressor

81
Q

N-acetylcystein

A
  • inhaled to lose mucus plugs
  • orally for acetominophen overdose
  • orally prophylaxis ad IV contrast induced nephropathy
82
Q

granuloma annulare?

A

asympto (no itching, burning..)

no-scaly, slightly erythematous annular plaque

irregular, well-defined edges

thick, rope-like border (different from ring worm etc..)

small –> grows out

usually localized to the wrist, ankles,dorsal surfaces of hands/feet

83
Q

Kallmann syndrome

A

clinical pres: hypogonadims (due to decreased synthesis of GnRH in the hypothalamus), anosmia, lack of secondary sexual characteristics

84
Q

flow of blood into and out of the thyroid gland:

A

arterial supply:

external carotid —> superior thyroid artery

Thyrocervical trunk –> inferior thyroid artery

Venous:

superior, middle and inferior thyroid vein

85
Q

First degree AV block

A

first degree = prolongation of the PR interval > 200 msec (.2 sec)

>5 little boxes or 1 big box

asymptomatic

86
Q

Pericarditis clinical presentation

A

Chest pain, that is sharp and pleuritic, worse with inspiration and relieved by sitting up and leaning forward

DEC capacity of the right ventricle, fluid backs up –> JVD

w/constrictive pericarditis –> kussmaul sign = JVD with inspiration

(normally inspiration decrease intrathoracic pressure so that blood from the superior vena cava flows to the right atrium and ventricle – but constriction of the heart by constrictiv pericarditis could prevent this thus –> JVD

Friction rub doesnt coincide with any specifc part of the cardiac cycle

EKG - diffuse ST elevation and diffuse PR depression

87
Q

Guaifenesin

A

Expectorant—thins respiratory secretions; does not suppress cough reflex

Stimulates the VAGUS NERVE to generate low viscosity secretion in the bronchial tree

NOT a cough suppresant

88
Q

Encapsulated bacteria:

what test is used to detect?

What meds are used?

A

SHiNE SKiS

Strep pneumo

H. influ type B

N. meningitidis

E. Coli

Salmonella

Klebsiella pneumo

Strep grou B

Encapsualted bacteria are opsonized and then cleared by the spleen – their capsules serve as an antiphagocytic virulence factor

asplenics have a DEC opsonizing ability and thus incerased risk for severe infections

**give vaccines for: S. pneumo, H. influ and N. meningitis**

capsule + protein conjugate serves as an antigen in vaccines

Test: add serum that contains anticapsular antibodies – look for the QUELLUNG reaction [capsule appears to swell in response to the antibodies– quellung/swellung]

89
Q

carpal bones

A

some loves try positions that they can’t handle

@ proximal radial side: scaphoid, lunate, triquetrum, pisiform

@ distal radial side: trapeziume, trapezoid, capitate, hamate

90
Q

why do we NOT want to use

A

diphenhydramine – antihistamine but also anticholinergic side effects which could make elderly indviduals delirious and confused, urinary retention (also bad for BPH!)

NOT for chronic insomnia – helps people fall asleep (side effect of sedation) BUT it disrupts normal sleep architecture

91
Q

CD4?

CD8?

A

CD4 = T helper cells

CD8 = cytotoxic T cells – bind to target cells and induce apoptosis (neoplastic cells, virally infected cells + cells from transplant donor)

92
Q

What breast pathology best describes the following…

A

msot common breast tumor in women under 25? fibroadenoma

Most common breast mass in postmenopausal women? invasive ductal CA

most commob breast mass in premenopausal women? fibrocystic change of the breast

most common form of breast cancer? invasive ductal CA

93
Q

what are the positive and negative symptoms of schizophrenia

A

Positive

delusions, hallucinations, disorganized speech, disorganied or catatonic behavior

Negative:

flat affect, social withdrawl, lack of motivation, lack of speech/thought

94
Q

femorath sheath

A

deep to inguinal ligament, find: artery, vein and lymph

NOT the nerve!

femoral line

palapate the nervous pulse –> palpate the femoral artery and insert the needle medial to the artery

95
Q

kluver bucy

A

bilateral amygdala / temporal lobe

HSV1 esp

hypersexuality, disinhibited behavior, hyperorality

96
Q

too many transfusions could be bad because…

A

iron overload –> hemosiderosis/hemochromatosis

iron is hard to remove from the body

97
Q

Cheyne-stokes respiration

A

repeating cycles of apnea, hypercapnia

followed by compensatory phase of hyperventilation and hypocapnia

due do diminished sensitivity to medullary center

caused by drug overdose, cerebral atherosclerosis, cerebral lesions and prolong circulation time from heart failure

98
Q

what is the function of the following APO proteins

A

Apo A-I –> activates LCAT (necessary for the maturation of HDL)

APO B-48 –> mediates chylomicro secretion from enterocytes

APO B-100 –> binds LDL R (from the liver)

APO C-II –> removes FFA from lipid particles

APO E (on all lipoprotein particles) –> mediates extra/remnant uptake; related to numerous disorders including Alz Dz

99
Q

Neostigmine

A

Reverse neuromuscular blockade

Ileus

Bladder atony

100
Q

Physostigmine

A

atropine overdose

or overdose of other anti-muscarinic drugs

101
Q

Edrophonium

A

aka Tensilon

diagnosis of myasthenia gravis

102
Q

pyridostigmine

A

treat myasthenia gravis

103
Q

echothiphate

A

treat open-angle glaucoma

104
Q

donepezil, rivastigmine, galatamine

A

treat Alz Dz

105
Q

clavulanic acid, sulbactam, tazobactam

A

used in combo with penicilins to degrade penicilinase/b-lactamse produced by bacteria that break down the penicilin structure and preven the abx from working apporpriately.

106
Q

warfarin overdose/antidote?

heparin overdose/antidote?

A

Warfarin: vitamin K, fresh frozen plasma

heparin: protamine sulfate

107
Q

vitamin D activation

A
  1. LIVER

–> 25-OH vitamin D (calcidiol)

  1. KIDNEY

–> 1,25 (OH)2 vitamin D (calcitriol) *ACTIVE*

108
Q

How do the following drugs affect the blood pressure?

phnoxybenzamine, epinephrine, phenylephrine

A

phenoxybenzamine: irreversible alpha blocker

Epinephrine: alpha and beta agonist –> stimluate beta2 on vascular smooth muscle and casue peripheral vasodilation –> pressure will drop

Phenylephrine: rev alpha agonist –>pure alpha and not induce B2 mediated vasodilation thus will vasoconstrict

AC–> alpha constrict

BD –> beta dilate

109
Q

Serotonin Syndrome

A

TOO MUCH SEROTONIN

ie) MAO + SSRI

SX: tremor, hyperreflexia, muscle, rigidity/clonus, hyperthermia, diaphoresis, flushed skin, agitation, seizures, cardiovascular collapse

  • STOP drug, give BENZO + supportive care*
  • if this fails –> give, cyproheptadine [blocks serotonin R]*
110
Q

common carotid and jugular vein?

A

BTW sternocleidomastoid muscle you’ll find the cartoid artery and jugular –>common carotid is medial the internal jugular

111
Q

how do you know that surfactant is at its appropriate level in a fetus?

A

lecithin:Sphingomyelin ratio >2:1

for lung maturity

proper name: dipalmitoylphosphatidylcholine

112
Q

spooning of the nails vs clubbing of the nails:

A

spooning = Koilonychia –> indicative of iron deficiency

clubbing of the nails –> oxygen deprivation/hypoxemia

113
Q

what are the phases of making drugs?

A

phase 1: assesses the safety of the drug on normal patients

phase 2: determines if the drug actually works on dz patients

phase 3: head to head trial with another drug

phase 4: post-marketing surveillance trial of pt after approval

114
Q

obligate intracellualr bacteria?

A

Rickettsia

chamydia

coxiella burnetti

115
Q

drug clearance?

A

CL = 0.7xVd/ half life

116
Q

FOX P3??

A

Found on the X chromosome

Codes for Forkhead Box Protein P3

Regulatory T cells – impt for self-tolerance

absence/mutation has been implicated in AI dz, lethal immune dysregulation, polyendocrinopathy, exocrinopathy, and X-linked I PEX syndrome

117
Q

Where are the following found in a lymph node?

B cells, Tcells, macrophages

A
118
Q

amino acids necessary for purine synthesis?

A

glycine, aspartate and glutamine

119
Q

What are langerhan cells?

What characteristic finding would you see on electron microscopy of a dendritic cell with Langerhans cell histiocytosis?

A

Birbeck granule

“tennis rackets” or rod shape

Collective group of proliferative disorders of dendritic (Langerhans) cells.

Presents in a child as lytic bone lesions and skin rash

or as recurrent otitis media with a mass involving the mastoid bone.

Cells are functionally immature and do not effectively stimulate primary T cells via antigen presentation

Cells express S-100 (mesodermal origin) and CD1a.

120
Q

Lung cancer mets?

A

liver, bones, adrenal glands, brain

121
Q

Lithium teratocenicity:

A

Ebstein anomaly

Tricupsid leaflets displaced inferiorly

RV hypoplasia

Tricuspid regurgitation or stenosis

Other anti-psychotic meds that are also teratogenic:

Carbamazepine [neural tube defects, craniofacial defects, IUGR, developmental dealy, hypoplastic fingernails]

Valporate – inhibit folate absoprtion, neural tube defects

Aripiprazole/risperidone are not technically teratogenic but can cause extrapyramidal symptoms in the newoborn

122
Q

Name the glycogen storage disease:

A

Severe hypoglycemia with elevated lactate: Von Gierke (type I)

hypoglycemia without elevated blood lactate: Cori (type III)

cardiomegaly: pompe [trashes the pump]

Myoglobinuria associated w/exercise: McArdle disease (type V)

123
Q

organophosphate poisoning?

A

inhibits the AChe –> increasing the ACh in the synaptic cleft

symptopms: DUMBBELSS

124
Q

what is normal pulmonary artery pressure?

A

NL: 8-20 mmHg

Pulmonary HTN >25 mmHg

125
Q

conditions associated with oligohydramions?

Polyhydraminos?

A

Oligo - less amniotic that nl

associated with: placental insufficiency, bilateral renal agenesis, posterior urethral valves / decrease fluid production

POTTER sequence: bilateral renal agenesis –>olighydramnios –> congenital abnormalities

P- pulm hypoplasia

O- oligohydraminos

T- twisted skin

T - twisted face

E-extremity/limb deformities

Poly- excess amniotic fluids -

esophageal or duodenal atresia, anecephaly, maternal diabetes

126
Q

what are the phases of drug metabolism?

What part of metabolism of drugs do elderly people lose first?

A

Phase 1 reactions - elderly pop loses first!

includes - oxidation, reduction, hydrolysis

**P450**

Phase 2: conjucation reaction

127
Q

essential amino acids:

A

PVT TIM HALL

phenyalanine

Valine

Threonine

Tryptophan

Isoleucine

methionine

Histidine

Arginine (only in children)

Leucine

Lysine

128
Q

insomnia

A

melatonin

antihistamies (diphenhydramine)

Trazadone

TCAs - amitriptyline (heart arrythmia)

Long acting bezos - addicting (temazepam, lorazepam)

Zolpidem/ambien

Zaleplon

eszopiclone/lunesta

ramelteon

129
Q

What arises from…

A

bulbus cordis: right ventricle and outflow tracts of left and right ventricle

left horn of sinus venous: coronary sinus

Primitive atrium - fibrous (trabeculated) portions of the left and right atria

Truncus arteriosus - ascending aorta and the pulmonary trunk

Primitive ventricle- fibrous (trabeculated) portions of the left and right ventricles

Right horn of sinus venous - smooth part of the right atrium

Right common and anterior cardinal veins - SVC

130
Q
A

USMLE Step 1 (15 decks)

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