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USMLE > DIT2 > Flashcards

DIT2 Flashcards

1
Q

Owl Eye Inclusions

A

CMV

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2
Q

Owl Eye nucleus

A

EBV/Hodgkin’s

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3
Q

Owl eye protozoa

A

Giardia

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4
Q

PKU pt…what does their skin look like?

A

fair

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5
Q

What is Intertrigo?

A

candidiasis of skin in folds

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6
Q

candida sepsis often associated with what?

A

central line/IV drug user

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7
Q

latex agglutination test

A

Cryptococcus

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8
Q

AIDs pt with chronic watery diarrhea. what will you see microscopically and with what stain?

A

acid fast oocysts=cryptosporidium

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9
Q

what are two forms of Giardia?

A

Trophozoite (4 flagella); cyst

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10
Q

anchovy paste exudate in liver

A

entamoeba hystolytica

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11
Q

what are the two forms of entamoeba histolytica and what do they look like?

A

Trophozoites–>have RBC in cytoplasm

Cysts–>can have 4 nuclei

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12
Q

How to treat entamoeba histolytica?

A

first metronidazole to kill the trophozoites

then use iodoquinol or paromomycin to rid of the cysts

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13
Q

what do you use metronidazole for?

A 
GET GAP on the metrotrain
Giardia
Entamoeba
Trichomonas
Gardenerella
anaerobic bacteria
Pylori (H.)
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14
Q

Naegleria fowleri…treatment? how effective is it?

A

Amphotericin B… rarely ever successful

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15
Q

Trypanosoma Brucei tx

A

Suramin and Melarsoprol

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16
Q

Chagas disease treatment?

A

Benzinidazole; nifurtimox

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17
Q

fever, pancytopenia, hepatosplenomegaly

A

Leishmania Donovani

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18
Q

what nerve innervates teres minor?

A

axillary

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19
Q

name the carpal bones

A

So long the pinky, here comes the thumb

Scaphoid
Lunate
Triquetrum
Pisiform
Hamate
Capitate
Trapizoid
Trapesium
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20
Q

Lunate dislocatioin can cause what

A

carpal tunnel syndrome

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21
Q

how does Acetaminophen work?

A

It’s a cox inhibitor that works mostly in the CNS…thus it’s less effective for antiinflammation but does work for antipyretic and analgesic

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22
Q

what is NAPQI?

A

acetaminophen metabolite that depletes glutathione

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23
Q

three uses of N acetylcystein?

A

Nephropathy, acetaminophen tox, cystic fibrosis

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24
Q

RA is what type of hypersensitivity?

A

Type IV and Type III

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25
Q

What are the conditions with over production of uric acid?

A

Lesch Nyhan, PRPP excess, VonGierke increased cell turn over

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26
Q

Probenecid inhibits excretion of what?

A

Penicillin

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27
Q

what diseases are associated with pseudogout?

A

hemochromatosis, hypo and hyperparathyroididsm

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28
Q

chondrocalcinosis on xray in knee? dx

A

pseudogout

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29
Q

three symptoms of ankylosing spondylitis?

A

bamboo sacraliliac joints,
Uveitis
aortic regurg

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30
Q

Drugs to treat Lupus?

A

Steroids, Immunosuppressive (cyclophosphomide), NSAIDS, hydroxychlorquine

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31
Q

28 year old AA woman presents with fever, rash, joint pain?

A

SLE

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32
Q

Symptoms of SLE

A 
RASH OR PAIN
Rash (malar or discoid)
Arthritis
Serositis
Hematologic abnormalities (cytopenia)
Oral/nasal ulcers
Renal disease/Raynaud
Photosensitivty
ANA
Immunosuppresants
Neurologic disorders
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33
Q

what are flat nevi called?

A

Junctional nevi

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34
Q

what are papular nevi called?

A

Intradermal nevi

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35
Q

if you see stratum corneum cells with nuclei…what do you think of? what is this called?

A

parakeratosis

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36
Q

albinism. causes?

A

Tyrosinase decrease activity
Tyrosine transport
failure of melanocytes to migrate

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37
Q

which layer of epidermis is affected in staphylococcal scalded skin syndrome?

A

stratum granulosum

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38
Q

pemphigous vulgaris vs bullos pemphigoid on histology. how are they different?

A

pemphigous vulgaris is net like in the stratum spinosum (desmosomes);
Bullos pemphigoid is a line at the level of the dermal epidermal junction (hemidesmosomes)

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39
Q

dermatitis herpetiformis…what is this? what do you see on biopsy?

A

Celiac disease antibody complexes attaching to dermal papilla

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40
Q

ring rash after drug?

A

erythema multiforme

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41
Q

what is the difference between TEN and Stevens johnson?

A

TEN is more than 30% of the body involvement

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42
Q

6 Ps of Lichen planus?

A

pruitic, purple, papule/plaque, planar, polygnal

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43
Q

Hep C is associated with what skin disorder?

A

Lichen planus

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44
Q

keratoacanthoma is associated with what?

A

squamous cell carcinoma of the skin

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45
Q

palisading nuclei on skin lesion

A

Basal cell carcinoma

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46
Q

ABCDE of melanoma risk?

A

asymmetry, border, color, diameter >6mm, evolving

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47
Q

keratin filled cysts in skin

A

seborrheic keratosis

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48
Q

what do you use to treat ecchinococcus?

A

prezaquantal

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49
Q

What is a bad outcome of ecchinococcus?

A

calcified liver cysts can rupture and cause anaphylaxis

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50
Q

what do you use to treat tenia solium/saginatum?

A

prazelquantel and albendazole

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51
Q

swiss cheese brain?

A

tenia (tape worms)

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52
Q

name two hook worms

A

Necator Americanus

Ancyclostoma duodenale

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53
Q

Aminoglycosides + Cephalosporins. what side effect

A

nephrotoxicity

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54
Q

Aminoglycoside +loop diuretics. waht side effect

A

ototoxicity

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55
Q

what are the side effects of aminoglycosides?

A

nephrotox, ototox, teratogen AmiNOTglycosides

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56
Q

what type of bacteria do aminoglycosides not workon?

A

anaerobes

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57
Q

what are the sideeffects of tetracyclins?

A

Teeth, tummy, Terrible vision

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58
Q

what are penicillin binding proteins?

A

transpeptidase

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59
Q

What do you use aminopenicillins to treat?

A 
Hemophilus
E. coli
Listeria
Proteus
Shigella
Salmonella
Enterococci
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60
Q

what drug has cholestatic hepatitis as a side effect?

A

macrolides

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61
Q

macrolides can potentiate what two other meds?

A

theophylline and oral anticoagulants

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62
Q

what are the sideeffects of macrolides?

A 
Motility
Arrythmias (QT prolongation)
Cholestatic hepatitis
Rash
eOsinophilia
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63
Q

what do you always give with Imipenem?

A

Cilastatin, which inhibits renal dehydropeptidase I to prevent drug inactivation

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64
Q

side effect of carbapenems

A

GI, rash, and seizures

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65
Q

vancomycin side effects?

A

Nephrotox, ototox, thrombophlebitis, redman

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66
Q

Sulfonamides. mech?

A

PABA antimetabolites that inhibit dihydropterate synthase

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67
Q

RedGreen color blindness relating to drug?

A

Ethanbutol and Amphotericin B

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68
Q

amphotericin B side effects?

A

nephrotoxicity, cardiotoxicity, anemia, hypotension

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69
Q

treatment for Trypanosoma Brucei

A

Suramin and Melarsoprol

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70
Q

treatment for trypanosoma Cruzi

A

Nifurtimox

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71
Q

treatment for leishmaniasis

A

amphotericin B and Stibogluconate

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72
Q

raltegravir side effect?

A

hypercholesterolemia

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73
Q

what do you treat with IFNbeta?

A

MS

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74
Q

What do you treat with INFgamma?

A

Chronic granulomatous disease

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75
Q

what do you use to treat parkinson’s

A 
Bromocriptine/ropinol
Amantadine
Levadopa
Selegiline
Antimuscarinic
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76
Q

what happens if a man has a lot of SHBG?

A

low testosterone–>gynecomastia, impotence…etc

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77
Q

What happens if a woman has low SHBG?

A

high testosterone–>hirsutism

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78
Q

How does OCP affect SHBG?

A

increases SHBG

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79
Q

where is estradiol produced?
estrone?
Estriol?

A

ovary=estradiol
estrone=fat cells
estriol=placenta

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80
Q

which hormones share the similar alpha unit with hCG?

A

FSH, LH, and TSH

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81
Q

Bombesin positive tumor in child

A

Neuroblastoma

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82
Q

what’s the clinical diagnostic difference in PEx for Wilm’s tumor and neuroblastoma?

A

neuroblastoma is irregular mass that crosses midline.

wilm’s will be a smooth unilateral tumor.

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83
Q

how do people with gigantism usually die?

A

cardiac failure

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84
Q

what will happen on labs with glucose tolerance test in a patient with acromegaly?

A

GH will not be suppressed

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85
Q

What is Pegvisomant?

A

GH receptor antagonist

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86
Q

ketoconazole inhibits/ ACTH induces what enzyme in the steroid synthesis pathway?

A

cholesterole Desmolase

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87
Q

Angiotensin II increases aldosterone via induction of what enzyme?

A

aldosterone synthase

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88
Q

what are the common features in hormones in adrenal hyperplasia diseases?

A

low coritsol causing increased in ACTH thus hyperplasia

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89
Q

what does deficiency in 3beta hydroxysteroid do?

A

none of the steroid hormones are produced (mineralo, corticosteroid, and sex hormones). Only DHEA is produced.

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90
Q

what are the effects of cortisol?

A 
BIG FIB
Blood pressure increase alpha1 receptors
Insulin resistance
Gluconeogenesis/lipolysis
Fibrosis of skin
Immunodeficiency (Due to decreased phospholipase A2)
Bone formation decrease
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91
Q

what are the side effects of corticosteroid excess

A

BAM CUSHINGOID
Buffalo hump
amenorrhea
moon facies

Crazy
ulcers
skin striae
hypertension
infections
necrosis of fem head
glaucoma
osteoporosis
immunesuppression
dm
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92
Q

treatments for nephrogenic Diabetes insipidus?

A

hydrochlorothiazide
amiloride
indemethacin

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93
Q

what induces aldosterone secretion?

A

high K, low Na, and AngII

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94
Q

which corticosteroid has really high mineralosteroid activity?

A

Fludrocortasone

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95
Q

what are the steps of thyroid hormone synthesis?

A

Oxidation (of I to I2)
Oganification (combine I to thyroglobulins –made of tyrosine)
Coupling (MIT and DIT)

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96
Q

what is the action of PTU?

A

it inhibit thyroid peroxidase: oxidation of I, organification of I to tyrosine on thryoglobulins, and coupling of the residues

It also inhibits 5’deiodinase preventing T4 conversion to T3 in periphery

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97
Q

Wolff-Chiakoff effect?

A

excess iodine actually inhibits thyroid peroxidase… resulting in decreased thyroid hormone despite giving more iodine

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98
Q

what does thyroid hormones control?

A

bone, brain, beta adrenergics, and basal metabolic rate

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99
Q

Jod Basedow phenomenon?

A

thyrotoxicosis in pt with iodeine deficiency goiter

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100
Q

how do you treat thyrotoxicosis?

A

PTU, Propranolol, and prednisone

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101
Q

homer wright pseudorosetts

A

medulloblastoma of brain
neuroblastoma of kidney

both are in kids

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102
Q

hyperthyroidism with nothing in the neck. what coouuuuuld it be?

A

struma ovarii

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103
Q

cretinism in developing country. cause?

A

iodine deficiency

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104
Q

cretinism in the US. cause?

A

thyroid dysgenesis/agenesis/maternal hypothyroidism

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105
Q

Hashimoto thyroditis is associated with what kind of cancer?

A

non Hodgkin’s lymphoma

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106
Q

Hurthle cells are seen in what disease

A

Hashimoto’s thyroiditis

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107
Q

Riedel’s Thyroditis can mimick what?

A

anaplastic thryoid carcinoma

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108
Q

Hot nodule. what is it NOT

109
Q

papillary thyroid carcinoma is associated with what gene mutations?

110
Q

what can you NOT use to distinguish follicular adenoma and follicular carcinoma?

A

fine needle aspiration

111
Q

Cotton Wool spots in retina

A

Diabetes, AIDS, hypertension

112
Q

what are the three complications of DM due to glycosylation

A

Retinopathy, Nephropathy, and peripheral neuropathy

113
Q

what can precipitate DKA in T1DM?

A

any stresses on the body that increases: catecholamines, glucagon, and cortisol…becasue these things all increase glucagon…leading to hyperglycemia.

common things are infections,severe illnesses, dehydration, alcohol/drugs, exogenous corticosteroids

114
Q

DKA tx

A

fluids, insulin, K

115
Q

metformin contraindication

A

renal failure

116
Q

how do the DPP4 inhibitors work?

A

They inhibit GLP breakdown to augment the oral glucose effect of insulin release

117
Q

GLP analogs. what are they? what’s the side effect?

A

Exenatide, Liraglutide

pancreatitis

118
Q

DDP4 inhibitors. what’s the side effects?

A

not as effective. also respiratory/urinary tract infection

119
Q

what is pramlintide?

A

amylin analog; decreases gastric emptying; decreases glucagon.

120
Q

what is the criteria for metabolic syndrome?

A

waist size >40/35
triglycerid >150
HDL 100 fasting (140 for 2 hour tolerance)

121
Q

How do you calculate BMI

A

weight/heigh^2

122
Q

what other than calcium regulates PTH? how?

A

Mg. if low–>increase PTH, if very low–>decrease PTH

123
Q

what drug causes SIADH?

A

cyclophosphomide, SSRI, carbamazapine

124
Q

VIPoma sx?

A

watery diarrhea, achlorhydria, hypokalemia

125
Q

prolactin is structurally homologous to what?

A

growth hormone

126
Q

in high iodine supplementation thyroid hormone production decreases. what is this called? and why does it decrease?

A

This is Wolff-Chiakoff; excess iodine inhibits organification of I2 to tyrosine units of thyroglobulin

127
Q

Anterior 2/3 of tongue is from what embryonic origin?

What about the posterior 1/3?

A

pharyngeal arches 1,2

pharyngeal arches 3,4

128
Q

what nerves stimulate the salivary glands?

A

SNS system stimulates sublingual via superior cervical ganglion

PNS stimulates parotid via VII and IX

129
Q

sialolithiasis treatment?

A

stone in salivary gland/duct… treat by sucking on sour candy

130
Q

salivary tumor with chondromyxoid stroma

A

pleomorphic adenoma

131
Q

salivary tumor with germinal centers

A

Warthin’s tumor

132
Q

most common malignant salivary gland tumor

A

mucoepidermoid carcinoma

133
Q

dark urine, light stool, jaundice

A

blockage in the biliary system

134
Q

what type of tissue can be in meckle’s diverticulum? what is it a remnant of?

A

it’s a remnant of the vitellin duct; it can have pancreatic and/or gastric tissue in it.

135
Q

punched out ulcers in esophagus

136
Q

linear ulcers in esophagus. ddx?

A

CMV esophagitis or mallory weiss

137
Q

anti smooth muscle abodies

A

autoimmune hepatitis

138
Q

why can’t chlamydia and rickettsia replicate outside?

A

because they can’t make ATP

139
Q

what stimulates gastrin secretion besides Ach?

A

phenylalanine, tryptophan, and calcium

140
Q

what kind of hormone does zollinger ellison syndrome. what other syndrome is it associated with?

A

gastrinoma…thus excess acid secretion.

it’s associated with MEN1

141
Q

how do you treat zollinger ellison?

A

PPI and octreotide

142
Q

what are the receptors on gastric parietal cells that regulates acid secretion?

A

M3, CCKb (gastrin receptor), H2 histamine R,

Prostaglandin and Somatostatin Gi receptors

143
Q

acute gastritis causes

A

NSAIDS,
alcohol,
burns (curling)
brain injury (Cushing’s)

144
Q

why does brain injury cause stomach ulcers?

A

this is cushing’s ulcer.

increased vagal tone leads to abundance of acid secretion

145
Q

what are the three antacids?

A

aluminum hydroxide
magnesium hydroxide
calcium carbonate

146
Q

what is a side effect of calcium carbonate?

A

hypercalcemia…leading to gastrin activation…which leads to rebound acid secretion.

147
Q

what are side effects of magnesium hydroxide? what is this drug?

A

this is an antacid.

It could cause diarrhea, hypotension/hypokalemia

148
Q

what are some side effects of aluminum hydroxide?

A

constipation, hypophosphatemia

149
Q

Cimetadine SE

A

Gynecomastia/impotence
CYP Inhibitor
Decreases methemoglobin
thrombocytopenia

150
Q

baby with exclusive diet of goat’s milk

A

Folate deficiency

151
Q

you can get what vitamin deficiency in abetalipoproteinemia?

A

D, E, A, K

152
Q

nephrotoxic in 75% patients

A

cyclosporin

153
Q

angiodysplasia… what is it? where is it?

A

abnl dilated blood vessels in GI. cecum, terminal llleum, and ascending colon. causes hematochezia.

Dx with angiography

154
Q

Niacin deficiency can be seen in what neoplastic disease of the GI tract?

A

carcinoid syndrome/tumor

155
Q

Down syndrome GI issues

A

Celiac
Duod atresia
hirshsprung
annular pancreas

156
Q

adenomatous colon polyps. what is it what are the types

A

can lead to adenocarcinoma. either tubular or villous

157
Q

what’s the most common type of colonic polyp?

A

hyperplastic

158
Q

Young child with colon polyp. what does it mean if it’s 1; what does it mean if it’s many?

A

1 is fine. many=juvenile polyposis syndrome… increased risk of adenocarcinoma

159
Q

colon cancer tumor marker?

A

CEA. not very specific

160
Q

Turcot syndrome?

A

colon cancer, medulloblastoma

161
Q

gardner’s syndrome?

A

colon cancer, bone/softtissue tumors, lipomas, retinal pigment epithelium hypertrophy

162
Q

what is unique about HNPCC colon cancer location?

A

It’s in the proximal colon versus almost everything else is in the distal

163
Q

what does CCK do?

A

it induces gall bladder contraction and secretion of pancreatic enzymes

164
Q

changes in normal aging in the heart

A

decreased ventricular size with increased septal thickness
Lipofuscin deposition
amyloid deposition

165
Q

bipolar patient treated with antidepressant could experience what side effect?

166
Q

metoprolol blocks renin release from juxtaglomerular cells. How does this happen?

A

Catecholamines bind to JG cells to induce renin release. metoprolol blocks beta1 catecholamine receptors

167
Q

rate limiting step in urea cycle?

A

CPSI which is activated by NAG

168
Q

where do the nitrogens come from to form urea?

A

Aspartate and NH3

169
Q

what medication should you give to pt post subarachnoid hemorrhage? why?

A

vasospasm often occurs post SAH, give Nimodipine to prevent further ischemia

170
Q

contents of the hepatoduodenal ligament?

A

portal vein, proper hepatic artery, and common bile duct

171
Q

are dark skinned children or light skinned children more likely to get rickets?

172
Q

hexagonal kidney stones…what’s the defect?

A

absorption Cysteine, Ornithing, Lysine, and Arginine. esp reabsorption of cystein thus causing kidneystones

173
Q

why is epi the drug of choice in anaphylaxis

A

epi is better because while it has alpha stim…it also has beta 2 stimulation thus bronchodilation

174
Q

CO tox treatment

A

100% O2 to overturn the competitive inhibition

175
Q

nodules in fallopian tubes. acquired fixation of uterus in the retroverted position.

A

endometriosis. dyschezia, dyspareunia, dysmenorrhea

176
Q

Nacetylcysteine does what to alleviate acetaminophen toxicity?

A

It regenerates glutathione AND it provides sulfhydryl groups for normal sulfation of acetamenophen

177
Q

how is acetaminophen metabolized normally? how is it metabolized to the toxic form?

A

normally it’s sulfation and glucuronidation.

In toxicity… it’s metabolized by CYP to NAPQI. when glutathione is depleted

178
Q

niacin side effects

A

flushing (vasodilation), hyerglycemia, hyperurecemia

179
Q

histo changes on lichen planus?

A

hypergranulosis…increased granular layer

180
Q

histo changes in atopic dermatitis/ other allergic/atopic skin conditions?

A

spongiosis… edema within the epithelia

181
Q

liver growth with OCP use?

A

hepatic adenoma

182
Q

most common hepatic benign tumor?

A

cavernous hemangioma. DO NOT biopsy

183
Q

name 2 key things in lambert eaton that is different than myasthenia?

A

better with use; has autonomic symptoms such as impotence

184
Q

upper and lower motor signs. no sensory involvement

185
Q

Hb Barts units; what disease is this associated?

A

gamma4; hydrops fetalis; associated with 4 deletion alpha thalassemias

186
Q

Hb Gower units

A

zeta2, epsilon2

187
Q

Hb A2 units

A

alpha2delta2

188
Q

Hb Fetal

A

alpha2gamma2

189
Q

HbH units? what disease is this associated with?

A

Beta4; 3 deletion alpha thalassemia

190
Q

how can you differentiate crigler nijjar type I and II?

A

phenobarbital (CYP inducer to increase UDP glucuroynl transf) will make type II better and type I will not get better

191
Q

elevated unconjugated Bili…ddx?

A

hemolysis, crigler nijjar, gilbert, physiologic

192
Q

spontaneous bacterial peritonitis is associated with what?

193
Q

serum ascites albumin gradient determines what?

A

SAAG is measure of serum albumin -ascites albumin

If the SAAG is greater than 1.1 then it’s portal hypertension… AKA the hydrostatic pressure is high and pushed the fluids out

194
Q

Mallory bodies are WHAT?

195
Q

hepatic adenoma is associated with what? what are some of its complications?

A

OCP and steroids; rupture/HCC

196
Q

angiosarcoma of the liver is associated with what?

A

vinyl chloride; arsenic

197
Q

ANA +/- antismooth muscle antibodies

A

autoimmune hepatitis type I

198
Q

Liver/kidney microsomal antibodies

A

autoimmune hepatitis type II

199
Q

pANCA associated liver disease

A

primary scleosing cholangitis

200
Q

primary biliary cirrhosis treatment

A

ursodeoxycholic acid

201
Q

What hormone should you measure to confirm menopause?

202
Q

bilateral femur fx with SOB, confusion, and petechiae. dx?

A

fat emboli, with microglobulin passing through the lungs via AV shunts to the arterial side

203
Q

neoplastic lymphnode that fluctuates in size with time

A

Follicular lymphoma. it’s the most indolent

204
Q

what is marcus gunn pupils?

A

It’s afferent defect of the pupililary reflex. It could be an optic nerve lesion but it could also be a optic tract lesion affecting the contralateral side

205
Q

why might you have hemolysis with Mycoplasma pneumo infection?

A

similar antigens leading to cross reactivity

206
Q

beta thalassemia results from defects in trascription, translation, or splicing. what is the most common?

A

splicing defects or translation termination

207
Q

what is granulomatosis infantiseptica?

A

Listeria granuloma

208
Q

what is thalassemia major versus minor?

A

major is homozygous deletion of beta gene; minor is heterozygous

209
Q

what do you think of when you see all sorts of crazy looking RBCs?

A

beta thalassemia major

210
Q

what kind of globin units do you usually see in beta thalassemia major

A

alpha2gamma2

211
Q

what kind of globin units do you see in beta thalassemia minor?

A

alpha2delta2; HbA2

212
Q

cystathione beta synthase deficiency

A

homocysteinuria

213
Q

what dictates salivation? SNS or PNS?

A

both, butPNS is more duh

214
Q

pt with hx of paget’s complains of hip pain now. what is it?

A

osteosarcoma

215
Q

marjolin’s ulcer

A

malignant transformation of an old injury more than 10 years later

216
Q

globus hystericus

A

lump in throat feeling without any real physical/neural causes

217
Q

180 bp fragments on electrophoresis gel when growth factor is not added?

A

apoptosis identification via DNA laddering

218
Q

vaginal foul disharge post delivery

A

think bacteroides species and endometritis

219
Q

whats the charge of ferrous hemoglobin? what about ferric?

A

Ferrous=2; ferric=3

220
Q

teenage male with profuse nose bleeds

A

angiofibroma

221
Q

pulmonary artery pressure >25mmhg

A

pulmonary hypertension

222
Q

dorsal column degeneration; peripheral neuropathy and ataxia. what vitamin deficiency?

223
Q

abdominal mass in HIV patient. basophilic cells on histo. what is this

A

burkitt’s lymphoma. EBV.

224
Q

ARDS what is injured

A

pulm endothelium OR alveolar epithelium

225
Q

classic location of CNS germinoma?

what are the 3 key symptoms?

A

Pineal gland;

sx: precocious puberty (ectopic hCG production), obstructive hydrocephalus, and parunaud’s syndrome

226
Q

risk factors for neonatal respiratory distress?

A

maternal DM, c section, prematurity

227
Q

causes of ARDS?

A

trauma, sepsis, shock, pancreatitis, uremia, gastic aspirations, amniotic emboli

228
Q

ivory white plaques on exterior of lung?

A

asbestosis

229
Q

what population is most at risk for central sleep apnea?

A

premature infants

Tx: caffeine

230
Q

what are the histo features of lead poisoning?

A

microcytic anemia; basophilic stippling, and ring sideroblast

231
Q

What enzyme is missing in acute intermittent porphyria?

A

porphobilinogen deaminase

232
Q

what are the symptoms of porphyria cutanea tarda?

A

blisters on dorsum of hands, hyperpigmentation, hypertrichosis, tea colored urine, hep C, alcoholism

233
Q

What are the symptoms of acute intermittent porphyria?

A

abd pain, psych sx, polyneuropathy, portwine urine, precipitation by drugs/alcohol

234
Q

what enzyme is missing in porphyria cutanea tarda?

A

uroporphyrinogen carboxylase

235
Q

sx of lead poisoning?

A

neuro/psych/developmental/HA sx, wrist drop, abd pain, renal failure

236
Q

rate limiting step of heme synthesis?

A

ALASynthase

237
Q

what is heme synthesized from? any cofactors?

A

glycine and succinylcoa; need B6

238
Q

what inhibits rate limiting step of heme synthesis?

A

heme and glucose

239
Q

What’s Ham’s test and what is it used for?

A

It’s used for paroxysmal nocturnal hemoglobinuria. It’s lowering pH to activate compliment and thus lysing the cell.
better test is flow cytometry

240
Q

name the 6 intrinsic RBC hemolytic anemias?

A

PNH, hereditary spherocytosis, G6PD, PK, and HbS, HbC

241
Q

three steps of platelet function?

A

adhesion, activation, aggregation

242
Q

B symptoms

A

fever, night sweat, weightloss

243
Q

what traits of Hodgkin’s Lymphoma histology is a good sign?

A

fewer reedsterberg cells; high lymphocyte

244
Q

what cancer has 14;18 translocation

A

diffuse B cell lymphoma and follicular lymphoma

245
Q

Teenager with thymic mass

246
Q

whats in cryoprecipitate?

A

fibrinogen/fibronectin, vwbF, VIII, XIII

247
Q

what is myelodysplastic syndrome?

A

dysplasia of myeloid precursors…ineffective maturation. RISK of AML

248
Q

pseudo pelger huet syndrome?

A

bilobed nutrophil…post chemo or in myelodysplastic syndrome

249
Q

what is TdT a marker for?

A

immature T and B cell… for ALL

250
Q

where does vonwillibrand factor come from?

A

endothelial cells and some from platelets

251
Q

what drugs cause sexual dysfunctions?

A

antihypertensive, antineuroleptics, antidepressants

252
Q

what are the layers of the endometrium?

A

stratum basale, stratum spongiosum, stratum compacta

253
Q

what is oligomenorrhea

A

menstrual cycle of more than 35 days

254
Q

what is menorrhagia?

A

heavy menstrual cycle

255
Q

what is metorrhagia?

A

frequent but irregular menstrual cycle

256
Q

what is polymenorrhea?

A

cycle shorter than 21 days

257
Q

at what phase is primary oocytes arrested in?

A

prophase I, the goes on once follicle matures

258
Q

at what phase is secondary oocytes arrested in?

A

metaphase II until fertilization

259
Q

what is N and C of cells?

A

N is ploidy; C=chromosome

260
Q

What is the N and C for gonium cells, primary cytes, secondary cytes, and mature germ cells?

A

Gonium=2N, 2C
Primary cytes=2N, 4C
Secondary cytes=1N, 2C
mature cells=1N, 1C

261
Q

hCG is detectable when in the serum? what about urine?

A

1 week post fertilization in serum, 2 weeks post fertilization in urine AKA same time that the woman misses her period

262
Q

fertilization occurs how long post ovulation?

263
Q

implantation occurs when?

264
Q

where is hCG made?

A

syncytialtrophoblast

265
Q

what is it called when coracoid scrapes the glenoid process?

A

Hill sach lesion

266
Q

what is gestational hypertension?

A

140/90 after 20 weeks

267
Q

causes of polyhydraminios?

A

inability to swallow, maternal DM, fetal anemia, and multiple gestation

268
Q

causes of oligohydraminios?

A

renal agenesis, urethral valve, placental insuff

269
Q

most common cause of miscarraige

A

trisomy 16

USMLE (9 decks)

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