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BT_Step1_NTK > Final Countdown > Flashcards

Final Countdown Flashcards

1
Q

What must you monitor on a pt. who is taking clozapine?

A

Abs. Neutrophil count.

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2
Q

pyrrolidonyl arylamiase (PYP) postitive ==> ?

A

S. pyogenes

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3
Q

low serum ceruloplasmin ==>

A

Wilson’s disease

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4
Q

fluoxetine: ?

A

SSRi

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5
Q

Deferozamine: ?

A

DOC for iron overdose; chelating agent that binds irons and converts it to water-sol.

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6
Q

Edetate calcium disodium: ?

A

DOC for lead poisoning; increases urinary excretion of lead.

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7
Q

cell body rounding; peripheral displacement of nuclei; dispersion of Nissl Substance to periphery of cell ==???

A

Axonal reaction.

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8
Q

Pt. with Hx of either: sickle cell, vasculitis, glucocorticoid Tx, alcoholism; presents with femoral head bone pain. ==> ???

A

Osteonecrosis (avascular necrosis)

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9
Q

Peds; fever for more than 5 days; bilat. conjuctivitis; swelling of hands and feet; cervical LAD, rash, mucositis (“strewberry” tongue) == >???

A

Kawasaki’s

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10
Q

Berkson’s bias: ?

A

type of selection bias that can be created by selecting hospitalized pt. as the control group.

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11
Q

What is the major risk factor for the dev. of intimal tears leading to aortic dissection?

A

HYPER-fucking-TENSION!

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12
Q

infection starts following organism’s penetration of the skin by filariform (infection-stage) larva and can be ddX by finding rhanditiform (non-infectious) larvaw in the stool. What organism?

A

Stronglyloides stercoralis

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13
Q

infection starts following organism’s penetration of the skin by filariform (infection-stage) larva and can be ddX by finding rhabditiform (non-infectious) larvaw in the stool. What organism?

A

Stronglyloides stercoralis

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14
Q

What personality disorder ~ magical beliefs, social anxiety, eccentric behaviors, and odd perceptual experiences?

A

Schizotypal personality disorder!

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15
Q

Lipid-filled intimal plaque = ?

A

atheromas=lipid-filled intimal plaques that bulge into the arterial lumen ==> create fixed stenosis ==> Claudication.

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16
Q

t(14;18) ==>

A

follicular lymphoma; a non-hodgkins lymphoma; bcl-2 overexpression

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17
Q

Malignant tumors of the parotid gland compresses what nerve and causes what?

A

CN7; causes ipsilateral facial droop

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18
Q

Malignant tumors of the parotid gland compresses what nerve and causes what?

A

CN7; causes ipsilateral facial droop

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19
Q

What is the drug that is responsible for the major part of the clot lysis in an acute MI?

A

tPA

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20
Q

What issue of the heart leads to increased LA pressure and increase PCWP?

A

mitral stenosis!

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21
Q

What vitamin/mineral overload is seen in sarcoidosis?

A

HyperCa2+; activated macrophages increase expression of a-alpha-hydroxylase, leads to excess 1,25-vitamin-D. (happends in other granulomatous disease too.

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22
Q

What vitamin/mineral overload is seen in sarcoidosis?

A

HyperCa2+; activated macrophages increase expression of a-alpha-hydroxylase, leads to excess 1,25-vitamin-D. (happends in other granulomatous disease too.

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23
Q

Uricosuric agents (eg. probenecid)

A

increase renal excretion of uric acid; 2nd DOC; contra in Pt. with Hx of renal stones.

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24
Q

D-penicillamine to Tx:

A

Wilson’s disease; Cu+ chelator.

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25
Q

Uricosuric agents (eg. probenecid)

A

increase renal excretion of uric acid; 2nd DOC; contra in Pt. with Hx of renal stones.

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26
Q

Failure of the left and right maxillary prominences to merge in the fetus causes what?

A

cleft palate

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27
Q

cleft palate is due to what embryo issue?

A

Failure of the left and right maxillary prominences to merge in the fetus

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28
Q

Pancreatic divisum is the most common congenital malformation of the pancreas, occurring in approximately 7% of the population. It is caused by what?

A

the failure of the ventral pancreatic duct to merge with the dorsal pancreatic duct.

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29
Q

Cleft ___ is the consequence of failed fusion between the medial nasal eminence and the maxillary process

A

Cleft lip

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30
Q

Cleft lip is the consequence of failed fusion between what two structures?

A

the medial nasal eminence and the maxillary process

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31
Q

failed fusion between the medial nasal eminence and the maxillary process ==> ???

A

Cleft Lip

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32
Q

Zygote is formed at day ZERO! when does implantation happen?

A

day 6-8; zygote is now called a blastocyst; each blastocyst forms it’s own placenta.

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33
Q

each blastocyst forms it’s own placenta, so if a prego shows only one placenta, when did splitting occur?

A

on or after day 5. If splitting occurred before the the blastocyst stage (eg. before implantation), there would be two chorions/placentas.

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34
Q

thryoid gland is derived from what germ cells?

A

endoderm

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35
Q

what structures are derived from neuroectoderm?hint: “COARNEE”

A

CNS nuerons;

Oligodendrocytes;

Asterocytes;

Retina, iris, & optic nerve;

Neurohypophysis (post. pit);

Epithalamus (pineal gland);

Ependymal cells;

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36
Q

Mammary glands are from?

A

surface ectoderm

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37
Q

Oral cavity epithelium, from?

A

surface ectoderm

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38
Q

Olfactory epithelium, from?

A

surface ectoderm

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39
Q

Distal anal canal below the pectinate line, from?

A

surface ectoderm

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40
Q

Enamel (ameloblasts are derived from surface ectoderm), from?

A

surface ectoderm

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41
Q

Adenohypophysis (via Rathke pouch), from?

A

surface ectoderm

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42
Q

Distal male urethra, from?

A

surface ectoderm

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43
Q

Parotid salivary glands, from?

A

surface ectoderm

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44
Q

Epidermis and accessory structures (e.g. hair, nails, sweat glands, sebaceous glands), from?

A

surface ectoderm

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45
Q

Ear; both the internal and external ear (not middle ear), from?

A

surface ectoderm

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46
Q

Lens of the eye, from?

A

surface ectoderm

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47
Q

Pia mater, Peripheral nervous system neurons, Arachnoid mater, are from?

A

neural crest cells

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48
Q

Schwann cells, are from?

A

neural crest cells

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49
Q

Sympathetic chain (autonomic postganglionic neurons), are from?

A

neural crest cells

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50
Q

Dorsal Root ganglia, are from?

A

neural crest cells

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51
Q

Adrenal Medulla chromaffin cells (vs. adrenal cortex, which is derived from mesoderm), are from?

A

neural crest cells

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52
Q

Facial and skull bones & Facial cartilage, are from?

A

neural crest cells

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53
Q

Parafollicular C cells, are from?

A

neural crest cells

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54
Q

Endocardial cushions of the heart, are from?

A

neural crest cells

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55
Q

Spiral septum (aorticopulmonary septum), are from?

A

neural crest cells

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56
Q

Odontoblasts (creates dentin), are from?

A

neural crest cells

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57
Q

Pigment cells (melanocytes), are from?

A

neural crest cells

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58
Q

round ligament of the liver is the remnant of what fetal structure?

A

the left umbilical vein

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59
Q

The structure that carries oxygenated blood from the placenta to the fetus becomes what?

A

the left umbilical vein ==> ROUND LIGAMENT

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60
Q

The intermediate mesoderm, develops into the urogential ridge, which derives what structures?

A 
Kidneys
Adrenal cortices
Superior ureters
Superior one third of the vagina
Uterus and cervix
Testes
Ovaries
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61
Q

Cells of an Aldo producing adrenal adenoma are derived from what?

A

urogential ridge of the intermediate mesoderm, of mesoderm.

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62
Q

The developing embryo is most susceptible to teratogens during weeks __________, when the major organ systems, including the nervous system, gastrointestinal system, and cardiovascular system begin to develop and orient within the embryo.

A

weeks 3-8, the embryonic period

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63
Q

What is the mcc of a pure sensory stroke?

A

lacunar infarct of the thalamus.

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64
Q

What is the thalamus derived from?

A

diencephalon

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65
Q

The myelencephalon gives rise to the?

A

medulla and the lower portion of the 4th ventricle. myel- is below mete–

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66
Q

What gives rise to the cerebellum and pons?

A

metencephalon

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67
Q

The zygote is from what?

A

fertilization of the ovum; occurs at the ampulla of the fallopian tube.

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68
Q

gastric varices; ONLY in the FUNDUS ==?

A

splenic vein thrombosis leading to dilation of the SHORT GASTRIC veins.

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69
Q

The main pancreatic duct and common bile duct will join to become what?

A

the hepatopancreatic ampulla of Vater

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70
Q

The ventral pancreatic bud gives rise to the:(3)

A

Uncinate process; Lowerpart of the head; Main pancreatic duct

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71
Q

What parts of the pancrease is from endoderm?

A

Exocrine pancreas & Pancreatic islet cells (alpha, beta, etc.)

72
Q

What does the midbrain and the cerebral aqueduct come from?

A

Mesencephalon

73
Q

microglia from?

A

mesoderm

74
Q

The umbilical arteries are a branch of what artery?

A

internal iliac a.

75
Q

dorsal–ventral differentiation of the spinal cord is d/t what?

A

Sonic Hedgehog signalling pathways; mut & defects ==> CNS and facial defects; holoprosencephly.

76
Q

Cerebellum, Pons, Upper-portion of 4th ventricle comes from what?

A

metecephalon; “CPU”; redditors love new CPUs man, thats so META.

77
Q

spleen ~ greater omentum b/c???

A

both from dorsal mesentary

78
Q

The medial umbilical ligaments is the post-natal remnant of what?

A

the right and left umbilical arteries

79
Q

Which umbillical vein obliterates during fetal dev.?

A

RIGHT umbilical vein

80
Q

Thalamus; 9Hypothalamus; Epithalamus (pineal gland); Third ventricle;Retina (please see Eye Development) comes from what?

A

diencephalon, which is below the telencephalon.

81
Q

the embryonic neural tube and neural crest cells are derived from what?

A

Neural plate folds

82
Q

Sclerotome, myotme, dermatome are from what?

A

Paraxial mesoderm

83
Q

gastrulation starts/occurs at what week?

A

week 3; makes 3 germ layers; EPIBLASTs==> ecto, meso, endoderm

84
Q

what week of dev. do genitalia show male/female characteristics?

A

week 10

85
Q

What cells form the primary yolk sac?

A

Hypoblast cells that migrate along the Cytotrophoblasts

86
Q

During gestational week 2, what happens to the embryoblast?

A

the embryoblast differentiates into 2 distinct cell layers, the epiblast and the hypoblast, forming a bilaminar embryonic disk. Think bilaminar occurs during the 2nd week.

87
Q

The blastocyst usually implants within wht part of the uterus?

A

the posterior superior wall of the uterus

88
Q

what are the two embryonic components form the placenta?

A

syncytiotrophoblasts &cytotrophoblast

89
Q

Of the two embryonic components form the placenta which one does not divide mitotically?

A

syncytiotrophoblasts

90
Q

Of the two embryonic components form the placenta which one divides mitotically?

A

cytotrophoblast; aids growth of the syncytiotrophoblast

91
Q

Creation of the trilaminar disc is initiated when what happens?

A

the epiblast invaginates to form the primitive streak.

92
Q

What embryonic components of the placenta produces human chorionic gonadotropin and human placental lactogen.

A

syncytiotrophoblast

93
Q

Which type of twins divide prior to the formation of the chorion, which occurs 0-4 days after fertilization?

A

Dichorionic diamniotic monozygotic twins

94
Q

Which type of twins divide after the formation of the chorion, which occurs 4 - 8 days after fertilization?

A

Monochorionic diamniotic monozygotic twins

95
Q

Dizygotic, or fraternal, twins develop from two zygotes (two eggs and two sperm), this yields???

A

yielding 2 chorions (and therefore 2 placentas), and 2 amniotic sacs.

96
Q

laryngeal inlet is from?

A

The respiratory diverticulum maintains a small, superior communication with the distal pharynx, which will become the laryngeal inlet.

97
Q

Celiac artery; Superior mesenteric artery; Inferior mesenteric artery come from?

A

Vitelline arteries

98
Q

4th arch arteries?

A

Aorta and RIGHT Subclavian “fOUR rhymes with AOR for Aorta. fouRS for Right Subclavian.”

99
Q

3rd arch arteries?

A

Common Carotid; “C is the 3rd letter”

100
Q

1st and 2nd arch arteries?

A

1st arch artery ~ maxillary artery
2nd arch artery ~ stapedial artery
“First is Max & Second is Stapedial”

101
Q

Pulmonary trunk and RIGHT pulm artery is from which arch?

A

6th arch;

102
Q

7th arch arteries?

A

“7 is S.”; Seventh InterSegmental Subclavian!

103
Q

The development of the recurrent laryngeal nerve is closely related to arterial development. The left recurrent laryngeal nerve loops laterally to the ductus arteriosus (ligamentum arteriosum in adults) under [what?] before traveling superiorly.

A

aortic arch 6

104
Q

what is elevated in asteocytes in pt. with hyperammoniemia?

A

Glutamate

105
Q

skin finding ~w/ PBC?

A

Pruritis (itchy skin); PBC Sx: hepatomegaly, steatorrhea, portal HTN.

106
Q

Venous drainage above the dentate line?

A

Superior rectal v –> internal iliac/inferior mesenteric.

107
Q

Venous drainage BELOW the dentate line?

A

inferior rectal v. ==> intermal pudendal vein ==> internal iliac v.

108
Q

Villous Atrophy, Crypt Hyperplasia, Intraepitheial lymphocyte infiltration ==?

A

Celiacs

109
Q

“double bubble sign” ~?

A

duodenal atresia ~ Down Synd.

110
Q

“Apple-peel: deformity == ?

A

Apple Peel atresia; occlusions of SMA

111
Q

If you have an elevated alk phos, what is the next test you should order?

A

Gamma-glutamyl transpeptidase (GGTP)

112
Q

if neonate passes meconium thru iumbilicus after birth, this is what?

A

persistent vitelline duct

113
Q

Xanthelasma…what disease?

A

PBC; also ~w/ ADEK def, d/t fat mal.abs

114
Q

what is the molecular mechanism of VIP, from a VIPoma?

A

Binds to Gs, activating AC and increasing cAMP

115
Q

What is in the Hepatoduodenal ligament?

A

the portal triad (common bile duct, hepatic artery, hepatic portal vein)

116
Q

If a patient is still bleeding after the Pringle maneuver, what is the source of the bleeding (2)?

A

IVC or hepatic veins

117
Q

patent processus vadinallis ==>

A

Indirect inguinal hernias

118
Q

weakness of transversalis fascia ==> ?

A

DIRECT inguinal hernias

119
Q

what covers a DIRECT inguinal hernia?

A

external spermatic fascia

120
Q

what covers indirect inguinal hernias?

A

all 3 spermatic layers; internal, cremasteric, external

121
Q

air in the biliary tree =?

A

gallstone ileus

122
Q

HSV-1 esophagitis endoscopy shows?

A

small vesicles–>punched out ulcers

123
Q

papable, but NON-tender gallbladder = ?

A

Courvoisier Sign == Pancreatic malignancy

124
Q

epigastic calcifications on imaging in an alcoholic?

A

chronic alcoholic pancreatitis

125
Q

What Inhibits cholesterol 7-alpha hydroxylase which catalyzes the RLS in the synthesis of bile acids–> decreases bile acid production results in decreased cholesterol solubility–>cholesterol stones.

A

Fibrates

126
Q

Gemfibrozil and fenofibrates are what?

A

Fibrates

127
Q

SIBO causes def. in all vitamins, except for what?

A

Vit,K & Folate, these INCREASE b/c bacteria are growing and producing a shit ton.

128
Q

CD16 & CD56 == ?

A

NK cells

129
Q

defect in linea alba covered by skins; incomplete closure of umbilical ring ==>

A

Umbilical hernia (in peds)

130
Q

L.O.F. mut. in MTP gene ==>

A

abetalipoproteinemia; acanthocytes

131
Q

foul-smelling stools, ADEK def., ataxia, retinitis pigmentosa are signs of?

A

abetalipoproteinemia; labs will have low lipid panel and ABSENT apoV and VLDL

132
Q

Histo of: Basal Zone hyperplasia; Lamina propria hyperplasia; Eosinophils/PMNs ==> ?

A

GERD

133
Q

histo: islands of cells

eosinophilic cytoplasm and oval-to-round stippled nuclei ==>

A

Carcinoid tumors

134
Q

“currant jelly stool” ==> ?

A

intussusception

135
Q

Transmural inflamm & non-caseatnig granuloms ==> ?

A

Crohns; cobblestone mucosa on gross.

136
Q

finely granular, diffusely homogenous, pale eosinophilic cytoplasm (ground glass hepatocytes) ~w/

A

HepB

137
Q

cricopharyngeal motor dysfunc. —>

A

Zankers diver.

138
Q

gram positive actinomycete; Diastase resistant = what bug?

A

T. whippelii

139
Q

Pathway of NOD2?

A

NF-kB –> cytokine prod.; ~w/ crohns

140
Q

CREST syndrome?

A 
Calcinosis/Anti-centromere ab
Raynaud Phenomenon
Esophageal Dysmotility
Sclerodactyly-finger ulcers w/ skin tightening
Telangiectasia
141
Q

Councilman & Apoptotic cell bodies are seen on histo of what diz process?

A

Seen on H&E of actue viral hepatitis

142
Q

What does the Sabin (live) vaccine increase that the Salk (killed) doesn’t?

A

mucosal IgA

143
Q

What does the onset of action of gas anesthetic depend one?

A

solubility in blood (blood/gas coefficient); High b/g coefficients are more soluble in blood, slower equilibration with brain, and longer onset

144
Q

Almost all volatile anesthetics increase what physiological parameter?

A

Cerebral blood flow; this is an undesirable effect as it results in increased ICP.

145
Q

What is the mc benign lung tumor, “coin lesion”, called and what are they made of.

A

Harmartomas. disorganized cartilage, fibrous and adipose tissue.

146
Q

What anti-arrhythmic drug also shortens phase 3 re-polarization (blockade of “plateau” Na+ current)

A

Class 1B;l Lidocaine, mexiletine

147
Q

What anti-arrhythmic drug has a strong polongation of phase 0 depol, and results in no changes to the length of the AP?

A

Class 1C; Flecainide, propanfenone.

148
Q

Which anti-arrhythmics also have moderate K+-ch. blocking activity?

A

Class 1A; quinidine, procainamide, disopyramide. moderate phase 0 block and prolonged AP length.

149
Q

intracerebral hemorrhage, progressive neurological deficits, located at basal ganglia, cerebellum, thalamus, pons = ??

A

Charcot-Bouchard aneurysms. Qid 498

150
Q

reddish-pink, PAS (+) granules of unsecreted polymers in the periportal hepatocytes == ?

A

Alpha-1 antitrypsin def. (ATT), in lungs as interalveolar septa destruction.

151
Q

bronchial hyperreactivity is a hallmark of what?

A

chronic asthma

152
Q

interstitial infiltration is a finding in what?

A

interstitial pneumonitis

153
Q

intraalveolar substance accumulation is a finding in what?

A

alveolar proteinosis

154
Q

rupture of the left ventricular free wall occurs how many days post MI?

A

5-14 days. causes profound hypotension and shock, leading to death.

155
Q

Synaptophysin is a protein found where?

A

presynaptic vesicles of neurons, nueroendocrine and neuroectodermal cells.

156
Q

Asterocytomas, ependymomas, and oligodendrogliomas are of what origin?

A

Glial origin; stain positive for GFAP.

157
Q

non-lactose fermenting, non-motile, gram negative rod == ?

A

Shigella

158
Q

motile, oxidase positive, gran-negative rod == ?

A

Pseudomonas

159
Q

chest pain that is sharp and pleuritic, and may be exacerbated by swallowing or relieved by leaning forward = ?

A

pericarditis. can be d/t pericardial inflammation overlaying the necrotic segment of the myocardium post MI.

160
Q

acute hyper-sensitivity reaction to drugs like, opioids, radiocontrast agents, and some ABX can be due to what?

A

IgE-independent mast cell activation; induces mast cells to degranulate by activating protein kinase A and PI3 kinase.

161
Q

IgE mediated degranulation is ~w/ what?

A

environmental exposures like food or plants, and some meds like beta-lactam and sulfonamide ABX.

162
Q

what is characterized histologically by spongiosis?

A

Acute eczematous dermatitis; S/Sx of papulovesicular, weeping lesions. seen in type 4 HSR.

163
Q

white blood cell casts are only form in the renal tubules and are pathognomonic for __________________when accompanied by symptoms of acute UTI.

A

acute pyelonephritis

164
Q

pyramidal cells of the hippocampus and the neocortex and the Purkinje cells of the cerbellum are at risk for what?

A

hypoxic-ischemic encephalopathy in global cerebral ischemia. hippocampus is first to be damaged

165
Q

easy fatigability, constipation, back pain, elevated serum protein, azotemia in elderly pt. should raise suspicion for what?

A

Multiple myeloma.

166
Q

large eosinophilic cast obstructing the tubular lumen is a sign of what?

A

multiple myeloma; those are Bence-Jones proteins.

167
Q

What classically presents with muddy brown, granular, and epithelial cell casts and free tubular epithelial cells in the urine?

A

Ischemic tubular necrosis

168
Q

NSAIDs can cause what two renal issues?

A

chronic interstitial nephritis or acute papilary necrosis.

169
Q

What does Pauci-immune RPGN mean?

A

no Ig or complement deposits on the basement membrane. Most pt. will have ANCA in their serum.

170
Q

What is a simple partial seizure?

A

aka simple focal. no loss of consciousness, motor jerking.

171
Q

Triad of low hemoglobin, thrombocytopenia, and absent hematopoietic cells in the bone marrow == ?

A

aplastic anemia; “dry tap”

172
Q

cataracts, gonadal atrophy, sustain muscle contraction == ??

A

myotonic dystrophy [AD}

173
Q

on histo: aggregates of packed follicles that obscure the normal lymph node archtecture == ?

A

Follilcular lymphoma. t(14;18), overexpression of anti-apoptotic BCL-2 protein.

174
Q

Hematogenous osteomyelitis occurs where in the bone?

A

long bone metaphysis in peds. (vertebral bodies in adults is the more common location)

175
Q

Hypophosphorylated Rb protein does what?

A

active; Rb protein prevents damage cells from proceeding pas the g1 to S check point.

BT_Step1_NTK (28 decks)

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