From UW Flashcards
1
Q
Histology of chronic bronchitis
A
Thickened bronchial walls with neutrophilic and lymphocytic infiltrates and mucous gland enlargement w/ increased goblet cells
2
Q
Histology of allergic asthma
A
Thick bronchial epithelium, bm and smooth muscle, inflammatory infiltrate (eosinophils and mast cells) and submucosal gland enlargement
3
Q
Cystic hygroma
A
Posterior neck mass d/t abnormal lymph outflow
Seen in XO
4
Q
de novo partial deletion of short arm of chromosome 5 (5p)
A
cri du chat
5
Q
Cause of keloids
A
Excess TGF-beta: fibroblasts into myofibroblasts beyond borders of wound
Excess collagen formation
6
Q
Immune cells involved in M. tuberculosis granuloma formation
A
Macrophages engulf, present to CD4: activated to kill -> form Langhans giant cells (nuclei around the periphery)
7
Q
Anastomosis that protects descending color
A
Marginal artery from the SMA
8
Q
Enzyme the breaks down glucose in the beta cell to enter the TCA cycle
A
Glucokinase
9
Q
Best option to rapidly increase blood glucose?
A
IM glucagon
10
Q
Signs of lead poisoning
A
Occupational exposure (painter, construction worker) Microcytic anemia, GI (constipation), mental status changes (confusion or decreased concentration)
11
Q
What does lead inhibit?
A
aminolevulinate dehydrates and ferrochelatase
12
Q
Where and when would you see ringed sideroblasts?
A
D/t precipitation of iron in developing erythrocytes d/t defects in heme synthesis
Seen in none marrow (not peripheral)
13
Q
Which nerve can you stimulate in obstructive sleep apnea and what does it do?
A
Hypoglossal nerve: moves tongue forward in increase diameter of airway
14
Q
Ornithine translocase deficiency
A
Defective hepatic urea cycle:
unable to convert ammonia (from aa catabolism) into urea; ammonia accumulates
15
Q
Afib in hx of aortic stenosis
A
LV hypertrophy d/t AS; dependent on atrial preload to maintain LV filling
When in afib: decreased preload leads to heart failure; will also have acute pulmonary edema
16
Q
Sensory innervation for anterior 2/3 of tongue?
A
Taste: chorda tymapni
Sensation: V3
17
Q
Sensory innervation for posterior 1/3 of tongue?
A
Glossopharyngeal (IX)
18
Q
What separates the anterior and posterior tongue?
A
Terminal sulcus w/ foramen cecum
19
Q
Motor innervation to the tongue?
A
Hypoglossal nerve (XII)
20
Q
Sensory innervation for posterior tongue root?
A
Vagus (X)
21
Q
What enzyme deficiency presents similarly to G-6-pd deficiency?
A
Gltathione reductase
22
Q
Chronic, unexpected panic attacks
A
panic disorder (vs GAD)
23
Q
What quadruple screen change would be seen in FGR?
A
Decreased estriol
24
Q
Most common placentation of monozygotic twins with early (1st week) division?
A
Monochorionic-diamniotic
25
Most common placentation of monozygotic twins with late (8-12 days) division?
monochorionic - monoamniotic
| high fatality rate
26
Absent CD18 on leukocytes
Leukocyte adhesion deficiency (integrins); leukocytes cant adhere to endothelium for migration into tissues
Skin and mucosal infection, no pus, poor wound healing
Delayed umbilical cord separation
Chronic leukocytosis
27
Reduced/absent methylene tetrahydrofolate reductase would lead to what?
Impaired ability to convert homocysteine to methionine; increased risk for thrombosis
28
Standard deviation %?
68/95/99.7
29
What nerve courses with the superior thyroid artery and vein? Where do they originate?
External branch of superior laryngeal
| Superior to thyroid gland/lateral to thyroid cartilage
30
What muscle does the external branch of the superior laryngeal nerve innervate? When is injury a risk?
Cricothyroid muscle
| During Thyroidectomy
31
What causes prolactinemia w/ antipsychotic use?
Blockade of tuberinfundibular pathway (connects hypothalamus to pituitary gland; tonic inhibitor of prolactin)
32
How do you test for tichomonas?
Wet mount/saline microscopy
33
What changes are seen in serum Ca, phosphorus and PTH in osteoporosis?
None
34
Anti-smooth muscle antibodies?
Autoimmune hepatitis
35
Anti-histidyl-tRNA is also called? When is it seen?
Anti-Jo
| Polyomositis
36
Histology of acute heart rejection
Dense infiltrate of mononuclear cells composed of T-lymphocytes
37
Histology of chronic rejection
Scant inflammatory cells and interstitial fibrosis
38
Chediak-Higashi
AR
Immunodeficient, albinism and neuro defects (nystagmus and neuropathies)
Defect in neutrophil phagosome lysosome fusion (giant cells)
39
Homocyteinuria
AR error of methionine metabolism
Lens dislocation, marfanoid habits, intellectual disability, thrombus
Treat by giving B6 and restricting methionine
40
Macrocyclic antibiotic for c. Diff
Fidaxomicin
41
What change causes decreased renal plasma flow and increase filtration fraction?
Constriction of efferent arteriole
42
Porphyria cutanea tarda
Uroporphyrinogen decarboxylase deficiency
| Photosensitivity: blisters etc
43
Continuous, machine like murmur
PDA
44
Which step of the citric acid cycle is inhibited by ethanol?
a-ketoglutarate to succinylcholine -CoA (a-ketoglyarate dehydrogenase complex)
It is thiamine dependent
45
What value changes when comparing populations of different disease prevalence?
PPV
46
What type of rash is seen in measles?
macularpapular
47
What stimulates the adrenal medulla?
Acetycholine
48
What is the strucutre of MHC class I?
heavy chain and B2-microglobulin
49
What is the structure of MHC class II?
alpha and beta polypeptide chains
50
What kind of signaling are Ca sensing receptors?
GCPR
51
Drug that causes vertical and horizontal nystagmus, MOA of this drug and antidote
PCP; NMDA antagmonist; benzos
52
Thyroglossal duct cyst presentation and origin
Sore spot on neck that is tender, fluctuant, and midline; made of ectopic tissue
Originates from floor of the primitive pharynx
53
Sx of mumps
Parotitis and orchitis (if not vaccinated)
54
Leber hereditary optic neuropathy
Mitochondrial disease
| Degeneration of retinal ganglion cells and axons: leads to painless loss of central vision, known as central scotoma
55
What enzyme does lead inhibit?
δ-Aminolevulinic acid dehydratase and ferrochelotase
56
Where would an embolism in a patient with non-valvular a-fib most likely come from
The left atrial appendage
57
What type of gland are sebaceous glands?
Holocrine
58
What is sorbitol converted to in the retina normally?
Fructose (via sorbitol dehydrogenase)
59
What molecules use zinc motifs to alter transcription?
Those with IC receptors:
thyroid hormones, steroids, fat-soluble vitamins
(Lipid soluble)
60
Inheritance of G6PD?
XR
61
Signs of lead toxicity
Poor, anemia, language regression in a child
62
How long does depletion of ATP and accumulation of toxins (resulting in loss of contractility) take in the setting ischemia?
60s
63
Histologic SE fo topical corticosteroid cream therapy?
Dermal atrophy: drying, cracking, tightening
| Due to decreased production of EC collagen matrix and GAGs
64
LE nerve injured when extensive time spent in lateral decubitus position
Common peroneal
| contacts the lateral neck of the fibula
65
Injury to deep peroneal nerve?
Foot drop (anterior compartment muscles used for dorsiflexion)
66
Injury to superficial peroneal nerve?
Decreased foot eversion
| Decreased sensation of lateral leg and dorsolateral foot
67
Signs of cocaine withdraw
depression, fatigue, hypersomnia, hyperplasia and vivid dreams
68
Fabry disease
XR; alpha-galactosidase A deficiency: accumulated globotriaosylceramide
Neuropathic pain, decreased sweating, angiokeratomas, telangiectasis, glomerular disease, CV disease
69
What do amatoxins halt?
(mushrooms)
| RNA pol II: blocking mRNA synthesis
70
What does ricin halt
(toxin from castor oil plant)
| Protein synthesis; cleaves rRNA of 60S subunit
71
What are anti-Smith ab specific for?
snRNA in the cytoplasm (these remove introns from mRNA)
72
Most common cause of paradoxical embolism?
ASD
| incomplete fusion of septum primum and secundum
73
Glossopharyngeal nerve lesion
(CN IX)
| Loss of taste of posterior 1/3, loss of sensation in upper pharynx, posterior tongue, tonsils and middle ear
74
What is the major determinant of severity in TofF?
RV outflow tract obstruction
75
Adenomyosis
Endometrial tissue in the myometrium
| Heavy bleeding, uniformly enlarged uterus
76
What is CNX derived from?
4th and 6th pharyngeal arch
77
Tay-Sachs
AR; B-hexosaminidase A deficiency: build up of GM2 gangliosides
Normal at first: neuro deterioration, weakness, sz, cherry red macula
(NO hepatosplenomegaly)
78
Rett syndrome
Normal until 5-18m
Loss of motor and language skills
Hand wringing, decreased head growth
XL MECP2 gene (de novo)
79
Deviation of mandible toward the effected lesion
CN V3
80
Renal clearance of PAH
Freely filtered into Bowman's space; majority is secreted by proximal tubule via carrier transport
None is reabsorbed
81
Cause of annular pancreas
Abnormal migration of ventral pancreatic bud
82
ADH secretion and storage
Hypothalamus, stored in posterior pituitary
83
What is the cause of hyper acute transplant rejection?
Preformed antibodies
84
What blood disorder would you see monoclonal gamma globulin spike?
Multiple myeloma
85
Congenital hypothyroidism
Lethargy, enlarge fontanelle, protruding tongue, umbilical hernia, poor feeding, constipation, dry skin, jaundice
86
Primary immune cells seen in COPD
macrophages, CD8 and neutrophils
87
Which cholesterol drug can cause gout?
niacin
88
What enzyme is inhibited in riboflavin deficiency?
Succinate dehydrogenase
89
Hemorrhoids above the dentate line
Internal; drain to the superior rectal vein -> inferior mesenteric vein
90
Hemorrhoids below the dentate line
External; inferior rectal vein -> internal pudendal vein -> internal iliac veins
91
Presentation of togavirus
Rubella; maculopapular rash that starts on face and spreads to body
Poastaruicular and occipital lymphadenopathy
92
What would be seen on light microscopy of a patient with linear deposit seen on IF?
Glomerular crescents
| Goodpasture; IgG and C3
93
Problem in xeroderma pigmentosum
Defective endonuclease nucleotide excision repair
| Thymine dimers created by UV light require special UV endonuclease
94
What allows elastin to stretch and recoil>
Interchain cross-linking involving lysine
95
What is increased in isolated diastolic heart failure?
LV end-diastolic volume
96
What yeast is seen in patients with central lines?
Candida (pseudohyphae with blastoconidia)
97
Where do you get B12?
Only from animal products (vegans at risk)
98
What part of the eye do Beta blockers effect to treat glaucoma?
Ciliary epithelium
99
When does non-disjunction usually occur?
During meiosis I
100
What is the concern in a patient with hyperthyroid and fever/sore throat?
Agranulocytosis (check WBC w/diff)
101
What enzyme is inhibited by fibrates?
cholesterol 7 alpha-hydroxylase
102
What immune cells would cause granulomas in sarcoidosis?
Th1, IL-2, IFN-gamma
103
What would brain imaging in a patient with PKU show?
Pallor of substantia nigra, locus ceruleus, and vagal nucleus dorsalis
104
Lack of neurophysin would lead to what?
DI
| neurophysiology carries oxytocin and ADH from the nuclei to the post pit
105
What collagen type is fibrotic scar tissue composed of?
Type 1 (similar to dermis, bone, tendon, ligament, blood vessels)
106
How do you differentiate an ecological study from other types?
Analysis of entire populations; not individuals
107
What artery would be at risk in a patient with a midshaft humerus injury and radial nerve injury?
Deep brachial artery
108
Renal papillary necrosis presentation
Abrupt hematuria w/family hx of SCD
109
CD20 indicates what?
Immature B cells (seen in B cell cancers)
110
CD40 is used for what?
Isotype switching
111
Hyper-IgM
```
XR defect of CD40L
Cannot signal to B-cells to class switch
```
112
Subclavian steal syndrome
Stenosis of subclavian leads to "steal" of blood from contralateral vertebral artery
113
Where would a pure sensory stroke be?
In the thalamus (VPL)
114
Common cause of lacunar infarcts?
Liphyalinosis and microatheromas
| lead to liquefactive necrosis
115
Which bio stats value relies on the prevalence of the disease in the population?
PPV (higher in populations with higher prevalence) and NPV
116
Thiamine deficiency will lead to decrease activity of what enzyme?
(a bunch, but can be diagnostic if) erythrocyte transketolase (is low and increases w/ thiamine supplement)
117
Insulin resistance in pregnancy
Due to human placental lactose (secrete by syncytiotrophoblast)
118
Hypoxemia with normal A-a
Hypoventilation (obesity, NM disorders) or low O2 inspiration (high altitude)
119
Acute intermittent porphyra
AD; deficiency of porphobilinogen deaminase
GI and neuro sx
Red urine that darkens
Give dextrose to down regulate ALA synthesis
120
hCG acts like what hormone?
TSH
121
Embryologic origin of the main pancreatic duct?
Ventral pancreatic primordium
122
What is deficient in Plummer Vinson?
Iron
123
HbS mutation?
Valine of glutamic acid
124
What cells synthesize the fibrous cap in an atheroma?
Smooth muscle cells
125
Most common amino acid in collagen
Glycine (Gly-X-Y)
126
How does Meckel diverticulum present?
Painless lower GI bleeding; can lead to intussusception: current jelly stool
127
What kind of necrosis occurs in the brain?
Liquefactive
128
Early morning vomiting and downward gaze preference
Pineal gland mass (usually a germinoma)
129
Embryologic origin of spleen?
Mesoderm
130
Anterior neck mass in a patient w/MG
Thymoma (thymus and inferior parathyroid glands derived from 3rd pharyngeal pouch)
131
Enzyme deficiency in Ehlers-Danlos?
Procollagen peptidase
132
Enzyme deficient in chronic granulomatous disease?
NADPH oxidase
133
Estrogen effect on thyroid levels
Increase total T4 (via elevation of TBG levels)
134
Cause of flame-shaped retinal hemorrhage
HTN
135
Serum Sickness
T3 HS
| Small vessels w/fibrinoid necrosis, neutrophil infiltration, deposition of IgG or IgM, decreased C3 levels
136
What prevents lactation in a pregnant patient?
Progesterone
137
What is increased in statin therapy?
LDL-r density
138
Thin eyebrows and delayed relaxation of DTRs
Hypothyroid; check TSH
139
Elderly patient with weight loss, anorexia and iron deficiency anemia
Colon cancer (guaiac positive: right sided)
140
Cause of death in sudden cardiac death?
Malignant ventricular arrhythmias (vfib)
141
Inferior surface of the heart
Mostly left ventricle
142
Blood supply to inferior surface of heart
Right coronary (gives rise to posterior descending) in right dominant people
143
Immune cells involved in graft vs host?
Graft T cells
144
What does the metanephric mesoderm of the kidney become?
Distal convoluted tubules
145
Cell surface marker for macrophages?
CD14
146
Rifaximin
Nonabsorbable antibiotic that alters GI flora to decrease production of ammonia
147
C1 inhibitor deficiency
Leads to elevated bradykinin; facial swelling, laryngeal edema, N/V/abd pain
148
What does the vascular endothelium secrete to inhibit platelet aggregation?
Prostacyclin
149
Jervell and Lange-Nielson Syndrome
AR; sensorineural hearing loss and congenital prolonged QT
| Defect in K channels
150
Sequelae of eating moldy grains
Liver cancer; Aspergillus aflatoxin induces p53 mutation
151
IgE against IgA
Selective IgA deficiency
| Anaphylaxis after blood transfusion
152
Finger drop
Radial nerve injury after/while it exits the supinator canal
153
Renal vein thrombosis
Nephropathy, flank pain, varicocele, hematuria, elevated lactate dehydrogenase
Loss of of ATIII
154
Intensity of aortic stenosis murmur is determined by what?
LV to aorta pressure difference
155
Esophageal dysfunction in CREST
Fibrous replacement of muscular in lower esophagus
156
What should be avoided in aldolase B deficiency?
Sucrose and fructose
157
Deposition of what is seen in the crescents of RPGN on IF?
Fibrin
158
Hereditary spherocytosis
Loss of central pallor
| Increased MCHC
159
What should be supplemented in hereditary orotic acuduria?
Uridine
160
SEs of erythropoiesis stimulating agents?
Thrombosis and increased HTN
161
Full alpha-1 messenger cascasde
Gq -> PLC -> IP3 and DAG
DAG -> PKC
IP3 -> increased IC Ca -> PKC
162
Histology of HIV-dementia
Microglial nodules
| subcortical dementia
163
DNA excision repair enzyme order
Glycosylase -> endonuclease -> lyase -> polymerase -> ligase
164
What should be suspected in a patient with renal angiomyolipomas?
Tuberous sclerosis; subependymal brain hamartomas, cardiac rhabdomyomas, facial angiofribomas and ash-leaf skin depigmentation
165
Type of necrosis seen in an MI?
Coagulative
166
Where is the most common site of obstruction in fetal hydronephrosis?
Ureteropelvic junction
167
Hemoglobin that is increased in beta thalassemia?
A2
168
When does myocardial perfusion occur?
During diastole
169
What can cause a ring-enhancing lesion besides toxo?
Primary central nervous system lymphoma (2nd most common in HIV after toxo)
Nocardia (abscess)
170
Pericardial fluid accumulation with late diastolic collapse of right atrium
Cardiac tamponade
171
Quatntifying pulses paradoxus with a BP cuff
Difference between systolic pressure when Korotkoff sound is heard during expiration and when it is heard throughout respiration (>10 is an exaggerated drop)
172
Features of colitis associated colorectal cancer (vs sporadic)
Younger, flat lesion (nonpolypoid), proximal > distal, multifocal, mutinous, poorly differentiated
Early p53 and late APC mutations
173
Dohle body
Basophilic granules in neutrophil
| Seen in leukemoid reaction/LAP positive
174
Mitochondrial vacuolization is indicative of what?
Irreversible cell injury
175
Beznos with long half-life
Diazepam, chlordiazepoxide, flurazepam
176
What is most indicative of malignancy on lymph node biopsy?
Monoclonal T-cell receptor gene rearrangements
177
Muddy brown casts in urine are indicative of what?
Acute tubular necrosis
178
What is primary central nervous system lymphoma?
A diffuse, large-cell non-Hodgkin B-cell lymphoma caused by EBV in cases of HIV
179
SE of prolactinoma
W: Galactorrhea, decreased estrogen
M: infertility, impotence
180
Histology of medullary thyroid cancer
Nests of polygonal cells with Congo red-positive deposits
181
What causes diabetic CN III neuropathy?
Ischemic nerve damage
182
What area increases productivity in long term steroid use?
Liver (gluconeogenesis and glycogenesis)
183
SE of L-dopa therapy even with carbidopa
Anxiety and agitation
184
Presence of riobthymidine, pseudouridine and cytidine residues on a stretch of RNA indicates what type of structure? What else will you find?
tRNA (the T loop specifically)
Will also have:
AA on the 3' CAA tail
D loop with dihydrouridine residues
185
Treatment of choice for specific phobia
Behavioral therapy
186
How do you prevent neonatal tetnus?
Vaccinate mom while pregnant
187
Differentiate hypoxic vs. secondary erthrocytosis
SaO2 < 92% or
PaO2 < 65%
True increased RBC mass
188
Next step in differentating metabolic alkalosis?
Urine chloride
189
Cholesterol meds most likely to cause gallstones
Fibrates
190
Most common site for anal fissure
Posterior midline, distal to dentate line
191
Synaptophysin on a tumor indicates what?
Neuronal origin
192
What are IV influenza vaccines directed against?
HA; blocks viral entry
193
MOA of PCP
NMDA antagonist
194
Where does the lowest urine osmolarity occur?
DCT
195
Enzyme primarily involved in brown pigment stones
beta-glucuronidase
196
How do beta blockers help in hyperthyroid?
Reduce beta effects and inhibit conversion of T4 to T3
197
Differentiate Tay-Sachs from Niemann Pick on PE?
Tay-Sachs does not have hepatosplenomegaly
198
What is the histological sign of eczematous dermatitis?
Spongiosis with edema fluid in the intercellular spaces of epidermis
199
What is responsible for the destruction of cells with decreased MHCI?
NK
200
What does silicosis impair that causes patients to get tuberculosis?
Macrophages
201
Assuming a normal rate of metabolic CO2 production, what would hypocapnia indicate?
Alveolar hyperventilation
202
Where in the female reproductive tract would simple cuboidal cells be found?
Ovary
203
What is the underlying mechanism of Zenker diverticulum formation?
Circopharyngeal motor dysfunction
204
What NT is decreased in Huntingtons?
GABA (due to loss of caudate nucleus and putamen)
205
Intraerythrocytic ring inclusions indicates what infection?
Babesiosis
206
What causes gynecomastia in patients with liver cirrhosis; what other findings would be seen due to this cause?
Hyerestrinism
| Spider angiomata, loss of hair, testicular atrophy, palmar erythema
207
Eyelide drooping is due to what cranial nerve?
CN III
208
What nerve causes ear pain in TMJ?
Mandibular division os CN V
209
Xeroderma pigmentosum is due to what?
Defective nucleotide excision repair d/t UV light
210
Cholinergic toxicity effects not corrected by atropine
Muscle weakness/paralysis
| these are nicotinic effects
211
Description of a lung abscess
Round density with air-fluid level on XR
212
Key immune cell in the formation of a lung abscess
Neutrophils
213
Attributable risk
(RR-1)/RR
214
ASA toxicity
1. Respiratory alkalosis d/t hyperventilation
| 2. Anion gap metabolic acidosis at 12 hrs d/t lipolysis, uncoupling of oxphos and inhibition of CAC
215
Friedrich ataxia
```
AR; FXN gene
Spinocerebellar and LC tract degeneration; dorsal root loss
Kyphoscoliosis and high arches
Hypertrophic cardiomyopathy
DM
```
216
Drugs that reduce the size of prostate
5-alpha reductase inhibitors (vs alpha inhibitors that relax smooth muscle)
217
What part of the bone is affected in osteomyelitis?
Metaphysis of long bones
218
Trendelenburg is due to weakness in muscles that primarily due what action?
Hip abduction
219
Parotitis in someone with vaccinations up to date
Staph a.
220
LH and FSH levels in menopause
Elevated
221
Marginated, ovular mules with hypopigmentation is caused by and treatment?
Malassezia
| Selenium
222
What causes Sheehan's syndrome?
Low cortisol (secondary to pituitary ischemia)
223
MOA of niacin to decrease cholesterol
Decreases amount of VLDL released by hepatocytes and blocks lipolysis in adipose tissue
224
Kidney involvement in vitamin D
Uses 1 alpha hydroxyls to convert inactive to calcitriol
225
Positive Thompson test indicates damage to what nerve?
Tibial; popliteus, flexor hallucis longus, flexor digitorum longus, and tibialis posterior
226
Tuberous Sclerosis
AD
Ash leaf spots (pale), facial angiofibromas (reddish-brown papules), astrocytomas, retinal hamartomas, cardiac rhabdomomas, renal angiomyolipomas
227
VHL
AD; chromosome 3
Hemangioblastomas of CNS and retina
Also tumors in: pancreas, adrenal, RCC
228
How do you form δ-aminolevulinic acid
Succinyl-CoA and Glycine
229
What enzymes does lead inhibit?
Ferrochelatase and ALA-dehydratase
| last and second step of heme synthesis
230
Markedly elevated lab value in muscular dystrophy
CPK
231
What forms the scar after a stroke?
Glial cells/astrocytes
232
When would a free wall rupture of the heart occur?
5-14 days after an MI
233
Histology of irreversible cell injury
Shrinkage of enroll body, deep eosinophilia of cytoplasm, pyknosis and loss of Nissl
234
Histology of axonal reaction
Cell body rounding, peripheral nuclei, dispersion of NIssl
235
MOA of misoprostol
Prostaglandin E1 agonist
236
MOA of Mifepristone
Progesterone and glucocorticoid antagonist
237
Cholesterol, bile and phosphatidylcholine in cholesterol stones
Cholesterol elevated
| Bile and choline low
238
Proteasome inhibitiors
Bortezomib
| Cause apoptosis; used in MM
239
Case control studies report what type of analysis?
OR
240
What does methemoglobin have strong affinity for?
Cyanide (to bind it instead of iron in mito)
241
A lesion where would drain to the popliteal lymph nodes?
lateral
242
After AST/ALT, what do you use to differentiate pancreatitis?
MCV
243
IgE independent hypersensitivity reaction
Activation of PKA and PI3
| Opioids, contrast dye, vancomycin
244
How does chronic HBV assist in HDV infection?
Coats the virus so it can enter the hepatocyte
245
Where does chronic lung transplant rejection usually occur?
Small airway
246
Disseminated gonococcal infection
Purulent arthritis
| Polyarthralgia, dermatitis, tenosynovitis
247
Sirolimus
Blocks mTOR; blocks IL2 signaling
248
Cyclosporine and Tacrolimus
Block calcineurin; block IL-2 transcription
249
Meniere disease
Increased endolymph in ear
| Vertigo, ear pain/fullness, hearing loss and tinnitus
250
NF-1
aka Von Recklinghausen
AD on 17; PNS tumors
Cafe-au-lait, neurofibromas, optic gliomas, lisch nodules,
251
Giant cell arteritis
HA, jaw claudication, visual changes, polymyalgia rheumatica
252
Step of the citric acid cycle that produces GTP?
Succinyl CoA -> succinate
253
MEN 1
Primary hyperparathyroid, pituitary and pancreatic tumors (VIPoma)
254
MEN 2A
Medullary thyroid, pheochromocytoma, PTH hypreplasia
255
MEN 2B
Meduallary thyroid, pheochromocytoma, mucosal neuromas/marfanoid
256
PE findings of opioid OD
Miosis, tachycardia, hypotension
257
Key event in HBV to hepatocellular ca?
Viral DNA integration into host genome
258
Breathing change in high altitude sickness?
hyperventilation
259
Dubin-Johnson Syndrome causes defective what?
Excretion of bilirubin glucuronides d/t mutation in the canalicular membrane transport protein
260
Histology of meothelioma
Epitheloid cells with desmosomes, containing abundant tonofilaments, studded with long, slender microvilli
261
Bilateral wedge shaped necrosis in the brain
Cortical watershed infarct
| hypoxic-ischemic encephalopathy
262
Councilman bodies
aka apoptotic bodies
| Round acidophilic hepatocytes about to undergo apoptosis
263
Bleeding in a patient with renal dysfunction
Uremic platelet dysfunction
Everything normal w/ prolonged bleeding time
Impaired aggregation d/t toxin build up
264
Most common causes of pancreatitis (2)
EtOH and gallstones
265
Sx of pericarditis
CP that improves when sitting up/foward, friction rub
266
Superior vena cava syndrome
Dyspnea, swelling of face/neck/UE, HA, dizziness, dilated veins
267
Osler-Weber-Rendu
Hereditary hemorrhagic telangiectasia
| Skin and mucosa (also GI, GU, brain, liver and spleen)
268
NF-2
AD; nervous system tumors
| B/L VIII schwannomas and meningiomas
269
Sturge-Weber
Neurocutaneous: facial and leptomeningeal angiomas
| Tram-track calcifications on skull
270
Cardiac association w/ ruptured berry aneurysms
Coarctation of the aorta
271
Ab to neutrophil myeloperoxidase
Churg-Strauss (Eosinophilic granulomatosis w/polyangiitis)
272
Elderly patient with recurrent lobar cerebral hemorrhages
Cerebral amyloid antipathy
273
Most likely location of spinal involvement in RA?
Cervical (subluxations)
274
How VwF affects the intrinsic pathway
Acts as a carrier protein for factor VIII
275
Enzyme deficient in inherited acute intermittent porphyria
AD; Porphobilinogen deaminase
276
How do you treat acute intermittent porphyria and how does this work?
Hemin or glucose infusion: down regulates ALA synthase
277
Sx and cause of acute intermittent porphyria
Abdominal and neuro sx d/t build up of ALA and PBG
278
Causes of acute intermittent porphyria
AD PBG deaminase defciency
| Induced via: barbs, antiepiliptics, EtOH and smoking
279
Artery at risk if a fracture occurs at the pterion
Maxillary
280
Sx of intrauterine toxoplasmosis infection
Hydrocephalus, chorioretinitis, and intracranial calcifications
281
Function of pili in N. gonorrhea
Attachment to nasal epithelium
282
Atheroembolic disease
Blue extremity, lived reticularis
Post invasive vascular procedure
Cholesterol debris in smaller vessels
283
Cause of meningitis resistant to cephalosporins
Listeria (resistant PBPs)
284
Cells responsive to insulin
Only those with GLUT-4: muscle and adipocytes
285
Glucagonoma
Necrolytic migratory erythema
| DM, GI sx, elecated glucagon
286
Fungus with single broad based bud
Blastomycosis
287
Thyroid in Hashimoto's
Mononuclear infiltrate w/ lymphocytes, plasma cells and germinal centers
Follicles surrounded by Hurthle cells
288
Origin of clear cell renal cell carcinoma
Proximal renal tubules
| Cuboidal with abundant cytoplasm; appear golden-yellow d/t lipid content
289
At what two points to oocytes arrest?
Meiosis I, prophase (in childhood)
| Meiosis II, metaphase (just prior to fertilization)
290
What amino acid is used to synthesize NO?
Arginine
291
What is the landmark for a descending aortic dissection?
Near the left subclavian artery
292
ST elevations in I and aVL indicate an MI where?
Left circumflex (these are lateral limb leads)
293
ST elevations in II, III and aVF indicate what coronary artery?
Right coronary artery
294
ST elevation in leads V1-V4, V5-V6 and I and aVL indicate what artery?
Left main coronary artery
295
Drug often given in a MI for bradycardia
Atropine (remember SE)
296
Paraneoplastic cerebellar degeneration
Seen in SC lung and female cancers
| Anti-Yo, anti-P/Q and anti-Hu (Purkinje neuron antigens)
297
Inherited syndromes that include pheocromocytoma
VHL, MEN2, NF1
298
What respiratory parameter is normal in ARDS?
Pulmonary capillary wedge pressure
299
Heart failure cells
Golden cytoplasmic granules that turn dark with Prussian blue
Hemosidern laden macrophages
300
Lipofuscin heart cells
D/t lipid per oxidation
| Normal aging
301
Manifestions of Chylomicronemia syndrome
Pancreatitis, lipemia retinalis, skin xanthomas, hepatosplenomegaly
302
OD with garlic breath as a symptom and treatment?
Arsenic poisoning
| Treat with dimercaprol or DMSA
303
Pathogenesis of idiopathic pulmonary artery HTN?
Vascular smooth muscle proliferation
304
Most common complications of hereditary spherocytosis
Pigmented gallstones
| Aplastic crisis with Parvovirus
305
Microscopy of Reye's syndrome
Microvesicular steatosis
306
Lab findings of XXY
decreased testosterone
| Increased LH, FSH and estradiol
307
What cognitive element does following multistep commands test?
Comprehension
308
Heart defect associated with equal pulses and cyanosis of the LE only
PDA
309
What vitamin is required to maintain epithelial lining of pancreatic ducts?
Vitamin A
310
What is seen in the lungs in ARDS?
Hyalin membranes
311
Cardiac complication seen in Kawasaki?
Coronary artery aneurysms
312
Brain tumor with fluid rich in cholesterol
Craniopharyngioma from anterior pituitary
313
Treatment for carcinoid syndrome
Octreotide
314
Cholestasis of pregnancy
Estrogen: cholesterol hypersecretion
Progesterone: gallbladder hypomobility
