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FA note cards > From UW > Flashcards

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

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2
Q

Histology of allergic asthma

A

Thick bronchial epithelium, bm and smooth muscle, inflammatory infiltrate (eosinophils and mast cells) and submucosal gland enlargement

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3
Q

Cystic hygroma

A

Posterior neck mass d/t abnormal lymph outflow

Seen in XO

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4
Q

de novo partial deletion of short arm of chromosome 5 (5p)

A

cri du chat

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5
Q

Cause of keloids

A

Excess TGF-beta: fibroblasts into myofibroblasts beyond borders of wound
Excess collagen formation

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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)

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7
Q

Anastomosis that protects descending color

A

Marginal artery from the SMA

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8
Q

Enzyme the breaks down glucose in the beta cell to enter the TCA cycle

A

Glucokinase

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9
Q

Best option to rapidly increase blood glucose?

A

IM glucagon

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10
Q

Signs of lead poisoning

A 
Occupational exposure (painter, construction worker)
Microcytic anemia, GI (constipation), mental status changes (confusion or decreased concentration)
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11
Q

What does lead inhibit?

A

aminolevulinate dehydrates and ferrochelatase

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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)

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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

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14
Q

Ornithine translocase deficiency

A

Defective hepatic urea cycle:

unable to convert ammonia (from aa catabolism) into urea; ammonia accumulates

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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

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16
Q

Sensory innervation for anterior 2/3 of tongue?

A

Taste: chorda tymapni
Sensation: V3

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17
Q

Sensory innervation for posterior 1/3 of tongue?

A

Glossopharyngeal (IX)

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18
Q

What separates the anterior and posterior tongue?

A

Terminal sulcus w/ foramen cecum

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19
Q

Motor innervation to the tongue?

A

Hypoglossal nerve (XII)

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20
Q

Sensory innervation for posterior tongue root?

A

Vagus (X)

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21
Q

What enzyme deficiency presents similarly to G-6-pd deficiency?

A

Gltathione reductase

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22
Q

Chronic, unexpected panic attacks

A

panic disorder (vs GAD)

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23
Q

What quadruple screen change would be seen in FGR?

A

Decreased estriol

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24
Q

Most common placentation of monozygotic twins with early (1st week) division?

A

Monochorionic-diamniotic

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25
Q

Most common placentation of monozygotic twins with late (8-12 days) division?

A

monochorionic - monoamniotic

high fatality rate

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26
Q

Absent CD18 on leukocytes

A

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

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27
Q

Reduced/absent methylene tetrahydrofolate reductase would lead to what?

A

Impaired ability to convert homocysteine to methionine; increased risk for thrombosis

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28
Q

Standard deviation %?

A

68/95/99.7

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29
Q

What nerve courses with the superior thyroid artery and vein? Where do they originate?

A

External branch of superior laryngeal

Superior to thyroid gland/lateral to thyroid cartilage

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30
Q

What muscle does the external branch of the superior laryngeal nerve innervate? When is injury a risk?

A

Cricothyroid muscle

During Thyroidectomy

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31
Q

What causes prolactinemia w/ antipsychotic use?

A

Blockade of tuberinfundibular pathway (connects hypothalamus to pituitary gland; tonic inhibitor of prolactin)

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32
Q

How do you test for tichomonas?

A

Wet mount/saline microscopy

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33
Q

What changes are seen in serum Ca, phosphorus and PTH in osteoporosis?

A

None

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34
Q

Anti-smooth muscle antibodies?

A

Autoimmune hepatitis

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35
Q

Anti-histidyl-tRNA is also called? When is it seen?

A

Anti-Jo

Polyomositis

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36
Q

Histology of acute heart rejection

A

Dense infiltrate of mononuclear cells composed of T-lymphocytes

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37
Q

Histology of chronic rejection

A

Scant inflammatory cells and interstitial fibrosis

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38
Q

Chediak-Higashi

A

AR
Immunodeficient, albinism and neuro defects (nystagmus and neuropathies)
Defect in neutrophil phagosome lysosome fusion (giant cells)

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39
Q

Homocyteinuria

A

AR error of methionine metabolism
Lens dislocation, marfanoid habits, intellectual disability, thrombus
Treat by giving B6 and restricting methionine

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40
Q

Macrocyclic antibiotic for c. Diff

A

Fidaxomicin

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41
Q

What change causes decreased renal plasma flow and increase filtration fraction?

A

Constriction of efferent arteriole

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42
Q

Porphyria cutanea tarda

A

Uroporphyrinogen decarboxylase deficiency

Photosensitivity: blisters etc

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43
Q

Continuous, machine like murmur

A

PDA

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44
Q

Which step of the citric acid cycle is inhibited by ethanol?

A

a-ketoglutarate to succinylcholine -CoA (a-ketoglyarate dehydrogenase complex)
It is thiamine dependent

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45
Q

What value changes when comparing populations of different disease prevalence?

A

PPV

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46
Q

What type of rash is seen in measles?

A

macularpapular

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47
Q

What stimulates the adrenal medulla?

A

Acetycholine

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48
Q

What is the strucutre of MHC class I?

A

heavy chain and B2-microglobulin

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49
Q

What is the structure of MHC class II?

A

alpha and beta polypeptide chains

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50
Q

What kind of signaling are Ca sensing receptors?

A

GCPR

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51
Q

Drug that causes vertical and horizontal nystagmus, MOA of this drug and antidote

A

PCP; NMDA antagmonist; benzos

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52
Q

Thyroglossal duct cyst presentation and origin

A

Sore spot on neck that is tender, fluctuant, and midline; made of ectopic tissue
Originates from floor of the primitive pharynx

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53
Q

Sx of mumps

A

Parotitis and orchitis (if not vaccinated)

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54
Q

Leber hereditary optic neuropathy

A

Mitochondrial disease

Degeneration of retinal ganglion cells and axons: leads to painless loss of central vision, known as central scotoma

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55
Q

What enzyme does lead inhibit?

A

δ-Aminolevulinic acid dehydratase and ferrochelotase

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56
Q

Where would an embolism in a patient with non-valvular a-fib most likely come from

A

The left atrial appendage

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57
Q

What type of gland are sebaceous glands?

A

Holocrine

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58
Q

What is sorbitol converted to in the retina normally?

A

Fructose (via sorbitol dehydrogenase)

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59
Q

What molecules use zinc motifs to alter transcription?

A

Those with IC receptors:
thyroid hormones, steroids, fat-soluble vitamins
(Lipid soluble)

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60
Q

Inheritance of G6PD?

A

XR

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61
Q

Signs of lead toxicity

A

Poor, anemia, language regression in a child

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62
Q

How long does depletion of ATP and accumulation of toxins (resulting in loss of contractility) take in the setting ischemia?

A

60s

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63
Q

Histologic SE fo topical corticosteroid cream therapy?

A

Dermal atrophy: drying, cracking, tightening

Due to decreased production of EC collagen matrix and GAGs

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64
Q

LE nerve injured when extensive time spent in lateral decubitus position

A

Common peroneal

contacts the lateral neck of the fibula

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65
Q

Injury to deep peroneal nerve?

A

Foot drop (anterior compartment muscles used for dorsiflexion)

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66
Q

Injury to superficial peroneal nerve?

A

Decreased foot eversion

Decreased sensation of lateral leg and dorsolateral foot

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67
Q

Signs of cocaine withdraw

A

depression, fatigue, hypersomnia, hyperplasia and vivid dreams

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68
Q

Fabry disease

A

XR; alpha-galactosidase A deficiency: accumulated globotriaosylceramide
Neuropathic pain, decreased sweating, angiokeratomas, telangiectasis, glomerular disease, CV disease

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69
Q

What do amatoxins halt?

A

(mushrooms)

RNA pol II: blocking mRNA synthesis

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70
Q

What does ricin halt

A

(toxin from castor oil plant)

Protein synthesis; cleaves rRNA of 60S subunit

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71
Q

What are anti-Smith ab specific for?

A

snRNA in the cytoplasm (these remove introns from mRNA)

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72
Q

Most common cause of paradoxical embolism?

A

ASD

incomplete fusion of septum primum and secundum

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73
Q

Glossopharyngeal nerve lesion

A

(CN IX)

Loss of taste of posterior 1/3, loss of sensation in upper pharynx, posterior tongue, tonsils and middle ear

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74
Q

What is the major determinant of severity in TofF?

A

RV outflow tract obstruction

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75
Q

Adenomyosis

A

Endometrial tissue in the myometrium

Heavy bleeding, uniformly enlarged uterus

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76
Q

What is CNX derived from?

A

4th and 6th pharyngeal arch

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77
Q

Tay-Sachs

A

AR; B-hexosaminidase A deficiency: build up of GM2 gangliosides
Normal at first: neuro deterioration, weakness, sz, cherry red macula
(NO hepatosplenomegaly)

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78
Q

Rett syndrome

A

Normal until 5-18m
Loss of motor and language skills
Hand wringing, decreased head growth
XL MECP2 gene (de novo)

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79
Q

Deviation of mandible toward the effected lesion

A

CN V3

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80
Q

Renal clearance of PAH

A

Freely filtered into Bowman’s space; majority is secreted by proximal tubule via carrier transport
None is reabsorbed

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81
Q

Cause of annular pancreas

A

Abnormal migration of ventral pancreatic bud

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82
Q

ADH secretion and storage

A

Hypothalamus, stored in posterior pituitary

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83
Q

What is the cause of hyper acute transplant rejection?

A

Preformed antibodies

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84
Q

What blood disorder would you see monoclonal gamma globulin spike?

A

Multiple myeloma

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85
Q

Congenital hypothyroidism

A

Lethargy, enlarge fontanelle, protruding tongue, umbilical hernia, poor feeding, constipation, dry skin, jaundice

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86
Q

Primary immune cells seen in COPD

A

macrophages, CD8 and neutrophils

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87
Q

Which cholesterol drug can cause gout?

A

niacin

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88
Q

What enzyme is inhibited in riboflavin deficiency?

A

Succinate dehydrogenase

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89
Q

Hemorrhoids above the dentate line

A

Internal; drain to the superior rectal vein -> inferior mesenteric vein

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90
Q

Hemorrhoids below the dentate line

A

External; inferior rectal vein -> internal pudendal vein -> internal iliac veins

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91
Q

Presentation of togavirus

A

Rubella; maculopapular rash that starts on face and spreads to body
Poastaruicular and occipital lymphadenopathy

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92
Q

What would be seen on light microscopy of a patient with linear deposit seen on IF?

A

Glomerular crescents

Goodpasture; IgG and C3

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93
Q

Problem in xeroderma pigmentosum

A

Defective endonuclease nucleotide excision repair

Thymine dimers created by UV light require special UV endonuclease

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94
Q

What allows elastin to stretch and recoil>

A

Interchain cross-linking involving lysine

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95
Q

What is increased in isolated diastolic heart failure?

A

LV end-diastolic volume

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96
Q

What yeast is seen in patients with central lines?

A

Candida (pseudohyphae with blastoconidia)

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97
Q

Where do you get B12?

A

Only from animal products (vegans at risk)

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98
Q

What part of the eye do Beta blockers effect to treat glaucoma?

A

Ciliary epithelium

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99
Q

When does non-disjunction usually occur?

A

During meiosis I

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100
Q

What is the concern in a patient with hyperthyroid and fever/sore throat?

A

Agranulocytosis (check WBC w/diff)

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101
Q

What enzyme is inhibited by fibrates?

A

cholesterol 7 alpha-hydroxylase

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102
Q

What immune cells would cause granulomas in sarcoidosis?

A

Th1, IL-2, IFN-gamma

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103
Q

What would brain imaging in a patient with PKU show?

A

Pallor of substantia nigra, locus ceruleus, and vagal nucleus dorsalis

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104
Q

Lack of neurophysin would lead to what?

A

DI

neurophysiology carries oxytocin and ADH from the nuclei to the post pit

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105
Q

What collagen type is fibrotic scar tissue composed of?

A

Type 1 (similar to dermis, bone, tendon, ligament, blood vessels)

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106
Q

How do you differentiate an ecological study from other types?

A

Analysis of entire populations; not individuals

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107
Q

What artery would be at risk in a patient with a midshaft humerus injury and radial nerve injury?

A

Deep brachial artery

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108
Q

Renal papillary necrosis presentation

A

Abrupt hematuria w/family hx of SCD

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109
Q

CD20 indicates what?

A

Immature B cells (seen in B cell cancers)

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110
Q

CD40 is used for what?

A

Isotype switching

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111
Q

Hyper-IgM

A 
XR defect of CD40L
Cannot signal to B-cells to class switch
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112
Q

Subclavian steal syndrome

A

Stenosis of subclavian leads to “steal” of blood from contralateral vertebral artery

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113
Q

Where would a pure sensory stroke be?

A

In the thalamus (VPL)

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114
Q

Common cause of lacunar infarcts?

A

Liphyalinosis and microatheromas

lead to liquefactive necrosis

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115
Q

Which bio stats value relies on the prevalence of the disease in the population?

A

PPV (higher in populations with higher prevalence) and NPV

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116
Q

Thiamine deficiency will lead to decrease activity of what enzyme?

A

(a bunch, but can be diagnostic if) erythrocyte transketolase (is low and increases w/ thiamine supplement)

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117
Q

Insulin resistance in pregnancy

A

Due to human placental lactose (secrete by syncytiotrophoblast)

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118
Q

Hypoxemia with normal A-a

A

Hypoventilation (obesity, NM disorders) or low O2 inspiration (high altitude)

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119
Q

Acute intermittent porphyra

A

AD; deficiency of porphobilinogen deaminase
GI and neuro sx
Red urine that darkens
Give dextrose to down regulate ALA synthesis

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120
Q

hCG acts like what hormone?

A

TSH

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121
Q

Embryologic origin of the main pancreatic duct?

A

Ventral pancreatic primordium

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122
Q

What is deficient in Plummer Vinson?

A

Iron

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123
Q

HbS mutation?

A

Valine of glutamic acid

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124
Q

What cells synthesize the fibrous cap in an atheroma?

A

Smooth muscle cells

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125
Q

Most common amino acid in collagen

A

Glycine (Gly-X-Y)

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126
Q

How does Meckel diverticulum present?

A

Painless lower GI bleeding; can lead to intussusception: current jelly stool

127
Q

What kind of necrosis occurs in the brain?

A

Liquefactive

128
Q

Early morning vomiting and downward gaze preference

A

Pineal gland mass (usually a germinoma)

129
Q

Embryologic origin of spleen?

130
Q

Anterior neck mass in a patient w/MG

A

Thymoma (thymus and inferior parathyroid glands derived from 3rd pharyngeal pouch)

131
Q

Enzyme deficiency in Ehlers-Danlos?

A

Procollagen peptidase

132
Q

Enzyme deficient in chronic granulomatous disease?

A

NADPH oxidase

133
Q

Estrogen effect on thyroid levels

A

Increase total T4 (via elevation of TBG levels)

134
Q

Cause of flame-shaped retinal hemorrhage

135
Q

Serum Sickness

A

T3 HS

Small vessels w/fibrinoid necrosis, neutrophil infiltration, deposition of IgG or IgM, decreased C3 levels

136
Q

What prevents lactation in a pregnant patient?

A

Progesterone

137
Q

What is increased in statin therapy?

A

LDL-r density

138
Q

Thin eyebrows and delayed relaxation of DTRs

A

Hypothyroid; check TSH

139
Q

Elderly patient with weight loss, anorexia and iron deficiency anemia

A

Colon cancer (guaiac positive: right sided)

140
Q

Cause of death in sudden cardiac death?

A

Malignant ventricular arrhythmias (vfib)

141
Q

Inferior surface of the heart

A

Mostly left ventricle

142
Q

Blood supply to inferior surface of heart

A

Right coronary (gives rise to posterior descending) in right dominant people

143
Q

Immune cells involved in graft vs host?

A

Graft T cells

144
Q

What does the metanephric mesoderm of the kidney become?

A

Distal convoluted tubules

145
Q

Cell surface marker for macrophages?

146
Q

Rifaximin

A

Nonabsorbable antibiotic that alters GI flora to decrease production of ammonia

147
Q

C1 inhibitor deficiency

A

Leads to elevated bradykinin; facial swelling, laryngeal edema, N/V/abd pain

148
Q

What does the vascular endothelium secrete to inhibit platelet aggregation?

A

Prostacyclin

149
Q

Jervell and Lange-Nielson Syndrome

A

AR; sensorineural hearing loss and congenital prolonged QT

Defect in K channels

150
Q

Sequelae of eating moldy grains

A

Liver cancer; Aspergillus aflatoxin induces p53 mutation

151
Q

IgE against IgA

A

Selective IgA deficiency

Anaphylaxis after blood transfusion

152
Q

Finger drop

A

Radial nerve injury after/while it exits the supinator canal

153
Q

Renal vein thrombosis

A

Nephropathy, flank pain, varicocele, hematuria, elevated lactate dehydrogenase
Loss of of ATIII

154
Q

Intensity of aortic stenosis murmur is determined by what?

A

LV to aorta pressure difference

155
Q

Esophageal dysfunction in CREST

A

Fibrous replacement of muscular in lower esophagus

156
Q

What should be avoided in aldolase B deficiency?

A

Sucrose and fructose

157
Q

Deposition of what is seen in the crescents of RPGN on IF?

158
Q

Hereditary spherocytosis

A

Loss of central pallor

Increased MCHC

159
Q

What should be supplemented in hereditary orotic acuduria?

160
Q

SEs of erythropoiesis stimulating agents?

A

Thrombosis and increased HTN

161
Q

Full alpha-1 messenger cascasde

A

Gq -> PLC -> IP3 and DAG
DAG -> PKC
IP3 -> increased IC Ca -> PKC

162
Q

Histology of HIV-dementia

A

Microglial nodules

subcortical dementia

163
Q

DNA excision repair enzyme order

A

Glycosylase -> endonuclease -> lyase -> polymerase -> ligase

164
Q

What should be suspected in a patient with renal angiomyolipomas?

A

Tuberous sclerosis; subependymal brain hamartomas, cardiac rhabdomyomas, facial angiofribomas and ash-leaf skin depigmentation

165
Q

Type of necrosis seen in an MI?

A

Coagulative

166
Q

Where is the most common site of obstruction in fetal hydronephrosis?

A

Ureteropelvic junction

167
Q

Hemoglobin that is increased in beta thalassemia?

168
Q

When does myocardial perfusion occur?

A

During diastole

169
Q

What can cause a ring-enhancing lesion besides toxo?

A

Primary central nervous system lymphoma (2nd most common in HIV after toxo)
Nocardia (abscess)

170
Q

Pericardial fluid accumulation with late diastolic collapse of right atrium

A

Cardiac tamponade

171
Q

Quatntifying pulses paradoxus with a BP cuff

A

Difference between systolic pressure when Korotkoff sound is heard during expiration and when it is heard throughout respiration (>10 is an exaggerated drop)

172
Q

Features of colitis associated colorectal cancer (vs sporadic)

A

Younger, flat lesion (nonpolypoid), proximal > distal, multifocal, mutinous, poorly differentiated
Early p53 and late APC mutations

173
Q

Dohle body

A

Basophilic granules in neutrophil

Seen in leukemoid reaction/LAP positive

174
Q

Mitochondrial vacuolization is indicative of what?

A

Irreversible cell injury

175
Q

Beznos with long half-life

A

Diazepam, chlordiazepoxide, flurazepam

176
Q

What is most indicative of malignancy on lymph node biopsy?

A

Monoclonal T-cell receptor gene rearrangements

177
Q

Muddy brown casts in urine are indicative of what?

A

Acute tubular necrosis

178
Q

What is primary central nervous system lymphoma?

A

A diffuse, large-cell non-Hodgkin B-cell lymphoma caused by EBV in cases of HIV

179
Q

SE of prolactinoma

A

W: Galactorrhea, decreased estrogen
M: infertility, impotence

180
Q

Histology of medullary thyroid cancer

A

Nests of polygonal cells with Congo red-positive deposits

181
Q

What causes diabetic CN III neuropathy?

A

Ischemic nerve damage

182
Q

What area increases productivity in long term steroid use?

A

Liver (gluconeogenesis and glycogenesis)

183
Q

SE of L-dopa therapy even with carbidopa

A

Anxiety and agitation

184
Q

Presence of riobthymidine, pseudouridine and cytidine residues on a stretch of RNA indicates what type of structure? What else will you find?

A

tRNA (the T loop specifically)
Will also have:
AA on the 3’ CAA tail
D loop with dihydrouridine residues

185
Q

Treatment of choice for specific phobia

A

Behavioral therapy

186
Q

How do you prevent neonatal tetnus?

A

Vaccinate mom while pregnant

187
Q

Differentiate hypoxic vs. secondary erthrocytosis

A

SaO2 < 92% or
PaO2 < 65%
True increased RBC mass

188
Q

Next step in differentating metabolic alkalosis?

A

Urine chloride

189
Q

Cholesterol meds most likely to cause gallstones

190
Q

Most common site for anal fissure

A

Posterior midline, distal to dentate line

191
Q

Synaptophysin on a tumor indicates what?

A

Neuronal origin

192
Q

What are IV influenza vaccines directed against?

A

HA; blocks viral entry

193
Q

MOA of PCP

A

NMDA antagonist

194
Q

Where does the lowest urine osmolarity occur?

195
Q

Enzyme primarily involved in brown pigment stones

A

beta-glucuronidase

196
Q

How do beta blockers help in hyperthyroid?

A

Reduce beta effects and inhibit conversion of T4 to T3

197
Q

Differentiate Tay-Sachs from Niemann Pick on PE?

A

Tay-Sachs does not have hepatosplenomegaly

198
Q

What is the histological sign of eczematous dermatitis?

A

Spongiosis with edema fluid in the intercellular spaces of epidermis

199
Q

What is responsible for the destruction of cells with decreased MHCI?

200
Q

What does silicosis impair that causes patients to get tuberculosis?

A

Macrophages

201
Q

Assuming a normal rate of metabolic CO2 production, what would hypocapnia indicate?

A

Alveolar hyperventilation

202
Q

Where in the female reproductive tract would simple cuboidal cells be found?

203
Q

What is the underlying mechanism of Zenker diverticulum formation?

A

Circopharyngeal motor dysfunction

204
Q

What NT is decreased in Huntingtons?

A

GABA (due to loss of caudate nucleus and putamen)

205
Q

Intraerythrocytic ring inclusions indicates what infection?

A

Babesiosis

206
Q

What causes gynecomastia in patients with liver cirrhosis; what other findings would be seen due to this cause?

A

Hyerestrinism

Spider angiomata, loss of hair, testicular atrophy, palmar erythema

207
Q

Eyelide drooping is due to what cranial nerve?

208
Q

What nerve causes ear pain in TMJ?

A

Mandibular division os CN V

209
Q

Xeroderma pigmentosum is due to what?

A

Defective nucleotide excision repair d/t UV light

210
Q

Cholinergic toxicity effects not corrected by atropine

A

Muscle weakness/paralysis

these are nicotinic effects

211
Q

Description of a lung abscess

A

Round density with air-fluid level on XR

212
Q

Key immune cell in the formation of a lung abscess

A

Neutrophils

213
Q

Attributable risk

214
Q

ASA toxicity

A
  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
Q

Friedrich ataxia

A 
AR; FXN gene
Spinocerebellar and LC tract degeneration; dorsal root loss
Kyphoscoliosis and high arches
Hypertrophic cardiomyopathy
DM
216
Q

Drugs that reduce the size of prostate

A

5-alpha reductase inhibitors (vs alpha inhibitors that relax smooth muscle)

217
Q

What part of the bone is affected in osteomyelitis?

A

Metaphysis of long bones

218
Q

Trendelenburg is due to weakness in muscles that primarily due what action?

A

Hip abduction

219
Q

Parotitis in someone with vaccinations up to date

220
Q

LH and FSH levels in menopause

221
Q

Marginated, ovular mules with hypopigmentation is caused by and treatment?

A

Malassezia

Selenium

222
Q

What causes Sheehan’s syndrome?

A

Low cortisol (secondary to pituitary ischemia)

223
Q

MOA of niacin to decrease cholesterol

A

Decreases amount of VLDL released by hepatocytes and blocks lipolysis in adipose tissue

224
Q

Kidney involvement in vitamin D

A

Uses 1 alpha hydroxyls to convert inactive to calcitriol

225
Q

Positive Thompson test indicates damage to what nerve?

A

Tibial; popliteus, flexor hallucis longus, flexor digitorum longus, and tibialis posterior

226
Q

Tuberous Sclerosis

A

AD
Ash leaf spots (pale), facial angiofibromas (reddish-brown papules), astrocytomas, retinal hamartomas, cardiac rhabdomomas, renal angiomyolipomas

227
Q

VHL

A

AD; chromosome 3
Hemangioblastomas of CNS and retina
Also tumors in: pancreas, adrenal, RCC

228
Q

How do you form δ-aminolevulinic acid

A

Succinyl-CoA and Glycine

229
Q

What enzymes does lead inhibit?

A

Ferrochelatase and ALA-dehydratase

last and second step of heme synthesis

230
Q

Markedly elevated lab value in muscular dystrophy

231
Q

What forms the scar after a stroke?

A

Glial cells/astrocytes

232
Q

When would a free wall rupture of the heart occur?

A

5-14 days after an MI

233
Q

Histology of irreversible cell injury

A

Shrinkage of enroll body, deep eosinophilia of cytoplasm, pyknosis and loss of Nissl

234
Q

Histology of axonal reaction

A

Cell body rounding, peripheral nuclei, dispersion of NIssl

235
Q

MOA of misoprostol

A

Prostaglandin E1 agonist

236
Q

MOA of Mifepristone

A

Progesterone and glucocorticoid antagonist

237
Q

Cholesterol, bile and phosphatidylcholine in cholesterol stones

A

Cholesterol elevated

Bile and choline low

238
Q

Proteasome inhibitiors

A

Bortezomib

Cause apoptosis; used in MM

239
Q

Case control studies report what type of analysis?

240
Q

What does methemoglobin have strong affinity for?

A

Cyanide (to bind it instead of iron in mito)

241
Q

A lesion where would drain to the popliteal lymph nodes?

242
Q

After AST/ALT, what do you use to differentiate pancreatitis?

243
Q

IgE independent hypersensitivity reaction

A

Activation of PKA and PI3

Opioids, contrast dye, vancomycin

244
Q

How does chronic HBV assist in HDV infection?

A

Coats the virus so it can enter the hepatocyte

245
Q

Where does chronic lung transplant rejection usually occur?

A

Small airway

246
Q

Disseminated gonococcal infection

A

Purulent arthritis

Polyarthralgia, dermatitis, tenosynovitis

247
Q

Sirolimus

A

Blocks mTOR; blocks IL2 signaling

248
Q

Cyclosporine and Tacrolimus

A

Block calcineurin; block IL-2 transcription

249
Q

Meniere disease

A

Increased endolymph in ear

Vertigo, ear pain/fullness, hearing loss and tinnitus

250
Q

NF-1

A

aka Von Recklinghausen
AD on 17; PNS tumors
Cafe-au-lait, neurofibromas, optic gliomas, lisch nodules,

251
Q

Giant cell arteritis

A

HA, jaw claudication, visual changes, polymyalgia rheumatica

252
Q

Step of the citric acid cycle that produces GTP?

A

Succinyl CoA -> succinate

253
Q

MEN 1

A

Primary hyperparathyroid, pituitary and pancreatic tumors (VIPoma)

254
Q

MEN 2A

A

Medullary thyroid, pheochromocytoma, PTH hypreplasia

255
Q

MEN 2B

A

Meduallary thyroid, pheochromocytoma, mucosal neuromas/marfanoid

256
Q

PE findings of opioid OD

A

Miosis, tachycardia, hypotension

257
Q

Key event in HBV to hepatocellular ca?

A

Viral DNA integration into host genome

258
Q

Breathing change in high altitude sickness?

A

hyperventilation

259
Q

Dubin-Johnson Syndrome causes defective what?

A

Excretion of bilirubin glucuronides d/t mutation in the canalicular membrane transport protein

260
Q

Histology of meothelioma

A

Epitheloid cells with desmosomes, containing abundant tonofilaments, studded with long, slender microvilli

261
Q

Bilateral wedge shaped necrosis in the brain

A

Cortical watershed infarct

hypoxic-ischemic encephalopathy

262
Q

Councilman bodies

A

aka apoptotic bodies

Round acidophilic hepatocytes about to undergo apoptosis

263
Q

Bleeding in a patient with renal dysfunction

A

Uremic platelet dysfunction
Everything normal w/ prolonged bleeding time
Impaired aggregation d/t toxin build up

264
Q

Most common causes of pancreatitis (2)

A

EtOH and gallstones

265
Q

Sx of pericarditis

A

CP that improves when sitting up/foward, friction rub

266
Q

Superior vena cava syndrome

A

Dyspnea, swelling of face/neck/UE, HA, dizziness, dilated veins

267
Q

Osler-Weber-Rendu

A

Hereditary hemorrhagic telangiectasia

Skin and mucosa (also GI, GU, brain, liver and spleen)

268
Q

NF-2

A

AD; nervous system tumors

B/L VIII schwannomas and meningiomas

269
Q

Sturge-Weber

A

Neurocutaneous: facial and leptomeningeal angiomas

Tram-track calcifications on skull

270
Q

Cardiac association w/ ruptured berry aneurysms

A

Coarctation of the aorta

271
Q

Ab to neutrophil myeloperoxidase

A

Churg-Strauss (Eosinophilic granulomatosis w/polyangiitis)

272
Q

Elderly patient with recurrent lobar cerebral hemorrhages

A

Cerebral amyloid antipathy

273
Q

Most likely location of spinal involvement in RA?

A

Cervical (subluxations)

274
Q

How VwF affects the intrinsic pathway

A

Acts as a carrier protein for factor VIII

275
Q

Enzyme deficient in inherited acute intermittent porphyria

A

AD; Porphobilinogen deaminase

276
Q

How do you treat acute intermittent porphyria and how does this work?

A

Hemin or glucose infusion: down regulates ALA synthase

277
Q

Sx and cause of acute intermittent porphyria

A

Abdominal and neuro sx d/t build up of ALA and PBG

278
Q

Causes of acute intermittent porphyria

A

AD PBG deaminase defciency

Induced via: barbs, antiepiliptics, EtOH and smoking

279
Q

Artery at risk if a fracture occurs at the pterion

280
Q

Sx of intrauterine toxoplasmosis infection

A

Hydrocephalus, chorioretinitis, and intracranial calcifications

281
Q

Function of pili in N. gonorrhea

A

Attachment to nasal epithelium

282
Q

Atheroembolic disease

A

Blue extremity, lived reticularis
Post invasive vascular procedure
Cholesterol debris in smaller vessels

283
Q

Cause of meningitis resistant to cephalosporins

A

Listeria (resistant PBPs)

284
Q

Cells responsive to insulin

A

Only those with GLUT-4: muscle and adipocytes

285
Q

Glucagonoma

A

Necrolytic migratory erythema

DM, GI sx, elecated glucagon

286
Q

Fungus with single broad based bud

A

Blastomycosis

287
Q

Thyroid in Hashimoto’s

A

Mononuclear infiltrate w/ lymphocytes, plasma cells and germinal centers
Follicles surrounded by Hurthle cells

288
Q

Origin of clear cell renal cell carcinoma

A

Proximal renal tubules

Cuboidal with abundant cytoplasm; appear golden-yellow d/t lipid content

289
Q

At what two points to oocytes arrest?

A

Meiosis I, prophase (in childhood)

Meiosis II, metaphase (just prior to fertilization)

290
Q

What amino acid is used to synthesize NO?

291
Q

What is the landmark for a descending aortic dissection?

A

Near the left subclavian artery

292
Q

ST elevations in I and aVL indicate an MI where?

A

Left circumflex (these are lateral limb leads)

293
Q

ST elevations in II, III and aVF indicate what coronary artery?

A

Right coronary artery

294
Q

ST elevation in leads V1-V4, V5-V6 and I and aVL indicate what artery?

A

Left main coronary artery

295
Q

Drug often given in a MI for bradycardia

A

Atropine (remember SE)

296
Q

Paraneoplastic cerebellar degeneration

A

Seen in SC lung and female cancers

Anti-Yo, anti-P/Q and anti-Hu (Purkinje neuron antigens)

297
Q

Inherited syndromes that include pheocromocytoma

A

VHL, MEN2, NF1

298
Q

What respiratory parameter is normal in ARDS?

A

Pulmonary capillary wedge pressure

299
Q

Heart failure cells

A

Golden cytoplasmic granules that turn dark with Prussian blue
Hemosidern laden macrophages

300
Q

Lipofuscin heart cells

A

D/t lipid per oxidation

Normal aging

301
Q

Manifestions of Chylomicronemia syndrome

A

Pancreatitis, lipemia retinalis, skin xanthomas, hepatosplenomegaly

302
Q

OD with garlic breath as a symptom and treatment?

A

Arsenic poisoning

Treat with dimercaprol or DMSA

303
Q

Pathogenesis of idiopathic pulmonary artery HTN?

A

Vascular smooth muscle proliferation

304
Q

Most common complications of hereditary spherocytosis

A

Pigmented gallstones

Aplastic crisis with Parvovirus

305
Q

Microscopy of Reye’s syndrome

A

Microvesicular steatosis

306
Q

Lab findings of XXY

A

decreased testosterone

Increased LH, FSH and estradiol

307
Q

What cognitive element does following multistep commands test?

A

Comprehension

308
Q

Heart defect associated with equal pulses and cyanosis of the LE only

309
Q

What vitamin is required to maintain epithelial lining of pancreatic ducts?

310
Q

What is seen in the lungs in ARDS?

A

Hyalin membranes

311
Q

Cardiac complication seen in Kawasaki?

A

Coronary artery aneurysms

312
Q

Brain tumor with fluid rich in cholesterol

A

Craniopharyngioma from anterior pituitary

313
Q

Treatment for carcinoid syndrome

A

Octreotide

314
Q

Cholestasis of pregnancy

A

Estrogen: cholesterol hypersecretion
Progesterone: gallbladder hypomobility

FA note cards (16 decks)

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