General 2 Flashcards
1
Q
A case control study is descriebd as
what is the outcome measured by
A
looking at the cases (people with the dz) vs the controsl (people without the diz)
Odds ratio (what are the odds of the dz
COHORT is RISKY
2
Q
where in the nephron is the lowest oms?
A
DCT
3
Q
in familial dyspbetalipoproteineimia III, what is dysfunctional?
A
APOE 3 or 4
can’t reuptake VLDL or chylomicrons so they acucmulate
4
Q
aortocavitary fistulas are an uncommon side efect of what?
what does the blood flow look like?
A
IVDA
flows from aortic root to r ventricle continuously (high pr essure to low pressure, L-R shunt)
leads to continous murmur
5
Q
psuedomonas looks like
is tx with?
A
cefipime (amonf others)
6
Q
In e coli HUS, what type of bilirubin is elevated?
A
serum indirect bilirubin is eelvated
7
Q
besides metronidazole, how can you treat BV?
A
clindamycin
(metro below the diaphragm, clinda above, except for BV)
8
Q
in a subarachnoid hemorrhage, willm you see intracerebral hemorrahge or blood in the sulci?
A
blood in the sulic
9
Q
what normal process in the liver is inhibited in alcoholics leading to hypoglucemia?
A
gluconeogenesis
pyruvate to acoa is thiamine depednent
aKG to succinyl coa is thiamine depdenent
NADH is required throughout
both these are oftend depldeted in alcoholics
10
Q
what are the main complications of sjogrens?
A
dental caires, corneal damage
NHL
11
Q
what are the findings of hyperIgM syndrome?
A
12
Q
where is the SI biopsied if worried about celiac dz?
A
13
Q
if theyre describing 3syphilis to you and they tell you the pt has a genital lesion, will it be a chancre or a gumma?
A
a gumma if it’s 3’
a condyloma lata if it’s 2’
a chancre if its 1’
14
Q
schistocytes indicate what dz?
what occurs to haptoglobin levels in this state?
A
hemolytic anemia
haptoglobin decreases
15
Q
a floppy baby with little hard poops, enlarged fontanelleae, umbilical hernia, protruding tongue , ? juandice can indicate what?
A
hypothyroidism
16
Q
what are the s/s of hyperphosphatemia?
what can cause it?
A
hypocalcemia
CKD
17
Q
crytpococcus neofrormans will have a + what test
A
india ink stain
latex agglutination
cx on SArbourd agar
think of Dr. Sarbourd in india cleaning the crypts with latex gloves on
18
Q
a lesion to the inferior pons will compress which nerves?
A
V
VI
VII
VIII–nystagmus
19
Q
is EF preserved in hypertrophic cardiomyopathy?
A
yes, weirdly
20
Q
what are some common causes of NAGMA and HAGMA
A
21
Q
how do triptans work?
A
5HT1b1d agonists that bind to trigeminal r and inhibit CGRP and cause vasoconstriction
22
Q
what class of drugs in Alzheimers can precipitate bradycardia and AV block?
A
anti cholinergics, donespil, rivastigmine, etc.
23
Q
what is the defense against Giardia?
A
IgA and CD4 celsls
24
Q
alanine is converted to what to make glucose?
A
aKG
25
is the muscularis thick or thin in Chron's disease?
Thick!
C-chrons, C-thiccc
26
in diverticulosis, what are the muscle laywers involved?
there is no muscularis propia in the diverticulm
27
high frequency deep brain stimulation can be done where in the brain for Parkinson's?
subthalamic nucleus
results in thalamocortical disinhibition
28
what is the cause of jejunal/ileal atresia?
vascular occlusion/anomaly
29
where is collagen synthesized?
in the RER
30
what is the PaO2, SaoO2, and O2 content in chronic blood loss?
PaO2 andSaO2 are normal
O2 content is decreased
31
what demarcates indirect vs direct inguinal hernia
the inferior epigastric vessels
32
what nonvesciular rash can be seen with HSV?
erythema multiforme
remmeber the edward cullen looking guy from sketchy with his rash
33
Azithioprine has what effect on B and t cells?
Decreases B and T cell count, decreases Ig and Il2
34
what pathogenic mechanism causes the cavitary lesions in TB?
leukocyte aggregation (activatED()
35
what is the MOA of sevelmer
oral phosphate binding resin that reduces systemic absorption of pO, typically used in CKD
36
what is the only prokaryotic ploymerase to have 5-3' exonuclease activity?
DNA polymerase 1
37
where is the binding site for complement on Ig?
Fc region near the hinge
38
wht is a contraindication to testosteorne therapy/
hematocrit \>50%
39
how does congenital hypothyroidism occur?
transplacental trasnfer of thyroxine
40
hypermobile joints and elastic skin think
ED-collagen synthesis defect
it's never marfans, elizabeth. really. it's not.
41
anterior nose bleeds occur where?
in the septum in Kesselbauchs plexus made up of
anterior ethmoidal
sphenopalatine
superior labial arteries
42
activation of which receptor type leads to immedaite flux of Na, Ca, and K?
nichotinic cholinergic R
43
most sporadic colorectal carinomas are due to mutation in what?
APC tumor supressor
44
learn this babe
45
h pylor might be described as what
an ulcer that when tested for pH turns red (high pH)
pH is high because of ammonia (urease)
46
Lactate Dehydrogenase is high in infections/injury and causes acidosis. under ischemic conditions, what is inhibited, causing this build up?
pyruvate dehydrogenase
47
what do eosiniphils look like?
what is their function?
destruction of helmonuths
48
how does prostate cancer metastasize to the lumbar spine?
prostatic venous plexus
49
what can you give with methotrexate to mitigate some of the folate related side effects?
whats another name that could be used because UW is a butthole?
leucovorin
folinic acid
50
strep pneumo is described how
what is it's virulence factor?
how does the VF work?
gram + in pairs (+- lancet shape)
polysaccharide capsuel (armor in skeychy)
makes it resistant to phagocytosis
51
facial pain, headache and a nasal eschar in a pt with redcent DKA, what is the dx?
how do you dx?
mucor or rhizopus
nasal mucosal biopst
52
how do you calculate TPR
53
describe the pathogenesis of b12 def in autoimmune gastritis?
autoimmune response that makes B cells which make autoab
autoimmuune response activates CD 4 T cells which attack the parietal cells and decrease them
this decreases gastric acid secretion and intrinsic factor
this leads to increase gastrin secretion by G cells in antrum and B12 def.
54
what might a pilocytic astrocytoma look like on mri
what are some other features?
rosenthal fibers, hair like projections, GFAP + frequently in the cerebellum, present with cerebellar signs/sx
55
if you think it sounds like a cushing syndrome, what else could it be?
lipodystrophy from antiretrovirals
56
what action does the supraspinatus primarily do
EXTENSION
S-for Sextension supraspinatus
57
s/s of dermatitis herpetiformis
steatorrhea
erythema and pruritis on the extensor surfaces with bullae and vesicles
IgA deposits
increased intestinal intraepithelial lymphocte s
58
low levels of what in the urine are found in those with increased calium oxalate stones?
low urinary citrate
59
what enzymes are antioxidants?
which aare proxidants?
superoxide dismutase, glutathione peroxidase, catalase
NADPH oxidase
60
what drug class is used to treat priaprism /prolonged erection?
a1 adrenergic agonism
it's agonizing to have A boner for tht long
61
you got this one babe
what does a fluid volume sqaure look like with DI?
62
know the different eting disorders
tbh this question was kinda stupud
63
biotin is used in the conversion of what to what
and others
pyrivate to OXA
64
describe coronary autoregulation in the setting of significant stenosis (\>50%)
perfusion pressure decreases but vasodilation allows blood flow to stay relative constant
65
what vein can be occluded by pancoast tumor or trombosis leading to unilateral venous dilation, facial plethora?
brachiocephalic vein
66
where are central lines placed?
what embryo does SVC come ffomr?
into the IJV or Sbclavian V until they reache the SVC
cardinal vins
67
ICS increase the responsiveness to what other asthma drug?
B2 R agonists (buy upregulating B2R)
68
nitroprusside does what to preload and afterload in CHF?
decreses preload and decreases afterload
69
what is the histology of a myxoma?
amorphous extracellular material
70
warfin indujced skin necrosis can be precipitated by underlying
protein C def.
leads to transient hypercoag state and microocclusions
71
is VQ ratio increased or decreased in exercise?
increased~
72
is the serpentine cord in TB related to acid-fastnes or virulendce?
virulence (lassoing the cells)
73
defect in CD18 means
what will you see on cbc?
leukocyte adhesion deficiency
persistent leukocytosis
74
what glucose metabolism disorder is symptomess?
fructokinase def.
gets shunted over by hexokinase
75
sertoli cells make ___ stimulated by \_\_\_\_
Ledig cells make ___ stimulated by \_\_\_
inhibin; FSH
Testosterone, LH
76
atelectasis (white out lung) will have tracheal deviation
towards the affected side
77
what is a type of PBP?
transpeptidases
78
describe FGF23 and phosphate metabolism?
suppresses vit D
inhibits renal reabsorption of phost.
79
does heparin prolong both pt and ptt?
apparently
80
in aplastic anemia, what is the MCV and the haptoglobin?
normal and normal
81
h pylori can lead to what
which can cause what?
multifocal atrophy
Maltoma
82
what does mitral stenosis look/sound like?
83
antiPLARy2 ab in the setting of nephrotic synfomr mean wha?
membranous nephropahy
84
what is pathonuemonic for dibaetic nephropathy on histology?
kellemer wilson lesions
85
understand mosaicism
86
what to auer rods look like?
what cancer is this most seen in?
AML, especially APML 15;17
87
what type of cell makes IL2?
t cells
88
more stats stuff that my brain STRUGGLES with
89
ope ya missed a AIP quest, who's surprirsed?
90
you got this one wrong before---
blind vag, bulge in inguinal area, looks like a female
high testosterone
x linked mutation in androgen receptor
91
what do you treat pheochromocytoma with?
phenoxybenzamine (names sound similar)
92
a difference in phenotype despite same genes measn what?
variable expreability
93
how do nitrates effect HR and EDV of the LV?
increases HR
decreases EDV
this reduces O2 demand on the heart by decreasing preload
94
describe Albright's herediary osteodystrophy?
what is the endocrine issue?
what is that?
short stature with short fingers and toes
hypocalcemia, hyperphosphatemia
high PTH
psuedohypoparathyroidism
resistance to PTH in the end orfans
95
allelic heterogenity describes what?
same phenotype
different genotype
96
hepatomegaly, gonadal dystrophy, and joint pains in the setting of hyperpigmentation indicates hwat?
hemochromotasis
elevated dermal hemosiderin deposition
97
portal hypertension can lead to blood backup in what vessel?
splenic vein
splenic congestion and splenomegay
due to retrograde flow from the liver
98
if you see yellow/tan honey crusting over skin, even if it's a burn, what bacteria is it?
staph aureus causing impetico
99
what mechanism does psudomonas use to be abx resistant?
efflux pumos
100
where is preproinsuline found?
cytosl (N-terminal)
101
a-ketoacid dehydrogenase def is seen in waht?
what cofactor is needed for this reaction?
maple syrup urine dz
thiamine
102
if testosterone is low in the smeiniferous tubules and epipdiymis, what is missing?
sertoli cells that secrete ABP and bind up the testosterone in that space
103
glucagon is mediat4ed by what recepotr?
GPCR
104
what causes hypoglycemic, hypoketotic syndrome after prolonged fast?
ACoA dehydrogenase deficiency
105
last minute memorize list
106
how do you treat hepatic encephalopathy?
wjat is the MOA?
lactulose
acidifies the intestinal lymen
NH3 converts to NH4
107
if warfin does stuff to cypc19, does cyp450 still change it\>
yes
108
the two hit hypothesis
germline has one inactivaated allele
secondhit happens during life
109
know these!
if recurrent laryngeal nerve is affected, which muscles are affected?
posterior cricoarytenois
lateral cricoarytenois
oblique orytenoid
transverse areythenoid
thyroarytenoid
ALL the arytenoids
110
DNA viruses besides except poxviruses, replicate where?
RNA viruses, except orthomixo and retro, replicate where?
in the nucleus
in the cytoplasm
111
what does hashimotos look like?
112
wwhere is broca's area?
113
post-ganglionic autonomic nerves are myelinated or nonmyelinated?
nonmyelinated!
114
what are some weird less common sx of iron def. anemia?
reduced taste sensation, burning sensation in mouth and lip dryness
115
stop getting this wronggggg
prader willi
deletion
duplication
paternal deletion
maternal duplication (disomy)
opposite for angelmans
116
if it doesnt transiliminate and disappears when you lie down, what is it?
varicocele
117
when using antiandrogen, what happens do testosterone,
it decreases in synthesis (over time)
118
CATCH-22 in Digeorge syndrome, what does the first C stand for?
conotruncal caridac defects
incluide truncus arteriosus
119
last minue memoriziation
120
aspergillus can look like what
can stain with what?
methenamine silver
121
i dont understand vit d and phosphate
122
damage to the middle cerebral artery can cause what vision defect?
homonymious hemianopia
123
know the sleep disturbances
124
what is an example of developmental field defect?
holoprosencepahly due to trisomy 13 or other mutations and environment like ETOH or reintoids
initlial defect leads to a bunch of issues
125
what's more common in down syndrome, duodenal atresia or pyloric stenosis?
duodenal atresia (D-Downs. D-duodenal)
126
What part of the tibia is affected in Osgood Schlatter syndrome?
the tibial tubercle
127
what test do you order if you think someone has trichomonas?
wet mount
128
n-MPO antibodies are the same as
PANCA
(eosinophilic granulomatosis with polyangitis is one example)
129
which cholesterol drug class can increase triglycerides?
bile acid binding resins (cholesturamine)
130
deos maternal IgM cross the placenta?
can neonate make own IgM and IgG?
no, but IgG can
yes
131
what type of transporter is GLUT4?
facilitated diffusion (carrrier mediated transpot)
132
helpfu; HIV drugs
133
RBF and GFR increase or decrease in pregnanct?
creatinine increases or decreases in pregnancy?
increase
decrease
134
total vascular systemic resistance increases or decreases during stress/exercise?
decreases to help get blood to more places
135
in atrial fibrillation, clots are likely to get thrown. what organs are susceptible to these infarctS?
brain and kidneys
136
which branch of tirgeminal will cause muffled hearing and pain with mastication (pterygoid syndrome?)
mandibular branch V3
137
what parameters are changed with vsd?
138
which part of the pancrease is derived from the ventral pancreatic primoridum?
main pancreatic duct
139
know these correlation coefficient graphs
140
in addition to proteus, what else can cause large staghorn calculi?
KLBSIELLA (like the horn on the dinosaur in sketchy)
141
besides pseudomonas and staph aureus what else likes to wreak havoc in CF patients?
Burkholderia cepacia sinopulmonary infection
142
someone who hasn't traveled/drank bad water, and has a liver absecess, what is the likely cause?
staph aureus hematogenous spread
most liver absdcesses in the usa are from bacterial sources
143
what type of immunity and which cytokine is the primary driver of giant cell arteritis?
cell mediated, IL6 (not MPO anca)
144
inhbition of what is very good at targeting T and B cells cancers?
ADA inhibitoin (cladrinbine)
145
what sort of defect can lead to increased risk of testicular torsion?
anatomical defect increasing mobility (bellclapper abnormalitiy)
146
know these elizabethhhh
147
what are the manifestations of sciatic nerve injury?
weakness in dorsiflexion and plantar flexion
weak knee flexion
148
cranial nerve palsies in diabetics can be caused by?
diabetic mononeuropathy due to vacular ischemia suplping the nerve
149
in pt's taking large amounts of albuterol, what can happen to K?
large intracellular shifts of K leading to hypokalemia
150
addtive efects and synergysim mean what?
by comparison, permissiveness means what?
two drugs function towards the same end goal and increase towards that same goal when used together
permisiveness is when one drug doesn't do anything to achieve X goal but when given with a drug that does achieve X goal, it increases the efficacy
151
in doing surgery of the right atrium, what nerve is most at risk of injury?
the phrenic nerve
reccurent laryngeal is most at risk during thyroid surgery
152
what do the extra ocular muscles look like on MRI?
what nerve supplies lateral rectus? ABDUCENS
153
subacute thyroiditis aka
granulomatous, De Quervians
thyroid pain, fever, initially hyperthyroid then hypothyroid
elevated thyroglobulin
decreased radioactive iodine uptake
154
pt's with bleeding, bruising, swollen gums, ecchymoses, etc, what is the porblem?
what is the problem in scurvy?
scurvy (vit c defi)
**collagen synthesis is messed up**
**can't undergo hydroxylation of proline and ;ysine**
155
asymetric breathsounds in a neonate should make you think of what right away?
diaphragmatic hernia leading to pulmonary hypoplasia
156
"slapped cheek" rash, is what virus?
what cell is infected in parvo?1
parvo
erythrocytes
157
how does bacterial resistance develop for aminoglycosides (streptomucin)
mutation in ribosomal proteins
transferase mutations
porin mutations
158
what is increased/decreased in TOF?
RVOT causes blood thru pulm artery to be blocked, leading to decreased pressure in the pulm artery (cuz no blood), but the R ventricle presure is increased cuz its' stuck. L atrial pressure is decreased because blood can't get form r to l very well.
159
1st gen antipsychotics
2nd gen antipsychotics
EPS
metabolic syndromes
160
what are the s/s of osteomyelitis?
fever, refusal to bear weight
inflammation and icnrased uptake of radiotracer
affects long bone metaphysis
161
if it says there is no immune complex deposition or immunoglobulin depsition, what must it be?
pauci immune (ANCA)
162
what is the cardiotoxic pathology ot trazutizumab?
decreased cardiac contractility with no fibrosis or necrosis
often reversible
163
what do you treat PAH with?
endothelin receptor antagonist-bonsentan
164
elvated AFP in serum and Achesterase in amnio can indicate what?
anencephaly
failure of fusion of the edges of the neural plate
165
chorioretinitis, brain calcifications, hepatomegaly, juanice, all inidcate which TORCHES?
toxoplasmosis- can get form undercooked meat
166
misclassification bias is a type of what?
recall bias
167
what is the most common bacteria and virus in COPD exacerbations
h flu and rhiniovirus
168
vertebral factures are pretty pathonumo for what\>
PTH and Ca levels are what in this dz?
osteoporisus
normal
169
pericardial knock is heard when?
acute pericarditis is indicated when
early diastole, shortly after S2, easy to confus with S3
assoz with constrictive pericarditis
pain improves with leaning forard, hear a friction rub
170
unfractionated heparin and direct thrombin inhibitors (gabatrans) will prolong what time?
direct Xa inhibitors will prolong
trhombin time
PT and PTT but not thrombin time
171
if BMI is \<18.5, what is the likely dianosis
anorexia (could be binge purge, so don't think it's bulimeia )
172
antigenic variation allows
bacteria to reinfect the host, esp if only IgA and IgG ab are formed which aren't great long term
173
PEs can cause right ventricular cavity to increase or decrease in size?
increase in cavity zise (dilation) rather than hypertrophy
174
what are the s/s of TCA overdose?
tachycardia, delirium, dialed pupils
orthostatic hypotension
conduction defects/arrhythmias
SZ/tremros
sedation, increased apetite
175
a pt just had a stroke because of peripheral artery stenosis in the carotid, what drug may be added?
what is a complication of said drug?
Aspirin
gi bleed
176
waht changes with old age in reference to dixogin?
liver or kidney?
renal clearnace of the drug can diminish with age and cause yelow vision amon ogher s/s
177
porcelain gallbladder is assox with which gallbladder Ca?
adenocarcinoma
cholangiocarcinoma is assox with fibrosis from fluke or pimrary sclerosing cholangitis
178
diphtheria can undergo what process to incresae what kind of toxin?
phage to make exptoxin
179
features of TTP?
180
can you be aware during focal onset seizures?
yes
181
what is teh defect in alkaptonuria?
def of homoginstic acid diogenase
can't turn tyrosine into fumarate for teh TCA
black pee
182
posteruir rostral pons in the near the lateral floor of the 4th ventricle, waht is secerete ther?
NE from locus ceruilis
183
is clubbing significant for COPD?
no unless there is underlin**g malignancy**
**more assoc withn malignangy**
184
mutliloped nutrophils are assox with cobalamin or folate def. ?
folate def.
Folate-4-8 lobed neutrophils (more like 6-8)
185
injury to the plantar foot can injure which enrve?
tibial nerve
loss of plantar flexion, stuch in dorsiflexion/feversion
186
live attenuated polio virus will lead to accumualtion of what ab?
duodena limunila igA because likes ot replicate in pyeers patches
187
fluid hydrothorax can occur in cirhosisi because of fluid movement where?
across the daipharem
188
first generation antihistamines can have what affects on what receptor?
muscaronic r antagonism leading to anticholinergic effects like dialted pupils and flushed chekes
189
aromatase inhitors include
these cantreat what?
letrozole, anastrozole, exemestane
ER+, HER- breast cancer
190
what makes the red stuff PAS + in whipple disease
glycoprotien
191
homebirth babies being brought in with downward gaze, AMS, bluging fontanel could have what?
ICH due to lack of vit K
192
spike and dome with sulver stain assox with lupus and diffuse thickening with neprhotic sx what is it?
membranous nephropahty
193
what does FSGS look like
194
what does membranoproliferative glomerulonephritis look like
195
what part of the ventricles is enlarged in huntingtons?
enlarged frontal horn of lateral ventricle
atrophy of caudarte nucleus
