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Stuff I Get Wrong > General 4 > Flashcards

General 4 Flashcards

1
Q

acute tubular necrosis will have what type of casts?

can be caused by

A

muddy casts

inraoperative iscemia

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2
Q

what does histoplasma look like inside macrphage?

A
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3
Q

what is the MOA of patiromer?

A

echanges Ca for K in the intestine to increase K loss

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4
Q

when are delta waves seen on EEG?

A

N3 during night terrors

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5
Q

what part of vit D metabolism does the sun do?

A

7-decholesterol to D3

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6
Q

how does an AV fistula change the PV loop?

A
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7
Q

which is elevated in hemophilia a and b, PT or PTT?

A

PTT is proloned

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8
Q

what is the workup for giant cell arteritis?

A

ESR and temporal a biopsy

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9
Q

what happens when you start a pt with bilateral renal stenosis on ace inhibitiros?

A

pts with BRAS are a dependent on AgII to cocnstrict the efferent renal artery so that they can maintain GFR

when ACEi are started, RBF decreases, GFR decreases and FF decreases and can lead to renal failure, tho most pts can toelratee

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10
Q

damage to the dominant parietal lobe/angular gyrus manifests as what?

A
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11
Q

if leptin R is knocked out, what will be high?

A

BMI and leptin levels, because no receptors to modualte the acticity

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12
Q

blanching erythema in the minutes following a superifical burn are due to what?

A

mast cells releasing histamine

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13
Q

know it bbbbb

A
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14
Q

diastolic heart failure can be caused by

A

decreased ventricular compliance and is characterized by normal LV EF, normal LVEDV and icnreased LV ED P

caused by hypertension, obesity and infiltratigve disroders like transthyretin-induced amyloidosuis, sarcoidosis

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15
Q

isoniazid must be processed by what in order for the drug to be activated

A

mycobacterial catalase peroxidase

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16
Q

left ventricular gallops, etierh S3 or S4 are best heard when

A

at the end of expiration at the cardiac apex

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17
Q

factor Xa inhbitors *Xaban* MOA

A

inhibit Xa thus blocking prothrombin to thrombin (II-IIA)

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18
Q

a midsystolic click probably indicates what?

A

mitral valve prolapse

snapping of the cordae tendidae

usually a defect in CT like in Marfans. ED, or OI

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19
Q

all of the chronic myeloproliferative disorders (PV, ET, PMF) except CML, have what receptor defect?

A

JAK2

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20
Q

atopic dermatitis

A

LOF in fillagrin leading to increased water loss and inflammation

causes dry skin and pruritis and can appear lichenified

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21
Q

foamy macrophages with acid fast bacilli

A

MAC

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22
Q

etoposide inhibits which topoismoerase?

A

topoisomerase II

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23
Q

what are teh effects of dobutamine?

A

B1 agonist

positive iontropy and cronotropy

increased CO

mild vasodialtion

increased O2 consumption (not ideal)

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24
Q

G6PD def is what kind of inheritance?

A

XL recessive

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25
Q

what is heteroplasmnu

A

mixing of multiple genetics

like females in mtDNA mutations aren’t as effected as males

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26
Q

colitis assox cancer is from what kind of mutation?

A

early p53

late APC

or multifocal

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27
Q

Wernicke’s aphasia is from a vessel damage wher?

A

MCA vessel damage

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28
Q

what part of the bladder is more likely to rupture in trauma?

A

bladder dome

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29
Q

LPS on g- bacgteria like e coli bind to what?

A

TLRs

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30
Q

high pulses in UE and low pulses in LE means

what is a compensation for this?

A

coarctaion of the aorta

collateral circulation leadnig to a continuous murmur in the back

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31
Q

HIV transmembrane protiens

A
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32
Q

retroperitoneal hematoma can look like

A

these can compress the femoral n leading to anterior thigh loss of sensation

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33
Q

highly proliferative cells like___

are more prone to

A

intestinal crypt cells

ionizing radiation becayse they don’t have as much time to repair the dna

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34
Q

how does a hyperthyroid state lead to bone loss?

A
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35
Q

titration curvee for substances in the kidney

A

glucose is fully reabsorbed in the PCT until it reaches it max cncetration at 200. once there, it will be excreted

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36
Q

what are some common clinical manifestations of hemocrhomatosis

A

arthritis

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37
Q

what does pcp look like with methamene silver stian?

A
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38
Q

what two factors likely have a strong role in development of LV hypertropyhy?

A

endothelin and AGII due to HTN

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39
Q

if the TIA has resolved, do you give TPA?

A

NO

primary therapy is secondary prevention with antiplatlet drugs like ASAs or clopidogrel and statins

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40
Q

JAK is a ___ tyrosine kinase

A

cytoplasmic

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41
Q

dermatomyositis can be a sign of what?

A

underlyinh malignancy, including ovarian adenocarcinoma

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42
Q

in cirrhosis leading to ascites, portal hypertension leads to splanich vasodilation leading to activation of

what drug to give?

A

RAAS causing vasoconstriction from ANG and fluid and Na retenion from aldosterone

giving spironolactone, an aldosterone inhibitor, can reduce fluid overload

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43
Q

why do glucocorticoids cause bone loss?

A

decreases osteoblast precurosr cell proliferation and diferentiation

and increases rankl and rank to increase bone reabsorption

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44
Q

diffuse axonal injury can occur when there is

A

shearing and disruption of the white matter tracts

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45
Q

bacteria in endocarditis like to attach to what?

A

fibrin deposits from prevously damaged calves

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46
Q

calcified focus (ghon focus) is characterisitic of

A

PRIMARY TB infeciton

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47
Q

what might neurocystocosis look like?

A
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48
Q

ventricular action potential and ekg corespondance

A
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49
Q

the borh and haldane effect

A
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50
Q

HFpEF due to left ventricular diastolic dysfunction

A
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51
Q

whaat do gaucher cells look like?

A
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52
Q

what is the molecular structure of collagen made of

A

Gly-X-Y so glycine is the most abundant substance

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53
Q

where is blood oxygen the lowest?

A

in the coronary sinus and in the heart in general since there is a ton of oxygen extration in the myocardium

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54
Q

what is a common cause of congenital goiter with high TSH and low T4

what is a common cause of congenital goiter with low TSH and high T4?

A

genetic defect in thyroid hormone production

maternal intake of PTU

iodine deficiency

transplacental TSHR stimulating Ab (grave’s dx)

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55
Q

someone has a ruptured cerebral anueyrsm and a heart defect. What is the heart defect?

A

coarctation of the aorta

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56
Q

salicylate tox can have a mixed acid-base disturbance due to the resp alkalosis and met acidosis so levels can be

A

normal ish pH

lowish HCO3 due to met acid

low paco2 due to resp compensation for the met acid and resp alkalosis

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57
Q

if someone has a drop in contractility and EF with dobutamine stress test, what does that mean?

A

fixed atherosclerotic lesion limiting blood flow

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58
Q

what is effect modification?

A

when the effect of an exposure on an outcome is modified by another variable

can identify this using stratified analysis

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59
Q

what is angle closure glaucoma?

what meds can cause this?

A

space between the cornea and iris is narrowed, limiting the flow of aqeous humor out of the anterior chamber and raising the pressure

those that cause mydriasis such as alpha adrenergic agonists and anticholinergics

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60
Q

what schistosomiasis can cause hepatosplenomegaly, portal hypertension, fever, diarhea

A

hepatic schistosomiasis

common in africa and asia

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61
Q

infantile hemangiomas ___ before they regress?

A

enlarge before they regress

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62
Q

dexrtromethrophan when combined with SSRIs/SNRIs or overdosed can cause

can also cause resp depression or NDMDA receptor inhibitoin and cause hallucinations

A

SERotonin snydrome

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63
Q

chimeric ab can cause

how is it resolved

A

serum sickness

phagocytes eat up the IC

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64
Q

verapmil works great on the heart but not the skmuscle. why?

A

skeletal m has litlte dependence on extracellular calcium

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65
Q

xerdoerma pigmentosum is deficient in

which requires

A

nucleotide excision repair

endonuclease

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66
Q

___ is more likely than bacterial infection to be the inciting agent of appendcitis

A

lumen obstruction (fecalithi)

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67
Q

what is AV nodal reentrent tachycardia?

A
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68
Q

in a niacin def, which enzymes will be effected?

A
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69
Q

in lactose intolerance the stool pH will be

the breath H will be

A

low

high

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70
Q

review

A
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71
Q

BNP is released based on wht?

A

ventricular wall stretch and strain increase tgat occyrs with volume overload

BNP and ANP are then secreted by the atira to stimulate vasodilation and salt and water excretion to alleviate volume overload

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72
Q

flate or b12 def leads to a defect in what

A

purine/pyridine bases

73
Q

what is the most common cause of spontaneous lobar hemorrhage in the elderly, esp parietal and occupial?

A

cerebral amyloid angiopathy

74
Q

memorize

A
75
Q

most cases of glioblastoma are associated with what mutation

A

EGFR

76
Q

liposacrcomas are made of what?

A

lipoblasts, non-membrane bound cytoplasmic lipid that shifts causing scalopping

77
Q

in addition to werenickes and korsakoffs syndrome in alcoholics, what else can occur?

A

alcohol related cerebellar degeneration

involves teh vemis

s/s include ataxia, unsteadiness, tremor, but no signs of confabulation, confusion, or other assox s.s of WK

78
Q

what are the s/s of wernickes?

what are the s/s of korsakoffs?

A

encephalopathy, oculomotor dysfunction, ataxia

issue is in mamillay body

lesions in the anteiror and medial thalami with amnesia, confabulation and preserved long term memory

79
Q

what is a possible pbscure cause for rectal bleeding?

A

meckel’s diverticulum with heterotopic gastric mucosa that can ulcerate and bleed

80
Q

what is the cause of wide split S2?

A

RBBB, pulmonic valve stenosus, pHTN, can delay pulomnic valve closure causing a delay between aortic valve closing and pulmonic valve closing, widdening the split that is most prominent in inspiration and lasts throughout expiraiton

81
Q

what GI drug should never be used in Parkinson’s pts and why?

A

Metoclopramide as it can exacerbate or brng on de novo parkinson’s with EPS due to it’s antagonistic effects on D2R

82
Q

explain the pathophysiology of hypothamic amenorrhea?

A

usually a really atheltic female who has a low BMI, low fat, low leptin which leads to a decrease in GnRH which decreases LH/FSH and low estrogen.

Low estrogen leads to bone loss, early osteoporosis and decreased peak bone density

83
Q

hey guess what.

know the difference between marfans and homocysteinuria

A

ITS NEVER MARFANS

homocysteinuria will be more likely to have intellectual disabilities, thrombosis

Marfans more likely to have aortic rood dilataion

84
Q

N meningitis has what

N gonorrhea has what

A

a capsule

no capsule, but pili and htat is its’ virualence factor

85
Q

what is the MOA of vangalcyclovir and gancyclovir

A

blocks DNA chain elongation

86
Q

what is the mechanism by which pathogens under antigenic shift

A

reassortment

87
Q

knwo

A
88
Q

where do stem cells of SI epithelium come from?

A

crypts of leberkuhn

89
Q

what is the primary cell type in the nodules of a cirrhotic liver?

A

hepatocytesl (not stellate)

90
Q

differentiate between splenic sequestration crisis and asplenic crisis

A
91
Q

what is the mechanism of tardive dyskinesia from prlonged antipsychotic use?

A

long term blcokade of DR leads to upregulation of the R

92
Q

what are the s/s of dopamine beta hydroxylase deficiency

A

impaired sympathetic adrenergic activity with normal parasympathetic and cholinergic activity

presents with postural hypotenison, exercise intoleracne, nasal congestion and erectile issues

93
Q

massive saddle pulmonary emboli causes waht type of shock?

A

obstructive shock

increase in CVP, decrease CO, increase in SVR

94
Q

know

A
95
Q

what is skewed x inactivation?

A

one X is turned off in every cell of a woman, but some women have skewed x inactivation, where the x defect may be more prominent

96
Q

renal afferent arteriolar dilation increases what?

renal efferent arteriolar constriction increases what?

A

GFR and RBF

GFR at the expense of RBF, therefore FF (GFr/RBF) increases

97
Q

what is the venous drainage of the rectum above and below the dentate line?

A

above the dentate line is the superior rectals which drain into the portal system via inferior mesentaeroc

below the dentate line is the inferior rectals which drains systemically via the internal iliac

98
Q

what does xerosis look like, what is a triggeer and what is the treatment

A

winter itch, worse with cold weather, use lukewarm bathing and aggressivr emolients

99
Q

more bc

A
100
Q

giving probenicid with PNC does what?

A

inhibits renal tubular secretion of PNC

101
Q

spider angiomas occur because of excess of what?

A

excess estrogen

102
Q

primary ovarian insufficiency occurs by a process of

A

follicular atresia, a type of apoptosis

103
Q

coating a stent in sirolimus is for what purpose?

A

to avoid intimial hyperplasia by reducing smooth muscle proliferation thru mTOR inhibition

104
Q

failure of ____ leads to failure of tripple helix formaiton and stabiliaztion by ___

A

proline hydroxylation; pro-alpha chains

105
Q

uncal or transtetnorial herniation will compress what?

A

oculomotor n.

106
Q

decrease in ___ functuon can lead to osteoporosis?

A

ovarian

remember, hyperthryoid can lead to bone reabsorption, but not hypothyroid

107
Q

girls with 17-hydroxylase deficiency will have low levels of what?

A

low renin levels.

can make aldosterone, so feedback inhibtion will lower renin

108
Q

if someone is an autosomal recessive gene carrier, they are unaffecte,d but may have

A

decrease activity in that gene

109
Q

if you think someone has rhabdo, bty they are on loop diuretics, what might they actuallt have?

A

hypokalemia secondary to loops

check electrolytes rather thanCK

110
Q

a psoas abscess can spread pus and infection into which space?

A

the groin

111
Q

what are the affects of ANP, AngII and aldosterone with sacubitril-valsartan therapy

A

increased ANP, decresaed aldosteorne, increased ANGII

112
Q

hiv drug mOAS

A
113
Q

what syndrome is assoz with mutations in CDKN2A on cr9p21

A

dysplastic nevus syndrme

(predisposed to melanoma)

114
Q

what is the normal LV repsonse to exervie?

A
115
Q

the first step of pyrimidine syntheis occurs where?

A

in the cytppasm

116
Q

alcohol induced cardiomyopathy is a type of what

A

dilated cardiomyopathy

117
Q

antifungal targets

A
118
Q

what is the MOA of tretinoins/retinoids?

A

normalize keratin

decrease epithelial cohesiveness

stmulate stem cell mitosis

119
Q

what is the effect of dihydro CCB?

A

decrease arteriolar resistance

decrease afterload and BP

increase SV and CO

decrease cardiac work

120
Q

pompe dx is a defect in which organelle?

A

lysosomes

121
Q

know

A
122
Q

psammoma bodies are found in what type of ovarian tumor?

A

serous cystadenocarcinoma

123
Q

warfarin skin necrosis is due to what?

A

reduced protein C levels

124
Q

what class of drigs will affect the phase 0 of cardiac myocytes?

A

procainamide (class I antiarthyrmics) prolong phase 0, rosk of QT prolongation and toursades

125
Q

the immiediateness of type I HSN is due to mast cells or IgE?

A

IgE ab

126
Q

what is ogilive syndrome?

A

pseudoobstruction of the large intestine

days to weeks post op

dilation of the cecum and LI

127
Q

popliteal A aneurytsm can compress which nerve and cause what problems?

A

compress the tibial n and cause issues with inverting and platnar flexing the foot

128
Q

meningioma is due to a mutation in

A

a tumor supressor gene

(NF2 or DAL1)

129
Q

the most common cause of type 4 RTA is

A

hypoaldosteronism

130
Q

what is tropical spastic paresis?

A

caused by HTLV1

causes pins and needles in LE, sexual dysfunction, bladder problems

131
Q

sclerotic lesions with increased radionnucleotirde uptake indicates what?

A

osteoBLASTIC lesions

often metastatic prostatic adenocarcinoma

132
Q

lead poisoning does what to ox phos?

A

uncouples ox phos

133
Q

what do cysteine stones look like?

A

hexagons

134
Q

which drug is more likely to cause hyperkalemia, lisinopril or metoprolol?

A

lisinopril

135
Q

what is this a picture of?

A

a choolesterol ebolus

it a complication of coronary angiography

136
Q

what cell secretes IL8?

A

macrophages

137
Q

what does proliferative endometrium look like?

what is the response during the proliferative phase?

A

straight glands from estrogen

granulosa cells are responding to FSH

138
Q

zeel neilson stain means

what is proohylaxis for MAC at cd count less than 50?

A

acid fast

azithromcin

139
Q

high afp wtihout hcg means what tumor?

what is a special feature of this type of tumor?

A

yolk sac tumor

schiller duval bodies look like glomeruli

140
Q

what is the only class of alyklating agents that can cross the BBB?

A

nitrosureaus,

includes carmustine (stines, and streptosozin)

141
Q

what is teh histological change in edema of atopic dermatitis?

A

spongiousus

142
Q

what are the s.s of sick sinus syndrome?

A

palpiations and syncope due to dysfunction at SA node

EKG may be normal or banormla

143
Q

what ype of lung cancer can elaborate ACTH and give the appearance of cushing’s syndrome?

A

small cell carcinoma

144
Q

what cell type would be seen in broncheoalveolar lavage in Sarcoidosis?

A

CD4 T cells

145
Q

what is the morphology of pasturela?

A

gram - non spore former coccobacillus

146
Q

what histologyical finding is often seen in chronic asthma

what is an association that is often seen in tampinade?

A

curshman spirals

pulsus paridoxicus

can be seen in copd or chronic ashtma

147
Q

what type of cancer is positive for calretinin?

A

mesotheliuoma

148
Q

know

A
149
Q

ehat electrolyte abn of calcium can cause prolonged QT and sz?

A

hypocalcemia

150
Q

PSGN has ___ in C3 levels?

can MCD present aftera URI?

A

decrease in C3, increase in ASO ab titers

yep

151
Q

ankylosing spondylitis can presetn with wht ype of murumr?

A

aortic regurg high pitched blowing early diastolic decrescnefo at lsb

152
Q

lesions ___ cause contralateral hemiballism

A

subthalamic nuclei

153
Q

whats atrial flutter look like?

A
154
Q

a stroke from a fib is due to emboli or thrombi?

A

emboli

155
Q

testicular seminomas are positive for what?

A

ckit and placental alkalinephosphatase

156
Q

Pas + epithelial crests in the kidney can be from

A

goodpastures

157
Q

sturge webber effects what size vessels?

A

small capillaries

158
Q

calcium ox stones normally have what calcium levels in the blood and urine?

A

normal serum ca and high urine ca

159
Q

pts with aml are likely ot have high levels od what in urine if undergoing tumor lysis syndrome

A

uric acid

160
Q

deletion in 1p19q means what brain tumor

A

olgiodendroglioma

clear cytoplasm (fried egg or chicken wire)

161
Q

s/s of carcinoid syndrome and hormone elaborated?

A

diarrhea, sob, wheezing, telenagiectasias, murmur

serotonin

162
Q

what is the treatment for TCA overdose when EKG changes are present

A

NaHCO2

(super prlonged QRS on TCA overdose_

163
Q

when MIF is present from the sertoli cells, what happens to the mullerian ducts

A

degenerate but mau remain as vestigial apendix testes

164
Q

what muscles are innervated by the median n?

A

abductor pollicis brevis,

opponens pollicis

flexor pollicis brevis,

lateral 2 lumbrical muscles

165
Q

what is pay-for-performance?

A

value based payment model that is based on quality and cost measurement

166
Q

Thoracic outlet syndrome is due to compression of the nv bundle between

A

anterior and middle sclane

167
Q

anti ccp will be + in

A

RA

168
Q

what is in the nodules in patients with familial dysbetalipoproteineima?

A

cholesterol laden macrophages

169
Q

whats the best treatment for aortic stenosis

A

percutaenous valve replacement

170
Q

what lung volume is decreased in restrictive lung dz?

A

residual volume

example: sarcoidosis

171
Q

what artery is lesionsed in laterall medullary (wallenbrug) syndrome?

A

PICA

172
Q

superior mesenteric ganglion pressure (release) is good for whwat

A

constpiatoin

inhibitory pressure but its a “release”

173
Q

baggy groin and eye issues and its a parasite?

A

onchocericosus

174
Q

which HLA for MS?

A

HLA DR2

remmeber 2 letters in MS

175
Q

which HLA for goodpastures and SLE?

A

DR3

remember 3 letters in SLE

and goodpastures

176
Q

which HLA with DMTI?

which HLA with RA?

A

HLA Dr4

remember 4 letters in DMTI and R looks like a 4

177
Q

which HLa with nephrotic syndrome?

A

HLA DR7

178
Q

which HLA with MG and Graves?

A

HLA B8

there be 8 GRAVES in my Gravis Yard

179
Q
A

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