General 5

Question 1

is bone marrow fibrosis normal with increased age?

Answer 1

no, but it does become hypocellular and decrease in mass, more fat

Question 2

what happens when you give a COPDer oxygen?

Answer 2

vasodilation occurs and shunts blood away from well-ventilated areas and increases physiologic dead space, increasing VQ mismatch

Question 3

are femoral hernias above or below the ingional lig?

Answer 3

BELOW because they are near the FEMOR

Question 4

5 a reductase inhibiotrs, like finasteride, have wht side effects?

what is the MOA?

Answer 4

gynecomastia and decreased libido

decrease dihydrotestosterone synthesis

Question 5

how does simultaneous use of aceteminophen and ethanol decrease hepatoxicity by tylenol?

Answer 5

through competitive inhbition by CYP P450 2E1, ethanol can decrease metabolism of NAPQI and therefore decrease NAPQI concentrations

Question 6

what is the mechanism of tylenol induced hepatotoxicity?

Answer 6

depleted glutathione, build up of NAPQI

NAPQI binds with mitochondira

leads to oxidative hepatocellular injury

Question 7

post-MI, what is a common occurance?

how can this be attenuated (avoided)

Answer 7

LV dilation driven by angiotensin II

ACEi

Question 8

what is the MOA of penicilliminie?

Answer 8

increases urinary excretion of Cu

Question 9

what happens to children exposed to second hand smoke?

Answer 9

mucocilliary dysfunction

imparied phagocytosis of alveolar macrophage

immune and inflam cell recruitment

Question 10

what are teh associated syndromes for small cell lung carcinoma?

Answer 10

SIADH

Cushing

Lamber Eaton

Question 11

know galactose metabolism deficiency

Answer 11

notable that galactose-1-phosphate uridyl transferase makes babies more at risk for e coli sepsis

Question 12

injury to the membranous urethra (posterior urethra) is assox with what findings?

anterior (spongy) urethral injury is assoxi with

Answer 12

pelvic fracture

blood at meatus

high riding boggy prostate

straddle injury

Question 13

flu vaccine neutralizes __

Answer 13

HA

inhibits viral entry into cells

Question 14

in hirshprungs, would a biopsy of the narrow submucsa portion or dilated portion show absence of neurons

Answer 14

narrow portion of the submucosa has an absence of ganglion celsl

(absence of myenteric and aurbacuh)

Question 15

in unilateral renal artery stenosis, what is the pathology of the stenotic kdiney?

and the normal kidney?

Answer 15

tubular atrophy, interstitial ischemia, glomerular crowding,

arteriolar thickening due to hyaline or hyperplastic arteriolarsclerosis

Question 16

non caseating granulomas in the GI tract may indicate

Answer 16

Crhons

Question 17

Cd55 defienciny-what will you find in the kidney?

Answer 17

hemosiderosis due to chronic RBC breakdown and iron depostion

Question 18

wht is the brain pathology for cerebral palsy?

Answer 18

periventricular leukomalacia or necrosis

Question 19

what has the fastest rate of metabolism in the glycolytic pathway?

Answer 19

fructose 1 phostphate because it bypasses PFK1, the rate limiting enzyme

Question 20

what are neurophysins?

Answer 20

carrier proteins for ADH and oxytocin

mutation in them could cause DI

Question 21

S4?

Answer 21

blood FOURced against a stiff ventricle

could mean diastolic dysfunction from LVH

Question 22

is the bladder extraperitoneal?

Answer 22

yes

Question 23

what is thyroglobulin?

Answer 23

large protein that carries around tyrosine to help make thyroid hormone. if you take exogenous thyroid homrone, thyroglobulin will be low, because no need to make your own TH

Question 24

add to list

Answer 24

Question 25

GPCRs help do what?

Answer 25

cellular binding/anchoring

Question 26

what drug class is prefered for RLS?

Answer 26

D2 agonists, like ropinerole, pramipexole

Question 27

systemic scleroderma risk?

Answer 27

lung intersitial fibrosis sclerosis and skin thickening of the limbs and trunk

Question 28

someone was on an abx and warfarin, and now the inr is super high. why?

Answer 28

abx can decrease intestinal flora which are required to make vitamin K and with depleted K, inr can shoot up metronidazole, flouroquinolones, macrolides

Question 29

what is a lung complication of CREST

Answer 29

pulmonary hypertension

Question 30

a monoclonal lymphocytic proliferation in the LN is strongly suggestive of

Answer 30

malignancy

Question 31

lymphocytic pleocytosis with elevated protein in CSF, lower extremity asymetric flaccid paralysis, parkonson's like sx all could mean

Answer 31

west nile virus

Question 32

if theyre talking about a squamous cell cancer in the tongue/oropharynx, make sure to think about

Answer 32

HPV! RB or TP53

Question 33

what does mitral stenosis look like

Answer 33

Question 34

gastric bypass can cause what? this depletes what? but increases what?

Answer 34

SIBO most vitamins, B12, D, A, E but increases K and Folate

Question 35

most cholesterol gallstones are due to what?

Answer 35

incraased cholesterol syhnthsis, gallbladder hypomotility, increased Ca or mucin, or decreased bile acid synthesis/recirculation decreaed bile acid synthesis happens with fibrate use (pt in this stem not on a fibrate) and recirculation issues happen with spinal cord injury, pregnancy or fasting, which did not apply in that stem

Question 36

K excretion

Answer 36

Question 37

know this ugh

Answer 37

Question 38

what hormones work the same as sildeniafi?

Answer 38

ANP and BNP activate gunayl cyclase and increase conversion of 5' triphosphate to cGMP

Question 39

B blockers do what to renin

Answer 39

decrease renin reelase from the GJ cells

Question 40

neuropathys

Answer 40

Question 41

pleitropy is

Answer 41

lots of phenotyoe manifestations from one genetic aberation

Question 42

which nucleus is assox with taste?

Answer 42

nucleus solitarious facial, glossopharyngeal and vagus all bring taste to that area

Question 43

pay attention to these labs if you think its ATN

Answer 43

FENA \>2 BUN:CRT 10:1 or more will have muddy brown casts and elevated spec gravity

Question 44

what is first line for treating hyperkalemia with EKG changs?

Answer 44

calcium gluconate

Question 45

what is gold standard for carpal tunnel diagnosis?

Answer 45

EMG/nerve conduction

Question 46

what common drugs can cause AV block?

Answer 46

digoxin CCB BB (doxirubicin causes Dilated cardiomyopathy)

Question 47

maintain ductus arteriosus with what

Answer 47

prostaglandin analogues PROSTaglandanins to PROP the DA open

Question 48

posterior sacral positions and treatments

Answer 48

Question 49

what are the s/s of anterior spinal cord syndrome?

Answer 49

anterior spinal artery compromise bilateral motor and temp/pain sensory deficits intact vibratory/pinpont sensation due to preserved DCML

Question 50

whats another drug besides clozapine that can cause **agranulocytosis?**

Answer 50

**mirtazipine or carbemaziepibe**, methimazole, colchicine, PTU, dapsone, ticlopidine clozapine can also cause somnolence, myocarditis, Sz metofrmin-lactivc acidosis in kidney damage, GI upset lithium-NDI, tremor, hypothyroid, hyperPTH, ebsteins anomaly valproic acid-elevated LFTs, thrombocytopenia (bleeding), Neural tube defect