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Incorrect questions Flashcards

1
Q

Anastrozole

A

Aromatase inhibitor that decreases estrogen

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2
Q

What hormone regulates fetal lung maturity?

A

Cortisol

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3
Q

Diagnosis of DM?

A

Fasting >126
random >200
Elevated HbA1c

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4
Q

Ezetimibe

A

prevents cholesterol absorption at small intestines brush border
(decreases LDL)

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5
Q

How to treat pyruvate dehydrogenase def.

A

increase intake of ketogenic nutrients
Lysine and leucine (purely ketogenic aa)
High fat diet

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6
Q

Signs and symptoms of a Glucagonoma

A 
4 D's:
Dermatitis (necrolytic migratory erythema) 
Diabetes
DVT
Depression
(normochromatic normocytic anemia)
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7
Q

How distinguish DI central from nephrogenic

A

Central responds to ADH (desmopressin test)

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8
Q

What enzyme is used to compensate for fructokinase def.?

A

Hexokinase

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9
Q

Colchicine

A

Acute gout tx

inhibits microtubule polymerization decreasing PMN chemotaxis (decreases LTB4)

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10
Q

Treatment for enterobiasis

A

Abendazole

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11
Q

Treatment for TCAD OD

A

NaHCO3 for widened QRS and ventricular arrhythmias

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12
Q

Drugs that cause lupus erythematous

A

HIP
Hydralazine
Isoniazid
Procainamide

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13
Q

Pathophys of drug induced lupus

A

metabolism by phase II acetylation and some people are slow acetylators

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14
Q

Captopril

A

ACE inhibitor

SE: angioedema so DO NOT USE with C1 esterase inhibitor deficiency

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15
Q

What is the crescent made of in rapidly progressive glomerulonephritis

A

Fibrin, monocytes, parietal cells, macs

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16
Q

Tx for urea acid cycle malfunction

A

protein restriction

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17
Q

What controls ventricular contraction rate during a fib?

A

AV node refractory period

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18
Q

What innervates the Trapezius?

A

CN XI

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19
Q

SCID defect

A

IL-2R gamma chain (x-linked)

Adenosine deaminase def (AR)

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20
Q

Antiphospholipid Ab Syndrome

A

Associated with SLE

increased aPTT, miscarriages, thrombosis, and +RPR

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21
Q

Hardy-weinberg analysis

A

Allele frequency: p (normal) +q(mutant)=1
Phenotypic frequency:
p^2 (freq in normal individuals) +2pq (carrier freq) + q^2 (freq of dz individuals) =1
calculating mutant allele frequency from disease prevalence: sq root (q^2)=q

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22
Q

Anal squamous cell carcinoma + HIV =

A

HPV 16 and 18

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23
Q

MOA of hydroxyurea

A

Increased HbF
sickle cell pain crisis

inhibits ribonucleotide reductase–> decreases DNA synthesis (S phase specific)
Melanoma, CML

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24
Q

Grades channel blockers MOA

A

Tx for sickle cell

inhibits efflux of K and h2o from cell–> prevents dehydration and reduces polymerization of HbS

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25
Q

Where is serotonin released from?

A

5HT comes from Raphe nuclei

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26
Q

where is NE released from?

A

Locus ceruleus

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27
Q

One month old with jaundice, muscle rigidity and lethargy

A

Crigler Najjar–absent UDP-glucuronosyl transferase

Build up of unconjugated (indirect) bilirubin

causes Kernicterus

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28
Q

JAK2-STAT mutation

A

Myeloproliferative disorders

Constitutive tyrosine phosphorylation activity

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29
Q

Teardrop RBC, hepatosplenomegaly, pancytopenia, STAT +

A

Primary Myelofibrosis

JAK2 mutation, obliteration of bone marrow

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30
Q

Base excision repair

A

Glycosylases–>Endonucleases–>Lyase–>Polymerase–>ligase

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31
Q

Growth factor receptor pathway

A

PI3K/Akt/mTOR

responsible for cell proliferation

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32
Q

Inhaled anesthetic effect on liver

A

Halothane causes acute hepatitis: prolonged PT

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33
Q

Maintenance dose

A

MD=Cpss x CL/(Bioavailability fraction)

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34
Q

Thiamine is a cofactor for…

A

ATP
Alpha-ketoglutarate dehydrogenase
Transketolase
Pyruvate dehydrogenase

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35
Q

Maxillary body necrosis

A

Wernicke

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36
Q

Southwestern

A

Detects DNA-bound proteins

Transcription factors, nucleases, histones

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37
Q

c-Jun and c-Fos

A

Transcription factors (DNA binding proteins)

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38
Q

Ras

A

porto-oncogene codes for membrane bound G-protein

bound to GTP=active
bound to GDP=inactive

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39
Q

CYP 450 inducers ++

A 
Chronic alcohol use
St john wort
phenytoin
phenobarbital
Nevi rapine
Rifampin
Griseofulvin
Carbamazepine

Chronic alcoholics steal Phen-phen and Never refuse greasy carbs

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40
Q

Abacavir

A

HLA-B*57:01
Type IV hypersensitivity
delayed rash

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41
Q

Effects of beta blocker on heart conduction

A

Slows AV node conduction–>increases AV nodal refractory period–> PR interval prolongation

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42
Q

Why treat for Group A strep

A

Prevent acute rheumatic fever and mitral valve damage

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43
Q

Amanita phalloides

A

Amatoxin in mushrooms

bind RNA pol Type II and inhibit mRNA synthesis

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44
Q

Garlic breath, vomiting, watery diarrhea QT prolongation,

A

Arsenic poisoning
exposure to insecticides or contaminated water

inhibits cellular respiration by messing with pyruvate dehyg.

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45
Q

Treatment for arsenic poisoning

A

Dimercaprol

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46
Q

Tx for Lead poisoning

A

CaNa2 EDTA

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47
Q

Treatment for Hepatic encephalopathy

A

Rifaximin

Lactulose (increased conversion of ammonia to ammonium ions)

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48
Q

MOA Rifaxmin

A

antibiotic that alters GI flora and decreases intestinal production of ammonia

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49
Q

Effect of ureter constriction on kidney function

A

increased hydrostatic pressure in capsule–>Decrease GFR

efferent constriction–> decreased FF

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50
Q

tx for cyanide tox

A

Na thiosulfate, hydroxocobalamin, sodium nitrate

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51
Q

Where adenocarcinoma in esophagus

A

lower 1/3

barrets esophagus common cause (obesity and GERD too)

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52
Q

where squamous cell carcinoma in esophagus?

A

upper 2/3

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53
Q

Rickets effect on bone

A

excess of unmineralized osteoid matrix

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54
Q

cryptococcus morphology

A

Budding yeast

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55
Q

Effect of IgA protease

A

allows bacteria to adhere to mucosa

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56
Q

P bodies

A

quality control and storage for mRNA in cytoplasm

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57
Q

Liver damage due to Hep B from

A

viral expression of HBsAg and HBcAg with MHC 1 which activates CD8 t cells which damage hepatocytes

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58
Q

PDA sound

A

continuous machine like murmur loudest at S2

left intraclavicular region

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59
Q

EBV on blood smear

A

See CD8+ T cells because they proliferate more and destroy the infected B cells

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60
Q

High Hct with normal RBC mass

A

Relative polycythemia

causes: dehydration and excessive diuresis

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61
Q

High Hct, increased RBC mass, low epo levels

A

Polycythemia vera

all three cell lines increase

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62
Q

High Hct, Increased RBC mass, high epo, saO2

A

secondary erythrocytosis from hypoxia

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63
Q

Hyperphenylalanemia and elevated prolactin

A

Dihydropteridine reductase deficiency

Get downstream deficiencies that lead to neurologic impairment

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64
Q

coordination of glycogenolysis and skeletal muscle contraction

A

Ca release from SR–> stimulates phosphorylase kinase–> phosphorylase glycogen phosphorylase (activate)

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65
Q

Defective ApoE

A 
Familial dysbetalipoproteinemia (type III hyperlipoproteinemia)
elevated Chylomicron and VLDL remnants

Palmar xanthomas
premature atherosclerosis

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66
Q

defective LPL or ApoC2

A

hyperchylomicronemia (type I)
Acute pancreatitis and eruptive xanthomas
increased everything

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67
Q

Defective LDL receptor

A 
familial hypercholesterolemia (type II)
premature atherosclerosis and tendon xanthomas
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68
Q

Increased VLDL

A 
Familial hypertriglyceridemia (type IV)
pancreatitis
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69
Q

Cofactors for Pyruvate dehydrogenase

A 
Tender Loving Care For Nancy
Thiamine
Lipoate
Coenzyme A
FAD
NAD

(also required for branched chain alpha ketoacid dehyd. and alpha ketoglutarate dehyd)

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70
Q

Sorbitol is converted to…

A

Fructose via sorbitol dehydrogenase

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71
Q

Reyes syndrome

A

Child with viral illness given aspirin
Encephalopathy, n/v, and fatty liver
Impaired beta oxidation–>impaired fatty acid metabolism in hepatic mitochondria

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72
Q

Role of ascorbate

A

Vit C
facilitates Iron absorption by keeping Fe2+ in reduced state
cofactor for DA–>NE
Hydroxylation of Proline to lysine

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73
Q

Beta glucuronidase

A

hydrolyzes bilirubin glucuronides and increases unconjugated bilirubin.

increase leads to pigmented gallstones

74
Q

Cause of pigment stones in gallbladder

A

Bacterial (e. coli) or helminthic (ascaris lumbricoides, clonorchis sinensis)

infect biliary tract–> release of beta-glucuronidase

also from hemolytic anemia

75
Q

What is a case-control study asking?

A

What happened?

Use odds ratio

76
Q

What is a cohort study asking?

A

who developed the dz? or who will develop the Dz?

use relative risk

77
Q

Buspirone

A

slow onset of action (2 wks) so no good for panic disorder

partial agonist of 5HT1A receptor

78
Q

Treatment for lung abscess

A

Clindamycin

good for anaerobes and aerobic G+ bugs

79
Q

Ivabradine

A

Cardiac rate control w/ no effect on contractility or relaxation

blocks funny channel in phase 4

80
Q

Osteocytes

A

connected via gap junctions

maintain structure of mineralized matrix and control release of Ca2+
regulate bony remodeling via signaling osteoblasts

81
Q

common cardinal veins become…

A

SVC and systemic circulation

82
Q

Exercise physiology: effects on blood flow

A

stimulation of muscle chemo and mechanoreceptors increase symp outflow thus increasing HR and contractility and vasoconstricing unused muscles

HOWEVER local metabolite production leads to arteriolar dilation w/in muscles–> decreasing systemic vascular resistance

83
Q

what influences peak bone density?

A

80% genetic
race (AA have stronger bones)
environmental

84
Q

Osgood-Schlatter dz

A

over use of secondary ossification center (apophysis) of tibial tubercle
limited leg extension

85
Q

CCA

A

3’end of tRNA used for recognizing protein

made up of chemically modified bases

86
Q

Umbilical hernia cause

A

incomplete closure of umbilical ring (defective lines alba)

reducible bulge

87
Q

Effects of renal hypoprofusion

A

increased renin release from JG cells–> hypertrophy of JG cells

88
Q

Pituitary tumor, parathyroid issues, pancreas tumor

A

MEN1

89
Q

asymptomatic hypercalcemia or renal stones with bitemporal visual field defects

A

MEN1

90
Q

Cuboidal or polygonal cells w/ abundant cytoplasm in a kidney tumor

A

clear cell carcinoma

originate from proximal tubules

91
Q

stimulus control treatment for insomnia

A

using bed only for sleep
go to bed only when tired
fixed wake up time
leave bed when unable to sleep

92
Q

location of anal fissure

A

Posterior midline (poor perfusion)

93
Q

Ras-MAP kinase pathway

A

Growth factor–> Autophos tyrosine residues–> interaction with SOS–> Active Ras (bound to GTP)–> MAP kinase–> transcription

Inactive Ras bound to GDP

94
Q

N-myc and C-myc

A

Transcription factors

95
Q

Cholesterol 7 alpha hydroxylase

A

Catalyze rate-limiting step in synthesis of bile acids

inhibited by Fibrates

96
Q

Ehlers-Danlos dysfunction

A

Deficiency in pro collagen peptidase
impaired N-terminal propeptide removal
can’t cross link collagen

97
Q

Lynch syndrome (hereditary nonpolyposis colon cancer) cause

A

Defective DNA mismatch repair

AD dz

98
Q

N-acetylcysteine

A

Treatment for CF and for acetaminophen overdose

99
Q

What causes Giant Cell arteritis?

A

cell mediated immunity
inflammatory infiltrate due to IL-6
tx with steroids and tocilizumab (ab against IL-6)

100
Q

Femoral n. location and injury

A

in psoas muscle then between psoas and illiacus

injury–> weakness of quads (difficulty with stairs and knee buckling)
sensory loss over anterior and medial thigh and leg
loss of patellar reflexes

101
Q

Kidney compensation for metabolic acidosis

A

increase HCO3 IN

Increase H+ and H2PO4 OUT

102
Q

Lactase deficiency signs

A

osmotic diarrhea

decreased pH in stool (bacterial fermentation of lactose)

103
Q

Parietal cell regulation

A

+ Gastrin, Histamine, ACh

- Prostaglandins, misoprostol, somatostatin

104
Q

parietal cell hyperplasia and enlargement of gastric folds

A

Zollinger-Ellison

105
Q

Positive empty can test

A

Supraspinatus

initial arm abduction before deltoid

106
Q

Latanoprost

A

topical prostaglandin
Galcoma tx
increases outflow

107
Q

What makes a drug have higher hepatic clearance?

A

increased lipophilicity and increased volume of distribution
lipophilicity makes it easier to enter hepatocytes and allows for a wider distribution (CNS)

108
Q

Tx for alcohol withdrawal

A

Benzodiazepines (diazepam or chlordiazepoxide)

109
Q

Ecological study

A

Looking at population data not individuals

110
Q

Homogenous deposition of eosinophilic hyaline material

A

Hyaline arteriolosclerosis

111
Q

cause of hyaline arteriolosclerosis

A

poorly controlled HTN and DM

112
Q

onion like concentric thickening

A

hyperplastic arteriolosclerosis

113
Q

hyperplastic arteriolosclerosis cause

A

due to malignant HTN

114
Q

proximal muscle weakness (trouble with stairs and standing from sitting), dry mouth and impotence

A

Lambert-Eaton myasthenic syndromes
better with muscle use
inhibition of presynaptic Ca channels
associated with small cell lung cancer

115
Q

Hydralazine

A

arteriolar vasodilator
leads to decreased SVR but stimulates baroreceptors–> symp stimulation–> RAAS–> sodium and fluid retention

also Minoxidil

116
Q

Chronic post mastectomy lymphedema with violaceous nodules

A

Angiosarcoma

117
Q

Signet ring cells

A

Gastric adenocarcinoma
infiltrate growth into stomach wall–leather bottle stomach
Loss of e-cadherin

involvement of supraclavicular LN and periumbilical nodes (sister mary joseph)

118
Q

Fixed cecum in URQ and bilious vomiting in first day of life

A

failure of midgut rotation around SMA

intestinal obstruction and midgut volvulus

119
Q

source of gonadal artery

A

abdominal aorta

120
Q

effect of bile and phosphatidylcholine on gallstones

A

more bile salt and phosphatidylcholine makes cholesterol more soluble–> decreases risk of gallstones

121
Q

Beta endorphin source

A

POMC–> just like ACTH and MSH

122
Q

Cross sectional study is what?

A

Snapshot–> measuring exposures and outcomes at the same time

123
Q

effect of nitroprusside on LV

A

decrease afterload and preload

124
Q

IgE-independent mast cell activation

A

Due to drugs (opioids, radio contrast, vanco)

degranulation due to PKA and PI3 K

diffuse itching and pain, bronchospasm and localized swelling (urticaria)

125
Q

causes of acute pancreatitis

A

Gallstones

alcoholism– also find anemia if malnourished

126
Q

Effects of insulin and hydration

A

increased serum bicarb. Intracellular shift of K+–> decreased serum K+

decreased serum osm

127
Q

Chronic interstitial nephritis and papillary necrosis

A

NSAID-associated chronic renal injury

months after taking NSAID

128
Q

Cause of Mallory-Weiss tears

A

increased intraabdominal pressure from vomiting or retching

can also find hiatal hernias

129
Q

white/yellow pseudomembranes on sigmoidoscopy + abdominal pain and diarrhea

A

C. Diff from antibiotics

cytotoxin A–diarrhea
Cytotoxin B–colonic epithelial cell necrosis and fibrin deposition

130
Q

Oliguria after a few days of hospitalization for internal bleeding

A

ATN

131
Q

Recovery phase of ATN

A

tubular re-epithelization and recovery

risk of hypokalemia

132
Q

Cirrhosis and estrogen

A

decreased P450 leads to decreased free tosterone/estrogen ratio

produces more sex hormone binding protein

Get gynecomastia, testicular atrophy, spider angiomata (dilation from estrogen), decreased body hair

133
Q

Liver biopsy with lymphocyte infiltration and granulomatous destruction of interlobular bile duct

A

Primary biliary cirrhosis

autoimmune dz w/ Anti-mitochondrial Ab

134
Q

middle aged woman with pruritus and fatigue w/ pale stools and dark urine

A

Primary biliary cirrhosis

cholestasis–>jaundice, pale stool, dark urine

can also get xanthelasma

135
Q

what do you see with reactive lymphoid hyperplasia that makes you suspect malignancy?

A

Monoclonal T-cell receptor gene rearrangements

136
Q

lung mass, progressive dizziness, limb and truncal ataxia, dysarthria and visual disturbances

A

Paraneoplastic cerebellar degeneration

cerebellar symptoms and small cell lung cancer

Autoimmune w/ antibodies against purkinje neurons (Anti-Yo, anti-P/Q, anti-Hu)

137
Q

Location of atherosclerosis

A

Abdominal aorta>coronary >popliteal>carotid artery

138
Q

Major cause of mortality in lung transplants

A

bronchiolitis obliterans

Chronic rejection–destruction of small airways

dyspnea and wheezing

139
Q

PAS stain

A

Whipple dz

stains glycogen and mucopolysaccharides

140
Q

older man with weight loss, diarrhea, arthritis, fever and adenopathy

A

Whipple dz

foamy macs with PAS+

141
Q

why are reticulocytes blue with wright-giemsa stain?

A

Residual rRNA

142
Q

Urinary 5-hydroxyindoleacetic acid

A

Carcinoid syndrome

143
Q

histology of a lung hamartoma

A

islands of mature cartilage, fat, smooth muscle and clefts lined by respiratory epithelium

144
Q

fluctuating painless lymphadenopathy

A

Follicular lymphoma
indolent non-hodgkin lymphoma

from B cells

145
Q

Splenomegaly and pancytopenia in older man

A

Hairy cell leukemia

Tartrate-resistant acid phosphatase (TRAP)

146
Q

Effects of obesity on the lungs

A

Restrictive lung disease
decreased compliance
Decreased ERV and FVC (as well as TLC)

147
Q

third brachial pouch

A

inferior parathyroid and thymus

148
Q

elevated aldo and renin

A

Secondary hyperaldosteroninsm
causes:
renal artery stenosis, diuretics, malignant HTN, Renin secreting tumor (JG cell tumor)

149
Q

Antiviral tx for VZV with resistance

A

Cidofovir and Foscarnet

do not need virus to phosphorylate them

150
Q

Etanercept

A

TNF-alpha inhibitor
tx for moderate to severe RA (along with methotrexate)
Acts as decoy receptor

-cept–> receptor molecule

151
Q

Raloxifine

A

SERM that inhibit osteoclast differentiation

152
Q

HTN, Hypokalemia, metabolic alk, decreased renin

A

Primary hypoaldo

153
Q

Aldo antagonist

A

Spironolactone, epleronone

SE: gynecomastia

154
Q

Tx for delirium

A

Low dose haloperidol for acute agitation and psychosis

155
Q

most common benign tumor of liver

A

Cavernous hemangioma–> dilated blood vessels in 30-50yo

156
Q

Inheritance of polycystic kidney dz

A

AD!!

Adults are DOMINANT Babies are NOT

157
Q

-dronate

A

Bisphosphonates

inhibit osteoclast activity

158
Q

Denosumab

A

bind RANKL

159
Q

Virus that leads to aplastic crisis in sickle cell pts

A

Parvovirus B19

Non enveloped single stranded DNA

160
Q

Proteasome inhibitors

A

tx for multiple myeloma
Bortezomib
inhibition leads to cell apoptosis

161
Q

Triptan MOA

A

postsynaptic serotonin agonist

162
Q

Why give sublingual or rectally?

A

Avoid high first pass in the liver

163
Q

Pancytopenia, venous thrombosis, hemolytic anemia

A 
Paroxysmal nocturnal hemoglobinuria 
Coombs -
CD 55/59 -
Cause: increased complement mediated RBC lysis 
Tx: Eculizumab
164
Q

Hemosiderosis

A

iron buildup in kidney due to chronic hemolysis

165
Q

Actinic Keratoses increase risk of…

A

Invasive squamous cell carcinoma

166
Q

Colitis associated carcinoma features

A

multifocal
Develop p53 mut EARLY, LATE APC mut
progresses from flat and non-polypoid dysplasia

167
Q

Theophylline intoxication

A

Seizures, tachyarrhythmias, n/v. diarrhea

tx: Beta blockers

168
Q

Hepatocyte swelling and cytoplasmic emptying (ballooning)

A

Acute viral hepatitis

Hepatocyte necrosis and apoptosis

169
Q

Councilman bodies

A

apoptosis of hepatocytes with cellular shrinkage and nuclear fragmentation with eosinophilia

seen in acute viral hepatitis

170
Q

SE Niacin

A

decreased renal excretion of uric acid–>acute gout

flushing, hyperglycemia, hepatotox

171
Q

Dyspnea, chest pain, hemorrhagic pleural effusion, pleural thickening

A

Mesothelioma

long slender microvilli and tonofilaments

172
Q

Pityriasis versicolor

A

Malassezia sp.

stratum corneum, spaghetti and meatballs

173
Q

Autoimmune destruction of melanocytes

A

Vitiligo

174
Q

Matrix metalloproteinases

A

wound healing

encourage myofibroblast accumulation at wound edges and tissue remodeling

175
Q

Hospitalized patient with ballooning cells and vacuolar degeneration of proximal tubule cells

A

ATN

Ischemic
or nephrotoxic (ethylene glycol)
176
Q

Oxalate crystals in tubular lumen

A

ethylene glycol poisoning

high anion gap met. acidosis

177
Q

Trastuzumab

A

tx for Her2+ breast cancer

blocks activation of tyrosine kinase

178
Q

SE of bile acid-binding resins

A

GI upset, impaired absorption, hyperTGs

179
Q

beta blockers plus NDHP CCB

A

additive negative chronotropic effect–> bradycardia and hypotension

180
Q

Pink mesangial matrix overgrowth and glomerular BM thickening

A

Kimmelstiel-Wilson nodules

DM glomeruli nephropathy

STEP1 Flashcards (9 decks)

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