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Step 1 - Elise > Kaplan > Flashcards

Kaplan Flashcards

1
Q

Low fasting blood glucose with ___ C-peptide means what?

a) increased
b) decreased

A

a) increased C-peptide due to insulinoma or sulfonylurea abuse
b) decreased C-peptide due to exogenous insulin

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2
Q

A female has increased serum LH, increased testosterone, decreased FSH, cystic follicles.

What?
Treatment

A

PCOS, resulting in hirsutism, amenorrhea, and obesity.

Treatment - spironolactone to block MC-R (diuretic) and anti-androgen (tx hirsutism).

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3
Q

A 42 year old female with hyperthyroid symptoms, increased T4 and decreased radioactive iodine uptake.

Suspect?

A

factitious thyrotoxicosis

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4
Q

Clumped Leydig cells producing insufficient testosterone, leading to decreased plasma T, increased plasma LH, and increased plasma estrogen. decreased inhibin –> increased FSH.

A

Klinefelter

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5
Q

What antimicrobial drug potentiates effects of warfarin? Why?

A

Ketoconazole, clarithromycin, ciprofloxacin, protease inhibitors are potent inhibitors of P450 enzymes.

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6
Q

carbamazepine, phenytoin, phenobarbital, rifampin - all have what in common?

A

They are potent hepatic enzyme inducers

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7
Q

Three main defenses against hypoglycemia.

A 
Decreased insulin (this is lost in DM1).
Increased glucagon (this is lost in DM1).
Increased epinephrine secretion (remains in DM1).
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8
Q

Downey type 2 cells are indicative of?

A

They are CD8 cytotoxic T cells, atypical lymphcotosis in the peripheral blood: indicative of Infectious mono caused by EBV.

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9
Q

Stellate granuloma, caused by gram negative bacillus, think?

A

Bartonella Henslae - Cat-scratch disease

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10
Q

Fungus, Camping in AZ v. Camping in Ohio-MS River Valleys.

A 
Coccidiomycosis (AZ)
Histoplasma capsulatum (OH-MS)
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11
Q

Rose garden fungus

A

Sporothrix schenckii

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12
Q

MCV values for…
Macrocytic anemia
Microcytic
Normocytic

A

Macrocytic 100
Normocytic: 80-100
Microcytic is less than 80

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13
Q

MCV >100. Neuro sx = what etiology?

No neuro sx = what etiology?

A

Macrocytic anemia caused by:
Neuro=B12 deficiency (methylmalonic acid)
No neuro=folate deficityy

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14
Q

Parvo B19, EBV, HIV, Hepatitis - all can cause what?

A

aplastic anemia

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15
Q

The acute phase reactant that plays a key role in iron regulation, and is the key mediator of Anemia of Chronic Disease.

A

Hepcidin, which internalizes iron and decreases iron release from macrophages and enterocytes.

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16
Q

IL-6 does what to hepcidin? How?

A

Increases hepcidin expression, leading to decreased absorption of iron from intestines and blockage of iron release from macrophages.

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17
Q

Decreased MCV, low TIBC, high Ferritin, low serum iron.

A

Anemia of Chronic Disease

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18
Q

Decreased MCV, low TIBC, high Ferritin, high serum iron.

A

Sideroblastic Anemias in which iron is available to developing erythrocytes, but not ised effectvely (X-linked ALAS-2 mutation)

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19
Q

High MCV with normal iron and normal MCV

A

nutritional megaliblastic anemias, secondary to folate for Vitamin B12 deficiency

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20
Q

Binucleate cells

A

Reed sterberg - ACD due to Hodgkin

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21
Q

Auer Rods - cancer and causes what if released by chemo?

A

Acute myelogenous Leukemia

causes DIC

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22
Q

transvaginal pudendal nerve block uses ___ as bony landmark?

A

ischial spine and sacrospinou sligament

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23
Q

21-hydroxylase deficiency

A

CAH (b/u of progesterone –> 17-hydroxyprogesterone

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24
Q

MPO stain

A

evaluates neuts, deficiency in MPO similar to chornic granulomatous disease. And used for AML.

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25
Q

Nitroblue tetrazolium

A

evaluate chornic granulomatous disease.

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26
Q

PAS stain

A

polysaccharides or glycoproteins or fungus

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27
Q

B cell, old men, SM, pancytopenia. stain?

A

hairy cell leukemia. TRAP with dry tap due to fibrosis.

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28
Q

primitive cell marker

A

CD34, TdT, CD10

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29
Q

mature cell marker

A

CD40, IgG, B7, cytoplasmic mu chains

30
Q

Primary defense against chlamydia/obligate intracellular pathogens

A

cell mediated cytotoxicity (Th1 dominant response)

31
Q

Primary defense against strep/staph/extracellular bacteria

A

complement mediated lysis

32
Q

Prevention of autoimmune diseases/returning an immune response to homeostasis

A

T-reg cells.

33
Q

associate a thyroidectomy with consequential hypocalcemia with…

A

hypoparathyroidism: reduced intestinal cell calcium transporter activity - PT-glands accidentally removed

34
Q

PTH action

A

kidney: it activates 1-hydroxylase, converting 25-hydroxyvitamin D3 to its active metabolite (1,25-dhydroxyvitamin D3) –> decreasing serum Ca

35
Q

five main tumors with paraneoplastic syndromes that are associated with overproduction of EPO

A

hepatocellular carcinoma, RCCa, hemangioblastoma, pheochromocytoma, uterine myomata

36
Q

increased carboxyhemoglobin indicates what?

A

CO toxicity (occupational)

37
Q

erythropoiesis, increased viscosity, low levels of EPO

A

polycythemia vera

38
Q

Alpha thalassemia trait v. HBH v. HbBarts

A

trait=2/4 allele deletion
HBH=3/4 allele deletion
Hb Barts=4/4 allele deletion

39
Q

male with alpha thalassemia trait has child with normal partner - probability he will have a child with trait

A

1/2 (probabliity he will transmit the 2 mutaitons together)

40
Q

At clinically relevant doses of warfarin, what factor is significantly affected? Result on labs?

Overdose?

A

Factor 7, prolonged PT/INR (extrinsic). NORMAL PTT.

Overdose - both PT and PTT elevated.

41
Q

What deficiency results in feminized external genitalia in a 46XY.

A

5alpha-reductase

42
Q

Infancy (Salt wasting) or childhood (percocious puberty) - what deficiency?

A

17alpha-hydroxylase

43
Q

Competitive inhibitor of 5alpha-reductase.

A

Finasteride, used to treat androgenic alopecia and BPH. CI in pregnancy

44
Q

What is the primary receptor for growth factors (of the 5 major types).

A

intrinsic tyrosine kinases.

Ras–> MAPK activation—> cell growth

45
Q

Most common cause of secondary hyperparathyroidism.

A

Chronic renal failure.

decreased phosphate excretion, = increased plasma phosphate, inhibiting Vit D production, decreasing intestinal Ca absorption, further lowering plasma Ca and stimulating PTH

46
Q

Dermatitis, tenosynovitis, polyarthritis triad. Sexually active, pili with antigenic phase variation that occur in pili (increased recurrent infectiton susceptibilty).

A

Gonococcal dermatitis-arthritis syndrome

47
Q

Polyarteritis in sexually active patients, think?

A

Neisseria gonorrhea.

48
Q

Triad of low grade fever, pain, impaired ROM.

A

Septic arthritis.

49
Q

Equation for active tension.

A

Active tension = total tension = passive tension

50
Q

Genetics:

Duchenne v. Becker MD

A

X-linked
Duchenne - frameshift
Becker - missense/point mutation

51
Q

Winged scapula - nerve, muscle, action deficit

A 
long thoracic 
(serratus anterior muscle, shoulder abduction/flexion)
52
Q

Pathogen that causes: Rash, bell’s palsy, chronic arthritis, heart palpitations.

A

borrelia burgdorferi (lyme disease)

53
Q

Axillary and radial nerves:
from what cord?
What muscle does axillary nerve supply?

A

Posterior cord.

Axillary nerve supplied deltoid and teres minor

54
Q

Tongue:

  • Sensory: posterior 1/3 vs. anterior 2/3
  • Taste: posterior 1/3 vs. anterior 2/3
  • Motor and actions of genioglossus, hyoglossus, palatoglossus muscle
A

Anterior 2/3 sensory trigeminal (CN5) and taste facial (CN7)
Posterior 1/2 - both sensory/taste are CN9 (glossopharyngeal)
-Motor and actions of genioglossus (protrusion to opposite; CN12), hyoglossus (retraction (CN12), palatoglossus muscle (up towards palate (CN10)

55
Q

What nerve carries general sensation from anterior 2/3 of tongue. What else is this nerve responsible for

A

V3 (trigeminal 3). Also responsible for motor innervation of muscles of mastication - temporalis, masseter, medial and lateral pterygoids.

56
Q

Chorea, athetosis (slow writhing movements), demenita, personality change. 20-40 year old.

What is this, what is the anatomical finding upon autopsy, what genetics?

A

Huntington Disease. AD CAG repeat expansion on chromosome 4). Find caudate nucleus atrophy.

57
Q

What structure is responsible for fine tuning movement?

Lesion of what part of this structure manifests as wide-based “drunken” gait?

Lesions of ___ hemispheres of ___ will affect movement of what body parts?

A

Cerebellum

vermis

lesions of LATERAL hemispheres of CEREBELLUM will affect movement of EXTREMITIES.

58
Q

What innervates the posterior half of the External Auditory Canal?

A

Auricular branch of Vagus Nerve (nerve that causes vasovagal syncope, cough, gag)

59
Q

Hip action nerve: actions

  • superior gluteal
  • obturator
A

abduction

adduction

60
Q

All four limbs affected paralyzed, bilateral Babinski, only vertical eye movements.

A

Basilar Artery - locked in syndrome.

Supplies ventral/medial pons.

61
Q

Internal capsule blood supply from ___ artery. Ischemia commonly due to uncontrolled HTN causes ___ deficit.

A

Middle Cerebral Artery.

Contralateral hemiplegia (CST).

62
Q

A lacunar stroke (lenticulostriate arteries) can result in a pure motor deficit due to involvement of the ____ internal capsule. Symptoms of this include ___.

A

Posterior IC.

Symptoms - UMN deficit signs on contralateral side of body. Contralateral lower face, sparing forehead.

63
Q

Medial longitudinal fasciculus connects the ___ nerve to the contralateral oculomotor nucleus, allowing conjugate gaze.

Disease and state when MLF is demyelinated producing inability to adduct affected eye in lateral conjugate gaze.

A

abducens

Multiple sclerosis, often has intranuclear opthalmoplegia.

64
Q

Salivary glands innervated by glossopharyngeal v. facial nerves.

A

Glossopharyngeal nerve innervates Parotid Gland (via Otic Ganglion)
Facial nerve innervates Submandibular and Sublingual Glands

65
Q

Cortex that processes visual information

A

occipital cortex

66
Q

Lesion of ___ nerve leads to loss of sensation of laryngeal mucosa above the vocal folds and loss of cough refelx?

A

Internal Branch of superior laryngeal nerve

67
Q

Right lower quadrantanopia caused by lesion of left ___ lobe.

Right upper quadrantanopia caused by lesion of left ___ lobe.

A

parietal lobe

temporal lobe

68
Q

Left sided sensory neglect is caused by damage to what two areas?

A

Right frontal or parietal lobe.

69
Q

Rare genetic disease characterized by accumulation of abnormal chemical material in lysosomes as a result of abnormal phosphotransferase in _____ (cell organelle).

A

Golgi apparatus

I-Cell Disease

Golgi cannot phosphorylate mannose residues on N-glycosylated enzymes destined to enter lysosomes.

70
Q

Antagonists of ___ receptor effective in tx BPH.

A

Alpha 1 antagonists.
Terazosin and doxazosin.

Alpha-1R found on bladder neck and stroma of prostate and in vasculature (inc. BP).

71
Q

hypersensitivity reaction to parasites.

A

type 1 - eosinophilic response

72
Q

Infant with hepatomegaly, cardiomegaly (often the CoD), and muscle weakness.

Disease and enzyme deficiency responsible.

A

Pompe

lysosomal alpha-1,2-glucosidase

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