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Kaplan clues Flashcards

1
Q

PLAP (placental alkaline phosphatase) positive (germ-cell tumor)

A

Seminoma
Radiosensitive

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2
Q

hCG pos tumor

A

Choriocarcinoma

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3
Q

AFP pos

A

embryonal cell carcinoma.
melingomyoloceal
Downs

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4
Q

What is elevated in Sertoli call tumor

A

testosterone

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5
Q

Reinke crystal, high androgens or estrogens

A

Leydig cell tumor

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6
Q

neuroendocrine tumors common location

A

Adrenal gland
Bifurcation of the aorta (iliac vessel ) peri-aortic sympathetic ganglia

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7
Q

tinia corporis treatment

A

clotrimazole, miconazole, terbinafine, butenafine

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8
Q

fluticasone treatment for

A

inflammatory dermatologic condition

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9
Q

Diabetes kidney below 10 years present with

A

microalbuminuria: mesangial expansion with GBM thickening

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10
Q

Diabetes kidney above 10years present with

A

Macroalbuminuria:
kimmelstiel Wilson nodules
FSGS
ESRD

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11
Q

Severe HTN effect

A

vascular remodeling
ischemic or hemorrhagic stroke
decrease blood flow= metal status effect

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12
Q

PTSD nightmares treatment

A

a1- antigonist= prazosin

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13
Q

dysphagia, obstruction and halitosis: out pouching of esophagus just below the cricopharyngeus muscle

A

Zenker diverticulum

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14
Q

Diarrhea and decrease bone mass

A

celiac disease/sprue

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15
Q

treatment of endomysial IgA, reticulin IgA, Dermatitis herpetiformis

A

*Celia sprue
dietary adjustment

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16
Q

syndrome of apparent mineralocorticoid excess (SAME): 11-B-Hydroxysteroid dehyrogenase 2

what is elevated

A

elevated cortisol

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17
Q

11-B-HSD2 function

11 beta-hydroxysteroid dehydrogenase type 2

A

degrade Cortisol
low urine-free cortisol

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18
Q

11-OH Deficiency

levels of K, RAAS and cortisol

A

hypokalemia, low RAAS and cortisol

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19
Q

1st hyperaldo adrenal tumor

levels of Aldo, Renin, Cortisol

A

high cortisol and Aldo
low renin and aldosterone secretion

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20
Q

Leishmania species are transmitted by

A

phlebotomize sandflies

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21
Q

Treatment for Leishmaniasis

A

sodium stibogluconate or
meglumine antimoniate

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22
Q

Altered mental status in COPD dt

A

hypercapnia

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23
Q

linear deposition of IgG in GBM is associated with

A

Pulmonary hemorrhage
RPGN
Goodpasture syndrome

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24
Q

PPV and NPV affected by

A

prevalence
prevalence=PPV/NVP

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25
Q

defective CD40L on TH2 cells

A

X-linked Hyper IgM
Isotype switching problem

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26
Q

Gi

A

MAD2

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27
Q

Gq

A

HAVe 1 M3 M1, AT1

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28
Q

GS

A

B1,B2,D2

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29
Q

TK family

A

growth factors, insulin

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30
Q

JAK-STAT

A

cytokines

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31
Q

Elevated methylmalonic acid

defficiency and effect

A

neuropathy in b12 deficiency

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32
Q

propionyl CoA & Methylmalonic acid

A

B12

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33
Q

congenital intracranial calcification

A

Toxoplasmosis

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34
Q

Treatment of Toxoplasmosis MOA

A

TMP SMX
Dihydrofolate reductase
Dihydropteroate synthetase (PABA)

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35
Q

China/Africa pt with nasopharyngeal carcinoma associated with

A

Burkitt lymphoma
Mononucleosis
Hodgkin’s
non-Hodgkin’s lymphoma

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36
Q

ACEI promotes

A

low Na+
high K+
no impact on phosphate handling
high bradykinin (preventing bradykinin breakdown)

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37
Q

Unilateral orbital swelling and redness, left lateral gaze palsy, ptosis,

A

Thrombosis
Cavernous sinus thrombosis

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38
Q

excessive sweating (Hyperhidrosis) can be treated with botulinum toxin(moa)

A

Prevents ACh release form sympathetic cholinergic neuron

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39
Q

neumerous tumor: colon, endometrial and ovarian

A

MLH1

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40
Q

GI stromal tumor, melanoma, seminoma (PLAP) AML

Mutation

A

KIT

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41
Q

APC

type of cancer

A

Polyposis : FAP
Gardner syndrome
Turcot Syndrome

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42
Q

VHL gene

inheritance,chromosome

A

Chromo 3, AD

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43
Q

VHL associated with

A

Pheochrom
hemangioblastoma (CNS…)
renal cell carcinoma
renal cyst

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44
Q

high bicarb, high pH, high P co2, hypo K (metabolic alkalosis) caused by drug?

A

Chronic furosemide use

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45
Q

reactivation VZV treatment

A

famciclovir

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46
Q

VZIg use in neonates and immunesuppressed for

A

VZV exposure

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47
Q

crescent shape protozoa (hiking)
facelike appearance with flagella

A

Giardia

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48
Q

bloody dysentery and flask-shaped ulcer, multinucleated cysts or trophozoites

A

Entamoeba histolytica

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49
Q

diarrhea with acid-fast cyst

A

cryptosporidium parvum

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50
Q

Increase GI Acid

A

Gastrin
Histamine
ACH

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51
Q

decrease GI acid

A

PG E2 and somatostatin

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52
Q

what is responsible for fetal sex indicator

A

dihydrotestosterone

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53
Q

histologic findings of Wilms tumor(nephroblastoma)

A

embryonic glomerular structures

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54
Q

Bone marrow expansion of calvarium

A

beta chain absent
sickle cell
thalasemia

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55
Q

CLL treatment

A

TK inhibitor Ibrutinib

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56
Q

hydroxyurea MOA

A

ribonucleotide reductase inhibitor in
sickle cell and myeloproliferative disorder

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57
Q

Most appropriate treatment for anti-phospholipid antibody syndrome

A

Warfarin

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58
Q

a proliferative synovitis with many lymphocytes, macrophages and plasma cells seen with?

A

RA

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59
Q

what is common with CHF and Pregnancy or teen females

A

S3 heart sound
volume overload

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60
Q

microscopic findings of medullary carcinoma of breast (BRACA1)

A

well-circumscribed, nests of malignant cells associated with prominent lymphoplasmacytic infiltrate.

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61
Q

diarrhea that resolves when nutrition is provided intravenously

A

Osmotic diarrhea
unabsorbed solutes: malabsorption syndrome

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62
Q

Body dysmorphic disorder associated with

A

disruption of day-to-day life and functioning

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63
Q

Lab: anti-glutamic acid decarboxylase (anti-GAD65)

A

T1DM
low insulin =lipolysis=>B-hydroxybutyrate

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64
Q

MOA of atypical antipsychotic for schizo

A

Blocks D2 and 5-HT 2a

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65
Q

atypical antipsychotic medication have

A

less anticholinergic and extrapyramidal SE but may cause weight gain and metabolic syndrome

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66
Q

SSRIs treats

A

mood disorder: anxiety, depression

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67
Q

visceral bias

A

pos/neg feelings toward a pt that influence clinical decision-making

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68
Q

anchoring bias

A

relying on the first piece of information obtained.

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69
Q

vertical gaze palsy, unable to look up

A

Pinealoma
tectum of the midbrain

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70
Q

colorectal adenocarcinoma is associated with

A

inflammatory bowel disease
UC

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71
Q

specific lab for SLE

A

anti-DS DNA and Anti-smith

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72
Q

drug induce SLE lab

A

Anti-histone

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73
Q

Anti-centromeric antibody

A

CREST

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74
Q

anti-mitochondrial antibody

A

1st biliary cirrhosis

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75
Q

Anti-TSH
Hyperthyroidism

A

Graves Dz

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76
Q

cardiac glycoside that directly inhibit Na/K Atpase

A

Digoxin: decrease Na efflux from monocyte -> ca increase-> increase contraction

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77
Q

Autosome: Prader-willi and angelman are

A

microdeletion chrom 15

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78
Q

Autosomal dominant polycystic kidney dz associated with

A

subarachnoid hemorrhage
saccular aneurysm
cyst in: liver, pancreas, spleen, Lungs

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79
Q

unilateral headache, jaw claudication, visual impairment and ESR

A

temporal arteritis

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80
Q

focal granulomatous vasculitis involving medium and larg arteries including carotid

A

temporal (gaint cell) arteritis

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81
Q

Temporal arteries is associated with ________________ in 50% of patients

A

Polymyalgia rheumatica ( shoulder pain and stiffness)

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82
Q

contributing factors to primary htn

A

dehydration
sympathetic activation
increasing RAAS => raises SVR

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83
Q

OTC catalizes

A

citrulline from carbamoyl phosphate and ornithine

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84
Q

defective OTC builds

A

ammonia and orotic aciduria

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85
Q

Decrease Citrulline, mitochondrial enzyme?

A

OTC

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86
Q

what reduces intestinal cell calcium transporter activity

A

Vit D as the result of neck surgery affecting PTH

PTH activates 1-hydroxylase in kidney

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87
Q

small laminated concentric calcified spherules on light microscopy

A

Psammoma bodies

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88
Q

PSaMMoma

A

papillary carcinoma of thyroid
Serous papillary cystadenocarcinoma
Malignant mesothelioma
Prolactinoma (M)

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89
Q

precocious sexual development in a female. suspect

A

granulose cell tumor
estrogen secreting

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90
Q

treatment for panic attack

A

Benzo to increase frequency of GABAa chloride channel opening

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91
Q

Characteristics of PCOS

A

ovulatory dysfunction and hyperandrogegism

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92
Q

firstline therapy for PCOS

A

combo oral contraceptives

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93
Q

high dose of midazolam needed for sedation is due to

A

cross-tolerance

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94
Q

A virus cytotoxic to fetal erythroid precursor cells, transplacental transmission

A

Parvo B19

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95
Q

Fetal US showing ascites, pericardial effusion and skin edema

A

hydrops fetalis
B19

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96
Q

a drug that cause corneal deposits

use for malaria and RA

A

Hydroxychloroquine

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97
Q

immunosuppressant blocks T-cell activation

A

cyclosporine

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98
Q

binds cyclophilin and inhibits calcineurin MOA of

A

cyclosporine

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99
Q

side effect of drug that prevents IL-2 transcription

A

Nephrotoxicity
severe hypertension
gingival hyperplasia

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100
Q

Hydroxychloroquine indicated for

A

malaria
SLE
RA

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101
Q

cyclosporine should be avoided in

A

hyperlipidemia and hyperglycemic pt

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102
Q

vaginal candida treatment

A

fluconozale
Topical azales

inhibits ergosterol synthesis

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103
Q

fungal cell wall inhibitor (invasive systemic aspergillosis )

A

the fungin family

Anidulafungin
caspofungin
micafungin

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104
Q

Amphotericin B and Nystatin moa

A

cell membrane integrity

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105
Q

Lanosterol synthesis affected by

A

terbinafine (dermatomycoses)

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106
Q

blood-tinged sputum (bug)

A

Strep Pneumo
Alpha-hemolytic Gram-pos cocci

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107
Q

Optochin sensitive, bile-soluble

A

strep pneumo

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108
Q

adult lobar pneumonia

A

Strep pneumo

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109
Q

Beta-hemolytic gram-pos cocci

A

Strep pyogenes (group A)
Strep agalactiae (Group B)

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110
Q

perinatal biliary atresia, dark urine, pale stool

3 viruses and

A

Rotavirus
Reovirus
cytomegalovirus
autoimmune

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111
Q

Bacitracin sensitive

A

Strep pyogenes

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112
Q

cause of hydrocele

A

Incomplete fusion of the processus vaginalis

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113
Q

microbiota responsible for vaginal acidity

A

Lactobacillus, a gram-positive, anaerobic rod

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114
Q

Lactobacillus create acidic pH by

A

breaking down glycogen to lactic acid
inhibit pathogen growth in the vagina

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115
Q

mycoplasma pneumoniae treatment

A

Azithromycin
Clarithromycin
Erythromycin

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116
Q

First-line treatment for atypical pneumonia

A

Macrolides

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117
Q

Intracellular eosinophilic inclusions composed of alpha-synuclein protien

A

parkinson disease

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118
Q

Lewy bodies also associated with

A

dementia
visual hallucinations
Parkinsonia-like symptoms

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119
Q

spongiform symptom—-Creutzfeldt-jakob

A

myoclonus

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120
Q

most beneficial effect of macrophage killing

A

interferon-gamma from TH1

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121
Q

atlantoaxial instability

A

RA
Down syndrome

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122
Q

Eosinophilic granulomatosis with polyangiitis, necrotizing vasculitis affecting multiple organ systems

A

p-ANCA

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123
Q

Elevation of c-ANCA associated with

A

Wegener granulomatosisis
granulomatosis with polyangiitis

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124
Q

Tophaceous gout is on histology skin biopsy from painful great toe

A

giant cell granuloma

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125
Q

cytokines for allergic rhinitis

A

IL-4- IgE antibody-mediated degranulation of mast cells

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126
Q

Immune response in rhinorrhea

A

Th2 response
cytokines: IL-4, IL-5 and IL-13

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127
Q

4-6 weeks post MI

A

autoimmune pericarditis
Dressler syndrome

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128
Q

ECG of pericarditis

A

diffuse ST elevation in many limb leads

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129
Q

medullary thyroid carcinoma associated with

A

MEN2A and MEN2B

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130
Q

Diarrhea and occasional flushing with amyloid demonstrating apple-green birefringence

Thyroid serotonin syndrome link

A

Thyroid parafollicular cells (c-cells)

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131
Q

autosomal dominant, ash-leaf, intellectual disability and seizures

A

tuberous sclerosis

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132
Q

tuberous sclerosis risk of benign neoplasm striated muscle

A

cardiac rhabdomyomas

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133
Q

monoclonal antibody that binds to GP IIb/3a to cause bleeding disorder

A

abciximab

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134
Q

platelet disorder like ITP and anti platelet agents associated with what lab finding?

A

normal PT and PTT, increased bleeding time

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135
Q

follicular conjunctivitis, scarring and blindness with intracytoplasmic inclusion bodies

A

chlamydia trachomatous

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136
Q

Infectious inactive form of chlamydia are

A

extracellular elementary body

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137
Q

non-infectious active form of chlamydia are

A

intracytoplasmic Reticular inclusion body

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138
Q

AD with 80% penetrance, probability of normal child

A

AD 50%
Child 50% m/F

=.5 *.5= 0.25

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139
Q

wiskott-Aldrich, X-linked mutation, IgM and IgG levels low

A

Thrombocytopenia
Eczema
Recurrent sinopulmonary infections

140
Q

lab: elevated Phytanic acid oxidase: organelle involve

A

Peroxisomal enzyme
Refsum disease
Retinitis pigmentosa

141
Q

appropriate anti- inflammatory for acute RA

A

NSAID: Celecoxib-COX-2 inhibitor

142
Q

Chronic RA treatment

A

DMARDs: eg: methotrexate and sulfasalazine

143
Q

toxin injection leading to reversible depending flaccid paralysis

A

Botulism from vacuum-packed food

canned food in adult
spores in kids

144
Q

primary TB infection

A

acid-fast bacilli
caseating granulomas: ghon complex

145
Q

destructive inflammatory lesion of the bone dt infected wound

A

Staph a. : Osteomyelitis

146
Q

Osteomyelitis x-rays presentation

A

destructive lytic lesion
periosteal elevation

147
Q

Lyme dz : Oxodes tick

manifestation

A

erythema migrans
AV block
Arthritis
facial palsy
type III hypersensitivity
Doxy

148
Q

Clostridial myonecrosis

caused by

A

exotoxin: alpha-toxin, lecithinase cause hemolysis=jaundice

149
Q

C.Diff risk factors

A

Toxin A/B
Antibiotic
watery diarrhea

150
Q

Risus sardonicus caused by

A

Tetanospasmin of C. tetani

151
Q

Aging is associated low GFR due to

A

glomerulosclerosis

152
Q

substrates for 21-a-HO

A

Progesterone
17 a-hydroxyprogesterone

153
Q

Potassium is ____________ in 21 a-hydroxylase

154
Q

11 B-HO (11 yo are salty): substrate

Electrolyte, defective

A

High Na retention, high BP
high 11 deoxycorticosterone

155
Q

17 a- HO (17 yo are salty):

Electrolyte

A

high NA, low K, HTN

156
Q

5a- reductase with 46 XX is ____________phenotype with late menarche (normal /virilization)

157
Q

5a-reductase with 46XY presentation

A

female appearing at birth
virilization at puberty (lost last chance to be a male)

158
Q

CD28 and B7 function

A

activate T-cell

159
Q

When does neonatal HSV present

160
Q

neonatal vesicular rash, lethargy, fever/hypothermia

161
Q

complication of vesicular rash on neonate

A

meningoencephalitis

162
Q

complication of hearing loss and microcephaly at birth

A

toxo
syphilis
zika
CMV
rubella

163
Q

pt with ascites, jaundice and gynecomastia

A

liver cirrhosis

164
Q

bleeding esophageal varices and portal HTN liver histology

A

fibrosis and disorganization of hepatic parenchyma

165
Q

centrilobular necrosis result from

A

ischemic injury
drug
toxic reaction

166
Q

2ndary hyperparathyroidism is caused by

A

chronic renal failure

167
Q

Lab for chronic renal failure

A

chronic low ca
high PTH
osteitis fibrosa cystica
metabolic acidosis
hyper K
uremia
fluid overload

168
Q

MC presentation of endometrial cancer in postmenopausal women

A

uterine bleeding

169
Q

endometrial biopsy shows

A

hyperplasia with atypia

170
Q

most important risk factor for endometrial cancer is

A

unopposed estrogen exposure
obesity

171
Q

How is smoking protective of endometrial cancer

A

stimulates the hepatic metabolism of estrogen

172
Q

What lab is normal with small-cell LC-ADH secretion

173
Q

ADH secretion in small-cell lung cancer lab that are decrease

A

serum Aldo
Osmolality
serum Na

174
Q

homeless pt appears intoxicated with no serum ethanol

A

ethylene glycol

175
Q

ethylene glycol effect on kidney

A

severe acute kidney injury

176
Q

treatment of Ethylene glycol

A

fomepizole
hemodialysis

177
Q

kidney stones due to ethylene glycol

A

oxalic acid + free Ca= calcium oxalate

178
Q

triple phosphate crystal seen with

A

UTI urease pos bacteria

179
Q

what is cystinuria

A

AR, excessive urinary excretion of cystine, ornithine, lysine and arginine

180
Q

corticol atrophy of frontal temporal lobe

A

frontotemporal dementia
pick dz

181
Q

Lewy body dementia present with

A

visual hallucinations and dementia
extrapyramidal motor symptoms

182
Q

focal neurological symptoms and memory loss

A

vascular dementia

183
Q

Hallmark of endometrial hyperplasia is

A

abnormal uterine/vaginal bleeding

184
Q

epithelial cells of endometrium is

A

Simple columnar epithelium

185
Q

management of HOCM pt

A

metoprolol to slow the heart rate
improve diastolic filling

186
Q

complement of anaphylatoxin

A

C3a, C4a, C5a

187
Q

C1 esterase inhibitor defi

A

hereditary angioedema

188
Q

Function of C1

A

recognize: IgG and IgM
activate complement

189
Q

pulse in Aortic Stenosis

A

Weak due to low amplitude

190
Q

mutation of MEN 2a/b

191
Q

Difference in MEN 2a/b

192
Q

2nd amenorrhea?

A

starts menses and stops

193
Q

causes of 2nd amenorrhea

A

athletes
underweight( hypothalamic)

194
Q

low GnRH, low FSH and estradiol levels results in

A

functional amenorrhea

195
Q

lab to monitor in anorexia N. refeeding

A

P04, K+, mg+
may cause fatal arrhythmias

196
Q

underdeveloped flipper limbs (phocomelia)

A

Thalidomide exposure

197
Q

Postop hepatic dysfunction, fulminant hepatic necrosis and malignant hyperthermia due to

A

Halothane
induction and maintenance of gen. anesthesia

198
Q

Histology of cardiac myxoma

A

stellate mesenchymal cell with inflammatory and endothelial cells

199
Q

Echinococcus granulosus is a custode that causes

A

hydatid cysts of the liver

cholangitis, jaundice, cirrhoris

200
Q

Treatment for echinococcus G.

small tapeworm, cholangitis, jaundice, cirrhoris

A

Albendazole
ethanol injection into the cyst to neutralize antigens

201
Q

haematobium transmission

A

cercariae in fresh water penetrate human skin

202
Q

neurocysticercosis cause of seizures is

A

taenia solium
tapeworm

203
Q

major concern with hydatid cyst is

A

anaphylaxis

204
Q

mycophenolate mofetil MOA and indication

A

inhibits inosine monophosphate dehydrogenase (purine)
immunosuppression in transplant

205
Q

inhibition of calcineurin by tacrolimus

A

Inhibits IL-2 transcription

206
Q

Daclixumab and basiliximab MOA

A

IL-2 receptor inhibition

207
Q

marfan syndrome gene

gene

A

FBN1 on chrom 15

208
Q

COL1A1 encodes for

209
Q

COL5A1 encodes for

A

Ehler-Danlos
type 5 collagen
easy bruising

210
Q

Fribrillin defect AD causes

211
Q

prevalence =

A

incidence * duration

212
Q

Renal transplant risk pyelonephritis due to

A

lack of sphincter
ascending bacteria infection

213
Q

prophylactic for renal transplant pyelonephritis

214
Q

Monoclonal antibody targeting CD20

215
Q

outer surface protein of TB causes

A

Delay Hypersensitivity response of T-cell
activate MP(IFN-Y),
recruit PMNs(IL-17 and IL-23) and
induce inflammation(INF)

216
Q

Duchenne MD is a (defect)

A

splicing defect
X-linked
Frame shift deletion or nonsense

217
Q

IL-2 transcription is blocked by

A

Cyclosporine

218
Q

Beta-hemolytic bacitracin-sensitive (GAS)

A

s. pyogenes

219
Q

colorectal adenocarcinoma associated with

A

ulcerative colitis

220
Q

SSPE: Subacute sclerosing pan encephalitis is associated with

A

Rubeola( Measles)

221
Q

Rubella(German measles) 3 day rash in adult

A

not teratogenic
persistant PDA
cataracts
sensorineural hearing loss

222
Q

Bowen disease

A

squamous cell carcinoma in situ of the penis
increase nuclear-to-cytoplasmic ratio,
crowding

223
Q

condyloma acuminatum

A

HPV

giant condyloma: more aggressive

224
Q

blocks reuptake of dopa, N EPI, serotonin

225
Q

Increase release of dopa, N EPI, serotonin

A

Amphetamine

226
Q

cocain toxicity treated with

A

supportive care and benzo

227
Q

twin separation at 0-3 day

A

2 amnion

2 chorion

228
Q

twin separation at 4-8 day

A

2 amnion

1 chorion

229
Q

twin separation at 9-12 days

A

1 amnion
1chorion

230
Q

twin separation after 12 days

A

incomplete: conjoined twins

231
Q

Polio hides in the

A

ventral horn

232
Q

Polio is associated with

A

LMNL
fasciculations
flaccid paralysis
hyporeflexia
muscle atrophy(muscle weakness)

233
Q

What are the post poliomyelitis syndrome

A

progressive muscle weakness
motor atrophy

234
Q

Pioliovirus is a

A

SS-RNA
Picornaviruses

235
Q

corticospinal tract lesions shows

A

ipsilateral spastic paresis
hyperreflexia

236
Q

C8, T1 are part of which trunk

A

lower trunk

237
Q

lower trunk lesion results in

A

clawing hand
Horner syndrome may present

238
Q

Upper trunk nerve root

A

C5, C6
lateral arm and forearm dermatome
media are rotation and flexion at the wrist

239
Q

Panic disorder

A

recurring cued and uncued panic
lasting generally 10 min
resultant behavior change

240
Q

panic attacks, excessive worry, anxiety that are difficult to control

A

Generalized anxiety disorder

241
Q

CF pt with abdominal pain

A

suspect pancreas auto digestion

242
Q

Gallstone will present with

A

colicky pain

243
Q

Mobitz 1 is: transient or permanent?

244
Q

mobitz II is a

what is the damaged tissue

A

partial AV block

245
Q

PR interval in Mobitz II is

246
Q

Mobtiz I PR is

A

progressively prolonged

247
Q

Mobitz II progress to Mobitz I or 3rd degree block

A

3rd degree

248
Q

Drugs

Blocks mobitz I/II

A

Beta-blockers, digoxin, and calcium blocker

249
Q

acetylcholinesterase inhibitors

A

increase ACH in synapses

250
Q

2-Pam (pralidoxin) and atropine treats

A

organophosphate poisoning

251
Q

cells involved with Zollinger-ellison

A

G-cell (acid secretion)
bloody diarrhea

252
Q

what is decreased in Sertoli-leydig cell tumors

A

FSH and LH

253
Q

What is increased in Sertoli-leydig cell tumor

A

testosterone

254
Q

a weak androgen secreted by adrenals only is

255
Q

slowest velocity of blood

A

capillaries
largest cross-sectional area

256
Q

CAMP test pos for

A

GBS (Strep agalactiae)
Beta hemolytic
bacitracin resistance

257
Q

increase urinary D-ALA and prophobilinogen

A

acute intermittent porphyria

258
Q

porphyria cutanea tarda enzyme

A

uroporphyrinogen decarboxylase
Most common porphyria

259
Q

Hashimoto thyroiditis

A

antithyroid antibodies
autoimmune

hyper then hypothyroidism

260
Q

Excess fructose consumption is associated with metabolic syndrome and essential HTN, why?

A

Fructose increase uric acid–>
uric acid activate RAAS…..

261
Q

hemerus surgical neck fracture affects

A

axillary nerve
abduction defect
Teres minor

262
Q

examples of channels frequently used to sublimate

A

visual arts
writing
music
mentoring…..

263
Q

eosinophilic nodular glomerulosclerosis is seen with

A

long term 15-20 years uncontrol diabetes
kimmelstiel-wilson nodules

264
Q

childhood treatment for lyme

A

Cefuroxime

265
Q

early Lyme DZ treatment

A

Amoxicillin

266
Q

Disseminated Lyme disease associated with

A

Bell’s palsy
complete heart block

267
Q

treatment for disseminated lyme

A

Cefuroxime (children)
Doxycycline (adult)

268
Q

What does GVHD and menstruation have in common

A

apoptosis: cell shrinkage, hyper chromatic pyknotic nuclei, and nuclear fragments

269
Q

duodenal obstruction with transition point b/t dilated and non-dilated bowel

A

Superior mesenteric artery syndrome

Intestinal Compression

ligament of Treitz / loss of fat pad

270
Q

Testicular cancer with lobulated fleshy appearance and nests of large malignant cells…

271
Q

the ability of genetic reassortment causing genetic shift is due to

A

Segmented genome of influenza

272
Q

drug reduce cardiac 02 demand in ischemia treatment is

A

Ranolazine

273
Q

used to prevent MI in pt with CAD

A

clopidogrel
GP2b/3a

274
Q

mcc death among ICU pt

A

Gram neg bacteremia

endotoxin (PLS)

275
Q

LPS effect

Endotoxin causes

hemodynamic and metabolic changes

A

myocardial dysfunction
DIC, ARDS
Liver/Renal failure
coma, death

276
Q

What happens to PFK with no insulin

A

Low PFK
Low glut 4 in muscle

277
Q

Recurrent median nerve action

A

thumb opposition, flex, abduct

thenar cutaneous

278
Q

treatment

Gastrinoma

proton pump inhibitor

A

lansoprazole

Nsaid associate gastric ulcer, GERD…

279
Q

metoclopramide indicated for

Prokinetic agent

A

diabetic gastroparesis

280
Q

mc nosocomial

post antibiotic severe diarrhea, scant blood

A

gram pos, anaerobic, spore rod

c-diff

281
Q

Neprohenic DI associated with

A

hi ADH and
Hi Na+

282
Q

SIADH is associated with

A

hi ADH
low NA+

283
Q

MC drug causing Nephogenic DI

A

Lithium( block adh)
Demeclocycline(treat SIADH)
Fluoride(florocarbon anesthetic

284
Q

AR

Friedreich ataxia gene

GAA

A

FXN (Frataxin) gene

chrom 9

285
Q

FXN

gait ataxia, progressive kyphoscoliosis,

atrophy of

A

spinal cord

friedreich ataxia: mito Iron processing defect

286
Q

risk factor for acute pancreatitis

severe pain radiating to the back

A

trauma
alcohol
gallstones

287
Q

post transplant prophylaxis for CMV

high mononuclear infiltration

A

Ganciclovir

288
Q

Renal condition associated with sJogren

A

Distal RTA

defective H+/HCO3

288
Q

tingling extremity

megaloblastic animia

what accumulates

A

N5-methyl THF

most stabled (trapped)

289
Q

joint aspiration with luekocytosis

RA pt with septic arthritix

treatment

A

vancomycin

290
Q

Group D strep

associated with

A

Malignancy
Bacteremia
endocarditis

B-hemolysis, growth in bile

291
Q

HIV pt with single ring-enhancing lesion in brain

A

enveloped DS linear DNA Virus

EBV

291
Q

triple-Neg BRCA1

medullary carcinoma

favorable prognostic appearane

A

nests of malignant cells associated with prominent lymphoplasmacytic infiltrate

292
Q

avoid cilostazol in

A

heart failure pt with reduced ejection fracture

PDE 3 inhibitor

293
Q

Positive CD10, CD19, CD20

A

t(14:18) BCL2

folicular lymphoma

294
Q

BCR-ABL1

A

CML and B-lymphoblastic leukemia

t(9:22)

295
Q

MAOIs antidepressant + cheeses and wine causes

A

severe hypertension

Tranylcypromine
Phenelzine
Selegiline
Isocarboxazid

296
Q

sclerosing cholangitis and iron deficiency anemia associated with

UC

A

pseudopolyps

bloody diarrhea

296
Q

Dexrozoxane

MOA

A

prevent free radical formation and prevent cardiotoxicity

Doxorubicin

297
Q

Amifostine

use for

A

Renal cisplatin toxicity

298
Q

Decreased IMP indicate

Lesch-Nyhan syndorme

A

x-linked HGPRT defect

299
Q

wilms tumor, neuroblastoma

marker

A

S100

or neurospecific enolase

299
Q

Homer-wright pseudorosettes

circular arrangements of tumor cell around a central fibrillary space

neuroendocrine markers

A

S-100 and neuron-specific enolase

sheets of small round blue cells

300
Q

rapid onset of hematuria, HTN and renal failure

A

RPGN : crescentic glomerulonephritis

301
Q

G Neg curved rod with polar flagella

associated with GBS

A

campylobacter jejuni

poultry

302
Q

Damage to occipital cortex and splenius of the corpus callosum

A

alexia without agraphia

can’t read but can write

303
Q

Granulomatosis with polyangiitis

associated with asthma and eosingophilia

A

Churg-strauss syndrome

p-ANCA (myeloperoxidase antibody)

304
Q

proteinase 3 antibody

Granulomatosis with polyangiitis

A

wagener

c-ANCA

305
Q

anaerobic metabolism

what enzyme are active in ischemic myocardium

A

glycolytic enzyme

306
Q

Freely filtered not reabsorbed or secreted

estimates GFR

A

creatinine

307
Q

child

intima thinkenning of small arteries and glomerular thrombosis/collaps

less urine, schistocytes

A

HUS in children

e-coli, shegella, salmonella

308
Q

gross presentation

marantic endocarditis

nonbacterial thrombotic endocarditis

A

small, sterile vegetation on MT valves

309
Q

Explosure to ____________________causes blastomyces dermatitidis

A

rotten wood

310
Q

appropriate initial therapy for septic shock

A

Hi dose Dopamin

alpha-1

311
Q

purplish-red mottling skin in parkinson treatment

drug

A

Amantadine

312
Q

confirm lyme with

A

western blot

antibodies

313
Q

pseodomonas toxin( exot. A)
diphtheria toxin

A

inhibits EF2

314
Q

hypo NA, OSMO, normovolemia

causes

A

hypothyroidism
siADH
hypoadrenal
chronic diuretic
reset osmostat

315
Q

Gen Oncology

cell Resist death

A

Bax, P53, BCL-2

causes proliferation

316
Q

Gen Oncology

Evade growth suppresion

A

E-cadherin
NF2: lost of gene regulate contact inhibition

mutation or absent

317
Q

Gen Oncology

sustained proliferative signal

A

Growth factors: HER2/Neu, EGFR
Signaling mlecule (Ras, B-Raf)
Transcription factor (MYC, P53)
Cell cycle regulator (Cyclins, CDKs)

318
Q

Gen Oncology

enable replication

A

tolemerase reactivation

reverse trascriptase

319
Q

Gen Oncology

indues angiogenesis

A

VEGF, FGF

bld vessel growth

320
Q

Gen Oncology

BRAF

A

melanoma
Hairy cell Leukemia
Papillary thyroid carcinoma

gene: serine/threonine kinase

321
Q

Gen Oncology

BCR-ABL

philidelphia

A

CML
ALL

9:22

322
Q

Gen Oncology

HER2/Neu(c-erbB2)

17q12

A

breast, Gastric cancer

RTK

323
Q

Gen Oncology

RET

A

MEN2a/b
papillary thyroid cancer
pheo

324
Q

Gen Oncology

KIT

A

gastrointestinal stromal
mastocytosis

cytokine receptor

325
Q

Gen Oncology

MYC

A

L- lung
N-Neuroblastoma
c- Burkitt Lymphoma

trascription factors

326
Q

Gen Oncology

KRAS

A

colorectal
Lung
Pancreatic

GTPase

327
Q

Gen Oncology

BCL-2

A

follicular lympoma (14:18)
diffuse large B cell lymphoma

antiapoptotic

328
Q

Gen Oncology

CCND1

t(11;14)

A

Mantle cell lymphoma (11;14). CD5 positive

cell cycle regulator

329
Q

Gen Oncology suppresor

p53

A

most human cancer
Li-Fraumeni syndrome

inhibit entry to S phase

330
Q

Gen Oncology suppresor

RB

A

Retinoblastoma
osteosarcoma

Rb protin, E2F

331
Q

Gen Oncology suppresor

APC gene

5q22.2

A

FAP(colorectal cancer)
sporadic colorectal cancer

B-catenin

332
Q

Gen Oncology suppresor

BRCA1/2

17q and 13q

A

Breast, ovarian, pancreatic

DNA repair protein

333
Q

Gen Oncology suppresor

MMR gene

Mismatch repair: MLH1

A

Lynch syndrome(HNPCC)

DNA repair protein(colon, gastric, ovary, endometrium cancer)

334
Q

Gen Oncology suppresor

DCC(deleted in colorectal cancer)

18q

A

colorectal cancer

335
Q

Gen Oncology suppresor

SMAD4(DPC4)

A

Pancreatic

TGF-B receptor signal

336
Q

Gen Oncology suppresor

MEN 1

A

Multiple Endocrine neoplasm

pituitary, parathyroid, pancrease

337
Q

Gen Oncology suppresor

NF1

A

neurofibromatosis

Ras, GTPase-activating protein 17q11.2

338
Q

Gen Oncology suppresor

NF2

Merlin (schwannomin)

A

Neurofibromatosis 2

bilateral hearing loss

339
Q

Gen Oncology suppresor

TSC1/2

Hamartin protein and Tuberin protine

A

tuberous scerosis

AD neurocutaneous syndrome

340
Q

Gen Oncology suppresor

TSC1/2

associated with

A

brain hamartomas,
cardiac rhabdomyomas, and
renal angiomyolipomas

adenoma sabecous, intellectual disabiity,ash leaf spot

341
Q

Gen Oncology suppresor

VHL: hypoxia-inducible factor 1a

associated with

A

hemangioblastomas,
bilateral renal cell carcinoma,
pheochromocytoma, and
renal/pancreatic cysts.

3q

342
Q

Gen Oncology suppresor

WT1/2

A

nephroblastoma

2-5 yo, urogenital development. 11q

343
Q

Superior mesenteric artery (SMA)

A

Intermittent small bowel obstruction

Step 1 Clues (27 decks)

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