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Step One > Learn from your mistakes > Flashcards

Learn from your mistakes Flashcards

1
Q

mushroom toxin

A

binds DNAP II

inhibits mRNA formation

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2
Q

location spinal accessory

A

posterior traingle

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3
Q

connection osteocytes

A

gap junctions

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4
Q

cause of insulin resistance in pregnancy

A

human placental lactogen

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5
Q

cause thoracic outlet syndrome

A

scalene muscles

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6
Q

fracture orbital floor

A

damage to infraorbital

loss of sensation over lip

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7
Q

bladder in MS

A

hypertonic

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8
Q

causes of vitamin A deficiency

A

obstruction of biliary tract

malabsorption

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9
Q

cause of gout

A

PRPP synthase problem

neutrophils responsible for gout symptoms

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10
Q

increased AFP and AchE

A

detects NT defects

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11
Q

causes of red cell aplasia

A

parvo B19, thymomas, lymphocytic leukemias

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12
Q

pattern of unstable relationships, self-image

A

borderline personality disorder

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13
Q

origin elastase in lungs

A

macrophages

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14
Q

supplemental O2 to COPD patient

A

hypercapnia that leads to V/Q mismatch and dead space ventilation

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15
Q

location enzymes for glycolysis, FA synthesis, PPP

A

cytosol

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16
Q

porphyria cutanea tarda

A

photosensitivity due to accumulation of porphyrinogens

due to uroporphyrinogen decarboxylase deficiency

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17
Q

frothy diarrhea

A

lactose intolerance

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18
Q

external rotation

A

infraspinatus

supplied by suprascapular nerve

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19
Q

estrogen on T4

A

increased TBG causing decreased free T4/T3

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20
Q

location schwannoma

A

cerebellopontine angle

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21
Q

true diverticulum

A

Meckels diverticulum

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22
Q

depersoanlization disorder

A

persistent depersonalization and derealization

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23
Q

histology Zoster

A

intranuclear inclusions and multinucleated cells on Tzanck smear

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24
Q

dysdiadochoknesia

A

cannot perform rapidly alternating from cerebellar lesion

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25
Q

accumulation of globotriaosylceramide

A

Fabry due to alpha galactosidase deficiency

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26
Q

midline episiotomy

A

cuts perineal body

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27
Q

COPD and EPO

A

increased due to hypoxia

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28
Q

dopamine agonists

A

pramipexole and bromocriptine

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29
Q

necessary for FA synthesis

A

NADPH

comes from PPP

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30
Q

sphincter of Oddi spasm

A

morphine causes it

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31
Q

inhibit androgen receptor binding

A

flutamide, cyproterone and spironolactone

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32
Q

amino acids in pyruvate dehydrogenase deficiency

A

ketogenic amino acids

lysine and leucine

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33
Q

smooth muscle proliferation in atherosclerosis

A

PDGF from endothelail cells, platelets, and macrophages

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34
Q

leukemoid reaction

A

basophilic oval inclusions in mature neutrophils

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35
Q

failure to obliterate omphalomesenteric duct

A

Meckel diverticulum

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36
Q

leukocyte adhesion deficiency

A

leukocytosis

failure to form pus from CD18 defect

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37
Q

results ureter obstruction

A

increase pressure in Bowman’s space

decreased GFR and FF

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38
Q

dermatomyositis as paraneoplastic syndrome

A

ovarian, lung, colorectal, non-Hodgkin lymphoma

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39
Q

cystinuria

A

defective cysteine, ornithine, lysine, arginine

increased kidney stones

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40
Q

causes of ESR

A

from macrophage released inflammatory markers

IL6, TNF alpha, IL1

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41
Q

locations osteomyelitis

A

kids-metaphasis

adults-epiphyseal

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42
Q

cholesteatomas

A

squamous cell debris

pearly mass behind tympanic membrane, leads to hearing loss

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43
Q

origin renal cell carcinoma

A

from proximal tubule

risk factors-obesity and smoking

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44
Q

tryptophan precursor

A

for serotonin

can get serotonin storm from MAOI or SSRI

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45
Q

bypass folate deficiency

A

give thymidine supplementation

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46
Q

cutaneous small vessel vasculitis from medication

A

leukocytoclastic vasculitis

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47
Q

restrictive cardiomyopathy causing diastolic dysfunction

A

amloid deposition

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48
Q

injury to prostatic plexus

A

erectile dysfucntion

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49
Q

shift to increase high oxygen affinity

A

erythrocytosis

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50
Q

S3

A

diastolic dysfunction

heart at apex in left lateral decubitus at end of expiration

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51
Q

congential hydrocephalus

A

leads to macrocephaly, poor feeding, spasticity and hyperreflexia (UMN from lengthening pyramidal neurons)

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52
Q

drug induced lupus metabolism

A

slow acetylators

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53
Q

predictor of RPGN severity

A

age

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54
Q

compensation fructose def

A

hexokinase activity

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55
Q

Tay Sachs

A

no hepatomegaly

buildup of GM2 ganglioside

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56
Q

Potter sequence

A

can occur from mother on ACEi

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57
Q

TNF alpha

A

activtes serine kinases

inhibits tyrosine phosphorylation

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58
Q

projecting

A

attributing one’s feelings to othrs

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59
Q

mesoderm

A

muscles, CT, cardio, blood, lymph, spleen, internal genitalia, kidneys, adrenal cortex

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60
Q

reticulocytes and B12

A

peak at 1 week

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61
Q

deficiency of dihydrobiopterin reductase

A

hyperphenylanemia and elevated prolactin

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62
Q

iliohypogastric nerve

A

from L1 lateral to upper psoas

injury during appendectomy causes decreased sensation at suprapubic region

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63
Q

pulmonary fibrosis

A

thickening and airway widening due to increased outward pulling by fibrotic tissue-supernormal expiratory flow rates

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64
Q

subthalamic nucleus

A

component of basal ganglia
role in modulation of basal ganglia output
leads to contralateral hemiballism

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65
Q

most common cause of coronary sinus dilation

A

elevated right sided heart pressure from pulmonary HTN

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66
Q

proprionic acidemia

A

deficiency of propionyl CoA carboxylase

low protein diet and minimal valine, isoleucine, methionine, and threonine

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67
Q

increase in pyruvate carboxylase

A

increased by acetyl CoA

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68
Q

complication aortic stenosis

A

A fib

reduced LV compliance, dependent on atrial contraction to maintain LV filling

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69
Q

rheumatoid arthritis

A

impacts cervical spine

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70
Q

Kisselbach plexus

A

nasal septum

cause of anterior nosebleeds

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71
Q

peak of aortic regurg

A

after aortic valve closure

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72
Q

cause of glial scar

A

from astrocytes

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73
Q

chronic hemolysis from paroxysmal nocturnal hemoglobinuria

A

iron deposition in kidney

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74
Q

histology intraductal papilloma

A

proliferation of papillary cells in duct or cyst wall with fibrovascular core

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75
Q

uridine supplementation

A

bypass enzyme defect in orotic aciduria

AR disorder of de novo pyrmidine synthesis

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76
Q

GI and neuro symptoms

reddish urine

A

acute intermittent porphyria

defect in porphobilinogen deaminase

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77
Q

failure in ristocetin test

A

vWF

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78
Q

selective arteriolar dilators

A

sodium and fluid retention

through stimulation of RAAS

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79
Q

systemic sclerosis

A

pulmonary hypertesnion develops

intimal thickening of pulmonary arterioles

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80
Q

wedge on CT from renal infarct

A

thromboembolism from a fib

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81
Q

raltegravir

A

integrase inhibitor

disrupts viral genome transcription

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82
Q

maintenance stage ATN

A

high volume, hypotonic urine

leads to hypokalemia

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83
Q

secreted product activated macrophages in atheroma

A

metalloproteases

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84
Q

microsomal mono-oxygenase

A

cancer by pro-carcinogens from p450 system

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85
Q

alleviated pain by leaning forward

A

acute pericarditis

leads to friction rub

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86
Q

Stewart Treves syndrome

A

cutaneous angiosarcoma
predisposing condition is radical mastectomy
results in chronic lymphedema in ipsilateral arm

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87
Q

niacin deficiency

A

low NAD and NADP

dehydrogenase and reductase complexes use it as cofactor

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88
Q

akathisia

A

restlessness with inability to sit still

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89
Q

resting membrane

A

mostly K and a bit of Na

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90
Q

control postpartum hemorrhage

A

compress internal iliac (gives rise to uterine arteries)

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91
Q

Chiari malformations

A

lead to herniation

chiari I presents in late adulthood

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92
Q

non-bacterial endocarditis

A

antiphospholipid syndrome, SLE, DIC

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93
Q

maturity onset diabetes

A

glucokinase mutations

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94
Q

choreiform movements

A

rheumatic disease

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95
Q

clubbing from hypoxia

A

lung disease, heart diseases, inflammatory bowel diseases

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96
Q

compensation in nephrotic syndrome

A

increase lipoprotein production

causes hyperlipidemia

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97
Q

sepsis and ARDS

A

leakage of protein and fluid into alveolar space

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98
Q

NNRTIs

A

does not require activation

most common-nevirapine and efavirenz

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99
Q

angiomyolipomas

A

associated with tuberous sclerosis

also brain hamartomas and ash leaf skin patches

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100
Q

bluish neoplasm under nail bed

A

glomus

modified smooth muscle in control of thermoregulation

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101
Q

cause of megaloblastosis

A

thymidine synthase deficiency

b12 and folate

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102
Q

treatment subarachnoid hemorrhages

A

calcium channel blockers

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103
Q

germline mosaicism

A

passed onto offspring while somatic is not

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104
Q

ecological studies

A

for populations

generate hypotheses but not conclusions

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105
Q

ST elevation I and aVL

A

lateral from left cricumflex

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106
Q

saddle anesthesia

A

block S2-S4 leading to loss of anal wink

cauda euina

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107
Q

profound hypotension from rupture of free wall

A

hemipericardium and cardiac tamponade

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108
Q

urticaria

A

edema in superficial dermis

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109
Q

imbalance in emphysema

A

proteinases from macrophages and nuetrophils

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110
Q

highest O2 content

A

coronary sinus

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111
Q

lactic acidosis in septic shock

A

decreased ox phos

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112
Q

intraerythrocytic rings

A

can be seen in babesia

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113
Q

ubiquitin proteasome

A

MHC I and CD8T cels

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114
Q

predominant cell in noncaseating granulomas

A

CD4

seen in sarcoidosis

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115
Q

nicoinic ligand gated

A

open after binding Ach

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116
Q

biphasic pattern and S100

A

schwannomas

neural crest origin

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117
Q

indication of severity mitral regurg

A

audible S3

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118
Q

neutrophil Abs

A

found in Wegeners

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119
Q

supracondylar fractures with anterolateral displacement

A

injury to radial

wrist drop

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120
Q

pulsus paradoxus

A

exaggerated drop in systolic BP

seen in cardiac tamponade, asthma, COPD, constrictive pericarditis

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121
Q

treatment trigeminal neuralgia

A

carbamazepine
inhibits sodium channels to recover from inactivation
leads to bone marrow suppression

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122
Q

babies to HBV mothers

A

high viral loads and HBeAg levels

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123
Q

nitrates

A

impact large veins to decrease preload

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124
Q

time elapsed from initial exposure or pathogenic insult

A

incubation period or latent period (noncommunicable)

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125
Q

crossing over within homologous regions

A

recombination between HSV

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126
Q

SCID

A

recurrent viral, fungal, or opportunistic infections (pneumocystis not seen in agammaglobulinemia)

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127
Q

type IV HSR

A

macrophages, CD4, CD8

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128
Q

panic disorder

A

recurrent unexpected panic attacks (social anxiety has fear of scrutiny and embarrassment)

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129
Q

hepatic encephalopathy and GI bleeding

A

from increased gut absorption

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130
Q

lowest pulmonary vascular resistance

A

when close to FRC

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131
Q

breathing in CHF

A

Cheyne stokes

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132
Q

failure of obliteration of processus vaginalis hernia

A

indirect

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133
Q

locus ceruleus

A

pigmented in posterior rostral pons near lateral floor of 4th ventricle
makes NE

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134
Q

MOA shiga and shiga like toxins

A

inactivate 60s ribosome

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135
Q

quick administration to hypoglycemic patients

A

glucagon

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136
Q

carotid massage

A

slows conduction through AV node

prolongs refractory period to terminate re-entrant tachycardia

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137
Q

maximal intensity PDA

A

at S2

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138
Q

Broa location

A

caudal part of inferior frontal gyrus of dominant hemisphere
patient may present with right hemiparesis

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139
Q

gallstones in Crohn disease

A

terminal ileum leads to bile acid lost in feces

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140
Q

genetic chronic myeloproliferative disorders

A

JAK/STAT activation

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141
Q

family history of pulmonary arterial hypertension

A

inactivating BMPR2 mutation that leads to dysfunctional endothelial and smooth muscle proliferation

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142
Q

diabetic autonomic neuropathy on bladder

A

overflow incontinence due to impaired detrusor contractility or bladder outlet obstruction

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143
Q

renal ammoniagenesis

A

anaerobic oxidation leading to lactate accumulation

glutamine metabolized to generate ammonium and bicarbonate

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144
Q

ureter in true pelvis

A

anterior to internal iliac artery

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145
Q

crossover study

A

treatments are switched

includes a washout period

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146
Q

S3

A

during diastole due to rapid passive filling of ventricle

during decompensated heart failure

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147
Q

result V/Q mismatch in PE

A

alkalosis and hyperventilation due to hypoxia

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148
Q

Patau manifestations

A

midline defects due to defect in fusion of prechordal mesoderm
holoprosencephaly, cleft lip/palate, omphalocele, polydactylyl, cutis asplasia (skin defect on scalp)

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149
Q

aspergillus

A

colonizing balls that shift when the patient changes positions

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150
Q

primaquine

A

kills hypnozoites that cause relapse in P vivax and P ovale

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151
Q

green color of sputum

A

from neutrophil MPO

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152
Q

tachyphylaxis from alpha 1 agonists

A

decreased production of Ne due to negative feedback, exacerbation of nasal congestion systems

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153
Q

sarcoidosis

A

erythema nodosum, arthralgias, hilar lymphadenopathy, elevated ACE
noncaseating granulomas in liver

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154
Q

causes of Down syndrome

A

meiotic nondisjunction, unbalanced translocations, mosaicism

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155
Q

source of obstruction in HCOM

A

anterior mitral leaflet and interventricular septum

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156
Q

diff sabin and salk

A

more IgA from sabin-live attenuated

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157
Q

chancroid from h. ducreyi

A

gray to yellow exudate

painful

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158
Q

constriction of efferent arteriole

A

impede blood flow

decrease RPF but increase FF

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159
Q

calories

A

carbs and protein 4

fat 9

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160
Q

type III dysbetalipoproteinemia

A

without ApoE liver cannot remove chylomicrons

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161
Q

primase

A

DNA dependent RNAP

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162
Q

borderline personality disorder

A

unstable relationships, self-image and impulsivity

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163
Q

injury to superior gluteal nerve

A

L4-S1 leaving pelvis through greater sciatic foramen above piriformis
from injections to superomedial quadrant of butt

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164
Q

injury to radial nerve

A

innervates extensors

results in wrist drop

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165
Q

thiazolidinedione

A

decrease resistance through PPAR

upregulates GLUT4 and adiponectin

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166
Q

hep D

A

defective replication

must be coated by HBsAg

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167
Q

vWF

A

platelet adhesion by crosslinking platelet glycoproteins with collagen

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168
Q

causes of myopathy with elevated CK

A

hypothyroidism, muscular dystrophies, inflammatory muscle diseases, medications

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169
Q

HUS labs

A

decreased hemoglobin and haptoglobin

increased lactate and increased unconjugated bilirubin

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170
Q

initial TB

A

growth inside cells

IFN at 2-4 weeks

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171
Q

final stages of MI

A

deposition of type I collagen

found in dermis, bone, tendons, ligaments, dentin, cornea, blood vessels, scar tissue

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172
Q

PD-1

A

binds PD-L1 downregualting immune response

similar to CTLA-4

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173
Q

innervation lateral rectus

A

CN VI

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174
Q

results arteriolar vasodilators

A

sympathetic activation, activates RAAS and leads to fluid and sodium retention

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175
Q

production of ribose 5 phosphate

A

transketolase

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176
Q

AV fistula

A

decrease TPR, increase CO, increase VR

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177
Q

eosinophilia and aspergillus

A

increased in ABPA

common in asthmatics and leads to proximal broncheictasis

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178
Q

MAO for treatment resistant

signs of treatment resistant

A

mood reactivity
leaden paralysis
rejection sensitivity

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179
Q

draining proximal to dentate line

A

IMA and internal iliac lymph nodes

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180
Q

cricopharyngeal motor dysfunction

A

leads to Zenker diverticulum

abnormal spasm or diminished relaxation of cricopharyngeal muscles

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181
Q

use of odds ratio

A

case control

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182
Q

best initial treatment for drug seekin behavior

A

medication history

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183
Q

gestational choriocarcinoma histology

A

cytotrophoblasts and syncytiotrophoblasts and dyspnea from hematogenous spread

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184
Q

stain for malabsorption

A

sudan III

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185
Q

use cilostazole

A

reduces platelet activation by inhibiting PDE
also vasodilator
good for patients with PAD

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186
Q

phenotypic mixing

A

coinfection by 2 viral strains
exchange nucleocapsids
genetic material not passed on

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187
Q

first line for gouty arthritis

A

NSAIDS

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188
Q

acute hemolytic transfusion reaction

A

fever, chills, chest and/or back pain, hemoglobinuria, complement mediate cell lysis
type II HSR

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189
Q

vitamin E def

A

mimic Friedreich ataxia

degeneration of spinocerebellar tracts, degeneration of dorsal columns

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190
Q

primary central nervous system lymphoma

A

second most common cause of ring enhancing lesions with HIV

191
Q

oral thrush, interstitial pneumonia, lymphopenia

A

vertical transmission of HIV in baby

192
Q

urea in kidney

A

cortical impermeable

transporters in medullary collecting duct acted on by vasopressin

193
Q

follicular lymphoma

A

waxing and waning

painless lymph node enlargement

194
Q

carnitine deficiency

A

impairs FA transport preventing beta oxidation into acetyl coA
unable to synthesize ketone bodies

195
Q

negative predictive value

A

probability of being free of disease if test is negative

196
Q

ankylosing spondylitis

A

limits chest expansion

monitor chest expansion

197
Q

dual identification

A

done independently to ensure proper surgical site

198
Q

lobes most dependent on gravity when supine

A

posterior segments of upper lobes and superior segments of lower lobes

199
Q

preferential excretion by liver

A

drugs that are more lipophilic

200
Q

cytokine in temporal arteritis

A

IL-6

201
Q

normal lab values and degenerating bones

A

osteoporosis

202
Q

treatment in asthma

A

leukotriene and Ach antagonists

203
Q

blood flow in exercise

A

match pulmonary and systemic circulation

204
Q

pneumococal vaccine

A

polysaccharide unconjugated

T cell independent response

205
Q

strongyloides in stool

A

rhaditiform (noninfectious)

206
Q

decompensated heart failure

A

reduced CO leads to compensatory sympathetic and RAAS

207
Q

transmigration

A

PECAM1

208
Q

thrombosis of varicose veins

A

remains superficial

more common complication is ulcer

209
Q

cognitive impairment and drugs

A

get social worker involved

210
Q

MOA lidocaine

A

inactivated sodium channels

preference for ischmeic areas

211
Q

morning stiffness

A

less than 30 min in osteoarthritis

212
Q

clubbing and cyanosis without BP or pulse discrepancy

A

large PDA complicated by Eisenmenger syndrome

213
Q

flank pain in nutcracker

A

loss of antithrombin III resulting in hematuria and elevated lactate dehydrogenase

214
Q

reabsorption of water

A

proximal tubule >60 regardless of hydration status

215
Q

two sample t test

A

averages between groups

216
Q

Kozak sequence

A

RccAUG as adenosine or guanine

change leads to decrease initiation in beta thal

217
Q

increase tricuspid regurg

A

inspiration

218
Q

galactosemia

A

from galactose 1 phosphate deficiency

leads to jaundice and E coli sepsis

219
Q

brown pigment stones

A

common after bacterial infection of biliary tract, beta glucuronidase released from injured hepatocytes and bacteria

220
Q

location thoracentesis

A

8/10/12

too low and you get the liver

221
Q

bacterial overgrowth from gastric bypass

A

deficiency of folic acid, B12, KADE

222
Q

location beta 1 receptors

A

heart and JGA

223
Q

ARDS cause

A

injury to alveolar pneumocytes leading from neutrophils leading to hyaline membranes

224
Q

osteosarcoma characteristics

A

from Paget

sunburst pattern and lifting of cortex

225
Q

Jimson weed

A

anticholinergic toxin

easily obtained drug of abuse

226
Q

Cadherins

A

adhesion molecules that are calcium dependent

form adherens junctions and desmosomes

227
Q

knee dislocation

A

posterior and anterior dislocations popliteal artery is at high risk

228
Q

sublimation

A

channeling in an appropriate way

mature defense mechanism

229
Q

location of action for PDE5 inhibitors

A

vascular smooth muscle of corpora cavernosa

230
Q

serratus anterior

A

stabilizes and rotates teh scapula upwards
innervated by long thoracic nerve
damage leads to winged scapula

231
Q

pancreas fluids

A

Cl and Bicarbonate exchanger
high low bicarb
low flow Cl

232
Q

acute intermittent porphyria

A

deficiency of porphobilinogen deaminase

leads to increased PBG and ALA

233
Q

electrolytes in DKA

A

hyperkalemia

hyponatremia

234
Q

blood diversion in cirrhosis

A

shift away from portal
increase in splenic vein
leads to splenomegaly

235
Q

hydrophobic N terminal

A

accumulation in cytosol

236
Q

blood smear alpha thalassemia

A

microcytic cells

237
Q

androgen binding protein

A

from sertolic cells

helps maintain high local concentration of testosterone

238
Q

Glucagon signaling

A

increase cAMP

Gs

239
Q

red safranin O

A

stains cartilage, mast cell granules and mucin

240
Q

vestige of gubernaculum in women

A

round ligament

projects through inguinal canal to labia majora

241
Q

PE acid base

A

respiratory alkalosis

242
Q

idopathic pulmonary arterial hypertension

A

injury to endothelium followed by narrowing and accelerated vascular injury
dilation of RV
results in pulmonary endothelial damage in young patient

243
Q

acyl CoA synthase deficiency symptoms

A

cardiomyopathy
hypoketonic hypoglycemia
elevated TG
muscle weakness

244
Q

MYC vs Ras

A

Ras is GTP

MYC is transcription activator

245
Q

increase Vmax on Lineweaver

A

decrease Y intercept

1/Vmax

246
Q

lactulose treatment of hepatic encephalopathy

A

acidifies GI tract turning NH3 into NH4

247
Q

exertional leg pain
arterial ulcers
dermal atrophy

A

peripheral artery atherosclerosis

248
Q

hoarseness from aneurysm at aorta

A

get recurrent laryngeal
innervates everything except cricothyroid
leads to posterior cricoarytenoid muscle dysfunction

249
Q

thin walled cavity in lungs

A

Coccidioies in SW america

can cause asymptomatic infection or mild pneumonia

250
Q

agrammatization

A

slow speech
found in lesion of Broca area
intact comprehension but poor repetition

251
Q

unmyelinated nerve fibers

A

autonomic postganglionic nerves

also slow pain, heat sensation, and olfaction

252
Q

larger sample size decreases

A

standard error

measure of variability around the mean

253
Q

HLA digested by macrophages during antigen processing

A

invariant chain

replaced by external protein to form MHC peptide complex

254
Q

cause of Prader Willi

A

loss of father

maternal uniparental disomy

255
Q

role of transcription factors

A

cellular differentiation

can also induce cells to revert to less specialized forms

256
Q

results of pernicious anemia

A

from chronic gastritis leads to increased gastrin as compensation for low acid
decreased IF

257
Q

clinical Gaucher

A

from accumulation of glucocerebroside accumulation

leads to splenomegaly, pancytopenia, skeletal destruction

258
Q

HIV and nephrotic

A

FSGS
collapsing glomerulopathy
leads to marked tubular injury and microcyst formation

259
Q

treatment pneumothorax

A

chest tube

positive pressure for ARDS

260
Q

effect vitamin D

A

increase Ca and Po

decrease PTH

261
Q

draining maxillary sinuses

A

most common to cause infection

semilunar in middle meatus

262
Q

lengthened during relaxation

A

I band

contains Z line

263
Q

cause of mitral stenosis

A

rheumatic fever

mid-diastolic murmur heart over apex when lying

264
Q

atrophy of brain from chronic alcoholism

A

atrophy of anterior lobes and cerebellar vermis-leads to Parkinsonian tremor

265
Q

painless lower GI bleeding

A

can be from Meckel diverticulum

266
Q

characteristics of HCOM

A

LV myocardium

normal coronary arteries

267
Q

removal of primers

A

DNAP I

268
Q

Lynch syndrome

A

colorectal cancer
ovarian cancer
endometrial cancer

269
Q

symptoms alkaptonuria

A

AR defect in homogentisic acid

darkened urine and osteoarthropathy

270
Q

homocystinuria

A

marfinoid features

defect in cystathionine beta synthase

271
Q

drugs that don’t cross the placenta

A

water soluble materials do not readily cross placenta

272
Q

a fib

A

leads to loss of a wave

273
Q

composition of regenerative nodules

A

hepatocytes

274
Q

cystic hygromas

A

lymphatic malformations involve loose areolar tissue

seen in turner, trisomies 18,13,21

275
Q

decrease in transmembrane concentration gradient

A

causes closer to 0 for equilibrium potential

276
Q

cause of lactose intolerance

A

downregulation of lactase production

277
Q

MOA cyclosporine

A

inhibits IL-2 transcription

inhibits calcineurin

278
Q

autoregulation of kidney

A

increase in FF due to increase in GFR and decrease in RPF due to efferent constriction

279
Q

cause of orthostatic hypotension

A

alpha 1 responsible

280
Q

histology membranous glomerulonephritis

A

spikes and domes

immune complexes with gaps between dark staining spikes

281
Q

xerosis

A

winter itch

moisturizing creams should be applied after bathing

282
Q

transmembrane receptors

A

hydrophobic AA

alanine, valine, leucine, isoleucine, phenylalanine, tryptophan, methionine, proline, and glycine

283
Q

spider angiomas

A

from estrogen excess

284
Q

complications of endometriosis

A

infertility

increased epithelial ovarian carcinoma but not endometrial

285
Q

crypt abscess

A

UC

286
Q

primary ovarian insufficiency

A

women <40 with amenorrhea

follicular depletion through accelerated atresia (apoptotic process)

287
Q

agglutination inhibition test

A

presence of agglutination is considered negative

288
Q

paclitaxel in drug eluting stent

A

decreases intimal hyperplasia

decrease rate of new endothelium forms over luminal surface

289
Q

insulin and GLUT4

A

increase glucose transporter from intracellular vesicles to cell membrane

290
Q

inferolaterally placed clavicle

A

due to deltoid

291
Q

heterozygotes with MCAD

A

decreased MCAD activity leads to hypoketoic hypoglycemia

292
Q

treatment hypokalemia in patient with furosemide

A

muscle cramps

check electrolyte levels

293
Q

psoas muscle

A

attaches to lesser trochanter

spread of infection can cause pain in groin

294
Q

varicella reactivation

A

HIV patients or immunocompromised

295
Q

role of HLA

A

antigen presentation

296
Q

joint space narrowing

A

osteoarthritis

overactivity of metalloproteases

297
Q

fixed ventilation and hypercapnia

A

due to increased dead space formation

298
Q

cerebellar and retinal hemangioblastomas

A

renal cell carcinoma and pheo

VHL syndrome

299
Q

location Kayser-Fleischer rings

A

cornea

300
Q

widening of mediastinum and abnormal aortic countour

A

aortic dissection

associated with uncontrolled HTN and Marfan syndrome

301
Q

part of brain chronic alcohol consumption

A

cerebellum (vermis)

from rhombencephalon

302
Q

composition leucine zipper

A

basic AA and leucine at every 7th position

is a transcription factor

303
Q

carbon dioxide for pyrimidine synthesis

A

occurs in cytosol
glutamine, Co2 and carbamoyl phosphate
reaction catalyzed by CPS II

304
Q

psoas muscle location

A

lateral to vertebral bodies

pain illicit-appendicitis

305
Q

linear IgG deposits in GBM

A

anti-GBM disease

306
Q

greatest increase in risk for coronary artery disease

A

smoking

307
Q

esophagus through diaphragm

A

with vagaus nerve

aortic with thoracic duct and azygos vein

308
Q

presentation von Gierke

A

hepatomegaly
fasting hypoglycemia
due to G6P def

309
Q

small testes, gynecomastia, increased long bone growth

A

Klinefelter

310
Q

most common sites intracerebral hemorrhage

A

thalamus and putamen

pontine causes pinpoint pupils and loss of horizontal gaze

311
Q

transformation zone

A

squamous non keratinized and simple columnar

susceptible to metaplasia

312
Q

origin Rathke pouch

A

surface ectoderm

can present as prolactinoma

313
Q

innervation of ear

A

vagus nerve provides cutaneous innervation to posterior part of external ear
the rest from trigem

314
Q

side effects tamoxifen

A

endometrial hyperplasia

risk of DVT

315
Q

rapid onset anxiety

A

without medical history likely from medical condition than primary anxiety disorder (could be from hyperthyroidism, hypoglycemia, cardiac arrhythmias, hypercortisol, pheo)

316
Q

sign cardiac tamponade

A

drop in pulse amplitude during inspiration

known as pulsus paradoxus

317
Q

acute mesenteric ischemia

A

NADH inhibits dehydrogenase

buildup of lactate leads to acidemia

318
Q

budding yeast

A

crypto

319
Q

necrotizing fasciitis

A

strep

PYAR+

320
Q

highest burden of atherosclerosis

A

coronary and lower abdominal aorta

321
Q

adverse effect prostatectomy

A

get cavernous nerves and cause erectile dysfunction

322
Q

increase TBG

A

increase total T4 (more bound)

no decrease in T4 if patient remains euthyroid

323
Q

beta blockers on glaucoma

A

on ciliary epithelium to decrease aqueous humor secretion (other muscles innervated by parasymp)

324
Q

breathing work

A 
stiff lungs (fibrosis, pulmonary edema, ARDS)-rapid shallow breaths
high resistance-asthma, COPD-slow breathing
325
Q

gallstones in pregnancy

A

estrogen increase in cholesterol

hypomotility from progesterone

326
Q

compensation chronic severe aortic regurg

A

eccentric hypertrophy, increase preload, increase SV

327
Q

risperidone amenorrhea

A

increase prolactin

decrease GnRH

328
Q

medication target CAH

A

target ACTH

329
Q

hypotension from muscarinic receptors

A

NO release

330
Q

sex determination

A

SRY encodes for testes determining factor
Sertoli makes anti-Mullerian (female suppressed)
Leydig-Wolffian and DHT for external genitalia

331
Q

substances increased in anaphylaxis

A

tryptase (marker of mast cell activation)

332
Q

artery off splenic

A

short gastric

left epiploic has good anastomosis

333
Q

MOA calcipotriene

A

vitamin D analog that inhibits keratinocyte proliferation and stimulate differentiation

334
Q

protein M

A

inhibits phagocytosis and mediates adherence

335
Q

colon cancer

A

right-occult bleeding
left-constipation and intestinal obstruction
rectosigmoid-hematochezia
tenesmus from rectal adenocarcinoma

336
Q

acute ureteral constriction

A

decreases GFR and FF

337
Q

imperforate hymen

A

incomplete degeneration of central portion of fibrous wall connecting walls of vagina
primary amenorrhea, normal secondary sexual characteristics and cyclic abdominal pain (hematocolpos)

338
Q

right nasal hemianopia

A

from calcification or aneurysm of ICA, at peri-chiasm

339
Q

acetylation of drugs

A

resistance to aminoglycosides

340
Q

result of V/Q mismatch

A

alveolar hyperventilation

341
Q

constrictive pericarditis on CT

A

calcification and thickening of pericardium

342
Q

cause of motor fluctuations in Parkinson disease

A

drug response is unpredictable

progressive nigrostriatal degeneration leads to decreased therapeutic window

343
Q

ectopic pregnancy histology

A

uterus would look proliferative on D and C

edematous stroma

344
Q

repressor in lac operon

A

defective operator cannot bind repressor
constitutive expression
CAP must work for it to be active

345
Q

aromatase deficiency

A

ambiguous genitalia for baby and hirsutism for mother

346
Q

laboratory findings SCID

A

T cell low and hypogammaglobulinemia

347
Q

lowest osmolarity in setting of ADH

A

DCT

348
Q

supinator canal

A

contains radial nerve

can be injured from repetitive pronation/supination

349
Q

homogeneous pale pink cytoplasm in liver

A

chronic hep B (mallory bodies are more clumped)

350
Q

landmark for LP

A

iliac crest

351
Q

polycythemia vera

A

low EP

overly sensitive to GF due to JAK mutations

352
Q

MOA fibrates

A

PPAR alpha leads to decreased hepatic VLDL production

353
Q

treatment PCOS

A

estrogen receptor modification

spironolactone not used in woman trying to get pregnant

354
Q

serum sickness

A

fibrinoid necrosis
acute serum sickness
decreased C3 levels

355
Q

ecthyma granulosa

A

Pseudomonas

common in immunocompromised patients with catheters

356
Q

stimulus control

A

dissociate from nonsleeping activities

357
Q

enzyme norepi to epi

A

PNMT

stimulated by cortisol

358
Q

cause of direct hernias

A

weakness of transversalis fascia

359
Q

acoustic neuroma

A

from CN VIII

360
Q

CIN

A

from HPV

use protection

361
Q

nifedipine

A

treat HTN without interfering with heart block

362
Q

rings for hernias

A

external abdominal oblique for superficial
transversalis for deep
surgical repair through superficial (external oblique aponeurosis)

363
Q

supraspinatus vs teres minor

A

teres-external and adduction

supraspinatus-external rotation only

364
Q

CML vs leukmoid

A

decreased alk in CML

increased alk in leukemoid

365
Q

dobutamine cardiac adaption

A

increased myocardial o2 consumption

366
Q

type 1 IFN (alpha and beta)

A

in viral infections
decrease protein synthesis
only made in presence of dsRNA

367
Q

optimal site for femoral nerve block

A

inguinal crease

femoral provides innervation to quads

368
Q

brachiocphalic obstruction

A

symptoms similar to SVC syndrome but only on R side

369
Q

homocystinuria enzymes and cofactor

A

pyridoxine as cofactor-for cystathionine beta synthase

restrict methionine

370
Q

AV shunts on PV loops

A

increases preload and decreases afterload

TPR is decreased due to bypassing of arterioles

371
Q

check in metabolic alkalosis

A

urine chloride levels

372
Q

niacin as cofactor

A

alpha ketoglutarate dehydrogenase
isocitrate dehydrogenase
pyruvate dehydrogenase

373
Q

ptosis, down and out, normal light in diabetic

A

from central ischemia

374
Q

oxalate crystals

A

ethylene glycol poisoning

seen in toxic renal injury

375
Q

cause of cleft lip

A

failure of maxillary and intermaxillary

376
Q

treatment tremulous patient

A

benzo administration

377
Q

most specific antibody for rheumatoid arthritis

A

citrullinated peptides

378
Q

treatment GBS

A

ampicillin can be given intrapartum

penicillin still DOC

379
Q

leuprolide

A

initial LH surge before suppression due to GnRH agonist and then negative feedback from continuous administration

380
Q

complete mole

A

no fetal structures

duplication paternal so 46xx

381
Q

spinal pain at night

A

metastatic

382
Q

derivative that binds to mu receptors

A

ACTH

POMC forms endorphins, ACTH, and MSH

383
Q

mutations that decrease 23BPG binding and increase hemoglobin oxygen

A

like fetal hemoglobin

gamma does not bind 23BPG

384
Q

RT-PCR

A

detect mRNA

385
Q

adrenergic drugs

A

eye from alpha 1

uterus from beta 2

386
Q

acute treatment agitation and psychosis with delirium

A

haloperidol

387
Q

damage to MLF

A

internuclear opthalmoplegia

can occur from lacunar stroke in pontine stroke ipsilateral eye

388
Q

result of left ventricular failure

A

fluid accumulation in lung interstitium and decreased compliance

389
Q

IV fluid

A

increase end-diastolic sarcomere length
given in hypovolemic shock
increases preload

390
Q

cardiac vegetations

A

fibrin deposition as nidus

391
Q

hereditary hemochromatosis

A

HFE defect in intestinal iron absorption

392
Q

predominant cell in sarcoidosis

A

CD4 T cells

393
Q

prevention neonatal tetanus

A

vaccinating women

transplacental IgG

394
Q

drop in PaCO2 from ventilator

A

vasoconstriction to decrease perfusion and edema

395
Q

presents with serum sickness like symptoms (joint pain, lymphadenopathy, urticaria)

A

hep B

396
Q

Ladd bands and constriction

A

failure of midgut rotation around SMA

397
Q

enzymes inhibited by lead

A

ferrochelatase and ALAD

398
Q

cardiac ion pump failure

A

increase Ca and increase Na

399
Q

cause of hemiballism

A

subthalamic nucleus
lacunar stroke
modulates basal ganglia
contralateral hemiballism (uncontrolled proximal limbs)

400
Q

NNRTI

A

do not require activation

nevirapine and efavirenz

401
Q

angioedema from ACEi

A

due to bradykinin accumulation

402
Q

pernicious anemia

A

pink in upper glandular component

403
Q

uric acid stones

A

patinet with diarrhea has dehydration

decrease pH makes them more concentrated in urine (pH increase conversion of urate salts into uric acid)

404
Q

carotid massage

A

increase baroreceptor firing

increase parasympathetic leads to increase in refractory period at AV node

405
Q

cleavage of proinsulin

A

occurs in secretory granules

results in C-peptide and insulin

406
Q

HIV drugs that cause hyperglycemia

A

protease inhibitors (navir ending)

407
Q

location transketolase

A

cytosol

408
Q

hemophilia A

A

PTT

409
Q

PCP MOA

A

NDMA antagonist

410
Q

pelvic fractures

A

common to posterior urethra injury leading to inability to void

411
Q

mediator in sepsis

A

TNFalpha

along with IL-1 and IL-6

412
Q

ipsilateral shoulder pain and Horner’s syndrome

A

compression of autonomic ganglia by Pancoast tumors

413
Q

acute mitral regurg compensation

A

afterload decrease
preload increase
SV increase

414
Q

cause of DIC in pregnancy

A

release of tissue factor into maternal circulation

amniotic origin associated with shock

415
Q

genetics ataxia telangiectasia

A

DNA ds break repair

416
Q

number of subjects

A

24/ER treatment

417
Q

aldolase B def

A

no sucrose

418
Q

internal laryngeal nerve

A

mediates afferent cough reflex

can be injured from injury to piriform recess

419
Q

common injury during hysterectomy

A

ureter
still able to void normally
results in flank pain

420
Q

prevention tissue necrosis

A

alpha 1 blockers

phentolamine

421
Q

IL-2

A

stimulates NK cells

reason of use in cancer treatment

422
Q

MOA opiates

A

hyperpolarization by increased potassium efflux out of the cells

423
Q

characteristic liquefactive necrosis

A

complete digestion

424
Q

hemodynamics severe aortic stenosis

A

sudden decrease in preload due to loss of atrial contraction

425
Q

caudal regression syndrome

A

lower extremity paralysis and incontinence

from maternal diabetes

426
Q

antibodies from vaccination

A

against hemagglutinin

results in inhibition of binding

427
Q

increased PWAP pressures

A

mitral stenosis

428
Q

septic abortion

A

retained products
staph aureus infection
present with fever and uterine tenderness (unlike gardnerella)

429
Q

sideroblastic anemia from isoniazid

A

ALAS deficiency
B6 degredation is a cofactor for this step
happens in mitochondria

430
Q

systolic murmur increases with inspiration

A

tricuspid regurg

431
Q

pellagra like symptoms in Hartnup

A

from niacin deficiency

432
Q

nerve near psoas

A

femoral

leads to decreased sensation on anterior thigh

433
Q

lesions causing UMN

A

precentral gyrus, corticospinal tract, internal capsule

434
Q

uncontrolled hydrocephalus

A

spasticity due to stretching of pyramidal tracts

435
Q

labs in dactylitis

A

decreased haptoglobin

increased indirect bilirubin and lactate dehydrogenase

436
Q

failure of endocardial cushions to fuse leading to single AV valve

A

ostium primum

seen in Down syndrome

437
Q

integrase inhibitors decrease

A

production of viral messenger RNA

438
Q

porcelain gallbladder risk

A

adenocarcinoma of gallbladder

439
Q

parvo virus aplastic crisis

A

from nonenveloped ssDNA
aplastic anemia-pancytopenia
aplastic crisis-just erythrocytes

440
Q

anti-glomerular basement membrane Ab

A

goodpasture

crescent on LM

441
Q

matching method

A

decreases confounding bias

442
Q

hepatocellular damage from anesthetic

A

halogenated

present with centrilobar necrosis

443
Q

diastolic heart failure

A

only end diastolic pressure increases

444
Q

cause S4

A

LV hypertrophy due to decreased heart compliance

445
Q

oculomotor palsy

A

posterior communicating artery aneurysm

446
Q

removal of primers

A

poly I

447
Q

IP3 association

A

PKC

PLC before interaction with IP3

448
Q

normal lab in ARDS

A

pulmonary capillary wedge pressure

449
Q

treatment homocystinuria

A

pyridoxine

450
Q

immune response to listeria

A

cell-mediated

451
Q

aVL and I

A

LCX MI

452
Q

presentation Henoch-Schonlein

A

abdominal pain, jaw pain, purpura, and hematuria

453
Q

primary hyperparathyroid

A

osteitis fibrosa cystica

subperiosteal erosions affecting phalanges

454
Q

MOA fidaxomicin

A

inhibits RNAP

can be used to treat C diff

455
Q

combination tonic-clonic and absence

A

treat with valproate

456
Q

first line of treatment gout patient with PUD

A

cannot give NSAIDS

give colchicine instead-results in nausea, diarrhea, vomiting

457
Q

boronic acid containing dipeptide

A

bortezomib

given to MM to cause cell apoptosis by acting as a proteasome inhibitor

458
Q

field defect

A

embryologic defect leads to multiple defects disrupting adjacent tissue

459
Q

supplementation in hereditary orotic aciduria

A

give uridine supplementation to bypass enzyme defect

460
Q

MAAM COCO

A

timing of valves and open/close

starting from bottom right

461
Q

anxiety without sleepiness

A

long or medium acting benzos (loarzepam)

long acting-DCF

462
Q

maternal hyperglycemia

A

results in beta cell hyperplasia that can lead to hypoglycemia in the newborn

463
Q

contribution to abscess

A

lysosomal content release by macrophages
leads to tissue damage
air fluid level helps diff from granuloma

464
Q

acute pericarditis

A

friction rub

465
Q

frontal lobe lesions

A

right-disinhibition

left-apathy

466
Q

risk for fungemia

A

neutrophils

localized would be deficit of T cells

467
Q

bacteria grow in hypertonic solution

A

enterococci

from cytoscopy

468
Q

labs Klinefelter

A 
increse LH and FSH
increase estrogen (elevated estradiol leads to gynecomastia)
469
Q

pathogenesis cholesterol gallstones

A

increase cholesterol

decrease bile acids and decrease phosphatidylcholine

470
Q

DOC adrenal crisis

A

dexamethasone

471
Q

endothelial inhibition of aggregation

A

prostacyclin (PGI2)

472
Q

most common tumor of liver (benign)

A

cavernous hemangioma
blood in variable size spaces lined by single epithelial layer
do not biopsy due to risk of fatal hemorrhage

473
Q

spinal and sensory loss

A

syringomyelia

ALS no loss of sensation

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