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1
Q

What cancer is t(8;14)?

What gene is over-expressed?

A

Burkitt Lymphoma

MYC

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2
Q

What is splitting?

A

Experiencing a person/situation as either all positive or all negative

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3
Q

What does mesencephalon give rise to?

A

Midbrain and aqueduct

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4
Q

What is equation for RRR?

A

RRR = ARR/Control Risk

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5
Q

What is schizoaffective disorder?

A

Mood episode with concurrent active-phase symptoms of schizophrenia + 2 or more weeks of delusions or hallucinations in the absence of prominent mood symptoms

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6
Q

What are the factors for Bacillus Anthracis?

What do they do?

A

Edema Factor and Lethal Factor

EF: Increases cAMP –> edema, phagocyte dysfunction

LF: Inhibits MAPK –> apoptosis

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7
Q

What is the function of the paraventricular hypothalamic nucleus?

A

Secretion of oxytocin, CRH, TRH, and small amounts of ADH

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8
Q

What is the equation for NNT?

A

NNT = 1/ARR

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9
Q

What does prosencephalon give rise to?

A

Telencephalon and Diencephalon

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10
Q

What is the function of the medial preoptic hypothalamic nucleus?

A

Secretion of GnRH, regulates sexual behavior

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11
Q

What is represented by this picture?

A

Leiomyoma

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12
Q

The graphs below represent the effects of 2 different drugs on a patient with A-Fib.

What drug is represented by the red line (Drug 1)?

What drug is represented by the blue line (Drug 2)?

A

Digoxin

Atenolol or Verapamil

***Remember, dihydropyridines (nifedipine, amlodipine) and ACE inhibitors are vasodilators (have effects on vessels), not on the heart itself***

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13
Q

What are the symptoms of 11-beta-hydroxylase deficiency?

What are the symptoms of 17-alpha-hydroxylase deficiency?

What are the symptoms of 21-hydroxylase deficiency?

A

Ambiguous genitalia, HTN, hypokalemia (congenital adrenal hyperplasia)

Girls have NL genitalia, boys have ambiguous genitalia; HTN, hypokalemia, no puberty

Ambiguous genitalia, hypotension, hyperkalemia

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14
Q

What are the toxins for Bordetella Pertussis?

What do they do?

A

Pertussis Toxin and Adenylate Cyclase Toxin

PT: Increases cAMP –> edema, phagocyte dysfunction

ACT: Increases cAMP –> edema, phagocyte dysfunction

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15
Q

What are the virulence factors for N. Meningitidis?

Which one is responsible for septic shock?

Which one is responsible for invading the nares?

Which one is responsible for avoiding phagocytosis?

A

Polysaccharide Capsule, IgA Protease, Lipo-oligosaccharide

Lipo-oligosaccharide

IgA Protease

Polysaccharide Capsule

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16
Q

What serum marker is most helpful in diagnosing parotitis?

A

Serum Amylase

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17
Q

What is the function of the ventromedial hypothalamic nucleus?

A

Mediates satiety; destruction leads to hyperphagia

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18
Q

What is the function of the arcuate hypothalamic nucleus?

A

Secretion of dopamine (inhibits prolactin), GHRH

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19
Q

What is the function of the suprachiasmatic hypothalamic nucleus?

A

Circadian rhythm regulation and pineal gland function

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20
Q

What are the expected lab changes for a patient with Addison’s Disease (Primary Adrenal Insufficiency)? (Na, K, Cl, Bicarb)

A

Na - Decreased

K - Increased

Cl - Increased

Bicarb - Decreased

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21
Q

What is represented by this biopsy?

Where is it most often found?

A

Cardiac Myxoma

Left Atrium

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22
Q

What disease is shown in the picture?

How can you tell?

A
  1. ) Sarcoidosis
  2. ) Noncaseating granulomas, multinucleated giant cells
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23
Q

What cancer is t(11;14)?

What gene is over-expressed?

A

Mantle Cell Lymphoma

Cyclin D1

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24
Q

What structures are marked A-E?

What structure is most affected in Huntington’s Disease?

A

A - Caudate Nucleus

B - Internal Capsule

C - Insular Cortex (Insula)

D - Putamen

E - Globus Pallidus

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25
What is suppression?
Putting unwanted feelings aside to cope with reality
26
What does telencephalon give rise to?
Cerebral hemispheres and lateral ventricles
27
What are the CYP450 inducers?
Carbamazepine Barbituates Phenytoin Rifampin Griseofulvin St. Johns Wort Modafinil Cyclophosphamide
28
What are the toxins for Streptococcus Pyogenes? What do they do?
Pyrogenic Exotoxin and Streptolysin O and S Toxin Pyrogenic: Super Ag --\> fever, shock; associated with Scarlet Fever, Strep TSS Streptolysin: Damages erythrocyte membranes --\> beta hemolysis
29
What is intellectualization?
Focusing on nonemotional aspects to avoid distressing feelings
30
What is labeled A-E? Describe each.
A - Z-line; anchor site for thin filaments (actin, tropomyosin, troponin) B - A band; thick filaments overlapped with thin filaments, as well as non-overlapped thick filaments; always remains the same length C - M-line; anchor site for thick filaments D - Area where thick and thin filaments overlap; shortens during muscle relaxation E - I band; section of thin filaments that do NOT overlap with thick filaments; lengthens during muscle relaxation
31
What does metencephalon give rise to?
Pons, cerebellum, and upper 4th ventricle
32
What does diencephalon give rise to?
Thalamus and 3rd ventricle
33
What does myelencephalon give rise to?
Medulla and lower 4th ventricle
34
What is represented by this picture?
Adenomyosis
35
What are the virulence factors for E. Coli and what do they cause?
LPS - Bacteriemia and Septic Shock K1 Capsular Polysaccharide - Neonatal Meningitis Verotoxin (shiga-like toxin) - Gastroenteritis (bloody) Heat-stable/Heat-labile Enterotoxins - Gastroenteritis (watery) P Fimbriae - UTI's
36
What is denial?
Behaving as if an aspect of reality does not exist
37
What is the endotoxin that is found in the outer membrane of many gram-negative bacteria? What is it composed of?
LPS O Antigen, Core Polysaccharide, Lipid A
38
What is the function of the supraoptic hypothalamic nucleus?
Secretion of ADH and small amounts of oxytocin
39
What is displacement?
Transferring feelings to less threatening object/person
40
If a drug is eliminated via first order kinetics, how long does it take to reach plasma steady state concentration?
4-5 half-lives
41
What is the equation for ARR?
ARR = Control Risk - Treatment Risk
42
What is included in MEN1 syndrome? What is included in MEN2A syndrome? What is included in MEN2B syndrome?
Primary Hyperparathyroidism, Pituitary Tumors, Pancreatic Tumors (Zollinger-Ellison Syndrome) Medullary Thyroid Carcinoma, Pheochromocytoma, Primary Hyperparathyroidism Medullary Thyroid Carcinoma, Pheochromocytoma, Mucosal Neuromas/Marfanoid Habitus
43
What disease is represented by this skin biopsy? What is seen on this biopsy?
Lichen Planus Hypergranulosis
44
What is projection?
Attributing one's own feelings to others
45
What is regression?
Reverting to earlier developmental stage
46
What serological markers are present during acute HBV infection? What serological markers are present during chronic HBV infection? What serological markers are present for a person vaccinated against HBV? What serological markers are present after clearing an HBV infection?
Anti-HBcAg IgM, HBsAg, HBeAg Anti-HBcAg IgG, HBsAg (Anti-HBe seen later) Anti-HBs Anti-HBs and Anti-HBe
47
What structures are marked A-F?
A - Rectus Abdominus B - Bladder C - Prostate Gland D - Anal Canal E - Ischioanal Fossa F - Gluteus Maximus
48
What are the areas labeled A-F?
A - Frontal Eye Field B - Broca's Area (Motor Speech) C - Primary Motor Cortex (Pre-central Gyrus) D - Primary Somatosensory Cortex (Post-central Gyrus) E - Wernicke's Area (Sensory Speech) F - Primary Visual Cortex
49
What are the toxins for Clostridium Difficile? What do they do?
Toxin A and Toxin B Toxin A: Recruits/activates neutrophils --\> release of cytokines --\> mucosal inflammation, fluid loss, diarrhea Toxin B: Induces actin depolymerization --\> mucosal cell death, bowel wall necrosis, pseudomembrane formation
50
What organism is seen in the picture below? How would you describe this organism? What does this cause in HIV+ patients?
Cryptococcus Neoformans Round/oval yeast surrounded by thick polysaccharide capsule Cryptococcal Meningitis
51
What is schizophreniform disorder?
1 or more months but less than 6 months, same symptoms as schizophrenia, functional decline not required
52
What disease is represented by this picture? What would you expect to see on biopsy?
Eczematous Dermatitis Spongiosis
53
What are the expected lab changes for a patient with Aplastic Anemia? (EPO, Reticulocytes, MCV, Haptoglobin)
EPO - Increased Reticulocytes - Decreased MCV - Normal Haptoglobin - Normal
54
What is the equation for relative risk?
RR = Treatment Risk/Control Risk
55
What is the toxin for Clostridium Botulinum? What does it do?
Botulinum Toxin Blocks Ach release at NMJ --\> flaccid paralysis
56
What are the arrows pointing at from left to right? What nerves innervate each muscle?
Lateral Rectus, Inferior Rectus, Superior Rectus, Medial Rectus, Superior Oblique, Lens SR, IR, MR, IO = CN 3 (Oculomotor) SO = CN 4 (Trochlear) LR = CN 6 (Abducens)
57
What is acting out?
Expressing unacceptable feelings through actions
58
What is a common adverse effect of methadone administration?
QT interval prolongation
59
What is the function of the lateral hypothalamic nucleus?
Mediates hunger; destruction leads to anorexia
60
What is schizophrenia?
6 or more months, including 1 or more months of active symptoms, including prodromal and residual periods; requires functional decline
61
What cancer is t(14;18)? What gene is over-expressed?
Follicular Lymphoma BCL2
62
What would you expect to see on biospy of this plaque?
Acanthosis and Hyperkeratosis
63
What is reaction formation?
Transforming unacceptable feelings/impulses into the opposite
64
What is the function of the posterior hypothalamic nucleus?
Mediates heat conservation; destruction leads to hypothermia
65
What is passive aggression?
Avoiding conflict by expressing hostility covertly
66
What is delusional disorder?
1 or more delusions for 1 or more months, no other psychotic symptoms, normal functioning apart from direct impact of delusions
67
What is rationalization?
Justifying behavior to avoid difficult truths
68
What is the toxin for Shigella Dysenteriae? What does it do?
Shiga Toxin ST: Halts protein synthesis via 60s subunit --\> intestinal epithelial cell death, diarrhea
69
What cancer is t(9;22)? What gene is over-expressed?
CML BCR-ABL1 Hybrid Oncoprotein
70
What is the function of the anterior hypothalamic nucleus?
Mediates heat dissipation; destruction leads to hyperthermia
71
What is sublimation?
Channeling impulses into socially acceptable behaviors
72
What is brief psychotic disorder?
1 or more days but less than a month, sudden onset, full return to function
73
What does the biopsy finding show? What disease process does this represent?
Kimmelstiel-Wilson Nodules Diabetic nephropathy/nodular glomerulosclerosis
74
What are the structures labeled A-E? What are their functions?
A, B, I, J - Dorsal columns; ascending sensory nerves for pressure, vibration, proprioception, fine touch C, H - Lateral corticospinal tract; UMNs from brain that control voluntary movement D, G - Lateral spinothalamic tract; sensory fibers for pain and temperature E, F - Anterior corticospinal tract
75
What is represented by this CT scan? What disease is this?
Ring-enhancing Lesions Toxoplasmosis
76
What does rhombencephalon give rise to?
Metencephalon and Myelencephalon
77
What are the CYP450 inhibitors?
Amiodarone Cimetidine Fluoroquinolones Clarithromycin Azole Anti-fungals Grapefruit Juice Isoniazid Ritonavir (proteae inhibitors)
78
What is the toxin for Corynebacterium Diphtheria? What does it do?
Diphtheria toxin Inhibits protein synthesis via ADP-ribosylation of EF2
79
What cancer is t(15;17)? What gene is over-expressed?
Acute Promyelocytic Lymphoma PML-RAR-alpha Hybrid Oncoprotein

COMLEX (2 decks)

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