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Caleb's Step 1 > March 18 > Flashcards

March 18 Flashcards

1
Q

Same alpha subunit as hCG

A

LH, FSH, TSH

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2
Q

Heteroplasmy

A

Reason mitochondrial diseases have clinical variability

mixture of genetic material cause mt are always fusing and dividing

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3
Q

Segment of the nephron that is IMPERMEABLE to water (regardless of ADH)

A

ascending loop of Henle

water flows downhill

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4
Q

Strep pneumo

A

gram positive lancet shaped diplococci in pairs

alpha hemolytic
optochin sensitive
bile soluble

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5
Q

Traumatic Aortic Rupture

A

At Aortic Isthmus due to tethering of Ligamentum arteriosum (just past Left subclavian)

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6
Q

Legionella outbreaks

A

colonization of the water supply

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7
Q

Dermatomyositis is associated with

A

Malignancy

lung, colorectal, ovarian, non-hodgkin lymphoma

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8
Q

MOA of Tricyclic Antidepressants

A

block reuptake of NE and 5-HT

tx: depression, OCD, peripheral neuropathy, chronic pain

ADR: Tri-C’s Convulsions, Coa, Cardiotoxicity, anticholingeric, alpha-1 block –> postural hypotension

OD tx: sodium bicarb to prevent arrhythmia

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9
Q

Tumor Stage and Grade

A

Stage > Grade for prognosis

stage: local tissue invasion, LN involvement, metastasis
grade: cellular description (well differentiated –> anaplastic)

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10
Q

Rate Control

A

AV nodal blocking drugs

beta blockers
calcium channel blockers

good for tx of Paroxysmal Atrial Fibrillation

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11
Q

Rhythm Control

A

Antiarrhythmics (sotalol, flecainide, amiodarone)

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12
Q

Class III Antiarrhythmics

A

Potassium Channel Blockers

A - amiodarone (pulm fibrosis, thyroid)
I - ibutilide
D - dofetilide
S - sotalol

prolong repolarization in cardiac myocytes

prolong AP duration, prolong QT interval

tx: A fib, A flutter, ventricular tachy

ADR: torsades do pointes -> V fib

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13
Q

Intracellular electrolyte derangements in CF

A

increased Cl- causes increased Na+ and water

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14
Q

Why is Ca++ elevated in sarcoidosis

A

activation of macrophages –> increased 1-alpha-hydroxylase activity in macrophages –> PTH independent production of 1,25-dihydrovitaminD –> increased intestinal absorption of Ca++

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15
Q

MOA Liver injury in HBV

A

HBsAg and HBcAg are loaded into MHC-I of infected hepatocytes –> CD8+ T-cells –> destruction of hepatocytes

HBV does not have a cytopathic effect.

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16
Q

Work of breathing in Restrictive vs Obstructive Pulmonary disease

A

Restrictive (Pulmonary Fibrosis) - least work with high RR and low TV - fast and shallow breaths - stiff lungs are hard to distend

Obstructive (asthma, COPD) - least work with low RR and high TV - slow deep breaths

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17
Q

Histology of Chronic Lung Transplant Rejection

A

aka Bronchiolitis obliterans

lymphocytic inflammation and destruction of the small airways (bronchioles) –> fibrinopurulent exudate and granulation tissue –> fibrosis and scarring

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18
Q

Histology of Acute Lung Transplant Rejection

A

perivascular and interstitial mononuclear cell infiltrate

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19
Q

Hypertensive Emergency

A

end-organ damage, papilledema, encephalopathy (altered mental status), acute kidney injury (increased Cr)

tx: Fenoldopam - D1 receptor agonist –> increased cAMP –> vasodilation!!

decreased systemic blood pressure
increased renal perfusion –> increased urine output

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20
Q

Familial chylomicronemia

A

Familial hypertriglyceridemia due to LPL deficiency

plasma looks milky, forms creamy supernatant, lipemia retinalis (milky appearing retinal vasculature)

risk of Acute Pancreatitis!

no increased risk for CAD

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21
Q

Nicotinic Receptors

A

Ligand gated ION channels

activation (perhaps with ACh at neuromuscular junction) allows:
Na and Ca to flow IN
K+ to flow OUT

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22
Q

Most common cardiac anomaly in Down Syndrome

A

complete atrioventricular canal defect

failure of endocardail cushion fusion –> ostium primum ASD + VSD + single AV valve

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23
Q

RNA Pol I location and function

A

Nucleolus for rRNA

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24
Q

Negative Skewed Distribution Curve

A

bulk is shifted to right

mean

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25
Q

Positive Skewed Distribution Curve

A

bulk is shifted left

mode

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26
Q

Croup

A

Laryngotracheitis

Paramyxoviridae - parainfluenza virus

barking cough and stridor

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27
Q

PFTs for COPD

A

TLC: increased
FEV/FVC: decreased
FVC: decreased
RV: increased

overinflated, can’t move air very well

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28
Q

Wolff-Parkinson-White

A

AV conduction tract bypassing AV node - AV accessory pathway

short PR
Wide QRS
delta wave- broad upstroke of QRS

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29
Q

Class IA antiarrhythmics

A

Quinidine, Procainamide, disopyramide
Block Na - decrease height of phase 0
Block K - prolong AP @ phase 3
depress phase 0 depolarization

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30
Q

Lactase Deficiency

A

aka Lactose Intolerance

osmotic diarrhea
decreased stool pH
increased stool osmolality
increased breath hydrogen content

31
Q

Attachment of Posterior Cruciate Ligament

A

PCL attaches at medial epicondyle of femur –> intercondylar area

PCL is Posterior to ACL

32
Q

Attachment of Anterior Cruciate Ligament

A

ACL attaches at lateral epicondyl of femur –> intercondylar area

ACL is Anterior to PCL

33
Q

Innervation of Anterior 2/3 of tongue

A 
Taste = Chorda Tympani of Facial CN VII
Sensation = Mandibular of Trigeminal CN V3
Motor = hypoglossal CN XII
34
Q

Innervation of Posterior 1/3 of tongue

A 
Taste = Glossopharyngeal CN IX
Sensation = Glossopharyngeal CN IX
Motor = Hypoglossal CN XII
35
Q

Causes of High Renin and High Aldo

in HTN with low K

A

Secondary HyperAldo

renin-secreting tumor (JG tumor)
diuretics
malignant HTN

36
Q

Causes of Low Renin and High Aldo

in HTN with low K

A

Primary HyperAldo

Aldo producing tumor
adrenal hyperplasia

37
Q

Causes of Low Renin and Low Aldo

in HTN with low K

A

Non-Aldo causes

congenital adrenal hyperplasia
Cushing syndrome
exogenous mineralocorticoids

38
Q

Acute dystonic reaction

A

ADR of D2 antagonists

Haloperidol, fluphenazine

39
Q

Causes of Polyhydramnios

A

Esophageal/Duodenal/Intestinal Atresia
Anencephaly (increased risk with anti-epileptics)

impaired fetal swallowing

OR

increased fetal urination due to uncontrolled GDM, parvovirus infection

40
Q

Causes of Oligohydramnios

A

Renal agenesis, ARPKD
impaired fetal urination

POTTER sequence
Pulm Hypoplasia
Oligohydramnios
Twisted Face
Twisted Skin
Extremity defects 
Renal Failure (in utero)
41
Q

Aortic Regurg

A

Widened pulse pressure
–> head bobbing

diastolic murmur heard at left sternal boarder

42
Q

Hydrocephalus ex-vacuo

A

Hydrocephalus (enlargement of the ventricles) due to neuronal loss

seen in patients with Neurodegenerative disease (AIDs dementia)

43
Q

Markers of Precursor B-cells

A

CD19
CD10

TdT - all lymphs

44
Q

Markers of Precursor T-cells

A

CD1
CD2
CD5

TdT - all lymphs

45
Q

MAOi

A

Selegiline, Phenelzine, Tranylcypromine

irreversibly bind MAO and prevent breakdown of amine neurotransmitters (NE, 5-HT, DA)

wait 2 weeks for MAO regeneration before starting SSRI

must avoid Tyramine containing foods - Wine and Cheese - for else HTN crisis

46
Q

de Quervain thyroiditis

A

Subacute Granulomatous Thyroiditis

painful enlargement of the thyroid following acute viral illness

causes transient hyperthyroid (weeks) followed by hypothyroid (months) –> full resolution

biopsy: lymphocytic infiltrate with macrophages and multinucleated giant cells

47
Q

Thiazolidinedione

A

pioglitazone

improves insulin sensitivity

enters nucleus and binds PPAR-gamma + RXR (retinoid X receptor) –> altered gene transcription

increased Fatty Acid uptake
Increased adiponectin (secreted by fat tissue, increases insulin sensitivity and fatty acid oxidation)
Increased insulin sensitivity (@muscle and liver)
decreased TNF-alpha
Decreased Leptin

48
Q

Thrombotic Thrombocytopenic Purpura

A

decreased ADAMTS13 –> vWF multimers –> microvascular thrombi (platelet rich) = impaired vWF cleavage

hemolytic anemia with schistocytes
thrombocytopenia (increased bleed time with normal PT and PTT)

+/-
renal failure / acute kidney injury
neurologic symptoms like sensory loss

49
Q

Reported measure of case-control study

A

Exposure Odds Ratio

ex. people with Dz and people without Dz vs exposure and non-exposure

50
Q

Reported measure of cohort study and clinical trials

A

Median Survival

those receiving treatment vs placebo

51
Q

Reported measure of cross-sectional study

A

Prevalence odds ratio

prevalence of disease in different populations

52
Q

Inheritance of NF-1

A

single gene autosomal dominant

NF-1 on Chr17

53
Q

Antioxidant enzymes

A

Superoxide Dismutase
Glutathione peroxidase
Catalase

get rid of ROS –> water + O2

ROS cause lipid peroxidation, protein damage, DNA breaks

54
Q

Acute Epiglottitis

A

due to Hib infection (Haemophilus influenza type b)

dysphagia, drooling, fever, cherry red epiglottis

55
Q

Extrinsic Pathway of Apoptosis

A

FasL binds Fas receptor (CD95)
-or-
TNF-alpha binds TNF

–> activation of caspase 8 and 10

occurs in negative selection in thymus

56
Q

Intrinsic Pathway of Apoptosis

A

Bcl-2 - antiapoptotic

BAX and BAK - proapoptotic

Bcl-2 binds cytochromeC, preventing apoptosis
p53 activates BAX/BAK - proapoptotic

low Bcl-2 allows cytochrome C to bind APAF-1 –> activation of Caspase 9 –> apoptosis

57
Q

Potassium Iodide

A

given to prevent uptake of radioactive iodine @ thyroid

ex. radiation exposure

58
Q

MAO capsaicin

A

depletion of Substance P –> decreased nociception!

59
Q

Shigella

A

Gram negative rod
Lactose non-fermentor = white colonies on MacConkey agar
Oxidase negative
no H2S production on TSI agar = not black colonies

mucosal invasion is pathogenic mechanism - invades via M cells –> spreads laterally to epithelial cells

watery –> bloody and mucus stools

Shiga Toxin - inactivates 60S rRNA

tx: ampicillin or TMP-SMX

60
Q

Lesion causing Right Homonymous Hemianopia

A

Left Optic Tract (between optic chiasma and LGN)

cannot see things on the right side

61
Q

Decreased leukocyte alkaline phosphatase

A

CML

t(9:22) = BCR-ABL

62
Q

Cells that perform glycolysis and only sometimes produce ATP?

A

RBCs

can do glycolysis to produce ATP
-or-
skip ATP production to produce 2,3-BPG - allows for increased O2 delivery to tissues

increased 2,3-BPG with RIGHT shift

63
Q

Wide Fixed splitting of S2 regardless of inspiration

A

ASD

can result in Eisenmenger syndrome - irreversible changes to pulmonary vessels

64
Q

Secreted with neurophysins

A

ADH and oxytocin

65
Q

Effects of Nitrates

A

vascular smooth muscle relaxation (veno>arterial)

reduced preload = decreased LV end-diastolic pressure and volume

reduced afterload due to arterial vasodilation

66
Q

MOA Verapamil and Diltiazem

A

Block Ca Channels

slow phase 4 depolarization @ SA and AV nodes

treatment for paroxysmal supraventricular tachycardia

67
Q

Screening for THF-alpha inhibitors

A

Must be evaluated for latent TB

TNF-alpha allows cell-mediated immunity - keeps latent TB in check

infliximab, etanercept

68
Q

Phentolamine

A

alpha-1 blocker

counteracts NE vasoconstriction, like if a pt is getting NE infusion and infusion site turns pale

69
Q

ADR of Methotrexate

A 
oral and GI ulcers
hair loss
pancytopenia
hepatotoxicity (hepatitis, fibrosis, cirrhosis)
pulmonary fibrosis

rescue with leucovorin!

70
Q

MOA Diabetic Neuropathy

A

diabetic microangiopathy (due to endoneural arteriole hyalinization) –> nerve ischemia

aka vessels undergo non-enzymatic glycosylation –> narrowing and hyalinization

71
Q

PrP

A

causes Prion Dz in beta-pleated sheet conformation

see spongiform transformation of gray matter on biopsy

72
Q

Nerve carrying Pleuritic Chest Pain

A

Phrenic

innervates Parietal Pleura @ mediastinum and diaphragm

73
Q

Primary TB

A

lower lobe
calcified LN
small fibrosis

Ghon complex

74
Q

Secondary TB

A

cavitary lesion in the Upper Lobe
-aka-
apical cavitary lesion

Caleb's Step 1 (16 decks)

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