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Caleb's Step 1 > March 23 > Flashcards

March 23 Flashcards

1
Q

Metanephric diverticulum = Ureteric Bud

A

collecting tubules, ducts, major and minor calyces, renal pelvis, ureters

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2
Q

Metanephric medoserm = Blastema

A

glomeruli, bowman’s space, proximal tubule, loops of Henle, distal convoluted tubule

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3
Q

increased TGF-beta

A

keloid scars

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4
Q

Polysachride vs Conjugate vaccine for Hib

A 
Polysaccharide
B-cell only
no memory cells
short immunity
not immunogenic in infancy
Conjugate 
B-cell and T-cell 
yes memory cells 
long immunity
immunogenic in infancy
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5
Q

most abundant amino acid in collagen

A

glycine

Glycine - X - Y - Gly - X- Y - Gly

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6
Q

What tissues cannot use ketones for energy

A

Liver and RBCs

Liver Produces Ketones

Muscle, Kidney, Brain - use Ketones

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7
Q

Heart failure med that prevents/improves ventricular remodeling

A

Mineralocoricoid receptor antagonists

spironolactone, eplerenone

contrainicated in pts with hyperK and renal failure

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8
Q

Noise induced hearing loss occurs due to damage of?

A

stereociliated hair cells on the Organ of Corti

high frequency sounds are lost first

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9
Q

Oppositional Defiant Disorder

A

argues
refuses to follow rules
deliberately annoys others
blames others

no serious violation of societal norms

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10
Q

Conduct Disorder

A

violates the basic rights of others or societal norms

criminal stuff

grow up to be Antisocial (Sociopath)

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11
Q

ADHD

A

onset before 12 years old

poor attention
hyperactivity
impulsivity

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12
Q

Internal Hemorrhoids venous drainage

A

Above pectinate line

middle rectal –> internal iliac
superior rectal –> inferior mesenteric –> liver

painless

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13
Q

External Hemorrhoids venous drainage

A

Below pectinate line

inferior rectal –> internal pudendal –> internal iliac –> caval system

pain via interior rectal branch of pudendal N.

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14
Q

Most common outcome of HBV infection

A

complete resolution (>95%)

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15
Q

NNRTI

A 
Efavirenz = efaVIRenz
Nevirapine = neVIRapine

allosteric RT inhibitors

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16
Q

NRTI

A

abacavir
tenofovir
emtricitabine
-VUDINEs

ADR: central fat deposition

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17
Q

PIs

A

daruNAVIR
ritoNAVIR
-NAVIRs

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18
Q

HEV

A

unenveloped RNA virus

fulminant hepatitis of pregnant women

fecal oral transmission

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19
Q

Stongyloides stercoralis

A

Rhabditiform larvae in the stool

infect via feet –> lungs –> GI

tx: ivermectin

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20
Q

Dihydropyridine calcium channel blockers

A

-dipines (amlodipine, nifedipine)

vasodilate vascular smooth muscle

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21
Q

non-DHPR calcium channel blockers

A

Verapamil>Diltiazem

reduce HR and contractility at cardiac muscle

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22
Q

Carcinoembryonic Antigen

A

elevated with pancreatic, gastric, breast, and colon cancers
also IBD, COPD, cirrhosis, pancreatitis, and smokers

used to monitor colorectal cancer (increased = worse prognosis, failure to normalize =persistent disease)

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23
Q

Tetrodotoxin

A

Fugu = Puffer fish

binds Na+ channels and prevents action potential.

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24
Q

Polymyalgia rheumatica

A

Pain and stiffness in hips and shoulders + fever, malaise, weight loss (NOT weakness)

associated with Giant Temporal Cell Arteritis

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25
Q

Primary Biliary Cholangitis

A

chronic autoimmune liver disease
+anti-mitochondrial antibodies

patchy lymphocytic inflammation with granulomatous destruction of intrahepatic bile ducts and necrosis

(similar histopath to graft-vs-host w/ lymphocytes in the liver)

Fat, Forty, Female, Fertile

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26
Q

Type I Muscle Fibers

A

@ postural skeletal muscle (paraspinal muscles)

slow twitch, red fibers

ATP from oxidative phosphorylation

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27
Q

Type II Muscle Fibers

A

IIa - fast twitch, aerobic oxidative phosphorylation

IIb - anaerobic glycogenolysis and glycolysis

biceps, deltoid, etc

rapid, forceful movements

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28
Q

Effects of ADH on the Medullary segment of the collecting duct?

A

increase urea and water reabsorption into the interstitium @ the medulla –> produce maximally concentrated urine

reabsorption of urea –> loop of Henle osmotic gradient!

29
Q

Stress Ulcer

A 
shock
burn - Curling Ulcer
sepsis
severe trauma
intracranial injury - Cushing Ulcer

Cushing ulcers due to vagus nerve stimulation from increased ICP –> increased ACh release –> hypersecretion of gastric acid

30
Q

MLF Lesion

A

Dorsal Pons

Internuclear Ophthalmoplegia

ipsilateral eye unable to adduct
contralateral abducts with nystagmus

convergence and pupillary light reflex preserved

31
Q

Mycobacterium leprae

A 
tuberculoid = mild 
lepromatous = severe

tuberculoid –> strong TH1 response (IL-2, IFN-gamma, IL-12) –> macrophage response –> bacterial killing but also hypopigmented well demarcated plaques

Lepromatous –> TH2 (IL-4, IL-5, IL-10) –> more numerous and poorly demarcated lesions

positive lepromin skin test = Tuberculoid

32
Q

When is beta-hCG first detectable in the serum?

A

8 days after fertilization

produced by syncytiotrophoblast

33
Q

I-cell Disease

A

Inclusion cell Disease - Autosomal Reessive lysosomal storage disorder

defection phosphotransferase enzyme –> extracellular secretion of proteins that should be sent to lysosome and inclusion bodies = lysosomes full of cellular debris that can’t be broken down

due to inability of the cell to target proteins to the lysosome - deficient phosphorylation of mannose residues on glycoproteins in the Golgi

34
Q

Essentail Fructosuria

A

Benign Fructokinase deficiency

hexokinase takes over the role of fructose metabolism and converts fructose –> fructose-6-phosphate

normally Fructose –> Fructose-1-phosphate via Fructokinase

fructose-1-phosphate then metabolized by Aldolase B

35
Q

Second Generation Antipsychotics

A

Clozapine, Olanzapine -zapines

ADRS: weight gain, dyslipidemia, hyperglycemia, increased risk of DM

routine monitoring of: weight, waist circumference, BP, fasting glucose, lipid profile

monitor bone marrow clozely with clozapine

tx: Schizophrenia (also bipolar, OCD, anxiety)

36
Q

Hyperacusis

A

increased sensitivity to sound

damage to Stapedius Nerve (branch of Facial Nerve CN VII) –> paralysis of the stapedius –> increased sensitivity to noise

37
Q

Achilles reflex

A

S1

38
Q

Pancreatic Beta Cell Function

A

Glucose –> GLUT2 channel –> TCA cycle –> increased ATP –> ATP binds K+ channel causing it to close –> depolarization –> calcium influx –> insulin release

K+ channles on beta cell regulated by ATP (which is produced from blood glucose)

39
Q

T-test

A

T for 2

40
Q

ANOVA

A

Analysis of Variance (3 words, 3 or more groups)

41
Q

Theophylline

A

bronchodilator

PDEi –> increased cAMP –> bronchodilation

OD: seizures and tachyarrhythmias

42
Q

Bacillus anthracis

A

only bacterium with polypeptide capsule - D-glutamate

43
Q

no dorsal column involvement

A

ALS

anterior horn and lateral corticospinal tracts

44
Q

Schwannoma

A

S-100 + (neural crest cell origin)

45
Q

Bupropion

A

does not cause sexual side effects

does cause seizures in eating disorders and preexisting seizure conditions

46
Q

MAOi

A

Tranylcypromine, Phenelzine, Selegiline, Isocarboxazid

for atypical depression

OD tx is phentolamine (after too much wine and cheese night)

47
Q

Hyperplastic arteriolosclerosis

A

due to persistant diastolic BP > 120-130

onion-like concentric thickening of arteriolar walls

48
Q

Edwards Syndrome

A

Trisomy 18

micrognathia, prominent occiput, low set ears, clenched fists with second and fifth digits on top of third and fourth, rocker-bottom feet

49
Q

Capitation

A

pay a fixed amount for all medical services

underlying structure of an HMO

50
Q

Hyperglycemia induced cataracts

A

accumulation of sorbitol in the lens –> water influx and osmotic cellular injury

glucose –> sorbitol –> fructose

51
Q

Osler-Weber-Rendu Syndrome

A

hereditary hemorrhagic telangiectasia

telangiectasias in the skin, oronasopharynx, respiratory tract, GI, urinary tract

these can rupture and cause bleeding (epistaxis, GI bleeds, hematuria)

52
Q

basophilic stippling

A

lead poisoning

53
Q

Cryptococcus neoformans

A

budding yeast, round/oval encapsulated cells with narrow-based buds

virulence: thick polysaccharide capsule

meningoencephalitis is HIV+ pts
tx: Amphotericin B + flucytosine

54
Q

Trichomoniasis

A

frothy yellow-green vaginal discharge
looks with saline microscopy
tx: metronidazole

55
Q

Bacterial vaginosis

A

Gardnerella vaginalis

thin white/gray discharge with fishy odor (with KOH)

clue cells = epithelial cells with gram variable rods

tx: metronidazole or clindamycin

56
Q

Candida vaginitis

A

thick “cottage cheese” discharge
pH (3.8 - 4.5)
tx: fluconazole

57
Q 
Cancer Drugs and Cell Cycles
S
G2
M
G1/G0
A

S - antimetabolites (azathioprine, 6-mercaptopurine, hydroxyurea, 5-FU) block DNA synthesis

G2 - bleomycin

M - microtubule inhibitors (paclitaxel, vinblastine, vincristine)

cell cycle independent - alkylating agents ( cyclophosphamide) platinum agents (cisplatin)

58
Q

Roseola

A

HHV6 and HHV7 - enveloped linear dsDNA

high fever +/- febrile seizure –> erythematous maculopapular rash that starts on trunk and spreads to face and arms/legs

kids <2y/o

59
Q

thin stratum granulosum and prominent parakeratotic stratum corneum

A

psoriasis

60
Q

presystolic sound that precedes first heart sound; is best heard at expiration in left lateral decubitus

A

S4 aka atrial gallop

heard immediately after atrial contraction as blood is forced into a stiff ventricle

Ventricular Hypertrophy
aortic stenosis

61
Q

Herpes Encephalitis

A

prefers temporal lobes

62
Q

D-xylose

A

monosaccharide that is absorbed directly, no need for pancreatic enzymes

decreased absorption with SIBO (small intestine bacterial overgrowth)

63
Q

Production of ketones in a fasting person?

A

stress hormones (cortisol, glucagon, catecholamines) –> increased hormone sensitive lipase activity –> TG conversion to free fatty acids and glycerol –> glycerol uptake in the liver for gluconeogenesis

also

TGs –> Acetyl-CoA via beta-oxidation —> ketone bodies

64
Q

Aortic Regurg

A

decrescendo diastolic murmur, high-pitched blowing, best heard white pt sits up and leans forward with breath held at end expiration

65
Q

selective albuminuria

A

minimal change disease

66
Q

First area of the brain to be damaged in global cerebral ischemia

A

hippocampus

67
Q

What causes outflow obstruction in HCM

A

mitral valve leaflet and interventricular septum

don’t give them nitrates, we need to increase preload and prop the door open

68
Q

Pulmonary vascular bed

A

hypoxia causes vasoconstriction (this is unique)

divert blood away from underventilated areas towards regions of better vent

Caleb's Step 1 (16 decks)

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