March 30

Question 1

Pheochromocytomas arise from _____ cells of the adrenal medulla, which are derived from _____ cells?

Answer 1

Chromaffin

Neural crest

Question 2

Why are PDE-5 inhibitors CI when pt is on nitrates?

Answer 2

PDE-5 inhibitor prevent degradation of cGMP and can cause severe hypotension

PDE-5 normally inhibits cGMP which prevents NO-induced vasodilation
–but blocks its action–increase cGMP =vasodilation which is only increased with nitrates

Question 3

What type of anemia can result from GI bleeding, such as with colon cancer?

Answer 3

Iron-deficiency anemia–microcytic anemia

Question 4

Thalassemia major can be differentiated from iron-deficiency anemia by what, because they both result in microcytic anemia?

Answer 4

Normal iron level with thalassemia major

Question 5

What are the 2 most common manifestations of AD von hippel-Lindau disease?

Answer 5

Hemangioblastomas and renal cell carcinoma

Question 6

Pt with mid-shaft humerus fracture are suspected to have damage to what nerve and loss of what?

Answer 6

Radial nerve-C5-T1

Loss of extension of the wrist–wrist drop

Question 7

What is the cause of the mutation to the CFTR gene on CH. 7 seen with CF?

Answer 7

Causes abnormal protein folding of the CFTR Cl- channel

Question 8

What are the 4 muscles of mastication and which one(s) lower the jaw and which one(s) close the jaw?

Answer 8

Lower–Lateral pterygoid — Lateral Lowers

Close–Masseter, teMporalis, Medial pterygoid— M’s Munch

Question 9

What are polymyxins used for and what are their side effects?

Answer 9

Used for gram (-) bugs–bind to and destroy cell membrane

Toxicities:

• Numbness of extremities
• Confusion
• Drowsiness
• Nystagmus
• Blurred vision

Question 10

What nerve can become compressed in athletes leading to decreased medial thigh sensation and decreased adduction?

Answer 10

Obturator–L2-L4

Question 11

HbS during sickle cell crisis causes what type of shift in O2 dissociation curve?

Answer 11

Right shift–lower affinity for O2

Question 12

Immunodeficiency that presents with coarse facies, recurrent staph abscesses, eczema and elevated IgE?

Answer 12

Job syndrome–Autosomal dominant hyper-IgE syndrome

Increase IgE and Decreased IFN-g–which leads to less phagocytic activity of macrophages b/c IFN-g is released from Th1 cells and activates macrophages

Question 13

This enzyme is found in all tissues, phosphorylates glucose for conversion into storage glycogen and is inhibited by glucose-6-phosphate?

Answer 13

Hexokinase

Question 14

What muscle is the origin of cremaster muscle?

Answer 14

Internal oblique

Question 15

Where is Broca’s area located?

Answer 15

Inferior frontal gyrus

Question 16

Immunodeficiency that presents after 6 months of age, in boys, with lack of B-cell maturation and increased incidence of bacterial infections?

Answer 16

X-linked (Bruton) agammaglobulinemia

Markedly decreased IgG and IgM and low IgA

Absent/scanty lymph nodes and tonsils

Question 17

What runs through the Cardinal ligament?

Answer 17

Uterine artery and vein

Question 18

Niacin (Vit B3) deficiency results in what?

Answer 18

Pellagra

• Diarrhea
• Dementia
• Dermatitis–C3/C4 dermatome circumferential “broad collar” rash
• Hyperpigmentation of sun-exposed limbs

Glossitis can occur with mild deficiency

Question 19

What branchial arches are responsible for generation of muscles that allow for palate elevation?

Answer 19

Branchial arches 3 and 4

3–stylopharyngeus—CN IX–swallow with style
4–Most pharyngeal constrictors; cricothyroid, levator veli palatini–CN X simply swallow

Question 20

What congenital infection is associated with a PDA?

Answer 20

Rubella

Question 21

What is deficient with maple syrup urine disease?

Answer 21

a-ketoacid dehydrogenase

Question 22

What is decreased in hemochromatosis?

Answer 22

Decreased total iron-binding capacity (TIBC) which is an indirect measure of serum transferrin, a protein that binds iron in the blood stream –so you would have an increased saturation of transferrin

Question 23

What neoplasm is associated with Auer rods?

Answer 23

Acute myelogenous leukemia

Question 24

What neoplasm is associated with Down syndrome and t(15;17) translocation and what is the tx for this cancer?

Answer 24

Acute promyelocytic leukemia–responds to all-trans retinoid acid (Vit A)–which causes differentiation of promyelocytes

Commonly presents with DIC and Auer rod inclusions

Question 25

What personality disorder is characterized by unstable mood, impulsivity, suicidality and sense of emptiness?

Answer 25

Borderline personality disorder –Cluster B

Question 26

What is the prodrug of prednisolone and is converted by 11-B-hydroxysteroid dehydrogenase?

Answer 26

Prednisone

Question 27

What is responsible for formation of male external genitalia?

Answer 27

DHT–Dihydrotestosterone

Also responsible for secondary sex characteristics and causes increased size of epididymis and prostate.

5a-reductase converts testosterone to DHT

Question 28

What occurs across the RBC membrane when CO2 levels are elevated in the blood?

Answer 28

Cl- is exchanged for HCO3- so more Cl- enters the cell to compensate for the increased carbonic anhydrase activity

Question 29

What 2 cells utilize the SGLT which acquire glucose through co-transport with Na?

Answer 29

Enterocytes and nephron cells

Question 30

When determining primers for PCR what do you use?

Answer 30

Top 5' start--left
Bottom 5' start--right 
------->
5' ATAGTACCG------------GACTAGCAC 3'
3' TATCATGGC-------------CTGATCGTG 5'

Question 31

What type of HSR is serum sickness?

Answer 31

Type III HSR —immune complexes are formed and deposited in membranes where they fix complement

Question 32

What is seen in the CSF of pt with Guillain-Barre syndrome?

Answer 32

Elevated protein

Normal cell count

Question 33

C. diff produces virulence factors that cause what cellular event to occur in the intestinal epithelial cells?

Answer 33

Apoptosis

Toxin-A binds to the brush border and Toxin- B which causes depolymerization of actin cytoskeleton