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Step Wrong Qs > May 11th > Flashcards

May 11th Flashcards

1
Q

multinucleated giant cells with intracytoplasmic AND intranuclear inclusions

A

Warthin-Finkeldey giant cells (fused lymphocytes)
Respiratory secretions
Measles

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2
Q

Most common causes of common cold

A

1- rhinovirus

2- coronavirus

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3
Q

Immune complex is what type of sensitivity

A

Type 3

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4
Q

CMV retinitis

A

Common cause of blindness in AIDS

Cotton-whool exudates, perivascular hemmorhage, retinal detachment

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5
Q

Mitral stenosis

A

Late diastolic murmur,

Best heard at apex

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6
Q

PAndemic vs epidemic

A

Pandemic: segmented virus, antigenic shift.

Epidemic, mutations, drift

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7
Q

S3 gallop

A

Dialated cardiomyopathy

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8
Q

De Quervain thyroiditis

A

Transient hypothyroidism following viral illness
Tender thyroid, elevated erythrocyte sedimentation and hypothyroid
EBC, Coxackie, flu, adeno

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9
Q

Varicella roster pathology

A

Cordry A inclusion bodies. Intracellular eosinophilic sorrounded by halo

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10
Q

Bactrim MoA (TMP-SMX)

A

Inhibits bacterial dihydrofolate reductase

Causes megalobalstic anemia

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11
Q

Premature baby risk

A

Bronchilitis caused by RSV

Wheezing bc bronchiole (vs pneumonia which is lung parenchyma)

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12
Q

Alcoholics have increased emzyme:

A

AST vs ALT (but both)

Gamma glutamyl transferase

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13
Q

Spindle shaped tumor

A

Kaposi sarcoma

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14
Q

Regan-lowe

A

Bordetella pertussis

Also bordet-gengoug

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15
Q

Ventilator associated pneiu==ymonia

A

Pseudomonas

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16
Q

CMV vs EBV owl eyes

A

EBV: reedsternberg, clear cells in lake (higher C:N ratio)
CMV: owl eyes, immediate halo. Owl eye.

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17
Q

Why dont IgG for hep C get rid of diseasse?

A

Antigenic variation. No proofreading 3’ to 5’

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18
Q

Aniline dyes

A

Methylene blue (stains orynebacterium diptheriae)

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19
Q

How do sufur granules look in histo

A

Purple plaque

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20
Q

Von Girk

A

Deficiency in glucose-6-phosphatase
Seizures, hypoglycemia
Hepatosplenomegaly

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21
Q

Define asterixis

A

Flapping whne outstretched hands

Suggestive of high ammonia levels

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22
Q

Where is ammonia broken down?

A

Initial steps: mitochonidrai

Late steps: cytoplasm

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23
Q

Duchennes

A

Frameshift mutation
Accelerated muscel breakdown, starts pelvis works up.
GOWER’s manuver
X linked

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24
Q

Toxicity of statins

A

Elevated creatine kinase
Rhabdommyolosis
Myostitis (muscle inflammation)

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25
Q

Cyanide poining

A

Bright red vessels in eyes
Bitteralmond breath
Fatigue
From fire/constructoin

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26
Q

Isonaiazid

A

Treatment/prophylaxis for TB

Causes neurotoxicity and heptotoxicity

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27
Q

Kartagener’s

A

Chornic sinusistis, bronchiectasis, situs inversus (mirror body organs)
Dyenin deficiency

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28
Q

Elevation of leucine, isoleucine, or valine in blood (

A

I Love Vermont
Maple syrup disease
Alpha ket acid dehydrogenase

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29
Q

Alcohol effect on NADH/NAD

A

Increased NADH: NAD ratio

NAD is used p.

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30
Q

Vitamin C

A

Hydroxylation of proline lysine

Facilitates iron obbsorption

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31
Q

Reyes syndrome

A

Impaired mitochondrial metabolism of fatty acid

Virus + aspirin

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32
Q

Hunter syndrom

A

Xlinked recessive
Intelectual disability, hearing loss, coarse face, hepatosplenegaly
And NO corneal clouding
Iduronate sulfatase

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33
Q

Ovoid cells within macrophages

A

Histoplasma capsulatum

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34
Q

Diabetic mononeuropathy

A

Usually CN III, ischemia of somatic, but spares parasympathetic.
“Down and out” gaze.
Normal reflex

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35
Q

Kidney stone pee

A

Hematuria

Normocacemia BUT hypercalciuria

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36
Q

Antifungal target:

A 
Mitosis: griseofulvin
DNA/RNA synthesis: flucytosine
Cell wall: caspofungin
Cell membrane: 
-amphoteracin, nyastatin (bind ergosterol)
-azoles inhibit ergosterol synthesis
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37
Q

Type 1 hypersensitivity

A 
Immediate
IgE
Anaphylaxis/allergies
Basophils, mast cells.
"Cell surface antibody bridging by antigen"
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38
Q

Type II hypersensitivity

A

Cytotoxic, IgG, IgM (deposits)
Complement activation.
NK, eosinophil, neutrophil, macrophage
Goodpasture, autoimmune hemolytic anemia

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39
Q

Type III hypersensitivity

A

Immune complex
Neutrophil
Complement activation

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40
Q

Type IV hypersensitivity

A

Delayed type
T cell, Macrophage (no humoral).
TB skin test

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41
Q

Leukocyte ahesion cascade

A

Margination: bloodflow
Rolling: P/E selectin (cell) + Integrin/sialyated glycoprotein (cell)
Activation: ICAM-1 (integrin ligand)
Tight adhesion: CD18
Transmigration: PECAM1 (platelet endothelial adhesion molecule

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42
Q

What cell can’t use ketones

A

RBCs. No mitochondria

43
Q

How do you treat muscle stiffness/tremor associated with antipsychotics?

A

Anticholinergic AND stop meds

44
Q

Most common cause of death after MI

A

V-Fib

45
Q

CO/End diastolic volume curve

A

X intercept = mean systemic pressure

Decreased total peripheral resistance = Increased slope of both Cardiac functiona nd venous return curve.

46
Q

L2

A

Sensory loss: upper thigh

Weakness: hip flexion

47
Q

L4

A

Patellar Reflex

48
Q

S1

A

Achilles reflex

49
Q

Third nerve crosses

A

Between posterior cerebral and Superior cerebral arteries

50
Q

Aneurysm from posterior cerebellar or posterior cerebral

A

Ipsilateral headache, diplopia, nonreactive pupil, ptosis, and down and out eye.
Smoking and hypertension

51
Q

Estrogen on thyroid

A

Less clearance of thyroid binding protein
Low free T4 for a little, then TSH makes more so free is equal.
Long term = increased TOTAL thyroid

52
Q

Diagnosing cholecystitis

A

Prefereed: ultrasound

Nuclear medicine scanning: more specific

53
Q

Age related macular degeneration (AMD)

A

Smoking makes wors.
Dry: gradual vision loss in one or both eyes. Difficulty reading/driving. Drusen depsoits (yellow spots on fundescopic). VEGF
Wet: acute vision loss, metamorphosia (distrotion of straigt lines). (Ray/green subretinal discoloration.

54
Q

Abortion

A

Misoprostol: prostaglandin E1 agonist
Mifepristone: progesterone/glucocorticoid antagonist
Methotrexate: Folic acid antagonist

55
Q

Effect modification

A

Effect of an exposure on an outcome is modified by another variable (Drug)
Vs. confounding, when coincidentally something was not thoguht of.

56
Q

alpha 1 antitrypsin deficinency (AAT)

A

Destruction by macrophages of alveolar walls.

Unsecretted AAT is seen within periportal hepatocytes as reddish-pink with acid-schiff.

57
Q

Trisomy 21 in utero

A

Low alpha feto protein (AFP) and unconjugated estriol

Increasedb-hCG and inhibin A

58
Q

Cardiac output calculation

A

CO = stroke vl X heart rate
Or
CO= rate of O2 consumption/ AV O2 difference

59
Q

Serotonin amino acid precursor

A

tryptophan

60
Q

How to treat serotonin syndrome

A

Antagonist (crypoheptadine)

61
Q

Xanthelasma

A

Yellow macule/laque on eyelid

Hyperlipidemia

62
Q

Hypoketotic hypoglycemia

A

Acyl CoA dehydrogenase deficiency (Acyl CoA to acetyl CoA from fatty acids)
Ketones: acetoacette

63
Q

Centriacinar emphysema

A 
Smoking history
Exertional dyspnea
Dialated airspaces on CT
Wheezes
Infiltrating neutrophil
64
Q

Kidney embryo origin

A

Ureteric bud: collecting system (ureter, calyces, collecting tubules/ducts)
Metanephric mesoderm: glomerulus, distal and proxuimal tubules.

65
Q

IL12 deficiency

A

Can’t make Th1, must treat with IFN-y

66
Q

Benzodiazepine MoA

A

Bind to bendodiazepine binding site, allosterically modulates biding of GABA.
Increases frequency of ion channel opening.

67
Q

Marker in Glomerulonephritis

A

Serum IgG antibodies to PLA2R (found in glomerular podocites).

68
Q

Paroxysmal nocturnal dyspnea

A

Marker of no DAF (CD55).

Heme cells attacked by IgG and complement

69
Q

Why dont calcium channel blockers block skeletal muscle?

A

Does not require extracellular calcium influx for excitation/contraction coupling

70
Q

Why is elastin rubber-like?

A

Because of elastin monomer cross-linking
Lysyl oxidase (requires copper). lysine common.
Desmosine cross-liinks

71
Q

Homocysteinuria

A

No methionine synthase (B12) or cyastathionine synthase (B6).
Can’t make cystine from homocystine. Elevated methionine.

72
Q

Big sideffect of ganciclovir

A

Neutropenia (bone marrow suppression). Worse if you give zidovudine or trimethroprim-sulfamethoxolate

73
Q

Define dysarthria

A

Weak muscles, resulting in slurred speech.

74
Q

Wallerian degeneration

A

Breakdown of axon distal to site of injury.
B/c BBB, macrophage recruitment is slow
Plaque forms, prevents axonal growth. Glial scar. Persistant myelin debris

75
Q

Chemicals in insulin metabolic acidosis URINE

A

Decreased pH (b/c HCO3 is removed to balance pH)
Decreased HCO3
Increased H2PO4- (to trap H+ for excretion)

76
Q

Hydrocele occurs where?

A

Inside tunica vaginalis

77
Q

S3 in adults

A

Limitation of ventricular movement during passive filling

Ventricular enlargement

78
Q

When can S3 be heard best?

A

Left lateral decibitus at END expiration

79
Q

Attrition bias

A

Form of SELECTION bias

people leaving study

80
Q

Dangerous consequence of Adenosine and dipyridamole?

A

Cardiac steal (bc they are vasodilators) from ischemic sections. Blood flows in least resistance.

81
Q

Hyaluronic acid

A

Present in strep pyogenes
NOT IMMUNOGENIC
Bc also present in connective tissue

82
Q

How do you better facilitate phagocytosis of strep pyogenes?

A

Add antibodies to protein M (virulence factor).

83
Q

Pulmonary embolism in breathe tests

A

Ventilation/perfusion mismatch

Leads to hypoxemia

84
Q

Ipratropium MoA

A

Blocks acetylcholine at muscariinc receptors

Prevents bronchoconstriciton, reduces parasympathetic stimulation

85
Q

Feeds descending colon

A

Inferior mesentaric artery

Feeds all hindgut (distal 1/3 of transverse, descending, sigmoid, rectum)

86
Q

Risk for galstone formation

A

High cholesterol

Low bile salts or phosphatidylcholine (both increase solubility)

87
Q

Pigmented gallstones

A

Calcium and unconjugated bilirubin
Usually secondary to bacterial (salmonella) or helminthic (chlonorchis sinesis) infection OR hemolytic anemia
Causes release of beta-glucuronidase by injured hepatocytes (increased unconjugated bilirubin)

88
Q

Gemfibrozil MoA

A

Fibrate, reduces cholesterol solubility (so it’s not absorbed)
Risk: can cause gallbladder stones (don’t give w/ history)

89
Q

Drug use for seizures

A

Absence: valproic acid/ethosuximide

Combined absence and tonic cloinic: valproate.

90
Q

Stop drinking drugs

A

Stop pleasure: Naltrexone

Once you stop drinking to stay sober (disulfram)

91
Q

Gonadal arteries arise from

A

Abdominal aorta, right under renal arteries

92
Q

HIrschprung

A

Failure of neural crest migration to intestinal wall.
No meissner or myenteric plexus.
Check submucosa of the rectum (narrowed part)

93
Q

Pheochromocytoma presentaton

A 
Episodic headache
Tachycardia
Diaphoresis
HTN, severe. 
(Catecholamine secreting tumor from chromaffin cells)
94
Q

Completely opacified hemithorax

A

Looks like pleural effusion BUT shortness of breath mixed with tracheal deviation TOWARD problem = collapse.
Likely mainstrem bronchi lesion/occlusion leading to collapse

95
Q

How to treat carcinoid syndrome

A

Octreotide

diagnosed by increased 5-HIAA urine excretion

96
Q

Most common kidney issue in SLE

A

Diffuse progressive glomerulonephritis

Proteinuria

97
Q

Treatment for SLE

A 
Skin/muscle: hydroxychloroquine
Organ involvement (nephritis): cyclophosphamide
98
Q

Langerhans cell histoicytosis

A

Disorder of dendritic cells (langerhan cells)
Present in kids 1-3 as lytic bone lesion, skin rash or recurrent otitis media. Jaw mass.
Tennis racket sapedBirbeck granules on EM

99
Q

Leukocyte adhesion defieicency (LAD)

A

No neutropihl going into periphery. High in blood, no pus in infection.
Absence of CD18 integrin.

100
Q

Anti IgG antibodies are pathomneumonic for what?

A

Rheumatoid arthritis

101
Q

Rheumatoid arthritis

A

Rheumatoid factor (anti IgG)
Fatigue, chroinic joint pain not made better by tylenol.
Bilateral hands and knees
Stiffness that improves with movement.

102
Q

Acute lymphocytic leukemia

A

3-7
Fever, atigue, decreased appetite, night sweats
Cervical lypmohadenopathy, anemia, petichial rash
>20% leukemic blasts

103
Q

Job syndrome

A 
Hyper IgE (Th17 can't make IL18, no neutrophil)
FATED
Faces weird (coarse, leathery) 
Abscess (cold)
T: Baby teeth retained 
E: IgE is high
D: derm (excema)

Step Wrong Qs (10 decks)

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