May 9th

Question 1

McArdle disease

Answer 1

gylcogen phosphorylase deficiciency
Weaknss and Fatigue with exercise
No rise in blood lactate after exerices
McArdle can’t cross last hurdle

Question 2

TATA box

Answer 2

Use: promoter reigion

Binds transcription factors and RNA polyermase II

Question 3

Proptosis

Answer 3

Abnormal protrusion (eye exopthalmus)

Question 4

Western blot

Answer 4

Detects target protei.
Electrophoresis
Nitrocellulose membrane probed with primary antibody
Secondary antibody binds to firs to be detected.

Question 5

Role of TGF beta

Answer 5

Fibrop=blast migration/proliferation

Remodels extracellular matrix (Scartissue)

Question 6

Serum sickness

Answer 6

Type III hypersensitivity reaction to nonhuman proteins

Causes: vasculitis (immune complex).

Question 7

MHC class 1

Answer 7

Heavy chain + beta2-microglubulin

Question 8

Wernicke encephalopathy

Answer 8

Triad: opthalmoplagia, ataxia, confusion
Hemorrhage and necrosis of mamillary bodies on autopsy.
Cause: chronic thiamine deficiency

Question 9

Thamin deficiency

Answer 9

ATP
alpha-keto dehydrogenase (TCA)
Transketolase (pentose phophate pathway)
Pyruvate dehydrogenase (TCA)

Question 10

Adrenal order

Answer 10

G: Salt
F: Sugar
R: Sex
Medulla: catecholamines (activated by preganglionic ACh)

Question 11

Ureter location

Answer 11

retroperitoneum:
Posterior to gonad vessel
Anterior to common/external illiac
True pelvis:
Anterior to internal illiac artery
Medial to ovarian vessel
Uterine artery crosses over ureter (water under the bridge).

Question 12

RBF calculation

Answer 12

RBF = PAH clearance/ (1-hematochrite)

PAH clearance = (urine PAH x urine flow rate) / plasma PAH

Question 13

MYasthenia gravis

Answer 13

Decrease in functional ACh receptors in POSTsynaptic terminal of neuromuscular junction.

Question 14

Treatment of myasthenia gravis

Answer 14

Cholinesterase inhibitor

Question 15

Muscarinic overstimulation

Answer 15

Caused by cholinesterase inhibitors (myestania gravis treatment)
Treated by antimuscarinic (scopolamine)

Question 16

Define dysarthria

Answer 16

Difficulty producing speach

But speech is normal

Question 17

Where does trigeminal nerve start?

Answer 17

Lateral mid pons (at level of middle cerebral peduncle)

Question 18

Define dysmetria

Answer 18

Lack of coordination, specifically over shooting stuff with nhands

Question 19

Anterior pons infearct

Answer 19

Coriticospinal tract (pyramids, cntrolateral hemiparesi, babinski)
Corticobulbar (contralateral facial palsy LOWER, dysarthria)
Contralateral dysmetria

Question 20

Clozapine side effect

Answer 20

Agranulocytosis (neutrophil count drops).

Seizures and myocarditis too

Question 21

Rifampin effect on P450

Answer 21

Inducer

Question 22

Malassezia

Answer 22

Tinea versicolor (skin infection)
Hyper/hyp pagmented macules and patches.
Spagetti and meatball apparence on KOH

Question 23

Multiple endocrine neoplasia 1

Answer 23

Primary hyperparathyroidism
Pituitary tumor (prolactin, visual)
Pancreatic tumor (gastrinoma)

Question 24

Multiple endocrine neolasia 2A

Answer 24

MEdullary thyroid cancer (calcitonin)
Pheochromocytoma
Parathyroid hyperplasia
RET gene (prot-onco)

Question 25

Multiple Endocrine neoplasia type 2B

Answer 25

MEdullary thyroid cancer (calcitonin)
Pheochromocytoma
Mucosal neuromas/marfanoid habitus
RETgene

Question 26

Respitory problems in Diabetic ketoacidosis

Answer 26

Respiratory failure
Pulmonary edema (no compensatory drop in PaCO2 with acidosis)

Question 27

Nevi difference

Answer 27

Junctional nevus: Nevus cell in epidermis only (flat, pigmented)
Compoind: invade dermis and stay in epidermis (raised, pigmented)
Intradermal nevi: Old, lose epidermal cells (Raised, NON pigmented)

Question 28

Acute bacterial parotitis

Answer 28

Eldery, post operative or dehdrated
Staph A most common.
Check serum amylase (with no lipase issues taht signify pancreatitis

Question 29

Fenofibrate MoA

Answer 29

Reduce hepatic VLDL (b activating proliferator activated receptor alpha (PARA).
Increase lipoprotein lipase

Question 30

Highest membrane permeability for K in normal neuron

Answer 30

On the way down (middle), depolarization (not top)

Question 31

Multiple Myeloma

Answer 31

Bone pain (lower back)
Fatigue/anemia
Kidney disease
Hypercalcemia

Question 32

Pramipexole MoA

Answer 32

Directly stimulates dopamine receptors

Question 33

define epistaxis

Answer 33

Nose bleed

Question 34

Denge fever

Answer 34

Fever, rash
Myalgia (bone break)
Epistaxis (thrombocytopenia)
Retro orbital pain
Aedes aegypti mosquito

Question 35

Amatoxins

Answer 35

From poisonus muchroom
Inhibit RNA polymerase II (halt mRNA synthesis)
Hepatosplenomegaly, jaudice,ALT and AST elevated

Question 36

Free wall rupture after heart attack timing

Answer 36

5-14 days, neutropihl and macrophage infiltration

Question 37

Complications of MI/time

Answer 37

Right ventrical failure (acute, hypetension, kussmaul sign [rise in JVD with inspiration, fluid back out])
Papillary muscle rupture (3-5 days) mitral regurge
Septum rupture (Intra ventricular) (3-5 days). Holosystolic murmur
Free wall rupture w/ pericardial tamponade (5-14 days)

Question 38

Friedreich ataxia

Answer 38

Cerebellar ataxia (spinocerebellar)
Dorsal root/collumn ganglia degeneration (loss of position, vibration). 
Kyphoscoliosis
Hypertrophic cardiomyopathy
AR, FRATAXIN gene. (Repeats, GAA)