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NBDE > Micro/Path > Flashcards

Micro/Path Flashcards

1
Q

From the following list select THREE items associated with Hep C

picorna
ssRNA
oral-anal
flavivirus
dsDNA
hepadna
blood borne
vaccination available
A

ssRNA
flavi
blood borne

cure available

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2
Q

From the following list select items associated with Hep A

picorna
ssRNA
oral-anal
flavivirus
dsDNA
hepadna
blood borne
vaccination available
A

picorna
ssRNA
oral anal
vaccine available

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3
Q

From the following list select items associated with Hep B

picorna
ssRNA
oral-anal
flavivirus
dsDNA
hepadna
blood borne
vaccination available
A

hepadna
dsDNA
blood borne
vaccination available

no cure

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4
Q

From the following list select items associated with Hep D

picorna
ssRNA
oral-anal
flavivirus
dsDNA
hepadna
blood borne
vaccination available
A

ssRNA
blood borne

deltavirus
only coinfx w B

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5
Q

From the following list select items associated with Hep E

picorna
ssRNA
oral-anal
flavivirus
dsDNA
hepadna
blood borne
vaccination available
A

ssRNA
oral anal

calicivirus
endemic kinda

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6
Q

flu virus:

family, genome, transmission

A

orthomyxo
ssRNA
respiratory droplets

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7
Q

respiratory syncytial virus:

family genome transmission

A

paramyxo ssRNA respiratory

bronchiolitis and pneumonia in infants

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8
Q

measles

family genome transmission

A

paramyxo, ssRNA, respiratory

measles = rubeola

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9
Q

mumps

family genome transmission

A

paramyxo, ssRNA, respiratory

mumps

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10
Q

rubella

family genome transmission

A

toga, ssRNA, respiratory

rubella (german measles)

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11
Q

adenovirus

A

adeno, dsDNA, respiratory

pharyngitis, conjunctivitis, pneumonia

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12
Q

rhinovirus

A

picorna (LIKE HEP A!), ssRNA, respiratory

common cold

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13
Q

HIV

A

retro, ssRNA, blood borne and genital

AIDS

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14
Q

CMV

A

herpesvirus, dsDNA, respiratory

mono

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15
Q

EBV

A

herpes, dsDNA, respiratory

infx mono

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16
Q

HSV1

A

herpes, dsDNA, oral

gongovostomatitis, herpes labialis

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17
Q

HSV2

A

herpes, dsDNA, genital (STD)

genital herpes

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18
Q

Rotaviruses are most common cause of gastroenteritis in children under 2.

Reoviruses have an icosahedral capsid composed of outer and inner protein shell with double-stranded segmented genome.

A

both true

reo: no envelope; icosahedral capsid; ds segmented RNA
have RNAdRNApol, replicate in c/pl

members of family:
rotaviruses and Colorado tick

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19
Q

non enveloped RNA viruses

A

reo (rota + colti)
calici (noro and sapo)
picorna (Hep A, rhino, Coxsackie A&B, polio, entero)

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20
Q

calici: envelope?, genome, members

A

no envelope; ssRNA; noro and sapo

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21
Q

reo: envelope? genome, members

A

no envelope, ds segmented RNA (THE ONLY)

rota (gastroenteritis in children <2) and Colorado tick fever

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22
Q

rota - which family and what causes

A

reo family, ds segmented RNA, causes gastroenteritis in children <2

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23
Q

picorna: envelope? genome, members

A

no envelope, ssRNA

Coxsackie A and B (B –> myocarditis); Hep A; rhino (common cold), polio

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24
Q

Which is a paramyxovirus which causes many respiratory infx in epidemics each winter. Common cause of bronchiolitis in infants, complicated by pneumonia in 10% of cases?

influenza
rubella
coxsackie
respiratory syncytial virus

A

RSV (ssRNA)

flu is orthomyxo (ssRNA)
coxsackie is picorna (ssRNA)
rubella is toga (ssRNA)

paramyxoviridae: ENVELOPED! have spikes
except RSV, have HA and NA (or fusion protein) in these spikes

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25
Q

paramyxoviridae: genome, envelope? members

A

ssRNA, envelope (spikes, NA, HA, fusion protein)

RSV, measles, mumps, paraflu

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26
Q

Cytopathic effect (CPE) is a single mechanism of infx.

All viruses cause CPE.

both true
both false
1 true, 2 false
1 false, 2 true

A

both false

not all cause CPE

CPEs:
necrosis, hypertrophy, giant cell formation, hypoplasia, metaplasia, altered shape, detachment from substrate, lysis, membrane fusion, inclusions, apoptosis

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27
Q

All of the following are Herpesviridae except

VZV
EBV
CMV
coxsackie (A&B)

A

coxsackies

are picorna (non enveloped, ssRNA)

herpesviridae are dsDNA, enveloped, replicate in nucleus
bud from Golgi!

all can establish silent infxs

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28
Q

DNA enveloped viruses

A

herpes, pox, hepadna

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29
Q

HSV1 latency site

A

trigeminal ganglion

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30
Q

HSV2 latency site

A

sacral ganglia

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31
Q

VZV latency site

A

DRG and cranial nerve ganglia

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32
Q

CMV latency site

A

endothelium and T lymphocytes

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33
Q

EBV latency site

A

memory B

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34
Q

vesicular rash

A

HSV1, HSV2, VZV

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35
Q

oncogenic herpesviridae

A

EBV and Kaposi (herpes 8)

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36
Q

Prions are most recently recognized and simplest infx agents, consisting of a single protein molecule

Prions contain no nucleic acid and therefore no genetic info

both true
both false
1 true, 2 false
1 false, 2 true

A

both true

Creutzfeldt-Jakob, mad cow

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37
Q

HSV2 is mainly spread through sexual contact

It cannot be spread from mother to infant during childbirth

both true
both false
1 true 2 false
1 false 2 true

A

1 true 2 false

of all herpesviridae, 1 and 2 recur in otherwise healthy ppl

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38
Q

Which of the following herpes lesions can be tx prophylactically by a vaccine?

HSV1
HSV2
VZV
EBV
CMV
A

VZV

two distinct phases: varicella (chicken pox) and zoster (shingles)

live attenuated vaccine done

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39
Q

Bacteriophage with ability to form stable, nondisruptive relationship within a bacterium is called a:

virulent phage
plasmid
temperate phage
phage T4

A

temperate phage

T4 infects E cole
plasmids: extrachoromosomal ds circular DNA with independent replication

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40
Q

bacterial virus

A

bacteriophage

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41
Q

cell within which virus replicates

A

host cell

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42
Q

integration into host genome without killing host

A

lysogenic cycle?

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43
Q

viral multiplication within host cell leading to destruction

A

lytic cycle

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44
Q

transfer of DNA from donor to recipient with DNA packaged in bacteriophage

A

transduction

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45
Q

transduction

A

transfer via bacteriophage

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46
Q

transformation

A

uptake of naked DNA

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47
Q

conjugation

A

exchange via F pili

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48
Q

Retroviruses contain RNA genome and reverse transcriptase.

Provirus forms as viral RNA; directly incorporated in host DNA.

both true
both false
1 true 2 false
1 false 2 true

A

1 true 2 false

provirus is DNA

for RNA viruses: transcription in c/pl except retroviruses and influenza
RNAdRNApol for all except retro (reverse transcriptase)

for DNA viruses: transcription in nucleus except pox
uses host DNAdRNApol

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49
Q

transcription of RNA viruses

A

in c/pl except flu and retro

viral RNAdRNApol except reverse transcriptase

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50
Q

transcription of DNA viruses

A

nucleus except pox

host DNAdRNApol

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51
Q 
All these are enveloped RNA except
rubella
flu A, B, C
rota
measles
A

rota is not enveloped

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52
Q

do adenoviridae have envelope?

A

no

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53
Q

does papilloma have envelope? what’s the genome?

A

no envelope, DNA

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54
Q

HepC: family, genome, envelope?

A

flaviviridae, ssRNA, no

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55
Q

retroviridae: envelope?

A

yes

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56
Q

Human adenoviruses are unlikely to target CNS BECAUSE adenoviruses prefer epithelial cells for replication.

both correct and related
both correct but unrelated
statement correct, reason wrong
statement not correct, reason correct
both wrong
A

both correct and relatedadeno - naked dsDNA

cause pneumonia, bronchitis, conjunctivitis

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57
Q

FOUR items assoc with polio

reo
salk vaccine
polio
sabin vaccine
transverse myelitis
picorna
MME vaccine
A

salk (IV deactivated)
polio (destroys ventral horns, mm paralysis)
sabin (oral live attenuated)
picorna (no envelope, ssRNA)

other picorna - HepA, rhino, entero, coxsackies

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58
Q

largest and most complex DNA:

pox
herpes
papova
parvo

A

pox

smallpox
enveloped, complex non-icosahedral shape
replicates in c/pl (unlike other DNA)
requires own DNAdRNApol because of that

other DNAs: hepadna (enveloped), papova (naked), adeno (naked), herpes (enveloped)

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59
Q

sabin vs salk and for what

A

polio

sabin oral live attenuated
salk IV deactivated

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60
Q

segmented RNA

A

reo

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61
Q

All are picorna except

polio
coxsackie
entero
hepadna
hep A
rhino
A

hepadna

picorna is ssRNA (naked)
hepadna is dsDNA enveloped

coxsackie A - herpangina, foot and mouth

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62
Q

EBV causes all except

Kaposi
infx mono
nasopharyngeal carcinoma
Burkitt's
oral hairy leukoplakia
A

Kaposi (which is herpes 8)

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63
Q

HIV1 and HIV2 are lentiviruses BECAUSE of their slowly progressive clinical effects

both true and related
both true but unrelated
first true second wrong
1 wrong 2 true
both wrong
A

correct and related

enveloped with spikes
genes: enc (for envelope proteins gp120 (binding) and gp41), pol (enzymes: reverse transcriptase, protease and integrase) and gag (core proteins)

CD4
giant cell CPE

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64
Q

lentiviruses

A

HIVs

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65
Q

retroviruses

A

lenti (HIV) and onco (HTLV)

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66
Q

HIV enzymes

A

env (gp120 and 41)
pol (enzymes: reverse transcriptase, protease and integrase)
gag (core proteins)

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67
Q

All negative polarity except

orthomyxo
paramyxo
rhabdo
retro

A

retro - + polarity
+ polarity can transcribe from original RNA
- polarity need RNAdRNApol

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68
Q

Child; recent vaccination (vaccinia).
Malaise and fever in hx, now rash on trunk and face.

variola
VZV
CMV
HSV1

A

VZV

vaccinia is against chicken pox

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69
Q

Flu has all except

ssDNA
hemagglutinin
neuraminidase
genetic reassortment
lipoprotein coat
A

ssDNA

wrong, has ssRNA
orthomyxo
enveloped

hemagglutinin - attachemtn
neuraminidase - penetration

antigenic shifts: reassortment
antigenic drifts: point mutations

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70
Q

Reye’s

A

encephalopathy, contraindicated in children, aspirin

also flu!

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71
Q

swelling of parotids

A

mumps

paramyxo, ssRNA, enveloped

orchitis and deafness as complications

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72
Q

skin rash w. Koplik spots

A

measles = rubeola

paramyxo

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73
Q

flu-like sx and lymphadenopathy + rash on whole body

A

rubella (toga, enveloped ssRNA)

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74
Q

complications include Reye’s syndrome

A

influenza!

orthomyxo, enveloped ssRNA
amantadine, rimantadine

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75
Q

Order steps in replicative cycle of virus.

A. release by budding through host plasma membrane or plasma membrane rupture
B. Replication and viral protein production
C. Attachment through receptor
D. Assembly of new virus particles
E. Entry via receptor-mediated endocytosis or membrane fusion
F. Uncoating triggered by pH changes in endosomes

A

C E F B D A

growth phases: 
adsorption
eclipse (uncoating, can't detect)
synthetic (around 12 hours post-infx, assembly of particles)
latent - no extracellular
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76
Q

Orthomyxo and Paramyxo share all except:

spherical shape
ssRNA
segmented RNA
hemagglutinin
-ssRNA
A

segmented

both enveloped, -ssRNA

paramyxo form syncytia

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77
Q

All cross placenta except:

rubella
herpes
HIV
measles
CMV
A

measles

reoviruses are the ONLY RNA that are double stranded

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78
Q

Which family includes rubi (rubella) and alpha (arthropod-borne)

picorna
reo
flavi
calici
toga
A

toga
rubella: flu-like, lymphadenopathy, then rash

congenital rubella - deafness, cataracts, heart defects

mumps - orchitis and deafness

Koplick = корь = rubeola aka measles

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79
Q

All are characteristics of Staph aureus except:

coagulase-negative
Gram +
causes infective endocarditis
possesses surface protein A
causes Toxic Shock Syndrome
A

coagulase-negative

Staph aureus is coagulase positive! other staphs are coagulase negative

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80
Q

THREE items associated with Staph aureus

protein A
streptokinase
causes toxic shock syndrome
M protein
streptolysin O
causes scalded skin syndrome
gas gangrene
A

protein A
toxic shock
scalded skin

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81
Q

M protein

A

Strep pyogenes

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82
Q

streptolysin

A

Strep pyogenes

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83
Q

exfoliative toxins

A

Staph aureus, scalded skin

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84
Q

botulinum neurotoxin

A

clostridium botulinum, botulism, mm and nn paralysis

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85
Q

gas gangrene

A

clostridium perfringens exotoxin

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86
Q

Predominant skin bacteria:

lactobacilli
lactic acid bacteria
Neisseria
staph

A

staph

other is corynebacteria

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87
Q

predominant oral cavity bacteria

A

streps, lactobacilli

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88
Q

predominant colon bacteria

A

bacteroides, lactics, enterics, clostridia

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89
Q

Lancefiled groupings are based on antigenic characteristics of cell wall carbohydrate called A substance.

Main pathogenic groups for humans are A, B, C, D, and G.

both true
both false
1 true 2 false
1 false 2 true

A

1 false, 2 true

Streps: catalase negative (unlike staphs!)
facultative anaerobes

Lancefield is classification of Streps based on C substance in cell wall (A-G pathogenic for human)

hemolysis patterns: complete beta, incomplete alpha, no gamma

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90
Q

beta hemolysis

A

complete

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91
Q

alpha hemolysis

A

incomplete (viridans?)

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92
Q

catalase in streps and staphs

A

streps -, staphs +

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93
Q

coagulase in staphs

A

all - except aureus

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94
Q

phases of bacterial growth

A

A - lag (active but not dividing)
B - log (growing and dividing exponentially, fastest most constant growth)
C - maximum stationary, some nutrients become depleted, toxic wastes accumulate
D - death - logarithmic decrease

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95
Q

Endotoxins are part of outer membrane of cell wall of

G+ only
G- only
both G+ and G-
neither; only in viruses

A

G-

endotoxin is LPS!
very pyrogenic, very potent, non-specific

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96
Q

Which is essential to the fx of outer membrane of G-?

protein
p-antigen receptors
coagulase
LPS

A

LPS

LPS = lipid A, core polysaccharide and O antigenic side chain

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97
Q

LPS composition

A

lipid A, core polysaccharide and O antigenic side chain

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98
Q

Detection of protein A can be used as specific id test for

strep pyrogenes
Neisseria gonorrhoeae
salmonella
staph aureus

A

staph aureus

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99
Q

Each produce hyaluronidase except:

staph aureus
strep pyogenes
bordetella pertussis
clostridium perfringens

A

bordetella pertussis

streps staphs and clostrs mak hyaluronidase and hymolysins

cholera and shigella make neuraminidase

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100
Q

which bacteria make neuraminidase

A

vibrio cholera and shigella dysenteriae (degrade intestinal mucosa)

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101
Q

Mycobacterium along with related Nocardia are classified as

coagulase +
collagenase +
acid-fast
phospholipase +

A

acid-fast

collagenase + is clostridium
coagulase + is only staph aureus
phospholipase + is clostridium perfringens

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102
Q

collagenase +

A

clostridium

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103
Q

phospholipase +

A

clostridium perfringens

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104
Q

In addition to peptidoglycan, acid fast cell wall of mycobacterium contains a large amt of glycolipids, especially _______ that make up ~60% of acid-fast cell wall

beta-lactamases
LPS
teichoic acids
mycolic acids

A

mycolic acids

tubercle of Ghon - primary lung lesion

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105
Q

teichoic acids

A

in G+ walls

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106
Q

Major factor of cariogenicity of S mutans is ability to adhere to tooth surface. Attachment achieved due to presence of extracellular glycocalyx, or:

plasma membrane
capsule
pellicle
reticulum

A

capsule

protects against phagocytosis, mediates adherence

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107
Q

Associated with G- cell wall:

thick murein layer
LPS
teichoic acids
mycolic acids
thin murein layer
A

LPS, thin murein

murein is cell wall PG
N-acetylmuramic acid

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108
Q

component of bacterial PGs

A

N-acetylmuramic acid

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109
Q

most species of lactic acid bacteria ferment glucose to galactose

lactobacillus specs frequently found in association with dental caries

both true
both false
1 true 2 false
1 false 2 true

A

1 false 2 true

ferment glucose into lactate (hence name)

strep is culprit in dental caries

actinomyces - root surface caries

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110
Q

Localized aggressive periodontitis bacteria are capnocytophaga ochraceus and

actinobacillus actinomycetemcomitans
wolinella recta
porphyromonas gingivalis
actinomyces israelii

A

Actinobacillus actinomycetemcomitans (Aa)

Generalized aggressive: Prevotella intermedia and Eikinella corrodens
–> rapid severe periodontal destruction around most teeth
15-25 yo

Localized aggressive: Capnocytophaga + Aa
12-19 yo
rapid and sever attachment loss at incisors and first molars + relative absence of plaque
also assoc w periodontitis in juvenile diabetes

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111
Q

Generalized aggressive periodontitis

A

15-25 yo
rapid sever generalized attachment loss
Prevotella intermedia and Eikenella corrodens

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112
Q

Localized aggressive periodontitis

A

12-19 yo
first molars and incisors, no plaque (n/ph dysfx?)
Capnocytophaga and Aa

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113
Q

Strep mutans grows optimally at pH < 7. It is

acidophilic
acidogenic
aciduric
alkaliphilic
neutrophilic
A

acidophilic

lactic acid is main enamel decalcifier

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114
Q

E coli is in family Enterobacteriaceae. All characteristic except:

capnophilic
facultative anaerobes
G-
rod shaped
flagellated
A

capnophilic

other well known enterics and Salmonella (typh) and Shigella (dysent)

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115
Q

Which is not characteristic of Strep pyogenes:

group A
G-
nonmotile
catalase -

A

G-

this is false, it’s G+

most streps are facultative anaerobes

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116
Q

alpha hemolytic streps

A

strep pneumoniae, strep viridans (endocarditis + caries)

117
Q

Order phases of phagocytosis:
A. Fusion of phagosome with lysosome to form phagolysosome
B. Formation of residual body containing indigestible material
C. Formation of phagosome
D. Chemotaxis and adherence of microbe to phagocyte
E. Discharge of waste material
F. Ingestion of microbe by phagocyte
G. Digestion of ingested microbe by enzymes

A

D F C A G B E

118
Q

Which is transferring DNA by cell-cell contact?

A

conjugation

ability to conjugate depends on presence of F+, coded by plasmid

119
Q

Transcription occurs in:

c/pl of prokaryotes and nucleus of eukaryots
c/pl of eukaryotes and nucleus of prokaryotes
nucleus of both
c/pl of both

A

c/pl in prokaryotes, nucleus in eukaryotes

transcription - from DNA to short-lived mRNA

120
Q

Attachment of microbes and other foreign cells to phagocytes by antibody molecules such as IgG and complement proteins such as C3b is called

conjugation
transformation
opsonization
adhesion

A

opsonization

two major opsonins are IgG and C3b

121
Q

M protein of Strep

A

resistance to phagocytosis

122
Q

DNAses A to D

A

cleaves DNA

123
Q

Streptococcal pyrogenic exotoxins

A

many manifestations

124
Q

Streptolysin O and S

A

lysis of blood cells

125
Q

Streptokinase A and B

A

dissolves fibrin

126
Q

hyaluronidase

A

breaks down hyaluronic acid

127
Q

strep exotoxin A

A

toxic shock

128
Q

strep exotoxin B

A

rapidly destroys tissue

129
Q

Spirochetes are a principal etiologic factor in necrotizing ulcerative gingivitis.

Prevotella intermedia is the most common spirochete found in pts with this dz.

both true
both false
1 true 2 false
1 false 2 true

A

1 true, 2 false

ANUG: Prevotella intermedia and spirochetes (like Treponema denticola)

Prevotella is not a spirochete

130
Q

Prevotella intermedia dzz

A

Generalized aggressive periodontitis and ANUG

131
Q

All are eukaryotes except:

fungi
plants
protozoa
bacteria

A

bacteria

132
Q

Aerobic respiration is more efficient than fermentation BECAUSE aerobic respiration utlizies metabolically derived organic acids as terminal electron acceptors.

both correct and related
both correct but not related
1 true 2 false
1 false 2 true
both false
A

1 true 2 false

133
Q

Bacteria most strongly linked with localized aggressive periodontitis is

porphyromonas gingivalis
tannerella forsythia
Aa
prevotella intermedia

A

Aa

134
Q

Anaerobic bacteria produce superoxide dismutase and catalase.

Most bacteria grow in either presence or absence of oxygen.

both true
both false
1 true 2 false
1 false 2 true

A

1 false 2 true

superoxide dismutase and catalase in obligate aerobes

135
Q

Some G+ but never G- (like Bacillus and Clostridium) are spore formers.

Spore contains complete cope of chromosome, bare minimum of essential proteins and ribosomes and high amts of Ca bound to dipicolinic.

both true
both false
1 true 2 false
1 false 2 true

A

both true

136
Q

One of the most common forms of traveler’s diarrhea is caused by an enterotoxin produced by

bacteroides
E coli
Neisseria
eikenella

A

e coli

s aureus and vibrio cholera also produce enterotoxin

137
Q

DNA is generally confined to

A

nucleoid

138
Q

site of translation

A

ribosomes

139
Q

storage of reserves of nutrients

A

inclusions

140
Q

attachment to surfaces

A

capsulealso protective against phagocytosis

141
Q

permeability barrier

A

plasma membrane

142
Q

motility

A

flagella

143
Q

which of the following opportunistically infects the host and utilizes exotoxin A?

Neisseria gonorrhoeae
helicobacter pylori
pseudomonas aerugonisa
staph aureus

A

Pseudomonas aeruginosa

G-, aerobic, has cytochrome oxidase (Fe cofactor)

144
Q

Which of the following is a symbiotic relationship in which both members benefit?

parasitism
mutualism
commensalism
margination

A

mutualism

145
Q

A missense mutation is a genetic mutation in which nucleotides are either inserted or deletd from a DNA sequene.

Translation of mRNA derived from this mutated gene results in a protein with the incorrect AA sequence

both true
both false
1 true 2 false
1 false 2 true

A

1 false 2 true

146
Q

Shrinkage in cell size by loss of cellular substance is known as

atrophy
hypertrophy
hyperplasia
metaplasia

A

atrophy

147
Q

Tissue transferred between genetically different members of same species is known as

autologous graft
allogeneic graft
syngeneic graft
xenogeneic graft

A

allogeneic graft

autologous - from self
syngeneic - genetically identical individuals
allogeneic - same species

CD4 and CD8 most of destruction in graft rejection

most common hyperacute rejection is ABO mismatch

148
Q 
cellular degradation by enzymes derived from sources extrinsic to the cell is known as:
necrosis
heterolysis
autolysis
apoptosis
A

heterolysis

149
Q

Interferons are species-specific proteins.

In contrast to antibodies, interferons are virus specific but not host specific.

both true
both false
1 true 2 false
1 false 2 true

A

first true, second false

IFNs are non-specific for viruses but specific for host

150
Q

Small polypeptides released by a cell in order to change the fx of same or another cell are called

collectins
cytokines
defensins
effector cells

A

cytokines

151
Q

Which metabolic pathway is used to convert arachidonic acid into PGs, prostacyclin or TXAs?

lipoxygenase
pentose phosphate
HMG-CoA reductase
COX

A

COS

lipoxygenase - related but LTS (bronchocontrictors)
pentose phosphate - regeneration of NADH
HMG-CoA - cholesterol synthesis

phospholipase A2 splits arachidonic acid from phospholipid

152
Q

Serotonin (5 HT) is a preformed vasoactive mediator with actions similar to

heparin
thrombin
ACh
histamine

A

histamine

synthesized from tryptophan

153
Q

Histamine is released largely by

m/ph
enteroendocrine cells
lymphocytes
n/ph
mast cells
A

mast cells

two major vasoactive amines are histamine and serotonin

anaphylaxis, dilation of arterioles, increased permeability of venules

154
Q

All about plasmin are correct except:

also called fibrinolysin
proteolytic enzyme derived from plasminogen
essential in blood clot dissolution (fibrinolysis)
component of non-specific immune system
most important fibrinolytic protease

A

immune

155
Q

Autoimmune dz impairs fx of cells in kidney that produce renin. Which product of adrenal cortex is affected?

Angiotensinogen
angiotensin I
angiotensin II
angiotensin converting enzyme
aldosterone
A

aldosterone

angiotensinogen is constantly circulating

converting enzymes - in lungs

156
Q

Cytochromes are found in m/ch inner membrane of prokaryotes.

M.ch electron transport proteins are clustered into complexes I, II, III and IV

both true
both false
1 true 2 false
1 false 2 true

A

1 false 2 true

I - FMN
II - CFAD
III - CoQ cytochrome c
IV - cytochrome c oxidase (components are cytochromes a)

cytochrome oxidase is terminal enzyme

157
Q

Which interleukin favors TH-1 type responses and counteracts IL-10?

IL-1
IL-2
IL-6
Il-12

A

IL-12

158
Q

m/ph IL

A

IL-1, promotes inflammation

159
Q

IL that stimulates proliferation and activation of T and B

A

IL-2

160
Q

IL that promotes B activation and IgE antibodies

A

IL-4

161
Q

IL that causes B cells to produce IgA

A

IL-5

stimulates eosinophils

162
Q

IL that produces fever

A

IL-6

163
Q

IL that inhibits TNF and IL-12 and suppresses inflammatory rxns and TH-1

A

IL-10

164
Q

stimulates hematopoiesis

A

IL-3

165
Q

can induce apoptosis

A

TNF alpha

166
Q

simulates IL-2 secretion, induces fever

A

IL-1

167
Q

stimulates T-killers

A

IL-2

168
Q

stimulates chemotaxis and adhesions of neutrophils

A

IL-8 sticky

169
Q

bacterial cell wall component susceptible to lysozyme is

LPS
teichoic acid
lipoprotein
peptidoglycan

A

peptidoglycan

170
Q

Which is site of mRNA attachment and AA assembly?

nucleolus
lysosomes
plasma membrane
Golgi
ribosomes
A

ribosomes

171
Q

catalase and other enzymes that break down hydrogen peroxide are located in

lysosomes
inclusion bodies
microbodies
centrioles

A

microbodies (eg peroxisomes)

superoxide dismutase
catalase
glutathione peroxidase
ceruloplasmin
transferrin
172
Q

All are potential characteristics of T cells except

CD3+
CD4+
CD8+
antigen recognition requires MHC proteins
frontline phagocytic cells
A

frontline phagocytic cells

this is wrong

CD3 is for T-cell receptor recognition of MHC

173
Q

Surface membrane Ig is a marker for

mature T
n/ph
mature B
monocytes

A

mature B

IL-2 potentiates natural killers
CD8+ release perforins and induce apoptosist cells - cell-mediated immunity

174
Q

Surgical wound closed by sterile suture would heal by

first intention
second intention
third intention
keloid formation

A

first intention
inflammation without infx

second closes without suture, too large, edges don’t approximate, via granulation and filling with connective tissue

1 vs 2 determined by type of wound

third - with scar

175
Q

Susceptibility to teratogens is specific for each developmental stage BECAUSE teratogens are dose dependent

A

both true but unrelated

maternal infx: TORCH
toxo other rubella CMV HSV
critical phase is first trimester

176
Q

Sxx of sepsis include all except

fever
weakness
painful urination
nausea
vomiting
A

painful urination

cytokines of sepsis: TNF and IL-1

177
Q

Which organ has a remarkable capacity to regenerate?

heart
brain
lungs
liver

A

liver

178
Q

M/ph is dominant cellular player in chronic inflammation.

Mononuclear phagocyte system (reticuloendothelial system) concists of closely related cells of bone marrow origin, including blood monocytes and tissue macrophages.

A

both true

179
Q

Order sequence of healing.

a. Epithelial bridges cross the wound.
B. Inflammation subsides and blanching begins.
C. Clotted blood covers incision and n/ph accumulate at wound margins
D. Connective tissue bridges the wound
E. Inflammatory cells are entirely absent
F. Granulation tissue fills the incision space

A

C A F D B E

inflammation absent after 1 month

180
Q

Each causes dermatophytosis except:

blastomyces
microsporum
trichophyton
epidermophyton

A

blastomyces

most effective anti-fungal is griseofulvin

181
Q

All are possible characteristic of fungi except:

dimorphic
prokaryotic
septated
sporulate

A

prokaryotic

182
Q

Fungus that produces sexual spores is

anamorph
promorph
metamorph
teleomorph

A

teleomorph

183
Q

Fungus with asexual spores

A

anamorph

184
Q

Endemic mycoses are fungal infx caused by dimorphic fungal pathogens Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis, Coccidioides posadasoo, and Paracocccodioides brasiliensis.

All of these agents produce primary infx in heart, with subsequent dissemination to other organs and tissues

A

1 true 2 false

Coccidio is respiratory
Blastomycosis too
Histoplasmosis can cause tuberculosis-like infx

Meds: amphotericin B, fluconazole

185
Q

Which is opportunistic in diabetes, leukemia, sever burns or malnutrition?

aspergillosis
cryptococcosis
zygomycosis
dermatophytoses

A

zygomycosis

186
Q

cryptococcus

A

meningitis, esp HIV

pigeons

187
Q

aspergilllus

A

lungs, birds

188
Q

All are superficial mycoses except

malassezia furfur
aspergillus fumigatus
hortae werneckii
piedraia hortae
trichosporon spp
A

aspergillus is lungs

189
Q

Malaria in humans is caused by one of four protozoan species of the genus:

trichomonas
plasmodium
cryptosporidium
toxoplasma

A

plasmodium

most serious is falciparum
others are vivax, malariae and ovale

190
Q

toxoplasma

A

cat feces, crosses placenta, encephalitis in AIDS

191
Q

etiologix agent of amebic dysentery?

giardia lamblia
trichomonas vaginalis
balantidium coli
entamoeba histolytica

A

entamoeba histolytica

trophozoite - active phase, cyst - dormant
tx w metronidazole

giardia also exists in two forms

trichomonas exists only as trophozoite, STD

balantidium is largest protozoan parasite

192
Q

Which is acquired by ingesting undercooked meat containing tissue cysts or food contaminated by cat feces

cryptosporidiosis
trichomoniasis
toxoplasmosis
giardiasis

A

toxoplasmosis

193
Q

Helminths are the largest internal human parasite

helminths reproduce sexually, generating millions of eggs and larvae

A

both true

nematodes - round worms
trematodes - flukes
cestodes - tape worms

nematodes: hookworms, ascaris
trematodes: blood flukes (schistosome), lung flukes, intestinal/hepatic flukes
cestodes: ribbon-shaped, intestinal adult worms (no intestinal tract in these worms): taenia, diphyllobothrium

marked eosinophilia

194
Q

cestodes are

A

tapeworms

195
Q

nematodes are

A

roundworms (ascaris, hookworms)

196
Q

trematodes are

A

blood flukes (schistosome)

197
Q

THREE items associated with adult polycystic kidney disease:

autosomal dominant
shrunken kidneys
corticomedullary cysts
large multicystic kidneys
liver cysts
hepatic fibrosis
A

AD
corticomedullary cysts
large multicystic kidneys

most common inherited nephropathy

for comparison, childhood PKD is recessive + hepatic fibrosis

198
Q

Malignant HTN can adversely affect all major organ systems. The most susceptible is

intestines
lungs
heart
brain
kidneys
A

kidneys

chronic HTN leads to arteriosclerosis

199
Q

Nephrolithiasis is manifested by severe spasms of pain (renal colic) and hematuria, often with recurrent stone formation.

Most commonly occurring form is strutive.

A

1 true, 2 wrong.

80-90% of kidney stones are Ca.

200
Q

Causes of hydronephrosis include all except:

nephrolithiasis
blood clot
tumor in or around ureter
bacterial infx
pregnancy
A

bacterial infx

–> causes pyelonephritis

urolithiasis is Ca or oxalate or both
in gout, hyperPTH, hyperCa emia

201
Q

nephrotic syndrome (glomerular dz) - all except

heavy proteinuria
lipiduria
hyperalbuminemia
hyperlipidemia
severe edema
A

hyperalbuminemia

albumin is lost! everything is lost, increased permeability

202
Q

nephritic vs nephrotic

A

nephritic is inflammation, ischemia, HTN, hematuria

nephrotic is proteinuria and edema

203
Q

Which is classic presentation of acute poststreptococcal glomerulonephritis?

rapidly progressing glomerulonephritis
nephroti syndrome
nephritic syndrome
nephrolithiasis

A

nephritic syndrome

nephritic syndrome is due to glomerular dz; CLASSIC presentation of acute poststreptococcal glomerulonephritis

204
Q

Dominant intrahepatic cause of portal hypertension is

obstructive thrombosis
sever right-sided heart failure
cirrhosis
constrictive pericarditis

A

cirrhosis

prehepatic: obstructive thrombosis, massive splenomegaly
posthepatic: tight heart failure, pericarditis, outflow obstruction (Budd-Chiari)

four major clinical consequences are: ascites; portosystemic shunts; congestive splenomegaly; hepatic encephalopathy, upper GI bleeds

205
Q

posthepatic portal HTN causes:

A

hepatic vein obstruction, right side failure, pericarditis

206
Q

sequelae of portal HTN

A

ascites, splenomegaly, hepatic encephalopathy, portosystemic shunts,

upper GI bleeds

207
Q

prehepatic portal HTN causes

A

thrombosis, splenomegaly

208
Q

Ascites is accumulation of excess fluid in pleural cavity.

In 85% cases, ascites is caused by cirrhosis.

A

1 false, 2 true

peritoneal accumulation

209
Q

Aside from xanthomas and pruritis, other manifestation of cholestasis is:

proteinuria
hypoBbemia
albuminemia
jaundice

A

jaundice

210
Q

Most common symptom of hepatocellular carcinoma is:

abdominal pain
confusion
wt loss
impotence
nausea
A

abdominal pain

Hep C - 80% cases with cirrhosis
Hep B - without cirrhosis

viral incubation generally 2-8 wks

211
Q

THREE items associated with hepatitis B

fecal-oral transmission
IV drug abuse
anti-HAV IgM
anti-delta agent antibody
perenteral transmission
HBsAg
A

IV, parenteral, HBsAg

HBsAg - first positive marker of acute infx
most pts recover fully

no association of HepA with HCC (yes for B and C)

212
Q

All are characteristics or sequelae of cirrhosis except:

fibrous septae
more prevalent in females
parenchymal regeneration
portal HTN
hepatocellular carcinoma
A

more prevalent in females

this is false; twice as common in men

cirrhosis: nodules + fibrosis

most common cause - alcohol abuse

213
Q

which type of emphysema is associated with aging and alpha1-antitrypsin deficiency?

paraseptal (distal acinar)
centriacinar (centrilobular)
panacinar (panlobular)
irregular

A

panacinar (panlobular)

emphysema = irreversible enlargement of airspaces DISTAL to terminal bronchiole + destruction of walls WITHOUT fibrosis.

lack of elastic recoil, increase in compliance

types:

centriacinar: chronic bronchitis and smoking; most common; upper lobes, respiratory bronchioles
panacinar: aging and alpha1-antitrypsin deficiency; lower loves, alveoli and acinar ducts
paraseptal (distal): spontaneous pneumothorax in young adults

emphysema + chronic bronchitis = COPD

214
Q

centriacinar emphysema

A

most common; respiratory bronchioles; upper lobes; smoking and bronchitis

215
Q

panacinar emphysema

A

alpha1-antitrypsin deficiency and aging; lower lobes; alveoli and alveolar ducts

216
Q

COPD = which two?

A

emphysema + chronic bronchitis

217
Q

smooth mm hyperplasia, excess mucus, inflammation in lungs

A

asthma

218
Q

mucous gland hyperplasia, hypersecretion

A

chronic bronchitis

at least 3 months in at least 2 consecutive yrs

219
Q

airspace enlargement, wall destruction

A

emphysema

220
Q

airway dilation and scarring

A

bronchiectasis

221
Q

inflammatory scarring/obliteration

A

bronchiolitis

222
Q

Most common type of asthma, atopic asthma, is a classis example of:

type I IgE-mediated hypersensitivity
type II IgE-mediated hypersensitivity
type III IgE-mediated hypersensitivity
type IV IgE-mediated hypersensitivity

A

type I

atopic - with evidence of sensitization
bronchospasm, mucus hypersecretion, inflammation in lungs, smooth mm hyperplasia

223
Q

chronic bronchitis

A

mucus hypersecretion and hyperplasia

224
Q

Causes of left-sided congestive heart failure include all except:

pulmonary edema
ischemic heart dz
mitral regurgitation
myocarditis

A

pulmonary edema

225
Q

malabsorption of fat soluble citamins is likely in most patients with:

Von Hippel-Lindau
cystic fibrosis
marfan’s syndrome
familial hypercholesterolemia

A

cystic fibrosis

bc impaired exocrine fxs
sweat test - diagnostic (reabsorption impaired)

226
Q

Marfan typical

A

tall, thin, long legs and arms; connective tissue disorder

227
Q

What’s caused by inhalation of carbon dust:

asbestosis
silicosis
coal worker’s pneumonia
anthracosis

A

anthracosis

pneumoconiosis: inhalation of inorganic dust particles; lead to fibrosis of lungs

anthracosis: carbon dust
coal workers - coal dust (C + Si); can be simple and progressive massive
silicosis - free Si dust; most common, most serious, assoc with TB

asbestosis –> diffuse interstitial fibrosis; bronchiogenic carcinoma and malignant mesothelioma of pleura

228
Q

asbestosis

A

most malignant, diffuse interstitial fibrosis

229
Q

silicosis

A

associated with TB, most serious and common

230
Q

coal workers

A

Si + C; simple and progressive massive

231
Q

anthracosis

A

C

232
Q

Interstitial pneumonia is most often caused by Strep pneumoniae.

Virulence of pneumococcus is associated with its capsular polysacch.

A

first false, second true

types of pneumonia:

lobar (Strep, intra-alveolar, middle age)
bronchopneumonia (wide variety of m/o, patchy, bronchioles and alveoli, elderly and infants)
interstitial (Mycoplasma or viruses; diffuse and patchy in walls, young children)

233
Q

most common cause of pneumonia in young children

A

viruses

234
Q

virulence of streps - main component

A

polysaccharide capsule

235
Q

which is most often responsible for ling abscesses

proteus
klebsiella
staphs
pseudomonas

A

staph

236
Q

TWO items associated with nodular melanoma

most common type of melanoma
radial growth phase predominates
vertical growth phase predominates
Hutchinson freckle
least common type of melanoma
bleeding or ulceration
A

vertical growth predominates
bleeding or ulceration

melanoma is most deadly skin cancer
related to sun exposure (sunburns during childhood)
melanocytes

growth phases:
radial (initial): horizontal spread in epidermis and supf dermis; prominent lymphocyte response, no metastatic

vertical: invade deeper layers; nodule appears; metastatic potential

clinical variants: most common is supf spreading (large flar, pigmented, mostly radial)

nodular is most aggressive, poorest prognosis, mostly vertical

lentigo - radial growth, Hutchinson freckle

acral-lentiginous - least common, on palm or sole; maybe not sun-related

237
Q

most aggressive melanoma

A

nodular, vertical

238
Q

most common melanoma

A

superficial, radial

239
Q

Hutchinson freckle

A

lentigo melanoma

240
Q

All are symptoms of pheochromocytoma except:

bradycardia
HTN
headaches
palpitations
diaphoresis
A

bradycardia

pheochromocytomas - chromaffin cells; catecholamines

241
Q

Most aggressive lung tumors, metastasize widely and are virtually incurable by surgical means:

epidermoid (squamous cell)
adenocarcinoma
small cell (oat cell)
large cell (anaplastic)

A

small cell (oat cell)

epidermoid (squamous cell): near hilus, related to smoking and men

adenocarcinoma:
periphery of lung, women, most common

small cell - most aggressive and highly malignant, near hilus; related to smoking

large cell(anaplastic) - variable, least common

242
Q

lung cancers related to smoking

A

squamous cell and small cell, both near hilum

squamous is male
small cell is v malignant and aggressive

243
Q

Which of these lymphomas usually involves abdominal organs and is closely linked to EBV?

non-Hodgkin
Hodgkin
mantle cell
burkitt's
follicular
A

burkitt’s

extra-nodal presentation is common in non-Hodgkin

244
Q

Hodgkin vs non-Hodgkin

A

presence of Reed-Sternberg in Hodgkin

245
Q

All of the following are peripheral T-cell and NK-cell neoplasms except:

mycosis fungoides/sezary syndrome
large granular lymphocytic leukemia
anaplastic large-cell lymphoma
Burkitt’s

A

Burkitt’s

is aggressive B

246
Q

Invasion of dermis by sheets and islands of neoplastic epidermal cells, often with keratin pearls, is characteristic of:

squamous cel carcinoma
basal cell carcinoma
malignant melanoma
nodular melanoma
lentigo maligna melanoma
A

squamous cell

more aggressive than basal; sun exposure
often keratotic, may ulcerate

90% of malignant cancers of oral cavity

247
Q

most cancers in oral cavity are

A

squamous cell carcinomas

248
Q

Basal cell carcinomas frequently metastasize BECAUSE they are locally aggressive and can form ulceration and bleed

A

first wrong, second true

basal cancers are invasive but not very metastatic
characterized by palisading

249
Q

most invasive cancer

A

basal cell

250
Q

most severe skin tumor

A

malignant melanoma

251
Q

Which is most likely to produce free radicals:

alkylating agent
UV light
virus
ionizing radiation

A

ionizing radiation

UV - cross-linking of bases in DNA
ionizing – free radicals

cells with high proliferation more sensitive to radiation

252
Q

_____ of the coon is most common malignancy of GI tract and is a major cause of morbidity and mortality worldwide.

sarcoma
adenocarcinoma
lymphoma

A

adeno

small intestine is uncommon for tumors

colorectal adenocarcinoma is second only to lung cancer

sigmoid most common

253
Q

Pt has prostate cancer. In addition to increase in prostate-specific antigen (PSA), which serum marker might also be elevated?

human chorionic gonadotropin
acid phosphatase
carcinoembryonic antigen-125
bence jones protein

A

acid phosphatase

prostate - most common cancer in men
lung cancer - most common killer on both genders

254
Q

Rhabdomyosarcoma is benign neoplasm from skeletal mm.

Leiomyomas, malignant smooth mm neoplasms, are most common neoplasm in women.

A

both false

sarcoma is malignant

leiomyoma is most common in women but benign

255
Q

All are characteristic or associations of breast cancer except:

positive family hx
late menarche
diet high in animal fats
delayed first pregnancy
obesity
A

late menarche

breast cancer - most common cancer; number 2 killer in women after lung

more commonly in left, outer upper quadrant

lymphatic widespread metastasis

early menarche, late menopause!
late first pregnancy (after 30)

256
Q

5yr survival rate of bronchogenic carcinoma is close to:

10%
20%
50%
60%
80%
A

10%

bronchogenic carcinoma - leading cayse of death from cancer
directly proportional to smoking

50% inoperable at time of diagnosis

257
Q

Often first signs of lung cancer are related to metastatic spread, particularly to:

liver
heart
brain
thyroid

A

brain

metastasis through lymphatic channels

258
Q

lung cancer gender prevalence

A

M:F = 4:1

259
Q

Hallmark of ___ is resebce of clonal malignant Reed-Sternberg cell in a lymph node biopsy or (rarely) extranodal tissue

chornic lymphocytic leukemia
non-Hodgkin lymphoma
multiple myeloma
Hodgkin lymphoma

A

Hodgkin

predominantly young men
commonly assoc w EBV and HIV

260
Q

Palpable mass lesions on digital rectal exams. What is most likely to indicate that neoplasm is malignant?

pleomorphism
atypia
metastasis
increased nuclear/cytoplasmic ratio
necrosis
A

metastasis

most important characteristic that distinguishes malignant from benign

261
Q

THREE items associated with multiple myeloma:

"punched-out" bone lesions
hypoCaemia
peak age 25-30
bence jones protein
T-cell proliferation
B-cell proliferation
urticaria
A

“punched-out” bone lesions
bence jones protein
B-cell proliferation

multiple myeloma - multifocal in skeleton
chiefly in elderly, 65-70 yo

Bence-Jones - free Ig in urine
hyperCaemia bc escapes from bones

excessive growth and malfx of plasma cells in bone marrow

262
Q

Which contains recognizable mature or immature cells or tissues representative of more than one germ cell layer and sometimes all three?

carcinoma
sarcoma
teratoma
APUDoma

A

teratoma

APUDoma - amine precursor uptake and decarboxylation - produces hormone-like substances

263
Q

Which is histologic landmark of malignancy?

dysplasia
anaplasia
metaplasia
desmoplasia

A

anaplasia - absence of differentiation

histologic features of malignancy:
anaplasia, hyperchromatism, pleomorphism, abnormal mitosis

desmoplasia is forming fibrous stroma – firm feel on palpation

264
Q

All are benign mesenchymal tumors except:

osteogenic sarcoma
lipoma
fibroma
chondroma

A

osteogenic sarcoma

is malignant

265
Q

Ewing sarcoma family of tumors encompasses Ewing sarcoma and primitive neuroectodermal tumor (PNET), which are primary malignant small round-cell tumors of bone and soft tissue.

Ewing sarcoma and PNET together account for 6-10% of primary malignant bone tumors and follow osteosarcoma as second most common group of bone sarcomas in children.

A

both true?

266
Q

malignant bone tumors

A

osteosarcoma and Ewing/PNET, in children

267
Q

All are benign except:

adenoma
fibroma
carcinoma
hemangioma
lipoma
A

carcinoma

in general, benign tumors are well-differentiated
anaplasia (lack of differentiation) is characteristic of malignant tumors

268
Q

Tumor from osteoclasts and osteoblasts

A

osteogenic sarcoma

269
Q

On surface of bone instead of interior

A

parosteal osteogenic sarcoma

270
Q

Malignant tumor from cartilage

A

Chondrosarcoma

271
Q

Most commonly in long bones, especially knee

A

malignant giant cell tumor

272
Q

Which bone tumor of nonosseous origin is characterized by constipation and visual disturbances?

Ewing
fibrosarcoma
chordoma
none

A

chordoma

Ewing - from bone marrow
chordoma - from notochord

273
Q

Which is a cutaneous disorder marked by hyperkeratosis and pigmentation of axilla, neck, flexures and anogenital region?

dermatofibroma
seborrheic keratosis
acrochordon
acanthosis nigricans
actinic keratosis
A

acanthosis nigricans
most pts have cancer

dermatofibromas - benign nodules, accumulation of fibrobalsts

acrochordon - skin tag (neck, armpit, groin)

actinic keratosis - premalignant, sunlight

seborrheic keratosis - warts in older people

274
Q

Melanoma in vertical growth that has invaded 1.5 mm into dermal layer has a higher metastatic potential than melanoma in horizontal growth phase.

Prognosis is best determined by measuring diameter of lesion.

A

first true, second false

prognosis determined by vertical growth
horizontal growth – no metastatic potential

275
Q

Schilling test may be used to detect:

folate deficiency
aplastic anemia
pernicious anmia
myelophthisic anemia

A

pernicious anemia

pernicious is B12 deficient megaloblastic anemia
Schilling tests for B12 absorption
stomatitis and atrophic glossitis are common
megaloblastic pernicious erythrocytes are macrocytic and hyperchromic

276
Q

Arterial or cardiac thrombi usually begin at sites of turbulence or endothelial injury.

Venous thrombi tend to grow retrograde from point of attachment.

A

1 true, 2 false

Virchow’s triad for thrombus formation: endothelial injury, stasis or turbulence, hypercoagulability.

All thrombi grow towards heart! Arterial retrograde, venous anterograde.

Venous mostly in legs. DVT can fly to lungs.

277
Q

Body structures most vulnerable to high blood pressure include all of the following except:

blood vessels
small intestines
brain
kidneys
heart
A

small intestine

278
Q

Most common cause of secondary HTN is:

pheochromocytoma
kidney dz
hypothyroidism
hyperparathyroidism

A

kidney dz

279
Q

THREE items associated with normocytic classification of anemia

iron deficiency
thalassemias
aplastic anemia
anemia of chronic dz
liver dz
vitamin B12 and folate deficiency
acute and chronic blood loss
A

aplastic
chronic dz
acute and chronic blood loss

280
Q

Macrocytic anemias:

A

liver dz

B12 and folate deficiency (this is megaloblastic)

281
Q

Normocytic anemias:

A

aplastic
chronic dz
acute and chronic blood loss

282
Q

Microcytic:

A

iron deficiency

thalassemias

283
Q

Warfarin is an effective anticoagulant that fx by its antagonistic action on:

Vit A
Vit D
Vit E
Vit K

A

Vit K

284
Q

Most common form of erythroblastosis fetalis is ABO incompatibility, which can vary in severity.

The less common form is called Rh incompatibility, which can cause very sever anemia in the baby.

A

both true

erythroblastosis fetalis is when mom and baby have different blood types. Mom’s ABs attack baby’s RBCs.

285
Q

Classic pentad of thrombotic thrombocytopenic purpura includes all except:

microangiopathic hemolytic anemia
thrombocytopenia
liver dysfx
transient neurologic deficits
fever
renal failure
A

liver dysfx

Idiopathic is when low plt count

286
Q

Which arteriosclerosis is characterized by calcific deposits in muscular arteries in persons older than 50?

Monckeberg medial sclerosis
atherosclerosis
hyperplastic arteriolosclerosis
hyaline arteriolosclerosis

A

monckeberg medial sclerosis

atherosclerosis is intimal lesions

287
Q

In sickle cell anemia, globin portion is abnormal die to valine being substituted for which?

glutamine
glutamic acid
aspartic acid
glycine

A

glutamic acid

HbS

[in HbC, lysine replaces –> decreased plasticity of RBCs]

288
Q

Flu-like symptoms but without fever. Cherry-red discoloration of skin, mucosa and tissues.

CO poisoning
mercury poisoning
fluoride poisoning
sarcoidosis
military TB
A

CO poisoning

affinity b/w CO and Hb is 200 stronger than with oxygen.

Hg –> renal
methanol –> blindness

289
Q

Hemophilia A and von Willebrand dz both directly involve clotting factors.

Hemophilia B also directly affects clotting factor VIII.

A

first is true, second is false

A - 8 (classical), B - 9

all lab tests normal except: prolonged partial thromboplastin time

vWF is AD

NBDE (15 decks)

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