Misc.

Question 1

Cleft palate caused by failure of

Answer 1

palatal process

Question 2

Cleft lip caused by failure of

Answer 2

maxillary prominence and intermaxillary segment

Question 3

The UTI of E. Coli is due to which virulence factor?

Answer 3

Fimbriae

Question 4

Dopamine (from hypothalamus) has what effect on prolactin release from the pituitary?

Answer 4

Dopamine INHIBITS prolactin

Question 5

Lactotrophs contain what additional receptor? (not for prolactin)

Answer 5

TRH receptors –> release prolactin when stimulated

Question 6

What is the mechanism of IL-2 chemotherapeutic effect?

Answer 6

Growth factor for T lymphocytes –> increased T cell and NK cell activity

Question 7

PSGN is mediated by what type of HS reaction and what immune deposit?

Answer 7

Type III/IgG immune complex deposit

Question 8

What drug is used to reduce risk of chronic kidney disease in pts with HTN/DM?

Answer 8

ACE or ARBS (use ARB if they have cough)

Question 9

What property of elastin contributes to its ability to stretch and recoil?

Answer 9

Interchain cross links involving lysine

Question 10

Patients with alpha-1 antitrypsin deficiency develop (what enzyme) degradation?

Answer 10

Elastin –> Early onset LOWER LOBE PREDOMINANT emphysema

Question 11

Persistent depressive DO (dysthymia) requires how long of symptoms?

Answer 11

Two years or more

Question 12

First line treatment for schizophrenia (MOA)

Answer 12

Antipsychotics: antagonism at postsynaptic dopamine D2 receptors

Question 13

Thyroidperoxidase catalyzes what reaction?

Answer 13

Thyroglobulin iodination

Question 14

What liver mass is classically identified incidentally as a pale yellow stellate scar?

Answer 14

Focal nodular hyperplasia (young women)

Question 15

Subclavian steal syndrome results in retrograde flow in what artery?

Answer 15

Left vertebral due to occlusion in L subclavian

Question 16

Kleinfelter syndrome usually does not present until

Answer 16

Puberty: gynecomastia and azoospermia, intellectual disability, tall stature with sparse facial and body hair, decreased muscle mass.

Question 17

Drugs can improve penetrance in the brain by inhibiting what?

Answer 17

P-glycoprotein EFFLUX pump

Question 18

Rapid antigen detection testing is needed prior to antibiotic treatment for

Answer 18

Group A strep antigen

Question 19

Age related changes to the respiratory system more prominently include

Answer 19

Decreased chest wall compliance and decreased alveolar elastic recoil –> increases tidal volume and decreases efficiency of alveolar-capillary gas exchange.

Question 20

Septic organ dysfunction is driven by

Answer 20

poor tissue oxygen use

Question 21

The 3 main mechanisms of cellular dysoxia in sepsis are

Answer 21

1. Bacterial components & acute phase cytokines trigger production of free radicals that damage mictochondria and ETC
2. Widespread microcirculatory failure
3. Increased capillary permability

Question 22

A loud S2 pulmonic component is indicative of

Answer 22

Pulmonary hypertension

Question 23

What artery supplies the AV node?

Answer 23

Posterior descending artery

Question 24

The posterior descending artery originates from either

Answer 24

RCA (80%)/R dominant
LCX (10%)/L dominant
Both (10%)/Codominant

Question 25

Renal artery blood flow is proportional to vessel radius raised to the what power?

Answer 25

4th power

FLOW = r^4

Question 26

Acute simple cystitis from recent sexual intercourse is treated empirically with what drug?

Answer 26

Trimethoprim-sulfamethoxazole

Question 27

What are some symptoms of acute simple cystitis?

Answer 27

Dysuria, urinary frequency/urgency, UA showing pyuria/bacteriuria

Question 28

Chromaffin cells in the adrenal medulla are directly stimulated by what neurotransmitter?

Answer 28

Acetylcholine (they secrete NE and EPI)

Question 29

Acyclovir is effective against what viruses?

Answer 29

HSV1, HSV2, VZV

Question 30

How does acyclovir get activated?

Answer 30

phosphorylated in the host cell to acyclovir monophosphate, then phosphorylated to active triphosphate form to impair DNA polymerase replication in HSV

Question 31

What two antifungal drugs bind ergosterol in cell membranes and create lysis-causing pores?

Answer 31

Amphotericin B and Nystatin (POLYENES)

Question 32

What does caspofungin block in the fungal cell wall?

Answer 32

glucan component (candida and aspergillus)

Question 33

Cyclosporine MOA

Answer 33

decreases IL-2 (inhibits T-cell proliferation, used in immunosuppressant therapy in transplant recipients)

Question 34

Flucytosine indication

Answer 34

in combination with amphotericin B for cryptococcal meningitis in HIV patients

Question 35

What is griseofulvin’s MOA?

Answer 35

Inhibits mitosis via interaction with fungal cell microtubules. Useful in dermatophyte infections

Question 36

How do anti-fungal azoles work?

Answer 36

inhibit synthesis of ergosterol

Question 37

How do echinocandins work?

Answer 37

Inhibit glucan synthesis (fungal cell wall)

Question 38

What are the echinocandins?

Answer 38

Caspofungin and micafungin

Question 39

What is the only pyrimidine used as an antifungal?

Answer 39

Flucytosine (converted to 5-FU and interferes with RNA and protein synthesis)

Question 40

Erythrocyte sedimentation rate tests for acute phase reactants such as

Answer 40

IL-1, IL-6, TFN alpha, IF gamma

Question 41

How do you perform ESR?

Answer 41

Place whole blood in a narrow tube, erythrocytes setlle at bottom

Question 42

Roleaux formation in ESR is indicative of what?

Answer 42

Presence of acute phase reactants

Question 43

Sudden cardiac death is most commonly due to

Answer 43

Ventricular fibrillation

Question 44

Regional contractile dysfunction more commonly presents as (what kind of shock)

Answer 44

Cardiogenic shock- hypotension and respiratory distress