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Boards Final Review > Misc. > Flashcards

Misc. Flashcards

1
Q

What nerve mediates forarm protonation?

A

Median Nerve (innervates pronator teres muscle)

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2
Q

What is the innervation to the serratus anterior muscle and what is its MOA?

A

innervation – long thoracic nerve (C5,6,7)

MOA - protraction and radiation of the scapula

**damage to long thoracic causes winging of scapula and being unable to raise arm above horizontal

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3
Q

What is the innervation and MOA of the trapezius muscle?

A

Innervation – accessory nerve (CN XI) and anterior rami of cervical nerves C3 and C4

MOA - powerful elevator of scapula, rotates the scapula during abduction above horizontal, retract and depress scapula

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4
Q

Define acid labile.

A

Breaks down and decomposes in acid environments

Ex. vibrio cholera likes basic (alkaline) environments, so when it enters the acidic stomach, it generally gets broken down and destroyed

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5
Q

Hypertrophic cardiomyopathy? Concentric Hypertrophy? Eccentric hypertrophy?

A

Hypertrophic cardiomyopathy – genetic, B-myosin heavy chain mutation causing hypertrophied interventricular septum, die at young age due to outflow obstruction

Concentric Hypertrophy – pressure overloaded state with chronic HTN or aortic stenosis and the wall thickens with increased sarcomeres in parallel

Eccentric hypertrophy – volume overloaded state, increased LV volume primarily due to ischemia, may be seen in endurance training, issues with contraction, sarcomeres added in series

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6
Q

What is the VATER association?

A

aka VACTERL association

Recognized ASSOCIATION of birth defects with no known pathogenic cause.

V - Vertebral anomalies
A - Anorectal malformations
C - Cardiovascular anomalies
T - Tracheoesophageal fistula
E - Esophageal atresia
R - Renal (Kidney) and/or radial anomalies
L - Limb defects
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7
Q

c-jun?

A

Transcription factor that is used to regulate cell proliferation – decreased levels lead to reduced growth rates

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8
Q

What is the role of Endothelin?

A

Endothelins are peptides that cause vasoconstriction and increase blood pressure.

IN THE LUNGS – Overproduction of endothelin in the lungs may cause pulmonary hypertension, which can sometimes be treated by the use of an endothelin receptor antagonist, such as bosentan, sitaxentan or ambrisentan.

IN THE HEART – Overexpression may also lead to hypertension and heart disease. Endothelin activates Gq pathway leading to increased Calcium release fromt eh sarcoplasmic reticulum

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9
Q

Heart condition described by “carotid artery shows upstroke is brisk and downstroke falls precipitously?”

A

Aortic regurgitation

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10
Q

Causes of metabolic acidosis with a normal ion gap?

A

HARD ASS

Hyperalimentation (too much IV nutrients)
Addison disease
Renal tubular acidosis
Diarrhea
Acetazolamide
Spirnolactone
Saline Infusion
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11
Q

Type of metabolic disturbance seen in kidney disease (ex. PCKD)?

A

metabolic acidosis ( can’t get risk of excess H+ or regenerate bicarb)

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12
Q

What part of the spleen filters blood? Which part makes white blood cells and antibodies?

A

Red pulp - filters blood

White pulp - makes antibodies and RBCs

[T cells hang out int he PALS]

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13
Q

What type of necrosis is seen in the lung?

A

Liquefactive

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14
Q

What is the epithelium lining of the seminiferous tubules?

A
  1. Spermatogonia – stem cells
  2. Spermatocytes - cells in the process of becoming sperm
  3. Sertoli cells - support the developing sperm (maintain the blood-testes barrier)
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15
Q

Walk through the process of spermatogenesis?

A

consists of 3 phases:

  1. Mitotic divisions – of spermatogonia to generate spermatocytes
  2. Meiotic divisions – of spermatocytes which produce haploid spermatids
  3. Spermiogenesis - spermatids are transformed into mature sperm through loss of cytoplasm and development of flagella

[spermatogenesis : 64 days]

[mitotic divisions of the spermatogonia stem cells]
1. primary spermatocyte (diploid 4N)
[meiosis I completed]
2. Secondary spermatocyte (haploid 2N)
[Meiosis II]
3. Spermatids (haploid 1N)
[Spermiogenesis]
4. Spermatozoa [mature sperm] (haploid 1N)
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16
Q

What is contraction, resorption and compression atelectasis?

A

contraction – fibrosis

resorption – toy or cancer blocking airflow, so everything behind collapses

compression - fluid within the pleura

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17
Q

What is Kasabach-Merritt syndrome?

A

Life-threatening disease found in infants in which a rapidly growing vascular tumor is responsible for thrombocytopenia, microangiopathic hemolytic anemia and consumptive coagulopathy.

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18
Q

Define dehisced?

A

split open

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19
Q

What is the Z-score?

A

Indicates the number of standard deviations a given value is from the mean.

Z-score = (data point-mean)/st. deviation

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20
Q

What is the rate limiting step in fatty acid biosynthesis?

A

Acetyl CoA Carboxylase

**stimulated by insulin

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21
Q

What is McCune-Albright Syndrome?

A

Mosaic somatic mutation in GNAS gene encoding the stimulatory alpha subunit of the G protein leading to it being constitutively active causing overproduction of several hormones.

Classic presentation: endocrine abnormalities (ex. precocious puberty, hyperthyroidism), Cafe-au-lait spots, fibrous dysplasia

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22
Q

ABL, BRAF, RAS, WT, VHL – which are tumor suppressors and which are proto-oncogenes?

A

Proto-oncogenes – ABL, BRAF, RAS

Tumor suppressors – WT, VHL

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23
Q

What is a common proto-oncogene mutation seen in Melanoma and Hairy ell Leukemia?

A

BRAF [Rs signal transduction]

24
Q

What cancers are associated with the RAS proto-oncogene?

A

Cholangiocarcinoma

Pancreatic adenocarcinoma

25
Q

What is spinal muscular atrophy?

A

Condition caused by a mutation in the survival motor neuron (SMN1) gene that encodes a protein involved in assembly of small nuclear ribonucleoproteins (snRNPs) in lower motor neurons. Defective snRNP assembly results in impaired spliceosome function and degeneration of anterior horn cells in the spinal cord.

26
Q

Which drugs are direct thrombin inhibitors?

A

Lepirubin
Argatroban
Bivalirudin
Dabigatran (oral)

27
Q

How do fibrates increase risk of gallstones?

A

Fibrates inhibit cholesterol 7a-hydroxylase which catalyzes the rate-limiting step in the synthesis of bile acids. The reduction in bile acid production decreases cholesterol solubility in bile favoring formation of cholesterol gallstones.

28
Q

What are cholesteatomas?

A

Collections of squamous cell debris that form a round, pearly mass behind the tympanic membrane in the middle ear. Primary cholesteatomas are the result of chronic negative pressure in the middle ear causing retraction pockets in the tympanic membrane that become cystic as squamous cell debris accumulates. These are the most common cause of painless otorrhea that may produce lytic enzymes that can erode through auditory ossicles leading to conductive hearing loss. If they grow large enough they can erode into the vestibular apparatus or facial nerve causing vertigo or facial palsies.

29
Q

Medication that inhibits PRPP amidotransferase

A

6-MP

30
Q

What is the most common type of eye pathology in NF-1?

A

Lisch nodules [pigmented hamartomas on the iris]

31
Q

Benzo antagonist?

A

Flumazenil

32
Q

What is the difference b/t Mallory bodies and Councilman bodies?

A

Mallory bodies – damaged cytokeratin filaments, seen with alcoholic liver disease, INTRACELLULAR

Councilman bodies – hepatocytes that have undergone apoptosis and will be seen with ballooning, seen with hepatitis, EXTRACELLULAR

**both eosinophilic and in the liver

33
Q

What is Stewart-Treves syndrome?

A

Cutaneous angiosarcoma (lymphangiosarcoma) which is a rare complication that forms as a result of chronic, long-standing lymphedema.

Histopathology shows infiltration of the dermis with slit-like abnormal vascular spaces.

34
Q

What is the MOA of Shigella?

A

Inactivated 60S ribosome from rRNA

35
Q

What are the side-effects of TZDs?

A 
FLUID RETENTION/edema
exacerbates heart failure
weight gain
hepatotoxicity
increased risk of fractures
36
Q

Which endocrine hormones bind Gs?

A

FLAT ChAMP

FSH
LH
ACTH
TSH
CRH
hCG
ADH (V2)
MSH
PTH

calcitonin, glucagon, GHRH

37
Q

Which endocrine hormones bind Gq?

A

GOAT HAG

GnRH
Oxytocin
ADH (V1)
TRH
Histamine (H1)
Angiotensin II
Gastrin
38
Q

Which endocrine hormones bind receptor tyrosine kinase? Intrinsic tyrosine kinase?

A

Receptor tyrosine kinase [uses JAK/STAT pathway]
PIGGlET

Prolactin
Immunomodulators (cytokines)
GH
G-CSF
EPO
Thrombopoietin
Intrinsic tyrosine kinase [uses MAP kinase pathway - think growth!!]
Insulin
IGF-1
FGF
PDGF
EGF
39
Q

Hemophagocytic lymphohistiocytosis?

A

Autosomal recessive disorder due to defects in perforin-related genes or assocaited with EBV. There is abnormal activation and proliferation of lymphohistiocytes leading to hemophagocytosis and upregulation of proinflammatory cytokines. THe immune system becomes overstimulated and begins to attack naive cells in the bone marrow, liver and brain.

Bone marrow aspiration - macrophages englulfing RBCs

Tx - Etoposide, corticosteroids, methotrexate, possible stem cell transplant is required

40
Q

What is desquamative interstitial pneumonia (DIP)?

A

Associated with smoking, it is considered an idiopathic intestitial pneumonia presenting in middle age with dyspnea. There is no desquamation of alveolar epithelium but rather pigment laden macrophage cells filling the alveoli.

41
Q

Trastuzumab?

A

monoclonal antibody against the cell surface HER2 receptor

42
Q

MOA infliximab?

A

anti-tumor necrosis factor-a monoclonal antibody

*immunosuppressive so it may cause flare-up of dormant TB

43
Q

P450 inhibitors?

A

SICKFACES.COM

Sodium Valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol (acute)
Chloramphenical
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
"Grapefruit juice"
44
Q

P450 inducers?

A

CRAP GPS

Carbamazepine
Rifampin
Alcohol (chronic)
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
45
Q

Disease manifestations of congenital toxo?

A

diffuse intercranial calcifications
Hydrocephalus
Chorioretinitis

46
Q

Disease manifestations of congenital syphilis?

A

skeletal abnormalities (osteochondritis and periostitis)
pseudoparalysis
persistent rhinitis
maculopapular rash

47
Q

Disease manifestations of congenital Rubella?

A

congenital heard disease (PDA and pulm artery stenosis)
sensorineural hearing loss
Ophthalmic abnormalities (Cataracts, glaucoma, pigmented retinopathy)

48
Q

Disease manifestations of congenital CMV?

A 
hepatosplenomegaly
Sensorineural hearing loss
thrombocytopenia
periventricular intracranial calcifications
microcephaly
49
Q

Disease manifestations of congenital HSV?

A 
conjunctivitis or keratoconjunctivitis
thrombocytopenia
elevated liver transaminases
mucocutaneous vesicles or scarring
CSF pleocytosis
50
Q

Which personality disorders fall under cluster A, B, C?

A

Weird, Wild, Worried

Cluster A “Weird”

  • schizoid
  • schizotypal
  • paranoid

Cluster B “Wild”

  • antisocial
  • narcissistic
  • histrionic
  • borderline

Cluster C “Worried”

  • Avoidant
  • Dependent
  • Obsessive compulsive
51
Q

What is the relationship b/t RANK, RANK-L and OPG?

A 
RANK = osteoclast
RANK-L = osteoblast
OPG = a RANK ligand

Estrogen decreases RANK-L expression and OPG blocks RANK-L interaction with RANK. When estrogen decreases there is less OPG therefore an upregulation of RANK-L which binds RANK activating them.

52
Q

Which cardiovascular drug may increase TAG levels?

A

Ezetimibe [prevents cholesterol absorption]

53
Q

What are the different bile acid resins?

A

Cholestyramine
Colestipol
Colesevelam

54
Q

Which CNs come from which pharyngeal arch?

A

Arch 1 - CN V2, V3 [meckels cartilage, muscle of mastication]

Arch 2 - CN VII [Stapedius, Stylohyoid]

Arch 3 - CN IX [stylopharyngeus]

Arch 4 - CN X (superior laryngeal branch) [cricothyroid]

Arch 6 - CN X (recurrent laryngeal branch) [larynx]

CAP(middle)PAC

55
Q

Walk through the tanner stages.

A

1
boy - prepubertal
girl - prepubertal
pubic hair - prepubertal

2
boy - enlarged scrotum + testes
girl - budding of breast and papilla, enlarging areola
pubic hair - sparse, long, slightly pigmented

3
boy - enlargement of penis
girl - training bra needed
pubic hair - dark, coarse, begins to curl

4
boy - penis develops glands, everything gets larger
girl - areola and papilla form second mound
pubic hair - adult hair in type but covering smaller area

5
Boy - adult
Girl - mature
pubic hair - adult in type and quantity

Boards Final Review (7 decks)

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