Miscellaneous II

Question 1

When does Babinski reflex disappear by?

Answer 1

12 months

Question 2

p53 tumor suppressor mechanism

Answer 2

p53 induces p21, which inhibits CDKs leading to hypophosphorylation (activation) of Rb –> hypophosphorylated Rb binds to and inactivates transcription factor E2F –> inhibition of G1-S progression.

Question 3

Hydroxyurea MOA

Answer 3

Inhibits ribonucleotide reductase, leading to decreased DNA synthesis.

Question 4

Benzos that don’t undergo phase 1 metabolism

Answer 4

LOT
Lorazepam
Oxazepam
Triazolam

Question 5

Ribonucleotide reductase

Answer 5

catalyzes the formation of deoxyribonucleotides from ribonucleotides.

Question 6

What lab technique do you use to detect single nucleotide polymorphisms (SNPs) and copy number variations (CNVS)?

Answer 6

microarrays

Question 7

Why do you get liver malfunction with kwashiorkor?

Answer 7

fatty change due to decreased apolipoprotein synthesis.

Question 8

other finding in fabry’s

Answer 8

hypohidrosis

Question 9

Effect of pupillary muscle contraction

Answer 9

smooth muscle constrict and close pupil. This explains why pilocarpine causes miosis.

Question 10

Muscarinic/cholinergic cardiac effects

Answer 10

decrease contractility + decrease conduction velocity

Question 11

Displacement vs. projection

Answer 11

displacement = transferring avoided ideas and feelings o a neutral person or object (venting basically – mother yelling at her child because her husband yelled at her. kicking the cat).
Projection - Attributing an unacceptable internal impulse to an external source (man who wants to cheat on his wife accuses his wife of being unfaithful).

Question 12

What is acral lentiginous melanoma? epidemiology?

Answer 12

Melanoma on palms, soles, oral mucosa. Most common type of melanoma in asians and blacks.

Question 13

What is a MALT lymphoma?

Answer 13

Form of lymphoma (originating from B cells) in mucosa-associated lymphoid tissue, frequently in stomach, but can be pretty much any mucosal site.

Question 14

MALT lymphoma associations

Answer 14

1) Sjogrens (presenting with parotid enlargement)
2) hashimoto’s
2) H pylori

Question 15

Effect of aging on respiratory function…

Answer 15

1) decreased arterial pO2

2) increased A-a gradient

Question 16

Muscle breakdown in esophagus

Answer 16

Upper 2/3’s = striated

Lower 1/3 = smooth

Question 17

Burn grading + presentation

Answer 17

1st degree = epidermis, superficial burn.
2nd degree = extends into superficial dermis. Redness with clear blisters.
3rd degree = extends through entire dermis. *painless
4th degree = into fat, muscle and bone. Black, charred. Painless.

Question 18

How would you tell proximal median nerve injury from distal ulnar nerve injury?

Answer 18

Pope’s blessing (median) and claw hand (distal ulnar) look the same in presentation except…
1) you’ll get atrophy of thenar with median lesion, and atrophy of hypothenar with ulnar.
AND
2) different sensory deficit.

Question 19

What does clawing of the hand indicate? How can you test for it?

Answer 19

1) Distal lesion, either to median or ulnar nerves. The other flexors exaggerate the loss of the lumbricals and the other fingers extend out at MCP (flex at DIP and PIP).
2) Person can’t extend fingers at rest.

Question 20

How do proximal hand lesions present? How can you test for it?

Answer 20

1) Can’t flex digits.

2) Person won’t be able to make a fist

Question 21

McMurray tests for…

Answer 21

Meniscal tears.

Question 22

Why would you get anovulation in chronic adrenal insufficiency?

Answer 22

Lack of estrogen due to disfunction of zone reticularis.

Question 23

Biochem of 2 cell hypothesis

Answer 23

Granulose cells lack 17alpha-hydroxylase and 17,20 lyase. Theca cells express these enzymes but lack aromatase.

Question 24

Uncoupling agents

Answer 24

1) 2,4-Dinitrophenol (used illicitly for weight loss)
2) aspirin
3) thermogenin (in brown fat)

Question 25

Glycogenolysis pathway

Answer 25

Glucagon binds to receptor –> ATP to cAMP –> PKA –> glycogen phosphorylase kinase –> glycogen phosphorylase causes glycogen to glucose.

Question 26

GLP-1 action

Answer 26

Released in response to nutrients –> potent anti hyperglycemic hormone, inducing glucose-dependent stimulation of insulin secretion and suppressing glucagon secretion. It’s inhibited by DPP-4. Therefore, by inhibiting DPP-4 you can increase GLP-1, which will increase glucose uptake in diabetics.

Question 27

What’s the point of using alpha-glucoside inhibitors?

Answer 27

Decrease postprandial hyperglycemia. They delay carbohydrate hydrolysis and glucose absorption, thus preventing postprandial hyperglycemia.

Question 28

alpha-glucosidase

Answer 28

Enzyme that sits in the brush border and breaks down starch and disaccharides to glucose.

Question 29

Labs in hyperthyroidism

Answer 29

Low TSH

Raised T3 or T4

Question 30

Why do you get amenorrhea with adrenal insufficiency?

Answer 30

CRH inhibits GnRH