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missed qs Flashcards

1
Q

hyperparathyroid bones

A

subperiosteal thinning; subperiosteal erosions of phalanges and salt and pepper calvarium on radiology

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2
Q

vit d deficient bones

A

unmineralized osteoid and widened seams

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3
Q

Paget’s bones

A

mosaic in lamellar bone, linked by cement lines

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4
Q

osteopetrosis bones

A

marble bone disease: unmineralized spongiosa in the medullary canals, (nl ppl replace w/marrow)

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5
Q

patient w/bitemporal hemianopsia and hyperCa what other tumor is likely

A

pancreatic bitemporal: pituitary hyperCa: PTH –> probably has MEN1

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6
Q

pathologic findings of cushing’s disease or ectopic ACTH cushing’s syndrome

A

hyperplasia! of fasiculata and reticularis (think congenital adrenal hyperplasia)

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7
Q

another name for somatomedin c

A

IGF-1

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8
Q

sensitive test for menopause

A

FSH (LH increases later)

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9
Q

insulin efffects: intrinsic TK–> what?

A

protein phosphatase: dephopsphorylates glycogen phosphorylase kinase and dephos glycogen synthase-> decr. glycogenolysis and incr. glycogen synthesis

and F16bPase –>glycogen synthesis and glycolysis

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10
Q

congenital adrenal hyperplasia tx

A

exogenous steroids–>suppress ACTH

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11
Q

Kallman syndrome

A

defective olfactory placode migration–>no GnRH secretors–>hypogonad and anosmia

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12
Q

anastrazole mech

A

aromatase inhibitor; for metastatic breast cancer

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13
Q

ketoconazole mech

A

decr. androgen synthesis

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14
Q

HER2/new activation–>which path

A

TK

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15
Q

Beta hydroxybutyrate: what is it

A

marker of insulin deficiency DM1 only

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16
Q

homocystinemia and insulin connection? atherosclerosis? tx effect

A

no insulin connection does –>athero folic acid tx helps

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17
Q

TZD mech

A

bind PPARy, an intracellular nuclear receptor

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18
Q

GLP-1 receptor

A

surface–>cAMP

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19
Q

complete vs. partial DI

A

complete: rise more than 50%

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20
Q

If someone has permanent central DI, where was the damage

A

hypothal NOT post. pit if it’s the pit that’s damaged, hypothal nuclei regenerate axons : )

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21
Q

prolactinomas and estrogen

A

untreated–>low E–>osteoporosis etc

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22
Q

glucagonoma symptoms

A

necrolytic migratory erythema! esp in groin + hypergly, stomatitis, cheilosis, abd pain

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23
Q

VIP presentation

A

intractable diarrhea, metabolic acidosis!, hypoK

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24
Q

somtatostatinoma presentation

A

abd pain, gall stones, constipation, steatorrhea

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25
Q

gestational diabetes tx

A

diet and light exercise then Insulin!

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26
Q

leuprolide mech

A

GnRH inhibitor

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27
Q

finasteride mech

A

DHTR inhibitor

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28
Q

GLUT1 cells and features

A

RBC, CNS: basal transport

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29
Q

GLUT2 cells and features

A

hepatocytes, B cells: insulin release regulation

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30
Q

placental glucose transporter

A

GLUT3

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31
Q

GLUT4 cells and features

A

muscle and adipocytes: insulin mediated

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32
Q

GLUT5 cells and features

A

sperm and GI tract: insulin mediated!

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33
Q

clomiphene mech

A

antiestrogen: for infertility from anovulation stops E neg fb on GnRH

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34
Q

mifepristone mech

A

RU486 antiprogestin, antiglucocorticoid

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35
Q

danazol mech

A

synthetic androgen; for endometriosis and hereditary angioedema

36
Q

spironolactone and testosterone

A

antiandrogenic: hirsutism tx

37
Q

flutamide mech

A

antiandrogen (binds testosterone Rs)

38
Q

f26bP effect on PFK1 and F16bPase

A

incr. PFK1, decr. F16bPase

39
Q

B blockers and thyrotoxicosis: mech

A

decr. symp to organs and decr peripheral T4-3!

40
Q

+ focal neuro signs

disease?

A

NF1

+ cafe au lait, lisch nodules

these are neurofibromas

optic gliomas

bony abnormalities

other tumors (i.e. brain tumors)

41
Q

caudal regression syndrome

signs and causes

A

flaccid legs

dorsiflexed contractures of feet

urinary incontinence

anything from anal atresia to sirenomelia

*maternal diabetes assoc

42
Q

membranous glomerulopathy histo

A

diffuse, uniform, thick GBM (LM)

irregular dense deposits btwn GBM and epithelial cells; look like spikes (EM)

IgG and C3 granular (IF)

43
Q

Colon cancer progresion of mutations

A

APC: small polyp (tumor suppressor)

K-RAS: bigger polyp (proto-onco)

p53 and DCC: malignant

44
Q

colon adenomas

size and progression to cancer risk

A

<1cm: very unlikely

>4 cm: very likely

45
Q

source of most airway resistance

A

Medium! and small bronchi (>2mm)

the right balance of narrowness but not parallel circuits

46
Q

lamotrigine

use

A

refractory partial seizures

or tonic clonic

or bipolar

47
Q

lamotrigine toxicity

A

better than most anticonvulsants

**serious hypersensitivity–>rash

48
Q

tiagabine mech/use

A

anticonvulsant (refractory partial)

inhibit GABA (tiaGABine) uptake

49
Q

topiramate mech/use

A

anticonvulsant (refractory partial)

block Na (and enhance GABA effect)

50
Q

Vigabatrin mech/use

A

anticonvulsant (refractory partial)

inhibit GABA trans-aminase, incr. concentration

(viGABA-TRin)

51
Q

clara cell fxn

A

lungs: secrete clara cell secretory protein, some surfactannt stuff

detox stuff via p450

52
Q

Wernicke enceophalopathy autopsy

A

foci of hemorrhage and necrosis

in mamillary bodies and periaqueductal gray

53
Q

transketolase

pathway and cofactor

A

hexose monophosphate: pentoses to G3P

*B1

54
Q

diagnosis of thiamine deficiency

A

increase in RBC transketolase activity post thiamine injxn

55
Q

lacunar infarct locations

A

post limb int. capsule

pons

cerebellum

BG

56
Q

causes of lacunar infarcts

A

lipohyalinosis and microatheromas

57
Q

meyer’s loop visual defect

A

pie in the sky (temporal)

58
Q
A
59
Q

CF nasal test results and why

A

incr. potential difference

btwn resp. epithelium and interestitium

nl CFTR inhibits Na channels + not pumping Cl out, means bringing more Na in from the surface

So more relatively negative epithelium!

60
Q

Delta F508 mutation

A

del phe (3 base pairs) -> abnl processing and degradation

61
Q

reasonn for tissue destruction in TB

A

type IV HSR!

62
Q

CF reproductive features

A

azoospermia, infertility b/c***absent vas deferens!!

63
Q

aspiration of stomach contents vs. oropharyngeal contents complications

A

stomach: chemical pneumonitis

oral pharyngeal: abscess

64
Q

anatomical cause of SVC

A

mediastinal mass!

(CA or thrombus from indwelling catheter)

65
Q

ABPA presentation

A

allergic bronchopulmonary aspergillosis d/t aspergillus fumigatus

compl. of asthma
- >transient, recurrent infiltrates and eventual proximal bronchiectasis and eosinophilia

more common in steroid dependent asthma

66
Q

Pulm Embolism ABG

A

hypoxiemia, respiratory alkalosis

67
Q

chronic rejection in the lungs affects?

A

small airways

(bronchiolitis obliterans)

(other txpl i.e. renal affects vascular)

68
Q

acute rejection in lung txpl pres

A

1-2 wks post, vascular damage

perivascular and peribronch9ial lymphos

dyspnea, dry cough, low grade fever

69
Q

rifampin mech

A

inhibit DdRp

70
Q

Ethambutol mech

A

somehow inhibits mycobact wall synth

71
Q

INH mech

A

inhibits mycolic acid synthesis

used in wall and virulence factors (sulfatides, wax D, cord factor)

72
Q

streptomycin mechanism

A

AG inhibits 30s

used to treat plague and tularemia and mycoavium

73
Q

when does incr. epo as a response to elevation kick in?

A

takes 10-14 d

before that you see resp. alk w/met compensation

once epo kicks in, PaO2 becomes pretty much normal

74
Q

long term high altitude adjustments

A

incr. epo

AND

incr. capillary density, incr. myoglobin, incr. mitochondria

75
Q

TB drug-> neuropathy

A

INH: similar shape to B6-> competes in synthesis of GABA->defective end products

also increases B6 urinary excretion

B6 deficiency: peripheral neuropathy

76
Q

TB drug activated by bacterial catalase-peroxidase

A

INH

77
Q

tx for abscesses above the diaphragm

below?

A

clinda above

metronidazole below

78
Q

caspofungin mech

A

inhibit glucan synth

(polysaccharide for cell wall)

79
Q

primary vs. reactivated TB lung lesions

A

primary: lower lobe, ghon focus: a calcified granuloma + hilar adenopathy once TB invades lymph

2*: upper lobe cavitations

80
Q

lower borders of the pleura

A

R side: mid clavicular 7 - mid axillary UPPER border of rib 10 - paravertebral 12

L side: mid clavicular 7 - mid axillary LOWER border of 10 - paravertebral 12

81
Q

lower border of lung relative to lower border of pleura

A

lung ends 2 intercostal spaces above

82
Q

TB drug requiring acidic environment?

A

pyrazinamide

83
Q

pleural effusion trachea direction

A

away

84
Q
A
85
Q
A

missed qs (1 decks)

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