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missed question 2 Flashcards

1
Q

BATS Drink Blood

A 
awake eyes open
awake eyes closed
N1
N2
N3
REM sleep
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2
Q

N2 sleep

A

buxism, sleep spindles, K complexes

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3
Q

N3 sleep

A

sleep walking, night terrors, bedwetting (pee and wee in stage 3)

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4
Q

sleep changes in elderly

A

decrease REM, decrease N3, increased sleep latency, increased early awakenings

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5
Q

REM sleep

A

loss of motor tone, increased brain use of O2, variable pulse/BP, increased ACh

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6
Q

hypothyroidism effect on cholesterol

A

down regulation of LDL receptor expression, decreased expression of lipoprotein lipase, decreased HMG CoA reductase

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7
Q

what is the cause of the ground glass appearance in RDS

A

diffuse atelectasis

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8
Q

where is GLUT 4

A

adipocytes and muscle cells

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9
Q

where is there not GLUT 4

A

brain, kidney, liver, intestine, RBC

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10
Q

acute organ rejection

A

occurs within first 6 months, usually involves sensitization of host T cells against graft/donor MHC molecules. histo shows dense mononuclear infiltrate.

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11
Q

adverse effects of thiazolidinediones (pioglitazone, rosiglitazone)

A

weight gain and edema

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12
Q

Histo for henoch schloein

A

small vessel vasculitis damaged by perivascular neutrophil accumulation.

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13
Q

temporomandibular disorder

A

TMJ + hypersensitivity of mandibular n

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14
Q

what does the mandibular n innervate

A

medial pterygoid, lateral pterygoid, master, temporals, tensor veli palentini, tensor tympani (in middle ear)

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15
Q

tx of toxo

A

pyrimethamine with sulfadiazine + leucorvorin

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16
Q

adverse effects of lithium

A

DI
hypothyroid
tremor
Epstein

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17
Q

adverse effects of carbamezpine

A

aplastic anemia
SIADH
neural tube defects

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18
Q

adverse effects of valproate

A

hepatotoxic

neural tube defects

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19
Q

adverse effects of lamotrogine

A

benign rash

SJS

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20
Q

what type of channel is the CFTR protein

A

ATP dependent

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21
Q

cytotoxic brain edema

A

starts hours after ischemic injury due to failure of ATP pumps plus release of glutamate –> increased intracellular Na

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22
Q

vasogenic brain edema

A

24-48 hours post ischemic event. release of inflammatory stuff disrupts the blood brain barrier and allows stuff like protein to enter

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23
Q

cystathione beta synthase requires what cofactor

A

pyridoxine (b6)

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24
Q

junctional nevi

A

limited to dermoepidermal junction

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25
Q

compound nevi

A

extend into the dermis- dermal and epidermal involvement

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26
Q

spinal stenosis

A

leg weakness, numbness, pain.
posture dependent: usually better when leaning forward.
Due to thickening of ligament flavum

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27
Q

triad of serotonin syndrome

A 
autonomic instability (tachycardia, HTN)
altered mental status
neuromuscular hyperactivity (tremor, hyperreflexia, clonus)
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28
Q

causes of normal anion gap metabolic acidosis

A

renal tubular acidosis
severe diarrhea
excessive saline infusion

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29
Q

DMARDs

A

methotrexate, sulfasalazine, hydroxychloroquine, minocycline, TNFa inhibitors

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30
Q

where does iron absorption mainly occur

A

duodenum and proximal jejunum

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31
Q

what is a histo hallmark of chrons

A

noncaseating granulomas

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32
Q

MOA of digoxin

A

inhibits N/K ATPase in myocardial cells –> decreased efflux of potassium and increased intracellular Ca.
parasympathetic activation of vagus nerve.

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33
Q

germinal matrix hemorrhage

A

inter ventricular hemorrhage, increased risk in preterm infants.
Germinal matrix has weak vascular network.

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34
Q

x linked agammaglobinemia

A

x linked defect in burton tyrosine kinase –> impaired B cell maturation and immunoglobulin production

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35
Q

branched chain alpha keto acid dehydrogenase enzyme complex requires what cofactor and deficiency leads to what disease

A

thiamine, maple syrup urine disease

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36
Q

androgen binding protein

A

made by sertoli cells, maintains high levels of testosterone in the seminiferous tubules and epidemics

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37
Q

abrupt cessation of alcohol use in chronic alcoholics

A

down regulation of GABA a, upregulation of glutamate via NMDA receptors

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38
Q

ekg third degree heart block

A

dissociation of P waves and QRS complex.

P waves occur regularly due to functioning SA node. QRS is slow bc of the ventricles and bundle of HIS

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39
Q

Foscarnet

A

gancyclovir resistant CMV tx.

causes hypo magnesium and decreased PTH leading to hypocalcemia.

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40
Q

primary myelofibrosis

A 
malignant expansion of megakaryocytic. 
bone marrow fibrosis. 
pancytopenia. 
splenomegaly. 
dacrocytes (tear shaped RBC)
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41
Q

gerstmann syndrome

A

infarct of middle cerebral artery leading to damage of the angular gyrus of the dominant parietal lobe.
sx: agraphia, can’t do math, finger agnosia, left-right confusion

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42
Q

rifaximin MOA

A

decreased gut bacteria to decrease production of ammonia

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43
Q

venous system of internal hemorrhoids

A

superior rectal vein to inferior mesenteric v

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44
Q

venous system of external hemorrhoids

A

inferior recta vein to internal pudendal vein to internal iliac.

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45
Q

branched chain alpha keto acid dehydrogenase cofactors

A 
thiamine
lipase
coenzyme A
FAD
NAD
(tender loving care for nancy)
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46
Q

autopsy findings of anaphylaxis

A

laryngeal edema, pulmonary edema, cerebral edema, hyperinflation of the lungs

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47
Q

non depolarizing neuromuscular blocking agents in pts with myasthenia gravis

A

competitive antagonists of nACh receptors- pts will have increased sensitivity
(vercuronium)

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48
Q

what is the most abundant amino acid in collagen

A

glycine

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49
Q

most common cause of congenital torticollis

A

malposition in utero or birth trauma

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50
Q

sx of fibromyalgia

A

msk pain, fatigue, psych problems, lasting for more than 3 months

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51
Q

sx of acute diverticulitis

A

LLQ abdominal pain, nausea, vomiting, change in bowel habit, tenderness with/without palpable mass, leukocytosis

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52
Q

complications of varicose veins

A

chronic edema, stasis dermatitis, skin ulcerations, poor wound healing, infection

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53
Q

most common cause of development of a fib

A

ectopic electrical foci in the pulmonary vein

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54
Q

CaSR

A

transmembrane receptors coupled to Gq protein

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55
Q

apnea of prematurity

A

central apnea due to immature central respiratory receptors

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56
Q

medullary respiratory centers

A

inspiration via dorsal input

expiration via ventral

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57
Q

gallstone ileus

A

gallstone causes fistula usually with duodenum, then stone passes freely until it gets trapped in the ileum. pt presents with signs of small bowel obstruction (ab pain, high pitched bowl sounds, air on X-ray)

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58
Q

obturator n

A

passes through the obturator canal. innervates thigh muscles of ADDuction, and sensory to medial distal thigh.
gets compressed with pelvic trauma or bladder tumors

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59
Q

aflatoxin intake increases risk of what type of cancer

A

liver carcinoma

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60
Q

primary amyloidosis

A

multiple myeloma

Ig light chains –> increased –> amyloid light chain in kidney, liver, spleen, heart, peripheral nerves, tongue, skin

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61
Q

secondary amyloidosis

A

chronic infection/inflammation

serum amyloid A –> increased –> amyloid in kidney, liver, spleen, heart, peripheral nerves, tongue, skin

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62
Q

dialysis related amyloid

A

ESRD, dialysis >5 years

B2 microglobulin–> decreased clearance –> Ab2-m in ligaments, shoulder joints, bone

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63
Q

hereditary/senile amyloidosis

A

AD inheritance/age related

transthyretin (prealbumin) –> mutated/aging –> ATTRm in heart, perihelia n, ligaments

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64
Q

narcolepsy with cataplexy will have decreased what

A

hypocretin 1 (orexin A) and hypocretin 2 (orexin B)

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65
Q

haldane effect

A

increase partial pressure of O2–> release of CO2 and H+

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66
Q

presence of oxalate crystals is consistent with what

A

ethylene glycol ingestion

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67
Q

Smooth ER function

A

synthesis and processing of hydrophobic compounds including lipids, phospholipids, and cholesterol derivatives (steroid hormones)

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68
Q

steroid producing cells usually contain a what

A

well developed smooth ER

adrenals, gonads, liver

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69
Q

rough ER function

A

synthesis and modification of targeted proteins, including polypeptide hormones

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70
Q

syndromes due to overproduction of peptide hormones by the rough ER

A

SIADH, insulinomas, zollinger Ellison, prolactinoma

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71
Q

secretin

A

causes increased bicarb and decreased Cl

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72
Q

renal plasma flow

A

renal blood flow x (1 - hematocrit)

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73
Q

cardio toxicity with trastuzumab

A

decrease in myocardial contractility without cardiomyocyte destruction or fibrosis

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74
Q

lower extremity cyanosis and clubbing without peripheral pulse discrepancy

A

PDA complicated by eisenmenger syndrome

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75
Q

cause of sinus bradycardia and tx

A

nodal ischemia and enhanced vagal tone: give atropine to reduce the vagal stimulation

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76
Q

where are beta 1 receptors found

A

cardiac muscle and JG cells

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77
Q

what brain structure is affected first in brain hypoxia

A

hippocampus

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78
Q

uncomplicated parapneumonic effusion

A

exudate, normal pH, normal glucose, low leukocytes.

due to movement of sterile exudate into pleural space.

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79
Q

focal nodular hyperplasia

A

liver lesion with central grey-white, depressed stellate scar with fibrous septa radiating to periphery

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80
Q

what does ang2 normally do

A

systemic vasoconstriction, constriction of glomerular efferent arteriole, increase aldosterone secretion

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81
Q

cytokines in ankylosing spondylitis

A

TNFa and IL17

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82
Q

where are most skeletal manifestations of ankylosing spondylitis

A

places of mechanical stress, mainly at sites of tendon insertion, ligaments and joint capsules.

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83
Q

meds associated with osteoporosis

A 
anticonvulsants that induce P450 (phenytoin, carbamazepine, phenobarbital)
aromatase inhibitor
mydroxyprogesterone
GnRH agonists
PPI
glucocorticoids
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84
Q

where is the area postrema

A

dorsal surface of medulla at caudal end of 4th ventricle

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85
Q

transformation

A

bacterium is able to take up exogenous DNA fragments, initiate it into its genome, and then express encoded proteins

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86
Q

transduction

A

bacteriophage (virus) transfers DNA from one bacteria to another

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87
Q

conjugation

A

one way DNA transfer, performed by one bacteria carrying a plasmid the the fertility factor

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88
Q

medullary thyroid cancer

A

originate from parafollicular calcitonin cells, get nests of polygonal spindle shaped cells with amyloid deposits.

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89
Q

cardiac drugs that reduce mortality in pts with an MI

A

ACE inhibitor, mineralocorticoid receptor antagonists, ARBs, beta blocker

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90
Q

transient global amnesia

A

self limiting amnesia for 24 hours, due to disfunction of the hippocampus

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91
Q

hormone levels in klinefelters

A

decreased testosterone, azoospermia, increased LH and FSH due to loss of feedback

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92
Q

MOA of terbinafine

A

inhibits synthesis of ergosterol of the fungal membrane inhibiting the enzyme squalene epoxidase

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93
Q

locus ceruleus

A

in posterior rostal pons near the lateral floor of the fourth ventricle. secretes NE.
controls RAS, sleep wake, autonomics (BP control)

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94
Q

what does porcelain gallbladder increase the risk of

A

adenocarcinoma of the gallbladder

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95
Q

what marker correlates with osteoblast activity

A

alkaline phosphatase

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96
Q

brachiocephalic v obstruction

A

only affects unilateral: UE and face swelling

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97
Q

most common cause of liver metastasis and how does it spread

A

colon cancer: through portal venous system

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98
Q

anterior dislocations of humerous

A

usually happen to an external rotated and abducted arm, damages the axillary n. get flattened deltoid and loss of sensation over lateral shoulder

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99
Q

common trigger of COPD exacerbation

A

viral or bacterial infections

rhinovirus, influenza, H flu, strep pneumo, morazella catahharalis

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100
Q

neuroleptic malignant syndrome

A

due to antipsychotic meds. hyperthermia, severe muscular rigidity, altered mental status, autonomic dysfunction.
due to dysregulation of dopamine

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101
Q

abruptio placentae

A

premature separation of placenta from uterus. abdominal pain, bleeding, tender, firm uterus

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102
Q

letrozole MOA

A

inhibits aromatase and suppreses ovarian estradiol production

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103
Q

acute hemolytic transfusion reactions are what type of hypersensitivity

A

type 2: complement mediated

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104
Q

where does post transcription modification of collagen occur

A

RER, uses vit C as a cofactor.

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105
Q

drugs for migraine prevention

A

anticonvulsants (topiramate and valproate), beta blockers, antidepressants (tricyclics or venlafaxine)

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106
Q

levels of what hormone are decreased in septic shock

A

vasopressin

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107
Q

insulin affect on lipid levels

A

increases lipoprotein lipase, decreases sensitivity of hormone sensitive lipase

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108
Q

tx opioid withdrawal

A

methadone or morphine

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109
Q

Potts disease

A

years after TB infection. Fevers and worsening back pain. get spinal abscess and contiguous bone destruction

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110
Q

pathophysiology of pulmonary fibrosis

A

increased lung elastic recoil and widened airspaces due to radial traction by surrounding fibrotic tissue

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111
Q

pediculins humans capitis

A

head lice

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112
Q

why are DMT1 pts who take endogenous insulin at a greater risk of hypoglycemia

A

can’t regulate exogenous insulin the same way and after time they also develop alpha cell failure which leads to decreased glucagon secretion

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113
Q

bevacizumab MOA

A

binds VEGF, inhibits angiogenesis.

can impair maintenance phase of wound healing bc of no blood supply.

114
Q

glomus body

A

thermoregulation

115
Q

late stage radiation dermatitis

A

fibrosis, homogenization of dermal collagen due to fibroblast activation by TGFb, vascular damage leads to ulceration, telangiectasis

116
Q

intercostobrachial n

A

originates from 2nd intercostal lateral cutaneous branch and innervates skin of axilla and medial arm

117
Q

how does n meningitis reach the meninges

A

nasopharynx –> blood stream –> choroid plexus –> meninges

118
Q

antibody dependent cellular toxicity

A

monoclonal IgG binds to surface antigen –> NK cell binds Fc portion of IgG using CD16 –> NK releases granules –> apoptosis

119
Q

causes of left shift

A

decreased H+, decreased 2,3 BPG, decreased temp

increased oxygen affinity

120
Q

temporal lobe epilepsy

A

focal seizures with impaired awareness. usually blank stare with automatisms (lip smacking, hand wringling). usually due to hippocampus issues. usually have aura (epigastric pain, olfactory issues)

121
Q

anterior compartment of the leg

A

deep perineal n, anterior tibial A and V

122
Q

factor 5 leiden

A

thrombophilia- hypercoaguable.

123
Q

marker for disease progression in patients wiht ALS

A

decreased vital capacity of the lung –> respiratory failure

124
Q

where in the bone does osteomyelitis infect

A

long bone metaphysis - highly vascular with slow flowing sinusoids

125
Q

alkaptonuria

A

AR.

defect in tyrosine metabolism (tyrosine to fumarate impaired)

126
Q

anal fissures

A

bright red blood and rectal pain. longitudinal tear in anal canal distal to the dentate line, most often at posterior midline of anal verge

127
Q

tx of anorexia nervosa

A

CBT, nutritional rehab, olanzepine

128
Q

tx of bulimia

A

CBT, nutritional rehab, SSRI (fluoxetine)

129
Q

common fibular (perineal N)

A

dorsiflexion, eversion, sensory to lateral calf and dorsal surface of foot

130
Q

tibial n

A

plantar flexion, inversion, sensory to plantar surface of foot, achilles reflex

131
Q

what enzymes is biotin a cofactor for

A

pyruvate carboxylase
acetyl coa carboxylase
propionyl coa carboxylase

132
Q

histo of respiratory bronchioles and alveoli

A

macrophages

133
Q

dextrans

A

facilitate adhesion of strep to fibrin–> attach to fibrin platelet aggregates

134
Q

what artery supplies the anterior wall of the right ventricle

A

right marginal

135
Q

posterior descending artery

A

posterior 1/3 of IV septum
inferior wall of left ventricle
posterior walls of ventricles
posteromedial papillary muscle

136
Q

left circumflex artery

A

lateral and posterior wall of left ventricle

anterolateral papillary muscle

137
Q

left anterior descending artery

A

anterior 2/3 of IV septum
anterior wall left ventricle
anterolateral papillary muscle

138
Q

subfalxin hernitaiton

A

cingulate gyrus herniates under falx cerebri.

contralateral leg weakness

139
Q

uncle herniation

A

uncut (medial temporal lobe) under the tentorium cerebelli.

dilated fixed pupil, contralateral hemiparesis (early), ipsilateral hemiparesis (late)

140
Q

tonsillar herniation

A

cerebellar tonsils through foramen magnum.

coma, loss of CN reflexes, flaccid paralysis, respiratory arrest

141
Q

sx of pneumothorax

A

shortness of breath, chest pain, decreased breath sounds unilaterally, subcutaneous crepitus, hypotension, tacky, tracheal shift

142
Q

manifestations of west nile

A

fever, flu like illness, can get near issues: meningitis, encephalitis, flaccid paralysis.
bird vectors

143
Q

what changes occur immediately after closure of a PDA

A

increased LV after load, decreased LV preload

144
Q

what maintains glucose levels during meals

A

glycogenolysis (first 12-18 hours of fasting) and gluconeogenesis

145
Q

which parameter in ARDS will be normal, and helps distinguish it from cariogenic pulmonary edema

A

pulmonary capillary wedge pressure

146
Q

suprachiasmic nucleus

A

circadian rhythm and pineal gland

147
Q

first generation antihistamines

A

hydroxyzine, promethazine, chlorpenarmine, diphenhydramine

148
Q

2nd generation antihistamines

A

loraditizine, cetirizine

149
Q

marijuana intox

A

conjunctival injection (red eye), tachycardia, increased appetite, dry mouth

150
Q

what conditions increase risk of reactivation Tb

A

chronic kidney disease, poorly controlled diabetes.

151
Q

increased tactile fremitus

A

consolidation

152
Q

neuroma

A

mess up in nerve regeneration: results in disorganized mass of axonal processes, schwann cells, vascular hyalinization, and fibrosis

153
Q

chronic axonal injury/inflammation

A

increases expression of voltage gates sodium channels

154
Q

cholangiocarcinoma histo

A

adenocarcinoma with cuboidal or columnar cells w prominent nucleoli arranged in glandular structures, + mucin producing, + desmoplastic response

155
Q

metalloproteinases

A

degrade extracellular matrix, help tumor cells invade the basement membrane

156
Q

tryptophan is a precursor for what

A

niacin, serotonin, melanin

157
Q

Hartnup disease

A

AR- mutations affecting the neutral amino acid transporter. especially can’t transport tryptophan, which makes niacin which makes NAD.
pt with niacin deficiency: pellagra like skin eruptions, and cerebellar ataxia

158
Q

which muscles attach to the lateral epicondyle and what is their function

A

extensor carpi radialis brevis and extensor digitorum

wrist flexion

159
Q

alkaptopruia manifestations in adulthood

A

arthritis, deposits of homogentistic acid in sclera and ear cartilage (blue-black)

160
Q

ornithine translocase deficiency

A

can’t get ornithine back into the mitochondria for the urea cycle. ammonia accumulates in the blood- hyperreflexia, lethargy, vomiting, seizures.
tx is limit protein intake

161
Q

symptoms of ascending aortic dissection

A

sudden sharp chest pain, blood pressure asymmetry, can go on to cause tampanade

162
Q

subacute granulomatous (de Quervian) throiditits

A

usually follows viral infection.
increased T3/4, increased thryoglobin, decreased TSH and radioactive uptake.
Painful diffuse goiter

163
Q

elastase

A

contained in macrophages and neutrophils.

164
Q

invasive pulmonary aspergilous

A

fever, chest pain, cough, dyspnea, hemoptysis

165
Q

minimal alveolar concentration

A

correlates to potency. the higher the MAC, the less potent a drug is.
decreases with age and body temp

166
Q

peripheral zone of the prostate

A

where most prostate cancer is- close to rectum so pts undergo transracial ultrasound guided biopsy

167
Q

most likely predisposing factor to infective endocarditis

A

developed country: mitral valve prolapse

underdeveloped: rheumatic heart disease

168
Q

what type of patients are at greatest risk of EBV associated cancer

A

HIV patients

169
Q

IgA protease

A

promotes adherence to mucosa

170
Q

hormone sensitive lipase

A

catalyzes metabolism of stored triglycerides into free fatty acids and glycerol

171
Q

spinal muscular atrophy

A

mutations in SMN1 gene–> issue with snRNA in LMN–> degeneration of anterior horn

172
Q

stasis dermatitis

A

erythema, induration, fibrosis, deposits of hemosideran –> manifests as red/brown discoloration

173
Q

thyrotropin receptor antibody

A

graves disease

174
Q

thyroid peroxidase antibody

A

hashimoto, postpartum thyroiditis, silent thyroiditis, some graves patents.

175
Q

patiromer MOA

A

binds colonic potassium in exchange for calcium

176
Q

obesity hypoventilation syndrome

A

hypoxemia, hypercapnia, normal A-a gradient, chronic fatigue, dyspnea, OSA

177
Q

REM sleep behavior disorder

A

alpha synuclein neurodegenerative disorder

178
Q

stimulation of what nerve might improve OSA

A

hypoglossal- pushes the tongue forward giving more space

179
Q

postmenopause osteoporosis

A

thinning of trabecular bone with loss of interconnecting bridges

180
Q

bone disease due to hyperparathyroidism

A

increased bone resorption in cordical bone with subperiosteal thinning and cystic degeneration

181
Q

complications of high volume blood transfusions

A

excess citrate chelates calcium, causing hypocalcemia

182
Q

what is the most significant risk factor for catheter associated UTI

A

duration of catheter use

183
Q

PCN moa

A

b-lactam that disrupts cell wall synthesis by inhibiting transpeptidase, a bacterial enzyme necessary for cell wall cross-linking

184
Q

causes of renal papillary necrosis

A

sickle cell, drug induced (NSAID), DM, pyelonephritis and UTI.

185
Q

virulence of listeria

A

listeriolysin O: generates pores in phagosome so it escapes cytoplasm and avoids lysosome.
actin-based transcellular spread.

infections are controlled mainly by the cytotoxic T cell response

186
Q

complete AV canal defect

A

osmium primum ASD, VSD, and single AV valve.

most common in down syndrome.

187
Q

abetalipoprotinemia

A

impaired formation of apoB containing lipoproteins.

first year of life: malabsorption, neuro abnormalities

188
Q

pathologic brain findings in MS

A

depletion of oligiodendricites

189
Q

where is epinephrine produced

A

adrenal medulla

190
Q

DNA binding protein

A

c-JUN, c-FOS

191
Q

pathogenesis of minimal change disease

A

immune dysfunction –> over production of glomerular permeability factor –> damaged podocyte –> foot process effacement and loss of anionic properties –> selective albuminemia

192
Q

raphe nuclei

A

serotonin releasing neurons

193
Q

highly proliferative cells

A

hemotapoietic stem cells, skin cells, gonads, intestinal crypt stem cells

194
Q

lipid lowering drug for preventing cardiovascular events

A

statins (HMG CoA reductase inhibitors)

195
Q

complications of obstructive sleep apnea

A

pulmonary HTN, HTN

196
Q

associated conditions of celiacs

A

other autoimmune disorders, T cell lymphoma

197
Q

BCL2

A

prevents signals from activating the intrinsic apoptotic cascade , mediated by release of cytochrome C and subsequent activation of capsases

198
Q

Tx of UTI

A

bactrim or nitrofuritonin

199
Q

myositis ossificans

A

formation of lamellar bone in extra skeletal tissues. triggered by trauma.
benign metaplastic bone with surrounding fibroblast proliferation.

200
Q

tx of carcinoid syndrome

A

ocreotide

201
Q

what enzyme is deficient in ehlers danlos and what is its normal function

A

pro collagen peptidase- cleaves terminal pro peptidase in extracellular space

202
Q

how does T3 lead to osteoporosis

A

increases bone respiration, stimulates osteoclasts, increased release of calcium

203
Q

which pulmonary function value remains increased once you have ARDS

A

Alveolar-arterial oxygen difference

204
Q

side effect of halothane

A

hepatitis

205
Q

epidermolysis bullosa

A

inheritable skin disorder. mutations involving intraepidermal and dermoepidermal adhesion complexes.
usually due to mutations in keratin genes

206
Q

how does prostate cancer spread to the bone

A

hematogenous thought the prosthetic venous plexus

207
Q

IgA nephropathy

A

nephritic, normal levels of complement, recurrent hematuria,

208
Q

the beta subunit of hemoglobin is most similar to what

A

myoglobin- so they will have similar curves

209
Q

phospholipase A2 receptor antibodies

A

membranous nephropathy

210
Q

what gets injured in an anterolateral displacement distal humoral fracture

A

radial n

211
Q

cause of primary spontaneous pneumothorax

A

rupture of apical sub pleural blebs

212
Q

Vit D analog MOA in psoriasis

A

activate vit D receptor–> inhibition of T cell and keratinocyte proliferation

213
Q

acute viral hepatitis histo

A

spotty necrosis with ballooning degeneration, eosinophilic apoptotic hepatocytes, mononuclear cell infiltrates

214
Q

retinal artery occlusion

A

painless vision loss. thromboembolus from internal carotid –> ophthalmic artery –> retinal artery

215
Q

alveolar ventilation

A

(tidal volume - dead space volume) x breaths/min

216
Q

internal laryngeal n

A

controls cough reflex. gets injured when stuff gets stuck in piriform recess

217
Q

medium chain acyl-CoA dehydrogenase deficiency

A

after significant fast: hypoketoic hypoglycemia (no acetoacetate), mild hepatomegaly, liver dysfunction

218
Q

adverse effect of methadone

A

QT prolongation

219
Q

stages of pages disease of the bone

A
  1. osteolytic (osteocytes)
  2. mixed
  3. osteosclerotic (osteoblasts)
220
Q

cause of diabetic mononeuropathy

A

ischemic nerve damage

221
Q

cause of HbC and HbS

A

missense mutation

222
Q

risk factors of uterine sarcoma

A

tamoxifen use, postmenopausal, pelvic radiation

223
Q

bone marrow of older pts vs younger pts

A

increased fat and decreased mass

224
Q

pure red blood cell aplasia has been associated with what cancers

A

thymomas and leukemias

225
Q

what heart structure is immediately anterior to the esophagus

A

left atrium

226
Q

MOA of caspofusion

A

block glucagon synthesis which inhibits cell wall synthesis

227
Q

cause of gestational thrombocytopenia

A

expansion of plasma volume and increased platelet sequestration

228
Q

what spinal tracts are affected in friedrichs ataxia

A

spinocerrobellar, lateral corticospinal, dorum columns

229
Q

acute allergic contact dermatitis

A

type 4 hypersensitivity.

has spongiosis and accumulation of edema fluid

230
Q

maintenance dose

A

Css x CL x dosing interval

steady state plasma concentration x drug clearance

231
Q

what can you give a diabetic pt with gastroparesis if they can’t take metoclopramide

A

erythromycin - activates motilin receptor

232
Q

stable angina

A

restricted coronary blood flow due to fixed atherosclerotic plaque that obstructs >70% of lumen

233
Q

carbon monoxide poisoning

A

increases carboxyhemoglobin, decreased oxygen carrying capacity and oxygen content, has no effect on dissolved amount of oxygen (PaO2)

234
Q

effects of heparin

A

prolonged thrombin time, prolonged PTT, decreased activity of factor Xa

235
Q

uterine fibroid

A

discrete, yellow-grey tumors. monoclonal proliferation of monocytes and fibroblasts

236
Q

granulose cell ovarian tumor

A

increased estrogen, increased inhibin, call-exner bodies, yellow theca cells with lipids

237
Q

most susceptible places to atherosclerosis

A

lower abdominal aorta and coronary arteries

238
Q

acquired methemoglobinemia

A

cyanosis that doesn’t improve with oxygen. due to topical anesthetic or dapsone. heme ions are oxidized and unable to bind oxygen

239
Q

HIV associated dementia

A

subcortical dementia with mood, attention, memory, and psychomotor dysfunction. change to viral tropism to microglia and macrophages.

240
Q

histo of aortic dissection

A

cystic medial degeneration

241
Q

histo of subacute granulomatous thyroiditis

A

mixed, cellular infiltration with occasional multinucleate giant cells

242
Q

why can patients with lactate dehydrogenase deficiency not do glycolysis

A

they can’t regenerate NAD+ from NADH

243
Q

when dermatomyositis is diagnosed what should you look out for

A

occult malignancy

244
Q

why can pts wth granulomatous disease or NHL have hypercalcemia

A

PTH independent activation of 1a-hydroxylase in macrophages

245
Q

axonal reaction

A

axon gets severed- cell body shows signs of edema: peripheral displacement of nuclei, dispersion of Kissel substance to the periphery

246
Q

what causes increased insulin resistance in pregnancy

A

human placental lactogen

247
Q

damage to what areas would result in complete hemisensory loss

A

ventral posterior lateral nucleus and ventral posterior medial nucleus of the thalamus

248
Q

aromatase inhibitors

A

anastrozole, letrozole, exemestane

249
Q

hydralazine, minodoxil MOA

A

selective arteriolar vasodilators: lower BP by lowering SVR but get reflex sympathetic innervation: increased CO and activation of RAAS.

250
Q

assessment to test for concentration

A

ask pt to recite months of the year backwards

251
Q

drugs with non-IgE mediated effect

A

opioids
vanco
radioiodine contrast

mast cell degranulation

252
Q

primary somatosensory cortex

A

controls sensory information to the contralateral side of the body (post central gyrus)

253
Q

risk factors of gastricadenocarcinoma

A

high salt diet, N-nitro containing foods, H pylori, autoimmune gastritis, obesity

254
Q

intestinal type gastric adenocarcinoma

A

ulcerated mass with irregular or heaped up edges.

glandular structures with cuboidal or columnar like intestinal cells

255
Q

diffuse type gastric adenocarcinoma

A

plaque like infiltration of stomach; lintitis plastia

signet ring cells without glandular structures

256
Q

why is DIC a common complication of sepsis

A

lipopolysaccharide is a procoagulant that triggers the coagulation cascade

257
Q

cysticercosis

A

ingestion of taenia solieum- fecal oral

get cysts in brain- can manifest as seizures

258
Q

cause of progressive valvular calcification

A

fibroblasts differentiate into osteoblast like cells

259
Q

kidney complications of BPH

A

increased hydrostatic force needed –> hydronephrosis –> parachymal atrophy and scarring leaking to CKD

260
Q

where do most pancreatic cancers arise from

A

pancreatic ductal system

261
Q

BRCA

A

DNA repair gene

262
Q

asbestos exposure

A

insulation, shipbuilding, drywall workers.

pleural plaques with calcifications

263
Q

what is the most common cause of bacterial meningitis in adults

A

strep pneumo

264
Q

propofol

A

highly lipophilic GABA agonist used for long term sedation.

adverse: hypotension

265
Q

etomidate

A

GABA agonist, hemodynamically neutral. causes adrenalcortico suppression

266
Q

ketamine

A

NMDA antagonist. preserves respiratory drive and is also sympametetic

267
Q

tx of tinea pedis

A

topical antfungals: miconazole, clotrimazole, terbinafine, tolnaftate

268
Q

mannitol MOA

A

increases plasma osmolarity–> pulls water into plasma –> decrease serum sodium concentration -> increase renal blood flow –> increased GFR and RBF

269
Q

where do the testis drain

A

para-aortic

270
Q

histo of acute viral hepatitis

A

hepatocyte necrosis (cellular swelling) and apoptosis with mononuclear infiltrate

271
Q

clinical use of lactated ringer and normal saline

A

volume resusitation (isotonic)

272
Q

use of dextrose 5% and .45 saline

A

free water deficit (hypotonic)

273
Q

HPV viral oncogenes

A

E6- p53

E7- Rb

274
Q

chronic granulomatous disease increases risk of infection with what type of organisms

A

catalase positive

275
Q

CYP3A4 inhibitors

A

fluconazole, voriconazole, ketoconazole, ciprofloxacin, clarithromycin, cimetidine, fluvoxamine.

276
Q

pudendal n

A

pelvic floor muscles, external urethral and anal spinchters

277
Q

tension from what muscle would cause a distal clavicle fracture

A

deltoid

278
Q

brain imaging of huntingtons disease

A

enlargement of frontal horns of lateral ventricle

279
Q

Cytokerratin

A

marker for epithelial derived tumors

280
Q

pemphigus vulgaris

A

LM: intraepithelial cleavage with detached keratinocytes, and retained keratinocytes along basement membrane

281
Q

adverse effect of calcineruin inhibitors (cyclosporine, tacrolimus)

A

increase BUN and Creatinine, renal arteriolar constriction–> HTN –> obliterative vasculopathy

282
Q

common triggers of drug induced hemolysis

A

anti-inflammatories, PCN, cephalosporins

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