Mix15

Question 1

Bacteria that have the innate capacity to undergo transformation are said to be naturally competent. What 4 bacterial types can do this?

Answer 1

Haemophilus, Strep, Bacillus, and Neisseria

Question 2

How does the FEV1/FVC ratio differ between obstructive vs restrictive lung dz?

Answer 2

Obstructive lung disease&raquo_space; reduced FEV1 more than FVC, causing a low FEV1/FVC ratio. Restrictive lung disease on the other hand (pulmonary fibrosis) keeps the alveoli open (lung volumes are low and airways are held open by fibrotic tissue) so FEV1/FVC is typically increased in restrictive lung disease Pt.

Question 3

What is the gene defect responsible for ALS, and what is a potential treatment?

Answer 3

SOD1 (copper zinc superoxide dismutase) and Riluzole (decreases glutamate release/glutamate excitotoxicity)

Question 4

What are the diff disease states that correlate with Cheynne Stokes breathing vs Kussmaul breathing?

Answer 4

Cheynne Stokes = CHF. Cycles of apnea followed by gradually increasing then decreasing volumes of airflow until next apnic period.

Kussmaul = severe metabolic acidosis (DKA). Deep and labored breathing pattern.

Question 5

Why does Resp Rate increase in pulmonary fibrosis or pulmonary edema?

Answer 5

Reduced lung compliance limits the tidal volume per breath, so respiratory control centers increase the RR to restore minute ventilation and decrease work of breathing.

Question 6

What’s the treatment of choice for bacterial vaginosis?

Answer 6

Metro or clindamycin. Treat woman only (guys are unaffected)

Question 7

Radial head subluxation (nursemaid’s elbow) is due to damage to what ligament?

Answer 7

annular ligament. Happens in kids 1-4 yo when there is a sharp tug on a pronated arm with elbow extended. Achieve reduction by fully supinating the forearm followed by fully flexing the elbow.

Question 8

Adrenergic B2 agonists such as ___ and ___ can be used to promote uterine relaxation and defer premature labor.

Answer 8

Terbutaline and ritodrine. These are selective B2 AR. B2 agonism also promotes bronchodilation and peripheral vasodilation.

** Isoproterenol = B1 and B2 agonist.

Question 9

What’s the pathognomonic mutation for most cases of melanoma, and what would you give to treat it?

Answer 9

BRAF V600E is seen in about 60% of cases. BRAF = protein kinase in signaling pathway for melanocyte proliferation. Give vemurafenib (inhibitor of mutated BRAF)

Question 10

How does teriparatide promote bone formation?

Answer 10

Teriparatide - recombinant PTH. Stimulates maturation of pre-osteoblasts into bone forming osteoblasts that lay down collagen and mineralize matrix. Teriparatide increases GI calcium absorption and renal calcium reabsorption.

Question 11

Porcelain gallbladder is assoc with chronic cholecystitis and may increase the risk of ___

Answer 11

gallbladder carcinoma

Question 12

What’s the most common cardiac manifestation of tertiary syphilis?

Answer 12

Late (tertiary) syphilis can manifest as cardiovascular involvement with ascending aortic aneurysms (with calcification on x-ray)&raquo_space; aortic valve insufficiency (murmur, high pitched S2)

Question 13

____ is the cytosolic enzyme that converts acetyl CoA to malonyl CoA, and serves as the rate limiting step in FA synth:

Answer 13

Acetyl CoA carboxylase (biotin B7 dependent)

** Malonyl CoA also inhibits the mitochondrial action of carnitine acetyltransferase, thereby inhibiting B-oxidation of newly formed FA.