mixed 04/15

Question 1

cyanide toxicity

Answer 1

-liver rhodanase normally transfers a sulfure to cyanide to form thiocyanide to be excreted in urine
-give sodium thiosulfate this can speed up the process
sulfur party

Question 2

acute viral hepatitis histo

Answer 2

• panlobular lymphocytic infiltrates, ballooning hepatocytes, hepatocyte necrosis and hepatocyte apoptosis.
• apoptotic hepatocytes form round acidophillic (pink staining on H and E) bodies known as councilman bodies or apoptotic bodies

Question 3

HIV structural genes

Answer 3

gag, pol and env

gag: p24, p7
pol
env: gp120 gp41

Question 4

The inferior thyroid artery arises from the throcervical trunk, a branch of the subclavian artery

Answer 4

-it courses deep to the vagus nerve, common carotid artery and internal jugular vein before turning toward the thyroid. Just before meeting the thyroid gland, this arty courses just superficial to the recurrent laryngeal nerve

Question 5

What is the best agent currently available to increase HDL cholesterol levels?

Answer 5

Niacin vitamin B3

Question 6

Mallory-weiss

assoc. alcoholism

Answer 6

tears occur secondary to rapid increase of intraabdominal and intraluminal gastric pressure, as when happens during retching and vomiting
-other precipitating factors include: coughing, hiccuping, repeated abdominal straining and trauma

Question 7

Cladribine (2CDA)

Answer 7

an adenosine analog - inhibits adenosine deaminase

• it achieves high intracellular concentrations, where it is incorporated into the DNA and causes DNA strand breaks.
• used to treat hairy cell leukemia
• penetrates the CNS, excreted in urine

Question 8

Beta blockers and mortality reduction

Answer 8

• beta blockers, particularly carveidiol sign. decrease heart failure progression as well as all-cause mortality in patients with CHF
• Cavedilol is unique among beta blockers in that it non-specifically antagonizes B1, B2 and a1 adrendergic receptors

Question 9

Jimson weed (datura stamonium) called Gardeners mydriasis –> belladonna alkaloid toxin

Answer 9

posess strong anticholinergic properties much like atropine poisoning!!!

treat? physostimine

Question 10

how to here AR the best?

Answer 10

-murmur is typically best heard at the left sternal border, with the patient leaning forward (brings the valve close to the chest wall) and at end expiration (listening during expiration often accentuates left-sided heart murmurs)

Question 11

respiratory resistance

Answer 11

• trachea and main stem bronchi is relatively high, but in medium sized bronchi there is even more turbulent flow so increased resistance
• resistance drops in the bronchioles and drops even more to the terminal bronchioles

Question 12

Hemolytic uremic syndrome HUS

Answer 12

• affects young children with acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia
• characteristic laboratory abnormalities include decrease RBC count,hematocrit and platelet count
• increased bleeding time, LDH, BUN and creatinine

Question 13

which renal calculi are radiolucent on X-ray?

Answer 13

uric acid stones!

Question 14

eisenmenger syndrome

Answer 14

late onset reversal of L to R shunt due to pulmonary vascular sclerosis resulting from chronic pulmonary HTN

Question 15

Li fraumeni syndrome p53

Answer 15

AD

-sarcomas, tumors of the breast, brain and adrenal cortex are most common

Question 16

Diabetic neuropathy of CN III is ischemic

Answer 16

SOMATIC nerve fibers are affected, the parasympathetic fibers of CN III retain function.
so we get the ptosis, down and out gaze in conjuction with normal light and accomodation reflexes as the parasympathetic fibers are ok!

Question 17

Intrathoracic spread of lung cancer

Answer 17

• may irritate the phrenic nerve, causing hiccups and diaphragmatic paralysis and dyspnea
• may involve the recurrent laryngeal nerve and cause hoarseness
• may involve the brachial plexus and can cause pain in the distribution of C8, T1 and T2 nerve roots