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Mixed Block Notes 6 Flashcards

1
Q

Soft Exudate

A

Grayish-white, cotton wool - due to microinfarct

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2
Q

Hard Exudate

A

Clear margins - due to leakage of protein

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3
Q

Absolute vs Relative Erythrocytosis

A

Red Cell Mass increased in Absoluate

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4
Q

Ureters lie antermedial to what structures in true pelvis

A

Internal Iliac

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5
Q

Death due to TCA toxicity

A

Cardiac Fast Na channel block –> Arrhythmia, Cardiogenic Shock

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6
Q

TCA’s also block

A

mAChR, alpha1, Cardiac Fast Na, H1; NE and 5-HT reuptake

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7
Q

Common precursor of Beta-Endorphin and ACTH

A

POMC (also yields MSH)

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8
Q

Gastroeneteritis with intestinal invasion

A

Salmonella, Shigella, EIEC, Campylobacter, Entamoeba histolytica

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9
Q

Stacked-brick intestinal adhesion

A

EAEC

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10
Q

Characteristic histologic findings in GERD

A

Basal zone hyperplasia, Elongation of lamina propria, Inflammatory cells (eo’s, Pmn’s, lymph’s)

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11
Q

First gen anti-histamines

A

Dim First Gen History Professors Dip Cope - Dimenhydrinate, Hydroxyzine, Promethazine, Diphenhydramine, Chlorpheniramine

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12
Q

Second gen anti-histamines

A

Second Gen History Certainly want tadine - Cetirizine, -adine

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13
Q

Bisphosphonates should be used carefully in patients with

A

Renal failure - Excreted unchanged

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14
Q

Common robertsonian translocations

A

14;21 and 21;22

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15
Q

Most susceptible parts of kidney to hypoxia

A

PCT, Thick Ascending Limb

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16
Q

Prophylaxis of cerebral vascular spasm following SAH

A

Nimodipine

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17
Q

Two types of pneumococcus vaccine

A

(23) Polysaccharide = B cell response = Less effective; (17) Polysaccharide conjugated to diph toxin = T cell response = better

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18
Q

Killed Vaccines

A

RIP Always = Rabies, Influenza, Polio, Hep A

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19
Q

3 adverse effects of all Protease Inhibitors

A

(1) Lipodystrophy; (2) Hyperglycemia; (3) P450 inhibition

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20
Q

What to use instead of rifampin for patients with mycobacterial infection in patients on protease inhibitors

A

Rifabutin

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21
Q

3 important mitochondrial syndromes

A

(1) Leber Hereditary Optic Neuropathy; (2) Myoclonic Epilepsy w/ Ragged-Red Fibers; (3) MELAS

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22
Q

Aortic Arch Derivatives

A

3 = Common/Internal Carotid; 4 = Aortic Arch, R Subclavian; 6 = Pulmonary Arters, Ductus Arteriosis

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23
Q

5 Dehydrogenase Cofactors

A

B1, B2 (FAD), B3 (NAD), B5 (CoA), Lipoid Acid

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24
Q

Prevention of neonatal tetanus

A

Vaccinate mom –> Placental transfer of IgG

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25
Q

Conversion of Pyruvate to PEP requires what 2 enzymes

A

Pyruvate Carboxylase, PEPCK

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26
Q

How can mitochondrial OAA be transported to cytosol

A

(1) Conversion to PEP; (2) Transamination to Aspartate; (3) Reduction to Malate

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27
Q

What step of CAC is GTP produced in?

A

Succinyl CoA to Succinate

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28
Q

Anti-arrhythmic specific for ischemic myocardium

A

Ischemic = Depolarized –> Lidocaine

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29
Q

What has currently replaced lidocaine for ventricular tachycardia

A

Amiodarone

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30
Q

Procainamide is more specific for arrhythmias arising from

A

Centers of normal automaticity

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31
Q

Prolonged administration of Verapamil pts with V Tach can

A

Lead to V fib and death –> Distinguish between Supraventricular and Ventricular Tach

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32
Q

Adenosine is used for

A

Acute treatment of Paroxysmal Supraventricular Tachycardia

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33
Q

Gene in PAH

A

BMPR2

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34
Q

Hypophosphorylated Rb prevents

A

G1 –> S (Hypophosphorylated = Active)

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35
Q

Colloid Cyst

A

Benign formation in third ventricle –> Lethal obstruction

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36
Q

Reticulin deposits and chronic inflammatory infiltrates in brain tumor

A

Xanthoastrocytoma

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37
Q

Activated Protein C inhibits

A

Factors Va and VIIIa

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38
Q

Aside from gas gangrene, C perf can cause

A

Late-onset food poisoining –> Transient watery diarrhea

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39
Q

X linked recessive disorders

A

Bruton, Wiskott, Fabry, G6PD, Ocular Albinism, Lesch-Nyhan, DMD, Hunter Syndrome, Hemphophilia, OTC Def

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40
Q

Autosomal Dominant disorders

A

HHT, Fam Hyperchol, FAP, MEN, NF1/2, Marfans, Her Spher, Achondroplasia, Huntingtons, Li-Fraumeni, BRCA1/2, Polycystic, Tuberous Sclerosis, vHL

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41
Q

HIV gene that is glycosylated and cleaved

A

ENV –> Gp140 –> Gp120 and Gp41

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42
Q

How does blood from Bronchial Arteries return

A

Majority to left heart in deoxy form via pulmonary veins (admixture); Some to right heart via azygous, acessory hemiazygous, or intercostal veins

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43
Q

Afferent fibers from Carotid and Aortic baroreceptors terminate in

A

Solitary nucleus of medulla

44
Q

Histology of Psoriasis

A

Hyperparakeratosis, Acanthosis, Elongation of Rete Ridges, Mitotic activity above epidermal basal layer, Reduced or absent stratum granulosum

45
Q

Munro microabscesses

A

PMNs form spongiotic clusters in superficial dermis and parakeratotic stratum corneum in Psoriasis

46
Q

Advantage of proline in collagen

A

Kink the polypeptide chain and enhance rigidity b/c of their ring configuration

47
Q

What happens to procollage once secreted

A

Cleaved C and N terminals –> Solubility decreases –> Collage fibrils –> Lysil Oxidase crosslinking

48
Q

Alkaptonuria is a defect in what pathway

A

Tyrosine to Fumarate

49
Q

What causes nipple inversion with breast cancer

A

Invades central region

50
Q

What causes skin retraction in breast cancer

A

Infiltration of Cooper ligaments

51
Q

Alternative to SSRI when sexual side effects occur

52
Q

Xanthoma vs Xanthelasma

A

Xanthoma is surrounded by inflammatory cells and fibrotic stroma, Xanthelasma not

53
Q

Ergonavine MOA

A

Constricts SM by stimulating both alpha adrenergic and 5-HT receptors

54
Q

Phentolamine MOA

A

a1 and a2 blocker

55
Q

In what part of bone is hematogenous osteomyelitis most likely

56
Q

Hyper IgM syndrome results from

A

Absence of CD40L on t cells or Genetic deficiency in isotype switching enzyme

57
Q

Hyper IgM manifestations

A

Recurrent sinopulmonary infections; Lymphoic hyperplasia

58
Q

IgA class switching is induced by

59
Q

Specific marker of mast cell activation

A

Tryptase (released in degranulation)

60
Q

Antimicrobials that block ENaChannels

A

Trimethoprim, Pentamadine

61
Q

Why is serum Na normal in Mineralocorticoid Excess

A

Aldosterone Escape via ANP –> Prevents edema and Na increase

62
Q

Contraction alkalosis

A

Reabsorption of HCO3-

63
Q

Where does uric acid precipitate in tubules

A

Low pH of Distal Tubules and Collecting Ducts

64
Q

Penicillinase-stable penicillins

A

Nafcillin, Oxacillin, Methicillin

65
Q

Prognosis of Capillary Hemangioma

A

Initially progress, eventually regress

66
Q

Histology in De Quervain’s Thyroiditis

A

Mixed, cellular infiltrate with multinucleated giant cells

67
Q

Opsoclonus-Myoclonus syndrome

A

Neuroblastoma

68
Q

Why not use TCA with BPH?

A

Anti-Cholinergic –> retention

69
Q

Why not use TCA with Orthostatic Hypotension?

A

Antagonizes alpha 1 peripherally

70
Q

Causes of Hypercalciuria

A

Mainly Idiopathic; Also Hyperoxaluria, Hyperuricosuira, Low urinary volume, Hypocitratruria

71
Q

Causes of Hyperoxalouria

A

Diet (chocolate, nuts, spinach; Low calcium diet (more oxalate absorbed)

72
Q

Main radiographic finding in Mesothelioma

A

Nodular or smooth pleural thickening

73
Q

Gold standard for Mesothelioma diagnosis

A

EM = Numerous long, slender microvilli with abundant tonofilaments (adenocarcinoma has short, plump microvilli)

74
Q

Bronchioalveolar carcinoma has a characteristic

A

Distribution along alveolar septa w/out vascular or lymphatic spread

75
Q

Gemcitabine vs Cytarabine

A

Both pyrimidine analogs, but Gemcitabine is not S phase specific, likely due to additional cytotoxic functions (eg inhibition of ribonucleotide reductase)

76
Q

Methotrexate vs 5-FU

A

Both inhibit thymidalate formation, but only MTX overcome by Folinic Acid supplementation

77
Q

Gottron papules and heliotrope rash

A

Dermatomyositis

78
Q

Antidote for Cyanide (nitroprusside) toxicity

A

Sulfur (Sodium Thiosulfate) = Donates sulfur to liver rhodanase to enhance conversion of cyanide to thiocyanate

79
Q

Microangiopathic hemolytic anemia

A

Small vessels = DIC, TTP, HUS

80
Q

Triggers of G6PD

A

Bactrim, Dapsone, Antimalarials, Nitrofurantoin, Fava Beans

81
Q

What is low in G6PD deficiency

82
Q

Cause of Lipofuscin

A

Free radical injury and lipid peroxidation

83
Q

Most common location of supine aspiration

A

Right Lower Lobe

84
Q

What underlies most cases of Hereditary Hypothalamic Diabetes Insipidus

A

Neurophysin II mutations

85
Q

SPINK1

A

Trypsin inhibitor secreated by pancreatic acinar cells

86
Q

Germ tubes when incubated at 37 degrees

A

Candida –> True Hyphae

87
Q

Hep B replication

A

dsDNA –> Template +RNA –> dsDNA

88
Q

Fate of tRNA that is mischarged

A

Will incorporate wrong AA into polypeptide chain (not corrected when charged by AA-tRNA synthetase proofreading)

89
Q

MOA of mushroom toxins

A

Inhibit DNA-dependent RNA polymerase Type II = mRNA

90
Q

RNA polymerase I vs II vs III

A

I = rRNA; II = mRNA; III = tRNA

91
Q

MOA of Ricin

A

Cleaves rRNA component of 60S subunit

92
Q

Resistance to Ethambutol

A

Increase production of Arabinosyl Transferase

93
Q

Resistance to Streptomycin

A

Modification of 30S protein structure

94
Q

Resistance to Pyrazinamide

A

Modify Pyrazinamidase, which must activate Pyrazinamide

95
Q

MOA of Bosentan

A

Endothelin-receptor antagonist

96
Q

Neutrophil Alk Phos

A

Elevated in Leukemoid reaction, Decr in CML

97
Q

Acute Leukemia blast percentage

A

Greater than 20%

98
Q

Eyelid manifestation of Primary Biliary Cirrhosis

A

Xanthelasma

99
Q

Primary acceptor of amino groups during breakdown of other Amino Acids

100
Q

Glycine + Methylene Group

101
Q

What type of colonic adenoma can secrete mucus

102
Q

Perfusion defect anatomically matched by ventilation defect

A

Collapsed lung

103
Q

First test for PE

A

CT angiography

104
Q

First line treatment for open angle glaucoma

A

Prostaglandins

105
Q

Muscle responsible for accomodation? control?

A

Ciliary muscle - solely under cholinergic (m3) control

Uworld (16 decks)

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