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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
Conversion of Pyruvate to PEP requires what 2 enzymes
Pyruvate Carboxylase, PEPCK
26
How can mitochondrial OAA be transported to cytosol
(1) Conversion to PEP; (2) Transamination to Aspartate; (3) Reduction to Malate
27
What step of CAC is GTP produced in?
Succinyl CoA to Succinate
28
Anti-arrhythmic specific for ischemic myocardium
Ischemic = Depolarized --> Lidocaine
29
What has currently replaced lidocaine for ventricular tachycardia
Amiodarone
30
Procainamide is more specific for arrhythmias arising from
Centers of normal automaticity
31
Prolonged administration of Verapamil pts with V Tach can
Lead to V fib and death --> Distinguish between Supraventricular and Ventricular Tach
32
Adenosine is used for
Acute treatment of Paroxysmal Supraventricular Tachycardia
33
Gene in PAH
BMPR2
34
Hypophosphorylated Rb prevents
G1 --> S (Hypophosphorylated = Active)
35
Colloid Cyst
Benign formation in third ventricle --> Lethal obstruction
36
Reticulin deposits and chronic inflammatory infiltrates in brain tumor
Xanthoastrocytoma
37
Activated Protein C inhibits
Factors Va and VIIIa
38
Aside from gas gangrene, C perf can cause
Late-onset food poisoining --> Transient watery diarrhea
39
X linked recessive disorders
Bruton, Wiskott, Fabry, G6PD, Ocular Albinism, Lesch-Nyhan, DMD, Hunter Syndrome, Hemphophilia, OTC Def
40
Autosomal Dominant disorders
HHT, Fam Hyperchol, FAP, MEN, NF1/2, Marfans, Her Spher, Achondroplasia, Huntingtons, Li-Fraumeni, BRCA1/2, Polycystic, Tuberous Sclerosis, vHL
41
HIV gene that is glycosylated and cleaved
ENV --> Gp140 --> Gp120 and Gp41
42
How does blood from Bronchial Arteries return
Majority to left heart in deoxy form via pulmonary veins (admixture); Some to right heart via azygous, acessory hemiazygous, or intercostal veins
43
Afferent fibers from Carotid and Aortic baroreceptors terminate in
Solitary nucleus of medulla
44
Histology of Psoriasis
Hyperparakeratosis, Acanthosis, Elongation of Rete Ridges, Mitotic activity above epidermal basal layer, Reduced or absent stratum granulosum
45
Munro microabscesses
PMNs form spongiotic clusters in superficial dermis and parakeratotic stratum corneum in Psoriasis
46
Advantage of proline in collagen
Kink the polypeptide chain and enhance rigidity b/c of their ring configuration
47
What happens to procollage once secreted
Cleaved C and N terminals --> Solubility decreases --> Collage fibrils --> Lysil Oxidase crosslinking
48
Alkaptonuria is a defect in what pathway
Tyrosine to Fumarate
49
What causes nipple inversion with breast cancer
Invades central region
50
What causes skin retraction in breast cancer
Infiltration of Cooper ligaments
51
Alternative to SSRI when sexual side effects occur
Bupropion
52
Xanthoma vs Xanthelasma
Xanthoma is surrounded by inflammatory cells and fibrotic stroma, Xanthelasma not
53
Ergonavine MOA
Constricts SM by stimulating both alpha adrenergic and 5-HT receptors
54
Phentolamine MOA
a1 and a2 blocker
55
In what part of bone is hematogenous osteomyelitis most likely
Diaphysis
56
Hyper IgM syndrome results from
Absence of CD40L on t cells or Genetic deficiency in isotype switching enzyme
57
Hyper IgM manifestations
Recurrent sinopulmonary infections; Lymphoic hyperplasia
58
IgA class switching is induced by
TGF-beta
59
Specific marker of mast cell activation
Tryptase (released in degranulation)
60
Antimicrobials that block ENaChannels
Trimethoprim, Pentamadine
61
Why is serum Na normal in Mineralocorticoid Excess
Aldosterone Escape via ANP --> Prevents edema and Na increase
62
Contraction alkalosis
Reabsorption of HCO3-
63
Where does uric acid precipitate in tubules
Low pH of Distal Tubules and Collecting Ducts
64
Penicillinase-stable penicillins
Nafcillin, Oxacillin, Methicillin
65
Prognosis of Capillary Hemangioma
Initially progress, eventually regress
66
Histology in De Quervain's Thyroiditis
Mixed, cellular infiltrate with multinucleated giant cells
67
Opsoclonus-Myoclonus syndrome
Neuroblastoma
68
Why not use TCA with BPH?
Anti-Cholinergic --> retention
69
Why not use TCA with Orthostatic Hypotension?
Antagonizes alpha 1 peripherally
70
Causes of Hypercalciuria
Mainly Idiopathic; Also Hyperoxaluria, Hyperuricosuira, Low urinary volume, Hypocitratruria
71
Causes of Hyperoxalouria
Diet (chocolate, nuts, spinach; Low calcium diet (more oxalate absorbed)
72
Main radiographic finding in Mesothelioma
Nodular or smooth pleural thickening
73
Gold standard for Mesothelioma diagnosis
EM = Numerous long, slender microvilli with abundant tonofilaments (adenocarcinoma has short, plump microvilli)
74
Bronchioalveolar carcinoma has a characteristic
Distribution along alveolar septa w/out vascular or lymphatic spread
75
Gemcitabine vs Cytarabine
Both pyrimidine analogs, but Gemcitabine is not S phase specific, likely due to additional cytotoxic functions (eg inhibition of ribonucleotide reductase)
76
Methotrexate vs 5-FU
Both inhibit thymidalate formation, but only MTX overcome by Folinic Acid supplementation
77
Gottron papules and heliotrope rash
Dermatomyositis
78
Antidote for Cyanide (nitroprusside) toxicity
Sulfur (Sodium Thiosulfate) = Donates sulfur to liver rhodanase to enhance conversion of cyanide to thiocyanate
79
Microangiopathic hemolytic anemia
Small vessels = DIC, TTP, HUS
80
Triggers of G6PD
Bactrim, Dapsone, Antimalarials, Nitrofurantoin, Fava Beans
81
What is low in G6PD deficiency
NADPH
82
Cause of Lipofuscin
Free radical injury and lipid peroxidation
83
Most common location of supine aspiration
Right Lower Lobe
84
What underlies most cases of Hereditary Hypothalamic Diabetes Insipidus
Neurophysin II mutations
85
SPINK1
Trypsin inhibitor secreated by pancreatic acinar cells
86
Germ tubes when incubated at 37 degrees
Candida --> True Hyphae
87
Hep B replication
dsDNA --> Template +RNA --> dsDNA
88
Fate of tRNA that is mischarged
Will incorporate wrong AA into polypeptide chain (not corrected when charged by AA-tRNA synthetase proofreading)
89
MOA of mushroom toxins
Inhibit DNA-dependent RNA polymerase Type II = mRNA
90
RNA polymerase I vs II vs III
I = rRNA; II = mRNA; III = tRNA
91
MOA of Ricin
Cleaves rRNA component of 60S subunit
92
Resistance to Ethambutol
Increase production of Arabinosyl Transferase
93
Resistance to Streptomycin
Modification of 30S protein structure
94
Resistance to Pyrazinamide
Modify Pyrazinamidase, which must activate Pyrazinamide
95
MOA of Bosentan
Endothelin-receptor antagonist
96
Neutrophil Alk Phos
Elevated in Leukemoid reaction, Decr in CML
97
Acute Leukemia blast percentage
Greater than 20%
98
Eyelid manifestation of Primary Biliary Cirrhosis
Xanthelasma
99
Primary acceptor of amino groups during breakdown of other Amino Acids
Glutamate
100
Glycine + Methylene Group
Serine
101
What type of colonic adenoma can secrete mucus
Villous
102
Perfusion defect anatomically matched by ventilation defect
Collapsed lung
103
First test for PE
CT angiography
104
First line treatment for open angle glaucoma
Prostaglandins
105
Muscle responsible for accomodation? control?
Ciliary muscle - solely under cholinergic (m3) control

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