MIXED BLOCKS I Flashcards
Number need to harm
1/AR
In Paget Disease of the bone. The initial phase of the disorder is _____.
Increased osteoclast activity
A drug that reduces (inhibits) uterine relaxation and causes dilation of the eyes (mydriasis) will work on which receptor?
Alpha and Beta - adrenergic agonist
What is likely decreased in nephrotic syndrome causing symmetric pitting edema?
Plasma Oncotic Pressure
Skin tumors associated to Neurofibromatosis Type I (von Recklinghausen) disease is from. ____________
Neural Crest
What mechanism does Eosinophils use to kill Shistosomiasis when stimulated?
Anti-body - dependent cell-mediated cytotoxicity
What condition causes a gain of function mutation of a Non-Receptor Tyrosine kinase protein in hematopoietic cells leading to persistent activation of signal transducers and activator of transcription (stats) protein?
Primary myelofibrosis
What is the adult derivative of the metanephric mesoderm that give rise or drives differentiation into tissue forming the mature kidney?
Distal Convlated Tubile, also Loop of Heale, glomeruli Bowman space, proximal tubules.
A person with Kyphosocoliosis, pes cavus, and bilateral lower extremity ataxia is of an increased risk of dying from ___________
Cardiomyophathy
Clinical improvement of myasthenia gravis after infusion of endropinonium indicates. ____________
Undertreated myasthenic crises
Impairment of which protective mechanism contributes to Mycobaterium Tuberculosis infection?
Interferon Signal
Leg immobilization associated with a cast that causes shrinkage of the leg (makes is smaller) is also seen in…
Adrenal Gland during prolonged Glucocorticoid therapy
Which medication is used to treat major depressive disorder and smoking cessation?
Bupropion
Which nerve is damaged in an anteromedial displacement of the supracondylar humeral fracture?
Median Nerve
Lymph from upper part of rectum drains to the ______
Inferior mesenteric nodes.
Dilation of eyes (drug)
Alpha adrenergic agnosit
Plasma normetanephrine and metanephrine levels excessive greater than normal is caused by……
Chromaffin cells of the adrenal medulla.
What is Relative Risk?
(a/a+b) / (c/c+d)
Which patients are easily infected with vibrio cholera (oxidase +, gram-negative bacilli that grow on selective alkaline media)?
Chronic Omeprazole users
What is positive predictive value?
a/a+b
What protein processing accounts for a single gene that codes for various unique proteins by selectively including or excluding different DNA coding regions (Exons) into mature MRNA?
Alternative Spicing
how do we prevent infection of meningococcal pilus antigen?
By preventing adherence to nasopharynx epithelial cells.
What are two types of pneumococcal vaccines designed against strep pneumonia, meningitis
Conjugate vaccines and Polysaccharide vaccine
What is specificity?
d/d+b
Gastric varices are commonly due to portal hypertension which is a complication of cirrhosis. Gastric varices can also be caused by ______
Splenic Vein Thrombosis
An autopsy in a patient that had a seizure and fever showed bilateral hemorrahagic necrosis of the inferior and medial temporal lobes. The condition is mostly caused by ________.
Herpes Simplex Virus (HSV encephalitic).
What enzyme is responsible for the color of greenish sputum (Community Acquired Strep Pneumonia)?
Myeloperoxidase
Punch out lesions with overlying thin membrane on the scalp. A small membranous sac with loop of bowl from the abdomen midline. What is responsible for this condition?
Patau Syndrome
What is the antidote for Serotonin Syndrome -(neuromuscular dysfunction) autonomic instability (rapid and large changes in blood pressure and heart rate)?
Cyproheptadine
Phase II
glucuronidation methylation, acetylation.
Entercoccus use beta-lactamase or low affinity penicillin-binding protein. This helps with resistance agonist ______________
Penicillin
A patient with COPD that received a high oxygen concentration can lead to increased CO2 retention (oxygen induced hyperapnia) leading to lethargy and confusion. This clinical decline is attributed to
Dead Space Ventilation
What is the formula for relative risk?
(a/a+b) / (c/c+d)
What is negative predictive value?
d/d+c
Pulsatile vessels within the intercostal space and diminished femoral pulses relative to the brachial pulses are suggestive of ______________
Tuner Syndrome (45, xo) associated with coarctation of aorta
What nerve lies in close proximity to the inferior thyroid artery?
Recurrent Laryngeal Nerve
What is the function or what does nitroglycerin do to improve cardiac symptoms (hemodynamic changes)?
Decreases the left ventricular end-diastolic volume
Inhibition of uterine contraction
Beta adrenergic agonist
Terbutaline, Indomethacin, Nifedipine, magnesium sulfate
What is the mechanism of action of the exotoxin (Diphtheria toxin)?
Intracellular Protein Ribosyliation
What is the virulence factor for E-coli that causes pneumonia and neonatal meningitis?
Capsule
An anesthetic injection between the right anterior and middle scalene muscle will paralyze which other muscle?
Diaphragm
What is the next best step in treating Myasthenia Gravis?
Increase Pyridostigmine dose
Mean Arterial Pressure
Cardiac output - Total Peripheral Resistance
Trimethoprim (bacteria), Methotrexate (human cell) , pyrimethamine protozoa.) - all prevent reduction of _____
Folic Acid to tetrahydrofolate
What does KRAS have to bind to for it to be active?
GTP
What diagnostic test result is most specific for acute cholecytitis
Failed gallbladder visualization on radionuclide biliary scan
Patients on Lamotrigine should be advised to see a physician immediately when they develop a…….
Skin Rash
Increased vagal tone, causing slowing of conduction through the AV, inhibition of Na-K-ATPase causing intracellular Na+ and Ca2+ increases cardiac contractility is associated with _________________
Digoxin
Gram-positive cocci that synthesize dextrans from sucrase is associated with (strep viridans)….
Dental Caries
A smoker whose biopsy shows bronchial mucosa that microscopically reveals areas of stratified squamous epithelium is similar to _________________
Barrett Esophagus
Uncontrolled hypertension and Diabetes Mellitus are the major risk factors involved in infaction of small vessels penetrating and supplying deep brain structures. These occlusions are due to….
Lipohyalinosis with small vessel occlusion and microatheroma.
Ejection Fraction
EDV - ESV
________
EDV
What enzyme is deficient in Pompe disease? (present in infancy, with marked cardiomegaly, severe generalized hypotonia, macroglossia, and hepamegaly)
Alpha-1,4 Glucosidase
Which organism is responsible for recurrent transient pulmonary infiltrate in a patient with bronchial asthma. (Cystic Fibrosis).
Aspergillus fumigatus
Decrease serum complement of C1 is a sign of angioedema. What medication is contraindicated in it?
(Ace Inhibitors) - Captopril
Ace-inhibitors can cause angio edema
Long term use of which .medication is suppose to reduce motality in Congestive Heart Failure (CHF)?
Lisinopril
Which structure is most likely to be injured during hysterectomy due to its close proximity to the uterine structures?
Ureters
Grayish discoloration of the macula with areas of adjacent hemorrahage. No history of diabetes mellitus or hypertention (age-related macula degeneration - AMD) treatment should target what?
Vascular Endothelial Growth Factor
What cellular function is protein-ribonucleic acid complex in SLE?
Removal of introns from RNA transcripts
A person with lower knee pain is given celecoxib therapy. What condition makes this drug a good choice?
Peptic Ulcer Disease
Demyelination of peripheral nerves in response to administration of myeline-like substance. Production of T-cell response is _____
Guillain-Barre Syndrome
What is the lymphatic drainage of the orifice of the anal canal?
Superficial Inguinal Lymph Nodes
A DNA-dependent RNA polymerase that incorporates short RNA primers into replicating DNA is
Primase
What is the best lab test to be done during diagnostic testing for hypothyroidism?
Serum TSH Levels
Fully developed secondary sexual characteristics, shortened vaginal canal with a rudimentary uterus, is known as…..
Mullerian Aplasia
Which response is most likely to be illicited with administration of milrinone phosphodiesterase - 3 inhibitor {amrinone}?
Vasodilation
Diffuse skin erythema, with an epidermis that comes off with a gentle touch is caused by…
Exotoxin mediated skin damage
A person that undergoes uncomplicated subtotal pancreatectomy, what test will be normal in this person?
Intestinal D-xylose absorption
What neurotransmitter is deficient in a child (boy) that is unable to roll from front to back or back to front with impaired tetrahydrobiopterin synthesis?
Serotonin
What medication is useful in treating GAD - Generalized Anxiety Disorder?
Citalopram (SSRI)
Enterococcus that produce an enzyme that is involved in acetyl group transfer to exogenous substances and located on the surface of the cytoplasmic membrane will be resistant to which antibiotics?
Gentamicin (aminoglysocide)
An elevation of arginine levels in plasma and cerebrospinal fluid. Deficient enzyme is also involved in production of______________
Urea
What does treatment with baronic acid-containing dipeptide with high affinity for proteasome catalytic site result in; when a patient has low back pain that worsens with lying flat and has hypercalcemia (multiple myeloma).
Cell Appototis
Neurotransmitter antagonized when a patient takes a medication that causes tilting of the head to one side
Dopaminergic D2
Verrucous, skin-colored lesions, over the labia majora is consistent with HPV (human papillomavirus.. Which can cause genital warts. When giving birth, the virus has affinity to infect what?
True Vocal Cords
Stool microscopy of patients with vibro cholera will show_______________
Mucus and some sloughed epithelial cells
The absence of myocardial necrosis and scarring despite vessel occlusion is a result of (arterial collaterals)……
Slow growth rate
In femoral neck fracture, which artery when damaged, will cause osteronecrosis?
Medial Femoral Circumflex artery
A new holosystolic murmur with a blowing quality that is best heard over the apex of the cardiac and has non tender lesions on the sole of the foot. The lesion most likely represents…..
Microemboli to skin vessel.
Whatl large-amplitude, fingering movement affecting the proximal muscles of the right arm are caused by…
Subthalamic Nucleus
What is the cause of chest pain in an SLE patient?
Pericardial inflammation
Which drug works within the cytoplasm of infected cells to inhibit synthesis of viral DNA and RNA template?
Nivarapine
If HBeAG persists for several months and host anti-HBeAg remains at low or undetectable levels what has occured?
Had acute Hepatitis B that has progressed to chronic with high infectivity.
Drug adminstration 3–mg dose exhibits intravenous concentration of 30mg/ml. What is Vd?
Vd = cp x Vd
______
F
Loading dose
cp x vd
______
f
What nerve lies in close proximity to the inferior thyroid artery?
Recurrent Laryngeal Nerve
Which nerve supplies the anterior compartment of the leg?
Deep Peroneal Nerve
Neurological symptoms of decreased sensation over both feet and bilateral absence of ankle reflexes are associated as
Endoneural arteriole dyolinization
Which cells are most likely to play a roll in the pathenogenesis of COPD? (slowly progressive dyspnea on exertion and cough productive of yellow-white sputum). Lung examination demonstrates miled bilateral expiatory wheezes.
Neutrophils
What enzymes degrade and attach viral proteins to major histocompability 1 molecules
Ubiquintin ligase
Enlarged lateral and third ventricle with a normal fourth ventricle, where will be the mass/obstruction?
Cerebral Aqueduct
Stoke Volume
Cardiac output / stroke volume
Alcohol withdrawal is associated with tremulousness_______.
Tremulousness
Phase I
reduction, oxidation, hydration
Budding yeast that form germ tubes at 37* is specific for Candida Albicans and before they enter the sputum they are found in the ____________
Oral Cavity
Which nerve is most likely injured in a total thyroidectomy?
Superior Laryngeal Nerve
What medication has the same intracellular targets as Trimethoprim (bacteria)?
Methotrexate (human cells)
Renal metabolism of which amino acid helps maximize acid excretion
Glutamate
A patient experiencing manic episodes with psychotic features and most likely received multiple doses of anti-psychotic medications to control his agitation suffers from hyperthermia, muscle rigidity, and confusion are characteristics of _____________________
Neuroleptic Malignant Syndroms
what is defective in xeroderma pigmentosum sunburn easily, thin, hyperpigmentation ?
Nucleotide excision repair
Inhibitor of which substance specifically reduce proliferation and differertiation of T-lymphocytes
Calcinuerine
What will a biopsy show in urticaria (hives) of a person that reacts to penicillin?
Dermal Edema (igE mediated hypersensitivity)
A cell that is identified as both CD4 and CD8 is characterized as….
Immature T Lymphocyte
What is the cause in mycobacterium leprae that causes large indurated nodules (tuberculosis).
Increased Interleukin -2 and Interferon-Y in skin lesions
What is a person who has an undetectable level of alpha-galactosidase (Fabry) at risk of developing?
Renal Failure
An injury to this nerve (superior laryngeal nerve), which muscle is affected?
Cricothyroid muscle
In amniocentesis, the phospholipid content in the amniotic fluid is used to…..
Fetal Lung Capacity
Which cytokine is responsible for a reduction in inflammation?
IL-10
What is sensitivity?
a
____
a+c
What is the mechanism of action of a drug given to prevent seizure recurrence after the administration of Lorazepam?
Phenyton - decrease Na+ current in cortical neurons
What is the mechanism of action of Dobutamine infusion which shows infusion which shows mild improvement M cardiac contractility?
Gs protein-adenylate cyclase activation
What medication is used in treating Shistosomiasis?
Praziquantel
Numbers need to treat
1/ARR
What mechanism explains rapid recovery from highly Lipophilic drug (Propofol)?
Tissue redistribution of the drug
Which antifungal medication used is based on the presence or amount of Ergosterol?
Nystatin
What is the pathological process responsible for giant cell arteritis?
1) Granulomatous inflammation of media
2) Elastic lamina traymentation.
3) Giant cell formation
Attributable risk reduction
A/a+b - (a/a+b)-(c/c+d)
How will PSGN present as impetigo skin infection? (Poststreptococcal Glomerulonephritis,)
Facial edema (puffiness), Dark urine (cola-colored), hypertension, urinary red blood cell cast.
In a dorsiflexed,everted foot and unable to tiptoe, sensory loss is most likely to be found at what nerve.
Planter Foot; Tibial Nerve
What interleukins is associated with Lepromatous (Lepromatous form of leprosy which causes lion features)
TH2 cytokines (IL-4, IL-5 and IL-10)
Why is the drug good in someone with a peptic ulcer disease and knee pain?
Celecoxib therapy - selective cychoxygenase 2 (Cox2) inhibitor and relieves pain with lower risk of bleeding and gastric ulceration than NSAIDS
What is the best way to determine if a gene is being expressed?
Northern Blot
Destruction of which layer of the gastric layer will present atrophy of the gastric body and fundus with normal appearing antrum
Upper Glandular layer
Volume of distribution
CP x C x T
________
F
What nerve is damaged in an anterolateral displacement of a supracondylor humeral fracture
Radial Nerve
An HIV patient whose cerebrospinal fluid culture grows mycobacterium tuberculosis, presents with headache and fever, is consistent with tuberculous meningitis and this isolate is most resistant to…..
Isoniazid
An acute viral or bacterial infection of the parotid glands is parotitis. Can be due to staphylococcus aureus. Risk factors include dehydration, intubation, and salivary flow obstruction. The serum marker used here is ______
Amylase
What is adds ratio?
ad/bc
A person presents with Giardia Lamblia Gastroentritis, failure to thrive and low immunoglobulin levels. What will a flow cytometry show a deficiency in?
CD 19+ and CD 20+
What will the changes by when you selectively contrict efferent arteriole in renal glomeruli?
increased GFR; increased FF
With Intramuscular inactivated vaccine and live attenuated oral vaccine, the level of polio vaccine antibody will differ ______________
Duodenal luminal igA
Beers criteria was developed to identify drugs requiring caution in geriatric patients. What are some of the medications?
Antihistamine (Diphenhydramine): ^ confusion, hallucinations, dry mouth, constipation
Benzodiazepines (other sedating medication): (Ativan)
Antipsychotics;
Antiarrhythmics;
Centrally acting drugs: (ex: Clonidine, Methyldopa, Moxonidine)
Pancreatitis is a major risk factor for acute respiratory distress syndrome. Which of the following will you find on an autopsy of ARDS?
Alveolar Hyalinemembrane
What is absolute risk?
(c/c+d) - A/a+b
what drug withdrawal presents with increased appetite, hypersomnia, intense psychomotor retardation, severe depression, lethargic.
Cocaine withdrawal
What makes up the vaccine for streptococcus pneumonia?
outer polysaccharide covering
Normal rotation but constriction of the duodenum by pancreatic tissue encircling the duodenum is likely caused by (annular pancreas)?
Abnormal migration of ventral pancreatic bud
Where does lymph from testes drain?
Abdominal Aorta
Isoniazid that increases urinary excretion and causes ataxia and decreased pain sensation is the cause of a deficnecy in…..
Vitamin C
Difficulty walking, past history of frequent respiratory infections with high rate of radiation-induces genetic mutation is suggestive of ataxia telangiectasia. A patient is most likely to experience ______________
Cerbral Atrophy
How does mycobaterium tuberculosis show resistance to many antimycobacterial agents?
Altered structure of enzymes involved in bacterial RNA synthesis
A sterile platelet-rich thromi attached to a mitral valve leaflet is characteristic of nonbacterial thrombotic endocarditis (NBTE) - marantic endocarditis its commonly associated to..
Advanced Malignancy
In which organ does glucagon metabolism to release glucose in its place?
Liver
Which medication can raise serum THeophyllme levels leading to toxicity (i.e. cardiac arrhythmias, seizures)?
Ciprofloxacin: Verapamil; Macrolides, Cimetidine
What is the mechanism of action of Ribavirin
Interfering with duplication of viral genetic material
Which medication is contraindicated with administration of Lithium that leads to ataxia, tremors, agitation confusion in hypertensive patients?
1) Thiazide Diuretics
2) Ace Inhibitors
What organism causes cold agglutinin that causes agglutination or clumping of red blood containing agglutins when chilled?
Mycoplasma pneumonia
What labs should be checked in patients taking Olanzapine?
Fasting Glucose and Lipid panel
What cognitive test will be used to assess for impaired attention and concentration?
Counting down from 100 to 1 in intervals of 3 or 7; reciting months of the year backwards
What medication is used to treat Myasltenia Gravis?
long-acting acetylcholine terase (pyridostigmine).
increased bone pain, increased alkaline phosphotase in a elderly patient is suggestive of
Paget Disease of the bone
Upper respiratory infection and ankle edema on physical exam with a decrease serum albumin suggest
nephrotic syndrome
What is the virulence factor in E coli that causes cystitis and pyelonephritis also septic shock
Fimbriae– cystitis and pyelonephritis
LPS endotoxin— Septic Shock
