Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

LopsNotes > Mixed Q’s 4 > Flashcards

Mixed Q’s 4 Flashcards

1
Q

Features of urolithiasis due to hyperparathyroidism?

A

Abdo pain
Vomiting
Haematuria
Hypercalcaemia
Hypophosphataemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for urothelial cancer of the bladder?

A

Age >60
Cigarette smoking
Occupational exposure to :- rubber plastic
Cyclophosphamide therapy

Painless Haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Vesicoureteral reflux features?

A

Retrograde urine flow from the bladder to the ureter
Hx of repeated infection
Increased risk of chronic pyelonephritis
U/S renal scarring —> dilated calyces with overlying cortical atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Adverse renal affect of penicillamine?

A

Membranous nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Glomerulonephritis 2o small vessel vasculitis features

A

Bld levels acute kidney injury
Proteinuria
HTN
Red cell cast
Exogenous immune complex deposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

1o thrombotic microangiopathy syndrome features?

A

Microangiopathic haemolytic Anaemia (MAHA) ( schistocytes on bld smear )
Thrombocytopenia
Organ damage
Neuro symptoms
Renal failure
Fever
N PT and PTT
Prolonged bleeding time
Histology:- plt rich thrombi in glomeruli and arterioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risk factors for kidney stones?

A

Increase urinary calcium
Increase urinary oxalate
Increase urinary uric acid
Decrease urinary citrate
Decrease fluid intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Prerenal acute kidney injury features?

A

Due to renal hypoperfusioin
Characteristics findings are:-
High urea
Nitrogen/creatinine ration >20:1
Low urine Na <20mEq/L
Low fractional excretion of Na <1%
High urine osmolality + specific gravity
Unremarkable urinanalysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Homogenous deposition of eosinophilic hyaline material in the intima and media of arteries is due to ?

A

Poorly controlled DM or HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CKD renal osteodystrophy features?

A

High PO4
Low 1,25 Vitmain D
Low Ca
2o hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Multiple myeloma features?

A

Hypercalcaemia
Normocytic Anaemia
Elevated gamma gap
Renal failure 2o light chain cast nephropathy ( large waxy eosinophilic casts composed of Bence Jones proteins in tubular lumen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Post streptococcal glomerulonephritis features?

A

Commonest cause of nephritic syndrome in children
Light microscopy: - enlarged hypercellular glomeruli
Lab results:- low C3 low total complement levels
Normal C4
High antistreptoccal antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Earliest sign of diabetic nephropathy?

A

Albuminuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Urine sediment in kidney stone shows ?

A

Free red blood cells (Haematuria)
Red cell casts are seen in glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Renal amyloidosis features?

A

Proteinuria and nephrotic syndrome
Biopsy:- apple green bifiringence with Congo red stain
Serum protein electrophoresis showing a monoclonal protein —>Ig light chain AL amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Contrast induced nephropathy features?

A

acute tubular necrosis —> diffuse necrosis of the proximal tubular cells
Acute inc in Creatinine and BUN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Henoch-Schonlein purpura features?

A

Lower limb palpable purpura
Abdominal pain +/- GI bleeding
Renal disease ( Haematuria )
Joint pain
IgA mediated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

1o hyperparathyroidism bone osteoporosis involves?

A

Subperiosteal absorption with cortical thinning
Affecting the appendicular skeleton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mobitz type I block after NSTEMI suggests blockage of which artery?

A

RCA —> supplies AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Oestrogen therapy + pregnancy affect on thyroid levels?

A

Increase in THG
Increase in total T4 and T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pt with diarrhoea weight loss and +ve tissue transglutaminase diagnosis?

A

Coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lab findings in Coeliac disease?

A

Low 25 hydroxyvitmain D
Low PO4
Low Ca leading to
High PTH
High ALP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Dopamine effect on renal and cardiac blood flow?

A

At low doses stimulates D1 reception causing vasodilation and increase renal and cardiac bld flow.

At higher dosages stimulates B1 and alpha 1 resulting in increased C.O and vasoconstriction ultimately leading to decreased C.O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Adenomysosis features?

A

Regular, heavy painful period
Gross pathology:- uniformly enlarged globular uterus with abnormal presence of endometrial glands and stroma in myometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is a case-control study?

A

Pts with the outcome ( case) compared to pts without the outcome ( control) according to history of exposure to >= 1 factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Large pituitary adenoma characteristics?

A

Commonest cause is prolactinoma
Headaches
Bitemporal hemianopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hemithorax volume and inspiratory lung compliance in pneumothorax?

A

Lung compliance decreases
Chest wall springs outward —-> hemithorax volume increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Best test to assess for impaired attention and concentration?

A

Counting down from 100 by intervals of 3 or 7
Reciting the months of the year backwards
Spelling world backwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

TB meningitis pathology findings by?

A

Thick gelatinous exudate at the base of the brain, cerebral vasculitis and hydrocephalus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

TB meningitis presentation

A

Subacute slowly progressively nausea
Vomiting
Fever
Cranial nerve deficits
Strokes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Sensitisation to allergens occur when?

A

Inhaled antigens induce Th cells to differentiate to TH2 —> promotes B cell maturation to switch to IgE

(T lymphocyte induction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

1o adrenal insufficiency features?

A

Occurs in pts with pre-existing autoimmune disease
Hypotension, hypovolumemia
Hypoglycaemia
Normocytic Anaemia
Eosinophilia
I
Low cortisol, low aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

1o adrenal insufficiency lab results renal?

A

Increase K
Low Na
Increase urine Na
Decrease urine K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Adhesion of cells to extracellular matrix involves which integrin?

A

Fibronectin
Collagen
Lamin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Francisella Tularensis (G-ve coco bacillus) mode of transmission

A

Contact with Wild animal
(Ulceroglandular disease, painful regional lymphadenopathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Commonest pathogens in sickle cell patients?

A

Strep pneumoniae
Neisseria meningitidis
H influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

CF genetic defect?

A

3 base pair deletion of phenylalanine (position 508) leading to abnormal post translational processing of transmembrane protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Midgut malrotation can cause ischaemia to structures supplied by which vessel?

A

Superior mesenteric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which protein is most involved in the transport process reactivating cold sores?

A

Kinesin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Normal Na level

A

Think 140
135-145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Normal urine osmolality?

A

300
Think a lot of stuff in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Pale yellow fluid leaking from umbilical stump cause?

A

Persistence of allantois remnant / patent urachus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Cause of fetal unilateral hydronephrosis

A

Ureteropelvic junction obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Sevelamer what is it and mechanism of action?

A

Used in CKD to reduce levels of phosphorus
Works by binding to intestinal phosphate and reducing absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Cause of stress incontinence?

A

Urethras sphincter dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Henoch-Schonlein purpura renal involvement is caused by?

A

IgA Immune complex deposition in glomerular mesangium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Normal WBC level

A

4 -12 K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Hgb normal level?

A

11-15
X3 = HCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Platlet normal level

A

15-400k

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

N eosinophil level?

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

N eosinophil level?

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Normal TIBC level?

A

350-400

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Pre-renal acute kidney injury labs ?

A

BUN/creatinine ratio >20:1
High urine osmolarity
Low factional excretion of Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Minimal change disease secondary changed?

A

Increase liver lipoprotein synthesis
Increase aldosterone + ADH
Increase liver albumin synthesis ( minimal compensation)
Increase Na and H2O retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Spironolactone effect?

A

Decrease excretion of Na and H2O
Decrease secretion of H and K in collecting tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Obstruction of IVC by RCC sign?

A

Bilateral pitting oedema
Tortuous vertical collateral abdominal veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Paraneoplastic syndromes assoc with RCC?

A

Erythrocytes is
Hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Urine pH in struvite stones?

A

High ph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Normal ADH nephron osmolarity?

A

PCT is isotonic with plasma
Decending loop of Henle is hypertonic >300
DCT most dilute 100 (impermeable to H2O)
Collecting tubules hypertonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Vesicoureteral reflux characteristics?

A

Short intravesical ureter length ( can resolve spontaneously)
Retrograde urine flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Salicylate poisoning features?

A

Tinnitus
Hyperventilation ( causing 1o resp alkalosis with 1o anion gap metabolic acidosis)
N+V
Hyperthermia
Increase lactic acid
Altered mental status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

GFR creatinine relationship ?

A

Need large decrease in GFR for a small decrease in creatinine
After significant GFR decrease then a small further decrease leads to a larger increase in creatinine

Everytime GFR halves, creatinine doubles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Pt with high renin and aldosterone causes?

A

Renal artery stenosis
Malignant HTN
Renin secreting tumour ( JGG cell tumour)
Diuretic use ( thiazides)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Early cellular changes in acute tubular necrosis?

A

Loss of epithelial cell polarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Intracellular causes of hypokalaemia?

A

Insulin
B2 activity e.g. albuterol, dobutamine
Stress induced e.g alcohol withdrawal, MI
Alkalosis
Increase cell reproduction e.g AML

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Lab findings in SIADH?

A

Hyponatraemia
Low serum osmolality
High urine osmolality
High urine Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Causes of SIADH?

A

CNS disturbance ( stroke, haemorrhage, trauma)
Medications (carbamazepine, SSRIs, NSAIDS)
Lung disease (pneumonia)
Malignancy (SCLC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Changes in hepatocytes after administration of insulin?

A

Autophophorylation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Epiglottis presentation?

A

Fever
Dysphagia
Drooling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Serum insulin level after administration of epinephrine?

A

Increase glucose
Low insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Group B Strep virulence factor?

A

Polysaccharide capsule contains Salic acid that prevents phagocytosis via molecular mimicry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Acute physiologic response to high altitude?

A
  1. Pulmonary vasoconstriction —> increased pulmonary vascular resistance
  2. Increase minute ventilation —> net increase PaO2 and Dec PaCO2
  3. Increase SNS —> net:- increase C.O
  4. Reduced aldosterone activity —> increase HCO3 excretion—> net:- diuresis and decreased plasma volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Diabetes symptoms are due to which cellular process?

A

Gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Round mass filling previous TB cavity?

A

Aspergilloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Bld results in pt with craniopharyngioma ?

A

(Tumour arising from pituitary gland embryonic tissue
Childhood
Pressure on on pituitary stalk)

Low glucose
Low ACTH
Normal Na / K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

How does PEEP help in ARDS?

A

Increase FRC
Reduce intrapulmonary shunting
Decrease V/Q mismatch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Familial hypcalcuiric Hypercalcaemia receptor mutation?

A

Mutation in the Calcium sensing receptors (CaSRs) membrane bound receptor coupled with a G protein that regulate PTH secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What are the DNA binding proteins ?

A

Transcription factors (Myc, CREB)
Steroid receptors ( cortisol, aldosterone, progesterone)
Thyroid hormone receptor
Fat soluble vitamin receptors (vitamin D, retinoic acid)
DNA transcription and replication proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

KRAS is active when bound to ?

A

GTP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Which cellular function occurs in the rough Endoplasmic reticulum ?

A

Synthesis of cell membrane protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Elevated CK
Weakness
Cardiomyopathy
Absence of ketones in urine
Hypoglycaemia
Diagnosis?

A

1o carnitine deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Hereditary fructose intolerance enzyme and precipitant?

A

Aldolase B deficiency
Consumption of fructose or sucrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is the most abundant amino acid in collagen

A

Glycine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Mitochondrial DNA features?

A

Exists as small circular chromosomes
Most common non nuclear DNA found in eukarotytic cells that resemble prokaryotic cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Which ion is most likely to flow out of the cell when its ion channel opens?

A

K+ only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Protein kinase is activated by ?

A

Broken down diacylglycerol (DAG )
And Ca+ released by IP3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Central DI is caused by deficiency in which hormone?

A

Vasopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Increase in oxygenation following pneumonia despite no change in CXR is due to?

A

Restored hypoxia pulmonary vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Definitive test for acromegaly ?

A

OGTT with GH measurements ( pts with acromegaly minimal suppression >75 after drinking glucose solution- N should drop)

90
Q

Anaplastic thryroid cancer biopsy findings?

A

Undifferentiated cells

91
Q

Medullary thyroid cancer bld findings?

A

High calcitonin
Normal TFT

92
Q

Bld results in androgen abuse?

A

Low GnRh
Low LH/FSH
High oestrogen
Reduced testosterone secretion
Impaired spermatogenesis

93
Q

Which intracellular pathway is stimulated by use of growth hormone?

A

JaK-STAT pathway

94
Q

Niemann- Pick presentation?

A

Deficiency of sphingomyleinase
Accumulation of sphyinogmyeloin
Neurologic regression (demyelination)
Hepatosplenomegaly
Retinal opacification ( cherry-red macula)
Lipid laden (foam) macrophages on histology

95
Q

How do testicular germ cell tumours cause gynaecomastia?

A

Secretion of hCG leading to impaired production of testosterone in Leydig cells.
Increased Leydig cell aromatase converting androgen to oestrogen

96
Q

Niemann- Pick deficiency?

A

Sphingomyelinase deficiency
Accumulation of sphingomyelin

97
Q

Effect of fructose 2,6 bisphosphate ?

A

Increase glycolysis
Decrease gluconeogenesis
Decrease conversion of alanine to glucose

98
Q

Protein defect and lipoprotein levels in familial dyslipidaemia?

A

Protein defect:- ApoE3 and ApoE4
Elevated chylomicrons and VLDL —> elevated cholesterol and TG

99
Q

Familial dysbetalipoproteinaemia presentation?

A

AR
Eruptive palmar xanthomas
Premature atherosclerosis

100
Q

The initial step of steroidogenesis occurs in the mitochondria the remaining steps occur in ?

A

The smooth endoplasmic reticulum

101
Q

Sorbitol accumulation accelerates presentation of ?

A

Cataract

102
Q

Polyol pathway steps?

A

Glucose —-aldose reductase —-> sorbitol—-sorbitol dehydrogenase —-> fructose

103
Q

Effects of unilateral orchid Tony?

A

Decreased sperm count
N erection
N libido
N 2o sexual characteristics

104
Q

Sarcoidosis Ca/vit D complication?

A

Activated macrophages in sarcoidosis express 1 alpha hydroxylase—-> excess production of 1,25 dihydroxy vitamin D and Hypercalcaemia

105
Q

Stress Hypoglycaemia features?

A

Transiently elevated bld glucose level in context of severe illness in pts with no hx of DM
Cortisol and catecholamines increase hepatic glycogenolysis and gluconeogenesis

106
Q

What is a precursor of niacin ?

A

Tryptophan

107
Q

Lead toxicity affect on haem synthesis?

A

Inhibit ferrochelatase and gamma aminolevulinic acid ALA dehydrates

108
Q

Brown pigment stones features?

A

Arise 2o to E.Coli or helminthic infections
B glucuronidase is released from injured hepatocytes and hydrolyses bilirubin to unconjugated bilirubin

109
Q

Activation of phospholipase C leads to ?

A

Formation of IP3 —> activations of protein kinase C and increase in intracellular Ca

110
Q

HGPRT deficiency leads to an increase in which enzyme?

A

PRPP aminotransferase
By increasing de novo purine synthesis

111
Q

Which vitamin is involved as a cofactor in amino acid transamination and decarboxylation?

A

B6 pyridoxine

112
Q

What is Inclusion cell disease ?

A

AR
Lysosomal storage disorder
Failure to thrive
Resp tract infections
Cognitive deficits in early life
Coarse faceless
Corneal clouding
Hepatosplenomegaly
Restricted joint movements

113
Q

Impaired tetrahydrobiopterin (BH4) synthesis causes deficiency in ?

A

Phenylalanine
BH4 is a cofactor

114
Q

Fatty acid beta oxidation is inhibited by ?

A

Malonyl-CoA inhibits CAT-1 rate limiting enzyme

115
Q

Organophosphate poisoning features?

A

Organophosphates widely used as pesticides
Irreversible cholinesterase (breakdown) inhibitor
Symptoms:- salivation, lacrimation
Diaphoresis
Bradycardia
Bronchospasm

116
Q

Mature erythrocytes lose their ability to synthesize haem because they lose which organelle?

A

Mitochondria

117
Q

Amatoxins in poisonous mushroom inhibit ?

A

RNA polymerase II —-> messenger RNA

( RNA I —> Ribosomal RNA)
(RNA III—-> Transfer RNA)

118
Q

Which collagen synthesis step is impaired in Ehlers Danlos?

A

SSLevage
Cleavage of N terminal peptides

119
Q

How does CO poisoning impairs HgB function ?

A

Competitive binding to haem with greater affinity than O2

120
Q

Niacin is an important cofactor for what enzymes ?

A

Dehydrogenases and reductases

121
Q

Glycerol /

A

Produced by degradation of TG in adipose tissue
Used by glycerol kinase in the liver and kidney to synthesise glucose during gluconeogenesis

122
Q

Classic galactosaemia features?

A

Deficiency of galactose-1-phosphate uridyl transferase
Clinical features

Cataracts
Liver enlargement
Autosomal Recessive
Sepsis (E.Coli)
Start of feeding
Intellectual disability
Colour (jaundice

123
Q

Lynch syndrome features?

A

Hereditary non polyposis colon cancer
AD
Abnormal nucleotide mismatch repair

124
Q

porphyria cutanea tarda enzyme deficiency?

A

Uropophyriongen decarboxylase

125
Q

Glycolysis rate limiting enzyme, cofactors, end product /

A

Glucose —
Phophofructokinase 1
Inhibited by citrate and ATP
Stimulated by AMP, fructose 2, 6 bisphophonate
Pyruvate

126
Q

Gluconeogenesis points?

A

Pyruvate
Fructose 1,6 bisphosphotase
Inhibited by AMp, fructose 2,6 bisphosphate
Stimulated citrate
Glucose

Require GTP, Biotin
Pathway stimulated by acetyl CoA

127
Q

Glycolysis points?

A

Glycolygen
Glycolygen phosphorylase
+ glucagon, epinephrine, cAMP
Glucose -1- phosphate

128
Q

Glycogenolysis points?

A

Glucose -1-phosphate
Glycogenolysis synthase
+ insulin
Glycogen

129
Q

HMP shunt points?

A

Glucose -6- phosphate
G6P dehydrogenase
Ribose 5 phosphate

NADH produced

130
Q

Fructose metabolism?

A

Fructose — fructokinase —> fructose -1-phosphate
—-> aldolase B —-> glyaceraldehyde + DHAP
Glyceraldehyde- 3- phosphate

131
Q

Pyruvate metabolism points ?

A

Pyruvate
Pyruvate dehydrogenase
Co-factors B1, B2, B3 , B5, lipoic acid
Acetyl-CoA
Mitochondria

132
Q

TCA cycle points ?

A

Isocitrate dehydrogenase
+ADP
-ve ATP, NADH, FADH

NIKO
F

133
Q

Urea cycle points ?

A

NH3 + CO2
Carbonyl Po4 synthetase II
+Nacetylglutamate
Urea

134
Q

Fatty acid synthesis points ?

A

Citrate
Acetyl CoA carboxylase
+ insulin
+citrate
-ve glucagon, palmitoyl CoA
Palmitate

135
Q

Fatty acid oxidation points?

A

Fatty acid
Carnitine acyltransferase I (CAT-1)
-ve malonyl-CoA
Acetyl CoA

136
Q

Ketogenesis points?

A

2 Acetyl CoA
HMG CoA synthase
Acetone + B hydroxybutarate

137
Q

Cholesterol synthesis points?

A

HMG CoA reductase
+insulin, thyroxine, oestrogen
-ve glucagon , cholesterol

138
Q

Acute cervicitis features?

A

Causes:- chalmydia, gonorrohea, foreign object, douching
Risk factors:- <25
Symptoms mucopurulent discharge and friable cx
Complications :- PID, infertility, ectopic pregnancy

139
Q

Complications of PCOS?

A

Endometrial hyperplasia and carcinoma

140
Q

Cycle variability with intermenustral spotting, heavy bleeding at start of menarche is due to?

A

Low and irregular GnRH pulses

141
Q

Monozygotic twins vs dizygotic twins /

A

Dizygotic= different sexes usually dichorionic/diamniotic
Monozygotic =same sex

142
Q

Incomplete fusion of the urethral(urogenital folds) results in ?

A

Hypospadias

143
Q

Failure of fusion of the genital tubercle?

A

Epispadias

144
Q

Maternal rubella infection features?

A

Maculopapular rash with head to toe progression
Joint pain
Postauricular lymphadenopathy
Fetus signs;- sensorineural deafness
Cataracts
PDA
Growth restriction ( microcephaly)

145
Q

Most common cause of UTI in men and women?

A

E.Coli (nitrate reductase producing bacteria)
Urine +ve nitrites
+ve leukocytes esterase
Mildly acidic pH

146
Q

Which hernias pass through inguinal canal to scrotum?

A

Indirect hernia 2o incomplete obliteration of the processus vaginalis

147
Q

Progesterone withdrawal causes endometrium to undergo?

A

Apoptosis —> menstrual bleeding

148
Q

Adverse effects with excess anabolic use?

A

Acne
Gynaemcomastia
Azospermia
Decreased testicular size
Increase aggression
Decreased endogenous testosterone
Decreased spermatogenesis

149
Q

Risk factor for ectopic pregnancy?

A

PID 2o gonorrhoea or chlamydia

150
Q

Congenital androgen insensitivity syndrome features?

A

Mutation of androgen receptors
XY male
Have testes
No internal or external genitalia male
Female or ambiguous external genitalia
No uterus or fallopian tubes

151
Q

Polyhydramnios fetal causes ?

A

Decreased fetal swallowing 2o anencephaly or GI obstruction
Increased fetal urination

152
Q

Pregnancy haematologic changes?

A

Decrease Hgb ( dilutional anaemia)
Prothrombotic state :- increase fibrinogen
Decreased Protein S and reduced fibrinolysis

153
Q

Loss of testosterone following bilateral orchiectomy changes?

A

Hypogonadal state ;- low testosterone
Decreased lean body wt
Increased subcut fat
Decreased bone density
Significant decrease in prostate volume

154
Q

Bacterial vaginosis features ?

A

Disruption of normal vaginal flora leading to overgrowth of gardnerella vaginalis
Greyish - white fishy smelling discharge
Clue cells —;- sq epithelial cells with adherent bacteria on wet mount microscopy

155
Q

Commonest cause of acute bacterial prostatitis ?

A

E.Coli
Others include
Proteus
Klebsiella
Pseudomonas

156
Q

Advise to give after vasectomy?

A

Viable sperm in the ejaculate for up to 3/12 and at least 20 ejaculations

157
Q

What is supine hypotension syndrome ?

A

Pregnant pts >20/4o due to compression of IVC by the uterus which in supine or Rt lateral decubitus position
Causing reduction in venous return and C.O —> severe hypotension

158
Q

Cause of gestational DM?

A

Human placental lactose —> increase insulin resistance leading to rise in serum glucose to provide nutrition for the fetus
When the compensatory rise in Maternal insulin is inadequate —> excess glucose

159
Q

Physiologic renal changes during pregnancy?

A

Increase GFR
Increase basement membrane permeability
Decreased tubular resorption of filtered protein
Trace proteinuria <300mg/24hrs

160
Q

Transexamic acid mechanisim of action?

A

Antifibrinolytic medication stabilises clots
Inhibits plasminogen cleavage into plasmin formation preventing fibrin degradation and clot dissolution

161
Q

Affect of gestational DM on baby’s glucose/insulin levels?

A

In utero to cope with high maternal glucose - fetus will develop beta cell hyperplasia producing excess insulin.
When child is born this will cause fatal hypoglycaemia because they/re no longer exposed to increase maternal glucose.

162
Q

Despite high prolactin levels during pregnancy why do women not lactate?

A

High progesterone produced by placenta bind to prolactin receptors in the alveolar cells in breast

163
Q

Prostate Ca bony mets findings?

A

Ostoblastic lesion resulting in new bone growth.
Disordered trabeculae and irregular glands with enlarged nuclei and prominent nucleoli

164
Q

Osteolytic bone mets 1o ca?

A

(M2N2R)
Melanoma
Multiple myeloma
Non Hodgkins lymphoma
Non small cell lung cancer
Renal cell cancer

165
Q

Choriocarcinoma features?

A

Malignant gestational trophoblastic disease
Composed of proliferation of anaplastic cytotrophoblasts and syncytiotrophoblasts without villi

Hx:- follows pregnancy, dyspnoea, haemoptysis, abnormal vaginal bleeding and v high b-hCG levels

166
Q

Placental abruption features/

A

Premature Detachment of placenta from uterus- 3rd trimester
Maternal vessels rupture at uteroplacental interface
Painful vaginal bleeding
Tender, firm uterus
Fetal HR low/N
Risk factors maternal HTN, tobacco, cocaine use

167
Q

Ectopic pregnancy presentation?

A

Unilateral lower abdominal pain, Adnexal tenderness and vaginal bleeding.
Ruptured ectopic think acute abdomen

168
Q

What is a krukenberg tumour?

A

Gastric tumour that has metastasised to the ovary.
Presents with wt loss, epigastic pain and adnexal mass.
Histo:- cells producing large amount of mucin displacing nuclei to periphery — signet cells

169
Q

Acute epididymitis features?

A

Acute unilateral testicular pain, tenderness epididymal oedema and pyuria. -ve urine culture
Retrograde passage of bacteria from the urethra
Young men:- chlamydia, gonorrhoea
Older men >35 g-ve colonic flora

170
Q

What prophylaxis is needed for pts with advanced HIV and CD4 count <200?

A

Pneumocystis jiroveci pneumonia prophylaxis with trimethoprim sulfamethoxazole

171
Q

Features of I cell disease?

A

Similar to hurlers
Coarse facial features
Developmental delay
Clouding corneas
Recurrent resp infections

172
Q

Defective step in I cell disease?

A

Post translational modification of proteins
Defect in phosphotransferase enzyme prevents phosphorylation of mannose

173
Q

Chance of an unaffected parent to be a carrier of a AR gene if they have unaffected parents and an affected sibling?

A

2/3

174
Q

Cardiac changes seen in endurance athletes heart?

A

Increase C.O
Increase S.V
Increase Lt ventricular cavity size
Increase end diastolic volume
LVEF unchanged

175
Q

What is the multiplication law ?

A

The probability that 2 or more independent events occurring together can be calculated by multiplying the individual probabilities of each event

176
Q

Injury of the auxiliary nerve?

A

Occurs 2o to shoulder trauma
Sensory loss over the lateral shoulder and weakness of shoulder abduction 2o denervation of the deltoid

177
Q

Stellate (Ito) cells features?

A

Primary cells in hepatic fibrosis
Produce large quantities of collagen
Stan blue with Masson trichrome stain

178
Q

Infant with severe life threatening enteroviral infection think?

A

X-linked agammaglobulinaemia —> low circulated B lymphocytes and immunoglobulins

179
Q

Blind jejunum and distal ileum that spirals around the ileocolic vessel is sure to ?

A

Vascular occlusion of superior mesenteric artery in utero cause intestinal atresia distal to the duodenum

180
Q

Haem changes on pregnancy ?

A

Increase blood plasma volume
Increased red cell mass
Slight decrease in Hgb( dilutional anaemia)

181
Q

Teratogenic SE of valproate ?

A

Decreases maternal folate —> increase risk of neural tube defects ( meaningocele, myelomeningocele)

182
Q

CIN grades ?

A

Low grade < 1/3 of epithelium involved, koilocytes
High grade >1/3 of epithelium involved, BM intact
Cervical carcinoma ( invades the BM)

183
Q

Features of testicular germ cell tumours ?

A

Non seminomatous :- partially differentiated germ cell
High hCG, AFP, LDH
Seminomas :- don’t secrete AFP

184
Q

Letrozole mechanism of action?

A

Aromatase inhibitor. Inhibits androgen to oestrogen conversion —> decrease oestrogen —> stimulate pituitary to increase LH/FSH —> stimulate ovulation

185
Q

PCOS presentation?

A

Irregular Menses
Hyperandrogenism (acne, hisutisim)
Obesity
High LH/FSH ratio
Bilateral enlarged cystic ovaries
Increase androgen
Increased peripheral oestrogen production

186
Q

Priapism 2o sickle cell disease?

A

Ischaemic priapism
Low O2
High CO2
Low pH
2o impaired penile venous outflow prevent relief

187
Q

Management of Klinefelter syndrome?

A

Male hypogonadisim —-> testosterone.
Will improve libido, erectile dysfunction,
Increase BMD and muscle development

188
Q

Ovarian torsion presentation?

A

Young pt
Ovary rotates around infundibulopelvic and uterovarian ligaments.
Sudden unilateral pelvic pain with tender acne all mass

189
Q

Partial androgen resistance features?

A

Loss of function/mutation of androgen receptor
High LH
High testosterone
N FSH
Under virilisastion of the external genitalia (microphallus)
Decreased hair
Oligospermia
Gynaecomastia

190
Q

Which finding is specific to pyelonephritis and helps differentiate it from cystitis?

A

White cell casts

191
Q

What is a koilocyte?

A

Seen in HPV infection
Atypical sq cell with perinuclear cytoplasmic clearing (halo) and dark, large irregular nucleus ( raisinoid)

192
Q

Features suggestive of ectopic pregnancy?

A

Hx of lower Abdo pain and vaginal bleeding
+ve pregnancy test
Adnexal mass

193
Q

Effect of maternal use of ACE I and ARBs on foetus?

A

Foetal renal hypoplasia/dysplasia —> decreased foetal urine production —>oligohydramnios —> Potter sequence

194
Q

Urinary incontinence seen in multiparous pregnant women?

A

Stress incontinence 2o increased intra-abdominal pressure, lax external urethral sphincter tone and lax pelvic floor

195
Q

Incidental mass in woman age 10-30 with Abdo discomfort likely?

A

Mature Teratoma ( most common)

196
Q

Causes of priapism?

A

Sickle cell disease
Trazodone

197
Q

What type of vaccine is given to prevent congenital rubella syndrome?

A

Maternal administration of a live attenuated vaccine before conception

198
Q

Cause of gallstones in pregnant women and those taking ocp?

A

Oestrogen induced cholesterol hypersecretion and progesterone induced gallbladder hypomotility.

199
Q

Management of vulvovaginal candidiasis?

A

Fluconazole
Wet mount microscopy:- psuedophyphae with budding yeast

200
Q

Restless leg syndrome characteristics?

A

Uncomfortable sensation in legs with urge to move them. Worse at night
Worsened by metacolopromaide, diphenhydramine
Mgx:- alpha 2 delta ca channel ligands e.g gabapentin, pregabalin
Dopamine agonist —> pramipexole

201
Q

Empyema features?

A

Accumulation of pus in pleural space
Commonest cause extension from alveoli i.e parapneumonic effusion

202
Q

What part of the brain regulates the circadian rhythm?

A

Suprachiasmatic nucleus of hypothalamic nuclei

203
Q

Pt with Crohn’s disease and hx of epistaxis, bruising prolonged PT and PTT?

A

Vitamin K deficiency

204
Q

How does vitamin K activate coagulation factors?

A

Vitamin k is a cofactor for gamma glutamic carboxylase with activates coat factors 2,7,9,10 via postranslational gamma carboxylation

205
Q

What is physiologic stress test?

A

Administration of dobutamine mimics excercise and increase myocardial O2 demand

206
Q

Stable angina and stress test ?

A

Is a fixed coronary artery stenosis with exercise will cause a mismatch of O2 supply and demand

207
Q

DNA mismatch repair characteristics?

A

Large quantities of Neoantigens
Downregulate expression of ‘MHC1 to avoid detection by CD8+cells
Treatment with immune checkpoint inhibitors restore cytotoxic T cell activity

208
Q

What is factitious disorder?

A

Intentional falsification of symptoms or induction of disease. Goal is to assume the pt role

209
Q

Coeliac disease features?

A

Assoc with HLA-DQ2, HLA-DQ8 serotypes
Symptoms:- diarrhoea, abdominal pain, malabsorption, iron deficiency anaemia
Duodenal biopsy:- intraepithelial lymphocytosis, crypt hyperplasia, villous blunting
-ve faecal occult bld

210
Q

Paraneoplastic cerebellar degeneration is what kind of process ?

A

Autoimmune response to tumour cells cross reacting with purkinje neuron antigens

211
Q

Achondroplasia inheritance ?

A

AD mutation of the FGFR3 gene
Therefore offspring have 50% chance of inheriting
No carrier status

212
Q

Spleen embryonic origin?

A

Spleen is of mesodermal origin (dorsal mesentry) but its blood supply ( splenic artery) is derived from the major foregut vessel, the coeliac trunk.

213
Q

Chromaffin cells in the adrenal medulla features?

A

Stimulated by acetylcholine and secrete catecholamines into bld stream
Chromaffin cells are modified neuroendocrine cells from the neural crest

214
Q

On CT scan where is the prostate located?

A

Between the bladder and the anal canal
Anterior to the anal canal

215
Q

Cause of retinal artery occlusion?

A

Thromboembolic complication of atherosclerosis travelling from internal carotid artery —> ophthalmic artery —> retinal artery

216
Q

Albuterol mechanism of action?

A

A beta 2 receptor agonist increases cAMP in bronchial smooth muscle
Induce bronchial smooth muscle relaxation to relieve airway spasm

217
Q

68/95/99 rule

A

68% of all observations lie within 1SD
95% of all observations lie within 2 SD (1.96 SD in normal distribution)
99% of all observations lie within 3 SD (2.58SD in normal distribution)

218
Q

95% confidence interval ?

A

CI of mean = mean +/- 1.96 x SD / square root of n

219
Q

Mechanism of action of Osteoprotegerin?

A

Blocks binding of activator of nuclear factor kappa B (RANK) to RANK- L (ligand) reducing formation of mature osteoclasts —> decreased bone resorption

220
Q

Imiquimod mechanism and use?

A

Topical immunomodulatory agent
Stimulates cellular and cytokines immune response to aberrant cells, also induces apoptosis and inhibits angiogenesis, activates toll like receptor up regulates NFkB
Used for HPV anogenial warts, actinic keratosis and superficial basal cell carcinoma

LopsNotes (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions