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SMART 1 > Mixed smart > Flashcards

Mixed smart Flashcards

1
Q

Which medication acts by increasing cardiac contractility (positive inotropic) and decrease vascular resistance and mean arterial blood pressure

A

Isoproterenol

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2
Q

Brown pigment stones which arise secondary to bacterial (E. coli) or helminthic infection of the biliary tract results in the release of

A

Beta-glucuronidase

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3
Q

What are the atypical cells in infectious mononucleosis seen on peripheral smear

A

cytotoxic T-lymphocyte (CD8+)

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4
Q

Cytokeratin most likely belong to which cell lineage

A

Epithelial cell

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5
Q

Dysphagia, hoarseness, loss of gag reflex on the ipsilateral side and deviation of the uvula toward the normal side is caused by a lesion

A

Lesion of the jugular foramen

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6
Q

Biopsy of small cell carcinomas will show neuroendocrine marker such as

A
  1. Neural cell adhesion molecule (NCAM, CD56) 2. Neuron specific enolase 3. chromogranin
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7
Q

Infusion of which drug causes vasoconstriction with increase systemic vascular resistance

A

Phenylpherine

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8
Q

Renal calculus in a a person with recurrent urinary tract infection is composed of

A

Struvite Stones

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9
Q

What is the mechanism of Fidaxomicin

A

Fidaxomicin inhibits the sigma subunit of RNA polymerase

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10
Q

CGG trinucleotide repeat is

A

Fragile X

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11
Q

Sense of motion when no motion is present or exaggerated sense of motion for a given bodily movement is

A

Vertigo

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12
Q

The degradation of Interferon Kappa B (IkB) on the surface of bacteria will directly lead to activation of

A

Nuclear factor-kappa B

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13
Q

What is the most common cases of HUS associated to

A

EHEC 0157:H7 associated with eating undercooked contaminated ground beef

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14
Q

Easy fatiguability, constipation, back pain, elevated serum protein and azotemia (high levels of nitrogen products) in an elderly patient is consistent with

A

Multiple myeloma

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15
Q

Gastric bypass surgery results in a deficiency of vitamins (B12, A, D, E, K) and Iron but an increase of

A

Folic acid and Vitamin K

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16
Q

What medication is used to treat toxoplasmosis ( 2 ring enhancing lesion with edema)

A

Pyrimethamine and sulfadiazine

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17
Q

What is the most common cause of aseptic meningitis

A

Enteroviruses

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18
Q

The bacteria uptake of exogenous DNA fragments and express the encode proteins is called

A

Transformation

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19
Q

Aspirin consumption leads to excessive production of

A

Leukotrienes

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20
Q

Primary Dengue virus infection can be asymptomatic or cause self-limited disease in most adults, secondary infection is with

A

A different viral serotype and are usually more severe

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21
Q

The primary cause of ring enhancing lesions in HIV patient is

A

Toxoplasmosis (Toxoplasma Gondi)

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22
Q

What kind of ventricular necrosis is observed by occlusion of the left coronary artery

A

Coagulation necrosis

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23
Q

In type I diabetes mellitus with diabetic ketoacidosis, the is a deficiency in a hormone that normally

A

Decreases glucagon secretion

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24
Q

What is involved in pathologic process in Rheumatoid arthritis

A
  1. Pannus Formatin (joint) 2. Boutonniere deformity 3. Systemic inflammation
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25
Q

What hormone is released after consumption foods high in fat and responsible for gall bladder contraction

A

Cholecytokinin (CCK)

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26
Q

What is contained in the anterior compartment of the leg that can illicit pain when compromised

A

Deep peroneal nerve

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27
Q

Small cell carcinomas frequently synthesizes hormones or hormone-like substances like

A

Vasopressin leading to syndrome of inappropriate antidiuretic hormone secretion

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28
Q

Failure of a patients neutrophil to turn blue on nitroblue tetrazolium testing is indicative of

A

chronic granulomatous disease

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29
Q

Which medication inhibits COX-1 and COX-2 enzymes via irreversible acetylation

A

Aspirin

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30
Q

In cystic fibrosis impairment of cystic fibrosis transmembrane conductance regulator protein does what

A

Reduces chloride secretion and Increases sodium absorption by respiratory epithelia

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31
Q

Symptoms of trapezius weakness include

A
  1. Drooping of the shoulder 2. Impaired abduction of the arm above horizontal 3. Winging of of the scapula
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32
Q

What is the effect of long term treatment with estrogen and progesterone in pregnancy and post menopausal women

A

Increase levels of Thyroxine-binding globulin leading to an increase in thyroid (T4) hormone levels

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33
Q

The key growth factor that promote angiogenesis in neoplastic and granulation tissues are

A

Vascular endothelial growth factor and Fibroblast growth factor

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34
Q

On Light microscopy of the most common adult brain tumor; Glioblastoma what is observed

A

pseudopalisading tumor cells around areas of necrosis is diagnostic

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35
Q

Pulsatile vessels within the intercostal spaces and diminished femoral pulses relative to brachial pulses is associated with

A

Turner syndrome—–> Coarctation of aorta (Continuous heart murmur—-> asso. PDA)

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36
Q

What is the action of Erythromycin in protein synthesis

A

Erythromycin interferes with translocation

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37
Q

Misattributing one’s own unacceptable feelings to another person

A

Projection

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38
Q

In which cells are androgens converted to estradiol

A

Granulosa Cells

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39
Q

A raised, red area on the anterior section of the neck of a new born is

A

Hemangioma

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40
Q

The second most common cause of ring enhancing lesions with mass effect in HIV is

A

Primary Central Nervous system Lympoma

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41
Q

What will a biopsy show of the intestinal mucosa of a person with Lactase deficiency

A

Normal intestinal mucosa

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42
Q

A hernia content that protrudes through DEEP INGUINAL RING and travels lateral to the inferior epigastric vessels is

A

Indirect Inguinal hernia due to (PATENT PROCESSUS VAGINALIS)— Infants

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43
Q

What bacteria toxin when injected into a dystonic tissue such as in torticollis produces dramatic but temporary relief

A

Botulinum Toxin type B and it is produced by a bacteria that has subterminal spore formation

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44
Q

Most common cause of bacterial meningitis in adults is

A

Strep pneumoniae and Neisseria meningitidis

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45
Q

An abnormal S4 can be heard in patient with reduced ventricular compliance due to

A

Sudden rise in end diastolic pressure with atrial contraction (increased stiffness of the left ventricular wall)

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46
Q

In a perforated appendicitis that have formed an abscess the most common bacteria that are frequently isolated are

A

Bacteroids fragilis

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47
Q

Which serum concentration is most likely to confirm the diagnosis of Hypothyroidism

A

Thyroid stimulating hormone

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48
Q

In riboflavin (B2) deficiency activity of which enzyme is deficient

A

Succinate dehydrogenase

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49
Q

What is the most likely cause of Macrocytosis in Sickle cell Disease or other hemolytic anemias

A

Increased folic acid requirements

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50
Q

Elastase found in bronchoalveolar lavage fluid is derived from

A

Alveolar macrophages

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51
Q

Abnormality in which of the following cells is responsible for fractures in Achondroplasia

A

Chondrocytes

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52
Q

The ability to administer bevacizumab as a single agent for metastatic colon cancer despite it being a foreign protein is as a result of

A

The agent being Humanized antibody

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53
Q

Thyroid nodule that shows intranuclear inclusion bodies and grooves, large cells with nuclei containing finely dispersed chromatin with ground glass appearance (Orphan Annie eye)

A

Papillary Thyroid cancer (Papillary carcinoma)

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54
Q

A patient experiencing cholestasis secondary to hepatocellular dysfunction or intrahepatic or extra hepatic biliary obstruction are at an increased risk of developing

A

Fat soluble vitamin deficiency

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55
Q

In what kind of patient will you see Extensive lymphocyte infiltration and granulomatous destruction of interlobular bile ducts

A

Female with long history of pruritus and fatigue who has pale stools and xanthelasma

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56
Q

Beta blockers lower blood pressure via

A
  1. Reducing myocardial contractility and heart rate 2. Decreasing renin release by the kidney
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57
Q

Compression of the nerve that passes through the Obturator canal (obturator nerve) will impair

A

Adduction of the thigh

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58
Q

The primary neoplasm in carcinoid tumor is

A

Small intestine

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59
Q

Selective Beta-1 adrenergic blocking agent with negative inotropic and chronotropic effect.

A

Cause a decrease in cardiac contractility (Esmolol)

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60
Q

Patients with Chronic granulomatous disease, their neutrophils are not able to

A

Kill Catalase + organisms

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61
Q

What bacteria causes Waterhouse-Friderichsen syndrome

A

N. Meningitidis

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62
Q

What is the short term treatment for insomnia in an elderly person

A

Ramelteon

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63
Q

What is the most common abnormality seen in Legionella pneumophila

A

Hyponatremia (Low Serum Sodium)

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64
Q

In squamous cell carcinoma of the esophagus ligation will involve arterial branches of

A

Aorta

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65
Q

Cerebellar lesion hemisphere results in

A
  1. Ipsilateral dysdiadochokinesia 2. Limb dysmetria 3. Intention tremors
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66
Q

Autosomal recessive disorder that DOES NOT cause typically significant bleeding despite aPTT prolongation is

A

Hageman Factor (factor XII) deficiency

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67
Q

A patient that request for help in stoping chronic alcohol consumption will be administered a medication that works by

A

Blocking the Mu opioid receptor (Naltrexone)

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68
Q

Which cytokine is responsible for the growth and differentiation of B-lymphocytes after exposure to antigens

A

IL4 amd IL5

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69
Q

In appendectomy and right ovarian resection what structure in most likely to be injured

A

Ureters

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70
Q

A combined disease involving the mitral and aortic valve will present with

A

Increased left ventricular diastolic pressure

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71
Q

A study that simultaneously measures exposures and outcomes is

A

Cross-sectional study

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72
Q

Medication for treating cryptococcal meningitis

A

Amphotericin B

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73
Q

Detection of parasite eggs in stool is used to diagnose

A

Schistosoma mansoni or S japonicum

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74
Q

Skin condition associated with areas of hot and humid and often most visible after extensive sun exposure

A

Malassezia Globosa (spaghetti and meatballs appearance on on KOH preparation)

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75
Q

Laboratory findings in Klinefelter syndrome is

A

Increased LH and FSH Increased Estradiol Decrease Testosterone

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76
Q

Hernia content protrude through femoral ring, travels inferior to inguinal ligament

A

Femoral Hernia due to (weakness of the proximal femoral canal)— women

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77
Q

Cholesterol stones is caused by inhibition of

A

7-alpha-hydroxylase

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78
Q

What substance Stimulates the release of Bicarbonate-rich secretions from exocrine pancrease

A

Secretin from Duodenal S cells

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79
Q

What is the adverse effect of adding Carbidopa to levodopa in the treatment of Parkinsons

A

Anxiety and agitation

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80
Q

What is the mechanism of Bupivacaine injection

A

Decrease permeability to Na

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81
Q

Which amino acid is highest in quantity or abundant during wound healing (collagen)

A

GLYCINE (Gly-X-Y)– covers every 3rd position

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82
Q

Well differentiated, dysplastic columnar cells that line alveolar septa without vascular or stromal invasion

A

Adenocarcinoma in situ (formerly- Bronchioloaveolar carcinoma) malignant neoplasm

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83
Q

In the treatment of persistent pulmonary hypertension in a new born what is the adverse effect of Nitric oxide

A

Methemoglobinemia

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84
Q

What is cause of orthostatic hypotension in a patient taking carbonic anhydrase inhibitor for altitude sickness

A

Hypovolemia

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85
Q

When Aspergillus causes wide spectrum of disease in immunocompromised individuals (eg. TB), they are described as

A

Colonizing

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86
Q

Which oral macrocyclic antibiotic used to treat recurrent Clostridium difficile colitis (pseudomembranous colitis) in a patient allergic to penicillin

A

Fidaxomicin

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87
Q

The risk of a child developing achondroplasia in a heterozygous parent is

A

50% chance of transmitting. Gain of function mutation in FGFR-3 gene

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88
Q

The absence of a segment of jejunum and ileum in a kid with Bilious emesis in due to

A

Intestinal atresia

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89
Q

Hemolytic anemia in Hemolytic Uremic syndrome (HUS) causes

A

Decrease hemoglobin and haptoglobin levels and an increase in serum lactate dehydrogenase and unconjugated bilirubin

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90
Q

On biopsy of a patient with ectopic pregnancy what will be observed

A

Dilated, coiled endometrial glands and edematous stroma (decidualized endometrium)

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91
Q

A smoking cessation medication that reduces nicotine cravings and while decreasing the pleasurable effects of cigarettes and other tobacco products

A

Varenicline

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92
Q

Microangiopathic hemolytic anemia, thrombocytopenia and renal insufficiency is characteristic of

A

Hemolytic uremic syndrome

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93
Q

What is the cause of abdominal Hernia

A

Incomplete closure of the umbilical ring

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94
Q

Which hormone levels should be monitored following evacuation of a hydatidiform mole

A

Beta-hCG levels

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95
Q

What is the cause of neonatal cataract formation due to accumulation of Galactitol in the lens

A

Galactokinase deficiency

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96
Q

Acute intermittent porphyria is what pattern of inheritance

A

Autosomal dominant

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97
Q

The difference between HbS and HbC

A

HbS allows hydrophobic interaction among hemoglobin molecules.

HbS is the substituition of glutamate with Valine

HbC is the substituition of glutamate with Lysine

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98
Q

What medication is used to treat Prolactinoma

A

Bromocriptine

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99
Q

A laboratory workup that shows elevated serum Methionine is an indication of homocystinuria which amino acid becomes essential

A

Cysteine

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100
Q

Severe bacterial and fungal infections, granuloma formation

A

Chronic granulomatous Disease

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101
Q

Hemangioma; a benign growth tumor originates from the

A

Endothelium

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102
Q

The progressive onset of heart failure in the setting of a recent viral infection (rhinorrhea, myalgia) is suggestive of

A

Dilated cardiomyopathy caused by viral myocarditis

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103
Q

Which of the diuretics will help loss fluid quicker, Thiazide or Loop diuretics

A

Loop diuretics (furosemide)

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104
Q

Clinically abrupt of severe headache is characteristic of Subarachnoid hemorrhage and is caused by

A

Rupture of the saccular (berry) aneurysm

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105
Q

How will the Inferior Vena Cava be described

A

Its formed by a union of the common iliac veins (right and left iliac veins at the level of L4-L5)

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106
Q

Confusion, headache, fever and nuchal rigidity is a symptoms of

A

Meningitis

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107
Q

Patients with mild asymptomatic hypercalcemia, reduced urinary excretion of calcium and high, normal or mildly elevated PTH (Familial Hypocalciuria Hypercalcemia - FHH) have a defect in

A

Membrane-bound receptor coupled with a G-protein (CaSR)

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108
Q

What is the cause of resistance to ciprofloxacin in streptococcus pneumonia

A

A mutation in genes encoding for Beta Lactamase

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109
Q

Unilateral (blood tinged) nipple discharge with/without a palpable mass or skin changes in mostly caused by

A

Intraductal Papilloma

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110
Q

Which medication when taken leads to Decrease GFR, causes hyperkalemia and cough

A

ACE- inhibitors (prils)

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111
Q

Administration of epinephrine that results in increase serum glucose concentration shows a defect in

A

Glucagon receptor

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112
Q

46 XY males who appear phenotypically female and have cryptochid testes due to androgen receptor defect

A

Androgen insensitivity syndrome

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113
Q

What medication is the strongest and most predictable effect in the inflammatory component of asthma

A

Corticosteroids (Fluticasone)

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114
Q

Which medication is useful in treating visceral nausea due to gastrointestinal insults such ar gastroenteritis, chemotherapy and general anesthesia

A

5-HT3 receptor antagonist (Ondansetron)

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115
Q

What medication used for organophosphate poisoning reverses both the muscarinic and nicotinic effects by restoring cholinesterase from its bound substances

A

Pralidoxime

116
Q

Which nerve stimulates or innervates the Carotid body chemoreceptor

A

Glossopharyngeal Nerve

117
Q

Which step is impaired in the vitamin D synthesis pathway that shows ELEVATED Parathyroid hormone and LOW serum calcium level

A

25-hydroxycholecalciferol—–> 1,25-dihydroxycholecalciferol

118
Q

Which anti-arrhythmic drugs show a decrease or prolong potassium flow from myocytes during phase 3

A

Sotalol Amiodarone Dofetilide

119
Q

In isolated diastolic heart failure, the Left Ventricular end diastolic pressure is

A

Increased. All other parameters are normal

120
Q

The substitution of (glutamate for arginine) near the protein C cleavage site in coagulation factor V gene product (Factor V Leiden) will

A

Pulmonary embolism Deep vein thrombosis Cerebral vein Thrombosis Recurrent pregnancy loss

121
Q

Hirsutism, Oligomenorrhea and acne

A

Late-onset 21-hydroxylase deficiency

122
Q

Initial treatment for gram-positive cocci in clusters that are catalase positive and coagulase negative (staph epidermidis) should include

A

Vancomycin

123
Q

Which cells contribute to the caseating granulomas in Mycoplasma Tuberculosis

A

CD4+ T lymphocyte and macrophages

124
Q

Meningitis with CSF showing lymphocytic pleocytosis; elevated protein level and normal glucose are suggestive of

A

Aseptic Meningitis

125
Q

In Vitamin D synthesis where is Cholecalciferol converted to 25-hydroxyvitamin D

A

Liver

126
Q

An infant with lactic acidosis and neurologic defects most likely has

A

Pyruvate dehydrogenase deficiency

127
Q

Untreated endocervical infection (cervicitis) can lead to

A

Infertility

128
Q

Hernia content protrude through the Hasselbach triangle, travels medial to the inferior epigastric vessels

A

Direct Inguinal Hernia due to (weakness of the TRANSVERSALIS FASCIA)– Older men

129
Q

Locus ceruleus; pigmented brainstem nucleus located in the posterior rostral pons near the lateral of the 4th ventricle produces

A

Norepinephrine

130
Q

IV drugs does not improve patients symptoms because of

A

Tight junctions

131
Q

Which medication prolongs activated Partial Thromboplastin Time and Prothrombin Time but NO effect on Thrombin time

A

Direct factor Xa inhibitor (Apixaban and Rivaroxaban)

132
Q

A long history of alcohol consumption leads to

A

Gait ataxia

133
Q

Vascular endothelium secrets which substance to inhibit platelet aggregation

A

Prostacyclin

134
Q

Which medication has the potential to redistribute fat from extremities to the trunk

A

High active ANTIRETROVIRAL Therapy (HAART) Antiretroviral medication

135
Q

Tissue damage and resultant abscess formation is primary caused by

A

Lysosomal enzyme release from neutrophils and macrophages

136
Q

Intestinal atresias of the midgut are a result of

A

Vascular occlusion

137
Q

The aortic arch baroreceptor and aortic body chemoreceptor is stimulated by

A

Vagus nerve

138
Q

Severe bacterial and viral infection in infancy, chronic diarrhea and mucocutaneous candidiasis. Labs show very low of absent CD3+ T cells and hypogammaglobulinemia

A

Severe combined immunodeficiency

139
Q

A person with food seeking behavior has a lesion in which area of the hypothalamus

A

Ventromedial nucleus

140
Q

What is the earliest histologic findings in a person with long bone/ or pelvic fracture who develops acute onset of neurologic abnormalities, hypoxemia and a petechial rash

A

Fat microglobules

141
Q

What observation is noted to indicate a compound is working specifically as a protease inhibitor

A

There is a lack of mature core

142
Q

What is the mechanism of Pramipexole in treating Parkinsons

A

Directly stimulates dopamine receptor

143
Q

What is the renal adult derivative of the metanephric mesoderm

A

Distal convoluted tubules

144
Q

What is expected to increase in a patient with CHF

A

Arteriolar resistance

145
Q

Repeated infarction of the spleen in sickle cell disease leads to

A

Scarring, FIBROSIS and ATROPHY

146
Q

Postpartum hemorrhage from a prior uterine surgery patient and removal of placenta in pieces is due to

A

Placenta accreta (villous tissue and placenta that is abnormally adherent to the myometrium

147
Q

Infantile and adult beriberi as in Wernicke-Korsakoff syndrome (confusion, ataxia, oculomotor abnormalities and permanent memory deficient is caused by deficient in

A

Thiamine

148
Q

What is the effect of positive predictive value of a test

A

Increase as prevalence increases

149
Q

What is the function of Cromolyn/Cromoglycate

A

Inhibits the release of histamine from the preformed vesicles or inhibit mast cell degranulation and prevent release of preformed chemicals

150
Q

In Rapidly progressive glomerulonephritis, immunofluorescent microscopy will show deposition of

A

Fibrin

151
Q

what diagnostic test will you do to check causal agent for abdominal pain and diarrhea

A

Microscopic examination of the stool for ova and parasites

152
Q

The ability of Tumor necrosis factor alpha (TNF-a) to decrease insulin-mediated glucose up take is mediated through

A

Upper regulation of SERINE and/or THREONINE RESIDUE PHOSPHORYLATION

153
Q

Head CT scan that shows marked enlargement of ventricles is suggestive of

A

Normal pressure hydrocephalus

154
Q

Bilateral Hilar adenopathy and elevated serum calcium and angiotensin-converting enzyme (ACE) levels are suggestive of

A

Sarcoidosis

155
Q

Which tendon is vulnerable to injury due to impingement between the acromion and the head of the humerus

A

Supraspinatus tendon

156
Q

In organophosphate poisoning, Atropine does not reverse the development of nicotinic effects such as

A

Muscle paralysis

157
Q

Flushing, hypotension and crampy diarrhea

A

Carcinoid tumor

158
Q

Recurrent nephrolithiasis in a young patient raises suspicion for cystinuria

A

Cystinuria

159
Q

Chronic hemolytic anemia, splenomegaly and iron overload as a result of impaired erythrocyte survival is caused by a deficiency in

A

Pyruvate Kinase

160
Q

What is the antidote for cyanide toxicity

A

Amyl nitrite (has ability to induce methemoglobinemia)

161
Q

The most common bacterial that causes acute otitis media, sinusitis and bacterial conjunctivitis in childhood are

A
  1. Streptococcus pneumonia 2. Haemophilus influenza (nontypeable) 3. Moraxella catarrhalis
162
Q

A patient with diarrhea who had a domestic animal with diarrhea. The likely enteric organism that can be transmitted to the patient with an animal is

A

Campylobacter jejuni

163
Q

The organism responsible for Waterhouse-Friderichsen syndrome (N. Meningitidis) most commonly causes

A

Meningitis

164
Q

Gs protein-adenylate cyclase activation increasing production of cAMP is the mechanism of which medication

A

Dobutamine

165
Q

Patients with ecchymoses, petechiae, mucosal bleeding and no other obvious cause of thrombocytopenia should suspect

A

Autoimmune platelet destruction

166
Q

Dactylitis (painful swelling of the hands and feet) is a common presentation of sickle cell disease in young children and is as a results of

A

Decreased levels of Haptoglobin

167
Q

In a complete mole examination of the tissue will show

A

46XX or 46XY (less common)

168
Q

After a gastrectomy life long administration of which substance is required

A

Water soluble vitamins (vitamin B12 supplementation)

169
Q

Gentamicin use will cause necrosis of which part of the nephron

A

Proximal tubule

170
Q

In hip adduction the muscle inserts onto the femur from

A

Ischium

171
Q

Chronic granulomatous disease is a condition caused by

A

X-linked mutation affecting NADPH oxidase

172
Q

What is the likely cause of jaundice in Dubin Johnson syndrome

A

Defective hepatocellular excretion of bilirubin glucuronides

173
Q

Increased collagen synthesis is by

A

Activation of nuclear gene transcription

174
Q

Large, reducible midline abdominal protrusion covered by skin that is more pronounced when baby cries in

A

Abdominal Hernia

175
Q

Blood glucose level within normal range despite PROLONGED FASTING is as a result of which hormone binding to intracellular receptor

A

Cortisol

176
Q

CARDIOMEGALY, severe generalized HYPOTONIA, MACROGLOSSIA and HEPATOMEGALY with abnormal accumulation of glycogen in lysosome is

A

Pompe disease

177
Q

Medication for atropine poisoning which can also be used to treat glaucoma is

A

Physostigmine

178
Q

What is the most important role of Neisseria gonorrhea in the course of infection

A

Facilitation of the bacterial enzyme mucosal adherence

179
Q

The primary virulence factor of staph pneumonia is

A

Polysaccharide Capsule– (without it it can not cause disease)

180
Q

What medication causes toxicity in human tissue when it binds to cell membrane cholesterol

A

Amphotericin B

181
Q

Failure of prothrombine time to correct with vitamin K supplementation (prolonged Prothrombine Time (PT) indicate

A

Factor VII (7) deficiency (because it has the shortest half life of all coagulation factors; 10,9,7,2)

182
Q

The exposure to risk factors years before disease manifestation is referred to as

A

Latent Period

183
Q

The leading cause of death in women is

A

Cardiovascular disease

184
Q

Recurrent infection that worsens with age, easy bleeding and eczema

A

Wiskott-Aldrich syndrome

185
Q

What cells are presented on the surface of Antigen presenting cells only (APC) is

A

MHC Class II

186
Q

The appropriate treatment for malignant hyperthermia is Dantrolene which affects

A

Intracellular calcium release in skeletal muscles

187
Q

Over expression of GLYCOPROTEINS with intrinsic tyrosine kinase activity leads t

A

Acceleration of cell proliferation

188
Q

Androgenetic alopecia is dependent on both hormonal and genetic factors the pattern of inheritance is

A

Polygenic

189
Q

Fatigue, pruritus, hepatomegaly and severe elevated alkaline phosphate level are suggestive of

A

Cholestasis

190
Q

Prolonged activated partial prothrombine time (PTT) with normal Prothrombine time (PT) is

A

Factor VIII (8) deficiency (Hemophilia A–X linked recessive)

191
Q

What is physiological effect of epinephrine injected intramuscularly

A

Uterine relaxation

192
Q

What is the likely underlying mechanism responsible for Turner syndrome

A

Loss of paternal chromosome X (45,X)

193
Q

What mechanism explains a patients rapid recovery from anesthesia propofol (highly lipophilic)

A

Tissue redistribution of the drug

194
Q

Congenital heart disease, dysmorphic facies and hypocalcemia

A

DiGeorge syndrome

195
Q

The most common adverse effect of thrombolysis is

A

Intracerebral hemorrhage

196
Q

A method of dealing with an unwanted behavior that a person has a problem with is

A

Suppression

197
Q

The cause of low oxygen and lower PaCO2 in Arterial blood gas is

A

Alveolar Hyperventilation

198
Q

Before alanine can be transferred to glucose its amino acid group is first transferred to

A

Alpha-Ketoglutarate

199
Q

What are the side effect of Non-dihydropyridine calcium channel blocker (diltiazem, verapamil)

A

Constipation, bradycardia atrioventricular conduction block and worsening heart failure with reduced left ventricular function

200
Q

Elevated opening pressure, increased neutrophils, decreased glucose and elevated protein in CSF is indication of

A

Bacterial meningitis

201
Q

Persistent fever and sore throat, anterior and posterior cervical lymphadenopathy and splenomegaly is due to what agent

A

Infectious mononucleosis from Epstein-Barr virus

202
Q

In electrophoresis, a single band that migrates less than HbA and HbS bands means the patient has

A

HbC disease which is caused my MISSENSE mutation

203
Q

Rupture of berry aneurysm of the circle of willis are associated with

A

Autosomal dominant polycystic kidney disease

204
Q

The room is spinning or tilting, difficulty walking due to loss of balance. Problem is

A

Inner Ear

205
Q

Primary central nervous system lymphoma is typically composed of

A

B-lymphocytes

206
Q

What test should be performed before beginning treatment with ETANERCEPT

A

Tuberculin Skin test (because this medication is a TNF-alpha inhibitor)

207
Q

Which medication when used in a Diabetes Mialitus patient can cause hypoglycemic episode

A

Non-selective Beta Blockers (Propranolol)

208
Q

The mixture of normal (46 XX) and mutated (45,X) somatic cells often leading to a milder form of a disease is

A

Somatic mosaicism

209
Q

In panic attack,, hyperventilating cause a

A

Decrease in arterial partial CO2 tension

210
Q

Glucose -6-phosphate dehydrogenase deficiency follows which inheritance pattern

A

X-linked recessive inheritance

211
Q

Pompe disease is caused by a deficiency of

A

Acid alpha-glucosidase (acid maltase)

212
Q

What is the mechanism of the diphtheria toxin

A

Inhibits protein synthesis through ADP-ribosylation of elongation factor -2 (EF-2) leading to necrosis.

213
Q

The leading cause of community acquired pneumonia, otitis media and meningitis in adults is

A

Strep pneumonia

214
Q

Hemolytic anemia, hyper-coagulability (eg. hepatic vein thrombosis) and pancytopenia are characteristics of

A

Paroxysmal nocturnal hemoglobinuria

215
Q

What is the therapeutic mechanism of Desmopressin is a person with von Willebrand disease (vWD)

A

Increase endothelial protein release

216
Q

Obstructive mass caused by incomplete degeneration of the central portion of the fibrous tissue band connecting the walls of the vagina

A

Imperforate hymen

217
Q

Monoclonal antibody against platelet IIb/IIa receptor prevent which substance from binding to platelets

A

Fibrinogen

218
Q

Acute promyelocytic leukemia (APML) which is the M3 variant of AML is associated with

A

t(15;17), cytogenic translocation involving the promyelocytic leukemia (PML) gene on chromosome 15 and retinic acid receptor on chromosome 17

219
Q

What medication is used to treat malignant hyperthermia

A

Dantrolene

220
Q

Haemophilus influenza type b (Hib) causes which conditions

A

Meningitis, pneumonia, epiglottitis and sepsis

221
Q

Red swollen, tender tongue; angular stomatitis and spoon shaped nails likely diagnosis

A

Iron deficieny

222
Q

In corynebacteria diphtheria the presence of what could prevent death in a child

A

IgG against circulating proteins (exotoxin B subunit)

223
Q

What is the mechanism of MILRINONE

A

Phosphodiesterase (PDE)-3 enzyme inhibitor Causes systemic arterial and venous dilation

224
Q

Impaired development of the THIRD PHARYNGEAL POUCH will cause

A

Hypoplastic mandible Low set of ears Bifid Uvula Cleft palate

225
Q

What is suggestive of Strongyloids stercoralis infection

A

Rhabditiform larvae in the stool

226
Q

7-dehydrocholesterol is converted to Cholecalciferol in Vitamin D synthesis in the

A

Skin (UV light sun)

227
Q

Insertion of a needle along the upper border of the 10 rib will injure

A

Right hepatic lobe

228
Q

Abnormal platelet aggregation to Ristocetin, Prolonged Bleeding time, Normal or prolonged PTT is

A

Von Willibrand disease

229
Q

Cirrhosis is characterized by

A

Diffuse hepatic fibrosis

230
Q

No upper vagina (short vagina) with rudimentary uterus, normal ovaries and normal secondary sexual characteristics

A

Mullerian aplasia

231
Q

Which antiviral agent that inhibits DNA polymerase in herpesvirus and reverse transcriptase in HIV does not require intracellular activation by viral or cellular kinases

A

Foscarnet

232
Q

Which medication used for bipolar disorder in pregnancy can lead to Ebstein anomaly (apical displacement of the tricuspid valve leaflet)

A

Lithium

233
Q

The use of human chronic gonadotropin (hCG) in infertility mimics which physiologic event

A

LH surge

234
Q

Which cell type is most predominant in a patient with sarcoidosis

A

CD4+ lymphocytes

235
Q

Most common cause of meningitis in neonates is

A

Strep agalactiae (group B streptococcus)

236
Q

Increasing which substance in a person with pyruvate dehydrogenase deficiency will help generate energy without elevating the lactate levels

A

Lysine

237
Q

Lung Tissue specimen of a person affected with Histoplasma capsulatum (Histoplasmosis) will show

A

Ovoid cells within macrophages (Histo hides in macrophages)

238
Q

What is the pathological finding seen in the affected area of varicella zoster virus

A

multi-nucleated giant cells with intranuclear inclusions in keratinocytes

239
Q

A person expresses unacceptable feelings meant for someone in their present life toward a different person

A

Displacement

240
Q

Fushed skin, dry oral mucosa, dilated and non reactive pupils is suggestive of

A

Atropine poisoning

241
Q

Which cells are responsible for the destruction of cells with decreased or absent MHC Class I proteins on their surface

A

Natural Killer cells

242
Q

Which structure is involved in upper abdominal pain after opioid administration

A

Smooth muscle cells

243
Q

Cause of anemia in CD55 and CD59 deficiency of a patient with Paroxysmal Nocturnal Hemoglobinuria is through

A

Complement Activation

244
Q

The important virulence factor in Ecoli is

A

Fimbrial antigen or pili

245
Q

What monoclonal antibody is used to treat an invasive ductal carcinoma that shows human epidermal growth factor receptor 2 (HER 2-positive breast cancer) and its target

A

Trastuzumab and it targets Tyrosine Kinase

246
Q

What is the histological finding in Intraductal Papilloma

A

Papillary Cells in a duct or cyst wall

247
Q

Soft, dark brown to black stones composed of calcium bilirubinate are

A

Brown pigment gallstones

248
Q

Failure of the extra-embryonic gut to return to the abdominal cavity leads to

A

Omphalocele or gastroschisis

249
Q

Most common cause of calcium kidney stone disease is idiopathic hypercalciuria which is characterized by

A

Normal serum calcium level with hypercalciuria (Normocalcemia, hypercalciuria)

250
Q

In multiple sclerosis there is demyelinatin of axons which occur in the area of the white matter. There is loss of what

A

Myelin sheath and depletion of Oligodendrocytes

251
Q

What is the laboratory diagnosis done to evaluate susceptibility to Ankylosing Spondylitis

A

Analysis of MHC Class I allele expression

252
Q

Which hormone when secreted causes diarrhea

A

Vasoactive intestinal polypeptide (VIP)

253
Q

Which cancer type and tumor antigen is most likely to produce highest antibody titer

A

Cervical cancer—– Human papilomavirus type 16 (E6) protein

254
Q

Shortness of breath, night sweats, weight loss biopsy shows multiple Noncaseating granulomas wit Giant cells

A

Sarcoidosis

255
Q

An unconscious shifting of emotions or desire associated with a person from the past to another person in the present is

A

Transferance

256
Q

Prolactinomas develop from lactotroph cells in the anterior pituitary (adenohypophysis) which is derived from

A

Surface ectoderm

257
Q

The most common cause of spontaneous lobar hemorrhage of the occipital and parietal areas in the elderly

A

Cerebral Amyloid angiopathy

258
Q

Severe hypotension, abdominal pain, vomiting, weakness and fever are suggestive of adrenal insufficiency. Pharmacological Treatment will be

A

Dexamethasone and hydrocortisone Aggressive fluid resuscitation

259
Q

Universal vaccination with HBsAg would almost entirely eliminate

A

Delta agent infection (Hepatitis Delta virus)

260
Q

The most aggressive type of lung cancer is

A

Small cell lung cancer (oat cell carcinoma)

261
Q

Changes in social behavior can manifest in variable ways after head injury. What is the left and right sided lesion associated with

A

Left-sided lesion is associated with apathy Right sided lesion associated with disinhibition

262
Q

In Fragile X condition there is

A

Gene Hypermethylation

263
Q

In cystinuria lab findings will show

A

Aminoaciduria

264
Q

Which organism is responsible for community acquired pneumonia in immunocompetent patient

A

Strep pneumonia

265
Q

What is important in using clavulanic acid or sulbactam or tazobactam with the penicillin family antibiotics

A

Decrease destruction of the penicillin family

266
Q

In which organisms is TROPHOZOITES AND CYSTS seen in stool of patients with intestinal protozoal

A

GIARDIA LAMBLIA and Entamoeba histolytica

267
Q

Aminoglycosides such as gentamicin are associated with ototoxicity (hearing loss, tinnitus) by

A

Inhibiting genetic code reading and protein synthesis

268
Q

What other medication can be used to treat Clostridium difficile infection

A

Metronidazole and vancomycin

269
Q

Tall males, poorly developed secondary sexual characteristics atrophic testes and infertility

A

Klinefelter syndrome (47XXY)

270
Q

Most common cause of meningitis in immunocompromised patients (AIDS patients)

A

Cryptococcus neoformans

271
Q

A microtubule associated ATP-powered motor protein that facilitates the Anterograde transport of neurotransmitter-containing secretory vesicle down AXONS to SYNAPTIC TERMINALS (nerve terminals)

A

Kinesin

272
Q

Acute effect of corticosteroid on white blood cells count in an increase in/ and decrease in

A
  1. Neutrophile Count 2. lymphocyte, monocyte, basophil and eosinophil count
273
Q

In carnitine deficiency or low carnitine, there is deficient synthesis of

A

Acetoacetate

274
Q

What component is responsible for rapid Neutrophil locomotion (migration)

A

Leukotriene B4

275
Q

Function of HIV gp41 protein

A

Inhibits viral Penetration into cells

276
Q

Transient hypersensitivity disorder characterized by pruritic erythematous plaques that arise suddenly and resolve over hours

A

Urticaria (Hives)– will present with DERMAL EDEMA

277
Q

What is the cause of secondary achalasia (inability to swallow liquids and difficulty belching) in a person from Central or South America

A

Trypanosoma cruzi

278
Q

Current depressive episode greater or equal to 2 weeks and past history suggestive of hypomanic episode are consistent with

A

Bipolar II disorder

279
Q

Arterial myocytes release ANP which function to inhibit

A

renin release

280
Q

Episodes of jaundice which may only become evident in the context of a trigger ( eg. illness, pregnancy, oral contraceptive use, etc) is

A

Dubin Johnson syndrome

281
Q

What is the cause of uncontrolled activation of pancreatic zymogens leading to pancreatic auto-digestion and acute pancreatitis

A

Premature cleavage of trypsinogen

282
Q

What parameter correlates with the potency of inhaled anesthetic

A

Minimal alveolar concentration

283
Q

The 180base pair Homeobox or Hox gene typically code for

A

Transcription Factors

284
Q

What is the mechanism of Flutamide in the treatment of prostate cancer

A

Competitive testosterone receptor inhibitor that prevents androgen receptor interaction

285
Q

What characteristic of a lesion best predicts its prognosis

A

Lymph node involvement by cells originating in the lesion

286
Q

What is responsible for the IL-2 anticancer effect on metastatic melanoma and renal cell carcinoma

A

Increase activity of T cells and Natural killer cells

SMART 1 (14 decks)

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