Mixto 3 Flashcards

1
Q

Precursores de NAD

A

Niacin
Triptophan
Nicotinamide

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2
Q

Brief psychotic episode vs schizophreniform disorder vs schizophrenia

A

-1 day up to less than a month
-a month up to 6 months
-six months + functional decline

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3
Q

Trazodone is used for__ and it can cause___ (rare but severe)

A

Insomnia associated to depression
Priapism

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4
Q

Fetal lung maturity markers ___ increase by week 30

A

Lecithin (or phosphatidylcholine) / sphingomyelin > 2

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5
Q

The more accurate a test, the ___ to 1 the area under the curve (AUC)

A

Closer

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6
Q

C.difficile pathogenic mec

A

Toxins A and B disrupt cytoskeleton integrity
Forms pseudomembranes

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7
Q

Rapid action anesthesia effects

A

-Propofol (Gaba agonist) reduces airway resistances Vit adv. e is vasodilation
-Etomidate: (gaba agonist) hemodinamically neutral. Adv. e is adrenocortical suppression
-Ketamine (NMDA antag): analgesic effect and brochodilation. Adv e is tachycardia

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8
Q

Thrombotic thrombocytopenic púrpura key dg feature

A

Hemolytic anemia

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9
Q

Vit E deficiency

A

Fat malabsorption
Neuro musc sts
Hemolytic anemia

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10
Q

Pulmonary hamartomas microscopy

A

Well circumscribed nodules of catilaginous tissue

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11
Q

Atypical mucin cells on thoracocentesis. Think of

A

Adenocarcinoma

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12
Q
A
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13
Q

Relationship of citrate and kidney stone prevention.
Hypocitruria will cause__

A

-Citrate binds Ca+2 preventing Ca+2 - oxalate complexes.
-Stone formation

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14
Q

Cancer cells generate most of their energy via ___ even if O2 levels are ok

A

Anaerobic glycolysis

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15
Q
A
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16
Q

Pt with mild pharyngeal erythema, cough and patchy interstitial infiltrates. Gram show no organisms. Think of ___. Treat with__

A

“Walking pneumonia” by Mycoplasma
Prot synthesis inhibitors like macrolides or tetracyclines (mycoplasma has no cell wall)

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17
Q

Myotonic dystrophy features

A

Distal musc weakness + delayed muscle relax after contraction (persistent grip myotonia)
Autosomal dom muscular dystrophy
Trinucleotide repeat expansion
Affects type l fibers (slow-twich)

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18
Q
A
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19
Q

Pembrolizumab is a checkpoint inhibitor which acts

A

Blocking PD-1-> restoring CD8 cells -> promoting apoptosis

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20
Q

V/Q mismatch and intrapulm shunting with decrease dead space ventilation vs increase dead space ventilation

A

Decreased in Pulm Edema
Increased in Pulm embolism

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21
Q
A
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22
Q

Un order to be absorbed in the terminal ileum, B12 must __. This won’t occur if there’s pancreatic insufficiency.

A

be released from R prot complex by pancreatic proteolytic enzymes
Bind to intrinsic factor and finally be absorbed.

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23
Q

Shiga toxin in EHEC affects

A

60S ribosomal subunit-> stopping prot synthesis-> cell death

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24
Q

Xa inhibitors like Rovaroxaban are preferred over Vit K antagonists when prolonged anticoagulation is required because

A

It has less variability in therapeutic effects

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25
Q
A
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26
Q

Acute measles infection depleted Vit __ stores

A

A

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27
Q

Pt from Ohio or Mississippi with calcified lesions on lung, mediastinum and spleen that are stable over time and asymptomatic. Think of

A

Histoplasma capsulatum

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28
Q
A
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29
Q

Sterile platelet-rich thrombi attached to mitral valve. Think of

A

Advanced malignancy (hypercoag and inflamm state)

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30
Q

Which nerve is directly associated (under) the int carotid artery in the cavernous sinus ?

A

Abducens

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31
Q

Which antidepre are associated with sexual dysfunction and which is not.

A

SSRI, tricyclics, trazodone 🏴‍☠️
Bupropion 😉

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32
Q

TAVI main complication

A

Ao regurgitation

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33
Q

Anogenital warts (verracous is looking) by VPH are treated with

A

Imiquimod

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34
Q

Colonic polyps transformation into adenoma is caused by___ and into carcinoma by__

A

KRAS gene activation
P53 gene inactivation

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35
Q

Mycobacterial infection defense depends on

A

Macrophages-> release IL-12-> Tcells -> INF gamma

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36
Q

Drugs that use just antigen binding fragments improve

A

Tissue penetration of the drug (smaller than full Ig)

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37
Q

Methylmalonic acidemia mec

A

Mut of Methylmalonic-CoA mutase impaires (propionyl-CoA → methylmalonyl-CoA → succinyl-CoA - TCA cycle).

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38
Q

Acid fast stain (+) means failure of decolorization with hydrochloric acid and OH. Organisms in which is used are

A

Mycobacterium
Nocardia

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39
Q

Bartonella associates to which disease?

A

Bacilliary angiomatosis

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40
Q

Absence seizures are treated with

A

Ethosuximide (only absence sts)
Valproic acid (if tonic-clonic mov)

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41
Q

Target shaped lesions on skin, think of

A

Erythema multiforme

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42
Q

Etanercept, infiximab and adalimumab are TNF-a inhibitors, before starting tto, make __ test

A

Tuberculin (impaires cell-mediated immunity)

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43
Q

Dissociative amnesia associates to

A

Forgetfulness of one specific event

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44
Q

Centriacinar vs panacinar emphysema associations

A

Centri: cigarette smoking
Pana: a-1 antitrypsin def

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45
Q

Mass in left atrium, think of___. It mimicks__. Histologically there are ___

A

Atrial myxoma
Mitral stenosis
Scattered cells in mucopolysaccharide stroma

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46
Q
A
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47
Q

In DNA replication, daughter strands differ the most on

A

Joining of DNA fragments by ligase (acts more on lagging strand than on leading one)

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48
Q
A
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49
Q

Premature NBs with <32 gestation require ___ to increase surfactant production

A

Corticoids

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50
Q

Recurrent inexplicable panic attacks (at least one is spontaneous), think of

A

Panic disorder

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51
Q

Chronic multiple worries (at least 6mo), anxiety and tension. Think of

A

Generalized anxiety disorder

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52
Q

Ivermectin is used to treat

A

Strongyloides s.

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53
Q

Nifurtimox is used to treat

A

Chagas’ disease (Trypanosoma cruzi)

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54
Q

Candida albicans distinctive feature from other candidas is its ability to

A

Form germ tubes

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55
Q

Haemophilus reqs x factor and V factor (NAD+) to grow. ____ produces the latest

A

S. Aureus

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56
Q

Adenovirus key features

A

Outbreaks (crowded places)
All year long
Pharyngoconjunctival fever (small % of pneumonia)

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57
Q

Common complication in premature NB is ___ from___

A

Inter ventricular hemorrhage
Germinal matrix

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58
Q

High levels of amylase without pancreatitis, think of

A

Parotitis

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59
Q
A
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60
Q

Glucagon causes glycolisis via

A

G prot on-> adenylyl cyclase -> AMP into cAMP -> PKA on -> phosphorylation of glycogen phosphorylase -> glycogen into globose-1 phosphate

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61
Q

Which enzyme promoted by insulin dephosphorylates glycogen synthesen leading to its activation

A

Protein phosphatase

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62
Q

Innervation of pelvic floor muscles and urinary sphincter

A

S2-S4

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63
Q

Inactivated influenza vaccine mec

A

Produces neutralizing antibodies against hemagglutinin antigen -> preventing viral entry

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64
Q

Increase prevalence + unchanged incidence. Think of

A

Prolongation of the disease

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65
Q

Highest obstructive apnea occurs during ___ of tongue, oropharynge, soft palet. This occurs during___ phase of sleep in __ position

A

Relaxation
REM
Supine

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66
Q

BZD withdrawal sts (tremor, rebound anxiety, insomnia, SNS hyperactivity) is treated wth

A

Long acting BZD (diazepam)

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67
Q
A
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68
Q

Congenital diafragmática hernia features

A

During first trimester, pleuroperitoneal folds don’t close properly-> abdo organs can move into thoracic space -> compression of lungs-> Pulm hypoplasia

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69
Q

Neurodegenerative disorders (Parkinson and Alzheimer’s) are usually associated to impairment of___. When it fails ___ start to aggregate

A

Ubiquitin-proteasome
Proteins

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70
Q

Histone acetylation is impaired in

A

Huntington disease

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71
Q

Common cause of metabolic acidosis with normal AG

A

Renal tubular acidosis

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72
Q

Maculopapular rash + fever while in mountain camping, think of

A

Rocky Mountain spotted fever by Rickettsia r

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73
Q

In hypovolemic shock, urea is

A

Reabsorbed

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74
Q

Atrophic kidney associated to a mass filling renal pelvis + recurrent UTIs + flank pain and hematuria. Think of ___

A

Struvite kidney stones

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75
Q

Struvite kidney stones is associated to ___ rods

A

Urease-producing organisms (Proteus and Klebsiella)

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76
Q

Most common cause of nephritic sd is ___

A

Immune complex deposition

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77
Q

Nephritic sd with normal serum complement levels, think of

A

IgA nephropathy
*usually associated to recent resp infection but must be suspected even if not present

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78
Q

Main attack mec for fighting encapsulated bacteria

A

MAC formation by complement prots (C3b, C5-C9)

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79
Q

Acyclovir:valacyclovir mec of action

A

Incorporates into viral DNA and terminates its synthesis

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80
Q

Rhinovirus features

A

Naked
SS (+)

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81
Q

IgA vasculitis features

A

Purpuric rash
Arthralgias
Renal compromised (hematuria, HTA)
Gastro involment
**leukocytoclastic vasculitis

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82
Q

Generalized anxiety disorder lasts ___ and can be treated with

A

6 or more months
SSRI (citalopram) or SNRI

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83
Q

MHC class ll is expressed on __. This is encoded by___. If this gene is affected, there will be no

A

B cells, macrophages
HLA-DR gene
Presentation of antigens processed in lysosomes

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84
Q

3-5 days of delayed reperfusion in AMI can lead to

A

Papillary musc rupture/damage
Interventricular septum rupture

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85
Q

5-15 days after MI, there could be

A

Free wall rupture and subsequently hemoperitoneum/ cardiac tamponade

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86
Q

Several months after MI, there could be

A

Left ventricular aneurysm

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87
Q

Which TB drug is hepatotoxic

A

Isoniazid

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88
Q

Nerve conduction in demyelinating neuropathy vs axonal neuropathy

A

DN: delayed or blocked
AN: reduced amplitude

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89
Q

Pt with depre + suicidal ideation +impulsivity when feeling rejected, think of

A

Borderline personality

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90
Q

Borderline personality vs bipolar disorder

A

Borderline has transient mood shifts, impulsivity in response to triggers

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91
Q

Entamoeba H reqs dual TTO because

A

Metronidazole is for killing trophozoites
Paromomycin to eliminate intraintrstinal cysts

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92
Q

Low reticulocyte count + high Lactate DHG + jaundice after taking new medication, think of

A

G6PD deficiency

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93
Q
A
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94
Q

Extra mammary nupples are the result of the incomplete involution of ___. Extra nipples present as

A

The mammary ridge
Lesions similar to nipples tender before menses

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95
Q

Cancer cells common survival mec

A

Expression of PD-L1 that binds to PD-1 on activated T cell-> cannot produce perforins nor IL-2

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96
Q

miRNA are involved in___ and is associated with

A

Development of several diseases
mRNA degradation and translational repression

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97
Q

4 major dopaminergic pathways

A

Mesolimbic
Mesocortical
Tuberoingundibular
Nigrostriatal

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98
Q

Which dopaminergic pathway is associated to prolactin inhibition

A

Tuberoinfundibular

99
Q

Sacubitril mec of action

A

Enhances and prolongs activity of ANP and BNP by inhibiting metaloproteases

100
Q

In fetal circulation, IVC blood is rich in O2 due to

A

Foramen Ovale shunting that moves blood from the right to the left ventricle and from there to the LV, Ao and rest of the body
*remember lungs are not working

101
Q

Pt unable to flex distal interphalangeal joint, think of

A

Flexor digitorum profundus lesion

102
Q

Pt unable to flex PI, think of

A

Lesion in flexor digitorum superficialis

103
Q

Blastomyces dermatitidis features

A

Mississippi and Ohio river valley
Pulm infections in immunocompetent with extrapulm sts if immunocompromised
Granuloma formation
Round yeast with broad based budding and think walls

104
Q

Aspirin intoxication in children or Reye sd causes

A

Hepatic disfx (hiperammnonemia) -> acute liver failure
Microvesicular steatosis in liver
Diffuse Astro cute swelling-> rapidly progressive encephalopathy

105
Q

Familiar Alzheimer’s disease is associated to ___ allele

A

Apolipoprot E-4

106
Q

Mut of methylene tetrahydrofolate reductase leads to decreased

A

Methionine

107
Q

Monoclonal antibodies features

A

From single B cell populations/ plasma cells
Bind to a single epitope
Very specific

108
Q

Polyclonal antibodies features

A

From multiple B cell populations
Multiple different antibodies
Bind to different epitopes
Broader response

109
Q

Latidsimus dorsi musc function

A

Extension, adduction, int rotation of humorous
Innervated by thoracodorsal nerve

110
Q

Pseudomonas features

A

Gram (-)
Non-lactose fermenting

111
Q

Pulmonary capillary wedge pressure is reflected in

A

Left atrial pressure

112
Q

BB act on Beta 1 receptors found in __ and ___

A

Cardiomyocytes and yuxtaglomerular cells

113
Q

Homocistenuria is associated to cystathionine beta synthase which need Vit ___ as a cofactor

114
Q

Pus related cytokine
Inflammation limitating enzyme

116
Q

NB continues systolic and diastolic murmur that ceases after 24, think of __ described as

A

Ductus arteriosus
Arterial left to right shunt

117
Q

Group A protein that is similar to myosin ___ it works by

A

M protein
Resisting phagocytosis

118
Q

Rubeola/measles complications

A

Pneumonia
Encephalitis (days)
Disseminated encephalomyelitis (weeks)
Subacute sclerosing
panencephalitis (years)

120
Q

Digoxin toxicity presents as___. Suspect in

A

Gastro( Anotexia, nausea, vomiting, abdo pain) and neuro
(Confusion, weakness, changes in color vision) sts
Elderly pts with controlled HF

121
Q

Which 2nd generation antipsychotics have higher risk of developing metabolic syndrome

A

Clozapine
Olanzapine

122
Q

Which antipsychotic is the only o e that reqs monitoring neutrophils due to risk of agranulocytosis

123
Q

Decreased number of tranverse tubules (T tubules) IB musc lead to

A

Uncoordinated contraction of myofibrils

124
Q

Which drug competes with nicotine binding to its receptor, decreases cravings and pleasurable effects from

A

Varenicline

125
Q

ARB vs ACEs

A

ARBs bind to angiotensin ll receptor blocking it (they don’t decrease its synthesis) don’t affect bradykinin
ACEs: decrease Agiotensin ll by blocking its conversion from Angiotensin l. Increase bradykinin

126
Q

Teenager with difficulty moving, kyphoscoliosis, foot abnormality and similar fam history, think of__

A

Friedreich ataxia (spinocerebellar, lat corticospinal and dorsal columns degeneration)

127
Q

Protease inhibitors in HIV TTO like Lopinavir can cause__ (adverse effects)

A

Lipodyateophia
Hyperglycemia

128
Q

Kid with returning from summer camp with painful oral vesicle/ulcers + maculopapular vesicles on hands and feet, think of __ watch out for

A

Hand-foot-mouth diseas by Enterovirus
Myocarditis
aseptic meningitis

129
Q

Invaginated small intestine into colonic segment is called __ which is associated to__ which causes

A

Intussusception
Viral infection
Hypertrophic of intestinal lymphoid follicles

130
Q

Klinefelter sd features

A

XXY
Learning probs
Gynecomastia And Small testes (primary hypogonadism)
tanner 1

131
Q

HER2 positive breast ca is treated with __ which acts via

A

Transtuzumab
Preventing activation of tyrosine kinase receptor -> apoptosis

132
Q

Viral meningitis is caused by

A

Enteroviruses (most common)
Arboviruses
HSV-2

133
Q

Bacterial vs viral meningitis

A

B: WBC > 1000, neutro predominance, glucose <45
V: WBC < 500, lymphocytic predominance, glucose N or little reduced

134
Q

Vegan diet deficiencies

A

Common: vitamin B12, vitamin D, calcium
Possible*: iron (women), zinc (children)

135
Q

Right (ascending) vs left (rectosigmoid) colon Ca

A

Right: large, bulky, protrude colonic lumen. Risk of bleeding and Iron deficiency anemia
Rectosigmoid: smaller, risk obstruction, altered bowel habits, nausea, vomit.

136
Q

Pt with personality changes, desinhibition and irritability. Think of injury in ___ cortex

A

Orbitofrontal

137
Q

Pt with language, sensory and memory difficulties. Apathy, hyperorality, hypersexual and visual agnosia. Think of injury in ___ cortex

138
Q

Pt with motivation, organization, and planning problems. Think of injury in ___ cortex

A

Lateral prefrontal (executive function)

139
Q

Atrial fib management long term

A

Rhythm control: Av node blockers (BB, CCB, Digoxin)
Heart rate control: cardioversion, antiarrythmics (flecainide, amiodarone) radiofreq ablation

140
Q

Mastectomy and axillary lymph dissection has risk of injurying

A

Intercostobrachial nerve

141
Q

Proteinuria in pregnancy occurs due to

A

Increase GFR

142
Q

Inmmunoglobulin regions that interacts with phagocytic cells and antigenic epitopes respectively

A

-Constant regions of heavy chains
-Light chains (constant and variable)

143
Q

Rifampin vs Isoniazid mec of action.

A

R: Inhibition of bacterial DNA-dependent RNA polymerase
I: Inhibition of mycolic acid synthesis

144
Q

Nontyphoidal salmonella features

A

S. Enteritidis or Newport
Poultry/ eggs related
Gastroenteritis
Neutro mediated
Self-limited and rarely invasive

145
Q

Typhoidal salmonella

A

S. Typhi or paratyphi
Typhoid fever
Progressive fever, macular rash (rose spots), GI bleeding, hepatosplenomegaly
Water/food contaminated
No neutro or phagocyte response
Extensive intracel replication

146
Q

Trimethoprim is similar to ___ because they both ___

A

Methotrexate (used in humans and trime in bacteria)
Inhibit dihydrofolate reductase -> folic acid can’t convert to tetrahydrofolate

147
Q

From under what ages children do not understand the finality of death

148
Q

Vaccine reactogenicity (adverse effects within hours) are due to

A

Innate immune resp (macrophages, monocytes and mast cells)

149
Q

C. difficile main histopathological feature

A

Pseudomembrane formation (neutro predominant inflam infiltrate, fibrin, bacteria and necrotic epithelium)

150
Q

Increased ICP signs with normal CT, think of

A

Cerebral venous HT

151
Q

Hypokalemia in the context of cocaine-induced MI occurs de to

A

Beta adrenergic hyperactivity

152
Q

Familial chylomicronemia sd type I key features

A

ApoC-2
High chylomicrons

153
Q

Familial chylomicronemia sd type Il key features

A

Aprobar-100
High LDL

154
Q

Familial chylomicronemia sd type I ll key features

A

ApoE
High chylomicrons and VLDL

155
Q

Alzheimer’s progression is associated with ___ protein which takes part in___

A

Tau protein
Microtubule stabilization

156
Q

Best initial tests and definitive dg test for Giant cell arteritis

A

C reactive Prot (CPR) and erythrocyte sedimentation rate (ESR) -> high -> temporal artery biopsy

157
Q

How to differentiate leukemia reaction from chronic myeloid leukemia

A

High or normal leukocyte alkaline phosphatase in leukemoid rx

158
Q

Interferon gamma is produced by ___ it activates __ and promotes

A

T cells and natural killers
Macrophages
Th1

159
Q

5- alpha resultase blockers like Tamsulosin cause gynecomastia due to

A

Less DHT conversion -> testosterone accumulates -> converts to estrogen

160
Q

Hypothermia shifts Hb curve to the __ meaning

A

Left
It increases its affinity for O2 (releases less)

161
Q

Flyby ride and glimepiride are

A

Sulfonylureas

162
Q

Liraglutide and exenatide are

A

GLP-1 agonists

163
Q

Sitagliptin and sexagliptin are

A

DPP-4 inhibitors

164
Q

Pt with migratory thrombophlebitis, suspect ___ most commonly of__

A

Cancer (adenocarcinoma)
Pancreas,colon and lung

165
Q

Phosphoinositol system

A

GDP to GTP
Gq protein
Pip2->DAG-> Pip 3
Ca+2 release from previous step is major activator of protein kinase C

166
Q

Type B Ao dissection vs Tyoe A

A

A: Ascending. Flap originates near Ao valve, Brachiocephalic trunk
B: descending. Flap forms near left subclavian artery

167
Q

Depletion of substance P will cause

A

Pain relief

168
Q

Tibial nerve function

A

Foot plantar flexion and eversion
Toe flexion

169
Q

Attention deficit vs absence seizures

A

Attention deficit can be interrupted by verbal/tactile stimuli. Treat with methylphenidate

170
Q

Precontemplation refers to

A

Pt doesn’t see the problem with his habits

171
Q

Legionella is detected by

A

Urine antigen test
Silver stain on charcoal yeast

173
Q

Lung capacity increased in COPD is ___

A

Functional residual capacity

174
Q

Fundoplication can hurt ant and post vagal branches passing through esophageal hiatus. This can affect

A

Gastric emptying speed (slows it down)

175
Q

Pt with yellow foul sputum and culture showing Fusobacterium and peptostreptococcus, how can this be explained?

A

Aspiration (OH, drugs, neuro disease-> loss of consciousness)
*these rods are normal mouth flora

176
Q

Autism key features

A

-social interactions affected
-repetitive patterns of behavior/ fixation
-not necessarily affects language or intellectual capacity

177
Q

Hydralazine, minoxidil effect

A

Direct relaxation of arteriolar smooth musc (vasodilatadors)
Activate RAA system (side effects)

178
Q

Methylation induced gene siliencing occurs in which trinucleotide repeats disease?

A

Fragile x sd

179
Q

Amphotericine main side effect

A

Nephrotoxicity

180
Q

Which sts persists even after adding carbidopa

A

Anxiety and agitation
* it does help with nausea/vomit, tachyarrythmia and postural hypotension)

181
Q

How does disease prevalence affect screening tests ?

A

The higher the prevalence, the lower the false positives (Higher positive predictive value)

182
Q

After 1-2 weeks after a stroke, which cells will be affected

A

Glial cells

184
Q

Amphotericine main side effect

A

Nephrotoxicity

185
Q

Flecainide and propafenone are class ___ antiarrythmics which block___

A

IC
Phase 0 (strong Na+ channels inhibition)

186
Q

X linked agammaglobulinemia features

A

Impaired B cell maturation
Recurrent sinopulm infections at 3-6 mo old
Chronic enteroviral infection
Small or absent lymphoid tissue (tonsils, adenoids)

187
Q

Pt with tx trauma, shortness of breath, subcutaneous crepitus and chest x-ray showing peripheral lung marking. Think of

188
Q

Which health care financing has fixed predetermined monthly fee paid by the pt?

A

Capitation

189
Q

Pulmonary fibrosis is treated with

A

Anti fibrotic agents that inhibit TGF-beta or other growth factors
*pirfenidone, nintedanib

190
Q

Cervicitis by Chlamydia or Gonorrhoeae can lead to

A

Pelvic inflammatory disease
Ectopic pregnancy
Infertility

191
Q

High altitude sickness features

A

Increased Erythrocytes: 1 2,3-BPG production (shifts Hb curve to the right), EPO, HCO3 excretion

192
Q

Urinary incontinence in pregnancy is due to increased intraabdo pressure or ureteral/bladder compression?

A

Increased Intraabdo pressure

193
Q

Urgency urinary incontinence mec

A

Detrusor muscle hyperactivity

196
Q

CNS and heart start developing at week __

197
Q

Which drug enhances K excretion in the collecting duct ?

198
Q

Adalimumab is used to treat___ by blocking ___ however, diseas can relapse because

A

Crohn’s
TNF-a
It induces antidrug formation

199
Q

Things to know about the locus coeruleus

A

Posterior rostral pons location
Pigmented
Near lat floor 4th ventricle
In charge of NE synthesis, mood control, arousal (reticular activ system), sleep-wake

200
Q

Secundary syphilis features

A

RPR and VDRL (+) (non-treponemal)
Antibody to cardiolipin-cholesterol-lecithin antigen
Diffuse rash + lymphadenopathy

201
Q

Treponemal syphilis tests

A

FTA-ABS and TP-EIA

202
Q

A pt with chlamydia usually has __ too. Treat with __

A

Gonorrhoeae
Ceftriaxone and doxycycline

203
Q

Common causes of Right-sided HF

A

Pulm circulation prob (PTH, embolism)
Right ventricle infarction

204
Q

Anatomic defect causing increase mobility of testis, think of

A

Testicular torsion

205
Q

PEEP helps with ARDS via

A

Increasing functional residual capacity

206
Q

Leptospirosis features

A

Outdoor activities
• Abrupt-onset fever, rigors, myalgia, headache
• Nausea, vomiting, diarrhea
Complications:
Hepatic/renal injury

207
Q

GH pathways

209
Q

Severe arthritis in adult life blue-black spots on his sclerae and ear cartilage, think of

A

Alkaptonuria (homogentisic acid dioxygenase)

211
Q

Renal events in DM by order

A
  1. GFR increases + glomerular hupertrophy
  2. Mesangial expansion, glomerular memb thickening, arteriolar hyalinosis, some albuminuria and HTN
    3.mesangial nodules, a lot of proteinuria, nephrotic sd, low GFR
212
Q

NB with loud snoring , difficulty breathing that improves in prone postition (tongue posteriorly displaced, u-shape cleft palate ) this is

A

Pierre Robin sequence

213
Q

Common findings in osteoarthritis

A

fissuring, flaking, and erosion (fibrillation) of articular cartilage.
Increased metalloproteinase activity

214
Q

Receptor activator nuclear factor Kappa B (RANK) is needed to form___ cells, overexpression of RANK will lead to

A

Osteoclasts
Increased bone resorption

215
Q

Mineralization of the bone is only done by ___ (cells)

A

Osteoblasts

216
Q

RANK-L is only on the surface of ___. When bind to RANK, It____ and when bind to osteoprotegerin, it___

A

Osteoblasts
Creates osteoclasts
It reduces osteoclasts formation

217
Q

Dermatomes from:
Bellybutton
Medial thighs
Later thighs

218
Q

Reduced cortisol can lead to

A

Hypoglicemia
Anemia (EPO reduction
Eosinophilia (no cortisol suppression-> rebound)

219
Q

PTT and PT normal values

A

25-40 PTT
11-15 PT

220
Q

Why can CKD cause bruising?

A

Excess ammonia breakdown-> excess nitric oxide-> downreg of vWF secretion and less gpIIb/IIIa (platelet aggregation)

221
Q

West Nile virus features

A

By mosquitoes
sRNA (+)
Southern US, Latam, Africa
Neuro sts: parkinsonian, confision, flaccid paralysis

222
Q

Pt with suprasternal and intercostal retractions, inspiratory stridor, and a barking cough, think of

A

Croup/parainflueza/laryngotracheitis
*key difference from laryngitis is barking cough and way less severe symptoms

224
Q

Delusional disorder vs schizophrenia or schizophreniform disorder

A

D: only delusions one or more for one month or more
S: delusions + hallucinations/disorganized speech/ neg sts for 6 or more months vs schizophreniform (same but for less than 6 months)

225
Q

28 week NB with intermittent episodes of no respiratory effort for >20 sec but well appearing between episodes, think of

A

Apnea of prematurity due to underdeveloped central stimulatory neurons that trigger inspiration and expiration

226
Q

Tumor cells metastasis mec

A

-Down-reg cadherins-> loose intercell junctions
-increase type lV collagenases-> degradate extracell matrix
-express CD44-> disseminate to lymph nodes

227
Q

Drug adm differs in babies in comparison to adults because

A

They have decreased gastric pH, reduced intestinal motility, increased proportion of total body water

228
Q

Small cell carcinoma of lung features

A

Central location
Markers: chromogranin, synaptophysin
Hyperchromic blue nuclei

230
Q

Collagen type in blood vessels ___ . Associated to __ sd

A

Type III
Ehlers Danlos

231
Q

Diseases associated to phases of collagen

A

I: no disease
ll: scurvy (Vit C needed for hydroxylation)
III: osteogenesis imperfecta (glycosylation - triple helix)
V: Ehlers Danlos. proteolisis
Vll: Menken sd (cross linking)

232
Q

Copper diseases to know

A

Menkes: defective ATP7A (Absent copper) -> copper need for crosslinking of collagen
Wilson’s: defective ATP7B -> copper Buildup.

234
Q

FISH (Fluorescence in situ
hybridization) used to detect

A

Microdeletion
Translocation
Duplication
*binds to specific genes

235
Q

Pleiotropy

A

One gene contributes to multiple phenotypes
Ex. Phenylketonuria

236
Q

Epistasis is

A

The allele of one gene affects the phenotypic expression of alleles in another gene

237
Q

McCune- Albright syndrome

A

Manchas Café-au-lait unilat e irregular
1 endocrinopatia

239
Q

Flow cytometry use

A

Assesses size, granularity and prot expression of INDIVIDUAL cells

240
Q

Direct ELISA detects ___ vs indirect ELISA__

A

The antigen on the sample (enzyme binds to primary antigen)
The antibody on the sample (two antibodies, longer)

241
Q

Prader-Willis vs Angelmanb

A

Uniparental disomy
Prader: mother gene is silenced/methylated. Father gene absent
Angel: father gene is methylated and mother gene is absent