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Step 1 > NBME 28 incorrects > Flashcards

NBME 28 incorrects Flashcards

1
Q

What is the purpose of a mixing study? (coagulation disorders)

A

If person is factor deficient, then mixing with normal serum will return PT/PTT to normal levels but if there is an inhibitor it will not.

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2
Q

What lab values do you expect for Hemophilias?

A

Prolonged PTT but normal PT

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3
Q

What lab values would you expect for vitamin K deficiency

A

Prolonged bleeding time, PT, and PTT

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4
Q

What lab values would you expect for Von Willebrand disease?

A

Prolonged bleeding time and PTT
Normal platelet count and and PT
No platelet aggregation with risotcetin cofactor assay

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5
Q

What lab values would you expect for D.I.C.

A

Prlonged bleeding time, PT, PTT and decreased platelets

widespread clotting factor activation

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6
Q

What is the difference between bernard soulier syndrome and von willebrand?

A

Bernard Soulier syndrome which is due to deficiency in gpIb and VWF is deficiency of VWF

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7
Q

Pt presents with pronged bleeding time normal platelet count but on smear no platelet clumping.

A

Glanzmann thrombasthenia. due to decreased GpIIb/ IIIa

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8
Q

Pt w/ history of lupus presents with increased bleeding time, decreased platelets and on bone marrow biopsy they have megakaryocytes

A

Immune thrombocytopenia. due to antibodies to GpIIb/IIIa

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9
Q

Thrombocytopenia (decreased platelets), decreased hemoglobin, schistocytes, increased LDH, and Increased creatine (kidney injury).
Normal PT/PTT

A

thrombotic microangiopathy (TTP/ or HUS)

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10
Q

Woman comes in with recurrent miscarriages, she also recently had a DVT and now presents with cerebral venous thrombosis (headache and papilledima)

A

she has factor V deficiency

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11
Q

Definition of relative risk.

A

Incidence rate of the exposed group divided by the incidence rate of the unexposed group. It is the likelihood an outcome based on if you were exposed versus if you were not exposed.

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12
Q

How do NSAIDs affect GFR

A

Prostaglandins dilate the Afferent arteriole, so NSAIDS it decrease GFR

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13
Q

how do ACE inhibitors affect GFR

A

angiotensin II constricts the efferent leading to an increase in GFR. So inhibiting it with an ACE inhibitor DILATES the efferent arteriole leading to a DECREASE in GFR

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14
Q

What two drugs can aminoglycosides work synergistically with?

A

Penicillins and monobactams

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14
Q

What two drugs can aminoglycosides work synergistically with?

A

Penicillins and monobactams

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15
Q

Boy presents with intellectual disability, long face, prominent ears and large testicles. What is the disease?

A

Fragile X syndrome due to trinucleotide repeat

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16
Q

Most common fractured carpal bone?

A

Scaphoid and presents with pain in anatomical snuffbox. need to treat bc it can lead to avascular necrosis

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17
Q

Most common dislocation during a FOOSH

A

lunate bone which can impinge medial nerve and cause carpal tunnel

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18
Q

what does CN 9 innervate

A

glossopharyngeal nerve provides motor and sensory information to stylopharyngeus nerve which helps with swallowing. also innervates parotid gland and provide sensory information to pharynx

19
Q

what part of the colon are diverticula most common?

A

sigmoid because it is the narrowest

20
Q

Monoclonal antibody that inhibits glycoprotein IIb/IIIa which inihibits platlet aggregation by that normally occurs because of binding with fibrinogen

A

Abciximab

21
Q

binds to adenosine diphosphate receptor (P2Y12 receptor) to inhibit platlet aggregation

A

clopidigrel

22
Q

phosphodiesterase III inhibitors reduce the degredation of adenosine

A

cliostazol and dipyridamole

23
Q

how does the liver or kidney regenerate after injury

A

in healthy indviduals the majority of cells are in G0 phase and can re-enter G1 phase after injury

24
Q

Pathogenesis of graves disease

A

Autoantibody that stimulates thyroid stimulating hormone receptors on thyroid follicular cells

25
Q

Myeloperoxidase deficiency MOA

A

inability to produce hydrochlorous acid within phagolysosomes

26
Q

Femoral neck fracture would cause?

A

Foot drop. because common peroneal nerve innervates dorsiflexion

27
Q

What is the mechanism of action of the pertussis toxin

A

It causes intracellular cAMP through inactivation of the Gi subunits of G protein couple receptors leading to unihibited adenylyl cyclase activity

28
Q

when is creatine kinase MB detectable after an MI?

A

6 hours

29
Q

What is CK MB indicative of?

A

coagulative necrosis due to increased cell membrane permeability which causes leaking of CK MB out of cytoplasm

30
Q

what is the definition of odd’s ratio

A

comparision of an outcome in the exposed group versus the outcome of an outcome in the unexposed group

31
Q

what happens during muscle disuse atrophy

A

Decrease in protein muscle synthesis and an increase in protein degradation.

32
Q

what amino acids do astrocytes transport?

A

glutamate, glycine, GABA

33
Q

where do Beta 1 receptors target

A

heart–> myocardial contraction

34
Q

Beta 2 receptor location

A

smooth muscle of bronchi and blood vessels, decreased uterine contractility

35
Q

what causes the formation of granulomas?

A

activation of IL-12 and IFN gamma

36
Q

Pathophysiology of hemochromatosis?

A

Mutation of HFE gene (iron sensing gene) which leads to abnormally increased intestinal absorption of iron

37
Q

sudden onset of pain, pulseless, cold extermity

A

embolic arterial occulusion

38
Q

Encephalomyopathy, lactic acidosis, reoccuring stroke-like episodes. Maternally inherited

A

Mitochondrial myopathy-MELAS

39
Q

What enzyme is deficient in facial flushing after alcohol consumption?

A

aldehyde dehydrogenase

40
Q

What happens between muscle contraction stimulus

A

sequestration of calcium in sarcoplasm reticulum to allow for relaxation

41
Q

What is tetany?

A

Increased firing that does not allow for any relaxation to occur and no calcium sequestration

42
Q

What infections are common in patients with chronic granulomatous disease?

A

catalase positive organsims. Staph, norcordia, burkholderia, asperigullus

43
Q

what kind of infections do patients with myeloperoxidase deficiency have?

A

Fungal

44
Q

where does osteosarcoma usually metastasize too?

A

Lungs

45
Q

what would be found on fine needle biopsy of a pt. diagnosed with hashimoto’s

A

lymphoid infiltrate with presence of hurthle cells

46
Q

what is the antibody in hashimoto thyroiditis?

A

antithyroglobin and antihryoid peroxidase antibodies

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