NBME 30 Flashcards
Deformation vs Disruption
Deformation = teratogen
changes to structures AFTER embryonic period. Extrinsic forces limiting normal organ development (Potter sequence)
Disruption = normal development occurs but something causes an abnormality (bands + compress + encircle)
Renal papillary necrosis
Severe ischemic injury
Sickle cell
Obstructive nephropathy
NSAIDs
DM
Severe pyelonephritis
Osteopetrosis
Excessive mineralization of bone
OSTEOCLAST = remodeling and arises from monocyte-macrophage lineage
Porphyria cutanea tarda
Severe cutaneous photosensitivity = blistering + hyperpigmentation
Urine color change
Decrease uroporphyringogen decarboxylase (Heme synthesis)
Bortezomib
Proteasome inhibitor
prevents Ag processing on MHC1 = not CD8 T cell activation
Tx of MM
Melanosome
specialized organelle w/n melanocytes that produce melanin
Gap junctions
connexin = communication between cells
think cardiac myocytes
Tight junctions
Claudins (Ca++ dependent) & occludins
inflammation = increases permeability
Crohn
Pleural effusion
Pneumonia
Catalyzing the formation of plasmin
MOA of fibrinolytic drugs used when percutaneous coronary intervention/CABG not an option
Plasmin
serine protease that cleaves fibrin clots
AML
Adults w/ pancytopenia
blast cells
mouth ulcers or gingival hypertrophy = neutropenia
ALL = doesnt include platelet
15;17
Vit. A
Multiple Myeloma
Clonal proliferation of plasma cells in bone marrow
Plasma cells = clock-face
recurrent bacteria infections
Animal RBC agglutinates when
heterophile Ab is present which is seen in EBV
EBV associated with Burkitt lymphoma + nasopharyngeal carincoma
Primary myelofibrosis
clonal expansion of Megakaryocytes = increase TGFb
Cytopenias
Extramedullary hematopoiesis = splenomegaly
Dacrocytes
Councilman bodies
Hepatocytes = apoptosis + necrosis
Eosinophilic cytoplasm
Acute + Chronic hepatitis
Posterior medial aspect of the kidney
Abscess
Psoas fascia
Increase ALP
dense thickening of bony cortex
Osteitis deformans (Paget)
Hypermetabolic states
Burns
Sepsis
Post-surgery
Traumatic injury
Majority of TH exists in which form
T4-globulin
ETC
Complex 1 or 2
1 = NADH
2 = FADH2
Leber Hereditary Optic Neuropathy
Mit.-inherited
Degeneration of optic nerve & retina in C/L
NRDS
Inadequate production of Surfactant by type 2
Atelectasis = alveolar collapse
Proteinsceous debris
Calcium oxalate stone Tx
Thiazide = inhibits NCC channel
Low sodium diet
Potassium citrate
Lies posterior & inferior to aortic valve
Mitral
Ehrlichiosis
Intracellular pathogen = E. chaffeensis
Tx: doxycycline = 30s
Fever + headache + myalgia + rash
Thrombocytopenia + leukopenia + increase transaminase
Estrogen initial site binding receptor
Cytosol
TH goes to the nucleus
Degeneracy
Different codons encode for the same AA
Multiple tRNA exists exist for most amino acids
Glucokinase
Liver, β cells of pancreas
Carcinoid tumors
Neuroendocrine
GI tract = SI
5-HIAA
Actinic purpura
Dorsal hands + Forearm
Dermal collagen atrophy + chronic sun exposure = blood vessel fragility
Increase
1. Central venous pressure = decrease preload
2. Pulmonary capillary wedge pressure = decrease preload
Reduce TPR
Decreases Contractility
DM neuropathy
Formation of advanced glycation in vascular endothelium = ischemic nerve
Persistent activation Na+ nociceptor
Tx: TCA + carbamazepine
↑ LV EDV = ↑SV
↓Pulse
Stimulation of Baroreceptors
Arterial stretch
Decrease SA and AV nodal activity by ↓cAMP
AV node particularly sensitive— ↑ PR interval
Short acting
Esmolol
Cystic hygroma = lymphangioma + cystically dilated space filled w/ lymph fluid
Turner 45, XO
Supplies
1. Flexors
2. Sensory fibers to the lateral forearm
3. Supinate
Musculocutaneous
Anterior interosseous
Pure motor
Occult blood = melena
Nocturnal diarrhea
Worsening ab pain
Wt loss
Colon cancer
Family history
IBD
Soft
Fleshy
Skin- colored papules
HPV
Dilated Submucosa veins in the anal canal
Hemorrhoids
↓ K+
Excessive dieting
Laxative = ↓pH
Diuretics (low Cl- –> high bicarb) + Vomiting= ↑pH
Atazanavir
Darunavir
Lopinavir
Ritonavir
Protease inhibitors
McArdle enzyme
Glycogen phosphorylase
↑ glycogen in muscle = painful muscle cramps
myoglobinuria (red urine) w/ strenuous exercise
Arrhythmia from electrolyte abnormalities
Second-wind phenomenon noted during exercise due tomuscular blood flow
PAS+
McArdle disease (type V)
Reflux nephropathy
2° vesicoureteral reflux = retrograde flow of urine from bladder into ureter + renal calyces
Abnormal ureteric valve
Chronically → renal parenchyma atrophy + chronic renal failure
Uterine atony
Postpartum hemorrhage
Boggy uterus
Want uterus to contract & stop vessel dilation
Tx: uterine massage + oxytocin (Gq) = ↑Ca++
Which vessels lie posterior to the liver
Hepatic veins → drain into IVC
Avulusion of celiac trunk /aorta
Retroperitoneal hemorrhage
Kappa:Lambda should be
Equal; when the ratio is↑ (skewed) = CLL
Cancer of mature B cells = large blue cells + scant cytoplasm
Cytopenia + lymphadenopathy
Tx: ilbruti-NIB
Pt w/ EBV, the atypical lymphocytes on smear area
Cytotoxic CD8+ T cells
Migration at developing thyroid gland
Along the thyroglossal duct
Base of neck = superior mediastinum
Base of tongue = thyroglossal duct
Muscarinic vs Nicotinic receptors
CNS = muscarinic
ONLY PNS = nicotinic
Cyclosporine
Calcinamin inhibitor = no T cell (IL-2) proliferation
Can cause stones
