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Daily Flashcard Quizzes > NBME16 > Flashcards

NBME16 Flashcards

1
Q

Describe Fanconi syndrome

A

reabsorptive defect of PCT
cannot reabsorb anything

high excretion:
AAs
glucose
HCO3
PO4

may result in metabolic acidosis (proximal renal tubular acidosis)

can be caused by hereditary, ischemia, drugs, etc

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2
Q

what does Kullikrein do

A

cleaves High-molecular weight Kininogen to Bradykinin to help activate PTT coag cascade.

it’s also chemotactic for neutrophils

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3
Q

where do you see hamartomas, ash-leaf spots, and seizures

A

tuberous sclerosis

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4
Q

what murmur are you going to hear ~3 days after MI

A

you’re at risk for free wall rupture, leading to tamponade, papillary muscle rupture

that will give you mitral regurg

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5
Q

what is the mech of resistance for VRE

A

substitution of d-lactate for d-alanine in peptidoglycan

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6
Q

what PTH finding do you see in Sarcoidosis

A

hypercalcemia
(2/2 1-alpha-hydroxylase mediated vitamin D activation in macrophages)

high 1,25-dihydroxycholecalciferol

low PTH (negative feedback)

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7
Q

what is Charcot Marie Tooth

A

Hereditary Motor and Sensory Neuropathy HMSN

abnormal myelin sheaths

associated with foot deformities (hammer toes), LE weakness, and sensory deficits (steppage gait)

(vs Friedrich Ataxia, w/ Hammer toes and degeneration of oligodendrocytes)

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8
Q

what is the buzzword cell for interstitial nephritis

A

eosinophils.

The forum guy doesn’t think any other kidney problems have eosinophils

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9
Q

what would cause cell convolution

A

decreased function of a channel/membrane protein

reversible change- cell could swell

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10
Q

what structure inferior to ovary is at risk of damage during ovarian removal

A

ureter

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11
Q

what is dysthymic disorder

A

mild depression lasting >2yrs

low mood with at least 2 other depressive symptoms

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12
Q

what is the cause of Reye syndrome

A

cerebral edema; hepatic encephalopathy

not viral encephalopathy

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13
Q

how do you promote blood filtration to get more flow through lymph

A

increase hydrostatic pressure (with 0.9% Saline)

just increasing arterial pressure isn’t effective

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14
Q

what is Graft vs Host disease

A 
onset varies
Grafted immunocompetent (donor) T cells proliferate in the immunocompromised host and reject host cells. 
Leads to severe organ dysfunction
Type 4 hypersensitivity

gives you maculopapular rash, jaundice, diarrhea, HSM, etc.

usually in bone marrow or liver transplant

potentially beneficial in leukemia (graft vs tumor effect)

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15
Q

what is a cross-sectional study

A

“what is currently happening”

so i you wanted to know what was going on at work, you measure some risk factor and “disease” among your employees
(level of noise vs hearing)

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16
Q

what are PCOS lab values with insulin, T, and LH

A

Fasting Insulin: increased (glucose increased)

T: increased

LH: increased (LH:FSH >2)

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17
Q

what is complicated about surgical repair of horseshoe kidney

A

anomalous origins of multiple renal arteries to each kidney

not abnormal origin of SMA

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18
Q

what cytokine will be positive in a positive TB test

A

Interferon-gamma

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19
Q

what’s a common side effect of chemotherapy drugs

A

sensory loss 2/2 microtubule damage for axonal transport

commonly 2/2 Vincristine, which damages tubulin

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20
Q

how does chronic inflammation present

A

“lymphocytic infiltration and collagen deposition”

mononuclear (monocyte, macrophage, lymphocyte, plasma cell) and fibroblast-mediated
persistent destruction and repair (proliferation and fibrosis)
granulomas: made of epithelial macrophages and giant cells

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21
Q

what is abnormal in spherocytosis

A

spectrin protein deficiency

pt may have splenectomy to get rid of destructive cause

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22
Q

which organelle transports to the Golgi

A

RER

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23
Q

what might you see in Small cell lung carcinoma

A

“infiltrating sheets w/o distinct organization”

paraneoplastic syndromes, including SIADH
which would make the pt hyponatremic

can also see cushing syndrome (high ACTH)

24
Q

what happens to myocytes cells while they’re in a cast

A

polyubiquitination

25
Q

what is Vincristine’s intracellular target

A

Tubulin

26
Q

what is natural transformation

A

ability for bacteria to take up naked DNA (from cell lysis in the environment)

especially seen in SHiN bacteria:
S pneumo
H influenzae
Neisseria

adding deoxyribonuclease to environment will degrade the naked DNA and prevent transformation

27
Q

knee-jerk answer for older person with asplenia and meningitis

A

S pneumo

28
Q

what neuro finding caused decreased muscle mass

A

degeneration of motor neurons leads to muscle atrophy

may present with LMNs, or even UMNs

29
Q

where is the ligamentum flavum, posterior longitudinal ligament, and anterior longitudinal ligament

A

ligamentum flavum:
most posterior; just before spinal cord in LP

posterior longitudinal ligament:
just anterior to spinal cord

anterior longitudinal ligament:
anterior to vertebral bodies

30
Q

what’s the most important predisposing factor for gout

A

alcohol

31
Q

what would explain 3 abortions and one poorly formed baby

A

unbalanced chromosome rearrangement
(not gonadal mosaicism)

they can give you miscarriage, stillbirth, or chromosomal imbalance like in Robertsonian Down Syndrome or Patau

32
Q

what is the difference between high and low stage

A

metastasis and LN involvement

invasion through BM doesn’t count

33
Q

what kills bacteria (strep pneumo) inside of a neutrophil

A

lysosomal hydrolases

34
Q

what is a treatment target for RA after prednisone and methotrexate is ineffective

A

TNF-alpha

with Adalimumab, Certolizumab, Infliximab monoclonal Antibodies, that target soluble TNF-alpha

35
Q

what is an embolism defect considered in the lungs

A

dead space

perfusion defect

36
Q

what’s the most appropriate action if pt demands opioid refill w/o PE abnormalities

A

determine which drugs have been prescribed in the past

vs refer to drug addiction program

37
Q

what 2 things point to ZE syndrome

A

Gastritis + pancreatic mass

could also incl sweating, black stools, light-headedness

causes high gastrin release

38
Q

what do septal defects and a persistent truncus arteriosus indicate

A

problem with neural crest migration

39
Q

what provides sensation to penis and allows erection reflex

A

pudendal nerve

responsible for afferent component of penile and clitoral erection

40
Q

what is a leukemiod reaction

A

reactive neutrophilic leukocytosis

distinguished from CML because it has
LAP positive with granulocytes
no basophils
no 9;22 translocation

41
Q

what drug increases fertility in PCOS

A

clomiphene

42
Q

what can happen with morphine tx

A

morphine is metabolized to active metabolites that accumulate (morphine 6 glucuronide) that provides the analgesia, but this can lead to toxic accumulation

43
Q

how does intervertebral disc rupture present

A

nerve associated with the inferior vertebral body is impinged
generally herniate posterior-laterally because of thin posterior longitudinal ligament

severe pain that radiates down leg
starts “almost immediately” after insult, lifting something over your head

a sciatic nerve tear will be muscle weakness
muscle tear would be local swelling and tenderness

44
Q

what are lamellar bodies

A

secretory organelles

may be low in a neonate with ARDS 2/2 type 2 pneumocytes with low lamellar bodies

45
Q

how can poliovirus translate efficiently in the absence of a 5’ methyl cap

A

it has an internal ribosome entry site that directs the translation of its mRNA

46
Q

what is contraindicated when you give isosorbide dinitrate

A

sildenafil- life threatening hypotension

47
Q

what do Gi and Gs proteins activate

A

adenylyl cyclase, which uses ATP to increase cAMP , which increases Protein Kinase A

48
Q

what do Gq proteins activate

A

Phospholipase C, which works on Lipids/PIP2 to make 2 things:
DAG –> Protein Kinase C
IP3 –> increase Ca for SM Contraction

“Phospholipase C and Protein Kinase C”

49
Q

what is I-cell disease

A

inherited lysosomal storage disorder

defect in N-acetylglucosamine-1-phosphotransferase, causing a failure of the Golgi to phosphorylate mannose residues on glycoproteins

proteins are secreted extracellularly rather than delivered to lysosomes

causes coarse facial features, clouded corneas, restricted joint movement, high plasma levels of lysosomal enzymes

50
Q

what is neomycin’s MOA

A

“nuclear bomb to bacteria”

it kills bacteria in the gut that generate ammonia, which is a useful tx in hepatic encephalopathy

51
Q

how do you treat cyclophosphamide-induced hemorrhagic cystitis

A

Mesna

its thiol group binds the toxic metabolite

52
Q

what is the mechanism of Li-Fraumeni syndrome

A

impaired regulation of apoptosis

Li Fraumeni is associated with p53 mutation, which is a tumor suppressor gene

p53 normally inhibits a defective cell from going from G1 to S phase either by inducing apoptosis or activating repair enzymes. Mutation of p53 means the cell won’t be stopped at the G1/S checkpoint

53
Q

what is the first location that will show signs of anoxic injury in kidney

A

proximal tubule

ischemia, think tubule

54
Q

how will lungs present after 1 week of cigarette smoke exposure

A

high mucus production and secretion

low activity of airway cilia (carcinogens destroy cilia)

low alveolar macrophage function (someone said not required for clearance of smoke irritants…?)

55
Q

what cell plays a role in recognizing and killing the virus-infected tumor cells

A

Tumor cells are killed by CD8+ T cells and NK cells

better answer between the two (if you’re unlucky) is CD8+ T cells

this would be HPV-16 giving you squamous cell carcinoma of the cervix

Daily Flashcard Quizzes (21 decks)

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