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UworldSUN > P2W1 > Flashcards

P2W1 Flashcards

1
Q

which neurons are unmyelinated

A

C fibers, slow pain, heat and olfaction for efferent. for afferent only the postganglionic autonomic neurons

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2
Q

what do you not use in x4 viruses? what are navirs and gravirs

A

maraviroc. protease and integrase inhibitors

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3
Q

difference between projection and transference and counter transference

A

projection is im mad at you so i think youre mad at me, and transference is my other friend made me mad so you are making me mad. counter transference is provider to patient

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4
Q

short palpebral fissures, bifid uvula, cleft palate, absent thymic shadow, chovstek sign, trosseau sign, dx and what is the embryological abnormality?

A

diGeorge, missing 3rd pharyngeal pouch

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5
Q

before alanine is made into glucose where does nitrate group need to transfered to?

A

alpha ketoglutarate

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6
Q

what viruses replicate in cytoplasm and nucleus and exceptions for both?

A

RNA and DNA; orthomyxovirus/retrovirus and poxvirus are exceptions

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7
Q

IgE blocker for asthmatic, moa?

A

reduces inflammation caused by histamines and leukotrienes

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8
Q

patient with GCA what is the inflammatory marker,and rx?

A

IL-6, tocililuzumab

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9
Q

full term baby, clitoromegaly, elevated androgens, 46XX, normal uterus. maternal virilization. what is dx?

A

not CAH. because maternal virilization in aromatase deficiency

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10
Q

boy XY with ambigious genitalia found that sertoli is not working, what are the internal and external organs look like? sertoli cell functinos (3)?

A

male and female for internal, male for external. sertoli cells make AMH (anti-mullerian hormone), androgen binding protein that concentrates testosterone, and inhibin to reduce FSH production

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11
Q

lung cancer with hyponatremia, what cellular marker is positive?

A

chromogranin, synpatophysin, NCAM neural cell adhesion molecule. vimentin is mesenchymal

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12
Q

in DNA replication, what removes the RNA primers to put down DNA?

A

DNA pol 1

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13
Q

stab wound in the back, which muscle internally rotates the humerus

A

lat dorsi

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14
Q

pectum excavatum and visual difficulties, dx and complication of this?

A

marfans, aortic dissection/murmurs

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15
Q

sequence of mRNA given, beta thalassemia- point mutation. what is the process that is disrupted?

A

kozak sequence, initiation of translation. GCCGCCRCC

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16
Q

how do SGA (second generation antipsychotics work)

A

block D2 receptors less strongly as well as 5HT-2A

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17
Q

most common lysosomal storage disease, what enzyme

A

gaucher, beta- glucocerebrosidase

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18
Q

headahces palpitations, flushing, BP crazy high, and fast heart beat, CT shows mass on the right dx?

A

catecholamine secreting tumor, urinary VMA and metanephrines

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19
Q

what drug causes increase in renal blood flow at low doses, and at high doses increases heart rate and lowers renal flow?

A

dopamine

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20
Q

34 yo man with hemotptysis shows bornchial mass with biopsy, polygonal eosinophilic cells positive for synaptophysin and chromogranin, dx?

A

carcinoid syndrome, two sources- GI (active) and bronchial (inactive)

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21
Q

dilation of aortic arch and hoarseness, what is dx and which muscle damaged?

A

LEFT recurrent laryngeal nerve, and innervates everything except cricothyroid

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22
Q

FOOSH complications (2)

A

lunate fracture- median nerve compression. scaphoid- avascular necrosis and anatomical snuffbox

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23
Q

MG rx and rx for SE of rx

A

cholinesterase inhibitor, then selective muscarinic antagonist glycopyrrolate

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24
Q

NNT equals

A

1/ARR

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25
Q

what nerve is vulnerable during thyroidectomy and what muscle?

A

superior laryngeal- cricothyroid. every other muscle in this region is recurrent laryngeal

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26
Q

small circular DNA in eukaryotic cells coding for rRNA, tRNA, proteins, where is this found?

A

mtDNA

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27
Q

para para, thymus is derived from which one together with what?

A

3rd pharyngeal pouch with inferior parathyroid

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28
Q

spherules that contain endospores, dx?

A

coccidioides

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29
Q

how does bone mets occur and through what path in the pelvis

A

hematogenous, vertebral venous plexus

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30
Q

mass in the tongue, biopsy, pink material inside surrounded by cells, what embryonic process failed?

A

migration- thyroid

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31
Q

cox 2 inhibitor side effect?

A

prevents Prostacyclin PGI2, which is a vasodilator, causing thrombotic events

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32
Q

dyspnea in obese male with hypercarbia with normal A-a gradient, dx and mechanism?

A

obesity hypoventilation syndrome (OHS)

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33
Q

99tm pertechnate positive in RLQ, with GI blleding in 4 yo, dx?

A

meckels

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34
Q

difference between NMS and serotonin syndrome

A

onset is slower for NMS, and has lead pipe rigidity with hyporeflexia, while SS has hyperreflexia and clonus

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35
Q

aortic dissection. biggest risk factor? smoking or HTN

A

HTN

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36
Q

diuretics effect common and unique,

A

CA inhibitor-metabolic acidosis. loop diuretic- no hyponatremia but volume depletion, hypocalcemia (unique). thiazide- hypercalcemia. All diuretics increase aldosterone, so K and H are low, except potassium sparing (also is metabolic acidosis

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37
Q

structure of MHC class II molecules and what is degraded during antigen processing

A

alpha beta chain and invariant chain which is degraded

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38
Q

how is elisa done?

A

antigen, then serum then anti human antibody with peroxidase attached, then susbtrate

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39
Q

sepsis due to GI blood loss, what is elevated in smooth muscle of bv of the patient? what is the only receptor that uses this…

A

IP3 because , alpha 1 receptors, vasoconstricting via Gq

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40
Q

Rb familial leads to what cancers

A

retinoblastoma and osteosarcoma

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41
Q

lacking nissl bodies in neurons, eosinophilic. nuclear shrunk, what is mechanism?

A

irreversible ischemic injury. nissl body is ER

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42
Q

DKA, nasal eschar, facial pain, headache, dx? and how to dx?

A

mucosal biopsy, its mucormycosis caused by mucor or rhizopus

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43
Q

guy in a bar fight last week gets nasal packing, which later reveals purulent discharge and erythema. then also has septic shock with a diffuse erythematous rash, dx and mechanism?

A

TSS by Staph aureus- nasal packing/tampons lead to TSS, via a superantigen which doesn’t need MHC class 2 processing (usually done by phagolysosome) but directly activates T cells. TLR activation is done by LPS, endotoxin

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44
Q

man with altered mental status, renal failure and oxalate stones and tubular degeneration with ballooning, dx?

A

ethylene glycol poisoning

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45
Q

sawtooth appearance in skin rash, hyperkeratosis, eosinophilic colloid bodies, dx

A

lichen planus

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46
Q

infertile guy, normal testosterone and LH, but testosterone concetrations low in seminiferous tubules and epididymus. dx?

A

sertoli cells not producing enough ABP, which keeps the testosterone in the lumen

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47
Q

gel electrophoresis shows after induction, 85 kDa is initally big then goes away and 35 and 45 kDa show up. what is happening?

A

proprotein is formed then cleaved into protein

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48
Q

what causes differentiation of cells and de-differentiation?

A

transcription factors

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49
Q

barefoot, transient skin rash,thin walled eggs in stool, what is complication? and dx

A

hookworm (necator, ancylostoma) , IDA

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50
Q

denervated eye, what drug causes constriction?

A

pilocarpine because it works not via acetylcholinesterase like physostigmine but as a cholinomimetic

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51
Q

median radial ulnar what muscles does it go between

A

pronator teres heads/FDP and FDS; deep and superficial extensor muscles; FDP and flexor carpi ulnaris

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52
Q

what happens in the lymph node germinal centers?

A

isotype switiching of B cells. the VDJ shit happens in the bone marrow

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53
Q

what form of virus is infectious by itself?

A

SS positive RNA, can replicate on its own. picornavirus

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54
Q

describe tract from eye (temporal ) to occipital lobe

A

ipsilateral optic nerve, lateral optic chiasm, optic tract, lateral geniculate nucleus, optic radiation, primary visual cortex

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55
Q

push against wall, winged scapula, what muscle and nerve?

A

serratus anterior, long thoracic nerve

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56
Q

how do azoles work, how about ampho B and side effect?

A

ergosterol synthesis vs ergosterol binding and pore formation. SE of azole is P450 inhibition

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57
Q

tyrosing kinase receptor binds ligand, what happens after?

A

dimerization, phosphorylation

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58
Q

pompe disease carrier wants kid, sperm donor doesn’t have but may be a carrier, incidence is 1/40000, what is likelihood of kid being affected?

A

p2 plus 2pq plus q2, so q2 equals 1/40000

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59
Q

systolic heart failure, milirinone mechanism?

A

PDE3 inhibitor, increases CAMP, increases myocardial contractility and causes vasodilation

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60
Q

TMP-SMX increases the INR of warfarin. why?

A

hepatic enzyme inhibition. CYP450 inhibition by TMP leads to less metabolism of warfarin leading to higher INR

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61
Q

chromosome translocations (3 lymphoma 3 leukemia). which one does bcl 2 and which one does c-myc and which one does cyclinD

A

(8,14)-burkitts, (11,14)-mantle cell, (14,18)-follicular. (12,21)ALL, (15,17) AML, (9,22)- CML. c-myc is burkitt, bcl2 is follicular, cyclin is mantle

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62
Q

what physiologic function leads to positive anti-histone antibodies?

A

acetylation of liver (phase 2 liver reaction)- drugs that cause drug induced lupus are metabolized by liver this way

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63
Q

3 ways that virus get new genetic material and explain

A

transduction- virus, transformation- pick up off the street, conjugation- sexy time

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64
Q

mechanism of TMP-SMX, similar drugs

A

sequential blockade; blocks DHF then THF synthesis from PABA. methotrexate (humans) and pyrimethamine (protzoans) works the same way

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65
Q

needle shaped, azure, cytoplasmic inclusions on sphere with blasts, dx and chromsomal translocation?

A

auer rods, acute promyelocytic leukemia, t(15,17)

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66
Q

alcohol cessation drugs (3)

A

acamprosate (NMDA), naltrexone (mu opioid), aldehyde dehdrogenase inhibitor (second line)

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67
Q

hypertensive emregency with AKI, what drug improves renal perfusion and natriuresis?

A

fenoldopam (dopamine-1 receptor agonist) causing vasodilation

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68
Q

how does leuprolide affect testosterone and DHT

A

both go up and come down in CONCERT. leuprolide does not affect 5-alpha reductase

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69
Q

macrocytic anemia, in woman with autoimmune thyroid disease, what is dx and mechanism. WHAT secretion is elevated?

A

pernicious anemia, chronic atrophic gastritis, causing mucosal destruction, which means no acid, which means increased gastrin

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70
Q

parasite ova detected after a person has an episode of wheezing, cough and dyspnea, dx and why respi sxs? what type of hypersensitvity?

A

ascaris, due to transpulmonary migration, IgE! (eosinophilic)

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71
Q

fluid filled capsule in the internal capsule after a pure motor stroke, due to what?

A

HTNive arteriolar sclerosis

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72
Q

intraerythrocytic organisms (3)

A

MBB- malaria (anopheles mosquito), babesiosis and bartonella

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73
Q

posterior aspect of shoulder trauma, cannot externally rotate arm, what muscle is damaged?

A

infraspinatus

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74
Q

young woman with headache, bilateral papilledema, visual disturbances, dx? what is mechanism of papilledema

A

IIH, optic nerve compression due to increased INTRACRANIAL not intraocular pressure

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75
Q

62 yo with constipation, low back pain, weight loss, perianal anesthesia, what is dx and nerves?

A

cauda equina syndrome, greater splanchnic nerves

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76
Q

person using cocaine just had MI, hypokalemia. why?

A

beta stimulation, produces insulin, as well as speeds up the Na/K ATP pump, pushing K inside.

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77
Q

what makes drug more inclined toward hepatic metabolism and not renal?

A

high lipophilicity and high volume of distribution

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78
Q

neutropenic fever, most likely cuprits?

A

patient’s own endogenous flora

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79
Q

sarcoidosis and hypercalcemia, what is the link?

A

activated macrophages express 1-alpha hydroxylase which makes 1,25- dihydrovitamin D

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80
Q

genetic frequency of 2 HLA-DR genes together is greater than expected, what is this called?

A

linkage disequilibrium

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81
Q

HPV likes to infect where else in the body and why

A

true vocal chords because predilection for stratifed squamous

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82
Q

dying cells apoptosing but still making protein, mechanism?

A

internal ribosome entry- 5’ UTR has a region that allows for mRNA translation in the beginning, even without the eIF (eukaryotic initiation factors)

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83
Q

TST for tuberculosis and for candida injection test and wheal/flare test uses what cell types response primarily

A

T cell, delayed hypersensitivty (typeIV)

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84
Q

dysphagia, food sticking, barium studies show birds beak, dx and mecahnism

A

achalasia, because myenteric plexus knocked out, specifically the inhibitory ganglion cells

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85
Q

woman with MVA presents with HA and neck pain, fracture in C2 foramina. then has nystagmus, ipsilateral cerebellar signs, loss pain/temperature in ipsilateral face and contralateral body, bulbar weakness, ipsilateral horners, where is the lesion?

A

vertebral artery dissection leading to PICA occlusion leading to lateral medullary wallenburg syndrome

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86
Q

molluscum contagiosum, biopsy?

A

eosinophilic intracytoplasmic inclusions

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87
Q

triple positive breast cancer treated with monoclonal antibody, what is it and what signaling mechanism?

A

Herceptin, tyrosine kinase

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88
Q

neonatal tetanus how to prevent and treat

A

prevent-maternal vaccination, treat- antibiotics and immunoglobulins

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89
Q

invasive breast cancer, what causes skin retraction

A

suspensory ligament fibrosis and shortening

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90
Q

metabolic acidosis in baby, with branched-chain alpha keto acids in blood and urine, dx and cofactor used in the enzyme?

A

maple syrup urine disease, thiamine for alpha-ketoacid dehydrogenase

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91
Q

muscarinic agnoist leads to what? in sm muscle

A

NO prodcution and vasodilation

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92
Q

difference bwetween complete and partial mole

A

complete is 46XX - absent ovum and sperm meet. absent fetal tissue, mostly hydropic villi, can progress to chorioCA. partial is XXX or XXY 69, two sperm fertilize one egg, present fetal tissue

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93
Q

rett syndrome inheritance

A

x linked dominant, in girls, guys die in utero

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94
Q

patient has urge to move legs at night, with IDA, what is dx and rx?

A

restless leg syndrome, dopamine agonist like pramipexole

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95
Q

9 mo girl with fever, then rash on the trunk with no fever. dx?

A

roseola HHV-6. rubella and measles have rash from face to trunk and spread. fever and rash come together

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96
Q

why does HbF have greater affinity for O2?

A

histidine replaced by serine, binds less tightly to 2,3BPG

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97
Q

patient has hemoptysis but no B sxs. past history of TB and has a cavity in a lung, now somehting is growing in that cavity, dx?

A

aspergilloma

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98
Q

over the decades more incidences of s aureus bacteremia, cause?

A

increased use of intravascular catheters

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99
Q

patient is hypoglycemic. but no symptoms of tremor, tachycardia etc, but hungry. what drug is causing this?

A

propranalol (blocking the neurogenic/autonomic symtpoms of hypoglycemia due to epinephrine/norE release. but not the ones mediated by Ach (hunger)). on top of that, blocking epinephrine induced gluconeogenesis/glucagon secretion

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100
Q

halflife equation

A

0.7*Vd/clearance

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101
Q

intermittent abdo pain, dark urine, neurological manifestation, no skin rash, dx? if skin rash, dx?

A

Acute intermittent porphyria- deficiency of PBG deaminase. If photosensitivity, caused by porphyrinogens. could be porphyria cutaneous tarda or also could be ferrochelatase

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102
Q

reentrant pathway, accessory conduction pathway, what is changes on ECG?

A

delta wave, short PR interval, widened QRS (WPW- ventricular preexcitement)

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103
Q

what cytokine is only made by lymphocytes?

A

IL-2. lymphocytes favorite cytokine. IFN alpha fights against virus

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104
Q

cavernous hemangioma increased risk of?

A

seizures and intracerebral hemorrhage

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105
Q

kid with fever and facial rash, now parent with arthritis, dx?

A

parvovirus b19

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106
Q

rod shaped kinetoplasts and chronic pinkish papule

A

leishmaniasis- from parasitic sand fly with protozoa

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107
Q

pseudomonas has an antibiotic-modifying enzyme, what antibiotic is it resistant to?

A

gentamycin (protein synthesis inhibitor)

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108
Q

distal hardening of finger bones, brief morning stiffness, activity related, acetaminophen doesn’t help.dx?

A

OA, RA is spongy swelling

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109
Q

what vessels have the lowest o2 content?

A

coronary sinus (heart has the greatest capillary network, leading to high oxygen demand)

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110
Q

guy with substance abuse problems, comes in and has hypersonolence, hyperphagia dysphoria and vivid dreams. which withrdrawal sxs is this?

A

cocaine

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111
Q

2 examples of true and false diverticula

A

true- meckels and appendix false- zenkers and diverticulosis in the colon

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112
Q

urine that turns black, what amino acid pathway is deficient

A

tyrosine to fumarate, dx: alkaptonuria due to build up of homogentisic acid

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113
Q

young woman with loud s2, parasternal heave, clear lungs, family history of mother dying at 40, dx?

A

pulmonary arterial hypertension (BMPR2)

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114
Q

bilateral sensorineural hearing loss and long QT, what is defect?

A

potassium channel- Jervell and Lange-Nielsen syndrome

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115
Q

hamartoma in lung? what is defintion?

A

abnormal mixture of cells in a normal location, chondroma in lung is common hamartoma

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116
Q

radiation accident, a lot of radioactive iodine release, what do you give?

A

potassium iodide to block uptake of radioactive iodine, protect the thyroid

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117
Q

psoriasis in young man, treatment?

A

Vit D analog (prevent hyperkeratinization) and corticosteroids,

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118
Q

struvite stone why did they form? mechanism

A

urease producing organisms made urine more alkaline because urease makes ammonia

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119
Q

man with transplanted kidney who gets allopurinol rx for gout, what drug that he is taking now will be affected and how?

A

azathioprine, 6-MP. This gets converted via XO to inactive metabolite but since XO is inhibited, it will boost the effects of this. effect is that 6-MP is like a fake purine that gets added to PRPP and HGPRT thinks it’s a purine

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120
Q

what lipid drug causes hypertriglyceridemia?

A

bile acid sequestrants, cholestyramine, col drugs. work in colon to prevent enterohepatic circulation. liver uses cholesterol to make more bile acids, but then SE makes more triglycerides

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121
Q

person w HIV develops hematological malignancy and then develops candida in the blood, fungemia. what defense mechanism breach led to this?

A

neutropenia. localized candida is T lymphocytes. so HIV predisoposes to candidiasis locally but systemic has to do with neutropenia

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122
Q

kids have FGFR when parents dont. what is genetic mechanism called?

A

germline mosaicism

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123
Q

3 enzymes used as antioxidants

A

superoxide dismutase, catalase, glutathione oxidase. NADPH oxidase is used to make O2-

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124
Q

heart failure, what diuretic improves mortality

A

spironolactone because it blocks aldosterone remodeling of heart

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125
Q

maxillary sinusitis how did it enter

A

middle nasal meatus

126
Q

how does estrogen protect against osteoporosis?

A

makes OPG (binds RANK to prevent RANK-L from binding) and decreases RANK production. RANK and RANK-L interaction leads to osteoclast maturation

127
Q

postauricular LAD, rash that spreads from face to trunk and extremities, what virus?

A

togavirus, dx: rubeola

128
Q

HEME synthesis- TB rx, lead poisoning

A

SA-PHUC-PH. ALA synthase needs B6. ALA dehydratase is inhibted in lead poisoning (and ferrochelatase). PBG deaminase for AIP, uroporphyrinogen deaminase in Porphyria cutanea tarda

129
Q

serotonin syndrome, rx?

A

octreotide

130
Q

gential lesions, vesicles, now has targetoid rash over the arm and mouth, dx? and a/w?

A

erythema multiforme- HSV and mycopalasma, and can lead to SJS and TEN

131
Q

wife has a kid with SCA, new husband, what to do to check for risk?

A

husband hb electrophoresis. it is autosomal recessive

132
Q

dizziness, retrograde flow through left vertebral artery, dx?

A

subclavian steal. atherosclerosis /obstruction in subclavian proximal to the left vertebral, causing steal from R vertebral.

133
Q

how does combined OCP and progestin- local and progestin systemic work?

A

local is to stop sperm from invading, systemic-including the COCP and systemic progestin (IUD) is to downregulate FSH/LH.

134
Q

HLA B*57:01 , HIV patient, don’t give which drug

A

abacavir

135
Q

why do you get green color in sputum in pneumonia?

A

myeloperoxidase is a blue green heme based enzyme that makes hypochlorous acid,

136
Q

older asian woman, smoker and rinker and fam history of breast ca in mother, eats food that she makes, renal mass shows cuboidal cells with clear cytoplasm. what is the risk factor associated with this condition

A

smoking. RCC

137
Q

young guy with both arms jerking in a seizure, rx?

A

broad spectrum- valproic or levitiracetam - because involves both hemispheres

138
Q

silicosis has tuberculosis why?

A

macrophages phagolysosome formation is disrupted

139
Q

22 yo guy with recurrent purulent papules on the back. why

A

rx doesn’t clear Staph aureus from nares (i though it was CGD but maybe cause no infections from young

140
Q

10 yo boy comes with fever, hypotensino, tachycardia, then develops new murmur, biopsy of heart shows these weird multi nucleated like cells in the myocardium, dx?

A

aschoff bodies and anitschkow cells due to rheumatic fever

141
Q

otitis leading to temporal lobe abscess, how did it gain entry?

A

mastoid air cells. ethmoid and maxillary is frontal lobe abscess

142
Q

32 yo woman with lump in throat, dysphagia of saliva, examination and investigation there’s nothing. dx?

A

globus sensation. feels psy

143
Q

focal neurological deficits and CT shows hemorrhage near the basal ganglia/thalamus area, dx?

A

charcot bouchard aneurysms of lenticulostriate arteries causing intraparenchymal hemorrhage in deep brain structures

144
Q

propofol effect fast on fast off, what is the mechanism?

A

highly lipophilic, leads to rapid redistribution of the drug

145
Q

after pregnancy, PVB, significantly increased B-HCG, hemoptysis, dx and what do you see on endometrial biopsy

A

chorioCA, proliferation of cytotrophoblasts (cyto- makes cells) and synctitiotrophoblast (synct- synthesizes hormones) with no villi

146
Q

kid scratching between toes, exhibit shows branching hyphae, rx?

A

clotrimazoleor miconazole, the antifungal cream! not permethrin- would show ova and feces on the scrape

147
Q

pulmonary embolism, O2, CO2, pH levels

A

low low high, CO2 due to hyperventilation

148
Q

homonymous hemianopia with macula sparing where is the defect?

A

PCA. macula sparing because MCA and PCA dual supply at the occipital pole

149
Q

social anxiety disorder rx?

A

SSRI, not beta blocker only if performance driven

150
Q

isoniazid causes what and how?

A

B6 deficiency due to increased excretion of B6. B6 makes GABA so neuropathy is common in isoniazid

151
Q

misoprostol and mifepristone moa

A

PGE analog and progesterone antagonist

152
Q

painless goiter, hypothyroidism, radiation exposure, diffuse lymphocytic infiltrate with epithelial cells that have prominent nucleoli and abundant eosinophilic cytoplasm, dx?

A

hashimotos and hurthle cells

153
Q

excessive eating, small hands and feet, temper tantrums in 3 yo boy, FISH cannot detect anything. dx and problem?

A

prader-willi, loss of paternal chromosome 15 all comes from mom

154
Q

mitral stenosis, when do you hear the snap

A

right after mitral valve opens

155
Q

prostate on MRI

A

right below pubic symphsis, and above anal canal and levator ani

156
Q

what is FGF 23

A

released in high phosphate states, to decrease 1-alpha hydroxylase, drops calcium reabsorption

157
Q

53 yo frequent headache and dizziness, high BP, facial plethora, splenomegaly, erythrocytosis, thrombocytosis, leukocytosis, dx and mutation?

A

poly vera, JAK/STAT WHICH IS A CYTOPLASMIC tyrosine kinase. bcr abl is too

158
Q

how do you treat CAH, 21 deficiency?

A

exogenous corticosteroids, replaces cortisol and stops ACTH excess production

159
Q

AIP (porphyria) what enzyme is deficient and what is management?

A

PBG deaminase. Give Hemin, which blocks ALA synthase. AAPHUC. order of substrate

160
Q

osteoporostic lady just had a fracture, what would the parathyroid hormone and calcium level be

A

normal

161
Q

haploid organism, outer and inner membrane but no nuclear membrane, and resistance to SOME penicilins. is it ecoli or chlamydia

A

ecoli, because chlamydia has a weird cell wall

162
Q

reye’s syndrome histo findings? sxs?

A

microvascular steatosis without inflammation, hepatomegaly vomiting and encephalopathy

163
Q

fastest and slowest cardiac conductino

A

purkinje (interventricular septum), atria, ventricles, av node

164
Q

what skin condition does celiac disease cause and why?

A

dermatitis herpetiformis because of tissue transglutaminase in the dermis

165
Q

baby with illness then won’t weight bear, where in bone is affected?

A

metaphysis, hematogenous osteomyelitis, slow blood flow in this area is good for infection progressing to necrosis

166
Q

middle aged guy with SOBOE, nodular densities, calcified hilar lymphnodes, biorefringent particles surrounded by dense collagen fibers, dx?

A

silicosis

167
Q

macroorchidism and joint laxity and learning difficulty in teenage boy, dx?

A

fragile x

168
Q

HLA associations

A

audiA3, O behave, PAIR, celion dion, hay multiple wolves pasture, 4 walls in a room, five-itis

169
Q

most common cause of viral meningits and viral family

A

enterovirus- picornaviridiae

170
Q

gowers sign only, getting worse. what is the inheritance. what is possibility that fetus son will get the disease?

A

1/2 x linked recessive. because it’s a boy. half the boys will get it, half the girls will be carrier

171
Q

how does adding enzyme affect the lineweaver burke plot?

A

y int is 1/vmax, x int is 1/km. adding enzyme increases vmax, but km (affinity) stays the same

172
Q

suspect cholecystitis, but initial imaging inconclusive, what following diagnostic test results with clinch dx?

A

not presence of echogenic structures, but the absence of gall bladder on radionuclide biliary scan

173
Q

serum glucose, sodium, and potassium levels in DKA

A

high low high/normal

174
Q

HCMC anemia with glossal pain, dry mouth etc

A

IDA

175
Q

recurrent stone formation in 16 year old, testing shows hexagonal crystals in the urine, dx?

A

cystinuria, because of defective dibasic amino acid transport

176
Q

vesicular rash on gums hardpalate and lips, what kind of virus? DNA/RNA/SINGLE/DOUBLE/NAKED/ENVELOPED

A

HSV-1. herpangina/HFMD is cosackie (RNA). HSV1 is DNA double strand, enveloped. parvo is single strand naked DNA

177
Q

patient with RTA, stabilized, then 2 days later has hypoxemia and tachypnea. ARDS pathophysiology?

A

endothelial damage leads to activated macrophages releasing cytokines and inflammatory mediated by neutrophils which damage and make membrane permeable

178
Q

gastrectomy, glossitis and macrocytic anemia. which portion of spinal cord damaged?

A

subacute combined degeneration- posterior column and lateral column (ataxia and spastic paresis)

179
Q

case control study, risk difference or odds ratio

A

odds ratio because you can pick the number of cases and controls

180
Q

cirrhosis, trichrome stains blue, what is the cell responsible for this

A

stellate cell of ito. usally stores vit A but when activated by injury it transforms into myofibroblasts that secrete collagen which stains blue on masson trichrome stain. Kupfer cells are the phagocytic macrophages

181
Q

TB meningitis leads to what type of hydrocephalus and how. other conditions that can cause this?

A

non-communicating because no CSF obstruction, destruction of arachnoid granulations lead to widespread dilation of ventricles. SAH and intraventricular hemorrahge can

182
Q

difference between somatic symptom, illness anxiety, conversion and factitious

A

somatic symptom got somatic symptom, illness anxiety no symptoms, conversion is neuro symptom, factitious is acting

183
Q

what drug given for HTN without affecting HR, patient has bradycardia

A

nifedipine (CCB)- dihydropyridine. verapamil and diltiazem affect heart

184
Q

patient with gout, given drug that binds to enzyme that is induced by IL-1, and inhibits inflammation, what is the drug? how does predinosone work?

A

celecoxib. COX-2. prednisone express anti-inflammatory peptides by affecting DNA

185
Q

waxy eosinophilic casts, gamma gap, dx?

A

MM

186
Q

PTSD for less than 1 month is called?

A

ASD

187
Q

absent cerebellar vermis and dilated fourth ventricle dx?

A

dandy-walker

188
Q

preproinsulin, has N-terminal hydrophobic residues that are missing. where does it get stuck?

A

cytosol. the N-terminal stuff takes it to the ER

189
Q

guy with COPD gets IM injection of a vaccine, which he gets yearly. how does vaccine prevent infection?

A

prevents viral entry by making antibodies against the hemagglutinin antigen, preventing entry. THIS is MOA for inactivated viruses, given IM, because they cannot infect cells, leading to humoral response. For live attenuated viruses given via intranasal, you generate cell-mediated response to attack infected cells

190
Q

man with obstructive urinary symptoms, smooth enlarged prostate, PSA normal, has hematuria (RBC) and cystoscopy shows increased trabeculations in the bladder wall, dx? and cause of hematuria?

A

BPH,friable vessels in the prostate. bladder CA you would see mucosa changes and have more storage sxs not obstructive

191
Q

thiazide diuretics side effect?

A

decreased glucose uptake and increased insulin resistance, and raising cholesterol

192
Q

19 yo woman in MVA, PMH of celiac, 3 episodes of pneumonia now has anaphylaxis after ABO transfusion, dx?

A

IgA deficiency, IgE can form against IgA, ABO would be antibody mediated and c1 inhibitor ONLY causes angioedema

193
Q

what drug reverses bronchial airway muscle contraction?

A

atropine and anticholinergics. edrophonium is a ACh-ase inhibitor and so is physostimine

194
Q

pupillary reflex blown and doll’s reflex blown, where in the brain is affected?

A

midbrain and pons respectively

195
Q

asbestosis exposure leads to what 2 cancers and which more common?

A

bronchogenic CA and mesothelioma, former

196
Q

moa of acyclovir

A

complete inhibtion of DNA replication. drug is a guanosine analog?

197
Q

pancytopenia without hepatosplenomegaly with recent respi infection

A

aplastic anemia

198
Q

additive permissive synergistic

A

additive and synergistic must have 2 drugs with similar effect. permissive is cortisol and glucagon/catecholamines

199
Q

phosphotidyl is protective or not protective of cholesterol stones?

A

protective

200
Q

chest tube insertion, cannot lift arm above head, muscle?

A

serratius anteror

201
Q

73 yo woman with low grade fever and leukocytosis and abdo tenderness with mass palpated in LLQ. diagnosis?

A

diverticulitis! can have mass. hernia should be in the groin

202
Q

explain heteroplasmy with an example

A

mitochondrial diseases, coexistence of distinct mTDNA genomes in an individual cell, explains the variability of expression in affected offspring of mother

203
Q

woman with type 1 DM, now has weight loss, ACTH test doesn’t do anything, hyperpigmentation, what are Na, K, Cl, and HCO3 levels and dx

A

low high high low- primary hypoaldosteronism (autoimmune)

204
Q

pancreatitis, AST2x>ALT, no stones, what will clinch dx?

A

macrocytic anemia due to folate def. alcohol related. can have hypocalcemia, hyperglycemia, leukocytosis, hyponatremia but all non-specific consequences of pancreatitis

205
Q

bugs crawling on skin

A

NOT LSD. spend more than 20 seconds reading the question carefully

206
Q

fever, joint pain urticarial rash, liver enzymes highly elevated, hepatomegaly, jaundice, dx?

A

HEP B, Hep C has no rash

207
Q

asthma, eosinophilia, sinusitis, granulomatous, dx?

A

p-anca churg-strauss polyangitis

208
Q

BRAF mutation, brain mets, where is source?

A

melanoma, BRAF V600E is common mutation

209
Q

patient with depressino taking SSRI is treated for cellulitis couple days ago, now comes in with diaphoresis, tremulus, clonus, hyperreflexia, dx? what drug?

A

SS kicked off by linezolid which also has MAO-i activity

210
Q

19 wks pregnant, US fetus shows bilaterally enlarged kidneys with diffuse small cysts, low AFI. what complication will boy have at birth? dx/

A

respi distress because of potter sequence due to oligohydramnios, ARPKD. can have HTN but later. aneurysm in ADPKD

211
Q

confusion, ataxia, opthalmoplegia, where in brain is affected?

A

mammilary body, above the midbrain

212
Q

pancreatitis because of hypertriglyceridemia, drug?

A

fenofibrate

213
Q

woman with lupus nephritis treated with prenisone and goes berserk, what is wrong and what WBC is high on CBC?

A

corticosteroid induced psychosis- RF is hypoalbuminemia. and neutrophil is high due to margination- the bats come off

214
Q

callous is thickening where

A

stratum corneum

215
Q

baby boy who is regressing in developmental assessment, anemia, from a poor part of town, what is dx and enzymes inhibited?

A

lead poisoning, 5-ALA and ferrocheletase

216
Q

saggy eyes, skin changes in old people due to what?

A

collagen fibril production

217
Q

Vancomycin moa

A

d-ala-d-ala binding. some bacteria mutate to d-ala-d-lactate

218
Q

how is CFTR gated?

A

two ATP, cyclic AMP is for olfactory and photoreceptor neurons

219
Q

tetatnus where does it travel in the body

A

puncture wound–>motor neurons –> spinal interneurons (inhibitory)

220
Q

what gene causes resistance to penicillin

A

mecA

221
Q

high A-a gradient is due to? and Co2 in these situatinos? is it perfusionor diffusion limited in these situations?

A

diffusion barrier. Co2 is normal. normally o2 and co2 are both perfusion limited, but o2 is more easily affected by diffusion than co2 is

222
Q

sarcoidosis, which WBC predominate

A

CD4 T cells IFN-gamma and tnf-alpha to activate macrophages

223
Q

guanosine analog that is antiviral, EBV and CMV are less susceptible than VZV or HSV. why?

A

b/c of viral thimidine kinase that activates acyclovir (which is the drug in this question) more present in VZV and HSV

224
Q

two opsonins and 4 chemotaxis

A

c3a and IgG, LTB4, bacterial products, C5a, IL-8

225
Q

2 complications from a condition that is positive osmotic fragility test

A

pigment gallstones and aplastic crisis after B19 infection

226
Q

30 s 50 s which antibiotics

A

amnioglycosides and tetracyclins, macrolides and chloramphenicol

227
Q

what is skeletal muscle preload and afterload

A

stretch of muscle before contraction and pressure against which muscle must contract

228
Q

fluoroquinolone resistance how? commonly

A

MDR efflux pumps

229
Q

RA, which paart of spine is involved?

A

cervical

230
Q

huntingtons affects which part of brain and what do you see on MRI

A

caudate atrophy, enlarged frontal horns of lateral ventricle

231
Q

neutral amino acids in the urine, dermatitis in sun exposed area, irritable behavior, ataxia in boy. what is rx?

A

niacin. dx is hartnup disease, leads to niacin deficiency because lack of neutral aa transporter

232
Q

uterus didelphys and limb deformities, recurrent miscarriages where is mutation

A

HOXA1

233
Q

zinc fingers found on hormone receptor. what hormone does it bind?

A

fat soluble hormones because zinc fingers bind to DNA directly. thyroid hormone is lipid soluble

234
Q

absence of melanocytes in epidermis, melanasome agreggations in cytoplasm, poor melanin formation dxx?

A

vitiligo, cafe-au-lait, albinism

235
Q

intestinal atresia is due to what and what characteristic surgical finding do you see?

A

vascular occlusion, apple peel/christmas tree- distal ileum winding around an ileocolic vessel

236
Q

zoster biopsy

A

multinucleated cells and intranuclear inclusions in keratinocytes

237
Q

left dominant circulation patient with AMI, block is right before branch to AV node, what is this artery?

A

left circumflex. most patients are right dominant, which means AV node is supplied by right. SA is also by right

238
Q

suprapubic cystostomy, what layer does it penetrate?

A

anterior abdominal aponeurosis, not through the peritoneum because bladder is extraperitoneal

239
Q

what immune thing protects against giardia? IgA or eos

A

IgA. rmb XLA and IgA def got problem with chronic giardia

240
Q

sarcomere where does actin bind to structural filaments? at the z line. what is actin and myosin called?

A

I band and A band

241
Q

positively or negatively skewed data, what is relatinoship between mean and median

A

positive- mean is greater than median, vv

242
Q

copper reduction test and glucose oxidase test is used for? asymptomatic patient with positive copper reduction and negative glucose oxidase

A

reducing sugar in the urine and urine dipstick uses glucose oxidase thing. aldolase B is the symptomatic one, essential fructosuria- fructokinase deficiency

243
Q

z drug mechanism?

A

GABAa, selective so no anxiolytic effects

244
Q

HIV and now CMV patient, what to give that doesn’t require intracellular activation?

A

usually gancyclovir which needs activation so can give foscarnet

245
Q

what causes honey colored crust

A

impetigo, staph aureus and GAS

246
Q

causes of SAH and ICH

A

saccular anueyrsm (marfans, ADPKD) and trauma for SAH. cb aneurysm due to HTN and CAA for ICH.

247
Q

cell starts replicating more after a signal. is it GDP binding to RAS or Rb being phosphorylated

A

Rb phosphorylation by Cyclin D and CDK4 leads to letting go of E2F by Rb

248
Q

internuclear opthalmoplegia and optic neuritis, comes and goes, moa?

A

decreased saltatory conductino- MS

249
Q

26 yo woman with genrealized weakness, mylagia, and unintentional weight loss. history of hypothyroidism on levothyroxine. NCNC anemia, Orthostatic hypotension, glucose is low, dx and what is urine and serum Na and K?

A

primary adrenal insufficiency- no aldosterone so high urine sodium and low urine K, high serum k and low serum Na because lack of cortisol stimulates ADH production: hyponatremia

250
Q

how is glycogenolysis regulated in muscle and liver

A

muscle- ca levels, liver-epinephrine and glucagon levels raise cAMP, to activate enzyme that does glycogenolysis

251
Q

baby born at term, has flattened face and club feet. and no breath sounds. what is the dx? and associated finding?

A

potter’s sequence, renal agenesis is the causes. rocker bottom feet….

252
Q

posionous mushroom ingestion toxin? and synthesis of what does it impair?

A

amatoxin; rRNA. toxin binds to RNA pol II

253
Q

guy with hodkins disease if found to have bacteria that is gram positive, cold resistant, motile, and narrow beta hemolysis. how is this bacteria cleared?

A

listeria. T-cell mediated because intracellular. Hodgkin’s is like immunosuppresion so cell mediated is weak, hence listeria infection

254
Q

fish bone near the piriform recess, nerve is damgaed, what sensation/reflex is lost?

A

cough, due to internal laryngeal nerve

255
Q

boy who keeps grunting sniffing, throat clearing, frequent eye blinking, shoulder shurggin. dx?

A

tourettes

256
Q

metabolic alkalosis patient is desating. what test is next?

A

urine chloride. this is next branching point in metabolic alkalosis. either it is low (in vomiting, and in diuretic use), which means volume depletion and saline responsive. however if cl high, it means excess aldosterone, saline unresponsive. (high aldosterone–> HTN–> pressure naturesis–> high urine Cl

257
Q

doxorubicin sideeffects? restrictive and ho cardiomyopathy-common causes

A

dilated cardiomyopathy is SE for doxo. common cause of restrictive is infiltartive (hemochromatosis, amyloidosi, sarcoidosis.) dilated- ABCCD, alcohol, beri beri, chagas/cocaine, doxorubicin

258
Q

metyrapone stimulation test, the 17 hydroxycorticoid rises and falls. what is this

A

metyrapone used in suspected cortisol/HPA abnormality. it blocks 11-b-hydroxylase, leading to low cortisol–>decreased negative –>feedback, increased ACTH (normally)

259
Q

MOA of rifampicin and isoniazid and vancomycin?

A

rifampicin (RNA polymerase inhibitor) isoniazid (inhibition of mycolic acid synthesis), vanco is d-ala-d-ala glycoprotein binder

260
Q

strept pneumo given radiolabled ceftriaxone, then protein electrophoresis, five distinct bands on radioautography

A

penicllin/ceftriaxone binds penicillin binding proteins such as transpeptidases

261
Q

rat poison ingestion, what is rx?

A

fresh frozen plasma- rat poison contains coumarin, which acts like warfarin- need 2,7,9,10 replacement quick.

262
Q

palliative patient on morphine, what drug precipitates opioid withdrawal sxs

A

buprenorphine- partial agonist, high affinty for mu agonist, kicks off real opioid

263
Q

13 yo girl that comes and shows lack of secondary sexual characteristics and blind vagina, and has hypokalemia and low Test and e2 levels, karyotype is XY. dx?

A

17a-hydroxylase deficiency

264
Q

disorderly, diffusely hypercellular connective tissue with cellular atypia and leaf like projections in breast stroma, dx?

A

phylloides

265
Q

at what day do you detect serum and urine b-hCG?

A

6-7 days implant, synctitiotrophoblast makes bhcg then 8 days detect in serum, 14 days in urine

266
Q

altitude sickness caused by and what happens to arterial pH, Hydrogen ion secretion and HCO3 reabsorption?

A

hypoxia. respiratory alkalosis. renal tries to compensate by decreasing H secretion and decreasing HCO3 reabsorption.

267
Q

southewestern blotting technique, which substance is identified?

A

c-Jun (like c-myc) it binds directly to DNA it is a proto-oncogene

268
Q

man with high frequency hearing loss related to work. which type of hearing loss and what is damaged?

A

sensorineurla, organ of corti cells

269
Q

which viral gp act on attachment and fusion? example of drug?

A

gp120 for attach, gp41 for fusion. CCR5/CXCR4 inhibitors / enfuviritide

270
Q

fatigue in 45 yo male, SOB, constipation, decreased concentration peripheral neuropathy, MCHC anemia, what do you see on peripheral smear?

A

basophilic stipling (lead poisoning)

271
Q

treatment for RA is initiatied, develops stomatitis and hepatotoxicity, what is the drug?

A

methotrexate

272
Q

middle aged guy presents with melena, segmental transumural inflammation and fibrinoid necrosis of medium sized vessels with internal elastic lamina involvement, dx? what predisposes to this?

A

polyarteritis nodosa, viral hepatits B

273
Q

younger guy with testicular pain, posterior/superior part of testes hurts, but cremasteric intact. urinalysis shows leukocytes but no organism, dx? and what caused it?

A

epididymitis, chlamydia/gonorrhea in younger guys, ecoli infection due to BPH-obstruction in older guys

274
Q

which antifungal prevents cell wall?

A

e-kinda-cant-do’s (echinocandins) casofungin etc

275
Q

what regulates hyperplasia of G-F-R layers in adrenal cortex

A

g is angiotensin, f and r is ACTH (but ACTH has transient effect of G too, so increase aldosterone synthesis)

276
Q

3 drugs used in MRSA when to use and moa of each and side effects

A

vancomycin, daptomycin, linezolid. vanco is d-ala-d-ala glycopeptide formation, dapto is cell membrane disruption of potential, linezolid is 23 subunit of ribosomes. linezolid can cause serotonin syndrome, vanco causes red man syndrome/nephroteox, dapto can cause myopathy

277
Q

upper middle lower rectum where does lymph drain

A

upper is sUPerior mesenteric. middle is superior mesenteric and internal iliac. lower is superficial inguinal

278
Q

NF-1 the neurofibromas are what and derived from? why headaches in NF?

A

schwann cells from neural crest, can have CNS tumors (optic gliomas, pilocytic astrocytomas)

279
Q

woman with CIN, what is the greatest risk factor for developing this? how about douching?

A

unprotected sexual intercourse. HPV is an STI…. douching leads to bacterial vaginosis, normal flora

280
Q

train of four stimulation for anesthetics, which one is equal but diminished at first then becomes a fade pattern

A

succinylcholine- depolarizing NMJ blocker

281
Q

what is tryptophan a precursor for? arginine? orotic acid?

A

melatonin, niacin, serotonin. arginine is precursor for urea, creatine, NO. orotic acid is pyrimidines

282
Q

repated jumping causes avulsion fractures in the?

A

tibial tubercle

283
Q

fever, tachycardia, hypertension and muscle rigidity after a major surgery. what is dx and rx and moa of rx?

A

malignant hyperthermia, commonly seen after inhaled anesthetic. rx is dantrolene which blocks ryanodine receptors prevents further Ca release

284
Q

alcohol and breast cancer link is found to be non-significant, but its found that the a lot of the alochol users died (and were deemed lost to follow up.) what is the bias in this study?

A

attrition bias which is a form of selection bias (which was the answer).

285
Q

what is lead time bias

A

lead time bias is when a screening tool detects the disease earlier and leads to a falsely prolonged survival time

286
Q

anterior compartment of the leg has acute compartment syndrome, what nerve is affected?

A

deep peroneal

287
Q

alcohol base disinfectant, which part of virus does it affect?

A

lipid bilayer. non-enveloped viruses are immune to this disinfectant

288
Q

cardiac biopsy shows prussian blue staining/lymphocytic infiltrate and multiple protozoa/numerous stellate cells in ground substance background/acellular pink material. 4 dx?

A

hemochromatosis, chagas disease, myxoma, senile amyloidosis

289
Q

nephrotic syndrome and left varicocele link? dx?

A

antithrombin 3 is lost, leading to hypercoagulable state

290
Q

61 yo with thyroid nodule, asymptomatic, FNA shows cells with large overlapping nuclei containing sparse, finely dispersed chromatin and inclusion bodies and grooves. dx?

A

papillary carcinoma of thyroid

291
Q

3 types of hypothyroidsm

A

riedels (woody hard fibrosis), hashimotos (germinal centers, lymphocytic infiltrate, hurthle cells- oxyphilic cells with granular cytoplasm), deQuervains (painful with multinucleated giant cells with mixed cellular infiltrate)

292
Q

angioedema causes? (4)

A

IgE dependent mast cell activation, IgE independent- opioids, vancomycin, contrast for radio (a/w pruritis), ACEi which increases bradykinin which increases vessel permeability, c1 inhibitor deficiency

293
Q

edwards or pataus or both? meckels/micrognathia/omphalocele/ rockerbottom feet/polydactyly/ cutis aplasia/heart-renal defects

A

e/e/p/b/p/p/b

294
Q

severe PPH in woman, what vessels should you ligate?

A

internal iliac because it supplies the uterine artery. uterus has collateral blood supply from the ovarian vessels in the IP ligament

295
Q

temporal lobe hemorrhage, leads to herniation. what sign would you see?

A

pupils dilated because uncal herniation leads to 3rd nerve palsy as it exits from midbrain. abducens nerve palsy is seen in intracranail pressure/central hernation

296
Q

turners syndrome, give growth hormone, what second messenger system do you use?

A

JAK/STAT

297
Q

guy with dilated ventricles, walls are not thick, no scarring. has fatigue and exertional dyspnea and dies from aortic anueuyrsm. dx and cause of aneuyrsm?

A

eccentric hypertrophy, aortic regurgitation. pressure overload leads to concentric hypertrophy (mitral stenosis). volume overload is eccentric

298
Q

two viruses infect one cell and then the offspiring gets a mutatino. offspring of the offspring reverts back to having no mutatino, what is this phenomenon called?

A

phenotypic mixing

299
Q

CF woman, has squamous metaplasia of the pancreatic ducts, deficiency in which vitamin?

A

Vitamin A- repsonsible for the orderly differentiation of specialized epithelia

300
Q

lung disease in competetnt, disseminated in immunocompromised, thick walled endospores in spherules, some empty some bursting, dx?

A

coccidioides immitis

301
Q

THBSO, post surgery develops flank pain and from loin to groin, ballotoable mass in flank. dx?

A

ureteral injury during surgery, causing hydronephrosis

302
Q

hodkin’s lymphoma guy, started on rx, later has lung problem- diffusion problem. dx and what is the drug? and mechanism?

A

pulmonary fibrosis and bleomycin, free radical generation by binding iron and oxygen, DNA double strand breaks results

303
Q

confusion and urinaryretention in older guy who has insomnia, what drug?

A

TCA-amitryptilin, has anticholinergic effects

304
Q

volume of distribution equation and concept

A

higher it is, the more it is lipophilic etc. drug dose divided by drug concentration

305
Q

what parts of brain is most susceptible to ischemia? (3)

A

hippocampus, purkinje cells of cerebellum and pyramidal cells of neocortex

306
Q

medullary carcinoma histology?

A

nests/sheets of polygonal cells in an amyloid background staining for congo red

307
Q

spindle shaped cells in a background of bone and osteoid, dx?

A

osteosarcoma

308
Q

neonate with abnormal facies, tetralogy of fallot and dx confirmed by FISH. what is dx and mechanism?

A

di george syndrome, pharyngeal pouch abnormality and chromosome microdeletion (22q11.2)

309
Q

what ratio is important in surfactant

A

lecithin (phosphotidylcholine) : sphingomyelinase should be greater than 2. lecithin production increases after 30

310
Q

hepatic encephalopathy mechanism?

A

excess ammonia absorbed by astrocyte, made into glutamine, but glutamine excess causes swelling and dysfunction in releasing glutamine to be converted into glutamate in the neurons. so block of excitatory transmission

311
Q

fever and maculopapular rash over body , arthralgia, malase, and LAD everywehere. test is done and found that patients serum added to cardiolipin, cholesterol, lecithin leads to clumping. what to do next?

A

treponemal tests because the VDRL test (described inquestion) can be positive for a lot of ther things

312
Q

antibody against Fc- portion of IgG is what?

A

rheumatoid factor

UworldSUN (11 decks)

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