PASS Basics

Question 1

Vitamin A can be used in treatment of what diseases?

Answer 1

anything where we need cells to mature: measles, promyeloblastic or AML (T15/17), Infections that wear away cells, burns.

Question 2

MCC of pancreatitis

Answer 2

kids: trauma, infection (coxsakie B, mumps), High TGs, hyperCa
Adults: alcohol, gall stones, high TGs, HyperCa

Question 3

indications for bariatric surgery

Answer 3

> 40 BMI
35 BMI + 1 Comorbidity
30 BMI + 2 Comorbidity

Question 4

Vit A Deficiency

Answer 4

cause - low absorption in ileum or sequestration in fat
poor night vision
hypoparathyrodism
Promeylo/AML (retinoid acid R defect)

Question 5

Vit A Fxn

Answer 5

PTH cofactor 
CSF Production 
cell maturation 
night vision 
antioxidant

Question 6

Vit A excess

Answer 6

pseudomotor cerebri

hyperaparathyroidism

Question 7

Vit B1 (Thiamine) FXN

Answer 7

pyruvate dehydrogenase
alpha ketoglutarate dehydrogenase
brr chained AA dehydrogenase
transketolase

Question 8

Thiamine Deficiency

Answer 8

Beriberi - heart dilation, peripheral neuropathy, wet (lung dilation)
Wernicke’s Encephalopathy/aphasia
Wernicke-korsakoff syndrome (+mammillary bodies)

Question 9

where is wernicke’s area

Answer 9

posterior temporal lobe

Question 10

MCC of myositis?

Answer 10

Hypothyroid
drugs (statins, INH, rifampin, steroids)
Cushings
infection (trichanella spirals from bear or Tinea Solum from pig meat)

Question 11

anabolic pathways happen in?

Answer 11

cytoplasm (making things)

Question 12

catabolic pathways happen in?

Answer 12

mitochondria (Breaking things down to get energy)
except glycolysis (in cyto)

Question 13

which pathways happen in cytoand mito?

Answer 13

heme synthesis
gluconeogenesis
FA synthesis
pyrimidine synthesis

Question 14

heme synthesis

Answer 14

in mito and cyto
Succinyl CoA (from Krebs) –>
B6, Glycine, and ALA synthase (makes porphyrin)

4X Porphyrin
Ferrochetalase (adds Fe2+)
=HEME!

Question 15

site of erythropoiesis

Answer 15

4 mos gestation - yolk sac
6 mos gestation - liver, spleen, flat bones
8 mos gestation - long bones
1 yr old - long bones (liver, spleen, and flat bones close, spleen CAN reopen)

Question 16

chloramphenicol

Answer 16

blocks peptidyl transferase on 50s subunit of ribosome
also (SE) blocks Complex IV of ETC

spectrum:
G+ (including S. aureus)
simple G-
Rickettsia

SE: Aplastic anemia, gray baby

Question 17

antimycin

Answer 17

blocks Complex III ETC (chemo drug)

Question 18

Oligomycin

Answer 18

blocks Complex V of ETC (ATP Synthetase)

Question 19

Statins effect on ETC

Answer 19

decreases CoQ (shuttle between Complex I, II, & III) 
if hepatitis or myositis with statins - give CoQ

Question 20

ETC Uncouplers?

Answer 20

Dinitrophenol (insecticide)
Aspirin (Reyes Synd)
FFAs (brown fat)

cause hyperthermia and MM can (malignant hyperthermia or neuroleptic malignant syndrome)

Question 21

uncoupling ETC due to anesthesia

Answer 21

malignant hyperthermia

Question 22

uncoupling ETC due to anti psychotica

Answer 22

neuroleptic malignant syndrome

Question 23

hepatic steatosis

Answer 23

micro:
reyes syndrome
tylenol poisoning
pregnancy

macro:
alcohol & obesity

Question 24

Tx for malignant hyperthermia or neuroleptic malignant syndrome?

Answer 24

Dantrolene (stabilizes SR to decrease Ca release)

Question 25

ascarbose and miglitol

Answer 25

block alpha 1 glucosidase (needed to breakdown & abs glucose).
use: post prandial hyperglycemia in DM

Question 26

exene”tide” and liraglu”tide”

Answer 26

incretin analogues
inhibit glucagon in pancreas
wt loss

Question 27

Sitagliptin and vilda”gliptin” and saxa”gliptin”

Answer 27

inhibit dipeptidyl peptidase (DPP - enzyme that break down incretins)
SE: pancreatitis
wt neutral

Question 28

Metformin/fanformin

Answer 28

inhibits gluconeogenesis in liver (pyruvate carboxylase)
pro: wt loss, decreases progression of preDM to DM
con: interacts with IV contrast –> renal failure
check creatinine
causes metabolic acidosis

Question 29

if IV contrast is needed in DM patient on Metformin?

Answer 29

stop metformin, IV fluids, N-acetylcystiene

Question 30

sulfonyl ureas

Answer 30

block voltage gated K channels in pancreatic beta cells
increases insulin release
SE:hypoglycemia, sulfa allergy, obesity

Question 31

anderson’s disease

Answer 31

no brr enzyme for glycogen synthesis

linear glycogen only on liver biopsy

Question 32

XR diseases

Answer 32

G6PD
alpha-galactosidase: Fabry 
iduronidase: hunters
NADPH oxidase: CGD 
HGPRT: Lesch Nyhan 
CAT1: Adrenoleukodystrophy
adenosine deaminase: SCID 
ornithine transcarbamoylase

Question 33

saturated fatty acid?

Answer 33

no double bonds

Question 34

main FA we make?

Answer 34

palmitic acid (c16) 
double bonds 3 carbons apart 
no double bonds after C10

Question 35

erythrocytic porphyria

Answer 35

porphyria in less than 1yo

Question 36

porphyria cutanea tarda

Answer 36

porphyria in >1yo