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Pathophysiology Flashcards

1
Q

gastrin: source

A

G cells

(antrum of stomach, duodenum)

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2
Q

vitamin B12 deficiency: manifestations

A

macrocytic megaloblastic anemia

hypersegmented PMNs

paresthesias

subacute combined degeneration (dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts)

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3
Q

CNI: name

A

olfactory nerve

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4
Q

adrenal corticotropic hormone (ACTH): source

A

anterior pituitary

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5
Q

gastric adenocarcinoma: characteristics findings

A

Virchow node: involvement of left supraclavicular node

Krukenberg tumor: bilateral metastases to ovaries with abundant mucin-secreting signet ring cells

sister Mary Joseph nodule: subcutaneous periumbilical metastasis

Blumer shelf: palpable mass on digital rectal exam

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6
Q

concentric hypertrophy: major causes

A

pressure overload:

hypertension

aortic stenosis

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7
Q

BCR-ABL mutation: associated conditions

A

CML

ALL

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8
Q

palpable purpura on exam: likely diagnosis

A

vasculitis

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9
Q

triceps reflex: associated nerve roots

A

C6-C8

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10
Q

vitamin B6 deficiency: manifestations

A

peripheral neuropathy

sideroblastic anemia

convulsions

hyperirritability

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11
Q

bulimia nervosa: first-line treatment

A

SSRI (specifically fluoxetine)

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12
Q

redman syndrome: cause

A

vancomycin

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13
Q

gastrosplenic ligament: connections

A

greater curvature of stomach to spleen

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14
Q

first pharyngeal arch: cartilage derivatives

A

maxilla

zygomatic bone

mandible

meckel cartilage

malleus and incus

sphenomandibular ligament

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15
Q

glucose-dependent insulinotropic peptide: regulation

A

increased by: fatty acids, amino acids, glucose

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16
Q

elevated alpha-fetoprotein (AFP): associated conditions

A

neural tube defect

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17
Q

TP53 mutation: associated conditions

A

Li-Fraumeni syndrome

most human cancers

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18
Q

zones of adrenal cortex: hormones produced

A

zona glomerulosa: mineralocorticoids (aldosterone)

zone fasciculata: glucocorticoids (cortisol)

zone reticularis: androgens (DHEA)

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19
Q

osteomyelitis with history of prosthetic joint replacement: likely pathogen

A

S epidermidis

S aureus

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20
Q
A
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21
Q

organized epithelioid histiocytes on histology: finding

A

granuloma

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22
Q

“double bubble” on abdominal x-ray: condition

A

duodenal atresia

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23
Q

anterior midline neck mass: most likely diagnosis

A

thyroglossal duct cyst

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24
Q

Heberden vs. Bouchard nodes: location

A

Heberden: DIP

Bouchard: PIP

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25
Q

clozapine: feared side effect

A

neutropenia

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26
Q

skeletal muscle: key control variables for autoregulation

A

lactate

adenosine

K+

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27
Q

arm abduction: muscles and nerves responsible by degree of abduction

A

0-15: supraspinatus (suprascapular)

15-100: deltoid (axillary)

>90: trapezius (spinal accessory)

>100: serratus anterior (long thoracic)

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28
Q

mucous (myxoid) cyst: presentation

A

benign ganglion cyst, often at the DIP joints, fluctuant

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29
Q

lepromatous vs. tuberculoid leprosy: type of immunity

A

lepromatous: type 1 (cellular)
tuberculoid: type 2 (immune complex)

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30
Q

salicylate toxicity: treatment

A

sodium bicarbonate

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31
Q

cause?

A

exercise

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32
Q

RET mutation: associated conditions

A

MEN2A

MEN2B

papillary thyroid carcinoma

pheochromocytoma

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33
Q

third aortic arch: derivatives

A

common carotid artery

proximal part of internal carotid artery

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34
Q

NSTEMI: type of occlusion

A

subtotal occlusion

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35
Q

NSAIDS vs. ACE inhibitors: effect on glomerular filtration

A

NSAIDS: inhibit prostaglandins -> inhibit dilation of afferent arteriole -> decreased GFR

ACE inhibitors: inhibit ATII -> inhibits constriction of efferent arteriole -> decreased GFR

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36
Q

HLA-DQ2/DQ8: associated conditions

A

celiac disease

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37
Q

vasoactive intestinal peptide (VIP): source

A

hypothalamus

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38
Q

location of cardiac tamponade

A

serous pericardium

(between visceral pericardium (or epicardium) and parietal pericardium)

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39
Q

dopamine receptors: G-protein class

A

D1: Gs

D2: Gi

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40
Q

vitamin D: name

A

D3 (cholecalciferol)

D2 (ergocalciferol)

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41
Q

minimal change disease: microscopy findings

A

LM: normal

IF: negative

EM: effacement of podocyte foot processes

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42
Q

meningitis CSF findings: bacterial

A

increased opening pressure

increased PMNs (neutrophils)

increased protein

decreased glucose

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43
Q

gastrohepatic ligament: connections

A

liver to lesser curvature of stomach

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44
Q

diffuse systemic sclerosis: antibody

A

anti-Scl-70 (anti-DNA topoisomerase I)

anti-RNA polymerase III

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45
Q

first pharyngeal arch: muscle derivatives

A

muscles of mastication (temporalis, masseter, lateral & medial pterygoids)

mylohyoid

anterior belly of digastric

tensor tympani

anterior 2/3 of tongue

tensor veli palatini

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46
Q

condition?

A

aortic regurgitation

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47
Q

evolution of STEMI ECG changes: hyperacute timeframe

A

peaked T wave

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48
Q

diffuse systemic sclerosis: manifestations

A

widespread skin involvement

early visceral involvement (interstitial fibrosis, pulmonary HTN, renal crisis, CV)

rapid progression

calcinosis and Raynaud phenomenon are mild

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49
Q

heart contractility: major determinant

A

sympathetic tone

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50
Q

class I antiarrhythmics: effect on action potential duration

A

class IA: prolong

class IB: shorten

class IC: minimal effect

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51
Q

area of brain responsible for BP control

A

nucleus solitarius

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52
Q

restless leg syndrome: associated conditions

A

iron deficiency

CKD

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53
Q

adrenergic receptors: G-protein class

A

alpha-1: Gq

alpha-2: Gi

beta-1/2/3: Gs

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54
Q

WBC casts in urine: associated conditions

A

acute interstitial nephritis (AIN)

acute pyelonephritis

transplant rejection

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55
Q

HLA-DR4: associated conditions

A

RA

DM type 1

Addison disease

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56
Q

Libman-Sacks endocarditis: associated conditions

A

SLE

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57
Q

fluorescent lamp factory: toxicity risk

A

mercury poisoning

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58
Q

“olive-shaped” mass on abdominal exam: condition

A

pyloric stenosis

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59
Q

Calf pseudohypertrophy

Diagnosis?

A

Muscular dystrophy

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60
Q

cannon a wave: cause

A

atria contract against closed tricuspid valve:

complete heart block

ventricular tachycardia

premature ventricular contraction

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61
Q

asbestosis: area of lung affected

A

lower lobes

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62
Q

evolution of STEMI ECG changes: 1-2 days

A

T wave inversion

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63
Q

pulmonary hypertension: finding on venous pressure curve

A

large a wave

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64
Q

growth hormone releasing hormone (GHRH): source

A

hypothalamus

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65
Q

stroke in lenticulostriate artery: area of lesion

A

striatum

internal capsule

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66
Q

ventricular pseudoaneurysm: typical location

A

inferior wall

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67
Q

propylthiouracil vs. methimazole: safety in pregnancy

A

propylthiouracil: safe in pregnancy
methimazole: teratogenic

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68
Q

T wave inversion: potential cause

A

NSTEMI

STEMI

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69
Q

STEMI: type of occlusion

A

total occlusion

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70
Q

vitamin C deficiency: manifestations

A

“scurvy”

swollen gums

easy bruising

hemarthrosis

petechiae

poor wound healing

“corkscrew” hair

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71
Q

tooth discoloration: cause

A

tetracyclines

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72
Q

SA node: vascular supply

A

RCA artery

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73
Q

IgA nephropathy: microscopy findings

A

LM: mesangial proliferation

IF: granular IgA deposits in mesangium

EM: mesangial deposits

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74
Q

2nd degree heart block (Mobitz type I): ECG findings

A

progressively lengthening PR interval

dropped beats

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75
Q

posterior pituitary: hormones

A

vasopressin (anti-diuretic hormone (ADH))

oxytocin

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76
Q

free wall rupture: timeframe in ischemia

A

5-10 days

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77
Q

UTI: causes and diagnosis

A

E coli: leading cause; pink on MacConkey agar; +nitrite

staph saprophyticus: 2nd leading; sexually active women; -nitrite; +urease

Klebsiella: large mucoid capsule; +nitrite; +urease

serratia: red pigment; nosocomial; +nitrite; +urease
enterococcus: nosocomial; -nitrite; -urease
proteus: swarming motility; struvite stones; +nitrite; +urease
pseudomonas: blue-green pigment; +nitrite; -urease

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78
Q

poststreptococcal glomerulonephritis vs. IgA nephropathy: timing after strep throat

A

PSGN: 2-4 weeks after strep throat

IgA: concurrently with strep throat

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79
Q

Achilles reflex: associated nerve roots

A

S1 - S2

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80
Q

amyloidosis: glomerular microscopy findings

A

LM: apple-green birefringence on Congo red stain

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81
Q

night terrors: stage of sleep

A

non-REM stage 3

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82
Q

relationship between compliance and pulse pressure

A

decreased compliance -> increased pulse pressure

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83
Q

lateral wall of LV: vascular supply

A

LCX artery

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84
Q

anterior wall of LV: vascular supply

A

LAD artery

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85
Q

posterior STEMI: ECG findings

A

ST elevations in V7-V9

anterior ST depressions

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86
Q

oxytocin: source

A

posterior pituitary

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87
Q

condition?

A

mitral regurgitation

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88
Q

vasopressin receptors: G-protein class

A

V1: Gq

V2: Gs

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89
Q

thyroid stimulating hormone (TSH): regulation

A

stimulated by:

TRH

inhibited by:

T4

T3

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90
Q

anemia: impact on blood viscosity

A

decrease

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91
Q

kidneys: key control variables for autoregulation

A

BP (via baroreceptors)

NaCl (via macula densa)

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92
Q

duodenal atresia: association

A

Down syndrome

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93
Q

cause?

A

vasopressors

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94
Q

acetylcholine: location of synthesis

A

basal nucleus of Meynert

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95
Q

antisocial personality disorder vs. conduct disorder

A

antisocial personality disorder: >= 18 years old

conduct disorder: <18 years old

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96
Q

enzymes requiring thiamine as cofactor

A

pyruvate dehydrogenase

alpha-ketoglutarate dehydrogenase

transketolase

branched-chain ketoacid dehydrogenase

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97
Q

measles: treatment

A

Vitamin A

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98
Q

vitamin B7: name

A

biotin

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99
Q

cortisol: source

A

adrenal cortex (zona fasciculata)

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100
Q

ALK mutation: associated conditions

A

lung adenocarcinoma

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101
Q

TCA toxicity: treatment

A

sodium bicarbonate

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102
Q

corticotropin releasing hormone (CRH): source

A

hypothalamus

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103
Q

Tinel sign: associated conditions

A

carpel tunnel syndrome

(tingling (pins and needles) after percussion of nerve on wrist)

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104
Q

globus sensation: cause

A

intense stress (e.g., divorce, etc)

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105
Q

vitamin B1 deficiency: manifestations

A

Wernicke encephalopathy (confusion, ophthalmoplegia, ataxia)

Korsakoff syndrome (confabulation, personality changes, memory loss)

dry beriberi (polyneuropathy, symmetric muscle wasting)

wet beriberi (dilated cardiomyopathy, edema)

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106
Q

vitamin B5: name

A

pantothenic acid

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107
Q

true ventricular aneurysm: timeframe in ischemia

A

weeks later

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108
Q

coal workers’ pneumoconiosis: area of lung affected

A

upper lobes

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109
Q

MMR mutation: associated conditions

A

Lynch syndrome:

colorectal cancer

endometrial cancer

ovarian cancer

urinary tract

small intestinal

stomach

biliary cancer

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110
Q

left supraclavicular lymph node: drainage

A

abdomen

(may be a sign of cancer in the abdominal cavity)

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111
Q

follicle stimulating hormone (FSH): function

A

estrogen synthesis / follicle growth

spermatogenesis

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112
Q

total peripheral resistance: major determinants

A

vessels (compliance, tone, etc) - primarily arterioles

blood viscosity

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113
Q

acute gout: treatment

A

NSAIDS (particularly indomethacin)

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114
Q

prolactin: regulation

A

tonically inhibited by dopamine from hypothalamus

also inhibited by:

prolactin

stimulated by:

TRH

VIP

oxytocin

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115
Q

growth hormone (GH): function

A

stimulates linear growth (via release of IGF-1 from liver)

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116
Q

rapidly progressive glomerulonephritis Type I (Goodpasture syndrome): microscopy findings

A

LM: crescents

IF: linear deposits

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117
Q

ST elevation: timeframe in STEMI

A

acute

(returns to normal in 3-7 days)

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118
Q

Wilson disease: treatment

A

penicillamine

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119
Q

vitamin A: name

A

retinal, retinol, retinoic acid

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120
Q

waxy casts in urine: associated conditions

A

ESRD

CKD

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121
Q

grey baby syndrome: cause

A

chloramphenicol

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122
Q

benzodiazepine toxicity: treatment

A

flumazenil

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123
Q

subendocardial ischemia: potential complications

A

stable angina

unstable angina

NSTEMI

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124
Q

CIN 1 vs. 2 vs. 3: definition

A

CIN 1: atypical cells occupy <1/3 of epithelium

CIN 2: atypical cells occupy 1/3-2/3 of epithelium

CIN 3: atypical cells occupy 2/3-3/3 of epithelium

(extension below epithelium is diagnostic of invasive carcinoma)

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125
Q

first pharyngeal arch: nerve derivatives

A

CN V

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126
Q

inferior wall of LV: vascular supply

A

PDA artery

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127
Q

evolution of STEMI ECG changes: >7 days

A

T wave returns to normal

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128
Q

somatic symptom disorder vs. illness anxiety disorder

A

somatic symptom disorder: significant anxiety about health in the presence of significant unexplained symptoms

illness anxiety disorder: significant anxiety about health without the presence of significant symptoms

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129
Q

cause?

A

decreased preload

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130
Q

Café-au-lait spots (unilateral), polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities

Diagnosis?

A

McCune-Albright syndrome

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131
Q

Kawasaki disease: classic presentation

A

young, Asian child

involvement of skin, lips, and tongue (red rash, desquamating over palms and soles, strawberry tongue)

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132
Q

sixth aortic arch: derivatives

A

proximal part of pulmonary artery

ductus arteriosus (on left only)

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133
Q

Child uses arms to stand up from squat

Diagnosis?

A

Duchenne muscular dystrophy

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134
Q

APC mutation: associated conditions

A

colorectal cancer

familial adenomatous polyposis (FAP)

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135
Q

HLA-DR5: associated conditions

A

Hashimoto thyroiditis

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136
Q

cardiac tamponade: presentation

A

Becks triad (hypotension, distended neck veins, distant heart sounds)

electrical alternans (alternating high and low voltage QRS complexes) or just low-voltage QRS

pulsus paradoxus (fall in BP by >10 mmHg during inspiration)

increased HR

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137
Q

posteromedial papillary muscle rupture: consequences

A

severe mitral regurgitation ->

acute heart failure

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138
Q

anterior pituitary: hormones

A

growth hormone (GH)

prolactin (PRL)

luteinizing hormone (LH)

follicle stimulating hormone (FSH)

adrenocorticotropic hormone (ACTH)

thyroid stimulating hormone (TSH)

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139
Q

serotonin: location of synthesis

A

raphe nuclei (medulla, pons)

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140
Q

SMAD4 mutation: associated conditions

A

pancreatic cancer

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141
Q

stroke in middle cerebral artery: area of lesion

A

lateral motor and sensory cortices (face and upper limb)

temporal lobe (including Wernicke area)

frontal lobe (including Broca area)

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142
Q

anti-Scl-70 (anti-DNA topoisomerase I): associated conditions

A

diffuse systemic sclerosis

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143
Q

vitamin B6: name

A

pyridoxine

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144
Q

vitamin E: name

A

tocopherol

tocotrienol

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145
Q

KRAS mutation: associated conditions

A

colon cancer

lung cancer

pancreatic cancer

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146
Q

ASA-intolerant asthma: treatment

A

anti-leukotrienes

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147
Q

TSC1 mutation: associated conditions

A

tuberous sclerosis

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148
Q

stroke in anterior inferior cerebellar artery (AICA): area of lesion

A

lateral pons

(facial nucleus, vestibular nuclei, spinothalamic tract, spinal trigeminal nucleus, sympathetic fibers, middle and inferior cerebellar peduncles, labyrinthine artery)

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149
Q

spherocytosis: impact on blood viscosity

A

increase

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150
Q

adrenal medulla: hormones

A

epinephrine

norepinephrine

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151
Q

fatty casts in urine: associated conditions

A

nephrotic syndrome

hypothyroidism

AKI

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152
Q

dystrophin mutation: associated conditions

A

Duchenne muscular dystrophy

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153
Q

FMR1 mutation: associated condition

A

Fragile X syndrome

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154
Q

vitamin K: name

A

phytomenadione

phylloquinone

phytonadione

menaquinone

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155
Q

CNIII: name

A

oculomotor nerve

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156
Q

absent a wave: cause

A

no organized atrial contraction:

atrial fibrillation

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157
Q

c-KIT mutation: associated conditions

A

gastrointestinal stromal tumor (GIST)

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158
Q

scarlett fever vs. Kawasaki disease: presentation

A

both: children, fever, diffuse red rash, desquamation, strawberry tongue

scarlett fever: sore throat, sandpaper skin

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159
Q

salmonella osteomyelitis: empiric treatment

A

ceftriaxone

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160
Q

first aortic arch: derivatives

A

part of maxilary artery

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161
Q

v wave: cause

A

venous filling

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162
Q

berylliosis: area of lung affected

A

upper lobes

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163
Q

subtotal occlusion: potential complications

A

stable angina

unstable angina

NSTEMI

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164
Q

MEN1 mutation: associated conditions

A

MEN1

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165
Q

anti-Ro / SSA: associated conditions

A

Sjogren syndrome

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166
Q

nitroblue tetrazolium dye reduction test abnormality: diagnosis

A

chronic granulomatous disease

(defect of NADPH oxidase) ->

susceptibility to catalase-positive organisms

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167
Q

evolution of STEMI ECG changes: acute timeframe

A

ST elevation

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168
Q

somatic symptom disorders vs. factitious disorders vs. malingering

A

somatic symptom disorders: symptoms are unconscious, motivation is unconscious (unexplained symptoms)

factitious disorders: symptoms are intentional, motivation is unconscious (patient consciously creates symptoms to get sympathy)

malingering: symptoms are intentional, motivation is intentional (patient consciously fakes disorder for a specific gain)

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169
Q

hypertension: type of hypertrophy

A

concentric hypertrophy

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170
Q

treatment-resistant psychosis: treatment

A

clozapine

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171
Q

meningitis CSF findings: fungal/TB

A

increased opening pressure

increased lymphocytes

increased protein

decreased glucose

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172
Q

unstable angina: ECG findings

A

ST depression

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173
Q

foramen cecum: what is it?

A

dimple at the back of the tongue, thought to be a normal remnant of the thyroglossal duct

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174
Q

growth hormone (GH): regulation

A

stimulated by:

GHRH

exercise

deep sleep

inhibited by:

IGF-1

somatostatin

glucose

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175
Q

neonatal respiratory distress syndrome: risk factors

A

prematurity

maternal diabetes (due to increased fetal insulin)

C-section delivery (due to decreased release of fetal glucocorticoids)

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176
Q

hyaline casts in urine: associated conditions

A

nonspecific - often normal

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177
Q

movement of essential tremor vs. Parkinson disease

A

essential tremor: worsened with movement

Parkinson disease: alleviated by movement

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178
Q

inferior myocardial infarction: treatment consideration

A

if bradycardia or AV block are present, do not use beta blockers

if RV is impacted, do not use nitrates

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179
Q

ectopic thyroid tissue: most common site

A

tongue

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180
Q

medial vs. lateral epicondylitis: movements that elicit pain

A

medial epicondylitis: pain with wrist flexion against resistance, passive wrist extension

lateral epicondylitis: pain with wrist extension against resistance, passive wrist flexion

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181
Q

Arachnodactyly, lens dislocation (upward and temporal), aortic dissection, hyperflexible joints

Diagnosis?

A

Marfan syndrome

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182
Q

vitamin B3: name

A

niacin

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183
Q

Crohn disease vs. UC: area of GI tract

A

CD: any portion, usually terminal ileum and colon, skip lesions, rectal sparing

UC: continuous colonic lesion, always rectal involvement

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184
Q

osteomyelitis with history of sickle cell disease: likely pathogen

A

salmonella typhi

S aureus

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185
Q

cataplexy: neurotransmitter involved

A

norepinephrine

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186
Q

Dressler syndrome: timeframe in ischemia

A

weeks later

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187
Q

CDKN2A mutation: associated conditions

A

melanoma

pancreatic cancer

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188
Q

evolution of STEMI ECG changes: hours

A

Q wave

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189
Q

condition?

A

aortic regurgitation

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190
Q

brain: key control variables for autoregulation

A

CO2

pH

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191
Q

aortic arch baroreceptors: type of BP sensed

A

high blood pressure only

(not good at sensing low BP)

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192
Q

PTEN mutation: associated conditions

A

prostate cancer

breast cancer

endometrial cancer

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193
Q

true ventricular aneurysm: typical location

A

anterior wall

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194
Q

second pharyngeal arch: nerve derivatives

A

CN VII

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195
Q

essential tremor: treatment

A

propranolol

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196
Q

carotid sinus baroreceptors: type of BP sensed

A

both high and low blood pressure

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197
Q

primary vs. secondary vs. tertiary intention in wound healing: definitions

A

primary intention: full approximation of edges of a wound, minimal scar

secondary intention: not possible to join skin, larger scar

tertiary intention: wound is left open initially, and then closed later

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198
Q

osteomyelitis with history of IV drug use: likely pathogen

A

S aureus

pseudomonas

candida

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199
Q

anti-La / SSB: associated conditions

A

Sjogren syndrome

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200
Q

homocystinuria: causes and treatment

A

cystathionine synthase deficiency (treat by decreasing dietary methionine; instead increase cysteine, B6, B12, and folate)

methionine synthase deficiency (treat by increasing dietary methionine)

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201
Q

gastrin: regulation

A

increased by: stomach distention, stomach alkalinization, vagal stimulation

decreased by: pH <1.5

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202
Q

rhabdomyolysis: electrolyte abnormalities

A

hyperkalemia (released from intracellular space)

hypocalcemia

hyperphosphatemia

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203
Q

hypothalamus: hormones

A

growth hormone releasing hormone (GHRH)

gonadotropin releasing hormone (GnRH)

corticotropin releasing hormone (CRH)

TSH releasing hormone (TRH)

vasoactive intestinal peptide (VIP)

somatostatin (SS)

dopamine (DA)

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204
Q

cardiac output: equation

A

CO = SV * HR

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205
Q

bacterial meningitis in neonates <6 months: most common causes

A

strep agalactiae

E. coli

listeria monocytogenes

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206
Q

y descent: cause

A

emptying of the atrium after tricuspid valve opens

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207
Q

secretin: regulation

A

increased by: acid and fatty acids in lumen of duodenum

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208
Q

anti-dsDNA: associated conditions

A

SLE

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209
Q

adrenal cortex: hormones

A

glucocorticoids (cortisol)

mineralocorticoids (aldosterone)

androgens

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210
Q

amino acid hormone: hydrophilic/hydrophobic?

A

could be either

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211
Q

Q wave: timeframe in STEMI

A

hours

(remains forever)

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212
Q

apex of heart: vascular supply

A

LAD artery

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213
Q

third pharyngeal arch: nerve derivatives

A

CN IX

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214
Q

acetaminophen toxicity: treatment

A

N-acetylcysteine

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215
Q

drug-induced pancreatitis: common causes

A

NRTIs (specifically didanosine)

valproic acid

sulfa drugs (specifically loop and thiazide diuretics)

corticosteroids

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216
Q

increased susceptibility to Neisseria infections

A

deficiencies in MAC complement proteins (C5-C9)

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217
Q

Prader-Willi syndrome vs. Angelman syndrome

A

Prader-Willi: paternal copy of gene is mutated/deleted

Angelman syndrome: maternal copy of gene is mutated/deleted

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218
Q

dopamine: location of synthesis

A

ventral tegmentum

substantia nigra pars compacta

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219
Q

condition?

A

mitral stenosis

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220
Q

anterior vs. posterior pituitary: embryologic origin

A

anterior: oral ectoderm (Rathke pouch)
posterior: neuroectoderm

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221
Q

CK-MB: timeframe of elevation in NSTEMI

A

increases 4-6 hours after MI

normalizes within 2-3 days

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222
Q

endocrine pancreas: hormones

A

insulin

glucagon

somatostatin

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223
Q

somatostatin: source

A

D cells

(pancreatic islets, GI mucosa)

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224
Q

glucose-dependent insulinotropic peptide: source

A

K cells

(duodenum, jejunum)

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225
Q

tamponade: timeframe in ischemia

A

5-10 days

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226
Q

posteromedial papillary muscle: vascular supply

A

PDA artery

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227
Q

second aortic arch: derivatives

A

stapedial artery

hyoid artery

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228
Q

polycythemia: impact on blood viscosity

A

increase

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229
Q

meningitis CSF findings: glucose

A

bacterial: decreased

fungal/TB: decreased

viral: normal

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230
Q

Crohn disease vs. UC: microscopy

A

CD: noncaseating granulomas, lymphoid aggregates

UC: crypt abscesses and ulcers, no granulomas

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231
Q

aortic regurgitation: type of hypertrophy

A

eccentric hypertrophy

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232
Q

histamine receptors: G-protein class

A

H1: Gq

H2: Gs

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233
Q

stroke in posterior inferior cerebellar artery (PICA): symptoms

A

lateral medullary (Wallenberg) syndrome

dysphagia, hoarseness, decreased gag reflex, hiccups

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234
Q

AV dissociation: finding on venous pressure curve

A

cannon a wave

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235
Q

complications of ischemia: weeks later

A

Dressler syndrome

true ventricular aneurysm

LV thrombus

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236
Q

aortic arch baroreceptors: cranial nerve

A

CN X (vagus)

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237
Q

cholecystokinin: regulation

A

increased by: fatty acids, amino acids

238
Q

gonadotropin releasing hormone (GnRH): source

A

hypothalamus

239
Q

iron toxicity: treatment

A

deferoxamine

240
Q

CNII: function

A

visual acuity

241
Q

fat soluble vitamins

242
Q

sixth pharyngeal arch: muscle derivatives

A

all intrinsic muscles of larynx except cricothyroid

243
Q

vitamin E deficiency: manifestations

A

hemolytic anemia

acanthocytosis

muscle weakness

decreased position and vibration sensation

ataxia

244
Q

right ventricular infarction: clinical hallmarks

A

elevated JVP

hypotension

245
Q

membranoproliferative glomerulonephritis Type I: microscopy findings

A

LM: “tram tracks” due to mesangial ingrowth and GBM splitting

IF: subendothelial deposits due to IgG and C3

246
Q

small vessel vasculitis: types

A

Behcet syndrome

cutaneous small-vessel vasculitis

eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

granulomatosis with polyangiitis (Wegener)

IgA vasculitis

microscopic polyangiitis

mixed cryoglobulinemia

247
Q

osteomyelitis with history of cat/dog bite: likely pathogen

A

pasteurella multocida

248
Q

condition?

A

mitral regurgitation

249
Q

serotonin syndrome vs. neuroleptic malignant syndrome manifestations

A

both have: high fever, hypertension, tachycardia, agitation, sweating, increased muscle tone

SS has: hyperreflexia, clonus, hyperactive bowel sounds

NMS has: hyporeflexia, norma/hypoactive bowel sounds

250
Q

high blood pressure: sensed by which baroreceptors?

A

aortic arch and carotid sinus

251
Q

mechanisms to decrease preload

A

remove volume

increase HR

pool blood in veins (nitrates)

252
Q

cholecystokinin: source

A

I cells

(duodenum, jejunum)

253
Q

vitamin B2 deficiency: manifestations

A

cheilosis (inflammation of lips, scaling/fissures at corners of mouth)

corneal vascularization

254
Q

complications of ischemia: first 4 days

A

arrhythmia

255
Q

causes of torsades de pointes: electrolyte abnormalities

A

hypokalemia

hypomagnesemia

hypocalcemia

256
Q

giant v wave: cause

A

tricuspid regurgitation

257
Q

liver failure: mechanism of edema

A

decreased plasma proteins (oncotic pressure)

258
Q

bruxism: stage of sleep

A

non-REM stage 2

259
Q

temporal arteritis: classic presentation

A

elderly female

headache

pain on chewing

high ESR

260
Q

dermatitis herpetiformis: first-line Tx

261
Q

neural crest cells: embryologic derivatives

A

melanocytes

PNS ganglia (cranial, dorsal root, autonomic)

adrenal medulla

schwann cells

bones of the viscerocranium (maxilla, mandible, etc)

outflow tract of the heart (aorticopulmonary septum)

262
Q

cortisol: regulation

A

stimulated by: ACTH from pituitary (via CRH from hypothalamus)

inhibited by: cortisol (via negative feedback on ACTH and CRH production)

263
Q

complications of ischemia: 5-10 days

A

free wall rupture

tamponade

papillary muscle rupture

ventricular pseudoaneurysm

septal rupture

fibrinous pericarditis

264
Q

squamous cell carcinoma of lung: associated paraneoplastic syndromes

A

hypercalemia (due to PTHrP)

265
Q

total occlusion: potential complications

266
Q

polyarteritis nodosa: size of vessels involved

A

medium vessels

267
Q

N-myc mutation: associated conditions

A

neuroblastoma

(derived from neural crest)

(most commonly in adrenal gland)

268
Q

LAD: territory

A

anterior wall

anterior septum

apex

anterolateral papillary muscle

269
Q

FXN mutation: associated condition

A

Friedreich ataxia

270
Q

3rd degree heart block: ECG findings

A

no association between P waves and QRS complexes

271
Q

HER2 mutation: associated conditions

A

breast carcinoma

gastric carcinoma

272
Q

NSTEMI: ECG findings

A

ST depression

T wave inversion

273
Q

tricuspid regurgitation: finding on venous pressure curve

A

giant v wave

274
Q

multiple myeloma: impact on blood viscosity

275
Q

NF2 mutation: associated conditions

A

neurofibromatosis type 2

276
Q

Crohn disease vs. ulcerative colitis: presence of extra-intestinal manifestations

A

CD: more likely

UC: less likely

277
Q

AV node: vascular supply

A

RCA artery

278
Q

diabetic glomerulonephropathy: microscopy findings

A

LM: Kimmelstiel-Wilson nodules (nodular sclerosis), mesangial expansion, GBM thickening

279
Q

lipofuscin: appearance

A

yellow-brown deposits in multiple organs found in elderly

(part of a normal aging process)

280
Q

aortic stenosis: type of hypertrophy

A

concentric hypertrophy

281
Q

condition?

A

hemorrhage

282
Q

toxins: mechanism of edema

A

increased capillary permeability

283
Q

follicle stimulating hormone (FSH): source

A

anterior pituitary

284
Q

vitamin B12: site of absorption

A

terminal ileum

285
Q

Takayasu arteritis: classic presentation

A

young, Asian female

weak pulses in one arm

BP difference between arms

bruits over arteries

high ESR

286
Q

inferior septum of heart: vascular supply

A

PDA artery

287
Q

second pharyngeal arch: muscle derivatives

A

muscles of facial expression

stapedius

stylohyoid

platysma

posterior belly of digastric

288
Q

prolactin: source

A

anterior pituitary

289
Q

thyroid: hormones

A

thyroxine (T4)

triiodothyronine (T3)

calcitonin

290
Q

cholinergic receptors: G-protein class

A

M1: Gq

M2: Gi

M3: Gq

291
Q

cardiac output: major determinants

A

preload

afterload

contractility

heart rate

292
Q

transmural ischemia: potential complications

293
Q

gastrocolic ligament: connections

A

greater curvature of stomach to transverse colon

294
Q

fourth aortic arch: derivatives

A

left: aortic arch
right: proximal part of right subclavian artery

295
Q

SMN1 mutation: associated condition

A

spinal muscular atrophy

296
Q

CD55/59 negative RBCs on flow cytometry: diagnosis

A

paroxysmal nocturnal hemoglobinuria

297
Q

c diff: treatment

A

oral vancomycin

298
Q

heart rate: major determinant

A

sympathetic tone

299
Q

poststreptococcal glomerulonephritis: microscopy findings

A

LM: enlarged and hypercellular glomeruli

IF: “starry sky” granular appearance due to IgG, IgM, and C3

EM: subepithelial humps

300
Q

RBC casts in urine: associated conditions

A

glomerulonephritis

hypertensive emergency

contact sports

301
Q

heart: key control variables for autoregulation

A

CO2

adenosine

NO

302
Q

somatostatin: regulation

A

increased by: acid

decreased by: vagal stimulation

303
Q

evolution of STEMI ECG changes

A

peaked T wave (hyperacute)

ST elevation (acute)

Q wave (hours)

T wave inversion (1-2 days)

ST segment returns to baseline (3-7 days)

T wave returns to normal (>7 days)

Q wave remains

304
Q

luteinizing hormone (LH): source

A

anterior pituitary

305
Q

VHL mutation: associated conditions

A

von Hippel-Lindau disease

306
Q

fibrinous pericarditis: timeframe in ischemia

307
Q

DCC mutation: associated conditions

A

colon cancer

308
Q

NF1 mutation: associated conditions

A

neurofibromatosis type 1

309
Q

loop vs. thiazide vs. K-sparing diuretics: labs

A

loop: hypokalemia, hypocalcemia, hypomagnesemia
thiazide: hypokalemia, hypercalemia, hyperuricemia, hyperglycemia, hyperlipidemia

K-sparing: hyperkalemia

310
Q

vitamin A deficiency: manifestations

A

night blindness

dry scaly skin

Bitot spots (due to corneal squamous metaplasia)

corneal degeneration

immunosuppression

311
Q

CYP450 inducers

A

phenytoin

phenobarbital

rifampin

carbamazepine

griseofulvin

St. Johns wort

312
Q

Paget disease of bone: labs

A

Ca: normal

phosphate: normal

alk phos: increased

PTH: normal

313
Q

splenorenal ligament: connections

A

spleen to left pararenal space

314
Q

iron: site of absorption

315
Q

meningitis CSF findings: protein

A

bacterial: increased

fungal/TB: increased

viral: normal/increased

316
Q

PKD2 gene: chromosome

A

chromosome 4

(15% of autosomal dominant polycystic kidney disease)

317
Q

hepatoduodenal ligament: connections

A

liver to duodenum

318
Q

GABA: location of synthesis

A

nucleus accumbens

319
Q

systolic blood pressure: major determinant

A

stroke volume

320
Q

T wave inversion: timeframe in STEMI

A

1-2 days

(returns to normal in >7 days)

321
Q

ejection fraction: equation

A

EF = SV / EDV

322
Q

cause?

A

decreased contractility

323
Q

condition?

A

aortic stenosis

324
Q

Alport syndrome: microscopy findings

A

EM: “basket-weave” due to irregular thickening of GBM

325
Q

third pharyngeal arch: cartilage derivatives

A

greater horn of hyoid

326
Q

LCX artery: territory

A

lateral wall of left ventricle

anterolateral papillary muscle

327
Q

second pharyngeal arch: cartilage derivatives

A

stapes

styloid process

lesser horn of hyoid

stylohyoid ligament

328
Q

vitamin K deficiency: manifestations

A

neonatal hemorrhage

increase PT and aPTT

329
Q

thyroid stimulating hormone (TSH): function

A

release of T4 and T3 from thyroid

330
Q

left main STEMI: ECG findings

A

ST elevation in aVR

diffuse ST depressions elsewhere

331
Q

infectious vs. malignant process: lymph node findings

A

infectious: soft, mobile, painful
malignant: hard, non-mobile, non-tender

332
Q

kawasaki disease: treatment

A

IV immunoglobulin

aspirin

333
Q

acute stress disorder vs. post-traumatic stress disorder: timeline

A

acute stress disorder: <1 month

post-traumatic stress disorder: >1 month

334
Q

heart failure: mechanism of edema

A

increased capillary hydrostatic pressure

335
Q

lateral collateral ligaments of the foot: weakest (and most easily injured)

A

anterior talofibular ligament

336
Q

CO poisoning: mechanism of toxicity

A

CO has an extremely high binding affinity for heme, displacing O2

337
Q

zones of the liver: causes of damage

A

zone I: viral hepatitis, injected toxins (cocaine)

zone II: yellow fever

zone III: ischemia, alcoholic hepatitis, metabolic toxins (ethanol, acetaminophen, rifampin, etc)

338
Q

fourth/sixth pharyngeal arches: cartilage derivatives

A

arytenoids

cricoid

corniculate

cuneiform

thyroid

339
Q

coal workers’ pneumoconiosis: appearance on CXR

A

small, rounded nodules in upper lobes

340
Q

biceps and brachioradialis reflexes: associated nerve roots

341
Q

flow equation (for blood)

A

ΔP = CO * TPR

342
Q

Kawasaki disease: feared complication

A

coronary artery aneurysm

343
Q

anterior septum of heart: vascular supply

A

LAD artery

344
Q

HLA-DR3: associated conditions

A

Graves disease

SLE

DM type 1

Hashimoto thyroiditis

Addison disease

345
Q

hemochromatosis: treatment

A

deferoxamine

phlebotomy

346
Q

meningitis CSF findings: viral

A

normal/increased opening pressure

increased lymphocytes

normal/increased protein

normal glucose

347
Q

positive technetium-99-pertechnetate scan: diagnosis?

A

Meckel diverticulum

348
Q

PDA artery: territory

A

inferior wall of LV

inferior septum of heart

posteromedial papillary muscle

349
Q

decreased alpha-fetoprotein (AFP): associated conditions

A

Down syndrome

trisomy 18

350
Q

osteomyelitis with no significant history: likely pathogen

351
Q

anterolateral papillary muscle: vascular supply

A

LAD artery + LCX artery

352
Q

sixth pharyngeal arch: nerve derivatives

A

CN X (recurrent/inferior laryngeal branch)

353
Q

osteomyelitis with history of vertebral involvement: likely pathogen

A

M tuberculosis (Pott disease)

S aureus

354
Q

cause?

A

increased afterload

355
Q

vitamin B3 deficiency: manifestations

A

diarrhea

dermatitis

dementia

356
Q

CNI: function

357
Q

mitral regurgitation: type of hypertrophy

A

eccentric hypertrophy

358
Q

papillary muscle rupture: timeframe in ischemia

359
Q

mechanisms to increase preload

A

add volume (blood transfusion, IV fluids)

slow HR

constrict veins (sympathetic stimulation, alpha-1)

360
Q

stroke in basilar artery: area of lesion

A

pons, medulla, lower midbrain

corticospinal and corticobulbar tracts

ocular cranial nerve nuclei, paramediam pontine reticular formation

361
Q

WT1 gene: chromosome

A

chromosome 11

(Wilms tumor)

362
Q

Elastic skin, hypermobility of joints, increased bleeding tendency

Diagnosis?

A

Ehlers-Danlos syndrome

363
Q

pathogens that cause osteomyelitis

A

S aureus (most common)

Neisseria gonorrhea (sexually active)

salmonella typhi (sickle cell disease)

S epidermidis (prosthetic joint replacement)

M tuberculosis (vertebral involvement)

Pasteurella multocida (dog/cat bite)

pseudomonas (IV drug use)

candida (IV drug use)

364
Q

HLA-C: associated conditions

365
Q

parathyroid: hormones

A

parathyroid hormone (PTH)

366
Q

delirium: neurotransmitter abnormalities

A

dopamine excess

acetylcholine suppression

367
Q

anti-histone antibody: associated conditions

A

drug-induced lupus

368
Q

low blood pressure: sensed by which baroreceptors?

A

carotid sinus only

(aortic arch not good at sensing low BP)

369
Q

silicosis: area of lung affected

A

upper lobes

370
Q

mechanisms to decrease afterload

A

decrease mean BP

treat aortic valve disease or hypertrophic cardiomyopathy

371
Q

meningitis CSF findings: cell type

A

bacterial: PMNs (neutrophils)

fungal/TB: lymphocytes

viral: lymphocytes

372
Q

pancreatic adenocarcinoma: associated paraneoplastic syndromes

A

Trousseau syndrome (migratory superficial thrombophlebitis)

nonbacterial thrombotic endocarditis

373
Q

2nd degree heart block (Mobitz type II): ECG findings

A

unchanging PR interval (usually normal but can be prolonged)

dropped beats

374
Q

BRAF mutation: associated conditions

A

melanoma

non-Hodgkin lymphoma

papillary thyroid cancer

hairy cell leukemia

375
Q

remains elevated for weeks after MI: which cardiac biomarker?

376
Q

normalizes in 2-3 days after MI: which cardiac biomarker?

377
Q

arrhythmia: timeframe in ischemia

A

first 4 days

378
Q

condition?

A

heart failure

379
Q

cauda equina syndrome: presentation

A

lower motor neuron lesions in lower extremities (loss of knee and ankle reflexes)

saddle anesthesia

loss of bladder and anal sphincter control

380
Q

mean arterial pressure: equation

A

MAP = DBP + 1/3 * (SBP - DBP)

MAP = DBP + 1/3 * PP

MAP = (2 * DBP + SBP) / 3

381
Q

stroke in anterior inferior cerebellar artery (AICA): symptoms

A

lateral pontine syndrome

paralysis of face, decreased lacrimation, decreased salivation, decreased taste from anterior 2/3 of tongue

382
Q

limited systemic sclerosis: manifestations

A

CREST syndrome

calcinosis cutis

Raynaud phenomenon

esophageal dysmotility

sclerodactyly

telangiectasia

383
Q

vitamin B9 deficiency: manifestations

A

macrocytic megaloblastic anemia

glossitis

hypersegmented PMNs

NO neurologic symptoms

384
Q

cause?

A

decreased compliance

385
Q

anti-Jo-1: associated conditions

A

polymyositis

dermatomyositis

386
Q

vasopressin (anti-diuretic hormone (ADH)): source

A

posterior pituitary

387
Q

HLA-A3: associated conditions

A

hemochromatosis

388
Q

opioid toxicity: treatment

389
Q

anti-CCP: associated conditions

390
Q

epithelial casts in urine: associated conditions

A

renal tubular necrosis

viral disease (CMV nephritis)

391
Q

membranoproliferative glomerulonephritis Type II: microscopy findings

A

LM: “tram track” due to mesangial ingrowth and GBM splitting

IF: intramembranous deposits due to C3 only

392
Q

secretin: source

A

S cells

(duodenum)

393
Q

vitamin B5 deficiency: manifestations

A

dermatitis

enteritis

alopecia

adrenal insufficiency

394
Q

infection: mechanism of edema

A

increased capillary permeability

395
Q

stroke volume: equation

A

SV = EDV - ESV

396
Q

pulse pressure: equation

A

PP = SBP - DBP

397
Q

GnRH: function

A

stimulates release of FSH and LH from the anterior pituitary

398
Q

PKD1 gene: chromosome

A

chromosome 16

(85% of autosomal dominant polycystic kidney disease)

399
Q

variceal bleeding prophylaxis: treatment

A

non-selective beta blockers

400
Q

medium-vessel vasculitis: types

A

Buerger disease (thromboangiitis obliterans)

Kawasaki disease (mucocutaneous lymph node syndrome)

polyarteritis nodosa

401
Q

Buerger disease: classic presentation

A

male smoker

gangrene and autoamputation of digits

Raynaud phenomenon

tender nodules over course of veins

402
Q

exuberant callus formation: association

A

corticosteroid-induced osteoporosis

403
Q

stroke in anterior cerebral artery: area of lesion

A

medial motor and sensory cortices (lower limbs)

404
Q

flushing, diarrhea, tricuspid regurgitation, pulmonic stenosis

diagnosis?

A

carcinoid syndrome

405
Q

Buerger disease (thromboangiitis obliterans): size of vessels involved

A

medium vessels

406
Q

high blood viscosity: causes

A

polycythemia

multiple myeloma

spherocytosis

407
Q

cause?

A

increased contractility

408
Q

troponins: timeframe of elevation in NSTEMI

A

increases 2-4 hours after MI

stays elevated for weeks

409
Q

prolactin: function

A

stimulates milk production

inhibits ovulation/spermatogenesis (via inhibition of GnRH release)

410
Q

VIP: function

A

stimulates release of prolactin from anterior pituitary

411
Q

hydrocephalus: types

A

communicating hydrocephalus: decreased CSF absorption

normal pressure hydrocephalus: idiopathic and affects elderly; causes classic triad of urinary incontinence, gait apraxia, and cognitive dysfunction (wet, wobbly, and wacky)

non-communicating hydrocephalus: structural blockage

412
Q

TSC2 mutation: associated conditions

A

tuberous sclerosis

413
Q

fourth pharyngeal arch: nerve derivatives

A

CN X (superior laryngeal branch)

414
Q

glomus tumor: associated conditions

A

neurofibromatosis type 1

415
Q

CRH: function

A

stimulates release of ACTH from anterior pituitary

416
Q

eccentric hypertrophy: major causes

A

volume overload:

aortic regurgitation

mitral regurgitation

cardiomyopathies

417
Q

gold mining factory: toxicity risk

A

mercury poisoning

418
Q

c wave: cause

A

tricuspid valve closure

419
Q

silicosis: appearance on CXR

A

“eggshell” calcification of hilar lymph nodes

may have numerous small opacities

420
Q

condition?

A

mitral stenosis

421
Q

DMPK mutation: associated condition

A

myotonic dystrophy

422
Q

unstable angina: type of ischemia

A

subendocardial ischemia

423
Q

stable angina: type of ischemia

A

subendocardial ischemia

424
Q

small cell lung cancer: associated paraneoplastic syndromes

A

Cushing syndrome (due to ACTH)

hyponatremia (SIADH)

cerebellar degeneration (anti-Hu antibodies)

encephalomyelitis (anti-Hu antibodies)

Lambert-Eaton myasthenic syndrome (presynaptic Ca channel antibodies)

425
Q

vitamin B12: name

426
Q

acute vs. chronic alcohol use: effect on CYP450

A

acute: inhibition of CYP450
chronic: induction of CYP450

427
Q

PKHD1 gene: chromosome

A

chromosome 6

(autosomal recessive polycystic kidney disease)

428
Q

stroke in posterior inferior cerebellar artery (PICA): area of lesion

A

lateral medulla

(nucleus ambiguus, vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, sympathetic fibers, inferior cerebellar peduncle)

429
Q

Crohn disease vs. UC: gross morphology

A

CD: transmural inflammation, fistulas, cobblestone mucosa

UC: mucosal/submucosal only, loss of haustra

430
Q

Gout, intellectual disability, self-mutilating behavior in a boy

Diagnosis?

A

Lesch-Nyhan syndrome

431
Q

AFB: meaning

A

acid-fast bacillus

432
Q

a wave: cause

A

atrial contraction

433
Q

fourth pharyngeal arch: muscle derivatives

A

most pharyngeal constrictors

cricothyroid

levator veli palatini

434
Q

autosomal dominant vs. recessive polycystic kidney disease: time of presentation

A

ADPKD: 40-50 years old

ARPKD: infancy

435
Q

ventricular tachycardia: finding on venous pressure curve

A

cannon a wave

436
Q

focal segmental glomerulosclerosis: microscopy findings

A

LM: segmental sclerosis and hyalinosis

IF: negative, or nonspecific deposits

EM: effacement of podocyte foot processes

437
Q

thyroid stimulating hormone (TSH): source

A

anterior pituitary

438
Q

c-MYC mutation: associated conditions

A

Burkitt lymphoma

439
Q

ST depression: potential cause

A

unstable angina

NSTEMI

440
Q

large a wave: cause

A

increased atrial contraction pressure:

tricuspid stenosis

pulmonary hypertension

441
Q

subluxation of the lens: causes (and direction)

A

Marfan syndrome: upward and outward

homocystinuria: downward and inward

442
Q

evolution of STEMI ECG changes: 3-7 days

A

ST segment returns to baseline

443
Q

growth hormone (GH): source

A

anterior pituitary

444
Q

fibrillin mutation: associated condition

A

Marfan syndrome

445
Q

vitamin C: name

A

ascorbic acid

446
Q

afterload: major determinants

A

blood pressure

stiffness of aortic valve

447
Q

condition?

A

aortic stenosis

448
Q

1st degree heart block: ECG findings

A

prolonged PR interval

no dropped beats

449
Q

right coronary artery: territory

A

SA node

AV node

450
Q

HLA-B8: associted conditions

A

Addison disease

myasthenia gravis

Graves disease

451
Q

granular “muddy brown” casts in urine: associated conditions

A

acute tubular necrosis (ATN)

452
Q

Kaposi sarcoma: treatment

A

combination HAART

453
Q

Situs inversus, chronic sinusitis, bronchiectasis, infertility

Diagnosis?

A

Kartagener syndrome

454
Q

decrease in blinking frequency: associated condition

A

Parkinson disease

455
Q

HLA-B27: associated conditions

A

psoriatic arthritis

ankylosing spondylitis

reactive arthritis

IBD-associated arthritis

456
Q

meningitis: common causes by age

A

0-6mo: GBS, E coli, listeria

6mo-6yr: S pneumo, N meningitis, H flu type b, GBS, enteroviruses

6-60 yr: N meningitidis, S pneumo, enteroviruses, HSV

>60yr: S pneumo, N meningitidis, H flu type b, GBS, listeria

457
Q

nephrotic syndrome: mechanism of edema

A

decreased plasma proteins (oncotic pressure)

458
Q

Kawasaki disease (mucocutaneous lymph node syndrome): size of vessels involved

A

medium vessels

459
Q

ventricular pseudoaneurysm: timeframe in ischemia

460
Q

low blood viscosity: causes

461
Q

vitamin B2: name

A

riboflavin

462
Q

direct inguinal hernia: iatrogenic cause

A

damage to iliohypogastric or ilioinguinal nerves

(often during appendectomy surgery)

463
Q

giant cell (temporal) arteritis: size of vessels involved

A

large vessels

464
Q

meningitis CSF findings: opening pressure

A

bacterial: increased

fungal/TB: increased

viral: normal/increased

465
Q

NSTEMI: type of ischemia

A

subendocardial ischemia

466
Q

vitamin B1: name

467
Q

large-vessel vasculitis: types

A

giant cell (temporal) arteritis

Takayasu arteritis

468
Q

lymphatic blockage: mechanism of edema

A

increased interstitial oncotic pressure

469
Q

WT1 mutation: associated conditions

A

Wilms tumor (nephroblastoma)

470
Q

burn: mechanism of edema

A

increased capillary permeability

471
Q

stroke in posterior cerebral artery: area of lesion

A

occipital lobe

472
Q

LV thrombus: timeframe in ischemia

A

weeks later

473
Q

c-ANCA (PR3-ANCA): associated conditions

A

granulomatosis with polyangiitis (Wegener)

474
Q

zinc factory: toxicity risk

A

cadmium poisoning

475
Q

septal rupture: timeframe in ischemia

476
Q

vitamin B12 deficiency: diagnosis

A

high methylmalonic acid

477
Q

fixed splitting of S2: diagnosis

479
Q

BRCA mutation: associated conditions

A

breast cancer

ovarian cancer

pancreatic cancer

480
Q

osteopetrosis: labs

A

Ca: normal/increased

phosphate: normal

alk phos: normal

PTH: normal

481
Q

norephinephrine: location of synthesis

A

locus ceruleus

482
Q

BCL-2 mutation: associated conditions

A

follicular large B cell lymphoma

diffuse large B cell lymphoma

483
Q

tricuspid stenosis: finding on venous pressure curve

A

large a wave

484
Q

poor R wave progression on ECG: association

A

anterior ischemia

485
Q

spots with a blue-white center on buccal mucosa

diagnosis?

A

Koplik spots

(likely measles)

486
Q

hydroxychloroquine in psoriasis

A

HCQ can worsed psoriasis rashes

487
Q

anti-Smith: associated conditions

488
Q

anti-microsomal antibody: associated conditions

A

Hashimoto thyroiditis

489
Q

yellow vision: cause

490
Q

TSH releasing hormone (TRH): source

A

hypothalamus

491
Q

cause?

A

increased preload

492
Q

osteomyelitis with history of sexual activity: likely pathogen

A

neisseria gonorrhea

493
Q

JAK2 mutation: associated conditions

A

chronic myeloproliferative disorders

494
Q

anti-centromere antibody: associated conditions

A

limited systemic sclerosis

495
Q

x descent: cause

A

atrial relaxation

496
Q

vitamin B9: name

497
Q

CNII: name

A

optic nerve

498
Q

essential amino acids

A

PVT TIM HaLL

phenylalanine

valine

tryptophan

threonine

isoleucine

methionine

histidine

leucine

lysine

499
Q

tension in LV: determinants

A

tension = (pressure * radius) / 2*wall thickness

500
Q

Rb mutation: associated conditions

A

retinoblastoma

osteosarcoma

501
Q

hyperkalemia: treatment

A

insulin

beta agonist

502
Q

healthy until 6 months of age, followed by frequent infections: process?

A

maternal antibodies are protective until about 6 months

think Brutons agammaglobulinemia

503
Q

p-ANCA (MPO-ANCA): associated conditions

A

microscopic polyangiitis

eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

504
Q

patellar reflex: associated nerve roots

505
Q

Takayasu arteritis: size of vessels involved

A

large vessels

506
Q

vitamin D deficiency: manifestations

A

rickets (children) - deformity, “bowlegs”

osteomalacia (adults) - bone pain, muscle weakness

507
Q

membranous nephropathy: microscopy findings

A

LM: GBM thickening

IF: granular deposits

EM: “spike and dome” subepithelial deposits

508
Q

oxytocin: function

A

causes uterine contractions during labor

ejection of milk from breast ductules

509
Q

atrial fibrillation: finding on venous pressure curve

A

absent a wave

510
Q

adrenal cortex vs. medulla: embryologic origin

A

cortex: mesoderm
medulla: neural crest

511
Q

stable angina: type of occlusion

A

subtotal occlusion

512
Q

mechanisms to increase afterload

A

raise mean BP

obstruct outflow of LV

513
Q

STEMI: type of ischemia

A

transmural ischemia

514
Q

osteoporosis: labs

A

Ca: normal

phosphate: normal

alk phos: normal

PTH: normal

515
Q

anticholinesterase poisoning: treatment

516
Q

unstable angina: type of occlusion

A

subtotal occlusion

517
Q

peaked T wave: timeframe in STEMI

A

hyperacute

518
Q

Turner syndrome: manifestations

A

short stature

streak ovaries

wide chest

coarctation of aorta

webbed neck

horseshoe kidney

amenorrhea

519
Q

STEMI: ECG findings

A

ST elevation

T wave inversion

Q wave

peaked T wave

520
Q

CYP450 inhibitors

A

valproic acid

isoniazid

cimetidine

erythromycin

clarithromycin

ciprofloxacin

omeprazole

metronidazole

amiodarone

grapefruit juice

521
Q

HLA-DR2: associated conditions

A

MS

SLE

Goodpasture syndrome

hay fever

522
Q

carotid sinus baroreceptors: cranial nerve

A

CN IX (glossopharyngeal)

523
Q

third pharyngeal arch: muscle derivatives

A

stylopharyngeus

524
Q

peptide hormone: hydrophilic/hydrophobic?

A

hydrophilic

525
Q

diastolic blood pressure: major determinant

A

total peripheral resistance

526
Q

limited systemic sclerosis: antibody

A

anti-centromere

527
Q

p53 gene: chromosome

A

chromosome 17

528
Q

steroid hormone: hydrophilic/hydrophobic?

A

hydrophobic

529
Q

Blue sclera

Diagnosis?

A

Osteogenesis imperfecta

530
Q

falciform ligament: connections

A

liver to anterior abdominal wall

531
Q

vitamin B9 (folate): site of absorption

A

small bowel

532
Q

Tourette syndrome vs. chronic motor tic disorder vs. vocal tic disorder

A

Tourette syndrome: motor + vocal tics

chronic motor tic disorder: only motor tics

vocal tic disorder: only vocal tics

533
Q

water soluble vitamins

A

B1, 2, 3, 5, 6, 7, 9, 12

C

534
Q

TRH: function

A

stimulates release of TSH from anterior pituitary

535
Q

sleep disturbance and vivid dreams in PTSD: treatment

A

alpha-1 blockers (prazosin in particular)

536
Q

GHRH: function

A

stimulates release of GH from anterior pituitary

537
Q

myostatic reflex pathway

A

tapping of tendon causes stretch of muscle

spindle afferent fibers sense the muscle strech via innervation of the intrafusal fibers

spindle afferent fibers carry the signal to alpha-motor neurons, which innervate the extrafusal fibers, causing muscle contraction

538
Q

gag reflex: nerves involved

A

CN IX: afferent (ipsilateral)

CN X: efferent (bilateral)

539
Q

immunoglobulin allotype: clinical relevance

A

allotypes of minor amino acid sequence differences in the constant domain of the antibody

allotypes are heritable, so they can be used to determine paternity cases

540
Q

DMD: type of mutation

A

frameshift

541
Q

portal systemic anastomoses: clinical signs and veins involved

A

esophagus: esophageal varices (left gastric -> esophageal vein -> azygos vein)
umbilicus: caput medusae (paraumbilical vein -> epigastric veins in abdominal wall)
rectum: anorectal varices (superior rectal -> middle/inferior rectal)

542
Q

Mallory-Weiss tear: common presentation

A

patient with history of alcoholism or bulimia

profuse vomiting followed by bloody vomiting

543
Q

structures perforating the diaphragm: vertebral levels

A

T8: IVC (through central tendon)

T10: esophagus, vagus

T12: aorta, thoracic duct, azygos vein (under median arcuate ligament)

544
Q

petechiae: hematologic cause

A

thrombocytopenia

545
Q

lactose intolerance: diagnosis

A

post-lactose hydrogen breath test

546
Q

low serum ceruloplasmin: diagnosis

A

Wilson diease

547
Q

beta-blocker overdose: treatment

548
Q

competitive vs. noncompetitive inhibitors: effect on Km

A

competitive: increased
noncompetitive: no change

549
Q

competitive vs. noncompetitive inhibitors: effect on Vmax

A

competitive: no change
noncompetitive: decrease

550
Q

cerebrocerebellum vs. spinocerebellum vs. vestibulocerebellum: signs of degeneration

A

cerebrocerebellum: dysdiadochokinesia, intention tremor, limb ataxia, dysarthria
spinocerebellum: truncal ataxia
vestibulocerebellum: nystagmus, problems with pursuit

551
Q

sarcoma vs. carcinoma: route of metastasis

A

sarcoma: hematogenously
carcinoma: lymphatics

(except renal cell carcinoma, hepatocellular carcinoma, choriocarcinoma, follicular thyroid carcinoma - these spread hematogenously)

552
Q

schizophrenia spectrum disorders: differentiating features

A

schizophrenia: positive and negative symptoms for >6 months

schizophreniform disorder: schizophrenia presentation for 1-6 months

brief psychotic disorder: schizophrenia presentation for <1 month

schizoaffective disorder: schizophrenia presentation with mood disorder

delusional disorder: delusions only

schizotypal personality disorder: less frequent/severe delusions

553
Q

Medicare parts A,B,C,D: services covered

A

A: hospital care, nursing homes / hospice

B: outpatient services

C: privately-adminstered replacement

D: prescription drug coverage

554
Q

transplant rejection vs. graft-versus-host disease: presentation

A

transplant rejection: widespread thombosis of graft vessles (hyperacute - minutes); vasculitis of graft vessels (acute - weeks to months); arteriosclerosis (chronic - months to years)

GvHD: rash, jaundice, diarrhea, hepatosplenomegaly (more common in bone marrow and liver transplants)

555
Q

HIV transmission during pregnancy: prophylaxis

A

zidovudine (NRTI)

556
Q

Li-Faumeni syndrome: associated mutations

557
Q

tuberous sclerosis: associated mutations

558
Q

tension pneumothorax: presentation

A

trachea deviates away from affect lung

increased intrathoracic pressure ->

mediatinal displacement ->

kinking of IVC ->

decreased venous return ->

decreased cardiac output

559
Q

leukemia in a child: likely diagnosis

A

acute lymphoblastic leukemia

560
Q

Down syndrome: associated conditions

A

ASD

Hirschsprung disease

AML/ALL

Alzheimer disease

duodenal atresia

561
Q

villous vs. tubular polyp: malignancy potential

A

villous: high malignancy potential
tubular: low malignancy potential
tubulovillous: intermediate malignancy potential

562
Q

iatrogenic causes of acute tubular necrosis (ATN)

A

antibiotics: aminoglycosides, beta-lactams, rifampin, vancomycin
antivirals: acyclovir, cidofovir, tenofovir, foscarnet
chemotherapy: cisplatin
other: radiocontrast dyes, IVIg

563
Q

Leber hereditary optic neuropathy: inheritance

A

mitochondial

(transmitted via mother)

564
Q

TB: prophylaxis treatment

A

isoniazid monotherapy

565
Q

carotid sheath: location of structures

A

common carotid artery: medial

internal jugular vein: lateral

vagus nerve: posterior

566
Q

“fried egg” appearance on CNS histology: diagnosis

A

oligodendroglioma

567
Q

probeniced: drug interactions

A

probeniced inhibits the organic anion transporter in the proximal convoluted tubule

OAT is also important for elimination of other drugs, particularly penicillins, which may required decreased doses

568
Q

iliohypogastric nerve: roots

569
Q

genitofemoral nerve: roots

570
Q

lateral femoral cutaneous nerve: roots

571
Q

obturator nerve: roots

572
Q

femoral nerve: roots

573
Q

sciatic nerve: roots

574
Q

common fibular (peroneal) nerve: roots

575
Q

tibial nerve: roots

576
Q

superior gluteal nerve: roots

577
Q

inferior gluteal nerve: roots

578
Q

pudendal nerve: roots

579
Q

iliohypogastric nerve: innervation

A

T12-L1

sensory: suprapubic region
motor: transversus abdominis, internal oblique

580
Q

genitofemoral nerve: innervation

A

L1-L2

sensory: scrotum / labia majora, medial thigh
motor: cremaster

581
Q

lateral femoral cutaneous nerve: innervation

A

L2-L3

sensory: anterior/lateral thigh
motor: none

582
Q

obturator nerve: innervation

A

L2-L4

sensory: medial thigh
motor: thigh adductors

583
Q

femoral nerve: innervation

A

L2-L4

sensory: anterior thigh, medial leg
motor: leg extenders

584
Q

sciatic nerve: innervation

A

L4-S3

sensory: none (splits into common peroneal and tibial nerves)
motor: hamstring muscles

585
Q

superficial fibular (peroneal) nerve: innervation

A

sensory: dorsum of foot (except webspace between hallux and 2nd digit)
motor: foot everters/plantarflexors

586
Q

deep fibular (peroneal) nerve: innervation

A

sensory: webspace between hallux and 2nd digit
motor: tibialis anterior (foot inversion and dorsiflexion)

587
Q

tibial nerve: innervation

A

L4-S3

sensory: sole of foot
motor: foot flexors

588
Q

superior gluteal nerve: innervation

A

L4-S1

sensory: none
motor: gluteus medius/minimus

589
Q

inferior gluteal nerve: innervation

A

L5-S2

sensory: none
motor: gluteus maximus

590
Q

pudendal nerve: innervation

A

S2-S4

sensory: perineum
motor: external urethral/anal sphincters

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