Practice Test One Flashcards
murmurs of endocarditis
mitral/tricuspid regurg which are holosystolic
most common cause of mitral stenosis and presenting symptoms
rheumatic fever (past). mid-diastolic murmur.
Peutz-Heghers syndrome
autosomal dominant disease due to kinase STK11. have pigmented skin lessons near mouth/hands/feet and abdominal pain from GI polyps
lipoma vs liposarcoma
nuclear abnomralities like “scalloping” and pleotropy
easily ruptured blisters which heal completely
must be above basal layer of epidermis (pemphigus vulgaris)
which pneumocytes secrete surfactant?
type 2 pneumocytes
most common cause of horners?
pancoast tumor pressing on sympathetic trunk
how to get turners syndrome patient preggo
IVF. they have streak ovaries so GnRH dn’t do shit
Diabetes inspidious in psyc patient
can be caused by Li mood stabalizers. So nephrogenic not central. can be called “renal tubular dysfunction”
sudden death in young atheles during excercise with heart murmos
hypertrophic cardiomyopathy. coronary arteries are normal but heart is big.
biventricular dilation occurs in
dialted cardiomyopathy not hypertrophic
when does the second heart sound occur?
when aortic pressure becomes > than LV pressure. NOT when LA > LV (that is when filling happens during diastoli
special consideration for IgA deficent patients with transfusions
they produce anti-IgA
what does DNA pol I do?
replaces primers of replication with DNA
ovarian cancer can cause ascities. got it?
good
ovarian cancer marker?
ca 125
drug cocktail given for transplant
calcineurin inhibitor (cyclosporine, tacrolimus, sirolimus), glucocorticoid (prednisone) and purine synthesis inhibitor (azothioprine or mycophenolate mofetil)
cyclosporine famously damages what?
kidneys
Metoclopramide should be avoided in
parkinsonians
what happens to electrolytes during ischemia?
K out, Na in
juxtaglomerulous cells release
renin (macula densa signals to them)
female athlete triad
disordered eating, amenorrhea and osteoporosis (central hypoestrogenism)
Familial hypercholesterolemia genetics
autosomal dominant. LDL receptor. So can’t clear LDL (and cholestrol as well). Xanthomas
where does the pancreas sit on CT?
anterior to the IVC and aorta at L2 kinda right beside/infront of the right kidney
where can DNA pol add bases?
3’ hydroxyl
why give heparin instead of warfarin during pregnancy?
cause heparin is water soluble so it can’t cross placenta while warfarin can
STD with purulent penile discharge, burning pee, gram negative
Neisseria gonorrhoeae
gram neg, kidney bene shaped, diplococci within white blood cells
N. gonorrhoeae
how does gonorrhoeae adhere and what properties does that have?
use pili. pili have phase variation (turn on and off) and antigenic variation
what is it called when two viruses infect the same cell and they swap material allowing for species mixing of viruses?
genetic reassortment
what happens if glycolysis is impared?
neonatal death
what is McArdle (glycogen storage disease type V)
no myophophorylase (muscle glycogen phosphorylase) which breaks down glycogen for glucose in muscle. results in exercise intolerance
pathophys of graves ophthalmopathy
lymphocytes invade and release cytokines which cause GAG production by fibroblasts
jugular venous tracing order
first (a) wave is right atrial contract, next (c) wave is bulge of tricuspid during R vent contract, downslop (x) is right atria relax, second wave (v) wave is continued inflow while pressure builds and then y downslope when atria starts emptying
features of teratology of the fallot
1: pulm stenosis
2: right vent hypertrophy
3: overriding aorta
4: ventricular septal defect
the CAAT and TATA box promote what?
transcription
what vitamin def mimics Ehlers-Danlos syndrome?
vitamin C
what does vitamin C def cause?
hypermobile joints, extensible skin, collagen defects, bruising and hemorrhage (vessels break easy)
what makes hepatic nodules in cirrhosis?
the nodules are actually hepatocytes while lined with fibroblasts.
soft, compressible mass that transilluminates in the head/neck? associated with what?
cystic hygroma (lymphatic malformation). due to chromosomal aneuploidy
lactose intolerance is due to what molecular changes?
decreased expression of lactase
radiation to neck/head causes what risk?
thyroid cancer. thyroid is super sensitive to radiation
inappropriate and increased sexual activity, oral fixation, hyperphagia, visual agnosia, aphasia, flat emotions. disease name and cause (brain lesion)
Kluver-Bucy syndrome due to destruction of amygdala (sometimes due to HSV). located under the basal ganglia but more lateral (underside/medial parts of temporal lobes)
cyclosporin mechanism
binds cyclophin which together inhibit calcineurin thus no calcium-dependent genes expressed including many cytokines. in particular IL-2 is not transcribed
what is tardive dyskinesia
involuntary movment disorder including lipsmacking and tongue protrusions after years of antipsychotics (antidopamines). upregulation of dopamine receptors.
what does dopamine hydroxylase make and what is that important for?
norepinephrine. first signs will be orthostatic hypotension. NE is in sympathetic postganglionic neurons (horners shit too).
advantage of inactivated polio vaccine over oral form?
doesn’t revert to virulent form
headache, puffy face, enlarged neck veins, shoulder pain, in chronic smoker
SVC syndrome
CT at the root of the aorta, where is the SVC?
just below and to the left of aorta (big one on top).
nerve which will be damaged with midshaft humerus fracture and subsequent defect?
radial nerve and wrist extension problems with tricep sparing cause the nerves for that have already left radial nerve
round eosinophilic inclusions in hipoocampal neurons with muscle contractions and death
rabies (Negri bodies)
orthostatic hydrostatic response is due to?
alpha1-adrenergic
how is aminoglycocide resistance gained?
1: poor drug penetrance (requires active transport)
2: mutations to 30S ribosome
3: enzymatic degradation
orlistat
inhibits intestinal lipase to help fatties lose weight
what connects the rectum to the liver (cause lord knows thats important)
inferior mesenteric vein
what secondary molecule is induced by insulin in the liver?
Fructose-2,6-bisphosphate via PFK2 induction
cavernous sinus contains?
internal carotid, CN 3/4/6 and trigem (V2/3). also is the only sinus which recieves blood from facial veins.
VSD vs teratology of fallot obvious physical difference
VSD doesn’t turn blue. ToF does especially during exertion
parasite that is prevalent in the homosexual community which causes diarrhea?
Entamoeba histolytica cause of anal sex (well oral-anal…)
hormones that are produced after oral glucose but not IV
Incretins: Glucagon-like peptide 1, Gastric Inhibitory Peptide. They stimulated insulin release.
hypertensive drug that may cause potter sequence and renal agenisis?
ACE inhibitors
how do statins change HDL, LDL, and Tri?
inhibit chol synth causing increased hepatic LDL-R (uptake more)
ApoB synth locations
this LDL/VLDL component is made full length ApoB100 in liver and truncated ApoB48 in intestine
Chlamydia treatment
protein synthesis inhibitor azithromycin (single dose)
probenecid
inhibits renal excretion of penicillin and cephalosporin
cilastatin
given to prolong imipenem by inhibiting hydrolysis in kidney
tetracyclin teratogen
yellows teeth and deposits in the bone. it associates with Ca and is codeposited in fetus
disease caused by loss of pyrimidine dimer fixing mechanism ?
xeroderma pigmentosum
how does cirrhosis effect estrogen and effects?
increases estrogen due to lower degradation. effects include spider angioma, palamar erythema, gynecomastia, testicular atrophy, and decrease body hair
neurofibromatosis type I findings
neurofibromas, pigmented lesions (schwann cell freckles in axilla, cafe-au-lait spots), pigmented iris hamartomas
percent within 1, 2, 3 SD of the mean?
68, 95, 99.7
what happened to atretic follicles?
they underwent apoptosis
what does proline hydroxylation do to collagen
stabalize the triple helix
uncal herniation results in?
CN3 compression
older women with compression fracture
low estrogen due to menopause (ovary)
first step in heme synthesis?
glycine and succinyl-CoA combined to make ALA
effect of ACE inhibitor on renin?
increases it
HIV diarrhea: multiple ulcers &mucosal erosions, large cells with basophilic intranuclear inclusions
cytomegalovirus
HIV diarrhea: nonulcerative inflammation, basophilic clusters on surface of mucosal cells
cryptosporidium
HIV diarrhea: distortion of villus architecture w/o inflammation. small spores with equatorial belt like structure
microsporidium
HIV diarrhea: granulomas, acid fast bacilli
mycobacterium avium complex
what does gp41 do in HIV?
membrane fusion
VHL cancers
cerebellar/retinal hemangioblastomas, renal clear cell carcinoma, pheo
where in the eye is copper deposited in Wilson’s disease?
cornea
vascular tethering of white cells uses what proteins?
selectin and ICAM
what generates the respiratory burst of the neutrophils?
NADPH oxidase (it makes superoxide ions)
fibroadenoma vs cystic change
fibroadenoma is the most common benign breast tumor and is well demarcated and small and changes with menstrual cycle. Meanwhile cystic change is the most common cause of palpable masses, however they change all of the breasts firmness and are painful and less defined
hyperchromic nests on skin
melanocytic nevus
two drugs which act on GABA channels?
benzodiazepines and barbiturates
flumazenil inhibits the actions of what drug class?
benzodiazepines
besides the mamillary bodies, what does alcohol break down in the brains?
cerebellar purkinje neurons, giving rise to the wobbliness of long time alcoholics
what embryonic structure is the cerebellum derived from?
rhombencephalon
what do leucine zippers do?
bind DNA
Reed-sternberg (big ass bilobed cell)
Hodgkin’s lymphoma
what does phospholipase C do after G protein signalling?
cleaves phospholipid to produce IP3 and DAG. IP3 stims Ca release from ER which together with DAG stimulate PKCs.
alcoholic heart problem
alcoholic dialated cardiomyopathy
what drug hits the mycolic acid found in acid-fast organisms?
Isoniazid
vaginal bleeding plus high beta-hCG weeks after birth
choriocarcinoma
how do retinoids (isotretinoin) work?
bind RA-receptor and RXR to prevent transcription. this calms down sebum production (used in acne)
perforates diaphram at T10
vagus and esophagus
hexokinase or glucokinase in the liver/pancreas?
glucokinase
osteomyelitis in adults, children, and sickle cell
adults: gonnarrhea
children: S aureus
sickle cell: Salmonella
which hemorrhage cauese pinopoint pupils, loss of horizontal gase, quadriparesis, decerebrate posturing and rapid coma to death
pontine hemorrhage
