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Step Uno > Practice Test One > Flashcards

Practice Test One Flashcards

1
Q

murmurs of endocarditis

A

mitral/tricuspid regurg which are holosystolic

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2
Q

most common cause of mitral stenosis and presenting symptoms

A

rheumatic fever (past). mid-diastolic murmur.

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3
Q

Peutz-Heghers syndrome

A

autosomal dominant disease due to kinase STK11. have pigmented skin lessons near mouth/hands/feet and abdominal pain from GI polyps

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4
Q

lipoma vs liposarcoma

A

nuclear abnomralities like “scalloping” and pleotropy

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5
Q

easily ruptured blisters which heal completely

A

must be above basal layer of epidermis (pemphigus vulgaris)

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6
Q

which pneumocytes secrete surfactant?

A

type 2 pneumocytes

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7
Q

most common cause of horners?

A

pancoast tumor pressing on sympathetic trunk

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8
Q

how to get turners syndrome patient preggo

A

IVF. they have streak ovaries so GnRH dn’t do shit

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9
Q

Diabetes inspidious in psyc patient

A

can be caused by Li mood stabalizers. So nephrogenic not central. can be called “renal tubular dysfunction”

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10
Q

sudden death in young atheles during excercise with heart murmos

A

hypertrophic cardiomyopathy. coronary arteries are normal but heart is big.

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11
Q

biventricular dilation occurs in

A

dialted cardiomyopathy not hypertrophic

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12
Q

when does the second heart sound occur?

A

when aortic pressure becomes > than LV pressure. NOT when LA > LV (that is when filling happens during diastoli

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13
Q

special consideration for IgA deficent patients with transfusions

A

they produce anti-IgA

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14
Q

what does DNA pol I do?

A

replaces primers of replication with DNA

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15
Q

ovarian cancer can cause ascities. got it?

A

good

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16
Q

ovarian cancer marker?

A

ca 125

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17
Q

drug cocktail given for transplant

A

calcineurin inhibitor (cyclosporine, tacrolimus, sirolimus), glucocorticoid (prednisone) and purine synthesis inhibitor (azothioprine or mycophenolate mofetil)

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18
Q

cyclosporine famously damages what?

A

kidneys

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19
Q

Metoclopramide should be avoided in

A

parkinsonians

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20
Q

what happens to electrolytes during ischemia?

A

K out, Na in

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21
Q

juxtaglomerulous cells release

A

renin (macula densa signals to them)

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22
Q

female athlete triad

A

disordered eating, amenorrhea and osteoporosis (central hypoestrogenism)

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23
Q

Familial hypercholesterolemia genetics

A

autosomal dominant. LDL receptor. So can’t clear LDL (and cholestrol as well). Xanthomas

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24
Q

where does the pancreas sit on CT?

A

anterior to the IVC and aorta at L2 kinda right beside/infront of the right kidney

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25
Q

where can DNA pol add bases?

A

3’ hydroxyl

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26
Q

why give heparin instead of warfarin during pregnancy?

A

cause heparin is water soluble so it can’t cross placenta while warfarin can

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27
Q

STD with purulent penile discharge, burning pee, gram negative

A

Neisseria gonorrhoeae

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28
Q

gram neg, kidney bene shaped, diplococci within white blood cells

A

N. gonorrhoeae

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29
Q

how does gonorrhoeae adhere and what properties does that have?

A

use pili. pili have phase variation (turn on and off) and antigenic variation

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30
Q

what is it called when two viruses infect the same cell and they swap material allowing for species mixing of viruses?

A

genetic reassortment

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31
Q

what happens if glycolysis is impared?

A

neonatal death

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32
Q

what is McArdle (glycogen storage disease type V)

A

no myophophorylase (muscle glycogen phosphorylase) which breaks down glycogen for glucose in muscle. results in exercise intolerance

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33
Q

pathophys of graves ophthalmopathy

A

lymphocytes invade and release cytokines which cause GAG production by fibroblasts

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34
Q

jugular venous tracing order

A

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

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35
Q

features of teratology of the fallot

A

1: pulm stenosis
2: right vent hypertrophy
3: overriding aorta
4: ventricular septal defect

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36
Q

the CAAT and TATA box promote what?

A

transcription

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37
Q

what vitamin def mimics Ehlers-Danlos syndrome?

A

vitamin C

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38
Q

what does vitamin C def cause?

A

hypermobile joints, extensible skin, collagen defects, bruising and hemorrhage (vessels break easy)

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39
Q

what makes hepatic nodules in cirrhosis?

A

the nodules are actually hepatocytes while lined with fibroblasts.

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40
Q

soft, compressible mass that transilluminates in the head/neck? associated with what?

A

cystic hygroma (lymphatic malformation). due to chromosomal aneuploidy

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41
Q

lactose intolerance is due to what molecular changes?

A

decreased expression of lactase

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42
Q

radiation to neck/head causes what risk?

A

thyroid cancer. thyroid is super sensitive to radiation

43
Q

inappropriate and increased sexual activity, oral fixation, hyperphagia, visual agnosia, aphasia, flat emotions. disease name and cause (brain lesion)

A

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)

44
Q

cyclosporin mechanism

A

binds cyclophin which together inhibit calcineurin thus no calcium-dependent genes expressed including many cytokines. in particular IL-2 is not transcribed

45
Q

what is tardive dyskinesia

A

involuntary movment disorder including lipsmacking and tongue protrusions after years of antipsychotics (antidopamines). upregulation of dopamine receptors.

46
Q

what does dopamine hydroxylase make and what is that important for?

A

norepinephrine. first signs will be orthostatic hypotension. NE is in sympathetic postganglionic neurons (horners shit too).

47
Q

advantage of inactivated polio vaccine over oral form?

A

doesn’t revert to virulent form

48
Q

headache, puffy face, enlarged neck veins, shoulder pain, in chronic smoker

A

SVC syndrome

49
Q

CT at the root of the aorta, where is the SVC?

A

just below and to the left of aorta (big one on top).

50
Q

nerve which will be damaged with midshaft humerus fracture and subsequent defect?

A

radial nerve and wrist extension problems with tricep sparing cause the nerves for that have already left radial nerve

51
Q

round eosinophilic inclusions in hipoocampal neurons with muscle contractions and death

A

rabies (Negri bodies)

52
Q

orthostatic hydrostatic response is due to?

A

alpha1-adrenergic

53
Q

how is aminoglycocide resistance gained?

A

1: poor drug penetrance (requires active transport)
2: mutations to 30S ribosome
3: enzymatic degradation

54
Q

orlistat

A

inhibits intestinal lipase to help fatties lose weight

55
Q

what connects the rectum to the liver (cause lord knows thats important)

A

inferior mesenteric vein

56
Q

what secondary molecule is induced by insulin in the liver?

A

Fructose-2,6-bisphosphate via PFK2 induction

57
Q

cavernous sinus contains?

A

internal carotid, CN 3/4/6 and trigem (V2/3). also is the only sinus which recieves blood from facial veins.

58
Q

VSD vs teratology of fallot obvious physical difference

A

VSD doesn’t turn blue. ToF does especially during exertion

59
Q

parasite that is prevalent in the homosexual community which causes diarrhea?

A

Entamoeba histolytica cause of anal sex (well oral-anal…)

60
Q

hormones that are produced after oral glucose but not IV

A

Incretins: Glucagon-like peptide 1, Gastric Inhibitory Peptide. They stimulated insulin release.

61
Q

hypertensive drug that may cause potter sequence and renal agenisis?

A

ACE inhibitors

62
Q

how do statins change HDL, LDL, and Tri?

A

inhibit chol synth causing increased hepatic LDL-R (uptake more)

63
Q

ApoB synth locations

A

this LDL/VLDL component is made full length ApoB100 in liver and truncated ApoB48 in intestine

64
Q

Chlamydia treatment

A

protein synthesis inhibitor azithromycin (single dose)

65
Q

probenecid

A

inhibits renal excretion of penicillin and cephalosporin

66
Q

cilastatin

A

given to prolong imipenem by inhibiting hydrolysis in kidney

67
Q

tetracyclin teratogen

A

yellows teeth and deposits in the bone. it associates with Ca and is codeposited in fetus

68
Q

disease caused by loss of pyrimidine dimer fixing mechanism ?

A

xeroderma pigmentosum

69
Q

how does cirrhosis effect estrogen and effects?

A

increases estrogen due to lower degradation. effects include spider angioma, palamar erythema, gynecomastia, testicular atrophy, and decrease body hair

70
Q

neurofibromatosis type I findings

A

neurofibromas, pigmented lesions (schwann cell freckles in axilla, cafe-au-lait spots), pigmented iris hamartomas

71
Q

percent within 1, 2, 3 SD of the mean?

A

68, 95, 99.7

72
Q

what happened to atretic follicles?

A

they underwent apoptosis

73
Q

what does proline hydroxylation do to collagen

A

stabalize the triple helix

74
Q

uncal herniation results in?

A

CN3 compression

75
Q

older women with compression fracture

A

low estrogen due to menopause (ovary)

76
Q

first step in heme synthesis?

A

glycine and succinyl-CoA combined to make ALA

77
Q

effect of ACE inhibitor on renin?

A

increases it

78
Q

HIV diarrhea: multiple ulcers &mucosal erosions, large cells with basophilic intranuclear inclusions

A

cytomegalovirus

79
Q

HIV diarrhea: nonulcerative inflammation, basophilic clusters on surface of mucosal cells

A

cryptosporidium

80
Q

HIV diarrhea: distortion of villus architecture w/o inflammation. small spores with equatorial belt like structure

A

microsporidium

81
Q

HIV diarrhea: granulomas, acid fast bacilli

A

mycobacterium avium complex

82
Q

what does gp41 do in HIV?

A

membrane fusion

83
Q

VHL cancers

A

cerebellar/retinal hemangioblastomas, renal clear cell carcinoma, pheo

84
Q

where in the eye is copper deposited in Wilson’s disease?

A

cornea

85
Q

vascular tethering of white cells uses what proteins?

A

selectin and ICAM

86
Q

what generates the respiratory burst of the neutrophils?

A

NADPH oxidase (it makes superoxide ions)

87
Q

fibroadenoma vs cystic change

A

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

88
Q

hyperchromic nests on skin

A

melanocytic nevus

89
Q

two drugs which act on GABA channels?

A

benzodiazepines and barbiturates

90
Q

flumazenil inhibits the actions of what drug class?

A

benzodiazepines

91
Q

besides the mamillary bodies, what does alcohol break down in the brains?

A

cerebellar purkinje neurons, giving rise to the wobbliness of long time alcoholics

92
Q

what embryonic structure is the cerebellum derived from?

A

rhombencephalon

93
Q

what do leucine zippers do?

A

bind DNA

94
Q

Reed-sternberg (big ass bilobed cell)

A

Hodgkin’s lymphoma

95
Q

what does phospholipase C do after G protein signalling?

A

cleaves phospholipid to produce IP3 and DAG. IP3 stims Ca release from ER which together with DAG stimulate PKCs.

96
Q

alcoholic heart problem

A

alcoholic dialated cardiomyopathy

97
Q

what drug hits the mycolic acid found in acid-fast organisms?

A

Isoniazid

98
Q

vaginal bleeding plus high beta-hCG weeks after birth

A

choriocarcinoma

99
Q

how do retinoids (isotretinoin) work?

A

bind RA-receptor and RXR to prevent transcription. this calms down sebum production (used in acne)

100
Q

perforates diaphram at T10

A

vagus and esophagus

101
Q

hexokinase or glucokinase in the liver/pancreas?

A

glucokinase

102
Q

osteomyelitis in adults, children, and sickle cell

A

adults: gonnarrhea
children: S aureus
sickle cell: Salmonella

103
Q

which hemorrhage cauese pinopoint pupils, loss of horizontal gase, quadriparesis, decerebrate posturing and rapid coma to death

A

pontine hemorrhage

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