Q Banks: Week of 03/27/17 # 2 Flashcards
If a man can get an erection but not maintain it, then he likely has ________________ erectile dysfunction.
psychogenic
Don’t be tricked into picking physiologic if they give you red herrings like diabetes or stroke.
How does AMP affect glycogen phosphorylase?
It is an allosteric activator.
What are catabolite activators?
Transcription factors that activate genes in response to metabolic activity
What is tactile fremitus and how is it used?
Tactile fremitus is vibration felt on the chest wall while the person is speaking.
It is decreased in pleural effusion, pneumothorax, and COPD.
It is increased in pneumonia.
Hyperresonace occurs in which lung disorders?
Emphysema and pneumothorax
Which lung disorders present with decreased breath sounds?
- COPD
- Pneumothorax
- Pleural effusion
- Bronchial occlusion
- Atelectasis
True or false: dullness to percussion can be found in atelectasis.
True!
Describe the role that each of the following nerves plays in micturition:
•Hypogastric
•Pelvic
• Pudendal
- Hypogastric: sympathetic to detrusor and internal urethral sphincter (“You need a lot of GAS if you’re in flight or fight.”)
- Pelvic: parasympathetic to detrusor and internal urethral sphincter (“The PElvic makes you PEe.”)
- Pudendal: volUNtary to external urethral sphincter
High levels of ________________ in the nephron prevent formation of kidney stones.
citrate
Citrate binds to calcium and does not form stones, so it helps shuttle excess calcium out of the kidney. In fact, potassium citrate can be given to help treat recurrent kidney stones.
BK virus causes ________________.
hemorrhagic cystitis and nephropathy in immunocompromised individuals (fountain peeing in the Sketchy scene)
EBV can cause what cancers in those with AIDS?
CNS lymphoma and Burkitt lymphoma
True or false: head bobbing is seen in those with aortic stenosis.
False. It is seen in those with aortic regurgitation.
Other signs of AR include bounding femoral pulses and a blowing diastolic murmur best heard at the lower-left sternal border.
Why does CCl4 damage the liver?
It gets oxidized by CYP450 and causes free radical damage.
Fever, anorexia, and dark urine are signs of what viral infection?
HAV
Describe the histologic signs of HAV.
“Spotty” –i.e., not widespread –ballooning degeneration of hepatocytes with inflammatory infiltrate
LDH will be elevated in those with what histologic sign of ovarian cancer?
Dysgerminoma with “fried egg” cells
True or false: all ovarian cancers secrete CA-125.
False. Only epithelial.
Other than VEGF, _________ is an important stimulator of endothelial cell formation.
FGF
Why does oxygen supplementation cause damage to the retinas of newborns?
For some reason, hyperoxia causes neovascularization in the retina which increases likelihood of retinal detachment.
What wrist sign is typical of rheumatoid arthritis?
Ulnar deviation
Healed areas of necrosis in the brain are lined with _______________.
astrocytes
How does aflatoxin cause HCC?
Aflatoxin B1 causes mutations in p53.
Non-bacterial endocarditis – characterized by sterile, platelet-rich thrombi –can be found in advanced ____________.
malignancy
It’s thought that adenocarcinomas secrete mucin into the bloodstream which damages endothelium and leads to widespread coagulation.
Hypoplasia of the cerebellar vermis and cystic dilation of the fourth ventricle is called ______________.
Dandy-Walker malformation
The other disorder you’re likely to mistake for this is Chiari II malformations (also called Arnold-Chiari malformations), but DW will definitely be symptomatic early on, whereas Chiari II presents later.
How can you distinguish parietal cells on H&E staining?
They are highly eosinophilic.
Ras is normally only active when binding _______.
GTP
Unilateral swelling from the TMJ to the mandible in an intubated patient likely indicates ____________.
parotitis
Parotitis is an infection of the parotid glands. Risk factors include anticholinergic medications (because of xerostomia), intubation, and dehydration. It presents with fever and swelling over the parotid gland. Definitive diagnosis can be made with CT or elevated serum amylase in the absence of pancreatitis.
If a section of spinal cord has a lateral horn, then it must be from what area?
T1 - L2
The lateral horn is the sympathetic nervous system which is only found in these levels.
What is transthyretin deposition?
Transthyretin is a protein produced by the liver that binds to thyroxine. It can accumulate in the heart and produce restrictive cardiomyopathy.
How will reduced compliance appear on an LV pressure-volume curve?
Increased pressure at the same volume as a normal curve
Temporal lobe lesions produce what visual defects?
Meyer’s loop passes through the temporal lobe, so disruptions here – such as from a tumor –usually produce the contralateral “pie in the sky” defect.
In developed countries, the most common pathology that leads to subacute bacterial endocarditis is __________________.
mitral valve prolapse
In third-world countries, it is rheumatic heart fever. If a stem says a patient has “no significant medical history,” then mitral valve prolapse is a better answer than rheumatic heart disease.
True or false: mitral annular calcification can cause infective endocarditis.
False. Mitral annular calcification is a valve defect that presents in older adults with calcification around the valve. It is not a nidus for IE.
How does the hot tub folliculitis from P. aeruginosa present?
As multiple, small papulopustular lesions
How can mania be differentiated from substance-abuse-induced psychosis?
Mania does not usually cause disturbances in vital signs, so if a patient presents with signs of mania but has diaphoresis, mydriasis, hypertension, or tachycardia, then consider substance abuse as a cause.
NPH insulin is an intermediate between which two other types of insulin (in terms of duration)?
Regular insulin (8 hours) and detemir (20 hours)
Which part of the urinary tract is most likely to become obstructed in a male with a pelvic fracture?
The bulbomembranous junction (just inferior to the prostate)
This area is least supported by adjacent tissues and is thus most likely to be blocked.
What x-ray sign is typical of necrotizing enterocolitis in an infant?
Curvilinear lucency lines around the bowel
Histologically, what are nevus cells?
Melanocytes without dendrites
Histologically, melanoma cells have what feature that nevus cells don’t?
Prominent nucleoli
True or false: any nevus cells that are below the basement membrane are malignant.
False. Compound nevi and intradermal nevi are both in the dermis but are benign.
Without using a microscope, how can you tell compound nevi and interdermal nevi apart?
Intradermal nevi have lost their melanin and typically appear as skin-colored.
The “air crescent” in lung cavitary lesions is indicative of _______________.
Aspergilloma
Varicella zoster virus (VZV) is also called _______________.
human herpesvirus 8
Which Gram-negative rod is triple positive?
H. pylori: catalase-, oxidase-, and urease-positive
What is the Sister Mary Joseph nodule?
Gastric adenocarcinoma that has metastasized to the periumbilical region
A positive quellung test indicates _______________.
S. pneumoniae
Risk of ovarian cancer ___________ with use of OCPs.
decreases
Back pain, jaundice, hematemesis, and fever are indicative of what virus?
Yellow fever
List two things that progesterone does at the hypothalamus.
- Negative feedback for both LH and FSH
* Increases basal body temperature (gotta warm the oven to cook a bun)
How do the testes stop producing sperm in response to increased temperature?
The Sertoli cells are heat-sensitive and down-regulate sperm production when the body gets too hot.
Which cytokines does the body make in response to LPS?
TNF-alpha, IL-1, and IL-6
HSV temporal lobe encephalitis is especially common in ________________.
the immunocompromised
True or false: Candida infections can make the vaginal pH as low as 1.0.
False. No vaginal pathology has a pH that low.
The normal pH is 3.8 to 4.5, and Candida does not alter the normal pH.
Describe the usual presentation of subacute sclerosing panencephalitis.
This neurodegenerative disorder most often presents 6-8 years after the primary measles infection! It is caused by demyelination and leads to progressive visual, motor, and behavioral disturbances. It presents with multifocal enhancing lesions on MRI and neurons with intracytoplasmic inclusions.
Which drug causes nystagmus at therapeutic levels?
Phenytoin
You know that phenytoin can cause cleft palate in fetuses, but what else can it cause?
- Hirsutism
- Microcephaly
- Low nasal bridge
- Cardiac defects
- Phalange hypoplasia
Why does the clitoris enlarge during puberty in girls with 5-alpha reductase deficiency (and XY chromosomes)?
Because there is still testosterone present, but not DHT. At puberty, the amount of testosterone vastly increases and leads to clitoromegaly.
What happens if an XY baby has defective AMH?
He will develop male external genitalia with both male and female internal genitalia.
Which type of estrogen rises the most in pregnancy?
Estriol (“esTRIol in your TRImesters”)
Diphtheria toxin leads to impaired _______________.
translocation –remember that it is elongation factor, not initiation factor, that diphtheria toxin binds to
Centrolobular hemorrhagic necrosis in the liver is caused by ________________.
ischemic injury (occlusion of the hepatic artery)
Which bacteria can undergo phage transformation?
- group A streptococcus
- Botulinum
- Cholera
- Diphtheriae
- shigElla
What does AIDS stand for?
Acquired Immune Deficiency Syndrome
What is found in the CSF of those with PML?
Nothing
MRI is the best diagnostic for PML.
Which antiviral is used to prevent vertical transmission of HIV?
Zidovudine
If a woman has pelvic pain and there are large red chunks in her cells, then she likely has _____________-.
C. trochomatis
What is the “classic sign” of yellow fever?
Bradycardia with fever
Think of the slow, languid water buffalo in the Sketchy scene – his heart was definitely slow.
How can you differentiate between late proliferative and early secretory endometrium?
Early secretory endometrium will have vacuoles starting in the glands –little cleared out areas of the glandular cells near the basement membrane.
Also, the secretory endometrium will start to have tortuous glands.
HEV used to be classified as a ____________ virus.
Calici
This is useful in remembering HEV’s features.
Scalded skin syndrome disrupts which intercellular connections?
Desmosomes (hence the easily ruptured blisters)
The biggest difference between IgA nephropathy and PSGN is ____________.
time!
IgA nephropathy presents in two or three days, while PSGN presents in two weeks.
Persistent activation of stellate cells is found in ______________.
micronodular cirrhosis; the stellate cells are what lay down the collagen
Which type of testicular cancer has an alveolar/papillary pattern?
Embryonal carcinoma
What is the histologic appearance of seminomas?
Large cells with watery cytoplasm (the fried-egg look)
Which testicular mass is most common in boys younger than 3?
Yolk sac
“Yolk sac for the Young.”
Which obstetric complication leads to dark blood from the vagina?
Abruptio placentae
It is darker because the fetal blood leaks from the intravillous spaces.
