Qbank4 Flashcards by Sierra Jin

what vaccines are conjugated? why?

vaccines of the encapsulated organisms… AKA hemophilus, neisseria, strep pneumo. Their virulence is via capsule, which is best counter acted by antibodies…thus a protein toxin is conjugated to activate T cells/B cell interaction for Ab isotype switch

How well did you know this?

Not at all

Perfectly

what kind of vaccine is varicella?

live attenuated

How well did you know this?

Not at all

Perfectly

what kind of vaccine is BCG?

live attenuated

How well did you know this?

Not at all

Perfectly

what is homeodomain genes?

hox genes.

How well did you know this?

Not at all

Perfectly

early diastolic snap with rumbling at heart apex

mitral valve stenosis

How well did you know this?

Not at all

Perfectly

fixed split

ASD

How well did you know this?

Not at all

Perfectly

Pt with mitral valve stenosis. what’s the probable cause?

rheumatic heart disease (chronic)

How well did you know this?

Not at all

Perfectly

which sun screen protects against UVB?

PABA; zinc

How well did you know this?

Not at all

Perfectly

which sun screen protects against UVA?

avobenzone, zinc

How well did you know this?

Not at all

Perfectly

unconjugated bilirubin is insoluble…what is it attached to?

albumin

How well did you know this?

Not at all

Perfectly

virulence factors of Pseudomonas

A (exotoxin A-EF ribosylation), Collagenase/Phospholipase C, DNase, Elastase, Fibrinolysin

How well did you know this?

Not at all

Perfectly

urinary incontinence in diabetic? sx and associations

can’t feel urge to urinate
overflow incontinence due to loss of efferent and afferent nerves
increased urination at night due to relaxation of pelvic muscles

How well did you know this?

Not at all

Perfectly

burning feet and GI distress. what vitamin is missing?

vitamin B5; CoA

How well did you know this?

Not at all

Perfectly

what structures are supplied by the PCA?

visual cortex, corpus callosum/splenium, thalamus, cranial nerves III and IV

How well did you know this?

Not at all

Perfectly

when do you use ADP receptor blockers?

PCI, unstable angina/nonSTEMI

How well did you know this?

Not at all

Perfectly

when do you use Heparin?

in pt prevention of DVT/PE

How well did you know this?

Not at all

Perfectly

name the top 3 possibilities of pituitary secretive tumor

prolactin, ACTH, GH

How well did you know this?

Not at all

Perfectly

harsh systolic crescendo, decrescendo murmur

HCM (or it could be aortic stenosis)

How well did you know this?

Not at all

Perfectly

Pt with calcium stones…which diuretic is good for them?

thiazides, because it increases passive calcium reabsoprtion… thus less calcium is dumped into the kidneys…thus less stones

How well did you know this?

Not at all

Perfectly

what is the mechanism by which thiazides lead to less calciuria

It inhibits Na/Cl transporter… thus less Na is in the tubular cell… Na then flows into the cell more readily in exchange for Ca pumped out to the blood… thus more calcium reabsorption.
hypovolemia created by the thiazides induces PT to reuptake more Na and thus Calcium follows

How well did you know this?

Not at all

Perfectly

pelvic fracture is likely to injur which part of the urethra in men?

membranous portion

How well did you know this?

Not at all

Perfectly

straddle injury is likely to injure which aprt of the urethra?

the proximal portion of the penile urethra

How well did you know this?

Not at all

Perfectly

what are some signs of tumor lysis syndrome? how do you treat it?

Tumor lysis syndrome you will have 1. Increased intracellular electrolyte leakage… like K and P. 2. You will have increased uric acid.

Thus complications include arrythmias, renal failure, gout.

Treat with Allopurinol/Pegloticase

How well did you know this?

Not at all

Perfectly

what does carbidopa do. what symptoms are lessened when used with levodopa; what symptoms will not better/worsen?

carbidopa inhibits Levodopa activity in the periphery and thus concentrates it in the brain.

This lessens N/V symptoms; but worsens agitation/anxiety

How well did you know this?

Not at all

Perfectly

low potency antipsychs are which? what are their SE?

Chlorpromazine and Thioridazine; SE include: anti cholinergic, antihistamine, antialpha andrenergic

what shoud you not give in digoxin tox?

calcium gluconate

HFE on intestine epithelium detects what and what does it do?

it interacts with transferrin...if low iron then will increase iron absorption by increasinf divalent metal transporter... n decreasing hepcidin... mut leads to inability to detect transferrin...leading to hemachromatosis

hemophilus travels to brain to cause meningitis via what route?

lymphatics

myxomatous changes in blood vessel

medial degeneration; marfan

what is cacipotriene?

vit D analog

what vitamin can you use to treat psoriasis?

vit D analogs

CD34 is what marker?

endothelial

what might a pt with abetaliproproteinemia have symptom wise? waht about histologically in the jejunal lumen?

sx: ataxia, malabsorption of fat soluble vitamins, steatorrhea. Histo: large foamy intestinal epithelium because no betalipoprotein =no chylomicron/VLDL/LDL thus the absoprbed fats cann't enter bloodstream and remains in the cells

what's the difference between plasmin over activation and DIC?

both will have increased bleeding and factor deficiency... However, only DIC will have ddimer

PTT does not rise when Heparin is given...dx?

ATIII deficiency

leukemias by age

ALL 60

what are the three causes of megalocytic anemia?

Folate/B12 deficiency | Orotic aciduria

what are causes of macrocytic-nonmegalocytic anemia?

liver disease alcoholism reticulocytosis

why are reticulocytes blue hued?

because they have RNA

number 1 cause of death in sickle cell adults?

acute chest syndrome; usually occurs post pneumonia

what are lysed in PNH? what are complications of PNH

RBC, WBC, and platelets are destroyed in PNH due to complement activation; Thus this leads to anemia/iron deficiency, AML deveopment potentially/infections, and THROMBOSIS due to bursting of platelet contents.

Pt with PNH dies, what is the likely cause?

thrombosis

how do you treat autoimmune hemolysis?

Steroids, IVIG to make the macrophages eat the IG instead of the IG on the RBC

what are CD34 cells

hematopoeitic stem cells

Eosinophilia is seen in waht malignancy

Hodgkins

lymphocytosis is seen in what bacteria infection

bordetella

alkylating chemotherapy is associated with what blood cancer?

myelodysplastic syndrome; AML

carribean patient with rash and lytic bone lesions

adult T cell lymphoma

suprachiasmatic nuclei

circadian rhythm

anterior nucleus of hypothalamus lesion

hyperthermia

Spongiosis of epidermis is seen in what?

eczema

what do you seen for skin biopsy for urticaria

dermal edema. no epidermal changes

urge incontinence in MS. where is the lesion?

frontal lobe thus decreasing in CNS inhibition of micturition center.

Where does micturitiion urge come from?

S2-S4. spinal micturition center

Fatigue, proximal weakness, myoedema with percussion to muscle, elevated CK

Hypothyroidism

why does an infection of the biliary system lead to brown stones?

bacteria injure hepatocytes...releasing beta glucuronidase...thus hydrolyzing conjugated bilirubin and precipitating stones

nasal ulcer, oliguria

Wengener CANCA

ether can destroy what kind of viruses?

enveloped

N acetylmuranic acid and N acetylglucosylamine are components of what?

peptidoglycan precursor

D-ala-D-ala is a structural component of waht

pepetidoglycan precursors that is bound by transpeptidases... Penicillins are analogs of these

why does Hep C have such large antigenic variation to its envelope?

Because it doesn't have 3'-5' exonuclease proof reading to the Viral coded RNA pol

Why do you see cataracts in galactokinase deficiency?

galactokinase deficiency prevents galactose conversion to galactose 1 phosphate... thus it will be acted upon by aldoase reductase and transformed to galacitol and build up in the lens

what kind of receptors are GABAa, b, and c?

A and C are chloride channels | GabaB is a Gi protein

What is GABA synthesized from?

Glutamate

What vitamin is needed in synthesis and catabolism of GABA?

What is the cause of stress incontinence?

weakened sphincter or pelvic floor

how is resistance against penicillins achieved

mutation of PBP or penicillinase

How is resistance against Aminoglycosides achieved?

acetylation or other modification of the abx

How is resistance against tetracyclnes achieved?

changing the ribosomal structure or efflux pump

How is resistance against floroquinolones achieved

changing gyrase structure

decreased FEV1/FVC

obstructive

increased FEV1/FVC

restrictive

the time period between starting to take vitamin E to seeing the clinical benefits of vitamin E is called?

latency period. This can also apply to pathogens

What is the rare disease assumption?

when i disease is rare... OR approximates RR

schiling test with elevated urine cobalamine indicates what's the issue?

decreased dietary intake of cobalamine... since clearly Intrinsic factor is there and the ileum is intact to intake it

bradycardia post MI in leads II, III, AVF. what vessel is occluded?

RCA

which is worse. arnold chiari I or II

II... this one both vermis and medulla are in the foramen magnum and there will be meningomyelocele

What's the vitamin most likely needing parenteral replacement?

B12, since people who are deficient are usually deficient due to atrophic gastritis... (unless they're strict vegetarians)

what makes green sputum?

neutrophil Myeloperoxide (contains heme)

eye lesion in HIV pt. What's the CD4 count?

less than 50. this is CMV

Squamous cell carcinoma of the bladder...what's the cause?

Schistomiasis hematobium

what's ethambutol's mechanism? side effect?

Mechanism: inhibition of D arabinose crosslinking thus inhibiting the cell wall. Side effect: Green/red color blindness

why is warfarin used for prophylaxis post mechanical valves and not heparin?

because heparin is ONLY IV

which cytokine is responsible for cachexia seen in cancer?

TNFa

glycogen phosphorylase is activated by what?

epinephrine and glucagon... leading to increased Calcium and PKA...thus phosphorylating glycogen phosphorylase kinase

what do you use to treat WPW?

procainamide, amiodarone

how many seconds are in a small box of ECG

0.04s

how many seconds are in a large box on ECG

0.2s

Afib treatments. How to rhythm control; how to rate control? what to do if the arrythemia is more than 48 hours?

if less than 48 hours: rate control with digoxin, beta blocker, calcium channel blocker rhythm control with sotalol and amiodarone If it's more than 48 hours you must start on heparin and warfarin

what is first degree AV block?

PR interval will be more than .2s

what heart abnl can lyme disease cause?

first and third degree heartblock

what is second degree AV block

mobitz I=wenckebach: longer longer drop | mobitz II=random drop

what is third degree AV block?

no correlation between atrial and ventricular beats

which way is R axis deviation toward? and which side is L axis deviation towards?

L is toward AVL | R is toward III

how to calclulate HR?

1500/small boxes estimate by 300-150-100-75-60-50

what are the key features of afib on EKG?

no p waves; irregularly irregular QRS

torsade with deafness?dx

Jervall and lange neisen

breast lesion with abundant lymphocytic infiltrate

medullary carcinoma (invasive)

what is comedonecarcinoma?

subset of DCIS characterized by central necrosis and no invasion

most common cause of death due to MI?

V fib within hours of the initial event

distended macrophage in lamina propria of small bowel would indicate what disease?

whipple

secreting tumor of the appendix...what should you think of?

carcinoid syndrome or another neuroendocrine tumor.

uniform rosette like glandular cells in the appendix with eosinophilic cytoplasm

neuroendocrine cells/carcinoid tumor

slightly larger RBC with blue hue.. what is it and why is it blue?

reticulocyte; mRNA remnant.

strawberry hemangioma; what's the growth pattern

at first grows with the child... then will regress within a couple of years

patient with bleeding demonstrates prolonged bleeding time and PTT. what is the dx?

vonwillebrand; autosomal dominant

prolonged TT, PT, PTT. bleeding time is normal

dysfibrinogenemia

delayed bleeding; normal PT and PTT

factor XIII deficiency... factors in cascade are not missing but can't crosslink fibrin

what' the effect of polycythemia vera on EPO?

EPO is decreased by feedback

what are key sx of churg strauss?

asthma, wrist/footdrop, heart, GI, kidney problems

what do you see on histo with churg strauss?

necrotizing granulomas; eosinophilia. high IgE

Name the small vessel vasculities?

Wengener's, micrscopic polyangiitis, churg strauss, henoch scholein

palpable purpura ...what do you think of?

vasculitis

which of the small vessel vasculities have granulomatous necrosis?

Wengener; churgstrauss

treatment for small vessel vasculities?

cyclophosphomide/corticosteroids

polyarteritis nodosa is associated with what infection seromarker?

hepB positive in 30%

what organs does polyarteritis nodosa effect and what organ does it not effect?

it affects skin, kidneys, brain, GI, heart SPARES LUNGS