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1
Q

true vocal cords

A

stratified squamous

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2
Q

paranasal sinus, laryngeal vestibule, false vocal cords, trachea

A

ciliated pseudostratified columnar mucus

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3
Q

pseudomonas

A

ecthyma gangrenosum; exotoxins perivascular

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4
Q

acute manic

A

lithium, valporate, carbamazepine + atypical (olanzipine)

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5
Q

wiskott-aldrich

A

thrombocytopenia, eczema, purpura; IgM low

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6
Q

immediate hypersensitivity

A

mast cells and basophils

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7
Q

Eosinophils

A

defense against parasites: when a parasite enters the bloodstream, binds to free IgE; this binds to an IgE Fc receptor (heavy chain) located on the eosinophil cell surface. Eosinophil –> major basic protein and other enzymes from its granules, substances that damage and destroy the antibody parasites. Antibody-dependent cellular killing (macrophages and NK cells also do this)

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8
Q

how to eosinophils regular type 1 hypersensitivity reactions

A

histaminase –> helps with atopic symptoms, granules also contain leukotrienes and peroxidases that facilitate inflammation

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9
Q

penetrating injury to the neck superior to cricoid cartilage injuries what nerve

A

ansa cervicalis

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10
Q

what is responsible for intimal thickening after intimal injury

A

smooth muscle cells –> synthesis of new collage, elastin, and proteoglycans

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11
Q

when does PPV increase

A

increase disease prevalence

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12
Q

when does NPV increase

A

decrease disease prevalence

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13
Q

what does carbidopa do in terms of side effects

A

lowers the peripheral side effects: nausea, vomiting, ventral extrasystoles, a. fib, postural hypotension; behavioral changes from levdopa worsen

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14
Q

tetrodotoxin

A

potent neurotoxin found in pufferfish; blocks voltage gated sodium channels in nerve membranes (passive transport)

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15
Q

NNRTIs

A

don’t rquire activation via intracellular phosphorylation: nevirapine, efavirenz, delavirdine

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16
Q

what happens when ribosome encounters a stop codon

A

releasing factors bind to the ribosome and stimulate release of the formed polypeptide chain and dissolution of the ribosome mRNA complex

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17
Q

neonatal opioid withdrawal

A

pupillary dilation, rhinorrhea, sneezing, nasal stuffiness, diarrhea, NV, shrill crying, tremor, seizures; tx: opium solution

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18
Q

astrocytes

A

tissue repair –> irreversible neuronal damage = gliosis –> scar –> glial hyperplasia Qstem: neuronal shrinkage and intense cytoplasmic eosinophilia

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19
Q

ARDS

A

Qstem: AA –> UTI–> shock, what is the lung look like: fluid accumulation in the alveolar spaces and alveolar hyaline membrane formation

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20
Q

zolpidem

A

short acting hypnotic agent, structurally unrelated to to benzos but binds to the same protion of GABAa receptor and increases the inhibitor actions of GABA on the CNS; treats insomnia, rapid onset, less potential for dependence

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21
Q

colonizing aspergillosis

A

old lung –> TB, emphysema, sarcoid; doesn’t invade lung tissue but grows inside the cavity –> fungus ball, asymptomatic may cough and hemoptysis

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22
Q

hypersensitivity aspergillosis

A

asthma, ABPA, wheezing fever migratory pulm infitrates

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23
Q

invasive aspergillosis

A

immunosuppressed, cough hemoptysis, pleuritic chest pain and fever, necrotizing pneumonia and granuloma formation, invades tissue, extrapulmonary involvement

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24
Q

propionyl CoA carboxylase defieicny

A

inccrease prop CoA –> poor feeding, vomiting, hypotonia, lethargy, anion gap acidosis

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25
Q

autosomal recessive deficiency of IFN-gamma receptor

A

disseminated myobacterial disease in infancy or early childhood, dissminated infect by the BCG vaccine

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26
Q

what are the risk factors for abscesses caused by peptostrep and fusobacteria (normally found in oral cavity)

A

alcohol, seizure, CVA and dementia

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27
Q

percholrate and pertechnetate

A

block iodide absoprtion by the thyroid gland via compettive inhibition

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28
Q

thionamides (meth and ptu)

A

decrease the formation of thyroid hormones by inhibiting thyroid peroxidase

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29
Q

Iodine salts

A

inhibits synthesis as well as release of thyroid horomones

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30
Q

treatment for psoarsis

A

topical: vitamin D analogs –> calcipotriene, calcitriol, taclcitol, activate the vit D receptor, a nuclear transcription factor that causes inhibition of keratinocyte proliferation and stimulation of keratinocyte differentiation

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31
Q

how to diagnose mild CF

A

measure nasal transepithelial potential difference; more negative nasoepithelial surface, increased luminal sodium absorption; results from CFTR protein fucked up so less Cl secretion and this inceased Na absorption (DIFF THAN SWEAT GLANDS)

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32
Q

How does etanercept reduce the biological activity of TNF-alpha

A

acts as a decoy receptor

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33
Q

TNF-a inhibitors

A

etanercept, adalimumab, infliximab (decrease macrophage function and may cause reactivation of TB)

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34
Q

what is the function of 16S rRNA in prokaryotic ribosomes

A

contains a nucleotide sequence complementary to an mRNA sequence (Shine-Dalgarno); essential for initiation of protein synthesis in prokaryotes

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35
Q

what does 23S rRNA found in the 50s subunit facilitate

A

peptide bond formation in protein translation

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36
Q

which of the following occurs outside of the osteoblast during collage synthesis

A

c-terminal propeptide removal

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37
Q

where do terminal propeptides get cleaved by N and C procollagen peptidases

A

RER

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38
Q

what do antipsychotics, esp TCAs and venlafaxine cause

A

mood switches, mania –> “i can buy the world, feeling great” after signs of depression such as low energy, decreased appetite, and insomia

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39
Q

what is BRCA-1 gene

A

located on chromosome 17; tumor surpressor gene

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40
Q

what is the major source of blood supply to the upper ureter

A

renal artery

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41
Q

how is the blood supply established with a donor kidney

A

anastomosing the donor renal artery with the recipients external iliac artery

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42
Q

transference

A

unconscious shifting of emotions or desires associated w/ one person (sibling, parents, etc.) to another (physician, therapist)

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43
Q

displacement

A

shifting of feelings or conflicts from one situation or person to another seen as safer less distressing. (medical resident fucked over by attending so then the medical resident slaps his medical student with a shit ton of work)

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44
Q

when does renal compensation occur

A

48 hours after the onset of hyperventilation –> kidneys will excrete bicarbonate in the urine to make up for the resp alkalosis

45
Q

how does colchicine work

A

binds to the protein subunit of microtubules and prevents their aggregation; this disrupts membrane-dependent functions such as chemotaxis and phagocytosis

46
Q

If ASD is not fixed in time what can happen

A

irreversible pulmonary vascular sclerosis

47
Q

In a boy with DM1, why is there so much peeing

A

increased tubular osmolality

48
Q

72 year old man abrupt onset of fever, headache, myaglgias, malaise, cough, and throat pain; two grand daughters school because had this earlier; mild hyperemia of the throat w/o exudate and patient is sent home on whatever; then comes back and has progressive dyspnea, chest pain, and productive cough

A

staph aureus, strep pneumo, and H. influenza b/c people with influenza can develop secondary bacterial pneumonia mostly old farts

49
Q

phencyclidine

A

agitation, dissociation, hallucinations, violent behavior, memory loss; nystagmus, ataxia

50
Q

cocaine

A

euphoria, increased arousal, agitation, chest pain, headaches, seizure; tachycardia, hypertension, mydriasis

51
Q

methamphetamine

A

agitation, psychosis, diaphoresis, violent behavior; tooth decay, HTN, tachy, choreiform movements

52
Q

LSD

A

visual hallucinations, depersonalization, euphoria, occasional dysphoria, and panic; mild tachy, mild HTN, alert and orientated

53
Q

Marijuana

A

increased appetite, euphoria, slowed reflexes, impaired time perception; dry mouth, conjunctival injection, mild tachy

54
Q

heroin

A

mild euphoria or lethargy to come; miosis, decreased respiratory rate, decreased bowel sounds

55
Q

interferons a and b work how

A

act on neighnoring cells (paracrine signaling) stimulating them to synthesize antiviral proteins that degrade intracellular mRNA and impair protein synthesis.

56
Q

interferon y

A

produced by NK and T cells and functions to promote Th1 differentiation, induce class II MHC expression, and activate macrophages

57
Q

haldane effect

A

(lungs) binding of oxygen to hemoglobin drives the release of H+ and CO2 from hemoglobin

58
Q

bohr effect

A

(peripheral tissues) high concentrations of CO2 and H+ facilitate oxygen unloading from hemoglobin

59
Q

acute mitral regurg

A

near normal left atrial compliance; tend to develop marked pulmonary hypertension and pulmonary edema

60
Q

chronic mitral regurg

A

adaptive increase in LA volume and compliance; more prone to a filb and mural thromembolism

61
Q

which class of class 1 antiarrhthymics are the slowest to dissociate from sodium channels

A

class 1 c: flecainide –> use dependence –> sodium blocking effects intensify as the heart rate increases due to less time between action potentials for the medication to dissociate from the receptor

62
Q

upper motor neuron lesions

A

corticospinal tracts of the spinal cords, the meddula, pons, and the midbrain, the internal capsul, or the precentral gyrus

63
Q

amyloidosis of the heart

A

deposition of abnormally folded (B pleaded sheet conformation) atrial natriuretic peptied derived proteins

64
Q

HIV replication cycle

A

polyprotein precursors are encoded by structural genes (gag, poly, env); only the polyprotein product of env gene is glycosylated to become gp 160; the gp160 is proteolytically cleaved by bindign to the CD4 receptors of susceptible cells; lastly, transmembrane gp41 anchors gp120 through oncovalent interactions, mediating the fusion process between viruses and target cells

65
Q

what do mutations in splice sites result in

A

formation of larger proteins that are usually nonfunctional, but often retain the immunoreactivity of the normal protein (binding to antibodies)

66
Q

what does B6 do to levodopa

A

motherfucker increases the peripheral metabolism of levodopa and decreases its effectiveness

67
Q

digital clubbing

A

associated with prolonged hypoxia; large cell lung cancer, tb, cystic fibrosis, suppurative lung diseases: empyema, bronchiectasis and chronic lung abscesses

68
Q

hemosiderin

A

prussian blue stain differentiates this from lipofuscin; both appear golden yellw or brownish cytoplasmic granules; then hemosiderin turns blue black

69
Q

hemosiderin containing alveolar macrophages

A

heart failure cells = indicate that episodes of pulmonary congestion and edema associated w/ chronic left-sided heart failure

70
Q

what does chronic lymphedema predispose you to

A

development of angiosacroma (stewart-Treves syndrome)

71
Q

when the combined effect of two drugs is equal to the sum of the effects expected from the individual drugs

A

additive effect

72
Q

when the combined effect exceeds the sum of individual drug effects

A

synergistic

73
Q

what does niacin potentiate

A

effects of some anti-hypertensive medications because of its vasodilatory effects

74
Q

what can niacin do in diabetic patients

A

cause insulin resistance, so have to increase diabetes medications

75
Q

how does tNF-a facilitate decrease in glucose uptake

A

upregulates serine residue phosphorylation –> insulin resistance (this can occur in the presence of catecholamines, glucocorticoids, and glucagon)

76
Q

what are the oxidative reactions of HMP shunt necessary for?

A

anabolic reactions that use NADPH as an electron donor (cholesterol and FA synthesis)

77
Q

what is drug-induced parkinsonism caused by

A

dopamine 2 receptor blockade in the nigrostriatal pathways

78
Q

how does the liver take up indirect bilirubin

A

pass process using organic anion transporting polypeptide ( OATP)

79
Q

how does the liver secrete direct bilirubin into the biliary system

A

active transport by a specific ATP-binding cassette protein known as MRP2 (organic anion transporter)

80
Q

combination of cyanotic toe discoloration and renal failure in old man follwing an invasive vascular procedure

A

atheroembolic disease of renal arteries (renal biopsy = cholesterol crystals in arterial lumen)

81
Q

what causes an increase in both systolic and diastolic blood pressures and a decrease in heart rate

A

a1-adrenergic agonists (phenylephrine, methoxamine)

82
Q

contraction of pupillary dilator muscle

A

mydriasis

83
Q

what is signet-ring carcinoma associated with

A

infiltrative growth within the stomach wall causing a leather bottle stomach (linitis plastica)

84
Q

cefuroxime

A

second generation cephalosporin; beta lactam antibiotics related to penicillins

85
Q

pure red cell aplasia

A

rare form of marrow failure characterized by severe hypoplasia of marrow erythroid elements in the setting of normal granulopoiesis and thrombopoiesis

86
Q

pathogenesis of pure red cell aplasia

A

inhibition of erythropoietic precursors and progenitors by IgG autoantibodies or cytotoxic T lymphocytes; associated with thymomas and lymphocytic leukemia; can also be caused by parvovirus B19

87
Q

what is the length constant

A

(space constant) measure of how far along an axon an electrical impulse can propagate (myelin increases length constant by increasing membrane resistance and reducing charge dissipation)

88
Q

time constant

A

the time it takes for a change in membrane potential; lower time constants allow quicker changes in membrane potentia, increasing axonal conduction speed; myelination decreases membrane capacitance, which reduced the time constant

89
Q

what is narcolepsy with cataplexy most often caused by?

A

lack of hypocretin-1 (orexin A) and hypocretin-2 (orexin B) which are produced onyly in neurons located in the lateral hypothalamus (these shits function to inhibit REM sleep-related phenomena and promote motherfucking wakefulness

90
Q

low CSF 5 hydroxyindole-acetic acid concentraton

A

associated with impulsive, destructive behaviors, particularly aggression, suicide, and violence

91
Q

elevated amounts of 14-3-3 protein in CSF

A

diagnosing Creutzfeldt Jakob disease

92
Q

what has the greatest potential in preventing recurrence of HSV-2

A

daily oral valacyclovir, acyclovir, or famciclovir

93
Q

antidepressants serotonin syndrome

A

SSRI
SNRI
MAOIs
TCAs

94
Q

analgesics serotonin syndrome

A

tramadol

95
Q

anti-emetics serotonin syndrome

A

5-HT3 receptor antagonists (ondansetron)

96
Q

antibiotics serotonin syndrome

A

linezolid

97
Q

neuropsychiatric serotonin syndrome

A

triptans

98
Q

what does atropine not reverse in organophosphate toxicity

A

nicotinic receptor effects: muscle paralysis; use prax.

99
Q

what should be used to diagnose toxic megacolon

A

plain abdominal X-ray

100
Q

orientation

A

providing name, location, current date

101
Q

comprehension

A

following multistep commands

102
Q

concentration

A

reciting months of the year backwards

103
Q

short-term memroy

A

recalling three unrelated words after 5 min

104
Q

long-term memory

A

providing details of significant life events

105
Q

language

A

writing a sensible sentence containing a noun and verb

106
Q

visual spatial

A

drawing a clock face

107
Q

classic histology for Burkitt lymphoma

A

diffuse medium-sized lymphocytes and high proliferation index represented by the high ki-67 fraction; starry sky –> prsence of benign macrophages

108
Q

what drugs are first line for isolated systolic htn in nondiabetic patients

A

thiazide diuretics and dihydropyridine calcium antagnoists

109
Q

what is the preferred treatment for DKA

A

after an initial insulin bolus, continuous intravenous regular (short-acting) insulin is preferred

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