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2024 - Élo - Qbank > Quiz 46,47,48 > Flashcards

Quiz 46,47,48 Flashcards

1
Q

How does one acquire brucellosis?

A

Drinking contaminated milk or coming in contact with infected livestock

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2
Q

What is fancisella tularensis?

A

Gram negative coccobacillus

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3
Q

What is the disease presentation of ulceroglandular tularemia?

A

Rupturing pustule followed by an ulcer with involvement of regional lymph nodes

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4
Q

How does one acquire ulcerglandular tularemia?

A

Handing rabbits, deer or their skins, or from tick bites that fed on the rabbits or deer.

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5
Q

What is the geographic location of fancisella tularensis? What is the treatment?

A

Arkansas/Missouri; treat with stretomycin

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6
Q

What is the inheritance pattern of Friedreich ataxia?

A

Autosomal recessive, resulting in trinucleotide repeat expansion.

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7
Q

Why is CN II susceptible to MS?

A

Myelinated by oligodendrocytes

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8
Q

What is the inheritance pattern of Fragile X syndrome?

A

X-linked dominant – resulting in trinucelotide repeat of CGG

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9
Q

What physical features are seen in Fragile X syndrome?

A

Long and narrow face with prominent forehead and chin, large ears, testicular enlargement.

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10
Q

What are affected by prevalence?

A

PPV and NPV

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11
Q

Decline in prevalence affects negative predictive value by…

A

Increasing the NPV

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12
Q

CDKN2A loss of function mutation results in what?

A

Melanoma

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13
Q

What is the intracellular form on chlamydiae? Extracellular form?

A

Reticulate bodies = intracellular; elementary bodies = extracellular

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14
Q

What chromosomal abnormality causes cri-du-chat syndrome?

A

Deletion of the short arm of chromosome 5 (5p-)

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15
Q

What cardiac defect is seen in Cri-du-chat?

A

Ventricular septal defect

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16
Q

What is seen on gross examination of the liver in focal nodular hyperplasia?

A

Central scar

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17
Q

What population is at risk for focal nodular hyperplasia?

A

Women taking OCPs or exogenous hormones.

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18
Q

What is the inheritance pattern of MCAD?

A

Autosomal recessive

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19
Q

What deficiency causes accumulation of C8-C10 acylcarnitines?

A

MCAD

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20
Q

Why is hyperammonemia seen in MCAD?

A

Body relies on proteolysis, which requires the urea cycle to breakdown ammonia

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21
Q

Why is there hypoglycemia in MCAD?

A

Decreased gluconeogenesis due to decreased NADH and ATP and decreased acetyl-CoA

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22
Q

MCAD deficiency results in what type of fasting metabolic deficiencies?

A

Hypoglycemic hypoketonic

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23
Q

Perfusion to the aorta distal to the coarctation is maintained via collateral flow through what arteries?

A

Internal thoracic (mammary) arteries which give rise to the anterior intercostal arteries

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24
Q

What is the cause of X-linked Bruton agammaglobulinemia?

A

Mutation in the cytoplasmic tyrosine kinase

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25
Q

What cell line maturation process is blocked in X-linked (Bruton) agammaglobulinemia?

A

B cell

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26
Q

What immunoglobulin(s) is/are deficient in X-linked agammaglobulinemia?

A

IgM, IgA, IgG

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27
Q

What results when the gamma chain of IL-2 receptor is absent?

A

SCID

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28
Q

What is the result of adenosine deaminase deficiency?

A

SCID

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29
Q

Tonic-clonic seizure activity produces what from skeletal muscles?

A

Lactic acid

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30
Q

What is the most common cause of peritoneal carcinomatosis?

A

Ovarian cancer

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31
Q

What is the classic auscultation of ASD?

A

Mid-systolic ejection murmur at the LUSB and a wide, fixed splitting of the second heart sound

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32
Q

What is heard on auscultation of PDA?

A

Machine-like murmur

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33
Q

What is the most common mutation worldwide for CF?

A

Delta F508 mutation on CFTR gene – prevents proper protein folding

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34
Q

What type of polyp has sawtooth glandular epithelium with proliferation of goblet and columnar epithelial cells?

A

Hyperplastic polyp

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35
Q

What does the thyroid diverticulum give rise to?

A

The thyroid gland

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36
Q

What are the muscles of facial expression developed from?

A

Second pharyngeal arch

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37
Q

What is a never event?

A

Shocking medical error that should never occur

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38
Q

What are the hormonal findings in Turner syndrome?

A

Increased FSH, increased LH, decreased estrogen, decreased inhibin, and normal growth hormone.

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39
Q

What karyotype results in Turner syndrome?

A

45,X

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40
Q

What is the chromosome site involved in FAP?

A

5q21 = APC gene

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41
Q

Is the APC gene an oncogene or tumor suppressor gene?

A

Tumor suppressor

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42
Q

What chromosome is affected in Wilms tumor?

A

11

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43
Q

What chromosome is affected in retinoblastoma? What other cancer is seen?

A

Chromosome 13, gene Rb; can also see osteosarcoma

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44
Q

What is the family and genome of the virus causing mumps?

A

Paramyxoviridae family; -ssRNA, helical enveloped virus

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45
Q

What are members of the paramyxoviridae family?

A

Measles, mumps, RSV, parainfluenza

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46
Q

What does diphtheria toxin do?

A

Inactivates eukaryotic elongation factor eEF-2

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47
Q

A rare AE of ticlopidine?

A

Neutropenia/agranulocytosis

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48
Q

What is the MOA of ticlopidine?

A

Inhibits ADP from binding to platelet receptors

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49
Q

What is the mechanism of action of clopidogrel?

A

Irreversibly blocks ADP from binding platelets.

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50
Q

What does medicare part A cover?

A

Hospital, nursing facility, hospice and home health care

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51
Q

What does medicare part B cover?

A

Services from physicians and other health care providers, Xrays, labs

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52
Q

What are allotypes? What can they be used for?

A

Minor amino acid differences in the constant domains of antibody molecules; dictated by genetic inheritance and can be used for paternal testing

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53
Q

What is Libman-Sacks endocarditis?

A

Small, granular vegetations on both sides of the leaflets; commonly affects aortic and mitral valve

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54
Q

What is the characteristic finding on biopsy of primary biliary cirrhosis?

A

Chronic granulomatous inflammation leading to destruction of medium-sized intrahepatic bile ducts

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55
Q

What antibodies are seen in primary biliary cirrhosis?

A

Antimitochondrial autoantibodies

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56
Q

What labs are elevated in primary biliary cirrhosis?

A

Alkaline phosphatase and conjugated bilirubin

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57
Q

PDSA model stands for what? What simple concept does it use?

A

Plan, do, study, act; “trial and error” concept

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58
Q

Paralysis to the genioglossus muscle results in what on physical exam?

A

Deviation toward side of lesion

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59
Q

What contains the epithelial stem cells?

A

The dermis skin appendages (eg hair follicles)

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60
Q

The heterophile antibody test is what type of assay?

A

Latex agglutination assay

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61
Q

What is used to diagnose EBV infectious mononucleosis?

A

Heterophile antibody test

62
Q

What is Trousseau’s sign?

A

Carpopedal spasms due to cutting off blood supply to hand with blood pressure cuff or tourniquet

63
Q

What is a complication of subtotal thyroidectomy?

A

Transient hypocalcemia due to accidental removal/damage to parathyroid glands

64
Q

What is the genotype and family of adenovirus?

A

dsDNA virus, linear, non-enveloped, icosahedral

65
Q

Name 5 drugs that can cause priapism

A

Hydralazine, prazosin, chlorpromazine, sildenafil, tadalafil

66
Q

What is Couvoisier sign? What does it suggest?

A

Non-tender, palpable gallbladder; suggests choledocholithiasis

67
Q

What is lysogenic conversion?

A

Virulence is modified by the stable presence of phage DNA in the bacterial cell

68
Q

List the examples of lysogenic conversion:COBEDS

A 
Cholera toxin
O antigen of Salmonella
Botulinum toxin
Erythrogenic toxin of S. pyogenes
Diphtheria toxin
Shigga toxin
69
Q

Why might dorsiflexion be lost when draining a popliteal cyst?

A

The common fibular (peroneal) nerve is superficial and lies immediately adjacent to the tendon of the biceps femoris.

70
Q

What nerve is responsible for dorsiflexion?

A

The deep fibular nerve - innervate anterior compartment of the leg

71
Q

What innervates the posterior compartment of the leg?

A

Tibial nerve

72
Q

What nerve is responsible for sensation to the sole of the foot?

A

Medial and lateral plantar nerves, both are branches of the tibial nerve

73
Q

What structures course through the popliteal fossa?

A

Popliteal artery and vein, and tibial nerve

74
Q

HEXA mutation results in what disease?

A

Tay Sachs

75
Q

What enzyme is deficient in Tay Sachs?

A

Hexosaminidase A - responsible for degradation of GM2 gangliosides

76
Q

What are characteristic findings on PE in Tay Sachs?

A

Cherry red spots in macula, blindness, psychomotor retardation

77
Q

What is the inheritance pattern of Tay Sachs?

A

Autosomal recessive

78
Q

What is the rate limiting step of glycolysis?

A

Phosphofructokinase 1

79
Q

Smudge cells are characteristic of what disease?

A

Chronic lymphocytic leukemia

80
Q

What personality disorder is characterized by colorful, exaggerated behavior and excitable shallow expression of emotions?

A

Histrionic PD

81
Q

Histrionic PD shows what type of behavior?

A

Draw attention to self, sexually seductive

82
Q

Patients who week constant reassurance from partners may have what type of personality disorder?

A

Dependent PD

83
Q

What causes pseudoappendicitis?

A

Yersinia enterocolitica

84
Q

What is yersinia entercolitica? (Gram stain, etc. etc. )

A

Gram negative rod, non-lactose fermenting, non-H2S producing, oxidase negative

85
Q

How can one acquire an infection with yersinia entercolitica?

A

Contaminated, unpasteurized milk; contaminated pork

86
Q

What temperature does yersinia entercolitica grow at? What is unique about this organism in temperature?

A

Grows well at less than body temp (77 F or 25 C); motile at 25 C and nonmotile at 37 C

87
Q

What is the cause of Chagas disease?

A

Trypanosoma cruzi

88
Q

Chagas disease can cause what?

A

Megaesophagus, megacolon, cardiomyopathy/cardiac failure

89
Q

What type of collagen makes articular hyaline cartilage?

A

Type II collagen

90
Q

What type of collagen makes bone?

A

Type I collagen

91
Q

What is the largest intestinal roundworm?

A

Ascaris lumbricoides

92
Q

What type of blot is used to identify protein-DNA interactions?

A

Southwestern blot

93
Q

What muscle(s) is/are innervated by the spinal accessory nerve?

A

Trapezius and sternocleidomastoid

94
Q

What are the most common cerebellar tumors in children?

A

Pilocytic astrocytoma and medulloblastoma

95
Q

Cyst with a mural nodule is seen on CT of brain, what is it?

A

Pilocytic astrocytoma

96
Q

What disease is pilocytic astrocytoma strongly associated with?

A

Type 1 neurofibromatosis

97
Q

What is a histiopathologic clue seen in pilocytic astrocytomas?

A

Rosenthal fibers - corkscrew-shaped, intensely eosinophilic structures deriving from accumulation o alpha-beta crystallin with astrocytic processes

98
Q

What stain can be done for pilocytic astrocytomas?

A

Glial fibrillary acidic protein (GFAP)

99
Q

Perivascular pseudorosettes

A

Ependymoma

100
Q

Where is a medulloblastoma found?

A

Located in the midline posterior fossa and infiltrates the cerebellar vermis

101
Q

What can be seen histologically in a medulloblastoma tumor?

A

Homer-Wright rosettes –considered pseudorosettes

102
Q

What in synthesized in the SER?

A

Phospholipids, triglycerides, and sterols (including sex hormones)

103
Q

What translocation is seen in follicular lymphoma?

A

14;18

104
Q

What translocation is seen in mantle cell lymphoma?

A

11;14

105
Q

What translocation is seen in AML?

A

15;17

106
Q

What translocation is seen in Burkitt lymphoma?

A

8;14

107
Q

What is the result of the translocation that occurs in follicular lymphoma?

A

Hybrid bcl-2/immunoglobulin heavy chain transcript due to t(14;18)

108
Q

What are the two inheritance patterns of Albers-Schonberg disease? When do they present?

A

Autosomal recessive – severe form; produces death in childhood

Autosomal dominant – presents late childhood to early adulthood

109
Q

What cell type is functioning abnormally in Albers-Schonberg disease?

A

Osteoclasts

110
Q

What is seen on an Xray of osteopetrosis?

A

Bony widening with partial obliteration of marrow spaces (Ehrlenmeyer flask-shaped lesions seen in long bones)

111
Q

What is the MOA of niacin?

A

Decreases VLDL, LDL, and triglycerides and increases HDL levels

112
Q

What is the most common SE of niacin?

A

Facial flushing

113
Q

What is the MOA of statins?

A

Ihibit HMG-CoA reductase

114
Q

What cord(s) make(s) up the median nerve? Musculocutaneous nerve?

A

Median arises from a combination of the medial and lateral cords of the brachial plexus;

Musculocutaneous arises from lateral cord only

115
Q

What are three types of antibodies that could be ordered to diagnose SLE?

A

Anti-smith antibodies, ANA, anti-dsDNA antibodies

116
Q

What type of seizures are treated and prevented by ethosuximide?

A

Absence seizures

117
Q

What should be used to treat status epilepticus immediately?

A

Benzos

118
Q

What status epilepticus?

A

Single unremitting seizure that lasts 5-10 minutes, or frequent seizures without interictal return to baseline state

119
Q

What is overexpressed in follicular lymphoma?

A

Bcl-2 – inhibits apoptosis and therefore allows for accumulation of cells

120
Q

What translocation occurs in follicular lymphoma?

A

14;18

121
Q

What type of HSR is MS?

A

Type IV - against myelin basic protein?

122
Q

What is the inheritance pattern of Becker muscular dystrophy?

A

X-linked recessive

123
Q

What is the genetic abnormality in Becker Muscular Dystrophy?

A

In-frame mutation of an X-linked gene

124
Q

What characteristics are seen in Turner syndrome?

A

Short stature cystic hygroma (webbed neck)

125
Q

What is the MOA of azoathioprine?

A

It is a purine antimetabolite and inhibits de novo purine synthesis.

126
Q

What is a major SE of azathioprine?

A

Bone marrow suppression - leukopenia, thrombocytopenia, anemia

127
Q

What are the TORCH infections?

A 
Toxoplasmosis
Other (syphilis)
Rubella
Cytomegalovirus
Herpes simplex virus
128
Q

What is the common triad of congenital CMV infection?

A

Cutaneous hemorrhages (“blueberry-muffin baby”), sensorineural deafness, periventricular CNS calcifications

129
Q

What two congenital infections result in “blueberry muffin baby”?

A

Rubella and CMV infection

130
Q

In an adult infected with Parvovirus B19, what infection do they have? What are the symptoms?

A

Rubella; symptoms include 3 day rash and transient arthralgia

131
Q

What is seen on an infant with an in utero rubella infection?

A

In utero rubella infection can cause mental retardation, PDA, pulmonary stenosis, blindness, encephalitis, sensorineural hearing loss, congenital cataracts and glaucoma, pigmentary retinopathy.

132
Q

What characteristics are seen in congenital syphilis?

A

Usually results in hydrops fetalis

If survive: Skeletal abnormalities (osteochondritis and periostitis), pseudoparalysis, persistent rhinitis and maculopapular rash (bronzing rash), deafness

133
Q

What vessels contain 60-70% of the total blood volume?

A

Systemic veins and venules

134
Q

What are the SEs of glucocorticoids?

A

Hypocalcemia, fluid retention, hypokalemia, hyperglycemia, and hypertension. With chronic use can see osteoporosis

135
Q

What chromosome is BRCA-1 found on?

A

Chromosome 17q

136
Q

What chromosome is BRCA-2?

A

Chromosome 13

137
Q

What chromosome is p53 found on?

A

17p

138
Q

What gene is associated with inherited breast and ovary cancer?

A

BRCA-1

139
Q

What interleukin is responsible for IgE?

A

IL-4

140
Q

Clawing of digits IV and V is associated with what nerve injury?

A

Ulnar nerve

141
Q

Total clawing of the hand is associated with what brachial plexus injury?

A

Lower trunk injury - combination of median and ulnar nerve

142
Q

What is the function of the lumbricals?

A

Extension at the interphalangeal joints while simultaneously flexing the metacarpophalangeal joint

143
Q

Lumbricals for digits IV and V are innervated by what nerve?

A

Deep palmar branch of the ulnar nerve

144
Q

What function does the superficial branch of the ulnar nerve serve?

A

Cutaneous sensory innervation to the palmar and dorsal surfaces of digit V and the ulnar half of digit IV

145
Q

What is amaurosis fugax?

A

Transient dimming of vision in entire visual field; can be due to microemboli from atherosclerotic plaques (associated with carotid bruits)

146
Q

Patients with celiacs have increased risk of what skin condition?

A

Dermatitis herpetiformis

147
Q

Patients with Celiacs have increased risk of what malignancies?

A

Intestinal lymphoma, esophageal SCC, and non-Hodgkin lymphoma

148
Q

What is seen in RBCs during G6PD deficiency related anemia?

A

Heinz bodies (blue granules located in periphery)

149
Q

What is the most common primary cardiac neoplasm? What is seen on histology?

A

Cardiac myxoma; consists of stellate mesenchymal cells with myxoid background and inflammatory and endothelial cells

150
Q

Where is the most common location for cardiac myxoid tumors?

A

Left atrium

2024 - Élo - Qbank (33 decks)

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