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Qbank > Quiz 57 > Flashcards

Quiz 57 Flashcards

1
Q

Acid-fast fecal oocysts in patient with AIDs

A

Cryptosporidium

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2
Q

How does cryptosporidium parvum cause diarrhea?

A

Direct lysis of cells of the brush border

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3
Q

Blistering rash with flaccid bullae and epithelial cell separation (acantholysis) is seen in what disease?

A

Pemphigus vulgaris

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4
Q

Positive Nikolsky sign is seen in what autoimmune blistering disease?

A

Pemphigus vulgaris

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5
Q

What are the antibodies against in pemphigus vulgaris?

A

Desmosomal proteins

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6
Q

Subepidermal, tense blisters that do not easily rupture (negative Nikolsky sign) is seen in what blistering disease?

A

Bullous pemphigoid

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7
Q

What are the antibodies directed against in bullous pemphigoid?

A

Hemidesmosomes

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8
Q

What disease has autoantibodies to desmosomes?

A

Pemphigus vulgaris

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9
Q

What organism is characterized by “box-car” large gram positive, spore forming rod?

A

C. Perfringens

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10
Q

What is the toxin associated with C. Perfringens and the myonecrosis?

A

Alpha toxin - lecithinase

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11
Q

What is the gram stain and morphology of C. Perfringens?

A

Gram positive rod - spore forming and anaerobic

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12
Q

Positive Nagler’s reaction for lecithinase is seen in what organism?

A

C. Perfringens

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13
Q

What is transplant rejection, immunologically?

A

Host immune system attacks the foreign tissue

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14
Q

What is GVHD?

A

Graft vs host disease - donor leukocytes consider recipient foreign and attack host tissue

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15
Q

What is a normal, non-pathologic form of intrinsic apoptosis?

A

Menstruation

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16
Q

Brain tumor with necrosis and hemorrhage; tumor cells are pleomorphic and frequently bizarre in appearance

A

GBM

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17
Q

What is seen histologically in GBM?

A

Necrosis, hemorrhage, and tumor cells that are pleomorphic with a bizarre appearance

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18
Q

A well differentiated variant of astrocytic tumor?

A

Fibrillary astrocytomas

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19
Q

Fried egg appearance is characteristic of what brain tumor?

A

Oligodendrogliomas

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20
Q

Nuclei surrounded by clear cytoplasm is seen in what type of brain tumor?

A

This is the fried egg appearance seen in oligodendrogliomas

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21
Q

Rosenthal fibers are a classic finding in what brain tumor?

A

Pilocytic astrocytoma

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22
Q

What patient population and where in the cranium do pilocytic astrocytomas form?

A

In children, usually located in the cerebellum

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23
Q

GBM form in what region in adults?

A

Cerebral cortex

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24
Q

Where do GBM form in children?

A

Brainstem

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25
Q

What is seen histologically in pilocytic astrocytoma?

A

Rosenthal fibers - “eosinophilic corkscrew fibers”

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26
Q

What portion of the collecting system resorbs the most water in the kidney?

A

Proximal convoluted tubule

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27
Q

What remains intact in a patient with locked in syndrome?

A

Vertical eye movements and blinking

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28
Q

What is delusional disorder?

A

Psychotic disorder involving one or more non-bizarre delusions in absence of other significant psychopathology

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29
Q

Partial glucocorticoid resistance can result in what PE and lab findings?

A

Increased BP, acne, hirsutism, hypokalemia, decreased renin

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30
Q

What is graft vascular disease?

A

Graft arteriosclerosis, a result from chronic transplant rejection

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31
Q

What can result from chronic transplant rejection?

A

Graft vascular disease

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32
Q

What is seen histologically in graft vascular disease?

A

Intimal and medial thickening or coronary arteries without associated atheroma formation

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33
Q

Patient with history of transplant dies, on autopsy there is intimal and medial thickening of the coronary arteries w/o association atheroma formation, what is the diagnosis?

A

Graft vascular disease

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34
Q

RBCs that lack the normal central pallor and concave shape

A

Spherocytes

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35
Q

What is the inheritance pattern of hereditary spherocytosis?

A

Autosomal dominant

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36
Q

What is defective in hereditary spherocytosis?

A

Cytoskeletal proteins - most commonly spectrin and ankyrin

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37
Q

Infection with what can cause red cell aplasia? Who is more likely to be affected?

A

Parvovirus B19; patients with pre-existing marrow disease (sickle cell anemia, HS)

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38
Q

What type of anemia is hereditary spherocytosis?

A

Normocytic and intrinsic hemolytic

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39
Q

How is hereditary spherocytosis diagnosed?

A

Osmotic fragility test

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40
Q

RBCs with heinz bodies and bite cells is seen in what disease?

A

G6PD

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41
Q

What disease can commonly cause hemolytic anemia in newborns?

A

Pyruvate kinase def.

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42
Q

What is the antibiotic of choice for pseudomembranous colitis?

A

Metronidazole

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43
Q

What is the mechanism of action of metronidazole?

A

Forms toxic free radical metabolites in the bacterial cell that damage DNA

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44
Q

What is an adverse effect of metronidazole?

A

Disulfiram-like reaction

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45
Q

What is seen in the labs of a patient with familial hypocalciuric hypercalcemia?

A

Increased serum calcium, decreased urine calcium, high levels of PTH

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46
Q

What is the defect in familial hypocalciuric hypercalcemia?

A

Defect in C coupled calcium sensing receptors

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47
Q

What is the genetic mutation in familial hypocalciuric hypercalcemia?

A

Autosomal dominant mutation of CaSR gene

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48
Q

Mutation in AIRE can cause what characteristic findings?

A

Autoimmune hypoparathyroidism; mucocutaneous candidiasis with hypocalcemia

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49
Q

What two arteries does CN III pass through?

A

Superior cerebellar artery and posterior cerebral artery

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50
Q

What region of the brain does the posterior cerebral artery supply?

A

Medial midbrain

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51
Q

A stroke involving the posterior cerebral artery causes what symptoms?

A

Contralateral hemianopia with macular sparing

52
Q

Compression of CN III can cause what symptoms?

A

Mydriasis and inability to adduct the eye

53
Q

What is the function of CN IV? What does it innervate?

A

Depression of the eye from the adducted position; innervates superior oblique muscles

54
Q

Patient with ptosis and down and out gaze has a damage to what CN?

A

CN III

55
Q

What muscle is responsible for abduction of the eye? What is its innervation?

A

Lateral rectus; supplied by CN VI (abducens n.)

56
Q

Why is there an increased cardiac afterload in a patient with nocturnal hypoxia?

A

Increased pulmonary and vascular resistance

57
Q

What is the inheritance pattern of G6PD?

A

X-linked recessive

58
Q

What is Leber hereditary optic neuropathy?

A

Acute/subacute vision loss, especially in young men

59
Q

What is the inheritance patter of Leber hereditary optic neuropathy?

A

Mitochondrial inheritance pattern

60
Q

What is the inheritance of neurofibromatosis?

A

Autosomal dominant

61
Q

What is the inheritance pattern of sickle cell anemia?

A

Autosomal recessive

62
Q

What is the inheritance pattern on Tay-Sachs?

A

Autosomal recessive

63
Q

Prolonged exercise (greater than a few hours) uses what metabolism to supply energy?

A

Hepatic gluconeogenesis

64
Q

What does hepatic glycogenolysis occur in regards to exercise?

A

First few hours of exercise

65
Q

Half life of a drug can be determined using what equation?

A

T 1/2 = (0.7 x Vd) / Cl

66
Q

How long does it take to reach steady state?

A

4-5 half lives

67
Q

(0.7 x volume of distribution) / clearance can be used to calculate what?

A

Half life

68
Q

Protein extracted from cells is subjected to electrophoresis, then transferred to a filter and exposed to labeled DNA. This describes what type of technique?

A

Southwestern blotting

69
Q

What is southwestern blotting used for?

A

Can be used to identify transcription factors

70
Q

What interactions are involved in a Southwestern blot?

A

DNA-protein interactions

71
Q

What technique is helpful in determining which tissues express the gene for a specific protein?

A

Northern blotting

72
Q

What technique can be used to compare DNA samples for genetic relatedness?

A

Southern blot

73
Q

What symptoms are seen in a patient on PCP?

A

Reckless behavior, horizontal or vertical (mostly) nystagmus, hypertension, tachycardia, diaphoresis

74
Q

What is a Marcus-Gunn pupil?

A

An afferent pupillary defect - Decreased sensitivity of the affected eye to light

75
Q

How can a Marcus-Gunn pupil be diagnosed?

A

Swinging light test

76
Q

What will you see in a Marcus-Gunn pupil upon the swinging flashlight test?

A

Stimulation of the unaffected eye leads to pupillary constriction in both eyes, stimulation of affected eye can lead to relative dilation of both eyes

77
Q

What type of T cells cause the development of IgE antibodies?

A

Th2

78
Q

What is responsible for isotype switching to IgE?

A

Th2 secretion of IL-4

79
Q

What cytokine is important in isotype switching to IgA?

A

IL-5

80
Q

Amyotrophic lateral sclerosis results in degeneration of what?

A

UMN and LMN

81
Q

Patient with UMN signs and LMN signs, what is on the top of your DDx?

A

ALS

82
Q

In ALS, what regions of the spinal cord are affected?

A

Corticospinal tract (UMN) and ventral anterior horn (LMN)

83
Q

Are fasciculations seen in LMN lesions or UMN lesions?

A

LMN lesions

84
Q

Damage to the caudate nucleus is seen in what disease?

A

Huntington disease

85
Q

What is damaged in Parkinson disease?

A

Substantia nigra

86
Q

What is seen on a EEG during an absence seizure?

A

3-Hz spike and wave complex

87
Q

Dynein does what in nerves?

A

Retrograde transport ( toward minus end)

88
Q

Chlamydophila pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae have what in common?

A

Cause atypical or walking pneumonia and do not gram stain

89
Q

What is the gram stain and morphology of H. Influenzae?

A

Gram negative coccobacilli

90
Q

What is required for growth of Legionella pneumophila?

A

Charcoal yeast extrac medium with iron and cysteine

91
Q

What is the gram stain and morphology of Moraxella catarrhalis?

A

Gram negative diplococcus

92
Q

What is a key genetic marker of neuroblastoma?

A

Amplification of N-myc oncogene (poorer prognosis)

93
Q

What is opsoclonus-myoclonus?

A

Opsoclonus - rapid, involuntary horizontal and vertical conjugate fast eye movements; myclonus - brief, involuntary twitching of muscles

94
Q

In a patient with a neuroblastoma, what is elevated in the serum and urine?

A

Homovanillic acid and VMA

95
Q

Young child with abdominal mass that crosses the midline, uncontrolled movement on lower limbs and eyes?

A

Neuroblastoma

96
Q

What is the most common cause of GI obstruction in children 3 months to 6 years?

A

Intussusception

97
Q

6 month old male presents with sudden onset of vomiting with reddish and gelatinous stool, what is the most likely underlying condition?

A

Intussusception

98
Q

What is the mechanism of action of lactulose in the treatment of hepatic encephalopathy?

A

Degraded by gut flora to lactic acid, which acidifies the gut lumen. Acidification of the gut lumen favors conversion of NH3 (ammonia) to NH4 (ammonium) - NH4 cannot cross intestinal lumen

99
Q

What are two other important treatments in hepatic encephalopathy besides lactulose?

A

Low protein diet and rifaximin (kills intestinal bacteria)

100
Q

What is the drug classification of hydroxyzine?

A

First generation H1 antihistamine

101
Q

Name 4 second generation H1 receptor antagonists

A

Fexofenadine, cetirizine, loratadine, desloratadine

102
Q

What regions of the brain are most commonly affected by kernicterus?

A

Basal ganglia and brainstem nuclei involved in oculomotor and auditory function

103
Q

Child with opisthotonos, high pitched cry, and abnormal Moro reflex is seen in what disease?

A

Kernicterus

104
Q

What is a common antibiotic that can cause of kernicterus in newborns?

A

Sulfonamide antibiotics

105
Q

During what stage of pregnancy should sulfonamide antibiotics be avoided? Why?

A

2nd and 3rd trimester; can cause kernicterus in newborns

106
Q

What antibiotic is associated with gray baby syndrome?

A

Chloramphenicol

107
Q

What is the MOA of chloramphenicol?

A

Blocks peptidyltransferase at 50S ribosomal subunit

108
Q

What is the acronym for metabolic acidosis?

A

MUDPILES

109
Q

What does the acronym MUDPILES stand for?

A

Methanol, uremia, DKA, propylene glycol (paraldehyde, paracetamol, phenformin), iron/isoniazid, lactic acidosis, ethylene glycol, salicylates (late)

110
Q

What is seen in the urine of a patient with ethylene glycol poisoning?

A

Oxalate crystals - calcium oxalate

111
Q

What enzyme metabolizes ethylene glycol?

A

Alcohol dehydrogenase

112
Q

What can be used as an antidote to ethylene glycol poisoning? Why?

A

Fomepizole - inhibits alcohol dehydrogenase

113
Q

What acid/base pathophysiology is seen with severe aspirin poisoning?

A

Early-primary respiratory alkalosis (stimulates resp drive); Late-metabolic acidosis (due to ASA metabolites

114
Q

What nerve pierces the coracobrachialis?

A

Musculocutaneous

115
Q

What nerve pierces the pronator teres?

A

Median

116
Q

What nerve pierces the supinator?

A

Radial

117
Q

What nerve pierces the flexor carpi ulnaris?

A

Ulnar nerve

118
Q

What muscle does the median nerve pierce?

A

Pronator teres

119
Q

What muscle does the musculocutaneous nerve pierce?

A

Coracobrachialis

120
Q

What nerve, artery and vein exit the greater sciatic foramen above the piriformis?

A

The superior gluteal nav

121
Q

What does the superior gluteal nerve innervate?

A

Gluteus medius and gluteus minimus

122
Q

What is the function of the gluteus medius and gluteus minimus?

A

Major abductors at the hip

123
Q

What is the function of the gluteus maximus?

A

Extensor and lateral rotator of the hip

124
Q

What innervates the gluteus maximus?

A

Inferior gluteal nerve

125
Q

Eosinophilic cytoplasmic inclusions seen in alcoholic liver disease

A

Mallory bodies

126
Q

What are Russell bodies?

A

Cytoplasmic inclusions of antibody in plasma cells

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