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Quiz 62 Flashcards

1
Q

Wernicke Korsakoff syndrome results from deficiency in what vitamin?

A

B1 - thiamine

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2
Q

What is the clinical triad of wernicke encephalopathy?

A

Encephalopathy, oculomotor dysfunction (nystagmus, lateral rectus palsy, conjugate gaze palsy) and gait ataxia

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3
Q

In Wernicke encephalopathy, what is administered for treatment?

A

Thiamine - must be given PRIOR to glucose

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4
Q

Is Korsakoff syndrome before or after Wernicke encephalopathy? Which of the two is reversible?

A

Korsakoff is late stage and is irreversible; Wernicke is reversible

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5
Q

What areas of the brain are thought to be affected by Korsakoff syndrome?

A

Thalamus (dorsomedial nuclei) and mammillary bodies

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6
Q

What is the MOA of trihexyphenidyl?

A

Muscarinic antagonist

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7
Q

What are the side effects of antimuscarinic meds?

A

Flushing, dry skin and mucous membranes, mydriasis, delirium, hyperthermia due to decreased sweating

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8
Q

What is the MOA of benztropine?

A

Muscarinic antagonists

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9
Q

The caudate nucleus comprises part of what ventricle?

A

Wall of lateral ventricle

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10
Q

Tumor in lateral ventricle can affect what nucleus?

A

Caudate nucleus

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11
Q

What is genetic shift?

A

Shuffling of segments of genomic RNA so new genetic combinations can be produced

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12
Q

What is genetic drift?

A

Minor antigenic changes from the accumulation of point mutations

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13
Q

What viruses can undergo genetic shift?

A

Orthomyxovirus, Bunyavirus, Arenavirus, Reovirus

BORA

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14
Q

What is seen histologically of a liposarcoma?

A

Pleomorphic lipocytes, with a cytoplasm filled with lipid vacuoles (positive for fat stains)

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15
Q

Deficiency in UMP synthase results in a buildup of what?

A

Orotic acid

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16
Q

How can one differentiate between ornithine transcarbamoylase def. and UMP synthase def?

A

Both will have orotic aciduria, but UMP synthase def. results in megaloblastemia

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17
Q

What is the oval window in the ear?

A

It separates the air-filled middle ear and fluid-filled inner ear

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18
Q

What is the scala tympani?

A

A perilymphatic chamber in the cochlea

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19
Q

What is the scala vestibuli?

A

A perilymphatic chamber in the cochlea

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20
Q

What is the composition of perilymph?

A

High sodium and low potassium (similar to extracellular fluid)

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21
Q

What is the scala media?

A

Cochlear duct that forms the endolymph

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22
Q

What is the composition of endolymph?

A

Similar to intracellular fluid - high potassium and low sodium

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23
Q

What contains the sensory epithelium or hair cells of the ear?

A

Organ of corti

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24
Q

What patient population and symptoms are seen with mucormycosis?

A

Ketoacidotic diabetic and neutropenic patients; headache, fever, sinusitis, black necrotic eschar on face/nose

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25
What is the cause of mucormycosis? What is seen on microscopy?
Mucor or Rhizopus spp. - see hyphae branch at 90-degree angles and have irregular width
26
Type I diabetic presents with HA, fever, nasal congestion, swelling of R eye with black necrotic nodule in nasal cavity. What organism is the most likely cause? What is seen microscopically?
Mucor or Rhizopus spp. See hyphae branching at 90-degree angles with irregular width
27
What artery supplies the distal end of the lesser curvature of the stomach?
R gastric artery
28
What artery supplies the proximal end of the lesser curvature of the stomach?
L gastric artery
29
What is the right gastric artery a branch of?
Proper hepatic artery
30
What arteries supply the lesser curvature of the stomach?
L and R gastric arteries - anastomose
31
What is often the source of bleeding in a duodenal ulcer?
Gastroduodenal artery
32
What arteries does the gastroduodenal artery give rise to?
Right gastroepiploic artery and superior pancreaticoduodenal artery
33
The gastroduodenal artery is a branch of what artery?
Common hepatic artery
34
What artery supplies the proximal portion of the greater curvature of the stomach?
Left gastroepiploic artery
35
What artery supplies the distal portion of the greater curvature of the stomach?
Right gastroepiploic artery
36
The left gastroepiploic artery is a branch of what artery?
Splenic artery
37
What arteries supply the fundus of the stomach?
Short gastric arteries
38
What happens to progesterone in the zona glomerulosa?
Undergoes 21 hydroxylation for the pathway of aldosterone synthesis
39
What are the most common causes of travelers diarrhea?
ETEC, shigella and C. Jejuni (later two produce bloody diarrhea)
40
If necessary, what antibiotics are used to treat travels diarrhea?
Fluoroquinolones (ciprofloxacin, ofloxacin, norfloxacin)
41
What blood vessels have the highest resistance?
Arterioles
42
The pressure point of aortic valve opening is equal to what pressure?
Diastolic blood pressure
43
Microscopic examination of the brain infected with HSV-1 encephalitis shows what?
Cowdry type A inclusions
44
When does one see Cowdry type A inclusions in the neurons and glia?
Herpes simplex infection (herpes encephalitis)
45
Examination of CSF with viral encephalitis shows what?
Lymphocytes, normal glucose, elevated proteins
46
What does microscopic examination show in progressive multifocal leukoencephalopathy?
Greatly enlarged oligodendrocyte nuclei with glassy amorphic viral inclusions
47
If greaty enlarged oligodendrocyte nuclei with glassy amorphic viral inclusions are seen on brain biopsy, what is the diagnosis?
Progressive multifocal leukoencephalopathy
48
Microglial nodules containing multinucleated giant cells on brain biopsy is characteristic of what?
Chronic HIV encephalitis
49
Extension of the thumb is controlled by what muscles?
Extensor pollicis longus and brevis
50
What nerve controls extension of the thumb?
Radial
51
What nerve innervates extensor pollicis longus and brevis?
Radial nerve
52
What affect does the radial nerve have on the thumb motion?
Extension
53
What muscles of the thumb does the median nerve innervate?
The thenar muscles - responsible for flexion, abduction, and opposition
54
What muscle adducts the thumb?
Adductor pollicis
55
What nerve innervates the adductor pollicis?
Ulnar
56
Adduction of the thumb is mediated by what muscle? What is its innervation?
Adductor pollicis; ulnar
57
What disease is associated with anticentromere antibodies?
CREST syndrome (limited systemic sclerosis)
58
What disease is associated with anti-DNA topoisomerase?
Diffuse systemic sclerosis; antibody is also called anti-Scl 70
59
What disease is associated with anti-RNPs?
Sjogren
60
What antibodies do you seen in diffuse systemic sclerosis?
Anti-DNA topoisomerase (anti-Scl 70)
61
What antibodies do you see in limited systemic sclerosis?
Anticentromere
62
When do you see Anti-Scl 70 antibodies?
Diffuse systemic sclerosis
63
What disease is associated with antimitochondrial antibodies?
Primary biliary cirrhosis
64
What disease is associated with anti-TSH receptor antibodies?
Graves disease
65
What is used pharmacologically for the treatment of OCD?
1st - SSRIs; if unresponsive the TCA clomipramine
66
What is the class of buspirone?
Nonbenzo anxiolytic
67
What is chlorpromazine?
Antipsychotic; selectively antagonizes dopamine D2 receptors
68
What TCA is used to treat OCD?
Clomipramine
69
What is the inheritance pattern of G6PD?
X linked recessive
70
What are common adverse reactions to heparin?
Bleeding and drug induced thrombocytopenia
71
What is the drug of choice in a patient with heparin induced thrombocytopenia?
Bivalirudin
72
What is the MOA of bivalirudin?
Direct inhibitor of thrombin
73
What is seen on ECG in a subendocardial infarction?
May show ST segment depression or flattening on various leads
74
What is seen on ECG in transmural infarction?
ST elevation
75
What are the aminopenicillins?
Amoxicillin and ampicillin
76
What is the unique pattern of ABGs in salicylate toxicity?
Initially respiratory alkalosis (ASA directly stimulates the resp center), then metabolic acidosis with anion gap (salicylates interfere with Krebs cycle)
77
What is the mechanism behind fever in ASA toxicity?
Uncoupling of the electron transport chain
78
What type of acid/base disorder is seen in HCTZ?
Metabolic alkalosis (excretion of H+ ions)
79
What are the four characteristics of MEN2B?
Medullary thyroid cancer, pheochromocytoma, mucosal neuromas (small nodules on lip) and marfanoid habitus
80
What gene is responsible for MEN2B?
Ret gene
81
What are the tumors of MEN1?
Parathyroid tumor, pituitary tumor (prolactinoma), pancreatic endocrine tumor
82
What gives rise to the smooth part of the right ventricle?
Bulbus cordis
83
What gives rise to the smooth part of the left ventricle?
Bulbus cordis
84
What gives rise the the smooth part of the right atrium?
Sinus venosus
85
What does the primitive atrium give rise to?
The trabeculated parts of the right and left atria
86
What gives rise to the ascending aorta and pulmonary trunk?
Truncus arteriosus
87
What is the root cause of renal osteodystrophy?
Kidney fails to excrete sufficient phosphate, causing a rise in PTH
88
Increase CaSR Ca2+ sensitivity does what to PTH?
Suppresses it
89
What is cinacalcet?
A calcimimetic - increases the sensitivity of the calcium-sensing receptor, decreasing PTH secretion
90
What are the four main neoplasmas associated with Psammoma bodies?
Papillary carcinoma of the thyroid, serous papillary cystadenocarcinoma of the ovary, meningioma, mesothelioma
91
What type of gene is APC?
Tumor suppressor gene

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