random decks

Question 1

which statistical test can evaluate if there is a significant difference between the means of multiple independent groups

Answer 1

analysis of variance (ANOVA)

Question 2

which statistical test can evaluate if there is a significant difference between the means of 2 groups

Answer 2

t-test

Question 3

how does a pt with a restrictive lung disease minimize the work of breathing

Answer 3

by increasing respiratory rate and decreasing tidal volume- rapid and shallow breathing

Question 4

how do pts with an obstructive lung disease (high airflow resistance) minimize the work of breathing

Answer 4

by taking slow deep breaths

Question 5

what are the 3 stop codons in mRNA sequence

Answer 5

UAG, UAA, UGA

Question 6

what is the deficent enzyme in glycogen storage disease type II (Pompe disease)?

Answer 6

acid a-glucosidase (acid maltase) causes glycogen accumulation in the lysosomes

Question 7

what are the major symptoms of glycogen storage disease type II (Pompe’s disease)?

Answer 7

Cardiomegaly and generalized hypotonia that presents in early infancy

Question 8

what does a muscle biopsy show in polymyositis?

Answer 8

over-expression of MHC class I on the sarcolemma with CD8+ lymphocytic infiltration

Question 9

cauda equina syndrome consists of damage to what nerve roots?

Answer 9

S2-S4

Question 10

what are symptoms of cauda equina syndrome

Answer 10

saddle anesthesia and loss of the anocutaneous reflex

Question 11

what are symptoms of untreated hydrocephalus in infants

Answer 11

hypertonicity and hyperreflexia (UMN injury due to stretching), developmental delay and seizures

Question 12

what is the result of a t(14;18)

Answer 12

over-expression of Bcl-2 an anti-apoptotic protein (causes cellular immortality) causing follicular lymphoma

Question 13

how do you treat lyme disease

Answer 13

doxycycline or penicillin type antibiotics (ceftriaxone)

Question 14

what is terbinafines MOA and what is it used to treat

Answer 14

inhibits the enzyme squalene epoxidase to inhibit synthesis of ergosterol. used to treat dermatophytosis

Question 15

what is etanercept’s MOA and what must be checked prior to initiation

Answer 15

its a TNF-a inhibitor therefore it impairs cell-mediated immunity. All pts should be checked for latent TB

Question 16

what protein regulates transition from G1 to S phase and how is it activated

Answer 16

Retinoblastoma protein (Rb)
active form is hypophosphorylated while inactive form is hyperphosphorylated. The inactive form allows for continuation of the cell cycle

Question 17

what causes hemoglobin C disease

Answer 17

missense mutation which causes negtively charged glutamate residue being replaced by a positively charged lysine in the beta chain

Question 18

rank HbA, HbS, HbC in order of speed of movement on gel electrophoresis

Answer 18

HbA> HbS>HbC

HbA is the most negatively charged

Question 19

which cells are predominantly found in the paracortex of the lymph nodes

Answer 19

T lymphocytes and dendritic cells

Question 20

what cardiac abnormalities are pts with turners syndrome at increased risk for

Answer 20

bicuspid aortic valve and aortic coarctation

valve without stenosis presents as an early systolic, high-frequency clink heard over the right second interspace. Is at higher risk for calcification and endocarditis

Question 21

what causes a trendelenburg sign

Answer 21

superior gluteal nerve injury (often do to trauma or damage during hip surgery or buttocks injections)

causing weakness of the gluteus medius and gluteus minimus and the pelvis to sag toward the unaffected side. the pt will lean toward the affected side when walking

Question 22

what are symptoms of primary hyperaldosteronism

Answer 22

hypertension, hypokalemia, metabolic alkalosis causing paresthesias and muscle weakness

Question 23

what is the most important mediator of sepsis? what produces it?

Answer 23

TNF-a produced by activated macrophages (IL-1 and 6 are also involved)

Question 24

what are the signs of McCune-Albright syndrome

Answer 24

fibrous dysplasia (multiple osteolytic lesions), endocrine abnormalities (precocious puberty), cafe-au-lait spots

Question 25

metabolism of what substance is defective in alkaptonuria and what is the clinical presentation

Answer 25

defective tyrosine metabolism (deficiency of homogentisic acid dioxygenase) the presence of homogentisic acid in the urine turns it black if allowed to sit out

Question 26

what is the enzyme defect in Fabry disease

Answer 26

a-glalactosidase A (this is a lipid storage disorder)

Question 27

what are the clinical features of Fabry disease

Answer 27

neuropathic pain, angiokeratomas, telangiectasias, glomerular disease (proteinuria), cerebrovascular disease (TIA, stroke), Cardiac disease (LVH)

Question 28

where do very long chain fatty acids get metabolized

Answer 28

since they cannot undergo b-oxidation in the mitochondia they are oxidized in the peroxisome - diseases may result if the perioxisomes are absent or disfunctional

Question 29

what causes pigmented gallstones

Answer 29

unconjugated bilirubin accumulation usually secondary to bacterial or helminthic infection of the biliary tract cauing increased Beta-Glucuronidase which increases the amount of unconjugated bilirubin. Can also be seen in chronic hemolytic anemia

Question 30

what is the function of Phosphoribosyl pyrophosphate (PRPP) synthase? and what does an activating mutation increase the risk of?

Answer 30

PRPP synthase is involved in purine and pyrimidine synthesis therefore increased function could lead to gout (more purines being made --> more being broken down--> uric acid formation)

Question 31

how is achondroplasia inherited

Answer 31

it's usually due to a sporatic mutation (advanced paternal age) but can also be Autosomal Dominant inheritance

Question 32

what are the signs and symptoms of opiod/heroin withdrawl

Answer 32

nausea, vomiting, abdominal cramping, muscle aches, dilated pupils, yawning, piloerection, lacrimation, hyperactive bowel sounds

Question 33

what does Acetyl CoA carboxylase do? and what does acyl CoA synthase do?

Answer 33

Acetyl CoA caboxylase - first step in fatty acid synthesis (requires biotin) Acyl CoA synthase - activates fatty acids to acyl CoA in the cytoplasm, which are then combined with carnitine and transported to the mitochondria to undergo beta oxidation

Question 34

A pt has a ruptured aorta from a car accident, where is the injury most likely located?

Answer 34

aortic isthmus (just after the left subclavian vein comes off the arch, where the ligamentum arteriosum is located) this is due to the extreme stretching and torsional forces on an area that is relatively immobile

Question 35

what is heteroplasmy

Answer 35

the condition of having different mitochondrial genomes within a single cell - in mitochondrial disease the percent affected determines the severity of the disease

Question 36

what cell linage is the anterior pituitary derived from

Answer 36

surface ectoderm

Question 37

what are the signs of serotonin syndrome

Answer 37

confusion, agitation, tremor, tachycardia, hypertension, clonus, hypereflexia, hyperthermia, and diaphoresis

Question 38

what causes serotonin syndrome

Answer 38

any drug that increases serotonin levels including SSRIs, MAO inhibitors when taken together or high doses of SSRIs alone

Question 39

what is the treatment for serotonin syndrome

Answer 39

supportive care and a serotonin receptor antagonist in severe cases such as cyproheptadine

Question 40

what are the functions of the Smooth ER

Answer 40

steroid and phospholipid synthesis and detoxification of drugs (prominent SERs are seen in cells of the adrenal)

Question 41

what is ApoE responsible for

Answer 41

binding to hepatic lipoprotein receptors causing removal of VLDL and chylomicrons from the blood

Question 42

when are "red, dead" neurons seen after a stroke

Answer 42

12-24 hours (eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance)

Question 43

to what lymph nodes do the testes drain? the penis? the scrotum?

Answer 43

testes - para-aortic nodes penis - deep inguinal nodes scrotum - superficial inguinal nodes

Question 44

what is Dactylitis and what disease is it associated with

Answer 44

painful swelling of the hands and feet associated with sickle cell disease

Question 45

what are common features of Patau syndrome and what causes them

Answer 45

midline defects including: holoprosencephally, microcephaly, microphthalmia, cleft lip/palete, omphalocele, intellectual disability and seizures, polydactyly and cutis aplasia

Question 46

what is I-cell disease

Answer 46

autosomal recessive lysosomal storage disorder, due to defect in protein targeting. defective phophotransferase enzyme prevents the phosphorylation of manose residues therefore instead of being transported to the lysosomes it

Question 47

how does SIADH normally present

Answer 47

euvolemic hyponatremia - low plasma sodium and osmolality, inappropriately concentrated urine, clinically normal body fluid levels

Question 48

what is milrinone's MOA

Answer 48

PDE-3 inhibitor - acts as an inotropic agent in the heart by increasing cAMP but also acts as a vasodilator in smooth muscles

Question 49

what are characteristics of a drug with a low Vd?

Answer 49

large molecular weight, bound extensively to plasma proteins or highly charged (Vd= 3-5 L)