Random (Nov-Jan) Flashcards
1
Q
Ventricular wall thickness is increased globally in
A
Hypertensive heart disease
2
Q
Gottron sign is seen in
A
Dermatomyositis
3
Q
Chest pain from GI/esophageal cause
A
Non exertional
Relieved by antacids
Ass with regurgitation, nausea, dysphagia
Nocturnal pain
4
Q
Most common lab abn in legionellosis
A
Hyponatremia
5
Q
Statins and fibrates adverse effects
A
Myopathy
6
Q
features of radial nerve injury
A
weakness on finger and thumb extension (finger drop)
7
Q
criteria for narcolepsy
at least 1 of
A
cataplexy (brief loss of consciousness ppt by strong emotions laughter etc)
low CSF hypocretin-1
shortened REM sleep latency
8
Q
Absent seizure features
A
Brief loss of consciousness (eg blank stare)
May have automatisms
Usually no postictal state
9
Q
Eczematous dermatitis histology
A
Spongiosis
10
Q
Other features of congenital torticollis
A
Hip dysplasia Metatarsus adductus (adduction of forefoot) Talipes equinovarus (club foot)
11
Q
% saturation of O2 is decreased in
A
CO poisoning
12
Q
Bicuspid aortic valve
A
Turner syndrome (susceptible to infectious endocard)
13
Q
Side effects of colchicine
A
Nausea
Abdominal pain
Diarrhea
14
Q
PICA ischemia leads to
A
Lateral medullary (wallenberg) syndrome
15
Q
Overuse of diphenoxylate leads to
A
Euphoria and physical dependence
16
Q
hPL stimulates production of which hormone
A
Insulin in pancreatic beta cells
17
Q
Gram positive anaerobic bacteria
Colonize mouth colon vagina
In dental caries and margins of gums
A
Actinomyces
18
Q
Contraindications of colchicine
A
Elderly
Severe renal dysfunction
19
Q
Tremors Anxiety Delirium Psychosis Withdrawal symptoms of
A
Alcohol
20
Q
Complex focal seizure
A
Loss of consciousness and post ictal state
21
Q
Excessive daytime sleepiness
Snoring
Gasping are features of
A
Obstructive sleep apnea
22
Q
Most common form of adrenal hyperplasia
A
21 hydroxylase deficiency
23
Q
Humoral component of type 4 hypersensitivity rxn
A
None
24
Q
candida vaginitis xtic
A
thick, cottage cheese discharge
25
Maternal virulization is commonly seen in
Aromatase deficiency
| Transfer of excess androgens in2 maternal circulation
26
incr methylmalonylcoA inv deficiency of
B12
27
Lamotrigine is used for
Bipolar depression
28
Cause of BPPV
Otoliths in semicircular canals
29
Enlarged uterus inconsistent with dates is seen in
Complete hydatidiform mole
30
Chest pain from coronary artery disease
Substernal
Radiates to arm, shoulder, or jaw
Ppt by exertion
Relieved by rest or nitroglycerin
31
Total oxygen content is decreased in
CO poisoning
| Anemia
32
Affected newborn girls in aromatase deficiency have
Normal internal genitalia
| Ambiguous or male-type external genitalia (clitoromegaly)
33
Teratogenic effects of warfarin
Nasal hypoplasia
| Stippled epiphysis
34
low Urine chloride metabolic acidosis
| causes:
vomiting/ nasogastric aspiration
| prior diuretic use
35
Side effects of methylphenidate
Decr appetite
| Weight loss
36
Abnormal premature keratinization of individual kerayocytes below stratum granulosum ? Term?
Dyskerayosis
37
Diagnosis of allergic bronchopulmonary aspergillosis
Eosinophilia
+ve aspergillus specific IgG
Incr aspergillus specific and total IgE
+ve skin test for aspergillus
38
Serum sickness
Lupus nephritis
PSGN hypersensitivity type
Type 3
39
Diabetes insipidus
Incr osm
Decr ICF
Decr ECF
Hyperosmotic volume contraction
40
Clozapine class
Antipsychotic
41
```
Epicanthal folds
Upslanting palpebral fissures
Protruding tongue
Excessive skin at nape of neck
Hyptonia
Weak startle (moro) reflex seen in
```
Down syndrome
42
Bupropion is used for
Major depression
43
Nicotine withdrawal symptoms
Dysphoria
Irritability
Anxiety
INCREASED APPETITE
44
CMV occurs in
Transplant pts
HIV
Fetuses (congenital infections)
45
Common causes of vertigo
Meniere disease
BPPV
Vestibular neuritis (labyrinthitis)
46
Fecal/embryonic tissue in complete hydatidiform mole?
Absent
47
High pitched blowing decrescendo murmur
Aortic regurgitation (diastolic murmur)
48
Double bubble sign on XRAY
Duodenal atresia
49
Pulmonary compliance in emphysema is
Increased
50
Motor features of tourette disorder
Facial grimacing
Blinking
Head/neck jerking
Tongue protrusion, sniffing
51
Serum sickness hypersensitivity
Type 3 hypersensitivity rxn to non human proteins---> vasculitis from tissue deposition of circulating immune complexes
52
Colchicine disrupts
Chemotaxis
Phagocytosis
Degranulation
53
```
abd pain
vomiting
diarrhea
hypotension
garlic breath due to
```
arsenic poisoning
54
```
Incr appetite
Hypersomnia
Intense psychomotor retardation
Severe depression
Withdrawal symptoms of
```
Stimulants (cocaine, amphetamine)
55
Risk of bupropion is greater with preexisting
Seizure disorder or eating disorder (anorexia or bulimia)
56
Mnemonic of features of Manic episode
```
DIGFAST
D- distractibility
I- impulsivity
G- grandiosity
F- flight of ideas
A- incr activity
S- decr need for sleep
T- talkativeness
```
57
Teratogenic effects of ACE inhibitors
Renal dysgenesis
| Oligohydramnios
58
bacterial vaginosis org
gardnerella vaginalis
59
Warfarin inhibits
Vitamin K dependent clotting factors esp VII
60
Teratogenic effects of lithium
Nephrogenic DI
Ebstein anomaly
Hypothyroidism
61
Gestational HTN
New onset incr bp at 20wks gestation
62
variable uterine dev
no upper vagina
primary amenorrhea
normal ovaries (reg dev of secondary sexual xtics)
mullerian aplasia /
vaginal agenesis
Mayer Rokitansky Kuster Hauser syndrome
63
incr homocysteine inv deficiency of
folate and B12
64
Teratogenic effects of valproate
Neural tube defects
65
Ebstein anomaly leads to
Decreased right ventricular volume
| Atrialization of right ventricle
66
Features of obesity hypoventilation syndrome
```
Obesity
Chronic fatigue
Dyspnea
Difficulty concentrating
Incr paCO2
```
67
K and H wasting at distal nephron is caused by
Aldosterone
68
Side effects of lamotrigine
Rash
Steven Johnson synd
Is an anticonvulsant
69
Brief jerking movements are seen with
Myoclonic generalized seizure
70
most common cause of alarming bloody nipple discharge
intraductal papilloma
71
```
Vaginal bleeding
INCREASED beta hCG
Hyperemesis gravidarum
Preeclampsia
Hyperthyroidism
Theca lutein cysts
```
Complete hydatidiform mole
| 46 XX or XY
72
other sources of arsenic poisoning
pressure-treated wood
minjg
glass making
pesticides
73
Simple focal seizure
No loss of consciousness or postictal state
74
Target INR
2-3
75
gerstmann syndrome
| affected lobe
dominant parietal lobe
76
Vasodilator in chemical cardiac stress tests
Adenosine
77
Gottron sign
Raised violaceous scaling eruption of knuckles
78
Causes of erectile dysfunction
Psychogenic stressors (rapid onset)morning erections present
Performance anxiety or depression
Medications (SSRIs, sympathetic blockers-clonidine, methyldopa)
Vascular or neurological impairment
Genitourinary trauma
79
Management of placenta accreta diagnosed during prenatal care
Cesarean delivery followed by hysterectomy
80
Causes of right shift in O2-Hb dissociation curve
Incr temperature
Decr pH
Incr 2,3 BPG
81
Teratogenic effects of methotrexate
Neural tube defects
Limb and craniofacial abn
Abortion
82
Cyt P450 inducers
```
Decr warfarin effect
Decr in efficacy
Carbamazepine, Phenytoin
Ginseng, St John's wort
OCP
Phenobarbital
Rifampin
```
83
% occlusion for positive inducible ischemia
80 and 60% occlusion of R&L CA
84
Transepithelial potential difference test in cystic fibrosis
Saline applied to nasal mucosa
| Incr Na absorption in CF patients causes a more negative nasal transepithelial potential difference
85
Maternal features of rubella
Low grade fever
Maculopapular rash with cephalocaudal progression
Postauricular and suboccipital lymphadenopathy
86
Kallman syndrome?
Impaired synthesis of GnRH by hypothalamus
87
Incr incidence of cholelithiasis in pregnancy and OCP use is associated with
Estrogen-induced cholesterol hypersecretion
| Progesterone-induced gallbladder hypomotility
88
Folic acid antagonist that inhibits DHF reductase
Methotrexate
89
Diffusion capacity for carbon monoxide in chronic bronchitis is
Normal
90
Hypersensitivity type in myasthenia gravis
Type 2
91
basal ganglia atrophy is seen in
Wilson dx
92
Posterior limb of internal capsule carries which fibers?
Corticospinal motor and somatic sensory fibers + visual and auditory fibers
93
Specificity calculation
d/b+d
TN/TN+FP
Rules into normal population (SPIN)
94
Useful meds in atypical subtype of major depression and treatment resistant depression
Monoamine oxidase (MAO inhib)
Phenelzine
Tranylcypromine
Selegiline
95
HPV imfection is associated with which cancers
Anogenital squamous cell carcinomas and precursors
| Squamous intraepithelial lesions
96
Pigment that causes greenish color to develop in bruises several days after an injury
Biliverdin
97
Deficiency of aromatase
AR
Early manifestation in embryo
Incr androgen and decreased estrogen levels in female fetus
98
Ataxia telang gene responsible for
DNA break repair
| DNA is hypersensitive to xray causing multiple chromosomal breaks
99
FEV1 and FVC in chronic bronchitis and emphysema
Decreased
100
Cl and Na in cystic fibrosis
Decr Cl secretion and incr Na absorption by respiratory epithelia resulting in dehydrated mucus
101
Thickening of stratum corneum
Hyperkeratosis
102
Phase 2 nonpacemaker cell blocked by
Class IV Antiarrhythmics
| Verapamil, Diltiazem
103
Key enzyme involved in steroidogenesis
Aromatase
104
Specific phobia meaning and duration
Marked anxiety about specific object or situation (flying, heights, animals, injections, blood)
Common (10% population)
> 6 months
105
ADHD treatment
Methylphenidate
106
AML features
Peroxidase +ve granules (auer rods)
107
radial nerve passes through
| injury can also occur due to
supinator canal
| direct trauma or dislocation of radius
108
pancreatic insufficiency is a cause of which vitamin deficiency
vitamin A
chronic pancreatitis or cystic fibrosis
109
ACE-I and statins and impotence
Not shown to cause impotence
110
Features of meniere disease
Recurrent vertigo
Ear fullness/pain
Unilateral hearing loss and tinnitus
111
Location of caudate nucleus
Inferolateral wall of anterior horn of lateral ventricle
112
IL-10 function
Anti-inflammatory
Immunomodulatory
Esp in pathogenesis of inflammatory bowel disease
113
Chronic HTN in pregnancy
>= 140/90 prior to conception or 20wks gestation
114
radial nerve injury due to
due to repetitive pronation and supination of forearm
115
Young black woman
Non caseating granulomas
Cough dyspnea chest pain
Macules/plaques/erythema nodosum
Sarcoidosis
116
Atrophy of caudate is seen in
Huntington's disease
117
trichomoniasis org
trichomonas vaginalis
118
Partial pressure of oxygen in nitrites poisoning?
Unchanged
119
Excessive alveolar elastin degradation is seen in
Alpha 1 antitrypsin def
120
In aromatase deficiency, At puberty impaired ovarian estrogen synthesis leads to
Primary amenorrhea
Osteoporosis
Tall stature (low estrogen delays fusion of epiphysis)
121
Measles and rubella pattern of spread
From head and neck spread downward
122
Late presentation of salt wasting or precocious puberty is seen in
21 hydroxylase deficiency
123
Common causes of non-valvular heart failure
IHD
Dilated cardiomyopathy
Hypertensive heart disease
Hypertrophic cardiomyopathy
124
Findings in colonic atresia
Constipation
| Abd distension
125
Insulin causes activation of
PFK 2
| Incr glycolysis
126
Conduction SPEED order in heart from slow to fast
1. AV node (0.05m/sec)
2. Ventricular muscle
3. Atrial muscle
4. Purkinje system (2.2 m/sec)
127
meds fr pregnancy termination
misoprostol -prostag E1 agonist
mifepristone -progest antag
methotrexate - folic acid antag
128
RV FVC and TLC in aging
Incr RV
Decr FVC
Unchanged TLC
129
Diagnosis of methylmalonylcoA mutase deficiency
Elevated urine methylmalonic acid and propionic acid
130
clomilphene
selective estrogen receptor modulator
| prevents negative feedback inhibition in hypothalamus and pituitary by circulating estrogen
131
risk factors for epithelial ovarian cancer
```
FAM hx
infertility
nulliparity
endometriosis
PCOS
lynch syndrome
post men hormone therapy
BRCA 1 or 2 mutation
```
132
Total O2 content (dissolved and attached to Hb) is increased in
Polycythemia
133
hyperkeratosis
night blindness
growth retardation
severe eye dryness and corneal ulceration
vitamin A deficiency
134
Most common indicators in obesity related restrictive lung dx
Decr ERV and FRC
135
one ureter injury during hysterectomy
| voiding in pt
can void normally
flank pain
fever
136
Autoantibodies ANA, anti Jo-1 can be seen in
Polymyositis
137
Botulinum toxin mechanism
Blocks Ach release into NM synapse
138
Parvovirus description
Non enveloped SS DNA virus
139
Causes of hypoxemia with elevated A-a
```
R-L shunt (septal defects, pulmonary edema)
V/P mismatch (PE, COPD)
Impaired diffusion (interstitial lung dx)
```
140
Dermatomyositis main features
Autoimmune
Prox muscle weakness
Violaceous discol of upper eyelids (heliotrope rash)
Elevated CPK levels
141
Tryptase is found in
Mast cell ----- anaphylaxis
142
accumulated HCO3 causes compensatory
decrease in ventilation
143
metabolic alkalosis
pH
HCO3
arterial pH > 7.45
| bicarb > 24mEq/L
144
Stage 3 of sarcoidosis
Disappearance of hilar lymphadenopathy
| CXR shows lung infiltrates only
145
Features of BPPV
Brief episodes brought on by head movement
146
metronidazole for
gardnerella and trichomonas
147
Patient with history of irregular menses at risk for
Inaccurate pregnancy dating (dating error)
148
androgen excess
hirsutism
acne
androgenic alopecia
PCOS
149
Emesis in duodenal atresia
Billous or non billous
150
Lithium used in pregnancy causes
Ebstein anomaly
| Apical displacement of tricuspid valve leaflets
151
Biliverdin (green color) is converted to UC bilirubin by
Biliverdin reductase
152
Ribavirin MOA
Interferes with duplication of viral genetic material
153
Main distinguishing xtic in atypical depression
Mood reactivity (feeling better in response to positive events)
154
First step in pathogenesis of coronary artery disease involves which cells
Endothelial cells
155
Diagnosis of biliary atresia
Liver biopsy
| Intrahepativ bile duct prolif, portal tract edema and fibrosis
156
FSH level incr during transition to menopause due to
resistant ovarian follicles
| lack of feedbck from inhibin
157
Cause of meniere disease
Incr pressure and volume of endolymph
158
Genetic influence on short arm of chromosome 20, or X and Y chromosomes is seen in
Androgenic alopecia
| Some are therefore X-linked recessive others are autosomal dominant
159
Generalized seizures involve
Both hemispheres at onset
160
albendazole is used for
tapeworm (cestodes)
| echinococcus cysts in liver
161
Tourette disorder definitive features
Multiple motor and >= 1 vocal tics
162
Fibrin deposits in Bowman's space seen in
Rapidly progressive glonerulonephritis
163
Initial drug of choice regardless of etiology for status epilepticus
IV benzodiazepines eg lorazepam
| Due to its efficacy and rapid onset of action
164
Abn in men with aromatase deficiency
No genital abnormality
| Tall stature and osteoporosis present
165
MOA of colchicine
Inhibits microtubular polymerization
| Binds to tubulin protein that helps form microtubules, prevents aggregation
166
Esmolol MOA
Short acting cardioselective B1 antagonist
Decr heart rate and myocardial contractility
Not a vasodilator
Does not increase renal perfusion
167
Sheehan syndrome
High estrogen during pregnancy---> enlargement of pituitary gland without proportional increase in blood supply--- ischemia
168
Ataxia telangiectasia mutated gene
Type of infections
Type of immune def
Sinopulmonary
| IgA immune deficiency
169
HPV proteins E6 and E7 inhibit
p53 and Rb tumor suppressor genes respectively
170
most common enteric parasite in US and canada
Giardia
171
Early systolic high frequency click over R 2ICS
Aortic ejection sound (turner syndrome)
172
Preeclampsia
New onset incr bp at 20 wks gestation and proteinuria or signs of end organ damage
173
risk factors for post partum hemorrhage
prolonged labor
| twin gestation
174
The genu of internal capsule carries
Corticobulbar fibers
| And lies between anterior and posterior branches
175
treatment of prolactinoma
```
dopamine agonist
(bromocriptine)
```
176
Jejunum/ileum atresia associated with
Gastroschisis
177
Landmark for appendectomy
Teniae coli
178
Fever in legionella
> 39 degrees (102.2F)
179
Neonatal features of rubella
Sensorineural deafness
Cataracts
Cardiac malformations (PDA)
180
treatment of wiskott Aldrich syndrome
HLA-matched bone marrow transplantation
181
MOA of sulfonylureas and meglitinides (eg glyburide)
Incr secretion of insulin and C-peptide from pancreas
182
Cellular components of type 2 hypersensitivity
NK cells
Eosinophils
Neutrophils
Macrophages
183
Diphenoxylate is combined with what to discourage abuse
Atropine
| Induces adverse effects if taken in high doses
184
Nitrites effect on heme
Convert heme Fe 2+ to oxidized ferric iron Fe3+
| Fe 3+ (methemoglobin)
185
Umbilical hernia is associated with
Down syndrome
| Hypothyroidism
186
prolactinoma features
```
headache
visual field defects
decr bone density
galactorrhea
infertility ,decr libido, impotence in men
```
187
Other features of atypical depression
```
Leaden paralysis (arms and legs feel extremely heavy)
Rejection sensitivity (overly sensitive to slight criticism)
Increased sleep and appetite
```
188
Humoral component of type 1 hypersensitivity
IgE
189
Severe hypertension features
```
Acute coronary syndrome
Intracranial or SAH
Aortic dissection
Papilledema
Retinal hemorrhage or exudates
Encephalopathy (confusion)
Pulmonary edema
AKI (incr creatinine)
```
190
Bilateral nodular hyperplasia and hyperfunctioning adrenal adenoma are xtic of
Primary hyperaldosteronism
191
Fetal/emb tissue in partial hydatidiform mole?
Present
192
Cellular component of type 4 hypersensitivity
T cells CD8+
| Macrophages
193
Deposition of inhaled corticosteroids on oral mucosa can be avoided by using
A spacer and rinsing mouth after inhalation
194
Symptoms of neonatal abstinence syndrome
```
Irritability
Hypotonia
Jittery movements
Diarrhea
Vomiting
Feeding intolerance
Sweating
Sneezing
Pupillary dilation
```
195
Risk groups for legionellosis
```
Elderly
Immunocompromised
Smokers
Alcoholics
Pts with COPD
```
196
cyanide toxicity can occur in pts treated with
nitroprusside
197
Mnemonic for LV pressure volume loop
MAAM
COCO
Mitral valve -close Isovol contraction (A-B)
Aortic valve -open ventricular ejection (B-C)
Aortic valve-close isovol relaxation (C-D)
Mitral valve-open vent filling (D-A)
198
Treatment of absent seizure
Ethosuximide
199
NSAIDS for acute gouty arthritis CI in PUD, alternative med?
Colchicine
200
Screening for GBS in pregnancy
Weeks 35-37
| Vaginal-rectal culture
201
Hydralazine function
Direct arteriolar vasodilator
| No significant effect on renal perfusion or natriuresis
202
Malignant transformation of neuroendocrine cells is ass with
Carcinoid tumors
| Eosinophilic cytoplasm, oval to round stippled nuclei
203
presence of S 3 gallop
severe mitral regurg best indicator
204
Marijuana is metabolized in
Liver
Distributed and stored in lipophilic tissues and slowly released
Detected in urine up to 30 days after daily use cessation
205
hyperhomocystinemia is related to deficiency of
B12, B6, folic acid
206
Prolonged untreated obstructive sleep apnea can cause
Pulmonary hypertension and RHF
207
Converts androstenedione to estrone
| And testosterone to estradiol
Aromatase
208
Mesalamine is used for
Crohn's disease
209
common sources of arsenic poisoning
insecticides
| contaminated water
210
Midgut malrotation position of cecum
RUQ instead of RLQ
211
affected patients in intraductal papilloma have no
associated breast mass or skin changes
212
Jejunum/ileum atresia is due to
Vascular injury
213
Duodenal atresia is due to
Failure of recanalization at 8-10 wks gestation
214
Age of onset of Tourette syndrome
< 18
215
In type 1 hypersensitivity there is Interaction with pre existing IgE bound to
Basophils and
| Mast cells
216
Duodenal atresia associated with
Down syndrome
217
Diffusion capacity for carbon monoxide in emphysema is
Decreased
218
Progesterone inhibits
Prolactin (negative feedback on anterior pituitary)
219
Preventive measure for GBS
Intrapartum penicillin
220
Verapamil MOA
Slowing phase 4 depolarization
221
Candida contributes normal flora in
Skin
Mouth
Vagina
222
Decrease uptake of iodine isotopes due to competitive inhibition
Perchlorate amd pertechnetate
223
Side effects NOT seen with bupropion
No weight gain or sexual side effects
224
Hypoaldosteronism can lead to
Type 4 renal tubular acidosis
225
Heme is converted to biliverdin by
Heme oxygenase
226
MOA of fenoldopam
Short acting
Selective
Peripheral dopamine 1 agonist (act adenylyl cyclase and incr cAMP) vasodil arterial beds, decr BP
Little effect on alpha 1 or beta receptors
227
Hyperaldosteronism presenting signs
Decr plasma renin activity
Hypertension
Hypokalemia
Metabolic alkalosis
228
Antibiotic for actinomyces
Penicillin
229
Incr susceptibility to pyogenic bacteria, enteroviruses and Giardia lamblia in
X linked agammaglobulinemia
230
Most common cause of post partum hemorrhage
Uterine atony (failure to contract adequately after delivery)
231
Enzyme in elastin for extensive cross linking
Lysyl oxidase
232
Low or absent circulating CD 19 and 20 B cells and panhypogammaglobulinemia in
X linked agammaglobulinemia
233
Teratogenic meds
```
Phenytoin
Lithium
Valproate
Methotrexate
ACE inhibitors
Isotretinoin
Warfarin
```
234
Decr cerebral Perfusion in panic attacks leads to
Neurological symptoms
235
vessels to ligate in mgt of post partum hemorrhage
internal iliac arteries (hypogastric arteries)
236
What is neonatal abstinence syndrome
Withdrawal from transplacental opiates by mother
237
Fewer side effect aldosterone antagonist
Eplerenone (use when spironolactone not tolerated)
238
in treponemal serologic test (RPR) patient's serum is mixed with solution of
cardiolipin
cholesterol
lecithin
detect antibodies to human cellular lipids released in2 bloodstream after destructio. by treponema
239
CXR essential for diagnosis of
Sarcoidosis
240
MOA of lorazepam
Incr influx of negatively charged Cl- ions in response to GABA binding
Leads to hyperpol of post syn neuron and suppression of action potential firing
241
Features of vestibular neuritis
Single episode that can last days
| Severe vertigo but no hearing loss
242
Cystic medial degeneration is?
| Seen in?
Myxomatous changes with pooling of proteoglycans in media layer of large arteries
Young individuals with Marfan syndrome
243
Atypical antipsychotics with greatest risk
Olanzapine and clozapine
244
Features of chest pain from chest wall/musc cause
Persistent/prolonged pain
Worse with movement or change in position
Often follows repititive activity
245
mifepristone
| receptor
progesterone antagonist
246
Teratogenic effects of isotretinoin
Microcephaly
Small ears
Thymic hypoplasia
Hydrocephalus
247
Chest pain from aortic cause
```
Sudden
Severe tearing pain
Radiates to back
Elderly men
HTN and risk factors of atherosclerosis
```
248
Accumulation of edema fluid in intercellular spaces of epidermis
Spongiosis
249
Affected systems in wegener's
Vessels -Systemic vasculitis (small and medium sized)
URT -sinusitis, epistaxis, otitis
Hemoptysis
Kidneys (RPGN)
250
nitroprusside is converted to
nitric oxide and cyanide ions
251
MOA of diphenoxylate
Opiod antidiarrheal agent
Structure related to meperidine
Binds to mu opiate receptors in GI and slows motility
252
Cervicofacial abscess
| Filamentous orgs
Actinomyces
253
Erythematous papulovesicar weeping lesions
Acute allergic contact dermatitis
254
gardnerella vaginalis xtic
thin off white discharge + fishy odor
no inflammation
positive whiff test (amine odor)
255
Fast acting antiarrhythmic for acute SVT
| Short acting
Adenosine
256
Stage 4 of sarcoidosis
Lung fibrosis
257
heavy menstrual bleeding
| uniformly enlarged uterus
adenomyosis
258
pH in bacterial vaginosis and trichomoniasis
> 4.5
259
Allergic bronchopulmonary aspergillosis ass history
Asthma
| Cystic fibrosis
260
Fas receptor is expressed on
T lymphocytes
| Plays impt role in patho of cancer and autoimmune dx like SLE
261
MOA of bupropion
Inhibits reuptake of NE and dopamine
262
Krukenberg tumor
Primary gastric cancer metastasis to ovary
| Nests of signet ring cells
263
Chest pain from pulmonary cause
Sharp/stabbing pain
Worse with inspiration
Pericarditis (worse when lying flat)
Pneumothorax (resp disress, hypoxia)
264
```
Ring-enhancing lesion
Respiratory symptoms
Fever
Headache
Acid fast beaded branching filaments
```
Nocardia
265
deposition of copper in cornea and basal ganglia
Wilson dx
266
Peptide hormone secreted by syncytiotrophoblast that leads to insulin resistance
Human placental lactogen (hPL)
267
vaginitis with vaginal inflammation present
trichomoniasis
| candida vaginitis
268
Lip smacking may be seen in
Complex focal seizure
269
ADH is synthesized in
Paraventricular and supraoptic nuclei of hypothalamus
270
Drug ass with reflex sympathetic activation resulting in increased heart rate and contractility, Na and fluid retention
Hydralazine
271
Side effect of clozapine
Agranulocytosis
272
Second generation (atypical) antipsychotics adverse effects
Metabolic!!!
Weight gain, dyslipidemia, hyperglycemia
Incr risk of DM
273
Warfarin not given alone. Why?
Warfarin decreases protein C while still having higher level of other procoagulants
Protein C half life = factor VII half life; short
As it acts against coagulation factors, also decr protein C
Leads to transient hypocoag
274
```
bicuspid aortic valve
broad chest
cubitus valgus
low hairline
narrow high arched palate
```
turner syndrome
275
Initial empiric treatment of coagulase-negative staph should include
Vancomycin
| If susceptibility results indicate methicillin sensitivity switch to Nafcillin or oxacillin
276
>200 CCG trinucleotide repeats in fragile X leads to
FMR1 hypermethylation
277
Treatment of specific phobia
Cognitive behavioral therapy with exposure
Acute - short acting benzodiazepines (alprazolam , lorazepam, oxazepam -slow onset)
Alorazolam is xanax
Lorazepam is ativan
278
placenta accreta
Placenta abnormally adherent to myometrium
279
vaginal / vulvar itching and redness, thick white discharge
candida vaginitis
280
Focal seizure
Involves 1 cerebral hemisphere at onset
281
Serum sickness can occu with admin of non human proteins like
Chimeric monoclonal antibodies (rituximab, Infliximab)
| Or non human Igs eg venom antitoxins
282
histopath findings in intraductal papilloma
papillary cells with fibrovasc core
283
Causes of increased maternal serum AFP
Open neural tube defects (anencephaly, open spina bifida)
Ventral wall defects (omphalocele, gastroschisis)
Multiple gestation
284
decr pCO2 is seen in
respiratory alkalosis
<40 mmHg
285
pH in candida vagjnitis
normal
286
Neonatal complications of diabetes during pregnancy
```
Premature delivery
Fetal macrosomia
Congenital malf (neural tube defects, CVS anomalies, caudal regression syndrome)
Respiratory distress
Transient hypoglycemia
Polycythemia and hyperviscosity
```
287
```
irregular menses
glucose intolerance/ diabetes
metabolic syndrome
obesity
acanthosis nigricans
```
PCOS
288
Causes of left shift in O2 -Hb dissociation curve
Decr temperature
Incr pH (decr H+)
Decr 2,3 BPG
289
patient with idiopathic intracranial htn usually a
young obese woman
with pseudotumor cerebri
290
Preformed mediators in mast cells
Histamine
| Tryptase
291
Medical conditions with polygenic inheritance (variable expressivity)
```
Androgenic alopecia
Glaucoma
Epilepsy
Schizophrenia
Hypertension
Ischemic heart disease
Type 2 DM
```
292
Germ tubes at 37 degrees for 3hrs seen with
Candida
293
```
Tremors
Anxiety
Perceptual disturbances
Insomnia
Psychosis
Withdrawal symptoms of
```
Benzodiazepines
294
Diffuse muscle contractions of limbs followed by rhythmic jerking seen in
Tonic clonic generalized seizure
295
Treatment of hypertensive emergency
Fenoldopam
296
CO2 a potent cerebral vasodilator exerts most significant effect in
Panic attacks
297
Jejunum/ileum atresia emesis
Billous emesis
Abd distension seen
298
First line treatment of acute gouty arthritis
NSAIDS eg Indomethacin
299
21 hydroxylase catalyzes conversion of
Progesterone to 11 deoxycorticosterone
300
Side effect of carbamazepine and valproate
Bone marrow abn
301
Good pasture syndrome hypersensitivity type
Type 2
302
Myoclonic generalized seizure
No loss of consciousness or post ictal state
303
Complete hydatidiform mole is p57
Negtive
304
MOA of desmopressin
Incr circulating factor 8 levels
| Stimulates vWF secretion from endothelial cells
305
Differentials of chest pain
```
Coronary artery disease
Pulmonary/pleuritic(pleurisy, pneumonia, pericarditis, PE)
Aortic (dissection, intramural hematoma)
GI/esophageal
Chest wall/musc
```
306
Partial pressure of O2 is normal in
CO poisoning
Anemia (low Hb)
Polycythemia
307
Med for exacerbations of crohn's disease
Prednisone
308
Hemophilia A responds to which med
Desmopressin (DDAVP)
309
MCC of congenital torticollis
Birth trauma
| Malposition of head in utero (4rm macrosomia or oligohydramnios)
310
Features of serum sickness
Fever
Pruritic skin rash
Low serum C3 and C4 levels
311
Absolute risk reduction calculation
ERcontrol - ERtreatment
ER - event rate
312
Ectopic pregnancy with no evidence of rupture
| Treatment
Single dose methotrexate
313
Marijuana use symptoms
```
Tachycardia
Conjuctival injection
Incr appetite
Dry mouth
Inappropriate laughter
Mild euphoria
```
314
treatment of arsenic poisoning
dimercaprol
| DMSA (succimer)
315
Presence of cANCA is typical in
Wegener's (granulomatosis with polyangitis)
316
Modt common opportunistic mycosis
Candida
317
Principal cause of high RBC chloride content in venous blood
Chloride shift
| HCO3 diffuse out of RBC in2 plasma and cl diffuse into RBC to maintain electrical neutrality
318
Vocal tics of tourette disorder
```
Grunts
Snorts
Throat clearing
Barking
Yelling
```
319
Immediate and long term treatments of panic disorder
Immediate - benzodiazepines
| Long term- SSRI / SNRI and/or CBT
320
Other indicators in obesity related restrictive lung disease
Residual volume?
Decr FEV1
Decr FVC
Decr TLC
RV is normal
321
Contractile function is decreased in which non valvular heart disease?
IHD
| Dilated cardiomyopathy
322
Treatment of juvenile myoclonic epilepsy
Broad spectrum anticonvulsant (eg valproic acid)
323
Which org develop in old lung cavities
Aspergillus
324
associated features of narcolepsy
hypnagogic or hypnopompic hallucinations
| sleep paralysis
325
Cyt P450 inhibitors
```
Incr warfarin effect
Incr bleeding risk
Acetaminophen, NSAIDs
Antibiotics/Antifungals eg metronidazole
Amiodarone
Cimetidine
Cranberry juice, Ginkgo biloba, Vitamin E
Omeprazole
Thyroid hormone
SSRIs eg Fluoxetine
```
326
common org in septic abortion
s.aureus
gram neg bacilli
327
Most common elbow injury in children
Radial head subluxation (nursemaid's elbow)
| Mostly 1-4 yr olds
328
Screening for gestational diabetes is more accurate in
3rd trimester
329
gap junctions important during
labour and delivery
| require coordination of individual myometrial cells
330
clindamycin to substitute metro in
bacterial vaginosis (gardnerella)
331
Increased septal thickening is present in
Hypertrophic cardiomyopathy
332
Hypertensive urgency
>= 180/120
333
Deposition of inhaled glucocorticoids on oral mucosa in asthma leads to
Oropharyngeal candidiasis
334
Lab findings of biliary atresia
Incr conjugated bilirubin and
| Gamma glutamyl transferase
335
Phase 3 blocked by
Class 3 Antiarrhythmics
Amiodarone
Sotalol
Dofetilide
336
Panic disorder is
Recurrent
| Unexpected panic attacks + >= 4 of the list of features
337
narcolepsy meaning
recurrent relapses into sleep or naps
| min 3 times/WK for 3 months
338
Panic attack xtic
```
Hyperventilation
Decr pCO2 (hypocapnia)
```
339
```
Nausea
Vomiting
Abd cramping
Muscle aches
Withdrawal symptoms of
```
Heroin
340
2 Features of polymyositis
Symmetrical proximal muscle weakness
| Incr diff climbing stairs, getting up 4rm chair, carrying heavy obj
341
Mast cell high affinity IgE receptor
FCERI
342
Drugs with high intrinsic hepatic clearance have
High lipophilicity and high volume of distribution
343
Features of fragile X syndrome
Macroorchidism
Dysmorphic facies
ADHD
ASD (delayed language acquisition and poor social skills)
344
CAG trinucleotide repeats are seen in
Huntington's disease
345
Partial hydatidiform mole is p57
Positive
346
Complications of polymyositis
Interstitial lung dx
| Myocarditis
347
Partial pressure of oxygen is
Amount if oxygen dissolved in plasma
348
incr HCO3 is seen in
metabolic alkalosis
| > 40 mmHg
349
Radial head subluxation occurs from
Pull on the hand while forearm is pronated and elbow extended
350
Tonic clonic generalized seizure
Loss of consciousness and post ictal state
351
Acute myelogenous leukemia is associated with
Down syndrome
352
Causes of hypoxemia with normal Alveolar to arterial gradient (A-a)
Hypoventilation (OHS, neuromusc disorders)
| Low inspired fraction of O2 (high altitude)
353
Colonic atresia associated with
Hirschsprung dx
354
Hypertensive emergency is
Severe hypertension with end organ damage
355
Dobutamine MOA
```
Beta 1 agonist
Gs protein
Adenylyl cyclase
Incr cAMP
Ca2+ activation
```
356
Vivid dreams
Depression
Fatigue
Are findings in withdrawal of
Stimulants
357
Chemicals released from degranulation of cells in type 1 hypersensitivity
Histamine
| Heparin
358
Med for gouty arthritis that reduces formation of LTB4
Colchicine
359
Aortic regurg best heard where?
| Patient position?
Along left sternal border at 3rd and 4th ICS while sitting up and leaning forward
360
Legionellosis symptoms
High fever
Confusion, headache
Diarrhea
361
primary risk factor for ectopic pregnancy
Tubal scarring
Prior N.gonorr and C.trach infection
362
Incr AFP level is seen in
Fetal neural tube defect
Twin gestation
Abd wall defects
Underest of gestational age
363
confirmatory test for treponema
FTA-ABS
364
Features of primary hyperaldosteronism
Incr aldosterone
Incr sodium
Decr k reabs
Decr H reabs
365
Secondary oocytes arrest at
Metaphase of meiosis 2 until fertilization
366
idiopathic intracranial htn symptoms
daily headache
bilateral papilledema
transient visual disturbance
symptoms worsen during valsava (cough, bending) due to incr ICP
367
Features of methemoglobin (Fe3+)
Binds tightly to cyanide
Causes dusky skin discoloration
Cannot carry O2
368
Most common inherited cause of intellectual disability
Fragile X syndrome
369
Features of biliary atresia
Jaundice with first 2 months of life
May appear healthy at birth
Dark urine
Acholic stools (pale or clay colored)
370
Carcinoid tumor on e-microscopy
Multiple dense core granules in cytoplasm which contain vasoactive molecules eg Serotonin, histamine, bradykinin and hormones eg gastrin
371
Robertsonian translocation is seen in
Down syndrome
| 46 XX t(14;21)
372
uses of loperamide
some cases of traveler's diarrhea
no fever or blood in stool
373
med for infertility prob in PCOS
clomiphene
374
```
Contaminated water
Cruise ships
Spas
Hospitals
Air conditioned hotels
Orgs?
```
Legionella
375
Features of PICA ischemia
Vertigo/nystagmus (vestibular nucleus)
Ataxia (inferior cerebellar peduncle)
Loss of pain and temperature in ipsilat face and contralat body
Ipsilat horner syndrome (sympathetic fibers inn head)
376
cervical intraepithelial neoplasia features
atypical squamous cells
| expansion of immature basal cells to epithelial surface
377
Sensitivity calculation
a/a+c
TP/TP+FN
Rules out of the normal population (SNOUT)
378
Fas receptor pathway
Extrinsic pathway of apoptosis
379
Biliary atresia is
Progressive
Complete or partial obstruction of extrahepatic bile ducts
Normal biliary tree at birth
380
cyanide antidotes
```
hydroxocobalamin (directly binds cyanide)
sodium nitrite (methemoglobinemia induction)
sodium thiosulfate (detoxifying sulfur donors)
```
381
Nitroglycerin function
Rapid acting vasodilator
| Decrease preload and CO
382
Med to prevent hemorrhagic disease of newborn
Vitamin K
383
Metabolic acidosis
Hypertension
Hypokalemia are present in
Primary hyperaldosteronism
384
presentation of septic abortion
```
fever
chills
lower abd pain
bloody or purulent discharge
boggy and tender uterus + dilated cervix
```
385
Treatment of generalized seizure
```
Broad spectrum
Lamotrigine
Levetiracetam (keppra)
Topimarate
Valproic acid
```
386
Unconjugated bilirubin is converted to conjugated bilirubin by
Glucuronyl transferase
387
Types of ALL
Precursor B cell and T cell types
Bcell -CD 19 and CD 10 +ve
T cell - CD 1,2,5 +ve
388
Risk factor for placenta accreta
Scar tissue from previous surgery (C-delivery) can result in malformed or absent decidual layer between placenta and myometrium
389
Eclampsia
Preeclampsia + new onset grand mal seizures
390
Contact dermatitis
| Type of hypersens?
Type IV (delayed)
391
Average hPL incr with increasing
Gestational age
392
```
male
eczema
recurrent infections
thrombi cut open is
B and T cell deficiency
```
wiskott Aldrich syndrome
393
med that inhibits microtubules of roundworms (ascaris, ancylostoma, enterobius)
mebendazole
394
Thickening of stratum spinosum
Acanthosis
395
Humoral component of type 3 hypersensitivity
Deposition of Ag-Ab complexes
396
V/P in pulmonary embolism
V/P mismatch
| Hypoxemia
397
kallman syndrome features
primary amenorrhea
absent secondary sexual xtics
olfactory sensory defect
398
normal vaginal pH
3.8 to 4.5
399
Features of congenital torticollis
Head tilted toward affected muscle
Contracted SCM muscle
Chin points away from contracted muscle
400
Ambiguous (virilized) genitalia at birth in females and normal genitalia in males
21 hydroxylase deficiency
401
Contact dermatitis
| Hypersensitivity type
Type 4
402
Treatment of tourette syndrome
Antipsychotics
Alpha 2 adrenergic agonists
Behavioral therapy
403
69 XXX or XXY
Normal to high beta hCG
Normal uterine size
Seen in
Partial hydatidiform mole
404
Globus pallidus and putamen are separated from thalamus by
Posterior limb of internal capsule
405
Panic disorder involves 4 or more of the following
```
Chest pain , palpitations, SOB, choking
Dizziness, paresthesias
Trembling, sweating, nausea, chills
Derealization, depersonalization
Fear of losing control or dying
Worry about additional attacks, avoidance behavior
```
406
Elevated muscle enzymes CK and aldolase are seen in
Polymyositis
407
Cause of vestibular neuritis
Inflammation of vestibular nerve
| Labyrinthitis
408
treatment of PCOS
weight loss
combination contraceptives
metformin
409
Radial head subluxation results in
Injury/tear to annular ligament attached to radial neck
By age 5 annular ligament bcms thick and strong, decrd likelihood of tear
410
IVF to achieve pregnancy in
turner syndrome
411
Two-sample t test for
Means of 2 populations
412
loperamide class
opiate antimotility drug
413
Raised, scaly plaques are from
Thickening of spinosum and corneum
414
TLC in chronic bronchitis is
Normal
415
Treatment of focal seizure
```
Narrow spectrum
Carbamazepine
Gabapentin
Phenobarbital
Phenytoin
```
416
FRC in chronic bronchitis is
Increased
417
Immunological finding in polymyositis
Incr expression of MHC 1 on sarcolemma
leads to autoantigens to CD8 cells
Then myocyte destruction
418
Bethanechol use
Post op urinary retention (music agonist)
419
Caspofungin MOA
Targets cell wall
| CASpofungin (case)
420
Diastolic function is decreased in
Hypertensive heart disease
| Hypertrophic cardiomyopathy
421
Cellular component of type 1 hypersensitivity
Basophils
| Mast cells
422
Aldosterone antagonists are
Spironolactone
| Eplerenone
423
Humoral component of type 2 hypersensitivity
IgG and IgM autoantibodies
| Complement activation
424
Which IL inhibits TH1 cytokines
Reduces MHC 2 expression
Suppresses activated macrophages and dendritic cells
IL 10
425
Decreased Maternal serum AFP is seen in
Aneuploidies
| Trisomy 18 and 21
426
Choriocarcinoma
Malignant form of gestational trophoblastic disease composed of anaplastic cytotrophoblasts and syncytiotrophoblast without villi
427
Before using warfarin, start with
Heparin/LMWH which will decrease the procoag forces transiently until other coagulation factor levels fall
428
Amniotic fluid embolism histology
Pulmonary artery branch with swirls of fetal squamous cells
429
presentation of cyanide toxicity
```
altered mental status
seizures
CVS collapse
lactic acidosis
bright red venous blood
```
430
Cholesteatoma
Collection of squamous cell debris that form round pearly mass behind tympanic membrane in middle ear
431
Treatment of neonatal abstinence syndrome
Opiod therapy eg
Morphine
Methadone
432
Dyskeratosis
| Found in? DX?
Squamous cell carcinoma
433
Screening for malabsorptive disorders
A qualitative assay of stool with sudan III stain
434
Another name for aldosterone-producing adrenal adenoma
Conn syndrome
435
Primary oocytes arrest at
Prophase of meiosis 1 until ovulation
436
ALL features
TdT +ve
| PAS +ve material
437
Severity of manic episode may include
Psychotic features (hallucinations, delusions)
438
TLC is emphysema is
INCREASED
