Random Q set 4

Question 1

What is the best way to visualize spirochetes, such as treponema pallidum, for diagnosis?

Answer 1

with dark field microscopy

will show helical motile organisms

Question 2

What is effect modification?

Answer 2

when the outcome of the main exposure is modified by another variable
NOT a confounder or a bias

Question 3

What do the elderly on the tea & toast diet sometimes get?

Answer 3

Scurvy–vit C deficiency
Vit C is needed as cofactor for the hydroxylation of proline & lysine residues of collagen in the Rough ER
Symptoms–gingival bleeding, petechiae, ecchymosis, corkscrew hairs

Question 4

When endometrial cells die off…which death process do they undergo?

Answer 4

apoptosis

Question 5

Why are patients with silicosis at increased risk for TB?

Answer 5

macrophages take in silica particles that damage them

more susceptible to TB

Question 6

What is the difference b/w empathy & support?

Answer 6

empathy–try to walk in their shoes & really understand

support–acknowledge the difficulty for the person, be there for them

Question 7

What is the presentation of congenital hypothyroidism?

Answer 7

hypotonia-floppy
poor feeding
jaundice
macroglossia
constipation
umbilical hernia
can develop into MR

Question 8

What is the site of protrusion, lower border, medial border for direct & indirect inguinal hernias?

Answer 8

Direct: 
Site--Hesselbach Triangle
Lower--inguinal ligament
Medial--rectus abdominis
Lateral--inferior epigastric vessels
Indirect:
Site--deep inguinal ring
Lower--inguinal ligament
Medial--inferior epigastric vessels

Question 9

Which type of hernia can be felt with deep palpation of the external inguinal ring w/ the tip of the finger? Or they can be in the scrotum…

Answer 9

Indirect Inguinal hernia

Question 10

What type of injury does ulnar nerve damage cause? What are 2 ways to damage the ulnar nerve?

Answer 10

claw hand

• *thru Guyon’s canal
• *hook of the hamate & pisiform bone

Question 11

How does chloroquine & primaquine treat malaria?

Answer 11

chloroquine–works on erythrocytic forms of plasmodium

primaquine–fights the latent stage of Pvivax & Povale in the liver

Question 12

What do central chemoreceptors respond to? Peripheral chemoreceptors?

Answer 12

Central–medulla, respond to pH

Peripheral–carotid & aortic bodies, respond to hypoxemia or hypercapnia

Question 13

Describe some of the symptoms that can occur with large vessel arteritis.

Answer 13

headache
craniofacial pain
polymyalgia rheumatica
sudden vision loss

Question 14

What is mucormycosis?

Answer 14

opportunistic infection
caused by Rhizopus, Mucor, or Absidia
paranasal sinuses infected
fungi are broad nonseptate hyphae that branch at right angles

Question 15

What are the symptoms of cardiac tamponade?

Answer 15

hypotension
tachycardia
elevated central venous pressure--JVD
muffled cardiac sounds
systolic drops 10 mmHg during inspiration

Question 16

How does anorexia affect the cardiovascular system?

Answer 16

hypotension
hypothermia
bradycardia
cardiac atrophy
cardiomyopathy
arrhythmias

Question 17

What is the only safe place to make an injection into the buttocks?

Answer 17

the superolateral quadrant, miss the superior gluteal nerve & the sciatic nerve.

Question 18

Give the important characteristics of multiple myeloma.

Answer 18

plasma cells in bone marrow
amyloid formation b/c of monoclonal immunoglobulin light chains
normocytic & normochromic anemia
hypercalcemia & bone resorption
Renal failure b/c of amyloid & plasma cells
Lytic lesions, Bence-Jones proteins, apple-green birefringence on Congo red stain

Question 19

What is the concept of heteroplasmy?

Answer 19

the coexistence of mutated & wild type versions of mitochondrial genomes in a given cell
Diseases of mitochondrial inheritance can be expressed differently in different people.

Question 20

What is the MOA of acyclovir in the treatment of herpes?

Answer 20

activated by viral thymidine kinase
viral DNA pol takes it up to make more DNA & synthesis is terminated
nucleoside analog

Question 21

What is a good initial treatment for alcohol withdrawal?

Answer 21

benzodiazepines that are long-acting stimulate the inhibitory action of GABAa receptors (the same as alcohol)
Ex: diazepam, chlordiazepoxide

Question 22

What are the characteristics of syringomyelia?

Answer 22

central cystic dilation in cervical spinal cord at the level of C8-T1 usually.
causes upper extremity loss of pain & temp sensation & weakness & hyporeflexia
lower extremity hyperreflexia & weakness

Question 23

What is the MOA of thiazolidinediones, such as pioglitazone? Side effects?

Answer 23

PPAR gamma activated

side effect: fluid retention, can exacerbate CHF

Question 24

What are the things that warfarin therapy inhibits?

Answer 24

factors 2, 7, 9, 10

Protein C & S (bad b/c these are naturally anticoagulant)

Question 25

Statins are metabolized by CYP 450 3A4. What are some inhibitors of this?

Answer 25

cimetidine
ciprofloxacin
erythromycin (a macrolide)
azole antifungals
grapefruit juice
isoniazid
ritonavir