Review 2

Question 1

The most important immunological marker of this acute infection is

Answer 1

Neonatal IgM is the antibody isotype used as a marker for acute infections in neonatal serum

Question 2

A 35-year-old female presents to her primary care physician with the complaint of uncontrollable episodes of flushing, diarrhea, and wheezing over the past two months. Urinalysis reveals elevated 5-HIAA. This patient is at an increased risk for a deficiency in what vitamin

Answer 2

This patient has carcinoid syndrome and is secreting excess serotonin (indicated by elevated 5-HIAA in urine). Tryptophan is the precursor for both serotonin and niacin. When most of the tryptophan is consumed to make serotonin, niacin deficiency may result in pellagra (the 4 Ds: dermatitis, diarrhea, dementia, death).

Question 3

A 24-year-old female, 10 weeks pregnant presents with all symptoms of Hyperthyroid and a suprasellar mass on brain MRI. Diagnosis and what hormones are affected?

Answer 3

Elevated TSH –> increased T3 and T4. The increase in T3 and T4 causes the symptoms of hyperthyroidism. The elevated levels of T3 and T4 induce a negative feedback mechanism on the hypothalamus-pituitary axis, preventing release of thyrotropin releasing hormone (TRH) in the hypothalamus.

Question 4

A 3-year-old male presents to the pediatrician with his mother. The child was born deaf. Physical examination reveals centrally notched incisors, a flattened nose, sharp anterior bowing of the tibia, and corneal erythema. Which of the following drugs may have prevented these birth defects?

Answer 4

The girl has congenital syphilis

Question 5

What structures are drained by the right lymphatic duct? Right lung: Which lobes

Answer 5

upper, middle and lower lobes of the right lung lower lobe of the left lung. This is because the inferior tracheobronchial nodes collect lymph from the left lower lobe but drain that fluid into the right tracheobronchial lymph nodes, which eventually drains into the right lymphatic duct.

Question 6

What is the function of measuring PAH s inulin?

Answer 6

PAH measures renal plasma flow while inulin indicated kidney function by measuring GFR

Question 7

A pt with anti-citrullinated peptides will have what type of anemia?

Answer 7

This pt has rheumatoid arthritis. Low: iron, iron, and TIBC and High: ferritin

Question 8

Often after upper respiratory infection or gastroenteritis, 90% occurs in children. Triad of palpable purpura, arthritis/arthralgias, abdominal pain, renal disease

Answer 8

IgA Vasculitis (Henoch-Schönlein purpura)

Question 9

Hepatitis C, low complement component 4

Answer 9

Cryoglobulinemic Vasculitis

Question 10

P-ANCA, high eosinophilia, mononeuritis multiplex

Answer 10

Eosinophilic granulomatosis w/ Polyangitis (formerly Churg-Strauss)

Question 11

Cytoplasmic- (c)ANCA (anti-proteinase 3), upper airway, lungs, kidneys, saddle-nose deformity

Answer 11

Granulomatosis w/Polyangitis (formerly Wegener granulomatosis)

Question 12

Perinuclear- (p)ANCA (anti-myeloperoxidase), lungs and kidney affected, similar to Wegener’s, but p-ANCA and no nasopharyngeal involvement

Answer 12

Microscopic Polyangitis

Question 13

Heavy smokers, autoamputation of digits, Raynaud phenomenon

Answer 13

Buerger: Segmental thrombosing vasculitis

Question 14

Usually middle-aged men. Hepatitis B seropositivity in 30% of patients. Fever, weight loss, malaise, headache. GI: abdominal pain, melena. Hypertension, neurologic dysfunction, cutaneous eruptions, renal damage.

Answer 14

Polyarteritis Nodosa

Question 15

Older females, unilateral headache, jaw claudication may lead to blindness due to ophthalmic artery occlusionAssociated with polymyalgia rheumatica

Answer 15

Giant cell :

Question 16

Adverse side affects of infliximab

Answer 16

TNF alpha inhibitor. Used for Chrons and can cause an increase in viral and fungal infection

Question 17

Pt with blurred vision, confusion, sweating, palpitations, and “nervousness” with similar episodes the past three months, as well as 10 lb weight gain. Laboratory analysis reveals blood glucose 50 mg/dL. Administration of glucose leads to relief of the symptoms, and on follow-up, an elevated serum C-peptide is discovered. What is the most likely cause of these symptoms?

Answer 17

Insulinoma from pancreatic Beta cells