Review

Question 1

Abdominal cramps, bloating, and diarrhea. Weight loss. Pale, foul-smelling stools. Positive antiendomysal antibodies.
What is diagnosis?
What will be found in histology?
What type of hypersensitivity disease is it?

Answer 1

Celiac disease
Villous atrophy
Type IV

Question 2

What is HELLP syndrome?
How to diagnose?
What is the next step in management?
How do you treat hypertension and risk of seizure?

Answer 2

Severe form of preeclampsia.
Hemolysis
Elevated Liver enzymes
Low Platelets

Laboratory criteria must be met

Induction of labor

IV labetalol or hydralazine and IV magnesium

Question 3

How do you treat a patient with torsades de pointes?

Answer 3

IV magnesium

Question 4

If you increase the cutoff value of a test (4ng/dL to 10ng/dL) what will happen to its sensitivity, specificity, and positive predictive value?

Answer 4

Decreased sensitivity (increased # of false negatives) 
Increased specificity (decreased # of false positives)
PPV will increase

Question 5

Which acute tuberculosis antibiotic can cause blurred vision and change in color blindness?

Answer 5

Ethambutol

Question 6

A viral protein binds to the cellular RB protein. How does it cause oncogenesis?

Answer 6

By preventing RB from binding to E2F transcription factor. It remains inactivated.

RB regulates the G1 to S transition of the cell cycle.

Question 7

Cyclin D activates:

Cyclin E activates:

Answer 7

CDK4

CDK2

Question 8

How does p53 cause apoptosis?

Answer 8

Synthesis of p21, which prevents RB from being inactivated (phosphorylated). This prevents cell entrance to S phase.

Question 9

AL amyloidosis

Answer 9

Abnormal deposition of immunoglobulin light chains (kappa or lambda)

Congo-red will show apple-green birefringence

Question 10

40 y/o woman with history of fatigue, joint pain, and episodic pain in her hands.
In the cold her fingers get numb, white, and blue. Then they turn red and swollen and painful inside (Raynaud phenomenon).
History of GERD.
PE: skin tightening of her face and hands (sclerodactyly).
Positive antinuclear antibodies.
Most likely diagnosis?

Answer 10

Systemic sclerosis (scleroderma)

Question 11

CREST scleroderma

Answer 11

Calcinosis
Raynaud phenomenon
Esophageal dysmotility 
Sclerodactyly 
Telangiectasias

Question 12

Which second messenger activates protein kinase A?

Answer 12

cAMP (Gs receptor)

Question 13

What does diacylglycerol (DAG) activate?

Answer 13

Protein kinase C

Question 14

What does IP3 do?

Answer 14

Increase intracellular calcium.

Question 15

Fatigue, numbness of fingers and toes; conjunctival pallor, decreased sensation to vibration and light touch. Deep tendon reflexes are absent.
Hemoglobin: 10.3g/dL
Hematocrit: 30%
Leukocyte count: 4,000/mm3
MCV: 110um3 
Platelet count: 125,000/mm3
Hypersegmented neutrophils.

Answer 15

Vit. B12 (cyanocobalamin)

Question 16

Pellagra (niacin)

Answer 16

Dermatitis
Dementia
Diarrhea

Question 17

UV exposure to DNA show an increase of:

Answer 17

Pyrimidine dimers