Rx_Random Set #1

Question 2

What structure causes pathogenicty of gram - bacteria?

Answer 2

• structures @ outer membrane
  
  • endotoxin
    
    • activate compliment, coag cascade, macrophages
  • LPS capsule

Question 3

Name structures & fxns

Answer 3

• Gram negative bacteria structure
• A = outer membrane
  
  • endotoxin ==> pathogenecity
  • LPS
• B = periplasmic space
• C = inner cytoplasmic membrane
  
  • contains penicilin-beingin proteins
• D = porins ==> endocytosis ==> inflammation
• E = peptidoglycan (target of penicillins & cephalosporins)

Question 4

Major pathologic findings in Parkinson’s

Answer 4

• neurons w/round, haloed, eosinophillic inclusion bodies in the cytoplasm = “lewy bodies”
  
  • made of alpha-synuclein
• depigmentation & degeneration of substantia nigra

Question 5

Open angle vs. closed angle glaucoma

Question 6

Epinephrine use in glaucoma

Answer 6

• agonist @ alpha₁ receptor ==> mydriasis (pupilarry dilation)
• no effect on ciliary muscles
• decreases aqueous humor production ==>
• used to tx open-angle
• NOT used in closed-angle

Question 7

Diffuse breast pain, multiple bilateral masses @ upper outer quadrants of breast ==> Dx?

Answer 7

• fibrocystic disease

Question 8

Histologic changes in fibrocystic disease

Answer 8

• fibrosis
• cysts
• sclerosis
• epithelial hyperplasia

Question 9

TGF-beta role in inflammation

Answer 9

• dampens inflammatory response

Question 10

Interferon-gamma source/fxn

Answer 10

• source = T lymphocytes
• fxn = stimulate macrophages

Question 11

Complications of inguinal surgery

Answer 11

• male infertility in the future
• inguinal repair ==> accidental ligation of vas deferens or obstruction via scar tissue ==> impaired sperm transport

Question 12

MLF lesion consequences

Answer 12

• Paralysis of the SAME side medial rectus muscle during OPPOSITE side gaze
• e.g. R MLF lesion ==> paralysis of R medial rectus during leftward gaze (+ left nystagmus)

Question 13

Amiodarone toxicity sx

Answer 13

• hyperthyroidism
  
  • weight loss
  • hyperreflexia
  • chest palpitiations

Question 14

Common causes of disseminated intravascular coagulation

Answer 14

• gram-negative sepsis
• malignancy
• acute pancreatitis
• transfusion rxns
• obstetric complications

Question 15

Mechanism of disseminated intravascular coagulation

Answer 15

• massive activation of coagulation cascade ==>
• thrombus formartion throughout vasculature ==>
• rapid consumption of platelets and coag factors ==> easy bleeding and bruising

Question 16

Tx for carcinoid tumor

Answer 16

octreotide = somatostatin analog

Question 17

5-HIAA in urine ==> Dx?

Answer 17

• carcinoid tumor
• 5-HIAA = metabolic product of serotonin

Question 18

Complications of carcinoid tumors

Answer 18

• R-sided heart disease
  
  • tricuspid regurgitation
  • pulmonic stenosis
• wheezing
• recurrent diarrhea
• flushing

Question 19

Tricuspid regurgitation murmur

Answer 19

• holosystolic
• high-pitched
• radiate to right sternal border

Question 20

child/teen w/ recurrent pneumonia + bronchiectasis + low weight + intermittent diarrhea ==> Dx?

Answer 20

Cystic fibrosis

Question 21

Common cause of pneumonia in CF + tx

Answer 21

• pseudomonas
• tx = gentamicin

Question 22

Conversion disorder =

Answer 22

• mimics dysfxn of voluntary motor or sensory system
• presentation:
  
  • pseudo-seizure
  • blindness
  • deafness
  • paresthesias
  • paralyses

Question 23

Dxn of Vit K

Answer 23

• cofactor for gamme-carboxylation of glutamic acid residues on clotting factors

Question 24

Vit K-dependent clotting factors

Answer 24

• II
• VII
• IX
• X
• Protein C & Protein S

Question 25

Congenital adrenal hyperplasia ==> glucocorticoid & sex hormone deficits + HTN + hypokalemia

Answer 25

• 17a-hydroxylase deficiency
• deficient glucocorticoid & sex steroids + elevated mineralcorticoids (aldosterone)
• ==> lack of sexual development/ambigious genitalia

Question 26

Layers of adrenal cortex & products

Answer 26

• Salt, Sugar, Sex
• Salt = outer zona glomerulosa
  
  • product = aldosterone ==> sodium retention
• Sugar = zona fasciculata
  
  • product = cortisol ==> many fxns + insulin resist + gluconeogenic
• Sex = zona reticularis
  
  • product = androgens

Question 27

Dx? Child presenting with recurrent respiratory infections…

Answer 27

• Cystic Fibrosis
• Chromosome 7 defect ==> defective chloride channel

Question 28

Drug for treating underlying cause of respiratory infections in CF?

Answer 28

• N-acetylcysteine ==> loosens mucus plugs