Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

STEP 1 > STEP 1 Week 5 > Flashcards

STEP 1 Week 5 Flashcards

1
Q

Innervation above and below the dentate line

A

Above: Inferior hypogastric plexus

Below: Inferior rectal nerve, branch of pudendal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Leuprolide effect on GnRH

A

It is a GnRH agonsit but also exhibits inhibition of endogenous GnRH release

So eventual drop in GnRH, LH, and FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kind of receptors on macrophages leads to inflammatory resposne

A

Activation of toll-like receptors by PAMPS

Leads to increased NF-kB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most hemodynamically neutral anesthetic

A

Etomadiate - no effect on heart rate, BP, CO

Can decrease cortisol so not used in shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rifaximin MOA

A

It is a GI abx that reduces bacterial production of ammonia - good for hepatic encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Drug tx for bulimia

A

Fluoxetine - SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What CN is most impacted in uncal herniation

A

CN III - will have a blown pupil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Hawthorne effect vs Pygmalian effect

A

Hawthorne - observation. bias, change in behavior when you know youre. being watched

Pygmalian - researchers act differently based on beliefs in efficacy of treatment that can impact outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where do squamous cell carcinomas spread first

A

Regional lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Complications associated with sjogrens

A

Non-hodgkins lymphoma (B cell mediated so can become neoplastic)

Corneal damage, dental carries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Production of what 3 things required tetrahydrobiopterin (BH4)

A

Tyrosine, serotonin, DOPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can be seen on micro weeks to months after axonal damage

A

Persistent myelin debris with eventual glial scar (triggered by astrocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does ingestion of carbon tetrachloride cause (CCl4)

A

Produces free radicals (CCl3) that causes lipid peroxidation and hepatic injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens in the right heart during a pulmonary embolism

A

Increase in size of the RV cavity and flow obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What kind of reaction is serum sickness

A

Type III hypersensitivity - complexes and complement activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Metabolic changes in methymalaonic coa mutase deficiency

A

AGMA, hypoglycemia, ketosis, hyperammonemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Equation for a confidence interval of 95%

A

CI = mean +/- 1.96 x (SD/sqrt of n)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How to differentiate alcohol-related pancreatitis

A

Usually will have macrocytosis because of vitmain deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which hypertensive drugs can cause edema

A

Calcium channel blockers - preferentially dilate arteries which increases capillary pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Component of Hib capsule that makes it so virulent

A

polyribosylribitol phosphate (PRP)

Binds factor H which allows for avoidance of complement opsonization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What causes paraneoplastic cerebellar degeneration

A

Immune response against tumor cells that cross react with Purkinje neuron antigens - dizziness, disarhria, visual disturbance

Anti-yo, anti-hu, anti-p/q

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What cells mediate formation of lung abscesses

A

Neutrophils - released granules cause liquefactive necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is insulin excreted

A

Both in the liver and kidney

In CKD diabetic patients, exogenous insulin can rise without excretion and cause hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is epinephrine administered with lidocaine

A

Epinephrine leads to vasoconstrichtion which:

  1. Reduces bleeding
  2. Increases duration of action (more remains at site of action)
  3. Less chance of side effects bc lower systemic absorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Affinity of myoglobin for oxygen

A

Much higher than oxygen

Beta subunits of hemoglobin are similar in structure to myoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cherry vs strawberry hemangioma

A

Cherry - adult, benign tumor of blood vessels, dont regress

Strawberry - baby, can be deep, usually regress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the breakdown of the fluid compartments

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is capitation

A

The payment plan of HMOs

Doctors are payed a flat fee per patient from a providing organization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Effects of removing CD3+ cells from bone marrow transplant graft

A

Helps reduce the chance of graft-verus host but also dont get the benefit of donor T cells attacking any leukemia or current infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does the pressure volume look like for exercise

A

Preload increases and contractiltiy increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

APC and KRAS activating/inactivsting mutations

A

APC - inactivating, it is a tumor suppresor gene

KRAS - activating, it is a protooncogene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What vessels are likely to be ruptured in a penetrating ulcer to the lesser curvature of the stomach

A

Left and right gastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Examples of bisphosphonates and MOA

A

alendronate and risedronate

Attach to hydroxyappetite on the bone and when they are taken up by osteoclasts they induce apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How does hypocalcemia cause constipation

A

Causes impaired smooth muscle contraction and gastric motility by inhibiting nerve polarization - interferes with movement of sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What occurs during the proliferation phase of wound healing

A

Occurs 5 days-3 weeks

Fibroblasts migrate and proliferate, excrete ground substance and Type III collagen

Also secrete FGF and VEGF which leads to new vessek formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

TX for restless leg syndrome

A

Iron replacement and dopamine agonists - pramipexole and ropinirole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Where to perform a femoral nerve block

A

Right below the inguinal ligament, lateral to the femoral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Sx of allergic bronchopulmonary aspergillosis

A

High IgE and eosinophils

Asthma of CF, mucus plugs that can cause bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What diuretic can cause ototoxicity

A

Loop diuretics

There is a Na/K/2Cl symporter in the ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Best drugs to stop alcohol cravings and MOA

A

Naltrexone - blocks mu opioid receptors and pleasure reward centers

Acamprosate - modulates glutamate in the NMDA receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Drugs with the most benefit for heart failure

A

Beta blockers and hormone regulators (ACEi, ARBs, Aldosterone bockers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Impact of PEEP on FRC

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the only DNA molecule with 5’ to 3’ exonuclease capability

A

DNA polymerase I

All of them can do proofreaading and exonuclease 3’ to 5’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What two conditions can give you a small anion gap

A

Multiple myeloma and hypoalbuminemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Effect on diffusing capacity of carbon dioxide in emphysema and AAT deficiency

A

Decreases

Due to destruction of alveoli and cappilary beds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What blocks beta oxidation of fatty acids

A

Malonyl-coA

Inhibits carnitine acyltransferase so that newly synthesized FA arent immediately broken down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What kind of proteins are made in the RER

A

RER is especially developed in organs with lots of excretion

The RER makes proteins for extracellular excretion or for insertion into the membrane, along with proteins for the RER, GB, lysosome system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Where does calcium bind on thin filaments

A

On troponin

Then causes a conformation change to shift tropomyosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What would be punctured at the left midclavicular line 5th intercostal

A

Left lung

Apex of the heart is at this point but deep to the lung

All other heart chambers lie medial to the MCL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What makes up the wall of a false diverticulum

A

Mucosa and submucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q
A

Dupuyetron contracture

Fibroblasitic proliferation and thickening of palmar fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What causes pus and sputum to be green

A

Myeloperoxidase - it i a blue-green heme based pigment

It helps neutrophils to form hydrochoorous acid for oxidative burst killing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What causes most infections in neutropenic patients (like due to chemo)

A

Patient’s own endogenous bacterial flora

Chemo damages the barrier in the gut that usually keeps bacteria in the gut, so they can travel to the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What would work well against a g(-) rod with B lactamase activity

A

Extended spectrum penicillin (like piperacillin) with a tazobactam/clavulanic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Drugs to avoid in elderly

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What vessels should be ligated during uteral bleeding after birth

A

Internal iliac - where the uterine arteries. branch from

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What causes ptosis

A

CN III paulsy - controls the levator palpebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What microscopically indicates axonal damage due to shearing of the white matter tracts

A

Widespread axonal swelling, accumulation of axonal transported proteins - amyloid precursor and alpha synucelin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What causes thrombocytopenia in HIT

A

When heparin-platelet-IgG complexes (from reaction with PF4) circulate they are removed by the liver causing a decrease in platelet number

They can also form clots that then cause even more platelets to be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

How can squatting reduce the murmur of mitral regurg

A

Squatting increases venour return, which increases the stretch on the LV, which helps to pull the valve more taught

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Why is clear cell renal carcinoma clear

A

The cells have a high concentration of glycogen and lipid - removed on staining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What electrolyte imbalance does pancreatitis cause

A

Hypocalcemia and hypomagnesemia - necrotic fat oulls them out of the serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What would be the first step in diagnosing malabsorption (what test specifically)

A

Looking for fat in the stool - sudan III stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

How can hypothyroidism cause prolactin release

A

Lactotrophs have TRH receptors so an increase in TRH can lead to an increase in prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Path of CN V2

A

Passes through the foramen rotundum thenthe pterygopalantine fossa then exits the skull through the infraorbital foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Damage to what part of the brain causes locked in syndrome

A

Bilateral ventral pons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What causes ganglion cysts

A

Mucoid degeneration of periarticular tissue leading to outpouching of tissue that serves as one way valve for mucinous fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

How does prone position help in ARDS

A

Normally, the posterior parts of the lung are weighed down by the heart and abdominal organs pushing against the diaphragm

Prone position takes this pressure away allow for a more even ventialtion-perfusion match as collpased posterior basal alveoli open up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Eye side effects of PDE5 inhibitors

A

They can impact the PDE6 in the retina which can cause blue vision and nonarteritic anterior ischemic optic neuropathy - monocular vision loss with populary defect and optic disc edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What antitussive can cause serotonin syndrome

A

Dextromethorphan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

MOA of dextromethorphan

A

Inhibition of medullary cough center through sigma receptor activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Inhivition of what enzyme can help reduce risk of colon cancer

A

COX-2 - NSAIDS

COX may play a role in prostogulandin production which aids in epithelial proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What causes basophilic stippling

A

Lead poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Cortisol and ADH relationship

A

Cortisol usually inhibits ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

How does a carotid massage slow heart rate

A

Increases parasympathetic tone - prolonged AV/SA node refractory period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Flow of aqueous humor through the eye

A

Produced by the epithelial cells of the ciliary body and then flow through the pupil into the anterior eye chamber

Drained by the trabelcular network into the canal of schlemm and into conjunctival veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

MOA of timolol

A

Nonselective B blocker that lowers production of aqueous humor by the ciliary body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What finger movements does the median nerve control

A

Thumb abduction, thumb opposition, thumb flexion

Thumb adduction is ulnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What are the contents of the portal triad

A

Hepatic artery, portal vein, common bile duct

If bleeding continue from liver after clamping, likely hepatic vein or IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What layers do you go through in a cricothyrotomy

A
  1. Skin
  2. Superficial cervical fascia (fat, part of platysma)
  3. Deep cervical fascia
  4. Crycothyroid membrane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Sx of chediak higashi

A
  • Immunodeficiency from neutrophil phagosome-lysosome fusion dysfunction. Granules cant be released so see them in neutrophils
  • Albinism
  • Eye problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

How does ACTH/cortisol impact production of catecholamines

A

Cortisol activates phenyethaolamine-N-methyltransferase (PNMT) which converts norepinephrine into epinephrine

Pituitary damage/low cortisol would reduce activity of PNMT and reduce epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What drives LV remodeling after an MI

A

Angiotensin II

Acei can help stop remodeling and maintain a normal LV shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What would mycobacterium avium complex look like on histo

A

Would look at bone marrow - Foamy macrophages, acid fast bacilli, possibly granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What causes the vasovagal response (like after a vaccine)

A

Cardioinhibition and vasodepressor response that causes bradychardia and hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Where is the damage in wernicke korsakov

A

Anterior and dorsomedial thalamic nuclei, mammilary bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Sequelae of etherothrombotic disease

A

Would see cholsterol clefts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Most common childhood brain tumor and location

A

Pilocytic astrocytoma - cerebellum

89
Q

What coenzymes are necessary for alphaketoglutarate/pyruvate/branched chain dehydrogenase

A

B1,B2,B3, B5, lipoate

90
Q

Location of lesion for decerebrate vs decordiate posturing

A

Decorticate (flexor) - above red nucleus (hemisphere, internal capsule)

Decerebrate (extensor) - below red nucleus (pons)

91
Q

How does the Huntington mutation cause disease

A

Gain of function mutation that causes acetylation of histones that turn off genes necessary for cell survival

92
Q

What is the only molecule with a gradient that draws it out of the cell

A

POtassium

93
Q

Function of ristocetin

A

Activates Gp 1b to induce vWF to bind to the endothelial surface and cause aggregation of platelets

94
Q

Where is inflammation localized in guillan barre

A

In the endoneurium - macrophages digest myelin

95
Q

Damage to what part of the brain could cause hemiballism (uncontrolled movement)

A

Subthalamic nuclei

96
Q

What would levels of CO2 and O2 be in PE/poor V/Q match

A

There would be low CO2 from hyperventilation but O2 wouldnt be high because hemoglobin in the perfused area can only absorb so much O2- cant comoensate for unperfused part

So low CO2 and low O2

97
Q

How are lysosomal storage deficiencies treated

A

You can replace the deficient enzyme

Have to use IV because the enzymes are large polyproteins - enter the cell by endocytosis

98
Q

Morphine and renal failure

A

Morphine is metabolized into two active metabolites that are renally excreted

In renal failure, these metabolites can cause OD

99
Q

Odds ratio formula

A

OR = (a/c)/(B/d)

100
Q

MAB that targets CD20+ cells

A

Rituximab

101
Q

What could cause a pure red cell anemia

A

Autoimmune destruction of red cell rpecursors - thymoma or parvovirus

102
Q

Best diagnostic tool for toxic megacolon (bloody diarrhea, abdominal pain, shock, fever)

A

Plain abdominal X-ray

103
Q

What to give post MI in the case of bradycardia

A

Atropine - anticholinergic effects

104
Q

Where to biopsy for celiac

A

Duodenum and PROXIMAL jejunum

105
Q

What is persistent depressive disorder (dysthymia)

A

depressed mood for 2 years with >2 sx

106
Q

What happens to the vena cava in cardiac tamponade

A

Becomes engorged because of restricted diastolic filling

107
Q

Complement vs phagocyte?

A

D - complement

E - phagocyte

108
Q

What cells are targeted by azithioprine

A

It is not specific - B and T cells, so drop in IL-2 and Ig

109
Q

How to diferenciate bw demyelinating and axonal nerve damage

A

Demyelinating - delayed conduction

Axonal damage - lower amplitude of impulse

110
Q

What is abiraterone

A

It is a 17-alpha-hydroxylase inhibitor used for refractory prostate cancer - stops the production of androgens in the adrenals

111
Q

What are angiosarcoma and expsure risks

A

A vascular tumor that is highly aggresses - expresses CD31 (PECAM 1)

Risks: PVC, arsenic, thorotrast (contrast medium)

112
Q

What are causes of dilated cardiomyopathy

A

Infection (chagas, viral), chemical (alcohol), familial (mutation in titin gene)

113
Q

Most common lung cancer cause of SIADH

A

Small cell lung cancer

114
Q

What is rasburicase

A

It is an analog of an enzyme called urate oxidase that turns uric acid into allantoin, a more soluble metabolits

Good for tumor lysis syndrome

115
Q

IMpact of an arteriovenous fistula on SVR, SV, etc

A

Decreased SVR - less pressure

Increased venous return - higher preload

Higher SV

116
Q

Where is preload on a AV curve

A

It is the volume during isovolumic contraction

117
Q

What causes bleeding in diverticulosis

A

Disruption to the vasa recta - diverticuli often occur where the vasa recta penetrate the smooth msucle and then the vessels can become damaged

118
Q

What kind of virus has infectious RNA - the RNA itself can cause infection

A

+SS RNA - must be able to use the host machinery without any other proteins being produced

EX: rhinovirus

119
Q

What would be present within an unstable plaque

A

Many macrophages that release metaloproteases that degrade the collagen of the cap and lead to possible rupture

120
Q

What is pralidoxime

A

Reactivates cholinesterase - would be used after atropine in an organophosphate poisoning to reverse neuromuscular sx (atropine doesnt work in muscle)

121
Q

Innervation of pelvic floor muscle and external anal/urethral sphincters

A

Pudendal nerve

Can lose anal wink reflex bcause skin from S2-S4 is no longer innervates

122
Q

What causes a change in skin color in chronic venous insufficiency

A

Statis dermatitis - deposits of hemosiderin after RBC. have gone into the extracellular space

123
Q

How to tell if a frameshift mutation has occured

A

The number of bases that has changed will not be divisible by 3

124
Q

What is Kallman syndrome

A

Presents as delayed puberty due to a failure of GnRH secreting neurons to migrate to the hypiothalamus from the olfactory placode - also presents as anosmia

125
Q

When is prinzmetal angina worse

A

At night - when vagal tone is highest

126
Q

How to treat ingestion of rat poison

A

Rat poison contains “super warfarin” so would give FFP

127
Q

What is it called when there is only one safe medical option

A

Directive counseling

128
Q

What is stained by PAS

A

Polysaccharides (fungal), mucosubstances, glycoprotein (whipples)

129
Q

What happens to pulm artery systolic pressure in left MI

A

Increases due to increased PCWP and LA pressure

130
Q

What causes achalasia

A

Reduced number of inhibitory neurons in the esophagus so there is an imbalance favoring contraction - decreased peristalsis in upper esophagus and increased contraction in lower

131
Q

Blood supply of papillary muscles

A

Anterolateral pappilary - LAD and left circumflex

Posteromedial - Posterior descending (just one supply so more easily ruptured)

132
Q

What allows influenza A to enter a cell

A

The surface glycoprotein - hemagglutinin

133
Q

What is the diagnostic tests for TTP

A

Peripheral blood smear that shows thrombocytopenia and hemolysis

Some have fever, neurologic sx, kidney disease

134
Q

What causes weak bones in osteogenesis imperfecta

A

Deficient type 1 collagen leads to less osteoid production by osteoblasts

135
Q

What causes spinal stenosis and sx

A

Usually caused by degenerative arthritis where the intervertebral disk starts to bulge into the spnal canal, leads to a change in pressure and thickening of ligamentum flavum

Neurogenic claudication - parasthesias, pain walking, weakness, worse with extension

136
Q

First line TX for OCD

A

SSRIs

137
Q

How do glucorticoids lead to weaker bones

A
  1. Inhibit osteoblasts
  2. Block osteoprotegrin and increase expression of RANK/RANK-L
  3. Block intestinal absorption of Ca
138
Q

How can large stable plaques allow for no symptoms

A

They are slow growing and the gradual shift to ischemia allows for time for collateral vessels to form

139
Q

What causes petechial rash and CNS sx in fat embolism

A

Small arteriovenous shunts allow for fat to flow into the CNS and skin

140
Q

Salivary changes in elderly

A

Acinar atrophy with fatty infiltration - reduced saliva production

141
Q

What eye problem can occur in neonatal CMV

A

Chorioretinitis

142
Q

What causes a zenker diverticulum

A

Cricopharyngeal motor. dysfunction - abnormal spasm or diminished relaxation that leads to increased pressure and creation of a false diverticulum

143
Q

Clonidine MOA

A

Alpha 2 agonist in the rostral ventrolateral medulla that leads to decreased presynaptic release of norepinephrine - slower HR and vasodilation

144
Q

Histo of medullary thyroid carcinoma

A

Polygonal cells in an amyloid stroma - stains with congo red

145
Q

Glioblastoma multiforme histo

A

Increased vascularity with pseudopalisading tumor cells around areas of necrosis

146
Q

Signs of a pure motor stroke

A

Clasp-knife rigidity, hyperreflexia, positive babinski

Would be in the internal capsule

147
Q

MOA of sirolimus

A

Binds to FKBP which inhibits the mTOR cellular pathway to stop the transcription cascade started by IL-2

148
Q

What causes billirubin stones

A

Occurs when a large amount of unconjugated billirubin is released into the billiary system

Usually secondary to an infection - damaged hepatocytes release beta glucaronidase that hydrolizes billirubin and leads to an accumulation of unconjugated billirubin

149
Q

What neurotransmitters are used in each type of SNS and PNS tracts

A

Notable : SNS uses Ach in adrenals and eccrine sweat glands

150
Q

Where are T cells and B cells located in the lymph node

A

T - paracrotex

B - germinal centers and medullary cords

151
Q

What is given in a heparin OD

A

Protamine sulfate - binds to heparin and forms a complex with no anticoagulant effect

152
Q

What defines a mild cognitive impairment

A

Abnormal cognitive assesment (<26/30) but still functioning independently

153
Q

Effects. of androgen deprivation in men

A
154
Q

Aneurysmal compression of CN III vs diabetic opthalmoplegia

A

In compression, there is primarily mydriasis - SNS fibers are on periphery, and then can become down and out

In diabetic ischemia, the core of the nerve is impacted first, where the motor fibers are. This causes down and out first with preservation of pupillary reflexes

155
Q

What can cause hypocalcemia after a transfussion

A

There is citrate in the blood to stop coagulation but it can bind to calcium and chelate causing hypocalcemia

156
Q

What occurs in germinal centers

A

B cells undergo isotype switching or remain as memory cells, also undergo affinity maturation (hypermutation for best Ig fit)

157
Q

What levels would be low in SLE

A

Low C3 and C4 because circulating immune complexes would cause complement activation

158
Q

What disease has anti-mitochondrial antibodies

A

PBC

159
Q

What is. the acid-base disturbane in pregnancy

A

There is chronic hyperventilation - progesterone triggers a feeling of being short of breathe and there is horme related laxity of. the chest wall leading to a higher TV

This leads to a respiratory alkalosis with a renal compensation of increased bicarb excretion

160
Q

Neck finding in Turner syndrome

A

Cystic hygroma - posterior neck mass composed of cystic. spaces and connective tissue

Due to lympphedema

161
Q

Is eisenmenger syndrome reversible?

A

No - pulmonary artery remodelling to become thicker is irreversible

162
Q

What muscles are innervated by the accessory nerve CN XI

A

Trapezius and sternocleidomastoid

Can be damaged in lymph node surgery

163
Q

What would be seen in brain injury caused by seizures

A

Reactive gliosis - proliferation of astrocytes

164
Q

What hemolytic disease is diagnosed by testing for increased osmotic fragility

A

Hereditary spherocytosis - mutation in ankyrin and spectrin leads to increased fragiloity (hemoglobin will leak out in a hypoosmptic solution)

165
Q

What are the sx of an anterior humerus dislocation

A

Flattening of the deltoid muscle, protrusion of the acromium, anterior axillary fullness

Decreased sensation of the upper arm - axillary nerve is compressed

166
Q

What would hashimotos look like on histo

A

Lymphoplasmacytic inflitrate with formation of germinal centers

Hurthle cells - granular and eiosinophilic cytoplasm

167
Q

What type of amyloid is deposited in dialysis patients

A

B2 - microglobulin - Component of MHC I that is usually filtered out of kidney

168
Q

Characteristics of Hyper IgE syndrome

A

Deficiency in Th17 cells due to STAT3 mutation - impaired neutrophil migration

ABCDEF

Abscesses, Baby teeth, Coarse facies, Derm problems (eczema), IgE, Fractures from minor trauma

169
Q

What is the goal of randomization

A

To make the underlying characteristics between groups the same - not necessarily to be the same size

170
Q

What causes hypocalciuric hypercalcemia

A

Calcium sensing receptors (CaSRs) in the parasthyroid (G-protein membrane) are not evry sensitive and require a higher level of calcium to release PTH

171
Q

Bones of the Hand

A

Some Lovers try positions that they cant hzndle

172
Q

How does resistance to isoniazid occur

A

Decreased expression of mycobacterial catalase peroxidase - needed to activate INH

173
Q

Which speech area causes word salad

A

Wernicke’s area - Wernicke word salad

174
Q

What kind of necrosis happens in the brain and what does it look like

A

Liquefactive - Hydrolytic enzyme induced tissue digestion. CSF filled spaces after digestion

175
Q

Signs and tx of arsenic poisoning

A

Basically affects all organs - long qt, vomiting, garlic breath

TX: Dimercaprol (chelates and pee out in urine)

176
Q

MOA of Beta blockers for graves

A

Blocks the upregulated beta receptors and also stops conversion of T4 to T3

177
Q

What is transferance

A

Unconscious shifting of desires or emotions from a person in the past to a person in the present

178
Q

What is the HIV window period

A

When there is high levels of viral RNA but there has not been an immune response yet - no Ig

179
Q

What anticonvulsant to give IV in status epilepticus and MOA

A

Phenytoin - Na channel blocker

180
Q

What can be given for variceal hemorrhage

A

Somatostain/ocreotide or vasopression - contrict portal vessels by stopping release of hormones that usually cause dilation

181
Q

What causes mitral dysfunction in marfans

A

WIthout fibrillin-1, TGF-beta can work unopposed and causes increased metalloproteases that reduce tissue integrity - fragmentation of elastin and collagen leading to myxomatous mitral degeneration

182
Q

What causes anemia in chronic kidney disease

A

Decrease in EPO

183
Q

What would cause portal hyopertension sx (big spleen, varices) with no liver involvement

A

Portal vein thrombosis

184
Q

How is PKU inherited

A

Autosomal recessive

185
Q

What are the molecules needed for osteoclast differentiation

A

M-CSF and RANK-L

186
Q

What cofactor is needed for the conversion of phenylalanine to tyrosine

A

Dihydrobiopterin reductase (recycles BH4)

187
Q

What is the psoas sign

A

Pain/resistance of leg extension - causes stretching of the muscle

188
Q

What can lead to death in rheumatic fever

A

Severe regurgitation or myocarditis/pancarditis

189
Q

Cytokines that cause systemic inflammation in sepsis

A

TNF-a, IL-1, IL-6

190
Q

What causes minieres disease and sx

A

Vertigo, nausea, sensorineural hearing loss

Caused by increased pressure of endolymph in the inner ear

191
Q

What happens if VEGF is unchecked in wound healing

A

Hypergranulation with lots of vasculation

192
Q

What is the most serious side effect of thyroid blocking drugs

A

Agranulocytosis - can present as a severe infection

193
Q

What muscle is pierced by the superficial inguinal ring

A

External oblique

Cremaster muscle originates from internal oblique

194
Q

Most common illnesses seen in Hib

A

Systemic - meningitis, bacteremia, pneumonia, epiglotitis

195
Q

Why does GFR increase early in diabetes

A

Higher glucose in urine leads to more reabsorption of Na in the PT (SGLT) which leads to less in the DCT - activates JG cells and RAAS system

196
Q

What causes myopia

A

Nearsightedness

increased posterior-anterior diameter of the eye - image is focused anterior to the retina

197
Q

What causes hypercalcemia in sarcoidosis

A

Activated macrophages in the lung that produce 1-alpha hydroxylase which makes more activated vitamin D - hugher intestinal absorption, some bone turnover

198
Q

Initial tests for diabetes

A

Fasting plasma glucose > 126

HBA1C > 6.5%

Random nonfasting glucose > 200

Urinalysis may show glucose but it is not specific

199
Q

Where are serotonergic neruons primarily found

A

Raphe nucleus of the brainstem - cell bodies throughout CNS

200
Q

What bleeding disorder is seen in renal dysfunction

A

Uremic platelet dysfunction

Uremic toxins that arent filtered out of the kidney circulate and cause platelet dysfunction - prolonged bleeding time but normal PT, PTT, platelet count

201
Q

MOA of entanercept

A

It is a biologic made uo of an Fc portion and a fake TNF-a receptor

Serves as a soluble receptor decoy protein as TNF-a binds to it instead of its real receptor

202
Q

meaning of -mab, -cept, -nib

A
  • mab = monoclonal antibody
  • cept = receptor molecule
  • nib = kinase inhibitor
203
Q

How do mabs lead to tumor destruction

A

Antibody dependent cellular cytotoxicity

The mabs/IgG bind to the host or foreign cell. NK cells bind to the Fc portion (with CD16) and then release granzymes that kill the cell

204
Q

What measure of comparison is used for case-controls

A

Odds ratio

205
Q

Innervation of the auditory canal

A

Posterior - vagus

Rest - CN V3

206
Q

Acid disturbance seen in chronic kidney disease

A

Metabolic acidosis (accumulation of uric acid) with respiratory compensation

207
Q

What is associated with itching, fatigue, and ulcerative cholitis?

A

Primary Sclerosing Cholangitis

208
Q

Cardinal sign of irreversible cellular injury

A

Membrane damage - plasma membrane, mitochondria (vacuoles and leaking of cyt c), lysosomes

209
Q

Associations with ADPKD

A

Berry aneurysms, liver cysts, mitral valve prolapse

Hypertension, hematuria

210
Q

Where is the bladder most likely to be damaged

A

Dome - less supported and extends into peritoneal cavaity - would get urine in peritoneum

211
Q

Hormone changes after ball removal

A

testosterone levels out but still low sperm count because cant compensate

212
Q

What is late stage radiation dermatitis

A

Fibrosis and homogenization of collagen (TGF-B), vascular damage, dilated microvasculature (telangectasia)

213
Q

How can beta blockers impact hypoglycemia

A

Beta blockers can remove the signals of hypoglycemia so individuals dont realize - blocks NE/Epi which are the drivers of tachicardia and anxiety in low glucose

Epinephrine also stimulates peripheral glycogenolysis and hepatic gluconeogeneiss so none with B blockers

214
Q

What is celecoxib

A

A selective COX-2 inhibitor that is good for inflammation without impacting GI

215
Q

What breast cancer marker is indicative of aggressive cancer

A

HER2

216
Q

Other than histamine what is released from mast cells in anaphylaxis

A

Tryptans

217
Q

How does binding of IgE lead to degranulation

A

Binding of IgE to a multivalent antigen leads to a shifting of IgE receptors so that they come into closer proximity and all bind the antigen

Triggers a non-receptor tyrosine kinase that triggers degranulation

218
Q

Pre-eclampsia is caused by …

A

Abnormal cytotrophoblast invasion that leads to low perfusion and low proangiogenic chemicals so dont get vessel remodeling by VEGF - high resistance vessels

219
Q
A

STEP 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions