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STEP Misc. Flashcards

1
Q

Pathology of hemolytic Uremic Syndrome

A

Infection with enterohemorrhagic Escherichia coli and Shigella dysenteriae from a production of shiga like toxin and shiga toxin respectively

symptoms: microangiopathic hemolytic anemia (fatigue, jaundice, dark urine), thrombocytopenia, renal dysfunction

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2
Q

language development at 12months

A

says first words, points to objects, uses several gestures with vocalizing, recognizes names of two objects, looks at them when named

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3
Q

language development at 15 months

A

uses three to five words

points to one body part

mature jargoning

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4
Q

language development at 18 months

A

uses 10-25 words

points to self

imitates environmental sounds

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5
Q

language development at 24 months

A

50+ words, 50% intelligibility, uses 2 word sentences, follows two step commands

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6
Q

language development at 36 months

A

uses 200+ words, 3 word sentences, 75% intelligibility, uses pronouns correctly

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7
Q

language disorders

A

deficiency in understand and producing language

can result in frustration

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8
Q

4 year old child milestones

A

walks down stairs with alternating feet, catches a ball, balances on one foot

draws square, ties a knot, cuts with scissors

able to tell sories

imaginative play/group play

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9
Q

language disorders

A

deficiency in understand and producing language

can result in frustration

**obtain a audiology evaluation for any child with a deficient language development

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10
Q

etiology of Paget disease of breast

A

ductal carcinoma insitu has malignant cells that migrate into the lactiferous sinuses and nipple skin

accumulation of malignant cells disrupts the normal epithelial barrier

(resembles eczema- erythema and scaling crust around nipple)

  • large cells with clear cytoplasm confined to the epidermis
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11
Q

MOA of local anesthetics

A

inhibit sodium channels and is most effective in rapidly firing neurons

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11
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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12
Q

side effect of bupivicaine

A

cardio toxicity

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12
Q

order or sensory loss from a local anesthetics

A

pain, temperature, touch, pressure

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13
Q

side effect of bupivicaine

A

cardio toxicity

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13
Q

order or sensory loss from a local anesthetics

A

pain, temperature, touch, pressure

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14
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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15
Q

side effect of benzocaine

A

methemoglobinemia

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16
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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16
Q

signs of riboflavin (vitamin B2) deficiency

A

angular chelitis, stomatitis, glossitis, rash, normocytic anemia

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17
Q

signs of niacin deficiency

A

diarrhea, dermatitis, dementia, neurological disturbances

-rash on sun exposed areas

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18
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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18
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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18
Q

signs of niacin deficiency

A

diarrhea, dermatitis, dementia, neurological disturbances

-rash on sun exposed areas

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19
Q

signs of folate deficiency

A

microcytic megalobalastic anemia with increase homocysteine levels with hyperhsegmented neutrophils

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19
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

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20
Q

signs of vitamin C deficiency

A

easy bruising petechiae, bleeding gums, anemia, coiled hair

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21
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

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21
Q

diffuse esophageal spasms and treatment

A

uncontrolled/uncoordiated contractions of the esophagus with a normal cardiac workup (can present with chest pain and dysphagia or solids and liquids)

calcium channel blockers ( reduce smooth muscle contractility by blocking voltage dependent L-type calcium channels)

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22
Q

pericarditis on ECG

A

diffuse ST segment elevation with reciprocal PR segment depression

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23
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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23
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

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23
Q

pericarditis on ECG

A

diffuse ST segment elevation with reciprocal PR segment depression

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24
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

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24
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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25
Q

signs of benzodiazepine overdose and treatment

A

ataxia, AMS, lethargy, slight respiratory depression

treatment: flumazenil ( inhibits alcohol dehydrogenase)

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26
Q

cocaine overdose signs and treatment

A

tachycardia, hypertension, pupillary dilation, agitation, hallucinations

treatment: bentos, Mixed a/b receptors blocker

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27
Q

opioid overdose signs and treatment

A

AMS, pupillary constriction, lethargy, respiratory depression and respiratory acidosis, constipation

treatment: naloxone

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28
Q

features of fragile X syndrome

A

prominent forehead, intellectual disability, large everted ears, long narrow face, MVP

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29
Q

pathogenesis of fragile X syndrome

A

X-linked dominant trinucleotide repeats of the CGG in the FMR1 gene that causes HYPERMETHYLATION and decreased gene expression

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30
Q

how does MVP sound

A

late systolic crescendo murmur with a mid systolic click

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31
Q

Down syndrome cardiac complication

A

endocardial cushion defect (ASD)

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32
Q

Duchenne muscular dystrophy defect

A

dilated cardiomyopathy

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33
Q

Friedrich ataxia cardiac complication

A

hypertrophic cardiomyopathy

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34
Q

homocystineura cardiac complication

A

increased risk of myocardial infarction and stroke

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35
Q

marfan syndrome cardiac complication

A

aortic dissection, aortic aneurysm, aortic regurgitation, MVP

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36
Q

pomp disease cardiac complications

A

cardiomegaly, hypertrophic cardiomyopathy

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37
Q

digeorge syndrome cardiac complication

A

conotruncal abnormalities (ToF, truncus arteriosis)

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38
Q

runer syndrome cardiac complications

A

bicuspid aortic valve, coarctation of the aorta

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39
Q

williams syndrome cardiac complications

A

supravalvular aortic stenosis

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40
Q

ASD

A

wide flexed splitting of A2

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41
Q

cardiac complications in alcohol exposure in utero

A

ASD, PDA, ToF, VSD

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42
Q

congenital rubella cardiac complications

A

PDA, pulmonary artery stenosis

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43
Q

cardiac complications from poorly controlled maternal diabetes

A

transposition of the great vessels, VSD

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44
Q

lithium exposure cardiac complications

A

ebstein anomaly ( enlarged atria)

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45
Q

hypertrophic cardiomyopathy murmur intensity

A

increases with reduced preload and decreases with increased preload

  • increased preload will precent the approximation of the IV septum and the mortal calve during systole
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46
Q

squatting

A

increases preload

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47
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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47
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

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47
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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47
Q

hand grip

A

increases afterload

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47
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

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48
Q

familial adenomatous polyposis

A

AD loss of function mutation in APC suppressor gene on chromosome 5

polyps after puberty and 100% of ppl will develop colorectal cancer

can also have Desmond tumors, brain tumors, and osteomas

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49
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

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49
Q

KRAS mutations are implicated in

A

spontaneous colorectal adenomas that give unregulated intracellular signaling

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50
Q

explain the spontaneous colorectal progression for colorectal adenomas

A

loss of APC gene leads to decreased interceulalr adhesion and increased proliferation

KRAS mutation leads to unregulated intracellular signaling

loss of TP53 leads to tumor formation

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50
Q

juvenilie polyposis syndrome is caused by

A

autosomal dominant mutations in SMAD

have hermartosous polyps before the age of 5

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51
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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51
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

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51
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

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51
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

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51
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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52
Q

juvenilie polyposis syndrome is caused by

A

autosomal dominant mutations in SMAD

have hermartosous polyps before the age of 5

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52
Q

explain the spontaneous colorectal progression for colorectal adenomas

A

loss of APC gene leads to decreased interceulalr adhesion and increased proliferation

KRAS mutation leads to unregulated intracellular signaling

loss of TP53 leads to tumor formation

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53
Q

peutz-jeghers syndrome

A

AD mutation in STK11

-hyperpigmentaed macules on the mouth, lips, hands, and genitalia with an increased risk of breast and gi cancers.

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54
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

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54
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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55
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

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55
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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56
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

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57
Q

class II antiarrythmics MOA

A

amiodarone, dofetilide, and sotalol

they block potassium channels which inhibits outward depolarizing currents during phase 3 prolonging ventricular repolarization

more common in dofetilide and sotalol

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57
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

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58
Q

prolonged ventricular depolarization on ECG

A

wide QRS –> torasdes

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59
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

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59
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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59
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

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59
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

How well did you know this?
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2
3
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5
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59
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

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60
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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61
Q

pathogenesis of squamous cell carcinoma

A

loss of TP53 tumor suppressor gene

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61
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

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62
Q

pathogenesis of melanoma

A

activating mutation in BRAF

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63
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

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63
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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63
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

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64
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

How well did you know this?
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2
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64
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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65
Q

precursor ot melanoma

A

dysplastic nevus or lentigo maligna

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65
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

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1
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2
3
4
5
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66
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

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66
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

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67
Q

nevus histology

A

rete rige bridging, shouldering, and lamellar fibrosis

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68
Q

lentigo maligna histology

A

blue black stained skin with malignant melanocytes that grow along the stratum basalt without invasion below the epidermis

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69
Q

pathogenesis of basal cell carcinoma

A

loss of function in the PTCH1 tumor suppresor gene which activated sonic hedgehog signaling pathway

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70
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

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70
Q

pathogenesis of basal cell carcinoma

A

loss of function in the PTCH1 tumor suppresor gene which activated sonic hedgehog signaling pathway

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70
Q
A
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70
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

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70
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

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70
Q

pathogenesis of psoriasis

A

mutation of the major histocompatibility complex receptor subtype

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70
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

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

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

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70
Q

cocaine overdose signs and treatment

A

tachycardia, hypertension, pupillary dilation, agitation, hallucinations

treatment: bentos, Mixed a/b receptors blocker

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71
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

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71
Q

signs of benzodiazepine overdose and treatment

A

ataxia, AMS, lethargy, slight respiratory depression

treatment: flumazenil ( inhibits alcohol dehydrogenase)

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71
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

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71
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

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72
Q

many round cells with multiple mitoses with clear cytoplasmic vacuoles scalloping the nucleus

A

liposarcomas

(most common soft tissue sarcoma)

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73
Q

fibroblast based malignancy that is characterized by anapestic spindle cells that may grow in an organized herringbone or a disorganized cellular fashion

A

fibrosarcoma

73
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

74
Q

benign skeletal muscle tumors with fascicles of polygonal cells with a vacuolated cytoplasm and a peripherally placed nucleus

A

rhabdomyomas

74
Q

mobile subcutaneous nodules that are composed of mature fat cells without pleomorphism

A

lipoma

75
Q

painful bull and erosions with oral involvement and extension of lesions with direct pressure

A

pemphigus vulgaris

76
Q

immunofluresence of pemphigus vulgaris will show

A

IgG and C3 deposits in a net like or chicken wire pattern along the epidermis

76
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

77
Q

bullous pemphigoid

A

IgG and C3 deposits along the basement membrane (tense bullae-hemidesmosome)

77
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

77
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

77
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

77
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

77
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

77
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

77
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

77
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

78
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

78
Q

bullous pemphigoid

A

IgG and C3 deposits along the basement membrane (tense bullae-hemidesmosome)

78
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

79
Q

immunoflouresence around dermal blood vessels

A

porphyria cutaena tarda or henoch schonlein purpura

80
Q

granular deposition of IgA in the upper papillary dermis

A

dermatitis herpatiformis (itchy vesicles on the elbows, knees and butt)

81
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

81
Q

sympathetic innervation to the eye

A

stellate ganglion and sympathetic chain - at the apex of the lung

82
Q

ciliary ganglion

A

carried by the oculomotor nerves and regulates parasympathetic input to the iris and lens

82
Q

otic ganglion

A

parasympathetic innervation to the parotid gland

near the mandibular nerve

83
Q

alcohol related cerebellar degeneration

A

cerebellar degeneration to the purkinje cells in the cerebellar vermis from long time alcohol use that leads to

wide based gait ataxia, postural tremor of the hands, truncal instability, blurred vision, falls

84
Q

Hypertrophic Cardiomyopathy has angina because

A

increased muscle mass increases the O2 demand

there is microvascular dysfunction that decreases O2 supply (poorly developed myocardial capillary networks)

EPICARDIAL CORONARY ARTERIES ARE NORMAL

84
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

85
Q

DNA gyrase

A

aka type II topoisomerase

removes supercoils

86
Q

helicase

A

unwind double helix

86
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

86
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

86
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

86
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

86
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

86
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

86
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

87
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

87
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

87
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

87
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

87
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

88
Q

helicase

A

unwind double helix

89
Q

single stranded DNA binding protein

A

stabilization of unwound template strands

90
Q

primase

A

aka RNA polymerase

synthesizes RNA primer

90
Q

DNA polymerase III

A

DNA synthesis (5–>3’ polymerase)

proofreading (3’–>5’ exonuclease acitvity)

91
Q

DNA polymerase I

A

removes RNA primer (5’–>3’ exonuclease) and replaces with DNA

92
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

93
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

93
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

93
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

93
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

93
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

93
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

93
Q

primase

A

aka RNA polymerase

synthesizes RNA primer

93
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

93
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

94
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

94
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

94
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

95
Q

DNA ligase

A

joins Okazaki fragment on lagging strand

96
Q

DNA polymerase I

A

removes RNA primer (5’–>3’ exonuclease) and replaces with DNA

prokaryotic polymerase

97
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

97
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

97
Q

primase

A

aka RNA polymerase

synthesizes RNA primer

98
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

98
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

98
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

98
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

98
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

98
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

98
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

98
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

98
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

98
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

99
Q

ovarian cancer marker

A

CA-125

ascites and ovarian mass

100
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

100
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

100
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

100
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

101
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

101
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

101
Q

primase

A

aka RNA polymerase

synthesizes RNA primer

102
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

102
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

102
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

102
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

102
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

102
Q

caclinurein inhibitors

A

immunossupressive agents that inhibit calcinurien

cyclosporine and tacrolimus

102
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

103
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

103
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

103
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

104
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

104
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

104
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

104
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

104
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

104
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

104
Q

primase

A

aka RNA polymerase

synthesizes RNA primer

104
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

104
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

104
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

105
Q

adverse effects of calcineurin inhibitors

A

dose dependent rise in BUN and creatinine levels and obliterative vasculopathy or the efferent and afferent arteries

106
Q

mammalian target of rapamycin inhibitors

A

sirolimus

107
Q

inhibitors of de novo purine synthesis

A

azathioprine or mycophenolate mofetil

they inhibit purine synthesis and act as an immunosuppressant agent

108
Q

azathioprine side effects

A

N/V

109
Q

adverse of prednisone

A

avascular necrosis of the femoral head, osteoporosis, hyperglycemia, and physiatrics disturbances.

110
Q

abdominal pain with fecal vomiting (brown fluid from the nasogastric tube) is indicative of

A

small bowel obstruction

111
Q

metaclopromide can be used to treat small bowl obstruction but is contraindicated in who

A

people with Parkinson’s disease

(it is a dopamine antagonist so it would exacerbate Parkinson’s issues)

112
Q

alkaptonuria

A

autosomal recessive defect in homogentisic acid deoxygenate which leads to impaired tyrosine metabolism

causes urine to become black with oxidized

can lead to ochronocosis (blue-black pigmentation of the eyes, ears, and nose) or ochronotic osteoarthropthy ( which is pigment deposition in the bones with pain)

113
Q

incursions in parkinsons disease

A

alpha synuclein filaments in the cytoplasm

(loss of dopamine in the substantial nigra)

resistance to flexion/extension, resting tremor

114
Q

tissue ischemia causes what cells to be intracellular and what cells to be extracellular

A

intracellular: Na+, Ca+, HCO3

extracellular: K+

sodium potassium pump doesn’t work

Ca+ intracellular is a hallmark of tissue injury

115
Q

where are the juxtaglomerular cells located and what do they secrete

A

they are located by the afferent arteriole of the glomerulus (encircle it)

they produce renin in response to decreased tubular NaCL, decreased pressure in the afferent arteriole and sympathetic stimulation

116
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

116
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

117
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

117
Q

primase

A

aka RNA polymerase

synthesizes RNA primer

117
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

117
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

117
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

117
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

117
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

117
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

118
Q

in ARDS what is suggestive of lung immaturity

A

phospholipid levels (most indicative) - lecithin and phsophatidyglycerol

sphingomyelin and surfactant proteins B and C have a small contribution to ARDS)

118
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

118
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

118
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

119
Q

fragility fracture

A

fracture from low level trauma like falling from standing height

indicative or significant bone loss and osteoporosis

120
Q

what can cause fragility fractures in a vigorously active woman

A

hypogonadtrvphic hypogonadism caused by vigorous excercise, low BMI or stress

causes decreases GnRH, FSH, and LH with decreased estrogen and accelerated bone loss

120
Q

homocystinuria

A

autosomal recessive defect in cystathionine beta synthase which leads to the buildup of methionine and homocysteine

will have marfanoid features, intellectual disability, hypercoagualbility, and downward subluxation

121
Q

why can heparin be used in pregnancy

A

it has a larger molecular weight and cant cross the placenta

121
Q

what features allow placental transfer of drugs

A

uncharged and lipholphilic, unbound to plasma proteins like albumin, low molecular weight

122
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

122
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

122
Q

primase

A

aka RNA polymerase

synthesizes RNA primer

122
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

122
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

122
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

122
Q

why can heparin be used in pregnancy

A

it has a larger molecular weight and cant cross the placenta

122
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

122
Q

what features allow placental transfer of drugs

A

uncharged and lipholphilic, unbound to plasma proteins like albumin, low molecular weight

122
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

122
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

122
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

122
Q

what can cause fragility fractures in a vigorously active woman

A

hypogonadtrvphic hypogonadism caused by vigorous excercise, low BMI or stress

causes decreases GnRH, FSH, and LH with decreased estrogen and accelerated bone loss

122
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

122
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

123
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

124
Q

neisseria honorrhea causes gonorrhea with what virulence factor

A

pilli (this also is what gives it it variance- no vaccination)

125
Q

CMV retinitis

A

cotton wool spots and retinal hemorrhage

(white opaque patches with hemorrhage at the retinal periphery)

usually in HIV patients with a CD4 count less than 50

125
Q

treatment of CMV retinitis

A

ganciclovir which inhibits DNA chain elongation

inhibits DNA polymerase

can also use focarnet, or valancivlovir all of which interfere with DNA replication

126
Q

special considerations for local anesthetics

A

if pt is allergic to ester compound use amide

if there is infected tissue there will need to be a higher dose (infection causes an acidic environment)

126
Q

Lynch syndrome

A

AD mutation that leads to defective DNA mismatch repair with microsatilliate instability

-colorectal cancer, endometrial cancer, ovarian cancer

MSH2,MLH1, MSH6

126
Q

medications used to treat BRAF positive melanomas

A

dabrafenib and vemurafenib which are BRAF inhibitors

126
Q

CMV retinitis

A

cotton wool spots and retinal hemorrhage

(white opaque patches with hemorrhage at the retinal periphery)

usually in HIV patients with a CD4 count less than 50

126
Q

wernicke encephalopathy

A

mammillary body atrophy

**encephalopahty, oculomotor dysfunction, ataxia

126
Q

cocaine overdose signs and treatment

A

tachycardia, hypertension, pupillary dilation, agitation, hallucinations

treatment: bentos, Mixed a/b receptors blocker

126
Q

ways RNA viruses can change genetic material

A

shift: reassortment that produces viral progeny and produces pandemics

drift: point mutations

127
Q

DNA ligase

A

joins Okazaki fragment on lagging strand

127
Q

recombination

A

gene exchange that occurs from 2 double stranded DNA molcueles from crossing over

127
Q
A
127
Q

pemphigus vulgas pathogenesis

A

autoantibodies target desmoglzins in the desmosomal junction which helps attach epidermal keratinocytes to each other

wit h this there will be deposits between keratinocytes and intraepithelial detachment of keratinocytes and retained keratinocytes along the basement membrane

127
Q

classes of local anesthetics

A

esters (one i)
amides (two i’s)

127
Q

signs of vitamin B6 deficiency

A

peripheral neuropathy, sideroblastic anemia (microcytic), chili tis, stomatitis, glossitis

127
Q

primase

A

aka RNA polymerase

synthesizes RNA primer

127
Q

mammalian target of rapamycin inhibitors

A

sirolimus

127
Q

benign growths composed of broad fascicles of rounded fibroblasts with abundant cytoplasm and significant surrounding collagenous matrix that infiltrates adjacent soft tissue

A

Desmond tumors

127
Q

patients with atrial fibrillation can be treated with chemical cardio version to receive rhythm control what are the options

A

amioderone, defetilide, flecainide, and sotalol

127
Q

biopsy of actinic keratosis shows

A

hyperkeratosis (thickening of the stratum corneum) and parakeratosis (nuclei in the stratum corneum)

127
Q

vitamin E deficiency

A

biliary disease, pancreatitis, hemolytic anemia , muscle weakness, ataxia

127
Q

signs of benzodiazepine overdose and treatment

A

ataxia, AMS, lethargy, slight respiratory depression

treatment: flumazenil ( inhibits alcohol dehydrogenase)

127
Q

type 1 pneumocytes vs. type 2

A

type 1: gas exhange
type 2: production of surfactant and regeneration of alveolar epithelium

127
Q

adverse effects of calcineurin inhibitors

A

dose dependent rise in BUN and creatinine levels and obliterative vasculopathy or the efferent and afferent arteries

127
Q
A
128
Q

what can cause fragility fractures in a vigorously active woman

A

hypogonadtrvphic hypogonadism caused by vigorous excercise, low BMI or stress

causes decreases GnRH, FSH, and LH with decreased estrogen and accelerated bone loss

128
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