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STEP1 > Step1_qbank_random2 > Flashcards

Step1_qbank_random2 Flashcards

1
Q

How is Galactosemia inherited? Which enzyme is defective?

A

AR; galactose-1-phosphate uridyltransferase

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2
Q

What effect does the hypothalamus have on prolactin secretion?

A

Inhibitory via dopamine production

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3
Q

Effect modification

A

when the effect of an exposure on an outcome is modified by another variable

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4
Q

What is the triad for babies that experienced in-utero Toxo

A

(1) hydrocephalus (2) choreoretinitis (3) intracranial calcifications

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5
Q

Anti inflammatory cytokines

A

TGF-B and IL-10

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6
Q

Treatment for severe allergic asthma

A

Omalizumab; [anti-IgE antibodies]

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7
Q

What is Omalizumab? How does it work?

A

recombinant humanized IgG1 monoclonal antibody; binds with IgE to inhibit the action of IgE –> decrease allergic response

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8
Q

Which organism grows well at 41C

A

Mycobacterium avium complex

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9
Q

What is the ppx for mycobacterium avium complex?

A

Azithromycin

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10
Q

What metabolizes pro-carcinogens? Where is it located?

A

cytochrome P-450 monooxygenase; in hepatic microsomes and ER

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11
Q

What is the function of cytochrome P-450 monooxygenase?

A

metabolize steroids, alcohol, toxins, and other foreign substances

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12
Q

What is the draw back to cytochrome P-450 monooxygenase?

A

Also converts pro-carcinogens into carcinogens –> mutations in human DNA

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13
Q

How long after fertilization during ovulation does it take for Beta-HCG to be positive?

A

8-11days

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14
Q

How is Isoniazid metabolized?

A

Acetylation

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15
Q

What dictates the speed one acetylates?

A

Whether they are fast or slow acetylates

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16
Q

Most common comorbidity for imperforate anus?

A

Urogenital tract anomalies

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17
Q

What is Etanercept function

A

Soluble decoy protein

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18
Q

[suffix of biological agents] (mab)

A

monoclonal AB

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19
Q

[suffix of biological agents] (cept)

A

receptor molecule

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20
Q

[suffix of biological agents] (nib)

A

kinase inhibitor

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21
Q

Which region of the kidney is impermeable to water

A

Thick and thin ascending limbs of Henle’s loop

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22
Q

What is the most potent cerebral vasodilator?

A

pCO2

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23
Q

What is the effect of decreased cerebral vascular resistance on cerebral perfusion and ICP?

A

Increase; Increase

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24
Q

[MoA] C. diptheriae - Diphteria toxin

A

Inactivates EF-2 via ribosylation, thus inhibiting host cell protein synthesis

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25
Q

[MoA] P. aeruginosa - Exotoxin A

A

Inactivates EF-2 via ribosylation, thus inhibiting host cell protein synthesis

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26
Q

[MoA] S. aureus - Enterotoxin

A

Superantigen that acts locally in the GI tract causing vomiting

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27
Q

[MoA] S. aureus - TSS toxin

A

Superantigen that stimulates T-cells leading to widespread cytokine release and shock

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28
Q

[MoA] - C. difficile - Cytotoxin B

A

Induces actin depolymerization leading to mucosal cell death, necrosis of colonic mucosal surfaces, and pseudomembrane formation

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29
Q

[MoA] - C. botulinum - Botulinum toxin

A

Blocks the presynaptic release of acetylcholine at the neuromuscular junction resulting in flaccid paralysis

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30
Q

[MoA] - B. pertussis - Pertussis toxin

A

Disinhibits adenylate cyclase via Gi ADP ribosylation, increasing cAMP production in the host cell; causes increased histamine sensitivity and phagocyte dysfunction

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31
Q

[MoA] - V. cholera - Cholera toxin

A

Activates adenylate cyclase via Gs ADP ribosylation, increasing cAMP production in the host cell; causes secretory diarrhea, dehydration, and electrolyte imbalances

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32
Q

Which med class would you use to dilate the pupil? Why?

A

alpha-adrenergic agonist; dilator muscle of the pupil has alpha 1 receptors

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33
Q

Which med class would you use to relax the uterus?

A

beta 2 agonists

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34
Q

How is lithium excreted?

A

Kidneys

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35
Q

Signs of lithium toxicity (6)

A

Neuromuscular excitability, irregular course tremors, fascicular twitching, agitation, ataxia, delirium

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36
Q

Drugs that increase lithium levels? (3)

A

Thiazide diuretic;, ACE inhibitors; NSAIDs

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37
Q

Effect of Pramipexole [Parkinsons]?

A

Stimulates dopamine receptors

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38
Q

Sputum shows many neutrophils no organisms

A

Legionella

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39
Q

[features of immunodeficiency disorders] Ataxia -telangiectasia

A

Ataxia; telangiectasia; sinopulmonary infections

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40
Q

[features of immundeficiency disorders] Chediak-Higashi Syndrome

A

Oculocutaneous albinism; pyogenic infection; progressive neurologic dysfunction

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41
Q

[features of immundeficiency disorders] Chronic Granulomatous disease

A

Severe bacterial and fungal infections; granuloma formation

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42
Q

[features of immundeficiency disorders] DiGeorge Syndrome

A

Congenital heart disease; dysmorphic facies; hypocalcemia

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43
Q

[features of immundeficiency disorders] Severe Combined Immundeficiency

A

Severe bacterial and viral infections in infancy; Chronic diarrhea; Mucocutaneous CANDIDIASIS

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44
Q

[features of immundeficiency disorders] C5-C9 deficiency

A

recurrent NEISSERIA infection

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45
Q

[features of immundeficiency disorders] Wiskott-Aldrich

A

Recurrent infections that worsen with age; easy bleeding; eczema

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46
Q

Sputum findings: esosinophils and Charcot-leyden crystals

A

Extrinsic allergic asthma

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47
Q

Clinical findings extrinsic allergic asthma?

A

Paroxymal breathlessness, wheezing

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48
Q

[Epi] Latent Period

A

Time elapsed from initial exposure;

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49
Q

[Epi] Lead time bias

A

Time between the initial detection of disease and a specific outcome (ie detecting diseases at earlier stages)

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50
Q

Dyspnea, cough, swelling of the face, neck, and upper extremities, dilated collateral veins in upper trunk

A

Superior vena cava syndrome

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51
Q

mutation in TATA box affects which cell function?

A

Transcription initiation

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52
Q

What is a TATA box? What does it bind (2)?

A

Promoter region; binds transcription factors and RNA polymerase II

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53
Q

Where is the TATA box located?

A

25 bases upstream from the beginning of the coding region

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54
Q

Which centers regulate Micturition reflex (urination)? (3)

A

Sacral micturition center (S2-S4) - bladder contraction; Pontine micturition center (pontine reticular formation); Cerebral cortex - inhibits sacral micturition center

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55
Q

Describe the function of the Sacral micturition center. Location/ Fibers involved

A

S2-S4; Parasympathetic fibers travel from S2-S4 ventral white matter within pelvic nerves and stimulate cholinergic receptors in the bladder wall —> BLADDER CONTRACTION

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56
Q

Describe the function of the Pontine micturition center.

A

Coordinates relaxation of external urethral sphincter w/ bladder contraction during voiding

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57
Q

Generally which fibers regulate bladder control

A

Descending cortical fibers

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58
Q

Which histones help pack DNA into nucleosome

A

H1 histone

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59
Q

Impaired balance, difficulty speaking, elevated serum transaminases; What do you suspect; What is the next test?

A

Wilson’s disease; slit lamp

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60
Q

Polycythemia vera (PV) define.

A

Clonal myeloproliferative disease of pluripotent hematopoietic stem cells

61
Q

Polycythemia vera (PV) characteristics.

A

Increased RBC mass, increased plasma volume, and low EPO levels

62
Q

Mutation associated with Polycythemia vera? Effect

A

JAK2 V617F; hematopoietic stem cells become more sensitive to growth factors

63
Q

What drug class is effective in preventing Chemo-induced vomiting?

A

5-HT3 receptor antagonists

64
Q

Name some 5-HT3 receptor antagonists.

A

Onansetron; granisetron; dolasetron

65
Q

Which neuropeptidesare deficient in the CSF of a Narcoleptic patient? Where are they produced

A

Hypocretin-1 (orexin-A) and Hypocretin-2 (orexin-B); lateral hypothalamus

66
Q

1st arrhythmia associated with myocardial ischemia.

67
Q

Pyrrolidonyl arylamidase (PYR)-positive, beta-hemolytic, gram-positive coccie in chains

A

S. Pyogenes

68
Q

S. agalactia is also known as___. Is Coag____. And catalase____. Gram ____ ____ in ____.

A

GBS; Negative; Negative; Gram positive cocci in chain

69
Q

S. aureus is a gram _____ _____ that grows in ____. Catalase____. Coag____. PYR___.

A

gram positive coccus that grows in chains. Catalase positive. Coag positive. PYR negative.

70
Q

C perferingen characteristics?

A

large spore forming; anarobic; gram positive ROD; catalase-neg; coag-neg

71
Q

Whar does C perferingen produce on blood agar?

A

Double zone of beta hemolysis

72
Q

A. Hydrophila characteristics? Likely exposure

A

oxidase-positive, non-fermenting, gram-negative ROD;; contaminated water

73
Q

Genus of organism that lack cell wall? Which Abx are not effective with them?

A

Mycoplasma genus; Penicillins

74
Q

Treatment for mycoplasma infections

A

tetracyclins; erythromycin

75
Q

Common cause of UTI (not E. Coli)? Whast is it resistant to?

A

Staph Saprophyticus; Novobiocin

76
Q

What is responsible for the toxic effects observed in meningitis and meningococcemia?

A

Lipooligosaccharide (LOS) -Outer membrane

77
Q

How does Lipooligosaccaride (LOS) differ from Lipopolysaccharide (LPS) of enteric gram neg rods?

A

Lacks the repeating O-antigen of LPS

78
Q

Hypopigmented or hyperpigmentedt skin patches or papules are characteristic of ___.

A

Pityriasis versicolor (aka tinea versicolor)

79
Q

Name the fungus that causes Pityriasis versicolor (aka tinea versicolor).

A

Malassezia furfur

80
Q

Where does the infection of Pityriasis versicolor (aka tinea versicolor) localize to? [which skin layer]

A

Stratum corneum

81
Q

Superficial inguinal lymph nodes drain cutaneous lymph from where?

A

umbilicus to feet [exclude posterior calf]

82
Q

Palpable firm superficial inguinal lymph nodes assoc with cancer where

A

external genitalia and anus

83
Q

Toxic side effect of Loop Diuretics and Aminoglycosides/salicylates/cisplatin

A

Ototoxicity

84
Q

Name some ototoxic agents

A

Aminoglycosides/salicylates/cisplatin

85
Q

Genome imprinting is produced by what?

A

DNA methylation (ie methyl group from S-adenocyl-methionine to a cyosine residue in a DNA molecule)

86
Q

Renal tubular ischemia affects which cells preferentially?

A

proximal tubules AND thick ascending limb of Henle’s loop

87
Q

What is Cytochrome c? [What does it activate? What does it bring about? Through which pathway?]

A

mitochondrial enzyme that activates caspsaes and indirectly brings cell death through intrinsic pathway apoptosis

88
Q

What are the regions of LPS; which is responsible for toxic shock?

A

O antigen, core polysaccaride, Lipid A; Lipid A responsible for toxic shock

89
Q

What are the Golgi tendon organs (GTOs)?

A

sensory receptors located at the junction of the muscle and tendon – innervated by group Ib sensory axons –contract when muscle extends against too much force

90
Q

What are A-delta fibers?

A

thin, myelinated nerve fibers; free nerve endings detect TEMP and PAIN

91
Q

Which sensory axons innervate muscle spindles (intrafusal fibers)?

A

Group Ia and group II

92
Q

What are muscle spindles (intrafusal fibers) sensitive to? What do they mediate?

A

changes in muscle length; stretch reflex

93
Q

Drug class that reduces prostate volume; Examples

A

5-Alpha reductase inhibitors; finasteride/dutasteride

94
Q

[stages of lobar pneumonia] Congestion - time/ presentation

A

(first 24hr) affected lobe is read heavy and boggy; vasc dilation/alveolar exudate (bacteria)

95
Q

[stages of lobar pneumonia] Red hepatiation - time/ presentation

A

(days 2-3) Red, firm lobe “liver like”; Alverolar exudate (erythrocytes, neutrophils, fibrin)

96
Q

[stages of lobar pneumonia] Gray hepatiation - time/ presentation

A

(days 4-6) Gray-brown firm lobe; RBCs disintergrate/ Averolar exudate (neutrophils and fibrin)

97
Q

[stages of lobar pneumonia] Resolution - time/ presentation

A

restoration of normal architecture; Enzymatic digestion of the exudate

98
Q

Gram positive organism causing cervicofacial manifestations after oral trauma

A

Actinomyces israelii

99
Q

Sulfur granules

A

Actinomyces israelii

100
Q

High fever, cough confusion, diarrhea - Causative organism? Lab findings?

A

HYPOnatremia; sputum gram stain showing many neutrophils but few/no organisms

101
Q

Amyloid precursor protein (APP) is involved in what process? Name an abnormal fragment.

A

Synaptic formation and repair; A-Beta-amyloid

102
Q

On which chromosome is Amyloid precursor protein (APP) located? Associated with which disease?

A

Chr 21; Down Syndrome

103
Q

Which bug likes alkaline selective media (thiosulfate-citrate-bile sats sucrose)

A

V. Cholera

104
Q

Which drug simulates an ideal environment in the body for V. Cholera?

A

Omeprazole

105
Q

Tinnitus, Vertigo, Hearing loss (sensorineural)

A

Meniere’s disease

106
Q

Disorder of inner ear characterised by increased volume of endolymph

A

Meniere’s disease

107
Q

How to estimate the risk of metastasis in Melanoma?

A

Vertical growth (depth) [Breslow thickness)

108
Q

What mediates paraneoplastic cachexia?

109
Q

Consider _____ deficiency with sudden death after blood transfusion.

A

Select immunoglobulin (IgA) deficiency

110
Q

Islets in Type 1 DM?

A

Leukocytic infiltration

111
Q

Islets in Type 2 DM?

A

Amyloid deposition

112
Q

Renal biopsy: ballooning and vacuolar degeneration of prox. Tubules AND multiple oxalate crystals

A

Toxic renal injury

113
Q

How does ethylene glycol lead to acute renal failure

A

Precipitation of calcium oxalate crystals in renal tubules

114
Q

Metabolic acidosis, increased osmolar gap, calcium oxalate crystals in urine, suggest WHICH INGESTION?

A

Ethylene glycol

115
Q

Organism that causes transient pulmonary infiltrates in asthmatic or CF

A

Aspergillus Fumigatus

116
Q

[Week 1 of illness] raising fever Bacteremia, relative bradycardia; [Week 2] abdominal pain; [Week 3] Hepatosplenomegaly, intestinal bleeding and perforation

A

Salmonella Typhi

117
Q

Delayed umbilical cord falling off - diagnosis

A

Leukocyte adhesion deficiency

118
Q

Cause of Leukocyte adhesion deficiency

A

Absence of CD18 antigen, which is needed to form INTERGRINS

119
Q

Long term complication of Hydrocephalus? Why?

A

Hypertonicity/Hyperreflexia; UMN damage

120
Q

What do lesions to the glossopharyngeal nerve result in?

A

Loss of the gag reflex (afferent limb); loss of sensation in the upper pharynx, posterior tongue, tonsils, and middle ear cavity, loss of sensation in the posterior 1/3 of the tongue

121
Q

Fever and HA; CSF: bean-shaped gram negative cocci in pairs

A

N. Meningitides

122
Q

Route of N. Meningitides infection? (4)

A

Pharynx –> blood –> choroid plexus –> meninges

123
Q

Which deficiency(s) predispose patients to warfarin induced skin necrosis? Treatment?

A

Protein C or S; FFP

124
Q

What causes acute appendicitis?

A

Obstruction of the appendicular lumen

125
Q

Notable biochemical abnormality in Alzheimer disease?

A

decreased acetylcholine level (2/2 decreased choline acetyltransferase activity in nucleus basalis)

126
Q

Where is the biochemical abnormality of Alzheimer disease seen (2)? What is that area responsible for?

A

[decrease acetylcholine level] basal nucleus of meynert and hippocampus; memory and cognition and formation of new memories

127
Q

What do ergot alkaloids (ergonovine) do?

A

constrict vascular smooth muscle by stimulating both alpha-Adrenergic and Serotonergic receptors

128
Q

Ergots alkaloids + Hypercontractile coronary artery segments (Prinzmetal’s angina) leads to what?

A

Coronary artery spasm, chest pain, and ST-segment elevation

129
Q

Biopsy of a non-tender cervical lymphnode that fluctuates in size is likely to show what?

A

Follicular small cleaved cell lymphoma

130
Q

Cell line Follicular small cleaved cell lymphoma is derived from? Cytogenetic change?

A

B cells (non-Hodgkin lymphoma); t(14;18) – over expression of bcl-2

131
Q

Flushing, watery diarrhea, bronchospasm - associated with what?

A

Carcinoid syndrome (malignant carcinoid tumor)

132
Q

What is elevated in urinary excretion in a person with carcinoid syndrome?

133
Q

Treatment for carcinoid syndrome?

A

Octreotide and surgery for mets

134
Q

Insidious-onset exertional dyspnea, restrictive PFTs, paraseptal and subpleural cystic airspace enlarge (honeycomb lung)

A

Idiopathic pulmonary fibrosis

135
Q

Gradual worsening of dyspnea and productive cough, bilateral patchy pulmonary opacification (2/2 intraalveolar accumulation of amorphous protein and phospholipid material–surfactant)

A

Pulmonary alveolar proteinosis (PAP)

136
Q

Crohn’s disease associated with increase activity of which cells? And also produce and activate what (3)?

A

TH-1 helper cells; IL-2 and interferon-y and activate macorphages –> synthesize TNF

137
Q

Cochlear part of CN VIII mediates what? Compression leads to what?

A

Hearing; Sensorineural hearing loss and tinnitus

138
Q

Vestibular part of CN VIII mediates what? Compression leads to what?

A

Balance; vertigo, dysequilibrium, and nystagmus

139
Q

Loss of taste in the anterior 2/3 of the tongue suggest problem with which CN?

140
Q

Compression of CN V results in what? (3)

A

Loss of sensation around the mouth and nose, loss of corneal reflex, and paralysis of the muscles of mastication

141
Q

Low hemoglobin, thrombocytopenia, absent hematopoietic cells in the bone marrow

A

Aplastic anemia

142
Q

Aplastic anemia is associated with a compensatory increase in what?

143
Q

Demylenation of axons results in what?

A

Impaired saltatory conduction down the axon

144
Q

1 test to demonstrate cystic duct obstruction. What would you see if obstructed?

A

HIDA scan; failed gallbladder visualization on radionucleotide biliary scan

145
Q

Findings of DIC. (5)

A

(1) prolonged PT and PTT; (2) thrombocytopenia and microangiopathic hemolytic anemia; (3) low fibrinogen; (4) elevated fibrin spil products (D-dimer); (5) Low factor V and VIII levels

146
Q

Abdominal discomfort, greasy stools, weight-loss; Biopsy: PAS-positive granules in lamina propria

A

Tropheryma whippelii

147
Q

Hamartoma on histology

A

“popcorn calcification” - disorganized cartilage, fibrous and adipose

148
Q

Gold standard diagnosis for Malignant mesothelioma

A

Electron microcopy

149
Q

tumor cells with numerous long, slender microvilli and abundant tonofilaments

A

Malignant mesothelioma

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