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STEP1 > Step1_qbank_self_assesment > Flashcards

Step1_qbank_self_assesment Flashcards

1
Q

ARDS is characterize by what?

A

Acute lung dysfuntion, pulmonary edema, normal left arterial pressure, and a PaO2/FIO2 <200

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2
Q

ARDS is caused by:_____

A

injury to endothelial cells lining the pulmonary capillaries - ajacent to the alveoli [2/2 inflammatory cytokines and neutrophils]

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3
Q

Which fibers are located interatrial septum near the tricuspid orafice

A

Purkinhe System

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4
Q

Bone tumor associated with Paget’s disease

A

Osteosarcoma

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5
Q

Globus hystericus

A

“lump in th throat sensation”; tiggered by emotions

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6
Q

Which vitamin can pregnant women NOT have? Why?

A

Vitamin A; It is lipid oluble –> not readily excreted in urine –> accumulates in stellate cells of the liver; RESULT: fetal micro encephaly, cardiac anomalies, early epiphyseal closure, growth retardation, spontaneous abortion

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7
Q

Drug that inhibits acetylcholin-like muscarinic agents?

A

Atropine

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8
Q

Drug that potentiates acetylcholin-like muscarinic agents?

A

physostigmine

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9
Q

[Drug tox] confusion, blurred vision, dry mucus membranes, intense thirst

A

atropine [anticholinergic]

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10
Q

Cadherins

A

Ca2+ dependent transmebrane protein that participate in desmosome formation via homologous interaction with cadherins on ajoining cells –DO NOT participate int hemidesmosome fuction

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11
Q

Molluscum contagiosum

A

Poxvirus; characterised by multiple firm, flesh colored, dome-shapped papules on skin and mucus membranes; pruritic and have umbilicated centers containing white curd like material

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12
Q

What triggers bicarb-rich fluid accumulation in the duodenum?

A

Low pH of the duodenal content; pH pancrase promopted (by secretin) to secrete bicarb-rich fluid –> neutralized the hydrogen atoms in chyme

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13
Q

What is most commonly injured in anterior or postrior knee dislocations?

A

Tibial artery

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14
Q

Most common organism responsible for Endometritis?

A

Bacteroides species

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15
Q

Normal activity of tyrosine kinase receptor

A

transient dimerization;

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16
Q

In erectile dysfuntion, Phosphodiesterase-5 inhibitors (sildenafil) promot rection through the relaxation of which tissues?

A

vinus sinus smooth muscle within the corpora cavernosa

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17
Q

Which tissues produce bicarb inresponse to stimulation? (2)

A

exocrine pancrease and epithelial cells of the biliary tract

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18
Q

What mediates bicarb secretion

A

Secretin (released by S cells)

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19
Q

DiGeorge syndrome is assoicated with failed development of_____?

A

3rd and 4th pharengeal pouches (predecessors of the thymus, parathyroids glands, and ultimobranchial body) –> defective T cell immunity (2/2 abscent/hypoplastic thymus)

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20
Q

Androgen inensitivity

A

X-linked; 46XY; Female phenotype; absence of testosterone receptors; testosterone levels are high; LH levels are high (2/2 hypothalamic-pituitary gland resistance to androgen feedback); FSH is normal; EVENTUALLY circulating androgens ar econverted to estradiol –> breast development etc. /// BLIND VAGINA//// wolffian and mullerian structures are absent

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21
Q

Mullerian agenesis

A

primary ammenorrhea; NO UTERUS, NO fallopian tubes, and proximal vaginal fails to develop; LH and FSH increased; estorgen leaves

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22
Q

Major cause of brain injury in the pre-mature infant? Where does it start?

A

Intraventricular hemorrhage; germial matrix

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23
Q

Side effect Cisplatin (tox)

A

hearing loss 2/2 damage to hair cells in the cochlear membranous labyrinth

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24
Q

Side effect of Amiodarone

A

delayed onset interstital pneumonitis (in isolation)

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25
Q

Side effect of Procainamide

A

delayed onset pleuritis (assoc. drug induced SLE)

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26
Q

Misoprostal is a ___analog that binds to ____.

A

PGE1 analog; binds to plasma membrane prostaglandin receptors

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27
Q

Misoprostal effect on upper GI tract

A

stimulate gastric epithelial cell mucus production AND decrease paretal cell acid secretion

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28
Q

Palmitoylation

A

process in which FATTY acids covalently acnchor to plasma membrane cyctein residues —> increasing hydrophobicity of tail

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29
Q

Nitoglycerine effect on HR? on end-systolic volume?

A

Increase HR; decrease end systolic volume

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30
Q

Whch bugs cause Impetigo

A

Staph a. and Group A strep

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31
Q

Which cell synthesize Androgen-binding protien (ABP)?

A

Sertoli cells (of the seminiferous epithelium)

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32
Q

What does Androgen-binding protein do?

A

maintains the high local concentration of testosterone needed for normal sperm production and maturation

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33
Q

Glucagon acts through which type of intracellular protein?

A

Gs-protein

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34
Q

Epinephrine acts through which type of intracellular protein?

A

beta 2 receptor

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35
Q

Sweat is mediated by what? Affected by damage to which structure?

A

cholinergic postganglionic fibers of the sympathetic nervous system; thoracic sympathetic trunk

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36
Q

Acid-base imbalance with suspected PE?

A

hypoxemia and resp. alk [increase pH and decreased PaCO2)

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37
Q

Rapid vancomycin infusion leads to ___ and why?

A

Red man syndrome; wide spread release of histamin from mast cells

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38
Q

What is Platelet Activating factor?

A

phospholipid inflammatory mediator that causes severe broncoconstriction, vasoconstriction, and platelet aggregation with microthrombus formation

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39
Q

Platelest activating factor at low concetrations

A

vasodilator –> leukocyte adhesion to endothelium, diapedesis (transmigration), degranulation and oxidative bursts

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40
Q

What produces platelet activating factor?

A

platelets, basophils, mast cells, neutrophils, monocytes, macrophages, and endothelial cells

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41
Q

Through which receptors doe platlet activating factor affect platelets

A

G protein-couple receptor (Gq) –> activates phospolipase C (PLC) –> generated inosotol triphosphate (IP3) and diacylglycerol from memebran proteins

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42
Q

IP3 mediated release of Ca2+ [ER] does what to platelets

A

promotes activation

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43
Q

Pulmonary Hypertension Pathogenesis

A

(1) injury to the pulmonary ENDOthelium 2/2 to an idiopathic mechanism/medical condition; (2) NARROWing of pulmonary vascular bed –> RVH; (3) vascular injury 2/2 to increased PA pressure; (4) INCREAse RV afterload; (5) DILATE the RV

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44
Q

osterogenesis imperfecta asscoc. with mutation in which genes?

A

COL1A1 and COL1A2

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45
Q

In a state of starvation, what happens biochemically

A

(1) decrease insulin and increase glucagon –> mobilize stored energy; (2) Glycogen degraded in the first 24hr of fast; (3) gluconeogenesis –> glucose formed from metabolic intermediates (glycerol, lactate, and alpha-ketoacids <–TG break down); (4) Blood level of ketone bodies increase w/in first few days of fast

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46
Q

Absenece of which enzyme impairs ketone formation

A

medium chain Acyl-CoA dehydrogenase

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47
Q

beta-oxidation –> ketone bodies

A

(1) catalyzed by acyl CoA dehydrogenase –> removal of 2C (acetyl-CoA) from fatty acids –> When the amount exceeds the capacity of the TCA cycle –> excess acetyl-CoA in shunted into the production of ketone bodies

48
Q

What is Ras and how does it function?

A

GTP-bindng, signal oncoprotein; involved in signal transmission from cell membrane to nucleus

49
Q

Bile salts efect on small intestin bacteria?

A

microbucudak emulsifying agents - disrupt the outer membranes of gram neg. eneric bacili

50
Q

Oranism tht has a haploid genome and an inner and outer cell membran, but NO nuclear membrane - sensitive to some penicillin ABx

A

Gram neg rod

51
Q

Eukaryote contain equimolar amounts of 18S and 28S rRNA molecule, explain.

A

Both rRNA molecules are transcribed from a single chromosom as a single trascript that subsequently under goes cleavage

52
Q

[Diabetic drugs] Insulin (lispro, aspar, glulisine/regular/NPH/ glargine, detemir)

A

Bind insulin receptor (tyrosine kinase actvity); Liver: increase glucose stored as glycoogen; muscle: increase glycogen and protein synthesis, K uptake; Fat: aid TG storage

53
Q

[Diabetic drugs] Biguanides (metformin)

A

Decrease gluconenogenesis; increase glycolysis; increase periferal glucose uptake (insulin sensitivity)

54
Q

[Diabetic drugs] Sulfnylureas (tolbutamide, chlorpropamide/ glybiride, glimepiride, glipizide)

A

Close K+ channel in beta-ccell membrane –> cell depolarizes –> tigger insulin release via Ca2+ influx

55
Q

[Diabetic drugs] Glitazones/ thiazolidinediones (pioglitazone, rosigiltazone)

A

Increase insulin sensitivity in periferal tissue; bind PPAR-y nuclear transcrition regulator

56
Q

[Diabetic drugs] alpha-glucosidase inhibitors ( acarbose, miglitol)

A

Inhibit intestinal brush border a-glucosidases; Delayed sugar hydrolysis and glucose absorbtion –> decreased postprandial hyperglycemia

57
Q

[Diabetic drugs] Amylin analogs (pramlintide)

A

decrease glucagon

58
Q

[Diabetic drugs] GLP-1 analogs (exentide, liraglutide)

A

increase insulin; decrease glucagon release

59
Q

[Diabetic drugs] DPP-4 inhibitors (linagliptin, saxagliptin, sitagliptan)

A

increase insulin; decrease glucagon release

60
Q

What is cimetidine’s (p 450 inhibitor) affect on warfarin metabolism? What happens to the PT?

A

slows metabolism; gradual increase og PT (over a period of days)

61
Q

P-450 Inducers (+) [8]

A

Modafinil; Barbituates; St. John’s Wart; Phenytoin; Rifampin; Griseofulvin; Carbamazepine; Chronic alcohol use

62
Q

P-450 Inhibitors (-)

A

Macrolides; Amiodarne; Grapefruit juice; Isoniazid; Cimetidine; Ritonavir; Acute alcohol abuse; Ciprofloxacin; Ketoconazole; Sulfanamide; Gemfibrozil; Quinidine

63
Q

cAMP effect on borncial smooth muscle cells

A

relax 2/2 inhibition of myosin phosphorylation and lowering intracellular calcium concentration

64
Q

osteomalacia (vita D deficiency) is characterized by deposition of which bone type?

A

excessive unmineralized osteoid matrix bone

65
Q

Characteristics of Papvaviridae DNA viruses (papillomaviruses and polymaviruses

A

Repicate w/in the host cell nucleus utilizing host vell DNA and RNA polymerases

66
Q

Characteristic of Poxviruses (DNA)

A

DO NOT replicate in the host cell

67
Q

Historlogy of Hashimotos thyroiditis

A

intesne lymphocytic iniltration of the thyroid gland –> folicular destruction and germinal center formation

68
Q

Which nerves are unmylenated? And what are they responsible for?

A

[Efferent] Autonomic postganglionic nerve; [***Afferent] “primary sensory” - slow pain, heat sensation, and olfaction

69
Q

Which family do enteroviruses belong to? What do they commonly cause?

A

picornaviridae - positive ssRNA; aseptic meningitis

70
Q

Examples of Enteroviruses?

A

poliovirus, coxackie A & B, echovirus, enterovirus, HepA

71
Q

Which HLA class II compnent s digested by macrophages during antigen processing?

A

Invarient Chain

72
Q

What is highly suggestive of insulin resistance

A

Elevated baseline insulin (in the setting of normoglycemia)

73
Q

The Marfan and homocystinuria similarity can be explained by what genetic process?

A

Geneteic Heterogeneity –mutations of different genes cause similar phenotypes

74
Q

How many ATP for every NADH

A

3 ATP

75
Q

How many ATP for every FADH2

A

2 ATP

76
Q

How many ATP for every GTP

A

1 ATP

77
Q

Anaerobic glycolysis and glycolysis in erythrocyte generate how many ATP per glucose molecule metabolized? Why?

A

2 ATP; erythrocytes lack mitochondria

78
Q

How many ATP are generated by aerobic metabolims of 1 molecule of glucose by the TCA cycle?

A

38 ATP

79
Q

How do triazole funtion?

A

Inhibit ergosterol synthesis; * ergosterol is an essential lipid in the fungal cell memebrane*

80
Q

Reiter Syndrome triad

A

(1) conjunctivitis; (2) urethritis; (3) seronegative arthritis

81
Q

Cardiac hypertrophy is characteried by what?

A

Increased rate of myosin mRNA synthesis

82
Q

PCOS is characterised by a decrease in which hormone?

A

FSH

83
Q

What typer of regulatory protein dictates differentiation of a progenitor cell into a dermal cell?

A

Transcription factors

84
Q

What drug/drug class can cause pupillary constriction in the denervated eye?

A

pilocapine; direct muscarinic cholinergic agonists

85
Q

What causes pernicious anemia?

A

immune-mediated destruction of gastric mucosa –> atrophic gastritis (loss of intrensic factor secreting parietal cells) –>hypochlorhydria –> increased serum GASTRIN –> anemia, icterus, fatigue, atrophic glossitis, paresthesias, weakness, unsteady gait

86
Q

Long term continuous leuprolide does what to male LH and testosterone production?

A

Inhibits LH release –> inhibits testosterone production

87
Q

Charachteristics of DiGeorge syndrome [22q11]:

A

thymic aplasia, parathyroid aplasia, cardiac and great vessel defects (TRUNCUS ARTERIOUSUS > tet. F. > interupted aortic arch)

88
Q

Defect expression of CD40 impairs what process?

A

Isotype switching

89
Q

Naive mature B cells produce which Ig molecules?

A

IgM and IgD

90
Q

DNA methylation affect of gene transcription

A

silences gene trascription

91
Q

Gaucher’s disease

A

*MC lysosomal storage disease - mutation of glucocerebrosidase chr 1q21; GLUCOCEREBROSIDE deposition in lysosomes of macrophages (normally it would have been degraded into its basic glucose and lipid elements - by glucocerebrosidase) –“wrinkle tissue paper” macrophages

92
Q

Clinical menifestations of Gaucher’s disease

A

Hepatomegaly, anemia, throbocytopenia, bleeding, osteopenia, bone pain, bone fractures

93
Q

Name the anti-TNF-alpha agents

A

Infliximab (monoclonal AB to TNF-alpha) and Etanerept (recombinant TNF receptor fusion protein)

94
Q

How does aspirin function?

A

Irriversibly inhibits COX 1 (also COX 2) –> thereby limiting thromboxain (TXA2) production in platelets –> decrease platelet aggregation and thrombus formation

95
Q

[fetal circulation] ductus arteriosus function:

A

shunt blood from the pulmonay artery to the proximal descending aorta

96
Q

[fetal circulation] foramen ovale function:

A

allows blood to pass from the right atrium directly into the left atrium — bypassing the lungs

97
Q

[fetal circulation] ductus venosus function:

A

blood from the placenta flows through the umbilical vein into the liver –> blood goes throu hepatic sinusoids OR divered to the IVC by the ductus venosus

98
Q

Define transformation.

A

process by which bacteria take up naked DNA from their environment and incoperate it into their genomes

99
Q

Define Transduction.

A

bacteriophage-mediated tranfer of genetic information; NOT inhibited by DNAse

100
Q

Define function of transposons

A

mediate the transfer of geneticinformation within a bacterium from one location of the genome to another

101
Q

What is Homebox genes’ function?

A

guiding morphogenes

102
Q

What is the result of mutation in HoxA-13

A

hand-foot-genital (HFG) syndrome

103
Q

Effects of 1,25 dihydroxycholecaliferol ingestion (2)

A

(1) Increase Ca2+ and Increase Phos; (2) enhance bone resoption and bone storage of Ca2+ and Phos

104
Q

Lesion in the MCA affect on vision

A

homonymous hemianopsia

105
Q

Intraabdominal malignancies involve which lymph nodes?

A

Supreaclavicular

106
Q

Decreasing which parameter will increase contraction velocity in isolated skeletal muscle?

A

Afterload

107
Q

What kind of diarrhea does Giardia bring?

A

Watery - malabsorbtive

108
Q

The following are signs of what: fatigue, decreased exercise tolerence, conjunctival pallor, white patches on gigival and buccal mucosa, hemorrages and bilateral exudates (fundoscopic); no palapable lymphadenopathy or organomegaly

A

acute leukemia

109
Q

What do you expect to see on periferal blood smear in acute leukemia?

A

Blast cells

110
Q

Virulence factor for Aspergillus

A

Vascular invasion

111
Q

Virulence factor Strep pneumoniae

A

Polysaccharide capsule

112
Q

Virulence factor H. Flu

A

Polysaccharide capsule

113
Q

Virulence factor N. meningitidis

A

Polysaccharide capsule

114
Q

Virulence factor mycobacterial organisms

A

Lipid rich cell wall

115
Q

Effect of portal hypertension on the spleen

A

Congestion –> red pulp expansion

116
Q

Treatment for esophageal variceal hemorrhage

A

Octreotide (somatostatin); reduces splanchnic blood flow and divert blood from the portal system –> systemic circulation –> splanchinic vasoconstriction [2/2 inhibition of hormones that produce splanchnic vasodilation – glucagon, and VIP]

STEP1 (13 decks)

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