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1
Q

Weil Felix test is used for

A

Test for rickettsial infections

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2
Q

Which is not from an insect/flea bite

A

Q fever Cox burn

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3
Q

Etiology of Q fever

A

Coxiella burnetii (can be in salivary gland) also CMV can be in salivary gland as well

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4
Q

Patient has swelling of submandibular, tenderness. Patient is alcoholic. Radiographic-mass radiopaque (sialolith) - circumscribed, 1cm x 1cm, what is the reason for swelling

A

Bacteria infection

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5
Q

Best method for bacteria to replicate and transfer most genetic information

A

Conjugation

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6
Q

Action of the pili in organisms pathogenicity

A

Attachment and adherence to host cells

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7
Q

Difference between staph and strep

A

Staph is catalase +

Strep is catalase -

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8
Q

Lancefield grouping

A

It’s a serotype classification (that is, describing specific carbohydrates presen on the bacterial cell wall)

Lancefield is determined by C-carb composition of cell wall

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9
Q

Streptomycin inhibits what

A

Protein production (translation)

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10
Q

What aspect of staph is responsible for food poisoning

A

Enterotoxin

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11
Q

MOA of staph aureus for drug resistance

A

Produces enzyme that breaks down penicillin, beta lactamase

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12
Q

What bacteria causes endocarditis in IV drug user

A

Staph aureus

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13
Q

Most common type of endocarditis

A

Streptococcus viridian
- alpha hemolytic strep

Acute —> staph
- subacute which is more common is viridans

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14
Q

Which of the following diseases has janeway lesions

A

Infective endocarditis

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15
Q

Which toxin produces scarlet fever

A

Erythogenic toxin (erythrogenic exotoxin)

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16
Q

Rash for scarlet fever

A

Erythrogenic toxin of group A beta hemolytic s.pyogenes

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17
Q

Strep mutans produces

A

Dextran which is glucose linked in alpha 1,6

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18
Q

What enzyme do oral bacteria use to create dextran and participates in bacterial aggregation on teeth

A

Glucosyltransferase

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19
Q

What enzyme primarily breaks down sucrose

A

Glucosyltransferase (dextran sucrase)

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20
Q

Streptococcus breaks down sucrose into what products

A

Glucose and fructose

Glucans —> dextrans + mutans + levans

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21
Q

Dextrans for polymers of

A

Glucose

Levans = polymers of fructose

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22
Q

How is glucose and fructose associated with caries

A

Dextrans and levans

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23
Q

Which of the following is not an oral bacterium and not found in dental plaque

A

Strep pyrogenes

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24
Q

Which of the following does NOT cause pneumonia

  • strep mutans
  • H influenza
  • S pneumoniae
A

Strep mutans

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25
Q

Most common bacteria on the dorsum of the tongue

A

S salivarius

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26
Q

Lipid A with a polysaccharide core is in which organism

A

Gram negative bacteria

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27
Q

Gram negative bacteria have LPS

What do gram positive bacteria have

A

Teichoic acids

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28
Q

N-muramic acid is part of

A

Bacterial cell wall

  • it occurs naturally as N-acetylmuramic acid in peptidoglycan
  • function is a structural component of bacterial cell walls. Chlamydia has none
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29
Q

Glycan binds what in bacterial cell wall

A

D-alanine

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30
Q

Rickettsia is a

A

Gram negative
Non spore forming
Highly pleomorphic bacteria

Responsible for typhus

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31
Q

Rickettsia diseases are destructive for/target?

A

Endothelial cells of capillaries

- rickettsia are small gram negative, aerobic, coccobacillary bacteria

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32
Q

Which one needs Arthropoda vector (insects) or fleas?

A

Rickettsia except for cox burn

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33
Q

Weil Felix test is used for

A

Test for rickettsial infections

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34
Q

Which is not from an insect/flea bite

A

Q fever cox burn (not bite)

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35
Q

Etiology of Q fever

A

Coxiella burnetii (can be in salivary gland) also CMV can be in salivary gland as well

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36
Q

The toxin of the gas gangrene organism has what kind of enzymatic activity

A

(C. Perfringens)

Lipase lecithinase

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37
Q

Clostridium tetani are all the following EXCEPT…

A

Gram positive
Anaerobic
Spores
Rod-shaped

No exception!!!!!

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38
Q

Mechanism of action of the tetanus toxin

A

Inhibition of neurotransmitter release (prevent release of GABA and glycine)

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39
Q

Over-treating with antibiotics, C. difficile, would should?

A

Pseudomembranous colitis

  • clostridium difficile causes diarrhea and intestinal colitis
  • CLINDAMYCIN
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40
Q

Spore forming bacteria

A

Clostridium (anaerobic) and bacillus (aerobic)

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41
Q

What ion is related to spores

A

Calcium dipicolinic (heat resistance of the endoscope)

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42
Q

Mycobacterium tuberculosis has mycolic acid that block antibiotics from penetrating

A

….

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43
Q

Legionnaires pneumophilia is mainly found in air-conditioning systems (prefer Aerosilized water)

A

….

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44
Q

An infection of the epithelial cells of the eye that can sometimes enter back into the nasopharynx

A

TRACHOMA due to chlamydia trachomatis

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45
Q

Blindness results from

A

Chlamydia trachomatis (trachoma and adult inclusion conjunctivitis)

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46
Q

Most common cause of non-gonococcal urethritis

A

Chlamydia

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47
Q

Bacillary dysentery (shigellosis) is caused by

A

Shigella

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48
Q

Which produces these toxins: protective antigen (PA), edema factor (EF), and lethal factor (LF)

A

Bacillus anthracis (causes anthrax)

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49
Q

Treponema palladium bacteria

A

Dark field microscopy

- syphilis causes oral hard chancre, not painful, use wassermann test

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50
Q

Hutchinson’s teeth is a sign of

A

Congenital syphilis infection

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51
Q

What Protozoa are spread in cat feces

A

Toxoplasma gondii

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52
Q

How is arbovirus transmitted

A

Arthropoda

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53
Q

Which virus doesnt have a latent phase

A

Rhinovirus and poliovirus

These DO establish a latent infection
- EBV, HSV-1 and 2, VZV, CMV (all herpesvirus) HEH, CV

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54
Q

Herpes virus is the only virus that gets it cell wall from

A

Host nuclear membrane

  • herpes virus —> dsDNA, enveloped, nuclear membrane, icosahedral nucleocapsid, establishes latent infection
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55
Q

Cytomegalovirus are associated with

A

Salivary glands (torches)

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56
Q

EBV and varicella zoster are members of

A

Herpesviridae
- EBV can cause burkitts lymphoma, nasopharyngeal carcinoma, B-cell lymphoma, hairy leukoplakia, and infectious mononucleosis

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57
Q

What happens with primary exposure to HSV1

A

Primary hermetic gingivostomatitis

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58
Q

What virus causes chicken pox

A

Varicella zoster virus

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59
Q

Epstein Barr virus is related to

A

Burkitts lymphoma

  • EBC can cause burkitts lymphoma, nasopharyngeal carcinoma, b-cell lymphoma, hairy leukoplakia, infectious mononucleosis
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60
Q

Left back stab at L1-L2

A

KIDNEY

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61
Q

What cause influenza to change year to year

A

Antigenic capsule (gene reassortment)

  • influenza virus is an orthomyxovirus with outer envelope has spikes (H and N) for attachment to host cells.
  • treatment with amantadine —> inhibits viral attachment and uncoating
  • the main mode of prevention is the vaccine, which consists of killed influenza A and B virus
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62
Q

What are the virulence factors of neisseria meningitis

A

Endotoxin LPS (gram negative)

WATERGHOUSE FRIDERISCHEN SYNDROME

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63
Q

Which is not associated with N.meningitis

A

Enterovirus (ex. Picornavirus)

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64
Q

What disease causing agents have a polysaccharide capsule

A

Even Some Super Killers Have Pretty Nice Capsules

  • e. Coli
  • s. Pneumonia
  • salmonella
  • k. Pneumonia
  • H. Influenza
  • p. Aeroginosa
  • n. Meningitis
  • c. Neoformans
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65
Q

Which virus can be transferred from mother to fetus and is associated with congenital abnormalities

A

rubella

TORCHES

  • toxoplasmosis
  • rubella
  • CMV
  • Herpes simplex
  • syphillis
  • lieseria through BLOOD not placenta crossing
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66
Q

Measles (rubeola) and mumps belong to which group of virus

A

Paramyxoviruses

  • jump cause parotitis and sometimes in adults orhocitis
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67
Q

Kopliks spots

A

Measles

  • ssRNA
  • paramyxovirus
  • transmitted by respiratory droplet
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68
Q

Hepatitis B virion

A

Dane particle

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69
Q

What has the longest incubation period

A

Hepatitis B

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70
Q

Hepatitis C virus is an RNA virus and is blood-borne (ssRNA, flavirius)

A

….

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71
Q

What version of hepatitis is chronic

A

Hepatitis C

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72
Q

Penicillin resistance comes from bacteria that contain what enzyme

A

Beta lactamase

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73
Q

MOA of amoxicillin

A

Disrupts cell wall and inhibits cross linking between peptidoglycan chains for gram (+)/(-)

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74
Q

Why doesnt amphotericin B work against bacteria

A

Ergosterol (fungi have in cell wall, bacteria don’t)

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75
Q

Polyene antifungal are specific to fungus because

A

It attacks the sterol that are present in fungi but not bacteria

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76
Q

Aminoglycosides MOA

A

binds to 30s ribosome and inhibits mRNA translation (protein synthesis, bactericidal)

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77
Q

Why dont you treat patients with penicillin and erythromycin

A

Penicillin only works on growing cells

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78
Q

Which one is the mechanism of action of fluorouracil

A

Suicide inhibitor of thymidylate synthase

  • flurorouracil is a pyrimidine analog, anti-neoplastic, interferes with DNA synthesis by blocking thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid
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79
Q

Naproxen (alive) is a reversible non-selective COX inhibitor that is more potent than aspirin

A

…

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80
Q

What medication blocks prostaglandins

A

Aspirin

  • aspirin irreversibly inhibits cocylooxgenase to decrease formation of precursor for thromboxane A2 (a platelet aggregator that is released by blood platelets) and prostaglandins
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81
Q

Lab test for warfarin

A

Prothrombin test (increases)

Warfarin = anticoagulant, inhibits vitamin K reductase —> affecting extrinsic pathways and prothrombin conversion so increase prothrombin time (normal ppt and bleeding time) HAEMOPHILA HAS INCREASED PPT

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82
Q

Sulfonamides compete with which molecule in their MOA

A

PABA to inhibit folic acid synthesis

Therefore cannot makes purines or pyrimidines

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83
Q

Sulfonamides block dihydrofolate and block what

A

Purine and pyrimidine synthesis

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84
Q

Detergent kills bacteria by interfering with the function of the cell membrane (destroy fat cell parts)

A

…

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85
Q

MOA of digoxin

A

Inhibition of Na.J ATPase that causes an increase in intracellular Na levels

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86
Q

What medication is a DNA gyrase inhibitor

A

Ciprofloxacin

-fluoroquinolone, end in -oxacins

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87
Q

MOA of clindamycin

A

Inhibits 50s

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88
Q

Main side effect of clindamycin

A

Pseudomembranous colitis (diarrhea)

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89
Q

Rifampin works as a RNA synthesis inbhitor

  • treatment of TB
  • inhibits RNA dependent RNA polymerase which stops mRNA transcription
A

….

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90
Q

What is the most common bacteria vaccine given in the US

A

DTP (diptheria, tetanus, and pertussis)

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91
Q

Bordetella pertussis (whooping cough) vaccine is

A

Killed vaccine

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92
Q

Live attenuated vaccine (ex = polio Sabin vaccine) is an active immunity

Polio vaccines: Sabin (oral/attenuated/alive) versus SalK (injection of killed bacteria)

A

….

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93
Q

Antibiotic used for meningitis caused by haemophilus influenza

A

Ceftriaxone

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94
Q

MOA of viagra

A

Inhibits cGMP-specific phosphodiesterase type 5 (PDE-5), which regulates blood flow

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95
Q

All will depress respiration, EXCEPT

  • general anesthesia
  • nitrous oxide
  • cocaine
A

Cocaine

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96
Q

Why is saliva hypotonic

A

Salivary duct cells reabsorbed Na and Cl- in exchange for K+ and HCO3

  • saliva is hyposmolar because reabsorption of water by striated duct cells is less than reabsorption of Na
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97
Q

What nerve innervates the salivary glands of the palate

A

CN 7

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98
Q

Which salivary glands are only mucous secreting

A

Palatine salivary gland (in the submucosa)

Only serous glands = von ebner and parotid gland

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99
Q

How would the parotid differ from sublingual (staining/histology) or mucous/serous gland

A

Parotid

  • serous
  • more eosinophilia

Sublingual

  • pale-stain due to mucous
  • bubbly appearance (foamy dark nuclei)
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100
Q

Serous demilunes are in what gland

A

Sublingual gland

  • serous demilunes are the serous cells at the distal end of mucous tubuloalveolar secretory unit of sublingual salivary glands. They secrete the proteins that contain lysozyme, which degrades the bacteria cell wells
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101
Q

What type of cells make up the demilunes of mucous something of sublingual glands

A

Serous cells

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102
Q

What is not derived from neural crest

A

Salivary glands and enamel

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103
Q

Epithelium of striated ducts of salivary ducts

A

Simple columnar epithelium

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104
Q

What parotid salivary glands resemble pancreatic ductal cells

A

Serous gland and intercalated ducts

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105
Q

Which salivary gland cell is more like proximal convoluted tubule in the kidney

A

Striated duct cell

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106
Q

What is in the parotid gland

A

FEAR

  • facial nerve
  • ECA
  • auriculotemporal nerve
  • retromandibular vein
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107
Q

Parotid gland duct (stensons duct) pierces the buccinator muscle and is located near maxillary 2nd molar

A

…

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108
Q

All of the primary ions are in saliva except

A

Calcium

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109
Q

What hormone stores glucose in adipose tissue

A

Insulin

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110
Q

Decreased insulin will result in

A

Increased gluconeogeneiss

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111
Q

What is phorphylated in an insulin receptor

A

Tyrosine

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112
Q

What needs a protein transporter to cross the cell membrane

A

Glucose through glut 4 FAC bidirectional transportation

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113
Q

Glucagon signals through

A

CAMP

  • glucagon receptor is a 7-transmembrane receptor coupled to a g-protein and cAMP
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114
Q

Glucagon and epinephrine both have in common

A

Glycogenolysis and GLUCONEOGENESIS

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115
Q

Oxidative phosphorylation occurs in what enzyme

A

Pyruvate dehydrogenase

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116
Q

What enzyme is used for decarboxylation

A

Pyruvate decarboxylase

Biotin = coenzyme

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117
Q

Rate limiting enzyme for glycolysis

A

PFK

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118
Q

Glucose-6-phosphate is not found in the muscles

A

…

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119
Q

Glucose is sequestered by which enzyme

A

Hexokinase

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120
Q

What is NOT true regarding hexokinase and glucokinase

A

They have the same KM
- glucokinase is higher, more affinity

  • glucokinase is a isoform of hexokinase found only in the liver and only uses substrate glucose
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121
Q

UTP-glucose reacts with which of the following in glycogen synthesis

A

Glucose-1-phosphate

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122
Q

What steps restores oxaloacetate in TCA

A

Malate, malate dehydrogenase

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123
Q

What enzymes produce oxaloacetate

A

Pyruvate carboxylase (pyruvate —> oxaloacetate)

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124
Q

What is the main source of glycerol

A

Glucose/pyruvate

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125
Q

Where is phosphoenolpyruvate found

A

Liver

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126
Q

Tidal volume

A

Normal volume of air disabled between normal inhalation and exhalation when no extra effort is applied (500mg)

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127
Q

Vital capacity =

A

IRV + ERV + TV

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128
Q

Residual volume

A

Air remaining after max exhalation

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129
Q

Pressure on a mountain is 250mm Hg, what is the partial pressure of oxygen

A

50 mmHg

  • oxygen = 20%
  • nitrogen = 80% so 250 x 0.2 = 50mm Hg
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130
Q

Epithelium of respiratory tract

A

Pseudostratified ciliated columnar epithleium with goblet cells

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131
Q

Stretch receptors (hering-Breuer reflex) of the lung is carried by vagus nerve (CN 10) to prevent over-inflation

A

…

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132
Q

What produces mucous in lungs

A

Clara cells

Nonciliated bronchiolar secretory cells that make GAGs to protect the bronchiole lining

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133
Q

Obstructive lunge disease —> compliance goes

A

UP

  • obstructive lung disease is characterized by increased resistance to air flow (lower than normal expiration flow rates) and high lung volumes. Decreased elasticity, increases compliance
    Ex: chronic bronchitis, emphysema, asthma
  • restrictive lung disease is characterized by low lung volumes and slightly higher than normal expiration flow rate (increased lung elasticity). Decreased compliance.
    Ex: interstitial fibrosis (lung hardening), asbestosis, and tuberculosis
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134
Q

In which can we see more squamous epithelium metaplasia

A

Bronchi

Another source said esophagus

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135
Q

Which organ most likely to undergo red infarction

A

Lung

  • white infarct affect solid organs (ex: spleen, heart, kidney) while red infarction (hemorrhagic infarct) affects lungs and other loose organs like testis, ovary, SI due to loose tissues that allow RBC to collect in the infarcted zone
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136
Q

Emphysema can lead to

A

Respiratory acidosis

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137
Q

Hyperventilation can cause

A

Alkalosis

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138
Q

Metabolic acidosis —>

A

Hyperventilation

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139
Q

After metabolic or respiratory acidosis, which abnormality of electrolytes is more likely

A

Hyperkalemia

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140
Q

When is intrapleural pressure the most negative

A

End of expiration

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141
Q

When is alveoli pressure the most negative

A

Beginning of inhalation

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142
Q

What kind of epithelium is found in the nasopharynx region

A

Ciliated pseudostratified columnar epithelium

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143
Q

Infant has trouble breathing, what cells are causing problems

A

Type 2 pneumocytes

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144
Q

What describes oxygen transport

A

Bohr effect

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145
Q

What is true about myoglobin

A

Graph is hyperbolic (hemoglobin = sigmoidal)

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146
Q

Carotid body measures

A

Partial pressure of O2

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147
Q

Carbon monoxide decreases O2 content but pO2 is normal

A

…

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148
Q

Patient is on nitrous, best way to measure efficiency

A

Reserve minute volume

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149
Q

Mineral for coagulation

A

Zinc and Ca

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150
Q

What carries iron in the plasma

A

Transferrin

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151
Q

Prothrombin acts with which one to form thrombin

A

Ca

- prothrombin and calcium/Pl/factor10a —> thrombin (liver)

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152
Q

What is the substrate of thrombin

A

Fibrinogen

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153
Q

If we put RBC in hypotonic solution

A

Hemolysis

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154
Q

Blood type: anti-A and anti-B both agglutinate. What blood type is it

A

AB

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155
Q

Which one of these helps in the retraction of the blood clots

A

Factor XIII

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156
Q

Boy bleeds during extraction, his maternal uncle and male cousin have same problem. What factor is involved

A

Factor VIII (hemophilia A and sex-linked)

  • characterized by having prolong partial thromboplastin time (PTT) and normal PT/bleeding time
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157
Q

Hemophilia B (Christmas) disease is due to a factor __ deficiency

A

Factor 9

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158
Q

Hemophilia C is NOT sex linked and is due to a factor __ deficiency

A

11

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159
Q

Know cytochrome p450. Choose exception

  • present in all tissues of the body and help with hormone synthesis/breakdown, cholesterol, synthesis, vitamin D metabolism
  • metabolize toxic compounds, mostly in liver
A

….

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160
Q

Enzyme: competitive inhibitor versus non competitive

A
  • increase K and Vmax stays the same

Non competitive inhibitors

  • Km stays the same
  • vmax decreases
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161
Q

In cells, N-glycosylation occurs in where?

A

RER (in all cells)

N-glycosylation is the attachment of sugar glycan to nitrogen (ex. Amide of asparagine)

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162
Q

Pyrimidine synthesis begins with what

A

Ribose 5-phosphate

  • R5P = result of pentose phosphate pathway, makes ribose for nucleotide synthesis and NAPD for FA/steroid
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163
Q

What process makes NADPH

A

Pentose phosphate shunt

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164
Q

Primary molecule for reduction biosynthesis ?

A

NADPH

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165
Q

Purine metabolism intermediate and precursor of adenosine and guanine??

A

IMP (inosine monophosphate)

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166
Q

When taking away phosphate group from (named a nucleotide)?

A

Nucleoside

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167
Q

Whats the difference between thymidine and uracil?

A

Methyl group on thyme

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168
Q

Phosphodiesterase bonds — connect DNA I bond - connects 2 amino acids

A

…

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169
Q

Whats a small molecule that can’t elicit immune response on its own?

A

Hapten

  • haptens are antigenic determinants, but are too small to elicit the formation of antibodies by themselves. They can elicit immune response when attached to bigger molecules
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170
Q

What elicits an immune response when bound to carrier protein?

A

Hapten

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171
Q

Alpha helix and beta sheets form (secondary protein structure) through hydrogen bonds

A

…

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172
Q

What is the main AA in the tertiary structure of protein?

A

Cysteine (disulfide bonds)

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173
Q

What kind of force holds proteins in the lipid bilayer?

A

Hydrophobic interaction

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174
Q

TRNA wobble is in the 3rd position of the codon

A

…

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175
Q

Which one plays an important role in detecting the starting codon (initation) for RNA transcription?

A

Sigma part

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176
Q

What determines protein turnover?

A

H-bonds and peptide bonds: breakdown and synthesis of proteins

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177
Q

Product of enzyme isocitrate dehydrogenase in TCA cycle

A

Alpha ketoglutarate

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178
Q

In the amino acid metabolism, what are they 2 primary acceptors of amine groups?

A

OAA and alpha-ketoglutarate

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179
Q

Phenylketonuria is a deficiency of?

A

Phenylalanine hydroxylase (PAH)

  • phenylalanine hydroxylase is responsible for the conversion of phenylalanine AA —> tyrosine
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180
Q

What amino acid is associated with taste sensation of umami?

A

L-glutamate

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181
Q

What is the charge of glutamic acid at pH = 1?

A

+2

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182
Q

What are the keto genic amino acids?

A

Leucine and lysine

  • ketogenic AA can be degraded directly into acetyl CoA, which is a precursor for ketone bodies
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183
Q

Nissl body is?

A

Rough ER

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184
Q

What residues are phosphorylated to activate/deactivate an enzyme (like glycogen synthase or glycogen phosphorylase)?

A

Serine

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185
Q

If patient is on a low carb diet, he/she wants low levels of?

A

Reduce production of insulin with low level of malonyl CoA

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186
Q

Apoptosis ? Hormone dependent physiologic involuted

A

…

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187
Q

What is the immune reactant in type 1 hypersensitivity? Antigen? Effector mechanism? Example of the hypersensitivity?

A
  • IgE
  • soluble antigen
  • mast-cell activation

Allergic rhinitis, asthma, systemic anaphylaxis

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188
Q

What is the immune reactant in type 2 hypersensitivity? Antigen(s)? Effector mechanism(s)? Example of the hypersensitivity(s)?

A
  • IgE
  • cell or matrix associated antigen
  • complement, FcR cells (phagocytes, NK cells)
  • example = some drug allergies, penicillin
  • IgE
  • cell surface receptor
  • antibody alters signaling
  • example = chronic urticaria
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189
Q

What is the immune reactant in type 3 hypersensitivity? Antigen? Effector mechanism? Example of the hypersensitivity?

A
  • IgG
  • soluble antigen
  • complement phagocytes
  • example = serum sickness, Arthus reaction
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190
Q

What is the immune reactant in type 4 hypersensitivity? Antigen(s)? Effector mechanism(s)? Example of the hypersensitivity(s)?

A
  • TH1 cells
  • soluble antigen
  • macrophage activation
  • example = contact dermatitis, tuberculin reaction
  • TH2 cells
  • soluble antigen
  • eosinophil activation
  • example = chronic asthma, chronic allergic rhinitis
  • CTL
  • cell-associated antigen
  • cytotoxicity
  • example = contact dermatitis
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191
Q

Alternative complement pathway starts with?

A

C3a = need this to activation the other ones
C5 (C5a = chemoatrractant) = most potent

  • alternative complement pathways starts with C3a. CD59, also known as protectin, which inhibits C9 polymerization during the formation of the membrane attack complex.

The classical pathway is inhibited by C1-inhibitor, which binds to C1 to prevent its activation

  • Mannose binding lectin
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192
Q

Interferon gamma (IF-G) receptor complex produces dimerization of chains —> secreted by t-cells, anti-viral/tumor, part of class II neurons

A
  • interferons are a group of signaling proteins made and released by host cells in response to the presence of pathogens, such as viruses, bacteria, parasites, or tumor cells. In a typical scenario, a virus-infected cell will release interferons causing nearby cells to heighten their anti-viral defenses
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193
Q

Cytotoxic T cells recognize?

A

Cytotoxic T cells (CD8) MHC1

CD4 cells = MH2

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194
Q

T- cell receptors (TCR) are similar to which one?

A

Fab

  • fab (an Fc receptor is a protein found on the surface of certain cells — including, among others, B lymphocytes, follicular dendritic cells, natural killer cells, macrophages, neutrophils, eosinophils, basophils, and mast cells — that contribute to the protective functions of the immune system
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195
Q

Which of the following is for a delayed hypersensitivity/latent infection?

A

T cells and macrophages, lymphocytes

Type 4

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196
Q

Similarity between Type 1 and type 2 hypersensitivity

A

Both require previous sensitization

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197
Q

Where does the antigen for MHC I come from?

A

Virus and infected cells

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198
Q

Which of the following is used to phagocytize bacteria?

A

Gamma Fc receptor + C3b

Gamma Fc receptor + C3b (all of the Fcgamma receptors) belong to the immunoglobulin superfamily and are the most important Fc receptors for inducing phagocytosis of opsonized microbes

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199
Q

The predominant cell in acute inflammatory response and in abscesses ?

A

PMN (polymorphonuclearcytes)

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200
Q

What causes pus?

A

Neutrophils

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201
Q

What secrets TNF-alpha and IL-1

A

Activated macrophages

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202
Q

Which WBC is the most abundant?

A

Neutrophils

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203
Q

Which type of WBC shows the lowest in blood?

A

Basophils

Never Let Monkeys Eat Bananas

  • neutrophil
  • lymphocyte
  • monocyte
  • eosinophil
  • basophils
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204
Q

CD4 cells recognize:

A

MH2

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205
Q

Postural reflex —>

A

Stretch reflex

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206
Q

Spasticity is defined as?

A

Hyper-responsive stretch reflect

  • spasticity is a hypertonus state of the affected muscles due to a release of the tonic inhibition of the brainstem, facilitatory info which leads to gamma motor neuron excitation. Thus, hyperactivity of the gamma fibers
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207
Q

Where does this arise in the spinal cord: sympathetic preganglionic cervical ganglion (SCG)?

A

T1-T8

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208
Q

Where are the cell bodies of the preganglionic sympathetic nerves that innervate the head?

A

Interomediolateral horn of spine (T1-L2)

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209
Q

NE is a post-synaptic sympathetic neurotransmitter

A

….

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210
Q

What neurotransmitter is found in nerves that transfer pain?

A

Substance P

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211
Q

Endomysium versus endoneurium

A

Endomysium = areolar CT around each muscle FIBER

Endoneurium = CT around myelin sheath/neuron axon

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212
Q

CNS myelin sheath is formed by?

A

Oligodendrocytes

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213
Q

PNS myelin is formed by?

A

Schwann cells

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214
Q

An impulse can travel from one nerve to another in one direction because the SYNAPSE limits the direction of travel

A

…

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215
Q

What solute affects membrane resting potential?

A

K+

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216
Q

Resting potential is -70mV and extracellular K+ increases and comes our of nowhere?

A

No change

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217
Q

What happens when there is a decrease in extracellular K?

A

Hyperpolarization

Low extracellular K = hyperpolarization

High extracellular K = depolarization

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218
Q

Vitamin C —>

A

Hydroxylation of proline and lysine during collagen synthesis

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219
Q

In collagen synthesis, what part happens outside the cell?

A

Lysyl oxidase (LOX) for cross-linking collagen

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220
Q

Lysyl oxidase - what is the cofactor needed?

A

Cu - copper

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221
Q

What is the 3rd AA sequence in collagen?

A

Glycine-proline-lysine
(Glycine-proline-X or glycine-X-hydroxyproline)

Glycine is found at almost every 3rd residue

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222
Q

What AAs other than glycine is found in collagen?

A

Proline and lysine

Lysine is involved in crosslinking

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223
Q

What is present in collagen, that isnt in elastin?

A

Hydroxylysine

  • tropocollagen is only found in collagen and reticular fibers, also has hydroxyproline and hydroxylysine
  • elastin has glycine, alanine, proline, and hydroxproline. It also has tropoelastin
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224
Q

What is NOT needed for synthesis for collagen?

A

Vitamin K or folic acid

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225
Q

What is responsible for calcium regulation ?

A

Parathyroid hormone

  • increase serum calcium
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226
Q

Main role of calcitonin?

A

Bone resorption

  • its produced primarily by the parafollicular cells (also known as c-cells) of the thyroid.
  • it acts to reduce blood calcium, opposing the effects of PTH
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227
Q

Osteoclasts —> monocytes

  • mature monocytes and macrophages are capable of differentiation into osteoclasts
A

…

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228
Q

What is not in periosteum?

A

Osteocytes

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229
Q

What cytokines are found in osteoclastic bone ?

A 
IL-1
IL-6
PGE2
TNF-alpha
MMPs
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230
Q

What are housed in howships lacunae?

A

Osteoclasts

  • howships lacunae = groove/cavity usually contains osteoclasts that occurs in bone which is undergoing resorption
  • trabecular bone is 1st resorbed by osteoclasts, creating a shallow resorption put (howships lacunae). Then, osteoblast deposit compact bone in the pit
231
Q

Endosteum?

A

Thin layer of CT that lines the surface of body tissue that form the medullary cavity of long bones

232
Q

What type of bone do you see after 2-3 years at the site of injury?

A

Compact bone

233
Q

Which of the following is not found in compact bone?

A

Fibroblast

234
Q

What is the chemical formula of the most common salt found in the bone?

A

HA: Ca10(PO4)6(OH)2

235
Q

Vitamin D deficiency —>

A 
Kids = rickets
Adults = osteomalacia
236
Q

Vitamin D:

25 hydroxycholecalciferol gets converted to 1,25 dihydroxycalciferol where?

A

Kidney

237
Q

Where do you get vitamin D from?

A

Skin, liver, kidney

238
Q

Innervation of the thenar muscle (thumb)

A

Median nerve

239
Q

What innervates the anterior wrist?

A

Median nerve

240
Q

What part of the arm is most susceptible to ulnar nerve injury?

A

Elbow

241
Q

Which muscle in the arm is innervated by the radial nerve (supplies upper limbs) —>

A

Triceps

242
Q

What brachial nerve and muscle is for circumduction of the arm?

A

Axillary (because of deltoids)

243
Q

Supination of the radio-ulnar joint?

A

Biceps brachii

244
Q

What muscle adducts the scapula?

A

Rhomboids

Adducts = trapezius and rhomboids (major and minor)

Abducts = serratus anterior, pectoralis

Serratus anterior = long thoracic nerve innervation

245
Q

Which one does not contribute to the posterior wall of the axilla?

A

Serratus anterior, humerus
- posterior wall = subscapularis, teres major, latissimus Doris, and scapula

Anterior border = pectoralis major and minor

  • medial border = serratus anterior and thoracic wall
  • lateral border = intertubecular sulcus
246
Q

Innervation that causes rotation of the arm?

A

C5

Doc says C5-C6

247
Q

If a person can’t flex their wrist, what nerves are involved?

A

C6-C7 (ulnar nerve, flexor Carli ulnaris muscle)

248
Q

What innervates the brachialis (biceps muscles)

A

Musculocutanous (C5-C7)

249
Q

What is the most distal portion of the brachial plexus?

A

?

Branches
- musculocutanous, axillary, median, radial, and ulnar nerve

250
Q

Axillary sheath surrounds the axillary vein, axillary artery, and 3 cords of the brachial plexus —>

A

NOT trunks/roots of branchial plexus

251
Q

Where do the 4th, 5th, and 6th intercostal veins drain?

A

Accessory hemizygous (formed by the 4th-8th intercostal veins)

252
Q

Right superior intercostal muscles drain into?

A

The right side azygous vein

253
Q

Azygous vein leaves impression on right lung

A

…

254
Q

What supplies the SA node ?

A

Right coronary artery

255
Q

Where is atherosclerosis most common?

A

Abdominal aorta

256
Q

What exits the thorax at 12?

A

Descending aorta

257
Q

Thoracic duct is behind what?

A

Esophagus and aorta

258
Q

Esophagus begins at what level?

A

Cricoid cartilage (C6), inferior to the cricothyroid

259
Q

What is posterior to the aorta

  • right kidney
  • liver
  • colon
A

Right kidney

Colon and pancreas are anterior to the abdominal aorta

260
Q

What are the visceral Artie’s of the abdominal/descending aorta?

A

Celiac trunk and inferior mesenteric

  • includes: celiac trunk, renal and superior/inferior mesenteric (not inferior phrenic)
261
Q

Direct branch of the celiac trunk?

A

Splenic artery (also left gastric and common hepatic artery)

262
Q

Hepatic portal vein contains blood from the?

A

Superior mesenteric and splenic vein

263
Q

Hepatic sinusoid drain what?

A

Portal blood to central vein

264
Q

What is not found in epithelium?

A

Meissner’s corpuscle (fine touch)

265
Q

Meissners plexus —>

A

Only parasympathetic

266
Q

Auerbach plexus —>

A

Both parasympathetic and sympathetic

- motor innervation to both layers of tunica muscularis

267
Q

Difference between lamina propria and dermis

A

Dermis has dense irregular CT

268
Q

What type of cells are in stratum granulosum layer?

A

Keratohyalin

269
Q

What is not present in an orthokeratinized layer?

A

Stratum lucidium

270
Q

Floor of the mouth is non-keratinized stratified squamous epithelium

Soft tissues structures that are NONKERATINIZED = soft palate, buccal mucosa

A

…

271
Q

Epithelium of palate?

A

Keratinized stratified squamous epithelium

  • hard palate, attached gingiva, dorsum of tongue = keratinized SSE
272
Q

What will cover the hard palate after an ulcer heals?

A

Parakaratinized stratum squamous epithelium

273
Q

Most adundant papillae?

A

Filiform

274
Q

Taste buds are involved in all papillae except?

A

Filiform

275
Q

You only have minor amounts of this taste bud?

A

Circumvallate papilla

276
Q

Antibody in mucosal surfaces?

A

IgA

277
Q

Tongue moves to the right?

A

Right CNXII damage

- damage/lesion to CN12 shows deviation towards paralyzed side when protruded because of weaker genioglossal muscle

278
Q

What protrudes the tongue —>

A

Geniolgossus

279
Q

What protrudes the mandible?

A

Lateral pterygoid

280
Q

What protrudes the hyoid bone —>

A

Geniohyoid helps move tongue and hyoid anteriorly

281
Q

What narrows the maxillary buccal vestibule when you open your mouth all the way?

A

Coronoid process

282
Q

All of the following elevate the larynx except the sternothyoid

A

…

283
Q

What creates the laryngeal prominence —>

A

Thyroid cartilage

284
Q

Most superior part of larynx?

A

Aryepiglottic fold (epiglottis)

285
Q

What muscle constrict to produce sound?

A

Lateral and transverse cricoarytenoid

286
Q

What is the only muscle to abduct (contract) the larynx (vocal fold)?

A

Posterior cricoarytenoid muscle

287
Q

What innervates muscles below the vocal fold and most of the laryngeal muscles —>

A

Recurrent laryngeal nerve (of CN 10)

288
Q

Internal laryngeal nerve innervates thyrohyoid membrane

A

…

289
Q

What occurs during tracheostomy?

A

Reduced airway resistance, reduced dead space

290
Q

Lumbar puncture

A

Between L3 and L4

291
Q

Trachea bifurcation

A

Sternal angle

292
Q

Thyroid hormone is stored in?

A

The colloid

293
Q

Where does the inferior thyroid artery come from?

A

Thyrocervical trunk

294
Q

The arteries that supply the thyroid gland are from the thyrocervical trunk and ECA (superior thyroid A)

A

…

295
Q

Terminal branches of the external carotid artery?

A

Superficial temporal artery and maxillary artery

296
Q

In the carotid triangle, what branch of the ECA wouldn’t you see?

A

Superficial temporal artery

297
Q

What makes up the carotid triangle?

A

Anterior border of SCM
Posterior belly of digastric
Superior omohyoid

298
Q

Submental triangle consists of?

A

Anterior digastric, hyoid bone, and mandible

299
Q

What structure is posterior to the carotid that runs along the longus capitas muscle

A

Sympathetic chain ganglia

300
Q

What is in the carotid sheath

A

Common carotid
Internal jugular
Vagus nerve (not ansa cervicalis or phrenic N)

301
Q

What does the sigmoid sinus drain into?

A

Internal jugular vein

302
Q

Where does deep facial vein drain into?

A

Pterygoid plexus

- deep facial vein connects the anterior facial vein and the pterygoid plexus

303
Q

What specific organs does the portal vein drain ?produce

A

Stomach (also drains spleen, pancreas, SI, and LI)

304
Q

Which one is not a function of the spleen?

A

Produce plasma cells

305
Q

The difference between the inferior vena cava and portal veins

A

Portal contain no valves

306
Q

Most common cause of portal hypertension —>

A

Liver cirrhosis (can also lead to esophageal varices)

307
Q

Esophageal varices commonly seen in what?

A

Alcoholics or portal hypertension from cirrhosis

308
Q

Esophageal varices can cause

A

Hematemesis (vomiting blood)

309
Q

Alcoholics and liver cirrhosis —>

A

Mallory bodies (inclusion found in the cytoplasm of liver cells, damaged intermediate filaments in the hepatocytes, usually found in people with alcoholic liver)

310
Q

Most frequent form of varicosities/varicose veins?

A

Superficial veins in the legs

311
Q

Veins —> thick tunica adventitia

Muscular arteries —> thick tunica media

A

…

312
Q

Initial venous drainage of the jejunum

A

Superior mesenteric vein

313
Q

Which endocrine gland is not essential for life?

A

Adrenal medulla

314
Q

What organ is not stimulated by the anterior pituitary

A

Adrenal medulla

315
Q

Which of the following is a cancer of the adrenal medulla

A

Pheochromocytoma

  • cardinal sign is persistent or episodic hypertension, often benign and results in irregular secretions of epi/NE
316
Q

Cell producing epinephrine and norepinephrine

A

Chromatic cells of adrenal medulla

317
Q

Which one is the end organ of the sympathetic system ?

A

Adrenal medulla

318
Q

B1 receptors

B2 receptors

Alpha 1 and alpha 2

A

Beta 1 = Heart, bronchoconstriction

Beta 2 = dilation, smooth muscle

Alpha 1 and 2 = NE

319
Q

Where is cortisol produced? Where is androgens produced?

A

Cortisol is produced in zona fasciculate

Androgens are produced in zona reticularis

320
Q

Female secreting endometrium, what cycle is she in?

A

Luteal

321
Q

Which organ doesnt make estrogen?

  • Graafian follicle
  • corpus luteum
  • adrenal medulla
  • theca interna
A

Adrenal medulla

  • Graafian follicle = after 1st meiotic division, 2N haploid stage
  • corpus luteum = hCG stimulates corpus luteum to secrete estrogen
  • adrenal medulla —> the adrenal CORTEX secretes estrogen, the medulla secretes catecholamine
322
Q

Which is an intracellular receptor?

A

Estrogen

- includes steroid, estrogen, progesterone, vitamin D derivatives

323
Q

Which of the following acts as nuclear receptor?

A

Vitamin D

- nuclear receptors include endogenous hormones, vitamin A and D

324
Q

What hormone promotes spermatogenesis ?

A

FSH

  • FSH promotes follicle development in female and stimulates serotli cells to produce androgen-binding protein, which stimulates spermatogenesis
  • LH promotes testosterone production in males and estrogen production in females
325
Q

Granuloma cells of females are similar to what cells found in males?

A

Serotoli cells

  • Sertoli cells help with spermatogenesis in the seminiferous tubules, activated by FSH
326
Q

Where is testosterone made?

A

Leydig cells

327
Q

Which is not in seminiferous tubules?

A

Leydig cell

  • found adjacent to seminiferous tubules in interesting tissues, regulated by LH
328
Q

Sperm stored/matured in?

A

Epididymis

329
Q

What sustain the corpus luteum after the 1st trimester ?

A

HCG

  • human chorionic gonadotropin made by placenta, allows corpus luteum to maintain high progesterone
330
Q

Immunoglobulin transfer from mother to fetus?

A

IgG through placenta

331
Q

Cell cycle immediately after fertilization?

A

Meiosis II

332
Q

What is not transcriptionally active?

A

Heterochromatin (highly condensed, still zipped up in chromosome)

333
Q

What phase is most variable in duration of the cell cycle?

A

G1

334
Q

What stage is DNA synthesis in the cell cycle?

A

S

335
Q

Histones are synthesis in which phase of the cell cycle?

A

S phase

336
Q

Hepatocytes from what embryonic tissues?

A

Endoderm

337
Q

GI tract, respiratory tract, thyroid, thymus, endocrine glands and organs, auditory system, urinary system, liver, and pancreas

What embryonic tissue?

A

Endoderm

338
Q

Epithelium of skin and nervous tissue

  • what embryonic tissue?
A

Ectoderm

339
Q

Connective tissue, bone, cartilage, blood cells, all muscles (cardiac, smooth, skeletal), body cavities and some cardiovascular and urinary systems

  • what embryonic tissue?
A

Mesoderm

340
Q

Ureter in kidney is from what embryonic tissue?

A

Mesoderm

341
Q

What are symptoms of trisomy 21 (Down syndrome)?

A

Wide neck, flat nose, small mouth

342
Q

Klinefelter syndrome —>

A

XXY

343
Q

Turners syndrome —>

A

XO

344
Q

What is the name of the cellular mass after fertilization but before implantation —>

A

Blastula

345
Q

Which stage of the zygote does implantation on the uterus occur?

A

Blastocyst

346
Q

The ligamentum arteriosum is a remnant of what embryological structure?

A

Fetal left ductus arteriosus
- ductus arteriosus connects the pulmonary artery to the descending aorta to bypass the fetal lungs, doesn’t disappear immediately after birth

347
Q

What goes with ligamentum arteriosum?

A

Left recurrent laryngeal N

348
Q

Ligamentum venosum comes from what?

A

Ductus venosus
- shunts left umbilical vein blood directly to the IVC, bypass liver

-ligamentum teres = remnant of umbilical vein on the liver

349
Q

Structure present in fetal heart that allows blood to pass from right to left atrium?

A

Fossa ovalis (remnant of fetal foramen ovale)

350
Q

Crista terminalis is located on?

A

Right atrium

  • it is the infection between the sinus venosus and the heart in the embryo
351
Q

Which term is the best for a carcinoma that doesn’t perforate basement membrane?

A

Dysplasia

  • dysplasia is non-malignant cellular growth, but may precede malignant changes in the tissue. It is associated with chronic irritation of a tissue, tissue appears somewhat structure less and disorganized and may consist of atypical cells without invasion
352
Q

Most indicative of cancer?

A

Anaplasia

353
Q

Which term describes the lack of differentiation?

A

Anaplasia (found in more malignant tumors)

354
Q

Metaplasia —> reversible replacement of one tissue type with another

A

…

355
Q

Which of the following would you not expect with a neoplasm/ not a characteristics of malignancy?

A

Aplasia

356
Q

Neoplasm differences:

Benign:

  • well differentiated
  • slow growth
  • encapsulated/well circumscribed
  • localized
  • movable

Malignant

  • less differentiated (anaplastic)
  • rapid growth
  • invasion/metastasis
  • immovable
A

…

357
Q

Multiple myeloma

A

Cancer of plasma cells in bone marrow

Punched our radiolusencies

358
Q

Having bence jones protein in urine indicates —>

A

Multiple myeloma

  • bence jones proteins
  • russel bodies (IgE inclusion)
  • punched out appearance
  • increased susceptibility to infection
359
Q

What are the lab results of a person that has prostate cancer?

A
  • increased serum acid phosphatase and increase prostatic specific antigen
  • prostate carcinoma with metastasis to the bone result in increased PTH, high alkaline phosphatase and increase in prostatic specific antigen
360
Q

Man has bony exocytosis with anaplasia glandular epithelium, what it is?

A

Prostate carcinoma which metastasis

361
Q

Most probably cause for prolonged bleeding time in a patient with leukemia

A

Decreased number of blood platelets

  • leukemia is a disease of the reticuloendothelial system involving uncontrolled proliferation of WBC
  • people with leukemia may have thrombocytopenia
362
Q

Reed-Sternberg cells?

A

Hodgkin’s lymphoma

363
Q

In addition to kaposis sarcoma, which other malignant neoplasm is often observed with AIDS?

A

Non-Hodgkin’s lymphoma

  • HIV (retrovirus) is an oncogenic RNA virus
  • non-Hodgkin’s lymphoma are cancers of lymphoid tissue with the involved tissue being enlarged and are accompanied by night sweats and fever
364
Q

Patient has ulcers in the gingiva. Lab values are 1200 WBC, 98% lymphocyte, normal platelet/RBC. What does the patient have?

A

Chronic lymphocytic leukemia (CLL)

  • ALL and CLL have high number of lymphocytes. The leukemia cells survive longer than normal cells and build up, crowding out normal cells in the bone marrow
365
Q

What do you find in the sweat of a person with cystic fibrosis?

A

Increased sodium and chloride

366
Q

Patient with rash on side of face, droopy eye lid, constriction of pupil, what nerve dysfunction?

A

Horners syndrome

  • damage to sympathetic (superior cervical ganglion)
367
Q

Tay Sachs disease is a deficiency in what enzyme

A

Hexosaminidase
- tay Sachs disease (hexosaminidase A deficiency) is an auto-immune autosomal recessive disorder causing deterioration of nerve cells due to accumulation of gangliosides (spinolipid) causing nerve death

368
Q

Sphingomyelin/sphingophospholipid:

Know characteristics
- not responsible for RBC recognition

Sphingomyelin function
- plasma membrane constituent
- nerve tissue constituent (myelin sheath)
- lysosomes
Major constituent
- ceramide and choline, accumulation is neimann-pick disease

A

…

369
Q

What diseases are lysosomal deficiency?

A

Newman-pick, gauchers, tay Sachs

370
Q

Prions affect which organ

A

Brain

371
Q

Mitral valve is messed up, what will you see?

A

Pulmonary edema

372
Q

What does not cause edema?

A

High albumin

Or shock

373
Q

Patient had a stroke. What common artery is occluded?

A

Middle cerebral artery

  • stroke can be caused in infarct in the brain
374
Q

Patient got epidural hemorrhage, which artery was severed?

A

Middle meningeal artery

375
Q

Person has acute hemorrhage, what occurs?

A

Heart rate increased

BP decreases

376
Q

Myocardial infarction —>

A
  • coagulative necrosis = ischemia, blood less, heart, kidney
  • liquefactive necrosis = enzyme digestion, infection (CNS)
  • gangrenous necrosis = large areas (lower extremities, bowel)
  • fat/calcified necrosis = pancreas, breast, etc
377
Q

Which one is autosomal dominant?

A

Gardners syndrome

378
Q

X-linked —> agammaglobulinemia (lack of gamma globulin in the blood causing immune deficiency)

A

…

379
Q

Atelectasis —> deflated/collapsed alveoli (reduction in gas exchange)

A

…

380
Q

What disease blocks acetylcholine receptors at NMJ?

A

Myasthenia gravis

381
Q

What tumor is associated with myasthenia gravis?

A

Thymoma

Tumor in the thymus gland, t-cell maturation

382
Q

What would a tumor of the anterior pituitary cause?

A

Affected ACTH specifically

383
Q

Excessive secretion of ACTH causes what syndrome?

A

Cushing’s syndrome

384
Q

Acromegaly as a result of a tumor of what —>

A

Anterior pituitary (causing high levels of growth hormone)

385
Q

Diabetes insipidus

A

Lack of ADH

386
Q

How would you describe diabetes type 1?

A

Autoimmune and islet cells appear degenerated

387
Q

What causes microanginema in diabetics?

A

Damage to small capillaries

388
Q

What is responsible for polyuria in diabetes?

A

Capacity of the kidneys to reabsorbed glucose is surpassed, glucose is lost in the urine alone with water and electrolytes

389
Q

Neurofibromatosis is characterized by?

A

Multiple large pigmented skin lesions

- cafe-au-lait, light brown spots on the skin

390
Q

Gastroesophageal reflex disease (GERD) - Barrett’s esophagus and is a premalignant metaplasia?

A

Adenocarcinoma

  • replacement of normal epithleium lining of the esophagus with simple columnar epithelium and goblet cells (which are found in lower GI)
391
Q

Where in the GI tract are you most likely to see achalasia?

A

Esophagus

- affects ability to perform peristalsis, nerve related

392
Q

Acute pyelonephritis

A
  • Infection of the RENAL PELVIS (kidney and ureters)
  • usually E.coli most often from a UTI or vesicoureteral reflux
  • active infection and abscess can develop
  • renal pelvis filled with pus (PMNs)
393
Q

Chronic pyelonephritis

A
  • implies recurrent kidney infections and can result in scarring of the renal parenchyma and impaired function
  • especially due to obstruction (usually e.coli infection of the renal pelvis)
394
Q

Acute glomerulonephritis

A
  • inflammation of the glomeruli of the kidney
  • present with Hematuria and proteinuria or acute or chronic renal failure
  • primary cause are intrinsic to the kidney
395
Q

What GI disease is characterized by non-caseating granulomas?

A

Crohn’s disease

396
Q

GI carcinoma/malignancy caused by villous adenoma

A

…

397
Q

What part of the colon has the most chance of an adenocarcinoma?

A

Rectum

  • rectum/sigmoid: associated with villus adenoma, such as ulcerative colitis, Crohn’s disease, Gardner’s syndrome and familial polyposis (colorectal: villous polyps)
398
Q

Positive anti-nuclear antibody test (ANA) and positive ant-smith antibody is specific for disease?

A

Lupus SLE

  • RH+ factor suggested that the patient has SLE, also has joint problems (RA)
399
Q

Which one is not an autoimmune disease?

  • arthus reaction
  • erythroblastosis fetalis
  • SLE
  • Multiple sclerosis
A

Erythroblastosis fetalis —> mom = rh (+)/baby rh (-), causes hemolytic anemia

400
Q

Sick cell anemia HbS what happens? (HbS = hemoglobin S, abnormal beta-globin)

  • agglutination and oxygenation
  • agglutination and deoxygenation
  • deglutinaton and deoxygenation
  • deglutinatoin and oxygenation
A

Agglutination and deoxygenation

401
Q

Sickle cell anemia —> what type of mutation ?

A

Missense mutation (single point mutation)

402
Q

Pernicious anemia results from what?

A

Lack of vitamin B12

403
Q

Megaloblastic anemia is due to a deficiency of?

A

Folic acid (B9)

404
Q

Most common type of anemia?

A

Iron deficiency anemia

405
Q

Chronic ulcer with chronic slow blood loss; what is the most likely complication?

A

Iron deficiency anemia

406
Q

Chronic blood loss from duodenum leads to —>

A

Microcytic and hypochromatic anemia (iron deficiency anemia)

407
Q

Chronic bleeding peptic ulcer, what is a sign/symptom?

A

Fecal occult (blood in stool)

408
Q

What does NOT cause cancer —> anthracosis

A

Anthracosis is caused by chronic exposure to coal, polluted air or cigarettes.

Black pigment is deposited in lung parenchyma

409
Q

Most common cancer of the lung —>

A

Adenocarcinoma

410
Q

Most common site in the lung to have squamous cell carcinoma?

A

Center of the lung

411
Q

Patient had dysphasia, dysphagia, weight loss, long term heavy smoker

A

Laryngeal carcinoma

412
Q

Lacrimal gland innervated by —>

A

Superior salivatory nucleus

- it synapses on the pterygopalatine ganglion

413
Q

Pain from which tract?

A

Lateral spinothalamic tract

414
Q

Patient is given topical to relieve what fibers:

A

A delta fibers

- NT for A delta fibers = glutamate

415
Q

Sensation on the face and teeth involved what nucleus?

A

Main sensory nucleus of V

416
Q

What are the primary sensory neurons of termination involved in pain from the maxillary 2nd molar?

A

Spinal nucleus of V

417
Q

Mesencephalic nucleus

A

Propioception of face, jaw-jerk reflex

418
Q

Main sensory nucleus

A

Light touch

419
Q

Spinal trigeminal nucleus

A

Pain and temperature

420
Q

Which subnucleus of the spinal nucleus of V is responsible for pain sensation

A

Pars interpolaris

421
Q

Subnucleus oralis

A
  • subnucleus oralis = transmission of discriminative (fine) tactile sense from the orofacial region
422
Q

Subnucleus Caudalis

A

Transmission of nocicpetion and thermal sensations from the head

423
Q

Pain from face goes to?

A

VPM = ventral posteromedially nucleus

Body pain = ventral posterolateral nucleus

424
Q

Branchiomeric nerves come from where?

A

CN 5, 7, 9, 10

425
Q

What nerve is involved in blinking?

A

CN V1 and CN7

426
Q

What nerve innervates the skin above the upper lip?

A

Infraorbital N

427
Q

Patient complains about burning sensation in the mandibular anterior?

A

Mental nerve

428
Q

What innervates the posterior hard palate? Anterior hard palate?

A

Posterior hard palate = greater palatine nerve

Anterior hard palate = nasopalatine N

429
Q

Which nerve innervate soft palate?

A

Lesser palatine nerve (CN V2)

430
Q

Which is part of the cavernous sinus?

A

CN 3, 4, 6, V1, V2 (mnemonic = O TOM CAT)

431
Q

What parasympathetic nerve runs through the foramen lacerum?

A

Greater petrosal nerve

432
Q

What foramen transmits preganglionic parasympathetic fibers?

A
  • foramen ovale for the lesser petrosal nerve
433
Q

Before synapsing in the submandibular ganglion, pre-parasympathetic travel to which nerve?

A

Chorda tympani

434
Q

What action of the lingual nerve stays with the nerve through its course?

A

Sensory to anterior 2/3 of tongue

435
Q

Which nerve does not transmit taste fibers from the tongue?

  • V
  • VII
  • X
A

V

436
Q

What is the position of the lingual nerve in respect to the inferior alveolar nerve?

A

Anterior and medial

437
Q

What ganglion does the postsympathetic for the submandibular ganglion?

A

Superior cervical ganglion

438
Q

Intraoral approach to get to the submandibular ganglion —>

A

Cut through mucous membrane ONLY

439
Q

If someone has motor loss underneath their right zygomatic, what nerve is damaged?

A

CN7 when existing the stylomastoid foramen

440
Q

If you cut the nerve for the stylomastoid foramen, what do you lose innervation to?

A

Orbicularis muscle (oculus and oris)

441
Q

CN 7 and 8 goes through?

A

Internal acoustic meatus

442
Q

What nerve brings preganglionic parasympathetic nerve fibers to the otic ganglion, then eventually to the parotid gland?

A

Lesser petrosal nerve through CN 9

443
Q

What goes between the superior pharyngeal constrictor and middle pharyngeal constrictor?

A
  • stylopharyngeus muscle

- glossopharyngeal nerve

444
Q

What runs between the middle and inferior constrictor muscles?

A

Internal laryngeal branch of the superior laryngeal nerve

Superior laryngeal artery from the superior thyroid artery

445
Q

What nerve goes between the palatoglossus and palatopharyngeus ?

A

Tonsillitis branch of CN9

446
Q

Circumvallate papilla are innervated by what nerve?

A

CN9

447
Q

What cranial nerve innervates levator Levi palatini?

A

CN X (pharyngeal branch)

448
Q

What nerve does not come out of the jugular foramen ?

  • CN9
  • CN10
  • CN11
  • CN12
A

CN 12 — goes through hypoglossal canal

449
Q

Gag reflex —> sensory limb (afferent) is mediated by?

A

CN 9

Motor efferent = CN 10

450
Q

What is not innervated by the hypoglossal nerve?

A

Palatoglossal — innervated by CN X

451
Q

Muscles inneravated by ansa cervicalis (C1-C3) include?

A

Infrahyoid muscles

452
Q

What is the primary sensory relay station of the brain (conduit)?

A

Thalamus

453
Q

What part of the brain controls hunger?

A

Hypothalamus

454
Q

The swallowing center: 2nd stage of deglutinatoin is located?

A

Medulla

455
Q

Sectioning of infundibular stalk of hypothalamus with normal hypophyseal tract leads to a decrease in what hormones?

A

ADH

Infundibular stalk = connection between hypothalamus and posterior pituitary

456
Q

What divides the diencephalon into 2?

A

3rd ventricle

457
Q

What lines the ventricle of the brain?

A

Ependymal cells

458
Q

What makes up the blood-brain barrier?

A

Astroytes, endothelial cells in capillaries connected by tight junction, water/lipids pass or selective transport

459
Q

Largest paranasal sinus?

A

Maxillary sinus

460
Q

Where does the maxillary sinus drain into?

A

Semilunar hiatus of the middle meatus

461
Q

Where does the nasolacrimal drain into?

A

Inferior concha

462
Q

Right maxillary sinus is infected, where does it spread to next?

A

Right ethmoid sinus

463
Q

What is the outer edge of the lateral wall of the ethmoid sinus?frontal

A

Orbit

464
Q

Anterior cerebral artery supplies what lobes?

A

Frontal and parietal lobes (medial surfaces of both)

465
Q

Arachnoid villa and granulation transport CSF from subarachnoid space to venous system

A

…

466
Q

Increase in CSF pressure causes what?

A

Brain herniation

467
Q

Vertebral artery pass through what foramen?

A

Magnum

468
Q

What is not part of the circle of willis?

A

Basilar artery

469
Q

Branches of the maxillary artery go through all of the following foramen except?

A

Foramen lacerum

470
Q

Maxillary vein and superior temporal veins drain into?

A

Retromandibular vein

471
Q

Each of the following structures lie between the hyoglossus and mylohyoid muscle expect one? Lingual artery (passes deep to hyoglossus m)

A

…

472
Q

What makes up the sphenoid bone?

A

Body
2 greater wings
2 lesser wings
Pterygoid process

473
Q

What forms the superior orbital fissure?

A

Greater and lesser wing of the sphenoid

474
Q

Foramen ovale is located in?

A

Greater wing of the sphenoid

475
Q

Medial border of the infratemporal fossa?

A

pterygomaxillary fissure

Lateral = ramus of mandible 
Medial = lateral pterygoid plate of the sphenoid
Anterior = posterior surface of the maxilla 
Posterior = carotid sheath 
Floor = medial pterygoid muscle 
Roof = greater wing of the sphenoid bone
476
Q

Guy shot in the back of the head, bullet exits above eyebrows. Which bone is least likely to get damaged?

A

Maxillary

477
Q

All of the following pass through th medial and lateral pterygoid except?

A

Buccal nerve — passes through lateral pterygoid heads

478
Q

What is anterior to the pharyngeal tonsils?

A

Palatoglossal fold

479
Q

Where is synovial fluid produced?

A

Internal synovial layer of the fibrous capsule (joint capsule)

480
Q

What cells are responsible for production of synovial fluid?

A

Type B synoviocytes

481
Q

What organ is found by the right kidney?

A

Colon

482
Q

All of the following are in the kidney medulla EXCEPT?

A

Glomerulus (cortex)

483
Q

In a healthy kidney, what does not get passed through?

A

Albumin and glucose

Clearance = 0mg/mL

484
Q

Most kidney reabsorption and ATP used in the nephron of the kidney?

A

Proximal convoluted tubule

- contain truncated pyramidal cells

485
Q

Where is the highest osmolality?

A

Loop of henle in the medulla

486
Q

Macula densa - location and function?

A
  • distal convoluted tubule
  • they sense NaCl concentration in thick ascending limb, can signal afferent arterioles to vasodilator and increase renin released from JG complex
487
Q

What would increase GFR?

A

Dilation of afferent arterioles in kidney

488
Q

Kidney substance filtered and secreted. The clearance rate is

  • = to inulin
  • greater inulin
  • less inulin
A

Greater inulin

489
Q

What is the para-aminohippurate (PAH) test used for?

A

Measure renal plasma flow

  • PAH —> freely filtered and secreted by the kidney = renal plasma flow
490
Q

Aldosterone is produced in the zona glomerulosa and affected DCT

A

…

491
Q

If you inhibit ACE, what hormone is decreased?

A

Aldosterone

492
Q

ADH is produced where?

A

Supraoptic nucleus of hypothalamus

493
Q

ADH increases water permeability/resorption at DCT by inserts aquaporin-2 channels into the DCT and collecting duct epithelial cells

A

…

494
Q

Deficiency of ADH —>

A

Dilute urine

495
Q

What are the primary stones in gout?

A

Urate crystals (uric acid)

496
Q

What do you want to inhibit in a person with gout?

A

Xanthine oxidase

- uric acid is an end product of purine metabolism, specifically through xanthine metabolism

497
Q

You could decrease plasma osmolality by injecting serum?

A

ADH

498
Q

What type of enzyme is fumerase?

A

Isoenzyme

499
Q

Ornithine is an intermediate of the urea cycle in mitochondria?

A

…

500
Q

Fumerase/fumarate connects urea cycle through?

A

TCA cycle

- hydration reaction

501
Q

In the urea cycle, where does the nitrogen come from?

A

Ammonia and aspartate

502
Q

What is an intermediate in the urea and precursor for ornithine?

A

Arginine

503
Q

What is around a myofibril?

A

Endomysium - surrounds a myofibril

Note:

  • epimysium: around entire muscle
  • perimysium: surrounds the muscle bundles (fascicles)
504
Q

What is the perimysium?

A

Surrounds the muscle bundles (fascicles)

505
Q

What is the epimysium?

A

Surrounds the entire muscle

506
Q

During muscle contraction when an AP reaches the NMJ, what is released?

A

Acetylcholine is released

507
Q

What is the function of calmodulin

A

Regulates smooth muscle contraction

-calmodulin activates the MLC-kinase: contraction is SLOW and prolonged

508
Q

When does cardiac muscles start to contract?

A

When there is an influx of calcium from the outside

509
Q

Parasympathetic nerves from vagus nerve have what effect on the heart?

A

LOWERS heart rate

  • note: the parasympathetic nerves from the vagus lowers heart RATE
510
Q

Regulation of the contraction in smooth muscle?

A

Calmodulin

511
Q

When calcium binds to calmodulin, it activates what?

A

MLC-kinase

512
Q

What controls the ATPase activity for smooth muscle?

A

Myosin

  • controls the ATPase activity
  • no t-tubules, poor SR, no troponin — so myosin is always ready to react and can hold long contractions
513
Q

What modulates smooth muscle action potential?

A

Acetylcholine

514
Q

What does acetylcholine cause the arrector pili to do?

A

Increase calcium entering the cell to erects the muscle

— if there is an increase in intracellular calcium —> greater activation of contractile proteins mult

515
Q

The skeletal muscles are what type of cells?

A

Multinucleated

516
Q

How many nuclei do cardiac and smooth muscle have?

A

Both have only 1 while skeletal has multiple

517
Q

Direct source of energy for skeletal muscle?

A

ATP —> ADP + phosphate

518
Q

How does ATP get transported out of the mitochondrial membrane?

A

ATP-ADP translocase ?

519
Q

Sarcolemma/sarcomere is only in what type of muscle?

A

Striated muscles

  • only skeletal and cardiac muscles are striated
520
Q

During isotonic muscle contraction, which bands would get shorter?

A

H and I band gets shorter

Note
- H band = light band that bisects the A band, shortens during contraction

  • I band = light band containing actin, shortens during contraction
521
Q

Increasing the load of muscles does what to velocity ?

A

Slows it down

522
Q

Gamma efferent motor fibers (gamma-motor) function?

A

Regulate change in muscle length and tone for stretch receptors (muscle spindles)

523
Q

Inorganic phosphate is released from ADP in myosin for?

A

POWERSTROKE

- myosin head pivots, pulling the actin filament toward the center (M-line)

524
Q

What is responsible for dissociation of phosphate group during muscle contraction?

A

Cocking action

  • cocking of the myosin head occurs, an ATP is plait into ADP + P
525
Q

Myosin has ATPase action that turns ATP —> ADP + phosphate. Release of the phosphate group causes the

A

Myosin power stroke

526
Q

Which one is not a glycoprotein hormone?

  • GH
  • Mucins
  • Immunoglobulins
  • TSH
  • HCG
A

GH (somatrophin, peptide hormone) —> inhibits insulin

HCG and TSH is a glycoprotein hormone

527
Q

Somatmedins function?

A

Promote cell growth

  • somatomedins aka somatotropin or GH found in the anterior pituitary
528
Q

alpha cells of the pancreas secrete what? Beta cells of the pancreas secrete what?

A 
Alpha = glucagon 
Beta = insulin
529
Q

Growth hormone stimulated chondrogenesis indirectly by using what?

A

Somatomedins

- they are a group of hormones that promote cell growth and division in response to stimulation by GH

530
Q

Vitamin K

A

Blood clotting

531
Q

What is biotin used for?

A

Pyruvate carboxylase, acetyl CoA (cofactor)

  • any carboxylase needs biotin cofactor
532
Q

What reaction requires thiamine (B1)?

A

Pyruvate decarboxylase

533
Q

B1 is a coenzyme for?

A

Decarboxylase reactions

534
Q

B2 is a coenzyme for?

A

FAD and FMN

535
Q

B3 is a coenzyme for?

A

B3 = niacin

Coenzyme for NAD
- deficiency = pellagra

536
Q

B6 coenzyme for?

A

Transamination reaction (amino acid and nucleic acid metabolism)

537
Q

What is the cofactor involved in transamination?

A

PLP vitamin B6

538
Q

Deficiency of B6

A

Peripheral neuropathy and dermatitis

539
Q

B12 is needed for what?

A

intrinsic factor absorption (cobalamin)

540
Q

Lumbar puncture

A

L3/L4

541
Q

Phosphatidylcholine

A

Lecithin

542
Q

Which does NOT cause vasoconstriction?

A

Histamine

543
Q

Muscarinic AcH receptors effects?

A

Sweating and salivation

544
Q

What hormone is responsible for milk secretion postpartum?

A

Oxytocin

  • oxytocin ejects breast milk produced in the paraventricular nucleus of the hypothalamus and stored in the posterior pituitary
545
Q

Advantage of using dry heat sterilization over autoclaving?

A

No dulling, it keeps instruments sharp

546
Q

Best method to sterilize instruments without corrosion?

A

Dry heat

547
Q

Ethylene oxide for sterilization is good for?

A

Heat labile tools

548
Q

If unable to use heat, what method should be used to sterilize instruments?

A

Ethylene oxide

549
Q

Whats a way to measure human basal energy?

A

Temperature

550
Q

What enzymes are not involved in making cDNA?

A
  • telomerase

The enzymes used to make cDNA are:

  • reverse transcriptase
  • RNA-dependent DNA-polymerase
551
Q

DNA fingerprinting?

A

Restriction site

552
Q

Which of the following types of blotting can be used to ID DNA restriction fragments?

A

Southern blotting
- restriction endonuclease are used to cut DNA

Northern = RNA
Southern = DNA
Western = proteins
553
Q

What are the 5 steps of PCR? What is PCR used for?

A
  1. Initialization
  2. Denature
  3. Annealing
  4. Extension
  5. Final elongation

Used to amplify and make more copies of DNA

554
Q

What is PCR step initialization?

A
  • DNA polymerase that need heat activation
555
Q

What is the PCR step denaturing?

A

Heat reaction for 20-30 seconds so DNA melts, disrupts H-bonds to yield ssDNA

556
Q

What is the PCR step annealing?

A

Reaction T is lowered for hybridization of primer to strain

557
Q

What is the PCR step extension?e

A

DNA polymerase added to synthesize new DNA complement, x2 DNA

558
Q

What is the PCR step final elongation?isoelectric put

A

Ensure all DNA strands have elongated

559
Q

When does pH = pKa?

A

Isoelectric point

560
Q

Mechanism of fluoride?

A

Enolase inhibitor (inhibits glycolysis)

561
Q

Regulation of F —> bone/urine

A

…

562
Q

What innervates the erector spinae muscles?

A

Dorsal branch of the spinal N

563
Q

Which lymph nodes are along the external vein?

A

Deep cervical lymph nodes

564
Q

Which structure has both afferent and efferent vessels?

A

Lymph nodes

565
Q

Tetrodotoxin (pufferfish) is a channel blocker for voltage gated Na channels, what happens to action potential?

A

NO action potential

566
Q

Which viruses do NOT have a latent phase?

A

Rhinovirus and poliovirus

567
Q

Which viruses do have a latent phase?

A

EBV, HSV-1 and 2, VZV, CMV, HEH, CV all herpes

568
Q

Herpes virus is the only virus that gets it cell wall from?

A

Host nuclear membrane

Herpes virus

  • dsDNA
  • enveloped
  • nuclear membrane
  • icosahedral
  • nucleocapsid
  • establishes latent infection
569
Q

CMV is associated with?

  • salivary glands
  • intestinal glands
  • chicken pox
  • mononucleosis
A

Salivary gland

570
Q

Which diseases cross the placenta?

A

TORCHES

571
Q

EBV and varicella zoster are members of?

A

Herpesviridae

EBV can cause burkitts lymphoma, nasopharyngeal carcinoma, b-cell lymphoma, hairy leukoplakia (lateral borders of tongue), infectious mononucleosis

572
Q

What causes influenza to change year to year?

A

Antigenic capsule (gene reassortment)

  • influenza virus is an orthomyxovirus with outer envelope has spikes (H and N) for attachment to host cells
  • treatment with amantidine —> inhibits viral attachment and uncoating
  • the main mode of prevention is the vaccine, which consists of killed influenza A and B virus
573
Q

What are the virulence factors of neisseria meningitis?

A

Endotoxin, LPS (gram negative)

N. Meningitis is an ENDOTOXIN (LPS) WATERHOUSE FRIDERISCHEN SYNDROME

574
Q

What is not associated with N.meningitis?

  • endotoxin
  • capsule
  • enterovirus
  • aerobic
A

Enterovirus

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