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1
Q

Crescent with no Ig or complement deposits

A

Pauci immune RPGN

elevated ANCA

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2
Q

Male bilateral gynecomastia sparse facial hair firm small testes

A

Klinefelter XXY

Tx testosterone

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3
Q

No thymus and severe bacterial/ viral infection and chronic diarrhea and mucocutaneous candidiasis

A

SCID

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4
Q

Organisms that inactivate EF2 via ribsoylation –> stop host protein synthesis

A

Diphtheria and pseudomonas

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5
Q

Tx unstable patient with bronchospasm

A

Propofol- GABA agonist
Etomidate- GABA agonist
Ketamine- preserve respiratory drive, increase release of catecholamines –> bronchodilation

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6
Q

Triamterone

A

ENaC inhibitor –> K+ secretion

used with thiazides and loop diuretics

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7
Q

Different mutation at same genetic locus –> similar phenotype

A

allelic heterogeneity

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8
Q

Acute dystonic reaction

A

Antipsych meds

D2 antagonists

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9
Q

Selective muscarinic antagonists

A

glycopyrrolate
hyocyamine
propantheline

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10
Q

Furosemide electrolytes

A

High bicarb
low Cl-
increase urine Na+ and K+

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11
Q

Asymptomatic birth, lethargy., poor feeding, protruding tongue, constipation, dry skin

A

Congenital hypothryroidism (high TSH and low Free T4)

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12
Q

Ejection click crescendo decrescendo, wide splitting of S2

A

pulmonic stenosis usually congenital defect

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13
Q

Initial management of transposition of great vessels

A

Prostaglandin to keep PDA open

atrial septostomy to maintain PFO

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14
Q

Subfalcine herniation

A

compress ACA

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15
Q

ABPA

A

Hx of asthma CF
CXR bronchiectasis
increase IgE, eosinophilia

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16
Q

Gouty arthritis therapy what cell inhibited

A

Neutrophils

mutation in PRPP synthetase gene

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17
Q

Epidermal hyperplasia, thick stratum corneum, papilloma, cytoplasmic vacuolization

A

cutaneous warts

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18
Q

Bactrim side effects

A

hyperkalemia via block epithelial Na+ channel in DCT and collecting duct
rash nausea and decrease folate

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19
Q

Bleomycin MOA and tox

A

induce ROS

cause pulm fibrosis

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20
Q

Chemo –> hematuria and suprapubic pain

A

hemorrhagic cystitis via cyclophosphamide –> increase acrolein –> cystitis
prevent with mesna

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21
Q

Increase allopurinol activity

A

Azathioprine

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22
Q

Specific grave disease symptom

A

skin thickening and induration over shin

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23
Q

Pneumonia, brain abscess and cutaneous, branching filaments

A

Nocardiosis

partially acid fast

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24
Q

Drug induced SLE

A

Hydralazine
isonazid
Procainamide

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25
Q

Polymyositis Ab

A

Anti Jo 1 (anti histidyl tRNA synthetase)

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26
Q

Bacteria resistant to vanco, collistin, nystatin, trimethoprim

A

Neisseria

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27
Q

COPD path

A

epithelial dysfunction –> Macrophage and neurtophils –> cytokines and protease elastase –> mucus hypersecretion and alveoli destruction

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28
Q

Fungi develop in old lung cavities

A

aspergillus

causes hemoptysis

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29
Q

Wrinkles

A

UVA –> photoaging

increase ROS –> increase cytokines –> decrease collagen and fibril and increase MMP

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30
Q

Garlic breath, vomit, watery diarrhea, stock and glove neuropathy

A

Arsenic poisoning

Tx Dimercaprol

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31
Q

Meds associated with gout

A

thiazide, aspirin, ACEi, cyclosporin

Tumor lysis syndrome

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32
Q

Tx distal polyneuropathy

A

gabapentin, TCA (duloxetine), capsaicin cream

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33
Q

Meds for open angle glaucoma

A 
muscarinic ag
PG agoinst
B blockers
a2 agonist
CAi
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34
Q

exudative pleural effusion

A

protein ratio >.5

LDH ratio >.6, more that 2/3 upper limit of normal

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35
Q

NE IV drip –> vein becomes cold, hard and pale

A

NE extravasation

Tx phentolamine

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36
Q

IL2

A

Th differentiation
Activate monocytes and NK cells
T cell growth –> IGNy
B cell stimulate division

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37
Q

Alcoholic liver disease effect on spleen

A

expansion of red pulp

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38
Q

Low C1 esterase inhibitor contradindications

A

ACEi

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39
Q

HIV global HA, malaise, fever

indio stain –> spherical yeast with thick capsule

A

crypto

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40
Q

Treat insomnia in elderly

A

Ramelteon

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41
Q

SIBO –> increase in

A

folate and vitamin k

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42
Q

adverse of ploglitazone

A

weight game and edema

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43
Q

strongyloides dx

A

rhabditiform larvae in stool

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44
Q

drug resistant seizures, epileptic foci in temporal lobe

Atrophy of hippocampal neurons with reactive gliosis, astrocyte prolferation

A

Temporal lobe epilepsy via hippocampal sclerosis

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45
Q

Risk of injury during thyroidectomy

A

External branch of superior laryngeal N

innervates crycothyroid M –> hoarse, deep voice

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46
Q

Cromolyn

A

inhibit mast cell degranulation and prevent relase of preformed chemical mediators
Tx asthma

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47
Q

Adenoma mutation sequence

A

decrease APC increase B catenin –> increase KRAS –> decrease p53 –> cancer

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48
Q

decrease platelet post heparin

A

HIT

decrease platelet via platelet removed by splenic macrophages

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49
Q

macrolide in diabetic gastropareisis

A

increase activation of motilin receptor

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50
Q

ADPKD and HA

A

berry aneurysm rupture

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51
Q

pruritic papulopustular rash
vacation
oxidase + Gram - rod

A

pseudomonas in pool water

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52
Q

lytic lesion proximal tibia with soft tissue swelling

A

osteosarcoma spindle shaped tumor

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53
Q

UTI post GU procedure

Gram + cocci

A

enterococcus

gamma hemolysis

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54
Q

cyclophosphamide MOA and tox

A

cross link DNA –> inhibit DNA synthesis

Tox hemorrhagic cystitis, bladder cancer

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55
Q

obturator N

A

adduct thigh

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56
Q

malignant melanoma with decrase integrin –> poor adhesion to what

A

fibronectin

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57
Q

PE blood gas

A

met alk
decrease PaCO2, PaO2
decrease serum HCO3

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58
Q

osteonecrosis artery of hip

A

medial circumflex femoral A

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59
Q

baby oliguria and flank masses increase Cr

A

ARPKD

complications = HTN congenital hepatic fibrosis

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60
Q

Translocation of chr 9 and 22 –> increase neutrophils, basophils and decrease RBCs

A 
CML
Tx Imatinib (TK1 inhibitor)
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61
Q

decrease MCV, erythrocyte basophilic stippling anemia

A

sideroblastic anemia

vitamin B6 deficiency

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62
Q

High free T4

low TSH and TBG undetectable

A

exogenous

leads to atrophy of thyroid follicles

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63
Q

Hemorrhate, splenomegaly and increase Hb and Hct

64
Q

RA dyspnea honeycomb

A

interstitial lung disease

decrease FRC, VC, TLC

65
Q

enlarged coronary sinus

A

increase right sided heart pressure

secondary to pulm HTN

66
Q

Leuprolide

A

continuous GnRH agonist

decrease fibroid size

67
Q

Mild cough rhinitis –> vomiting with cough

A

Bordatella pertusis

68
Q

Migraine therapy

A

triptan NSAID antiemetics ergotamne

anticonvulsant, BB, antidepressant

69
Q

Large VSD intracardial pressure

A

Normal RA

increase RV, LA, LV

70
Q

Mild hemophilia A drug given during dental procedure

A

Desmopessin

71
Q

Desquamation in neck axilla inguinal folds perioral

exfoliative

A

Staph scalded skin syndrome

cleanes desmoglein in desmosomes

72
Q

Dehydration lab values

A 
Prerenal 
BUN:Cr >20
FeNa <1
Urine Na <10
urine osm >500
73
Q

osteomalacia is decrease mineralization where

74
Q

High fever rhinosinusitis

A

H flu

Tx: amoxicillin and clavulonate

75
Q

Pregnant mild anemia

A

due to hemodilution –> increase plasma volume to RBC mass
decrease platelet production and increase platelet consumption
increase thromboembolic events

76
Q

Hypoxia effect on pump circulation

A

decrease O2 –> increase VGKC –> increase VGCC –> increase Ca2+ –> contraction –> pulm edema

77
Q

starry sky
t (8:14)
mandible mass

A

Burkitt

cMYC- IGH

78
Q

sudan black, MPO, Auer rods, increase blast cells

A

APML –> can lead to DIC

79
Q

giant cell arteritis inflammatory infiltrate

A

CD4 T cells and macrophages
increase IL6
Tx tocilizumab

80
Q

low vitamin K

A

increase PT and PTT

normal bleeding time

81
Q

encephalopathy, abdominal pain, HA, microcytic anemia, increase protoporphyrin and ALA

A

lead poisoning
inhibit ALAD and ferrochelatase
sideroblastic anemia

82
Q

growth defect glucosuria proteinuria phosphaturia low K+ high Cl- NAGMA

A

Fanconi defect in PCT

83
Q

Risk factors of gastric adenocarcinoma

A 
increase salt
processed meat
H pylori
Autoimmune gastrits
obese
84
Q

rhinorrhea SOB cough after aspirin started

A

Tx leukotriene receptor antag (montelukast)

85
Q

Fever non productive cought rhinorrhea myalgia HA low WBC, increase D dimer, increased ferritin normal procalcitonin ground glass opacity

A

COVID
ssRNA postive
crown like appearance

86
Q

Acute onset chest pain worse with inspiration tachy and decreased breath sounds

A

PE –> resp alkalosis without compensation
decrease O2 and CO2
normal HCO3

87
Q

arrhythmia drug that increase QT but lower incidence of torsades

A 
amiodarone
class 3
88
Q

sheets of uniform small round cells separated with fibrous septae scant cytoplasm early metastasis to lung and bones

A

Ewing sarcoma

89
Q

DKA effect on NH4

A

increase production and secretion of NH4 in PCT

90
Q

how does alcohol prevent gluconeogenesis

A

decrease NAD+

91
Q

Fever confuion HA photophobia CNS palsy

CSF high protein, neutrophils, motile trophozite

A

Naegleria fowler

Tx amphotericin B

92
Q

worsen asthma with bronchoilators

A

status asthmaticus –> eosinophils in wall of airways with mucus plugs in lumen
Charcot leyden crystals and Curshmann spirals

93
Q

general LAD and t(14:18)

A

NHL

increase BCL2

94
Q

T12 diaphragm

A

Aorta and thoracic duct

95
Q

intraluminal thrombi in arteries and veins sparing vessel wall extend contiguously

A

throboangiitis obliterans

96
Q

RECENT onset kidney stones LAD hepatosplenomegaly CD3

A

T cell lymhoma/leukemia

via HTLV 1 –> increase tax protein –> increase NFKB –> increase growth and survival

97
Q

tear drop cells

A

primary myelofibrosis

no bone marrow for hematopoiesis so use spleen

98
Q

blowing holosystolic murmur over cardiac apex with radiation to axilla

A

mitral regurgitation

Rheumatic fever

99
Q

Jaundice via hemolytic anemia, splenomegaly increase bilirubin increase MHCH

A

Hereditary spherocytosis

100
Q

Cisplatin MOA and tox

A

cross link DNA –> inhibit DNA synthesis

Nephrotox ototox, peripheral neuropathy, decrease all electrolytes

101
Q

urinary eosinophils pyuria hematuria WBC casts

Abx use, PPI, NSAIDS

102
Q

coin lesion popcorn calcification islands of cartilage in lung

A

lung hamartoma

103
Q

test performed before etanercept use

104
Q

decrescendo diastolic, treponemal Ab, mediastinal widen

A

tertiary syphilis vasa vasorum endoarteritis

105
Q

No change in cortisol in low dose dexamethasone abut decrease in cortisol in high dose

A

pituitary adenoma

106
Q

Envelope stones

A

calcium oxalate

107
Q

coffin lid stone

108
Q

rhomboid rosette stone

109
Q

ST elevation V1-3

110
Q

ST elevation V3-4

A

LAD Anterior

111
Q

ST elevation 1, aVL, V5 V6

A

Lateral

Lateral Circumflex

112
Q

ST elevation II, III, aVF

A

Inferior

Right coronary A

113
Q

St elevation V1-3, V7-V9

A

Posterior

Posterior descending

114
Q

Precocious puberty
Cafe au lait
Fibrous dysplasia of bone

A

McCune Albright

115
Q

Light touch, vibration, propioception

A

posterior column

116
Q

pain, temperature, crude touch

A

spinothalamic tract

117
Q

Tx for schistosomiasis

A

praziquantel
causes vaculolation of the tegument
spastic paralysis

118
Q

Perceive right half of visual field but not left half in both eyes

A

Lesion in right optic tract

119
Q

CN III palsy, compres contra corticospinal tract (hemiparesis)

A

Uncal herniation

120
Q

Bilateral ovarian tumor
Acanthosis nigricans
mucin filled signet ring cancer cells

A

Krukenberg tumor

metastasis from gastric adenocarcinoma

121
Q

Long thoracic N innervation

122
Q

BB warning for hydroxyurea

A

myelosuppression

123
Q

Techoic acid

A

gram positive bacteria

124
Q

open mouth

A

lateral pterygoid M

125
Q

Mydriasis, confusion, widened QRS

A

TCA overdose

126
Q

Gout synovial fluid

A

cloudy

moderately elevated WBC and normal glucose

127
Q

Autism associated with

A

Fragile X syndrome

128
Q

Post MI Cardiac tamponade due to

A

LV rupture of free wall

129
Q

Most common intestinal roundworm parasites in the world

A

Ascaris lumbricoides

130
Q

Rabies virus

A

bullet shaped ssRNA

131
Q

T(x) night terrors

132
Q

Diabetic meds that causes pancreatitis

A

GLP1 agonist

133
Q

Caput medusae

A

paraumbilical veins and superficial epigastric vein

134
Q

Anthrax Treatment

A

Penicillin, doxycycline, ciprofloxacin

135
Q

Bleeding from what artery when laparoscopic gastric band erodes posteriorly

A

L gastric A

136
Q

Drug resistant osteomyelitis

A

Pasturella multocida

137
Q

OA compression treats what

A

Vagus and hypoglossal N problems

138
Q

systolic murmur in crescendo-decrescendo from left sternal border to the apex radiate to suprasternal notch

A

hypertrophic cardiomyopathy

139
Q

Daycare diarrhea

A

Rotavirus ds RNA segmented

140
Q

Drug that causes placental abruption

A

cocaine

presynaptic blockade of NT reuptake pumps

141
Q

Erb’s Duchenne

A

medially rotated, pronated

142
Q

most reliable lab test to predict mortality in acute pancreatitis

A

elevated BUN

143
Q

hemorrhoids and portal hypertension

A

Superior rectal V

144
Q

Adnexal mass and ascites

A

ovarian fibromas

145
Q

Between lateral ventricle to third ventricle

A

Foramen of Monro

146
Q

How many half lives to achieve steady state

147
Q

Exudative effusion

A

infection, malignancy, PE, collagen vascular disease

148
Q

For flexion SD apply pressure on what area during inhalation

149
Q

Diphtheria

A

gram positive, non motile rod shaped bacteria

150
Q

Crypto meningitis treatment

A

amphotericin B

151
Q

GERD metaplasia

A

glandular metaplasia

152
Q

Muscle that protects brachial plexus

A

subclavius M

153
Q

Most common pancreatic cancer location

A

head of pancreas

154
Q

Detrusor M Artery

A

Anterior division of internal iliac A

155
Q

Associated with celiac disease

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