Tues July 14

Question 1

cancers may cause hypercalcemia by secreting which substance?

Answer 1

PTHrP (parathyroid hormone RELATED PEPTIDE)

Question 2

where is the inflammation primarily found in chronic lung transplant rejection?

Answer 2

small airways

Question 3

pathophysiology of chronic lung transplant rejection?

Answer 3

Submucosal lymphocytic infiltrates in the small airways lead to inflammation and subsequent granulation tissue into the lumen, which leads to obstruction and obliteration

Question 4

what will be found on histology of HYPER ACUTE lung transplant rejection?

Answer 4

preformed host antibodies against donor tissue lead to immediate inflammation consisting of hemorrhage and fibrinoid necrosis

Question 5

what will be found on histology of ACUTE lung transplant rejection?

Answer 5

this is a cell-mediated response so there will be mononuclear infiltrate - found in the small vessels which may expand into the alveolar walls

Question 6

What are the steps in activation of G q coupled proteins?

Answer 6

Gq activates phospholipase C, which breaks down PIP2 into DAG and IP3. IP3 increases intracellular calcium, which activates protein kinase C

Question 7

will a PCA aneurysm effect the CN III fibers of the ipsilateral eye or contralateral eye?

Answer 7

ipsilateral

Question 8

which insulins are the only human recombinant insulins that do not have changes to the amino acid sequence?

Answer 8

Regular insulin and NPH

Question 9

Rupture at which part of the bladder can result in intraperitoneal free fluid?

Answer 9

At the dome - this portion is covered by the peritoneum and rupture here may result in urine going into the intraperitoneal space

Question 10

is the relationship between creatinine level and GFR linear or exponential?

Answer 10

EXPONENTIAL - non linear

Question 11

pathophys of tetanus?

Answer 11

-enters via wound - the pathogen stays at the infection site and the toxin enteres the presynaptic terminals of lower motor neurons and travels retrograde to the spinal chord, where it blocks inhibitory interneurons

Question 12

which region in the lymph nodes is populated by t cells?

Answer 12

paracortex

Question 13

whats the function of tracheal toxin in bortedella pertussis?

Answer 13

directly damaged and destroys ciliated epithelial cells leading to a loss of airway protection

Question 14

whats the function of pertussis toxin in bortedella pertussis?

Answer 14

enters cells and activates adenylyl cyclase leading to alterations in cell signalling that inhibit phagocytosis

Question 15

which substances are responsible for coronary blood flow autoregulation?

Answer 15

adenosine and NO - maintain blood flow wihtin a constant range

Question 16

what occurs in the first few weeks of mycobarium TB infection?

Answer 16

the mycobacteria get into macrophages and inhibit phagolysosome function, allowing them to replicate within cells. It takes a few weeks before the t cells are activated

Question 17

giant pronormoblasts may be seen in which conditions?

Answer 17

Aplastic crisis caused by parvovirus 19

Question 18

what does a LOW blood/gas partition coefficient mean?

Answer 18

The gas is poorly soluble in blood, it will saturate very quickly leading to fast rise in partial pressure

Question 19

what does a HIGH blood/gas partition coefficient mean?

Answer 19

The gas is highly soluble in blood, the blood will saturate slowly leading to a slow rise in the partial pressure of the gas in the blood

Question 20

what conditions is someone receiving testosterone replacement at risk for?

Answer 20

• increased risk of prostate cancer (metabolized into DHT which stimulates the prostate)
• erythrocytosis - it leads to increased blood viscosity secondary to increased intestinal iron absorption and thus increased risk for clots

Question 21

what measurements should be monitored after starting someone on testosterone replacement therapy?

Answer 21

PSA and hematocrit

Question 22

the presence of which marker in a pregnant woman with Hep B indicates a very high risk of vertical transmission to the baby?

Answer 22

HBeAg

Question 23

how does administration of corticosteroids to a pregnant women at risk of premature labour help prevent respiratory distress in the infant?

Answer 23

it accelerates maturation of the type II pneumocytes in the baby’s lungs

Question 24

what deposits in the glomerulus in post-strep glomerulonephritis?

Answer 24

IgG and C3

Question 25

what will be seen on IF and EM of post strep glomerulonephritis?

Answer 25

IF - granular staining along GMB

EM - subepithelial humps

Question 26

methadone may increase risk for which cardiac condition?

Answer 26

long QT syndrome

Question 27

what is torsades de pointes?

Answer 27

a ventricular arythmia that may cause syncope and SCD

Question 28

A patient has multiple myeloma with bony lesions, what will their PTH, 1,25 vit D and urinary Ca levels be?

Answer 28

decreased PTH (via negative feedback from increased serum calcium), decreased 1,25vitD (from decreased conversion in kidney due to decreased PTH), and increased urinary Ca (loss of Ca due to lack of PTH)

Question 29

how does digoxin cause heart rate lowering effects?

Answer 29

Increases vagal tone slowing down the ventricles

-by blocking the Na/K atpase in vagal afferent fibers it sensitizes baroreceptors

Question 30

kegels strengthen which muscles?

Answer 30

the levator ani

Question 31

wide and fixed splitting of S2 is suspicious for…

Answer 31

an atrial septal defect

Question 32

what can cause a transient shunt reversal of the left to right shunt?

Answer 32

activites that increase the right pressure such as coughing or straining

Question 33

A patient who has just received blood transfusions has tingling or muscle spasms. What is going on?

Answer 33

There are experiencing symptoms of hypocalcemia due to chelation of calcium with citrate. Donated blood is mixed with citrate to prevent coagulation. Large transfusions can result in chelation.