UW wrong 2 Flashcards
1
Q
Beta blockers help in hyperthyroidism by
A
decreasing tachycardia
decreases peripheral conversion of T4 to T3
2
Q
Increased acetylcholinesterase and AFP in amniotic fluid means
A
neural tube defects
fusion of edges of neural plate
3
Q
nightmares are part of what of sleep
A
REM sleep
4
Q
REM sleep is characterized by
A
muscle paralysis
5
Q
social anxiety disorder should be treated first with
A
SSRI or SNRI
6
Q
sterile platelet rich thrombi on the mitral valve is characteristic of
A
nonbacterial endocarditis
7
Q
nonbacterial endocarditis is most associated with
A
malignancy
8
Q
the MC presentation of nonbacterial endocarditis is
A
systemic embolization (stroke, acute limb ischemia) otherwise asymptomatic
9
Q
Failed low dose dexamethasone test with suppressed cortisol with high dose dexamethasone is
A
cushing syndrome d/t pituitary adenoma
10
Q
in primary osteoporosis, levels of calcium, phosphate, and PTH are typically
A
normal
11
Q
Tay-sachs disease is caused by
A
beta-hexoaminidase A deficiency
12
Q
a beta-hexoaminidase A deficiency in Tay-Sachs causes a build up of
A
GM2 ganglioside (cell membrane glycoprotein) within lysosomes
13
Q
normal early development that suddenly regresses (neurologic deterioration), weakness, hypotonia, seizures, blindness, macrocephaly, abnormal startle reflex, cherry red macula
A
Nieman-pick
14
Q
progressive neurodegeneration
peripheral neuropathy
optic atrophy
A
Krabbe disease
15
Q
In Krabbe disease you get a build up of
A
galactocerebroside
16
Q
globotriaosylceramide accumlation
A
Fabry disease
17
Q
angiokeratomas
peripheral neuropathy
glomeropathy
that typically present in adulthood
A
Fabry disease
18
Q
buildup of sphingomyelin
A
Nieman-pick disease
19
Q
diseases with cherry red macula
A
Gaucher
Niemann-Pick
Tay-sachs
20
Q
beta-glucocerebroside accumulation
A
Gaucher disease
21
Q
build up of sulfatides
A
metachromatic leukodystrophy
22
Q
difference between tay-sacks and niemann-pick
A
tay sach’s has no hepatosplenomegaly
23
Q
BCR-ABL is an oncogene that codes for
A
fusion protein with constitutive tyrosine kinase activity
stimulates proliferation of granulocytic precursors
development of CML
24
Q
c-myc is a
A
nuclear phosphoprotein that functions as a transcription activator
25
penicillins and cephalosporins function by
irreversibly binding to penicillin binding proteins such as transpeptidases
26
vancomycin works by
binds to d-ala-d-ala residues on cell wall glycoproteins
| prevents transpeptidases from forming cross-links
27
NE affects BP by
stimulation of alpha 1
| vasoconstriction via increased IP3 second messenger pathway
28
NE affects the heart by
stimulation of beta 1 in heart
increase contractility, conduction, HR
via increase cAMP through Gs mediated rec
29
acute ureteral constriction or obstruction causes
decreased GFR and FF
30
hormones that use the PIK system
oxytocin
ADH
GNRH
31
hormone that uses JAK/STAT path
erythropoietin
32
brain tumors of neuron origin stain with
synaptophysin
| protein found on presynaptic vesicles of neurons
33
brain tumors of glial cell origin stain with
GFAP
| astrocytomas, ependymomas, oligodendrogliomas
34
the most deoxygenated blood in the body is from
cardiac venous system in coronary sinus
35
noise induced hearing loss from trauma to
stereociliated hair cells of organ of corti
36
low frequency sound is registered in the
distal cochlea
37
Auer rods in AML stain for
myeloperoxidase
38
propionyl-CoA is derived from metabolism of
```
valine
isoleucine
methionine
threonine
odd chain FA
```
39
propionic acidemia presents as
```
lethargy
poor feeding
vomiting
hypotonia
1-2 weeks after birth
```
40
Entacapone is a
COMT inhibitor for Parkinsons
41
MOA of entacapone
decrease peripheral metabolism of levodopa
42
what drug enhances the effect of endogenous dopamine
amantadine
43
end plate potential for MG
reduced amplitude
44
treat cholinergic toxicity in medicated MG patients with
antimuscarinics
glycopyrrolate
hyoscyamine
propantheline
45
liver changes in sarcoidosis
scattered granulomas
46
cancer resistance to meds MOA
human multi-drug resistance gene codes P-glycoprotein
transmembrane ATP dependent efflux protein
broad specificity for hydrophobic compounds
47
reverse transcriptase PCR is used to detect
mRNA
48
Build up of arginine
progressive spastic diplegia
growth delay
abnormal movements
arginase deficiency
49
arginase is used in what cycle
urea cycle
50
diabetic neuropathy is caused by
- diabetic microangiopathy leading to nerve ischemia
| - accumulation of sorbitol leading to osmotic nerve injury
51
endoneural inflammatory infiltration of peripheral nerves is characteristic of
Guillain-Barre syndrome
also see segmental demyelination
52
mutation of myelin protein gene
Charcot-Marie-Tooth disease
53
Symptom of Charcot-Marie-Tooth disease
weakness of foot dorsiflexion d/t common perineal nerve
54
severe bacterial and viral infections in infancy
chronic diarrhea
mucocutaneous candidiasis
possible absent thymus
severe combined immunodeficiency
55
recurrent infections that worsen with age
easy bleeding
eczema
wiskott-aldrich syndrome
56
severe bacterial and fungal infections
| granuloma formation
chronic granulomatous disease
57
oculocutaneous albinism
pyogenic infections
progressive neurologic dysfunction
chediak-higashi syndrome
58
ataxia
telangiectasis
sinopulmonary infections
ataxia-telangiectasia
59
ions with negative equilibrium potential
potassium or chloride
60
ions with positive equilibrium potential
sodium of calcium
61
JAK kinase second messenger system
growth hormone
prolactin
interferon
interleukin
62
surface receptor for insulin is a
transmembrane protein with intrinsic tyrosine kinase activity in its cytoplasmic domain
63
Insulin promotes mitogenic functions like DNA synthesis and cell growth via
MAP kinase pathway
64
insulin promotes metabolic functions such as translocation of GLUT-4 to cell membrane, glycogen synthesis, fat synthesis via
PI3K activation --> activates protein phosphatase
65
what does protein phosphatase do in glycogen synthesis
dephosphorylates glycogen synthase
66
afferent limb of gag reflex via
CN IX
67
efferent limb of gag reflex via
CN X
68
nerve that mediates cough reflex
internal laryngeal nerve (branch of superior laryngeal nerve, CN X)
69
Damage to left piriformis recess damages what nerve
internal laryngeal nerve (CN X)
70
histology of interstitial lung disease
```
lymphoplasmacytic infiltrates
focal fibroblastic proliferation
areas of dense fibrosis
honeycombing
hyperplasia of type 2 pneumocytes (idiopathic)
```
71
therapy for interstitial lung disease directed at
slowing progression of fibrosis
| inhibit TGF-beta and other fibrogenic growth factors (PDGF, fibroblastic growth factor, VEGF)
72
Pirfenidone is a
antifibrotic agent
| inhibits TGF-beta
73
acute decompensated HF d/t dilated cardiomyopathy (doxorubicin) causes what changes in RA and LVED pressures
both increased
74
right atrial pressure is synonymous with
central venous pressure
75
virally infected cells secrete
type I interferon alpha and beta
76
what does type I interferon alpha and beta do to infected viral cells
transcription of antiviral enzymes to halt protein synthesis
only happens in presence of dsRNA which forms in infected cells from viral replication
77
pressure of the RA
<5
78
pressure of right ventricle
25/5
79
pressure of pulmonary artery
25/10
80
pressure of aorta
120/80
81
pressure of LA
<10
82
pressure of LV
120/10
83
how does propranolol work to stop essential tremors
prevents interaction of epi and NE interaction with receptors at adrenergic synapses
dampens sensitivity of muscle spindles/smooths out force of contraction
84
MC CFTR gene mutation
3 bp deletion of phenylalanine at AA position 508 (deltaF508)
causes impaired post-translational processing of CFTR that is detected by ER
85
once delta F508 mutation found my ER what happens
abnormal protein targeted for proteosomal degradation preventing it reaching cell surface
86
what FA can't undergo mitochondrial beta oxidation
very long chain FA
certain branched chain FA (phytanic acid)
undergo beta and alpha oxidation in peroxisomes instead
87
what are two peroxisomal diseases
Zellwegger syndrome
| X-linked adrenoleukodystrophy
88
```
widened sutures
large anterior fontanelle
hepatomegaly
hypotonia/seizures/developmental delay
death within months of initial presentation
```
Zellweger syndrome
| peroxisomal disease
89
defective transport of VLCFA into peroxisomes
X-linked adrenoleukodystrophy
90
childhood or adulthood neurological deterioration
| adrenal insufficiency
X-linked adrenoleukodstrophy
91
protein modification
| sorting/transport
golgi
92
digestion of cellular debris and pathogens
lysosomes
93
TCA cycle
FA oxidation
E transport chain (ATP synthesis)
Apoptosis
mitochondria
94
oxidation of VLCFA and branched FA
| hydrogen peroxide degeneration
peroxisomes
95
degradation of ubiquitinated proteins
proteasomes
96
synthesis of integral membrane and secretory proteins
rough ER
97
drug detox
| lipid, phospholipid, steroid synthesis
smooth ER
98
watery diarrhea stool findings
no leukocytes or RBC
99
dysentery of inflammatory diarrhea stool findings (shigella, salmonella, campylobacter, EIEC, yersinia, clostridium, entamoeba)
PMN
| with or without RBC
100
enteric fever stool findings (salmonella typhi)
mononuclear leukocytes
101
isoniazid must be processed by
mycobacterial catalase peroxidase
102
accessory conduction pathway
| atrioventricular conduction tract bypassing the atrioventricular node
WPW syndrome
103
drug directed at CD20
| lymphoma
rituximab
104
CML
| drug that inhibits proliferation of BCR/ABL expressing cells without inducing apoptosis
Imatinib
105
chimeric (human/murine) IgG1 monoclonal Ab to TNF-alpha
Infliximab
use in RA, AS, fistulizing Crohn's
106
IL-2 is used for
RCC
| melanoma
107
chimeric mouse-human Ab against platelet GpIIb/IIIa receptor
Abciximab
administered during angioplasty in patients w/ACS
108
treatment for hemophilia A or B
thrombin
109
hemophilia A and B lead to
failure to convert prothrombin into thrombin and deficient thrombus formation
110
Treatment of bradycardia from infer MI
atropine
111
atropine MOA
blocks vagal influence on SA and AV nodes
| increases HR
112
Atropine is contraindicated in
patients with glaucoma
muscarinic receptor blockade
mydriasis = narrowing of anterior chamber angle, diminished outflow of aqueous humor
cause closed angle glaucoma
113
base excision repair steps
```
glycosylase
endonuclease
lyase
polymerase
ligase
```
"GELPL"
114
glycosylate cleaves
the altered base leaving an AP site (first step)
115
endonuclease cleaves
5' end (2nd step)
116
lyase cleaves
3' end (3rd step)
117
DNA polymerase does what in base excision repair
fills single nucleotide gap (4th step)
118
Ligase does what
seals the nick (5th step)
119
hypertensive hemorrhage at posterior rostral pons near lateral flow of fourth ventricle
locus ceruleus
| NE
120
pigmented chemical made in the midbrain
DA
| substantia nigra
121
NE is converted into Epi primarily in the
adrenal medulla
122
bursitis d/t repetitive or prolonged kneeling
prepatellar bursitis
123
bursitis in those with OA or inflammatory joint disease
popliteal bursitis
124
bursitis d/t direct blue to distal thigh or prolonged/repetitive quad activity (running)
supra patellar bursitis
125
increased orotic acid in urine
kid with increased blood ammonia levels
sleepiness, vomiting, fever
tachypnea
ornithine transcarbamylase deficiency
126
what will build up in ornithine transcarbamylase deficiency
orotic acid in urine
| carbamoyl phosphate
127
where does ornithine transcarbamylase work
mitochondria
128
self-mutilation and hyperuricemia is characteristic of
Lesch-Nyan
| HGPRT deficiency
129
GAS is
PYR positive
| bacitracin sensitive
130
in sickle cell disease sicking of cells will cause
permanent deformation
premature RNC destruction by macrophages
mechanical stress
intra and extravascular hemolysis
131
sickle cell disease will show what changes to indirect bilirubin and LDH
Increased both
decrease haptoglobin
132
what does haptoglobin do
binds circulating Hgb and reduces renal excretion of free Hgb
preventing tubular injury
133
motion sickness
vertigo
treat with
```
H1 or M1 receptor antagonist
(vestibular cause)
diphenhydramine
meclizine
scopolamine
```
134
mechanical and chemical irritants to Gi tract nausea treat with
5-HT3 receptor antagonist
| zolfran
135
cancer drug vomiting treat with (central nausea)
D2 receptor antagonist
metoclopramide
prochlorperazine
136
Ejection fraction
EDV-ESV/EDV
137
Crohn's disease people get what kind of kidney stones
oxalate stones
reduced intestinal calcium oxalate formation from malabsorption, ends up in urine
138
what kind of kidney stones do people with myeloproliferative disease and hemolytic anemia
uric acid stones
139
hyper acute renal transplant reaction
| min to hours
preformed antibodies
140
acute renal transplant reaction
| less than 6 months
exposure to donor antigens induces (host T-cell sensitization) humoral/cellular activation of naive immune cells
141
chronic renal transplant reaction
| months to years
chronic low grade immune response refractory to immunosuppressants
142
superior vena cava syndrome is caused by
mediastinal mass
143
with TCA overdose, widened QRS interval or ventricular arrhythmia are an indication for
sodium bicarbonate
144
cardiac symptoms from TCA overdose are d/t
blockage of cardiac fast sodium channels
145
lesions of the macula cause
central scotomas
146
first step of infective endocarditis
disruption of normal endocardial surface
| followed by formation of sterile fibrin-platelet nidus
147
stool findings for strongyloides stercoralis
rhabditiform larvae
148
detection of parasite eggs in stool is used to diagnose
schistosomiasis
| mansion or japonicum
149
dorsal pancreatic bud forms
majority of pancreas
body
tail
most of head
150
ventral pancreatic bud makes
precursor of uncinate process
inferior/posterior portion of head
major pancreatic duct
151
low back pain relieved with leaning forward due to
spinal stenosis
intervertebral disc herniation
ligamentum flavum hypertrophy
osteophyte formation affecting facet joints
152
Fabry disease is at most risk for development of
renal failure
TIA/stroke
cardiac disease (LVH)
153
burning pain in hands and soles
hypohidrosis
exacerbated by exercise or stress
Fabry disease
154
dermatomyositis and polymyositis is associated with
being paraneoplastic syndrome with adenocarcinoma (ovary, lung, pancreas)
155
HER2 is a
transmembrane tyrosine kinase
156
what makes salmonella typhi worse than salmonella enterica
extensive intra-phagocytic multiplication
| blunted neutrophil response d/t capsular antigen Vi
157
inactivated viral vaccines primarily generate
humoral immune response against extracellular viral antigens
prevents viral entry into cell
158
live attenuated viral vaccines generate
strong cell-mediated immune response that can kill virally infected cells in addition to providing humoral immunity
159
kinesin is a
microtubule motor protein
160
what does kinesis do
anterograde transport of intracellular vesicles and organelles toward the plus ends of microtubules
161
nitrates relieve chest pain by increasing cGMP that lead to
myosin light chain dephosphorylation resulting in vascular SM relaxation
162
Paget disease starts with increased activity of
osteoclasts
163
```
initially healthy baby with dark urine
gray stools
elevated direct bilirubin and GGT
jaundice
firm hepatomegaly
```
biliary atresia
164
biopsy of biliary atresia would show
intrahepatic bile duct proliferation
portal tract edema
fibrosis
165
Clomiphene is A
estrogen receptor modulator
166
osmolarity of renal proximal tubule
300
167
osmolarity of descending limb
400-1000
168
osmolarity of ascending limb
200-800
169
osmolarity of DCT
100
170
osmolarity of collecting tubule
300-1200
171
in bacteria, RNA primers are removed by
DNA polymerase I
