Uworld Added 2 Flashcards
1
Q
Saddle anesthesia and Loss of anocutaneous reflex =
A
S2-S4 lesion (cauda equina syndrome)
2
Q
Danazol MOA
A
Synthetic androgen for endometriosis and hereditary angioedema
3
Q
Mifepristone MOA
A
Synthetic steroid with anti-progestin and anti-glucocorticoid effects
4
Q
Mitotane MOA
A
Adrenocorticolytic used primarily for adrenocortical carcinoma
5
Q
Maintenance Dose =
A
Cpss x CL / [Bioavailability fraction]
6
Q
Half life =
A
(Vd x 0.7) / CL
7
Q
Loading Dose =
A
(Vd x Cpss) / [Bioavailability Fraction]
8
Q
Methoxamine MOA
A
Selective a1 agonist
9
Q
a2 activation effects
A
Decr insulin, Decr lipolysis, Decr aqueous humor production, Incr Platelet Aggregation
10
Q
b1 activaiton effects
A
HR/Contractility, Incr Renin and Lipolysis
11
Q
b2 activation effects
A
Vasodilation/Bronchodilation; Incr Lipolysis and Insulin; Decr uterine tone; Ciliary muscle relaxation and acqueous humor production
12
Q
Recurrent kidney stones in young patient indicates
A
Inborn error of metabolism
13
Q
Sodium Cyanide-Nitroprusside test
A
Detects presence of (sulfhydryl groups) urine cystine (converts cystine to cysteine and nitroprusside binds to make purple)
14
Q
Treatment of Cystinuria
A
Hydration and Alkalinization of urine
15
Q
Microscopic finding of irreversible cardiac ischemic injury
A
Vacuoles and Phospholipid-containing amorphous densities w/in mitochondria
16
Q
Glandular epithelial changes from Proliferative to Secretory stages in endometrium
A
Pseudostratified, elongated, mitotically active epithelial cells –> Acquire large cytoplasmic vacuoles
17
Q
Features that differentiate LEMS from MG
A
Hypo/areflexia, Autonomic symptoms, Classic incremental response to repetitive stimuli
18
Q
Pyruvate Carboxylase activity is increased by
A
Acetyl-CoA
19
Q
Citrate is a regulator of
A
Positive regulator of AcCoA Carboxylase, F-1,6-BP; Negative of PFK1 and 2 (inhibiting glycolysis)
20
Q
Narcolepsy with Cataplexy is most often caused by
A
Lack of Hypocretin 1/2 (Orexin A/B) from Lateral Hypothalamus
21
Q
Elevatd 14-3- protein in CSF
A
CJD
22
Q
Low CSF 5-hydroxyindole-acetic acid
A
Impulsive, destructive behaviors
23
Q
How to differentiate syphillis from other spirochetes on darkfield
A
Motility
24
Q
H ducreyi requires what in culture
A
Factor X (like H flu)
25
Fever and sore throat in pt with hyperthyroidism being treated
AGRANULOCYTOSIS
26
Arthralgias with PTU
50% develop ANCA, some develop arthralgias and glomerulonephritis
27
Abdominal pain, distension, fever, diarrhea, shock in Ulcerative Colitis
Possibility of Toxic Megacolon
28
Alveolar proteases (eg. elastase) are produced by
Macrophages and PMNs
29
Acute Hypotension, Tachycardia, Elevated CVP (JVD) with Pulsus paradoxus
Cardiac Tamponade
30
Reid Index
Chronic Bronchitis --> Ratio of Gland thickness to total thickness of wall between epithelium and cartilage
31
When not to use Probenicid for Hyperuricemia
Poor renal function, Risk for uric acid stones or uric acid nephropathy
32
MOA of Rasburicase
Urate Oxidase: Uric Acid --> Allantoin
33
CHOP therapy is for
Non-hodgkin lymphoma
34
Herpesvirus drug that doesn't require viral kinase
Cidofovir, Foscarnet
35
Peritrichious Flagella
Characteristic of highly motile organisms such as Proteus mirabilis
36
"serpentine" or "medusa head" chains on microscopy
B anthracis
37
How does tetanus toxin causes paralysis
Wound --> Motor Neuron Axons --> Spinal Cord --> Inhibits inhibitory motor neuron
38
Features of Edwards Syndrome
Rocker bottom, Micrognathia, Low set ears, Clenched hands, Prominent Occiput, ASD/VSD, Omphalocele, Horeshoe kidney
39
Features of Patau Syndrome
Microcephaly, Holoprosencephaly, Microphtalmia, Polydactyly, Cleft lip/palate, Rocker bottom feet, Cystic kidneys, VSD
40
Methods of Isoniazid resistance
(1) Decr expression of catalase-peroxidase enzyme necessary for activation; (2) Modification of protein binding site
41
Rheumatic aortic disease usually produces
Combined AS and Aortic Regurgitation
42
Acanthocytes indicate
Abetalipoproteinemia
43
Which genes play major role in Type 1 DM
HLA-DQ and DR
44
Pancreatic islet amyloid deposition is seen in
Type 2 DM (universal)
45
Dose effects of dopamine
Low = D1 + B1; High = D1 + B1 + A1
46
Sensory innervation of Deep Fibular Nerve
Between first and second toes
47
Trauma or sustained pressure (cast) to the neck of the fibular
Injury to the common peroneal nerve
48
Basophil granules contain
Heparin, Histamine, SRS-A
49
What activates ALA synthase
CYP inducers, Barbiturates, Anti-epileptics, EtOH, Smoking
50
What inhibits ALA synthase
Heme, Glucose
51
Conversion of 1,3-BPG to 2,3-BPG is increased in
Hypoxia, Chronic Anemia
52
Babesiosis
Malaria-like illness w/ prediliction for asplenic patients
53
Toxoplasmosis in immunocompetent causes
flu-like illness
54
Brucellosis causes
Fever, malaise, LAD, HSM
55
Childreen 1-3 with gingivostomatitis characterized with intranuclear inclusions
HSV-1
56
MOA of Mesna
Binds Acrolein (toxic metabolite of cyclophosphamide)
57
Atypical Depression
Improvement in mood in response to something positive
58
MAOi's are used for
Atypical Depression, Anxiety, Refractory
59
Jejunal, Ileal, and Colonic Atresia are caused by
Vascular accidents in utero, NOT abnormal fetal development
60
Presentation of Follicular Lymphoma
Indolent course, Painless lymph node enlargement or abdominal discomfort from abdominal mass
61
Presentation of Diffuse Large Cell Lymphoma
Aggressive --> Large LN or extranodal mass (oropharyngeal lymphoid tissue and GI tract commonly involved)
62
Presentation of Hairy Cell Leukemia
Splenomegaly, Pancytopenia in older men
63
DNA Polymerase I vs III
I has 5' to 3' exonuclease activity (removes RNA primer, performs repair of damage), 5' to 3' polymerase activity, and 3' to 5' exonuclease activity; III performs bulk of replication
64
Signs of Acute Tubular Necrossi
Oliguria, Muddy Brown Casts, Anion Gap Metabolic Acidosis
65
Signs of Aromatase Deficiency
Maternal virilization, High androgens, Low estrogen, Tall, Osteoporosis --> Girls have ambiguous genitalia, boys just tall and osteoporosis
66
Function of Red Nucleus
Motor control of Upper extremities
67
Skin biopsy in Dermatitis Herpetiformis shows
PMNs and fibrin at tips of dermal papilla = microabcesses; IgA deposits
68
Infant with malabsorption, failure to thrive, progressive ataxia, acanthocytes
Abetalipoproteinemia
69
Epinephrine stimulates B2 receptors in skeletal muscle to
Incr BF, Glycogenolysis, Lipolysis
70
Endocrine comorbidities with Down Syndrome
Hypothyroid, T1DM, Obesity
71
Rheumatology and Hematology comorbidities with Down Syndrome
Acute Leukemia, Atlantoaxial instability
72
are only found in Alzheimer's dementia
Neurofibrillary Tangles
73
Lewy bodies
Round, eosinophilic, intracytoplasmic inclusions that contain neurofilaments of a-synuclein
74
Negri Bodies
Round eosinophilic inclusions seen in the cytoplasm of pyramidal hippocampal neurons and cerebellar purkinje cells
75
When does the metonephros begin to produce urine
8-10 wks
76
Most common cause of fetal hydronephrosis
Inadequate recanalization of the ureteropelvic junctions
77
Tumor that causes necrolytic migratory erythema
Glucagonoma
78
Manifestations of Somatostatinoma
DM, Steatorrhea, Cholelithiasis, Hypochlohydria
79
Order of sound /pressure waves in inner ear
Round window --> Scala Vestibuli --> Scala Tympani --> Basilar Membrane dilation
80
Brown pigment stones typically arise secondary to
Infection of the biliary tract --> Releases B-Glucoronidase --> Hydrolysis of bilirubin glucoronides --> incr amount of unconjugated bilirubin in bile
81
7a-Hydroxylase function
Convert cholesterol to bile acids (sufficient activity reduces likelihood of cholesterol stone formation)
82
Important to metabolism/levels of digoxin
Renal clearance mostly, Plasma protein binding and body mass somewhat; Not liver enzymes
83
Most common known viral cause of acute hemorrhagic cystitis in children (and males in particular)
Adenovirus (serotypes 11 and 21 of B subgroup)
84
Pathogenesis of Centriacinar Emphysema
Smoke --> Macrophages --> PMNs --> Proteases active, Antiproteases inactivated
85
Club/Clara cell function
Nonciliated, secretory cells in terminal respiratory epithelium --> Secrete protein, surfactant and help detoxify
86
Is S3 or S4 always pathologic in young patients
S4 always in younger, Not always in older
87
V/Q and Acid/Base consequences of PE
Redistribution of blood to unaffected --> V/Q mismatch --> Hypoxemia stimulates hyperventilation --> Respiratory Alkalosis
88
3 NNRTI's
Nevirapine, Efavirenz, Delavirdine
89
MOA of Enfuvirtide
Prevent fusion by binding gp41
90
Most concerning AE of NNRTI's
Hepatic Failure with Encephalopathy
91
Holoprosencephaly is associated with
Trisomy 13 and 18, Fetal Alcohol Syndrome
92
Deformation vs Malformation
Deformation occurs due to extrinsic mechanical force; Malformation is a primary defect in cells or tissues that form an organ
93
"Disruption"
Secondary breakdown of a previously normal tissue or structure
94
Aldolase function
A/B/C metabolize F-1,6-BP to G3P and DHAP; Aldose B also metabolizes F-1-P to Glyceraldehyde and DHAP
95
Tx Aldolase B deficiency by
Eliminating dietary fructose (sucrose)
96
Sucrose
Fructose + Glucose
97
Lactose
Galactose + Glucose
98
Maltose
Glucose + Glucose
99
For patients with stiff lungs, work of breathing is minimized when
RR is high, TV is low
100
For patients with high airflow resistance, work of breathing is minimized when
RR is low, TV is high
101
LPS/LOS cause sepsis by induction of systemic inflammatory response characterized by
TNFa, IL-1b, IL-6, IL-8 (much of which is formed after interaction with TLR-4)
102
Osteoporosis is defined as
Bone density >2.5 SD below mean for peak young adult bone density
103
Risk factors for Osteoporotic Fractures
White/Hispanic/Asian, Hx, Decr activity, Low body weight, Excessive alcohol or tobacco, Premature menopause
104
How do GC's incr bone loss
(1) Decr GI absorption of Ca, (2) Inhibit collagen synthesis, (3) Decr GnRH, (4) Incr urinary Ca loss
105
Side effects of Statins
Myotoxicity, Hepatotoxicity (discontinue if LFT's >3x normal)
106
CYP Inducers
Chronic Alcohol, St Johns wort, Phenytoin, Phenobarbital, Nevirapine, Rifampin, Griseofulvin, Carbamazepine
107
CYP substrates
Anti-epileptics, Theophylline, Warfarin, OCPs
108
CYP inhibitors
Acute Alcohol, Ritonavir, Amiodarone, Cimetidine, Ketoconazole, Sulfonamides, Isoniazid, Grapefruit, Quinidine, Macrolides (ex azithromycin)
109
Acanthosis
Incr thickness of stratum spinosum (psoriasis commonly associated with acanthosis)
110
Spongiosis
Intercellular epidermal edema --> incr space b/t cells (eg eczematous dermatitis)
111
Dyskeratosis
Premature keratinization of individual keratinocytes (eg SCC)
112
First line for isolated systolic HTN in non diabetics
Thiazides and DHP CCBs
113
HTN drug that can lead to flushing and peripheral edema
Amlodipine
114
First line for essential HTN in general public
HCTZ
115
Most frequent AE's w/ Verapamil
Constipation, Gingival hyperplasia
116
Drugs that cause Gingival Hyperplasia
Phenytoin, CCBs, Cyclosporine
117
MOA of Clomiphene
SERM that prevents negative feedback inhibition on hypothalamus (used in PCOS)
118
Diseases that cause myocardial fibrosis
Dermatomyositis, Muscular Dystrophy, Sarcoidosis, Scleroderma
119
Why doesnt Anti-HepC IgG confer immunity?
RNA polymerase errors --> Varied antigenic structure
120
AE's of Amphotericin B
Infusion reaction, Thrombophlebitis, Nephrotoxicity, HypoMg/HypoK, Anemia (suppressed EPO)
121
BH4 is a cofactor for synthesis of
Tyrosine, DOPA, Serotonin, Prolactin, NO
122
Cardiac morphology changes with aging
(1) Decr LV chamber size; (2) Sigmoid IV septum; (3) Incr interstitial CT; (4) Lipofuscin accumulation
123
Murmur of VSD
Loud holosystolic murmur over left sternal border 3-4 intercostal space (smaller = louder)
124
Phenylethanolamine N-methyltransferase
NE to Epi
125
Systemic sclerosis is thought to be due to activation of what cell type
CD4
126
A strict vegetarian diet can cause a deficiency of
B12
127
Free wall rupture occurs how long after MI
3-7 days
128
Triad of muffled heart sounds, elevated JVP, profound hypotension indicate
Pericardial Tamponade
129
How does GI bleed precipitate Hepatic Encephalopathy
Incr nitrogen delivery to gut in form of hemoglobin --> converted to ammonia and enters bloods stream
130
Molecules that act thru nuclear receptors
TH, Retinoids, PPAR, Fatty Acids
131
Spirochetes are universally sensitive to
Penicillin (gram nevative peptidoglycan cell wall)
132
Xeroderma Pigmentosa is defect in
DNA excision repair
133
DNA mismatch repair defect
Lynch syndrome
134
Why doesn't Ceftriaxone work on Chlamydia
Cell wall lacks peptidoglycan (Ureaplasma lacks cell wall alltogether)
135
Phentolamine MOA
Alpha 1 and 2 blocker (no BB effects)
136
Dose-dependent effects of Epinephrine
Increases systolic, Increases HR, and either increases or decreases diastolic dependending on dose (a1 at high, or B2 at low)
137
Kappa opioid receptors mediate
Miosis
138
Hexamethonium MOA
Potent nicotinic receptor antagonist
139
Defect in keratins 5 and 14
Epidermolysis Bullosa Simplex
140
Characteristic Triad of Ataxia Telangiectasia
Those + Incr risk of sinopulmonary infections (IgA deficiency)
141
ATM gene is responsible for
DNA break repair (hypersensitive to x ray radiation)
142
Why does lead cause hypochromic anemia
Inhibits mitochondrial iron transport
143
Bare Lymphocyte Syndrome
Absent MHC II --> T and B cell deficiency
144
Features of Lesch-Nyhan
Hyperuricemia, Gout, Pissed off, Retardation, dysTonia
145
AICA block
Facial droop means AICA's pooped
146
Process of Base Excision Repair
Abnormal Base --> Glycosylase removes --> Endonuclease and Lyase cleave 5 and 3' --> DNA polymerase and ligase
147
Pyrophosphate analog that doesn't require phosphorylation
Foscarnet
148
Properties of Type 1 muscle fibers
Slow = Aerobic, High myoglobin and mitochondria
149
Side chain cleavage enzyme in adrenals
Cholesterol --> Pregnenalone
150
Pulmonary Stretch Receptors
C fibers in lungs and airways that regulate degree of distension (Hering-Breuer reflex)
151
Infant with Air in bowel wall, Abdominal distension, and Bloody stools
Necrotizing Enterocolitis
152
N-acetylmuramic acid and N-acetylglucosamine
Saccharides that combine with AA chain to form peptidoglycan cell wall
153
Tay Sachs findings
Cherry Red Macula, Neurodegeneration, Developmental delay, Onion Skin Lysosomes, No HSM (vs Niemann-Pick)
154
Niemann-Pick findings
Cherry Red Macula, Neurodegeneration, Foam Cells, HSM
155
Important genes altered by PPARg
Adiponectin, FA transport, Insulin receptor, Glut-4
156
DOC for Complex Partial Seizures
Carbamazepine
157
PTH effects on bone cells
Incr RANKL and M-CSF production by osteoblasts; Decr OPG
158
MOA of Pergolide
D2 agonist
159
Isoniazid vitamin deficiency
B6 --> Peripheral neuropathy (GABA def)
160
4 phases of lobar pneumonia
Congestions (first 24hr) --> Red Hepatization (2-3d) --> Gray Hepatization (4-6d) --> Resolution
161
Microscopic appearance in Congestion --> Red --> Gray Hepatization
Vascular Dilatation, Mostly bacteria --> RBCs, PMNs, Fibrin --> Disintegrated RBCs, PMNs and Fibrin
162
MTB virulence factor allowing for intracellular proliferation
Sulfatide
163
Soft Exudate
Grayish-white, cotton wool - due to microinfarct
164
Hard Exudate
Clear margins - due to leakage of protein
165
Absolute vs Relative Erythrocytosis
Red Cell Mass increased in Absoluate
166
Ureters lie antermedial to what structures in true pelvis
Internal Iliac
167
Death due to TCA toxicity
Cardiac Fast Na channel block --> Arrhythmia, Cardiogenic Shock
168
TCA's also block
mAChR, alpha1, Cardiac Fast Na, H1; NE and 5-HT reuptake
169
Common precursor of Beta-Endorphin and ACTH
POMC (also yields MSH)
170
Gastroeneteritis with intestinal invasion
Salmonella, Shigella, EIEC, Campylobacter, Entamoeba histolytica
171
Stacked-brick intestinal adhesion
EAEC
172
Characteristic histologic findings in GERD
Basal zone hyperplasia, Elongation of lamina propria, Inflammatory cells (eo's, Pmn's, lymph's)
173
First gen anti-histamines
Dim First Gen History Professors Dip Cope - Dimenhydrinate, Hydroxyzine, Promethazine, Diphenhydramine, Chlorpheniramine
174
Second gen anti-histamines
Second Gen History Certainly want tadine - Cetirizine, -adine
175
Bisphosphonates should be used carefully in patients with
Renal failure - Excreted unchanged
176
Common robertsonian translocations
14;21 and 21;22
177
Most susceptible parts of kidney to hypoxia
PCT, Thick Ascending Limb
178
Prophylaxis of cerebral vascular spasm following SAH
Nimodipine
179
Two types of pneumococcus vaccine
(23) Polysaccharide = B cell response = Less effective; (17) Polysaccharide conjugated to diph toxin = T cell response = better
180
Killed Vaccines
RIP Always = Rabies, Influenza, Polio, Hep A
181
3 adverse effects of all Protease Inhibitors
(1) Lipodystrophy; (2) Hyperglycemia; (3) P450 inhibition
182
What to use instead of rifampin for patients with mycobacterial infection in patients on protease inhibitors
Rifabutin
183
3 important mitochondrial syndromes
(1) Leber Hereditary Optic Neuropathy; (2) Myoclonic Epilepsy w/ Ragged-Red Fibers; (3) MELAS
184
Aortic Arch Derivatives
3 = Common/Internal Carotid; 4 = Aortic Arch, R Subclavian; 6 = Pulmonary Arters, Ductus Arteriosis
185
5 Dehydrogenase Cofactors
B1, B2 (FAD), B3 (NAD), B5 (CoA), Lipoid Acid
186
Prevention of neonatal tetanus
Vaccinate mom --> Placental transfer of IgG
187
Conversion of Pyruvate to PEP requires what 2 enzymes
Pyruvate Carboxylase, PEPCK
188
How can mitochondrial OAA be transported to cytosol
(1) Conversion to PEP; (2) Transamination to Aspartate; (3) Reduction to Malate
189
What step of CAC is GTP produced in?
Succinyl CoA to Succinate
190
Anti-arrhythmic specific for ischemic myocardium
Ischemic = Depolarized --> Lidocaine
191
What has currently replaced lidocaine for ventricular tachycardia
Amiodarone
192
Procainamide is more specific for arrhythmias arising from
Centers of normal automaticity
193
Prolonged administration of Verapamil pts with V Tach can
Lead to V fib and death --> Distinguish between Supraventricular and Ventricular Tach
194
Adenosine is used for
Acute treatment of Paroxysmal Supraventricular Tachycardia
195
Gene in PAH
BMPR2
196
Hypophosphorylated Rb prevents
G1 --> S (Hypophosphorylated = Active)
197
Colloid Cyst
Benign formation in third ventricle --> Lethal obstruction
198
Reticulin deposits and chronic inflammatory infiltrates in brain tumor
Xanthoastrocytoma
199
Activated Protein C inhibits
Factors Va and VIIIa
200
Aside from gas gangrene, C perf can cause
Late-onset food poisoining --> Transient watery diarrhea
201
X linked recessive disorders
Bruton, Wiskott, Fabry, G6PD, Ocular Albinism, Lesch-Nyhan, DMD, Hunter Syndrome, Hemphophilia, OTC Def
202
Autosomal Dominant disorders
HHT, Fam Hyperchol, FAP, MEN, NF1/2, Marfans, Her Spher, Achondroplasia, Huntingtons, Li-Fraumeni, BRCA1/2, Polycystic, Tuberous Sclerosis, vHL
203
HIV gene that is glycosylated and cleaved
ENV --> Gp140 --> Gp120 and Gp41
204
How does blood from Bronchial Arteries return
Majority to left heart in deoxy form via pulmonary veins (admixture); Some to right heart via azygous, acessory hemiazygous, or intercostal veins
205
Afferent fibers from Carotid and Aortic baroreceptors terminate in
Solitary nucleus of medulla
206
Histology of Psoriasis
Hyperparakeratosis, Acanthosis, Elongation of Rete Ridges, Mitotic activity above epidermal basal layer, Reduced or absent stratum granulosum
207
Munro microabscesses
PMNs form spongiotic clusters in superficial dermis and parakeratotic stratum corneum in Psoriasis
208
Advantage of proline in collagen
Kink the polypeptide chain and enhance rigidity b/c of their ring configuration
209
What happens to procollage once secreted
Cleaved C and N terminals --> Solubility decreases --> Collage fibrils --> Lysil Oxidase crosslinking
210
Alkaptonuria is a defect in what pathway
Tyrosine to Fumarate
211
What causes nipple inversion with breast cancer
Invades central region
212
What causes skin retraction in breast cancer
Infiltration of Cooper ligaments
213
Alternative to SSRI when sexual side effects occur
Bupropion
214
Xanthoma vs Xanthelasma
Xanthoma is surrounded by inflammatory cells and fibrotic stroma, Xanthelasma not
215
Ergonavine MOA
Constricts SM by stimulating both alpha adrenergic and 5-HT receptors
216
Phentolamine MOA
a1 and a2 blocker
217
In what part of bone is hematogenous osteomyelitis most likely
Diaphysis
218
Hyper IgM syndrome results from
Absence of CD40L on t cells or Genetic deficiency in isotype switching enzyme
219
Hyper IgM manifestations
Recurrent sinopulmonary infections; Lymphoic hyperplasia
220
IgA class switching is induced by
TGF-beta
221
Specific marker of mast cell activation
Tryptase (released in degranulation)
222
Antimicrobials that block ENaChannels
Trimethoprim, Pentamadine
223
Why is serum Na normal in Mineralocorticoid Excess
Aldosterone Escape via ANP --> Prevents edema and Na increase
224
Contraction alkalosis
Reabsorption of HCO3-
225
Where does uric acid precipitate in tubules
Low pH of Distal Tubules and Collecting Ducts
226
Penicillinase-stable penicillins
Nafcillin, Oxacillin, Methicillin
227
Prognosis of Capillary Hemangioma
Initially progress, eventually regress
228
Histology in De Quervain's Thyroiditis
Mixed, cellular infiltrate with multinucleated giant cells
229
Opsoclonus-Myoclonus syndrome
Neuroblastoma
230
Why not use TCA with BPH?
Anti-Cholinergic --> retention
231
Why not use TCA with Orthostatic Hypotension?
Antagonizes alpha 1 peripherally
232
Causes of Hypercalciuria
Mainly Idiopathic; Also Hyperoxaluria, Hyperuricosuira, Low urinary volume, Hypocitratruria
233
Causes of Hyperoxalouria
Diet (chocolate, nuts, spinach; Low calcium diet (more oxalate absorbed)
234
Main radiographic finding in Mesothelioma
Nodular or smooth pleural thickening
235
Gold standard for Mesothelioma diagnosis
EM = Numerous long, slender microvilli with abundant tonofilaments (adenocarcinoma has short, plump microvilli)
236
Bronchioalveolar carcinoma has a characteristic
Distribution along alveolar septa w/out vascular or lymphatic spread
237
Gemcitabine vs Cytarabine
Both pyrimidine analogs, but Gemcitabine is not S phase specific, likely due to additional cytotoxic functions (eg inhibition of ribonucleotide reductase)
238
Methotrexate vs 5-FU
Both inhibit thymidalate formation, but only MTX overcome by Folinic Acid supplementation
239
Gottron papules and heliotrope rash
Dermatomyositis
240
Antidote for Cyanide (nitroprusside) toxicity
Sulfur (Sodium Thiosulfate) = Donates sulfur to liver rhodanase to enhance conversion of cyanide to thiocyanate
241
Microangiopathic hemolytic anemia
Small vessels = DIC, TTP, HUS
242
Triggers of G6PD
Bactrim, Dapsone, Antimalarials, Nitrofurantoin, Fava Beans
243
What is low in G6PD deficiency
NADPH
244
Cause of Lipofuscin
Free radical injury and lipid peroxidation
245
Most common location of supine aspiration
Right Lower Lobe
246
What underlies most cases of Hereditary Hypothalamic Diabetes Insipidus
Neurophysin II mutations
247
SPINK1
Trypsin inhibitor secreated by pancreatic acinar cells
248
Germ tubes when incubated at 37 degrees
Candida --> True Hyphae
249
Hep B replication
dsDNA --> Template +RNA --> dsDNA
250
Fate of tRNA that is mischarged
Will incorporate wrong AA into polypeptide chain (not corrected when charged by AA-tRNA synthetase proofreading)
251
MOA of mushroom toxins
Inhibit DNA-dependent RNA polymerase Type II = mRNA
252
RNA polymerase I vs II vs III
I = rRNA; II = mRNA; III = tRNA
253
MOA of Ricin
Cleaves rRNA component of 60S subunit
254
Resistance to Ethambutol
Increase production of Arabinosyl Transferase
255
Resistance to Streptomycin
Modification of 30S protein structure
256
Resistance to Pyrazinamide
Modify Pyrazinamidase, which must activate Pyrazinamide
257
MOA of Bosentan
Endothelin-receptor antagonist
258
Neutrophil Alk Phos
Elevated in Leukemoid reaction, Decr in CML
259
Acute Leukemia blast percentage
Greater than 20%
260
Eyelid manifestation of Primary Biliary Cirrhosis
Xanthelasma
261
Primary acceptor of amino groups during breakdown of other Amino Acids
Glutamate
262
Glycine + Methylene Group
Serine
263
What type of colonic adenoma can secrete mucus
Villous
264
Perfusion defect anatomically matched by ventilation defect
Collapsed lung
265
First test for PE
CT angiography
266
First line treatment for open angle glaucoma
Prostaglandins
267
Muscle responsible for accomodation? control?
Ciliary muscle - solely under cholinergic (m3) control
268
Treatment of Restless Leg Syndrome
(1) Limit alcohol, nicotine, caffeine; (2) Dopamine Agonists (eg pramipexole)
269
Restless Leg is common in those with
Iron Deficiency, CKD, Diabetes
270
Treatment of Cataplexy
Muscarinic Antagonists (narcolepsy)
271
When does the neural tube form
Third week of fetal life
272
When do the neuropores close
Week Four = Anterior on day 25, Posterior on day 27
273
Tensilon Test
Tx of MG pt with Edrophonium (short acting AChEsterase inhibitor); Lack of improvement = cholinergic crisis
274
What mediates rapid decrease in myocardial calcium before relaxation
Na/Ca pump sarcolemmal pump; and Ca-ATPase
275
Major immune mechanism against Giardia
CD4 and IgA
276
RUQ pain after opiate
Biliary colic from contraction of SM cells in sphincter of oddi
277
Mu opioid effects on Histamine, Parietal Cells
Increase histamine (don't use in hypotension); Decr parietal gastric acid secretion
278
Non-caseating granulomas - Crohn's or Ulcerative colitis
Crohn's
279
Unidirectional enzymes in glycolysis
Gluco/Hexokinase, PFK-1, Pyruvate Kinase
280
F-2,6-BP activates what?
PFK1 = Glycolysis
281
Insulin vs Glucagon effects on PFK1
Insulin --> PFK2 --> F-2,6-BP --> PFK-1 = Glycolysis; Glucagon inactivates PFK-2 via phosphorylation
282
What causes myocardial swelling with ischemia?
No ATP to pump Na (Na/K) or Ca (Ca-ATPase) out
283
Mechanism of nitrites in cyanide poisoning
Oxidized iron to Fe3+, which binds and sequesters cyanide, preventing it from binding cytochrome a-a3
284
What is used beside nitrites in cyanide poisoining
Thiosulfate --> Sulfate binds cyanide
285
Most common cause of aPTT prolongation
Lupus anticoagulants
286
Common findings in PCA stroke
(1) Contralateral hemianopia; (2) Contralateral parasthesias and numbness [thalamus]
287
Cranial Nerves supplied by PCA
III and IV
288
Why gallstones in Crohn's
Can't resorb bile acids in terminal ileum
289
Rate limiting step in catecholamine synthesis? What blocks this?
Tyrosine Hydroxylase - Metyrosine
290
What maintains cardiac output in acute/subacute aortic regurgitation
HR temporarily, but mainly increased LV preload
291
Carbamazepine adverse effects
(1) BM suppression; (2) Hepatotoxic; (3) SIADH
292
Drugs that cause SIADH
Carbamazepine, Cyclophosphamide, SSRI's
293
Allergic contact dermatitis is due to
Antigen presentation by Langerhans cell --> CD4 response
294
Acanthosis
Incr in spinosum (think psoriasis)
295
Hypergranulosis
Excessive granulation of s granulosum (think lichen planus)
296
Max and min pressures in RV, Pulmonary Artery
4-25 in RV; 9-25 in PA
297
Treatment of PSGN
Loop diuretics and Vasodilators to relieve edema and hypertension
298
Most important prognostic indicator in PSGN
Age
299
Osteoporosis tends to affect what bone
Trabecular - Vertebral bodies, Neck of femure
300
what is characteristic of hyperparathyroidism
Subperiosteal resorption with cystic degeneration
301
Vit D bone loss is characterized by
Excessive unmineralized osteoid
302
Osteopetrosis is characterized by
Persistance of primary, unmineralized spongiosa in medullary canals
303
Drugs that cause seizures
I BItE my tongue - INH, Buproprion, Imipenem, Enflurane
304
Most common sites of intracranial hemorrhage
Deep brain = Basal ganglia, Cerebellar nuclei, Thalamus, Pons
305
Cerebral amyloid angiopathy tends to occur in what areas
Lobar/cortical parenchyma
306
Findings with Pulmonary Silicosis
Nodular densities and eggshell calcifications
307
Pulmonar berylliosis findings
Resembles sarcoidosis (nodular infiltrates, enlarged lymph nodes, non-caseating granulomas), but is not strongly associated with pleural plaques or effusions
308
Findings in coal worker's pneumoconiosis
Multiple discrete nodules most prominent in upper lung zones
309
X ray of hypersensitivity pneumonitis due to inhalation of organic dust
Diffuse nodular interstitial infiltrates
310
Granulomatous destruction of liver bile ducts
Primary biliary cirrhosis
311
Intrahepatic hydatid cysts
Echinococcus
312
Mechanism of gingival hyperplasia with phenytoin
PDGF
313
Phenytoin toxicity mainly effects
Cerebellum and vestibular system --> Ataxia, Nystagmus
314
Systolic ejection murmur that increases with standing? Decreases with standing?
Hypertrophic CM - increases; Valvular aortic stenosis - decreases
315
Wide splitting of S1 accentuated by inspiration
Delayed closure of tricuspid = Complete right bundle branch block or tricuspid stenosis
316
Carboxylation of glutamate residues
Vitamin K
317
Erythropoeisis and peripheral blood smeal in Acute Intermittent Porphyria
Erythropoeisis and peripheral blood smear normal
318
Opiates used for diarrhea
Loperamide, Diphenoxylate
319
Pathogens most responsible for post-flu pneumonia
Pneumococcus, S aureus, H flu
320
Mycobacterium kanasaii symptoms
Pulmonary tuberculosis-like symptoms
321
High intracellular NADH in setting of hypoglycemia
Fuel other than glucose is being metabolized
322
High NADH/NAD+ ratio
Pyruvate to lactate and OAA to malate => Inhibits gluconeogenesis
323
What antibody is rarely seen in drug-induced Lupus
Anti-dsDNA (look for anti-histone)
324
Range for microalbuminuria
30-300 ug/mg creatinine
325
MOA of Adenosine in Supraventricular Tachy
Slows conduction thru AV node by hyperpolarizing the nodal pacemaker and conducting cells
326
All inhalational anesthetics, except what, are respiratory depressants
NO
327
Inhalational anesthetics preferred in pts with asthma
Halothane, Sevofluorane - Bronchodilation properties
328
Inhalational anesthetic effects on hepatic, renal, and cerebral BF
Decr hepatic; Incr cerebral; Decr GFR and RPF
329
Main side effects of bile acid binding resins
HyperTG (incr VLDL and TG synthesis), GI upset, Malabsorption, Gallstones
330
First line treatment of hypertriglyceridemia
Fibrates - decr hepatic synthesis
331
Clinical manifestations of schistosomiasis result from
Th2-mediated granulomatous response directed against eggs (with eos and mac's)
332
Periportal Pipestem Fibrosis
Hepatic schistosomiasis
333
Echinococcus reservoir
Dog
334
Diphyllobothrium latum comes from
Freshwater fish
335
2,3-BPG only binds to
Deoxyhemoglobin
336
Why doesn't HbF bind 2,3-BPG as well
Serine residues instead of histidine
337
HbC
Glutamic acid --> Lysine = Mild, chronic hemolytic anemia
338
Directly responsible for intimal thickening in athersclerosis
Smooth muscle cells (NOT FIBROBLASTS)
339
Treatment with Menotropin and hCG
Menotropin is human menopausal gonadotropin and acts like FSH; hCG acts like LH surge
340
Hepatolenticular degeneration
(GP and Putamen) Wilson's disease --> Wing-beating tremor, Psychosis
341
Burning or stabbing sensation in one half of body
Thalamic syndrome
342
Mechanism of Dermatitis Herpetiformis
Cross reaction of anti-Gliadin ab's with Reticulin in epidermal basement membrane
343
Cerebral amyloid angiopathy vs hypertensive hemorrhage
Lower mortality rate, More benign clinical course than hypertensive hemorrhage
344
Hematuria and proteinuria in subacute BE
Immune complex deposition
345
Bacteriostatic antibiotic that inhibits binding of aminoacyl-tRNA to 30S subunit
Tetracyclines
346
What is upregulated after statins lower total serum cholesterol
LDL receptor
347
LCAT vs CETP
LCAT catalyzes esterification of cholesterol (nascent HDL to mature HDL); CETP transfers cholesterol to other lipoprotein particles
348
Endocrine hormones that increase cAMP
FLAT ChAMP CGC - FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH, Calcitonin, GHRH, Glucagon
349
Hormones that increase cGMP
ANP, BNP, NO (EDRF)
350
Endocrine Hormones that increase IP3
GOAT HAG - GnRH, Oxytocin, ADH (V1), TRH, H1, AgII, Gastrin
351
Intrinstic tyrosine kinase receptors
Insulin, IGF-1, FGF, PDGF, EGF
352
Receptor-associated tyrosin kinase
PIGGLET - Prolactin, Immunomodulators (Cytokines, IFN), GH, G-CSF, EPO, Thrombopoetin - Acidophils and Cytokins
353
Resistant to Ampicillin but sensitive to Ceftriaxone
Beta-Lactamase production
354
Meniere's disease
Triad of vertigo, sensorineural hearing loss, tinnitus --> Incr production and/or decr excretion of endolymph
355
Blastomycosis on chest x ray
Mimics TB --> Granulomatous nodules
356
Systolic ejectin in aortic stenosis
Decr, because it takes longer for valve to open
357
Most common cause of pyridoxine deficiency
INH
358
First line for malignant otitis externa
Fluoroquinolone
359
Renal and lungs masses --> Improvement after removing renal mass
RCC --> Tx with IL_2
360
Central Venous Pressure and what tend to correlated
Pulmonary capillary wedge (at least in septic shock?)
361
Normal CVP and PCWP
CVP 2-8; PCWP 2-15
362
Effects of Ia, b, and c on AP conduction conduction velocity
Ia slows, Ib no effect, Ic slows
363
Effects of Ia, b, and c on AP duration
Ia prolongs, Ib shortens, Ic minimal effect
364
Predominant actions of Class II antiarrhythmics
Slow sinus node discharge rate, Slow AV node conduction and prolong refractoriness
365
Predominant effects of Class III antiarrhythmics
Prolong AP duration; No effect on conduction velocity
366
Predominant effects of Class IV antiarrhythmics
Slow sinus node discharge rate; Slow AV node conduction and prolong refractoriness
367
MOA of Adenosine
A1 receptors --> Activates K channels --> incr K conductance --> transient conduction delay thru AV node
368
Digoxin effects on AP duration and QT interval
Decr APD, Shorten QT interval
369
C3a stimulates
Histamine release --> Permeability, Dilation
370
Platelet Activating Factor causes
Platelet agg, Vasoconstriction, Bronchoconstriction, Incr leukocyte adhesion to endothelium
371
Hyperplastic polyps are composed of
Well-differentiated mucosal cells that form glands and crypts
372
Hamartomatous polyps are composed of
Mucosal glands, Smooth muscle, CT
373
Inflammatory polyps are seen in
UC, Crohn's --> Regenerating intsetinal mucosa
374
Lymphoid polyps are found in
children
375
4 Non-neoplastic polys
Hyperplastic, Hamartomatous, Inflammatory, Lymphoid
376
Symptoms of Diffuse Esophageal Spasm
Dysphagia and Chest pain
377
Phosphoglucomutase
Glucose 1 6 phosphate
378
Carnitine deficiency
Impairs FA transport into mitochondria, restricting ketone body formation
379
Skeletal Muscle Carnitine def symptoms
Myoglobinemia, Weakness after exercise, Elevated muscle TG's, Hypoketonemia
380
Medium Chain Acyl-CoA DH deficiency
Hypglycemia, Hypoketonemia
381
Tryptophan is a precursor for
Nicotinic Acid, Serotonin, Melatonin
382
Clinical manifestations of Hartnup disease are primarily due to
Tryptophan malabsorption --> Niacin deficiency
383
Symptoms of Hartnup
Most children asymptomatic --> Can have pellagra-like rashes, photosensitivity, ataxia
384
Urinary excretion of what AA's is normal in Hartnup
Proline, Hydroxyproline, Arginine
385
Thiamine use by the body is maximal in states of
Accelerated carb metabolism
386
Pyridoxine def results in
Anemia, Peripheral neuropathy, Dermatitis
387
Tocopherol deficiency
Vitamin E = Myelopathy and neuro
388
How do Listeria and Shigella survive intracellularly
Escape from phagosome into cytosol
389
How does MTB survive intracellularly
Blocks fusion of phagosome with lysosome, Inhibits phagolysosome acidification
390
Immune response to Listeria
IFNg, TNFb, IL-12 --> Cell mediated response --> macrophage killing
391
Gram negative rod that grows at 4 degrees
Listeria
392
Uricosuric drugs
Probenecid, Sulfinpyrazone
393
Xanthine oxidase inhibitor safer than allopurinol
Febuxostat
394
Most common manifestation of CMV in HIV
Retinitis
395
Epispadias results from
Faulty positioning of genital tubercle in fifth week of gestation
396
Virus that aquires lipid envelope form nucleus
Herpes family
397
Blockade of what receptor inhibits gluconeogenesis, glycogenolysis, and lipolysis
B2
398
Main effect of nitrates in treating angina
Reduce preload --> reduce LV volume
399
Herniation causing CN III neuropathy
Uncal
400
Most common cause of Abetalipoproteinemia
LOF mutation in Microsomal TG Transfer Protein (MTP) --> Normally folds apoB and transfers lipids into chylomicros or VLDL
401
Polyol pathway impairment occurs in tissues that
Do not rely on insulin for glucose transport (lens, peripheral nerves, kidney, blood vessels)
402
Elevated galactitol
Galactosemia --> Cataracts
403
Cross linking of proteins by glycosylation products in vessels facilitates
Inflammatory cell invasion, Deposition of LDL --> Atheroscerlosis
404
Skeletal findings in hyperparathyroidism
Cortical (compact) bone in appedicular skeletal --> Subperiosteal erosions, Salt-and-pepper skull, Osteolytic cysts (osteitis fibrosa cystica)
405
Disorganized lamellar bone structure in mosaic pattern
Paget's
406
Osteoid matrix accumulation around trabeculae
Vit D deficiency - Excessive unmineralized osteoid with widened osteoid seams
407
Persistence of primary spongiosa in medullary cavity with no mature trabeculae
Osteopetrosis --> Accumulation of woven bone, diffuse skeletal thickening
408
Trabecular thinning with fewer interconnections
Osteoporosis
409
How do erythrocytes utilize NADPH
Maintain Glutathione in reduced state by glutathione reductase
410
What is a Heinz body
Denatured Hb from oxidative stress
411
As opposed to serotonin syndrome, NMS is characterized by
Absence of myoclonus and presence of rigidity
412
Keratoderma blennorhagicum commonly associated with
Reactive Arthritis
413
Mechanism of Pertussis toxin
Disinhibits AC via Gi ADP ribosylation --> incr cAMP --> Incr histamine sensitivity and phagocyte dysfunction
414
Direct tissue effects of GH
(1) Insulin resistance; (2) Fat utilization; (3) Protein synthesis
415
Indirect tissue effects of GH
IGF-1 by liver --> Growth of bone, cartilage, soft tissue
416
GH vs IGF-1 receptor
GH is JAK-STAT; IGF-1 is specific receptor TK
417
Main sites of digestion and absorption of dietary lipids
Duodenum --> Jejunum
418
How does diet affect calcium stones
Low calcium diet actually increases risk; High protein and Na diet increases risk
419
What is recommended for patients with calcium stones who have hyperoxaluria
Pyridoxine --> Decreases endogenous oxalate production
420
Vitelline vs Cardinal veins
Vitelline form portal; Cardinal form caval
421
PG's that mediate protection of gastric mucosa
PGI2 and PGE2
422
Salicylism
Vertigo, Tinnitus, Hearing loss
423
Classic Legionnaires presentation
Very high fever in smoker + diarrhea, confusion, cough
424
Coccidiomycosis in immunocompetent
Usually asymptomatic
425
Conversion of NE to Epi occurs where? Stimulated by?
Adrenal medulla by PNMT - Stimulated by Cortisol (incr PMNT gene expression)
426
COMT converts epi and NE to
Metanephrine and Normetanephrine
427
SGLT2 inhibitors
Canagliflozin, Dapaglifozin
428
AE's of SGLT2 inhibitors
Urinary tract and Genital mycotic infections; Symptomatic hypotension
429
What should be assessed before starting SGLT2 inhibitors
Renal function
430
Which anti-diabetic requires LFT's
Thiaxolidinediones
431
Soft, breathy voice =
Vocal cord dysfunction
432
Acid-base abnormality in ATN
Retention of H and anions --> high anion gap metabolic acidosis
433
Recovery phase of ATN
Profuse diuresis, HypoK/Mg/PO4/Ca
434
Triptan MOA
5-HT 1b/d agonists --> Inhibit vasoactive peptides, promote vasoconstriction, block pain pathways
435
Bupropion MOA
DA, NE reuptake inhibitor
436
Migraine prophylaxis
TCAs, SNRI's, BB's, Valproate, Topiramate
437
What cholesterol meds increase bile acid synthesis
Binding resins; Fibrates
438
First and second line treatment of AF with RVR
CCBs/BB's, then Digoxin
439
Delayed afterdepolarizations
Occur in states of hyperexcitability (eg high intracellular Ca or high catecholamine states) - How digoxin can lead to Vtach
440
Signs of Uncal (transtentorial) herniation
CNIII, Contralateral or ipsilateral hemiparesis (crus cerebri), Contralateral homonymous hemianopsia with macular sparing (PCA)
441
Subfalcine herniation sign
ACA compression
442
Duret hemorrhage
Caudal displacement of brainstem --> Rupture of paramedian basilar artery branches --> Duret
443
Ingestion of what can cause myxomatous degeneration
Sweet peas --> Angiolathyrism
444
Incr murmur in HOCM
Decrease preload or afterload --> Decr LVEDV and increase outflow obstruction
445
Bile salt deconjugation
Colonic bacteria in small intestine --> Steatorrhea due to failure of miscelle formation
446
Final product of FA oxidation that enters CAC
Succinyl CoA (from methlymalonyl CoA)
447
Lab findings in SLE
Hemolytic anemia, Thrombocytopenia, Leukopenia, Hypocomplementemia
448
Cause of anemia and thrombocytopenia in SLE
Type II hypersensitivity
449
Fibrous intimal thickening with endocardial plaques limited to right heart
Carcinoid heart disease --> Pulmonic stenosis, Restrictive cardiomyopathy
450
How to grow H flu in sheeps blood agar
S aureus --> X factor released by hemolysis, V factor secreted by s aureus
451
Fat embolism syndrome is characterized by
pulmonary insufficiency, diffuse neuro impairment, thrombocytopenia, anemia
452
46 XY with normal Leydig cells but total absence of Sertoli
Male external genitalia (DHT); Both Female and Male internal genitalia (need Sertoli to produce MIF)
453
Treatment of pinworm (Enterobius)
Albendazole
454
Diethylcarbamazine is used to treat
Loa Loa, Wuchereria bancrofti
455
Ivermectin is used to treat
Strongyloides, Onchocerciasis
456
Nifurtimox is used to treat
Trypanosomes, including Chagas
457
Praziquantel is used to treat
Schistosoma, Clonorchis, Tenia, Diphyllobothrium - Praise the SC TD
458
Don't use colchicine in
Pregnancy, Renal dysfunction
459
Glucocorticoids inhibit what step of PG synthesis
LPA2
460
Preferred treatment of acute gouty arthritis in elderly or renal failure
Glucocorticoids
461
Specific inhibitor of 5-lipoxygenase
Zileuton --> Inhibits LTB4, C4, D4, E4
462
Monteleukast MOA
LTD4 receptors
463
Stimulation of B1 receptors in heart causes what 3 effects:
(1) + Inotropy; (2) Weak + chronotropy; (3) Incr conduction velocity
464
FGF contributions
Angiogenesis, Embryonic development, Hematopoeisis, Wound repair
465
Incr LV diastolic pressure in paitent with suspect Mitral Stenosis
Aortic valve also dysfunctional
466
Mechanism of Ciguatoxin and Batrachotoxin
Binds Na channel, keeping it open --> persistent depolarization
467
Toxin that acts similarly to Tetrodotoxin
Saxitoxin
468
What increases solubility of cysteine
High pH - So risk of cystine stone with low pH
469
Cystine shares transporter with
Ornithine, Arginine, Lysine
470
OTC deficiency symptoms
Hyperammonemia, Mental retardation
471
Daptomycin is not effective in treating
Gram negatives; Pneumonia (surfactant)
472
Terbinafine MOA
Squalene Epoxidase
473
Effectiveness of Unfractionated Heparin vs LMWH
Unfractionated has equal activity against Factor Xa and Thrombin; LMWH has greater activity against Factor Xa than thrombin
474
How to separate Gamma hemolytic Strep's
Enterococci is PYR+, Grows in bile and NaCl; Bovis is PYR-, grows in bile but not NaCl
475
How to separate Alpha hemolytic Strep
Viridans is Optochin resistant and Bile insoluble
476
Effect of TNFa on Insulin receptor
Phosphorylates serine residues of Insulin Receptor Substrate 1 --> Decr activity
477
Phosphorylation of serine residues of Insulin Receptor Substrate 1
TNFa, Catecholamins, Glucocorticoids, Glucagon --> Insulin resistance
478
Papillary Thyroid cancer histology
Large cells w/ overlapping nuclei, Finely dispersed chromatin, Ground glass appearance = Orphan Annie
479
Benign follicular thyroid adenoma vs carcinoma
Invasion of vessels or capsule
480
Corneal reflex pathway
Nasociliary V1 --> Temporal branch of VII
481
Contents of Superior Orbital Fissue
CN III, V1 branches, CNIV, CNVI, Superior Ophthalmic veins
482
Bleeding in CKD patient
Uremic toxins --> Impair platelet aggregation
483
HIV Bloody diarrhea - Hemorrhagic polypoidal lesions, Spindle cells with surrounding blood vessel proliferation
Kaposi sarcoma
484
Chronic rejection of lung transplant
Small airways --> Bronchiolitis obliterans
485
Most common cause of elevated AFP
Dating error - Confirm with fetal US
486
Decreased Estriol on Triple Test
Placental insufficiency
487
Retrolental fibroplasia
Retinopathy of prematurity - Neovascularization from hypoxia and oxygen therapy
488
Serum added to mixture of cardiolipin, lecithin, cholesterol
Rapid Plasma Reagin test
489
7a hydroxylase
Cholesterol --> Bile Salts
490
Tholase
Condenses two equivalents of Acetyl-CoA to form Acetoacetyl-CoA --> Substrate for HMG CoA Reductase
491
Extremely high hCG may cause
Hyperemesis gravidarum, Pre-eclampsia, Hyperthyroidism, Theca-lutein cysts
492
Drugs that increase Lithium levels
Thiazides (not loops), ACEi's, NSAIDs
493
Lithium reabsorption in kidney is linked to
Na reabsorption
494
Major AA responsible for transferring nitrogen to liver for disposal
Alanine
495
Hepatic tumor that can regress after OCT discontinuation
Hepatic Adenoma
496
Most common benign liver tumor
Cavernous Hemangioma
