UWorld Journal Flashcards
(739 cards)
1
Q
blood supply to the liver
A
celiac –> common hepatic
2
Q
uncomplicated umbilical hernia pathophys
A
incomplete closure of umbilical ring (doesn’t become linea alba)
3
Q
long term asthma tx
A
glucocorticoids (like fluticasone)
4
Q
what kind of volume contraction is diabetes insipidus
A
hyperosmotic vol contraction (lose more water than electrolytes, up osm, down ECF and ICF)
5
Q
filtration rate of substance X (equation)
A
filtration rate of X = inulin clearance/plasma X
6
Q
excretion rate of substance X (equation)
A
excretion rate of X = (inulin clearance)(plasma X) - (reabsorption of X)
7
Q
amanita (mushroom) pathophys
A
bind to RNA polymerase I –> halt mRNA synth –> apoptosis
8
Q
which cells make elastase in the lungs?
A
alveolar macrophages and neutrophils
9
Q
where is the vomiting center of the brain?
A
chemoreceptor trigger zone dorsal medulla (area postrema)
10
Q
agent present in perforated appendicitis
A
bacteroides fragilis (or other normal flora like E. coli, enterococci, streptococci)
11
Q
how does pCO2 affect ICP
A
pCO2 down –> vasoconstriction (up vasc resistance) –> down ICP
12
Q
gaussian distribution: SDs and %data
A
w/in 1 = 68%
w/in 2 = 95
2/in 3 = 99
13
Q
hyperlipid med causes flushing
A
niacin
14
Q
enzyme responsible for green sputum
A
myeloperoxidase from neutrophils
15
Q
drug with AE of gingival hyperplasia
A
phenytoin
16
Q
tx for DM with nephropathy
A
glycemic control + ACE inhibitors (-prils)
17
Q
what is hot tub folliculitis
A
pseudomonas infection of skin from pool –> puritic papulopustular rash
18
Q
what does the vitaline duct connect
A
ileum and umbilicus
19
Q
abnormalities w/ vitaline duct
A
persistent (meconium from umbilicus)
meckel diverticulum (MC)
sinuses/cysts
20
Q
when to use a chi-square test
A
association btwn 2 categorical variables
21
Q
pathophys of trisomies
A
usually due to meiotic nondisjunction
22
Q
what is used for MAC prophylaxis in AIDS pts?
A
azithromycin
23
Q
Tx status epilepticus
A
IV benzos (lorazepam)
24
Q
whats in MEN1
A
primary hyperparatyroidism
pit tumors
panc tumors
25
whats in MEN2A
medullary thyroid CA (calcitonin)
pheo
parathyroid hyperplasia
26
whats in MEN2B
medullary thyroid CA
pheo
mucosal neuromas
27
oral candida vs leukoplakia
candida scrapes off
28
e. coli pathophys --> septic shock
lipid A (of LPS) --> septic shock
29
septic shock sx
```
fever
hTN
diarrhea
oliguria
DIC
```
30
what nerve is hurt if you lose plantar flexion and foot inversion?
tibial nerve
31
what are the deficits a/w tibial nerve injury?
cant plantarflex or invert
| sensory: sole of foot (not big toe)
32
GH signaling pathway
JAK-STAT
33
where does heme synth take place
mitochondria
34
sx of congenital hypothyroidism
floppy baby, puffy face, umbilical hernia, protruding tongue, large anterior fontanelle
35
whats used in making NO
arginine, NADPH, O2
36
when do you see overlapping fingers in a newborn
edwards (tri18)
37
when do you see air in the biliary tree
gallstone ileus
38
when do you hear high pitched bowel sounds
small bowel obstruction
39
how do you get vibrio parahemolyticus
contaminated shellfish
40
what are the crescents in RPGN made of
fibrin
41
how to measure mitral regurge severity
time from S2 (A2) to opening snap
42
when do you see a liver w/ lymphocytic infiltration and destruction of small intrahepatic bile ducts?
primary biliary cholangitis
| graft vs host disease
43
find out wtf azathioprine is
i dunno, look it up
44
cause of different clinical manifestations of a mitochondrial disorder
heteroplasmy (diff mitochondrial genomes in same cell)
45
pathophys cleft palate
maxillary prominence fails to fuse w/ intermaxillary segment (5th/6th week)
46
enzymes involved in regulating hypoglycemia due to fasting
glucagon (up hepatic glycogenolysis)
E/NE
cortisol (increases gluconeogenesis, lipolysis, proteolysis)
47
vitamin changes in SI bacterial overgrowth
more vit K, folate
| less B12, iron, vit ADE
48
anticholinergic effects on vision/eyes
limit accomodation (blur close vision)
mydriasis
dry eyes
49
big P gap btwn aortic and LV P during systole indicates
aortic stenosis
50
chronic renal allograft rejection path
obliterative intimal thickening
tubular atrophy
interstitial fibrosis
51
hyperacute rejection of renal allograft path
vascular fibrinoid necrosis
| neutrophil infiltration
52
COPD effects on kidney
hypoxia --> increased EPO production
53
capsofungin mechanism
suppress fungal cell wall synthesis
54
what karyotype is most common in partial mole
46XX (1 sperm duplicate)
55
how do you know if the CI is statistically significant?
95% does not include null
56
how to avoid acyclovir nephrotox
aggressive IV hydration
57
chest pain reproduced with palpation or changes in position
costosternal syndrome
58
bronchi vs bronchioles, cell differences
both have cilia
| bronchioles lack goblet cells, glands, cartilage
59
pathophys of finger drop
repetitive movements --> damage to supinator canal --> radial nerve/deep branch/posterior interosseus nerve injury --> cant extend fingers/thumb
60
complication of reactive arthritis
```
feratoderma blennorrhagicum (vesicles on palms/soles)
sacroiliitis
```
61
cause of caudal regression syndrome in newborns
uncontrolled DM (+other unknown)
62
AE levels in thiazide diuretic use
hypo: Na, K
hyper: Ca, glucose, cholesterol, urea
63
nerve compressed in saturday night palsy
radial
64
cytokines involved in granuloma formation (TB)
macs secrete IL-12 (activate TH1)
| TH1 make IFN-alpha (recruits macs)
65
pathophys of S3
turbulent blood flow in ventricles from increased volume
66
pathophys of S4
blood hits stiff ventricle
67
which ulcers are rarely malignant
duodenal
68
whats the defect in Ehlers-Danlos
collagen synthesis
69
problem in scurvy
no vit C --> cant hydroxylate proline and lysine
70
where do you get the saphenous vein
inferolateral to pubic tubercke = femoral triangle: inguinal lig (sup), sartorius (lat) and adductor longus (med)
71
emphysema mechanism
oxidative injury --> macs/neuts make proteases --> degrade matrix + make more free radicals that mess with protease inhibitors --> proteases go wild (protease-antiprotease imbalance) --> acinar wall destruction --> irreversible airspace dilation
72
liquefactive necrosis pathophys
ischemia --> neurons release lysosomal enzymes which degrade tissue --> phagocytes come and remove necrosis --> cavity --> astrocytes proliferate around area to make scar (gliosis)
73
deltaF508 mutation --> ?
CF
74
what exactly happens w/ an RPR
mix serum w/ cardiolipin, cholesterol, lecithin
if it aggregates there are Abs present from cell destruction from treponema
(note: NOT testing for Abs against treponema)
75
difference btwn AF conduction and purkinje conduction
```
AF = tachy (more common)
purkinje = brady
```
76
things made from POMC
ACTH
MSH
some endorphins apparently that act @ opioid receptors
77
pneumonia post flu (MC organisms)
strep pneumo
staph aureus
H flu
78
where (exactly) do beta blockers work
inhibit NT binding to receptor in adrenergic synapses
79
MC aortic rupture after blunt trauma
aortic isthmus
| ascending is next but v rare
80
enzyme defect in xeroderma
defect in nucleotide excision repair
can't take out thymine dimers
defective UV-specific ENDONUCLEASES
81
what does a virus need to do genetic shift?`
segmented genes
82
what is a/w absent CD18?
leukocyte adhesion deficiency
83
AEs of dopamine
```
anxiety
agitation
confusion
delusions
hallucinations
```
84
what is IP3
inositol triphosphate
85
how does silicosis make someone more susceptible to TB?
silicosis impairs macrophage fxn (phagolysosomes disrupted by internalized silica, maybe)
86
liver and lungs?
alpha-1-antitrypsin deficiency
87
sx of pellagra
dermatitis
diarrhea
dementia
88
internal hemorrhoid drainage
middle rectal vein --> internal iliac
| superior rectal vein --> inferior mesenteric
89
external hemorrhoid drainage
inferior rectal vein --> internal pudendal vein
90
what is pulsus paradoxus
fall in systolic BP > 10 w/ inspiration (cardiac tamponade, constrictive pericarditis, COPD, asthma, PE)
91
boggy uterus
uterine atony
92
surgery to stop uterine bleeding: which arteries?
bilateral internal iliacs
93
how do you dx parotitis
```
increased amylase (w/o pancreatitis)
US/CT
```
94
parotitis sx
swelling
trismus
dysphagia
fever/chills
95
effects of prolactinoma on women
amenorrhea
galactorrhea
decreased bone density (less E)
96
prolactin inhibitory effects
suppress LH (and FSH, but less)
97
dx gout
synovial fluid crystal analysis (same as synovitis)
98
major AE w/ lamotrigine
stevens-johnson-syndrome
99
watershed areas of gut
splenic flexure
| resctosigmoid jxn
100
what O2 thing stays the same in methemoglobinemia
PO2 (measure of dissolved O2, not whats on Hb)
101
opioid mechanism
```
bind to mu receptors
G-protein coupled activation of K channels
up K efflux
hyperpolarization of neurons
termination of pain transmission
```
102
lack CD 55
paroxysmal noctural hemoglobinuria
103
paroxysmal noctural hemoglobinuria kidney things
hemoglobinuria (duh)
| chronic hemolysis --> iron deposition in kidneys (hemosiderosis) --> mess with PCT fxn
104
Abs that react with tissue transglutaminase
celiac (tissue transglutaminase IgA)
105
dx for celiacs
check tissue transglutaminase IgA/antiendomysial Abs
| biopsy duodenum or jejunum (flattened villi, increased intraepithelial lymphocytes)
106
ovary + stomach
krukenberg tumor
107
krukenberg tumor histo
mucin secreting signet cells
108
genes involved in colon adenoma to carcinoma
p53 and DCC
109
long QT mechanism
mutations in K channels --> prolong action potentials
110
hereditary pattern of NF1
AutoDom, chromosome 17
111
hemolysis of enterococcus
gamma.....no hemolysis
112
class I vs class II HLAs
```
class I: B
class II: DP, DQ, DR
```
113
narrowing of the sacroiliac joints
ankylosing spondylitis
114
HLA a/w ankylosing spondylitis
HLAB27
115
drug abuse: nystagmus
PCP
116
what type of muscle fiber are postural muscles
type I: slow twitch: red, high myoglobin, high mitochondrial
| mostly aerobic metabolism
117
wheres the vision loss with a right temporal lobe lesion
pie in the sky on L
| meyers loop
118
recombination vs reassortment vs phenotypic mixing
recombination: non segmented viruses (progeny can have all new traits)
reassortment: segmented viruses (progeny can have either or both traits)
phenotypic mixing: 2 viruses in 1 host, released virions can have mix of phenotypes, next generation goes back to original
119
sertoli cells do what
make inhibin in response to FSH (inhibin inhibits FSH)
| help with spermatogenesis
120
leydig cells do what
make T in response to LH (T inhibits LH and GnRH)
121
wtf are zinc fingers
DNA binding domain found on hormones that bind to DNA
122
which hormones have zinc fingers
steroids, thyroid hormone, fat soluble vitamin receptors (i know that isnt a hormone, leave me alone)
123
what does CO do to Hb
binds crazy strong (Hb is now carboxyhemoglobin)
124
CO on the O2 curve
left shift
125
marcus gunn pupil
lesion optic nerve
126
number needed to harm equation
1/attributable risk
| AR = rate of tx - rate of placebo
127
causes of primary polydipsia
MDMA
| psych d/os
128
complication of cavernous hemangioma
intracerebral hemorrhage
129
tx for adrenal crisis
glucocorticoid: hydrocortisone or dexamethasone
130
NO mechanism
NO --> up cGMP --> decrease intracellular Ca --> decrease myosin light chain kinase activity --> myosin light chain dephosphorylation --> muscle relaxation
131
what converts heme into biliverdin
heme oxygenase
132
when do you see postherpetic neuralgia
VZV (not HSV)
133
when to use the two sample t-test
comparing means of 2 pops
134
organophosphate mechanism
acetylcholinesterase inhibitor
135
where do you absorb fat
jejunum
136
abnormal ristocetin test
von Willebrand disease (poor platelet agg w/ ristocetin, agg w/ normal plasma)
Bernard-Soulier/GP Ib def (poor platelet agg w/ ristocetin, doesn't fix w/ normal plasma)
137
mucocutaneous bleeding
von Willebrand (vWF)
Bernard-Soulier (GP IIb)
Glanzmann (GP IIb-IIIa)
138
diff btwn true and pseudo diverticula
true: include mucosa, submucosa, *muscularis* and serosa layers (Meckels, appendix)
pseudo: mucosa, submucosa, serosa (zenker, colon ticks)
139
what cells do Ab-dependent-cell-mediated-cytotox
eosinophils
macs
neuts
NK cells
140
when to use MAO-Is
atypical depression
| Tx-resistant depression
141
atypical depression features
mood reactivity
leaden paralysis
rejection sensitivity
increased sleep/appetite
142
axonal rxn
changes in neuron after its severed
| swollen, rounded, nuc displaced, nissl substance is granular and dispersed (central chromatolysis)
143
blood Abs: types
usually IgM (O moms have IgG -- can cross placenta)
144
pharmacodynamic potentiation
more than the sum of its parts
145
Ca levels in metastatic bone cancer
hypercalcemia from destruction of bone
146
dopaminergic pathways
mesolimbic (+ schizo sx)
mesocortical (- schizo sx)
nigrostriatal (movement)
tuberoinfundibular (inhibit prolactin)
147
tx for postprandial hyperglycemia
lispro
aspart
glulisine
148
tx for TCA cardiotox
sodium bicarb (more basic serum -- neutralizes TCA, increases extracellular sodium to overcome competitive inhibition)
149
vit def --> pancreatic gland metaplasia
vit A
150
vit E def --> ?
infertility
151
vit D def --> ?
rickets (kids)
| osteomalacia (adults)
152
interscalene nerve block affects brachial plexus and...
ipsilateral diaphragm (avoid in pts w/ chronic lung dz or contralateral phrenic nerve dysfxn)
153
where does collagen production take place in the cell?
RER
154
cells involved in delayed type hypersensitivity
CD4, CD8, macs
155
what does DNA polymerase III do
5-3 DNA synthesis
| 3-5 exonuclease activity (proofreading)
156
what does DNA polymerase I so
5-3 DNA synthesis
3-5 exonuclease activity (proofreading)
5-3 exonuclease activity (remove RNA primer)
157
why do preggers have increased insulin resistance
syncytiotrophoblast makes human placental lactogen (hPL)
158
making catecholamines
adrenal medulla
| symp release *Ach* --> chromaffin cells --> make catecholamines (80% epi, 20% NE)
159
muscles worked in kegels
levator ani (iliococcygeus, pubococcygeus, puborectalis)
160
wheres the problem: weakness in dorsiflexion and eversion, impaired dorsal foot/lateral shin sensation
common peroneal nerve
161
hypertrophic scarring mechanism
elevated transforming growth factor (TGF-beta) increases fibroblast proliferation/activity
162
likely blood problems with cirrhosis
less clotting factors (liver makes II, VII, IX, X) (DisCo was born in 1972) --> VII has shortest half life
less albumin --> edema
163
R vs L sided colon CA
R: more space, bigger, bulkier --> occult bleeding, anemia
L: smaller, narrow lumen --> obstruction, changes in bowel habits
164
drug that lengthens QT but doesnt have high risk of torsades
amiodirone
165
muscle biopsy shows ragged red fibers
mitochondrial myopathy
166
sx of mitochondrial myopathy
muscle weakness, myalgia, lactic acidosis, neuropathy, seizures
167
1st/2nd gen antihistamines (list)
1st: diphenhydramine, hydroxyzine, promethazine, clorpheniramine
2nd: loratadine, cetirizine
168
diff btwn 1st/2nd gen antihistamines
2nd: better for old folk: less anti-Ach, anti-5HT, anti-alpha-adrenergic --> minimal side effects; less lipophilic --> dont cross BBB
169
deficiency common in sickle cell anemia (or other hemolytic anemias)
folic acid deficiency due to increased RBC turnover
170
folic acid def --> macrocytic anemia path
low folic acid --> impair DNA synth --> slows diving rate --> cytoplasmic components build up --> big cells
171
mediator of cachexia (wasting in systemic dz)
TNF-alpha
IL-1 beta
IL-6
172
MCC renal infarction
thromboembolism (from atrium or ventricle)
173
bladder things in MS
spastic bladder from UMN lesion
bladder hypertonia --> does not relax/distend
full emptying
174
phenotypic mixing
2 viruses in one cell
released virions have shared features
progeny are first generation
(no genetic changes, just pheno)
175
cells responsible for inflammation in gout
neutrophils
176
whats damaged in the ear with prolonged exposure to loud noises
organ of corti
177
retinal artery occlusion mechanism
usually from bruit
internal carotid
ophthalmic artery
retinal artery
178
white/yellow scars on the retina
toxo in utero
179
uretal obstruction does what to GFR and FF?
GFR goes down
| FF goes down
180
consequences of treating NARDS
O2 given during treatment can --> retinal damage
| retinopathy of prematurity or retrolental fibroplasia
181
deficiency in SCID
def adenosine deaminase --> no T or B cells
182
acyclovir mechanism
nucleoside analog
phosphorylated by virus
gets incorporated into viral DNA
terminates synthesis
183
ortner syndrome
mitral stenosis --> atrial dilation --> impinge left recurrent laryngeal nerve --> hoarseness
184
fibrates --> gallstones: mechanism
inhibit bile acid synth
decreased cholesterol solubility, increased microcrystal formation
--> gallstones
185
etanercept mechanism
TNF-alpha inhibitor
| acts as decoy receptor?
186
vermiis lesion -->
```
truncal ataxia (wide, unsteady gait)
maybe vertigo and nystagmus
```
187
Hep B/C vs steatosis histo
Hep B: granular, homogenous eosinophilic inclusions
hep C: lymphoid aggregates, focal areas of macro-steatosis
steatosis: large and small vesicles of fat
188
signet ring in stomach
gastric adenocarcinoma
189
gastric adenocarcinoma lesion characteristics
diffuse involvement of stomach wall (lose E-cadherin)
| plaque-like appearance, ill defined
190
what immune cell increases with corticosteroid use
neutrophils (demargination - they fall off tissues into blood, but can't fight stuff there --> increased risk of infection)
191
MC complication of bicuspid aortic arch
aortic stenosis
| then endocarditis, then dissection
192
which joints are affected by rheumatoid arthritis
small joints: PIP, MCP, MTP (spares DIP)
| cervical spine
193
where are very long chain fatty acids oxidized?
peroxisomes
194
what nerve innervates sensation on posterior part of external auditory canal?
vagus (X)
195
what drugs reactivate TB
TNF-alpha inhibitors
| enantercept, infliximab, adalimumab
196
age changes that can --> isolated systolic HTN
increased arterial stiffness (decreased elastin, increased collagen)
197
MC renal stones
Ca stones (oxalate, phosphate)
198
MC Ca levels that --> stones
hypercalciuria w/ normocalcemia (vit D and PTH regulate serum)
199
where in the body is the oxygenation of blood lowest?
coronary sinus (heart extracts more O2 than the tissues do)
200
what mediators are responsible for coronary blood flow?
adenosine and NO
201
deficiency in Fabry dz
alpha-galactosidase A (X-linked)
202
part of bacteria that allows it to go into different -tonic solns
cell wall (use of ABX against cell wall takes away this ability)
203
enoxaparin mech
LMWH
| bind ATIII, which binds to factor Xa so it cant convert prothrombin to thrombin
204
clavulanic acid mech
beta lactamase inhibitor (protects beta-lactamase susceptible ABX)
205
agents responsible for recurrent infections in pt w/ CGD
catalase positive
206
areas of gut involved in Hirschsprung dz
rectum and anus (always)
| usually sigmoid colon too
207
markers for small cell lung cancer
neural cell adhesion molecules (NCAM, aka CD56)
| all are signs of neuroendocrine differentiation
208
signs of vit E def
neuron/RBCs susceptible to oxidative stress -->
| ataxia (neuromusc dz), impaired prop/vibe, hemolytic anemia
209
causes of frothy, foamy urine
proteinuria or bile salts in urine
210
deficiency in Lesch-Nyhan syndrome
hypoxanthine-guanine phosphoribosyltransferase (HGPRT): purine salvage pathway
211
latissimus dorsi movements
extension
adduction
internal rotation
212
innervation of latissimus dorsi
thoracodorsal nerve
213
schizophreniform time frame
> 1 month
214
bipolar I vs II
I: mania > 1 wk, may or may not have psychosis
II: hypomania and MDE (no psychosis)
215
testicular tumor that could also stimulate thyroid
non seminomatous germ cell (secrete beta-hCG)
216
detrusor mvmt
contraction --> urination
| relaxation --> retention
217
lymphatic drainage of rectum
proximal to anal dentate line --> inferior mesenteric and internal iliac lymph nodes
distal to anal dentate line --> inguinal
218
things that increase ammonia
gut bacteria make ammonia from nitrogen degradation
GI bleed --> Hb breakdown --> up ammonia
excess dietary protein --> up ammonia
or infection, sedatives, metabolic things (hK)
219
tx for hepatic encephalopathy
rifaximin
| lactulose
220
rifaximin mechanism to treat hepatic encephalopathy
antibiotic (inhibit bact RNA synthesis by binding to DNA dependent RNA polymerase)
hurt gut flora --> they cant make ammonia from nitrogen
221
lactulose mechanism to treat hepatic encephalopathy
catabolized by gut flora to short chain fatty acids --> lower colonic pH --> increase conversion of ammonia to ammonium
222
when will you see a high QRS voltage in precordial (V) leads
ventricular hypertrophy
223
QRS complex in AF
narrow
224
irregularly irregular heart rhythm
AF
225
why higher dose for oral nitrates?
high first pass metabolism
226
ADE of thionamides
agranulocytosis
227
presentation of pt w/ thionamide induced agranulocytosis
sore throat
fever
oral ulcerations
infection
228
uniformly enlarged uterus
adenomyosis (endometrial glandular tissue in myometrium)
229
white reflex in kids
retinoblastoma
230
tumors a/w retinoblastoma
osteosarcomas (mutation in each of the two Rb genes)
231
MC congenital adrenal hyperplasia deficiency
21-hydroxylase deficiency
232
HIV structural genes and proteins
gag --> p24, p7 --> core proteins
pol --> proteases, reverse transcriptase, integrase
env --> glycosylated --> gp160 --> cleaved in ER --> gp120, gp41 --> attachment
233
what drains into the superficial inguinal lymph nodes?
all skin below umbilicus + anus below dentate line, including scrotum
EXCEPT testes, glans penis, posterior calf
234
pancreatic pseudocyst formation mechanism
acute pancreatitis --> enzymes disrupt walls of ducts --> panc enzymes leak into peripancreatic space --> inflammatory rxn --> granulation tissue encapsulates the fluid --> pseudocyst (fibrose w/ time)
235
MC pseudocyst location
lesser peritoneal sac (btwn stomach, duo and transverse)
236
pathogenesis of acute calculous cholecystitis
persistent obstruction (stone) --> hydrolysis of luminal lecithins to lysolecithins --> disrupts protective mucus membrane --> bile salts irritate --> PG release --> inflammation --> hypomotility --> up P/distension --> ischemia --> bacteria invade (usually E.coli, enterococcus, kleb or enterobacter)
237
actions of BNP
dilate arterioles and veins
promote diuresis/natriuresis
(lower BP)
238
what is kinesin
motor protein a/w microtubles
| in neurons: bring vesicles to nerve terminal
239
what cells do fetal corticosteroids affect
type II pneumocytes (accelerate maturity --> increased surfactant)
240
genes a/w APML
t(15; 17)
PML gene on 15
RARA (retinoic acid receptor alpha) on 17
241
cancers w/ epidermal GF receptors (ERBB1/2)
ERBB1 = certain lung
| ERB2 (aka HER2/neu) = ovarian, gastric tumors
242
order of heavy Ig chains (letters)
M, D, G, E, A
243
immune defense against candida
superficial candida: T cells
| disseminated: neutrophils
244
CNs for tongue
motor: XII, X (palatoglossus only)
sensory: V3 (ant 2/3) IX (post 1/3), X (tongue root)
taste: VII (ant 2/3), IX (post 1/3), X (throat)
245
what can you give infants with MSUD to improve (besides diet)
high dose Thiamine
246
where does renal clear cell carcinoma originate?
proximal renal tubules (epithelial cells)
247
what to think when there's candida in sputum sample
its just from the oral cavity
248
condition of fetus --> maternal virilization during pregnancy
aromatase deficiency
249
what does secretin do?
get panc to secrete bicarb
250
hormone levels in klinefelters
LH and FSH up
inhibin, T down
sperm count none
251
sildenafil mechanism
phosphodiesterase-5 inhibitor (up cGMP --> vasodilation)
252
defect in Marfan synd
defect in fibrillin-1 gene (microfibril that forms sheth around elastin fibers)
253
eggshell calcification on cysts
echinococcus granulosus (or multicularis w/ multiple) hydatid cysts
254
complication of surgery on echinococcus cysts
anaphylaxis
255
graves dz sx that arise as a result of increased expression of beta adrenergic receptors
```
HTN
tachycardia
sweating
heat intolerance
weight loss
hyperreflexia
(NOT exopthalmos which is from like a 1000 other things)
```
256
why do you get exopthalmos in Graves dz
lymphocytic infiltration, enlargement of extraocular muscles (myositis), fibroblast proliferation, and overproduction of mucopolysaccharides in response to anti-thyroid Abs
257
where is a saddle emboli
pulmonary artery bifurcation
258
fungus: spherules packed with endospores
coccidiodes immitis (spherules bigger than RBCs)
259
colon adenomas most likely to undergo malignancy
villous (vs tubular or tubulovillous)
260
UV damage to DNA
covalent bond formation btwn adjacent pyrimidines
261
blood gases @ high altitude (2 days)
alkalosis
low PaO2
low CO2 (hypervent)
low bicarb
262
high altitude changes (short)
lower partial pressure of O2 in air --> hypoxemia --> trigger hyperventilation --> CO2 drops --> resp alkalosis (acute) --> renal excretion of bicarb (24-48 hrs later)
263
long term altitude changes
```
increased 2,3-DPG
increased EPO/Hb production
increased pulm diffusing capacity
up angiogenesis (VEGF)
up mitochondria
hemoconcentration (HCO3 diuresis)
```
264
Tc-perechnetate scan is for....
has an affinity for parietal cells
| if its taken up in the RLQ suspect Meckel diverticulum
265
cells in Meckel diverticula
it has ectopic gastric mucosa that secretes acid --> ulceration/bleeding
266
red blood cells without central pallor
spherocytes
267
increased mean corpuscular Hb concentration
spherocytosis
268
polymyalgia rheumatica
neck, torso, shoulder and pelvic girdle pain
morning stiffness
see in giant cell vasculitis
269
cholesterol gallstones description
yellow/grey/hard
270
pigment stones description
brown/black/soft
| made of calcium salts (from unconjugated bilirubin)
271
stop codons
UAA
UAG
UGA
272
what happens at a stop codon
releasing factor proteins bind to ribosomes, release polypeptide and ribosome
273
cardiac tissue conduction velocity
```
fastest to slowest
purkinje
atrial
ventricular
AV
```
274
prolactin --> osteoporosis mechanism
high prolactin --> suppress GnRH from hypothalamus --> hypogonadism --> low E --> low bone density
275
causes of accelerated bone loss
```
hi prolactin
low E
hi PTH
hi thyroid
low vit D
chronic glucocorticoids
```
276
what is celecoxib
selective COX-2 inhibitor
| anti-inflammatory effects w/ less risk of GI bleeds/ulcers
277
ornithine is a/w what
urea cycle
278
vertebral subluxation
usually AA joint
malalignment --> cord compression (posterior odontoid)
--> neck pain, stiffness or neuro findings, hTN (loss of symp)
extension from intubation can exacerbate
279
where are the serotonergic neurons in the CNS
raphe nuclei in brainstem
280
cardiac ischemia and contractility by time
complete ischemia stops contractility w/in 60 s
281
how do you know if a carcinoid tumor has metastasized?
while in intestines they dont make syndrome (liver metabolizes stuff)
if they make mets outside --> syndrome
282
Bcl-2
apoptosis inhibitor
| a/w folliciuilar cell lymphoma
283
calcineurin
protein phosphatase in T cells
dephosphorylates nuclear factor of activated T cells (NFAT)
part of T cell immune response
284
retinoblastoma protein (Rb)
regulator of G1-->S
active when hypophosphorylated --> binds to E2F transcription factor --> STOPS transition
inactive when phosphorylated --> cycle goes on
285
where do testes drain to?
para-aortic nodes
286
Guillain Barre light microscopy description
segmental demyelination of peripheral nerves
| endoneural inflammatory infiltrate
287
lung rejection: acute
```
1-2 wks post transplant
rxn to HLA - cell mediated (CD8s)
--> vascular damage
sx: dyspnea, dry cough, low fever
CXR: perihilar and lower lobe opacities
path: perivasc/peribronch lymphocytic infiltrates
prevent w/ immunosuppression
```
288
lung rejection: chronic
months-years
- -> inflammation of small bronchioles (bronchiolitis obliterans)
path: inflammation and fibrosis of bronchial wall --> narrow/obstruct
sx: dyspnea, non-productive cough and wheezing
289
broad chest with wide spaced nipples/inverted nipples
turners
290
where do you find peptostreptococcus
normal mouth flora (anaerobic)
291
where do you find fusobacterium
normal mouth flora (anaerobic)
292
causes of lung abscesses
aspiration (think normal flora or nosocomial)
| complication of pneumonia, endocarditis, septicemia
293
necrotizing pneumonia agents
staph aureus
e coli
klebsiella
pseudomonas
294
speed of Hb mvmt during gell electrophoresis
fast (far) to slow (close)
| HbA > HbS > HbC
295
dystrophin
component of skeletal muscle
| links cytoskeleton to transmembrane proteins
296
Gilbert bilirubin
unconjugated hyperbilirubinemia
297
Dubin Johnson bilirubin
conjugated hyperbilirubinemia
298
dx of acute cholecystitis w/ nuclear medicine hepatobiliary scan
radiotracer is given IV
taken up by hepatocytes and put into bile
if bile duct is obstructed you never visualize the gallbladder
299
hypothyroid myopathy sx
muscle pain, cramps: proximal muscles
| delayed reflexes and *myoedema*
300
myoedema
focal mounding of muscle following percussion (found in hypothyroid myopathy)
301
what impacts coronary blood flow (heart-wise)
duration of diastole: blood only goes into coronaries (during diastole) because the ventricle relaxes enough to lower the pressure so it's lower than the aortic pressure
increased HR makes that less possible
302
features of methylmalonic acidemia
newborn w/ lethargy/vomiting
hyperammonemia, ketotic hypoglycemia, metabolic acidosis
urine: elevated methylmalonic acid and propionic acid
303
maple syrup urine disease defect
cant breakdown branched chain amino acids (leucine, isoleucine, valine)
304
defect in Niemann Pick
sphingomyelinase (--> extra sphingmyelin)
305
Osgood-Schlatter dz
overuse injury of knee (secondary ossification center (apophyisis) f tibial tubercle)
problem @ patellar ligament
306
dysfunction in Kartagener synd
dynein arms
307
types of exocrine gland
merocrine
apocrine
holocrine
308
merocrine secretion mechanism
via exocytosis
309
apocrine secretion mechanism
via membrane bound vesicles
310
holocrine secretion mechanism
cell lysis releases entire contents
311
where do you put the filter to prevent PEs
IVC
312
H. flu capsule
type B is made of polyribitol phosphate (PRP)
| prevents phagocytosis
313
type B and non type B H flu
type B: capsule, causes epiglottitis, meningitis and bacteremia, vaccine now
non type B: more common since vaccine --> non invasive dz like sinusitis, bronchitis, otitis media and conjunctivitis
314
ankylosing spondylitis extraskeletal sx
resp: limited chest expansion --> hypovent (monitor chest expansion)
CV: ascending aortitis --> dilation of aortic ring and aortic insufficiency
eye: anterior uveitis --> blurred vision, pain, photophobia, red eyes
315
type of necrosis after irreversible ischemic injury
```
most tissues (not brain): coagulative necrosis
brain: liquefactive
```
316
MCC of transmural infarction
fully obstructive thrombus superimposed on a ruptured atherosclerotic coronary artery plaque
(less occlusion on plaque --> unstable angina)
(stable atheromatous w/o overlying thrombus, occluding 75% --> stable angina)
317
treatment for congenital adrenal hyperplasia (21-hydroxylase def)
give steroids (--> less ACTH --> less androgen)
318
most common twin bags (fraternal)
dichorionic
| diamniotic
319
most common twin bags (identical)
monochorionic
| diamniotic
320
ecological studies
analysis of populations, not individuals
321
main RFs for adenocarcinoma of the pancreas
```
age
smoking
DM
chronic panc
genetics
```
322
signs of pancreatic adenocarcinoma
palpable but nontender gallbladder (Courvoisier sign)
obstructive jaundice (pruritus, dark urine, pale stools)
weight loss
323
how does ionizing radiation work
DNA double-strand breakage
| free radical formation
324
diff in Abs in sabin vs salk vaccine
Sabin: live attenuated --> stronger mucosal secretory IgA
325
status epilepticus management
`benzos to stop
phenytoin to prevent recurrence
if doesnt stop: phenobarbital
326
phenytoin mechanism
reduce sodium current in cortical neurons
327
how to tell tuberculoid from lepromatous leprosy
lepromin skin test (+ --> tuberculoid)
328
tuberculoid vs lepromatous leprosy T cell involvement
Th1: tuberculoid
Th2: lepromatous
329
livedo reticularis means...
sign of embolism
330
lesion of which hypothalamic nucleus makes you fat
ventromedial
331
ring enhancing lesion in brain
toxoplasmosis (HIV, multiple)
aspergillus (lungs more likely, immunocomp)
glioblastomas (solitary/butterfly)
neurocysticercosis (travel, multiple)
TB (travel, multiple)
nocardia (immunocomp, branching filaments)
332
pyrrolidonyl arylamidase (PYR) positive
strep pyogenes
| replaced bacitracin sensitive-ness
333
ecthyma gangrenosum agent
pseudomonas aeruginosa
334
what cells make the fibrous cap in atheromas
vascular smooth muscle cells (VSMCs)
335
tumor a/w Paget
Osteosarcoma
| periosteal elevation
336
gouty arthritis
neutrophils
| negatively bindingent MSU crystals
337
positive nasopharyngeal swab
influenza
338
germ line mosaicism
mutation in sperm / eggs only
339
cadherins
bind epi cells together
340
hemidesmosomes
cells attached to BM
| integrins
341
firm, fles-Colore Papules
umbilicated
pruritic
Molluscum Contagiosum
| large eosin inclusions
342
Knee dislocation vessel / nerve injury
popliteal artery
343
cocaine nasal signs
chronic discharge
| per for ation / ulcers/ sinusitis
344
craniopharyngioma vision loss
bi temporal hemianopsia
| compress optic chiasm
345
winged scapula muscle / nerve
Serratus anterior
| long thoracic nerve
346
acute stress disorder vs PTSD
ASD: >1 week,
347
acute intermittent porphyria defect
porphobiligen deaminase
348
increased RBC osmotic fragility
spherocytosis
| sickle / thal = decreased
349
why remove spleen in spherocytosis
less anemia, jaundice, bilirubin gallstones
350
osteocytes connected by
gap junctions
351
other cardiac output equation
CO = rate os 02 cons upton/ arterio venous 02 Content difference
352
polycythemia vera gene
JAK2
353
fatigable Chewing
myasthenia gravis
354
myasthenia gravis mechanism
Ab mediated T cell dependent attack on post-synaptic NMJ (nicotinic-ACh receptors)
often hyper plastic thymic tissue
maybe thymoma
355
metabolic levels in DKA
glucose up
K up
Na down
356
Chiari malformation MRI
downward displacement of elongated arebellar tonsils thru foramen. Magnum
357
misoprostol Mech
PGE 1 analog
| up gastric mucus
358
palmitoylation
add fatty acid
up hydrophobicity
anchor to membranes
359
nitrate heart effect
venodilation
| reflex tachy
360
why is skin bronze in hemochromatosis
hemosiderin in dermal macs and increased melanin production
361
where else do you see HTN in portal HTN
splenic vein → splenomegaly
| NOT IVC
362
Causes of impetigo
```
Strep B
Staph aureus (may have bulla)
```
363
why N-terminal peptide signaling sequences
get them to RER
| w /o end up in cytosol
364
coenzyme needed for branch chain amino acid catabolism
thiamine
365
what maintains high T levels in semi nitrous tubules and epididymus
Leydig (makeT)
| Sertoli (make androgen binding protein)
366
What to ablate in hyperhidrosis
hands: Stellate ganglion
axillary: thoracic sympathetic trunk (T 2)
367
What do you stain w / red safarin O
cartilage, mast cell granules and mucin
368
What female structure goes thru inguinal canal
round ligament
369
blood gases in PE
V/Q mismatch → hypoxemia → hyperventilation → hypocapnia →alkalosis
370
when do you see red man synd
Vancomycin
| fast infusion → mast cells release histamine
371
defect in osteo genesis imperfecta
type I collagen (bones)
| COL 1A1 and CoL 1 A2
372
hypoglycemia after prolonged fasting W / low ketones suggests
impaired beta-oxidation
| MC def acyl-CoA dehydrogenase
373
octreotide Mech
somatostatin analog
| inhibit release of bio-active peptides
374
how to make proteins during apoptosis
internal ribosome entry
| Start in the middle of sequences
375
Complications of Crohn dz
```
apthous mouth ulcers
bowel obstruction
fistulae / abscesses/ fissures
erythema nodosum
arthritis/ankylosing spondylitis
uveitis
gallstones/kidney stones
B12/folate def → anemia
up risk adenocarcinoma and cholangiocarcinoma
```
376
Crohn in which part of Gl
terminal ileum MC
| any possible
377
Warfarin and P 450
P 450 inducers → up Warfarin metabolism → down efficacy
| inhibitors → down Warfanin metabolism→ up bleeding risk
378
malnutrition → what bone problems
osteomalacia
379
what is Osteomalacia
decreased mineralization of osteoid
| from vitD deficiency
380
signs of peripheral artery dz
pain when moving
cramping
thin skin
ulcers
381
muscles innervated by recurrent laryngeal
all intrinsic larynx muscles for sound production
| EXCEPT Cricothyroid
382
Broca's aphasia
expressive aphasia (w/ agrammatism)
frustration ( aware )
preserved comprehension
383
Wernick's aphasia
receptive aphasia
not aware
impaired comprehension
fluent aphasia (word salad)
384
insulin levels indicative of insulin resistance
high baseline during fasting
385
detect in Lesh- Nyhan Synd
hypoxanthine-guanine phosphoribosyltransf erase
386
long term Tx w/ mechanical valve
warfarin
387
leuprolide Mech
GnRH analog
| continuous → inhibits FSH/ LH → less T
388
cardio problems in DiGeorge
conotruncal defects → persistent truncus arteriosus, tetra logy of Fallot, interrupted aortic arch
389
hormones causing trouble in esophageal Varices
VIP, glucagon → vasodilate splanchnic veins
| inhibited by octreotide
390
more likely to have folate or B12 def in alcoholics
folate (B12 only after a long time)
391
rib levels of lungs (bottom)
midclavicular: 6
midaxillary: 8
paravertebral: 10
392
nerve damaged in supracondylar humeral frx with anterolaterral displacement
radial
393
ACE inhibitor effects on kidney
lower angiotensin II levels
(angiotensin II usually vasoconstricts efferent arteriole and ups GFR)
increases GFR, ups creatinine
don't use in pts w/ bilat renal artery stenosis (--> acute renal failure)
394
part of resp tract affected by HPV
only affects stratified squamous epithelium
| true vocal cords
395
signs of aplastic anemia
pancytopenia w/o splenomegaly
| bone marrow bx: dry tap, hypocellular made of mostly adipose
396
ether kills which viruses?
enveloped
397
narrow hyphae branch @ 45 degrees
aspergillus
398
median nerve course in forearm
thru pronator teres
between flexor digitorum superficialis and profundus
under flexor retinaculum
399
TATA box purpose
promoter region for transcription initiation
400
hemiballismus mech
injury to contralateral subthalamic nucleus → decrease excitation of globus pallidus → reduce inhibition of thalamus → extra movement
401
myasthenia gravis hypersensitivity
type II (IgG autoantibodies)
402
HTN drug that also treats BPH
alpha-1 antagonists (doxazosin, prazosin)
403
MCC coronary sinus dillation
increased R heart P from pulmonary hypertension
404
arginase deficiency vs other urea cycle d/os
arginase def has mild or no hyperammonemia
405
anemia to think of with low B6
sideroblastic (ALA synthase uses is as cofactor)
406
bone marrow in sideroblastic anemia
stain w/ Prussian blue
microcytic, hypochromic RBCs
ring sideroblasts
407
basophilic cotton candy on pap
actinomyces
408
crohn histo
```
transmural inflammation
noncaseating granulomas (may → occult bleed)
```
409
MCC malignant otitis externa
pseudomonas aeruginosa
410
amaurosis fugax
transient monocular vision loss
411
labs for giant cell (temporal) arteritis
C-reactive protein (CRP)
| erythrocyte sedimentation rate (ESR)
412
likely bursa from kneeling
prepatellar bursitis (housemaid's knee)
413
likely bursa from obesity or overuse in athletes
anserine bursa (+pain in medial knee)
414
likely bursa from osteoarthritis or inflammatory joint dz
popliteal (Baker) cyst
415
tx for alcoholism to reduce cravings
naltrexone
416
naltrexone mechanism
blocks mu-opioid receptor
| blocks rewarding/reinforcing effects
417
Treacher-Collins syndrome
abnormal development of 1st and 2nd arch
418
CYP450 inducers
```
carbamazepine
phenobarbital
phenytoin
rifampin
griseofulvin
St. johns wort
modafinil
cyclophosphamide
```
419
CYP450 inhibitors
```
amiodarone
cimetidine
fluoroquinolones
erythromycin/clarithromycin
azoles
isoniazid
ritonavir
grapefruit juice
```
420
physostigmine vs neostigmine
phsyo penetrates CNS, neo doesn't
421
neuropathic pain NT affected by capsaicin
substance P (decreased)
422
for what pathway is G6PD the rate limiting enzyme
pentose phosphate pathway (main source of NADPH)
423
what do you need NADPH for
```
reducing glutathione (prevent oxidative damage)
making cholesterol, fatty acids and steroids
```
424
glucagonoma sx
DM
necrolytic migratory erythema
GI sx
anemia
425
necrolytic migratory erythema
erythematous papules/plaques on face/perineum/extremities
| lesions getting bigger/coalesce, leaving a bronze, central indurated area w/ peripheral blistering/scaling
426
surfactant levels in 3rd trimester
lecithin (phosphatidylcholine) goes up after 30 wks
phosphatidylglycerol goes up after 36 wks
sphingomyelin stays relatively constant
L/S > 2 shows adequate surfactant production
427
organ susceptibility to infarction
most to least
| CNS, heart, kidney, spleen, liver
428
glucagon signaling
```
Gs receptor
adenylate cyclase
up cAMP
activates protein kinase A
(same as epinephrine, but epi uses beta receptors)
```
429
lithium ADEs
diabetes insipidus
hypothyroidism
tremor
ebstein anomaly
430
how long after vasectomy do you have viable sperm
3 months/20 ejaculations
431
what does c-Myc do
make protein that is a transcription activator
432
lymphoma genes
follicular: BCL2 (inhibit apoptosis)
Burkitt: c-Myc (transcription activator controls prolif/apop)
CML: BCR-ABL (inhibits apop, increase tyrosine kinase activity)
433
where does complement bind to an Ab
Fc region of heavy chain near hinge point
434
indirect hernia pathophys
patent processus vaginalis
lateral to inf epigastric vessels, thru deep inguinal ring
most common hernia
435
direct hernia pathophys
weakness of transversalis fascia
medial to epigastric vessels, thru hesselbach's triangle
more common in elderly
436
femoral hernia pathophys
weakness of proximal femoral canal
| inferior to inguinal lig, thru femoral ring
437
Hesselbach's triangle
inguinal ligament
inferior epigastric vessels
rectus abdominus
most common hernia in women
438
pearly mass in middle ear
cholesteatomas (NOT made of cholesterol)
| made of squamous cell debris
439
why shouldn't Kieran get Dengue fever again
once you get it you have lifetime immunity to that serotype
but if you get a secondary infection with a diff serotype your immune system goes batshit (Ab enhancement, more immune complex formation, increased T-cell response)
440
how does hyperglycemia → retinopathy
glucose → sorbitol (by aldose reductase) → fructose
sorbitol and fructose increase osmotic pressure
more water → osmotic cellular injury
(lens: more water → bursts fiber cells → lens becomes opaque)
441
stage of eggs until ovulation
prophase of meiosis I
442
stage of eggs just before fertilization
metaphase of meiosis II
443
what do you give to pts with methotrexate to avoid myelosuppression?
leucovorin (folinic acid - reduced form of folic acid that doesn't need DHF-reductase)
444
wtf are neurophysins
carrier proteins for oxytocin and vasopressin (ADH)
445
what tests to run if you think they have type I DM
```
fasting blood glucose (>126)
Hb A1c (>6.5)
```
446
when do you do glucose tolerance tests
gestational DM
CF-related DM
equivocal other testing
447
risk when you give gancyclovir with SMX/TMP
myelosuppression
448
ADEs a/w erythropoiesis -stimulating agents
risk of thromboembolic events
| HTN
449
breast: ducts distended by pleiomorphic cells w/ prominent central necrosis that do not penetrate BM
ductal carcinoma in situ
450
breast: palpable masses with orderly rows of cells organized in a single file
lobar carcinoma
451
breast: disorderly, hypercellular CT w/ leaf-like projections
phyllodes tumor (from breast stroma)
452
signs of selective IgA def
recurrent sinopulm infections,
recurrent GI infections
autoimmune d/os (celiacs)
453
what happens when you give O blood to someone IgA def
anaphylaxis
454
ovarian venous drainage
L into L renal vein
| R into IVC
455
uterine venous drainage
uterine veins into internal iliacs
456
sx of hyperthyroidism NOT due to increased metabolic rate
pretibial myxedema
exophthalmos
periorbital edema
all due to autoimmune response against TSH receptor
457
sx of Friedrich ataxia
spinocerebellar tract degeneration → gait ataxia
lateral CST degeneration → muscle weakness
kyphoscoliosis
foot abnormalities (pes cavus)
hypertrophic CM, CHF
DM
458
gyn: when do you do nucleic acid amplification testing
neisseria
| chlamydia
459
how do you tell what kind of mutation it was by length?
non-sense: the difference in base pairs is divisible by 3
missense: same length
frameshift: not divisible by 3
460
what does dextrans do (viridans)
lets the bacteria bind to fibrin
461
main immune against neisseria
MAC (C5b-C9)
462
immune response to poison ivy
urushiol is substance
delayed type IV hypersensitivity
CD8 cells, mainly
463
phenylalanine catabolism
phenylalanine → tyrosine (if not = PKU) → fumarate → TCA
464
leucine catabolism
leucine → acetyl CoA → TCA
465
valine catabolism
valine → propionyl CoA → methymalonyl CoA (need biotin) → succinyl CoA (need B12) → TCA
466
isoleucine catabolism
isoleucine → propionyl CoA → methymalonyl CoA (need biotin) → succinyl CoA (need B12) → TCA
467
threonine catabolism
threonine → propionyl CoA → methymalonyl CoA (need biotin) → succinyl CoA (need B12) → TCA
468
methionine catabolism
methionine → propionyl CoA → methymalonyl CoA (need biotin) → succinyl CoA (need B12) → TCA
469
how do L and R frontal lobe lesions differ in Sx?
right: disinhibited
left: apathy
470
hypersensitivity to tobacco shows
Buerger dz
471
path of buerger dz
segmental vasculitis
472
bone pain, anemia, kidney dz, hypercalcemia shows
multiple myeloma
473
dantrolene mechanism
antagonize ryanodine receptors
inhibit Ca release from SR
relax muscles
474
how do you hurt the long thoracic nerve (→ winged scapula)
chest tube
| dissection of axillary lymph node (mastectomy)
475
deep peroneal nerve injury →
motor: dorsiflexion, toe extension
sensory: flip flop toe crease
476
superficial peroneal nerve injury →
motor: eversion
sensory: dorsal foot/lateral malleolus/lateral shin
477
tibial nerve injury →
motor: plantarflexion, inversion, toe flexion
sensory: sole
478
sciatic nerve injury →
tibial + common peroneal (deep + superficial)
| ALSO can't flex knee
479
femoral nerve →
motor: hip flex, knee extend
sensory: medial thigh/leg + knee
480
primary HSV in children Sx
gingivostomatitis: vesicular lesions on lips and hard palate
481
mechanism of viral infection → CHF
viral myocarditis → dilated CM (eccentric hypertrophy, systolic dysfunction)
482
hawthorne effect
change behavior because you know youre being studied
483
berkson's bias
selection bias in choosing hospitalized pts as control group
484
IF in membranous glomerulonephropathy
granular deposits
485
IF in membranoproliferative glomerulonephritis
granular deposits
486
IF in anti-BM glomerulonephritis
linear
487
what kind of drug is chlordiazepoxide
benzo
488
where are brunner glands? what do they do? when would you see them get bigger?
duodenum
secrete alkaline stuff (when acid comes in → secretin released → alkaline released)
excess acid or H pylori → hyperplasia
489
what kind of hydrocephalus causes symmetrical enlargement?
communicating hydrocephalus
490
normal CSF flow
lateral ventricles → interventricular foramen on Monro → 3rd ventricle → cerebral aqueduct → 4th ventricle → foramina of Luschka and Magendie → subarachnoid space (arachnoid granulations absorb it) → venous sinuses
491
mechanism of communicating hydrocephalus
no obstruction
dysfunction or obliteration of subarachnoid villi
problem w/ arachnoid granulations
492
mechanism of thymic aplasia in DiGeorge
maldevelopment of 3rd and 4th pharyngeal pouch derivatives
493
T cells kill
viral
fungal
protozoan
intracellular bacteria
494
where in the lymph nodes are T cells?
paracortex (btwn follicles and medulla)
495
what are transmembrane domains?
part of integral membrane proteins
| made of alpha helices and hydrophobic amino acid residues
496
what part of DNA synthesis requires folate?
```
making dTMP (deoxythymidine monophosphate)
can give thymidine to compensate a smidge
```
497
why does hereditary spherocytosis cause jaundice?
hemolysis → increased bilirubin production
498
what is a multi-compartment model of distribution?
model for highly lipophilic drugs (eg propofol)
drug is administered (central compartment - plasma)
quickly goes to well-vascularized peripheral compartment (brain, liver, kidney, lungs)
long time → poorly vascularized peripheral compartment (muscle, fat, bone)
499
what does RANKL stand for
receptor activator of nuclear factor kappa-B ligand (part of osteoclast differentiation)
500
what to give in panic disorder if not benzos (due to abuse or whatever)
SSRIs +/- CBT
501
hyperparakeratosis and reduced or absent stratum granulosum →
psoriasis
502
where will you see neutrophils in psoriasis
they form clusters in parakeretonic stratum (called Munro microabscesses)
503
signs of hemolytic anemia
jaundice
increased LDH
decreased haptoglobin
504
hemolytic anemia + thrombocytopenia
TTP
505
germ tubes
candida albicans
506
spherules
coccidioides immitis
507
nonseptate hyphae @ wide angles
mucor
| rhizopus
508
budding yeast
cryptococcus neoformans
509
latex agglutination test (+) for soluble polysaccharide ag
cryptococcus neoformans
510
virus that gets their envelope from host nuclear membrane
herpesviruses (other enveloped viruses get it from the plasma membrane)
511
nerve at risk during thyroidectomy
superior laryngeal nerve (external branch)
512
what does the external branch of the superior laryngeal nerve innervate
cricothyroid muscle (tenses vocal cords)
513
what happens if you injure the external branch of the superior laryngeal nerve
you get a low hoarse voice with limited pitch range
514
rash in measles
maculopapular
starts after fever
face then trunk, coalesces
515
hypercalcemia, hypercalciuria, hypophosphatemia
primary PTHism
516
skeletal manifestation of hyperparathyroidism
usually involves cortical (compact) bone in appendicular skeleton
subperiosteal thinning/erosions
salt and pepper skull
osteolytic cysts in the long bones (osteitis fibrosa cystica)
517
what are you trying to access when placing central lines/.
SVC
518
phosphorylation of serine and threonine residues of insulin receptor/substrate →
increased insulin resistance
| see w/ TNF-alpha, catecholamines, glucagon, glucocorticoids
519
neoplasm with rosenthal fibers and granular eosinophilic bodies
pilocytic astrocytomas
520
MC CNS tumor in AIDS pts
primary CNS lymphoma (usually a/w EBV)
521
collagen post MI
7 days post MI: granulation tissue (type III)
| from 2 wks - 2 mo: fibrosis (type I) → scar
522
pee coming out of umbilicus
patent urachus (persistent allantois remnant)
523
orphan annie eyes (description)
overlapping cells w/ large nuc containing sparse, finely dispersed chromatin. + intranuclear inclusion bodies and grooves
524
areas most likely affected in graft v host
skin (maculopapular or desquamating)
liver
GI
525
complications post subarachnoid hemorrhage
vasospasm: 4-12 days after, no significant change on CT
hydrocephalus: CT shows increased CSF P and ventricular dilation
rebleed: most dangerous, can see on CT
526
tx to prevent vasospasm post subarachnoid hemorrhage
nimodipine
527
pathophys of CF resp glands
CFTR misfolding
non functional CFTR Cl channel → impaired Cl absorption and activation of ENaC
increased ENaC activity → increased Na absorption
water follows
→ thick mucus outside cells
528
pathophys of CF sweat glands
CFTR misfolding
non functional CFTR Cl channel → impaired Cl absorption and inhibition of ENaC
decreased ENaC activity → decreased Na absorption
→ very salty sweat
529
muscle pain with exercise that gets better with rest
claudication (usually from stenotic lesions from atheromas)
530
tx for cyanide poisoning
amyl nitrates
531
asthma med affecting parasympathetics
ipratroprium (anti-Ach)
532
psammoma bodies
papillary thyroid carcinoma
mesothelioma
papillary serous carcinoma of the ovary
meningioma
533
lamellar wet keratin
craniopharyngiomas
534
perivascular rosettes
ependymomas
535
pseudo-palisading brain tumor
glioblastomas
536
homer-wright rosettes
medulloblastomas
537
palisading nuclei around verocay bodies
schwannomas
538
hemolytic anemia, hypercoagulability and pancytopenia
paroxysmal nocturnal hemoglobinuria
539
Abs against citrullinated peptides/proteins
RA
540
rheumatoid factors
autoantibodies targeting Fc portion of human IgG
541
effect of long term topical corticosteroids on skin
skin atrophy, dryness, telangiectasias, ecchymoses
542
what does it mean if someone tests positive for varicella IgG Abs?
they have had it before (prob protected against chicken pox but not shingles)
543
acute repeated knee episodes
gout
544
tx for gallstones (non-surgical)
hydrophilic bile acids
545
where do you see cytokeratins?
epithelial cells
546
what takes out introns and assembles snRNPs?
spliceosome
547
what is deficient in narcolepsy
hypocretin-1 (CSF)
| hypocretin-2
548
S-100 positive
melanoma
| schwannoma
549
highly cellular areas mixed with myxoid regions of low cellularity
schwannomas
550
dopamine actions by dose
low: D1 → renal/mesenteric vasodilation
high: beta 1 → cardiac contractility
very high: alpha 1 → general vasoconstriction
551
mechanism: being treated for leukemia → oligouria
tumor lysis syndrome
obstructive uropathy (crystals)
acute renal failure
552
tx to avoid tumor lysis syndrome
alkalinize the urine + hydration
553
MCC bacterial meningitis in adults
strep pneumo
554
back pain w/ recent endocarditis or bacteremia
vertebral osteomyelitis
555
proximal muscle weakness, CN involvement, autonomic sx
lambert eaton syndrome
556
intron start/stop
GU @ 5'
| AG @ 3'
557
alpha-1-antitrypsin liver path
intrahepatocyte accumulation of polymerized AAT molecules → cirrhosis and hepatocellular carcinoma
granules stain reddish-pink with PAS and resist diastase digestion
558
what to give to people exposed to radioactive iodine
potassium iodide
559
possible complications from orbital floor fractures
enophthalmos
entrapment of inferior rectus → impaired superior gaze
injured infraorbital nerve → numbness/paresthesis of upper cheek, upper lip, and upper gingiva
560
propranolol in hyperthyroid
decrease symp effects on heart (excess thyroid hormone upregulates catecholamine receptors)
inhibit iodothyronine deiodinase (decrease conversion of T4 to T3)
561
coronary blood flow (R vs L)
L: only during diastole (P too high in systole)
R: constant (P not so crazy)
562
cheilosis, glossitis, dermatitis and peripheral neuropathy
B6 def
563
vitamin C other name
ascorbic acid
564
black urine when exposed to air
alkaptonuria
565
features of alkaptonuria
black urine
blue-black face pigmentation
ochronotic arthropathy
566
portal hypertension affects which other veins
left gastric vein → esophageal or gastric varices
| splenic vein → fundal gastric varices
567
pathophys of peau d'orange
cancerous cells obstruct lymphatic drainage due to spread to the dermal lymphatic spaces
568
OR equation
PrEvent/(1 - PrEvent)
569
tx for narcolepsy
modafinil
570
movement proteins in a neuron
kinesin (anterograde - move along axon)
| dynein (retrograde - toward cell body)
571
bicuspid aortic arch → which heart murmur
aortis stenosis
572
marfan cardiac problems
aortic root dz: aneurysms, regurg or dissection
573
effects of increased estrogen on thyroid
increased levels of thyroxine-binding globulin
| increase in total thyroid hormone levels, but normal free thyroid hormone
574
what is bosentan
competitive endothelin receptor antagonist
| use to treat pulmonary arterial HTN
575
pathophys of hyperacusis
injury to facial nerve (VII) affects stapedius nerve → stapedius muscle is paralyzed → stapes oscillates more wildly → hyperacusis
576
what is NF-kappaB
proinflammatory transcription factor that increases cytokine production
577
what do neisseria pili do?
prevent attachment to epithelial surfaces
578
what are the non-medical options for parkinsons?
high frequency brain stim of globus pallidus internus or subthalamic nucleus (promotes thalamo-cortical disinhibition)
579
what do you call the genital ulcer in syphilis?
primary: chancre
secondary: condyloma lata (maybe w/ maculopapular rash)
tertiary: gumma (maybe w/ aortic problems, tabes dorsalis, etc)
580
pathophys of renal osteodystrophy
decrease GFR → decrease Ca/P → PTH kicks in → osteitis fibrosa cystica
581
diffuse erythema, skin comes off easily with pressure
staphylococcal scalded skin syndrome (exotoxin mediated)
582
posterior column degeneration
tertiary syphilis
| B12 deficiency
583
ataxia, repeated sinopulm infections, oculocutaneous telangiectasia (late)
ataxia-telangiectasia (inefficient DNA repair)
584
barr body description
heavily methylated DNA and deacetylated histones
585
renal blood flow equation
(renal artery P - renal vein P) / renal vascular resistance
RBF = PAH clearance / (1 - hematocrit)
PAH clearance = PAHurine x urine flow / PAHserum
586
hepatosplenomegaly, neuro regression, cherry red macular spot
Niemann-Pick
587
insulin analogs w/ AA substitution @ the C terminal end of the B chain
lispro
aspart
glulisine
588
which aortic arch makes the carotids?
3rd
589
normal heart pressures
RA: 1-6
RV: 1-15/30
PA: 6/12 - 15/30
PCWP: 6-12
590
immune defense against giardia
CD4 and secretory IgA production (impairs adherence)
591
lobar pneumonia stages
congestion
red hepatization
gray hepatization
resolution
592
what makes Ras active or inactive?
bound to GTP = active
593
single broad based bud
blastomyces dermatidis
594
bowel appearance in primary lactase deficiency
normal
595
rat poison = ?
warfarin
596
lung dz description in morbid obesity
extrinsic restrictive lung disease
597
PFTs in morbid obesity
down: ERV, FRC, FEV-1, FVC, TLC
| normal residual volume
598
ribavirin mech
nucleoside antimetabolite
| interferes with viral genetic duplication
599
medullary thyroid cancer: what part of thyroid
parafollicular, calcitonin secreting C cells
600
what mitochondrial change is indicative of irreversible cell damage?
vacuolization
601
severe bilateral radicular pain, saddle anesthesia, hyporeflexia, bowel/bladder incontinence (late)
cauda equina syndrome
602
how does the pudendal nerve get damaged during labor
stress placed on pelvic floor (it's close to the ischial spine)
603
pudendal nerve injury →
weakness of perineal musculature → fecal/urinary incontinence, perineal pain and sexual dysfunction
604
SER fxn
make steroids/phospholipids
detox
sarcoplasmic reticulum
605
statistical power eq
1 - beta
| beta = probability of a type II error
606
type I error
reject the null, but its true
607
type II error
don't reject the null but should have
608
strep pneumo vaccine
unconjugated polysaccharide vaccine → T cell independent response
conjugated polysaccharide + protein Ag → robust T cell response
609
where does isotype switching take place?
germinal centers of lymph nodes
610
diseased modifying antirheumatic drugs
```
methotrexate
sulfasalazine
hydroxychloroquine
minocycline
TNF alpha inhibitors
```
611
zenker diverticulum pathophys
diminished relaxation of cricopharyngeal muscles → increased intraluminal P in oropharynx → mucosa herniates
612
lung cells that regenerate
type II pneumocytes
613
signs of constrictive pericarditis
JVD
Kussmaul
pulsus paradoxus
pericardial knock
614
enterobacter cloacae description
lactose fermenting gram negative rod
615
acute hemolytic transfusion rxn sx
fever/chills
chest/back pain
hemoglobinuria
w/in minutes to hours of transfusion
616
acute hemolytic transfusion rxn mechanism
type II (Ab mediated) HS
617
papillary muscle dysfxn → which murmur
mitral regurg
618
histo of choriocarcinoma
proliferation of cytotrophoblasts (mono-nuc) and syncytiotrophoblasts (multi-nuc)
619
pouch → thymus
3rd
620
wrist/thumb extension when blood pressure cuff is inflated
carpal spasm (Trousseau sign)
621
why do you see Trousseau sign and Chvostek sign in DiGeorge pts?
parathyroid hypoplasia (3rd/4th pouch) → hypocalcemia
622
blood supply cut off in inferior MI
posterior descending artery (usually from right coronary artery)
623
parts of kidney susceptible to hypoxia (and why)
PCT thick LoH
| active transport of ions needs ATP (and O2)
624
H pylori effects on gastric/duodenal mucosa
bacteria destroy mucosal layer (urease) → gastric ulcers
bacteria destroy delta cells → less somatostatin → increased gastrin → increased H+ secretion → duodenum can't compensate → duodenal ulcers
625
blood supply to Wernicke's area
MCA (inferior division)
626
blood supply to Broca's area
MCA (superior division)
627
tumor classification that determines prognosis
stage (extent of expansion)
628
postprandial epigastric pain w/ generalized atherosclerosis
chronic mesenteric ischemia
629
when do you see red neurons?
12-24 hrs post ischemic stroke
630
what starts DIC in Ob complications
release of tissue factor from placenta into maternal circulation
631
tx for bacteroides fragilis (beta lactam producer)
piperacillin-tazobactam
| works for pseudomonas too
632
acute graft rejection histo
dense interstitial lymphocytic infiltrate (T cell mediated)
633
what do you treat with all-trans-retinoic acid
APL
634
when in pulmonary vascular resistance lowest?
functional residual capacity
635
MCC of sudden cardiac death in first 48 hrs post acute MI
ventricular tachycardia
636
path of cirrhosis
diffuse hepatic fibrosis
| replace normal tissue w/ parenchymal nodules
637
MCC neonatal intraventricular hemorrhage
low birth weight → fragile germinal matrix (lines ventricles)
638
first area damaged in global ischemia
hippocampus
639
most abundant AA in collagen
glycine
640
DKA pts are susceptible to what?
mucor infection
641
black necrotic eschar in nasal cavity
mucormycosis
642
long term complication of ASD
Eisenmenger syndrome
| pulmonary vascular sclerosis → chronic pulmonary HTN
643
levels that increase risk of gallstones
increased cholesterol
decreased bile salts
decreased phosphatidylcholine
644
renal problems + eosinophilia
acute interstitial nephritis
645
mechanism of ataxia telangiectasia
AutoRec
ATM gene
impaired DNA break repair → IgA deficiency → airway infections
646
human recombinant insulins w/o any AA modification
```
regular insulin (duh)
NPH
```
647
eq to use for 95% confident
Mean +/- 1.96 x SD/sqrt n (95)
| Mean +/- 2.58 x SD/sqrt n (99)
648
MCC bloody nipple discharge
intraductal papilloma
| proliferation of papillary cells in a cyst wall or duct that may contain focal atypia
649
movement of PAH into/out of the tubules
freely filtered by glomerulus but majority is secreted by PCT
not reabsorbed anywhere
650
melanocyte embryology derivative
neural crest cells
651
turner syndrome mechanism of genetic loss
paternal meiotic nondisjunction
652
hereditary pulmonary arterial HTN genetics
2 hit mechanism starts with an abnormal BMPR2
653
pulmonary arterial HTN pathophys
```
dysfunctional endothelial and smooth muscle proliferation
increased endothelin (vasoconstrictor)
decreased NO and prostacyclin
```
654
what do you grow on a Bordet-Gengou medium
bordetella pertussis
655
cough lasting > 2 wks a/w post-tussive emesis
pertussis (adults lose immunity w/o boosters)
656
ADEs of methotrexate
```
oral/GI ulcers
alopecia
pancytopenia
hepatotoxicity
pulmonary fibrosis
```
657
how does iodine kill things?
halogenation of proteins and nucleic acids
| kills spores too
658
what happens with septic emboli
tricuspid valve endocarditis → pulmonary emboli → wedge shaped hemorrhagic lesions
659
blood supply to ureters
proximal: renal artery
distal: superior vesical artery
660
causes of acute serum sickness
exposure to an antigen
antigenic heterologous proteins (like monoclonal Abs)
nonhuman immunoglobulins (like venoms)
non protein drugs (penicillin, cefaclor, TMP-SMX)
661
fever, pruritic skin rash, arthralgias
acute serum sickness
662
clasp knife spasticity
initial resistance to passive extension followed by a sudden release of resistance
663
pure motor weakness affecting contra arm, leg, lower face
internal capsule stroke
664
Hashimoto histo
```
intense lymphocytic infiltrate, often with germinal centers
Hurthle cells (large oxyphilic cells filled with granular cytoplasm)
```
665
pyruvate kinase deficiency splenomegaly pathophys
deformed RBCs are destroyed in red pulp by reticuloendothelial cells → hyperplasia → splenomegaly
666
why do you check phospholipid levels in amniocentesis?
check lung development
667
what is the difference btwn CML and leukemoid rxn
both have elevated WBC and increased precursors (bans/myelocytes)
CML also has decreased leukocyte (neut) alkaline phosphatase (normal in leukemoid)
668
pronephros →
regresses
669
mesonephros →
wolffian duct in males
| vestigial Gartner's duct in females
670
metanephric diverticulum (ureteric bud) →
collecting system: collecting tubules, ducts, calyces, renal pelvis, ureters
671
metanephric mesoderm (blastema) →
glomeruli, Bowman's space, proximal tubules, LoH, DCTs
672
tx for lymphoma w/ CD20 marker
rituximab
673
tx for CML
imatinib
674
what cancers do you treat w/ IL-2
renal cell carcinoma
| melanoma
675
how does imatinib work
inhibits tyrosine kinase (made by BCR/ABL)
| inhibits cell proliferation but doesn't induce apoptosis
676
buildup in B12 def
```
methylmalonic acid (MMA) and homocysteine
→ neuro symptoms
```
677
signs of cocaine withdrawl
increased appetite
hypersomnia
psychomotor retardation
severe depression (crash)
678
signs of opiate withdrawl
dilated pupils
yawning
n/v/d
lacrimation
679
Ca action in muscle cells
bind to troponin C, displace tropomyosin, expose myosin binding sites on actin filaments
680
MC pediatric malignancy
ALL
681
how to tell diff btwn B-cell and T-cell ALL
B-cell more common
B cell lineages: TdT, CD10, CD 19, CD20
T cell lineages: CD2, CD3, CD4, CD5, CD7, CD8
T-cell often presents w/ mediastinal mass → respiratory sx, dysphagia, SVC syndrome
682
when to give group strep B prophylaxis
intrapartum
| check GBS @ 35-37 wks
683
MS cell type changes
depletion of oligodendrocytes
proliferation of astrocytes
lipid laden macs
684
CSF in MS
increased IgG (oligoclonal bland on protein electrophoresis)
685
when do you see oligodendrocyte depletion
MS
| progressive multifocal leukoencephalopathy
686
what do mitochondria do in apoptosis
release cytochrome c → activates caspases → intrinsic pathway apoptosis
687
when do you see superficial hemangiomas
aka infantile, capillary or strawberry
| first weeks of life, initially grow fast, regress spontaneously by late childhood
688
kind of injury to urethra (men)
posterior: pelvic fractures
anterior: straddle injuries
689
signs of urethral injury (men)
can't void but feel the need
high riding, boggy prostate
blood @ urethral meatus
690
vitamin given in measles
vitamin A: prevent ocular comps, reduce risk of pneumonia, encephalitis
691
pneumoconioses by lobe
asbestos: lower
| silica/coal: upper
692
pneumoconiosis w/ hilar calcifications
silicosis (eggshell calcifications)
693
charcot-bouchard aneurysms bleed where?
MC: basal ganglia, cerebellar nucs, thalamus, pons
694
basal ganglia blood supply
lenticulostriate arteries (from MCA)
695
pathophys of pulmonary abscesses
macs/neuts release lysosomal enzymes
696
short vagina, small uterus, normal secondary sex characteristics
Mullerian aplasia (Mayer-Rokitansky-Kuster-Hauser syndrome)
697
adrenal insufficiency → what electrolyte levels
adrenal insufficiency → less aldosterone
less Na
more K
more H (→ low HCO3 from non-anion gap acidosis → Cl retention to maintain electrical neutrality)
698
how to tx cyanide poisoning
```
hydroxocobalamin (binds CN ions)
sodium nitrate (induce methemoglobinemia)
sodium thiosulfate (add sulfur molecule → thiocyanate)
```
699
vitamin A toxicity (acute)
nausea, vomiting, vertigo, blurred vision
700
vitamin A toxicity (chronic)
```
alopecia
dry skin
hyperlipidemia
hepatotox
hepatosplenomegaly
visual problems
papilledema (from pseudotumor cerebri)
```
701
vitamin A toxicity (teratogen)
microcephaly
cardio anomalies
fetal death
(all worse in first trimester)
702
where does parvovirus like to replicate
bone marrow (tropism for erythrocytes)
703
MCC aortic stenosis in developed nations
calcific degeneration of trileaflet aortic valve
704
MCC aortic stenosis in developing nations
rheumatic valve dz (usually involves mitral too)
705
high cortisol levels that don't suppress with low dose dexamethasone but do with high dose
cushing syndrome (pituitary tumor)
706
high cortisol levels don't suppress with even high dose dexamethasone
ectopic (paraneoplastic) ACTH
707
how to manage somatic symptom disorder
schedule regular visits with the same provider
708
what cells promote migration/proliferation in atherosclerotic plaques
platelets, macs, dysfunctional endothelial cells
| → platelet-derived growth factor released
709
newborn with jaundice, anemia, positive coombs test
hemolytic disease of the newborn (erythroblastosis fetalis)
710
epinephrine effects on diastolic BP
low dose: beta 2 > alpha 1
| high dose: alpha 1 > beta 2
711
most important muscle in valsalva
rectus abdominis
712
what do anti-smith Abs actually affect
snRNPs (takes out introns)
713
pneumatosis intestinalis present in what condition
necrotizing enterocolitis
714
acute allergic contact dermatitis histo
spongiosis
715
```
severe fasting hypoglycemia
high blood lactate
gout
hepatomegaly
enlarged kidneys
```
Von Gierke
716
cardiomegaly
hypertrophic CM
exercise intolerance
Pompe disease
717
hepatomegaly
hypoglycemia
hyperlipidemia
normal lactate levels
Cori dz
718
muscle cramps
myoglobinuria
arrhythmia
McArdle dz
719
episodic peripheral neuropathy
angiokeratomas
hypohidrosis
Fabry
720
hepatosplenomegaly
pancytopenia
osteoporosis
aseptic necrosis of femur
Gaucher dz
721
progressive neurodegeneration
hepatosplenomegaly
foam cells
cherry red spot on macula
Niemann-Pick
722
progressive neurodegeneration
developmental delay
lysosomes with onion skin
cherry red spot on macula
Tay-Sachs
723
peripheral neuropathy
developmental delay
optic atrophy
globoid cells
Krabbe dz
724
central and peripheral demyelination
| ataxia and dementia
metachromatic leukodystrophy
725
```
developmental delay
gargoylism
airway obstruction
corneal clouding
hepatosplenomegaly
```
hurler synd
726
milder Hurler w/ aggressive behavior and no corneal clouding
Hunter synd
727
failure of processus vaginalis to obliterate →
indirect inguinal hernia
| communicating hydrocele
728
reye syndrome histo
microvesicular steatosis
729
tx for arsenic poisoning
dimercaprol
| DMSA
730
vitamin given to pts with homocystinuria
vit B6
731
how much lumin has to be blocked to cause angina
at least 75%
732
most important action in preventing renal stones
increase hydration
733
actions of angiotensin II
systemic vasoconstriction
constriction of EFFerent glomerular arteriole
increased aldosterone
734
pathophys of diverticulosis
pulsion (increased luminal pressure) → mucosa and submucosa outpouch thru muscularis
735
what cells cant use ketones
RBCs
736
fibrosis and cysts in lungs show
idiopathic pulmonary fibrosis (honeycombing)
737
autodom polycystic kidney dz vs autoRec (timing)
autodom usually shows up around 40-50
| autorec in first year of life
738
sustained muscle contraction, weakness, cataracts, frontal balding, gonadal atrophy
myotonic dystrophy
739
what is the main regulator of iron homeostasis?
hepcidin made by the liver
| it inhibits iron absorption and release from macs
