Uworld Review

Question 1

Chronic abdominal pain that is postprandial and accompanied by weight loss in a patient with a history of atherosclerosis is highly suspicious for
Findings also show one shrunken, atrophic kidney, and the other being enlarged and HTN indicates

Answer 1

Intestinal ischemia

Renal artery stenosis- other kidney compensates and becomes enlarged while the stenotic one becomes atrophied.

Question 2

Differentiating between tuberculoid and lepromatous leprosy with the lepromin skin test (like a PPD test)
MOA of each type

Answer 2

Tuberculoid will have an indurated response to the intradermal injection due to the activity of TH1 response. Well defined, few hypopigmented lesions with diminished sensation

Lepromatous leprosy will not have a reaction due to a weak TH1 response. This type is usually due to TH2 response and is a more widespread infection with poorly demarcated plaques and development of leonine facies

Question 3

Acute cholecystitis is caused by ______ in more than 90% of cases
How will this appear on US and cholescintigraphy?

Answer 3

Obstruction with a gallstone of the cystic duct

gallbladder wall thickening, pericholecystic fluid and positive sonography Murphy sign. Presence of gallstones alone is not diagnostic!
*Gallbladder will not be able to be visualized with the radiotracer dye due to obstruction

Question 4

Tumors cells develop resistance via ______gene; whose product is a ______
Where else in the body is this protein product found?

Answer 4

MDR1 gene- produces a P-glycoprotein (normally in intestinal and renal epithelium to eliminate foreign compounds, and on the BBB) that is a TM proteins functioning as an ATP-dependent efflux pump

Question 5

Normal cardiac pressure readings in the chambers of the heart, PA and aorta are?

Answer 5

Systolic atrial pressure= diastolic ventricular pressure since valves are open
Increased by contraction- higher Systolic ventricle pressure=respective valve systolic pressure
Atria only have diastolic pressures*

RA= 5 so RV= 25/5 so PA= 25/10
PCWP estimates LA= 10-12 so LV=130/10 and aorta =130/90

Question 6

Which diuretic would most likely improve survival in a patient with acute decompensated HF with decreased EF

Answer 6

Spironolactone- block the deleterious effect of aldosterone on the heart as well, which typically causes regression of myocardial fibrosis and improvement in ventricular remodeling

Usually given in addition to standard ACE-i and beta blockers

Question 7

Pathogenesis of diverticulosis (false diverticula) involves what term

What is the term for inflammation and subsequent scarring of the gut wall creating diverticula

Answer 7

Pulsion- an increased intraluminal pressure created during strained bowel movements

Traction- results in pulling and out pouching of all gut wall layers- true

Question 8

BH4 is a cofactor in synthesis of what 3 products?

Answer 8

—>Tyrosine—->DOPA

Tryptophan—5HT

Question 9

________ us a metalloprotease that cleaves and inactivated endogenous peptides including natriuretic peptides, glucagon, oxytocin and bradykinin

Used pharmacologically?

Answer 9

Neprilysin

Sacubitril- inhibit this metalloprotease to increase levels of endogenous natriuretic peptides in HF

Question 10

5 medication classes that are associated with osteoporosis fractures:

Answer 10

Anticonvulsants that induce P450 (phenobarbital, phenytoin, CM)- increase vit D catabolism
Aroma tase inhibitor/medroxyprogesterone- decrease estrogen
GnRH agonist- decrease estrogen and testosterone
PPI- decrease calcium absorption
Glucorticoids- decrease bone formation

Question 11

Carbidopa is added to levodopa to:

What AE is likely to remain or worsen after addition of carbidopa?

Answer 11

Decrease the peripheral conversion of levodopa- increases DA in CNS

Anxiety and agitation- central effects of DA (others: insomnia, confusion, hallucinations, behavior changes)

*DA stimulating nausea/vomitting in the emetic center of the brainstem which is located OUTSIDE the BBB, so DA decarboxylase inhibitors help with this AE

Question 12

Difference in symptom presentations of vWF deficiency and VIII deficiency

Answer 12

VWF- bleeding from skin and mucosal sites: gingiva, nasal mucosa, endometrium, GI

VIII- deeper tissue bleeding, joints and muscles, hematuria, GI

Question 13

Organism that contaminates food and can cause differing presentations in three likely populations of patients
Immunocompromised- invasive infection; meningoencephalitis, sepsis
Pregnant women- flu-like diarrhea, vomiting, muscle aches. Causes preterm labor and newborn has generalized skin rash (or sepsis)

Answer 13

Listeria

Question 14

Stroke affecting the _______ artery, results in vertigo/nystagmus from vestibular nucleus damage, ipsilateral cerebellar signs from inferior cerebellar peduncle damage, loss of pain/temp sensation in ipsilateral face and contralateral body (spinal trigeminal nucleus and spinothalamic tract), and dysphagia due to bulbar weakness of nucleus ambiguous damage, and descending sympathetic fibers damage causing Horner’s

Answer 14

PICA- lateral medullary syndrome (Wallenburg)

PICA is a branch of the vertebral artery

Question 15

An untreated small prolactinoma that is causing elevated prolactin and secondary amenorrhea is at risk for developing ______
MOA?

Answer 15

Decreased bone density- low estrogen levels leads to increased production of inflammatory cytokines, especially IL-1 an TNF-alpha, increasing the expression of RANKL and resulting increased osteoclasts activity

Question 16

LPL is normally bound to ______ on vascular endothelium, allowing it to interact with chylomicrons and VLDL to ______

A deficiency of LPL will have elevated:
Likely clinical outcomes if untreated are:

Answer 16

Heparin sulfate (heparin admin releases these lipases allowing LPL to be measured in serum)

Release FFA into adjacent tissues

Chylomicrons and TG- causing acute pancreatitis, milky-appearing vasculature and eruptive xanthomas (extensor surfaces surrounded by erythema)

Question 17

______ deficiency is likely to cause tendon xanthomas, xanthelasmas (eyelid deposits), and early MI

Answer 17

LDL receptor or B100 deficiency

Question 18

A low frequency, diastolic heart sound is heart shortly after S2 is _________
Best heart with patient in what position and doing what
Best heard where on the chest?

Answer 18

S3 heart sound

LLdecubitus and at end expiration (decreasing lung volume and bringing the heart closer to the chest wall)- listening over the cardiac apex

Question 19

Cryptococcus neoformans can be found in what two morphologies?

Answer 19

Yeast with a thick polysaccharide capsules

Round cells with narrow based budding yeast

Question 20

______ is the tendency of study subjects to change their behavior as a result of their awareness that they are being studied

_____ is selection bias by choosing hospitalized patients as the control group
____ is the effect of when a researcher’s beliefs in the efficacy of treatment can potentially affect the outcome

Answer 20

Hawthorne’s effect (observer effect)

Berkson’s bias (selection bias)

Pygmalion effect

Question 21

The venous components of internal hemorrhoids drain into the ________, which is ligated to cut the blood supply to the hemorrhoid, causing them to degenerate

External hemorrhoids drain via _____

Answer 21

Supervisor rectal vein- branch of the inferior mesenteric vein

Via inferior rectal vein into the internal pudendal vein

Question 22

The most common indicator of obesity-related disease is a reduction in ________

Answer 22

Expiration reserve volume

Reduction in chest wall compliance due to increase weight and a reduction in lung compliance due to microatelectasis, results in a restrictive lung disease panel

Question 23

TSH receptor is also present on ______, which is why Grave’s opthalmopathy is caused by stimulation of orbital ______, leading to excess deposition of extracellular GAGs, accompanied by a massive _______, which expands the extraocular muscles and retro-orbital tissues more

Treatment for Grave’s opthalmopathy?

Answer 23

Fibroblasts! (Also on adipocytes and other cell types)
Stimulates orbital fibroblasts by thyrotoxicosis receptor ABs
Accompanied by a massive T cell activation and inflammatory infiltrate

Glucorcorticoids- reduces the inflammation (they also decrease peripheral conversion of T4–>T3

Question 24

_____ is a 5HT1a receptor agonist for GAD. It does not cause sedation, addiction or tolerance. It takes 1-2 weeks to take effect, so cannot be used for acute anxiety.

Answer 24

Buspirone

Question 25

Patient with recurrent pulmonary infections, unsteady gait and discoordination of eye movements when looking at moving objects, and numerous superificial blanching nests of distended capillaries on sun exposed skin likely a mutation in what?

Answer 25

ATM gene—> failure to detect dna damage and failure to half progression of the cell cycle Ataxia-telangiectasia- Ataxia, Angiomas, igA deficiency, high AFP

Question 26

Immunocompromised Patient with neutropenia is most likely susceptible to ______ Patient presents with sepsis and multiple dark skin patches with necrotic centers and occasional ulcerations, normal platelet count/PT/PTT likely has _____. What are the four important virulence factors? How does this infection presentation differ from necrotizing fasciitis?

Answer 26

Gram negative sepsis Ecthyma gangrenosum- strongly associated with P aeroginosa bacteremia* (Dalmatian on sketchy spots) Exotoxins A- EF-2 ADP ribosylation Endotoxin- fever, shock Phospholipase C- degrades cell membranes Pyocyanin pigment Presents with a single site of infection with erythema, edema, pain out of proportion to PE, then progresses to pruritic discoloration, bullae, sensory loss due to necrosis

Question 27

in diabetic ketoacidosis, one enzyme is responsible for the generation of FFA and ketones to be utilized for energy needs Will appear as a normal fasting serum glucose during starvation and positive urine ketones

Answer 27

Hormone sensitive lipase- found in adipose tissue to break down TGs into FFA and glycerol, providing substrates for ketone production and GNG, respectively.

Question 28

>90% of Viral causes of meningitis is by what pathogen?

Answer 28

Enterovirus (Coxsackie, poliovirus, and echovirus) Negative gram stain and sterile culture *aseptic meningitis*

Question 29

Diphtheria acquires its virulence factor via ________, allowing it to produce pseudomembranous pharyngitis Strep pneumo acquire the ability to produce capsules via E.coli acquire the ability to form pili via _____ Environmental influences permitting the toxin synthesis occurs in :

Answer 29

Phage conversion of Tox gene, encodes for exotoxin AB Transformation (bacteria bind and import short pieces naked DNA from prior bacterial cell lysis) Bacterial conjugation (direct transfer of plasmids via sex pilus) Spore forming organisms

Question 30

Patient with cirrhosis presents with vomiting bright red blood and subsequently develops hepatic encephalopathy. What is the precipitating factor for the encephalopathy?

Answer 30

GI bleeds cause increased nitrogen delivery to the gut in the form of Hb, which is converted to ammonia and absorbed into the blood

Question 31

High molecular weight, high plasma protein binding, and high charge and hydrophilicity tend to have low ______

Answer 31

Vd (3-5L) | These characteristics trap the drug in the plasma compartment

Question 32

What occurs if on observation the cell body of the neuron is enlarged, there is an eccentric nucleus, enlargement of the nucleolus and dispersion of Nissl? Neuronal atrophy will appear as

Answer 32

Axonal reaction from loss of axon Loss of neurons and reactive gliosis

Question 33

_______ is a SERM used in treatment of estrogen positive breast cancer. It is a prodrug that is metabolized by ______ to its active metabolite

Answer 33

Tamoxifen- metabolized by CYP2D to endoxifen Patients with mutations in the CYP2D are exposed to decreased active substance and have a higher risk of disease relapse

Question 34

______ is a cell membrane protein that drives efflux of a number of substance out of the cell. It is the primary mechanism by which tumor cells cause multi drug resistance

Answer 34

P-glycoprotein

Question 35

what activities decrease the intensity of a LVOT obstruction murmur Increase the intensity? Where is it best hear

Answer 35

Decreased murmur by increasing LVEDV or afterload- squatting, hand grip, or passive leg raise Increased murmur by decreasing LVEDV or afterload- sudden standing, valsalva, NO administration Best heard at LLS border and apex

Question 36

Harsh, holosystolic murmur increased intensity with hand grip and heard at the LLS border but is otherwise asymptomatic is indicative of:

Answer 36

VSD | Increased systemic resistance increases afterload which causes increased flow across the VSD

Question 37

A bacterial organism has a virulence factor, which is a cell wall associated protein that has homology with tropomyosin and myosin. Name the virulence factor and its function for this organism

Answer 37

Strep pyogenes is coated with M protein | This prevents phagocytosis and inhibits complement binding

Question 38

X-linked recessive disorders: X-linked dominant disorder?

Answer 38

``` Ornithine transcarbamylase def Fabry’s Wiskott-Aldrich Ocular albinism G6PD def Hunter syndrome Bruton’s agammaglobulinemia Hemophilia Lesch-Nyah syndrome Duchenne and Becker ``` *boys and female patients with turner’s are more likely to have these disorders Fragile X syndrome- trinucleotide repeat in FMR1 gene causes hypermethylation and decreased expression

Question 39

________ is the unconscious shifting of emotions or desires associated with a person from the past to another person in the present Whereas _____ is when a person expresses unacceptable feelings meant for someone in their present life toward a different, safer person

Answer 39

Transference Displacement

Question 40

Mutation in fragile X syndrome is on what gene and results in what change to the gene? What can be used to diagnose the gene mutation? When does the trinucleotide expansion occur?

Answer 40

FMR1 gene on long arm of X chromosome- hypermethylation which inactivates the gene, preventing transcription, which impairs neural development Souther blot can be used to measure the degree of methylation and number of repeats Expansion occurs during meiosis of oocytes

Question 41

cancer immunotherapy involves mab that block a specific cell surface receptor found on T lymphocytes to facilitate destruction of cancer cells. What are the 2 cell surface receptors targeted?

Answer 41

PD-1 and anti-CTLA-4 ABs Programmed death receptor (PD-1) binds PD-L1 ligand, downregulating the immune response against tumor cells by inhibiting cytotoxic T cells Tumor cells evade the immune system by increasing ligand to bind PD1 or CTLA-4 MAB against PD1 blocks T cell inhibition to promote apoptosis of tumor cells

Question 42

Episodic systemic, muscular and GI symptoms and biopsy showing transmural inflammation of mid sized arteries with areas of eosin staining arterial wall necrosis and disruption of internal elastic lamina is indicative of _______ Highly associated with?

Answer 42

Polyarthritis nodosa Hepatitis B! Different from Buerger disease- intermittent claudication and gangrene/phlebitis and raynaud phenomenon *intact internal elastic lamina and sparing of vessel walls! Mostly highly cellular inflammatory thrombosis. Associated with smoking

Question 43

arteriovenous concentration gradient of anesthetics is the difference between- What characteristic of anesthetics affects this gradient?

Answer 43

Conc of gas anesthetic in arterial and venous blood High tissue solubility, large amount is taken up from the blood, which results in low venous conc. So saturation of the blood requires further absorption of anesthetic to replace that which went into peripheral tissues. If blood saturation takes longer, brain saturation is delayed and onset is slower. Lower tissue solubility has smaller AV gradients as less goes into peripheral tissue

Question 44

Migratory thrombophlebitis should raise suspicion for _______ due to _______

Answer 44

Visceral Cancer- many visceral cancers have hypercoagulability as a paraneoplastic syndrome(pancreas, colon, lung) These adenocarcinomas produce a thromboplastin-like substance capable of causing chronic intravascular coagulations that disseminate and migrate

Question 45

Resistance to ______ group of anti-fungals is accomplished by the organism decreasing its ergosterol incorporation into the cell membrane

Answer 45

Amphotericin and Nystatin- polyenes They typically bind to ergosterol in the cell membrane and create pore and cause cell lysis. Downregulating ergosterol will decrease these drugs efficacy

Question 46

``` Stress incontinence (with coughing, sneezing etc) is due to: Urge incontinence (A sudden overwhelming urge to urinate) is due to: Overflow incontinence (incomplete emptying or persistent involuntary dribbling) is due to: ```

Answer 46

Urethral sphincter dysfunction Detrusor muscle hyperactivity Impaired detrusor activity or bladder outlet obstruction

Question 47

Type B aortic dissections of the descending aorta typically originate close to: Characteristics of B vs A

Answer 47

Left subclavian artery (type A are in ascending aorta usually in sinotubular junction) B- intimal flap. Usually starts a near subclavian A- intimal tear Either can propagate proximally or distally (B and A, resp) to involve aortic arch branches. Either can propagate to involve the thoracoabdominal aorta branches (celiac trunk, intercostal arteries, renal arteries)

Question 48

Intermittent claudication is almost always the result of _______ of larger arteries

Answer 48

Atherosclerosis- atheromas: lipid filled intimal plaques that bulge into the lumen to prevent sufficient increases in blood flow to muscle

Question 49

What two antiarrhythmics classes prolong the QT interval? | Which drug of these actually has a very low risk of TdP?

Answer 49

Class III and IA- both has potassium blocking affects Amiodarone

Question 50

Risk of UTI can be reduced by 3 interventions when dealing with indwelling catheters:

Answer 50

Avoiding unnecessary catheterization, using sterile techniques when inserting them, and removing them as soon as possible *they should not be changed frequently, only for specific indications like active infection or obstruction!

Question 51

Five species of thermally dimorphic fungi are: (Forming mold hyphae in ambient temperatures (25-30C) and yeast single cells in body temperatures) Defining info about each one

Answer 51

Sporothrix schenckii- cigar shaped bud yeast, subcutaneous nodules along lymphatics Coccidioides immitis- thick walled spherules filled with endospores, SW Histoplasma capsulatum- oval yeast within macrophages, Ohio/Mississippi river, bat and bird droppings Blastomyces dermatidis- double refractive wall and single broad based bud, Great Lakes region (or ohio and Mississippi River) Paracoccidioides brasiliensis- budding blastoconidia/pirate wheel shape, central and S. America

Question 52

_______ induces CytP450, causing lower plasma concentrations of drugs like warfarin to decrease their efficacy

Answer 52

St. John’s Wort Others: modafinil, chronic alcohol, phenytoin, phenobarbital, nevirapine, rifampin, griseofulvin, carbamazepine/cyclophosphamide

Question 53

Characteristic findings of this type of hypothyroidism will show intense mononuclear infiltrate consisting of lymphocytes and plasma cells with active germinal centers*. Residual follicles will be surrounded by ______

Answer 53

Hashimoto’s thyroiditis Follicles surrounded by large oxyphilic cells filled with granular cytoplasm (Hurthle cells)- represent follicular epithelial cells that have undergone metaplastic change in response to inflammation

Question 54

Course of the median nerve: courses with the brachial artery between biceps and brachialis muscles, then gains access to the medial antecubital fossa where it courses between the humeral and ulnar heads of the _____ muscle. The nerve then travels between what two muscles before entering the wrist and hand within the ________ Difference between proximal and distal lesions

Answer 54

Between the heads of the pronator teres Between flexor digitorum profundus and superficialis muscles Within the flexor retinaculum Proximal- supracondylar humerus fracture or entrapment between pronator teres= sensory loss in median n distribution and weakness on thumb flexion/opposition, flexion of 2nd and 3rd digits, and wrist flexion/abduction. Preacher’s hand on attempt to make a fist Distal- preserved flexion of second and third digits and wrist with normal sensation over the thenar eminence

Question 55

What nerves lies between the flexor carpi ulnaris and the flexor digitorum profundus and typically courses between the olecranon and the medial epicondyle? Nerve that courses inferior to the teres major within the axilla then through the supinator muscle? Nerve that penetrates the coracobrachialis before descending between biceps and coracobrachialis toward the brachialis?

Answer 55

Ulnar nerve Radial nerve Musculocutaneous nerve

Question 56

______ synthesis promotes B cell IgE and IgG | ______ synthesis promotes B cell IgA and eosinophils

Answer 56

IL-4 | IL-5

Question 57

what mitochondrial enzyme of the TCA cycle will most likely be most inhibited in chronic alcoholics?

Answer 57

AlphaKG DH- thiamine dependent, which alcoholics are usually deficient in (Also pyruvate DH and transketolase) Because of the NADH:NAD+ increased ratio, technically all TCA enzymes requiring NAD+ will be inhibited, but especially those requiring thiamine

Question 58

Tartrate-resistant acid phosphatase, urinary hydroxyproline, and urinary deoxypyridinoline reflect ______ cell activity

Answer 58

Osteoclasts *deoxypyridinole is most reliable

Question 59

______ is a potent LONG ACTING full Mu-opioid agonist with good BA. Its prolonged effects suppress withdrawal symptoms and cravings, allowing for opioid abuse/withdrawal treatment. Important AE?

Answer 59

Methadone- respiratory depression and QT prolongation *buprenorphine is the partial agonist- less respiratory depression

Question 60

Diffuse muscle rigidity, high fever, autonomic instability (HTN, tachycardia), and elevated CK due to rhabdomyolysis is likely due to overdose with: Treated with

Answer 60

Anti-psychotics- neuroleptic malignant syndrome Add dantrolene- antagonizing the ryanodine receptors, inhibiting calcium ion release. Or bromocriptine, a DA agonist. *serotonin syndrome does not cause diffuse muscle rigidity. More so tremors/clonus, hyperreflexia, sweating, HTN, hyperthermia, diarrhea Treat this with cyproheptadine, 5HT-2 antagonist

Question 61

Reye’s syndrome hepatic damage will result in what appearance on light microscopy and EM

Answer 61

LM- microvesicular steatosis; small fat vacuoles in hepatocytes. NO NECROSIS OR INFLAMMATION PRESENT EM- decreased number of mitochondria and glycogen depletion

Question 62

Child with a lace-like erythematous rash on her stomach, back and extremities. Started two days ago on her cheeks. 3 days prior she had a HA, low-grade fever and congestion. Where does this organism likely replicate?

Answer 62

Parvovirus Replicates in erythrocytes precursors in the bone marrow

Question 63

Organism that causes UTIs in elderly man who just underwent a GU procedure. Gram positive cocci in chains and has PYR positivity, and ability to grow in bile and 6.5% Nacl What type of hemolysis does it possess?

Answer 63

Enterococcus - gamma hemolysis (no hemolysis)

Question 64

A green inspissated mass in the distal ileum is a _____ | This is a very specific finding for ________, which death is most commonly from a _______ complication

Answer 64

Dehydrated Meconium ileus Very specific finding for cystic fibrosis- most deaths are from pneumonia

Question 65

Histology of liver showing 1. Accumulation of large and small vesciles of fat and CLUMPED amorphous eosinophilia intracytoplasmic inclusions 2. Lymphoid aggregates within the portal tracts and focal macrovesicular steatosis with apoptosis of hepatocytes 3. Accumulation of finely granular DIFFUSELY homogenous pale eosinophilic cytoplasm

Answer 65

1. Alcoholic steatosis with Mallory bodies: made up of tangled intermediate filaments 2. Hep C 3. Hep B, ground-glass hepatocytes* made up of accumulated HB surface antigen within infected cells

Question 66

Marked ballooning and vacuolar degeneration of PCT, multiple oxalate crystals in the lumen of PCT is likely from:

Answer 66

ATN from ethylene glycol poisoning

Question 67

_______ deficiency is an inherited enzyme abnormality that results in abnormally slow metabolic degradation of exogenous choline ester drugs like ______. Will present as fasciculations with prolonged muscular paralysis

Answer 67

Pseudocholinesterase

Question 68

Most common cause of primary/idiopathic pericarditis is:

Answer 68

Viral

Question 69

_______ is a wheel shaped virus that is most notable for infantile gastroenteritis. Major cause of acute diarrhea in the winter Name the characteristics of this virus

Answer 69

Rotavirus- ds RNA with 11 segments icosahedral

Question 70

Dehydration and loose stools in a woman with long standing DM type 1 is likely due to

Answer 70

Motility disorder

Question 71

Cholinergic/AchE poisoning is treated with ______ and _______

Answer 71

Atropine (competitive inhibitor) | Pralidoxime (regenerates AchE if given early)

Question 72

Antigenic ______ is due to reassortment of viral genome segments Antigenic ______ is minor changes based on random mutation

Answer 72

Shift- human flu A reassort with swine flu B. Pandemics Drift- mutations in NA or HA. Epidemics

Question 73

Adaptive response at the cellular level of starting a statin is:

Answer 73

Increased transcription of HMGcoA reductase

Question 74

Spleen is protected by WHAT RIBS

Answer 74

9th-11th ribs *kidneys are below the 11th- 12th rib

Question 75

Nondisjunction resulting in klinfelter’s syndrome most likely occurred in what stage of spermatogenesis

Answer 75

Primary spermatocytes- this form exists after it crosses the blood testis barrier and enters meiosis I. Meiosis II is secondary spermatocyte Spermatic are all haploid

Question 76

When the body has enough calcium and you add it to the serum, the pathway will shunt to production of what type of vitamin D?

Answer 76

24,25 dihydroxycholecaciferol (inactive metabolite pathway also done by the kidney)

Question 77

What tendons in the hand flex the distal phalanx

Answer 77

Flexor digitorum profundus tendon *superficialis flexes the middle phalanx at the proximal interphalangeal joints

Question 78

Wipe down the workbench with alcohol- what type of virus will be successfully inactivated by this?

Answer 78

Enveloped virion- messes up the lipid bilayer

Question 79

Patient comes in with signs of anemia/blood loss from the GI system on labs and occult tests but endoscopy and colonoscopy are negative is likely due to: ______ which is most often on the right side of the colon

Answer 79

Angiodysplasia- tortuous dilation of vessels that causes hematochezia

Question 80

Blanching lesions on skin and mucous membranes, recurrent epistaxis and skin discolorations, GI bleeds or hematuria will also likely have ______ (structural abnormality) and this syndrome is called:

Answer 80

Hereditary hemorrhagic telangiectasia | Will likely also have AVMs

Question 81

Anterior vaginal wall prolapse is indicative of

Answer 81

Cystocele- prolapse bladder

Question 82

Scleroderma patients are likely to develop what lung disease

Answer 82

Pulmonary HTN or interstitial fibrosis

Question 83

6yo boy is having difficulty with motor coordination, shuffling gait, shows impaired upward gaze and pupillary response to light and an enlarged lateral and third ventricles. Where is the mass most likely located? What does this mass produce?

Answer 83

Pineal gland Compression of tectum causes vertical gaze palsy and obstructive hydrocephalus from cerebral aqueduct compression Pinealoma produces beta-HCG which can cause puberty in males

Question 84

What labs do you need to check when put a patient on propylthiouracil?

Answer 84

CBC- causes Agranulocytosis and aplastic anemia

Question 85

Necator americanus and ancylostoma parasite infects via _______ These two hook worms may result in a ___________, resulting in fatigue and irritability

Answer 85

Larvae enter the body by penetrating exposed skin (especially feet) then travel through the blood stream to lungs and trachea and get swallowed into GI Microcytic anemia