Uworld4 Flashcards

1
Q

Dx of atopic dermatitis cannot be made without […].

A

Dx of atopic dermatitis cannot be made without intense pruritus.

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2
Q

The main side effects of bile acid-binding resins are GI upset, impaired absorption of nutrients and drugs (like statins!), and […].

A

The main side effects of bile acid-binding resins are GI upset, impaired absorption of nutrients and drugs (like statins!), and hypertriglyceridemia.

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3
Q

The antiarrhythmic agents quinidine, procainamide, disopyramide, ibutilide, dofetilide, and sotalol have been implicated in […].

A

The antiarrhythmic agents quinidine, procainamide, disopyramide, ibutilide, dofetilide, and sotalol have been implicated in prolonged QT / torsades de pointes.Along with phenothiazines, TCAs

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4
Q

The […] vein drains the ipsilateral jugular and subclavian veins.

A

The brachiocephalic vein drains the ipsilateral jugular and subclavian veins.Right brachiocephalic drains the right lymphatic ductObstruction causes sx similar to SVC syndrome but on just one side of the body

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5
Q

Tx for Legionnaires is with […] or newer macrolides (i.e. azithromycin).

A

Tx for Legionnaires is with respiratory fluoroquinolones (i.e. levofloxacin) or newer macrolides (i.e. azithromycin).

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6
Q

Tx for Legionnaires is with respiratory fluoroquinolones (i.e. levofloxacin) or […].

A

Tx for Legionnaires is with respiratory fluoroquinolones (i.e. levofloxacin) or newer macrolides (i.e. azithromycin).

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7
Q

[…] is uncommon with portal vein thrombosis since sinusoidal hypertension does not develop.

A

Ascites is uncommon with portal vein thrombosis since sinusoidal hypertension does not develop.

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8
Q

Resistance is maximal between bronchial generations 2-5, but drops in subsequent generations (e.g. small bronchi, bronchioles) because […].

A

Resistance is maximal between bronchial generations 2-5, but drops in subsequent generations (e.g. small bronchi, bronchioles) because the summated cross-sectional area massively increases.Upper and lower respiratory tract each account for ~50% of total airway resistance.

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9
Q

Airway resistance peaks in […].

A

Airway resistance peaks in medium-sized bronchi.Highly turbulent flow

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10
Q

[…] is used in organophosphate poisoning - it regenerates cholinesterase in the nm junction.

A

Pralidoxime (2-PAM) is used in organophosphate poisoning - it regenerates cholinesterase in the nm junction.

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11
Q

Piperacillin-tazobactam, metronidazole, carbapenems, and clindamycin are antimicrobials with […].

A

Piperacillin-tazobactam, metronidazole, carbapenems, and clindamycin are antimicrobials with anaerobic activity.

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12
Q

Proceed cautiously with […] when renal artery stenosis is present.

A

Proceed cautiously with ACE inhibitors when renal artery stenosis is present.Elevated levels of ATII are necessary to maintain GFR.

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13
Q

Isolated systolic hypertension is caused by […].

A

Isolated systolic hypertension is caused by age-related decreases in the compliance of the aorta and its proximal major branches.Or, “aortic stiffening”… high systolic, normal diastolic

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14
Q

INH neuropathy occurs through […].

A

INH neuropathy occurs through vitamin B6 deficiency.

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15
Q

Patients with an imperforate anus often have other congenital malformations, with […] anomalies being the most common.

A

Patients with an imperforate anus often have other congenital malformations, with urogenital tract anomalies being the most common.

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16
Q

[…] is a recombinant form of human Brain Natriuretic Peptide (BNP) and can be used in patients with decompensated left ventricular dysfunction leading to CHF.

A

Nesiritide is a recombinant form of human Brain Natriuretic Peptide (BNP) and can be used in patients with decompensated left ventricular dysfunction leading to CHF.

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17
Q

Both ANP and BNP activate […].

A

Both ANP and BNP activate guanylate cyclase.Natriuretic peptides cause vasodilation, diuresis, and a decrease in BP. They counteract endothelin, sympathetic effects, and angiotensin II.

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18
Q

High-grade dysplasia is synonymous with […].

A

High-grade dysplasia is synonymous with carcinoma in situ.Low-grade dysplasia does not involve the entire thickness of the epithelium.

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19
Q

Severe lactic acidosis in conjunction with a lessened difference between arterial and venous O2 content = […]

A

Severe lactic acidosis in conjunction with a lessened difference between arterial and venous O2 content = cyanide poisoningVenous blood still highly oxygenatedGive nitrites to form methemoglobin

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20
Q

Albendazole is the first line treatment for enterobiasis, but […] is an alternate agent preferred in pregnant patients.

A

Albendazole is the first line treatment for enterobiasis, but pyrantel pamoate is an alternate agent preferred in pregnant patients.

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21
Q

Nifurtimox is used to treat diseases caused by […].

A

Nifurtimox is used to treat diseases caused by trypanosomes.Inc. Chagas disease

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22
Q

Shigella can induce apoptosis of the host cell and spread to adjacent cells via protrusions created through host-cell […] polymerization.

A

Shigella can induce apoptosis of the host cell and spread to adjacent cells via protrusions created through host-cell actin polymerization.Musocal invasion = essential pathogenic mechanism

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23
Q

[…] is the primary histologic finding in patients with eczematous dermatitis.

A

Spongiosis is the primary histologic finding in patients with eczematous dermatitis.Epidermal accumulation of edematous fluid in the intercellular spaces

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24
Q

Hypergranulosis = excessive granulation in the stratum granulosum of the epidermis, seen in conditions such as […]

A

Hypergranulosis = excessive granulation in the stratum granulosum of the epidermis, seen in conditions such as lichen planus

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25
Q

Immunocompromised shingles patients are best treated with either foscarnet or […].

A

Immunocompromised shingles patients are best treated with either foscarnet or cidofovir.Thymidine kinase-deficient VZV tends to be exclusively from AIDS pts

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26
Q

Repetitive myocardial stunning can result in […].

A

Repetitive myocardial stunning can result in hibernating myocardium.

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27
Q

The vascular endothelium secretes […] to inhibit platelet aggregation.

A

The vascular endothelium secretes prostacyclin (=PGI2) to inhibit platelet aggregation.Synthetic prostacyclin is used in the tx of pulmonary HTN, peripheral vascular disease, and Raynaud syn

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28
Q

Allopurinol or […] can be used to reduce uric acid levels in tumor lysis syndrome.

A

Allopurinol or rasburicase can be used to reduce uric acid levels in tumor lysis syndrome.=recombinant version of urate oxidase

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29
Q

Impairment of complement-mediated cell lysis can be accomplished by staphylococcal […], which binds the Fc portion of IgG.

A

Impairment of complement-mediated cell lysis can be accomplished by staphylococcal protein A, which binds the Fc portion of IgG.

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30
Q

IgA protease is produced by S. pneumo, H. flu, and […] sp.

A

IgA protease is produced by S. pneumo, H. flu, and Neisseria sp.

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31
Q

[…] results from the deposition of calcium hydroxyapatite crystals in periarticular soft tissues.

A

Calcific tendonitis results from the deposition of calcium hydroxyapatite crystals in periarticular soft tissues.Rotator cuff tendons are commnly affected

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32
Q

Suffix of a biological agent indicated whether a medication is a monoclonal antibody (=[…]), a receptor molecule (=cept), or a kinase inhibitor (=nib).

A

Suffix of a biological agent indicated whether a medication is a monoclonal antibody (=mab), a receptor molecule (=cept), or a kinase inhibitor (=nib).For monoclonal abs: u=human, o=mouse, xi=chimeric, zu=humanized, xizu=chim/hum hybrid

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33
Q

Suffix of a biological agent indicated whether a medication is a monoclonal antibody (=mab), a receptor molecule (=[…]), or a kinase inhibitor (=nib).

A

Suffix of a biological agent indicated whether a medication is a monoclonal antibody (=mab), a receptor molecule (=cept), or a kinase inhibitor (=nib).For monoclonal abs: u=human, o=mouse, xi=chimeric, zu=humanized, xizu=chim/hum hybrid

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34
Q

Suffix of a biological agent indicated whether a medication is a monoclonal antibody (=mab), a receptor molecule (=cept), or a kinase inhibitor (=[…]).

A

Suffix of a biological agent indicated whether a medication is a monoclonal antibody (=mab), a receptor molecule (=cept), or a kinase inhibitor (=nib).For monoclonal abs: u=human, o=mouse, xi=chimeric, zu=humanized, xizu=chim/hum hybrid

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35
Q

Vascular rxn to endothelial and intimal injury is intimal hyperplasia and fibrosis, predominantly mediated by reactive […] cells that migrate from the media to the intima.

A

Vascular rxn to endothelial and intimal injury is intimal hyperplasia and fibrosis, predominantly mediated by reactive smooth muscle cells that migrate from the media to the intima.SMCsFollowed by SMC proliferation and collagen synthesis to produce a neointima, can result in reactive intimal hyperplasia

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36
Q

Ranibizumab, bevacizumab = […]

A

Ranibizumab, bevacizumab = VEGF inhibitorsWet AMD

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37
Q

[…] is the only agent in the pyrimidine class of antifungals.

A

Flucytosine is the only agent in the pyrimidine class of antifungals.Converted to 5-FU within the fungal cell, interferes with RNA/protein synth

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38
Q

[…] fermentation is a property of S. aureus.

A

Mannitol fermentation is a property of S. aureus.Other staphylococci cannot ferment mannitol.

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39
Q

Nongonococcal urethritis (NGU) is most commonly caused by C. trachomatic or […].

A

Nongonococcal urethritis (NGU) is most commonly caused by C. trachomatic or Ureaplasma urealyticum.Other causes include Mycoplasma and Trichomonas sp.Tx = azithromycin

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40
Q

The immune deficiency of ataxia-telangiectasia primarily manifests as an […].

A

The immune deficiency of ataxia-telangiectasia primarily manifests as an IgA deficiency.

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41
Q

Hyperkeratotic vesicles on the palms and soles = […]

A

Hyperkeratotic vesicles on the palms and soles = keratoderma blennorrhagicumReactive arthritis… other derm manifestation is circinate balanitis (serpiginous annular dermatitis of the glans penis)

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42
Q

Currently […] has replaced lidocaine in the management of v tach.

A

Currently amiodarone has replaced lidocaine in the management of v tach.

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43
Q

Verapamil is used for supraventricular or ventricular tachyarrhythmias? […]

A

Verapamil is used for supraventricular or ventricular tachyarrhythmias? Supra - because it slows conduction through the AV node.DO NOT give for ventricular tach –> v fib –> death

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44
Q

[…] is indicated for use in the acute tx of paroxysmal supraventricular tachycardia.

A

Adenosine is indicated for use in the acute tx of paroxysmal supraventricular tachycardia.It is not indicated in v tach

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45
Q

Glucagon, TSH, and PTH receptor complexes are what type? […]

A

Glucagon, TSH, and PTH receptor complexes are what type? Gs

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46
Q

Heme oxygenase converts heme to […].

A

Heme oxygenase converts heme to biliverdin.

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47
Q

[…] typically results from a re-entrant impulse traveling through slowly and rapidly conducting segments of the AV node.

A

Paroxysmal supraventricular tachycardia (PSVT) typically results from a re-entrant impulse traveling through slowly and rapidly conducting segments of the AV node.Tx: carotid massage, Valsalva –> increase cardiac parasymp tone

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48
Q

Class […] antiarrhythmic drugs exhibit use-dependence.

A

Class 1C antiarrhythmic drugs exhibit use-dependence.Prolongs the QRS duration in a rate-dependent manner… slowest of the class 1s to dissociate from the Na channel

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49
Q

Class […] antiarrhythmics demonstrate reverse use-dependence.

A

Class III antiarrhythmics demonstrate reverse use-dependence.Slower HR, more prolonged QT inverval… no effect on QRS duration

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50
Q

Synthesis of GABA is mediated by […]. Catabolism of GABA is mediated by GABA transaminase.

A

Synthesis of GABA is mediated by glutamate decarboxylase. Catabolism of GABA is mediated by GABA transaminase.Both use vitB6 as a cofactor!

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51
Q

Synthesis of GABA is mediated by glutamate decarboxylase. Catabolism of GABA is mediated by […].

A

Synthesis of GABA is mediated by glutamate decarboxylase. Catabolism of GABA is mediated by GABA transaminase.Both use vitB6 as a cofactor!

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52
Q

[…] bone composes only 15% of the total skeleton by weight but is metabolically more active because of its large surface area.

A

Trabecular bone composes only 15% of the total skeleton by weight but is metabolically more active because of its large surface area.=spongy=cancellousOsteoporosis primarily involves trabecular bone.

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53
Q

Sickle cell trait RBCs will sickle when […] is added.

A

Sickle cell trait RBCs will sickle when sodium metabisulfite is added.

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54
Q

Sorbitol-containing MacConkey agar is used for isolation of […].

A

Sorbitol-containing MacConkey agar is used for isolation of O157:H7 E. coli.Additionally, O157:H7 does not produce glucuronidase.

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55
Q

Ribosomes attach to the RER via the […], a protein complex containing ribophorins that bind the large 60S subunit.

A

Ribosomes attach to the RER via the translocon, a protein complex containing ribophorins that bind the large 60S subunit.Pancreatic and plasma cells are especially rich in ribosomes

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56
Q

Mu receptors are GPCRs whose actions are mediated through various pathways – one pathway involves increased […] efflux.

A

Mu receptors are GPCRs whose actions are mediated through various pathways – one pathway involves increased potassium efflux.–> hyperpolarization of postsynaptic neurons –> blocked pain transmission

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57
Q

The more common NNRTIs include nevirapine, efavirenz, and […].

A

The more common NNRTIs include nevirapine, efavirenz, and delavirdine.

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58
Q

In lung transplant, chronic rejection causes inflammation of the […].

A

In lung transplant, chronic rejection causes inflammation of the small bronchioles.Bronchiolitis obliteransPresents with dyspnea, nonproductive cough, and wheezing

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59
Q

In systemic mastocytosis, there is increased secretion of […].

A

In systemic mastocytosis, there is increased secretion of histamine.Results in increased gastric acid secretion

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60
Q

[…] is a positive regulator of acetyl-CoA carboxylase and fructose-1,6-bisphosphatase.

A

Citrate is a positive regulator of acetyl-CoA carboxylase and fructose-1,6-bisphosphatase.Indicator of high energy stores because it is formed in the first rxn of Krebs cycle

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61
Q

Alanine allosterically inhibits which glycolytic enzyme? […]

A

Alanine allosterically inhibits which glycolytic enzyme? Pyruvate kinaseDuring gluconeogenic state

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62
Q

[…] is an allosteric activator of pyruvate carboxylase.

A

Acetyl-CoA is an allosteric activator of pyruvate carboxylase.High levels = energy excess

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63
Q

Cystathione synthase requires vitamin B6 and the amino acid […].

A

Cystathione synthase requires vitamin B6 and the amino acid serine.

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64
Q

The macula has a separate blood supply from the […], while the rest of the retina is supplied by the central retinal artery.

A

The macula has a separate blood supply from the choroid artery, while the rest of the retina is supplied by the central retinal artery.This explains the finding of cherry-red macula when central retinal artery is occluded.

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65
Q

Amino acids that are glucogenic and ketogenic = […]

A

Amino acids that are glucogenic and ketogenic = Ile Trp PheKetogenic AAs = Leucine, Lysine

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66
Q

Serum albumin levels, […] levels, and prothrombin time are reflective of liver function and are of greatest prognostic significance in pts with cirrhosis.

A

Serum albumin levels, bilirubin levels, and prothrombin time are reflective of liver function and are of greatest prognostic significance in pts with cirrhosis.

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67
Q

[…] is a 72 kD enzyme that is detected in inflammatory cells but is undetectable in most normal tissues.

A

COX-2 is a 72 kD enzyme that is detected in inflammatory cells but is undetectable in most normal tissues.

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68
Q

[…] is the only available IV agent that improves renal perfusion while it lowers blood pressure.

A

Fenoldopam is the only available IV agent that improves renal perfusion while it lowers blood pressure.Stimulation of dopamine receptors in kidney -> improved renal blood flow, increased sodium, increased water excretion

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69
Q

[…] asthma is the most common type.

A

Extrinsic allergic asthma is the most common type.E.g. animal dander

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70
Q

Cellular integrins are the receptor of […].

A

Cellular integrins are the receptor of CMV.NAchR = rabiesICAM1/CD54 = rhinoCD21/CR2 = EBV

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71
Q

Fetor hepaticus = […]

A

Fetor hepaticus = malodorous breath in pts with poor hepatic function

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72
Q

Early-onset food poisoning = S. aureus, B. cereus ; Late-onset food poisoning = […]

A

Early-onset food poisoning = S. aureus, B. cereus ; Late-onset food poisoning = C. perfringens

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73
Q

Hyperglycemia is a metabolic side effect seen with which psychiatric drug class? […]

A

Hyperglycemia is a metabolic side effect seen with which psychiatric drug class? 2nd generation antipsychotics (atypicals)– Low-potency antipsychotics are more likely to cause sedation, anticholinergic, anti-adrenergic side effects

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74
Q

Bisphosphonates are structural analogues of […], an important component of hydroxyapatite.

A

Bisphosphonates are structural analogues of pyrophosphate, an important component of hydroxyapatite.Make hydroxyapatite more insoluble and interfere with osteoclasts.Patient who take bisphosphonates must STAY UPRIGHT for 30 minutes because these agents are caustic to the esophagus.

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75
Q

The four morphologic stages of lobar pneumonia: […], red hepatization, gray hepatization, and resolution.

A

The four morphologic stages of lobar pneumonia: congestion, red hepatization, gray hepatization, and resolution.

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76
Q

Pulsus alternans occurs in patients with l[…].

A

Pulsus alternans occurs in patients with left ventricular dysfunction.Beat to beat variation in the magnitude of the pulse pressure in the presence of a regular cardiac rhythm

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77
Q

A dicrotic pulse is most common in patients with severe […].

A

A dicrotic pulse is most common in patients with severe systolic dysfunction.Pulse with two distinct peaks, one during systole and one during diastole

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78
Q

A […] refers to rapid ejection of a large stroke volume against a decreased afterload.

A

A hyperkinetic pulse refers to rapid ejection of a large stroke volume against a decreased afterload.Fever, exercise, PDA, A-V fistula

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79
Q

Vernet syndrome = dysfunction of […]

A

Vernet syndrome = dysfunction of CN IX,X,XI=Jugular foramen syndrome

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80
Q

[…] = when one hormone allows another to exert its maximal effect

A

Permissiveness = when one hormone allows another to exert its maximal effectCortisol exerts permissive effect on many hormones to help improve response to stressors

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81
Q

Systolic ejection murmur that increases in intensity on standing = […]

A

Systolic ejection murmur that increases in intensity on standing = hypertrophic cardiomyopathyIf it decreases on standing –> aortic stenosis

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82
Q

A fib may cause the murmur of […] to disappear completely.

A

A fib may cause the murmur of mitral/tricuspid valve stenosis to disappear completely.Diastolic murmur with presystolic accentuation due to atrial contraction

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83
Q

Wide splitting of S1 that is accentuated by inspiration = […]

A

Wide splitting of S1 that is accentuated by inspiration = delayed closure of tricuspid valveRBBB or tricuspid stenosis

84
Q

Very long chain (and some branched) fatty acids are metabolized within […].

A

Very long chain (and some branched) fatty acids are metabolized within peroxisomes.Accumulate in Zellweger syndrome –> infants can’t form myelin in the CNS –> hypotonia, seizures, early death

85
Q

Refsum disease = defect in peroxisomal alpha oxidation –> accumulation of […]

A

Refsum disease = defect in peroxisomal alpha oxidation –> accumulation of phytanic acidTx = AVOID CHLOROPHYLL

86
Q

In urushiol-induced contact dermatitis, […] are the primary effector cells and directly destroy keratinocytes expressing haptenated proteins.

A

In urushiol-induced contact dermatitis, CD8+ T cells are the primary effector cells and directly destroy keratinocytes expressing haptenated proteins.

87
Q

In glaucoma, timolol and other beta-blockers (also acetazolamide) decrease aq. humor secretion by the […].

A

In glaucoma, timolol and other beta-blockers (also acetazolamide) decrease aq. humor secretion by the ciliary epithelium.On the other hand, Prostaglandin F2alpha (“-prost”) and cholinomimetics increase outflow.

88
Q

Patients with mild myopia often note improvement […].

A

Patients with mild myopia often note improvement with age (as presbyopia develops).

89
Q

The […] test is the most sensitive provocative diagnostic test for coronary vasospasm.

A

The ergonovine test is the most sensitive provocative diagnostic test for coronary vasospasm.Prinzmetal’s can be treated with nitrates and CCBs

90
Q

After crawling to the endothelial cell periphery, neutrophils migrate out of the vasculature by squeezing in between the cells via integrin attachments and adherence to […].

A

After crawling to the endothelial cell periphery, neutrophils migrate out of the vasculature by squeezing in between the cells via integrin attachments and adherence to PECAM-1.=platelet endothelial cell adhesion molecule 1… found primarily at the peripheral intercellular junctions of endothelial cells

91
Q

Carbamazepine can cause […], so CBC should be monitored regularly.

A

Carbamazepine can cause aplastic anemia, so CBC should be monitored regularly.Also a P450 inducer

92
Q

Foscarnet is a pyrophosphate analogue that can […].

A

Foscarnet is a pyrophosphate analogue that can chelate calcium.Moreover, foscarnet-induced renal wasting of magnesium may lead to hypomagnesemia and a reduction in PTH release, which contributes to hypocalcemic state.

93
Q

[…] is the most comon cause of spontaneous lobar hemorrhage.

A

Amyloid angiopathy is the most comon cause of spontaneous lobar hemorrhage.Esp. in adults > 60… tends to involve OCCIPITAL and PARIETAL loves

94
Q

Homeobox genes code for […] that play an important role in morphogenesis.

A

Homeobox genes code for DNA-binding transcription factors that play an important role in morphogenesis.

95
Q

[…] refers to selection bias created by choosing hospitalized pts as the control group.

A

Berkson’s bias refers to selection bias created by choosing hospitalized pts as the control group.

96
Q

[…] describes the fact that a researcher’s beliefs in the efficacy of a treatment can potentially affect the outcome.

A

Pygmalion effect describes the fact that a researcher’s beliefs in the efficacy of a treatment can potentially affect the outcome.

97
Q

Active ingredient in cannabis is […].

A

Active ingredient in cannabis is THC.Conjunctival injection (red eyes), tachycardia, increased appetite, and dry mouth

98
Q

The major adverse effect of zidovudine is […].

A

The major adverse effect of zidovudine is bone marrow suppression.

99
Q

Nodularity of the uterosacral ligaments and fixed retroversion of the uterus are commonly found on vaginal exam in patients with […].

A

Nodularity of the uterosacral ligaments and fixed retroversion of the uterus are commonly found on vaginal exam in patients with endometriosis.Dysmenorrhea + dysparenunia + dyschezia + frequenrly infertile

100
Q

All the skin from the umbilicus down (including the anus up to the dentate line) but excluding the posterior calf drains to the […] lymph nodes.

A

All the skin from the umbilicus down (including the anus up to the dentate line) but excluding the posterior calf drains to the superficial inguinal lymph nodes.Prostate and bladder drain to iliac nodes

101
Q

High circulating levels of […] prevent lactogenesis while also promoting breast growth and development during pregnancy.

A

High circulating levels of estrogen and progesterone prevent lactogenesis while also promoting breast growth and development during pregnancy.By 2nd/3rd trimesters of pregnancy, progesterone production has been assumed by the placenta and estrogen production has been assumed by the fetal adrenal gland.

102
Q

In TSS, activation of T cells releases […] from the T cells and IL-1 / TNF from macrophages.

A

In TSS, activation of T cells releases IL-2 from the T cells and IL-1 / TNF from macrophages.

103
Q

MAC is an intrinsic property of the anesthetic that does not depends on the type of surgery, duration of anesthesia, or sex/height/wt of the patient… It DOES, however, depend on […].

A

MAC is an intrinsic property of the anesthetic that does not depends on the type of surgery, duration of anesthesia, or sex/height/wt of the patient… It DOES, however, depend on body temperature (and decreases with increasing patient age).

104
Q

Atropine, TCAs, H1 antags, neuroleptics, and antiparkinsonian drugs all have […].

A

Atropine, TCAs, H1 antags, neuroleptics, and antiparkinsonian drugs all have antimuscarinic effects.Including flushed skin and mydriasis

105
Q

Initial investigation of choice in […] is an u/s, which shows an edematous and enlarged gallbladder and no gallstones.

A

Initial investigation of choice in acalculous cholecystitis is an u/s, which shows an edematous and enlarged gallbladder and no gallstones.RFs: sepsis, immunosupp, total parenteral nutr, major trauma, burns, DM, infxn, mech vent, opiate usage, cor heart dis, cholesterol emboli, mult tranfs, childbirth, or nonbiliary surgery

106
Q

Non-bacterial thrombotic endocarditis (NBTE) associated with cancer is called […].

A

Non-bacterial thrombotic endocarditis (NBTE) associated with cancer is called marantic endocarditis.Tumor-assoc. release of procoagulants, as in Trousseau syndrome (migratory thrombophlebitis)

107
Q

The integrins are a family of transmembrane protein receptors that interact with the extracellular matrix by binding to collagen, fibronectin, and […].

A

The integrins are a family of transmembrane protein receptors that interact with the extracellular matrix by binding to collagen, fibronectin, and laminin.

108
Q

[…] is a proteoglycan component of the extracellular matrix that is primarily associated with reticular fibers and basal laminae.

A

Heparan sulfate is a proteoglycan component of the extracellular matrix that is primarily associated with reticular fibers and basal laminae.

109
Q

Viral exchange of surface proteins with no actual genetic exchange = […]

A

Viral exchange of surface proteins with no actual genetic exchange = phenotypic mixingCo-infection of a host cell by two viral strains

110
Q

Enterocytes with clear / foamy cytoplasm = […]

A

Enterocytes with clear / foamy cytoplasm = abetalipoproteinemiaCan’t synth Apo B –> component of chylomicrons and VLDL

111
Q

Abetalipoproteinemia is most commonly caused by an autosomal recessive, loss-of-function mutation in the […] gene.

A

Abetalipoproteinemia is most commonly caused by an autosomal recessive, loss-of-function mutation in the MTP gene.Manifests during first year of life with malabsorption + low plasma triglyc/cholest levels + ADEK deficency, especially E

112
Q

The […] pancreatic bud forms the pancreatic tail, body, most of the head, and the small accessory pancreatic duct.

A

The dorsal pancreatic bud forms the pancreatic tail, body, most of the head, and the small accessory pancreatic duct.

113
Q

The […] pacreatic bud forms the uncinate process, a portion of the pancreatic head, and the proximal portion of the main pancreatic duct.

A

The ventral pacreatic bud forms the uncinate process, a portion of the pancreatic head, and the proximal portion of the main pancreatic duct.Dorsal and ventral buds fuse during 8th week of fetal life.

114
Q

[…] is the only medication that reverses both muscarinic and nicotinic effects of organophosphates by “restoring” cholinesterase from its bond with these substances.

A

Pralidoxime is the only medication that reverses both muscarinic and nicotinic effects of organophosphates by “restoring” cholinesterase from its bond with these substances.Only effective if given early after the exposure*Atropine only reverses muscarinic effects – still in danger of muscle paralysis

115
Q

Phosphatidlyserine and thrombospondin are […] displayed on plasma membranes of damaged cells.

A

Phosphatidlyserine and thrombospondin are intrinsic apoptotic signals displayed on plasma membranes of damaged cells.(UV light, heat, hypoxia, toxins, radiation)

116
Q

Cysteine-aspartic-acid-proteases = […]

A

Cysteine-aspartic-acid-proteases = caspasesContain cysteine, able to cleave aspartic acid residues

117
Q

IgG anti-D is routinely administered at […] genstation and in the immediate postpartum period.

A

IgG anti-D is routinely administered at 28 weeks genstation and in the immediate postpartum period.

118
Q

Basophilic clusters seen on the surface of intestinal musocal cells (in the setting of diarrhea) = […]

A

Basophilic clusters seen on the surface of intestinal musocal cells (in the setting of diarrhea) = cryptosporidium

119
Q

Occlusion of the hepatoduodenal ligament to detect source of bleeding = […] maneuver

A

Occlusion of the hepatoduodenal ligament to detect source of bleeding = Pringle maneuverIf liver bleeding does not cease when the potral triad is occluded, it is likely there has been an injury to the INF VENA CAVA or hepatic veins.

120
Q

What do you test next to determine whether elevated alk phos is of hepatic or bony origin? […]

A

What do you test next to determine whether elevated alk phos is of hepatic or bony origin? Gamma-glutamyl transpeptidase

121
Q

Osteoclasts with up to 100 nuclei = […]

A

Osteoclasts with up to 100 nuclei = Paget’s diseaseOsteoclasts originate from the mononuclear phagocytic lineage… formed when several precursor cells fuse to create a multinucleated, mature cell

122
Q

The two most important factors for osteoclastic differentiation are produced by the osteoblast; they are […].

A

The two most important factors for osteoclastic differentiation are produced by the osteoblast; they are M-CSF and RANK-L.

123
Q

Transforming growth factor beta increases formation of […] and collagen.

A

Transforming growth factor beta increases formation of osteoblasts and collagen.Also decreases bone resorption by increasing osteoclastic apoptosis

124
Q

Estrogenic influence predisposes to gallstone formation by upregulating hepatic […] activity.

A

Estrogenic influence predisposes to gallstone formation by upregulating hepatic HMG-CoA reductase activity.Progesterone reduces bile acid secretion and slows gallbladder empyting.

125
Q

[…] catalyzes the first step in the beta-oxidation pathway and is the most commonly deficient enzyme.

A

Acyl-CoA dehydrogenase catalyzes the first step in the beta-oxidation pathway and is the most commonly deficient enzyme.

126
Q

The […] contains a sequence complementary to the Shine-Dalgarno sequence on mRNA.

A

The 16S rRNA contains a sequence complementary to the Shine-Dalgarno sequence on mRNA.Found in the 30S subunit… sequence binding is necessary for initiation of protein translation

127
Q

A contraindication to using verapamil would be in the setting of CHF due to its […].

A

A contraindication to using verapamil would be in the setting of CHF due to its potent negative inotropic effect.Carioselectivity of CCBs: verapamil > diltiazem > nifedipine

128
Q

[…] nonspecifically antagonizes beta-1, beta-2, and alpha-1 adrenergic receptors.

A

Carvedilol nonspecifically antagonizes beta-1, beta-2, and alpha-1 adrenergic receptors.Slows the progression of heart failure and reduces all-cause mortality in pts with CHF

129
Q

[…] is a phosphodiesterase inhibitor that increases cardiac contractility and decreases preload and afterload.

A

Milrinone is a phosphodiesterase inhibitor that increases cardiac contractility and decreases preload and afterload.

130
Q

[…] is a JAK2 inhibitor that has been approved for the treatment of primary myelofibrosis.

A

Ruxolitinib is a JAK2 inhibitor that has been approved for the treatment of primary myelofibrosis.

131
Q

The majority of cases of CLL exhibit increased expression of the proto-oncogene […].

A

The majority of cases of CLL exhibit increased expression of the proto-oncogene BCL-2.Similar to follicular lymphoma

132
Q

[…] is the preferred insulin for DKA.

A

Regular insulin administered as an IV infusion is the preferred insulin for DKA.

133
Q

The mainstay of therapy for acute mania is a mood stabilizing agent plus […].

A

The mainstay of therapy for acute mania is a mood stabilizing agent plus an atypical antipsychotic (e.g. olanzapine).

134
Q

Chlordiazepoxide is a […].

A

Chlordiazepoxide is a long half-life benzodiazepine.

135
Q

[…] are seen in almost all patients with myotonic dystrophy.

A

Cataracts are seen in almost all patients with myotonic dystrophy.My tone, my testicles, my toupee, my tickerMuscles show atrophy, no fibrofatty replacement

136
Q

[…] contains factor VIII, factor XIII, vWF, and fibrinogen.

A

Cryoprecipitate contains factor VIII, factor XIII, vWF, and fibrinogen.

137
Q

When the LAD alone is occluded by a plaque, the […] artery is the preferred vessel for bypass grafting.

A

When the LAD alone is occluded by a plaque, the left internal mammary (thoracic) artery is the preferred vessel for bypass grafting.Superior patency rates… but when multiple vessels require vascularization, great saphenous grafts are routinely used.

138
Q

Longest vein in the body is the […].

A

Longest vein in the body is the great saphenous vein.

139
Q

The femoral triangle is bordered by the inguinal ligament superiorly, […] muscle laterally, and adductor longus muscle medially.

A

The femoral triangle is bordered by the inguinal ligament superiorly, sartorius muscle laterally, and adductor longus muscle medially.

140
Q

Suppression of cholesterol […] activiy reduces conversion of cholesterol into bile acids.

A

Suppression of cholesterol 7alpha-hydroxylase activiy reduces conversion of cholesterol into bile acids.Through fibrate medications

141
Q

Pharmacotherapy with fibrates, […], or ceftriaxone is a risk factor for gallstone formation.

A

Pharmacotherapy with fibrates, octreotide, or ceftriaxone is a risk factor for gallstone formation.

142
Q

[…] is an enzyme that condenses two equivalents of acetyl-CoA to form acetoacetyl-CoA, a substrate for HMG-CoA synthase.

A

Thiolase is an enzyme that condenses two equivalents of acetyl-CoA to form acetoacetyl-CoA, a substrate for HMG-CoA synthase.

143
Q

Lacrimation and yawning are fairly specific for […] withdrawal.

A

Lacrimation and yawning are fairly specific for opioid withdrawal.+dilated pupils, piloerection, hyperactive bowel sounds

144
Q

Maneuvers that increase vagal tone increase […] and help prevent a reentrant circuit from conducting.

A

Maneuvers that increase vagal tone increase the refractory period in the AV node and help prevent a reentrant circuit from conducting.e.g. Valsalva, carotid massage

145
Q

AED that can cause bone marrow suppression, hepatotoxicity, and SIADH = […]

A

AED that can cause bone marrow suppression, hepatotoxicity, and SIADH = carbamazepineUsed for simple partial, complex partial, and generalized tonic-clonic seizures

146
Q

Serotypes 11 and 21 of […] subgroup B have been implicated in hemorrhagic cystitis.

A

Serotypes 11 and 21 of adenovirus subgroup B have been implicated in hemorrhagic cystitis.Can be outbreaks in children

147
Q

[…] is a beta-mimetic tocolytic drug used to delay labor – linked to inc. risk of neonatal intraventricular hemorrhage, hypoglycemia, hypocalcemia, and ileus.

A

Terbutaline is a beta-mimetic tocolytic drug used to delay labor – linked to inc. risk of neonatal intraventricular hemorrhage, hypoglycemia, hypocalcemia, and ileus.

148
Q

S3 is a low-frequency sound that is commonly associated with increased […] volume.

A

S3 is a low-frequency sound that is commonly associated with increased left ventricular end-systolic volume.

149
Q

The cognitive test for concentration is reciting months of the year backwards. The test for executive function is […].

A

The cognitive test for concentration is reciting months of the year backwards. The test for executive function is drawing a clock.Visual-spacial is intersecting pentagons.

150
Q

Pectoralis minor originates on 3rd/4th/5th ribs and inserts on […].

A

Pectoralis minor originates on 3rd/4th/5th ribs and inserts on coracoid process of the scapula.

151
Q

The […] insert on the inferior lateral aspect of the clavicle.

A

The subclavius and deltoid insert on the inferior lateral aspect of the clavicle.Pec major on inferior medial ; trap on superior lateral ; SCM on superior medial

152
Q

Damage to the […] can result in what is called the “split-brain” syndrome.

A

Damage to the corpus callosum can result in what is called the “split-brain” syndrome.

153
Q

FAD is an electron carrior in the TCA cycle and serves as a cofactor for […].

A

FAD is an electron carrior in the TCA cycle and serves as a cofactor for succinate dehydrogenase.Succinate -> fumarateRiboflavin deficiency

154
Q

S. aureus’s Protein A binds with […].

A

S. aureus’s Protein A binds with the Fc portion of IgG antibodies at the complement-binding site, preventing complement activation.Decreased C3b -> impaired opsonization/phagocytosis

155
Q

Many drugs used in anesthesia (e.g. succunylcholine, tetracaine, remifentanil) are metabolized by […].

A

Many drugs used in anesthesia (e.g. succunylcholine, tetracaine, remifentanil) are metabolized by plasma hydrolysis.

156
Q

Procaine, lidocaine, and aspirin are metabolized through […].

A

Procaine, lidocaine, and aspirin are metabolized through liver hydrolysis.Phase I type rxn

157
Q

Pentobarbital and phenobarbital go through liver […].

A

Pentobarbital and phenobarbital go through liver hydroxylation.Cat by cyp450

158
Q

Phenol and chloramphenicol are two drugs that go through liver […].

A

Phenol and chloramphenicol are two drugs that go through liver sulfate conjugation.Phase II pathway

159
Q

The diuretic […] is excreted unchanged.

A

The diuretic chlorothiazide is excreted unchanged.Very few drugs are not metabolized in the body.

160
Q

Drug-induced lupus has been linked to drugs that are metabolized by […].

A

Drug-induced lupus has been linked to drugs that are metabolized by N-acetylation in the liver.

161
Q

Recombination occurs in […] viruses ; reassortment occurs in segmented viruses.

A

Recombination occurs in dsDNA viruses ; reassortment occurs in segmented viruses.

162
Q

Type I dyslipidemia = […]

A

Type I dyslipidemia = chylomicronemiaDefect in LPL, ApoC-II —> acute pancreatitis

163
Q

Type II dyslipidemia = […]

A

Type II dyslipidemia = hypercholesterolemiaDefect in LDLR, ApoB-100 —> premature coronary artery disease

164
Q

Type III dyslipidemia = […]

A

Type III dyslipidemia = dysbetalipoproteinemiaDefect in ApoE (elevated chylomicrons and VLDL remnants) —> premature coronary artery disease and peripheral vasc disease

165
Q

Type IV dyslipidemia = […]

A

Type IV dyslipidemia = hypertriglyceridemiaDefect in ApoA-V –> high VLDL —> increased risk of pancreatitis, obesity, insulin resistance

166
Q

[…] is used for prophylaxis and tx of PCP pneumonia in HIV+ pits – also used to treat leishmaniasis and African sleeping sickness.

A

Pentamidine is used for prophylaxis and tx of PCP pneumonia in HIV+ pits – also used to treat leishmaniasis and African sleeping sickness.

167
Q

The induction of insulin resistance and beta cell dysfunction along with high free fatty acids is termed “[…]”.

A

The induction of insulin resistance and beta cell dysfunction along with high free fatty acids is termed “lipotoxicity”.

168
Q

Clonidine activates […] receptors in the brainstem.

A

Clonidine activates alpha2-adrenergic receptors in the brainstem.

169
Q

[…] toxins = belladonna alkaloids

A

Jimson Weed toxins = belladonna alkaloidsStrong anticholinergic properties, like atropine poisoning”Gardener’s mydriasis”

170
Q

[…] is an opiate anti-diarrheal structurally related to meperidine.

A

Diphenoxylate is an opiate anti-diarrheal structurally related to meperidine.

171
Q

In addition to belligerence, PCP is known to cause loss of coordination, nystagmus, and […].

A

In addition to belligerence, PCP is known to cause loss of coordination, nystagmus, and acute brain syndrome.Constellation of sx including disorientation, poor judgement, and memory lossBut TRAUMA from violence is most common cause of death

172
Q

[…] must be processed by mycobacterial catalase-peroxidase for the drug to be activated.

A

Isoniazid must be processed by mycobacterial catalase-peroxidase for the drug to be activated.

173
Q

Intraventricular hemorrhage (IVH) is a common complication of prematurity that usually originates from the […].

A

Intraventricular hemorrhage (IVH) is a common complication of prematurity that usually originates from the germinal matrix.Highly cellular/vascularized layer in the subventricular zone from which neurons and glial cells migrate out during brain development

174
Q

Chronic rejection in lung transplant pts causes the small airway disease […].

A

Chronic rejection in lung transplant pts causes the small airway disease bronchiolitis obliterans.Lymphocytic inflammation, necrosis, fibrosis of bronchiolar wall, occlusion of bronchiolar lumenContrast with acute rejection, where there are perivascular mononuclear infiltrates (+dry cough, dyspnea, fever, parenchymal infiltrates on CXR)

175
Q

An epidural hematoma may initially cause […] due to a Cushing’s response to increased intracranial pressure.

A

An epidural hematoma may initially cause hypertension and bradycardia due to a Cushing’s response to increased intracranial pressure.

176
Q

The side effects most frequently associated with […] are flushing, chest burning (due to bronchospasm), hypotension, and high grade AV block.

A

The side effects most frequently associated with adenosine are flushing, chest burning (due to bronchospasm), hypotension, and high grade AV block.

177
Q

[…] is a partial agonist of nicotinic ACh receptors that can assist with smoking cessation.

A

Varenicline is a partial agonist of nicotinic ACh receptors that can assist with smoking cessation.

178
Q

A high serum level of […] is diagnostic for 21-hydroxylase deficiency.

A

A high serum level of 17-hydroxyprogesterone is diagnostic for 21-hydroxylase deficiency.Testing often performed during routine newborn screening

179
Q

[…] catalyzes the conversion of cholesterol into pregnenolone.

A

Desmolase catalyzes the conversion of cholesterol into pregnenolone.

180
Q

3beta-hydroxysteroid dehydrogenase converts dehydroepiandrosterone to […].

A

3beta-hydroxysteroid dehydrogenase converts dehydroepiandrosterone to androstenedione.Deficiency leads to rare form of CAH

181
Q

Sickle cell, […], steroid therapy, and alcoholism are associated with avascular necrosis of the femoral head.

A

Sickle cell, SLE, steroid therapy, and alcoholism are associated with avascular necrosis of the femoral head.Groin pain that is exacerbated by weight bearing… dx with MRI

182
Q

c-Jun and c-Fos are […].

A

c-Jun and c-Fos are nuclear transcription factors.Directly bind to DNA via a leucine zipper motif

183
Q

Lung cancer, followed by […], is the most common cause of SVC syndrome.

A

Lung cancer, followed by non-Hodgkin lymphoma, is the most common cause of SVC syndrome.Mediastinal mass

184
Q

Antibodies against […] are the most important source of protection from influenza.

A

Antibodies against hemagglutinin are the most important source of protection from influenza.

185
Q

The […] nerve provides sensory innervation above the vocal cords.

A

The internal branch of the superior laryngeal nerve provides sensory innervation above the vocal cords.External branch does cricothyroid… Recurrent does all other muscles and sensory inn. below

186
Q

[…] after subarachnoid hemorrhage causes cerebral ischemia, presenting as new-onset confusion and/or focal neuro deficit 4-12 days after initial insult.

A

Secondary vasospasm after subarachnoid hemorrhage causes cerebral ischemia, presenting as new-onset confusion and/or focal neuro deficit 4-12 days after initial insult.Give nimodipine to help prevent

187
Q

CGD can be diagnosed by absence of the normal blue and fluorescent green pigment produced by the nitroblue tetrazolium test and […] test, respectively.

A

CGD can be diagnosed by absence of the normal blue and fluorescent green pigment produced by the nitroblue tetrazolium test and dihydrorhodamine flow cytometry test, respectively.

188
Q

[…] directly modulates the activity of enzymes in the metabolic pathways regulated by insulin.

A

Protein phosphatase directly modulates the activity of enzymes in the metabolic pathways regulated by insulin.

189
Q

E. coli’s […] causes presentation as neonatal meningitis.

A

E. coli’s K1 capsular polysaccharide causes presentation as neonatal meningitis.P fimbriae allows for UTI presentation

190
Q

Irinotecan and topotecan inhibit […].

A

Irinotecan and topotecan inhibit topoisomerase I.Top I makes ss nicks to relieve NEG supercoiling ; Top II induces transient ds breaks to relieve both pos and neg supercoiling

191
Q

Etoposide and podophyllin inhibit […].

A

Etoposide and podophyllin inhibit topoisomerase II.Etoposide –> testicular cancer and small cell lung cancer ; Podophyllin –> genital warts

192
Q

The […] ligament is torn and displaced in radial head subluxation (Nursemaid’s elbow).

A

The annular ligament is torn and displaced in radial head subluxation (Nursemaid’s elbow).Sudden traction on the outstretched and pronated arm of a child

193
Q

Segmental thrombosing vasculitis that extends into contiguous veins and nerves, encasing them in fibrous tissue = […]

A

Segmental thrombosing vasculitis that extends into contiguous veins and nerves, encasing them in fibrous tissue = Buerger’s disease

194
Q

Increased AFP on quad screen –> omphalocele, gastroschisis, […], open neural tube defects

A

Increased AFP on quad screen –> omphalocele, gastroschisis, multiple gestation, open neural tube defects

195
Q

Peripheral enthesitis = inflammation at the site of insertion of tendons into bone = associated with […]

A

Peripheral enthesitis = inflammation at the site of insertion of tendons into bone = associated with ankylosing spondylitisCause pain, tenderness, swelling

196
Q

Enthesopathies of the costovertebral/costosternal junctions may cause […] in what disease?

A

Enthesopathies of the costovertebral/costosternal junctions may cause hypoventilation / decreased chest expansion in what disease?Ankylosing spondylitis… chest expansion must be monitored

197
Q

Meniere’s disease is characterized by an increased […].

A

Meniere’s disease is characterized by an increased volume of endolymph.Tinnitus, vertigo, sensorineural hearing loss

198
Q

Mononuclear, parenchymal infiltration with well-developed germinal centers = […]

A

Mononuclear, parenchymal infiltration with well-developed germinal centers = Hashimoto’s

199
Q

Mixed, cellular infiltration with occasional multinuclear giant cells on thyroid histology = […]

A

Mixed, cellular infiltration with occasional multinuclear giant cells on thyroid histology = subacute de Quarvain’s granulomatous thyroiditis

200
Q

[…] has been shown to be superior to aspirin in the tx of peripheral arterial disease.

A

Cilostazol has been shown to be superior to aspirin in the tx of peripheral arterial disease.PDE inhibitor used in pts with intermittent claudication… vasodilation + platelet agg inhibition

201
Q

Hypercalcemia in sarcoidosis is caused by […].

A

Hypercalcemia in sarcoidosis is caused by inc 1,25-vitD by activated macrophages.Suppresses PTH secretion

202
Q

First line drug for restless leg syndrome (after nonpharm interventions are tried) […]

A

First line drug for restless leg syndrome (after nonpharm interventions are tried) Dopamine agonistslike pramipexole or ropinirole… FYI - SSRIs worsen RLS

203
Q

[…] is associated with circulating IgG4 abs to the phospholipase A2 receptor.

A

Idiopathic membranous nephropathy is associated with circulating IgG4 abs to the phospholipase A2 receptor.

204
Q

Triptans, Tramadol, Linezolid, Ondansetron… what do they have in common? […]

A

Triptans, Tramadol, Linezolid, Ondansetron… what do they have in common? Implicated in serotonin syndrome

205
Q

[…] may secrete large amounts of mucus, leading to secretory diarrhea.

A

Villous adenomas may secrete large amounts of mucus, leading to secretory diarrhea.Commonly sessile polyps, sometimes with velvety or cauliflower-like projections