Week 2 Flashcards
Name the primary site of action of PTH
Bone and renal tubules
When should you screen for high risk HPV strains?
Every 5 years, beginning at age 21
What is the MOA of benztropine?
Muscarinic antagonist
What is the normal value of creatinine?
0.6-1.2
What is the definitive treatment of spherocytosis?
Splenectomy
What is classically seen in the peripheral blood smear of a patient with acute promyelocytic leukemia?
Auer rods
What disease is associated with gatron papules and a heliotrope rash?
Dermatomyositis
A 28 year old male seen for recent changes in behavior. On PE, there is a tremor and mild jaundice. LFT normal, total bilirubin 3.0, direct bili 0.6. You suspect wilson disease. What would you order to confirm?
ceruloplasmin
A 45 year old female has noticed increased difficulty when raising from a chair and mild myalgias. the weakness is more pronounced in proximal part of extremities. She has difficulty coming her hair. Aside from weakness, examination is normal. No PMH, not on any medications, lab tests show CK is high. What is the most likely diagnosis?
Polymyositis
Acute use of high doses of steroids can lead to electrolyte abnormalities. Name one electrolyte abnormality you would expect to see.
Hypernatremia and hypokalemia
Orlistat is a pancreatic lipase inhibitor. What is it used for?
Weight loss.
What acid base abnormality is associated with acetazolamide?
Metabolic acidosis
What is the mode of inheritance of Wiskott Aldrich syndrome?
x-linked recessive
What pathogen is associated with water-house friedrich?
Neisseria meningitides
What acid base abnormality is seen with the use of hydrochlorothiazide and furosemide?
Metabolic alkalosis
A 31 year old man complains of acute chest pain. ECG shows ST elevation in most leads. What is the most likely diagnosis?
Pericarditis
Which coronary artery is most commonly affected in by acute MI affecting the anterior intraventricular septum?
LAD
What is the drug class of chlorpropamide?
Sulfonyurea
A 56 year old female presents with cough and a 10lbs weight loss. She has a 20 pack-year history. On physical exam there is wheezing on the left thorax and supraclavicular lymphadenopathy. CT shows a mass. What is the next best indicator or diagnostic test?
Lymph node biopsy since it is easily accessible
What will the histopathology of the kidney show in a patient with diabetic nephropathy?
Kimmestein Wilson nodules
Name one substance secreted by chromaffin cells in the adrenal gland secrete.
Norepinephrine and epineprhine
What tumor is associated with translocation 11;22?
Ewing Sarcoma
In what type of observation studies is relative risk ratio typically used?
Cohort study
What is the first line maintenance therapy for bipolar disorder?
Lithium or mood stabilizer
What is the mechanism of action of fisostigmine?
Anti-cholinesterase
What type of antibody is usually seen in waldonstrom microglobulinemia?
IgM
What is the first line therapy for bacterial vaginosis?
Metronidazole
A patent ductus arteriosis is described as a machine-like murmur. What is used to keep it open?
Prostaglandins
A 45 year old female complaining of itching for a couple of months. On physical exam she is normal except for xanthelasma. Labs show high alk-phos and minimal elevation of AST and ALT. What is the most likely diagnosis?
Primary biliary cirrhosis
A 59 year old male with a PMH of longstanding uncontrolled diabetes and chronic kidney disease is admitted for pericarditis. You suspect the pericarditis is due to uremia. What is the most appropriate treatment for this patient at this time?
Treat uremia with dialysis.
What is the definitive treatment for primary biliary cirrhosis?
Liver transplant
What enzyme deficiency is responsible for gilbert disease?
UDP glucuronltransferase
Venus drainage from right adrenal gland flows directly in to what vessel?
IVC
What would you expect to see on peripheral blood smear of a patient with G6PD deficiency who is symptomatic after taking isoniazid?
Hanes bodies; bite cells; hemolysis;
what is a common side effect of a-carbose?
osmotic Diarrhea, GI effects
A 55 year old female has had pneumonia twice in the past and comes to the office complaining of persistent cough and sputum production for the past two years. A recent CXR shows increased bronchial markings. You are suspecting bronchiectasis. What test would you order to confirm?
Only diagnose it on a hi-def CT scan
Which viral infection is polyarteritis nodosa classically associated with?
Hepatitis B
Beri-beri is a disorder that presents with symmetrical peripheral neuropathy and can involve the heart, which may lead to heart failure. What is the treatment of beri-beri in adults?
Thiamine (vitamin B1)
What is the most likely diagnosis in a patient with weight loss, painful rash, pancreatic mass, and diarrhea? This patient also has hyperglycemia that is resistant to any oral hyperglycemic agents.
Glucononoma
What is the most serious adverse effect of metformin?
Lactic acidosis
Virchow’s node is associated with what primary tumor?
Any gastric tumor
You are evaluating a 10 year old boy with a history of hemolytic anemia requiring multiple transfusions since infancy. A hemoglobin electrophoresis shows elevated hemoglobin F and A2 with absense of A1. What is the most likely diagnosis?
Beta thalissemia major
What sensory receptors are responsible for finding the abnormal vibratory sensations with diabetic neuropathy?
Pacinian corpuscles
Pemphigus vulgaris is an autoimmune disorder. What proteins are the antibodies directed against?
Desmoglein
Teenager seen at the office with enlarged parotid glands and excoriation of the knuckles, dental carries, and metabolic alkalosis. What is the most likely diagnosis?
Bulemia
What autoimmune disorder is associated with keratoconjunctivitis and dry mouth?
Sjogren syndrome
Myasthenia gravis can present as a paraneoplastic syndrome of what?
Thymoma
What part of the nephron does ADH have an effect on?
Collecting Duct
What antibody is represented by the pink line (image shown)? Image showing antibodies to hepatitis B.
IgG Antibodies against the hepatitis B core
IBD associated arthritis is associated with which MHC class I serotype?
HLA B-27
What acid base abnormality is most likely to develop in a patient with symptomatic obstructive sleep apnea?
Respiratory Acidosis
Which heart valve is usually involved in a patient who develops endocarditis due to IV drug use?
Tricuspid (most likely pathogen is S. aureus)
Wornicke-korsakoff syndrome is due to damage to which structures of the brain?
Mamillary bodies (or also medial-dorso nucleus of the thalamus)
What is the most appropriate treatment for post-menopausal female for breast cancer?
(This will not be on the test) Aromatase inhibitor, anastrosal) (?)
The lateral striae arteries are usually responsible for lacunar infarcts in patients with long standing hypertension. What are they a branch of?
Middle Cerebral Artery
What medication is used to treat breast cancer that is HER2 nu-positive and estrogen/progesterone negative?
Trustuzumab
You are asked to evaluate a 28 year old woman who presented with diarrhea. Her labs show NA 137, K+ 3.3, Cl 112, HCO3 15. What is the anion gap?
10 (shortcut is na-cl-hco3)
An 8 year old girl is brought to your office for a routine examination. She is developmentally delayed. She has an inappropriate outburst of laughter and seems happy all the time. She has a small head and deeply set eyes, as well as a wide grin. On physical exam she has ataxia. What chromosomal abnormality is responsible for this conditlion?
Angelman Syndrome (15q11 or 15q13)
What is the mode of inheritance of marfan syndrome?
AD
In a patient with von Willebrand disease would you expect PTT to be high or low?
High. (Increased PTT and bleeding time)
What is the karyotype associated with Klinefelter?
47XXY
What is the most common cause of ESRD in the US?
Diabetes, diabetic glomerulopathy (hypertension is #2)
Which type of thalassemia leads to hydrops fatalis?
Severe alpha thalassemia (BARTS)
What is the most likely diagnosis in a patient who has an anaphylacic reaction following a blood transfusion?
IgA deficiency
What is the antidote for cyclophosphamide toxicity?
Mesna
The juxtaglomerular apparatus is responsible for controlling renal blood flow via the release of which hormone?
Renin
Which vitamin deficiency can lead to a condition associated with a dermatitis photo-sensitivity, dementia, and diarrhea?
Vitamin B3 niacin
What is the target of autoantibodies associated with pernicious anemia?
Parietal cells; intrinsic factor
A patient is diagnosed with MALT lymphoma. What is the most appropriate treatment?
Treat H. Pylori
USPSTF recommends 1x screening for abdominal aortic aneurysm with an ultrasound in all men who have ever smoked. At what age should this be completed?
65 years old
You’re evaluating a patient in the ICU and the EKG shows electrical alternans. What is the most likely diagnosis?
Cardiac tamponade
What step of collagen synthesis is affected by vitamin c deficiency?
Hydroxylation
A 30 year old male, iv drug user, develops pain in the right knee with swelling and painful passive and active movements. On PE fever of 102, right knee is red, swollen, and tender to palpation. Arthrocentesis shows cell count of 75,000 WBC and no crystals. Gram stain and cultures are pending. What is the most likely diagnosis?
Septic arthritis
What antibodies are associated with CREST variant scleroderma?
Anti-centromere
Where is the hormone responsible for breast milk production synthesized?
Adenohypothesis or anterior pituitary
Name the foramen through which cranial nerve v2 or the maxillary division of the trigeminal nerve exits.
Foramen rotundum
A 36 year old female has been complaining of progressive weakness that is worse in the evening. She is also complaining of diplopia, unilateral ptosis, and dysphagia. On physical exam, deep tendon reflexes are normal and there are no sensory changes. What is the most likely diagnosis?
Myasthenia gravis
Name a tumor marker for neuroblastoma
Bombesin; NSE
A patient with rheumatoid arthritis develops pulmonary fibrosis. Which drug was a part of her regimen?
Methotrexate
What is a first line treatment for von Willebrand disease?
Desmopressin
Postmenopausal woman comes to your office to review her labs. Would you expect FSH to be high or low in this patient?
High
Glucose is normally fully reabsorbed in the proximal tubule. How high can the plasma glucose level be before the transporters are saturated and glucose spills over into the urine?
200-300
What can lead to hypocalcemia in a patient post-thyroidectomy?
Parathyroid accidentally damaged during surgery
What diagnosis is associated with peripheral blood smear shown below? (smudge cells)
CLL
Name a 5-lipoxygenase pathway inhibitor.
Zileuton (it blocks the conversion of arachadonic acid)
What is the most appropriate treatment for a patient found to be infected with neiserria gonorrhea?
Ceftriaxone and doxycycline
Rinee’s test can be used in the clinic to detect what kind of hearing loss?
Conductive hearing loss
What is the most likely diagnosis in a patient who develops syncope of sudden onset without warning and with sudden recovery?
Arrhythmia
Ipatropium is an antimuscarinic agent. What disease is it used for?
Asthma or COPD
What is the next best step for a patient with signs and symptoms highy suggestive of rocky mountain spotted fever?
Treat immediately with doxycycline, even before any confirmatory labs
What is the mechanism of action of methimazole?
Inhibits thyroid peroxidase
What is the most common cause of primary hyperaldosteronism?
Adenoma
A 60 year old male is complaining of a dull headache, a burning sensation in the tips in the fingers, and itching after taking a shower. What is the most likely diagnosis?
Polycythemia vera
What artery supplies the leg and foot area of the motor and sensory homunculus?
Anterior cerebral artery
Which medication is known to inhibit NaCl reabsorption at the distal tubule and also reduces excretion of calcium?
Hydrochlorothiazide
You’re counseling a patient on fertility and conception. Your patient says that her menstrual cycle is very consistent every month and she bleeds every 32 days. On which day of her cycle would you predict her to be ovulating?
Luteal phase is always 14 days from day patient bleeds. In this example, it is 32-14= day 18
What strains of HPV are associated with cervical cancer?
16 and 18
What test would you order to identify excess iron stores in a patient you suspect has hemochromatosis?
Transferrin
Herring bodies are nerve endings found in the posterior pituitary. What hormones do they store?
ADH and oxytocin
What is the most appropriate treatment for a patient with syphillis?
Penicillin
