Week 4 Flashcards
1
Q
dizygotic twins (ie male and female) always have ____ amnion(s) and ____ chorion(s)
A
2, 2;
ie diamnionic, dichorionic
2
Q
with monozygotic twins, it is most common to have ___chorion(s) and _____ amnion(s)
A
1, 2
ie monochorionic, diamniotic
3
Q
excess malonyl-Coa inhibits what metabolic process?
A
beta oxidation (inhibits carnitine acyltransferase)
malonyl-coa is made in FA synth
4
Q
all newborns should receive _____ prophylaxis to prevent ____ complications
A
vitamin K;
bleeding
5
Q
nitrates:
activate _____, increasing intracellular levels of ____. this causes myosin light-chain _____
A
guanylate cyclase;
cGMP;
dephosphorylation
6
Q
herpetic gingivostomatitis follows _____ infection with HSV1
A
Primary
7
Q
_____ is when a bacterium takes up exogenous DNA fragments and is able to express the encoded proteins
A
transformation
8
Q
what drug increases both PT and aPTT?
what is its effect on thrombin time?
A
direct factor Xa inhibitors (ie apixaban);
no effect
9
Q
patients with trisomy 21 have 3 copies of _____ ____ _____ = increased risk of early onset Alzheimers
A
amyloid precursor protein (APP)
10
Q
an alveolus with a smaller radius has a _____ collapsing pressure than one with a larger radius
A
higher;
ie as radius decreases, pressure increases (if no surfactant)
11
Q
high altitude results in _____ O2 levels with ____ ____ (an acid base thing)
A
low (hypoxemia);
respiratory alkalosis
see low HCO3 levels in respone
12
Q
what kind of capsue does HiB have?
A
polyribosyl ribitol phosphaste (PRP) capsule
13
Q
LV leads in biventricular pacemakers course through the coronary sinus, which resides where?
A
AV groove on posterior aspect of heart
14
Q
condyloma ____ is seen in ___ syphillis. condyloma ____ is caused by HPV
A
lata, secondary;
accuminata
15
Q
what 2 endocrine drugs can cause agranulocytosis?
A
PTU, methimazole
16
Q
_____ is a short acting sulfonylurea and has a _____ risk of causing hypoglycemia
A
glipizide;
lower
17
Q
the lower trunk of the brachial plexus contains what nerve roots?
how is it damaged?
A
C8, T1;
sudden upward stretching ie grabbing tree branch when falling
18
Q
what kidney disease is characterized by eiosinophila? whats a common cause?
A
interstitial nephritis;
beta lactams
19
Q
a _____ ____ _____ is multiple malformations that occur secondary to an embryonic disturbance in an adjoining group of cells. what is an example?
A
developmental field defect;
holoprosencephaly
20
Q
what neurotoxin impairs both muscarinic and nicotinic neurotransmission?
A
botulinum neurotoxin
21
Q
inhibition of nicotinic or muscarinic transmission causes changes in CMAP?
A
nicotinic–see decreased compound muscle action potential (CMAP)
ie from botulinum
22
Q
why do arteriolar vasodilators cause edema and fluid retention?
A
due to reflex RAAS activation
ie hydralazine
23
Q
1st committed step of gluconeogenesis is conversion of pyruvate to _____ via ______. depends on what vitamin?
A
oxaloacetate;
pyruvate carboxylase;
B7 (biotin)
24
Q
proteosome inhibitors such as ______ kill tumor cells by what mechanism?
A
bortezomib;
increase cell apoptosis (ie multiple myeloma)
25
_____ selectively inhibits funny sodium channels --> prolonging phase ___ --> _____ _____
ivabradine;
4;
slows HR (no effect on contractility)
26
cannulation of the femoral artery should be _____ the inguinal ligament to decrease the risk of _____ hemorrhage
below;
retroperitoneal
(increased risk of hemorrhage if above)
27
what ligament do the ovarian vessels, nerves, and lymphatics run in?
suspensory ligament of ovary (infundibulopelvic)
ligate these during ovary removal
28
what disinfectant causes coagulation of cell cytoplasm?
which forms free radicals?
which halogenates proteins and nucleic acids?
coag = chlorhexidine;
free rad = H2O2
halogenate = iodine
29
acyl-coa dehydrogenase deficiency causes ____ketotic ____glycemia when fasting (ie sick)
hypo;
hypo
vs glycogen storage disorders which are hyperketotic
30
Afib with aortic stenosis:
| significantly reduces _____ --> decreased CO --> systemic hypotension. can also cause pulmonary ____
LV preload;
| edema
31
uremia:
| causes _____ bleeding time, _____ platelet count, _____ PT, ____ aPTT
prolonged;
normal, normal, normal
due to impaired platelet aggregation
32
which is longer lasting, regular insulin or NPH?
NPH
33
AV shunts:
| ____ preload, ____ afterload,
increase;
decrease
(decreased resistance to flow bc bypass arterioles)
34
what forms the clear spaces in Renal cell carcinoma?
glycogen and lipid accumulation
35
complete mole:
| results when a _____ is fertilized by a ______. what is the genotype?
```
empty ovum;
haploid sperm (that duplicates);
```
46, XX (only paternal DNA tho)
36
_____ withdrawal is characterized by acute severe depression, hyperphagia, hypersomnia, and vivid dreams
cocaine
37
milrinone inhibits what?
how does this effect the heart?
what about blood vessels
phosphodiesterase 3;
increase cAMP = increase Ca = increase contractility;
increase cAMP = systemic vasodilation
38
of the 3 types of muscle, which is not dependent on extracellular Ca?
skeletal (bc it is mechanically coupled)
39
what cell can produce pyruvate that sometime yields no ATP?
| what is being produced?
erythrocytes;
producing 2,3-bisphospoglycerate
40
what is used to treat delirium?
low-dose antipsychotics (ie haloperidol)
41
overdose of what vitamin can cause intracranial hypertension, skin changes, and hepatosplenomegaly?
vitamin A
42
exercise:
_____ blood pressure;
_____ SVR
slightly increased;
| decreased
43
what fungus is characterized as ovoid cells within MQs?
histoplasma
44
triad of portal vein thrombosis:
portal HTN, splenomegaly, varicosities
liver NOT changed on histology
45
people with blood group A or B typically have antibodies in the serum that are Ig____;
people with type O blood have antibodies in the serum that are Ig___
A or B = IgM;
O = IgG (can cross placenta--> fetal hemolysis)
46
Tay-Sachs:
what enzyme is defecient?
build up what?
causes progressive _____ and a cherry red spot on the _____.
Hexosaminidase A;
GM2 ganglioside;
neurodegeneration;
macula
NO HEPATOSPLENOMEGALY (vs Niemann Pick)
47
proteins destined for the _____ require phosphorlyation of mannose residue in the ____. this is deficient in what disease?
lysosomes;
golgi;
I-cell (N-acetylgluocsaminyl-1-phosphotransferase deficiency)
48
I-cell disease:
where do proteins end up?
symptoms = ____ facies, ____ corneas
extracellular space;
coarse facies;
clouded
49
VSD:
occurs when?
heard where?
____ in maneuvers that increase afterload (ie ____)
holosystolic;
left sternal border;
increases;
handgrip
50
Mitral valve prolapse and Hypertrophic cardiomyopathy murmurs increase with maneuvers that ____ preload and ____ afterload
decrease, decrease;
and vice versa (ie decrease with increased preload)
51
increased afterload (ie ____) causes a _____ in the aortic stenosis murmr
hand grip;
| decrease
52
carnitine deficiency:
impaired FA transport into _____, leading to ____ and ____ injury (lack of ATP from citric acid) and impaired _____ production during fasting
mitochondria;
skeletal muscle, myocyte;
ketone
53
do central or peripheral chemoreceptors respond to changes in blood O2?
what are these called?
peripheral;
carotid bodies
54
combining ganciclovir with TMP-SMX increases the risk of what side effect?
BM suppression (ie neutropenia)
55
we are most worried about irreversible changes in _____ in patients with L-->R shunting (ie ASD)
pulm vessels (ie Pulm HTN)
56
what 2 ligaments make up the lesser omentum?
hepatogastric, hepatoduodenal
57
treatment of congenital adrenal hyperplasia focuses on suppressing what?
ACTH secretion (via corticosteroids)
58
PAH is secreted from the blood into the tubular fluid by cells of the ______ via a ______ process
PCT;
| carrier mediated
59
what other nerve can be paralayzed with interscalene nerve block of the brachial plexus?
causes paralysis of what?
phrenic;
| diaphragm
60
orbital floor fractures can damage what nerve?
| what muscle can become entrapped?
infraorbital (V2);
inferior rectus (decreased vertical gaze)
61
what part of the respiratory tract provides the most airway resistance?
medium size bronchi
62
what is characterized as a pearly mass behind the tympanic membrane that can cause hearing loss?
what is it made of?
cholesteatoma;
squamous cell debris
63
mechanism of action for beta blockers in glaucoma treatment:
decrease aq humuor secretion by ciliary epithelium
64
Juxtaglomerular cells are modified ____ _____ cellls of the ____ _____. undergo hyperplasia in response to _____
smooth muscle;
afferent arteriole;
hypoperfusion (long term)
65
resistance to cephalospornis is caused by what?
change in PBP structure
66
psoriasis:
____ stratum granulosum;
munro microabscessess, which are PMNs in the ____
decreased;
| stratum corneum
67
high levels of bile salts and phosphatidylcholine ____ cholesterol solubility and ____ risk of gallstones
increase, decrease
68
umbilical hernias are due to a defect in the ____ _____; associated with what 2 conditions?
linea alba;
down, hypothyroidism
69
skeletal muscle contraction causes an increase in intracellular ___ which activates ____ ____, stimulating glycogen phosphorylase and _____ glycogenolysis
Ca;
phosphorylase kinase;
increasing
(glucagon and epinephrine cause in increase in cAMP)
70
what enzyme compensates for fructokinase deficiency?
hexokinase (converts fructose to F6P-->glycolysis)
71
in what form of polycythemia is RBC mass normal?
relative polycythemia (ie fluid lose)
72
which increases more from the apex of the lung to the base, ventilation or perfusion?
the ventilation/perfusion ratio _____ from apex to base
perfusion;
| decreases (ie highest at apex)
73
what 2 findings are essential to TTP diagnosis?
microangiopathic hemolytic anemia, thrombocytopenia
74
obstruction of what causes unilateral symtpoms similar to SVC syndrome?
brachiocephalic vein
75
which complement protein is decreased in PSGN?
C3
76
myoglobin demonstrates a ______ oxygen-dissociation curve
hyperbolic
| higher affinity than Hb
77
severe hypertension in retinal vessels causes what?
flame hemorrhages
78
sheehan syndrome:
high ____ levels during pregnancy cause enlargement of gland. peripartum hypotension can cause ____ _____ --> hypopituitarism
estrogen;
| ischemic necrosis
79
name 2 DNA binding domains
Zinc-finger;
| leucine zipper
80
sorbitol is formed by conversion of glucose via ____ _____. sorbitol is then metabolized into ____ by ____ ____
aldolase reductase;
| fructose, sorbitol dehydrogenase
81
____ can be used to treat patients who have a combination of tonic-clonic and absence seizures
valproic acid
82
beta 2 activation causes _____ of the uterus;
which receptor causes pupillary dilation?
relaxation (tocolysis);
alpha 1
83
which 2 tests are preferred for diagnosis of Type 1 DM?
HbA1C (more than 6.5);
fasting blood glucose (over 126)
84
aminoglycosides inhibit _____ genetic code reading and protein synth by binding to the ____ ribosomal subunit
mRNA;
| 30S
85
what are the three P's of MEN1?
pituitary tumor, pancreatic endocrine tumor (ie gastrinoma), and parathyroid adenoma
86
in endocarditis:
______ are due to microemboli.;
_____ are due to immune complex deposition
janeway lesions (painless)
osler nodes (painful)
87
strongyloides infection can be diagnosed by finding _____ in the stool
rhabditiform larvae
88
estrogen _____ levels of thyroxine-binding globulin. this ____ total thyroid levels. free levels of thyroid _____
increases;
increase;
stay the same
89
alkaptonuria:
| deficiency in _____ blocks the metabolism of _____
homogentisate oxidase;
| tyrosine
90
_____ disorder meets criteria for schizophrenia in addition to a major mood disorder. patients must have more than ____ of hallucinations/delusions _____ a major mood episode
schizoaffective;
2 weeks;
without (to differentiate from major mood disorder with psychotic features)
91
findings in anemia:
| _____ SaO2, ____PaO2, _____ total O2
normal, normal;
| decreased (due to decreased Hb)
92
hamartomas in the lung are made of _____ and _____
lung tissue, cartilage
93
bilateral ligation of what can be used to control post partum hemorrhage?
internal iliac
94
what determines the ventricular response in atrial fibrillation?
AV node refractory period
95
incomplete fusion of the urethral folds results in ____, an abnormal opening of the urethra along the _____ shaft of the penis
hypospadias;
| ventral
96
what drug can be used to treat drug-induced parkinsonism?
| what is it's mechanism of action?
benztropine -- anticholinergic
97
familial hypocalciuric hypercalcemia:
| defective ____ Sensing. causes ____ calcium levels , _____ PTH levels
Ca2+;
increased, normal to increased
98
calcium efflux from cardiac cells prior to relaxation is mediated by what 2 methods?
Na/Ca exchanger and SR Ca-ATPase pump
99
miRNA and siRNA basepair with complementary ____ sequences. this induces _____ ____ _____
mRNA;
post transcriptional gene silencing
ie, repressess translation
100
megaloblastic anemias are due to defects in ______ synthesis.
DNA
101
what is the etiology of bilateral wedge-shaped infarcts, parallel to the longitudinal fissure in the brain?
global hypoperfusion
102
Myocardial ischemia:
loss of contractility occurs within _____;
if ischemia is less than _____, this is reversible dysfunction
60 seconds;
| 30 minutes
103
obstructive sleep apnea:
| due to relaxation of _____ muscle tone-->closure of airway. associated with ____ headaches. can cause ____ heart failure
pharyngeal;
morning;
right
104
what are the 2 blood supplies to the liver?
hepatic artery, portal vein
less sussceptible to infarction
105
primary biliary choloangitis:
| characterized by _____ infiltration, _____, and destruction of ____ bile ducts
lymphocytic, granulomas;
intrahepatic;
antimitochondrial antibody
106
methylmalonic acidemia:
due to deficiency of ____ ____;
characterized by metabolic ____, _____ hypoglycemia, and ____ammonemia
methylmalonyl-coa mutase;
| acidosis, ketotic, hyperammoniaemia
107
penicillin and cephalosporins cause _____ Vasculitis. characterized by what symptom?
leukocytoclastic;
| palpable purpura of lower extremity
108
the _____ pancreatic bud forms the uncinate process and contributes to the main pancreatic duct. everything else is formed by the _____ pancreatic bud
ventral;
| dorsal
109
pulmonary actinomycosis commonly follows _____ and can also be due to ___ ____
aspiration;
| dental caries
110
St. John;s Wort ____ CYP450. Grapefruit Juice ____ it.
induces, inhibits
111
lesions of the ____ lower extremity can cause lymphadenopathy in both popliteal and inguinal areas
lateral
| medial only causes inguinal lymphadenopathy
112
triptans:
| agonists or antagonists of what receptor?
5HT1b or 1d agonists
cause vasoconstriction of meningeal vessels
113
what vitamin can be useful in the treatment of measles?
vitamin A
114
patients with increased elastic resistance (ie _____) breath at ___ RR and ___ tidal volumes
pulm fibrosis;
high, low
(vs COPD, which breathe at lower rates due to increased airflow resistance)
115
a high mitotic index is typical of what kind of lymphoma?
| associated with what?
burkitt lymphoma;
EBV
116
recurrent ______ is characterized by scarring at the upper and lower poles of the kidney. most often due to ____ _____ ( a structural abnormality)
pyelonephritis;
vesicoureteral reflux
117
glycolysis, FA synth, and the pentose phosphate pathway occur where in the cell?
cytoplasm
| beta ox, TCA, gluconeogenesis = in mitochondria
