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Wrong Answers Flashcards

1
Q

This medication used for TB can have a side effect of peripheral neuropathy.

A

Isoniazid

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2
Q

Peripheral neuropathy can be prevented if isoniazid is given together with what?

A

B6 (pyridoxine)

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3
Q

This is a fusion inhibitor used in treatment of HIV. It binds to CCR5 on surface of T cells to inhibit interaction with gp120 (thus preventing viral binding).

A

Maraviroc

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4
Q

This medication is used to prevent vaso-occlusive pain episodes in patients with sickle cell disease.

A

Hydroxyurea

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5
Q

Hydroxyurea acts by increasing the production of _______ _______, which reduces polymerization of sickle hemoglobin and sickling of RBCs.

A

Fetal Hemoglobin

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6
Q

This is a major side effect of hydroxyurea that must be monitored for.

A

Myelosuppression

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7
Q

This drug used for TB inhibits arabinosyl transferase III, which disrupts assembly of mycobacterial cell walls.

A

Ethambutol

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8
Q

What is the major side effect of ethambutol, and how does it present?

A

Optic neuritis – presents as blurred vision and red-green color blindness

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9
Q

What type of drug class should NOT be used in pts with a hx of reactive airway disease or other respiratory disorders?

A

Nonselective beta-adrenergic receptor blockers (ie, propranolol)

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10
Q

What are the intestinal nematodes?

A 
Enterobius vermicularis (pinworm)
Ascaris lumbricoides (giant roundworm)
Strongyloides stercoralis (threadworm)
Necator americanus (hookworms)
Trichuris trichiura (whipworm)
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11
Q

What are the treatments for the intestinal nematodes?

A

Enterobus vermicularis (pinworm) = pyrantel pamoate or bendazoles

Ascaris lumbricoides (giant roundworm) = bendazoles

Strongyloides stercoralis (threadworm) = ivermectin or bendazoles

Necator americanus (hookworms) = bendazoles

Trichuris trichiura (whipworm) = bendazoles

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12
Q

What are the tissue nematodes?

A

Toxocara canis
Onchocerca volvulus
Loa Loa
Wuchereria bancrofti

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13
Q

What are the treatments for tissue nematodes?

A

Toxocara canis = bendazoles

Onchocerca volvulus = ivermectin

Loa Loa = diethylcarbamazine

Wuchereria bancrofti = diethylcarbamazine

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14
Q

What are the cestodes?

A

Taenia solium
Diphyllobothrium latum
Echinococcus granulosus

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15
Q

What are the treatments for the cestodes?

A

Taenia solium = praziquantel and albendazole (neurocysticercosis)

Diphyllobothrium latum = praziquantel

Echinococcus granulosus = albendazole

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16
Q

What are the trematodes?

A

Schistosoma

Clonorchis sinensis

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17
Q

What are the treatments for the trematodes?

A

Schistosoma = praziquantel

Clonorchis sinensis = praziquantel

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18
Q

This medication is a 5-alpha reductase inhibitor that decreases dihydrotestosterone levels by decreasing its conversion from testosterone. Helps with BPH.

A

Finasteride

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19
Q

Why should females of child-bearing age NOT handle finasteride?

A

Can cause feminization of the male fetus

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20
Q

What are infants born to mothers with DM at increased risk for within the first few hours after birth?

A

Hypoglycemia – due to in utero hyperglycemia and overproduction of insulin in the infant immediately after delivery

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21
Q

This is the most common thyroid malignancy and is strongly linked to hx of radiation exposures (especially in childhood).

A

Papillary carcinoma

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22
Q

What can be seen on histology of papillary carcinoma?

A

Psammoma bodies

Ground-glass nuclei

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23
Q

This disease presents with chronic crusting, eczema-like reaction, and ulcers around the nipple.

A

Paget disease

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24
Q

Paget disease of the breast are often associated with what malignancy?

A

Invasive ductal carcinoma

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25
Q

This is an ovarian tumor consisting of ectopic thyroid tissue (causes elevation of thyroid hormones in some patients).

A

Struma ovarii

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26
Q

These are a type of cyst caused by luteinization and hypertrophy of the theca interna cells.

A

Theca lutein cysts

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27
Q

Theca lutein cysts form as a result of overstimulation of what?

A

Beta-hCG

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28
Q

MEN syndromes type 2A and 2B are caused by mutations in what?

A

RET

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29
Q

MEN syndromes type 2A and 2B are associated with what diseases?

A

Pheochromocytoma

Medullary thyroid cancer

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30
Q

These tumors are ovarian metastases from GI tract primary cancers. They are poorly cohesive adenocarcinomas with signet ring cells.

A

Krukenberg tumors

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31
Q

This is secreted by squamous cell malignancies and increases calcium levels, resulting in suppression of endogenous PTH level secretion.

A

PTHrP (parathyroid hormone-related peptide)

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32
Q

This is one of the most common cardiac tumors in children and infants, composed of hamartomatous cardiac tissue.

A

Cardiac rhabdomyoma

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33
Q

What cardiac tumor is strongly associated with tuberous sclerosis (mainly in children)?

A

Cardiac rhabdomyoma

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34
Q

ECG reading showing steadily increasing PR intervals until a beat is dropped, then resets.

A

Mobitz Type I

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35
Q

What are the main characteristics of ToF?

A

Pulmonic valve stenosis
Right ventricular hypertrophy
Overriding aorta
VSD

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36
Q

What does ToF look like on CT?

A

Boot-shaped heart

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37
Q

What coronary artery and ECG leads are involved in the septal heart area?

A

LAD

V1-V2

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38
Q

What coronary artery and ECG leads are involved in the anterior heart area?

A

LAD

V3-V4

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39
Q

What coronary artery and ECG leads are involved in the lateral heart area?

A

Left circumflex

I, aVL, V5, V6

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40
Q

What coronary artery and ECG leads are involved in the inferior heart area?

A

Right coronary

II, III, aVF

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41
Q

What coronary artery and ECG leads are involved in the posterior heart area?

A

Posterior descending

V1-V3, posterior leads V7-V9

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42
Q

This disease is characterized by ineffective erythropoiesis – patients present within their first year of life with a nonmegaloblastic, macrocytic anemia and structural defects.

A

Diamond-Blackfan anemia

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43
Q

What lab studies will be seen with Diamond-Blackfan anemia?

A

Decreased reticulocytes

Increased fetal hemoglobin

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44
Q

This disease has a classic presentation of an erythematous malar rash with circumoral pallor and a reticular rash that begins on the arms and spreads to trunk.

A

Erythema infectiosum (Fifth Disease)

***Rash is called “slapped cheek” rash

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45
Q

What causes erythema infectiosum?

A

Parvovirus B19

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46
Q

What can occur happen to a fetus upon infection of a seronegative pregnant female with erythema infectiosum?

A

May cause severe fetal anemia and hydrops fetalis

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47
Q

Gestational DM is caused by a production of what?

A

Human placental lactogen (HPL)

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48
Q

When is screening for gestational DM?

A

24-28 wks gestation via oral glucose tolerance test

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49
Q

This disease is a common, usually self-limited disease primarily of children. It is systemic IgA vasculitis that presents with a purpuric rash, arthritis, GI pain and perhaps bleeding.

A

Henoch-Schonlein purpura

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50
Q

What causes hematuria in Henoch-Schonlein purpura?

A

Mesangial IgA deposition in glomeruli

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51
Q

In embryonic development of the kidney, what forms from the metanephric mesenchyme?

A

Glomeruli
PCTs
Loop of Henle
DCTs

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52
Q

In embryonic development of the kidney, what forms from the ureteric bud structures?

A 
Collecting tubules
Minor calyces
Major calyces
Renal pelvis
Ureters
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53
Q

This disease is caused by the absence of the stratum basalis layer of endometrial lining, resulting in endometrial lining that is inadequate for zygote implantation.

A

Asherman syndrome

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54
Q

What are common symptoms of Asherman syndrome?

A

Recurrent spontaneous abortion

Secondary amenorrhea

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55
Q

This is a disorder that causes psychological distress and impairment in function due to one or more somatic symptoms not explained by another medical condition.

A

Somatic symptom disorder

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56
Q

In what stage does sleepwalking occur? What waves are predominate?

A

NREM stage 3 – Delta waves

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57
Q

List the sleep stages and their corresponding EEG waveforms.

A 
Awake (eyes open) = Beta
Awake (eyes close) = Alpha
NREM stage N1 = Theta
NREM stage N2 = Sleep spindles and K-complexes
NREM stage N3 = Delta
REM = Beta
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58
Q

This is a disorder of sleep-wake cycle involving a significant decrease in REM latency.

A

Narcolepsy

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59
Q

This disorder involves at least 4 days of elevated mood and increased energy. It also includes –>

  • Pressure speech
  • Increased psychomotor activity
  • Decreased need for sleep
A

Hypomanic episode

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60
Q

How does a hypomanic episode differ from a manic episode?

A

Hypomanic episodes do NOT cause marked functional impairment, result in hospitalization, or involve psychosis

Manic is also 7 or more days

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61
Q

What is the equation for incidence in a treatment group?

A

A/(A+B)

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62
Q

What is the equation for incidence in a placebo group?

A

C/(C+D)

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63
Q

What is the equation for relative risk (RR)?

A

[A/(A+B)] / [C/(C+D)]

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64
Q

What is the equation for attributable risk (AR)?

A

[A/(A+B)] - [C/(C+D)]

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65
Q

What is the equation for odds ratio?

A

AD/BC

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66
Q

What is the equation for sensitivity?

A

TP/(TP + FN)

or

A/(A+C)

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67
Q

What is the equation for specificity?

A

TN/(TN + FP)

or

D/(D+B)

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68
Q

What is the equation for positive predictive value (PPV)?

A

TP/(TP + FP)

or

A/(A+B)

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69
Q

What is the equation for negative predictive value (NPV)?

A

TN/(FN + TN)

or

D/(C+D)

70
Q

A patient presents with distal lymphangitis and occupation puts him or her at risk for skin injury from thorns. What is the microorganism?

A

Sporotrichosis

71
Q

This is a childhood infection usually caused by human herpesvirus 6.

A

Roseola

72
Q

What is the clinical presentation of roseola?

A
  • 3 to 5 days high fever with abrupt defervescence

- Macular or maculopapular rash on neck and trunk that spreads to extremities

73
Q

This microorganism will present in sexually active females as frothy, foul-smelling, greenish-yellow discharge.

A

Trichomonas vaginalis

74
Q

Trichomonas vaginalis is a (IMMOTILE/MOTILE) protozoan.

A

Motile

75
Q

This is microorganism is a gram-positive, weakly acid-fast bacilli with a filamentous appearance in tissues and culture. It can cause pulmonary infections in immunocompromised pts.

A

Nocardia

76
Q

What is the best treatment for Nocardia?

A

TMP-SMX

77
Q

This presents as painful, vesicular genital lesions accompanied by painful lymphadenopathy.

A

HSV-2 (genital herpes)

78
Q

How can HSV-2 be diagnosed? What will it show?

A

Tzanck smear – shows multinucleated giant cells

79
Q

This microorganism presents with nocturnal perianal itching and is usually seen in school-aged children.

A

Enterobius vermicularis (pinworm)

80
Q

This microorganism is a nonenveloped, single-stranded RNA enterovirus that causes hand-foot-and-mouth disease.

A

Coxsackie Virus A

81
Q

This is caused by a constellation of symptoms caused by a neuroendocrine tumor that secretes vasoactive substances (ie, serotonin).

A

Carcinoid Syndrome

82
Q

What is the clinical presentation of carcinoid syndrome?

A
  • Episodic upper body flushing
  • Telangiectasias
  • Diarrhea
  • Bronchospasm
83
Q

What is the treatment for carcinoid syndrome?

A

Octreotide or Lanreotide

84
Q

What Abs are seen with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

85
Q

What Abs are seen with drug-induced lupus?

A

Anti-histone

86
Q

What Abs are seen with polymyositis?

A

Anti-Jo-1

87
Q

What Abs are seen with limited systemic sclerosis (CREST)?

A

Anti-centromere

88
Q

What Abs are seen with diffuse systemic sclerosis?

A

Scl-70 (anti-DNA topoisomerase I)

89
Q

What Abs are seen with RA?

A
  • Rheumatoid factor

- Anti-cyclic citrullinated peptide

90
Q

What Abs are seen with mixed CT disease?

A

Anti-U1 ribonucleoprotein

91
Q

What Abs are seen with Sjogren’s disease?

A
  • SSB/La

- SSA/Ro

92
Q

This disease presents with polyuria, polydipsia, and an inability to concentrate urine due to a lack of ADH secretion from the posterior pituitary.

A

Central diabetes insipidus

93
Q

A supracondylar fracture of the humerus can result in injury to what nerve?

A

Median N.

94
Q

This is a genetic disorder of the type IV collagen, resulting in basement membrane defects.

A

Alport Syndrome

95
Q

What issues are caused due to the basement membrane defects in Alport syndrome?

A
  • Hematuria
  • Sensorineural hearing loss
  • Vision loss from lens defects

***Hereditary nephritis can present in childhood

96
Q

This is the term that refers to subjects modifying their behaviors based on knowing that they are being studied.

A

Hawthorne effect

97
Q

Pemphigus vulgaris is an autoimmune disease caused by what?

A

IgG Abs against desmosomes (desmoglein 1 and desmoglein 3) located on surface of keratinocytes

98
Q

Pemphigus vulgaris is (SUBEPIDERMAL/INTRAEPIDERMAL).

A

Intraepidermal

99
Q

What disease presents with flaccid bullae, erosions on the skin and oral mucosa, and a positive Nikolsky sign (skin tears on bullae when slightly touched)?

A

Pemphigus vulgaris

100
Q

Bullous pemphigoid is an autoimmune disease caused by what?

A

IgG Abs against hemidesmosomes (BP180 and BP230)

101
Q

Bullous pemphigoid is (SUBEPIDERMAL/INTRAEPIDERMAL).

A

Subepidermal

102
Q

What disease presents with tense bullae and a negative Nikolsky sign?

A

Bullous pemphigoid

103
Q

What can a positive Homan sign indicate could be present?

A

DVT

***Dorsiflex foot, causes pain in calf

104
Q

Homan test is unreliable for accurate diagnosis of DVT, so what is the first line imaging modality for accurate diagnosis of DVT?

A

Compression ultrasonography

105
Q

This microorganism is a lactose-negative and oxidase-negative rod that produces H2S (hydrogen sulfide).

A

Salmonella typhimurium

106
Q

How does Salmonella cause watery to bloody diarrhea?

A

Via direct adherence and invasion into both enterocytes and macrophages (utilizing a type III secretion system)

107
Q

This is a polymorphic ventricular tachycardia and often occurs as a complication of treatment with QT-prolonging medications (including antipsychotics such as haloperidol).

A

Torsades de pointes

108
Q

What is used to treat a hemodynamically stable patient with torsades de pointes?

A

IV magnesium

109
Q

What is the pharmacology for Afib and Atrial flutter?

A
  • Adenosine
  • Amiodarone
  • Beta blockers
  • Calcium channel blockers (ie, diltiazem, verapamil)
  • Digoxin
110
Q

What is the pharmacology for Digoxin toxicity?

A
  • Anti-digoxin Fab fragments

- Magnesium sulfate

111
Q

What is the pharmacology for monomorphic ventricular tachycardia?

A
  • Amiodarone

- Lidocaine

112
Q

What is the pharmacology for paroxysmal supraventricular tachycardia?

A

Adenosine

113
Q

What is the pharmacology for sinus brady?

A

Atropine

114
Q

What is the pharmacology for TCA toxicity?

A

Sodium bicarbonate

115
Q

Rabies virus can cause fatal encephalitis, resulting in what characteristic finding upon autopsy?

A

Negri bodies (neuronal eosinophilic cytoplasmic inclusions)

116
Q

This is the most common organism that causes impetigo.

A

Staph aureus

117
Q

Staph aureus most commonly causes a nonbullous form of impetigo, however there is a bullous form and it is due to what toxin?

A

Exfoliative toxin A

118
Q

The MOA of exfoliative toxin A in bullous impetigo is similar to the pathophysiology of pemphigus vulgaris, which is what?

A

Auto-Abs are directed against desmoglein A

119
Q

What is the ANCA staining pattern for GPA (granulomatosis with polyangiitis) and its most common ANCA Ag?

A

C-ANCA

PR3

120
Q

This disease is characterized by frequent ENT, pulmonary, and renal symptoms and has a C-ANCA staining pattern.

A

GPA (granulomatosis with polyangiitis)

121
Q

What is the ANCA staining pattern and Ag for microscopic polyangiitis?

A

P-ANCA

MPO

122
Q

What is the ANCA staining pattern and Ag for Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)?

A

P-ANCA

MPO

123
Q

What is the ANCA staining pattern and Ag for Antiglomerular basement membrane-autoAb disease?

A

P-ANCA

MPO

124
Q

What is the ANCA staining pattern and Ag for drug-induced ANCA-associated vasculitis?

A

P-ANCA

MPO

125
Q

What is the ANCA staining pattern and Ag for ulcerative colitis?

A

P-ANCA

Myeloid-specific nuclear envelope protein

126
Q

What is the ANCA staining pattern and Ag for Primary sclerosis cholangitis?

A

P-ANCA

Myeloid-specific nuclear envelope protein

127
Q

Sickle cell disease is an autosomal (DOMINANT/RECESSIVE) disorder caused by a mutation of (ADULT/FETAL) hemoglobin.

A

Recessive

Adult

128
Q

What substitution occurs in Sickle Cell disease?

A

Valine replaces glutamic acid on the beta chain of adult Hgb

129
Q

This is a self-limiting thyrotoxicosis caused by a release of pre-formed thyroid hormone from an inflamed thyroid gland. It classically follows a flu-like illness. Distinguishable from other hyperthyroid etiologies b/c it is the ONLY type with a painful, enlarged thyroid gland.

A

Subacute granulomatous thyroiditis (de Quervain thyroiditis)

130
Q

This is a protozoan parasite that causes malodorous watery diarrhea.

A

Giardia lamblia

131
Q

What is the 1st-line treatment for Giardia lamblia?

A

Metronidazole
Tinidazole
Nitazoxanide

132
Q

What is the MOA of Metronidazole?

A

Creates free radical metabolites that damage DNA

133
Q

Where is Histoplasmosis endemic to?

A
  • Mississippi River Vally

- Ohio River Valley

134
Q

Where is Blastomycosis endemic to?

A
  • Southeastern and South-Central US (bordering Miss. and Ohio River basins)
  • Midwestern US and Canadian provinces bordering Great Lakes
  • New York and Canada along the St. Lawrence River and the Nelson River
135
Q

Where is Coccidiomycosis endemic to?

A
  • Southwestern US

- California

136
Q

Where is Paracoccidioidmycosis endemic to?

A
  • Certain regions of Mexico

- Central and South America

137
Q

Infection with Histoplasma capsulatum is the most common cause of _______ _______, ahead of TB and radiation therapy.

A

Chronic mediastinitis

138
Q

The most common cause of respiratory distress in premature infants is neonatal RDS, which is caused by surfactant deficiency. A major component of surfactant is _________, the level of which would be decreased in the lungs of a neonate with RDS.

A

dipalmitoylphosphatidylcholine

139
Q

What is the most common cause of sudden death within 24 hours after onset of MI symptoms?

A

Arrhythmia (primarily ventricular tachycardia or Vfib)

140
Q

What is the most common cause of ASD?

A

Failure of the ostium secundum to close during formation of the atrial septum

141
Q

What is the heart sound for an ASD?

A

Fixed splitting of the S2 heart sound (pulmonary valve closes after the aortic valve because of increased right ventricular blood volume)

142
Q

When an ASD is large, right-to-left shunting may eventually develop, which is called what?

A

Eisenmenger syndrome

143
Q

Sickle cell disease patients are at risk of having an _______ _______, often associated with parvovirus B19 infection, during which time erythropoiesis is suppressed.

A

Aplastic crisis

144
Q

Ventilation, perfusion, and compliance differ in the lung because of gravitational forces. When standing, ventilation, perfusion, and compliance are (MORE/LESS) at the apex than at the base of the lungs.

A

Less

145
Q

Cystine kidney stones are the rarest, and appear with what shape on microscopy?

A

Hexagon

146
Q

What testing would be positive for cystine kidney stones?

A

Cyanide-nitroprusside testing

147
Q

This type of dyslipidemia results in elevated serum triglycerides and affected patients are at risk of developing acute pancreatitis.

A

Hyperchylomicronemia (type I familial dyslipidemia)

148
Q

In Hyperchylomicronemia, what would centrifugation of a blood sample look like?

A

There would be a creamy layer in the supernatant

149
Q

This presents as a papulovesicular, pruritic skin rash on the elbows and knees and is associated with Celiac disease.

A

Dermatitis herpetiformis

150
Q

What is the pathophysiology of dermatitis herpetiformis?

A

Development of IgA Abs that react against gliadin and cause micro abscess formation at the dermal papillae tips

151
Q

Obstructive sleep apnea causes hypoxia, which can trigger pulmonary vasoconstriction and lead to what?

A

Pulmonary HTN

152
Q

What is the best auscultatory location for the aortic valve?

A

Right upper sternal

Second intercostal

153
Q

What is the best auscultatory location for the pulmonic valve?

A

Left upper sternal

Second intercostal

154
Q

What is the best auscultatory location for the tricuspid valve?

A

Left lower sternal

Fourth intercostal

155
Q

What is the best auscultatory location for the mitral valve?

A

Left mid-clavicular

Fifth intercostal

156
Q

This murmur sound is a high-pitched blowing, early diastole decrescendo.

A

Aortic regurgitation

157
Q

This murmur sound is a crescendo-decrescendo systolic ejection.

A

Aortic stenosis

158
Q

This murmur sound is a mid-systolic high-pitched crescendo-decrescendo.

A

Pulmonary stenosis

159
Q

This murmur sound is holosystolic and high-pitched.

A

Tricuspid valve regurgitation

160
Q

This murmur sound has an opening snap with delayed rumble during late diastole.

A

Mitral stenosis

161
Q

This murmur sound is a late systolic crescendo with mid-systolic click.

A

Mitral valve prolapse

162
Q

This murmur sound is holosystolic, high-pitched, and radiates to the axilla.

A

Mitral valve regurgitation

163
Q

What are the diastolic murmurs?

A

Aortic regurgitation
Pulmonic regurgitation
Mitral stenosis
Tricuspid stenosis

164
Q

What are the systolic murmurs?

A 
Aortic stenosis
Pulmonic stenosis
Mitral regurgitation
Tricuspid regurgitation
Mitral valve prolapse
165
Q

What do the PFTs look like in obstructive lung diseases (ie, COPD)?

A

Decreased FEV1
Decreased FVC
Decreased FEV1/FVC ratio
Increased TLC

166
Q

What are the recommended drugs for HTN in pregnancy?

A

Hydralazine
Labetalol
Nifedipine
Methyldopa

167
Q

What is the DOC for panic disorder and/or agoraphobia?

A

Paroxetine (type of SSRI)

168
Q

During menopause, a loss of sensitivity to gonadotropins results in an increase of what?

A

FSH

LH

169
Q

What levels are measured clinically to determine if a woman has reached menopause?

A

Elevated FSH

170
Q

This is a parasite that causes the highly pathogenic Primary Amebic Meningoencephalitis (PAM) and is transmitted through contaminated water that contacts the nasal mucosa.

A

Naegleria fowleri

***Called the “Brain-eating amoeba”

*Boards* (6 decks)

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