Wrongs Flashcards
Person with Hashimotos, comes with megaloblastic anemia, raised methylmalonic acid and total homocysteine levels?
What is the cause?
Failure of Intrinsic Factor production because the symptoms are of Vitamin B12 deficiency.
Which enzyme does Vitamin B12 serves as a co-factor, such that in Vitamin B12 deficiency Methylmalonic acid levels INCREASE in serum?
Methylmalonyl-CoA MUTASE
Which enzyme does Vitamin B12 serves as a co-factor, such that in Vitamin B12 deficiency HOMOCYTEINE levels INCREASE in serum?
Methionine Synthase needs Vitamin B12 as co factor
64 year old woman- NO wrinkles on face and neck, there’s synovial thickening of wrists B/L.
What will happen to the following:
Esophygeal Peristalsis: Increased/Decreased
Lower Esophygeal Sphincter Tone: Increased/Decreased.
Esophygeal Peristalsis: Decreased
Lower Esophygeal Sphincter Tone: Decreased.
(Esophygeal dysmotility can cause Barret’s esophagus and fibrous stricture formation in sceroderma patients)
Uworld:
Name two pulmonary complications of systemic sclerosis?
Interstitial fibrosis
Pulmonary HTN-IMPORTANT TO REMEMBER.
Uworld:
In diffused Scleroderma, there is Dermal layer (contraction/expansion) due to deposition of ___________.
There is atrophy/inflammation if intradermal adipose tissue and hair follicles.
Expansion, collagen
Atrophy
Which antibodies are found in:
Diffuse scleroderma?
Limited Scleroderma?
Anti- Scl 70 (Anti-DNA Topoisomerase 1 ab) and Anti-RNA Polymerase 3 ab
Anti-Centromere Ab( Crest Syndrome)
E.Coli causing pyelonephritis, what is the virulence factor?
P Pili ( In FA) In NBME 13, the correct option was “ADHESINS”
Looseness of Lateral Collateral Ligament, suggestive of a tear. Lack of which component in the ligament will most likely limit the healing of this injury?
Blood Vessels.
6 year old girl has sever abdominal pain, vomiting, nausea. She are pastries and cake at a party.
What is the cause of these findings?
Enterotoxigenic ingestion
For Transvaginal hysterectomy, the uterus must be seperated from all surrounding pelvic structures. Incision of which structure is important? The structure attaches to cervical region and extends posteriorely?
Uterosacral ligament
What is the cause of Hypercalcemia in a patient of Multiple Myeloma?
Local IL-1 and TNF effects
Hence, IL-1 is also called osteoclast activating factor and causing lytic bone lesions in Multiple Myeloma
2 treatment drugs used for Multiple Myeloma and also tell their MOA?
- IL-6 inhibitor
2. BORTEZOMIB- 26S proteosome inhibitor so it facilitates apoptosis
After administration of Desmopressin, what findings in the nephron best describes the tubular osmolality, compared with serum in the patient of Nephrogenic DI?
Proximal tubule:
JG Apparatus:
Medullary CD:
Isotonic
Hypotonic
Hypotonic
Which artery’s stroke causes C/L paralysis and sensory loss in face and upper limbs? ( Also causes Aphasia and Hemineglect according to dominant and non-dominant hemisphere thingy?
And which artery’s stroke causes C/L paralysis and Sensory loss in LOWER limbs and urinary incontinence?
MIDDLE CEREBRAL ARTERY
ANTERIOR CEREBRAL ARTERY
What happens if there is a stoke of Anterior Spinal Artery?
Also called Medial Medullary Syndrome- due to infarction of paramedian branches of ASA
C/L paralysis of upper and lower limbs.
Tongue deviates ipsilaterally ( Ipsilateral hypoglossal function)
Cardiac arrest due to cocaine is due to?
Cocaine-induced INHIBITION OR NE REUPTAKE
Blood Glucose Concentration increased after several hours of receiving insulin. What is the cause of patient’s hyperglycemia?
Activation of hepatic adenylyl cyclase
Gram Negative rod that produces pyocanin?
Psuedomonas
What the mechanism of persistent colonization of pseudomonas in a CF patient despite aggressive treatment with antibiotics?
Biofilm formation in the lower respiratory tract makes pseudomonas eradication really tough in CF patients
MOA of Cisplatin drug?
Cytotoxic platinum analogs that bind to DNA and form intrastrand and interstrand cross-links.
Pt of Myesthenia Gravis has increased her dose of Neostigmine because she has started experiencing INCREASED MUSCLE WEAKNESS LATELY?
Increased muscle weakness despite increasing Neostigmine’s dose means that DESENSITISATION OF NICOTINIC RECEPTORS has occurred in this patient due to use of neostigmine.
MOA of Cephalexin?
Interference with bacterial cell wall synthesis.
Pt has Hemoptysis Hematuria Hypochromic microcytic anemia Weight loss
What is the renal disease that the patient has?
Good Pasture’s Syndrome.
How does GoodPasture’s Syndrome look on LM, IF and EM?
LM: Glomerular Crescents
IF: LINEAR IgG and C3 deposition.
EM: No deposits.
Decreased serum levels of which hormone is the cause of erectile Dysfunction in a patient of Alcoholic Liver Disease?
Testosterone
Winging of scapula. Which nerve is damaged?
Long Thoracic nerve
What is a special property of Pindolol?
Partial agonism
Patient comes to you with 2-week history of heart murmur and hepatomegaly. She has a 3-month history of cutaneous flushing with hypotension and crampy diarrhea.
What is the most likely site of a primary neoplasm in this patient?
Small Intestine
MOA of erythromycin?
Binds to 50S ribosomal unit and interferes with translocation.
A researcher in a pharmaceutical company designs a new protease inhibitor that inhibits replication of HIV in T-lymphocytes in culture. In subsequent assays, which of the following findings is most likely to indicate that the compound is working specifically as a protease inhibitor?
A) the drug prevents integration of proviral DNA into host genome
B) the RNA is partially reverse transcribed into Proviral DNa
C) There is a lack of mature core
C) There is a lack of mature core
Patient has infectious mononucleosis. Atypical cells with abundant lacey cytoplasm jn the peripheral blood smear are most likely derived from which cells?
Abundant lacey cytoplasms describe the presence of reactive lymphocytes. Reactive lymphocytes are a common occurence in a viral illness. These cells come from T-lymphocytes.
Where is a pharyngeal cleft cyst located?
Anterior to sternocleidomastoid muscle
MOA of ciprofloxacin?
Inhibits DNA gyrase
Bupivacaine’s MOA?
Decreased permeability to Na+
A 65y old man dies after complete occlusion of the left coronary artery. The left ventricle contains a large irregular area that is soft and pale. Which of the following processes is most likely responsible?
Coagulation necrosis
you did liquifactive necrosis which was wrong
