3/24-4/12

Front 1

Someone who feels sad and then happy goes and buys a bunch of stuff what drug would you want to tx them with?

Back 1

you would want to give an anti-psychotic (lithium, carbamazepine, & valproate)

Front 2

What drug can you use for simple, complex partial seizures, bipolar disorder, & trigeminal neuralgia

Back 2

carbamazepine

Front 3

this drug treats tonic-clonic seizures, mood disroders, and if preggo can cause neural tube defects

Back 3

valproate

Front 4

someone has a tremor and they blame it on the voice in there head what can you give to treat this?

Back 4

probabaly drug-induced Parkinson's caused by an anti-psychotic, give them an anti-muscarinis "park your mercedes- benz" benztropine

Front 5

what kind of drug is paroxetine?

Back 5

serotonin-reuptake inhibitor makes manic worse

Front 6

Bupropian is what

Back 6

dopamine and NE re-uptake inhibitor, used for depression and stopping smoking

Front 7

PCA supplies which regions of the brain

Back 7

comes off the basiliar at pontomesocephalic junction supplies the thalamus, tedial temporal lobe, splenium of corpus callousoum, para hipo gyrus, fusiform gyrus, & occiptal lobe

Front 8

anterior chordate artery supplies

Back 8

is last branch of internal carotid before trifurcation, post limb, gen of internal capsule, optic tract, lateral geniculate body, choroid plexus, uncux, hippocampas, & amygldala

Front 9

Back 9

good pic to know

Front 10

Strict diets to lose weight devoid of a vitamine is likely?

Back 10

think vegan- B12 cobalamin, causes megaloblastic anemia..take years to see a problem bc tons in the hepatic storage

Front 11

Most water soluble vitamins flush out the body

Back 11

FAST except for cobalamin & folate

Front 12

tibial hematomoa & painful gums in a 79 yo poor woman your thinking?

Back 12

Vit C defieicieny, ascorbic acid- from fruits (poor homeless ppl wont have that) scurvy: hemorrhage, subperiosteal hematoma, bleed, gingivial swelling
also important to hydroxylase prolyl and lysyl--> precollagen

Front 13

Folic acid deficicney you would see

Back 13

megaloblastic anemia & neural tube deficients

Front 14

Zinc deficiency you would seee

Back 14

growth retardatsion/infertility and acrodermatitis

Front 15

2 mutatnt strains no problem, but together they make progeny that becomes virulent this describes

Back 15

recombination (genetic) 2 viruses must exchange genes for their progeny to change that much

Front 16

host cell co infected and they exchange whole genome, sudden change describes?

Back 16

reassortment

Front 17

Uptake of naked DNA in prok/euk describes?

Back 17

transformation

Front 18

inhibition one virus replication and release describes?

Back 18

interference

Front 19

describe how morphine works

Back 19

activates mu opiod receptors, which is a G-protein linked so has many secondary messengers...K+ conductance increase the efflux so you hyperpolarize and terminate pain, close Ca2+

Front 20

immigrant with fever, rash, face travels to body and lyphadenopathy behind the ears

Back 20

thinking no vaccine for measle, mumps, rubella, rubella presents with a rash, face--> trunk/extremities...fast spread- no darkening, lymphadenopathy is rubella too which is caused by togavirus!

Front 21

bean-shape bacteria appears in an army person how did he get this?

Back 21

nasopharynx--> blod--> choroid plexus--> meninges transmit by respiratory droplets

Front 22

polydraminiosis appears in pregnant lady what are the likely causes

Back 22

Gi obsturction (duodenal, esophageal, intestinal atresia) or anencephaly

Front 23

What is seen with a baby in the womb w renal agenesis?

Back 23

severe oligohydromanisos ( too low) potter's syndrome

Front 24

Normal thryoid gland exists in anterior neck lower in fron of the upper trachea & larynx...thyroid gland is an outpouch that descends- remaining forms the

Back 24

thyroglossal duct

Front 25

What happens if the thyroid fails to migrate?

Back 25

you form thyroid in the tongue "linguial thyroid" or "thyroglossal duct"

Front 26

What should surgeons be catious of when removing a thyroglossal cyst

Back 26

it may be the only thyroid hormone a child so can cause severe hypothyroidism

Front 27

Common signs of 3 mo old w hypothyroidism

Back 27

dry skin, constipated, mass appears in throat, hard to swallow, Macroglossia,

Front 28

foramen cecum t is a normal remenant of what

Back 28

thyroglossal duct

Front 29

Failure of GnRH to migrate from olfactory is

Back 29

kallman's syndrome

Front 30

tested fail to migrate to scrotum is

Back 30

cryptorchidism

Front 31

What does sensitivity measure?

Back 31

#True (+)/ patients w dz. (TP+FP)
ability of test to tell who has the disease good for illnesses that are severe or can be prevented w early tx

Front 32

What is sepcficity?

Back 32

more expensive, and how much the test can detect a true negative, TN(TN+FP)
confirmatory test after a + test is seen

Front 33

3 ways to get Down Syndrome?

Back 33

1. trisomy 21 -95% cases, meiototis nondisjunction failure of homologous chrom to seperate (always maternal)
2. unbalanced robertsonian translocation- 2-3% DS, 46 chromosome an extra chrom
3. mosaicism: patient has 2 cell lines one normal and one with DS

Front 34

genetic imprinting and partial deletion are example for which disease

Back 34

prader-willi and angelman

Front 35

uniparental disomy is what and give an example

Back 35

2 copies from one parent and none from the other--> complete hyatidform mole

Front 36

21 yo fasting w jaundice and an increased amount of unconjugated bilirubin is

Back 36

gilber-syndrome

Front 37

what happens with gilbert syndrome

Back 37

you decrrease UDP glucornyl transferase or decr in bilirubin uptake, increasing inconjugated amount and usually onset w stress/fasting

Front 38

What is AST:ALT in an alcholic w hepatitis

Back 38

2:1

Front 39

What is AST/ALT in a person w viral hepatitis

Back 39

ALT>AST

Front 40

What is suppression?

Back 40

mature defense mechanisms, voluntarily withholding an idea or feeling from conscious awareness ( not thinking about boards till later)

Front 41

What is repression?

Back 41

involuntary withholding an idea or feeling from conscious awareness- rape forget about it until see it on tv

Front 42

what is humor?

Back 42

appreciating the amusement nature of anxiety making it light

Front 43

Describe altruism

Back 43

guilty feelings are alleviated with generosity towards others

Front 44

What is isolation

Back 44

describing a hard time w no emotion connection, seperate feelings from a horrible event

Front 45

what is the only class of antibody that crosses the placenta?

Back 45

IgG

Front 46

some dopamine drugs block the interfindibular area what would this cause in a patient?

Back 46

galactorrhea & lacrimation, heavy breasts, sexual dysfunction

Front 47

which hormones use the JAK/STAT pathway

Back 47

GH & prolactin!

Front 48

mutation of germline RET effects?

Back 48

adrenal medulla (pheochromoctyoma) parathyroid (3/4th pharyngeal pouch), & parafollicular cells derived from neural crest cells (4t/5th pouches)

Front 49

MEN are unique because

Back 49

all derived from neural crest cells, remember MEN 2A= parathyroid, pheochromocytoma, & medullary thyroid cancer (parafollicular C Cells)
MEN 2B= pheochromocytoma & oral mucosa & medullary thyroid cancer

Front 50

Decribe the role of histones in Huntington's Disease

Back 50

hypermethylated histones bind to DNA and prevent transcription and production of neurotrophic factors

Front 51

What ae histones?

Back 51

small proteins complex with DNA make some genome unavailable for transcription

Front 52

adrenal cortex develops from the

Back 52

mesoderm

Front 53

adrenal medulla develops from the

Back 53

ectoderm (neural crest cells)

Front 54

Whats the genetic inheritance for sickle cell anemia

Back 54

autosomal recessive

Front 55

erythrocytes get their energy with which 2 pathways

Back 55

glycolysis and shunt (HMP)
HMP- makes NADPH to prevent damage & G6PD is the rate-limiting enzyme in this reaction

Front 56

How is hydrogen peroxide reduced in RBC?

Back 56

with glutathione peroxidase and oxidizes with glutathion and regnerated which produces one NADPH

Front 57

So which 2 mechanisms would present with problens in RBC?

Back 57

G6PD deficiency
glutathione (wouldn't make NADP& glutathione)
increase amount of damage

Front 58

RMP at -70 mantained by

Back 58

a lot of K+ conductance and some Na+ conductance
K= -80 mV
Na= +60 mV

Front 59

Pt presents with reduced vision in the R eye, and exam shows R. hemanymous hemaniopa, with direct light on R pupil dilates, but indirect it constrict whats the likely area injured

Back 59

optic tract

Front 60

what is hemanymous hemaniopa

Back 60

vertical loss of vision on same side in both eyes

Front 61

if it was a lateral geniculate nucleus lesion what would you see

Back 61

contralateral homonymous hemaniopa but pupil reflex would be intact

Front 62

why does the marcus-gun pupil form with optic tract lesion

Back 62

because this is a combination of nasal & temporal fibers going to the back and the nasal carries pretectal nucleus fibers to pupil

Front 63

what would visual cortex lesion present with

Back 63

contralateral homonymous hemaniopa w macula sparing but light reflex would be normal

Front 64

pt w lesion under arm, seizures, and history of that mom had skin cancer what embryological derivative did the lesion develop from?

Back 64

neural crest cells, melanoma is the 3rd common cancer to mestastize to the brain

Front 65

name the order of common metastasis to the brain

Back 65

lung, breast, melanoma

Front 66

where do mealnocytes come from?

Back 66

neural crest cells

Front 67

50 yo presents w this and recurrent gum bleeding what are you thinking?

Back 67

Aeur rod, AML (M3 AML) accumulate myeloblasts in Bone marrow..stain with MPO..crystals aggregate= auer rods

Front 68

Which chromosomes characterize acute promyelocytic leukemia

Back 68

t (15;17) the translocation of the retinoic acid RAR on chrom 17 to chrom 15, RAR disruption blocks maturation of& promyelocyts accumulate...numerous primary granules incr DIC tx: trans-retinois acid

Front 69

describe conversion disroder

Back 69

sudden loss of sensory/motor from stress etc. common in females but no pathophysiology is present (all labs normal) pt can be indifferent to symptom

Front 70

Describe what controls the symptoms of jetlag in the hypothalamus?

Back 70

suprachiasmatic nucleus detect photosensitivie from the retina and controls pineal gland to release melatonin and cortisol during day time from ACTH

Front 71

24 yo w headaches, visual changes and you see an intracranial calcified mass..remove it and see cystic space w brown rich cholesterol what other structure shares origin with this?

Back 71

pituitary gland, its a craniopharyngioma derived from Rathke's pouch remnants

Front 72

Benign tumor seen in children and adults MC supratentorial tumor

Back 72

chraniopharyngioma

Front 73

what embryo layer does the Rathke's pouch develop from

Back 73

ectoderm invaginates and protrustion forms anterior pit

Front 74

What does the posterior pituitary gland develop from?

Back 74

neurhyphosis from the neuroectoderm

Front 75

retrograde studies are more likely to have

Back 75

recal biasis

Front 76

Whats the problem w recall studies?

Back 76

people who had adverse effects are more likely to recall the risk factors they were exposed to than people who didnt have adverse effects

Front 77

4 yo w difficult walking and cells show radiation-induced genetic mutation whats the likely problem?

Back 77

ataxia-relangiectasia defect in ATM gene codes for DNA repair enzymes, see cerebellar defects, spider angioma, & igA def...

Front 78

an older pt comes in w visual disturbances you check and see yellow 1.5 mm diameter on the macula what kind of visual disturbances are they having?

Back 78

central scotoma

Front 79

what is central scotoma

Back 79

any visual defect surrounded by relatively unimpaired field of vision

Front 80

macular degeneration causes

Back 80

central vision loss usually age related

Front 81

3 mo old w recurrent vomiting & when seend he has pancreas in his duodenum what hapened?

Back 81

ventral portion of pancreas ringed around the duodenum

Front 82

how does pancreas development start off

Back 82

dorsal bud is behind the stomach/duodenuma and ventral bud is in front, it then rotates behind and sits there

Front 83

what does the ventral pancreatic bud develop into

Back 83

uncinate process

Front 84

someone with a gap in the long arm of the X arm will probably present with

Back 84

macroorchidism (enalrged testes), long face w a large jaw, large everted ears, autism, mitral valve prolapse & MR

Front 85

what is the mechanism of fragile X syndrome

Back 85

repeast of CGG on the FMR1 gene, causes a skip in the long -arm of X when methylated

Front 86

a study done testing colorectal cancer w + biopsy and those with - colorectal cancer by age & race is avoiding

Back 86

confounding variables

Front 87

taking out variable that could effect a study is eliminating

Back 87

confounding variables

Front 88

Does CO poisoning affect PaO2?

Back 88

No, only decrease oxygen binding on hemoglobin and unloading of O2 to tissues

Front 89

Does CO cause any methemoglobin?

Back 89

No that is when fe2+ gets reduced to Fe3+ which is the unusable form for O2, usually occurs bc of drugs

Front 90

how does congenital torticollis present?

Back 90

baby with possible mass on the neck & unable to turn their head one way, cries when turned a certain way and prefers the other

Front 91

How does congenital torticollis usually happen?

Back 91

2-4 weeks it's seem either due to malposition of the head in utero/birth canal causes SCM injury or birth trauma

Front 92

What does maternal hypertension cause

Back 92

asymmetrical growth, a normal head with reduced abdominal circumference

Front 93

an upper respiratory infection of the maternal such as rubella could cause what in an infant?

Back 93

usually not a problem but w rubella can cause mental retardation & congenital heart defects

Front 94

influenza A combined with animal virus oxthomyovirus causes what to occur

Back 94

genetic reassortment

Front 95

What is needed in a virus to have genetic reassortment occur?

Back 95

segmented genomes

Front 96

VII cranial nerve controls what w hearing?

Back 96

innervates the stapedius muscle which causes oscillation in the stapes making it more sensitive to sound ( if problem people have trouble hearing normal sounds)

Front 97

Gram + motiliy tumbling rod seen in someone who is an organ transplant pt and w fever, headache, and vomiting...CSF shows pleocytosis & normal level of glucose

Back 97

listeria meningitis

Front 98

Can women with Turner Syndrome XO become pregnant?

Back 98

5% do without medical assistance but 95% do by in vitro fertilization, and donor oocytes & estrogen/progesterone to maintain their lining

Front 99

genetically fm born to a 23yo mom shows male ambigous genitalia and the mom experiences facial hair growth and a deepening of voice, what is the baby missing ?

Back 99

aromatase

Front 100

What does aromatase do?

Back 100

converts androsterndione--> estrone & tesosterone --> estradiol

Front 101

why does the mom with the baby aromtase def get facial hair growth and a deep voice?

Back 101

extra androgens in the placenta

Front 102

what does someone with a 5 alpha deficiency present with?

Back 102

male with decr synthesis of DHT and feminized internal genitalia

Front 103

What is the lecithin/ sphingomyeling ratio used to indicate?

Back 103

fetal lung maturity
>1.9= mature

Front 104

How do we measure lecithin / sphingomyelin?

Back 104

mothers amniocentosis bc pulmonary secretions come from fetus, and after 32/33 weeks the lecithin should be much greater

Front 105

What hormones most control the release of lecithin/sphingomyelin?

Back 105

glucocorticoids

Front 106

2 siblings with the same mitochondrial disease from their mother have varied expression, how come?

Back 106

mitochondria are randomly distributed to the kids, some get normal, damaged, or mixed...this is called heteroplasmy!

Front 107

a male with a small phallus, hypospadia, and nomral HTN/electrolytes is deficient in?

Back 107

5 alpha hydroxylase

Front 108

failure to fuse the maxillary prominence with the medial nasal results in

Back 108

cleft lip

Front 109

a mother comes in at 16-18 weeks for her triple test and you find low alpha-feto protein, she also drinks & smokes what is this associated with?

Back 109

trisomy 21

Front 110

What is a high alpha-feto protein associated with for a child?

Back 110

omphalocele, gastroschisis, neural tube defects (also see high acetycholinesterease), & multiple gestation

Front 111

what is 2 standard deviations cover?

Back 111

95%

Front 112

Ventral pancreatic buds form from what, and make what?

Back 112

come from the liver diverticulum and form the head of pancreas, main duct, & uncinate process

Front 113

What does the dorsal bud make?>

Back 113

everything else in the pancreas- body, tail, isthmuc, acessory pancreatic duct, rest of main

Front 114

What happens in pancreatic divisum

Back 114

The 2 ventral and dorsal fail to fuse so you have 2 drainage systems, santori from dorsal= minor papilla will drain most of the pancreas, the ventral wirsung open major papilla inferior/posterior head & unicinate drianage

Front 115

A drug allowing people to survive longer with CLL with do what to incidence & prevalence?

Back 115

incidence will be same, prevalence will incr (more people staying alive w the disease)

Front 116

Alzheimer's disease early onset related to what genes:

Back 116

APP (21), presenilin-1 (14), & presenilin-2 (1)

Front 117

Alzheimer's late onset due to what genes

Back 117

ApoE4(19)