30 Day Step 1 Flashcard Set

Front 1

The increased alpha fetoprotein and erythropoeitin associated with hepatocelluar carcinoma may lead to what condition?

Back 1

Budd-Chiari syndrome.

Front 2

PAS positive globules in the liver means what? How is this trait inherited?

Back 2

This means ALPHA-1 ANTITRYPSIN deficiency and this trait is inherited in a CODOMINANT form.

Front 3

How is Wilson's disease inherited? What gene is it associated with?

Back 3

Wilson's is an Autosomal Recessive disease associated with the ATP7B gene.

Front 4

Wilson's disease can present with what type of anemia?

Back 4

Hemolytic anemia.

Front 5

What is the classic triad of hemochromotosis?

Back 5

Micronodular cirrhosis, diabetes mellitus, and skin pigmentation.

Front 6

What diseases of the heart and liver are at greater risk in hemochromoatosis?

Back 6

CHF and hepatocellular carcinoma.

Front 7

How do you treat hemochromotosis and what is the HLA association that it has?

Back 7

Hemochromatosis is treated with phelobotomy and deferoxamine. It is associate with HLA-A3.

Front 8

Dumping syndrome is associated with what condition? What is the recommendation to avoid dumping syndrome?

Back 8

Dumping syndrome is associated with gastric bypass surgery. The contents of the stomach move into the small intestine too quickly and cause an osmotic diarrhea. The recommendation is to eat smaller more frequent meals that are high in fat, in order to delay gastric emptying.

Front 9

What type of cells are proliferating in Menetrier's disease? How does this explain why it is a protein losing enteropathy?

Back 9

Because of increased proliferation of the mucus-producing (mucous) cells of the stomach, it presents as a protein losing enteropathy from the increased mucus production, higher pH (there is also parietal cell atrophy), leading to decreased protein digestion.

Front 10

Aside from antigliadin antibodies, what is the screening test used to diagnose celiac sprue?

Back 10

Elevation of SERUM LEVELS of TISSUE TRANSGLUTAMINASE.

Front 11

What three contributors work synergistically to enhance acid secretion from the stomach? What nervous innervation can be transected in order to inhibited acid secretion if necessary?

Back 11

Histamine, Gastrin, and Vagal stimulation. The vagal stimulation can be transected in order to treat over secretion of acid if necesssary.

Front 12

What is the pharmacological screening test used to diagnose Atrophic Gastritis?

Back 12

The Pentagastrin screening test. Lowered response of the parietal cells to this indicates atrophic gastritis.

Front 13

What type of ulcers do burn victims get in their stomachs? Why?

Back 13

Curling's ulcers due to decreased plasma volume --> which leads to sloughing of the gastric mucosa.

Front 14

What type of ulcers do victims of head trauma get? Why?

Back 14

Cushing's ulcer's due to increased vagal stimulation --> increase ACh production --> and increased H+ production.

Front 15

What problems in the kidneys can lead to gastritis?

Back 15

Think renal failure or any problem that is going to increase the BUN. Hyperuricemia can lead to acute gastritis.

Front 16

Pernicious anemia and Type A atrophic gastritis (body/fundus) leads to increase for what type of cancer?

Back 16

Gastric carcinoma.

Front 17

Type B atrophic gastritis and H.pylori infection leads to increased risk of what type of cancer?

Back 17

Increased risk of MALT lymphoma.

Front 18

What type of cancer does stomach cancer most frequently present as? What are two common features? What blood type is at greater risk?

Back 18

Stomach cancer is almost always an Adenocarcinoma. Two key features include signet ring cells and acanthosis nigricans. Type A blood puts you at greater risk.

Front 19

What nervous input decreases Somatostain secretion?

Back 19

Vagal input decreases Somatostatin secretion.

Front 20

H. Pylori produces what compound with it's urease that is cytotoxic to gastric cells?

Back 20

Ammonium (NH4+).

Front 21

How does CCK inhibit gastric emptying?

Back 21

CCk inhibits gastric emptying by relaxing the orad stomach, which increases its compliance.

Front 22

Under normal conditions, can Gastrin, secretin, or GIP inhibit gastric emptying? When can they?

Back 22

Under normal conditions these hormones cannot inhibit gastric emptying. Under pharmacological conditions at high doses they can.

Front 23

What is the most common anomally of the GI tract?

Back 23

Meckel's diverticulum.

Front 24

What is volvulus due to in infants, and thus when does it present?

Back 24

Volvulus in infants is due to a congenital malrotation, so it presents early, and most likely before intussuception.

Front 25

What part of the colon does volvulus affect in older patients?

Back 25

The sigmoid colon is the most frequent site of a large-bowel volvulus because it is poorly supported, compared to other bowel sites.

Front 26

Which family of virus does HEV belong to? What type of patient does HEV kill?

Back 26

HEV is a naked capsid, RNA virus that belongs the the Hepeviridae Family.

Front 27

Describe the morphology of Adenoviridae. What infections do they cause?

Back 27

Adenoviridae is a group of naked capsid, dsDNAviruses that may cause URI, GI enteritis, and Conjunctivitis.

Front 28

Which viral family does HCV belong to? describe its morphology. How is it spread?

Back 28

HCV belongs to the Flaviviridae family. It is an enveloped RNA virus that is usually transmitted sexually or parenterally.

Front 29

Which viral family does HBV belong to? Describe the HBV morphology. How is it transmitted?

Back 29

HBV belongs to the Hepadnaviridae. It is an enveloped dsDNA virus that is transmitted sexually or parenterally.

Front 30

Describe the morphology of the Picornaviridae family. Which Hepatitis virus belongs to this family? Which other viruses belong to this family? (*PERCH)

Back 30

This is a family of naked capsid RNA viruses. HAV belongs to this family as well as Poliovirus, Echovirus (asepticc meningitis), Rhinovirus (common cold), Coxsackie (aseptic meningitis, herpangina-febrilpharyngitis, hand-foot-mouth disease, myocarditis)

Front 31

What is the cytotoxin-associated gene that of H.pylori and what type of secretion system does it possess?

Back 31

The gene is Cytotoxin Associated Gene A (CagA) and the secretion system is a Type III secretion system.

Front 32

What type of heterotopic rest is more likely to cause bleeding in the small intestine: Gastric or Pancreatic?

Back 32

Gastric.

Front 33

What is the enzyme defect associated with Gilbert's disease?

Back 33

Gilbert's = Bilirubin glucuronyltransferase (bilirubin-UGT) deficiency. Signs and symptoms appear with stress such as fasting and infection. Leads to unconjugated bilirubinemia.

Front 34

What are the prominent findings in the liver and brain in a child that is diagnosed with Reye syndrome?

Back 34

Liver = microvesicular steatosis; Brain = edema. All cells in both tissues show MITOCHONDRIAL disruptions by electronmicroscopy.

Front 35

In what types of iron states do we see hemosiderin?

Back 35

Hemosiderin (this is a PIGMENT!)is seen in hemochromatosis and other conditions with increased hepatic iron stores.

Front 36

When do we see PAS positive stains?

Back 36

PAS positive stains are seen in alpha-1-antitripsin deficieny, and also when there is glycogen present in the tissue.

Front 37

What disease displays Rhodamine-positive granules in the liver or other tissues?

Back 37

These granules reflect copper accumulation in patients with Wilson's disease.

Front 38

This Colonic Polyp comprises 90% of all colonic polyps are is characterized microscopically by a SAWTOOTH glandular epithelium composed of proliferated goblet cells and columnar epilthelium. What is this polyp and does it have malignant potential?

Back 38

This is a Hyperplastic polyp that is most commonly found in the in the sigmoid colon or rectum and has no malignant potential.

Front 39

Tubular adenomas, tubulovillous adenomas, and villous adenomas of the colon are true neplastic polyps containing dyplastic epithelium. What are the most significant histological findings affecting the malignant potential of these polyps?

Back 39

The malignant potential of these polyps increases with SIZE, and the percentage of the polyp that has a VILLOUS CONFIGURATION.

Front 40

In Cirrhosis, what is the main connective tissue that makes up the bridging fibrosis?

Back 40

Fibrotic bands of collagen.

Front 41

What type of spread/transmission is uncommon for Shigella species?

Back 41

Spread through contaminated water is unusual for Shigella species.

Front 42

Epidemics of this bacterial GI infection have debilitated entire armies when there has been crowding and sanitation has been poor.

Back 42

Shigella species; shigellosis; dysentery

Front 43

What antibiotic may shorten the duration of shigellosis?

Back 43

TMP-SMX.

Front 44

This bacteria produces septicemia, causes wound infections, cellulitis, fasciitis, and myositis after exposure to seawater or after cleaning shellfish.

Back 44

Vibrio vulnificus. Anybody who is more prone to septicemia is more vulnerable to this infection. Fluid-filled blisters that progress to muscle necrosis, especially affecting the lower limbs.

Front 45

What are the number one and number two most common bacterial causes of diarrhea in the U.S.?

Back 45

Campylobacter and Salmonella.

Front 46

Describe the cellular morphology of V.vulnificus. What antibiotic is used to treat?

Back 46

Gram-negative, comma-shaped, oxidase-positive rods that are extremely sensitive to acid. Treat with Tetracycline, or 3rd Gen Cephalosporins.

Front 47

What histological picture can be expected in Necrotizing Enterocolitis in the newborn?

Back 47

A pseudomembrane composed of coagulated fibrin, neutrophils, and cellular debris overlying the mucosa.

Front 48

Is the occlusion of the gastroduodenal artery a problem for the stomach?

Back 48

No the stomach has a very rich anasomotic arterial supply that can tolerate the occlusion of the gastroduodenal artery.

Front 49

What part of the pancreas do Gastrinomas arise in?

Back 49

The non-endocrine portion of the pancreas.

Front 50

What is the name of the Enterotoxin that Staph aureus makes? Bacillus causes an enteritis that mimics that of Staph aureus, except Bacillus is usually associated with infected rice. Why?

Back 50

Enterotoxin A; Bacillus survives the boiling of the rice because it is a spore-former. It germinates as the rice cools (say overnight in an Asian household) and then it grows and elaborates an enterotoxin.

Front 51

Explain the trophic actions that Gastrin, CCK, and Secretin have on the GI tract.

Back 51

Gastrin can stimulate mucosal growth throughout the GI tract as well as the growth of the exocrine pancreas. CCK and Secretin only stimulate growth of the exocrine pancreas. None of the other hormones appears to have trophic activity.

Front 52

What is the anastomosis that allows blood flow to organs that are supplied by the celiac trunk, if the celiac trunk becomes blocked?

Back 52

The superior and inferior pancreatoduodenal arteries, which freely anastomose, effectively connectinf the superior mesenteric artery with the celiac trunk.

Front 53

What is the name of the parasite that you should associate with the bladder?

Back 53

Shistosoma haematobium.

Front 54

What are the names of the parasites that you should associate with the brain?

Back 54

Naegleria fowleri, Acanthomoeba, and Echinococcus granulosis.

Front 55

What are the names of the parasites that you should associate with the lungs?

Back 55

Dirofilaria and Paragonimus Westermani.

Front 56

Neuroendocrine tumors present with what chemical markers?

Back 56

Neuron-specific enolase, chromogranin, and synaptophysin.

Front 57

What tumors do you see alpha-fetoprotein in?

Back 57

Liver cancer cells and nonseminomatous germ cell tumors of the testis.

Front 58

What is endomesial antibody used in screening for?

Back 58

Celiac disease.

Front 59

Which tumors present with Smooth muscle actin staining?

Back 59

Leiomyomas and leiomyosarcomas.

Front 60

How does muscarinic activity of the M3 receptors affect blood vessels with intact endothelium vs. blood vessels denuded of endothelium?

Back 60

Blood vessels/intact endothelium with muscarinic agonist = VASODILATION!!!

Blood vessels denuded of endothelium with muscarinic agonist = VASOCONSTRICTION!!!

Front 61

What substances are chemotactic for neutrophils?

Back 61

IL-8, C5a, Leukotriene B4, Kalikrein, N-formyl-methonyl peptides from bacteria, and fibrinopeptides.

Front 62

Which cytokines mediate granuloma formation?

Back 62

IL-2 and Interferon Gamma.

Front 63

What immunologic deficiency leads to retained primary teeth, abscesses, coarse facies, increased IgE and eczema?

Back 63

JOB'S SYNDROME; Lack of IFN-y production by T-cells, and neutrophils fail to respond to chemotactic stimuli

Front 64

What is the only family of DNA viruses that does not require a host cell nucleus in order to complete their life cycle? Give a example from this family.

Back 64

Poxviruses are the only DNA viruses that complete their lifecycle in the cytoplasm of the host. Molluscum contagiosum virus is one of the poxviruses.

Front 65

Even though Orthomyxoviridae are RNA viruses, why do they require the host cell nucleus in order to replicate?

Back 65

This is because they use host cell mRNA molecules as a primer, and thus require the nucleus.

Front 66

Which bacteria is described as a Gram-negative pleomorphic rod requiring Factors X and V. What disease can this cause in children?

Back 66

This describes Haemophilus. It can cause otitis media and meningitis in unvaccinated children.

Front 67

What are common indicators for splenectomy treatment?

Back 67

Hereditary spherocytosis, thalassemia major, certain forms of immune thrombocytopenic purpura (ITP) unresponsive to medical managment, and Hodgkin disease.

Front 68

Which two sugars compete for binding to a secondary active transporter in the small intestine?

Back 68

Glucose and Galactose.

Front 69

What can interfere with a Xyulose absorption test for malabsorption?

Back 69

Pentose rich fluids.

Front 70

In a pregnant woman needing antibiotic therapy that would normally be treated with a tetracycline antibiotic such as Doxycycline, what are the two alternatives that you should use?

Back 70

Chloramphenicol, or a 3rd Generation Cephalosporin

Front 71

HIV patient presents with rash. Exam reveals a mixture of pinpoint and slightly larger bright red spots and nodules on the skin. Nodules are firm and do not blanch with pressure, but they bleed profusely when they are injured. Diagnosis?

Back 71

Bacilliary angiomatosis; Bartonella henslae; CD4+ count <200

Front 72

What is the test used to screen for maternal antibodies to Rh+ positive cells in maternal serum?

Back 72

The Indirect Coombs test.

Front 73

Is an indirect Coomb's test used for detecting antibodies in serum or antibodies bound to cell?

Back 73

Antibodies in serum. The Direct Coomb's test is used to detect antibodies bound to cells.

Front 74

What are direct fluorescent antibody tests used for?

Back 74

Used primarily in lab kits for detection of particular strains of microorganisms.

Front 75

What is an indirect fluorescent antibody test used for?

Back 75

This is a method for detecting antigens that is used sometimes in microbiology to detect parasites or fungi.

Front 76

What is the function of the gene product of the 11:22 translocation found in Ewing's sarcoma? What is the cell type origin of Ewing's?

Back 76

The 11:22 gene product is a member of the ETS family of transcription factors (usually FLT1). This protein acts as a constituitively active transcription factor that stimulate proliferation. Ewings sarcoma is of neural phenotype and characteristically involves bone.

Front 77

What is PNET?

Back 77

PNET is a childhood tumor that normally involves soft tissue and is a primitive neuroectodermal tumor (PNET)

Front 78

Name three tumor types in which cyclin dependent kinases are affected.

Back 78

Glioblastoma, melanoma, and sarcomas.

Front 79

Name seven examples of tumors in which growth factors are affected.

Back 79

Astrocytoma, Osteosarcoma, stomach cancer, bladder cancer, melanoma, hepatocellular carcinoma, and thyroid cancers.

Front 80

Name seven examples of tumors in which growth factor receptors are affected.

Back 80

These include squamous cell carcinoma of the lung, gliomas, breast cancers, ovarian cancers, leukemia, MEN 2a, Familial medullary thyroid carcinomas, and GI stromal tumors.

Front 81

Name 8 examples of tumors in which signal transducing proteins are affected.

Back 81

Colon, lung, pancreatic, bladder, kidney, melanoma tumors, hematologic malignancies, and hepatocellular carcinoma.

Front 82

Will damage to the anatomical neck, or the surgical neck of the humerus cause damage to the Axillary nerve?

Back 82

Damage to the surgical neck will injure the axillary nerve.

Front 83

Administration of what two Vitamin derivatives are absolutely contraindicated in pregnancy, and require a pregnancy test before dispensation?

Back 83

Vitamin A (Isoretinoin used for recalcitrant nodular acne) could lead to sever birth defects and Vitamin K which could lead increase the incidence of pregnancy related clotting disorders.

Front 84

What are the three key metabolic enzymes that involve Thiamine?

Back 84

Transketolase, AKDH, PDH.

Front 85

CAG triplet repeats of Huntigton's lead to what type of polymer?

Back 85

A polyglutamine peptide chain.

Front 86

CD3 is a marker for what type of cells? What is its function?

Back 86

Associated with T-cell receptor and is important for signal transduction.

Front 87

What signal transduction pathway does ANP stimulate?

Back 87

cGMP pathway.

Front 88

Buerger's disease is associated with patients that have what habit and what HLA types?

Back 88

Smokers with HLA-A9, and HLA-B5.

Front 89

What are clue cells? What is the whiff test? (Bacterial Vaginosis aka Gardnerella)

Back 89

Sloughed-off vaginal mucosal cells engulfed with Gram-negative bacilli of Gardinerlla vaginalis. The whiff test is the amine (FISHY) odor that is given off when vaginal fluids are treated with KOH.

Front 90

Bone abnormalities, B-glucocerebrosidase deficiency, glucocerebroside accumulation in macrophage, fibrillar cytoplasm that looks like wrinkled tissue paper.

Back 90

Gaucher disease.

Front 91

Monocyte nuclei shape?

Back 91

Shaped like a half moon.

Front 92

Plasma cell nuclei shape?

Back 92

Cart-wheel pattern that are located to one side of the cell.

Front 93

Cytotoxic T-cell nuclei shape?

Back 93

Rounded nuclei.

Front 94

What is the most important mechanism of inhibition in RDS of the infant?

Back 94

Decreased tidal volume due to increased elastic recoil, with reduced compliance because of a lack of surfactant. The reduced compliance causes a restrictive pattern of pulmonary disease.

Front 95

What muscle relaxant should not be given to children, or used with caution, because it can cause acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest and even death? What disease is this associated with?

Back 95

The muscle relaxant is Succinylcholine, and this has occurred when children who were subsequently found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne's.

Front 96

Boyscout or anyone returning home from camping trip with signs and symptoms of possible meningitis, and motile organisms in their spinal fluid aspirate?

Back 96

This eukaryotes like amoebas from FRESH WATER LAKES!!! aka Naegleria fowleri, or Acanthomoeba.

Front 97

70s ribosomes, polycistronic mRNA, and peptidoglycan are all characteristics of eukaryotes or prokaryotes?

Back 97

PROKARYOTES!!!

Front 98

Weakness, fatigue, abdominal pain, nausea, low BP with prominent orthostatic changes (all CLASSIC SYMPTOMS for what?), and positive PPD?

Back 98

Miliary TB of the adrenal medulla and secondary Addison's disease.

Front 99

What are the three muscles intrinsic to the thenar eminence?

Back 99

Abductor pollicis brevis, the flexor pollicis brevis, and the opponens pollicis.

Front 100

Which serotype of Neisseria is not included in the vaccine against meningitis and why?

Back 100

Serotype B (50% of infections in U.S.) is not included in the vaccine because the marker involves sialic acid, which is non-immunogenic. The serotypes that are covered by the vaccine are types A,C,W-135 and Y.

Front 101

dsDNA virus that has a complex lipid envelop?

Back 101

Poxviridae = small pox and molluscum contagiosum virus

Front 102

What is herpangina and what causes it?

Back 102

This manifests with lesions in the rear of the mouth on the palate and fauces. Coxsackie virus is responsible for this.

Front 103

Positive-sense ssRNA virus that is non-segmented and naked infecting orally. Family?

Back 103

Picornaviruses

Front 104

Bulbar dysfunction (involvement) causing poor sucking, reduced swallowing, and respiratory failure. Muscle weakness, loss of deep tendon reflexes, loss of voluntary movement fasciculations, fibrillation potentials on EMG. A baby or child presenting with these signs and symptoms has what?

Back 104

INFANTILE SPINAL MUSCLE ATROPHY!!! with autosomal recessive inheritance. ANTERIOR HORN CELL DEGENERATION with LMN INVOLVEMENT ONLY. ***Abnormality in gene that "TURNS-OFF" perinatal programmed cell death***

Front 105

Type II hypersensitivity such as maternal antibodies against Rh antigen can also be referred to as what type of a disease?

Back 105

Cytotoxic disease.

Front 106

What is the difference in M3 receptor stimulation of the bronchiolar smooth muscle vs. the vascular smooth muscle with intact endothelium?

Back 106

M3 stimulation constricts bronchiolar smooth muscle and relaxes vascular smooth muscle with intact endothelium.

Front 107

Sickling of HbS occurs in what part of the kidney and in which structures?

Back 107

This occurs in the medulla in the Vasa Recta (peritubular capillaries). The hypoxia and very high osmolarity in the renal medulla favor this sickling.

Front 108

Libman-Sacks Endocarditis (LSE) affects patients with what disease?

Back 108

SLE; mitral valve and aortic valve are most commonly involved.

Front 109

Myocardial fibrosis (which may cause arrhythmias) is a complication of what autoimmune disease (*antitopoisomerase)?

Back 109

Systemic Sclerosis (antitopoisomerase)

Front 110

What is the difference in presentation of the ST segment on ECG in the event of a Transmural infarct versus a Subendocardial infarct?

Back 110

Transmural inarct = ST segment elevation

Subendocardial infarct = ST segment depression

Front 111

Who mostly get femoral hernias and what structure do these hernias pass below?

Back 111

Women usually get femoral hernias and they usually pass below the inguinal ligament.

Front 112

Homologous recombination (any process that signifies integration into the bacterial genome) in a bacterium requires the presence of what gene?

Back 112

recA, (or recombinase A enzyme).

Front 113

How does major depressive disorder affect sleep stages?

Back 113

Patients with MDD have increased REM sleep. They usually exhibit decreased REM latency and decreased stage 4(deep) sleep.

Front 114

Rupturing pustule followed by an ulcer with involvement of the regional lymphnodes. Bacteremia, splenomegaly, rash, atypical pneumonia, endotoxic shock. infection from ticks that feed on wild rabbit and deer blood or handling these furs.

Back 114

Francisella tularensis. Treatment is Streptomycin.

Front 115

Infection: Relapsing fever after hiking in the woods.

Back 115

Borrelia burgdorferi; Lyme disease.

Front 116

Infection: Contaminated milk or contact with livestock.

Back 116

Brucella.

Front 117

Infection: Weil disease; organism acquired by ingestion of water that is contaminated with animal urine.

Back 117

Leptospira.

Front 118

What cells and immune components are found in the lesions of Dermatitis herpatiformis? How do you treat?

Back 118

Neutrophils and Granular deposits of IgA and C3. Treatment with Dapsone (antimycobacterial) which is thought to have inhibitory action on myeloperoxidase.

Front 119

LARGE TENSE blisters of the trunk, extremities, INTERTRIGINOUS AREAs, oral cavity (less common). Elderly patient (derm problem)?

Back 119

Bullous pemphigoid.

Front 120

Disease of the elderly that causes large, FLACCID BULLAE and shows prominent oral involvement!!!

Back 120

Pemigus vulgaris.

Front 121

Which passage of the CSF may be blocked and not produce hydrocephalus?

Back 121

The Formen of Luschka (pick magendie if luschka is not offered)

Front 122

Gram-negative pleomorphic rod with POLYRIBITOL capsule. Child meningitis.

Back 122

Haemophilus influenzae Type B

Front 123

Motile Gram-positive rod.

Back 123

Listeria.

Front 124

Bluberry mufin babies with multiple petechia, ecchymoses, macules, papules, and plaques.

Back 124

Congenital CMV infection.

Front 125

Infections that cause Erythema multiforme?

Back 125

HSV, Enteroviruses, Mycoplasma, Chlamydia, HIstoplasmosis.

Front 126

Drugs that cause Erythema multiforme?

Back 126

Penicillin, sulfonamides, phenytoin, aspirin, corticosteroids, cimetidine, allopurinol, oral contraceptives.

Front 127

Neoplasia that cause Erythema multiforme?

Back 127

Leukemia, lymphoma, multiple myeloma and *sarcoidosis

Front 128

Foods that cause Erythema multiforme?

Back 128

Emulsifiers in margarine.

Front 129

Targetoid lesions of Erythema Multiforme caused by what type of hypersensitivity?

Back 129

Type III immune complex deposition.

Front 130

Erythema infectiosum, sickle-cell aplastic anemia, hydrops fetalis, stillbirth. Viral infection?

Back 130

Parvo B19.

Front 131

Gram-positive, beta hemolytic cocci that can ferment mannitol and is salt resistant.

Back 131

Staph aureus.

Front 132

A Ristocetin positive test tells you what about bleeding abnormalities?

Back 132

The patient has Von Willebrand disease.

Front 133

THROMBOCYTOPENIA, GIANT PLATELETS, and increased bleeding: nose bleeds, mucosal bleeding, easy bruising, and GI bleeding.

Back 133

BERNARD SOULIER syndrome, which is a defect in GLYCOPROTEIN I(B) RECEPTOR.

Front 134

AA amyloid is associated with what type of disease?

Back 134

This is secondary amyloidosis (serum associated amyloid-SAA) protein and it is associated with autoimmune disease and chronic infection. SAA is an acute-phase reactant

Front 135

AB2M (Beta-2 microglobulin) amyloid is associated with what chronic medical treatment?

Back 135

Long-term hemodialysis; this amyloid depositis in musculoskeletal areas.

Front 136

AL amyloid is a primary amyloidosis associated with deposition where?

Back 136

These are light chain amyloids that deposit systemically, usually in the heart and the kidney (e.g. bence-jones proteins)

Front 137

ATTR (Transthyretin) is a primary amyloidosis protein associated with deposition where?

Back 137

This is mostly associated with cardiac deposition.

Front 138

The CFTR channel is gated by hydrolysis of what molecule? What protein regulates this channel?

Back 138

The CFTR is an ion channel that allows Cl- flow down its concentration gradient. It is gated by ATP-hydrolysis and involves regulation by PKA (Protein Kinase A phosphorylation).

Front 139

How is diagnosis of cystic fibrosis confirmed in the lab?

Back 139

With the use of DNA probes.

Front 140

Which nerve innervates all of the interosseus muscles?

Back 140

The ulnar nerve.

Front 141

t(4;11)(q21;q23)

Back 141

ALL.

Front 142

The bacteria that causes swimming pool or fish tank granuloma?

Back 142

Mycobacterium marinum.

Front 143

If an HIV patient is infected with Mycobacterium avium what is their T-cell count?

Back 143

<60 CD4+ cells

Front 144

If an HIV patient is infected with Mycobacterium tuberculosis (most common cause of atypical pneumonnia in AIDS patients) what is their T-cell count?

Back 144

>400 CD4+ count

Front 145

Diffuse axonal injury is seen after what type of trauma?

Back 145

It is specifically damaging to white matter secondary to acceleration/deceleration injury.

Front 146

Opthalmopelgia, psuedobulbar palsy, axial dystonia, and bradykinesia. Widespread neuronal loss and gliosis in subcortical areas. Sparing of cerebral and cerebellar cortices.

Back 146

Progressive Supranuclear Palsy.

Front 147

What is the tissue origin of a carotid body tumor? What NTs do the cells produce? What climates are these more common in?

Back 147

Carotid body tumor is a paraganglioma originating from the carotid body. It is similar to a pheocromocytoma and secretes chatecholamines including norepi, and dopamine. This is found more commonly in people living at high altitude (e.g. Peru) due to physiologic hyperplasia of the carotid body.

Front 148

The middle meningeal artery enters the middle cranial fossa through what opening?

Back 148

The foramen spinosum.

Front 149

The Olfactory nerve enters the anterior cranial fossa via what opening?

Back 149

The cribiform plate of the ethmoid bone.

Front 150

The opthalmic vein, nerve, and all of the cranial nerves of the eye (CN III, IV, VI) except CN II (Optic nerve) pass through what opening in the skull?

Back 150

The Superior Orbital Fissure.

Front 151

What passes through the optic canal?

Back 151

The Optic nerve (CN II) an the opthalmic artery.

Front 152

Through what opening does the maxillary nerve pass through in the skull?

Back 152

The Foramen Rotundum.

Front 153

The Foramen ovale of the skull transmits what nerve?

Back 153

The Mandibular nerve.

Front 154

The internal auditory meatus of the skull transmits which nerves?

Back 154

CN VII and VIII.

Front 155

Which CN's go through the Jugular foramen?

Back 155

IX, X, and XI.

Front 156

The Hypoglossal nerve travels through which canal?

Back 156

The Hypoglossal canal

Front 157

The foramen magnum transmits what structures?

Back 157

The Spinal cord, vertebral arteries, and CN XI.

Front 158

What are the molecules that inhibit the fusion of the phagosome and the lysosome and allow M.tuberculosis to survive inside of macrophages?

Back 158

Sulfatides, which are sulfalipids that are hydrolyzed to form sulfuric acid.

Front 159

What is the surface protein of M.tuberculosis which is used to elicit the delayed-type hypersensitivity skin test (Mantoux test)?

Back 159

Tuberculin.

Front 160

What bacterium is an Auramine-Rhodamine stain used for?

Back 160

Mycobacterium.

Front 161

Does central retinal artery occulsion produce painful or painless loss of vision?

Back 161

It produces sudden unilateral painless visual loss.

Front 162

CD 21 protein is a complement receptor to which EBV envelope protein can bind. What cell type is this found on?

Back 162

B cells.

Front 163

What two viruses infect oligodendrocytes?

Back 163

JC Papovavirus (progressive multifocal leukencephalopathy), and Measels virus (Subacute sclerosing panencephalitis)

Front 164

What is the macrophage receptor used for Early Infection by the HIV virus? What is the receptor used for late infection and what cell type is it on?

Back 164

Macrophage-CCR5-early infection.

T-lymphocyte-CXCR4-late infection.

(*Follicular dendritic cells may trap virions with Fc receptor for immunoglobulin)

Front 165

CT scan shows a well circumscribed cystic lesion in the 3rd ventricle with no calcium deposition. Histologic examination shows that the wall of the cyst consists of a single layer of MUCIN-producing columnar epithelium with CILIATED apical surface. The cyst contains mucinous fluid. Diagnosis?

Back 165

Colloid cyst

Front 166

Describe the unusual lining of the cyst that develops in the brain or abdominal cavity following ingestion of Tenia solium.

Back 166

The lining of a cystecercus consists of three cell layer, the most superficial of which resembles the dome-shaped urothelial cells of the bladder.

Front 167

Hook like projection called a scolices makes you think of what (scolices detached from the wall, accumulating within the cyst and producing SANDLIKE sediment) (LIVER and LUNGS are favorite spots)?

Back 167

Echinococcus granulosus.

Front 168

Cerebellar hemisphere or 3rd ventricle cyst. Elongated astrocytes with abundant fibrillary background. Numerous Rosenthal fibers. The wall of the cystic component is composed of glial (astrocytic) cells, usually of a reactive nature. Diagnosis?

Back 168

Pilocytic astocytoma.

Front 169

Colloid cysts are what type of misplaced tissue?

Back 169

Misplaced embryonic endodermal epithelium.

Front 170

Trauma to muscle that heals with fibroblastic proliferation that then ossifies even though there is no connection to bone. X-ray shows flocculent radiodensities surrounding a radiolucent center. This can resemble osteosarcoma of the elderly. Diagnosis?

Back 170

Myositis Ossificans.

Front 171

Streptococcus bovis and endocarditis are associated with what maligancy?

Back 171

Carcinoma of the colon and other colon diseases.

Front 172

Group D streptococci are distinguished by having a cell wall carbohydrate composed of what?

Back 172

Glycerol Teichoic acid!

Front 173

Which Strep species is non-groupable because is does not have a C cell wall carbohydrate?

Back 173

Strep pneumoniae.

Front 174

List the problems associated with Trisomy 21.

Back 174

ALL, AML; Elpilepsy; Atlantoaxial dislocation; cardiac malfomations of all types; duodenal atresia and imperforate anus; autoimmune hypothyroidism; visual problems; Alzheimer's disease.

Front 175

Women going through menopause have high levels of GnRH, FSH, and LH due to loss of feedback inhibition from estrogen. Which hormone is responsible for hot flashes?

Back 175

LH is responsible for hotflashes.

Front 176

Prealbumin; thyroxine and retinol transporter; senile cardiac amyloidosis; familial amyloid polyneuropathies.

Back 176

ATTR (Transerythretin)

Front 177

Blood culture negative endocarditis (queer); patient with preexisting valvular disease; Duke's criteria (people are queer at DUKE); splenomegaly (queer); digital clubbing (queer); purpuric rash (or none- queer); microscopic hematuria; emboli (queer); diagnosis made via serological testing with microimmunofluorescent test for what organism?

Back 177

Coxiella producing Q-Fever endocarditis.

Front 178

Sudden onset of loss of vision or blackspots in the visual field without the onset of pain. Diagnosis?

Back 178

Amaurosis fugax- microemboli entering the opthalmic artery.

Front 179

Tripolar mitoses are due to what abnormality and signify what condition?

Back 179

They are due to abnormalities of the mitotic spindle and they indicate malignant disease.

Front 180

The superior laryngeal artery is accompanied by what nerve? What does this nerve innervate?

Back 180

It is accompanied by the internal branch of the superior laryngeal nerve, which will provide sensation in the laryngeal mucosa above the vocal folds.

Front 181

The laryngeal mucosa below the mucosal folds receives sensory innervation from which nerve? Ligation of this nerve also results in the paralysis of the lateral cricothyroid muscle.

Back 181

The recurrent laryngeal nerve

Front 182

Which nerve supplies the sensory innervation of the pharyngeal mucosa?

Back 182

The Glossopharyngeal nerve (CN IX).

Front 183

Which nerve supplies the motor function of the cricothyroid muscle?

Back 183

This gets motor function from the external branch of the superior laryngeal nerve.

Front 184

What are the two main causes of schistocytes in a peripheral blood, which are found most commonly in Microangiopathic Hemolytic Anemias?

Back 184

DIC and Prosthetic valves.

Front 185

Repeated passive immunity with antibodies from another host can lead to what type of hypersensitivity reaction?

Back 185

Type III Hypersensitivity.

Front 186

Anti-ribonuclear protein (or Anti-RNP) is found in what musculoskeletal disease?

Back 186

Mixed connective tissue disease.

Front 187

Anti-RAP is a marker for what musculoskeletal disease?

Back 187

Anti-RAP.

Front 188

Anti-Pol-I antibody is found in what musculoskeletal disease?

Back 188

Scleroderma, along with anti-topoisomerase (anti-Scl-70)

Front 189

Pharyngoconjunctivitis, in children from a swimming pool. Diagnosis?

Back 189

Adenovirus.

Front 190

Describe the conditions that are most commonly associated with the development of Benign associated Acanthosis Nigracans (accounts for 80% of cases-develops gradually and usually occurs in childhood and during puberty).

Back 190

It may be an autosomal dominant trait with variable penetrance, or found in association with obesity, or endocrine abnormalities (particularly with pituitary and pineal tumors and with diabetes), or also as a part of a number of rare congenital syndromes.

Front 191

What is the mechanism by which Seborrheic keratoses and Aconthosis Nigracans may result from association with underlying tumors or malignancies (found in middle aged and older individuals)?

Back 191

In these situations these findings are produced due to the abnormal production of epidermal growth promoting factors released by a variety of tumors.

Front 192

What is the most common association of Acanthosis Nigracans and malignancy?

Back 192

Most commonly associated with underlying gastrointestinal carcinoma.

Front 193

Diagnose this description: epidermis and underlying enlarged dermal papillae undulate sharply to form numerous repeating peaks and valleys. Variable hyperplasia may be seen, along with hyperkeratosis and slight basal cell layer hyperpigmentaion.

Back 193

Acanthosis Nigracans.

Front 194

Trisomy disorder associated with severe mental retardation, abnormal forebrain structures, polydactyly, sever CNS problems (arhinencephaly and holoprosencephaly), sloping forehead, microphthalmia, cleft lip and cleft palate, and death within one year.

Back 194

Patau syndrome, or Trisomy 13.

Front 195

Trisomy syndrome characterized by sever mental retardation, rocker bottom feet (which could also be seen in another trisomy!!! so beware), low-set ears, micrognathia, clenched hands, prominent occiput, and death within one year?

Back 195

Edwards syndrome, Trisomy 18.

Front 196

What are cold agglutinins usually triggered by?

Back 196

Mycoplasma pneumoniae infection, or Lymphomas.

Front 197

What is Ecthyma gangrenosum and what organism causes this?

Back 197

This is the name of the characterstic lesion that occurs during Pseudommonas septicemias. It has a black, necrotic center and a raised hemorrhagic ring outside.

Front 198

Traumatic wounds through shoe bottoms in persons wearing sneakers or rubber-soled shoes puts that person at increased risk for infection with what organism?

Back 198

Pseudomonas.

Front 199

This disease forms crystals and often affects knees, wrists, elbows, shoulders, or ankles.

Back 199

Pseudogout, where crystals are formed of calcium pyrophosphate dihydrate (CPPD), which are radiologically dense.

Front 200

In this disease crystals are formed of calcium pyrophosphate dihydrate (CPPD), which are radiologically dense. If the patient is asymptomatic because the deposition is primarily within cartilage, the condition is sometimes called chondrocalcinosis.

Back 200

This describes Pseudogout.

Front 201

What are two substances that limit the absorption of Quinolones?

Back 201

Iron and Calcium. Therefore Fluoroquinolone antibiotics should not be taken with Iron supplements, Calcium supplements, or Antacids.

Front 202

Describe the etiology of Paget disease (Osteitis deformans).

Back 202

Paramyxoviruses (measels and RSV) infect osteoclasts in bone. Thus affected bone is thickened and coarse, with disorderly osteoblastic and osteoclasttic activity.

Front 203

This is a chronic disorder that primarily affects elderly males and results in enlarged and deformed bones. Patients present with enlargement of the head and chronic pain. Radiologic findings plus elevated alkaline phosphatase levels are suggestive diagnosis.

Back 203

Paget's disease (Osteitis deformans)

Front 204

What specific enzyme is elevated in patients with Sarcoidosis?

Back 204

ACE is elevated in 60% of patients with Sarcoidosis.

Front 205

What professions could put someone at risk for Berylliosis? What some of the symptoms of the disease?

Back 205

Exposure to beryllium occurs in occupations associated with metal, ceramics, and nuclear weapons. To be diagnosed with Berylliosis the patient must have a history of beryllium exposure, a positive beryllium lymphocyt proliferation test on bronchoalveolar lavage, and noncaseating pulmonary granulomas on lung biopsy.

Front 206

Berylliosis can mimic what disease?

Back 206

It can mimic sarcoidosis with Type IV hypersensitivity leading to granuloma formation, dry cough, shortness of breath, fatigue, weight loss, and cutaneous nodules. Chest X-ray shows hilar lymphadenopathy.

Front 207

A fibroblast growth factor receptor deficiency describes what disease?

Back 207

Achondroplasia.

Front 208

How do you make a diagnosis of Primary Syphilis?

Back 208

Darkfield or fluorescent microscopy of the lesion. 50-60% of patients will be negative by nonspecific serology.

Front 209

Diffuse maculopapular rash (copper or bronze colored), including the palms and soles, patchy alopecia. Condylomata lata (flat wartlike perianal and mucous membrane lesions). Diagnosis?

Back 209

Secondary Syphilis. Serologic nonspecific and specific test are both positive.

Front 210

Stillbirth, keratitis; 8th nerve damage, notched teeth; most born asymptomatic or with rhinitis --> widespread desquamating maculopapular rash. Diagnosis?

Back 210

Congenital Syphilis.

Front 211

Brachial plexus derivation of the Ulnar Nerve?

Back 211

Derived from the Medial Cord (C8,T1).

Front 212

Brachial plexus derivation of the Musculocutaneous Nerve?

Back 212

Derived from the Lateral Cord (C5,6,7)

Front 213

Brachial plexus derivation of the Axillary and Radial Nerves?

Back 213

Both are derived from the Posterior Cord (supplied by the posterior branches of C5-T1).

Front 214

Brachial plexus derivation of the Median Nerve?

Back 214

The Medial and Lateral cords give rise to the median nerve (C5-T1).

Front 215

Brachial plexus derivation of the Suprascapular Nerve?

Back 215

Superior branch (C5,6)

Front 216

Brachial plexus derivation of the Long Thoracic Nerve?

Back 216

C5,6, and 7 give you winged scapula that gets you to heaven.

Front 217

What is the intrinsic muscle of the thumb is responsible for adduction and is supplied by the ulnar nerve?

Back 217

Adductor Pollicis, which is supplied by the ulnar nerve, which is derived from the Medial cord of the brachial plexus.

Front 218

Angiomyolipoma is associated with what?

Back 218

Tuberous sclerosis.

Front 219

Peutz-Jeghers syndrome is associated with an increased potential to develop carcinomas of what?

Back 219

The pancreas, colon, stomach, small intestine, breast, ovary, uterus, cervix, and lung.

Front 220

Which cytokine instructs the macrophages of granulomas to become epitheliod and multinucleated giant cells?

Back 220

Interferon-gamma.

Front 221

Vasculitis symptoms, Eosinophilia!!!, Asthma!!!; variant of polyarteritis nodosa; sometimes there are granulomas; p-ANCA; abdominal and GI pain that could be associated with vasculitis; chronic maculopapular skin rash; rhinitis. Diagnosis?

Back 221

Churg-Strauss.

Front 222

What condition follows the overly rapid correction of sever hyponatremia? What parts of the brain are involved? *Symptoms include rapidly evolving para- or quadraparesis, ofteen accompanied by pseudobulbar symptoms such as dysarthria or dysphagia.

Back 222

Central Pontine Myelinosis. The lesions usually specifically involves the basis pontis and portions of the pontine tegmentum.

Front 223

This is a syndrome with the combination of precocious sexual development, irregularly shaped ("coast of maine") pigmented skin macules, and Polyostotic Fibrous Dysplasia. This latter condition is characterized by local bony defects containing unmineralized whorls of connective tissue.

Back 223

These are the symptoms of McCune-Albright syndrome.

Front 224

This condition is characterized by local bony defects containing unmineralized whorls of connective tissue and is associated with McCune-Albright syndrome.

Back 224

This is Polyostotic Fibrous Dysplasia.

Front 225

Hypertrophic osteoarthropathy (formation of new bone beneath periosteum of the phalanges) is associated with what diseases?

Back 225

Thoracic cancer, chronic lung disease, and chronic liver disease.

Front 226

Precocious puberty, cafe au lait spots, fibrous dysplasia characterized by multiple localized whorls of connective tissue. Diagnosis?

Back 226

McCune-Albright syndrome.

Front 227

X-linked recessive disorder (male family history) presenting with triad of thrombocytopenia (epistaxis), skin rash (eczema), and recurrent sinopulmonary infections. Serum IgM levels are low, but IgG, IgA, and IgE levels are increased. Diagnosis? Etiology?

Back 227

Wiskott-Aldrich syndrome, due to CYTOSKELETAL DEFECT in T-CELLS that inhibits their binding to B-cells. Patients thus have DEFECTIVE RESPONSES to POLYSACCHARIDE antigens.

Front 228

Ataxia telangectasia is associated with what type of enzyme deficiency?

Back 228

DNA repair enzyme deficiency.

Front 229

Testosterone issues with anosmia. Diagnosis?

Back 229

Kallman syndrome. Hypothalamic dysfunction.

Front 230

Sublingual gland --> Submandibular gland --> Parotid Gland?

Back 230

Pure Mucous --> Mucous Serous Mixed --> Pure Serous

Front 231

bcr-abl Philadelphia chromosome protein has what kind of activity?

Back 231

Tyrosine kinase activity.

Front 232

CLL has increased cells of what type?

Back 232

Lymphocytes.

Front 233

CML has increased cells of what type?

Back 233

Neutrophils and Metamyelocytes; lesser numbers of eosinophils and basophils; small number of blasts.

Front 234

For a chart of the holes in the skull go to test #41 question #28

Back 234

For a chart of the holes in the skull go to test #41 question #28

Front 235

Helminth autoinfection is only possible with which two species of worms?

Back 235

Strongyloides stercoralis (the threadworm), and Taenia solium (the pork tapeworm).

Front 236

Does the BCG vaccine protect you against TB?

Back 236

NO!!! It is used to prevent the sequelae of TB like pericarditis and meningitis, but patients may still acquire TB.

Front 237

Hemibalismus is due to a lesion in what part of the brain?

Back 237

In the Subthalamic Nucleus.

Front 238

What is the most common cause of bronchiolitis and pneumonia in children under 1 year?

Back 238

RSV; Paramyxo family = Negative sense, single stranded RNA, nonsegmented, helical, enveloped virus.

Front 239

Lewy bodies are intracytoplasmic eosinophilic inclusions that contain what type of proteins?

Back 239

Lewy bodies contain alpha-synuclein and UBIQUITIN!!!

Front 240

What signs and symptoms are particular to Diffuse Lewy Body disease?

Back 240

The presence of extrapyramidal symptoms and visual hallucinations, as well as an undulating clinical course. It involves the limbic cortex, basal nucleus of Meynert and the substantia nigra

Front 241

What type of cells are seen in the histology of xanthomas?

Back 241

Xanthomas are tumor-like dermal collections of faomy histiocytes containing cholesterol and lipids. The lesions may also contain multinucleated giant cells (Touton giant cells) with clustered nuclei and foamy cytoplasm. Xanthomas may be related to hyperlipidemia or lymphoproliferative malignancies (e.g. lymphomas and leukemias)

Front 242

What are Munro microabscesses, when do we see them, and what is in them?

Back 242

Munro microabscesses are small collections of neutrophils in the cornified epidermis, of Psoriasis.

Front 243

There is a specific association between maternal diabetes and what cardiac abnormalitiy? What about in the sacrum?

Back 243

Maternal diabetes = transposition of great vessels and Sacral regression syndrome.

Front 244

Why might you see glucose in the urine of pregnant women?

Back 244

Because there is a lowered threshold on glucose reabsorption during pregnancy.

Front 245

What is the most common cause of sudden cardiac death in the U.S.?

Back 245

Ischemic heart disease due to atherosclerosis of the coronary arteries and creation of arrhythmias in areas of ischemia.

Front 246

List the major criteria for the diagnosis of rheumatic fever (Type II hypersensitivity).

Back 246

Pancarditis, arthritis, subcutaneous nodules, chorea, and erythema marginatum.

Front 247

Increased susceptibility to infections and hypocalcemia at birth. Diagnosis?

Back 247

DiGeorge syndrome. (3rd and 4th pharyngeal pouch problem). They have an absent thymus and so are unable to complete T-cell maturation.

Front 248

What are the skin appendages that contain epidermal stem cells and contribute to regeneration of epithelium of full thickness epidermis abraded skin?

Back 248

Hair follicles and sweat glands in the epidermis.

Front 249

Microvilli are extensions of what types of cytoskeletal proteins?

Back 249

Actin fliaments, or microfilaments.

Front 250

Biopsy of the small intestine in a neonate with congenital microvillus atrophy would reveal striking lessening of what types of cytoskeletal proteins?

Back 250

Myosin bands, suggesting abnormal binding of the myosin to the actin cable.

Front 251

Name the cancers that most commonly present with Trousseau's sign (migratory thrombophlebitis).

Back 251

Pancreatic cancer (traditionally), but also with other adenocarcinomas, such as lung cancer, colon cancers, and gastric cancer.

Front 252

L-myc is associated with what cancer?

Back 252

Small cell carcinoma of the LUNG.

Front 253

Which viruses are non-infectious as naked nucleic acid because they are required to carry their own unique enzymes, and thus would make good composite viruses, and controlled infections?

Back 253

Negative-sense RNA viruses, Poxviridae, and Retroviruses.

Front 254

Which cells possess CD14 (the endotoxin receptor)?

Back 254

Macrophages (aka Epithelioid cells).

Front 255

CD56 is present on what type of cells?

Back 255

Natural Killer cells.

Front 256

What are the most numerous types of cells stimulated in a Type IV hypersensitivity reaction?

Back 256

Macrophages.

Front 257

How is neonatal meningitis with Group B Strep prevented?

Back 257

Ampicillin is given I.V. to the mother during labor.

Front 258

There are two types of IgA: IgA1 and IgA2. Which type predominates in the serum and which type predominates in mucosal secretions?

Back 258

IgA Type 1 predominates in the serum; IgA Type 2 (Dimer) predominates in the mucosal secretions.

Front 259

IgA is a dimer with a secretory component held together by what? What adds the secretory component?

Back 259

The J chain. The secretory component is added by mucosal cells as it is transported into the lumen of the organ system.

Front 260

What is the most common of all the primary immunodeficiency diseases?

Back 260

Selective IgA deficiency.

Front 261

Which immunoglobulin is the receptor on mature, but naive B lymphocytes?

Back 261

IgD (CRAZY!!!!)

Front 262

Which immunoglobulin is it that mediates antibody-dependent, cell-mediated cytotoxicity?

Back 262

IgG; IgG molecules bind the Fc receptor of NK cells, neutrophils, and macrophages.

Front 263

ST-segment elevation occurs with what cardiac insults?

Back 263

Transmural infarction, Prinzmetal's variant anginal, Pericarditis.

Front 264

ST-segment depression occurs with which cardiac insults?

Back 264

Exertional angina, Unstable angina, and Subendocardial infarction.

Front 265

Angina that can improve when the patient gets up and moves around or possibly with Nitroglycerin.

Back 265

Prinzmetal variant angina.

Front 266

In initiating a reflex arc, which structure sense tension within the muscle and produces inhibitory feedback to relieve the tension so that the reflex may take place?

Back 266

The Golgi tendon apparatus produces inhibitory feedback to alpha motor neurons to relieve tension.

Front 267

Which cells are responsible for carrying efferent motor impulses in a reflex arc in response to afferent information from intrafusal fiber stretch via the 1a nerves?

Back 267

Alpha motor neurons.

Front 268

Which muscle fibers sense muscle length and produce afferent impulses via the 1a fibers that stimulate alpha motor neurons and muscle contraction is response to stretch.

Back 268

The Intrafusal muscle fibers.

Front 269

Which type of muscle fibers are responsible for constituting the bulk of the contracting muscle belly, and produce muscle tension?

Back 269

Extrafusal fibers.

Front 270

Estrogen increases the synthesis of what coagulation factor?

Back 270

Factor VIII.

Front 271

Why does von Willebrand disease present increased PTT, and bleeding time, but normal PT?

Back 271

Because it is a combined coagulation factor (Factor VIII) and platelet disorder.

Front 272

What is the trinucleotide sequence that is expanded in Friedreich's ataxia? How is this disease inherited and what makes it unique?

Back 272

Friedreich's is the expansion of GAA, with defects in the frataxin gene. Friedreich's ataxia is unique because it is the first known recessive genetic disease that is caused by a trinucleotide repeat expansion; most are autosomal dominant. It affects both UMN and LMN.

Front 273

Genetic disease associated with cataracts and heart conduction defect. Chronic, slowly progressive multisystem disease primarily characterized by muscle wasting. Sensory findings clearly suggest neurologic rather than musculoskeletal process. Diagnosis?

Back 273

Myotonic dystrophy.

Front 274

Autoantibodies directed against transmembrane cadherin adhesion molecules induces acantholysis (breakdown of cell-cell connections) with resulting intraepidermal blister formation. Diagnosis?

Back 274

Pemigus vulgaris.

Front 275

Prominent oral ulcers (containing IgG and C3), uncomfortable skin erosions from ruptured blisters. More common in those with Mediterranean or Jewish heritage. The epidermis at the edge of the erosions is easily disrupted by sliding pressure (Nikolsky sign). Diagnosis?

Back 275

Pemphigus vulgaris.

Front 276

How is the diagnosis of Pemphigus vulgaris confirmed and what is the mortality rate associated with the condition?

Back 276

Diagnosis is confirmed when biopsy with immunofluorescent studies demonstrates intraepithelial IgG and C3. Treatment involves long-term corticosteroid use, which contributes to the overall 5-15% mortality for the condition.

Front 277

How is Tuberous sclerosis inherited?

Back 277

Autosomal Dominant.

Front 278

What other conditions should you associated meningiomas with?

Back 278

Breast cancer and possible, high estrogen states.

Front 279

What brain and heart lesions are people with Tuberous sclerosis at risk for?

Back 279

Astrocytomas and Cardiac rhabdomyomas (probably actually skeletal muscle harmartomas).

Front 280

What differentiate FAB M1-M7

Back 280

M1- myeloblasts
M2- myeloblasts and promyelocytes
M3- promyelocytes and auer rods
M4- promonocytes and monocytes
M5- monocytes (detected with CDs or esterase reaction)
M6- erythroblasts
M7- megakaryoblasts

Front 281

Endocardial cushion defects of Down syndrome are due to what?

Back 281

Inadequate migration of neural crest cells.

Front 282

Coarctation of the aorta in Turner syndrome is due to what?

Back 282

Ectopic ductal tissue.

Front 283

What is the most common reason for atrial septal defects found in the general population?

Back 283

Inadequate septum secundum.

Front 284

What is the mechanism of development of Tetralogy of Fallot?

Back 284

This is cause by a failure of the AP septum to align.

Front 285

Testicle tumor with endodermal tissue that resembles primitive glomeruli (cytoplasmic eosinophilic granules that stain for alpha-fetoprotein and alpha-1-antitrypsin)?

Back 285

Yolk-sac tumor.

Front 286

Placental alkaline phosphatase means what testicle tumor?

Back 286

Seminoma.

Front 287

CD28 and B7?

Back 287

These are complementary molecules expressed on T cells and antigen presenting cells that play a role in T cell activation.

Front 288

What is LFA-1 integrin (CD18)? What does it bind to? Why does it do it?

Back 288

LFA-1 is responsible for strong binding between monocytes, T lymphocytes, macrophages, neutrophils, dendritic cells, and injured endothelium, as well as eachother. It interacts with Intracellular Adhesion Molecule (ICAM)-1. This interaction causes the strong adhesion necessary to promote diapedesis into the area of acute inflammation.

Front 289

Honey crusted impetigo vs. blister-like impetigo?

Back 289

Strep vs. Staph.

Front 290

What is the only normal derivative of the embryonic notochord that is still found in adults?

Back 290

The nucleus pulposis of the intervertebral disks.

Front 291

A Sacrococcygeal teratoma is a tumor that arises from what part of the epiblast?

Back 291

The primitive streak, which allows the cells to pass through that give rise to the notochord and the mesoderm.

Front 292

Arthoconidia and spherules?

Back 292

Coccidioides immitis.

Front 293

Monomorphic, ENCAPSULATED yeast?

Back 293

Cryptococcus; pigeon

Front 294

Which zone of the of the liver lobule contains P450 enzymes and is most susceptible to ishcemic injury because it is the farthest away from the blood supply? What to the branches of the hepatic artery travel next to?

Back 294

Zone 3- the Pericentral vein zone; Branches of the hepatic artery travel with branches of the portal vein.

Front 295

Which cells in the liver are the fat containing cell? What space are they located in? What Vitamin do they store?

Back 295

These are "Ito" cell that are located in the space of Disse, and they store Vitamin A

Front 296

Which is the area of the live lobule that shows the greatest amount of injury from exposure to toxins, as well as the area that shows infiltration with hepatitis?

Back 296

This describes the periportal zone (zone that contains branches of the portal veins, running with the hepatic artery) or zone 1.

Front 297

Which nerve carries information from the carotid sinus to the Medulla?

Back 297

CN IX.

Front 298

Which nerve carries information from the aortic arch to the medulla?

Back 298

CN X.

Front 299

High FEVER, no rash, ulceration, or petechiae. Labs show ablsolute leukopenia, thrombocytopenia, and increased serum transaminases. Peripheral blood smear shows GRANULOCYTES that CONTAIN BERRY-LIKE CLUSTERS OF INTRACELLULAR ORGANISMS (morulae). Diagnosis?

Back 299

Erlichia phagocytophilia; carried by the Ioxides tick that also carries Borrelia and Babesia.

Front 300

Dermacentor tick transmits what?

Back 300

Rickettsia rickettsiae and Francisella Tularensis .

Front 301

Ulceroglandular disease with fever and ulcer at tick bite site. Lymphnode enlargment is seen. Handling rabbit pelts?

Back 301

Francisella tularensis.

Front 302

What are the diseases that the Anopheles mosquito transmits?

Back 302

The encephalitis viruses, all of the malarias, dengue, yellow fever, and filariasis.

Front 303

Amplification of the N-myc gene is associated with a poor prognosis of what tumor?

Back 303

Neuroblastoma in children.

Front 304

Mass above the optic chiasm in a child, showing multiloculated cystic solid tumor containing dark brown, oily fluid.

Back 304

Craniopharyngioma; Rathke's pouch.

Front 305

Tumor derivative from Rathke's pouch that can histologically resemble ameloblastomas (tumors which are derived from dental epithelium).

Back 305

Craniopharyngioma.

Front 306

Xanthomas most likely mean hetero- or homozygote for the autosomal dominant Familial Hypercholesterolemia gene? What is this effect called?

Back 306

Homozygote, and a 6 fold increase in plasma LDL, compared to a 3 fold increase for heterozygotes. This is called gene dosing.

Front 307

What is the main difference between cardiac muscle and skeletal muscle in terms of how each one stores calcium and the effects that calcium has on the tissue?

Back 307

Cardiac muscle stores calcium in Transverse tubules (T-tubules)(CACR-calcium activated calcium release with the SR), SR, and terminal cisternae. Skeletal muscle stores calcium in only the SR and the terminal cisternae, and the T-tubules here are purely used for conduction purposes (VACR-voltage activated calcium release with the SR). Cardiac muscle is therefore much more sensitive to changes in calcium.

Front 308

Describe the Marcus-Gunn phenomenon.

Back 308

In case of inadequate entrance of light into an eye, such as in retinal detachment or optic neuritis, swinging light from the normal eye into the affected eye will result in dilation of both pupils.

Front 309

How do you treat Batonella henselae?

Back 309

Azithromycin or Doxycyclin.

Front 310

Which Chlamydial species can produce a suppurative nodal granuloma? What is this disease called?

Back 310

Chlamydia trachomatis can do this and it is called lymphogranuloma venereum.

Front 311

How is Coxiella burnetti transmitted and what disease does it produce? What can this disease progress to?

Back 311

COXIELLA burnetti is transmitted by inhaling DUST or drinking MILK from infected mammals, especially SHEEP and COWS. It produces Q-FEVER, which is marked by mild NON-SPECIFIC SYMPTOMS or PNEUMONIA, and may PREOGRESS to MYOCARDITIS or HEPATITIS.

Front 312

Patient presents with painfully enlarged lymph nodes in the right axilla. The lymph node is biopsied and numerous granulomas filled with necrotic debris are observed. (*she owns a cat).

Back 312

Batonella henselea.

Front 313

Trench fever. Bug? Vector?

Back 313

B.quintana transmitted by the human body louse.

Front 314

Rat-bite fever. Bug?

Back 314

Streptobacillus moniliformis (gram-negative bacillus)

Front 315

Oroya fever. Bug? Disease?

Back 315

B.bacilliformis; this is an acute febrile illness with severe anemia.

Front 316

Verruga. Bug? Disease?

Back 316

Verruga is actually the chronic cutaneous form of Oroya fever caused by B.bacilliformis.

Front 317

This is a condition that is associated with abnormalities of a broad skull and associated facial and dental abnormalities. It affects bones that form from INTRAMEMBRANOUS OSSIFICATION, including bones of the skull, facial bones, and clavicles.

Back 317

Cleidocranial Dysostosis

Front 318

Wernike's aphasia can present with what type of visual abnormalities and why?

Back 318

Since Wernike's area often contains optic radiation fibers from the left lateral geniculate nucleus projecting to the left primary visual cortex in the occipital lobe, Wernike's aphasia sometimes also presents with right upper visual field blocks (right upper quadrantanopia)

Front 319

What type of genetic material encodes bacterial resistance to Fluoroquinolones and how is resistance conferred?

Back 319

The genes encoding resistance to Quinolones are primarily CHROMOSOMALLY encoded. They involve MUTATIONS in the structural genes for DNA GYRASE and TOPOISOMERASE TYPE IV. It ALSO involves DECREASED UPTAKE cause by mutations in genes that regulate membrane permeability

Front 320

For a listing of all the different types of analyses that are used in particular instances for particular types of studies go to Q-bank Test #44 Q#18

Back 320

For a listing of all the different types of analyses that are used in particular instances for particular types of studies go to Q-bank Test #44 Q#18

Front 321

Leukocyte adhesion deficiency is an autosomal recessive disease in which there is an absence of what molecules?

Back 321

CD11/CD18 family of glycoproteins that are INTEGRINS. Hallmark of this condition is an inability to form abscesses or pus.

Front 322

What is the hallmark of Leukocyte adhesion deficiency (LAD)?

Back 322

Hallmark of this condition is an inability to form abscesses or pus.

Front 323

Which are the most common anaerobic organisms isolated from lung abscess (all of which are typically oral flora)?

Back 323

Bacterioides, Fusobacterium, and Peptococcus species..............don't for get Klebsiella is there a lot too.

Front 324

Subarachnoid hemorrhages which are caused by rupture of berry aneurysm are associated with what diseases, conditions, or habits?

Back 324

Ruptured berry aneurysms are found in patients with a history of Marfan's, Ehlers-Danlos, Adult polycystic kidney disease, hypertension, and smoking.

Front 325

Hemochromatosis is associated with which HLA? Which are the organs that it most affects?

Back 325

HLA-A3; affects skin, liver, pancreas, spleen, heart, and joints.

Front 326

What is Sudan stain for?

Back 326

Staining Fat; (the Sultan from Sudan is Big and FAT)

Front 327

What is Reticulin stain for?

Back 327

Demonstrating fibrosis.

Front 328

What do you use to stain the liver for Iron?

Back 328

Prussian blue.

Front 329

Tacrine and other acetycholinesterase inhibitors are used in symptomatic therapy of what degenerative CNS disease and why?

Back 329

These medications are used in the treatment of Alzheimer's disease because the pathology of the disease includes degeneration of cerebral cholinergic systems such as the basal nucleus of Meynert, which project to the neocortex and are involved in memory and learning.

Front 330

Degeneration of the cerebral cholinergic system in the basal nucleus of Meynert. Diagnosis?

Back 330

Alzheimer's disease.

Front 331

B-CLL cells in Chronic Lymphocytic Leukemia mean what?

Back 331

Poorer prognosis.

Front 332

Bombesin is a marker for what tumors?

Back 332

Neuroblastomas, small cell carcinoma, gastric carcinoma, and pancreatic carcinoma

Front 333

S-100 is a marker for what tumors?

Back 333

Melanmoa, neural tumors, astrocytomas.

Front 334

Labeling of Ki-67, a nuclear factor, correlates with what aspect of a neoplasm?

Back 334

Ki-67 labeling correlates with a neoplasms rate of growth and, therefore, with prognosis.

Front 335

Lewy bodies, Pick bodies, and nerofibrillary tangles all have what protein in common?

Back 335

UBIQUITIN.

Front 336

If you see joint space narrowing, osteophytes, subchondral sclerosis, and subchondral cysts what do you think?

Back 336

Osteoarthritis.

Front 337

A lesion to the visual radiations that project to the Cuneus of the occipital cortex would cause what type of vision problems?

Back 337

This would cause a contralateral lower quadrantanopia.

Front 338

A lesion of Meyer's loop, to fibers which terminate in the Lingual gyrus of the occipital lobe would result in what vision problems?

Back 338

A contralateral upper quadrantanopia.

Front 339

What disease is due to a loss of Phosphatidylinositol glycan A? What is the short name of this molecule? What does it do?

Back 339

Phosphatidylinositol glycan A (PIG-A), is deficienct in Paroxysmal nocturnal dyspnea. PIG-A is responsible for the synthesis of the anchoring molecule Glycosyl phosphatidylinositol.

Front 340

What is the most common defect in beta-chain fatty acid oxidation?

Back 340

Medium-Chain Acyl Dehydrogenase Deficiency (MCADD).

Front 341

Which branch of the Inferior Mesenteric Artery would provide collateral circulation to the affected part of the transverse colon if there was a blockage of the Superior Mesenteric Artery at its origin from the aorta?

Back 341

The left collic artery is a branch of the inferior mesenteric artery that supplies the descending colon from the splenic flexure to the sigmoid colon. This would most likely anastomose with the middle colic artery, which is a branch of the superior mesenteric artery.

Front 342

What 4 of the main branches of the Superior Mesenteric Artery?

Back 342

Intestinal, Ileocolic, Right colic, Middle Colic.

Front 343

When is the drug Maraviroc used and what is its mechanism of action?

Back 343

Maraviroc is a CCR5 co-receptor antagonist. CCR5 is one the co-receptors required for entry into macrophages. Maraviroc binds CCR5 and prevents the interaction of HIV-1 gp120 and CCR5.

Front 344

What is the single most important job for a microbe to be able to perform (bacteria or virus) to be able to infect a cell?

Back 344

It must be able to bind to that cell.

Front 345

What is more important in the immune response to Influenza A virus: being able to bind and inactivate its Neuraminidase or its Hemagglutinin?

Back 345

Binding and inactivating its Hemagglutinin, because this is the molecule that allows the virus to bind to human cells.

Front 346

Classic triad of migratory polyarthritis, tenosynovitis, and dermatis. Diagnosis? ***Treatment?!?

Back 346

Gonococcal arthritis. The treatment of choice is either a Third Generation Cephalosporin, such as Ceftriaxone, or a Fluoroquinolone such as Ciprofolaxcin.

Front 347

Odd behavior, including magical thinking (ESP, telepathy, secret spells and goodluck charms); ideas of reference, illusions, idiosynchratic meanings, social anxiety, paranoia, or suspiciousness; Lack close firends, have odd speech, social isolation; ill fitting or mismatched clothing. Diagnosis?

Back 347

Schizotypal personality disorder.

Front 348

Unable to hold a job, reckless and aggressive; confers a different but related diagnosis if you are under 18 y/o. Diagnosis?

Back 348

If you are older than 18 you have Antisocial personality disorder; if you are younger than 18 you have Conduct Disorder.

Front 349

Extreme shyness, feelings of inadequacy, sensitivity to rejection, and avoidance of social interaction.

Back 349

Avoidant personality disorder.

Front 350

Depth and variability of mood; impulsivity, promiscuity, gambling, overeating, substance abuse, self-mutilation, splitting, passive aggression, may have a history of sexual abuse; dependent and hostile; are often in unstable, but intense interpersonal relationships. Diagnosis?

Back 350

Borderline personality disorder.

Front 351

First-line treatment of Giardiasis?

Back 351

Metronidazole.

Front 352

Medication for Rocky Mountain spotted fever, chlamydial infection, nongonoccal urethritis, and acne?

Back 352

Tetracycline; use (Do)xycycline if there are kidney problems.

Front 353

Where is the Juxtaglomerular apparatus (JGA) in found in the nephron?

Back 353

The JGA are modified pericytes- cells that serve to support small blood vessels that can differentiate into a fibroblast, smooth muscle cell or macrophage. The JGA are modified pericytes of the Glomerular areterioles and are found in the tunica media of the afferent arterioles.

Front 354

What are the3 main stimuli that JGA cells respond to?

Back 354

JGA cells are modified pericytes that are found in the tunica media of the afferent arteriole that respond to Beta-1 adrenergic stimulation, decreased renal perfusion, and decreased NaCl absorption in the macula densa.

Front 355

Which wall of the nephron is the macula densa found in and where does it sit in the nephron?

Back 355

The macula densa is found in the wall of the distal convoluted tubule adjacent to the afferent arteriole, inside of the Jugtaglomerular apparatus. The macula densa senses NaCl concentration in the distal tubule lumen.

Front 356

Which strains of strep are responsible for causing poststreptococcal glomerulonephritis?

Back 356

M12 and M14.

Front 357

Hypercholesterolemia has what type of inheritance pattern?

Back 357

It is an autosomal dominant inheritance of a loss of function mutation (loss of function of his LDL receptors).

Front 358

What does a dominant negative mutation mean? What is a classic example of a disease that is due to a dominant negative mutation?

Back 358

A dominant negative mutation produces a gene product that acts antagonistically with the normal gene product. A classic example is Marfan syndrome, because the mutant Fibrillin-1 disrupts microfibril formation even though the other fibrillin gene encodes the normal protein.

Front 359

Paradoxical high Hb % sat, with low PaO2?

Back 359

This is due to Carbon Monoxide poisoning and CO taking up the space in the plasma away from PO2, but taking up binding sites on Hb making the Sat % normal-high.

Front 360

Nystagmus of the left eye could result from a lesion to which CN?

Back 360

The Left CN VIII (vestibulocochlear nerve).

Front 361

Malignant melanoma has a propensity for metastasizing to what part of the body?

Back 361

The subserosal adipose tissue of the small intestine.

Front 362

A child who has repeated susceptibility to Staph infections likely has what disease? Why are they susceptible to Staph?

Back 362

Chronic granulomatous disease. They are particularly susceptibile to Staph because they are lacking NADPH oxidase- they cannot produce superoxide anions.

Front 363

What treatment is indicated for reducing the frequency and severity of serious infection associated with Chronic Granulomatous Disease (CGD)?

Back 363

Interferon-gamma is used to treat CGD.

Front 364

What is the treatment indicated for both Primary Immunodeficiency and the treatment of Chronic Immune Thrombocytopenic Purpura?

Back 364

Intravenous IgG.

Front 365

What are the diseases associated with an indication for splenectomy?

Back 365

Hereditary spherocytosis, thalassemia major, certain forms of ITP unresponsive to treatment, and Hodgkin disease.

Front 366

Deficiency of CD18. Diagnosis? Signs and symptoms?

Back 366

Leukocyte adhesion deficiency, which results from a deficiency of CD18, which is the common beta chain of most integrins. It causes white blood cells to be unable to extravasate, and therefore causes protracted wound healing and susceptibility to infections.

Front 367

Patients with SCID have a particular decrease in cell showing which CD marker?

Back 367

CD4+ helper T-cells.

Front 368

What particular type of organism would a patient be susceptible to if they lacks Cytotoxic CD8+ cells?

Back 368

They would have high susceptibility to viral pathogens.

Front 369

What is CD14 and why is it important?

Back 369

CD14 is the endotoxin receptor found on macrophages. Patient with a deficiency of endotoxin receptor would have diminished responses to gram-negative bacteria.

Front 370

What is Thiothixene? What is its potentially most dangerous side effect?

Back 370

Thiothixene is a typical antipsychotic, therefore is potentially most dangerous side effect is Neuroleptic Malignant Syndrome.

Front 371

What type of medication is Alprazolam and what are its side effects?

Back 371

This is a benzodiazepine and is associated with side effects such as drowsiness, dizziness, confusion, and anterograde amnesia, as well as respiratory depression.

Front 372

What is Torsemide and what are its associated side effects?

Back 372

Torsemide is a loop diuretic, which are associated with ototoxicity, as well as electrolyte disturbances such as hyponatremia, hypokalemia, hypocalcemia, hypochloremia and an elevated BUN!!!

Front 373

Warfarin has the side effect of skin necrosis, but especially in patients with what condition?!

Back 373

In patient with Protein C-deficiency!

Front 374

When thrombosis, due to Polycythemia vera or other diseases, affects the hepatic veins and inferior vena cava, what is this condition called?!?!?

Back 374

BUDD-CHIARI SYNDROME!!!

Front 375

Hepatic vein thrombosis?

Back 375

Budd-Chiari; likely associated with Polycythemia vera.

Front 376

What type of virus is most likely to need an attenuated live vaccine to be administered in order to have immunity to it?

Back 376

A Syncitial virus. The only way to develop strong cell-mediated immunity to it is to either recover from infection or to be vaccinated with a living viral agent.

Front 377

What virus type other than syncitial viruses might have the requirement of a live attenuated vaccine in order to confer immunity?

Back 377

Enveloped viruses.

Front 378

Which bacteria possesses Protein A? What does this protein do?

Back 378

Staph aureus; this protein binds the Fc portion of IgG.

Front 379

Which bacteria possess Exotoxin A?

Back 379

Psuedomonas.

Front 380

How does Displacement deal with emotion?

Back 380

It redirects feelings away from an object felt to be unacceptable to an object felt to be safe or acceptable. Displacment often "runs down hill". (i.e. kicking the wall instead of your boss)

Front 381

How does Acting out deal with emotion?

Back 381

Here the real emotion is covered, not expressed. It is differentiated from displacement in that the emotion is covered up, not redirected.

Front 382

Explain and describe Projection of emotion.

Back 382

This is when a person attributes his own thoughts and emotions onto someone else, e.g. a man who has committed adultery becomes convinced that his wife is having an affair even though there is no evidence of it.

Front 383

What is Reaction Formation? (*for every action there is an equal and opposite reaction).

Back 383

This is when an unacceptable impulse is transformed into its opposite, as if the person is trying to convince himself that the original feeling or impulse did not exist. Could also be an excessive overreaction.

Front 384

What is Undoing?

Back 384

This is acting our the reverse of unacceptable feelings or behavior in order to correct the behavior, e.g. a man who is sexually aroused bya a woman he meets immediately leaves and buys flowers for his wife.

Front 385

This child is able to speak in two-word sentences, and the parents are able to understand most of the child's speech. She can name body parts, scribble with a crayon, and stack six blocks. She can stand on tiptoes, aim and throw a ball, and turn a door knob. How old is this child.

Back 385

This child is most likely 2 years old. These are all actions that a two year old can do.

Front 386

This child is only able to arrange three small cubes in a vertical stack, and can climb stairs by herself. How old is this child?

Back 386

This child is 1 year old.

Front 387

At what age can a child cut paper with scissors and ride a tricycle?

Back 387

This happens by age 3.

Front 388

Which lymphocyte type would be a greatest importance in the production of an immune response after receiving a KILLED vaccine?

Back 388

CD4+ cells.

Front 389

Which lymphocyte type would be a greatest importance in the production of an immune response after receiving a LIVE ATTENUATED vaccine?

Back 389

CD8+ cells.

Front 390

Do bacteria contain introns or do splicing?

Back 390

NO!!!`

Front 391

How does a bacterium protect itself from autodigestion of its own DNA with its own restriction enzymes?

Back 391

It methylates the restriction sequences for each enzyme.

Front 392

What are the most common organisms that cause acute cystitis?

Back 392

Escherichia coli, Staph saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis.

Front 393

What is the first-line therapy for uncomplicated acute cystitis?

Back 393

3 days of TMP/SMX (Bactrim)

Front 394

What is the first line therapy for acute cystitis with complications?

Back 394

For complicated cases of cystitis, first-line is empiric therapy with a fluoroquinolone, such as cuproflaxacin for 7-14 days.

Front 395

What OTC medication interacts with Fluoroquinolones and dramatically decreases their absorption from the GI tract?

Back 395

ANTACIDS!!!

Front 396

What can Nitrofurantoin be used for?

Back 396

Acute Cystitis (UTIs) when fluroroquinolones cannot be used (e.g. when the patient takes antacids).

Front 397

How do the fungal "-AZOLES" work?

Back 397

They interfere with the synthesis of ergosterol by inhibiting 14-alpha-demethylase (a fungal P450 enzyme) that converts lanosterol to ergosterol.

Front 398

What is the mechanism of action of Rifampin?

Back 398

It inhibits a DNA-dependent RNA polymerase.

Front 399

Which anti-tuberculosis drug inhibits mycolic acid synthesis?

Back 399

Isoniazid!!!

Front 400

What is the function of a drug that inhibits the 5-HT3 receptor, and what type of receptor is this?

Back 400

The agent that inhibits the 5-HT3 receptor, such as Granisetron, is one that has antiemetic effects. The 5-HT3 receptor is a ligand-gated ion channel.

Front 401

What is the equation for O2 consumption?

Back 401

CO x (CaO2-CvO2) =VO2

Front 402

Which test results come back faster when testing for Down syndrome: FISH or Karyotype analysis?

Back 402

FISH (by up to a month).

Front 403

Acetylcholinesterase assays are used to help diagnose what type of degenerative CNS condition?

Back 403

Alzheimer's syndrome.

Front 404

CGG is the trinucleotide repeat for which disorder?

Back 404

Fragile X syndrome.

Front 405

Gram-negative bacilli that produces pitted colonies with a bleach-like odor on agar. This bug can cause a subacute bacterial endocarditis and is normal flora of the oral cavity. Who am I?

Back 405

Eikenella corrodens. (CRAZY!!!)

Front 406

How can a mutation be beneficial (good) to an organism?

Back 406

may provide advantage over other organisms - example, a change in color of an organism might allow it to camouflage better in its surroundings

Front 407

Constipation, bone pain, kidney stones, and mood disturbances. Which mineral dysregulation?

Back 407

Hypercalcemia.

Front 408

Hypotension, arrhythmias, and hyporeflexia. Can cause hypocalcemia. Which mineral dysregulation?

Back 408

Increased Mg 2+!!!; Hypermagnesemia.

Front 409

Weakness, muscle cramps, arrhythmias, tremors, nystagmus, and an EXTENSOR PLANTAR REFLEX. Which mineral dysregulation?

Back 409

Mg 2+ !!!; Hypomagnesemia.

Front 410

Muscle weakness, diplopia, LOW CARDIAC OUTPUT, and MENTAL STATUS changes. Which ion dysregulation?

Back 410

Phosphorous; Hypophosphatemia.

Front 411

Small cleaved cell in a follicular pattern suggests?

Back 411

Lymphoma.

Front 412

Atypical nests of squamous cells suggests?

Back 412

Squamous cell carcinoma.

Front 413

What is the mechanism of action of Clindamycin? What is the main mechanism or resistance to Clindamycin?

Back 413

Clindamycin is an inhibitor of protein elongation. Methlyation of the 23s ribosomal RNA is the main source of bacterial resistance, unless the bacterium can form spores.

Front 414

What is a main mechanism of resistance against Erythromycin?

Back 414

Drug export (efflux) pumps.

Front 415

Why does serum macroglobulin concentration rise at the end of full-blown AIDS?

Back 415

This is because the CD4+ count is so critically low, that no TH2 cytokines are available to promote isotype switching. The patient becomes unable to make any immunoglobulin other than IgM (the macroglobulin).

Front 416

What are the key cells that atopic allergy depends on?

Back 416

TH2 cells and B lymphocytes (IgE), mast cells and basophils.

Front 417

What is the most important cell involved in abscess formation?

Back 417

Neutrophils.

Front 418

Granulomas are most profoundly dependent on what type of cell?

Back 418

TH1 lymphocytes and their cytokines that recruit and activate macrophages.

Front 419

What type of EEG (Hz and voltage) will a Tonic-Clonic seizure show? What do you treat it with?

Back 419

This will show low-voltage fast (10Hz) neuronal activity. Initial drugs of choice are Phenytoin, Valproic acid, and Carbamazepine.

Front 420

What is a medication used in the treatment of postherpetic neuralgia?

Back 420

Gabapentin.

Front 421

Once inside the lungs, where can carbon pigment spread?

Back 421

The black carbon pigment that is commonly inhaled in polluted cities can spread from the lungs to the mediastinal lymphnodes.

Front 422

How do Statins inhibit HMG-CoA reductase?

Back 422

They are competitive inhibitors.

Front 423

The amnion, the chorion, the chorionic plate, the chorionic villi, and the blood cells in the chorionic villi vessels are contributed by the mother or the fetus?

Back 423

The FETUS!!!

Front 424

The deciduas basalis where the placenta adheres to the uterus, the placental septae (support function for deciduas basalis), and the blood cells in the intervillous space are contributed by the mother or the fetus?

Back 424

The MOTHER!!!

Front 425

What is the classic triad of cardiac tamponade?

Back 425

1) decreased arterial pressure 2) increased systemic venous pressure 3) a small quiet heart

Front 426

What is Kusmal sign?

Back 426

A rise in the systemic venous pressure upon inspiration (seen in restrictive cardiac conditions, due to effusion or restrictive pericarditis)

Front 427

What is pulsus paradoxus?

Back 427

A fall of more than 10mmHg in the systolic pressure with inspiration.

Front 428

What differentiates Bullous pemphigoid from Pemphigous vulgaris?

Back 428

Bullous pemphigoid shows subepidermial blistering, rather than intraepidermal blistering. Bullous pemphigoid also does not usually have mucous membrane involvement.

Front 429

What are the auto-antibodies seen in Bullous pemphigoid?

Back 429

Anti- alph-6 integrin, BP Ag1, BP Ag2, and lamanin 5.

Front 430

What is the autoantibody seen in Pemphigus vulgaris?

Back 430

Anti-Desmoglein 1 or 3.

Front 431

Bullae with the cleavage plane above the basal layer of the epidermis (intraepidermal cleavage, caused by autoantibodies to the junctions of epidermal cells) especially with oral involvement that precedes skin lesions, suggests what disease?

Back 431

Pemphigus vulgaris

Front 432

Is Carbon monoxide a diffusion limited gas or a perfusion limited gas? Will its partial pressure in blood reach its partial pressure in alveoli within 1 second (the amount of time an RBC spends in the capillary)lilke oxygen will?

Back 432

CO is a diffusion related gas because it diffuses across the alveolar membrane slowly. Therefore its alveolar partial pressure will not fully equilibration with its plasma partial pressure in one second.

Front 433

Which cardiovascular pathologies produce sharp, stabbing, kinfe-like chest pains?

Back 433

Only PERICARDITIS and DISSECTING AORTIC ANEURYSM produce knifelike pains. So how do you tell the difference? Pain with dissecting aortic aneurysms is usually unrelated to breathing, whereas the pain associated with PERICARDITIS varies with, and CAN AFFECT, BREATHING.

Front 434

What does a characteristic ECG of Pericarditis look like?

Back 434

Diffuse ST elevations with upright T waves.

Front 435

Barbiturates, alcohol, phenothiazines, and MAO inhibitors affect sleep patterns in what way? Abrupt discontinuation of their use can cause what phenomenon?

Back 435

These substances decrease the amount of REM sleep while the patient is taking them. Withdrawal of the agent then allows the body to compensate for "missed" REM sleep, and REM rebound develops. This is characterized by an increase in the number and intensity of dreams for several days after discontinuation of the drug in question.

Front 436

When do Hypnopompic hallucinations occur during the sleep cycle?

Back 436

These occur as the patient is waking.

Front 437

At what stage of sleep do night terrors (pavor nocturnus) occur and in what patient population?

Back 437

Night terrors generally occur in children and they occur in Stage 4 sleep.

Front 438

At the site of an injury the wound becomes red, hot, and swollen. The patient has an extremely high temperature and there is regional lymph node involvement. Petechial rash is observed in the area of the wound and the patient's fingertips are darkly discolored and COOL to the touch. There is a Gram-positive coccus cultured from the infection site. Diagnosis for condition and bug?

Back 438

TOXIC SHOCK SYNDROME!!! Either Streptococcus (Exotoxin A) or Staphlococcus (TSST) could produce this exotoxin-mediated toxic shock syndrome.

Front 439

What are the two cells that are most important in mediating the response and creating the conditions associated with Toxic-shock? What are the chemical mediators associated?

Back 439

IL-1, IL-6, and TNF-alpha are release from macrophages and INF-gamma is released from T-helper cells.

Front 440

How do superantigens that cause toxic shock, work?

Back 440

They crosslink the outside of the variable-beta region of the T-cell receptor to the outside of the MHC class II molecules on the APCs. This causes stimulation of large numbers of TH cells in the absence of antigen specificity, system wide.

Front 441

What is Amaurosis Fugax?

Back 441

Its when a patient develops microemboli that enter the opthalmic artery and leading to black spots in the vision. On examination there is often atherosclerosis (and possibly a carotid bruit) on the ipsilateral side.

Front 442

Why can a patient with chronic bronchitis develop edema?

Back 442

This can occurs due to pulmonary hypertension and eventual right ventricular overload.

Front 443

Which serotypes of Chlamydia trachomatis are responsible for being the leading cause of preventable infectious blindness worldwide?

Back 443

Chlamydial serotypes A,B, Ba, and C = blindness in children.

Front 444

Which body is the inactive, but infectious form of Chlamydia? How do you stain for intracellular chlamydia?

Back 444

The elementary body is infectious, but inactive. You stain for intracellular Chlamydia using iodine and Giemsa.

Front 445

What is Amaurosis Fugax?

Back 445

Its when a patient develops microemboli that enter the opthalmic artery and leading to black spots in the vision. On examination there is often atherosclerosis (and possibly a carotid bruit) on the ipsilateral side.

Front 446

Why can a patient with chronic bronchitis develop edema?

Back 446

This can occurs due to pulmonary hypertension and eventual right ventricular overload.

Front 447

What are the macrophages of the CNS?

Back 447

Microgilal cells!!!!

Front 448

Which serotypes of Chlamydia trachomatis are responsible for being the leading cause of preventable infectious blindness worldwide?

Back 448

Chlamydial serotypes A,B, Ba, and C = blindness in children.

Front 449

Which degenerative CNS disease is associated with granulovacuolar degeneration and Hirano bodies?

Back 449

ALZHEIMER's disease!!!

Front 450

Does Alzheimer's disease have accumulations of abnormal proteins extracellularly, intracellularly, or both?

Back 450

Both intra- and extracellularly!!!

Front 451

Which body is the inactive, but infectious form of Chlamydia? How do you stain for intracellular chlamydia?

Back 451

The elementary body is infectious, but inactive. You stain for intracellular Chlamydia using iodine and Giemsa.

Front 452

How do carbon particles in the lungs get to the regional lymph nodes?

Back 452

Alveolar macrophages transport them. This process is normal and natural, and is called Anthracosis.

Front 453

What are the macrophages of the CNS?

Back 453

Microgilal cells!!!!

Front 454

Which degenerative CNS disease is associated with granulovacuolar degeneration and Hirano bodies?

Back 454

ALZHEIMER's disease!!!

Front 455

Homogentisic acid is found to be built up in what disease? Where does this pigment deposit? What is the name of this pigmentation?

Back 455

Homogentisic acid is a black occurring pigment in Alkaptonuria. The pigmentation, referred to as ochronosis, especially involves CONNECTIVE TISSUE and CARTILAGE!!!

Front 456

Lipofuscin is a naturally occurring pigment in aging postmitotic cells such as cardiac myocytes and neurons, but what process causes the production of these pigments?

Back 456

Lipofuscin is the result of lipid peroxidation of Polyunsaturated fatty acids in the plasma membranes and represents an epiphenomenon of free-radical injury.

Front 457

Does Alzheimer's disease have accumulations of abnormal proteins extracellularly, intracellularly, or both?

Back 457

Both intra- and extracellularly!!!

Front 458

How do carbon particles in the lungs get to the regional lymph nodes?

Back 458

Alveolar macrophages transport them. This process is normal and natural, and is called Anthracosis.

Front 459

Homogentisic acid is found to be built up in what disease? Where does this pigment deposit? What is the name of this pigmentation?

Back 459

Homogentisic acid is a black occurring pigment in Alkaptonuria. The pigmentation, referred to as ochronosis, especially involves CONNECTIVE TISSUE and CARTILAGE!!!

Front 460

Lipofuscin is a naturally occurring pigment in aging postmitotic cells such as cardiac myocytes and neurons, but what process causes the production of these pigments?

Back 460

Lipofuscin is the result of lipid peroxidation of Polyunsaturated fatty acids in the plasma membranes and represents an epiphenomenon of free-radical injury.

Front 461

What pigment is produced from the conversion of tyrosinase-catalyzed oxidation of tyrosine to dihydroxyphenylalanine?

Back 461

MELANIN!!!!

Front 462

Describe the defense mechanism known as Splitting.

Back 462

Splitting is associated with Borderline personality disorder, which is characterized by short-term psychotic episodes (e.g. depression), self-mutilation, "SPLITTING" persons in to the "GOOD/BAD" extremes on a continuum, and markedly unstable interpersonal relationships.

Front 463

Describe the defense mechanism known as Intellectualization.

Back 463

This is often a mechanism used by patients with obsessive-compulsive disorder as a way to explain/justify their perfectionism and inflexible, orderly routines.

Front 464

Which personality disorder is best associated with the defense mechanism of Projection?

Back 464

Projections is best associated with a Paranoid Personality disorder, in which patients attribute their own inner feelings to others.

Front 465

Which personality disorder is best associated with the defense mechanism of Regression?

Back 465

Regression is associated with Histrionic patients, as demonstrated by their excessive emotion and attention-seeking behavior.

Front 466

Spirillum minus causes what disease?

Back 466

Rat-bite fever.

Front 467

60 y/o smoker with pneumonia that causes severe headache and muscle pain, and requires ventilation soon after onset. Growth of organism of Charcoal yeast extract. Diagnosis?

Back 467

Legionella pneumophilia.

Front 468

Growth of organism of Charcoal yeast extract?

Back 468

Legionella pneumophilia.

Front 469

Cause of atypical pneumonia in immunosuppressed individuals (e.g. elderly, smokers, heavy drinkers). Pneumonia can present with mental confusion and diarrhea. Bug?

Back 469

Legionella.

Front 470

This bug must be grown on cysteine and iron media (*charcoal yeast extract [CYE])?

Back 470

Legionella.

Front 471

Myosin ATPase activity is the main factor governing what property of muscle contraction?

Back 471

ATPase activity governs the maximum velocity of shortening of the muscle, which is increased to high levels when the ATPase activity is elevated. The maximum velocity is achieved when there is no afterload (force = 0)

Front 472

Increasing the frequency of muscle contraction, muscle hypertrophy, increasing muscle mass, and recruiting additional motor units will have what affect on the functioning of a muscle?

Back 472

These will only affect the maximum load that a muscle can lift.

Front 473

The presentation of rapidly progressive ataxia and dementia at a young age, without any family history of degenerative CNS inheritance is suggestive of what disease?

Back 473

Prion-related disease.

Front 474

Rapidly progressive dementia with pyramidal signs, myoclonus, and cerebellar or extrapyramidal signs. Syndrome evolves over weeks to months, and death occurs within one year. Diagnosis?

Back 474

Prion disease.

Front 475

This disease is characterized by dysarthria, dysphagia, dementia, gait ataxia, extrapyramidal symptoms, and VERTICAL GAZE IS IMPAIRED!!! Diagnosis?

Back 475

Progressive Supranuclear Palsy.

Front 476

Rapidly progressive dementia, axonal degeneration, neuronal loss, gliosis, astrocytic proliferation, memory loss, startle myoclonus, involuntary movements, EEG shows HIGH-VOLTAGE SLOW WAVES!!!

Back 476

Prion disease.

Front 477

Patient has "foot drop" (impaired dorsiflexion). Which nerve is damaged?

Back 477

Deep peroneal nerve.

Front 478

Knee extension is impaired. Which nerve is damaged?

Back 478

Femoral nerve.

Front 479

Hip adduction is impaired. Which nerve is damaged?

Back 479

Obturator nerve.

Front 480

Knee flexion is impaired. Which nerve is damaged?

Back 480

Sciatic nerve.

Front 481

When is maternal folate being used to synthesize the neural tube of the fetus?

Back 481

The first 3-4 weeks of pregnancy before the mother knows she is pregnant.

Front 482

What type of birth defects can anticonvulsants cause related to dietary deficiencies?

Back 482

Anticonvulsants such as Phenytoin can impair the absorption of folate as well as increase the rate of folate metabolism. Thus a pregnant woman on anticonvulsants is at risk for developing a fetus with neural tube defects.

Front 483

CFA/I-III (colonization factor antigens), AAF/I, II (adherence fimbriae), bindle-forming pili, intimin, invasion plasmid antigen protein, and Dr fimbrae are all what type of proteins, involved in what pathogenic process?

Back 483

These are all adhesins that promote adherence to the urinary tract mucosa and are involved in the pathogenic process of acute cystitis.

Front 484

What are Opa (opacity) proteins and which bacterium has them?

Back 484

These are proteins found in the outer membrane of N.gonorrhoeae that mediate adherence and undergo antigenic variation.

Front 485

What bug produces toxins Stx-1 and Stx-2?

Back 485

These are the Shiga-like toxins produced by E.coli.

Front 486

How do spirochetes employ their mobility?

Back 486

From an internal flagellum (axial filiament).

Front 487

How do you treat Lyme's disease?

Back 487

Doxycycline, amoxicillin, or azithromycin.

Front 488

How does bcl-2 inhibit apoptosis?

Back 488

1) Preventing increases in mitochondrial permeability 2) Serving as docking protein for proapoptotic proteins.

Front 489

The concentration of which pregnancy hormone rises throughout the term of gestation and is proportional to fetal mass? What other hormone rises throughout pregnancy?

Back 489

hPL- Human placental lactogen!!! Progesterone also rises throughout pregnancy.

Front 490

What type of progesterone is only made in the corpus luteum because it lacks 17-alpha hydroxylase?

Back 490

17-OH progesterone.

Front 491

What role does corticotropin releasing hormone (CRH), play in pregnancy and in the fetus?

Back 491

CRH rises sharply around week 28 and is thought to play a role in initiating labor and stimulating fetal lung maturation.

Front 492

Cystic medial necrosis of the aorta usually presents in questions with clues about what disease?

Back 492

Marfan's syndrome.

Front 493

Aneurysms involving the proximal aorta are usually seen in questions involving what disease?

Back 493

Tertiary syphilis.

Front 494

What are the two congenital heart-disease conditions that are associated with Turner syndrome?

Back 494

Coarctation of the aorta, and bicuspid aortic valve.

Front 495

In addition to Renal cell carcinoma and Hepatocellular carcinoma, what are the three other tumors that are most commonly associated with ectopic erythropoetin production?

Back 495

Hemangioblastoma, pheochromocytoma, and uterine myomata.

Front 496

Does primary Polycythemia vera have increased or decreased Erythropoeitn levels?

Back 496

DECREASED!!! whereas the Epo levels in ectopic (secondary) Polycythemia vera are increased.

Front 497

Is primary infection or reactivation disease more common in a Toxoplasma gondii infection of AIDS patients?

Back 497

Reactivation disease. 70-80% of the world's population is seropositive for Toxoplasma gondii.

Front 498

What is the main mechanism of transmission of Toxoplasma gondii in the U.S.?

Back 498

The disease is most commonly spread in the U.S. by ingestion of cysts from undercooked pork, but can also be spread transplacentally or from cat feces.

Front 499

How does Toxoplasma make it from the gut to the brain?

Back 499

Tachyzoites develop intracellularly in phagocytic cells and then spread to the brain, muscle, and other tissues, where they can encyst and multiply.

Front 500

How is Wiskott-Aldrich inherited?

Back 500

X-linked.

Front 501

What protein deficiency is responsible for the shortened half-life of platelets in Wiskott-Aldrich syndrome? What procedure can correct the thrombocytopenia?

Back 501

CD43 deficiency (Surface sialophorin) is the deficiency that leads to decreased platelet half-life in Wiskott-Aldrich syndrome. Splenectomy can correct the thrombocytopenia, but not the immune defect.

Front 502

Which gamma globulins are increased and which are decreased in Wiskott-Aldrich syndrome? Which X-linked gene is mutated?

Back 502

IgM is decreased, while Ig(A) and IgE are increased. Mutations in the Wiskott-(A)ldrich serum protein (WASP) gene on the short arm of the X chromosome are responsible for this disease.

Front 503

Which cytokine is responsible for enhancing the production of myeloid cell in the bone marrow?

Back 503

IL-3

Front 504

Which cytokine is the product of a TH2 cell that stimulates isotype-switching to igE in B lymphocytes?

Back 504

IL-4

Front 505

Which cytokine is the product of a TH2 cell that stimulates isotype-switching to IgA in B lymphocytes?

Back 505

IL-5

Front 506

Which cytokine is produce by T-helper cells and causes the activation and cloning of many categories of lymphocytes and has therefore been used to treat various types of cancer?

Back 506

IL-2.

Front 507

IL-10 is produced by which set of TH cells and dampens the response of which TH cells?

Back 507

IL-10 is produced by TH2 cells and stimulates TH2 cells even further. It also depresses the response pathway of TH1 cells.

Front 508

IFN-gamma is produced by which set of TH cells and dampens the response of which TH cells?

Back 508

IFN-gamma is produced by TH1 cells and stimulates TH1 cells even further. It also depresses the response pathway of TH2 cells.

Front 509

What condition has a link to HLA-DQ3 (also HLA-DQ7 and HLA-DR4)?

Back 509

Alopecia areata (or totalis, or universalis). This is loss of hair caused by an autoimmune attack on hair follicles, with antibodies being usually directed against anagen-phase hair follicle structures.

Front 510

Sun exposure causing squamous cell carcinoma at the vermillion of the lip usually had what precursor lesion occurring before it?

Back 510

Actinic chelitis (actinic lesion of the lip mucosa).

Front 511

The gene for Freidriech's ataxia is coded for on which Chromosome?

Back 511

Chromosome 9.

Front 512

What happens to the spinal cord in Freidriech's ataxia? Which tracts of the spinal cord are primarily affected?

Back 512

There is atrophy of the spinal cord. The atrophic changes principally involve the CORTICOSPINAL and SPINOCEREBELLAR tracts, and the POSTERIOR COLUMNS.

Front 513

12 y/o girl has stumbling falls. BROAD-BASED, SLOW, CLUMSY, GAIT with a tendency to lurch from side to side. Several year later she develops clumsiness of fine motor movements and a coarse intention tremor of the upper limbs and dies in the 4th decade of life from pneumonia?

Back 513

Freidriech's ataxia. Autosomal recessive trinucleotide repeat disorder (GAA).

Front 514

Loss of tactile discrimination and of position and vibrational sense (dorsal columns), spastic paresis (corticospinal tracts), limb dystaxia (spinocerebellar tracts). Diagnosis? (*starts when patient is a child)

Back 514

Freidriech's ataxia.

Front 515

Is anaphylaxis humoral or cell mediated?

Back 515

Humoral mediated.

Front 516

Which cytokine is secreted by B-cells and macrophages and activates NK and TH1 cells?

Back 516

IL-12.

Front 517

Which cytokine that is released by macrophages mediates septic shock, causes leukocyte recruitment, and vascular leak?

Back 517

TNF-alpha.

Front 518

Which cytokine activates endothelium to express adhesion molecules? (*secreted by macrophages)

Back 518

IL-1.

Front 519

Which cytokine stimulates T-cells?

Back 519

IL-2

Front 520

Which cytokine stimulates bone-marrow similar to GM-CSF?

Back 520

IL-3.

Front 521

Which cytokine is a major chemotactic factor for neutrophils?

Back 521

IL-8.

Front 522

Which cytokine promotes class switching in B-cells to IgE and IgG?

Back 522

IL-4.

Front 523

What is angiostatin?

Back 523

this is an anti-angiogenic factor expressed by tumors that tends to inhibit angiogenesis.

Front 524

What is thrombospondin?

Back 524

This is a multifunctional glycoprotein that interferes with tumor growth, angiogenesis, and metastasis.

Front 525

Myocardial infarction is associated with rises in what enzymes?

Back 525

AST, LDH, CPK-MB, and Troponin I

Front 526

What is the mechanism of increased leukocytes (mostly neutrophils) after a myocardial infarction?

Back 526

Increased epinephrine, which decreases leukocyte adhesion molecules, so the neutrophils detatch from the walls of the endothelium, and the count is artificially raised.

Front 527

Adenylate cyclase exotoxin production happens with what bug that first infects the lungs?? What are two other bugs that use this same mechanism to cause pathology in the intestine?

Back 527

Inhalation anthrax. ETEC and Vibrio cholera produce adenylate cyclase toxins that take effect in the small intestine and cause secretory diarrhea.

Front 528

What bacterum is known to cause a fatal hemorrhagic mediastinal lymphadenitis upon inhalation of its spores?

Back 528

Bacillus anthracis

Front 529

Where does the rash of Toxic Shock syndrome reside?

Back 529

On the palms and soles.

Front 530

What is the most common cause of viral encephalitis in the U.S.?

Back 530

HSV-1.

Front 531

Where does Rabies virus do most of its damage in the brain?

Back 531

Negri bodies are found in Hippocampal and Purkinje neurons of the Cerebellum.

Front 532

Branchial, or lateral cervical, cysts are the result of the incomplete obliteration of what developmental structures?

Back 532

The Second pharyngeal cleft.

Front 533

What structures do branchial cysts (incomplete obliterations of the second pharyngeal cleft) often border?

Back 533

They may be situated along the anterior border of the sternocleidomastoid muscle, or anterior to the external auditory meatus.

Front 534

Can Isoniazide and Iron both cause an anion gap metabolic acidosis?

Back 534

YES!!!

Front 535

What are other names of a port-wine nevus/stain? What disease is this found in? What other lesion will be present and on which side of the body relative to the nevus?

Back 535

Facial angioma, or nevus flammeus. This is found in Sturge-Weber disease. There will also be an ipsilateral meningial angiomatosis on the surface of the hemisphere

Front 536

What sized blood vessels are affected in Sturge-Weber disease?

Back 536

Capillary sized blood vessels.

Front 537

What does GIP in the hormone GIP, stand for?

Back 537

Glucose-dependent Insulinotropic Peptide.

Front 538

What is the only gastric hormone that can respond to the presence of all three macronutrients: carbs, fats, proteins?

Back 538

GIP.

Front 539

Which Gastric hormone is stimulated by amino acids, peptides, and vagal stimulation?

Back 539

Gastrin.

Front 540

Which gastric hormone is stimulated by fatty acids and amino acids?

Back 540

CCK.

Front 541

Which gastric hormone is stimulated by acid and fatty acids?

Back 541

Secretin.

Front 542

Which gastric hormone is stimulated by acid and decreased vagal stimulation?

Back 542

Somatostatin.

Front 543

Which gastric hormone is increased by distention and vagal stimulation?

Back 543

VIP.

Front 544

A fluid protein/serum ratio >0.5 found in an effusion, a fluid LDH/serum LDH >0.6, or a fluid LDH more than 2/3 the normal upper limit for serum qualifies that fluid as what?

Back 544

An Exudative fluid.

Front 545

What type of cause should you first consider whenever a pleural effusion is unilateral?

Back 545

Bacterial cause.

Front 546

What do dilated cardiomyopathy, mitral valve prolapse, and infective endocarditis have in common?

Back 546

Stasis and the possibility of systemic thromboembolism.

Front 547

What is the mechanism by which Staph aureus protects itself from phagocytosis?

Back 547

Staph aureus evades phagocytosis by producing Protein A, which binds the Fc component of IgG, thus preventing opsinization.

Front 548

IgA proteases do what job for the bacteria that produce them?

Back 548

They protect them from being immediately shed from mucosal surfaces (e.g. Strep pneumo, N. meningitidis, N.gonorrhoeae, and H.influenzae.

Front 549

Inactivation of complement is a mechanism of what Gram-positive coccus to protect itself against opsinization?

Back 549

Streptococcus pneumoniae

Front 550

What is the difference in autoantibodies that are associated with Grave's disease vs. Hashimoto's thyroiditis?!?

Back 550

Hashimoto's = antimicrosomal, or antithyroglobulin!!!!

Grave's = anti-TSH-receptor antibodies!!!

Front 551

What is Wermer syndrome?

Back 551

The same thing as MEN I !!!

Front 552

If a patient presents with a history of kidney stones (parathyroid) and ulcers (ZE syndrome), what diagnosis should you consider?

Back 552

MEN I !!!!

Front 553

Orthostatic hypertension and Parkinsonism. Diagnosis?

Back 553

Shy-Drager syndrome. There is an autonomic nervous system failure, leading to orthostatic hypotension and parkinsonism.

Front 554

What is Sipple syndrome?

Back 554

MEN II, which is characterized by parathyroid disease, medullary thyroid carcinoma, and pheochromocytoma.

Front 555

Adenomas of the digestive tract and CNS gliomas (astrocytoma and medulloblastoma). Diagnosis?

Back 555

Turcot syndrome.

Front 556

This childhood tumor is recognized by cells with cytoplasmic content of eosinophilic thick and thin fliaments. There are embryonal, alveolar, and pleomorphic variants. This malignancy is of skeletal muscle origin. Diagnosis?

Back 556

Rhabdomyosarcoma.

Front 557

This malignancy appears as a monotonous mass of primitive, small, round cells, with a thin rim of clear cytoplasm. This is a tumor of bone, in children. Diagnosis and translocation?

Back 557

Ewing's sarcoma t(11:22).

Front 558

Which lymph nodes are most often involved in Hodgkin's lymphoma?

Back 558

The cervical and mediastinal lymph nodes.

Front 559

What is the diagnostic criteria with reference to weight for anorexia nervosa?

Back 559

Must have lost >15% of baseline.

Front 560

Describe Conversion disorder.

Back 560

Conversion disorder is manifested by chronic neurologic pain or deficit with no objective organic cause. The patients chief complaint is acute pain with no sign of another neurological deficit.

Front 561

Can the arterial PO2 or the mixed venous PO2 be affected by decreased hemoglobin?

Back 561

Only the mixed venous PO2 can be affected!!!

Front 562

What are the most prominent cell types found in the lines of Zahn associated with premortem thrombi?

Back 562

Platelets.

Front 563

What distunguishes ITP from TTP?

Back 563

ITP is distinguished from TTP by the absence of fragmented red cells.

Front 564

What is the mechanism of ITP?

Back 564

ITP is an immune-mediated destruction of platelets by the spleen after the platelets have been coated with anti-GpIIb/IIIa, or anti-GpIb-IX antibody.

Front 565

What is the diagnostic test used for confirming Cryptococcus meningitis in AIDS patients?!? (*it's not india ink ;) )

Back 565

The test that is actually used in hospital situations is LATEX PARTICLE AGGLUTINATION to detect capsular antigen shed into the CSF!!!

Front 566

Bilateral, linear areas of infarct in the brain at autopsy, such as the parasagittal areas in the junctional zone between the anterior and middle cerebral arteries. Diagnosis?

Back 566

Ischemia with necrosis showing at the border zone (watershed) infarcts. They occur as the result of severe ishcemia, which most profoundly affects the poorly perfused areas, at the boundaries between major arterial territories.

Front 567

Tumor suppressor gene: NF-1

List the function and associated tumor type.

Back 567

Fxn: Inhibition of Ras

Tumor type: Neuroblastoma

Front 568

Tumor suppressor gene: NF-2

List the function and associated tumor type.

Back 568

Fxn: Cytoskeleton stability

Tumor type: Meningioma/Schwannoma

Front 569

Tumor suppressor gene: APC

List the function and associated tumor type.

Back 569

Fxn: Inhibition of signal transduction

Tumor type: (FAP) Colon, stomach, others

Front 570

Tumor suppressor gene: Rb

List the function and associated tumor type.

Back 570

Fxn: Cell cycle regulation

Tumor type: Retinoblastoma, osteosarcoma

Front 571

Tumor suppressor gene: p53

List the function and associated tumor type.

Back 571

Fxn: Cell cycle arrest at G1 and apoptosis

Tumor type: Most human cancers

Front 572

Tumor suppressor gene: BRCA-1

List the function and associated tumor type.

Back 572

Fxn: DNA repair

Tumor type: Female breast cancer and ovarian cancer

Front 573

Tumor suppressor gene: BRCA-2

List the function and associated tumor type.

Back 573

Fxn: DNA repair

Tumor type: Male breast cancer

Front 574

Tumor suppressor gene: WT-1

List the function and associated tumor type.

Back 574

Fxn: Nuclear transcription

Tumor type: Wilms tumor (kidney)

Front 575

Tumor suppressor gene: ATM

List the function and associated tumor type.

Back 575

Fxn: Protein kinase activating p53

Tumor type: Ataxia telangectasia, Bloom syndrome, Fanconi

Front 576

What is the component in a bee sting that causes anaphylactic reaction?

Back 576

Melitin.

Front 577

What are the anaphylatoxins?

Back 577

C3a and C5a.

Front 578

What should you check for when a child presents with one half of her body larger than the other, aniridia, genital anomalies, and mental retardation?

Back 578

A Wilm's tumor; this is WAGR syndrome.

Front 579

When does ITP most commonly occur?

Back 579

After an Upper Respiratory Infection.

Front 580

This disease is characterized by the absence of platelet GpIb (the receptor for von Willebrand factor).

Back 580

Bernard Soulier.

Front 581

Glanzmann Thrombosthenia is cause by a deficiency or abnormality of which platelet Gp?

Back 581

Gp IIb/IIIa receptors for fibrinogen, which results in a functional defect in platelets that prevents them from aggregating.

Front 582

What disease is represented by this classic triad: Adenoma sebaceum (angiofibromas of the sebaceous glands), epilepsy, and mental retardation?

Back 582

Tuberous sclerosis.

Front 583

Gliobalstoma multiforme arises from which cells?

Back 583

Atstrocytes; GFAP positivity.

Front 584

What infection classically presents with a "psoas abscess"?

Back 584

Spinal tuberculosis.

Front 585

Parietal cells of the stomach give what products?

Back 585

Intrinsic factor and gastric acid.

Front 586

G cells in the antrum of the stomach produce what?

Back 586

Gastrin.

Front 587

I cells in the duodenum and jejunum produce what?

Back 587

CCK; cholecystik(I)nin

Front 588

S cells in the duodenum produce what?

Back 588

Secretin.

Front 589

D cells in the pancreatic islets and GI mucosa produce what?

Back 589

Somatostatin.

Front 590

K cells in the duodenum and jejunum produce what?

Back 590

GIP (Glucose-dependent Insulinotropic Peptide).

Front 591

Parasympathetic ganglia in sphincters, gallbaldder, and small intestine produce what substance in common?

Back 591

VIP (Vasoactive Intestinal Peptide).

Front 592

What is the major mechanism by which invasive helminths are killed? What type of antibodies coat their surface?

Back 592

Invasive helminths are killed via Type II hypersensitivity. They are coated by IgE antibodies and eosinophils release majorbasic protein from their granules.

Front 593

What is the purpose for mast cell producing chemotactic factors for eosinophils in a Type I hypersensitivity reaction?

Back 593

Eosinophils have histaminase (modulates histamine), and arylsulfatase A (modulates leukotrienes)

Front 594

What is the marker, or antigen recognition site for all T-cells?

Back 594

CD3.

Front 595

What is the antigenic marker for Histiocytes, which includes Langerhans cells?

Back 595

CD1.

Front 596

What is the marker for the most common leukemia in children?

Back 596

CD10; CALLA-B antigen

Front 597

What does CALLA-B stand for?

Back 597

Common ALL Antigen of B-cells; this is CD10

Front 598

What cell shows a CD 15/30 marker?

Back 598

Reed-Sternberg cell of Hodgkin lymphoma.

Front 599

CD45 is on which leukocytes?

Back 599

ALL LEUKOCYTES!!!

Front 600

What is the key determinant in antigen presentation or vaccine administration that determines whether a patient produces antibodies other than IgM to non-self molecules?

Back 600

In order for a patient to produce antibodies other than IgM, B-cells must present PROTEINS to T-cells in order for the T-cells to release cytokines back to the B-cells TO UNDERGO ISOTYPE SWITCHING. In the absence of B-cells presenting protein (e.g. capsular antigen vaccines without conjugation to a protein) naive B cells will only be able to make IgM via their own response to antigen.

Front 601

What type of antibodies will be made in response to a capsular-antigen-only vaccine, in which the capsular antigens are not conjugated to proteins?

Back 601

In the absence of protein, the only response a patient can produce is IgM because T-cells (which only respond to protein presented by B-cells) are required for isotype switching.

Front 602

What is the CD receptor on the B-cell that is responsible for accepting cytokines to induce isotype switching?

Back 602

CD40 responds to cytokines to induce isotype switching.

Front 603

Thymus independent antigens include LPS and Polysaccharide capsular antigen. What type of immunoglobulins are made in response to introduction of thymus independent antigens to the immune system?

Back 603

IgM only, by the B-cells without help from T-cells; this is because these antigens lack a peptide component and thus cannot be presented by MHC II to Th-cells to induce isotype switching in the B-cells.

Front 604

What are the 3 "T" defects of the heart that always produce cyanotic conditions?

Back 604

Tetralogy of Fallot, Transposition of the great vessels, and Persistant Truncus arteriosus.

Front 605

What is the etiology of a Persistent truncus arteriosus? What other defect will be associated with this malformation?

Back 605

Persistent truncus arteriosus results from a failure of the CONOTRUNCAL RIDGES to form the AORTICOPPULMONARY SEPTUM. Likewise, since the conotruncal ridges also participate in the formation of the membranous interventricular septum, a ventricular septal defect will also be evident in patients with this condition.

Front 606

Infants born alive with a Transposition of the Great Vessels defect must have what other defects present?

Back 606

They must have a PDA or VSD or both, that allow mixing of oxygenated blood.

Front 607

What fibers make up the I-band of a sarcomere?

Back 607

Actin filaments; these contract, thus their length in the sarcomere changes when a muscle contracts.

Front 608

What makes of the A-band of a sarcomere?

Back 608

The A-band is made mainly of myosin filaments. While the mysoin and actin filaments slide past each other during muscle contraction, the myosin is not a contractile filament and thus "A"lways remains the same length.

Front 609

What is the drug of choice for fungal TOENAIL infections and why?

Back 609

Terbinafine is the drug of choice for toenail infections because toenails are difficult to penetrate and slow to respond. Terbinafine works on toes.

Front 610

What are the most common fungi that infect nail beds? What are the drugs of choice for treating nail infections?

Back 610

Trichophyton rubrum, T. mentagrophytes, and Epidermophyton floccosum are the most common dermatophytes causing fungal nail infections. Oral Imidazoles are commonly used for nail infections. The one exception is Terbinafine which is specifically used to treat fungal toenail infections.

Front 611

Fluconazole and Griseofulvin are oral imidazoles that are used to treat what type of nail infections?

Back 611

Fungal FINGERNAIL infections. Not toenail infections. That is the job of Terbinafine.

Front 612

What is Itraconazole used for?

Back 612

Aspergillosis, blastomycosis, histoplasmosis, and fungal fingernail infections.

Front 613

What is Nystatin most commonly used to treat and with what other substance is it combined?

Back 613

Nystatin is used in combination with Triamcinolone to treat fungal skin infections and infections affecting the mouth, vagina, or GI.

Front 614

What is the treatment of choice when you have nail bed or hairs infected with fungus?

Back 614

Oral Imidazoles or Griseofulvin.

Front 615

What are two other names for brittle, discolored nails that are infected with fungus?

Back 615

Tinea unguium, or Onchomycosis.

Front 616

Which viruses integrate into the host genome and transcribe their own genome from there?

Back 616

RETROVIRUSES!

Front 617

What is the behavior of a patient who is showing an adaptive mechanism of Regression?

Back 617

Regression is the adoption of a behavior appropriate to an earlier stage of development. This is often seen when a child who was previously toilet trained develops enuresis after the birth of a younger sibling.

Front 618

What is the short definition of Suppression?

Back 618

Forgetting, but info is retrievable; forget and remember.

Front 619

What is the short definition of Repression?

Back 619

Forgetting so that info is not retrievable; forget and forget.

Front 620

What is the short definition of Dissociation?

Back 620

Separating oneself from one's own experience; Fuge, depersonalization, amnesia, multiple personality disorder.

Front 621

What is the short definition of Sublimation?

Back 621

Moving an unacceptable impulse into an acceptable channel; Art, literature, mentoring.

Front 622

What is the short definition of Introjection?

Back 622

The outside becomes inside; Superego, being like parents.

Front 623

The thenar muscels and the skin of the hypothenar eminence are innervated mainly by the median nerve, but which ventral ramus contributes most?

Back 623

This is innervated mainly by the C8 ventral ramus.

Front 624

Which nerve innervates the ADDUCTOR POLLICIS?

Back 624

The recurrent branch of the ULNAR NERVE.

Front 625

A laceration of the Radial nerve at the wrist produces what symptoms?

Back 625

Only sensory loss to the dorsal aspect of the thumb; NO MOTOR LOSS.

Front 626

How will a Median nerve laceration from a supracondylar fracture of the humerus affect the wrist?

Back 626

This will give weakened wrist flexion with ulnar deviation.

Front 627

Hand of benediction is an injury to which nerve at what level of the arm? What other "type of hand" presents with injury to this nerve?

Back 627

A Median nerve at he the level of the elbow results in the hand of benediction; can't flex first three digits. A lesion here can also give ape hand- loss of opposition with opponens pollicis muscle.

Front 628

Do lesions of the median nerve at the wrist present with hand of benediction or disrupted function? What is lost?

Back 628

NO!!! Lesions of the median nerve at the wrist present without hand of benediction and with NORMAL FUNCTION of wrist FLEXION, digital FLEXION, and PRONATION. What is LOST is THUMB OPPOSITION, SENSATION of the lateral 3 1/2 digits of the palm, and there is THENAR ATROPHY.

Front 629

Loss of hypothenar muscles, 3rd and 4th lumbricles and all interossei. weakening of wrist flexion with radial deviation. Loss of add- and abduction of digits 2-5. Weakened IP extension, loss of thumb adduction."Claw hand" is seen. Diagnosis of lesioned nerve and location?

Back 629

These all result from lesions of the ULNAR nerve and can be seen to verying degrees with any lesions from the elbow (medial epicondyle), wrist, fracture of the hook of hammate, or midshaft clavicle fracture.

Front 630

Loss of elbow flexion and weakness in supination; loss of sensation of the lateral aspect of the forearm. Diagnosis?

Back 630

Musculocutaneous nerve lesion.

Front 631

Loss of abduction of the arm above the horizon to above the head. Diagnosis? Which nerve roots are involved?

Back 631

Long Thoracic nerve lesion (C5, 6, 7); can't protract scapula

Front 632

Loss of shoulder abduction between 0-15 degrees is a lesion to what nerve, which affects what muscle?

Back 632

Suprascapular nerve (C5, C6); Supraspinatus muscle

Front 633

Weakness of lateral rotation of the shoulder is a lesion of what nerve, which involves what muscle?

Back 633

Suprascapular nerve (C5,6); Infraspinatus muscle

Front 634

What are Heinz bodies of G6PD deficiency made of? What are other states where Heinz bodies can occur?

Back 634

Oxidized and denatured hemoglobin. Other conditions where Heinz bodies can occur are the thalassemias and other variants of unstable hemoglobins.

Front 635

What disease has hemoglobin crystals?

Back 635

Hemoglobin C or Hemoglobin SC disease; the crystals are hexagonal or rhomboid shaped.

Front 636

What are Pappenheimer bodies?

Back 636

These are iron containing dark-blue granules found in Wright-stained red cells in patients with sideroblastic anemia.

Front 637

What does the presence of a Howel-Jolly body in RBCs indicate?

Back 637

Howell-Jolly bodies are nuclear remnants within red blood cells that are normally removed by the spleen. The presence of Howell-Jolly bodies indicates either the absence of the spleen (i.e. surgical removal) or a nonfunctioning spleen.

Front 638

How are UBG and CB found in the urine in the normal state vs. extravascular hemolysis, or viral hepatitis, or obstructive jaundice?

Back 638

Normal = UBG +; CB 0

Extra. Hem. = UBG ++; CB 0

Viral Hepatitis = UBG++; CB+

Obstruction = UBG 0; CB ++

Front 639

In complete heart block the ventricles beat independent of the SA node at what rate? (*remember this to help diagnose when only heart rate is given).

Back 639

30-45 beats/min

Front 640

When you see a heart rate of 40/min and a blood pressure with a large difference between systolic and diastolic (e.g.130/60) what should you think of? How do you explain the slow HR and wide pulse pressure?

Back 640

Think of complete heart block. The ventricles are contracting at their intrinsic rate independent of the SA node.(CO = SV x HR) Because CO is normal and HR is down, SV must increase. When SV increases, a greater amount of blood must be accomodated in the arterial tree with each heartbeat, which causes a greater rise and fall in pressure during systole and diastole.

Front 641

Is the pulse pressure increased or decreased in aortic valve obstruction?

Back 641

DECREASED!!! Putting less out so less returns = lower systolic BP and higher diastolic (sitting in veins) BP.

Front 642

How does increase End diastolic volume affect Pulse pressure?

Back 642

Increased ED = Increase SV = increased Pulse pressure

Front 643

A diabetic patient has a lesion that began several weeks ago as a blister. Now it is a painful, erosive, expanding sore. Affected site is black, with necrotic center and raised red edges. Bacterium and toxin? What is this classic lesion called?

Back 643

Pseudomonas and Exotoxin A, which works like Diptheriae toxin. This lesion is called Ecthyma gangrenosum.

Front 644

How do Pseudomona Exotoxin A, and Diptheriae toxin work?

Back 644

Both of these toxins inhibit protein synthesis by acting on EF-2. EXOTOXIN A has its primary target in the LIVER cell. DIPTHERIA TOXIN target cells are HEART and NERVE cells.

Front 645

What is the mechanism of action Anthrax toxin?

Back 645

Anthrax toxin is an adenylate cyclase that causes fluid loss from cells.

Front 646

What is the mechanism of action Cholera toxin?

Back 646

Cholera toxin acts to increase adenylate cyclase activity by ribosylation of GTP-binding protein.

Front 647

What is the mechanism of action Clostridium perfringens alpha toxin?

Back 647

C. perfringens alpha toxin is a lecithinase.

Front 648

What is the mechanism of action E.coli labile toxin?

Back 648

E.coli labile toxin works in a similar fashion to Cholera toxin.

Front 649

Cholera toxin and what E.coli toxin work in a similar fashion?

Back 649

Cholera toxin and E.coli Labile toxin.

Front 650

What is the mechanism of action Pertusis toxin?

Back 650

Pertus(I)s toxin causes fluid loss by ribosylating Gi protein and inhibiting it, thus allowing increased cAMP production by adenylate cyclase.

Front 651

What is the mechanism of action Shiga toxin?

Back 651

Shiga toxin decreases protein synthesis by inhibiting the 60s ribosomal subunit.

Front 652

What is the mechanism of action of Streptococcal erythrogenic toxins?

Back 652

They act similarly to the diptheria toxin, but do so by increasing cytokine production.

Front 653

What kind of odor do pseudomona infections have?

Back 653

A fruity odor.

Front 654

What feature of Pseudomonas allows it to form pulmonary microcolonies, which are difficult to remove by phagocytosis?

Back 654

It's capsule/slim layer.

Front 655

What are the two main super antigens produced by Gram (+) bugs? Which bugs produce them?

Back 655

Staph = TSST-1

Strep= Exotoxin A (also called Erythrogenic, or Pyogenic Toxin)

Front 656

Which bacterial toxins are the main cAMP inducers?

Back 656

ETEC (LT), Vibrio cholera, Anthrax, and Pertussis (Gi).

Front 657

Which bacterial toxin is a LECITHINASE involved in myonecrosis?

Back 657

Clostridium perfringens!!!

Front 658

What is the mechanism of action of Staph aureus Alpha Toxin?

Back 658

Pore formation in cellular membranes.

Front 659

What type of amyloid is found in cardiac amyloidosis?

Back 659

ATTR, or amyloid transerythetin

Front 660

What does removal of an organ (e.g. kidney) do to total peripheral resistance? Why? How does this affect cardiac output? Does removal of an organ affect arterial BP long term?

Back 660

In increases TPR, because there are fewer parallel pathways now in the circulatory system. Increased TPR leads to a decrease in CO. Removal of an organ does not affect arterial BP long term.

Front 661

Cerebellar abscesses have a strong association to what type of infection?

Back 661

Otitis Media.

Front 662

Subdural empyema in infants is a complication of what type of infection?

Back 662

Bacterial meningitis.

Front 663

Middle ear infection and sinusitis can cause what type of brain abscesses?

Back 663

Frontal and temporal lobe abscesses.

Front 664

Otitis media can cause what type of brain abscesses?

Back 664

Cerebellar and temporal lobe abscesses.

Front 665

What is the embryological origin and adult function of the Falciform ligament?

Back 665

The Falciform ligament is the remnant of the Umbilical Vein. The ligament attaches the liver to both the diaphragm and abdominal wall. It also divides the anatomic left and right lobes of the liver.

Front 666

What is the embryological origin and function of the Ligamentum arteriosum?

Back 666

The ligamentum arteriosum is the remnant of the embryologic ductus arteriosus. During fetal life, the ductus arteriosus provides a communication between the pulmonary artery and the aorta, and shunts blood from the pulmonary circulation into the systemic circulation.

Front 667

What structures derive from the Mullerian ducts in a woman? In a man?

Back 667

In a woman the Mullerian ducts become the ovaries the uterus, and the proximal 2/3 of the vagina. In men androgens and mullerian inhibiting factor cause the Mullerian ducts to regress.

Front 668

The Auer rods of Promyelocytes in M3 can cause what reaction when they cells are lysed at the beginning of chemotherapy?

Back 668

DIC!!!

Front 669

Monoclonal spike and Rouleax formation?

Back 669

Multiple Myeloma

Front 670

Syncytia formation are characteristic of what viral families?

Back 670

Paramyxoviruses and Herpesviridae.

Front 671

Guarnieri bodies are cytplasmic inclusions characteristic of what virus?

Back 671

Smallpox.

Front 672

Giant-cell (syncytia) pneumoniae is a complication of infection with what virus?

Back 672

Measels (Rubeola)

Front 673

Do the firing rates of the arterial baroreceptors increase or decrease with an increase in blood pressure? As BP increases dose sympathetic outflow increase or decrease?

Back 673

Baroreceptor firing rates increase as BP increases. As BP increases, sympathetic stimulation goes down.

Front 674

What is Cubital tunnel syndrome?

Back 674

This causes paresthesias and numbness on the ulnar side of the hand due to compression of the ulnar nerve at the elbow.

Front 675

What nerve is damaged in Lunate dislocation?

Back 675

The Median nerve.

Front 676

What are two heat-stable molecules that autoclaves do not destroy?

Back 676

LPS and Prions.

Front 677

What is the etiology of the Tay-Sachs mutation?

Back 677

Frameshift and premature stop codon in the Hexosaminidase A gene.

Front 678

What is the cause of hereditary angioedema?

Back 678

Hereditary angioedema is a recessvie genetic disease caused by a deficiency of C1 esterase inhibitor. Edema of mucosal surfaces is an important feature of this disease.

Front 679

What type of response is important in combating extracellular encapsulated organisms?

Back 679

Antibody B-cell response.

Front 680

"Mosaic pattern" of newly formed woven bone; increased hat size Diagnosis? What are complications of this disease?

Back 680

Paget's disease. Complications include myelophtistic anemia, high output cardiac failure (the woven bone is highly vascular), pain secondary to nerve compression. OSTEOSARCOMA or other sarcomas typically involving the jaw, pelvis, or femur are also possible complications.

Front 681

What do the Rosenthal fibers of a Pilocytic astrocytoma look like?

Back 681

Corckscrew-shaped, intensely eosinophilic structures deriving from accumulation of alpha-beta-crystalin within astrocytic processes.

Front 682

Tumor in the cerebellum appearing as a cyst with a mural nodule and containing abundant Rosenthal fibers. Diagnosis?

Back 682

Pilocytic astrocytoma.

Front 683

Tumor in the 4th ventricle of a child; ependymal cells organized around small vessels (perivascular PSEUDOROSSETTES) or around small lumina (true ependymal rosettes, mimicking the primordial ependymal) canal. Diagnosis?

Back 683

Ependymoma.

Front 684

This is a malignant neoplasm of childhood that originates from glioneuronal precursors. Located in the (M)IDLINE posterior fossa and infiltrates CEREBELLAR VERMIS. Not a solid (not cystic) tumor and consists of undifferentiated small cells arranged in PATTERNLESS SHEETS. Diagnosis?

Back 684

Medulblastoma!!!

Front 685

Cohort studies use what calculation of their data to analyze their usefulness?

Back 685

Cohort studies are analyzed using relative risk, which is calculated as the incidence rate of the exposed group divided by the incidence rate of the unexposed group.

Front 686

What is the purpose of a Cross-sectional study? What is the data analysis technique most associated with this type of study?

Back 686

Cross-sectional studies are Interested in looking at one point in time and measuring the prevalence of a disease. Incidence and causality are not evaluated. It trys to assess the association of risk factors and disease. The Chi square test is used to evaluate Cross sectional studies.

Front 687

What is the purpose of a Cohort study? What is the data analysis technique most associated with this type of study?

Back 687

The purpose of a Cohort study is to look prospectively and evaluate the incidence and causality of a disease. This does not evaluate prevalence. Here single risk factors may affect many diseases. The study starts out with "no disease" and "ends with disease". Relative risk and attributable risk are used to analyze these studies.

Front 688

What is the purpose of a Case-control study? What is the data analysis technique most associated with this type of study?

Back 688

The purpose of a case control study is to retrospectively look at the causality of a disease. Incidence and prevalence are not evaluated. Case control studies start with certain cases of a disease ("begin with disease") and try to assess the many risk factors for a single disease. Compares a group that has the disease vs. a group that doesn't. Here odds ratios are used to estimate risks.

Front 689

What is unusual about the effects that breast cancer has on bone when it metastasizes?

Back 689

It produces both lytic and blastic metastases to bone.

Front 690

Locked-in syndrome is due to a lesion in which CNS structure? Which blood vessel is responsible? Which tracts are the most affected?

Back 690

"Locked-in" syndrome is due to a lesion of the ventral pons after a stroke of a segment of the basilar artery. Descending corticospinal and corticolbulbar fibers are interrupted.

Front 691

What is the purpose of a Cross-sectional study? What is the data analysis technique most associated with this type of study?

Back 691

Cross-sectional studies are Interested in looking at one point in time and measuring the prevalence of a disease. Incidence and causality are not evaluated. It try s to assess the association of risk factors and disease. The Chi square test is used to evaluate Cross sectional studies.

Front 692

What is the purpose of a Cohort study? What is the data analysis technique most associated with this type of study?

Back 692

The purpose of a Cohort study is to look prospectively and evaluate the incidence and causality of a disease. This does not evaluate prevalence. Here single risk factors may affect many diseases. The study starts out with "no disease" and "ends with disease". Relative risk and attributable risk are used to analyze these studies.

Front 693

What is the purpose of a Case-control study? What is the data analysis technique most associated with this type of study?

Back 693

The purpose of a case control study is to retrospectively look at the causality of a disease. Incidence and prevalence are not evaluated. Case control studies start with certain cases of a disease ("begin with disease") and try to assess the many risk factors for a single disease. Compares a group that has the disease vs. a group that doesn't. Here odds ratios are used to estimate risks.

Front 694

What is unusually about the effects that breast cancer has on bone when it metastasizes?

Back 694

It produces both lytic and blastic metastases to bone.

Front 695

Locked-in syndrome is due to a lesion in which CNS structure? Which blood vessel is responsible? Which tracts are the most affected?

Back 695

"Locked-in" syndrome is due to a lesion of the ventral pons after a stroke of a segment of the basilar artery. Descending corticospinal and corticolbulbar fibers are interrupted.

Front 696

What is the purpose of a Cross-sectional study? What is the data analysis technique most associated with this type of study?

Back 696

Cross-sectional studies are Interested in looking at one point in time and measuring the prevalence of a disease. Incidence and causality are not evaluated. It trys to assess the association of risk factors and disease. The Chi square test is used to evaluate Cross sectional studies.

Front 697

What is the purpose of a Cohort study? What is the data analysis technique most associated with this type of study?

Back 697

The purpose of a Cohort study is to look prospectively and evaluate the incidence and causality of a disease. This does not evaluate prevalence. Here single risk factors may affect many diseases. The study starts out with "no disease" and "ends with disease". Relative risk and attributable risk are used to analyze these studies.

Front 698

What is the purpose of a Case-control study? What is the data analysis technique most associated with this type of study?

Back 698

The purpose of a case control study is to retrospectively look at the causality of a disease. Incidence and prevalence are not evaluated. Case control studies start with certain cases of a disease ("begin with disease") and try to assess the many risk factors for a single disease. Compares a group that has the disease vs. a group that doesn't. Here odds ratios are used to estimate risks.

Front 699

What is unusual about the effects that breast cancer has on bone when it metastasizes?

Back 699

It produces both lytic and blastic metastases to bone.

Front 700

Locked-in syndrome is due to a lesion in which CNS structure? Which blood vessel is responsible? Which tracts are the most affected?

Back 700

"Locked-in" syndrome is due to a lesion of the ventral pons after a stroke of a segment of the basilar artery. Descending corticospinal and corticolbulbar fibers are interrupted.

Front 701

Mandibulo Facial Dystosis is due to abnormal development of which embryologic pharyngeal structure?

Back 701

The First Pharyngeal Arch.

Front 702

What is the most common disorder of RBCs in the human population?

Back 702

G6PD deficiency, which is an x-linked disorder.

Front 703

Which lipoproteins use ApoB100?

Back 703

VLDL and IDL (because it is derived from VLDL).

Front 704

Which lipoproteins use ApoB48?

Back 704

Chylomicrons.

Front 705

Which lipoproteins use ApoAI?

Back 705

HDL.

Front 706

What is the job of capillary lipoprotein lipase? What is the job of CII?

Back 706

Capillary protein lipase is the same thing as endothelial cell lipoprotein lipase, which is responsible for clearing tryglycerides from the chylomicron core, producing easily absorbable free fatty acids and glycerol. CII is a chylomicron protein that "turns on" lipoportein lipase and is also present in VLDL.

Front 707

This drug increases the elimination of VLDL, leads to decreased TAGs, and increases HDL. It has a side effect of muscle toxicity and acts via PPAR-alpha to induce LP lipase gene. This is for hypertryglyceridemia. Which drug?

Back 707

Gemfibrozil/Clofibrate ("Fibrates")

Front 708

This drug decreases VLDL synthesis and leads to decreased LDL. This is for hypercholesterolemia and hypertriglyceridemia. Side effects include GI irritation, hyperuricemia, hyperglycemia, flushing, and puritis. Which drug?

Back 708

Nicotinic acid (Niacin).

Front 709

This drug increases the elimination of bile salts and leads to the increased expression of LDL receptors, which leads to decreased LDL. This is used for hypercholesterolemia. Which drug?

Back 709

Cholestyramine/Colestipol

Front 710

What are "HEART FAILURE CELLS"?!? Why do they appear in left heart failure?

Back 710

These are HEMOSIDERIN-LADEN MACROPHAGES. These are often seen in left-sided congestive heart failure because of the increase in pulmonary capillary pressure with tiny hemorrhages. The pulmonary alveolar macrophages phagocytize the dead erythrocytes and retain the iron from the hemoglobin in the from of hemosiderin.

Front 711

What is the inheritance pattern of Huntington's disease?

Back 711

Autosomal Dominant.

Front 712

What is estrogen breakthrough bleeding and what is it caused by?

Back 712

Estrogen breakthrough bleeding is the type of bleeding that occurs with anovulation. This is caused by continuous estrogen stimulation of the endometrium without interruption by cyclic progesterone secretion and withdrawal.

Front 713

What is a common cause of anovulation in young females? What hormone challenge is used to confirm anovulation in the patient?

Back 713

Polycystic ovarian syndrome is a common cause of anovulation in young females. Administration and withdrawal of PROGESTERONE will cause menstrual bleeding and confirm anovulation in the patient.

Front 714

Elevation of what hormone is indicative of ovulation? Why?

Back 714

Elevated progesterone is indicative of ovulation because it means that the follicle has ruptured and that the corpus luteum that has been left behind is now producing progesterone.

Front 715

This disorder is defined by one or more symptoms affecting voluntary motor or sensory function suggesting a neurological condition. It is precipitated by psychological stressors. The symptoms are not intentionally produced or explained by other medical conditions. Diagnosis?

Back 715

Conversion disorder.

Front 716

Fracture of the hook of hamate may cause a lesion to what nerve?

Back 716

The Ulnar nerve.

Front 717

What are the levels of HIV virus, p24, and HIV viral RNA at the onset of acute infection?

Back 717

At acute infection all of these particles are very high, but the levels soon drop and coincide with sharper increases in p24-Ab, envAg-Ab, and a gradual drop in CD4+

Front 718

At what point does HIV infection begin to become symptomatic? What are the two key factors?

Back 718

HIV starts to become symptomatic when the CD4+ count falls to such a level the p24-Ab can no longer suppress rampant viral replication. p24 and HIV viral RNA at this time make a sharp rise approaching the levels that they first did at the time of acute infection.

Front 719

Antibodies to HIV protein p24 rise with initial infection and stay elevated until some years later when the patient begins to become symptomatic of the infection. In contrast to the course of this antibody, which antibodies steadily rise throughout the lifetime of the HIV patient?

Back 719

IgM env-Ab (antibody to the viral envelope)

Front 720

What part of the body does most of the replication of the HIV virus take place?

Back 720

In the lymphatics.

Front 721

The usefulness of the technique of transcutaneous electrical nerve stimulation (TENS) is explained by what theory? What does this theory postulate?

Back 721

TENS attenuation of pain is explained by the Gate theory of pain, which postulates that transcutaneous electrical nerve stimulation works by over-stimulating sensory neurons involved in pain and thus activating the inhibitory interneurons in the spinal cord, thereby partially blocking the transmission of pain impulses. which are called "gate keepers"

Front 722

Ulnar deviation from injury to the Median nerve results from the inactivation of what muscle?

Back 722

Flexor carpi radialis.

Front 723

What are the cancers that can spread to Virchow's node (left supraclavicular)?

Back 723

Stomach, neck, and mediastinal cancers.

Front 724

What immune process are individuals that are deficient in C3, at increased risk for? Why?

Back 724

Individuals deficient in C3 are at increased risk for developing Type III hypersensitivity. The most important functions of C3 are removing immune complexes from the bloodstream and enhancing opsinization of antigens.

Front 725

What is the amino acid from which Nitric Oxide in the endothelium of blood vessels is produced?

Back 725

Arginine.

Front 726

What is the malignant lymphocyte type found in CLL? What CD markers are present?

Back 726

The neoplastic cells of CLL have an immunophenotype somewhat like B-cells, with IgM, or IgM and IgD, on their surfaces. In addition, both the tumor cells and normal B-cells have CD19 and 20 marker; also occasionally CD5, which is a T-cell marker present on a small minority of B-cells in CLL.

Front 727

CD14 identifies what cell?

Back 727

Macrophages.

Front 728

CD16 and CD56 identifies what cell?

Back 728

NK cells.

Front 729

What is the aggressive nephrotic syndrome associated with both IV drug abusers and HIV that is poorly responsive to steroids, with a poor prognosis, and shows focal and segmental sclerosis and hyalinization with focal deposits of IgM and C3?

Back 729

Focal Segmental Glomerulosclerosis.

Front 730

Lacunar-type (retraction of pale cytoplasm producing an empty space) RS cells surrounded by tissue from a mediastinal lymph node that shows broad collagen bands, which represent sclerosis. Classic RS cells are hard to find. Diagnosis?

Back 730

Nodular scelrosis (hodgkin) lymphoma.

Front 731

What is a Plasmacytoma? What happens when they involve bone?

Back 731

This is a solitary myeloma involving soft tissue such as lungs, nasopharynx, and nasal sinuses. There is plasma cell proliferation with an M-spike of IgG resembling multiple myeloma, but without significant metastatic potential. Some plasmacytomas involving bone eventually (up to 10-20 yrs) develop into frank multiple myeloma.

Front 732

An elderly patient presents with a monoclonal spike on serum electrophoresis, but no identifiable mass or bone marrow lesion. Diagnosis?

Back 732

Monoclonal gammopathy of undetermined significance.

Front 733

A soft-tissue myeloma that is commonly found in the lung, nasopharynx, and nasal sinuses. M-spike with IgG and plasma cell proliferation is present, but lacks metastatic potential. Diagnosis?

Back 733

Plasmacytoma.

Front 734

What are the extrarenal signs of ADPKD? What gene mutation is this disease due to?

Back 734

Extrarenal manifestations of ADPKD include LIVER CYSTS, Berry aneurysms, and MITRAL VALVE PROLAPSE. PKD-1(polycystin-1) is the mutated gene involved with ADPKD.

Front 735

Which disease, ADPKD or ARPKD, presents with unilateral kidney invovlement?

Back 735

ARPKD presents with unilateral kidney involvment. in ADPKD the kidneys develop marked enlargement bilaterally, with large cysts bulging through the surface.

Front 736

CNS atrophy, gingivitis, gastritis, and renal tubular changes are all signs of chronic poisoning with what metal? (*tuna fish)

Back 736

MERCURY!!!

Front 737

What is the primary gastric hormone responsible for increasing intestinal blood flow after a fatty meal?

Back 737

CCK!!!

Front 738

Describe the histological differences between a Thyroid Adenoma and a Thyroid Cyst.

Back 738

A Thryroid (follicular) adenoma is a common benign lesion of the thyroid, which upon microscopic examination shows benign COLLOID FOLLICLES. In contrast, a Thyroid cyst is a common benign cystic SPACE that develops in some thyroids.

Front 739

What is the most common Thyroid carcinoma?

Back 739

Papillary carcinoma.

Front 740

Which Thyroid neoplasm is more malignant: Follicular carcinoma or Papillary carcinoma?

Back 740

Follicular carcinoma.

Front 741

With regard to muscle tensions (i.e. active/passive/total), preload is another name for which of these tension types?

Back 741

Passive tension.

Front 742

What is the treatment of choice for Klebsiella pneumonia in an alcoholic?

Back 742

3rd generation cephalosporin with or without an aminoglycoside.

Front 743

Serotypes D-K are serotypes of what most common bacterial STD in the U.S.?

Back 743

Chlamydia trachomatis.

Front 744

What is another name for Osteopetrosis?

Back 744

Albers-Schonberg disease.

Front 745

This disease presents with pathological fracturing of bone, cranial nerve defecits, anemia, and generalized bony widening with partial obliteration of marrow spaces. Diagnosis? Pathophysiology?

Back 745

This is Osteopetrosis (dominant type seen in adulthood) (Albers-Shconberg disease). There are abnormal osteoclasts that are seen in the bone marow that are frequently enlarged with bizzare shapes. Bones are thick and brittle; anemia is secondary to marrow loss and cranial nerve deficits secondary to narrowing of bony ostea.

Front 746

Is Osteopetrosis an autosomal dominant condition, autosomal recessive condition, or both?

Back 746

Both. There is an adult form and a childhood form. The childhood version is autosomal recessive, severe, and leads to death early. The adult form is autosomal dominant.

Front 747

What pathogenic process causes the kidney to appear large and edematous at autopsy?

Back 747

Acute hypovolemic shock.

Front 748

What pathological process makes the kidneys appear atrophic and shrunken, with the cortex virtually disappeared and showing frequent cysts?

Back 748

End-stage renal failure; the cysts will be present especially if the patient has been on dialysis for years.

Front 749

What causes the kidneys to have severe arteriolar damage in the form of necrotizing arteriolitis, with a grossly mottled and hemorrhagic appearance?

Back 749

Malignant hypertension.

Front 750

What does it mean if a kidney has wedge shaped areas of necrosis within the cortex?

Back 750

This means that emboli have reached the renal arteries and caused renal infarcts (e.g. left-sided subacute endocarditis that leads to septic emboli.

Front 751

Common variable immunodeficiency is one of the most common forms of congenital immune deficiency syndrome. What is the pathologic process of the disease?

Back 751

CVID is due to an INABILITY of B-LYMPHOCYTES to MATURE into plasma cells. Consequently, levels of immunoglobulins are depressed an patients suffer from DEPRESSED HUMORAL immunity. (Classically happens to immature 31 year olds)

Front 752

Where is the toxin gene of Clostridium tetani found in the organism: genomic or plasmid DNA?

Back 752

The tetanus toxin of Clostridium tetani is produced by virtue of possession of a NON-CONJUGATIVE PLASMID.

Front 753

What are episomes in bacteria?

Back 753

Episomes are plasmids that have integrated into the bacterial chromosome.

Front 754

What is the test used to identify a pathogenic strain of Corynebacterium diptheriae?

Back 754

The ELEK test! (ELEK! is the sound you make when you have a pseudomembrane in your throat).

Front 755

What type of Diptheroids can produce diptheria toxin?

Back 755

Only lysogenized organism that have been infected with lysogenic viruses can produce diptheria toxin.

Front 756

What are the 6 main bacterial toxins that are acquired by way of viral lysogeny?

Back 756

REMEMBER ABCDE-O!!

shig(A)-like toxin, (B)otulinum exotoxin, (C)holera toxin, (D)iptheria toxin, (E)rythrogenic exotoxins of Strep pyogenes, (O) antigen of Salmonella

Front 757

Where does Polio replicate?

Back 757

Orpharynx and small intestine.

Front 758

Patients with HBV are at risk for developing what vasculitis?

Back 758

Polyarteritis nodosa.

Front 759

Polyarteritis nodosa is associated with what virus and disease?

Back 759

HBV and Hepatitis B.

Front 760

Polymyalgia rheumatica is associated with what vasculitis in older adults?

Back 760

Giant cell (Temporal) Arteritis.

Front 761

What is Subacute Sclerosing Panencephalitis (SSPE) and what virus is associated?

Back 761

Subacute sclerosing panecephalitis is a rare complication of measles (rubeola) infection at an early age. It is thought that the immune and neurologic systems of very young children may permit the virus to become est. in the brain. Symptoms include changes in personality, behavior, and memory, myclonic jerks, blindness, and spaticity, may appear 6 to 7 years after clinical infection.

Front 762

Symptoms include changes in personality, behavior, and memory, myclonic jerks, blindness, and spaticity, may appear 6 to 7 years after clinical infection. The infection happens in children.

Back 762

MEASLES!!!

Front 763

What is the pathophysiology of the "peau d'orange" effect in inlfammatory breast carcinoma?

Back 763

This cancer involves spread via dermal lymphatics and therefore has a high incidence of systemic metastasis and a poor prognosis. If the lymphatics become blocked, then the area of skin may develop lymphedema and the peau d'organge appearance.

Front 764

There are two main types of coarctation of the aorta: Preductual and Postductal. Which type allows you to survive into adulthood? Which type is associated with rib notching?

Back 764

Preductal (infantile) type:
-Narrowing of the aorta proximal to the opening of the ductus arteriosus; causes reversal of flow in the intercostal arteries, leading to rib notching

Postductal (adult) type:
-Narrowing of the aorta distal to the opening of the ductus arteriosus; MOST COMMON TYPE, and allows survival into adulthood; disparity of pressure between upper and lower extremities.

Front 765

What type of Reed-Sternberg cells are characteristic of Nodular sclerosing hodgkin lymphoma?

Back 765

Lacunar cell Reed-Sternberg cells.

Front 766

22 y/o woman presents with painless cervical lymphadenopathy, night sweats, and generalized pruritus. Enlarged cervical lymph node is removed and the cut surface shows broad bands of FIBROSIS. Diagnosis?

Back 766

Nodular Sclerosing Hodgkin lymphoma.

Front 767

Patient has the sudden onset of ataxia, hoarseness, and difficulty swallowing. Felt like the room was spinning, and collapsed and was unable to ambulate due to weakness and lack of coordination. The next day the swallowing and hoarseness began. PE reveals left pupil constricted relative to the right, left sided ptosis, and decreased elevation of the palate. Temperature and pinprick sensation are reduced on the left face and on the right side of the body below the neck. Which cranial nerves are affected? What's the diagnosis?

Back 767

Left CN V, IX, X; this is Wallenberg syndrome due to a PICA infarct.

Front 768

JC Papovavirus associated PML in AIDS patients is associated with a CD4+ count of what?

Back 768

<50 CD4+

Front 769

Lateral medullary syndrome comes from an occlusion of what artery?

Back 769

PICA (Wallenberg syndrome).

Front 770

What are the main signs and symptoms of Wallenberg syndrome?

Back 770

Vertigo, nystagmus, and nausea and vomiting due to involvement of the VESTIBULAR NUCLEI. Ipsilateral cerebellar signs occur due to damage to the INFERIOR CEREBELLAR PEDUNCLE. In addition, lesions of the NUCLEUS AMBIGUOUS made of fibers of CN IX and X can lead to ipsilateral paralysis of the vocal cord, dysphagia, and palate droop. Finally lesions of SPINAL TRACT & NUCLEUS OF CN V produce loss of pain and temp sensation on the ipsilateral side of the face and contralateral body.

Front 771

Neuro presentation: Contralateral spastic hemiparesis of the body, contralateral loss of position and vibration sense on the body, ipsilateral tongue deviation. Diagnosis?

Back 771

Medial medullary syndrome.

Front 772

Neuro presentation: contralateral spastic hemiparesis of the body, contralateral loss of vibration sense and position sense. Possible medial strabismus (due to damage to fibers of CN VI). Diagnosis?

Back 772

Medial pontine syndrome.

Front 773

Neuro presentation: Symptoms are similar to Wallenberg syndrome, except that the fibers of CN VII and VIII, are affected which produce FACIAL DROOP AND HEARING LOSS!!!

Back 773

LATERAL PONTINE syndrome; so, symptoms of Wallenberg syndrome + FACIAL DROOP & HEARING LOSS = LATERAL PONTINE SYNDROME

Front 774

Neuro presentation: contralateral spastic hemiparesis that affects mostly upper limb and lower half of the face. There can also be dilated pupil, ptosis, and lateral strabismus (due to damage of the CN III fibers). Diagnosis?

Back 774

Medial midbrain syndrome (Weber syndrome).

Front 775

1) Vertigo, nystagmus, nausea, vomiting (vestibular nuclei)
2) Ipsilateral cerebellar signs (inferior cerebellar peduncle)
3) Dysphagia and dysphonia (nucleus ambiguus)
4) Loss of pain and temp in ipsilat. face and contralat body (spinal tract and nucleus of trigeminal)
5) Horner syndrome (descending hypothalamics)

Diagnosis?

Back 775

Lateral medullary syndrom (Wallenberg syndrome), which is caused by a PICA occlusion.

Front 776

What are the structures that can be affected with throracic outlet syndrome?

Back 776

The lower trunk of the brachial plexus and the subclavian artery pass laterally over the upper surface of the first rib and lie posterior to the scalenus anterior. Thus, in the case of thoracic outlet syndrome, these structures may be compressed between the scalenus anterior and a cervical rib. This most commonly effects the ulnar nerve (C8, T1).

Front 777

What is the most likely mechanism by which Streptococcus pnemoniae has acquired resistance to penicillin?

Back 777

Strep pneumo is a natural transformer that does not require special culture conditions to bind free DNA from its environment and import it. It is likely that TRANSFORMATION is the mechanism by which PENICILLIN-BINDING PROTEIN MUTATIONS have been transferred to this species.

Front 778

What is the most common means of drug transfer between gram-negative bacilli?

Back 778

F+ to F- CONJUGATION plasmid transfer.

Front 779

What is the mechanism by which Staph aureus is believed to have gained Methicillin resistance and by which Pseudomonas is believed to have gained imipenem resistance?

Back 779

GENERALIZED TRANSDUCTION!!!

Front 780

What are three major bacteria that are capable of natural transformation?

Back 780

Haemophilus influenzae, Strep pneumoniae, and Neisseria species.

Front 781

What are two examples of bacteria that have undergone lysogenic conversion with their toxins (i.e. undergone lysogeny with viruses that have stably integrated into their genomes)?

Back 781

Cholera and Shiga toxins.

Front 782

What is the most common molecular mechanism responsible for the formation of multiple drug resistance plasmids found in bacteria?

Back 782

Transposon site-specific recombination.

Front 783

What is the mechanism by which VRSA is thought to have developed from MRSA? Which bug helped MRSA out?

Back 783

VRSA is thought to have arisen because Enterococcus donated a multidrug resistant plasmid, produced by transposition to MRSA.

Front 784

What is the mechanism of the immunologic defect associated with MHC I deficiency? Which cells are absent in the patient? How will they present?

Back 784

In MHC I deficiency there is a defect in the development of CD8+ cells in the thymus. This defect occurs because there is no MHC I cytotoxic cells cannot be selected, although helper T-cells (CD4+) which recognize MHC class II molecules, are normally produced.

Front 785

What is the major defect found in patients with Hyper-IgM syndrome (HIGM)? Is it a problem with B-cells or T-cells? What type of infections are these patients susceptible to?

Back 785

The major problem in HIGM syndrome is with the CD40L on the Helper T-cells. B-cells need both IL-4 and CD40-CD40L stimulation from the T-cell in order to undergo isotype switching. Patients are susceptible to pyogenic infections and often form IgM autoantibodies to neutrophils, platelets, or tissue antigens. X-LINKED RECESSIVE.

Front 786

How do you treat otitis externa due to Pseudomonas?

Back 786

Use antipseudomonal penicillins.

Front 787

Restrictive endocarditis disease that causes endomyocardial fibrosis with associated eosinophilia. Most common in tropical/temperate climates. Diagnosis?

Back 787

Loeffler endocarditis!!!