Bbc Segment 9

Front 1

famous combination for ALL

Back 1

prednisone
vincristine

Front 2

famous combination for wilm's tumor

Back 2

dactinomycin
vincristine

Front 3

famous combination for hodgin's dz (not MOPP!)

Back 3

ABVD

adriamycin, bleomycin, vinblastine, dacarbazine

Front 4

side effect of cisplatin

Back 4

renal tox

Front 5

side effect of vincristine

Back 5

peripheral neuropathy

Front 6

what is the DOC for a child with a viral infection (for symptomatic control, not to combat the virus)

Back 6

acetaminophen
(Tylenol)

Front 7

drug used for acute gout or ankylosing spondylitis

Back 7

indomethacin (NSAID)

Front 8

MOA of ASA

Back 8

IRREVERSIBLE acetylation of COX (this leads to less TXA2 so platelets don't aggregate = anticoag)

Front 9

what is celecoxib

Back 9

selective COX2 inhibitor

used in chronic pain (OA)
risk of thrombosis, stroke, MI

Front 10

SSx in MILD ASA OD

Back 10

tinnitus, central hyperventilation (resp alkalosis)

Front 11

SSx in severe ASA OD

Back 11

respiratory acidosis
metabolic acidosis (kidney tried to compensate for earlier resp alkalosis)

Front 12

what is reye's sydrome

Back 12

fulminant hepatitis and cerebral edema

caused by using ASA in kids w viral infection.....use acetaminophen (tylenol) instead

Front 13

name 3 slow acting drugs for long term use in RA

Back 13

gold (add when NSAID fail)
D penicillamine (add when gold fails or too toxic)
MTX (add when all else has failed)

Front 14

mitochondria is site of these 3 biochemical reactions (in their entirety...mito is also site of part of 3 other rxns...the other part takes place in cytosol)

Back 14

TCA cycle
fatty acid oxidation
formation of acetyl coA

Front 15

cytosol is site of these 4 biochem rxns (in their entirety)

Back 15

glycolysis
HMP shunt
protein synthesis
fatty acid synthesis

Front 16

these 3 biochemical rxns take place partly in cytosol and partly in mitochondria

Back 16

heme synthesis
urea cycle
gluconeogensis

(takes 2 to HUG)

Front 17

lysosomes contain what kind of enzymes

peroxisomes contain what kind of enzymes

Back 17

lysosomes - hydrolytic

peroxisomes - oxidative

Front 18

DOC toxoplasma gondii

Back 18

bactrim or pyrimethamine -sulfadiazine

Front 19

30S inhibitors? 50s inhibitors?

Back 19

30 TA's work in the CEC building

30 S = TA - tetracyclines, aminoglycosides
50S = CEC - chloramphenicol, erythromycin, clindamycin

Front 20

cycloheximide....what does this do

Back 20

inhibits eukaryotic 60s peptidyl transferase

Front 21

diphteria toxin....moa

Back 21

inhibits eukaryotic 60s elongation factor

Front 22

lectin....moa

Back 22

inhibits initiation of ribosomal subunit formation (messes w 40 and 60S)

Front 23

puromycin...what the heck is this

Back 23

inhibits translation in pro and eukaryotes by being incorporated into peptide chain and causing premature chain termination

Front 24

what kind of drug is pyrimethamine

Back 24

anti folate....messes w protozoal protein synthesis

antimalarial

Front 25

what is azathioprine

Back 25

a derivative of mercaptopurine (6MP)....this is a purine derivative used to cause immunosuppression

Front 26

rifampin binds to what bacterial molecule to inhibit transcription (DNA to RNA)

Back 26

bacterial RNA pol

Front 27

what is alpha amanitin

Back 27

mushroom poison, blocking eukaryotic polymerase II (so inhibits transcription)

Front 28

graphically, a substrate and it's competitive inhibitor share what

Back 28

1/Vmax (cross at the same point on the y axis)

Front 29

graphically, a substrate and it's noncompetitive inhibitor share what

Back 29

-1/Km (begin at same point on the negative x axis)

Front 30

UGH. name the essential AAs (10)

Back 30

valine, leucine, isoleucine
tryptophan, phenylalanine, methionine
lysine, arginine
histidine, threonine

Front 31

which aa's are strictly ketogenic (can make acetyl coA)

Back 31

leucine, isoleucine

Front 32

tyrosine is the precursor to what

Back 32

dopa, dopamine
NE, epi
T3, T4
melanin

Front 33

tyrosine is derived from what essential AA

Back 33

phenylalanine

Front 34

tryptophan is the amino acid precursor to what molecules

Back 34

melatonin
seratonin
niacin

Front 35

glutamate is the aa precursor to what

Back 35

GABA

Front 36

glycine is the aa precusor to what

Back 36

porphyrin, heme
creatine (glycine + arginine)

Front 37

histidine is the aa precursor to what

Back 37

histamine

Front 38

defective enzyme in albinism

Back 38

tyrosinase

Front 39

defective enzyme in alkaptonuria

Back 39

homogentisate oxidase

SSx - arthritis, ochronosis (dark pigmented CT), dark urine

Front 40

defective enzyme in MSUD

Back 40

branched chain decarboxylase

(get buildup of branched chain aas causing maple syrup smell)

Front 41

what are the branched chain aa's

Back 41

valine, leucine, isoleucine

has a ring to it...say it again and again, baby

Front 42

defective enzyme in homocystinuria

Back 42

cystathionine synthetase

Ssx - MR, lens dislocation

Front 43

defective transporter in cystinuria

Back 43

dibasic aa transporter

get COAL cystine urinary stones

Front 44

defective transporter in hartnup dz

Back 44

neutral aa transporter

leads to tryptophan deficiency, which leads to niacin deficiency, which leads to pellagra

Front 45

2 causes of pellagra and Sx

Back 45

hartnup dz and niacin deficiency

3 D's of pellagra - dementia, dermatitis, diarrhea

Front 46

definition of epimer

Back 46

isomers that differ in only one carbon (glucose and galactose)

Front 47

what are the reducing sugars

Back 47

glucose, galactose, fructose

Front 48

maltose (beer) - composition and bond

Back 48

glucose + glucose

a 1-4
think adrianna likes beer...a for alpha

Front 49

lactose (milk) composition and bond

Back 49

galactose + glucose

B 1-4
think B for breast

Front 50

sucrose (table sugar) composition and bond

Back 50

glucose + fructose

a1 b2
think Adriannas Breasts are sweet like sugar..for A and B. yes, that's right

Front 51

bond in glycogen and starch

Back 51

a 1-4 chains w a 1-6 branches

Front 52

what is the bond in cellulose

Back 52

B1-4 (cannot be hydrolyzed by humans, thus cellulose indigestible)

Front 53

enzyme defect in fructosuria

Back 53

fructokinase

beningn, Asx, as fructose is harmless

Front 54

enzyme defect in fructose intolerance

Back 54

aldolase B

hypoglycemia, liver failure bc fructose 1 P cant get out of liver, inhibiting glycogenolysis and gluconeogenesis

Front 55

enzyme defect in galactosemia

Back 55

uridyltransferase

(buildup galactose 1 P)
SSx - cataracts, MR

Front 56

don't drink milk if you have diarrhea, why

Back 56

diarrhea can result in temporary lactase deficiency = worse diarrhea

Front 57

name for the inferior articular processes of S5 which project inferiorly bilaterally on each side of the sacral hiatus

Back 57

sacral cornua

Front 58

which are the true ligaments of the pelvic and hip region

Back 58

sacroiliac ligaments

there are 3 - anterior, posterior, and interosseous

Front 59

sacrospinous ligaments connects the sacrum to the ischial spines, forming what two structure

Back 59

greater and lesser sciatic foramen

Front 60

what's the ganglion impar..where is it located

Back 60

ganglion impar is the site where the R and L sympathetic chains join
it sits just anterior to coccyx

Front 61

levator ani mm

Back 61

puborectalis
pubococcygeus
iliococcygeus

Front 62

mm of the pelvic diaphragm

Back 62

levator ani + coccygeus mm

levator ani = puborectalis, pubococcygeus, iliococcygeus

Front 63

origination and insertion of piriformis

Back 63

originates at inferior aspect of anterior sacrum

inserts onto greater trochanter of femur

Front 64

action of piriformis mm

Back 64

externally rotate thigh, extend thigh

abduct thigh when hip flexed

Front 65

innervation of piriformis

Back 65

S1 and S2

Front 66

innervation of psoas mm

innervation of iliacus mm

Back 66

psoas - L1-3

iliacus - femoral nerve = L2, L3

Front 67

flexion contracture of iliopsoas causes what lumbar SD

Back 67

commonly L1 or L2

flexed, R and S to side of contracture

Front 68

what nerves comprise lumbar plexus

Back 68

T12 to L4

Front 69

what nerves comprise sacral plexus

Back 69

L4-S4.....but only a portion of S4.

comprised of sciatic, pudendal, and superior and inferior gluteal nerves

Front 70

what nerves comprise sciatic nerve

Back 70

L4-S3 (so think of sciatic nerve as all of sacral plexus minus S4)

Front 71

through what pelvis foramen does sciatic nerve run

Back 71

greater sciatic notch, just below piriformis mm usually

Front 72

what are the 4 types of sacral motion

Back 72

inherent, respiratory, postural, dynamic

Front 73

the respiratory and craniosacral motion axis is located where

Back 73

S2 (2 of them at S2)

Front 74

the postural motion axis is located where

Back 74

S3

Front 75

what sacral axis is engaged if you stand on your R leg

Back 75

right sacral oblique axis

rule is...when youput wt on 1 leg, the same side oblique axis is engaged

Front 76

L5 sidebending does what to the sacrum

Back 76

engages ipsilateral sacral oblique axis

ex - L5 sidebent L....a left sacral oblique axis is engaged

Front 77

hirschprung's dz

Back 77

aka aganglionic megacolon
congenital lack of myenteric plexus leading to static colon...compensatory dilation prox to denervated bowel

Front 78

what causes hisrchsprung's dz

Back 78

loss of fxn mutation in RET oncogene

Front 79

ischemic bowel dz usually occurs at what two spots

Back 79

splenic flexure and rectosigmoid jxn......
these are watershed areas btwn superior mesenteric and inferior mesenteric supply zones

Front 80

gardener's syndrome

Back 80

FAP + triad of osteomas, desmoid tumors, and sebaceous cysts

Front 81

turcot's syndrome

Back 81

adenomatous polyps + CNS tumors

Front 82

what is the neurochemical imbalance in tourettes...and what drug do we use to treat (best efficacy)

Back 82

tourettes = too much Dopamine

treat with haloperidol

Front 83

a patient suffers an MI that is restricted to the interventricular septum. he develops a new murmur. what is the murmur?

Back 83

tricuspud regurg.

tricupid valve has 3 leaflets, anterior, posterior, septal, and septal sits near IV septum so it is disturbed.

Front 84

look on the scope and see organisms w double walled spherules

Back 84

environmental form of dimorphic fungi Coccidioides immitus

Front 85

cigar shaped yeast cells

Back 85

the dimorphic fungi sporothrix schenkii

Front 86

2 organisms described as branching, gram positive rods

Back 86

actinomyces israelii
nocardia asteroides

Front 87

nonseptate hyphae seen on scope

Back 87

Rhizopus/Mucor

rhizopus has roots, mucor does not
cause rhinocerebral mucormycosis....a sinus infection that evntually involves all the sinuses, palate, orbit, and brain

Front 88

conditions that predispose you to rhinocerebral mucormycosis

Back 88

DKA
neutropenia
organ Tplant
immunosuppresion

poor prog. Tx w ampho B and surgery to remove the infected tissue

Front 89

anaerobic gram positive spore forming rod

Back 89

Clostridum perfringens

gas gangrene

Front 90

pt gets a hip replacement and develops osteomyelitis. most likely organism?

Back 90

staph epidermidis
catalse positive, coagulase negative gram positive coccus

Front 91

gram negative rod that does not ferment lactose

Back 91

salmonella
causes osteomyelitis in sickle cell dz

Front 92

an IV drug user develops osteomyelitis..you should consider what bug

Back 92

e. coli
gram negative rod that ferments lactose

Front 93

deficiency of what enzyme leads to tay sachs

Back 93

beta hexosaminidase A

Front 94

deficiency of what two enzymes results in sandhoff dz

Back 94

beta hexosaminidase A
beta hexosamindase B

sandhoff - AR, Sx = HSM and cherry red spot on macule. BM aspirate shows cells containing oligosaccharides

Front 95

defiicency of what enzyme results in hurler syndrome

Back 95

alpha L iduronidase

Front 96

deficiency of what enzyme results in krabbes dz

Back 96

galactosylceramide beta galactosidase

Front 97

deficiency of what enzyme results in Niemann pick dz

Back 97

sphingomyelinase

Front 98

what are the guidelines for infections to look for in HIV positive pts with particular T cell counts

Back 98

T cells > 200/mm3 - comm. aq pneumonia, kaposi sarcoma, lymphoma
<200/mm3 - P. jiroveci and candidiasis
<100/mm3 - cryptococcal meningitis
<50/mm3 - MAI and CMV retinitis

Front 99

describe the process of ASA overdose, baby

Back 99

ASA OD causes ox phos uncoupling --> hyperventilation
thus respiratory alkalosis
kidney responds w metabolic acidosis
as ASA rises to tox level, central repiratory paralysis occurs and you get hypoventilation --> increase CO2 causing respiratory acidosis.
SOO mild ASA OD - tinitius, hyperventialtion, resp alkalosis and metab acidosis
high ASA OD - resp acidosis and metab acidosis

Front 100

DOC for cryptosporidiosis

Back 100

nitazoxanide


can also treat giardia

Front 101

what class of drugs contraindicated for concurrent use w celecoxib, a COX 2 inhibitor (NSAID)

Back 101

sulfa

cant use celecoxib in sulfa allergic pts

Front 102

only drug to Tx ALS

Back 102

riluzole
glutamate receptor blocker
and NA channel blocker

Front 103

what is the greatest risk factor for cholangiocarcinoma

Back 103

liver fluke clonorchis sinensis

Front 104

most significant risk for a child to develop intussusception

Back 104

adenovirus

Front 105

Still's dz Sx

Back 105

this is juvenile rheumatoid arthritis
acutely febrile, polyarthritis, RF negative, micrognathia

Front 106

SSx psoriatic arthritis

Back 106

like RA but with psoriasis
RF netgaitve
affects DIPs primarily (nl RA - spares DIP)
sausage digits
HLA b27+

Front 107

SSx Felty sydrome

Back 107

polyarticular RA, splenomegaly, neutropenia, leg ulcers, increase infections

Front 108

sclerosis of the vertebral endplates in osteopetrosis yields what classic radiologic finding

Back 108

rugger jersey vertebrae

(like a striped rugby shirt, the vertebra is light on top, dark in middle, light on bottom)

Front 109

what is legg-calve-perthe's dz

Back 109

aseptic necrosis of femoral head in children without a trauma Hx

Front 110

what is osgood schlatter dz

Back 110

aseptic necrosis of tibial tuberosity

Front 111

patellofemoral tracking syndrome

Back 111

anterior knee pain, worse climbing stairs

Front 112

what causes osteitis fibrosa cystica

Back 112

severe hyperparathyroidism.

leads to focal bony damage causing microFx and 2ndary hemorrhage. these in turn cause ingrowth of fibrous tissue and hemosiderin deposition ( a brown tumor)..the "tumors" undergo cystic degeneration

Front 113

what is the most common benign bone tumor

Back 113

osteochondroma

Front 114

what is an enchondroma

Back 114

benign cartilage tumor

cartilage forms within bone

Front 115

what are the 3 benign cartilaginous tumors

Back 115

osteochondroma (most common of all benign bone tumors)
endochondroma
chondroblastoma

Front 116

what is a chondroblastoma

Back 116

tumor of cartilage producing cells
benign, rare, 10-20 yo
hits femur, tibia, humerus epiphyses

Front 117

what are the 3 benign bone tumors (bone, not cartilage)

Back 117

osteoma, osteoid osteoma, osteoblastoma

Front 118

where do osteomas primarily form

Back 118

these are benign, usually multiple, PAINLESS tumors usually found in the skull and facial bones - form protrusions
associated w gardner's syndrome (FAP)

Front 119

where do osteoid osteomas form

Back 119

primarily in the proximal tibia and femur
PAINFUL

Front 120

where do you mostly find osteoblastomas

Back 120

spine
it looks like an osteoid osteoma morphologically but it's larger and found in vertebral column

Front 121

12 year old boy w a painful soft tissue mass arising from the diaphysis of his femur. Histo reveals + Homer wright rosettes and the lesion itself has an onion skin appearance due to reactive bone

Back 121

ewing's sarcoma

peak 10-15 yo. 11; 22 translocation (11+22 =33.. patrick ewing's jersey), onion skin appearance due to bone layering itself to protect from tumor. "going out for eWINGs and ONION rings"

Front 122

you read. codman's triangle. you Dx.

Back 122

osteosarcoma

Front 123

AR dz with heterogeneous presentation....Sx of proximal hip and shoulder girdle weakness

Back 123

limb girdle muscular dystrophy

elevated creatinine kinase

Front 124

Sx and inheritance of facioscapulohumeral muscular dystrophy

Back 124

AD
onset adolescence, face and shoulder girdle weakness, MR, +/- cardiac defects,

Front 125

Pt presents w MR, long face, temporal and masseter mm wasting, atrophied gonads, inability to voluntarily relax muscles after forceful contraction, mostly producing distal weakness

Back 125

myotonic muscular dystrophy

AD - trinucleotide repeat

Front 126

name the 4 neural tube derived brain tumors (gliomas)

Back 126

astrocytoma (fibrillary and pilocytic most common)
medulloblastoma
oligodendroglioma
ependymoma

Front 127

what is the most common childhood brain tumor

Back 127

medulloblastoma

found only in cerebellum. found midline in kids

Front 128

what are the 3 neural crest derived brain tumors - what do they all have in common?

Back 128

meningioma
schwannoma
neurofibroma
the neural crest derived tumors are all benign