Dit Questions 2

Front 1

What are the symptoms of pheochromocytoma?

Back 1

Episodic Hyperadrenergic Symptoms (5 P's)
-Pressure (elevated BP)
-Pain (headache)
-Perspiration
-Palpitations (tachycardia)
-Pallor

Front 2

What lab test can be used to diagnose pheochromocytoma?

Back 2

-test for urinary VMA (a breakdown product of NE)

Front 3

What class of drug is used to treat pheochromocytoma? (FA p287)

Back 3

-alpha-antagonists, especially phenoxybenzamine, a nonselective, irreversible alpha-blocker

Front 4

What is Charcot’s triad? (FA p320)

Back 4

Charcot's Triad of Cholangitis
-Jaundice
-Fever
-RUQ pain

Cholangitis is inflammation of the bile duct. The most common cause is a bacterial infection, and the problem is then an ascending cholangitis.

Front 5

What is the function of MacConkey’s agar? (FA p138)

Back 5

It's for lactose-fermenting enterics (pink colonies)

Front 6

What infection is a/w polyarteritis nodosa? (FA p270)

Back 6

-Hepatitis B seropositivity in 30% of patients

Front 7

What are the potential outcomes of a primary tuberculosis infection? (FA p147)

Back 7

-heals by fibrosis-->immunity and hypersensitivity-->tuberculin positive
-progressive lung disease (HIV, malnutrition)-->death (rare)
-severe bacteremia-->miliary tuberculosis-->death
-preallergic lymphatic or hematogenous dissemination-->dormant tubercle bacilli in several organs-->reactivation in adult life

Front 8

When is the typical cavitary lung lesion of TB seen: primary infection or secondary infection? (FA p147)

Back 8

primary infection-ghon complex-TB granulomas with lobar and perihilar lymph node involvement

Front 9

A young man comes to your office with an internal struggle over a decision to join the priesthood. On further questioning he revels that he has had thoughts of “being with other men.” What defense mechanism do you suspect this man is displaying? (FA p418)

Back 9

Reaction Formation-process whereby a warded-off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite

Front 10

What is the difference between a promoter region and an enhancer region on DNA? (FA p78)

Back 10

Promoter-site where RNA polymerase and muyltiple other transcription factors bind to DNA upstream from gene locus (AT-rich upstream sequence with TATA and CAAT boxes)
-Enhancer-Stretch of DNA that alters gene expression by binding transcription factors

Front 11

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•asthma

Back 11

-type I?????

Front 12

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•contact dermatitis (poison ivy)

Back 12

-Type IV

Front 13

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•Goodpasture’s syndrome

Back 13

-Type II

Front 14

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•Arthrus reaction

Back 14

-Type III

Front 15

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•anaphylaxis

Back 15

-Type I

Front 16

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•serum sickness

Back 16

-Type III

Front 17

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•autoimmune hemolytic anemia

Back 17

-Type II

Front 18

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•transplant rejection

Back 18

-Type IV

Front 19

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•Rh incompatability (erythroblastosis fetalis)

Back 19

-Type II

Front 20

Categorize the following disorders as either type I, II, II, or IV hypersensitivity. (FA p202)
•TB skin test

Back 20

-Type IV

Front 21

What pulmonary artery pressures indicate pulmonary hypertension? (FA p479)

Back 21

-Normal pulmonary artery pressure =10-14 mmHg

-pulmonary hypertension>=25 mmHg or >35 mmHg during exercise

Front 22

What are the branches off of the right coronary artery?

Back 22

-Acute marginal artery-supplies right ventricle
-80% of the time, the RCA supplies the inferior portion of the left ventricle via the PD artery (=right dominant)

Front 23

What is the most commonly occluded artery of the heart?

Back 23

LAD-which supplies the anterior interventricular septum

Front 24

What is particularly dangerous about an occlusion of the RCA? (FA p244)

Back 24

-In the majority of cases, the SA and AV nodes are supplied by the RCA

Front 25

What are the branches off of the left coronary artery?

Back 25

-20% of the time, the PD arises from the CFX
-Circumflex artery-supplies posterior left ventricle
-Left anterior descending artery (LAD)-supplies apex and anterior interventricular septum

Front 26

What are the three most common primary brain tumors in adults?
What are the three most common primary brain tumors in children? (FA p406)

Back 26

-adults-Glioblastoma multiforme, Meningioma, Schwannoma
-Children-Pilocytic astrocytoma, Medulloblastoma, Ependymoma

Front 27

What symptoms are seen with excess administration / toxicity of an acetylcholinesterase inhibitor? What substances are known for causing this type of toxicity? (FA p228)

Back 27

Symptoms include DUMBBELSS
-Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation (also abdominal cramping)
-Parathion and other organophosphates

Front 28

What is pulse pressure? What is the equation for mean arterial pressure (MAP)? (FA p245)

Back 28

-Pulse Pressure=systolic pressure - diastolic pressure
-MAP=CO x TPR
or
-MAP = 2/3 diastolic pressure + 1/3 systolic pressure

Front 29

Which antibiotic fits the following description?
-drug of choice for gonorrhea (FA p180)

Back 29

-Ceftriaxone

Front 30

Which antibiotic fits the following description?
-drug class for Lyme disease or Rocky Mountain spotted fever (FA p182)

Back 30

-Tetracyclines

Front 31

Which antibiotic fits the following description?
-prophylaxis for those exposed to someone with H. influenza type B infection (FA p185)

Back 31

-Rifampin

Front 32

Which antibiotic fits the following description?
-prophylaxis in someone with history of recurrent UTIs (FA p185)

Back 32

TMP-SMX

Front 33

Which antibiotic fits the following description?
-used to treat Giardia lamblia (FA p184)

Back 33

-Metronidazole

Front 34

Which antibiotic fits the following description?
-can be used to treat MRSA as well as C. diff colitis (FA p181)

Back 34

-Vancomycin

Front 35

What are the different forms of vitamin D? (FA p97)

Back 35

-D2=ergocalciferol-ingesed from plants
-D3=cholecalciferol-consumed in milk, formed in sun-exposed skin
-25-OH D3=storage form
-1,25-(OH)2 D3 (calcitriol)=active form

Front 36

What ratio indicates fetal lung maturity?
What is the proper name for the main component of pulmonary surfactant? (FA p474)

Back 36

-A lecithin-to-sphingomyelin ratio of >2.0 in amniotic fluid is indicative of fetal lung maturity
-dipalmitoyl phosphatidylcholine

Front 37

What are the two most common complications after an MI? (FA p263)
What is Dressler’s syndrome? (FA p263)

Back 37

-Cardiac arrhythmia-important cause of death before reaching V failure and pulmonary edema
-Dressler's Syndrome-autoimmune phenomenon resulting in fibrinous pericarditis (several weeks post-MI)

Front 38

What is the underlying problem in Wilson’s disease?

Back 38

-Inadequate hepatic copper excretion and failure of copper to enter circulation as ceruloplasmin. Leads to copper accumulation, especially in liver, brain, cornea, kidneys, and joints

Front 39

What are the characteristics of Wilson’s disease?

Back 39

ABCD-
-Asterixis
-Basal ganglia degeneration (parkinsonian symptoms)
-Ceruloplasmin decreased, Cirrhosis, Corneal deposits, Copper accumulation, Carcinoma (hepatocellular), Choreiform movements
-Dementia
-Hemolytic anemia

Front 40

What is the treatment for Wilson’s disease? (FA p319)

Back 40

-Penicillamine

Front 41

What are the different zones of the adrenal cortex?
What hormones are generated in each zone of the adrenal cortex and in the adrenal medulla? (FA p280)

Back 41

GFR
-Zona Glomerulosa-aldosterone
-Zona Fasciculata-cortisol and sex hormones
-Zona Reticularis-sex hormones
-Adrenal Medulla-catecholamines

Front 42

What are all of the possible side-effects of glucocorticoid use? (FA p346)

Back 42

-Cushing-like symptoms
-Immunosuppresion
-Cataracts
-Acne
-Osteoporosis
-Hypertension
-Peptic Ulcers
-Hyperglycemia
-Psychosis

Front 43

What are the principle signs and symptoms of Lesch-Nyhan syndrome?
What enzyme is defective in this syndrome, and what is its biochemical role? (FA p111)

Back 43

-Retardation, self-mutilation, aggression, hyperuricemia, gout, choreoathetosis
-HGPRT-He's Got Purine Recovery Trouble
-converts hypoxanthine to IMP and guanine to GMP

Front 44

Lesch-Nyhan Syndrome
-inheritance
-what enzyme is defective
-what is excess

Back 44

-x-linked recessive
-HGPRT
-results in excess uric acid production

Front 45

Describe how heart failure, liver failure, infections and toxins, and lymphatic blockage would affect the Starling forces of fluid movement through capillaries. (FA p257)

Back 45

-heart failure-increases capillary pressure
-liver failure-decreases plasma proteins
-infections and toxins-increases capillary permeability
-lymphatic blockage-increases interstitial fluid colloid osmotic pressure

Front 46

What cardiac defects are seen in Tetralogy of Fallot?
What is the cause of Tetralogy of Fallot? (FA p258)

Back 46

-PROVe=Pulmonary stenosis, RVH, Overriding aorta (overrides the VSD), VSD
-caused by anterosuperior displacement of the infundibular septum

Front 47

What are the main differences between delirium and dementia?
Which is more commonly reversible? (FA p420)

Back 47

-DeliRIUM=changes in sensoRIUM
-characterized by acute changes in mental status, disorganized thinking, hallucinations (often visual), illusions, mesperceptions, disturbance in sleep-wake cycle, cognitive dysfunction

-DeMEMtia-characterized by MEMory loss
-characterized by memory deficits, aphasia, apraxia, agnosia, loss of abstract thought, behavioral/personality changes, impaired judgment. Patient is alert; no change in level of consciousness

-delirium is often reversible

Front 48

•most common malignancy in children (FA p340)

Back 48

acute lymphocytic leukemia

Front 49

•most common solid tumor location in children (FA p406)

Back 49

brain tumor

Front 50

•2 most common brain tumors in children (FA p406)

Back 50

astrocytoma and medulloblastoma

Front 51

•most common supratentorial brain tumor in children (FA p406)

Back 51

craniopharyngioma

Front 52

•most common extracranial solid tumor in children (FA p287)

Back 52

neuroblastoma

Front 53

•most common malignant bone tumor in children (FA p360)

Back 53

osteosarcoma

Front 54

•most common tumor of adrenal medulla in children (FA p287)

Back 54

neuroblastoma

Front 55

•most common renal tumor in children (FA p447)

Back 55

Wilm’s tumor

Front 56

•most common primary cardiac tumor in kids (FA p268)

Back 56

rhabdomyoma

Front 57

What is the mechanism of action of the drug lanosoprazole?
What other drug works in the same manner? (FA p322)

Back 57

-proton pump inhibitors-irreversibly inhibit H/K-ATPase in stomach parietal cells
-omeprazole

Front 58

What test is used to confirm the diagnosis of hereditary spherocytosis?
What findings are a/w hereditary spherocytosis? (FA p335)

Back 58

-increased mean corpuscular hemoglobin concentration
-increased red-cell distribution width
-intrinsic, extravascular hemolysis due to ankyrin, band 3.1, or spectrin defect. RBCs are small and round with no central pallor. Associated with splenomegaly, aplastic crisis (B19 infection). Howell-Jolly bodies present after splenectomy.

Front 59

What embryologic structure gives rise to the external auditory meatus? (FA p130)

Back 59

1st branchial cleft

Front 60

What are the advantages and disadvantages of oral contraceptive use in females? (FA p471)

Back 60

-Advantages-reliable, decreased risk of endometrial and ovarian cancer, decreased incidence of ectopic pregnancy, decreased pelvic infections, regulation of menses
-disadvantages-taken daily, no protection against STDs, increased triglycerides, depression, weight gain, nausea, hypertension, hypercoagulable state

Front 61

What is the basic difference between endometriosis and endometrial hyperplasia?
How does the clinical presentation of each differ? (FA p464)

Back 61

-endometriosis-non-neoplastic endometrial glands/stroma in abnormal locations outside the uterus. Characterized by cyclic bleeding (menstrual type) from ectopic endometrial tissue resulting in blood-filled "chocolate cysts." Manifests clinically as severe menstrual-related pain.
-Endometrial hyperplasia-abnormal endometrial gland proliferation usually caused by excess estrogen stimulation. Increases risk for endometrial carcinoma. Clinically manifests as postmenopausal vaginal bleeding.