Missed Qbank Questions

Front 1

Potter's syndrome

Back 1

Babies with Potter’s can’t “Pee” in utero. *necessary for lung development

Bilateral renal agenesis →
oligohydramnios →
limb deformities, facial deformities, pulmonary hypoplasia.

Caused by malformation of ureteric bud.

Front 2

Paget's disease

Back 2

bone pain with increased osteoclastic bone resorption

increased alk phosphatase levels (↑ ALP)

Abnormal bone architecture caused by ↑ in both osteoblastic and osteoclastic activity.

Serum calcium, phosphorus, and PTH levels are normal.

Mosaic bone pattern; long bone chalk-stick fractures

Can lead to osteogenic sarcoma.

Front 3

Hemophilia B

Back 3

X-linked recessive

Factor IX deficiency

Front 4

Patau's syndrome

Back 4

Microphthalmia,
microcephaly, cleft
lip/palate

NEEDS FA

Front 5

A1AT deficiency

Back 5

Misfolded gene product protein accumulates in hepatocellular ER.

↓ elastic tissue in lungs → emphysema.

PAS-positive globules in liver.

Autosomal recessive.

Front 6

NK cells

Back 6

destroy cells w/decreased MHC I particles (virally infected cells do this)

Front 7

Trazodone

Back 7

highly sedating anti-depressant

used to treat insomnia or as an adjunct to an SSRI (fluoxetine) when there is depression associated insomnia- b/c SSRIs cause reduced libido, anorgasmia, and delayed ejaculation (SSRI good for pre-ejac)

S/E: priapism, contraindicated in boys

Front 8

MCC of elevated AFP?

Back 8

dating error due to underestimation of gestational age

neural tube defects, anterior abdominal wall defects (omphalocele, gastroschisis), multiple gestation

Front 9

decreased AFP?

Back 9

Down's syndrome

Front 10

increased hCG?

Back 10

Hydatidiform mole or choriocarcinoma

Front 11

what do the mesonephric ducts turn into

Back 11

Males->Wolffian ducts -> ductus deferens, epidydimis

Females ->Gartner's ducts

Front 12

what does the ureteric bud turn into?

Back 12

collecting system of kidney (collecting ducts, minor and major calyces, renal pelvis, ureters)

Front 13

What does the metanephric mesoderm turn into?

Back 13

filtration system of kidney
(glomerulus, bowmans space, proximal tubule, loop of henle, distal tubule, collecting tubule)

Front 14

characteristics of males w/Fragile X

Back 14

moderate mental retardation
large ears, long face, prominent jaw
macroorchidism

trinucleotide repeat disorder

Front 15

characteristics of Klinefelter

Back 15

47 XXY

MILD mental retardation/normal intelligence
tall male w/ gynecomastia, small testis, and infertility

Front 16

characteristics of Turners

Back 16

45 XO

Primary amennorhea
mild mental retardation
webbed neck
shielded chest
ovarian dysgenesis

Front 17

characteristics of 47 XYY

47 XXX

Back 17

47 XYY- tall, acne, criminal behavior due to lower IQ

47 XXX- clinically silent

Front 18

characteristics of Marfans

Back 18

tall stature
arachnodactyly (long and thin fingers)
ectopia lentis (lens displacement)
dilatation of proximal aorta (dissecting aortic aneurysms)

Front 19

characteristics of acute dystonia

Back 19

twisting, involuntary movts
abnormal posture

muscle pains and stiffness

Front 20

characteristics of tardive dyskinesia

Back 20

"Tongue"
involuntary perioral movts
(biting, chewing, grimacing, tongue protusions)

Front 21

characteristics of Akathisia

Back 21

inability to sit still or remain standing in one place

Front 22

characteristics of neuroleptic malignant syndrome

Back 22

delirium, fever, muscle rigidity and autonomic instability

rare, FATAL syndrome

caused by adverse reaction to antipsychotic drugs

Front 23

characteristics of Acute mania

Back 23

grandiose delusions (chosen by holy spirit for magnificent purpose)

flight of ideas

Front 24

characteristics of delirium

Back 24

confusion or clouding of sensorium

dazed and unclear abt their surroundings

not oriented to time and place

often very difficult to get their attn

Front 25

MCC of palpitations

Back 25

anxiety

usu due to any change in heart rate or rhythm

Front 26

What does an irregularly irregular tachyarrythmia indicate?

What will the EKG show?

Back 26

Atrial fibrillation

EKG will show absent p waves (b/c coordinated atrial contractions don't occur) and irregularly irregular series of QRS complexes

Front 27

MCC of Atrial fibrillation?

Back 27

Binge drinking
Increased cardiac sympathetic tone
Pericarditis

Front 28

What will EKG show in Afib?

Back 28

irregularly irregular series of QRS complexes and absent P-waves

P-waves always absent in AF bc coordinated atrial contractions don't occur

Front 29

pt has Prolonged QT interval?

Back 29

Torsades, unique form of Vtach

QT interval defines period of ventricular depolarization + repolarization on EKG

Front 30

pt has High QRS voltage?

Back 30

ventricular hypertrophy (usu due to untreated chronic HTN)

Front 31

pt has Prolonged QRS complex?

Back 31

Bundle branch block

sign of ventricular dyssynchrony or slowed intraventricular impulse conduction

Front 32

pt has ST elevation?

Back 32

transmural MI

Front 33

findings on biopsy of hyperacute renal allograft rejection

Back 33

vascular fibrinoid necrosis
neutrophil inflammation
infarction of graft

Front 34

findings on biopsy of chronic renal allograft rejection

Back 34

occurs months to years after

recipient Abs against graft endothelium

obliterative intimal smooth muscle hypertrophy
fibrosis of cortical arteries

Front 35

What is the most likely cause of UTIs characterized by dysuria and hematuria, in daycare center outbreaks

Back 35

Adenovirus causing acute hemorrhagic cystitis (diffuse inflammation of the bladder)

Front 36

Splitting of S2 that does NOT change w/ respiration?

Back 36

ASD

Front 37

Systolic ejection murmur

that is accentuated by standing?

Back 37

aortic stenosis

hypertrophic obstructive cardiomyopathy

Front 38

Early diastolic decrescendo murmur that decreases with amyl nitrate

Back 38

aortic regurgitation

Front 39

late diastolic murmur eliminated by atrial fibrillation

Back 39

mitral (and/or tricuspid) stenosis

Front 40

low pitched holosystolic murmur that increases with maneuvers that increase afterload

Back 40

VSD

Front 41

continuous flow murmur

Back 41

PDA

Front 42

Ulnar nerve lesions can produce:

Back 42

• Clawing of the 4th and 5th digits
• Wasting of the hypothenar eminence and dorsal interosseous muscles
• Loss of sensation to the back of the 5th digit and half of the 4th digit

Front 43

Chagas disease:

Back 43

• Caused by T cruzi

• Can cause cardiac failure. megaesophagus and megacolon

Front 44

The highest drop in the pressor is across the

Back 44

arterioles because they are the segment with the highest resistance (not capillaries!)

Front 45

What gives the symptoms of Flaccid muscle paralysis, Tachycardia, mydriasis, and elevated body temperature

Back 45

The botulinum toxin binds to motor neurons and prevents the release of acetylcholine. causing:
• Flaccid muscle paralysis due to deceased Ach stimulation of nicotinic receptors in the neuromuscular junction
• Tachycardia. mydriasis(excessive dilation of pupil). and elevated body temperature due to decreased Ach activity at the muscarinic receptors

Front 46

Psoriatic arthritis

Back 46

is similar to rheumatoid arthritis although the process is less destructive

• Psoriatic arthritis is rheumatoid factor-negative and is associated with the HLA-B27 haplotype

Front 47

Infection by the herpes simplex virus is recognized by

Back 47

nuclear homogenization (“ground-glass” nuclei). intranuclear inclusions (Cowdry type A bodies). and the formation of multinucleated cells.

When a person is infected, the disease will manifest itself with the appearance of vesicles that ulcerate and cause burning. itching, and pain

Although there are two medications used to treat HSV infections (acyclovir and ganciclovir). only Acyclovir can be used without causing bone marrow suppression

Front 48

common congenital anomaly that may contain heterotopic gastric mucosa

Back 48

• Meckers diverticulum
• in the distal ileum about 12 inches from the ileocecal valve
• Heterotopic gastric mucosa can cause abdominal pain

Front 49

What can cause lower than expected levels of drug even when pt is reporting taking them?

Back 49

• Chronic alcohol use and cigarette smoking can induce cytochrome P450. which is located in the smooth endoplasmic reticulum of the liver
• This can enhance the metabolism of other drugs. leading to lower than expected plasma levels

Front 50

What are chemoattractants causing the accumulation of white blood cells?

Back 50

• C5a attracts to the site of complement activation
• Other chemotactic factors for neutrophils include IL-8. fibrinopeptides, leukotrienes, and forrnyl methionyl peptides from bacteria

Front 51

Mech of action of Organophosphate insecticides, such as parathion.

Symptoms?

Back 51

acetylcholinesterase inhibitors

• These agents increase acetylcholine levels at all cholinergic synapses

• Symptoms include bradycardia, increased gastrointestinal motility, increased secretions, miosis, and blurred vision

Front 52

• Pseudomyxoma peritonei

Back 52

is produced when a malignant or benign mucus-producing tumor (mucinous cystadenoma or mucinous cystadenocarcinoma) produces gel-like mucus that fills the peritoneal cavity
• The ovaries and appendix are the usual sites for these tumors

Front 53

the EKG will show intermittent. nonconducted atrial beats not preceded by lengthening AV conduction

What is this?
What is it caused by?

Back 53

• Mobitz type II AV block

• Metoprolol is a selective beta-1 blocker, but every beta-blocker can cause different degrees of AV blockade

Front 54

Patient with an ovarian mass (usually a benign fibroma) with hydrothorax and ascites

Back 54

Meigs syndrome

Front 55

Low back pain and a stretching or pulling sensation are characteristic of

Back 55

ascites in some patients (ascites can also be asymptomatic)

Front 56

Trigeminal nerve

Back 56

• principal motor nerve supplying the muscles of mastication

• three major branches: ophthalmic. maxillary, and mandibular The ophthalmic and maxillary nerves are purely sensory. The mandibular nerve has both sensory and motor functions

• The motor nucleus of cranial nerve V is located in the mid-pons

Front 57

Pt presents with the cluster of diarrhea, flushing, and abdominal pain.

how to diagnose?

Back 57

Carcinoid syndrome

Diagnosis can be confirmed by demonstrating the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in urine.

Front 58

Direction of tranport for Dynein and Kinesin?

Back 58

"DR. KA"

• Kinesin: toward the (+) end of microtubule (anterograde)

• Dynein: toward the (-) end of the microtubule (retrograde)

Front 59

retroperitoneal organs

Back 59

most of the duodenum, most of the pancreas (except the tail), ascending and descending colon, rectum, anal canal, kidney, adrenal glands, ureters, aorta, and inferior vena cava

Front 60

What are Anticholinergics such as trihexyphenidyl helpful in alleviating

Side effects

Back 60

tremors and rigidity associated with Parkinson disease

Antimuscarinic agents block cholinergic tone and can lead to various side effects. including dry mouth, constipation. mydriasis. urinary retention. and decreased sweating

Front 61

mYdriasis vs. mIosis

Back 61

mYdriasis vs. mIosis

Y is your pupil so big!!! (pupil is dilated)

I don't notice (pupil is constricted)

Front 62

Features of Kartagener syndrome include:

Back 62

• Triad of situs inversus. chronic sinusitis and bronchiectasis.

• Dynein arms of microtubules are missing or defective.

• Ciliary function (mucous sweeping or ciliary elevator functioning. sperm motility. embryonic cell movement) is adversely affected.

Front 63

Pt comes in with bilateral papilledema. nausea/vomiting. nuchal rigidity, and mental status changes

Back 63

A tumor (medulloblastoma) blocking the 4th ventricle can block CSF circulation, leading to an increase in the intracranial pressure

Front 64

What are the symptoms of a pt who has been abusing stimulants such as amphetamines, cocaine, and methamphetamines?

What can be given to tx them?

Back 64

Stimulant usage can cause agitation, mydriasis. arrhythmias, seizures, psychosis, and hyperthermia

• Acute treatment measures generally involve the use an antipsychotic +1- a benzodiazepine

• Because stimulants are basic substances. acidification of the urine with AMMONIUM CHLORIDE will hasten their elimination

Front 65

What drug absorbs residual compounds in the stomach after oral ingestion of drugs or poisons

Back 65

Activated charcoal

Front 66

What drug chelates iron and increases its clearance from the body

Back 66

Deferoxamine

Front 67

What drug induces vomiting and is useful for orally ingested drugs

Back 67

Ipecac

Front 68

What drug is an opiate (morphine, codeine, heroin) antagonist

Back 68

Naloxone

Front 69

cause of heterophile-positive infectious mononucleosis

Back 69

EBV

Front 70

responsible for heterophile-negative mononucleosis

Back 70

CMV

Front 71

Downey cells

Back 71

atypical reactive lymphocytes (CD8+ lymphocytes) that may comprise up to 70% of the white cells in a CBC

associated with EBV or CMV

Front 72

Cold agglutinins

Back 72

antibodies that agglutinate red blood cells at 4°C

observed in Mycoplasma pneumonia and autoimmune hemolytic anemia

Front 73

Koilocyte

Back 73

found in cells infected with HPV (human papillomavirus)

characterized by perinuclear vacuolization and an enlarged nucleus

Front 74

Negri bodies

Back 74

found in neurons infected with the rabies virus and represent sites of virus assembly

Front 75

Owl’s-eye inclusions

Back 75

found in cells infected with CMV

CMV is responsible for heterophile-negative mononucleosis.

Front 76

Side effect of cyclosporine

Back 76

cyclosporine-induced nephrotoxicity rises with increasing doses and duration of the cyclosporine therapy

Front 77

the most common cause of nephrotic syndrome in children

Back 77

Minimal change disease (lipoid nephrosis)

Glomeruli appear normal by light microscopy, but fusion of podocyte foot processes is seen by EM

Front 78

Associate the following findings with diseases:
• Increased Reid index:

• Apical cavitary lesions:

• Curschmann spirals:

• Elevated sweat salt levels:

• Enlarged hilar glands:

Back 78

• Increased Reid index: chronic bronchitis

• Apical cavitary lesions: tuberculosis

• Curschmann spirals: asthma

• Elevated sweat salt levels: cystic fibrosis

• Enlarged hilar glands: granulomatous diseases, lymphoma, or tumor

Front 79

Acute theophylline overdose

Back 79

can present with early symptoms of sinus tachycardia, tremors, and severe neurologic symptoms such as seizures

Theophylline acts by INHIBITING phosphodiesterase and by ANTAGONIZING ADENOSINE receptors

Front 80

Tx for Patients with diabetes and hypertension

Mech of action?

S/E?

Back 80

ACE inhibitors for the management of hypertension since these agents also protect against diabetic nephropathy

• ACE inhibitors block the formation of AT-II which is a potent vasoconstrictor and increase bradykinin levels.

• The ACE inhibitors are associated with the development of angioedema, dry “hacking” cough (due to bradykinin) and hyperkalemia

CONTRAINDICATED w/ bilateral renal artery stenosis