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92 Cards in this Set

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Which serum marker is best measured in MI?
a) first 8 hours
b) 8-24 hours
c) 2-7 days
a) troponin
b) CK-MB
C) LDH-1
What is pleiotropy?
A single gene mutation can have various phenotypic outcomes.

E.g. RB gene#: retinoblastoma and osteosarcoma
Where in the kidney can you find epithelial cells with a brush border?
proximal tubule: enhances reabsorption
Which 2 substances are present in a genotype male in early fetal life?
TDF: testes differentation factor -> induces testes
MIF: mullerian inhibiting factor -> prevents female internals
Which type of disease in newborns presents with:
a) severe hyperammonemia and respiratory alkalosis
b) hypoketotic hypoglycemia, hyperammonemia and cardiomyopathy
c) hypoglycemia, lactic/ketoacidosis and hepatosplenomegaly
d) feeding difficulties, lethargy, seizures, coma, renal/liver disease
e) metabolic acidosis with ketosis, elevated lactate, mild hyperammonemia, vomiting, encephalopathy, neutropenia, thrombocytopenia
a) urea cycle defects
b) # fatty acid oxidation
c) # carbohydrate metabolism
d) aminoacidopathy
e) organic acidemias
What is the most common cause of maternal death in preeclampsia?
cerebral hemorrhage and ARDS
What is the effect of captopril in a kidney with renal artery stenosis?
Renal arty stenosis: incr aldosteron and angiotensin II. Latter contstrics efferent arterioles to increase GFR.

Captopril = ACE inhibitor -> less angiotensin II -> decrease GFR
What disease do you suspect in woman <50 year, with hypertension, autoimmune diseases and beaded renal artery stenosis?
FMD: fibromuscular dysplasia
What does APGAR stand for?
Appearance
Pulse
Grimace
Activity
Respiration
Which muscle group allows you to maintain balance when standing on 1 foot?
gluteus minimus and medius (sup gluteal nerve)
Arthus reaction - which type hypersensitivity?
type III
Serum sickness - which type hypersensitivity?
type III
DTH reaction - which type hypersensitivity?
type IV
Contact hypersensitivity - which type hypersensitivity?
type IV
reaction to parasites - which type hypersensitivity?
type II
M.Gravis - which type hypersensitivity?
type II = anti-human antibodies (crossreacting, etc)
Glomerulonephritis - which type hypersensitivity?
type III = immune complex deposition
What marker can be measured in:
neuroblastoma, small cell ca, gastric ca, pancreatic ca
bombesin
Which tumor marker?
melanoma, astrocytoma, schwannoma
s-100
Which tissue contains:
desmin
striated skeletal muscle
Which tissue contains:
vimentin
connective tissue
which cell components transport intracellular vesicles?
Kinesin (towards + = membrane)
Dynein (towards -)
Which tissue contains:
titin
muscle: component sarcomere
Which tissue contains:
cytokeratin
epithelial cells
Which tissue contains:
spectrin and ankyrin
erythrocytes
what do microvilli contain?
myosin
Where can you find clathrin in the cell?
cytoplasmic side plasma membrane (coated pits-endocytosed vesicles)
Match:

1) hyper IgM
2) SCID
3) Bruton's agammaglob.
4) bare lymphocyte syndrome

a) # tyrosine kinase
b) # CD40L
c) # adenosine deaminase
d) # MHC II receptor
e) # il-2 gamma chain receptor
1 = b
2 = c e
3 = a
4 = d
What disease:
delayed separation umbilical cord stump in newbord and infection of the stump (omphalitis)?
LAD: leukocyte adhesion deficiency

Measure cd18 intergrin subunit by flow cytometry
Which poison?
hyperventilation
respiratory alkalosis
metabolic acidosis
dehydration
hypokalemia
salicylate poisoning
Which poison?
N, V, abdominal pain, shock,
liver failure after 2-6 d
acetaminophen poisoning
Which poison?
hypoxia
cherry red mucous membranes and lips
carbon monoxide poisoning
Which poison?
anemia (with basophilic RBC stippling), neuropathy, abdominal pain
chronic lead poisoning
which poison?
cns atrophy
gingivitis
gastritic
renal tubular changes
chronic mercury poisoning

(acute: renal tubular necrosis and GI necrosis)
Which antibiotics are associated with myalgia, arthropathy and leg cramps in pts <18 years
fluoroquinolones
Which disease?
Acute bone ischemia lasting up to 2 weeks. Usually following viral illness. Hereditary. Erlenmeyer flask femur.
Gaucher (crisis)

Glucocerebrosides accumulate in macropahges in bone marrow.
What brain tumor is more common in AIDS patients (cd4<40)?
B-cell lymphoma: multicentric mass in brain and meninges
Match:
1)genoihyoid
2)stylopharyngeus
3)palatopharyngeus, cricophraungeus, palatoglossus

a)pharyngeal plaxus
b)c1 via hypoglossal nerve
c)CN IX
1 = b (moves hyoid bone ant to open pharynx)
2 = c (elevates pharynx)
3 = a
What is the result of destruction vs stimulation of these parts of the hypothalamus
1) lateral nucleus
2) ventromedial nucleus
3) septal nucleus
1)starvation vs eating
2)eating vs starvation
3)agressive behavior
Orchitis:
1) plasma cells and lymphocytes with endarteritis
2) neutrophils
3) gumma formation
4) granulomas
1 + 3) syphilis
2) nonspecific or gonorrea
4) TB
what causes localized paradoxical movement in the heart?
MI: muscle there can not contract: bulges outward during systole
What intestinal disease do you think of when a pts passes fecal material in urine?
Crohn -> fistulas (involves entire wall)
What kind of gallstones exist?
* cholesterol monohydrate (+ little calcium salts) -> radiolucent

* black stones: calcium salts -> radiopaque

* brown (pigment) stones: calcium soaps (calcium, palmitate, stearate), unconjugated bili, cholesterol -> ass biliary tract infection (beta-glucuronidase, asia), hemolytic anemia, liver cirrhosis/fluke

nb: all stones: mucin glycoproteins
What are the 10 essential amino acids?
"Any Help In Learning these Little Molecules Proves Truly Valuable."

Arginine (urea cycle)
Histidine
Isoleucine
Leucine (ketogenic)
Threonine
Lycine (ketogenic)
Methionine
Phenylalanine
Tryptophan
Valine
Which 2 brain areas are involved in vomiting induction?
4th ventricle (area postrema in floor)

medulla (lat reticular formation)
Which drug?

disorientation, reckless behavior, distorsions of body image, detachment

nystagmus, hypertension, tachycardia, diaphoresis, motor incoordination, mydriasis
Phenylcyclidine = PCP = angel dust
Which drug?

euphoria, nervous, hyperactive, short attention span, insomnia

tachycardia, hypertension, sweating
Amphetamine
Which drug?

visual distorsions

nausea, weakness, parestesias
Lysergic acid diethylamine = LSD
Which drug?

Lethargic, somnolent

Hypotension,miosis, decreased bowel sounds
Heroin
What is the most common form of congenital adrenal hyperplasia?
21-hydroxylase deficiency

increase androgens
decrease cortisol, aldosteron (latter in severe cases -> salt waisting)
What substances form bilayer vesicles instead,droplets, and micelles in water?
phospholipids and sphingolipids -> amphipathic -> bilayer

cholesterol esters and triglycerides are hydrophobic -> droplets

Long fatty acids -> micelles
Where can the median nerve be compressed?
carpal tunnel and between the 2 heads of the pronator teres muscle near elbow
What does the thoracic duct drain?
everything except right arm/chest/head (right lymphatic duct)
What is the source of
1) AA amyloid
2) AL amyloid
1) liver (produced in response to cytokines)
2) bone marrow
What is heteroplasmy?
In 1 individual there are normal and mutated mitochondrial DNA molecules
Which disease?

anti-mitochondrial antibodies
Primary biliary cirrhosis

(ass with systemic sclerosis, sjogren, RA, thyroiditis, celiac disease, glomerulonephritis)
Which disease?

anti-smooth muscle antibodies
Autoimmune hepatitis
Which disease?

anti-centromere antibodies
limited systemic sclerosis, CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia)
Which disease?

anti-topoisomerase I antibodies
diffuse systemic sclerosis
Which disease?

anti-histone antibodies
Drug induced lupus
Which disease?

anti-ribonucleoprotein antibodies
MCTD
Which disease?

anti-platelet gp2a/3b antibodies
ITP
Which disease?

anti-type IV collagen antibodies
Goodpasture
Which disease?

anti-neutrophil cytoplasma antibodies
Wegener's granulomatosis (c-anca)
Which disease?

anti-microsomal antibodies
hashimoto thyroiditis
What are secondary effects of Sjogren?
caries, parotid gland enlargment, recurrent tracheobronchitis
What is the difference between gout and pseudogout?
Gout: needle-like crystals, strongly negatively birefringent

Pseudogout: rough cuboidal crystals, weakly pos birefringent (calcium pyrophosphate)
What are normal vaginal flora?
prepubertal/postmenopauzal: staph. epidermidis

child-baring age: lactobacillus, candida, streptococcus
What should be checked in a child with increased food intake and weight loss?
blood glucose -> dm
Where is the AV node located?
in the interatrial septum
How can you distinguish primary from secondary hyperparathyroidism?

nb: both osteitis fibrosa
secondary: renal failure
decreased phosphate excretion -> hyperphosphatemia -> inhibits 1,25 dihydroxycholecalciferol -> lower CA, increase PTH,

ALSO: vit D deficiency

Primary: high PTH, high CA, low phosphate
Which disease?

ring like calcifications in media of medium-sized arteries
Monckeberg arteriolosclerosis
What changes are found in muscle after short and chronic endurance exercize?
Short: increase VEGF
Long: increase fibroblastic growth factor and increase mitochondria
What is the most common site of obstruction in hydrocephalus?
aquaduct of sylvius

(Luschka and Magendie are 4th ventricle outlets and less common)
What is the Reid index?
Lung

ratio gland depth: total wall

high in chronic bronchitis due to gland hyperplasia (smokers)
Which AML? Which genetic#?

>30% blasts
>50% promyelocytes and myelocytes
some maturation
M2 myeloblastic with maturation

t(8:22) (q22;q22)
Which AML? Which genetic#?

>30% blasts
>50% erythroblasts
M6 erythrocytic
Which AML? Which genetic#?

>30% blasts
majority promyelocytic with kidney shaped nuclei
auer rods
M3 hypergranular promyelocytic

t(15;17) (q22;q11)

Cave DIC
Which AML? Which genetic#?

>30% blasts
>20% promonocytes or monocytes
M4 myelomonocytic

t(6;9) (p23;q34)

Possibly DIC
Which AML? Which genetic#?

>30% blasts
<10% granulocytes
M5 monocytic

Possibly DIC
Which AML? Which genetic?

>30% blasts
No maturation
M1

t(6;9) (p23;q34)
Which AML? Which genetic?

>30% blasts
blasts react with antiplatelet antibodies
M7 = megakaryoblastic
Which antibodies can be found in SLE?
Pathognomic: anti-SM (30%)
anti-dsDNA (70%)
ANA (95-100%)
anti-ribonucleoprotein (low titer in 30% -> also present in MCTD)
What characterizes non-hodgkin lymphoma? And what cells do they contain?
All: monoclonal origin

80% B-lymph
20% histiocytic (langerhans cell histiocytosis) or T-lymphocytic (mucosis fungoides)
What's the difference between chylous and pseudochylous effusion?
Chylous: lymphatic fluid = high triglycerides, low cholesterol

Pseudochylous: fungus = high triglycerides and high cholesterol
Which 'other' hormones can increase serum glucose?
GH: decline insulin receptors
ACTH: cortisol decreases insulin sensitivity
TSH: increased absorption intestines
Which biochemical steps require thiamine?
thiamin-> thiamine pyrophosphate

1) cofactor pyruvate dehydrogenase complex to convert pyruvate to acetyl coA

2) transketolase in the pentose phosphate pathway
Which 5 diseases are associated with # tyrosine metabolism?
1) albinism

2) phenylketonuria

3) cretinism

4) tyrosinosis (liver/kidney#)

5) alkaptonuria
Which disease?

blue-tinged sclera, small bluish misshapen teeth, hearing loss, bone fragility
osteogenesis imperfecta
what is gliosis?
astrocytosis: at any cns damage site
What substances have a higher concentration in plasma in nephrotic syndrome?
cholesterol - hyperlipidemia
Where is the tumor?

#vertical gaze
insomnia
Pineal gland

decrease melatonin - insomnia