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215 Cards in this Set
- Front
- Back
type of mutation in CF |
frameshift mutation |
|
what is cross sectional study? |
study of prevalence measure exposure and outcome using surveys |
|
what is the connection between osteocytes? |
gap junctions |
|
IgG against hep C cannot confer effective immunity...Y? |
due to structural antigenic variety of envelope protein. |
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how to distinguish bet schizoid and avoidant personality D? |
schizoid dont care if people accepts them. avoidant: care |
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positive trendleneberg post hip surgery..which nerve is affected? |
superior gluteal nerve injury. SGN innervates glut medius aand minimus and TFL |
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what is a + trendelenberg sign? |
upon standing...sag contra upon walk... sag ipsi |
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which type of hypersensitivity reaction is MG? give other example |
TYPE II exp. goodpasture syndrome: antibodies bind to IgG and IgM forming immune complex activating autoimmune against type 4 collagen 3alfa chain |
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contact dermatitis and sarcoidosis .. which type of hypersensitivity reaction? |
4 |
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which type of insulin should not be given SC in DKA ( given IV) and Why? its action lasts for 8 hrs |
Regular insulin risk of dehydration |
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list the duration of insulin meds? shorter to longer |
lispro/aspart, regular, NPH, detemir, glargine 4,8,18,24,24 |
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hypochromic megaloblastic anemia+ mental retardation+ growth retrdation+ orotic acid in urine |
orotic aciduria deficiency of orotate phosphribosyl transferace |
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what should be normal in ARDS? and when that parameter would be elevated? |
PCWD it will be high in cariogenic pulmonary oedema. |
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what is case control study? what is the most common bias? |
study of the disease and controls without caring about exposure to risk. selection bias. |
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what are normal aging of the heart? |
decrease base to apex dimension perinuclear brown pigments lipofuscin sigmoid septum decrease LV cavity |
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HOCM changes |
increase septum to wall thickness disorganized myocyte bundles myofiber disarray |
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what are CMV related fetal changes ? |
seizures jaundice chorioretinitis sensorineural deafness microcephaly hepatospleenomegaly |
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what are other eye infection in utero |
rubella = cataract inclusion conjunctivitis= c. trachomatis |
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what are host cell receptor/ vision vision protein binding specificity? HIV EBV parvovirus B19 |
CD4 and HIV p120 that activates gp41 CD 21 and EBV gp350 erythrocyte P antigen and parvovirus B19 |
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list three causes of S3? |
rapid filling in high compliant LV slow filling in low compliant LV high ESV with blood flow in already filled ventricle= in LVSF |
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what is abacavir ( NRTI) HSR? |
it is type 4 HSR with positive HLA - B 57*: 01 molecule resulting in rash, GI upset and fever |
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describe IgA? |
two monomers, J protein and secretory piece |
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list insulin receptors and their effects? |
- Muscurinic M3 = Gq= increase insulin - Glucagon= Gs/Gq= increase insulin - B2- GLP1= Gs= increase insulin - Alfa 2 = Gi= inhibitory - somatostatin= Gi= inhibitory |
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what is A-a gradient? |
PAo2- Pao2 PAo2 = 150- (PaCo2/0.8) A-a should not exceed 10-15. if exceeded: interstitial vs alveolar hypoventilation vs V/Q mismatch |
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list Sx of lysch nyhan syndrome? |
HGPRT deficency H : hyperuricemia G : gout P : pissed off: self mutilation, chorioathetosis R: retardation T: dystonia |
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list type of collagen, location and associated disease: 1 2 3 4 |
- 1: in bone and tendon: osteogenesis imperfecta (AD) - 2 in cartilage and nucleus pulposus - 3: skin and granulation tissue and BM: EH syndrome - 4: in basement membrane: in alport syndrome |
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what is type II error? |
fail to reject null hypothesis when it is truly false = 1- B |
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what is type 1 error? |
reject null hypothesis when it is true alfa |
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most common organism in prosthetic valve and VP shunt is.... |
staph.epidermodos by producing extracellular polysaccharide biofilm |
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DDX of polyhydraminos: |
anencephaly gastric: atresia cardiac: fetomaternal Hrge B19 infection |
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DDX of oligohydraminous |
renal: agenesis, post urethral valve pulmonary: hypoplasia |
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list the functions of thalamic nuclei |
VM: satiety centre.. affected in craniopharyngioma Lateral: hunger centre Ant: temp Supraoptic and paraventricular: circadian rhythm and light suprachiasmatic: ADH and oxytocin |
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if the patient feels spectacular. what is the dx? |
acute mania. Tx: lithium, valporate, carbamezapine. |
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how to prevent cardiotoxicity ( DCM) with doxrubicin? |
dexrazoxane |
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what is permissiveness |
one drug allows the other to exert maximal effects. |
|
treatment of 21-hydroxylase deficiency is .... |
ACTH supplement |
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what is the dominant effects of hypothalamus on prolactin? |
inhibitory |
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Silicosis increase the risk of TB by... |
impair macrophage killing |
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ACEI reduce GFR by.... |
vasodilation |
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low frequency detected at the......... high frequency is detected at.......... |
apex of cochlea=helicotrema base of cochlea= oval & round window |
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features of fragile X |
mental retardation Autism long face prominent forehead, chin, ears macroorchidism tooth crowding arched palate |
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genetics of fragile X syndrome is........ |
hypermethyltion of FMR 1 gene |
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examples of syndromes due to chromosomal breakage.... |
fanconi syndrome ataxia telangactasia bloom xeroderma pigmentosum |
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examples in DNA mismatch repair include |
lynch syndrome increasing risk of HNPCC |
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what is relative risk |
(a/(a+b)) / ( c/(c+d)) |
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what is OR |
ad/bc |
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Norepi works by vasoconstriction of the NE antidote is |
alfa 1 alfa 1 receptor blocker= phentolamine |
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acute rheumatic fever is associated with .... bodies |
aschoff |
|
burkitt lymphoma |
t8:14 associated with EBV high K-67 fraction starry sky appearance |
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gait instability+ eczema+ must odor urine = |
PKU mutation in phenyalanine hydroxylase |
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4 findings in TOF |
- VSD - LVH - overriding of aorta - RVOT obstruction/ pulmonary atresia |
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what is the embryo event in TOF? |
ant and cephalhead deviation of infundibular septum |
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squat in TOF helps in |
increase PVR = afterload |
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what is ATTACK rate |
number of people who got the disease/ no of people who were at risk |
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old man with h/o COPD has fever, confusion, low PR, water diarrhoea, hyponatremia and gram stain shows neutrophils but NO bacteria |
legionella pneumonia |
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holosystolic murmur more with inspiration= |
tricuspid regurgitation |
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which artery is affected in pterion # or epidural hematoma ( lens shape) |
middle meningeal A |
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what type of toxin in C. tetani? what are the Sx? |
extotoxin metalloproteinase increased reflexes |
|
hypertrophy vs hyperplasia |
hypertrophy: increase in size hyperplasia: increase in number |
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firs generation antipsychotics. name two types and side effects? |
low potency: anticholinergic SE and sedatives: chlorpromazine and thioridazone high potency : neurological SE and muscle rigidity :flufenazine and haloperidol |
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CCB - verapamil and diltiazem? - nifedipine and amlodipine? |
- cardiac specific to slow AV node - vasodilators |
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metoprolol is a |
nonspecific B blocker . more B1> B2 |
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eosinophils play a role in host defence against parasitic infection by............ |
1. antibody dependent cell mediated cytotoxicity 2. production of IL-5 |
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high osmo low ICF low ECF = |
DI= profuse sweating |
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low ECF normal ICF normal osmo |
acute GI bleed |
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low osmo low ECF high ICF |
adrenal insufficiency opposite to hypertonic NaCl infusion |
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high osmo high ECF low ICF |
hypertonic saline infusion |
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low osmo high ICF high ECF |
primary polydipsia |
|
HIV patient with fever intracellular oval bodies stain + in Sabouraud stain |
histoplasma capsulatum |
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cerebllar taxia+ telangectasia+ sinupulmonary infection = |
ataxia telangectasia AR from mutation of ATM gene that is responsible for DNA break repairs |
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foscarnet? |
pyrophosphate analog used in HIV + if the have gancyclovir resistant CMV or acyclovir resistant herpes |
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acyclovir? |
nucleoside analog activated by thymidine kinase inhibit DNA polymerase of herpes |
|
lamivudine |
NRTI needs to be phosphorylated inhibit HIV reverse transcriptase |
|
squinavir |
PI |
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what are Sx of organophosphate poisoning? how to reverse that? |
DUMBLES diarrhoea, urination, miosis, bradycardia, bronchospasm, lacrimation, emesis ,salivation reversed by atropine ( risk of muscle paralysis) and pralidoxime |
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anterior shoulder dislocation happens when ar in ...... position results in .. nerve injury |
abduction + external rotation axillary nerve |
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mom has probability of carrying a gene is 1/30 dad has 1/100 AR probability that a child will carry the disease is.... |
(1/2 x 1/130) x (1/2 x 1/100) |
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G+ rods with tumbling motility= |
listeria. grows in unpasteurized milk |
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drug blocks IIb/IIIa receptor= gland man syndrome |
abciximab |
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zidovudine + gancyclovir = S.E of ...... |
bone marrow suppression |
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early adenoma to late adenoma requires |
K-ras |
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late adenoma to carcinoma requires activation of |
p53 and DCC |
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AR crigler najjar syndrome is lack of indirect bilirubin conjugation due to lack of.. |
UGT enzyme |
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AR recessive results in black earlobe and sclera, arthritis of shoulder and hip, black urine= |
alkaptonuria |
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1g protein = cal 1g CHO= cal 1g ETOH= cal 1g fat= cal |
4 4 7 9 |
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drugs can cause hepatic granulomatosis |
methyldopa hydralazine quinidine |
|
post op elevated LFT |
halothane induced hepatotoxicity |
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features of tay-sacks D |
developmental regression cherry red spot in macula accumulation of GM3 startle with voices |
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most common G-ve bacilli seen in intrabdominal abscess is..... |
B.fragilis |
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list Ddx of metabolic alkalosis |
low Chloride: diuretic use, N/V, gastric aspiration ( saline responsive) , can be eu/hypovolemic. high chloride: 1 hperaldosteronism, bushings, ectopic ACTH, barter and gitelman syndrome ( saline unresponsive), hypervolemic CHECK URINE CHLORIDE |
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what is the RPF EQUATION? |
FF= GFR/FPF constriction of efferent arteriole increase GFR & RPF initially, as the constriction is severe, both decrease |
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PTH increase serum calcium by 3 mechanisms: |
- increase osteoclast activity - increase renal absorption of calcium - increase formation of 1,25 OHD |
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drug used to treat ETOH craving is....... drug used to maintain abstinence is........ |
naltrexone disulfiram |
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most common cofactor in transamination ( btw amino acid and alfa-ketoacid) as well as decarboxylation is ........ |
biotin |
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most common cofactor of carboxylation is ..... |
biotin pyruvate carboxylase acetyl CoA carboxylase propionyl Co A carboxylase 3MC CoA carboxylase |
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determine half life |
volume of distribution x 0.7 / clearance achieved in 4-5 half lives |
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maintenance dose |
steady state plasma conc x clearance / bioavailability in IV : bioavailability =1 |
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loading dose |
volume of distribution x steady state plasma conc/ bioavailability fraction loading dose in renal/liver failure is the same but maintenance dose is decreased |
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how can valproate produce teratogenicity? |
meningocele. by inhibiting folic acid absorption |
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ahminoglycosides works by.... |
inhibiting mRNA reading by binding to 30S subunit |
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what are signs of marijuana intoxication? |
conjunctival injection tachycardia dry mouth increase appetite |
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treat BPH BY........ |
alfa-1 blocker that decrease PVR |
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mefipristone works ............ |
progestrone antagonist |
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glucose is transported by ...... |
carrier protein + no energy = facilitated diffusion |
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amino acids safely given to pyruvate dehydrogenase deficiency patients are... |
lysine and leucine |
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asthmaitic or CF patients has infection with increase eosinophils , IgE and IgG , most likely infection of .... |
ABPA |
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young male+ arthritis+ conjunctivitis+ urethritis+ sacroilitis+ HLA-B27 = |
reactive arthritis/ seronegative spondyloarthropathy |
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kid+ rash from haed to toe+ postauricular LN = |
rubella / togavirus |
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RR>1, RR=1 RR<1 |
- exposure is associated with increase risk of disease - exposure is NOT associated with risk of disease - exposure is associated with decrease risk of disease |
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if null value ( RR=1) is not within CI, p value is.... |
< 0.05 for 95% and < 0.01 for 99% |
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c.tetani exert its toxic effects through..... the toxic substance travels from wound to..... to.... |
spores motor neuron, spinal cord the the organism remains in the wounded area |
|
pathogen travels from wound to spinal cord to brain to salivary gland = |
rabies |
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CN 3 lesion involves |
eye deviated down and out diagonal diplopia ptosis dilation of pupil and loss of accommodation CN 3 externally rotate and elevate, adducts |
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CV 4 lesion involves |
eye is upward vertical diplopia CN 4 abduct, depress and int rotate the eye |
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CV 6 lesion involves |
eye deviate medially horizontal diplopia CN 6 abducts the eye |
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EHEC and shigella inhibit protein synthesis by... |
inactivate protein S60 subunit complication: HUS they are unable to ferment sorbitol and can not produce glucoronidase |
|
drugs that decrease warfarin effects are |
rifampin phynetoin phenobarb cholestyramine |
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water reabsorbtion in kidneys occurs mainly in.... |
proximal tubule |
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the immune mechanism against giardiasis is .... |
CD4+ helper and secretory IgA production |
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most common causes of giardiasis in childhood is....... |
IgA deficiency CVD X-linked agammaglobenimeia |
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coronary steal syndrome can be worsened by two types of medications? |
dipyridamole and adenosine |
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mitral stenosis can cause ....... in PCWP |
increase increase pulmonary HTN |
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niacin B3/ makes NAD+ deficiency can cause...... synthesized in the body by.. |
pellagra: diarrhoea, dementia, dermatitis tryptophan |
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4 reasons the drug has low Vd |
- hydrophilic - charged - high molecular weight - high plasma protein binding |
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treat TCA toxicity by..... |
administering bicarbonate |
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acetaminophen toxicity in treated with ..... |
NAC increase glucoronidation and sulfation |
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GVHD is ........ |
donor T cells against MHC of recipient |
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snRNP is synthesized by |
RNA polymerase II |
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cerebllar hemangioblastomas + cysts in liver/kidney/pancreas + AD = |
VHL disease |
|
fat emboli : you see black fat drops in |
osmium tetroxide |
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G -ve coccobacili grows in hematin and NAD+ in chocolate agar pathogenesis via capsular polysacchride |
H. influenza |
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what is spikes protocol in delivering bad news? |
s: set the stage p: perception I: invite k: knowledge E: empathy s: summary and strategy |
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where is CTZ? |
dorsal medulla at the caudal end of 4th ventricle |
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major factor in determining coronary flow is......... |
DT : diastolic time |
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when would B-HCG detected in - blood - urine |
day 8 day 14 |
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lipo-oligo-sachhride of N.meningitis is = |
LPS of G-ve rods |
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dystrophic calcification has two steps |
1. cell necrosis 2. calcium deposits with normocalcemia |
|
lung volume/ flow curve |
obstructive : left restrictive : right tracheal stenosis: mid but all is low |
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fever+ hemolytic anemia+ jaundice/ elevated LFT + in northwestern USA= you see intra-erythrocytic cross shaped parasites |
babesiosis ( same vector as lyme D : ixodes-stick) |
|
exposed to bird/ bat in ohio/ mississippi river |
histoplasmosis |
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a medium that inhibit growth of all except N gonorrhoea/ meningitis is: |
thyer-martin medium |
|
past exposure to TB with no symptoms is due to |
Th1 : CD4 T lymphocytes and macrophages |
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to study associations in case-control study , use ... |
exposure odds ratio odds of cases/ odds of controls |
|
GEitis acquired from - pets - day care - shellfish - camping |
- campylobacter - shigella - V. parahymolyticus - giardia |
|
seizure meds - eTHuxamide - phynetoin, valporic, carbamezapine |
- block Ca++ channels in THalamus - block Na channels |
|
MAOI acts through..... |
inhibiting MAO degradation pre-synaptically. same MOA to tyramine |
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the only cell can not use ketone bodies are |
RBC...coz no mitochindria liver can not use ketone bodies ( no thiophorase |
|
list the functions of lipoproteins - Apo A - apo B48 - apo B100 -apo C - Apo E 3& 4v |
- LCAT activation : chylomicron estratification -chylomicron secretion by intestinal cells -CMs uptake by extra hepatic cells -LPL activation -VLDL and CMs uptake by liver cells |
|
what are the amino acids of transmembrane part of the G-protein receptors? |
non polar, hydrophobic AA: alanine, phenylalanine, methionine, valine, isoleucine usually makes for TSH, LH , FSH |
|
a kid with confusion, vomiting high ammonium level, high orotic acid in urine? Dx = |
OTC note in carbamoyl phosphate synthase there is NO orotic acid in urine |
|
same above findings + megaloblastic anemia= |
orotic acidurea |
|
patients with pyruvate dehydrogenase deficiency would have low lactic acid production by using two ketogenic AA |
lysine and leucine |
|
each fatty acid B oxidation produces : |
1 NADH, 1 FADH2 , 1 acetyl-Co A( 3 NADH, 1 FADH2, 1 GTP) |
|
hypoglycemia + hypoketonemia= |
acyl Co-A dehydrogenase deficiency/ MCAT deficiency |
|
hypoglycemia+ high TG+ lactic acidosis+ stunt growth= |
G^-phosphatase deficiency Von GIERKE D |
|
what are neutral a.a? |
leucine isoleucine valine alanine phenylalanine tyrosine tryptophan histidine serine threonine |
|
diarrhoea+ pellagra+ ataxia+ excretion of nutral aa in urine = |
hartnup disease results in niacin deficiency B3 here, proline, hydroxyproline and arginine are not excreted ( as fanconi syndrome) |
|
B12 is depleted after ...... folate is depleted after .... |
4 yrs 4 months |
|
cardiomegaly, growth retardation, PAS +ve material in lysosomes of heart and skeletal muscles, normoglycemia= |
pompe= PAS +ve acid-alfa-glucosidasex deficiency/ acid maltase deficiency |
|
defective pathway from tyrosine to fumarate , black color urine due to high homogentisate = |
alkaptunuria AR |
|
amatoxin is a fungal poison resulting in .... |
inhibition of mRNA formation by polymerase II most affected cells are: GI and proximal convoluted tubules. |
|
ricin: toxin from castor oil inhibit ... |
rRNA formation of 60S subunit |
|
M.pneumonia requires ------- rich medium to grow |
cholestrol |
|
klebsella requires ....... medium to grow as it contains bile |
McConey |
|
all organisms will respond to Abx targeting peptiglycan wall except .... |
mycoplasma, ureaplasma: as those contain phospholipid layer |
|
treatment of recurrent genital herpes: |
oral acyclovir, vala or famcyclovir. for years and then re-evaluated |
|
G-ve rods ... describe approach |
on MacConey agar - lactose frementer: fast vs slow fast: E.Coli, klebsella, enterobacter slow: citrobacter, serratia - lactose non ferementer: Do OXIDASE TEST: oxidase positive: psudomonas oxidase -ve: do H2S H2S + : salmonella and proteus H2S -ve: shigella |
|
what is hydrocephalus ex taco? |
ventricular dilates 2nd to cortical atrophy. no increase in CSF pressure. exp: HIV, demetias |
|
central hypogonadism+ ansomnia+ normal vision = |
kallman syndrome defect migration of GnRH neutrons to their location at hypothalamus |
|
in any gene surgery , they should be worried .... ligament as all blood supply to ovaries from aorta goes there |
suspensory ligament |
|
transmural inflammation with fibroid necrosis anywhere in the body except lungs = |
PAN |
|
a drug can precipitate opioid withdrawal ... |
bupenorphine |
|
providing preventive measures in health care system is called .... |
capitation |
|
pitutary tutors can cause prolactinomas. what are the effects on GnRH production? |
low GnRH low LH low testosterone |
|
function of alfa 1 is |
vasoconstrictor vagal stimulant leading to low PR increase uretheral sphincter tone and prostate contraction |
|
alfa 2 mediation through |
decrease IOP low lipolysis low presynaptic NE release high plot aggregation |
|
ketamine blocks morphine tolerance by .. |
NMDA receptor block which blocks glutamate ( glutamate can worsen opioid tolerance) |
|
in addition of systemic Sx; pyelonephritis will have ...... in urine |
WBC casts |
|
CK increase is a result of ...... damage |
cell membrane |
|
treatment of: - SVT - VT |
- adenosine - lidocaine .. now amiodarone |
|
vaginal infection, what is interrupted in: - vaginosis - trichomoniasis - candida |
-high PH - high PH -decrease lactobacillus normal flora |
|
ACEI will affect unilateral RAS or bilateral? |
bilateral |
|
niacin treatment for DLP can cause flushing through .... |
PG mediation. thats y use aspirin 1 hr prior to give niacin |
|
for adnexal mass removal; which ligament should be ligated? |
suspensory |
|
isobrobide dinitrate is given BID instead of TID to prevent..... |
tolerance |
|
coronary sinus dilatation = ... |
pulmonary HTN |
|
most important risk for CIN is ... |
multiple sexual partners |
|
B1 blocker reduces BP by inhibiting catecholamines release and decrease ..... |
renin secretion. |
|
to maximize the power, researches should maximize ..... |
power 1-B |
|
young lady + ETOH and smoking make her sick + reddish urine + abdominal pain + skin changes later = |
PBG deaminase deficiency = AIP AD and treated by heme and dextrose infusion |
|
four causes for lactic acidosis: |
- decrease oxygen utilization: CN poisoning - less oxygen delivery: shock, cardiac/ pulmonary failure. - increase metabolic demands: seizure and exercise. - decrease lactate catabolism: liver failure. - enzyme defects |
|
two enzymes are vulnerable to lead poisoning .. |
ALA dehydratase ferrochelatase |
|
Furosemide on high doses can cause .... |
ototoxicity |
|
describe genome replication of Hepatitis B? |
doulble stranded DNA to single template RNA to double st DNA |
|
opsonization is affected by .... bacteria |
encapsulated |
|
bacteria that impair the complement pathway is through ..... |
staph protein A |
|
IgA protease is secreted by |
strept, H.INFLUENZA, NISSERIA impair IgA function at the mucosal level |
|
describe tongue - motor innervation - sensory innervation - taste innervation |
- all motor is hypoglossal except palatoglossus : vagus - sensory 2/3: mandibular branch of 5 post 1/3 : glossopharyngeal - taste: 2/3; chorda tympani post 1/3: GPH nerve |
|
what is leuprolide |
GnRH analogue the decrease testosterone and DHT |
|
what medications is used ETOH - abstience promoting/ prevent craving - maintain abstenience |
naltrexone disulfram, acamprosate |
|
rifampin resistance is through ... |
genetic mutation of DNA dependent RNA polymerase |
|
the only part that persists through the respiratory epithelium is .... |
cilia |
|
when you hear S4? |
restrictive cardiomyopathy LVH diastolic HF |
|
what prevent lactation in 35 week pregnant? |
estrogen and progestrone |
|
what is the reason for gestational diabetes? |
HPL |
|
in a patient with depression with PMH of rapid response to SSRI... you should ask about.... symptoms. |
manic |
|
oxalacetate + pantothenic acid/CoA = |
citrate + succinyl CoA |
|
treat neonatal abstinence syndrome with ... |
morphine/ methadone |
|
post strept pharyngitis complication = post street skin/ pharyngitis complication = |
acute rheumatic fever PSGN |
|
nitrates should be accompanied by ........ to prevent reflux tachycardia and increase oxygen demands to the heart. |
b-blockers |
|
HIV +ve, with fever and diarrhoea, CD4 < 50 , pathogen grows at 41:.. |
MAC treat with azithromycin |
|
acute mania is treated by .... |
mood stabilizer: valporic aid, carbamezapine, lithium. atypical antupsychotic: olanzepine |
|
the only condition resulting in high ammonia AND OROTIC ACID is ... |
OTC deficiency |
|
muscles of mastications are innervated by |
mandibular branch of CN 5 |
|
mifeprestone is ..... |
anti-progestin |