Things I Always Forget

Front 1

What is Staph. saprophyticus known for causing?

Back 1

UTIs

Front 2

Two most common drugs/classes used to treat UTIs?

Back 2

TMP SMX, FQNs, can also use Nitrofurantoin for E. coli

Front 3

Childhood rash, begins at head and moves down, postauricular lymphadenopathy. What is the disease?

Back 3

Rubella (Togavirus)

Front 4

Childhood rash, begins at head and moves down, preceded by cough, coryza, conjunctivitis, koplik spots. What is the disease?

Back 4

Measles (paramyxovirus)

Front 5

Can have rash, parotitis, meningitis (orchitis or oophoritis in young adults). What is the disease?

Back 5

Mumps (paramyxovirus)

Front 6

Erythematous, sandpaper-like rash, fever, sore throat. What is the disease?

Back 6

Scarlet fever, caused by Strep. pyogenes

Front 7

Vesicular rash on palms and soles, ulcers in oral mucosa. What is the disease?

Back 7

Hand foot mouth disease, caused by Coxsackievirus Type A (Picornavirus)

Front 8

Squamous cells with perinuclear cytoplasmic clearing.
1) What are they called?
2) When are they seen?

Back 8

1) Koilocytes
2) Seen in HPV

Front 9

Which type of hepatitis is sexually transmitted?

Back 9

Hepatitis B, you can get it in BED!

Front 10

What two forms does candida albicans take?

Back 10

At 20 deg. C- pseudohyphae and budding yeasts

At 37 deg. C- germ tubes

Front 11

What is Fitz-Hugh Curtis syndrome?

Back 11

Infection of the liver capsule and adhesions of parietal peritoneum to liver, secondary to PID

Front 12

What bacteria would you suspect in a traumatic open wound infection?

Back 12

C. perfringens

Front 13

What bug would you suspect in a childhood infection if no other information given?

Back 13

H. influenza

Front 14

What bacteria would you suspect after a dog or cat BITE?

Back 14

Pasteurella multocida

Front 15

Which bacteria is identified by a positive PAS stain?

Back 15

T. whippelii (Whipple's disease)

Front 16

What is the histological finding in Whipple's disease?

Back 16

PAS-positive macrophages in intestinal lamina propria & mesenteric LNs.

Front 17

What does PAS stain actually stain?

Back 17

Stains glycogen and mucopolysaccharides.
"PASs the sugar"

Front 18

Name the (4) urease positive bacteria.

Back 18

Proteus, Klebsiella, H. pylori, Ureaplasma
"Particular Kinds Have Urease"

Front 19

What does elevated maternal AFP indicate?

Back 19

Neural tube defects or abdominal wall defects (spina bifida, omphalocoele, etc.)

Front 20

What is the DOC for cardiogenic shock and what is its mechanism of action?

Back 20

1) Dobutamine is DOC
2) Mechanism of action is sympathomimmetic, stimulates beta 1 receptors

Front 21

What is the DOC for anaphylactic shock?

Back 21

epinephrine

Front 22

What is the DOC for septic shock?

Back 22

Norepinephrine (have alpha 1 actions with alpha beta 1)?

Front 23

Which two antibiotics are used for narrow spectrum anaerobic coverage?

Back 23

metronidazole or clindamycin

Front 24

What is mydriasis?

Back 24

mydrIasis is dIlation of the pupil.

Front 25

Describe the difference between displacement and projection.

Back 25

Displacement- your feelings are transferred to a neutral person/object (like yelling at your sig. other when you mess something up)
Projection- your feelings are directed purposefully at an external source (eg man who wants to cheat who suspects his wife of cheating or closet homosexual hates homosexuals)

Front 26

Describe the defense mechanism identification.

Back 26

Identifying with someone who is more powerful (child who is abused becoming an abuser)

Front 27

What is the difference between rationalization and anticipation?

Back 27

Rationalization is using a logical reason to describe why you did something that wasn't your true reason for doing it. Anticipation is planning realistically for future discomfort.

Front 28

What is reaction formation?

Back 28

Reaction formation is when a warded off feeling is replaced by an unconscious desire for the opposite. (E.g. someone with overwhelming sexual desires decides to be a monk)

Front 29

What is the difference between repression and suppression?

Back 29

Repression is when you CAN'T remember something painful, Suppression is when you purposely withhold an idea or feeling from consciousness.
"Suppression has two Ps and so does PurPose". You are withholding on purpose.

Front 30

What is anaclitic depression?

Back 30

depression in an infant attributable to continued separation from caregiver.

Front 31

What can you give to an ADHD patient at night if they can't sleep?

Back 31

Clonidine (alpha-2 agonist)- will decrease NE release.

Front 32

What is the difference between fluoxetine and fomepizole?

Back 32

Fluoxetine- SSRI
Fomepizole- inhibits alcohol dehydrogenase and is an antidote for methanol/ethylene glycol poisoning

Front 33

What neurotransmitter changes do you see in depression?

Back 33

Dec. NE, Dec. 5HT, Dec. dopamine

Front 34

What neurotransmitter changes do you see in anxiety?

Back 34

Inc. NE, Dec. GABA, Dec. 5HT

Front 35

What neurotransmitter change do you see in both Alzheimer's and Huntington's?

Back 35

Decreased ACh

Front 36

What two neurotransmitters are decreased in Huntington's disease?

Back 36

GABA and ACh

Front 37

What neurotransmitter changes are seen in schizophrenia?

Back 37

Increased dopamine

Front 38

What neurotransmitter changes are seen in Parkinson's disease?

Back 38

Decreased dopamine, Increased serotonin, Increased ACh

Front 39

What are the plaques and the tangles made of in Alzheimer's disease?

Back 39

Plaques- Extracellular beta amyloid with neuronal fibers wrapped around them
Tangles- Intracellular, tau protein, abnormally phosphorylated

Front 40

Two differences between Alzheimer's and Pick's disease?

Back 40

1) Alzheimer's has neurofibrillary tangles (hyperphosphorylated tau protein) and Pick's has "intracellular aggregated tau". In both cases, it accumulates in neurons.
2) Alzheimer's usually starts with memory loss, Pick's starts with personality change before memory loss

Front 41

What part of the brain does Pick's disease spare?

Back 41

Parietal lobe and posterior 2/3 of superior temporal gyrus.

Front 42

What is a Lewy body?

Back 42

Abnormal aggregate of alpha-synuclein in a nerve cell

Front 43

In what 3 diseases would you see Lewy bodies?

Back 43

Parkinson's, Lewy Body dementia, and one type of Alzheimer's

Front 44

Name the high potency neuroleptic (antipsychotic drugs). (2/3)

Back 44

Haloperidol, trifluoperazine (possibly moderate), fluphenazine

Front 45

Name the low potency neuroleptic drugs (2)

Back 45

thioridazine, chlorpromazine

Front 46

What is the difference between schizoaffective and schizophreniform disorder?

Back 46

Schizoaffective- you have two weeks of just schizo symptoms with no mood disorder, but also sometimes have mania/depression
Schizophreniform- just like schizophrenia but greater than 1 month and less than 6.

Front 47

What are the two categories of antibiotics that shouldn't be taken with antacids?

Back 47

Tetracyclines (VACUUM The BedRoom
Vibrio cholera, acne, uroplasma, urolytica, mycoplasma pneumonia, tularemia, H. pylori, Burelia burgdorferi, Rickettsia)

& Fluoroquinolones
Gram negative rods of urinary and GI tracts

Front 48

Which cancers would metastasize to Virchow's node?

Back 48

stomach (probably most likely in question), mediastinal, neck

Front 49

How long after eating before glycogen reserves are gone and gluconeogenesis takes over?

Back 49

1 day, less if exercising (16-24 hours); another source said 12 hours.

Front 50

Antibodies to centromeres are found in what illness?

Back 50

CREST scleroderma

Front 51

Antibodies to SS-A (Ro) and SS-B (La) are found in which illness?

Back 51

Sjogren syndrome

Front 52

Which is more common in the US, chlamydia or gonorrhea?

Back 52

Chlamydia
Gonorrhea is GONE from the US :)

Front 53

Name the classes of drugs (5) that would cause galactorrhea as a side effect.

Back 53

Typical Antipsychotics (haloperidol)
TCAs
Dopamine depleting drugs (methyldopa, resperidone), opiates, and H2 blockers (cimetidine)

Front 54

What is the inheritence pattern of Bruton's agammaglobulinemia?

Back 54

X-linked recessive

Front 55

What is the most accurate molecule to estimate exact GFR?

Back 55

Inulin

Front 56

What molecule slightly over-estimates GFR?

Back 56

Creatine

Front 57

What is phenylephrine and what are its effects?

Back 57

It's an alpha agonist, alpha1 > alpha2. It causes pupillary dilation, vasoconstriction, and nasal decongestion (because of smooth muscle contraction)

Front 58

What virus is associated with polyarteritis nodosa?

Back 58

Hepatitis B (in 30% of patients)

Front 59

What is the mechanism of Reye's syndrome?

Back 59

Aspirin metabolites inhibit beta oxidation by reversible inhibition of mitochondrial enzymes --> fatty liver and liver failure --> hypoglycemia and hyperammonemia bc urea cycle happens in the liver

Front 60

If you see FASICULATIONS, think...

Back 60

Lower Motor Neuron

Front 61

Drugs/categories that can cause SIADH (6)

Back 61

TCAs, SSRIs, MAOIs, antipsychotics, carbamazepine (seizure/mood disorder) and anti-neoplastics

Front 62

What psych disease is associated with Tourette's syndrome?

Back 62

OCD

Front 63

What is the difference between buspirone and buproprion?

Back 63

Buspirone- 5-HT4 agonist that is used to treat generalized anxiety disorder, period.

Buproprion- increased dopamine and NE via unknown mechanism, used to treat depression and quit smoking

Front 64

What is the difference between bromocriptine and dobutamine?

Back 64

Bromocriptine- dopamine agonist

Dobutamine- primarily beta 1 agonist, used to treat heart failure & cardiogenic shock

Front 65

What is naloxone/naltrexone and what are they used for? (2)

Back 65

Opiod antagonist

1) Used for acute opioid OD
2) Used to treat alcoholism (when person is NOT drinking and desires not to start again)

Front 66

How does suboxone work? (combo of naloxone & buprenorphine)

Back 66

buprenorphine is an opioid which is what the patient wants. If they take it orally, the naloxone is inactive so they get the opioid effects. If they try to inject it, the naloxone (opioid antagonist) is active so the patient doesn't get the benefit of the buprenorphine

Front 67

What is miosis?

Back 67

Pinpoint pupil

Remember because "i" looks like a pinpoint and the "o" is like an eye and comes right after.

Front 68

What is the difference between Wernicke and Korsakoff?

Back 68

Wernicke- classic triad of confusion, ophlamoplegia (paralysis of one or more extraoccular muscles), and ataxia

Wernicke's can PROGRESS to Korsakoff psychosis which is irreversible memory loss, confabulation, personality change

*Might want to think "Korsakoff is Konfabulation"

Front 69

Wernicke-Korsakoff syndrome is associated with what sort of pathological brain damage?

Back 69

Periventricular hemorrhage & necrosis of the mammillary bodies

Front 70

How do you calculate standard error of the mean?

Back 70

Standard deviation/ (sq. root of sample size)

Front 71

What's the difference between t-test, ANOVA, and chi-squared?

Back 71

t-test compares TWO means,
ANOVA compares more than two means,
chi-squared compares categorical outcomes (like black/white/hispanic)

Front 72

What kind of virus is each type of hepatitis?

Back 72

A- Picorna (RNA)
B- Hepadnavirus (DNA)
C- Flavivirus (RNA)
D- Deltavirus (RNA)
E-HepEvirus (RNA)

Front 73

In a normal type of gaussian distribution, what percent of the population fall 1, 2, and 3 STDs from the mean?

Back 73

1- 68%
2- 95%
3- 99.7%

Front 74

What are the 5 parts of the apgar score?

Back 74

A- appearance
P- pulse
G- grimace
A- activity
R- respiration

Front 75

Which drugs can be given to shorten stage 4 sleep? Why would they be given?

Back 75

imipramine, benzodiazepines

Would be given for night terrors, bed-wetting

Front 76

What is the key to initiating sleep?

Back 76

Serotonergic predominance in the raphe nucleus.

Front 77

Describe the pathway that leads to melatonin release.

Back 77

Retina detects darkness --> NE release from SCN (suprachiasmatic nucleus) --> signeals pineal gland which releases melatonin

Front 78

In what disease would you see polyuria, acidosis, growth failure, and electrolye imbalances?

Back 78

Fanconi Syndrome

Front 79

Red urine in the morning

Back 79

Paroxysmal Nocturnal hemoglobinurea

Front 80

Which tumors would you see with von hippel lindau disease?

Back 80

renal cell carcinoma, hemangioblastomas (brain/eyes), angiomatosis, pheochromocytoma

Front 81

Retinal hemorrhages with pale centers? What are they called and what do they indicate?

Back 81

Roth's spots, bacterial endocarditis

Front 82

Situs inversus, chronic sinusitis, bronchiectasis, infertility. What is the disease?

Back 82

Kartagener's syndrome

Front 83

What is Kartagener's syndrome?

Back 83

Dynein defect affecting cilia

Front 84

Smooth, flat, moist white lesions on genitals might indicate what?

Back 84

Condylomata lata (2ndary syphilis)

Front 85

Name 4 enzymes that thiamine is a cofactor for.

Back 85

Pyruvate dehydrogenase (pyruvate --> acetyl coA)
alpha ketoglutarate dehydrogenase (alphaketoglutarate --> succinyl coA)
transketolase (HMP shunt, reverse part that makes ribose 5 phosphate)
branched chain AA dehydrogenase (degrading branched chain AAs)

Front 86

Most common cause of meningitis in all adults

Back 86

Strep. pneumo. Note that if scenario was college kid or military recruit, it would probably be N. meningitidis.

Front 87

In order to prevent tetany, what part of the C. tetani bug do you have to create a response to?

Back 87

The toxin, NOT the bacteria itself

Front 88

What do pigmented gallstones look like?
What (risk factors) are they associated with?

Back 88

They look black and crumbly, have not very much cholesterol in them, and are radio-paque. They are made when there is too much unconjugated bilirubin around.

They are found mostly in chronic hemolysis but also alcoholic cirrhosis, advanced age, and biliary infection (like liver fluke)

Front 89

What do cholesterol gall stones look like?
What (risk factors) are they associated with?

Back 89

radiolucent, i'm guessing they look more like cholesterol

Can happen in obesity, crohn's disease, CF, advanced age, clofibrate, estrogens, multiparity, and rapid weight loss, and Native Americans

Front 90

How long after ischemic damage do you get loss of myocyte contractility?
How long does it take for irreversible damage?

Back 90

60 seconds
30 minutes

Front 91

How do you calculate attributable risk % when given relative risk?

Back 91

RR-1/RR = attributable risk percent

Front 92

Describe what the aortic baroreceptor reflex detects and the afferent/efferent limbs.

Back 92

1) It detects INCREASED bp
2) Afferent- vagus nerve, efferent- vagus nerve

Front 93

Describe what the carotid baroreceptor reflex detects and the afferent/efferent limbs.

Back 93

1) Detects increased and decreased BP
2) Afferent limb- glossopharyngeal, efferent limbs- vagus nerve

*Think about it this way - you have TWO carotids, the carotid baroreceptor detects TWO things (inc. and dec. BP), and there are TWO nerves (glossopharyngeal and vagus)

Front 94

What is the difference between pO2 and O2 content (arterial)?

Back 94

pO2 = dissolved O2
O2 content = dissolved O2 + O2 bound to Hgb

Front 95

What do all the apoproteins do?
A-1
B-48
B-100
C-II
E 3/4

Back 95

A-1- LCAT activation
B-48- chylomicron assembly/secretion by intestine
B-100- LDL uptake by extrahepatic cells; Goljan says it's assembly and secretion of VLDL by liver. Both B100 & VLDL have 4 letters.
Apo C-II- LPL activation
Apo E 3/4- VLDL/chylomicron remnant uptake by liver

Front 96

Describe central pontine myelinosis aka osmotic demyelination syndrome.

Back 96

When you rapidly correct hyponateremia, water rushes out of cells, leading to demyelination of axons in the basis pontis.

Front 97

What are the symptoms of central pontine myelinosis?
What is the radiographic finding in this disease?

Back 97

Acute paralysis, dysarthria (can't talk), dysphagia (can't swallow), and diplopia (double vision), LOC
You will see abnormal increased signal in the PONS on T1 weighted MRI

Front 98

How does liver use TG breakdown to form glucose?

Back 98

First off, remember that TGs break into FA + Glycerol. Liver can't use fatty acids to make glucose (except odd chain which are rare), but it CAN use glycerol:
Glycerol --> glycerol 3 phosphate (glycerol kinase) --> DHAP --> gluconeogenesis

Front 99

What is the mechanism of action of amphotericin B and why does it have such bad side effects?

Back 99

MOA- binds ergosterol (sterol in fungal cell walls) and makes a hole
Why so bad in humans? Bc it can also bind cholesterol --> side effects like fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia

Front 100

What drug is used specifically to treat the ophthalmopathy associated with graves' disease?

Back 100

glucocorticoids

Front 101

Draw out the tryptophan metabolite pathways.

Back 101

*Hint: "Who tripped before sara? meredith" and "fan peered in"

p. 107 FA

Front 102

isosorbide dinitrate is what kind of drug?
Name two main side effects.

Back 102

- it's a nitrate
- flushing and headache due to vasodilation

Front 103

What is transference?

Back 103

When you see in someone (say, your therapist) characteristics of someone else (say, your father), so you start to treat your therapist like your father.

Front 104

What enzyme are you missing in chronic granulomatous disease?
What does that enzyme normally do?
What test will be negative?
What bugs (class) are you susceptible to and why?

Back 104

1) NADPH oxidase
2) Normally turns O2 into a reactive oxygen species so it can kill bacteria
3) Nitroblue tetrazolium dye reduction test
4) Susceptible to catalase positive bugs because a person with CGD can still use H2O2 (made by bacteria) to hurt bacteria, but catalase positive bacteria can neutralize their own H2O2 so humans can't hurt them

Front 105

Androgen --> estradiol in egg

Where does it occur?
What enzyme catalyzes?
Hormone that up-regulates it?

Back 105

1) In granulosa cells
2) Aromatase
3) FSH

Front 106

Describe the features of cauda equina syndrome.

Back 106

saddle anesthesia, loss of anocutaneous reflex (poke anus & sphincter contracts), associated with S2-S4 nerve roots.

Front 107

What hormone changes are seen in Addison's disease?

Back 107

Decrease in cortisol and aldosterone

Front 108

What 5 classes of medications are used to treat glaucoma?

Back 108

alpha agonist, beta blockers, certain diuretics like carbonic anhydrase inhibitors & mannitol, cholinomimetic drugs, prostaglandins

Front 109

What is the difference between ash leaf spots and cafe au lait spots? What diseases are they associated with?

Back 109

Ash leaf- lighter spot, cafe au lait-darker spot

Ash leaf assoc. with tuberous sclerosis, cafe au lait assoc. with neurofibromatosis type I

Front 110

What types of cancer are associated with tuberous sclerosis?

Back 110

- renal cysts and renal angiomyolipomas, cardiac rhabdomyomas, and astrocytomas

Front 111

What is achalasia? What is it due to? How do you diagnose it?

Back 111

- lower esophageal sphincter unable to relax
- due to loss of auerbach's plexus
- diagnose with a barium swallow

Front 112

What is the difference between Wegener's granulomatosis and Goodpasture's syndrome (mechanism)?

Back 112

Goodpasture's syndrome = anti-gbm antibodies on immunofluorescence

Wegener's syndrome = ANCA antibodies (c-ANCA), vasculitis

*Both can have lung and kidney manifestations, Wegener's involves the upper airway w/ sinusitis and stuff

Front 113

Which glomerulonephritis has a tram track appearance on electron microscopy? Which has wire loop on LM?

Back 113

Membranoproliferative GN has tram track

Lupus has wire loop (LUPus has wire LOOP)

Front 114

What are the uses for metronidazole?

Back 114

GET GAP on the METRO

Giardia, entamoeba, trichomonas
Gardinerella vaginalis, anaerobes, H. Pylori

Front 115

What are the two most common complications after and MI?

Back 115

1) cardiac arrhythmias
2) Left. ventricular failure --> right ventricular failure

Front 116

What is the WAGR complex?

Back 116

Mnemonic for things you can see with a Wilms' tumor (renal tumor, most common tumor of early childhood).

W- wilms
A- anorida (lack of iris)
G- genitourinary malformation
R- retardation (mental/motor)

Front 117

What is Km

Back 117

It's the amount of substrate required to reach 1/2 Vmax for a reaction.

Front 118

On a lineweaver burke plot, what is on the x axis, the y axis, and the slope?

How about the x intercept and y intercept?

Back 118

x axis is 1/[s], y axis is 1/velocity, and slope is km/vmax.

X intercept = -1/km, y intercept= 1/vmax

Front 119

Describe what would change on a lineweaver burke plot in presence of a competitive inhibitor? non-competitive inhibitor?

Back 119

Competitive inhibitor will keep Vmax the same but will increase Km

Non-competitive inhibitor will keep Km the same but will decrease Vmax

Front 120

Write out the 4 pharm eqs that are need to know.

Back 120

1) Vd= drug given (IV) / drug measured (plasma drug [ ])

2) CL = (.7 x Vd) / half life

3) LD = Css x Vd

4) MD = Css x CL

Front 121

How much drug (%) is left after 4 half lives?

Back 121

93.75%

Front 122

What is the difference between 0 order and first order elimination?

Back 122

zero order- no matter how much there is in the body, it gets eliminated at the same rate

first order- the more there is in the body, the faster it gets eliminated

Front 123

Name three drugs that follow zero order kinetics for elimination.

Back 123

Phenytoin, aspirin, ethanol

Front 124

Name three acidic drugs and describe what you would give to treat an OD.

Back 124

aspirin (salycylATE), methotrexATE, phenobarbitol

Would give NaHCO3 to force the acidic drug to be in it's charged (dissociated) form and get trapped in urine.

Front 125

Name one basic drug and describe what you would give to treat an OD.

Back 125

AmphetaMINES.

Would give NH4Cl to force drug to be in its protonated (NON-dissociated) form.

Front 126

Phase I vs. Phase II metabolism.
When does cytochrome p450 work?
When does conjugation occur?
Which phase is lost first in geriatric patients?

Back 126

- Phase I = cytochrome p450
- Phase II = conjugation
- Phase I = lost first in geriatric patients

Front 127

Name some drugs that have a low therapeutic index (4).

Back 127

Lithium, warfarin, phenobarbitol, digoxin

Also pheytoin, gentamycin, 5FU, and AZT

Front 128

Which part of the autonomic nervous system controls erection? ejaculation?

Back 128

Think "Point and Shoot"

Parasympathetic controls erection, Sympathetic controls ejaculation

Front 129

What other pathology is myasthenia gravis associated with (4 things)?

Back 129

50% have thymic hyperplasia, 20% have thymic atrophy, 15% have thymoma, not sure the % but can also be associated with bronchogenic carcinoma

Front 130

What is cycloplegia? What can cause it?

Back 130

Paralysis of the ciliary muscle of the eye --> loss of accommodation

Can be caused by muscarinic antagonism

Front 131

What type of receptors are nicotinic AcH receptors? Muscarinic?

Back 131

Nicotinic- Na/K channels, ligand gated

Muscarinic- G-protein coupled receptors that act through second messengers

Front 132

Describe (in general) the products of phase I metabolism.

What types of reactions occur in phase I?

Back 132

1) Generally slightly polar and slightly more water soluble.

2) Reduction, oxidation, hydrolysis

Front 133

Describe (in general) the products of phase II metabolism.

What types of reactions occur in phase II?

Back 133

1) Generally very polar and no longer active.

2) Acylation, glucuronydation, and sulfation

Front 134

What do you use to prophylax close contacts for N. meningitidis?

Back 134

Rifampin

Front 135

What is the difference between Li Fraumini Syndrome and Von Hippel Lindau Syndrome? (cause & presentation)

Back 135

Li Fraumini- caused by germline mutation of p53 tumor suppressor gene. Associated with breast cancer, brain tumors, acute leukemia, sarcomas (soft tissue & bone)

Von Hippel Lindau- caused by mutation tumor suppressor gene (VHL) on chromosome 3. Presentation is: cavernous hemangiomas in skin, mucosa, and organs. Bilateral renal cell carcinoma. Hemangioblastoma in retina, brain stem, cerebellum. Pheochromocytomas. Autosomal dominant.

Front 136

To which LNs do the following drain?
1) Stomach
2) Duodenum, jejunum
3) Sigmoid colon

Back 136

1) Celiac nodes
2) Superior mesenteric
3) Colic --> inferior mesenteric

Front 137

To which LNs do the following drain?
1) Rectum (above pectinate line)
2) Anal canal (below pectinate line)
3) Testes

Back 137

1) Internal iliac
2) Superficial inguinal
3) para-aortic

Front 138

To which LNs do the following drain?
1) Scrotum
2) Thigh (superficial)
3) Lateral side of dorsum of foot

Back 138

1) Superficial inguinal
2) Superficial inguinal
3) Popliteal

Front 139

Which parts of the body does the right lymphatic duct drain?

Back 139

Right arm and right half of head

Front 140

Which three cytokines enhance the activity of NK cells?

Back 140

IL-12, IFNbeta and IFNalpha

Front 141

What's the name of the more old-fashioned test for paroxysmal hemoglobinuria and what is the test?

Back 141

- Ham's test
- When red blood cells lyse at a very low pH

Front 142

After which exposures would you give pre-formed Ab?

Back 142

tetanus, rabies, HBV, botulinum, also RSV (premature babies)

"To Be Healed Rapidly"

Front 143

What's the difference between bullous pemphigoig and pemphigous vulgaris?

Back 143

Bullous pemphigoid- antibodies against hemidesmosomes;
Integrins are involved (FA p. 370)

Pemphigus vulgaris- antibodies against desmosomes
cadherins connect intermediate filaments (keratin/desmoplakin)

Front 144

What three antibodies are associated with SLE?

Back 144

Anti-ANA, Anti-dsDNA, Anti-Smith

Front 145

Which antibody is associated with drug-induced lupus?

Back 145

Anti-histone

Front 146

Which antibody is associated with rheumatoid arthritis?

Back 146

Anti-IgG (Rheumatoid Factor)

Front 147

Which antibody is associated with CREST scleroderma?

Back 147

Anti-centromere

Front 148

Which antibody is associated with diffuse scleroderma?

Back 148

Anti-Scl-70 (aka anti-DNA topoisomerase I)

Front 149

Which antibody is associated with primary biliary cirrhosis?

Back 149

Antimitochondrial

Front 150

Which antibodies are associated with Hashimoto's thyroiditis?

Back 150

Antimicrosomal (anti-thyroid peroxidase), Anti-thyroglobulin

Front 151

Which antibody is associated with polymyositis/dermatomyositis?

Back 151

Anti-Jo-1

Front 152

Which antibodies are associated with both SLE and Sjogren's syndrome?

Back 152

Anti-SS-A (Anti-Ro) and Anti-SS-B (Anti-La)

Front 153

Anti-U1 RNP (ribonucleoprotein) antibody is associated with which disease?

Back 153

mixed connective tissue disease

Front 154

Which disease is anti-smooth muscle antibody associated with?

Back 154

Autoimmune hepatitis

Front 155

Which disease is anti-glutamate decarboxylase antibody associated with?

Back 155

Type 1 diabetes mellitus

Front 156

Which disease is c-ANCA associated with?

Back 156

Wegener's granulomatosis

Front 157

Which antibody is Churg-Strauss/Microscopic polyangiitis associated with?

Back 157

p-ANCA

Front 158

Which disease is mpo-ANCA associated with?

Back 158

Pauciimmune crescentic glumerulonephritis

Front 159

What is the only disease that Goljan says ESR is useful in diagnosing?

Back 159

Temporal arteritis

Front 160

Name the disease and symptoms:
Defect in BTK gene blocks B cell differentiation/maturation.

Back 160

Bruton's agammaglobulinemia

Recurrent bacterial infections after 6 months, will see low Ig of all classes and no circulating B cells.

Front 161

Name the disease and signs/symptoms:
Defective CD40L on helper T cells --> inability to class switch

Back 161

Hyper-IgM Syndrome

Severe pyogenic infections early in life.

Front 162

Name the disease and signs/symptoms:
Defective isotype switching --> deficiency in a certain class of Igs

Back 162

Most commonly it's Selective IgA deficiency

Would see decreased secretory IgA, sinus & lung infections, milk allergies & diarrhea, and anaphylaxis if you give them blood products containing IgA

Front 163

Name the disease and signs/symptoms:
Defect in B-cell maturation due to various causes

Back 163

Common variable immunodeficiency

Onset in late teens/early twenties, have B cells in peripheral blood but decreased Ig/plasma cells, have increased risk of autoimmune disease, lymphoma, sinopulmonary infections, and GI infections.

Front 164

Name the disease and signs/symptoms:
22q11 deletion (usually)

Back 164

Thymic aplasia (DiGeorge Syndrome)

Symptoms: Facial abnormalities, hypoparathyroidism --> hypocalcemia --> tetany, cardiac malformations, depression of T cell numbers, recurrent viral/fungal infections

Front 165

Name the disease and signs/symptoms:
Decreased TH1 and NK cells

Back 165

Disease- IL12 receptor deficiency

Symptoms- disseminated mycobacterial infections (TB, leprosy), decreased IFN gamma.

Front 166

Name the disease and signs/symptoms:
Th cells fail to produce IFN gamma so neutrophils can't respond to chemotactic stimuli

Back 166

Disease- Hyper IgE (aka Job's) syndrome'

Signs/Symptoms- Coarse facies, cold (neutrophils can't get there) staph. abscesses, retained primary teeth, increased IgE, dermatologic problems (eczema)

Front 167

T cell dysfunction with candida albicans infections of skin and mucous membranes is called?

Back 167

Chronic mucocutaneous candidiasis

Front 168

Name the two mutations associated with SCID that we learned.

Back 168

IL2 receptor (most common), and adenosine deaminase deficiency

Front 169

What are the symptoms of SCID?

Back 169

Recurrent viral, bacterial, fungal, and protozoal infections

Front 170

Defect in either "kinase involved in cell cycle" or "DNA repair enzymes" --> IgA, IgE deficiency. What is the disease and symptoms?

Back 170

The disease is ataxia-telangiectsia

The symptoms are: cerebellar defects (ataxia), spider angiomas (telangiectsia), and IgA deficiency

Front 171

Name the disease and signs/symptoms:
Progressive deletion of B & T cells

Back 171

Disease- Wiskott-Aldrich syndrome

Symptoms: Thrombocytopenic purpura, Infection, Eczema (notice in this one you have eczema so you can remember increased IgE), also increased IgA but decreased IgM

Front 172

Name the disease and signs/symptoms:
Defect in LFA-1 integrin (CD18) protein on phagocytes

Back 172

Disease- leukocyte adhesion deficiency (type 1)

Symptoms- recurrent bacterial infections, absent pus formation, delayed separation of umbilicus, neutrophilia

Front 173

Name the disease and signs/symptoms:
Defect in microtubular function that make it so lysosome can't fuse with phagosome

Back 173

Disease- Chediak-Higashi syndrome

Signs/Sx- Recurrent pyogenic infection by staph & strep, partial albinism, peripheral neuropathy (or other neuro problems), giant inclusion bodies in leukocyte precurser cells

Front 174

Name the disease and signs/symptoms:
Lack of NADPH oxidase --> decreased ROS and respiratory burst

Back 174

Disease- Chronic granulomatous disease

Signs/Sx: Increase susceptibility to catalase positive organisms such as S. aureus, E.coli, Aspergillus, candida, klebsiella

Front 175

Which organisms are catalase +/-?

Back 175

Basically all aerobic bacteria are catalase positive except for strep and the enterococci.

Front 176

What is the normal relationship between the pulmonary artery and the aorta (physical)?

Back 176

The pulmonary artery is anterior and to the left of the aorta.

Front 177

Transposition of the great vessels is due a failure of what embryonic process?

Back 177

Septation

Front 178

What chromosome is VHL mutation located on?

Back 178

Chromosome 3 (can remember bc Von Hippel Lindau has three words)

Front 179

What hematologic finding would you expect in an alcoholic?

Back 179

Increased MCV (macrocytosis) - can be increased even without thiamine deficiency

Front 180

What is the mechanism of action of nitroprusside?

Back 180

Balanced arterial and venous vasodilator, so it decreases both preload and afterload. Increases cGMP leading to increased NO.

Front 181

For how many hours after an MI will you see no histological change?

Back 181

4 hours

Front 182

What type of proteins are the myc proteins?

Back 182

Mammalian transcription factors (DNA binding)

C-myc is over-expressed in burkitt lymphoma

Front 183

What types of infections are asplenic patients at risk of?

Back 183

Encapsulated bacteria-

Salmonella, Klebsiella, H. flu, Neisseria meningitidis, Strep. pneumo, Group B Strep.

Front 184

What kind of agar does H. flu need to be grown on?

Back 184

Chocolate agar with factors V (NAD+) and X (hematin).

Front 185

What is the treatment for gonorrhea?

Back 185

Ceftriaxone (for the gonorrhea) + azithromycin for the chlamydia the person also probably has.

Front 186

Name the three anti-TNF antibodies and which one is a receptor mimic?

Back 186

Etanercept, Infliximab, Abalimumab

Etanercept is the receptor mimic

Front 187

What are the clinical effects of the following?
- missing C1 esterase
- missing C3
- missing C5-C8
- missing DAF (CD55-59)

Back 187

-missing C1 esterase- hereditary angioedema and increased bradykinin
- missing C3- severe, recurrent pyogenic sinus and respiratory tract infections, inc. susceptibility to type III hypersensitivity
- missing C5-C8- Neisseria bacteremia infections
- missing DAF - paroxysmal nocturnal hemoglobinuria

Front 188

What is erythema chronica migrans?

Back 188

The bullseye rash in lyme disease.

Front 189

What are the proteins (on leukocyte and on vasculature) that mediate rolling?

Back 189

Leukocyte- sialyl lewis x

Vasculature- E-selectin, P-selectin

Front 190

What are the proteins (on leukocyte and on vasculature) that mediate tight binding?

Back 190

Leukocyte- LFA-1 (integrin)

Vasculature- ICAM-1

Front 191

What proteins on leukocyte and on vasculature mediate diapedesis?

Back 191

PECAM-1 on both.

Front 192

What cytokine, released from macrophages, leads to granuloma formation?

Back 192

TNF-alpha

Front 193

In what three cases would you see a decreased ESR?

Back 193

Sickle cell (altered shape), polycythemia (too many), CHF (don't know why)

Front 194

How does iron poisoning cause death?

Back 194

Peroxidation of lipid membranes.

Front 195

What are the symptoms of acute and chronic iron poisoning?

Back 195

Acute- gastric bleeding

Chronic- metabolic acidosis, scarring leading to GI obstruction

Front 196

Name the type of amyloid and what it is derived from in the following disease:
Primary amyloidosis

Back 196

AL, Ig light chains (this is seen in multiple myeloma)

"L" for Light chain

Front 197

Name the type of amyloid and what it is derived from in the following disease:
Secondary amyloidosis

Back 197

AA, serum amyloid associated proteins (SAA)- present in chronic inflammatory disease

Think "A" for acute phase reactants

Front 198

Name the type of amyloid and what it is derived from in the following disease:
Senile cardiac amyloidosis

Back 198

AF, Transthyretin

Think "F" for old fogies.

Front 199

Name the type of amyloid and what it is derived from in the following disease:
Diabetes mellitus type II

Back 199

AE, Amylin

Think "E" for endocrine

Front 200

Name the type of amyloid and what it is derived from in the following disease:
Medullary Carcinoma of the thyroid

Back 200

A-CAL, Calcitonin

Calcitonin is made in the thyroid (parafollicular cells)

Front 201

Name the type of amyloid and the protein it is derived from in Alzheimer's

Back 201

beta-amyloid, derived from APP (amyloid precurser protein)

Front 202

Name the type of amyloid and the protein it is derived from in Dialysis associated amyloidosis

Back 202

beta2 microglobulin, derived from MHC class I proteins

Front 203

What is the difference between hyperplasia and hypertrophy?

Back 203

Hypertrophy- increase in size of cells

Hyperplasia- increase in number of cells

Front 204

Which skin cancer is xeroderma pigmentosum and albinism most especially associated with?

Back 204

squamous cell carcinoma of skin

Front 205

What condition is associated with squamous cell carcinoma of the esophagus vs. esophageal adenocarcinoma?

Back 205

Squamous- Plummer vinson syndrome

Adeno- Barrett's esophagus

Front 206

What malignancies are associated with Paget's disease of bone?

Back 206

Secondary osteosarcoma and fibrosarcoma

Front 207

Which cancers are associated with acanthosis nigricans?

Back 207

Visceral malignancies (stomach, lung, breast, uterus)

Front 208

Which cancers are associated with radiation exposure?

Back 208

Sarcomas & papillary thyroid cancer.

Front 209

Name the associated cancer & gene product:
abl

Back 209

Cancer- CML
Gene product- tyrosine kinase

Front 210

Name the associated cancer and gene product:
c-myc

Back 210

Cancer- Burkitt's lymphoma
Gene product- Transcription factor

Front 211

Name the associated cancer & gene product:
bcl-2

Back 211

Cancer- Follicular and undifferentiated lymphomas

Gene production- "anti-apoptotic molecule"

Front 212

Name the associated cancer & gene product:
erb-B2

Back 212

Breast, ovarian, and gastric carcinomas

Tyrosine kinase

Front 213

Name the associated cancer & gene product:
ras

Back 213

Colon carcinoma

GTPase

Front 214

Name the associated cancer & gene product:
L-myc

Back 214

Lung tumor

Transcription factor

Front 215

Name the associated cancer & gene product:
N-myc

Back 215

Neuroblastoma

Transcription factor

Front 216

Name the associated cancer and type of gene product:
ret

Back 216

MENIIa and IIb

Tyrosine kinase

Front 217

Name the associated cancer and type of gene product:
c-kit

Back 217

GIST

Cytokine receptor

Front 218

Name the cancer(s) that is associated with the following oncogene:
Rb

Back 218

retinoblastoma, osteosarcoma

Front 219

Name the cancer(s) that is associated with the following oncogene:
p53

Back 219

Most human cancers, Li-Fraumeni syndrome

Front 220

Name the cancer(s) that is associated with the following oncogene:
BRCA1

Back 220

Breast and ovarian cancer

Front 221

Name the cancer(s) that is associated with the following oncogene:
BRCA2

Back 221

Just breast cancer

(BRCA2 only causes breast cancer bc it's "2" for 2 breasts)

Front 222

Name the cancer(s) that is associated with the following oncogene:
p16

Back 222

Melanoma

Front 223

Name the cancer(s) that is associated with the following oncogene:
APC

Back 223

Colorectal cancer (associated with FAP)

Front 224

Name the cancer(s) that is associated with the following oncogene:
WT1

Back 224

Wilms' tumor

Front 225

Name the cancer(s) that is associated with the following oncogene:
NF1/NF2

Back 225

Neurofibromatosis type 1 and type 2

Front 226

Name the cancer(s) that is associated with the following oncogene:
DPC

Back 226

Pancreatic cancer

DPC = "deleted in pancreatic cancer"

Front 227

Name the cancer(s) that is associated with the following oncogene:
DCC

Back 227

Colon cancer

DCC = "deleted in colon cancer"

Front 228

Prostate acid phosphatase is a marker for?

Back 228

Prostate carcinoma

Front 229

CEA is a marker for ?

Back 229

non-specific, but produced by colorectal/pancreatic cancers, also gastric, breast, and thyroid medullary carcinomas

Front 230

AFP is a marker for what cancers?

Back 230

hepatocellular carcinomas and nonsemimnomatous germ cell tumors of the testis (yolk sac tumors)

Front 231

beta hCG is a marker for what cancers?

Back 231

Hydatidiform moles, choriocarcinomas, and gestational trophoblastic tumors

Front 232

CA-125 is a marker for what tumors?

Back 232

Ovarian and malignant epithelial tumors

Front 233

S-100 is a marker for what tumors?

Back 233

melanoma, neural tumors, and astrocytomas

Front 234

Alkaline phosphatase is a marker for what cancers?

Back 234

metastases to bone

Front 235

Bombesin is a marker for what cancers?

Back 235

Neuroblastoma, lung & gastric cancer

Front 236

TRAP is a marker for what cancer?

Back 236

Hairy cell leukemia

"TRAP the hairy animal"

Front 237

CA-19-9 is a marker for what cancer?

Back 237

Pancreatic adenocarcinoma

Front 238

Calcitonin is a marker for what cancer?

Back 238

Thyroid medullary carcinoma

Front 239

HTLV-1 is associated with which cancers?

Back 239

Adult T-cell leukemia/lymphoma

Front 240

Schistosoma haemotobium is associated with what cancers

Back 240

squamous cell carcinoma of transitional epithelium (bladder)

Front 241

Name the four tumors that form psammoma bodies.

Back 241

- Papillary (thyroid)
- Serous papillary (ovary)
- Meningioma
- Mesothelioma

Can think "PSaMM"

Front 242

Name the types of cancer that would be likely to metastasize to the brain.

Back 242

"Lots of Bad Stuff Kills Glia"

Lung, Breast, Skin, Kidney, GI

Front 243

Name the types of cancer that would be likely to metastasize to the liver.

Back 243

"Cancer Sometimes Penetrates Benign Liver"

Colon > Stomach > Pancreas > Breast > Lung

Front 244

Name the types of cancer that would be likely to metastasize to bone.

Back 244

"PT Barnum Loves Kids"

Prostate, thyroid, testes, breast, lung, kidney

Front 245

What types of lesions would lung, prostate, and breast cancer form in bones?

Back 245

lung = lytic
prostate= blastic
Breast = lytic & blastic

Front 246

What vitamin deficiency leads to pellagra?

Back 246

Niacin (B3)

Front 247

Hartnup disease is the inability to reabsorb what type of AAs?

Back 247

nonpolar (esp. tryptophan)

Front 248

What is role of chromium?

Back 248

Cofactor for insulin; helps insulin do its job

Front 249

What is the most important (for boards) role of copper in the body?

Back 249

Cofactor for lysyl oxidase which cross-links collagen and elastic tissue.
Deficiency --> weak collagen/elastic tissue (dissecting aortic aneurysm)

Front 250

What is the role of selenium in the body?

Back 250

Component of glutathione peroxidase- helps convert H2O2 to water (aka anti-oxidant)- FA p. 102

Front 251

What are two situations when you would restrict protein in the diet?

Back 251

- Cirrhosis (can't do urea cycle)
- Chronic renal failure (can't excrete urea)

Front 252

What is a leiomyoma?

Back 252

Benign tumor of smooth muscle

Front 253

Name the four sections of the adrenal gland and what is made in them.

Back 253

Zona glomerulosa (mineralocorticoids), Zona fasiculata (glucocorticoids), and Zona reticularis (sex hormones), and medulla (catecholamines)

Front 254

Where are Peyer's patches located?

Back 254

Terminal ileum

Front 255

Which lymphoma is the most common of the B cell lymphomas and is inactivation of an apoptosis (bcl-2) gene?

Back 255

Follicular B cell lymphoma

Front 256

What drugs would precipitate G6PD flare-up?

Back 256

Oxidizing agents like fava beans, sulfonamides, primaquine, anti-TB drugs, bactrim, dapsone, nitrofurantoin

Front 257

What bacteria is described by "motile Gram positive rods that produce a very narrow zone of beta-hemolysis on sheep blood agar"

Back 257

Listeria

Front 258

What kind of immunity do you need to fight Listeria? Why?

Back 258

Cell-mediated, bc Listeria is facultative intracellular and reproduce in cytoplasm. Think of it kind of like TB.

Front 259

What is the mechanism of ibuprofin?

Back 259

Reversible COX-1 and COX-2 inhibitor. Note- same mechanism as acetaminophen but acetominophen doesn't have peripheral (anti-inflamm) effects.

Front 260

Name the cytochrome p450 inducers.

Back 260

Think BCG PQRS
B- barbiturates
C- carbamazepine
G- griseofulvin
P- phenytoin
Q- quinidine
R- Rifampin
S- St. John's Wort

Front 261

Name the cytochrome p450 inhibitors.

Back 261

Think "Inhibit yourself from drinking beer from a KEG because it makes you ACUTEly SICk"

Protease inhibitors
ketoconazole
Erythromycin
Grapefruit juice
Acute alcohol abuse
Sulfonamides
Isoniazid
Cimetidine

Front 262

Which antibiotic has a side effect of aplastic anemia?

Back 262

Chloramphenicol

Front 263

How long does it take for glycogen to be depleted during fasting?

Back 263

8-12 hours.

Front 264

EBV is associated with which three types of cancer?

Back 264

Hodgkin's lymphoma, non-Hodgkin's lymphoma, and nasopharyngeal carcinoma.

Front 265

How do osteocytes communicate with each other?

Back 265

Gap junctions

Front 266

What is the toxicity that nitroprusside can cause? How would you treat it/why?

Back 266

CN toxicity, treat it with sulfur (sodium thiosulfate) because then you get SCN instead of CN. (It helps your body do what it would normally do).

Also treat with nitrite and hydroxocobalamin.

Front 267

Describe three ways you might identify strep. pneumo in lab.

Back 267

1) Alpha hemolytic
2) Optochin sensitive
3) Bile soluble

(Remember viridans is the optochin resistance one bc they are in dental caries and "not afraid of the CHIN")

Front 268

What is the enzyme that converts G6P to glucose?

Back 268

Glucose 6 phosphatase

Front 269

Name three treatments for CN poisoning and how they work.

Back 269

- Nitrite (like amyl nitrite)- the nitrite induces the formation of methemoglobin, which can bind and sequester CN in the blood
- thiosulfate- helps body add S to CN to make SCN, which is ectreted in urin
- hydroxocobalamin - binds CN to form the harmless form of B12 "cyanocobalamin"

Front 270

High serum levels of antibodies against polyribitol ribose phosphate would be seen in which baterial infection?

Back 270

H. flu (the capsule is made of PRP); we kill H. flu through antibodies --> complement and opsonization

Front 271

Which anti-cancer drug is unique for having neurotoxicity inc. peripheral neuropathy as a side effect? Where does it work?

Back 271

Vincristine- works during M phase to block polymerization of microtubules.

Front 272

What is the difference between and alkaloid and an alkylating agent?

Back 272

Both are anti-cancer.

Alkaloids are drugs vincristine, vinblastine, and taxols that inerfere with microtubules during the M phase

Alkylating agents add alkyl groups to DNA that is already formed and affect the entire cell cycle as well as resting cells (but less so). They are also called "nitrogen-mustard type" (at least one category is).

Front 273

What chromosome is the myc gene on (aka what translocations would you see myc gene messed up in?)

Back 273

Anything with chromosome 8

Front 274

What gene mutation and cancer would you suspect with translocation (14;18)?

Back 274

Bcl-2, follicular lymphoma

Front 275

What is risperidone?

Back 275

Atypical anti-psychotic, special side effect is galactorrhea

Front 276

Draw the sarcomere, including:
Z line, M line, H zone, A band, I band, myosin, and actin.

Back 276

FA p. 377

Front 277

What nerve innervates the posterior half of the external ear canal?

Back 277

The auricular branch of the vagus nerve

Front 278

What nerve innervates the anterior half of the external ear canal?

Back 278

The 5th cranial nerve (trigeminal)

*The nerves go in alphabetic order- trigeminal is outer, vagal (later in the alphabet) is further into the ear

Front 279

What is the enzyme in the TCA cycle that generates FADH2?

Back 279

succinate dehydrogenase

Front 280

What's the treatment for toxoplasmosis?

Back 280

Sulfadiazine and pyrimethamine

Front 281

What two drugs would you give specifically to lower TGs?

Back 281

Fibrates first, then niacin

Front 282

How might you recognize TCA side effects in a question stem?

Back 282

anti-cholinergic + arrhythmias

Front 283

What do you use to treat TCA arrhythmias?

Back 283

NaHCO3

Front 284

Name 4 MAOIs.

Back 284

Phenelzine, tranylcypromine, isocarboxacid, selegiline

Front 285

Which antifungals affect the cell WALL vs. the CELL membrane?

Back 285

Caspofungin- cell wall

Azoles, amphotericin, nystatin, and terbinafine- cell membrane

Front 286

In which cancer are RAS mutations found?

Back 286

Follicular thyroid cancers and some follicular adenomas

Front 287

What are the two "exceptions" to the way the autonomic nervous system is innervated?

Back 287

1) The sweat glands are part of the sympathetic nervous system but their post-ganglionic receptors are ACh/muscarinic, 2) and the adrenal medulla is part of the sympathetic nervous system but it is acted upon directly from spinal cord by cholinergic fibers.- Need to add to this card what kind of receptors at the adrenal medulla (musc. or nic.)

Front 288

What is the MOA of clavulinic acid?

Back 288

Decreases bacterial cleavage of the beta lactam ring of amoxicillin

Front 289

What is the first cell after the stem cell in any WBC lineage?

Back 289

"blasts"

Front 290

What does low leukocyte alkaline phosphatase indicate? high?

Back 290

Low- indicates CML

High or normal- indicates leukemoid reaction

Low levels in leukemia.

Front 291

What two cells are cross-linked in a superantigen reaction?

Back 291

T cell (helper) and APC (like macrophage or dendritic cell)

Front 292

Radiation has what effect on DNA?

Back 292

Double-stranded DNA breaks + formation of free radicals --> damage

Front 293

What type of virus will have a phospholipid-containing particle surface?

Back 293

An enveloped virus

Front 294

What specific family of viruses gets their envelope from the host cell nuclear membrane?

Back 294

The herpesviridae

Front 295

What is E. coli's pathogenic factor in cystitis/pyelonephritis?

Back 295

Fimbriae

Front 296

What is E. coli's pathogenic factor in pneumonia neonatal meningitis?

Back 296

K capsule

Front 297

What is E. coli's pathogenic factor in septic shock?

Back 297

LPS endotoxin

Front 298

What is the step of galactose metabolism that is messed up in classic galactosemia?

Back 298

Galactose 1-P --> glucose 1-P + UDP galactose via (galactose 1-P) uridyl transferase

Front 299

Reversible or irreversible
Decreased ATP synthesis

Back 299

Reversible

Front 300

Reversible or irreversible?
Cellular swelling

Back 300

Reversible

Front 301

Reversible or irreversible?
Nuclear chromatin clumping/disaggregation of nuclear granules

Back 301

Reversible

Front 302

Reversible or irreversible?
Decreased glycogen

Back 302

Reversible

Front 303

Reversible or irreversible?
Fatty change

Back 303

Reversible

Front 304

Reversible or irreversible?
Ribosomal detachment

Back 304

reversible

Front 305

Reversible or irreversible?
mitochondrial swelling

Back 305

reversible

Front 306

Reversible or irreversible?
Nuclear pyknosis, karyolysis, karyorrhexis

Back 306

Irreversible

Front 307

Reversible or irreversible?
Ca2+ influx

Back 307

Irreversible (leads to caspase activation)

Front 308

Reversible or irreversible?
plasma membrane damage

Back 308

irreversible

Front 309

Reversible or irreversible?
lysosomal rupture

Back 309

irreversible

Front 310

Reversible or irreversible?
mitochondrial permeability and vauolization

Back 310

irreversible

Front 311

Which cells in male produce testosterone?

Back 311

Leydig cells (can remember bc it's the male hormone, and boys "lie" and "dig").

Front 312

Which cells in male produce inhibin and what does inhibin do?

Back 312

Sertoli cells

Inhibin inhibits FSH release from the anterior pituitary

Front 313

What three classes of drugs would cause toxicity when given with lithium?

Back 313

thiazide diuretics, NSAIDs, and ACE inhibitors

Front 314

What kind of cells make renin?

Back 314

JG cells

Front 315

How would you treat homocysteinuria due to a cystathionine synthases deficiency?

Back 315

Decrease Met in diet, Increase Cys in diet, and increase B12 & folate in diet

Front 316

How would you treat homocysteinuria due to a decreased affinity of cystathionine synthases for pyridoxal phosphate?

Back 316

Increased vitamin B6 in diet

Front 317

What medium do you use to stain cryptococcus & what does it look like?

Back 317

India ink

Looks like bright circles on dark background- the bright circles are the thick capsule that doesn't stain

Front 318

What do you use to treat cryptococcus?

Back 318

Amphotericin B

Front 319

Which hepatitis virus gets integrated into the human genome and causes cancer that way?

Back 319

Hep. B

Front 320

Describe the difference between hepatitis B core antigen and eAg.

Back 320

Antibody to the core antigen is the only thing present during the window period. Antigen E vs. antibody to antigen E is how you determine infectivity in a chronic infection (if they have the eAg but not Ab, it's high infectivity)

Front 321

What three microbes can cause HIV associated esophagitis?

Back 321

Candida (would see white/grey membranes)
HSV-1- small punched out ulcers
CMV- linear ulceration

Front 322

What does isospora belli cause in HIV patients?

Back 322

chronic, watery diarrhea

Front 323

How is dixogin excreted?

Back 323

Renally

Front 324

What things make dixogin toxicity worse?

Back 324

Renal failure (including decreased activity due to aging), hypokalemia (bc then dig can bind at the K+ binding site on the Na/K ATPase), quinidine (due to decreased clearance)

Front 325

What types of drugs can induce mania in bipolar disorder?

Back 325

Anti-depressants (such as TCAs)

Front 326

Where in the renal tubule does ADH act?

Back 326

In the collecting tubules, acts at V2 receptors.

Front 327

What is the mechanism of action of flutamide?

Back 327

It is a nonsteroidal, competitive inhibitor of androgens at the testosterone receptor; used to treat prostate carcinoma

Front 328

Why do women/pregnant women get cholethiasis?

Back 328

1) bc they have estrogen induced cholesterol hypersecretion
2) bc they have progesterone induced gallbladder hypomotility

Front 329

What is the embryologic origin (tissue layer) of the lens of the eye vs. the retina?

Back 329

The retina derives from the neuroectoderm and the lens of the eye derives from the surface ectoderm.

Front 330

What major organs does portal circulation include?

Back 330

Gut, spleen, pancreas

Front 331

What's the difference between neurofibrmatosis type 1 and tuberous sclerosis?

Back 331

NF1- you get

Front 332

What are the anaphylatoxins?

Back 332

c3a nd c5a

Front 333

osteomyelitis in normal child causative organism?

Back 333

s. aureus

Front 334

osteomyelitis in child w. sickle cell anemia?

Back 334

salmonella

Front 335

infection of post-partum mom (breasts). organis?

Back 335

s. aureus

Front 336

Give examples of intrinsic tyrosine kinase receptors (that signal via MAP kinase)

Back 336

EGFR, PDGFR, FGFR

Front 337

Give examples of receptors that do NOT have intrinsic tyrosine kinase activity and signal via the JAK STAT pathway

Back 337

Cytokine receptors, growth hormone, prolactin, IL-2

Front 338

Why does arterial resistance increase in lungs as blood oxygen decreases?

Back 338

To divert the blood away from underventilated areas and towards more well-ventilated areas.

Front 339

Is paramesonephric duct found in males or females?

Back 339

Females (Think females are Pretty and they have the Paramesonephric duct)

Front 340

What are the tumors of MEN1 syndrome?

Back 340

Pituitary, parathyroid, and pancreas tumors

Front 341

What two genetic disorders can have webbing of the neck?

Back 341

Down Syndrome and Turner's

Front 342

What is the mechanism of action and use for prazosin?

Back 342

It's an alpha 1 blocker used to treat hypertension and urinary retention in BPH.

Front 343

Hydrocholric acid and alcohol are used to decolorize after staining with carbolfuschsin in a ______ stain?

Back 343

acid-fast

Front 344

Describe sex hormones, aldosterone, and 17-hyrdoxyprogesterone levels for 17alpha hydroxylase deficiency.

Back 344

Sex hormones - decreased
Aldosterone - increased (HTN)
17-hydroxyprogesterone - low

Front 345

Describe sex hormones, aldosterone, and 17-hyrdoxyprogesterone levels for 21 hydroxylase deficiency

Back 345

Sex hormones- increased
Aldosterone- decreased (hypOtension)
17-hydroxyprogesterone- increased

Front 346

Describe sex hormones, aldosterone, and 17-hyrdoxyprogesterone levels for 11 beta hydroxylase deficiency

Back 346

sex hormones- elevated

aldosterone- decreased, but mineralocorticoids are elevated (HTN) bc 11 deoxycorticosterone can bind aldosterone receptors

17-hydroxyprogesterone levels- increased

Front 347

Lung mass + hyponatremia makes you think?

Back 347

SIADH

Front 348

What is the only thing you absolutely need to supplement after total gastrectomy?

Back 348

Vitamin B12 (parenteral); can no longer absorb due to loss of IF.

Front 349

Myoglobin-rich, glycogen-poor muscle fibers with many mitochondria describes which type of muscle?

Back 349

Type I (slow twitch); they perform mostly by aerobic metabolism and have lots of myoglobin for O2 storage and mitochondria for aerobic respiration.

Front 350

Where are thyroid hormone receptors located?

Back 350

IN the nucleus (as opposed to other steroid hormones that are in the cytoplasm like glucocorticoids, mineralocorticoids, etc.)

Front 351

Describe how HgbC would move on gel electrophoresis?

Back 351

It's a missense mutation that forms a more positively charged molecule, so it migrates more slowly towards the positive charge.

Front 352

Which direction do proteins move on a gel?

Back 352

towards the positive (cathode)

Front 353

Dextrans facilitate streptococcal adherence to ________?

Back 353

Fibrin

Front 354

Erythemia infectiosum looks like what and is caused by what?

Back 354

slapped cheek rash, caused by parvovirus B19

Front 355

Roseola infantum looks like what and is caused by what?

Back 355

Looks like very high fever for a few days followed by maculopapular rash that starts on trunk and spread peripherally; caused by Herpes virus type 6

Front 356

What is the mechanism of action of amlodipine?

Back 356

Anti-hypertensive, anti-anginal ca2+ channel blocker that causes coronary and peripheral vasodilation. Can be used to treat Prinzmetal's angina.

Front 357

What is the MOA and use for ergonovine?

Back 357

MOA- agonist for alpha adrenergic and serotonergic receptors

Use- to test if someone has vasospasm (Prinzmetal's angina)

Front 358

Name a very virulent bacteria that you only need ten organisms in you to get sick...

Back 358

Shigella

Front 359

What is the difference between effect modification and confounding?

Back 359

Effect modulation is when you design the study fine, but something might be modifying the effect you measure. For example, you find that risk of sunburn is higher in beach-goers that don't wear sunscreen vs. non-beach-goers that don't wear sunscreen. What you have measured is a true effect (going to the beach --> more sunburn), but there is also an EFFECT of not wearing sunscreen that may be modifying your results.
Confounding would be if you compared beach-goers that don't wear sunscreen to non beach-goers that do wear sunscreen and blamed the results on going to the beach without accounting for wearing sunscreen.

Front 360

What does DNA polymerase III (3' to 5' exonuclease) do?

Back 360

Removes improper base-pair nucleotide nduring replication

Front 361

What is a hurthle cell and when do you see it?

Back 361

You see it in Hashimoto's thyroiditis, it's a thyroid follicular cell that undergoes metaplastic change, leaving large, oxyphilic cells with granular cytoplasm

Front 362

What nerve is at increased risk during thyroidectomy?

What muscle?

Back 362

superior laryngeal n (external branch)

Cricothyroid is the only laryngeal muscle supplied by that nerve

Front 363

The H. flu vaccine is specifically against what part of the bug and what is it conjugated to?

Back 363

Against the capsule, conjugated to diptheria toxoid or other protein

Front 364

Patient presents with hydrocephalus, chorioretinal lesions, enlarged ventricles, and scattered intracranial calculi acquired in utero. Diagnosis?

Back 364

Toxoplasmosis

Front 365

What's the difference between neurofibromatosis (type I) and tuberous sclerosis?

Back 365

Tuberous sclerosis- ash leaf spots, facial lesions (adenoma sebaceum), cortical and retinal hamartomas, seizures, MR, renal cysts and renal angiomyolipomas, cardiac rhabdomyomas, increased incidence of astrocytomas

Neurofibromatosis- cafe au lait spots, neural tumors, lisch nodules (pigmented iris hamartomas), skeletal disorders, optic pathway gliomas

Front 366

Name the intraperitoneal organs (13).

Back 366

Stomach, First part of the duodenum [5 cm], fourth part of the duodenum, jejunum, ileum, cecum, appendix, transverse colon, sigmoid colon, Rectum (upper 1/3), liver, spleen, pancreas (only tail).

Front 367

Name the retroperitoneal organs (12).

Back 367

The rest of the duodenum (2nd and 3rd parts), ascending colon, descending colon, Rectum (middle 1/3), pancreas (except tail), kidneys, adrenal glands, proximal ureters, renal vessels, gonadal vessels, inferior vena cava, aorta

Front 368

Cryoglobulinemia is associated with which hepatitis?

Back 368

Hep. C (C for both cryo and Hep C).

Front 369

What are the need to know enzymes in purine synthesis?

Back 369

PRPP synthetase

Front 370

What are the need to know enzymes in pyrimidine synthesis?

Back 370

carbamoyl phosphate synthetase II, ribonucleotide reductase, thymidylate synthase, dihydrofolate reductase (part of regenerating N5N10 methylene THF to use to make dTMP)

Front 371

Patient presents, lucid, after fracture of temporal bone. Most like type of hemorrhage?

Back 371

Epidural

Front 372

Patient presents with slow onset of symptoms; patient is elderly or alcoholic or shaken baby. Most likely type of hemorrhage?

Back 372

Subdural hematoma

Front 373

Patient has "worst headache of life" and bloody or yellow spinal tap. Patient might have Marfan's, Ehlers-Danlos, or APCKD. Most likely type of hemorrhage?

Back 373

Subarachnoid

Front 374

Lesion of which cranial nerve would lead to hyperacusis?

Back 374

Cranial nerve VII, bc it innervates the stapes? which dulls sound

Front 375

What organism and subtype causes lymphogranuloma venereum?

Back 375

Org- chlamydia

Subtype- L1-L3 (L for lymphogranuloma)

Front 376

What cancers are commonly found in MEN1?

Back 376

Parathyroid, Pituitary (prolactin or GH), and Pancreas (endocrine)

Front 377

What cancers are commonly found in MEN2a?

Back 377

Medullary thyroid carcinoma (secretes calcitonin), Pheochromocytoma, Parathyroid tumors

Front 378

What cancers are commonly found in MEN2b?

Back 378

Medullary thyroid carcinoma (secretes calcitonin), pheochromocytoma, and oral/intestinal ganglioneuromatosis

Front 379

Which bacteria causes gas gangrene and late food poisoning?

Back 379

C. perferingins

Front 380

What's the difference between Reiter's syndrome and Reye's syndrome?

Back 380

Reye's - giving a child aspirin during a viral infection

Reiter's- reactive arthritis. It has a triad of conjunctivitis/anterior uveitis, urethritis, and arthritis (can't see, can't pee, can't climb a tree)

Front 381

What TNF alpha blocker Ab is particularly known for predisposing patient to infection?

Back 381

Infliximab

Front 382

Where in kidney is erthyropoietin made?

Back 382

In the endothelial cells of the peritubular capillaries

Front 383

What is the mechanism of action of tamsulosin and what is it used to treat?

Back 383

MOA- alpha 1 antagonist (selective for alpha 1 A & D), used to treat BPH. Doesn't bind to vascular alpha 1 receptors.

Front 384

What's the difference between citrate and ascorbic acid?

Back 384

Citrate is part of the TCA cycle and ascorbic acid is vitamin C (collagen, scurvey, etc.)

Front 385

Which STD (or sometimes STD) has a positive whiff test?

Back 385

Bacterial vaginosis

Front 386

What's the difference between protein A and IgA protease?

Back 386

Protein A- binds the fc region of IgG and inhibits opsonization and phagocytosis

IgA protease- cleave IgA, is secreted by strep pneumo and H. flu type B and Neisseria and S. aureus, and it's how they colonize mucosa.

Front 387

What's the difference between urea and uric acid and orotic acid?

Back 387

Urea- the way the body gets rid of NH4+ (via the UREA cycle) in the liver

Uric acid or urate-is what builds up in gout. Associated pathologies are Lesch Nyhan syndrome.

Orotic acid- an intermediate in the normal de novo pyrimidine synthesis pathway

Front 388

How are the urea cycle and orotic acid related?

Back 388

Carbamoyl phosphate synthetase is an enzyme in both the pyrimidine synthesis pathway and the urea cycle.

You can get orotic aciduria from a blockage at the orotic acid step in DNA synth, and the urea cycle can't help you out. But you can ALSO get a blockage at the carbamoyl phosphate step in the urea cycle, so the CP can get funneled into DNA synthesis instead.

Front 389

What's the difference between transketolase and aldolase?

Back 389

Transketolase catalyzes the reversible steps of the HMP shunt.

Aldolase B catalyzes the breakdown of fructose (F 1 P --> ?)

Front 390

Serum sickness often causes decreased levels of?

Back 390

Complement proteins

Front 391

Vitamin B6 (pyridoxine) is required as a cofactor in:

Back 391

Transaminase reactions, decarboxylation reactions, glycogen phosphorylase, cystathionine synthesis, and heme synthesis. Also needed to convert tryptophan --> niacin

Front 392

Thiamine is a required as a cofactor in which reactions?

Back 392

transketolase, alpha ketoglutarate dehydrogenase, pyruvate dehydrogenase

Front 393

Riboflavin is required as a cofactor in which reaction?

Back 393

TCA cycle succinate --> fumarate (succinate dehydrogenase)

Front 394

Biotin is needed as a cofactor in which reactions?

Back 394

Carboxylase- pyruvate carboxylase, acetyl co-A carboxylase, propionyl coA carboxylase, and 3-methylcrotonyl-coA carboxylase

Front 395

What is folate needed for in the body?

Back 395

nucleic acid synthesis

Front 396

Which testicular vein drains into the renal vein on that side --> varicocele?

Back 396

LEFT

Front 397

What can be use to get rid of symptoms of VIPoma?

Back 397

Somatostatin

Front 398

Patient presents with murmur, bounding femoral pulsations, and head-bobbing. Diagnosis?

Back 398

Aortic regurgitation

Front 399

Which are the 4 short-acting benzodiazepines?

Back 399

Alprazolam, Triazolam, Oxazepam, Midazolam

Think MOAT bc it's a short swim across a moat.

Front 400

What are the side effects of methotrexate?

Back 400

Myelosuppression, macrovascular fatty change in liver, mucositis (mouth ulcers), teratogenic, neurotoxicity

Front 401

What can methotrexate be used to treat?

Back 401

leukemia, lymphoma, choriocarcinoma, sarcoma + abortion, ectopic pregnancy, RA, psoriasis

Front 402

Myxomatous degeneration of the arteries would lead to...

Back 402

dissecting aortic aneurysm aka "dissecting hematoma"

Front 403

What prevents lactation during pregnancy bc prolactin levels are increased?

Back 403

estrogen & progesterone; they stimulate it's secretion but block its action at the breast

Front 404

What is the dexamethasone test?

Back 404

It's a glucocorticoid that you give to ppl with Cushing syndrome to see where the cause of the problem is

Front 405

Name three oxidase positive, gram negative bacteria.

Back 405

Pseudomonas, campylobacter, vibrio cholerae

Front 406

What is erythema gangrenosum?

Back 406

It's a necrotic skin infection seen in septic patients infected with pseudomonas. It looks like bruises of different sizes in photo.

Front 407

What's a bacteria that invades Schwann cells?

Back 407

Mycobacterium leprae

Front 408

What is the mechanism of enterococci resistance against aminoglycosides?

Back 408

Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation

Front 409

What are the results of acute salicylate intoxication?

Back 409

First- hyperventilation leading to respiratory alkalosis

Second (within a few hours)- anion gap metabolic acidosis due to accumulation of organic acids in the blood

Front 410

Which birth defects are most commonly associated with anal atresia?

Back 410

GU tract defects like epispadias, hypospadias, bladder exstrophy

Front 411

What does VACTERL stand for?

Back 411

vertebral defects, anal atresia, cardiac anomalies, tracheoesophageal fistula, esophageal atresia, renal anomalies, and limb anomalies

Front 412

Name 5 class III anti-arrhythmics

Back 412

Sotalol, ibutilide, bretylium, dofetilide, amiodarone

Front 413

Which TB drug requires processing by mycobacterial catalase peroxidase to be activated?

Back 413

Isoniazid

Front 414

What biochemical intermediate activates pyruvate carboxylase?

Back 414

Acetyl-coA

Front 415

What would you see on cardiac catheterization with mitral regurgitation?

Back 415

You'd see an increased left atrial pressure during filling/diastole bc there is already going to be blood in there that regurgitated up during the previous systole.

Front 416

Hyperplastic arteriosclerosis has what pathologic finding?

Back 416

Onion-skin like concentric thickening of arteriolar walls

Front 417

What is the result of Hep C infection in most patients?

Back 417

Stable, chronic hepatitis

Front 418

What are the causes of acute pancreatitis?

Back 418

GET SMASHED

Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune disease, Scorpion sting, Hypercalcemia/HyperTG, ERCP, Drugs

Front 419

Name 4 drugs that can cause pancreatitis.

Back 419

Dedanazine, retinivir, stavudine, sulfa drugs

Front 420

Amino groups are primarily transferred to what molecule during the metabolism of amino acids?

Back 420

Alpha ketoglutarate

Front 421

What would you have to supplement if you had a folic acid deprivation?

Back 421

Thymidine bc there's no other way to make it without using folate. FA p. 68

Front 422

What heart defect is associated with Turner's syndrome?

Back 422

Coarctation of the aorta. World also says bicuspid aortic valve and aortic dissection in adulthood.

Front 423

What would you give to treat someone who was exposed to heavy iodine isotopes?

Back 423

Potassium iodide, which would encourage uptake of the KI instead of the bad stuff they were exposed to because it all goes through the "sodium iodide symporter" (NIS) & into follicular cells.

Front 424

What is the life-threatening side effect associated with lamotrigine?

Back 424

hypersensitivity that manifests as a skin rash

Front 425

What is the reaction & cofactor for eye damage in diabetes?

Back 425

Glucose --> sorbitol, via aldose reductase, cofactor is NADPH

Front 426

Draw the circle of willis (13 arteries + optic chiasm and CN III)

Back 426

FA p. 405

Front 427

Which mycosis is described as a "spherule filled with endospores"?

Back 427

Coccidiomycosis

Front 428

What's the STATIN of choice when you are also giving a cyt p450 inhibitor?

Back 428

pravastatin

Front 429

How are statins normally metabolized?

Back 429

The cyt p450 system

Front 430

What is the effect of angiotensin II on the glomerular arteries?

Back 430

It constricts both, but preferentially the efferent.

Front 431

What is the effect of an ACE inhibitor on the glomerular arteries?

Back 431

Will dilate both but more effect on the efferent bc that's that one angiotensin II constricts more

Front 432

When do you see spongiosis in skin?

Back 432

Eczematous dermatitis INCLUDING:
atopic dermatitis
allergic contact dermatitis
photoeczematous dermatitis
primary irritant dermatitis

Front 433

Keratin is present in what types of cells?

Back 433

Epithelial

Front 434

Name the live virus vaccines

Back 434

smallpox, yellow fever, chickenpox, Sabin's polio, MMR

Front 435

What is the appropriate response to the vestibuloccular reflex test?

Back 435

COWS

Cold water- fast phase of nystagmus to opposite side
Warm water- fast phase of nystagmus to same side

If it's messed up, lesion is on the same side.

Front 436

Newborn presents with enlargement of head, cranial sutures separated, normal weight. US shows thinning of cerebral cortex + enlargement of lateral ventricles. Diagnosis?

Back 436

Stenosis of the aqueduct of sylvius

Front 437

Name two spore-forming bacteria that can survive high temperatures.

Back 437

Bacillus and Clostridium

Front 438

What are the symptoms and cause of graft vs host disease?

Back 438

Sx: diarrhea, skin rash, jaundice, hepatosplenomegaly

Cause: T cells from graft attack patient's own cells

Front 439

What nerve could be damaged by severing the inferior thyroid artery?

Back 439

recurrent laryngeal nerve

Front 440

What nerve could be damaged by severing the superior thyroid artery?

Back 440

the superior laryngeal nerve (external branch) aka external laryngeal nerve

Front 441

What kind of RBCs would you see in DIC?

Back 441

schistocytes bc they are getting mechanically damaged by the clots.

Front 442

What would phosphate levels be in chronic kidney disease?

Back 442

high, because kidney can't clear phosphate

Front 443

Talk about the reversibility of dysplasia vs. neoplasia

Back 443

Dysplasia considered reversible, neoplasia isn't

Front 444

An ulcer in the inferior curvature of the stomach could penetrate which artery?

Back 444

Left gastric

Front 445

What is the only fungus (pathogenic) that has a polysaccharide capsule?

Back 445

cryptococcus

Front 446

What two stains can you use to stain for cryptococcus?

Back 446

mucocarmine (looks red) and india ink (shows up bright on black background)

Front 447

Describe the difference in diffusion of CO2 vs. O2?

Back 447

CO2 diffuses much faster, so if you have a diffusion issue, you'd expect CO2 to look ok but O2 diffusion to be messed up.

Front 448

Which is the anti-viral that doesn't require viral thymidine kinase to be active?

Back 448

Cidofovir

Front 449

Why does patient with Tetralogy of Fallot squat?

Back 449

Because squatting increase TPR, which decreases the rt to left shunt and allows more blood to go through the pulmonary circulation

Front 450

What seizure drug is first line for absence seizures?

Back 450

ethosuximidie

Front 451

What is the MOA of ethosuximide?

Back 451

blocks T-type Ca2+ channels

Front 452

What is the mechanism of action of trimethoprim?

Back 452

inhibits bacterial dihydrofolate reductase (purine synthesis)

Front 453

What are the side effects of hydralazine?

Back 453

reflex sympathetic activation leading to increased heart rate, contractility, and increased renin activity + nausea/headache

Front 454

Describe the mechanism of action of nitric oxide on smooth muscle.

Back 454

NO leads to increased cGMP which leads to decreased Ca2+ entry --> decreased activity of MLCK and thus dephosphorylation of myosin and relaxation

Front 455

What is the first step in evaluation for fat soluble vitamin malabsorption?

Back 455

a sudan III satin, which will identify the presence of fat in a stool sample. If >7 mg/day are excreted, it's described as malabsorption

Front 456

Patient presents with history of pain & stiffness in shoulders & knees + darkening of sclera and cartilage. Diagnosis?

Back 456

alkaptonuria

Front 457

What IS alkaptonuria?

Back 457

It's a deficiency of homogentisic acid oxidase which is needed to turn tyrosine into fumarate. You get the pigment due to accumulated homogentisic acid

Front 458

Which two diseases have granulomatous thickening of the media of the arteries?

Back 458

Takayasu's arteritis + temporal arteritis

Front 459

Which vasculitis has immune complex-mediated transmural damage with fibrinoid necrosos?

Back 459

Polyarteritis nodosa

Front 460

What histologic changes would you see 10-14 days post MI?

Back 460

granulation tissue + neovascularization

Front 461

Which transporter transports Glucose/galactose in from the intestine?

Back 461

SGLT-1

Front 462

Which transporter transports fructose in from the intestine?

Back 462

GLUT-5

Front 463

Which glucose transporter is insulin responsive?

Back 463

glut 4

Front 464

Which glucose transporter transports sugars across basal intestinal side into bloodstream?

Back 464

GLUT 2

Front 465

What glucose transporter do the brain and RBCs use?

Back 465

GLUT 1

Front 466

Which cells secrete renin

Back 466

JG cells of kidney

Front 467

Which branchial pouch forms superior parathyroids and which one forms inferior?

Back 467

3rd- inferior, 4th- superior

Front 468

Where in kidney is 1 alpha hydroxylase located?

Back 468

proximal tubule

Front 469

Which hormones signal via IP3?

Back 469

GOAT

GnRH, Oxytocin, ADH, TRH

Front 470

Which hormone has an intranuclear receptor?

Back 470

T3/T4

Front 471

Which hormones signal via the JAK/STAT pathway and what kind of receptor do they use?

Back 471

GH, prolactin, IL-2, using a receptor-associated tyrosine kinase receptor

Front 472

Why do you get skin hyperpigmentation in Addison's syndrome?

Back 472

because you have low cortisol --> high ACTH, and MSH (causing the skin pigmentation) is a by-product of the ACTH production from POMC precurser protein

Front 473

How would you distinguish Addison's from secondary adrenal insufficiency?

Back 473

secondary wouldn't have elevated ACTH (because it would be due to LOW ACTH) so you wouldn't get skin hyperpigmentation or hyperkalemia (no mineralocorticoid effects)

Front 474

What is acute, primary adrenal insufficiency due to adrenal hemorrhage called?

Back 474

Waterhouse Friderichsen syndrome

Front 475

What is the embryological origin of the chromaffin cells?

Back 475

Neural crest

Front 476

Which types of MEN syndrome is pheochromocytoma associated with?

Back 476

2A and 2B

Front 477

What is the rate-limiting step in catecholamine synthesis?

Back 477

Tyrosine hydroxylase (Tyr --> L DOPA)

Front 478

What gene over-expression is bad prognosis in neuroblastoma?

Back 478

n-myc

Front 479

What HLA subtype is Hashimoto's thyroiditis associated with?

Back 479

HLA-DR5

Front 480

Pot-bellied, pale, puffy-faced child with protruding umbilicus and protuberant tongue. Dx?

Back 480

severe fetal hypothryoidism (aka cretinism)

Front 481

Self-limited hypothyroidism with granulomatous inflammation after flulike illness =?

Back 481

de Quervain's thyroiditis

Front 482

Rock-hard thyroid, replaced by fibrous tissue, painless = ?

Back 482

Riedel's thyroiditis

Front 483

Stress-induced catecholamine surge leading to death by arrhythmia; complication of Graves' is called?

Back 483

thyrotoxicosis

Front 484

Are hot thyroid nodules malignant?

Back 484

not usually

Front 485

What's the most common type of thyroid cancer?

Back 485

papillary thyroid carcinoma

Front 486

How do you tell the difference between primary and secondary hyperparathyroidism?

Back 486

Primary - PTH first --> Hypercalcemia

Secondary - Hypocalcemia first --> increased PTH

So bottom line is that primary has hypercalcemia and secondary has hypocalcemia (usually secondary to dec. vitamin D due to renal disease)

Front 487

Patient presents with cystic bone spaces filled with brown fibrous tissue & bone pain. Dx?

Back 487

osteitis fibrosis cystica secondary to hyperparathyroidism

Front 488

What's the name for bone lesions due to secondary or tertiary hyperparathyroidism due, in turn, to renal disease?

Back 488

Renal osteodystrophy

Front 489

Explain Chvostek's sign and Trousseau's sign

Back 489

Chvostek's- tap on facial nerve --> contraction of facial muscles

Trousseau's- tighten BP cuff around brachial artery and generate carpal spasm

Both are signs of tetany secondary to hypocalcemia

Front 490

Patient presents with hypocalcemia, high PTH, shortened 4th/5th digits, and short stature. Diagnosis?

Back 490

pseudohypoparathyroidism aka Albright's hereditary osteodystrophy

Front 491

What's the most common type of pituitary adenoma?

Back 491

prolactinoma

Front 492

What is the relationship of growth hormone to insulin?

Back 492

Growth hormone inhibits insulin release and prevents you from breaking down carbs

Front 493

Where is EPO released from?

Back 493

endothelial cells of peritubular capillaries

Front 494

Where does IgA accumulate in IgA nephropathy?

Back 494

the mesangium

Front 495

Where do you see immune complexes in post-strep GN?

Back 495

Sub-epithelial

Front 496

Where do you see immune complexes in lupus?

Back 496

sub-endothelial

Front 497

Which diuretic decreases calcium excretion?

Back 497

thiazide

Front 498

How are the urea cycle/the TCA cycle related?

Back 498

Urea cycle uses alphaketoglutarate to hold onto NH4+ until it can be put through urea cycle. If urea cycle is messed up, that deplates alphaketoglutarate and inhibits the TCA cycle

Front 499

Which virus family acquires their envelope from the nuclear membrane?

Back 499

Herpes

Front 500

What are the side effects of isoniazid?

Back 500

Think INH damages Neurons and Hepatocytes; also causes drug-induced lupus

*Remember, giving B6 can help prevent neurotoxicity and lupus

Front 501

Patient presents with mild urethritis. He doesn't have gonorrhea. A few weeks later, he gets acute conjunctivitis, right knee pain, and rash on his palms & soles. Dx?

Back 501

Reiter syndrome.

Remember: Can't see, can't pee, can't climb a tree (and apparently you get a rash also).

Front 502

Name two symptoms specific for Graves' disease

Back 502

pretibial myxedema & exophthalmos

Pretibial myxedema- accumulations of GAGs in the dermis leading to non-pitting edema on lower legs that looks like "orange peel"

Front 503

Which HLA type is associated with type 1 diabetes?

Back 503

HLA-DR 3/4

Front 504

What is the histolic finding in type 1 diabetes?

Back 504

islet cell leukocytic infiltrate

Front 505

What is the histologic finding in type 2 diabetes?

Back 505

islet amyloid deposits

Front 506

How would you diagnose Zollinger Ellison disease?

Back 506

serotonin; inhibits regular gastrin but not the gastrin being released by the tumor

Front 507

What's the difference between zollinger-ellison and Menetrier's disease?

Back 507

ZE- gastrin hyper-secretion due to tumor, stomach shows rugal thickening

Menetrier's- gastric hypertrophy with protein loss, parietal cell atrophy, and increased mucous cells; rugae are so hypertrophied they look like brains

Front 508

What cancers are found in MEN2A vs. MEN2B?

Back 508

MEN 2A- medullary thyroid carcinoma, pheochromocytoma, parathyroid tumors

MEN2B- medullary thyroid carcinoma, pheochromocytoma, oral/intestinal ganglioneuromatosis

Front 509

What is rhizopus?

Back 509

a yeast that acts like mucor

Front 510

What is absidia?

Back 510

a yeast that acts like mucor

Front 511

What is the MOA of donepezil?

Back 511

acetylcholinesterase inhibitor (used to treat Alzheimer's)

Front 512

What is the INITIAL lesion in Paget's disease of bone caused by (cell type)?

Back 512

osteoclasts

Front 513

What type of drug is cefazolin?

Back 513

1st generation cephalosporin

Front 514

Name the first generation cephalosporins.

Back 514

cefazolin, caphalexin

Front 515

Name the Ca2+ channel blockers that work on blood vessels.

Back 515

nifedipine, amlodipine

Front 516

Name the Ca2+ channel blockers that work at the heart.

Back 516

Verapamil, diltiazem

Front 517

Which ca2+ blockers works the most at the heart and the least at vessels?

Back 517

Verapamil

Front 518

What types of arteries does atherosclerosis affect vs. hyaline arteriosclerosis?

Back 518

athero- large muscular/elastic arteries

hyaline arteriosclerosis- arterioles

Front 519

What does the law of laplace say?

Back 519

As radius increases, so does stress on the walls

Front 520

Syphilis is a vasculitis of what type of blood vessels?

Back 520

arterioles

Front 521

What particular vessels does syphilis damage in the aorta?

Back 521

vasa vasorum

Front 522

Why does aortic regurg cause bounding pulses?

Back 522

because you have increased EDV but your heart also works fine so you have increased stroke volume on each beat (as opposed to mitral regurg secondary to left heart failure, where you have increased EDV bc heart can't pump out well enough)

Front 523

What is the pattern of inheritance and chromosome of marfan syndrome?

Back 523

autosomal dominant, chromosome 15

Front 524

Why do you get hyperestrogenism in cirrhosis?

Back 524

bc liver can't metabolize estrogen, AND liver can't metabolize 17 keto steroids so they get turned into estrogen

Front 525

How is petechiae different from telangiectasia?

Back 525

petechiae is non-blanching

Front 526

Lesion only seen in AIDS patients, looks like kaposi sarcoma. Name & causative organism

Back 526

Bacillary angiomatosis, caused by bartonella hensliae.

Front 527

How do you visualize bartonella hensliae?

Back 527

silver stain

Front 528

What two diseases does baronella hensliae cause?

Back 528

cat scratch disease and bacillary angiomatosis

Front 529

Name two side effects of cyclophosphamide.

Back 529

Myelosuppression, hemorrhagic cystitis

Front 530

What is mesna used for?

Back 530

Give when treating with cyclophosphamide; thiol group binds toxic metabolite and reduces hemorrhagic cystitis

Front 531

What is polyarteritis nodosa?

Back 531

immune complex mediated transmural vasculitis that affects small and medium arteries

Front 532

Which arteries does polyarteritis nodosa tend to avoid?

Back 532

pulmonary

Front 533

What disease is associated with polyarteritis nodosa?

Back 533

hepatitis B

Front 534

Describe the rash of rocky mt. spotted fever.

Back 534

begins on hands and feet, moves to trunk

Front 535

Name three spirochetes

Back 535

treponema, borrelia, leptospira

Front 536

Melanoma is a malignany of what type of cells?

Back 536

melanocytes

Front 537

What embryologic layer do melanocytes derive from?

Back 537

neural crest

Front 538

Describe the diarrhea of Crohn's vs UC.

Back 538

Crohn's is sometimes bloody, US is always bloody

Front 539

Which nerve runs between biceps brachii and corachobrachialis?

Back 539

musculocutaneous

Front 540

Which nerve runs between flexor carpi ulnaris and flexor digitorum profundus?

Back 540

ulnar n.

Front 541

Which nerve runs between olecranon and medial epichondyle of humerus?

Back 541

ulnar

Front 542

Which nerve runs through the supinator near the head of the radius?

Back 542

radial n.

Front 543

Which nerve runs between the humeral and ulnar heads of pronator teres and then between flexor digitorum superficialis and flexor digitorum profundus before entering the wrist?

Back 543

median n.

Front 544

Name two microbes associated with Guillain Barre syndrome

Back 544

campylobacter and herpesvirus

Front 545

Why can acetazolamide be used to treat glaucoma?

Back 545

bc it decreases HCO3 and decreases aqueous humor formation

Front 546

What's the difference in the rash of rubella vs. measles?

Back 546

Measles spreads from head to toe, rubella is truncal

Front 547

Where are you tender in rubella?

Back 547

postauricular tenderness

Front 548

What is the other MOA of metoprolol besides just beta blocker/actions at the heart?

Back 548

It blocks catecholamine induced renin release by the kidney

Front 549

What's the actual stimulus for renin release?

Back 549

decreased blood volume

Front 550

What are the side effects of acetazolamide?

Back 550

hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy

Front 551

What are the side effects of thiazide diuretics?

Back 551

hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperUricemia, and hypercalcemia + sulfa allergy

Front 552

Why would an adult sickle cell patient have jaundice?

Back 552

due to hemolytic anemia

Front 553

Why would a sickle cell patient have increased MCV?

Back 553

folate deficiency due to increased cell turnover

Front 554

Which anti-depressant can be used to treat diabetic neuropathy?

Back 554

amitryptaline

Front 555

What type of drug is sertraline?

Back 555

SSRI

Front 556

Which anti-depressant can be used to treat diabetic neuropathy?

Back 556

amitryptaline

Front 557

What type of drug is sertraline?

Back 557

SSRI

Front 558

What parts of the kidney are most susceptible to ischemic damage?

Back 558

1) straight portion of proximal tubule
2) In medulla- Na/K/2Cl cotransport channel in the thick ascending limb is most susceptible to hypoxia

Front 559

What parts of the nervous system are most susceptible to ischemic damage?

Back 559

- Purkinje cells in cerebellum & neurons in laters 3,5, and 6 of the cerebral cortex

Front 560

In a normal cell, describe which way the Na/K ATPase pump works?

Back 560

It PUMPs K+ into cells and PUMPS Na+ out (Na+ has tendency to rush in and K+ has tendency to rush out)

Front 561

What are the lethal effects of increase Ca2+ in the cytosol of a cell?

Back 561

- enzyme activation (proteases, endonucleases, etc.)
- Reentry of Ca 2+ into mitochondria- increased mitochondrial membrane permeability and releases cytochrome c into the cytosol --> apoptosis

Front 562

Where is myeloperoxidase found and what does it do?

Back 562

Found in phagolysosome; combines hydrogen peroxide with chloride to form bleach

Front 563

What does superoxide dismutase do?

Back 563

converts superoxide free radicals to peroxide and O2

Front 564

What does catalase do?

Back 564

degrades peroxide into O2 and water

Front 565

Name three anti-oxidant vitamins/minerals

Back 565

Vitamin E, vitamin C, and selenium

Front 566

What protein are microtubules made out of?

Back 566

tubulin

Front 567

What is the MOA of etoposide and bleomycin?

Back 567

They prevent synthesis of tubulin in G2 phase of cell cycle

Front 568

What is the MOA of vinca alkaloids/colchicine?

Back 568

bind to tubulin in microtubules; interferes with assembly of mitotic spindle

Front 569

What is hte MOA of paclitaxel?

Back 569

enhances tubulin polymerization so the mitotic spindle can't disassmble

Front 570

Name three intermediate filament proteins

Back 570

keratin, desmin, vimentin

Front 571

What are mallory bodies?

Back 571

damaged, ubiquinated intermediate filaments in hepatocytes in alcoholic liver disease

Front 572

What is the normal action of bcl-2

Back 572

anti-apoptotic

Front 573

What is normal BAX gene action?

Back 573

pro-apoptotic

Front 574

What's the rate-limiting step of the TCA cycle?

Back 574

isocitrate dehydrogenase

Front 575

Name 4 things that pyruvate can be made into

Back 575

acetyl coA, OAA, lactate, ALANINE

Front 576

What is the point of the alanine cycle?

Back 576

transports ammonia from muscle to liver
Pyruvate + NH3 --> alanine (which is then transported to liver)
NH4+ then undergoes urea cycle in liver

Front 577

Why are alanine and glutamine found in such high concentrations in blood?

Back 577

They are two major carriers of nitrogen from tissues

Front 578

Describe a transaminase reaction

Back 578

AA-NH3 + alpha-ketoglutarate --> ketoacid (like pyruvate) + glutamate

Front 579

Absence of pyruvate dehydrogenase would lead to?

Back 579

lactic acidosis + neurologic defects

Front 580

Which way is the tail pointing in positive skew?

Back 580

To the right

Front 581

Which measure of average is the lowest in positive skew?

Back 581

mode < median < mean

Front 582

What is the formula for power?

Back 582

1-beta

Front 583

How do you calculate standard error of the mean?

Back 583

standard dev. / (sq. root n)

Front 584

What's the formula for confidence interval?

Back 584

CI = mean - Z (SEM) to mean + Z (SEM)

Z for 95% CI is 1.96

Front 585

chi squared test is used to compare?

Back 585

categorical outcomes

Front 586

Which hepatidites can you immunize against?

Back 586

Hep A & Hep B

Front 587

What are the reportable STDs?

Back 587

HIV, gonorrhea, syphilis

Front 588

What are the reportable Hepatidites?

Back 588

Hep A, B, and C

Front 589

What are the reportable diseases "of children"?

Back 589

measles, mumps, rubella, chicken pox

Front 590

What are the reportable diarrheal disease?

Back 590

salmonella & shigella

Front 591

What bacterial lung disease is reportable?

Back 591

TB

Front 592

Describe medicare parts A, B, C, D

Back 592

A- hospital/inpatient
B- outpatient/doctors
C- combo of A & B
D- DRUGS

Front 593

What's the difference between sleep patterns in the elderly vs. in depression?

Back 593

Elderly- decreased slow wave, decreased REM

Depression- decreased slow wave, increased REM

Front 594

Describe the suicide rate & rate of mental illness in the eldery.

Back 594

Decreased incidence of psychiatric disorders but increased suicide risk

Front 595

How long can normal grief last?

Back 595

Up to 2 months

Front 596

What's the formula for BMI?

Back 596

weight in kg/ height in meters^2

Front 597

What's the BMI cutoff for obese?

Back 597

30

Front 598

During which sleep stage does bruxism occur?

Back 598

Stage 2

Front 599

What neurotransmitter is key in intiating REM sleep? Which neurotransmitter reduces REM sleep?

Back 599

AcH increases REM sleep, NE reduces REM sleep

Front 600

In what disease would you see early morning wakening?

Back 600

depression

Front 601

What treatments do you use for narcolepsy?

Back 601

amphetamines, modafinil (stimulant), sodium oxybate

Front 602

galactose + glucose =

Back 602

lactose

Front 603

glucose + glucose =

Back 603

maltose

Front 604

fructose + glucose

Back 604

sucrose

Front 605

Where does digestion of proteins begin?

Back 605

In stomach

Front 606

What's the official name for omega 3 fatty acid?

Back 606

linolenic acid

Front 607

Where does digestion of primary triglycerides begin?

Back 607

small intestine

Front 608

Which apoprotein is needed to transfer chylomicron from intestine into blood?

Back 608

B48 - remember because the 8 is twisted up like an intestine

Front 609

What hormones are decreased in anorexia?

Back 609

estrogen, secondary to decreased gonadotropin releasing hormone

Front 610

Describe the pathogenesis of arrhythmia in bulimia.

Back 610

Vomiting, so you have a metabolic alkalosis. That leads to H+ leaving cells, and in return K+ moves into cells, so you basically have hypokalemia --> arrhythmia

Front 611

High leptin means?

Back 611

you are full - tells you not to eat

Front 612

What does insulin do to sodium?

Back 612

Increases sodium retention --> hypertension, etc.

Front 613

What does it mean when alk phos is elevated?

Back 613

That bone mineralization is being allowed to happen (bc you are inhibiting the thing that normally inhibits mineralization)

Front 614

What is the effect of a cytochrome p450 activator on vitamin D?

Back 614

It will increase vitamin D metabolism into inactive metabolite (so it'll look like vitamin D deficiency)

Front 615

What are the side effects of vitamin A toxicity?

Back 615

hepatic and papilledema (headaches, increased ICP)- think of the bear hunter eating bear liver presenting with headaches

Front 616

What other fat soluble vitamin issue causes bleeding besides Vit. K deficiency?

Back 616

Vitamin E overdose

Front 617

Why do you get neuropathy with thymine deficiency?

Back 617

bc you can't make ATP so you can't make myelin --> neuropathy

Front 618

Which drug can lead to reduced vitamin B6?

Back 618

Isoniazid

Front 619

What are the two anti-oxidant effects of vitamin C?

Back 619

It regenerates vitamin E and thus decreases oxidized LDL

It also neutralizes hydroxyl free radicals

Front 620

What is dry beriberi?

Back 620

peripheral neuropathy

Front 621

Deficiency of vitamin B6 would give you what symptoms?

Back 621

sideroblastic anemia, convulsions, peripheral neuropathy (needed for heme synthesis and neurotransmitter synthesis)

Front 622

What can cause zinc deficiency?

Back 622

alcoholism, diabetes, chronic diarrhea

Front 623

What are the sx of zinc deficiency

Back 623

poor wound healing (involved in collagen remodeling), dysguesia, anosmia, perioral rash

Front 624

What are the sx of selenium deficiency?

Back 624

muscle pain/weakness, cardiomyopathy

Front 625

What does insoluble vs. soluble fiber do?

Back 625

insoluble- absorbs water, binds carcinogens (like estrogen)

soluble- decreases cholesterol, increases fecal bacterial mass

Front 626

What chromosome is prader willi/angelman on?

Back 626

15

Front 627

What would be an immunological sign that a fetus has a congenital infection?

Back 627

Increased IgM in cord blood (normal fetus doesn't have that)

Front 628

What is the most common cancer metastatic to bone?

Back 628

breast

Front 629

gyn cancer deaths?

Back 629

look up:
Goljan says Endometrial, then ovarian, then cervical, but I think Endo/ov are switched

Front 630

What cancer is a sequelae of clonorchis sinensis and opisthorchis viverrini infection?

Back 630

cholangiocarcinoma of the bile ducts

Front 631

Rb gene is on what chromosome?

Back 631

13

Front 632

Would bilateral retinoblastoma be hereditary or spontaneous?

Back 632

hereditary

Front 633

Wt-1 is associated with what tumor and is on what chromosome?

Back 633

Tumor= Wilms, chromosome- 11

Front 634

DCC is on what chromosome?

Back 634

18

Front 635

What is the order of genes mutated in APC colon cancer?

Back 635

APC --> Ras --> DCC --> p53

Front 636

Which cdk/cyclins are in charge of G1 to S transition?

Back 636

cdk 2, cyclins D & E

Front 637

Which cdk/cyclins are in charge of G2 to M transition?

Back 637

cdk 1, cyclin A & B

Front 638

Where in the cell cycle does p53 work?

Back 638

G1 to S transition

Front 639

Which hepatitis is associated with IV drug use?

Back 639

B

Front 640

What kind of damage is CCl4 associated with?

Back 640

liver (centrilobular necrosis, fatty change)

Front 641

What kind of damage are nitrosamines (smoked foods) associated with?

Back 641

esophagus, stomach

Front 642

What kind of damage is arsenic associated with?

Back 642

skin (squamous cell carcinoma), liver (angiosarcoma)

Front 643

What kind of damage is naphthalene (aniline dyes) assoc. with?

Back 643

bladder (transitional cell carcinoma)

Front 644

What kind of damage are alkylating agents associated with?

Back 644

blood (leukemia)

Front 645

Paraneoplastic effects: small cell lung carcinoma?

Back 645

ACTH, ACTH-like peptide, ADH

Front 646

Paraneoplastic effects: intracranial neoplasms?

Back 646

ADH

Front 647

Squamous cell lung carcinoma, renal cell carcinoma, breast carcinoma paraneoplastic effects?

Back 647

PTH-related peptide, TGF-beta, TNF, IL-1

Front 648

Paraneoplastic effects of renal cell carcinoma, hemangioblastoma, hepatocellular carcinoma, pheochromocytoma?

Back 648

EPO

Front 649

Paraneoplastic effects of thymoma, small cell lung carcinoma

Back 649

Abs against presynaptic Ca2+ channels at NM junction (Lambert Eaton syndrome)

Front 650

Paraneoplastic effects of leukemias & lymphomas

Back 650

Hyperuricemia due to excess nucleic acid turnover (ie cytotoxic therapy)

Front 651

Where is antigen loaded for MHC I?

Back 651

In RER of mostly intracellular peptides

Front 652

Where is antigen loaded for MHC II?

Back 652

acidified endosome- following release of invariant chain

Front 653

HLA A3 associated with what disease?

Back 653

hereditary hemochromatosis

Front 654

HLA B8 associated with what dissease?

Back 654

Graves' disease

Front 655

HLA DR2 associated with what diseases?

Back 655

MS, hay fever, SLE, Goodpasture's

Front 656

HLA SR4 associated with what (2) diseases?

Back 656

RA, type 1 diabetes

Front 657

HLA DR5 associated with what diseases?

Back 657

Pernicious anemia, Hashimoto's thyroiditis

Front 658

HLA DR7 associated with what diseases?

Back 658

steroid responsive nephrotic syndrome

Front 659

What cytokine(s) induce NK cells?

Back 659

IL12, IFNalpha, IFNbeta

Front 660

Describe signal 1 & signal 2 for activation of TH cells (general)

Back 660

signal I - MHC II binding to TCR
Signal II- B7 on APC binding to CD28 on TH cell

Front 661

Describe signal I and signal II for activation of cytotoxic T cells.

Back 661

1) CD8+ T cell binding to MHCI
2) TH1 cell releasing IL2 which binds to IL2R on CD8+ t cell

Front 662

Describe signal I and signal II for B cell class switching

Back 662

1) cytokines (IL4/IL5, released by TH2 cells)
2) CD40L (TH2 cell) binding to CD40 (B cell)

Front 663

Which type of antibody crosses the placenta?

Back 663

IgG

Front 664

What makes something a thymus independent antigen?

Back 664

if it lacks a peptide component

Front 665

What does IL3 do?

Back 665

stimulates bone marrow

Front 666

Which cytokine activates macrophages & TH1 cells?

Back 666

IFN gamma

Front 667

Which antibody types does IL4 increase?

Back 667

IgE, IgG

Front 668

Which Ab types does IL5 increases?

Back 668

IgA

Front 669

What bug is associated with waterhouse friederichsen syndrome?

Back 669

N meningitidis!!

Front 670

What type of cells have CD45?

Back 670

all leukocytes

Front 671

What type of cells have CD14?

Back 671

macrophages

Front 672

What type of cells have CD56?

Back 672

NK cells

Front 673

What type of cells have CD16?

Back 673

NK cells

Front 674

What type of cells have CD1?

Back 674

histiocytes

Front 675

What type of cells have CD15/30

Back 675

Reed Sternberg cells (Hodgkin's lymphoma)

Front 676

What type of cells have CD10?

Back 676

B cell leukemias

Front 677

How does endotoxins/LPS stimulate macs?

Back 677

directly, without Th cells, by stimulating CD14

Front 678

Why do you get calcium elevation in granulomatous disease?

Back 678

Because macrophages (giant cells) secrete vitamin D which --> increased calcium

Front 679

Which chromosome is HLA system found on?

Back 679

Short arm of chromosome 6

Front 680

What vitamin can be of benefit in the treatment of measles?

Back 680

Vitamin A

Front 681

What's the main treatment for gestational diabetes?

Back 681

insulin

Front 682

Eosinophils are found in what renal pathology?

Back 682

drug induced interstitial nephritis

Front 683

What test is used to monitor warfarin? heparin?

Back 683

warfarin - PT, heparin, aPTT

Front 684

risperidone can have what unwanted side effect?

Back 684

hyperprolactinemia, leading to galactorrhea and amenorrhea

Front 685

Where do carcinoid tumors arise from?

Back 685

Endocrine (enterochromaffin) cells of the intestinal mucosa; if carcinoid is symptomatic (for ex. in liver), it is metastatic

Front 686

Branching structures with interspersed calcified structures. What kind of thyroid cancer?

Back 686

Papillary carcinoma

Front 687

What type of fat will cause an supranate (floating on top?)

Back 687

excess chylomicrons

Front 688

What type of fat will cause an infranate (floating at the bottom)?

Back 688

VLDL, bc it has more protein than a chylomicron

Front 689

What vitamin is MOST decreased in abetalipoproteinemia?

Back 689

Vitamin E... don't understand why, other than that it's fat soluble

Front 690

What is a marker for disrupted athersclerotic plaques?

Back 690

C reactive protein (serum)

Front 691

What does the junction of communicating branches with main cerebral vessels in the brain lack?

Back 691

internal elastic lamina, smooth muscle

Front 692

In aortic dissection, describe the pathogenesis (2 parts)

Back 692

cystic medial degeneration (due to tissue problems or hypertension) followed by an intimal tear (either due to the weakness or due to hypertension)

Front 693

Why do you get stasis dermatitis with DVTs?

Back 693

You basically have a back-up of pressure and it causes the penetrating branches (which normally carry blood from superficial to deep branches) to rupture --> ulceration, etc.

Front 694

What's the difference bt Charcot-Bouchard & Berry aneurysms?

Back 694

Charcot-bouchard- associated with hypertension- bursts and causes intraparenchymal hemorrhage

Berry- associated with Marfan/Ehler's Danlos- bursts and causes subarachnoid hemorrhage

Front 695

What part of the intestine does Hirschsprung always affect?

Back 695

rectum

Front 696

What nerve is involved with salivary secretion from submandibular/sublingual glands?

Back 696

CN VII (actually paraysmpathetic)

Front 697

What does malassezia furfur cause?

Back 697

hypo/hyperpigmented patches

Front 698

What does BNP do?

Back 698

dilates arterioles/veins & promotes diuresis

Front 699

Which cell count is increased with glucocorticoids?

Back 699

Neutrophils, bc of demargination of PMNs that used to be attached to vessel walls

Front 700

Which histone is not part of the core?

Back 700

H1

Front 701

What would pH, PaO2, and PaCO2 be in PE?

Back 701

hypoxemia --> hyperventilation --> resp. alkalosis

inc. pH, dec. paO2, dec. paCO2

Front 702

1 week post-stroke, lipids in brain would be?

Back 702

Macrophages eating products of myelin breakdown

Front 703

How do you rescue from MTX tox?

Back 703

give leucovorin, which allows you to replenish folate derivates that are needed for DNA synthesis.

Front 704

Where is urine the most dilute in H2O deprived animal?

Back 704

ascending loop of henle and distal convoluted tubule

Front 705

What are the side effects of thiazolidinediones?

Back 705

1) hepatotox (check liver enzymes)
2) cardiotox

Front 706

Where would s. aureus be carried if you were a carrier?

Back 706

nares

Front 707

What is the mechanism of pulmonary hypertension in CHF?

Back 707

reactive vasoconstriction secondary to pulmonary venous constriction

Front 708

What would be going on if nucleoli were increased in size?

Back 708

increased RNA polymerase activity --> rRNA synthesis

Front 709

Rb gene is associated with what two tumors?

Back 709

osteosarcoma, retinoblastoma

Front 710

Damage to what part of brain --> hemibalismus?

Back 710

STN

Front 711

Stimulation of which adrenergic receptors increase insulin release?

Back 711

beta receptors

Front 712

Cofactor for homocysteine --> methionine?

Back 712

B12-CH3

Front 713

Cofactor for homocysteine --> cystathionine

Back 713

B6

Front 714

Why wouldn't you give fibrates and statins together?

Back 714

increased risk of myopathy/myositis

Front 715

baby has rigidity and spasms after dad cuts umbilical cord with knife. Dx?

Back 715

tetanus

Front 716

What LNs do testicles drain to?

Back 716

para-aortic (retroperitoneal)

Front 717

Side effects (2) of verapamil?

Back 717

constipation, AV block

Front 718

Bone changes in hyperparathyroidism?

Back 718

subperiosteal resorption with cystic degeneration

Front 719

What lobe is broca's area in?

Back 719

frontal lobe

Front 720

What lobe is Wernicke's area in?

Back 720

temporal lobe

Front 721

What neurotransmitter is associated with morphine tolerance?

Back 721

glutamate

Front 722

Major virulence factor of s. pneumo is?

Back 722

capsule

Front 723

What are the stones in pseudogout made of?

Back 723

calcium pyrophosphate

*note- calcific tendonitis has calcium hydroxyapatite stones & renal stones are calcium oxalate

Front 724

What is the treatment for acute intermittent porphyria?

Back 724

glucose + heme (bc they decrease ALA synthase activity)

Front 725

What's the difference between a tumor that causes Horner's syndrome vs. SVC?

Back 725

Horner's - superior sulcus tumor

SVC- mediastinal mass

Front 726

Pt with history of UC, non-compliant with meds, presents with fever, bloody diarrhea, tender/distended abdomen. Dx?

Back 726

toxic megacolon

Front 727

What's the diagnostic test for toxic megacolon?

Back 727

x-ray (plain film)

Front 728

What's the antidote for arsenic?

Back 728

demercaprol

Front 729

Which type of esophageal cancer is associated with smoking?

Back 729

squamous esophageal cancer

Front 730

Which type of esophageal cancer is associated with Barrett's esophagus?

Back 730

adenocarcinoma

Front 731

How is Hep A transferred?

Back 731

fecal oral; could be via raw/steamed shellfish or contaminated water

Front 732

What do you do to fix severe hypoglycemia outside of the hospital?

Back 732

IM glucagon injection

Front 733

Why do cells synthesize interferon in response to viral infection?

Back 733

the interferon tells other cells to stop transcribing viral DNA

Front 734

What drug class besides glucocorticoids --> buffalo hump/hyperlipidemia?

Back 734

HIV protease inhibitors

Front 735

What's the mechanism of action of isoproteronol?

Back 735

b1/b2 agonist (increases HR, dec. vascular resistance)

Front 736

Which specific cells are responsible for the damage in atherosclerosis?

Back 736

smooth muscle cells

Front 737

What is the diagnosis of urine osmolality increases greater than 50% during a water deprivation test?

Back 737

complete central DI

Front 738

Ulcer in distal duodenum with high basal acid secretion. Dx?

Back 738

zollinger ellison (non-gastric neoplasm)

Front 739

What hormone is a granulosa theca cell tumor likely to excrete?

Back 739

estrogen

Front 740

What are the 2 worst prognostic factors for liver failure?

Back 740

increased PT, decreased albumin

Front 741

t(15;17)- cancer?

Back 741

AML

Front 742

t(9;22)- cancer?

Back 742

CML

Front 743

t(14;18)- cancer?

Back 743

follicular lymphoma

Front 744

t(8;14)- cancer?

Back 744

Burkitt's lymphoma

Front 745

t(11;14)- cancer?

Back 745

mantle cell lymphoma

Front 746

Pear-shaped trophozoite?

Back 746

giardia

Front 747

What lecithin/sphingomyelin ratio indicates fetal lung maturity?

Back 747

2:1

Front 748

What's another name for lecithin?

Back 748

phosphatidylcholine

Front 749

What causes facial wrinkles?

Back 749

decreased collagen fibril production

Front 750

At what point of pulmonary function tests is PVR lowest?

Back 750

FRC (air isn't putting too much pressure but neither is surrounding musculature)

Front 751

What bacterial cell wall is made up of long, branched lipids?

Back 751

mycobacterium

Front 752

What do combined OCPs do to inhibit pregnancy?

Back 752

Increase estrogen/progesterone --> inhibited FSH/LH (so you don't get LH surge and ovulation)

Front 753

What is the MOA of terbinafine?

Back 753

inhibits fungal squalene epoxidase

Front 754

A benign hamartoma of lung would contain what type of tissue?

Back 754

hyaline cartilage

Front 755

Alkoptonuria prevents which reaction from taking place?

Back 755

tyrosine --> fumarate

Front 756

Long QT syndrome predisposes to?

Back 756

torsades de pointes --> sudden death

Front 757

Pol gene mutations in HIV indicate what (with respect to meds)

Back 757

Resistance to protease inhibitors and nucleoside/non-nucleoside RT inhibitors

Front 758

What are the three types of antigens that enterics have some combination of?

Back 758

O antigen (external component of LPS), K antigen (capsule, covers O), H antigen (flagella, if the bacteria has flagella)

Front 759

VDRL false positives are caused by?

Back 759

Think "VDRL"
V- viruses
D- drugs
R- rheumatic fever
L- lupus/leprosy

Front 760

What's the murmur of coarctation of the aorta?

Back 760

systolic murmur between the shoulder blades

Front 761

Most common cause of infectious endocarditis (overall)

Back 761

s. viridans

Front 762

Most common cause of infectious endocarditis in IVDA?

Back 762

s. aureus

Front 763

Most common cause of infectious endocarditis in ppl with prosthetic valves?

Back 763

Staph epidermidis

Front 764

Most common overall valve involved with infectious endocarditis?

Back 764

mitral valve

Front 765

What is the definition of ARDS?

Back 765

Acute onset lung dysfunction, pulmonary edema, normal LA pressure, and PaO2/FiO2 of <200

Front 766

What is the cause of ARDS?

Back 766

Endothelial cell damage --> leakage into the alveoli

Front 767

Where are SA node & AV node?

Back 767

SA node is near opening of SVC, AV node is "interatrial septum near AV orifice" or nearby the pulmonary artery, seems like

Front 768

What type of cancer is associated with Paget's disease of bone?

Back 768

osteosarcoma

Front 769

What type of cancer is described as "often occurs in metaphysis, has Codman's triangle/sunburst pattern of bone from elevation of periosteum"

Back 769

osteosarcoma

Front 770

What is globus hystericus?

Back 770

sensation of lump in throat, no physical findings

Front 771

What is histology of leiomyoma?

Back 771

whorled pattern of smooth muscle bundles

Front 772

What is the histology of endometriosis?

Back 772

non-neoplastic endometrial glands/stroma; basically looks like an endometrial gland but isn't in the endometrium

Front 773

How long are the base pairs in DNA laddering and what do they mean?

Back 773

180 bp, they mean apoptosis

Front 774

What is the inheritence of osteogenesis imperfecta?

Back 774

autosomal dominant

Front 775

If two children present with an autosomal dominant dis. but parents have no sx, what's up?

Back 775

Could be germline mosaicism. Means some germ cells are affected, some aren't.

Front 776

What structure is most likely to be damaged in anterior or posterior dislocation of knee joint (tibia relative to femur)?

Back 776

popliteal artery

Front 777

Patient presents with lower abdominal pain, fever low BP after giving birth. Tender uterus and foul-smelling vaginal discharge. Dx and organism?

Back 777

Dx- endometritis

Organism- commonly bacteroides; caused by mixed flora

Front 778

What is sublimation?

Back 778

Mature defense mechanism where you convert unacceptable feelings/drives into acceptable ones

Front 779

Once you take away a kidney, what is the new GFR, right after & then six weeks after?

Back 779

50% (right after), 80% (weeks after)

Front 780

Where in the brain is a craniopharyngioma found?

Back 780

near the pituitary gland (so it would cause the same visual problems)

Front 781

How long do sx have to last before it's considering schizophrenia?

Back 781

6 months

Front 782

Associated with temporal encephalitis?

Back 782

Herpes Simplex (1)

Front 783

Acute Intermittent Porphyria is from a failure to transform what to what?

Back 783

Porphobilinogen to Hydroxymethylbilane

Front 784

What enzyme is messed up in acute intermittent porphyria?

Back 784

porphobilinogen deaminase

Front 785

Describe LDH characteristics of an exudate.

Back 785

Exudates have either- pleural fluid/serum protein > 0.5, pleural fluid LDH/serum LDH > 0.6, or pleural fluid LDH more than 2/3 the upper limit of normal serum LDH

Front 786

Patient complains of difficulty chewing gum & diplopia when reading or watching TV for long periods. Has has no extremity weakness or other med problems. Dx?

Back 786

Myasthenia gravis

Front 787

Thymus is formed by what embryonic structure?

Back 787

third pharyngeal pouch

Front 788

What is a Dandy Walker malformation?

Back 788

Enlarged posterior fossa w/ absent or shrunken cerebellar vermis replaced by a large, midline cyst that = expanded 4th ventricle

Front 789

MOA and use for phenoxybenzamine?

Back 789

irreversible alpha blocker, non-selective, use for pheochromocytoma

Front 790

What is the MOA of phentolamine?

Back 790

reversible non-selective alpha blocker

Front 791

The alpha-1 selective alpha blockers end in?

Back 791

-zosin

Front 792

What is the germinal matrix?

Back 792

Highly cellular & vascular region where cells migrate of during brain development

Front 793

Where does intraventricular hemorrhage usually arise in premature infant?

Back 793

germinal matrix

Front 794

Which anti-neoplastic is associated with acoustic nerve damage?

Back 794

cisplatin/carboplatin (think about "PLAYing the piano"

Front 795

What process attaches receptor carboxyl tails to the plasma membrane?

Back 795

palmitoylation

Front 796

What is the effect of Nitroglycerin on heart rate?

Back 796

Decreases preload, leading to reflex tachycardia (increases HR)

Front 797

43 y old man, inc. tiredness, dry mouth, impotence. Mild hepatomegaly, atrophic testes. High blood glucose. Urine pos. for glucose, neg. for ketones and protein. Has strange skin pigmentation. Dx?

Back 797

Hereditary hemochromatosis!!

Front 798

What does androgen binding protein do and what secretes it?

Back 798

sertoli cells secrete; it keeps levels of testosterone up in the seminferous tubules/epididymis by making testosterone less lipophilic so it can't leave

Front 799

which sympathetic structure controls tarsal muscle, lacrimal gland, radial muscle of iris, and salivary glands?

Back 799

cervical sympathetic ganglion

Front 800

Which sympathetic structure controls sweating (axilla)?

Back 800

thoracic sympathetic trunk

Front 801

What's the difference bt the macula densa and the JG cells?

Back 801

Macula dense- part of the distal tubule that loops back around and touches the glomerulus- senses decreased sodium in tubule and causes afferent arteriole to relax + causes JG cells to release renin

JG cells- IN the afferent arteriole, sense decreased BP and release renin in response

Front 802

Which kidney is taken during living kidney donation & why?

Back 802

L, bc it has a longer renal vein

Front 803

Describe % of total body weight that is water, ECF, and ICF.

Back 803

Remember the 60-40-20 rule

60% water, 40% intracellular, 20% extracellular fluid
*Note: all the numbers are with respect to total body mass

Front 804

What molecule is used to measure extracellular volume?

Back 804

inulin

Front 805

What molecule is used to measure plasma volume (1/4 of extracellular volume)?

Back 805

radiolabeled albumin

Front 806

Formula for Clearance?

Back 806

Cx = [Urine] * Urine flow rate / [Plasma]

Front 807

What is a normal GFR?

Back 807

~100 mL/min

Front 808

What can be used to estimate an effective renal plasma flow?

Back 808

PAH

Front 809

How is renal plasma flow different from renal blood flow?

Back 809

RBF is larger- plasma only makes up a portion of renal blood flow

Front 810

What is the formula for renal blood flow?

Back 810

RBF = RPF/(1-Hct)

Front 811

What two molecules can be used to estimate GFR?

Back 811

inulin & PAH

Front 812

What is the result of increased plasma protein concentration on GFR?

Back 812

Decreased GFR

Front 813

What is the result of constriction of ureter on GFR?

Back 813

decreased GFR

Front 814

What is the threshold where you start seeing glucose in urine?

Back 814

160-200 mg/dL glucose

Front 815

What is the phosphate level in renal failure and WHY?

Back 815

Phosphate is HIGH, bc kidney can't filter it. Don't get confused- PTH is also high (so you might think phosphate was low), but PTH is high as a REACTION to the high phosphate (and low calcium).

Front 816

Why does angiotensin II lead to contraction alkalosis (think about proximal tubule)

Back 816

bc it activates a sodium/H+ transporter. You reabsorb more sodium which means you excrete more H+ --> alkalosis

Front 817

Where does PTH act to increase calcium retention by kidney?

Back 817

Early distal convoluted tubule (increases Ca2+/Na+ exchcange which leads to increased Ca2+ reabsorption)

Front 818

When aldosterone is reabsorbing Na+, what is getting secreted?

Back 818

H+ and K+

Front 819

Where in the kidney does ADH work?

Back 819

In the collecting tubule (SAME as aldosterone)... don't be confused by Justin's picture

Front 820

Where is angiotensinogen released from?

Back 820

liver

Front 821

What does ADH normally respond to?

Back 821

changes in osmolality

Front 822

What does take precedence in terms of ADH response?

Back 822

low blood volume takes precedence over osmolality

Front 823

What does aldosterone normally respond to/regulate?

Back 823

blood volume

Front 824

Where is ADH released from?

Back 824

posterior pituitary

Front 825

What is PTH's indirect action on Calcium/Phosphate?

Back 825

PTH stimulates proximal tubule cells to make vitamin D which increases calcium and phosphate absorption

Front 826

Besides decreased renal arterial pressure, what ELSE do JG cells release renin in response to?

Back 826

Increased sympathetic discharge (beta 1 activation)

Front 827

How does ANP work to increase Na+ loss & water loss?

Back 827

It increases GFR which increases Na+ filtration, but there's no increase in reabsorption later on. This leads to Na+ loss & water loss bc water follows Na+

Front 828

Why doesn't renin basically do the same thing as ANP?

Back 828

bc the renin angiotensin system also leads to aldosterone release which leads to Na+/water reabsorption. So you inc. GFR but you don't lose volume like you do with ANP

Front 829

Hypo or Hyper K:
Digitalis

Back 829

hyper

Front 830

Hypo or Hyper K:
b blocker

Back 830

hyper

Front 831

Hypo or Hyper K:
insulin

Back 831

hypo

Front 832

Two ions- when you don't have them, you get arrhythmias?

Back 832

K+, Mg+

Front 833

What is Winter's formula and when is it used?

Back 833

It is PCO2 = 1.5 (bicarb) + 8 +/- 2

It's used to calculate appropriate respiratory compensation to metabolic acidosis

Front 834

Name the mnemonic used to describe increased anion gap metabolic acidoses.

Back 834

MUDPILES

Methanol, Uremia, Diabetic ketoacidosis, Paraldehyde/Phenformin/Propylene glycol, Iron/INH, Lactic acidosis, Ethylene glycol, Salicylates

Front 835

What is uremia?

Back 835

abnormally high level of nitrogen waste products in blood (aka pre-renal azotemia)

Front 836

Patient presents with basic urine (pH > 5.5) and hypokalemia and calcium kidney stones. Dx and cause?

Back 836

Dx: Type 1 (distal) renal tubular acidosis

Cause: can't excrete H+ in collecting tubule

Front 837

Patient presents with hypokalemia, hypophosphatemia, and mildly basic urine. Dx & cause?

Back 837

Dx: Type II (proximal) renal tubular acidosis, caused by Fanconi syndrome

Cause: defect in proximal tubule HCO3- reabsorption

*Note: the hypophosphate is due to generally messed up proximal tubule, NOT related to bicarb directly

Front 838

Patient presents with kyperkalemia, and pretty much normal urine; which type of renal tubular acidosis & cause?

Back 838

Type IV

Cause: Lack of collecting tubule response to aldosterone or hypoaldosteronism

Front 839

What is a way you can tell apart post-strep and IgA nephropathy via sx?

Back 839

post-strep normally has periorbital edema/peripheral edema whereas IgA just has bouts of hematuria

Front 840

calcium oxalate forms what type of stones?

Back 840

kidney

Front 841

Ammonium magnesium phosphate makes what kind of stone?

Back 841

kidney stone, assoc. with urease positive organisms

Front 842

Uric acid causes what kind of stones?

Back 842

kidney (5%) + implicated in gout

Front 843

Cystine creates what kind of stones

Back 843

kidney (assoc. with cystinuria)

Front 844

What histo/path would you expect to see in renal cell carcinoma?

Back 844

polygonal CLEAR cells

Front 845

Wilms' tumor presentation (just the tumor)

Back 845

HUGE palpable flank mass

Front 846

Transitional cell carcinoma is associated with the following toxins?

Back 846

Think Pee SAC

phenacetin, smoking, aniline dyes, and cyclophosphamide

Front 847

white cell casts + UTI = ?

Back 847

pyelonephritis (infection of cortex, spares glomeruli/vessels)

Front 848

What cell type is associated with drug-induced interstitial nephritis?

Back 848

EOSINOPHILS

Front 849

What is biggest problem when recovering from ATN?

Back 849

high volume diuresis leading to hypokalemia

Front 850

What renal path is associated with shock, sepsis (ischemia), crush injury, or toxins?

Back 850

Acute tubular necrosis

Front 851

Muddy brown casts are associated with?

Back 851

acute tubular necrosis

Front 852

Patient presents with oliguria, anorexia, flank pain, high anion-gap metabolic acidosis & osmolar gap. Calcium oxalate crystals in urine, ballooning and vacuolar degeneration, mostly in proximal convoluted tubules. Dx?

Back 852

ethylene glycol poisoning

Front 853

What would you think if you saw a medullary cyst & small kidneys?

Back 853

medullary cystic disease, poor prognosis, can lead to progressive renal insufficiency

Front 854

resp or conducting? terminal bronchioles

Back 854

conducting

Front 855

Which characteristic of the respiratory conducting zone extends the furthest?

Back 855

pseudostratified ciliated columnar cells- extend to respiratory bronchioles; NOT to alveoli

Front 856

What do clara cells do?

Back 856

secrete a component of surfactant & degrade toxins

Front 857

Which should be higher, lecithin or sphingomyelin to indicate fetal lung maturity?

Back 857

lecithin

Front 858

If there's elastase in intra-alveolar fluid, where did it come from?

Back 858

infiltrating neutrophils or macrophages

Front 859

Describe the relation of the pulmonary artery to the bronchus at each lung hilus.

Back 859

RALS
right anterior, left superior

Front 860

Name two muscles used for active inspiration?

Back 860

scalene, sternomastoid (also external intercostals)

Front 861

What organ makes ACE?

Back 861

lungs

Front 862

What protein ACTIVATES bradykinin?

Back 862

kallikrein

Front 863

What's the formula for collapsing pressure?

Back 863

2 (surface tension) / radius

Front 864

What's the difference between FRC and RV?

Back 864

Residual volume is the one you can't measure- what's left when you maximally expire.

FRC- what's left when you breathe out normally = RV + ERV

Front 865

Describe why the apex is the largest contributor of functional dead space?

Back 865

Because there's so much extra oxygenated air in the apex vs. blood flow (V/Q is like 3 or something)

Front 866

What's the formula to calculate dead space?

Back 866

VD = Tidal volume * (PaCO2-PeCO2)/PaCO2

PeCO2= expired air CO2

Front 867

Which form of hemoglobin has low affinity for O2?

Back 867

taut form

Think about an uptight person who wants to everything alone- doesn't want to work with O2 or carry it around

Front 868

Which form of Heme (Fe2+ or Fe3+) likes to carry oxygen?

Back 868

Fe2+

Front 869

What does Fe3+ oxygen have an affinity for?

Back 869

CN-

Front 870

What is methemglobin?

Back 870

oxidized form of heme that doesn't bind O2 well (Fe3+)

Front 871

What pO2 would have a Hgb saturation of >75%?

Back 871

50 mmHg (or greater)

Front 872

What specifically (which variable) causes diffusion issues in emphysema?

Back 872

decreased Area for diffusion

Front 873

What specifically (which variable) causes diffusion issues in pulmonary fibrosis?

Back 873

increased thickness due to fibrosis

Front 874

What is value for pulmonary hypertension?

Back 874

>25 mmHg

Front 875

What gene can cause primary pulmonary hypertension?

Back 875

BMPR2 gene

Front 876

Given pressure in pulmonary artery, P in L atrium, and CO, what's PVR?

Back 876

R = Ppulm artery-PLatrium / CO

*Note: this is arearrangement of P = Q * R

Front 877

What is the equation for blood oxygen content?

Back 877

O2 content = Hgb * O2 binding capacity (1.34) * % sat + dissolved O2 * .003

Front 878

What's the equation for alveolar PAO2 (estimate)?

Back 878

PAO2 = 150 - PACO2 / 0.8

Front 879

Particles of what size would reach the terminal bronchioles and get phagocytized by macrophages?

Back 879

2-2.5 uM

Front 880

What is the main way of transporting CO2 from tissues to lungs?

Back 880

As bicarbonate

Front 881

What is the haldane effect?

Back 881

In lungs, O2 hops on to Hb which promotes H+ release, H+ in blood combines with HCO3 --> H20 + CO2, so CO2 can get

Front 882

How much bicarb do you normally re-absorb?

Back 882

most of it

Front 883

What is the imaging test of choice for a PE?

Back 883

CT angiography

Front 884

What's Homans' sign?

Back 884

When you have a tender calf upon dorsoflexion of the foot; sign of DVT

Front 885

Which type of emphysema is caused by smoking?

Back 885

centriacinar

Front 886

Which type of emphysema is caused by alpha1 anti-trypsin deficiency?

Back 886

panacinar

Front 887

In what disease would you see PAS positive hepatocytes?

Back 887

alpha 1 ant-trrypsin deficiency?

Front 888

What is a Curschmann's spiral?

Back 888

Spirals of a mucus substance with cells attached that are coughed up in asthma

Front 889

What part of the lung is affected in bronchiectasis?

Back 889

bronchi

Front 890

Patient presents with "eggshell calcification" of hilar LNs in upper lobes. Dx?

Back 890

silicosis

Front 891

Patient presents with "ivory white" calficied pleural plaques and gloden-brown fusiform rods (that look like dumbbell) inside macrophages. Dx?

Back 891

asbestosis

Front 892

What part of lung does asbestosis effect (upper or lower)

Back 892

lower

Front 893

What would you give MOM before birth of baby to prevent RDS?

Back 893

steroids

Front 894

Which way does trachea deviate in tension pneumothorax?

Back 894

away from the lesion

Front 895

Why would someone have renal problems & lung cancer?

Back 895

Can get a calcium stone from hypercalcemia related to PTHrP being released from a squamous cell tumor

Front 896

What histologic finding is mesothelioma associated with?

Back 896

psammoma bodies

Front 897

MOA of theophylline?

Back 897

causes bronchodilation by inhibiting phosphodiesterase, decreasing cAMP hydrolysis

Front 898

What's the MOA of guaifenesin?

Back 898

expectorant, doesn't suppress cough

Front 899

Why might you use N-acetylcysteine in CF?

Back 899

to loosen mucus plugs

Front 900

What is the MOA of bosentan?

Back 900

competitively antagonizes endothelin-1 receptors, decreasing pulmonary vascular resistance- used to treat pulmonary HTN

Front 901

What is endothelin-1?

Back 901

Protein that constricts blood vessels and causes hypertension

Front 902

What is diagnostic IQ score for MR?

Back 902

<70

Front 903

What's the difference between classical and operant conditioning?

Back 903

classical- natural response is elicited by a learned stimulus (salivation elicited by bell)

operant- learning in which a particular action is elicited bc it produces a reward

Front 904

Desired reward produces action is called?

Back 904

positive reinforcement

Front 905

removal of aversive stimulus elicits behavior is called?

Back 905

negative reinforcement

Front 906

application of an aversive stimulus extinguishes unwanted behavior is called?

Back 906

punishment

Front 907

discontinuation of reinforcement eliminates behavior is called?

Back 907

extinction

Front 908

Which type of reinforcement schedule will lead to rapid extinguishment?

Back 908

reward after every response

Front 909

How can you remember the freudian structure of the mind?

Back 909

the shortest word (id) is the most primal, longest (superego) is the most refined/elevated

Front 910

What brain path would you see in ADD?

Back 910

decreased frontal lobe volume

Front 911

Treatment for Tourette's?

Back 911

haloperidol (anti-psychotics)

Front 912

Name two things that differentiate Rett's from Childhood disintegrative disorder.

Back 912

1) Rett's is mostly in girls, CDD mostly in boys
2) Rett's has hand-writing, CDD doesn't

Front 913

Would delirium or dementia have an abnormal EEG?

Back 913

delirium

Front 914

What type of hallucination is common in schizophrenia?

Back 914

auditory

Front 915

What is a risk factor for schizophrenia in teens?

Back 915

marijuana use

Front 916

How long do you have to have depression sx before you dx major depression?

Back 916

2 weeks

Front 917

Name two drug classes you would use to treat atypical depression

Back 917

SSRIs, MAOIs

Front 918

How long do PTSD sx have to last to be considered PTSD?

Back 918

1 month