0524

Question 1

osteoid matrix accumulation around trabeculae

Answer 1

rickets

Question 2

subperiosteal thinning/resorption with cystic degeneration

Answer 2

hyperparathyroidism

Question 3

trabecular thinning with fewer interconnections

Answer 3

osteoporosis

Question 4

lamellar bone structure resembling a mosaic

Answer 4

Paget’s disease

Question 5

cement lines in Paget’s disease

Answer 5

irregular sections of lamellar bone linked by areas of previous bone resorption

Question 6

primary (unmineralized) spongiosa filling medullary canal with no mature trabeculae

Answer 6

osteopetrosis

Question 7

Bartonella henselae

Answer 7

1. cat-scratch disease.
2. bacillary angiomatosis.
3. culture-negative endocarditis.

Question 8

cat-scratch disease

Answer 8

low fever.
lymphadenopathy.
self-limited.

Question 9

infxs assoc. with Reiter’s syndrome

Answer 9

Chlamydia.
Campylobacter.
Yersinia.
Salmonella.
Shigella.

Question 10

secondary infx in pts with influenza

Answer 10

elderly pts at risk.

most commonly due to:

1. S.pneumoniae.
2. S.aureus.
3. H.influenzae.

Question 11

why are influenza pts vulnerable to secondary bacterial infx?

Answer 11

virally-induced damage to mucociliary clearance mechs of resp epithelium

Question 12

indications for long-term uric acid tx

Answer 12

(allopurinol or uricosuric drugs)

1. macroscopic tophaceous deposits.
2. more than 3 episodes/yr.
3. uric acid stones.
4. gross elev of serum uric acid.

Question 13

during aerobic exercise, increased skel muscle CO2 production causes?

Answer 13

increased PCO2 of mixed venous blood

decreased pH of venous blood

Question 14

what happens to O2 content of venous blood during exercise?

Answer 14

decreased bc exercising muscles extract add’l O2

Question 15

tx of Lyme disease

Answer 15

doxycycline, ceftriaxone, or penicillin-type ABx

Question 16

what drug can help pts with tobacco cessation by reducing cravings and decreasing the rewarding effects of nicotine?

Answer 16

varenicline: partial agonist of nicotinic ACh receptors

Question 17

nicotine patch

Answer 17

full agonist of nicotinic ACh receptors in CNS- stimulates reward pathways

Question 18

what is the most likely outcome for a pt that is acutely infected with HCV?

Answer 18

stable chronic hepatitis.

closely followed by chronic hepatitis progressing to cirrhosis.

Question 19

which d/o affects DIP joints?

Answer 19

OA

Question 20

antibodies in celiac sprue

Answer 20

anti-gliadin.
anti-reticulin.
anti-endomysial.

Question 21

what is necessary for acute pyelonephritis to develop?

Answer 21

vesicoureteral reflux- so bacteria can ascend from bladder to ureters/kidneys

Question 22

microscopic findings in acute pyelo

Answer 22

massive interstitial infiltration with neutrophils.
neutrophils also fill tubular lumina.

may also see tubulorrhexis and microabscesses.

Question 23

morning stiffness in RA

Answer 23

lasts more than 30 min

Question 24

anti-phospholipid Abs

Answer 24

1. SLE

2. APLA syndrome

Question 25

APLA syndrome

Answer 25

1. hypercoagulability. 2. paradoxical INCREASED PTT. 3. recurrent miscarriages.

Question 26

growth factors required for H.influenzae

Answer 26

X (hematin). | V (NAD+).

Question 27

Legionella pneumonia

Answer 27

1. high fever, relative bradycardia. 2. headache, confusion. 3. watery diarrhea. 4. HYPOnatremia. 5. sputum Gm stain with many neutrophils, few organisms.

Question 28

which pneumonia is assoc. with hyponatremia?

Answer 28

Legionella ONLY.

Question 29

which pneumonia has a CXR that appears worse than the pt?

Answer 29

Mycoplasma pneumoniae

Question 30

pneumonia with GI sx (watery diarrhea)

Answer 30

Legionella

Question 31

major virulence factor of S.pyogenes

Answer 31

protein M: inhibits phagocytosis and complement. mediates bact adherence.

Question 32

which staph bug can ferment MANNITOL?

Answer 32

S.aureus only

Question 33

GI bugs that cause diarrhea with a small inoculum

Answer 33

Shigella (10). Campyolbacter (500). Entamoeba histolytica (1). Giardia (1).

Question 34

toxoplasmosis encephalitis

Answer 34

multiple necrotizing brain lesions in both cerebral hemispheres (ring-enhancing on MRI)... lead to fever, HA, AMS, focal neuro findings, seizures.

Question 35

toxoplasmosis TX

Answer 35

pyrimethamine + sulfadiazine.

Question 36

most common cause of bact meningitis in adults of all ages

Answer 36

STREPTOCOCCUS PNEUMONIAE

Question 37

TX of coag-neg staph infx (ex: S.epidermidis)

Answer 37

empiric tx with vancomycin +/- rifampin or gentamicin due to widespread resistance

Question 38

scarlet fever bug

Answer 38

GAS- S.pyogenes

Question 39

scarlet fever sx

Answer 39

``` pharyngitis, possible gray exudates. inflamed strawberry tongue. fever. blotches that become sandpaper-like rash. circumoral pallor. ```

Question 40

EF-2 function

Answer 40

needed for tRNA to insert new AA into growing protein chain during translation

Question 41

vitiligo

Answer 41

partial or complete loss of epidermal MELANOCYTES resulting in absent pigment. connected to autoimmune disorders.

Question 42

increased melanosome aggregates within melanocyte cytoplasm

Answer 42

cafe au lait spots

Question 43

what does TATA box bind?

Answer 43

transcription factors and RNA pol II

Question 44

what does CMV cause in immunocompetent adults?

Answer 44

subclinical infx. | if clinical sx develop, it is mononucleosis.

Question 45

decreased neutrophil (leukocyte) alkaline phosphatase

Answer 45

CML

Question 46

areas first affected by ischemic colitis

Answer 46

1. splenic flexure. 2. distal sigmoid colon. (watershed areas, affected by hypotension and low perfusion states)