Quiz 63, 64, 65 Flashcards

1
Q

What type of acid base disorder is seen with high doses of theophylline?

A

Respiratory alkalosis

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2
Q

What type of acid/base status is seen in chronic lung disease?

A

Respiratory acidosis

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3
Q

What is the acid/base status seen in opioid overdose?

A

Respiratory acidosis

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4
Q

What is the presentation of Wiskott-Aldrich syndrome?

A

Recurrent infections, thrombocytopenia with HSM, and eczema

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5
Q

What are the immunoglobulin levels in Wiskott-Aldrich syndrome?

A

Elevated IgA and Ig E in the absence if IgM

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6
Q

What is the inheritance pattern of Wiskott-Aldrich syndrome?

A

X linked recessive

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7
Q

What drugs can cause SIADH?

A

Antidepressants (fluoxetine, TCAs, MAOIs), antipsychotics, anticonvulsants, antineoplastics

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8
Q

What is the MOA of buspirone?

A

5-HT1A partial agonist and moderate antagonist at dopamine receptors

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9
Q

What nerve arises from the lateral cord of the brachial plexus?

A

Musculocutaneous and part of the median nerve

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10
Q

What cords give rise to the median nerve?

A

Lateral and medial cord

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11
Q

What nerves does the posterior cord give rise to?

A

Axillary and radial nerve

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12
Q

What cord does the ulnar nerve come from?

A

Medial cord

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13
Q

Single thyroid nodule with normal colloid follicles, surrounded by bands of fibrous tissue without capsular or vascular invasion describes what?

A

Follicular adenoma

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14
Q

How does a diffuse nontoxic goiter present?

A

Diffuse glandular enlargement, or with multiple nodules of varying size; patients commonly found to be iodine deficient or taking lithium

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15
Q

A painful, granulomatous inflammation of the thyroid with subsequent enlargement describes what?

A

Subacute (De Quervain) thyroiditis

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16
Q

What disease does urine turn black upon standing?

A

Alkaptonuria

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17
Q

What are the symptoms of alkaptonuria?

A

Arthritis at a young age, with negative RF; ochronosis (blue-black pigmentation in ears, nose, cheeks)

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18
Q

What enzyme is deficient in alkaptonuria?

A

Homogentisic oxidase

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19
Q

What is the inheritance pattern of alkaptonuria?

A

Autosomal recessive

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20
Q

Deficiency in homogentisic oxidase results in what disease?

A

Alkaptonuria

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21
Q

What form the external ear canal?

A

First pharyngeal cleft

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22
Q

What forms middle-ear cavity and auditory tube?

A

First pharyngeal pouch

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23
Q

If the second pharyngeal cleft remains patent, what forms?

A

Lateral cervical cyst - forms on the lateral side of the neck and is not mobile

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24
Q

Cytomegalovirus infection in utero results in what findings?

A

“Blueberry muffin disease;” thrombocytopenia purpura, intracerebral calcifications, jaundice, hepatosplenomegaly

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25
Q

What are the consequences of rubella infection in utero?

A

PDA, pulmonary stenosis, cataracts, microcephaly, deafness

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26
Q

In utero infection with toxoplasmosis results in what consequences?

A

Retinochoroiditis, intracerebral calcifications, hydrocephalus

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27
Q

What is the “window period” in Hep B infection?

A

Negative for HBsAg and HBsAb

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28
Q

What is present in the serum during the “window period” of HBV infection?

A

Positive for HBcAb and HBeAb

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29
Q

Patient presents with RUQ, serum shows presence of HBcAb and HBeAb, but negative for HBsAg and HBsAb, what is the diagnosis?

A

Window period of HBV infection

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30
Q

Patients requiring multiple blood transfusions are at risk for what?

A

Hemosiderosis - acquired iron overload

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31
Q

What is beta thalassemia major?

A

Failure to produce beta chains of hgb

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32
Q

What are antibodies directed against in Graves disease?

A

Thyroid stimulating hormone receptor

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33
Q

What type of HSR is Graves disease?

A

Type II noncytotoxic

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34
Q

When does one hear a pericardial knock?

A

Constrictive pericarditis

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35
Q

Crohn’s disease is associated with what dermatological lesion?

A

Erythema nodosum

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36
Q

What is erythema nodosum?

A

Inflammation os subcutaneous fat, typically on anterior lower extremities

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37
Q

What organism can produce chronic diarrhea and megaloblastic anemia, commonly found in Scandinavia and the great lakes region?

A

Diphyllobothrium latum

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38
Q

What geological location is Diphyllobothrium latum infection acquired?

A

Great Lake region and Scandinavia

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39
Q

How does Diphyllobothrium latum present?

A

Megaloblastic anemia in Great Lakes region after consumption of poorly cook fish

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40
Q

What is the beef tapeworm?

A

Taenia saginata

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41
Q

What is the pork tapeworm?

A

Taenia solium

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42
Q

What artery runs in the radial groove?

A

Profunda brachii artery

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43
Q

What artery is immediately medial to the tendon of the biceps brachii?

A

Brachial artery

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44
Q

What organism can continue to cause reinfection because of antigenic variation and phase variation of the pili?

A

N. Gonorrhoea

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45
Q

What is the gram stain and morphology of N. gonorrhoea?

A

Gram negative diplococcus

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46
Q

What can happen to a patient being treated for syphilis within the first 24 hours of treatment initiation?

A

Jarisch-Herxheimer reaction

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47
Q

Infant presents to the ER after being abandoned with cleft palate, desquamating maculopapular rash and has a positive RPR test. Treatment with penicillin is begun. What do signs/symptoms do you need to watch for in the next 24 hours? What is this reaction called?

A

Jarisch-Herxheimer reaction - signs of endotoxic shock due to release of endotoxin from T. Pallidum upon treatment (death of bacterium)

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48
Q

Radiation exposure is a major risk factor for what type of thyroid cancer?

A

Papillary thyroid carcinoma

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49
Q

What are the major pathologic features of papillary thyroid carcinoma?

A

Ground-glass, clear nuclei (Orphan Annie eyes), nuclear grooves, papillary fronds with fibrovascular cores, psammoma bodies

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50
Q

What cancers can you see psammoma bodies in?

A

Serous papillary cystadenocarcinoma of the ovary, meningioma, malignant mesothelioma, papillary thyroid carcinoma

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51
Q

What is Sezary syndrome?

A

Leukemic form of a type of cutaneous T cell lymphoma

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52
Q

What are Tingible body macrophages? When do you see them?

A

Macrophages containing debris from ingested lymphocytes; can see them in benign reactive lymphadenitis

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53
Q

What is the MOA of alteplase?

A

Tissue plasminogen activator - bind plasminogen –> plasmin –> plasmin degrades fibrin and fibrinogen

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54
Q

The ligamentum teres hepatis is an embryologic remnant of what?

A

Umbilical vein

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55
Q

Patient presents with nontender, stony hard thyroid that does not move with swallowing. Marked fibrous reaction is seen on pathologic examination. What is the diagnosis?

A

Riedel thyroiditis

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56
Q

What is the presentation of Riedel thyroiditis? What is seen on biopsy?

A

Rock hard painless goiter; destructive thyroid fibrosis

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57
Q

What is the gram stain and morphology of H. Influenzae?

A

Gram negative pleomorphic coccobacilli

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58
Q

What is necessary to culture H. Influenzae?

A

Chocolate agar with factor V and X

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59
Q

What are bacterial causes of conjunctivitis?

A

H influenzae, S aureus, S pneumoniae, Moraxella spp.

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60
Q

What is the most common fungal meningitis of immunocompromised individuals in the US?

A

Cryptococcus neoformans

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61
Q

Patient with HIV presents with low grade fever and progressive headache. What is the likely causal organism?

A

Cryptococcus neoformans

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62
Q

What are the CSF findings in a fungal infection?

A

Lymphocytes, decreased glucose, increased protein, and moderately elevated opening pressure

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63
Q

Encapsulated budding yeasts

A

Cryptococcus neoformans

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64
Q

Budding yeasts resembling a wheel with spokes

A

Paracoccidioides brasiliensis

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65
Q

Intracellular yeasts within macrophages

A

Histoplasma capsulatum

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66
Q

Septate hyphae at 45 degree angles

A

Aspergillus

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67
Q

What is the Charcot triad? What is it indicative of?

A

Fever, jaundice, RUQ pain; indicative of cholangitis

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68
Q

Increased alkaline phosphatase is characteristic of what?

A

Biliary tract obstruction

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69
Q

What physical exam finding helps differentiate between a stone within the cystic duct vs. a stone in the common bile duct?

A

Stones within the cystic duct do not cause jaundice, whereas stones in the common bile duct produce jaundice

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70
Q

What is familial primary hypoparathyroidism?

A

Inherited condition resulting from gain of function mutation in calcium-sensing receptor

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71
Q

What is the pathophysiology of familial primary hypoparathyroidism?

A

Gain of function mutation in calcium sensing receptor –> constant “occupancy” signal –> decreased PTH secretion even when Ca levels are low

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72
Q

What labs are seen in familial primary hypoparathyroidism?

A

Low PTH, high Phosphorous, low calcium

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73
Q

How can familial primary hypoparathyroidsim present?

A

Low calcium causing seizures, tetany and muscle twitching/cramps

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74
Q

What are the 5 “Rs” of medication safety?

A

Right patient, right dose, right drug, right route, right time

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75
Q

What type of amyloid is deposited in a patient with rheumatoid arthritis?

A

Secondary amyloidosis - AA type

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76
Q

Long term hemodialysis results in deposition of what type of amyloid?

A

A Beta 2 M

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77
Q

By what mechanism does S pneumoniae evade the immune response in the respiratory mucosa?

A

Production of IgA protease

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78
Q

What organism has a hyaluronic acid capsule?

A

S pyogenes

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79
Q

Gram positive coccus, bacitracin resistant and CAMP+ beta hemolytic

A

S. Agalactiae

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80
Q

What is the MOA of probenecid?

A

Inhibits proximal tubule reabsorption of urate

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81
Q

What is the MOA of colchicine?

A

Binds tubulin, decreasing microtubular polymerization, decreasing LTB4, and decreasing leukocyte and granulocyte migration

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82
Q

What is the MOA of allopurinol?

A

Prodrug - suicide substrate/ converted to alloxanthine by xanthine oxidase; alloxanthine inhibits xanthine oxidase

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83
Q

Testicular tumor with elevated placental alkaline phosphatase and normal hCG and alpha-fetoprotein is seen in what tumor?

A

Seminoma

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84
Q

The majority of the secretions in the sublingual gland are what?

A

Mucous

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85
Q

The majority of secretions from the submandibular gland are what?

A

Mixed mucous and serous

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86
Q

What majority of secretions form the parotid gland are what?

A

Serous

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87
Q

Polyarteritis nodosa is associated with what viral infection?

A

Mostly Hep B

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88
Q

Hepatitis B infection has been related to what vasculitis disease?

A

Polyarteritis nodosa

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89
Q

What is polyarteritis nodosa?

A

Vasculitis of small and medium sized vessels; shows segmental necrotizing vasculitis; affects all organs except the lungs

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90
Q

What forms the most anterior wall of the heart?

A

Right ventricle

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91
Q

What forms the most posterior wall of the heart?

A

Left atrium

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92
Q

Describe the anatomic location of the left atrium

A

Most of the diaphragmatic surface of the heart (lies on the diaphragm); forms the most left boarder of the heart

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93
Q

Describe the anatomic location of the right atrium

A

Forms the most right border of the heart; its anterior surface is on the right side of the sternum from approx. thrid to sixth rib

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94
Q

Penetrating wound to the left fourth intercostal space just lateral to the sternum will most likely injure what structure?

A

Right ventricle

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95
Q

What is transmitted by the sand fly?

A

Leishmaniasis

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96
Q

What is the treatment for cutaneous leishmaniasis?

A

Sodium stibogluconate

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97
Q

Soldier returns from his service in Afghanistan complaining of an erythematous ulcerated lesion on his left hand that will not heal. He says he was bitten on his hand by a sandfly. What is the most likely diagnosis?

A

Cutaneous leishmaniasis

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98
Q

Histologically, what are leiomyomas characterized by?

A

Whorls of spindle shaped smooth muscle cells

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99
Q

What type of channel is GABAa?

A

Chloride ion channel macromolecular complex

100
Q

What are the symptoms of congenital toxoplasmosis?

A

Hydrocephalus, intracranial calcifications, retinochoroiditis

101
Q

Low oxygen tension is necessary for the growth of microaerophiles. What organisms are these?

A

C jejuni, Helicobacter, Borrelia

102
Q

An encapsulated budding yeast is characteristic of what?

A

Cryptococcus neoformans

103
Q

Cytosolic citrate does what to phosphofructokinase and acetyl CoA carboxylase?

A

Negative allosteric regulator of PFK I, and positive allosteric regulator of acetyl CoA carboxylase

104
Q

What is the rate limiting step for fatty acid synthesis?

A

Acetyl CoA carboxylase

105
Q

Why does the pulse pressure widen with anemia?

A

Increased CO with a simultaneous decrease in systemic vascular resistance

106
Q

Medullary thyroid carcinoma is associated with what MEN syndrome?

A

MEN 2A; MEN 2B

107
Q

What neoplasias are associated with MEN 2A?

A

Medullary thyroid carcinoma, pheochromocytoma, parathyroid tumor

108
Q

Ret oncogene is associated with what MEN syndrome?

A

MEN 2A and MEN 2B

109
Q

What neoplasia are seen in MEN 2B?

A

Medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas and marfanoid habitus

110
Q

What neoplasm are associated with MEN 1 syndrome?

A

Parathyroid tumor, pituitary tumor, pancreatic endocrine tumor

111
Q

What test is used to detect IgG anti-Rh Ab circulating in the mother’s blood?

A

Indirect Coombs test

112
Q

What test is used to diagnose a child at risk for development of hemolytic disease of the newborn?

A

Direct Coombs test

113
Q

What type of infections are patients with Wiskott-Aldrich more susceptible to?

A

Recurrent opportunisit infections with organisms that have polysaccharide capsules

114
Q

What immunoglobulin is decreased in patients with Wiskott-Aldrich?

A

IgM

115
Q

What immunoglobulin(s) are elevated in Wiskott-Aldrich?

A

IgA and IgE

116
Q

What is the life expectancy of Wiskott-Aldrich? What causes death?

A

Usually die before second decade of life, from infection or non-Hodgkin lymphoma

117
Q

What is the defect in Wiskott-Aldrich syndrome?

A

WAS protein - critical role in actin cytoskeleton rearrangement

118
Q

What is the inheritance pattern on hyper-IgM syndrome?

A

X linked

119
Q

What is the defect in hyper-IgM syndrome?

A

CD40L on activated TH cells

120
Q

What lab findings are associated with nephrogenic DI?

A

Increased serum sodium and serum osmolality, decreased urine osmolality and increased ADH

121
Q

What stage of syphilis do you see a gumma?

A

Tertiary

122
Q

What stage of syphilis do you see tabes dorsalis?

A

Tertiary

123
Q

What stage of syphilis do you see a maculopapular, bronizing rah and condylomata lata?

A

Secondary syphilis

124
Q

What part of the spinal cord does tertiary syphilis affect?

A

Dorsal columns and dorsal roots

125
Q

What tapeworm competes with the host for Vitamin B12?

A

Diphyllobothrium latum

126
Q

How does one get Diphyllobothrium latum?

A

Eating poorly cooked fish

127
Q

What is a Prussian blue stain used for?

A

Staining for liver deposition

128
Q

What can Prussian blue stains help differentiate between?

A

Iron deposition in hemochromatosis and lipofuscin “wear and tear”

129
Q

What is the MOA of propylthiouracil?

A

Inhibits thyroid peroxidase

130
Q

What does thyroid peroxidase do?

A

Oxidizes iodide to iodine, iodination of tyrosyl residues (organification) on thyroglobulin, and coupling

131
Q

What are the side effects of propylthiouracil?

A

Agranulocytosis, leukopenia, thrombocytopenia, aplastic anemia

132
Q

Patient in New Mexico develops sudden chills, high fever, malaise, n/v and headache. Additionally he develops cough and blood tinged sputum with patchy infiltrates on CXR. What is the likely causal organism?

A

Yersinia pestis

133
Q

Infection with yersina pestis can cause what?

A

Many forms: mild LAD, bubonic plague (hemorrhagic LAD), and pneumonic plague (sudden onset illness with blood tinged sputum)

134
Q

What is brucellosis?

A

Infection with brucella abortus - undulating fever, LAD, HSM

135
Q

When does one see tularemia?

A

Infection with Francisella tularensis - caused by rabbits and shit

136
Q

What is visual agnosia?

A

Inability to recognize familiar objects despite the ability to see

137
Q

Visual agnosia is caused by what type of lesion?

A

Temporo-occipital association cotex

138
Q

What are the signs and symptoms of hypoparathyroidism?

A

Severe hypocalcemia and hyperphosphatemia; Tetany, Carpopedal spasms, muscle and abdominal cramps, tingling of lips and hands

139
Q

What is the MOA of triptans?

A

5HT agonist

140
Q

What is the function of Subscapularis muscle?

A

Internal rotation of the arm?

141
Q

What is the innervation of the subscapularis?

A

Upper and lower subscapular nerves

142
Q

What is the function of the teres minor?

A

External rotation of the arm

143
Q

What is the innervation of the teres minor?

A

Axillary nerve

144
Q

What is the equation for half life?

A

T1/2 = (0.7 x Vd)/Cl

145
Q

What is the mechanism of metoclopramide?

A

D2 antagonist

146
Q

Where does metoclopramide exert its antiemetic effect?

A

Area postrema

147
Q

What is metoclopramide used for?

A

Antiemetic; can be used for chemo

148
Q

What is the MOA of meclizine? What is it used for?

A

H1 antagonist; motion sickness

149
Q

What is the MOA of ondansetron?

A

5-HT3 antagonist

150
Q

What is the MOA of scopolamine?

A

Antimuscarinic agent

151
Q

3

A

Qq

152
Q

Child with T1D has tonsillectomy. One week later presents with numerous small yellow granules that are gram + and have numerous non-acid fast branching filaments at the periphery. Whats the organism?

A

Actinomyces israelii

153
Q

Abscesses with gram positive filamentous rods in sulfur granules is knee jerk for what?

A

Actinomyces israelii

154
Q

What is the genetic defect associated with neuroblastoma?

A

Amplification of MYCN gene

155
Q

Amplification of MYCN gene results in what?

A

Neuroblastoma

156
Q

Palpable, nontender, right intra-abdominal mass that crosses the midline in a child is suggestive of what?

A

Neuroblastoma

157
Q

What is elevated in the serum of a patient with neuroblastoma?

A

Homovanillic acid

158
Q

Translocation of MYCC gene results in what tumor?

A

Burkitt lymphoma

159
Q

What genetic issue is associated with Burkitt lymphoma?

A

Translocation 8;14 - resulting in translocation of MYCC gene

160
Q

8;14 translocation is seen in what disease?

A

Burkitt Lymphoma

161
Q

What is Conn syndrome?

A

Primary aldosteronism - a syndrome of aldosterone hypersecretion

162
Q

Why is there yearly revaccination against influenza?

A

Genetic drift - minor antigenic changes in surface antigens

163
Q

What is the most common cause of intraparenchymal hemorrhage?

A

Hypertension

164
Q

Where do most intraparenchymal hemorrhages occur?

A

Internal capsule and basal ganglia

165
Q

Charcot-Bouchard aneurysms can rupture what vessels?

A

Lenticulostriate vessels of the basal ganglia

166
Q

What type of crystals are found in joint aspiration of pseudogout?

A

Calcium pyrophosphate dihydrate crystals

167
Q

Rhomboid crystals on joint aspiration are associated with what?

A

Psuedogout

168
Q

What is seen when crystals are arranged parallel to the axis of polarized light in pseudogout?

A

Blue - positive birefringence on polarization

169
Q

What cells in the ovarian follicle produce estrogen during the follicular phase?

A

Granulosa cells

170
Q

What secretes estrogen during the luteal phase?

A

Corpus luteum

171
Q

When does formation of the notochord begin?

A

Third week

172
Q

What is gastrulation?

A

Converts two layer embryo into a three layer embryo

173
Q

When is organogenesis complete?

A

By the end of the eighth week

174
Q

The notochord is derived from what cells?

A

Epiblast cells

175
Q

Measles belongs to what family?

A

Paramyxoviridae

176
Q

Rubella is part of what virus family?

A

Togovirus

177
Q

Mumps is part of what virus family?

A

Paramyxoviridae

178
Q

Fluid in the peritoneal cavity accumulates where in a woman?

A

The rectouterine space (pouch of Douglas)

179
Q

Where is the rectouterine space?

A

Located between the uterus and rectum with a close relationship to the posterior fonix

180
Q

What is the MOA of vincristine?

A

Inhibits microtubule polymerization (formation)

181
Q

What phase of the cell cycle is affected by vincristine?

A

M phase

182
Q

What is the MOA of vinblastine?

A

Inhibits microtubule polymerization

183
Q

What are the SEs of vinblastine?

A

Bone marrow suppression, alopecia, diarrhea

184
Q

What SE is vincristine “known for”?

A

Peripheral neuropathy

185
Q

What is the MOA of paclitaxel?

A

Prevents depolymerization of microtubules

186
Q

What is the MOA of doxorubicin?

A

DNA intercalation - DNA strand breaks

187
Q

Waht is the MOA of cyclophosphamide?

A

Alkylating agent - attacks guanine N7 - dysfunctional DNA

188
Q

What is used to protect patients from hemorrhagic cystitis with the use of cyclophosphamide?

A

Mensa - traps acrolein and its protective

189
Q

What is the MOA of bleomycin?

A

Complexes iron-forming ROS and intercalates into DNA

190
Q

What plasmodium causes a severe form of malaria resulting in very severe anemia, pulmonary edema, renal failure and shock?

A

P. Falciparum

191
Q

What transmits malaria?

A

Anopheles mosquitoes

192
Q

What malarial infection can cause cerebral malaria?

A

P falciparum

193
Q

Chloroquine resistance is a problem with what malarial infection?

A

P falciparum

194
Q

What malarial infections can cause relapse? Why?

A

P ovale and P vivax - both have persistent hypnozoites

195
Q

How do you treat P vivax infection?

A

Chloroquine then primaquine

196
Q

How do you treat P ovale infection?

A

Chloroquine then primaquine

197
Q

How do you treat P malariae?

A

Chloroquine (no radical cure necessary)

198
Q

Patient has likely malarial infection with a fever that spikes every 72 hours; what is the most likely organism?

A

P malariae

199
Q

What is Bowen disease?

A

In situ penile squamous cell carcinoma

200
Q

How does Bowen disease present?

A

Gray-white plaque on penis (form of carcinoma in situ)

201
Q

How does Bowenoid papulosis present?

A

Multiple reddish-brown papular lesions on the penis (form of carcinoma in situ)

202
Q

How does Erythoplasia of Queyrat present?

A

Soft red plaque on penis; form of carcinoma in situ

203
Q

Opaque, gray-white flat penile plaque on the shaft of the penis; biopsy shows dysplastic squamous epithelium. Topical ointments have not helped this plaque. What is the most likely diganosis?

A

Bowen disease - in situ carcinoma

204
Q

What calcium channel blocker has been associated with an accelerated progression to / exacerbation of heart failure?

A

Verapamil

205
Q

What calcium channel blockers are used in patients with CHF?

A

Amlodipine and felodipine

206
Q

What antihypertensive drugs are protective against diabetic nephropathy?

A

ACE inhibitors and ARBs

207
Q

What drugs are indicated for HTN with HF?

A

Diuretics, ACE inhibitors/ARBs, beta blockers (only in compensated HF), and aldosterone antagonists

208
Q

What are the three most common causes of otitis media in a child?

A

S pneumo, H influenzae, M catarrhalis

209
Q

What is the second most common cause of bacterial pneumonia in a patient with COPD?

A

M catarrhalis (behind nontypeable H influenzae)

210
Q

What is the gram stain and morphology of H pylori? What other characteristics are important?

A

Gram negative rod, urease +, oxidase +, catalase +, microaerophilic

211
Q

What is the gram stain and morphology of C jejuni? What other important characteristics?

A

Gram negative rod, urease negative, microaerophilic, oxidase positive, grows at 42 C, microaerophilic

212
Q

How can one get C jejuni infection?

A

Undercooked poultry (or meat), unpasteurized milk, or infected animals (cats, dogs, pigs)

213
Q

How can one estimate a type II error? (Use an equation)

A

1 - Power = Type II error

214
Q

What is HER-2? What disease is it associated with? What is used in treatment?

A

Epidermal growth factor 2 - tyrosine kinase receptor; breast cancer; trastuzumab

215
Q

RET protooncogene encodes what?

A

Receptor tyrosine kinase

216
Q

What does the gene ATM encode? What disease is this gene associated with?

A

ATM encodes a protein in the IP3 kinase family; mutated in ataxia telangiectasia

217
Q

Hereditary nonpolyposis CRC is associated with what type of mutation?

A

DNA repair gene mutation involved in post-replication repair

218
Q

Xeroderma pigmentosum is associated with what type of mutation?

A

DNA repair gene mutation - specifically pyrimidine dimer repair

219
Q

By what mechanism does cryptosporidium parvum cause diarrhea?

A

Intracellular replication in the brush border of the intestine

220
Q

What is the toxin produced by pseudomonas aeruginosa?

A

Exotoxin A - ADP ribosylates and inhibits EF-2

221
Q

What is the gram stain and morphology of Bacillus anthracis?

A

Large, boxcar-shaped gram positive rod; aerobic and spore forming

222
Q

Describe the appearance of crytpococcus neoformans

A

Monomorphic, encapsulated yeast

223
Q

What CSF findings are indicative of fungal infection?

A

100-1000 cells, mostly lymphocytes, glucose < 45, and proteins >50

224
Q

What stain is used to visualize Pneumocystis jirovecii?

A

Methenamine silver

225
Q

What type of transduction results in clones of bacteria acquiring new and distinct genetic traits?

A

Generalized transduction

226
Q

What infections are transmitted by Ixodes tick?

A

Anaplasma phagocytophilum, babesia, borrelia burgdorferi

227
Q

Ehrlichiosis presents with what? What is seen microscopically?

A

Headache, fever, and rash with cytoplasmic morulae in a monocyte

228
Q

Drescribe the gram stain and morphology of Ehrlichia. What cell does it infect?

A

Gram negative bacilli; forms morulae in monocyte

229
Q

What is seen microscopically with an Anaplasma infection?

A

Morulae in granulocytes

230
Q

St louis encephalitis virus is part of what virus family?

A

Flavivirus

231
Q

How does cryptosporidium cause diarrhea?

A

Infects brush border of small intestine and causes direct cell lysis

232
Q

What bugs invade the submucosa of the intestine?

A

Entamoeba histolytica and shigella dysenteriae

233
Q

What is the mechanism of the shiga toxin?

A

Activates 60S ribosomal subunit

234
Q

What is the mechanism of the enterotoxigenic E. coli?

A

Ribosylates Gs

235
Q

Thick walled, spherical yeast with multiple buds encircling the central cell

A

Paracoccidioides

236
Q

What is used in the treatment for toxoplasmosis in immunecompetent patients?

A

Sulfadiazine + pyrimethamine (and leucovorin folinic acid rescue)

237
Q

What is the MOA of pyrimethamine?

A

Inhibits DHFR

238
Q

What is used for the treatment of typranosoma brucei?

A

Suramin for blood borne and melarsoprol for CNS penetration

239
Q

What does trypanosoma brucei cause?

A

African sleeping sickness

240
Q

What transmits T. Brucei?

A

Tsetse fly - painful bite

241
Q

What is the treatment for T. Cruzi?

A

Benznidazole or nifurtimox

242
Q

What is the treatment for leishmaniasis?

A

Sodium stibogluconate

243
Q

What is the MOA of permethrin? What is it used to treat?

A

Inhibits sodium channels in parasites; antimite/louse therapy

244
Q

What is the MOA of malathion? What is it used to treat?

A

Acetylcholinesterase inhibitor; anti mite or louse therapy

245
Q

What is the MOA of lindane?

A

Blocks GABA channels