May 18/19th

Question 1

What is seen on biopsy of Buerger’s disease?

Answer 1

Segmental thrombosing vasculitis often extends into contiguous veins and nerves, encasing them in fibrous tissue

Question 2

What are Gottron papules? When do you see them?

Answer 2

Flat-topped, violaceous papules over the joints of fingers seen in dermatomyositis

Question 3

In trisomy 21, is there a nondisjunction during meiosis I or II?

Answer 3

Meiosis I

Question 4

How is hypomania differentiated from mania?

Answer 4

Hypomania has lesser degree severity and functional impairment and the absence of psychosis

Question 5

Patient exhibits noticeable change in behavior but are often very productive despite requiring less sleep; also history of major depressive episode

Answer 5

Bipolar II disorder

Question 6

Manic episodes plus depressive episodes (but not required for diagnosis)

Answer 6

Bipolar I

Question 7

Hypomanic episode and 1 or more major depressive episodes required for diagnosis

Answer 7

Bipolar II

Question 8

What is factitious disorder?

Answer 8

Patient deceptively produces signs and symptoms of illness to assume sick role; want to obtain attention and medical care from health care personnel

Question 9

What is the MOA of minoxidil?

Answer 9

Opens ATP dependent K channels, resulting in hyperpolarization and therefore relaxation

Question 10

What drugs can cause coronary steal syndrome?

Answer 10

Adenosine and dipyridamole; they are selective vasodilators of coronary vessels

Question 11

What is diphenoxylate?

Answer 11

Opioid anti-diarrheal; slows motility

Question 12

What is the leading cause of CAP, otitis media, and meningitis in adults?

Answer 12

S pneumo

Question 13

What is seen on biopsy of GI tract in celiac disease?

Answer 13

Increased intraepithelial lymphocytes; variable loos of villus height, crypt hyperplasia

Question 14

Crypt abscesses in colonic mucosa is seen in what disease?

Answer 14

Ulcerative colitis

Question 15

What is the main distinguishing characteristic of atypical depression?

Answer 15

Mood reactivity (feeling better in response to positive events)

Question 16

What medications can be useful in atypical depression or treatment-resistant depression?

Answer 16

MAIs - eg phenelzine, tranylcypromine, selegiline

Question 17

What type of enzymes require B3 usually?

Answer 17

Dehydrogenase and reductase enzymes; although FAD is needed for succinate dehydrogenase

Question 18

What is Kussmaul sign? When do you see it?

Answer 18

Paradoxical rise in JVP on inspiration; seen in constrictive pericarditis

Question 19

What is small intestinal bacterial overgrowth?

Answer 19

Due to gastric bypass surg; excessive bacterial overgrowth results in vit b12, A, D, E, iron def but and increase in folic acid and Vit K by the bacteria

Question 20

What 5 catalase + species predominantly infect CGD?

Answer 20

S aureus, Burkholderia cepacia, Serratia, Nocardia, Aspergillus

Question 21

The middle inferior rectal vein drains into what?

Answer 21

Internal iliac

Question 22

The inferior rectal vein drains into what?

Answer 22

Internal pudenal vein

Question 23

How does HBV increase the risk for HCC?

Answer 23

Integrates into the host genome with transcription of HBx protein which inactivates p53 tumor suppressor protein

Question 24

Infant with inability to oxidize VLCFAs and phytanic acid (BCFA) is seen in what diseases?

Answer 24

Peroxisomal disease (eg Zellweger and Refsum)

Question 25

What organelle metabolizes VLCFAs and FAs with branch points at odd-numbered carbons?

Answer 25

Peroxisome