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Question 1

What neuronal histopathologic changes are associated with shrinkage of the cell body, pyknosis of the nucleus, loss of nissl substance, and eosinophilic cytoplasm?

Answer 1

acute neuronal injury/red neuron - transient severe insult that leads to cell death

Question 2

What neuronal histopathologic changes are associated with enlargement of the cell body, eccentric nucleus, enlargemetn of the nucleolus, and dispersion of the Nissl sybstance?

Answer 2

axonal reaction d/t loss of axon (axon is severed)

Question 3

What neuronal histopathologic change is d/t loss of neurons and funcitonal groups of neurons and reactive gliosis?

Answer 3

neuronal atrophy d/t progressive degenerative disease

Question 4

What psych disorder is characterized by mood Sx (major depressive, manic, or mixed) with concurrent Sx of schizophrenia with at least a 2w period of psychotic Sx (delusions or hallucinations) in the absence of prominent mood Sx)?

Answer 4

Schizoaffective disorder

Question 5

What psych disorder is characterized by two+ delusions, hallucinations, disorganized speech/behavior, or negative Sx that are present for longer than 1 mo. but less than 6 mo.

Answer 5

Schizophreniform disorder

Question 6

What kind of muscle type are paraspinal muscle characterized as?

Answer 6

Type I - slow twitch required to perform actions requiring low-level sustaining force like postural maintenance

Question 7

What muscle fiber type are pec major, LD, biceps brachii, and deltoid more composed of

Answer 7

Type II - required for rapid forceful pulses of movement

Question 8

What are 3 cytogenic abnormalities that can produce Down sydrome?

Answer 8

1. Trisomy 21
2. Unbalanced Robertsonian ttranslocations
   3 Mosaicism.

Question 9

What is pituitary apoplexy and how does it present?

Answer 9

hemorrhage into a preexisting pituitary adenoma - pt presents with acute, severe headache, ophthalmoplegia, and altered snesorium

Question 10

What is the pathophysiology of Sheehan syndrome?

Answer 10

stimulatory effect of high E during pregnancy causes pituitary gland to become enlarged and vasculature; if postpartum hemorrhage occurs and causes hypotension while pituitary is enlarged, it can undergo necrosis and cause panhypopituitarism
-also commonly present with hypothyroidism and hypocortisolism

Question 11

Which opioid effects are most resistant to tolerance development?

Answer 11

constipation and miosis

Question 12

How do sulfonylureas work as “antidiabetic” meds?

Answer 12

they directly bind to the regulatory subunits of KATP channels causing them to close and depolarize the cell so that Ca2+ can come in and stimulate release of insulin

Question 13

What is the regulatory substance that stimulates KATP channel closure in insulin-producing pancreatic beta cells?

Answer 13

ATP

Question 14

What does CREST syndrome stand for?

Answer 14

calcinosis, raynaud sydrome, esophageal dysmotility, sclerodactyly, and telangiectasia

Question 15

What is the pathogenesis of CREST syndrome?

Answer 15

unknown pathogen stimulates accumulation of CD4 lymphocytes which secrete biologically-active substances and stimulate fibroplasts to produce collagen

Question 16

What is the hallmark of systemic sclerosis seen in CREST syndrome?

Answer 16

excessive tissue fibrosis

Question 17

What is the pathogenesis of esophageal dysmotility in CREST?

Answer 17

it is a result of atrophy and fibrous replacement of esophageal muscles - esophageal body and LES become atonic and dilated, resulting in severe reflux - main Sx are heartburn, regurgitation, and risk of dysphagiea

Question 18

What two things can esophageal dysmotility increase the risk of?

Answer 18

Barret esophagus and esophageal dysmotility d/t esophageal dilation which causes reflux

Question 19

Where is elastase derived from in the lungs?

Answer 19

It is a neutral protease contained in macrophage lysosomes and in large azurophil granules of the neutrophils
-normally it is balanced by antielastase activity of serum a1 antitrypsin

Question 20

What type of cells constitute over 95% of the epithelial lining of alveoli?

Answer 20

Type I pneumocytes

Question 21

What type of cells secrete phsopholipid species, including dipalmitoyl phosphatidylcholine which is the major components of pulmonary surfactant?

Answer 21

Type II pneumocytes

Question 22

What are non-ciliated, secretory constituents of the terminal respiratory epithelium which secrete proteins that inhibit neutrophil recruitment and activation?

Answer 22

Clara cells

Question 23

What secretes mucin in the alveoli?

Answer 23

goblet cells

Question 24

What is the Haldane effect?

Answer 24

binding of O2 to Hb drives the release of H+ and CO2 from Hb in lungs

Question 25

What is the Bohr effect?

Answer 25

high concentrations of CO2 and H+ facilitate oxygen unloading from Hb in peripheral tissues

Question 26

What does number needed to harm represent?

Answer 26

number of people that must be treated for one adverse event to occur

NNH = 1/attributable risk

Question 27

Who do you calculate attributable risk?

Answer 27

adverse event rate in Tx group - adverse event rate in placebo

Question 28

What are the motor and sensory innervations of the musculocutaneous nerve?

Answer 28

flexor muscles of the upper arm (biceps brachi, coracobrachialis, and brachialis) and sensory innervation ot lateral forearm

Question 29

What Sx present with Conn syndrome/primary hyperaldosteronism?

Answer 29

Na+ retention and K+ excretion - hypertension and hypokalemia with metabolic alkalosis. This can cause muscle weakness and paresthesias d/t hypokalemia

Question 30

What is the MOA of vinca alkaloids?

Answer 30

inhibit microtubule polymerization after binding to B-tubulin which prevents synthesis of mitotic spindle in deviding cells - leads to failure of division and cell death

Question 31

What is the main side effect of vincristine?

Answer 31

peripheral neuropathy

Question 32

What chemotherapeutic agents are associated with burning on urination and urgency?

Answer 32

cyclophosphamide or isofosfamide-induced hemorrhagic cystitis

Question 33

What chemotherapeutic agents are associated wtih leg swelling and orthopnea?

Answer 33

Doxorubicin - an anthracycline antibiotic and chemotherapeutic intercalating agent

Question 34

What chemotherapeutic agent is associated with dry cough and extertional dyspnea/pulmonary fibrosis?

Answer 34

bleomycin

Question 35

What chemotherapeutic agent is most associated with tarry stool?

Answer 35

alkylating agents

Question 36

What drug is associated with abdominal pain and jaundice?

Answer 36

mercaptopurine

Question 37

How does nitroglycerin administration bypass first pass effects?

Answer 37

tablets are given sublignally