3/17

Question 1

What diseases might you give sulfasalazine for? MOA?

Answer 1

IBD

Inhibit cytokine, PG, leukotriene synthesis during inflammation

Question 2

What causes failure to thrive in young CF patients?

Answer 2

Malabsorption due to obstructive fibrosis and progressive insufficiency of the exocrine pancreas. Pancreatic lipase supplementation is needed.

Question 3

Neural tube defects lead to increased WHAT in amniotic fluid?

Answer 3

AFP and AChE

Question 4

What are the two examples of anterior neural tube defects?

Answer 4

encephalocele (herniation of brain tissue through cranial defect)

anencephaly (total absence of brain and calvarium)

Question 5

What are three examples of posterior neural tube defect?

Answer 5

Spina bifida occulta
Meningocele
Meningomyelocele

Question 6

What is Hirschsprung’s disease?

Answer 6

Failure of neural crest cells to migrate to intestinal wall

Leads to absence of myenteric and submucosal nervous plexi in a segment of colonic wall

Question 7

What reabsorbs CSF?

Answer 7

Arachnoid granulations

Question 8

What is suggested by fever, jaundice, and anorexia in an IV drug user?

Answer 8

Acute viral hepatitis

Question 9

What are Councilman bodies?

Answer 9

Acidophilic (apoptotic) bodies found in apoptotic hepatocytes, which can be seen in acute viral hepatitis

Question 10

Where are Peyer’s patches located?

Answer 10

Ileum

Question 11

Where are Brunner’s glands and crypts of Lieberkuhn located?

Answer 11

Duodenum

Question 12

What artery supplies the femoral head?

Answer 12

Obturator artery

Question 13

Why is the obturator artery clinically significant in children?

Answer 13

It supplies the femoral head proximal to the epiphyseal growth plate

Question 14

Sx of paresthesias, weakness, dizziness, n/v, hyporeflexia, and diarrhea after consuming fish points to what toxin?

Answer 14

Tetrodotoxin from puffer fish

Question 15

What toxins inhibit protein synthesis?

Answer 15

Diptheria toxin, exotoxin A (pseudomonas), shiga toxin, shiga-like toxin (EHEC, incl O157:H7)

Question 16

How do diptheria toxin and exotoxin A work?

Answer 16

Ribosylate and inactivate elongation factor-2, inhibiting human cell protein synthesis

Question 17

What is the best auscultatory indicator of Mitral stenosis severity?

Answer 17

A2-OS interval, shorter = worse

A2 is the aortic component of S2

Question 18

Hypopigmented or hyperpigmented skin patches are associated with what organism?

Answer 18

Malassezia furfur fungus

Called tinea versicolor (or pityriasis versicolor)

Question 19

What are the cutaneous mycoses?

Answer 19

Dermatophytosis

Pityriasis versicolor

Question 20

What type of mycosis is sporotrichosis?

Answer 20

Subcutaneous

Question 21

What are the mycoses with systemic involvement (esp the lungs)?

Answer 21

Histoplasmosis, coccidioidoses, blastomycosis

Question 22

What are the opportunistic mycoses?

Answer 22

Candida, Aspergillus, Mucor, Rhizopus

Question 23

What organism has a “spaghetti and meatball” appearance?

Answer 23

Malassezia furfur

Question 24

How do you diagnose pityriasis (tinea) versicolor?

Answer 24

KOH tx of skin scrapings

Question 25

Dextrans produced by Viridans group streptococci allow it to attach to what?

Answer 25

Fibrin

Question 26

What type of genetic material does parvovirus B19 have?

Answer 26

non-enveloped linear (-) ssDNA

Question 27

Genetic material of EBV?

Answer 27

enveloped ds DNA

Question 28

What viruses have circular dsDNA?

Answer 28

Nonenveloped: HPV, JC virus (PML in HIV), BK virus (renal infx) Enveloped: HBV is partially circular, but also dsDNA

Question 29

Patients should be tested for what before receiving TNF-a inhibitor like Etanercept?

Answer 29

Latent TB infx or any other underlying infx

Question 30

Why would you administer Etanercept? MOA?

Answer 30

For moderate to severe RA TNF-a inhibitor

Question 31

What do you give an alcoholic with pneumonia? Why?

Answer 31

Clindamycin, to cover anaerobes from oral flora, commonly the cause of aspiration PNA in alcoholics

Question 32

What are the sx of theophylline toxicity?

Answer 32

Abd pain, vomiting, seizures

Question 33

What drugs cause lupus?

Answer 33

Hydralazine Procainamide Isoniazid Especially with slow acetylators

Question 34

Bleeding, secretory diarrhea, and partial intestinal obstruction indicate what type of adenomatous polyp?

Answer 34

Villous adenoma

Question 35

What does adding cyanide then nitroprusside to urine test for?

Answer 35

Detects sulfhydryl groups, particularly for cystine, which turns it purple, indicating cystinuria

Question 36

What is tamoxifen's effect on breast? Endometrium? Bone?

Answer 36

Breast: reduce cancer Endometrium: increase hyperplasia/cancer risk Bone: reduce osteoporosis

Question 37

Tubular proteinuria is associated with loss of what kinds of proteins?

Answer 37

Low molecular weight proteins, e.g. b2-microglobulin, Ig light chains, amino acids, retinol binding protein

Question 38

Overload proteinuria is associated with loss of what kinds of proteins?

Answer 38

Low molecular weight proteins that are filtered by the GBM, but overwhelm the reabsorption by proximal tubule. E.g. overproduction of Ig light chain in multiple myeloma

Question 39

What are the causes of functional proteinuria?

Answer 39

Exercise, high fever, emotional stress, cold exposure

Question 40

What function do ApoE3 and ApoE4 serve?

Answer 40

Uptake of chylomicrons and VLDL by hepatic apolipoprotein receptors

Question 41

What function does ApoB-100 serve?

Answer 41

Uptake of LDL by receptor mediated uptake in extrahepatic tissues

Question 42

ApoA-I function?

Answer 42

LCAT activation for cholesterol esterification into HDL

Question 43

ApoB-48 fxn?

Answer 43

Chylomicron assembly and secretion

Question 44

ApoC-II fxn?

Answer 44

Lipoprotein lipase activation