3/22/16

Question 1

RAS

Answer 1

GTPase proto-oncogene (signal transduction)
Increased signaling = cell growth, differentiation and survival
Active form = RAS-GTP (loss of GTP-ase = always active)

Question 2

ABL

Answer 2

Proto-oncogene on Chr. 9
CML
Tanslocated to 22 BCR (hybrid tyrosine kinase)

Question 3

All sensory modalities of the face (except for olfactory), pass through the _______ _______ ______ of the thalamus on their way to cortex (decussate lower in brainstem before going through thalamuscontra)

Answer 3

Ventral posteromedial nucleus (VPM) (supplied by posterior cerebral artery)

Question 4

Overuse of HCTZ can cause…

Answer 4

Hypokalemia (decreased early distal tubule Na+ absorption increased delivery and reabsorption by late distal in exchange for K+)

Question 5

Amiloride

Answer 5

Falls into the class of potassium sparing diuretics

Question 6

Pentoxifylline

Answer 6

Enhances blood flow by increasing deformability of RBCs to decrease viscosity in blood
Use: Patients suffering from claudication

Question 7

Pain disorder TX

Answer 7

Rehabilitation (PT)
Psychotherapy 
Behavioral therapy
TCAs
Venlafaxine

Question 8

Deficiency due to CD40 ligand

Answer 8

X-linked hyper-IgM syndrome

Tx: immunoglobulin replacement therapy

Question 9

Bloody CSF without a traumatic tap

Answer 9

HSV-1

Question 10

Fitz-Hugh-Curtis Syndrome

Answer 10

Inflammation of liver capsule

Rare complication of PID

Question 11

Presbyacusis: Organ of Corti

Answer 11

Responsible for sensing high-pitched sounds at its proximal portion

Question 12

Trastuzumab is recombinant monoclonal antibody to ERBB2 (oncogene). How does it work?

Answer 12

Binds receptor on cancer cells preventing receptor stimulation and inhibiting cell growth.
Additionally, the binding of the antibody facilitates cell mediated cytotoxicity

Question 13

Heinz bodies are a hallmark of ______ and represent accumulations of denatured hemoglobin

Answer 13

G6PD

Question 14

Tamoxifen ADRs

Answer 14

Endometrial hyperplasia/carcinoma
Increased bone density
Hypercoagulability
Hot flashes
Night sweats 
Vaginal discharge

Question 15

Court- appointed legal guardians have the authority to….

Answer 15

Sign informed consent documents on behalf of mentally impaired

Question 16

Don’t want to “MIS” that the MRS. Is pregnant

Answer 16

Misoprostol is PGE1 analog
Increases mucosal secretion and decreases acid production in GI tract
Induces uterine contractions and cervical ripening in pregnant women

Question 17

Secondary increase in PTH production is caused primarily by the reduction in….

Answer 17

Phosphate excretion (hyperphosphatemia increases PTH secretion)

Question 18

PEP (phosphoenolpyruvate carboxykinase)

Answer 18

Regulatory enzyme in the gluconeogenesis pathway

Acts in cytosol to convert oxaloacetate to phosphoenolpyruvate

Question 19

Prolonged isovolumetric contraction is seen with aortic stenosis…why?

Answer 19

Higher pressure is required to overcome the resistance of the valve to open it

Question 20

Eczema, asthma, and hay fever are what type of reaction?

Answer 20

Hypersensitivity type I reaction

Question 21

Unchecked proliferation of granulocytes in CML

Answer 21

BCR-ABL Philadelphia chromosome fusion t(9;22)

Question 22

Monoclonal antibody against RANK-L (RANK-L is an activator of NF-kB pathway thus this drug indirectly acts by inhibiting NF-kB pathway

Answer 22

Denosumab

Question 23

Tx for anemia due to Hereditary spherocytosis

Answer 23

Splenectomy Corrects anemia completely but spherocytes persist

Question 24

What structures are within cardinal (transverse cervical) ligament?

Answer 24

Right uterine artery and vein

Question 25

Neurogenic bladder in diabetes/ Chronic reflux associated pyelonephritis

Answer 25

Blunting, uneven scaring, and thickened dilation of calyces | Also proteus infections leading to struvite stones (staghorn calculi)

Question 26

Structures of the femoral triangle from lateral to medial (NAVEL)

Answer 26

``` Nerve (femoral) Artery (femoral) Vein (femoral) Empty space in femoral canal Lymphatics Note: Artery, Vein, lymphatics are within femoral sheath ```

Question 27

Clindamycin MOA

Answer 27

Inhibits translocation, preventing movement of peptide chain from the A site to the P site Do not confuse with chloramphenicol which affects peptidyl transferase activity at 50 S.

Question 28

Nodular goiter that has hyperfunctioning nodule, causing Hyperthyroidism

Answer 28

Plummer’s disease

Question 29

Subacute bacterial endocarditis, particularly in setting of MVP

Answer 29

Viridans streptococci (S. mutans, S. sanguinis, S. oralis, and S. mitis)

Question 30

PDA use indomethacin

Answer 30

PGE2 inhibitor

Question 31

Hypophosphatemic Rickets Inheritance

Answer 31

X-linked Dominant

Question 32

Muscarinic antagonist that can be used to alleviate urinary urgency in patients with cystitis and to ease bladder spasm

Answer 32

Oxybutynin

Question 33

Spina bifida occulta is caused by what?

Answer 33

Failure of POSTERIOR vertebral arches to close in utero | Folic acid before 28th day of pregnancy

Question 34

Ventricular tachyarrhythmias and intraventricular conduction abnormalities (ex. A LBBB) are common long term complications of MI why?

Answer 34

Myocardium becomes scarred and loses it intrinsic conducting abilities

Question 35

Location of intraductal papilloma

Answer 35

Lactiferous ducts | Tx: tight fitting support bras, cessation of breast feeding, ice packs

Question 36

SJS associated with use of what anticonvulsants?

Answer 36

Lamotrigine Phenytoin Ethosuximide Carbamazepine

Question 37

Topiramate ADRs

Answer 37

Psychomotor slowing, sedation and renal stones

Question 38

PPD test example of what type of hypersensitivity?

Answer 38

``` Type IV (also Type 4 = contact dermatitis) Response does not involve antibodies (Delayed T-cell mediated type) ```

Question 39

Sixth aortic arch

Answer 39

Proximal part of pulmonary arteries and (on left only) PDA

Question 40

Addison’s disease in men

Answer 40

Because we produce androgens mainly in our balls you will not see sexual dysfunction or hair loss (but women do…especially hair loss in pubic and axillary)

Question 41

Treatment for fifth disease (erythema infectiosum)

Answer 41

Self- limited (no treatment necessary)

Question 42

Gaussian Distribution

Answer 42

``` 68% = fall between 1 SD 95% = fall between 2 SD 99% = fall between 3 SD ```

Question 43

Malassezia furfur causes _______ _______; KOH preparation shows “spaghetti and meatballs” mycelia

Answer 43

Tinea Versicolor

Question 44

Tubulointerstitial nephritis “muddy brown casts”

Answer 44

``` Sulfonamides (thiazide and loop diuretics) Methicillin Ciprofloxacin Cephalosporins Allopurinol NSAIDs Proton pump inhibitors Rifampin ```

Question 45

Highly effective topical antibiotic against gram-positive (some gram negative) bacteria that works by inhibiting bacterial wall synthesis (peptidoglycan synthesis)

Answer 45

Bacitracin

Question 46

What is elevated in B12 deficiency

Answer 46

Homocysteine | Methylmalonic acid

Question 47

AAs are covalently bound to 3’ end of tRNA molecules. This reaction is catalyzed by ____________ . tRNA molecules have a ______ triplet on the 3’ end.

Answer 47

Aminoacyl-tRNA synthetase CCA