3/22 - UW 17

Question 1

What is digital clubbing caused by?

Answer 1

Hypoxic conditions: Heart or lung disease, IBD, hyperthyroidism, malabsorption

Question 2

What kind of nuclear material is in the mitochondria?

Answer 2

mtDNA is a small, circular chromosome coding for 14 proteins and their associated rRNA and tRNA

Question 3

What MRSA tx causes Red Man Syndrome and nephrotoxicity? MOA?

Answer 3

Vanc, blocks glycopeptide polymerization be binding to D-alanyl-D-alanine

Question 4

What is Red Man Syndrome?

Answer 4

Due to vancomycin: flushing or rash on face, neck, torso due to nonspecific mast cell degranulation, NOT IgE-mediated

Question 5

What MRSA tx causes myopathy and CPK elevation, that is inactivated by surfactant? MOA?

Answer 5

Daptomycin, depolarizes cellular membrane

Question 6

What MRSA tx causes thrombocytopenia and optic neuritis, and increases risk for serotonin syndrome? MOA?

Answer 6

Linezolid, inhibits 50S subunit

Question 7

What street drug causes nystagmus?

Answer 7

Phencyclindine (PCP)

Question 8

What street drug causes chest pain and sz?

Answer 8

Cocaine

Question 9

What street drug causes choreiform movements?

Answer 9

Meth

Question 10

Cocaine MOA?

Answer 10

Blocks reuptake of DA, NE, 5HT in CNS

Question 11

Phencyclidine (PCP) MOA?

Answer 11

Antagonizes NMDA rececptor

Question 12

Acyclovir MOA?

Answer 12

Guanosine analog: first phosphorylated by viral thymidine kinase (rate limiting step) to monophosphate, then to active triphosphate form

Question 13

Why are EBV and CMV less susceptible to acyclovir than HSV and VZV?

Answer 13

Different thymidine kinase limits ability to activate acyclovir by phosphorylation

Question 14

Why is CMV more sensitive to ganciclovir than other herpesviruses?

Answer 14

Differences in viral DNA polymerase structure

Question 15

What is the primary site of rRNA synthesis?

Answer 15

Nucleolus

Question 16

What do RNA polymerase I, II, and III do?

Answer 16

RPI: rRNA
RPII: mRNA, snRNA, miRNA
RPIII: tRNA, 5S rRNA

Question 17

What is the fxn of Secretin?

Answer 17

Pancreatic BICARB secretion

Question 18

What is the effect of CCK on the gallbladder? What is it secreted by?

Answer 18

Contraction, secreted by duodenal and jejunal I cells

Question 19

What is the fxn of Gastrin?

Answer 19

Secretion of gastric acid, and gastric motility

Question 20

What is an antidepressant that doesn’t have sexual dysfunction side effects?

Answer 20

Bupropion

Question 21

What CN carries motor innervation to the tongue?

Answer 21

Hypoglossal (CN XII), except the palatoglossus muscle (CN X)

Question 22

What CNs carry general sensory from the tongue?

Answer 22

Anterior 2/3: mandibular branch of trigeminal (CN V3)
Posterior 1/3: glossopharyngial (CN IX)
Posterior part of tongue root: CN X

Question 23

What CNs carry gustatory sensation from the tongue?

Answer 23

Anterior 2/3: chorda tympani of facial nerve (CN VII)
Posterior 1/3: glossopharyngeal (CN IX)
Posterior of tongue root: CN X

Question 24

Jejunal ulcers is strongly suggestive of what neoplasm?

Answer 24

Gastrinomas: neuroendocrine tumors of the pancreas, peripancreatic tissue, or duodenum

Question 25

Sx of VIPoma?

Answer 25

Intractable diarrhea, metabolic acidosis, hypokalemia

Question 26

With gout, what accumulates in the synovial fluid and forms crystals?

Answer 26

Monosodium urate (uric acid salt)

Question 27

With gout, levels of what increases in the serum?

Answer 27

Uric acid

Question 28

What is lead time bias?

Answer 28

Bias in lead time (time between detection and outcome) due to different detection methods, without actual change in time to outcome

Question 29

What is suggested with fatigue, bradycardia, weight fain, and slowed DTRs?

Answer 29

Hypothyroidism

Question 30

What does the dexamethasone suppression test screen for?

Answer 30

Cushing's syndrome (cortisol excess)

Question 31

What substrates can be formed into propionyl CoA?

Answer 31

Isoleucine, valine, threonine, methionine Cholesterol Odd cahin fatty acids

Question 32

What cofactor is necessary for the carboxylation of propionyl CoA to methylmalonyl CoA?

Answer 32

Biotin, cofactor for propionyl CoA carboxylase

Question 33

What product of methylmalonyl CoA enters the TCA?

Answer 33

Succinyl CoA

Question 34

What is the cofactor for isomerization of methylmalonyl CoA to succinyl CoA?

Answer 34

B12

Question 35

A newborn with lethargy, emesis, hypotonia, AGMA, ketosis, and hypoglycemia is suggestive of what?

Answer 35

Propionyl acidemia

Question 36

Phosphoinositol system?

Answer 36

Ligand ginds to Gq, activates PLC, hydrolyzing PIP2 into DAG and IP3. DAG stimulates PKC. IP3 increased intracellular Ca

Question 37

What is visible 12-28 hours after ischemic inj to the brain?

Answer 37

Red neurons (eosinophilic cytoplasm, pyknotic nuclei, loss of Nissl substance)

Question 38

What is visible 3-6 hours after ischemic inj to the brain?

Answer 38

No visible changes

Question 39

What is visible 3-5 days after ischemic inj to the brain?

Answer 39

Macrophage infiltration and phagocytosis

Question 40

What is visible 1-3 days after ischemic inj to the brain?

Answer 40

Necrosis and neutrophilic infiltration

Question 41

What is visible 1-2 weeks after ischemic inj to the brain?

Answer 41

Reactive gliosis and vascular proliferation = liquefactive necrosis

Question 42

When does the glial cell form after ischemic inj to the brain?

Answer 42

Over 2 weeks later

Question 43

When do you see macrophages after an ischemic inj to the brain?

Answer 43

3-5 days

Question 44

What do you see neutrophils after an ischemic inj to the brain?

Answer 44

1-3 days

Question 45

DKA is strongly associated with what fungal infection?

Answer 45

Mucor species

Question 46

What is the most common cause of lacunar infarcts?

Answer 46

hypertensive arteriolosclerosis of small, penetrating arterioles

Question 47

What lymph nodes does the prostate drain to?

Answer 47

Internal iliac nodes primarily, as well as external iliacs and sacral

Question 48

What liver disease presents with severe, nocturnal pruritis?

Answer 48

Primary Biliary Cirrhosis

Question 49

What is the pathogenesis of primary biliary cirrhosis?

Answer 49

Autoimmune destruction of intrahepatic bile ducts and cholestasis

Question 50

Which cholesterol medication has a side effect of gouty arthritis?

Answer 50

Niacin

Question 51

Niacin MOA?

Answer 51

Decreasing hepatic synthesis of triglycerides and VLDL. Also increase HDL by 25-30%

Question 52

What medications increase serum uric acid levels?

Answer 52

Niacin, HCTZ, cyclosporing, pyrazinamide

Question 53

Proopiomelanocortin (POMC) is the precursor for what endogenous peptides?

Answer 53

beta-endorphin, ACTH, MSH

Question 54

What is the eponym for esophageal cells showing dysplasia at high risk of adenocarcinoma?

Answer 54

Barrett's esophagus (intestinal type epithelium with goblet cells

Question 55

What are the risk factors for esophageal squamous cell carcinoma?

Answer 55

Primary: alcohol and tobacco Secondary: Plummer-Vinson syndrome, achalasia, corrosive strictures

Question 56

What are the 3 components of a craniopharyngioma (arising from remnants of Rathke's pouch)?

Answer 56

1. solid (actual tumor cells) 2. cystic (filled with machinery oil liquid) 3. calcified

Question 57

What are some sx of congenital hypothyroidism?

Answer 57

Jaundice, macroglossia, myxedema, lethargy, hypotonia, hoarse cry

Question 58

Congenital hypothyroidism is associated with what cardiac abnormalities?

Answer 58

ASD, VSD