4/1 - UW 38

Question 1

How does herpes zoster present clinically?

Answer 1

Burning sensation/pain in a dermatome

Question 2

How does herpes zoster present histologically?

Answer 2

Sample from a vesicle base reveals INTRAnuclear inclusions in keratinocytes and multinucleated giant cells (positive Tzank smear)

Question 3

Pancreatic pseudocysts are formed by what tissue?

Answer 3

Granulation tissue (pancreatic enzymes induce inflammatory reaction in walls of surrounding organs)

Question 4

How do the walls of cysts and pseudocysts differ?

Answer 4

True cyst: epithelial cells

Pseudocyst: granulation tissue

Question 5

If reducing the dose of levodopa/carbidopa doesn’t help reduce neuro sx, what can be given?

Answer 5

Atypical antipsychotics (eg clozapine)

Question 6

Which one is worse, CGD or Myeloperoxidase deficiency?

Answer 6

MPO def

Question 7

With Niacin administration, medications for what comorbidities need to be adjusted?

Answer 7

Anti-HTN: need to decrease (compounding vasodilatory effects)
DM: need to increase (Niacin increases insulin resistance)
Gout: need to be careful (Niacin increases uricemia)

Question 8

Which glomerular arteriole is constricted by Angiotensin II?

Answer 8

Efferent!

Question 9

After how long is ischemic myocardial damage no longer reversible?

Answer 9

Over 30 min

Question 10

What makes tPA a clot-specific thrombolytic?

Answer 10

Only binds plasminogen in the presence of fibrin

Question 11

What 3 antithrombotic agents bind to plasminogen?

Answer 11

tPA, streptokinase, urokinase

Question 12

Scopolamine MOA? Use?

Answer 12

Muscarinic antagonist (ie in the gut)

Question 13

What part of the spinal cord is most affected by tabes dorsalis?

Answer 13

Dorsal roots and dorsal columns

Question 14

What is a late stage urinary sx of BPH?

Answer 14

Overflow incontinence

Question 15

What disease can cause glomerular sclerosis and hyalinosis?

Answer 15

Diabetic nephrosclerosis

Question 16

What effect does cAMP have on platelet aggregation?

Answer 16

Decrease

Question 17

What agents increase platelet cAMP? How?

Answer 17

Dipyridamole and Cilostazol increase platelet cAMP (decreasing aggregation) by decreasing phosphodiesterase (which breaks down cAMP)

Question 18

Which platelet phosphodiesterase inhibitor is also a direct arterial vasodilator?

Answer 18

Cilostazol

Question 19

When is argatroban used?

Answer 19

Treatment of heparin-induced thrombocytopenia. It is a direct thrombin inhibitor

Question 20

What cells mediate the formation of noncaseating granulomas in Crohns disease?

Answer 20

Th1

Question 21

For what cases of C. diff would you use each of the following: metronidazole, vancomycin, fidaxomicin?

Answer 21

Metronidazole: mild/moderate cases
Vancomycin: severe cases
Fidaxomicin: recurring cases

Question 22

What is the clinical presentation of Polycythemia Vera?

Answer 22

Peptic ulceration (altered blood viscosity)
Itching (histamine release)
Gouty arthritis (increased cell turnover)
Moderate, reversible HTN (expanded blood volume)

Question 23

What signaling pathway mediates Polycythemia Vera?

Answer 23

Mutation in JAK2 (non-receptor tyrosine kinase associated with EPO receptor), causing constant phosphorylation of STAT

Question 24

What lymphoma is mediated by constitutive expression of a transcription factor?

Answer 24

Burkitt lymphoma (c-myc overexpression)

Question 25

What type of tyrosine kinase is JAK2?

Answer 25

Non-receptor associated, linked to various myeloproliferative disorders (PV, essential thrombocythemia, primary myelofibrosis)

Question 26

In which organs do Fluorinated anesthetics increase or decrease blood flow?

Answer 26

Increase: cerebral Decrease: renal, hepatic

Question 27

What monoclonal antibody is used in NHL against CD20?

Answer 27

Rituximab

Question 28

What monoclonal ab to TNF-alpha is used in RA?

Answer 28

Infliximab (also used for ankylosing spondylitis and fistulizing Crohn's disease)

Question 29

How does imatinib treat CML?

Answer 29

Inhibitor of BCR-ABL tyrosine kinase

Question 30

"Ground glass" cytoplasm is seen in what thyroid pathology?

Answer 30

Papillary carcinoma

Question 31

What thyroid pathology is seen in MEN 2A and 2B?

Answer 31

Medullary thyroid cancer

Question 32

In which glycogen storage disease do you see glycogen accumulation in lysosomal vacuoles?

Answer 32

Pompe disease, alpha-glucosidase

Question 33

Which glycogen storage disease do you NOT see muscle involvement?

Answer 33

Von Gierke disease, glucose 6 phosphatase deficiency

Question 34

What is the process of collagen synthesis?

Answer 34

In the ER: 1. Signal sequence is removed 2. Hyroxylation of proline and lysine (vit C dependent) 3. Glycosylation of hydroxylysine 4. Triple helix formation and secretion Extracellular: 1. Procollagen peptidases cleave into tropocollagen 2. Covalent crosslinking by lysyl oxidase

Question 35

What is the most likely cause of death due to rheumatic fever?

Answer 35

Severe myocarditis (causing cardiac dilation, MR, and HF)

Question 36

At how many weeks gestation do lecithin levels start to rise?

Answer 36

32-33 weeks

Question 37

What stimulates lung maturation?

Answer 37

Cortisol

Question 38

How do oxytocin levels change during pregnancy?

Answer 38

They don't. Oxytocin RECEPTORS increase in the myometrium later in pregnancy

Question 39

End state chronic liver disease is characterized by what histology?

Answer 39

Cirrhosis: diffuse fibrosis with replace of normal lobular architecture by fibrous lined regenerative parenchymal nodules

Question 40

In what hepatic pathology do you see dilation of sinusoids and perivenular hemorrhage?

Answer 40

Budd Chiari syndrome

Question 41

In what hepatic pathology do you see granulomatous destruction of bile ducts?

Answer 41

Primary biliary cirrhosis

Question 42

In what gender do you see PBC?

Answer 42

Women

Question 43

How is Ras protein activated?

Answer 43

Binding to GTP

Question 44

What does MAPK do?

Answer 44

Nuclear transcription factor