4/18/19 Flashcards
1
Q
amniotic fluid high in AFP and/or acetylcholinesterase
A
failure of fusion of neural tube
2
Q
Failure for rostral neuropore fusion
A
anencephaly
3
Q
Failure of caudal neuropore fusion
A
spina bifida
4
Q
Colitis-associated colorectal cancer tumors are
A
multifocal, flat lesions
more aggressive
more likely to have high histopathological grade
younger patients
5
Q
sporadic colorectal cancer tumors are
A
singular, polypoid
6
Q
Complement binding site for IgG and IgM for C1
A
Fc portion of the heavy chain closer to the hinge region
7
Q
solitary, painless ulcer
A
primary syphilis
8
Q
painless progressive red serpiginous ulcerative lesions without LAD, biopsy shows donovan bodies
A
granuloma inguinal by klebsiella granulomatous
9
Q
deep, purulent, painful ulcers w/matted/supurative lypmhadenitis
A
H. ducreyi
chancroid
10
Q
multiple painful superficial vesicles or ulcerations with erythematous base
A
HSV
11
Q
What slows the progression of hemochromatosis in women
A
physiology iron loss from menstruation and pregnancy
12
Q
Klinefelter syndrome labs
A
Increased LH and FSH
decreased testosterone
no sperm
13
Q
Mutation in GNAS gene
constant G protein activation
Hormone overproduction
A
McCune-Albright
14
Q
Symptoms of McCune Albright
A
peripheral precocious puberty
irregular cafe-au-lait spots
polyostotic fibrous dysplasia (multiple osteolytic lesions in hip and pelvis)
15
Q
complications of McCune Alright
A
Thyrotoxicosis
Acromegaly
Cushing syndrome
16
Q
Beta thalassemia is a defect in
A
transcription, processing, translation of beta-globing mRNA
17
Q
Disorders in heme synthesis are
A
porphyrias
18
Q
Treatment for BPH that also decreases prostate volume
A
Finasteride
5-alpha-reductase inhibitor
19
Q
Griseofulvin effects
A
fungal mitosis
20
Q
Flucytosine effects
A
fungal DNA and RNA synthesis
21
Q
Capsofungin effects
A
fungal cell wall
22
Q
Amphotericin B, nystatin bind
A
ergosterol in fungal cell membrane
23
Q
azoles inhibit synthesis of
A
ergosterol in fungal cell membrane
24
Q
Made from remnants of Rathke’s pouch (anterior pituitary)
A
craniopharyngioma
25
Supersellar tumor in children composed of calcified cysts containing cholesterol crystals
craniopharyngioma
26
Treatment for carcinoid syndrome
Octreotide
| synthetic analog of somatostatin with longer half life
27
MC complication of fibrinolytic therapy for acute MI
intracerebral hemorrhage
| why PCI is preferred
28
Cortisol levels show no change (continues to be elevated) with high dose dexamethasone suppression test
ectopic ACTH secretion
| adrenal adenoma/carcinoma
29
Cortisol levels decrease with high dose dexamethasone suppression test
pituitary adenoma
30
Decreased transverse tubules in muscle fibers
causes uncoordinated contraction of myofibrils within affected muscle fibers
31
lipids absorbed in small intestine cannot go to blood and accumulate in intestinal epithelium resulting in enterocytes w/clear or foamy cytoplasm
Abetalipoproteinemia
32
Procalcitonin rises with
bacterial toxins
33
Procalcitonin decreases with
viral infections
34
Positive acute phase reactants
| rise in acute inflammatory states
```
fibrinogen
CRP
ferritin
hepcidin
ceruloplasmin
haptoglobin
VWf
complement
```
35
Negative acute phase reactants
| fall in acute inflammatory states
albumin
transferrin
transthyretin (prealbumin)
36
Primary Tb infection affects
Ghon complex
| lower lobe and ipsilateral hilar lymph node
37
Secondary Tb infection affects
If walls of the granuloma weaken, M. tuberculosis can escape bronchogenically and cause reactivation secondary disease
apical cavitary lesions
MC in immunosuppression
38
Miliary tuberculosis
hematogenous dissemination of bacteria to multiple organs like liver
39
Antioxidant enzymes
superoxide dismutase
glutathione peroxidase
catalase
convert ROS to water and oxygen
40
Bruises change from blue to green by
Heme oxygenase in macrophages
| heme into biliverdin, CO, and ferrous iron
41
Bruises change from green to yellow by
biliverdin reductase (reducer)
biliverdin to bilirubin
bilirubin in transferred to liver bound to albumin
42
Obstructed right brachiocephalic (innominate) vein
possibly from apical lung tumor
redness and edema on one side of the face
engorgement of subcutaneous veins
43
Meningioma histology
whorled pattern of cell growth that forms nests
| may calcify into round eosinophilic laminar structures (psammoma bodies)
44
Ebstein anomaly associated with what drug
lithium
45
Nightmares occur during
REM
muscle paralysis
final third of the night
46
Gerstmann syndrome
Agraphia
Acalculia
Finger agnosia
left-right disorientation
47
What is affected in Gerstmann syndrome
acute ischemic stroke to angular gyrus of dominant parietal lobe
supplied by middle cerebral artery
48
Sterile platelet rich thrombi on mitral valves
nonbacterial thrombotic endocarditis (marantic)
| underlying hyper coagulable state
49
nonbacterial thrombotic endocarditis is associated with
```
advanced malignancy esp. mutinous adenocarcinoma
SLE (Libmann-sacks endocarditis)
antiphospholipid syndrome
DIC
extensive burns
```
50
Myocardial stretch stimulates release of
ANP and BNP
51
ANP and BNP are broken down by
neprilysin (metalloprotease)
52
Sacubitril is used for
chronic heart failure
neprilysin inhibitor
enhances ANP and BNP effects
53
ANP and BNP MOA
activate guanylate cyclase
form cGMP
stimulates diuresis and peripheral vasodilation
54
interferon alpha is made by
leukocytes
antiviral
anti-tumor activity
55
cachexia is caused by
TNF-alpha
suppressing appetite
increasing basal metabolic rate
56
Transient hemolytic anemia from M. pneumoniae resolves as
IgM antibody titers decline (6-8 weeks)
| fading immune response against bacteria
57
Haemophilus needs both
X factor hematin
| V factor NAD+
58
Standard HF treatment that improve survival
ACE inhibitors
Beta blocker
mineralocorticoid receptor antagonist
59
Brain area associated with emotion and personality
orbitofrontal cortex
60
Kluver-Bucy syndrome
```
behavioral changes
apathy
hyperorality
hyper sexuality
visual agnosia
temporal cortex injury
```
61
Cromolyn and nedocromil are
mast cell stabilizing agents
| inhibit mast cell degranulation
62
36 yo female with arthalgias and nodules on her legs
| bilateral hilar adenopathy
Sarcoidosis
63
biopsy of sarcoidosis
noncaseating granulomas that stain negative for fungi and acid fast bacilli
64
Rheumatoid factor is
- antibody (typically IgM) specific for Fc compartment of IgG
- binds IgG and ACPAs
- forms immune complexes that deposit of synovium and cartilage
65
Anorexic girl with no periods, her labs show
decreased LH and FSH
| decreased estradiol
66
HPV likes to affect what kind of epithelium
stratified squamous
true vocal cords
cervix
anus
67
migratory thrombophlebitis should raise suspicion of
visceral cancer
pancreas, colon, lung
"Trosseau sign"
68
S3/S4 is best heard at
the apex in LL decubitus at end expiration
69
S3/S4 has decreased intensity with
valsalva
| decreases preload
70
MCC of transtentorial herniation
hemorrhage
| brain tumor
71
first sign of uncle herniation
fixed and dilated pupil on side of the lesion
72
presentation of uncle herniation may be
- ipsilateral paralysis of CN III muscles
- contralateral or ipsilateral hemiparesis
- contralateral homonymous hemianopsia with macula sparing
73
Dog bite
| mouse like odor
pasteurella multocida
| tx with augmentin
74
depolarizing (succinylcholine) anesthetic will have what kind of TOF stimulation
phase I: constant but diminished
| phase II: fade (seen in prolonged exposure to succinylcholine or abnormal plasma cholinesterase activity)
75
non depolarizing (vecouronium) anesthetic will have what kind of TOF stimulation
Fade throughout
76
Birth control pills work by
decreasing serum gonadotropin levels
decreased GnRH in hypothalamus
decreased FSH and LH in anterior pituitary
inhibits ovulation
77
Progestin only pills cause
impairment of embryo implantation by thinning uterine lining
78
Progestin only and IUD levonorgestrel prevent pregnancy by
thickening cervical mucus
prevents sperm from accessing uterus
continue to have periods
79
Clomiphene MOA
selective estrogen receptor modulator
stimulates FSH and LH production
stimulation of follicle development in ovaries
80
copper IUD works by
creating intrauterine environment that is toxic to sperm
81
hyperprolactinemia treated with
dopamine agonists
bromocriptine
cabergoline
decreases prolactin secretion by binding DA receptors
82
Treatment for coagulase negative staph should initially include
vancomycin
83
Bilateral pitting LE edema, flank mass, and tortuous abdominal veins is concerning for
IVC obstruction by renal cell carcinoma with extension to IVC
84
Classic triad of RCC
flank pain, palpable mass, hematuria
85
Common paraneoplastic syndrome with RCC
erythrocytosis
| hypercalcemia from PTH-rp
86
CREST syndrome stands for
```
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias
```
87
Antibodies against what is found in CREST
Anti-centromere
| Anti-DNA topoisomerase (scl-70) highly specific for systemic sclerosis (diffuse scleroderma)
88
Anti-dsDNA is specific for
SLE
89
Anti-histone Abs are found in
```
drug induced lupus
procainamide
hydralazine
isoniazid
D-penicillamine
```
90
Anti-Ro/SSA and anti-La/SSB are found in
Sjogren's
91
Sjogren's disease is associated with
non-Hodgkin lymphomas
92
Beurger disease (thromboangiitis obliterates) is characterized by
segmental vasculitis extending into contiguous veins and nerves
93
histology for Beurger disease
- highly cellular inflammatory intraluminal thrombi with neutrophils and multinucleate giant cells in arteries and veins
- sparing of vessel wall and internal elastic lamina
94
Karyotype of partial mole
69 XXX or XXY
| maternal or paterna DNA
95
Karyotype of complete mole
46 XX or XY
| paternal DNA only
96
immunochemistry of partial mole
p57 positive
97
immunochemistry of complete mole
p57 negative
