4/3 - UW 42

Question 1

What is congenital torticolis?

Answer 1

SCM injury and fibrosis by 2-4 weeks of age, due to either in utero malpositioning (from macrosomia or oligohydramnios) or birth trauma

Question 2

What maternal pathology can cause asymmetric intrauterine growth restriction (normal head size, reduced abd circ)?

Answer 2

Maternal HTN

Question 3

What molecules act by tyrosine kinase activating receptors?

Answer 3

Insulin
Growth factors (EGF, TGF-b, VEGF)

Question 4

What is the host defense reaction against mycobacteria?

Answer 4

Mycobacteria are intra-macrophage; Macrophages release IL-12, stimulating Th1 and NK cells to release IFN-y, which activates JAK-STAT in the macrophage

Question 5

What mediates chronic renal allograft rejection?

Answer 5

Low grade cellular and humoral immune responses against alloantigens

Question 6

Poor intestinal absorption of cystine suggests what other pathology?

Answer 6

Cystine excretion in feces and urine (along with ornithine, lysine, and arginine; all dibasic AAs).

Question 7

What AA insolubility causes kidney stones?

Answer 7

Cystine

Question 8

Which catecholamine is primarily produced in the adrenals?

Answer 8

Epinephrine

Question 9

What is another name for dihydroxyphenylalanine?

Answer 9

Dopa, produced by tyrosine hydroxylase

Question 10

What enzyme converts dopa to dopamine?

Answer 10

Dopa decarboxylase

Question 11

What enzyme converts dopamine to NE?

Answer 11

dopamine beta-hydroxylase

Question 12

What enzyme converts NE to epinephrine?

Answer 12

PNMT

Question 13

What hormone increases PNMT expression?

Answer 13

Cortisol (which is very high in the venous drainage of adrenal cortex, which travels through adrenal medulla to stimulate Epi synthesis)

Question 14

What disease is the result of valine substituting for glutamic acid?

Answer 14

Sickle cell, at 6th codon of beta globulin

Question 15

What disease is the result of a phenylalanine deletion (deltaF508)?

Answer 15

CF

Question 16

What mediates phase 4 in cardiac pacemaker cells?

Answer 16

Na channels, but then Ca channels towards the end, which is how CCB can slow heart rate

Question 17

What intracellular and extracellular K levels are seen in DKA?

Answer 17

Intracellular: decreased
Extracellular: increased

Question 18

How does insulin affect K movement?

Answer 18

Insulin causes cellular uptake of K

Question 19

How does estrogen affect thyroid hormone levels?

Answer 19

Increases in total T4, with normal thyroid function

Question 20

Why does total T4 increase with estrogen?

Answer 20

Estrogen decreases catabolism of TBG

Question 21

What therapy would reduce recurrence of genital herpes?

Answer 21

Daily oral “-cyclovir”

Question 22

What do you give lamivudine for?

Answer 22

HIV, NRTI

Question 23

What are probenecid and allopurinol used for?

Answer 23

CHRONIC FUCKING GOUT YOU MOTHERFUCKER

Question 24

What you do you give for ACUTE gout???

Answer 24

NSAIDs or COLCHICINE

Question 25

Colchincine MOA?

Answer 25

Binds intracellular protein tubulin, preventing polymerization into microtubules, impairing leukocyte migration and phagocytosis, reducing inflammation in gouty arthritis.

Question 26

What gout medication causes diarrhea?

Answer 26

Colchicine

Question 27

Why don't you give probenecid or allopurinol for acute gout?

Answer 27

They can precipitate release of stored uric acid

Question 28

What hepatitis virus is HEV similar to?

Answer 28

HAV (unenveloped, ssRNA, fecal-oral)

Question 29

Damage to what part of the spinal cord mediates the muscular effects of poliovirus?

Answer 29

Damage to anterior horn lower motor neuron cell bodies

Question 30

What can actinic keratoses progress to?

Answer 30

Squamous cell carcinoma

Question 31

RUQ pain after mu opioid use indicates what?

Answer 31

Biliary colic due to contraction of smooth muscle cells in the sphincter of Oddi

Question 32

What is the opioid of choice for biliary and pancreatic pain?

Answer 32

Meperidine, due to less constriction of sphincter of Oddi

Question 33

Where are mu opioid metabolized?

Answer 33

Liver

Question 34

How do mu opioids mediate vasodilation?

Answer 34

Histamine release, also causing itching

Question 35

What bowel symptoms do mu opioids usually cause?

Answer 35

Constimpation by slowing gut motility

Question 36

What is mu opioid effect on parietal cells?

Answer 36

Decrease acid secretion

Question 37

What symptom can you see with combined aminoglycosides and loop diuretics?

Answer 37

Ototoxicity

Question 38

What are 1st gen antihistamines?

Answer 38

Hydroxyzin, promethazine, chlorpheniramine, diphenhydramine

Question 39

What are the major side effects of 1st gen antihistamines?

Answer 39

Anti-muscarinic, -serotonergic (appetite stimulation), -alpha adrenergic (postural dizziness), can cross BBB (sedation, cognitive deficits)

Question 40

What generation antihistamine is fexofenadine?

Answer 40

Second (less antimuscarinic, antiserotonergic, antialpha adrenergic properties)

Question 41

What type of anterior mediastinal mass do patients with Myasthenia Gravis present with?

Answer 41

Thymoma or Thymic hyperplasia

Question 42

What structures are derived from the 3rd pharyngeal pouch?

Answer 42

Thymus | Inferior parathyroid glands

Question 43

What is the purpose of Edrophonium (Tensilon test) in myasthenia gravis?

Answer 43

A short acting AChE-I that can test if more AChE-I is needed normally

Question 44

What are the most common side effects of verapamil?

Answer 44

Constipation and gingival hyperplasia (more rarely: bradycardia, heart block)

Question 45

What is VHL?

Answer 45

AD mutation on chromosome 3 characterized by: - capillary hemagioblastomas in retina/cerebellum - congenital cysts/neoplasms in kidney, liver, pancreas

Question 46

What is Von Recklinghausen's disease?

Answer 46

NF-1: PERIPHERAL nervous system tumors (neurofibromas, optic nerve gliomas, Lisch nodules in the iris, cafe au lait spots)

Question 47

What is NF-2?

Answer 47

AD, CENTRAL nervous system tumors: bilateral CN VIII schwannomas, multiple meningiomas

Question 48

What is tuberous sclerosis?

Answer 48

AD, CNS hamartomas, kidney/liver/pancreatic cysts, cutaneous angiofibromas. SEIZURES!

Question 49

What is Osler-Weber-Rendu syndrome?

Answer 49

Hereditary hemorrhagic telangiectasia, AD, rupture of telangiectasias may cause epistaxis, GI bleeding, or hematuria

Question 50

What is the skin lesion in tertiary syphilis called?

Answer 50

Gumma

Question 51

What stage of syphilis has a chancre?

Answer 51

Primary