4/4 - UW 44

Question 1

What type of action tremor commonly improves with a bit of alcohol?

Answer 1

Essential tremor

Question 2

What is the first line treatment for essential tremors?

Answer 2

Propranolol

Question 3

What are 2 things Benztropine is used for? MOA?

Answer 3

BenzTROPINE (like aTROPTINE) is an anticholinergic, for:

• Parkinson tremor
• EPS of neuroleptics (eg haloperidol)

Question 4

Most common use for Haloperidol?

Answer 4

Positive sx of psychosis

Question 5

What benzo is used for treating status epilepticus and anxiety?

Answer 5

Diazepan (Valium)

Question 6

What medications might cause a falsely elevated neutrophil count?

Answer 6

Corticosteroids (due to “demargination” of neutrophils attached to the vascular wall)

Question 7

What IFNs are released by cells in response to viral infection?

Answer 7

Type I IFNs (alpha and beta)

Question 8

What do Type I alpha and beta IFN do?

Answer 8

Suppress viral replication and induce apoptosis of neighboring infected cells

Question 9

Under what circumstances do RNaseL and PKR degrade mRNA and inhibit translation initiation?

Answer 9

In the presence of dsRNA (which only comes from viruses!)

Question 10

What syndrome is characterized by hemolytic anemia, hypercoagulability, and pancytopenia?

Answer 10

Paroxysmal nocturnal hemoglobinuria (PNH, which is neither paroxysmal nor nocturnal)

Question 11

What gene mutation causes PNH?

Answer 11

PIGA mutation within a clonal population of hematopoietic stem cells

Question 12

What syndrome is caused by a mutation affecting the synthesis of GPI anchor?

Answer 12

PNH, with a mutation in the PIGA gene.

Question 13

What type of brain neoplasm is associated with Psammoma bodies?

Answer 13

Meningioma

Question 14

What are 3 examples of neoplasms what for psammoma bodies?

Answer 14

• Meningioma
• Papillary thyroid carcinoma
• Papillary ovarian adenocarcinoma

Question 15

What gives elastin its elasticity?

Answer 15

Un-hydroxylated proline and lysine are able to covalently bond to fibrillin in the extracellular space, forming crosslinks

Question 16

What enveloped viruses acquire the lipid bilayer of the host cell NUCLEAR membrane?

Answer 16

Herpesviruses (including CMV)

Question 17

What type of breast cancer is Comedocarcinoma a subset of?

Answer 17

Ductal carcinoma in situ (DCIS)

Question 18

What breast cancer is seen histologically as solid sheets of pleomorphic, high grade cells with central necrosis?

Answer 18

Comedocarcinoma

Question 19

What glycogen storage disease presents as exercise intolerance, myoglobinuria, and muscle pain with activity?

Answer 19

McArdle’s syndrome (myophosphorylase deficiency: unable to breakdown muscle glycogen to G1P)

Question 20

What congenital defect is suggested by a “differential cyanosis”?

Answer 20

PDA, where the R to L shunt occurs after the L subclavian artery branches off the Aorta.

Question 21

Hepatomegaly and increased LFTs 2d-4w post-op typically indicates what?

Answer 21

Halothane-associated hepatitis

Question 22

What causes microvesicular fatty change? Macro?

Answer 22

Micro: Reye syndrome
Macro: alcohol

Question 23

What enzyme is deficienct in Acute Intermittent Prophyria (AIP)?

Answer 23

Prophobilinogen deaminase deficiency

Question 24

In what disorder do you get reddish urine that darkens on exposure to light and air? Why?

Answer 24

Acute Intermittent Prophyria (AIP), because the PBG substrate (built up from deficiency of PBG deaminase) oxidizes.

Question 25

How to treat Acute Intermittent Porphyria?

Answer 25

Prevent formation of PBG by inhibiting ALAS (upregulated by P450 inducers, downregulated by HEME and GLUCOSE)

Question 26

What is "chloride shift"?

Answer 26

Chloride diffuse INTO RBCs in exchange for bicarb ions that OUT.

Question 27

What is the most prominent ADR of Cisplatin?

Answer 27

Nephrotoxicity (acute tubular injury iwth mild renal insufficiency)

Question 28

How does Cisplatin exert its chemotherapeutic effect?

Answer 28

It is a Platinum-containing compound that forms a reactive oxygen species which forms DNA crosslinks

Question 29

What is amifostine?

Answer 29

A thiol-based cytoprotective free-radical scavenging agent, to prevent nephrotoxicity from platinum-containing agents (like cisplatin)

Question 30

When might you use NAC for renal protection?

Answer 30

Prevent radiocontrast-induced nephropathy from IV contrast CT scans, in patients with renal insufficiency.

Question 31

When might you use Fomepizole?

Answer 31

Methanol or ethylene glycol poisoning (competitive antagonist to alcohol dehydrogenase)

Question 32

What is the most cytokine important mediator of sepsis?

Answer 32

TNF-a

Question 33

Rupture of Charcot-Bouchard aneurysms cause what?

Answer 33

Intracerebral hemorrhage, NOT SAH

Question 34

Which variant of AML is associated with t(15;17)?

Answer 34

M3

Question 35

What gene product is produced by t(15;17)? (Like BCR-ABL is produced by t(9;22)

Answer 35

PML/RARa

Question 36

What is the malfunctioning protein seen in AML?

Answer 36

Retinoic acid receptor alpha

Question 37

Mutations of genes that code for epidermal growth factor (EGF) receptors are associated with what neoplasms?

Answer 37

``` Non-small cell lung carcinoma (erbB1) Breast cancer (erbB2, ie HER2/neu) Some ovarian and gastric tumors ```

Question 38

Defective platelet derived growth factor (PDGF) plays a role in what neoplasm?

Answer 38

Chronic Myelomonocytic Leukemia

Question 39

Aside from retinoblastoma, what other neoplasm does Rb gene play a role in?

Answer 39

Osteosarcoma