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Flashcards in 4/6&7 overall review Deck (127)
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1
Q

What is underlying pathophys of ARDS?

-what will CXR look like?

A

Damage to endothelial cells lining the pulm caps.

  • results in leakage of fluids into alveoli.
  • CXR will show “white out” of the lungs.
2
Q

Alveolar wall destruction

-which disease?

A

emphysema

3
Q

aneurysmal dilations

-usually have absent what?

A

internal elastic lamina.

4
Q

Cardiac tissue conduction velocity

  • order?
  • mnemonic:
A

Park At Ventura Ave.

  • purkinje system = fastest
  • atrial muscle
  • ventricular muscle
  • AV node = slowest
5
Q

Which chamber are SA and AV node located?

A

RA

6
Q

Conduction speed of atrial muscle vs ventricular muscle.

-which one faster?

A

atrial muscle faster than ventricular muscle.

7
Q

Paget disease of bone

-most often associated w/which bone tumor?

A

osteosarcoma.

8
Q

Age distribution in osteosarcoma?

A

bimodal.

9
Q

radiological findings in osteosarcoma:

A
  • areas of mixed lysis & sclerosis = radioopaque & radiolucent areas.
  • periosteal elevation.
  • reactive new bone formation.
  • lifting of cortex.
10
Q

Osteophytes

-RA or osteoarthritis?

A

osteoarthritis

11
Q

Trabecular bone

  • aka?
  • damaged preferentially in which disease?
A
  • spongy, cancellous.

- osteoporosis.

12
Q

globus hystericus

-what is it?

A

“lump in your throat”.

13
Q

karyorrhexis

-what is it?

A

nuclear fragmentation - part of apoptosis.

-get 180 bp fragments.

14
Q

Blurred vision: think what mechanism?

A

-think a ciliary muscle/lens issue, NOT a pupillary size issue!

15
Q

Pleiotropy

A

Impact a single gene has on multiple phenotypes.

16
Q

tumor cell w/round nuclei and prominent lipid vacuoles.

A

Burkitt lymphoma

17
Q

t(12;21): which disease?

A

ALL

-better prognosis.

18
Q

IL-1 primarily released by which cell?

A

macros

19
Q

TNF-alpha primarily released by which cell?

A

macros

20
Q

GM-CSF

-stim prod of which cells?

A

granulocytes + monocytes

21
Q

What can cause dissociation of cadherins?

A

Removing Ca from extracellular fluid. Leads to loss of cell-to-cell adhesion.
-Cadherin intercellular interactions are Ca dependent.

22
Q

In post & ant dislocations of knee (so ACL/PCL injuries), which nerve or vessel is most likely to be injured?

A

Popliteal artery

  • tibial n. in similar location but not as susceptible to this type of injury like pop. artery is.
  • popliteal vein same location but superficial to artery. Also not as likely to be injured in this kind of injury.
23
Q

Psych: reflection is most similar to what other technique?

A

summarization

24
Q

Psych: facilitation

-what is it?

A

Encouraging the pt to talk more: “tell me how your drinking increased”.

25
Q

What changes does cocaine cause to your nose area?

A
  • atrophic nasal mucosa.
  • chronic nasal discharge.
  • thinning of nasal septum.
  • oropharyngeal ulcers.
26
Q

Hay fever

-what is it?

A

Seasonal form of allergic rhinitis.

-provoked by pollen from plants.

27
Q

Which cell = primary player in asthma?

A

mast cell.

28
Q

Long thoracic nerve

-which nerve roots?

A

C5-C7

29
Q

Is there bicarb in sweat?

A

not really.

30
Q

PTSD

  • by definition how long has it been going on?
  • what do you call it if it hasn’t been going on that long?
A

PTSD > 1 month.

< 1 month (but > 3 days) = acute stress disorder.

31
Q

Schizo Sxs < 1 mo: whats it called?

A

brief psychotic episode

32
Q

Number needed to treat: equation?

A

1/ARR

  • ARR = absolute risk reduction.
  • so if 40% survived w/Tx, and 20% survived w/o Tx. Then ARR = 40-20 = 20%.
  • 1/ARR = 1/.2 = 5.
33
Q

Viral cause of kluber bucy?

-explain:

A

HSV-1 encephalitis causes damage to temporal lobe.

  • amygdala is in temporal lobe.
  • damage to amydala => kluver bucy.
34
Q

Acute intermittent porphyria

  • what builds up?
  • inheritance pattern?
A
  • porphobilinogen.

- auto-dom.

35
Q

Porphyria cutanea tarda

-what builds up?

A

uroporphyrinogen 3.

36
Q

trinucleotide repeat diseases

-all cause Sxs in which system?

A

CNS

37
Q

Is penetrance an all or nothing thing?

A

ya

38
Q

genetic heterogeneity

-define:

A

mutations at diff genes cause same phenotype.

39
Q

In adults, S3 usually heard in setting of what heart problem?

A

Heart failure - either systolic or diastolic.

40
Q

Transudate vs Exudate:

-pleural fluid LDH/serum LDH: > .6

A

Exudate.

*transudates dont have LDH in them.

41
Q

Osmotic fragility test: (+)

-which disease?

A

Hereditary spherocytosis

*pathognomonic.

42
Q

Target cells:

  • seen in which diseases?
  • mnemonic:
A

HALT said the hunger to his target:

  • HbC disease
  • Asplenia
  • Liver disease
  • Thalassemia
43
Q

Diabetic neuropathy of DM:

-symmetrical/bilateral?

A

yes, symmetrical.

44
Q

There will be a question where you have to differentiate LEMS vs MG:

  • Associated w/which organ?
  • Which one is more common?
  • Which one more commonly presents w/eye weakness?
  • Which one gets better w/more activity?
A
  • MG = thymoma. LEMS = small cell lung cancer.
  • MG = much more common.
  • MG = more likely to get diplopia.
  • LEMS = better w/increased use.
45
Q

RB gene

  • which chrom?
  • can lead to which tumors?
A
  • 13

- retinoblastomas, osteosarcomas.

46
Q

Neisseria

-gram +/-?

A

gram (-)

47
Q

DiGeorge: pouch or arch?

-mnemonic?

A

Pouch.

-George Foreman “punches”.

48
Q

serum sodium levels in DKA?

A

hyponatremia

-Dilutional hyponatremia. Water shifted from intra to extracellular compartments due to the hyperosmolarity.

49
Q

spina bifida cystica

-aka?

A

myelomeningocele.

50
Q

androgen insensitivity

-why do they develop breasts?

A

free testosterone aromatized to estrogen.

  • develop breasts.
  • there is inc. LH & testosterone (& therefore Estrogen) bc LH has no neg. feedback bc test. receptors in hypoT insensitive as well.
51
Q

Intraventricular hemorrhage:

-happens in which pt population?

A
  • Low birth weight babies (< 32 weeks).

* most often occurs in the germinal matrix.

52
Q

How are transmembrane proteins anchored inside the cytoplasm?

A

palmitoylation.

53
Q

Nitroglycerin:

-effect on HR?

A

reflex tachy.

-so give it w/a beta blocker.

54
Q

pseudohypoparathyroidism

  • inheritance pattern?
  • Sxs:
A
  • auto-dom.

- short stature, hypocalcemia, short 4th & 5th digit, PTH resistance.

55
Q

Allelic heterogeneity

  • define:
  • example:
A

Different mutations in the same genetic locus cause similar phenotypes.
-ie. Duchenne MD vs Becker. Same gene, different mutation, similar phenotype.

  • dont confuse w/genetic heterogeneity where mutations in different genes can cause similar phenotypes.
  • dont confuse w/phenotypic heterogeneity where mutations in the same gene can result in different phenotypes.
56
Q

lysyl oxidase

  • whats it do?
  • cofactor?
  • which disease results in dec. absorption/transport of this cofactor?
A
  • cross links collagen in extracellular space.
  • copper
  • Menke’s disease
57
Q

polydactyly

-think what disease?

A

Patau

-P & P.

58
Q

In what situation would a legit female have serum karyotyping w/XY?

A

She gone bone marrow transplant from a male donor!

*her peripheral blood cells will have XY, but rest of her tissues will obviously still have her own XX.

59
Q

Signal sequences for SRP to take halt translation & take ribo+polypep to protein pore in RER:
-what type of AAs in that signal sequence?

A

hydrophobic.

60
Q

Do sebaceous glands have sym inn?

A

No.

61
Q

Safranin O

-stains what red?

A

Cartilage, mast cell granules, & mucin.

62
Q

H.pylori quadruple therapy:

A

PPI, bismuth subsalicylate, tetracycline, metronidazole.

63
Q

Red man syndrome of vanc.

  • mechanism?
  • IgE mediated?
  • prevention?
A
  • Rapid infusion of vanc causes histamine release.
  • Not IgE mediated!
  • Slow infusion rate + pre-treatment w/anti-histamine.
64
Q

leiomyoma

  • Sxs:
  • whos the pt?
A
  • menorrhagia, miscarriage, palpable mass in lower abdomen, passing clots occasionally.
  • black woman in her 30s or 40s (pre-menopausal).
65
Q

Why are chlamydia resistant to penicillins?

A

1) They’re intracellular.

2) They dont have cell wall. They have disulfide bonds in their outer membrane that give them stability instead.

66
Q

Glitazones

  • mech:
  • tox:
A
  • PPAR receptor agonist, inc. insulin receptor sensitivity.
  • weight gain, edema, hepatotox, HEART FAILURE.

*PPAR receptor agonist = for instance, one action of that gene is to inc. GLUT4 receptors on adipocytes.

67
Q

Biguanides: metformin

  • mech:
  • tox:
A
  • dec gluconeo, inc. glycolysis, inc. peripheral insulin sensitivity.
  • lactic acidosis, mild inc. in LFTs, GI upset.
68
Q

Glyburide

  • what is it?
  • whats it do?
A
  • Sulfonylurea.
  • Closes K channel, causes influx of Ca, and release of insulin from pancreas.

*mimics normal action of ATP.

69
Q

Pt shows up to ER w/asthma attack - if she’s treat w/b-2 agonist, how long will it take on that nebulizer to experience significant relief?

A

Could be as long as 15-20 min.

-this shit is not instantaneous!

70
Q

MAP kinase

-what does MAP stand for?

A

Mitogen Activated Protein kinase.

71
Q

woven bone vs lamellar bone

-which one is immature/pathologic?

A

woven is either immature or pathologic bone.

72
Q

Only enveloped virus who gets its envelope from nuclear envelope?

A

herpesvirus

73
Q

Only DNA virus that does NOT replicate in the nucleus:

A

poxvirus

74
Q

Papovirus

-what is it?

A

Includes papillomaviridae & polyomaviridae.

75
Q

Lichen Planus

-associated w/which virus?

A

hepC.

76
Q

Duchenne

-what type of mutation?

A

frameshift

77
Q

Ego defense: intellectualization

  • mature or immature?
  • what is it?
A
  • immature.

- man intellectualizing his cancer Dx by researching it extensively & talking about it in a detached fashion.

78
Q

G6PD def.

-why do you get back pain?

A

Hb in urine = nephrotoxic.

-back pain is from kidney pain.

79
Q

Names some unmyelniated nerves:

A
  • afferent for olfaction, heat, slow pain.

- post-ganglionic autonomic neurons.

80
Q

What can cause a marfanoid body habitus?

A
  • Marfans.
  • Homocystinuria.
  • Men 2B.
81
Q

genetic heterogeneity vs allelic heterogeneity.

-which one deals w/1 gene and which one deals w/2 genes?

A

genetic heterogeneity = deals w/2 or more genes.

-allelic deals w/1 gene.

82
Q

Aerobic respiration: how many max ATP?

Anaerobic: how many max ATP?

A
  • 38

- 2

83
Q

leukoplakia

-occurs on what type of tissue?

A

Only occurs on mucosal surfaces!

84
Q

Reactive arthritis

-what does this include?

A
  • conjunctivitis/uveitis.
  • urethritis.
  • arthritis.
85
Q

Callus

  • inc. thickness of which layer of skin?
  • whats the medical term for this?
  • what other disease shows this?
A
  • stratum corneum.
  • hyperkaratosis.
  • psoriasis.
86
Q

Whats the regulatory protein that dictates the differentiation of a progenitor cell into a more specializes cell?
-growth factor? txn factor?

A
  • transcription factor.

* growth factors usually regulate synthesis of txn factors, but the answer here is txn factors.

87
Q

Peutz-Jegher syndrome

-inheritance:

A

auto-dom.

88
Q

Can you refer to warfarin as a vitamin-k antagonist?

A

yes

89
Q

Someone given a mechanical valve, which med do you give them to prevent clot formation. Life-long med.

A

warfarin.

-NSAIDs wont cut it alone. You can add a daily low-dose aspirin though which will be useful.

90
Q

Which Ig types are made w/o any class switching?

A

IgM & IgD.

91
Q

CD40 receptor

-is receptor on B cell or T cell?

A

B cell.

92
Q

H__ is the only histone not in the nucleosome core.

A

H1

93
Q

Most prevalent lysosomal storage disease:

A

Gaucher disease.

94
Q

What % occlusion of coronary for stable angina?

-how does it progress to unstable?

A
  • 75%

- Thrombus formation w/incomplete coronary occlusion = unstable angina. Someone w/unstable angina needs to be admitted.

95
Q

COX-1 or COX-2

-aspirin blockage of this inhibits platelet aggregation:

A

COX-1

96
Q

TXA2 production: dep on COX-1 or COX-2?

A

COX-1

97
Q

focal segmental glomerulosclerosis

  • nephrotic or nephritic?
  • mnemonic?
A
  • nephrotic.

- focal focal sounds like fuck. HIV pts are fucked and fucking got them their HIV.

98
Q
Berger disease (IgA nephropathy)
-nephrotic or nephritic?
A

nephritic

99
Q

Asthma exacerbation:

-What will CXR show?

A

CXR is typically normal.

100
Q

Spont. pneumothorax

-trachea deviates toward or away from lesion?

A

toward.

101
Q

Tension pneumothorax

-trachea deviates toward or away from lesion?

A

away.

102
Q

nephrogenic DI

-Tx:

A

hydrochlorothiazide, indomethacin, amiloride.

103
Q

Ethylene glycol

-how does it result in kidney stones?

A

Its converted to oxalate.

104
Q

Serum anion gap:

  • equation?
  • whats normal?
A
  • anion gap = (Na) - (Cl + HCO3)

- normal = 10-14

105
Q

Ethylene glycol poisoning

-presentation:

A
  • anion gap metabolic acidosis
  • gross hematuria, flank pain, oliguria.
  • its toxic metabolite causes ATN.
106
Q

How does Iron OD cause inc. anion gap metabolic acidosis?

A

Iron OD => ox. phos. uncoupler (like salicylates) => lactic acidosis => inc. anion gap metabolic acidosis.

107
Q

PCR:

-what happens during cooling (2nd step, after heating)?

A

Primers bind.

*important to know that the primers are added in excess.

108
Q

Coronal image

-which side is the patients right side?

A

left side of image.

-just like if a pt was lying down.

109
Q

URI: which sinuses are most commonly affected?

-why?

A

maxillary sinuses
-bc their path of drainage is located superior to the floor of the sinus. Thus, gravity does not favor drainage of these sinuses.

110
Q

MCA territory infarct

  • what sort of visual defect?
  • why?
A
  • homonymous hemianopsia.

- can damage optic radiations.

111
Q

Central scotoma

-can it be caused by a vessel occlusion?

A

Not usually bc macula has more than 1 blood supply.

-usually due to macular degeneration or optic neuritis.

112
Q

Virchow node

-which node?

A

left supraclavicular.

*you know its left bc thoracic duct drains into it.

113
Q

Sarcomere: what are its borders:

  • extends from ______ to _______.
  • whats attached to these borders?
A

Z line to Z line.

-actin.

114
Q

Sarcomere electron micrograph

-whats the darkest portion called? perpendicular to actin/myosin.

A

Z line.

-where actin attaches.

115
Q

Z-lines

-what overlies the Z-lines?

A

T tubules & terminal cisternae of SR overlie the Z lines and I bands.

116
Q

Which band doesn’t change length during muscle contraction?

A

A-band.

117
Q

white patches on gingival and oral mucosa

-what is it?

A

oral thrush most probably.

118
Q

Acute leukemia

-how can the thrombocytopenia present?

A

Bleeding complications like

  • petechiae
  • gingival bleeding
  • retinal hemorrhages
119
Q

Acute leukemia

-how can the leukopenia present?

A

Opportunistic infections

  • candida (oral thrush).
  • aspergillosis
  • bacterial pneumonia
  • perirectal infection.
120
Q

What is a prominent virulence factor of aspergillus that allows it to disseminate?

A

Vascular invasion.

121
Q

expansion of red pulp in the spleen

-one common cause?

A

cirrhotic liver leading to hepatosplenomegaly.

-that excess blood backup in the spleen causes expansion of the red pulp sinusoids.

122
Q

Red pulp of spleen

-structure:

A

Blood filled sinuses and cords lined by macrophages.

123
Q

esophageal varice hemorrhage

  • Tx:
  • mechanism?
A

octreotide

-indirectly constricts splanchnic vasculature by inhibiting splanchnic vasodilators (VIP, glucagon).

124
Q

ADP receptor inhibitors

-which is the only one that is a reversible blocker?

A

ticagrelor

125
Q

cutaneous anthrax

-is the black eschar painful or painless?

A

painless

126
Q

A positive ferric chloride test is strongly suggestive of:

A

An aspirin overdose (b/c phenols are used in production of aspirin and this test looks for phenols).

127
Q

Which thyroid carcnioma spreads hematogenously?

A

follicular carcinoma