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Question 1

risk of myopathy is enhanced when statins taken with….

Answer 1

gemfibrozil- reduces hepatic clearance of statins

also niacin and ezetimibe but to lesser extent

Question 2

pathway of nesseria meningitidus from entry to meninges

Answer 2

inhaled–> nasopharnyx–> blood –> choroid plexus –> meninges

Question 3

when you look at horizontal cut on CT, are you looking at it from above or below

Answer 3

below

Question 4

arteries of less curvature of stomach (top) and greater curvature (bottom)

Answer 4

lesser- left and right gastric arteries

greater- left and right gastroepiploic arteries

Question 5

infarct of medial pons at level of middle cerebellar pedunce

Answer 5

affect CST- contralateral hemiparesis, Babinski
affect CBT- contralateral facial palsy
affect corticopontine fibers- contralateral dysmetria and dysdiachokinesia

trigeminal nerve arises through there

Question 6

which myotoms for biceps reflex

Answer 6

C5-C6

Question 7

which proteins does RER make

Answer 7

secretory proteins
integral membrane proteins
proteins within ER, golgi, and lysosomes

Question 8

lynch syndrome gene

Answer 8

aut dom- defect mismatch repair

MSH2, MLH1- encode for MutS and MutL

Question 9

what drug can help prevent cerebral vasospasm and death after subarachnoid hemorrhage

Answer 9

CCBs (nimodipine)

Question 10

3 mitochondrial diseases

Answer 10

• leber herditary optic neuropathy
• myoclonic epilepsy with ragged red fibers
• mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS)

Question 11

which drug prolongs QT interval without risk of torsades

Answer 11

amiodarone

Question 12

which cells release proteases in emphysema

Answer 12

neutrophils and macrophages

Question 13

DOC for acute decompensated heart failure

Answer 13

diuretics

Question 14

Mc Murray test

Answer 14

pain popping on external rotation –> medial meniscus tear

pain popping on internal rotation –> lateral meniscus tear

Question 15

areas to injure radial nerve

Answer 15

• midshaft fracture of humerus

- compress axilla (crutches or sleeping with arm over chair)

Question 16

radial injury presentation

Answer 16

wrist drop
loss of elbow, wrist, finger extension
decrease grip strength
lose sensation over posterior arm/forearm and dorsal hand

Question 17

L3-L4 radiculopathy

Answer 17

weakeness of knee extension

decreased patellar reflex

Question 18

L4-L5 radiculopathy

Answer 18

weak dorsiflexion

difficulty in heel-walking

Question 19

L5-S1 radiculopathy

Answer 19

weak plantarflexion
decreased achilles reflex
difficulty toe walking

Question 20

causes of osteonecrosis

Answer 20

Corticosteroids
Alcoholism
Sickle cell disease
tramau

The bends

Legg-Calve- perthes disease
Gauchers
Slipped capital femoral epiphysis

CAST Bent LEGS

Question 21

giant cell tumor

Answer 21

20-40 years old

epiphyseal end of long bones- knee

locally aggressive, benign

soap bubble on x-ray

multinucleated giant cells

Question 22

mixed connective tissue disease

Answer 22

features of SLE, sclerosis, polymyositis

anti-U1 RNP

Question 23

which disease is endomysial inflammation and which perimysial inflamm?

Answer 23

endomysial- polymyositis

perimysial- dermatomyositis

Question 24

which layer does staph scalded syndrome affect?

Answer 24

stratum granulosum

Question 25

erythema multiforme

Answer 25

macules, papules, vesicles, target lesions ``` assocations: infections (mycoplasma, HSV) drugs (Sulfa, beta-lactams, phenytoin) cancer autoimmune ```

Question 26

McCune-Albright syn

Answer 26

GNAS mutation --> const. AC ``` cafe-au-lait endocrine abnl (precocious puberty, thryoid) fibrous dysplasia (multiple osteolytic lesions) ```

Question 27

congenital hypothyroidism

Answer 27

infants develop constipation, hypotonia, macroglossia, umbilical hernia, large anterior fontanelle

Question 28

patellar fracture

Answer 28

from blow to anterior patella swelling, tenderness, inability to extend knee against gravity

Question 29

thoracic outlet syndrome

Answer 29

compress lower trunk of brachial plexus in scalene triangle upper extremity weakness, tingling, numbness

Question 30

scaphoid fractures at risk for

Answer 30

avascular necrosis `

Question 31

which muscle in greater sciatic foramen

Answer 31

piriformis

Question 32

merocrine exocrine glands

Answer 32

cells release watery secretory product via exocytosis salivary, eccrine, apocrine

Question 33

apocrine exocrine glands

Answer 33

release membrane bound vesicles with secretory product mammary glands

Question 34

holocrine exocrine glands

Answer 34

release entire contents of cells via cell lysis sebaceous glands

Question 35

lambert-eaton myasthenic syndrome symptoms

Answer 35

proximal muscle weakness CN involved autonomic disturbances most have malignancy (small cell lung cancer)

Question 36

Ehlers-danlos enzyme defect

Answer 36

procollagen peptidase- cleaves terminal propeptides from procollagen in extracellular space

Question 37

potency of anesthetic determined by

Answer 37

minimum alveolar concentration (indirect relationship)

Question 38

structures of neural crest

Answer 38

``` melanocytes odontoblasts tracheal cartilage enterochromaffin cells laryngeal cartilage ``` Parafollicular cells of thyroid adrenal medulla schwann cells spiral membrane MOTEL PASS

Question 39

location of locus ceruleus

Answer 39

posterior rostral pons near lateral floor of 4th ventricle

Question 40

tPA transient side effect

Answer 40

reperfusion arrythmia

Question 41

how does alcohol lead to hypoglycemia

Answer 41

metabolism of ethanol reduces NAD+ to NADH--> inhibits gluconeogenesis

Question 42

systemic mastocytosis

Answer 42

mast cell proliferation- KIT mutations --> excessive histamine hypotension, pruritis, excess gastric acid secretion, inactivates pancreas and intestinal enzymes (diarrhea)

Question 43

hereditary pum hypertension hits

Answer 43

1st hit- BMPR2- aut dom- smooth muscle cell proliferation 2nd hit- (infection, drugs, ion defects) - activates the disease- vasoconstriction

Question 44

krukenberg tumor morphology

Answer 44

increased mucin production | signet ring- nuclei pushed to periphery

Question 45

ataxia telengctasia gene and symptoms

Answer 45

ATM- DNA break repair from radiation ataxia, telengctasia, recurrent resp infections

Question 46

how to treat mild vs severe hypoglycemia in DM1 patient

Answer 46

mild- fast-acting carbs (juice, glucose tablets severe- intramuscular glucagon

Question 47

shapes of urine stones

Answer 47

calcium oxalate- octahedron (square with X) Calcium phosphate- elongated, wedge shaped Mg ammonium phosphate- rectangular prisms or struvite uric acid- rhomboid cystine- flat yellow hexagonal

Question 48

how does chronic diarrhea lead to uric acid stones

Answer 48

lose HCO3--> increase excretion of H+ to compensate --> acidic environment in urine --> increase conversion of urate (soluble) to uric acid (insoluble)

Question 49

c-myc function

Answer 49

transcription activator

Question 50

what should be the next lab after elevated alk phos?

Answer 50

gamma-glutamyl transpeptidase | determines if elevated alk phosphate is due to hepatic/gall baldder cause or bone will be elevated in hepatic cause