April 8

Question 1

What is released from eosinophils, what is its main function and what is it thought to contribute to?

Answer 1

Production of histamines and major basic protein–responsible for killing helminths

Also thought to contribute to the epithelial damage seen with atopic asthma

Question 2

Benign capillary hemangioma of the elderly that does NOT regress?

Answer 2

Cherry hemangioma

Question 3

What are the broad-spectrum anticonvulsants used to treat most seizures (tonic clonic, myoclonic, Absence) except for focal onset seizures (simple and complex), which should be treated with what?

Answer 3

Broad spectrum–lamotrigine, levetiracetam, topiramate, valproic acid

Narrow spectrum–carbamazepine, gabapentin, phenobarbital, phenytoin

Question 4

Defect in ATM gene which results in failure to repair DNA ds breaks causing cell cycle arrest—presents with cerebellar defects, spider angiomas, and IgA deficiency?

Answer 4

Ataxia-telangiectasia

Spider angiomas–telangiectasia–> superficial blanching nests of distended capillaries

Increased AFP
Decreased IgA, IgG, and IgE

IgA deficiency–predisposes to upper airway infections

Question 5

The femoral triangle consists of what? (from lateral to medial)

Answer 5

Femoral nerve, Femoral artery, Femoral vein, deep inguinal nodes/lymphatic vessels, ligament

NAVEL

Question 6

Where is the best location to inject lidocaine to anesthetize the skin and muscles of the anterior thigh?

Answer 6

Femoral nerve block at the inguinal crease lateral to the femoral artery

Question 7

What neoplasm has a 15;17 translocation and what protein is abnormal?

Answer 7

Acute promyelogenous leukemia

Abnormal Retinoic acid receptor

Question 8

What drug is used for intermittent claudication and also causes vasodilation?

Answer 8

Cilostazol

Also dipyridamole

Question 9

Where is the most common location for H. pylori, even when a pt develops duodenal ulcers?

Answer 9

Antrum of the stomach in pre-pyloric area

Question 10

Patients with pancreatic exocrine dysfunction are still able to absorb what?

Answer 10

Monosaccharides–Glucose, galactose, fructose—absorbed by enterocytes without enzymes from pancreas

D-xylose can also be absorbed and absorption test is used to distinguish GI mucosal damage from other causes of malabsorption

Question 11

What is important when performing a maternal quad screen?

Answer 11

Accurate dating–women with abnormal periods can have improper dating and can through off results from quad screen, such as elevated AFP when its really normal

Question 12

Pulmonary TB is controlled by what 2 immune cells?

Answer 12

CD4+ T-cells and macrophages

Question 13

How is concentration tested?

Answer 13

Reciting months of the year backwards

Question 14

How can RBF be calculated?

Answer 14

RBF = PAH CL/ 1-HCT

PAH CL= RPF= U[PAH] x V (flow) / P[PAH]

Question 15

What CN run through the Jugular foramen?

Answer 15

IX
X
XI

Question 16

Caudal regression syndrome–sacral agenesis causing lower extremity paralysis and urinary incontinence is associated with what maternal abnormality?

Answer 16

Maternal diabetes

Also associated with congenital heart defects, neural tube defects, and macrosomia

Question 17

Increased estrogen, seen with pregnancy and hormone replacement therapy will can an increase in what, which will effect the thyroid hormones?

Answer 17

Thyroid binding protein increase–increases total thyroid hormone levels –T4 pool
–Negative feedback keeps free (biologically active) levels normal

Question 18

Internal hemorrhoids are caused by increased pressure in what venous drainage?

Answer 18

Superior rectal vein draining into inferior mesenteric vein

Question 19

Primary membranous nephropathy is most likely caused by what?

Answer 19

IgG4 antibodies to phospholipase A2 receptor–PLA2R

–Transmembrane protein abundant on podocytes

Question 20

What cells contain a well-developed smooth ER?

Answer 20

All steroid producing cells–adrenals, gonads, liver

Contains enzymes for steroid and phospholipid biosynthesis

Question 21

What are the retroperitoneal organs that if damaged can cause blood or gas accumulation in retroperitoneal space?

Answer 21

SAD PUCKER

• Suprarenal (adrenal) glands
• Aorta and IVC
• Duodenum–2nd through 4th part
• Pancreas–except tail
• Ureters
• Colon–descending and ascending
• Kidneys
• Esophagus–thoracic portion
• Rectum

Question 22

Primary central nervous system lymphoma is commonly associated with what disease and made up of what cells?

Answer 22

HIV/AIDs–defining illness

B-lymphocytes–needs to be differentiated from toxo–as it can show ring-enhanced lesions on MRI

Question 23

What factors are needed to grow H. influenzae?

Answer 23

Factor X–Hematin and Factor V–NAD+

Can be crossed-streaked with S. aureus which will provide NAD+

Question 24

Sporadic and genetic renal cell carcinoma of associated with what mutation?

Answer 24

VHL gene mutation on chromosome 3p

Question 25

Where is the most common location for a Pilocytic astrocytoma to arise?

Answer 25

Cerebellum–seen in children, GFAP+

Cystic and solid components
–Differentiates it from Medulloblastoma–which is solid

Question 26

A benign tumor that forms under the nail bed has what cell origin and what is the function of this cell?

Answer 26

Glomus tumor–glomangioma —-red/blue lesion under the nail bed

Originates from the modified smooth muscle cells that control the thermoregulatory functions of dermal glomus bodies

Question 27

Brown pigmented gallstones are most likely caused by what and what is the pathogenesis?

Answer 27

Infection of biliary tract from E. coli or helminhic

–Release of B-Glucouronidase causes an increase amount of unconjugated bilirubin –causing the pigmented gallstones

Question 28

The Z-line of a muscle fiber is where ____ are anchored?

Answer 28

Thin actin filaments

Question 29

What is the teratogen effect of valproate?

Answer 29

Neural tube defects –decreases the level of folic acid

Question 30

What is the treatment for recurrent cases of C. Diff?

Answer 30

Fidaxomicin –inhibits RNA polymerase leading to protein synthesis impairment and cell death

Oral vanco and metronidazole are 1st line tx if not recurrent

Question 31

Dietary lipids are mostly absorbed from the _______.

Answer 31

Jejunum

Question 32

Holosytolic murmur that increases in intensity on inspiration is most likely due to what?

Answer 32

Tricuspid regurgitation

Question 33

What muscle occupies most of the space in the greater sciatic foramen and can compress the sciatic nerve?

Answer 33

Piriformis –causing piriformis syndrome

Question 34

What is the cause of gigantism?

Answer 34

Increased GH from the anterior pituitary before the closure of the epiphyseal growth plates—GH causes increased IGF-1 release from the liver which promotes bone, cartilage and soft-tissue growth

Acromegaly in adults

Question 35

What is found on the labs of pt with paroxysmal nocturnal hemoglobinuria?

Answer 35

CD55/59 NEG RBCs on flow cytometry

Caused by increased complement-mediated intravascular RBC lysis–impaired synthesis of GPI anchor for decay-accelerating factor that protects RBC membrane from complement

Question 36

TdT is a marker for what?

Answer 36

Pre-T and B cells seen in lymphoid neoplasms