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amboss Flashcards

1
Q

manifestation of kaposki sarcoma

A

abdominal pain and diarrhea

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2
Q

what are the effects of vipoma,on HCL, B12 malabsorption, and glucose

A

This results in excess fluid and electrolyte secretion into the lumen, leading to secretory diarrhea and hypokalemia. VIP also inhibits gastric acid secretion, leading to achlorhydria. Reduced gastric acid can lead to iron and vitamin B12 malabsorption, which can result in anemia, as seen in this patient. The hyperglycemia often noted in patients with WDHA syndrome is secondary to enhanced glycogenolysis caused by the effect of high portal vein VIP signaling on the liver.

CARCINOID TUMOR

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3
Q

px of sma syndrome

A

postprandial pain and biliary emesis

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4
Q

ivc vompression

A

The inferior vena cava is located in the retroperitoneum where it passes posterior to the second and third segments of the duodenum and the pancreas. can be comressed in low pressure

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5
Q

salmonella entreditits cause what

A

prolonged secretion of organism

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6
Q

peyer patch necrosis is a complication of which bacteria

A

salmonella typhi

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7
Q

erythema nodosum,reactie arthiritis and bacteremia and acute abdomen is a complication of which bacteria

A

yeresina entrocloitis aaffects particularly in patients with HLA-B27

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8
Q

qhow to differentiate between etec and cholera

A

ETEC infection would typically manifest with nausea, and possibly vomiting, and fever that last 24–72 hours.

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9
Q

high igg4 levels increased

A

autoimmune pancreatitis, which is associated with other autoimmune disorders such as retroperitoneal fibrosis, Riedel thyroiditis, and non-infectious aortitis. T

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10
Q

where does herpes labilais occur

A

nonkeratinized sturucture of mouth

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11
Q

who develops diverticular disease early

A

marfans,eD,apckd

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12
Q

pathophys of volvulus

A

Closed-loop mechanical bowel obstruction → accumulation of gas and feces within the loop → increased intraluminal pressure → impaired capillary perfusion of bowel → bowel strangulation, ischemia, and gangrene
Torsion of the mesenteric vascular pedicle → occlusion/thrombosis of mesenteric vessels → bowel strangulation, ischemia, and gangrene

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13
Q

which virus associated with high mortality rate in 3rd trimester

A

Hepatitis E virus infection during pregnancy is associated with a high mortality rate (as high as 10–25% during the third trimester) due to fulminant hepatic failure. The exact mechanism behind this phenomenon is not known

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14
Q

clinical signs of fulmiinant liver failure

A

Manifestations include hepatic encephalopathy, coagulopathy, and elevated transaminase

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15
Q

differentiate gastritis from gastropathy

A

gastropathy is minimal damage with no inflammation

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16
Q

pathophys of chemical gastropathy

A

Acute erosive gastropathy is characterized by ischemia of the mucosa due to hypovolemia (e.g., sepsis) and exposure to injurious substances (e.g., smoking, cocaine use). In acute erosive gastropathy, hemorrhage and loss of the superficial epithelium occur, further compromising the normal protective barrier of the stomach and allowing acid to penetrate through the mucosa, which directly damages the vasculature

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17
Q

pathophys of mentier disease

A

The pathogenesis involves increased signaling of EGFR, which results in proliferation of epithelial cells of the mucous cell compartment.

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18
Q

imperforate anus

A

anal atresia, causes fistula formation comes from the genitals/asosciated with vacterl

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19
Q

annular pancreas

A

failure of rotation of the ventral bud of pancrease =fusion(if there is failure =divisim=separate drainage)=ring,symotoms depend on preampullary or postampullary=double boubble sign

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20
Q

what is apple peel atresia

A

A form of intestinal atresia characterized by a blind proximal end (usually the duodenum) with the distal small bowel wrapped around the superior mesenteric artery in a spiral that resembles an apple peel. Can be an isolated malformation, associated with malrotation, or secondary to in utero vascular accidents(cocaine,cigs,and mdma increases)

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21
Q

causes of double bubble

A

atresia,annular pancreas, ladll bands

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22
Q

causes of apple peel

A

colorectal cancer, jejunal atresia

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23
Q

hypothyroidism in neonate along with umbilical hernia

A

which may in rare cases result in abdominal distention, a delay in passing meconium, bilious vomiting, and dilated bowel loops due to an adynamic ileus

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24
Q

a patient undergoes surgery with anesthetic later develops jaundice what is it

A

halothane induced fulminant hepatitis(only look out for developing countris)

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25
Q

why do we have pseudomembranous colitis

A

epithelium sloughed, high neutrophils from crypts +exudate

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26
Q

difference between gasropathy and gastritis

A

gastritis =inflammation

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27
Q

acute gastirits

A

neutrophils at the epitheli

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28
Q

why in acute ulcer is scarring absent

A

it is a feature of chronic inflammation

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29
Q

a paerson has a disease which worsens upon sunlight what viral etiology

A

hep c

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30
Q

which rna polymerase hepb uses

A

uses host polymerase so probably rna polymerase 2

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31
Q

colorectal cancer lesions

A

unifocal=sporadic,multifocal=uc associated=non polypoid dysplasia=APC mutation-early in fmailial and sporadic lade in uc along with early p53

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32
Q

association of primary biliary choangitis

A

Sjögren syndrome, CREST syndrome, and rheumatoid arthritis.

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33
Q

when is the prodrome symtom of hep b infection

A

it is a serum sickenss reaction occurs after 2 weeks then goes to jaundice

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34
Q

where does parotid gland drain and submandibular gland

A

he salivary duct (Wharton duct) ends in the sublingual caruncle

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35
Q

hepatitis A diagnoiss

A

antibodies agains virus incubation period 1 week

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36
Q

what is backwash ileitis

A

inflammation of the terminal ileum in the context of ulcerative colitis

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37
Q

what is heriditary pancreatitis

A

n autosomal dominant condition caused by a mutation in the PRSS1 gene. Characterized by recurrent attacks of acute pancreatitis that can start during childhood.

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38
Q

causes of distal ileal obstuction

A

fecalits,meckel,and gall stone ileus

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39
Q

how to differentiate betweeen CBS1 deficiney and otc deficiency

A

presency of urea

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40
Q

measured sodium

A

measured sodium+0.016*(serum glucose-100)

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41
Q

gemofibraxil

A

activates lpl and ppar alpha(hdl synthesis)

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42
Q

hostone deacetylase causes

A

exposes positive charge causes tighter binding

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43
Q

eukaryotes rnase activity

A

RNA exonuclease activity is performed by RNase H and flap endonuclease-1.

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44
Q

why people with UV light exposure are at increased risk of developing melanoma

A

UV light creates linkage to dna(thymine and cytosine) which increases the risk of BRAF mutationtherefore increases the risk of malignant melanoma

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45
Q

failure of base excision repair associated with( deamination)

A

colorectal cancer

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46
Q

translocation in lung adenocarcnimoa

A

Chromosomal translocation of the ALK gene results in the fusion oncogene EML4-ALK, which leads to lung adenocarcinoma. This translocation occurs more frequently in nonsmokers and patients younger than 65 years of age. In addition, signet ring cells are more likely to be seen in lung adenocarcinomas with the EML4-ALK oncogene than those without it. Activating mutations in the EGFR gene and KRAS gene can also cause lung adenocarcinoma. Testing the biopsy specimen for acti

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47
Q

how does diphteria affect on a molecular level

A

inhibtis translocation by inhibiting ADp ef2 so cant provide energy to transloacate

48
Q

which two drugs, dont need to be activated by virus

A

cidofovir and phoscarnet

49
Q

cancers associated with lync

A

right-sided colon cancers that are diagnosed at a relatively young age (< 50 years old). It is also associated with gastric and endometrial cancer (as seen in this patient’s family), as well as ovarian cancer and urothelial cancer.

50
Q

how does daptomycin work

A

This patient has been started on daptomycin, a bactericidal antibiotic that causes a potassium ion efflux and rapid membrane depolarization, resulting in inhibition of intracellular synthesis of DNA, RNA, and proteins.

51
Q

pathophys of cachexia

A

yndrome characterized by progressive wasting of skeletal muscle mass with or without loss of body fat that occurs in patients with advanced cancer
Pathophysiology: excess in proinflammatory cytokines (IL-1, IL-6, IFN-γ, and TNF-α) as a result of tumor growth → ↑ basal metabolic rate and catabolism
Negative nitrogen balance
Proteasomal activation and breakdown of myosin in skeletal muscle with loss of adipose tissu

52
Q

how does m protien block phagocytosis/also has hylauronic acid

A

inhibits alternative complement pathway

53
Q

process of BEr

A

BAADL

54
Q

where does crosslinking of collage n occur in

A

rer(involves formation of h-disulfide bonds)

55
Q

which disease associated with elastin fuck up

A

william, marfans, menkes

56
Q

why mucus hypervisiocus in cystic fibrosis

A

The efflux of Cl- through the ATP-gated chloride channel normally has an inhibitory effect on Na+ reabsorption into the cell. If the chloride channel is defective, then Na+ reabsorption is increased.

57
Q

cftr gene

A

misfolded protein → retention for degradation of the defective protein in the rough endoplasmic reticulum (rER) → absence of ATP-gated chloride channel o

58
Q

which amino acid destroyed in cystic fibrosis

A

phenylalanine

59
Q

how to differentiate between turner mosaicism and true turners

A

clinical phenotype milder however primary amneorrhea and short stature present.moreover a barr body not present in true turner but it is there in mosaicims

60
Q

which drugs have a high pka

A

(e.g., phenytoin, propylthiouracil, allopurinol, and amphetamines)

61
Q

meiosis 1 homology

A

Like in meiosis I, the frequency of recombination observed between two loci is inversely correlated with the distance between those loci.

62
Q

for viral recombination occur

A

one cell must me infected by two virus

63
Q

2 aminoacids coded by 1 codon

A

methonine and tryptophan UGG

64
Q

severe neutropenia predisposes to

A

bacterial(pyogenic) one week later fungal

65
Q

which diseases have complete pentrance

A

osteogensis imperfecta/neurofibromatosis

66
Q

incomplete pentrance

A

brca

67
Q

variable expressivity

A

marfans /nf1

68
Q

pleiotrophy

A

pku, sickle and marfan

69
Q

allele heterozenity

A

single gene disorder-g6pd,familialhypercholostremia and thalassemia

70
Q

locus heterozingity

A

osteogensis/albinism

71
Q

mechanism of cahcexia

A

interleukins activate NFkb

72
Q

effects of tnf alpha

A

TNF-α in particular is known to stimulate muscle catabolism via the alteration of hormone levels that regulate muscle growth (i.e., IGF-1, GH). Furthermore, TNF-α-mediated suppression of appetite in the hypothalamus, as well as peripheral activation of lipases, leads to the reduction of body fat. Cachexia occurs not only in the setting of cancer but also in conditions such as AIDS, COPD, heart failure, or end-stage renal disease.

73
Q

epigentics modification in dna vs histones

A

methylation/acetylation-histone=acetylation

74
Q

eruptive xanthoma, vs tuberous vstendionus xandthoma vs palamar xanthoma

A

eruptive in type 1(itchey), thendinous in type2 and 3

palmar in thype 3

75
Q

abetalipoproetinmia symtoms

A

retinitis pigmentosa, coagulopathy, myopathy, and spinocerebellar degeneration (due to vitamin E deficiency).

76
Q

why only viral infection causes reyes syndrome, why do we have hyperammoniemia

A

This causes hepatic mitochondrial injury that prevents hepatic ATP

77
Q

should theophylline be adminstered with antibiotics

A

Theophylline and moxifloxacin should not be administered concurrently as they both can lower seizure threshold. This is especially important in patients with a history of seizures or known ce

78
Q

should i give a person with depression flyroquinones

A

no can cause torsades

79
Q

facial defomities in pagets

A

enlarged skull, dental malocclusion due to difficulty chewing,

80
Q

in a neuron where is RER located

A

ince the rough ER is located only in the soma and dendrites, these regions are visualized with Nissl stain while the axon is not.

81
Q

triple x karyotyp

A

Seizure disorder, learning disability, and a 47, XXX karyotype is characteristic of triple X syndrome, a non-inherited aneuploidy that results from nondisjunction of chromosomes during gamete division

82
Q

disc herniation pathophys

A

The nucleus pulposus is the only remnant of the notochord, the rod of mesoderm that is essential for the development of the overlying ectoderm into neuroectoderm and formation of the neural plate

83
Q

which drugs cause drug induced lupus

A

sulfonamides, hydralazine, procainamide, phenytoin, anti-TNF drugs (particularly etanercept and infliximab), and methyldopa.

84
Q

where other pathway ribose 5 phosphate is formed

A

formed form fructose 6 phosphate

85
Q

dna polymerase for eukaryotes

A

The eukaryotic equivalents of DNA polymerase III are DNA polymerase δ and DNA polymerase ε.

86
Q

how does ergosterol cause hypomagnese

A

This side effect can occur in renal tubular cells, with a resulting increase in membrane permeability that leads to increased diffusion of H+ ions from the urine back into the cells. This H+ ion movement creates a favorable concentration gradient for diffusion of magnesium from the renal tubular cells to the tubular lumen, thereby leading to increased magnesium excretion in the urine.

87
Q

how would th elung compliance change in PTX

A

it would decrease

88
Q

cricothyroid muscle

A

Contraction of the cricothyroid muscle causes vocal cord contraction, which controls pitch elevation. Involvement of the cricothyroid muscle should be suspected in any patient with changes in vocal pitch.

89
Q

which two congenital heart diseases can cause pulmonary edema

A

tuncus artrious and tapvr

90
Q

talk abt splitting of bronchus

A

The trachea divides into the left main bronchus and the right main bronchus at the carina. The right main bronchus then splits into the upper lobe bronchus, as well as the intermediate bronchus (bronchus intermedius), which subsequently splits into the right middle and lower lobe bronchi. Because the right main bronchus is orientated more vertically than the left, the majority of aspirated foreign bodies are found in the right lung airways; more than half of these bodies are localized in the intermediate bronchus.

91
Q

fibrosis of broncial walls presents as in bronchiectasis

A

tram track lines

92
Q

what is difference between compilcated and uncomplicated paranpneumonic pleural effusion

A 
pathophys Stage I (exudative): accumulation of fluid and pus
Stage II (fibrinopurulent): aggregation of fibrin deposits that form septations and pockets
Stage III (organizing): formation of thick fibrous peel on pleural surface that restricts lung mo
93
Q

what increases risk of Rheumatoid arhtiris

A

penumocisocis

94
Q

3 intracellular bacteria

A

chalamdia, leiogenilla, coxiella,

95
Q

3 intracellular bacteria

A

chalamdia, leiogenilla, coxiella,

96
Q

which fungi causes verrucous skin lesios

A

manifestations (e.g., verrucous skin lesions similar to those of cutaneous blastomycosis) paraccocidomycosis

97
Q

which is the only yeast to cause dissemated infection in hosts in immunocompetent

A

blastomycosis resembles sq cell carcinoma

Genitourinary involvement: prostatitis, orchitis, epididymitis

98
Q

pattern of distributionin sporthorix

A

lymphacutaneus distribution/ what are the morphology

cigar shaped yeast

99
Q

histopath of sporthorix

A

rosette-like clusters of conidia at the tips of the conidiophores (

100
Q

leaading caude of death in systemic sclerosis

A

pulmonary hypertension

101
Q

airway resistance in copd vsasthma

A

asthma its reversible copd fixed over a period of time due to prolonged inflammation

102
Q

which atelectasis causes sarcodisos

A

adhesive increases

103
Q

idiopathic pulmonary fibrosis causes malignancy risk

A

yes

104
Q

a patient has shortness of breath, hilar lymphadenopathy, and erythema nodosum. and high interferon what is the diagnosi

A

active tuberculosis

105
Q

risk factor for spontaneus ptx

A

tall and smoker

106
Q

mechanism of increased shunt fraction in ARDS

A

hypoxemic vasoconstriction

107
Q

ARDS vs CHF xray findings why very different

A

Reduces V/Q mismatch from dependent atelectasis

Increases lung compliance

108
Q

types of rejection in acute and chronic

A

https://www.youtube.com/watch?v=dzcFTqNjw2w

109
Q

two types of immune reaction in acute rejection

A

humoral and cmi( th4 rcauses recruitment of macrophages)

110
Q

cmv pneumonitis which antigen

A

b antigen

111
Q

a person has a history of gingivitis a month later he develops cough dyspnea and fever what can it be

A

actinomyces

112
Q

a man comes with distented neck veins what does she have

A

she has svc syndrome

113
Q

type 2 pneumocytes injured in

A

Alveoli consist of type I pneumocytes, which are thin, squamous cells that form the majority of the alveolar surface, and type II pneumocytes, which are cuboidal cells that form clusters in alveolar tissue. Type II pneumocytes proliferate in response to lung damage (e.g., from influenza infection) and can differentiate into type I pneumocytes, which are unable to replicate. Type II pneumocytes also secrete surfactant, which decreases surface tension and prevents alveolar collapse.

114
Q

how does a posterior mas lesion manifest in. mediastinum

A

compresses the lung =dyspnea

hoarnsess due to recurrent laryngeal nerve

115
Q

radiation induced lung injury

A

4-12 weeks(pneumonitis) 6 months later fibrosis

116
Q

primary tb which population afeect

A

immunocpromised and children

117
Q

location of primary tb vs secondary tb

A

primary is middle lower lobe, secondary it is upper and posterior lbe

usmle (38 decks)

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