Blocks 19-28 Flashcards Preview

Review and Memorization > Blocks 19-28 > Flashcards

Flashcards in Blocks 19-28 Deck (227):
1

What potentially damaging enzyme is made by alveolar macrophages?

Alveolar macrophages make elastase, which can be damaging if it is allowed to run out of control.

2

How do you minimize confounding in an experiment?

Confounding is minimized in an experiment by controlling for as many variables as possible.

3

What is the similarity between myasthenia gravis and goodpasture's syndrome?

Both goodpasture's syndrome and myasthenia gravis are type 2 autoimmunities

4

What does lysosomal enzyme release by macrophages lead to in the lung?

Lysosomal enzyme release by macrophages in the lung leads to lung destruction and abscess formation.

5

The release of what enzyme is stimulated by an increase in free fatty acids?

Insulin release is stimulated by an increase in free fatty acids. These also prevent the potentially beneficial effects of insulin.

6

What enzyme is released by osteoblasts to allow for calcium deposition in osteoid?

Osteoblasts release alkaline phosphatase to increase the pH in the osteoid to allow for calcium deposition.

7

Where is the CTZ located?

The CTZ is located in the dorsal inferior medulla

8

How does eplerenone work?

Eplerenone is an antialdosterone agent used in the management of CHF. It is a potassium sparing diuretic.

9

What is the natural history of hemangiomas?

Hemangiomas will initially grow with the child after birth, but will almost always regress before puberty.

10

What is the best therapy for the management of an acute manic attack?

Valproate is the best choice for the management of an acute manic attack.

11

What is the order of steps for repairing DNA damage caused by cytosine deamination and cross-linking?

The order of steps leading to DNA repair is: glycosylation, endonuclease , lyase, DNA polymerase, and ligase.

12

Which enzymes activate and inhibit 6-MP respectively?

HGPRT activates 6-MP and Xanthine oxidase inhibits it.

13

How thiazolidinediones work?

Glitazones work by modifying transcription of glucose and lipid metabolizers

14

How does calcium play a role in muscle fiber activation?

Calcium binds troponin in the muscle fiber to initiate movement.

15

What does an obstructive lesion in a bronchus lead to?

An obstructive lesion in a bronchus leads to collapse of the lung tissue and deviation of the trachea to the side of the collapse

16

How do eosinophils work?

Eosinophils work by initiating ADCC.

17

How can amphotericin cause PVCs?

Amphotericin can cause renal damage leading to PVCs.

18

How is the murmur of aortic stenosis defined?

Aortic stenosis has a characteristic crescendo-decrescendo murmur

19

How does rabies get into the brain?

Rabies climbs up the peripheral nerve to the junction with the CNS axon. It can then cross the synapse and bind acetylcholine receptors on the far side allowing it to get into the CNS

20

What is one condition that can cause hypoxemia in the lower extremities, but not in the upper?

PDA can cause hypoxemia in the lower extremities, but not in the upper. Go for this over coarctation unless you have a good reason.

21

What is the system that leads excess dopamine to cause galactorrhea?

The tuberoinfundibular system is responsible for excess dopamine causing galactorrhea.

22

What are the two go to agents for managing VTAC?

Lidocaine or amiodarone are the go-to agents with the highest specificity for cardiac tissue in the management of VTAC

23

What is the relationship between oxygen content and blood flow in the lung?

Unlike in other systems blood is shunted away from areas in the lung with low oxygen content.

24

What is the most common cause of congenital adrenal hyperplasia? What is blocked by this mutation?

21 hydroxylase deficiency is the most common cause of congenital adrenal hyperplasia. It prevents the conversion of progesterone to 11-deoxycortisone.

25

What urine measurement is important when considering metabolic acidosis?

Need to measure urine chloride to assess metabolic acidosis.

26

Which class of drugs are 5-HT1b/d agonists?

Triptans are 5-HT1b/d agonists that enhance serotonin activity and aid in migraines by causing vasoconstriction in these areas

27

What is the only sensory pathway that doesn't pass through the thalamus?

Smell is the only sensory pathway that doesn't pass through the thalamus.

28

The binding of what molecule causes the detachment of the myosin head from the actin filament?

ATP binding to myosin causes it to detach from the actin filament leading to contraction.

29

What vitamin disorder can cause edema and neuropathy?

Don't forget Beri-beri in your differential diagnosis for edema (Wet Beriberi) and neuropathy (Dry beriberi). Both are due to a deficiency of thiamine.

30

What genotype is common in patients with reactive arthritis?

Reactive arthritis is commonly observed in those with the HLA-B27 genotype

31

What is the main nitrogen acceptor for lysine in the urea cycle?

Alpha-ketoglutarate is the main nitrogen acceptor for lysine in the urea cycle.

32

How can botulinum survive in the environment?

Botulinum is a spore forming bacterium that can survive in the environment for an extended period of time.

33

How does the flu vaccine work?

The flu vaccine block hemagluttinin and prevents the virus from entering cells

34

What is the treatment of choice for an acute septic arthritis?

Ceftriaxone is indicated if there are lots of neutrophils in a joint capsule

35

What is the first line treatment for essential tremor?

propranolol is the first line treatment for essential tremor

36

What will cause a buildup of dihydrofolate in the system?

Dihydrofoltate reductase inhibitors will cause an accumulation of DHF in the blood

37

What type of capsule does anthrax have?

Anthrax has an antiphagocytic d-glutamate capsule

38

A deficiency of which two vitamins can cause megaloblastic anemia?

A deficiency of either folic acid or cyanocobalamin (Vit. B12) will cause megaloblastic anemia

39

Which vaccinations can help prevent cancer?

Vaccination agains HPV and Hep B can help prevent cancer (Along with others, I'm sure).

40

Which heart condition can lead to Cheyne-Stokes breathing?

Advanced CHF can lead to Cheyne-Stokes breathing

41

What type of infection does someone have who has elevated protein, normal glucose, and predominantly lymphs in their CSF?

Viral meningitis is associated with elevated protein, normal glucose, and predominantly lymphs.

42

Which type of organ rejection leads to bronchiolitis obliterans?

Chronic rejection leads to bronchiolitis obliterans.

43

What drug can cause myosin dephosphorylation?

Nitroglycerin causes myosin dephosphorylation and can help to relax the myocardium.

44

A deformation of which structure will lead to a malformed pancreatic duct?

The ventral pancreatic bud normally combines with the dorsal bud to form the main pancreatic duct. If this is disrupted then there can be two primary duct systems formed.

45

What are two conditions minors can be treated for without parental consent?

Pregnancy and STDs can be treated without parental consent.

46

What is the difference between PBC and PSC?

Primary biliary cirrhosis is more common in middle aged females and is intrahepatic and autoimmune. Primary sclerosing cholangitis on the other hand is more common in men with ulcerative colitis and affects the primary bile duct (can ascend)

47

What is a long term effect caused by an untreated prolactinoma?

prolonged prolactinomas can lead to hypogonadism and in women can cause all of the effects of menopause.

48

Blocking which substance will prevent the proliferation and differentiation of T Lymphocytes?

Blocking calcineurin will block the proliferation and differentiation of T lymphocytes by preventing the formation of IL-2

49

What cause of bloody diarrhea is carried by domestic animals?

Campylobacter is carried by domestic animals, which can be spread by the fecal-oral route.

50

What enzyme is released by mast cells along with histamine?

Tryptase is released by mast cells at the same time as they release histamine

51

A patient who is binging/purging and has a BMI of 23 has which disorder?

Bulemia

52

Which two mutations can lead directly to a truncated protein?

Both a nonsense and a frame-shift mutation can lead to a truncated protein due to a pre-mature stop codon.

53

What is the main enzyme activated by enteropeptidase?

Trypsin is the main enzyme activated by enteropeptidase. It then activates more of itself and the other pancreatic enzymes.

54

It is important to supplement which vitamin in babies that are exclusively breast fed?

It is important to supplement vitamin D in babies that are exclusively breast-fed.

55

What is described by an endospore with spherules in the human body?

coccidioidomycosis has an endospore form with spherules and endospores

56

What drug provides the best initial treatment for alcohol withdrawal?

BNZ provide the best initial treatment for alcohol withdrawal.

57

Which enzyme has 5'-3' exonuclease activity?

5'-3' exonuclease activity is restricted to DNA polymerase 1. It also has 3'-5' exonuclease activity for normal proofreading.

58

Children with Down Syndrome are at increased risk of which cancer?

Acute Lymphoblastic Leukemia is more common in children with Down Syndrome.

59

Which class of drugs works by binding to and increasing the activity of ATIII?

The heparins work by binding and increasing the activity of AT3. Unfractionated heparin is the best at this followed by LMWH and enoxaparin

60

Which superdrug works by disrupting the cell membrane potential and is used in MRSA infections?

Daptomycin works by disrupting the cell membrane potential and is used in MRSA infections.

61

What are the effects of a deficiency of vitamin B12?

A cobalamin deficiency results in neuropathy and megaloblastic anemia

62

What is the pathophysiology of HUS?

HUS causes a microangiopathic hemolytic anemia. It is associated with E. Coli O157:H7

63

What is the best treatment of paroxysmal supraventricular tachycardia?

Adenosine is the best treatment for PSVT

64

What is the main metabolic deficiency associated with alzheimers?

Acetylcholine deficiency in the brain is characteristic of Alzheimers.

65

What is the lack of acetylcholine in Alzheimers associated with?

The deficit of acetylcholine observed in alzheimers is associated with a lack of choline acetyltransferase in the nucleus basalis.

66

Which drug class can induce prinzmetal's angina?

Ergots can induce prinzmetal's angina due to the hypercontractable state of the vasculature in people who suffer from this disorder.

67

What are the components of the rabies vaccine?

Rabies vaccine consists of the killed virus.

68

What are the differences between CML, leukemoid Rxn, and AML?

Both CML and Leukemoid reaction will have many activated myelocytes on the peripheral smear, but will have few blasts. AML, on the other hand, will have large numbers of blasts apparent on a blood smear.

69

Which two cyclodextrins prevent the binding of complement to normal cells? What disease is caused if they are lacking?

CD55 and CD59 work to prevent the binding of complement to normal cells. If they are absent then Paroxysmal nocturnal hematuria can result.

70

Of which category of bias is attrition bias a subset?

Attrition bias is a subset of selection bias.

71

What is unique about echovirus?

Echovirus is a picornavirus that uses alternative splicing to generate different protein products from the same mRNA

72

What disorder is associated with eating ice?

Pica is often associated with eating ice and this can indicate an iron deficiency anemia

73

What will result if Bruton's Tyrosine kinase is mutated?

BTK mutations cause X-linked agammaglobulinemia which will have functional T-cells, but few b-cells leading to an absence of germinal centers.

74

How does VIP work?

Vasoactive Intestinal Peptide inhibits gastric acid secretion, relaxes smooth muscle, and increases secretion of bicarbonate and chloride.

75

A fractured clavicle has an elevated medial portion. What happened?

The SCM muscle is responsible for the elevation of the medial portion of a fractured clavicle.

76

A patient presents with hypocapnia and a normal metabolic production of CO2. What is going on?

Alveolar hyperventilation is a cause of hypocapnia in the presence of a normal metabolic production of CO2.

77

What substance is required for adherence to the extracellular matrix and when is it often absent?

Fibronectin is required for cells to adhere to the ECM. It is often absent in tumor cells.

78

What disorder has cafe-au-lait spots on the skin, scoliosis, eye problems, learning disorders, and a predisposition to cancers of the nerves?

Neurofibromatosis type I is an autosomal dominant disorder that is characterized by cafe-au-lait spots and neurofibromas on the skin. It can also cause eye and learning problems.

79

What disorder is associated with bilateral acoustic neuromas?

NF2 is associated with bilateral schwannomas, meningiomas, and ependymomas.

80

Which cells in the testicle are damaged by cryptorchidism?

The sertoli cells in the testicle are easily damaged by the increased temperature of cryptorchidism.

81

If the ventricles are beating at 45-55 BPM what has happened and which cells are in charge?

In complete heart block the AV node will take over pacemaking for the ventricles at a rate of 45-55 BPM.

82

A patient was recently started on chemotherapy and now has uric acid crystals in their urine. What happened?

Tumor lysis syndrome is an emergency that can lead to uric acid crystals forming in the collecting ducts due to the low pH there.

83

What is the most common tumor of the cerebellopontine angle? What do they cause?

Schwannomas are the most common tumors of the cerebellopontine angle. They affect CNVIII and can also get V and VII.

84

What is a common adverse event associated with thyroid surgery?

HypoPARAthyroidism is a common result from preceeding thyroid surgery. It is due to ligation of the arteries supplying the parathyroid gland during the operation.

85

What are the components of the vaccine to N. meningitidis?

The meningitis vaccine is composed of capsular polysaccharides from the meningococcus.

86

Why is transferrin increased instead of decreased in iron-deficiency anemia?

Transferrin is increased in iron-deficiency anemia, so that any iron that is received can be effectively moved around the body.

87

Which vitamin will cause papilledema, dry skin, and hepatosplenomegaly?

Vitamin A overdose can cause papilledema, dry skin, and hepatosplenomegaly.

88

What is the most important metabolite of primidone?

Primidone is used in the treatment of essential tremor because it is metabolized to phenobarbital. Cory is primed and it calms him down.

89

What is a feared outcome in Goodpasture's syndrome?

Crescent formation is a bad sign in patients with Goodpasture's syndrome.

90

What is the mechanism of the neuropathic side effects of isoniazid?

Isoniazid can compete with vitamin B6 (Pyridoxal Phosphate) leading to its neuropathic side effects.

91

Why is it uncommon to find infarcts in the liver?

The liver has a dual blood supply, so it is uncommon for an infarct to occur in an otherwise healthy liver. Transplanted livers can have this problem though.

92

What is the major benefit of vaccinating children against HiB?

H. flu vaccine prevents meningitis in small children.

93

Of the autoimmune intestinal diseases, which is associated with skip lesions?

Chrohn's disease is associated with skip lesions and fistulas.

94

What disease is associated with gonadal atrophy and difficulty releasing a doorhandle?

Myotonic dystrophy has a grasping the doorhandle sign and can cause gonadal atrophy.

95

What substance is associated with NOD2 and promotes cytokine production?

NF-kB promotes cytokine production and is associated with NOD2 receptors.

96

At what point after an infarct will myocardium begin to appear abnormal?

Myocardium will appear normal until about four hours after the onset of symptoms.

97

Which cell line is responsible for the problems associated with the tetralogy of fallot?

A defect in the development of the neural crest cells is responsible for causing the tetralogy of fallot.

98

What is the equation for the odds ratio?

Odds ratio is the cross product of the 2X2 table.

99

What is the formula for relative risk?

RR=(TP/TP+FP)/(FN/(TN+FN))

100

What is required for pyelonephritis to develop?

Colonization of the bladder is insufficient for causing acute pyelonephritis. There must also be vesicoureteral flow in order to establish an infection of the kidney.

101

What measure of lung function is elevated in patients with COPD?

Functional reserve capacity is elevated in those with COPD.

102

Which chamber of the heart lies closest to the esophagus?

The left atrium is most closely associated with the esophagus.

103

What vascular structure is located closest to the posterior esophagus?

The descending aorta is located closest to the posterior esophagus.

104

What heart disorder is associated with an S4 heart sound?

Left ventricular hypertrophy is associated with an S4 heard near the apex of the heart.

105

If a patient is shifting their negative associations from one person to another what is this known as?

Transference is when someone shifts the focus of their associations from one person to another.

106

What effect will a saline infusion have on the cardiac cycle?

A saline infusion will increase the pre-load and lead to a higher EDV

107

What thyroid measure will be decreased in someone who is taking T3?

T4 and TSH will both be decreased in someone who is taking levothyroxine. T3 should be increased because this is the drug. The same would go for T4 supplementation.

108

A person with a deficiency of phenylalanine hydroxylase will develop what disorder?

PKU will have very early developmental delays associated with seizures. It is often due to a deficiency of phenylalanine hydroxylase.

109

What is used as prophylaxis in someone who is exposed to meningococcus?

Rifampin is a good choice for monotherapy in those exposed to meningitis.

110

What is the result of calcineurin mediated activation of IL-2?

IL-2 leads to enhanced activity of NK cells along with other lymphocytes.

111

What is the most potent vasodilator of the brain?

pCO2 is the most potent vasodilator of the brain.

112

What is the term for when the observed frequency of a haplotype is greater than that predicted by the individual allelic frequencies?

Linkage disequilibrium is when the actual frequency of a haplotype is greater than that predicted by the individual allelic frequencies.

113

What does it mean when there are golden yellow deposits in macrophages in the lung?

Golden yellow macrophages in the lung in a patient with edema indicate CHF. Hemosiderin is the composition of these graules due to extravasation of blood by the congested lung parenchyma

114

A tumor in the superior sulcus of the lung is known as what?

Pancoast tumors arise in the lung apex at the superior sulcus.

115

What is the most common cause of aspiration pneumonia?

Aspiration of oropharyngial bacteria is the most common cause of aspiration pneumonia. Aspirating gastric contents usually causes a chemical pneumonitis.

116

What test can be used to measure the effectiveness of vWF?

The ristocetin challenge can be used to measure the effectiveness of vWF.

117

How does spironolactone work?

Spironolactone blocks the effects of aldosterone to cause its effects. Aldosterone normally leads to a greater excretion of hydrogen ions, so acidosis can be a side effect of treatment.

118

What is the immediate cause of death in patients with a ventricular wall rupture?

Profound hypotension due to decreased blood return is the main cause of death in patients with ventricular wall rupture.

119

What serum measurement is associated with ovarian and endometrial cancers?

CA-125 is associated with ovarian and endometrial cancers

120

What is the outcome of rapid correction of hyponatremia?

Rapid correction of hyponatremia can lead to osmotic demyelination syndrome, which is also known as central pontine myelinolysis.

121

A decrease in which maternal serum marker is associated with down syndrome?

A decrease in AFP is associated with trisomy 21.

122

What is the relationship between a hydrocele and an indirect hernia?

A communicating hydrocele is a connection to the abdominal cavity through the processus vaginalis. This is the same mechanism that can cause an indirect hernia.

123

Capillary wedge pressure is not increased in ARDS

Remember!

124

How does vancomycin work?

Vancomycin binds D-ala-D-ala to prevent the formation of peptidoglycan and disrupt the cell wall.

125

What would a stab wound above the clavicle hit?

A stab wound above the clavicle is still able to hit the lung pleura, which amazingly extends that high.

126

What bacterium that infects the lungs requires Buffered Charcoal Yeast Extract to grow?

Legionella can only be cultured by growing on buffered charcoal yeast extract.

127

What street drug is most likely to result in a violent patient?

PCP is the drug most likely to cause violence in a patient.

128

Define Lead Time Bias?

Lead time bias is when you detect a disease earlier and so it appears that people are living longer with the disease when they really aren't.

129

What portion of the urethra is most likely to be damaged in a car crash?

The membranous urethra is the part most likely to be traumatically injured. It is located immediately below the prostate.

130

What serum markers need to be checked in those taking a statin?

Statins can cause damage both to the liver and muscles, so it is important to measure CK and Liver enzymes in these patients.

131

What is a way that RBCs can manage their own oxygen carrying capacity?

RBCs can use mutase to anaerobically generate 2,3-BPG and regulate their oxygen carrying capacity.

132

Which medical technique is most responsible for the increase in nosocomial infections (esp. sepsis)?

The increased use of intravascular devices is making infections more common in hospitals.

133

A young patient presents with microvesicular steatosis in their liver after a viral infection. What medication did they take?

Reye syndrome is associated with microvesicular steatosis in the liver and is due to young patients taking aspirin for a viral infection.

134

What is the one drug that affects the RAAS system that will lead to a decrease in the levels of bradykinin.

ACE inhibitors are the one drug class that will affect the production of bradykinin by the lungs.

135

What is the effect of using glucocorticoids to treat Graves disease?

Glucocorticoids are frequently used to treat Graves disease and can reduce the inflammatory symptoms.

136

What is the pathophysiology of Lambert-Eaton syndrome?

Lambert-Eaton syndrome is an autoimmune disorder with antibodies against pre-synaptic calcium channels. It is often associated with SCLC.

137

What is a potential problem related to sarcoidosis that can cause hypercalcemia?

Excess production of vitamin D by macrophages can be one component of sarcoidosis. This can lead to hypercalcemia and hypercalciuria.

138

Where do thyroid hormones exert their function?

Thyroid hormones bind a nuclear receptor directly.

139

How is uremic platelet dysfunction detected?

Uremic platelet dysfunction will only have an increased bleeding time.

140

What portion of the sarcomere will only have thick fibers?

The H-band is the region of the sarcomere that only has thick fibers. From inner to outer the segments spell HAIZ.

141

Which proto-oncogene is activated in medullary thyroid cancer?

RET is activated in medullary thyroid cancer.

142

What is required to make a diagnosis of dysthymia?

Dysthymia is long term (>2 yr) sadness that never meets the diagnostic criteria fro major depression.

143

What disorder is associated with an accumulation of sphingomyelin?

Niemann-Pick disease is associated with an accumulation of sphingomyelin in the lysosomes.

144

What two nerves pass through the superior orbital fissure?

V1 and CN3 both pass through the superior orbital fissure.

145

What complement component is associated with PSGN?

C3 is associated with PSGN

146

What disorder is most likely present in a child with a delayed sloughing of the umbilical cord?

Leukocyte adhesion deficiency is associated with a delayed sloughing of the umbilical cord. It is due to a deficit of integrins. It will lead to increased bacterial infections without granulomas.

147

What is the role of leukotriene B4 (LTB4)

LTB4 serves as a chemotactant for both leucocytes and neutrophils

148

What is the most effective way to sterilize equipment exposed to hepatitis A?

Boiling hepatitis A will kill it.

149

What mutation is associated with DiGeorge syndrome?

Deletion of 22q11 can lead to several syndromes, but DiGeorge is the most famous. Velocardiofacial syndrome is another.

150

What would be a good treatment choice for those who are infected with an intracellular parasite that has signet ring shaped cells?

Mefloquine is a good treatment choice for malaria.

151

What is the difference between blocking COX-2 and COX-1

COX-2 blockers don't affect platelet functioning and are less likely to cause gastric problems.

152

What enzyme should be supplemented in those with cystic fibrosis?

Probably several, but one important one is pancreatic lipase.

153

What is the DOC in anaphylactic shock?

Epinephrine is indicated in anaphylactic shock.

154

Which artery is in close approximation to the recurrent laryngeal nerve?

The inferior thyroid artery gets very close to the recurrent laryngeal nerve

155

What are two symptoms in addition to jaundice that may be observed in patients with hepatitis A?

Fever and dark urine are associated with acute hepatitis A. The darkened urine is due to bilirubinuria.

156

What is a good way to assess nutrient deficiencies that is non-invasive?

Stool sampling is a good way to assess nutrient deficiencies.

157

What is an alcohol associated condition that can lead to an increased MCV (other than cirrhosis)

Alcoholic pancreatitis can be associated with an increased MCV.

158

If a patient presents with a pigmented tumor under the nail and it is not a melanoma then what is it?

Glomus tumors are the second choice for pigmented tumors under the nail. The glomus bodies normally help with thermoregulation.

159

What is the composition of the crystals formed in gout?

The crystals formed in gout are not uric acid, but instead are made of monosodium urate.

160

What hormone prevents lactation in pregnant women?

Progesterone prevents women from lactating during pregnancy.

161

What is a good treatment to prevent TIA that can cause bleeding?

Aspirin can be used to help prevent TIA, but it can also lead to gastrointestinal bleeding.

162

What does the lecithin:sphingomyelin ratio describe?

The lecithin:sphingomyelin ratio is useful in determining the developmental status of the lungs. Lecithin is a component of surfactant and begins to increase significantly late in pregnancy, while sphingomyelin is produced at a relatively stable rate the whole time.

163

What will a Tzanck smear show in primary HSV infection?

Primary HSV infection will have large intracellular vesicles in Tzanck smear.

164

What is the effect of caspofungin?

caspofungin get the "capsule" AKA the cell wall, which is where it acts.

165

What is the histological picture of someone with mucormycosis?

Mucormycosis has broad non-septate hyphae that branch at 90 degree angles or greater.

166

What are the most important virulence factors of E. coli in the urinary tract?

Fimbriae (pili) of E. coli are its most important virulence factors in the urinary tract. It can turn them on and off as needed for adherence.,

167

What is the HAART drug that is most likely to cause hyperglycemia?

Indinavir is the HAART drug most associated with the development of diabetes. Indians get diabetes.

168

What cells will stain for lipids after a stroke?

The microglia eat all of the dead oligodendrocytes, so they will stain for lipids and myelin after a stroke.

169

What nerve innervates the carotid body and sinus (mostly)?

The glossopharyngial nerve is the main innervation for the carotid body and sinus.

170

What is the result of volume expansion in the heart?

Volume expansion leads to an increased EDV with stretched sarcomeres in the heart. This can stimulate the release of ANP.

171

The loss of which cranial nerve is associated with vertical gaze diplopia?

CNIV palsy is associated with vertical gaze diplopia.

172

What is the difference in treatment management with 5-FU and methotrexate?

The side effects of methotrexate can be minimized through treatment with Leucovorin (folinic acid), but those of 5-FU cannot.

173

What must you know in order to be able to do PCR?

It is crucial to know the flanking sequences of the one that you want to look at in order to do PCR.

174

What should signet ring cells in the stomach indicate?

Signet ring cells in the stomach are a strong indicator of linitis plastica, which is a very invasive cancer.

175

What disease is associated with C-ANCA (anti-neutrophil Abs)

Granulomatosis w/ polyangiitis (Wegener's) is associated with C-ANCA

176

What is the cause of diabetic neuropathy?

Microvascular damage to peripheral nerves leads to diabetic neuropathy

177

What is the name of the ACHE inhibitor that can cross the BBB?

Of the ACHE inhibitors only physostigmine can cross the BBB.

178

If you want to stop overactive T-cells what do you need an antibody against? B-Cells?

CD3 antibodies can stop overactive helper T-Cells, but rituximab (anti-CD20) is needed to stop overactive B-Cells.

179

What should be your first thought in an older person who comes in with a very severe headache of sudden onset?

Subarachnoid hemorrhage (most often due to a saccular aneurysm) is the most likely explanation of this constellation of symptoms.

180

A disorder of what tissue is responsible for the hyper-flexibility observed in Ehlers-Danlos?

A disorder of collagen is responsible for the stretchy skin and hyperflexible joints in Ehlers-Danlos.

181

What is the condition that predisposes the Non-Hodgkins lymphoma in patients with HIV?

EBV is the virus (herpesviridae dsDNA) that predisposes to lymphoma in pts. with HIV.

182

What is defective in patients with hypertrophic cardiomyopathy?

A defect in the B-myosin gene is responsible for hypertrophic cardiomyopathy.

183

A deficit of ornithine can be treated with what lifestyle modification?

Ornithine is required for protein metabolism, so when it is deficient a diet low in protein can help to alleviate the symptoms

184

What is the best initial treatment for someone with severe hyperthermia?

Cold blankets are the best treatment for someone with severe hyperthermia.

185

Why should patients with renal artery stenosis not be treated with ACE inhibitors?

Patients with renal artery stenosis should not be treated with ACE inhibitors because their kidneys are relying on the autoregulation of angiotensin 2 to have an adequate filtration fraction.

186

What is the best statistical measure in those who have already experienced the outcome that is being studied?

An odds ratio is the best way to measure those who have already experienced the outcome. RR is for cohort studies.

187

What is the most likely form of kidney damage in patients who have sickle-cell disease?

Papillary necrosis is the most likely form of kidney damage in those with sickle-cell disease or trait

188

What veins form the SVC?

The cardinal veins combine to form the superior vena cava.

189

What role does Acetyl-CoA play in gluconeogenesis?

Acetyl-CoA is an important activator of gluconeogenesis. It activates pyruvate carboxylase

190

What AA is able to directly provide nitrogen for the urea cycle?

Aspartate is able to directly provide nitrogen for the urea cycle.

191

What maneuver will allow for the best listening to an S3 gallop?

listening at the end of expiration with the patient in the left lateral decubitus position will bring the heart the closest to the chest wall and give the best chance to hear the murmur

192

Why does rheumatic fever develop after S. pyogenes infection?

Bacterial and human epitope homology is responsible for the development of this serious problem. There is overlap in the specificity.

193

What is the main toxic effect of acyclovir? How can it be prevented?

Renal toxicity is the biggest problem associated with acyclovir. It can be prevented with aggressive hydration.

194

What divisions lead to the formation of the radial nerve?

The posterior divisions form the radial nerve. Remember this because the radial nerve also innervates the posterior part of the arm and forearm.

195

What mechanism can allow someone to survive a complete occlusion of a coronary artery?

If the atherosclerotic plaque forms slowly enough then there can be time for collateral circulation to develop and prevent ischemia even with complete occlusion of the main vessel.

196

Glucose-1-phosphate enters glycolysis closer to the TCA than fructose-1-phosphate. True or false?

False, fructose-1 phosphate actually enters glycolysis much closer to the TCA than Glc-1-P

197

What nerve innervates the bottom of the foot?

The tibial nerve innervates the bottom of the foot

198

What is the main site of water reabsorption in the kidney?

The proximal tubule is the main site of water reabsorption in the kidney.

199

What is the name of a common flesh eating bacterium that it a G+ coccus that is coagulase and catalase negative, but pyr positive?

Strep pyogenes is a common flesh eating bacterium that is a G+ coccus that is catalase and coagulase negative and pyr positive

200

What disease will classically present with teardrop erythrocytes?

Myelofibrosis has teardrop cells.

201

What is the characteristic appearance of erythrocytes in DIC?

In DIC erythrocytes will be cleaved by fibrin fibrils in the capillaries creating schistocytes.

202

What are the characteristics of the X-linked recessive form of inheritance?

X-linked recessive disorders are only demonstrated in males and cannot be passed from father to son.

203

What will happen initially after treatment is begun for megaloblastic anemia?

The reticulocyte count will initially rise after treatment is begun for megaloblastic anemia, but it will then return to normal.

204

What is the normal series of mutations leading to adenocarcinoma of the colon in the traditional sporadic way?

The traditional series of mutations is APC, K-Ras, and finally P-53.

205

Which type of hydatidiform mole will have triploidy?

Partial moles will have a triploid karyotype.

206

Which CDs are associated with immature B-cells?

CD10 and CD19 are associated with immature B-cells

207

Which CDs are associated with immature T-Cells?

CD1,2, and 5 are associated with immature T-cells

208

What drug is able to decrease the production of aqueous humor in the ciliary epithelium?

Timolol decreases the production of aqueous humor in the ciliary epithelium.

209

What form of nephropathy can look very similar to PSGN, but develops faster?

IgA nephropathy can look very similar to PSGN, but will develop more quickly after an infection than PSGN.

210

What is the equation for number needed to harm?

NNH=1/attributable risk. AR=Risk exposed/risk not exposed

211

Hibernating myocardium is a _____________ condition of ___________ myocytes.

Hibernating myocardium is a reversible condition of ischemic myocytes

212

What is the difference between nephrogenic diabetes insipidus and central diabetes insipidus?

Nephrogenic diabetes insipidus will not be helped by the administration of ADH, while central diabetes insipidus will.

213

What is the most specific antibody in lupus?

Anti-smith Abs are the most specific for SLE. Anti-DsDNA are a good option, but not great.

214

Why is the chloride concentration of RBCs higher in venous blood than in arterial blood?

Chloride shifts into RBCs in the venous blood to balance the charge generated when Hb binds CO2

215

What is the heart's intrinsic mediator of cardiac blood flow?

Nitric oxide is normally the intrinsic mediator of cardiac blood flow.

216

A patient presents with muscle cramps following minimal exertion. What is the most likely cause?

Atherosclerosis with lipid filled plaques is a common cause of muscle cramps with minimal exertion.

217

A deficiency in which enzyme will lead to urine that changes color on sitting?

Alkaptonuria is due to a deficiency of homogentisate oxidase, which normally aids in converting tyrosine to fumarate

218

What can a clearing in a prepared cell indicate?

Clearings in prepared cells are often associated with locations where glycogen or lipids used to be.

219

What is the name of a mu-agonist for the stomach that slows motility?

Diphenoxylate is a mu-agonist for the stomach that slows motility.

220

What artery normally supplies the posterior descending artery that runs along the diaphragmatic portion of the heart?

The Right coronary artery normally gives off a branch that supplies the diaphragmatic portion of the heart.

221

What drug used to treat MTB works best in an acidic environment?

Pyrazinamide works best in the acidic environment of the lysosome

222

What is the effect of pulmonary arterial hypertension on the pulmonary arteries?

Smooth muscle hypertrophy is the normal result of PAH.

223

What is likely going on in a thin woman who has a low LH, FSH, and estrogen level?

Anorexia is a common cause of low LH, FSH, and estrogen in women.

224

What is a novobiocin resistant bacterium that can cause urinary tract infections?

Staph. Saprophyticus is a novobiocin resistant bacterium that causes urinary tract infections.

225

What is the role of the superior laryngeal nerve?

The superior laryngeal nerve provides motor innervation to the cricothyroid muscle and provides sensation above the vocal cords. It runs with the superior thyroid artery.

226

A newborn with many defects in their midline has what syndrome?

Patau syndrome commonly has midline defects.

227

What is the most likely cause of death in someone with acute rheumatic fever?

Severe myocarditis is the most likely cause of death in acute rheumatic fever.