Blocks 29-37 Flashcards Preview

Review and Memorization > Blocks 29-37 > Flashcards

Flashcards in Blocks 29-37 Deck (223):
1

What is the origin of the trigeminal nerve?

The trigeminal nerve arises at the midcerebellar peduncle in the mid-pons

2

What cofactor is required to convert pyruvate to OAA?

Biotin is required to convert pyruvate to OAA.

3

A patient presents with a normal BMI and has eroded enamel and enlarged salivary glands on exam. What is the diagnosis?

Bulemia is associated with a normal BMI and evidence of binging and purging

4

What is a key cytokine for initiating the activation of macrophages by TH1 cells?

IFN-gamma is required to begin the process of activating macrophages by TH1 cells

5

What nerve is potentially damaged in someone who has a mastectomy? What can this cause?

A mastectomy can damage the long thoracic nerve and can cause a winged scapula.

6

What change is observed in the cardiac output curve with an MI?

An MI will cause a decrease in the cardiac output, but will not affect the venous return.

7

What molecule is associated with immunity to HiB?

Polyribitol ribose phosphate is associated with immunity to HiB.

8

A patient presents with mitral stenosis and the diastolic pressure of their left ventricle is increased. What other problem do they have?

A problem with the aortic valve will cause an increase in the diastolic pressure of the left ventricle in patients with mitral stenosis (or without...I think)

9

What are the consequences of Dubin-Johnson syndrome? What is the metabolic error associated with it?

Dubin-Johnson syndrome leads to a black liver and some icterus. It is due to a defect in the excretion of conjugated bilirubin.

10

How does a drug work that binds to GP41?

Drugs that bind GP41 on HIV are fusion inhibitors. They prevent viral entry into the host cell. Maraviroc and Enfurvirtide are examples

11

How is the transport of bilirubin handled from the blood through the liver?

Bilirubin is taken up into the liver passively, but has to be excreted into the biliary tract actively.

12

Which part of the nephron do potassium sparing diuretics work in?

Potassium sparing diuretics work in the collecting duct of the nephron

13

What will be caused by a complete lack of UGT (Uridine 5'-diphospho-glucuronosyltransferase)?

Crigler-Najjar disorder is caused by a complete lack of UGT. This leads to extreme indirect bilirubinemia and death early in life

14

What immune response will be initiated by the live polio vaccine?

The live polio vaccine will not cause significant changes in the level of serum IgA, but will cause a substantial increase in the gut levels of IgA.

15

What do fatty streaks in arteries indicate?

Fatty streaks in arteries indicate intracellular accumulations of fat in foamy macrophages. They are reversible and do not necessarily correspond to the location of future atherosclerosis.

16

What is something that you need to watch out for with clozapine?

Clozapine is an atypical antipsychotic that can cause agranulocytosis, so it is important to check a CBC regularly on pts taking this medication.

17

What drugs used to lower cholesterol significantly increase the risk of gallstones when used together?

Gemfibrozil and Cholestyramine together greatly increase the risk of cholesterol gallstones. Both increase the cholesterol concentration of bile.

18

What drug class does selegiline belong to?

Selegiline is an MAOI, not an SSRI.

19

What disease is associated with heterophile antibody? What can it cause?

Heterophile antibody is associated with EBV. It can cause Burkitt's lymphoma.

20

What is associated with Kaposi's sarcoma?

Kaposi's sarcoma is associated with HHV-8

21

What is the best urine test for the early detection of diabetes mellitus?

Microalbuminuria is the best test for early diabetes detection in the urine.

22

What is the result of hydrocephalus ex vacuo?

Hydrocephalus ex vacuo leads to an apparent increase in the size of the ventricles and is not due to increased ICP.

23

What disease is associated with osteoid matrix accumulation around trabeculae?

Rickets is associated with osteoid matrix accumulation around trabeculae.

24

What disease is associated with eczema, thrombocytopenia, and a B/T lymph deficiency?

Wiskott-Aldrich syndrome is associated with eczema, thrombocytopenia, and a B/T lymph deficiency.

25

What can be the result of vasodilation of cardiac tissue during an ischemic attack?

Vasodilators can actually make an ischemic attack worse, because they can overcome the body's natural compensation (like ACE in renal artery stenosis).

26

Damage to which ligament will allow greater forward motion of the tibia with respect to the femur?

Damage to the ACL will give greater mobility of the tibia WRT the femur and can lead to a positive drawer sign.

27

What deficiency will cause the synthesis of excess aldosterone in the zona glomerulosa?

A deficiency of 17a-hydroxylase will shunt metabolism to the aldosterone pathway

28

What type of drug can cause dilation of the eye and can stop uterine contractions?

Sympathomimetics can dilate the eye (alpha-1) and slow uterine contractions (beta 2).

29

How can women with Turner's Syndrome become pregnant?

It is very difficult, though not impossible, for a women with Turner's syndrome to become pregnant. It (usually) requires a donor egg and regular hormone therapy to maintain the pregnancy.

30

What molecule produced by viridans strep allows for adhesion to fibrin-platelet aggregates?

Dextrans produced by viridans strep allow for adhesion of these bacteria to the fibrin-platelet aggregates of the heart valves.

31

Which enzyme in the adrenal medulla synthesizes and secretes epinephrine?

PNMT is under the regulatory control of cortisol and causes the synthesis and secretion of epinephrine.

32

What molecule would hemoglobin behave most like if its subunits were separated?

Hemoglobin would behave almost exactly like myoglobin if its subunits were separated.

33

What is contraindicated in patients with small cell carcinoma?

Surgery is contraindicated in patients diagnosed with small cell carcinoma because it has almost certainly metastasized, even if it is not detected.

34

What is the difference between oral thrush and leukoplakia?

Oral thrush is caused by candida and can be easily scraped off, but leukoplakia cannot.

35

What is the most common source of E. coli bacteremia?

The urinary tract is the most common site of bacteremia caused by E. coli.

36

What is c-Jun?

c-Jun is a DNA binding protein.

37

How does high blood solubility of the inhaled anesthetics affect their onset of action?

Inhaled anesthetics with a high blood solubility have a much slower onset of action because it takes more time for a sufficient concentration of the agent to accumulate

38

What is beta in statistical analysis?

Beta is the likelihood of making a type two error (not detecting a difference when there is one). Power is 1-beta

39

What form of heparin is the best at binding and activating ATIII?

Unfractionated heparin is the best at binding and enhancing the activity of ATIII.

40

How does digoxin work?

Digoxin inactivates the Na/K transporter. This decreases sodium efflux, decreases K influx, and dec. calcium efflux.

41

Which part of the nephron is completely impermeable to water?

The thick/thin ascending limb of Henle's Loop is completely impermeable to water.

42

What is the diagnosis in someone who presents with hemangioblastomas and cysts/cancers in the kidney or other organs?

Von Hippel-Lindau syndrome is associated with hemangioblastomas and cysts/cancers in the kidney and other organs

43

What is the pathophysiology of PSGN?

PSGN has circulating immune complexes that bind the kidney.

44

What pulmonary infection can cause hemolysis due to infection of RBCs? This anemia will clear with the resolution of the disease.

Mycoplasma pneumonia is an intracellular organism that can lead both to pneumonia and to a hemolytic anemia due to attempts to clear the organism. The anemia will resolve after the infection is cleared

45

What is the cause of a complete hydatidiform mole?

Complete moles are due to paternal fertilization of an empty egg followed by genetic duplication. This means that the karyotype of the mole can appear XX even though it is from the father.

46

What is the cause of warfarin induced infarcts (they can look a lot like ecchymoses)

An initial loss of protein C and Protein S before the other clotting factors are affected, means that warfarin initially induces a hypercoaguable state that can cause necrosis of the skin.

47

Where, other than the adrenal medulla, can pheochromocytoma develop?

Pheos can also develop in the bladder wall.

48

What is another name for lactose?

Lactose is also known as galactosyl-B1,4-glucose.

49

What is usually the initial site of infection that causes PSGN? What bacterium?

A strep pyogenes infection of the skin is usually the infection that leads to PSGN.

50

What is the most common cause of chronic bronchitis?

Environmental (smoking) causes are the most likely to lead to chronic bronchitis

51

What is the target of the circulating antibodies in myasthenia gravis?

Myasthenia gravis is mediated by circulating antibodies against ACH receptors on the cell surface.

52

What is a severe condition that can arise in someone with varicose veins?

Varicose veins can eventually lead to skin ulcerations

53

What is the name of a serotonin-norepinephrine reuptake inhibitor that can cause mania as a side effect?

Venlafaxine is a SNRI that can lead to mania as a side effect (unmasking bipolar).

54

What is a good drug to improve survival in those with advanced CHF?

Spironolactone is a good drug for improving survival in those patients with late-stage CHF

55

What is the name of the hormone produced in pregnancy that most strongly predisposes to gestational diabetes?

Human Placental lactogen is the hormone in pregnancy that predisposes to gestational diabetes

56

What is another term for precise?

Reliable. Don't forget it because they may try to trick you.

57

Where does n-Myc bind its target?

n-Myc as one of the protooncogenes (Mike's sister returned with her two new breasts she was able to grow because of her herbs). Binds to DNA in the nucleus.

58

Which type of tumors would synaptophysin be found in?

Synaptophysin is found in neuromas.

59

What cell markers are associated with a disorder that is associated with an absence of ALL immunoglobulins?

X-linked agammaglobulinemia is a deficiency of BTK to allow the development of B-cells, so look for markers like CD19, 20, and 21

60

What is the main source of glucose after 24 hours have passed?

Gluconeogenesis is the main source of glucose after 24 hours have passed.

61

What is the association with cystic hygromas?

Cystic hygromas of the neck are associated with Turner's syndrome. If there is a problem with the neck it is likely turners...

62

What is the name of an irreversible antagonist of both alpha-1 and alpha-2 receptors?

Phenoxybenzamine is an irreversible inhibitor of Alpha-1 and alpha-2.

63

A patient presents with a case of diarrhea two weeks after being treated with doxycycline for malaria prophylaxis. What is the diagnosis and how is the damage caused?

Patients who are treated with antibiotics and then develop diarrhea most likely have C. diff. It works by disrupting the cytoskeleton integrity of the enterocytes.

64

What is the most common cause of a young, healthy person dying while exercising?

Massive cardiac hypertrophy is the most common cause of young people dying while exercising.

65

What is another name for folinic acid?

Folinic acid is also known as leucovorin.

66

What heart condition is commonly associated with acute pulmonary edema?

Acute mitral regurgitation is commonly associated with acute pulmonary edema.

67

What cofactor is required to convert homocysteine to methionine?

Vitamin B12 is required to convert homocysteine to methionine.

68

What leads to siderophages?

Heart failure cells, or siderophages, are the result of left ventricular dysfunction causing pulmonary hypertension and extravasation of RBC fragments into the alveolar space.

69

What disease will result from the effacement of podocyte processes?

Minimal change disease is common in children and causes proteinuria. Under EM it will have effacement of the podocyte processes.

70

What tumor is described by scattered cells in a mucopolysaccharide stroma?

Myxomas have scattered cells in a mucopolysaccharide stroma.

71

What is the most important risk factor for cervical carcinoma?

Multiple sexual partners is the most important risk factor for cervical carcinoma (due to inf. w/ HPV)

72

Which glucose transporter is sensitive to insulin production? Where is it found?

Only GLUT 4 synthesis is sensitive to insulin production. It is found on muscle cells and adipocytes.

73

Which nucleus in the brain is responsible for the synthesis of serotonin?

The Raphe nucleus makes serotonin.

74

Where is erythropoietin synthesized?

EPO is made in the kidneys

75

Which organ is present at the tenth intercostal space in the midaxillary line on the right?

The liver can be hit if someone attempts to perform a thoracentesis in the tenth intercostal space on the right.

76

What symptoms are associated with fever, multiple strange joint pains (Polymyalgia rheumatica), and eventual blindness?

Temporal Arteritis is associated with all of these things, but it will most commonly present with a one sided headache. Don
t let the polymyalgia rheumatica fool you though.

77

What mutation will lead to cystinuria?

A mutation in the dibasic transporter in the gut lumen and the kidneys will lead to cystinuria. Will actually affect four aminoacids: cystine, ornithine, lysine, and arginine (all are dibasic)

78

What are the effects of a prolactinoma in men?

Prolactinomas in men will decrease GnRH, which leads to a decrease in testosterone and LH.

79

What are the keys to diagnosing an illness associated with an intention tremor and optic neuritis?

Multiple sclerosis requires diagnosing two lesions in two different parts of the CNS at two different times.

80

How are urea and bicarbonate handled in the proximal tubule?

Urea is slightly reabsorbed in the proximal tubule, so its concentration will increase less than that of inulin, PAH, or Creatinine. Bicarb is mostly reabsorbed, but not entirely, so its conc will decrease but not like glucose and AAs

81

What organ lies below the midclavicular line?

The lungs are located below the midclavicular line. Also known as the nipple line.

82

What is the location of the ureter at the pelvic brim?

At the pelvic brim the ureter has just crossed over the external iliac artery and is slightly lateral to the internal iliac artery.

83

What is the result of a normal metyrapone challenge?

A normal metyrapone challenge will lead to an increase in ACTH indicating an intact HPA axis.

84

What provides the elasticity in elastin?

The elastic property of elastin is a result of its interchain crosslinks with lysine.

85

What tumor stains with TRAP?

Hairy cell leukemia stains with TRAP. No others!

86

Which abnormal structure will stain with peroxidase?

The auer rods found in AML (esp in PML) will stain with peroxidase.

87

What class of drugs should not be combined with chlorpheniramine?

Chlorpheniramine is a 1st generation antihistamine. It should not be combined with other sedating agents like BNZ.

88

How does N. meningitidis cause meningitis?

Meningococcus spreads to the brain through the blood. It then colonizes the choroid plexus.

89

How does clostridium perfringens cause cellular damage?

Lecithinase is the main way that C. perfringens causes cellular damage. It cleaves phospholipids.

90

What disease will cause reduced saltatory conductance due to demyelination?

Multiple sclerosis is famous for causing decreased saltatory conductance due to its demyelinating effects.

91

What drug is associated with a chronic cough and HTN?

Always be thinking ACE inhibitors in a pt. with hypertension on ACE inh who develops a chronic cough.

92

What is the main role for niacin? What serious side effect can it cause?

Niacin is currently one of the best agents available for raising HDL cholesterol. The downside is that it can induce gout attacks.

93

Holoprosencephaly is an example of which type of developmental issue?

Holoprosencephaly is an example of malformation.

94

A defect in what genetic system will lead to xeroderma pigmentosum?

Xeroderma Pigmentosum is due to a loss of endonuclease repair mechanisms.

95

What drug can cause hyperprolactinemia and drug induced amenorrhea in someone being treated for psychosis?

Risperidone can cause hyperprolactinemia and can lead to drug induced amenorrhea

96

What is the most specific antibody to rheumatoid arthritis?

Anti-CCP antibodies are the most specific for rheumatoid arthritis. Rheumatoid factor is more common, but can also be associated with other disorders.

97

Ataxia Telangiectasia is due to a defect in ______________.

Ataxia telangiectasia is due to a defect in DNA break repair mechanisms.

98

Metformin is contraindicated in diabetics with this comorbidity.

Metformin is contraindicated in diabetic patients who also have kidney failure.

99

What enzyme removes the RNA primer in prokaryotes with its 5' exonuclease activity?

POL1 removes the primer in prokaryotes with its 5' exonuclease activity.

100

Atrophy of which neural structure is associated with Wilson's disease?

Atrophy of the basal ganglia is associated with Wilson's disease.

101

What is the key association with right sided endocarditis?

Right sided endocarditis is usually due to S. aureus. It is acute and associated with IVDU.

102

What do you have to remember about carrier frequencies when it comes to the risk of inheritance?

Carrier frequencies have to be divided in half when calculating the risk that a gene will be passed on.

103

What form does rhogam take?

Rhogam is an IgG antibody against Rh+ blood

104

How does prostacyclin work?

Prostacyclin in the heart works to inhibit platelet aggregation.

105

What problem can MI and Afib cause in the kidney?

Embolic infarcts can arise in the kidney following the development of atrial fibrillation or a myocardial infarction

106

What is the most likely site of aortic rupture in a car accident?

The aortic isthmus is the most likely site of aortic rupture after a car wreck.

107

Someone begins having massive bleeding after treatment with heparin. What do you do next?

Protamine sulfate is the antidote for heparin toxicity it is less effective with low molecular weight heparin.

108

How do tetrodotoxin and the toxin of "red tide" work?

tetrodotoxin and red tide both cause voltage-gated sodium channel inactivation thus preventing action potentials.

109

Where does an infection with cryptococcus usually begin?

Cryptococcus infections usually begin in the lungs.

110

What disease will stain positive with PAS and has diastase resistant granules?

Whipple disease stains positive with PAS and has diastase resistant granules.

111

Which part of the histone complex is located outside of the nucleosome core?

Histone H1 is located outside of the nucleosome core.

112

What is the common outcome of prion disease and improper ubiquitination of the proteins?

Accumulations of misfolded proteins (amyloid) are the endproduct of either improper protein degradation (udiquitination issues) or misfolding (prion disease)

113

Excess release of __________ will lead to biliary cholic.

Excess release CCK will lead to biliary cholic. Remember the five Fs: Female, forty, fertile, fat, and fucked up red cells

114

In which portion of the lymph node will you find T cells?

T cells are located in the paracortex of the lymph node.

115

What is the most common presentation of cryptococcus infection?

The most common way that cryptococcus will present is with meningitis (although it most commonly colonizes the lungs first)

116

What is an important undesirable side effect of phenytoin?

Phenytoin can cause hirsuitism. It also has 0 order kinetics

117

Which type of colon lesion is most likely to undergo malignant transformation?

Villous adenomas are the most likely to undergo malignant transformation even when they are small

118

Which class of antiarrhythmics does not have a significant effect on the action potential?

Class 1C antiarrhythmics do not significantly prolong or shorten the action potential. They simply slow the initial depolarization.

119

Which infection is associated with ground glass inclusions in the liver?

Hepatitis B is associated with ground glass inclusions in the liver.

120

What is the likely cause of hypoglycemia combined with hypoketonemia?

Medium chain acyl-CoA dehydrogenase deficiency will lead to hypoglycemia combined with hypoketonemia.

121

Functional mitral regurgitation can be due to hemodynamic changes and will resolve once those have been addressed.

Remember it!

122

Which fetal condition is associated with polyhydramnios?

Anencephaly is associated with polyhydramnios

123

What is the difference noted between TTP and DIC when it comes to clotting tests?

TTP will not show changes in the clotting times, but DIC has an inc. PT, PTT, and will have decreased plasma fibrinogen

124

What is one possible outcome of a tumor in the pineal gland?

Pineal gland tumors can lead to precocious puberty.

125

What tumor can occur in postpartum women and has a proliferation of cytotrophoblasts and syncytiotrophoblasts?

Choriocarcinoma can arise after delivery of a fetus and has a proliferation of cytotrophoblasts and syncytiotrophoblasts.

126

How long will myocytes continue to contract after the onset of an ischemic injury?

Myocytes will initially stop contracting within a minute of the onset of ischemia. This damage is reversible for about 30 minutes.

127

What side effect is thioridazine associated with?

Thioridazine is associated with retinal deposits that look like retinitis pigmentosa.

128

A young adult who presents with recent onset of headaches and ataxia may be seeing effects of what congenital defect?

Arnold-chiari 1 malformations can be asymptomatic initially, but then present with problems later in life.

129

A defect in what embryological system leads to a transposition of the great vessels?

A defect in septation leads to a transposition of the great vessels. It is due to an error in neural crest spiraling.

130

Pre-treatment with which drug will prevent epinephrine from causing tachycardia and cause it to increase the diastolic blood pressure?

Pre-treatment with B-Blockers will prevent tachycardia with epinephrine treatment and cause it to increase the diastolic pressure

131

What group of people are especially pre-disposed to aspiration pneumonia?

Epileptics are pre-disposed to aspiration pneumonia.

132

Which class of drugs can be used to treat urge incontinence? How do they work?

Muscarinic antagonists (oxybutynin) can treat urge incontinence. They target M3 receptors in the bladder.

133

How can hyperventilation cause CNS effects?

Hyperventilation leads to hypocapnia. This can cause CNS effects by vasoconstricting.

134

What hormone is responsible for male pattern hair loss?

Dihydrotestosterone is responsible for male pattern hair loss, not testosterone

135

What phase of digestion decreases the secretion of gastric acid?

The intestinal phase of digestion decreases the secretion of gastric acid and increases the release of secretin.

136

What can be inferred from a ghon complex?

All that can be inferred from a ghon complex is that the patient once had a primary infection with tuberculosis.

137

Which two small molecules act directly to increase the amount of cGMP in the cell? How are they different from sildenafil?

Both ANP and NO act to increase the concentration of cGMP in the cell. Sildenafil on the other hand works by preventing the degradation of cGMP.

138

What is the diagnosis in a patient with flat topped fleshy papules and a purple rash above their eyes?

Gottron papules (flat topped papules over joints) and the heliotrope rash (erythematous sign above the eyes) are both commonly found in dermatomyositis.

139

Which step of the TCA directly synthesizes GTP?

The conversion of succinyl CoA to succinate leads to the formation of a molecule of GTP.

140

What is Kussmaul's sign and what is it associated with?

Patients with fibrinous pericarditis will have a paradoxical increase in JVP on inspiration. This is known as Kussmaul's sign.

141

Where is the third pacing lead in an AV pacemaker placed?

The pacing lead for the AV node is placed through the coronary sinus in the atrioventricular groove.

142

The combination of the jugular vein with the subclavian vein forms which vessel?

The brachiocephalic vein combines the subclavian and jugular veins.

143

A patient with Raynaud's syndrome who has recurrent reflux that is unresponsive to therapy is experiencing what condition?

CREST syndrome is associated with raynaud's, and it can cause sclerosis of the esophagus resulting in severe reflux.

144

Which type of urinary incontinence calls for cholinergic agonists?

Non-obstructive urinary retention can be effectively treated with cholinergic agonists.

145

A patient with a normal PaCO2 and a decreased PaO2 will have a(n) __________ A-a gradient.

A patient with a normal PaCO2 and a decreased PaO2 will have an increased A-a gradient.

146

How can bacterial endocarditis lead to glomerulonephritis?

Circulating antibody complexes from a bacterial endocarditis can lead to a secondary glomerulonephritis.

147

How is the lagging strand in DNA synthesized?

The lagging strand of DNA is initially constructed using multiple short fragments that are then tied together.

148

What is the best way to diagnose celiac disease?

A biopsy of the small intestine showing blunted villi and lymphocytic invasion is the best way to diagnose celiac disease.

149

How do interferons play a role in preventing the spread of a virus?

Interferons released by an infected cell will shut down the surrounding cells to prevent the spread of the virus.

150

What is the diagnosis in a breast biopsy that has sheets of pleomorphic cells with central necrosis within the ducts?

Comedocarcinoma is a type of DCIS that has high grade pleomorphic cells in sheets within the ducts

151

What is the difference between denial and fantasy?

Denial is when the patient refuses to acknowledge the problem, whereas fantasy is where the patient accepts that there is a problem, but substitutes an unrealistic fantasy in place of the reality of the situation.

152

How can reperfusion in myocytes be detected?

Reperfusion injury in myocytes is shown by cell membrane damage causing CK to leak out.

153

Completely crossing which layer of the stomach transforms an erosion into an ulcer?

If an erosion completely crosses the muscularis mucosa then it has become an ulcer.

154

Which molecules are produced by TH1 cells in sarcoidosis to help fight the infection?

IL-2 and IFN-gamma are produced in sarcoidosis to fight the infection and activate macrophages.

155

What tissue line leads to neurofibromas?

Neurofibromas are tumors of Schwann cells that develop from the neural crest.

156

What condition will have a mononuclear infiltration of the thyroid with germinal centers?

Hashimoto's thyroiditis has a mononuclear infiltration of the thyroid with germinal centers.

157

What condition will have a mixed cellular infiltration with giant cells in the thyroid?

DeQuervain's subacute thyroiditis will have a mixed cellular infiltration with giant cells. It usually does not lead to hypothyroidism and will have a painful thyroid gland.

158

Which STD will have inherent resistance to ceftriaxone? Why?

Chlamydia will have inherent resistance to ceftriaxone because it doesn't have peptidoglycan in its cell wall.

159

What is the best way to increase the fraction of blood that reaches the peripheral circulation in someone with mitral regurgitation?

Decreasing the left ventricular afterload will increase the fraction of blood that reaches the systemic circulation in a patient with mitral regurgitation.

160

Where was the error in a child with down syndrome who inherited both of the mothers alleles on chromosome 21?

A non-disjunction error in meiosis 1 will lead to a child inheriting one copy of each of the mothers two chromosome 21s

161

Where is neurophysin normally secreted? What drug can cause an increase in the level of secretion leading to excess ADH?

Neurophysin is normally secreted in the posterior pituitary to carry ADH and oxytocin to the site of excretion. Carbamazepine can increase its release.

162

A patient who began a new medication for their diabetes about a week ago and presents with a low C3 and appears very ill had what happen?

Serum sickness is a possible side effect of the sulfonamides. It will cause a vasculitis 5-10 days after exposure and will have a low C3 level.

163

What is the similarity between diphtheria toxoid and Toxin A of pseudomonas?

Both of these toxins inactivate EF-2.

164

A patient with a persistent cough and low grade fever has cold agglutinins. What is she infected with?

Mycoplasma pneumonia can cause the development of cold agglutinins

165

Where does the lymphatic system in the lower anal canal drain?

All skin below the umbilicus except for that on the posterior calf drains to the superficial inguinal node.

166

What is the normal blood pressure in the right ventricle?

The right ventricle normally has a pressure around 25/4 mmHg.

167

What disease is dermatitis herpetiformis associated with?

Dermatitis herpetiformis is associated with celiac disease.

168

How does succinylcholine work? What is its antidote for overdose?

Succinylcholine acts as both a depolarizing and non-depolarizing muscular blocker. It is initially phase 1 (depolarizing), but with continued infusion becomes phase 2 (non-depolarizing). Phase 2 NMBs can be reversed with neostigmine.

169

What genetic condition is associated with fatty enterocytes on intestinal biopsy?

Abetalipoproteinemia will lead to a malabsorptive diarrhea in babies and can look a lot like lactose intolerance clinically. It will have fatty enterocytes on histology

170

A deficiency of what enzyme will lead to high orotic acid levels in the urine?

A deficiency of Ornithine transcarbamoylase (OTC) will lead to high levels of orotic acid in the urine.

171

What will bilateral renal agenesis lead to?

Bilateral renal agenesis will lead to Potter's syndrome with oligohydramnios leading to compression of the face and poor lung development.

172

What is the equation for total resistance in a circuit?

1/Rt = 1/r1 + 1/r2 + 1/r3 +... This is easy, so don't forget it.

173

What mutation is most likely to lead to cystic fibrosis?

DelF508 mutation is most likely to lead to cystic fibrosis. This results in abnormal posttranslational processing.

174

What is the result of long term use of corticosteroids?

The long term use of corticosteroids will lead to the suppression of the HPA axis and atrophy of the adrenal glands. This makes the body unable to effectively respond to stress.

175

What additional management step is needed in someone who is going to have surgery if they are chronic users of corticosteroids?

Need to prepare to give a higher dose of corticosteroids after the surgery. This "stress dose" will account for the additional need after surgery.

176

What muscle is responsible for flexion of the hip?

The psoas major muscle (along with the iliacus muscle) is responsible for flexion of the hip.

177

Which ion is responsible for rapid depolarization of the pacemaker cells?

Calcium influx is responsible for the rapid depolarization of the pacemaker cells.

178

Which ion is responsible for the pacemaker function of the nodal cells?

Slow sodium channels are responsible for the gradual depolarization that serves as a pacemaker in the nodal cells.

179

What is the equation for relating the flow rate difference between two differently sized tubes?

A2=A1 * (V1/V2)

180

What can ADPKD look a lot like on CT scan?

Autosomal dominant polycystic kidney disease can look a lot like metastatic cancer on CT, but it will be associated with hematuria as well.

181

What molecule does RAS bind?

RAS binds GTP

182

What is the role of B-blockers in arrhythmias?

Beta blockers slow AV nodal conduction and increase the PR interval.

183

How does HbS lead to sickling of the cells?

In its deoxygenated state HbS allows for hydrophobic interactions between molecules of HbS

184

What is the most common cause of GERD. What is one unusual way that it can present?

Gastroesophageal junction incompetence is the most common cause of GERD. It can present as a nocturnal cough.

185

What type of procedure is most likely to lead to sepsis due to enterococcus?

Genitourinary procedures are most likely to lead to enterococcal sepsis.

186

What drug will induce the metabolism of phenytoin?

Rifampin will induce the metabolism of many drugs including phenytoin.

187

What is one way that beta blockers can help to treat hyperthyroidism?

Beta blockers prevent the conversion of T4 to T3 in the peripheral tissues.

188

What is the relationship between angiotensin converting enzyme and bradykinin?

ACE normally inactivates bradykinin (a bronchoconstrictor). When therapy with ACE inhibitors is begun the levels of bradykinin will rise and can cause a persistent dry cough.

189

What is the best treatment for carcinoid tumors?

Carcinoid tumors are best treated with octreotide.

190

What is the pathophysiology of vegetations?

Vegetations arise when there is damage to the endocardium that allows for fibrin deposition on the valves.

191

Where are lipophilic drugs normally metabolized and excreted?

The liver is the most common site for the metabolism and excretion of lipid soluble drugs.

192

A patient presents with abnormal bleeding (or even hypovolemic shock) 7-8 weeks after her last menstrual period. What happened?

Ectopic pregnancy will have a decidualized uterus without a fetus in it. When one ruptures it can lead to hypovolemic shock.

193

What is associated with dense interstitial lymphocytic infiltrates in a transplanted organ?

Acute graft rejection will have dense interstitial lymphocytic infiltrates.

194

What class of medications can lead to right ventricular hypertrophy and sudden death?

Appetite suppressant medications can lead to RVH and sudden death.

195

What class of drugs can lead to lithium toxicity in someone who has taken the same dose for many years?

(Loop) and thiazide diuretics can interact with lithium and increase its toxicity by preventing its elimination.

196

What process in the thyroid is inhibited by methimazole?

Methimazole inhibits the organification of iodine

197

How does silicosis affect macrophages? What does this lead to?

Silicosis impairs the functioning of macrophages and predisposes to infection with MTB.

198

What cancer is associated with neurofilaments in the lung?

SCLC is associated with neurofilaments in the lung.

199

If a patient presents with a midabdominal pain and has a history of gallstones what has happened?

If gallstones get into the intestine and are sufficiently large they can lodge at the iliocecal junction and cause severe pain and problems.

200

Which part of the spinal cord is associated with tertiary syphilis?

Tabes dorsalis is a degeneration of the dorsal columns that is associated with tertiary syphilis.

201

When will the concentration of H2PO4 be increased?

H2PO4 will be increased in metabolic acidosis, esp. ketoacidosis. This is a titratable acid that can be excreted in the urine.

202

Which nerve provides general sensation to the anterior 2/3 of the tongue?

The trigeminal nerve, not the facial nerve, provides general sensory innervation to the anterior 2/3 of the tongue.

203

What is the most common AA in collagen?

Glycine is the most common AA in collagen and makes up 1/3 of the entire structure.

204

What gene defect is associated with problems of the lens, periosteum, and aortic media?

Marfan syndrome is a deficiency of fibrillin-1 that causes problems with the lens, periosteum, and aortic media.

205

What is the diagnosis in a sputum gram stain with many neutrophils, but not observed bacteria in a patient with a very high fever?

Legionella pneumonia can cause a very high fever and will not be easily observed on gram stain because it doesn't have a peptidoglycan wall.

206

What other virus can undergo genetic reassortment like flu?

Rotavirus can also undergo reassortment similar to flu.

207

What is the infection that causes Waterhouse-Friedrichson syndrome more frequently associated with?

N. mening is most commonly associated with meningitis, but can also cause Waterhouse-Friedrichson syndrome in severe cases.

208

What is the best way to diagnose diabetes in the general population?

Fasting glucose is the preferred test for diagnosing diabetes in the general population. OGTT is generally only used in those who are pregnant.

209

How do anti-epileptics affect the serum level of warfarin?

Anti-epileptics often induce cyp metabolism and can increase the metabolism of other drugs like warfarin.

210

What is a good second line choice in someone who failed ACE therapy?

Sartans are a good second line drug for those who fail ACE therapy.

211

What is the characteristic lesion associated with diabetic nephropathy?

Kimmelstein-Wilson nodules are associated with diabetic nephropathy.

212

What is the metabolic cause of megaloblastic anemia?

At its heart megaloblastic anemia is caused by a deficiency in DNA synthesis. This can be associated with many insults including folate and B12 deficiencies.

213

What is the most common cancer caused by working in a rubber plant?

Bladder cancer is strongly associated with working in a rubber plant.

214

What effect do statins have on LDL receptor density?

Statins increase the density of LDL receptors.

215

Massive interstitial infiltration with polys in the kidneys is caused by _________?

Massive interstitial infiltration of the kidneys is most commonly associated with acute pyelonephritis

216

What does Bcl-2 stand for and what is it associated with?

B-Cell lymphoma-2 gene is associated with follicular B-cell lymphomas with a t14:18 translocation.

217

What defines delusional disorder?

Delusional disorder will have a single defining delusion that will not generally interfere in the pts. life and will not lead to arrests/hospitalizations

218

What disease is associated with an accumulation of sphingomyelin?

Niemann-Pick disease is associated with sphingomyelin accumulation.

219

What disease is associated with an accumulation of GM2-ganglioside?

Tay-Sachs disease is associated with an accumulation of GM-2 ganglioside.

220

What is the most likely outcome from acute Hep B?

Hep B most commonly leads to complete resolution.

221

What hormone increases the secretion of bicarbonate from the pancreas?

Secretin increases the release of bicarbonate from the pancreas, but does not cause the release of pancreatic enzymes.

222

Which nerve roots contribute to the phrenic nerve?

C3-5 contribute to the phrenic nerve.

223

What tests will be abnormal in vWF disease?

vWF disease will lead to a prolonged PTT and bleeding time. Hemophilias do not prolong the bleeding time,