Blocks 38-46 Flashcards Preview

Review and Memorization > Blocks 38-46 > Flashcards

Flashcards in Blocks 38-46 Deck (204):
1

A child presents with delayed puberty and anosmia?

Delayed puberty and anosmia indicate Kallman syndrome. It is due to a deficiency of GnRH.

2

Someone who has eosinophils in a lung sputum biopsy and has difficulty breathing at seemingly random times has what?

Allergic asthma will seem to happen at random times and is associated with eosinophils and respiratory allergens.

3

What are the structures formed from the first pharyngeal arch?

Trigeminal nerve (V2 and V3 forms this), muscles of mastication, ant. belly of the digastric, mylohyoid, tensor tympani, tensor veli palatini, the incus, malleus, and jaw. Maxillary artery and external carotid artery

4

What are the structures of the second pharyngeal arch?

Facial nerve, muscles of facial expression, stapedius, stylohyoid, post. belly of the digastric, stapes, temporal styloid process, lesser horn of the hyoid.

5

What are the structures of the third arch?

Glossopharyngeal nerve, stylopharyngeus muscle, greater horn of the hyoid, common carotid and internal carotid arteries.

6

Which nerve is the most likely to be damaged during a herniation of the tentorium cerebelli?

The occulomotor nerve is the most likely to be damaged if there is a herniation across the tentorium cerebelli

7

What is the major virulence factor of strep pyogenes?

Protein M is the major virulence factor of Strep pyogenes

8

What is the equation for filtration fraction?

FF=GFR/Renal Plasma Flow (RPF). RPF= (1-hematocrit)*Renal blood flow

9

What problem will cause a holosystolic murmur that is accentuated by the hand grip maneuver?

A holosystolic murmur accentuated by the hand grip maneuver is a VSD

10

A baby presents with urine that smells like burnt sugar. They are not feeding well and are sickly. What is wrong?

A defect in the metabolism of branched chain AAs will present with urine that smells like "burnt sugar". This is maple syrup urine disease.

11

What is an example of an antiarrhythmic that does not affect the duration of the action potential, but will widen the QRS complex?

Flecanide is a class 1C antiarrhythmic that widens the QRS, but doesn't affect the action potential (QT interval)

12

High activity of what enzyme would predispose an atherosclerotic plaque to rupture?

High MMP activity in an atherosclerotic plaque greatly increases the likelihood that it will rupture.

13

A stab wound to the fourth intercostal space at the left sternal border would hit what structure?

A stab wound to the fourth (or third) intercostal spaces would hit the right ventricle if it was at the left sternal border.

14

What is the best long term therapy for CHF?

The best long term therapy for CHF is with an ACE inhibitor or a beta blocker. Diuretics are only useful for symptomatic relief.

15

What is the site of very long chain FA oxidation?

The peroxisome is the target of very long chain FA oxidation.

16

What is courvoisier's sign and what does it mean?

Courvoisier's sign is a palpable non-tender gallbladder and it may indicate a tumor in the head of the pancreas, especially when combined with weight loss and obstructive jaundice.

17

What are the effects of nitroprusside on the heart?

Nitroprusside decreases both the afterload and the preload by dilating the arteries and veins.

18

How does vWF work?

vWF binds to collagen and platelet glycoproteins to aid in platelet aggregation.

19

What does AKT bind and where is its action?

AKT can bind mTor to have an effect in the nucleus.

20

A child presents with massive proteinuria and facial edema a while after a bee sting. What is wrong?

Minimal change disease will have proteinuria and facial edema. It can be associated with many different immunogenic conditions.

21

What is the MOA of ticlopidine?

Ticlopidine, like clopidogrel, is an ADP receptor inhibitor that prevents platelet action.

22

What is the role of FAS in the immune system?

FAS binds to FAS ligand to allow for activation induced T lymphocyte death.

23

Where is GIIb/IIIa found? What can prevent its function?

GIIb/IIIa is mainly found on the surface of platelets. Abciximab binds and inactivates it.

24

What is the problem in ataxia-telangiectasia? What is associated with it?

Ataxia-telangiectasia is an error in DNA repair. It can lead to cerebellar atrophy and can present with recurrent respiratory infections and difficulty walking.

25

A patient presents with facial edema and distended veins in the neck and upper limb. What is going on?

SVC syndrome is due to obstruction of the vena cava, usually by a tumor. It presents with facial edema and distended veins in the neck and upper limb.

26

Where will the PCL be found on CT scan?

The PCL is found on the posterior side of the knee

27

If you see narrow angle septate hyphae in a patient who sounds like they are having their sinuses eaten off what is going on?

Invasive aspergillosis will have narrow septate hyphae.

28

What drug can help to prevent ovarian cancer? How?

Oral contraceptives can help to prevent ovarian cancer by decreasing the number of ovulations.

29

What hormone will both increase the release of gastric acid and will lead to parietal cell hyperplasia?

Gastrin will increase the release of gastric acid and will cause parietal cell hyperplasia.

30

Which enzyme will iodinate thyroglobulin?

Thyroid peroxidase will iodinate thyroglobulin

31

What are the stop codons?

UAA, UAG, and UGA are the stop codons.

32

Which part of the arm will be hurt in a child who fell while holding his keeper's hand?

The annular ligament of the elbow is the location most likely to be injured in this situation. It will lead to an extended and pronated forearm that is painful when moved.

33

What will a left shift in the oxygen binding curve cause?

A left shift in the oxygen binding curve will lead to an increased release of EPO and erythrocytosis.

34

What is the most likely cause of shock in an E. coli infection?

Lipid A is the enterotoxin most likely to cause septic shock in this scenario.

35

What is the best choice in someone who failed aspirin therapy?

Clopidogrel is the best choice in someone who has failed aspirin therapy.

36

What is the most famous drug for increasing cholinergic tone in someone who has been poisoned with an anti-cholinergic?

Physostigmine is a cholinesterase inhibitor that increases cholinergic tone.

37

Which family of viruses are most likely to cause aseptic meningitis?

Enteroviruses (ssRNA+) including echovirus and coxsackie virus cause more than 90% of aseptic meningitis.

38

Which cell tissues will be found in a Meckel's diverticulum?

All three layers of the intestine will be found in a meckel's diverticulum as it is due to failure of regression of the vitelline duct.

39

What injury will lead to glial hyperplasia?

Glial hyperplasia is the eventual outcome of an infarct in the brain.

40

How is D-xylose absorbed?

D-xylose is a monosaccharide that can be directly absorbed without digestion by the intestines.

41

What is the most likely cause of sudden death in someone who has just experienced symptoms of an MI?

Vfib is the most likely cause of sudden death in someone experiencing a heart attack.

42

What cofactors are required for the pyruvate dehydrogenase complex?

PDH complex requires CoA, FAD, Lipoic acid, NAD, and thiamine pyrophosphate.

43

A deficiency of which enzyme will lead to adrenal cortical hyperplasia?

A deficiency of 21-B hydroxylase will lead to adrenal cortical hyperplasia.

44

Which artery is occluded in someone who has ST elevation in leads II,III, and aVF?

The RCA supplies the inferior wall of the heart most of the time and an infarct in it will cause II, III, and aVF elevation. This is the diaphragmatic surface.

45

What is most likely to kill you if you are struck by lightning?

Cardiac arrhythmia is the most common cause of death in lightning strikes.

46

What congenital anomaly will cause jaundice in a 3 week old child with light stool and dark urine?

Biliary atresia will cause jaundice in a three week old child.

47

What is the mode of inheritance of G6PD deficiency?

G6PD deficiency is an X-linked recessive disorder.

48

What is the most likely outcome of a radionuclide scan in someone with cholecystitis due to gallstones?

It will generally not be possible to visualize the gallbladder using radionuclide biliary scanning in someone with cholecystitis due to gallstones

49

What is the cellular location of an isolate containing small round molecules of DNA?

The mitochondria is the only part of the cell to have its own genome!

50

A patient presents with monthly pain and abdominal tenderness. She has never had a menstrual period. What is the most likely diagnosis?

An imperforate hymen will lead to monthly pain during the menstrual cycle without any bleeding

51

What is the result of chronic rejection of an organ?

Obliterative vascular fibrosis is the result of chronic rejection of an organ.

52

What artery is most likely to be damaged if an ulcer erodes through the posterior wall of the duodenal bulb?

The gastroduodenal artery runs immediately posterior to the duodenal bulb.

53

Where is the median nerve found in the forearm?

The median nerve runs between the flexor digitorum superficialis and profundus in the forearm.

54

What physical force is enhanced in restrictive lung disease?

Restrictive lung disease will lead to increased radial traction on the conducting airways.

55

What is the normal aPTT?

The normal aPTT is between 25 and 40 seconds. The PT should be shorter than that.

56

A patient presents with a split S2 heart sound that is unaffected by breathing. What is wrong?

An atrial septal defect will lead to a split S2 sound that does not change with respiration.

57

How will CHF affect the levels of ACE in the lung? Should you do anything about it?

CHF will increase the levels of ACE in the lung because the RAAS will be active. This is bad and can be blocked with ACE inhibitors

58

What will happen if you inactivate the operator locus of the lac operon?

An inactivating mutation in the operator locus of the lac operon will cause it to become constitutively active.

59

What is the effect of an ongoing intravascular hemolysis?

Ongoing intravascular hemolysis can lead to the development of pigmented gallstones.

60

A patient presents with a high fever, watery diarrhea, and hyponatremia. What is the diagnosis?

Legionella infection can lead to a high fever (40 celsius), watery diarrhea, and hyponatremia

61

Many small intracellular inclusions are observed in the macrophages of someone from the ohio valley. What is the cause?

Histoplasma is an intracellular ovoid fungus. The inclusions can look somewhat like signet rings.

62

How does milrinone work?

milrinone blocks PDE3 and increases the concentration of cAMP both centrally and peripherally. Centrally it increases the inotropic effect and peripherally it causes vasodilation

63

What neurons are lost in huntington's disease?

Huntington's disease leads to a loss of GABAergic neurons in the caudate nucleus

64

How are hydralazine, procainamide, and phenytoin metabolized?

N-acetylation in the liver is used to metabolize the anti-histone inducing drugs.

65

A patient has sarcoidosis and presents with a loss of appetite, thirst, stupor, and hypercalcemia. What is going on?

Sarcoidosis leads to increased vit. D production by macrophages and can cause toxicity due to this. Excess vitamin D leads to those symptoms.

66

A tumor in the brain has mixed areas of high and low density. What type is it?

Schwannomas are characterized by mixed areas of high and low density.

67

What is the significance of surface glycoproteins in enveloped viruses?

Surface glycoproteins give enveloped viruses the ability to infect humans.

68

What leads to the increased glycogen breakdown observed in exercising muscle?

Calcium release from the sarcoplasmic reticulum leads to the increased breakdown of glycogen in exercising skeletal muscle.

69

A patient presents with long limbs and a tall stature? What hormone caused this?

IGF-1 is released from the liver in response to GH. GH is abnormally elevated in gigantism and acromegaly.

70

Where is the atrial septal defect of down syndrome seen?

The ASD of down syndrome is most commonly found near the cardiac cushion.

71

How does trimethoprim work?

Trimethoprim, like methotrexate and pyrimethamine, is a DHFR inhibitor. Each acts at a different stage of the process.

72

Someone suddenly begins experiencing mental status changes during dialysis. What has happened?

Delirium can come on very quickly and can cause severe mental status changes. It is often due to electrolyte imbalances

73

What is the most likely reason that someone would pass out during an ear exam?

Putting pressure on the posterior portion of the ear canal can activate a vagovagal reflex and cause someone to pass out.

74

What are the four most important chemotactants for neutrophils?

LTB4, IL-8, C5a, and bacterial components will cause neutrophil chemotaxis.

75

What is the mechanism causing pulmonary HTN in someone with left ventricular failure?

Reactive vasoconstriction secondary to venous congestion is the mechanism of Pulm HTN in someone with CHF

76

What can cause a disease that appears a like mononucleosis, but doesn't have a positive monospot test (heterophile antibodies that can agglutinate animal blood)

CMV can cause a mononucleosis like syndrome without the positive monospot test of EBV.

77

What are the branched AAs?

Leucine, isoleucine, and valine are the branched AAs.

78

What is the initial lesion that leads to an abdominal aortic aneurysm?

An intimal streak will progress to atherosclerosis and can cause an abdominal aortic aneurysm.

79

A patient presents with pain in many different joints that comes and goes. She also gets fatigued and has trouble sleeping. What is the diagnosis?

Fibromyalgia

80

What will cause growth retardation and discolored teeth in babies?

Tetracyclines can cause growth retardation and discolored teeth in children who were exposed in utero

81

What is the cause of damage due to CCl4?

CCl4 causes free radical injury.

82

What drugs are the most dangerous for those who are old and shaky?

Long acting BNZ are more dangerous than zolpidem in those who are old.

83

How will phenytoin affect the serum levels of warfarin?

Phenytoin induces the metabolism of warfarin along with phenobarbital and rifampin.

84

What is the diagnosis in a patient who presents with fibrous intimal thickening of the right heart only? They also have an increased 5-hydroxyindoleacetic acid level in their urine.

Carcinoid syndrome will lead to fibrous intimal thickening of the right heart and increased levels of 5-hydroxyindoleacetic acid in the urine.

85

What is the best treatment in someone who has polydipsia and whose urine conentrates normally in a water deprivation test?

Primary polydipsia is best treated with water restriction.

86

What disease presents with periorbital edema and microhematuria?

Glomerulonephritis can cause periorbital edema and microhematuria.

87

Where do renal cell carcinomas arise?

Renal cell carcinomas generally arise in the proximal tubules.

88

Damage to which nucleus will lead to hemiballismus?

Damage to the contralateral STN will lead to hemiballismus.

89

What vitamin almost always has to be given parenterally if it is deficient?

Vitamin B12 almost always has to be given parenterally.

90

A patient has a serum sickness like presentation with pruritus and then has an elevation in ALT and AST?

Hepatitis B will often have a pruritic "serum-sickness" phase before they develop a rise in AST and ALT.

91

What is the most likely cause of progressive dyspnea?

Pulmonary HTN is the most likely cause of progressive dyspnea.

92

What infection will give a fishy odor on the KOH whiff test?

Bacterial vaginosis will give a fishy odor on KOH whiff test.

93

What is the underlying cause of Sheehan's syndrome?

Sheehan's syndrome is due to blood loss and ischemic necrosis of the pituitary. Esp common in women giving birth.

94

Why is it difficult to develop immunity to Hep C?

Hepatitis C can vary its antigenic structure.

95

What is displacement?

Displacement is when emotions are directed from a totally inappropriate target (hitting your wife) to a only slightly less inappropriate one (punching the wall).

96

What is the main site of lipid absorption?

The jejunum is the main site of lipid absorption.

97

What disease will cause a segmental vasculitis that extends into the contiguous veins and nerves?

Buerger's disease will cause a vasculitis that extends into the contiguous veins and nerves

98

What is most likely to cause hypoglycemia in a type 1 diabetic who is otherwise well controlled?

Exercise can cause hypoglycemia in a well controlled type 1 diabetic.

99

What can cause a continuous ulcerative esophagitis in an AIDS patient?

CMV can cause a severe esophagitis in HIV patients. HSV can also, but not VZV.

100

What is a possible primary site for a tumor of the ovary with signet cells and mucus secretion?

Krukenberg tumors will have signet ring cells and can metastasize from the stomach.

101

What is the cause of acute dystonia in patients who have just started antipsychotics?

Dopaminergic blockade can lead to acute dystonia in patients just starting antipsychotics.

102

What will antibodies against type 4 collagen cause?

Goodpasture's syndrome is anti-GBM antibodies that causes hemoptysis and oliguria.

103

What will be the outcome of an infection that decreases the number of somatostatin producing cells in the stomach?

H. pylori infections can decrease the number of somatostatin cells in the stomach leading to ulceration.

104

What two treatment regimes can cause central obesity with thin limbs?

Both HAART and steroids can cause a cushinoid appearance.

105

What does acute tricuspid endocarditis in an IVDU predispose to?

Acute tricuspid endocarditis pre-disposes to infarcts of the lung parenchyma.

106

What infection binds CR2?

EBV binds CD21 (AKA CR2 and C3d)

107

What is the best way to prevent central line infections?

Washing your hands

108

Which anti-tuberculosis drug requires activation in the MTB cells?

Isoniazid requires activation by a peroxidase in the MTB cell.

109

What part of the nephron is the most likely to demonstrate signs of ischemic injury in ATN?

The proximal tubules are the most likely site of ischemic injury in ATN.

110

What is a major side effect of isoniazid?

Isoniazid can cause hepatotoxicity in 10-20% of patients.

111

What type of patient can have a localized pericarditis?

Pericarditis in patients recovering from an MI can be just over the area of damaged tissue.

112

What type of syndrome will cause a loss of sensation over the arms and neck?

A syrinx will cause a cloak-like distribution of sensory loss.

113

How can cancers acquire multidrug resistance?

Multidrug resistance in cancer cells is due to an ATP dependent membrane transporter.

114

What is the cause of excessive androgen and mineralocorticoid production?

11-beta hydroxylase deficiency will lead to hypertension, hypokalemia, and ambiguous genitalia in females.

115

What does lots of calcification in an unusual site indicate?

Dystrophic calcification indicates cell death and injury.

116

What is the only family of viruses that are ssDNA and non-enveloped?

Only Parvoviruses are ssDNA without an envelope.

117

What disease will cause transmural inflammation of the arterial wall with fibrinoid necrosis?

Polyarteritis nodosa will cause this. It is associated with Hepatitis B.

118

What type of disorders can lead to a mitral valve prolapse?

Connective tissue disorders can lead to a mitral valve prolapse.

119

What are the most common causes of squamous cell carcinoma in the esophagus?

Alcohol and tobacco are the most common causes of squamous cell carcinoma in the esophagus. They are synergistic.

120

What cellular organelle is required for the synthesis of porphyrin?

Mitochondria are required for the synthesis of porphyrin.

121

If it looks like cancer and it's in the lung...

It's cancer! (unless it is a hamartoma)

122

What should you be thinking in a child with bleeding and palpable lesions?

HSP will cause abdominal discomfort, palpable purpura, and is also associated with joint pain

123

What will be the effects on the cardiac output graph of an AV fistula?

An AV fistula will cause an increase in cardiac output, decrease TPR, and increase the mean systemic pressure

124

If a child is having sudden episodes of syncope and has QT prolongation what should you be thinking of?

Potassium channelopathies will cause QT prolongation and can lead to arrhythmias including torsades and others that will have sudden syncope.

125

What is the change in the heart that can lead to an S4 sound?

A stiff ventricle will lead to an S4 gallop.

126

What are the metabolic results of primary adrenal insufficiency?

Primary adrenal insufficiency will lead to hyperkalemia, hyponatremia, hypochloremia, and metabolic acidosis.

127

What is increased in MTB that is seen to grow in serpentine-like cords?

Cord factor indicates a higher virulence in MTB it causes serpentine cord like growth

128

Cells that produce ____________ will have very well developed smooth ER.

Cells that produce steroids will have a very well developed smooth ER as this is where steroids are made.

129

A young african american child presents with swollen and painful hands and feet. What is likely to be decreased in their blood?

Sickle cell anemia can lead to hand and foot syndrome with swelling and pain. Children with sickle-cell anemia have lower levels of haptoglobin.

130

How do you treat toxoplasmosis?

Toxoplasmosis is treated with pyrimethamine and sulfadiazine (antiprotozoans)

131

What hepatitis antigen is detected, but doesn't correlate well with virus replication?

HBsAg can be detected as an envelope component of HBV, but it doesn't correlate well with the rate of viral replication.

132

What makes zolpidem a better choice for sleep induction than short acting BNZ?

Zolpidem is less addicting than the short acting BNZ drugs.

133

How does AZT work?

AZT blocks chain elongation because it is incorporated into the growing chain, but does not allow for chain elongation.

134

What is a characteristic finding in the lungs of someone with ARDS?

ARDS will characteristically have alveolar hyaline membranes

135

What is defective in someone with infertility and repeated respiratory infections who has dextrocardia?

Kartagener's syndrome has defective dynein arms leading to immotile cilia.

136

How does raltegravir work?

Raltegravir (like the other -tegs) acts to prevent inTEGration

137

What genetic condition is associated with angiomyolipomas? What else will it cause?

Tuberous sclerosis is associated with angiomyolipomas, brain hamartomas, and ash-leaf skin lesions

138

What common cause of meningitis in newborns is resistant to ceftriaxone?

Listeria is resistant to ceftriaxone and should be treated with ampicillin.

139

What changes in potassium will be observed in someone undergoing DKA?

Patients with DKA will have decreased intracellular potassium and increased extracellular potassium.

140

What leads to the greenish hue of sputum in acute infections?

Myeloperoxidase is produced by neutrophils and has a characteristic blue-green hue that gives the resulting mucus a greenish hue.

141

What is wrong in someone who has degeneration of their dorsal columns and lateral corticospinal tracts?

Vitamin B12 deficiency will lead to subacute combined degeneration of the spinal cord that affects the dorsal columns and lateral corticospinal tracts.

142

What is the deformity observed in chronic lung rejection?

Destruction of the small airways (bronchiolitis obliterans) is a common finding in chronic lung transplant rejection.

143

If a patient is experiencing proteinuria of albumin and a couple of other proteins, what is this called?

Selective proteinuria is when only a small range of proteins are being excreted in the urine. This is common in minimal change disease.

144

What things can cause a left shift in blood?

Decreased 2,3-BPG, decreased temperature, and decreased H+ will lead to a left shift.

145

Errors at what stage of development can lead to Turner's syndrome in a child that would not necessarily be detected until puberty?

An error early in mitosis can lead to turner's syndrome with mosaicism.

146

Anorexia can cause ___________ of the parotid gland.

Anorexia can cause swelling of the parotid glands

147

A child with atrialization of the right ventricle and decreased right ventricular volume likely had a parent with what condition?

Children born to parents who are bipolar and taking lithium are at risk for Ebstein's anomaly.

148

What is an anxiolytic that does not have significant hypnotic, sedative, or euphoric effects?

Buspirone is an anti-anxiety medication that doesn't have hypnotic, sedative, or euphoric effects. It does take about two weeks to go into full effect.

149

Where is urine concentration the lowest?

Urine concentration is lowest in the distal convoluted tubule due to the reabsorption of NaCl without water.

150

What are two drugs that can be used to help prevent tumor lysis syndrome?

Rasburicase (degrades) and allopurinol (prevents synthesis) both can help to prevent the excess buildup of uric acid during tumor lysis syndrome.

151

Non-Dihydropyridine CCBs have a _________ inotropic effect on the heart?

CCBs have a negative inotropic effect on the heart and should not be combined with other drugs (like B-Blockers) that have the same effect.

152

What congenital deformity is more likely in the child of a mother taking valproate?

Meningocele is more common in the child of a mother taking valproate.

153

An increase in the RANK receptor will cause what?

An increase in the RANK receptor will lead to increased bone resorption.

154

What is the most common cause of bacterial meningitis in adults?

Strep pneumo is the most common cause of meningitis in adults. Don't be tricked into choosing N. mening unless it is called for.

155

What is found in biopsies in people with HSP?

Henoch-Schonlein purpura will have IgA and C3 deposition in the vessels it affects. It is also associated with skin rash, abdominal pain, and joint pain.

156

What sequelae are possible in those with hemochromatosis?

Hemochromatosis can lead to liver cirrhosis and hepatocellular carcinoma

157

What aspect of therapy with opioids is least likely to resolve with time?

The constipation associated with opiate therapy is unlikely to resolve with time.

158

If someone is burning their hands frequently on the stove and has some arm weakness you should be thinking?

Synrinx will cause a cloak-like problem with sensation and will have weakness as it gets larger.

159

How does oseltamivir work?

Oseltamivir is a neuraminidase inhibitor that prevents the packaging and release of viral particles.

160

What is the difference in the mechanism of action between the azoles and Ampho B?

Amphotericin works by binding ergosterol and punching holes in cells, but the azoles work by preventing the synthesis of ergosterol in the first place.

161

In addition to pain during the menstrual period, what other side effect is common with endometriosis?

Endometriosis can also cause dyspareunia.

162

What is the only tissue in the body that relies absolutely on glucose?

RBCs have no organelles and are therefore only able to use glycolysis as an energy source.

163

What bacterium can cause meningitis in immunosuppressed people and has a tumbling motility.

Listeriosis comes from contaminated food, has a tumbling motility, and can cause meningitis in the immunosuppressed.

164

What type of colon cancer can look like a cauliflower and secrete a lot of mucus?

Villous adenocarcinoma can look like a cauliflower and can secrete a lot of mucus.

165

Guillan Barre is an immune mediated demyelination of the nerves.

Remember!

166

What is one possible additional problem that can arise in those with nephrotic syndrome?

Nephrotic syndrome can lead to an increase in the production of lipoproteins.

167

What is more common in colon cancer that arises in a setting of colitis (UC or Crohn's)?

Colon cancer arising around colitis more commonly is multifocal and will often have an early p53 mutation.

168

Which cell lines are important for forming granulomas?

Macrophages are activated by TH1 cells leading to a granuloma

169

If a patient is experiencing pain that has no identifiable physical cause during a time of intense stress, then what is going on?

Conversion disorder leads to the manifestation of neurologic symptoms when under severe emotional stress.

170

What is the best way to confirm a diagnosis of toxic megacolon?

Plain X-Ray is the best way to confirm a diagnosis of Toxic Megacolon.

171

Where are low sounds detected in the cochlea?

Low sounds are detected deep in the cochlea near the helicotrema

172

What patient population is most likely to present with cherry hemangiomas?

Cherry hemangiomas appear in aging adults, while strawberry hemangiomas appear in the first weeks of life and regress before puberty

173

Apart from the change in chloride excretion, what other change is noted in cystic fibrosis?

Increased sodium absorption into cells is also noted in cystic fibrosis

174

What is often the first event leading to the development of acute appendicitis?

Obstruction of the lumen of the appendix is often the first step along the path to developing acute appendicitis.

175

What problem can occur in someone receiving blood who has had recurrent nasal infections?

People with selective IgA deficiency can have serious problems when receiving even matched blood, because they will have antibodies to IgA that may be present in the sample.

176

How does carbamazepine work?

Carbamazepine is a sodium channel blocker for the cortical neurons.

177

What bias is minimized by double-blinding?

Observer bias is minimized by double blinding.

178

What is the most likely outcome in the kidney with granulomatosis with polyangiitis?

Crescentic glomerulonephritis is the most likely outcome in granulomatosis with polyangiitis.

179

What effect do inhaled anesthetics have on blood flow to the brain?

inhaled fluorinated anesthetics increase blood flow to the brain by decreasing peripheral resistance.

180

What is the goal of giving nitrate therapy in the morning and afternoon, but not in the evening?

Having "off-time" prevents the development of tolerance in those taking nitrates

181

What class of diuretics can cause hyponatremia as well as hypokalemia?

Thiazide diuretics can cause hyponatremia in addition to hypokalemia.

182

What changes will be observed in the small intestine under light microscopy in someone with lactose intolerance?

There will be no changes observed in light microscopy.

183

What is one possible cause of the ammonemia observed in hepatic encephalopathy?

Increased absorption of ammonia from bacteria that make it in the colon is one cause of the increased blood ammonia.

184

Which beta blockers are selective?

"A" - "M" beta blockers are mostly selective Carvedilol and carteolol excepted.

185

What is the most likely patient to present with a strawberry hemangioma?

Cherry hemangiomas appear in aging adults, while strawberry hemangiomas appear in the first weeks of life and regress before puberty

186

What is a likely cause of a pancreatitis that is acute and resolves with fasting?

Severe hypertriglyceridemia (>1000) will potentially cause an acute pancreatitis that resolves with fasting.

187

What problem will lead to dilated ureters and renal pelvis?

Urinary flow obstruction will lead to dilated ureters and renal pelvis.

188

What is the Hawthorne effect?

The hawthorne effect is the tendency of a study population to affect an outcome after they are aware they are being studied.

189

What is messed up in polycythemia vera?

Polycythemia vera will lead to an increased hematocrit, WBC count, and platelets. It is due to constitutive activation of JAK-2 which is a non-receptor tyrosine kinase.

190

What will happen microscopically in ARDS?

Inflammation of the small vessels of the lungs will lead to a transudate leaking into the alveolar spaces.

191

What is the cause of steatosis in binge drinkers?

Macrovesicular steatosis seen in binge drinking is due to a lack of fatty acid oxidation because there isn't enough NAD+.

192

How does Kleinfelter's syndrome affect hormone levels?

Kleinfelter's syndrome leads to scarring of the testes which decreases the production of Testosterone and inhibin. This causes an increase in the production of LH and FSH.

193

A pregnant woman becomes hypotensive when she lays down. What is going on?

Pregnant women can actually become hypotensive when they lay down because the baby will press on their IVC

194

What does a lack of ApoE3 and ApoE4 lead to?

Dysbetalipoproteinemia will lead to very high cholesterol and impaired reabsorption of chylomicron remnants by the liver

195

What aortic arch gives rise to a vessel that will lead to a continuous murmur in newborns?

The PDA is formed from the 6th aortic arch

196

What is the name for a culture medium that will allow only certain bacteria to grow?

A selective medium "selects" against some bacteria while allowing others to grow.

197

If an HIV positive patient develops purple lesions, what may have happened?

Kaposi Sarcoma looks like purple lesions on the skin and is associated with HHV-8 infection in HIV positive patients

198

What is one potentially beneficial effect of thiazide diuretics in older women?

Thiazide diuretics increase the absorption of calcium in the distal tubule and can help prevent the bone loss of osteoporosis.

199

What is the equation for half-life that uses the Vd and Clearance?

t1/2 = (Vd*0.7)/Cl

200

What is Trousseau's syndrome and what other condition has a similar pathophysiology?

Trousseau's Syndrome is migratory thrombophlebitis associated with cancer. It is due to a hypercoaguable state similar to marantic vegetations.

201

What is wrong with a baby that has hydrocephalus, intracranial calcifications, and chorioretinitis?

Congenital toxoplasmosis has hydrocephalus, intracranial calcifications, and chorioretinitis. It is due to in utero infection.

202

What change in the ventricles can lead them to produce ANP?

Hypertrophy of the ventricles in hypertension can induce the expression of genes in the ventricles that make ANP.

203

What is the most likely cause of death in a woman with diabetes?

MI is the most common cause of death in those with diabetes.

204

A minor league player with acne has an excess of what?

Testosterone can cause severe acne.