Combank Assessment #2 P2

Question 1

How does PCOS present clinically?

Answer 1

increased LH, decreased FSH, increased testosterone, increased androgens and increased estrogens; manifests clinically with amenorrhea, infertility, obesity and hirsutism

Question 2

How does PCOS cause infertility?

Answer 2

elevated LH levels and elevated LH:FSH ratio; high levels of LH cause down regulation of the LH receptors at the ovaries this prevents the LH surge needed to trigger ovulation during the menstrual cycle

Question 3

How is schistosomiasis acquired and how may it present?

Answer 3

exposure to contaminated water; can present with severe itching after exposure to the skin

Question 4

What is the DOC for shistosomiasis and how does it work?

Answer 4

Praziquantel; causes calcium influx that depolarizes the tough outer tegument of the worm leading to paralysis and death

Question 5

Mebendazole and albendazole both inhibit?

Answer 5

beta-tubulin polymerization, which inhibits microtubule formation thereby damaging the structural integrity of helminthic parasites

Question 6

This is an NSAID that closes a PDA

Answer 6

Indomethacin

Question 7

This is a prostaglandin PGE1 analog used to keep the PDA open

Answer 7

Alprostadil

Question 8

What are first line medications to treat PTSD?

Answer 8

SSRIs

Question 9

Transmural inflammation with “creeping fat” is hallmark of which inflammatory bowel disease?

Answer 9

Crohn’s disease

Question 10

Crypt abscesses (clusters of neutrophils within damaged epithelium) are a distinguishing characteristic of which inflammatory bowel disease?

Answer 10

ulcerative colitis

Question 11

What is the MOA of Doxepin?

Answer 11

first generation TCA; blocks reuptake of NE and serotonin at the synapse

Question 12

What is the classic presentation of DiGeorge syndrome?

Answer 12

a triad of conotruncal cardiac abnormalities, hypocalcemia and thymic hypoplasia

Question 13

What is a well known paraneoplastic syndrome of small cell lung cancer which causes hyponatremia?

Answer 13

SIADH

Question 14

In what portion of the nephron does ADH act on?

Answer 14

collecting tubule

Question 15

Polymyalgia rheumatica most commonly presents in what population of patients?

Answer 15

females over the age of 50 years old

Question 16

How does polymylgia rheumatica present?

Answer 16

causes myalgias and stiffness of the shoulder and hip girdle muscles; commonly associated with giant cell arteritis

Question 17

What causes panlobular emphysema and how does it present??

Answer 17

involves entire respiratory lobule; occurs in patients with alpha 1 antitrypsin deficiency which leads to destruction of lung elastin

Question 18

Smoking causes what kind of emphysema?

Answer 18

centrilobular emphysema

Question 19

What is DIC and what characterizes it?

Answer 19

a complicated d/o that involves both excess bleeding and widespread thrombosis; fibrinogen is decreased while fibrin split products are increased

Question 20

The ventral posterior medial nucleus of the thalamus receives sensory information from?

Answer 20

face; thalamus then sends this information to the primary sensory cortex

Question 21

The ventral posterior lateral nucleus of the thalamus receives sensory input from?

Answer 21

the body and projects it to the primary sensory cortex

Question 22

What should be checked when oral potassium fails to increase serum levels of potassium in a hypokalemic patient?

Answer 22

check for an underlying hypomagnesemia condition; this is b/c magnesium is a cofactor in potassium channel function within the kidney, acting to close channels in the absence of aldosterone, in cases of low serum Mg, these channels can remain open causing potassium wasting

Question 23

What is Still’s murmur?

Answer 23

a benign pediatric murmur that commonly presents in healthy children 2-8 y.o.; typically heard as a mid-systolic murmur of musical quality between the apex of the heart and left sternal border

Question 24

Where are indirect inguinal hernias located?

Answer 24

lateral to the inferior epigastric artery

Question 25

Where are direct inguinal hernias located?

Answer 25

medial to the epigastric artery

Question 26

Indirect hernias result from?

Answer 26

a patent processus vaginalis -- this can lead to formation of a hydrocele

Question 27

What type of hernia is most common in women and what does it result from?

Answer 27

femoral hernias are most common in women; these result from a defect in the femoral canal

Question 28

Direct inguinal hernias involve penetration into?

Answer 28

Hesselbach's Triangle

Question 29

What is sensitivity?

Answer 29

% of known positives that actually test positive

Question 30

How do you calculate sensitivity?

Answer 30

true positive / [true positives + false negatives]

Question 31

How do you calculate specificity?

Answer 31

true negatives / [true negatives + false positives]

Question 32

Tuberous sclerosis has what inheritance pattern?

Answer 32

autosomal dominant

Question 33

Ash leaf spots (hypopigmented macules) are associated with?

Answer 33

Tuberous sclerosis

Question 34

What is the most common manifestation of tuberous sclerosis in the kidneys?

Answer 34

Angiomyolipoma

Question 35

Tetany is a sign of?

Answer 35

hypocalcemia

Question 36

Which syndrome has an increased association with horseshoe kidney development?

Answer 36

Turner Syndrome (XO)

Question 37

Major hormone responsible for gallbladder contraction and pancreatic enzyme secretion

Answer 37

CCK

Question 38

CCK is produced by endocrine cells that line the mucosa of the small intestine in response to?

Answer 38

ingested fats and proteins

Question 39

Secretin is produced by cells in the small intestine in response to?

Answer 39

acidity that results from the secretion of chyme into the small intestine

Question 40

Pepsinogen secreted by the chief cells of the stomach is converted to the active form of pepsin in what conditions?

Answer 40

low gastric pH; thus hydrochloric acid is responsible for the conversion of pepsinogen to pepsin, which breaks down proteins in food

Question 41

When is trypsinogen secreted into the duodenum?

Answer 41

when the pancreas is stimulated by CCK

Question 42

Which enzyme acts to convert trypsinogen into the active form of trypsin in the small intestine?

Answer 42

enteropeptidase

Question 43

What is primarly lateral sclerosis?

Answer 43

a benign condition that manifests as a disturbance of upper motor neurons

Question 44

What is Patau syndrome?

Answer 44

a trisomy 13 that leads to rocker-bottom feet, microphthalmia, microcephaly, cleft lip, holoprosencephaly and polydactyly

Question 45

What is Edwards syndrome?

Answer 45

a trisomy of chromosome 18 that results in mental developmental delay, rocker-bottom feet, micrognathia, clenched hands, and congenital heart disease

Question 46

Microdeletions of chromosome 5 leads to what syndrome?

Answer 46

cri-du-chat syndrome - results in microcephaly, mental developmental delay and a high pitched cry or mewing

Question 47

What characterizes Williams syndrome?

Answer 47

Elfin facies, mental retardation, hypercalcemia, and extreme friendliness towards strangers; due to a deletion on chromosome 7

Question 48

Risk factors for endometrial hyperplasia and endometrial adenocarcinoma are factors that?

Answer 48

increase exposure of the endometrial lining of the uterus to unopposed estrogen throughout one's life

Question 49

This drug induces the expression of insulin-responsive genes

Answer 49

Rosiglitazone

Question 50

Pancreatic head tumors most commonly present with?

Answer 50

pain, obstructive jaundice, dark urine, steatorrhea, clay colored stools and weight loss

Question 51

Which vaccines are egg-based?

Answer 51

MMR, influenza vaccine, yellow fever vaccine

Question 52

What are the three major branches that originate from the celiac trunk (a major branch of the abdominal aorta)?

Answer 52

left gastric artery, common hepatic artery, splenic artery

Question 53

Sheehan syndrome -- ischemic necrosis of the anterior pituitary is a complication of?

Answer 53

massive blood loss during delivery

Question 54

What is the DOC for Chagas Disease?

Answer 54

Nifurtimox

Question 55

S3 is associated with what type of cardiomyopathy?

Answer 55

dilated cardiomyopathy

Question 56

What is Leigh syndrome?

Answer 56

caused by pyruvate dehydrogenase deficiency; cannot convert pyruvate to acetyl coA so excess pyruvate becomes lactate causing lactic acidosis; patients present with poor feeding, developmental delay, seizures, abnormal eye movements, ataxia and mental delays

Question 57

Diffuse large B cell lymphoma has what age of onset? what manifestation is a common presenting symptom?

Answer 57

onset during 7th to 8th decades of life; extranodal manifestations are a common presenting symptom and can lead to enlarging mass seen in the testicle

Question 58

What causes a varicocele?

Answer 58

dilatation of the pampiniform plexus of the spermatic veins

Question 59

What is known as a "bag of worms"?

Answer 59

varicocele

Question 60

What is a hydrocele?

Answer 60

collection of peritoneal fluid in the tunica vaginalis - a layer that surrounds the testes and spermatic cord

Question 61

What is a unique finding of a hydrocele during examination?

Answer 61

fluid in the hydrocele transilluminates

Question 62

Tay-Sachs disease involves a deficiency in what enzyme?

Answer 62

Hexosaminidase A -- leads to accumulation of GM2 ganglioside

Question 63

What enzyme is deficient in Niemann-Pick disease?

Answer 63

Sphingomyelinase

Question 64

Epidermis, nerves, and melanocytes all stem from what embryological layer?

Answer 64

Ectoderm

Question 65

What is Korsakoff psychosis characterized by?

Answer 65

amnesia, hallucinations, and confabulation due to thiamine deficiency; it is associated with alcoholism

Question 66

A blowing holosystolic murmur loudest at the left 4th intercostal space is descriptive of?

Answer 66

VSD

Question 67

Trichomonas vaginalis causes what type of discharge?

Answer 67

foul-smelling greenish discharge

Question 68

How is trichomonas vaginalis best visualized?

Answer 68

via a wet mount slide

Question 69

What is the indicated treatment for Trichomonas, Giardia, Gardnerella, anaerobes

Answer 69

Metronidazole

Question 70

Name the cluster A personality disorders

Answer 70

paranoid, schizoid, schizotypal

Question 71

Name the cluster B personality disorders

Answer 71

antisocial, borderline, histrionic, narcissistic

Question 72

Name the cluster C personality disorders

Answer 72

avoidant, dependent, obsessive-compulsive

Question 73

What disease is characterized by hemangioblastomas of the CNS, retina, pancreas, kidneys and adrenal glands?

Answer 73

Von-Hippel-Lindau disease

Question 74

Von Hippel Lindau disease is due to error on what chromosome?

Answer 74

Chromosome 3

Question 75

What is the most common primary renal tumor in children? what chromosome is affected?

Answer 75

Wilm's tumor; chromosome 11

Question 76

La Crosse virus a member of the Bunyaviradae family causes?

Answer 76

California encephalitis

Question 77

What does retroperitoneal mean?

Answer 77

located between the posterior parietal peritoneum and posterior abdominal wall

Question 78

Primary retroperitoneal structures include....

Answer 78

adrenal glands, kidneys, ureters, bladder, aorta, IVC and rectum

Question 79

Secondary retroperitoneal structures include....

Answer 79

head, neck, and body of pancreas, ascending colon, descending colon, duodenum (except first portion)

Question 80

What does secondary retroperitoneal mean?

Answer 80

structures that were once suspended by mesentery but migrated posterior