Parasympathetic stimulation of the parietal cells is mediated through what neurotransmitter and through what receptor?
-M3 muscarinic receptor which operates through a Gq protein releasing phospholipase C (IP3/DAG pathway)
What are the laboratory findings in grave's disease for the following:
Serum T4: High
Free T4: High
Serum TSH: Low
Thyroid Iodine Uptake: HIGH
What type HIV drug would be given to a pregnant Pt?
What is the MOA of thses drugs?
What are some names of these drugs?
NRTIs (nucleoside reverse-tramscriptase inhibitors)
-Competitive inhibtion of RNA-dependant-DNA-polymerase and termination of the DNA chain
-Zidovudine, lamivudine, abacavir, tenofovir, emtricitobine
What part of the lung does M. tuberculosis prefer? Why?
What kind of psychiatric disorder is chracterized by aggression towards people or animals, antisocial tendancies, decitfulness and serious violations of rules?
What type of hypersensitivity reaction is Gullian-Barre syndrome? Why?
--> It is caused by antigenic activation of T-cells leading to macrophage activation.
Pt. with ammenorehea, loss of vision, and galactorrhea with recent history of peptic ulcer disease. Explain:
MEN1--> Wermer syndrome
MEN1 typically presents with petuitary adenoma, parathyroid tumor and tumors of the pancreas.
Vison changes and galactorrhea--> PRL secreting Petuitary adenoma
PUD--> Gastrin secreting adenoma of the pancreas.
What muscles are affected in carpel tunnel syndrome?
Opponens pollicis, abductor policis brevis, flexor policis brevis
Pt. immigrates from central america with cough and fever. KOH of sputum reveals multiple yeast budding concentrically from a larger yeast. What bug?
Looks like a "Pilot's Wheel"
This electrolyte abnormality can cause Digoxin toxicity. How?
Digoxin increases ionotropy by inhibiting Na+/K+-ATPase and thereby increases intracellular Ca+ by decreasing the activity of the Na+/Ca++ exchanger present on the sarcoplasmic retuculum.
Drug that is effective in treating the pain from post herpetic neuralgia.
Infant being weaned from the breast is experiecing vomiting, nausea, and hypoglycemia.
What is the problem? What builds up?
Heriditary fructose intollerance.
Aldolase B deficiency
"All-dose ladies B-tol(erance) in their foot-toes (fructose) shoes"
Frutose-1-phosphate builds up becuase it is trapped in the cell but is unable to be converted to GAP and DHAP by aldolase.
Most common cause of testicular mass in an infant male?
Marker and cell type present?
Yolk sac tumor
Angina that is caused by physical activity and relieved by NO or rest is characterized by what EKG finding?
ST segment depression
--> ischemia that does not fully penetrate the wall
AKA Stable angina
A serum ascities-albumin gradient (SAAG) of what value is a cutoff? What does this mean?
What is the equation to calculate the SAAG?
>1.1g/dL indicates that the ascities is due to portal HTN
<1.1 indicates that the ascites is due to decreased plasma colloid oncotic pressure
SAAG= (Serum albumin) - (Ascitic Albumin)
--> This makes sense because as long as your ascitic albumin is low, then water is not being drawn out into the abdominal cavity
Reactivation of TB is what kind of hypersensitivity reaction?
Type IV--> delayed type T cell response
Isoniazide can cause depletion of what vitamin?
Prolonged PT time and hemarthosis as well as prolonged surgery bleeding is cause by a deficiency in what branch of the coagulation pathway?
What is the believed cause of aspiring induced asthma?
Surfactant is produced by
Type II pneumocytes
A somatostatinoma will cause what S&S?
-Hyperglycemia (due to insulin oposition)
Somatostatin is produced where?
In the Delta cells of the pancreas
MOA of amilioride and triamterine?
Inhibit Na/K-ATPase in the distal convuluted tubule
--> K sparing
Pancreatic chapman point?
Between ribs 7 and 8 on the right
Magnesium toxicity will present initially with increased or decreased DTR? Why?
Mg opposes Ca entry and therefore Ach release from the presynaptic neurons
Characteristic finding on biopsy of brain with rabies?
Tapeworm found in dog feces that causes hydatid cyst disease?
Tx with Albendazole
Most important metabolic abnormalities with acute alcohol toxicity?
-Hypoglycemia--> due to increased NADH from acetate formation leading to decreased gluconeogenisis
-->lactic acidosis from the hypoglycemia
What is the purpose of the RB gene?
Holds DNA in the G1 phase until it is ready for cell division
Night terrors and enuresis occur durring what stage of sleep?
What is the characteristic of this stage on EEG?
Supination of the foot involves what three movements?
Inversion, adduction and plantarflexion
MOA of aminoglycosides?
Major side effect?
Example of drug?
Bind to and inhibit 30s subunit
Ototoxicity--> contraindicated in pregnancy
Most common cause of epididymitis in middle age? Tx?
Ceftriaxone and Doxycycline
Triad of Bachet syndrome?
Renal cell carcinoma has a strong association with this genetic abnormality
Children who walk on their toes?
Duschenes muscular dystrophy
MOA and use of methylphenedate?
Block NE and Dopamine reuptake
Used in ADHD
Cerebral palsy pts have this characteristic gait
Extreme adductor hypertonicity
Focal segmental glomerulonephritis is associated with what two chronic illnesses?
HIV and Narcotic abuse
Mass in the right upper quadrant in a patient with recent weight loss and is a long term smoker
Couvoisier's sign--> caused by obstruction of the bile duct by the head of the pancreas
Tumor marker associated with pancreatic cancer
Which vitamin deficiency is associated with angular chelitis?
Vitamin B2--> Riboflavin
A mutation in what chromosome is resposible for sickle cell anemia?
AR or AD?
ash leaf spots (hypopigmentation), angiofibromas, cardiac rhabdomyomas, mental retardation
Level and dermatographic distribution of the medial antebrachial cutaneous N.?
Function and innervation of the biceps femoris?
Knee flexion and hip extension
-Long head is innervated by the Sciatic (L5-S3)
-Short head is innervated by the common peroneal branch of the sciatic (L5-S2)
Hepatits form that replicates via a reverse transcriptase?
This form of hepatitis coats itself with LDL and VLDL to infect hepatocytes
This type of hepatitis has high fetal and pegnancy mortality
Crainal manipulation of this bone is indicated in AOM
Most of the eustation tube is closely associated with the temporal bone.
First line Tx of diabetes?
What are the first gen atypical antipsychotics?
What are their MOAs?
Fluphenazine, haloperidol, droperidol, chlropromazine, thioridizine
--> Inhibition at D2 receptors
CAG trinucleotide repeat
-->anticipation caused by alippage of the DNA polymerase during transcription
Fragile X syndrome
Study of choice to determin disease prevelance in a population?
Drug commonly used as an antispasmotic in COPD and has a common side effect of dry mouth?
DOC for A. isralii causing 'lumpy jaw' abscess. (yellow granular discharge)
H2 blockers like the ones used in GERD all end in what?
Rinitidine, cimetidine, famotadine etc
Tinitus, sensoryneural hearing loss, and vertigo
Roaring in the ears and spinning room
What two muscles are tested with the finklestein test?
Abductor pollicis longus
Extensor pollicis brevis
Amiodarone can cause what respiratory abnormality?