DIT and Random Flashcards
1
Q
Clinical manifestations of sarcoidosis
A
GRUELING
Granulomas
RA
Uveitis
Erythema nodosum
Lymphadenopathy
Idiopathic
Not TB
Gamma Globulinemia
2
Q
What is seen in synovial asparate in gout?
Pseudogout?
A
Gout: - Birefringence with needle shaped crystals
Pseudogout: + birefringence with Rhomboid shapped crystals
3
Q
Decreased AFP on amniocentesis
A
Trisomy 21
4
Q
Psammoma bodies are observed in these patholigic conditions
A
Papillary adenocarcinoma of thyroid
Serous cystAdenocarcinoma of ovary
Meningioma
Mesothelioma
PSAMMoma
5
Q
Parotid gland enlargement in a thin female?
A
Bulima/Anorexia nervosa
Parotid gland enlargement is evidence of purging
6
Q
Which DNA polymerase has 5’–>3’ exonuclease activity?
A
DNA Polymerase I
7
Q
Which prokaryotic polymerase has 3’–>5’ exonuclease activity?
A
DNA polymerase III to proofread
8
Q
Dark urine upon exposure to light
A
Acute intermittant porphyria
Uroporphyrinogen I Synthase defect
9
Q
Major lamotrigine use and side effect?
A
Partial refractory seizures
Steven-johnson syndrome
10
Q
Major adverse effect associated with Ethosuxamide
A
Steven-johnson syndrome
11
Q
Location of GLUT-1,2,3,4,5
A
GLUTE-1: RBC and Brain
GLUTE-2: Liver, B islet cells, Kidney
GLUTE-3: Neurons
GLUTE-4: Skeletal muscle and Adipose
GLUTE-5: Frutose trnasporter in the GI
12
Q
What structures are derived from the first aortic arch?
A
The maxillary artery
13
Q
Structure derived from the second aortic arch?
A
Stapedial artery
(Stapedial is Second)
14
Q
Third aortic arch
A
Common carotid and proximal internal carotid
(C is the **3rd **letter of the alphabet)
15
Q
Fourth aortic arch
A
Left: Aortic Arch
Right: proximal part of right subclavian
16
Q
6th aortic arch
A
Proximal part of the pulmonary arteries
Ductus arteriosus
17
Q
Which embryonic layer are the folling dervied from:
Branchial Clefts
Branchial arches
Branchial pouches
A
Clfects: eCtoderm
Arches: mesoderm (ARMESoderm)
Pouches: Endoderm
or CAP from outside to inside
18
Q
Cartilage, muscles and nerves derived from the first branchial arch?
A
Meckel’s cartilage, Mandible, Malleus, Mandibular ligament
Muscles: Muscles of Mastication, Masseter, lateral and Medial pterygoid, myelohyoid, anterior belly of digastric and tensor tymapni and tensor veli palitini
Nerves: V2 and V3
The M’s
19
Q
2nd branchial arch cartilage, muscles, and nerves
A
The S’s
Cartilage: Stapes, Styloid preocess, Stylohyoid ligament
Muscles: Facial expression, Stapedius and Stylohyoid
Nerves: CN VII (Seven=Smile)
20
Q
3rd branchial arch cartilage, muscles and nerves
A
“Pharyngeal”
Catilage: greater horn of hyoid
Muscles: stylopharyngeus innervated by glossopharyngeal nerve (CNVIII)
21
Q
Arches 4-6 cartilage, muscles, and nerves
A
Cartilage: thyroid, cricoid, and other laryngeal cartilage
Muscles: 4th: Pharyngeal constrictors, cricothyroid, levator veli palatini
Muscles: 6th: all intrinsic laryngeal except cricothyroid
Nerves: 4th: Superior laryngeal branch of CNX
Nerves: 6th: Recurrent laryngeal branch of CNX
22
Q
Structures derived from the 3rd and 4th branchial pouches
A
3rd: inferior parathyroids and thymus
4th: **superior **parathyroids
23
Q
Developes into the ascending aorta and pulmonary trunk
A
truncus areteriosis
24
Q
forms the smooth part of the left and right ventricles
A
bulbus cordis
25
The primitive ventricle and primitive atria form
The trabeculated parts of the ventricles and trabeculated parts of the atria respectively
26
coronary sinus is formed by the
left horn of the sinus venosus
27
Right horn of the sinus venosus forms the
smooth part of the right atrium
28
SVC is formed by
the right common cardinal vein and the right anterior cardinal vein
29
What does HCV lack that makes it so prone to mutations?
3'--\>5' exonuclease activity
30
How is the fick principle used to calculate Cardiac Output?
CO= O2 consumption/(arterialO2-VenousO2)
31
These drugs are hypnotics that cause sedation and are also anxiolytics. What is their MOA?
Ben**Z**odia**Z**epines
Increase Cl channel frequen**zzzzzz**
32
What is the most common indolent non-hodgkin lymphoma in adults?
Follicular lymphoma
33
protein that regulates the G1--\>S phase transition
How does it work?
Rb
Supresses transcription when in the hypophophrylated (active) state and is bound to EF2
When CyclinD and E and CDK4 and 6 (respectively) phophorylate Rb it becomes inactive and releases EF2 allowing transcription to take place
34
receptor that contains C and Adelta fibers and transmits pain and temperature
Free nerve endings
35
Sense pressure and deep static touch, are located in hair follicles...
What kind of fibers do they carry?
Merkel Discs
Carry large myelinated fibers and adapt slowly
36
Fine, light touch receptors that are located on hairless skin and adapt quickly...
What kind of fibers
Meisner corpuscles
Large myelinated fibers
37
Location, function, and fiber type associated with paccinian corpuscles
Large myelinated fibers
Deep skin, ligaments and joints
Sense vibration and pressure
38
Most common salivary glad tumor
Pleomorphic adenoma--\> painless mobile mass composed of cartilage and epithelium and recurs frequently
39
Benign cyctic tumor with germinal centers found in the parotid gland
Warthin tumor
| (papillary cystadenoma lymphomatosum)
40
msot common malignant salivary gland tumor
What is it composed of?
How does it present?
Mucoepidermoid carcinoma
--\>mucinous and squamous components
--\>presents as a painful mass and commonly involves the facial nerve
41
acute, fatty, foul smelling diarrhea
Giardia
(pear shapped nuclei with tumbling motility)
42
Tx for giaridia
Metronidazole
43
RBC inside of trophozoites with multiple nuclei
Entomoeba histolytica
44
DOC for entomoeba histolytica
--Trophozoites with Metronidazole and tinidazole
--Cysts with iodoquinol and paromycin
45
Bugs treated with metronidazole?
**GET GAP **on the **Metro**
**G**iardia
**E**ntomoeba
**T**richomonas
**G**ardnerella
**A**nerobic bacteria
**P**ylori (H. pylori)
46
Triad of conginital toxoplasmosis?
Choriretinitis
Hydrocephalus
Intracranial calcifications
47
Tx of toxoplasmosis
Sulfadiazine and pyrimethamine
48
Bug that causes african sleeping sickness
trypanosoma bruci (tsetse fly)
49
spiking fevers
hepatosplenomegaly
pancytopenia
Macrophages containing amastigotes
Leishmania donovani (sand fly)
50
Cutaneous ulcers that are slow to head after a bug bit?
Cutaneous leishmaniasis
51
Anopheles mosquito
Malaria
52
48 hr fever cycle
P. vivax and ovale
53
Malaria assocatied with irregular fever
P. falciparum
54
72hr fever cycle
P. malariae
55
Vivax and oval can remain dormant so must be treated with what drug
Primaqine
56
Bananna shapped gametocyte
P. falciparum
57
Tx for malaria
Start with Chloroquine
If resistant add Mefloquine
if Vivax/Ovale (48hr cycle) add primaquine
58
Tx for babesiosis
Quinine and azithromycin
59
Neomatodes that are trasmitted orally (either Fecal-oral or ingestion)
**E**nterbius (pinworm-scotch tape)
**A**sacaris (giant roundworm--Loeffler eosinophilic pneumonitis)
**T**richinella (bears--\> in the muscle)
60
Stongyloids transmission and Tx
Penetrate skin of feet--\>venous--\>lungs blahblahblah
Ivermectin or albendazole
61
Three worms from feet penetrations
**S**trongyloides
**A**ncylostoma
**N**ecator
d
62
Cestode that causes neurocystercerosis
Tanea solium
63
Cysts from dog feces
echinococcus granulosus (ethanol injected to kill cysts before removal)
64
Helminths with portal hypertension and splenomegaly
Schistosoma
65
Top 3 most common cancers in men in US
Prostate
Lung
Colon
66
Most common cancer in women in US
Breast
Lung
Colon
Uterus
67
Men most mortalities from cancer
Lung
Prostate
Colon
(switch one and two most common)
68
Most mortalities from cancer in women in US
Lung
Breast
Colon
(Switch first and second most common)
69
What CDK and cycldin is involved in Rb protein phosporylation
Cyclin D activated CDK4--\>Rb phosphorylation
Phosphorlated Rb detaches from EF2 and allows G1-S phase to continue
70
Tumors associated with tuberous sclerosis?
Skin manifestation to TS?
-Cardiac rhabdomyoma, renal angiomyolipoma, astrocytoma
## Footnote
**Ash Leaf spots**
71
Most common three drug regimin for testicular cancer?
**E**radicate **B**all **C**ancer
**E**topiside
**B**leomycin (can be replaced with Ifosfomide)
**C**isplatin
72
Cancer drug that stabilizes microtubules
Paclitaxel and taxols
TAXES stabilize society
73
Side effects of glucocorticoid use
**BAM CUSHINGOID**
**B**uffalo Hump
**A**menorrhea
**M**oon faces
**C**razy (psychosis)
**U**lcers
**S**kin changes
**H**TN
**I**nfection
**N**ecrosis of the femoral head
**G**alucoma and cataracts (hyperglycemia)
**O**steoporosis
**i**mmunosuppression
**D**iabetes
74
Patient with a recent subarachnoid hemorrhage (4-12d) develops similar symptomes (muscle weakness) as the original event. What is the most likely cause?
Cerebral vasospasm
Seen in \>50% of SAH and will manifest with similar physical finidings and a negative non-contrast CT
75
MOA of colchicine
Inhibits microtubule formation thereby affecting leukocyte migration and chemotaxis
76
Etoposide inhibits....
Topoisomerase II
77
Morphine acts by...
Inihbiting mu receptors and causing **increase potassium efflux from the post-synaptic neuron.**
78
Paitient with a significant family Hx of early cancers of the brain, adrenal cortex, breast, leukemia and sarcomas. What is the mutation and what is the name of the disorder?
Li-Fraumeni Syndrome
Mutation in p53
79
Mutation in pecam-1 would affect this step of leukocyte migration...
Transmigration
80
A young child with difficulty walking, oral telangiextasias and recurrent infections
Ataxia-telangiectasia
ATM gene mutation
Cerebellar atrophy
81
Hemosiderin laden macrophages in the lungs are indicative of this pathology
Left ventricular dysfunction
Heart failure cells
82
This is supplemented in orotic acidurea
Uridine
83
Pulmonary edema has what effect on lung compliance?
Reduces it
84
Where does osteomyelitis most common occur?
Metaphysis of long bones
85
What does hyperPTH look like on xray?
**Subperiosteal thinning** with cystic degeneration
86
Selective proteinuria
Loss of albumin without loss of the bulkier proteins like IgG and IgM
87
Why is albumin the predominant protein lost in minimal change disease?
Becuase mostly the negatively charged molecules are lost from the GBM in MCD and albumin is small enough to fit through pores.
Without charge exclusion from heparan sulfate and other proteoglycans, albumin leaks
88
X-linked disorder consisting of excema, recurrent infections and thrombocytopenia
Wiscott-Aldrich syndrome
89
Replicates in cold environment and exhibits tumbling motility. Almost exclusively seen in IC adults.
Listeria monocytogenes
90
A 85 year old patient with focal motor deficits and hypertension.
CT of the head reveals a small cystic lesion in the brain. What is the cause of this lesion?
Lacunar infarct
--\>Hyaline arteriolosclerosis
91
What cholesterol lowering drugs cause hypertriglyceridemia? How?
Bile acid binding resins (cholecytyramine)
--\>raise TGs by binding bile acids and forcing the liver to mobilize LDL and increase uptake to resynthesize bile acids
92
What lipid lowering drug increases the toxicity of statins?
Gemfibrozil (fibrates)
Increased the myopathic toxicity
93
Lobular strokes occuring in the cerebral hemisphere and not as severe as other strokes
Cerebral amyloid angiopathy
94
Nitrogen in urea are derved from what two compounds?
NH3 and Aspartate
95
antipsychotic that causes retinal deposits
Thio**R**idizine
**R**etinal deposits
96
Findings in pulmonary silicosis
Eggshell calcification of hilar lymph nodes
Birefringent silica crystals
97
What is the most potent echosinoid chemotactic agent?
Which of these are implicated in asthma related bronchospasm?
Leukotriene B4
Asthma: LTC4, D4 and E4
98
Which of the anti-tuberculoid drugs have highest acticity at low pH (in the lysosmes)
Pyrazinamide
99
Is KRAS an anti- or proto-oncogene?
Proto-oncogene
100
What AAs should be restricted in a pt with MSUD
Isoleucine
Leucine
Valine
**I** **L**ove **V**ermont maple syrup
101
Enzyme defect in acute intermittant porphyria?
KNOW WHERE IN THE CYCLE THIS FITS
Porphobilinogen deaminase
AKA
Uroporphyrinogen I Synthase
102
Hemophilia inheritance pattern?
X-linked recessive
103
Myasthenia gravis pts will benefit from what surical procedure? Why?
Thymectomy
Most MG pts have hyperplastic thymic tissue producing the AChR auto antibodies (causing a type II hypersensitivity) and a small percentage of them also have thymoma
104
Digeorge syndrome--\> conginital aplasia of which structures
3rd (thymus and inferior parathyroids) and 4th (superior parathyroids) pharyngeal **POUCHES**
**POUCHES**
**POUCHES**
**POUCHES**
105
Levels of serum pH, K, and Na in DKA
pH is low
K is high (relitively because total stores are low due to loss in urine)
Na is low (due to osmotic pressure of glucose and loss in urine)
106
Anti-cancer agent that is extremely ototoxic
cisplatin
107
Slowly progressive cough and dyspnea in a patient being Tx'ed for a ventricular arrythmia
Amiodarone
108
Process by which fatty acids are anchored to the plasma membrane
polmitoylation
109
mutations in the same gene presenting with varying degrees of disease
Allelic heterogenicy
110
Point mutation in FGFR3
Achondroplasia
111
Two enzymes that require thiamine (B1) as a cofactor.
Transketolase
Alpha-ketoacid decarboxylase (MSUD)
112
Type and size of RBC seen in thalassemias
Microcytic
Target cells
113
In females the gubernaculum persists as the
round ligament of the uterus
114
PAF (platelet activating factor) causes what response through what receptor?
Vasoconstriction
Bronchoconstriction
Platelet activation and thrombus formation
Gq receptor mediated (IP3 and Ca)
115
First step of FA oxidation is catalyzed by what enzyme?
Acetyl-CoA Dehydrogenase
Deficiency causes severe fasting hypoglycemia with decreased ketones
116
Which of the tumor supporssor and proto-oncogenes is a transmembrane (rather than intranuclear) receptor?
Ras
MAP-kinase receptor
117
In a lineweaver-burke plot, increased enzyme will have what effect on the graph
The y-intercept will decrease (Increased 1/vmax)
x-intercept (1/Km) will stay the same becuase the affinity of the receptor for the substrate has not changed
118
Pt with apthous (oral) ulcers and perianal disease. What part of the GI tract is most likley affected?
Ileum
--\> Most commonly area affected by **crohns disease**
119
Which fibers are the only ones in the body that are unmyelinated
Postganglionic autonomic fibers
First order olefactory fibers
C fibers carrying slow pain and dull sense
120
Entero viruses (coxsackie, polio, echo, entero, and hepatitis) are all part of what family of viruses?
Picornoviruses
121
During antigen processing, what chain is processed by macrophages
invariant chain
122
Different mutations in **different genes** causing **similar phenotypes** is called:
Different mutations in the **same gene** causing **similar phenotypes** is called:
Different mutations in the **same gene** causing **different phenotypes** is called:
Genetic heterogenicity
Allelic heterogenicity
Phenotypic heterogenicty
123
Aminoglycosides, amphoterocin B, radiocontrast dyes and heavy metals are all toxic to the...
Kidney
124
Leuprolide MOA
GnRH analogue which decreases LH and FSH when dosed continuously
Mimics endogenous GnRH when dosed in pusatile manner
125
Only type of renal stone that does not show up on plain x-ray
Uric acid stones
126
How does N-acetylcysteine tx the pulmonary sx of cystic fibrosis
N-acetylcysteine breaks the disulfide bonds of the mucus glycoproteins which leads to loosening of the mucus
127
Polyarteritis nodosa is associated with what other disease
Hepatitis B
128
TZDs should be monitored closely with what tests?
LFTs due to heptaotoxicity
129
Should be given to reduce cisplatin toxicity
What toxicity is associated with cisplatin?
Amifostine
--\>Nephrotoxicity
130
2 year old child with non-rhytmic eye movements, myoclonus and an abdominal mass
Neuroblastoma
131
Fist coagulation factor to decrease in chronic liver disease?
Factor VII
132
C-myc serves what function?
In which neoplastic process is it dysfunctional?
Transcription activator
Burkitt Lymphoma t(8;14)
133
Medical Tx of pulmonary HTN
Bosetan--\> endothelian antogonist--\> vasoconstriction and inhibition of endothelial cell proliferations
134
Swish and swallow for oral cadidiasis
Nystatin
Not absorbed from the GI tract
Similar in action to amphertericin B
135
Bonchiolitis obliterans
chonic lung transplant rejection
Obliteration of the small airways
136
Patient treated for bradycardia now has eye pain
Atropine--\> caused acute closed angle glaucoma
137
Vincristine toxicity
neurotoxicity
138
bradycardia and STEMI in II III and aVF, what artery
Right coronary artery
Supplies SA node (brady) and inferior heart (II, III, aVF)
139
Migratory thrombophelbitis should make you think....
Cancer
140
Councilman bodies
Acidophillic bodies on H&E stain indicating apoptosis
141
Most common benign liver tumor
cavernous hemangioma
142
endoneural inflammatory infiltrate present after upper respiratory tract infection
Guillian-barre
143
Preferred location of biopsy in hirshprung Dz
Rectal suction biopsy
144
Reactive arthritis marker
HLA-B27
145
Besides a phepchromocytoma, what else would be on the differential of a person with maligant HTN and palpitations
Withdrawl from clonidine and B-blockers
146
Purpose of bromodeoxuridine in tumor grading
Thymidine analogue
--\> increased uptake into the tumor indicates many cells in the S-phase--\>High grade and rapidly dividing
147
Patient diagnosed with dibetes mellitus who has epidermal necrolysis of the lower extremity and abdominal pain
Glucagonoma
148
Mitral valve deposits and MI in the setting of no coronary artery involvement
Libmann-Sachs endocarditis
caused by SLE and hypercoagulability
149
Cofactor needed to convert glutamyl residues into y-carboxyglutamate
Vitamin K
150
Increaed serum transaminases with dificulty speeking and ataxia
Wilson disease
Slip lamp exam for keiser fleischer rings
151
What malignancy is likely to arise with retinoblastoma
Sarcomas
Specifically osteosarcoma
152
Anti-Hu, Anti-Yu, and Anti-Pu Ab
Paraneoplastic degeneration of the cerebellum
153
Disturbed color preception, nausea, vomiting and anorexia are caused by what medication
digoxin
154
Comedocarcinoma is also known as a
Ductal carcinoma in situ
155
Type of degeneration seen in hepatitis
Ballooning degeneration
156
Foscarnet chelates this electrolyte
Calcium--\>Tx of cmv retinitis can lead to neprotoxicity and seizures
