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Flashcards in DIT and Random Deck (156):
1

Clinical manifestations of sarcoidosis

GRUELING

Granulomas

RA

Uveitis

Erythema nodosum

Lymphadenopathy

Idiopathic

Not TB

Gamma Globulinemia

2

What is seen in synovial asparate in gout?

Pseudogout?

Gout: - Birefringence with needle shaped crystals

Pseudogout: + birefringence with Rhomboid shapped crystals

3

Decreased AFP on amniocentesis

Trisomy 21

4

Psammoma bodies are observed in these patholigic conditions

Papillary adenocarcinoma of thyroid

Serous cystAdenocarcinoma of ovary

Meningioma

Mesothelioma

PSAMMoma

5

Parotid gland enlargement in a thin female?

Bulima/Anorexia nervosa

Parotid gland enlargement is evidence of purging

6

Which DNA polymerase has 5'-->3' exonuclease activity?

DNA Polymerase I

7

Which prokaryotic polymerase has 3'-->5' exonuclease activity?

DNA polymerase III to proofread

8

Dark urine upon exposure to light

Acute intermittant porphyria

Uroporphyrinogen I Synthase defect

9

Major lamotrigine use and side effect?

Partial refractory seizures

Steven-johnson syndrome

10

Major adverse effect associated with Ethosuxamide

Steven-johnson syndrome

11

Location of GLUT-1,2,3,4,5

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

What structures are derived from the first aortic arch?

The maxillary artery

13

Structure derived from the second aortic arch?

Stapedial artery

(Stapedial is Second)

14

Third aortic arch

Common carotid and proximal internal carotid

(C is the 3rd letter of the alphabet)

15

Fourth aortic arch

Left: Aortic Arch

Right: proximal part of right subclavian

 

A image thumb
16

6th aortic arch

Proximal part of the pulmonary arteries

Ductus arteriosus

17

Which embryonic layer are the folling dervied from:

Branchial Clefts

Branchial arches

Branchial pouches

Clfects: eCtoderm

Arches: mesoderm (ARMESoderm)

Pouches: Endoderm

or CAP from outside to inside

18

Cartilage, muscles and nerves derived from the first branchial arch?

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

2nd branchial arch cartilage, muscles, and nerves

The S's

Cartilage: Stapes, Styloid preocess, Stylohyoid ligament

Muscles: Facial expression, Stapedius and Stylohyoid

Nerves: CN VII (Seven=Smile)

20

3rd branchial arch cartilage, muscles and nerves

"Pharyngeal"

Catilage: greater horn of hyoid

Muscles: stylopharyngeus innervated by glossopharyngeal nerve (CNVIII)

21

Arches 4-6 cartilage, muscles, and nerves

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

Structures derived from the 3rd and 4th branchial pouches

3rd: inferior parathyroids and thymus

4th: superior parathyroids

23

Developes into the ascending aorta and pulmonary trunk

truncus areteriosis

24

forms the smooth part of the left and right ventricles

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?

BenZodiaZepines

Increase Cl channel frequenzzzzzz

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

Q image thumb

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

Giardia

Entomoeba

Trichomonas

Gardnerella

Anerobic bacteria

Pylori (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)

Enterbius (pinworm-scotch tape)

Asacaris (giant roundworm--Loeffler eosinophilic pneumonitis)

Trichinella (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

Strongyloides

Ancylostoma

Necator

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

Ash Leaf spots

71

Most common three drug regimin for testicular cancer?

Eradicate Ball Cancer

Etopiside

Bleomycin (can be replaced with Ifosfomide) 

Cisplatin

72

Cancer drug that stabilizes microtubules

Paclitaxel and taxols

TAXES stabilize society

73

Side effects of glucocorticoid use

BAM CUSHINGOID

Buffalo Hump

Amenorrhea

Moon faces

Crazy (psychosis)

Ulcers

Skin changes

HTN

Infection

Necrosis of the femoral head

Galucoma and cataracts (hyperglycemia)

Osteoporosis

immunosuppression

Diabetes

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

A image thumb
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

ThioRidizine

Retinal 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 Love Vermont maple syrup

101

Enzyme defect in acute intermittant porphyria?

KNOW WHERE IN THE CYCLE THIS FITS

Porphobilinogen deaminase

AKA

Uroporphyrinogen I Synthase

A image thumb
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

A image thumb
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