Final Countdown Flashcards
1
Q
What must you monitor on a pt. who is taking clozapine?
A
Abs. Neutrophil count.
2
Q
pyrrolidonyl arylamiase (PYP) postitive ==> ?
A
S. pyogenes
3
Q
low serum ceruloplasmin ==>
A
Wilson’s disease
4
Q
fluoxetine: ?
A
SSRi
5
Q
Deferozamine: ?
A
DOC for iron overdose; chelating agent that binds irons and converts it to water-sol.
6
Q
Edetate calcium disodium: ?
A
DOC for lead poisoning; increases urinary excretion of lead.
7
Q
cell body rounding; peripheral displacement of nuclei; dispersion of Nissl Substance to periphery of cell ==???
A
Axonal reaction.
8
Q
Pt. with Hx of either: sickle cell, vasculitis, glucocorticoid Tx, alcoholism; presents with femoral head bone pain. ==> ???
A
Osteonecrosis (avascular necrosis)
9
Q
Peds; fever for more than 5 days; bilat. conjuctivitis; swelling of hands and feet; cervical LAD, rash, mucositis (“strewberry” tongue) == >???
A
Kawasaki’s
10
Q
Berkson’s bias: ?
A
type of selection bias that can be created by selecting hospitalized pt. as the control group.
11
Q
What is the major risk factor for the dev. of intimal tears leading to aortic dissection?
A
HYPER-fucking-TENSION!
12
Q
infection starts following organism’s penetration of the skin by filariform (infection-stage) larva and can be ddX by finding rhanditiform (non-infectious) larvaw in the stool. What organism?
A
Stronglyloides stercoralis
13
Q
infection starts following organism’s penetration of the skin by filariform (infection-stage) larva and can be ddX by finding rhabditiform (non-infectious) larvaw in the stool. What organism?
A
Stronglyloides stercoralis
14
Q
What personality disorder ~ magical beliefs, social anxiety, eccentric behaviors, and odd perceptual experiences?
A
Schizotypal personality disorder!
15
Q
Lipid-filled intimal plaque = ?
A
atheromas=lipid-filled intimal plaques that bulge into the arterial lumen ==> create fixed stenosis ==> Claudication.
16
Q
t(14;18) ==>
A
follicular lymphoma; a non-hodgkins lymphoma; bcl-2 overexpression
17
Q
Malignant tumors of the parotid gland compresses what nerve and causes what?
A
CN7; causes ipsilateral facial droop
18
Q
Malignant tumors of the parotid gland compresses what nerve and causes what?
A
CN7; causes ipsilateral facial droop
19
Q
What is the drug that is responsible for the major part of the clot lysis in an acute MI?
A
tPA
20
Q
What issue of the heart leads to increased LA pressure and increase PCWP?
A
mitral stenosis!
21
Q
What vitamin/mineral overload is seen in sarcoidosis?
A
HyperCa2+; activated macrophages increase expression of a-alpha-hydroxylase, leads to excess 1,25-vitamin-D. (happends in other granulomatous disease too.
22
Q
What vitamin/mineral overload is seen in sarcoidosis?
A
HyperCa2+; activated macrophages increase expression of a-alpha-hydroxylase, leads to excess 1,25-vitamin-D. (happends in other granulomatous disease too.
23
Q
Uricosuric agents (eg. probenecid)
A
increase renal excretion of uric acid; 2nd DOC; contra in Pt. with Hx of renal stones.
24
Q
D-penicillamine to Tx:
A
Wilson’s disease; Cu+ chelator.
25
Uricosuric agents (eg. probenecid)
increase renal excretion of uric acid; 2nd DOC; contra in Pt. with Hx of renal stones.
26
Failure of the left and right maxillary prominences to merge in the fetus causes what?
cleft palate
27
cleft palate is due to what embryo issue?
Failure of the left and right maxillary prominences to merge in the fetus
28
Pancreatic divisum is the most common congenital malformation of the pancreas, occurring in approximately 7% of the population. It is caused by what?
the failure of the ventral pancreatic duct to merge with the dorsal pancreatic duct.
29
Cleft ___ is the consequence of failed fusion between the medial nasal eminence and the maxillary process
Cleft lip
30
Cleft lip is the consequence of failed fusion between what two structures?
the medial nasal eminence and the maxillary process
31
failed fusion between the medial nasal eminence and the maxillary process ==> ???
Cleft Lip
32
Zygote is formed at day ZERO! when does implantation happen?
day 6-8; zygote is now called a blastocyst; each blastocyst forms it's own placenta.
33
each blastocyst forms it's own placenta, so if a prego shows only one placenta, when did splitting occur?
on or after day 5. If splitting occurred before the the blastocyst stage (eg. before implantation), there would be two chorions/placentas.
34
thryoid gland is derived from what germ cells?
endoderm
35
what structures are derived from neuroectoderm?hint: "COARNEE"
CNS nuerons;
Oligodendrocytes;
Asterocytes;
Retina, iris, & optic nerve;
Neurohypophysis (post. pit);
Epithalamus (pineal gland);
Ependymal cells;
36
Mammary glands are from?
surface ectoderm
37
Oral cavity epithelium, from?
surface ectoderm
38
Olfactory epithelium, from?
surface ectoderm
39
Distal anal canal below the pectinate line, from?
surface ectoderm
40
Enamel (ameloblasts are derived from surface ectoderm), from?
surface ectoderm
41
Adenohypophysis (via Rathke pouch), from?
surface ectoderm
42
Distal male urethra, from?
surface ectoderm
43
Parotid salivary glands, from?
surface ectoderm
44
Epidermis and accessory structures (e.g. hair, nails, sweat glands, sebaceous glands), from?
surface ectoderm
45
Ear; both the internal and external ear (not middle ear), from?
surface ectoderm
46
Lens of the eye, from?
surface ectoderm
47
Pia mater, Peripheral nervous system neurons, Arachnoid mater, are from?
neural crest cells
48
Schwann cells, are from?
neural crest cells
49
Sympathetic chain (autonomic postganglionic neurons), are from?
neural crest cells
50
Dorsal Root ganglia, are from?
neural crest cells
51
Adrenal Medulla chromaffin cells (vs. adrenal cortex, which is derived from mesoderm), are from?
neural crest cells
52
Facial and skull bones & Facial cartilage, are from?
neural crest cells
53
Parafollicular C cells, are from?
neural crest cells
54
Endocardial cushions of the heart, are from?
neural crest cells
55
Spiral septum (aorticopulmonary septum), are from?
neural crest cells
56
Odontoblasts (creates dentin), are from?
neural crest cells
57
Pigment cells (melanocytes), are from?
neural crest cells
58
round ligament of the liver is the remnant of what fetal structure?
the left umbilical vein
59
The structure that carries oxygenated blood from the placenta to the fetus becomes what?
the left umbilical vein ==> ROUND LIGAMENT
60
The intermediate mesoderm, develops into the urogential ridge, which derives what structures?
```
Kidneys
Adrenal cortices
Superior ureters
Superior one third of the vagina
Uterus and cervix
Testes
Ovaries
```
61
Cells of an Aldo producing adrenal adenoma are derived from what?
urogential ridge of the intermediate mesoderm, of mesoderm.
62
The developing embryo is most susceptible to teratogens during weeks __________, when the major organ systems, including the nervous system, gastrointestinal system, and cardiovascular system begin to develop and orient within the embryo.
weeks 3-8, the embryonic period
63
What is the mcc of a pure sensory stroke?
lacunar infarct of the thalamus.
64
What is the thalamus derived from?
diencephalon
65
The myelencephalon gives rise to the?
medulla and the lower portion of the 4th ventricle. myel- is below mete--
66
What gives rise to the cerebellum and pons?
metencephalon
67
The zygote is from what?
fertilization of the ovum; occurs at the ampulla of the fallopian tube.
68
gastric varices; ONLY in the FUNDUS ==?
splenic vein thrombosis leading to dilation of the SHORT GASTRIC veins.
69
The main pancreatic duct and common bile duct will join to become what?
the hepatopancreatic ampulla of Vater
70
The ventral pancreatic bud gives rise to the: (3)
Uncinate process; Lower part of the head; Main pancreatic duct
71
What parts of the pancrease is from endoderm?
Exocrine pancreas & Pancreatic islet cells (alpha, beta, etc.)
72
What does the midbrain and the cerebral aqueduct come from?
Mesencephalon
73
microglia from?
mesoderm
74
The umbilical arteries are a branch of what artery?
internal iliac a.
75
dorsal--ventral differentiation of the spinal cord is d/t what?
Sonic Hedgehog signalling pathways; mut & defects ==> CNS and facial defects; holoprosencephly.
76
Cerebellum, Pons, Upper-portion of 4th ventricle comes from what?
metecephalon; "CPU"; redditors love new CPUs man, thats so META.
77
spleen ~ greater omentum b/c???
both from dorsal mesentary
78
The medial umbilical ligaments is the post-natal remnant of what?
the right and left umbilical arteries
79
Which umbillical vein obliterates during fetal dev.?
RIGHT umbilical vein
80
Thalamus; 9Hypothalamus; Epithalamus (pineal gland); Third ventricle;Retina (please see Eye Development) comes from what?
diencephalon, which is below the telencephalon.
81
the embryonic neural tube and neural crest cells are derived from what?
Neural plate folds
82
Sclerotome, myotme, dermatome are from what?
Paraxial mesoderm
83
gastrulation starts/occurs at what week?
week 3; makes 3 germ layers; EPIBLASTs==> ecto, meso, endoderm
84
what week of dev. do genitalia show male/female characteristics?
week 10
85
What cells form the primary yolk sac?
Hypoblast cells that migrate along the Cytotrophoblasts
86
During gestational week 2, what happens to the embryoblast?
the embryoblast differentiates into 2 distinct cell layers, the epiblast and the hypoblast, forming a bilaminar embryonic disk. Think bilaminar occurs during the 2nd week.
87
The blastocyst usually implants within wht part of the uterus?
the posterior superior wall of the uterus
88
what are the two embryonic components form the placenta?
syncytiotrophoblasts &cytotrophoblast
89
Of the two embryonic components form the placenta which one does not divide mitotically?
syncytiotrophoblasts
90
Of the two embryonic components form the placenta which one divides mitotically?
cytotrophoblast; aids growth of the syncytiotrophoblast
91
Creation of the trilaminar disc is initiated when what happens?
the epiblast invaginates to form the primitive streak.
92
What embryonic components of the placenta produces human chorionic gonadotropin and human placental lactogen.
syncytiotrophoblast
93
Which type of twins divide prior to the formation of the chorion, which occurs 0-4 days after fertilization?
Dichorionic diamniotic monozygotic twins
94
Which type of twins divide after the formation of the chorion, which occurs 4 - 8 days after fertilization?
Monochorionic diamniotic monozygotic twins
95
Dizygotic, or fraternal, twins develop from two zygotes (two eggs and two sperm), this yields???
yielding 2 chorions (and therefore 2 placentas), and 2 amniotic sacs.
96
laryngeal inlet is from?
The respiratory diverticulum maintains a small, superior communication with the distal pharynx, which will become the laryngeal inlet.
97
Celiac artery; Superior mesenteric artery; Inferior mesenteric artery come from?
Vitelline arteries
98
4th arch arteries?
Aorta and RIGHT Subclavian "fOUR rhymes with AOR for Aorta. fouRS for Right Subclavian."
99
3rd arch arteries?
Common Carotid; "C is the 3rd letter"
100
1st and 2nd arch arteries?
1st arch artery ~ maxillary artery
2nd arch artery ~ stapedial artery
"First is Max & Second is Stapedial"
101
Pulmonary trunk and RIGHT pulm artery is from which arch?
6th arch;
102
7th arch arteries?
"7 is S."; Seventh InterSegmental Subclavian!
103
The development of the recurrent laryngeal nerve is closely related to arterial development. The left recurrent laryngeal nerve loops laterally to the ductus arteriosus (ligamentum arteriosum in adults) under [what?] before traveling superiorly.
aortic arch 6
104
what is elevated in asteocytes in pt. with hyperammoniemia?
Glutamate
105
skin finding ~w/ PBC?
Pruritis (itchy skin); PBC Sx: hepatomegaly, steatorrhea, portal HTN.
106
Venous drainage above the dentate line?
Superior rectal v --> internal iliac/inferior mesenteric.
107
Venous drainage BELOW the dentate line?
inferior rectal v. ==> intermal pudendal vein ==> internal iliac v.
108
Villous Atrophy, Crypt Hyperplasia, Intraepitheial lymphocyte infiltration ==?
Celiacs
109
"double bubble sign" ~?
duodenal atresia ~ Down Synd.
110
"Apple-peel: deformity == ?
Apple Peel atresia; occlusions of SMA
111
If you have an elevated alk phos, what is the next test you should order?
Gamma-glutamyl transpeptidase (GGTP)
112
if neonate passes meconium thru iumbilicus after birth, this is what?
persistent vitelline duct
113
Xanthelasma...what disease?
PBC; also ~w/ ADEK def, d/t fat mal.abs
114
what is the molecular mechanism of VIP, from a VIPoma?
Binds to Gs, activating AC and increasing cAMP
115
What is in the Hepatoduodenal ligament?
the portal triad (common bile duct, hepatic artery, hepatic portal vein)
116
If a patient is still bleeding after the Pringle maneuver, what is the source of the bleeding (2)?
IVC or hepatic veins
117
patent processus vadinallis ==>
Indirect inguinal hernias
118
weakness of transversalis fascia ==> ?
DIRECT inguinal hernias
119
what covers a DIRECT inguinal hernia?
external spermatic fascia
120
what covers indirect inguinal hernias?
all 3 spermatic layers; internal, cremasteric, external
121
air in the biliary tree =?
gallstone ileus
122
HSV-1 esophagitis endoscopy shows?
small vesicles-->punched out ulcers
123
papable, but NON-tender gallbladder = ?
Courvoisier Sign == Pancreatic malignancy
124
epigastic calcifications on imaging in an alcoholic?
chronic alcoholic pancreatitis
125
What Inhibits cholesterol 7-alpha hydroxylase which catalyzes the RLS in the synthesis of bile acids--> decreases bile acid production results in decreased cholesterol solubility-->cholesterol stones.
Fibrates
126
Gemfibrozil and fenofibrates are what?
Fibrates
127
SIBO causes def. in all vitamins, except for what?
Vit,K & Folate, these INCREASE b/c bacteria are growing and producing a shit ton.
128
CD16 & CD56 == ?
NK cells
129
defect in linea alba covered by skins; incomplete closure of umbilical ring ==>
Umbilical hernia (in peds)
130
L.O.F. mut. in MTP gene ==>
abetalipoproteinemia; acanthocytes
131
foul-smelling stools, ADEK def., ataxia, retinitis pigmentosa are signs of?
abetalipoproteinemia; labs will have low lipid panel and ABSENT apoV and VLDL
132
Histo of: Basal Zone hyperplasia; Lamina propria hyperplasia; Eosinophils/PMNs ==> ?
GERD
133
histo: islands of cells
| eosinophilic cytoplasm and oval-to-round stippled nuclei ==>
Carcinoid tumors
134
"currant jelly stool" ==> ?
intussusception
135
Transmural inflamm & non-caseatnig granuloms ==> ?
Crohns; cobblestone mucosa on gross.
136
finely granular, diffusely homogenous, pale eosinophilic cytoplasm (ground glass hepatocytes) ~w/
HepB
137
cricopharyngeal motor dysfunc. --->
Zankers diver.
138
gram positive actinomycete; Diastase resistant = what bug?
T. whippelii
139
Pathway of NOD2?
NF-kB --> cytokine prod.; ~w/ crohns
140
CREST syndrome?
```
Calcinosis/Anti-centromere ab
Raynaud Phenomenon
Esophageal Dysmotility
Sclerodactyly-finger ulcers w/ skin tightening
Telangiectasia
```
141
Councilman & Apoptotic cell bodies are seen on histo of what diz process?
Seen on H&E of actue viral hepatitis
142
What does the Sabin (live) vaccine increase that the Salk (killed) doesn't?
mucosal IgA
143
What does the onset of action of gas anesthetic depend one?
solubility in blood (blood/gas coefficient); High b/g coefficients are more soluble in blood, slower equilibration with brain, and longer onset
144
Almost all volatile anesthetics increase what physiological parameter?
Cerebral blood flow; this is an undesirable effect as it results in increased ICP.
145
What is the mc benign lung tumor, "coin lesion", called and what are they made of.
Harmartomas. disorganized cartilage, fibrous and adipose tissue.
146
What anti-arrhythmic drug also shortens phase 3 re-polarization (blockade of "plateau" Na+ current)
Class 1B;l Lidocaine, mexiletine
147
What anti-arrhythmic drug has a strong polongation of phase 0 depol, and results in no changes to the length of the AP?
Class 1C; Flecainide, propanfenone.
148
Which anti-arrhythmics also have moderate K+-ch. blocking activity?
Class 1A; quinidine, procainamide, disopyramide. moderate phase 0 block and prolonged AP length.
149
intracerebral hemorrhage, progressive neurological deficits, located at basal ganglia, cerebellum, thalamus, pons = ??
Charcot-Bouchard aneurysms. Qid 498
150
reddish-pink, PAS (+) granules of unsecreted polymers in the periportal hepatocytes == ?
Alpha-1 antitrypsin def. (ATT), in lungs as interalveolar septa destruction.
151
bronchial hyperreactivity is a hallmark of what?
chronic asthma
152
interstitial infiltration is a finding in what?
interstitial pneumonitis
153
intraalveolar substance accumulation is a finding in what?
alveolar proteinosis
154
rupture of the left ventricular free wall occurs how many days post MI?
5-14 days. causes profound hypotension and shock, leading to death.
155
Synaptophysin is a protein found where?
presynaptic vesicles of neurons, nueroendocrine and neuroectodermal cells.
156
Asterocytomas, ependymomas, and oligodendrogliomas are of what origin?
Glial origin; stain positive for GFAP.
157
non-lactose fermenting, non-motile, gram negative rod == ?
Shigella
158
motile, oxidase positive, gran-negative rod == ?
Pseudomonas
159
chest pain that is sharp and pleuritic, and may be exacerbated by swallowing or relieved by leaning forward = ?
pericarditis. can be d/t pericardial inflammation overlaying the necrotic segment of the myocardium post MI.
160
acute hyper-sensitivity reaction to drugs like, opioids, radiocontrast agents, and some ABX can be due to what?
IgE-independent mast cell activation; induces mast cells to degranulate by activating protein kinase A and PI3 kinase.
161
IgE mediated degranulation is ~w/ what?
environmental exposures like food or plants, and some meds like beta-lactam and sulfonamide ABX.
162
what is characterized histologically by spongiosis?
Acute eczematous dermatitis; S/Sx of papulovesicular, weeping lesions. seen in type 4 HSR.
163
white blood cell casts are only form in the renal tubules and are pathognomonic for __________________when accompanied by symptoms of acute UTI.
acute pyelonephritis
164
pyramidal cells of the hippocampus and the neocortex and the Purkinje cells of the cerbellum are at risk for what?
hypoxic-ischemic encephalopathy in global cerebral ischemia. hippocampus is first to be damaged
165
easy fatigability, constipation, back pain, elevated serum protein, azotemia in elderly pt. should raise suspicion for what?
Multiple myeloma.
166
large eosinophilic cast obstructing the tubular lumen is a sign of what?
multiple myeloma; those are Bence-Jones proteins.
167
What classically presents with muddy brown, granular, and epithelial cell casts and free tubular epithelial cells in the urine?
Ischemic tubular necrosis
168
NSAIDs can cause what two renal issues?
chronic interstitial nephritis or acute papilary necrosis.
169
What does Pauci-immune RPGN mean?
no Ig or complement deposits on the basement membrane. Most pt. will have ANCA in their serum.
170
What is a simple partial seizure?
aka simple focal. no loss of consciousness, motor jerking.
171
Triad of low hemoglobin, thrombocytopenia, and absent hematopoietic cells in the bone marrow == ?
aplastic anemia; "dry tap"
172
cataracts, gonadal atrophy, sustain muscle contraction == ??
myotonic dystrophy [AD}
173
on histo: aggregates of packed follicles that obscure the normal lymph node archtecture == ?
Follilcular lymphoma. t(14;18), overexpression of anti-apoptotic BCL-2 protein.
174
Hematogenous osteomyelitis occurs where in the bone?
long bone metaphysis in peds. (vertebral bodies in adults is the more common location)
175
Hypophosphorylated Rb protein does what?
active; Rb protein prevents damage cells from proceeding pas the g1 to S check point.
