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Flashcards in Final review Deck (396):
1

histones rich in what AA

lysine and arginine

2

uracil formed by

deamination of cytosine

3

AAs coded by only 1 codon

methionine (AUG)
tryptophan (UGG)

4

genetic code is NOT conserved in?

mitochondria

5

telomerase is what kind of enzyme

reverse transcriptase enzyme (RNA-dependent DNA polymerase)

6

eukaryotic DNA Polymerase alpha function

makes own primer
replicates lagging strand

7

eukaryotic DNA Polymerase beta function

replic leading strand

8

eukaryotic DNA Polymerase delta function

DNA repair

9

eukaryotic DNA Polymerase gamma function

replic mitochondrial DNA

10

NER vs BER

NER - endonuclease first
BER - glycosylase first

11

what does amanitin (mushroom poison) do

inhib RNA polymerase II

12

where does mRNA processing take place

nucleus

13

antibodies to spliceosomal snRNPs seen in what pts

Lupus

14

noncoding RNAs are

carry out out functions w/o first being translated
snRNA
rRNA
tRNA

15

tRNAs contain what anticodon @ 3' end

CCA

16

tRNA charged via? and using?

aminoacyl-tRNA synthetase
using ATP

17

where does start codon first attach on ribosome

P site

18

aminoglycosides MOA

bind 30S + inhib formation of initiation complex causing mRNA misreading

19

tetracyclines MOA

bind 30S + block aminoacyl-tRNA for entering A site

20

chloramphenicol MOA

binds 50S + inhibit peptidyl transferase (23S rRNA)

21

macrolides MOA

binds 50S + prevent release of uncharged tRNA after it donates its AA (prevents TRANSLOCATION)

22

clindamycin + lincomycin MOA

bind 50S + block translocation

23

nissl bodies are

RER in neurons (seen in DENDRITES)

24

free ribosome function

synth of cytosolic + organellar proteins

25

RER rich areas =

mucus-secreting goblet cells of SI
AB-secreting plasma cells

26

SER rich areas =

liver hepatocytes
steroid-hormone producing cells in adrenal cortex

27

COPI vesicle trafficking

Golgi-->ER
retrograde Golgi transport

28

COPII vesicle trafficking

ER--->Golgi (cis)
anterograde Golgi transport

29

Clathrin vesicle trafficking

trans-Golgi --> lysosomes
plasma membrane --> endosomes (receptor-mediated endocytosis)

30

def in peroxisome function leads to

accum of VLCFA

31

protein translation initiation/termination depends on a

GTPase

32

dynein moves

retrograde (from +-->-)
towards nucleus

33

kinesin moves

anterograde (from - --> +)
towards axon/nerve terminal

34

axonemal dynein is an?

ATPase (causes bending of cilium)

35

ouabain binds to what

K+ site on Na/K ATPase

36

ligamentum flava connects

vertebrae

37

elastin is rich in what AAs

proline + glycine (NONhydroxylated)

38

indirect ELISA

use test antigen to find Ab

39

direct ELISA

use Ab to find antigen

40

Southern blot =

DNA sample and DNA probe

41

Nouthern blot =

RNA sample w/ DNA probe
useful for mRNA studies!

42

Western blot =

protein sample w/ Ab probe

43

Southwestern blot =

DNA-binding protein (TF) w/ oligonucleotide probe

44

fluorescence preferred to visualize

microdeletions! (things at a MOLECULAR level)

45

cDNA only contains

CODING portion of gene (exons)

46

AD diseases usually are

defects in structural genes

47

AR diseases are usually

enzyme deficiencies

48

folate and B12 stored in

liver

49

B1 required for enzymes:

alpha-ketoglutarate
transketolase
Pyruvate DH
branched-chain amino acid DH

50

B7 cofactor for enzymes:

in carboxylation!
pyruvate carboxylase (pyruvate --> OA)
acetyl-CoA carboxylase (acetyl-CoA --> malonyl CoA)
propionyl-CoA carboxylase (propionyl CoA --> methylmalonyl CoA)

51

B12 cofactor for enzymes:

homocysteine methyltransferase (homocysteine --> methionine); indirectly affects SAM (bc needs methionine)
methylmalonyl-CoA mutase (methylmalonyl-CoA --> succinyl CoA)

52

4 functions of vit C

1) antioxidant
2) keeps Fe in reduced state (so increases absorption)
3) hydroxylation of proline and lysine for collagen
4) in dopamine beta-hydroxylase --> convert dopamine to NE

53

ethanol metab shunts which 2 processes

pyruvate --> lactate
OAA --> malate

to regen NAD+!

inhibs gluconeogenesis + stim FA synth

54

mitochondria is site of

FA oxidation (beta-oxidation)
acetyl-CoA prod
TCA cycle
oxidative phosphorylation

55

cytoplasm is site of

glycolysis
FA synthesis
HMP shunt
protein synth (RER)
steroid synth (SER)
cholesterol synth

56

mitochondria AND cytoplasm are sites for

Heme synth
Urea cycle
Gluconeogenesis

57

phosphorylase

adds inorganic phosphate W/O using ATP!!

58

shuttle producing 32 ATP

malate-aspartate (in heart/liver)

59

shuttle producing 30 ATP

glycerol-3-phosphate (muscle)

60

hexokinase properties

LOW Km and Vmax
UNINDUCED by insulin

61

glucokinase properties

HIGH Km and Vmax
INDUCED by insulin

62

fasting state changes seen in glycolysis/gluconeogenesis

increased FBPase-2, cAMP
decreased PFK-1, PFK-2, fructose-2,6-bisphosphate
glucagon!!

63

increased fructose-2,6-bisphosphate is sign of what state

fed

64

fed state changes seen in glycolysis/gluconeogenesis

decreased FBPase-2, cAMP
increased PFK-1, PFK-2, fructose-2,6-bisphosphate
insulin!!

65

carboxylase function

adds CO2 group w/ help of biotin!

66

when you see F-2,6-Bisphosphate think:

there's enough glucose, we need more energy!

67

arsenic poisoning key feature

garlic breath

68

similar to pyruvate DH complex

alpha-ketoglutarate DH complex

69

pyruvate DH complex deficiency features

buildup of pyruvate and alanine --> lactic acidosis
X-linked gene mut of E1-alpha subunit
neuro deficits in infancy!

70

pyruvate DH complex deficiency tx

increase ketogenic nutrients:
high fat content
increase LEUCINE or LYSINE intake

71

Cori disease vs. von Gierke disease

Cori - NORMAL blood lactate levels
von Gierke - elevated lactate + hepatic steatosis

72

Niemann-Pick vs. Tay-Sachs

Tay-Sachs has NO hepatosplenomegaly

73

Hurler's synd vs. Hunter's synd

Hunter's synd:
NO corneal clouding!
aggressive behavior
X-linked!

74

4 fates of pyruvate

alanine
OAA
acetyl-CoA
lactate

75

pyruvate --> alanine

alanine aminotransferase (w/ B6) - amino group from liver to muscle (from glutamate)

76

pyruvate --> OAA

pyruvate carboxylase (w/ biotin) - OAA can replenish TCA cycle or go to GNG

77

pyruvate --> acetyl-CoA

pyruvate DH complex (B1, B2, B3, B5, lipoic acid) - glycolysis to TCA cycle

78

pyruvate --> lactate

LDH (w/ B3) - anaerobic glycolysis (RBCs, kidney medulla, lens, testes, cornea)

79

citrate synthase rxn

acetyl-CoA --> citrate

80

isocitrate DH rxn

isocitrate --> alpha-ketoglutarate

81

alpha-ketoglutarate DH rxn

alpha-KG --> succinyl-CoA

82

succinate DH is part of?

complex II in ETC and uses FADH2
converts succinate --> fumarate

83

blocks complex I of ETC

amytal
rotenone
MPP

84

blocks complex III of ETC

antimycin A

85

blocks complex IV of ETC

H2S
CO
sodium azide (N3-)
CN-

86

blocks ATPase of ETC

oligomycin A

87

uncoupling agents do what in ETC

produce heat by allowing H+ to leak down their concentration gradient

88

examples of uncoupling agents

2,4-DNP
thermogenin (in brown fat)
aspirin

89

sites for HMP shunt (pentose phosphate pathway)

lactating mammary glands
liver
adrenal cortex
RBCs

90

AA required during periods of growth

Arg
His

91

what donates NH4 group to citrulline to make argininosuccinate

aspartate
catalyzed by arginosuccinate synthetase

92

ornithine transcarbamoylase rxn

ornithine --> citrulline

93

in urea cycle, argininosuccinate to arginine step creates what?

fumarate

94

which step creates urea

arginine to ornithine via arginase

95

what 2 AA can be used in urea cycle to remove NH4

alanine
glutamate (w/ NH4 --> becomes glutamine which is directly transported to liver from muscles)

96

tx for hyperammonia

reduce protein intake
benzoate, phenylbutyrate (bind AA --> facilitate excretion)
lactulose - acidify GI tract + trap NH4

97

homocystinuria vs. Marfan

lens subluxation in:
-Marfan = upward
-homocystinuria = downward and inward

98

accum of what AA in maple syrup urine dz

Ile
Val
Leu (especially this)

99

FA synth begins w/

citrate (in mitochondria) --> transport to cytoplasm + become acetyl-CoA by ATP citrate lyase

100

FA degrad inhib by

malonyl-CoA

101

urine tests detect which ketone

acetoacetate only

102

function of pancreatic lipase

degrad of TG in SI

103

function of LPL

degrad of TG in chylomicrons and VLDLs

104

function of hepatic lipase

degrad of TG in IDLs

105

function of hormone-sensitive lipase

degrad of TG in adipocytes

106

function of LCAT (lecithin-cholesterol acyltransferase)

esterification of cholesterol

107

function of CETP (cholesterol ester transfer protein)

transfer of cholesterol esters to other lipoprotein particles

108

chylomicron function

TG --> peripheral tissues
chylomicron remnants (depleted of TG): cholesterol --> liver
secreted by intestinal epith cells

109

VLDL function

hepatic TG --> periph tissues
secreted by liver

110

IDL function

TG + cholesterol --> liver
formed in degrad of VLDL

111

LDL function

hepatic cholesterol --> periph tissues
taken up via recept-med endocytosis
formed by hepatic lipase modif of IDL in periph tissue

112

HDL function

cholesterol from periphery --> liver
repository of apoC and apoE
secreted from liver and intestine

113

hyperchylomicronemia vs. familial hypercholesterolemia

no increased risk of atherosclerosis in hyperchylomicronemia (but pancreatitis!)

114

thalamus a relay for everything except?

olfaction!

115

increase preload by

increased BV (overhydration, transfusion, preg)
exercise (slight)
increased sympathetic activity

116

wide splitting seen in conditions that

delay RV emptying like pulm stenosis, RBBB
exaggeration of normal inspiration split, but ALSO split in expiration (but by less)

117

fixed splitting seen in

ASD; pulmonic closure delayed regardless of breath by SAME amount

118

paradoxical splitting seen in

delayed LV emptying (like aortic stenosis, LBBB)
P2 occurs BEFORE A2, and paradoxically, on inspiration gets closer to A2 thereby eliminating the split

119

only virus w/ 2 identical ssRNA molecules

retrovirus

120

only DNA virus that replicates in cytoplasm

poxvirus
others replic in nucleus

121

only 2 RNA viruses that replicate in nucleus

influenza, retrovirus
others replic in cytoplasm

122

virus that acquires its envelope from nuclear membrane

herpesvirus family

123

ONLY ssDNA virus

parvovirus

124

all DNA viruses are linear except:

papilloma, polyoma (circular, supercoiled)
hepadna (circular, incomplete)

125

all DNA viruses are icosahedral except:

poxvirus (complex)

126

3 poxviruses:

variola (smallpox)
vaccinia (cowpox - provides immunity to smallpox)
Molluscum contagiosum

127

EBV latent in

B-cells

128

CMV latent in

mononuclear cells (lymphocytes, monocytes)

129

Roseola features:

high fevers that can cause seizures, followed by macular rash

130

Tzank test to check for

HSV-1, 2
VZV

131

Deformed cell seen in EBV infection

atypical lymphocytes (CD8+ reactive T-cells) aka Downey cells (w/ foamy appearing basophilic cytoplasm)

132

drug that forms a maculopapular rash that covers trunk + extremities when given to EBV mono pt

amoxicillin

133

all picornaviruses are _________ except __________

enteroviruses (fecal-oral spread)
rhinovirus is not

134

rhinovirus is unique from other picornaviruses in that

it is destroyed by stomach acid and therefore does not cause GI dz

135

#1 cause of fatal diarrhea in children + its MOA

rotavirus - decrease reabsorp of Na and loss of K (due to villous destruction)

136

paramyxoviruses contain what protein

F (fusion) protein --> resp eptih cells to fuse + form multinucleated cells

137

tx for RSV pneumonia in pre-mature infants

palivizumab (Mab against F protein)
also, ribavirin

138

measles vs. rubella rash

both are descending maculopapular rashes, BUT:
measles - involves hands/feet
rubella - truncal

139

complications of measles

SSPE (subacute sclerosing panencephalitis)
encephalitis
giant cell pneumo (rare)

140

rabies infection found in what part of brain

Purkinje cells of cerebellum (Negri bodies seen in neurons)

141

vaccines available for which hepatitis viruses

HAV, HBV (and HDV by extension)

142

env gene in HIV forms

envelope proteins gp120 and gp41 (from cleavage of gp160)

143

gp120 function in HIV

attachment to host CD4+ T-cell

144

gp41 function in HIV

fusion and entry

145

gag gene in HIV is also known as? and forms what?

p24
capsid protein

146

pol gene in HIV forms

reverse transcriptase
aspartate protease
integrase

147

nef gene in HIV does what?

decreases expression MHC class I proteins on surface of infected cells

148

false negative ELISA/Western blot seen in which HIV population

those w/ acute infection (bc low Ab)

149

false positive ELISA/Western blot seen in which HIV population

babies born to infected mothers bc gp120 crosses placenta

150

latent HIV phase, virus replicates in where in body

LN

151

oral candidiasis in HIV pts when CD4 < ?

400

152

esophageal candidiasis in HIV pts when CD4 < ?

100

153

histo difference in B.henselae vs Kaposi sarcoma in HIV

B.hens = NEUTROPHILIC infiltrate
Kaposi = LYMPHOCYTIC infiltrate

154

opportunistic infections seen with CD4 < 400

oral candidiasis

155

opportunistic infections seen with CD4 < 200

cryptosporidium - diarrhea
JC virus (reactivation) - PML
PCP

156

opportunistic infections seen with CD4 < 100

esophageal candida
Histoplasmosis dissem dz (HSM, fever, cough, etc)
Toxoplasmosis (MANY ring-enhancing lesions)

157

opportunistic infections seen with CD4 < 50

C.neoformans
CMV retinitis (cotton-wool spots)
MAC

158

T.gondii vs. primary CNS lymphoma in HIV pts (histo)

T.gondii - MANY ring-enhancing lesions
CNS lymphoma - usually FOCAL lesion

159

bugs mimicking appendicitis

Y.pestis (mesenteric adenitis)
Salmonella
C.jejuni

160

tx for atypical pneumo

macrolide

161

tx for neonatal pneumo

ampicillin + gentamicin

162

empiric tx for meningitis

ceftriaxone + vancomycin
add ampicillin if Listeria suspected!
also maybe give dexamethasone

163

Neisseria meningitidis presents first w/

purpura on skin before meningitis

164

+ leukocyte esterase test seen in

BACTERIAL UTI

165

+ nitrate test seen in

GRAM NEG bacterial UTI (presence of Enterobactericeae)

166

measles vs. rubella

postauricular LAD in rubella!

167

Fitz-Hugh-Curtis synd features

from PID
infects liver capsule
see "violin-string" adhesions of parietal peritoneum to liver

168

avoid what when taking tetracyclines

anything w/ divalent cations bc inhibs absorption

169

aminoglycoside resistance is by

transferase enzymes that acetylate, phosphorylate or adenylate drug to inactivate it

170

macrolide resistance is by

methylation of 23S rRNA

171

anaerobic infection tx

clindamycin (above diaphragm)
metronidazole (below diaphragm)

172

SE of sulfonamides

HST
hemolysis in G6PD def pts
nephrotox (tubulointerstitial nephritis)
photosensitivity
kernicterus in infants
displace other drugs from albumin (like warfarin)

173

prophylaxis for meningococcal infection

ciprofloxacin
rifampin (for children)

174

prophylaxis for H.flu meningitis

rifampin

175

prophylaxis for recurrent UTIs

TMP-SMX

176

prophylaxis for endocarditis w/ surgical or dental procedures

penicillins

177

prophylaxis for preg women w/ GBS

ampicillin DURING labor

178

prophylaxis of strep pharyngitis in child w/ prior rheumatic fever

oral penicillin

179

prophylaxis for prevention of post surgical infection due to S.aureus

cefazolin

180

prophylaxis for prevention of gonoccocal or chlamydial conjunctivitis in newborn

erythromycin ointment

181

prophylaxis for MAC if CD4 <50

azithromycin

182

toxoplasmosis, antimalarial tx

pyrimethamine

183

T.cruzi tx

nifurtimox

184

leshmaniasis tx

Na stibogluconate

185

ribavirin MOA/SE

competitively inhib IMP dehydrogenase + inhib synth of guanine nucleotides
SE = hemolytic anemia, teratogen

186

foscarnet binds to

pyrophosphate-binding site of enzyme

187

enfuvirtide binds to

gp41

188

tenofovir unique in that it is a

nucleoTIDE analog (does not have to be phosphorylated to be active)

189

HIV prophylaxis during preg

zidovudine

190

tx for chronic granulomatous disease

IFN-gamma

191

maraviroc MOA

CCR5 anatagonist; inhib gp120 conformational change

192

murmur ass. w/ coarctation of aorta

aortic regurg

193

heart disorder ass w/ 22q11 synd

ToF
truncus arteriosus

194

heart disorder ass w/ congenital rubella

PDA
pulmonary artery stenosis

195

heart disorder ass w/ Turner's synd

Coarctation of aorta (preductal)
bicuspid aortic valves

196

heart disorder ass w/ infant of diabetic mother

transposition of great vessels

197

monckeberg lesion seen in what part of artery

media

198

atherosclerosis deposits seen in what part of artery

intima

199

AAA ass w/?

Atherosclerosis

200

thoracic aortic aneurysm ass w/ + can cause what?

HTN
also, can cause AR

201

ST depression

stable/unstable angina

202

ST elevation

prinzmetal's angina

203

tx for prinzmetal's angina

dihydropyridine CCB

204

MI ECG changes seen

ST depression --> ST elevation

205

most useful marker in detecting MI reinfarction

CK-MB

206

MI changes seen in 0-4 hrs

NO gross/microscopic changes

risk of arrhythmia, shock

207

MI changes seen in 4-12 hrs

dark mottling (pale w/ tetrazolium stain)
early coag necrosis, edema

risk of arrhythmia

208

MI changes seen in 12-24 hrs

still dark mottling
contraction bands from reperfusion injury (via fibrinolytic therapy)
release of necrotic cell content into blood

risk of arrhythmia

209

MI changes seen in 1-3 days

hyperemic tissue
extensive coag necrosis; acute inflamm; NEUTROPHILS!

risk of fibrinous pericarditis (in transmural infarcts esp)

210

MI changes seen in 3-14 days

yellow-brown central softening!
MACROPHAGES, granulation tissue @ margins

risk of: free wall rupture (can cause cardiac tamponade), papillary muscle rupture (can cause MR), IV septum rupture (can cause VSD), ventricular aneurysm [all from macrophage weakening]

211

MI changes seen in 2 wks to several months

gray-white tissue!
scar seen

risk of Dressler's synd

212

MI changes reversible w/in

20-40 mins

213

causes a systolic dysfunction

dilated cardiomyopathy

214

causes a diastolic dysfunction

hypertrophic cardiomyopathy
restrictive cardiomyopathy

215

marker used to dx CHF

BNP

216

common cause of cor pulmonale

pulm HTN (from obliteration of pulm vasculature by COPD)

217

bacterial endocarditis signs

Fever
Roth spots
Osler's nodes
Murmur
Janeway lesions
Anemia
Nail-bed hemorrhages (splinter hemorrhages)
Emboli

218

Rheumatic fever signs

Fever
Erythema marginatum
Valvular lesions (fibrosis and vegetations)
ESR elevated
Red-hot joints (migratory polyarthritis)
Subcut. nodules
Syndenham's chorea

219

2 things seen on histo w/ rheumatic fever

Aschoff bodies (granuloma w/ giant cells)
Anitschkow's cells (activated histiocytes that look like "caterpillar cells" bc of condensed chromatin, abund cytoplasm)

220

ECG changes in pericarditis

widespread ST elevations and/or PR depression

221

pericardial knock heard when

early diastole (shortly after S2)
brief, high-freq sound

222

cause of Raynaud's phenom

arteriolar vasospasm

223

tx for Raynaud's

dihydropyridine CCB (vasodil)
aspirin (to prevent clots)

224

vasculitis w/ increased p-ANCA + differences b/w them

microscopic polyangiitis - no granulomas; segmental fibrinoid necrosis
churg-strauss synd - granulomatous, necrotizing vasculitis w/ eosinophilia

225

vasculitis w/ increased c-ANCA

Wegener's granulomatosis

226

strawberry hemangioma

infancy
grows rapidly, regresses spontaneously (around 5-8y.o)

227

cherry hemangioma

elderly
no regression; freq increases w/ age
thin-walled BV

228

pyogenic granuloma

raised capillary hemangioma
ass w/ trauma + pregnancy

229

cystic hygroma

cavernous lymphangioma often on posterior neck/lateral chest wall
ass w/ Turner synd

230

glomus tumor

painful! (but benign)
red-blue tumor UNDER FINGERNAILS
glomus cell (mod SM cells) tumor - controls thermoregulation

231

bacillary angiomatosis

B.hensalae
in AIDS pts
necrotizing granulomatous adenitis (inflamm of LN) w/ stellate microabscesses

232

angiosarcoma

BV malignancy
head, neck, breast areas
ass w/ pts receiving radiation therapy (esp breast cancer, Hodgkin's lymphoma)
metastasis to brain/bone

233

lymphangiosarcoma

persistant lymphedema
ass. w/ post-radical mastectomy

234

spider angiomas

red central papule w/ outwardly radiating vessels that BLANCH on pressure
estrogen dependent!
ass w/ preg, liver dz, pts taking OCPs and estrogen

235

cavernous hemangioma

dilated vascular spaces w/ thin-walled endoth cells
soft blue compressible masses

236

Sturge-Weber disease

congenital - affects capillary-sized vessels
findings:
port-wine stain on face (nevus flammeus)
ipsilateral leptomeningeal angiomatosis (intracerebral AVM)
seizures
early-onset glaucoma
skull opacities ("tram-track" calcifications)

237

drug class protective against diabetic nephropathy

ACE inhib

238

arteriolar vasodilator

hydralazine

239

vasodilation OR venodilation (but not both together) can ALWAYS lead to a (SE)

compensatory tachycardia

240

malig HTN 1st line drug

nitroprusside (balanced arterial/venous vasodil)

241

fenoldapam MOA

dopamine D1 recept agonist

242

malig HTN w/ renal failure: use what drug?

fenoldopam

243

fenoldopam causes what effects

coronary, periph, renal, splanchnic vasodil
decreases BP and increases natriuresis

244

beta-blockers CI w/ what other drug

non-dihydropyridine CCBs

245

beta-blockers CI in angina

pindolol
acebutolol

bc partial Beta agonists

246

precapillary sphincters respond to

histamine, decreased O2, increased pCO2, decreased pH - causes dilation of capillaries

247

HMG-CoA reductase inhibitors inhib conversion of HMG-CoA to?

mevalonate

248

3 SE of niacin

hyperuricemia (--> gout)
hyperglycemia (--> acanthosis nigracans)
red flushing of face

249

SE of fibrates

myositis
hepatotox
chol gallstones

CI w/ statins

250

MOA of fibrates

upregulate LPL --> increased TG clearance
activates PPAR-alpha

251

fibrates increases conc of what lipoprotein

IDL

252

digoxin indicated for

chronic CHF (bc increases contractility)
Afib (bc decreases AV node conduction and depresses SA node)

253

poor prognostic indicator of digoxin tox

hyperkalemia

254

factors predisp to digoxin tox

hypokalemia
quinidine, verapamil (displaces digoxin binding from tissue binding sites --> decreased excretion)
renal failure (decreases excretion)

255

increased markers in NTD

AFP
AChE (confirmatory)

256

ass w/ Chiari I malformation

syringomyelia

257

ass w/ Chiari II malformation

hydrocephalus
aqueductal stenosis
thoracolumbar myelomeningocele common
herniation!!

258

ass w/ Dandy Walker malformation

hydrocephalus
spina bifida
agenesis!!

259

causes of glossitis

B12 def
riboflavin (B2) def
Fe def
niacin def (B3)

260

NE changes/synth in

increased in anxiety
decreased in depression

Locus ceruleus

261

dopamine changes/synth in

increased in schizophrenia
decreased in depression, Parkinson's

ventral tegmentum and SNc (midbrain)

262

serotonin (5-HT) changes/synth in

decreased in anxiety, depression

Raphe nucleus (pons)

263

ACh changes/synth in

decreased in Alzheimer's, Huntington's
increased in REM sleep, Parksinson's

Basal nucleus of Meynert

264

GABA changes/synth in

decreased in anxiety, Huntington's

Nucleus accumbens

265

BBB composed of

astrocyte foot process
tight junctions
BM

266

areas of brain w/o BBB

area postrema
neurohypophysis
OVLT (senses changes in osmolarity)

267

melatonin can inhibit the prod of

LH and FSH from ant pituitary

268

globus pallidus internus does what to movement

inhibits

269

globus pallidus externus does what to movement

facilitates

270

subthalamic nucleus does what to movement

inhibits

271

substantia nigra pars compacta does what to movement

facilitates

272

SNr does what to movement

inhibits

273

how does MPP cause Parkinson's

destroys dopaminergic cells in substantia nigra by inhib ETC @ complex 1

274

how does MPTP become MPP

MAO metabolism

275

cause of neuronal death in Huntington's

NMDA-recept binding and glutamate toxicity

276

drug that is metab to active phenobarbitol-like metabolite

primidone

277

intention tremor = dysfun in what area

cerebellar damage

278

hemiballismus = lesion where

contralateral STN

279

myoclonus = lesion where and is common in what conditions

nucleus ambiguus of medulla
w/ metabolic abnorm (like liver or renal failure)

280

lesion of hippocampus =

inability to make NEW memories (anterograde amnesia)

281

lesion of superior colliculus -->

parinaud's synd (paralysis of upward gaze)

282

conduction aphasia = damage to

arcuate fasciculus

283

ass w/ CN III palsy

PComm artery aneurysm

284

common causes of intraparenchymal hemorrhage

systemic HTN!
amyloid angiopathy
vasculitis
neoplasm

285

genetic cause of ALS

defect in superoxide dismutase 1

286

tx for ALS/it's MOA

riluzole - decreases presynaptic glutamate release (can moderately increase survival)

287

nonbenzo hypnotics?

zolpidem
zaleplon
eszopiclone

288

CN III and vascular damage -->

motor dysfunct --> ptosis, down and out pupil

289

CN III compressive damage --->

parasymp dysfunct --> blown pupil (absent pupillary light reflex)

290

pie in the sky lesion

temporal lesion (MCA)
aka Meyer's loop

291

pie on the floor lesion

parietal lesion (MCA)
aka dorsal optic radiation

292

right homonymous hemianopia

left optic TRACT lesion
**switch for left

293

left anopia

right optic NERVE lesion
**switch for right

294

butorphanol MOA/uses

MOA - mu-partial agonist; kappa full agonist
uses - severe pain

295

tramadol MOA/uses

weak opioid agonist; inhib serotonin + 5-HT reuptake
use - chronic pain

296

tolerance does not develop to which opioid SE

constipation
miosis

297

1st line prophylaxis of status epilepticus

phenytoin

298

1st line for simple, complex, tonic-clonic seizures

carbamazepine

299

1st line for trigeminal neuralgia

carbamazepine

300

DOC for partial seizures

lamotrigine

301

1st line for seizures in children

phenobarbitol

302

valproic acid MOA

blocks NMDA receptors
increases GABA conc by inhib breakdown + increasing synth

303

1st line for acute status epilepticus + eclampsia seizures

diazepam, lorazepam

304

1st line for eclampsia seizures

MgSO4

305

phenytoin blood SE

megaloblastic anemia by decreasing folate absorption (bc of inhib of intestinal conjugase)

306

CI for barbiturate use

acute intermittant porphyria

307

osteoclasts stain positive for what + req what 2 signals

TRAP positive
M-CSF + RANK-L signals

308

substance that can cause morphine tolerance + what can block it?

glutamate (NMDA activation)
ketamine can block

309

complex regional pain syndrome type I vs. II

type I - NO evidence of nerve damage; severe, burning pain, muscle spasm, joint stiffness, restricted mobility, vasospasm, increased hair growth
type II - evidence of nerve damage

310

early detection of diabetic nephropathy =

check for microalbuminemia

311

oral ulcers can be seen in what dz?

pemphigus vulgaris
paraneoplastic pemphigus
Behcet dz
Crohn's dz

312

examples of flat bones

skull
sternum
bones of pelvis

313

most common location of hematogenous osteomyelitis in adults

vertebral body

**also same location for Pott's dz

314

classic findings in multiple myeloma

-easy fatiguability (from anemia)
-constipation (from hypercalcemia)
-bone pain in back and ribs usually (from production of osteoclast activating factor by myeloma cells and subseq bone lysis)
-renal failure

315

dz found in metaphysis of long bone

osteochondroma
osteosarcoma
osteomyelitis in children

316

dz found in epiphysis of long bone

giant cell tumor (osteoclastoma)

317

dz found in diaphysis of long bone

Ewing sarcoma
chondrosarcoma (w/in medullary cavity)

318

DI dx w/ urine specific gravity <

1.006

319

systolic dysfunction

DCM

320

diastolic dysfunction

HCM (due to LV rigidity)
RCM

321

GI drug CI in pts w/ Parkinson or SI obstruction

metoclopramide

322

estrogen deficiency can lead to:

-atrophied vagina
-infertility
-breast atrophy
-osteopenia

323

types of substances that CAN'T cross placenta

water-solube (like conjugated bilirubin, heparin)

324

types of substances that can cross placenta

lipophilic substances (like unconj bilirubin, warfarin)

325

smoking cessation ass w/ what effects?

-prolong life expectancy
-decreases risk of MI, cerebrovascular injury, lung cancer
-slows rate of pulm function loss

326

EDS = problem w/ what enzyme

lysyl oxidase (contains Copper)

327

macrolide resistance

methylation of 23S rRNA binding site

328

aminoglycoside resistance

transferase enzymes that inactivate drug by acetylation, phosphorylation, or adenylation

329

chloramphenicol resistance

plasmid-encoded acetyltransferase that inactivates drug

330

step in urea cycle that forms urea

hydrolyzation of L-arginine by arginase to ornithine and urea; ornithine transported back to mitochondria to restart

331

Bloom synd defect?

mut in DNA helicase

332

hyperestrogenemia causes?

spider angiomas (telangiectasias)
palmar erythema
gynecomastia
testicular atrophy
decreased body hair
Dupuytren's contractures

333

Kayser-Fleisher rings located in what part of eye?

cornea

334

Lisch nodules of NF1 located in what part of eye?

iris

335

retinal lesions caused by what diseases?

DM
HTN
pseudoxanthoma elasticum
Tay-Sachs disease

336

osteogenesis imperfecta involves what part of eye?

sclerae

337

different retinoid meds

isotretinoin
acetretin
tretinoin
adapalene
tazarotene

338

"sputum eosinophils" think:

asthma

339

most common cause of death w/ HCM

Vfib

340

most common cause of death w/ RCM

CHF

341

AA w/ 3 titratable protons

His
Arg
Lys
Asp
Glu
Cys
Tyr

342

tx for hemorrhagic cystitis (if already occurring)

N-acetylcysteine

343

magenta-colored tongue =

vit B2 deficiency

344

burnt almonds smell?

cyanide poisoning

345

dimorphic fungi

Sporothrix schenkii
Blastomyces
Paracoccidioides
Coccidioides
Histoplasma

molds @ 25-30C
yeast @ 35-37C

346

DOC for toxoplasmosis

pyrimethamine and sulfadiazine

347

Reactive arthritis seen after infection w/ what 6 bugs?

Campylobacter
Shigella
Salmonella
Yersinia
Chlamydia
Bartonella

348

tx for acute mania

mood stabilizer (lithium, carbamazepine, valproate) + atypical antipsych (olanzapine usually)

349

findings highly ass w/ ankylosing spondylitis

-enthesopathies (inflamm @ site of insertion of tendons into bone)
-pain can limit chest wall expansion --> causes hypoventilation (monitor chest wall!!)
-ascending aortitis --> dilation of aortic ring and aortic insuff
-anterior uveitis in 20-30%

350

source of N in urea cycle?

aspartate

351

function of prokaryotic 16S rRNA

contains seq complimentary to Shine Dalgarno seq on mRNA --> necessary for initiation of protein synth

352

3'-->5' DNA exonuclease activity

proofreading + removal of mismatched nucleotides

353

K-ATP channel regulatory substance in pancreatic beta-cells

ATP

354

mRNA translation regulation/degradation depends on?

cytoplasmic P bodies

355

essential activator of CPS1 + substrates formed from?

N-acetylglutamate
precursors = acetyl-CoA + glutamate

356

babies exclusively breast-fed req supplementation of what vit?

vit K and D

357

BH4 = cofactor in?

dopamine
serotonin
tyrosine
NO

358

SSPE caused by measles virus due to lack of Ab to what?

M-component of virus

359

common cause of death in PCP toxicity?

trauma

360

most common non-nuclear DNA found in eukaryotic cells?

mtDNA

361

common cause of death in diphtheria infection?

cardiomyopathy

362

1st thing to do in acute diphtheria infection?

admin passive immunization (diphtheria antitoxin)

363

1st line tx for acute gout

NSAIDS
2nd line = colchicine; then GC

364

increased # of trinucleotide repeats in Fragile X synd leads to?

hypermethylation of FMR1 gene --> inactivation

365

inhaled anesthetic solubility correlates to?

blood/gas partition coefficient

366

inhaled anesthetic potency correlates to?

MAC

367

clearance of inhaled anesthetic usually by

exhalation through lungs

368

parvovirus B19 replicates in?

bone marrow

369

MOA of pentazocine

opioid narcotic w/ partial agonist activity and weak antag activity @ mu receptors

370

pentazocine SE

withdrawal symptoms in pts dependent on or tolerant to opioids

371

gastric ulcers form because of?

lack/destruction of mucosal layer

372

duodenal ulcers form bc of?

increased acid production

373

UMN lesion sites =

-CS tract
-medulla, pons, midbrain
-internal capsule
-precentral gyrus (primary motor cortex)

374

alpha-receptors _______ insulin secretion?

inhibit

375

beta-receptors _______ insulin secretion?

stimulates

376

NADPH used in?

-anabolic processes (steroid + FA synth)
-resp burst
-P-450
-glutathione reductase

377

what inhibits glucokinase activity

F-6-P

378

what inhibits hexokinase activity

G-6-P

379

stim/inhib of pyruvate kinase?

stim by: F-1,6-BP
inhib by: ATP, alanine

380

LDH pathway impt in?

RBC
leukocytes
kidney medulla
lens
testes
cornea

381

Chlamydia cell wall lacks _________? It also uses an EXTERNAL __________ bc ________?

lacks peptidoglycan;
uses external ATP source bc they're obligate intracellular organisms

382

OTC deficiency unique in that it's inheritance is?

X-linked recessive (vs. most other urea cycle enzyme defects which are AR)

383

OTC stimulated by what vitamin?

biotin

384

tyrosine can form what 2 substances?

Dopa
thyroxine

385

tyrosinase activity on Dopa produces?

melanin

386

Tay-Sachs histo?

lysosomes w/ onion skin

387

Niemann-Pick histo?

foam cells

388

Gaucher disease histo + unique feature?

Gaucher's cells (macrophages w/ cytoplasmic fibrils) - look like crumpled tissue paper
unique - bone crises

389

Krabbe disease histo + unique feature?

globoid cells
unique - optic atrophy

390

FA synth starting substrate?

citrate

391

FA synth req what vitamin?

biotin (for acetyl-CoA --> malonyl-CoA)

392

what inhibits acyl-CoA translocation from cytoplasm to mitochondrial matrix?

malonyl-CoA

393

injections in superomedial part of buttock injure what?

gluteal nerves

394

injections in inferomedial part of buttock injure what?

sciatic nerve

395

serotonin-releasing neurons

raphe nucleus (in brainstem)

396

NE-secreting neurons

nucleus ceruleus (in dorsal pons)