Fri Jul 10

Question 1

when a patient comes in with organophosphate poisoning, how do you treat them?

Answer 1

First atropine, then pralidoxime

Question 2

why do you give atropine before pralidoxime?

Answer 2

you need to give pralidoxime as well, since it treats the nicotinic symptoms of organophosphate poisoning, but it causes a transient rise in Ach so you need to give atropine first

Question 3

an anteriolateral displacement of a supracondylar humerus fracture may damage which nerve?

Answer 3

RADIAL

Question 4

an anteriomedial displacement of a supracondylar humerus fracture may damage which nerve?

Answer 4

MEDIAN

Question 5

which virus causes hand-foot-mouth disease?

Answer 5

enterovirus (coxsacckievirus)

Question 6

how is coxsackievirus spread?

Answer 6

fecal-oral route

Question 7

what are anti-jo-1 antibodies?

Answer 7

antibodies against tRNA synthetase

Question 8

which disease has anti-jo-1-antibodies?

Answer 8

polymyositis

Question 9

what will be found on biopsy of polymyositis?

Answer 9

endomysial inflammation - mononuclear infiltrate and patchy necrosis

Question 10

what will be seen on biopsy of someone with dermatomyositis?

Answer 10

perifascicular inflammation

Question 11

presentation of polymyositis?

Answer 11

symmetrical proximal muscle weakness - difficulty climbing stairs, getting up, carrying heavy objects

Question 12

which hormone stimulates leydig cells?

Answer 12

LH

Question 13

which hormone stimulates sertoli cells?

Answer 13

FSH

Question 14

which vessels does nitroprusside act on?

Answer 14

both veins and arteries - reduces afterload and preload

Question 15

how is excess ammonia processed in the brain?

Answer 15

Converted to glutamine

Question 16

what happens when astrocytes have excess glutamine?

Answer 16

they swell up (increased osmolarity) and this leads to impaired glutamine release–> disruption of excitatory neurotransmission

Question 17

how should you evaluate someone who may have vertebral osteomyelitis?

Answer 17

blood cultures and MRI of the spine

Question 18

volume overload in the ventricles leads to which type of hypertrophy?

Answer 18

eccentric

Question 19

the decrease in function KCNH2 mutation is a cause of…

Answer 19

congenital long QT

Question 20

unfractionated heparin MOA?

Answer 20

binds to both antithrombin and thrombin, forming a complex that inactivates thrombin

also binds to and inhibits Xa

Question 21

low molecular weight heparin MOA?

Answer 21

binds and inactivates factor Xa

Question 22

how does shiga and shiga-like toxin work?

Answer 22

binds to 60s ribosomal subunit, inhibiting protein synthesis and leading to cell death

Question 23

at what CD4 count is someone susceptible to toxoplasmosis?

Answer 23

<100

Question 24

how does fructose-2,6,BP effect glycolysis?

Answer 24

activates phosphofructokinase-1, promoting the conversion of fructose-6-P to fructose,1,6-P

Question 25

high concentrations of fructose-2,6 BP inhibit...

Answer 25

gluconeogenesis

Question 26

what effect does cholesterol have on risk of gallstones?

Answer 26

high cholesterol leads to increased likelihood of cholesterol precipitation and gallstone formation

Question 27

what effect do bile salts and phosphatidylcholine have on risk of gallstones?

Answer 27

these increase the solubility of cholesterol and thus if they are higher it decreases risk

Question 28

what antibodies are present in membranous nephropathy?

Answer 28

phospholipase A2 receptor antibodies (PLA2R)

Question 29

aortic stenosis most commonly results from...

Answer 29

age-related calcific aortic valve disease

Question 30

pathogenesis of age-related calcific aortic valve disease?

Answer 30

In early stages damage to the valves over time lead to endothelial dysfunction and onset of an atherosclerotic process. The presence of inflammatory mediators eventually leads to fibroblast differentiation into osteoblast-like cells, leading to bone matrix deposition with progressive valvular calficiation

Question 31

which strain of hepatitis uses reverse transcriptase?

Answer 31

hepatitis B

Question 32

how do atrial myxomas appear histologically?

Answer 32

scattered cells with a mucopolysaccharide stroma

Question 33

which type of lung cancer may cause SIADH?

Answer 33

small cell lung carcinoma

Question 34

which markers are often present in small cell lung carcinoma?

Answer 34

neuroendocrine markers - neural adhesion molecules, chromogranin, neuron-specific enolase, synaptophysin.

Question 35

what would a biopsy of a white spot in someone with vitiligo show?

Answer 35

no melanocytes or pigment

Question 36

where does a neuroblastoma occur?

Answer 36

adrenal medulla

Question 37

presentation of a neuroblastoma?

Answer 37

young child <2 years, abdominal mass, opsoclonus-myoclonus, periorbital ecchymyoses

Question 38

what will neuroblastoma look like on histology?

Answer 38

small blue cells with homer wright rosettes

Question 39

what predicts prognosis of a neuroblastoma?

Answer 39

N-myc - poor prognosis

Question 40

is there blood and leukocytes in the stool of someone with norovirus?

Answer 40

no

Question 41

how may someone contract campylobacter other than undercooked meats?

Answer 41

contact with warm-blooded animals

Question 42

where do B cells usually aggregate in lymph nodes?

Answer 42

they usually aggregate in the cortex to form lymphoid follicles

Question 43

why do loop diuretics cause metabolic alkalosis?

Answer 43

- the loss of Na stimulates aldosterone, leading to increased secretion of H and K - more Cl- is lost than Na resulting in decreased total body electronegativity, leading to the kidneys holding on to more HCO

Question 44

if someone on loop diuretics develops metabolic alkalosis, what can you give them?

Answer 44

CA inhibitors

Question 45

what enzyme do fibrates inhibit?

Answer 45

cholesterol-7-alpha-hydroxylase - the rate limiting step in bile acid synthesis, resulting in decreased bile salt synthesis and increased excretion of cholesterol

Question 46

fibrates increase the risk for what?

Answer 46

gallstones - increased cholesterol in gallbladder

Question 47

what property leads to propofols short duration of action?

Answer 47

rapid redistribution of the drug into tissues

Question 48

how do GLP-1 agonists work?

Answer 48

increase glucose-dependent insulin secretion, decrease glucagon and delay gastric emptying

Question 49

side effects of GLP-1 agonists?

Answer 49

pancreatitis, weight loss

Question 50

where does the focal image fall with myopia?

Answer 50

anterior to the retina

Question 51

where does the focal image fall with hyperopia?

Answer 51

posterior to the retina