Hodge Podge

Question 1

What type of sensitivity is contact dermatitis from Poison Ivy? What mediates?

Answer 1

Type IV: mediated by T cells

Question 2

What is the ubiquitin protease pathway?

Answer 2

Uses ubiquitin ligase to break down proteins in cells so they can be recycled or presented in MHC

Question 3

Drug of choice in anaphylactic shock?

Answer 3

Epinephrine: even if it is a drug mediated allergy

1. B2 dilation of bronchioles
2. A1 constriction
3. B1 increase in contractility

Question 4

Which are the stop codons?

Answer 4

1. UAA
2. UGA
3. UAG

Question 5

What happens when ribosome hits stop codon?

Answer 5

Releasing factor binds ribosome to release protein

Question 6

Presentation of digeorge?

Answer 6

"CATCH 22Q"
Cardiac: tetralogy, truncus 
Abnormal facies 
Thymic HYPOplasia 
Craniofacial deformities: clefts 
HYPO calcemia / thyroid

Question 7

Function of nucleosis?

Answer 7

Synthesize and assemble r-RNA

Question 8

Lead poisoning in adult?

Answer 8

1. Mental status change
2. Constipation
3. Microcytic
4. Basophilic stippling

Question 9

What is head bobbing and wide pulse pressure indicative of?

Answer 9

Aortic regurg

Question 10

What can rapid correction of HYPOnatremia cause?

Answer 10

Osmotic demyelination syndrome of pons

Question 11

When is PVR lowest in lung?

Answer 11

FRC: less oxygen compressing vasculature

Question 12

NT in tetanus and botulism?

Answer 12

Tetanus: GABA / GLYCINE
BOTULISM: ACH

Question 13

Function of GABA and glycine?

Answer 13

Inhibitory NTs

Question 14

Toxin in C. perfringens?

Answer 14

Lecithinase which cleaves phospholipids

Question 15

What does H flu require to grow?

Answer 15

Factor V: NAD

Factor X: Hematin

Question 16

How does CNIII palsy present?

Answer 16

1. Drooping of upper eyelid
2. Eye stuck down and out
3. Impaired pupillary constriction

Question 17

Presentation of common peroneal nerve injury?

Answer 17

1. Loss of sensation on foot dorsum
2. Foot drop: loss of dorsal flexiion
   - Often injured in lateral blows to knee since nerve wraps around fibula

Question 18

Dry beriberi?

Answer 18

Thiamin deficiency causing:

1. Symmetric peripheral neuropathy
2. Cardiac involvement (wet)
3. CNS issues (wet)

Question 19

Anesthetic effect on cerebral / renal / liver flow?

Answer 19

Cerebral: Increase
Renal: Decreased
Liver: decreased

Question 20

What does wedge pressure measure?

Answer 20

LA pressure

Question 21

What is tryptophan a precursor of?

Answer 21

5HT

Question 22

Appearance of serotonin syndrome?

Answer 22

1. NM excitation: spasm, clonus, rigidity
2. Hyperthermia / tachy
3. Vomit / sweat
4. Agitation, confusion

Question 23

What is cyproheptadine?

Answer 23

Histamine antagonist with non specific 5HT antagonism properties
- Can be used to treat serotonin syndrome

Question 24

What is chronic lymphedema risk factor for?

Answer 24

Angiosarcoma of skin

Question 25

What does IL 4 do? 12?

Answer 25

4: TH2 differentiation 12: TH1 differentiation * Released by APCs when interacting with naive TH

Question 26

What are TH1/2 involved in?

Answer 26

TH1: Cell mediated immunity TH2: Antibody mediated immunity

Question 27

What does IFN-Gamma do?

Answer 27

Released by TH1 cells to activate macs

Question 28

T3 or 4 more potent?

Answer 28

T3

Question 29

What is reverse T3?

Answer 29

Inactive form generated from peripheral use of T4

Question 30

The production of what corresponds with severity of giant cell arteritis?

Answer 30

IL6

Question 31

Part of heart at left sternal border, fourth intercostal?

Answer 31

Right ventricle

Question 32

What composes majority of anterior heart border?

Answer 32

Right ventricle

Question 33

Nerve for afferent and efferent pupillary response to light?

Answer 33

Afferent: II Efferent: III

Question 34

What is SMA syndrome?

Answer 34

Transverse duodenum being trapped between SMA and aorta = epigastric pain and bilious vomit

Question 35

Earliest change in diabetic nephropathy?

Answer 35

GBM thickening: normally has negative hep sulfate to deflect proteins but this is lost = microalbuminuria

Question 36

What to do in early diabetic albuminuria?

Answer 36

ACEI

Question 37

What is modafinil used to treat?

Answer 37

Narcolepsy

Question 38

Treatment for trigeminal neuralgia?

Answer 38

Carbamazepine

Question 39

What is holosystolic murmur at apex?

Answer 39

Mitral regurg

Question 40

What is an S3 gallop?

Answer 40

Increased LV filling rate

Question 41

What is TNF alpha responsible for?

Answer 41

Sequestration of TB in granulomas

Question 42

MOA of PTU and methimazole?

Answer 42

Both: stop organification and coupling by thyroid peroxidase PTU: stope peripheral conversion of T4-3

Question 43

When are bilateral acoustic neuromas seen?

Answer 43

NF2

Question 44

What is following: 1. Cafe au lait spots 2. Multiple neurofibromas 3. Lisch nodules

Answer 44

NF1

Question 45

Area of brain first damaged by ischemia?

Answer 45

Hippocampus

Question 46

Baby with large tongue, large anterior fontanelle, umbilical hernia and regression?

Answer 46

HYPOthyroid

Question 47

What precedes PSGN and ARF?

Answer 47

PSGN: strep impetigo OR pharyngitis ARF: only ARF

Question 48

Dynamic changes in mitral regurg?

Answer 48

1. Decreased Afterload 2. Increased Preload 3. Increased EF

Question 49

Time course of schizo diagnosis?

Answer 49

6, schizophrenia: functional decline required

Question 50

What does LVEDP indicate?

Answer 50

Preload

Question 51

Signs of open angle glaucoma?

Answer 51

Progressive loss of peripheral vision

Question 52

Cause of open angle glaucoma?

Answer 52

Increased production or decreased outflow of humor

Question 53

Goal of open angle treatment?

Answer 53

Decrease intraocular pressure: BBs do this by decreasing aqueous humor production

Question 54

Why do PPIs cause osteopenia?

Answer 54

Ca needs acidic environment to be absorbed

Question 55

How are osteocytes attached to each other?

Answer 55

Gap junctions

Question 56

Effects of estrogen on T4?

Answer 56

- E2 increases TBG production transiently dropping T4 levels | - TSH will ramp up to increase T4 again increasing overall pool by having the same free amount

Question 57

What is substance P?

Answer 57

Pain transmitter

Question 58

When is slit lamp exam used?

Answer 58

Kayser fleischer rings in wilson disease

Question 59

When are anti smooth muscle antibodies seen?

Answer 59

Autoimmun hepatitis

Question 60

What is bipolar I?

Answer 60

Manic episodes | - Depression common but not required

Question 61

What is bipolar II?

Answer 61

Depression: | - Hypomanic episodes

Question 62

What does TGF beta control in healing?

Answer 62

Fibroblast migration and proliferation

Question 63

Cells involved in skin test like TB?

Answer 63

Mac, CD4, CD8

Question 64

Why isn't muscle contracting in MG?

Answer 64

Can't reach the end plate potential since the receptors are blocked

Question 65

Which diuretic increases serum Ca?

Answer 65

Thiazides

Question 66

Chediak higashi presentation?

Answer 66

1. Albinism 2. Immunodeficiency: neut phagolysosome defects 3. Neuro Defects: nystagmus

Question 67

What is following: 1. Albinism 2. Immunodeficiency 3. Neurologic defects

Answer 67

Chediak higashi

Question 68

What type of secretion to sebaceous glands use?

Answer 68

Holocrine: cell lysis releasing contents

Question 69

Bone injured in fall on hand?

Answer 69

Scaphoid

Question 70

Bone with pain in snuff box?

Answer 70

Scaphoid

Question 71

What is BRAF?

Answer 71

Involved in signalling in melanocyte proliferation - mutation can = melanoma

Question 72

Mutation seen in melanoma?

Answer 72

BRAF

Question 73

Cytokines high in Mycobacterial infx?

Answer 73

TH1 mediated: 1. IL2 2. IL12 3. IFN gamma

Question 74

First line gout treatment?

Answer 74

NSAIDs

Question 75

How to diagnose vertebral osteomyelitis?

Answer 75

MRI of spine

Question 76

What is thin granulosum, keratotic corneum and foci of neutrophils?

Answer 76

Psoriasis