January 26

Question 0

Myasthenia Gravis type ? hypersensitivity disorder?

Name another type ? hypersensitivity disorder.

Answer 0

Type II
Ab (IgG or IgM) binds to extracellular Ag or extracellular matrix components

also Type II is Goodpasture

Question 1

Wolff Parkinson White syndrome

1. name of accessory pathway
2. part of the ECG affected and how

Answer 1

1. bundle of Kent
2. affects PR interval: shortened PR interval
   affects QRS interval: elongated QRS
   adds pre-excitation bump called a delta wave just before the nl Q wave, shortens the PR and elongates the QRS

Question 2

Goodpasture syndrome

Type ? hypersensitivity disorder

Answer 2

Type II

Ab to GBM

Question 3

Copper abs in the GI
In the liver copper is bound to ___________ to become __________.
Excreted into ____________.

Answer 3

alpha-2 globulin to form ceruloplasmin
excreted 85-95% into bile and stool
5-15% excreted renally

Question 4

CN’s involved in the consensual light reflex

Answer 4

CN II afferent (in)

CN III efferent (out)

Question 5

CN III palsy ssx

Answer 5

1. ptosis
   down & out gaze (unopposed lateral rectus VI and sup. oblique CN IV)
2. ciliary m. & iris sphincter (CN III parasympathetics) = fixed dilated pupil & loss of accommodation

Question 6

most dreaded cause of CN III palsy

Answer 6

enlarging intracranial aneurism

Question 7

bounding femoral pulse and carotid pulse assoc. with head bobbing.
which valve is affected and how?

Answer 7

Aortic regurgitation

bounding pulses due to increased left ventricular stroke volume

Question 8

C. diphtheria AB toxin mechanism of action

Answer 8

A subunit attaches
B subunit enters cell: RYBOSYLATION. transfer ribose from NAD to histidine residue on EF-2. Inactivates EF-2 and inhibits protein synthesis -> cell death

Question 9

FT-AB tests for…

Answer 9

Syphilis

Question 10

tertiary syphilis effect on the heart

Answer 10

obliteration of vaso vasorum -> medial tear -> thoracic aortic aneurysm

Question 11

preferred method for early detection of diabetic nephropathy

Answer 11

microalbuminuria (30-300 mg/day in 24 hr urine collection OR 30-300 micrograms / mg of creatine in spot test)

Question 12

% of coronary blood flow during systole vs. diastole

Answer 12

30% systole
70% diastole

during systole compresson vessels limits flow/perfusion. during strenuous exercise increased HR and decreased diastole time is limiting factor for coronary blood flow

Question 13

warfarin molecular mechanism of action

Answer 13

blocks glutamate residue carboxylation

Question 14

Treatment for Acute Manic Episode

Answer 14

1. Lithium
2. Valproate
3. Carbamazepine
   +
4. Atypical (Olanzapine)

Tx is effective in only 60% of pts

Question 15

Aortic Regurgitation Murmur

Answer 15

Early Diastolic

Duration of murmur = severity of regurge
worse regurge = longer duration, even to holosystolic
less bad regurge = early

Question 16

oxytocin production

Answer 16

paraventricular nuclei of the hypothalamus

Question 17

ADH (vasopressin) production site

Answer 17

Supraoptic nucleus of the hypothalamus