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Aa Shit You Don't Know > Kaplan > Flashcards

Kaplan Flashcards

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1
Q

What is cyclobenzaprine? What is a potential side effect

A

Spasmolytic, which is a centrally acting muscle relaxant. They are structurally related to the tricyclic antidepressants and thus can have anticholinergic effects such as dry mouth, impairment of urination, and tachycardia.

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2
Q

Blood supply to the bladder is from the superior and inferior vesicle arteries: describe where the vesical arteries arise from

A

Superior vesicle arteries are branches of the umbilical arteries, which are branches of the internal iliac arteries.
Inferior vesicle are direct branches of the internal iliac arteries.

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3
Q

What kind of stones would you see in a HbS patient or hereditary spherocytosis?

A

Calcium bilirubinate

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4
Q

Klumke palsy/Thoracic outlet syndrome are due to injury/cpmpression of what structures respectively?

A

Klumke: traction/tear of Lower trunk (C8-T1)
Thoracic outlet syndrome: compression of lower trunk and subclavian vessels
Get klumpke from either upward force on arm during delivery, or grabbing tree limb while falling

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5
Q

Cirgarettes, aromatic amines, cyclophosphamide, radiation are risk factors for what type of bladder cancer?

A

Transitional cell

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6
Q

Goiter that is non-tender, stony hard, limited gland mobility, extensive fibrosis, dyspnea/dysphagia/hoarseness (mimics malignancy)

A

Riedel thyroiditis

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7
Q

Where is the BRCA-1 gene located?

A

17q

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8
Q

Gilbert vs Crigler-Najjar

A

Gilbert is a mild decrease in UDP-glucuronysyltransferase activity; results in asymptomatic or mild jaundice (INDIRECT bili)that is often due to stress, illness, etc.
Crigler is absent UDP-Glucuronysyltranserase. This is more severe, presents early in life with jaundice, kernicterus. Treat w/ plasmapharesis/phototherapy. Liver transplant curative

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9
Q

How do you calculate SVR?

A

SVR=(MAP-RAP)/CO

MAP=diastolic +1/3 of pulse pressure (systolic - diastolic)

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10
Q

What does a larger y intercept on a MM plot mean?

A

Decreased vMax

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11
Q

Tumor with elongated astrocytes w/ long bipolar processes and numerous eosinophilic intracellular inclusions with a twisted appearance.

A

Pilocytic astrocytoma (Rosenthal fibers are corkscrew-shaped, intensely eosinophilic strucutres derived from accumulation of aB-crystallin within astrocytic processes)

  • low grade tumor in children/young adults. Usually in posterior fossa, cerebellar hemispheres.
  • CYST W/ MURAL NODULE
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12
Q

What mutation is seen with familial isolated glucocorticoid deficiency? What levels are low, what levels are high?

A

ACTH receptor (melanocortin-2 receptor; MC2R) gene. ACTH normally stimulates corticosteroid and androgen production, so an ACTH receptor defect results in low adrenal glucocorticoid and androgen levels. Aldosterone will be normal as its synthesis and release is stimulated by ATII and hyperkalemia, nut not ACTH

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13
Q

Multinucleated giant cells found in painful goiter that was proceeded by a viral illness

A

de Quervain thyroiditis

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14
Q

What is human granulocytic anaplasmosis?
What is the bacteria, and vector?
Presentation?

A

Intracellular bacterium transmitted by Ixodes tick (also tansmits lyme/babesia)
Presents similar to RMSF but does not have a rash
PATHOGNOMONIC: presence of MORULAE inside the patients GRANULOCYTES. Tx w/ doxycycline

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15
Q

What is the mutation seen in Cri-du-chat? What are some features of this disorder?

A

Deletion of the short arm of chromosome 5 (5p-)
Short stature, distorted laryngeal anatomy, profoudn intellectual disability, wide set eyes, downward slanting eyes
ventricular septal defects

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16
Q

What is the histology of a rash in SLE?

A

deposition of autoreactive IgG and complement at the dermoepidermal junction

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17
Q

What anti-pseudomonal beta lactam can you give a patient who is allergic to beta-lactams?

A

Aztreonam

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18
Q

Brain tumor with fried egg appearance: round nuclei with clear cytoplasm?

A

Oligodendroglioma

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19
Q

Invasion of dermal lymphatic spaces—> painful breast with warm, swollen, erythematous skin, peau d’ orange

A

Inflammatory carcinoma.

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20
Q

CTG repeat, Auto Dominant

A

Cataracts,Toupee (early balding), Gonadal atrophy

This is myotonic dystrophy, which is a defect in the myotonic dystrophy Protein kinase; DMPK

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21
Q

Mobitz type I (wenckebach)

A

Increasing PR interval length until QRS wave is lost

Does not require tx

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22
Q

How do you calculate incidence rate?

A

of new cases/ # of people at risk

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23
Q

What are the labs for Paget disease of bone?

A

Serum alk phos is high, but serum calcium, phosphorus, and pth levels are normal. Can also hydroxyproline in urine

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24
Q

What class of lipid-lowering agents upregulates LPL and activates PPAR-a to induce HDL synthesis? What does this put patients at risk for?

A

Fibrates; puts patients at risk of cholesterol gallstones via inhibition of 7a-hydroxylase

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25
OTC deficiency inheritance
X-linked; although there is significant, though milder, symptomatology in heterozygous females.
26
When would you see falsely elevated HbA1c?
When patients have low rates of RBC erythropoiesis, such as patients w/ iron or vitamin b12/folate anemia, renal failure (lack of EPO), bone marrow suppression w/ alcohol, and splenectomy (increased RBC survival)
27
What are the parts of: | Medicare A-D
Medicare A: room/board while in hospital Medicare B: outpatient medical services Medicare C: Medicare advantage (private) plans (similar to PPO/HMO) Medicare D: Retail prescription drug coverage
28
What disease is the result of defective crosslinking of the triple helix of collagen molecules due to loss of Copper cofactor?
Menkes ATP7A gene; results in ATP dependent copper transporter deficiency. X-Linked Recessive Sparse depigmented hair, seizures, FTT, neurodegeneration
29
Bone marrow shows megakaryocyte hyperplasia, peripheral blood smear shows normal platelet morphology. Autoimmune disorder in which antibodies form against platelet glycoproteins. Tx is w/ steroids and intravenous immunoglobulin IVIG
Idiopathic thrombocytopenic purpura
30
What is the innervation of the hand lumbricals? What is their action? Full claw hand seen in which pathology?
I,II are median nerve III, IV are deep branch of ulnar nerve Flex MTP, extend interphalangeal joints Full claw hand seen in Lower cord injury (C8-T1), which is a combined median and ulnar nerve injury
31
Schistosoma haematobium, long term foley use, bladder stones are risk factors for what type of bladder cancer?
Squamous cell carcinoma
32
PR interval greater than .2 seconds?
First degree block
33
superoxide-dismutase 1 (SOD1) glutamate excitotoxicity
ALS
34
Mobitz type II
Constant PR interval w/ random dropped QRS complexes. Likely a defect in His-Purkinje. Needs a pacemaker.
35
Baby has high-pitched cry, lethargy, hypotonia, seizures: kernicterus. Mom took TMP/SMX 1 week prior to birth.
TMP/SMX can displace bilirubin from albumin causing kernicterus
36
Testicular tumor that produces a yellow, mucinous mass that histologically shows endodermal sinus formation and presence of hyaline droplets. What is this? What is tumor marker used to monitor?
Yolk-sac tumor | Alpha-fetoprotein
37
Smallpox (variola major)
Poxvirus, brick shaped dsDNA virus Thick viral envelope Golgi membranes w/ polypeptides and modified hemagluttin Guarnieri inclusion bodies
38
What does a Pyruvate kinase defect cause?
Reduced ATP, rigid RBCs, extravascular HEMOLYSIS. - will also see 2,3x the normal levels of 2,3 BPG in red cells, leading to lower affinity of Hb for O2 (right shift) - Echinocytes
39
Bilateral damage to the median temporal lobes, including the hippocampus, results in what?
Profound loss of ability to acquire new information, known as ANTEROgrade amnesia
40
What is mandibulofacial dysostosis?
Abnormal development of the first, second pharyngeal arch, cleft, and pouch. Abnormally formed mandible, ears, facial bones and palate.
41
COBEDS: Bacteerial toxic factors acquired during lysogeny | -what does COBEDS stand for
Cholera toxin, O antigen of Salmonella, Botulinum exotoxin, Erythrogenic exotoxins of Strep pyogenes, Diphtheria toxin, Shiga toxin
42
This metalloprotease normally cleaves ultralarge von Willebrand factor (ULVWF). What is it? What disorder?
ADAMTS13, Thrombotic Thrombocytopenic Purpura
43
Marburg virus
Filovirus Linear, non-segmented, ssRNA Niemann-Pick cholesterol transporter mediates entry Hemorrhagic fever, pancreatitis, rash. Only supportive tx available. Category A agent
44
Palatine shelves (maxillary prominences) fail to fuse w/ each other or the primary palate (fused medial nasal prominences)?
Cleft palate
45
When you lower the cutoff point for a disease toward the normal, what do you do to the sensitivity? To the negative predictive value?
You would increase the sensitivity, which also would increase the negative predictive value, which is the probability that a negative test result is a true negative.
46
Where do you do a pudendal nerve block
Ischial spine
47
What happens if you sever CN IX,X bilaterally?
-Normally, firing rate of baroreceptors rise w/ increasing MAP. If theyre cut, they will send no signal and make brain believe pt is hypotensive. Decrease in PNS activity, increase in sympathetic
48
Clefts Arches Pouches What origin?
Clefts: ectoderm Arches: mesoderm and neural crest Pouches: endoderm
49
Machinery like murmur associated w/ maternal rubella (+ sense, ssRNA, enveloped Togavirus)
Rubella
50
How does a Marcus Gunn pupil work?
AKA relative afferent pupillary defect - shine light into normal eye, constriction of the normal eye (direct) and contralateral (consensual) is observed. - Now, when light is then swung to affected eye, BOTH pupils DILATE instead of constrict due to impaired conduction of light signal along the injured optic nerve.
51
Atypical intraductal epithelial cell proliferation with comedonecrosis
DCIS
52
Patient presents with firm, solitary thyrid nodule with dysphagia and hoarseness. Biopsy shows atypical, uniform, polygonal neoplastic cells and proteinaceous stromal material that is not colloid
Medullary carcinoma of the thyroid; which is a neuroendocrine tumor derived from parafollicular C cells. Parafollicular C cells are Neural crest cell origin
53
Lassa virus
Enveloped, ss, bisegmented, ambisense RNA virus Arena virus Glycoprotein binding to alpha-dystroglycan Zinc binding protein regulated viral transcription
54
Lateral maxillary prominence fails to fuse w/ medial nasal prominence?
Cleft lip
55
Which two muscles have their origins on the hook of hamate?
Flexor digiti minimi and opponens digiti minimi
56
Menkes disease mutation vs Wilson disease mutation
Menkes=ATP7A | Wilson=ATP7B
57
What is the nerve from the mandibular division of CN V that supplies the anterior half of the external auditory meatus and the facial surface of the upper part of the auricle?
Auriculotemporal nerve
58
The floor of the orbit is the roof of the?
Maxillary sinus
59
Glutamate release inhibitor and glutamate receptor blocker, as well as sodium channel blocker that is the only drug known to increase survival time in ALS pts.
Riluzole
60
1st trimester screening shows very low beta h-CG and very low PAPP-A. Second trimester screening shows decrease in AFP, uE3 (unconjugates estriol), inhibin A, and betah-CG
Edwards syndrome trisomy 18 Severe intellectual disability, micrognathhia, prominent occiput, low-set ears, short neck, rocker-bottom feet, and clenched hands with overlapping fingers.
61
As you move right (towards zero) on a MM plot, what happens to the Km?
Km is greater, which means lower affinity
62
Machupo virus
Mmarenavirus; which is an arenavirus. Black typhus, aka bolivian hemorrhagic fever. Vector is large vesper mouse. Petechiae and MASSIVE ORAL BLEEDING
63
AR disorder characterized by profound hypoglycermia, lactic acidosis, hyperuricemia, hyperlipidemia, and hepatomegaly due to both glycogen and fat accumulation:
Glucose-6-phosphatase deficiency (Von Gierke) - usually presents at about 3-4 months - impaired gluconeogenesis - avoid fructose and galactose; treat w/ frequent oral intake of glucose/cornstarch
64
Bruton Agammaglobulinemia: Inheritance: What is not found in circulation? What would be found in bone marrow? At risk for what types of infection?
An X-linked deficiency of a Bruton Tyrosine Kinase, which is important for B-Cell maturation. No B lymphocytes in circulaiton; maturation stopped at pre-B cell level in bone marrow. Antibodies are key against extracellular encapsulated organisms
65
Velocity through a vessel is inversely proportional to the...?
Velocity through a vessel is inversely proportional to the cross sectional area. Therefore, capillaries have the largest total cross sectional area and the slowest velocity
66
ALS symptoms LMN vs UMN
LMN (ventral horn): muscular atrophy and fasiculations | UMN: hyperreflexia, hypertonia, clasp knife spasticity, Babinski
67
What is another name for the enzyme a1,4-glucosidase? What disease is it deficient in?
Acid maltase, Pompe disease. Glycogen storage type II. Cardiomyopathy
68
CD117 (c-KIT) and Placental Alkaline Phosphatase are immunohistochemical STAINS for what?
Seminoma, fried egg shit
69
Where are G cells found in the stomach? Where are they found in the small intestine?
Gastrin is a peptide produced by G cells in the gastric antrum. G cells are found in the duodenal and jejunal mucosa
70
Tuberculoid vs Lepromatous lepracy
Tuberculoid is more indolent because Th1 response was good and made granulomas Leprmatous has a weak cell-mediated response, but has a more significant Th2 response. Worse
71
Malignant otitis externa that can spread to the brain via the sigmoid sinus. Also can produce ethyma gangenosum.
Pseudomonas aeruginosa major cause of malignant otitis externa.
72
Tumor marker for choriocarcinoma?
Beta hCG

Aa Shit You Don't Know (13 decks)

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