March 21 2014

Question 1

What are Howell-Jolly bodies?

Answer 1

Nuclear remnants within RBCs that are typically removed by the spleen.

They look like little periods (.) on the periphery of the cell with purple-red color

Indicate absent spleen or hypo-functioning spleen (think splenic auto-infarct in Sickle Cell)

Question 2

What is basophilic stippling and in what disorders would you see this?

Answer 2

Blue-ish granules in RBC cytoplasm = ribosomal precipitates

Thallessemias, alcohol abuse, lead, heavy metal poisoning

Question 3

Sickle cell anemia is caused by a ____ mutation on the ____ chain of Hb in RBCs

Answer 3

Point, Beat globin

Question 4

In Sickle Cell anemia, glutamate is replaced by ______.

Answer 4

Valine

GAG to GUG

Question 5

Tx for Sickle Cell pain crises?

Answer 5

Hydration, oxygen therapy, and narcotics

Question 6

What protozoa infection is spread by the tsetse fly?

Answer 6

Trypanosomiasis (African Sleeping Sickness - enlarged lymph nodes, recurrent fevers, coma)

Question 7

Viscerosomatic reflex for the uterus?

Answer 7

T10-L1

Question 8

Hiding true motives behind elaboration of an incorrect explanation is called ___?

Answer 8

Rationalization

Question 9

What is abnegation?

Answer 9

Denial

Person rejects true fact bc dealing with it is uncomfortable

Question 10

Attributing feelings to other people that you are actually feeling (but denying) is called ____?

Answer 10

Projecting

Question 11

Excluding your own desires and impulses from the conscious mind and putting them into the unconscious is called _____?

Answer 11

Repression

Question 12

Reverting to a younger, less developed stage rather than dealing with situation like an adult is called ____?

Answer 12

Being a big ass baby…

Regression

Question 13

What are the top three causes of neonatal meningitis?

Answer 13

S. agalactiae
E. coli
Listeria

Question 14

UTIs in patients with catheters. Think of this bug -?

Answer 14

Staph. epidermidis

Question 15

UTIs in sexually active females. Think of this bug -? Though it may not be the most common.

Answer 15

Staph saprolyticus

Question 16

Gram positive, lancet shaped diplococci

Answer 16

Strep pneumo

Question 17

Dihydrofolate reductase inhibitor that decreases level of folate? What kind of anemia can this cause? What is a main clinical use?

Answer 17

Methotrexate (used for RA)

Macrocytic (MCV > 100) megaloblastic

Question 18

MOA and clinical application of Ramelteon

Answer 18

selective melatonin receptor agonist

binds to M1 and M2 receptors in the suprachiasmatic nucleus

• -> regulate circadian rhythm
• -> increase wakefullness in AM

Question 19

Identity disturbance, suicidal thoughts, and impulsivity

Answer 19

borderline personality

Question 20

Intense interpersonal relationships, rapidly shifting emotions, submissive

Answer 20

First two could be either borderline personality OR dependent personality disorder

Add in submissive = dependent personality disorder

Question 21

Inappropriate sexual seduction, attention seeking behavior, rapidly shifting emotions

Answer 21

Histrionic

Question 22

Arrogance, lack of empathy, feelings of gradiosity

Answer 22

narcissistic personality disorder

Question 23

Ovarian tumor with ectopic thyroid tissue (complete with hormone production) =?

Answer 23

Struma ovari

Question 24

Benign neoplasm of smooth muscle origin. Most common tumor in all of women.

Answer 24

Leiomyoma aka fibroids (NOT precursor for leiomyosarcoma)

Estrogen sensitive

Question 25

Ovarian fibromas are assc with ____ syndrome. What is it?

Answer 25

Meig's Fibroma, ascites, pleural effusion

Question 26

Anovulation, hirsutism, infertility, obesity, and diabetes are all associated with what female disorder?

Answer 26

PCOS (polycystic ovarian)

Question 27

Bilateral cystic adnexal masses caused by either reaction to elevated hCG or hypersensitivity to hCG =

Answer 27

theca lutein cysts

Question 28

Diagnosis of a manic or hypomanic episode requires 3 or more of certain disturbances. Name them.

Answer 28

``` "DIG FAST" D - distractibility I- irresponsibility G- gradiosity F- flight of ideas A - agitation S- sleep, decreased need T - talkativity ```

Question 29

Bipolar I vs. Bipolar II

Answer 29

Bipolar I - at least one manic episode | Bipolar II - at least one hypomanic episode and one major depressive episode in the past

Question 30

A fracture of the medical epicondyle will most likely damage what nerve? Root levels?

Answer 30

Ulnar C8-T1 --> claw hand

Question 31

Reactivation Tb (apex) is considered which type of hypersensitivity reaction?

Answer 31

IV - delayed type

Question 32

Drug regimen for Tb?

Answer 32

RIPE...S Rifampin, isoniazid, pyrazinimide, ethambutol, streptomycin

Question 33

Isoniazid causes depletion of ____

Answer 33

B6

Question 34

What is the only thumb movement not involving the median nerve? What nerve is responsible?

Answer 34

Thumb adduction - ulnar nerve

Question 35

Obstruction to urine flow by stones typically occurs at what 3 sites:

Answer 35

ureteropelvic junction crossing of ureter over iliac vessels as ureter enters bladder

Question 36

Viscerosomatic levels for kidney =?

Answer 36

T10, T11

Question 37

Gentimicin MOA?

Answer 37

Binds to 30S and prevents protein synthesis

Question 38

What is HELLP syndrome

Answer 38

Hemolysis, elevated liver enzymes, low platelets

Question 39

What connects the 3rd and 4th ventricle?

Answer 39

Aqueduct of sylvius

Question 40

Foramen of magendie connects what to what? Luschka?

Answer 40

4th ventricle to medial entrance to subarachnoid space LATERAL

Question 41

What connects the lateral and 3rd ventricle?

Answer 41

Foramen of monro

Question 42

Gram negative rod septic shock is caused by what virulence factor?

Answer 42

lipid A portion of lipopolysaccharide

Question 43

Septic shock is characterized by _____??

Answer 43

Hypotension High CO (that becomes depressed as symptoms progress) Low systemic vascular resistance Low cardiac filling pressure

Question 44

McArdle disease is deficiency of what? How do you treat it?

Answer 44

muscle glycogen phosphorylate (glycogen storage disease) = exercise intolerance, easy fatigue, myalgia, muscle cramps...potentially rhabdomyolysis TX: oral sucrose

Question 45

What should you expect from serological findings of McArdle disease?

Answer 45

increased creatine kinase | increased myoglobin