May 16

Question 1

Ischemic infarct CT appearance

Answer 1

Hypodense, poorly delinieated

Edema, loss of grey/white matter distinction

Question 2

Infarct course

Answer 2

During first 48 hours, red neurons.
Neutrophils move in, then microglia (macrophage).
Microglia stain the strongest as fat cells. (Break down stuff, cause of liquefactive necrosis)

Question 3

Acute decompensated heart failure in CXR

Answer 3

Cardiomegaly
Secondary pulmonary edema (kerly b lines).
Perihilar alveolar edema (batwing)

Question 4

Path of CSF flow

Answer 4

Choroid plexus secretes, lateral ventricle->interventricular foramen of monro -> third ventricle -> cerebral aqueduct -> fourth ventricle -> foramina of Luschka and Magendie -> subarachnoid space.
Absorbed y arachnoid granulations into venous sinus.

Question 5

DSM5 for tourette

Answer 5

Multiple motor and one+ vocal tic (not necessarily concurrent)
>1 year.
Before 8
Treat with: antipsychitics, alpha-receptor antagonist, therapy

Question 6

Filtration Fraction

Answer 6

FF = GFR/ RPF
GFR: creatnine.
RPF: PAH.
Clearance (urine X flow / serum).

Question 7

Consequence of giardiasis

Answer 7

Lactose intolerance (lactase deficiency)
Lactose -> Galactose

Question 8

Projection

Answer 8

Misattributing one’s own feelings to another who doesnt have them.
I lost the game. They must be ashamed of me (when really I’m ashamed).

Question 9

TNF-alpha inhibitors

Answer 9

Adalimumab, infliximab, etanercept.

Question 10

G6PD

Answer 10

X linked
Rate limiting in Pentose Phosphate (Glucose -6- phosphate to 6-phpsphogloconate (creating NADPH).
Oxidative damage causes hemolysis. (TMP/SMX for UTI can cause)

Question 11

Acidos/alkalosis compensaton

Answer 11

Met Acid: pH down, pCO2 down (HyperVent), HCO3 down.
Resp Acid: pH down, pCo2 Up, HCO3 up.
Met Alk: pH up, pCO2 up, HCO3 up.
Resp alk: pH up, pCO2 down, HCO3 down.

Question 12

Ankylosing spondylitis

Answer 12

Low back pain, improves with exercise but not rest (pain at night).
Hip, butt.
Limited chest expansion, chest mobility.
Systemic issues (fever, chills).
B27

Question 13

Foot drop

Answer 13

Mostly common peroneal nerve

Question 14

How is isoniazid metablized?

Answer 14

Liver. Acetylation (phase II)

Also: procainamide, hydralazine, TNF-alpha inhibitors.

Question 15

Epinephrine effects

Answer 15

Alpha 1= vascular smooth muscle. VasoC.
Beta 1= skeletal smooth muscle. VasoD. increase heart rate.
If high dose, alpha 1 predominate, increased BP. If low, beta2 = decreased blood pressure.

Question 16

Which HIV gene is related to rsistance to drugs?

Answer 16

Pol = to reverse transcriptase inhibitor and protease inhibtor
ENV: to escape antibodies (capsule).

Question 17

Drugs used for PBH AND HTN

Answer 17

Doxazosin, prazosin, terazosin

Alpha 1 lockers. Useful for vasoD too.

Question 18

Corticosteroids increase what immune cell?

Answer 18

Neutrophil. Bc demargination.

Previously attached to vessel wall, so they release.

Question 19

Enteric bacteria produce what?

Answer 19

Folate

Vitamin K

Question 20

Absence seizures

Answer 20

Mostly kids.
No postictal period. No recollection.
Ethosuximide or sodium valproate.
3Hz spike in EEG.

Question 21

Amniotic fluid embolism

Answer 21

Cardiognic shock
Respiratory failure, hyoxemic
DIC
Seizures, coma
Histology shows: fetal squamous cell and mucin in pulmonary arteries of mom.

Question 22

Kallmann syndrome

Answer 22

Failure of GnRH secreting neurons to migrate. KAL1 mutation or FGFR1 mutation (codes for migration).
Hypogonadism, anosmia.
Delayed puberty.

Question 23

Delayed puberty

Answer 23

14 in boys

12 in girls

Question 24

Southwestern blot

Answer 24

Used to identify proteins that bind to DNA.

Question 25

Choronic kindey disease

Answer 25

``` GFR down. VitD (1,25,dihydroxyvitaminD) decrease (intestinal Ca+ down) Phosphate retention (low GFR) Low serum calcium -> high PTH trying to correct ```

Question 26

systemic sclerosis (limited)

Answer 26

``` Crest Calcium nodules. Raynauds phenominon. (Can lead to ulcer) Esophageal dysmotility Sclerodactyly Telangiectasia ```

Question 27

Rickets

Answer 27

``` VitD deficiency Excess of unmineralized osteoid matriz (bc no calcium to do it) Frontal bossing, craiotabes (soft skull) [prewalk] Genu varum (bowing of femur) [post walk] ```

Question 28

Marker for fetal lung maturity

Answer 28

Phospholipids | Specifically (lectin to sphingomyelin ration (L/S), above 2

Question 29

Transport of glucose into the cell

Answer 29

Mostly by facillitated diffusion with help of GLUT | Steroselective for D-glucose

Question 30

How to reverse Methotrexate toxicity?

Answer 30

``` Folinic acid (leucovorin). THF without the need for DHF reductase (inhibited by MTX) ```

Question 31

Super antigen affects what cells?

Answer 31

``` Macrophages (MHCII) T lymphocytes (TCR) ```

Question 32

Spice nucleotide

Answer 32

GU XXXXX.....XXXX AG

Question 33

CHF affects lung

Answer 33

Causes decrease in lung compliance | Fluid causes swelling of tissue

Question 34

Obstructed braciocephalic vein

Answer 34

Apical lung tumor, or thrombotic occlusion (central catheter) Ipsilateral face swelling, subcutanous vein engorgement, and arm swelling.

Question 35

Brachiocephalic vein obstrcution vs superior vena cava syndrome

Answer 35

BV: ipsilateral SVC: both sides

Question 36

Superomedial injection

Answer 36

Causes Trendelenburg gait. Hip drop when ipsilateral foot raised. Injury to controlateral superior gluteal. Weaked gluteus minimus can't contract on side of injury

Question 37

When to add mesna and for what?

Answer 37

Cyclophosphamide or ifosfamide (breast cancer) | To avoid hemorrhagic cystitis.

Question 38

RSV

Answer 38

Bronchiolitis (lower respiratory tract). Before age of 2. | Rhinorrea and congestion followed by wheezing and crackles.

Question 39

Adenomyosis

Answer 39

Endometrial glandular tissue within myometrial Heavy menstrual bleeding Painful Uniformly enlarged uterus.

Question 40

Displacement

Answer 40

Emotions are transferred from person/object causing negative emotions to more neutral person/object. "My wife cheated on me, so I yelled at my kids for doing little things"

Question 41

Spironolactone MoA

Answer 41

Aldosterone receptor antagonist Potassim diarrhetic @ collecting duct. Aldosterone puts in transporter (Na out/ K, H in).