Missed Concepts

Question 1

MCC of Spontaneous lobar hemorrhage (esp in elderly)?

Answer 1

cerebral amyloid angiopathy (MC lobes? occipital & Parietal)

Question 2

Transference

Answer 2

unconscious shifting of emotions for a person in the PAST to a person in the present

Question 3

Displacement

Answer 3

expressing unacceptable feelings meant for someone in their present life to a “safer” person

Question 4

KRAS gene and RAS protein

Answer 4

G-protein coupled receptor protein. growth factor binds a tyrosine kinase receptor, Ras gets GTP bound (now active), phosphorylate MAPK and initiates phosphorylation cascade

Question 5

Scopalamine

Answer 5

selective muscarinic AchR antagonist. decreases Ach activity in places like the gut (can be used for GI issues with AchEI treatment for Myasthenia Gravis)

Question 6

MCC of Croup (brassy cough, stridor)?

Answer 6

Paramyxovirus (parainfluenza)

Question 7

Calicivirus (aka Norwalk)?

Answer 7

Gastroenteritis

Question 8

where does HPV like to infect?

Answer 8

stratified squamous epithelium (e.g. cervix, true vocal cords, anus).

Question 9

Embryologic mechanism of TOF?

Answer 9

abnl neural crest migration –> deviation of the infundibular septum

Question 10

Fibrate MOA?

Answer 10

inhibit cholesterol 7alpha hydroxylase.

needed for bile acid synthesis –> results in less cholesterol solubility and cholesterol gallstones

Question 11

cat scratch disease?

Answer 11

Bartonella henslae

Question 12

Bartonella henslae

Answer 12

self limited - fever and lymphadenopathy
from cat scratch
assoc w - bacillary angiomatosis, culture negative endocarditis.

Question 13

malignant otitis externa from swimming pool

Answer 13

pseudomonas aerigonasus

Question 14

hot tub folliculitis

Answer 14

pseudomonas

Question 15

neutrophil migration?

Answer 15

leukotriene B4 (then 5HETE, C5a, and IL8)

Question 16

where do cephalosporins bind?

Answer 16

penicillin binding proteins = TRANSPEPTIDASES

Question 17

Meglitinides

Answer 17

similar to sulfonylureas

bind and close ATP dependent K channels in pancreatic beta cells (more depolarization, more insulin release)

Question 18

Tx BPH and HTN?

Answer 18

alpha1 blockers (Doxazosin, Prazosin, and Terazosin)

Question 19

Clozapine

Answer 19

use: Tx resistant Schizophrenia or Schizophrenia + suicidal
AR: agranulocytosis, Sz, myocarditis, metabolic syndrome

Question 20

Toxic Shock

Answer 20

SuperAg interaction with MHC molecules on APCs
Tcells release IL2
Macs release IL1

Question 21

NNH

Answer 21

1/Absolute Risk

Question 22

Absolute risk

Answer 22

rate of adverse event in experimental group vs control

Question 23

Secretory phase of menstrual cycle?

Answer 23

second half (after ovulation)
Progestrone (from corpus luteum) --> glandularization,  thicker mucus, engorged spiral arteries

Question 24

what structure is most susceptible to injury during hysterectomy?

Answer 24

ureter! (unilateral so can still produce urine)

Question 25

Glycogen synthesis regulation?

Answer 25

rate limiting enzyme: glycogen synthase active when DEphosphorylated by insulin pathway breakdown: activated by PKA (GPCR) via glucagon

Question 26

Insulin receptor activation

Answer 26

Tyr kinase - activates IRS1 MAPK --> mitogenic PI3K --> metabolic: GLUT4 to membrane, fat and glycogen synthesis (through protein phosphatase).

Question 27

TX of exophthalmus in Graves?

Answer 27

Steroids!

Question 28

Mucormycosis

Answer 28

DKA, black eschar on nasal septum | biopsy: broad non septate hyphae, RIGHT Angle brr

Question 29

Gout

Answer 29

Needle-shaped, negative birefringent crystals

Question 30

MCC bronchiolitis in kids <2?

Answer 30

RSV (diffuse wheezes and crackles)

Question 31

Drugs to avoid in elderly

Answer 31

``` anticholingeric (first gen antihistamines) alpha blockers TCAs Benzos/ sedating meds antipsychotics antiarrhyx skeletal MM relaxants ```

Question 32

angiomatosis

Answer 32

knots of capillaries vonHipple Lindau Bacillary angiomatosis (Bartonella/cat scratch) Sturge-Webber (port wine stain)

Question 33

Centriacinar emphysema

Answer 33

heavy smoking | proteinases (elastase) from PMNs & Macs

Question 34

C Diphtheriae culture

Answer 34

``` black colonies on cysteine-tellurite agar metachromatic granules (IC) seen w methylene blue staining ```

Question 35

epiglottitis?

Answer 35

H. flu

Question 36

virulence factor for H Flu

Answer 36

PRP

Question 37

digoxin elimination?

Answer 37

kidney

Question 38

Reverse Transcriptase PCR?

Answer 38

mRNA

Question 39

Osteomyelitis in SCD

Answer 39

Salmonella - motile G (-) non lactose fermenting, oxidase neg capsule (Vi Antigen)

Question 40

Chronic interstitial nephritis

Answer 40

analgesic nephropathy - chronic NSAID use | ischemic papillary necrosis