My notes from test

Question 1

what is the protein?

Damage Secretory vesicles to get down the axon to synaptic terminals

Answer 1

Kinesin protein (microtubule associated ATP protein- antrograde movement)

Question 2

What is the defecitive protein in Glanzmann thrombasthenia?

and what is the common presentation?

Answer 2

GPIIbIIIa
remember: M= 3, and have 2a

חסר שלו או שהוא דפוק

mucocutaneous bleeding
No PLT clumping on blood smear

Question 3

How a platlet plug is formed?

Answer 3

stractural change in GPIIb/III3on PLT&raquo_space; binding to fibrinogen&raquo_space; forming PLT Plug

Question 4

Which medication inhibit PLT aggragation?

Answer 4

Aspirin (COX1,2, TXA2)
Clopidogrel (P2Y12)

Question 5

Which medication inhibit glycoprotein (GP) IIb/IIIa

Answer 5

Abciximab

Question 6

Which substance oppose the function of Thromboxane A2, and what it would lead to

Answer 6

Prostacyclin (prostaglandin I2)
Inhibit PLT aggregation + Vasodilation

Shyntesis in endothelial vascular cells

Question 7

Which phase in the Cardiac myocytes CBB work ? and what they cause?

Answer 7

**CCB (Verapamil, dilitiazem **
Class IV antiarrythmic

Slow sinus rate, prolong condction AV node, Depress myocardial contractility

Question 8

Which phase in the Cardiac myocytes Class III Anti-aryttmhic work ? and what they cause?

Amiodarone, Sotalol, Dofetilide

Answer 8

Late repolarization- stage 3 block pottasium Channels from outward current

prolongation of re-polarization, AP duration, and QT interval

Question 9

Which medication maintance Sinus rythem in Proxismal Afib

3

Answer 9

Type III AA-
Amiodarone, sotalol, dofetilide

Can cause Hyperkalemia

Question 10

Which drugs are class 1 anti arrhythmic

Answer 10

Salty cab- inhibit Na in non pacemaker cells
1c- can’t use post MI
1a- The queen Di after using cocaine
1b- Best post MI

Question 11

Whats the likely diagnosis?

Pancytopenia (or at least 1 type of cytopenia) + dysplastic erythrocytes +pervious Chemo Tx.

Answer 11

Myelodysplastic syndrome

Question 12

Whats the likely diagnosis?
Blood smear with Hypolobulated and hypograndular neutrophils + Oval macrocytes

and what likely to be seen on BM biopsy

Answer 12

MDS
(myelodisplatic syndrome)
Likely on BM: Dysplastic Erythroid and myeloid progenitor cells

Oval macrocyts- dysplastic erytrocytes» most common in MDS

Question 13

Which moleculs produce by the POMC

3

Answer 13

• beta- endrophins
• ACTH
• MSH

Question 14

pharma

What is the mechanism of action of Metformin

2 arms

Answer 14

Activated AMP protein Kinase
Inhibit- mitocondrial G6D

Question 15

Metformin
What are the metabolid effect on:
* Glucose and liver
* Glucose absorpation
* Glucose uptake / utilization
* Fatty acid

Answer 15

• Inhibit Hepatic Gluconeogenesis
• Deacrese interstitial Glucose absorpation
• increase peripheral Glucose uptake / utilization
• inhibit lipogenesis- Reduce circulating lipid levels

Unchange insulin levels (risk hypoglycemia) , weight loss

Question 16

Which DM medication has a risk for both Hypoglycemin events + gain weight ?

Answer 16

Sulfanylurea (Glyburide, Glimepridine)
Stimulate beta cells to secrete insulin

Question 17

Where is Wernicke area location and where is Broca

For each one what is the symptoms

Answer 17

E- Wernicke&raquo_space; What? dont understand. are not aware to their situation
B- Broca&raquo_space; Bla bla bla, understand but can’t talk (somtimes write also proparly) frustrated

B- Inf.frontal gyrus
E- Caudal sup. temporal lobe

Question 18

What tumors are associated with VHL syndrome

3

Answer 18

• RCC
• Hemangiobalstima (Cerebellar &ratinal)
• Pheochromocytoma

3 letters = chromosome 3

Question 19

Whice protein is mutated in Hemochromatosis? what it cause

Answer 19

HFE protein
Cause Hepatocytes and Enterocyte to decect falsly low iron levels&raquo_space; increase accumulation in the body:
DMT1 (divalent metal transporter) by Enterocytes
Decreasing Hepcidin synthsis = more Iron absorbes to the blood

Question 20

Hemochromatosis have a high risk for whice comlication?

Answer 20

Liver chirrosis + HCC

Question 21

What is the primary virulence factor of M.tuberculosis

Answer 21

Cord Factor

protect bacteria from being digest by macrophages

Question 22

What is the mnemonic for Reactive Artheritis

Reiters syndrome

Answer 22

• Cant see- Conjuctuvitis
• Cant pee- Urethritis
• Can’t climb a tree- Arthritis

Question 23

Which 4 disease are HLA-B27 positive

“mnemoninc PAIR”

Answer 23

• Psoriatic Arthritis
• Ankylosing spondylitis
• IBD
• Reactive arthritis

Question 24

Whice pathogens can exceed reactive arthritis

5

Answer 24

• Chlamydia
• Campylobacter
• Salmonella
• Shigella
• Yersinia

Sterile arthritis due to deposition of immunce complex

Question 25

What type of medication Abatacept is? And what is the effect on T-cells

Answer 25

**CTLA4-Ig** bind CD80/86 in more affinity then T cells = prevent co-stimulation of T cells = **T cells Anergy = reduce inf.**

Question 26

What the mnemonic For D-george Syndrome? | Catch 22

Answer 26

chromosome 22. C-Cardiac abnormalitiy (Tetralogy OF, truncus arteriosis) A- Abnormal Face T-Thymia aplasia (T-cell def.) C-Cleft palate H- Hypocalcemia/ HypoPTH 22- 22q11 micro-deletion ## Footnote defect development od pharyngeal pouch

Question 27

How we diagnose Congenital Hypothyroidism and why clinical menstifation does not present in birth

Answer 27

1. Dx- elevated TSH + low T4 2. not present in birth- transplacental trasnfer of maternal T4

Question 28

What the cause of Diabetes insipidus

Answer 28

Impaired ADH (anti-diuretic hormone) Central- problem in production Nephrogenic- prolem in kideny

Question 29

how is DI clinicly present? how to destinguish from central to nephrogenic?

Answer 29

presentation- large volume of very dilute urine < 300 mOsml/L distinguish: **Exogenous ADH:** if increase urine osmolality = central if little increase to none = nephrogenic

Question 30

Which injury can cause persistant central DI and which transient? anatomicaly

Answer 30

Persistant- **Hypothalamic injury** where Magnocellular neurons produce ADH Transient- anywhere below the indfuldibiulm (including post. pituitray)

Question 31

Which muscles are innervated by Abducens nerve (VI)

Answer 31

Lateral rectus | dipolipia, eye deviate medialy

Question 32

Which muscles are innervated by Trochlear nerve (CN IV)

Answer 32

Sup. oblique | eye deviated upward, Vertial& torsional diplopia

Question 33

Which Hepatitis antigen reflect immunization and not contamination

Answer 33

HBsAb | alone

Question 34

Where are fluids build up in communication hydrocele? and in what age group is common

Answer 34

Tunica vaginalis in the setting of patent processus vaginalis- painless ## Footnote common in newborne

Question 35

How to calculate drug conentration with a given Drug dose, Half life, and vol of distibution

Answer 35

Drug concentation = Drug dose / Vd after that- by having the Hald life we reduce 50% every half life

Question 36

which part of the spine is involve in Reumatoid arthritis

Answer 36

Cervical spine | instability and cord compression

Question 37

Hox Genes What are they coded for?

Answer 37

Transcription factors >> **bind to regulatory regions on DNA**

Question 38

Lack in which molecule will lead to inhibition of glycolysis? in pt with Lactate dhydrogenase def.

Answer 38

NAD+

Question 39

Whats the diagnosis? 2 yr old boy >> urine turn black overnight

Answer 39

Alkaptonuria- AR Homogentinsic acid dioxygenase def in **tyrosine metabolism** ## Footnote **HOO is has DARK PEE** OHH for - Ochronosis

Question 40

in Alkaptonuria which sunstance is accumulate and leat to what reaction

Answer 40

Homogentisate accumulate >> oxidise if allow to sit = black- blue colour = ochronosis **also black pigmentation on the face and ochronotic arthropathy**

Question 41

# whats the diagnosis? 26yr old women, dry flaky skin since chilhood, worse in winter and improve in warm weather in spring ## Footnote and what cause this situation

Answer 41

**Ichthyosis vulgaris** **Filaggrin gene** Defective kertinocyte desquamation

Question 42

Which family is para-infulenze pathogen? which URI it can cause

Answer 42

CROUP (Barking cough)

Question 43

Which virus is resposible for aplastic crisis in sick cell anemia and hydrops fatalis?

Answer 43

Parvovirus

Question 44

Which complication can occur after Subarachnoid hemmorage?

Answer 44

**Atrial vasospasm**- delyed cerebral ischemia = new focal deficit can treat with CCB- Nimodipine

Question 45

what is epinephrine effect on adrnregic receptors? a1,b1,b2

Answer 45

beta1- increase HR + contractility, SBP beta 2- lower DBP (low dose) a1- increase DBP (high dose)

Question 46

What is the function of Neprulysin inhibitor (Sacubitril) in the setting of CHF?

Answer 46

Enhance of activity of **ANP and BNP** Diuresis + Vasodilation inhibit metalloproteases

Question 47

What the effect of ANP and BNP on the 1. kidneys 2. Adrenal gland 3. Blood vessels

Answer 47

1. kidneys- elevate GFR, Diuresis, renin inhibition 2. Adrenal gland- inhibit aldosterone 3. Blood vessels- vasodilation + permeability

Question 48

Defect in which biochimical way lead to magaloblestosis?

Answer 48

DNA synthsis , need Folate and B12

Question 49

Which medication increase E3 ubiquitin ligase in MM

Answer 49

Lenalidomide

Question 50

Out of the 4 clinical disfectants: 1. which are sporicidal 2. which cause disruption of cell membrane 3. which cuase halogenation of proteins & nucleic acids * Alcohols (isopropanol, etahnol) * Cholohexidine * Hydrogen peroxide * Iodine

Answer 50

1. which are sporicidal- **Hydrogen peroxice, Iodine** 2. which cause disruption of cell membrane- **Alcohols + Chlorhexidine** 3. which cuase halogenation of proteins & nucleic acids- **iodine**

Question 51

Which are the 4 common pathogens to cause Diarrhea in HIV

Answer 51

1. CMV 2. Cryptosporidium 3. Microsporidium 4. Mycobacterium avieum

Question 52

What is the perpose of protease inhibitor in HIV

Answer 52

block viral proteas from cleaving gag-pol polyproteins >> immature virions that are noninfectious

Question 53

What are the 3 main causes of Heat related illness in elderely?

Answer 53

1. tonic contraction of peripherial vasculate 2. Reduce sweat glands density 3. loss of rete pegs and dermal capilleris = less effective epidermal area for heat transfer

Question 54

Which medication exacerbate hypoglycemia and mask hypoglycemic symptoms mediated by epinephrine and NE?

Answer 54

Non-selective Beta blockers

Question 55

Which medication can be use to treat Hyperprolactenemia?

Answer 55

Dopamine agonist (Cabergoline, Bromocriptine)

Question 56

**Spinal stenosis ** whats make the pain worse and what relieve the pain?

Answer 56

Make it worse- walking upright + standing relieve pain- leaning on a stroller / shopping cart

Question 57

What is the most common cause if Spinal Stenosis

Answer 57

Degenerative arthritis (pt >60) Disc herniation, ligamentum flavun hyperthrophy, oeteophy formation affecting facet joints

Question 58

What the difference between physican burnout to fatigue?

Answer 58

burnout- emontional exhustuim Fatiuge- just being tired

Question 59

What is the mechanism used by Gonoccoc to avoid host defense?

Answer 59

**Antigenic variation** their pili (hair like protein polymerase projection) - go antigenic variation. means evert time he express only 1 type of pili genes, and through recombination they produe new types of pili

Question 60

Whats the most common cause of vertigo

Answer 60

Benign paroxysmal positional vertigo **most often due to Canalithiasis = presence of crystalline debris in semicircular canals **

Question 61

Whats the diagnosis? filling dizinnes, with brief sever spinning sansation when lookin up at objects, having Dix Hallpike meunver positive

Answer 61

BPPV Beingh paroxysmal positional vertigo ## Footnote Dix-hallpike menuver- vertigo and nystagmus when pt quickly lies back supine + head rotated 45 degrees

Question 62

Which trisomy is the most common resuly of nondisjuction due to advance maternal age?

Answer 62

Trisomy 18- Edwards Clenched hands, overlapping fingers Rocker bottem feats VSD Microganthia (small mandible)

Question 63

Patau syndrome- chromosome anomality? physical anomality

Answer 63

13 polydactyly midline facial defect- clef plip/plate. GI - omphalocele, umbilical hernia

Question 64

What will be the consquence of incomplete roation of the midgut? ## Footnote complete = 90 counter clockwise + 180 counterclockwise = 270 total

Answer 64

**midgut malrotation** Ladd band compress the extrinsic duodenal = interstiral obsturction

Question 65

What each letter showing

Answer 65

A- Endoplasmatic reticulum B- nucelouls C- nucleus D- mitochondria E- Exocrine granules

Question 66

Which vitamin deficiancy will vegan patient have?

Answer 66

Calcium Vitamin D Cobalamin (B12) | possible: iron , zinc

Question 67

defiecncy in which vitamin cause pallegra?

Answer 67

Niacin (B3) or trypthophan

Question 68

which bacterial associated with urethritis are aspetic on gram stain and how we diagnosed? | 3

Answer 68

**non gonococcal urethritis** Chlamydia trachomatis Mycoplasma genitalium Trichomonas Vaginalis **will ceack by PCR** | only N. gonorrhoeae will stan gram positive intracellular dipolococci

Question 69

What the treatment for Gonococcal urethritis?

Answer 69

N. gonorrhoeae Ceftriaxone

Question 70

Whats the treatment for non-gonococcal urethritis

Answer 70

קלמידיה טרוכומאטיס, מיקופלזמה גניטליום, טריכומונאס וגינלאס אזיתרומיצין / דוקסיציקלין

Question 71

What are the comlication of HELLP syndrome?

Answer 71

H- hemolysis, E-elevated liver enzymes L- low P- PLT severe pre-eclampsia comlication **risk for** seizures , DIC, renal insufficiency

Question 72

Which ligament contain the ovarian artery, vein and lymphatics, nerve

Answer 72

Suspensory ligament of the ovary Infundibulopelic ligament

Question 73

Which Toxicity IV acyclovir can cause and how we treat?

Answer 73

Nephrotoxocity- crystalization, crystalluria and renal tubuer demege. Tx: Adequate hydration

Question 74

Which Ulcerative STD are painful? | 2

Answer 74

* Chancroid- H.ducreyi (**You do cry with ducreyi**) * HSV

Question 75

which ulcerative STD's are not painful?

Answer 75

1. Granuloma inguinale (Donovanosis)- Klebsiella granulomatis 2. Shypilis- T.pallidum 3. Lymphogranuloma venerum- Chlamydia Trachomatis

Question 76

from which location a neonatal intraventricular hemmorhage usually originate?

Answer 76

**Germinal metrix** in infant before 32 wks gasteation or < 1500 gram

Question 77

what is the major virulance factor of GBS

Answer 77

**polysaccharide capsule with sialic acid** >> reduce effectivness of defense due to **molecular mimicry**

Question 78

a lesion in the Intercostal brahial nerve dring axillary disscection can cause _______________

Answer 78

**Sensory dysfucntion-** burning, aching, diminish sensation

Question 79

a lesion in theLong thoacic nerve dring axillary disscection can cause _______________

Answer 79

Serratus ant. - Sacpular winging, Weak arm abduction above horizontal level

Question 80

a lesion in the Thoracodorsal nerve dring axillary disscection can cause _______________

Answer 80

L.dorsi loss powerful adduction of arm + medially rotation

Question 81

What is the most common cause of primary hypothyroidisim

Answer 81

Thyorid dysgenesis | Treatment- Levothyroxine

Question 82

What are Hemosiderin

Answer 82

Iron-storage complex (ferritin michelles) brown or yellow brown pigments | liver -in kupffer cells ## Footnote Mainly in Pt with **Chronic hemolytic anemia (b-talasemmia)** needed blood transfution = **iron overload**

Question 83

Which medication will be given in Hypertensive emergency? and what the effect on HR, SVR, vessels?

Answer 83

**Labetalol** non selective a1,b1,b2 inhibitor Deacrease HR Decrease SVR Peripherial Vasodilation SV not change

Question 84

Which enzyme is decrease in CML

Answer 84

Leukocyte (neutrophil) alkaline phosphatase

Question 85

How CML confirmed

Answer 85

**Philadelphia chromosome** Tranlocation 9 >>22 >> BCR-ABL1

Question 86

How to diagnose Naegleria fowleri

Answer 86

Motile trophozoites on CSF wet mount

Question 87

Which are the amniotic fluid markers of maturity? | 3

Answer 87

Phosphatydylcholine (lechitin) + phosphotydylglecerol- increase Sphingomeylin- stay low

Question 88

What is the defect in Xeroderma pigmentosum

Answer 88

**Neucleotide excision repair ** UV specific endonuclease | Thyamine dimers

Question 89

What are the symptoms of Cholinergic stimulation | SLUDGE BAM

Answer 89

SLUDGE BAM: S-salviation L-lacrimination U- urination D- defecation G-GI distress E- emesis B-Bradycardia A-Abdominal cramps M-miosis

Question 90

Anion Gap Metabolic acidosis DDx | MUDPILES

Answer 90

MUDPILES: Methanol Uremia DKA Phenpormin, paraldhyde Iron Lactic acidosis Ethylene glycol Salicylates

Question 91

Which medication can be given to reactivate AchE after organophosphate poisning

Answer 91

**Pralidoxime**

Question 92

What prevent class Xa anticoagulents

Answer 92

Prothrombin >> thrombin (IIa)

Question 93

Alendronate Which family medication is it?

Answer 93

Bi-phosphonate disrupt osteoclasts

Question 94

Which medication decrease para-thyroid hormone realse due to secondary hyper-para in pt on dialysis

Answer 94

Calcicalect = calcimimetic - decrease PTH release

Question 95

Which luekotrient stimulate neutrophils migration

Answer 95

Leukotriant B4

Question 96

Which triad define PNH? in what gene the mutation and what it ceause

Answer 96

1. hemolytic anemia 2. Hypercoagulability 3. pancytopenia PIGA GENE- def. in CD55 + CD59 comlement inhibitor protien

Question 97

Anemia. when we will see hypersygmented neutrophils?

Answer 97

Folic acid Def. Clue- Alcohol use

Question 98

Koplik spots and maculopapular rash that strat on the face and spread down is a common finding in ______________

Answer 98

Measles virus (Rubeola)

Question 99

Which artery can be damage by femoral neck fracture and which complication in can cause

Answer 99

Medial circumflex Femoral artery Neck N close to M = medial | Femoral neck and head necrosis

Question 100

H.pylori is asocciated with which type of lymphoma?

Answer 100

Gastric MALT lymphoma

Question 101

Which artery can send emboli ceausing TIA

Answer 101

Internal carotid artery

Question 102

Why due mallory weiss syndrome occur

Answer 102

Increase intraluminal gastric pressure due to retching, bomiting or other abdominal straining | treas in esopagogastric- suqmicolumnar junciton

Question 103

Which RNA polymerase function exclusively in the necleolus? and what he transcribe?

Answer 103

RNA polymerase I 45S pre-rRNA gene >> encode for rRNA 18S, 5.8S. 28S rRNA | all the 8

Question 104

Canagliflozin is a medication of the family ____________ which cause glucose ________ in the ____________(PCT/DC/LPH) and ________ diuresis

Answer 104

Canagliflozin is a medication of the family **SGLT-2** which cause glucose **reabsorption** in the (**PCT**/DC/LPH) and **osmotic** diuresis | CGLZ- like SGLT2 ## Footnote Na- glucose channels

Question 105

Which pathogen causes meningoencephalitis in pt with AIDS <100 CD4, that stain in INDA ink

Answer 105

Cryptococcus neoformans budding- yeast with polysaccharide capsule

Question 106

What is the cause for non pitting edema? in which congenital symotms this is common?

Answer 106

Lymphatic outflow obstruction Turner syndrome

Question 107

What is the purpose of phase I trail?

Answer 107

Test new treatment on humens- small and healty population - adverse effect + Max tolerance dose

Question 108

What is the purpose of phase II trail?

Answer 108

Treatment effecay- subject with the disease.

Question 109

What is the purpose of phase III trail?

Answer 109

asses the safety and effectiveness of new treatment compared to std. involve 2 groups of affected subjects

Question 110

what is the purpose of phase IV trail

Answer 110

adverse affect over time after approval and is on the marker.

Question 111

What is the mechanism of action of Celecoxib?

Answer 111

**Selective COX 2 inhibitor** >> decrease inflammation | Cox b = b its 2. cox2 ## Footnote not ingibiton Cox 1 = prevent Gatromocusal injury

Question 112

How do HBV immunizaiton prevent infection ? | against which part HBV we are immunizied

Answer 112

Recombinant **HBsAg** >> HBsAb >> binding to the **envelope** of circulating viral particles and **inhibitnig viral entry** Vaccinated HBV = **only anti-HBs (Ab) positive**

Question 113

What the HBV viral load level and which serology marker is positive in **chronic infection**

Answer 113

DNA viral load < 2000 + HBsAg + Anti-HBc - IgG+ | active / carrier

Question 114

how to indentified HBV acute infeciton serology

Answer 114

**anti-HbC IgG or IgM** ## Footnote IgM + HBsAg = acute IgG + HBsAg = chronic

Question 115

Which serology is positive in the **window period** of HBV infection

Answer 115

HBeAg + anti-HBc IgM

Question 116

HBV how to differenate Vaccinated vs recover?

Answer 116

**HBcAb** HBsAb + HBcAb = recover

Question 117

How we treat unvaccinated pt to HBV after exposure?

Answer 117

HBV vaccine + IVIG | for vaccinated = nothing. just follow up

Question 118

Whats the treatment for chronic HBV | which medication are C/I in pregnancy? and MDD

Answer 118

Entecavir + Tenofovir or peygylated INF-alpha Entecavir + tenofovie - CI in pregnent womens INF- alpha- CI for MDD

Question 119

How to differente between HCV active / recover? | serology

Answer 119

active- HCV RNA + anti-HCV Ab Recover- Anti HCV ab , no positive RNA

Question 120

Which mefication will be given to HCV infection and what sould we check first

Answer 120

Sofobavir + Simeprevir check HBV before treatment

Question 121

What is the purpose of Case- control studies

Answer 121

Compare risk factor exposure between cases and protocol (disease vs non disease)

Question 122

What is the puprose of prospective cohort

Answer 122

Compare disease indicene based on having / not having risk factor

Question 123

What is crossover study?

Answer 123

Randomly subjects having a sequence of 2 or more treatment . the pt themslefs are their own controls. washout phase- prevent prior treatment influence

Question 124

What is the presentation of Median nerve injury

Answer 124

Ape hand Motor: weaken thumb flexation and oppositions Sensory: 3 digit numbness on the palm side | cross between flexod digitorum superficials + profundus

Question 125

What is Meckels Diverticulum

Answer 125

anatomic connection between ileum and umbilics = incomplete obliteration of vitelline duct true devirticulum= consist all 3 layers of interstitial wall (mucose , Sub + muscularis) | can present with hematochezia + abdominal pain

Question 126

For each verices which portal circulation is open Esophageal varices Antrorecal varices Capud medusae

Answer 126

* Esophageal varices- Left gastric vein * Antrorecal varices- Sup. rectal vein * Capud medusae- Paraumbilical veins

Question 127

How to calculate Helf life? which parameters?

Answer 127

Vd + 0.7 /CL

Question 128

how to claculate loading dose?

Answer 128

Vd * Css Css= steady state plasma concentraion | affected by body weight + compistion

Question 129

How to calculate maintance dose?

Answer 129

Css XCL X dosing interval

Question 130

In which diseases we will see nasal polyps? | 3

Answer 130

* Granulamatosis with polyangitis (Wegener) * CF * Asthema

Question 131

In wihch disease we will see lend dislocation?

Answer 131

1. DM 2. Marfan >> upward 3. Homocysteine (marfan + pigur) >> downeard 4. Alport (type IV collagen) ## Footnote הומואים מסתכלים למטה

Question 132

Why HCV can survive and not resolve in the body clue- a reason why theres not effective cacination

Answer 132

**Genetic variation**

Question 133

what is the most common Cardiac neoplasm

Answer 133

Myxoma- most common LA

Question 134

Which mdecation is used to treat hyperthyroidism?

Answer 134

Thiomide drugs (methimazole + propylthiouricul inhibit thyroid peroxidase >> no iodine organofication + couplint to iodtyrosinses

Question 135

Which mutation seen in marfan syndrome?

Answer 135

FBN1 >> fibrillin1

Question 136

Chromosomal deposition of Klineflter synd

Answer 136

47 XXY

Question 137

Which anatomy development fail in **Cleft lip**

Answer 137

Fail to fusion of maxillary prominance and intermaxiilary segment

Question 138

Which protien is a marker for Epithelial cell carcinomas

Answer 138

Cytokeratin

Question 139

HER 2 rceptor is a family member of:

Answer 139

EGFR receptors intrinsic TK activity

Question 140

What is isotype switching

Answer 140

in espone to antigen >> swtiching of AB b cell produce

Question 141

Which AA is converted during Acidosis

Answer 141

Glutamine >> glutamte to generate amnioum and HCO3-

Question 142

What is the treatment for expose to rabies?

Answer 142

prophylactic vaccine- rabies immuniglobulin and vaccine vaccine- verious rabdovirus strains grown in tissue cell culture and inactivate **after onset of symptoms not effective**

Question 143

CF mutation location,. type of receptos

Answer 143

F508 (AR) **ATP gated chloride channel**

Question 144

What are the 2 main function of vWF?

Answer 144

1. PLT adhesion- PLT glycoprotein with expose collagen 2. Carrier protein for factor VIII

Question 145

Which anatomical place is frquently associated with Pelvic fracture

Answer 145

**Bulbomembranous junction** underneath the prostate

Question 146

What is the immune mechanism of sarcoidosis?

Answer 146

APC secrete IL12 >> Th1 >>IL-2 + INF-gamma >>Th1 prolifarion (IL-2) + activate macrophages (INF-y) >> granuloma formation

Question 147

What is the mehcanism of action of ARBS

Answer 147

Angiotensin II receptor blocker (type I)

Question 148

Communication hydrocheplaus is a common complication of _----------------_______ thet reasult in ___________

Answer 148

Sub arachnoid bleeding Reault in- impair absorbation of CSF by the arachnoid

Question 149

Which defeciency can Valporate form

Answer 149

Folate >> Neural tue defects

Question 150

Which cells in the skin have Tennis racquet shape (Birbeck granules) and interact with T lymphocytes | צורה של מחבט טניס

Answer 150

Langerhans cells

Question 151

Which Amino acid and where its accumulate in Hyperammonion state?

Answer 151

amonium >> glutamine in astrocytes less glutamine avalibale to turn to glutamate = impain exitatory neurotrasnmittion

Question 152

Who am I? What is the Stain?

Answer 152

Cryptococcus neoformans (yeast), AIDS high risk India in staining

Question 153

What are the stages of Base excision repair?

Answer 153

1. glycosylase- cleave alter base 2. Endonucleas- cleave 5' end 3. Lyase cleave the 3' sugar 4. DNA polymerase- Fills the gap 5. Ligase- Seals the nick

Question 154

**Familiel Retinoblastoma** Which tumors are most common?

Answer 154

Osteosarcomas "2 hit hypothsis"

Question 155

Which proteins are mostly affected in HCM

Answer 155

AD Cardiac myosin binding protein C Cardiac Beta-myosin heavy chain

Question 156

Which situation is characterized by acute and painless monocular vision loss + Cherry red macula + pale retina

Answer 156

**Central retinal artery occlusion**

Question 157

What is the virulence factor of thypodial Slamonella?

Answer 157

Vi capsular antigen- Inhibtir neutrophil pagocytosis and recruitment= intracellular replication without a problem

Question 158

What is a common Adverse affect of **nondihydroprydine** CCB (Dilitiazem, verapamil) compare to dhidroproydine (amliodipine)

Answer 158

**nondihydroprydine** AV block constipation bradycardia **dihydroprydine** Lightheadness flushing peripheral edema

Question 159

silicosis increase risk for TB due to

Answer 159

Imparied macrophage function

Question 160

Which muscle is innervated by the Thoracodorsal nerve?

Answer 160

Lattisumus dorsi Extension, Adduction , internal rotaion of humerus

Question 161

what are the major risk in Theophylline intoxication ?

Answer 161

Seizures Tacchyarrhytmia (no prolong QT)

Question 162

How to calculate NNH (number needed to harm)

Answer 162

1/ ARI ARI= risk of Adverse effect in treatment - risk AE in control

Question 163

How to defferiante Staph from Strep

Answer 163

**Staph are catalase positive**

Question 164

What are common adverse affect of Biphosphonate? and which other 2 (boney) situation are related to this medication

Answer 164

Medication induce esophagitis other 2 : Osteonecrosis of Jaw A-typical femoral fractureres

Question 165

Which bacteria have IgA proteses and what its function?

Answer 165

N.gonorhoeae N.meningitidis Strep.pneumo Hemophilus Function- Cleavage of hinge region >> facilitate bacterial adherence to mucose

Question 166

MG pt are senstive and resistance to which types of medication?

Answer 166

sensetive- Nondepolarizing agents (vecuronum, rocuronium) Resistance- depolarizing agents (Succunylcholine)

Question 167

Which medication is given to castreation-resistant prostate cancer

Answer 167

Abriaterone (17-a-hydroxylase inhibitor)

Question 168

Why some type of Influenze virus cannot infect humens?

Answer 168

encoded for Hemagglutinin (surface glycoprotein) that cannot bind humen cells (e.g silialyc acid)

Question 169

How does Megaloblastic changes (def. in folate or B12) will affect neutrophuls? | for exp. alcohol use disorder

Answer 169

Hypersegmented | also macrocytic RBC- prone to hymolysis

Question 170

Presentation of Acoustic nuromas (like Schwannoma) | 2 feature

Answer 170

Unilateral Sensorinural loss + tinnitus | CN VIII

Question 171

Which congenital disease present with Bi-lateral acoustic nuromas?

Answer 171

NF-2

Question 172

Which Glycogen storage disese couse poor exrcise tolerance which improve by consuming simple sugars

Answer 172

McArdle Disease (type V) def. in myophosporylase (first step of breaking glycogen) | present only in the muscle

Question 173

Which disease is characterzied by unilateral eczematous rash in the nipple and areola? and what biopsy will show

Answer 173

Paget disease biopsy will show - malignant adenocarcinoma

Question 174

What the pathophysiology of direct and indirect inguinal hernia

Answer 174

direct- (older men) weakness of transversalis fascia indirect- (male infant) patent processus vaginalis | both above inguinal ligament

Question 175

Loud S1 can present with

Answer 175

Mitral stenosis | leaf stiffness- mild disease

Question 176

Why in PE theres increase in deade space?

Answer 176

less oxygen that being inhalted is participating in gas exchange to tue emboli obstruction

Question 177

Which 2 enzymes incativate 6-mercptopurine (azathiopurine)

Answer 177

Xhanthine oxdidase Thiopurine methyltransferase (TPMT) | transplant rejection, automuumune, leukemia

Question 178

# Gallstone iliues why it causes whats a common finding

Answer 178

1. cause by a lrage gallstones erode into the interstital lumen common finding- **pneumobilia-** air in the biliary tract

Question 179

Which proteins accumulate in FTD

Answer 179

Abnormal phosphorylated Tau proteins (also in Alz demetia) + Abnormal TDP-43 prtien inclusion (also found in ALS)

Question 180

Vessel landmark for inguinal hernia

Answer 180

Inf. epigastric vessel

Question 181

Where the inf. epigastric vein will be in: Direct hernia Indiruct hernia

Answer 181

direct- medial Indirect- Laterl MD in IL (md in israrl)

Question 182

The disease Cystinuria. What is the cause which protiens will be effected and what will be the consequence | COAL menminic

Answer 182

Cystinuria- AR, defective transportion of Cys, Arg, Ornithine, lysine **COAL** across interstial and renal tubul epithlium **Only reccurent nephrolithiasis** Cystiene Hexogonal cristals in urinalysis

Question 183

Which urinary stones are they? What will be the PH

Answer 183

Manesium -ammonium phosphate (struvite / triple phosphate) PH > 7

Question 184

which medication can lower cysteine level (cystenuria)

Answer 184

Pencilmine- cyst cathelator

Question 185

Which 2 etilogies are related to polyhydramnions

Answer 185

Impair swallowing- GI obstruction and anenchaply >> increase urination

Question 186

What is the pathophysiology of Wilson disease

Answer 186

defective copper transport protein (ATP7B) >> impaired bliary xcretion of copper >> accumulation in Heptocytes >> deposition in External tissues

Question 187

Which kind of diseases are seen in the present of **Blotchy red muscle fibers in gomori trhicome stain**

Answer 187

Mitochondrial myopathies | MERRF (myoclonic epilepsy with ragged red fibers ## Footnote other mitcohondrial diaseae: Leber optic, MELAS = mitochondiral encepalopathy with stroke like epsodes and lactic acidosis.

Question 188

Which CD surface is found on macrophage epithloid cell surface

Answer 188

CD14

Question 189

What is the cretiria of MDD | SIGECAPS

Answer 189

S- skepp disturbance I- interest G- guilt/ worthless E- energy (loss) C- concentration diff. A- anhedonia P- psyomotor agition S-suicid (tought / plan) | more then 2 weeks

Question 190

Which toxidrome can cause Cyclosporine + consuming Grapefruit jucie

Answer 190

Calcineurin inhibitor nephrotoxicity Inhibiton of CYP3A in the gut by grapefruit >> elevated levels of Cyclosporine >> nephrotoxicity

Question 191

In which nuecleus is located Seratonin relasinh hormones

Answer 191

Raphe neuclei

Question 192

Which factors Hib need for growth?

Answer 192

X factor- hematin V factor - NAD+

Question 193

In which type of agar Hib can grow toghther with Staph.aeurs and why?

Answer 193

Sheep agar: Staph aureus secrete V factor (NAD+) and X factor (hematin) needed for Hib growth | sheep agar is not rich in V and X factor + have incativate V factor

Question 194

What is the Tx for essintial tremor

Answer 194

non specific b-adrenergic antagonist : **propanolol**

Question 195

What are the reasons for seeing Burr cells ? ## Footnote 4

Answer 195

* Uremia * Pyruvate kinase def. * Microangiopatic hymolytic uremia * mechanical demege

Question 196

Why Budesonide had less sys adverse affect then otherglucocorticoids?

Answer 196

High first pass metabolism = active in the GI and less in the systemic circulaiton. (reduce degradation by the liver) **good for IBD**

Question 197

Which syndrome is the most associated with WILM tumors?

Answer 197

**WAGR syndrome** W- Wilms tumors A- aniridia (abscence of iris) G-gentourinary anomalis R- range of development delay

Question 198

Which type of medications are inhibiting NF-kB?

Answer 198

Glucocorticoids | inhibit transcription factors in the nucelus

Question 199

Which shunt can be seen before closing of the Ductus arteriosus

Answer 199

Left to right (also in patent ductus arteriosus) in the embroyonal life: right to left

Question 200

Which Congenital heart diasease are Left to Right shunt | CVAP

Answer 200

the Acyanotic rull of thumb: Acyanotic = L to R Cyanotic = R to L **Acyanotic ** CVAP: common AV canal VSD ASD Patent ductus arteriosus

Question 201

Which congenital Heart diase are L to R shunt | 5 T's

Answer 201

**cyanotic HD** 1. TGA 2. TOF 3. Truncus arteriosus 4. Tricuspid valve abnormality 5. Total animalous pulmonary venous connection

Question 202

whats the main different between PKU and BH deficiency

Answer 202

PKU - only effect the phenylalanine hydroxylase (from Phe >> Tyr) BH4- def. in Dhdropteriding reductase = PKU + affect on melanin . catcholamine (via low L-dopa) and also Seratonin All the pathways need BH4. treatment is restricted diet + BH4 supplements

Question 203

What is the MOA of Listeria monocytogenes

Answer 203

Listeriolysin O enzyme >> create pores in phagosomes >> bacteria escape lysosomal destruction Actin based transcellular spread (without returinig to the ECM)

Question 204

What is the most common cause of bloody nipple discharge without mass / skin changes

Answer 204

**Intraductal papilloma=** myoepithliel lining fibrovascular core

Question 205

Which uterine exposure is chracterized by this symptoms: Facial dysmorphism- short palpebral fissure, this upper lip. smooth philtrum Growth-retardation Neurological abnormalities Behavioral difficulties

Answer 205

Fetal alchol syndrome

Question 206

What is the hormonal balance in Klinefleter syndrome XXY47

Answer 206

low testosterone high LH & FSH high Estradiol

Question 207

What are the 5 main causes of Avascular necrosis and which site is the common

Answer 207

**Thrombotic / Embolic occlusion Glucocorticoids ** also: Vascular inflammation Exessive alcohol use Traumatic fracture | Femoral head

Question 208

What is the cause of preec,ampsia?

Answer 208

increase anti-angiogenic factor relase decrease in VEFG

Question 209

What happens to Tau in AZD disease

Answer 209

Tau is hyerphosphorylated >> disconnect from microtubule >> instability and breakdown of microtubules >> intracellular neurofibrillary tangles

Question 210

Which pathogen is a common one in dorms and where people live toghter thet cause -Pharyngoconjuctival fever with acute onset fever, cough, congestion, pharyngitis and conjuctivitis

Answer 210

Adenovirus

Question 211

Whatare cholesteatomas and where they are form

Answer 211

Squemous cell debris >> form pearly mass behind tympanic membrane >> can cause conductive hearing loss

Question 212

Which enzyme of galactose metabolism present with isolated presence of cataracts?

Answer 212

Galactokinase deficency Cataracts: due to galacticol accumulation

Question 213

Which enzyme in galactose metabolism present with hepatic and renal dysfunction, FTT, vomiting and latreghy

Answer 213

GALT- galactose 1 phosphate uridyl transferase due to acculmulation of Galactose 1 phosphate = toxic metabolite

Question 214

How to calculate Absolute risk reduction?

Answer 214

ARR= Event rate in control - ER in treatment

Question 215

How to calculate the Event rate?

Answer 215

ER = num of event in the treatment group / total num of subject in the treatment arm

Question 216

what is the MOA of PCSK9 | Evolocumab, alirocumab

Answer 216

decrease LDL receptor degradation >> greater uptake by the liver

Question 217

What is the pathophysologic of Chronic granulomatous disease (CGD) and how is being diagnose

Answer 217

Defective in NADPH oxidase diagnosis: Dihydrodamine testing- measure PMN respiratoy bursh. if theres no increase in flurosence green > pt have CGD | Phagocyte metabolism disorder

Question 218

What is the treatment for Hepatic enecephalopathy

Answer 218

Lactulose- increase conversion of ammonia to ammonium Rifaximin- Decrease intraluminal (intestinal) amonia production

Question 219

Which medication can help to relieve alkalemia in altitude sickness

Answer 219

Acetazolamide (cabonic anhydrase inhibitor) = more loss of HCO3-

Question 220

Which embryonological pouches are maldevelop in Di-gorege syndrome?

Answer 220

3+4 paryngeal / brachial pouches

Question 221

What is the pathogenesis of Gillian barre syndrome

Answer 221

Molecular mimicry >> T ceels agains shwann cells >> segmental demyalination + endonneurial inflammatory inflitrate

Question 222

What id the def. in Duchenne?

Answer 222

Frame shift mutation of **Dystrophin gene** | X linked = affect boys

Question 223

Werding Hofman Syndrome which gene is dagmage , what is the consequence

Answer 223

SMA type 1 Gene- mutaton at SMN1 childhood degenartion of ant. horn = symmetric progressive weakness

Question 224

Which type of insulin is given as a treatment of DKA

Answer 224

Regular insulin work within mintues. also the treatment for when realsing home after DKA- just subcutanoeus and not IV (peaks in 2-4 hours)

Question 225

What blood gas paramter should be change in order to low ICP

Answer 225

lowering Pa**CO2** >> vasoconstirction >> reduction in cerebral blood volume >> decrease ICP

Question 226

What is the traid of Wiskott Aldrich syndrome

Answer 226

1. Eczema 2. Easy bleeding (thrombocytopenia) 3. Reccurent infections (pyogenic- Hib, N.meningitis, Strep.pneumo) **Combined B and T deficiency** WAITER: Wiskoot Aldrich I-imunnodeficieny T-thrombocytopenia E-eczema R- reccurent infections ## Footnote WAS gene mutation

Question 227

Chediak higasi syndrome gene and presentation

Answer 227

LYST gene = **LYS**osomal **T**rafficking defect (fusion defect) **CHEDIAK menmonic** C-CNS/ neurological defect HE- hemorrhage Di- decrease immunity A- albinism (silver grey hair, oculocutneous ) K- coarse granules (peripheral Blood Smear)

Question 228

What is the treatment options for Lyme disease

Answer 228

Doxycycline , Ceftriaxone

Question 229

Which pathway is activated in Chronic hyperglycemia that leads to cataract

Answer 229

polyol pathway Glucose >> sorbitol via aldose reductase High sorbitol levels >> accumulate in different tissues >> influx of water and osmotic cellular injury >> cataract along with: neuropathy, retinopathy, nephropathy

Question 230

Which diasease are positive for Anti-Jo1 (Anti-tRNA synthetase)

Answer 230

Poly and dermatomyositis

Question 231

what is the MOA of Shiga toxin produce by EHEC and S.dysenteriae

Answer 231

AB cytotoxin >> attack 60S ribosomal unit >> inhibit protein synthesis >> intestinal mucosal Cell death | if there hematognous spread >> HUS

Question 232

Which condition cause Fever, prurituc rash, pain, joints with PMN 7-10 daysafter reciving a foreign protein

Answer 232

**Serum sickness HSR III**

Question 233

What is the pathophys of serm sickness

Answer 233

foreign proteins >> present on APC MHC II >> CD4 bind and activate >> stimulate B cells to form high affinity IgG >>IgG bind and generating immune complex **High quantities of Immune complexes >> activate classical complement >> high C5a,C3a** C3a , C5a Anaphyltoxins: Increase vascular permeability, chemotaxis, mast cell granulation

Question 234

Which Gene in Bacteria encoded for Penicillin binding protein 2a (PBP)

Answer 234

MecA gene

Question 235

Where does Rota virus work (damage site)

Answer 235

Doudonum and proximal jejunum invase villous epithelium >> **villus blunting , prolifration of secretory crypt cells, loss of brush border enzymes** Watery diarreah without fecal luekocytes

Question 236

What will be shown in Polyarthritis nodusa in histology?

Answer 236

segmental , trans mural arterial inflammation with fibrinoid necrosis. often associated with HBV and HCV

Question 237

What is the first line treatment of Trigiminal neuralgia and what is the MOA?

Answer 237

Carbamazepine by inhibition of nueronal high frequency firing by blocking Na channels | can cause BM suppression >> CBC should moniter periodically

Question 238

Which disease can GAS cause

Answer 238

phyringitis Scarlet fever Impetigo Necrotizing fascitis

Question 239

Waht is scarlet fever triad

Answer 239

streaverry tounge rash except the face (sandpaper like) pharyngitis | can present also with "slapped cheeks"

Question 240

Which brachial plexus root is most suspectabl for injury in Cervical spondylosis

Answer 240

C7 root

Question 241

What is the MOA of monoclonal Ab against cancer cell surface?

Answer 241

Fc portion identified by NK cells via CD16 >> Ab-dependent cellular cytotoxicity >> realse granzyms and perforin

Question 242

What is the pathogenesis of Occult or close NTD?

Answer 242

Failure of Vertebral arch fusion (low liying conus medullaris, thickened filum termineale)

Question 243

What is the pattern of inheritance of HLA match? | And what are the chances for 2 brotehs to have the exact match?

Answer 243

one HLA heplotype from dad and one from mom the chance of 2 brothers from same perent to have excat match is 25%

Question 244

What is a Lead time bias?

Answer 244

Diagnosis of a condition earlier then conventional studies. | increase in survival time depite no improvment in mortality rate

Question 245

Leiomyomas VS adenomyosis uterus size and shape menustral bleeding

Answer 245

Leiomyomas: Uterus non tender + irregulary shape. Adenomyosis (endometirum glands in uterie myometrium): Uniformly enlarge uterus both can cause regular heavy menses

Question 246

In Adrenal crisis which medicaiton should be given first

Answer 246

Glucocorticoids (also fluid resuscitation)

Question 247

Which pathogen must survive the acidic stomach before reaching the intestine

Answer 247

Vibrio cholera

Question 248

PT undere use of PPI are in greater risk for Gatroentritis by --------

Answer 248

V. cholrea

Question 249

What is the meaning of S3 sound and when it heard?

Answer 249

over 40 yrs: Eccentric hyperthropy of LV Diastole-in passive ventricular filling **Best- ** cardiac apex when pt is in lateral postion *also in High CO states: pregnency and thyrotoxicisis *also MR,AR,Dilated Cardiomyopathy

Question 250

What is the meaning of S4 sound and when it heard?

Answer 250

Late diastole (atricl systole) due to bloods strikes a stiff LV Concentric Hyperthropy Prolong HTN, severe AS

Question 251

What are the light criteria for Exudative pleural effusion

Answer 251

pleural protein / serum protein > 0.5 or pleural LDH / serum LDH > 0.6 or Pleural LDH greather 2/3 upper limit of normal serum LDH

Question 252

Which nerve responsible for pleuritic chest pain in LL pneumonia?

Answer 252

Phernic nerve (c3-C5)

Question 253

Which mutations aoccur in the adenoma to carcinoma sequence (colon)

Answer 253

1. from normal to small polyp- APC tumor suppresor gene 2. increase size (uncontrolled cell prolifration)- KRAS 3. Malignant transformation- TP53

Question 254

What is Sevelamer

Answer 254

Nonabsorbale anion exhange resin >> bind intestinal Phosphate to reduce absorbtion In CKD due to Hyperphosphatemia | Secondary hyper-para due to CKD

Question 255

Which IL is elevated in Ankylosing spondylitis (HLA-b27)

Answer 255

IL-17 >> stimulate production of TNF-a and prtostaglnding: **Bony erosin + abnormal bone growth** | Bamboo spine

Question 256

What are the triad of Niacin def. (pellagra)

Answer 256

1. Dermatitis 2. Diarrhea 3. Dementia

Question 257

Niacin is a essintial component of the coenzymes ------ and ------- also, he can obtained trough dietary taking or synthezied endogenously from --------------

Answer 257

**NAD , NADP** **Tryptophan** Niacin is a essintial component of the coenzymes **NAD** and **NADP** also, he can obtained trough dietary taking or synthezied endogenously from**Tryptophan**

Question 258

What makes murmurs louder of softer

Answer 258

Inspiration = Right sided louder **RINspiration** Expiration >> Left sided louder **LEXpiration**

Question 259

# Murmurs louder of softer? Increase preload will cause murmurs to be -------- except ---------- (2 situations)

Answer 259

Increase preload will cause murmurs to be**Louder** except **HOCM, MVP** (2 situations) יותר דם מחזיר את המסתם המיטרלי ואת הספטום למקום- לכן הפוך

Question 261

# Murmurs louder of softer? Decrease preload will cause murmurs to be -------- except ---------- (2 situations)

Answer 261

Increase preload will cause murmurs to be**Softer** except **HOCM, MVP** (2 situations) Valsalva- מוריד את הSVR, ולכן פחות דם חוזר ללב

Question 262

What will be the affect on the Afterload in this 2 manuvers: 1. Hand grip 2. Amyl nitrite (medication)

Answer 262

1. Hand grip - Increase Afterload 2. Amylnitrite- Decrease afterload

Question 263

Increase Afterlode will cause ------- murmurs to be -------- except ---------- (2 situations)

Answer 263

Increase Afterlode will cause **louder regurgitation** murmurs except **MVP, HOCM (softer)**

Question 264

Systolic Cresendo-decresendo murmue is due to What is the clinical presentation

Answer 264

Aortic stenosis **SAD triad** Syncope Angina Dyspnea (extorcitnal) 1. old patient- **old and sad** 2. calcificed valve

Question 265

Holosystolic murmue is due to What is the clinical presentation

Answer 265

Mitral regurgitation **Rheu-mitral = Hx of Rheumatic fever** | Radiate to axilla

Question 266

Which murmur present with opening snap

Answer 266

MS Hx rheumatic fever **Operating System is MicroSoft = OS is MS**

Question 267

Which murmur present with mid -systolic click and which poulaiton we should think about it

Answer 267

Mitral valve prolapse **to win MVP , your team has to CLICK** think about young women with psychiatric Hx

Question 268

Which murmer have is a mid systolic with wide spletting fixed of S2

Answer 268

Atrial septal defect

Question 269

Which murmur is holosystolic at left sternal border

Answer 269

VSD

Question 270

Which substance inhibit the MAT (monoamine transporter? | 3

Answer 270

* Cocaine * SNRI * TCA

Question 271

Which drug can lead to mucosal atrophy >> nasal septal perforation

Answer 271

Cocaine

Question 272

What is the MOA of BZD

Answer 272

Increasing frequency of Clhoride channel opening in the presence of GABA GABA A receptors

Question 273

What is the sydndrome? Normal development until 6-18months >> loss of motor and language sklls >> stereotype hand movment and Decelartion of head growth

Answer 273

MECP2 gene **Rett Syndrome**

Question 274

Which artery can be octruct in Anorexia and why?

Answer 274

Extreme weight loss >> deplet mesenteric fat >> Compression of 3rd part doudonam by SMA **Sup mesentaric artery syndrome = small bowl obstruction**

Question 275

Young pt with HF sign + Viral prodrome. in what to suspect?

Answer 275

Dilated cardiomyopathy after Viral myocarditis

Question 276

What is the diagnosis? ipsilateral horner syndrome + upper limb pain paresthesia in a smoker

Answer 276

Pancost tumor

Question 277

What is the demege to the temporal artery in GCA

Answer 277

Intmial thicking , granulomatous inflammation of media, giant cell formation , elasticlamina fragmentaiton

Question 278

Which diseases are associated with Saccular (berry) aneurysms?

Answer 278

ADPKD Ehlers -Danlos HTN in circle of willis

Question 279

Which type of cell jucntions play a critical role in labor contraction

Answer 279

GAP junctions (from connecxi43) upregulate by estrogens

Question 280

Which pritens are bulding the tight junctions

Answer 280

Claudins , occludin

Question 281

Which proteins built the Desmosomes and Adherenes jucntion and Hemidesmosomes

Answer 281

Hemi- integrins Adherent junction + Desmosomes= Cadherins (Desmogleins + desmoplakin)

Question 282

Which enzyme Vitamin K helps and how to process called

Answer 282

**Gamma glutamul carboxylase** in **posttransitional carboxylation** help to coagulaiton factorsbind Ca in the blood >> effifect coagulaiton

Question 283

all the following effect are realated to a curtain group of anesthetics: incdrase cerebral clood flow >> can ceause ICP Myocardial depression, hypotension, respiratory depression, decrease renal function

Answer 283

Volatile (halothane, isoflurane, desflurane, sevoflurane)

Question 284

Which glands neutralized the gastric acid secretion

Answer 284

Brunner - Alkaline mucous

Question 285

What is the effect of Hemochromatosis on Joints?

Answer 285

Arthritis ( mainly 2-3 MCP joints) Chondrocalcinosis

Question 286

Which prophylacxis antibiotic is indiceted for HIV with CD <200 under 100 under 50

Answer 286

Trimethropin - Sulfamethaxazole P.neumocystic jirovecci under < 100: TMP-SMX (also) for toxoplasma <50 Azitromycin- Mycobacrterium avium complex

Question 287

Which CN move trough the Sup.orbital fissure

Answer 287

III, IV, VI < V1 opthalmic vein , sympathetic fibers

Question 288

In which skull foramen is each CN V branch is coming out V1 V2 V3

Answer 288

V3- sup.orbital fissure V2- foramin rotundum V3- foramen ovale

Question 289

The middle meaningeal artery and vein is going trough which foramen?

Answer 289

Foramen spinosum

Question 290

CN IX, X, XI and the jugular vein are going trough the ----------- foramen

Answer 290

Jugular foramen

Question 291

Actinic keratosis can form transformation into -------

Answer 291

SSC

Question 292

What we will give in Heparin overdose and Warfarin overdose

Answer 292

Heparin overdose- Protamine (bind heparin = inactivated complex) Warfarin- vitamin K + FFP

Question 293

Statin inhibit ________

Answer 293

HMG- CoA reductase

Question 294

Myotonic Dystrophy what is the gene, and what is the change in the gene

Answer 294

DMPK gene >> Expension of CTG trincleotide repeats | AD

Question 295

What is the Negetive predicted value (NPP) and what is the PPV

Answer 295

NPP- probability not having the disease when the test result is negetive (TN- total number of negetive test) PPV- probability of having the disease when the test is positive | They are vary with the prestest probaility of the disease ## Footnote High risk = low NPV, low risk = High NPV

Question 296

What are the histologi sign of Celiac disease

Answer 296

Crypt hyperplasia, Villous atrophy, Intraepithelial lympocyte infiltration

Question 297

Thoracic outlet syndrome What is the mechanism | and what is the presentation

Answer 297

Compression on the brachial plexus as it pass trough the scalene triangle (ant. + middle scelene + first rib) upper extrimity numbness + tingling and weakness (ulner distribuitaion) + worsen with repatitive overhead arm movments

Question 298

Which is a risk factor for Thoracic outlet syndrome

Answer 298

Extra cervical rib

Question 299

Sideroblastic anemia cuase?

Answer 299

Imparied heme production within RBC

Question 300

Which type of anemia Isonizied can cuase (mycobacteria treatment) which enzyme it inhibit?

Answer 300

Sideroblastic anemia iron granuls in mitochondria around the nucleus. inhibit pyridoxine phosphokinse >> convert **pyrodixne (b6)** into its active form **pyrodixime is cofactor of lambda-aminoevulinic acid (ALA) synthase** = rate limiting step in heme shytesis **microcytic anemia**

Question 301

Which eletrolyte is increase in absorption in CF

Answer 301

Na

Question 302

What is coronary artery L/R dominance mean?

Answer 302

R dominance (80% of Pt)- PDA is coming out of RCA L dominance (20%)- PDA is coming out of LCA (circumflex- branch of LCA)

Question 303

What does it mean coronary dominance?

Answer 303

From which main coronary artery the decending posterior artery (PDA) is branching from ( RCA vs LCA)

Question 304

Whats the diagnosis? Swimming pool exposure + pruritic papulopustular rash in public places or hotels swimming pool or hot tubs

Answer 304

P. aeruginosa - self limitied infection

Question 305

What is the main difference between dilirum and alcholoic hallucinations?

Answer 305

in aclcoholic hallucinations the orientation is **intact**

Question 306

When Delirium tremens happens?

Answer 306

after 48 hrs from onset of withdrwal

Question 307

Which toxidrome cause yawing?

Answer 307

**o**piods **OOOOOO's - כמו פיהוק**

Question 308

Toxidrome?? Violence/ aggression/ psychosis, analgesia (super humen strengh)

Answer 308

Phencyclidine (PCP)

Question 308

What te different between BZD to barbituates on the influence on Chloride ion channels

Answer 308

BZD- increase frequency of Cl chennel opening Barbiturates- Increase duration of Cl channel opening Ben wants it happen more often (frequency) but Barb wants it to last longer (duration)

Question 309

Phencyclidine what is the MOA? which association should be berry in mind?

Answer 309

NMDA receptor antagonist association: Rotary ("torsional") nystagmus =ניסטגמוס סיבובית (בצורה דיאגונלית) Phen-cyclidine = cycle like rotary nystagmus

Question 310

What is the MOA of MDMA (Ecsrasy)

Answer 310

Blocking Seratonin and dopamin receptor to uptake the neurotransmitors.

Question 311

What are associationg with MDMA (Ecstasy)?

Answer 311

They are like super- SSRI therefore: **Seratonin syndrome** SIADH - Hyponathremia, thirst >> seziures Bruxism - also in metaenphatamine **Hallucination persisting perception disorder-** re-expirence active effect of MDMA without taking MDMA

Question 312

Which association should think of Marijuana ?

Answer 312

* Paranoia * Psychosis * Cannabinoid hyperemesis syndrome- **in response to heat symptoms are make it better = take a hot shower**

Question 313

On which monoamines Cocaine and Meathamphetamine works and wat are the MOA of each one

Answer 313

1. Cocaine- Block reuptake of monoamine (5HT, NE, DA) 2. Metaamphtamine- Enhance realse of monoamines (all the 3)

Question 314

Which drugs are GABA modulators?

Answer 314

Barbs + BZD

Question 315

What is the MOA of LSD and what is a common buzz word for inhanlet LSD

Answer 315

5HT2a agonist (increase 5HT activity) common buzz word- Rush between upper lip and nose

Question 316

Which proteins are needed to in order to process antigens by MHC I

Answer 316

**TAP** Transporter associated with antigen processing

Question 317

What is the pathogen? Fever, chills, cough, shortness of breath. lobar pneumonia, immune response with Th1 cells, INF-gamma and IL-2

Answer 317

Legionella pneumonia inteacellular organism- cell-mediated immune response

Question 318

Which medication treat both Abscnce sezuris and both tonic clonic

Answer 318

Valporic acis

Question 319

Which Anti epileptic are good to treat of focal sezuries

Answer 319

Phynytoin Carbamazepine Gabapentine

Question 320

Which Anti epileptic are use to treat Generlized sezuris?

Answer 320

valporic acid Levetiracetam

Question 321

What is precision

Answer 321

reliability- ability to test to reproduce indentical or similar reasults in reapted mesurment

Question 322

What is accuracy? (Validity

Answer 322

ability of a test to measure what its suppose to measure. **need to be equivalent to results to the Gold standart test**

Question 323

What is the acute effect of corticosteriods on WBC

Answer 323

neutrophilia - due to demargination from previosly attech to vessels wall all the rest decrease: Lymphocye, monocyte, eosinophils, basophils | less neutrophil are recruit to fghit infections

Question 324

What are the adverse effectof COX1 inhibitor (Aspirin, NSADIS)

Answer 324

Gastric ulceration (reduce mocosal protection) Increse bleeding (lowPLT aggregation)

Question 325

Which drug is celecoxib

Answer 325

COX-2 inhibitor (selective) lower risk to peptic ulcers + bleeding

Question 326

Whatis the inital treatment of Status epilepticus?

Answer 326

Lorazepam and phenytoin

Question 327

Whiich Anti-sezurie medication block Na channels?

Answer 327

Pheyntoin + Carbamazepine (*also valporic acid)

Question 328

wihch pathogens can cuase acute exacerbation of COPD

Answer 328

Rhinovirus, Influenzea RSV Hemophilus, Moraxella catarrhalis, Strep pneumo

Question 329

Whuch pathogen resposible for Athlet's foot? and what is the treatment?

Answer 329

**Tinea pedis** Clotrimazole (azole end + Terbinafine) | Dermatophytes

Question 330

Which medication n is given to Cutaneous Larva migrans

Answer 330

Albendazole

Question 331

Whats the main difference between Chi-square to t-test?

Answer 331

Chi-square- Qualitative (categorical) t-test- quantitive

Question 332

What is the job of IL-10 realse by macrophage and regulatory T-cells

Answer 332

Anti-inflammatory

Question 333

Which area in the bone is most affected in osteomylaitis?

Answer 333

Metaphysis of ling bones | due to higly vascular region with slow flowing sinusoids

Question 334

Which Receptors Lactotroph cells express?

Answer 334

TRH receptors >> increase TRH production can lead to hyperprolactinemia

Question 335

Which nucelus is damage in PCA and what it would lead to

Answer 335

Thalamus Contra-lateral Hemisensory loss

Question 336

Which hormone responsible for the decelop of internal male genitalia and which for the external male genitalia

Answer 336

internal - Testosterone = Wolffian duct prolifration External = DHT

Question 337

Which hormone allow for the mullerian duct prolifate and wolldian duct regresion

Answer 337

Absence of AMH (SRY gene on Y chromosome) Absence of testosterone = wolffian duct regression = female external genitalia

Question 338

Which hear sound is associated with volume overload?

Answer 338

S3 (dilated cardiomyopathy, MR or AR, HFrEF)

Question 339

What is a synovial fluid WBC for Septic arthritis?

Answer 339

> 100K WBC

Question 340

What ios preventable adverse event

Answer 340

injury / delyaed diagnosis die to failure to follow evidence based best practice guidline for example: not diagnosting hypothroidism in a perspon with depression and fatiuge

Question 341

What is the MOA of PPI

Answer 341

Block H/K Atpase pump

Question 342

Omeprazole and Lansoprazole are a medication from the family of________

Answer 342

PPI

Question 343

What is the adverse affect of hCG secreting tumore on testis?

Answer 343

Suppresses testosterone production in **leydig cells** >> increasing aromatase activity = testosterone to estradiol >> more astrogens = gnycomastia

Question 344

Which GI complication is common in Scleroderma

Answer 344

**SIBO** Small interstinal bacterial over growth Alter intestinal motility due to smooth muscle fibrosis and atrophy

Question 345

In Enfective endocarditis. what is the effect of the kidney?

Answer 345

Glomerulonephritis due to circulating **immune complex (HSR III)** = AKI + hematuria with RBC casts

Question 346

Coarctation of the aorta present with ------- which is a risk factor for --------------

Answer 346

Secondary HTN >> Cerebral aneurysm

Question 347

Pt present with pruritus and signs of Vit A deficency should be evaluated to

Answer 347

Primary biliary cholangitis

Question 348

What is the psthophysiology of Subclavian steal syndrome

Answer 348

Severe stenosis of proximal subclavian >> reverse blood flow from CL vertebral to ipsilateral Vertebral artery >> Vertebrobasilar insufficency (dizzy, vertigo, drop attacks).

Question 349

What is the treatment for migranes and what is the MOA of the medication

Answer 349

Triptan (sumatriptan) 5- HT agonist >> inhibiton of vasoactive peptide ralise (Calcitoni gene related peptide and substance C **Stimulate trigeminovascular seratonin receptors** **for acute migrane**

Question 350

What is the reason for Cystic hygroma (foe example- post. neck mass)

Answer 350

Obstruciton of lymphatic system >> suspect Turner

Question 351

Synthetic EPO can incrase risk for

Answer 351

1. HTN 2. thromboembolic events

Question 352

Which part of the immune system Candida antigen test is assessing

Answer 352

**Cell mediate immune response**

Question 353

Which phase Call VI anti-arrytmic block

Answer 353

Phase 4, CCB for L-type = Slowing phase 4 depolarization

Question 354

What is the MOA of tetanospasmin (exotoxin)

Answer 354

Prevent release of inhibitory neurotransmitters = **Glycine and GABA** >> increase activition of motor nreves >> spasms, hyperreflexia

Question 355

Why Toxo is treated with Sulfadiazine and pyrimethamine?

Answer 355

Synergistic reduction of DNA synthesis (prevent formation of THF- a necessary co-factor for purine synthesis)

Question 356

Whats the diagnosis? Pt with sudden onset confusion , Memory loss, anterograde amnesia >> resolving in 2 hours? which area in the brain does bot function properly?

Answer 356

**Transient global amnesia** self limited , up to 24 hrs hippocampus dysfunction- responsible for creating new memmories

Question 357

Which pathogen can cause pneumonay after aspiration? | Tx

Answer 357

**Actinomycosis** have sulfur granules- look purple | Penicillin G

Question 358

Which medication reduce Uterine contractility + cause hypokalemia?

Answer 358

Beta-2 agonist in uterine - as tocolytics in other cells- B2 agonist activation >> stimulate Na/K atpase pumps, K interalization =hypokalemia

Question 359

Which diureticswork in A and B

Answer 359

A- Carbonic anhydraze (Acetazolamide) B- Osmotic diuretics (Mannitol)

Question 360

Which diuretics work on D

Answer 360

Loop diuretics - furosamide

Question 361

Which diuretics workon E

Answer 361

DCT- Thiazide (Hydrocholothiazide)

Question 362

Which diuretics work on F

Answer 362

Pottasium sparing diuretics * Aldosterone antagonist * Na chennel blokers (amiloride)

Question 363

How the endometrium in pregnency (also ectioc present)

Answer 363

Progesterone promote Decidualization >> Dilated coiled endometrial glands, Edematous stroma

Question 364

What is the 68-95-99.7 rule

Answer 364

Std: 1 Std- 68% of population (each side 34) 2 Std- 95% of population (each side 16) 3std- 99.7 of population

Question 365

Which medication help smoking cessation by reducing wthdrway symptoms and less reward affect of nicotine

Answer 365

Vareniciline= partial agonist of nicotine Ach receptor in CNS פחות מגרים את הרצפטור לניקוטין

Question 366

Which glycolysis enzyme is activating by insulin

Answer 366

PFK2 (result in activation pof PFK-1) conversion of F-6P >> F-1-6 BP

Question 367

Which enzyme catalyze the rate limitng step of glycolysis

Answer 367

PFK-1

Question 368

Whice and where Epinaphrine is made? which hormones upregulate and downregulate it?

Answer 368

In the adrenal meddula by PNMT (phenylethanolamine -N - Methyltransferase) Upregulate by Cortisol- elevate the expression of the enzyme Any case of low Cortisol (like Pituatry resection , low ACTH)= less Ep by the adrenal medulla (from NE)

Question 369

Chronic use of which medication can cuse Osteoporosis

Answer 369

Prednisone (steroid use)

Question 370

Calcification of the bladder increase the risk of-------------

Answer 370

Adenocarcinoma of the bladder

Question 371

What is Procelain bladder?

Answer 371

Menastification of chronic cholecystitis >> which cause thick gallbladder wall with calcifications

Question 372

How to calculate odd ratio?

Answer 372

a/c / b/d = OR

Question 373

Whats the treatment for scabias?

Answer 373

Topical permethrin >> block NT by imparing Voltage gated Na channels

Question 374

Who am I and what is the treatment

Answer 374

Sarcoptes Scabiei (Scabies) Tx: Topical Permethrin

Question 375

Whats the treatment for Impetigo?

Answer 375

Topical Mupirocin

Question 376

Which syndrome is with high FSH, LH , low testosterone and azoospermia, with high serum inhibin

Answer 376

Klifenlter syndrome 47XXY

Question 377

Which IL are produce by Th1 and TH17 in the mechanism of RA

Answer 377

TNF-alpha >> proliferation of inflammatory cells IL-1 >> synthesis of matrix metalloproteinases, which enhance T-cell immune repsone

Question 378

What is the common reason of Empyema?

Answer 378

bacterial translocation for the alveoli (progression of complex para-pneumonic effusion)

Question 379

What is the role if IL-12, and when theres a def. what sould we give?

Answer 379

Secrete by macrophages when presenting an antigen on MHC II >> differentiation of T0 to T1 >> produce IL-2, INF-y, lymphotoxin beta if thetes def in IL-12 >> inability to mount a strong cell mediategranulomatous response >> need to give INF-y (which will activate macrophages + CD8

Question 380

Which kind of infections pt with IL-12 def. are suspectel to

Answer 380

Myobacterina infections 12 letters in mycobacteria

Question 381

What is Restless leg syndrome: when it worse and when it ease what the proposed explantion in this syndrome whats the Tx

Answer 381

uncomfortable sensation in the legs + urge to move them sym. worst- with inactivity and nighttime improve- movement Explanation: CNS iron def. + abnormalities in Dopaminergic transmitting (dopamine antagonist = worst it) Tx: alpha-2-delta Ca channel ligands = Gabapentin + Pregabalin dopmine agonist - second line

Question 382

Which DiBacteria is transfer by Cat scracth or bite?

Answer 382

Batonella Henselae

Question 383

What is the mechanism of Radiation -induce injury?

Answer 383

inflammatoy response >> acute manifistation (3-12 wks) - exudiatve alveolitis >> Hylaine membrane formation (alveolar) delay phase (6-12 months) >> Pulmonary fibrosis

Question 384

Postpartum Hemmorahge can be manage by clippin which vein?

Answer 384

Internal iliac artery

Question 385

What is the Deficiecny in Chronic Granulamatous Disease

Answer 385

NADPH oxidase deficiency

Question 386

Which Fungal is brance in 90 dagree?

Answer 386

Rhizopus, Mucor, Absidia species causes Mucormycosis

Question 387

Which infection cause achalesia due to the distruction of Meissner and auerbach plexus?

Answer 387

Chagas diases- Trypanosoma cruzi

Question 388

What is Haldane effect?

Answer 388

Binding of O2 which cause to 1. unloading of CO2 from Hb 2. Protons arerealsed

Question 389

Which channels have problem in Long QT syndrome?

Answer 389

Voltage gated K channels

Question 390

What happens when PD-1 connect to PD-L1

Answer 390

active T cells becoming Exhausted T-cells

Question 391

What is the MOA of n. Meningitis? (the Pilli)

Answer 391

Attach to nasopharyngeal epithalial cells

Question 392

Which substance are given in Oral rehydration solution and what the job of each one

Answer 392

Glucose- trivial calories + enhance Na abosbation ( Na-glucose transporter - SGLT-1) NA- he goes and water goes after him K- replace diarrheal K loss Citrate- metbolized in liver to HCO3- >> elevate buffering capacity to helo correct acidosis

Question 393

What is the most importent factor in determing the prognosis of urothelial carcinoma?

Answer 393

Depth of invasion

Question 394

What is the difference between dery and wet beri beri

Answer 394

Dry- symmetric peripherial neuropathy (motor &sensory) Wet- cardiomyopathy and HF

Question 395

Thiamine is co-factor for which 3 enzymes:

Answer 395

Pyruvate dhydrogenase a-ketoglutarate (same co-factors as pyruvate) Transketolase *remember TP (beacuse a-keto is same as pyruvae DH). and TPP is the cofactor f thiamine (thiamine pyrophosphate)

Question 396

If gastric bypass is mentioned what should i suspect?

Answer 396

Vitamins Def. Thiamine, ADEK, B12, folic acid

Question 397

Which protein is resposible of antrograde movment alont the nueron exon

Answer 397

Kinesin- K arry out = antrograde Dyanin- Retrograde movment (Dine in = retrogarde) also the protein which allow HSV travel from sensory ganglia (dyanin and kinesin)

Question 398

What is the diff. between congenital deformation and malformation

Answer 398

deformation- change in shape and postion of a structure that decelop normally (club foot) malformation- defect in organogenesis (Aka spina bidis, hloproenchepaaly)

Question 399

What is a congenital association

Answer 399

multiple anomaly without knowing why they occur togethrer remember VACTERL: Vertebral defects, anal atresia, Cardiac defects, Trachoesophageal fitula, Renal anomalis, Limb abnormaliy

Question 400

Which part of GI tract is with high association to the Sup. mesenteric artery and vein

Answer 400

3rd part of duodunum - tumor in that area can press on the SMA

Question 401

Which co-factor is neede in the hydroxylation of Lysine and proline in collagen synthesis

Answer 401

Vitamin C in RER (rough endoplasmatic reticulum)

Question 402

Which gene is damage in PAH (pulmonary heraditary hypertension)

Answer 402

BMPR2 (AD) smooth muscle cell prolifration

Question 403

Which benign condition in early infancy can cuse a painless bloody-streaked stool

Answer 403

Food protein induce allergic proctocolitis (non IgE mediated)

Question 404

Lukocyte adhesion cascade: Which 2 molecules help PMN to adhede to blood vessel

Answer 404

1. Integrin 2. Sialylated glycoprotein

Question 405

Which molecules participate in the Rolling of PMN?

Answer 405

On endothelial cells: P-selectin E -selectin on PMN- Sialyated glycoprotein attachment

Question 406

In leukocyte adhesion cascade , what couse the activation of PMN?

Answer 406

Chemokines release + binding of selectins = conformation change to a high-affinity state of Integrins )on PMN)

Question 407

Which protein is responsible of adhesion and chemotaxis of neutrophils

Answer 407

CD18

Question 408

Which connections allow the tight adesion of PMN to endothel?

Answer 408

ICAM-1 on endothel CD18 beta 2 integrins (Mac-1, LFA-1) on PMN

Question 409

Which protein allow thw trasnmifration of PMN from the blood to the tissue?

Answer 409

PECAM-1

Question 410

Whuch medication can be give to Idiopathic pulmonary fibrosis?

Answer 410

TGF-beta inhibitor aka Pirfenidone =**P**ulmonary **F**ibrosis **DONE**

Question 411

Which molecule is provitamin D3 which change on UV light ?

Answer 411

7- Dehydrocholestraol

Question 412

What it the function of the Central Chemoreceptors vs Carotid Chemoreceptors? (what each one is sensing and what happend?)

Answer 412

Carotid and arotic bodies >> sensing PaO2 >> in high oxygen state >> reduce stimulation >> decrease RR Central chemoreceptors? Sense CO2 >> high CO2 >> decrease PH >> hyperventilation **not confuse with blood PH- which can't go trough the BBB, only the H ions in the CSF is senses**

Question 413

What is the mehanism of demege in Diffuse axonal injury?

Answer 413

tearing the white matter tracts during rapid accelraiton and / deceleration injury. multiple lesions in white matter tracts, axonal swelling in gery white matter junctions

Question 414

What s the underline mechanism of Neonatal respiratory distress syndrome?

Answer 414

indaquate surfactant production >> more tension and less compliance >> diffuse collapse (atelectasis) ---- CXR as ground glass opacites and air bronchogram

Question 415

What will be change in Aging and the kidney?

Answer 415

Reduce renal mass and functional glomeruli >> reduce GFR and Cr clearance Reduce renal blood flow Reduce hormonal responsivness

Question 416

What is the treatment forcryptoccocal meaningtitis?

Answer 416

Fluconazole

Question 417

Which hormone we want to low in PCOS ti induce fartility?

Answer 417

Estrogen levels by: Letrozole- aromatase inhibitor Chlomiphene citrate- bind astorgen receptors in the brain

Question 418

When I hear Peau dorange i think?

Answer 418

Inflammatory breast cancer yes its itchy yes its firm yes its with edema yes its obstuct the lymphatic drainage

Question 419

What it the porpuse of Rasburicase (TLS)

Answer 419

Convert uric acid to more soluble metabolite (recombenent verision of Urate oxidase)

Question 420

What happens to the Chest wall and the lung compliance in aging and how it effect RV, FVC and TLC

Answer 420

Chest wall- decrese compliance Lung - increase complience (due to loss of elastic recoil) RV- increase (air trapp) FVC- decrease TLV- unchange

Question 420

Which drugs are anti-urmiec agents?

Answer 420

Rasburicase >> urate oxidase version of the animal enzyme Allopurinol (competitive inhibitor) << unhibit Xanthine oxidase (purine catabolism) = less xhantine and uric acid Febuxostat (non selective xhantine oxidase inhibitor)- same as allopurinol, less adverse affect or interactions

Question 421

Where do Bile acid absorb? which disease damage this sight and can cause wasting of bile >> gallstones

Answer 421

Terminal ilium Chron's love terminal ilieum >> waste of bile acid >> suprasaturation of cholesterol in the bile >> gallstone formation

Question 422

Which medication is given to RA when MTX failed to treat disease?

Answer 422

Etanercept (TNF-alpha inbhibitor) fusion protein- connect the false receptor to FC component of humen IgG1 act as decoy (false) receptor that bind TNF-a like a sponge and prevent the TNF-a to bind his functional receptos

Question 423

What is the suffix of biological agents as follow? Receptor molecule suffix kinase inhibitor suffix

Answer 423

Receptor- Cetp Kinase- nib

Question 424

Which treatment can cause body fat distribution

Answer 424

Highly active Anti-retroviral therapy

Question 425

What are the 2 most common cause of HIV with multiple ring enhancing lesion

Answer 425

1. Toxo 2. Primary central neurvos system lymphoma >> B cell origin corrleation with EBV

Question 426

what is the flame looking part and what the reasons?

Answer 426

Fibrinoid necrosis who bleed into nerve fiber layers >> dots and flame shape hemmorage in HTN

Question 427

What is the result of a defficancy of INF-y signalin? and when its often happens?

Answer 427

Disseminated mycobacterial disease often after BCG vaccine (for TB)

Question 428

Methylmalonic acidosis Inheretance? pathway? Dx

Answer 428

AR Organic acidemia in newborns def of methmalonyl-CoA mutase Dx: Elected propionic acid, hypoglycemia and metabolic acidosis (ketone) hyperammonemia

Question 429

Which organs are prone to demege due to systemic hypotension

Answer 429

1. Hippocampus >> remember hipothens = hipocampus watershad zones: 2. Splenic flexure 3. Rectosigmoid junction 4. borders of the area supplied by the ACA, MCA PCA

Question 430

What is the MOA of MAO inhibitors?

Answer 430

inhibit MAO - mitocondrial enzyme that break down NT (dopamine, NE, sratonin)

Question 431

Why MOA-inhibitor can cuase HTN crisis?

Answer 431

beacuse Tyramine is sympatomimetic that is broken down by MOA in the intestne. and when its inhibited >> thyamine escape central ciruclation >> HTN crisis (when consuming thamyne rich food)

Question 432

What is the pathophyiologyof Hirschpaung?

Answer 432

NC cells fail to migrate to the bowl wall. no Submucosal (Meissner) and Myenteric (Aurbach) plexus = unable to relxax submocusal abscene og ganglionic cells -- seen in the narrowed segments of the bowl

Question 433

Which antiemetics are useful for Chemotherapy emesis?

Answer 433

Dopamine receptor antagonist 5-HT receptor antagonist second line: Neurokinin 1 receptor antagonist

Question 434

What is the treatment for Malignant hyperthermia and how do we treat it + what is the MOA

Answer 434

Genetic mutation in RYR1 receptor >> inalation anesthatics & succunylchole >>Malignant HT >> Tx with Dentrolene = ihibit Ca realse from the abnormal RyR1 (from sarcoplasmic reticulum)

Question 435

Which anti-coagulant is good for most pregnant women? What about pregnant women > 37 weeks?

Answer 435

Heparin >> LMWH = Enoxaparin in term change to unfractionated heparin > short half-life

Question 436

What is the effect of Estrogen on the thyroid

Answer 436

Increase TBG level >> Increase total thyroid hormone levels with normal levels of free Thyroid hormones

Question 437

Which AA cannot be broken in MSUD (maple syrup urinary disease)

Answer 437

Valine, isoleucine , lucine

Question 438

Which co-factors are needed by pyruvate dehydrogenase? which other 2 enzymes need the same co-factors

Answer 438

1. Thiamine (b1) 2. Lipoate 3. Coenzyme A 4. FAD 5. NAD alpha-ketoglutarate dehydrogenase Brahcned chain alpha keto acid Dhydrogenase complex (BCKDC)- syrum maple disease

Question 439

Avoid fibrates (like Gemfibrozil) when there's an underlying ---------------- disease

Answer 439

Avoid fibrates (like Gemfibrozil) when there an underline Gallbladder disease

Question 440

most important interlukin In spetic shock

Answer 440

TNF-alpha

Question 441

What is the treatmet for cerebral vasospasm after SHA

Answer 441

CCB- increase cerebral vasodilation and decrease calcium depndent excitotoxicty

Question 442

Which pathway will be activated by Insulin? and what will be the result of this activaion

Answer 442

RTK >> PI3K pathway >> activating protein phosphatase >> dephosphorylate glycogen synthase >> active glycogen synthase

Question 443

What is the patophysiology of Chronic Lung tansplant rejection

Answer 443

Sub-mucosal infflamtion granulation and scarring & bronchiolitis obliterans

Question 444

What will happen to GFR and Fractional Filtreation when the res a Urethral obstuction

Answer 444

GFR will decrease FF will decrease (GFR: RPF) due to arteriole consticrtion beacuse of GFR decrease

Question 445

What is the influence of Preeclampsia on Placental vascular resistance uteroplacental perfusion Umbilican vein oxygen delivery

Answer 445

Placental vascular resistance- Increase uteroplacental perfusion- decrease Umbilican vein oxygen delivery- decrease

Question 446

Which medication can cause Hypsensitive reaction with association to HLA- B*57:01 allele

Answer 446

NRTI- **Abacavir** HSR-4

Question 447

What is a permissiveness affect of medicaions

Answer 447

Permissive drug has no effect on physiologic process itself but when combine with another drug it exert its maximal effect on the process.

Question 448

What is the pathogenesis of Reye syndrome

Answer 448

Acute liver failure + rapidly progressive enephalopathy. **Damage to mitochondria >> impair fatty acid beta oxidation within hepatocytes**

Question 449

Which organ in the body is derive of the mesoderm but its bloody supply is from the foregut origin

Answer 449

Spleen supply by the celiac trunk

Question 450

Which abdominal blood vessel originate fromt he: Forgut Midgut Hindgut

Answer 450

Forgut- Celiac artery Midgut- SMA Hindgut- IMA

Question 451

How do we detect C. defficelle infection?

Answer 451

PCR for bacterial toxin gene

Question 452

which family of medication can cause transient bluish discoloration to vision

Answer 452

PDE-5 (Sildenafil, Tadalafil)

Question 453

What is the presentation of right sided colon cancer?

Answer 453

occult bleeding Iron def. anemia grow to the lumen

Question 454

What is 2 distinct features between NMS to seratonin syndrome

Answer 454

NMS- Diffuse rigidity + hypoflexia Seratonin syndrome- clonus, hyperreflexia

Question 455

Which ligament is involve in overian torsion?

Answer 455

Infundibulopelvic ligaments

Question 456

What is Mullerian degeneration?

Answer 456

Process of Axonal degeneration and breakdown of myelin sheath distal to the site of injury. In CNS- there's myelin debris and not axonal degneration

Question 457

Whats the different in MPA between LMWH and Unfrcational heparin?

Answer 457

LMWH- only inhibit factor Xa by binding and activating AT III Unfr. Heparin- bind to AT III and inhibit both factor Xa and both Thrombin

Question 458

In anapylaxis which specific anzyme is relased from MAST cells garnules?

Answer 458

Tryptase - support clinical Dx of anapylaxis after pt is tabilized

Question 459

What is the Dx. what will see in biopsy?

Answer 459

Urtecaria (IgE mediated degranulation of mast cells) Edema of superficial dermis

Question 460

what is Sudan III stain?

Answer 460

Stain for testing malabsorption of fat

Question 461

Classic Galactosemia caused by a def in -----------. symptoms including vomiting after breasfeeding, jaundice and------- sepsis.

Answer 461

Classic Galactosemia caused by a def in GALT (Glactose-1-phosphate uridyl transferase). symptoms including vomiting after breasfeeding, jaundice and e.coli (Gram neg. rod ) sepsis.

Question 462

Lagionella can cause bardy/tachycardia with fiver, also, it can cause watery/ bloody diarrhea. and can be diagnose by ------------------------------

Answer 462

Lagionella can cause bardycardia with fiver, also, it can cause watery diarrhea. and can be diagnose by urine antigen test and culture on BCYE

Question 463

Which activating mutation is with correlation with gout?

Answer 463

PRPP synthetase (De novo purine synthesis) - activating mutation

Question 464

In gout ,, which WBC is involve?

Answer 464

Neurtrophils , thats why using NSAIDS is a first line. if C/I >> colchicine is uaseful- inhibit PMN chemotaxis and phagocytosis

Question 465

Which Pathogen has a Corkscrew shape on Silver stain?

Answer 465

Trponoma pallidum (syphilis)

Question 466

Garlic odor on breath? (tocixdrome) and whats the Tx?

Answer 466

Arsenic poisinig Tx: Dimercarpol DMSA

Question 467

How metformin is cleared?

Answer 467

By the kidney. if not >> can lead to Lactic acidosis

Question 468

In which disease we test for Ab to Cardiolipin- Cholesterol- Lectihin antigen

Answer 468

syphilis (RPR, VDRL- nontreponemal) not specific

Question 469

Which Drugs interact with Chelation cations and what does ites effect?

Answer 469

drugs: Tetracyclines, Fluroqionolone, levothyroxine Iron, Ca, Ma, Aluminum Effect: compkex in GI tract >> decrease absorbation of the medicine

Question 470

What is Immune privilege?

Answer 470

Areas in the body that conceled from the immune system by physical barriers like: eye, Testes

Question 471

Maple syrup urine disease which enzymr id def. inheritence? Enzyme function?

Answer 471

Def. in BCKDC (branched chain alpha keto dehydrogenase complex (thiamine dep.) AR function: breakdown of branched AA- Leucine, Isoleucine, Valine (for the TCA cycle)

Question 472

Sweet smell urine + irritabilty, porr eating in infant?

Answer 472

Maple syrup. BCKDC def. (isoluecine, leucine, Valine- VIL)

Question 473

Classic Galactosemia is an ------ inheritence

Answer 473

AR

Question 474

What we see here?

Answer 474

A-vascular necrosis of femoral head

Question 475

22 year old with with neck mass + multiple soft papules on lips and tounges + arm span exceed his height with long fingers whats the Dx?

Answer 475

MEN2B (RET) PMM Pheochromocytoma- episodic Headcaes Medullart thyroid cancer- Calcitonen Marfan hebitus / mucosal neuromas

Question 476

What is Calcineurin?

Answer 476

protien phosphatase essential to activation of IL-2 (induce transcription of it)>> promote grow and differenation of T cells.

Question 477

Which medications inhibit Calcinineurin?

Answer 477

Cyclosporine + Tacrolimus

Question 478

What is The lepromin skin test?

Answer 478

injecting inactivated Mycobacterium leprae under the skin, is a diagnostic tool that helps classify the type of leprosy in a person already diagnosed with the disease; a positive result>> where a nodule forms, tuberculoid leprosy; a negative result >> where no nodule forms, is associated with lepromatous leprosy , a more severe form of the disease characterized by a weaker immune response, more widespread lesions, and a higher bacterial load

Question 479

Which deposits are found in Psuedogout (CPPD)

Answer 479

Calcium pyrophosphate- rhmboid shape (כמו אונקיות זהב)

Question 480

Which Pathogen is a/w progressive multifocal leukoencephalopathy (PML)

Answer 480

JC virus- due to attack on the oligodandrocyte

Question 481

What is the pathology seen in Reye syndrome

Answer 481

- Mitochondiral toxin >> impair FA oxidation - Hepatic dysfunction >> ammonia accumulation - Astrocyte swelling >> due to the amonia high levels

Question 482

Firm violacenous nodule in setting of chronic lymphadema?

Answer 482

agiosarcoma mainly 10 yrs after breast cancer treatment

Question 483

In which enzyme reaction of the TSA cycle GTP is generate

Answer 483

Succinul -COA >> Succinate

Question 484

Which reactions in the TCA generate NADH

Answer 484

Malate to Oxaloacetate Isocitrate to alpha-ketoglutarate alpha-keto glutarate to succinyl-coA

Question 485

Tx for Anticholinergic?

Answer 485

Alisa Tea party ( Hot as a hare, dry as a bonem red as a beet, blind as a bat, mad is a hatter full as a flask, fast as a fiddle Physostigmine

Question 486

Macrophage with hemosidrein is indicated of?

Answer 486

Hemmorahge

Question 487

Which signal transduction is mediated trough EPO

Answer 487

JAK/ STAT >> promot erytrocyte precursor survival and differentiation

Question 488

What ios the surgical treatment for persistent AFib

Answer 488

Ablation of the AV node (located on the endocardial surface of of right atrium near the insertion of the septal leaflet and the orficie of coronary sinus

Question 489

which medication can be used to treat visceral nausa

Answer 489

5-HT3 receptor antagonist (ondansetron) reduce neause and vomiting caused by GI upset

Question 490

What are hemartomas?

Answer 490

Bening lung neoplasms microscopically characterized by nodules of disorgioanzed mature Connective tissue (Cartilage , fat) + entrapped respiratory epithalium.

Question 491

In case of carrying to much weight - Which structre is resposible for giving up in order to not cause the body damage?

Answer 491

Golgi tendon

Question 492

What are the 4T's of ant. mediastinum mass?

Answer 492

Thymoma Teratoma (and other Germ cell tumors) Terrible lymphoma Thyroid neoplasm

Question 493

regards to levels of b-HCG and alpha-Feto proteins. What would be the levels in seminomas and non-seminomas tumors?

Answer 493

Seminoma- eleveted beta-hcg, AFP almost always normal Non-seminomas- Eleveted AFP + b-HCG

Question 493

Which tumors are non seminomas?

Answer 493

Yolk sac tumors, Chrocarcinoma, Embryonal carcinoma

Question 494

What is Eisenmenger syndrome?

Answer 494

Left to right shunt >>Stiffining and narrowing of blood vessels in lungs >> PAH >> Right to Left shant >> cyanosis , clubbing, polycythemia

Question 495

Wide fixed splitting of S2

Answer 495

ASD

Question 496

Which enzyme is expressed by macropahges in Granulamatous diseases? TB, Sarcoidosis)

Answer 496

alpha-1- hydroxylase >> more active Vitamin D >> hypercalcemia

Question 497

Low maternal serum of alpha-feto protein?

Answer 497

Aneuploidies >> Trisomy 18 & 21

Question 498

High maternal serum of alpha-feto protein

Answer 498

1. open NTD 2. Ventral wall defect (omphalocele, gastroschisis) 3. multipe gestation

Question 499

How to values in Down syndrome will change in the Quadraple screen test

Answer 499

low APF Low unconjucated estriol High b-HCG High inhibin A

Question 500

Which is the most common indicator of obesity realted disease in Lung test?

Answer 500

Reduction in ERV (Expiratory reserve volume) also FRC = ERV + RV

Question 501

What is the purpose of Southwestern bloth?

Answer 501

dsDNA probes to indentify DNA binding protiens (aka. transcription factors)

Question 502

Which Fungi are di-morphic

Answer 502

Histaplasma capsultum, Blastomyces, Coccidiodes, Sporotherix, paracocciodes

Question 503

What is the Clinical menifistetion of Vitamin E def.

Answer 503

Hemplytic Anemia Neurological Deficit (Ataxia, Loss of vibatory sensation, hyporeflexia)

Question 504

Erythematous rush in sun exposure regions + Anemia +Reticulocytosis

Answer 504

Warm Agglutinin disease (IgG) >> AIHA >> Extravascular hemolysis ( Secndary to SLE)

Question 505

Which Vitamin Def. will cause Epithalial squemous metaplasia?

Answer 505

Vitamin A - responsible for differeation to specilized epithlium (like mucus secrting and ect..) to a kertinizing epithlium

Question 506

What are the sequence of mutations in colon cancer?

Answer 506

1. APC inactivation + beta-catenin accumulation = hyperproliferative epithelium 2. KRAS activation = Adenoma (increase in size) 3. P53 inactivation = Carcinoma

Question 507

How to calculate False negetive?

Answer 507

1- sensetivity X number of pt with the disease

Question 508

Which subtype is the most abundant in RCC?

Answer 508

Clear cell carcinoma

Question 509

Which plance int he nephron is not permable to water

Answer 509

Thick + Thin ascendin loop (regardless of vasopressin levels)

Question 510

Absence of HLA-DR cells indicicate defective expression of ------ which can lead to ---------------

Answer 510

MHC-II can lead to impair activaiton of T & B cells >> resulting in form of SCID

Question 511

Which medication treat COPD by blocking Ach at muscarinic receptors (inhibit parasymphatetic)

Answer 511

Ipratropium- anticholinergic ( der. of atropine)

Question 512

What the impact of Unilateral Rental artery stenosis on the unaffected kidney?

Answer 512

eleveted systemic pressure >> increase NA excretion

Question 513

What is Heteroplasmy?

Answer 513

Variability in presentation altough having the same mutation in mitochondrial disease- inherit from mother only, severity depends on the amount of normal and mutent mitochondria in the daugther cell.

Question 514

Why Brown pigmented stones formes/?

Answer 514

Secondary to bacterial (E.coli) or Helminthic inf. of the biliary tract. realse of beta-glucoronidase by injured hepatocytes and bacteria.

Question 515

What is the cause of formation of black stones?

Answer 515

Chronic hemolysis (Sickle cells, spherocytosis), increase enterohepatic cycling of bilirubin

Question 516

Which co-factor is needed for Transamination reactions? (for exemple between AA to alpha-keto-acid)

Answer 516

B6- pyrodoxal phosphate (active B6) in AST, ALT

Question 517

Which kind of PH changes occur when giving excess normal saline infusion

Answer 517

Metabolic acidosis with no AG.

Question 518

What is the enzyme def. in Cyclic neutropenia?

Answer 518

Neutrophil elastase

Question 519

What is Biliary sludge?

Answer 519

mixture of particulate solids that have precipitated from bile. Such sediment consists of cholesterol crystals, calcium bilirubinate pigment, and other calcium salts **Can cause transient bile duct obstruction** >> promote cholesterol gallstone formation cuase by hipomobility of the gallbladder

Question 520

What is the pathopysiology of Dudenal atresia?

Answer 520

Recanalzation failur = double bubble sign

Question 521

What is the pathophysiology of Jeujenal / ilial atresia?

Answer 521

Vascular occlusion. true for all midgut- Jejunum, ileum, proximal colon (SMA occlusion)

Question 522

In glaucoma what is the target of Timolol in treating?

Answer 522

Diminish secretion of aqueous humor by the ciliary epithlium

Question 523

Which Clinical feature is very carecteristic for PCP (phencyclidine)

Answer 523

Nystagmus (can be vary) and memory loss= distinguish symptoms PCP = like the P is a sunglasses= nystagmus also: ataxia, amnesia they are very violent

Question 524

Huntington disease is cherectarzie by ------ reaptes and affect the ------- nucleus

Answer 524

CAG repeats Atrophy of Caudate nucleus

Question 525

Age realted macular degeneration leading to loss of portion of central visual field called:

Answer 525

Central scotoma

Question 526

Whats the diagnosis?

Answer 526

AMD = Age related macular degeneration

Question 527

What is the Tx for colesterol gallstones in pt who refuse surgery?

Answer 527

Hydrophilic bile acids ( ursodeoxycholic acid) = promote gallstone dissulution by reducing cholesterol secretion and increase biliary bile acid concentration

Question 528

How to calculate Number needed to harm?

Answer 528

NNH= 1/ Absolute Risk increase ARI = Adverse event rate in study - AER in control Adverse event rate= adverse event (exp. death) / sum of people treated

Question 529

Which place is the principal site of NE synthesis in the brain?

Answer 529

Locus coeruleus - posterior rostal pons near the lateral floor of the 4th ventricle

Question 530

Who do prolactin can ceuase hypogonadism?

Answer 530

suprresion of the GnRH produciton from the hypothalamus

Question 531

Which 2 mediators (vasoconstrictors) have an prominent role in the development of LVH

Answer 531

1. Angiotensin II 2. Endothelin

Question 532

What is the most common inherited disorder of bilirubin metabolism?

Answer 532

Gilbert syndrome low activity of Hepatic UDP glucoronsyltrsaferase = less conjugated bilirubin

Question 533

Pt with self resolving scleral icterus + isolated indirect hyperbilirubinemia at periods of stress. Dx?

Answer 533

Gilbert syndrome

Question 534

Which type of Hormone is produce by Seratoli cells?

Answer 534

Anti mullerian hormone in fetus ABP = androgen binding protein that bind testesoron to keep viable sperms Inhibin secreted by seratoli cells to provide a negative feedback to FSH

Question 535

What will be the effect of Seratoli cells dysfunction on FSH, inhibin and fertility

Answer 535

- impaired fertility - increase FSH levels - Decrease inhibin

Question 536

DDx for blusih neoplasm uderneath the nail bed?

Answer 536

1. glomus tumor (glomangioma)- modify smooth muscle cells = thermoregulaiton 2. Subungual melanoma

Question 537

What is pleiotropy?

Answer 537

Multiple phenotypic manifestations reasults from a single genetic mutation

Question 538

What is Gentic linkage?

Answer 538

tendancy of alleles located nearby to be inherent together

Question 539

Which WBC are the promary mediators in COPD

Answer 539

PMN, CD8, Macrophages Emphysema + Hypersecretion (Chronic bronchitis)

Question 540

What is the Function of R protin secreted from salivery glands

Answer 540

to bond B12 in the stomachand realsed it in the duodenum (by pancreatic proteases) so IF can contet it

Question 541

What is The genetic material in Compleye mole vs partial mole

Answer 541

Complete- 46XX/ 46XY ( ovum fertilized by 2 sperm w/o maternal chromosomes) Partial- normal ovum (with maternal chromosomes) fertilized by 2 sperms- 69XXX, 69 XXY 69XYY

Question 542

In which type of molar pregnancy fetus part would be presence?

Answer 542

Parital mole

Question 543

Which Brain structure will suffet the most from Chronic Thiamine Def. and by decrease in which enzyme activity?

Answer 543

Mamillary body decrease activity of tansketolase

Question 544

Which IL envolve in

Answer 544

IL-4 + IL-13

Question 545

Which IL involve in patohgeenesis of sepsis?

Answer 545

TNF-a + IL-1

Question 546

Which IL involve in psoriasis?

Answer 546

IL-17 + IL-23

Question 547

Which iL are involve in Granuloma formation?

Answer 547

IL-12 + INF-gamma

Question 548

Which feture will present in Peripheral blood smear on lead posining?

Answer 548

Basophilic stippling (remeber TAILS for microcystic anemia = Talahsima, anemia of chronic, Iron def, Lead posining, Sideroblastic anemia

Question 549

In which type of cancer this will be sown?

Answer 549

SCLC

Question 550

Prolong use of NSAIDS can lead to (nephrytic / nephrotic syndrome) which can further increase the risk of ----------- necrosis

Answer 550

Chronic interstitial nephritis, ischemic papillary necrosis

Question 551

Which condition is characteristic with short limbs , frontal bossig , midface hypoplasia with normal torsi length

Answer 551

**Achondroplasia = גמדות** Autosomal dominant condition mutation at FGFR3- responsible of limiting endochondroal ossification. **in Achondroplasia become consistenly activated = inhibition of chondrocyte prolifration**

Question 552

Hypocalcemia after Blood transfusion can be caused by

Answer 552

High levels of citrate in transfusion >> chalte calcium in blood

Question 553

What is the Tx for Alcohol withdrwal with psycohomotor agiation in order to prevent the progression into seziures and delerium?

Answer 553

**BZD (Lorazepam, Diazepam, Chrdiazepoxide)**- long acting

Question 554

Spinal muscle atrophy **SMA** Gene? What the impaired molecular function?

Answer 554

SMN1 (Survival motor neuron) gene Impaired assembly if snRNP >> Defective Splicesome function >> no introns are being remove from Pre-mRNA >> degenration of Ant. horn cells in spinal cord

Question 555

Syndrome of bilateral sensorineural hearing loss + congenital long QT syndrome

Answer 555

Jervell and lange nielsen syndrome (AR) **Mutations in Voltage gated K channels**