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Flashcards in NBME16 Deck (55)
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1

Describe Fanconi syndrome

reabsorptive defect of PCT
cannot reabsorb anything

high excretion:
AAs
glucose
HCO3
PO4

may result in metabolic acidosis (proximal renal tubular acidosis)

can be caused by hereditary, ischemia, drugs, etc

2

what does Kullikrein do

cleaves High-molecular weight Kininogen to Bradykinin to help activate PTT coag cascade.

it's also chemotactic for neutrophils

3

where do you see hamartomas, ash-leaf spots, and seizures

tuberous sclerosis

4

what murmur are you going to hear ~3 days after MI

you're at risk for free wall rupture, leading to tamponade, papillary muscle rupture

that will give you mitral regurg

5

what is the mech of resistance for VRE

substitution of d-lactate for d-alanine in peptidoglycan

6

what PTH finding do you see in Sarcoidosis

hypercalcemia
(2/2 1-alpha-hydroxylase mediated vitamin D activation in macrophages)

high 1,25-dihydroxycholecalciferol

low PTH (negative feedback)

7

what is Charcot Marie Tooth

Hereditary Motor and Sensory Neuropathy HMSN

abnormal myelin sheaths

associated with foot deformities (hammer toes), LE weakness, and sensory deficits (steppage gait)

(vs Friedrich Ataxia, w/ Hammer toes and degeneration of oligodendrocytes)

8

what is the buzzword cell for interstitial nephritis

eosinophils.

The forum guy doesn't think any other kidney problems have eosinophils

9

what would cause cell convolution

decreased function of a channel/membrane protein

reversible change- cell could swell

10

what structure inferior to ovary is at risk of damage during ovarian removal

ureter

11

what is dysthymic disorder

mild depression lasting >2yrs

low mood with at least 2 other depressive symptoms

12

what is the cause of Reye syndrome

cerebral edema; hepatic encephalopathy

(not viral encephalopathy)

13

how do you promote blood filtration to get more flow through lymph

increase hydrostatic pressure (with 0.9% Saline)

just increasing arterial pressure isn't effective

14

what is Graft vs Host disease

onset varies
Grafted immunocompetent (donor) T cells proliferate in the immunocompromised host and reject host cells.
Leads to severe organ dysfunction
Type 4 hypersensitivity

gives you maculopapular rash, jaundice, diarrhea, HSM, etc.

usually in bone marrow or liver transplant

potentially beneficial in leukemia (graft vs tumor effect)

15

what is a cross-sectional study

"what is currently happening"

so i you wanted to know what was going on at work, you measure some risk factor and "disease" among your employees
(level of noise vs hearing)

16

what are PCOS lab values with insulin, T, and LH

Fasting Insulin: increased (glucose increased)

T: increased

LH: increased (LH:FSH >2)

17

what is complicated about surgical repair of horseshoe kidney

anomalous origins of multiple renal arteries to each kidney

(not abnormal origin of SMA)

18

what cytokine will be positive in a positive TB test

Interferon-gamma

19

what's a common side effect of chemotherapy drugs

sensory loss 2/2 microtubule damage for axonal transport

commonly 2/2 Vincristine, which damages tubulin

20

how does chronic inflammation present

"lymphocytic infiltration and collagen deposition"

mononuclear (monocyte, macrophage, lymphocyte, plasma cell) and fibroblast-mediated
persistent destruction and repair (proliferation and fibrosis)
granulomas: made of epithelial macrophages and giant cells

21

what is abnormal in spherocytosis

spectrin protein deficiency

pt may have splenectomy to get rid of destructive cause

22

which organelle transports to the Golgi

RER

23

what might you see in Small cell lung carcinoma

"infiltrating sheets w/o distinct organization"

paraneoplastic syndromes, including SIADH
which would make the pt hyponatremic

can also see cushing syndrome (high ACTH)

24

what happens to myocytes cells while they're in a cast

polyubiquitination

25

what is Vincristine's intracellular target

Tubulin

26

what is natural transformation

ability for bacteria to take up naked DNA (from cell lysis in the environment)

especially seen in SHiN bacteria:
S pneumo
H influenzae
Neisseria

adding deoxyribonuclease to environment will degrade the naked DNA and prevent transformation

27

knee-jerk answer for older person with asplenia and meningitis

S pneumo

28

what neuro finding caused decreased muscle mass

degeneration of motor neurons leads to muscle atrophy

may present with LMNs, or even UMNs

29

where is the ligamentum flavum, posterior longitudinal ligament, and anterior longitudinal ligament

ligamentum flavum:
most posterior; just before spinal cord in LP

posterior longitudinal ligament:
just anterior to spinal cord

anterior longitudinal ligament:
anterior to vertebral bodies

30

what's the most important predisposing factor for gout

alcohol