NMBE 13 practice test Flashcards
(25 cards)
Scleroderma in regards to esophagus and LES tone (increase/decrease)?
Decreased esophageal peristalsis Decreased lower esophageal sphincter tone
Warfarin overdose treatment (both mild and severe)
In mild cases, can be treated with Vitamin K (delayed response, need to generate more. In severe cases, can be treated with fresh frozen plasma (much more rapid)
Chronic transplant rejection mediated by CD8+ T cells is due to….
Direct cytotoxicity to graft cells
clostridium tetani mechanism
A protease that cleaves SNARE –>inhibits inhibitory neurotransmitter (glycine, GABA) release from Renshaw cells in spinal cord leading to spasticity (opisthotonos, trismus)
The presence of _____ aids the bacteria in adhering to the urinary tract epithelium and withstanding the urine flow
adhesions (pilli)
Heteroplasmy
A cell can have some mitochondria that have a mutation in the mtDNA and some that do not (variable expression in mitochondrial inherited diseases) I.E. mother has 50% mutation and then daughters and sons have 100% mutation
Placenta Accreta
all or part of the placenta adheres abnormally to the myometrium Accreta – chorionic villi attach to the myometrium, rather than being restricted within the decidua basalis. Leads to an increase in heavy bleeding when vaginal birth is attempted
Schizoid
does not like being with people, prefers individual activities, indifferent to sexual behavior SchizoiD=Distant
Key in diagnosis is that it causes social or occupational dysfunction (lots of people can be weird, but it needs to interfere with daily life to be diagnosed)
avoidant personality
Hypersensitive to rejection, socially inhibited, timid, feelings of inadequacy, desires relationships with others (vs. schizoid)
-biggest difference from schitzoid is that avoidant pts WANT to interact with people
Celiac disease is associated with what condition
Dermatitis Herpetiformis -Pruritic papules, vesicles, and bullae (often found on elbows
Pemphigus vulgaris
Potentially fatal autoimmune skin disorder with IgG antibody against desmoglein 1 and desmoglein 2 (component of desmosomes that link together squamous cells of the epidermis). Nikolsky sign + (separation of epidermis upon manual stroking of skin)
Lesch Nyhan Syndrome (what is absent, what are pathways affected, what is produced more, what are sx)
Defective purine salvage, owing to absence of HGPRT
Hypoxanthine –> IMP
Guanine –> GMP
Results in excessive uric acid production and de novo purine synthesis -self mutilation behavior, hyperuricemia, gout, aggression
tx: allopurinol (xanthine oxidase inhibitor), which makes sense since cannot recycle the purines, produce more urea down the line.
Crescendo-Decrecendo heart murmur
Aortic Stenosis Systolic murmur following ejection click Often due to aggravated calcific aortic stenosis or bicuspid aortic valve Can lead to: syncope, angina, dyspnea on exertion (SAD)
Acute intermittent porphyria
AD Porphobilinogen deaminase is defective enzyme Symptoms (5 P’s):
- Painful abdomen
- Port wine–colored urine
- Polyneuropathy
- Psychological disturbances
- Precipitated by drugs (e.g., cytochrome P-450 inducers), alcohol, starvation
Ventricular Septal Defect murmur
holosystolic harsh sounding murmur. Loudest at tricuspid area most common congenital cardiac defect
Lambert Eaton = Myasthinic Syndrome
Antibodies to calcium channels at presynaptic terminal Results in proximal muscle weakness when less ACh released improves with muscle use because Calcium eventually work its way into presynaptic terminal Associated with small cell lung cancer
Hunter Syndrome
Mild Hurler + aggressive behavior, no corneal clouding. Iduronate sulfatase deficiency XLR (boys hunt, eyes are clear to hunt)
Hurler Syndrome
Autosomal Recessive developmental delay, gargoylism, airway obstruction, corneal clouding, hepatosplenomegaly
-α-l-iduronidase deficiency
NOT X-Linked!
Interleukin 1 (secreted by macrophages)
Also called osteoclast activating factor endogenous pyrogen, causes fever and acute inflammation. Activates endothelium to express adhesion molecules
Gilbert Syndrome
caused by UDP gluconyl transferase deficiency (converting UCB –> CB in liver) increased unconjugated bilirubin without overt hemolysis. Bilirubin with fasting and stress VERY common and usually asymptomatic
Type 2 error (beta)
Says there is not an effect or difference when in fact there is. =false negative error power and type 2 errors are inversely proportional (increase sample size, precision of measurement, decrease chance for type 2 error)
Japanese food leads to increased risk of what and why?
gastric cancer due to increased nitrosamines in smoked foods
elbow flexion done by what muscles and innervated by what nerve?
biceps and brachialis both innervated by musculocutaneous nerve
Minimal Change Disease
most common form of nephrotic syndrome characterized by 2+ protein in urine, puffy eyes, no red cell casts -Usually found in children Often 1° (idiopathic) and may be triggered by recent infection, immunization, immune stimulus. Rarely, may be 2° to lymphoma See effacement of the foot processes and loss of negative glomerular charge (changes seen on EM, normal on Light microscope)
In children 1-10 years who do not have hypertension, gross hematuria, renal failure, extra-renal symptoms such as rashes or purpura, or low complement levels it is reasonable to start therapy with prednisone without obtaining a renal biopsy
