Our Clues 10

Question 1

How would you promote DNA transcription?

Answer 1

Loosen DNA
Acetylation
Add more A’s & T’s

Question 2

Dx of painless erythematous lesions on palms and soles

Answer 2

Janeway lesions
- infective endocarditis
- septic emboli/microabscesses

Question 3

What is the 2nd messenger of smooth muscle?

Answer 3

Contraction by hormone or neurotransmitter
- IP3/DAG

Contraction by distention
- calcium-calmodulin

Question 4

Amino Acids
(Sulfur)

Hormones with lots of disulfide bonds

Answer 4

Methionine & Cysteine

“PIGI”
- Prolactin
- Insulin
- Growth Hormone
- Inhibin

Question 5

Amino Acids
(Aromatic)

Answer 5

Phenylalanine
Tryptophan
Tyrosine

Question 6

Most immunogenic bacteria

Answer 6

Shigella
(MCC of diarrhea in daycare)

Question 7

What is the rate-limiting enzyme of gluconeogenesis?

Answer 7

Pyruvate carboxylase

Question 8

Infections that cause heart block

Answer 8

“LSD Loves Company”
Legionella
Salmonella: Typhoid Fever
Diphtheria
Lyme Disease
Chaga’s disease

Question 9

DOC to raise HDL

Answer 9

Niacin

Question 10

Chaperone HSP-70
guides proteins where?

Answer 10

Mitochondria

Question 11

“Ragged red fiber”
“Wavy red fiber”

Answer 11

Mitochondrial diseases

Question 12

What are the X-linked recessive enzyme deficiencies?

Answer 12

“A GOLF PATCH”

Adenosine deaminase (SCID)
G6PD
OTC
Lesch-Nyhan (HGPRT)
Fabry’s (alpha-galactosidase)
PRPP synthetase
Adrenal leukodystrophy (CAT-1)
Tyrosine kinase
CGD (NADPH oxidase)
Hunter’s (Iduronidase)

Question 13

What is the antibody for autoimmune T1 DM?

Answer 13

Anti-glutamic acid decarboxylase (anti-GAD)

Question 14

Dx of elevated C-peptide and elevated insulin in:
- newborns
- mass in pancreas
- drug

Answer 14

• nesidioblastosis
• insulinoma
• sulfonylureas

Question 15

Anticoagulants used that do not require bridge therapy

Answer 15

Rivaroxaban
Apixaban

Question 16

Anti-centromere antibody

Answer 16

CREST syndrome
- mildest form of scleroderma

• calcinosis cutis
• Reynaud’s phenomenon
• esophageal dysmotility
• sclerodactyly
• telangiectasias

Question 17

Dx with:
- periosteal erosion
- only arthritis to attack C1 and C2
- only arthritis to attack pannus or synovium

Answer 17

Rheumatoid arthritis

Question 18

DOC for venous clots

Answer 18

Heparin

(Heparin before warfarin w/ 2 day bridge)

Question 19

Which 2nd messenger systems are affected by calcium?

Answer 19

IP3/DAG, Calcium, Calcium-Calmodulin

(Sx consistent with smooth muscle contraction, gastric, hypothalamic hormones)

Question 20

What 2nd messenger do the following use?
- estrogen
- progesterone
- testosterone
- cortisol

Answer 20

NONE!

All steroid hormones are fat soluble hormones
Do not use 2nd messenger b/c they are able to freely cross membrane

Question 21

What two membranes depolarize w/ Ca?

Answer 21

Atrium and thalamus

(Everything else uses Na to depolarize)

Question 22

If susceptible to encapsulated organisms, vaccinate against what?

Answer 22

Susceptible due to asplenia

“No Spleens Here”
- Neisseria meningitidis
- Strep pneumo
- H influenzae

Question 23

What is the rate-limiting enzyme of glycolysis?

Answer 23

Phosphofructokinase 1 (PFK-1)

Question 24

Causes of microsteatosis

Answer 24

Sign of uncoupling

1) pregnancy
2) Tylenol poisoning
3) Reye’s syndrome

Question 25

Amino acids (Both glucogenic and ketogenic)

Answer 25

PITT Phenylalanine Isoleucine Threonine Tryptophan

Question 26

Amino Acids (Ketogenic only)

Answer 26

Lysine Leucine

Question 27

Drug-Induced Lupus serum marker

Answer 27

Anti-histone antibody

Question 28

Top 3 bacteria for GU tract What if nitrite neg? What if post-coital?

Answer 28

1) E. coli 2) Proteus 3) Klebsiella Enterococcus Staph saprophyticus

Question 29

What is the screening tests for cystic fibrosis?

Answer 29

Immunoreactive trypsin Then: Chloride sweat test (use pilocarpine)

Question 30

What’s caused by Sodium Nitroprusside?

Answer 30

Cyanide poisoning (Side note: best drug for HTN crises except for pregnancy or aortic dissection)

Question 31

How would you determine if it’s fulminant hepatitis?

Answer 31

Hepatic encephalopathy Evidence of GABA

Question 32

Apoptosis - What is the gene? - What is the protein? - What is the label? - What is the enzyme?

Answer 32

- p53 - Cyclin D - phosphatidylserine - caspase

Question 33

List drugs that cause pulmonary fibrosis

Answer 33

“My Nose Cannot Breathe Bad Air” Methotrexate Nitrofurantoin Carmustine Bleomycin Busulfan Amiodarone

Question 34

What are the bacteria that are curved rods?

Answer 34

Helicobacter Vibrio vulnificus Campylobacter

Question 35

Describe characteristics of water-soluble compounds

Answer 35

Charged Large Acid Vd low Short half-life (<12 hours) Excreted in kidney - nephrotoxic - check renal labs - C/I in renal failure No CNS toxicity

Question 36

Dx of slapped-cheek appearance

Answer 36

Parvovirus B19 (Slapped cheek = 5 fingers = 5th disease d/t parvo B19)

Question 37

What is the most common bone cancer?

Answer 37

Metastasis Multiple myeloma

Question 38

What are acanthocytes? Causes?

Answer 38

RBCs coated with lipids MCC of hyperlipidemia - obesity - nephrotic syndrome - renal failure - pregnancy

Question 39

Dx of dead birds in the area with the symptoms of meningitis

Answer 39

West Nile virus

Question 40

Presence of: Anti-smooth muscle antibody Indicates what Dx?

Answer 40

Scleroderma Autoimmune hepatitis

Question 41

What lab findings is most indicative of a poor heart failure prognosis?

Answer 41

Hyponatremia (Yes: K too, but Na is the more serious of the two)

Question 42

Causes of macrosteatosis

Answer 42

1) obesity 2) alcohol

Question 43

Top 3 causes of pancreatitis - children - adults

Answer 43

Children - trauma - infections (coxsackie B, mumps) - hypertriglyceridemia Adults - gallstones - alcohol - hypertriglyceridemia

Question 44

Clue of Dx: nasal polyps

Answer 44

In children: - asthma - cystic fibrosis

Question 45

Important lab markers for iron deficiency anemia

Answer 45

Ferritin is low TIBC is high

Question 46

Dx of IgA Nephropathy with cataracts + deafness

Answer 46

Alport’s - X-linked recessive - involves type IV collagen - late onset renal failure

Question 47

Why do plasma proteins not leak out of the blood vessel?

Answer 47

Heparin sulfate is a negative charge in the basement membrane that repels negatively charged plasma proteins

Question 48

What is the control (nervous) of arteries? (Resting condition)

Answer 48

Sympathetic control (Usually constricted)

Question 49

What is the control (nervous) of veins? (Resting condition)

Answer 49

Parasympathetic control (Usually dilated)

Question 50

What controls HR? What receptors does it have?

Answer 50

SA node Beta-1 receptors