Practice Test One Flashcards
1
Q
murmurs of endocarditis
A
mitral/tricuspid regurg which are holosystolic
2
Q
most common cause of mitral stenosis and presenting symptoms
A
rheumatic fever (past). mid-diastolic murmur.
3
Q
Peutz-Heghers syndrome
A
autosomal dominant disease due to kinase STK11. have pigmented skin lessons near mouth/hands/feet and abdominal pain from GI polyps
4
Q
lipoma vs liposarcoma
A
nuclear abnomralities like “scalloping” and pleotropy
5
Q
easily ruptured blisters which heal completely
A
must be above basal layer of epidermis (pemphigus vulgaris)
6
Q
which pneumocytes secrete surfactant?
A
type 2 pneumocytes
7
Q
most common cause of horners?
A
pancoast tumor pressing on sympathetic trunk
8
Q
how to get turners syndrome patient preggo
A
IVF. they have streak ovaries so GnRH dn’t do shit
9
Q
Diabetes inspidious in psyc patient
A
can be caused by Li mood stabalizers. So nephrogenic not central. can be called “renal tubular dysfunction”
10
Q
sudden death in young atheles during excercise with heart murmos
A
hypertrophic cardiomyopathy. coronary arteries are normal but heart is big.
11
Q
biventricular dilation occurs in
A
dialted cardiomyopathy not hypertrophic
12
Q
when does the second heart sound occur?
A
when aortic pressure becomes > than LV pressure. NOT when LA > LV (that is when filling happens during diastoli
13
Q
special consideration for IgA deficent patients with transfusions
A
they produce anti-IgA
14
Q
what does DNA pol I do?
A
replaces primers of replication with DNA
15
Q
ovarian cancer can cause ascities. got it?
A
good
16
Q
ovarian cancer marker?
A
ca 125
17
Q
drug cocktail given for transplant
A
calcineurin inhibitor (cyclosporine, tacrolimus, sirolimus), glucocorticoid (prednisone) and purine synthesis inhibitor (azothioprine or mycophenolate mofetil)
18
Q
cyclosporine famously damages what?
A
kidneys
19
Q
Metoclopramide should be avoided in
A
parkinsonians
20
Q
what happens to electrolytes during ischemia?
A
K out, Na in
21
Q
juxtaglomerulous cells release
A
renin (macula densa signals to them)
22
Q
female athlete triad
A
disordered eating, amenorrhea and osteoporosis (central hypoestrogenism)
23
Q
Familial hypercholesterolemia genetics
A
autosomal dominant. LDL receptor. So can’t clear LDL (and cholestrol as well). Xanthomas
24
Q
where does the pancreas sit on CT?
A
anterior to the IVC and aorta at L2 kinda right beside/infront of the right kidney
25
where can DNA pol add bases?
3' hydroxyl
26
why give heparin instead of warfarin during pregnancy?
cause heparin is water soluble so it can't cross placenta while warfarin can
27
STD with purulent penile discharge, burning pee, gram negative
Neisseria gonorrhoeae
28
gram neg, kidney bene shaped, diplococci within white blood cells
N. gonorrhoeae
29
how does gonorrhoeae adhere and what properties does that have?
use pili. pili have phase variation (turn on and off) and antigenic variation
30
what is it called when two viruses infect the same cell and they swap material allowing for species mixing of viruses?
genetic reassortment
31
what happens if glycolysis is impared?
neonatal death
32
what is McArdle (glycogen storage disease type V)
no myophophorylase (muscle glycogen phosphorylase) which breaks down glycogen for glucose in muscle. results in exercise intolerance
33
pathophys of graves ophthalmopathy
lymphocytes invade and release cytokines which cause GAG production by fibroblasts
34
jugular venous tracing order
first (a) wave is right atrial contract, next (c) wave is bulge of tricuspid during R vent contract, downslop (x) is right atria relax, second wave (v) wave is continued inflow while pressure builds and then y downslope when atria starts emptying
35
features of teratology of the fallot
1: pulm stenosis
2: right vent hypertrophy
3: overriding aorta
4: ventricular septal defect
36
the CAAT and TATA box promote what?
transcription
37
what vitamin def mimics Ehlers-Danlos syndrome?
vitamin C
38
what does vitamin C def cause?
hypermobile joints, extensible skin, collagen defects, bruising and hemorrhage (vessels break easy)
39
what makes hepatic nodules in cirrhosis?
the nodules are actually hepatocytes while lined with fibroblasts.
40
soft, compressible mass that transilluminates in the head/neck? associated with what?
cystic hygroma (lymphatic malformation). due to chromosomal aneuploidy
41
lactose intolerance is due to what molecular changes?
decreased expression of lactase
42
radiation to neck/head causes what risk?
thyroid cancer. thyroid is super sensitive to radiation
43
inappropriate and increased sexual activity, oral fixation, hyperphagia, visual agnosia, aphasia, flat emotions. disease name and cause (brain lesion)
Kluver-Bucy syndrome due to destruction of amygdala (sometimes due to HSV). located under the basal ganglia but more lateral (underside/medial parts of temporal lobes)
44
cyclosporin mechanism
binds cyclophin which together inhibit calcineurin thus no calcium-dependent genes expressed including many cytokines. in particular IL-2 is not transcribed
45
what is tardive dyskinesia
involuntary movment disorder including lipsmacking and tongue protrusions after years of antipsychotics (antidopamines). upregulation of dopamine receptors.
46
what does dopamine hydroxylase make and what is that important for?
norepinephrine. first signs will be orthostatic hypotension. NE is in sympathetic postganglionic neurons (horners shit too).
47
advantage of inactivated polio vaccine over oral form?
doesn't revert to virulent form
48
headache, puffy face, enlarged neck veins, shoulder pain, in chronic smoker
SVC syndrome
49
CT at the root of the aorta, where is the SVC?
just below and to the left of aorta (big one on top).
50
nerve which will be damaged with midshaft humerus fracture and subsequent defect?
radial nerve and wrist extension problems with tricep sparing cause the nerves for that have already left radial nerve
51
round eosinophilic inclusions in hipoocampal neurons with muscle contractions and death
rabies (Negri bodies)
52
orthostatic hydrostatic response is due to?
alpha1-adrenergic
53
how is aminoglycocide resistance gained?
1: poor drug penetrance (requires active transport)
2: mutations to 30S ribosome
3: enzymatic degradation
54
orlistat
inhibits intestinal lipase to help fatties lose weight
55
what connects the rectum to the liver (cause lord knows thats important)
inferior mesenteric vein
56
what secondary molecule is induced by insulin in the liver?
Fructose-2,6-bisphosphate via PFK2 induction
57
cavernous sinus contains?
internal carotid, CN 3/4/6 and trigem (V2/3). also is the only sinus which recieves blood from facial veins.
58
VSD vs teratology of fallot obvious physical difference
VSD doesn't turn blue. ToF does especially during exertion
59
parasite that is prevalent in the homosexual community which causes diarrhea?
Entamoeba histolytica cause of anal sex (well oral-anal...)
60
hormones that are produced after oral glucose but not IV
Incretins: Glucagon-like peptide 1, Gastric Inhibitory Peptide. They stimulated insulin release.
61
hypertensive drug that may cause potter sequence and renal agenisis?
ACE inhibitors
62
how do statins change HDL, LDL, and Tri?
inhibit chol synth causing increased hepatic LDL-R (uptake more)
63
ApoB synth locations
this LDL/VLDL component is made full length ApoB100 in liver and truncated ApoB48 in intestine
64
Chlamydia treatment
protein synthesis inhibitor azithromycin (single dose)
65
probenecid
inhibits renal excretion of penicillin and cephalosporin
66
cilastatin
given to prolong imipenem by inhibiting hydrolysis in kidney
67
tetracyclin teratogen
yellows teeth and deposits in the bone. it associates with Ca and is codeposited in fetus
68
disease caused by loss of pyrimidine dimer fixing mechanism ?
xeroderma pigmentosum
69
how does cirrhosis effect estrogen and effects?
increases estrogen due to lower degradation. effects include spider angioma, palamar erythema, gynecomastia, testicular atrophy, and decrease body hair
70
neurofibromatosis type I findings
neurofibromas, pigmented lesions (schwann cell freckles in axilla, cafe-au-lait spots), pigmented iris hamartomas
71
percent within 1, 2, 3 SD of the mean?
68, 95, 99.7
72
what happened to atretic follicles?
they underwent apoptosis
73
what does proline hydroxylation do to collagen
stabalize the triple helix
74
uncal herniation results in?
CN3 compression
75
older women with compression fracture
low estrogen due to menopause (ovary)
76
first step in heme synthesis?
glycine and succinyl-CoA combined to make ALA
77
effect of ACE inhibitor on renin?
increases it
78
HIV diarrhea: multiple ulcers &mucosal erosions, large cells with basophilic intranuclear inclusions
cytomegalovirus
79
HIV diarrhea: nonulcerative inflammation, basophilic clusters on surface of mucosal cells
cryptosporidium
80
HIV diarrhea: distortion of villus architecture w/o inflammation. small spores with equatorial belt like structure
microsporidium
81
HIV diarrhea: granulomas, acid fast bacilli
mycobacterium avium complex
82
what does gp41 do in HIV?
membrane fusion
83
VHL cancers
cerebellar/retinal hemangioblastomas, renal clear cell carcinoma, pheo
84
where in the eye is copper deposited in Wilson's disease?
cornea
85
vascular tethering of white cells uses what proteins?
selectin and ICAM
86
what generates the respiratory burst of the neutrophils?
NADPH oxidase (it makes superoxide ions)
87
fibroadenoma vs cystic change
fibroadenoma is the most common benign breast tumor and is well demarcated and small and changes with menstrual cycle. Meanwhile cystic change is the most common cause of palpable masses, however they change all of the breasts firmness and are painful and less defined
88
hyperchromic nests on skin
melanocytic nevus
89
two drugs which act on GABA channels?
benzodiazepines and barbiturates
90
flumazenil inhibits the actions of what drug class?
benzodiazepines
91
besides the mamillary bodies, what does alcohol break down in the brains?
cerebellar purkinje neurons, giving rise to the wobbliness of long time alcoholics
92
what embryonic structure is the cerebellum derived from?
rhombencephalon
93
what do leucine zippers do?
bind DNA
94
Reed-sternberg (big ass bilobed cell)
Hodgkin's lymphoma
95
what does phospholipase C do after G protein signalling?
cleaves phospholipid to produce IP3 and DAG. IP3 stims Ca release from ER which together with DAG stimulate PKCs.
96
alcoholic heart problem
alcoholic dialated cardiomyopathy
97
what drug hits the mycolic acid found in acid-fast organisms?
Isoniazid
98
vaginal bleeding plus high beta-hCG weeks after birth
choriocarcinoma
99
how do retinoids (isotretinoin) work?
bind RA-receptor and RXR to prevent transcription. this calms down sebum production (used in acne)
100
perforates diaphram at T10
vagus and esophagus
101
hexokinase or glucokinase in the liver/pancreas?
glucokinase
102
osteomyelitis in adults, children, and sickle cell
adults: gonnarrhea
children: S aureus
sickle cell: Salmonella
103
which hemorrhage cauese pinopoint pupils, loss of horizontal gase, quadriparesis, decerebrate posturing and rapid coma to death
pontine hemorrhage
