Questions I got Wrong (3) Flashcards Preview

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Flashcards in Questions I got Wrong (3) Deck (290):
1

Which structures develop from the Mesonephric (aka Wolffian) ducts?

"BEEDS"

Bladder

Epididymis

Ejaculatory Duct

Ductus Deferens

Seminal Vesicles

2

First Line Treatment for PJP

TMP-SMX

3

Mode of Inheritence of Leber Hereditary Optic Neuropathy (LHON)

Mitochondrial

4

Which metabolite in the urine will turn black upon standing?

Homogentistic Acid

5

Alkaptonuria is a deficiency in which enzyme?

Homogentistic Acid Oxidase

6

Homogentistic Acid Oxidase is involved in the breakdown of which molecule?

Tyrosine

7

If you have excess ______, it can make Alkaptonuria worse.

Tyrosine

8

Which molecule builds up in the tissue and excreted urine in patients with Alkaptonuria?

Homogentistic Acid

9

Mode of Inheritence of Alkaptonuria

Autosomal Recessive

10

Adverse effects of Thiazolidinediones

1. Peripheral Edema (water retention)

2. Heart Failure

3. Weight Gain

4. Decreased Bone density

11

Which anti-microbial drug will cause Aplastic Anemia?

Chlormaphenicol

(Binds to 50s)

12

Next Step in HIV management after Western Blot?

Quantify the Viral Load and establish a risk profile by obtaining a CD4 cell count

13

What are the (4) inactivated vaccintes?

RIP Always

Rabies

Influenza (Intramuscular)

Polio (Salk)

Hepatitis A

14

Cranial nerve responsible for 1st Branchial arch structures

CN V

15

Cranial nerve responsible for 2nd Branchial arch structures

CN VII

16

Cranial nerve responsible for 3rd Branchial arch structures

CN IX

17

Cranial nerve responsible for 4-6th Branchial arch structures

CN X

18

"When at the restaurant of the golden ARCHES, children tend to first CHEW, then SMILE, then SWALLOW STYLishly or SIMPLY SWALLOW, and then SPEAK"

Nerves responsible for the various Branchial Arches

1 - Chew (CN V - V2 and V3)

2 - Smile (CN VII)

3 - Swallow Stylishly (CN IX - Stylopharyngeus)

4 - Simply Swallow (CN X - Superior Laryngeal Branch)

6 - Speak (CN X - Recurrent Laryngeal Branch)

19

Which muscles are derived from the 1st Branchial Arch?

"MATT" + Muscles of Mastication

M - Mylohyoid

A - Anterior Belly of the Digastric

T - Tensor Tympani

T - Tensor Veli Palatini

20

Alkylating agent that cross-links DNA @ Guanine

Cyclophosphamide

21

Prophylactic Treatment for a Pt about to receive Cyclophosphamide

Mensa + Fluids

22

Artery and Nerve in the Anterior Compartment of the leg

Anterior Tibial Artery

Deep Peroneal Nerve

23

Nerve in the Lateral Compartment of the leg

Superficial Peroneal Nerve

24

Artery and Nerve in the Posterior Compartment of the leg

Posterior Tibial Artery

Tibial Nerve

25

Side-Effects of SERMs

Inducing symptoms of Menopause

(i.e. Vaginal dryness, HOT FLASHES, etc.)

26

"Helmet-Shaped" RBCs are commonly seen in which process?

DIC

27

Which form of Glutathione is going to build up in Pts with G6PD?

REDUCED Glutathione

28

Ras belongs to which family?

Guanosine Triphosphate-Binding Protein

(small GTPase)

29

Tx for Wilsons Disease

1. Chelation with Penicillamine (Chemical Antagonist)

2. Oral Zinc

30

Triad of Meniere Disesae

1. Sensorineural hearing loss

2. Vertigo

3. Tinnitus

31

Which type of frequency (low vs. High) is lost in Meniere Disease?

Low

32

Cause of Meniere Disease

Increase in the volume of ENDOLYMPH

33

Will Meniere Disease present with Nystagmus?

NO

34

What is Charcot triad? Which disease is it related to?

Bacterial Cholangitis

1. Fever

2. RUQ Pain

3. Jaundice

35

Will you see jaundice in Choledocolithiasis?

NO

36

What type of vitamin deficiency presents with Lesch-Nyhan Syndrome? Explain.

Vitamin B9 and B12 (Hypersegmented Neutrophils)

You are inhibiting the recycling of purines, the body then relies on DE NOVO synthesis which will deplete the Vitamin B9 and B12 levels

37

What type of adverse blood cell will you see on a blood smear in a patient with Lesch-Nyhan Syndrome?

Segmented Neutrophils

38

Beta-blockers can ______ in pts with Hyperosmolar Hyperglycemic State

Mask Tachycardia

39

"Chest x-ray shows scattered opacities, likely calcifications, in the peripheral lymph nodes of the upper lobes."

Silicosis

40

Chemical antagonist for Lead

EDTA

41

Chemical antagonist for Wilsons Disease

D-Penicillamine

42

Chemical antagonist for Iron

Deferoxamine

43

Neurologic deficits due to a vascular infarct and you see the tongue of the pt is deviating upon protrusion. What are you automatically thinking about?

Medial Medullary Syndrome

44

An infarct of the __________ produces contralateral weakness in an upper motor neuron pattern (due to damage to the corticospinal tract in the medullary pyramids), which is seen with this patient’s hyperreflexia in the arm and leg. Loss of proprioception and vibratory sensation (due to damage to the medial lemniscus) occurs below the neck, while sparing the face.

Medial Medulla

45

Which artery is involved in Medial Medullary Syndrome?

Anterior Spinal Artery (@ the medulla)

46

Which enters the CNS more rapidly? (Direct or Indirect Sympathometics)?

INDIRECT

47

Which has a better Bioavaliability? (Direct or Indirect Sympathometics)

DIRECT

(They are normally given IV)

48

Which are longer lasting? (Direct or Indirect Sympathometics)

INDIRECT

49

Which bug is related to Aspiration Pneumonia?

Peptostreptococcus

(i.e. Bacteroides fragilis and Prevotella)

50

Clinical presentation of Aspiration Pneumonia?

Foul Smelling breath

(In alcoholics or unconscious patients)

51

Name the 2 dominant mutations present with Turcot Syndrome

1. APC (FAP + Medulloblastoma)

2. MLH1 DNA mismatch repair gene (FAP + Glioblastoma Multiforme)

52

Two lab tests that you can order to diagnose HELLP syndrome associated with prengnancy

1. Liver Function Tests

2. Blood Smear (hemolysis)

53

Perineal tear during pregnancy and problems with holding in stool

External Anal Spincter

54

Damage to the Levator ani muscles during childbirth will lead to ________ .

Urinary Incontinence

(typically)

55

Pt hasn't had a period but the ovaries and uterus are normal. She also has hypertension. What are you thinking?

Congenital Adrenal Hyperplasia

(17-Hydroxylase Deficiency)

56

Pts with HLA-DR5 have an increased risk of developing (2)

1. Hashimotos Thyroiditis

2. Pernicious Anemia

57

The vaccine against Haemophilus influenzae targets ________ .

Polyribosylribitol Phosphate

(i.e. Type b polysaccharide capsule)

58

The vaccine against Salmonella Typhi targets ____________ .

Vi Capsule

59

Symptoms of Hypoglycemia (2)

1. Diaphoresis

2. Tachycardia

60

Which drug should you use cautiously in Pts with CHF due to its ability to Mask Hypoglycemia?

Beta-Blockers

61

Typical Presentation of Pts with Hyperosmolar Hyperglycemic State

1. Dehydrated (i.e Dry mucous membranes, decreased skin tugor)

2. Tachycardia

62

Describe the various steps of the action potential in SMOOTH muscle.

1. Action potentials depolarize the myocyte membrane (activating voltage-gated calcium channels)

2. Calcium then binds and activates calmodulin (activates myosin light-chain kinase (MLCK))

3. MLCK phosphorylates MYOSIN (allowing it to form cross bridges with actin)

4. Resulting in muscle contraction

63

Where does calcium bind in a Skeletal Muscle vs a Smooth Muscle?

Skeletal: Troponin C

Smooth: Calmodulin (which will activate myosin light-chain kinase)

64

Best treatment for ventricular fibrillation?

Class IB

(i.e. Lidocaine or Mexiletine)

65

Which drug class is the BEST to use post-MI for acute ventricular arrhythmias?

Class IB

(i.e. Lidocaine or Mexiletine)

66

Which drug class is used in REFRACTORY ventricular tachycardia as a "last resort" medication?

Class IC

(i.e. Flecainide and Propafenone)

67

Which drug class is contraindicated in structural and iscehmic heart disease?

Class IC

(i.e. Flecainide and Propafenone)

68

Drugs that are contraindicated in pregnancy

“MCAT”

Metronidazole

Chloramphenicol

Aminoglycosides

Tetracycline

69

Symptoms of Hypoglycemia

“TIRED”

Tachycardia

Irritability

Restlessness

Excessive Hunger

Diaphoresis / Depression

70

What is the cause of Thyrotoxicosis Factitia?

Taking too much Endogenous Levothyroxine

71

What is the patient population who is at risk for taking too much Levothyroxine?

Fitness Ethusiasts that are trying to lose weight

72

Thyroid Functional studies associated with "Thyrotoxicosis Factitia"?

TSH - Decreased

T3 - Increased

T4 - Increased ("Free thyroxine")

73

At what % of arterial blockage will you see stable angina?

> 70%

74

Which drug has the adverse side-effect of fat redistribution, predominately around the face? (it's not glucocorticoids)

Protease Inhibitors

75

If the anterior or posterior tibial artery is occluded, which artery in the foot is going to ensure adequate profusion?

Arcuate Artery

76

Which artery in the foot is a branch off of the Dorsal Artery of the foot and sends perforating branches down to the plantar artery of the foot?

Arcuate Artery

77

What is the lead point in pts with Intestinal Intussusception?

Hyperplasia of the Peyers Patches

78

What is the function of Peyer's Patches in the Intestine?

M cells within the Peyers Patches take up antigens and PRESENT them to B-Cells which will then secrete IgA antibodies in response to that antigen

79

First response to hypovolemic shock due to hemorrhage

Tachycardia

80

How to diagnose C. Difficile

Toxin Assay

81

If you have a mutation in the ______ receptor, HIV will not be able to enter the cells via the macrophages

CCR5

82

Ziehl-Neelsen Stain is used for which organisms? (3)

1. Mycobacteria

2. Nocardia

3. Cryptosporidium oocytes

(i.e. Acid-Fast bacteria/protozoa)

83

Giemsa stain is used for which organisms? (5)

"Certain Bugs Really Test my Patience"

1. Chlamydia

2. Borrelia

3. Rickettsia

4. Trypanosomes

5. Plasmodium

84

What does Periodic acid-Schiff stain?

Stains Glycogen and mucopolysaccharides

"PaSs the sugar"

(Dx of Whipple Disease / Tropheryma whipplei)

85

MOA of Theophylline

Phosphodiesterase Inhibitor

(Increases cAMP intracellularly)

86

What type of drug should you use to treat an overdose of Theophylline

B-Blocker

(It will decrease cAMP levels)

(Use a cardioselective B-Blocker if the pt has Asthma)

87

Why would a baby, who is receiving formula and breast feeding, develop anemia?

Breast milk does not have much IRON in it and you can develop a MICROCYTIC anemia if you do not supplement

88

How do you develop a Microcytic Anemia?

Cell volume decreases due to heme synthesis impairment caused by a lack of iron (or other causes)

89

Explain how "severe underperfusion of peripheral muscles" can lead to an elevated anion gap acidosis

Causes elevated levels of LACTIC ACID

(mud piLes)

90

Normal Anion Gap

8-12

91

What is going to cause a metabolic acidosis with a HIGH anion gap?

"MUDPILES"

Methanol

Uremia

Diabetic ketoacidosis

Paraldehyde

Iron, Isoniazid

Lactic acidosis (i.e. anerobic metabolism of muscles or underperfusion of peripheral muscles)

Ethylene glyco (i.e. anti-freeze)

Salicylates (i.e. aspirin)

92

Which drugs most commonly have zero order kinetics?

“Zero PEAs”

Phenytoin

Ethanol

Aspirin

93

Treatment for Kaposi Sarcoma

Interferon alpha2b

94

Ulcerated lesion in the nose associated with Hemoptasis and kidney problems

Wegners Granulomatosus

95

Which two diseases can present with an absent thymic shadow?

SCID

DiGeorge Syndrome (Has cardiac and facial problems too!)

96

Why do pts have multiple fractures in CKD?

Pts with CKD have elevated Ca2+ levels and leads to elevated PTH secretion

Phosphate will then bind to Calcium in the blood and cause HYPOCALCEMIA

PTH also binds to osteoblasts which will increase RANKL which will inhibit the release of osteoprotegrin and increase osteoclastic activity.

97

5% of _______ present with MEN1, but they are mainly sporadic

VIPomas

98

Clinical presentation of VIPomas

Diarrhea with HYPOKALEMIA

Muscle weakness, tetany and possible paralysis due to Hypokalemia

99

Vitamin deficiency with perifollicular and subperiosteal hemorrhage

Vitamin C

100

Why is AST higher than ALT in pts with yellow fever?

Damage to muscle!

101

Triad of Plummer Vision Syndrome

1. Iron deficiency Anemia

2. Atrophic Glossitis

3. Esophageal Webs

102

Painful mucosal lacerations of the distal esophagus

Mallory-Weiss Tears

103

Which one is more common: Hodgkin or non-Hodgkin Lymphoma?

Non-Hodgkin! (90%)

104

Triad for normal pressure hydrocephalus

1. Urinary Incontinence

2. Gait ataxia

3. Dementia

("Wet - Wacky - Weird")

105

Painful swallowing/odynophagia can present with compression of which cranial nerves and ischemia to which part of the brainstem?

CN IX and X

Ischemia to the medulla

106

_______ is administrated in Pts to increase the cytotoxicity of 5-FU

Thymidine

107

Tender raise lesions on fingers and toe pads

Osler Nodes

108

Round, white spots on the retina surrounded by hemorrhage

Roth Spots

109

Small blood clots that run vertically under the fingernails

Splinter Hemorrhages

110

Modified Duke Criteria

Dx of Subacute Bacterial Endocarditis

1. Predisiposing factor (history of mitral valves prolapse)

2. Temperature >38C

3. Vascular phenomena (patient has signs of microemboli)

4. Immunologic phenomena (patient has Osler nodes - tender, raised lesions)

5) Microbiologic evidence (most likely organism is Strep Viridans)

111

What are the various things (3) seen with microemboli?

1. Osler Nodes

2. Roth Spots

3. Splinter Hemorrhages

112

Pneumonic for infective endocarditis

"FROM JANE"

Fever

Roth Spots

Osler Nodes

Murmur

Janeway Lesions

Anemia

Nail Hemorrhage (splinter hemorrhages)

Emboli

113

First-Line treatment for SEVERE nausea and vomiting due to chemotherapy treatment

Ondansetron

114

Treatment for motion sickness

Acetylcholine antagonist

(i.e. Scopolamine)

115

Tx for nausea and vomiting but you have to watch out in pts with Parkinsons Disease

Metoclopramide

116

Treatments for post-operative associated nausea or in vestibular/labyrinthine disorders

Histamine Antagonists

117

Which laryngeal muscle develops from Pharyngeal arch 4?

Cricothyroid Muscle

(innervated by the SUPERIOR LARYNGEAL nerve)

118

Pharyngeal Pouch 1 gives rise to _______ .

External auditory meatus

119

Pharyngeal Pouch 2 gives rise to ________ .

Epithelial lining of the Palatine Tonsils

120

Pharyngeal Pouch 3 gives rise to _______ .

1. Inferior Parathyroids (Dorsal Wings)

2. Thymus (Ventral Wings)

121

Pharyngeal Pouch 4 gives rise to _______ .

1. Superior Parathyroids (Dorsal Wings)

2. Ultimobrachial body and Parafollicular C cells of the Thyroid (Ventral Wings)

122

DiGeorge Syndrome involves aberrant development of which Pharyngeal Pouches?

3rd and 4th

123

If a pt suffers complete thrombosis to the Basilar artery, they are most likely going to have ______ .

Locked-in Syndrome

124

Presentation of Locked-in Syndrome

Completely Paralyzed but consciously intact

Pts can feel, hear, see and understand everything going on in their environment

125

Locked-in syndrome involves which tracts?

1. Corticospinal Tracts

2. Corticobulbar Tracts

126

Which muscle is the only ABductor of the vocal cords?

Posterior Cricoarytenoid Muscles

(innervated by Recurrent Laryngeal Nerve)

127

Patient with episodic flushing and diarrhea, in combination with shortness of breath

Malignant Carcinoid Syndrome

128

Typically, 90% of carcinoid tumors originate from the ________ or _______ .

Distal Ileum

Appendix

129

Carcinoid tumors are typically asymptomatic until _________ .

Metastasis to the liver occurs

130

Why is carcinoid syndrome typically asymptomatic before it spreads to the liver?

Metabolically active metabolites are normally INACTIVATED by the liver

Once liver mets has occured, the metabollically active metabolites will be secreted directly into the systemic circulation via the HEPATIC PORTAL VEIN

131

What are the main (3) vasoactive substances and their effects that are present in Carcinoid syndrome?

1. Serotonin (causes fibrosis in the tricuspid and pulmonary valve)

2. Gastrin (nausea and diarrhea)

3. Histamine (flushing of the skin)

132

MOA of Procarbazine

MAO-Inhibitor

133

Physiologic function of Angiotensin II

Binds to Angiotensin Receptor Type I (GPCR coupled to Gq)

Activates Phospholipase C (PIP2 --> IP3 + DAG)

IP3 opens Ca2+ channels and increases influx

DAG goes on to activate protein kinase C

Net Result: Smooth Muscle Contraction @ the EFFERENT renal arteriole

134

Meckels Diverticulum is cause by failure of the _______ to obliterate. Which artery supplies it?

Vitilline Duct

Superior Mesenteric Artery

135

Components of the Glomerular Filtration Barrier

1. Endothelial Cells

2. Glomerular Basement Membrane

3. Epithelial Podocytes

136

Pathogenesis of Minimal Change Disease

Normally presents after a Cold

Loss of HEPARIN SULFATE (negatively charged)

No longer can prevent NEGATIVELY charged molecules (i.e. albumin) from being filtered into the urine

137

Which lipid lowering drug is related to Gallstone formation?

Gemfibrozil

138

MOA of Gemfibrozil

Activates PPAR-alpha

(i.e. increases Triglyceride clearance)

139

How does Gemfibrozil cause Gallstone formation?

Associated with cholesterol gallstones, by reducing cholesterol solubility and reducing bile acid synthesis secondary to inhibition of 7-α-HYDROXYLASE

140

Schistosomiasis will lead to which type of cancer?

Squamous Cell Cancer

141

Smoking will lead to which type of cancer in the bladder?

Transitional Cell Cancer

142

MOA Bupropion

Atypical Antidepressant

143

Contraindication for Bupropion

Pts with Anorexia Nervosa

(i.e. Pts that have lowered thresholds for SEIZURES)

144

Cause of cri-du-chat syndrome

Chromosome 5 deletion

145

Thrombus in the Hepatic vein is known as ______ .

Budd-Chiari Syndrome

146

Where is vitamin K produced?

Bacteria in the GI Tract

147

Multiple courses of antibiotics can _____ . Which will cause a _______ deficiency.

Kill the Bacteria in the GI Tract

Vitamin K

148

Drug Class:

Methicillin, dicloxacillin, oxacillin, and nafcillin

Penicillinase-Resistant Penicillin

149

HLA associated with Bechet Disease

HLA-B51

150

What is Bechet Disease?

Autoimmune vasculitis characterized by ORAL and GENITAL aphthous ulcers

151

Define Trismus

Sustained skeletal muscle contraction of the jaw

(i.e. Lock Jaw)

152

Exotoxin released by Clostridium Tetani

Tetanospasmin

153

Define Tenesmus

Sensation of the need to empty the bowel accompanied by pain and cramping, although there is little stool to pass

154

What is Tenesmus associated with?

It is usually associated with INFLAMMATORY (either infectious or noninfectious) diseases of the bowel

155

What is the physiologic change that happens in the airways when Pts with Emphysema breath with PURSED LIPS?

Increased pressure in the smaller airways

Increases the pressure in the LARGER airways by increasing resistance so that it will keep them open during expiration

156

What happens to compliance of the lungs in Pts with Emphysema?

INCREASED

(Increased ELASTASE activity causes the destruction of Elastic Fibers)

157

What happens to recoil of the lungs in Pts with Emphysema?

Decreased

158

What happens to the Diffusing capacity of the lungs for carbon monoxide (DLOC) in pts with Emphysema?

Decreases

(Due to the destruction of Alveolar Walls)

159

Diagnostic Criteria for Chronic Bronchitis

Productive cough for > 3 MONTHS in a year for > 2 CONSECUTIVE years

160

What is the REID index and in which disease will it be increased?

Thickness of mucosal gland layer to thickness of wall between epithelium and cartilage

Increased >50% in Chronic Bronchitis

161

First-Line intervention for Pts with Tourrette's Syndrome

Behavioral Interventrions

162

Second-Line intervention for Pts with Tourrette's Syndrome

Antipsychotics

(i.e. Haloperidol, pimozide and Risperidone; Also Clonidine)

163

Which two metastatic cancers can cause intracranial hemorrhages?

1. Renal Cell Carcinoma

2. Malignant Melanoma

164

MOA Enfuviritide

Prevents ENTRY of viral particles into the target host cell

165

MOA Maraviroc

Prevents ATTACHMENT of virus to the target host cell

166

MOA of "-gravir" drugs

(i.e. Dolutegravir, Elxitegravir, Raltegravir)

Block incorporation of the viral genome into the host cell genome

(i.e. Integrase Inhibitors)

167

MOA of "-navir" drugs

(i.e. Atazanavir, Darunavir, Fosamprenavir, Indinavir, Lopinavir, Ritonavir, Saquinavir)

Interfering with posttranslational processing of viral proteins

(i.e. Protease Inhibitors)

168

1st aortic arch

Maxillary artery bilaterally

169

2nd aortic arch

Hyoid and Stapedial Arteries bilaterally

170

3rd aortic arch

Portions of Proximal internal and distal Common carotid arteries bilaterally

171

5th aortic arch

DEGENERATES

172

Left 4th aortic arch

Portion of the adult aortic arch that is DISTAL to the point at which the fetal Ductus Arteriosus originates

173

Right 4th aortic arch

Right proximal subclavian artery

174

Left 6th aortic arch

Ductus Arteriosus

175

Right 6th aortic arch

Proximal portion of the right pulmonary artery

176

Common presentations of MS

1. Sensory and motor deficits, often in the extremities (usually asymmetric, and can lead to bowel and bladder dysfunction)

2. Optic neuritis that can result in visual loss or changes such as internuclear ophthalmoplegia

3. Cerebellar abnormalities, which can include ataxia, nystagmus, and tremor.

177

MOA: Reduced hepatic triglyceride and VLDL Synthesis

Niacin

178

MOA: Peroxisome proliferator activated receptor-α agonist

Gemfibrozil

179

MOA: Inhibition of the 3-hydroxy-3-methylglutaryl coenzyme A reductase

Statins

180

MOA: Increased excretion of bile acids in the stool

Cholestyramine

181

MOA: Inhibition of cholesterol absorption in the gastrointestinal tract

Ezetimibe

182

Common symptoms that present with Cluster Headaches

1. Lacrimation

2. Conjunctival injection

3. Ptosis

4. Nasal congestion

183

Which enzymes does Lead inhibit?

1. ALA Dehydratase

2. Ferrochelatase (Final Step in Heme synthesis)

184

Pneumonic for which way the Hb-O2 curve shifts

"CADET, face Right!"

Carbon Dioxide

Acidosis

2,3 - DPG

Elevation

Temperature increase

185

Periodic acid–Schiff-positive remnants of autophagic vacuoles, or Bunina bodies, are found in the anterior horn of the spinal cord in patients with _______ .

ALS

186

Eosinic intracytoplasmic inclusions are seen in patients with ________ .

Rabies

187

Pancytopenia + Skeletal abnormalities = _________

Fanconi Anemia

188

Cause and mode of inheritance of Fanconi Anemia

Autosomal Recessive

Cells cannot properly repair a type of DNA damage known as "interstrand cross-links"

189

Best treatment for pts with Fanconi Anemia

Bone Marrow Transplant

190

MOA of Celecoxib

Inhibits COX-2

191

Function of COX-2

Found in inflammatory cells and vascular endothelium and mediates inflammation and pain

192

Vascular Ehlers-Danlos Syndrome (Type IV) is associated with a defect in the formation of ______ .

Type III procollagen

193

Pts with Vascular Ehlers-Danlos Syndrome (Type IV) are a high risk of developing _________ .

Berry Aneurysms

194

Epidermoylsis bullosa is associated with an abnormality in _______ .

Keratin 14 and 5

195

Fibrillin in on which chromosome?

15

196

Mode of inheritance of Vascular Ehlers-Danlos Syndrome (Type IV)

Autosomal Dominant

197

Treatment for Carbon Monoxide Poisoning

Oxygen Therapy

198

Adverse effect of Oxygen therapy when treating pts with Carbon Monoxide Poisoning

Formation of Free Radicals

Absorptive Atelectasis

199

Explain the process of Absorptive Atelectasis

Absorptive atelectasis occurs when high FiO2 causes a large volume of nitrogen in the lungs to be replaced with oxygen, reducing the volume of the alveoli, and resulting in alveolar collapse

200

Positive symptoms of Schizophrenia are associated with an increase in which neurotransmitter?

Dopamine

201

Decrease in GABA is associated with ______ .

Anxiety Disorders

202

Decrease in Ach is associated with _______ .(2)

1. Alzheimer's Disease

2. Huntington's Disease

203

Decrease in Serotonin is associated with ______ .

Depression

204

Increase in Norepinephrine is associated with _______ .

Anxiety Disorders

205

Which amino acids are NOT being reabsorbed when you have stones that are Hexagonal in shape?

"COLA"

Cystine

Ornithine

Lysine

Arginine

206

Undescended testicle(s) are associated with which an increased risk for which type of cancer?

Germ Cell Tumors

207

What develops after fever has resolved as a bright, blanchable erythema on the cheeks (“slapped cheeks”) with perioral pallor?

Erythema Infectiosum

208

Drug Class:

Chlordiazepoxide

Benzodiazepine

209

Use of Chlordiazepoxide

Used in preventing and treating delirium tremens due to its LONG half-life and ACTIVE metabolites, leading to decreased peaks/troughs and fewer withdrawal symptom

210

Difference between DLBCL and SLL

HISTOLOGY

DLBCL - large, basophilic cytoplasm, disorganized cell morphology

SLL - diffuse infiltrate of small, round, mature-appearing lymphocytes with MINIMAL cytoplasm

211

Histology shows large cells with prominent nucleoli and pale to clear "halos" of cytoplasm in the epidermis

Paget's Disease

212

Which organelle will load MHC I?

Rough ER

213

CT Findings: Perisigmoid inflammatory changes, such as fat stranding

Diverticulitis

214

Small intracellular yeast

Histoplasmosis

215

Duodenal ulcers affect which artery?

Gastroduodenal A.

216

Explain the "3-2-1" criteria for Lynch Syndrome

"3" family members with Lynch-associated cancers

Spanning "2" generation

"1" relative diagnosed before age 50 and 1 first degree relative with the diagnosis

217

FAP/Lynch syndrome + malignant CNS tumor

Turcot Syndrome

(i.e. Turcot = TURBAN)

218

Autosomal dominant syndrome featuring numerous hamartomas throughout GI tract, along with HYPERPIGMENTED mouth, lips, hands, genitalia. Associated with risk of breast and GI cancers

Peutz-Jeghers Syndrome

219

Cause of Lynch Syndrome

Mutations in Mismatch Repair genes (i.e. MLH1)

220

_______________ is characterized by a high blood level of methemoglobin, in which the oxygen-carrying iron is present in the oxidized (ferric Fe3+) state instead of the reduced (ferrous Fe2+) state

Methemoglobinemia

221

MOA of Dapsone

Oxidizing Agent

222

Dapson can cause _________ .

Methemoglobinemia

223

Treatment of Methemoglobinemia

Methylene Blue

224

Inhaled corticosteroids used in Asthma patients can decrease the transcription of inflammatory cytokines and cause ________ .

Oral Candidiasis

225

Define Aniridia

Partial or complete lack of the iris

226

Severe abdominal pain, nausea, hematemesis, hypotension, and tachypnea are signs of ____________ .

Acute Iron Overload

227

Tx of Acute Iron Overload

Deferoxamine

228

CD-18 = _____ .

LFA-1 integrin

229

"SNOUT"

Sensitivity to RULE OUT a disease

230

What is the probability of a Pt truly having cancer?

POSITIVE PREDICTIVE VALUE

231

Which structures run in the CENTER of the bronchopulmonary segments?

1. Tertiary Bronchus

2. Arteries

232

Which structures run in the PERIPHERY of the bronchopulmonary segments?

1. Veins

2. Lymphatics

233

Contraindication to tPA therapy

Blood pressure >185/90 mmHg

234

Pathogenesis of Wilsons Disease

Decreased Copper secretion in to the bile due to a mutation in the ATP7B gene which encodes for a copper transporter that functions mainly in the liver

235

Younger Pt with multiple angiokeratomas (the small, reddish-black papules on his abdomen and scrotum), acroparesthesia (intermittent peripheral paresthesias), and heat intolerance.

Fabry's Disease

236

Enzyme deficient and accumulated substrate in Fabry's Disease

alpha-Galactosidase A

Ceramide Trihexoside

237

Non-specific serum Ab found in Pts with Treponema pallidum can bind to __________ which is found in the _________ of the cell.

Cardiolipin (aka diphosphatidylglycerol)

Inner Mitochondrial Membrane

238

Enflurane is more likely to cause _______ when compared to the other inhaled anesthetics

Seizures

239

___________ is transmitted via the fecal-oral route, and infection rates are high in sub-Saharan Africa.

Hepatitis E

240

Which hepatitis can cause hepatic tissue necrosis and is associated with pregnancy women?

Hepatitis E

241

Treatment for Pts with anemia due to SLE

Administration of EPO

242

Treatment for Pts with anemia due to aplastic anemia and Fanconi anemia

Bone marrow Transplant

243

Tx for Pts with Iron deficiency anemia

Ferrous Sulfate

244

Administration of alkylating agents (I.e. cyclophosphamide) to pts with ________ will cause hemorrhagic cystitis.

Franconi Anemia

245

Clinical presentation:

Short stature

Hyperpigmentation

Cafe haul air spots

Increased MCV

Fanconi Anemia

246

Cause of Fanconi Anemia

Defect in a multiprotein complex that is required for HOMOLOGOUS RECOMBINATION DNA REPAIR

247

SBLA Syndrome

Sarcoma - Breast - Leukemia - Adrenal Gland

(Aka Li-Fraumeni Syndrome)

248

Mutation in Li-Fraumeni Syndrome

TP53

249

Tanner Stages

1 - Prepuberty

2 - Breast Bud stage with Downy Hair

3 - Coarse pubic hair

4 - Areola rising

5 - Pubic hair spreading to medial thigh

250

Thalidomide is used to treat ___________.

Multiple Myeloma

251

MOA of Cilastatin

Inhibitor of dehydropeptidase at the Proximal Tubule of the kidneys

252

Function of Cilastatin

Boost the efficacy of Imipenem

(Broad spectrum antibiotic from the Carbapenem class)

253

Which carbapenem is resistance to dehydropeptidase Inhibitors (I.e. Cilastatin)

Meropenem

254

What do Obstructive and Restrictive Lung Diseases have in common?

Decreased Vital Capacity

255

Most common cause of Meningitis in Pts around College age (I.e. 18-24)

Neisseria Meningitidis

256

Blood smear:

“Lymphocytes with multiple long cytoplasmic projections”

Hairy Cell Leukemia

257

Treatment for MS

Interferon Beta

258

Antibodies in Guillain Barre syndrome are directed towards __________.

Endoneurium of peripheral nerves

259

Presentation of brain tumor:

Does not invade the parenchyma

Smooth demarcation

Originates next to dura

Meningioma

260

Meningiomas arise from ___________.

Arachnoid Mater

261

Brain tumor with neovascular proliferation

Glioblastoma Multiforme

262

Brain tumor with undifferentiated tumor cells

Metastasis to the brain

263

Rickettsiales Bacteria species that presents with “berry like” cytoplasmic inclusions in Neutrophils

Ehrlichia chaffeensis

(I.e. Ehrlichiosis)

264

Which DM medication can have a Disulfiram-like reaction?

First Generation Sulfonylurea

(I.e. Tolbutamide)

265

First-line Treatment for Metastatic Prostate Cancer

Leuprolide and Flutamide

(Flutamide is a nonsteroidal antiandrogen that competitively inhibits androgens at the testosterone Receptor)

266

Most common cellular cause of Cystic Fibrosis

Class II mutation

(Impaired CFTR channel processing and trafficking from the REF to the Golgi Apparatus)

267

Non-caseating granulomas + IBD = ____________

Crohn’s Disease

(Typically Painful!)

268

Normal range for anion gap

8 - 16

269

Granulocyte Colony Stimulating Factor (G-CSF) binds to which type of Receptor?

Transmembrane Receptor

(It is a glycoprotein Growth Factor)

270

Chromosome for BRCA1

17

(Same as NF-1)

271

BRCA-2 Chromosome

13

272

Wilms Tumor Chromosome

11

273

Which type of cancer in the colon can increase your risk for other cancers?

Lynch Syndrome

(80% risk of colorectal cancer and others; I.e. GI Tract, Urinary Tract, Female Reproductive Tract)

274

Dissection or thrombosis of the vertebral or posterior inferior cerebellar artery classically results in _____________.

Lateral Medullary Syndrome

275

Manifestations of ______________ include:

hoarseness

dysphagia

ipsilateral Horner syndrome

absent pain and temperature sensation from the ipsilateral face and contralateral body

vomiting

vertigo

ataxia

Lateral Medullary Syndrome

(Aka Wallenberg Syndrome)

276

Tension Pneumothorax can cause _________

JVD

(Because of buildup of intrathoracic pressure, there is a decrease in venous return and thus decreased cardiac output, which results in hypotension)

277

Essential fatty acids

Linoleic and Linolenic Acid

278

HLA-BW2W

Kawasaki Disease

279

HLA-8

Graves’ disease

280

Histology of Pagets Disease

Large cells with clear halos

281

Bulky arytenoid cartilage

Laryngomalacia

282

Arytenoid cartilage is derived from which pharyngeal arch?

6th

283

Tx for moderate-to-severe Alzheimer’s disease

Memantine

284

MOA of memantine

NMDA Receptor Antagonist

285

MOA Lorcaserin

Selective Serotonin 2C Receptor Agonist

286

Only FDA drug to pass a phase 3 clinical trial as a selective serotonin 2C Receptor Agonist in aiding weight loss

Lorcaserin

287

Arachnoid granulations drain into _________

Superior Sagittal Sinus

288

Which way does Uvua deviated?

Contralateral side of CN X lesion

289

Effect of Non-selective Beta Blockers on SVR

INCREASE

290

Without insulin in Pts with DKA, __________ can no longer be inhibited and you get an increase in Free Fatty Acids which will lead to an increase in Ketone Bodies

Hormone sensitive Lipase