Quiz 46,47,48 Flashcards
(150 cards)
1
Q
How does one acquire brucellosis?
A
Drinking contaminated milk or coming in contact with infected livestock
2
Q
What is fancisella tularensis?
A
Gram negative coccobacillus
3
Q
What is the disease presentation of ulceroglandular tularemia?
A
Rupturing pustule followed by an ulcer with involvement of regional lymph nodes
4
Q
How does one acquire ulcerglandular tularemia?
A
Handing rabbits, deer or their skins, or from tick bites that fed on the rabbits or deer.
5
Q
What is the geographic location of fancisella tularensis? What is the treatment?
A
Arkansas/Missouri; treat with stretomycin
6
Q
What is the inheritance pattern of Friedreich ataxia?
A
Autosomal recessive, resulting in trinucleotide repeat expansion.
7
Q
Why is CN II susceptible to MS?
A
Myelinated by oligodendrocytes
8
Q
What is the inheritance pattern of Fragile X syndrome?
A
X-linked dominant – resulting in trinucelotide repeat of CGG
9
Q
What physical features are seen in Fragile X syndrome?
A
Long and narrow face with prominent forehead and chin, large ears, testicular enlargement.
10
Q
What are affected by prevalence?
A
PPV and NPV
11
Q
Decline in prevalence affects negative predictive value by…
A
Increasing the NPV
12
Q
CDKN2A loss of function mutation results in what?
A
Melanoma
13
Q
What is the intracellular form on chlamydiae? Extracellular form?
A
Reticulate bodies = intracellular; elementary bodies = extracellular
14
Q
What chromosomal abnormality causes cri-du-chat syndrome?
A
Deletion of the short arm of chromosome 5 (5p-)
15
Q
What cardiac defect is seen in Cri-du-chat?
A
Ventricular septal defect
16
Q
What is seen on gross examination of the liver in focal nodular hyperplasia?
A
Central scar
17
Q
What population is at risk for focal nodular hyperplasia?
A
Women taking OCPs or exogenous hormones.
18
Q
What is the inheritance pattern of MCAD?
A
Autosomal recessive
19
Q
What deficiency causes accumulation of C8-C10 acylcarnitines?
A
MCAD
20
Q
Why is hyperammonemia seen in MCAD?
A
Body relies on proteolysis, which requires the urea cycle to breakdown ammonia
21
Q
Why is there hypoglycemia in MCAD?
A
Decreased gluconeogenesis due to decreased NADH and ATP and decreased acetyl-CoA
22
Q
MCAD deficiency results in what type of fasting metabolic deficiencies?
A
Hypoglycemic hypoketonic
23
Q
Perfusion to the aorta distal to the coarctation is maintained via collateral flow through what arteries?
A
Internal thoracic (mammary) arteries which give rise to the anterior intercostal arteries
24
Q
What is the cause of X-linked Bruton agammaglobulinemia?
A
Mutation in the cytoplasmic tyrosine kinase
25
What cell line maturation process is blocked in X-linked (Bruton) agammaglobulinemia?
B cell
26
What immunoglobulin(s) is/are deficient in X-linked agammaglobulinemia?
IgM, IgA, IgG
27
What results when the gamma chain of IL-2 receptor is absent?
SCID
28
What is the result of adenosine deaminase deficiency?
SCID
29
Tonic-clonic seizure activity produces what from skeletal muscles?
Lactic acid
30
What is the most common cause of peritoneal carcinomatosis?
Ovarian cancer
31
What is the classic auscultation of ASD?
Mid-systolic ejection murmur at the LUSB and a wide, fixed splitting of the second heart sound
32
What is heard on auscultation of PDA?
Machine-like murmur
33
What is the most common mutation worldwide for CF?
Delta F508 mutation on CFTR gene -- prevents proper protein folding
34
What type of polyp has sawtooth glandular epithelium with proliferation of goblet and columnar epithelial cells?
Hyperplastic polyp
35
What does the thyroid diverticulum give rise to?
The thyroid gland
36
What are the muscles of facial expression developed from?
Second pharyngeal arch
37
What is a never event?
Shocking medical error that should never occur
38
What are the hormonal findings in Turner syndrome?
Increased FSH, increased LH, decreased estrogen, decreased inhibin, and normal growth hormone.
39
What karyotype results in Turner syndrome?
45,X
40
What is the chromosome site involved in FAP?
5q21 = APC gene
41
Is the APC gene an oncogene or tumor suppressor gene?
Tumor suppressor
42
What chromosome is affected in Wilms tumor?
11
43
What chromosome is affected in retinoblastoma? What other cancer is seen?
Chromosome 13, gene Rb; can also see osteosarcoma
44
What is the family and genome of the virus causing mumps?
Paramyxoviridae family; -ssRNA, helical enveloped virus
45
What are members of the paramyxoviridae family?
Measles, mumps, RSV, parainfluenza
46
What does diphtheria toxin do?
Inactivates eukaryotic elongation factor eEF-2
47
A rare AE of ticlopidine?
Neutropenia/agranulocytosis
48
What is the MOA of ticlopidine?
Inhibits ADP from binding to platelet receptors
49
What is the mechanism of action of clopidogrel?
Irreversibly blocks ADP from binding platelets.
50
What does medicare part A cover?
Hospital, nursing facility, hospice and home health care
51
What does medicare part B cover?
Services from physicians and other health care providers, Xrays, labs
52
What are allotypes? What can they be used for?
Minor amino acid differences in the constant domains of antibody molecules; dictated by genetic inheritance and can be used for paternal testing
53
What is Libman-Sacks endocarditis?
Small, granular vegetations on both sides of the leaflets; commonly affects aortic and mitral valve
54
What is the characteristic finding on biopsy of primary biliary cirrhosis?
Chronic granulomatous inflammation leading to destruction of medium-sized intrahepatic bile ducts
55
What antibodies are seen in primary biliary cirrhosis?
Antimitochondrial autoantibodies
56
What labs are elevated in primary biliary cirrhosis?
Alkaline phosphatase and conjugated bilirubin
57
PDSA model stands for what? What simple concept does it use?
Plan, do, study, act; "trial and error" concept
58
Paralysis to the genioglossus muscle results in what on physical exam?
Deviation toward side of lesion
59
What contains the epithelial stem cells?
The dermis skin appendages (eg hair follicles)
60
The heterophile antibody test is what type of assay?
Latex agglutination assay
61
What is used to diagnose EBV infectious mononucleosis?
Heterophile antibody test
62
What is Trousseau's sign?
Carpopedal spasms due to cutting off blood supply to hand with blood pressure cuff or tourniquet
63
What is a complication of subtotal thyroidectomy?
Transient hypocalcemia due to accidental removal/damage to parathyroid glands
64
What is the genotype and family of adenovirus?
dsDNA virus, linear, non-enveloped, icosahedral
65
Name 5 drugs that can cause priapism
Hydralazine, prazosin, chlorpromazine, sildenafil, tadalafil
66
What is Couvoisier sign? What does it suggest?
Non-tender, palpable gallbladder; suggests choledocholithiasis
67
What is lysogenic conversion?
Virulence is modified by the stable presence of phage DNA in the bacterial cell
68
List the examples of lysogenic conversion:COBEDS
```
Cholera toxin
O antigen of Salmonella
Botulinum toxin
Erythrogenic toxin of S. pyogenes
Diphtheria toxin
Shigga toxin
```
69
Why might dorsiflexion be lost when draining a popliteal cyst?
The common fibular (peroneal) nerve is superficial and lies immediately adjacent to the tendon of the biceps femoris.
70
What nerve is responsible for dorsiflexion?
The deep fibular nerve - innervate anterior compartment of the leg
71
What innervates the posterior compartment of the leg?
Tibial nerve
72
What nerve is responsible for sensation to the sole of the foot?
Medial and lateral plantar nerves, both are branches of the tibial nerve
73
What structures course through the popliteal fossa?
Popliteal artery and vein, and tibial nerve
74
HEXA mutation results in what disease?
Tay Sachs
75
What enzyme is deficient in Tay Sachs?
Hexosaminidase A - responsible for degradation of GM2 gangliosides
76
What are characteristic findings on PE in Tay Sachs?
Cherry red spots in macula, blindness, psychomotor retardation
77
What is the inheritance pattern of Tay Sachs?
Autosomal recessive
78
What is the rate limiting step of glycolysis?
Phosphofructokinase 1
79
Smudge cells are characteristic of what disease?
Chronic lymphocytic leukemia
80
What personality disorder is characterized by colorful, exaggerated behavior and excitable shallow expression of emotions?
Histrionic PD
81
Histrionic PD shows what type of behavior?
Draw attention to self, sexually seductive
82
Patients who week constant reassurance from partners may have what type of personality disorder?
Dependent PD
83
What causes pseudoappendicitis?
Yersinia enterocolitica
84
What is yersinia entercolitica? (Gram stain, etc. etc. )
Gram negative rod, non-lactose fermenting, non-H2S producing, oxidase negative
85
How can one acquire an infection with yersinia entercolitica?
Contaminated, unpasteurized milk; contaminated pork
86
What temperature does yersinia entercolitica grow at? What is unique about this organism in temperature?
Grows well at less than body temp (77 F or 25 C); motile at 25 C and nonmotile at 37 C
87
What is the cause of Chagas disease?
Trypanosoma cruzi
88
Chagas disease can cause what?
Megaesophagus, megacolon, cardiomyopathy/cardiac failure
89
What type of collagen makes articular hyaline cartilage?
Type II collagen
90
What type of collagen makes bone?
Type I collagen
91
What is the largest intestinal roundworm?
Ascaris lumbricoides
92
What type of blot is used to identify protein-DNA interactions?
Southwestern blot
93
What muscle(s) is/are innervated by the spinal accessory nerve?
Trapezius and sternocleidomastoid
94
What are the most common cerebellar tumors in children?
Pilocytic astrocytoma and medulloblastoma
95
Cyst with a mural nodule is seen on CT of brain, what is it?
Pilocytic astrocytoma
96
What disease is pilocytic astrocytoma strongly associated with?
Type 1 neurofibromatosis
97
What is a histiopathologic clue seen in pilocytic astrocytomas?
Rosenthal fibers - corkscrew-shaped, intensely eosinophilic structures deriving from accumulation o alpha-beta crystallin with astrocytic processes
98
What stain can be done for pilocytic astrocytomas?
Glial fibrillary acidic protein (GFAP)
99
Perivascular pseudorosettes
Ependymoma
100
Where is a medulloblastoma found?
Located in the midline posterior fossa and infiltrates the cerebellar vermis
101
What can be seen histologically in a medulloblastoma tumor?
Homer-Wright rosettes --considered pseudorosettes
102
What in synthesized in the SER?
Phospholipids, triglycerides, and sterols (including sex hormones)
103
What translocation is seen in follicular lymphoma?
14;18
104
What translocation is seen in mantle cell lymphoma?
11;14
105
What translocation is seen in AML?
15;17
106
What translocation is seen in Burkitt lymphoma?
8;14
107
What is the result of the translocation that occurs in follicular lymphoma?
Hybrid bcl-2/immunoglobulin heavy chain transcript due to t(14;18)
108
What are the two inheritance patterns of Albers-Schonberg disease? When do they present?
Autosomal recessive -- severe form; produces death in childhood
Autosomal dominant -- presents late childhood to early adulthood
109
What cell type is functioning abnormally in Albers-Schonberg disease?
Osteoclasts
110
What is seen on an Xray of osteopetrosis?
Bony widening with partial obliteration of marrow spaces (Ehrlenmeyer flask-shaped lesions seen in long bones)
111
What is the MOA of niacin?
Decreases VLDL, LDL, and triglycerides and increases HDL levels
112
What is the most common SE of niacin?
Facial flushing
113
What is the MOA of statins?
Ihibit HMG-CoA reductase
114
What cord(s) make(s) up the median nerve? Musculocutaneous nerve?
Median arises from a combination of the medial and lateral cords of the brachial plexus;
Musculocutaneous arises from lateral cord only
115
What are three types of antibodies that could be ordered to diagnose SLE?
Anti-smith antibodies, ANA, anti-dsDNA antibodies
116
What type of seizures are treated and prevented by ethosuximide?
Absence seizures
117
What should be used to treat status epilepticus immediately?
Benzos
118
What status epilepticus?
Single unremitting seizure that lasts 5-10 minutes, or frequent seizures without interictal return to baseline state
119
What is overexpressed in follicular lymphoma?
Bcl-2 -- inhibits apoptosis and therefore allows for accumulation of cells
120
What translocation occurs in follicular lymphoma?
14;18
121
What type of HSR is MS?
Type IV - against myelin basic protein?
122
What is the inheritance pattern of Becker muscular dystrophy?
X-linked recessive
123
What is the genetic abnormality in Becker Muscular Dystrophy?
In-frame mutation of an X-linked gene
124
What characteristics are seen in Turner syndrome?
Short stature cystic hygroma (webbed neck)
125
What is the MOA of azoathioprine?
It is a purine antimetabolite and inhibits de novo purine synthesis.
126
What is a major SE of azathioprine?
Bone marrow suppression - leukopenia, thrombocytopenia, anemia
127
What are the TORCH infections?
```
Toxoplasmosis
Other (syphilis)
Rubella
Cytomegalovirus
Herpes simplex virus
```
128
What is the common triad of congenital CMV infection?
Cutaneous hemorrhages ("blueberry-muffin baby"), sensorineural deafness, periventricular CNS calcifications
129
What two congenital infections result in "blueberry muffin baby"?
Rubella and CMV infection
130
In an adult infected with Parvovirus B19, what infection do they have? What are the symptoms?
Rubella; symptoms include 3 day rash and transient arthralgia
131
What is seen on an infant with an in utero rubella infection?
In utero rubella infection can cause mental retardation, PDA, pulmonary stenosis, blindness, encephalitis, sensorineural hearing loss, congenital cataracts and glaucoma, pigmentary retinopathy.
132
What characteristics are seen in congenital syphilis?
Usually results in hydrops fetalis
If survive: Skeletal abnormalities (osteochondritis and periostitis), pseudoparalysis, persistent rhinitis and maculopapular rash (bronzing rash), deafness
133
What vessels contain 60-70% of the total blood volume?
Systemic veins and venules
134
What are the SEs of glucocorticoids?
Hypocalcemia, fluid retention, hypokalemia, hyperglycemia, and hypertension. With chronic use can see osteoporosis
135
What chromosome is BRCA-1 found on?
Chromosome 17q
136
What chromosome is BRCA-2?
Chromosome 13
137
What chromosome is p53 found on?
17p
138
What gene is associated with inherited breast and ovary cancer?
BRCA-1
139
What interleukin is responsible for IgE?
IL-4
140
Clawing of digits IV and V is associated with what nerve injury?
Ulnar nerve
141
Total clawing of the hand is associated with what brachial plexus injury?
Lower trunk injury - combination of median and ulnar nerve
142
What is the function of the lumbricals?
Extension at the interphalangeal joints while simultaneously flexing the metacarpophalangeal joint
143
Lumbricals for digits IV and V are innervated by what nerve?
Deep palmar branch of the ulnar nerve
144
What function does the superficial branch of the ulnar nerve serve?
Cutaneous sensory innervation to the palmar and dorsal surfaces of digit V and the ulnar half of digit IV
145
What is amaurosis fugax?
Transient dimming of vision in entire visual field; can be due to microemboli from atherosclerotic plaques (associated with carotid bruits)
146
Patients with celiacs have increased risk of what skin condition?
Dermatitis herpetiformis
147
Patients with Celiacs have increased risk of what malignancies?
Intestinal lymphoma, esophageal SCC, and non-Hodgkin lymphoma
148
What is seen in RBCs during G6PD deficiency related anemia?
Heinz bodies (blue granules located in periphery)
149
What is the most common primary cardiac neoplasm? What is seen on histology?
Cardiac myxoma; consists of stellate mesenchymal cells with myxoid background and inflammatory and endothelial cells
150
Where is the most common location for cardiac myxoid tumors?
Left atrium
