QUIZ 61 Flashcards

1
Q

Where does HSV-1 remain latent?

A

Trigeminal root ganglion

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2
Q

Where does V1 exit the skull?

A

Superior orbital fissure

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3
Q

Where does V2 exit the skull?

A

Foramen rotundum

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4
Q

Where does V3 exit the skull?

A

Foramen ovale

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5
Q

What is the MOA of cinacalcet?

A

Calcimimetic agent - increases the sensitivity of calcium-sensing receptor CaSR on chief cells; causes a reduction in PTH

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6
Q

What is the MOA of pamidronate?

A

Inhibits osteoclastic activity

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7
Q

What virulence factor of S aureus inhibits opsonization?

A

Protein A - binds to the Fc portion of IgG

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8
Q

What does Protein A helps S. aureus with?

A

Avoid opsonization (and therefore phagocytosis)

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9
Q

What is the characteristic triad of Wiskott-Aldrich syndrome?

A

Thrombocytopenia, immunodeficiency, eczema

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10
Q

In Wiskott-Aldrich syndrome, are IgM, IgE, and IgA increased or decreased?

A

IgM low; IgE and IgA increased

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11
Q

What is the inheritance pattern on Wiskott-Aldrich syndrome?

A

X-linked recessive disease

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12
Q

What is the mutation that occurs in Wiskott-Aldrich syndrome?

A

WASP gene mutation - functions in reorganizing actin cytoskeleton

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13
Q

Malignant hyperthermia can results from what drug?

A

Succinylcholine (and inhaled anesthetic)

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14
Q

What is dantrolene used for?

A

Malignant hyperthermia

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15
Q

What is the MOA of dantrolene?

A

Ryanodine receptor blocker - reduced release of calcium from SR

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16
Q

What happens to the sleep cycle in a patient with major depressive disorder?

A

Increased REM sleep

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17
Q

What neoplasia are seen in MEN 1?

A

Parathyroid, pituitary, pancreatic islet cells

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18
Q

What affect does a prolactin secreting tumor have on gonadotropins?

A

Suppresses them

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19
Q

What is seen on a biopsy of temporal arteritis?

A

Focal granulomatous inflammation with giant cells

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20
Q

What can be seen on a biopsy of polyarteritis nodosa?

A

Fibrinoid necrosis

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21
Q

What nerve lies on the anterior surface of the anterior scalene?

A

Phrenic nerve

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22
Q

What innervates the cricothyroid muscle?

A

Superior laryngeal nerve

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23
Q

What are pigment gallstones made of?

A

Calcium bilirubinate

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24
Q

What are the risk facrots for pigment gallstones?

A

Hepatic cirrhosis, hemolytic anemia, liver fluke infection ( Clonorchis sinesis)

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25
Q

Clonorchis sinensis is usually found where and can cause what?

A

Found in Asia; risk factor for pigment gallstones

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26
Q

What is clonorchis sinensis transmitted?

A

Freshwater snails to fish to humans

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27
Q

FNA of thyroid nodule reveals atypical uniform polygonal neoplastic cells; what is the most likely diagnosis?

A

Medullary carcinoma - derived from parafollicular cells

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28
Q

What cell type are medullary carcinomas of the thyroid derived from?

A

Parafollicular C cells

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29
Q

Baby born with small jaw, prominent occiput, low set ears, short neck, rocker-bottom feet, clenched hands with overlapping fingers, what is the disease?

A

Trisomy 18 - Edwards syndrome

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30
Q

Baby born with holoprosencephaly, cleft lip and palate, and small eyes, what is the disease?

A

Trisomy 13 - Patau syndrome

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31
Q

What is Loeffler endocarditis?

A

Endomyocardial fibrosis with hypereosinophilia syndrome - restrictive heart disease that causes endomyocardial fibrosis with associated eosinophilia

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32
Q

Patient presents with watery diarrhea, and some blood-tinged stool with abdominal cramping and fever. Organism is microaerophilic, oxidase-positive, gram-negative, curved rod with polar flagella. What is it?

A

C jejuni

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33
Q

How is one infected with C jejuni usually?

A

Contaminated poultry

34
Q

What is gram stain and morphology of C jejuni?

A

Gram negative curved rod with polar flagella; also oxidase positive and microaerophilic

35
Q

What drug class is used for the treatment of ulcerative colitis?

A

5-aminosalicylates (eg mesalamine)

36
Q

What is the MOA of mesalamine?

A

Its an aminosalicylate - anti-inflammatory

37
Q

What aminosalicylates are used to treat ulcerative colitis?

A

mesalamine, olsalazine, and sulfasalazine

38
Q

What is an act of commission?

A

Doing something wrong that could potentially lead to undesirable outcome or AE

39
Q

What is a medical error classified as an act of omission?

A

Failing to do the right thing

40
Q

What affects does 21-hydroxylase deficiency have on blood glucose, potassium, sodium?

A

No aldosterone or cortisol = low blood glucose, increased potassium, low sodium

41
Q

What affects does a 21 hydroxylase deficiency have on 46,XX genitalia?

A

Ambiguous - increased 21 hydroxylase substrate goes to production of androstenedione, dihydrotestosterone, and testosterone = virilization

42
Q

What will be markedly elevated in the serum of a patient with 21 hydroxylase deficiency?

A

17-OH progesterone

43
Q

Male fetus with normal differentiation of internal reproductive tract, but external genitalia is feminized. What is the enzyme deficiency?

A

5-alpha reductase

44
Q

5 alpha reductase deficiency results in what phenotype of a 46, XY fetus?

A

Normal internal male reproductive tract; external genitalia is feminized

45
Q

Team STEPPS is a teamwork system that promotes what four skills?

A

Leadership, communication, situation monitoring, mutual support

46
Q

What is the presentation of congenital toxoplasmosis?

A

Chorioretinitis, hydrocephalus, intracranial calcifications

47
Q

What causes congenital toxoplasmosis?

A

Toxoplasma gondii

48
Q

How is congenital toxoplasmosis treated?

A

Pyrimethamine and sulfadiazine

49
Q

What is the mechanism of action of pyrimethamine? What is it used to treat?

A

Inhibits dihydrofolate reductase; used to treat toxoplasmosis

50
Q

What is the mechanism of action of sulfadiazine?

A

Inhibits dihydropteroate synthetase

51
Q

Isolated high alkaline phosphatase can be seen in what diseases? (Name 6)

A

PBC, sclerosing cholangitis, granulomatous hepatitis, abscesses, tumor infiltration, bone disease

52
Q

What is a Virchow’s node? What is it a sign of?

A

Enlarged left supraclavicular lymph node; may be first presentation of intra abdominal cancer (usually stomach)

53
Q

Bladder rupture into peritoneum results in what lab findings of the fluid?

A

High urea, creatinine, ammonia; amylase and lipase are low

54
Q

Fluid from ascites results in what lab findings?

A

High ammonia and alkaline phosphatase; low creatinine and urea

55
Q

How does one differentiate from bladder rupture fluid and ascites?

A

Ascites has low creatinine and urea; bladder rupture has high creatinine and urea

56
Q

Methemoglobinemia in a new born with hypertension is due to what drug administration?

A

Excessive nitric oxide

57
Q

How is methemoglobinemia treated?

A

Methylene blue and increased oxygen

58
Q

What is the MOA of methylene blue?

A

Facilitates conversion of methemglobin back to hemoglobin by NADH-methemglobin reductase

59
Q

What is EDTA? What is it used for?

A

Chelating agent; used to bind and clear heavy metals such as lead

60
Q

What can be used to treat cyanide ingestion?

A

Nitrite

61
Q

In a negative skew, which way is the tail?

A

Left

62
Q

In a positive skew, which way is the tail?

A

Right

63
Q

High-pitched, blowing, early-diastolic murmur, most intense at left sternal border.

A

Aortic regurg

64
Q

Widened pulse pressure and “water-hammer pulse” occur in what murmur?

A

Aortic regurg

65
Q

What is used in the treatment of Wilson’s disease?

A

Penicillamine and trientine (copper chelating agents)

66
Q

What is penicillamine?

A

Copper chelating agent

67
Q

What is trientine?

A

Copper chelating agent

68
Q

What is succimer used to treat?

A

Lead, arsenic, mercury overdose/toxicity

69
Q

What can be used to treat arsenic?

A

Dimercaprol, penicillamine, or succimer

70
Q

What can be used to treat iron toxicity?

A

Deferoxamine

71
Q

What can be used to treat lead poisoning?

A

EDTA, dimercaprol, succimer

72
Q

What can be used to treat mercury poisoning?

A

Dimercaprol, penicillamine, succimer

73
Q

What can dimercaprol be used to treat?

A

Lead, arsenic, mercury

74
Q

Locked in syndrome is due to a lesion where?

A

Ventral pons

75
Q

Rheumatoid arthritis is commonly associated with what HLA?

A

HLA-DR4

76
Q

Psoriatic arthritis is associated with what HLA?

A

HLA-B27

77
Q

Inflammatory bowel disease is associated with what HLA?

A

HLA-B27

78
Q

Reactive arthritis is associated with what HLA?

A

HLA-B27

79
Q

Graves disease is associated with what HLA?

A

HLA-DR3

80
Q

What HLA is SLE associated with?

A

HLA-DR2, HLA-DR3

81
Q

What chemotherapeutic drug can cause chronic pneumonitis that can progress to pulmonary fibrosis?

A

Bleomycin

82
Q

What is the MOA of bleomycin?

A

Intercalating agent that complexes with iron (forming ROS) and induces DNA strand breaks