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1
Q

Causes of unconjugated/indirect hyperbilirubinemia

A

Hemolytic
Physiologic
Crigler-Najjar Syndrome (=UDP-glucuronyl transferase defcy)
Gilbert Syndrome (= glucuronyltransferase mutn)

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2
Q

Causes of conjugated/direct hyperbilirubinemia

A 
Biliary tract obstruction
Biliary tract disease (primary sclerosing cholangitis, primary biliary cirrhosis)
Dubin-Johnson Syndrome (=cMOAT defcy)
Rotor Syndrome (=low bilirubin transport)
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3
Q

Causes of mixed hyperbilirubinemia

A

Hepatitis

Cirrhosis

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4
Q

Trousseau Syndrome

A

Association of migratory thrombophlebitis with pancreatic cancer (or other adenocarcinoma//lung/colon/gastric)
–Seen with weight loss and abdominal pain

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5
Q

Dieterle Silver Stain is used to identify…

A

Legionella pneumophila

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6
Q

Quellung reaction is used to identify…

A

the capsular serotype of strep. pneumo.

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7
Q

Four genera that have a requirement of cysteine

A

Francisella, Brucella, Pasteurella, Legionella

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8
Q

Most common causes of Carpal Tunnel Syndrome

A 
Myxoedema
Edema
Diabetes mellitus
Idiopathic
Acromegaly
Neoplasm

Trauma
Rheumatoid arthritis
Amyloidosis
Pregnancy

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9
Q

Boundaries of the anatomical snuffbox

A

Abductor pollicis longus
Extensor pollicis longus
Extensor indicis
(all innervated by Radial nerve)

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10
Q

Radial nerve is characteristically injured during what type of fracture? and/or during what type of compression?

A

Mid-humeral shaft fracture
and/or
extended axillary compression of spiral groove

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11
Q

Most common immunodeficiency in the U.S.

A

Selective IgA deficiency

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12
Q

South American malaria is resistant to…

A

chloroquine

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13
Q

Chloroquine can exacerbate the symptoms of…

A

psoriasis.

Can also cause “chloroquine retinopathy”

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14
Q

Treatment of choice for unknown species of Plasmodium falciparum that is chloroquine-resistant (or patient is unable to tolerate chloroquine)

A

Atovaquone + Proguanil

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15
Q

Combination therapy for Cryptococcus neoformans

A

Amphotericin B + Flucystocine

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16
Q

Therapy for cytomegalovirus infections

A

Gancyclovir

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17
Q

Combination therapy for life-threatening bacterial infections, i.e. pseudomonal infections

A

Gentamycin + Ceftriaxone

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18
Q

Uses of Foscarnet (phosphonoformic acid)

A

Against CMV infections with immunocompromised patients

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19
Q

Mechanism of Foscarnet

A

Inhibits viral DNA polymerase by mimicking pyrophosphate portions of nucleotide triphosphates

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20
Q

Mechanism of Tetracycline

A

Inhibits aminoacyl-tRNA to ribosomes

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21
Q

Mechanism of fluoroquinolones

A

Inhibit DNA gyrase and topoisomerase IV

22
Q

Blocks release of ACh

Causes flaccid paralysis via neurotoxin

A

Clostridium botulinum

23
Q

Blocks release of GABA and Glycine

Causes spastic paralysis via neurotoxin

A

Clostridium tetani

24
Q

Increase levels of cAMP

Enterotoxigenic

A

E. coli (ETEC)
Vibrio cholerae
Bordatella pertussis
Bacillus anthracis

25
Most common urea cycle disorder
Ornithine transcarbamylase (OTC) deficiency
26
Ornithine transcarbamylase deficiency inheritance and symptomology
``` X-lined recessive Lethargic neonate Poorly controlled breathing/body temp Unusual body movements Hyperammonemia Elevated glutamine Elevated urine orotic acid ```
27
Most distinctive glomerular lesion associated with diabetes
Nodular glomerulosclerosis (Kimmelstiel-Wilson nodule) Characterized by: Proteinuria/nephrotic syndrome Nodular/ovoid hyaline masses Thickened basement membranes
28
A palpable mass in the left supraclavicular node can be the presenting finding of...
gastric carcinoma
29
Most common causes of drug-induced lupus
Procainamide (sodium channel blocker) Hydralazine (adjunct HTN therapy) Isoniazid (TB med)
30
Prototypical CREST Syndrome presentation
``` Calcinosis/anti-Centromere antibodies Raynaud's phenomenon Esophagela dysmotility Sclerodactyly Telangiectasias of the skin ```
31
Carcinomas spread via...
lymphatics into regional lymph nodes.
32
Sarcomas and carcinomas that typically metastasize via hematogenous spread
Renal cell carcinoma Hepatocellular carcinoma Follicular carcinoma of thyroid Choriocarcinoma (malignancy of trophoblasts)
33
Carcinoma that characteristically seeds body cavities
Ovarian carcinoma | esp. to peritoneum
34
Von Willebrand factor is derived from...
Weibel-Palade bodies of endothelial cells and alpha-granules of platelets
35
Test that measures extrinsic and common pathways of coagulation cascade
Prothrombin Time | F7; 2, 5, 10, and fibrinogen
36
Test that measures the intrinsic and common pathways of the coagulation cascade
Partial Thromboplastin Time | F12, 11, 9, 8; 2, 5, 10, and fibrinogen
37
Treatment for disorders of fibrinolysis due to plasmin overactivity
Aminocaproic Acid | blocks activation of plasminogen
38
What are lines of Zahn?
Alternating layers of platelets/fibrin and RBCs seen with thrombosis
39
What is the Virchow Triad?
1) disruption of blood flow 2) endothelial cell damage 3) hypercoaguable state
40
Presentation of Cystathionine beta-Synthase (CBS) Deficiency
``` Homocystinuria Vessel thrombosis Mental retardation Lens dislocation Long slender fingers ```
41
Hookworms responsible for iron deficiency anemia in the developing world
Ancylostoma duodenale | Necator americanus
42
Presentation of Plummer-Vinson Syndrome
Anemia (microcytic, iron def anemia) Dysphagia (esophageal web) Beefy-Red Tongue (atrophic glossitis)
43
What is the rate limiting step in the production of heme?
Succinyl CoA ======> ALA (aminolevulinic acid) Enzyme: [ALA synthase] Cofactor: Vit B6
44
What is the final step in the production of heme and where does it occur?
Iron binds to Protoporphyrin via [Ferrochelatase] in the mitochondria
45
What other condition has similar iron laboratory findings as Microcytic Sideroblastic Anemia?
Hemachromatosis | both "iron overloaded state"
46
What are the three normal types of hemoglobin?
alpha2 gamma2 = HbF alpha2 beta2 = HbA alpha2 delta2 = HbA1
47
What is hemoglobin Barts?
Tetramer of gamma-globin chains seen with alpha-thalassemia (four gene deletions) *incompatible with life => hydrops fetalis
48
What is HbH?
Tetramer of beta-globin chains seen with alpha-thalassemia (three gene deletions) => severe anemia
49
What virus can lead to an aplastic crisis with beta-Thalassemia Major or Hereditary Spherocytosis patients?
Parvovirus B19
50
Where is folate absorbed from food?
Jejunum

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