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1
Q

What’s the most common breast mass in men under 25?

A

Gynecomastia

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2
Q

What gene is involved in the oncogenesis of cervical cancer?

A

p53 - HPV has E6 and E7 proteins which combine with and inactivate the tumor suppressor genes p53 and p105rB respectively

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3
Q

What is the HER2 receptor?

A

Tyrosine kinase receptor

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4
Q

What does the RET gene encode?

A

Receptor tyrosine kinase

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5
Q

What is the most likely complication of a bicuronate uterus?

A

Frequent abortions

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6
Q

Describe the developmental cycle of Chlamydia.

A

EB - elementary body that is infectious

RB - metabolically active form

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7
Q

What is Paget disease and how does it present?

A

Paget disease - adenocarcinoma cells within the squamous epithelium of the skin near the nipple

Presentation - nipple inflammation, pigmentation, eczematoid changes

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8
Q

What symptoms follows entry of amniotic fluid into circulation?

A

Respiratory depression

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9
Q

What type of teratoma can develop appearance of mature thyroid tissue?

A

Monodermal teratoma

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10
Q

What is the most common cause of septic arthritis in otherwise healthy, sexually active adults?

A

Neisseria gonorrhea

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11
Q

Why is there virtually no immunity to reinfection with neisseria?

A

May express over 1 million variants of pili

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12
Q

Masculinized female fetus suggests what disorder?

A

21-hydroxylase deficiency

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13
Q

What hormone is immediate elevated in 21-hydroxylase deficiency?

A

17-OH progesterone

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14
Q

What does vaginal pruritus and white discharge suggest?

A

Candidiasis

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15
Q

What serum hormone level might you expect in a patient with frequent early spontaneous abortions?

A

Decreased progesterone

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16
Q

Where does herpes lay dormant?

A

Sacral ganglia

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17
Q

What uterine tumor on biopsy exhibits well-demarcated borders and a whorled surface?

A

Leiomyoma

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18
Q

What is a tumor marker for leiomyoma?

A

Smooth muscle actin

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19
Q

What does fever, abdominal pain, tender cervix in a sexually young woman suggest?

A

PID - probably gonorrhea or chlamydia

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20
Q

Which vaginal infection produces a neutrophilic discharge with gram-negative cocci?

A

Neisseria gonorrhea

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21
Q

Oocyte surrounded by several layers of follicular cells within a small antrum - what type of follicle is this?

A

Secondary follicle

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22
Q

How does acyclovir work?

A
  1. Inhibits viral DNA polymerase

2. Also gets incorporated into viral DNA

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23
Q

What are 2 late sequelae of Group A streptococcal infection?

A
  1. Rheumatic fever

2. Acute post-streptococcal glomerulonephritis

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24
Q

How can you differentiate rheumatic fever vs. acute post-streptococcal glomerulonephritis just based on the preceding infection?

A

Post-streptococcal glomerulonephritis - can present after either skin infection or acute pharyngitis

Rheumatic fever - only follows acute pharyngitis; does NOT follow skin infection

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25
What should you be suspicious of if amniocentesis at 18 weeks reveals LOW alpha fetal protein?
Down syndrome
26
Why are clavulanic acid, sulbactam, and tazobactam added to penicillin family medications?
They are beta lactamase inhibitors - they decrease the destruction of the antibiotic by beta lactamases
27
What is the Hawthorne effect?
Tendency of a study population to affect an outcome due to the knowledge of being studied
28
Is a triploid karyotype partial or complete mole?
Partial mole
29
What can help prevent calcium crystal precipitation?
1. Increased citrate | 2. High fluid intake
30
How have enterococci developed resistance to aminoglycosides?
Have modifying enzymes that transfer different chemical groups (acetyl, adenyl, or phosphate) to the aminoglycoside molecule and thereby impair antibiotic binding to ribosomal subunits
31
Breast biopsy: cellular, myxoid stroma that encircles and compresses epithelium-lined glandular and cystic spaces
Fibroadenoma
32
What causes formation of a bicuronate uterus?
Failure of the paramesonephric ducts to fuse
33
Where does the proximal 1/3 of the ureter receive its blood supply from?
Branches of the renal artery
34
Contrast where lymph from the scrotum vs. the testes drain.
Scrotum - superficial inguinal lymph nodes Testes - para-aortic nodes
35
What are the 3 types of groin hernia and their relation to the inguinal ligament?
Above the inguinal ligament - direct and indirect Below the inguinal ligament - femoral
36
Describe the location of a femoral hernia.
Below inguinal ligament Lateral to the pubic tubercle Medial to the femoral vein
37
What drugs can be used to treat postoperative urinary retention?
Muscarinic agonist (e.g. bethanechol) or alpha 1 blocker
38
Why would we not use oxybutynin for postoperative urinary retention?
Oxybutynin is an antimuscarinic agent commonly used for urge incontinence - would worsen the condition
39
What virulence factor in Group A strep prevents phagocytosis?
M protein
40
What are the complications of PID?
1. Infertility | 2. Ectopic pregnancy
41
What is the most common viral cause of hemorrhagic cystitis?
Adenovirus
42
What are the effects of IL-2?
1. Promotes the growth of lymphocytes (B and T cells) | 3. Activates NK cells and macrophages
43
What should you be careful to ligate when doing surgery on the ovary?
Suspensory ligament - carries most of the nerves and vessels to the ovary
44
Contrast direct and indirect inguinal hernia relative to inferior epigastric vessels.
Direct hernia - medial to interior epigastric vessels Indirect hernia - lateral to inferior epigastric vessels
45
Contrast the causes of direct and indirect inguinal hernia.
Direct - weakness of transversalis fascia Indirect - persistent processus vaginalis and failure of the internal inguinal ring to close
46
Contrast the causes of direct and indirect inguinal hernia.
Direct - weakness of transversalis fascia Indirect - persistent processus vaginalis and failure of the internal inguinal ring to close
47
What findings make you suspicious of pyelonephritis?
1. Systemic manifestations of febrile illness (or UTI) 2. White blood cell casts 3. Pain upon urination
48
What are the two most common causes of urethritis in males?
Chlamydia and gonorrhea (can also co-infect)
49
How do you treat chlamydia/gonorrhea?
Ceftriaxone - for gonorrhea | Doxycycline or azithromycin - for chlamydia
50
Masculinization of a female fetus with virilization of the mother during gestation Diagnosis?
Aromatase deficiency in the fetus
51
Where is the prostate located on CT?
Pretty central - in between the pubic symphysis and the anal canal
52
Describe the reaction that occurs with an acute hemolytic transfusion reaction.
Type II hypersensitivity - host antibody binds antigen on donor RBC and activates complement
53
What pregnancy complication are SLE patients at increased risk for?
Repeated 2nd or 3rd trimester miscarriages due to antiphospholipid antibody syndrome
54
Explain how eosinophils are involved in antibody-dependent cytotoxicity.
Eosinophils have Fc receptors on their surface that bind IgE-parasite antigen complexes. This stimulates the eosinophils to release major basic protein and other enzymes from their granules.
55
What is cystinuria and how does it present?
Autosomal recessive defect in the transporter of cystine, ornithine, arginine and lysine - presents as cysteine stones The defect impairs the transporter's affinity in both the intestine and the kidney so you have decreased reabsorption once it is filtered at the glomerulus
56
What does a "bunch of grapes" removed from the uterus suggest?
Hydatidiform mole
57
What hormone level should be monitored in patients who have had a hydatidiform mole removed?
beta hCG
58
How do you treat chlamydia/gonorrhea?
Gonorrhea - ceftriaxone | Chlamydia - doxycycline or azithromycin
59
What should you be suspicious of in a patient who suffers both a renal infarct and a stroke?
Embolism from the left side of the heart - causes include atrial fibrillation, aortic aneurysm, infective endocarditis
60
What are 4 things caused by Kartagener's syndrome?
1. Male infertility 2. Situs inversus 3. Recurrent sinusitis 4. Bronchiectasis - destruction and widening of the larger airways
61
What causes gram-negative sepsis?
LPS - specifically the lipid A component
62
What are UAA, UAG, and UGA?
Stop codons
63
What recognizes stop codons to terminate protein synthesis?
Releasing factors
64
What is most important virulence factor in uropathogenic E coli?
P fimbriae
65
How can you prevent recurrence of herpes?
Daily treatment with oral acyclovir, valacyclovir, or famciclovir
66
What often happens to the ovaries in Turner syndrome?
Dysgensis (including complete absence)
67
Describe what happens in cryptorchidism.
Undescended testes --> temperature is higher than it should be --> damage to semniferous tubules which have the Sertoli cells --> low sperm count, impaired inhibin synthesis, increased FSH (because of low inhibin levels)
68
Describe the calcium levels in the blood and urine in patients with calcium stones.
Hypercalciuria but NORMOcalcemia
69
What are PCOS patients at increased risk of developing?
Endometrial adenocarcinoma and type 2 diabetes
70
Describe the path of the ureters.
They cross over the external/common iliac vessels and under the gonadal (and ovarian) vessels As they enter the pelvis, they pass medial to the gonadal vessels and lateral to the internal iliac vessels
71
What staphylococcus is responsible for almost half of all UTI's in sexually active young women?
Saprophyticus
72
What should you be suspicious of in an elderly man who is straining on urination?
Bladder outflow obstruction likely due to BPH
73
What can happen to the kidneys in BPH?
Parenchymal pressure atrophy
74
What is the mechanism of acyclovir?
1. Nucleoside analog that gets incorporated into viral DNA and terminates DNA synthesis 2. Also inhibits DNA polymerase
75
What is the role of "tan fat-containing tissue"?
Brown adipose tissue - heat production

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