Sun Jul 12

Question 1

how do cystine kidney stones appear on microscopy?

Answer 1

hexagonal

Question 2

patients with cysteinuria are unable to absorb which 4 amino acids?

Answer 2

COLA
cysteine
ornithine
lysine
arginine

Question 3

what is the MOA of sulfamethoxazole?

Answer 3

Structural analog of PABA which competes with PABA and inhibits dihydropteroate synthetase - enzyme needed for dihydrofolic acid synthesis

Question 4

what is sulfamethoxazole an analogue of?

Answer 4

PABA

Question 5

what enzyme does sulfamethoxazole inhibit?

Answer 5

dihydropteroate synthetase

Question 6

which enzyme does methotrexate, trimethoprime, and pyrimethamine inhibit?

Answer 6

dihydrofolate reductase

Question 7

function of dihydrofolate reductase?

Answer 7

converts dihydrofolic acid into tetrahydrofolic acid

Question 8

MOA of NRTI’s?

Answer 8

they get incorporated into DNA, but since they have a missing 3’hydroxyl group, 3’5’ phosphodiester bond formation cannot occur and instead there is chain termination

Question 9

what is tenofavir?

Answer 9

an NRTI

Question 10

how may tenofavir result in acute kidney injury?

Answer 10

it is eliminated by the PCT in the kidenys, and high concentration may interfere with mitochondrial DNA synthesis leading to cellular toxicity

Question 11

at which pH does uric acid precipiate?

Answer 11

acidic pHs

Question 12

where is the lowest pH in the nephrons?

Answer 12

the DCTs and collecting ducts

Question 13

how can you prevent tumour lysis syndrome?

Answer 13

urine alkalinization (to prevent uric acid precipitation), aggressive hydration, and allopurinol (to reduce uric acid production)

Question 14

where are the pretectal and edinger-westphal nuclei found?

Answer 14

upper midbrain

Question 15

where is ghrelin produced?

Answer 15

the gastric pits of the stomach

Question 16

which enzyme is deficient in AIP ?

Answer 16

PBG deaminase

Question 17

which enzyme is deficient in porphyria cutanea tarda?

Answer 17

uroporphyrinogen decarboxylase

Question 18

abciximab MOA?

Answer 18

GPIIb/IIIa receptor antagonist- thus blocks GPII/IIIa from binding to fibrinogen and forming a platelet plug

Question 19

clopidogrel MOA?

Answer 19

blocks platelet aggregation via blocking P2Y12 on platelet ADP receptors

Question 20

which type of diuretic increases Ca reabsorption?

Answer 20

thiazides

Question 21

pathophys of ankylosing spondylitis?

Answer 21

increased osteoclast activity leads to bone erosions, with new bone formation occuring primarily at the periosteal margin and cartilage, leading to bridging syndesmophytes and ankylosis

Question 22

do gastric ulcers require biopsy?

Answer 22

yes as they may be malignant

Question 23

do duodenal ulcers require biopsy?

Answer 23

no -they are very rarely malignant

Question 24

presentation of fibromyalgia?

Answer 24

widespread musculoskeletal pain
fatigue
impaired attention and concentration
psych disturbances(depression/anxiety)
multiple tender points

> 3 months

Question 25

does polymyalgia rheumatica have tender points of psych symptoms?

Answer 25

NOOOOO

Question 26

presentation of classic dengue fever?

Answer 26

- flulike febrile illness with myalgias and joint pain (break bone fever) - retro-orbital pain - rash

Question 27

presentation of dengue hemorrhagic fever?

Answer 27

increased vascular permeability - thrombocytopenia - spontaneous bleeding - positive tourniquet test (petechia after sphygomomanometer cut inflation for 5 min)

Question 28

how is dengue fever spread?

Answer 28

aedes mosquito

Question 29

what type of virus is dengue fever?

Answer 29

ss RNA | Flavivirus

Question 30

the superior laryngeal nerve is part of which Cranial nerve?

Answer 30

CN X

Question 31

what is the function of the superior laryngeal nerve?

Answer 31

sensory - mediates affarent limb of cough reflex - carries sensation from the mucosa to the vocal cords

Question 32

which nerve runs superficially through the piriform recesS?

Answer 32

the internal laryngeal nerve (a branch of the superior laryngeal nervE)

Question 33

what mediates the affarent and efferent limbs of the gag reflex?

Answer 33

CN IX and X respectively

Question 34

presentation of graft vs host disease?

Answer 34

any organ can be targeted but it commonly involves the skin, liver and GI tract - may present as maculopapular rash that goes to the palms and soles - abnormal LFTs - diarrhea, abdominal pain and GI bleeding

Question 35

what are the embryological deritivates of the neural tube?

Answer 35

- Ne - Astrocytes - Spinal cord - Pineal gland - Oligodendrocytes - Retina - Ependymal cells - Neurohypophysis

Question 36

what does the brain and spinal cord derive from?

Answer 36

neural tube

Question 37

what does the posterior pituitary and pineal gland derive from?

Answer 37

neural tube

Question 38

what does the retina derive from?

Answer 38

neural tube

Question 39

what are the embryological deritivates of the neural crest?

Answer 39

- Schwann cells - PNS - Adrenal medulla - Myenteric plexus - Spiral membrane - Melanocytes - Odontoblasts - Thyroid C-cells - Endocardial cushion - Laryngeal cartilage

Question 40

which bones are derived from the neural crest?

Answer 40

skull bones

Question 41

which layers of the meninges are derived from the neural crest?

Answer 41

pia and arachnoid

Question 42

what are the embryological deritivates of the surface ectoderm?

Answer 42

``` anterior pituitary (rathkes pouch) lens and cornea inner ear sensory organs olfactory epithelium salivery glands epidermis, sweat and mammary glands ```

Question 43

where do the mammary glands derive from?

Answer 43

surface ectoderm

Question 44

what does rathkes pouch derive from?

Answer 44

surface ectoderm

Question 45

where do melanocytes derive from?

Answer 45

neural crest

Question 46

where do the salivary glands derive from?

Answer 46

surface ectoderm

Question 47

how many calories are produced by 1 gram of fat?

Answer 47

9

Question 48

how many calories are produced by 1 gram of protein?

Answer 48

4

Question 49

what is the function of the lateral pterygoids?

Answer 49

Opening the jaw

Question 50

adverse effects of clozapine?

Answer 50

Agranulocytosis Seizures Metabolic syndrome Myocarditis

Question 51

gram stain of nocardia?

Answer 51

filamentous, branching, gram + rods Partially acid fast

Question 52

treatment of nocardia?

Answer 52

TMT-SMX

Question 53

presentation of rocky mountain spotted fever?

Answer 53

Begins with fever, headache, myalgias, and malaise, followed 3-5 days later with a macular rash that moves from the extremities inwards

Question 54

what causes rocky mountain spotted fever?

Answer 54

rickettsia rickettsia

Question 55

treatment of rocky mountain spotted fever?

Answer 55

doxycycline

Question 56

what is the half life of naloxone?

Answer 56

<1 hr - short half-life (this means patients who overdosed may need repeated dosings)

Question 57

how will diastolic blood pressure be effected during aerobic exercise?

Answer 57

There is vasoconstriction of splanchnic arterioles but larger amounts of vasodilation of arterioles in the muscles, during aerobic exercise, leading to an overall decreased SVR. However the increased venous return and stroke volume of the heart during aerobic exercise offsets this, leading to an overall unchanged or slightly decreased diastolic pressure

Question 58

how will systolic blood pressure be effected during aerobic exercise?

Answer 58

It will be increased-- due to increased venous return to the heart and increased contractility resulting in greater stroke volume

Question 59

MOA of ethosuximide

Answer 59

Blocks thalamic T-type Ca channels

Question 60

what neurotransmitter is produced by the nucleus of Meynert?

Answer 60

Ach