Test 60

Question 1

increased aspartate aminotransferase and alanine amiontransferase

Answer 1

hepatcellular damage

Question 2

increased alkaline phosphatase and gamma-glutamyl

AST > ALTtranspeptidase

Answer 2

bilitary injury

Question 3

labs that have greatest prognostic significance in pts w/ cirrhosis

Answer 3

impaired biosynthetic capacity:
serum albumin
prothrombin time

imapired transport/metabolic capacity:
bilirubin

Question 4

observer bias

Answer 4

investigators decision is affected by prior knowledge of exposure status

Question 5

selection bias

Answer 5

subjects are selected for a study or from selective losses during follow up

Question 6

confounding

Answer 6

part of exposure-disease relationship can be explained by another variable

Question 7

wheal observed from an insect sting

Answer 7

Type I hypersensitivity

allergens in insect venom> Ab class switching to IgE>
subsequent exposure>
degranulation of mast cella nd basophils>
release of histamine/heparin

Question 8

Depressed mood occuring most days for at least 2 years+
2 of the following:
pooor appetite
insomnia
low energy
low self esteem
poor concentration
feeling of helplessness

Answer 8

dysthymic disorder

Question 9

major depression

Answer 9

at least 5 sxs are present for at least 2 weeks

SIGECAPS

Question 10

wound at 5th intercostal space along left midclavicular line

Answer 10

left lung

Question 11

left ventricle

Answer 11

reaches as far as 5th intercostal space at left midclavicular line

*all 4 champers lie medial ot the line

Question 12

thoracocentesis

Answer 12

ABOVE the o7th rib in the midclavicular line
9th rib midaxillayr line
11th rib along posterior scapula

Question 13

insertion of needle below 9th rib at the middle axiallary line

Answer 13

liver injury

Question 14

cause of alteration in gene expression in huntington disease

Answer 14

deacetylation of histones

prevents trxn of certain genes that code for neurotrophic factors> neuronal cell death

inhibits histone acetyltransferase

Question 15

hypoacetylated histones

Answer 15

bind tight to DNA

prevent trxn of gnes in associated regions

Question 16

can cause release of ANP and BNP from ventricular myocytes>

natriuresis and diuresis

Answer 16

ventricular hypertrophy**

volume overload

Question 17

reperfusion injury

Answer 17

resutls from rgeneration of oxygen free radicals

Question 18

reflects osteoBLASTIC activity

Answer 18

alkaline PHOSPHATASE

Question 19

Tartrate resistant acid phosphatase
urinary hydroxyproline
urinary deoxypyridinolone**most reliable

Answer 19

osteoCLASTIC activity

Question 20

Necrotizing fasciitis
pYR positive
beta hemomlytic
Gram + cocci
grows in chains

Answer 20

S. pyogenes (GAS)

PYR positive

Question 21

candida albicans associations

Answer 21

wearing dentures
diabetes
immunosuppression

Question 22

tx for absence AND tonic clonic

Answer 22

sodium valproate

Question 23

ehtosuximide

Answer 23

ONLY absence

Question 24

phenytoin

Answer 24

tonic clonic seizures

Question 25

carbamezapine

Answer 25

complex partial seizures | generalized tonic clonic

Question 26

oculomotor dysfxn ataxia confusion

Answer 26

wernicke syndrome MOst resolve after thiamine administration

Question 27

korsakoff syndrome

Answer 27

complication of Wernicke encephalopathy permanent memory loss and confabulation

Question 28

uninhibited bladder contractions tx

Answer 28

urge incontinence ANTIMUSCARINIC DRug (M3 receptors)--oxybutynin

Question 29

ADULT onset ASTHMA eosinophilia p-ANCA mononeuropathy--> wrist drop

Answer 29

Churg Strauss syndrome

Question 30

pANCA

Answer 30

antibodies against neutrophil myeloperoxidase

Question 31

chronic restrictive granulomatous interstitial lung disease elevated ACE levels

Answer 31

Sarcoidosis

Question 32

hemoptysis | circulating autoAbs agasinst a-3 chain of collagen IV> damage alveolar and glomerular basement membranes

Answer 32

Goodpasture syndrome

Question 33

inhibit synthesis of ergosterol by fungal p450 enzyes | suppress human p450> drug drug itneractions

Answer 33

itraconazole

Question 34

amphotericin B

Answer 34

binds ergosterol in cell membrane> pore foramtion/cell lysis

Question 35

Terbinafine

Answer 35

accumulates in hair/nails inhibits fungal squalene 2,3 epoxidase

Question 36

how does shigella gian acess?

Answer 36

M cells in peyers patches in ileum through endycoytosis

Question 37

how does TPN induce gallstone formation

Answer 37

secondary to bile stasis d/t ABSENT enteral stimulation/disturbance of enterohepatic bile acid cirucliont in those w/ ileal resections

Question 38

complications of recovery phase of acute tubular necrosis

Answer 38

dehydration | HYPOkalemia d/t high volume, hypo tonic urine

Question 39

key GFs that promote angiogneesis in neoplastic nad granulation tissue

Answer 39

VEGF and FGF

Question 40

how do proinflammatory cytokines indirectly promote angiogenesis

Answer 40

IL-1 and IFNy thorugh increased VEGF expression

Question 41

progressive dyspnea fine crackles clubbing diffuse reticular opacities

Answer 41

interstitial lungn disease> | pulmonary fibrois w/ thickening and stiffening of pulmonary interstitium

Question 42

What causes supernormal expiratory flow rates (higher than normal) in pts w/ interstitial lung disease?

Answer 42

``` pulmonary fibrois> increased elastic recoil> airway wideningi d/t outward pulling> decrease in airflow resistance> supernormal expiratory flow rates ```

Question 43

anaplastic tumors

Answer 43

bear NO resemblance to the tissue of origin pleomorphic cells w/ large hypochoromiatic nuclei that gorw in a disorganized fashion

Question 44

atrial myxoma histological findings

Answer 44

scattered cells w/in a mucopolysaccharide stroma large peduculated mass in left atrium

Question 45

leads to strictures and fistulas in Chrons

Answer 45

TRANSMURAL INFLAMMATIoN