tues aug 11

Question 1

cyclosporine MOA

Answer 1

calcineurin inhibitor - blocks IL 2 production and release thus decreasing t cell actiavation

Question 2

adverse effects of cyclosporine?

Answer 2

• neprhotoxicity
• neurotoxicity
• hirsutism
• gingival hyperplasia

Question 3

tacrolimus MOA

Answer 3

calcineurin inhibitor - impairs IL2 production and release

Question 4

adverse effects of tacrolimus

Answer 4

nephro/neurotoxicity

Question 5

sirolimus MOA

Answer 5

-blocks mTOR -> decreased t cell induced proliferation

Question 6

what kind of necrosis occurs in the lungs in the situation of a lung abcess?

Answer 6

liquefactive necrosis

Question 7

how does adenosine effect the heart?

Answer 7

decreases heart rate and conduction velocity

Question 8

where do you access the herniated fragment in disc herniation, when performing a laminectomy?

Answer 8

the lamina

Question 9

myenteric plexus AKA

Answer 9

aurbachs

Question 10

submucosal plexus AKA

Answer 10

messenteric

Question 11

what is the cytokine effect seen in cancer??

Answer 11

release of cytokines in chronic disease that can lead to cachexia (TNFalpha, IL1,IL6 etc may activate ubiquitin system in cells causing cell death)

Question 12

what neoplastic syndromes are seen in small cell lung cancer?

Answer 12

siADH
ACTH
lambert eaton

Question 13

what neoplastic syndrome may be seen in squamous cell lung cancer?

Answer 13

PTHrp leading to hypercalcemia

Question 14

idiopathic pulmonary fibrosis lung findings

Answer 14

fibroplastic foci and patchy fibrosis

-no granulomas

Question 15

fibroplastic foci is buzzword for..

Answer 15

idiopathic pulmonary fibrosis

Question 16

findings of cryptogenic organizing pneumonia?

Answer 16

• lymphocytic infiltrate

- fibrosis

Question 17

what is solar elastosis (actinic elastosis)

Answer 17

an accumulation of abnormal elastin in the dermis of the skin or conjuctiva of the eye which occurs from cumulative effects of sun exposure (photoaging)

Question 18

how do alcohol based products work against pathogens?

Answer 18

they disrupt lipid membranes

Question 19

what toxin of group A strep causes scarlet fever?

Answer 19

erythrogenic toxin

Question 20

which toxin of group A strep causes toxic shock?

Answer 20

speA and speC

Question 21

which toxin of group A strep causes necrotizing fascitis??

Answer 21

speB

Question 22

is subacute thyroidits (dequiverns thyroidits) painful?

Answer 22

yes

Question 23

histology of subacute thyroiditis?

Answer 23

granulomas

Question 24

at low doses dopamine activates

Answer 24

D1 receptors -> increased renal blood flow

Question 25

D1 receptor is coupled to..

Answer 25

Gs

Question 26

D2 receptor is coupled to...

Answer 26

Gi

Question 27

at medium doses dopamine acts on...

Answer 27

B1 receptors

Question 28

at high doses dopamine acts on...

Answer 28

alpha 1 receptors

Question 29

what is found in the urine of someone with acute interstitial nephritis?

Answer 29

pyuria, classicaly with eosinophils

Question 30

causes of acute interstitial nephritis (tubulointerstitial nephritis)?

Answer 30

diuretics, NSAIDS, penicillins, PPIs, rifampin, quinoloes, and may occur secondary to infection/disease

Question 31

findings in hereditary hemorrhagic telangiectasia? (osler-weber-rendu syndrome)?

Answer 31

- telangiectasias - reccurrent epistaxis - skin discolourations - AV malformatinos - GI bleeds - hematuria

Question 32

what are paneth cells?

Answer 32

cells found in the intestines and secrete antimicrobial peptides

Question 33

which part of the ureter is the last to recanulize?

Answer 33

the proximal portion

Question 34

function of petroleum jelly on wound?

Answer 34

acts as a barrier so things dont get in it and keeps moisture in

Question 35

what do HOX genes code for?

Answer 35

transcription factors needed during embryognesis

Question 36

how do prostaglandins effect the uterus?

Answer 36

increase uterine contractions

Question 37

what substances are combined by ALAS to make ALA?

Answer 37

succinyl-coa and glycine

Question 38

buzz word for rotavirus?

Answer 38

wheel-like shape

Question 39

what is the shape of the capsid of rotavirus?

Answer 39

icosahedral

Question 40

what type of genetic material does rotavrius have?

Answer 40

segmented, DS rna

Question 41

why are ACTH secreting tumours associated with bone fractures?

Answer 41

cortisol causes osteoporosis

Question 42

what is a pseudocholinesterase deficiency?

Answer 42

an autosomal recessive inheritance of a blood enzyme. Results in increased sensitivity to certain anesthetics

Question 43

inheritance of pseudocholinesterase deficiency?

Answer 43

AR

Question 44

what is thought to provoke attacks in vasospastic angina?

Answer 44

increased vagal tone (this is why its seen more at night)

Question 45

explain the pathophys of vasospastic angina?

Answer 45

- caused by endothelial dysfunction and autonomic imbalance - Ach from the vagus nerve stimulates endothelial muscarinic receptors to release NO and cause vasodilation, but the endothelial cells have deficient endothelial NO and instead spasm

Question 46

what are the types of germ cell tumours in males?

Answer 46

seminomas and non-seminomas (embryonal carcinoma, yolk sac tumour, choriocarcinoma)

Question 47

what is often detectable in the blood of someone with a germ cell tumour?

Answer 47

hormons such as LDH, beta hCGH and alpha fetoprotein

Question 48

what do leydig cell tumours secrete?

Answer 48

estrogen or testosterone

Question 49

presentation of ALS?

Answer 49

both upper and motor neuron symptoms

Question 50

microscopic neurological findings of ALS?

Answer 50

- loss of neurons in anterior horn (LMNs) - loss of lateral corticospinal tracts (UMNs) - loss of neurons in the motor nuclei (V, IX, X, XII) - denervation atrophy of muscles

Question 51

where does poliomyelitis damage?

Answer 51

the anterior horns

Question 52

does polio effect both the lower and upper motor neurons?

Answer 52

NO JUST THE LOWER

Question 53

huntington disease presentation?

Answer 53

-progressive dementia, beahviour changes, choreiform movements

Question 54

damage to the brainstem below the red nucleus causes what kind of posturing?

Answer 54

-decerebrate (extensor) - due to loss of excition to the upper limb flexs

Question 55

damage to the brainstem above the red nucleus causes what kind of posturing?

Answer 55

decorticate (flexor posturing) - due to loss of excitation to the upper limb extensors

Question 56

what condition causes a widely split fixed S2 with a midsystolic ejection murmur?

Answer 56

ASD - due to increased blood going to the right side

Question 57

does a VSD cause a split S2?

Answer 57

yes but it is not fixed

Question 58

what kind of murmur is heard with a VSD?

Answer 58

-holosystolic with split S2

Question 59

how do thryoid hormone levels change in response to temperature?

Answer 59

Hypothermia -> increased thyroid hormones | Hyperthermia -> decreased thyroid hormones

Question 60

what reaction does lactate dehydrogenase perform?

Answer 60

Converts pyruvate to lactate (this regenerates NAD from NADH)

Question 61

how do patients with a lactate dehydrogenase deficiency present?

Answer 61

-during strenous muscle activity leading to aneorobic conditions in the muscle, these patients cannot generate lactate and thus cannot regenerate NAD. Normally NAD+ would feed back into glycolysis so glycolysos would continue, but now it cannot and this leads to muscle breakdown, pain, fatigue

Question 62

presentation of lactate dehydrogenase deficiency?

Answer 62

fatigue, muscle pain, and cramps during exercise

Question 63

which structure contains the ovarian artery?

Answer 63

-suspensory ligament (infundibular ligament)

Question 64

nosocomial bloodstream infections are usually from which source?

Answer 64

intravascular catheters