USMLE STEP 1 COMPREHENSIVE REVIEW PART II Flashcards
(1917 cards)
0
Q
What Staphylococcus aureus protein inhibits phagocytosis?
A
Protein A
1
Q
Which two negative sense RNA viruses have neuraminidase enzymes?
A
Mumps and influenza virus
2
Q
Which four bacteria require cysteine for growth?
A
Pasteurella, Brucella, Legionella, and Francisella (all of the-ellas)
3
Q
What fungus causes endocarditis in IV drug users?
A
Candida albicans
4
Q
What viruses are associated with Cowdry type A intranuclear inclusions?
A
Herpes virus I and II
5
Q
Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene?
A
Streptococcus viridans
6
Q
What is the term for cestode-encysted larvae found in intermediate hosts?
A
Cysticerci
Does this remind you of Game of Thrones?
7
Q
What fungus is characterized by hypopigmented spots on the thorax, spaghetti-and-meatball KOH staining, and pityriasis or tinea versicolor?
A
Malassezia furfur (treat with selenium sulfide)
8
Q
What nematode is known as threadworms? What is the treatment?
A
Strongyloides stercoralis;
treated with Thiabendazole
9
Q
What are known as jumping genes?
A
Transposons
10
Q
What virus produces koilocytic cells on a Papanicolaou (Pap) smear?
A
HPV
11
Q
Which dimorphic fungus is endemic in the Ohio, Mississippi, Missouri, and Eastern Great Lakes, is found in soil with bird and bat feces, and is associated with infections in spelunkers and chicken coop cleaners?
A
Histoplasma capsulatum
12
Q
Which of the following Enterobacteriaceae family members—Yersinia, Klebsiella, Enterobacter, Escherichia, Proteus, and Citrobacter— do not ferment lactose?
A
All are lactose fermenters except Yersinia and Proteus.
13
Q
What two HIV regulatory genes down-regulate MHC class I expression in the host?
A
nef and tat genes
14
Q
What size ribosomes do fungi have?
A
80S ribosomes (because they are eukaryotic)
15
Q
What is the term for an abnormal amount of collagen type III that produces a large bulging scar, seen primarily in blacks?
A
Keloid
16
Q
True or false? Klinefelter syndrome cannot be diagnosed until puberty.
A
TRUE
17
Q
What form of sunlight is the most carcinogenic?
A
Ultraviolet B (UVB) sunlight
18
Q
What renal pathology involves uniform thickening of the glomerular capillary wall, granular appearance under the microscope, and effacement of foot processes?
A
Membranous glomerulonephritis
19
Q
What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
A
HIV
20
Q
What enzyme is deficient in chronic granulomatous disease of childhood?
A
NADPH oxidase
21
Q
What rare disorder presents as a large, hard, irregular thyroid gland due to fibrous proliferation of connective tissue in the thyroid gland and extends to adjacent structures?
A
Riedel thyroiditis
22
Q
Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
A
Group A β-hemolytic streptococci
23
Q
What benign cardiac tumor is associated with tuberous sclerosis?
A
Rhabdomyoma
24
What are the rules of 10 regarding pheochromocytoma?
10% are bilateral, 10% malignant, and 10% familial, 10% in children, and 10% outside the adrenal gland
25
What vascular pathology is associated with HTN in the upper extremities, hypotension in the lower extremities, and a radial-femoral delay?
Postductal coarctation of the aorta (adult)
26
What seronegative spondyloarthropathy is seen in HLA-B27-positive young females and presents with the triad of conjunctivitis, urethritis, and arthritis affecting the knees and ankles?
Reiter syndrome
27
What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
Tylosis
28
A 20-year-old woman who was recently diagnosed with a sexually transmitted disease goes to the ER with a tender, painful, swollen, and erythematous knee (monoarticular). What organism is the likely culprit?
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
29
What vasculitis is characterized by systemic vasculitis in small to medium- size vessels (except the lung); affecting young males; 30% HBsAg-positive; P-ANCA and autoantibodies against myeloperoxidase?
Polyarteritis nodosa
30
What malignant bone tumor is associated with familial retinoblastoma?
Osteosarcoma
31
What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
Polycystic kidney disease of childhood
32
In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal, cerebellar, medulla, or spinal cord hemangioblastomas; and epidermal cysts?
von Hippel-Lindau syndrome
33
What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
Swan-neck deformities
34
What is the term for white retinal spots surrounded by hemorrhage? In what condition are they seen?
Roth spots, and they are seen in bacterial endocarditis.
35
A 70-year-old man complains of urinary urgency, nocturia, hesitancy, postvoid dribbling, urinary retention, and a PSA result of 6.5 ng/mL. What is your diagnosis?
BPH. Although an argument can be made for prostatic cancer (you should expect a much higher PSA result), these are buzzwords for BPH. Prostatic cancer is usually silent until late in the disease, when obstructive symptoms begin to occur.
36
What triad consists of endothelial injury, changes in laminar flow, and hypercoagulation?
Virchow triad, associated with the formation of a thrombus.
37
What bone cell has receptors for PTH?
Osteoblasts (Remember, they modulate the function of osteoclasts.)
38
What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
Gastric ulcer
39
What is the term for normal cellular genes associated with growth and differentiation?
Proto-oncogenes
40
Blue sclera is seen in what hereditary bone disorder?
Osteogenesis imperfecta
41
What form of anemia is diagnosed with sucrose lysis test and Ham test?
Paroxysmal nocturnal hemoglobinuria
42
In what rare AR disorder do you see neutropenia, defective degranulation, and delayed microbial killing due to a problem in chemotaxis and migration?
Chédiak-Higashi syndrome
43
What myeloid disorder is characterized by increased hematocrit, blood viscosity, basophils, and eosinophils; intense pruritus; and gastric ulcers due to histamine release from basophils, increased LAP, and plethora?
Polycythemia vera (Remember, polycythemia vera is a risk factor for acute leukemias.)
44
If you order a V/Q scan for suspected pulmonary emboli, is the filling defect seen on the ventilation or perfusion side?
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
45
What transports iron in the blood?
Transferrin
46
What hematological malignancy is particularly likely to affect patients with Down syndrome?
ALL (nearly 15-20 times the normal risk)
47
What childhood pathology involves anterior bowing of the tibia, epiphyseal enlargements, and costochondral widening, with the endochondral bones being affected?
Rickets
48
A Japanese man has weight loss, anorexia, early satiety, epigastric abdominal pain, and a palpable left supraclavicular lymph node. On endoscopy you find a large, irregular ulcer with elevated margins on the lesser curvature of the stomach. What is your diagnosis?
Gastric carcinoma
49
What drug causes a sixfold increase in schizophrenia, can impair motor activity, and can cause lung problems?
Marijuana
50
What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
Transient ischemic attack
51
What is the name of the tumor when gastric carcinoma spreads to the ovaries?
Krukenberg tumor
52
What condition results from a deficiency in the enzyme hexosaminidase A?
Tay-Sachs disease
53
Which cerebral herniation results in compression of the anterior cerebral artery?
Cingulate gyrus herniation (subfalcine)
54
What pathology involves excessive fibrosis throughout the body via increased fibroblast activity, occurs in women more than men, and is most commonly seen in the third to the fifth decade?
Scleroderma
55
What is the term for the syndrome consisting of hepatomegaly, ascites, and abdominal pain due to hepatic vein thrombosis?
Budd-Chiari syndrome
56
What form of angina is characterized by • Coronary artery vasospasm, symptom occurrence at rest, ST segment elevation (during episode), and no signs on ECG?
Prinzmetal variant angina
57
What form of angina is characterized by • Coronary artery luminal narrowing, symptom occurrence during exertion, ST segment depression on ECG?
Stable angina
58
What form of angina is characterized by • Coronary artery nonocclusive thrombus; symptom occurrence with increasing frequency, duration, intensity, and decreasing activity, frequently at rest?
Unstable (crescendo) angina
59
What skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules?
Benign lentigo
60
What is the term for nonneoplastic abnormal proliferation of cell size, shape, and cellular organization?
Dysplasia
61
What diagnosis ensues from finding well-demarcated erythematous plaques with silvery scales on the knees, elbows, and scalp along with nail bed pitting and discoloration?
Psoriasis
62
What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
Kimmelstiel-Wilson disease
63
What autoimmune liver disease is characterized by affecting a middle-aged woman with jaundice, pruritus, fatigue, xanthomas, increased direct bilirubin levels, and antimitochondrial Abs?
Primary biliary cirrhosis
64
What cell in chronic inflammation is derived from blood monocytes?
Macrophages
65
True or false? Pancreatic insufficiency results in vitamin B12 malabsorption.
True. Pancreatic enzymes begin the breakdown of vitamin B12-R complex in the duodenum.
66
What neuroendocrine tumor produces excess serotonin; is associated with diarrhea, flushing, bronchospasms, wheezing; and is diagnosed by findings of elevated urinary 5-HIAA levels?
Carcinoid tumor
67
What tumor constitutes 40% of testicular tumors in children?
Teratoma
68
What urinary metabolite is elevated in pheochromocytoma?
Vanillylmandelic acid (VMA)
69
A 25-year-old black woman presents with nonproductive cough, shortness of breath, fatigue, and malaise; she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE levels. What do you diagnose?
Sarcoidosis
70
What are the four reasons for hypochromic microcytic anemia with a low MCV?
1. Sideroblastic anemias (i.e., porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
71
What is characterized by an intense inflammatory reaction, an increase in the amounts of granulation tissue and wound contraction by myofibroblasts?
Healing by secondary intention
72
What thyroiditis presents as a tender, enlarged, firm thyroid gland, usually preceded by an upper respiratory viral illness?
de Quervain thyroiditis
73
What disorder leads to IgG autoantibodies to the TSH receptor?
Graves disease
74
What intrauterine deficiency leads to failure to thrive, mental retardation, motor incoordination, and stunted growth?
Iodine, resulting in congenital hypothyroidism
75
What pancreatic islet cell tumor is associated with MEN I syndrome?
Gastrinoma
76
What type of PUD is classically described by the onset of burning epigastric pain 1 to 3 hours after eating that is relieved by food?
Duodenal ulcer
77
What disease arises from the adrenal medulla, displaces and crosses the midline, metastasizes early, is the most common solid tumor, and is seen in the 2-to 4-year-old age group?
Neuroblastoma
78
What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
Familial hypercholesterolemia
79
A 20-year-old woman goes to the ER with ptosis, diplopia, weakness in her jaw muscles when chewing, and muscle weakness with repeated use. What is your diagnosis?
Myasthenia gravis
80
What is the term for RBCs with smooth undulations on the surface of their membrane, commonly seen in uremia?
Burr cells (echinocytes)
81
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Beta-hCG
Choriocarcinomas and trophoblastic tumors
82
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-125
Ovarian cancer
83
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-19.9 and CEA
Pancreatic cancer
84
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • alpha-Fetoprotein
Hepatoma and nonseminomatous testicular germ cell tumors
85
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Calcitonin
Medullary carcinoma of the thyroid
86
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • PSA and prostatic acid phosphatase
Prostate cancer
87
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Placental alkaline phosphatase
Seminoma
88
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CEA
Cancer of the lung, stomach, colon, and breast
89
What seronegative spondyloarthropathy is seen in HLA-B27-positive young men, involves the sacroiliac joints, has no subcutaneous nodules, and has a bamboo spine appearance on radiograph?
Ankylosing spondylitis
90
What disorder is associated with decreased platelet count, prolonged PT and PTT, decreased fibrinogen, and increased fibrin split products (D-dimers)?
Disseminated intravascular coagulation (DIC)
91
What spirochete is responsible for Lyme disease?
Borrelia burgdorferi
92
What very aggressive lung cancer metastasizes early and is associated with smoking and paraneoplastic syndromes?
Small cell carcinoma (oat cell)
93
What bone disorder is characterized by brown tumors, bone pain, deformities, and fractures due to excessive PTH?
Osteitis fibrosa cystica (von Recklinghausen disease)
94
What glycogen storage disease is due to the following enzyme deficiencies? • Lysosomal glucosidase (acid maltase)
Pompe's disease
95
What glycogen storage disease is due to the following enzyme deficiencies? • Muscle phosphorylase
McArdle's syndrome
96
What glycogen storage disease is due to the following enzyme deficiencies? • Glucose-6-phosphatase
von Gierke's disease
97
What ovarian disease involves psammoma bodies?
Serocystadenocarcinoma
98
What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma?
Hydatidiform mole
99
In what condition do you see dimpling on the kidney's surface?
Pyelonephritis
100
What are the most common causes of osteomyelitis • Overall?
Staphylococcus aureus
101
What are the most common causes of osteomyelitis • In neonates?
Streptococcus agalactiae
102
What are the most common causes of osteomyelitis • In patients with sickle cell disease?
Staphylococcus aureus (but they are more prone to salmonella infections)
103
What are the most common causes of osteomyelitis • In drug addicts?
Pseudomonas
104
What malignant neoplasm of the bone is associated with Homer-Wright pseudorosettes; onion skinning of the periosteum on radiographs of the femur, pelvis, and tibia; and chromosome 11;22 translocation?
Ewing's sarcoma
105
What lymphoma is characterized by CD19, CD20, CD5; CD23-negative; and chromosome 11;14 translocations?
Mantle cell lymphoma
106
What components of the complement cascade form the MAC?
C5b-C9
107
True or false? HPV infection increases the risk of developing squamous cell carcinoma of the penis.
True. HPV serotypes 16 and 18 are risk factors for squamous cell carcinoma.
108
What form of coarctation of the aorta is associated with Turner syndrome?
Preductal (infantile)
109
True or false? An elevated serum osteocalcin level is a marker for increased bone formation.
True. Increased alkaline phosphatase levels also are associated with increased bone formation.
110
What is the most common opportunistic infection of the CNS in HIV?
Toxoplasmosis
111
What hereditary bone disorder is due to decreased osteoclast function, resulting in thick, sclerotic bones that fracture easily?
Osteopetrosis (Albers-Schönberg disease)
112
True or false? Pancreatic delta-cell tumors inhibit CCK secretion, leading to gallstones and steatorrhea.
True. Delta-Cell tumors produce excess somatostatin, which inhibits CCK, gastrin (hypochlorhydria), and insulin secretion (diabetes).
113
What is the term for the speckled appearance of the iris in patients with Down syndrome?
Brushfield spots
114
What is the term for the collapse of the vertebral body due to TB?
Pott disease
115
What organ must metastasize for carcinoid heart disease to occur?
Liver
116
Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and mucocutaneous neuromas
MEN III (or IIb)
117
Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and parathyroid adenomas (or hyperplasia)
MEN IIa (or Sipple syndrome)
118
Which subset of MEN syndrome is associated with the following? • Parathyroid, pancreatic, and pituitary gland tumors and Zollinger-Ellison syndrome
MEN I (or Wermer syndrome)
119
What X-linked recessive disease involves mental retardation, self-mutilation, choreoathetosis, spasticity, a decrease in HGPRT, and an increase in uricemia?
Lesch-Nyhan syndrome
120
What disorder is associated with spider angiomas, palmar erythema, gynecomastia, testicular atrophy, encephalopathy, abnormalities in clotting factors, and portal HTN?
Cirrhosis
121
What is your diagnosis of a young, thin asymptomatic female with a midsystolic click on cardiac auscultation?
Mitral valve prolapse
122
What infection is associated with ring-enhancing lesions seen on computed tomography (CT) of the brain in an HIV-positive individual?
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
123
What is the term for a reversible change in one cell type to another?
Metaplasia (usually to a more protective cell type)
124
What liver tumor is associated with oral contraceptive pill use?
Hepatic adenomas
125
What CNS developmental abnormality is associated with downward displacement of the cerebellar vermis and medulla compressing the fourth ventricle and leading to obstructive hydrocephalus?
Arnold-Chiari malformation type 2
126
What disease involves a lack of both T cell-mediated and humoral immune responses that can be either X-linked or AR?
Severe combined immunodeficiency disease
127
What condition results in the following CSF results? • Opening pressure 70 to 180 mm H2O; 0-10 WBCs (monocytes); glucose 45 to 85, protein 15 to 45
Normal values
128
What condition results in the following CSF results? • Opening pressure 450 mm H2O; 5 WBCs (90% lymphocytes); normal glucose and protein levels
Brain abscess
129
What condition results in the following CSF results? • Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
Viral meningitis
130
What condition results in the following CSF results? • Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
TB meningitis
131
What condition results in the following CSF results? • Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
Bacterial meningitis
132
True or false? Removal of the ileum results in vitamin B12 deficiencies.
True. The ileum is the site where vitamin B12 is absorbed.
133
What is the term for edema that has LDH below 200, protein level 2.5, and a specific gravity below 1.020?
Transudative; exudative has the opposite values and has an elevated cellular content.
134
What is the term for thickened, hyperpigmented skin in the axillae, groin, and skin folds associated with malignancies, obesity, and DM?
Acanthosis nigricans
135
How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome?
>3.5 g/day of protein, along with generalized edema, hypoalbuminemia, and hyperlipidemia
136
What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
Heroin
137
What catecholamine-hypersecreting tumor, a secondary cause of HTN, results in headache, diaphoresis, anxiety, tachycardia, and palpitations?
Pheochromocytoma
138
What is the term for flattened nose, low-set ears, and recessed chin seen in patients with bilateral renal agenesis?
Potter facies
139
What type of healing occurs in a clean surgical incision?
Primary intention
140
What are the two most common viral infections in HIV?
CMV retinitis and HSV-2
141
What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result?
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
142
Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?
Cushing's disease (pituitary) has elevated ACTH and cortisol suppression with dexamethasone, whereas Cushing's syndrome (adrenal adenoma) has decreased ACTH and no cortisol suppression with dexamethasone.
143
What CD4 T-cell receptor does the HIV virus bind to?
gp120
144
What is the term for RBC fragments?
Schistocytes
145
What disorder is due to a deficiency in tyrosinase?
Albinism
146
What two Abs are used to diagnose Hashimoto's thyroiditis?
Antithyroglobulin and antimicrosomal Abs
147
What urease-producing gram-negative curved rod is associated with PUD and chronic gastritis?
Helicobacter pylori, which is also associated with an increased risk of gastric carcinoma
148
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Alkylating agents
Leukemias and lymphomas
149
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Aromatic amines and azo dyes
Hepatocellular carcinoma
150
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Arsenic
Squamous cell carcinoma (skin, lung) and angiosarcoma of the liver
151
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Asbestos
Mesothelioma and bronchogenic carcinoma
152
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Naphthylamine
Bladder cancer
153
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Benzenes
Leukemias
154
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Vinyl chloride
Angiosarcoma of the liver
155
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Chromium and nickel
Bronchogenic carcinoma
156
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Polycyclic aromatic hydrocarbons
Bronchogenic carcinoma
157
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Nitrosamines
Gastric cancer
158
What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
159
What pancreatic islet cell tumor is associated with hypoglycemia, sweating, hunger, confusion, and increased C-peptide levels?
Insulinoma
160
What substance is used to test platelets' response in patients with von Willebrand disease?
Ristocetin
161
What X-linked recessive disorder that is due to an abnormality in the dystrophin gene, has onset by age 5 with progressive proximal muscle weakness, calf pseudohypertrophy, and elevated CPK levels?
Duchenne muscular dystrophy (Remember, Becker's is slower in progress, less severe, later in onset, and lacks cardiac involvement.)
162
What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
Bronchioloalveolar carcinoma
163
What estrogen-producing tumor of the female genital tract is characterized by Call-Exner bodies?
Granulosa cell tumor of the ovary
164
What AD syndrome involves 1000 or more edematous polyps, most commonly affects the colorectal area, and is associated with chromosome 5q21?
Familial polyposis coli
165
What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
166
What prostaglandin is associated with maintaining patency of the ductus arteriosus?
PGE (along with low oxygen tension)
167
What is the term for dilated veins within the spermatic cord?
Varicocele
168
What type of hemostasis in an intravascular space consists of fibrin, platelets, RBCs, and WBCs?
Thrombus
169
What is the most common primary malignant tumor in bone?
Osteosarcoma
170
What is the most common infectious agent in HIV?
Pneumocystis carinii
171
What myeloid disorder is characterized by dry bone marrow aspirations, splenomegaly, leukoerythroblastosis, teardrop RBCs, and hyperuricemia due to increased cell turnover?
Myelofibrosis with myeloid metaplasia
172
What disease that involves mental retardation, flat face, muscle hypotonia, and a double-bubble sign on radiograph poses an increased risk of Alzheimer's disease and ALL?
Down syndrome (trisomy 21)
173
What form of anemia is associated with IgG Abs against Rh antigens, positive direct Coombs test, and splenomegaly?
Autoimmune hemolytic anemia
174
What urinary metabolite is increased in patients with carcinoid syndrome?
5-hydroxyindoleacetic acid (5-HIAA)
175
What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
Primary sclerosing cholangitis
176
What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
LC4, LD4, and LE 4
177
What are the three Bs of adult polycystic kidneys?
1. Big 2. Bilateral 3. Berry aneurysm
178
What AR disease involves a defect in AA 508 on chromosome 7, causing a defect in Cl- transportation that leads to recurrent pulmonary infections and an increase in viscid mucoid secretions along with pancreatic insufficiencies?
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
179
What law states that an enlarged, palpable gallbladder is more likely due to cancer than stone obstruction?
Courvoisier's law
180
What is the term for air in the pleural space?
Pneumothorax
181
What disorder of bone remodeling results in thick, weak bones and is associated with high-output cardiac failure?
Paget disease (osteitis deformans)
182
What is the term to describe the increase in organ size due to the increase in cell size and function?
Hypertrophy
183
What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?
Meningioma
184
True or false? Ethyl alcohol induces the cytochrome P-450 enzymes.
TRUE
185
What are the five components of portal HTN?
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
186
What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
Prader-Willi syndrome and Angelman syndrome, respectively
187
What CNS tumor arises from Rathke's pouch?
Craniopharyngioma
188
What is the triad of Reiter syndrome?
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see, can't wee, can't kick with your knee
189
Which of the following is not a risk factor for cholesterol gallstones: pregnancy, OCP use, female gender, hemolytic anemia, cirrhosis, and obesity? (May be more than one answer.)
Cirrhosis and hemolytic anemia, which are risk factors for pigmented gallstones.
190
Name the nephritic disease based on the immunofluorescent staining. • Mesangial deposits of IgA and C3
IgA nephropathy (Berger disease)
191
Name the nephritic disease based on the immunofluorescent staining. • Smooth and linear pattern of IgG and C3 in the GBM
Goodpasture disease
192
Name the nephritic disease based on the immunofluorescent staining. • Granular deposits of IgG, IgM, and C3 throughout the glomerulus
Postinfectious GN
193
What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
GP IIb/IIIa, which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
194
What virus is associated with body cavity large B-cell lymphomas?
HHV-8
195
What germ cell tumor is seen in the 15-to 35-year-old age group, peaks when the person is 35 years of age, and is a bulky mass that spreads via the lymphatic system?
Seminoma
196
What transmural inflammatory bowel disease can be found from the mouth to anus, has noncaseating granulomas, is discontinuous (skip lesions), and has a cobblestone appearance, thickening of the bowel wall, linear fissures, and aphthous ulcers with normal mucosa between?
Crohn disease
197
Does ELISA or Western blot confirm whether a patient is HIV-positive?
ELISA screens and Western blot confirms the diagnosis.
198
What GN is highly associated with hepatitis B and C infections?
Membranoproliferative glomerulonephritis (MPGN)
199
What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation?
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
200
What is the term for excessive amounts of granulation tissue that can block re-epithelialization and wound healing?
Proud flesh
201
What is released from the mitochondria to trigger apoptosis?
Cytochrome c
202
How much of a vessel must be stenosed to cause sudden cardiac death?
More than 75% of the vessel
203
Oxidation of Hgb forms what bodies in patients with G-6-PD deficiency?
Heinz bodies
204
What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN, hypokalemia, and low rennin levels?
Conn syndrome (primary hyperaldosteronism)
205
What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
EBV
206
What normochromic, normocytic AD anemia has splenomegaly and increased osmotic fragility?
Hereditary spherocytosis
207
What does prepubertal hypersecretion of growth hormone lead to?
Gigantism
208
What enzyme is deficient in alkaptonuria?
Homogentisic oxidase
209
What sex cell tumor causes precocious puberty, masculinization, gynecomastia in adults, and crystalloids of Reinke?
Leydig cell tumor
210
Name four major risk factors for atherosclerosis.
DM, hypercholesterolemia, smoking, and HTN are major risk factors. Being male, obesity, sedentary lifestyle, homocysteine elevation, oral contraceptive pills, and genetics are minor risk factors for atherosclerosis.
211
Name the AD disease associated with chromosome 15 in which the patient has long extremities, lax joints, pigeon chest, and posterior mitral leaflet prolapse and is prone to developing dissecting aortic aneurysm.
Marfan syndrome
212
What is the term for a large VSD that leads to pulmonary HTN, RVH, and cyanosis due to right-to-left reversal of the shunt?
Eisenmenger syndrome, which can also occur with any left-to-right shunt
213
Eating fava beans can produce the Mediterranean type of what deficiency?
G-6-PD deficiency
214
What form of hemophilia is X-linked recessive and due to a deficiency in factor VIII?
Hemophilia A
215
What leukemia affects a 4-year-old child with 3 months of fever, fatigue, generalized lymphadenopathy, CNS involvement, hepatosplenomegaly, bleeding, and platelet count below 100, 000?
ALL
216
What protein deficiency results in respiratory distress syndrome of newborns?
Deficiency in surfactant
217
What are the three components of amyloid?
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
218
What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
Myasthenia gravis
219
What are the three left-to-right shunts?
1. VSD 2. ASD 3. PDA
220
What protein causes fibrinolysis?
Plasmin
221
What pancreatic islet cell tumor is associated with watery diarrhea, hypokalemia, and achlorhydria?
VIPoma
222
True or false? Obesity, DM, HTN, multiparity, early menarche, and late menopause are all risk factors for endometrial carcinoma.
False. They are all risk factors for endometrial carcinoma except multiparity. Nulliparity, estrogen-producing tumors, and estrogen replacement therapy are also risk factors for endometrial carcinoma.
223
What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
Lisch nodules
224
What GI pathology is associated with a positive string sign, an increase in the number of bloody stools, RLQ pain, skip lesions, terminal ileum most commonly affected, occurrence in women more than men, and an increased thickness of the bowel?
Crohn disease
225
What is the most common fungal infection in HIV?
Candida
226
True or false? GERD is a cause of asthma.
True. Don't forget this in your differential diagnosis of an asthmatic.
227
Name the product or products of arachidonic acid: • Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
PGI2
228
Name the product or products of arachidonic acid: • Vasodilation
PGD2, PGE2, and PGF 2
229
Name the product or products of arachidonic acid: • Pain and fever
PGE2
230
Name the product or products of arachidonic acid: • Vasoconstriction and platelet aggregation produced by platelets
TXA2
231
Name the product or products of arachidonic acid: • Chemotactic for neutrophils
LTB4
232
Name the product or products of arachidonic acid: • Vasodilation, bronchospasm, and increased vascular permeability
LTC4, LTD4, and LTE4
233
Which hepatitis B Ab indicates low transmissibility?
HBeAb
234
What pneumoconiosis is associated with exposure to the following occupations or materials? • Miners, metal grinders, and sandblasters
Silicosis Note: Coal worker's pneumoconiosis is synonymous with black lung disease, an upper lobe occupational disorder
235
What pneumoconiosis is associated with exposure to the following occupations or materials? • Aerospace industry, nuclear reactors
Berylliosis
236
What pneumoconiosis is associated with exposure to the following occupations or materials? • Shipyards, brake linings, insulation, and old building construction
Asbestosis
237
What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
Porcelain gallbladder
238
What is the term to describe a decrease in the cell size and function usually associated with disuse?
Atrophy. Disuse can also be due to immobilization, ischemia, aging, and a host of other causes.
239
Which B-cell neoplasm has the following cell surface markers: CD19, CD20, CD5 (T-cell marker), CD23; and are CD10-negative?
CLL (B-cell origin)
240
What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur, humerus, and tibia?
Caisson disease
241
What are the four DNA oncogenic viruses?
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
242
Is the AD or AR form of osteopetrosis malignant?
The AR form is malignant and AD is benign.
243
What carcinoma produces hematuria, flank pain, and a palpable mass?
This is the triad of renal cell carcinoma
244
Name at least three causes of metastatic calcification.
Remember the mnemonic PAM SMIDT P, (hyper) Parathyroid/ Paget disease A, Addison's disease M, Milk-alkali syndrome/metastatic cancer S, Sarcoidosis M, Multiple myeloma I, Immobilization/idiopathic D, Vitamin D intoxication T, Tumors
245
What is the only subtype of Hodgkin's lymphoma that is most commonly seen in females?
Nodular sclerosis
246
What is the leading cause of preventable premature death and illness in the United States?
Smoking
247
What prion-associated CNS pathology produces rapidly progressive dementia with myoclonus, involuntary movements, and death within 6 to 12 months?
Creutzfeldt-Jakob disease
248
What breast malignancy has tumor cells with a halo surrounding the nucleus and is an ulceration of the nipple and areola with crusting, fissuring, and oozing?
Paget disease of the breast
249
What breast pathology involves malignant cells with halos invading the epidermis of the skin?
Paget disease of the breast
250
Macro-ovalocytes in the peripheral blood smear are formed from what cell in the bone marrow?
Megaloblasts
251
Name the type of exudate, given the following examples. • Sunburn
Serous exudates
252
Name the type of exudate, given the following examples. • Uremic pericarditis
Fibrinous exudates
253
Name the type of exudate, given the following examples. • Parasitic infection
Eosinophilic exudates
254
Name the type of exudate, given the following examples. • Diphtheria infection
Pseudomembranous exudates
255
Name the type of exudate, given the following examples. • Meningococcal infection
Purulent exudates
256
Name the type of exudate, given the following examples. • Rickettsial infection
Hemorrhagic exudates
257
What parasite is associated with squamous cell carcinoma of the urinary bladder?
Schistosoma haematobium
258
What malabsorption syndrome produces abdominal distention, bloating, flatulence, diarrhea, steatorrhea, and weight loss shortly after eating bread products?
Celiac sprue (gluten-sensitive enteropathy)
259
What herpes virus is associated with Kaposi sarcoma?
HHV 8
260
What is the term for the copper corneal deposits found in Wilson's disease?
Kayser-Fleischer rings
261
Name the six vitamin K-dependent coagulation factors.
Factors II, VII, IX, and X and proteins C and S.
262
What ovarian carcinoma is characterized by psammoma bodies?
Cystadenocarcinoma
263
A marfanoid patient presents with tearing retrosternal chest pain radiating to her back. What is your first diagnosis?
Dissecting aortic aneurysm. MI is also high on the list, but these are buzzwords to look for dissection.
264
What malignant neoplasm of the skin is associated with keratin pearls?
Squamous cell carcinoma
265
Name four chemotactic factors for neutrophils.
N-formyl-methionine LTB4 C5a IL-8
266
What is the term for granuloma at the lung apex in TB?
Simon focus
267
What are the three platelet aggregating factors?
1. ADP 2. PG 3. TXA2
268
What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
Waterhouse-Friderichsen syndrome
269
What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart?
Aschoff bodies of rheumatic fever
270
What is the leading cause of primary hyperparathyroidism?
Chief cell adenoma (80%)
271
In what X-linked recessive disease is there a decrease in the HMP shunt, along with Heinz body formation?
G-6-PD deficiency
272
What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb-containing area?
Target cell
273
True or false? Raynaud's phenomenon has no underlying pathology.
False. The disease has no associated pathology; the phenomenon is arterial insufficiency due to an underlying disease.
274
What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
Intraductal papilloma
275
What form of hemophilia is X-linked recessive and is due to a deficiency in factor IX?
Hemophilia B
276
What are the two reasons for megaloblastic anemia with elevated MCV?
Vitamin B12 deficiency and folate deficiency
277
Is cigarette smoking associated with transitional cell carcinoma of the bladder?
Yes. It is also a cause of cancers of the lung, esophagus, ureter, and kidney, just to name a few.
278
What disease has multiple schwannomas, café-au-lait spots on the skin, and Lisch nodules and is associated with chromosome 17q?
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
279
What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
Eaton-Lambert syndrome
280
In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
Malignant mesothelioma
281
What is the term for cytoplasmic remnants of RNA in RBCs, seen in lead poisoning?
Basophilic stippling
282
What is the triad of fat embolism?
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g., long bone fracture)
283
Upon seeing negatively birefringent needle-shaped crystals from a joint aspiration of the great toe, what form of arthritis do you diagnose?
Gout
284
What condition is manifested by bilateral sarcoidosis of the parotid glands, submaxillary gland, and submandibular gland with posterior uveal tract involvement?
Mikulicz syndrome
285
What female genital tract disorder is characterized by obesity, hirsutism, infertility, amenorrhea, elevated LH and testosterone levels, and low FSH levels?
Polycystic ovary disease (Stein-Leventhal syndrome)
286
What bronchogenic carcinoma is associated with an elevated level of Ca2+, involves keratin pearls, occurs in men more than women, is associated with smoking, occurs in the major bronchi, and is seen in the central areas of the lung?
Squamous cell carcinoma
287
What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
PKU
288
True or false? Being a white male increases your risk factor for testicular cancer.
Oddly enough, it is true. Cryptorchidism, Klinefelter syndrome, testicular feminization, and family history of testicular cancer are all risk factors.
289
Can an acute MI be diagnosed only by looking at an ECG?
No. Remember, tests do not diagnose, they confirm or refute your diagnosis. Also, diagnosis of MI requires two of three criteria: chest pain consistent and characteristic of MI, elevated cardiac enzymes consistent with MI, and ST segment elevation of 2 mm or more in at least two contiguous leads.
290
What autoimmune syndrome is characterized by keratoconjunctivitis, corneal ulcers, xerostomia, and an increased risk of high-grade B-cell lymphomas? What two Ab tests are used in making the diagnosis?
Sjögren's syndrome; SS-A (Ro) and SS-B (La)
291
True or false? Sickle cell anemia, Caisson disease, chronic steroid use, and Gaucher disease are causes of avascular necrosis of bone.
True. Fractures and trauma, however, are the most common causes.
292
What gene stimulates apoptosis when DNA repair is unable to be done?
p-53
293
Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis?
Ulcerative colitis
294
What test uses p24 protein when diagnosing HIV?
ELISA test
295
How many café-au-lait spots are necessary for the diagnosis of neurofibromatosis type 1?
At least six
296
What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction?
Mallory-Weiss syndrome
297
What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
Metastatic calcification
298
What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
Volvulus
299
What form of poisoning is associated with bitter almond-scented breath?
Cyanide
300
Name the type of hypersensitivity reaction based on the following properties. • Circulating Ab-Ag immune complexes deposited in the tissue result in neutrophil attraction and the release of lysosomal enzymes.
Type III hypersensitivity (immune complex)
301
Name the type of hypersensitivity reaction based on the following properties. • IgE-mediated release of chemical mediators from basophils and mast cells; need prior exposure to Ag in the past; eosinophils amplify and continue reaction; can be system or localized.
Type I hypersensitivity (anaphylactic)
302
Name the type of hypersensitivity reaction based on the following properties. • IgG or IgM Abs against a specific target cell or tissue; complement-dependent or ADCC.
Type II hypersensitivity (cytotoxic)
303
Name the type of hypersensitivity reaction based on the following properties. • Reaction-mediated by sensitized T-cells
Type IV hypersensitivity (cell-mediated)
304
What highly undifferentiated aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes?
Primitive neuroectodermal tumors (i.e., medulloblastomas and retinoblastomas)
305
What syndrome is due to anti-GBM Abs directed against the lung and kidneys?
Goodpasture syndrome
306
What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
307
What tumor is seen in the 2-to 4-year-old age group; does not cross the midline; has immature glomeruli, tubules, and stroma; and metastasizes late to the lungs?
Wilms tumor
308
What CNS tumor commonly produces tinnitus and hearing loss?
Schwannoma
309
True or false? Anticentromere Abs are used in diagnosing CREST syndrome.
True. Scl-70 Abs are used in diagnosing diffuse scleroderma.
310
What AR CNS disorder presents early in childhood with gait ataxia, loss of deep tendon reflexes, impaired vibratory sensation, hand clumsiness, and loss of position sense?
Friedreich ataxia
311
What potent platelet aggregator and vasoconstrictor is synthesized by platelets?
TXA2
312
Which type of cerebral herniation is associated with CN III palsy?
Transtentorial (uncal)
313
What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
Syphilitic
314
What is the main type of cell involved in cellular immunity?
T lymphocyte
315
What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
Melasma
316
What is the classic triad of TB?
Fever, night sweats, and hemoptysis
317
True or false? Blood clots lack platelets.
True. A thrombus has platelets, but clots do not.
318
What malignant tumor of the skin is associated with Birbeck granules?
Histiocytosis X
319
What type of anemia is the result of a deficiency in intrinsic factor?
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
320
What cancer is particularly likely to affect English chimney sweeps?
Scrotal cancer, due to the high exposure to polycyclic aromatic hydrocarbons
321
What is the term for a raised fluid-filled cavity greater than 0.5 cm that lies between the layers of the skin?
Bulla
322
What virus is associated with the endemic form of Burkitt lymphoma?
EBV
323
With which pituitary adenoma is an elevated somatomedin C level associated?
GH-producing adenoma
324
What three criteria allow you to differentiate an ulcer from an erosion or carcinoma?
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
325
Name the four right-to-left congenital cardiac shunts.
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
326
What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?
Hypoparathyroidism
327
Does PT or PTT test the extrinsic coagulation pathway?
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT, which means warfarin, extrinsic, PT; heparin, intrinsic, PTT)
328
What leukemia is associated with four-leaf-clover lymphocytes on peripheral blood smear?
Adult T-cell leukemia
329
What ring is a weblike narrowing of the gastroesophageal junction?
Schatzki ring
330
With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
Henoch-Schönlein purpura
331
What rapidly progressive and aggressive T-cell lymphoma affects young males with a mediastinal mass (thymic)?
Lymphoblastic lymphoma
332
What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
Flea-bitten kidney (can also be seen in pyelonephritis)
333
True or false? Psammoma bodies are seen in medullary carcinoma of the thyroid.
False. Elevated calcitonin levels are seen in medullary carcinoma of the thyroid. Psammoma bodies are seen in papillary carcinoma of the thyroid and ovaries, as well as meningiomas.
334
What is the lecithin:sphingomyelin ratio in respiratory distress syndrome of newborns?
<2
335
What syndrome has loss of deep tendon reflexes, muscle weakness, and ascending paralysis preceded by a viral illness?
Guillain-Barré syndrome
336
What form of endocarditis do patients with SLE commonly encounter?
Libman-Sacks endocarditis
337
What is the term for black pigmentation of the colon associated with laxative abuse?
Melanosis coli
338
Are the following major or minor Jones criteria of rheumatic fever? • Fever
Minor
339
Are the following major or minor Jones criteria of rheumatic fever? • Migratory polyarthritis
Major
340
Are the following major or minor Jones criteria of rheumatic fever? • Subcutaneous nodules
Major
341
Are the following major or minor Jones criteria of rheumatic fever? • Elevated acute phase reactants (e.g., ESR)
Minor
342
Are the following major or minor Jones criteria of rheumatic fever? • Arthralgias
Minor
343
Are the following major or minor Jones criteria of rheumatic fever? • Pericarditis
Major
344
Are the following major or minor Jones criteria of rheumatic fever? • Erythema marginatum
Major
345
Are the following major or minor Jones criteria of rheumatic fever? • Sydenham chorea
Major
346
What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
Bcl-2
347
Which hepatitis strain is a defective virus that can replicate only inside HBV-infected cells?
Hepatitis D
348
What are the three main components of amyloid?
Fibrillary protein, amyloid protein, and glycosaminoglycans (heparin sulfate mainly)
349
What leukemia is characterized by Philadelphia chromosomal translocation (9;22); massive splenomegaly; peripheral leukocytosis (commonly > 100, 00); decreased LAP levels; and nonspecific symptoms of fatigue, malaise, weight loss, and anorexia?
CML
350
What is the difference between a Ghon focus and a Ghon complex?
A Ghon focus is a TB tubercle, whereas a Ghon complex is a focus with hilar lymph node involvement.
351
In what disease do you see horseshoe kidneys, rockerbottom feet, low-set ears, micrognathia, and mental retardation?
Edward syndrome (trisomy 18)
352
What parasitic infection is associated with cholangiocarcinoma?
Clonorchis sinensis
353
What disorder is associated with loss of polarity, anaplasia, pleomorphism, discohesiveness, increase in the nuclear:cytoplasmic ratio, hyperchromasia, and increase in the rate of mitosis?
Malignancy
354
What is the term for telescoping of the proximal bowel into the distal segment presenting as abdominal pain, currant jelly stools, and intestinal obstruction?
Intussusception
355
What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
Amanita phalloides
356
What type of erythema do you see in • Ulcerative colitis?
Erythema nodosum
357
What type of erythema do you see in • Rheumatic fever?
Erythema marginatum
358
What type of erythema do you see in • Stevens-Johnson syndrome?
Erythema multiforme
359
What benign bone tumor is associated with Gardner syndrome?
Osteoma
360
What renal calculus is associated with urea-splitting bacteria?
Magnesium ammonium phosphate (struvite)
361
What lymphoma is associated with bleeding and cryoglobulin precipitation at low temperatures, headache and confusion due to hyperviscosity, IgM M-protein spike on serum electrophoresis, and Russell bodies?
Waldenström's macroglobulinemia
362
What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis?
Mercury
363
What slow-growing CNS tumor in 30-to 50-year-old patients with a long history of seizures has fried egg cellular appearance in a network of chicken wire?
Oligodendroglioma
364
Goodpasture Ag is a component of what type of collagen?
Type IV collagen
365
If a peripheral blood smear shows schistocytes, reticulocytes, and thrombocytopenia, is it more commonly seen in patients with ITP or TTP?
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
366
After traveling in a plane across the Atlantic Ocean, an obese male goes to the ER with swollen right leg and sudden onset of shortness of breath. What do you immediately diagnose?
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
367
What cell type involves humoral immunity?
B lymphocyte
368
What is the first sign of megaloblastic anemia on a peripheral blood smear?
Hypersegmented neutrophils
369
What is the term for gastric ulcers associated with severely burned or traumatic patients?
Curling ulcers (think curling iron = burn)
370
What syndrome arises from mutation in the fibrillin gene (FBN1) on chromosome 15q21?
Marfan syndrome
371
What AD disorder is characterized by degeneration of GABA neurons in the caudate nucleus resulting in atrophy, chorea, dementia, and personality changes?
Huntington disease
372
What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?
Mycoplasma pneumoniae
373
What is the triad of Felty syndrome?
Neutropenia, splenomegaly, and rheumatoid arthritis
374
What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
Chemotaxis
375
What is the term for a benign melanocytic tumor associated with sun exposure that presents as tan-to-brown colored and has sharply defined well-circumscribed borders?
Benign nevus (mole)
376
What small- to medium- sized vasculitis is seen in a 35-year-old man who is a heavy smoker presenting with claudication symptoms in the upper and lower extremities?
Buerger disease (thromboangiitis obliterans)
377
What is the term for pelvic inflammatory disease of the fallopian tubes?
Salpingitis
378
What disease with familial mental retardation produces large, everted ears and macro-orchidism?
Fragile X syndrome
379
What type of skin carcinoma occurring on sun-exposed sites has a low level of metastasis?
Squamous cell carcinoma
380
What is the tetrad of tetralogy of Fallot?
VSD, RVH, overriding aorta, and pulmonary stenosis
381
What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome?
Bronchiectasis
382
What is an elevated, fluid-filled cavity between skin layers up to 0.5 cm?
Vesicle (e.g., poison ivy)
383
What is the term for panhypopituitarism secondary to ischemic necrosis and hypotension postpartum?
Sheehan syndrome
384
What disease is diagnosed by findings of ANAs and anti-SCL-70 antibodies?
Scleroderma
385
What is the name of the ovarian cyst containing ectodermal, endodermal, and mesodermal elements (i.e., skin, hair, teeth and neural tissue)?
Teratoma (dermoid cyst)
386
What syndrome is seen in iron-deficient middle-aged women with esophageal webs?
Plummer-Vinson syndrome
387
What are the three causes of transudate?
CHF, cirrhosis, and nephrosis
388
A chronic alcohol abuser goes to the ER with weakness, a sore, beefy red tongue, loss of vibration and position sense, arm and leg dystaxia, elevated levels of methylmalonic acid in the urine, and anemia with an MCV above 105 fL. What is your diagnosis, and how will you monitor his response to treatment?
Subacute combined degeneration of the spinal cord is treated with IM vitamin B12 injections. If treatment is working, you will see an increased reticulocyte count on the peripheral smear in about 5 days.
389
What form of GN is characteristically associated with crescent formation?
Rapidly progressive glomerulonephritis (RPGN)
390
What vitamin deficiency may result in sideroblastic anemia?
Vitamin B6
391
What is the term for TB with the cervical lymph node involved?
Scrofula
392
Influx of what ion is associated with irreversible cell injury?
Massive influx of calcium
393
What pathology is associated with elevated levels of Ca2+, cardiac arrhythmias, bone resorption, kidney stones, and metastatic calcifications?
Primary hyperparathyroidism
394
What type of metal poisoning causes mental retardation, somnolence, convulsions, and encephalopathy?
Lead
395
What syndrome is rheumatoid arthritis with pneumoconiosis?
Caplan syndrome
396
True or false? All of the following are risk factors for cervical cancer: multiple pregnancies, early age of intercourse, multiple sexual partners, OCP use, smoking, HIV, and STDs.
True. Don't forget this list; you will be asked.
397
What is the term for precipitation of calcium phosphate in dying or necrotic tissue?
Dystrophic calcification
398
What congenital small bowel outpouching is a remnant of the vitelline duct?
Meckel diverticulum
399
What type of crystals are associated with gout?
Monosodium urate crystals
400
What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?
Mees lines
401
What is the tumor at the bifurcation of the right and left hepatic ducts?
Klatskin tumor
402
IgE-mediated mast cell release, C3a and C5a, and IL-1 all trigger the release of what vasoactive amine?
Histamine
403
What disease is seen in the 20-to 40-year-old age group, is more prevalent in women than men, involves diarrhea with or without bloody stools, starts in the rectum and ascends without skipping areas, includes pseudopolyps, and has a thickness of the bowel that does not change?
Ulcerative colitis
404
What disorder causes joint stiffness that worsens with repetitive motion, crepitus, effusions, and swelling and commonly affects the knees, hips, and spine?
Osteoarthritis
405
What condition is characterized by a 46XY karyotype, testes present, and ambiguous or female external genitalia?
Male pseudohermaphrodite (dude looks like a lady!)
406
What is the term for RBC remnants of nuclear chromatin in asplenic patients?
Howell-Jolly bodies
407
What is the term for gastric ulcers associated with increased intracranial pressure?
Cushing's ulcers
408
What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
Hemolytic uremic syndrome
409
Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
Osteomalacia. Osteoporosis has normal levels of calcium, phosphorus, and alkaline phosphatase.
410
What vascular tumor associated with von Hippel-Lindau syndrome involves the cerebellum, brainstem, spinal cord, and retina?
Hemangioblastoma
411
How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
At least 5 lobes
412
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Epidermis
Labile
413
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Skeletal muscle
Permanent
414
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Pancreas
Stable
415
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • CNS neurons
Permanent
416
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Fibroblasts
Stable
417
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Hematopoietic cells
Labile
418
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Liver
Stable
419
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Smooth muscle
Stable
420
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Cardiac muscle
Permanent
421
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Mucosal epithelium
Labile
422
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Kidney
Stable
423
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Osteoblasts
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states, do not proliferate.)
424
What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
Astrocytoma
425
True or false? Elevated ASO titers and serum complement levels are associated with poststreptococcal GN.
False. ASO titers are elevated, but serum complement levels are decreased.
426
What glycoprotein allows platelets to adhere to von Willebrand factor?
GP Ib
427
What encephalitis is associated with the JC virus?
Progressive multifocal leukoencephalopathy
428
Hereditary angioneurotic edema (AD) produces local edema in organs (e.g., GI, skin, respiratory tract). What enzyme deficiency causes increased capillary permeability due to a release of vasoactive peptides?
C1 esterase inhibitor (C1INH)
429
Is an anti-HAV IgG Ab associated with immunization or recent infection?
Anti-HAV IgG Abs are associated with immunization or a prior infection. Anti-HAV IgM is associated with acute or recent infection.
430
Which integrin mediates adhesion by binding to lymphocyte function- associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
Intercellular adhesion molecule (ICAM) 1
431
Name the cerebral vessel associated with the following vascular pathologies. • Subarachnoid hemorrhage
Berry aneurysm in the circle of Willis
432
Name the cerebral vessel associated with the following vascular pathologies. • Subdural hemorrhage
Bridging veins draining into the sagittal sinus
433
Name the cerebral vessel associated with the following vascular pathologies. • Epidural hemorrhage
Middle meningeal artery
434
True or false? Live vaccines are contraindicated in patients with SCID.
TRUE
435
What is the term for the round intracytoplasmic eosinophilic inclusions containing ɑ-synuclein found in the dopaminergic neurons of the substantia nigra?
Lewy bodies
436
In which form of emphysema, panacinar or centriacinar, is the effect worse in the apical segments of the upper lobes?
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
437
What syndrome results if the enzyme ɑ-1-iduronidase is deficient? L-iduronate sulfatase deficiency?
Hurler syndrome and Hunter syndrome, respectively
438
What percentage of the bone marrow must be composed of blast for leukemia to be considered?
At least 30% blast in the bone marrow
439
What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
CHF
440
What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
Fitz-Hugh-Curtis syndrome
441
True or false? Patients with Turner syndrome have no Barr bodies.
True. Remember, the second X chromosome is inactivated, and so is the Barr body. Turner syndrome has only one X chromosome.
442
What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
Auspitz sign
443
What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
Hgb F
444
What vasculitis affects a 30-year-old Asian female having visual field deficits, dizziness, decreased blood pressure, and weakened pulses in the upper extremities?
Takayasu arteritis (medium-size to large vessels)
445
A 20-year-old college student has fever, grey-white membranes over the tonsils, posterior auricular lymphadenitis, and hepatosplenomegaly. What is your diagnosis? What test do you order to confirm your diagnosis?
EBV infections resulting in infectious mononucleosis can be diagnosed by the Monospot test. (Remember, it may be negative in the first week of the illness, so retest if you have a high index of suspicion.)
446
What cell type is commonly elevated in asthma?
Eosinophil
447
What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
Pseudogout
448
What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
Medullary carcinoma of the thyroid
449
What illegal drug can cause rhabdomyolysis, MI, cerebral infarct, and lethal cardiac arrhythmias?
Cocaine
450
What AA is substituted for glutamic acid at position 6 on the Beta-chain in patients with sickle cell anemia?
Valine
451
What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine?
Melanin
452
What tumor marker is associated with seminomas?
Placental alkaline phosphatase
453
What type of GN, associated with celiac disease and dermatitis herpetiformis, has mesangial deposits of IgA, C3, properdin, IgG, and IgM?
Berger disease (IgA nephropathy)
454
What AD disease is associated with chromosome 4p; does not present until the person is in his or her 30s; and involves atrophy of the caudate nucleus, dilatation of the lateral and third ventricles, and signs of extrapyramidal lesions?
Huntington disease
455
What pattern of inheritance is G-6-PD deficiency?
X-linked recessive
456
What adenocarcinoma presents with elevated levels of acid phosphatase, dihydrotestosterone, PSA, and bone pain?
Prostatic carcinoma
457
Is Dubin-Johnson or Rotor syndrome associated with black pigmentation of the liver?
Both are AR with conjugated hyperbilirubinemia, but Dubin-Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
458
What oxygen-dependent killing enzyme requires hydrogen peroxide and halide (Cl-) to produce hypochlorous acid?
Myeloperoxidase
459
What condition results in a strawberry gallbladder?
Cholesterolosis
460
What three chemical agents are associated with angiosarcomas of the liver?
Arsenic, thorotrast, and vinyl chloride
461
What is the term for programmed cell death?
Apoptosis (Remember, there is a lack of inflammatory response.)
462
What potentially fatal disease occurs in children who are given aspirin during a viral illness?
Reye syndrome
463
What metal poisoning produces microcytic anemia with basophilic stippling?
Lead poisoning
464
What inflammatory bowel disorder is continuous, with extensive ulcerations and pseudopolyps, and is associated with HLA-B27?
Ulcerative colitis
465
What is the pentad of TTP?
Neurologic symptoms Renal failure Thrombocytopenia Fever Microangiopathic hemolytic anemia (Don't forget it. When I was an intern, my senior resident asked me this question more times than I would like to remember.)
466
Which hepatitis B Ag correlates with infectivity and viral proliferation?
HBeAg
467
What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000?
Job syndrome
468
What female pathology is associated with endometrial glands and stroma outside the uterus commonly affecting the ovaries as chocolate cysts?
Endometriosis
469
What is the karyotype in Turner syndrome?
45XO
470
What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?
Hirschsprung disease (aganglionic megacolon)
471
What syndrome is associated with gastrin-producing islet cell tumor resulting in multiple intractable peptic ulcers?
Zollinger-Ellison syndrome
472
What type of collagen is associated with keloid formation?
Type III
473
The "tea-and-toast" diet is classically associated with what cause of megaloblastic anemia?
Folate deficiency (very common in the elderly)
474
What is the term for ascending bacterial infection of the renal pelvis, tubules, and interstitium causing costovertebral angle tenderness, fever, chills, dysuria, frequency, and urgency?
Pyelonephritis
475
How can a deficiency in adenosine deaminase be a bone marrow suppressor?
It causes a buildup of dATP, which inhibits ribonucleotide reductase and leads to a decrease in deoxynucleoside triphosphate, a precursor of DNA, resulting in overall bone marrow suppression.
476
Which phenotype of osteogenesis imperfecta is incompatible with life?
Type II
477
With what is cherry red intoxication associated?
Acute CO poisoning
478
What are the four most common causes of femoral head necrosis?
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
479
What are the four signs of acute inflammation?
Rubor (red), dolor (pain), calor (heat), tumor (swelling); also sometimes there is loss of function
480
Name the hypochromic microcytic anemia based on the following laboratory values. • Increased iron, decreased TIBC, increased percent saturation, increased ferritin
Sideroblastic anemia
481
Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, TIBC, and percent saturation; increased ferritin
Anemia of chronic disease
482
Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, percent saturation, and ferritin; increased TIBC
Iron deficiency anemia
483
Name the hypochromic microcytic anemia based on the following laboratory values. • Normal iron, TIBC, percent saturation, and ferritin
Thalassemia minor
484
Which form of emphysema is associated with an alpha1-antitrypsin deficiency?
Panacinar
485
An 80-year-old woman presents to you with right-sided temporal headache, facial pain and blurred vision on the affected side, and an elevated ESR. Your diagnosis?
Temporal arteritis (giant cell arteritis)
486
What type of neurofibromatosis is associated with bilateral acoustic schwannomas?
Type 2
487
What disorder is due to a deficiency in the enzyme glucocerebrosidase?
Gaucher disease
488
What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
Boutonnière deformities
489
True or false? Atelectasis is an irreversible collapse of a lung.
False. Atelectasis is a reversible collapse of a lung.
490
What viral infection in patients with sickle cell anemia results in aplastic crisis?
Parvovirus B 19
491
What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
Klinefelter syndrome
492
What CNS developmental abnormality is associated with 90% of syringomyelia?
Arnold-Chiari malformation type 2
493
What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
Onion skinning
494
A 30-year-old woman goes to your office with bilateral multiple breast nodules that vary with menstruation and have cyclical pain and engorgement. What is your diagnosis?
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer, which is commonly unilateral, single nodule, no variation with pregnancy.
495
What disease is X-linked recessive, is associated with eczema thrombocytopenia and an increased chance of developing recurrent infections, involves a decrease in serum IgM and in the T cell-dependent paracortical areas of the lymph nodes, and means that the patient is likely to develop malignant lymphoma?
Wiskott-Aldrich syndrome
496
Which form of melanoma carries the worst prognosis?
Nodular melanoma
497
Patients with sickle cell anemia are at increased risk for infection from what type of organisms?
Encapsulated bacteria
498
How many major and/or minor Jones criteria are required for the diagnosis of rheumatic fever?
Two major or one major and two minor
499
What skin carcinoma is a superficial dermal infiltrate of T lymphocytes seen in males more than 40 years old and presents as scaly red patches or plaques?
Mycosis fungoides (cutaneous T-cell lymphoma)
500
What Hgb-derived endogenous pigment is found in areas of hemorrhage or bruises?
Hemosiderin
501
What is a palpable, elevated solid mass up to 0.5 cm?
Papule
502
True or false? Monocytosis is seen in TB.
TRUE
503
What pathology is associated with podagra, tophi in the ear, and PMNs with monosodium urate crystals?
Gout
504
What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile, ischemia, Staphylococcus, Shigella, or Candida infection?
Pseudomembranous colitis
505
What do the risk factors late menopause, early menarche, obesity, nulliparity, excessive estrogen, genetic factor p53, and brc-abl characterize?
Breast cancer
506
What thyroid carcinoma is associated with radiation exposure, psammoma bodies, and Orphan Annie eye nuclei?
Papillary carcinoma of the thyroid
507
Name three opsonins.
Fc portion of IgG, C3b, and mannose-binding proteins
508
What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?
Beryllium
509
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Window period
HBcAb IgM
510
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Immunization
HBsAb IgG
511
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Prior infection
HBcAb IgG and HBsAb IgG
512
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Acute infection
HBcAb IgM, HBV-DNA, HBeAg, HBsAg
513
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Chronic infection
HBcAb IgG, HBV-DNA, HBeAg, HBsAg
514
Name the type of necrosis. • The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
Coagulative necrosis
515
Name the type of necrosis. • Seen as dead tissue with coagulative necrosis
Gangrenous necrosis
516
Name the type of necrosis. • Seen as dead tissue with liquefactive necrosis?
Liquefaction necrosis
517
Name the type of necrosis. • Due to lipase activity and has a chalky white appearance
Fat necrosis
518
Name the type of necrosis. • Soft, friable, cottage-cheese appearing; characteristically seen in TB
Caseous necrosis
519
Name the type of necrosis. • Histologically resembles fibrin
Fibrinoid necrosis
520
Name the three enzymes that protect the cell from oxygen-derived free radicals.
Superoxide dismutase, glutathione peroxidase, catalase
521
What are the rules of 2 for Meckel diverticulum?
2% of population, 2 cm long, 2 feet from ileocecal valve, 2 years old, and 2% of carcinoid tumors
522
What aneurysm of the circle of Willis is associated with polycystic kidney disease?
Berry aneurysm
523
A 20-year-old black woman goes to you with nonspecific joint pain, fever, and a malar rash over the bridge of her nose and on her cheeks. This is a classic example of what autoimmune disease? What are three autoantibody tests you could order to make the diagnosis?
SLE; ANA, anti-dsDNA and anti-Sm (anti-Smith)
524
True or false? Excess lead deposits in the oral cavity.
True. It deposits at the gingivodental line, known as the lead line.
525
What is the term for increased iron deposition resulting in micronodular cirrhosis, CHF, diabetes, and bronzing of the skin?
Hemochromatosis
526
What AR disorder is due to a deficiency in glycoprotein IIb-IIIa, resulting in a defect in platelet aggregation?
Glanzmann syndrome
527
What protein-losing enteropathy has grossly enlarged rugal fold in the body and fundus of the stomach in middle-aged males, resulting in decreased acid production and an increased risk of gastric cancer?
Ménétrier's disease
528
What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities, red cell aplasia, and muscle weakness?
Myasthenia gravis
529
Which subtype of AML is most commonly associated with Auer rods?
M3 (promyelocytic leukemia)
530
What condition results from a 46XX karyotype and female internal organs with virilized external genitalia?
Female pseudohermaphrodite
531
Two weeks after her son has a throat infection, a mother takes the boy to the ER because he has fever, malaise, HTN, dark urine, and periorbital edema. What is your diagnosis?
Poststreptococcal GN
532
What X-linked recessive immune disorder is characterized by recurrent infections, severe thrombocytopenia, and eczema?
Wiskott-Aldrich syndrome
533
What form of arthritis is associated with calcium pyrophosphate crystals?
Pseudogout
534
What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury?
Hypertrophic scar
535
What is the term for inflamed, thickened skin on the breast with dimpling associated with cancer?
Peau d'orange
536
What rare vasculitis has the following characteristics: males aged 40 to 60; affecting small arteries and veins; involving nose, sinuses, lungs, and kidneys; C-ANCA and autoantibodies against proteinase 3?
Wegener granulomatosis
537
What retrovirus is associated with adult T-cell leukemia?
HTLV-1
538
What disease is seen in children younger than 5 years of age and is characterized by X-linked recessive cardiac myopathies, calf pseudohypertrophy, lordosis, protuberant belly, an increase then a decrease in CPK, and death commonly in the second decade of life?
Duchenne muscular dystrophy
539
What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
Giant cell bone tumor (osteoclastoma)
540
What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
Minimal change disease
541
What is the term for tissue-based basophils?
Mast cells
542
What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
Osteosarcoma
543
Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
Extravascular hemolysis if it occurs in the spleen; if in the liver, it results in hepatomegaly.
544
What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
Prostatic carcinoma
545
What stromal tumor in males is characterized histologically with crystalloids of Reinke?
Leydig cell tumor
546
What pulmonary disease, most commonly associated with smoking, results in enlarged, overinflated lungs owing to the destruction of the alveolar walls with diminished elastic recoil?
Emphysema
547
What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
Factor XII for the intrinsic; factor VII for the extrinsic pathway
548
What chronic systemic inflammatory disease commonly seen in women aged 20 to 50 is a progressive, symmetric arthritis affecting the hands, wrists, knees, and ankles that improves with increased activity?
Rheumatoid arthritis
549
Name the following descriptions associated with bacterial endocarditis: • Retinal emboli
Roth spots
550
Name the following descriptions associated with bacterial endocarditis: • Painful subcutaneous nodules on fingers and toes
Osler nodes
551
Name the following descriptions associated with bacterial endocarditis: • Painless hyperemic lesions on the palms and soles
Janeway lesions
552
What two CD cell surface markers do Reed- Sternberg cells stain positive for?
CD15 and CD30
553
What two lysosomal storage diseases have cherry-red spots on the retina?
Niemann-Pick and Tay-Sachs diseases
554
True or false? Increased leukocyte alkaline phosphatase (LAP) is associated with CML.
False. Increased LAP is seen in stress reactions and helps differentiate benign conditions from CML, which has low LAP levels.
555
What syndrome has multiple adenomatous colonic polyps and CNS gliomas?
Turcot syndrome
556
What is the term for a venous embolus in the arterial system?
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
557
Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
Embolic
558
What is the name for the following RBC indices? • The coefficient of variation of the RBC volume
Red blood cell distribution width index (RDW)
559
What is the name for the following RBC indices? • Average mass of the Hgb molecule/RBC
Mean corpuscular hemoglobin (MCH)
560
What is the name for the following RBC indices? • Average volume of a RBC
Mean corpuscular volume (MCV)
561
What is the name for the following RBC indices? • Average Hgb concentration/given volume of packed RBCs
Mean corpuscular hemoglobin concentration (MCHC)
562
What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes?
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis, or IHSS)
563
Which HPV serotypes are associated with condyloma acuminatum?
HPV serotypes 6 and 11
564
Which form of melanoma carries the best prognosis?
Lentigo maligna melanoma
565
What is the term for an increase in the number of cells in a tissue?
Hyperplasia
566
A 60-year-old man has back pain (compression spinal fracture), hypercalcemia, increased serum protein, Bence- Jones proteinuria, and monoclonal M-spike on serum electrophoresis. What is your diagnosis?
Multiple myeloma
567
What is the term for pus in the pleural space?
Empyema
568
What is flat, circumscribed nonpalpable pigmented change up to 1 cm?
Macule (e.g., a freckle)
569
Name the macrophage based on its location: • Liver macrophages
Kupffer cells
570
Name the macrophage based on its location: • Bone macrophages
Osteoclasts
571
Name the macrophage based on its location: • Brain macrophages
Microglia
572
Name the macrophage based on its location: • Lung macrophages
Pulmonary alveolar macrophages
573
Name the macrophage based on its location: • Connective tissue macrophages
Histiocytes
574
Name the macrophage based on its location: • Epidermal macrophages
Langerhans cells
575
What is the term for a large, immature RBC that is spherical, blue, and without a nucleus?
Reticulocyte
576
What testicular tumor of infancy is characterized by elevated-fetoprotein levels and Schiller-Duval bodies?
Yolk sac tumor
577
Starry sky appearance of macrophages is pathognomonic of what lymphoma?
Burkitt lymphoma
578
In which region of the lung are 75% of the pulmonary infarcts seen?
Lower lobe
579
For what disease are SS-A(Ro), SS-B(La), and R-ANA diagnostic markers?
Sjögren disease
580
What HPV serotypes are associated with increased risk of cervical cancer?
HPV serotypes 16, 18, 31, and 33
581
Do the following structures pick up stain from hematoxylin or eosin? • Nuclei
Hematoxylin
582
Do the following structures pick up stain from hematoxylin or eosin? • Nucleoli
Hematoxylin
583
Do the following structures pick up stain from hematoxylin or eosin? • Cytoplasm
Eosin
584
Do the following structures pick up stain from hematoxylin or eosin? • Collagen
Eosin
585
Do the following structures pick up stain from hematoxylin or eosin? • RBCs
Eosin
586
Do the following structures pick up stain from hematoxylin or eosin? • Calcium
Hematoxylin
587
Do the following structures pick up stain from hematoxylin or eosin? • Bacteria
Hematoxylin
588
Do the following structures pick up stain from hematoxylin or eosin? • Fibrin
Eosin
589
Do the following structures pick up stain from hematoxylin or eosin? • Thyroid colloid
Eosin
590
What commonly encountered overdose produces headache, tinnitus, respiratory alkalosis, metabolic acidosis, confusion, vomiting, and tachypnea?
ASA (salicylate)
591
What AR syndrome is due to a deficiency of glycoprotein Ib, resulting in a defect in platelet adhesion?
Bernard-Soulier syndrome
592
What AD renal disorder is associated with mutations of the PKD 1 gene on chromosome 16 and berry aneurysms in the circle of Willis and presents in the fifth decade with abdominal masses, flank pain, hematuria, HTN, and renal insufficiency?
Adult polycystic kidney disease
593
Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Months to years after transplantation; gradual onset of HTN, oliguria, and azotemia; seen as intimal fibrosis of the blood vessels and interstitial lymphocytes
Chronic rejection
594
Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Immediately after transplantation; seen as a neutrophilic vasculitis with thrombosis
Hyperacute rejection
595
Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Weeks to months after transplantation; abrupt onset of oliguria and azotemia; seen as neutrophilic vasculitis and interstitial lymphocytes
Acute rejection
596
What type of collagen is abnormal in patients with osteogenesis imperfecta?
Type I (makes sense, since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
597
What coronary artery vasculitis is seen in Japanese infants and children less than 4 years old with acute febrile illness, conjunctivitis, maculopapular rash, and lymphadenopathy?
Kawasaki disease
598
What disease has IgG autoantibodies, occurs in women more than men, and includes exophthalmos, pretibial myxedema, nervousness, heart palpitations, and fatigue?
Graves disease
599
What condition is defined by both testicular and ovarian tissues in one individual?
True hermaphrodism
600
A mother takes her 2-week-old infant to the ER because the baby regurgitates and vomits after eating and has peristaltic waves visible on the abdomen and a palpable mass in the right upper quadrant. What is your diagnosis?
Pyloric stenosis
601
What variant of polyarteritis nodosa is associated with bronchial asthma, granulomas, and eosinophilia?
Churg-Strauss syndrome
602
What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?
Laminin
603
What B-cell neoplasm is seen in males with massive splenomegaly, produces dry tap on bone marrow aspirations, and stains positive for tartrate-resistant acid phosphatase (TRAP)?
Hairy cell leukemia
604
What form of nephritic syndrome is associated with celiac sprue and Henoch- Schönlein purpura?
IgA nephropathy
605
What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia, tetany, and T-cell deficiency?
DiGeorge syndrome
606
What is the treatment for physiologic jaundice of newborns?
Phototherapy
607
How many months in how many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
3 months of symptoms in 2 consecutive years
608
What chronic inflammatory WBC is associated with IgE-mediated allergic reactions and parasitic infections?
Eosinophils
609
What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa?
Peutz-Jeghers syndrome
610
What is the term for formation of a stable fibrin-platelet plug to stop bleeding?
Hemostasis
611
True or false? All of the following are risk factors for breast cancer: early menses, late menopause, history of breast cancer, obesity, and multiparity.
False. All except multiparity are risk factors for breast cancer. Nulliparity, increasing age, and family history in first-degree relative are also risk factors. Memorize this list!
612
Is jugular venous distention a presentation of isolated left or right heart failure?
Right-sided
613
Name the hepatitis virus based on the following information. • Small circular RNA virus with defective envelope
Hepatitis D
614
Name the hepatitis virus based on the following information. • Enveloped RNA flavivirus
Hepatitis C
615
Name the hepatitis virus based on the following information. • Naked capsid RNA calicivirus
Hepatitis E
616
Name the hepatitis virus based on the following information. • Enveloped DNA hepadnavirus
Hepatitis B
617
Name the hepatitis virus based on the following information. • Naked capsid RNA picornavirus
Hepatitis A
618
What AR disease involves a decreased amount of sphingomyelinase, massive organomegaly, zebra bodies, and foamy histiocytes and is associated with chromosome 11p?
Niemann-Pick disease
619
What is the term for hypoperfusion of an area involving only the inner layers?
Mural infarct
620
What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
Marrow failure, cancer, and leukemia
621
Notching of the ribs, seen on chest radiograph in patients with postductal coarctation of the aorta, is due to collateralization of what arteries?
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
622
What is the physiologic storage form of iron?
Ferritin
623
What is the term for occlusion of a blood vessel due to an intravascular mass that has been carried downstream?
Embolism
624
What AR disorder of copper metabolism can be characterized by Kayser- Fleischer rings, decreased ceruloplasmin levels, and increased urinary copper excretion and tissue copper levels?
Wilson disease. (Remember, patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
625
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • c-myc
Burkitt lymphoma
626
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • L-myc
Small cell cancer of the lung
627
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1 and int-2
Melanoma, cancer of the stomach and bladder
628
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • et
MEN II and III syndromes
629
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras
Pancreas and colon
630
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • cyclin D
Mantle cell lymphoma
631
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • N-myc
Neuroblastoma
632
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • CDK4
Melanoma
633
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • abl
CML and ALL
634
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1, int-2, erb-2, and erb-3
Breast cancer
635
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • sis
Astrocytoma
636
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras and erb-2
Lung cancer
637
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • erb-1
Squamous cell carcinoma of the lung
638
What AD GI neoplasia produces multiple adenomatous polyps, osteomas, fibromas, and epidural inclusion cysts?
Gardner syndrome
639
What disease involves microcephaly, mental retardation, cleft lip or palate, and dextrocardia?
Patau syndrome (trisomy 13)
640
What type of GN occurs most commonly in children after a pharyngeal or skin infection; is immune complex-mediated; and is seen as lumpy-bumpy subepithelial deposits?
Postinfectious GN
641
What are the three most common sites for left-sided heart embolisms to metastasize?
Brain, spleen, and kidney
642
With what two pathologies is a honeycomb lung associated?
Asbestosis and silicosis
643
What AD disorder due to a mutation in fibroblast growth factor receptor 3 results in normal-size vertebral column and skull and short, thick extremities?
Achondroplasia
644
True or false? Hyperkalemia increases the effect of digoxin.
False. hyperkalemia decreases digoxin's activity, while hypokalemia, hypomagnesemia, and hypercalcemia all increase digoxin toxicity.
645
Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
Dantrolene
646
Which overdose carries a higher mortality rate, that of benzodiazepines or barbiturates?
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
647
What antiviral agent is used in the treatment of drug-induced Parkinson's disease?
Amantadine
648
Are the following responses associated with histamines H1 or H2 receptor activation? • Edema
H 1
649
Are the following responses associated with histamines H1 or H2 receptor activation? • Gastric acid secretion
H 2
650
Are the following responses associated with histamines H1 or H2 receptor activation? • SA nodal activity
H 2
651
Are the following responses associated with histamines H1 or H2 receptor activation? • Pain and pruritus
H 1
652
Are the following responses associated with histamines H1 or H2 receptor activation? • Bronchial smooth muscle activity
H 1
653
Are the following responses associated with histamines H1 or H2 receptor activation? • Inotropic action and automaticity
H 2
654
True or false? The lack of dopamine production in the substantia nigra leads to the extrapyramidal dysfunction, characteristically seen in patients with Parkinson's disease.
True. The lack of dopamine leads to an excess of ACh, hence extrapyramidal dysfunction.
655
Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
PGI 2
656
Which CNS ACh receptor or receptors are excitatory? Inhibitory?
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
657
True or false? Beta2-Adrenergic agents are used in the management of an acute asthmatic attack.
True. They are useful in the early-phase response to an asthmatic attack.
658
Do local anesthetics bind to the activated or inactivated sodium channels?
Inactivated
659
What is the drug of choice for treating Tourette syndrome?
Pimozide
660
What mosquito is responsible for the transmission of malaria?
Anopheles mosquito
661
What enzyme is inhibited by disulfiram?
Acetaldehyde dehydrogenase
662
Which diuretic is used as an adrenal steroid antagonist?
Spironolactone
663
What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
Fentanyl
664
What is the drug of choice for penicillin-resistant gonococcal infections?
Spectinomycin
665
What is the DOC for treating torsade de pointes?
Magnesium
666
Is heparin contraindicated in pregnancy?
No. Heparin is safe in pregnancy, but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
667
What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
Griseofulvin
668
Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
Carbamazepine
669
What are the three Beta-lactamase inhibitors?
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
670
Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
Carbamazepine
671
Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
672
Which class of diuretics is used to treat metabolic acidosis, acute mountain sicknesses, and glaucoma and to aid in the elimination of acidic drug overdoses?
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
673
What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Raloxifene
674
Which tetracycline is used in the treatment of SIADH?
Demeclocycline
675
How is the eye affected by use of opioids?
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
676
Name the antimicrobial agent whose major side effect is listed. • Grey baby syndrome
Chloramphenicol
677
Name the antimicrobial agent whose major side effect is listed. • CN VIII damage (vestibulotoxic)
Aminoglycosides
678
Name the antimicrobial agent whose major side effect is listed. • Teratogenicity
Metronidazole
679
Name the antimicrobial agent whose major side effect is listed. • Cholestatic hepatitis
Erythromycin
680
Name the antimicrobial agent whose major side effect is listed. • Hemolytic anemia
Nitrofurantoin
681
Name the antimicrobial agent whose major side effect is listed. • Dental staining in children
Tetracycline
682
Name the antimicrobial agent whose major side effect is listed. • Altered folate metabolism
Trimethoprim
683
Name the antimicrobial agent whose major side effect is listed. • Auditory toxicity
Vancomycin
684
Name the antimicrobial agent whose major side effect is listed. • Cartilage abnormalities
Quinolones
685
What are the two side effects of opioids to which the user will not develop tolerance?
Constipation and miosis
686
Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
Valproic acid
687
What antitubercular agent causes loss of red-green visual discrimination?
Ethambutol
688
Name the insulin preparation based on the peak effect and duration of action. • Peak, 8 to 16 hours; duration, 24 to 36 hours
Ultralente
689
Name the insulin preparation based on the peak effect and duration of action. • Peak, 0.5 to 3 hours; duration, 5 to 7 hours
Regular insulin
690
Name the insulin preparation based on the peak effect and duration of action. • Peak, 8 to 12 hours; duration, 18 to 24 hours
Lente or NPH insulin (neutral protamine Hagedorn insulin)
691
Name the insulin preparation based on the peak effect and duration of action. • Peak, 0.3 to 2 hours; duration, 3 to 4 hours
Lispro insulin
692
Is digoxin or digitoxin renally eliminated?
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
693
What is the drug of choice for steroid-induced osteoporosis?
Alendronate
694
What are the first signs of overdose from phenobarbitals?
Nystagmus and ataxia
695
How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
Inhaled anesthetics with low lipid solubility have low potency (directly related), so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
696
What α1-agonist, not inactivated by catechol-O-methyl transferase (COMT), is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
Phenylephrine
697
Which laxative is used in the treatment of hepatic encephalopathy ?
Lactulose
698
Are hydrolysis, oxidation, and reduction phase I or II biotransformations?
Phase I
699
What β-blocker is also an α-blocker?
Labetalol
700
What agent is used IM to treat acute dystonias?
Diphenhydramine
701
True or false? Anaerobes are resistant to the effects of aminoglycosides.
True. Aminoglycosides use O 2-dependent uptake and therefore are ineffective for treatment of anaerobic infections.
702
What two β-blockers decrease serum lipids?
Acebutolol and Pindolol
703
If a drug is ionized, is it water or lipid soluble? Can it cross a biomembrane?
Ionized drugs are water soluble, and since only lipid-soluble drugs can cross biomembranes, an ionized drug cannot cross them without the help of a carrier.
704
What are the longest-acting and shortest-acting benzodiazepines?
Diazepam is longest acting and midazolam is shortest acting.
705
What is the DOC for severe infections with Sporothrix, Mucor, Histoplasma, Cryptococcus, Candida, and Aspergillus?
Amphotericin B
706
What neurotransmitter is presynaptically inhibited by reserpine and guanethidine?
NE
707
Which two cephalosporins cross the blood-brain barrier?
Cefuroxime and cefaclor
708
What agent, in combination with a MAOI inhibitor, can cause hypertensive crisis?
Tyramine
709
True or false? Cocaine-induced coronary ischemia should not be treated with β-blockers.
True. β-Blockade would result in unopposed-adrenergic stimulation and worsen the patient's symptoms. Calcium channel blockers are the way to go.
710
What antimuscarinic is used as an inhalant for asthma?
Ipratropium
711
What two forms of insulin, if mixed together, precipitate zinc?
Lente insulin and either NPH or protamine zinc insulin (PZI)
712
What androgen receptor blocker is used in the treatment of prostatic cancer?
Flutamide
713
What are the first signs of phenobarbital overdose?
Nystagmus and ataxia
714
Which virus is treated with the monoclonal antibody palivizumab?
RSV
715
Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?
Lithium
716
Which class of antiarrhythmics are potassium channel blockers?
Class III
717
Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
M 2
718
What antiepileptic agent has SIADH as a side effect?
Carbamazepine
719
What is the only anesthetic that causes cardiovascular stimulation?
Ketamine
720
Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
Dapsone
721
What form of antimicrobial therapy is best for an immunocompromised patient?
Bactericidal
722
Which direct-acting vasodilator is associated with SLE-like syndrome in slow acetylators?
Hydralazine
723
What class of heparin is active against factor Xa and has no effect on PT or PTT?
Low molecular weight heparin (LMWH)
724
What is the DOC for coccidioidomycosis?
Fluconazole
725
What three cephalosporins have good penetration against Bacteroides fragilis?
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
726
Which form of alcohol toxicity results in ocular damage?
Methanol
727
What immunosuppressive agent is converted to 6-mercaptopurine?
Azathioprine
728
Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
729
What enzyme is inhibited by trimethoprim?
Dihydrofolate reductase
730
What are the two absolute requirements for the cytochrome P450 enzyme system?
NADPH and molecular O 2
731
What three PGs are potent platelet aggregators?
PGE 1, PGI 2 (most potent), and TXA 2
732
A depressive patient who is taking paroxetine goes to the ER with pain and is given meperidine. Shortly afterward she develops diaphoresis, myoclonus, muscle rigidity, hyperthermia, and seizures. What is your diagnosis?
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs, TCADs, dextromethorphan, and meperidine. Treat it with cyproheptadine.
733
What class of drugs is used in the treatment of demineralization of the bone?
Bisphosphonates
734
What is the only class of diuretics to retain Cl- used in the short-term treatment of glaucoma and of acute mountain sickness?
Acetazolamide
735
True or false? All aluminum-containing antacids can cause hypophosphatemia.
True. Aluminum reacts with PO4, resulting in AlPO4, an insoluble compound that cannot be absorbed.
736
What TCA drug causes sudden cardiac death in children?
Desipramine
737
What two β2-agonists are used to produce bronchodilation?
Metaproterenol and albuterol
738
What IV-only agent inhibits water reabsorption in the PCTs and is used to treat increased intracranial pressure, increased intraocular pressure, and acute renal failure?
Mannitol
739
What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
They prevent mast cell degranulation.
740
What two β2-agonists cause myometrial relaxation?
Ritodrine and terbutaline
741
Where in the spinal cord are the presynaptic opioid receptors?
In the dorsal horn of the spinal cord on the primary afferent neurons
742
What thrombolytic agent is derived from β-hemolytic streptococci, is antigenic, and produces depletion of circulating fibrinogen, plasminogen, and factors V and VII?
Streptokinase
743
What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Terbinafine
744
Which class of antihypertensives produces angioedema, hyperkalemia, and a dry cough?
ACE inhibitors (the-pril agents)
745
Which medication requires an acidic gastric pH for activation to form a protective gel-like coating over ulcers and GI epithelium?
Sucralfate
746
Of what serotonin receptor is sumatriptan an agonist?
5HT1D
747
A patient with a history of epilepsy goes to the ER with sedation, gait ataxia, diplopia, and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
Phenytoin
748
What are the five penicillinase-resistant penicillins?
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
749
Which aminoglycoside is the DOC for tularemia and the bubonic plague?
Streptomycin
750
Is the following description characteristic of competitive or noncompetitive antagonists: parallel shift to the right on a dose-response curve, complete reversibility with increase of the dose of the agonist drug, and capacity to decrease the potency of the agonist drug?
Competitive antagonist
751
True or false? Progestins are used in combination with estrogens to decrease the risk of endometrial cancer.
TRUE
752
What neuroleptic agent causes agranulocytosis but does not induce tardive dyskinesia?
Clozapine
753
What two factors influence low oral bioavailability?
First-pass metabolism and acid lability
754
What is the only site in the body that uses M1 receptors?
The stomach
755
What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L-dopa if used concomitantly?
Vitamin B 6 (pyridoxine)
756
True or false? Acetaminophen has analgesic and antipyretic activities but lacks anti-inflammatory effects.
TRUE
757
What happens to plasma concentration of a drug if there is a large volume of distribution?
The larger the volume of distribution, the lower the plasma concentration of a drug.
758
Why should opioid analgesics be avoided for patients with head trauma?
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
759
What is the drug of choice in the treatment of the lepra reaction?
Clofazimine
760
What two drugs, when mixed, can lead to malignant hyperthermia?
Succinylcholine and halothane (Treatment is with dantrolene.)
761
What three β-blockers are used in the treatment of glaucoma?
1. Propranolol 2. Timolol 3. Carteolol
762
What is the neurotransmitter at the K-receptor?
Dynorphin
763
True or false? Succinylcholine is a nicotinic receptor agonist.
TRUE
764
What is the drug of choice for hypertensive patients with a decreased renal function?
α-Methyldopa (Guanabenz or clonidine is also used.)
765
What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?
Volume of distribution is decreased when a large percentage of drug is protein bound.
766
What antihistamine is used in the treatment of serotonergic crisis?
Cyproheptadine
767
What is the drug of choice for early Parkinson's disease?
Selegiline
768
What is the site of action of the following? • Osmotic diuretics
The entire tubule barring the thick ascending limb
769
What is the site of action of the following? • Loop diuretics
Ascending limb
770
What is the site of action of the following? • Thiazide diuretics
Early distal tubule
771
What is the site of action of the following? • K+-sparing diuretics
Early collecting duct
772
What is the site of action of the following? • Aldosterone antagonists
Distal convoluted tubules
773
What hematologic malignancy is treated with the monoclonal antibody rituximab?
Non-Hodgkin lymphoma
774
Which sodium channel blocker is used to treat lithium-induced diabetes insipidus?
Amiloride
775
Which two antipsychotic drugs create a high risk for developing extrapyramidal syndrome (EPS) side effects?
Haloperidol and fluphenazine (but use of any high-potency phenothiazine runs the risk of EPS)
776
Could an overdose with either zolpidem or zaleplon be reversed with flumazenil?
Yes, because they both activate the BZ1-receptors, which can be reversed by flumazenil.
777
What drug blocks intragranular uptake of NE?
Reserpine
778
True or false? Antimicrobial agents that slow bacterial growth are bactericidal.
False. Bacteriocidals kill; bacteriostatics slow growth.
779
Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
Nicotinic acid, because its side effects include hyperuricemia and exacerbation of ulcers.
780
What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
Mebendazole
781
What antiviral agents inhibit neuraminidases of influenza A and B?
Zanamivir and oseltamivir
782
What three cephalosporins inhibit vitamin K-dependent factors?
Cefamandole, cefoperazone, and moxalactam
783
Which direct-acting vasodilator is used clinically to treat hypertensive emergencies, insulinomas, and as a uterine smooth muscle relaxant?
Diazoxide
784
Which leukotriene—LTA4, LTB4, LTC4, or LTD4—is not associated with anaphylaxis and bronchoconstriction?
LTB4
785
What neuroleptic agent causes retinal deposits, hypotension, and torsades de pointes?
Thioridazine
786
What oral hypoglycemic agent inhibits α-glucosidase in the brush border of the small intestine?
Acarbose
787
What enzyme is inhibited by sulfonamides?
Dihydropteroate synthetase
788
What is the most important determinant of drug potency?
The affinity of the drug for its receptor
789
True or false? Estrogen use increases the risk of developing ovarian cancer.
False. Risk of breast and endometrial cancer but not ovarian cancer increases with the use of estrogen.
790
Which sedative-hypnotic is contraindicated for patients taking warfarin?
Chloral hydrate
791
What mixed α-antagonists are used for patients with pheochromocytoma?
Phentolamine and phenoxybenzamine
792
What are the four types of signaling mechanisms?
1. Intracellular receptors
2. Membrane receptors
3. Enzymes
4. Intracellular effectors
793
The dose of which second-generation sulfonylurea agent must be decreased for patients with hepatic dysfunction?
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
794
Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
d-Tubocurarine
795
What transient deficiency may result in a hypercoagulable state if warfarin is given alone?
Transient protein C deficiency, because of its relatively short half-life, may result if warfarin is instituted alone.
796
What component of the vascular system is most sensitive to the effects of calcium channel blockers?
Arterioles
797
What drug blocks glucose uptake, leading to decreased formation of ATP and resulting in immobilization of the parasite?
Albendazole
798
What is the site of action for carbonic anhydrase inhibitors?
Proximal tubule
799
What phase of the cell cycle are the following antineoplastic agents specific for? • Bleomycin
G2 phase
800
What phase of the cell cycle are the following antineoplastic agents specific for? • Cytarabine
S phase
801
What phase of the cell cycle are the following antineoplastic agents specific for? • Vinblastine
Mitosis
802
What phase of the cell cycle are the following antineoplastic agents specific for? • Alkylating agents
G0 phase
803
What phase of the cell cycle are the following antineoplastic agents specific for? • Paclitaxel
Mitosis
804
What phase of the cell cycle are the following antineoplastic agents specific for? • Vincristine
Mitosis
805
What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Thioguanine
S phase
806
What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Mercaptopurine
S phase
807
What phase of the cell cycle are the following antineoplastic agents specific for? • Dacarbazine
G0 phase
808
What phase of the cell cycle are the following antineoplastic agents specific for? • Hydroxyurea
S phase
809
What phase of the cell cycle are the following antineoplastic agents specific for? • Cisplatin
G0 phase
810
What phase of the cell cycle are the following antineoplastic agents specific for? • Nitrosoureas
G0 phase
811
Inhibition of peripheral COMT, allowing increased CNS availability of L-dopa, is accomplished by what two agents?
Tolcapone and entacapone
812
What medication is a PGE1 analog that results in increased secretions of mucus and HCO3-in the GI tract?
Misoprostol
813
Is there a difference between mathematical and clinical steady states? If so, what are their values (half-lives)?
There is a difference; it takes about 7 to 8 half-lives to reach mathematical steady state and 4 to 5 half-lives to reach clinical steady state.
814
True or false? At high doses aspirin has uricosuric properties.
True. At high doses ASA decreases uric acid reabsorption in the renal tubules, resulting in uricosuric actions. At low doses ASA decreases tubular secretion of uric acid, leading to hyperuricemia.
815
What antiviral agent is used to treat RSV, influenza A and B, Lassa fever, and hantavirus and as an adjunct to IFN-in hepatitis C?
Ribavirin
816
Which aminoglycoside is used only topically because it is too toxic for systemic use?
Neomycin
817
Which class of antiarrhythmics blocks sodium channels?
Class 1 (1A, 1B, and 1C)
818
What form of penicillin is used in the treatment of life-threatening illnesses?
Penicillin G (benzylpenicillin)
819
What is the DOC for esophageal candidiasis?
Fluconazole
820
True or false? Flumazenil is used in the treatment of barbiturate overdose.
False. Flumazenil is unable to block the effects of barbiturates.
821
Which three aminoglycosides have vestibular toxicity?
1. Streptomycin 2. Gentamicin 3. Tobramycin
822
What is the term for the amount of a drug that is needed to produce the desired effect?
Potency
823
What agent used in the treatment of BPH and baldness is a 5-α-reductase inhibitor?
Finasteride
824
What β-blocker is also a membrane stabilizer?
Propranolol
825
Name one of the ADP receptor antagonists used in patients who are post-MI, have had TIAs, have unstable angina, and are allergic to ASA?
Ticlopidine or clopidogrel
826
What is the treatment for nephrogenic diabetes insipidus induced by lithium?
Amiloride
827
Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
Nimodipine
828
What two drugs inhibit the release of neurotransmitters from storage granules?
Guanethidine and bretylium
829
What is the DOC for hyperprolactinemia?
Pergolide
830
True or false? The faster the rate of absorption, the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
False. The faster the rate of absorption, the smaller the Tmax and larger the Cmax (bioinequivalence). The slower the rate of absorption, the larger the Tmax and smaller the Cmax.
831
What tetracycline is associated with hepatotoxicity?
Chlortetracycline
832
What is the term for how well a drug produces its desired response?
Efficacy
833
What drug, if given during pregnancy, would cause the uterus to exhibit signs of progesterone withdrawal and induce an abortion?
RU 486
834
Is allopurinol used in the acute treatment of gout?
No, it is used in chronic treatment of gout to decrease the uric acid pools in the body.
835
What three cephalosporins can produce disulfiram-like reactions?
1. Cefamandole 2. Cefoperazone 3. Moxalactam
836
What is the physiologic basis for the actions of birth control pills?
They block the midcycle surge of LH.
837
When a drug is administered orally and enters into portal circulation, it undergoes hepatic metabolism. What is the name of this effect?
First-pass effect
838
Which thrombolytic agent, activated in the presence of fibrin, is manufactured by recombinant DNA process?
Alteplase
839
Which benzodiazepine is most commonly used IV in conscious sedation protocols?
Midazolam
840
What is the drug of choice for threadworm, trichinosis, and larva migrans?
Thiabendazole
841
Can you tell which drug is more toxic based on therapeutic indices alone?
No, therapeutic indices can tell which drug is safer, not more toxic.
842
What blood disorder is a side effect of metformin?
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
843
A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity, a temperature of 104° F, altered mental status, and hypotension. What is your diagnosis and what is the treatment?
Neuroleptic malignant syndrome is a potentially life-threatening condition which is treated with symptomatic support, bromocriptine, and dantrolene.
844
Which α-blocking agent is used to treat refractory hypertension and baldness?
Minoxidil (orally and topically, respectively!)
845
What components of the coagulation cascade are affected by estrogen?
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II, VII, IX, and X.
846
What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency?
Sulfonamides
847
What enzyme of cholesterol synthesis is inhibited by the statins?
HMG-CoA reductase
848
What bactericidal agents are resistant to β-lactamases and are used to treat in-hospital life-threatening infections?
Imipenem and meropenem
849
What adrenergic receptors use inositol triphosphate (IP3) and diacylglycerol (DAG) for their second messenger system?
α1-Receptors
850
True or false? Dopamine antagonists at the D2A receptor have the capacity to induce pseudoparkinsonism.
TRUE
851
What two PGs are used to induce labor?
PGE2 and PGF2α
852
How are drugs that are excreted via the biliary system resorbed by the GI tract?
Enterohepatic cycling
853
Which drugs bind to the 30S ribosomal subunit and interfere with the initiation complex, causing a misreading of mRNA?
Aminoglycosides
854
What antiviral agent blocks the attachment and penetration of influenza A virus?
Amantadine
855
What is the antidote for organophosphate ingestion?
Atropine and 2-PAM (pralidoxime)
856
Which antihypertensive class is used to help stop the progression of microalbuminuria?
ACE inhibitors (-pril)
857
What class of drugs are the DOCs for peptic ulcer disease, Zollinger-Ellison syndrome, and gastroesophageal reflux disease?
Proton pump inhibitors
858
What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
Chloramphenicol
859
Inhibition of peripheral aromatic amino acid decarboxylase and increased CNS availability of L-dopa are results of what drug used in the treatment of Parkinson's disease?
Carbidopa and benserazide
860
What type of drug elimination is characterized by the following? • Elimination independent of plasma concentration; constant amount eliminated per unit time; no fixed half-life
Zero-order elimination
861
What type of drug elimination is characterized by the following? • Elimination directly proportional to plasma level; constant fraction eliminated per unit time; fixed half-life
First-order elimination
862
True or false? NSAIDs have analgesic, antipyretic, anti-inflammatory, and antiplatelet activities.
TRUE
863
True or false? Tetracyclines are bactericidal.
False. They are bacteriostatic.
864
What class 1A antiarrhythmic agent has SLE-like syndrome side effect in slow acetylators?
Procainamide
865
What is the major pulmonary side effect of µ-activators?
Respiratory depression
866
What neuroleptic agent is also considered to be an antihistamine?
Risperidone
867
What form of penicillin is stable in acid environments?
Penicillin V
868
What is the term for the proportion of a drug that reaches systemic circulation?
Bioavailability
869
What two drugs block dopa-decarboxylase in the periphery to decrease the conversion of L-dopa to dopamine?
Carbidopa and benserazide
870
What is the DOC for bipolar disorder?
Lithium
871
True or false? If a mother delivers a Rho-positive baby, she should receive Rho-immunoglobulin.
True if she is Rho-negative; false if she is Rho-positive
872
True or false? Both GABA and glutamic acid are excitatory neurotransmitters in the CNS.
False. Glutamic acid is excitatory, but GABA is inhibitory.
873
What is the drug of choice for asymptomatic meningitis carriers?
Rifampin
874
What drug is used to differentiate a cholinergic crisis from myasthenia gravis?
Edrophonium
875
What class of antianginal activates the NO pathway to produce endothelial vasodilation?
Nitrates
876
What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
Celecoxib
877
What is the DOC for blastomycoses and sporotrichoses?
Itraconazole
878
What are the two most important features in the diagnosis of malaria?
Splenomegaly and anemia (with a high index of suspicion)
879
Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system.
Oxazepam, temazepam, and lorazepam ( OTL, Outside The Liver)
880
What drug is an M1-specific antispasmodic?
Pirenzepine
881
Which centrally acting α2-adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy?
Methyldopa
882
What is the monoamine oxidase B (MAOB) inhibitor?
Selegiline
883
What antitubercular agent causes a red-orange tinge to tears and urine?
Rifampin
884
What two classes of drugs can cause schizoid behavior?
Glucocorticoids and amphetamines
885
What tetracycline is associated with vestibular toxicity?
Minocycline
886
What is the most potent NMJ blocker and also has no cardiovascular side effects?
Doxacurium
887
What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
D2 and 5HT3 receptors
888
Which group of antihypertensive agents best decreases left ventricular hypertrophy?
Thiazide diuretics
889
What area of the brain is linked to emotion and movement?
Mesolimbic system
890
Why are clozapine and olanzapine unlikely to result in EPS effects?
Because they do not block D2A receptors, they are antagonists of 5HT2 receptors.
891
What class of pharmaceuticals are inactive until they are metabolized to their active products?
Prodrugs
892
True or false? You would not prescribe probenecid for a patient with gout who is an overexcretor of uric acid.
True. Probenecid can precipitate uric acid crystals in the kidney if the patient is an overexcretor of urate.
893
True or false? Dopamine antagonists are antiemetic.
True. They block the dopamine receptors in the chemoreceptor trigger zone.
894
What bactericidal agent is the DOC for MRSA, enterococci, and Clostridium difficile?
Vancomycin
895
True or false? β-Blockers are contraindicated in patients who present to the hospital with CHF.
True. β-Blockers are a component of CHF regimen for stable patients, not those who are decompensated. (This means you discharge a patient from the hospital with a prescription for a -blocker; you don't start -blockers when the patient is admitted.)
896
True or false? Fluoroquinolones are bactericidal.
True. They inhibit DNA gyrase (topo II).
897
What antiviral agent for ganciclovir-resistant infections has limited utility because of its nephrotoxic side effect?
Foscarnet
898
What oral hypoglycemic agent stimulates pancreatic β-cell release of insulin and is given just prior to meals because of its short half-life?
Repaglinide
899
True or false? There is no absorption of an IV-administered drug.
True. No loss of drug and no absorption if a drug is given IV.
900
What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells, not a fixed number?
Log-kill hypothesis (follows first order kinetics)
901
What is the only local anesthetic to produce vasoconstriction?
Cocaine
902
Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway?
Zileuton
903
What is the only diuretic that works on the blood side of the nephron?
Spironolactone (binds to aldosterone receptors)
904
Do you monitor heparin's therapeutic levels by PT or PTT?
Heparin, intrinsic pathway, PTT; warfarin, extrinsic pathway, PT (mnemonic: hPeT, wPiTT)
905
What is the only neuroleptic that does not cause an increase in weight or appetite?
Molindone
906
What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension?
Metaraminol (α1, β1 )
907
What antiarrhythmic agent is the DOC for treating and diagnosing paroxysmal supraventricular tachycardia (PSVT) and AV nodal arrhythmias?
Adenosine (it is an excellent agent to use in emergencies because its half-life is 30 seconds)
908
What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
Aminophylline
909
Which nicotinic receptor antagonist is inactivated to laudanosine?
Atracurium
910
What α2-antagonist is used to treat impotence and postural hypotension?
Yohimbine
911
What drug of choice for ascaris causes neuromuscular blockade of the worm?
Pyrantel pamoate
912
Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing?
Phase 1
913
Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?
Tetracycline
914
What antifungal agent is used in the treatment of androgen receptor-positive cancers?
Ketoconazole
915
What MAOI does not cause a hypertensive crisis?
Selegiline
916
Which penicillin can cause interstitial nephritis?
Methicillin
917
Is hirsutism a side effect of estrogen or progestin therapy?
Progestin
918
Which potassium-sparing drug is an aldosterone receptor antagonist ?
Spironolactone
919
What are the three signs of morphine overdose?
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
920
Which anticonvulsant is used in the treatment of bipolar disorder and neuropathic pain?
Gabapentin
921
True or false? Metformin is contraindicated in obese patients because of weight gain as its side effect.
False. Metformin does not have weight gain as a potential side effect (unlike sulfonylureas).
922
What is the DOC for the treatment of the late phase response in an asthmatic attack?
Corticosteroid
923
If you double the infusion rate of a drug, how long will it take to reach steady state?
Regardless of the rate of infusion, it takes 4 to 5 half-lives to reach steady state.
924
What is the neurotransmitter at the µ-receptor?
β-Endorphin
925
What is the DOC for the following protozoal infections? • Amebiasis
Metronidazole
Part of "G*E*T to the Metro"
926
What is the DOC for the following protozoal infections? • Leishmaniasis
Stibogluconate
927
What is the DOC for the following protozoal infections? • Pneumocystis carinii pneumonia
Trimethoprim/sulfamethoxazole (TMP-SMX)
928
What is the DOC for the following protozoal infections? • Giardiasis
Metronidazole
929
What is the DOC for the following protozoal infections? • Trichomoniasis
Metronidazole
930
What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability?
Pentoxifylline
931
What enzyme system is the most common form of phase II biotransformation?
Glucuronidation
932
In what three areas of the body are sympathetics the predominant tone?
1. Sweat glands 2. Arterioles 3. Veins
933
What is the only antifungal agent to penetrate CSF?
Fluconazole
934
Which class of antiarrhythmics are β-blockers?
Class II
935
What three cephalosporins are eliminated via biliary mechanisms?
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
936
Which centrally acting α2-adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Clonidine
937
What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?
Infliximab
938
Which macrolide is used in the treatment of gastroparesis?
Erythromycin
939
What syndrome is characterized by the triad of renal tubular acidosis, nephrosis, and amino aciduria?
Fanconi-like syndrome
940
In what area of the brain can an excess of dopamine lead to psychotic symptoms?
Mesocortical area
941
Name five causes for zero-order metabolism.
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
942
What antitubercular agent requires vitamin B6 supplementation?
Isoniazid
943
Which antihistamine is one of the DOCs for treatment of vertigo?
Meclizine
944
What is the DOC for treating Entamoeba histolytica, Giardia, Trichomonas, Bacillus fragilis, and Clostridium difficile infections?
Metronidazole
945
Which class of antihypertensives is used in the treatment of BPH?
α-Blockers (-zosins)
946
Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex?
Azithromycin
947
What is the drug of choice, which inhibits oxidative phosphorylation in cestodes, for taeniasis?
Niclosamide
948
Which class of antihyperlipidemics would you avoid for a patient with elevated triglyceride levels?
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore, they are not used if a patient has hypertriglyceridemia.
949
True or false? Ergotamines, because of their vasodilation action, cause migraines.
False. Ergotamines are used in the treatment of migraines for their vasoconstrictive action in the cerebral circulation.
950
Is DM a contraindication to use of a β-blocker in a patient who is having an MI?
Absolutely not. Diabetics who are given a β-blocker for an acute chest syndrome have significantly better outcomes than those who do not.
951
What β2-agonist is used as a prophylactic agent in the treatment of asthma?
Salmeterol
952
What hormone can be affected by dopamine release in the tuberoinfundibular pathway?
In the tuberoinfundibular pathway, dopamine release will decrease prolactin release, which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.
953
What determines the plasma level at steady state?
The rate of infusion
954
What enzyme is inhibited by propylthiouracil (PTU)?
5' deiodinase
955
What is the DOC for CMV retinitis?
Ganciclovir
956
What agent antagonizes the effects of heparin?
Protamine sulfate
957
What antihypertensive agent produces cyanide and thiocyanate as byproducts?
Nitroprusside
958
What is the DOC for β-blocker-induced bronchospasms?
Ipratropium
959
What is the only neuroleptic agent that does not cause hyperprolactinemia?
Clozapine
960
True or false? Gynecomastia is a side effect of cimetidine.
True. Cimetidine can decrease androgen production and lead to gynecomastia.
961
What three drugs are associated with SLE-like syndrome in slow acetylators?
Hydralazine, isoniazid, and procainamide (HIP)
962
What is the drug of choice for filariasis and onchocerciasis?
Diethylcarbamazine
963
What aminoglycoside causes disruption of CN I?
Streptomycin
964
Which anticonvulsant causes gingival hyperplasia?
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
965
What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
ASA
966
What antifungal agent is activated by fungal cytosine deaminase to form 5-FU?
Flucytosine
967
Irreversible ototoxicity is associated with which loop diuretic?
Ethacrynic acid
968
What competitive estrogen receptor antagonist is used in the treatment of breast cancer?
Tamoxifen
969
Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
Doxycycline
970
True or false? Dopamine is an excitatory neurotransmitter in the CNS.
False. Dopamine is an inhibitory neurotransmitter in the CNS.
971
What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?
Metformin
972
Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
Phase 4
973
Which prophylactic asthmatic agent is an antagonist of LTD4?
Zafirlukast
974
What are the three C's of a TCAD overdose?
Coma, convulsions, and cardiotoxicity
975
What is the neurotransmitter at the δ-receptor?
Enkephalin
976
What body fluid preferentially breaks down esters?
Blood
977
What are the two broad-spectrum penicillins?
Ampicillin and amoxicillin
978
What are the three components to the asthma triad?
Nasal polyps, rhinitis, and aspirin hypersensitivity
979
Which class of antiarrhythmics are calcium channel blockers?
Class IV
980
What are the glycoprotein receptors that platelets and fibrinogen cross-link to when forming a thrombus?
GP IIb and IIIa receptors
981
Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
Propofol
982
Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
Physiologic antagonism
983
What GnRH analog is used as a repository form of treatment in prostatic cancer?
Leuprolide
984
Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis?
Clindamycin
985
What is the DOC for trigeminal neuralgia?
Carbamazepine
986
What drug that penetrates the blood-brain barrier is found in asthma preparations and used as a nasal decongestant?
Ephedrine
987
What is the term for drug removal per unit of time in a given volume of blood?
Clearance
988
Which two tetracyclines have the highest plasma binding?
Doxycycline and minocycline
989
What do the following values indicate? • ED50
Effective dose for 50% of drug takers (median effective dose)
990
What do the following values indicate? • TD50
Toxic dose for 50% of drug takers (median toxic dose)
991
What do the following values indicate? • LD50
Lethal dose for 50% of drug takers (median lethal dose)
992
Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity?
Agents that decrease ACh function reduce tremors and rigidity, not bradykinesias.
993
A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
Spasms of the uterus, bladder, and the biliary tree occur with all of the opioids except meperidine.
994
What form of oxidation takes place with the addition of a water molecule and breakage of bonds?
Hydrolysis
995
In a ventricular pacemaker cell, what phase of the action potential is affected by NE?
Phase 4; NE increases the slope of the prepotential, allowing threshold to be reached sooner, and increases the rate of firing.
996
Anatomical and alveolar dead spaces together constitute what space?
Physiologic dead space is the total dead space of the respiratory system.
997
What three organs are necessary for the production of vitamin D3(cholecalciferol)?
Skin, liver, and kidneys
998
What is the effect of LH on the production of adrenal androgens?
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
999
What four conditions result in secondary hyperaldosteronism?
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
1000
What are the five hormones produced by Sertoli cells?
1. Inhibin 2. Estradiol (E2) 3. Androgen-binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antimüullerian hormone
1001
What is the term for the negative resting membrane potential moving toward threshold?
Depolarization (i.e., Na+ influx)
1002
Does the left or right vagus nerve innervate the SA node?
Right vagus innervates the SA node and the left vagus innervates the AV node
1003
How does ventricular repolarization take place, base to apex or vice versa?
Repolarization is from base to apex and from epicardium to endocardium.
1004
What is the term for any region of the respiratory system that is incapable of gas exchange?
Anatomical dead space, which ends at the level of the terminal bronchioles.
1005
What four factors shift the Hgb-O2 dissociation curve to the right? What is the consequence of this shift?
Increased CO2, H+, temperature, and 2, 3-BPG levels all shift the curve to the right, thereby making the O2 easier to remove (decreased affinity) from the Hgb molecule.
1006
What two factors result in the apex of the lung being hypoperfused?
Decreased pulmonary arterial pressure (low perfusion) and less-distensible vessels (high resistance) result in decreased blood flow at the apex.
1007
What is the ratio of pulmonary to systemic blood flow?
1:1. Remember, the flow through the pulmonary circuit and the systemic circuit are equal.
1008
To differentiate central from nephrogenic diabetes insipidus, after an injection of ADH, which will show a decreased urine flow?
Central. Remember, there is a deficiency in ADH production in the central form.
1009
In what area of the GI tract are water-soluble vitamins absorbed?
Duodenum
1010
What wave is the cause of the following venous pulse deflections? • The rise in right atrial pressure secondary to blood filling and terminating when the tricuspid valves opens
V wave
1011
What wave is the cause of the following venous pulse deflections? • The bulging of the tricuspid valve into the right atrium
C wave
1012
What wave is the cause of the following venous pulse deflections? • The contraction of the right atrium
A wave
1013
What are the four functions of saliva?
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
1014
When a person goes from supine to standing, what happens to the following? • Dependent venous pressure
Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------
1015
When a person goes from supine to standing, what happens to the following? • Dependent venous blood volume
Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------
1016
When a person goes from supine to standing, what happens to the following? • Cardiac output
Decreases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
1017
When a person goes from supine to standing, what happens to the following? • BP
Decreases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------
1018
When does the hydrostatic pressure in Bowman's capsule play a role in opposing filtration?
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
1019
What happens to intrapleural pressure when the diaphragm is ontracted during inspiration?
Intrapleural pressure decreases (becomes more negative).
1020
What is used as an index of cortisol secretion?
Urinary 17-OH steroids
1021
If the pH is low with increased CO2 levels and decreased HCO3- levels, what is the acid-base disturbance?
Combined metabolic and respiratory acidosis
1022
What is the term that refers to the number of channels open in a cell membrane?
Membrane conductance (think conductance = channels open)
1023
What are the five tissues in which glucose uptake is insulin independent?
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
1024
Place in order from fastest to slowest the rate of gastric emptying for CHO, fat, liquids, and proteins.
Liquids, CHO, protein, fat
1025
Is most of the coronary artery blood flow during systole or diastole?
Diastole. During systole the left ventricle contracts, resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
1026
What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole?
The JG cells
1027
What are the three functions of surfactant?
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
1028
Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, and stimulated by hypoglycemia
Epinephrine
1029
Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, proteolytic, and stimulated by hypoglycemia and AAs
Glucagon
1030
Name the hormone—glucagon, insulin, or epinephrine: • Glycogenic, gluconeogenic, lipogenic, proteogenic, glycolytic, and stimulated by hyperglycemia, AAs, fatty acids, ketosis, ACh, GH, and Beta-agonist
Insulin
1031
Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
Hydrophobic (water-insoluble) end faces the aqueous environment and the hydrophilic (water-soluble) end faces the interior of the cell.
1032
What type of muscle is characterized by no myoglobin, anaerobic glycolysis, high ATPase activity, and large muscle mass?
White muscle; short term too
1033
What percentage of CO2 is carried in the plasma as HCO3- ?
90% as HCO3-, 5% as carbamino compounds, and 5% as dissolved CO2
1034
What is the most potent male sex hormone?
Dihydrotestosterone
1035
With a decrease in arterial diastolic pressure, what happens to • Stroke volume?
Decreases
1036
With a decrease in arterial diastolic pressure, what happens to • TPR?
Decreases
1037
With a decrease in arterial diastolic pressure, what happens to • Heart rate?
Decreases
1038
What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed?
Amylase hydrolyzes alpha-1, 4-glucoside linkages, forming alpha-limit dextrins, maltotriose, and maltose.
1039
Does the heart rate determine the diastolic or systolic interval?
Heart rate determines the diastolic interval, and contractility determines the systolic interval.
1040
On a graphical representation of filtration, reabsorption, and excretion, when does glucose first appear in the urine?
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
1041
What is the relationship between preload and the passive tension in a muscle?
They are directly related; the greater the preload, the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
1042
What is the rate-limiting step in the synthetic pathway of NE at the adrenergic nerve terminal?
The conversion of tyrosine to dopamine in the cytoplasm
1043
How many days prior to ovulation does LH surge occur in the menstrual cycle?
1 day prior to ovulation
1044
How are flow through the loop of Henle and concentration of urine related?
As flow increases, the urine becomes more dilute because of decreased time for H2O reabsorption.
1045
What is the PO2 of aortic blood in fetal circulation?
60%
1046
How do elevated blood glucose levels decrease GH secretion? (Hint: what inhibitory hypothalamic hormone is stimulated by IGF-1?)
Somatotrophins are stimulated by IGF-1, and they inhibit GH secretion. GHRH stimulates GH secretion.
1047
What segment of the nephron has the highest concentration of inulin? Lowest concentration of inulin?
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
1048
What type of resistance system, high or low, is formed when resistors are added in a series?
A high-resistance system is formed when resistors are added in a series.
1049
What hormones, secreted in proportion to the size of the placenta, are an index of fetal well-being?
hCS and serum estriol, which are produced by the fetal liver and placenta, respectively, are used as estimates of fetal well-being.
1050
What primary acid-base disturbance is caused by an increase in alveolar ventilation (decreasing CO2 levels) resulting in the reaction shifting to the left and decreasing both H+ and HCO3- levels?
Respiratory alkalosis (summary: low CO2, low H+, slightly low HCO3-)
1051
What respiratory center in the caudal pons is the center for rhythm promoting prolonged inspirations?
Apneustic center (deep breathing place)
1052
What area of the GI tract has the highest activity of brush border enzymes?
Jejunum (upper)
1053
What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
Adrenarche
1054
What period is described when a larger-than-normal stimulus is needed to produce an action potential?
Relative refractory period
1055
Does T3 or T4 have a greater affinity for its nuclear receptor?
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
1056
What are the three main functions of surfactant?
1. Lowers surface tension, so it decreases recoil and increases compliance 2. Reduces capillary filtration 3. Promotes stability in small alveoli by lowering surface tension
1057
What is the only important physiological signal regulating the release of PTH?
Low interstitial free Ca2+ concentrations
1058
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH decreased, Ca2+ increased, Pi increased
Secondary hypoparathyroidism (vitamin D toxicity)
1059
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH increased, Ca2+ decreased, Pi decreased
Secondary hyperparathyroidism (vitamin D deficiency, renal disease)
1060
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH decreased, Ca2+ decreased, Pi increased
Primary hypoparathyroidism
1061
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH increased, Ca2+ increased, Pi decreased
Primary hyperparathyroidism
1062
What is the amount in liters and percent body weight for the following compartments? • ECF
14 L, 33% of body weight
1063
What is the amount in liters and percent body weight for the following compartments? • Interstitial fluid
9.3 L, 15% of body weight
1064
What is the amount in liters and percent body weight for the following compartments? • ICF
28 L, 40% of body weight
1065
What is the amount in liters and percent body weight for the following compartments? • Vascular fluid
4.7 L, 5% of body weight
1066
What is the amount in liters and percent body weight for the following compartments? • Total body water
42 L, 67% of body weight
1067
What hormone is secreted by the placenta late in pregnancy, stimulates mammary growth during pregnancy, mobilizes energy stores from the mother so that the fetus can use them, and has an amino acid sequence like GH?
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
1068
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 increased
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
1069
What thyroid abnormality has the following? • TRH increased, TSH decreased, T4 decreased
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
1070
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 decreased
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
1071
What thyroid abnormality has the following? • TRH increased, TSH increased, T4 decreased
Primary hypothyroidism (Low T4 has a decreased negative feedback loop, resulting in both the hypothalamus and the anterior pituitary gland to increase TRH and TSH release, respectively.)
1072
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 increased
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
1073
What two stress hormones are under the permissive action of cortisol?
Glucagon and epinephrine
1074
If the radius of a vessel doubles, what happens to resistance?
The resistance will decrease one-sixteenth of the original resistance.
1075
What prevents the down-regulation of the receptors on the gonadotrophs of the anterior pituitary gland?
The pulsatile release of GnRH
1076
True or false? Epinephrine has proteolytic metabolic effects.
False. It has glycogenolytic and lipolytic actions but not proteolytic.
1077
What is the only 17-hydroxysteroid with hormonal activity?
Cortisol, a 21-carbon steroid, has a -OH group at position 17.
1078
Does the oncotic pressure of plasma promote filtration or reabsorption?
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
1079
Why is the base of the lung hyperventilated when a person is standing upright?
The alveoli at the base are small and very compliant, so there is a large change in their size and volume and therefore a high level of alveolar ventilation.
1080
By removing Na+ from the renal tubule and pumping it back into the ECF compartment, what does aldosterone do to the body's acid-base stores?
The removal of Na+ results in the renal tubule becoming negatively charged. The negative luminal charge attracts both K+ and H+ into the renal tubule and promotes HCO3- to enter the ECF and results in hypokalemic alkalosis.
1081
What hormone causes contractions of smooth muscle, regulates interdigestive motility, and prepares the intestine for the next meal?
Motilin
1082
What two vessels in fetal circulation have the highest PO2 levels?
Umbilical vein and ductus venosus (80%)
1083
How many days prior to ovulation does estradiol peak in the menstrual cycle?
2 days prior to ovulation
1084
What serves as a marker of endogenous insulin secretion?
C-peptide levels
1085
What is the term for the total volume of air moved in and out of the respiratory system per minute?
Total ventilation (minute ventilation or minute volume)
1086
What is the renal compensation mechanism for alkalosis?
Increase in urinary excretion of HCO3-, shifting the reaction to the right and increasing H+
1087
What is a sign of a Sertoli cell tumor in a man?
Excess estradiol in the blood
1088
In the systemic circulation, what blood vessels have the largest pressure drop? Smallest pressure drop?
Arterioles have the largest drop, whereas the vena cava has the smallest pressure drop in systemic circulation.
1089
What is the major stimulus for cell division in chondroblasts?
IGF-1
1090
What are two causes of diffusion impairment in the lungs?
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
1091
What are the four effects of suckling on the mother?
1. Increased synthesis and secretion of oxytocin 2. Increased release of PIF by the hypothalamus 3. Inhibition of GnRH (suppressing FSH/LH) 4. Milk secretion
1092
A migrating myoelectric complex is a propulsive movement of undigested material of undigested material from the stomach to the small intestine to the colon. During a fast, what is the time interval of its repeats?
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
1093
With an increase in arterial systolic pressure, what happens to • Stroke volume?
Increases
1094
With an increase in arterial systolic pressure, what happens to • Vessel compliance?
Decreases
1095
With an increase in arterial systolic pressure, what happens to • Heart rate?
Decreases
1096
What enzyme is needed to activate the following reactions? • Trypsinogen to trypsin
Enterokinase
1097
What enzyme is needed to activate the following reactions? • Chymotrypsinogen to chymotrypsin
Trypsin
1098
What enzyme is needed to activate the following reactions? • Procarboxypeptidase to carboxypeptidase
Trypsin
1099
In a ventricular pacemaker cell, what phase of the action potential is affected by ACh?
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance, taking longer to reach threshold and slowing the rate of firing.
1100
What is the most potent stimulus for glucagon secretion? Inhibition?
Hypoglycemia for secretion and hyperglycemia for inhibition
1101
What is the term for the summation of mechanical stimuli due to the skeletal muscle contractile unit becoming saturated with calcium?
Tetany
1102
What form of renal tubular reabsorption is characterized by low back leaks, high affinity of a substance, and easy saturation? It is surmised that the entire filtered load is reabsorbed until the carriers are saturated, and then the rest is excreted.
A transport maximum (Tm) system
1103
In an adrenergic nerve terminal, where is dopamine converted to NE? By what enzyme?
Dopamine is converted into NE in the vesicle via the enzyme dopamine-Beta-hydroxylase.
1104
Is the clearance for a substance greater than or less than for inulin if it is freely filtered and secreted? If it is freely filtered and reabsorbed?
Filtered and secreted: Cx > Cin (i.e., PAH). Filtered and reabsorbed: Cx < Cin (i.e., glucose), where Cx = clearance of a substance and Cin = clearance of inulin.
1105
What is the term for the load on a muscle in the relaxed state?
Preload. It is the load on a muscle Prior to contraction.
1106
The surge of what hormone induces ovulation?
LH
1107
What are the two best indices of left ventricular preload?
LVEDV and LVEDP (left ventricular end-diastolic volume and end-diastolic pressure, respectively)
1108
What stage of male development is characterized by the following LH and testosterone levels? • LH pulsatile amplitude and levels increase, with increased testosterone production.
Puberty
1109
What stage of male development is characterized by the following LH and testosterone levels? • Both LH and testosterone levels drop and remain low.
Childhood
1110
What stage of male development is characterized by the following LH and testosterone levels? • LH secretion drives testosterone production, with both levels paralleling each other.
Adulthood
1111
What stage of male development is characterized by the following LH and testosterone levels? • Decreased testosterone production is accompanied by an increase in LH production.
Aged adult
1112
What primary acid-base disturbance is caused by a loss in fixed acid forcing the reaction to shift to the right, thereby increasing HCO3- levels?
Metabolic alkalosis (summary: high pH, low H+ and high HCO3-)
1113
When referring to a series circuit, what happens to resistance when a resistor is added?
Resistance increases as resistors are added to the circuit.
1114
Why is there an increase in prolactin if the hypothalamic-pituitary axis was severed?
Because the chronic inhibition of dopamine (PIF) on the release of prolactin from the anterior pituitary gland is removed, thereby increasing the secretion of prolactin.
1115
Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR?
Because creatinine is filtered and a small amount is secreted
1116
What acid form of H+ in the urine cannot be titrated?
NH4+(ammonium)
1117
Regarding the venous system, what happens to blood volume if there is a small change in pressure?
Because the venous system is more compliant than the arterial vessels, small changes in pressure result in large changes in blood volume.
1118
In what stage of sleep is GH secreted?
Stages 3 and 4 (NREM)
1119
Where does the conversion of CO2 into HCO3- take place?
In the RBC; remember, you need carbonic anhydrase for the conversion, and plasma does not have this enzyme.
1120
From the fourth month of fetal life to term, what secretes the progesterone and estrogen to maintains the uterus?
The placenta
1121
What two factors are required for effective exocytosis?
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
1122
What is the best measure of total body vitamin D if you suspect a deficiency?
Serum 25-hydroxy-vitamin D (25-OH-D)
1123
What hormone is required for 1, 25-dihydroxy-vitamin D (1, 25-diOH-D) to have bone resorbing effects?
PTH
1124
Is bone deposition or resorption due to increased interstitial Ca2+concentrations?
Bone deposition increases with increased Ca2+ or PO 4- concentrations, whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
1125
The opening of what valve indicates the termination of isovolumetric relaxation phase of the cardiac cycle?
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
1126
Why is there a decrease in the production in epinephrine when the anterior pituitary gland is removed?
The enzyme phenyl ethanolamine N-methyltransferase (PNMT), used in the conversion of epinephrine, is regulated by cortisol. Removing the anterior pituitary gland decreases ACTH and therefore cortisol.
1127
Name the period described by the following statement: no matter how strong a stimulus is, no further action potentials can be stimulated.
Absolute refractory period is due to voltage inactivation of sodium channels.
1128
How many carbons do estrogens have?
Estrogens are 18-carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
1129
True or false? The alveolar PO2 and PCO2 levels match the pulmonary end capillary blood levels.
True. Because of intrapulmonary shunting, there is a slight decrease in PO2 and increase in PCO2 between the pulmonary end capillary blood and the systemic arterial blood.
1130
In high altitudes, what is the main drive for ventilation?
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
1131
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, decrease; ICF, no change; body, no change
Loss of isotonic fluid (diarrhea, vomiting, hemorrhage)
1132
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, increase; ICF, increase; body, decrease
Gain of hypotonic fluid (water intoxication or hypotonic saline)
1133
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, decrease; ICF, decrease; body: increase
Loss of hypotonic fluid (alcohol, diabetes insipidus, dehydration)
1134
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF: increase; ICF: no change; body: no change
Gain of isotonic fluid (isotonic saline)
1135
Describe what type of fluid is either gained or lost with the following changes in body hydration for the ECF volume, ICF volume, and body osmolarity, respectively: • ECF, increase; ICF, decrease; body, increase
Gain of hypertonic fluid (mannitol or hypertonic saline)
1136
What hormone excess produces adrenal hyperplasia?
ACTH
1137
Is there more circulating T3 or T4 in plasma?
T4; because of the greater affinity for the binding protein, T4 has a significantly (nearly fifty times) longer half-life than T3.
1138
Why is the cell's resting membrane potential negative?
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
1139
True or false? Thyroid size is a measure of its function.
False. Thyroid size is a measure of TSH levels (which are goitrogenic).
1140
If the radius of a vessel is decreased by half, what happens to the resistance?
The resistance increases 16-fold.
1141
What neurotransmitter is essential for maintaining a normal BP when an individual is standing?
NE, via its vasoconstrictive action on blood vessels
1142
What form of diabetes insipidus is due to an insufficient amount of ADH for the renal collecting ducts?
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available, but the renal collecting ducts are impermeable to its actions.
1143
Name the three methods of vasodilation via the sympathetic nervous system.
1. Decrease alpha-1 activity
2. Increase Beta-2 activity
3. Increase ACh levels
1144
What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate excretion
PTH
1145
What hormone is characterized by the following renal effects? • Calcium excretion, phosphate excretion
Calcitriol
1146
What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate reabsorption
Vitamin D3
1147
True or false? Progesterone has thermogenic activities.
True. Elevated plasma levels of progesterone can raise the body temperature 0.5° to 1.0°F.
1148
How long is the transit time through the small intestine?
2 to 4 hours
1149
Where is the last conducting zone of the lungs?
Terminal bronchioles. (No gas exchange occurs here.)
1150
True or false? Cortisol inhibits glucose uptake in skeletal muscle.
True; cortisol inhibits glucose uptake in most tissue, making it available for neural tissue use.
1151
What percentage of cardiac output flows through the pulmonary circuit?
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
1152
Name the Hgb-O2 binding site based on the following information: • Least affinity for O2; requires the highest PO 2 levels for attachment (approx. 100 mm Hg)
Site 4
1153
Name the Hgb-O2 binding site based on the following information: • Greatest affinity of the three remaining sites for attachment; requires PO2 levels of 26 mm Hg to remain attached
Site 2
1154
Name the Hgb-O2 binding site based on the following information: • Remains attached under most physiologic conditions
Site 1
1155
Name the Hgb-O2 binding site based on the following information: • Requires a PO2 level of 40 mm Hg to remain attached
Site 3
1156
Which three factors cause the release of epinephrine from the adrenal medulla?
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
1157
How many ATPs are hydrolyzed every time a skeletal muscle cross-bridge completes a single cycle?
One, and it provides the energy for mechanical contraction.
1158
Why would a puncture to a vein above the heart have the potential to introduce air into the vascular system?
Venous pressure above the heart is subatmospheric, so a puncture there has the potential to introduce air into the system.
1159
What type of saliva is produced under parasympathetic stimulation?
High volume, watery solution; sympathetic stimulation results in thick, mucoid saliva.
1160
In what area of the GI tract does iron get absorbed?
Duodenum
1161
Why is the apex of the lung hypoventilated when a person is standing upright?
The alveoli at the apex are almost completely inflated prior to inflation, and although they are large, they receive low levels of alveolar ventilation.
1162
What pancreatic islet cell secretes glucagons?
alpha-Cells; glucagon has stimulatory effects on -cells and inhibitory effects on -cells.
1163
What are the four characteristics of all protein-mediated transportation?
1. Competition for carrier with similar chemical substances 2. Chemical specificity needed for transportation 3. Zero-order saturation kinetics (Transportation is maximal when all transporters are saturated.) 4. Rate of transportation faster than if by simple diffusion
1164
What is secretin's pancreatic action?
Secretin stimulates the pancreas to secrete a HCO3--rich solution to neutralize the acidity of the chyme entering the duodenum.
1165
Why is there an increase in FF if the GFR is decreased under sympathetic stimulation?
Because RPF is markedly decreased, while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
1166
What triggers phase 3 of the action potential in a ventricular pacemaker cell?
Rapid efflux of potassium
1167
What is the primary target for the action of glucagon?
Liver (hepatocytes)
1168
What is the renal compensation mechanism for acidosis?
Production of HCO3-, shifting the reaction to the left and thereby decreasing H+
1169
What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts?
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
1170
What hormone, produced by Sertoli cells, if absent would result in the formation of internal female structures?
MIF
1171
What happens to the lung if the intrapleural pressure exceeds lung recoil?
The lung will expand; also the opposite is true.
1172
What two factors determine the clearance of a substance?
Plasma concentration and excretion rate
1173
What type of muscle contraction occurs when the muscle shortens and lifts the load placed on it?
Isotonic contraction
1174
What type of potential is characterized as being an all-or-none response, propagated and not summated?
Action potential
1175
What primary acid-base disturbance is caused by a gain in fixed acid forcing the reaction to shift to the left, decreasing HCO3- and slightly increasing CO2?
Metabolic acidosis (summary: low pH, high H+, and low HCO3-)
1176
What two pituitary hormones are produced by acidophils?
GH and prolactin are produced by acidophils; all others are by basophils.
1177
What organ of the body has the smallest AV oxygen difference?
The renal circulation has the smallest AV O2 (high venous PO2) difference in the body because of the overperfusion of the kidneys resulting from filtration.
1178
What is the titratable acid form of H+ in the urine?
H2PO4- (dihydrogen phosphate)
1179
What hypothalamic hormone is synthesized in the preoptic nucleus?
GnRH
1180
What five factors promote turbulent flow?
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
1181
What is the major hormone produced in the following areas of the adrenal cortex? • Zona glomerulosa
Aldosterone Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
1182
What is the major hormone produced in the following areas of the adrenal cortex? • Zona fasciculata
Cortisol Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
1183
What is the major hormone produced in the following areas of the adrenal cortex? • Zona reticularis
DHEA (androgens) Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
1184
Where is most of the body's Ca2+ stored?
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
1185
What is the relationship between ventilation and PCO2 levels?
They are inversely related. If ventilation increases, there will be a decrease in PCO2 levels and vice versa.
1186
Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
T4, as long as T4 levels remain constant, TSH will be minimally effected by T3.
1187
What is the signal to open the voltage-gated transmembrane potassium channels?
Membrane depolarization is the stimulus to open these slow channels, and if they are prevented from opening, it will slow down the repolarization phase.
1188
Increased urinary excretion of what substance is used to detect excess bone demineralization?
Hydroxyproline
1189
What is the term to describe how easily a vessel stretches?
Compliance (think of it as distensibility)
1190
What is the ratio of T4:T3 secretion from the thyroid gland?
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
1191
Do the PO2 peripheral chemoreceptors of the carotid body contribute to the normal drive for ventilation?
Under normal resting conditions no, but they are strongly stimulated when PO2 arterial levels decrease to 50 to 60 mm Hg, resulting in increased ventilatory drive.
1192
What determines the overall force generated by the ventricular muscle during systole?
The number of cross-bridges cycling during contraction: the greater the number, the greater the force of contraction.
1193
Where does most circulating plasma epinephrine originate?
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
1194
What causes a skeletal muscle contraction to terminate?
When calcium is removed from troponin and pumped back into the SR, skeletal muscle contraction stops.
1195
What happens to intracellular volume when there is an increase in osmolarity?
ICF volume decreases when there is an increase in osmolarity and vice versa.
1196
Which CHO is independently absorbed from the small intestine?
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
1197
When is the surface tension the greatest in the respiratory cycle?
Surface tension, the force to collapse the lung, is greatest at the end of inspiration.
1198
What adrenal enzyme deficiency results in hypertension, hypernatremia, increased ECF volume, and decreased adrenal androgen production?
17-alpha-Hydroxylase deficiency
1199
In reference to membrane potential (Em) and equilibrium potential (Ex), which way do ions diffuse?
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
1200
Under normal conditions, what is the main factor that determines GFR?
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
1201
The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle?
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
1202
What vessels in the systemic circulation have the greatest and slowest velocity?
The aorta has the greatest velocity and the capillaries have the slowest velocity.
1203
Thin extremities, fat collection on the upper back and abdomen, hypertension, hypokalemic alkalosis, acne, hirsutism, wide purple striae, osteoporosis, hyperlipidemia, hyperglycemia with insulin resistance, and protein depletion are all characteristics of what disorder?
Hypercortisolism (Cushing syndrome)
1204
What enzyme is essential for the conversion of CO2 to HCO3-?
Carbonic anhydrase
1205
True or false? The parasympathetic nervous system has very little effect on arteriolar dilation or constriction.
TRUE
1206
What three lung measurements must be calculated because they cannot be measured by simple spirometry?
TLC, FRC, and RV have to be calculated. (Remember, any volume that has RV as a component has be calculated.)
1207
What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
They chronically inhibit ADH secretion; when there is a decrease in the blood volume, the stretch receptors send fewer signals, and ADH is secreted.
1208
What cell converts androgens to estrogens?
Granulosa cell
1209
What hormone acts on Granulosa cells?
FSH
1210
How long is the transit time through the large intestine?
3 to 4 days
1211
Does subatmospheric pressure act to expand or collapse the lung?
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
1212
What hormone constricts afferent and efferent arterioles (efferent more so) in an effort to preserve glomerular capillary pressure as the renal blood flow decreases?
AT II
1213
Why is there a minimal change in BP during exercise if there is a large drop in TPR?
Because the large drop in TPR is accompanied by a large increase in cardiac output, resulting in a minimal change in BP.
1214
What is the effect of insulin on protein storage?
Insulin increases total body stores of protein, fat, and CHOs. When you think insulin, you think storage.
1215
What is the term for an inhibitory interneuron?
Renshaw neuron
1216
What triggers phase 0 of the action potential in a ventricular pacemaker cell?
Calcium influx secondary to slow channel opening
1217
What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Percentage of original filtered volume left in the lumen
At the end of the PCT 25% of the original volume is left
1218
What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Percentage of Na+, Cl-, K+ left in the lumen
At the end of the PCT 25% of Na+, Cl-, K+ is left
1219
What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Osmolarity
300 mOsm/L
1220
What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Concentration of CHO, AA, ketones, peptides
No CHO, AA, ketones, or peptides are left in the tubular lumen.
1221
True or false? Enterokinase is a brush border enzyme.
False. It is an enzyme secreted by the lining of the small intestine.
1222
Where does the synthesis of ACh occur?
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
1223
What pancreatic islet cell secretes somatostatin?
delta-Cells; somatostatin has an inhibitory effect on alpha- and Beta-islet cells.
1224
Why is O2 content depressed in anemic patients?
Anemic patients have a depressed O2 content because of the reduced concentration of Hgb in the blood. As for polycythemic patients, their O2 content is increased because of the excess Hgb concentrations.
1225
What term describes the volume of plasma from which a substance is removed over time?
Clearance
1226
If capillary hydrostatic pressure is greater than oncotic pressure, is filtration or reabsorption promoted?
Filtration; if hydrostatic pressure is less than oncotic pressure, reabsorption is promoted.
1227
What cells of the parathyroid gland are simulated in response to hypocalcemia?
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
1228
At the base of the lung, what is the baseline intrapleural pressure, and what force does it exert on the alveoli?
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean), resulting in a force to collapse the alveoli.
1229
What hormone is necessary for normal GH secretion?
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
1230
What is the signal to open the voltage-gated transmembrane sodium channels?
Membrane depolarization is the stimulus to open these channels, which are closed in resting conditions.
1231
What hormones are produced in the median eminence region of the hypothalamus and the posterior pituitary gland?
None; they are the storage sites for ADH and oxytocin.
1232
What is the most energy-demanding phase of the cardiac cycle?
Isovolumetric contraction
1233
What presynaptic receptor does NE use to terminate further neurotransmitter release?
alpha2-Receptors
1234
Are salivary secretions hypertonic, hypotonic, or isotonic?
Hypotonic, because NaCl is reabsorbed in the salivary ducts
1235
What is the effect of T3 on heart rate and cardiac output?
T3 increases both heart rate and cardiac output by increasing the number of Beta-receptors and their sensitivity to catecholamines.
1236
Why will turbulence first appear in the aorta in patients with anemia?
Because it is the largest vessel and has the highest velocity in systemic circulation
1237
What is the origin of the polyuria if a patient is dehydrated and electrolyte depleted?
If the polyuria begins before the collecting ducts, the patient is dehydrated and electrolyte depleted. If the polyuria originates from the collecting ducts, the patient is dehydrated with normal electrolytes.
1238
What is the physiologically active form of Ca2+?
Free ionized Ca2+
1239
What are the two factors that affect alveolar PCO2 levels?
Metabolic rate and alveolar ventilation (main factor)
1240
Why is spermatogenesis decreased with anabolic steroid therapy?
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone, produced by Leydig cells, is needed for spermatogenesis.
1241
What type of membrane is characterized as being permeable to water only?
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
1242
What thyroid enzyme is needed for oxidation of I- to I'?
Peroxidase, which is also needed for iodination and coupling inside the follicular cell
1243
What is the most important stimulus for the secretion of insulin?
An increase in serum glucose levels
1244
What term is described as the prestretch on the ventricular muscle at the end of diastole?
Preload (the load on the muscle in the relaxed state)
1245
What peripheral chemoreceptor receives the most blood per gram of weight in the body?
The carotid body, which monitors arterial blood directly
1246
What adrenal enzyme deficiency results in hypertension, hypernatremia, and virilization?
11-Beta-Hydroxylase deficiency results in excess production of 11-deoxycorticosterone, a weak mineralocorticoid. It increases BP, Na+, and ECF volume along with production of adrenal androgens.
1247
What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
Osmosis; water will diffuse from higher to lower water concentrations.
1248
When do hCG concentrations peak in pregnancy?
In the first 3 months
1249
How many milliliters of O2 per milliliter of blood?
0.2
1250
What type of cell is surrounded by mineralized bone?
Osteocyte
1251
What two forces affect movement of ions across a membrane?
Concentration force and electrical force
1252
What happens to the resistance of the system when a resistor is added in a series?
Resistance of the system increases. (Remember, when resistors are connected in a series, the total of the resistance is the sum of the individual resistances.)
1253
What is the greatest component of lung recoil?
Surface tension; in the alveoli, it is a force that acts to collapse the lung.
1254
Where is ADH synthesized?
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
1255
How is velocity related to the total cross-sectional area of a blood vessel?
Velocity is inversely related to cross-sectional area.
1256
True or false? Aldosterone has a sodium-conserving action in the distal colon.
True. In the distal colon, sweat glands, and salivary ducts, aldosterone has sodium-conserving effects.
1257
What form of hormone is described as having membrane-bound receptors that are stored in vesicles, using second messengers, and having its activity determined by free hormone levels.
Water-soluble hormones are considered fast-acting hormones.
1258
What forms of fatty acids are absorbed from the small intestine mucosa by simple diffusion?
Short-chain fatty acids
1259
What is the term for the day after the LH surge in the female cycle?
Ovulation
1260
The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
1261
What is the region of an axon where no myelin is found?
Nodes of Ranvier
1262
What disorder of aldosterone secretion is characterized by • Increased total body sodium, ECF volume, plasma volume, BP, and pH; decreased potassium, renin and AT II activity; no edema?
Primary hyperaldosteronism (Conn syndrome)
1263
What disorder of aldosterone secretion is characterized by • Decreased total body sodium, ECF volume, plasma volume, BP, and pH; increased potassium, renin, and AT II activity; no edema?
Primary hypoaldosteronism (Addison's disease)
1264
What four factors affect diffusion rate?
1. Concentration (greater concentration gradient, greater diffusion rate) 2. Surface area (greater surface area, greater diffusion rate) 3. Solubility (greater solubility, greater diffusion rate) 4. Membrane thickness (thicker the membrane, slower the diffusion rate) Molecular weight is clinically unimportant
1265
How long after ovulation does fertilization occur?
8 to 25 hours
1266
What is the name of the force that develops in the wall of the lungs as they expand?
Lung recoil, being a force to collapse the lung, increases as the lung enlarges during inspiration.
1267
What day of the menstrual cycle does ovulation take place?
Day 14
1268
How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated, and how?)
A decrease in cutaneous blood flow results from constriction of the arterioles, and decreased cutaneous blood volume results from constriction of the venous plexus.
1269
What two compensatory mechanisms occur to reverse hypoxia at high altitudes?
Increase in erythropoietin and increase in 2, 3-BPG, also called 2, 3-diphosphoglycerate (2, 3-P2Gri) (increase in glycolysis)
1270
What female follicular cell is under LH stimulation and produces androgens from cholesterol?
Theca cell
1271
What is the main factor determining FF?
Renal plasma flow (decrease flow, increase FF)
1272
Where is the action potential generated on a neuron?
Axon hillock
1273
If free water clearance (CH2O) is positive, what type of urine is formed? And if it is negative?
If positive, hypotonic urine (osmolarity <300 mOsm/L); if negative, hypertonic urine (osmolarity > 300 mOsm/L)>>
1274
What cell in the heart has the highest rate of automaticity?
SA node; it is the reason it is the primary pacemaker of the heart.
1275
What is pumped from the lumen of the ascending loop of Henle to decrease the osmolarity?
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
1276
True or false? In skeletal muscle relaxation is an active event.
True. Sarcoplasmic calcium-dependent ATPase supplies the energy to terminate contraction, and therefore it is an active process.
1277
What three factors increase simple diffusion?
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
1278
What is the pancreatic action of CCK?
CCK stimulates the pancreas to release amylase, lipase, and proteases for digestion.
1279
What is the rate-limiting step in a conduction of a NMJ?
The time it takes ACh to diffuse to the postjunctional membrane
1280
Is excretion greater than or less than filtration for net secretion to occur?
Excretion is greater than filtration for net secretion to occur.
1281
What acid-base disturbance is produced from vomiting?
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+, K+, and Cl-.
1282
What phase of the menstrual cycle is dominated by estrogen? Progesterone?
Follicular phase is estrogen-dependent with increased FSH levels, while the luteal phase is progesterone-dependent.
1283
Name the lung measurement based on the following descriptions: • The amount of air that enters or leaves the lung system in a single breath
Tidal volume (VT)
1284
Name the lung measurement based on the following descriptions: • The maximal volume inspired from FRC
Inspiratory capacity
1285
Name the lung measurement based on the following descriptions: • Additional volume that can be expired after normal expiration
Expiratory reserve volume (ERV)
1286
Name the lung measurement based on the following descriptions: • Maximal volume that can be expired after maximal inspiration
Vital capacity (VC)
1287
Name the lung measurement based on the following descriptions: • Volume in the lungs at the end of passive expiration
Functional residual capacity (FRC)
1288
Name the lung measurement based on the following descriptions: • Additional air that can be taken in after normal inspiration
Inspiratory reserve volume (IRV)
1289
Name the lung measurement based on the following descriptions: • Amount of air in the lungs after maximal expiration
Residual volume (RV)
1290
Name the lung measurement based on the following descriptions: • Amount of air in the lungs after maximal inspiration
Total lung capacity (TLC)
1291
What growth factors are chondrogenic, working on the epiphyseal end plates of bone?
Somatomedins (IGF-1)
1292
What determines the Vmax of skeletal muscle?
The muscle's ATPase activity
1293
True or false? All of the hormones in the hypothalamus and anterior pituitary gland are water soluble.
TRUE
1294
What is the effect of T3 on the glucose absorption in the small intestine?
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.
1295
Is the bound form or free form of a lipid-soluble hormone responsible for the negative feedback activity?
Free form determines hormone activity and is responsible for the negative feedback loop.
1296
What region or regions of the adrenal cortex are stimulated by ACTH?
Zona fasciculata and zona reticularis
1297
Are the following parameters associated with an obstructive or restrictive lung disorder: decreased FEV1, FVC, peak flow, and FEV1/FVC; increased TLC, FRC, and RV?
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
1298
What is the respiratory compensation mechanism for metabolic alkalosis?
Hypoventilation, which increases CO2, shifting the reaction to the right and increasing H+
1299
During puberty, what is the main drive for the increased GH secretion?
Increased androgen secretion at puberty drives the increased GH secretion.
1300
What type of potential is characterized as graded, decremental, and exhibiting summation?
Subthreshold potential
1301
What three organs are responsible for peripheral conversion of T4 to T3?
Liver, kidneys, and pituitary gland via 5' deiodinase enzyme
1302
The closure of what valve indicates the beginning of isovolumetric contraction?
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
1303
How many carbons do androgens have?
Androgens are 19-carbon steroids.
1304
At the apex of the lung, what is the baseline intrapleural pressure, and what force does it exert on the alveoli?
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
1305
True or false? Renin secretion is increased in 21-β-hydroxylase deficiency.
True. Increased renin and AT II levels occur as a result of the decreased production of aldosterone.
1306
What are the four ways to increase TPR?
1. Decrease the radius of the vessel 2. Increase the length of the vessel 3. Increase the viscosity 4. Decrease the number of parallel channels
1307
What form of estrogen is of placental origin?
Estriol
1308
What term is an index of the effort needed to expand the lungs (i.e., overcomes recoil)?
Compliance; the more compliant a lung is, the easier it is to inflate.
1309
At which three sites in the body is T4 converted to T3?
1. Liver 2. Kidney 3. Pituitary gland (via 5'-deiodinase enzyme)
1310
Using Laplace's relationship regarding wall tension, why is the wall tension in an aneurysm greater than in the surrounding normal blood vessel's wall?
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
1311
What percentage of nephrons is cortical?
Seven-eighths of nephrons are cortical, with the remainder juxtamedullary.
1312
To what is the diffusion rate indirectly proportional?
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
1313
ADH is secreted in response to what two stimuli?
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
1314
What vessels have the largest total cross-sectional area in systemic circulation?
Capillaries
1315
How many days before the first day of menstrual bleeding is ovulation?
14 days in most women (Remember, the luteal phase is always constant.)
1316
What is the major muscle used in the relaxed state of expiration?
Under resting conditions expiration is considered a passive process; therefore, no muscles are used. In the active state the abdominal muscles can be considered the major muscle of expiration.
1317
What subunit of hCG is used to detect whether a patient is pregnant?
The β-subunit; remember, the α-subunit is nonspecific.
1318
What happens to capillary oncotic pressure with dehydration?
Oncotic pressure increases because of the removal of water.
1319
What cells of the kidney are extravascular chemoreceptors for decreased Na+, Cl-, and NaCl?
Macula densa
1320
What is the effect of insulin on intracellular K+ stores?
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
1321
What triggers phase 4 of the action potential in a ventricular pacemaker cell?
Decreasing potassium conductance, which results in increased excitability
1322
What is it called when levels of sex steroids increase, LH increases, and FSH increases?
GnRH pulsatile infusion
1323
What parasympathetic neurotransmitter of the GI tract stimulates the release of gastrin?
Gastrin-releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)
1324
What reflex increases TPR in an attempt to maintain BP during a hemorrhage?
The carotid sinus reflex
1325
What is the name of the regulatory protein that covers the attachment site on actin in resting skeletal muscle?
Tropomyosin
1326
Which way does the Hgb-O2 dissociation curve shift in patients with CO poisoning?
The pathologic problem with CO poisoning is that CO has 240 times as much affinity for Hgb molecule as does O2, reducing the carrying capacity and shifting the curve to the left, making it difficult to remove the CO molecule from Hgb.
1327
What is the main factor determining GFR?
Glomerular capillary pressure (increased glomerular capillary pressure, increased GFR and vice versa)
1328
What is the effect of hypoventilation on cerebral blood flow?
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
1329
What cells of the thyroid gland are stimulated in response to hypercalcemia?
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
1330
What is the term for the amount of blood in the ventricle after maximal contraction?
Residual volume
1331
What does failure of PaO2 to increase with supplemental O2 indicate?
Pulmonary shunt (i.e., pulmonary embolism)
1332
What two substances stimulate Sertoli cells?
FSH and testosterone
1333
The clearance of what substance is the gold standard of renal plasma flow?
Para-aminohippurate (PAH)
1334
What bile pigment is formed by the metabolism of bilirubin by intestinal bacteria, giving stool its brown color?
Stercobilin
1335
Is ACh associated with bronchoconstriction or bronchodilation?
Bronchoconstriction is associated with parasympathetic stimulation (ACh), and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
1336
What are the growth factors released from the liver called?
Somatomedins
1337
Regarding skeletal muscle mechanics, what is the relationship between velocity and afterload?
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
1338
What happens to extracellular volume with a net gain in body fluid?
The ECF compartment always enlarges when there is a net gain in total body water and decreases when there is a loss of total body water. Hydration status is named in terms of the ECF compartment.
1339
What are the six substances that promote the secretion of insulin?
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. β-Agonists 6. ACh
1340
Does O2 or CO2 have a higher driving force across the alveolar membrane?
O2 has a higher driving force but is only one-twenty-fourth as soluble as CO2. CO 2 has a very small partial pressure difference across the alveolar membrane (47-40 = 7 mmHg), but it is extremely soluble and therefore diffuses readily across the membrane.
1341
What is used as an index for both adrenal and testicular androgens?
Urinary 17-ketosteroids
1342
How are resistance and length related regarding flow?
Resistance and vessel length are proportionally related. The greater the length of the vessel, the greater the resistance is on the vessel.
1343
Is filtration greater than or less than excretion for net reabsorption to occur?
Filtration is greater than excretion for net reabsorption to occur.
1344
What hormone, stimulated by epinephrine, results in an increase in lipolysis?
Hormone-sensitive lipase, which breaks down triglyceride into glycerol and free fatty acid
1345
True or false? Miniature end-plate potentials (MEPPs) generate action potentials.
FALSE
1346
Is GH considered a gluconeogenic hormone?
Yes, it decreases fat and muscle uptake of glucose, thereby increasing blood glucose levels.
1347
True or false? Somatic motor neurons innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen.
TRUE
1348
What happens to intraventricular pressure and volume during isovolumetric contraction?
As the name indicates, there is no change in volume but there is an increase in pressure.
1349
Do high levels of estrogen and progesterone block milk synthesis?
Yes, they stimulate the growth of mammary tissue but block milk synthesis. At parturition, the decrease in estrogen lifts the block on milk production.
1350
What two factors lead to the development of the bends (caisson disease)?
Breathing high-pressure nitrogen over a long time and sudden decompression result in the bends.
1351
In what type of circuit is the total resistance always less than that of the individual resistors?
Parallel circuit
1352
What is the term for days 15 to 28 in the female cycle?
Luteal phase
1353
What happens to total and alveolar ventilation with • Increased rate of breathing?
With an increased rate of breathing the total ventilation is greater than the alveolar ventilation. Rapid, shallow breathing increases dead space ventilation with little change in alveolar ventilation. (This is hypoventilation).
1354
What happens to total and alveolar ventilation with • Increased depth of breathing?
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards, so remember it.
1355
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol decreased, ACTH increased
Primary hypocortisolism (Addison's disease)
1356
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol increased, ACTH increased
Secondary hypercortisolism (pituitary)
1357
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol increased, ACTH decreased
Primary hypercortisolism
1358
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol decreased, ACTH decreased
Secondary hypocortisolism (pituitary)
1359
What happens to flow and pressure in capillaries with arteriolar dilation? Arteriolar constriction?
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
1360
What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↑, RPF ↑, FF normal, capillary pressure ↑
Dilation of afferent arteriole
1361
What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↑, RPF ↓, FF ↑, capillary pressure ↑
Constriction of efferent arteriole
1362
What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↓, RPF ↑, FF ↓, capillary pressure ↓
Dilation of efferent arteriole
1363
What has occurred to the renal arterioles based on the following changes in the GFR, RPF, FF, and glomerular capillary pressure? • GFR ↓, RPF ↓, FF normal, capillary pressure ↓
Constriction of afferent arteriole
1364
Which direction is air flowing when the intra-alveolar pressure is zero?
When the intra-alveolar pressure equals zero, there is no airflow.
1365
What phase of the female cycle occurs during days 1 to 15?
Follicular phase
1366
What determines the effective osmolarity of the ICF and the ECF compartments?
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
1367
What region of the brain houses the central chemoreceptors responsible for control of ventilation?
The surface of the medulla
1368
What is the site of action of cholera toxin?
Cholera toxin irreversibly activates the cAMP-dependent chloride pumps of the small and large intestine, producing a large volume of chloride-rich diarrhea.
1369
Name the phase of the ventricular muscle action potential based on the following information: • Slow channels open, allowing calcium influx; voltage-gated potassium channels closed; potassium efflux through ungated channels; plateau stage
Phase 2
1370
Name the phase of the ventricular muscle action potential based on the following information: • Slight repolarization secondary to potassium and closure of the sodium channels
Phase 1
1371
Name the phase of the ventricular muscle action potential based on the following information: • Fast channels open, then quickly close, and sodium influx results in depolarization
Phase 0
1372
Name the phase of the ventricular muscle action potential based on the following information: • Slow channels close, voltage-gated potassium channels reopen with a large influx of potassium, and the cell quickly repolarizes
Phase 3
1373
Where in the kidney are the long loops of Henle and the terminal regions of the collecting ducts?
In the medulla; all the other structures are cortical.
1374
What is absorbed in the gallbladder to concentrate bile?
Water
1375
What type of hormone is described as having intracellular receptors, being synthesized as needed, mostly bound to proteins, and having its activity determined by free hormone levels?
Lipid-soluble hormones are considered slow-acting hormones.
1376
What are the three stimuli that result in the reninangiotensin-aldosterone secretion?
1. Low pressure in the afferent renal arteriole 2. Low sodium sensed by the macula densa 3. Increased β-1-sympathetic stimulation of the JG cells
1377
Is there a shift in p50 values with anemia? Polycythemia?
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
1378
What hormone level peaks 1 day before the surge of LH and FSH in the female cycle?
Estradiol
1379
True or false? Active protein transport requires a concentration gradient.
True; it requires both a concentration gradient and ATP to work.
1380
Up to how many hours post ejaculation do sperm retain their ability to fertilize the ovum?
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
1381
What type of membrane channel opens in response to depolarization?
Voltage-gated channel
1382
What are the five effects of insulin on fat metabolism?
1. Increased glucose uptake by fat cells 2. Increased triglyceride uptake by fat cells 3. Increased conversion of CHOs into fat 4. Decreased lipolysis in fat tissue 5. Decreased ketone body formation
1383
True or false? In a skeletal muscle fiber, the interior of the T-tubule is extracellular.
True. They are evaginations of the surface membranes and therefore extracellular.
1384
Under resting conditions, what is the main determinant of cerebral blood flow?
Arterial PCO2 levels are proportional to cerebral blood flow.
1385
On the venous pressure curve, what do the following waves represent? • A wave?
Atrial contraction Atrial, Contraction, Venous
1386
On the venous pressure curve, what do the following waves represent? • C wave?
Ventricular contraction Atrial, Contraction, Venous
1387
On the venous pressure curve, what do the following waves represent? • V wave?
Atrial filling (venous filling) Atrial, Contraction, Venous
1388
What cell type in the bone is responsible for bone deposition?
Osteoblast (Remember, blasts make, clasts take)
1389
True or false? The blood stored in the systemic veins and the pulmonary circuit are considered part of the cardiac output.
False. Cardiac output refers to circulating blood volume. The blood in the systemic veins and the pulmonary circuits are storage reserves and therefore are not considered in cardiac output.
1390
What hormone disorder is characterized by the following abnormalities in sex steroids↓, LH↓, and FSH↓? • Sex steroids , LH , FSH
Pituitary hypogonadism
1391
What hormone disorder is characterized by the following abnormalities in sex steroids↑, LH↓, and FSH↓? • Sex steroids , LH , FSH ?
GnRH constant infusion
1392
What hormone disorder is characterized by the following abnormalities in sex steroids↓, LH↑, and FSH↑? • Sex steroids , LH , FSH ?
Primary hypogonadism (postmenopausal women)
1393
What are the three characteristics of autoregulation?
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
1394
What is the fastest-conducting fiber of the heart? Slowest conduction fiber in the heart?
Purkinje cell is the fastest, and the AV node is the slowest.
1395
What equals the total tension on a muscle minus the preload?
Afterload
1396
What follicular cell possesses FSH receptors and converts androgens into estradiol?
Granulosa cells
1397
What are the primary neurotransmitters at the following sites? • Postganglionic sympathetic neurons
NE
1398
What are the primary neurotransmitters at the following sites? • Chromaffin cells of the adrenal medulla
Epinephrine
1399
What are the primary neurotransmitters at the following sites? • Brainstem cells
Serotonin
1400
What are the primary neurotransmitters at the following sites? • The hypothalamus
Histamine
1401
What are the primary neurotransmitters at the following sites? • All motor neurons, postganglionic parasympathetic neurons
ACh
1402
What are the primary neurotransmitters at the following sites? • Autonomic preganglionic neurons
ACh
1403
What region of the nephron has the highest osmolarity?
Tip of the loop of Henle (1200 mOsm/L)
1404
What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
1405
What is the term for the amount of blood expelled from the ventricle per beat?
Stroke volume
1406
True or false? Oxytocin initiates rhythmic contractions associated with labor.
False. It does increase uterine synthesis of prostaglandins, which increase uterine contractions.
1407
Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
DLCO, an index of lung surface area and membrane thickness, is decreased in fibrosis because of increased membrane thickness and decreased in emphysema because of increased surface area without increase in capillary recruitment; in exercise there is an increase in surface area due to capillary recruitment.
1408
What enzyme converts androgens to estrogens?
Aromatase
1409
The clearance of what substance is the gold standard of GFR?
Inulin
1410
How does myelination affect conduction velocity of an action potential?
The greater the myelination, the greater the conduction velocity.
1411
What are the three end products of amylase digestion?
1. Maltose 2. Maltotetrose 3. α-Limit dextrans (α-1, 6 binding)
1412
Where is most of the airway resistance in the respiratory system?
In the first and second bronchi
1413
What is the respiratory compensation mechanism for metabolic acidosis?
Hyperventilation, which decreases CO2, shifting the reaction to the left and decreasing H+
1414
How are resistance and viscosity related regarding flow?
Viscosity and resistance are proportionally related. The greater the viscosity, the greater the resistance is on the vessel.
1415
T3 increases bone ossification through synergistic effect with what hormone?
GH
1416
Name the ventricular muscle membrane channel: • Closed at rest; depolarization causes channels to open slowly
Voltage-gated calcium channel
1417
Name the ventricular muscle membrane channel: • Always open
Ungated potassium channel
1418
Name the ventricular muscle membrane channel: • Closed at rest; depolarization causes channels to open quickly; will not respond to a second stimulus until cell is repolarized.
Voltage-gated sodium channel
1419
Name the ventricular muscle membrane channel: • Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization
Voltage-gated potassium channels
1420
What are the three glycogenic organs?
Liver, kidney, and GI epithelium
1421
Is CO2 a perfusion-or diffusion-limited O2 gas?
Since CO2 is 24 times as soluble as O2, the rate at which CO2 is brought to the membrane determines its rate of exchange, making it perfusion-limited a gas. For O2 the more time it is in contact with the membrane, the more likely it will diffuse, making it diffusion-limited.
1422
What is the term for the potential difference across a cell membrane?
Transmembrane potential (an absolute number)
1423
What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency, glucocorticoid deficiency, and an excess of adrenal androgens?
21-β-Hydroxylase deficiency leads to hypotension, hyponatremia, and virilization.
1424
When the ECF osmolarity increases, what happens to cell size?
Increase in ECF osmolarity means a in decrease in ICF osmolarity, so cells shrink.
1425
When does cortisol secretion peak?
In early-morning sleep, usually between the sixth and eighth hours
1426
What is the term for ventilation of unperfused alveoli?
Alveolar dead space
1427
What is the bioactive form of thyroid hormone?
T3
1428
What acid-base disturbance occurs in colonic diarrhea
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
1429
What two AAs act as excitatory transmitters in the CNS, generating EPSPs?
Glutamine and aspartate
1430
What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects?
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
1431
In a parallel circuit, what happens to resistance when a resistor is added in parallel
Resistance decreases as resistors are added in parallel.
1432
What component of the ANS is responsible for movement of semen from the epididymis to the ejaculatory ducts?
Sympathetic nervous system
1433
What happens to O2 affinity with a decrease in p50?
O2 affinity increases with a decrease in the p50, making O2 more difficult to remove from the Hgb molecule.
1434
If the ratio of a substance's filtrate and plasma concentrations are equal, what is that substance's affect on the kidney?
If the ratio of the filtrate to plasma concentration of a substance is equal, the substance is freely filtered by the kidney.
1435
What does a loss of afferent activity from the carotid sinus onto the medulla signal?
A loss of afferent activity indicates a decrease in BP, and an increase in afferent activity indicates an increase in BP.
1436
What are the five F's associated with gallstones?
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
1437
True or false? Menstruation is an active process due to increased gonadal sex hormones?
False. It is a passive process due to decreased sex hormones.
1438
What happens to the intrapleural pressure when the diaphragm relaxes?
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
1439
What component of the renin-angiotensin-aldosterone axis increases sodium reabsorption in the proximal convoluted tubules and increases thirst drive?
AT II
1440
What large-diameter vessel has the smallest cross-sectional area in systemic circulation?
The aorta
1441
Excess bone demineralization and remodeling can be detected by checking urine levels of what substance?
Hydroxyproline (breakdown product of collagen)
1442
What happens to the following during skeletal muscle contraction? • A band
No change in length
1443
What happens to the following during skeletal muscle contraction? • I band
Shortens
1444
What happens to the following during skeletal muscle contraction? • H zone
Shortens
1445
What happens to the following during skeletal muscle contraction? • Sarcomere
Shortens
1446
What happens to the following during skeletal muscle contraction? • Actin and myosin lengths
No change in length
1447
What are the three effects of insulin on protein metabolism?
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
1448
What is the main mechanism for exchange of nutrients and gases across a capillary membrane?
Simple diffusion; it does not use protein-mediated transport
1449
What event signifies the first day of the menstrual cycle?
Onset of bleeding
1450
Name the muscle type based on the histological features: • Actin and myosin in sarcomeres; striated; uninuclear; gap junctions; troponin:calcium binding complex; T tubules and SR forming dyadic contacts; voltage-gated calcium channels
Cardiac muscle
1451
Name the muscle type based on the histological features: • Actin and myosin in sarcomeres; striated; multinuclear; lacks gap junctions; troponin:calcium binding; T tubules and SR forming triadic contacts; highest ATPase activity; no calcium channels
Skeletal muscle
1452
Name the muscle type based on the histological features: • Actin and myosin not in sarcomeres; nonstriated; uninuclear; gap junctions; calmodulin:calcium binding; lacks T tubules; voltage-gated calcium channels
Smooth muscle
1453
Name the valve abnormality based on the following criteria: • Back-filling into the left atrium during systole; increased v-wave, preload, left atrial volume, and left ventricular filling
Mitral insufficiency
1454
Name the valve abnormality based on the following criteria: • Systolic murmur, increased preload and afterload, decreased aortic pulse pressure and coronary blood flow
Aortic stenosis
1455
Name the valve abnormality based on the following criteria: • Diastolic murmur, increased right ventricular pressure, left atrial pressure, and atrial to ventricular pressure gradient; decreased left ventricular filling pressure
Mitral stenosis
1456
Name the valve abnormality based on the following criteria: • Diastolic murmur; increased preload, stroke volume, and aortic pulse pressure; decreased coronary blood flow; no incisura; and peripheral vasodilation
Aortic insufficiency
1457
Circulating levels of what hormone cause the cervical mucus to be thin and watery, allowing sperm an easier entry into the uterus?
Estrogen
1458
What hormone controls relaxation of the lower esophageal sphincter during swallowing?
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
1459
What is the term for the difference between systolic and diastolic pressures?
Pulse pressure
1460
What hormone, produced by the Sertoli cells, is responsible for keeping testosterone levels in the seminiferous tubules nearly 50 times that of the serum?
Androgen-binding protein
1461
True or false? There are no central O2 receptors.
TRUE
1462
What cell type of the bone has PTH receptors?
Osteoblasts, which in turn stimulate osteoclasts to break down bone, releasing Ca2+ into the interstitium. (Remember, blasts make, clasts take.)
1463
What substance is secreted by parietal glands and is required for life?
Intrinsic factor (IF)
1464
What is the only way to increase O2 delivery in the coronary circulation?
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
1465
What is the term for the load a muscle is trying to move during stimulation?
Afterload
1466
What is the term for days 1 to 7 of the female cycle?
Menses
1467
What is the term for the force the ventricular muscle must generate to expel the blood into the aorta?
Afterload
1468
What happens to the tonicity of the urine with increased ADH secretion?
The urine becomes hypertonic because of water reabsorption in the collecting duct.
1469
What form of renal tubular reabsorption is characterized by high back leak, low affinity for substance, and absence of saturation and is surmised to be a constant percentage of a reabsorbed filtered substance?
Gradient-time system
1470
What type of circuit is described when the total resistance is always greater than the sums of the individual resistors?
Series circuit
1471
What hormone excess brings about abnormal glucose tolerance testing, impaired cardiac function, decreased body fat, increased body protein, prognathism, coarse facial features, and enlargements of the hands and feet?
Increased secretion of GH postpuberty leading to acromegaly.
1472
What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
The V/Q ratio increases, since the area is ventilated but hypoperfused as a result of the occlusion.
1473
What hormone has the following effects: chondrogenic in the epiphyseal end plates of bones; increases AA transport for protein synthesis; increases hydroxyproline (collagen); and increases chondroitin sulfate synthesis?
GH, especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
1474
True or false? Bile pigments and bile salts are reabsorbed in the gallbladder.
FALSE
1475
What component of an ECG is associated with the following? • Conduction delay in the AV node
PR interval
1476
What component of an ECG is associated with the following? • Ventricular depolarization
QRS complex
1477
What component of an ECG is associated with the following? • Atrial depolarization
P wave
1478
What component of an ECG is associated with the following? • Ventricular repolarization
T wave
1479
Where is the greatest venous PO2 in resting tissue?
Renal circulation
1480
Near the end of pregnancy, what hormone's receptors increase in the myometrium because of elevated plasma estrogen levels?
Oxytocin
1481
What respiratory center in the rostral pons has an inhibitory affect on the apneustic center?
Pneumotaxic center (short, fast breaths)
1482
For what hormone do Leydig cells have receptors?
LH
1483
What primary acid-base disturbance is cause by a decrease in alveolar ventilation (increasing CO2 levels) resulting in the reaction shifting to the right and increasing H+ and HCO3- levels?
Respiratory acidosis (summary: high CO2, high H+, slightly high HCO3-)
1484
What lecithin: sphingomyelin ratio indicates lung maturity?
2.0 or greater
1485
What is the term for the negative resting membrane potential becoming more negative?
Hyperpolarization (i.e., K+ influx)
1486
What type of resistance system (i.e., high or low) is formed when resistors are added in parallel?
A low-resistance system is formed by resistors added in parallel.
1487
Why is hypothyroidism associated with night blindness?
Thyroid hormones are necessary for conversion of carotene to vitamin A.
1488
What is the FiO2 of room air?
0.21; it is a fancy way of saying 21% of the air is O2.
1489
Where are the lowest resting PO2 levels in a resting individual?
Coronary circulation
1490
What is the rate-limiting step in the production of steroids?
The conversion of CHO to pregnenolone via the enzyme desmolase
1491
In the water deprivation test, does a patient with reduced urine flow have primary polydipsia or diabetes insipidus?
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
1492
True or false? There is an inverse relationship between fat content and total body water.
True; the greater the fat, the less the total body water.
1493
What is the role of the negative charge on the filtering membrane of the glomerular capillaries?
The negative charge inhibits the filtration of protein anions.
1494
What cardiac reflex is characterized by stretch receptors in the right atrium, afferent and efferent limbs via the vagus nerve, and increased stretch leading to an increase in heart rate via inhibition of parasympathetic stimulation?
Bainbridge reflex
1495
Where in the GI tract does the reabsorption of bile salts take place?
Bile salts are actively reabsorbed in the distal ileum.
1496
What three structures increase the surface area of the GI tract?
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
1497
Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
Splitting of the first heart sound occurs during inspiration because of the increased output of the right ventricle, delaying the closure of the pulmonic valve.
1498
How much dietary iodine is necessary to maintain normal thyroid hormone secretion?
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
1499
What is the central chemoreceptor's main drive for ventilation?
CSF H+ levels, with acidosis being the main central drive, resulting in hyperventilation (the opposite being true with alkalosis)
1500
What result occurs because of the negative alveolar pressure generated during inspiration?
Air flows into the respiratory system.
1501
Corticotropin-releasing hormone promotes the synthesis and release of what prohormone?
Pro-opiomelanocortin (POMC) is cleaved into ACTH and β-lipotropin.
1502
What happens to free hormone levels when the liver decreases production and release of binding proteins?
Free hormone levels remain constant, and the bound hormone level changes with a decrease in binding hormones.
1503
What type of estrogen is produced in peripheral tissues from androgens?
Estrone
1504
What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
1505
Where is renin produced?
In the JG cells of the kidney
1506
True or false? Right-sided valves close before the valves on the left side of the heart.
False. Right-sided valves are the first to open and last to close.
1507
What enzyme is associated with osteoblastic activity?
Alkaline phosphatase
1508
What is the order of attachment of O2 to Hgb-binding sites in the lung? Order of release from the binding sites in the tissue?
Order of attachment is site 1, 2, 3, 4, and for release is 4, 3, 2, 1.
1509
What hormone is secreted into the plasma in response to a meal rich in protein or CHO?
Insulin
1510
What happens to blood flow and pressure downstream with local arteriolar constriction?
With arteriolar constriction both the flow and pressure downstream decrease.
1511
What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?
Achalasia
1512
True or false? Ungated channels are always open.
True. They have no gates, so by definition they are always open.
1513
What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis, resulting in an erection?
Parasympathetics (parasympathetics point, sympathetics shoot)
1514
What muscle type is characterized by low ATPase activity, aerobic metabolism, myoglobin, association with endurance, and small muscle mass?
Red muscle
1515
What happens to diastolic and systolic intervals with an increase in sympathetic activity?
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
1516
Circulating levels of what hormone in men is responsible for the negative feedback loop to the hypothalamus and the anterior pituitary gland regulating the release of LH?
Testosterone
1517
How are pulse pressure and compliance related?
They are inversely proportional to each other; as pulse pressure increases, compliance decreases.
1518
What three substances stimulate parietal cells?
ACh, histamine, and gastrin
1519
What two factors result in the base of the lung being hyperperfused?
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
1520
True or false? Without ADH the collecting duct would be impermeable to water.
True. Without ADH hypotonic urine would be formed.
1521
How does ventricular depolarization take place, base to apex or vice versa?
Depolarization is from apex to base and from endocardium to epicardium.
1522
What are effects of PTH in the kidney?
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
1523
Regarding muscle mechanics, how is passive tension produced?
It is produced by the preload on the muscle prior to contraction.
1524
Insulin-induced hypoglycemia is the most reliable (by far not the safest) test for what hormone deficiency?
GH deficiency
1525
In regards to solute concentration, how does water flow?
Water flows from a low-solute to high-solute concentrations.
1526
Which extravascular chemoreceptor detects low NaCl concentrations?
Macula densa
1527
If the AV difference is positive, is the substance extracted or produced by the organ?
A positive AV difference indicates that a substance is extracted by the organ, and a negative difference indicates that it is produced by the organ.
1528
What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
1529
Why is there a transcellular shift in K+ levels in a diabetic patient who becomes acidotic?
The increased H+ moves intracellularly and is buffered by K+ leaving the cells, resulting in intracellular depletion and serum excess. (Intracellular hypokalemia is the reason you supplement potassium in diabetic ketoacidosis, even though the serum levels are elevated.)
1530
True or false? Catechol-O-methyl transferase (COMT) is not found in smooth muscle, liver, and the kidneys.
False. That is precisely where COMT is found; it is not found in adrenergic nerve terminals.
1531
What somatomedin serves as a 24-hour marker of GH secretion?
IGF-1 (somatomedin C)
1532
What receptor is in the smooth muscle cells of the small bronchi, is stimulated during inflation, and inhibits inspiration?
Stretch receptors prevent overdistension of the lungs during inspiration.
1533
True or false? Thyroid hormones are necessary for normal menstrual cycles.
True. They are also necessary for normal brain maturation.
1534
What component of the cardiovascular system has the largest blood volume? Second largest blood volume?
The systemic veins have the largest blood volume, and the pulmonary veins have the second largest blood volume in the cardiovascular system. They represent the reservoirs of circulation.
1535
Serum concentration of what substance is used as a clinical measure of a patient's GFR?
Creatinine
1536
Where does CHO digestion begin?
In the mouth with salivary α-amylase (ptyalin)
1537
How does the sympathetic nervous system affect insulin secretion?
It decreases insulin secretion.
1538
How does cell diameter affect the conduction velocity of an action potential?
The greater the cell diameter, the greater the conduction velocity.
1539
Calf pseudohypertrophy
Duchenne muscular dystrophy
1540
Kayser-Fleischer rings
Wilson disease
1541
Aschoff bodies
Rheumatic fever
1542
Curschmann spirals
Bronchial asthma (whorled mucous plugs)
1543
Charcot-Leyden crystals
Bronchial asthma (eosinophil membranes)
1544
Keratin pearls
Squamous cell carcinoma
1545
Bence-Jones proteinuria
Multiple myeloma
1546
Russell bodies
Multiple myeloma
1547
WBCs in the urine
Acute cystitis
1548
RBCs in the urine
Bladder carcinoma
1549
RBC casts in the urine
Acute glomerulonephritis
1550
WBC casts in the urine
Acute pyelonephritis
1551
Renal epithelial casts in the urine
Acute toxic or viral nephrosis
1552
Waxy casts
Chronic end-stage renal disease
1553
Signet ring cells
Gastric carcinoma
1554
Heinz bodies
G-6-PD deficiency
1555
Mallory bodies
Chronic alcoholic
1556
Auer rods
AML-M3
1557
Starry sky pattern
Burkitt lymphoma
1558
Birbeck granules
Histiocytosis X
1559
Reed-Sternberg cells
Hodgkin lymphoma
1560
Call-Exner bodies
Granulosa/thecal cell tumor of the ovary
1561
Cowdry type A bodies
Herpesvirus
1562
Orphan Annie cells
Papillary carcinoma of the ovary
1563
Streaky ovaries
Turner syndrome
1564
Blue-domed cysts
Fibrocystic change of the breast
1565
Reinke crystals
Leydig cell tumor
1566
Schiller-Duval bodies
Yolk sac tumor
1567
Codman triangle on radiograph
Osteosarcoma
1568
Councilman bodies
Toxic or viral hepatitis
1569
Blue sclera
Osteogenesis imperfecta
1570
Soap bubble appearance on radiograph
Giant cell tumor of the bone
1571
Pseudorosettes
Ewing sarcoma
1572
Neurofibrillary tangles
Alzheimer disease
1573
Homer-Wright rosettes
Neuroblastoma
1574
Lewy bodies
Parkinson disease
1575
Lucid interval
Epidural hematoma
1576
Bloody tap on lumbar puncture
Subarachnoid hemorrhage
1577
Pseudopalisades
Glioblastoma multiforme
1578
Senile plaques
Alzheimer disease
1579
Café-au-lait spot on the skin
Neurofibromatosis
1580
Name the most common cause. • Blindness worldwide
Chlamydia trachomatis
1581
Name the most common cause. • Blindness in the United States
Diabetes mellitus
1582
Name the most common cause. • Dementia in persons aged 60 to 90 years
Alzheimer disease
1583
Name the most common type. • Learning disability
Dyslexia
1584
Name the most common type. • Mental retardation
Fetal alcohol syndrome
1585
Name the most common type. • Phobia
Stage fright (discrete performance anxiety)
1586
Name the most common type. • Psychiatric disorder in women of all ages
Anxiety disorders; for men it is substance abuse.
1587
Name the most common type. • Specific phobia
Public speaking (Remember: stage fright)
1588
Name the most common cause. • Chronic pancreatitis
Alcohol abuse
1589
Name the most common cause. • Infectious pancreatitis
Mumps
1590
Name the most common cause. • Insomnia
Depression
1591
Name the most common cause. • Hospitalization in children younger than 1 year of age
RSV
1592
Name the most common cause. • Croup
Parainfluenza virus
1593
Name the most common cause. • A cold in the winter and summer
Coronavirus
1594
Name the most common cause. • A cold in the spring and fall
Rhinovirus
1595
Which virus is the MCC of a cold in the summer and fall? Winter and spring?
Rhinoviruses for summer and fall; coronaviruses for winter and spring
1596
Name the most common type or cause. • Restrictive cardiomyopathy
Amyloidosis
1597
Name the most common type or cause. • Death in the United States
Ischemic heart disease (MIs)
1598
Name the most common type or cause. • Sudden cardiac death
Ventricular fibrillation (V fib)
1599
Name the most common type or cause. • Right heart failure
Left heart failure
1600
Name the most common type or cause. • Childhood heart disease in the United States
Congenital heart disease
1601
Name the most common type or cause. • Cyanotic heart disease
Tetralogy of Fallot
1602
Name the most common type or cause. • Subacute bacterial endocarditis
Streptococcus viridans
1603
Name the most common type or cause. • Acute bacterial endocarditis
Staphylococcus aureus
1604
Name the most common type or cause. • Viral pneumonia leading to death
RSV
1605
Name the most common type or cause. • Infection in a patient on a ventilator
Pseudomonas aeruginosa
1606
Name the most common type or cause. • Bronchiolitis in children
RSV
1607
Name the most common type or cause. • Pulmonary HTN in children
VSD
1608
Name the most common type or cause. • Reversible HTN in the United States
Alcohol abuse
1609
Name the most common type or cause. • Spontaneous pneumothorax
Emphysematous bleb
1610
Name the most common type or cause. • Nonorganic pneumoconiosis
Asbestosis
1611
Name the most common type or cause. • Cellular injury
Hypoxia
1612
Name the most common type or cause. • Hypoxia
Ischemia
1613
Name the most common type or cause. • Lobar pneumonia
Streptococcus pneumoniae
1614
Name the most common type or cause. • Lung abscess
Aspiration
1615
Name the most common type or cause. • Cirrhosis in the United States
Alcohol consumption
1616
Name the most common type or cause. • Nephrotic syndrome
Membranoproliferative glomerulonephritis (MGN)
1617
Name the most common type or cause. • Nephrotic syndrome in children
Lipoid nephrosis
1618
Name the most common type or cause. • Liver transplantation in adults
Alcoholic cirrhosis
1619
Name the most common type or cause. • UTIs
Escherichia coli
1620
Name the most common type or cause. • Urinary tract obstruction
BPH
1621
Name the most common type or cause. • Painless hematuria
Renal cell carcinoma
1622
Name the most common type or cause. • Hematuria
Infection
1623
Name the most common type or cause. • GN in the world
IgA nephropathy
1624
Name the most common type or cause. • Nephritic syndrome in children
Minimal change disease
1625
Name the most common type or cause. • Nephritic syndrome in adults
MGN
1626
Name the most common type or cause. • Acute renal failure in the United States
Acute tubular necrosis
1627
Name the most common type or cause. • Acute tubular necrosis
Ischemic
1628
Name the most common type or cause. • Diarrhea in children
Rotavirus
1629
Name the most common type or cause. • Intestinal obstructions in adults
Adhesions and hernias
1630
Name the most common type or cause. • Neonatal bowel obstruction
Hirschsprung disease
1631
Name the most common type or cause. • Rectal bleeding
Diverticulosis
1632
Name the most common type or cause. • Mallory-Weiss syndrome
Alcoholism
1633
Name the most common type or cause. • Anovulation
Polycystic ovaries
1634
Name the most common type or cause. • Breast lump in females
Fibrocystic change of the breast
1635
Name the most common type or cause. • Hematologic cause of papillary necrosis
Sickle cell disease
1636
Name the most common type or cause. • Panhypopituitarism
Sheehan syndrome
1637
Name the most common type or cause. • Cushing syndrome
Pituitary adenoma
1638
Name the most common type or cause. • Noniatrogenic hypothyroidism in the United States
Hashimoto thyroiditis
1639
Name the most common type or cause. • Hypothyroidism in the United States
Iatrogenesis
1640
Name the most common type or cause. • Pyogenic osteomyelitis
Staphylococcus aureus
1641
Name the most common type or cause. • Neonatal septicemia and meningitis
Streptococcus agalactiae (Group B Streptococcus, or GBS)
1642
Name the most common type or cause. • Sinusitis and otitis media in children
Pneumococcus
1643
Name the most common type or cause. • Meningitis in adults
Pneumococcus
1644
Name the most common type or cause. • Meningitis in renal transplantation patients
Listeria monocytogenes
1645
Name the most common type or cause. • Infantile bacterial diarrhea
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
1646
Name the most common type or cause. • Infantile diarrhea
Rotavirus
1647
Name the most common type or cause. • Chancre
Haemophilus ducreyi
1648
Name the most common type or cause. • Urethritis in a young, newly sexually active individual
Staphylococcus saprophyticus
1649
Name the most common type or cause. • Cystitis
Escherichia coli
1650
Name the most common type or cause. • Erysipelas
Streptococcus pyogenes
1651
Name the most common type or cause. • Chronic metal poisoning
Lead
1652
Name the most common type or cause. • Acute metal poisoning in the United States
Arsenic
1653
Name the MCC of death. • In neonates
Neonatal respiratory distress syndrome (NRDS)
1654
Name the MCC of death. • In SLE
Renal failure
1655
Name the MCC of death. • In diabetic individuals
MI
1656
Name the MCC of death. • In patients with cystic fibrosis
Pulmonary infections
1657
What is the MCC of death in the United States?
Heart disease
1658
What is the second leading cause of death in the United States?
Cancer
1659
What is the MCC of death in children aged 1 to 14 in the United States?
Accidents
1660
What is the second leading cause of death in children aged 1 to 14 in the United States?
Cancer
1661
What is the MCC of cancer mortality in males and females?
Lung cancer
1662
What is the second leading cause of cancer deaths in males? In females?
For males it's prostate cancer, and for females it's breast cancer.
1663
What is the MCC of death in black males aged 15 to 24?
Homicide. It is also the leading cause of death in black females aged 15 to 24.
1664
What are the two MCC of acute epididymitis in males? • Less than 35 years old
Neisseria gonorrhoeae and Chlamydia trachomatis
1665
What are the two MCC of acute epididymitis in males? • More than 35 years old
Escherichia coli and Pseudomonas sp.
1666
What is the most common causative organism of acne vulgaris?
Propionibacterium acnes
1667
What is the MCC of viral conjunctivitis?
Adenovirus
1668
What is the MCC of the following endocarditis scenarios? • Post dental work
Streptococcus viridans
1669
What is the MCC of the following endocarditis scenarios? • Following biliary infections
Enterococcus faecalis
1670
What is the MCC of the following endocarditis scenarios? • Non-IV drug user
Staphylococcus aureus
1671
Name the MCC. • Epiglottitis in an unvaccinated child
Haemophilus influenzae type B
1672
Name the MCC. • Pneumonia in adults
Streptococcus pneumoniae
1673
Name the MCC. • Pneumonia in a neutropenic burn patient
Pseudomonas sp.
1674
Name the MCC. • Pneumonia in a patient with atypical bird exposure and hepatitis
Chlamydia psittaci
1675
Name the MCC. • Walking pneumonia, seen in teens and military recruits
Mycoplasma pneumoniae
1676
Name the MCC. • Aspiration pneumonia in an alcoholic
Klebsiella pneumoniae
1677
Name the MCC. • Pneumonia in an HIV-positive patient with CD4 less than 200
Pneumocystis carinii
1678
What is the MCC of the following meningitides? • In patients who have AIDS or are immunocompromised
Cryptococcus
1679
What is the MCC of the following meningitides? • In military recruits
Neisseria meningitides
1680
What is the MCC of the following meningitides? • In those 12 months to 6 years of age
Haemophilus influenzae type B
1681
What is the MCC of the following meningitides? • In neonates to 3 months of age
Streptococcus agalactiae and Escherichia coli
1682
What is the MCC of the following meningitides? • In adults
Streptococcus pneumoniae
1683
What is the MCC of the following meningitides? • In renal transplant patients
Listeria monocytogenes
1684
What is the most common one? • Helminthic parasite worldwide
Ascaris lumbricoides
1685
What is the most common one? • Helminth parasitic infection in the United States
Enterobius vermicularis
1686
What is the most common one? • Form of necrosis
Coagulative
1687
What is the most common one? • Organism that causes pyelonephritis
Escherichia coli
1688
What is the most common one? • Congenital cardiac anomaly
VSD
1689
What is the most common one? • Cardiac anomaly in children
PDA
1690
What is the most common one? • Complication of PDA
Subacute bacterial endocarditis
1691
What is the most common one? • Congenital heart defect in adults
ASD
1692
What is the most common one? • Type of ASD
Ostium secundum defects
1693
What is the most common one? • Vasculitis
Temporal arteritis
1694
What is the most common one? • Form of vasculitis
Temporal arteritis
1695
What is the most common one? • Cardiac tumor
Left atrial myxoma
1696
What is the most common one? • Cardiac tumor of infancy
Rhabdomyoma
1697
What is the most common one? • Cardiac pathology in patients with SLE
Libman-Sacks endocarditis
1698
What is the most common one? • Cardiac anomaly in Turner syndrome
Coarctation of the aorta
1699
What is the most common one? • Valve abnormality associated with rheumatic fever
Mitral valve stenosis
1700
What is the most common one? • Viral cause of myocarditis
Coxsackie B
1701
What is the most common one? • Primary lung cancer
Adenocarcinoma
1702
What is the most common one? • Primary malignant tumor of the lungs
Adenocarcinoma (30% to 35%)
1703
What is the most common one? • Neoplastic tumor in the lungs
Metastatic carcinomas
1704
What is the most common one? • Bladder tumor
Transitional cell carcinoma
1705
What is the most common one? • Renal calculus type
Calcium oxylate
1706
What is the most common one? • Kidney stone type
Calcium oxalate
1707
What is the most common one? • Solid tumor in children
Neuroblastoma
1708
What is the most common one? • Renal pathology in patients with SLE
Diffuse proliferative GN
1709
What is the most common one? • Cancer of the esophagus in the world
Squamous cell carcinoma
1710
What is the most common one? Esophageal cancer in the United States
Adenocarcinoma (because of Barrett esophagus)
1711
What is the most common one? • Malignant tumor of the esophagus
Squamous cell carcinoma
1712
What is the most common one? • Benign GI tumor
Leiomyoma
1713
What is the most common one? • Site of ischemia in the GI tract
Splenic flexure
1714
What is the most common one? • Type of PUD
Duodenal ulcers (4 times as common as gastric)
1715
What is the most common one? • Location of a duodenal ulcer
Anterior wall of the first part of the duodenum
1716
What is the most common one? • Location of a gastric ulcer
Lesser curvature of the antrum of the stomach
1717
What is the most common one? • Site for carcinoid tumors
Appendix (second is terminal ileum)
1718
What is the most common one? • Site for colonic diverticula
Sigmoid colon
1719
What is the most common one? • Site of Crohn disease
Terminal ileum
1720
What is the most common one? • Site of ulcerative colitis
Rectum
1721
What is the most common one? • Site of pancreatic cancer
Head of the pancreas
1722
What is the most common one? • Pancreatic islet cell tumor
Insulinoma
1723
What is the most common one? • Stone type associated with cholecystitis
Mixed (both cholesterol and calcium)
1724
What is the most common one? • Liver tumor
Metastatic carcinoma
1725
What is the most common one? • Primary malignant tumor in the liver
Hepatocellular carcinoma
1726
What is the most common one? • Primary tumor of the liver
Hemangioma (benign)
1727
What is the most common one? • Organism associated with liver abscesses
Entamoeba histolytica
1728
What is the most common one? • Renal cell cancer type
Clear cell
1729
What is the most common one? • Esophageal carcinoma
Squamous cell carcinoma
1730
What is the most common one? • Solid tumor in the body
Nephroblastoma
1731
What is the most common one? • Malignancy in children
ALL
1732
What is the most common one? • Lymph node affected in non-Hodgkin lymphoma
Periaortic lymph nodes
1733
What is the most common one? • Subtype of Hodgkin lymphoma
Nodular sclerosis
1734
What is the most common one? • Thyroid cancer
Papillary carcinoma
1735
What is the most common one? • Thyroid adenoma
Follicular adenoma
1736
What is the most common one? • Malignant thyroid tumor
Papillary carcinoma of the thyroid
1737
What is the most common one? • Pituitary tumor
Chromophobe adenoma
1738
What is the most common one? • Pituitary adenoma
Prolactinoma
1739
What is the most common one? • Tumor arising within the bone
Multiple myeloma
1740
What is the most common one? • Tumor on sun-exposed sites
Basal cell carcinoma
1741
What is the most common one? • Malignant germ cell tumor in women
Choriocarcinoma
1742
What is the most common one? • Primary malignant tumor of the ovary
Serocystadenocarcinoma
1743
What is the most common one? • Malignant tumor in women
Breast
1744
What is the most common one? • Cancer of the vulva
Squamous cell carcinoma
1745
What is the most common one? • Primary malignant tumor of the female genital tract in the world
Cervical neoplasia
1746
What is the most common one? • Primary malignant tumor of the female genital tract in the United States
Adenocarcinoma of the cervix
1747
What is the most common one? • Tumor of the female genitourinary tract
Leiomyoma
1748
What is the most common one? • Benign tumor of the ovary
Serocystadenoma
1749
What is the most common one? • Benign tumor of the breast
Fibroadenoma
1750
What is the most common one? • Benign breast tumor in females less than 35 years old
Fibroadenoma
1751
What is the most common one? • Histologic variant of breast cancer
Infiltrating ductal carcinoma
1752
What is the most common one? • Benign lesion that affects the breast
Fibrocystic change of the breast
1753
What is the most common one? • Malignant tumor of the breast
Invasive ductal carcinoma
1754
What is the most common one? • Female genital tract malignancy resulting in death
Ovarian cancer
1755
What is the most common one? • Malignancy of the female genital tract
Endometrial cancer
1756
What is the most common one? • Tumor of the female genital tract
Leiomyoma (fibroids)
1757
What is the most common one? • Benign ovarian tumor
Cystadenoma
1758
What is the most common one? • Malignant carcinoma of the ovaries
Cystadenocarcinoma
1759
What is the most common one? • Stromal tumor of the ovary
Ovarian fibroma
1760
What is the most common one? • Germ cell tumor of the ovary
Dysgerminoma
1761
What is the most common one? • Tumor in men aged 15 to 35
Testicular tumors
1762
What is the most common one? • Testicular tumor in men over 50 years old
Testicular lymphoma
1763
What is the most common one? • Germ cell tumor in men
Seminoma
1764
What is the most common one? • Testicular tumor in infants and children
Yolk sac tumor
1765
What is the most common one? • Germ cell tumor in boys
Yolk sac tumor
1766
What is the most common one? • Malignant tumor in the bone of teenagers
Osteosarcoma
1767
What is the most common one? • Intraspinal tumor
Ependymoma
1768
What is the most common one? • Eye tumor in children
Retinoblastoma
1769
What is the most common one? • Organ involved in amyloidosis
Kidney
1770
What is the most common one? • Complication of nasogastric tube feeding
Aspiration pneumonia
1771
What is the most common one? • Acquired GI emergency of infancy
Necrotizing enterocolitis
1772
What is the most common one? • Organism associated with mastitis
Staphylococcus aureus
1773
What is the most common one? • Tumor in individuals exposed to asbestos
Bronchogenic carcinoma
1774
What is the most common one? • Proliferative abnormality of an internal organ
BPH
1775
What is the most common one? • Inflammatory arthritis
Rheumatoid arthritis
1776
What is the most common one? • Form of muscular dystrophy
Duchenne muscular dystrophy
1777
What is the most common one? • Joint affected in pseudogout
Knee
1778
What is the most common one? • Route for infectious arthritis
Hematogenous
1779
What is the most common one? • Form of arthritis
Osteoarthritis
1780
What is the most common one? • Route of spread in pyogenic osteomyelitis
Hematogenous
1781
What is the most common one? • Bone disorder in the United States
Osteoporosis
1782
What is the most common one? • Primary tumor metastasis to the bone
Breast
1783
What is the most common one? • Bone tumor
Metastatic
1784
What is the most common one? • Neurotransmitter in the brain
GABA, quantitatively
1785
What is the most common one? • Site of a cerebral infarct
Middle cerebral artery
1786
What is the most common one? • Primary CNS tumor in adults
Glioblastoma multiforme
1787
What is the most common one? • Primary CNS tumor in children
Medulla blastoma
1788
What is the most common one? • Brain tumor
Metastatic
1789
What is the most common one? • Primary CNS tumor
Glioblastoma multiforme
1790
What is the most common one? • Intramedullary spinal cord tumor in adults
Ependymoma
1791
What is the most common one? • Location of ependymomas in children
In children, the fourth ventricle; in adults, the lateral ventricle or spinal cord
1792
What is the most common one? • Melanoma in dark-skinned persons
Acral-lentiginous melanoma
1793
What is the most common one? • Type of melanoma
Superficial spreading melanoma
1794
What is the most common one? • Skin tumor in the United States
Basal cell carcinoma
1795
What is the most common one? Site of congenital diaphragmatic hernias
Left posterolateral side of the diaphragm, usually resulting in pulmonary hypoplasia.
1796
What is the most common one? • Type of hernia seen in males more than 50 years old
Direct; in males less than 50 years old indirect hernias are the most common type.
1797
What is the most common one? • Sites for abdominal aorta aneurysm
Between the renal arteries and at the bifurcation of the abdominal aorta
1798
What is the most common one? • Site for atherosclerotic plaques in the abdominal aorta
The bifurcation of the abdominal aorta
1799
What is the most common one? • Site for an ectopic abdominal pregnancy
The rectouterine pouch (of Douglas)
1800
What is the most common site for implantation of the blastocyst?
On the superior body of the posterior wall of the uterus
1801
Where is the most frequent site of ectopic pregnancy?
Ampulla of the fallopian tube
1802
What is the most common diagnosis made (or missed!) resulting in a malpractice suit?
Breast cancer
1803
What is the most common serotype of enterohemorrhagic Escherichia coli?
0157:H7
1804
What is the most common circulation Ig in the plasma?
IgG
1805
What is the most common cancer diagnosed in men? In women?
In men it is prostate cancer, and in women it is breast cancer.
1806
What is the second most common cancer diagnosed in both males and females?
Lung and bronchus cancer
1807
What are the two leading causes of cancer-related death in men?
Prostate and lung cancer, respectively
1808
What are the two leading causes of cancer-related death in women?
Breast and lung cancer, respectively.
1809
What is the most common primary diagnosis resulting in an office visit for males? For females?
For males, HTN; for females, pregnancy.
1810
What is the most common disease or infection reported to the CDC?
Chlamydia; gonorrhea is second (Remember, it is mandatory to report STDs to the CDC.)
1811
What is the most common STD?
HPV
1812
Name the most common reported STD. • In females
Chlamydia
1813
Name the most common reported STD. • In males
Gonorrhea
1814
What is the most common sexual assault?
Pedophilia
1815
What is the most common form of elderly abuse?
Nearly 50% of all reported cases of elderly abuse are due to neglect. Physical, psychological, and financial are other forms of elderly abuse with an overall prevalence rate of 5% to 10%.
1816
What is the most common complement deficiency?
C2 deficiency
1817
What is the most common organ involved in amyloidosis?
Kidney
1818
What is the most common form of non-Hodgkin lymphoma in the United States?
Follicular lymphoma
1819
In which quadrant is breast cancer most commonly found?
Upper outer quadrant (left more than right)
1820
What is the most common cardiac tumor? In what chamber does it most commonly arise?
90% of benign myxomas arise within the left atrium near the fossa ovalis.
1821
What cerebral lobes are most commonly affected in herpes encephalitis?
Temporal lobes
1822
What is the most common condition leading to an intracerebral bleed?
HTN
1823
What carpal bone is most commonly fractured? Dislocated?
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
1824
What is the costliest health care problem in the United States?
Alcohol and its related problems cost the country approximately $100 billion a year.
1825
What is the most abused drug across all age groups?
Alcohol. Nearly 10% of adults have a problem with alcohol.
1826
What are the two most common chains of the TCR?
α-and β-chains are on most T cells.
1827
What is the most common form of inherited dwarfism?
Achondroplasia
1828
What is the most common lethal AR disorder affecting white Americans?
Cystic fibrosis
1829
What is the most common genetic cause of mental retardation?
Down syndrome (it is slightly more common than fragile X syndrome.)
1830
What is the most common chromosomal abnormality associated with CLL?
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
1831
Name the most common one. • Chromosomal disorder
Down syndrome (trisomy 21)
1832
Name the most common one. • Heart defect in Down syndrome
Endocardial cushion defect
1833
Name the most common one. • Chromosomal disorder involving sex chromosomes
Klinefelter syndrome
1834
Name the associated chromosomal translocation. • CML
Chromosome 9, 22 (Philadelphia chromosome)
1835
Name the associated chromosomal translocation. • Ewing sarcoma
Chromosome 11, 22
1836
Name the associated chromosomal translocation. • Adult familial polyposis
Chromosome 5, 21
1837
Name the associated chromosomal translocation. • Burkitt lymphoma
Chromosome 8, 14
1838
Name the associated chromosomal translocation. • Acute promyelocytic leukemia (M3)
Chromosome 15, 17
1839
Name the associated chromosomal translocation. • M3 AML
Chromosome 15, 17
1840
Name the associated chromosomal translocation. • Follicular lymphoma
Chromosome 14, 18
1841
Name the associated chromosome. • Cri-du-chat
Chromosome 5p
1842
Name the associated chromosome. • Patau syndrome
Chromosome 13
1843
Name the associated chromosome. • Huntington disease
Chromosome 4p
1844
Name the associated chromosome. • Familial hypercholesterolemia
Chromosome 19
1845
Name the associated chromosome. • Gaucher disease
Chromosome 1
1846
Name the associated chromosome. • Niemann-Pick disease
Chromosome 11p
1847
Name the associated chromosome. • Tay-Sachs disease
Chromosome 15q
1848
Name the associated chromosome. • Cystic fibrosis
Chromosome 7
1849
Name the associated chromosome. • Chronic lymphocytic leukemia (CLL)
Chromosome 12
1850
Name the associated chromosome. • Marfan disease
Chromosome 15
1851
Name the associated chromosome. • Neurofibromatosis type 1
Chromosome 17
1852
Name the associated chromosome. • Neurofibromatosis type 2
Chromosome 22q
1853
Name the associated chromosome. • Down syndrome
Chromosome 21
1854
Name the associated chromosome. • Edward syndrome
Chromosome 18
1855
Name the associated chromosome. • VON Hippel-Lindau disease
Chromosome 3p
1856
What is the most common chromosomal disorder?
Down syndrome
1857
What is the MCC of inherited mental retardation?
Down syndrome
1858
What is the most common lysosomal storage disorder?
Gaucher disease
1859
What chromosome is mutant in patients with cystic fibrosis?
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
1860
Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
Chromosome 19
1861
What chromosome is associated with the AR form of SCID?
Chromosome 20q (deficiency in adenosine deaminase)
1862
On what chromosome is the adenomatous polyposis coli gene?
Chromosome 5q21
1863
Name the associated chromosome. • Albinism
Chromosome 11p
1864
What mineral is associated with impaired glucose tolerance?
Chromium (Cr)
1865
What mineral is associated with hypothyroidism?
Iodine (I)
1866
What mineral is an important component of the enzyme xanthine oxidase?
Molybdenum (Mb)
1867
What vitamin deficiency produces angular stomatitis, glossitis, and cheilosis?
Riboflavin (B2) deficiency
1868
What vitamin is a component of the coenzyme thiamine pyrophosphate (TPP)?
Thymine (B1)
1869
Avidin decreases the absorption of what vitamin?
Biotin. Avidin is found in raw egg whites.
1870
What are the four Ds of niacin deficiency?
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
1871
What mineral is an important component of glutathione peroxidase?
Selenium (Se)
1872
What mineral deficiency in children is associated with poor growth and impaired sexual development?
Zinc (Zn) deficiency
1873
What mineral, via excessive depositions in the liver, causes hemochromatosis?
Iron (Fe)
1874
What vitamin is needed for the production of heme?
Pyridoxine (B6)
1875
What vitamin is a component of the enzymes fatty acid synthase and acyl CoA?
Pantothenic acid
1876
What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
1877
What vitamin deficiency is evidenced by poor wound healing, loose teeth, bleeding gums, petechiae, and ecchymosis?
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
1878
What are the three carboxylase enzymes that require biotin?
Pyruvate, acetyl CoA, and propionyl CoA carboxylase
1879
What vitamin requires IF for absorption?
Cyanocobalamin (B12)
1880
What mineral is a component of cytochrome a/a3?
Copper
1881
Leukopenia, neutropenia, and mental deterioration are signs of what mineral deficiency?
Copper
1882
What vitamin deficiency causes a glove-and-stocking neuropathy seen in alcoholics?
Pyridoxine (B6) deficiency
1883
What mineral deficiency involves blood vessel fragility?
Copper deficiency
1884
Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency?
Folic acid deficiency
1885
What vitamin deficiency can result in high-output cardiac failure?
Thiamine
1886
Name the antidote. • Carbon monoxide (CO)
Oxygen
1887
Name the antidote. • Mercury
Dimercaprol, penicillamine
1888
Name the antidote. • Isoniazid
Pyridoxine
1889
Name the antidote. • Atropine
Physostigmine
1890
Name the antidote. • Arsenic
Dimercaprol, D-penicillamine
1891
Name the antidote. • Digoxin
Antidigoxin Fab fragments
1892
Name the antidote. • Gold
Dimercaprol
1893
Name the antidote. • Ethylene glycol
Ethyl alcohol
1894
Name the antidote. • Opioids
Naloxone, naltrexone
1895
Name the antidote. • Organophosphates
Atropine, 2-PAM (pralidoxime)
1896
Name the antidote. • Warfarin
Vitamin K
1897
Name the antidote. • Copper
D-Penicillamine
1898
Name the antidote. • Heparin
Protamine sulfate
1899
Name the antidote. • Iron
Deferoxamine, penicillamine
1900
Name the antidote. • Cyanide
Amyl nitrate, sodium nitrate, or sodium thiosulfate
1901
Name the antidote. • Methyl alcohol
Ethyl alcohol
1902
Name the antidote. • Acetaminophen
N-Acetylcysteine
1903
Name the antidote. • Nitrates
Methylene blue
1904
Name the antidote. • Lead
Penicillamine, EDTA (calcium disodium edetate), or dimercaprol
1905
Name the antidote. • Benzodiazepines
Flumazenil
1906
Name the antidote. • AChE inhibitors
Atropine with pralidoxime
1907
Name the antidote. • Anticholinergics
Physostigmine
1908
A known IV drug abuser goes to the ER with respiratory depression and pinpoint pupils and in a semicomatose state. What overdose do you suspect, and what agent will you give to reverse its effects?
The triad of respiratory depression, pinpoint pupils, and coma in an IV drug abuser suggests opioid overdose (e.g., heroin), and you should give naloxone.
1909
Cherry red intoxication is associated with what form of poisoning?
CO
1910
What toxicities are caused by the following agents? • Occupational nitrous oxide exposure
Anemia
1911
What toxicities are caused by the following agents? • Methoxyflurane
Nephrotoxicity
1912
What toxicities are caused by the following agents? • Halothane
Hepatitis, with or without necrosis
1913
What are the first signs of overdose from phenobarbitals?
Nystagmus and ataxia
1914
What are the three signs of morphine overdose?
Pinpoint pupils, decreased respiratory rate, and coma
1915
What is the major pulmonary side effect of µ-activators?
Respiratory depression
1916
What are the two side effects of opioids to which the user will not develop tolerance?
Constipation and miosis
