USMLE Step I Comprehensive review Flashcards
This set is a comprehensive review of material covered on the USMLE step I. It can most effectively be used in the familiarization mode or test mode. Use it to create multiple choice tests for yourself (3834 cards)
0
Q
Afferent pupillary defect (CN II lesion); in an efferent pupillary defect (CN III), B/L constrict when light is shined in the unaffected eye and consentual pupil constriction occurs when light is shined in the affected eye.
A
Is an afferent or efferent pupillary defect described as B/L pupillary constriction when light is shined in the unaffected eye and B/L paradoxical dilation when light is shined in the affected eye?
1
Q
Thyroid gland
A
What gland is found in the muscular triangle of the neck?
2
Q
Cauda equina
A
What is the name of the spinal cord passing within the subarachnoid space and forming the spinal nerves that exit the lumbar and sacral foramina?
3
Q
Thyroarytenoid muscles
A
Name the laryngeal muscle described by the following: • Pulls the arytenoids cartilages closer to the thyroid, relaxing the vocal ligaments and thereby decreasing the pitch
4
Q
Cricothyroid muscles
A
Name the laryngeal muscle described by the following: • Tenses the vocal ligaments, increasing the distance between the cartilages, thereby increasing the pitch
5
Q
Lateral cricoarytenoid muscles
A
Name the laryngeal muscle described by the following: • Adducts the vocal ligaments, closes the air passageway during swallowing, and allows phonation
6
Q
Posterior cricoarytenoid muscles
A
Name the laryngeal muscle described by the following: • Only muscle to abduct the vocal cords
7
Q
Opposite the second upper molar tooth
A
Where does the parotid (Stensen’s) duct enter the oral cavity?
8
Q
Third aortic arch MS CARD is my mnemonic for the aortic arch derivatives
A
From what aortic arch are the following structures derived? • Common and internal carotid arteries
9
Q
Fifth MS CARD is my mnemonic for the aortic arch derivatives
A
From what aortic arch are the following structures derived? • Degenerates
10
Q
Second MS CARD is my mnemonic for the aortic arch derivatives
A
From what aortic arch are the following structures derived? • Stapes artery
11
Q
First MS CARD is my mnemonic for the aortic arch derivatives
A
From what aortic arch are the following structures derived? • Maxillary artery
12
Q
Fourth MS CARD is my mnemonic for the aortic arch derivatives
A
From what aortic arch are the following structures derived? • Arch of the aorta and right subclavian artery
13
Q
Sixth MS CARD is my mnemonic for the aortic arch derivatives
A
From what aortic arch are the following structures derived? • Right and left pulmonary arteries and the ductus arteriosus
14
Q
External abdominal oblique
A
What abdominal muscle contributes to the anterior layer of the rectus sheath, forms the inguinal ligament, and in men gives rise to the external spermatic fascia of the spermatic cord?
15
Q
Medial compartment of the thigh, obturator nerve
A
Name the compartment of the lower extremity and the nerve based on its movements. • Adduct the thigh and flex the hip
16
Q
Posterior compartment of the leg, tibial nerve
A
Name the compartment of the lower extremity and the nerve based on its movements. • Plantar flex the foot, flex the toes, and invert the foot
17
Q
Anterior compartment of the leg, deep peroneal nerve
A
Name the compartment of the lower extremity and the nerve based on its movements. • Dorsiflex the foot, extend the toes, and invert the foot
18
Q
Anterior compartment of the thigh, femoral nerve
A
Name the compartment of the lower extremity and the nerve based on its movements. • Flex the hip and extend the knee
19
Q
Posterior compartment of the thigh, tibial nerve
A
Name the compartment of the lower extremity and the nerve based on its movements. • Extend the hip and flex the knee
20
Q
Lateral compartment of the leg, superficial peroneal nerve
A
Name the compartment of the lower extremity and the nerve based on its movements. • Plantar flex the foot and evert the foot
21
Q
STARS 1. Upper Subscapularis 2. Thoracodorsal 3. Axillary 4. Radial 5. Lower Subscapularis
A
What are the five branches of the posterior cord of the brachial plexus?
22
Q
Right brachiocephalic artery
A
Name the correct artery. • The right recurrent laryngeal nerve passes around it.
23
Q
Arch of the aorta
A
Name the correct artery. • The left recurrent laryngeal nerve passes around it.
24
The splenic vein
The inferior mesenteric artery drains into it.
25
Functionally they are part of the left lobe of the liver because they receive their blood supply from the left hepatic artery. Anatomically they are considered part of the right lobe of the liver.
Are the quadrate and caudate lobes of the liver functionally part of the left or right lobe?
26
Pubis, ilium, and ischium
What bones make up the acetabulum?
27
LARP: Left goes Anterior and Right goes Posterior (because of the rotation of the gut; remember your embryology!)
What is the anatomic positioning of the right and left gastric nerve plexus of the esophagus as they pass through the diaphragm?
28
Middle meningeal artery
What vessel is lacerated in an epidural hematoma?
29
TRUE
True or false? Below the arcuate line, all the aponeurotic fibers run anterior to the rectus abdominis.
30
Medial rectus (CN III) (LR6 SO4)3
What ocular muscle • Adducts the eyeball and is involved in horizontal conjugate gaze?
31
Superior rectus (CN III) (LR6 SO4)3
What ocular muscle • Elevates and adducts the eyeball?
32
Superior Oblique (CN IV) (LR6 SO4)3
What ocular muscle • Depresses and abducts the eyeball?
33
Inferior Oblique (CN III) (LR6 SO4)3
What ocular muscle • Elevates and abducts the eyeball?
34
Lateral rectus (CN VI) (LR6 SO4)3
What ocular muscle • Abducts the eyeball and is involved in horizontal conjugate gaze?
35
Inferior rectus (CN III) (LR6 SO4)3
What ocular muscle • Depresses and adducts the eyeball?
36
Constrictor pupillae and ciliary muscles
Which muscles of the eye are under parasympathetic control?
37
A left CN X lesion results in the uvula deviating to the right. (Uvula points away from the affected side.)
Which direction does the uvula deviate in a left vagus nerve lesion?
38
Subdural hematoma is a rupture of the cerebral veins where they enter the superior sagittal sinus.
Is a subdural hematoma an arterial or venous bleed?
39
CN I, II, III, VI, and XII Add 1 + 1 = 2, 1 + 2 = 3, 1 + 2 + 3 = 6, 1 + 2 + 3 + 6 = 12
Which CNs are found in the midline of the brainstem?
40
"Lady between two Majors": latissimus dorsi, pectoralis major, and teres major
What muscles insert in or on the intertubercular groove of the humerus?
41
Chorda tympani of CN VII
What nerve supplies taste sensation to the anterior two-thirds of the tongue?
42
Right atrium
What part of the heart forms • The right border?
43
Left ventricle and auricle of left atrium
What part of the heart forms • Left border?
44
Tip of the left ventricle
What part of the heart forms • Apex?
45
Left atrium and tip of the right atrium
What part of the heart forms • Base?
46
Conus arteriosus of the right ventricle and right and left auricles
What part of the heart forms • Superior border?
47
Right ventricle
What part of the heart forms • Anterior wall?
48
Left atrium
What part of the heart forms • Posterior wall?
49
Left ventricle and tip of right ventricle
What part of the heart forms • Diaphragmatic wall?
50
CN V1 carries the sensory and CN VII carries the motor component of the blink reflex.
What nerves carry the sensory and motor components of the blink reflex?
51
Stapedius muscle
What muscle keeps the stapes taut against the oval window?
52
NAVEL: Femoral Nerve, Artery, Vein, Empty space, and Lymphatics/Lacunar ligament
Name the components of the femoral canal, working laterally to medially.
53
Levator palpebrae superioris
What muscle is most superior in the orbit?
54
Fibrous pericardium
What portion of the pericardium adheres to the tunica adventitia of the great vessels?
55
The superior mesenteric vein and the splenic vein (after it receives the inferior mesenteric vein) join to form the portal vein.
What two veins form the portal vein?
56
CN II is the sensory limb and CN III is the motor component through parasympathetic stimulation.
What CNs are responsible for the sensor and motor components of the light reflex?
57
During a lumbar puncture the needle passes through the interlaminar space in the midline of L3-L4, with the tip of the iliac crest in the flexed position as the landmark. Order of puncture: 1. Skin 2. Superficial fascia 3. Deep fascia 4. Supraspinous ligament 5. Interspinous ligament 6. Interlaminar space 7. Epidural space 8. Dura mater 9. Arachnoid mater 10. Subarachnoid space. (They ask this in some variation every year, so know it.)
Arrange the following layers in the correct sequence through which a needle must pass in a lumbar puncture. • Skin • Subarachnoid space • Interspinous ligament • Dura mater • Deep fascia • Epidural space • Superficial fascia • Interlaminar space • Supraspinous ligament • Arachnoid mater
58
Ciliary ganglion producing a tonic pupil
What ocular ganglion is affected if the pupil on the affected side sluggishly responds to light with normal accommodation?
59
Vertebra prominens (C7 in 70% of cases, C6 in 20%, T1 in 10%)
What is the name for the most prominent spinous process?
60
SITS—Subscapularis, Infraspinatus, Teres minor, Supraspinatus
What muscles make up the rotator cuff?
61
They are preganglionic sympathetic axons. They are white because they are myelinated.
What is the function of white rami communicantes?
62
Supraspinatus and infraspinatus
What muscle or muscles are innervated by the following nerves? • Suprascapular nerve
63
Subscapularis
What muscle or muscles are innervated by the following nerves? • Upper subscapularis nerve
64
Latissimus dorsi
What muscle or muscles are innervated by the following nerves? • Thoracodorsal nerve
65
Serratus anterior
What muscle or muscles are innervated by the following nerves? • Long thoracic nerve
66
Median nerve
What nerve is associated with the following functions? • Flex the wrist and digits, pronate the wrist and the LOAF (Lumbricales, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis) muscles of the hand
67
Musculocutaneous nerve
What nerve is associated with the following functions? • Flex the shoulder, flex the elbow, and supinate the elbow
68
Ulnar nerve
What nerve is associated with the following functions? • Innervation of the flexor carpi ulnaris, flexor digiti profundus (pinky and ring fingers), and the intrinsic muscles of the hand
69
Radial nerve
What nerve is associated with the following functions? • Supinate the wrist, extend the wrist and digits, extend the shoulder and elbow
70
Transverse abdominis
What abdominal muscle runs horizontally, contributes to the posterior rectus sheath, and contributes to form the conjoint tendon?
71
The sensory limb is via CN IX, and the motor limb is from CN X.
Which CNs act as the sensory and motor components of the gag reflex?
72
The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
Which kidney is lower? Why?
73
Thoracic and sacral
What two regions of the vertebral column are considered primary curvatures?
74
Hemiazygous vein
What vein drains the lower third of the thoracic wall?
75
When it crosses the teres major
At what point does the axillary artery become the brachial artery?
76
Left CN XII lesion would result in the tongue pointing to the left (points at the affected side).
What direction would the tongue protrude in a left CN XII lesion?
77
C4 (the upper border of the thyroid cartilage)
At what vertebral level does the common carotid artery bifurcate?
78
False. Females are more likely to develop femoral hernias then males (remember Female's Femoral).
True or false? Males are more likely to develop femoral hernias than females.
79
Anterior compartment (it's the blood supply to the posterior compartment)
In what compartment of the thigh is the profundus femoris artery found?
80
The cupola of the lung is posterior to the subclavian artery and vein. It is the reason one must be cautious when performing subclavian venipuncture.
Where is the cupola of the lung in relation to the subclavian artery and vein?
81
True. The odontoid process of C2 acts as the vertebral body of C1 allowing lateral rotation of the head.
True or false? The first cervical vertebra has no vertebral body.
82
Gluteus maximus
What is the largest muscle in the body?
83
It both begins and ends at T4 (sternal angle [of Louis]).
At what vertebral levels does the aortic arch begin and end?
84
Left anterior descending artery
What artery travels with the following veins? • Great cardiac vein
85
Posterior interventricular artery
What artery travels with the following veins? • Middle cardiac vein
86
Right coronary artery
What artery travels with the following veins? • Small cardiac vein
87
Internal carotid artery
The ophthalmic artery is a branch of what vessel?
88
IVC Remember: 1 at T8, 2 at T10, and 3 at T12
What structure or structures cross the diaphragm at • T8 level?
89
Esophagus and esophageal nerve plexus (CN X) Remember: 1 at T8, 2 at T10, and 3 at T12
What structure or structures cross the diaphragm at • T10 level?
90
Aorta, azygos vein, and thoracic duct Remember: 1 at T8, 2 at T10, and 3 at T12
What structure or structures cross the diaphragm at • T12 level?
91
The carotid sinus is a pressure-sensitive (low) receptor, while the carotid body is an oxygen-sensitive (low) receptor. (Remember "Sinus Pressure").
Is the carotid sinus sensitive to pressure or oxygen?
92
CN XI and X
What nerve or nerves supply general sensation and taste to the posterior third of the tongue?
93
Dilator pupillae muscle
Which muscle of the eye is under sympathetic control?
94
True. on the right lung the oblique fissure divides the middle from the inferior lobe and the horizontal fissure further divides the middle from the upper lobe. On the left the oblique divides the superior from the inferior lobe.
True or false? both the left and right lungs have an oblique fissure?
95
1. Lateral pectoral 2. Lateral head of the median 3. Musculocutaneus
What are the three branches of the lateral cord of the brachial plexus?
96
There are no valves and no smooth muscle in the walls of the veins in the face.
What is the major difference between the veins in the face and the veins in the rest of the body?
97
Clavicle, acromion, and glenoid fossa of the scapula and the humerus
Name the bony articulations of the following sites. Be specific. • Shoulder
98
Humerus with ulna (major) and radius (minor)
Name the bony articulations of the following sites. Be specific. • Elbow
99
Radius with scaphoid and lunate and ulna with triquetrum and pisiform (Remember, for major articulations, wrist/radius and humerus/ulna = elbow)
Name the bony articulations of the following sites. Be specific. • Wrist
100
Cricothyroid muscle; all other laryngeal muscles are innervated by the recurrent laryngeal nerve.
What is the only laryngeal muscle innervated by the external laryngeal nerve?
101
Esophagus, SVC, vagus nerve, azygos vein, thoracic duct, thymus, and phrenic nerve
What seven structures are found in more than one mediastinum?
102
There are 10 bronchopulmonary segments on the right and 8 on the left.
How many bronchopulmonary segments are on the right lung? Left lung?
103
Ligament of Treitz
The duodenal-jejunal flexure is suspended from the posterior abdominal wall by what?
104
Palatoglossus muscle is innervated by CN X; all other tongue muscles are innervated by CN XII.
What is the only tongue muscle innervated by CN X?
105
Internal abdominal oblique
What abdominal muscle runs in a posteroinferior direction, splits to contribute to the rectus sheath, contributes to the formation of the conjoint tendon, and in men gives rise to the middle spermatic fascia and the cremasteric muscle of the spermatic cord?
106
Inferior pancreaticoduodenal, middle colic, right colic, ileocolic, and 10 to 15 intestinal arteries
What are the five branches of the superior mesenteric artery?
107
S2, S3, S4—keeps the pee-pee off the floor!
What spinal nerves contribute to the pelvic splanchnic (parasympathetic) nerves that innervate the detrusor muscle of the urinary bladder?
108
Cerebral aqueduct
What connects the third and the fourth ventricles?
109
Axillary nerve and posterior humeral artery
What nerve and artery could be affected in a humeral neck fracture?
110
Indirect hernia passes in the inguinal canal; a direct hernia passes directly through Hesselbach's triangle.
What type of hernia is described as passing through the deep lateral ring of the inguinal canal?
111
1. Posterior auricular vein 2. Posterior division of the retromandibular vein
What two vessels come together to form the external jugular vein?
112
The pulmonary vein, which carries oxygenated blood from the lung to the left atrium.
What is the only vein in the body with a high O2 content?
113
The left gastric, splenic, and common hepatic arteries
What are the three branches of the celiac trunk?
114
Nasopharynx
What region of the pharynx does the eustachian tube enter?
115
The tensor veli palatine is innervated by the mandibular division of the trigeminal nerve; all others are innervated by CN X.
What is the only muscle of the soft palate that is innervated by CN V3?
116
31 pairs
How many pairs of spinal nerves exit from the spinal cord?
117
Anterior tibial artery
What artery turns into the dorsalis pedis when it crosses the extensor retinaculum?
118
Argyll Robertson pupils
What is the term for pupils that react normally to accommodation but have bilateral loss of constriction in response to light?
119
Foramen of Monro
What connects the lateral ventricles to the third ventricle?
120
Lingual nerve of CN V3
What nerve supplies general sensation to the anterior two-thirds of the tongue?
121
Visceral pleura
What type of pleura is adherent to the surface of the organ?
122
Left coronary artery
What artery supplies the left ventricle, left atrium, and interventricular septum?
123
Waldeyer's ring
Where are the tonsillar tissues?
124
Camper's fascia; Scarpa's fascia is devoid of fat. (Remember campers are fat.)
What is the name of the superficial subcutaneous fascia of the abdomen containing fat?
125
1. Tinea coli 2. Haustra 3. Epiploic appendages
What are the three anatomic characteristics that differentiate the large bowel from the small bowel and the rectum?
126
The optic disk is the blind spot.
What area of the posterior aspect of the eye has no photoreceptors?
127
Musculophrenic and superior epigastric arteries
At the level of rib 6, the internal thoracic artery divides into what two arteries?
128
Housemaid's knee
What is the name of inflammation of the prepatellar bursa?
129
C1 through C4
What nerve roots constitute the cervical plexus?
130
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Heart and pericardium
131
Posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Descending aorta
132
Superior and anterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Thymus
133
Superior and middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Phrenic nerve
134
Superior and posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Esophagus
135
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Trachea
136
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Ascending aorta
137
Superior and posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Thoracic duct
138
Superior and posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Azygos vein
139
Superior and middle
Name the compartment of the mediastinum associated with the following thoracic structures: • SVC
140
Posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Splanchnic nerves
141
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Aortic arch
142
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • IVC
143
Posterior
Name the compartment of the mediastinum associated with the following thoracic structures: • Vagus nerve
144
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Brachiocephalic vein
145
Middle
Name the compartment of the mediastinum associated with the following thoracic structures: • Pulmonary artery and veins
146
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Left common carotid artery
147
Superior
Name the compartment of the mediastinum associated with the following thoracic structures: • Left subclavian artery
148
Adrenal medulla
What is the only organ in the body supplied by preganglionic sympathetic fibers?
149
The left is a branch of the aortic arch, while the right is a branch of the brachiocephalic trunk.
The left subclavian artery is a branch of what artery?
150
1. Masseter 2. Temporalis 3. Medial pterygoid 4. Lateral pterygoid
What are the four muscles of mastication?
151
Rib 7 articulates with T7 and T8. Each rib articulates with the corresponding numerical vertebral body and the vertebral body below it.
With what thoracic vertebra or vertebrae does rib 7 articulate?
152
Left colic, superior rectal, and sigmoidal arteries
What are the three branches of the inferior mesenteric artery?
153
Mitral (bicuspid) valve
What is the only valve in the heart with two cusps?
154
Caput medusa, internal hemorrhoids, esophageal varices, retroperitoneal varices, and splenomegaly
What are five clinical signs of portal HTN?
155
1. Iliocostalis 2. Longissimus 3. Spinalis ("I Love Science" muscles)
What three muscles constitute the erector spinae?
156
Median nerve
What nerve is compromised in carpal tunnel syndrome?
157
The popliteal artery, the deepest structure in the popliteal fossa, risks injury in a supracondylar fracture of the femur.
What vascular injury may result from a supracondylar fracture of the femur?
158
Radial nerve and the profunda brachii artery
What nerve and artery could be affected in a midshaft humeral fracture?
159
. Duodenum (all but the first part) 2. Ascending Colon 3. Ureters 4. Pancreas 5. Supra renal glands (adrenals) 6. Descending colon 7. Aorta 8. Kidneys 9. Rectum 10. IVC D CUPS DAKRI is the mnemonic, everything else is covered with peritoneum
Name the 10 retroperitoneal organs.
160
C3, C4, and C5 keep the diaphragm alive!
Ventral rami of what cervical nerves constitute the phrenic nerve?
161
Ampulla
What is the region of the fallopian tube where fertilization most commonly occurs?
162
Foramen of Winslow
What foramen must be traversed for entry into the lesser peritoneal sac?
163
CN XI, vertebral arteries
Name the structure that enters or exits the following foramina: • Foramen magnum
164
Middle meningeal artery
Name the structure that enters or exits the following foramina: • Foramen spinosum
165
CN V2
Name the structure that enters or exits the following foramina: • Foramen rotundum
166
CN V3 and the lesser petrosal nerve
Name the structure that enters or exits the following foramina: • Foramen ovale
167
CN IX, X, and XI; sigmoid sinus
Name the structure that enters or exits the following foramina: • Jugular foramen
168
Internal carotid artery and sympathetic plexus
Name the structure that enters or exits the following foramina: • Carotid canal
169
CN VII
Name the structure that enters or exits the following foramina: • Stylomastoid foramen
170
CN XII
Name the structure that enters or exits the following foramina: • Hypoglossal canal
171
CN VII and VIII
Name the structure that enters or exits the following foramina: • Internal auditory meatus
172
CN II and ophthalmic artery
Name the structure that enters or exits the following foramina: • Optic canal
173
CN I
Name the structure that enters or exits the following foramina: • Cribriform plate
174
Subclavian vein
What vessel can be found atop the scalene anterior?
175
Motor aspect
What component of the corneal reflex is lost in a CN VII deficit?
176
A right CN V lesion results in weakened muscles of mastication, and the jaw deviates to the right.
A motor lesion to the right CN V results in deviation of the jaw to which side?
177
Ulnar and radial arteries (ulnar is the main supplier)
What two arteries join to form the superficial and deep palmar arches of the hand?
178
Round and ovarian ligaments
What two ligaments of the uterus are remnants of the gubernaculum?
179
L4 to S3 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Tibial nerve
180
L4 to S3 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Common peroneal nerve
181
L2 to L4 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Femoral nerve
182
L2 to L4 (L2 to L4, thigh; L4 to S3, leg)
What segments of the lumbosacral plexus form the following nerves? • Obturator nerve
183
Left: stomach, spleen, and left kidney; right: liver, duodenum, and right kidney
What three structures are in contact with the left colic flexure? With the right colic flexure?
184
1. Sartorius 2. Gracilis 3. Semitendinous
What three muscles constitute the pes anserinus?
185
Stylopharyngeus muscle is innervated by CN IX; all other pharyngeal muscles are innervated by CN X.
What is the only pharyngeal muscle not innervated by CN X?
186
The right and left pulmonary arteries, the only arteries that carry deoxygenated blood
What vessels carry deoxygenated blood into the lungs from the right ventricle?
187
Common peroneal nerve
Fracture of the fibular neck, resulting in foot drop, is an injury of what nerve?
188
Superior vena cava
What vein is formed by the union of the right and left brachiocephalic veins?
189
The superior border of the inferior intercostal rib is your landmark for a pleural tap because along the inferior border of each rib is the neurovascular bundle, and you would risk injury if you went below the rib.
If inserting a needle to perform a pleural tap or insertion of a chest tube, do you use the inferior or the superior border of a rib as your landmark? Why?
190
Popliteus
What muscle laterally rotates the femur to unlock the knee?
191
Posterior chamber
What chamber of the eye lies between the iris and the lens?
192
Right coronary artery
What artery supplies the right atrium, right ventricle, sinoatrial and atrioventricular nodes?
193
1. Dorsal scapular 2. Suprascapular 3. Long thoracic 4. Nerve to subclavius
What four branches of the brachial plexus arise prior to the first rib?
194
T9
What vertebral level is marked by the xiphoid process?
195
Common peroneal nerve
What lower extremity nerve is described by the following motor loss? • Loss of eversion; inversion, dorsiflexion, and plantarflexion of the foot
196
Tibial nerve
What lower extremity nerve is described by the following motor loss? • Loss of flexion of the knees and toes, plantarflexion, and weakened inversion
197
Femoral nerve
What lower extremity nerve is described by the following motor loss? • Loss of knee extension, weakened hip flexion
198
Superior gluteal nerve
What lower extremity nerve is described by the following motor loss? • Loss of abduction of the hip resulting in Trendelenburg gait
199
Sciatic nerve
What lower extremity nerve is described by the following motor loss? • Loss of flexion of the knee and all function below the knee, weakened extension of the thigh
200
Obturator nerve
What lower extremity nerve is described by the following motor loss? • Loss of adduction of the thigh
201
Median nerve lesion
What nerve lesion presents with ape or simian hand as its sign?
202
Deltoid
What muscle acts in all ranges of motion of the arm?
203
Inferior phrenic artery
What is the first branch of the abdominal artery?
204
The right gonadal vein drains into the inferior vena cava directly, and the left gonadal vein drains into the left renal vein.
What vessel does the right gonadal vein drain into?
205
Trapezius and sternocleidomastoid
What two muscles do you test to see whether CN XI is intact?
206
CN IX and X
What two CNs are responsible for the carotid body and sinus reflexes?
207
T4 vertebral level posteriorly and anteriorly at the sternal angle (angle of Louis).
At what vertebral level does the trachea bifurcate?
208
Resorb CSF into the blood
What is the function of the arachnoid granulations?
209
Long thoracic nerve. To avoid confusing long thoracic nerve and lateral thoracic artery: long has an n for nerve; lateral has an a for artery.
Damage to what nerve will give you winged scapula?
210
Nucleus pulposus
What portion of the intervertebral disk is a remnant of the notochord?
211
Puborectalis
What component of the pelvic diaphragm forms the rectal sling (muscle of continence)?
212
Four Ms and a U 1. Median 2. Medial antebrachial 3. Medial pectoral 4. Medial brachial cutaneus 5. Ulnar
What are the five branches of the median cord of the brachial plexus?
213
Humerus (between the medial epicondyle and the trochlea)
What bone houses the ulnar groove?
214
Maxillary division of CN V and glossopharyngeal nerves
What CN is associated with the sensory innervation of • Nasopharynx?
215
Glossopharyngeal nerve
What CN is associated with the sensory innervation of • Oropharynx?
216
Vagus nerve
What CN is associated with the sensory innervation of • Laryngopharynx?
217
Pia mater
What protective covering adheres to the spinal cord and CNS tissue?
218
Urinary trigone
What is the name of the urinary bladder where the ureters enter and the urethra exits?
219
Volkmann's contracture
What is the term when the brachial artery is compressed, resulting in ischemic contracture of the hand?
220
Chordae tendineae
What attaches the cusps of the valves to the papillary muscles in the heart?
221
Internal iliac nodes
What is the lymphatic drainage of the pelvic organs?
222
Infrapatellar bursa
What bursa is inflamed in clergyman's knee?
223
Psoas major
What muscle is the chief flexor of the hip?
224
Parasympathetic stimulation, via the vagus nerve, results in bronchoconstriction, whereas sympathetic stimulation results in bronchodilation.
What component of the ANS, when stimulated, results in bronchoconstriction?
225
The Palmar interosseus ADducts, whereas the Dorsal interosseus ABducts (PAD and DAB)
What muscles in the hand adduct the fingers?
226
Subarachnoid hematoma
What type of cerebral bleed is due to a rupture of a berry aneurysm in the circle of Willis?
227
1. Temporal 2. Zygomatic 3. Buccal 4. Mandibular 5. Cervical (Two Zebras Bit My Clavicle.)
What are the five terminal branches of the facial nerve?
228
Medial meniscus
What structure of the knee is described thus? • C-shaped shock absorber; aids in attachment of the tibia to the femur via the medial collateral ligament
229
Posterior cruciate ligament
What structure of the knee is described thus? • Prevents posterior displacement and has medial-to-lateral attachment on the tibia
230
Lateral collateral ligament
What structure of the knee is described thus? • Prevents adduction
231
ACL
What structure of the knee is described thus? • Prevents anterior displacement and has lateral-to-medial attachment on the tibia
232
Medial collateral ligament
What structure of the knee is described thus? • Prevents abduction
233
The sensory component is through the superior laryngeal nerve, and the motor limb is via the recurrent laryngeal nerve.
What branches of CN X are the sensory and motor components of the cough reflex? Be specific.
234
The internal laryngeal nerve supplies sensory information from above the vocal cords while the recurrent laryngeal nerve supplies sensory information below.
What nerves provide sensory innervation above the vocal cords? Below the vocal cords?
235
First pharyngeal groove; all others degenerate.
From what pharyngeal groove is the external auditory meatus derived?
236
Phallus
What embryonic structure forms the adult male structure? • Corpus cavernosus, corpus spongiosum, and glans and body of the penis
237
Labioscrotal swelling
What embryonic structure forms the adult male structure? • Scrotum
238
Urogenital sinus
What embryonic structure forms the adult male structure? • Urinary bladder, urethra, prostate gland, bulbourethral gland
239
Gonads
What embryonic structure forms the adult male structure? • Testes, seminiferous tubules, and rete testes
240
Urogenital folds
What embryonic structure forms the adult male structure? • Ventral part of the penis
241
Gubernaculum
What embryonic structure forms the adult male structure? • Gubernaculum testes
242
Mesonephric duct
What embryonic structure forms the adult male structure? • Epididymis, ductus deferens, seminal vesicle, and ejaculatory duct
243
PGE and intrauterine or neonatal asphyxia maintain patency of the ductus arteriosus. Indomethacin, ACh, and catecholamines promote closure of the ductus arteriosus.
Which PG is associated with maintaining a PDA?
244
6 weeks 10 weeks
When does the primitive gut herniate out of the embryo? When does it go back into the embryo?
245
Cleft palate
What results when the palatine prominences fail to fuse with the other side?
246
Vitelline fistula
What is the term for a direct connection between the intestine and the external environment through the umbilicus because the vitelline duct persists?
247
From the wall of the yolk sac
Where do the primordial germ cells arise?
248
Male pseudo-intersexuality (hermaphrodite); these individuals are 46XY.
What disorder is due to a 5--reductase deficiency, resulting in testicular tissue and stunted male external genitalia?
249
The zygote divides mitotically; only germ cells divide meiotically.
Does the zygote divide mitotically or meiotically?
250
Third week
During what embryonic week does the intraembryonic coelom form?
251
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebral hemispheres
252
Mesencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Midbrain
253
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebellum
254
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Medulla
255
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Diencephalon
256
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Metencephalon
257
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Telencephalon
258
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Thalamus
259
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Eye
260
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Pons
261
Rhombencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Myelencephalon
262
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Pineal gland
263
Mesencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Cerebral aqueduct
264
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Neurohypophysis
265
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Third ventricle
266
Proencephalon* *diencephalon derivative
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Hypothalamus
267
Proencephalon
Name the primary vesicle the following structures are derived from (proencephalon, mesencephalon, or rhombencephalon). • Lateral ventricles
268
Gestational trophoblastic neoplasia (GTN or choriocarcinoma)
What malignant tumor of the trophoblast causes high levels of hCG and may occur after a hydatidiform mole, abortion, or normal pregnancy?
269
Respiratory distress syndrome; treatment with cortisol and thyroxine can increase production of surfactant.
What syndrome is due to a deficiency of surfactant?
270
None; they are not formed until a girl reaches puberty.
How many oogonia are present at birth?
271
Transposition of the great vessels arises from a failure of the aorticopulmonary septum to grow in a spiral.
What right-to-left shunt occurs when the aorta opens into the right ventricle and the pulmonary trunk opens into the left ventricle?
272
Ligament teres
What are the adult remnants of the following structures? • Left umbilical vein
273
Fossa ovale
What are the adult remnants of the following structures? • Foramen ovale
274
Medial umbilical ligaments
What are the adult remnants of the following structures? • Right and left umbilical arteries
275
Ligamentum arteriosum
What are the adult remnants of the following structures? • Ductus arteriosus
276
Ligamentum venosum
What are the adult remnants of the following structures? • Ductus venosus
277
Treacher Collins syndrome
Mandibular hypoplasia, down-slanted palpebral fissures, colobomas, malformed ears, and zygomatic hypoplasia are commonly seen in what pharyngeal arch 1 abnormality?
278
SHIP: Shifting of the aorta, Hypertrophy of the right ventricle, Interventricular septal defect, Pulmonary stenosis
What is the tetrad of tetralogy of Fallot?
279
Hypospadia
What is the term for the external urethra opening onto the ventral surface of the penis?
280
CN V
What CN is associated with the • First pharyngeal arch?
281
CN VII
What CN is associated with the • Second pharyngeal arch?
282
CN IX
What CN is associated with the • Third pharyngeal arch?
283
CN X
What CN is associated with the • Fourth pharyngeal arch?
284
None; it degenerates.
What CN is associated with the • Fifth pharyngeal arch?
285
CN X
What CN is associated with the • Sixth pharyngeal arch?
286
Hirschsprung's disease (colonic gangliosus)
What disease results in a failure of neural crest cells to migrate to the myenteric plexus of the sigmoid colon and rectum?
287
DiGeorge's syndrome
What immunologic syndrome is due to a pharyngeal pouch 3 and 4 failure?
288
The notochord
What embryonic structure, around day 19, tells the ectoderm above it to differentiate into neural tissue?
289
Cryptorchidism; normally the testes descend into the scrotum within 3 months of birth.
What is the term for failure of the testes to descend into the scrotum?
290
Membranous septal defects are interventricular; a persistent patent ovale results in an interatrial septal defect.
Is a membranous septal defect more commonly interventricular or interatrial?
291
The second pharyngeal pouch and groove
What pharyngeal pouch and groove persist when a pharyngeal fistula is formed?
292
hCG can be detected in the blood by day 8 and in the urine by day 10.
How early can a pregnancy be detected by hCG assays in the blood? In urine?
293
First M PITS for pharyngeal pouch derivatives
From what pharyngeal pouch is the following structure derived? • Middle ear
294
Fourth M PITS for pharyngeal pouch derivatives
From what pharyngeal pouch is the following structure derived? • Superior parathyroid gland and ultimobranchial body of the thyroid
295
Third M PITS for pharyngeal pouch derivatives
From what pharyngeal pouch is the following structure derived? • Inferior parathyroid gland and thymus
296
Second M PITS for pharyngeal pouch derivatives
From what pharyngeal pouch is the following structure derived? • Palatine tonsil
297
Epispadia
What is the term for the external urethra opening onto the dorsal surface of the penis?
298
True. The elimination of the unfertilized egg is menses.
True or false? In females, meiosis II is incomplete unless fertilization takes place.
299
Muscles of the internal eye
What adult structures are derived from preotic somites?
300
Extrahepatic biliary atresia
What disorder is associated with jaundice, white stools, and dark urine due to biliary duct occlusion secondary to incomplete recanalization?
301
hCG
What hormone, produced by the syncytiotrophoblast, stimulates the production of progesterone by the corpus luteum?
302
Four
How many mature sperm are produced by one type B spermatogonium?
303
They are all formed by the fifth month of fetal life.
All primary oocytes in females are formed by what age?
304
Truncus arteriosus
From what embryonic structure are the following structures derived? • The ascending aorta and the pulmonary trunk
305
Sinus venosus
From what embryonic structure are the following structures derived? • The sinus venarum, coronary sinus, and the oblique vein of the left atrium
306
Primitive ventricle
From what embryonic structure are the following structures derived? • The right and left ventricles
307
Bulbus cordis
From what embryonic structure are the following structures derived? • The aortic vestibule and the conus arteriosus
308
Primitive atrium
From what embryonic structure are the following structures derived? • The right and left atria
309
Eisenmenger's syndrome
After a longstanding left-to-right shunt reverses, causing cyanosis, and becomes a right-to-left shunt, what is it termed?
310
True. The thyroid gland, the lungs, and the pharyngeal pouches are foregut derivatives that are not a component of the gastrointestinal system.
True or false? The thyroid gland is an embryologic foregut derivative.
311
Mesonephric duct (ureteric bud)
What embryonic structure forms the following adult structures? • Collecting ducts, calyces, renal pelvis, and ureter
312
Urogenital sinus
What embryonic structure forms the following adult structures? • Urinary bladder and urethra
313
Phallus, urogenital folds, and labioscrotal swellings
What embryonic structure forms the following adult structures? • External genitalia
314
Metanephros
What embryonic structure forms the following adult structures? • Nephrons, kidney
315
Urachus
What embryonic structure forms the following adult structures? • Median umbilical ligament
316
TRUE
True or false? The epithelial lining of the urinary bladder and the urethra are embryologic hindgut derivatives.
317
1. The lesser omentum (consisting of the hepatoduodenal and hepatogastric ligaments) 2. Falciform ligament 3. Coronary ligament of the liver 4. Triangular ligament of the liver Liver is ventral; all other ligaments are dorsal mesentery derivatives.
Name the four ventral mesentery derivatives.
318
Hypertrophic pyloric stenosis due to hypertrophy of the muscularis externa, resulting in a narrowed pyloric outlet
Projectile nonbilious vomiting and a small knot at the right costal margin (olive sign) are hallmarks of what embryonic disorder?
319
Meiosis I; disjunction with centromere splitting occurs during meiosis II.
The separation of 46 homologous chromosomes without splitting of the centromeres occurs during what phase of meiosis?
320
Third week; they are derived from the wall of the yolk sac.
Blood and its vessels form during what embryonic week?
321
Phallus
What embryonic structure forms the adult female structures? • Glans clitoris, corpus cavernosus, and spongiosum
322
Mesonephric duct
What embryonic structure forms the adult female structures? • Gartner's duct
323
Gonads
What embryonic structure forms the adult female structures? • Ovary, follicles, rete ovarii
324
Paramesonephric ducts
What embryonic structure forms the adult female structures? • Uterine tube, uterus, cervix, and upper third of the vagina
325
Labioscrotal swelling
What embryonic structure forms the adult female structures? • Labia majora
326
Urogenital folds
What embryonic structure forms the adult female structures? • Labia minora
327
Gubernaculum
What embryonic structure forms the adult female structures? • Ovarian and round ligaments
328
Urogenital sinus
What embryonic structure forms the adult female structures? • Urinary bladder, urethra, greater vestibular glands, vagina
329
The gut rotates clockwise around the superior mesenteric artery.
What direction does the primitive gut rotate? What is its axis of rotation?
330
Testicular feminization syndrome (Dude looks like a lady!)
What syndrome occurs when a 46XY fetus develops testes and female external genitalia?
331
Hydatidiform mole
Preeclampsia in the first trimester, hCG levels above 100, 00 mIU/mL, and an enlarged bleeding uterus are clinical signs of what?
332
False. It closes just after birth because the change in pulmonary circulation causes increased left atrial pressure.
True or false? The foramen ovale closes just prior to birth.
333
Metaphase II
At ovulation, in what stage of meiosis II is the secondary oocyte arrested?
334
Duodenal atresia
What is the name for failed recanalization of the duodenum resulting in polyhydramnios, bile-containing vomitus, and a distended stomach?
335
A patent processus vaginalis
What remains patent in a hydrocele of the testis, allowing peritoneal fluid to form into a cyst?
336
True. The laryngotracheal (respiratory) diverticulum is divided from the foregut by the tracheoesophageal septum. --------------------------------------------------------------------------------
True or false? The respiratory system is derived from the ventral wall of the foregut.
337
Patent urachus
What is the name for failure of the allantois to close, resulting in a urachal fistula or sinus?
338
The mouth
What structure is derived from the prochordal plate?
339
Spleen
What is the only organ supplied by the foregut artery that is of mesodermal origin?
340
Sacrococcygeal teratoma
What tumor is derived from primitive streak remnants and often contains bone, hair, or other tissue types?
341
Omphalocele and gastroschisis
What two pathologic conditions occur when the gut does not return to the embryo?
342
True. Remember, it degenerates 4 to 5 days post fertilization, and implantation occurs 7 days post fertilization!
True or false? For implantation to occur the zona pellucida must degenerate.
343
Cleft lip
What results when the maxillary prominence fails to fuse with the medial nasal prominence?
344
The primitive streak grows caudal to rostral.
What is the direction of growth for the primitive streak, caudal to rostral or rostral to caudal?
345
Third week
During what embryonic week do somites begin to form?
346
Week four, and they remain dormant there until puberty.
In men, at what embryonic week do the primordial germ cells migrate to the indifferent gonad?
347
Third week
What embryonic week sees the formation of the notochord and the neural tube?
348
Persistent truncus arteriosus
What right-to-left shunt occurs when only one vessel receives blood from both the right and left ventricles?
349
1. Cytotrophoblast 2. Syncytiotrophoblast 3. Extraembryonic mesoderm
What three embryonic cell layers form the chorion?
350
They are in the grey matter of the CNS.
Where are the preganglionic neuron cell bodies, the CNS or the PNS?
351
CN VII, IX, and X; taste and general sensation for the tongue is sent to the solitary nucleus.
Which three CNs send sensory information to the solitary nucleus?
352
Medial medullary syndrome
What syndrome is associated with the following brainstem lesions? • Vertebral artery or anterior spinal artery occlusion, resulting in contralateral corticospinal tract and medial lemniscus tract deficits and an ipsilateral CN XII lesion
353
Medial pontine syndrome
What syndrome is associated with the following brainstem lesions? • Contralateral corticospinal and medial lemniscus tract deficits and an ipsilatera medial strabismus secondary to a lesion in CN VI
354
Pontocerebellar angle syndrome
What syndrome is associated with the following brainstem lesions? • Slow-growing acoustic neuroma producing CN VII deficiencies
355
Lateral medullary (Wallenberg's) syndrome
What syndrome is associated with the following brainstem lesions? • Occlusion of the PICA, resulting in ipsilateral limb ataxia, ipsilateral facial pain and temperature loss, contralateral pain and body temperature loss, ipsilateral Horner's syndrome, and ipsilateral paralysis of the vocal cords, palate droop, dysphagia, nystagmus, vomiting, and vertigo
356
Lateral pontine syndrome
What syndrome is associated with the following brainstem lesions? • AICA or superior cerebellar artery occlusion, resulting in ipsilateral limb ataxia, ipsilateral facial pain and temperature loss, contralateral loss of pain and temperature to the body, ipsilateral Horner's syndrome, ipsilateral facial paralysis, and hearing loss
357
Medial midbrain (Weber's) syndrome
What syndrome is associated with the following brainstem lesions? • Posterior cerebral artery occlusion resulting in a contralateral corticospinal tract signs, contralateral corticobulbar signs to the lower face, and ipsilateral CN III palsy
358
CN III and IV
What CNs are affected if there is a lesion in • The midbrain?
359
CN IX, X, and XII
What CNs are affected if there is a lesion in • The upper medulla?
360
CN VI, VII, and VIII
What CNs are affected if there is a lesion in • Pontomedullary junction?
361
CN V
What CNs are affected if there is a lesion in • The upper pons?
362
Accessory nucleus
What is the only CN nucleus found in the cervical spinal cord?
363
Motor nucleus of CN V
What component of the trigeminal nuclei • Supplies the muscles of mastication?
364
Spinal trigeminal nucleus
What component of the trigeminal nuclei • Receives sensory input (all but pain and temperature) from the face, scalp, dura, and the oral and nasal cavities?
365
Mesencephalic nucleus
What component of the trigeminal nuclei • Forms the sensory component of the jaw jerk reflex?
366
The lateral vestibular nucleus
What deep cerebellar nuclei receive Purkinje cell projections in • The flocculonodular lobe?
367
The fastigial nucleus
What deep cerebellar nuclei receive Purkinje cell projections in • The vermis?
368
The interposed nucleus
What deep cerebellar nuclei receive Purkinje cell projections in • The lateral cerebellar hemispheres?
369
The dentate nucleus
What deep cerebellar nuclei receive Purkinje cell projections in • The intermediate hemispheres?
370
The granule cell is the only excitatory neuron in the cerebellar cortex, and it uses glutamate as its neurotransmitter. All the other cells in the cerebellum are inhibitory neurons, and they use GABA as their neurotransmitter.
What is the only excitatory neuron in the cerebellar cortex, and what is its neurotransmitter?
371
CN III, IV, and VI
What three CNs are associated with conjugate eye movements?
372
Hypotonia (rag doll appearance)
What is the term to describe the soft, flabby feel and diminished reflexes seen in patients with acute cerebellar injury to the deep cerebellar nuclei?
373
The Romberg sign is present if the patient sways or loses balance when standing with eyes open. In a dorsal column lesion, patients sway with eyes closed. (Don't forget this one.)
What bedside test is used to differentiate a dorsal column lesion from a lesion in the vermis of the cerebral cortex?
374
Superior cerebellar peduncle; the inferior and the middle consist mainly of incoming (afferent) tracts and fibers.
Which one of the cerebellar peduncles is mainly responsible for outgoing (efferent) information?
375
Lower extremity and lower trunk information travels in the dorsal spinocerebellar tract. The upper trunk and extremity information travels in the cuneocerebellar tract. (Cuneocerebellar and fasciculus cuneatus both apply to upper extremities.)
What tract carries unconscious proprioceptive information from the Golgi tendon organs and muscle spindles to the cerebellum, helping monitor and modulate muscle movements?
376
The Babinski reflex is present in UMN lesions. Muscle atrophy due to disuse, hyperreflexia, spastic paralysis, increased muscle tone, and weakness are commonly seen in UMN lesions.
What reflex, seen in lesions of the corticospinal tract, is an extension of the great toe with fanning the of remaining toes?
377
Ptosis (eyelid drooping), miosis (pupillary constriction), and anhydrosis (lack of sweating) occur when the preganglionic sympathetic fibers from T1-to T4 are obstructed.
What is the triad of Horner's syndrome?
378
Semicircular canal
What component of the inner ear • Contains perilymph and responds to angular acceleration and deceleration of the head?
379
Semicircular duct
What component of the inner ear • Contains endolymph and responds to head turning and movement?
380
Utricle and saccule
What component of the inner ear • Contains endolymph and gravity receptors monitoring linear acceleration and deceleration of the head, noting changes in head position?
381
Subacute combined degeneration, which is bilateral below the level of the lesion.
What is the name of demyelination of the corticospinal tract and the dorsal column in the spinal cord due most commonly to a vitamin B12 deficiency?
382
Wernicke's encephalopathy
What encephalopathy causes ocular palsies, confusion, and gait abnormalities related to a lesion in the mammillary bodies and/or the dorsomedial nuclei of the thalamus?
383
MGB
Which thalamic nucleus receives auditory input from the inferior colliculus?
384
They are in ganglia in the PNS.
Where are the postganglionic neuron cell bodies, the CNS or the PNS?
385
Syringomyelia
What disease is a cavitation of the spinal cord causing bilateral loss of pain and temperature at the level of the lesion?
386
Suprachiasmatic nucleus
What nucleus of the hypothalamus receives visual input from the retina and helps set the circadian rhythm?
387
White rami are preganglionic fibers, whereas grey rami are postganglionic fibers.
Are white rami preganglionic or postganglionic fibers?
388
Posterior hypothalamic zones; lesions here result in poikilothermy (environmental control of one's body temperature).
What area of the hypothalamus is responsible for recognizing a decrease in body temperature and mediates the response to conserve heat?
389
CN V1, the occulomotor division of the trigeminal nerve, is the sensory component of the corneal reflex.
What CN transmits sensory information from the cornea?
390
Lumbar splanchnics
What preganglionic sympathetic fibers are responsible for innervating the smooth muscle and glands of the pelvis and the hindgut?
391
The first sensory neuron is in the dorsal root ganglia. It carries ascending sensory information in the dorsal root of a spinal nerve, eventually synapsing with second sensory neuron. In the brainstem (DCML) and the spinal cord (spinothalamic) the second neuron cell body sends its axons to synapse in the thalamus. The third sensory neuron cell body is a thalamic nuclei that sends its fibers to the primary somatosensory cortex.
Where are the cell bodies for the DCML and spinothalamic sensory systems?
392
Accommodation
What term describes the reflex that increases the curvature of the lens, allowing near vision?
393
CN X (Remember, the vagus nerve supplies the parasympathetic information from the tip of the pharynx to the end of the midgut and all between.)
What CN carries preganglionic parasympathetic fibers that innervate the viscera of the neck, thorax, foregut, and midgut?
394
Anterior hypothalamic zone; lesions here result in hyperthermia.
What area of the hypothalamus is responsible for recognizing an increase in body temperature and mediates the response to dissipate heat?
395
Climbing fibers;, they are monosynaptic input on Purkinje cells. Mossy fibers, also excitatory, are axons of all other sources and synapse on granule cells.
What excitatory fibers arise from the inferior olivary nuclei on the contralateral side of the body?
396
CN III, VII, IX, and X
What four CN carry preganglionic parasympathetic fibers?
397
Meningomyelocele All except occulta cause elevated-fetoprotein levels.
Name the form of spina bifida. • Meninges and spinal cord project through a vertebral defect
398
Meningocele All except occulta cause elevated-fetoprotein levels.
Name the form of spina bifida. • Meninges project through a vertebral defect
399
Myeloschisis All except occulta cause elevated-fetoprotein levels.
Name the form of spina bifida. • An open neural tube lying on the surface of the back
400
Occulta All except occulta cause elevated-fetoprotein levels.
Name the form of spina bifida. • Defect in the vertebral arch
401
LGB (think EYES)
Name the thalamic nucleus based on its input and output. • Input from the optic tract; output projects to the primary visual cortex of the occipital lobe
402
Ventral posteromedial nucleus
Name the thalamic nucleus based on its input and output. • Input from the trigeminal pathways; output to primary somatosensory cortex of the parietal lobe
403
Ventral lateral nucleus
Name the thalamic nucleus based on its input and output. • Input from globus pallidus and the cerebellum; output to the primary motor cortex
404
Ventral posterolateral nucleus
Name the thalamic nucleus based on its input and output. • Input from medial lemniscus and the spinocerebellar tracts; output to the primary somatosensory cortex
405
Ventral anterior nucleus
Name the thalamic nucleus based on its input and output. • Input from globus pallidus and substantia nigra; output to primary motor cortex
406
Medial nuclear group (limbic system)
Name the thalamic nucleus based on its input and output. • Input from the amygdala, prefrontal cortex, and temporal lobe; output to the prefrontal lobe and the cingulated gyrus
407
MGB (think EARS)
Name the thalamic nucleus based on its input and output. • Input from inferior colliculus; output to primary auditory cortex
408
Anterior nuclear group (Papez circuit of the limbic system)
Name the thalamic nucleus based on its input and output. • Input from the mammillary bodies via the mammillothalamic tract and the cingulated gyrus; output to the cingulated gyrus via the anterior limb of the internal capsule
409
Kayser-Fleischer ring
What is the name of a thin brown ring around the outer edge of the cornea, seen in Wilson's disease?
410
They innervate LMNs.
What do UMNs innervate?
411
The thalamus (I like to think of the thalamus as the executive secretary for the cerebral cortex. All information destined for the cortex has to go through the thalamus.)
What area of the brain serves as the major sensory relay center for visual, auditory, gustatory, and tactile information destined for the cerebral cortex, cerebellum, or basal ganglia?
412
Superior colliculus (Remember S for Superior and Sight). The inferior colliculus processes auditory information from both ears.
Which of the colliculi help direct the movement of both eyes in a gaze?
413
Normally corticobulbar fiber innervation of the CNs is bilateral (the LMN receives information from both the left and right cerebral cortex), but with CN VII the LMN of the upper face receives bilateral input but the lower facial LMNs receive only contralateral input. --------------------------------------------------------------------------------
How do the corticobulbar fibres of CN VII differ from the rest of the CNs?
414
Gerstmann's syndrome; spoken language is usually understood.
What syndrome is described by a lesion in the angular gyrus (area 39) resulting in alexia, agraphia, acalculia, finger agnosia, and right-left disorientation?
415
Eight pairs through seven cervical vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Cervical vertebrae?
416
Twelve pairs through twelve thoracic vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Thoracic vertebrae?
417
Five pairs through five lumbar vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Lumbar vertebrae?
418
Five pairs through five sacral vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Sacral vertebrae?
419
One pair with three to five coccygeal vertebrae. Totaling 31 pairs of spinal nerves.
How many pairs of spinal nerves are associated with • Coccygeal vertebrae?
420
Two Lateral foramina of Luschka and 1 Medial foramen of Monroe (L for Lateral and M for Medial)
What are the three sites where CSF can leave the ventricles and enter the subarachnoid space? (Name the lateral and the medial foramina.)
421
CN III and IV
What CNs arise from • The midbrain?
422
CN V, VI, VII, and VIII
What CNs arise from • The pons?
423
CN IX, X, and XII CN XI arises from the cervical spinal cord.
What CNs arise from • The medulla?
424
Transcortical apraxia; Wernicke's area of the left hemisphere cannot communicate with the right primary motor cortex because of the lesion in the corpus callosum.
What disconnect syndrome results from a lesion in the corpus callosum secondary to an infarct in the anterior cerebral artery, so that the person can comprehend the command but not execute it?
425
False. Water readily diffuses across the blood-brain barrier, but glucose requires carrier-mediated transport.
True or false? Glucose readily diffuses across the blood-brain barrier.
426
Golgi tendon organs are stimulated by Ib afferent neurons in response to an increase in force or tension. The inverse muscle reflex protects muscle from being torn; it limits the tension on the muscle.
What encapsulated group of nerve endings seen at the muscle-tendon junction responds to an increase in tension generated in that muscle? (This is dropping a box that is too heavy to carry.)
427
Huntington's chorea; patients have chorea, athetoid movements, progressive dementia, and behavioral problems.
What chromosome 4, AD disorder is a degeneration of GABA neurons in the striatum of the indirect pathway of the basal ganglia?
428
Klüver-Bucy syndrome
What syndrome is described as bilateral lesions of the amygdala and the hippocampus resulting in placidity, anterograde amnesia, oral exploratory behavior, hypersexuality, and psychic blindness?
429
When a patient closes the eyes while standing with feet together, the visual and cerebellar components of proprioception are removed, so you are testing the dorsal columns. Swaying with eyes closed is a positive Romberg's sign indicating a lesion in the dorsal columns. The cold water caloric test mimics a brainstem lesion by inhibiting the normal reflex response. (COWS: Cold Opposite Warm Same)
By asking a patient to close the eyes while standing with feet together, what two pathways are you eliminating from proprioception?
430
Poliomyelitis; it is a bilateral LMN lesion.
What is the name of bilateral flaccid paralysis, hyporeflexia, and hypotonia due to a viral infection of the ventral horn of the spinal cord?
431
Anterior spinal artery
What branch off the vertebral artery supplies • The ventrolateral two-thirds of the cervical spinal cord and the ventrolateral part of the medulla?
432
PICA
What branch off the vertebral artery supplies • The cerebellum and the dorsolateral part of the medulla?
433
Frontal lobe syndrome (lesion in the prefrontal cortex)
What syndrome causes inability to concentrate, easy distractibility, apathy, and regression to an infantile suckling or grasping reflex?
434
True. Although the CSF normally contains 0 to 4 lymphocytes or monocytes, the presence of PMNs is always considered abnormal.
True or false? The presence of PMNs in the CSF is always abnormal.
435
Ependymal cells
What cells lining the ventricles have cilia on their luminal surface to move CSF?
436
The junction where the anterior communicating and anterior cerebral arteries join. As the aneurysm expands, it compresses the fibers from the upper temporal fields of the optic chiasm, producing bitemporal inferior quadrantanopia
What is the most common site for an aneurysm in cerebral circulation?
437
Central sulcus (sulcus of Rolando)
What fissure of the cerebral cortex runs perpendicular to the lateral fissure and separates the frontal and the parietal lobes?
438
Hemiballismus
What is the name of violent projectile movements of a limb resulting from a lesion in the subthalamic nuclei of the basal ganglia?
439
Argyll Robertson pupils accompany a loss of both direct and consensual light reflexes, but the accommodation-convergence reaction remains intact. It can also be seen in patients with pineal tumors or multiple sclerosis.
What is the term for the type of pupil seen in neurosyphilis, and what ocular reflexes are lost?
440
True. Muscle spindles are modified skeletal muscle fibers. They are the sensory component of the stretch reflexes.
True or false? Intrafusal fibers form muscle spindles.
441
Areas 44 and 45
What Brodmann area is associated with • Broca's area?
442
Areas 41 and 42
What Brodmann area is associated with • Primary auditory cortex?
443
Areas 1, 2, and 3
What Brodmann area is associated with • Primary somatosensory cortex?
444
Areas 5 and 7
What Brodmann area is associated with • Somatosensory association cortex?
445
Area 4
What Brodmann area is associated with • Primary motor cortex?
446
Area 6
What Brodmann area is associated with • Premotor cortex?
447
Areas 18 and 19
What Brodmann area is associated with • Visual association cortex?
448
Area 8
What Brodmann area is associated with • Frontal eye fields?
449
Area 17
What Brodmann area is associated with • Primary visual cortex?
450
Area 22 and occasionally 39 and 40
What Brodmann area is associated with • Wernicke's area?
451
Vitreous humor
What is the fluid of the posterior compartment of the eye?
452
Expressive aphasia
What aphasia produces a nonfluent pattern of speech with the abilty to understand written and spoken language seen in lesions in the dominant hemisphere?
453
The vermis
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls the axial and proximal musculature of the limbs?
454
Lateral part of the hemispheres
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Is involved in motor planning?
455
Flocculonodular lobe (one of my favorite words in all of medicine!)
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls balance and eye movements?
456
Intermediate part of the hemispheres
In a topographical arrangement of the cerebellar homunculus map, what area or lobe • Controls distal musculature?
457
Microglia (Microglia and mesoderm both begin with M)
What glial cell is derived from mesoderm and acts as a scavenger, cleaning up cellular debris after injury?
458
Parkinson's disease (I can't underestimate all of the buzzwords in this question. Remember it.)
What direct-pathway basal ganglia disease is described by masklike facies, stooped posture, cogwheel rigidity, pill-rolling tremor at rest, and a gait characterized by shuffling and chasing the center of gravity?
459
Middle cerebral artery
What artery supplies most of the lateral surfaces of the cerebral hemispheres?
460
Supraoptic nuclei; lesions here result in diabetes insipidus.
What hypothalamic nucleus is responsible for the production of ADH?
461
True. High-frequency sound waves stimulate the hair cells at the base of the cochlea, whereas low-frequency sound waves stimulate hair cells at the apex of the cochlea.
True or false? High-frequency sound waves stimulate hair cells at the base of the cochlea.
462
Ventromedial nucleus; lesions here result in obesity.
What nucleus of the hypothalamus is the satiety center, regulating food intake?
463
Cones (C for color and cones)
What cells of the retina sees in color and needs bright light to be activated?
464
The Purkinje cell
What cell's axons are the only ones that leave the cerebellar cortex?
465
Pelvic splanchnics (They all begin with P.)
What splanchnic carries preganglionic parasympathetic fibers that innervate the hindgut and the pelvic viscera?
466
Nystagmus is named by the fast component, which is the corrective attempt made by the cerebral cortex in response to the initial slow phase.
Is nystagmus defined by the fast or slow component?
467
Left eye anopsia (left nasal and temporal hemianopsia)
Name the ocular lesion; be specific. • Left optic nerve lesion
468
Left homonymous hemianopsia
Name the ocular lesion; be specific. • Right calcarine cortex lesion
469
Left homonymous hemianopsia
Name the ocular lesion; be specific. • A right LGB lesion (in the thalamus)
470
Bitemporal heteronymous hemianopsia
Name the ocular lesion; be specific. • Optic chiasm lesion
471
Right nasal hemianopsia
Name the ocular lesion; be specific. • A right lateral compression of the optic chiasm (as in aneurysms in the internal carotid artery)
472
Left homonymous hemianopsia
Name the ocular lesion; be specific. • Left Meyer's loop lesion of the optic radiations.
473
Planning and fine-tuning of voluntary skeletal muscle contractions. (Think coordination.) Remember, the function of the basal ganglia is to initiate gross voluntary skeletal muscle control.
What is the function of the cerebellum?
474
Dysmetria; this is seen in a finger-to-nose test.
What is the name for inability to stop a movement at the intended target?
475
Preoptic area of the hypothalamus; if the lesion occurs after puberty, amenorrhea or impotence will be seen.
If a lesion occurs before the onset of puberty and arrests sexual development, what area of the hypothalamus is affected?
476
Calcarine sulcus
What sulcus divides the occipital lobe horizontally into a superior cuneus and inferior lingual gyrus?
477
alpha-Motor neurons innervate extrafusal muscle fibers (a motor unit), whereas gamma-motor neurons innervate intrafusal muscle fibers.
Do alpha-or gamma-motor neurons innervate extrafusal muscle fibers?
478
Convergence
Contracting both medial rectus muscles simultaneously makes the images of near objects remain on the same part of the retina. What term describes this process?
479
Contralateral. The spinothalamic tract enters the spinal cord and immediately synapses in the dorsal horn, crosses over, and ascends contralateral in the spinal cord, brainstem, thalamus, and postcentral gyrus.
Will a unilateral lesion in the spinothalamic tract result in a contralateral or ipsilateral loss of pain and temperature?
480
Ciliary ganglion
What ganglion supplies the postganglionic parasympathetic fibers to the ciliary muscles of the eye?
481
Spinothalamic tract (anterolateral system)
In what tract does pain, temperature, and crude touch sensory information ascend to the postcentral gyrus of the parietal lobe?
482
Superior olivary nucleus
What CN nucleus receives auditory information from both ears via the cochlear nuclei?
483
Dorsal motor nucleus of CN X
What parasympathetic nucleus is found on the floor of the fourth ventricle and supplies preganglionic fibers innervating the terminal ganglias of the thorax, foregut, and midgut?
484
Bilateral degeneration of the dorsal columns in the spinal cord secondary to syphilis is known as tabes dorsalis. A high-step gait is seen in patients with tabes dorsalis because of the inability to feel the ground beneath their feet.
What sensory system is affected in the late spinal cord manifestation of syphilis?
485
They innervate skeletal muscle.
What do LMNs innervate?
486
The fasciculus gracilis (Graceful), which lies closest to the midline of the spinal cord.
What tract carries the ipsilateral dorsal column fibers from the lower limbs in the spinal cord?
487
False. CSF is a clear isotonic solution with lower concentrations of K+ and HCO3-. It does have higher concentrations of Cl- and Mg2+.
True or false? CSF is a clear, hypertonic solution with higher concentrations of K + and HCO3-, than the serum.
488
Sensory
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal root?
489
Both
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal rami?
490
Both
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Ventral rami?
491
Motor
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Ventral root?
492
Sensory
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Dorsal root ganglion?
493
Both
What type of fiber or fibers are carried in (answer motor, sensory, or both) • Spinal nerve?
494
Ipsilateral loss at and below the level of the lesion
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • Dorsal column tract?
495
Ipsilateral loss below the level of the lesion
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • Corticospinal tract?
496
Ipsilateral flaccid paralysis
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • LMN?
497
Contralateral loss below and bilateral loss at the level of the lesion
Describe the loss for each of the following in a hemisection of the spinal cord. (Brown-Sáequard syndrome) • Spinothalamic tract?
498
PPRF
What area of the brain acts as the center for ipsilateral horizontal gaze?
499
Receptive aphasia is due to a lesion in Brodmann areas 22, 39, and 40; generally the patient is unaware of the deficit.
What aphasia is seen as an inability to comprehend spoken language and speaking in a word salad?
500
Initiate and manage gross skeletal muscle movement control
What is the function of the basal ganglia?
501
The basilar artery is formed at the pontomedullary junction.
What artery is formed by the union of the two vertebral arteries?
502
Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a LMN lesion at the level of the lesion and UMN lesion below the level of the lesion.
What disease is described by bilateral flaccid weakness of the upper limbs (LMN) and bilateral spastic weakness of the lower limbs (UMN) beginning at the cervical level of the spinal cord and progressing up or down the cord?
503
D1 receptor; inhibition of the direct pathway occurs through the D2 receptors.
Which dopamine receptor excites the direct pathway of the basal ganglia?
504
Although both pathways are associated with disinhibition, the indirect basal ganglia pathway is associated with a decreased level of cortical excitation.
Does the direct or indirect basal ganglia pathway result in a decreased level of cortical excitation?
505
Lateral fissure (fissure of Sylvius)
What fissure of the cerebral cortex separates the frontal and temporal lobes rostrally and partially separates the parietal and temporal lobes?
506
Frontal eye field (Brodmann area 8)
What area of the brain acts as the center for contralateral horizontal gaze?
507
The conus medullaris terminates at the level of the second lumbar vertebra.
In an adult, where does the spinal cord terminate and what is it called?
508
The fast component is directed toward the affected side of a cerebellar lesion.
If a patient with a cerebellar lesion has nystagmus, which way is the fast component directed, toward or away from the lesion?
509
Amygdala; it helps imprint an emotional response in memory.
What area of the limbic system is responsible for attaching emotional significance to a stimulus?
510
Intention tremor; it is a sign of cerebellar lesions. A tremor at rest (i.e., pill rolling) is seen in basal ganglia lesions.
What is the name of the tremor that occurs during movements and is absent while the person is at rest?
511
Confabulation; it is commonly seen in Korsakoff's syndrome.
What is the term for making up stories regarding past experiences because of an inability to retrieve them?
512
Prefrontal cortex; it is in front of the premotor area.
What frontal lobe cortex is associated with organizing and planning the intellectual and emotional aspect of behavior?
513
The substantia nigra is the largest nucleus in the midbrain. It contains melanin and uses GABA and dopamine as its neurotransmitters.
What is the largest nucleus in the midbrain?
514
Left abducens nerve
Where is the lesion that produces these symptoms when a patient is asked to look to the left? • Left eye can't look to the left
515
Right medial longitudinal fasciculus
Where is the lesion that produces these symptoms when a patient is asked to look to the left? • Right eye can't look left, left eye nystagmus, and convergence is intact
516
Left abducens nucleus or right cerebral cortex
Where is the lesion that produces these symptoms when a patient is asked to look to the left? Neither eye can look left with a slow drift to the right
517
Lateral hypothalamic zone; lesions here result in aphagia. (Notice the difference between the feeding center and the satiety center; they are in different zones.)
What area of the hypothalamus is the feeding center?
518
Indirect pathway (Tourette syndrome for example)
In what pathway of the basal ganglia do lesions result in hyperactive cortex with hyperkinetic, chorea, athetosis, tics, and dystonia?
519
The hallmarks of LMN lesion injury are absent or decreased reflexes, muscle fasciculations, decreased muscle tone, and muscle atrophy What two areas of the skin do flaccid paralysis). Don't forget, LMN lesions are ipsilateral at the level of the lesion!
What happens to muscle tone and stretch reflexes when there is a LMN lesion?
520
Direct pathway; a good example is Parkinson's disease.
In what pathway of the basal ganglia do lesions result in an underactive cortex with hypokinetic, slow, or absent spontaneous movement?
521
Contralateral muscle weakness when above the decussation, whereas an UMN injury below the pyramidal decussation results in ipsilateral muscle weakness.
What sided muscle weakness is seen in an UMN corticospinal tract injury above the pyramidal decussation?
522
Fovea
What area of the retina consists of only cones and has the greatest visual acuity?
523
The fasciculus cuneatus
What tract carries the ipsilateral dorsal column fibers from the upper limbs in the spinal cord?
524
Multiple sclerosis
What CNS demyelinating disease is characterized by diplopia, ataxia, paresthesias, monocular blindness and weakness, or spastic paresis?
525
Parasympathetic
What part of the ANS (i.e., PNS or CNS) controls the constriction of the pupil in response to light?
526
CN III
With which CN are preganglionic parasympathetic axons arising from the Edinger- Westphal nucleus associated?
527
Internal carotid artery
Ophthalmic artery is a branch of what artery?
528
The anterior nucleus of the thalamus
What thalamic relay nucleus do the mammillary bodies project to?
529
Astrocytes
What cells contribute to the blood-brain barrier and proliferate in response to CNS injury?
530
Hypermyelination of the corpus striatum and the thalamus (seen in cerebral palsy)
What causes slow writhing movements (athetosis)?
531
The limbic system
What area of the brain is responsible for emotion, feeding, mating, attention, and memory?
532
Ciliary ganglion. (These fibers are carried in CN III. Remember it like this:-ili-in ciliary ganglion looks like the III of CN III.)
What is the name of the postganglionic parasympathetic ganglion that innervates • The papillary sphincter and ciliary muscle of the eye?
533
The otic ganglion. (These fibers are carried in CN IX. Remember it like this: the -oti-is in both otic ganglion and parotid gland.)
What is the name of the postganglionic parasympathetic ganglion that innervates • The parotid gland?
534
The submandibular ganglion. (Submandibular ganglion innervates the submandibular gland; easy enough.)
What is the name of the postganglionic parasympathetic ganglion that innervates • The submandibular and sublingual glands?
535
Pterygopalatine ganglion (I remember this as the only ganglion left.)
What is the name of the postganglionic parasympathetic ganglion that innervates • The lacrimal gland and oral and nasal mucosa?
536
Preganglionic sympathetic neurons
What neuronal cell bodies are contained in the intermediate zone of the spinal cord? (T1-L2)
537
Anterior limb of the internal capsule is supplied by the anterior cerebral artery.
What limb of the internal capsule is not supplied by the middle cerebral artery?
538
Corticospinal tract
What tract is responsible for voluntary refined movements of distal extremities?
539
Rathke's pouch; they can result in compression of the optic chiasm.
Craniopharyngiomas are remnants of what?
540
Dorsal spinocerebellar tract; the accessory cuneate nucleus is the second nucleus for the cuneocerebellar tract.
Clarke's nucleus is the second ascending sensory neuron of which spinocerebellar tract?
541
Celiac, aorticorenal, and superior mesenteric ganglias. (Remember all " Splanchnics" are Sympathetic except for the Pelvic splanchnics, which are Preganglionic Parasympathetic fibers.)
Name the three postganglionic sympathetic ganglia that receive input from thoracic splanchnics.
542
CN IV
What is the only CN to arise from the dorsal surface of the midbrain?
543
The myotatic reflex is responsible for the tension present in all resting muscle.
What basic reflex regulates muscle tone by contracting muscles in response to stretch of that muscle?
544
In the ventral horn of the spinal cord. UMN cell bodies are in the precentral gyrus of the frontal lobe.
Where are the LMN cell bodies of the corticospinal tract?
545
Clarke's nucleus
What nucleus, found in the intermediate zone of the spinal cord, sends unconscious proprioception to the cerebellum?
546
The subclavian artery
The vertebral artery is a branch of what artery?
547
Tensor tympani
What muscle of the middle ear is innervated by the mandibular division of CN V?
548
VPL nucleus sends its fibers to synapse in the postcentral gyrus of the parietal lobe.
The fibers of nucleus gracilis and nucleus cuneatus cross at the medullary decussation and ascend contralateral to what thalamic relay nucleus?
549
The stapedius muscle
What muscle of the middle ear is innervated by CN VII?
550
Saccule and utricle
What part of the inner ear contains the gravity receptors for changes in the position of the head?
551
Edinger-Westphal nucleus (via CN III)
What nucleus supplies the preganglionic parasympathetic fibers to the ciliary ganglion?
552
The raphe nuclei
What reticular nuclei synthesize serotonin from L-tryptophan and plays a role in mood, aggression, and inducing sleep?
553
Patients with unilateral cerebellar lesions fall toward the side of the lesion.
Will a patient with a unilateral lesion in the cerebellum fall toward or away from the affected side?
554
Nucleus ambiguus, resulting in the uvula deviating away from the side of the lesion.
A unilateral lesion in what nucleus will produce ipsilateral paralysis of the soft palate?
555
True. They are the sensory component of a spinal reflex.
True or false? Neurons in the dorsal horn participate in reflexes.
556
Sympathetic chain ganglion
What ganglion receives preganglionic sympathetic fibers from T1 to L1-2 and innervates smooth muscle, cardiac muscle, glands, head, thoracic viscera, and blood vessels of the body wall and limbs?
557
Thoracic splanchnic fibers
What preganglionic sympathetic fibers are responsible for innervating the foregut and the midgut?
558
Light regulates the activity of the pineal gland via the retinal-suprachiasmatic- pineal pathway.
Does light or darkness regulate the pineal gland?
559
Melatonin, serotonin, and CCK
Name the three hormones produced by pinealocytes.
560
The pH of CSF is 7.33, acidotic.
Is the pH of CSF acidotic, alkalotic, or neutral?
561
The DCML system. (Remember, everything but pain and temperature.)
What ascending sensory system carries joint position, vibratory and pressure sensation, and discriminative touch from the trunk and limbs?
562
The vestibulo-ocular reflex
What reflex enables the eyes to remain focused on a target while the head is turning?
563
Rods
What cells of the retina see in black and white and are used for night vision?
564
Skeletal muscles
Name the muscle type based on these descriptions: • Discontinuous voluntary contraction, multinuclear striated unbranched fibers, actin and myosin overlapping for banding pattern, triadic T tubules, troponin and desmin as Z disc intermediate filament.
565
Cardiac muscle
Name the muscle type based on these descriptions: • Continuous involuntary contraction, uninuclear striated branched fibers, actin and myosin overlapping for banding pattern, dyadic T tubules, intercalated discs, troponin and desmin as a Z disc intermediate filament.
566
Smooth muscle
Name the muscle type based on these descriptions: • Involuntary contraction, uninuclear nonstriated fibers, actin and myosin not forming banding pattern; lack of T tubules, gap junctions, and calmodulin.
567
Duodenum
What segment of the small intestine is associated with Brunner's glands?
568
Mitochondria-linked disorders are always inherited from the mother.
Who is responsible for passing on mitochondrial DNA genetic disorders?
569
Dendrites receive information, whereas axons send information.
What part of a neuron receives information?
570
Type IV collagen
What type of collagen is associated with the basement membrane?
571
Transitional epithelium. The distal portion of the penile urethra is composed of stratified epithelium.
What is the epithelial lining of the prostatic portion of the urethra?
572
Juxtaglomerular (JG) cell
What cell of the nephron is responsible for renin production and secretion?
573
Cilia
What cell surface modification of ependymal cells and respiratory epithelium has a 9 + 2 microtubular configuration and movement as its function?
574
True. (They are quite a busy bunch of cells!)
True or false? The following are functions of hepatocytes: protein production, bile secretion, detoxification, conjugation, and lipid storage.
575
Major basic protein
What substance found in eosinophils is toxic to parasitic worms?
576
Granulose cells secrete progesterone. After fertilization the granulose cells form from follicular cells.
After fertilization, what cells of the corpus luteum • Secrete progesterone?
577
Theca cells secrete estrogen. After fertilization the theca cells form from the theca interna.
After fertilization, what cells of the corpus luteum • Secrete estrogen?
578
Integument (skin and its derivatives)
What is the largest organ in the body?
579
Malpighian layer (made up of the stratum basale and stratum spinosum)
On what layer of the epidermis does all mitosis occur?
580
The small subunit (40S) binds first.
What ribosomal subunit binds first to the mRNA strand?
581
PALS
What is the T-cell area of the spleen?
582
Copper (Cu+)
What element is needed for the proper alignment of tropocollagen molecules?
583
Zonula occludens (tight junctions)
What type of cell surface projection lies on the lateral surface of cells closest to the apex and acts to seal off the outside environment from the rest of the body?
584
Nucleolus. Ribosomal assembly also takes place in the nucleolus.
What organelle is responsible for ribosomal RNA synthesis?
585
APocrinE glands (APES is my memory aid) Axilla, Areola, and Anus all begin with A. APES are hairy (associated with hair follicles). They smell (odor production), and if confronted by an APE, your Adrenergic nervous system would be firing (innervation).
What sweat gland type is associated with odor production and hair follicles and is found in the axilla?
586
Fungiform papillae
What papillae send their senses via chorda tympani of CN VII?
587
True. (Remember, blood flows from the portal tracts to the central vein, so it is the first area to receive blood and therefore oxygen.)
True or false? The portal tract of the liver lobule is the first area to be oxygenated in the liver.
588
Spermatogonia (type A)
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 46/2n (divide meiotically)
589
Primary spermatocyte
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 46/4n
590
Spermatid
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 23/1n
591
Spermatogonia (type B)
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 46/2n (divide mitotically)
592
Secondary spermatocyte
Match the chromosome and haploid number with the stage of sperm development, spermatid, spermatocyte (primary or secondary), spermatogonia (type A or B): • 23/2n
593
Steroid synthesis, drug detoxification, triglyceride resynthesis, and Ca2+handling
What are the four functions of SER?
594
IgA
Which immunoglobulin is secreted by the plasma cells in the gastrointestinal tract?
595
The inner cortex (paracortex) contains the T cells, so it is considered the thymic-dependent area.
What area of the lymph node is considered the thymic-dependent area?
596
Heterochromatin, the light stuff in the nucleus on an electron microscope image.
What type of chromatin is transcriptionally inactive?
597
Submandibular gland produces mainly serous and the sublingual gland produces mainly mucous secretions.
Both submandibular and sublingual glands are innervated by CN VII (facial) and produce mucous and serous secretions. Which one mainly produces serous secretions?
598
Microglia. All others are neuroectodermal derivatives.
What is the only neuroglial cell of mesodermal origin?
599
Outside the cell
Where is tropocollagen aggregated to form a collagen fibril?
600
1. Phosphorylation of mannose (lysosomes only) 2. Removal of mannose residues 3. Formation of glycosylate proteins 4. Phosphorylation of sulfate amino acids
What are the four posttranslational modifications done by the Golgi apparatus?
601
Stratified squamous nonkeratinized epithelium, which has cilia that beat toward the oropharynx.
What is the epithelial cell lining the nasopharynx?
602
1. Nails 2. Hair 3. Sweat glands (both apocrine and sebaceous)
What are the three epidermal derivatives?
603
Stereocilia
What are the long microvilli in the inner ear and male reproductive tract called?
604
True. Blood flows from the portal tracts (distal) to the central vein (proximal), so it is the first area affected during hypoxia.
True or false? The central vein of the liver lobule is the first area affected during hypoxia.
605
Leydig cells produce testosterone. LH stimulates Leydig cells. (Both start with L.)
What cell of the male reproductive system produces testosterone?
606
In the PNS, myelin is produced by Schwann cells, in the CNS by oligodendrocytes.
Myelin is produced by which cells in the PNS? In the CNS?
607
Langerhans cells (found in the stratum spinosum)
What cell type of the epidermis functions as antigen-presenting cells?
608
B cells are mainly found in the peripheral white pulp and germinal centers in the spleen.
What cell type is found in the peripheral white pulp of the spleen?
609
The vagina
What area of the female reproductive tract is lined by stratified squamous epithelium rich in |glycogen?
610
Thymus gland. (Thymus gland is essential for T cell maturation.)
What encapsulated lymphoid organ is characterized by presence of Hassall's corpuscles, and absence of germinal centers and B cells?
611
M-cells
What cell transports IgA, is secreted by plasma cells, and is in Peyer's patches to the gastrointestinal lumen?
612
Chief cells
What are the cells of the parathyroid gland that produce PTH?
613
Thick skin
What skin type on the palms and soles is characterized by the absence of hair follicles and presence of stratum lucidum?
614
Gap junctions
What is the name of hydrophilic pores that allow the direct passage of ions and particles between two adjacent cells?
615
Secondary lysosome (think of the primary as inactive and secondary as active)
What type of lysosome is formed when lysosome fuses with a substrate for breakdown?
616
Microvillus
What cell membrane structure increases the surface area of a cell and has actin randomly assorted within its structure?
617
1. Laminin 2. Heparan sulfate (heparitin sulfate) 3. Fibronectin 4. Type IV collagen
What are the four components of the basement membrane?
618
Free polysomes. Membrane-associated polysomes are the site of protein synthesis destined to leave the cell.
What organelle synthesizes proteins that are intended to stay within the cell?
619
Parietal cells (Remember, they secrete HCl, too.)
What cell type of the body or fundus of the stomach secretes IF?
620
Chief cells
What cell type of the body or fundus of the stomach secretes pepsinogen?
621
Estrogen; the first 14 days of the female reproductive cycle mark the proliferative phase.
What hormone, produced by the granulose cell, stimulates the endometrium to enter the proliferative phase?
622
Macula densa
What cells of the nephron function as sodium concentration sensors of the tubular fluid?
623
Euchromatin, the dark stuff in the nucleus on an electron microscope image.
What type of chromatin is transcriptionally active?
624
Parafollicular C cells
What cells of the thyroid gland secrete calcitonin?
625
True. Transcription (conversion of DNA to RNA), as well as replication, occurs in the nucleus.
True or false? The nucleus is the site of transcription.
626
One day after the LH surge and 2 days after the estrogen peak.
How many days after the LH surge is ovulation?
627
Stratum spinosum
In what layer of the epidermis is melanin transferred from melanocytes to keratinocytes?
628
Merkel cells (Merkel's tactile cells)
What cells of the epidermis, derived from the neural crest, act as mechanoreceptors?
629
Renin
What substance do the JG cells of the kidney secrete in response to low blood pressure?
630
Upper third skeletal muscle, middle third both skeletal and smooth muscle, and lower third smooth muscle
What is the rule of one-third regarding muscle type of the esophagus?
631
Circumvallate papillae
What papillae are responsible for sweet taste?
632
The outer cortex contains most of the germinal centers and therefore also most B cells.
What area of the lymph node contains germinal centers?
633
False. The gallbladder does not produce bile, but it concentrates bile via active sodium transport; water follows the sodium.
True or false? The gallbladder functions to produce bile.
634
True. Hyperpolarization inhibits the postsynaptic membrane.
True or false? Depolarization of the postsynaptic membrane excites the neuron.
635
Type I pneumocytes
In the alveoli, what cell type is • for gas exchange?
636
Type II pneumocytes
In the alveoli, what cell type is • responsible for producing surfactant?
637
Alveolar macrophages (dust cells)
In the alveoli, what cell type is • part of the mononuclear phagocytic system?
638
Syncytiotrophoblast. (The cytotrophoblast gets incorporated into the syncytiotrophoblast.)
Which trophoblast layer of the placenta remains until the end of pregnancy?
639
Stratum lucidum
What is the first epidermal layer without organelles and nuclei
640
Ileum
What area of the small intestine is characterized by Peyer's patches?
641
Lymph nodes
What lymphoid organ has the following characteristics: outer and inner cortical areas, encapsulation, germinal centers, and high endothelial venules?
642
Collecting ducts, which make them readily permeable to water reabsorption.
What area of the nephron is sensitive to the effects of ADH?
643
Nissl substances; there is a great deal of RER in neuron cell bodies, indicating high protein synthesis.
What is the name of RER in neurons?
644
Oxytocin
What hormone causes milk letdown?
645
1. Tight junctions 2. Capillaries that lack fenestration 3. Very selective pinocytosis by the capillaries
What are the three reasons for the effectiveness of the blood-brain barrier?
646
Melanocytes
What cell type of the epidermis originates from the neural crest?
647
12 days after ovulation
If no fertilization occurs, how many days after ovulation does the corpus luteum begin to degenerate?
648
Red pulp (Remember, Red pulp and RBCs begin with R.)
What area of the spleen consists of splenic cords of Billroth and phagocytoses RBCs?
649
Vimentin
What is the name of the protein coat that surrounds the nuclear envelope?
650
Filiform papillae
What papillae are touch receptors on the tongue and send their sensations via CN V3 (mandibular division)?
651
Stratum corneum (keratinized)
What is the most superficial layer of the epidermis?
652
Kartagener's syndrome (also known as immotile cilia syndrome) --------------------------------------------------------------------------------
What syndrome is characterized by dynein arm abnormality resulting in chronic sinusitis, recurrent pulmonary infections, and infertility?
653
To provide attachment between contiguous cells and to maintain a semipermeable barrier
What are the functions of the zonula occludens and the zonula adherens
654
Sarcoplasmic reticulum
What is the name of the SER of striated muscle?
655
Ductus epididymis, which is lined by pseudostratified epithelium with stereocilia.
Where do sperm go for maturation?
656
Prophase of meiosis I (between 12th and 22nd week in utero)
When is the first arrested stage of development in the female reproductive cycle?
657
PCT
What is the longest and most convoluted segment of the nephron?
658
Keratinocytes, the most numerous cells in the epidermis, carry melanin and produce keratin.
What cells of the epidermis carry the pigment melanin?
659
Large intestine. Water is passively removed from the lumen.
What segment of the gastrointestinal tract lacks villi, has crypts, and actively transports sodium out of its lumen?
660
Palms and soles of the feet. Sebaceous glands are associated with hair follicles, which are lacking on the palms and soles of the feet.
What two areas of the skin do not contain sebaceous glands?
661
Alveoli; they are part of the respiratory portion.
Which of the following is not part of the conducting portion of the respiratory system: trachea, bronchi, alveoli, or larynx?
662
The inner membrane of the mitochondria (cristae)
Where are the enzymes for the ETC and oxidative phosphorylation found?
663
Peyer's patch
What lymphoid organ is characterized by germinal centers, plasma cells that secrete IgA, and no encapsulation?
664
Kinesins. Dynein generates retrograde transportation of information.
What generate anterograde transport of information in a neuron?
665
Hyaluronic acid (all sulfates bind to the core protein)
What is the only glycosaminoglycan (GAG) that binds to the linker portion of the proteoglycan?
666
Osteoclasts
What cell in bone is a part of the mononuclear phagocytic system?
667
Inhibin, müllerian-inhibiting factor, and androgen binding protein
What three factors do Sertoli cells produce for normal male development?
668
Stratum granulosum
What epidermal layer's function is to release lipids to act as a sealant?
669
An internal elastic lamina
What does the tunica intima of arteries have that veins do not?
670
Duct cells secrete HCO3-, electrolytes, and water. The acini secrete the enzymes necessary for carbohydrate, nucleic acid, protein cleavage, and emulsification of fats.
Do the duct or the acini cells of the pancreas secrete HCO3-?
671
Paneth cells
What cell of the duodenum contains high concentrations of lysozymes and has phagocytic activity?
672
The venae recta maintain the gradient via countercurrent flow.
What maintains the osmotic gradient that is critical to the concentrating ability of the kidney?
673
Afferent arteriole
Are the JG cells of the nephron a part of the afferent or efferent arteriole?
674
Enteroendocrine (EE) cells; they also secrete secretin.
What cell of the duodenum secretes CCK?
675
Chondroitin sulfate and keratan sulfate
What are the proteoglycans of cartilage and bone?
676
Menses. (Ovulation occurs 14 days before the beginning of menses.)
What is the term for the first 3 to 5 days of the female reproductive cycle?
677
Metaphase of meiosis II (in the oocyte of the graafian follicle)
What is the second arrested stage of development in the female reproductive cycle?
678
60S and 40S. The large subunits (60S) are made in the nucleolus and the small subunits (40S) are made in the nucleus.
What ribosomal subunit sizes do eukaryotic cells have?
679
Saltatory conduction
What term describes how an action potential is propagated along an axon?
680
The secretory phase is progesterone-dependent and 14 days long, whereas the length of the proliferative phase varies
What phase of the female reproductive cycle is 14 days long?
681
Polysome. Ribosomes read from the 5' to the 3' end of the mRNA.
A single mRNA strand translated by a ribosome is termed what?
682
Sertoli cell
What cell is under control of FSH and testosterone; secretes inhibin, MIF, and androgen-binding protein; and phagocytizes the excess cytoplasm of the spermatid?
683
H1 histones
What histone binds two nucleosomes together?
684
Hydroxyapatite
What is the major inorganic component of bone?
685
Chromaffin cells (adrenal medulla)
What cells of the adrenal gland are neural crest derivatives?
686
In the peroxisome until it is 10 carbons long; the rest is completed in the mitochondria.
Where does Beta-oxidation of very long chain fatty acids begin?
687
Mitochondria
What organelles make ATP, have their own dsDNA, and can synthesize protein?
688
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
How do delusions, illusions, and hallucinations differ?
689
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage, removing the causative agent, and giving cyproheptadine.
What syndrome is characterized by sweating, insomnia, nausea, diarrhea, cramps, delirium, and general restlessness secondary to MAOI and SSRI in combination?
690
18 years old (except if emancipated)
What is the legal age to be deemed competent to make decisions?
691
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
With what stage of sleep is enuresis associated?
692
Confounding bias
When more than one explanation can account for the end result, what form of bias occurs?
693
Increased GABA levels decrease the likelihood of learned helplessness.
Increased levels of what neurotransmitter, in the hippocampus, decrease the likelihood of learned helplessness?
694
By causing rebound insomnia and decrease in REM sleep
How does ceasation of barbiturate use affect sleep?
695
Spearman correlation
What type of correlation compares two ordinal variables?
696
Klüver-Bucy syndrome
What syndrome is characterized by bilateral medial temporal lobe lesion, placidity, hyperorality, hypersexuality, hyperreactivity to visual stimuli, and visual agnosia?
697
Transvestite fetishism
What is the term for having fantasies or dressing in female clothes for sexual arousal by heterosexual men?
698
Somatoform disorder
What disorder is described as having • Unconscious symptoms with unconscious motivation?
699
Malingering
What disorder is described as having • Conscious symptoms with conscious motivation?
700
Factitious disorder
What disorder is described as having • Conscious symptoms with unconscious motivation?
701
Reliability (think of it as "nice grouping" or "precise")
What is the term for the ability of a test to measure something consistently?
702
Small to medium-sized cerebral vessels
What cerebral vessel size is affected in patients with vascular dementia?
703
Al-Anon
What is the name of the program that deals with codependency and enabling behaviors for family members of alcohol abusers?
704
Profound (I.Q. range < 20)
What level of mental retardation is characterized by • Needing a highly structured environment with constant supervision?
705
Severe (range 20-34)
What level of mental retardation is characterized by • Having the ability to communicate and learn basic habits but training is usually not helpful?
706
Mild (50-70)
What level of mental retardation is characterized by • Being self-supportive with minimal guidance and able to be gainfully employed (includes 85% of the mentally retarded)?
707
Moderate (35-49)
What level of mental retardation is characterized by • Can work in sheltered workshops and learn simple tasks but need supervision?
708
Introjection (a sports fan is a good example)
Name these immature defense mechanisms: • Taking others' beliefs, thoughts, and external stimuli and making them part of the self. (Hint: if it's done consciously, it is called imitation.)
709
Regression
Name these immature defense mechanisms: • Returning to an earlier stage of development (e.g., enuresis)
710
Blocking
Name these immature defense mechanisms: • Inability to remember a known fact (aware of forgetting)
711
Somatization
Name these immature defense mechanisms: • Psychic feelings converted to physical symptoms
712
Premature ejaculation
What is the term for ejaculation before or immediately after vaginal penetration on a regular basis?
713
Concrete operations (6-12 years)
At what stage of cognitive development (according to Piaget) do children • See death as irreversible?
714
Formal operations (> 12 years)
At what stage of cognitive development (according to Piaget) do children • Have abstract thinking?
715
Preoperational (2-6 years)
At what stage of cognitive development (according to Piaget) do children • Lack law of conservation and be egocentric?
716
No, it is never acceptable to lie.
Is it acceptable to lie, even if it protects a colleague from malpractice?
717
Prevalence increases. (Note: Incidence does not change.)
What happens to prevalence as duration increases?
718
REM sleep. Nightmares are frightening dreams that we recall.
With what stage of sleep are nightmares associated?
719
Specificity (it deals with the healthy)
What is the statistical term for the proportion of truly nondiseased persons in the screened population who are identified as nondiseased?
720
Total and NREM sleep decrease considerably as we age, but REM sleep remains relatively constant (20%) up to age 80, then begins to decline.
In the elderly, what happens to total sleep time, percentage of REM sleep, and percentage of NREM sleep?
721
Dopamine levels rise with waking; dopamine is associated with wakefulness.
What happens to dopamine levels when we awaken?
722
Previous suicide attempt
What is the primary risk factor for suicide?
723
IQ
What is defined as a general estimate of the functional capacities of a human?
724
These are the gross pathologic changes associated with Alzheimer's disease.
What dementia is associated with dilated ventricles with diffuse cortical atrophy, decreased parietal lobe blood flow, and a decrease in choline acetyl transferase activity?
725
Hypoactive sexual desire disorder
What is the term for a deficiency or absence of sexual fantasies or desires?
726
Agoraphobia. It also means having a sense of humiliation or hopelessness.
What phobia is described as the fear of open spaces?
727
Venlafaxine. (It also has a mild dopaminergic effect.)
What antidepressant, which recently was approved for general anxiety disorder, inhibits the reuptake of NE and 5-HT?
728
Substituted judgment. It is made by the person who best knows the patient, not the closest relative.
What judgment states that the decision, by rights of autonomy and privacy, belongs to the patient, but if the patient is incompetent to decide, the medical decision is based on subjective wishes?
729
Native Americans
What ethnic group has the highest adolescent suicide rate?
730
Senile plaques, neurofibrillary tangles, and granulovascular changes in neurons
What are the three microscopic pathologic changes seen in Alzheimer's disease?
731
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
When does most REM sleep occur, in the first or second half of sleep?
732
Flumazenil
What is the name of the benzodiazepine antagonist used in the treatment of an overdose?
733
Projective drawing. The artistic form is irrelevant, but the size, placement, erasures, and distortions are relevant.
What type of test asks a patient to draw a scene, attempting to find out the individual's unconscious perceptions in his or her life?
734
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
What is the biochemical trigger for REM sleep?
735
Bender Visual Motor Gestalt Test
What neuropsychologic test shows nine designs to the patient, then asks for recall of as many as possible?
736
1. Short attention span 2. Impulsivity 3. Hyperactivity
What are the three characteristics of ADHD?
737
It is rare with normal grief; however, it is relatively common in depression
Is suicidal ideation a component of normal grief?
738
During REM sleep
In what stage of sleep is it easiest to arouse a sleeping individual?
739
Nominal scale (categorical, e.g., male or female)
What scale separates things into groups without defining the relationship between them?
740
Confidence interval. It is a way of admitting estimation for the population.
What specifies how accurately the sample values and the true values of the population lie within a given range?
741
For the USMLE Step 1 the answer is no, but if the information would do more harm than good, withhold. This is very rare but it does occur.
If the family member of a patient asked you to withhold information, would you?
742
Huntington's chorea. (Death in 15-20 years, often via suicide.)
What AD dementia has a defect in chromosome 4, onset between the ages of 30 and 40, choreoathetosis, and progressive deterioration to an infantile state?
743
100%, with about 20% remaining positive after 1 year
What percentage of children born to HIV-positive mothers will test positive for HIV at birth?
744
Separation anxiety
Name the reaction that appears in babies who are temporarily deprived of their usual caretaker. (This reaction usually begins around 6 months of age, peaks around 8 months, and decreases at 12 months.)
745
Clonidine
Which drug is used to treat opioid withdrawal, ADHD, and sometimes Tourette's syndrome?
746
Chromosome 15
What chromosome is autism linked to?
747
Positive correlation
What type of correlation is defined as • Two variables that go together in the same direction?
748
Zero correlation
What type of correlation is defined as • Two variables with no linear relation to one another?
749
Negative correlation
What type of correlation is defined as • One variable that diminishes in the presence of the other?
750
Norm reference (i.e., 75% of the students in the class will pass)
When the results of a test are compared to findings for a normative group, what form of reference does the objective test use?
751
Null hypothesis (what you hope to disprove)
What hypothesis states that the findings of a test are a result of chance?
752
Anhedonia
What is the term to describe the inability to feel any pleasant emotions?
753
Vaginismus; it is the female counterpart of premature ejaculation.
What is the term for involuntary constriction of the outer third of the vagina to prevent penile penetration?
754
Test-retest reliability
What is the term for the same results achieved again on testing a subject a second or third time?
755
At birth (reflex)
At what age does a child develop • Endogenous smile?
756
8 weeks (response to a face)
At what age does a child develop • Exogenous smile?
757
12 to 16 weeks (in response to mother's face)
At what age does a child develop • Preferential smile?
758
Id
Per Freud, with what part of the unconscious are sex and aggression (instincts) associated?
759
Acetaldehyde dehydrogenase. When this enzyme is blocked, acetaldehyde builds up, and its presence in excess results in nausea and hypotension.
What enzyme is inhibited by disulfiram?
760
It is best to begin with open-ended questions, allowing patients to describe in their own words what troubles them. You can then move to closed-ended questions when narrowing the diagnosis.
What type of questions should you begin with when a patient seeks your medical opinion?
761
Fixed interval
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • On a set time schedule?
762
Fixed ratio (rewards set behaviors)
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • After a set number of responses?
763
Variable interval
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • Varying in time?
764
Variable ratio If it is based on time, it is an interval, and if it is based on the number of responses, it is a ratio.
What type of scheduled reinforcement states that after a desired response, the reinforcement is given • Varying in the number of responses?
765
Phallic stage (4-6 years)
At what stage of psychosexual development (according to Freud) do children fear castration?
766
Very superior (<2.5% of the population)
What is the label given to an individual whose IQ is • 130
767
High average
What is the label given to an individual whose IQ is • 110 to 119
768
Low average
What is the label given to an individual whose IQ is • 80 to 89
769
Borderline
What is the label given to an individual whose IQ is 70 to 79
770
Average
What is the label given to an individual whose IQ is • 90 to 109
771
Mentally disabled
What is the label given to an individual whose IQ is • Below 69
772
Superior
What is the label given to an individual whose IQ is • 120 to 129
773
Stage 4
At what stage of sleep is GH output elevated?
774
Case control studies cannot assess incidence or prevalence, but they can determine causal relationships.
Can incidence, prevalence, and cause and effect be assessed in • Case control studies?
775
Cross-sectional studies determine prevalence, not incidence or cause and effect.
Can incidence, prevalence, and cause and effect be assessed in • Cross-sectional studies?
776
Cohort studies determine incidence and causality, not prevalence.
Can incidence, prevalence, and cause and effect be assessed in • Cohort studies?
777
NO!! Remember, only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
Can a physician commit a patient?
778
1. Benefits of the procedure 2. Purpose of the procedure 3. Risks of the procedure 4. The nature of the procedure (what you are doing) 5. The alternative to this procedure and its availability (Don't forget the last one; this is where physicians get in trouble.)
What are the five pieces of information considered necessary for fully informed consent?
779
Prevalence rate
What is the term for the number of individuals who have an attribute or disease at a particular point in time?
780
Validity (remember, reliability is necessary but not the only thing needed for validity)
What is the term for the degree to which a test measures what it is intended to measure?
781
Id (pleasure principle)
What Freudian psyche component is described as • The urges, sex aggression, and "primitive" processes?
782
Superego
What Freudian psyche component is described as • The conscience, morals, beliefs (middle of the road)?
783
Ego
What Freudian psyche component is described as • Reality, rationality, language basis?
784
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
What medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity?
785
Neologisms. Thomas Jefferson noted, "Necessity obliges us to neologize." (Abnormal use of neologisms is known as neolalism.)
What is the term for new made-up words?
786
Standardized rate
What rate removes any difference between two populations, based on a variable, to makes groups equal?
787
Yes. The only civil liberty they lose is the freedom to come and go as they please.
Can committed mentally ill patients refuse medical treatment?
788
Reinforcement
What is the term for any stimulus that increases the probability of a response happening?
789
No, but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Does REM deprivation interfere with performance on simple tasks?
790
Dependent
Name the cluster C personality disorder: • Gets others to assume responsibility, is subordinate, and is fearful of being alone and caring for self
791
Obsessive-compulsive
Name the cluster C personality disorder: • Orderly, inflexible, perfectionist; makes rules, lists, order; doesn't like change, has a poor sense of humor, and needs to keep a routine
792
Avoidant
Name the cluster C personality disorder: • Sensitive to criticism, shy, anxious; socially isolated but yearns to be in the crowd
793
Sexual aversion disorder
What is the term for a complete aversion to all sexual contact?
794
Type I symptoms (positive); schizophrenics have them, but otherwise healthy persons do not.
What type of symptoms in schizophrenia are associated with • Dopamine receptors?
795
Type II symptoms (negative); otherwise healthy persons have them, but schizophrenics do not.
What type of symptoms in schizophrenia are associated with • Muscarinic receptors (ACh)?
796
NREM sleep. Remember awake body, sleeping brain
What general pattern of sleep is described by slowing of EEG rhythms (high voltage and slower synchronization), muscle contractions, and lack of eye movement or mental activity?
797
No, it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
Is spousal abuse a mandatory reportable offense?
798
Formation of an identity through issues of independence and rebellion; they define who they are.
What is the key issue surrounding teenagers' maturation?
799
As the standard deviation increases, the greater the chance of error.
What is the relationship between chance of error and • Standard deviation?
800
As sample size increases, the lower the chance of error.
What is the relationship between chance of error and • Sample size?
801
Histrionic
Name the cluster B personality disorder: • Colorful, dramatic, extroverted, seductive, and unable to hold long-term relationships
802
Borderline
Name the cluster B personality disorder: • In a constant state of crisis, promiscuous, unable to tolerate anxiety-causing situations, afraid of being alone, and having intense but brief relationships
803
Antisocial
Name the cluster B personality disorder: • Criminal behavior; lacking friends, reckless, and unable to conform to social norms
804
Narcissistic
Name the cluster B personality disorder: • Grandiose sense of self-importance; demands constant attention; fragile self-esteem; can be charismatic
805
Look for broken blood vessels in the baby's eyes.
In what organ system would you attempt to localize a sign for shaken baby syndrome"? What do you look for?
806
Infant Doe. Generally, parents cannot forego lifesaving treatment, but this case states that there are exceptions to the rule.
What case is known as "let nature take its course"?
807
Reject it
If the P value is less than or equal to .05, what do you do to the null hypothesis?
808
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
809
TAT (Thematic apperception test)
What projective test asks the patient to tell a story about what is going on in the pictures, evaluating the conflicts, drives, and emotions of the individual?
810
Bell pad
What has proved to be the best way to extinguish enuresis?
811
Ordinal scale (e.g., faster/slower, taller/shorter)
What scale assesses a rank order classification but does not tell the difference between the two groups?
812
Hypothyroidism. (TSH levels must be monitored.)
What is associated with prolonged lithium use?
813
Ratio scale
What scale has a true zero point, graded into equal increments, and also orders them?
814
6 years old
By what age should children be able to draw the following figures? • Triangle
815
4 years old
By what age should children be able to draw the following figures? • Cross
816
7 years old
By what age should children be able to draw the following figures? • Diamond
817
5 years old
By what age should children be able to draw the following figures? • Square
818
3 years old
By what age should children be able to draw the following figures? • Circle
819
4.5 years old (Alphabetic order except with a diamond last: circle, cross, rectangle, square, triangle)
By what age should children be able to draw the following figures? • Rectangle
820
Antisocial personality
What personality disorder affects 75% of the prison population?
821
Stanford-Binet Scale, developed in 1905, is useful in the very bright, the impaired, and children less than 6 years old.
What is the first formal IQ test used today for children aged 2 to 18?
822
Foods rich in tyramine (e.g., cheese, dried fish, sauerkraut, chocolate, avocados, and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
What type of foods should patients taking MAOIs avoid? Why?
823
Stranger anxiety
What form of anxiety, appearing at 6 months, peaking at 8 months, and disappearing by 1 year of age, is seen in the presence of unfamiliar people?
824
1. Protest 2. Despair 3. Detachment
What are the three stages that children aged 7 months to 5 years go through when they are separated from a primary caregiver for a long time?
825
1. Skin color 2. Heart rate 3. Reflexes 4. Muscle tone 5. Respiratory rate APGAR, Appearance, Pulse, Grimace, Activity, Respiration
What five things are checked in the APGAR test?
826
Birth defects, low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS), and SIDS
What are the top three causes of infant mortality?
827
Moving objects, along with large bright objects with curves and complex designs.
Do newborns have a preference for still or moving objects?
828
Alcoholics Anonymous
What is the name of the 12-step program believed to be the most successful for the treatment of alcohol abuse?
829
Long-term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?
830
Trazodone
What serotonin reuptake inhibitor's major sexual side effect is priapism?
831
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
What is the central issue regarding the Roe vs. Wade decision (legalization of abortion)?
832
The biofeedback model is based on the parasympathetic nervous system.
What part of the ANS is affected in the biofeedback model of operant conditioning?
833
Sensitivity (it deals with the sick)
The proportion of truly diseased persons in the screened population who are identified as diseased refers to?
834
At least 15%
How far below ideal body weight are patients with anorexia nervosa?
835
False. These beliefs are characteristic of people with an external locus of control.
True or false? According to social learning theory, people who believe that luck, chance, or the actions of others control their fate have an internal locus of control.
836
Anorgasmia. (The overall prevalence is 30%.)
What is the term for an inhibited female orgasm?
837
1. Incompetent patient (determined by the courts) 2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer) 3. Waiver signed by the patient 4. Emergency
What are the four exceptions to requirements for informed consent?
838
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
What is the term for recurrent and persistent pain before, after, or during sexual intercourse?
839
Selection bias
What type of bias is it when the sample population is not a true representative of the population?
840
During stage 3 and 4 (remember, it is called deep sleep.)
In what stage of sleep is it hardest to arouse a sleeping individual?
841
REM latency; normally it is about 90 minutes.
What is the period between falling asleep and REM sleep called?
842
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent, so no one knew what the patient would have wanted. Therefore, the decision was based on what a "reasonable" person would have wanted.
What case is best known for use of the "best interest standard"?
843
Disulfiram
What drug is used to prevent alcohol consumption by blocking aldehyde dehydrogenase?
844
Superego
According to Freud, what facet of the psyche represents the internalized ideals and values of one's parents?
845
Melatonin. It is a light-sensitive hormone that is associated with sleepiness.
What pineal hormone's release is inhibited by daylight and increased dramatically during sleep?
846
Somatization disorder
What somatoform disorder is described as • Having a F:M ratio of 20:1, onset before age 30, and having 4 pains (2 gastrointestinal, 1 sexual, 1 neurologic)?
847
Conversion disorder
What somatoform disorder is described as • La belle indifférence, suggestive of true physical ailment because of alteration of function?
848
Body dysmorphic disorder
What somatoform disorder is described as • Unrealistic negative opinion of personal appearance, seeing self as ugly?
849
Hypochondriasis (they will begin with "I think I have...")
What somatoform disorder is described as • Preoccupied with illness or death, persisting despite reassurance, lasting longer than 6 months?
850
Somatoform pain disorder
What somatoform disorder is described as • Severe, prolonged pain that persists with no cause being found, disrupts activities of daily living?
851
One-way ANOVA
What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?
852
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive-compulsive disorder and learning disabilities.
What disease is described by the following characteristics: multiple motor and vocal tics, average age of onset 7, a M:F ratio of 3:1, and association with increased levels of dopamine?
853
Substantia nigra
In Parkinson's disease, what area of the basal ganglia has a decreased amount of dopamine?
854
Enkephalins
What naturally occurring substances mimic the effects of opioids?
855
Generalized anxiety disorder
What disorder, experienced more than half of the time for a 6-month period, is described as being fearful, worrisome, or impatient and having sleep disturbances, poor concentration, hyperactivity, and an overall sense of autonomic hyperactivity?
856
50%. The uncles and older siblings are the most likely perpetrators, although stepfathers also have a high rate.
What percent of sexual abuse cases are committed by family members?
857
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
Kaiser-Fleischer rings, abnormal copper metabolism, and ceruloplasmin deficiency characterize what disease, which may include symptoms of dementia when severe?
858
School phobia
To what does failure to resolve separation anxiety lead?
859
Mean
What is the term to describe the average?
860
It increases REM and total sleep time.
How does L-tryptophan affect sleep?
861
Your duty is to tell the patient, not the family. The patient decides who gets to know and who doesn't, not you.
Should information flow from the patient to the family or vice versa?
862
Yes, as long the illness does not threaten limb or life. If illness is critical or an emergency, treat the child.
Can parents withhold treatment from their children?
863
Alternative hypothesis (what is left after the null has been defined)
What is the name of the hypothesis you are trying to prove?
864
50%, with 50% of them having the child
What percent of unwed mothers are teenagers?
865
Increased REM sleep, decreased REM latency, and decreased stage 4 sleep, leading to early morning awakening
What happens to REM, REM latency, and stage 4 sleep during major depression?
866
Substance P. (Opioids relieve pain in part by blocking substance P.)
What 11-amino acid peptide is the neurotransmitter of sensory neurons that conveys pain from the periphery to the spinal cord?
867
True. In positively skewed distributions the mode is less than the median is less than the mean.(Remember to name a skewed distribution: the tail points in the direction of its name. positive skew tails point to the positive end of a scale.)
True or false? In a positively skewed curve the mean is greater than the mode.
868
Loose association
What is the term to describe jumping from one topic to the next without any connection?
869
Pregnancy
What is the leading cause of school dropout?
870
1. Sleep paralysis 2. Hypnagogic hallucinations (while falling asleep) 3. Sleep attacks with excessive daytime sleepiness 4. Cataplexy (pathognomonic) Narcolepsy is a disorder of REM sleep, with REM occurring within 10 minutes of sleep.
Name the four components of the narcoleptic tetrad.
871
Cortisol levels increase. Lymphocyte levels decrease in sleep-deprived individuals.
What happens to cortisol levels in sleep-deprived individuals?
872
Sleep latency
What is the period between going to bed and falling asleep called?
873
Dysthymia, which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
What disorder is characterized by a depressed mood and a loss of interest or pleasure for more than 2 years?
874
Operant conditioning (reinforcement is after a response)
What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
875
TSH. 5-HT and prolactin increase during sleep, and dopamine levels decrease during sleep.
What pituitary hormone is inhibited during sleep?
876
Punishment
Based on operant conditioning, what type of reinforcement is described when • Adding a stimulus stops a behavior?
877
Extinction
Based on operant conditioning, what type of reinforcement is described when • Removing a stimulus stops a behavior?
878
Positive reinforcement
Based on operant conditioning, what type of reinforcement is described when • Adding a stimulus reinforces a behavior?
879
Negative reinforcement
Based on operant conditioning, what type of reinforcement is described when • Removing a stimulus reinforces a behavior?
880
(MA/CA) x 100 = IQ score, where MA = mental age and CA = chronological age
What is the formula to calculate IQ?
881
Decrease (5-HT and dopamine levels do the same)
What happens to NE levels in • Major depression?
882
Increase (5-HT and dopamine levels do the same)
What happens to NE levels in • Bipolar disorder?
883
Good Samaritan Law. (Physicians are not required to stop and help.)
What law was adopted to shield physicians from liability when helping at the scene of an accident?
884
Incidence rate
What is the term for the number of new events occurring in a population divided by the population at risk?
885
Dissociative fugue. (Patients are unaware of memory loss.)
What is the term to describe inability to recall the past and possible assumption of a completely new identity?
886
Aversive conditioning
What classical conditioning therapy or modification is described as • Pairing noxious stimuli to an inappropriate behavior?
887
Exposure
What classical conditioning therapy or modification is described as • Forcing patients to confront their fears by being exposed to them until they are extinguished?
888
Systematic desensitization
What classical conditioning therapy or modification is described as • Triage of a hierarchy of fears (from least to most), then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
889
Recall bias. These problems arise in retrospective studies.
Failure to accurately recall the past leads to what form of bias?
890
Inversely proportional: the higher the potency, the lower the anticholinergic side effects.
Regarding neuroleptics, what is the relationship between potency and anticholinergic side effects?
891
Agranulocytosis; approximately 2% develop this side effect.
What potentially lethal side effect of clozapine should be monitored with frequent blood drawing?
892
True; also, stressful marriage, early sexual experiences in the back of a car, and sex with a prostitute all increase the risk of premature ejaculation.
True or false? Being college educated increases a man's risk of having premature ejaculation.
893
Specific rate (e.g., men aged 55-60)
What is the term for the rate measured for a subgroup of a population?
894
Latency stage (6-12 years)
In what stage of psychosexual development, according to Freud, do children resolve the Oedipus complex?
895
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
Where is lithium metabolized and excreted?
896
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.
At what age do children begin to understand the irreversibility of death?
897
Oxazepam, temazepam, and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation, not via the cytochrome p450 system.
What are the three benzodiazepines that do not undergo microsomal oxidation?
898
The Halsted-Reitan battery. It consists of finger oscillation, speech sound perception, rhythm, tactual, and category testing.
What neuropsychologic test has five basic scales testing for the presence and localization of brain dysfunction?
899
Disorganized schizophrenia
What subtype of schizophrenia is characterized by • Childlike behaviors, unorganized speech and behaviors, poor grooming, incongruous smiling and laughter, and the worst prognosis?
900
Catatonic schizophrenia
What subtype of schizophrenia is characterized by • Stuporous mute echopraxia and automatic obedience, waxy flexibility with rigidity of posture?
901
Paranoid schizophrenia
What subtype of schizophrenia is characterized by • Delusions of persecution and/or grandeur, auditory hallucinations, late onset, and the best prognosis?
902
No, you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
If a patient cannot pay, can you refuse services?
903
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
Does alcoholism increase the rate of suicide?
904
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
What is the term for the dementia characterized by decremental or patchy deterioration in cognitive function due to a cerebrovascular accident?
905
Range
What is the term for the difference between the highest and the lowest score in a population?
906
Decreased REM sleep and REM rebound during withdrawal
How is sleep affected in a person with alcohol intoxication?
907
Need 3 panic attacks over 3 weeks (remember, they come out of the blue.)
How many attacks are needed over how much time before panic disorder is diagnosed?
908
Autism. Head-banging, rocking, and self-injurious behaviors are also common in autism.
What axis I disorder is characterized by pronoun reversal, preference for inanimate objects, obliviousness to the external environment, lack of separation anxiety, and abnormalities in language development?
909
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
What major side effect of neuroleptics is characterized by pill rolling, shuffling gait, and tremors that abate during sleep?
910
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first, not worry about legal responsibility.
If you report a suspected case of child abuse and are wrong, are you protected from legal liability?
911
Yes
Can advance directives be oral?
912
Bipolar disorder (manic-depressive disorder)
Increased self-esteem, flight of ideas, decreased sleep, increased libido, weight loss, and erratic behavior are all symptoms of what disorder?
913
Without children (but don't think about this one for too long)
Is marital satisfaction higher for couples with or without children?
914
From age 5 onward IQ stabilizes.
At what age does IQ stabilize?
915
Broca's aphasia
Name the aphasia based on these characteristics: • Nonfluent speech, telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension
916
Transcortical aphasia
Name the aphasia based on these characteristics: • Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat
917
Conduction aphasia
Name the aphasia based on these characteristics: • Lesion is in the parietal lobe or arcuate fibers because the connection between Broca's and Wernicke's area is severed; word comprehension preserved; inability to write or speak the statement (can't tell you what you said)
918
Global aphasia
Name the aphasia based on these characteristics: • Both Broca's and Wernicke's areas damaged by lesion in the presylvian speech area; trouble repeating statements; poor comprehension with telegraphic speech
919
Wernicke's aphasia
Name the aphasia based on these characteristics: • Lesion in Brodmann area 22; impaired comprehension; incoherent rapid, fluent speech; verbal paraphrasias; trouble repeating statements
920
Pick's disease
What rare form of dementia is associated with personality changes and affects the frontal and temporal lobes?
921
Naloxone or naltrexone
Which drug is used to treat respiratory depression associated with an overdose of opioids?
922
False-positive rate
What rate is indicated by 1-specificity?
923
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
When does most of the NREM sleep (stage 3 and 4) occur, in the first or second half of sleep?
924
Stage 1
Name the stages of sleep with these EEG patterns: • Disappearance of alpha waves, appearance of theta waves
925
Stage 3 and 4
Name the stages of sleep with these EEG patterns: • Delta waves
926
REM
Name the stages of sleep with these EEG patterns: • Sawtooth waves, random low voltage pattern
927
Being awake
Name the stages of sleep with these EEG patterns: • Alpha waves
928
Stage 2
Name the stages of sleep with these EEG patterns: • Sleep spindles, K-complexes
929
Methylphenidate (Ritalin)
What is the drug of choice for treating ADHD?
930
True. PIF is dopamine in the tuberoinfundibular system.
True or false? Prolactin levels can serve as a rough indicator of overall dopamine activity.
931
Fixation (arrested development)
What is the term for failure to give up infantile patterns of behavior for mature ones?
932
No. It is abnormal only if it interferes with normal sexual or occupational function.
Is masturbation considered an abnormal sexual practice?
933
Flurazepam
Which benzodiazepine has the longest half-life?
934
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
In the classical conditioning model, when a behavior is learned, what must occur to break the probability that a response will happen?
935
The granule cell. Its neurotransmitter is glutamic acid, which is also the principal neurotransmitter of the visual pathways.
What is the most abundant neuron in the cerebellum?
936
Dissociation
Name these anxiety defense mechanisms: • Separating oneself from the experience. The facts are accepted but the form is changed for protection.
937
Rationalization
Name these anxiety defense mechanisms: • Use of explanations to justify unacceptable behaviors.
938
Acting out
Outburst to cover up true feelings (emotion is covered, not redirected).
939
Displacement
Use of an outlet for emotions (stuff flows downhill).
940
Isolation of affect
Fact without feeling (la belle indifférence)
941
Intellectualization
Replacing normal affect with "brain power"
942
Repression
Unconsciously forgetting(forgetting that you forgot something!)
943
Undoing
Fixing impulses by acting out the opposite of an unacceptable behavior
944
Passive-aggressive
Setting up to be let down (it is unconscious; if conscious, you're just rude)
945
Reaction formation
A complete opposite expression of your inward feeling (e.g., arguing all the time with someone you are attracted to when your feelings are not known)
946
Schizotypal
Name these cluster A personality disorders: • Odd, strange; has magical thinking; socially isolated, paranoid, lacks close friends; has incongruous affect
947
Schizoid
Name these cluster A personality disorders: • Socially withdrawn, seen as eccentric but happy to be alone
948
Paranoid
Name these cluster A personality disorders: • Baseline mistrust; carries grudges; afraid to open up; uses projection as defense mechanism; lacks hallucinations or delusions
949
Chi-square.
What statistical method do you use when analyzing • Cross-sectional studies?
950
Relative risk and/or attributable risk. (Cohort studies deal with incidence.)
What statistical method do you use when analyzing • Cohort studies?
951
Odds ratio. (Case control studies deal with prevalence.)
What statistical method do you use when analyzing • Case control studies?
952
Absolutely not! Answer any question you are asked.
If a patient asks you a question and you do not know the answer, do you tell a white lie or simply not respond?
953
True. IQ correlates well with education and academic achievement but is not a predictor of success.
True or false? There is a strong positive correlation between IQ and academic achievement.
954
Posttraumatic stress disorder. (Important: symptoms must be exhibited for longer than 1 month.)
What is the term for headaches, inability to concentrate, sleep disturbances; avoidance of associated stimuli; reliving events as dreams or flashbacks following a psychologically stressful event beyond the normal range of expectation?
955
Brief psychotic disorder. (In schizophreniform disorder the symptoms last longer than 6 months.)
What is the term for a schizophrenic episode lasting longer than 30 days with full return to former functioning capacity?
956
Facial expression (the second is vocal intonation)
What is the primary method of nonverbal communication of emotional states?
957
Crude mortality rate
What type of mortality rate is defined as the number of deaths • In the population?
958
Cause-specific mortality rate
What type of mortality rate is defined as the number of deaths • From a specific cause per population?
959
Proportionate mortality rate
What type of mortality rate is defined as the number of deaths • From a specific cause per all deaths?
960
Case fatality rate
What type of mortality rate is defined as the number of deaths • From a specific cause per number of persons with the disease?
961
Being a female physician increases the risk of suicide nearly four times the general population.
Does being a female physician increase or decrease the risk of suicide?
962
Yes, by three to four times. Having multiple sexual partners, being overweight, and pelvic pain and/or inflammatory disorders are also likely to be seen in sexually abused females.
Are sexually abused females more likely to have learning disabilities than the general population?
963
Lead-time bias (remember, patients don't live longer with the disease; they are diagnosed sooner.)
What form of bias is due to false estimates of survival rates?
964
Positive predictive value
The probability that a person with a positive test result is truly positive refers to what value?
965
Criterion-referenced tests. You need a certain number correct to pass (e.g., the USMLE).
Objective tests that base the result of the examination on a preset standard use what form of reference?
966
True. It is considered medical treatment, so it can be withdrawn or refused. (Remember the Cruzan case.)
True or false? A patient can refuse a feeding tube.
967
Cut down (ever tried and failed?) Annoyed (criticism makes angry?) Guilty (about drinking behavior?) Eye opener (drinking to shake out the cobwebs?)
What are the CAGE questions?
968
Interval scale (a ruler, for example)
What type of scale is graded into equal increments, showing not only any difference but how much?
969
Teeth grinding is associated with stage 2 sleep.
With what stage of sleep are bruxisms associated?
970
False-negative rate
What rate is indicated by 1- sensitivity?
971
Nevirapine; it cuts the rate from 20% to 10%. AZT is also used, cutting the rate from 20% to 10%.
What drug is being given to HIV-positive mothers during labor and to the children after birth to decrease the risk of mother-to-child HIV transmission?
972
Rapid cycling bipolar disorder
What is the name of depression and mania alternating within a 48-to 72-hour period?
973
REM sleep. Remember, awake brain in a sleeping body.
Aroused EEG pattern (fast low voltage and desynchronization), saccadic eye movements, ability to dream, and sexual arousal are all associated with what general pattern of sleep?
974
Epstein-cardiac anomaly of the tricuspid valve
What is the teratogenic effect associated with lithium?
975
Dementia Urinary incontinence Gait apraxia (NPH wet, wacky, wobbly)
What is the triad of NPH?
976
Sad but true. Some women can have multiple successive orgasms.
True or false? Only men have refractory sexual periods.
977
Münchhausen's syndrome (factitious disorder)
In which syndrome does a person present with intentionally produced physical ailments with the intent to assume the sick role?
978
Anticipation
Name these mature defense mechanisms: • Preparing for an upcoming event
979
Altruism
Name these mature defense mechanisms: • Helping others without expecting any return
980
Sublimation
Name these mature defense mechanisms: • Converting an unacceptable impulse to a socially acceptable form (Hint: it is the most mature of all defense mechanisms)
981
Suppression
Name these mature defense mechanisms: • Forgetting on purpose (so you can actually remember it)
982
Humor
Name these mature defense mechanisms: • Easing anxiety with laughter
983
Frontal lobe
Name the area of the cerebral cortex with the function described: • Speech; critical for personality, concentration, initiating and stopping tasks (do one thing and begin a new without completion of the first), abstract thought, and memory and higher-order mental functions
984
Temporal lobe
Name the area of the cerebral cortex with the function described: • Language, memory, and emotion (Hint: herpesvirus infects here commonly)
985
Parietal lobe
Name the area of the cerebral cortex with the function described: • Intellectual processing of sensory information, with the left (dominant) processing verbal information, the right processing visual-spatial orientation
986
Basal ganglia
Name the area of the cerebral cortex with the function described: • Initiation and control of movements
987
Cerebellum
Name the area of the cerebral cortex with the function described: • Skill-based memory, verbal recall, balance, refined voluntary movements
988
Pons
Name the area of the cerebral cortex with the function described: • Important for REM sleep; origin of NE pathway
989
Limbic system
Name the area of the cerebral cortex with the function described: • Motivation, memory, emotions, violent behaviors, sociosexual behaviors, conditioned responses
990
Occipital lobe
Name the area of the cerebral cortex with the function described: • Recall of objects, distances, and scenes; visual input processed here
991
Correlation. No, correlation does not imply causation.
What is the degree to which two measures are related? Does it imply causation?
992
Alzheimer's (dementia of Alzheimer's type, DAT). (Remember, Alzheimer's constitutes 65% of dementias seen in patients 65 years old.)
What is the most common form of dementia?
993
Nicotine (but it sure has a nasty withdrawal!)
What is the only drug that does not have an intoxication?
994
Ego syntonic
What is the term to describe homosexuals who • Are comfortable with their own person and agree with their sense of self?
995
Ego dystonic
What is the term to describe homosexuals who • Are uncomfortable with their own person and disagree with their sense of self?
996
Triazolam
Which benzodiazepine has the shortest half-life?
997
Two-way ANOVA. It allows the test to check several variables at the same time.
What statistical test compares the means of groups generated by two nominal variables by using an interval variable?
998
Recovery and death
What are the two ways to leave the prevalence pot?
999
REM and stage 4 sleep; they decrease.
What aspects of sleep are affected during benzodiazepine use?
1000
Primary erectile disorder
What is the term to describe a man who has • Never been able to achieve an erection?
1001
Selective erectile disorder
What is the term to describe a man who has • The ability to have an erection sometimes and other times not?
1002
Secondary erectile disorder (Male erectile disorder is the same as impotence.)
What is the term to describe a man who has • Used to be able to achieve an erection but now cannot?
1003
Sleepwalking is associated with stage 4 and occurs most often in the first third of sleep.
What stage of sleep is associated with somnambulism?
1004
1. What did the patient want? 2. What would the patient say? 3. What is in the patient's best interests?
What are the three surrogate criteria?
1005
True; 80% have visited a doctor in the previous 6 months. And 50% within the last month!
True or false? Four-fifths of those who attempt suicide first give a warning.
1006
Yes. (Remember, Jehovah's witnesses refuse blood transfusions.)
Can a patient refuse life-saving treatment for religious reasons?
1007
Pygmalion effect (experimenter expectancy). This can be eliminated with double-blind studies.
What form of bias occurs when the experimenter's expectation inadvertently is expressed to the subjects, producing the desired effects? How can it be eliminated?
1008
Hypnopompic hallucinations occur during awakening, whereas hypnagogic hallucinations occur while one is falling asleep.
What type of hallucination occurs during awakening?
1009
About 80% of stage 4 sleep is recovered, approximately half of REM is recovered, and only one-third of total sleep is ever made up.
When attempting to make up sleep, what stage of sleep is recovered?
1010
When showing two pictures in rapid succession, you split the pictures half a second apart, resulting in the second picture masking the first (indicating poor short-term memory). This is seen in nearly 33% of schizophrenic patients.
What is backward masking, and is there a positive correlation with schizophrenic patients?
1011
False. Separation, divorce, being widowed, and unemployment increase your risk, but being single does not.
True or false? Being single increases your risk of suicide.
1012
False. Childbirth carries five times as much risk of serious psychiatric illness as abortion.
True or false? Serious psychiatric illness is more common after abortion than childbirth.
1013
Type II error (beta error). (Remember it as saying something doesn't work when it does.)
What type of error is made if you accept the null hypothesis when it is false?
1014
Stage 2, which accounts for approximately 45% of total sleep time, with REM occupying 20%.
Most sleep time is spent in what stage of sleep?
1015
Yes. In a negatively skewed distribution the mean is greater than the median is greater than the mode.
In a negatively skewed curve is the mean greater than the mode?
1016
Adjustment disorder. It is a diagnosis of exclusion (used if no other choice).
What axis I disorder is characterized by a clinically significant syndrome that affects social, occupational, and/or academic achievement; occurs less than 3 months after a stressor; and abates less than 6 months after the stressor is removed?
1017
Projective test. Most tests with a wide range of possibilities for the answers are projective.
What type of personality test is the Rorschach inkblot test, objective or projective?
1018
The T-test (used when comparing two groups)
What statistical test checks to see whether the groups are different by comparing the means of two groups from a single nominal variable?
1019
Akathisia
What antipsychotic movement disorder can occur at any time and is characterized by a subjective sense of discomfort that brings on restlessness, pacing, sitting down, and getting up?
1020
Seasonal affective disorder (treat with bright light therapy)
What form of depression is due to abnormal metabolism of melatonin?
1021
1. The child poses an imminent danger to self or others. 2. The child is unable to self-care daily at the appropriate developmental level. 3. The parents or guardians have no control over the child or will not promise to ensure the child's safety even though they refuse hospitalization.
What three circumstances allow a child to be committed to institutional care?
1022
Shaping (successive approximation)
What operant conditioning therapy or modification is described as • Reinforcing successive attempts that lead to the desired goal (gradual improvement)?
1023
Stimulus control
What operant conditioning therapy or modification is described as • Having a stimulus take over the control of the behavior (unintentionally)?
1024
Biofeedback
What operant conditioning therapy or modification is described as • Providing the person with information regarding his or her internal responses to stimuli with methods of controlling them?
1025
Fading
What operant conditioning therapy or modification is described as • Removing a reinforcement (without the patient knowing) gradually over time to stop a condition?
1026
Extinction
What operant conditioning therapy or modification is described as • Stopping the reinforcement that is leading to an undesired behavior?
1027
Axis IV
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Psychosocial and environmental problems (stressors)?
1028
Axis III
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Medical or physical ailments?
1029
Axis II
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Personality and mental disorders?
1030
Axis V
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Global assessment of function?
1031
Axis I
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place • Clinical disorders (e.g., schizophrenia)?
1032
Actually, yes. You should encourage your patient to try other forms of medicine as long as they are not contraindicated with the patient's preexisting illness. You must be able to accept the health beliefs of your patients, even if you don't agree.
Should you refer a patient to a form of folk medicine even if you don't believe in it?
1033
Grasp proceeds release
In regard to motor development during infancy, choose the motor response that happens first. • Release or grasp
1034
Proximal to distal progression
In regard to motor development during infancy, choose the motor response that happens first. • Proximal or distal progression
1035
Ulnar to radial progression
In regard to motor development during infancy, choose the motor response that happens first. • Radial or ulnar progression
1036
Palms-up before palms-down maneuvers
In regard to motor development during infancy, choose the motor response that happens first. • Palms up or down
1037
Parental assignment and culture (not biology)
What are the strongest determinants of gender identity?
1038
NREM sleep. Night terrors are dreams that we are unable to recall.
With what stage of sleep are night terrors associated?
1039
Measurement bias
What type of bias is it when the information is distorted because of the way it is gathered?
1040
Verbigeration
What term describes senseless repetition of words or phrases?
1041
The courts. These are legal, not medical terms.
Who decides competency and sanity?
1042
Splitting
Name these narcissistic defense mechanisms: • Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
1043
Denial
Name these narcissistic defense mechanisms: • Not allowing reality to penetrate because afraid of becoming aware of painful aspect of reality.
1044
Projection
Name these narcissistic defense mechanisms: • Person takes his or her own feelings, beliefs, wishes, and so on and thinks they are someone else's. (e.g., a cheating man thinks his wife is unfaithful)
1045
The blood withdrawn is the unconditioned stimulus, inducing the unconditioned response (fainting). The needle is part of the blood-drawing procedure and is the conditioned stimulus (unconditioned and conditioned stimuli are paired) resulting in the conditioned response (fainting at the sight of the needle).
Which is the conditioned response, the conditioned stimulus, the unconditioned response, the unconditioned stimulus in this case? A patient has blood withdrawn and faints. The next time she goes to have blood taken, she faints at the sight of the needle.
1046
1. Notify police. 2. Try to detain the person making the threat. 3. Notify the threatened victim.
What three actions should take place when one person threatens the life of another? (Hint: think of the Tarasoff decision.)
1047
Limbic system
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Apathy, aggression, inability to learn new material, and memory problems
1048
Dorsal prefrontal cortex
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Apathy, poor grooming, poor ability to think abstractly, decreased drive, poor attention span (Hint: if the lesion is in the dominant hemisphere, the patient will develop Broca's aphasia)
1049
Dominant temporal lobe
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Euphoria, delusions, thought disorders, Wernicke's aphasia, auditory hallucinations (Hint: the lesion is in the left hemisphere)
1050
Dominant parietal lobe (Gerstmann's syndrome)
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Agraphia, acalculia, finger agnosia, right-left disorientation
1051
Orbitomedial frontal lobe
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Withdrawn, fearful, explosive moods, violent outbursts, and loss of inhibitions
1052
Nondominant parietal lobe
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Denial of illness, hemineglect, construction apraxia (can't arrange matchsticks)
1053
Occipital lobe (Anton's syndrome if it is due to bilateral posterior cerebral artery occlusions)
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Denies being blind, cortical blindness
1054
Nondominant temporal lobe
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion. • Dysphoria, irritability, musical and visual abilities decreased
1055
GH. The largest output of GH in a 24-hour period is during stage 4 sleep.
What hormone's release is strongly associated with stage 4 sleep?
1056
M:F 4:1 committing, but M:F ratio of attempts is 1:3 (males commit more but females try it more)
What is the male-to-female ratio for committing suicide?
1057
Accuracy (think of it as all the trues, because they are the ones correctly identified)
What is the term for the total percentage of correct answers selected on a screening test?
1058
Type I error (alpha error). (Remember it as saying something works when it doesn't.) The chance of a type I error occurring is the P value.
What type of error is made if you reject the null hypothesis when it is true?
1059
Addition (They are mutually exclusive.)
If one event precludes another event, their probabilities are combined by what method?
1060
True; military service and independent self-care by a child over 13 years old also emancipate.
True or false? Marriage emancipates a child less than 17 years old.
1061
Amnesia. (The person is aware of the memory loss.)
What term describes the inability to recall personal information, commonly associated with trauma?
1062
The death of a spouse. The higher the score, the greater the risk of developing an illness in the next 6 months.
What is the most stressful event as determined by the Holmes and Rahe scale?
1063
Nearly 25% of patients taking lithium develop polyuria and polydipsia.
What renal side effect is commonly seen in patients taking lithium?
1064
Chi-square (when you are in doubt and have nominal data, use chi-square)
What statistical test, using nominal data only, checks whether two variables are independent events?
1065
Compulsions. They are actions done to fix the bad thoughts. Obsessions are the thoughts.
What is the term for repetitive actions blocking recurring bad thoughts?
1066
False. You need clear evidence the patient is not competent; if you are unsure, assume the patient is competent.
True or false? A patient has to prove his or her competency.
1067
True. Yohimbine, sodium lactate, and epinephrine can also induce panic attacks; they are considered panicogens.
True or false? Panic attacks can be induced by hyperventilation or carbon dioxide.
1068
Crossover study
In what study, for ethical reasons, is no group left out of intervention?
1069
Parkinson's disease
Shuffling gait, cogwheel rigidity, masklike facies, pill-rolling tremor, and bradykinesia describe what form of dementia?
1070
Unipolar disorder (major depression)
Anhedonia, lack of motivation, feelings of worthlessness, decreased sex drive, insomnia, and recurrent thoughts for at least 2 weeks, representing a change from previous level of function, describes what disorder?
1071
Creutzfeldt-Jakob's disease. Patients first develop vague somatic complaints and anxiety, rapidly followed by dysarthria, myoclonus, ataxia, and choreoathetosis.
What form of dementia is characterized by onset at age 40 to 50, rapid progression, infection by a prion, and death within 2 years?
1072
Mode
The most frequent number occurring in a population is what?
1073
Nigrostriatal pathways (basal ganglia)
Movement disorders are associated with what dopamine pathway (what part of the brain)?
1074
Histamine
What neurotransmitter is associated with sedation and weight gain?
1075
Negative predictive value
The probability that a person with a negative test result is truly disease free refers to what value?
1076
Denial Anger Bargaining Depression Acceptance No, they can be skipped, repeated, and completed out of sequence.
What are the five Kübler-Ross stages of death and dying? Must they be completed in order?
1077
P = .05; P < .05 rejects the null hypothesis
What P value defines whether the hull hypothesis should or should not be rejected?
1078
Prolactin
What hormone level increases in the first 3 hours of sleep?
1079
SSRIs
What is the most widely used class of antidepressants?
1080
Prevalence increases. (Remember, prevalence can decrease in only two ways, recovery and death.)
What happens to prevalence as the number of long-term survivors increases?
1081
Hypertension
What is the primary predisposing factor for vascular dementia?
1082
Pedophilia
What paraphilia is defined as • Sexual urges toward children?
1083
Voyeurism
What paraphilia is defined as • Deriving sexual pleasure from watching others having sex, grooming, or undressing?
1084
Exhibitionism
What paraphilia is defined as • Having a recurrent desire to expose the genitals to strangers?
1085
Sadism
What paraphilia is defined as • Deriving sexual pleasure from other peoples' pain?
1086
Masochism
What paraphilia is defined as • Deriving sexual pleasure from being abused or in pain?
1087
Necrophilia
What paraphilia is defined as • Having sex with cadavers?
1088
Zoophilia
What paraphilia is defined as • Sexual fantasies or practices with animals?
1089
Coprophilia
What paraphilia is defined as • Combining sex with defecation?
1090
Urophilia
What paraphilia is defined as • Combining sex with urination?
1091
Frotteurism
What paraphilia is defined as • A male rubbing his genitals on a fully clothed female to achieve orgasm?
1092
ACh; think about the ANS.
Name the neurotransmitter at the neuromuscular junctions for all of the voluntary muscles in the body.
1093
Impaired ejaculation
What are the pharmacologic effects seen sexually with • α1-Blockers?
1094
Inhibited orgasm
What are the pharmacologic effects seen sexually with • Serotonin?
1095
Impotence
What are the pharmacologic effects seen sexually with • β-Blockers?
1096
Priapism
What are the pharmacologic effects seen sexually with • Trazodone?
1097
Increased erection and libido
What are the pharmacologic effects seen sexually with • Dopamine agonists?
1098
Erectile dysfunction
What are the pharmacologic effects seen sexually with • Neuroleptics?
1099
Median (think of it as the halfway point)
What is the term for the point on a scale that divides the population into two equal parts?
1100
FALSE
True or false? Pregnancy ensures emancipation.
1101
True. Being female, having positive symptoms, quick onset, and family history of mood disorders are all good prognostic predictors of schizophrenia.
True or false? Paranoid and catatonic schizophrenia are good prognostic predictors.
1102
Prevalence increases.
What happens to prevalence as incidence increases?
1103
Pearson correlation
What type of correlation compares two interval variables?
1104
Transference. When it is from the physician to the patient it is called countertransference.
What term is defined as a patient unconsciously placing his or her thoughts and feelings on the physician in a caregiver or parent role?
1105
Phase III. It is considered the definitive test.
What phase of Food and Drug Administration approval tests • The efficacy and occurrence of side effects in large group of patient volunteers?
1106
Phase I
What phase of Food and Drug Administration approval tests • The safety in healthy volunteers?
1107
Phase II
What phase of Food and Drug Administration approval tests • The protocol and dose levels in a small group of patient volunteers?
1108
1. Large sample size 2. Large effect size 3. Type I error is greater
In biostatistics, what are the three criteria required to increase power?
1109
Since they are independent events, their probabilities would be multiplied.
If the occurrence of one event had nothing to do with the occurrence of another event, how do you combine their probabilities?
1110
Double-blind study. It is the most scientifically rigorous study known.
What type of random controlled test is least subjective to bias?
1111
Because incidence is defined as new events; treatment does not decrease the number of new events. It does decrease the number of individuals with the event (prevalence would decrease).
Why isn't the incidence of a disease decreased when a new treatment is initiated?
1112
1. 7-methyl guanine cap on the 5' end 2. Addition of the poly(A) tail to the 3' end 3. Removal of introns
What are the three posttranscriptional modifications?
1113
Glutamine
What AA is the major carrier of nitrogen byproducts from most tissues in the body?
1114
Aspartic acid and glutamic acid
What two AAs have a pKa of 4?
1115
2 acetyl CoA per glucose, producing 12 ATPs per acetyl CoA, resulting in a total of 24 ATPs produced from glucose (via acetyl CoA) enter the TCA cycle
How many acetyl CoAs per glucose enter into the TCA cycle?
1116
Topoisomerase I (Relaxase)
What topoisomerase makes ssDNA cuts, requires no ATP, relaxes supercoils, and acts as the swivel in front of the replication fork?
1117
Shine-Dalgarno sequence
In prokaryotes, what is the name of the RNA sequence that ribosomes bind to so translation can occur?
1118
Autosomal recessive
Name the pattern of genetic transmission: both M and F are affected; M-to-M transmission may be present; both parents must be carriers; the trait skips generations; two mutant alleles are needed for disease; and affected children may be born of unaffected adults?
1119
Elongation factor-G and GTP
What factors are needed for translation in prokaryotes?
1120
Isoleucine, leucine, and valine
What three AAs must patients with maple syrup urine disease not eat?
1121
2 ATPs, via the amino acyl tRNA synthase enzyme
How many high-energy bonds are used to activate an AA?
1122
Niacin (B3)
What water-soluble vitamin deficiency results in pellagra?
1123
Glucokinase
What glycolytic enzyme has a high Vmax, high Km, and low affinity for glucose?
1124
12 ATPs per acetyl CoA that enter the tricarboxylic acid (TCA) cycle (Krebs cycle)
How many ATPs are generated per acetyl coenzyme A (CoA)?
1125
HMP shunt
What cytoplasmic pathway produces NADPH and is a source of ribose 5-phosphate?
1126
Acetyl CoA (pyruvate to acetyl CoA)
What is the main inhibitor of pyruvate dehydrogenase?
1127
3'end of the codon (third position) on mRNA and 5' end of the anticodon (first position) on tRNA.
Where on the codon and anticodon does the wobble hypothesis take place?
1128
Excision endonuclease, which removes thiamine dimers from DNA
What DNA excision and repair enzyme is deficient in patients with xeroderma pigmentosum?
1129
Unconjugated (indirect)
What form of bilirubin is carried on albumin?
1130
Leucine and lysine
What are the two ketogenic AAs?
1131
Prokaryotes. Polycistronic and prokaryotes both start with P.
Which organisms have polycistronic mRNA?
1132
Citrate, via the citrate shuttle
As what compound do the carbons for fatty acid synthesis leave the mitochondria?
1133
1. Glucagon 2. NADH 3. Acetyl CoA 4. ATP
What four substances increase the rate of gluconeogenesis?
1134
1. α-Ketoglutarate dehydrogenase 2. Pyruvate dehydrogenase 3. Transketolase Thiamine pyrophosphate (TPP) functions as a coenzyme vital to tissue respiration. It is required for the oxidative decarboxylation of pyruvate to form acetyl-coenzyme A, providing entry of oxidizable substrate into the Krebs cycle for the generation of energy
With what three enzymes is thiamin pyrophosphate (TPP) associated?
1135
PCR
What test uses very small amounts of DNA that can be amplified and analyzed without the use of Southern blotting or cloning?
1136
apo B-48
What apoprotein is required for the release of chylomicrons from the epithelial cells into the lymphatics?
1137
Aminoacyl-tRNA synthetase, which uses 2 ATPs for this reaction.
What enzyme catalyzes the covalent bonding of the AA's carboxyl group to the 3' end of tRNA?
1138
Short-chain fatty acids
What must be supplemented in patients with medium-chain acyl CoA dehydrogenase (MCAD) deficiency?
1139
Hydroxyproline
What form of AA is found only in collagen?
1140
Sorbitol (resulting in cataracts)
In a diabetic patient, to what does aldose reductase convert glucose?
1141
HMG-CoA reductase
What enzyme catalyzes the rate-limiting step in cholesterol metabolism?
1142
pI (isoelectric point)
What is the term for the pH at which the structure carries no charge?
1143
Fructose-1, 6-bisphosphatase
What enzyme catalyzes the rate-limiting step in gluconeogenesis?
1144
Probenecid, a uricosuric agent
What is the drug of choice in treating a patient with hyperuricemia due to underexcretion of uric acid?
1145
Homogentisate oxidase deficiency is seen in patients with alcaptonuria.
What enzyme deficiency results in darkening of the urine when exposed to air?
1146
Transcription factor IID
In eukaryotes, what transcription factor binds to the TATA box before RNA polymerase II can bind?
1147
Primase
What enzyme produces an RNA primer in the 5'-3' direction and is essential to DNA replication because DNA polymerases are unable to synthesize DNA without an RNA primer?
1148
Acetyl CoA carboxylase
What enzyme catalyzes the rate-limiting step in fatty acid synthesis?
1149
DNA polymerase-γ
Name the eukaryotic DNA polymerase based on the following information: • Replicates mitochondrial DNA
1150
DNA polymerase-α
Name the eukaryotic DNA polymerase based on the following information: • Synthesizes the lagging strand during replication
1151
DNA polymerase-δ
Name the eukaryotic DNA polymerase based on the following information: • Synthesizes the leading strand during replication
1152
1. Glucose from liver glycogen 2. Glucose from gluconeogenesis 3. Body protein 4. Body fat
What is the order of fuel use in a prolonged fast?
1153
Shifts it to the right
Which way will the O2 dissociation curve shift with the addition of 2, 3-bisphosphoglycerate (2, 3-BPG) to adult hemoglobin (Hgb)?
1154
Thymidylate synthase
What enzyme of pyrimidine synthesis is inhibited by the following? • 5-FU
1155
Dihydrofolate reductase
What enzyme of pyrimidine synthesis is inhibited by the following? • Methotrexate
1156
Ribonucleotide reductase
What enzyme of pyrimidine synthesis is inhibited by the following? • Hydroxyurea
1157
If a carboxyl group is the R group, it is acidic; if an amino group is the R group, it is said to be basic.
What is found in the R group if the AA is acidic? Basic?
1158
Pyruvate carboxylase
What gluconeogenic mitochondrial enzyme requires biotin?
1159
EF-2 and GTP
What factors are needed for translocation in eukaryotes?
1160
S phase
DNA replication occurs during what phase of the cell cycle?
1161
Uric acid
What is the end product of purine catabolism?
1162
The poly(A) site on the DNA
What causes transcription to stop in eukaryotes?
1163
Succinate dehydrogenase
What enzyme of the TCA cycle catalyzes the production of the following: • FADH2
1164
Succinyl CoA synthetase
What enzyme of the TCA cycle catalyzes the production of the following: • GTP
1165
Isocitrate dehydrogenase, α-ketoglutarate dehydrogenase, and malate dehydrogenase
What enzyme of the TCA cycle catalyzes the production of the following: • NADH (hint: 3 enzymes)
1166
Methanol (wood alcohol)
What form of alcohol causes blindness?
1167
There are two bacterial promoter regions upstream. The TATA box is - 10 base pairs upstream, and the -35 promoter site is self-explanatory.
How many base pairs upstream is the prokaryotic TATA box promoter?
1168
Linoleic acid and linolenic acid
What are the two essential fatty acids?
1169
Fatty acids cannot cross the blood-brain barrier; therefore, they cannot be used as an energy source.
During a prolonged fast, why is the brain unable to use fatty acids?
1170
Conjugated (direct) hyperbilirubinemia
What type of jaundice is seen in Rotor's syndrome?
1171
Solved as 30% T + 30% A = 60%; therefore, C + G = 40%; then C = 20% and G = 20% (example of Chargaff's rule)
If a sample of DNA has 30% T, what is the percent of C?
1172
β-Oxidation of fatty acids
From where is the energy for gluconeogenesis derived?
1173
Frameshift
Name the type of mutation: • The deletion or addition of a base
1174
Missense
Name the type of mutation: New codon specifies a different AA
1175
Large segment deletions
Name the type of mutation: • Unequal crossover in meiosis with loss of protein function
1176
Silent
Name the type of mutation: • New codon specifies for the same AA
1177
Nonsense
Name the type of mutation: • New codon specifies for a stop codon
1178
Unconjugated free bilirubin
What form of bilirubin can cross the blood-brain barrier?
1179
Arginine
What AA is broken down into N2O, causing an increase in cyclic guanosine monophosphate (cGMP) of smooth muscle, hence vasodilation?
1180
NADPH, O2, and cytochrome b5
What three things are needed to produce a double bond in a fatty acid chain in the endoplasmic reticulum?
1181
Factors II, VII, IX, X, and proteins C and S
What are the vitamin K-dependent coagulation factors?
1182
3' end. Phosphate (PO4) is at the 5' end.
Is the hydroxyl (-OH) end of DNA and RNA at the 3' or the 5' end?
1183
61 codons code for AAs and 3 codons (UAA, UGA, UAG) code for the termination of translation.
How many codons code for AAs? How many for termination of translation?
1184
Glyceraldehyde dehydrogenase
What is the enzyme for the oxidative reaction in glycolysis?
1185
GM2 ganglioside Caused by a deficiency of β-hexosaminidase A
What substrate builds up in Tay-Sachs disease?
1186
Mitochondrial inheritance
What pattern of genetic transmission is characterized by no transmission from M, maternal inheritance, and the potential for the disease to affect both sons and daughters of affected F?
1187
Glycogen synthase
What is the rate-limiting enzyme of glycogen synthesis?
1188
Sphingosine
What sphingolipid is formed by the union of serine and palmitoyl CoA?
1189
Vitamin D
What causes an increase in bone mineralization and Ca2+ along with PO4- absorption from the GI tract and kidney tubules?
1190
Glucose and galactose
What two sugars can be used to produce cerebrosides?
1191
Homeodomain proteins
What group of eukaryotic regulatory proteins has a major factor in controlling the gene expression embryonically?
1192
The lack of glutathione peroxidase activity results in a decrease in NADPH production, leaving glutathione in the reduced state.
What causes the lysis of RBCs by oxidizing agents in a G-6-PD deficiency?
1193
pH of 2 and 9
All AAs have titration plateaus at what pH values?
1194
SER
What cytoplasmic organelle carries the enzymes for elongation and desaturation of fatty acyl CoA?
1195
The promoter indicates where transcription will begin.
What is the binding site for RNA polymerase?
1196
Vitamin A is responsible for vision and epithelial health.
What vitamin is necessary for epithelial health?
1197
LDL
What lipoprotein is formed if an IDL particle acquires cholesterol from a HDL particle?
1198
Quaternary structure
What structure of a protein describes the interaction among subunits?
1199
Ea (activation energy)
What is the only factor of enzyme kinetics that the enzyme affects?
1200
Inactivated; glucose results in decreased cAMP levels and therefore blocks protein binding between cAMP and CAP.
Is the Lac operon activated or inactivated in the presence of both glucose and lactose?
1201
Acetyl CoA, FADH2, and NADH
At the end of each round of β-oxidation, what is released?
1202
Phosphofructokinase-1 and costs 1 ATP
What is the rate-limiting enzyme on glycolysis?
1203
Uroporphyrinogen-I synthase
What enzyme of heme synthesis is deficient in the autosomal dominant disorder acute intermittent porphyria?
1204
Aldehyde dehydrogenase
What enzyme is blocked by disulfiram?
1205
α-1, 6 transferase
Deficiencies in what enzyme result in insoluble glycogen synthesis formation?
1206
eIF-2 in the P site
What eukaryotic translation enzyme is associated with the following: • Initiation
1207
eEF-1
What eukaryotic translation enzyme is associated with the following: • Elongation
1208
No enzymes are needed. When the stop codon reaches the A site, it results in termination.
What eukaryotic translation enzyme is associated with the following: • Termination
1209
Asparagine
What AA undergoes N-glycosylation?
1210
Orotic acid (purine metabolism)
What is the pyrimidine intermediate that joins PRPP (5-Phosphoribosyl-1-Pyrophosphate)?
1211
Farnesyl pyrophosphate (FPP)
What intermediate of cholesterol synthesis anchors proteins in the membranes and forms CoA?
1212
Tyrosine
What AA is a phenol?
1213
Hormone-sensitive lipase
What hormone is activated in adipose tissue when blood glucose levels decrease?
1214
2 NADPHs per acetyl CoA
How many NADPHs are used per addition of acetyl CoA into a fatty acid chain?
1215
EF-1 and GTP
What factors are needed for elongation in eukaryotes?
1216
Hypoxanthine (remember, IMP is a precursor for AMP and GMP)
What purine base is contained in inosine monophosphate?
1217
Aspartate and carbomoyl PO4-
What are the two ways that nitrogen can enter into the urea cycle?
1218
Lactose must be present and glucose must be absent
What two requirements must be met for the Lac operon to be activated?
1219
G1 phase (gap 1)
Name the phase of the eukaryotic cell cycle: • Period of cellular growth (translation and transcription) before DNA synthesis
1220
G2 phase (gap 2)
Name the phase of the eukaryotic cell cycle: • Period of cellular growth (translation and transcription) after DNA synthesis
1221
S phase
Name the phase of the eukaryotic cell cycle: • Period of DNA replication (preparing for mitosis)
1222
G0 phase
Name the phase of the eukaryotic cell cycle: • Cells cease replicating (i.e., nerve cell)
1223
True. Remember, RBCs do not contain mitochondria, so they cannot metabolize aerobically.
True or false? RBCs anaerobically use glucose in both the well-fed and fasting states.
1224
Succinyl CoA synthetase
What enzyme of the TCA cycle catalyzes the substrate level phosphorylation?
1225
apo A-1
What apoprotein on HDL activates lecithin-cholesterol acyltransferase (LCAT)?
1226
1. Glycine 2. Aspartate 3. Glutamine
What three AAs are used to synthesize the purine ring?
1227
2 ATPs by oxidative phosphorylation
How many ATPs are produced from cytoplasmic NADH oxidation using the glycerol phosphate shuttle?
1228
Phenylalanine hydroxylase
What enzyme is deficient in patients with PKU?
1229
1. Malate dehydrogenase 2. Isocitrate dehydrogenase 3. α-Ketoglutarate dehydrogenase
What three steps of the TCA cycle generate NADH?
1230
ALA dehydrogenase and ferrochelatase
What two enzymes of heme synthesis are inhibited by lead?
1231
Lipoprotein lipase
What enzyme, induced by insulin and activated by apo C-II, is required for chylomicron and VLDL metabolism?
1232
G-6-PD deficiency; pyruvate kinase deficiency is second.
What is the most common genetic deficiency resulting in hemolytic anemia?
1233
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • AA deficiency
1234
Positive
Are the following conditions associated with a negative or positive nitrogen balance? • Growth
1235
Positive
Are the following conditions associated with a negative or positive nitrogen balance? • Pregnancy
1236
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • Uncontrolled DM
1237
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • Starvation
1238
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • Infection
1239
Positive
Are the following conditions associated with a negative or positive nitrogen balance? • Recovery from injury
1240
Negative
Are the following conditions associated with a negative or positive nitrogen balance? • Kwashiorkor
1241
Hepatocytes lack the enzyme succinyl CoA acetoacetyl CoA transferase (thiophorase).
Why is the liver unable to metabolize ketone bodies?
1242
Cholera toxin
What toxin ADP-ribosylates via Gs protein to increase cAMP?
1243
Thiamine and folate
What two vitamins are inactivated when they come in contact with acetaldehyde?
1244
Palmitate
Name the end product or products: • Fatty acid synthesis
1245
Acetyl CoA and propionyl CoA (in odd chain fatty acids)
Name the end product or products: • Fatty acid oxidation
1246
Reverse transcription
What is the term for production of a DNA copy from an RNA molecule?
1247
Galactose and glucose
What two monosaccharides are produced when lactose is hydrolyzed?
1248
The enzyme lysyl oxidase requires Cu2+and O2 to function properly.
What mineral is required for cross-linking of collagen molecules into fibrils?
1249
Southern blot
What blotting technique uses the following for analysis? • DNA
1250
Western blot
What blotting technique uses the following for analysis? • Protein
1251
Northern blot
What blotting technique uses the following for analysis? • RNA
1252
Four high energy bonds, two from ATP in AA activation and two from GTP
How many high-energy bonds does the cycle of elongation cost?
1253
PRPP aminotransferase
What enzyme of purine synthesis is inhibited by allopurinol and 6-mercaptopurine?
1254
True. Remember, carbamoyl phosphate synthetase and ornithine transcarbamoylase are mitochondrial enzymes.
True or false? The urea cycle takes place in both the cytoplasm and the mitochondria.
1255
Propionic acid
What is the only fatty acid that is gluconeogenic?
1256
DNA polymerase I
What enzyme has a 5' to 3' synthesis of the Okazaki fragments, 3' exonuclease activity, and 5' exonuclease activity?
1257
Mitochondria
In what organelle does the TCA cycle occur?
1258
Genomic libraries are made from nuclear DNA, are fragmented, and contain all sequences found in the particular genome copied.
Do genomic or cDNA libraries contain introns, exons, promoters, enhancers, and are they fragmented?
1259
Purine nucleoside phosphorylase
What enzyme is deficient in selective T cell immunodeficiency?
1260
True. Adipose depends on glucose uptake for dihydroxyacetone phosphate (DHAP) production for triglyceride synthesis.
True or false? Adipose tissue lacks glycerol kinase.
1261
N-5-methyl THF
In what form is excess folate stored in the body?
1262
Translation
What is the term for taking an mRNA molecule and arranging the AA sequence forming a protein?
1263
Ribonucleotide reductase
What enzyme is blocked by hydroxyurea?
1264
Albumin
What protein carries free fatty acids to the liver?
1265
Sphingomyelin
What substrate is built up in Niemann-Pick disease?
1266
True. Restriction endonucleases cut only unmethylated DNA.
True or false? Methylation of bacterial DNA prevents restriction endonuclease from cutting its own chromosomes.
1267
Lysine and tyrosine
What two AAs have a pKa of 10?
1268
Homocysteine methyl transferase
What is the only enzyme in the body that uses N-5-methyl folate?
1269
Vitamin K deficiency has normal bleeding time and increased PT, and vitamin C deficiency has increased bleeding time and normal PT.
How can you differentiate vitamin K from vitamin C deficiency by bleeding time and PT levels?
1270
A gene (a rather simple definition but accurate)
What is the term for a unit of DNA that encodes a particular protein or RNA molecule?
1271
The coding strand is identical to mRNA, and the template strand is complementary and antiparallel.
Is the coding or the template strand of DNA identical to mRNA (excluding the T/U difference)?
1272
Uroporphyrinogen I synthetase
What enzyme is deficient in acute intermittent porphyria?
1273
1. TTP 2. Lipoic acid 3. Coenzyme A from pantothenate 4. NAD(H) (from niacin or tryptophan) 5. FADH2 (from riboflavin)
What five cofactors and coenzymes are required by pyruvate dehydrogenase?
1274
X-linked recessive
What pattern of genetic transmission affects only M and has no M-to-M transmission, and mother is usually an unaffected carrier?
1275
Galactitol
To what does aldose reductase convert galactose?
1276
Xanthine, hypoxanthine, theophylline, theobromine, caffeine, and uric acid are all purines.
Name three purine bases that are not found in nucleic acids.
1277
Riboflavin (B2)
What water-soluble-vitamin deficiency is associated with cheilosis and magenta tongue?
1278
Ceramide
What is the precursor of all sphingolipids?
1279
1. Ca2+ : calmodulin ratio 2. Epinephrine 3. Glucagon
What three substances stimulate glycogenolysis?
1280
The hairpin loop made by reverse transcriptase at the 3' end of the first strand is the primer.
What is the primer for the synthesis of the second strand in production of cDNA from mRNA?
1281
EF-Tu or EF-ts and GTP
What factors are needed for elongation in prokaryotes?
1282
MstII; changing codon 6 (from A to T) destroys the restriction site.
What restriction endonuclease site is destroyed in sickle β-globin allele?
1283
Biotin, ATP, and CO2
What complex is needed for propionyl CoA carboxylase?
1284
Glutamate dehydrogenase
What enzyme catalyzes the reversible oxidative deamination of glutamate and produces the TCA cycle intermediate α-ketoglutarate?
1285
Uroporphyrinogen III cosynthase
What enzyme is deficient in congenital erythropoietic porphyria?
1286
Allopurinol
What is the drug of choice for treating a patient with hyperuricemia due to overproduction of uric acid?
1287
Vmax
What is the maximum rate possible with a given amount of enzyme?
1288
Production of oxygen free radicals
From what do catalase, superoxide dismutase, and glutathione peroxidase defend the cell?
1289
Phosphorylation of mannose residues
What signals are used to direct an enzyme to a lysosome?
1290
Carbamoyl phosphate synthetase I
What enzyme catalyzes the rate-limiting step of the urea cycle?
1291
Glycerol kinase
What liver enzyme, for triglyceride synthesis, converts glycerol to glycerol-3-phosphate?
1292
Liver
What organ functions to keep blood glucose levels normal through both well-fed and fasting states and produces ketones in response to increased fatty acid oxidation?
1293
X-linked recessive
What pattern of inheritance does G-6-PD deficiency follow?
1294
Transcription (C comes before L in the alphabet, and transCription comes before transLation)
What is the term for conversion of a dsDNA molecule to the base sequence of an ssRNA molecule?
1295
Scavenger receptor (SR-B1)
Via what cell surface receptor does HDL cholesterol from the periphery enter hepatoceles?
1296
Carnitine acyl CoA transferase II
Which shuttle is used to bring fatty acyl CoA from the cytoplasm for ketogenesis?
1297
Thymidylate synthetase
What enzyme is blocked by 5-FU?
1298
Gilbert's syndrome
What disease has a genetically low level of UDPglucuronate transferase, resulting in elevated free unconjugated bilirubin?
1299
Arginine
What AA has a pKa of 13?
1300
Lesch-Nyhan syndrome
What X-linked recessive disorder is characterized by hyperuricemia, spastic cerebral palsy, mental retardation, and self-mutilation?
1301
2 ATPs, because RBCs use only anaerobic metabolism.
How many ATPs per glucose are generated from glycolysis in RBCs?
1302
Glycogen phosphorylase
What enzyme catalyzes the rate-limiting step in glycogenolysis?
1303
G-C rich sequences, because they have 3 hydrogen bonds, where A-T has 2 hydrogen bonds, resulting in higher melting points.
Would a G-C or an A-T rich dsDNA sequence have a higher melting point? Why?
1304
Alanine and glutamine
As what AAs do muscles send nitrogen to the liver?
1305
Ganglioside
What sphingolipid cannot be produced without sialic acid and amino sugars?
1306
Affinity decreases; they are inversely proportional.
What happens to affinity if you increase Km?
1307
Indirect or unconjugated
What type of bilirubin is found in neonatal jaundice?
1308
Methionine (start) and tryptophan are the only two AAs with only one codon.
What two AAs do not have more than one codon?
1309
External 3', 5' PDE bonds
What bonds are broken by exonucleases?
1310
Uracil and orotic acid levels increase with ornithine transcarbamoylase deficiency and are normal in carbamoyl phosphate synthetase deficiency.
How can a genetic deficiency of carbamoyl phosphate synthetase be differentiated from an ornithine transcarbamoylase deficiency?
1311
IDL
Name the lipoprotein based on the following characteristics. • apo E
1312
LDL
Name the lipoprotein based on the following characteristics. • apo B-100
1313
VLDL
Name the lipoprotein based on the following characteristics. • apo E, apo B-100, apo C-II
1314
HDL
Name the lipoprotein based on the following characteristics. • apo A-1, apo E, apo C-II
1315
Chylomicrons
Name the lipoprotein based on the following characteristics. • apo E, apo C-II, apoB-48
1316
True. The energy status of the cell dictates if the cycle is running or relaxing.
True or false? There is no hormonal control to the TCA cycle.
1317
1. Liver 2. Muscle 3. Adipose tissue
What are the three tissues where triacylglycerols are produced?
1318
Pertussis toxin
What toxin ADP-ribosylates via Gi to increase cAMP?
1319
δ-ALA synthase
What enzyme catalyzes the rate-limiting step in heme synthesis?
1320
Cori cycle
What cycle is responsible for converting to glucose in the liver the lactate produced in the RBCs?
1321
S1 nuclease
What enzyme is used to remove the hairpin loop during production of cDNA from mRNA?
1322
No, unsaturated fatty acids have double bonds.
Does a saturated fatty acid have double bonds?
1323
Uracil
What pyrimidine base is found • Only in RNA?
1324
Thymine
What pyrimidine base is found • Only in DNA?
1325
Cytosine
What pyrimidine base is found • In both DNA and RNA?
1326
Proline and lysine
What two AAs require vitamin C for hydroxylation?
1327
The liver (in the mitochondria)
What is the only organ in the body that can produce ketone bodies?
1328
The energy of activation
What determines the rate of reaction?
1329
Anticipation, associated with fragile X syndrome; Huntington's disease is also associated with a decrease in onset of age.
What is the term for the number of trinucleotide repeats increasing with successive generations and correlating with increased severity of disease?
1330
Dihydrofolate reductase
What enzyme is blocked by methotrexate/ trimethoprim?
1331
Aldolase B deficiencies are treated by eliminating fructose from the diet.
What fructose metabolism enzyme is deficient in patients with vomiting, apathy, diarrhea, jaundice, proximal renal tubular acidosis, hypoglycemia, and hyperuricemia?
1332
PRPP aminotransferase
What enzyme catalyzes the rate-limiting step in purine synthesis?
1333
Vitamin C
What water-soluble-vitamin deficiency is associated with poor wound healing, easy bruising, bleeding gums, anemia, and painful glossitis?
1334
1. Cortisol (stimulates PEPCK) 2. Glucagon 3. GTP
What three substrates control the enzyme PEPCK for the conversion of oxaloacetate (OAA) to pyruvate in the cytoplasm?
1335
I-cell disease is a result of a genetic defect affecting the phosphorylation of mannose residues.
What genetic defect is characterized by coarse facial features, gingival hyperplasia, macroglossia, psychomotor and growth retardation, club foot, claw hand, cardiorespiratory failure, and death in the first decade of life?
1336
3-Phosphoglycerate kinase and pyruvate kinase; this produces two ATPs per enzyme (total four ATPs)
What two glycolytic enzymes catalyze the substrate-level phosphorylations?
1337
Cholesterol biosynthesis
What pathway uses HMG CoA synthetase in the cytoplasm?
1338
RES(Reticular endothelial system)
Where in the body is heme converted to bilirubin?
1339
Sigma factor
What protein is required by prokaryotic RNA polymerases to initiate transcription at the promoter region of DNA?
1340
Aspartate transcarbamylase
What enzyme catalyzes the rate-limiting step in pyrimidine synthesis?
1341
It increases Ca2+ excretion from the kidney and increases bone mineralization.
What are the two actions of calcitonin?
1342
Purine nucleoside phosphorylase
What enzyme of the purine salvage pathway is deficient in the following? • Selective T-cell immunodeficiency
1343
Adenosine deaminase
What enzyme of the purine salvage pathway is deficient in the following? • SCID
1344
HGPRT
What enzyme of the purine salvage pathway is deficient in the following? • Lesch-Nyhan syndrome
1345
Alanine cycle
In what cycle does glucose go to the muscle, where it is converted to pyruvate and then into alanine before being taken back to the liver?
1346
UMP
What is the primary end product of pyrimidine synthesis?
1347
Uracil
What pyrimidine base is produced by deaminating cytosine?
1348
Histidine, because of the imidazole ring found in the R group, is basic.
What AA is classified as basic even though its pK is 6.5 to 7?
1349
Ferrochelatase
What enzyme is deficient in hereditary protoporphyria?
1350
eEF-2 is the site where Pseudomonas and Diphtheria toxins work.
What elongation factor is inactivated by ADP ribosylation, preventing translation?
1351
Omega-3; linoleic is omega-6
Is linolenic acid an omega-3 or omega-6 fatty acid?
1352
38 ATPs if aerobic, 2 ATPs if anaerobic (36 ATPs[malate shuttle] + 4 ATPs[Glycolysis] - 2 ATPs[phosphorylate glucose] = 38 ATPs)
How many ATPs per glucose are generated in glycolysis?
1353
Acetoacetate, acetone, and β-hydroxybutyrate
Name the three ketone bodies.
1354
1. Cytosine 2. Uracil (only in RNA) 3. Thymidine
What three bases are pyrimidines?
1355
rRNA
Name the RNA subtype based on the following: • The most abundant form of RNA in the cell
1356
snRNA
Name the RNA subtype based on the following: • Found only in the nucleus of eukaryotes and functions to remove introns from mRNA
1357
mRNA
Name the RNA subtype based on the following: • Only type of RNA that is translated
1358
tRNA
Name the RNA subtype based on the following: • Carries AA to the ribosome for protein synthesis
1359
Ribozymes
Name the RNA subtype based on the following: • RNA molecules with enzymatic activity
1360
hnRNA
Name the RNA subtype based on the following: • Found only in the nucleus of eukaryotic cells and are precursors of mRNA
1361
Glucose-6-phosphatase
What enzyme is deficient in the following glycogen storage disease? • von Gierke's disease
1362
Lysosomal α-1, 4-glucosidase
What enzyme is deficient in the following glycogen storage disease? • Pompe's disease
1363
Muscle glycogen phosphorylase
What enzyme is deficient in the following glycogen storage disease? • McArdle's disease
1364
Hepatic glycogen phosphorylase
What enzyme is deficient in the following glycogen storage disease? • Hers' disease
1365
Operon
In prokaryotes, what is the term for a set of structural genes that code for a select group of proteins and the regulatory elements required for the expression of such gene?
1366
Lysine and arginine
What are the two most common AAs found in histones?
1367
1. Epinephrine synthesis 2. Phosphatidyl choline 3. Creatine 4. Methylation of cytosine 5. N-methyl cap of mRNA
What five pathways use SAM (S-adenosylmethionine) as the methyl donor?
1368
Complex 4
What complex of the ETC contains Cu2+?
1369
6 ATPs (remember 2 pyruvates per glucose are produced, and 2 NADHs result from production of acetyl CoA, so 6 ATPs)
How many ATPs per glucose are produced by pyruvate dehydrogenase?
1370
70S ribosomes in prokaryotes and 80S ribosomes in eukaryotes
What is the size of the prokaryotic ribosome?
1371
Omega-3 fatty acids
What type of fatty acid is associated with a decrease in serum triglycerides and cardiovascular disease?
1372
Albinism. Tyrosine is converted to melanin by the enzyme tyrosinase.
What disease is produced by a deficiency in the enzyme tyrosinase?
1373
VLDLs
In what form are triglycerides sent to adipose tissue from the liver?
1374
The energy of activation (Ea)
What determines the rate of a reaction?
1375
G-6-PD
What is the rate-limiting enzyme of the HMP shunt?
1376
Pyridoxal phosphate is derived from vitamin B6 and is needed to transfer the amino groups of one carbon skeleton to another.
What vitamin is necessary for the transfer of one amino group from a carbon skeleton to another?
1377
Sphingomyelin (lecithin also, but it is not a sphingolipid)
What is the only sphingolipid that contains choline and PO4?
1378
DNA ligase
What protein catalyzes the formation of the last PDE bond between the Okazaki fragments to produce a continuous strand?
1379
Nephrotoxic oxylate stones
What type of damage to the kidneys is caused by drinking ethylene glycol (antifreeze)?
1380
Biotin (only if eaten in large quantities)
What water-soluble-vitamin deficiency may result from eating raw eggs?
1381
β-Galactosidase
Regarding the Lac operon, for what do the following genes code? • Z gene
1382
Galactoside permease
Regarding the Lac operon, for what do the following genes code? • Y gene
1383
Lac repressor protein
Regarding the Lac operon, for what do the following genes code? • I gene
1384
Thiogalactoside transacetylase
Regarding the Lac operon, for what do the following genes code? • A gene
1385
2, 4-Dinitrophenol
What attaches to protons and allows them to enter into the mitochondria without going through the ATP-generating system?
1386
Hypocalcemia and hypophosphatemia
1-α-Hydroxylase activity is increased in response to what two physiologic states? (hint: think of vitamin D activity)
1387
β-Hydroxybutyrate
What is the major ketone body produced during alcoholic ketoacidosis?
1388
Isocitrate dehydrogenase
What enzyme catalyzes the rate-limiting step in the TCA cycle?
1389
Autosomal dominant
Name the pattern of genetic transmission characterized thus: both M and F are affected; M may transmit to M; each generation has at least one affected parent; and one mutant allele may produce the disease.
1390
Internal 3', 5' PDE bonds
What bonds are broken by endonucleases?
1391
GLUT 2
Name the GLUT transporter based on the following: • Found in liver and pancreatic β-cells
1392
GLUT 4
Name the GLUT transporter based on the following: • Found in skeletal muscle and adipose tissues
1393
GLUT 3 and 4
Name the GLUT transporter based on the following: • Found in most tissues, including brain and RBCs
1394
Carnitine acyltransferase-I
What enzyme catalyzes the rate-limiting step in fatty acid oxidation?
1395
Succinate dehydrogenase
What enzyme of the TCA cycle also acts as complex II of the ETC?
1396
Buffers (remember that buffers are best when they are used in a pH range near its pK)
What is the term for chemicals that keep the pH constant despite the formation of acids and bases during metabolism?
1397
Biotin, ATP, and CO2
In the mitochondria, what complex is needed for pyruvate carboxylase to catalyze the reaction from pyruvate to OAA?
1398
3 ATPs by oxidative phosphorylation
How many ATPs are produced from cytoplasmic NADH oxidation using the malate shuttle?
1399
Acetyl CoA carboxylase
What is the rate-limiting step of the following? • Fatty acid synthesis
1400
Carnitine acyltransferase I
What is the rate-limiting step of the following? • β-Oxidation
1401
HMG CoA synthase
What is the rate-limiting step of the following? • Ketogenolysis
1402
HMG CoA reductase
What is the rate-limiting step of the following? • Cholesterol synthesis
1403
3'-5' direction, synthesizing RNA in the 5'-3' direction
What direction does RNA polymerase move along the template strand of DNA during transcription?
1404
False. Histidine operon is activated when there are low intracellular levels of histidine.
True or false? Histidine activates the histidine operon.
1405
The kidneys excrete the excess nitrogen from the body as urea in the urine.
What organ is responsible for the elimination of excess nitrogen from the body?
1406
Increase enzyme concentrations
What is the only way to increase maximum velocity (Vmax)?
1407
Adenine and guanine
Name the two purine bases found in both DNA and RNA.
1408
EF-Tu and EF-Ts of the 30S ribosomal subunit
What prokaryotic positioning enzyme in translation is blocked by the following? • Tetracycline
1409
EF-G of the 50S subunit
What prokaryotic positioning enzyme in translation is blocked by the following? • Erythromycin
1410
IF-2 of the 30S subunit
What prokaryotic positioning enzyme in translation is blocked by the following? • Streptomycin
1411
True. DNA polymerases have 3'-5' exonuclease activity for proofreading.
True or false? DNA polymerases can correct mistakes, whereas RNA polymerases lack this ability.
1412
Glycine and succinyl-CoA
What are the two precursors of heme?
1413
A decrease in Ca2+ and an increase in PO4-
What two factors cause PTH to be secreted?
1414
Transketolase and transaldolase. The reactions they catalyze are reversible.
What are the nonoxidative enzymes of the HMP shunt? Are the reactions they catalyze reversible or irreversible?
1415
Isoleucine, threonine, tryptophan, tyrosine, and phenylalanine
What are the five AAs that are both ketogenic and glucogenic?
1416
Aspartame
What artificial sweetener must patients with PKU avoid?
1417
Chromosome 5
Cri-du-chat syndrome results in a terminal deletion of the short arm of what chromosome?
1418
Glucosyl cerebroside
What substrate gets built up in Gaucher's disease?
1419
Single-strand DNA binding protein
What protein prevents ssDNA from reannealing during DNA replication?
1420
Conjugated (direct) hyperbilirubinemia, a transport defect
What type of jaundice is seen in Dubin-Johnson syndrome?
1421
cDNA libraries are derived from mRNA, are continuous, and contain no introns or regulatory elements.
What type of DNA library is made from the mRNA from a tissue expressing a particular gene?
1422
Isoniazid treatment
What is the most common cause of vitamin B6 deficiency?
1423
Glucocerebrosidase
What lysosomal enzyme is deficient in • Gaucher's disease?
1424
Sphingomyelinase
What lysosomal enzyme is deficient in • Niemann-Pick disease?
1425
Hexosaminidase A
What lysosomal enzyme is deficient in • Tay-Sachs disease?
1426
Barr bodies in females, T-cell receptor loci, and immunoglobulin light and heavy chain loci
What are the three exceptions to the rule of codominant gene expression?
1427
9 kcal/g from fat metabolism; 4 kcal/g from both CHO and protein metabolism
How many kilocalories per gram are produced from the degradation of fat? CHO? Protein?
1428
Increase the concentration of enzymes
What is the only way to increase the Vmax of a reaction?
1429
Diacylglycerols and phosphatidic acid
From which two substances are phospholipids made?
1430
Succinyl CoA
What intermediate enables propionyl CoA to enter into the TCA cycle?
1431
Vitamin A
What vitamin is an important component of rhodopsin?
1432
Palindrome
What is the term to describe the 5'-3' sequence of one strand being the same as the opposite 5'-3' strand?
1433
Glucose-6-phosphatase
What gluconeogenic enzyme is absent in muscle, accounting for its inability to use glycogen as a source for blood glucose?
1434
Rickets prior to fusion, osteomalacia if the deficiency occurs after epiphyseal fusion.
What is the term for vitamin D deficiency prior to epiphyseal fusion?
1435
Crigler-Najjar syndrome
In what disease is there a genetic absence of UDP-glucuronate transferase, resulting in an increase in free unconjugated bilirubin?
1436
Xanthine oxidase
What enzyme requires molybdenum as a cofactor?
1437
1. Fructose-6-phosphate 2. Glucose-6-phosphate 3. Glyceraldehyde-3-phosphate
At what three sites can the HMP shunt enter into glycolysis?
1438
pK (think of it as where half is base and half is acid)
What is the term for the pH range where the dissociation of H+ occurs?
1439
The rate of β-oxidation
What regulates the rate of ketone body formation?
1440
1. Fructokinase 2. Glucokinase 3. Glycerol kinase 4. PEPCK 5. Pyruvate carboxylase 6. Galactokinase 7. Fructose-1, 6-bisphosphatase 8. Glucose-6-phosphatase
What are the eight liver-specific enzymes?
1441
There are two eukaryotic upstream promoters. The TATA box is -25 base pairs upstream; the CAAT box is -75 bases upstream.
How many bases upstream is the eukaryotic TATA box promoter?
1442
IF and GTP (eIF for eukaryotes)
What is needed to initiate translation?
1443
16S subunit
What part of the 30S ribosome binds to the Shine-Dalgarno sequence?
1444
Complex I
What component of the ETC is inhibited by the following? • Barbiturates
1445
Cytochrome b/c1
What component of the ETC is inhibited by the following? • Antimycin A
1446
Cytochrome a/a3
What component of the ETC is inhibited by the following? • Cyanide
1447
Fo/F1 complex
What component of the ETC is inhibited by the following? • Oligomycin
1448
ATP/ADP Translocase
What component of the ETC is inhibited by the following? • Atractyloside
1449
Cytochrome a/a3
What component of the ETC is inhibited by the following? • CO
1450
Complex I
What component of the ETC is inhibited by the following? • Rotenone
1451
Cytochrome a/a3
What component of the ETC is inhibited by the following? • Azide
1452
Tryptophan
What AA is a precursor of the following substances? • Serotonin
1453
Glutamate
What AA is a precursor of the following substances? • GABA
1454
Histidine
What AA is a precursor of the following substances? • Histamine
1455
Glycine/arginine
What AA is a precursor of the following substances? • Creatine
1456
Tryptophan
What AA is a precursor of the following substances? • NAD
1457
Arginine
What AA is a precursor of the following substances? • N2O
1458
Homocysteine methyl transferase and methylmalonyl CoA transferase
What two enzymes are vitamin B12-dependent
1459
Prolyl and lysyl hydroxylases
What two post-transcriptional enzymes in collagen synthesis require ascorbic acid to function properly?
1460
1. Skin 2. Liver 3. Kidney
What three organs participate in production of vitamin D?
1461
Folic acid
What water-soluble-vitamin deficiency is associated with neural tube defects in the fetus?
1462
G1 phase; G2 and S phase are diploid (2N).
What phase of Interphase is haploid (N)?
1463
Glutamate
What neurotransmitter inhibits the optic nerve bipolar cell and shuts off in response to light?
1464
Histone acetylases is a regulator favoring gene expression. All of the others favor inactivation.
Which of the following—DNA methylating enzymes, scaffolding proteins, histone acetylases, or deacetylases—is a regulator of eukaryotic gene expression?
1465
X-linked dominant
Name the pattern of genetic transmission characterized thus: both M and F affected; no M-to-M transmission; affected M passes trait to all daughters, every generation; affected F passes trait to both sons and daughters; a single mutant allele can produce the disease.
1466
Vitamin E
What fat-soluble vitamin is connected to selenium metabolism?
1467
In eukaryotes transcription occurs in the nucleus and translation in the cytoplasm.
Why are eukaryotes unable to perform transcription and translation at the same time like prokaryotes?
1468
The folding of an AA chain
What is determined by the secondary structure of an AA?
1469
Folate, vitamin B12, and vitamin B6
What three vitamin deficiencies are associated with homocystinemia?
1470
When the pH is more acidic than the pI, it has a net positive charge, and when the pH is more basic than the pI, it has a net negative charge.
If the pH is more acidic than the pI, does the protein carry a net positive or net negative charge?
1471
cDNA, when it is made from mRNA
What form of continuous DNA, used in cloning, has no introns or regulatory elements?
1472
The one start codon, AUG, in eukaryotes codes for methionine and in prokaryotes formylmethionine.
What is the start codon, and what does it code for in eukaryotes? Prokaryotes?
1473
Diphyllobothrium latum
What parasite found in raw fish can produce vitamin B12 deficiency?
1474
Thymine
Methylating uracil produces what pyrimidine base?
1475
RNA polymerase III
Name the eukaryotic RNA polymerase based on the following: • Synthesizes tRNA, snRNA, and the 5S rRNA
1476
RNA polymerase II
Name the eukaryotic RNA polymerase based on the following: • Synthesizes hnRNA, mRNA, and snRNA
1477
RNA polymerase I
Name the eukaryotic RNA polymerase based on the following: • Synthesizes 28S, 18S and 5.8S rRNAs
1478
ELISA is used as a screening test because it is very sensitive; Western blot is used as a confirmatory test because it detects antibodies (protein) to the HIV virus.
What is the primary screening test used to detect HIV-infected individuals? Confirmatory test?
1479
None. Denaturation of dsDNA breaks hydrogen bonds, not covalent bonds.
How many covalent bonds per purine-pyrimidine base pairing are broken during denaturation of dsDNA?
1480
A-T are linked by 2 hydrogen bonds, C-G by 3 hydrogen bonds.
How many hydrogen bonds link A-T? C-G?
1481
Helicase (requires ATP for energy)
What DNA replication enzyme breaks the hydrogen bond of base pairing, forming two replication forks?
1482
Nitroblue tetrazolium reduction test (NBT). It is negative in patients with CGD because there is no production of oxygen radicals.
What test is done to diagnose CGD?
1483
The number of Ags that the Ab can bind
What is the valence of an Ig molecule equal to?
1484
Allelic exclusion. It is to ensure that one B cell produces only one Ab.
What is the name of the process that ensures that each B cell produces only one heavy-chain variable domain and one light chain?
1485
IgM
What is the major Ab of the primary immune response?
1486
Cell-mediated immunity
What form of immunity is responsible for removal of intracellular infections?
1487
False. Direct tests detect Ags; indirect tests detect Abs.
True or false? Direct fluorescent Ab test is used to detect Abs in a patient?
1488
Thrombocytopenia, eczema, and immunodeficiency is the triad of this X-linked recessive disorder.
What is the triad of Wiskott-Aldrich syndrome?
1489
C3 deficiency
What complement factor deficiency leads to • Increased susceptibility to pyogenic infections?
1490
C5-C8 deficiency
What complement factor deficiency leads to • Recurrent gonococcal infections?
1491
C1, C2, or C4 deficiency
What complement factor deficiency leads to • Leukocyte adhesion deficiency with poor opsonization?
1492
C1 inhibitor (C1-INH)
What complement factor deficiency leads to • Hereditary angioedema?
1493
IgG4
Which IgG cannot activate complement?
1494
CD40 ligand
Name the T-cell CD marker: • Essential for Ab isotype switching (for B cell binding)
1495
CD8
Name the T-cell CD marker: • Interacts with MHC class I molecules
1496
CD3
Name the T-cell CD marker: • Expressed on all T cells and is needed as a signal transducer for the T cell receptor
1497
CD4
Name the T-cell CD marker: • Interacts with MHC class II molecules
1498
CD28
Name the T-cell CD marker: Is a costimulatory molecule in T cell activation
1499
Dendritic cells, macrophages, and thymic epithelial cells
What three cells are essential for T-cell differentiation in the thymus?
1500
B cells; macrophages and dendritic cells are nonspecific.
What is the only specific Ag-presenting cell?
1501
Rigors, leukopenia, decrease in blood pressure, and increase in temperature
What is the tetrad of Jarisch-Herxheimer reaction?
1502
Plasma cell (mature B lymphocyte)
What is the name of the B cell that secretes Ig?
1503
There would be two Fab and Fc regions.
What would be the result if an Ab were cleaved with papain?
1504
14 days
What is the bone marrow maturation time for a phagocytic cell?
1505
LTC4 and LTD4
Which leukotrienes are associated with the late-phase inflammatory response?
1506
Affinity (one of each)
What is the term for the strength of the association between Ag and an Ab?
1507
False. Fewer Ags are needed to trigger a secondary response.
True or false? More Ag is needed to produce a secondary immune response than a first immune response.
1508
Avidity (more than one binding site)
What is the term for the strength of association between multiple Abbinding sites and multiple antigenic determinants?
1509
IgG
What Ig mediates ADCC via K cells, opsonizes, and is the Ig of the secondary immune response?
1510
Coombs test
What test is used to detect anti-RBC Abs seen in hemolytic anemia?
1511
CD8+ T cells (cytotoxic) Remember, 8×1=8 (CD×8×MHC class I=8); 4×2=8 (CD×4 MHC class II 8)
What subset of T cells recognizes the MHC class I Ags?
1512
CD40
What cell surface marker is found on activated helper T cells?
1513
IgA, IgD, IgE, IgG, and IgM
What are the five Ig isotypes?
1514
Beta2-integrins
Which integrin mediates the adhesion to endothelial cells for migration in and out of the blood during an immune response?
1515
Type II hypersensitivity reaction
What type of hypersensitivity is an Ab-mediated response against our own cells, receptors, or membranes via IgG or IgM?
1516
Antigenic determinant (epitope)
What is the term to describe the limited portion of an Ag that is recognized by an Ab?
1517
INF-gamma
What cytokine do Th1 cells secrete to inhibit Th2 cell function?
1518
Thymic epithelial cells, dendritic cells, and macrophages
What three cells are essential for T-cell maturation?
1519
Hapten (not immunogenic)
What is the term for a single isolated antigenic determinant?
1520
The Fc region of IgG and C3b
What are the two opsonizing factors?
1521
IgA deficiency; patients commonly present with recurrent sinopulmonary infections and GI disturbances.
What is the most common Ig deficiency?
1522
Primary follicle (in the white pulp)
What is the name of the B cell-rich area of the spleen?
1523
IL-8. It not only is chemotactic, it also acts as an adhesive for neutrophils.
What IL, produced by macrophages, is chemotactic for neutrophils?
1524
IgA
What Ig prevents bacterial adherence to mucosal surfaces?
1525
1. One cell type 2. One Ab type 3. Random selection of hypervariable regions, and only cells with bound Ag undergo clonal expansion
What are the three rules of clonal selection?
1526
7 to 14 days
What is a plasma cell's life expectancy?
1527
Idiotypes
What are defined by Ag-binding specificity?
1528
Affinity
What type of binding occurs with one Fab or one idiotype of IgG?
1529
CD3 molecule. It transmits signals to the inside of the T cell to trigger activation
What molecule that is needed to trigger T cell activation is noncovalently linked to TCR?
1530
Thymus-independent Ags
What is the term for Ags that activate B cells without T-cell signaling?
1531
1. Covalent bonding between the hapten and carrier 2. B-cell exposure to hapten twice 3. T-cell exposure to carrier twice
What are the three rules governing a secondary immune response?
1532
Type IV hypersensitivity reaction (delayed type because of the 48-96 hour latency)
What type of hypersensitivity is a T cell-mediated response to Ags that are not activated by Ab or complement?
1533
Kupffer cells
Name the macrophages by location: • Liver
1534
Alveolar macrophages
Name the macrophages by location: • Lungs
1535
Microglial cells
Name the macrophages by location: • CNS
1536
Mesangial macrophages
Name the macrophages by location: • Kidney
1537
Adenosine deaminase (ADA) deficiency
What is the first human disease successfully treated with gene therapy?
1538
CD16 and CD56
What receptors are the best markers for NK cells?
1539
False. It is reversible because the Ags and Abs are not linked covalently.
True or false? Ag-Ab binding is irreversible
1540
T cells, B cells, and macrophages
What three major cell lines participate in the acquired immune system?
1541
ELISA. It detects anti-p24 IgG.
What test is used to screen for HIV?
1542
Immature B cells
During what stage of B-cell development is IgM first seen on the surface?
1543
IgE
What Ig is responsible for Antibody-Dependent Cell-mediated Cytotoxicity of parasites, has a high-affinity Fc receptor on mast cells and basophils, and is responsible for the allergic response?
1544
True. B cell antigen receptors are Abs.
True or false? B-cell Ag receptors can be secreted.
1545
More Ab is produced in less time in a secondary immune response (shorter lag period).
Are more Abs produced in a primary or a secondary immune response?
1546
Opsonization
By which process do Abs make microorganisms more easily ingested via phagocytosis?
1547
MHC class II Ags. This is accomplished via CD4 T cells.
What MHC class acts to remove foreign Ags from the body?
1548
Pernicious anemia
What disorder is characterized by autoantibodies to IF?
1549
IL-4, IL-10, and IL-13
What cytokines do Th2 cells secrete to inhibit Th1 cell function?
1550
Valence
What is the term for the number of Ag-binding sites on an Ig?
1551
RBCs. That is why it is called red pulp.
Which major cell type is found in the red pulp of the spleen?
1552
Lipoxygenase pathway, from arachidonic acid
What is the name of the pathway that produces leukotrienes?
1553
Mast cells
What is the term to describe basophils that have left the bloodstream and entered a tissue?
1554
1. IgA receptor 2. Transport of IgA across epithelial barriers 3. Protection of IgA from degradative proteases
What are the three major functions of secretory IgA?
1555
IL-3 (3 face down is an M)
What IL is important in myeloid cell development?
1556
Isotypes
What is the term for different classes and subclasses of the same gene products?
1557
IgM
What is the first Ab a baby makes?
1558
Flow cytometric analysis
What test, by using specific Abs to different receptors, allows for rapid analysis of cell types in a blood sample?
1559
PALS (Parietolateral lymphocytic sheath)
What is the name of the T cell-rich area of the spleen?
1560
C3a, C4a, and C5a
What three complement fragments are also anaphylatoxins?
1561
CD40
Name the B-cell CD marker: • Required for class switching signals from T cells
1562
CD21; it is a complement receptor for cleaved C3
Name the B-cell CD marker: • Receptor for EBV
1563
CD19
Name the B-cell CD marker: • Used clinically to count B cells in blood
1564
Agglutination test
What immunologic test checks for a reaction between Abs and a particular Ag? (hint: ABO typing)
1565
LTB4
Which leukotriene is chemotactic for neutrophils?
1566
IgA
What Ig is associated with mucosal surfaces and external secretions?
1567
Allotypes
What are the genetic variants of a molecule within members of the same species?
1568
IL-4 is secreted to activate B cells. This begins the second step in the immune response, known as Activation. CD4 T cells secrete INF-alpha to activate macrophages
What cytokine do CD4 T cells secrete to activate B cells when the specific peptide in the groove of the MHC II molecule interacts with the TCR?
1569
Invariant chain
Which protein prevents internal binding of self proteins within an MHC class II cell?
1570
There would be a Fab' region; thus, it would still be able to participate in precipitation and agglutination.
What would be the result if an Ab were cleaved with pepsin?
1571
Catalase-negative bacteria secrete H2O2 as a byproduct (remember, catalase breaks down H2O2), allowing the neutrophils to use it as the substrate for the other toxic metabolites. Patients with CGD are prone to catalase-positive bacterial infections.
Why are patients with Chronic Granulomatous Disease not prone to develop infections from catalase-negative bacteria?
1572
gamma and delta chains
What are the two chains of the TCR that are mainly found on the skin and mucosal surfaces?
1573
IL-4
Which IL is associated with increases of IgG and IgE?
1574
Adaptive branch. The adaptive branch of the immune system has a slow initiation with rapid responses thereafter.
What branch of the immune system is acquired in response to an Ag?
1575
False. B cells recognize unprocessed Ags, but T cells can recognize only processed Ags.
True or false? T cells can recognize, bind, and internalize unprocessed Ags.
1576
Type III hypersensitivity reaction
What type of hypersensitivity is a result of high circulating levels of soluble immune complexes made up of IgG or IgM Abs?
1577
Mature B cell; the memory B cell can have IgG, IgA, or IgE on its surface.
At what stage of B-cell development can IgM or IgD be expressed on the cell surface?
1578
DiGeorge syndrome, which is due to a failure of the third and fourth pharyngeal pouch development. Remember, B cell deficiencies are associated with extracellular infection. T cell deficiencies are associated with intracellular infections
What T cell deficiency syndrome is associated with facial anomalies, hypoparathyroidism, thymic hypoplasia, and recurrent viral and fungal infections?
1579
Ag-Ab complexes. The alternative pathway protects without use of Abs; the pathogen is the stimulus.
What is the stimulus for the classical pathway activation?
1580
IgM; IgD follows shortly thereafter.
What is the first membrane-bound Ig on B cell membranes?
1581
Hypervariable region
What region of the Ig does not change with class switching?
1582
Invariant chain. This is essential because the CD4 T cells have antigen receptors only for peptides bound to the MHC II molecule. (MHC restriction)
In MHC class II molecules, what chain blocks access to the peptide-binding groove during transportation within the cell, ensuring that the MHC class II-peptide complex is transported to the surface?
1583
The short arm of chromosome 6
What chromosome codes for HLA gene products?
1584
T cells, not B cells
What cells are atypical on a peripheral blood smear in heterophil-positive mononucleosis?
1585
IgA
What is the major Ig of the secondary immune response in the mucosal barriers?
1586
Ataxia-telangiectasia
What AR disorder is seen by age 1 to 2 with recurrent sinopulmonary infections, uncoordinated muscle movements, and dilation of the blood vessels?
1587
1. C5a 2. Leukotriene B4 3. IL-8 4. Bacterial peptides
What are the four chemotactic agents?
1588
Th2
What subset of CD4 helper T cells stimulate B-cell division and differentiation?
1589
Hypervariable region (three per light chain; three per heavy chain)
Which region of the variable domain comprises the Ag-binding site of the Ab?
1590
False; it is for the production of toxic metabolites.
True or false? The increased oxygen consumption after phagocytosis is for ATP production.
1591
Antigenic determinant (epitope). (Idiotypes bind to epitopes.)
What is the limited portion of a large Ag that will actually be recognized and bound to an Ab and that contains approximately five to six amino acids or four to five hexose units?
1592
C5a
What complement factor or factors are associated with • Chemotaxis?
1593
C5-C9
What complement factor or factors are associated with • Membrane attack complex (MAC)?
1594
C3b
What complement factor or factors are associated with • Opsonization?
1595
C3a, C4a, C5a
What complement factor or factors are associated with • Anaphylaxis?
1596
As the isotype is switched, the Ab specificity does not change because it does not affect the variable chains.
What happens to the Ab specificity when class switching occurs in mature B cells?
1597
IL-10
What IL down-regulates cell mediated immunity?
1598
Autograft
Name the type of graft described by these transplants: • From one site to another on the same person
1599
Isograft
Name the type of graft described by these transplants: Between genetically identical individuals
1600
Allograft
Name the type of graft described by these transplants: • From one person to the next (the same species)
1601
Xenograft
Name the type of graft described by these transplants: • From one species to another
1602
Chemotaxis
What is the name of the process in which cells migrate toward an attractant along a concentration gradient?
1603
Hormone secretion for T-cell differentiation and T-cell education to recognize self from nonself
What are the two functions of the thymus in T-cell differentiation?
1604
Paracortex
What is the name of the T cell-rich area of the lymph node?
1605
CD3
What cell surface marker do all T cells have?
1606
True. Common variable hypogammaglobinemia first appears by the time patients reach their 20s and is associated with a gradual decrease in Ig levels over time.
True or false? Patients with common variable hypogammaglobinemia have B cells in the peripheral blood.
1607
IgM
What is the Ig associated with the primary immune response?
1608
MHC class I antigens; they are also found on the surface of platelets.
What MHC class of antigens do all nucleated cells carry on their surface membranes?
1609
IgG
What Ig is responsible for activation of complement, opsonization, and ADCC and is actively transported across the placenta?
1610
Processed antigenic peptides bound in the groove of the MHC molecule
What type of Ag do T cells recognize?
1611
IgA
What Ig is the major protective factor in colostrum?
1612
The CD4 T cell; the APC is the first cell in the immune response.
What is the second cell involved in the immune response?
1613
Negative selection. This helps to prevent autoimmune diseases.
What is the term for thymic induction of T cells with high-affinity Ag receptors for self that are programmed to undergo apoptosis?
1614
1. H2O2 2. Superoxide 3. Hydroxyl radical 4. Myeloperoxidase 5. Hypochlorous acid
What five main oxidizing reactions are used to kill ingested organisms?
1615
IgE
What Ig is associated with ADCC for parasites?
1616
True. Remember, all nucleated cells (and platelets) have MHC class I Ags, and RBCs are not nucleated.
True or false? RBCs do not have MHC class I Ags on their surface.
1617
IgE. It attaches via receptor for the Fc region of the heavy epsilon chain
What Ig is associated with mast cell and basophil binding?
1618
IL-2. T cells express IL-2 receptors on their surface to induce self-expression.
What IL do T cells secrete to induce T-and B-cell division?
1619
CD4+T cells
Development of what T cell line follows low affinity for self-MHC class II Ags in the thymus?
1620
Cytokine. If a cytokine affects another class of leukocytes, it is called an interleukin.
What is the term for a substance secreted by a leukocyte in response to a stimulus?
1621
Th2 cells
What subset of CD4 T cells is responsible for mast cell and eosinophil precursor proliferation?
1622
1. Recognize self from nonself 2. Amplify via cell division or complementation 3. Control the level of the response 4. Remove foreign material
What are the four major functions of the acquired immune system?
1623
CD14
What endotoxin receptor is the best marker for macrophages?
1624
Immunogenicity; antigenicity refers to Ab/lymphocyte reaction to a specific substance.
What is the term for the inherent ability to induce a specific immune response?
1625
The Beta-2-microglobin. It is the separately encoded Beta-chain for class I Ags.
What molecule differentiates the MHC class I from II Ag? (Hint: it's in the light chain.)
1626
Bruton X-linked hypogammaglobinemia. Tyrosine kinase deficiency leads to inadequate B cell maturation.
What B cell disorder is characterized by pre-B cells in the bone marrow, no circulating B cells in plasma, normal cell-mediated immunity, low Igs, and appearance by 6 months of age?
1627
IgG3
What subtype of IgG does not bind to staphylococcal A protein?
1628
Eosinophil chemotactic factor A
What mast cell mediator is a chemotactic agent?
1629
IgG
What is the major Ig of the secondary immune response?
1630
TCR
What T-cell surface projection recognizes and reacts to foreign Ags (presented by APCs)?
1631
Western blot
What is the confirmatory test for HIV?
1632
Leukotriene B4 (LTB4)
What is the name of the major chemotactic agent released from • Neutrophils?
1633
IL-8 (IL-1 and TNF-gamma also)
What is the name of the major chemotactic agent released from • Macrophages?
1634
C5a
What is the name of the major chemotactic agent released from • The blood serum? (Hint: it is a complement factor.)
1635
F-Met-Peptides
What is the name of the major chemotactic agent released from • Bacteria?
1636
CD19
What cell surface marker is found on blood B cells?
1637
Primary follicle of the cortex
What is the name of the B cell-rich area in the lymph node?
1638
1. Decrease concentrations of Ag levels 2. Administer IgG in high concentrations 3. Inhibit B cells with Ag bound to IgG (complexes) 4. Turn off the original T or B cell with anti-Ab
What are the four ways to down-regulate the immune system?
1639
IgG
What is the only Ig that crosses the placenta?
1640
Rho (D) immune globulin (RhoGAM), an anti-RhD IgG antibody, prevents generation of RhD-specific memory B cells in the mother.
What is given to pregnant women within 24 hours after birth to eliminate Rh+ fetal blood cells from their circulation?
1641
IL-7 (A 7 upside down is an L; L is for Lymphoid)
What IL is essential for lymphoid cell development?
1642
Plasma cell
What type of cell can never leave the lymph node?
1643
HMP shunt
Via what pathway is glycolysis increased after phagocytosis?
1644
Transient hypogammaglobinemia of infancy; it usually resolves by age 16 to 30 months.
What is the term for a delay in the onset of normal IgG synthesis seen in the fifth to sixth month of life?
1645
Th1; they are also responsible for delayed-type hypersensitivity (type IV)
What subset of CD4 helper T-cell function is helping the development of CD8 T cells?
1646
Avidity. There is a positive correlation between valence numbers and avidity.
What is the term for the strength of the association between Ags and Abs?
1647
Free, unprocessed Ag
What type of Ag do B cells recognize?
1648
IgD; IgM is also correct.
What Ig is associated with Ag recognition receptor on the surface of mature B cells?
1649
Chromosome 6
Which chromosome is associated with MHC genes?
1650
Ag processing; it is needed for class I molecules. Class II molecules have an invariant chain that protects them from breakdown.
What is the term for processing an APC's pinocytosed material by fusing with a lysosomal granule and cleaving the Ag into peptide fragments?
1651
Radial Immuno Diffusion (RID) for Ig levels.
What is the most common precipitin test used in clinical medicine?
1652
IgM
What Ig activates the complement cascade most efficiently?
1653
Microcytotoxic assay
What assay is used to identify MHC class I molecules?
1654
IL-5. It also stimulates eosinophil proliferation.
Which IL increases IgA synthesis?
1655
Hapten; if it is coupled with a carrier, it may become immunogenic.
What is the term for an immunogenic agent that is too small to elicit an immune response?
1656
Myasthenia gravis
What type II hypersensitivity disorder is defined as • Autoantibodies directed against ACh receptors?
1657
Autoimmune thrombocytopenia purpura
What type II hypersensitivity disorder is defined as • Autoantibodies directed against platelet integrin?
1658
Goodpasture syndrome
What type II hypersensitivity disorder is defined as • Autoantibodies against the type IV collagen in the basement membrane of the kidneys and lungs?
1659
Graves disease
What type II hypersensitivity disorder is defined as • Autoantibodies directed against the TSH receptor?
1660
Autoimmune hemolytic anemia
What type II hypersensitivity disorder is defined as • Autoantibodies directed against RBC Ag I?
1661
IgA
What Ig activates the alternate pathway, neutralizes bacterial endotoxins and viruses, and prevents bacterial adherence?
1662
NADPH oxidase is deficient, resulting in an inability to produce toxic metabolites.
What enzyme is deficient in patients with CGD?
1663
IgG4
What subtype of IgG does not activate complement cascade?
1664
T and B-cells belong to the adaptive branch, whereas PMNs, NK cells, eosinophils, macrophages, and monocytes belong to the innate branch.
What two cell lines of the immune system do not belong to the innate branch?
1665
CD4+ T cells (helper)
What subset of T cells recognizes the MHC class II Ags?
1666
CD8+ T cells
What T cell line arises from low affinity for self-MHC class I Ags in the thymus?
1667
MHC class I Ags (the endogenous pathway). This allows the body to eliminate tumor cells, virus-infected cells—anything the body recognizes as nonself via CD8+ T cells.
What MHC class functions as a target for elimination of abnormal host cells?
1668
Neutrophils, eosinophils, and basophils
What are the three polymorphonuclear leukocytes? Be specific.
1669
Primary Hemochromatosis
What disease is associated with the HLA-A3 allele
1670
Psoriasis, ankylosing spondylitis, inflammatory bowel disease, and Reiter's syndrome
What diseases are associated with the HLA-B27 allele
1671
Systemic lupus erythematosus
What disease is associated with the HLA-DR2 and HLA-DR3 alleles
1672
Sjogren's syndrome, active hepatitis, systemic lupus erythematosus (with HLA-DR2) and type 1 diabetes (with HLA-DR4)
What diseases are associated with the HLA-DR3 allele
1673
Rheumatoid arthritis and type 1 diabetes (with HLA-DR3)
What diseases are associated with HLA-DR4
1674
It forms a germinal tube at 37°C.
What does Candida albicans do that distinguishes it from other fungi?
1675
Entamoeba histolytica (treat with metronidazole)
What protozoal parasite results in dysentery with blood and pus in the stool, is transmitted via fecal-oral route, is diagnosed by cysts or trophozoites in the stool, and forms liver abscesses and inverted flask-shaped lesions in the large intestine?
1676
Pseudomonas aeruginosa
What is the most likely causative organism for a patient with folliculitis after spending time in a hot tub?
1677
HIV and poxvirus
What two viruses get their envelope not from budding but from coding?
1678
Hepatitis B
Which type of hepatitis can cause hepatocellular carcinoma?
1679
Clostridium perfrigens
Gas gangrene is associated with which Clostridium species?
1680
Blastomyces dermatitidis
Which dimorphic fungus is found as hyphae with nondescript conidia in rotting wood in the Upper Great Lakes, Ohio, Mississippi, eastern seaboard of the United States, and southern Canada?
1681
Toxoplasma gondii
Which parasitic organism, when it crosses the placenta, results in intracerebral calcifications, chorioretinitis, microcephaly, hydrocephaly, and convulsions?
1682
Staphylococcus aureus
What staphylococcal species is positive for Beta-hemolysis and coagulase?
1683
Anopheles mosquito
What vector is associated with malaria?
1684
Pseudohyphae
What is the term for hyphae with constrictions at each septum that are commonly seen in Candida albicans?
1685
Echinococcus multilocularis
Which cestode infection results in alveolar hydatid cyst disease?
1686
Hepatitis C
Which hepatitis virus is in the Flaviviridae family?
1687
Shigella
What nonmotile gram-negative, non-lactose-fermenting facultative anaerobic rod uses the human colon as its only reservoir and is transmitted by fecal-oral spread?
1688
Coxiella burnetii
What is the only Rickettsia that is stable in the environment?
1689
After the eclipse period
Regarding the viral growth curve, is the internal virus present before or after the eclipse period?
1690
HBc Ab
What Ab is an indication of recurrent disease for hepatitis?
1691
Listeria monocytogenes
What small gram-positive, non-spore-forming rod is a facultative intracellular parasite that grows in the cold and is associated with unpasteurized milk products?
1692
Poxvirus
What is the only DNA virus that is not icosahedral?
1693
Fusobacterium
Which organism causes trench mouth?
1694
False. Adenovirus vaccine is a live pathogenic virus in an enteric coated capsule. All of the others are inactivated vaccines.
True or false? All of the following are inactivated vaccines available in the United States: influenza, Vibrio cholera, hepatitis A, rabies, and adenovirus.
1695
Plasmodium falciparum
Name the Plasmodium species based on the following information: No persistent liver stage or relapse; blood smear shows multiple ring forms and crescent-shaped gametes; irregular febrile pattern; associated with cerebral malaria
1696
Plasmodium malariae
Name the Plasmodium species based on the following information:No persistent liver stage or relapse; blood smear shows rosette schizonts; 72-hour fever spike pattern
1697
Plasmodium ovale
Name the Plasmodium species based on the following information:Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites with oval, jagged infected RBCs; 48-hour fever spike pattern
1698
Plasmodium vivax
Name the Plasmodium species based on the following information: Persistent hypnozoite liver stage with relapses; blood smear shows amoeboid trophozoites; 48-hour fever spike pattern; the most prevalent form worldwide
1699
False. The PPD tests exposure to TB.
True or false? A positive PPD skin test indicates the patient has active pulmonary disease.
1700
CMV; Toxoplasma also causes intracerebral calcifications but it is a parasite.
What viral infection is known to cause intracerebral calcifications?
1701
HPVs 16 and 18
What viruses are associated with cervical carcinoma?
1702
Helicobacter pylori
What motile, gram-negative spiral bacillus with flagella is oxidase positive, urease positive, and associated with gastritis, peptic ulcer disease, and stomach cancer?
1703
GP41
What glycoprotein in the HIV virus is used for fusion?
1704
HBeAg
What Ag is needed to diagnose an infectious patient with hepatitis B?
1705
Borrelia recurrentis
Which organism causes multiple infections by antigen switching?
1706
HBsAg (incubation period)
What is the first Ag seen in an individual with hepatitis?
1707
Variola (smallpox)
With which DNA virus are Guarnieri bodies associated?
1708
Enterobius vermicularis; the treatment is albendazole.
What nematode is known as pinworms? What is the treatment?
1709
P1 protein
What protein allows Mycoplasma to attach to the respiratory epithelium?
1710
Rotavirus
What organism is associated with the following types of diarrhea? Day care-associated diarrhea in infants
1711
Clostridium perfringens
What organism is associated with the following types of diarrhea? Watery diarrhea from beef, poultry, or gravies
1712
Vibrio cholera
What organism is associated with the following types of diarrhea? Rice water stools
1713
Vibrio parahaemolyticus
What organism is associated with the following types of diarrhea? Diarrhea associated with raw or undercooked shellfish
1714
Enterohemorhagic Escherichia coli
What organism is associated with the following types of diarrhea? Bloody diarrhea associated with hamburger ingestion
1715
Sporothrix schenckii
Which fungus is found worldwide on plants, is a cigar-shaped yeast in tissue form, and results in rose gardener's disease?
1716
Hepatitis A (infectious)
Which type of hepatitis is a picornavirus?
1717
Listeria
What gram-positive rod is distinguished by its tumbling motility?
1718
The sandfly
What is the vector for Leishmania infections?
1719
Eclipse period
What is the term of the viral growth period when no viruses can be found intracellularly?
1720
Coxiella burnetii
What organism causes Q fever?
1721
1. Picornavirus 2. Calicivirus 3. Reovirus (Remember PCR)
What are the three naked RNA viruses?
1722
gag gene
HIV's capsid, core nucleocapsid, and matrix proteins are products of what structural gene?
1723
Histoplasma capsulatum infects the cells of the RES and can result in hepatosplenomegaly.
What facultative intracellular fungus is associated with hepatosplenomegaly?
1724
Hepatitis E
What type of hepatitis has the highest mortality rate among pregnant women?
1725
Meningococcus (Gonococcus does not)
Which gram-negative diplococcus ferments maltose?
1726
No. Prions are infectious proteins, so antibiotics are useless.
Are antibiotics helpful in treating a disease caused by a prion?
1727
Bacillus anthracis
What bacterium is responsible for woolsorter's disease?
1728
Coxsackie A
What picornavirus is associated with hand-foot-and-mouth disease?
1729
Schistosoma have separate males and females.
What is the only trematode that is not hermaphroditic?
1730
Legionella (think air conditioners)
What water-associated organism is a weakly stained gram-negative rod that requires cysteine and iron for growth?
1731
EBV
With what virus are Downey type II cells associated?
1732
False. Interferons are produced by virally infected cells to inhibit viral replication via RNA endonucleases. They do not act directly on the virus, nor are they virus specific.
True or false? Interferons are eukaryotic proteins that inhibit viral replication by being virus specific.
1733
Aedes mosquito
What is the vector for yellow fever?
1734
Brucella
What small, facultative gram-negative intracellular rod's transmission is associated with unpasteurized dairy products and undulant fever?
1735
TRUE
True or false? All Proteus species are urease positive.
1736
Epidermophyton
Which genus of dermatophytes is associated with the following sites of infection? • Nails and skin only
1737
Microsporum
Which genus of dermatophytes is associated with the following sites of infection? • Hair and skin only
1738
Trichophyton
Which genus of dermatophytes is associated with the following sites of infection? • Skin, hair, and nails
1739
P24
What protein of the HIV virus does ELISA detect to determine whether a patient is HIV positive?
1740
Staphylococcus
What genus of bacteria is described by catalase-positive, gram-positive cocci in clusters?
1741
True. Staphylococcus aureus and group D enterococci also grow in high-salt media.
True or false? Vibrio parahaemolyticus require NaCl in its growth medium.
1742
Molluscum contagiosum
What virus causes small pink benign wartlike tumors and is associated with HIV-positive patients?
1743
Brucella and Listeria (has tumbling motility)
What two bacteria are associated with drinking unpasteurized milk?
1744
Taenia solium
What cestode causes cysticercosis?
1745
HHV 6
What DNA virus is associated with exanthem subitum (roseola)?
1746
Mycobacterium leprae
Which acid-fast rod is an obligate intracellular parasite?
1747
Gametocytes
What form of the Plasmodium species is ingested by mosquitoes?
1748
Bordetella pertussis
What small gram-negative aerobic rod requires Regan-Lowe or Bordet- Gengou medium for growth?
1749
False. Staphylococci have catalase; streptococci do not.
True or false? Streptococci have catalase.
1750
1. Neisseria meningitidis 2. Haemophilus influenzae 3. Streptococcus pneumoniae
What three bacteria are positive to quellung reactive test?
1751
Staphylococcus aureus
A patient goes to the ER with abdominal cramps, vomiting, diarrhea, and sweating less than 24 hours after eating potato salad at a picnic; what is the most likely responsible organism?
1752
TRUE
True or false? All spore formers are gram positive.
1753
Hepadnavirus
What is the only DNA virus that has the reverse transcriptase enzyme?
1754
Integrase
What enzyme does HIV use to integrate the proviral dsDNA into the host?
1755
Hepatitis B and hepatitis C
What are the two hepatitis viruses that can be chronic and can lead eventually to hepatocellular carcinoma?
1756
Clostridium botulinum
What gram-positive spore-forming anaerobic rod blocks the release of ACh at the NMJ, resulting in reversible flaccid paralysis?
1757
Protease, integrase, and reverse transcriptase
Name three products of HIV's pol gene.
1758
Hypnozoite
What form of Plasmodium species affects the liver?
1759
Yersinia pestis
What small coagulase-positive, gram-negative rod with bipolar staining is a facultative intracellular parasite resulting in buboes?
1760
Trypanosoma cruzi
What hemoflagellate species is the cause of Chagas disease?
1761
ACh receptor
To what host cell receptor does the rabies virus attach?
1762
Hepatitis A
Which hepatitis virus is in the Picornaviridae family?
1763
Abs to HBsAg
Abs to what hepatitis B Ag provide immunity?
1764
Blastoconidia
What type of spore is defined as an asexual budding daughter yeast cell?
1765
Parasites
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Eukaryotic cell, 15 to 25 microns, 80S ribosomes, no cell walls, replicates via cytokinesis with mitosis and meiosis
1766
Bacteria
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Small prokaryotic cells; no histones; 70S ribosomes; no sterols in cell membrane; peptidoglycans in cell wall; replicate by binary fission
1767
Fungi
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Eukaryotic cell; 3 to 10 microns; 80S ribosomes; chitinous cell wall; ergosterol in cell membrane; replicate via cytokinesis with mitosis and meiosis
1768
Viruses
Which of the following characteristics accurately describe fungi, bacteria, viruses, or parasites? • Acellular; some are enveloped; replicate within the host cell; no cell walls
1769
Aedes (the same for yellow fever)
What mosquito is the vector for dengue fever?
1770
False. Meningococcus is encapsulated; Gonococcus is not.
True or false? Gonococcus is encapsulated.
1771
Variola virus (Smallpox)
What virus is associated with Guarnieri bodies?
1772
After the latent period
Regarding the viral growth curve, is the external virus present before or after the latent period?
1773
Nocardia asteroides
What aerobic branching rod that is gram positive and partially acid-fast is associated with cavitary bronchopulmonary disease in immunosuppressed patients?
1774
Pneumocystis carinii
What obligate extracellular fungus is silver stain-positive and is associated with pneumonia in patients with AIDS?
1775
Salmonella typhi
What Vi-encapsulated gram-negative motile anaerobic rod that produces H2S is associated with enteric fever, gastroenteritis, and septicemia?
1776
Vibrio vulnificus
What is the most likely organism causing cellulitis in a patient who was cut by an oyster shell?
1777
Calicivirus
What virus is associated with the Norwalk agent?
1778
Streptococcus agalactiae
Describe the organism based on the following information: • Beta-Hemolytic Streptococcus; positive cAMP test; hydrolyzes hippurate
1779
Pneumococcus (Streptococcus pneumoniae)
Describe the organism based on the following information: • Alpha-Hemolytic Streptococcus; lysed by bile; sensitive to Optochin
1780
Streptococcus viridans
Describe the organism based on the following information: • Alpha-hemolytic Streptococcus; not lysed by bile; not sensitive to Optochin
1781
Streptococcus pyogenes
Describe the organism based on the following information: • Beta-hemolytic Streptococcus sensitive to bacitracin
1782
Clostridium perfringens
What is the only nonmotile pathogenic Clostridium species?
1783
Positive sense RNA can be used as mRNA. Negative sense RNA cannot be used as mRNA; it requires special RNA-dependent RNA polymerases.
If a virus has positive sense RNA, can it be used as mRNA or is a template needed?
1784
Adult tapeworms develop in the definitive host, whereas cysticerci or larvae develop in the intermediate host.
Where do adult tapeworms develop, in the intermediate or definitive host?
1785
Enterococcus (Streptococcus faecalis)
Which streptococcal species is characterized by being catalase negative, turning bile esculin agar black, producing a positive PYR test, and resulting in biliary and urinary tract infections?
1786
1. Burkitt's lymphoma 2. Nasopharyngeal carcinoma 3. Thymic carcinoma
What three carcinomas are associated with EBV?
1787
Rochalimaea quintana (now called Bartonella quintana)
Which organism causes trench fever?
1788
The onset of symptoms for Neisseria gonorrhea conjunctivitis is 2 to 5 days, whereas onset of symptoms for Chlamydia trachomatis is 5 to 10 days.
Based on the onset of the symptoms, how are bacterial conjunctivitis from Neisseria and Chlamydia differentiated?
1789
Tetanospasmin (also called tetanus toxin)
What toxin, produced by Clostridium tetani, binds to ganglioside receptors and blocks the release of glycine and GABA at the spinal synapse?
1790
True. So are rubeola, smallpox, yellow fever, and the Sabin polio vaccine.
True or false? All of the following are live attenuated vaccines available in the United States: measles, mumps, varicella zoster, and Francisella tularensis.
1791
Filovirus
What family do the following viruses belong to? • Ebola
1792
Bunyavirus
What family do the following viruses belong to? • California encephalitis
1793
Bunyavirus
What family do the following viruses belong to? • Hantavirus
1794
Rhabdovirus
What family do the following viruses belong to? • Rabies
1795
Paramyxovirus
What family do the following viruses belong to? • RSV
1796
Paramyxovirus
What family do the following viruses belong to? • Measles
1797
Campylobacter jejuni
What microaerophile is a motile gram-negative curved rod with polar flagella that causes infectious diarrhea at low doses (<500)?
1798
Legionella
What bacterium is diagnosed using the Dieterle silver stain?
1799
The vaccine contains 23 capsular polysaccharides.
How many strains of Pneumococcus capsular polysaccharides are present in the vaccine?
1800
Trichuris trichiura is treated with albendazole.
What nematode is known as whipworms? What is the treatment?
1801
Streptolysin O
Which Streptococcus pyogenes toxin is immunogenic?
1802
Neisseria gonorrhoeae
A urethral swab of a patient shows gram-negative diplococci in PMNs; what organism do you diagnose?
1803
Arthroconidia with hyphae
A suspected dermatophyte infection is stained with KOH. What spore type do you expect to see?
1804
Measles (rubeola)
What negative sense RNA virus is associated with cough, coryza, and conjunctivitis with photophobia?
1805
M12 strains
Which M-protein strain of Streptococcus pyogenes is associated with acute glomerulonephritis?
1806
1. Cough 2. Coryza 3. Conjunctivitis
What are the three C's of measles?
1807
Arboviruses (bunyavirus, flavivirus, and togavirus)
What is the term given to arthropod-borne viruses?
1808
Leptospira
Which organism causes Weil's disease?
1809
Sporozoites
What form of the Plasmodium species are injected into humans by mosquitoes?
1810
Parvovirus (it is the only ssDNA virus)
What ssDNA virus must make dsDNA before it makes mRNA?
1811
The tsetse fly
What is the vector of African sleeping sickness?
1812
Reverse transcriptase
What HIV enzyme produces a dsDNA provirus?
1813
Corynebacterium diphtheriae
What non-spore-forming gram-positive aerobic rod produces bull neck, sore throat with pseudomembranes, myocarditis, and sometimes respiratory obstructions?
1814
Diphyllobothrium latum
What organism is associated with megaloblastic anemia?
1815
Tinea favosa (favus)
What is the most serious form of tinea capitis, which results in permanent hair loss and is highly contagious?
1816
Snails
What are the first intermediate hosts for trematodes?
1817
Y, W-135, and C and A capsular polysaccharides
What are the four capsular polysaccharides used in the Neisseria meningitides vaccine?
1818
Cryptococcus
What is the only encapsulated fungal pathogen?
1819
Conidia
What type of spore is asexual and formed of hyphae?
1820
Plasmodium malariae; the others are tertian.
What is the only Plasmodium that is quartan?
1821
Serratia
Which bacteria are associated with the following pigment production? • Red pigmentation
1822
Corynebacterium diphtheriae
Which bacteria are associated with the following pigment production? • Black-gray pigmentation
1823
Pseudomonas aeruginosa
Which bacteria are associated with the following pigment production? • Pyocyanin (blue-green)
1824
Staphylococcus aureus
Which bacteria are associated with the following pigment production? • Yellow pigmentation
1825
Hepatocellular carcinoma is associated with hepatitis B and C infections, not with EBV.
Which carcinoma—Burkitt's lymphoma, nasopharyngeal carcinoma, hepatocellular carcinoma, or thymic carcinoma—is not associated with EBV?
1826
K1 capsule
What capsular serotype is associated with Escherichia coli- induced meningitis?
1827
HBsAg and HBeAg
What two Ags must be positive for a patient to have chronic active hepatitis?
1828
HBcAb and HBeAb. You see the antibodies c and e.
In the window phase of a hepatitis B infection, which Abs do you see?
1829
TRUE
True or false? All streptococci are catalase-negative
1830
The first trimester
In what trimester is the fetus most vulnerable to congenital rubella syndrome?
1831
Vesicular stomatitis virus
What virus causes hoof-and-mouth disease?
1832
Meningococcus grows on chocolate agar, and Gonococcus grows on Thayer-Martin medium.
Which gram-negative diplococcus grows on chocolate agar? Thayer- Martin medium?
1833
Trichomonas vaginalis (treat with metronidazole)
Which protozoal parasitic vaginal infection produces a positive whiff test with KOH staining?
1834
Poxvirus
Name the DNA virus • Linear dsDNA; enveloped; virion-associated polymerases; replicates in the cytoplasm :
1835
Herpes virus
Name the DNA virus • Linear dsDNA; nuclear envelope; icosahedral; replicates in the nucleus
1836
Adenovirus
Name the DNA virus: • Linear dsDNA; naked; replicates in the nucleus
1837
Parvovirus
Name the DNA virus: • ssDNA; naked; icosahedral; replicates in the nucleus
1838
Hepadnavirus
Name the DNA virus: • Partially dsDNA circular; enveloped; virion-associated polymerases; has RNA intermediate; replicates in the nucleus
1839
Papovavirus
Name the DNA virus: • Circular dsDNA; naked; icosahedral; replicates in the nucleus
1840
Cryptococcus
What fungus is urease positive?
1841
Bacillus anthracis
What bacterium is characterized by large boxcar-shaped gram-positive rods and is spore-forming, aerobic, and associated with cutaneous infections and woolsorter's disease?
1842
Yes
Is the Salk polio vaccine inactivated?
1843
True. They all have helical nucleocapsids and virion-associated polymerases too.
True or false? All negative sense RNA viruses are enveloped.
1844
Proteus
What urease-positive non-lactose-fermenting gram-negative rod with swarming-type motility is associated with staghorn renal calculi?
1845
Varicella virus and influenza virus
What two viruses are associated with Reye's syndrome?
1846
Neisseria meningitidis
Which organism releases endotoxins prior to cell death?
1847
Gardnerella vaginalis
Clue cells are associated with which organism that causes vaginal discharge?
1848
Rhabdovirus
What is the name of the bullet-shaped virus?
1849
Cryptococcus neoformans
What fungus is characterized by India ink staining of the CSF that produces colorless cells with a halo on a black background?
1850
HBsAg as its envelope
What does hepatitis D virus need from hepatitis B virus to be infective?
1851
Hepatitis E (enteric)
Which type of hepatitis is a calicivirus?
1852
Mycoplasma
What genus is known as the smallest free living bacteria? (hint: has no cell wall and has sterols in the membrane)
1853
Heart, esophagus, and colon. Remember, you get megas: cardiomegaly, megaesophagus, and megacolon.
What three organs can be affected by Trypanosoma cruzi?
1854
HPV serotypes 1 and 4
Which serotypes of HPV are associated with plantar warts?
1855
Escherichia coli
What facultative gram-negative anaerobic rod is motile, ferments lactose, and is the MCC of UTIs?
1856
Reovirus
What is the only dsRNA virus?
1857
1. Bunyavirus 2. Orthomyxovirus 3. Arenavirus 4. Reovirus Remember BOAR
What are the four segmented RNA viruses?
1858
Plasmodium malariae
What type of Plasmodium affects • Only mature RBCs?
1859
Plasmodium vivax
What type of Plasmodium affects • Only reticulocytes?
1860
Plasmodium falciparum
What type of Plasmodium affects • RBCs of all ages?
1861
Ergosterol
What is the major cell membrane sterol found in fungi?
1862
HBeAb
What Ab is an indication of low transmissibility for hepatitis?
1863
Reverse transcriptase
What is the term for RNA-dependent DNA polymerase?
1864
Clostridium botulinum
Which gram-positive bacteria infection of infancy is associated with ingestion of honey?
1865
Schistosoma haematobium
Which trematode is associated with bladder carcinoma in Egypt and Africa?
1866
Cryptococcus neoformans
Which encapsulated fungus is found in soil enriched with pigeon droppings?
1867
Herpes I
What virus lies dormant in the • Trigeminal ganglia?
1868
Varicella
What virus lies dormant in the • Dorsal root ganglia?
1869
Herpes II
What virus lies dormant in the • Sensory ganglia of S2 and S3?
1870
Shiga toxin (enterohemorrhagic Escherichia coli produces Vero toxin, which is quite similar to shiga toxin)
What is the name of the exotoxin Shigella dysenteriae produces, which interferes with the 60S ribosomal subunit and results in eukaryotic protein synthesis inhibition?
1871
Giardia lamblia (treat with metronidazole)
What protozoal parasite forms flasked-shaped lesions in the duodenum, is transmitted via fecal-oral route, and is commonly seen in campers who drank stream water?
1872
Hot pink with PAS and grey to black with silver stain
What color do fungi stain with PAS? Silver stain?
1873
Mycobacterium marinum
A tropical fish enthusiast has granulomatous lesions and cellulitis; what is the most likely offending organism?
1874
Coccidioides immitis
Which dimorphic fungus is found as Arthroconidia in desert sand of the southwestern United States (e.g., San Joaquin Valley)?
1875
Ureaplasma urealyticum
Which mycoplasma species is associated with urethritis, prostatitis, and renal calculi?
1876
Ixodes (also the vector for Lyme disease)
What tick is the vector for babesiosis?
1877
Poxvirus replicates its DNA in the cytoplasm.
What is the only DNA virus that does not replicate its DNA in the nucleus of the host cell?
1878
Bacillus cereus
What organism would you suspect in a patient with diarrhea after eating rice?
1879
Francisella tularensis
What small gram-negative facultative intracellular rod is transmitted to human host by Dermacentor tick bite?
1880
True. They absorb nutrients from the host's GI tract.
True or false? Cestodes have no GI tract.
1881
Mumps
What negative sense RNA virus is associated with parotitis, pancreatitis, and orchitis?
1882
>10 mm
What is the size of a positive PPD test for the following? (Reactive) • IV drug abuser
1883
>5 mm
What is the size of a positive PPD test for the following? (Reactive) • Patient with AIDS
1884
>10 mm
What is the size of a positive PPD test for the following? (Reactive) • Recent immigrant from India
1885
>15 mm
What is the size of a positive PPD test for the following? (Reactive) • Healthy suburban male without any medical illnesses
1886
>5 mm
What is the size of a positive PPD test for the following? (Reactive) • Posttransplantation patient taking immunosuppressive agents
1887
Rhinovirus and hepatitis A virus
What are the only two picornaviruses that do not lead to aseptic meningitis?
1888
Taenia saginata
Which cestode in raw or rare beef containing cysticerci results in intestinal tapeworms?
1889
Parvovirus B-19
What DNA viral disease is associated with aplastic crisis in patients with sickle cell anemia?
1890
GP120
What glycoprotein in the HIV virus attaches to CD4?
1891
Salmonella
What Enterobacteriaceae are prone to produce osteomyelitis in sickle cell patients?
1892
Pasteurella multocida
What organism is commonly associated with a cellulitis from an animal bite?
1893
Chromomycosis
What fungus is seen as colored cauliflower lesions?
1894
Birds
What is the reservoir for the togavirus?
1895
Both Neisseria and Moraxella are gram-negative cocci.
What are the two exceptions to the rule "all cocci are gram positive"?
1896
Necator americanus is treated with mebendazole and iron therapy.
What nematode is known as hookworms? What is the treatment?
1897
env structural protein
What HIV structural gene produces GP120 and GP41?
1898
Leishmania donovani (kala azar is also known as visceral leishmaniasis)
Which hemoflagellate species causes kala azar?
1899
CMV; remember, EBV is associated with heterophile-positive mononucleosis.
What DNA virus is associated with heterophile-negative mononucleosis?
1900
Rabies
What negative sense RNA virus is associated with intracytoplasmic inclusion bodies called Negri bodies?
1901
Clostridium tetani
What large, spore-forming, gram-positive anaerobic rod is associated with infections due to puncture wounds and trauma?
1902
The reduviid bug
What is the vector for Chagas disease?
1903
Positive sense RNA means it can serve as mRNA and therefore has 5'-3' polarity
What is the polarity (i.e., 5'-3' or 3'-5') of a positive sense RNA?
1904
Yellow fever (flavivirus)
What viral infection is associated with black vomit?
1905
Klebsiella pneumoniae
What encapsulated gram-negative, lactose-fermenting rod is associated with pneumonia in patients with alcoholism, diabetes, and chronic lung disease?
1906
The cat
What is the essential reservoir host for Toxoplasma gondii?
1907
Actinomyces israelii
What gram-positive anaerobic rod with branching filaments is a component of the normal flora of the mouth and female genital tract and is responsible for draining abscesses with sulfur granules in the exudates?
1908
Thrush
What is the term for Candida infection of the oral mucosa?
1909
Dimorphic
What is the term for fungi that can convert from hyphal to yeast forms?
1910
Picornaviridae
To what viral family does the polio virus belong?
1911
Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Neisseria meningitidis; also Cryptococcus neoformans, a fungus
Name at least three bacteria that use capsules to prevent immediate destruction from the host's defense system.
1912
True. They lyse the host cell
True or false? There are no persistent infections with naked viruses?
1913
JC virus
What virus is associated with progressive multifocal leukoencephalopathy?
1914
Pseudomonas aeruginosa
What bacterium is a gram-negative, oxidase-positive aerobic rod that produces a grapelike odor and pyocyanin pigmentation?
1915
CMV, Toxoplasma gondii, and Listeria
Which three organisms cause heterophilic negative mononucleosis?
1916
Clostridium botulinum
What bacterium found in poorly preserved canned food causes flaccid paralysis?
1917
Mumps and influenza virus
Which two negative sense RNA viruses have neuraminidase enzymes?
1918
Protein A
What Staphylococcus aureus protein inhibits phagocytosis?
1919
Pasteurella, Brucella, Legionella, and Francisella (all of the-ellas)
Which four bacteria require cysteine for growth?
1920
Candida albicans
What fungus causes endocarditis in IV drug users?
1921
Herpes virus I and II
What viruses are associated with Cowdry type A intranuclear inclusions?
1922
Streptococcus viridans
Which streptococcal species is associated with dental caries and infective endocarditis in patients with poor oral hygiene?
1923
Cysticerci
What is the term for cestode-encysted larvae found in intermediate hosts?
1924
Malassezia furfur (treat with selenium sulfide)
What fungus is characterized by hypopigmented spots on the thorax, spaghetti-and-meatball KOH staining, and pityriasis or tinea versicolor?
1925
Strongyloides stercoralis is treated with thiabendazole.
What nematode is known as threadworms? What is the treatment?
1926
Transposons
What are known as jumping genes?
1927
HPV
What virus produces koilocytic cells on a Papanicolaou (Pap) smear?
1928
Histoplasma capsulatum
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?
1929
All are lactose fermenters except Yersinia and Proteus.
Which of the following Enterobacteriaceae family members—Yersinia, Klebsiella, Enterobacter, Escherichia, Proteus, and Citrobacter— do not ferment lactose?
1930
nef and tat genes
What two HIV regulatory genes down-regulate MHC class I expression in the host?
1931
80S ribosomes (because they are eukaryotic)
What size ribosomes do fungi have?
1932
Keloid
What is the term for an abnormal amount of collagen type III that produces a large bulging scar, seen primarily in blacks?
1933
TRUE
True or false? Klinefelter syndrome cannot be diagnosed until puberty.
1934
Ultraviolet B (UVB) sunlight
What form of sunlight is the most carcinogenic?
1935
Membranous glomerulonephritis
What renal pathology involves uniform thickening of the glomerular capillary wall, granular appearance under the microscope, and effacement of foot processes?
1936
HIV
What enveloped RNA retrovirus infects CD4 T cells and uses the enzyme reverse transcriptase?
1937
NADPH oxidase
What enzyme is deficient in chronic granulomatous disease of childhood?
1938
Riedel thyroiditis
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?
1939
Group A β-hemolytic streptococci
Rheumatic fever most commonly follows pharyngeal infections with what bacteria?
1940
Rhabdomyoma
What benign cardiac tumor is associated with tuberous sclerosis?
1941
10% are bilateral, 10% malignant, and 10% familial, 10% in children, and 10% outside the adrenal gland
What are the rules of 10 regarding pheochromocytoma?
1942
Postductal coarctation of the aorta (adult)
What vascular pathology is associated with HTN in the upper extremities, hypotension in the lower extremities, and a radial-femoral delay?
1943
Reiter syndrome
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?
1944
Tylosis
What AD disease involves hyperkeratosis of the palms and soles in association with esophageal carcinoma?
1945
Neisseria gonorrhea (history of STD in patient with monoarticular infectious arthritis: think gonococcus)
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?
1946
Polyarteritis nodosa
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?
1947
Osteosarcoma
What malignant bone tumor is associated with familial retinoblastoma?
1948
Polycystic kidney disease of childhood
What bilateral AR disorder seen in infancy as progressive renal failure has multiple small cysts at right angles to the cortical surface?
1949
von Hippel-Lindau syndrome
In what syndrome does the patient have angiomatosis; renal cell carcinomas; pheochromocytomas; retinal, cerebellar, medulla, or spinal cord hemangioblastomas; and epidermal cysts?
1950
Swan-neck deformities
What is the term for hyperextension of the PIP and flexion of the DIP joints in rheumatoid arthritis?
1951
Roth spots, and they are seen in bacterial endocarditis.
What is the term for white retinal spots surrounded by hemorrhage? In what condition are they seen?
1952
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.
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?
1953
Virchow triad, associated with the formation of a thrombus.
What triad consists of endothelial injury, changes in laminar flow, and hypercoagulation?
1954
Osteoblasts (Remember, they modulate the function of osteoclasts.)
What bone cell has receptors for PTH?
1955
Gastric ulcer
What type of peptic ulcer disease is characterized by the onset of burning epigastric pain immediately after eating?
1956
Proto-oncogenes
What is the term for normal cellular genes associated with growth and differentiation?
1957
Osteogenesis imperfecta
Blue sclera is seen in what hereditary bone disorder?
1958
Paroxysmal nocturnal hemoglobinuria
What form of anemia is diagnosed with sucrose lysis test and Ham test?
1959
Chédiak-Higashi syndrome
In what rare AR disorder do you see neutropenia, defective degranulation, and delayed microbial killing due to a problem in chemotaxis and migration?
1960
Polycythemia vera (Remember, polycythemia vera is a risk factor for acute leukemias.)
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?
1961
Ventilation of an unperfused lung segment is highly suspicious for pulmonary embolism.
If you order a V/Q scan for suspected pulmonary emboli, is the filling defect seen on the ventilation or perfusion side?
1962
Transferrin
What transports iron in the blood?
1963
ALL (nearly 15-20 times the normal risk)
What hematological malignancy is particularly likely to affect patients with Down syndrome?
1964
Rickets
What childhood pathology involves anterior bowing of the tibia, epiphyseal enlargements, and costochondral widening, with the endochondral bones being affected?
1965
Gastric carcinoma
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?
1966
Marijuana
What drug causes a sixfold increase in schizophrenia, can impair motor activity, and can cause lung problems?
1967
Transient ischemic attack
What is the term for neurologic signs consistent with a cerebrovascular accident but lasting 24 hours with full recovery?
1968
Krukenberg tumor
What is the name of the tumor when gastric carcinoma spreads to the ovaries?
1969
Tay-Sachs disease
What condition results from a deficiency in the enzyme hexosaminidase A?
1970
Cingulate gyrus herniation (subfalcine)
Which cerebral herniation results in compression of the anterior cerebral artery?
1971
Scleroderma
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?
1972
Budd-Chiari syndrome
What is the term for the syndrome consisting of hepatomegaly, ascites, and abdominal pain due to hepatic vein thrombosis?
1973
Prinzmetal variant angina
What form of angina is characterized by • Coronary artery vasospasm, symptom occurrence at rest, ST segment elevation (during episode), and no signs on ECG?
1974
Stable angina
What form of angina is characterized by • Coronary artery luminal narrowing, symptom occurrence during exertion, ST segment depression on ECG?
1975
Unstable (crescendo) angina
What form of angina is characterized by • Coronary artery nonocclusive thrombus; symptom occurrence with increasing frequency, duration, intensity, and decreasing activity, frequently at rest?
1976
Benign lentigo
What skin condition is a localized proliferation of melanocytes presenting as small, oval, light brown macules?
1977
Dysplasia
What is the term for nonneoplastic abnormal proliferation of cell size, shape, and cellular organization?
1978
Psoriasis
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?
1979
Kimmelstiel-Wilson disease
What renal disease in diabetic patients is seen as a halo of capillaries around the mesangial nodules?
1980
Primary biliary cirrhosis
What autoimmune liver disease is characterized by affecting a middle-aged woman with jaundice, pruritus, fatigue, xanthomas, increased direct bilirubin levels, and antimitochondrial Abs?
1981
Macrophages
What cell in chronic inflammation is derived from blood monocytes?
1982
True. Pancreatic enzymes begin the breakdown of vitamin B12-R complex in the duodenum.
True or false? Pancreatic insufficiency results in vitamin B12 malabsorption.
1983
Carcinoid tumor
What neuroendocrine tumor produces excess serotonin; is associated with diarrhea, flushing, bronchospasms, wheezing; and is diagnosed by findings of elevated urinary 5-HIAA levels?
1984
Teratoma
What tumor constitutes 40% of testicular tumors in children?
1985
Vanillylmandelic acid (VMA)
What urinary metabolite is elevated in pheochromocytoma?
1986
Sarcoidosis
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?
1987
1. Sideroblastic anemias (i.e., porphyrin and heme synthesis disorders) 2. Thalassemia 3. Iron deficiency 4. Lead poisoning
What are the four reasons for hypochromic microcytic anemia with a low MCV?
1988
Healing by secondary intention
What is characterized by an intense inflammatory reaction, an increase in the amounts of granulation tissue and wound contraction by myofibroblasts?
1989
de Quervain thyroiditis
What thyroiditis presents as a tender, enlarged, firm thyroid gland, usually preceded by an upper respiratory viral illness?
1990
Graves disease
What disorder leads to IgG autoantibodies to the TSH receptor?
1991
Iodine, resulting in congenital hypothyroidism
What intrauterine deficiency leads to failure to thrive, mental retardation, motor incoordination, and stunted growth?
1992
Gastrinoma
What pancreatic islet cell tumor is associated with MEN I syndrome?
1993
Duodenal ulcer
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?
1994
Neuroblastoma
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?
1995
Familial hypercholesterolemia
What AD disease associated with chromosome 19 involves a defect in the LDL receptors that leads to skin and tendon xanthomas?
1996
Myasthenia gravis
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?
1997
Burr cells (echinocytes)
What is the term for RBCs with smooth undulations on the surface of their membrane, commonly seen in uremia?
1998
Choriocarcinomas and trophoblastic tumors
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Beta-hCG
1999
Ovarian cancer
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-125
2000
Pancreatic cancer
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CA-19.9 and CEA
2001
Hepatoma and nonseminomatous testicular germ cell tumors
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • alpha-Fetoprotein
2002
Medullary carcinoma of the thyroid
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Calcitonin
2003
Prostate cancer
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • PSA and prostatic acid phosphatase
2004
Seminoma
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • Placental alkaline phosphatase
2005
Cancer of the lung, stomach, colon, and breast
Name the cancer associated with the following tumor markers. (Some may have more than one answer.) • CEA
2006
Ankylosing spondylitis
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?
2007
Disseminated intravascular coagulation (DIC)
What disorder is associated with decreased platelet count, prolonged PT and PTT, decreased fibrinogen, and increased fibrin split products (D-dimers)?
2008
Borrelia burgdorferi
What spirochete is responsible for Lyme disease?
2009
Small cell carcinoma (oat cell)
What very aggressive lung cancer metastasizes early and is associated with smoking and paraneoplastic syndromes?
2010
Osteitis fibrosa cystica (von Recklinghausen disease)
What bone disorder is characterized by brown tumors, bone pain, deformities, and fractures due to excessive PTH?
2011
Pompe's disease
What glycogen storage disease is due to the following enzyme deficiencies? • Lysosomal glucosidase (acid maltase)
2012
McArdle's syndrome
What glycogen storage disease is due to the following enzyme deficiencies? • Muscle phosphorylase
2013
von Gierke's disease
What glycogen storage disease is due to the following enzyme deficiencies? • Glucose-6-phosphatase
2014
Serocystadenocarcinoma
What ovarian disease involves psammoma bodies?
2015
Hydatidiform mole
What cystic swelling of the chorionic villi is the most common precursor of choriocarcinoma?
2016
Pyelonephritis
In what condition do you see dimpling on the kidney's surface?
2017
Staphylococcus aureus
What are the most common causes of osteomyelitis • Overall?
2018
Streptococcus agalactiae
What are the most common causes of osteomyelitis • In neonates?
2019
Staphylococcus aureus (but they are more prone to salmonella infections)
What are the most common causes of osteomyelitis • In patients with sickle cell disease?
2020
Pseudomonas
What are the most common causes of osteomyelitis • In drug addicts?
2021
Ewing's sarcoma
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?
2022
Mantle cell lymphoma
What lymphoma is characterized by CD19, CD20, CD5; CD23-negative; and chromosome 11;14 translocations?
2023
C5b-C9
What components of the complement cascade form the MAC?
2024
True. HPV serotypes 16 and 18 are risk factors for squamous cell carcinoma.
True or false? HPV infection increases the risk of developing squamous cell carcinoma of the penis.
2025
Preductal (infantile)
What form of coarctation of the aorta is associated with Turner syndrome?
2026
True. Increased alkaline phosphatase levels also are associated with increased bone formation.
True or false? An elevated serum osteocalcin level is a marker for increased bone formation.
2027
Toxoplasmosis
What is the most common opportunistic infection of the CNS in HIV?
2028
Osteopetrosis (Albers-Schönberg disease)
What hereditary bone disorder is due to decreased osteoclast function, resulting in thick, sclerotic bones that fracture easily?
2029
True. Delta-Cell tumors produce excess somatostatin, which inhibits CCK, gastrin (hypochlorhydria), and insulin secretion (diabetes).
True or false? Pancreatic delta-cell tumors inhibit CCK secretion, leading to gallstones and steatorrhea.
2030
Brushfield spots
What is the term for the speckled appearance of the iris in patients with Down syndrome?
2031
Pott disease
What is the term for the collapse of the vertebral body due to TB?
2032
Liver
What organ must metastasize for carcinoid heart disease to occur?
2033
MEN III (or IIb)
Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and mucocutaneous neuromas
2034
MEN IIa (or Sipple syndrome)
Which subset of MEN syndrome is associated with the following? • Medullary carcinoma of the thyroid, pheochromocytoma, and parathyroid adenomas (or hyperplasia)
2035
MEN I (or Wermer syndrome)
Which subset of MEN syndrome is associated with the following? • Parathyroid, pancreatic, and pituitary gland tumors and Zollinger-Ellison syndrome
2036
Lesch-Nyhan syndrome
What X-linked recessive disease involves mental retardation, self-mutilation, choreoathetosis, spasticity, a decrease in HGPRT, and an increase in uricemia?
2037
Cirrhosis
What disorder is associated with spider angiomas, palmar erythema, gynecomastia, testicular atrophy, encephalopathy, abnormalities in clotting factors, and portal HTN?
2038
Mitral valve prolapse
What is your diagnosis of a young, thin asymptomatic female with a midsystolic click on cardiac auscultation?
2039
Toxoplasmosis (although you should rule out cerebral abscess due to other organisms)
What infection is associated with ring-enhancing lesions seen on computed tomography (CT) of the brain in an HIV-positive individual?
2040
Metaplasia (usually to a more protective cell type)
What is the term for a reversible change in one cell type to another?
2041
Hepatic adenomas
What liver tumor is associated with oral contraceptive pill use?
2042
Arnold-Chiari malformation type 2
What CNS developmental abnormality is associated with downward displacement of the cerebellar vermis and medulla compressing the fourth ventricle and leading to obstructive hydrocephalus?
2043
Severe combined immunodeficiency disease
What disease involves a lack of both T cell-mediated and humoral immune responses that can be either X-linked or AR?
2044
Normal values
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
2045
Brain abscess
What condition results in the following CSF results? • Opening pressure 450 mm H2O; 5 WBCs (90% lymphocytes); normal glucose and protein levels
2046
Viral meningitis
What condition results in the following CSF results? • Opening pressure 100 mm H2O; 120 WBCs (90% lymphocytes); normal glucose levels; protein 17
2047
TB meningitis
What condition results in the following CSF results? • Opening pressure 250 mm H2O; WBCs 250 (90% lymphocytes); glucose 35; protein 100
2048
Bacterial meningitis
What condition results in the following CSF results? • Opening pressure 400 mm H2O; WBCs 8500 (90% PMNs); glucose 15; protein 120
2049
True. The ileum is the site where vitamin B12 is absorbed.
True or false? Removal of the ileum results in vitamin B12 deficiencies.
2050
Transudative; exudative has the opposite values and has an elevated cellular content.
What is the term for edema that has LDH below 200, protein level 2.5, and a specific gravity below 1.020?
2051
Acanthosis nigricans
What is the term for thickened, hyperpigmented skin in the axillae, groin, and skin folds associated with malignancies, obesity, and DM?
2052
>3.5 g/day of protein, along with generalized edema, hypoalbuminemia, and hyperlipidemia
How many grams of protein must be excreted in 24 hours to produce the diagnosis of nephrotic syndrome?
2053
Heroin
What illicit drug can cause amyloidosis and focal segmental glomerulosclerosis in the kidney?
2054
Pheochromocytoma
What catecholamine-hypersecreting tumor, a secondary cause of HTN, results in headache, diaphoresis, anxiety, tachycardia, and palpitations?
2055
Potter facies
What is the term for flattened nose, low-set ears, and recessed chin seen in patients with bilateral renal agenesis?
2056
Primary intention
What type of healing occurs in a clean surgical incision?
2057
CMV retinitis and HSV-2
What are the two most common viral infections in HIV?
2058
Achalasia. (Think Chagas disease if it presents in a person from Central or South America.)
What disorder is defined by inability of the lower esophageal sphincter to relax with swallowing and a bird beak barium swallow result?
2059
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.
Does Cushing syndrome or Cushing disease have elevated ACTH levels and cortisol suppression with dexamethasone?
2060
gp120
What CD4 T-cell receptor does the HIV virus bind to?
2061
Schistocytes
What is the term for RBC fragments?
2062
Albinism
What disorder is due to a deficiency in tyrosinase?
2063
Antithyroglobulin and antimicrosomal Abs
What two Abs are used to diagnose Hashimoto's thyroiditis?
2064
Helicobacter pylori, which is also associated with an increased risk of gastric carcinoma
What urease-producing gram-negative curved rod is associated with PUD and chronic gastritis?
2065
Leukemias and lymphomas
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Alkylating agents
2066
Hepatocellular carcinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Aromatic amines and azo dyes
2067
Squamous cell carcinoma (skin, lung) and angiosarcoma of the liver
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Arsenic
2068
Mesothelioma and bronchogenic carcinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Asbestos
2069
Bladder cancer
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Naphthylamine
2070
Leukemias
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Benzenes
2071
Angiosarcoma of the liver
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Vinyl chloride
2072
Bronchogenic carcinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Chromium and nickel
2073
Bronchogenic carcinoma
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Polycyclic aromatic hydrocarbons
2074
Gastric cancer
Name the cancer associated with the following chemical agents. (Some may have more than one answer.) • Nitrosamines
2075
1. Autoimmune hypersplenism 2. Trauma 3. Anemia 4. Spherocytosis 5. Sickle cell anemia
What are the five conditions associated with normochromic normocytic anemia with a normal MCV and an elevated reticulocyte count?
2076
Insulinoma
What pancreatic islet cell tumor is associated with hypoglycemia, sweating, hunger, confusion, and increased C-peptide levels?
2077
Ristocetin
What substance is used to test platelets' response in patients with von Willebrand disease?
2078
Duchenne muscular dystrophy (Remember, Becker's is slower in progress, less severe, later in onset, and lacks cardiac involvement.)
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?
2079
Bronchioloalveolar carcinoma
What subset of adenocarcinoma arises from the terminal bronchioles and/or alveolar walls?
2080
Granulosa cell tumor of the ovary
What estrogen-producing tumor of the female genital tract is characterized by Call-Exner bodies?
2081
Familial polyposis coli
What AD syndrome involves 1000 or more edematous polyps, most commonly affects the colorectal area, and is associated with chromosome 5q21?
2082
Bouchard nodes in the PIP joints; Heberden nodes in the DIP joints.
What is the term for osteophyte formation at the proximal interphalangeal (PIP) joints in osteoarthritis? In the distal interphalangeal (DIP) joints?
2083
PGE (along with low oxygen tension)
What prostaglandin is associated with maintaining patency of the ductus arteriosus?
2084
Varicocele
What is the term for dilated veins within the spermatic cord?
2085
Thrombus
What type of hemostasis in an intravascular space consists of fibrin, platelets, RBCs, and WBCs?
2086
Osteosarcoma
What is the most common primary malignant tumor in bone?
2087
Pneumocystis carinii
What is the most common infectious agent in HIV?
2088
Myelofibrosis with myeloid metaplasia
What myeloid disorder is characterized by dry bone marrow aspirations, splenomegaly, leukoerythroblastosis, teardrop RBCs, and hyperuricemia due to increased cell turnover?
2089
Down syndrome (trisomy 21)
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?
2090
Autoimmune hemolytic anemia
What form of anemia is associated with IgG Abs against Rh antigens, positive direct Coombs test, and splenomegaly?
2091
5-hydroxyindoleacetic acid (5-HIAA)
What urinary metabolite is increased in patients with carcinoid syndrome?
2092
Primary sclerosing cholangitis
What chronic liver disease has a beaded appearance of the bile ducts on cholangiogram?
2093
LC4, LD4, and LE 4
What three LTs are associated with bronchospasms and an increase in vessel permeability and vasoconstriction?
2094
1. Big 2. Bilateral 3. Berry aneurysm
What are the three Bs of adult polycystic kidneys?
2095
Cystic fibrosis. (Parents are usually the first to find out because the baby tastes salty.)
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?
2096
Courvoisier's law
What law states that an enlarged, palpable gallbladder is more likely due to cancer than stone obstruction?
2097
Pneumothorax
What is the term for air in the pleural space?
2098
Paget disease (osteitis deformans)
What disorder of bone remodeling results in thick, weak bones and is associated with high-output cardiac failure?
2099
Hypertrophy
What is the term to describe the increase in organ size due to the increase in cell size and function?
2100
Meningioma
What slow-growing primary CNS tumor that affects mostly females is associated with psammoma bodies?
2101
TRUE
True or false? Ethyl alcohol induces the cytochrome P-450 enzymes.
2102
1. Caput medusae 2. Esophageal varices 3. Ascites 4. Splenomegaly 5. Hemorrhoids
What are the five components of portal HTN?
2103
Prader-Willi syndrome and Angelman syndrome, respectively
What syndrome results when there is a deletion to paternal chromosome 15? Maternal?
2104
Craniopharyngioma
What CNS tumor arises from Rathke's pouch?
2105
1. Conjunctivitis 2. Nongonococcal urethritis 3. Peripheral arthritis Can't see, can't wee, can't kick with your knee
What is the triad of Reiter syndrome?
2106
Cirrhosis and hemolytic anemia, which are risk factors for pigmented gallstones.
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.)
2107
IgA nephropathy (Berger disease)
Name the nephritic disease based on the immunofluorescent staining. • Mesangial deposits of IgA and C3
2108
Goodpasture disease
Name the nephritic disease based on the immunofluorescent staining. • Smooth and linear pattern of IgG and C3 in the GBM
2109
Postinfectious GN
Name the nephritic disease based on the immunofluorescent staining. • Granular deposits of IgG, IgM, and C3 throughout the glomerulus
2110
GP IIb/IIIa, which is why GP IIb/IIIa inhibitors are used in the treatment of acute coronary syndromes
What glycoprotein allows platelets to adhere to each other through the use of fibrinogen?
2111
HHV-8
What virus is associated with body cavity large B-cell lymphomas?
2112
Seminoma
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?
2113
Crohn disease
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?
2114
ELISA screens and Western blot confirms the diagnosis.
Does ELISA or Western blot confirm whether a patient is HIV-positive?
2115
Membranoproliferative glomerulonephritis (MPGN)
What GN is highly associated with hepatitis B and C infections?
2116
Barrett esophagus has an increased risk of developing adenocarcinoma of the esophagus.
What is the term for squamous to columnar metaplasia of the distal esophagus secondary to chronic inflammation?
2117
Proud flesh
What is the term for excessive amounts of granulation tissue that can block re-epithelialization and wound healing?
2118
Cytochrome c
What is released from the mitochondria to trigger apoptosis?
2119
More than 75% of the vessel
How much of a vessel must be stenosed to cause sudden cardiac death?
2120
Heinz bodies
Oxidation of Hgb forms what bodies in patients with G-6-PD deficiency?
2121
Conn syndrome (primary hyperaldosteronism)
What syndrome that is due to an adrenal gland adenoma produces excess aldosterone resulting in HTN, hypokalemia, and low rennin levels?
2122
EBV
What virus is associated with both nasopharyngeal carcinoma and Burkitt lymphoma?
2123
Hereditary spherocytosis
What normochromic, normocytic AD anemia has splenomegaly and increased osmotic fragility?
2124
Gigantism
What does prepubertal hypersecretion of growth hormone lead to?
2125
Homogentisic oxidase
What enzyme is deficient in alkaptonuria?
2126
Leydig cell tumor
What sex cell tumor causes precocious puberty, masculinization, gynecomastia in adults, and crystalloids of Reinke?
2127
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.
Name four major risk factors for atherosclerosis.
2128
Marfan syndrome
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.
2129
Eisenmenger syndrome, which can also occur with any left-to-right shunt
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?
2130
G-6-PD deficiency
Eating fava beans can produce the Mediterranean type of what deficiency?
2131
Hemophilia A
What form of hemophilia is X-linked recessive and due to a deficiency in factor VIII?
2132
ALL
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?
2133
Deficiency in surfactant
What protein deficiency results in respiratory distress syndrome of newborns?
2134
1. Fibrillary protein 2. Amyloid protein 3. Glycosaminoglycans
What are the three components of amyloid?
2135
Myasthenia gravis
What autoimmune disorder is due to Abs directed to ACh receptors at the NMJ?
2136
1. VSD 2. ASD 3. PDA
What are the three left-to-right shunts?
2137
Plasmin
What protein causes fibrinolysis?
2138
VIPoma
What pancreatic islet cell tumor is associated with watery diarrhea, hypokalemia, and achlorhydria?
2139
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.
True or false? Obesity, DM, HTN, multiparity, early menarche, and late menopause are all risk factors for endometrial carcinoma.
2140
Lisch nodules
What is the term for pigmented iris hamartomas seen in patients with neurofibromatosis type 1?
2141
Crohn disease
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?
2142
Candida
What is the most common fungal infection in HIV?
2143
True. Don't forget this in your differential diagnosis of an asthmatic.
True or false? GERD is a cause of asthma.
2144
PGI2
Name the product or products of arachidonic acid: • Vasodilation and inhibition of platelet aggregation produced by vascular endothelium
2145
PGD2, PGE2, and PGF 2
Name the product or products of arachidonic acid: • Vasodilation
2146
PGE2
Name the product or products of arachidonic acid: • Pain and fever
2147
TXA2
Name the product or products of arachidonic acid: • Vasoconstriction and platelet aggregation produced by platelets
2148
LTB4
Name the product or products of arachidonic acid: • Chemotactic for neutrophils
2149
LTC4, LTD4, and LTE4
Name the product or products of arachidonic acid: • Vasodilation, bronchospasm, and increased vascular permeability
2150
HBeAb
Which hepatitis B Ab indicates low transmissibility?
2151
Silicosis Note: Coal worker's pneumoconiosis is synonymous with black lung disease, an upper lobe occupational disorder
What pneumoconiosis is associated with exposure to the following occupations or materials? • Miners, metal grinders, and sandblasters
2152
Berylliosis
What pneumoconiosis is associated with exposure to the following occupations or materials? • Aerospace industry, nuclear reactors
2153
Asbestosis
What pneumoconiosis is associated with exposure to the following occupations or materials? • Shipyards, brake linings, insulation, and old building construction
2154
Porcelain gallbladder
What is the term for calcification of the gallbladder seen on radiograph due to chronic cholecystitis or adenocarcinoma of the gallbladder?
2155
Atrophy. Disuse can also be due to immobilization, ischemia, aging, and a host of other causes.
What is the term to describe a decrease in the cell size and function usually associated with disuse?
2156
CLL (B-cell origin)
Which B-cell neoplasm has the following cell surface markers: CD19, CD20, CD5 (T-cell marker), CD23; and are CD10-negative?
2157
Caisson disease
What disease caused by decompression sickness leads to multiple foci of ischemic necrosis that affect the head of the femur, humerus, and tibia?
2158
1. HPV 2. EBV 3. Hepatitis B 4. Kaposi sarcoma
What are the four DNA oncogenic viruses?
2159
The AR form is malignant and AD is benign.
Is the AD or AR form of osteopetrosis malignant?
2160
This is the triad of renal cell carcinoma
What carcinoma produces hematuria, flank pain, and a palpable mass?
2161
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
Name at least three causes of metastatic calcification.
2162
Nodular sclerosis
What is the only subtype of Hodgkin's lymphoma that is most commonly seen in females?
2163
Smoking
What is the leading cause of preventable premature death and illness in the United States?
2164
Creutzfeldt-Jakob disease
What prion-associated CNS pathology produces rapidly progressive dementia with myoclonus, involuntary movements, and death within 6 to 12 months?
2165
Paget disease of the breast
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?
2166
Paget disease of the breast
What breast pathology involves malignant cells with halos invading the epidermis of the skin?
2167
Megaloblasts
Macro-ovalocytes in the peripheral blood smear are formed from what cell in the bone marrow?
2168
Serous exudates
Name the type of exudate, given the following examples. • Sunburn
2169
Fibrinous exudates
Name the type of exudate, given the following examples. • Uremic pericarditis
2170
Eosinophilic exudates
Name the type of exudate, given the following examples. • Parasitic infection
2171
Pseudomembranous exudates
Name the type of exudate, given the following examples. • Diphtheria infection
2172
Purulent exudates
Name the type of exudate, given the following examples. • Meningococcal infection
2173
Hemorrhagic exudates
Name the type of exudate, given the following examples. • Rickettsial infection
2174
Schistosoma haematobium
What parasite is associated with squamous cell carcinoma of the urinary bladder?
2175
Celiac sprue (gluten-sensitive enteropathy)
What malabsorption syndrome produces abdominal distention, bloating, flatulence, diarrhea, steatorrhea, and weight loss shortly after eating bread products?
2176
HHV 8
What herpes virus is associated with Kaposi sarcoma?
2177
Kayser-Fleischer rings
What is the term for the copper corneal deposits found in Wilson's disease?
2178
Factors II, VII, IX, and X and proteins C and S.
Name the six vitamin K-dependent coagulation factors.
2179
Cystadenocarcinoma
What ovarian carcinoma is characterized by psammoma bodies?
2180
Dissecting aortic aneurysm. MI is also high on the list, but these are buzzwords to look for dissection.
A marfanoid patient presents with tearing retrosternal chest pain radiating to her back. What is your first diagnosis?
2181
Squamous cell carcinoma
What malignant neoplasm of the skin is associated with keratin pearls?
2182
N-formyl-methionine LTB4 C5a IL-8
Name four chemotactic factors for neutrophils.
2183
Simon focus
What is the term for granuloma at the lung apex in TB?
2184
1. ADP 2. PG 3. TXA2
What are the three platelet aggregating factors?
2185
Waterhouse-Friderichsen syndrome
What syndrome is due to a Neisseria sp. infection in a child resulting in bilateral hemorrhagic infarcts of the adrenal glands?
2186
Aschoff bodies of rheumatic fever
What foci of fibrinoid necrosis are surrounded by lymphocytes and macrophages throughout all the layers of the heart?
2187
Chief cell adenoma (80%)
What is the leading cause of primary hyperparathyroidism?
2188
G-6-PD deficiency
In what X-linked recessive disease is there a decrease in the HMP shunt, along with Heinz body formation?
2189
Target cell
What is the term for a RBC that has a peripheral rim of Hgb with a dark central Hgb-containing area?
2190
False. The disease has no associated pathology; the phenomenon is arterial insufficiency due to an underlying disease.
True or false? Raynaud's phenomenon has no underlying pathology.
2191
Intraductal papilloma
What benign solitary papillary growth within the lactiferous ducts of the breast commonly produces bloody nipple discharge?
2192
Hemophilia B
What form of hemophilia is X-linked recessive and is due to a deficiency in factor IX?
2193
Vitamin B12 deficiency and folate deficiency
What are the two reasons for megaloblastic anemia with elevated MCV?
2194
Yes. It is also a cause of cancers of the lung, esophagus, ureter, and kidney, just to name a few.
Is cigarette smoking associated with transitional cell carcinoma of the bladder?
2195
Neurofibromatosis I (chromosome 22q is with neurofibromatosis II and no Lisch nodules)
What disease has multiple schwannomas, café-au-lait spots on the skin, and Lisch nodules and is associated with chromosome 17q?
2196
Eaton-Lambert syndrome
What syndrome is due to Abs directed to calcium channels and causes muscle weakness that improves with repeated use?
2197
Malignant mesothelioma
In what rare lung malignancy have 90% of patients had an occupational exposure to asbestos?
2198
Basophilic stippling
What is the term for cytoplasmic remnants of RNA in RBCs, seen in lead poisoning?
2199
1. Petechiae 2. Hyperactive mental status 3. Occurrence within 24 to 48 hours of the initial insult (e.g., long bone fracture)
What is the triad of fat embolism?
2200
Gout
Upon seeing negatively birefringent needle-shaped crystals from a joint aspiration of the great toe, what form of arthritis do you diagnose?
2201
Mikulicz syndrome
What condition is manifested by bilateral sarcoidosis of the parotid glands, submaxillary gland, and submandibular gland with posterior uveal tract involvement?
2202
Polycystic ovary disease (Stein-Leventhal syndrome)
What female genital tract disorder is characterized by obesity, hirsutism, infertility, amenorrhea, elevated LH and testosterone levels, and low FSH levels?
2203
Squamous cell carcinoma
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?
2204
PKU
What disorder is due to a deficiency in the enzyme phenylalanine hydroxylase?
2205
Oddly enough, it is true. Cryptorchidism, Klinefelter syndrome, testicular feminization, and family history of testicular cancer are all risk factors.
True or false? Being a white male increases your risk factor for testicular cancer.
2206
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.
Can an acute MI be diagnosed only by looking at an ECG?
2207
Sjögren's syndrome; SS-A (Ro) and SS-B (La)
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?
2208
True. Fractures and trauma, however, are the most common causes.
True or false? Sickle cell anemia, Caisson disease, chronic steroid use, and Gaucher disease are causes of avascular necrosis of bone.
2209
p-53
What gene stimulates apoptosis when DNA repair is unable to be done?
2210
Ulcerative colitis
Is ulcerative colitis or Crohn disease more commonly associated with primary sclerosing cholangitis?
2211
ELISA test
What test uses p24 protein when diagnosing HIV?
2212
At least six
How many café-au-lait spots are necessary for the diagnosis of neurofibromatosis type 1?
2213
Mallory-Weiss syndrome
What is the term for severe and protracted vomiting resulting in linear lacerations at the gastroesophageal junction?
2214
Metastatic calcification
What is the term for hypercalcemia resulting in precipitation of calcium phosphate in normal tissue?
2215
Volvulus
What is the term for a twisting of the bowel around its vascular axis resulting in intestinal obstruction?
2216
Cyanide
What form of poisoning is associated with bitter almond-scented breath?
2217
Type III hypersensitivity (immune complex)
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.
2218
Type I hypersensitivity (anaphylactic)
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.
2219
Type II hypersensitivity (cytotoxic)
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.
2220
Type IV hypersensitivity (cell-mediated)
Name the type of hypersensitivity reaction based on the following properties. • Reaction-mediated by sensitized T-cells
2221
Primitive neuroectodermal tumors (i.e., medulloblastomas and retinoblastomas)
What highly undifferentiated aggressive CNS tumor of primordial neuroglial origin develops in children and is associated with pseudorosettes?
2222
Goodpasture syndrome
What syndrome is due to anti-GBM Abs directed against the lung and kidneys?
2223
Intrinsic. The extrinsic pathway is activated by the release of tissue factors.
What pathway of the coagulation cascade is activated when it is in contact with foreign surfaces?
2224
Wilms tumor
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?
2225
Schwannoma
What CNS tumor commonly produces tinnitus and hearing loss?
2226
True. Scl-70 Abs are used in diagnosing diffuse scleroderma.
True or false? Anticentromere Abs are used in diagnosing CREST syndrome.
2227
Friedreich ataxia
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?
2228
TXA2
What potent platelet aggregator and vasoconstrictor is synthesized by platelets?
2229
Transtentorial (uncal)
Which type of cerebral herniation is associated with CN III palsy?
2230
Syphilitic
What form of vasculitis involves the ascending arch and causes obliterative endarteritis of the vasa vasorum?
2231
T lymphocyte
What is the main type of cell involved in cellular immunity?
2232
Melasma
What skin condition has irregular blotchy patches of hyperpigmentation on the face commonly associated with OCP use and pregnancy?
2233
Fever, night sweats, and hemoptysis
What is the classic triad of TB?
2234
True. A thrombus has platelets, but clots do not.
True or false? Blood clots lack platelets.
2235
Histiocytosis X
What malignant tumor of the skin is associated with Birbeck granules?
2236
Pernicious anemia (secondary to a lack of vitamin B12 absorption)
What type of anemia is the result of a deficiency in intrinsic factor?
2237
Scrotal cancer, due to the high exposure to polycyclic aromatic hydrocarbons
What cancer is particularly likely to affect English chimney sweeps?
2238
Bulla
What is the term for a raised fluid-filled cavity greater than 0.5 cm that lies between the layers of the skin?
2239
EBV
What virus is associated with the endemic form of Burkitt lymphoma?
2240
GH-producing adenoma
With which pituitary adenoma is an elevated somatomedin C level associated?
2241
1. Less than 3 cm 2. Clean base 3. Level with the surrounding mucosa
What three criteria allow you to differentiate an ulcer from an erosion or carcinoma?
2242
Truncus (1) arteriosus Transposition of the (2) great vessels Tri(3)cuspid atresia Tetra(4)logy of Fallot They all begin with T
Name the four right-to-left congenital cardiac shunts.
2243
Hypoparathyroidism
What do low levels of Ca2+ and PO4- along with neuromuscular irritability indicate?
2244
PT for extrinsic and PTT for intrinsic (remember: wPeT and hPiTT, which means warfarin, extrinsic, PT; heparin, intrinsic, PTT)
Does PT or PTT test the extrinsic coagulation pathway?
2245
Adult T-cell leukemia
What leukemia is associated with four-leaf-clover lymphocytes on peripheral blood smear?
2246
Schatzki ring
What ring is a weblike narrowing of the gastroesophageal junction?
2247
Henoch-Schönlein purpura
With what disease do you see IgA deposits in small vessels of the skin and the kidneys?
2248
Lymphoblastic lymphoma
What rapidly progressive and aggressive T-cell lymphoma affects young males with a mediastinal mass (thymic)?
2249
Flea-bitten kidney (can also be seen in pyelonephritis)
What is the term for the appearance of the kidney in malignant hypertension (it has petechiae on its surface)?
2250
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.
True or false? Psammoma bodies are seen in medullary carcinoma of the thyroid.
2251
<2
What is the lecithin:sphingomyelin ratio in respiratory distress syndrome of newborns?
2252
Guillain-Barré syndrome
What syndrome has loss of deep tendon reflexes, muscle weakness, and ascending paralysis preceded by a viral illness?
2253
Libman-Sacks endocarditis
What form of endocarditis do patients with SLE commonly encounter?
2254
Melanosis coli
What is the term for black pigmentation of the colon associated with laxative abuse?
2255
Minor
Are the following major or minor Jones criteria of rheumatic fever? • Fever
2256
Major
Are the following major or minor Jones criteria of rheumatic fever? • Migratory polyarthritis
2257
Major
Are the following major or minor Jones criteria of rheumatic fever? • Subcutaneous nodules
2258
Minor
Are the following major or minor Jones criteria of rheumatic fever? • Elevated acute phase reactants (e.g., ESR)
2259
Minor
Are the following major or minor Jones criteria of rheumatic fever? • Arthralgias
2260
Major
Are the following major or minor Jones criteria of rheumatic fever? • Pericarditis
2261
Major
Are the following major or minor Jones criteria of rheumatic fever? • Erythema marginatum
2262
Major
Are the following major or minor Jones criteria of rheumatic fever? • Sydenham chorea
2263
Bcl-2
What gene inhibits apoptosis by preventing the release of cytochrome c from mitochondria?
2264
Hepatitis D
Which hepatitis strain is a defective virus that can replicate only inside HBV-infected cells?
2265
Fibrillary protein, amyloid protein, and glycosaminoglycans (heparin sulfate mainly)
What are the three main components of amyloid?
2266
CML
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?
2267
A Ghon focus is a TB tubercle, whereas a Ghon complex is a focus with hilar lymph node involvement.
What is the difference between a Ghon focus and a Ghon complex?
2268
Edward syndrome (trisomy 18)
In what disease do you see horseshoe kidneys, rockerbottom feet, low-set ears, micrognathia, and mental retardation?
2269
Clonorchis sinensis
What parasitic infection is associated with cholangiocarcinoma?
2270
Malignancy
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?
2271
Intussusception
What is the term for telescoping of the proximal bowel into the distal segment presenting as abdominal pain, currant jelly stools, and intestinal obstruction?
2272
Amanita phalloides
What mushroom poisoning is associated with fulminant hepatitis with extensive liver necrosis?
2273
Erythema nodosum
What type of erythema do you see in • Ulcerative colitis?
2274
Erythema marginatum
What type of erythema do you see in • Rheumatic fever?
2275
Erythema multiforme
What type of erythema do you see in • Stevens-Johnson syndrome?
2276
Osteoma
What benign bone tumor is associated with Gardner syndrome?
2277
Magnesium ammonium phosphate (struvite)
What renal calculus is associated with urea-splitting bacteria?
2278
Waldenström's macroglobulinemia
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?
2279
Mercury
What type of acute metal poisoning involves stomach and colon erosion and acute tubular necrosis?
2280
Oligodendroglioma
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?
2281
Type IV collagen
Goodpasture Ag is a component of what type of collagen?
2282
TTP; thrombocytopenia with megathrombocytes is more characteristic of ITP.
If a peripheral blood smear shows schistocytes, reticulocytes, and thrombocytopenia, is it more commonly seen in patients with ITP or TTP?
2283
Pulmonary embolism due to a DVT; this is not absolute but a classic description.
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?
2284
B lymphocyte
What cell type involves humoral immunity?
2285
Hypersegmented neutrophils
What is the first sign of megaloblastic anemia on a peripheral blood smear?
2286
Curling ulcers (think curling iron = burn)
What is the term for gastric ulcers associated with severely burned or traumatic patients?
2287
Marfan syndrome
What syndrome arises from mutation in the fibrillin gene (FBN1) on chromosome 15q21?
2288
Huntington disease
What AD disorder is characterized by degeneration of GABA neurons in the caudate nucleus resulting in atrophy, chorea, dementia, and personality changes?
2289
Mycoplasma pneumoniae
What atypical pneumonia can be diagnosed with elevated cold agglutinin titers?
2290
Neutropenia, splenomegaly, and rheumatoid arthritis
What is the triad of Felty syndrome?
2291
Chemotaxis
What is the term for the unidirectional attraction of cells toward a chemical mediator released during inflammation?
2292
Benign nevus (mole)
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?
2293
Buerger disease (thromboangiitis obliterans)
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?
2294
Salpingitis
What is the term for pelvic inflammatory disease of the fallopian tubes?
2295
Fragile X syndrome
What disease with familial mental retardation produces large, everted ears and macro-orchidism?
2296
Squamous cell carcinoma
What type of skin carcinoma occurring on sun-exposed sites has a low level of metastasis?
2297
VSD, RVH, overriding aorta, and pulmonary stenosis
What is the tetrad of tetralogy of Fallot?
2298
Bronchiectasis
What is the term for chronic necrotizing pulmonary infections resulting in permanent airway dilation and associated with Kartagener syndrome?
2299
Vesicle (e.g., poison ivy)
What is an elevated, fluid-filled cavity between skin layers up to 0.5 cm?
2300
Sheehan syndrome
What is the term for panhypopituitarism secondary to ischemic necrosis and hypotension postpartum?
2301
Scleroderma
What disease is diagnosed by findings of ANAs and anti-SCL-70 antibodies?
2302
Teratoma (dermoid cyst)
What is the name of the ovarian cyst containing ectodermal, endodermal, and mesodermal elements (i.e., skin, hair, teeth and neural tissue)?
2303
Plummer-Vinson syndrome
What syndrome is seen in iron-deficient middle-aged women with esophageal webs?
2304
CHF, cirrhosis, and nephrosis
What are the three causes of transudate?
2305
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.
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?
2306
Rapidly progressive glomerulonephritis (RPGN)
What form of GN is characteristically associated with crescent formation?
2307
Vitamin B6
What vitamin deficiency may result in sideroblastic anemia?
2308
Scrofula
What is the term for TB with the cervical lymph node involved?
2309
Massive influx of calcium
Influx of what ion is associated with irreversible cell injury?
2310
Primary hyperparathyroidism
What pathology is associated with elevated levels of Ca2+, cardiac arrhythmias, bone resorption, kidney stones, and metastatic calcifications?
2311
Lead
What type of metal poisoning causes mental retardation, somnolence, convulsions, and encephalopathy?
2312
Caplan syndrome
What syndrome is rheumatoid arthritis with pneumoconiosis?
2313
True. Don't forget this list; you will be asked.
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.
2314
Dystrophic calcification
What is the term for precipitation of calcium phosphate in dying or necrotic tissue?
2315
Meckel diverticulum
What congenital small bowel outpouching is a remnant of the vitelline duct?
2316
Monosodium urate crystals
What type of crystals are associated with gout?
2317
Mees lines
What is the term for transverse bands on the fingernails seen in patients with chronic arsenic poisoning?
2318
Klatskin tumor
What is the tumor at the bifurcation of the right and left hepatic ducts?
2319
Histamine
IgE-mediated mast cell release, C3a and C5a, and IL-1 all trigger the release of what vasoactive amine?
2320
Ulcerative colitis
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?
2321
Osteoarthritis
What disorder causes joint stiffness that worsens with repetitive motion, crepitus, effusions, and swelling and commonly affects the knees, hips, and spine?
2322
Male pseudohermaphrodite (dude looks like a lady!)
What condition is characterized by a 46XY karyotype, testes present, and ambiguous or female external genitalia?
2323
Howell-Jolly bodies
What is the term for RBC remnants of nuclear chromatin in asplenic patients?
2324
Cushing's ulcers
What is the term for gastric ulcers associated with increased intracranial pressure?
2325
Hemolytic uremic syndrome
What platelet disorder is characteristically seen in children following a bout of gastroenteritis with bloody diarrhea?
2326
Osteomalacia. Osteoporosis has normal levels of calcium, phosphorus, and alkaline phosphatase.
Are elevated alkaline phosphatase and decreased phosphorus and calcium levels more consistent with osteoporosis or osteomalacia?
2327
Hemangioblastoma
What vascular tumor associated with von Hippel-Lindau syndrome involves the cerebellum, brainstem, spinal cord, and retina?
2328
At least 5 lobes
How many segments in a neutrophilic nucleus are necessary for it to be called hypersegmented?
2329
Labile
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Epidermis
2330
Permanent
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Skeletal muscle
2331
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Pancreas
2332
Permanent
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • CNS neurons
2333
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Fibroblasts
2334
Labile
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Hematopoietic cells
2335
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Liver
2336
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Smooth muscle
2337
Permanent
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Cardiac muscle
2338
Labile
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Mucosal epithelium
2339
Stable
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Kidney
2340
Stable (Labile cells proliferate throughout life; stable cells have a low level of proliferation; and permanent cells as the name states, do not proliferate.)
Name the type of regeneration (i.e., labile, stable, or permanent) based on the following examples. • Osteoblasts
2341
Astrocytoma
What CNS tumor cells stain positive for glial fibrillary acidic protein (GFAP)?
2342
False. ASO titers are elevated, but serum complement levels are decreased.
True or false? Elevated ASO titers and serum complement levels are associated with poststreptococcal GN.
2343
GP Ib
What glycoprotein allows platelets to adhere to von Willebrand factor?
2344
Progressive multifocal leukoencephalopathy
What encephalitis is associated with the JC virus?
2345
C1 esterase inhibitor (C1INH)
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?
2346
Anti-HAV IgG Abs are associated with immunization or a prior infection. Anti-HAV IgM is associated with acute or recent infection.
Is an anti-HAV IgG Ab associated with immunization or recent infection?
2347
Intercellular adhesion molecule (ICAM) 1
Which integrin mediates adhesion by binding to lymphocyte function- associated Ag 1 (LFA-1) and MAC-1 leukocyte receptors?
2348
Berry aneurysm in the circle of Willis
Name the cerebral vessel associated with the following vascular pathologies. • Subarachnoid hemorrhage
2349
Bridging veins draining into the sagittal sinus
Name the cerebral vessel associated with the following vascular pathologies. • Subdural hemorrhage
2350
Middle meningeal artery
Name the cerebral vessel associated with the following vascular pathologies. • Epidural hemorrhage
2351
TRUE
True or false? Live vaccines are contraindicated in patients with SCID.
2352
Lewy bodies
What is the term for the round intracytoplasmic eosinophilic inclusions containing ɑ-synuclein found in the dopaminergic neurons of the substantia nigra?
2353
Centriacinar worse in upper lobes; panacinar worse in base of lower lobes
In which form of emphysema, panacinar or centriacinar, is the effect worse in the apical segments of the upper lobes?
2354
Hurler syndrome and Hunter syndrome, respectively
What syndrome results if the enzyme ɑ-1-iduronidase is deficient? L-iduronate sulfatase deficiency?
2355
At least 30% blast in the bone marrow
What percentage of the bone marrow must be composed of blast for leukemia to be considered?
2356
CHF
What is the term for the heart's inability to maintain perfusion and meet the metabolic demands of tissues and organs?
2357
Fitz-Hugh-Curtis syndrome
What syndrome occurs when pelvic inflammatory disease ascends to surround the liver capsule in violin string adhesions?
2358
True. Remember, the second X chromosome is inactivated, and so is the Barr body. Turner syndrome has only one X chromosome.
True or false? Patients with Turner syndrome have no Barr bodies.
2359
Auspitz sign
What is the term for the sign revealed when a psoriatic scale is removed and pinpoint bleeding occurs?
2360
Hgb F
What type of Hgb is increased in patients with sickle cell anemia who take hydroxyurea?
2361
Takayasu arteritis (medium-size to large vessels)
What vasculitis affects a 30-year-old Asian female having visual field deficits, dizziness, decreased blood pressure, and weakened pulses in the upper extremities?
2362
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.)
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?
2363
Eosinophil
What cell type is commonly elevated in asthma?
2364
Pseudogout
What pathology is associated with deposition of calcium pyrophosphate in patients older than 50 years?
2365
Medullary carcinoma of the thyroid
What thyroid carcinoma secretes calcitonin and arises from the parafollicular C cells?
2366
Cocaine
What illegal drug can cause rhabdomyolysis, MI, cerebral infarct, and lethal cardiac arrhythmias?
2367
Valine
What AA is substituted for glutamic acid at position 6 on the Beta-chain in patients with sickle cell anemia?
2368
Melanin
What endogenous pigment found in the substantia nigra and melanocytes is formed by the oxidation of tyrosine to dihydroxyphenylalanine?
2369
Placental alkaline phosphatase
What tumor marker is associated with seminomas?
2370
Berger disease (IgA nephropathy)
What type of GN, associated with celiac disease and dermatitis herpetiformis, has mesangial deposits of IgA, C3, properdin, IgG, and IgM?
2371
Huntington disease
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?
2372
X-linked recessive
What pattern of inheritance is G-6-PD deficiency?
2373
Prostatic carcinoma
What adenocarcinoma presents with elevated levels of acid phosphatase, dihydrotestosterone, PSA, and bone pain?
2374
Both are AR with conjugated hyperbilirubinemia, but Dubin-Johnson syndrome is differentiated from Rotor by the black pigmentation of the liver.
Is Dubin-Johnson or Rotor syndrome associated with black pigmentation of the liver?
2375
Myeloperoxidase
What oxygen-dependent killing enzyme requires hydrogen peroxide and halide (Cl-) to produce hypochlorous acid?
2376
Cholesterolosis
What condition results in a strawberry gallbladder?
2377
Arsenic, thorotrast, and vinyl chloride
What three chemical agents are associated with angiosarcomas of the liver?
2378
Apoptosis (Remember, there is a lack of inflammatory response.)
What is the term for programmed cell death?
2379
Reye syndrome
What potentially fatal disease occurs in children who are given aspirin during a viral illness?
2380
Lead poisoning
What metal poisoning produces microcytic anemia with basophilic stippling?
2381
Ulcerative colitis
What inflammatory bowel disorder is continuous, with extensive ulcerations and pseudopolyps, and is associated with HLA-B27?
2382
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.)
What is the pentad of TTP?
2383
HBeAg
Which hepatitis B Ag correlates with infectivity and viral proliferation?
2384
Job syndrome
What disease involves cold skin abscesses due to a defect in neutrophil chemotaxis and a serum IgE level higher than 2000?
2385
Endometriosis
What female pathology is associated with endometrial glands and stroma outside the uterus commonly affecting the ovaries as chocolate cysts?
2386
45XO
What is the karyotype in Turner syndrome?
2387
Hirschsprung disease (aganglionic megacolon)
What is the term for a congenital absence of the ganglionic cells of the Auerbach and Meissner plexus in the rectum and sigmoid colon?
2388
Zollinger-Ellison syndrome
What syndrome is associated with gastrin-producing islet cell tumor resulting in multiple intractable peptic ulcers?
2389
Type III
What type of collagen is associated with keloid formation?
2390
Folate deficiency (very common in the elderly)
The "tea-and-toast" diet is classically associated with what cause of megaloblastic anemia?
2391
Pyelonephritis
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?
2392
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.
How can a deficiency in adenosine deaminase be a bone marrow suppressor?
2393
Type II
Which phenotype of osteogenesis imperfecta is incompatible with life?
2394
Acute CO poisoning
With what is cherry red intoxication associated?
2395
1. Steroids 2. Alcohol 3. Scuba diving 4. Sickle cell anemia
What are the four most common causes of femoral head necrosis?
2396
Rubor (red), dolor (pain), calor (heat), tumor (swelling); also sometimes there is loss of function
What are the four signs of acute inflammation?
2397
Sideroblastic anemia
Name the hypochromic microcytic anemia based on the following laboratory values. • Increased iron, decreased TIBC, increased percent saturation, increased ferritin
2398
Anemia of chronic disease
Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, TIBC, and percent saturation; increased ferritin
2399
Iron deficiency anemia
Name the hypochromic microcytic anemia based on the following laboratory values. • Decreased iron, percent saturation, and ferritin; increased TIBC
2400
Thalassemia minor
Name the hypochromic microcytic anemia based on the following laboratory values. • Normal iron, TIBC, percent saturation, and ferritin
2401
Panacinar
Which form of emphysema is associated with an alpha1-antitrypsin deficiency?
2402
Temporal arteritis (giant cell arteritis)
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?
2403
Type 2
What type of neurofibromatosis is associated with bilateral acoustic schwannomas?
2404
Gaucher disease
What disorder is due to a deficiency in the enzyme glucocerebrosidase?
2405
Boutonnière deformities
What is the term for flexion of the PIP and extension of the DIP joints seen in rheumatoid arthritis?
2406
False. Atelectasis is a reversible collapse of a lung.
True or false? Atelectasis is an irreversible collapse of a lung.
2407
Parvovirus B 19
What viral infection in patients with sickle cell anemia results in aplastic crisis?
2408
Klinefelter syndrome
What syndrome has elevated FSH and LH levels with decreased testosterone levels and 47XXY karyotype?
2409
Arnold-Chiari malformation type 2
What CNS developmental abnormality is associated with 90% of syringomyelia?
2410
Onion skinning
What is the term for fibrinoid necrosis of the arterioles in the kidney secondary to malignant hypertension?
2411
Fibrocystic change of the breast. This highlights the distinguishing features from breast cancer, which is commonly unilateral, single nodule, no variation with pregnancy.
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?
2412
Wiskott-Aldrich syndrome
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?
2413
Nodular melanoma
Which form of melanoma carries the worst prognosis?
2414
Encapsulated bacteria
Patients with sickle cell anemia are at increased risk for infection from what type of organisms?
2415
Two major or one major and two minor
How many major and/or minor Jones criteria are required for the diagnosis of rheumatic fever?
2416
Mycosis fungoides (cutaneous T-cell lymphoma)
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?
2417
Hemosiderin
What Hgb-derived endogenous pigment is found in areas of hemorrhage or bruises?
2418
Papule
What is a palpable, elevated solid mass up to 0.5 cm?
2419
TRUE
True or false? Monocytosis is seen in TB.
2420
Gout
What pathology is associated with podagra, tophi in the ear, and PMNs with monosodium urate crystals?
2421
Pseudomembranous colitis
What GI pathology can be caused by a patient taking clindamycin or lincomycin or by Clostridium difficile, ischemia, Staphylococcus, Shigella, or Candida infection?
2422
Breast cancer
What do the risk factors late menopause, early menarche, obesity, nulliparity, excessive estrogen, genetic factor p53, and brc-abl characterize?
2423
Papillary carcinoma of the thyroid
What thyroid carcinoma is associated with radiation exposure, psammoma bodies, and Orphan Annie eye nuclei?
2424
Fc portion of IgG, C3b, and mannose-binding proteins
Name three opsonins.
2425
Beryllium
What chemical can be dangerous if you work in the aerospace industry or in nuclear plants?
2426
HBcAb IgM
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Window period
2427
HBsAb IgG
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Immunization
2428
HBcAb IgG and HBsAb IgG
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Prior infection
2429
HBcAb IgM, HBV-DNA, HBeAg, HBsAg
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Acute infection
2430
HBcAb IgG, HBV-DNA, HBeAg, HBsAg
Which hepatitis B serology markers—HBcAb IgG, HBcAb IgM, HBeAg, HBsAb IgG, HBsAg, HBV-DNA—are associated with the following periods? • Chronic infection
2431
Coagulative necrosis
Name the type of necrosis. • The most common form of necrosis; denatured and coagulated proteins in the cytoplasm
2432
Gangrenous necrosis
Name the type of necrosis. • Seen as dead tissue with coagulative necrosis
2433
Liquefaction necrosis
Name the type of necrosis. • Seen as dead tissue with liquefactive necrosis?
2434
Fat necrosis
Name the type of necrosis. • Due to lipase activity and has a chalky white appearance
2435
Caseous necrosis
Name the type of necrosis. • Soft, friable, cottage-cheese appearing; characteristically seen in TB
2436
Fibrinoid necrosis
Name the type of necrosis. • Histologically resembles fibrin
2437
Superoxide dismutase, glutathione peroxidase, catalase
Name the three enzymes that protect the cell from oxygen-derived free radicals.
2438
2% of population, 2 cm long, 2 feet from ileocecal valve, 2 years old, and 2% of carcinoid tumors
What are the rules of 2 for Meckel diverticulum?
2439
Berry aneurysm
What aneurysm of the circle of Willis is associated with polycystic kidney disease?
2440
SLE; ANA, anti-dsDNA and anti-Sm (anti-Smith)
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?
2441
True. It deposits at the gingivodental line, known as the lead line.
True or false? Excess lead deposits in the oral cavity.
2442
Hemochromatosis
What is the term for increased iron deposition resulting in micronodular cirrhosis, CHF, diabetes, and bronzing of the skin?
2443
Glanzmann syndrome
What AR disorder is due to a deficiency in glycoprotein IIb-IIIa, resulting in a defect in platelet aggregation?
2444
Ménétrier's disease
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?
2445
Myasthenia gravis
What myopathy due to autoantibodies to ACh receptors can present with thymic abnormalities, red cell aplasia, and muscle weakness?
2446
M3 (promyelocytic leukemia)
Which subtype of AML is most commonly associated with Auer rods?
2447
Female pseudohermaphrodite
What condition results from a 46XX karyotype and female internal organs with virilized external genitalia?
2448
Poststreptococcal GN
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?
2449
Wiskott-Aldrich syndrome
What X-linked recessive immune disorder is characterized by recurrent infections, severe thrombocytopenia, and eczema?
2450
Pseudogout
What form of arthritis is associated with calcium pyrophosphate crystals?
2451
Hypertrophic scar
What is the term for excessive production of collagen that flattens out and does not extend beyond the site of the injury?
2452
Peau d'orange
What is the term for inflamed, thickened skin on the breast with dimpling associated with cancer?
2453
Wegener granulomatosis
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?
2454
HTLV-1
What retrovirus is associated with adult T-cell leukemia?
2455
Duchenne muscular dystrophy
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?
2456
Giant cell bone tumor (osteoclastoma)
What malignant neoplasm of the bone has a soap bubble appearance on radiograph?
2457
Minimal change disease
What nephrotic syndrome has effacement of the epithelial foot processes without immune complex deposition?
2458
Mast cells
What is the term for tissue-based basophils?
2459
Osteosarcoma
What malignant bone tumor is characterized by Codman triangle (periosteal elevation) on radiograph?
2460
Extravascular hemolysis if it occurs in the spleen; if in the liver, it results in hepatomegaly.
Is splenomegaly more commonly associated with intravascular or extravascular hemolysis?
2461
Prostatic carcinoma
What cancer of the male genitourinary system is associated with osteoblastic bony metastasis?
2462
Leydig cell tumor
What stromal tumor in males is characterized histologically with crystalloids of Reinke?
2463
Emphysema
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?
2464
Factor XII for the intrinsic; factor VII for the extrinsic pathway
What factor gets activated in the intrinsic pathway of the coagulation cascade? Extrinsic pathway?
2465
Rheumatoid arthritis
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?
2466
Roth spots
Name the following descriptions associated with bacterial endocarditis: • Retinal emboli
2467
Osler nodes
Name the following descriptions associated with bacterial endocarditis: • Painful subcutaneous nodules on fingers and toes
2468
Janeway lesions
Name the following descriptions associated with bacterial endocarditis: • Painless hyperemic lesions on the palms and soles
2469
CD15 and CD30
What two CD cell surface markers do Reed- Sternberg cells stain positive for?
2470
Niemann-Pick and Tay-Sachs diseases
What two lysosomal storage diseases have cherry-red spots on the retina?
2471
False. Increased LAP is seen in stress reactions and helps differentiate benign conditions from CML, which has low LAP levels.
True or false? Increased leukocyte alkaline phosphatase (LAP) is associated with CML.
2472
Turcot syndrome
What syndrome has multiple adenomatous colonic polyps and CNS gliomas?
2473
Paradoxic emboli most commonly enter the arteries through a patent septal defect in the heart.
What is the term for a venous embolus in the arterial system?
2474
Embolic
Are hemorrhagic cerebral infarcts more commonly associated with embolic or thrombotic occlusions?
2475
Red blood cell distribution width index (RDW)
What is the name for the following RBC indices? • The coefficient of variation of the RBC volume
2476
Mean corpuscular hemoglobin (MCH)
What is the name for the following RBC indices? • Average mass of the Hgb molecule/RBC
2477
Mean corpuscular volume (MCV)
What is the name for the following RBC indices? • Average volume of a RBC
2478
Mean corpuscular hemoglobin concentration (MCHC)
What is the name for the following RBC indices? • Average Hgb concentration/given volume of packed RBCs
2479
Hypertrophic cardiomyopathy (hypertrophic subaortic stenosis, or IHSS)
What cardiomyopathy is due to a ventricular outflow obstruction as a result of septal hypertrophy and leads to sudden cardiac death in young athletes?
2480
HPV serotypes 6 and 11
Which HPV serotypes are associated with condyloma acuminatum?
2481
Lentigo maligna melanoma
Which form of melanoma carries the best prognosis?
2482
Hyperplasia
What is the term for an increase in the number of cells in a tissue?
2483
Multiple myeloma
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?
2484
Empyema
What is the term for pus in the pleural space?
2485
Macule (e.g., a freckle)
What is flat, circumscribed nonpalpable pigmented change up to 1 cm?
2486
Kupffer cells
Name the macrophage based on its location: • Liver macrophages
2487
Osteoclasts
Name the macrophage based on its location: • Bone macrophages
2488
Microglia
Name the macrophage based on its location: • Brain macrophages
2489
Pulmonary alveolar macrophages
Name the macrophage based on its location: • Lung macrophages
2490
Histiocytes
Name the macrophage based on its location: • Connective tissue macrophages
2491
Langerhans cells
Name the macrophage based on its location: • Epidermal macrophages
2492
Reticulocyte
What is the term for a large, immature RBC that is spherical, blue, and without a nucleus?
2493
Yolk sac tumor
What testicular tumor of infancy is characterized by elevated-fetoprotein levels and Schiller-Duval bodies?
2494
Burkitt lymphoma
Starry sky appearance of macrophages is pathognomonic of what lymphoma?
2495
Lower lobe
In which region of the lung are 75% of the pulmonary infarcts seen?
2496
Sjögren disease
For what disease are SS-A(Ro), SS-B(La), and R-ANA diagnostic markers?
2497
HPV serotypes 16, 18, 31, and 33
What HPV serotypes are associated with increased risk of cervical cancer?
2498
Hematoxylin
Do the following structures pick up stain from hematoxylin or eosin? • Nuclei
2499
Hematoxylin
Do the following structures pick up stain from hematoxylin or eosin? • Nucleoli
2500
Eosin
Do the following structures pick up stain from hematoxylin or eosin? • Cytoplasm
2501
Eosin
Do the following structures pick up stain from hematoxylin or eosin? • Collagen
2502
Eosin
Do the following structures pick up stain from hematoxylin or eosin? • RBCs
2503
Hematoxylin
Do the following structures pick up stain from hematoxylin or eosin? • Calcium
2504
Hematoxylin
Do the following structures pick up stain from hematoxylin or eosin? • Bacteria
2505
Eosin
Do the following structures pick up stain from hematoxylin or eosin? • Fibrin
2506
Eosin
Do the following structures pick up stain from hematoxylin or eosin? • Thyroid colloid
2507
ASA (salicylate)
What commonly encountered overdose produces headache, tinnitus, respiratory alkalosis, metabolic acidosis, confusion, vomiting, and tachypnea?
2508
Bernard-Soulier syndrome
What AR syndrome is due to a deficiency of glycoprotein Ib, resulting in a defect in platelet adhesion?
2509
Adult polycystic kidney disease
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?
2510
Chronic rejection
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
2511
Hyperacute rejection
Based on the following information, is the renal transplantation rejection acute, chronic, or hyperacute? • Immediately after transplantation; seen as a neutrophilic vasculitis with thrombosis
2512
Acute rejection
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
2513
Type I (makes sense, since they have a predisposition for fractures and type I collagen is associated with bones and tendons)
What type of collagen is abnormal in patients with osteogenesis imperfecta?
2514
Kawasaki disease
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?
2515
Graves disease
What disease has IgG autoantibodies, occurs in women more than men, and includes exophthalmos, pretibial myxedema, nervousness, heart palpitations, and fatigue?
2516
True hermaphrodism
What condition is defined by both testicular and ovarian tissues in one individual?
2517
Pyloric stenosis
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?
2518
Churg-Strauss syndrome
What variant of polyarteritis nodosa is associated with bronchial asthma, granulomas, and eosinophilia?
2519
Laminin
What component of the basement membrane binds to collagen type IV and heparin sulfate and is a cell surface receptor?
2520
Hairy cell leukemia
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)?
2521
IgA nephropathy
What form of nephritic syndrome is associated with celiac sprue and Henoch- Schönlein purpura?
2522
DiGeorge syndrome
What syndrome is characterized by embryologic failure of the third and fourth pharyngeal pouches resulting in hypocalcemia, tetany, and T-cell deficiency?
2523
Phototherapy
What is the treatment for physiologic jaundice of newborns?
2524
3 months of symptoms in 2 consecutive years
How many months in how many years must a person cough with copious sputum production for the diagnosis of chronic bronchitis to be made?
2525
Eosinophils
What chronic inflammatory WBC is associated with IgE-mediated allergic reactions and parasitic infections?
2526
Peutz-Jeghers syndrome
What AD syndrome produces hamartomatous polyps in the small intestine and pigmentation of the lips and oral mucosa?
2527
Hemostasis
What is the term for formation of a stable fibrin-platelet plug to stop bleeding?
2528
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!
True or false? All of the following are risk factors for breast cancer: early menses, late menopause, history of breast cancer, obesity, and multiparity.
2529
Right-sided
Is jugular venous distention a presentation of isolated left or right heart failure?
2530
Hepatitis D
Name the hepatitis virus based on the following information. • Small circular RNA virus with defective envelope
2531
Hepatitis C
Name the hepatitis virus based on the following information. • Enveloped RNA flavivirus
2532
Hepatitis E
Name the hepatitis virus based on the following information. • Naked capsid RNA calicivirus
2533
Hepatitis B
Name the hepatitis virus based on the following information. • Enveloped DNA hepadnavirus
2534
Hepatitis A
Name the hepatitis virus based on the following information. • Naked capsid RNA picornavirus
2535
Niemann-Pick disease
What AR disease involves a decreased amount of sphingomyelinase, massive organomegaly, zebra bodies, and foamy histiocytes and is associated with chromosome 11p?
2536
Mural infarct
What is the term for hypoperfusion of an area involving only the inner layers?
2537
Marrow failure, cancer, and leukemia
What are the three causes of normochromic normocytic anemia with a normal MCV and a low reticulocyte count?
2538
Dilation of the internal mammary arteries results in erosions on the inner surface of the ribs and is seen as notching.
Notching of the ribs, seen on chest radiograph in patients with postductal coarctation of the aorta, is due to collateralization of what arteries?
2539
Ferritin
What is the physiologic storage form of iron?
2540
Embolism
What is the term for occlusion of a blood vessel due to an intravascular mass that has been carried downstream?
2541
Wilson disease. (Remember, patients commonly present with psychiatric manifestations and movement disorders but may be asymptomatic.)
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?
2542
Burkitt lymphoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • c-myc
2543
Small cell cancer of the lung
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • L-myc
2544
Melanoma, cancer of the stomach and bladder
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1 and int-2
2545
MEN II and III syndromes
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • et
2546
Pancreas and colon
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras
2547
Mantle cell lymphoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • cyclin D
2548
Neuroblastoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • N-myc
2549
Melanoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • CDK4
2550
CML and ALL
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • abl
2551
Breast cancer
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • hst-1, int-2, erb-2, and erb-3
2552
Astrocytoma
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • sis
2553
Lung cancer
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • Ki-ras and erb-2
2554
Squamous cell carcinoma of the lung
Name the cancer associated with the following oncogenes. (Some may have more than one answer) • erb-1
2555
Gardner syndrome
What AD GI neoplasia produces multiple adenomatous polyps, osteomas, fibromas, and epidural inclusion cysts?
2556
Patau syndrome (trisomy 13)
What disease involves microcephaly, mental retardation, cleft lip or palate, and dextrocardia?
2557
Postinfectious GN
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?
2558
Brain, spleen, and kidney
What are the three most common sites for left-sided heart embolisms to metastasize?
2559
Asbestosis and silicosis
With what two pathologies is a honeycomb lung associated?
2560
Achondroplasia
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?
2561
False. hyperkalemia decreases digoxin's activity, while hypokalemia, hypomagnesemia, and hypercalcemia all increase digoxin toxicity.
True or false? Hyperkalemia increases the effect of digoxin.
2562
Dantrolene
Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
2563
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
Which overdose carries a higher mortality rate, that of benzodiazepines or barbiturates?
2564
Amantadine
What antiviral agent is used in the treatment of drug-induced Parkinson's disease?
2565
H 1
Are the following responses associated with histamines H1 or H2 receptor activation? • Edema
2566
H 2
Are the following responses associated with histamines H1 or H2 receptor activation? • Gastric acid secretion
2567
H 2
Are the following responses associated with histamines H1 or H2 receptor activation? • SA nodal activity
2568
H 1
Are the following responses associated with histamines H1 or H2 receptor activation? • Pain and pruritus
2569
H 1
Are the following responses associated with histamines H1 or H2 receptor activation? • Bronchial smooth muscle activity
2570
H 2
Are the following responses associated with histamines H1 or H2 receptor activation? • Inotropic action and automaticity
2571
True. The lack of dopamine leads to an excess of ACh, hence extrapyramidal dysfunction.
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.
2572
PGI 2
Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
2573
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
Which CNS ACh receptor or receptors are excitatory? Inhibitory?
2574
True. They are useful in the early-phase response to an asthmatic attack.
True or false? Beta2-Adrenergic agents are used in the management of an acute asthmatic attack.
2575
Inactivated
Do local anesthetics bind to the activated or inactivated sodium channels?
2576
Pimozide
What is the drug of choice for treating Tourette syndrome?
2577
Anopheles mosquito
What mosquito is responsible for the transmission of malaria?
2578
Acetaldehyde dehydrogenase
What enzyme is inhibited by disulfiram?
2579
Spironolactone
Which diuretic is used as an adrenal steroid antagonist?
2580
Fentanyl
What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
2581
Spectinomycin
What is the drug of choice for penicillin-resistant gonococcal infections?
2582
Magnesium
What is the DOC for treating torsade de pointes?
2583
No. Heparin is safe in pregnancy, but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
Is heparin contraindicated in pregnancy?
2584
Griseofulvin
What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
2585
Carbamazepine
Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
2586
1. Clavulanic acid 2. Sulbactam 3. Tazobactam
What are the three Beta-lactamase inhibitors?
2587
Carbamazepine
Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
2588
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
2589
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
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?
2590
Raloxifene
What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
2591
Demeclocycline
Which tetracycline is used in the treatment of SIADH?
2592
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
How is the eye affected by use of opioids?
2593
Chloramphenicol
Name the antimicrobial agent whose major side effect is listed. • Grey baby syndrome
2594
Aminoglycosides
Name the antimicrobial agent whose major side effect is listed. • CN VIII damage (vestibulotoxic)
2595
Metronidazole
Name the antimicrobial agent whose major side effect is listed. • Teratogenicity
2596
Erythromycin
Name the antimicrobial agent whose major side effect is listed. • Cholestatic hepatitis
2597
Nitrofurantoin
Name the antimicrobial agent whose major side effect is listed. • Hemolytic anemia
2598
Tetracycline
Name the antimicrobial agent whose major side effect is listed. • Dental staining in children
2599
Trimethoprim
Name the antimicrobial agent whose major side effect is listed. • Altered folate metabolism
2600
Vancomycin
Name the antimicrobial agent whose major side effect is listed. • Auditory toxicity
2601
Quinolones
Name the antimicrobial agent whose major side effect is listed. • Cartilage abnormalities
2602
Constipation and miosis
What are the two side effects of opioids to which the user will not develop tolerance?
2603
Valproic acid
Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
2604
Ethambutol
What antitubercular agent causes loss of red-green visual discrimination?
2605
Ultralente
Name the insulin preparation based on the peak effect and duration of action. • Peak, 8 to 16 hours; duration, 24 to 36 hours
2606
Regular insulin
Name the insulin preparation based on the peak effect and duration of action. • Peak, 0.5 to 3 hours; duration, 5 to 7 hours
2607
Lente or NPH insulin (neutral protamine Hagedorn insulin)
Name the insulin preparation based on the peak effect and duration of action. • Peak, 8 to 12 hours; duration, 18 to 24 hours
2608
Lispro insulin
Name the insulin preparation based on the peak effect and duration of action. • Peak, 0.3 to 2 hours; duration, 3 to 4 hours
2609
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
Is digoxin or digitoxin renally eliminated?
2610
Alendronate
What is the drug of choice for steroid-induced osteoporosis?
2611
Nystagmus and ataxia
What are the first signs of overdose from phenobarbitals?
2612
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.
How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
2613
Phenylephrine
What α1-agonist, not inactivated by catechol-O-methyl transferase (COMT), is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
2614
Lactulose
Which laxative is used in the treatment of hepatic encephalopathy ?
2615
Phase I
Are hydrolysis, oxidation, and reduction phase I or II biotransformations?
2616
Labetalol
What β-blocker is also an α-blocker?
2617
Diphenhydramine
What agent is used IM to treat acute dystonias?
2618
True. Aminoglycosides use O 2-dependent uptake and therefore are ineffective for treatment of anaerobic infections.
True or false? Anaerobes are resistant to the effects of aminoglycosides.
2619
Acebutolol and Pindolol
What two β-blockers decrease serum lipids?
2620
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.
If a drug is ionized, is it water or lipid soluble? Can it cross a biomembrane?
2621
Diazepam is longest acting and midazolam is shortest acting.
What are the longest-acting and shortest-acting benzodiazepines?
2622
Amphotericin B
What is the DOC for severe infections with Sporothrix, Mucor, Histoplasma, Cryptococcus, Candida, and Aspergillus?
2623
NE
What neurotransmitter is presynaptically inhibited by reserpine and guanethidine?
2624
Cefuroxime and cefaclor
Which two cephalosporins cross the blood-brain barrier?
2625
Tyramine
What agent, in combination with a MAOI inhibitor, can cause hypertensive crisis?
2626
True. β-Blockade would result in unopposed-adrenergic stimulation and worsen the patient's symptoms. Calcium channel blockers are the way to go.
True or false? Cocaine-induced coronary ischemia should not be treated with β-blockers.
2627
Ipratropium
What antimuscarinic is used as an inhalant for asthma?
2628
Lente insulin and either NPH or protamine zinc insulin (PZI)
What two forms of insulin, if mixed together, precipitate zinc?
2629
Flutamide
What androgen receptor blocker is used in the treatment of prostatic cancer?
2630
Nystagmus and ataxia
What are the first signs of phenobarbital overdose?
2631
RSV
Which virus is treated with the monoclonal antibody palivizumab?
2632
Lithium
Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?
2633
Class III
Which class of antiarrhythmics are potassium channel blockers?
2634
M 2
Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
2635
Carbamazepine
What antiepileptic agent has SIADH as a side effect?
2636
Ketamine
What is the only anesthetic that causes cardiovascular stimulation?
2637
Dapsone
Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
2638
Bactericidal
What form of antimicrobial therapy is best for an immunocompromised patient?
2639
Hydralazine
Which direct-acting vasodilator is associated with SLE-like syndrome in slow acetylators?
2640
Low molecular weight heparin (LMWH)
What class of heparin is active against factor Xa and has no effect on PT or PTT?
2641
Fluconazole
What is the DOC for coccidioidomycosis?
2642
1. Cefotetan 2. Cefoxitin 3. Ceftizoxime
What three cephalosporins have good penetration against Bacteroides fragilis?
2643
Methanol
Which form of alcohol toxicity results in ocular damage?
2644
Azathioprine
What immunosuppressive agent is converted to 6-mercaptopurine?
2645
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
2646
Dihydrofolate reductase
What enzyme is inhibited by trimethoprim?
2647
NADPH and molecular O 2
What are the two absolute requirements for the cytochrome P450 enzyme system?
2648
PGE 1, PGI 2 (most potent), and TXA 2
What three PGs are potent platelet aggregators?
2649
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs, TCADs, dextromethorphan, and meperidine. Treat it with cyproheptadine.
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?
2650
Bisphosphonates
What class of drugs is used in the treatment of demineralization of the bone?
2651
Acetazolamide
What is the only class of diuretics to retain Cl- used in the short-term treatment of glaucoma and of acute mountain sickness?
2652
True. Aluminum reacts with PO4, resulting in AlPO4, an insoluble compound that cannot be absorbed.
True or false? All aluminum-containing antacids can cause hypophosphatemia.
2653
Desipramine
What TCAD causes sudden cardiac death in children?
2654
Metaproterenol and albuterol
What two β2-agonists are used to produce bronchodilation?
2655
Mannitol
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?
2656
They prevent mast cell degranulation.
What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
2657
Ritodrine and terbutaline
What two β2-agonists cause myometrial relaxation?
2658
In the dorsal horn of the spinal cord on the primary afferent neurons
Where in the spinal cord are the presynaptic opioid receptors?
2659
Streptokinase
What thrombolytic agent is derived from β-hemolytic streptococci, is antigenic, and produces depletion of circulating fibrinogen, plasminogen, and factors V and VII?
2660
Terbinafine
What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
2661
ACE inhibitors (the-pril agents)
Which class of antihypertensives produces angioedema, hyperkalemia, and a dry cough?
2662
Sucralfate
Which medication requires an acidic gastric pH for activation to form a protective gel-like coating over ulcers and GI epithelium?
2663
5HT1D
Of what serotonin receptor is sumatriptan an agonist?
2664
Phenytoin
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?
2665
1. Cloxacillin 2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM)
What are the five penicillinase-resistant penicillins?
2666
Streptomycin
Which aminoglycoside is the DOC for tularemia and the bubonic plague?
2667
Competitive antagonist
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?
2668
TRUE
True or false? Progestins are used in combination with estrogens to decrease the risk of endometrial cancer.
2669
Clozapine
What neuroleptic agent causes agranulocytosis but does not induce tardive dyskinesia?
2670
First-pass metabolism and acid lability
What two factors influence low oral bioavailability?
2671
The stomach
What is the only site in the body that uses M1 receptors?
2672
Vitamin B 6 (pyridoxine)
What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L-dopa if used concomitantly?
2673
TRUE
True or false? Acetaminophen has analgesic and antipyretic activities but lacks anti-inflammatory effects.
2674
The larger the volume of distribution, the lower the plasma concentration of a drug.
What happens to plasma concentration of a drug if there is a large volume of distribution?
2675
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
Why should opioid analgesics be avoided for patients with head trauma?
2676
Clofazimine
What is the drug of choice in the treatment of the lepra reaction?
2677
Succinylcholine and halothane (Treatment is with dantrolene.)
What two drugs, when mixed, can lead to malignant hyperthermia?
2678
1. Propranolol 2. Timolol 3. Carteolol
What three β-blockers are used in the treatment of glaucoma?
2679
Dynorphin
What is the neurotransmitter at the K-receptor?
2680
TRUE
True or false? Succinylcholine is a nicotinic receptor agonist.
2681
α-Methyldopa (Guanabenz or clonidine is also used.)
What is the drug of choice for hypertensive patients with a decreased renal function?
2682
Volume of distribution is decreased when a large percentage of drug is protein bound.
What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?
2683
Cyproheptadine
What antihistamine is used in the treatment of serotonergic crisis?
2684
Selegiline
What is the drug of choice for early Parkinson's disease?
2685
The entire tubule barring the thick ascending limb
What is the site of action of the following? • Osmotic diuretics
2686
Ascending limb
What is the site of action of the following? • Loop diuretics
2687
Early distal tubule
What is the site of action of the following? • Thiazide diuretics
2688
Early collecting duct
What is the site of action of the following? • K+-sparing diuretics
2689
Distal convoluted tubules
What is the site of action of the following? • Aldosterone antagonists
2690
Non-Hodgkin lymphoma
What hematologic malignancy is treated with the monoclonal antibody rituximab?
2691
Amiloride
Which sodium channel blocker is used to treat lithium-induced diabetes insipidus?
2692
Haloperidol and fluphenazine (but use of any high-potency phenothiazine runs the risk of EPS)
Which two antipsychotic drugs create a high risk for developing extrapyramidal syndrome (EPS) side effects?
2693
Yes, because they both activate the BZ1-receptors, which can be reversed by flumazenil.
Could an overdose with either zolpidem or zaleplon be reversed with flumazenil?
2694
Reserpine
What drug blocks intragranular uptake of NE?
2695
False. Bacteriocidals kill; bacteriostatics slow growth.
True or false? Antimicrobial agents that slow bacterial growth are bactericidal.
2696
Nicotinic acid, because its side effects include hyperuricemia and exacerbation of ulcers.
Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
2697
Mebendazole
What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
2698
Zanamivir and oseltamivir
What antiviral agents inhibit neuraminidases of influenza A and B?
2699
Cefamandole, cefoperazone, and moxalactam
What three cephalosporins inhibit vitamin K-dependent factors?
2700
Diazoxide
Which direct-acting vasodilator is used clinically to treat hypertensive emergencies, insulinomas, and as a uterine smooth muscle relaxant?
2701
LTB4
Which leukotriene—LTA4, LTB4, LTC4, or LTD4—is not associated with anaphylaxis and bronchoconstriction?
2702
Thioridazine
What neuroleptic agent causes retinal deposits, hypotension, and torsades de pointes?
2703
Acarbose
What oral hypoglycemic agent inhibits α-glucosidase in the brush border of the small intestine?
2704
Dihydropteroate synthetase
What enzyme is inhibited by sulfonamides?
2705
The affinity of the drug for its receptor
What is the most important determinant of drug potency?
2706
False. Risk of breast and endometrial cancer but not ovarian cancer increases with the use of estrogen.
True or false? Estrogen use increases the risk of developing ovarian cancer.
2707
Chloral hydrate
Which sedative-hypnotic is contraindicated for patients taking warfarin?
2708
Phentolamine and phenoxybenzamine
What mixed α-antagonists are used for patients with pheochromocytoma?
2709
1. Intracellular receptors 2. Membrane receptors 3. Enzymes 4. Intracellular effectors
What are the four types of signaling mechanisms?
2710
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
The dose of which second-generation sulfonylurea agent must be decreased for patients with hepatic dysfunction?
2711
d-Tubocurarine
Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
2712
Transient protein C deficiency, because of its relatively short half-life, may result if warfarin is instituted alone.
What transient deficiency may result in a hypercoagulable state if warfarin is given alone?
2713
Arterioles
What component of the vascular system is most sensitive to the effects of calcium channel blockers?
2714
Albendazole
What drug blocks glucose uptake, leading to decreased formation of ATP and resulting in immobilization of the parasite?
2715
Proximal tubule
What is the site of action for carbonic anhydrase inhibitors?
2716
G2 phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Bleomycin
2717
S phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Cytarabine
2718
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for? • Vinblastine
2719
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Alkylating agents
2720
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for? • Paclitaxel
2721
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for? • Vincristine
2722
S phase
What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Thioguanine
2723
S phase
What phase of the cell cycle are the following antineoplastic agents specific for? • 6-Mercaptopurine
2724
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Dacarbazine
2725
S phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Hydroxyurea
2726
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Cisplatin
2727
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for? • Nitrosoureas
2728
Tolcapone and entacapone
Inhibition of peripheral COMT, allowing increased CNS availability of L-dopa, is accomplished by what two agents?
2729
Misoprostol
What medication is a PGE1 analog that results in increased secretions of mucus and HCO3-in the GI tract?
2730
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.
Is there a difference between mathematical and clinical steady states? If so, what are their values (half-lives)?
2731
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.
True or false? At high doses aspirin has uricosuric properties.
2732
Ribavirin
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?
2733
Neomycin
Which aminoglycoside is used only topically because it is too toxic for systemic use?
2734
Class 1 (1A, 1B, and 1C)
Which class of antiarrhythmics blocks sodium channels?
2735
Penicillin G (benzylpenicillin)
What form of penicillin is used in the treatment of life-threatening illnesses?
2736
Fluconazole
What is the DOC for esophageal candidiasis?
2737
False. Flumazenil is unable to block the effects of barbiturates.
True or false? Flumazenil is used in the treatment of barbiturate overdose.
2738
1. Streptomycin 2. Gentamicin 3. Tobramycin
Which three aminoglycosides have vestibular toxicity?
2739
Potency
What is the term for the amount of a drug that is needed to produce the desired effect?
2740
Finasteride
What agent used in the treatment of BPH and baldness is a 5-α-reductase inhibitor?
2741
Propranolol
What β-blocker is also a membrane stabilizer?
2742
Ticlopidine or clopidogrel
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?
2743
Amiloride
What is the treatment for nephrogenic diabetes insipidus induced by lithium?
2744
Nimodipine
Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
2745
Guanethidine and bretylium
What two drugs inhibit the release of neurotransmitters from storage granules?
2746
Pergolide
What is the DOC for hyperprolactinemia?
2747
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.
True or false? The faster the rate of absorption, the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
2748
Chlortetracycline
What tetracycline is associated with hepatotoxicity?
2749
Efficacy
What is the term for how well a drug produces its desired response?
2750
RU 486
What drug, if given during pregnancy, would cause the uterus to exhibit signs of progesterone withdrawal and induce an abortion?
2751
No, it is used in chronic treatment of gout to decrease the uric acid pools in the body.
Is allopurinol used in the acute treatment of gout?
2752
1. Cefamandole 2. Cefoperazone 3. Moxalactam
What three cephalosporins can produce disulfiram-like reactions?
2753
They block the midcycle surge of LH.
What is the physiologic basis for the actions of birth control pills?
2754
First-pass effect
When a drug is administered orally and enters into portal circulation, it undergoes hepatic metabolism. What is the name of this effect?
2755
Alteplase
Which thrombolytic agent, activated in the presence of fibrin, is manufactured by recombinant DNA process?
2756
Midazolam
Which benzodiazepine is most commonly used IV in conscious sedation protocols?
2757
Thiabendazole
What is the drug of choice for threadworm, trichinosis, and larva migrans?
2758
No, therapeutic indices can tell which drug is safer, not more toxic.
Can you tell which drug is more toxic based on therapeutic indices alone?
2759
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
What blood disorder is a side effect of metformin?
2760
Neuroleptic malignant syndrome is a potentially life-threatening condition which is treated with symptomatic support, bromocriptine, and dantrolene.
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?
2761
Minoxidil (orally and topically, respectively!)
Which α-blocking agent is used to treat refractory hypertension and baldness?
2762
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II, VII, IX, and X.
What components of the coagulation cascade are affected by estrogen?
2763
Sulfonamides
What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency?
2764
HMG-CoA reductase
What enzyme of cholesterol synthesis is inhibited by the statins?
2765
Imipenem and meropenem
What bactericidal agents are resistant to β-lactamases and are used to treat in-hospital life-threatening infections?
2766
α1-Receptors
What adrenergic receptors use inositol triphosphate (IP3) and diacylglycerol (DAG) for their second messenger system?
2767
TRUE
True or false? Dopamine antagonists at the D2A receptor have the capacity to induce pseudoparkinsonism.
2768
PGE2 and PGF2α
What two PGs are used to induce labor?
2769
Enterohepatic cycling
How are drugs that are excreted via the biliary system resorbed by the GI tract?
2770
Aminoglycosides
Which drugs bind to the 30S ribosomal subunit and interfere with the initiation complex, causing a misreading of mRNA?
2771
Amantadine
What antiviral agent blocks the attachment and penetration of influenza A virus?
2772
Atropine and 2-PAM (pralidoxime)
What is the antidote for organophosphate ingestion?
2773
ACE inhibitors (-pril)
Which antihypertensive class is used to help stop the progression of microalbuminuria?
2774
Proton pump inhibitors
What class of drugs are the DOCs for peptic ulcer disease, Zollinger-Ellison syndrome, and gastroesophageal reflux disease?
2775
Chloramphenicol
What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
2776
Carbidopa and benserazide
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?
2777
Zero-order elimination
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
2778
First-order elimination
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
2779
TRUE
True or false? NSAIDs have analgesic, antipyretic, anti-inflammatory, and antiplatelet activities.
2780
False. They are bacteriostatic.
True or false? Tetracyclines are bactericidal.
2781
Procainamide
What class 1A antiarrhythmic agent has SLE-like syndrome side effect in slow acetylators?
2782
Respiratory depression
What is the major pulmonary side effect of µ-activators?
2783
Risperidone
What neuroleptic agent is also considered to be an antihistamine?
2784
Penicillin V
What form of penicillin is stable in acid environments?
2785
Bioavailability
What is the term for the proportion of a drug that reaches systemic circulation?
2786
Carbidopa and benserazide
What two drugs block dopa-decarboxylase in the periphery to decrease the conversion of L-dopa to dopamine?
2787
Lithium
What is the DOC for bipolar disorder?
2788
True if she is Rho-negative; false if she is Rho-positive
True or false? If a mother delivers a Rho-positive baby, she should receive Rho-immunoglobulin.
2789
False. Glutamic acid is excitatory, but GABA is inhibitory.
True or false? Both GABA and glutamic acid are excitatory neurotransmitters in the CNS.
2790
Rifampin
What is the drug of choice for asymptomatic meningitis carriers?
2791
Edrophonium
What drug is used to differentiate a cholinergic crisis from myasthenia gravis?
2792
Nitrates
What class of antianginal activates the NO pathway to produce endothelial vasodilation?
2793
Celecoxib
What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
2794
Itraconazole
What is the DOC for blastomycoses and sporotrichoses?
2795
Splenomegaly and anemia (with a high index of suspicion)
What are the two most important features in the diagnosis of malaria?
2796
Oxazepam, temazepam, and lorazepam ( OTL, Outside The Liver)
Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system.
2797
Pirenzepine
What drug is an M1-specific antispasmodic?
2798
Methyldopa
Which centrally acting α2-adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy?
2799
Selegiline
What is the monoamine oxidase B (MAOB) inhibitor?
2800
Rifampin
What antitubercular agent causes a red-orange tinge to tears and urine?
2801
Glucocorticoids and amphetamines
What two classes of drugs can cause schizoid behavior?
2802
Minocycline
What tetracycline is associated with vestibular toxicity?
2803
Doxacurium
What is the most potent NMJ blocker and also has no cardiovascular side effects?
2804
D2 and 5HT3 receptors
What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
2805
Thiazide diuretics
Which group of antihypertensive agents best decreases left ventricular hypertrophy?
2806
Mesolimbic system
What area of the brain is linked to emotion and movement?
2807
Because they do not block D2A receptors, they are antagonists of 5HT2 receptors.
Why are clozapine and olanzapine unlikely to result in EPS effects?
2808
Prodrugs
What class of pharmaceuticals are inactive until they are metabolized to their active products?
2809
True. Probenecid can precipitate uric acid crystals in the kidney if the patient is an overexcretor of urate.
True or false? You would not prescribe probenecid for a patient with gout who is an overexcretor of uric acid.
2810
True. They block the dopamine receptors in the chemoreceptor trigger zone.
True or false? Dopamine antagonists are antiemetic.
2811
Vancomycin
What bactericidal agent is the DOC for MRSA, enterococci, and Clostridium difficile?
2812
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.)
True or false? β-Blockers are contraindicated in patients who present to the hospital with CHF.
2813
True. They inhibit DNA gyrase (topo II).
True or false? Fluoroquinolones are bactericidal.
2814
Foscarnet
What antiviral agent for ganciclovir-resistant infections has limited utility because of its nephrotoxic side effect?
2815
Repaglinide
What oral hypoglycemic agent stimulates pancreatic β-cell release of insulin and is given just prior to meals because of its short half-life?
2816
True. No loss of drug and no absorption if a drug is given IV.
True or false? There is no absorption of an IV-administered drug.
2817
Log-kill hypothesis (follows first order kinetics)
What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells, not a fixed number?
2818
Cocaine
What is the only local anesthetic to produce vasoconstriction?
2819
Zileuton
Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway?
2820
Spironolactone (binds to aldosterone receptors)
What is the only diuretic that works on the blood side of the nephron?
2821
Heparin, intrinsic pathway, PTT; warfarin, extrinsic pathway, PT (mnemonic: hPeT, wPiTT)
Do you monitor heparin's therapeutic levels by PT or PTT?
2822
Molindone
What is the only neuroleptic that does not cause an increase in weight or appetite?
2823
Metaraminol (α1, β1 )
What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension?
2824
Adenosine (it is an excellent agent to use in emergencies because its half-life is 30 seconds)
What antiarrhythmic agent is the DOC for treating and diagnosing paroxysmal supraventricular tachycardia (PSVT) and AV nodal arrhythmias?
2825
Aminophylline
What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
2826
Atracurium
Which nicotinic receptor antagonist is inactivated to laudanosine?
2827
Yohimbine
What α2-antagonist is used to treat impotence and postural hypotension?
2828
Pyrantel pamoate
What drug of choice for ascaris causes neuromuscular blockade of the worm?
2829
Phase 1
Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing?
2830
Tetracycline
Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?
2831
Ketoconazole
What antifungal agent is used in the treatment of androgen receptor-positive cancers?
2832
Selegiline
What MAOI does not cause a hypertensive crisis?
2833
Methicillin
Which penicillin can cause interstitial nephritis?
2834
Progestin
Is hirsutism a side effect of estrogen or progestin therapy?
2835
Spironolactone
Which potassium-sparing drug is an aldosterone receptor antagonist ?
2836
1. Pinpoint pupils 2. Decreased respiratory rate 3. Coma
What are the three signs of morphine overdose?
2837
Gabapentin
Which anticonvulsant is used in the treatment of bipolar disorder and neuropathic pain?
2838
False. Metformin does not have weight gain as a potential side effect (unlike sulfonylureas).
True or false? Metformin is contraindicated in obese patients because of weight gain as its side effect.
2839
Corticosteroid
What is the DOC for the treatment of the late phase response in an asthmatic attack?
2840
Regardless of the rate of infusion, it takes 4 to 5 half-lives to reach steady state.
If you double the infusion rate of a drug, how long will it take to reach steady state?
2841
β-Endorphin
What is the neurotransmitter at the µ-receptor?
2842
Metronidazole
What is the DOC for the following protozoal infections? • Amebiasis
2843
Stibogluconate
What is the DOC for the following protozoal infections? • Leishmaniasis
2844
Trimethoprim/sulfamethoxazole (TMP-SMX)
What is the DOC for the following protozoal infections? • Pneumocystis carinii pneumonia
2845
Metronidazole
What is the DOC for the following protozoal infections? • Giardiasis
2846
Metronidazole
What is the DOC for the following protozoal infections? • Trichomoniasis
2847
Pentoxifylline
What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability?
2848
Glucuronidation
What enzyme system is the most common form of phase II biotransformation?
2849
1. Sweat glands 2. Arterioles 3. Veins
In what three areas of the body are sympathetics the predominant tone?
2850
Fluconazole
What is the only antifungal agent to penetrate CSF?
2851
Class II
Which class of antiarrhythmics are β-blockers?
2852
1. Cefamandole 2. Cefoperazone 3. Ceftriaxone
What three cephalosporins are eliminated via biliary mechanisms?
2853
Clonidine
Which centrally acting α2-adrenergic agonist is used in the treatment protocol of opioid withdrawal?
2854
Infliximab
What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?
2855
Erythromycin
Which macrolide is used in the treatment of gastroparesis?
2856
Fanconi-like syndrome
What syndrome is characterized by the triad of renal tubular acidosis, nephrosis, and amino aciduria?
2857
Mesocortical area
In what area of the brain can an excess of dopamine lead to psychotic symptoms?
2858
1. Sustained release 2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity
Name five causes for zero-order metabolism.
2859
Isoniazid
What antitubercular agent requires vitamin B6 supplementation?
2860
Meclizine
Which antihistamine is one of the DOCs for treatment of vertigo?
2861
Metronidazole
What is the DOC for treating Entamoeba histolytica, Giardia, Trichomonas, Bacillus fragilis, and Clostridium difficile infections?
2862
α-Blockers (-zosins)
Which class of antihypertensives is used in the treatment of BPH?
2863
Azithromycin
Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex?
2864
Niclosamide
What is the drug of choice, which inhibits oxidative phosphorylation in cestodes, for taeniasis?
2865
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore, they are not used if a patient has hypertriglyceridemia.
Which class of antihyperlipidemics would you avoid for a patient with elevated triglyceride levels?
2866
False. Ergotamines are used in the treatment of migraines for their vasoconstrictive action in the cerebral circulation.
True or false? Ergotamines, because of their vasodilation action, cause migraines.
2867
Absolutely not. Diabetics who are given a β-blocker for an acute chest syndrome have significantly better outcomes than those who do not.
Is DM a contraindication to use of a β-blocker in a patient who is having an MI?
2868
Salmeterol
What β2-agonist is used as a prophylactic agent in the treatment of asthma?
2869
In the tuberoinfundibular pathway, dopamine release will decrease prolactin release, which is why dopamine agonists are used in the treaatment of hyperprolactinemic states.
What hormone can be affected by dopamine release in the tuberoinfundibular pathway?
2870
The rate of infusion
What determines the plasma level at steady state?
2871
5' deiodinase
What enzyme is inhibited by propylthiouracil (PTU)?
2872
Ganciclovir
What is the DOC for CMV retinitis?
2873
Protamine sulfate
What agent antagonizes the effects of heparin?
2874
Nitroprusside
What antihypertensive agent produces cyanide and thiocyanate as byproducts?
2875
Ipratropium
What is the DOC for β-blocker-induced bronchospasms?
2876
Clozapine
What is the only neuroleptic agent that does not cause hyperprolactinemia?
2877
True. Cimetidine can decrease androgen production and lead to gynecomastia.
True or false? Gynecomastia is a side effect of cimetidine.
2878
Hydralazine, isoniazid, and procainamide (HIP)
What three drugs are associated with SLE-like syndrome in slow acetylators?
2879
Diethylcarbamazine
What is the drug of choice for filariasis and onchocerciasis?
2880
Streptomycin
What aminoglycoside causes disruption of CN I?
2881
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
Which anticonvulsant causes gingival hyperplasia?
2882
ASA
What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
2883
Flucytosine
What antifungal agent is activated by fungal cytosine deaminase to form 5-FU?
2884
Ethacrynic acid
Irreversible ototoxicity is associated with which loop diuretic?
2885
Tamoxifen
What competitive estrogen receptor antagonist is used in the treatment of breast cancer?
2886
Doxycycline
Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
2887
False. Dopamine is an inhibitory neurotransmitter in the CNS.
True or false? Dopamine is an excitatory neurotransmitter in the CNS.
2888
Metformin
What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?
2889
Phase 4
Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
2890
Zafirlukast
Which prophylactic asthmatic agent is an antagonist of LTD4?
2891
Coma, convulsions, and cardiotoxicity
What are the three C's of a TCAD overdose?
2892
Enkephalin
What is the neurotransmitter at the δ-receptor?
2893
Blood
What body fluid preferentially breaks down esters?
2894
Ampicillin and amoxicillin
What are the two broad-spectrum penicillins?
2895
Nasal polyps, rhinitis, and aspirin hypersensitivity
What are the three components to the asthma triad?
2896
Class IV
Which class of antiarrhythmics are calcium channel blockers?
2897
GP IIb and IIIa receptors
What are the glycoprotein receptors that platelets and fibrinogen cross-link to when forming a thrombus?
2898
Propofol
Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
2899
Physiologic antagonism
Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
2900
Leuprolide
What GnRH analog is used as a repository form of treatment in prostatic cancer?
2901
Clindamycin
Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis?
2902
Carbamazepine
What is the DOC for trigeminal neuralgia?
2903
Ephedrine
What drug that penetrates the blood-brain barrier is found in asthma preparations and used as a nasal decongestant?
2904
Clearance
What is the term for drug removal per unit of time in a given volume of blood?
2905
Doxycycline and minocycline
Which two tetracyclines have the highest plasma binding?
2906
Effective dose for 50% of drug takers (median effective dose)
What do the following values indicate? • ED50
2907
Toxic dose for 50% of drug takers (median toxic dose)
What do the following values indicate? • TD50
2908
Lethal dose for 50% of drug takers (median lethal dose)
What do the following values indicate? • LD50
2909
Agents that decrease ACh function reduce tremors and rigidity, not bradykinesias.
Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity?
2910
Spasms of the uterus, bladder, and the biliary tree occur with all of the opioids except meperidine.
A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
2911
Hydrolysis
What form of oxidation takes place with the addition of a water molecule and breakage of bonds?
2912
Phase 4; NE increases the slope of the prepotential, allowing threshold to be reached sooner, and increases the rate of firing.
In a ventricular pacemaker cell, what phase of the action potential is affected by NE?
2913
Physiologic dead space is the total dead space of the respiratory system.
Anatomical and alveolar dead spaces together constitute what space?
2914
Skin, liver, and kidneys
What three organs are necessary for the production of vitamin D3(cholecalciferol)?
2915
LH has no effect on the production of adrenal androgens; ACTH stimulates adrenal androgen production.
What is the effect of LH on the production of adrenal androgens?
2916
1. CHF 2. Vena caval obstruction or constriction 3. Hepatic cirrhosis 4. Renal artery stenosis
What four conditions result in secondary hyperaldosteronism?
2917
1. Inhibin 2. Estradiol (E2) 3. Androgen-binding protein 4. Meiosis inhibiting factor (in fetal tissue) 5. Antimüullerian hormone
What are the five hormones produced by Sertoli cells?
2918
Depolarization (i.e., Na+ influx)
What is the term for the negative resting membrane potential moving toward threshold?
2919
Right vagus innervates the SA node and the left vagus innervates the AV node
Does the left or right vagus nerve innervate the SA node?
2920
Repolarization is from base to apex and from epicardium to endocardium.
How does ventricular repolarization take place, base to apex or vice versa?
2921
Anatomical dead space, which ends at the level of the terminal bronchioles.
What is the term for any region of the respiratory system that is incapable of gas exchange?
2922
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.
What four factors shift the Hgb-O2 dissociation curve to the right? What is the consequence of this shift?
2923
Decreased pulmonary arterial pressure (low perfusion) and less-distensible vessels (high resistance) result in decreased blood flow at the apex.
What two factors result in the apex of the lung being hypoperfused?
2924
1:1. Remember, the flow through the pulmonary circuit and the systemic circuit are equal.
What is the ratio of pulmonary to systemic blood flow?
2925
Central. Remember, there is a deficiency in ADH production in the central form.
To differentiate central from nephrogenic diabetes insipidus, after an injection of ADH, which will show a decreased urine flow?
2926
Duodenum
In what area of the GI tract are water-soluble vitamins absorbed?
2927
V wave
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
2928
C wave
What wave is the cause of the following venous pulse deflections? • The bulging of the tricuspid valve into the right atrium
2929
A wave
What wave is the cause of the following venous pulse deflections? • The contraction of the right atrium
2930
1. Provide antibacterial action 2. Lubricate 3. Begin CHO digestion 4. Begin fat digestion
What are the four functions of saliva?
2931
Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------
When a person goes from supine to standing, what happens to the following? • Dependent venous pressure
2932
Increases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------
When a person goes from supine to standing, what happens to the following? • Dependent venous blood volume
2933
Decreases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate.
When a person goes from supine to standing, what happens to the following? • Cardiac output
2934
Decreases Remember, the carotid sinus reflex attempts to compensate by increasing both TPR and heart rate. --------------------------------------------------------------------------------
When a person goes from supine to standing, what happens to the following? • BP
2935
It normally does not play a role in filtration but becomes important when there is an obstruction downstream.
When does the hydrostatic pressure in Bowman's capsule play a role in opposing filtration?
2936
Intrapleural pressure decreases (becomes more negative).
What happens to intrapleural pressure when the diaphragm is ontracted during inspiration?
2937
Urinary 17-OH steroids
What is used as an index of cortisol secretion?
2938
Combined metabolic and respiratory acidosis
If the pH is low with increased CO2 levels and decreased HCO3- levels, what is the acid-base disturbance?
2939
Membrane conductance (think conductance = channels open)
What is the term that refers to the number of channels open in a cell membrane?
2940
1. CNS 2. Renal tubules 3. Beta Islet cells of the pancreas 4. RBCs 5. GI mucosa
What are the five tissues in which glucose uptake is insulin independent?
2941
Liquids, CHO, protein, fat
Place in order from fastest to slowest the rate of gastric emptying for CHO, fat, liquids, and proteins.
2942
Diastole. During systole the left ventricle contracts, resulting in intramyocardial vessel compression and therefore very little blood flow in the coronary circulation.
Is most of the coronary artery blood flow during systole or diastole?
2943
The JG cells
What modified smooth muscle cells of the kidney monitor BP in the afferent arteriole?
2944
1. Increase compliance 2. Decrease surface tension 3. Decrease probability of pulmonary edema formation
What are the three functions of surfactant?
2945
Epinephrine
Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, and stimulated by hypoglycemia
2946
Glucagon
Name the hormone—glucagon, insulin, or epinephrine: • Glycogenolytic, gluconeogenic, lipolytic, glycolytic, proteolytic, and stimulated by hypoglycemia and AAs
2947
Insulin
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
2948
Hydrophobic (water-insoluble) end faces the aqueous environment and the hydrophilic (water-soluble) end faces the interior of the cell.
Is the hydrophobic or hydrophilic end of the phospholipids of the cell membrane facing the aqueous environment?
2949
White muscle; short term too
What type of muscle is characterized by no myoglobin, anaerobic glycolysis, high ATPase activity, and large muscle mass?
2950
90% as HCO3-, 5% as carbamino compounds, and 5% as dissolved CO2
What percentage of CO2 is carried in the plasma as HCO3- ?
2951
Dihydrotestosterone
What is the most potent male sex hormone?
2952
Decreases
With a decrease in arterial diastolic pressure, what happens to • Stroke volume?
2953
Decreases
With a decrease in arterial diastolic pressure, what happens to • TPR?
2954
Decreases
With a decrease in arterial diastolic pressure, what happens to • Heart rate?
2955
Amylase hydrolyzes alpha-1, 4-glucoside linkages, forming alpha-limit dextrins, maltotriose, and maltose.
What linkage of complex CHOs does pancreatic amylase hydrolyze? What three complexes are formed?
2956
Heart rate determines the diastolic interval, and contractility determines the systolic interval.
Does the heart rate determine the diastolic or systolic interval?
2957
At the beginning of splay is when the renal threshold for glucose occurs and the excess begins to spill over into the urine.
On a graphical representation of filtration, reabsorption, and excretion, when does glucose first appear in the urine?
2958
They are directly related; the greater the preload, the greater the passive tension in the muscle and the greater the prestretch of a sarcomere.
What is the relationship between preload and the passive tension in a muscle?
2959
The conversion of tyrosine to dopamine in the cytoplasm
What is the rate-limiting step in the synthetic pathway of NE at the adrenergic nerve terminal?
2960
1 day prior to ovulation
How many days prior to ovulation does LH surge occur in the menstrual cycle?
2961
As flow increases, the urine becomes more dilute because of decreased time for H2O reabsorption.
How are flow through the loop of Henle and concentration of urine related?
2962
60%
What is the PO2 of aortic blood in fetal circulation?
2963
Somatotrophins are stimulated by IGF-1, and they inhibit GH secretion. GHRH stimulates GH secretion.
How do elevated blood glucose levels decrease GH secretion? (Hint: what inhibitory hypothalamic hormone is stimulated by IGF-1?)
2964
Terminal collecting duct has the highest concentration and Bowman's capsule has the lowest concentration of inulin.
What segment of the nephron has the highest concentration of inulin? Lowest concentration of inulin?
2965
A high-resistance system is formed when resistors are added in a series.
What type of resistance system, high or low, is formed when resistors are added in a series?
2966
hCS and serum estriol, which are produced by the fetal liver and placenta, respectively, are used as estimates of fetal well-being.
What hormones, secreted in proportion to the size of the placenta, are an index of fetal well-being?
2967
Respiratory alkalosis (summary: low CO2, low H+, slightly low HCO3-)
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?
2968
Apneustic center (deep breathing place)
What respiratory center in the caudal pons is the center for rhythm promoting prolonged inspirations?
2969
Jejunum (upper)
What area of the GI tract has the highest activity of brush border enzymes?
2970
Adrenarche
What is the term to describe the increased rate of secretion of adrenal androgens at the onset of puberty?
2971
Relative refractory period
What period is described when a larger-than-normal stimulus is needed to produce an action potential?
2972
T3 has a greater affinity for the nuclear receptor and therefore is considered the active form.
Does T3 or T4 have a greater affinity for its nuclear receptor?
2973
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
What are the three main functions of surfactant?
2974
Low interstitial free Ca2+ concentrations
What is the only important physiological signal regulating the release of PTH?
2975
Secondary hypoparathyroidism (vitamin D toxicity)
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH decreased, Ca2+ increased, Pi increased
2976
Secondary hyperparathyroidism (vitamin D deficiency, renal disease)
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH increased, Ca2+ decreased, Pi decreased
2977
Primary hypoparathyroidism
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH decreased, Ca2+ decreased, Pi increased
2978
Primary hyperparathyroidism
What endocrine abnormality is characterized by the following changes in PTH, Ca2+, and inorganic phosphate (Pi)? • PTH increased, Ca2+ increased, Pi decreased
2979
14 L, 33% of body weight
What is the amount in liters and percent body weight for the following compartments? • ECF
2980
9.3 L, 15% of body weight
What is the amount in liters and percent body weight for the following compartments? • Interstitial fluid
2981
28 L, 40% of body weight
What is the amount in liters and percent body weight for the following compartments? • ICF
2982
4.7 L, 5% of body weight
What is the amount in liters and percent body weight for the following compartments? • Vascular fluid
2983
42 L, 67% of body weight
What is the amount in liters and percent body weight for the following compartments? • Total body water
2984
Human chorionic somatomammotropin (hCS) or human placental lactogen (hPL)
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?
2985
Graves disease (Increased T4 decreases TRH and TSH through negative feedback.)
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 increased
2986
Secondary hypothyroidism/pituitary (Low TSH results in low T4 and increased TRH because of lack of a negative feedback loop.)
What thyroid abnormality has the following? • TRH increased, TSH decreased, T4 decreased
2987
Tertiary hypothyroidism/hypothalamic (Low TRH causes all the rest to be decreased because of decreased stimulation.)
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 decreased
2988
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.)
What thyroid abnormality has the following? • TRH increased, TSH increased, T4 decreased
2989
Secondary hyperthyroidism (Increased TSH results in increased T4 production and increased negative feedback on to hypothalamus and decreased release of TRH.)
What thyroid abnormality has the following? • TRH decreased, TSH decreased, T4 increased
2990
Glucagon and epinephrine
What two stress hormones are under the permissive action of cortisol?
2991
The resistance will decrease one-sixteenth of the original resistance.
If the radius of a vessel doubles, what happens to resistance?
2992
The pulsatile release of GnRH
What prevents the down-regulation of the receptors on the gonadotrophs of the anterior pituitary gland?
2993
False. It has glycogenolytic and lipolytic actions but not proteolytic.
True or false? Epinephrine has proteolytic metabolic effects.
2994
Cortisol, a 21-carbon steroid, has a -OH group at position 17.
What is the only 17-hydroxysteroid with hormonal activity?
2995
The oncotic pressure of plasma promotes reabsorption and is directly proportional to the filtration fraction.
Does the oncotic pressure of plasma promote filtration or reabsorption?
2996
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.
Why is the base of the lung hyperventilated when a person is standing upright?
2997
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.
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?
2998
Motilin
What hormone causes contractions of smooth muscle, regulates interdigestive motility, and prepares the intestine for the next meal?
2999
Umbilical vein and ductus venosus (80%)
What two vessels in fetal circulation have the highest PO2 levels?
3000
2 days prior to ovulation
How many days prior to ovulation does estradiol peak in the menstrual cycle?
3001
C-peptide levels
What serves as a marker of endogenous insulin secretion?
3002
Total ventilation (minute ventilation or minute volume)
What is the term for the total volume of air moved in and out of the respiratory system per minute?
3003
Increase in urinary excretion of HCO3-, shifting the reaction to the right and increasing H+
What is the renal compensation mechanism for alkalosis?
3004
Excess estradiol in the blood
What is a sign of a Sertoli cell tumor in a man?
3005
Arterioles have the largest drop, whereas the vena cava has the smallest pressure drop in systemic circulation.
In the systemic circulation, what blood vessels have the largest pressure drop? Smallest pressure drop?
3006
IGF-1
What is the major stimulus for cell division in chondroblasts?
3007
Decrease in surface area and increase in membrane thickness (Palv O2 > PaO2)
What are two causes of diffusion impairment in the lungs?
3008
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
What are the four effects of suckling on the mother?
3009
It repeats every 90 to 120 minutes and correlates with elevated levels of motilin.
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?
3010
Increases
With an increase in arterial systolic pressure, what happens to • Stroke volume?
3011
Decreases
With an increase in arterial systolic pressure, what happens to • Vessel compliance?
3012
Decreases
With an increase in arterial systolic pressure, what happens to • Heart rate?
3013
Enterokinase
What enzyme is needed to activate the following reactions? • Trypsinogen to trypsin
3014
Trypsin
What enzyme is needed to activate the following reactions? • Chymotrypsinogen to chymotrypsin
3015
Trypsin
What enzyme is needed to activate the following reactions? • Procarboxypeptidase to carboxypeptidase
3016
Phase 4; ACh hyperpolarizes the cell via increasing potassium conductance, taking longer to reach threshold and slowing the rate of firing.
In a ventricular pacemaker cell, what phase of the action potential is affected by ACh?
3017
Hypoglycemia for secretion and hyperglycemia for inhibition
What is the most potent stimulus for glucagon secretion? Inhibition?
3018
Tetany
What is the term for the summation of mechanical stimuli due to the skeletal muscle contractile unit becoming saturated with calcium?
3019
A transport maximum (Tm) system
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.
3020
Dopamine is converted into NE in the vesicle via the enzyme dopamine-Beta-hydroxylase.
In an adrenergic nerve terminal, where is dopamine converted to NE? By what enzyme?
3021
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.
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?
3022
Preload. It is the load on a muscle Prior to contraction.
What is the term for the load on a muscle in the relaxed state?
3023
LH
The surge of what hormone induces ovulation?
3024
LVEDV and LVEDP (left ventricular end-diastolic volume and end-diastolic pressure, respectively)
What are the two best indices of left ventricular preload?
3025
Puberty
What stage of male development is characterized by the following LH and testosterone levels? • LH pulsatile amplitude and levels increase, with increased testosterone production.
3026
Childhood
What stage of male development is characterized by the following LH and testosterone levels? • Both LH and testosterone levels drop and remain low.
3027
Adulthood
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.
3028
Aged adult
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.
3029
Metabolic alkalosis (summary: high pH, low H+ and high HCO3-)
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?
3030
Resistance increases as resistors are added to the circuit.
When referring to a series circuit, what happens to resistance when a resistor is added?
3031
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.
Why is there an increase in prolactin if the hypothalamic-pituitary axis was severed?
3032
Because creatinine is filtered and a small amount is secreted
Why is the clearance of creatinine always slightly greater than the clearance of inulin and GFR?
3033
NH4+(ammonium)
What acid form of H+ in the urine cannot be titrated?
3034
Because the venous system is more compliant than the arterial vessels, small changes in pressure result in large changes in blood volume.
Regarding the venous system, what happens to blood volume if there is a small change in pressure?
3035
Stages 3 and 4 (NREM)
In what stage of sleep is GH secreted?
3036
In the RBC; remember, you need carbonic anhydrase for the conversion, and plasma does not have this enzyme.
Where does the conversion of CO2 into HCO3- take place?
3037
The placenta
From the fourth month of fetal life to term, what secretes the progesterone and estrogen to maintains the uterus?
3038
Calcium and ATP are required for packaged macromolecules to be extruded from the cell.
What two factors are required for effective exocytosis?
3039
Serum 25-hydroxy-vitamin D (25-OH-D)
What is the best measure of total body vitamin D if you suspect a deficiency?
3040
PTH
What hormone is required for 1, 25-dihydroxy-vitamin D (1, 25-diOH-D) to have bone resorbing effects?
3041
Bone deposition increases with increased Ca2+ or PO 4- concentrations, whereas resorption (breakdown) is increased when there are low levels of Ca2+ or PO4-.
Is bone deposition or resorption due to increased interstitial Ca2+concentrations?
3042
Opening of the mitral valve indicates the termination of the isovolumetric relaxation phase and the beginning of the ventricular filling phase.
The opening of what valve indicates the termination of isovolumetric relaxation phase of the cardiac cycle?
3043
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.
Why is there a decrease in the production in epinephrine when the anterior pituitary gland is removed?
3044
Absolute refractory period is due to voltage inactivation of sodium channels.
Name the period described by the following statement: no matter how strong a stimulus is, no further action potentials can be stimulated.
3045
Estrogens are 18-carbon steroids. (Removal of one carbon from an androgen produces an estrogen.)
How many carbons do estrogens have?
3046
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.
True or false? The alveolar PO2 and PCO2 levels match the pulmonary end capillary blood levels.
3047
The main drive shifts from central chemoreceptors (CSF H+) to peripheral chemoreceptors monitoring low PO2 levels.
In high altitudes, what is the main drive for ventilation?
3048
Loss of isotonic fluid (diarrhea, vomiting, hemorrhage)
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
3049
Gain of hypotonic fluid (water intoxication or hypotonic saline)
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
3050
Loss of hypotonic fluid (alcohol, diabetes insipidus, dehydration)
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
3051
Gain of isotonic fluid (isotonic saline)
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
3052
Gain of hypertonic fluid (mannitol or hypertonic saline)
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
3053
ACTH
What hormone excess produces adrenal hyperplasia?
3054
T4; because of the greater affinity for the binding protein, T4 has a significantly (nearly fifty times) longer half-life than T3.
Is there more circulating T3 or T4 in plasma?
3055
The resting membrane potential of the cell is -90 mV because of the intracellular proteins.
Why is the cell's resting membrane potential negative?
3056
False. Thyroid size is a measure of TSH levels (which are goitrogenic).
True or false? Thyroid size is a measure of its function.
3057
The resistance increases 16-fold.
If the radius of a vessel is decreased by half, what happens to the resistance?
3058
NE, via its vasoconstrictive action on blood vessels
What neurotransmitter is essential for maintaining a normal BP when an individual is standing?
3059
Central/neurogenic diabetes insipidus; in the nephrogenic form there is sufficient ADH available, but the renal collecting ducts are impermeable to its actions.
What form of diabetes insipidus is due to an insufficient amount of ADH for the renal collecting ducts?
3060
1. Decrease alpha-1 activity 2. Increase Beta-2 activity 3. Increase ACh levels
Name the three methods of vasodilation via the sympathetic nervous system.
3061
PTH
What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate excretion
3062
Calcitriol
What hormone is characterized by the following renal effects? • Calcium excretion, phosphate excretion
3063
Vitamin D3
What hormone is characterized by the following renal effects? • Calcium reabsorption, phosphate reabsorption
3064
True. Elevated plasma levels of progesterone can raise the body temperature 0.5° to 1.0°F.
True or false? Progesterone has thermogenic activities.
3065
2 to 4 hours
How long is the transit time through the small intestine?
3066
Terminal bronchioles. (No gas exchange occurs here.)
Where is the last conducting zone of the lungs?
3067
True; cortisol inhibits glucose uptake in most tissue, making it available for neural tissue use.
True or false? Cortisol inhibits glucose uptake in skeletal muscle.
3068
100%; the percentage of blood flow through the pulmonary and systemic circulations are equal.
What percentage of cardiac output flows through the pulmonary circuit?
3069
Site 4
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)
3070
Site 2
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
3071
Site 1
Name the Hgb-O2 binding site based on the following information: • Remains attached under most physiologic conditions
3072
Site 3
Name the Hgb-O2 binding site based on the following information: • Requires a PO2 level of 40 mm Hg to remain attached
3073
1. Exercise 2. Emergencies (stress) 3. Exposure to cold (The three Es)
Which three factors cause the release of epinephrine from the adrenal medulla?
3074
One, and it provides the energy for mechanical contraction.
How many ATPs are hydrolyzed every time a skeletal muscle cross-bridge completes a single cycle?
3075
Venous pressure above the heart is subatmospheric, so a puncture there has the potential to introduce air into the system.
Why would a puncture to a vein above the heart have the potential to introduce air into the vascular system?
3076
High volume, watery solution; sympathetic stimulation results in thick, mucoid saliva.
What type of saliva is produced under parasympathetic stimulation?
3077
Duodenum
In what area of the GI tract does iron get absorbed?
3078
The alveoli at the apex are almost completely inflated prior to inflation, and although they are large, they receive low levels of alveolar ventilation.
Why is the apex of the lung hypoventilated when a person is standing upright?
3079
alpha-Cells; glucagon has stimulatory effects on -cells and inhibitory effects on -cells.
What pancreatic islet cell secretes glucagons?
3080
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
What are the four characteristics of all protein-mediated transportation?
3081
Secretin stimulates the pancreas to secrete a HCO3--rich solution to neutralize the acidity of the chyme entering the duodenum.
What is secretin's pancreatic action?
3082
Because RPF is markedly decreased, while GFR is only minimally diminished; this results in an increase in FF (remember FF = GFR/RPF).
Why is there an increase in FF if the GFR is decreased under sympathetic stimulation?
3083
Rapid efflux of potassium
What triggers phase 3 of the action potential in a ventricular pacemaker cell?
3084
Liver (hepatocytes)
What is the primary target for the action of glucagon?
3085
Production of HCO3-, shifting the reaction to the left and thereby decreasing H+
What is the renal compensation mechanism for acidosis?
3086
Acetylcholinesterase breaks ACh into acetate and choline (which gets resorbed by the presynaptic nerve terminal).
What enzyme found in a cholinergic synapse breaks down ACh? What are the byproducts?
3087
MIF
What hormone, produced by Sertoli cells, if absent would result in the formation of internal female structures?
3088
The lung will expand; also the opposite is true.
What happens to the lung if the intrapleural pressure exceeds lung recoil?
3089
Plasma concentration and excretion rate
What two factors determine the clearance of a substance?
3090
Isotonic contraction
What type of muscle contraction occurs when the muscle shortens and lifts the load placed on it?
3091
Action potential
What type of potential is characterized as being an all-or-none response, propagated and not summated?
3092
Metabolic acidosis (summary: low pH, high H+, and low HCO3-)
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?
3093
GH and prolactin are produced by acidophils; all others are by basophils.
What two pituitary hormones are produced by acidophils?
3094
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.
What organ of the body has the smallest AV oxygen difference?
3095
H2PO4- (dihydrogen phosphate)
What is the titratable acid form of H+ in the urine?
3096
GnRH
What hypothalamic hormone is synthesized in the preoptic nucleus?
3097
1. Increased tube radius 2. Increased velocity 3. Decreased viscosity 4. Increased number of branches 5. Narrowing of an orifice
What five factors promote turbulent flow?
3098
Aldosterone Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
What is the major hormone produced in the following areas of the adrenal cortex? • Zona glomerulosa
3099
Cortisol Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
What is the major hormone produced in the following areas of the adrenal cortex? • Zona fasciculata
3100
DHEA (androgens) Remember, from the outer cortex to the inner layer, Salt, Sugar, Sex. The adrenal cortex gets sweeter as you go deeper.
What is the major hormone produced in the following areas of the adrenal cortex? • Zona reticularis
3101
In bone; nearly 99% of Ca2+ is stored in the bone as hydroxyapatite.
Where is most of the body's Ca2+ stored?
3102
They are inversely related. If ventilation increases, there will be a decrease in PCO2 levels and vice versa.
What is the relationship between ventilation and PCO2 levels?
3103
T4, as long as T4 levels remain constant, TSH will be minimally effected by T3.
Is T3 or T4 responsible for the negative feedback loop on to the hypothalamus and anterior pituitary gland?
3104
Membrane depolarization is the stimulus to open these slow channels, and if they are prevented from opening, it will slow down the repolarization phase.
What is the signal to open the voltage-gated transmembrane potassium channels?
3105
Hydroxyproline
Increased urinary excretion of what substance is used to detect excess bone demineralization?
3106
Compliance (think of it as distensibility)
What is the term to describe how easily a vessel stretches?
3107
20:1T4T3. There is an increase in the production of T3 when iodine becomes deficient.
What is the ratio of T4:T3 secretion from the thyroid gland?
3108
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.
Do the PO2 peripheral chemoreceptors of the carotid body contribute to the normal drive for ventilation?
3109
The number of cross-bridges cycling during contraction: the greater the number, the greater the force of contraction.
What determines the overall force generated by the ventricular muscle during systole?
3110
From the adrenal medulla; NE is mainly derived from the postsynaptic sympathetic neurons.
Where does most circulating plasma epinephrine originate?
3111
When calcium is removed from troponin and pumped back into the SR, skeletal muscle contraction stops.
What causes a skeletal muscle contraction to terminate?
3112
ICF volume decreases when there is an increase in osmolarity and vice versa.
What happens to intracellular volume when there is an increase in osmolarity?
3113
Fructose; both glucose and galactose are actively absorbed via secondary active transport.
Which CHO is independently absorbed from the small intestine?
3114
Surface tension, the force to collapse the lung, is greatest at the end of inspiration.
When is the surface tension the greatest in the respiratory cycle?
3115
17-alpha-Hydroxylase deficiency
What adrenal enzyme deficiency results in hypertension, hypernatremia, increased ECF volume, and decreased adrenal androgen production?
3116
Ions diffuse in the direction to bring the membrane potential toward the equilibrium potential.
In reference to membrane potential (Em) and equilibrium potential (Ex), which way do ions diffuse?
3117
Hydrostatic pressure of the glomerular capillaries (promotes filtration)
Under normal conditions, what is the main factor that determines GFR?
3118
Closure of the aortic valve indicates the termination of the ejection phase and the beginning of the isovolumetric relaxation phase of the cardiac cycle.
The closure of what valve indicates the beginning of the isovolumetric relaxation phase of the cardiac cycle?
3119
The aorta has the greatest velocity and the capillaries have the slowest velocity.
What vessels in the systemic circulation have the greatest and slowest velocity?
3120
Hypercortisolism (Cushing syndrome)
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?
3121
Carbonic anhydrase
What enzyme is essential for the conversion of CO2 to HCO3-?
3122
TRUE
True or false? The parasympathetic nervous system has very little effect on arteriolar dilation or constriction.
3123
TLC, FRC, and RV have to be calculated. (Remember, any volume that has RV as a component has be calculated.)
What three lung measurements must be calculated because they cannot be measured by simple spirometry?
3124
They chronically inhibit ADH secretion; when there is a decrease in the blood volume, the stretch receptors send fewer signals, and ADH is secreted.
What is the venous and arterial stretch receptors' function regarding the secretion of ADH?
3125
Granulosa cell
What cell converts androgens to estrogens?
3126
FSH
What hormone acts on Granulosa cells?
3127
3 to 4 days
How long is the transit time through the large intestine?
3128
Subatmospheric pressure acts to expand the lung; positive pressure acts to collapse the lung.
Does subatmospheric pressure act to expand or collapse the lung?
3129
AT II
What hormone constricts afferent and efferent arterioles (efferent more so) in an effort to preserve glomerular capillary pressure as the renal blood flow decreases?
3130
Because the large drop in TPR is accompanied by a large increase in cardiac output, resulting in a minimal change in BP.
Why is there a minimal change in BP during exercise if there is a large drop in TPR?
3131
Insulin increases total body stores of protein, fat, and CHOs. When you think insulin, you think storage.
What is the effect of insulin on protein storage?
3132
Renshaw neuron
What is the term for an inhibitory interneuron?
3133
Calcium influx secondary to slow channel opening
What triggers phase 0 of the action potential in a ventricular pacemaker cell?
3134
At the end of the PCT 25% of the original volume is left
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
3135
At the end of the PCT 25% of Na+, Cl-, K+ is left
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
3136
300 mOsm/L
What are the following changes seen in the luminal fluid by the time it leaves the PCT of the nephron? • Osmolarity
3137
No CHO, AA, ketones, or peptides are left in the tubular lumen.
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
3138
False. It is an enzyme secreted by the lining of the small intestine.
True or false? Enterokinase is a brush border enzyme.
3139
In the cytoplasm of the presynaptic nerve terminal; it is catalyzed by choline acetyltransferase.
Where does the synthesis of ACh occur?
3140
delta-Cells; somatostatin has an inhibitory effect on alpha- and Beta-islet cells.
What pancreatic islet cell secretes somatostatin?
3141
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.
Why is O2 content depressed in anemic patients?
3142
Clearance
What term describes the volume of plasma from which a substance is removed over time?
3143
Filtration; if hydrostatic pressure is less than oncotic pressure, reabsorption is promoted.
If capillary hydrostatic pressure is greater than oncotic pressure, is filtration or reabsorption promoted?
3144
The chief cells of the parathyroid gland release PTH in response to hypocalcemia.
What cells of the parathyroid gland are simulated in response to hypocalcemia?
3145
Intrapleural pressure at the base is -2.5 cm H2O (more positive than the mean), resulting in a force to collapse the alveoli.
At the base of the lung, what is the baseline intrapleural pressure, and what force does it exert on the alveoli?
3146
Normal thyroid hormones levels in the plasma are necessary for proper secretion of GH. Hypothyroid patients have decreased GH secretions.
What hormone is necessary for normal GH secretion?
3147
Membrane depolarization is the stimulus to open these channels, which are closed in resting conditions.
What is the signal to open the voltage-gated transmembrane sodium channels?
3148
None; they are the storage sites for ADH and oxytocin.
What hormones are produced in the median eminence region of the hypothalamus and the posterior pituitary gland?
3149
Isovolumetric contraction
What is the most energy-demanding phase of the cardiac cycle?
3150
alpha2-Receptors
What presynaptic receptor does NE use to terminate further neurotransmitter release?
3151
Hypotonic, because NaCl is reabsorbed in the salivary ducts
Are salivary secretions hypertonic, hypotonic, or isotonic?
3152
T3 increases both heart rate and cardiac output by increasing the number of Beta-receptors and their sensitivity to catecholamines.
What is the effect of T3 on heart rate and cardiac output?
3153
Because it is the largest vessel and has the highest velocity in systemic circulation
Why will turbulence first appear in the aorta in patients with anemia?
3154
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.
What is the origin of the polyuria if a patient is dehydrated and electrolyte depleted?
3155
Free ionized Ca2+
What is the physiologically active form of Ca2+?
3156
Metabolic rate and alveolar ventilation (main factor)
What are the two factors that affect alveolar PCO2 levels?
3157
Exogenous steroids suppress LH release and result in Leydig cell atrophy. Testosterone, produced by Leydig cells, is needed for spermatogenesis.
Why is spermatogenesis decreased with anabolic steroid therapy?
3158
Semipermeable membrane; a selectively permeable membrane allows both water and small solutes to pass through its membrane.
What type of membrane is characterized as being permeable to water only?
3159
Peroxidase, which is also needed for iodination and coupling inside the follicular cell
What thyroid enzyme is needed for oxidation of I- to I'?
3160
An increase in serum glucose levels
What is the most important stimulus for the secretion of insulin?
3161
Preload (the load on the muscle in the relaxed state)
What term is described as the prestretch on the ventricular muscle at the end of diastole?
3162
The carotid body, which monitors arterial blood directly
What peripheral chemoreceptor receives the most blood per gram of weight in the body?
3163
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.
What adrenal enzyme deficiency results in hypertension, hypernatremia, and virilization?
3164
Osmosis; water will diffuse from higher to lower water concentrations.
What is the term for diffusion of water across a semipermeable or selectively permeable membrane?
3165
In the first 3 months
When do hCG concentrations peak in pregnancy?
3166
0.2
How many milliliters of O2 per milliliter of blood?
3167
Osteocyte
What type of cell is surrounded by mineralized bone?
3168
Concentration force and electrical force
What two forces affect movement of ions across a membrane?
3169
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.)
What happens to the resistance of the system when a resistor is added in a series?
3170
Surface tension; in the alveoli, it is a force that acts to collapse the lung.
What is the greatest component of lung recoil?
3171
In the supraoptic nuclei of the hypothalamus; it is stored in the posterior pituitary gland.
Where is ADH synthesized?
3172
Velocity is inversely related to cross-sectional area.
How is velocity related to the total cross-sectional area of a blood vessel?
3173
True. In the distal colon, sweat glands, and salivary ducts, aldosterone has sodium-conserving effects.
True or false? Aldosterone has a sodium-conserving action in the distal colon.
3174
Water-soluble hormones are considered fast-acting hormones.
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.
3175
Short-chain fatty acids
What forms of fatty acids are absorbed from the small intestine mucosa by simple diffusion?
3176
Ovulation
What is the term for the day after the LH surge in the female cycle?
3177
Opening of the aortic valve terminates the isovolumetric phase and begins the ejection phase of the cardiac cycle.
The opening of what valve indicates the beginning of the ejection phase of the cardiac cycle?
3178
Nodes of Ranvier
What is the region of an axon where no myelin is found?
3179
Primary hyperaldosteronism (Conn syndrome)
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?
3180
Primary hypoaldosteronism (Addison's disease)
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?
3181
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
What four factors affect diffusion rate?
3182
8 to 25 hours
How long after ovulation does fertilization occur?
3183
Lung recoil, being a force to collapse the lung, increases as the lung enlarges during inspiration.
What is the name of the force that develops in the wall of the lungs as they expand?
3184
Day 14
What day of the menstrual cycle does ovulation take place?
3185
A decrease in cutaneous blood flow results from constriction of the arterioles, and decreased cutaneous blood volume results from constriction of the venous plexus.
How does sympathetic stimulation to the skin result in decreased blood flow and decreased blood volume? (Hint: what vessels are stimulated, and how?)
3186
Increase in erythropoietin and increase in 2, 3-BPG, also called 2, 3-diphosphoglycerate (2, 3-P2Gri) (increase in glycolysis)
What two compensatory mechanisms occur to reverse hypoxia at high altitudes?
3187
Theca cell
What female follicular cell is under LH stimulation and produces androgens from cholesterol?
3188
Renal plasma flow (decrease flow, increase FF)
What is the main factor determining FF?
3189
Axon hillock
Where is the action potential generated on a neuron?
3190
If positive, hypotonic urine (osmolarity <300 mOsm/L); if negative, hypertonic urine (osmolarity > 300 mOsm/L)>>
If free water clearance (CH2O) is positive, what type of urine is formed? And if it is negative?
3191
SA node; it is the reason it is the primary pacemaker of the heart.
What cell in the heart has the highest rate of automaticity?
3192
NaCl is removed from the lumen to dilute the fluid leaving the loop of Henle.
What is pumped from the lumen of the ascending loop of Henle to decrease the osmolarity?
3193
True. Sarcoplasmic calcium-dependent ATPase supplies the energy to terminate contraction, and therefore it is an active process.
True or false? In skeletal muscle relaxation is an active event.
3194
1. Increased solubility 2. Increased concentration gradient 3. Decreased thickness of the membrane
What three factors increase simple diffusion?
3195
CCK stimulates the pancreas to release amylase, lipase, and proteases for digestion.
What is the pancreatic action of CCK?
3196
The time it takes ACh to diffuse to the postjunctional membrane
What is the rate-limiting step in a conduction of a NMJ?
3197
Excretion is greater than filtration for net secretion to occur.
Is excretion greater than or less than filtration for net secretion to occur?
3198
Hypokalemic metabolic alkalosis occurs from vomiting because of the loss of H+, K+, and Cl-.
What acid-base disturbance is produced from vomiting?
3199
Follicular phase is estrogen-dependent with increased FSH levels, while the luteal phase is progesterone-dependent.
What phase of the menstrual cycle is dominated by estrogen? Progesterone?
3200
Tidal volume (VT)
Name the lung measurement based on the following descriptions: • The amount of air that enters or leaves the lung system in a single breath
3201
Inspiratory capacity
Name the lung measurement based on the following descriptions: • The maximal volume inspired from FRC
3202
Expiratory reserve volume (ERV)
Name the lung measurement based on the following descriptions: • Additional volume that can be expired after normal expiration
3203
Vital capacity (VC)
Name the lung measurement based on the following descriptions: • Maximal volume that can be expired after maximal inspiration
3204
Functional residual capacity (FRC)
Name the lung measurement based on the following descriptions: • Volume in the lungs at the end of passive expiration
3205
Inspiratory reserve volume (IRV)
Name the lung measurement based on the following descriptions: • Additional air that can be taken in after normal inspiration
3206
Residual volume (RV)
Name the lung measurement based on the following descriptions: • Amount of air in the lungs after maximal expiration
3207
Total lung capacity (TLC)
Name the lung measurement based on the following descriptions: • Amount of air in the lungs after maximal inspiration
3208
Somatomedins (IGF-1)
What growth factors are chondrogenic, working on the epiphyseal end plates of bone?
3209
The muscle's ATPase activity
What determines the Vmax of skeletal muscle?
3210
TRUE
True or false? All of the hormones in the hypothalamus and anterior pituitary gland are water soluble.
3211
Thyroid hormones increase serum glucose levels by increasing the absorption of glucose from the small intestine.
What is the effect of T3 on the glucose absorption in the small intestine?
3212
Free form determines hormone activity and is responsible for the negative feedback loop.
Is the bound form or free form of a lipid-soluble hormone responsible for the negative feedback activity?
3213
Zona fasciculata and zona reticularis
What region or regions of the adrenal cortex are stimulated by ACTH?
3214
Obstructive lung disorders. The opposite changes (where you see decrease exchange it for increase and vice versa) are seen in a restrictive pattern.
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?
3215
Hypoventilation, which increases CO2, shifting the reaction to the right and increasing H+
What is the respiratory compensation mechanism for metabolic alkalosis?
3216
Increased androgen secretion at puberty drives the increased GH secretion.
During puberty, what is the main drive for the increased GH secretion?
3217
Subthreshold potential
What type of potential is characterized as graded, decremental, and exhibiting summation?
3218
Liver, kidneys, and pituitary gland via 5' deiodinase enzyme
What three organs are responsible for peripheral conversion of T4 to T3?
3219
Mitral valve closure indicates the termination of the ventricular filling phase and beginning of isovolumetric contraction.
The closure of what valve indicates the beginning of isovolumetric contraction?
3220
Androgens are 19-carbon steroids.
How many carbons do androgens have?
3221
Baseline apical intrapleural pressure is -10 cm H2O (more negative than the mean) resulting in a force to expand the alveoli.
At the apex of the lung, what is the baseline intrapleural pressure, and what force does it exert on the alveoli?
3222
True. Increased renin and AT II levels occur as a result of the decreased production of aldosterone.
True or false? Renin secretion is increased in 21-β-hydroxylase deficiency.
3223
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
What are the four ways to increase TPR?
3224
Estriol
What form of estrogen is of placental origin?
3225
Compliance; the more compliant a lung is, the easier it is to inflate.
What term is an index of the effort needed to expand the lungs (i.e., overcomes recoil)?
3226
1. Liver 2. Kidney 3. Pituitary gland (via 5'-deiodinase enzyme)
At which three sites in the body is T4 converted to T3?
3227
The wall tension is greater because the aneurysm has a greater radius than the surrounding vessel.
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?
3228
Seven-eighths of nephrons are cortical, with the remainder juxtamedullary.
What percentage of nephrons is cortical?
3229
Diffusion rate is indirectly proportional to membrane thickness and is directly proportional to membranes surface area.
To what is the diffusion rate indirectly proportional?
3230
ADH is secreted in response to increased plasma osmolarity and decreased blood volume.
ADH is secreted in response to what two stimuli?
3231
Capillaries
What vessels have the largest total cross-sectional area in systemic circulation?
3232
14 days in most women (Remember, the luteal phase is always constant.)
How many days before the first day of menstrual bleeding is ovulation?
3233
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.
What is the major muscle used in the relaxed state of expiration?
3234
The β-subunit; remember, the α-subunit is nonspecific.
What subunit of hCG is used to detect whether a patient is pregnant?
3235
Oncotic pressure increases because of the removal of water.
What happens to capillary oncotic pressure with dehydration?
3236
Macula densa
What cells of the kidney are extravascular chemoreceptors for decreased Na+, Cl-, and NaCl?
3237
Insulin increases intracellular K+ stores while decreasing serum K+ levels.
What is the effect of insulin on intracellular K+ stores?
3238
Decreasing potassium conductance, which results in increased excitability
What triggers phase 4 of the action potential in a ventricular pacemaker cell?
3239
GnRH pulsatile infusion
What is it called when levels of sex steroids increase, LH increases, and FSH increases?
3240
Gastrin-releasing peptide (GRP) stimulates G cells to release Gastrin. (All G's)
What parasympathetic neurotransmitter of the GI tract stimulates the release of gastrin?
3241
The carotid sinus reflex
What reflex increases TPR in an attempt to maintain BP during a hemorrhage?
3242
Tropomyosin
What is the name of the regulatory protein that covers the attachment site on actin in resting skeletal muscle?
3243
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.
Which way does the Hgb-O2 dissociation curve shift in patients with CO poisoning?
3244
Glomerular capillary pressure (increased glomerular capillary pressure, increased GFR and vice versa)
What is the main factor determining GFR?
3245
Hypoventilation results in an increase in PCO2 levels and therefore an increase in blood flow.
What is the effect of hypoventilation on cerebral blood flow?
3246
The parafollicular cells of the thyroid (C cells) release calcitonin in response to hypercalcemia.
What cells of the thyroid gland are stimulated in response to hypercalcemia?
3247
Residual volume
What is the term for the amount of blood in the ventricle after maximal contraction?
3248
Pulmonary shunt (i.e., pulmonary embolism)
What does failure of PaO2 to increase with supplemental O2 indicate?
3249
FSH and testosterone
What two substances stimulate Sertoli cells?
3250
Para-aminohippurate (PAH)
The clearance of what substance is the gold standard of renal plasma flow?
3251
Stercobilin
What bile pigment is formed by the metabolism of bilirubin by intestinal bacteria, giving stool its brown color?
3252
Bronchoconstriction is associated with parasympathetic stimulation (ACh), and catecholamine stimulation is associated with bronchodilation (why epinephrine is used in emergency treatment of bronchial asthma.)
Is ACh associated with bronchoconstriction or bronchodilation?
3253
Somatomedins
What are the growth factors released from the liver called?
3254
An increase in the afterload decreases velocity; they are inversely related. (V equals 1 divided by afterload.)
Regarding skeletal muscle mechanics, what is the relationship between velocity and afterload?
3255
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.
What happens to extracellular volume with a net gain in body fluid?
3256
1. Glucose 2. Amino acid (arginine) 3. Gastrin inhibitory peptide (GIP) 4. Glucagon 5. β-Agonists 6. ACh
What are the six substances that promote the secretion of insulin?
3257
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.
Does O2 or CO2 have a higher driving force across the alveolar membrane?
3258
Urinary 17-ketosteroids
What is used as an index for both adrenal and testicular androgens?
3259
Resistance and vessel length are proportionally related. The greater the length of the vessel, the greater the resistance is on the vessel.
How are resistance and length related regarding flow?
3260
Filtration is greater than excretion for net reabsorption to occur.
Is filtration greater than or less than excretion for net reabsorption to occur?
3261
Hormone-sensitive lipase, which breaks down triglyceride into glycerol and free fatty acid
What hormone, stimulated by epinephrine, results in an increase in lipolysis?
3262
FALSE
True or false? Miniature end-plate potentials (MEPPs) generate action potentials.
3263
Yes, it decreases fat and muscle uptake of glucose, thereby increasing blood glucose levels.
Is GH considered a gluconeogenic hormone?
3264
TRUE
True or false? Somatic motor neurons innervate the striated muscle of the bulbospongiosus and ischiocavernous muscles and result in ejaculation of semen.
3265
As the name indicates, there is no change in volume but there is an increase in pressure.
What happens to intraventricular pressure and volume during isovolumetric contraction?
3266
Yes, they stimulate the growth of mammary tissue but block milk synthesis. At parturition, the decrease in estrogen lifts the block on milk production.
Do high levels of estrogen and progesterone block milk synthesis?
3267
Breathing high-pressure nitrogen over a long time and sudden decompression result in the bends.
What two factors lead to the development of the bends (caisson disease)?
3268
Parallel circuit
In what type of circuit is the total resistance always less than that of the individual resistors?
3269
Luteal phase
What is the term for days 15 to 28 in the female cycle?
3270
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).
What happens to total and alveolar ventilation with • Increased rate of breathing?
3271
With an increased depth of breathing both the total and alveolar ventilation increase. This concept is always tested on the boards, so remember it.
What happens to total and alveolar ventilation with • Increased depth of breathing?
3272
Primary hypocortisolism (Addison's disease)
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol decreased, ACTH increased
3273
Secondary hypercortisolism (pituitary)
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol increased, ACTH increased
3274
Primary hypercortisolism
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol increased, ACTH decreased
3275
Secondary hypocortisolism (pituitary)
What pathophysiologic disorder is characterized by the following changes in cortisol and ACTH? • Cortisol decreased, ACTH decreased
3276
Capillary flow and pressure increase with arteriolar dilation and decrease with arteriolar constriction.
What happens to flow and pressure in capillaries with arteriolar dilation? Arteriolar constriction?
3277
Dilation of afferent arteriole
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 ↑
3278
Constriction of efferent arteriole
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 ↑
3279
Dilation of efferent arteriole
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 ↓
3280
Constriction of afferent arteriole
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 ↓
3281
When the intra-alveolar pressure equals zero, there is no airflow.
Which direction is air flowing when the intra-alveolar pressure is zero?
3282
Follicular phase
What phase of the female cycle occurs during days 1 to 15?
3283
The concentration of plasma proteins determines effective osmolarity because capillary membranes are freely permeable to all substances except proteins.
What determines the effective osmolarity of the ICF and the ECF compartments?
3284
The surface of the medulla
What region of the brain houses the central chemoreceptors responsible for control of ventilation?
3285
Cholera toxin irreversibly activates the cAMP-dependent chloride pumps of the small and large intestine, producing a large volume of chloride-rich diarrhea.
What is the site of action of cholera toxin?
3286
Phase 2
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
3287
Phase 1
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
3288
Phase 0
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
3289
Phase 3
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
3290
In the medulla; all the other structures are cortical.
Where in the kidney are the long loops of Henle and the terminal regions of the collecting ducts?
3291
Water
What is absorbed in the gallbladder to concentrate bile?
3292
Lipid-soluble hormones are considered slow-acting hormones.
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?
3293
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
What are the three stimuli that result in the reninangiotensin-aldosterone secretion?
3294
The p50 value does not change in either anemia or polycythemia; the main change is the carrying capacity of the blood.
Is there a shift in p50 values with anemia? Polycythemia?
3295
Estradiol
What hormone level peaks 1 day before the surge of LH and FSH in the female cycle?
3296
True; it requires both a concentration gradient and ATP to work.
True or false? Active protein transport requires a concentration gradient.
3297
Up to 72 hours; the ovum losses its ability to be fertilized 8 to 25 hours after release.
Up to how many hours post ejaculation do sperm retain their ability to fertilize the ovum?
3298
Voltage-gated channel
What type of membrane channel opens in response to depolarization?
3299
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
What are the five effects of insulin on fat metabolism?
3300
True. They are evaginations of the surface membranes and therefore extracellular.
True or false? In a skeletal muscle fiber, the interior of the T-tubule is extracellular.
3301
Arterial PCO2 levels are proportional to cerebral blood flow.
Under resting conditions, what is the main determinant of cerebral blood flow?
3302
Atrial contraction Atrial, Contraction, Venous
On the venous pressure curve, what do the following waves represent? • A wave?
3303
Ventricular contraction Atrial, Contraction, Venous
On the venous pressure curve, what do the following waves represent? • C wave?
3304
Atrial filling (venous filling) Atrial, Contraction, Venous
On the venous pressure curve, what do the following waves represent? • V wave?
3305
Osteoblast (Remember, blasts make, clasts take)
What cell type in the bone is responsible for bone deposition?
3306
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.
True or false? The blood stored in the systemic veins and the pulmonary circuit are considered part of the cardiac output.
3307
Pituitary hypogonadism
What hormone disorder is characterized by the following abnormalities in sex steroids↓, LH↓, and FSH↓? • Sex steroids , LH , FSH
3308
GnRH constant infusion
What hormone disorder is characterized by the following abnormalities in sex steroids↑, LH↓, and FSH↓? • Sex steroids , LH , FSH ?
3309
Primary hypogonadism (postmenopausal women)
What hormone disorder is characterized by the following abnormalities in sex steroids↓, LH↑, and FSH↑? • Sex steroids , LH , FSH ?
3310
1. Flow independent of BP 2. Flow proportional to local metabolism 3. Flow independent of nervous reflexes
What are the three characteristics of autoregulation?
3311
Purkinje cell is the fastest, and the AV node is the slowest.
What is the fastest-conducting fiber of the heart? Slowest conduction fiber in the heart?
3312
Afterload
What equals the total tension on a muscle minus the preload?
3313
Granulosa cells
What follicular cell possesses FSH receptors and converts androgens into estradiol?
3314
NE
What are the primary neurotransmitters at the following sites? • Postganglionic sympathetic neurons
3315
Epinephrine
What are the primary neurotransmitters at the following sites? • Chromaffin cells of the adrenal medulla
3316
Serotonin
What are the primary neurotransmitters at the following sites? • Brainstem cells
3317
Histamine
What are the primary neurotransmitters at the following sites? • The hypothalamus
3318
ACh
What are the primary neurotransmitters at the following sites? • All motor neurons, postganglionic parasympathetic neurons
3319
ACh
What are the primary neurotransmitters at the following sites? • Autonomic preganglionic neurons
3320
Tip of the loop of Henle (1200 mOsm/L)
What region of the nephron has the highest osmolarity?
3321
Acid is needed for the activation of pepsin and therefore needed for protein digestion.
What pH (acidotic or alkalotic) is needed for pepsinogen to pepsin conversion?
3322
Stroke volume
What is the term for the amount of blood expelled from the ventricle per beat?
3323
False. It does increase uterine synthesis of prostaglandins, which increase uterine contractions.
True or false? Oxytocin initiates rhythmic contractions associated with labor.
3324
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.
Why does carbon monoxide diffusion in the lung (DLCO) decrease in emphysema and fibrosis but increase during exercise?
3325
Aromatase
What enzyme converts androgens to estrogens?
3326
Inulin
The clearance of what substance is the gold standard of GFR?
3327
The greater the myelination, the greater the conduction velocity.
How does myelination affect conduction velocity of an action potential?
3328
1. Maltose 2. Maltotetrose 3. α-Limit dextrans (α-1, 6 binding)
What are the three end products of amylase digestion?
3329
In the first and second bronchi
Where is most of the airway resistance in the respiratory system?
3330
Hyperventilation, which decreases CO2, shifting the reaction to the left and decreasing H+
What is the respiratory compensation mechanism for metabolic acidosis?
3331
Viscosity and resistance are proportionally related. The greater the viscosity, the greater the resistance is on the vessel.
How are resistance and viscosity related regarding flow?
3332
GH
T3 increases bone ossification through synergistic effect with what hormone?
3333
Voltage-gated calcium channel
Name the ventricular muscle membrane channel: • Closed at rest; depolarization causes channels to open slowly
3334
Ungated potassium channel
Name the ventricular muscle membrane channel: • Always open
3335
Voltage-gated sodium channel
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.
3336
Voltage-gated potassium channels
Name the ventricular muscle membrane channel: • Open at rest; depolarization is stimulus to close; begin to reopen during the plateau phase and during repolarization
3337
Liver, kidney, and GI epithelium
What are the three glycogenic organs?
3338
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.
Is CO2 a perfusion-or diffusion-limited O2 gas?
3339
Transmembrane potential (an absolute number)
What is the term for the potential difference across a cell membrane?
3340
21-β-Hydroxylase deficiency leads to hypotension, hyponatremia, and virilization.
What adrenal enzyme deficiency can be summed up as a mineralocorticoid deficiency, glucocorticoid deficiency, and an excess of adrenal androgens?
3341
Increase in ECF osmolarity means a in decrease in ICF osmolarity, so cells shrink.
When the ECF osmolarity increases, what happens to cell size?
3342
In early-morning sleep, usually between the sixth and eighth hours
When does cortisol secretion peak?
3343
Alveolar dead space
What is the term for ventilation of unperfused alveoli?
3344
T3
What is the bioactive form of thyroid hormone?
3345
Hypokalemic metabolic acidosis occurs in colonic diarrhea because of the net secretion of HCO3- and potassium into the colonic lumen.
What acid-base disturbance occurs in colonic diarrhea
3346
Glutamine and aspartate
What two AAs act as excitatory transmitters in the CNS, generating EPSPs?
3347
1. Dilation of the afferent arteriole 2. Constriction of the efferent arteriole 3. Inhibition of reabsorption of sodium and water in the collecting ducts
What are the three mechanisms of action for atrial natriuretic peptide's diuretic and natriuretic affects?
3348
Resistance decreases as resistors are added in parallel.
In a parallel circuit, what happens to resistance when a resistor is added in parallel
3349
Sympathetic nervous system
What component of the ANS is responsible for movement of semen from the epididymis to the ejaculatory ducts?
3350
O2 affinity increases with a decrease in the p50, making O2 more difficult to remove from the Hgb molecule.
What happens to O2 affinity with a decrease in p50?
3351
If the ratio of the filtrate to plasma concentration of a substance is equal, the substance is freely filtered by the kidney.
If the ratio of a substance's filtrate and plasma concentrations are equal, what is that substance's affect on the kidney?
3352
A loss of afferent activity indicates a decrease in BP, and an increase in afferent activity indicates an increase in BP.
What does a loss of afferent activity from the carotid sinus onto the medulla signal?
3353
1. Fat 2. Forty 3. Female 4. Familial 5. Fertile
What are the five F's associated with gallstones?
3354
False. It is a passive process due to decreased sex hormones.
True or false? Menstruation is an active process due to increased gonadal sex hormones?
3355
Relaxation of the diaphragm increases the intrapleural pressure (becomes more positive).
What happens to the intrapleural pressure when the diaphragm relaxes?
3356
AT II
What component of the renin-angiotensin-aldosterone axis increases sodium reabsorption in the proximal convoluted tubules and increases thirst drive?
3357
The aorta
What large-diameter vessel has the smallest cross-sectional area in systemic circulation?
3358
Hydroxyproline (breakdown product of collagen)
Excess bone demineralization and remodeling can be detected by checking urine levels of what substance?
3359
No change in length
What happens to the following during skeletal muscle contraction? • A band
3360
Shortens
What happens to the following during skeletal muscle contraction? • I band
3361
Shortens
What happens to the following during skeletal muscle contraction? • H zone
3362
Shortens
What happens to the following during skeletal muscle contraction? • Sarcomere
3363
No change in length
What happens to the following during skeletal muscle contraction? • Actin and myosin lengths
3364
1. Increased amino acid uptake by muscles 2. Decreased protein breakdown 3. Increased protein synthesis
What are the three effects of insulin on protein metabolism?
3365
Simple diffusion; it does not use protein-mediated transport
What is the main mechanism for exchange of nutrients and gases across a capillary membrane?
3366
Onset of bleeding
What event signifies the first day of the menstrual cycle?
3367
Cardiac muscle
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
3368
Skeletal muscle
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
3369
Smooth muscle
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
3370
Mitral insufficiency
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
3371
Aortic stenosis
Name the valve abnormality based on the following criteria: • Systolic murmur, increased preload and afterload, decreased aortic pulse pressure and coronary blood flow
3372
Mitral stenosis
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
3373
Aortic insufficiency
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
3374
Estrogen
Circulating levels of what hormone cause the cervical mucus to be thin and watery, allowing sperm an easier entry into the uterus?
3375
VIP is an inhibitory parasympathetic neurotransmitter that results in relaxation of the lower esophageal sphincter.
What hormone controls relaxation of the lower esophageal sphincter during swallowing?
3376
Pulse pressure
What is the term for the difference between systolic and diastolic pressures?
3377
Androgen-binding protein
What hormone, produced by the Sertoli cells, is responsible for keeping testosterone levels in the seminiferous tubules nearly 50 times that of the serum?
3378
TRUE
True or false? There are no central O2 receptors.
3379
Osteoblasts, which in turn stimulate osteoclasts to break down bone, releasing Ca2+ into the interstitium. (Remember, blasts make, clasts take.)
What cell type of the bone has PTH receptors?
3380
Intrinsic factor (IF)
What substance is secreted by parietal glands and is required for life?
3381
Increasing blood flow is the only way to increase O2 delivery in the coronary circulation because extraction is nearly maximal during resting conditions.
What is the only way to increase O2 delivery in the coronary circulation?
3382
Afterload
What is the term for the load a muscle is trying to move during stimulation?
3383
Menses
What is the term for days 1 to 7 of the female cycle?
3384
Afterload
What is the term for the force the ventricular muscle must generate to expel the blood into the aorta?
3385
The urine becomes hypertonic because of water reabsorption in the collecting duct.
What happens to the tonicity of the urine with increased ADH secretion?
3386
Gradient-time system
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?
3387
Series circuit
What type of circuit is described when the total resistance is always greater than the sums of the individual resistors?
3388
Increased secretion of GH postpuberty leading to acromegaly.
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?
3389
The V/Q ratio increases, since the area is ventilated but hypoperfused as a result of the occlusion.
What happens to V/Q ratio if a thrombus is lodged in the pulmonary artery?
3390
GH, especially IGF-1. GH also increases the incorporation of thymidine in DNA synthesis and uridine in RNA synthesis.
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?
3391
FALSE
True or false? Bile pigments and bile salts are reabsorbed in the gallbladder.
3392
PR interval
What component of an ECG is associated with the following? • Conduction delay in the AV node
3393
QRS complex
What component of an ECG is associated with the following? • Ventricular depolarization
3394
P wave
What component of an ECG is associated with the following? • Atrial depolarization
3395
T wave
What component of an ECG is associated with the following? • Ventricular repolarization
3396
Renal circulation
Where is the greatest venous PO2 in resting tissue?
3397
Oxytocin
Near the end of pregnancy, what hormone's receptors increase in the myometrium because of elevated plasma estrogen levels?
3398
Pneumotaxic center (short, fast breaths)
What respiratory center in the rostral pons has an inhibitory affect on the apneustic center?
3399
LH
For what hormone do Leydig cells have receptors?
3400
Respiratory acidosis (summary: high CO2, high H+, slightly high HCO3-)
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?
3401
2.0 or greater
What lecithin: sphingomyelin ratio indicates lung maturity?
3402
Hyperpolarization (i.e., K+ influx)
What is the term for the negative resting membrane potential becoming more negative?
3403
A low-resistance system is formed by resistors added in parallel.
What type of resistance system (i.e., high or low) is formed when resistors are added in parallel?
3404
Thyroid hormones are necessary for conversion of carotene to vitamin A.
Why is hypothyroidism associated with night blindness?
3405
0.21; it is a fancy way of saying 21% of the air is O2.
What is the FiO2 of room air?
3406
Coronary circulation
Where are the lowest resting PO2 levels in a resting individual?
3407
The conversion of CHO to pregnenolone via the enzyme desmolase
What is the rate-limiting step in the production of steroids?
3408
Primary polydipsia; patients with diabetes insipidus will continue to produce large volumes of dilute urine.
In the water deprivation test, does a patient with reduced urine flow have primary polydipsia or diabetes insipidus?
3409
True; the greater the fat, the less the total body water.
True or false? There is an inverse relationship between fat content and total body water.
3410
The negative charge inhibits the filtration of protein anions.
What is the role of the negative charge on the filtering membrane of the glomerular capillaries?
3411
Bainbridge reflex
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?
3412
Bile salts are actively reabsorbed in the distal ileum.
Where in the GI tract does the reabsorption of bile salts take place?
3413
1. Plicae circularis (3 times) 2. Villi (30 times) 3. Microvilli (600 times)
What three structures increase the surface area of the GI tract?
3414
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.
Does physiologic splitting of the first heart sound occur during inspiration or expiration? Why?
3415
150 mcg/day is the minimal daily intake needed. Most people ingest 500 mcg/day.
How much dietary iodine is necessary to maintain normal thyroid hormone secretion?
3416
CSF H+ levels, with acidosis being the main central drive, resulting in hyperventilation (the opposite being true with alkalosis)
What is the central chemoreceptor's main drive for ventilation?
3417
Air flows into the respiratory system.
What result occurs because of the negative alveolar pressure generated during inspiration?
3418
Pro-opiomelanocortin (POMC) is cleaved into ACTH and β-lipotropin.
Corticotropin-releasing hormone promotes the synthesis and release of what prohormone?
3419
Free hormone levels remain constant, and the bound hormone level changes with a decrease in binding hormones.
What happens to free hormone levels when the liver decreases production and release of binding proteins?
3420
Estrone
What type of estrogen is produced in peripheral tissues from androgens?
3421
Promotes systemic venous return into the chest and increases the caliber and volume of the pulmonary vessels
What changes does more negative intrathoracic pressure cause to systemic venous return and to the pulmonary vessels?
3422
In the JG cells of the kidney
Where is renin produced?
3423
False. Right-sided valves are the first to open and last to close.
True or false? Right-sided valves close before the valves on the left side of the heart.
3424
Alkaline phosphatase
What enzyme is associated with osteoblastic activity?
3425
Order of attachment is site 1, 2, 3, 4, and for release is 4, 3, 2, 1.
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?
3426
Insulin
What hormone is secreted into the plasma in response to a meal rich in protein or CHO?
3427
With arteriolar constriction both the flow and pressure downstream decrease.
What happens to blood flow and pressure downstream with local arteriolar constriction?
3428
Achalasia
What occurs when the lower esophageal sphincter fails to relax during swallowing due to abnormalities of the enteric nervous plexus?
3429
True. They have no gates, so by definition they are always open.
True or false? Ungated channels are always open.
3430
Parasympathetics (parasympathetics point, sympathetics shoot)
What component of the ANS is responsible for dilation of the blood vessels in the erectile tissue of the penis, resulting in an erection?
3431
Red muscle
What muscle type is characterized by low ATPase activity, aerobic metabolism, myoglobin, association with endurance, and small muscle mass?
3432
Systolic interval decreases secondary to increased contractility; diastolic interval decreases secondary to an increase in heart rate.
What happens to diastolic and systolic intervals with an increase in sympathetic activity?
3433
Testosterone
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?
3434
They are inversely proportional to each other; as pulse pressure increases, compliance decreases.
How are pulse pressure and compliance related?
3435
ACh, histamine, and gastrin
What three substances stimulate parietal cells?
3436
Increased pulmonary arterial pressure (high perfusion) and more distensible vessels (low resistance) result in increased blood flow at the base.
What two factors result in the base of the lung being hyperperfused?
3437
True. Without ADH hypotonic urine would be formed.
True or false? Without ADH the collecting duct would be impermeable to water.
3438
Depolarization is from apex to base and from endocardium to epicardium.
How does ventricular depolarization take place, base to apex or vice versa?
3439
PTH increases Ca2+ reabsorption in the DCT of the kidney and decreases PO4- reabsorption in the PCT.
What are effects of PTH in the kidney?
3440
It is produced by the preload on the muscle prior to contraction.
Regarding muscle mechanics, how is passive tension produced?
3441
GH deficiency
Insulin-induced hypoglycemia is the most reliable (by far not the safest) test for what hormone deficiency?
3442
Water flows from a low-solute to high-solute concentrations.
In regards to solute concentration, how does water flow?
3443
Macula densa
Which extravascular chemoreceptor detects low NaCl concentrations?
3444
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.
If the AV difference is positive, is the substance extracted or produced by the organ?
3445
Transport maximum (Tm) occurs when all function carriers are saturated and therefore is an index of the number of functioning carriers.
What is used as an index of the number of functioning carriers for a substance in active reabsorption in the kidney?
3446
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.)
Why is there a transcellular shift in K+ levels in a diabetic patient who becomes acidotic?
3447
False. That is precisely where COMT is found; it is not found in adrenergic nerve terminals.
True or false? Catechol-O-methyl transferase (COMT) is not found in smooth muscle, liver, and the kidneys.
3448
IGF-1 (somatomedin C)
What somatomedin serves as a 24-hour marker of GH secretion?
3449
Stretch receptors prevent overdistension of the lungs during inspiration.
What receptor is in the smooth muscle cells of the small bronchi, is stimulated during inflation, and inhibits inspiration?
3450
True. They are also necessary for normal brain maturation.
True or false? Thyroid hormones are necessary for normal menstrual cycles.
3451
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.
What component of the cardiovascular system has the largest blood volume? Second largest blood volume?
3452
Creatinine
Serum concentration of what substance is used as a clinical measure of a patient's GFR?
3453
In the mouth with salivary α-amylase (ptyalin)
Where does CHO digestion begin?
3454
It decreases insulin secretion.
How does the sympathetic nervous system affect insulin secretion?
3455
The greater the cell diameter, the greater the conduction velocity.
How does cell diameter affect the conduction velocity of an action potential?
3456
Duchenne muscular dystrophy
Calf pseudohypertrophy
3457
Wilson disease
Kayser-Fleischer rings
3458
Rheumatic fever
Aschoff bodies
3459
Bronchial asthma (whorled mucous plugs)
Curschmann spirals
3460
Bronchial asthma (eosinophil membranes)
Charcot-Leyden crystals
3461
Squamous cell carcinoma
Keratin pearls
3462
Multiple myeloma
Bence-Jones proteinuria
3463
Multiple myeloma
Russell bodies
3464
Acute cystitis
WBCs in the urine
3465
Bladder carcinoma
RBCs in the urine
3466
Acute glomerulonephritis
RBC casts in the urine
3467
Acute pyelonephritis
WBC casts in the urine
3468
Acute toxic or viral nephrosis
Renal epithelial casts in the urine
3469
Chronic end-stage renal disease
Waxy casts
3470
Gastric carcinoma
Signet ring cells
3471
G-6-PD deficiency
Heinz bodies
3472
Chronic alcoholic
Mallory bodies
3473
AML-M3
Auer rods
3474
Burkitt lymphoma
Starry sky pattern
3475
Histiocytosis X
Birbeck granules
3476
Hodgkin lymphoma
Reed-Sternberg cells
3477
Granulosa/thecal cell tumor of the ovary
Call-Exner bodies
3478
Herpesvirus
Cowdry type A bodies
3479
Papillary carcinoma of the ovary
Orphan Annie cells
3480
Turner syndrome
Streaky ovaries
3481
Fibrocystic change of the breast
Blue-domed cysts
3482
Leydig cell tumor
Reinke crystals
3483
Yolk sac tumor
Schiller-Duval bodies
3484
Osteosarcoma
Codman triangle on radiograph
3485
Toxic or viral hepatitis
Councilman bodies
3486
Osteogenesis imperfecta
Blue sclera
3487
Giant cell tumor of the bone
Soap bubble appearance on radiograph
3488
Ewing sarcoma
Pseudorosettes
3489
Alzheimer disease
Neurofibrillary tangles
3490
Neuroblastoma
Homer-Wright rosettes
3491
Parkinson disease
Lewy bodies
3492
Epidural hematoma
Lucid interval
3493
Subarachnoid hemorrhage
Bloody tap on lumbar puncture
3494
Glioblastoma multiforme
Pseudopalisades
3495
Alzheimer disease
Senile plaques
3496
Neurofibromatosis
Café-au-lait spot on the skin
3497
Chlamydia trachomatis
Name the most common cause. • Blindness worldwide
3498
Diabetes mellitus
Name the most common cause. • Blindness in the United States
3499
Alzheimer disease
Name the most common cause. • Dementia in persons aged 60 to 90 years
3500
Dyslexia
Name the most common type. • Learning disability
3501
Fetal alcohol syndrome
Name the most common type. • Mental retardation
3502
Stage fright (discrete performance anxiety)
Name the most common type. • Phobia
3503
Anxiety disorders; for men it is substance abuse.
Name the most common type. • Psychiatric disorder in women of all ages
3504
Public speaking (Remember: stage fright)
Name the most common type. • Specific phobia
3505
Alcohol abuse
Name the most common cause. • Chronic pancreatitis
3506
Mumps
Name the most common cause. • Infectious pancreatitis
3507
Depression
Name the most common cause. • Insomnia
3508
RSV
Name the most common cause. • Hospitalization in children younger than 1 year of age
3509
Parainfluenza virus
Name the most common cause. • Croup
3510
Coronavirus
Name the most common cause. • A cold in the winter and summer
3511
Rhinovirus
Name the most common cause. • A cold in the spring and fall
3512
Rhinoviruses for summer and fall; coronaviruses for winter and spring
Which virus is the MCC of a cold in the summer and fall? Winter and spring?
3513
Amyloidosis
Name the most common type or cause. • Restrictive cardiomyopathy
3514
Ischemic heart disease (MIs)
Name the most common type or cause. • Death in the United States
3515
Ventricular fibrillation (V fib)
Name the most common type or cause. • Sudden cardiac death
3516
Left heart failure
Name the most common type or cause. • Right heart failure
3517
Congenital heart disease
Name the most common type or cause. • Childhood heart disease in the United States
3518
Tetralogy of Fallot
Name the most common type or cause. • Cyanotic heart disease
3519
Streptococcus viridans
Name the most common type or cause. • Subacute bacterial endocarditis
3520
Staphylococcus aureus
Name the most common type or cause. • Acute bacterial endocarditis
3521
RSV
Name the most common type or cause. • Viral pneumonia leading to death
3522
Pseudomonas aeruginosa
Name the most common type or cause. • Infection in a patient on a ventilator
3523
RSV
Name the most common type or cause. • Bronchiolitis in children
3524
VSD
Name the most common type or cause. • Pulmonary HTN in children
3525
Alcohol abuse
Name the most common type or cause. • Reversible HTN in the United States
3526
Emphysematous bleb
Name the most common type or cause. • Spontaneous pneumothorax
3527
Asbestosis
Name the most common type or cause. • Nonorganic pneumoconiosis
3528
Hypoxia
Name the most common type or cause. • Cellular injury
3529
Ischemia
Name the most common type or cause. • Hypoxia
3530
Streptococcus pneumoniae
Name the most common type or cause. • Lobar pneumonia
3531
Aspiration
Name the most common type or cause. • Lung abscess
3532
Alcohol consumption
Name the most common type or cause. • Cirrhosis in the United States
3533
Membranoproliferative glomerulonephritis (MGN)
Name the most common type or cause. • Nephrotic syndrome
3534
Lipoid nephrosis
Name the most common type or cause. • Nephrotic syndrome in children
3535
Alcoholic cirrhosis
Name the most common type or cause. • Liver transplantation in adults
3536
Escherichia coli
Name the most common type or cause. • UTIs
3537
BPH
Name the most common type or cause. • Urinary tract obstruction
3538
Renal cell carcinoma
Name the most common type or cause. • Painless hematuria
3539
Infection
Name the most common type or cause. • Hematuria
3540
IgA nephropathy
Name the most common type or cause. • GN in the world
3541
Minimal change disease
Name the most common type or cause. • Nephritic syndrome in children
3542
MGN
Name the most common type or cause. • Nephritic syndrome in adults
3543
Acute tubular necrosis
Name the most common type or cause. • Acute renal failure in the United States
3544
Ischemic
Name the most common type or cause. • Acute tubular necrosis
3545
Rotavirus
Name the most common type or cause. • Diarrhea in children
3546
Adhesions and hernias
Name the most common type or cause. • Intestinal obstructions in adults
3547
Hirschsprung disease
Name the most common type or cause. • Neonatal bowel obstruction
3548
Diverticulosis
Name the most common type or cause. • Rectal bleeding
3549
Alcoholism
Name the most common type or cause. • Mallory-Weiss syndrome
3550
Polycystic ovaries
Name the most common type or cause. • Anovulation
3551
Fibrocystic change of the breast
Name the most common type or cause. • Breast lump in females
3552
Sickle cell disease
Name the most common type or cause. • Hematologic cause of papillary necrosis
3553
Sheehan syndrome
Name the most common type or cause. • Panhypopituitarism
3554
Pituitary adenoma
Name the most common type or cause. • Cushing syndrome
3555
Hashimoto thyroiditis
Name the most common type or cause. • Noniatrogenic hypothyroidism in the United States
3556
Iatrogenesis
Name the most common type or cause. • Hypothyroidism in the United States
3557
Staphylococcus aureus
Name the most common type or cause. • Pyogenic osteomyelitis
3558
Streptococcus agalactiae (Group B Streptococcus, or GBS)
Name the most common type or cause. • Neonatal septicemia and meningitis
3559
Pneumococcus
Name the most common type or cause. • Sinusitis and otitis media in children
3560
Pneumococcus
Name the most common type or cause. • Meningitis in adults
3561
Listeria monocytogenes
Name the most common type or cause. • Meningitis in renal transplantation patients
3562
Enteropathogenic Escherichia coli (Rotavirus is the MCC overall.)
Name the most common type or cause. • Infantile bacterial diarrhea
3563
Rotavirus
Name the most common type or cause. • Infantile diarrhea
3564
Haemophilus ducreyi
Name the most common type or cause. • Chancre
3565
Staphylococcus saprophyticus
Name the most common type or cause. • Urethritis in a young, newly sexually active individual
3566
Escherichia coli
Name the most common type or cause. • Cystitis
3567
Streptococcus pyogenes
Name the most common type or cause. • Erysipelas
3568
Lead
Name the most common type or cause. • Chronic metal poisoning
3569
Arsenic
Name the most common type or cause. • Acute metal poisoning in the United States
3570
Neonatal respiratory distress syndrome (NRDS)
Name the MCC of death. • In neonates
3571
Renal failure
Name the MCC of death. • In SLE
3572
MI
Name the MCC of death. • In diabetic individuals
3573
Pulmonary infections
Name the MCC of death. • In patients with cystic fibrosis
3574
Heart disease
What is the MCC of death in the United States?
3575
Cancer
What is the second leading cause of death in the United States?
3576
Accidents
What is the MCC of death in children aged 1 to 14 in the United States?
3577
Cancer
What is the second leading cause of death in children aged 1 to 14 in the United States?
3578
Lung cancer
What is the MCC of cancer mortality in males and females?
3579
For males it's prostate cancer, and for females it's breast cancer.
What is the second leading cause of cancer deaths in males? In females?
3580
Homicide. It is also the leading cause of death in black females aged 15 to 24.
What is the MCC of death in black males aged 15 to 24?
3581
Neisseria gonorrhoeae and Chlamydia trachomatis
What are the two MCC of acute epididymitis in males? • Less than 35 years old
3582
Escherichia coli and Pseudomonas sp.
What are the two MCC of acute epididymitis in males? • More than 35 years old
3583
Propionibacterium acnes
What is the most common causative organism of acne vulgaris?
3584
Adenovirus
What is the MCC of viral conjunctivitis?
3585
Streptococcus viridans
What is the MCC of the following endocarditis scenarios? • Post dental work
3586
Enterococcus faecalis
What is the MCC of the following endocarditis scenarios? • Following biliary infections
3587
Staphylococcus aureus
What is the MCC of the following endocarditis scenarios? • Non-IV drug user
3588
Haemophilus influenzae type B
Name the MCC. • Epiglottitis in an unvaccinated child
3589
Streptococcus pneumoniae
Name the MCC. • Pneumonia in adults
3590
Pseudomonas sp.
Name the MCC. • Pneumonia in a neutropenic burn patient
3591
Chlamydia psittaci
Name the MCC. • Pneumonia in a patient with atypical bird exposure and hepatitis
3592
Mycoplasma pneumoniae
Name the MCC. • Walking pneumonia, seen in teens and military recruits
3593
Klebsiella pneumoniae
Name the MCC. • Aspiration pneumonia in an alcoholic
3594
Pneumocystis carinii
Name the MCC. • Pneumonia in an HIV-positive patient with CD4 less than 200
3595
Cryptococcus
What is the MCC of the following meningitides? • In patients who have AIDS or are immunocompromised
3596
Neisseria meningitides
What is the MCC of the following meningitides? • In military recruits
3597
Haemophilus influenzae type B
What is the MCC of the following meningitides? • In those 12 months to 6 years of age
3598
Streptococcus agalactiae and Escherichia coli
What is the MCC of the following meningitides? • In neonates to 3 months of age
3599
Streptococcus pneumoniae
What is the MCC of the following meningitides? • In adults
3600
Listeria monocytogenes
What is the MCC of the following meningitides? • In renal transplant patients
3601
Ascaris lumbricoides
What is the most common one? • Helminthic parasite worldwide
3602
Enterobius vermicularis
What is the most common one? • Helminth parasitic infection in the United States
3603
Coagulative
What is the most common one? • Form of necrosis
3604
Escherichia coli
What is the most common one? • Organism that causes pyelonephritis
3605
VSD
What is the most common one? • Congenital cardiac anomaly
3606
PDA
What is the most common one? • Cardiac anomaly in children
3607
Subacute bacterial endocarditis
What is the most common one? • Complication of PDA
3608
ASD
What is the most common one? • Congenital heart defect in adults
3609
Ostium secundum defects
What is the most common one? • Type of ASD
3610
Temporal arteritis
What is the most common one? • Vasculitis
3611
Temporal arteritis
What is the most common one? • Form of vasculitis
3612
Left atrial myxoma
What is the most common one? • Cardiac tumor
3613
Rhabdomyoma
What is the most common one? • Cardiac tumor of infancy
3614
Libman-Sacks endocarditis
What is the most common one? • Cardiac pathology in patients with SLE
3615
Coarctation of the aorta
What is the most common one? • Cardiac anomaly in Turner syndrome
3616
Mitral valve stenosis
What is the most common one? • Valve abnormality associated with rheumatic fever
3617
Coxsackie B
What is the most common one? • Viral cause of myocarditis
3618
Adenocarcinoma
What is the most common one? • Primary lung cancer
3619
Adenocarcinoma (30% to 35%)
What is the most common one? • Primary malignant tumor of the lungs
3620
Metastatic carcinomas
What is the most common one? • Neoplastic tumor in the lungs
3621
Transitional cell carcinoma
What is the most common one? • Bladder tumor
3622
Calcium oxylate
What is the most common one? • Renal calculus type
3623
Calcium oxalate
What is the most common one? • Kidney stone type
3624
Neuroblastoma
What is the most common one? • Solid tumor in children
3625
Diffuse proliferative GN
What is the most common one? • Renal pathology in patients with SLE
3626
Squamous cell carcinoma
What is the most common one? • Cancer of the esophagus in the world
3627
Adenocarcinoma (because of Barrett esophagus)
What is the most common one? Esophageal cancer in the United States
3628
Squamous cell carcinoma
What is the most common one? • Malignant tumor of the esophagus
3629
Leiomyoma
What is the most common one? • Benign GI tumor
3630
Splenic flexure
What is the most common one? • Site of ischemia in the GI tract
3631
Duodenal ulcers (4 times as common as gastric)
What is the most common one? • Type of PUD
3632
Anterior wall of the first part of the duodenum
What is the most common one? • Location of a duodenal ulcer
3633
Lesser curvature of the antrum of the stomach
What is the most common one? • Location of a gastric ulcer
3634
Appendix (second is terminal ileum)
What is the most common one? • Site for carcinoid tumors
3635
Sigmoid colon
What is the most common one? • Site for colonic diverticula
3636
Terminal ileum
What is the most common one? • Site of Crohn disease
3637
Rectum
What is the most common one? • Site of ulcerative colitis
3638
Head of the pancreas
What is the most common one? • Site of pancreatic cancer
3639
Insulinoma
What is the most common one? • Pancreatic islet cell tumor
3640
Mixed (both cholesterol and calcium)
What is the most common one? • Stone type associated with cholecystitis
3641
Metastatic carcinoma
What is the most common one? • Liver tumor
3642
Hepatocellular carcinoma
What is the most common one? • Primary malignant tumor in the liver
3643
Hemangioma (benign)
What is the most common one? • Primary tumor of the liver
3644
Entamoeba histolytica
What is the most common one? • Organism associated with liver abscesses
3645
Clear cell
What is the most common one? • Renal cell cancer type
3646
Squamous cell carcinoma
What is the most common one? • Esophageal carcinoma
3647
Nephroblastoma
What is the most common one? • Solid tumor in the body
3648
ALL
What is the most common one? • Malignancy in children
3649
Periaortic lymph nodes
What is the most common one? • Lymph node affected in non-Hodgkin lymphoma
3650
Nodular sclerosis
What is the most common one? • Subtype of Hodgkin lymphoma
3651
Papillary carcinoma
What is the most common one? • Thyroid cancer
3652
Follicular adenoma
What is the most common one? • Thyroid adenoma
3653
Papillary carcinoma of the thyroid
What is the most common one? • Malignant thyroid tumor
3654
Chromophobe adenoma
What is the most common one? • Pituitary tumor
3655
Prolactinoma
What is the most common one? • Pituitary adenoma
3656
Multiple myeloma
What is the most common one? • Tumor arising within the bone
3657
Basal cell carcinoma
What is the most common one? • Tumor on sun-exposed sites
3658
Choriocarcinoma
What is the most common one? • Malignant germ cell tumor in women
3659
Serocystadenocarcinoma
What is the most common one? • Primary malignant tumor of the ovary
3660
Breast
What is the most common one? • Malignant tumor in women
3661
Squamous cell carcinoma
What is the most common one? • Cancer of the vulva
3662
Cervical neoplasia
What is the most common one? • Primary malignant tumor of the female genital tract in the world
3663
Adenocarcinoma of the cervix
What is the most common one? • Primary malignant tumor of the female genital tract in the United States
3664
Leiomyoma
What is the most common one? • Tumor of the female genitourinary tract
3665
Serocystadenoma
What is the most common one? • Benign tumor of the ovary
3666
Fibroadenoma
What is the most common one? • Benign tumor of the breast
3667
Fibroadenoma
What is the most common one? • Benign breast tumor in females less than 35 years old
3668
Infiltrating ductal carcinoma
What is the most common one? • Histologic variant of breast cancer
3669
Fibrocystic change of the breast
What is the most common one? • Benign lesion that affects the breast
3670
Invasive ductal carcinoma
What is the most common one? • Malignant tumor of the breast
3671
Ovarian cancer
What is the most common one? • Female genital tract malignancy resulting in death
3672
Endometrial cancer
What is the most common one? • Malignancy of the female genital tract
3673
Leiomyoma (fibroids)
What is the most common one? • Tumor of the female genital tract
3674
Cystadenoma
What is the most common one? • Benign ovarian tumor
3675
Cystadenocarcinoma
What is the most common one? • Malignant carcinoma of the ovaries
3676
Ovarian fibroma
What is the most common one? • Stromal tumor of the ovary
3677
Dysgerminoma
What is the most common one? • Germ cell tumor of the ovary
3678
Testicular tumors
What is the most common one? • Tumor in men aged 15 to 35
3679
Testicular lymphoma
What is the most common one? • Testicular tumor in men over 50 years old
3680
Seminoma
What is the most common one? • Germ cell tumor in men
3681
Yolk sac tumor
What is the most common one? • Testicular tumor in infants and children
3682
Yolk sac tumor
What is the most common one? • Germ cell tumor in boys
3683
Osteosarcoma
What is the most common one? • Malignant tumor in the bone of teenagers
3684
Ependymoma
What is the most common one? • Intraspinal tumor
3685
Retinoblastoma
What is the most common one? • Eye tumor in children
3686
Kidney
What is the most common one? • Organ involved in amyloidosis
3687
Aspiration pneumonia
What is the most common one? • Complication of nasogastric tube feeding
3688
Necrotizing enterocolitis
What is the most common one? • Acquired GI emergency of infancy
3689
Staphylococcus aureus
What is the most common one? • Organism associated with mastitis
3690
Bronchogenic carcinoma
What is the most common one? • Tumor in individuals exposed to asbestos
3691
BPH
What is the most common one? • Proliferative abnormality of an internal organ
3692
Rheumatoid arthritis
What is the most common one? • Inflammatory arthritis
3693
Duchenne muscular dystrophy
What is the most common one? • Form of muscular dystrophy
3694
Knee
What is the most common one? • Joint affected in pseudogout
3695
Hematogenous
What is the most common one? • Route for infectious arthritis
3696
Osteoarthritis
What is the most common one? • Form of arthritis
3697
Hematogenous
What is the most common one? • Route of spread in pyogenic osteomyelitis
3698
Osteoporosis
What is the most common one? • Bone disorder in the United States
3699
Breast
What is the most common one? • Primary tumor metastasis to the bone
3700
Metastatic
What is the most common one? • Bone tumor
3701
GABA, quantitatively
What is the most common one? • Neurotransmitter in the brain
3702
Middle cerebral artery
What is the most common one? • Site of a cerebral infarct
3703
Glioblastoma multiforme
What is the most common one? • Primary CNS tumor in adults
3704
Medulla blastoma
What is the most common one? • Primary CNS tumor in children
3705
Metastatic
What is the most common one? • Brain tumor
3706
Glioblastoma multiforme
What is the most common one? • Primary CNS tumor
3707
Ependymoma
What is the most common one? • Intramedullary spinal cord tumor in adults
3708
In children, the fourth ventricle; in adults, the lateral ventricle or spinal cord
What is the most common one? • Location of ependymomas in children
3709
Acral-lentiginous melanoma
What is the most common one? • Melanoma in dark-skinned persons
3710
Superficial spreading melanoma
What is the most common one? • Type of melanoma
3711
Basal cell carcinoma
What is the most common one? • Skin tumor in the United States
3712
Left posterolateral side of the diaphragm, usually resulting in pulmonary hypoplasia.
What is the most common one? Site of congenital diaphragmatic hernias
3713
Direct; in males less than 50 years old indirect hernias are the most common type.
What is the most common one? • Type of hernia seen in males more than 50 years old
3714
Between the renal arteries and at the bifurcation of the abdominal aorta
What is the most common one? • Sites for abdominal aorta aneurysm
3715
The bifurcation of the abdominal aorta
What is the most common one? • Site for atherosclerotic plaques in the abdominal aorta
3716
The rectouterine pouch (of Douglas)
What is the most common one? • Site for an ectopic abdominal pregnancy
3717
On the superior body of the posterior wall of the uterus
What is the most common site for implantation of the blastocyst?
3718
Ampulla of the fallopian tube
Where is the most frequent site of ectopic pregnancy?
3719
Breast cancer
What is the most common diagnosis made (or missed!) resulting in a malpractice suit?
3720
0157:H7
What is the most common serotype of enterohemorrhagic Escherichia coli?
3721
IgG
What is the most common circulation Ig in the plasma?
3722
In men it is prostate cancer, and in women it is breast cancer.
What is the most common cancer diagnosed in men? In women?
3723
Lung and bronchus cancer
What is the second most common cancer diagnosed in both males and females?
3724
Prostate and lung cancer, respectively
What are the two leading causes of cancer-related death in men?
3725
Breast and lung cancer, respectively.
What are the two leading causes of cancer-related death in women?
3726
For males, HTN; for females, pregnancy.
What is the most common primary diagnosis resulting in an office visit for males? For females?
3727
Chlamydia; gonorrhea is second (Remember, it is mandatory to report STDs to the CDC.)
What is the most common disease or infection reported to the CDC?
3728
HPV
What is the most common STD?
3729
Chlamydia
Name the most common reported STD. • In females
3730
Gonorrhea
Name the most common reported STD. • In males
3731
Pedophilia
What is the most common sexual assault?
3732
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%.
What is the most common form of elderly abuse?
3733
C2 deficiency
What is the most common complement deficiency?
3734
Kidney
What is the most common organ involved in amyloidosis?
3735
Follicular lymphoma
What is the most common form of non-Hodgkin lymphoma in the United States?
3736
Upper outer quadrant (left more than right)
In which quadrant is breast cancer most commonly found?
3737
90% of benign myxomas arise within the left atrium near the fossa ovalis.
What is the most common cardiac tumor? In what chamber does it most commonly arise?
3738
Temporal lobes
What cerebral lobes are most commonly affected in herpes encephalitis?
3739
HTN
What is the most common condition leading to an intracerebral bleed?
3740
The scaphoid is the most commonly fractured and the lunate is the most commonly dislocated.
What carpal bone is most commonly fractured? Dislocated?
3741
Alcohol and its related problems cost the country approximately $100 billion a year.
What is the costliest health care problem in the United States?
3742
Alcohol. Nearly 10% of adults have a problem with alcohol.
What is the most abused drug across all age groups?
3743
α-and β-chains are on most T cells.
What are the two most common chains of the TCR?
3744
Achondroplasia
What is the most common form of inherited dwarfism?
3745
Cystic fibrosis
What is the most common lethal AR disorder affecting white Americans?
3746
Down syndrome (it is slightly more common than fragile X syndrome.)
What is the most common genetic cause of mental retardation?
3747
Trisomy 12 (nearly 50% of patients with CLL have abnormal karyotypes.)
What is the most common chromosomal abnormality associated with CLL?
3748
Down syndrome (trisomy 21)
Name the most common one. • Chromosomal disorder
3749
Endocardial cushion defect
Name the most common one. • Heart defect in Down syndrome
3750
Klinefelter syndrome
Name the most common one. • Chromosomal disorder involving sex chromosomes
3751
Chromosome 9, 22 (Philadelphia chromosome)
Name the associated chromosomal translocation. • CML
3752
Chromosome 11, 22
Name the associated chromosomal translocation. • Ewing sarcoma
3753
Chromosome 5, 21
Name the associated chromosomal translocation. • Adult familial polyposis
3754
Chromosome 8, 14
Name the associated chromosomal translocation. • Burkitt lymphoma
3755
Chromosome 15, 17
Name the associated chromosomal translocation. • Acute promyelocytic leukemia (M3)
3756
Chromosome 15, 17
Name the associated chromosomal translocation. • M3 AML
3757
Chromosome 14, 18
Name the associated chromosomal translocation. • Follicular lymphoma
3758
Chromosome 5p
Name the associated chromosome. • Cri-du-chat
3759
Chromosome 13
Name the associated chromosome. • Patau syndrome
3760
Chromosome 4p
Name the associated chromosome. • Huntington disease
3761
Chromosome 19
Name the associated chromosome. • Familial hypercholesterolemia
3762
Chromosome 1
Name the associated chromosome. • Gaucher disease
3763
Chromosome 11p
Name the associated chromosome. • Niemann-Pick disease
3764
Chromosome 15q
Name the associated chromosome. • Tay-Sachs disease
3765
Chromosome 7
Name the associated chromosome. • Cystic fibrosis
3766
Chromosome 12
Name the associated chromosome. • Chronic lymphocytic leukemia (CLL)
3767
Chromosome 15
Name the associated chromosome. • Marfan disease
3768
Chromosome 17
Name the associated chromosome. • Neurofibromatosis type 1
3769
Chromosome 22q
Name the associated chromosome. • Neurofibromatosis type 2
3770
Chromosome 21
Name the associated chromosome. • Down syndrome
3771
Chromosome 18
Name the associated chromosome. • Edward syndrome
3772
Chromosome 3p
Name the associated chromosome. • VON Hippel-Lindau disease
3773
Down syndrome
What is the most common chromosomal disorder?
3774
Down syndrome
What is the MCC of inherited mental retardation?
3775
Gaucher disease
What is the most common lysosomal storage disorder?
3776
Patients with cystic fibrosis have a mutation in the chloride channel protein in the CFTR gene on chromosome 7.
What chromosome is mutant in patients with cystic fibrosis?
3777
Chromosome 19
Familial hypercholesteremia is due to a mutation in the LDL receptor gene. What chromosome carries it?
3778
Chromosome 20q (deficiency in adenosine deaminase)
What chromosome is associated with the AR form of SCID?
3779
Chromosome 5q21
On what chromosome is the adenomatous polyposis coli gene?
3780
Chromosome 11p
Name the associated chromosome. • Albinism
3781
Chromium (Cr)
What mineral is associated with impaired glucose tolerance?
3782
Iodine (I)
What mineral is associated with hypothyroidism?
3783
Molybdenum (Mb)
What mineral is an important component of the enzyme xanthine oxidase?
3784
Riboflavin (B2) deficiency
What vitamin deficiency produces angular stomatitis, glossitis, and cheilosis?
3785
Thymine (B1)
What vitamin is a component of the coenzyme thiamine pyrophosphate (TPP)?
3786
Biotin. Avidin is found in raw egg whites.
Avidin decreases the absorption of what vitamin?
3787
1. Diarrhea 2. Dermatitis 3. Dementia 4. Death
What are the four Ds of niacin deficiency?
3788
Selenium (Se)
What mineral is an important component of glutathione peroxidase?
3789
Zinc (Zn) deficiency
What mineral deficiency in children is associated with poor growth and impaired sexual development?
3790
Iron (Fe)
What mineral, via excessive depositions in the liver, causes hemochromatosis?
3791
Pyridoxine (B6)
What vitamin is needed for the production of heme?
3792
Pantothenic acid
What vitamin is a component of the enzymes fatty acid synthase and acyl CoA?
3793
Cyanocobalamin (B12) deficiency (Folic acid deficiency has only homocystinuria as a sign.)
What vitamin deficiency produces homocystinuria and methylmalonic aciduria?
3794
Ascorbic acid (vitamin C) deficiency (These are the signs of scurvy.)
What vitamin deficiency is evidenced by poor wound healing, loose teeth, bleeding gums, petechiae, and ecchymosis?
3795
Pyruvate, acetyl CoA, and propionyl CoA carboxylase
What are the three carboxylase enzymes that require biotin?
3796
Cyanocobalamin (B12)
What vitamin requires IF for absorption?
3797
Copper
What mineral is a component of cytochrome a/a3?
3798
Copper
Leukopenia, neutropenia, and mental deterioration are signs of what mineral deficiency?
3799
Pyridoxine (B6) deficiency
What vitamin deficiency causes a glove-and-stocking neuropathy seen in alcoholics?
3800
Copper deficiency
What mineral deficiency involves blood vessel fragility?
3801
Folic acid deficiency
Megaloblastic anemia and thrombocytopenia are signs of what vitamin deficiency?
3802
Thiamine
What vitamin deficiency can result in high-output cardiac failure?
3803
Oxygen
Name the antidote. • Carbon monoxide (CO)
3804
Dimercaprol, penicillamine
Name the antidote. • Mercury
3805
Pyridoxine
Name the antidote. • Isoniazid
3806
Physostigmine
Name the antidote. • Atropine
3807
Dimercaprol, D-penicillamine
Name the antidote. • Arsenic
3808
Antidigoxin Fab fragments
Name the antidote. • Digoxin
3809
Dimercaprol
Name the antidote. • Gold
3810
Ethyl alcohol
Name the antidote. • Ethylene glycol
3811
Naloxone, naltrexone
Name the antidote. • Opioids
3812
Atropine, 2-PAM (pralidoxime)
Name the antidote. • Organophosphates
3813
Vitamin K
Name the antidote. • Warfarin
3814
D-Penicillamine
Name the antidote. • Copper
3815
Protamine sulfate
Name the antidote. • Heparin
3816
Deferoxamine, penicillamine
Name the antidote. • Iron
3817
Amyl nitrate, sodium nitrate, or sodium thiosulfate
Name the antidote. • Cyanide
3818
Ethyl alcohol
Name the antidote. • Methyl alcohol
3819
N-Acetylcysteine
Name the antidote. • Acetaminophen
3820
Methylene blue
Name the antidote. • Nitrates
3821
Penicillamine, EDTA (calcium disodium edetate), or dimercaprol
Name the antidote. • Lead
3822
Flumazenil
Name the antidote. • Benzodiazepines
3823
Atropine with pralidoxime
Name the antidote. • AChE inhibitors
3824
Physostigmine
Name the antidote. • Anticholinergics
3825
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.
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?
3826
CO
Cherry red intoxication is associated with what form of poisoning?
3827
Anemia
What toxicities are caused by the following agents? • Occupational nitrous oxide exposure
3828
Nephrotoxicity
What toxicities are caused by the following agents? • Methoxyflurane
3829
Hepatitis, with or without necrosis
What toxicities are caused by the following agents? • Halothane
3830
Nystagmus and ataxia
What are the first signs of overdose from phenobarbitals?
3831
Pinpoint pupils, decreased respiratory rate, and coma
What are the three signs of morphine overdose?
3832
Respiratory depression
What is the major pulmonary side effect of µ-activators?
3833
Constipation and miosis
What are the two side effects of opioids to which the user will not develop tolerance?
