UW Day Six

Question 1

Age does what to CV system?

Answer 1

stiffens arterials

Question 2

BMPR2 double hit - what inherited syndrome?

Answer 2

familial pulmonary fibrosis

• First hit - predisposes to excessive endothelial and smooth muscle proliferation
• Second hit - activates disease process, resulting in cardiac remodeling, elevated pulmonary vascular resistance, and progressive pulmonary HTN

Question 3

Reliable = ?(aka) = ? definition
v
Accurate = ?definition

Which is the gold standard measurement?

Answer 3

Reliable = precise = in same area, not necessarily correct (he doesnt always do a good job, but he is reliable)

Accurate = close to the correct value all the time )gold standard measurement)

Question 4

increased estrogen does what to the TBG? T3/T4?

Answer 4

increases TBG and the number of bound thyroid molecules, but free/active Thyroid hormone remains normal.

Question 5

use what blot to descern if a gene is being expressed.

Answer 5

Northern blot - mRNA

Question 6

what determines severity of ToF?

Answer 6

right ventricular outflow obstruction

Question 7

a pedunculated mass in LA - scattered cells within a mucopolysaccharide stroma, abnormal blood vessels, and hemorrhage

Answer 7

atrial myxoma

Question 8

Urinary incontinence - etiology of:
stress

urge

overflow

Answer 8

stress- loss of urethral support and intraabdominal pressure exceeds urethral sphincter pressure.

urge - detrusor overactivity/overcontraction

overflow - impaired detrusor contactility (impaired urination), bladder outlet obstruction

Question 9

muddy brown casts are pathogneomonic for ____ (flattening of priximal tubular epithelial cell with loss of rbush border ad subsequent cell necrosis an ddenudation of tubular basement membrane)

Answer 9

ATN

Question 10

What bug’s virulence factors?
LPS (macrophage activation and release of IL-1, 6, TNF-a) - bacteremia and septic shock
K1 capsular polysaccharide (prevents phagocytosis and complement mediated lysis) - neonatal meningitis
Verotoxin (shiga-like toxin that inactivates 60S rib., halting protein synthesis) - bloody gastroenteritis
HS/HL enterotoxins (incr fluid secretion) - watery gastroenteritis
P fibrae (adhesion to uroeptihelium) - UTI

Answer 10

E coli

Question 11

3 MCC of meningitis in newborns

Answer 11

Group B strep - agalactiae
E. coli
Listeria

Question 12

4 MCC of meningitis in 6mo-6years

Answer 12

Strep pneumo
Neisseria meningtidis
HiB
Enteroviruses

Question 13

4 MCC of meningitis in 6 years to 60 years

Answer 13

Strep pneumo
Neisseria meningitidis
Enteroviruses
HSV

Question 14

3 MCC of meningitis in 60+ years

Answer 14

Strep pneumo
Gram negative rods
Listeria

Question 15

S-100 means?

Answer 15

Neural crest origin

Question 16

GFAP means?

Answer 16

astrocyte derivative (GBM, oligodendroglioma, ependymoma, peripheral nerve sheath tumor)

Question 17

TNF-alpha, think what shock?

Answer 17

septic shock (IL-1 and IL-6 too)

Question 18

hypochromic microcytic anemia, reflexively think what

Answer 18

occult blood loss (GI)

Question 19

E. coli O157:H7 and shigella cause what?

sx: AKI, thrombocytopenia, HA with schistocytes
labs: decr Hb, Platelet count; increased BT, Lactate dehydrogenase, Br, BUN, Cr

Answer 19

HUS

Question 20

synaptophysin means what type of tumor?

Answer 20

neuronal origin: neuroectoderm, neuroendocrine

Question 21

adult intracranial tumor that arises from falx cerebri or tentorium cerebelli. involves somatosensory cortex and (CL sensory loss) or parietal association cortex (CL hemineglect).

Answer 21

meningioma

Question 22

unconjugated BR produce ___ gallstones

Answer 22

pigmented

Question 23

germ tubes

Answer 23

candida

Question 24

iron storage protein

Answer 24

ferritin

Question 25

iron transport protein

Answer 25

trasferrin

Question 26

target skin lesions - name and cause

Answer 26

erythema multiforme Mycoplasma, HSV,

Question 27

filtration fraction =

Answer 27

FF = GFR/RPF RPF = RBF x (1-Hct) = PAH clearance = (urine PAH x urine flow rate) / plasma [PAH]

Question 28

What is this: -Manic (1 week of severe symptoms, marked impairment in functioning, psychotic features possible and hospitalization) + or - depressive episode. - Hypomanic episode(s) (less than four days, no psychotic features, changes functioning from baseline) + at least one depressive episode - at least two years of fluctuating, mild hypomanic and depressive symptoms.

Answer 28

Bipolar 1 Bipolar 2 Cyclothymic

Question 29

RBF =

Answer 29

= (renal artery pressure - renal vein pressure) / renal vascular resistance = PAH / (1-Hct)

Question 30

Chronic lymphademia predisposes to...

Answer 30

angiosarcoma

Question 31

Catalase + organisms

Answer 31

Cats Need PLACESS to Belch their Hairballs: | Nocardia, Psudomonas, Listeria, Aspergillus, Candida, E coli, Staphylococci, Serratia, Burkholderia, H pylori

Question 32

Encapsulated bacteris

Answer 32

Please SHiNE my SKis | Pseudomonas, Strep pneumo, HiB, Neisseria, E. coli, Salonella, Klebsiella

Question 33

Location of interventricular hemorrhage in premature newborns

Answer 33

germinal matrix

Question 34

What does Shaken Baby Syndrome cause?

Answer 34

subdural hematoma - bridging veins

Question 35

What can colonize old lung cavities (from TB, emphysema, sarcoidosis)

Answer 35

aspergillus

Question 36

Ventricular gallop: - Features: turbulent flow through the ventricles due to increased volume or heard during rapid filling of ventricles in diastole. - Normal in young adults, pregnancy, children - Abnormal in >40, HF, Restrictive cardiomyopathy, high output states

Answer 36

S3 gallop (right after S2

Question 37

Atrial gallop: - heard immediately after atrial contraction phase as blood is forced through a stiff ventricle - Normal in healthy older adults - Abnormal in younger adults, children, acute MI, ventricular atrophy

Answer 37

S4 gallop (before S1)

Question 38

digital clubbing is seen in...

Answer 38

hypoxia (i.e. restrictive diseases - bronchiectasis, TB, CF, empyema, chronic lung abscess)

Question 39

difference in cell type found in CSF between bacterial, fungal/TB, and viral.

Answer 39

bacterial - PMNs | fungal/TB and viral - lymphocytes

Question 40

What do these diagnostic markers in urine indicate (in respect to cause of UTI)? 1. positive leukocyte esterase 2. positive nitrite test 3. positive urease test

Answer 40

1. positive leukocyte esterase - WBC activity 2. positive nitrite test - reduction of urinary nitrates by bacterial species (i.e. E coli) 3. positive urease test - urease-producing bugs (Proteus, Klebsiella)