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1

Saddle anesthesia and Loss of anocutaneous reflex =

S2-S4 lesion (cauda equina syndrome)

2

Danazol MOA

Synthetic androgen for endometriosis and hereditary angioedema

3

Mifepristone MOA

Synthetic steroid with anti-progestin and anti-glucocorticoid effects

4

Mitotane MOA

Adrenocorticolytic used primarily for adrenocortical carcinoma

5

Maintenance Dose =

Cpss x CL / [Bioavailability fraction]

6

Half life =

(Vd x 0.7) / CL

7

Loading Dose =

(Vd x Cpss) / [Bioavailability Fraction]

8

Methoxamine MOA

Selective a1 agonist

9

a2 activation effects

Decr insulin, Decr lipolysis, Decr aqueous humor production, Incr Platelet Aggregation

10

b1 activaiton effects

HR/Contractility, Incr Renin and Lipolysis

11

b2 activation effects

Vasodilation/Bronchodilation; Incr Lipolysis and Insulin; Decr uterine tone; Ciliary muscle relaxation and acqueous humor production

12

Recurrent kidney stones in young patient indicates

Inborn error of metabolism

13

Sodium Cyanide-Nitroprusside test

Detects presence of (sulfhydryl groups) urine cystine (converts cystine to cysteine and nitroprusside binds to make purple)

14

Treatment of Cystinuria

Hydration and Alkalinization of urine

15

Microscopic finding of irreversible cardiac ischemic injury

Vacuoles and Phospholipid-containing amorphous densities w/in mitochondria

16

Glandular epithelial changes from Proliferative to Secretory stages in endometrium

Pseudostratified, elongated, mitotically active epithelial cells --> Acquire large cytoplasmic vacuoles

17

Features that differentiate LEMS from MG

Hypo/areflexia, Autonomic symptoms, Classic incremental response to repetitive stimuli

18

Pyruvate Carboxylase activity is increased by

Acetyl-CoA

19

Citrate is a regulator of

Positive regulator of AcCoA Carboxylase, F-1,6-BP; Negative of PFK1 and 2 (inhibiting glycolysis)

20

Narcolepsy with Cataplexy is most often caused by

Lack of Hypocretin 1/2 (Orexin A/B) from Lateral Hypothalamus

21

Elevatd 14-3- protein in CSF

CJD

22

Low CSF 5-hydroxyindole-acetic acid

Impulsive, destructive behaviors

23

How to differentiate syphillis from other spirochetes on darkfield

Motility

24

H ducreyi requires what in culture

Factor X (like H flu)

25

Fever and sore throat in pt with hyperthyroidism being treated

AGRANULOCYTOSIS

26

Arthralgias with PTU

50% develop ANCA, some develop arthralgias and glomerulonephritis

27

Abdominal pain, distension, fever, diarrhea, shock in Ulcerative Colitis

Possibility of Toxic Megacolon

28

Alveolar proteases (eg. elastase) are produced by

Macrophages and PMNs

29

Acute Hypotension, Tachycardia, Elevated CVP (JVD) with Pulsus paradoxus

Cardiac Tamponade

30

Reid Index

Chronic Bronchitis --> Ratio of Gland thickness to total thickness of wall between epithelium and cartilage

31

When not to use Probenicid for Hyperuricemia

Poor renal function, Risk for uric acid stones or uric acid nephropathy

32

MOA of Rasburicase

Urate Oxidase: Uric Acid --> Allantoin

33

CHOP therapy is for

Non-hodgkin lymphoma

34

Herpesvirus drug that doesn't require viral kinase

Cidofovir, Foscarnet

35

Peritrichious Flagella

Characteristic of highly motile organisms such as Proteus mirabilis

36

"serpentine" or "medusa head" chains on microscopy

B anthracis

37

How does tetanus toxin causes paralysis

Wound --> Motor Neuron Axons --> Spinal Cord --> Inhibits inhibitory motor neuron

38

Features of Edwards Syndrome

Rocker bottom, Micrognathia, Low set ears, Clenched hands, Prominent Occiput, ASD/VSD, Omphalocele, Horeshoe kidney

39

Features of Patau Syndrome

Microcephaly, Holoprosencephaly, Microphtalmia, Polydactyly, Cleft lip/palate, Rocker bottom feet, Cystic kidneys, VSD

40

Methods of Isoniazid resistance

(1) Decr expression of catalase-peroxidase enzyme necessary for activation; (2) Modification of protein binding site

41

Rheumatic aortic disease usually produces

Combined AS and Aortic Regurgitation

42

Acanthocytes indicate

Abetalipoproteinemia

43

Which genes play major role in Type 1 DM

HLA-DQ and DR

44

Pancreatic islet amyloid deposition is seen in

Type 2 DM (universal)

45

Dose effects of dopamine

Low = D1 + B1; High = D1 + B1 + A1

46

Sensory innervation of Deep Fibular Nerve

Between first and second toes

47

Trauma or sustained pressure (cast) to the neck of the fibular

Injury to the common peroneal nerve

48

Basophil granules contain

Heparin, Histamine, SRS-A

49

What activates ALA synthase

CYP inducers, Barbiturates, Anti-epileptics, EtOH, Smoking

50

What inhibits ALA synthase

Heme, Glucose

51

Conversion of 1,3-BPG to 2,3-BPG is increased in

Hypoxia, Chronic Anemia

52

Babesiosis

Malaria-like illness w/ prediliction for asplenic patients

53

Toxoplasmosis in immunocompetent causes

flu-like illness

54

Brucellosis causes

Fever, malaise, LAD, HSM

55

Childreen 1-3 with gingivostomatitis characterized with intranuclear inclusions

HSV-1

56

MOA of Mesna

Binds Acrolein (toxic metabolite of cyclophosphamide)

57

Atypical Depression

Improvement in mood in response to something positive

58

MAOi's are used for

Atypical Depression, Anxiety, Refractory

59

Jejunal, Ileal, and Colonic Atresia are caused by

Vascular accidents in utero, NOT abnormal fetal development

60

Presentation of Follicular Lymphoma

Indolent course, Painless lymph node enlargement or abdominal discomfort from abdominal mass

61

Presentation of Diffuse Large Cell Lymphoma

Aggressive --> Large LN or extranodal mass (oropharyngeal lymphoid tissue and GI tract commonly involved)

62

Presentation of Hairy Cell Leukemia

Splenomegaly, Pancytopenia in older men

63

DNA Polymerase I vs III

I has 5' to 3' exonuclease activity (removes RNA primer, performs repair of damage), 5' to 3' polymerase activity, and 3' to 5' exonuclease activity; III performs bulk of replication

64

Signs of Acute Tubular Necrossi

Oliguria, Muddy Brown Casts, Anion Gap Metabolic Acidosis

65

Signs of Aromatase Deficiency

Maternal virilization, High androgens, Low estrogen, Tall, Osteoporosis --> Girls have ambiguous genitalia, boys just tall and osteoporosis

66

Function of Red Nucleus

Motor control of Upper extremities

67

Skin biopsy in Dermatitis Herpetiformis shows

PMNs and fibrin at tips of dermal papilla = microabcesses; IgA deposits

68

Infant with malabsorption, failure to thrive, progressive ataxia, acanthocytes

Abetalipoproteinemia

69

Epinephrine stimulates B2 receptors in skeletal muscle to

Incr BF, Glycogenolysis, Lipolysis

70

Endocrine comorbidities with Down Syndrome

Hypothyroid, T1DM, Obesity

71

Rheumatology and Hematology comorbidities with Down Syndrome

Acute Leukemia, Atlantoaxial instability

72

are only found in Alzheimer's dementia

Neurofibrillary Tangles

73

Lewy bodies

Round, eosinophilic, intracytoplasmic inclusions that contain neurofilaments of a-synuclein

74

Negri Bodies

Round eosinophilic inclusions seen in the cytoplasm of pyramidal hippocampal neurons and cerebellar purkinje cells

75

When does the metonephros begin to produce urine

8-10 wks

76

Most common cause of fetal hydronephrosis

Inadequate recanalization of the ureteropelvic junctions

77

Tumor that causes necrolytic migratory erythema

Glucagonoma

78

Manifestations of Somatostatinoma

DM, Steatorrhea, Cholelithiasis, Hypochlohydria

79

Order of sound /pressure waves in inner ear

Round window --> Scala Vestibuli --> Scala Tympani --> Basilar Membrane dilation

80

Brown pigment stones typically arise secondary to

Infection of the biliary tract --> Releases B-Glucoronidase --> Hydrolysis of bilirubin glucoronides --> incr amount of unconjugated bilirubin in bile

81

7a-Hydroxylase function

Convert cholesterol to bile acids (sufficient activity reduces likelihood of cholesterol stone formation)

82

Important to metabolism/levels of digoxin

Renal clearance mostly, Plasma protein binding and body mass somewhat; Not liver enzymes

83

Most common known viral cause of acute hemorrhagic cystitis in children (and males in particular)

Adenovirus (serotypes 11 and 21 of B subgroup)

84

Pathogenesis of Centriacinar Emphysema

Smoke --> Macrophages --> PMNs --> Proteases active, Antiproteases inactivated

85

Club/Clara cell function

Nonciliated, secretory cells in terminal respiratory epithelium --> Secrete protein, surfactant and help detoxify

86

Is S3 or S4 always pathologic in young patients

S4 always in younger, Not always in older

87

V/Q and Acid/Base consequences of PE

Redistribution of blood to unaffected --> V/Q mismatch --> Hypoxemia stimulates hyperventilation --> Respiratory Alkalosis

88

3 NNRTI's

Nevirapine, Efavirenz, Delavirdine

89

MOA of Enfuvirtide

Prevent fusion by binding gp41

90

Most concerning AE of NNRTI's

Hepatic Failure with Encephalopathy

91

Holoprosencephaly is associated with

Trisomy 13 and 18, Fetal Alcohol Syndrome

92

Deformation vs Malformation

Deformation occurs due to extrinsic mechanical force; Malformation is a primary defect in cells or tissues that form an organ

93

"Disruption"

Secondary breakdown of a previously normal tissue or structure

94

Aldolase function

A/B/C metabolize F-1,6-BP to G3P and DHAP; Aldose B also metabolizes F-1-P to Glyceraldehyde and DHAP

95

Tx Aldolase B deficiency by

Eliminating dietary fructose (sucrose)

96

Sucrose

Fructose + Glucose

97

Lactose

Galactose + Glucose

98

Maltose

Glucose + Glucose

99

For patients with stiff lungs, work of breathing is minimized when

RR is high, TV is low

100

For patients with high airflow resistance, work of breathing is minimized when

RR is low, TV is high

101

LPS/LOS cause sepsis by induction of systemic inflammatory response characterized by

TNFa, IL-1b, IL-6, IL-8 (much of which is formed after interaction with TLR-4)

102

Osteoporosis is defined as

Bone density >2.5 SD below mean for peak young adult bone density

103

Risk factors for Osteoporotic Fractures

White/Hispanic/Asian, Hx, Decr activity, Low body weight, Excessive alcohol or tobacco, Premature menopause

104

How do GC's incr bone loss

(1) Decr GI absorption of Ca, (2) Inhibit collagen synthesis, (3) Decr GnRH, (4) Incr urinary Ca loss

105

Side effects of Statins

Myotoxicity, Hepatotoxicity (discontinue if LFT's >3x normal)

106

CYP Inducers

Chronic Alcohol, St Johns wort, Phenytoin, Phenobarbital, Nevirapine, Rifampin, Griseofulvin, Carbamazepine

107

CYP substrates

Anti-epileptics, Theophylline, Warfarin, OCPs

108

CYP inhibitors

Acute Alcohol, Ritonavir, Amiodarone, Cimetidine, Ketoconazole, Sulfonamides, Isoniazid, Grapefruit, Quinidine, Macrolides (ex azithromycin)

109

Acanthosis

Incr thickness of stratum spinosum (psoriasis commonly associated with acanthosis)

110

Spongiosis

Intercellular epidermal edema --> incr space b/t cells (eg eczematous dermatitis)

111

Dyskeratosis

Premature keratinization of individual keratinocytes (eg SCC)

112

First line for isolated systolic HTN in non diabetics

Thiazides and DHP CCBs

113

HTN drug that can lead to flushing and peripheral edema

Amlodipine

114

First line for essential HTN in general public

HCTZ

115

Most frequent AE's w/ Verapamil

Constipation, Gingival hyperplasia

116

Drugs that cause Gingival Hyperplasia

Phenytoin, CCBs, Cyclosporine

117

MOA of Clomiphene

SERM that prevents negative feedback inhibition on hypothalamus (used in PCOS)

118

Diseases that cause myocardial fibrosis

Dermatomyositis, Muscular Dystrophy, Sarcoidosis, Scleroderma

119

Why doesnt Anti-HepC IgG confer immunity?

RNA polymerase errors --> Varied antigenic structure

120

AE's of Amphotericin B

Infusion reaction, Thrombophlebitis, Nephrotoxicity, HypoMg/HypoK, Anemia (suppressed EPO)

121

BH4 is a cofactor for synthesis of

Tyrosine, DOPA, Serotonin, Prolactin, NO

122

Cardiac morphology changes with aging

(1) Decr LV chamber size; (2) Sigmoid IV septum; (3) Incr interstitial CT; (4) Lipofuscin accumulation

123

Murmur of VSD

Loud holosystolic murmur over left sternal border 3-4 intercostal space (smaller = louder)

124

Phenylethanolamine N-methyltransferase

NE to Epi

125

Systemic sclerosis is thought to be due to activation of what cell type

CD4

126

A strict vegetarian diet can cause a deficiency of

B12

127

Free wall rupture occurs how long after MI

3-7 days

128

Triad of muffled heart sounds, elevated JVP, profound hypotension indicate

Pericardial Tamponade

129

How does GI bleed precipitate Hepatic Encephalopathy

Incr nitrogen delivery to gut in form of hemoglobin --> converted to ammonia and enters bloods stream

130

Molecules that act thru nuclear receptors

TH, Retinoids, PPAR, Fatty Acids

131

Spirochetes are universally sensitive to

Penicillin (gram nevative peptidoglycan cell wall)

132

Xeroderma Pigmentosa is defect in

DNA excision repair

133

DNA mismatch repair defect

Lynch syndrome

134

Why doesn't Ceftriaxone work on Chlamydia

Cell wall lacks peptidoglycan (Ureaplasma lacks cell wall alltogether)

135

Phentolamine MOA

Alpha 1 and 2 blocker (no BB effects)

136

Dose-dependent effects of Epinephrine

Increases systolic, Increases HR, and either increases or decreases diastolic dependending on dose (a1 at high, or B2 at low)

137

Kappa opioid receptors mediate

Miosis

138

Hexamethonium MOA

Potent nicotinic receptor antagonist

139

Defect in keratins 5 and 14

Epidermolysis Bullosa Simplex

140

Characteristic Triad of Ataxia Telangiectasia

Those + Incr risk of sinopulmonary infections (IgA deficiency)

141

ATM gene is responsible for

DNA break repair (hypersensitive to x ray radiation)

142

Why does lead cause hypochromic anemia

Inhibits mitochondrial iron transport

143

Bare Lymphocyte Syndrome

Absent MHC II --> T and B cell deficiency

144

Features of Lesch-Nyhan

Hyperuricemia, Gout, Pissed off, Retardation, dysTonia

145

AICA block

Facial droop means AICA's pooped

146

Process of Base Excision Repair

Abnormal Base --> Glycosylase removes --> Endonuclease and Lyase cleave 5 and 3' --> DNA polymerase and ligase

147

Pyrophosphate analog that doesn't require phosphorylation

Foscarnet

148

Properties of Type 1 muscle fibers

Slow = Aerobic, High myoglobin and mitochondria

149

Side chain cleavage enzyme in adrenals

Cholesterol --> Pregnenalone

150

Pulmonary Stretch Receptors

C fibers in lungs and airways that regulate degree of distension (Hering-Breuer reflex)

151

Infant with Air in bowel wall, Abdominal distension, and Bloody stools

Necrotizing Enterocolitis

152

N-acetylmuramic acid and N-acetylglucosamine

Saccharides that combine with AA chain to form peptidoglycan cell wall

153

Tay Sachs findings

Cherry Red Macula, Neurodegeneration, Developmental delay, Onion Skin Lysosomes, No HSM (vs Niemann-Pick)

154

Niemann-Pick findings

Cherry Red Macula, Neurodegeneration, Foam Cells, HSM

155

Important genes altered by PPARg

Adiponectin, FA transport, Insulin receptor, Glut-4

156

DOC for Complex Partial Seizures

Carbamazepine

157

PTH effects on bone cells

Incr RANKL and M-CSF production by osteoblasts; Decr OPG

158

MOA of Pergolide

D2 agonist

159

Isoniazid vitamin deficiency

B6 --> Peripheral neuropathy (GABA def)

160

4 phases of lobar pneumonia

Congestions (first 24hr) --> Red Hepatization (2-3d) --> Gray Hepatization (4-6d) --> Resolution

161

Microscopic appearance in Congestion --> Red --> Gray Hepatization

Vascular Dilatation, Mostly bacteria --> RBCs, PMNs, Fibrin --> Disintegrated RBCs, PMNs and Fibrin

162

MTB virulence factor allowing for intracellular proliferation

Sulfatide

163

Soft Exudate

Grayish-white, cotton wool - due to microinfarct

164

Hard Exudate

Clear margins - due to leakage of protein

165

Absolute vs Relative Erythrocytosis

Red Cell Mass increased in Absoluate

166

Ureters lie antermedial to what structures in true pelvis

Internal Iliac

167

Death due to TCA toxicity

Cardiac Fast Na channel block --> Arrhythmia, Cardiogenic Shock

168

TCA's also block

mAChR, alpha1, Cardiac Fast Na, H1; NE and 5-HT reuptake

169

Common precursor of Beta-Endorphin and ACTH

POMC (also yields MSH)

170

Gastroeneteritis with intestinal invasion

Salmonella, Shigella, EIEC, Campylobacter, Entamoeba histolytica

171

Stacked-brick intestinal adhesion

EAEC

172

Characteristic histologic findings in GERD

Basal zone hyperplasia, Elongation of lamina propria, Inflammatory cells (eo's, Pmn's, lymph's)

173

First gen anti-histamines

Dim First Gen History Professors Dip Cope - Dimenhydrinate, Hydroxyzine, Promethazine, Diphenhydramine, Chlorpheniramine

174

Second gen anti-histamines

Second Gen History Certainly want tadine - Cetirizine, -adine

175

Bisphosphonates should be used carefully in patients with

Renal failure - Excreted unchanged

176

Common robertsonian translocations

14;21 and 21;22

177

Most susceptible parts of kidney to hypoxia

PCT, Thick Ascending Limb

178

Prophylaxis of cerebral vascular spasm following SAH

Nimodipine

179

Two types of pneumococcus vaccine

(23) Polysaccharide = B cell response = Less effective; (17) Polysaccharide conjugated to diph toxin = T cell response = better

180

Killed Vaccines

RIP Always = Rabies, Influenza, Polio, Hep A

181

3 adverse effects of all Protease Inhibitors

(1) Lipodystrophy; (2) Hyperglycemia; (3) P450 inhibition

182

What to use instead of rifampin for patients with mycobacterial infection in patients on protease inhibitors

Rifabutin

183

3 important mitochondrial syndromes

(1) Leber Hereditary Optic Neuropathy; (2) Myoclonic Epilepsy w/ Ragged-Red Fibers; (3) MELAS

184

Aortic Arch Derivatives

3 = Common/Internal Carotid; 4 = Aortic Arch, R Subclavian; 6 = Pulmonary Arters, Ductus Arteriosis

185

5 Dehydrogenase Cofactors

B1, B2 (FAD), B3 (NAD), B5 (CoA), Lipoid Acid

186

Prevention of neonatal tetanus

Vaccinate mom --> Placental transfer of IgG

187

Conversion of Pyruvate to PEP requires what 2 enzymes

Pyruvate Carboxylase, PEPCK

188

How can mitochondrial OAA be transported to cytosol

(1) Conversion to PEP; (2) Transamination to Aspartate; (3) Reduction to Malate

189

What step of CAC is GTP produced in?

Succinyl CoA to Succinate

190

Anti-arrhythmic specific for ischemic myocardium

Ischemic = Depolarized --> Lidocaine

191

What has currently replaced lidocaine for ventricular tachycardia

Amiodarone

192

Procainamide is more specific for arrhythmias arising from

Centers of normal automaticity

193

Prolonged administration of Verapamil pts with V Tach can

Lead to V fib and death --> Distinguish between Supraventricular and Ventricular Tach

194

Adenosine is used for

Acute treatment of Paroxysmal Supraventricular Tachycardia

195

Gene in PAH

BMPR2

196

Hypophosphorylated Rb prevents

G1 --> S (Hypophosphorylated = Active)

197

Colloid Cyst

Benign formation in third ventricle --> Lethal obstruction

198

Reticulin deposits and chronic inflammatory infiltrates in brain tumor

Xanthoastrocytoma

199

Activated Protein C inhibits

Factors Va and VIIIa

200

Aside from gas gangrene, C perf can cause

Late-onset food poisoining --> Transient watery diarrhea

201

X linked recessive disorders

Bruton, Wiskott, Fabry, G6PD, Ocular Albinism, Lesch-Nyhan, DMD, Hunter Syndrome, Hemphophilia, OTC Def

202

Autosomal Dominant disorders

HHT, Fam Hyperchol, FAP, MEN, NF1/2, Marfans, Her Spher, Achondroplasia, Huntingtons, Li-Fraumeni, BRCA1/2, Polycystic, Tuberous Sclerosis, vHL

203

HIV gene that is glycosylated and cleaved

ENV --> Gp140 --> Gp120 and Gp41

204

How does blood from Bronchial Arteries return

Majority to left heart in deoxy form via pulmonary veins (admixture); Some to right heart via azygous, acessory hemiazygous, or intercostal veins

205

Afferent fibers from Carotid and Aortic baroreceptors terminate in

Solitary nucleus of medulla

206

Histology of Psoriasis

Hyperparakeratosis, Acanthosis, Elongation of Rete Ridges, Mitotic activity above epidermal basal layer, Reduced or absent stratum granulosum

207

Munro microabscesses

PMNs form spongiotic clusters in superficial dermis and parakeratotic stratum corneum in Psoriasis

208

Advantage of proline in collagen

Kink the polypeptide chain and enhance rigidity b/c of their ring configuration

209

What happens to procollage once secreted

Cleaved C and N terminals --> Solubility decreases --> Collage fibrils --> Lysil Oxidase crosslinking

210

Alkaptonuria is a defect in what pathway

Tyrosine to Fumarate

211

What causes nipple inversion with breast cancer

Invades central region

212

What causes skin retraction in breast cancer

Infiltration of Cooper ligaments

213

Alternative to SSRI when sexual side effects occur

Bupropion

214

Xanthoma vs Xanthelasma

Xanthoma is surrounded by inflammatory cells and fibrotic stroma, Xanthelasma not

215

Ergonavine MOA

Constricts SM by stimulating both alpha adrenergic and 5-HT receptors

216

Phentolamine MOA

a1 and a2 blocker

217

In what part of bone is hematogenous osteomyelitis most likely

Diaphysis

218

Hyper IgM syndrome results from

Absence of CD40L on t cells or Genetic deficiency in isotype switching enzyme

219

Hyper IgM manifestations

Recurrent sinopulmonary infections; Lymphoic hyperplasia

220

IgA class switching is induced by

TGF-beta

221

Specific marker of mast cell activation

Tryptase (released in degranulation)

222

Antimicrobials that block ENaChannels

Trimethoprim, Pentamadine

223

Why is serum Na normal in Mineralocorticoid Excess

Aldosterone Escape via ANP --> Prevents edema and Na increase

224

Contraction alkalosis

Reabsorption of HCO3-

225

Where does uric acid precipitate in tubules

Low pH of Distal Tubules and Collecting Ducts

226

Penicillinase-stable penicillins

Nafcillin, Oxacillin, Methicillin

227

Prognosis of Capillary Hemangioma

Initially progress, eventually regress

228

Histology in De Quervain's Thyroiditis

Mixed, cellular infiltrate with multinucleated giant cells

229

Opsoclonus-Myoclonus syndrome

Neuroblastoma

230

Why not use TCA with BPH?

Anti-Cholinergic --> retention

231

Why not use TCA with Orthostatic Hypotension?

Antagonizes alpha 1 peripherally

232

Causes of Hypercalciuria

Mainly Idiopathic; Also Hyperoxaluria, Hyperuricosuira, Low urinary volume, Hypocitratruria

233

Causes of Hyperoxalouria

Diet (chocolate, nuts, spinach; Low calcium diet (more oxalate absorbed)

234

Main radiographic finding in Mesothelioma

Nodular or smooth pleural thickening

235

Gold standard for Mesothelioma diagnosis

EM = Numerous long, slender microvilli with abundant tonofilaments (adenocarcinoma has short, plump microvilli)

236

Bronchioalveolar carcinoma has a characteristic

Distribution along alveolar septa w/out vascular or lymphatic spread

237

Gemcitabine vs Cytarabine

Both pyrimidine analogs, but Gemcitabine is not S phase specific, likely due to additional cytotoxic functions (eg inhibition of ribonucleotide reductase)

238

Methotrexate vs 5-FU

Both inhibit thymidalate formation, but only MTX overcome by Folinic Acid supplementation

239

Gottron papules and heliotrope rash

Dermatomyositis

240

Antidote for Cyanide (nitroprusside) toxicity

Sulfur (Sodium Thiosulfate) = Donates sulfur to liver rhodanase to enhance conversion of cyanide to thiocyanate

241

Microangiopathic hemolytic anemia

Small vessels = DIC, TTP, HUS

242

Triggers of G6PD

Bactrim, Dapsone, Antimalarials, Nitrofurantoin, Fava Beans

243

What is low in G6PD deficiency

NADPH

244

Cause of Lipofuscin

Free radical injury and lipid peroxidation

245

Most common location of supine aspiration

Right Lower Lobe

246

What underlies most cases of Hereditary Hypothalamic Diabetes Insipidus

Neurophysin II mutations

247

SPINK1

Trypsin inhibitor secreated by pancreatic acinar cells

248

Germ tubes when incubated at 37 degrees

Candida --> True Hyphae

249

Hep B replication

dsDNA --> Template +RNA --> dsDNA

250

Fate of tRNA that is mischarged

Will incorporate wrong AA into polypeptide chain (not corrected when charged by AA-tRNA synthetase proofreading)

251

MOA of mushroom toxins

Inhibit DNA-dependent RNA polymerase Type II = mRNA

252

RNA polymerase I vs II vs III

I = rRNA; II = mRNA; III = tRNA

253

MOA of Ricin

Cleaves rRNA component of 60S subunit

254

Resistance to Ethambutol

Increase production of Arabinosyl Transferase

255

Resistance to Streptomycin

Modification of 30S protein structure

256

Resistance to Pyrazinamide

Modify Pyrazinamidase, which must activate Pyrazinamide

257

MOA of Bosentan

Endothelin-receptor antagonist

258

Neutrophil Alk Phos

Elevated in Leukemoid reaction, Decr in CML

259

Acute Leukemia blast percentage

Greater than 20%

260

Eyelid manifestation of Primary Biliary Cirrhosis

Xanthelasma

261

Primary acceptor of amino groups during breakdown of other Amino Acids

Glutamate

262

Glycine + Methylene Group

Serine

263

What type of colonic adenoma can secrete mucus

Villous

264

Perfusion defect anatomically matched by ventilation defect

Collapsed lung

265

First test for PE

CT angiography

266

First line treatment for open angle glaucoma

Prostaglandins

267

Muscle responsible for accomodation? control?

Ciliary muscle - solely under cholinergic (m3) control

268

Treatment of Restless Leg Syndrome

(1) Limit alcohol, nicotine, caffeine; (2) Dopamine Agonists (eg pramipexole)

269

Restless Leg is common in those with

Iron Deficiency, CKD, Diabetes

270

Treatment of Cataplexy

Muscarinic Antagonists (narcolepsy)

271

When does the neural tube form

Third week of fetal life

272

When do the neuropores close

Week Four = Anterior on day 25, Posterior on day 27

273

Tensilon Test

Tx of MG pt with Edrophonium (short acting AChEsterase inhibitor); Lack of improvement = cholinergic crisis

274

What mediates rapid decrease in myocardial calcium before relaxation

Na/Ca pump sarcolemmal pump; and Ca-ATPase

275

Major immune mechanism against Giardia

CD4 and IgA

276

RUQ pain after opiate

Biliary colic from contraction of SM cells in sphincter of oddi

277

Mu opioid effects on Histamine, Parietal Cells

Increase histamine (don't use in hypotension); Decr parietal gastric acid secretion

278

Non-caseating granulomas - Crohn's or Ulcerative colitis

Crohn's

279

Unidirectional enzymes in glycolysis

Gluco/Hexokinase, PFK-1, Pyruvate Kinase

280

F-2,6-BP activates what?

PFK1 = Glycolysis

281

Insulin vs Glucagon effects on PFK1

Insulin --> PFK2 --> F-2,6-BP --> PFK-1 = Glycolysis; Glucagon inactivates PFK-2 via phosphorylation

282

What causes myocardial swelling with ischemia?

No ATP to pump Na (Na/K) or Ca (Ca-ATPase) out

283

Mechanism of nitrites in cyanide poisoning

Oxidized iron to Fe3+, which binds and sequesters cyanide, preventing it from binding cytochrome a-a3

284

What is used beside nitrites in cyanide poisoining

Thiosulfate --> Sulfate binds cyanide

285

Most common cause of aPTT prolongation

Lupus anticoagulants

286

Common findings in PCA stroke

(1) Contralateral hemianopia; (2) Contralateral parasthesias and numbness [thalamus]

287

Cranial Nerves supplied by PCA

III and IV

288

Why gallstones in Crohn's

Can't resorb bile acids in terminal ileum

289

Rate limiting step in catecholamine synthesis? What blocks this?

Tyrosine Hydroxylase - Metyrosine

290

What maintains cardiac output in acute/subacute aortic regurgitation

HR temporarily, but mainly increased LV preload

291

Carbamazepine adverse effects

(1) BM suppression; (2) Hepatotoxic; (3) SIADH

292

Drugs that cause SIADH

Carbamazepine, Cyclophosphamide, SSRI's

293

Allergic contact dermatitis is due to

Antigen presentation by Langerhans cell --> CD4 response

294

Acanthosis

Incr in spinosum (think psoriasis)

295

Hypergranulosis

Excessive granulation of s granulosum (think lichen planus)

296

Max and min pressures in RV, Pulmonary Artery

4-25 in RV; 9-25 in PA

297

Treatment of PSGN

Loop diuretics and Vasodilators to relieve edema and hypertension

298

Most important prognostic indicator in PSGN

Age

299

Osteoporosis tends to affect what bone

Trabecular - Vertebral bodies, Neck of femure

300

what is characteristic of hyperparathyroidism

Subperiosteal resorption with cystic degeneration

301

Vit D bone loss is characterized by

Excessive unmineralized osteoid

302

Osteopetrosis is characterized by

Persistance of primary, unmineralized spongiosa in medullary canals

303

Drugs that cause seizures

I BItE my tongue - INH, Buproprion, Imipenem, Enflurane

304

Most common sites of intracranial hemorrhage

Deep brain = Basal ganglia, Cerebellar nuclei, Thalamus, Pons

305

Cerebral amyloid angiopathy tends to occur in what areas

Lobar/cortical parenchyma

306

Findings with Pulmonary Silicosis

Nodular densities and eggshell calcifications

307

Pulmonar berylliosis findings

Resembles sarcoidosis (nodular infiltrates, enlarged lymph nodes, non-caseating granulomas), but is not strongly associated with pleural plaques or effusions

308

Findings in coal worker's pneumoconiosis

Multiple discrete nodules most prominent in upper lung zones

309

X ray of hypersensitivity pneumonitis due to inhalation of organic dust

Diffuse nodular interstitial infiltrates

310

Granulomatous destruction of liver bile ducts

Primary biliary cirrhosis

311

Intrahepatic hydatid cysts

Echinococcus

312

Mechanism of gingival hyperplasia with phenytoin

PDGF

313

Phenytoin toxicity mainly effects

Cerebellum and vestibular system --> Ataxia, Nystagmus

314

Systolic ejection murmur that increases with standing? Decreases with standing?

Hypertrophic CM - increases; Valvular aortic stenosis - decreases

315

Wide splitting of S1 accentuated by inspiration

Delayed closure of tricuspid = Complete right bundle branch block or tricuspid stenosis

316

Carboxylation of glutamate residues

Vitamin K

317

Erythropoeisis and peripheral blood smeal in Acute Intermittent Porphyria

Erythropoeisis and peripheral blood smear normal

318

Opiates used for diarrhea

Loperamide, Diphenoxylate

319

Pathogens most responsible for post-flu pneumonia

Pneumococcus, S aureus, H flu

320

Mycobacterium kanasaii symptoms

Pulmonary tuberculosis-like symptoms

321

High intracellular NADH in setting of hypoglycemia

Fuel other than glucose is being metabolized

322

High NADH/NAD+ ratio

Pyruvate to lactate and OAA to malate => Inhibits gluconeogenesis

323

What antibody is rarely seen in drug-induced Lupus

Anti-dsDNA (look for anti-histone)

324

Range for microalbuminuria

30-300 ug/mg creatinine

325

MOA of Adenosine in Supraventricular Tachy

Slows conduction thru AV node by hyperpolarizing the nodal pacemaker and conducting cells

326

All inhalational anesthetics, except what, are respiratory depressants

NO

327

Inhalational anesthetics preferred in pts with asthma

Halothane, Sevofluorane - Bronchodilation properties

328

Inhalational anesthetic effects on hepatic, renal, and cerebral BF

Decr hepatic; Incr cerebral; Decr GFR and RPF

329

Main side effects of bile acid binding resins

HyperTG (incr VLDL and TG synthesis), GI upset, Malabsorption, Gallstones

330

First line treatment of hypertriglyceridemia

Fibrates - decr hepatic synthesis

331

Clinical manifestations of schistosomiasis result from

Th2-mediated granulomatous response directed against eggs (with eos and mac's)

332

Periportal Pipestem Fibrosis

Hepatic schistosomiasis

333

Echinococcus reservoir

Dog

334

Diphyllobothrium latum comes from

Freshwater fish

335

2,3-BPG only binds to

Deoxyhemoglobin

336

Why doesn't HbF bind 2,3-BPG as well

Serine residues instead of histidine

337

HbC

Glutamic acid --> Lysine = Mild, chronic hemolytic anemia

338

Directly responsible for intimal thickening in athersclerosis

Smooth muscle cells (NOT FIBROBLASTS)

339

Treatment with Menotropin and hCG

Menotropin is human menopausal gonadotropin and acts like FSH; hCG acts like LH surge

340

Hepatolenticular degeneration

(GP and Putamen) Wilson's disease --> Wing-beating tremor, Psychosis

341

Burning or stabbing sensation in one half of body

Thalamic syndrome

342

Mechanism of Dermatitis Herpetiformis

Cross reaction of anti-Gliadin ab's with Reticulin in epidermal basement membrane

343

Cerebral amyloid angiopathy vs hypertensive hemorrhage

Lower mortality rate, More benign clinical course than hypertensive hemorrhage

344

Hematuria and proteinuria in subacute BE

Immune complex deposition

345

Bacteriostatic antibiotic that inhibits binding of aminoacyl-tRNA to 30S subunit

Tetracyclines

346

What is upregulated after statins lower total serum cholesterol

LDL receptor

347

LCAT vs CETP

LCAT catalyzes esterification of cholesterol (nascent HDL to mature HDL); CETP transfers cholesterol to other lipoprotein particles

348

Endocrine hormones that increase cAMP

FLAT ChAMP CGC - FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH, Calcitonin, GHRH, Glucagon

349

Hormones that increase cGMP

ANP, BNP, NO (EDRF)

350

Endocrine Hormones that increase IP3

GOAT HAG - GnRH, Oxytocin, ADH (V1), TRH, H1, AgII, Gastrin

351

Intrinstic tyrosine kinase receptors

Insulin, IGF-1, FGF, PDGF, EGF

352

Receptor-associated tyrosin kinase

PIGGLET - Prolactin, Immunomodulators (Cytokines, IFN), GH, G-CSF, EPO, Thrombopoetin - Acidophils and Cytokins

353

Resistant to Ampicillin but sensitive to Ceftriaxone

Beta-Lactamase production

354

Meniere's disease

Triad of vertigo, sensorineural hearing loss, tinnitus --> Incr production and/or decr excretion of endolymph

355

Blastomycosis on chest x ray

Mimics TB --> Granulomatous nodules

356

Systolic ejectin in aortic stenosis

Decr, because it takes longer for valve to open

357

Most common cause of pyridoxine deficiency

INH

358

First line for malignant otitis externa

Fluoroquinolone

359

Renal and lungs masses --> Improvement after removing renal mass

RCC --> Tx with IL_2

360

Central Venous Pressure and what tend to correlated

Pulmonary capillary wedge (at least in septic shock?)

361

Normal CVP and PCWP

CVP 2-8; PCWP 2-15

362

Effects of Ia, b, and c on AP conduction conduction velocity

Ia slows, Ib no effect, Ic slows

363

Effects of Ia, b, and c on AP duration

Ia prolongs, Ib shortens, Ic minimal effect

364

Predominant actions of Class II antiarrhythmics

Slow sinus node discharge rate, Slow AV node conduction and prolong refractoriness

365

Predominant effects of Class III antiarrhythmics

Prolong AP duration; No effect on conduction velocity

366

Predominant effects of Class IV antiarrhythmics

Slow sinus node discharge rate; Slow AV node conduction and prolong refractoriness

367

MOA of Adenosine

A1 receptors --> Activates K channels --> incr K conductance --> transient conduction delay thru AV node

368

Digoxin effects on AP duration and QT interval

Decr APD, Shorten QT interval

369

C3a stimulates

Histamine release --> Permeability, Dilation

370

Platelet Activating Factor causes

Platelet agg, Vasoconstriction, Bronchoconstriction, Incr leukocyte adhesion to endothelium

371

Hyperplastic polyps are composed of

Well-differentiated mucosal cells that form glands and crypts

372

Hamartomatous polyps are composed of

Mucosal glands, Smooth muscle, CT

373

Inflammatory polyps are seen in

UC, Crohn's --> Regenerating intsetinal mucosa

374

Lymphoid polyps are found in

children

375

4 Non-neoplastic polys

Hyperplastic, Hamartomatous, Inflammatory, Lymphoid

376

Symptoms of Diffuse Esophageal Spasm

Dysphagia and Chest pain

377

Phosphoglucomutase

Glucose 1 6 phosphate

378

Carnitine deficiency

Impairs FA transport into mitochondria, restricting ketone body formation

379

Skeletal Muscle Carnitine def symptoms

Myoglobinemia, Weakness after exercise, Elevated muscle TG's, Hypoketonemia

380

Medium Chain Acyl-CoA DH deficiency

Hypglycemia, Hypoketonemia

381

Tryptophan is a precursor for

Nicotinic Acid, Serotonin, Melatonin

382

Clinical manifestations of Hartnup disease are primarily due to

Tryptophan malabsorption --> Niacin deficiency

383

Symptoms of Hartnup

Most children asymptomatic --> Can have pellagra-like rashes, photosensitivity, ataxia

384

Urinary excretion of what AA's is normal in Hartnup

Proline, Hydroxyproline, Arginine

385

Thiamine use by the body is maximal in states of

Accelerated carb metabolism

386

Pyridoxine def results in

Anemia, Peripheral neuropathy, Dermatitis

387

Tocopherol deficiency

Vitamin E = Myelopathy and neuro

388

How do Listeria and Shigella survive intracellularly

Escape from phagosome into cytosol

389

How does MTB survive intracellularly

Blocks fusion of phagosome with lysosome, Inhibits phagolysosome acidification

390

Immune response to Listeria

IFNg, TNFb, IL-12 --> Cell mediated response --> macrophage killing

391

Gram negative rod that grows at 4 degrees

Listeria

392

Uricosuric drugs

Probenecid, Sulfinpyrazone

393

Xanthine oxidase inhibitor safer than allopurinol

Febuxostat

394

Most common manifestation of CMV in HIV

Retinitis

395

Epispadias results from

Faulty positioning of genital tubercle in fifth week of gestation

396

Virus that aquires lipid envelope form nucleus

Herpes family

397

Blockade of what receptor inhibits gluconeogenesis, glycogenolysis, and lipolysis

B2

398

Main effect of nitrates in treating angina

Reduce preload --> reduce LV volume

399

Herniation causing CN III neuropathy

Uncal

400

Most common cause of Abetalipoproteinemia

LOF mutation in Microsomal TG Transfer Protein (MTP) --> Normally folds apoB and transfers lipids into chylomicros or VLDL

401

Polyol pathway impairment occurs in tissues that

Do not rely on insulin for glucose transport (lens, peripheral nerves, kidney, blood vessels)

402

Elevated galactitol

Galactosemia --> Cataracts

403

Cross linking of proteins by glycosylation products in vessels facilitates

Inflammatory cell invasion, Deposition of LDL --> Atheroscerlosis

404

Skeletal findings in hyperparathyroidism

Cortical (compact) bone in appedicular skeletal --> Subperiosteal erosions, Salt-and-pepper skull, Osteolytic cysts (osteitis fibrosa cystica)

405

Disorganized lamellar bone structure in mosaic pattern

Paget's

406

Osteoid matrix accumulation around trabeculae

Vit D deficiency - Excessive unmineralized osteoid with widened osteoid seams

407

Persistence of primary spongiosa in medullary cavity with no mature trabeculae

Osteopetrosis --> Accumulation of woven bone, diffuse skeletal thickening

408

Trabecular thinning with fewer interconnections

Osteoporosis

409

How do erythrocytes utilize NADPH

Maintain Glutathione in reduced state by glutathione reductase

410

What is a Heinz body

Denatured Hb from oxidative stress

411

As opposed to serotonin syndrome, NMS is characterized by

Absence of myoclonus and presence of rigidity

412

Keratoderma blennorhagicum commonly associated with

Reactive Arthritis

413

Mechanism of Pertussis toxin

Disinhibits AC via Gi ADP ribosylation --> incr cAMP --> Incr histamine sensitivity and phagocyte dysfunction

414

Direct tissue effects of GH

(1) Insulin resistance; (2) Fat utilization; (3) Protein synthesis

415

Indirect tissue effects of GH

IGF-1 by liver --> Growth of bone, cartilage, soft tissue

416

GH vs IGF-1 receptor

GH is JAK-STAT; IGF-1 is specific receptor TK

417

Main sites of digestion and absorption of dietary lipids

Duodenum --> Jejunum

418

How does diet affect calcium stones

Low calcium diet actually increases risk; High protein and Na diet increases risk

419

What is recommended for patients with calcium stones who have hyperoxaluria

Pyridoxine --> Decreases endogenous oxalate production

420

Vitelline vs Cardinal veins

Vitelline form portal; Cardinal form caval

421

PG's that mediate protection of gastric mucosa

PGI2 and PGE2

422

Salicylism

Vertigo, Tinnitus, Hearing loss

423

Classic Legionnaires presentation

Very high fever in smoker + diarrhea, confusion, cough

424

Coccidiomycosis in immunocompetent

Usually asymptomatic

425

Conversion of NE to Epi occurs where? Stimulated by?

Adrenal medulla by PNMT - Stimulated by Cortisol (incr PMNT gene expression)

426

COMT converts epi and NE to

Metanephrine and Normetanephrine

427

SGLT2 inhibitors

Canagliflozin, Dapaglifozin

428

AE's of SGLT2 inhibitors

Urinary tract and Genital mycotic infections; Symptomatic hypotension

429

What should be assessed before starting SGLT2 inhibitors

Renal function

430

Which anti-diabetic requires LFT's

Thiaxolidinediones

431

Soft, breathy voice =

Vocal cord dysfunction

432

Acid-base abnormality in ATN

Retention of H and anions --> high anion gap metabolic acidosis

433

Recovery phase of ATN

Profuse diuresis, HypoK/Mg/PO4/Ca

434

Triptan MOA

5-HT 1b/d agonists --> Inhibit vasoactive peptides, promote vasoconstriction, block pain pathways

435

Bupropion MOA

DA, NE reuptake inhibitor

436

Migraine prophylaxis

TCAs, SNRI's, BB's, Valproate, Topiramate

437

What cholesterol meds increase bile acid synthesis

Binding resins; Fibrates

438

First and second line treatment of AF with RVR

CCBs/BB's, then Digoxin

439

Delayed afterdepolarizations

Occur in states of hyperexcitability (eg high intracellular Ca or high catecholamine states) - How digoxin can lead to Vtach

440

Signs of Uncal (transtentorial) herniation

CNIII, Contralateral or ipsilateral hemiparesis (crus cerebri), Contralateral homonymous hemianopsia with macular sparing (PCA)

441

Subfalcine herniation sign

ACA compression

442

Duret hemorrhage

Caudal displacement of brainstem --> Rupture of paramedian basilar artery branches --> Duret

443

Ingestion of what can cause myxomatous degeneration

Sweet peas --> Angiolathyrism

444

Incr murmur in HOCM

Decrease preload or afterload --> Decr LVEDV and increase outflow obstruction

445

Bile salt deconjugation

Colonic bacteria in small intestine --> Steatorrhea due to failure of miscelle formation

446

Final product of FA oxidation that enters CAC

Succinyl CoA (from methlymalonyl CoA)

447

Lab findings in SLE

Hemolytic anemia, Thrombocytopenia, Leukopenia, Hypocomplementemia

448

Cause of anemia and thrombocytopenia in SLE

Type II hypersensitivity

449

Fibrous intimal thickening with endocardial plaques limited to right heart

Carcinoid heart disease --> Pulmonic stenosis, Restrictive cardiomyopathy

450

How to grow H flu in sheeps blood agar

S aureus --> X factor released by hemolysis, V factor secreted by s aureus

451

Fat embolism syndrome is characterized by

pulmonary insufficiency, diffuse neuro impairment, thrombocytopenia, anemia

452

46 XY with normal Leydig cells but total absence of Sertoli

Male external genitalia (DHT); Both Female and Male internal genitalia (need Sertoli to produce MIF)

453

Treatment of pinworm (Enterobius)

Albendazole

454

Diethylcarbamazine is used to treat

Loa Loa, Wuchereria bancrofti

455

Ivermectin is used to treat

Strongyloides, Onchocerciasis

456

Nifurtimox is used to treat

Trypanosomes, including Chagas

457

Praziquantel is used to treat

Schistosoma, Clonorchis, Tenia, Diphyllobothrium - Praise the SC TD

458

Don't use colchicine in

Pregnancy, Renal dysfunction

459

Glucocorticoids inhibit what step of PG synthesis

LPA2

460

Preferred treatment of acute gouty arthritis in elderly or renal failure

Glucocorticoids

461

Specific inhibitor of 5-lipoxygenase

Zileuton --> Inhibits LTB4, C4, D4, E4

462

Monteleukast MOA

LTD4 receptors

463

Stimulation of B1 receptors in heart causes what 3 effects:

(1) + Inotropy; (2) Weak + chronotropy; (3) Incr conduction velocity

464

FGF contributions

Angiogenesis, Embryonic development, Hematopoeisis, Wound repair

465

Incr LV diastolic pressure in paitent with suspect Mitral Stenosis

Aortic valve also dysfunctional

466

Mechanism of Ciguatoxin and Batrachotoxin

Binds Na channel, keeping it open --> persistent depolarization

467

Toxin that acts similarly to Tetrodotoxin

Saxitoxin

468

What increases solubility of cysteine

High pH - So risk of cystine stone with low pH

469

Cystine shares transporter with

Ornithine, Arginine, Lysine

470

OTC deficiency symptoms

Hyperammonemia, Mental retardation

471

Daptomycin is not effective in treating

Gram negatives; Pneumonia (surfactant)

472

Terbinafine MOA

Squalene Epoxidase

473

Effectiveness of Unfractionated Heparin vs LMWH

Unfractionated has equal activity against Factor Xa and Thrombin; LMWH has greater activity against Factor Xa than thrombin

474

How to separate Gamma hemolytic Strep's

Enterococci is PYR+, Grows in bile and NaCl; Bovis is PYR-, grows in bile but not NaCl

475

How to separate Alpha hemolytic Strep

Viridans is Optochin resistant and Bile insoluble

476

Effect of TNFa on Insulin receptor

Phosphorylates serine residues of Insulin Receptor Substrate 1 --> Decr activity

477

Phosphorylation of serine residues of Insulin Receptor Substrate 1

TNFa, Catecholamins, Glucocorticoids, Glucagon --> Insulin resistance

478

Papillary Thyroid cancer histology

Large cells w/ overlapping nuclei, Finely dispersed chromatin, Ground glass appearance = Orphan Annie

479

Benign follicular thyroid adenoma vs carcinoma

Invasion of vessels or capsule

480

Corneal reflex pathway

Nasociliary V1 --> Temporal branch of VII

481

Contents of Superior Orbital Fissue

CN III, V1 branches, CNIV, CNVI, Superior Ophthalmic veins

482

Bleeding in CKD patient

Uremic toxins --> Impair platelet aggregation

483

HIV Bloody diarrhea - Hemorrhagic polypoidal lesions, Spindle cells with surrounding blood vessel proliferation

Kaposi sarcoma

484

Chronic rejection of lung transplant

Small airways --> Bronchiolitis obliterans

485

Most common cause of elevated AFP

Dating error - Confirm with fetal US

486

Decreased Estriol on Triple Test

Placental insufficiency

487

Retrolental fibroplasia

Retinopathy of prematurity - Neovascularization from hypoxia and oxygen therapy

488

Serum added to mixture of cardiolipin, lecithin, cholesterol

Rapid Plasma Reagin test

489

7a hydroxylase

Cholesterol --> Bile Salts

490

Tholase

Condenses two equivalents of Acetyl-CoA to form Acetoacetyl-CoA --> Substrate for HMG CoA Reductase

491

Extremely high hCG may cause

Hyperemesis gravidarum, Pre-eclampsia, Hyperthyroidism, Theca-lutein cysts

492

Drugs that increase Lithium levels

Thiazides (not loops), ACEi's, NSAIDs

493

Lithium reabsorption in kidney is linked to

Na reabsorption

494

Major AA responsible for transferring nitrogen to liver for disposal

Alanine

495

Hepatic tumor that can regress after OCT discontinuation

Hepatic Adenoma

496

Most common benign liver tumor

Cavernous Hemangioma