What does this picture show? In what disease, do you famously see this?
Reactive CD8 T cell Lymphocytes; EBV
Female Internal Structures: Tubes Uterus Cervix, 1/3 of vagina
How do you calculate Relative Risk?
Incidence of the exposed/Incidence of unexposed
ECG shows HR 120 beats/min, irregular rhythm, narrow QRS complexes and no P waves. What is the problem?
Acyclovir MOA? EBV/CMV vs HSV/VZV?
MOA: Guanosine analog that is activated into active triphosphate form via Thymidine kinase
In HSV and VZV, this kinase is produced but in EBV and CMV=>it is not produced
Class switching for IgE and IgD
Why is there only a modest increase in BP when a patient exercises?
vasodilation within muscles
In an eukaryotic cell, if there is a DNA molecules that resemble bacterial chromosomes, you should think it is from?
Hyperphagia and obesity, what nucleus?
How would PO2, % saturation, and O2 content change with anemia, CO poisoning and polycythemia?
Anemia: PO2 and % saturation=Normal; O2 content=decreased
Polycythemia: PO2 and % saturation=Normal; O2 content=increased
CO Poisioning: PO2=Normal; % saturation and O2 content decreased
Patient has ABG of pH 7.59, pCO2 49 mmHg, and pO2 85? What kind of an acid base disorder does this patient have? What is the next best test of choice?
Metabolic Alkalosis, Check Urine chloride
A Patient has flushing, purple vascular lesions, watery diarrhea, bronchospasm w/abdominal tumor in the small intestine. Elevated Urine 5 HIAA. What is the Dx? and Tx?
Metastatic Carcinoid Tumor
Tx: Octreotide-Somatostatin Analog
Mortality Cancer in US for men and women?
MC inherited hypercoagulable (thrombophilic) disease?
Factor Leiden V
1 week old boy is vomiting and poorly feeding. The boy is dehydrated. Na+ 122 mEq/L. What is the mostly likely Dx?
Congenital Adrenal hyperlasia
MC Congenital Adrenal Hyperplasia? What symptoms do you see in this disease?
21 hydroxylase def.=>Latter number=1=>increase in androgen synthesis
Cortisol, aldosterone synthesis decreased
17 progesterone elevated
serum ACTH elevated
What do you see in a patient with 17 hydroxylase def.?
Normal Kids with severe HTN.
In a female patient with 21 hydroxylase def., what do you see?
Glucagon MOA in myocytes?
Increased cAMP and increased Ca2+ in cardiac myocytes
What will you see in the lumbar puncture of a patient with Cryptococcus? TOC for acute and long term?
Low Glucose, and increased protein, usually grown on sabouraud agar
TOC acute: amphotericin B
Long Term: Azole
Hypoxathine is converted to Uric Acid by? What drug inhibits this?
Xanthine Oxidase; Allopurinol
Long Term Drugs for Gout?
Uricosuric agents: Probenicid or sulfinpyrazone
Xanthine Oxidase Inhibitors: Allopurinol
Probenecid MOA? Use? AE?
MOA: inhibits reabsorption uric acid in the proximal convoluted tubules
Use: Chronic Gout in patients with good renal function
AE: Uric Acid Stones (Caliculi)
Allopurinol MOA? Use?
MOA: Xanthine Oxidase Inhibitor
Use: Chronic Gout
MC prosthetics, shunt placement and catheter bug?
What Immunoglobulin cannot cross the placenta?
What disease is a benign epidermal tumor that presents as a tan to brown, round, flat coin-like lesion that looks like it can be scrapped off (stuck on appearance)?
IV drug user with high grade fever, fatigue and dyspnea with hemmorhagic infarc in the lungs. Dx?
Tricuspid Endocarditis by S. Aureus
Okazaki fragments are put together by?
Pencillin and Cephalosporin MOA? Resistance?
MOA: Binds to PBP irreversibly and inhibits transpeptidases
Resistance: Through Protein structural change
HBcAg makes what kind of proteins? And where is it?
Glycoprotein that forms spheres and tubules that is about 22 nm in diameter that poorly correlates with viral replication is associated with what antigen?
With Statins, MC adverse effect and what should you check?
Rhabdomyolysis and LFTs
Sudden, painless, onesided blindness with cherry red macula. Dx?
Central retinal artery occlusion
Alpha 1 adenergic stimulation can cause reflex?
Flattened Face, epicanthal folds and endocardial cushion defect. MOA?
Down Syndrome: Nonmeiotic disjunction
Chewing difficulty, persistent headaches, and tenderness over the temples. Dx?
Temporal Giant Cell arteritis
Hemoglobin of 9.0 g, increased LDH and indirect bilirubin increased.
RBCs incubated hypotonic saline, hemoglobin is released. What test is it? and what is specific for? MOA of the disease?
Positive osmotic fragility Test; Hereditary Spherocytosis (AD)
MOA: Spectrin and ankrin def.
With any hemolytic anemia, the patient is at an increased risk of developing what?
MC neurological complication of VZV?
Post Herpetic Neuralgia
Asbestos workers are more likely to get what kind of cancer?
Female with exertional dyspnea has inherited condition. Mostly likely MOA of her disease?
BMPR2=>Vascular smooth muscle proliferation
Hypotensive, tachycardic, hypoglycemic, with vomiting and weight loss you should think? DOC?
Adrenal Crisis (b/c of adrenal insufficiency)
Hx of travel, Anorexia, nausea, dark urine, low grade fever and mild right upper abd. quadrant tenderness suggests? A Bx is likely to show which of the following?
Acute Viral Hepatitis,
Bx: Diffuse Ballooning degeneration, mononuclear cell infiltrates, and councilman bodies
What is the haldane effect and where does it occur? What is opposite to this effect and where does that occur?
Haldane effect=>increases in O2 leads to CO2 and H+ unloading; in the lungs
Bohr Effect=>peripheral tissues
Primary Ammenorhea in a patient with fully developed secondary sexual characteristics suggests the presence of? MCC of this presence is?
Anatomic defect MC=>imperforated hymen