Wrong Answers Flashcards
(170 cards)
1
Q
This medication used for TB can have a side effect of peripheral neuropathy.
A
Isoniazid
2
Q
Peripheral neuropathy can be prevented if isoniazid is given together with what?
A
B6 (pyridoxine)
3
Q
This is a fusion inhibitor used in treatment of HIV. It binds to CCR5 on surface of T cells to inhibit interaction with gp120 (thus preventing viral binding).
A
Maraviroc
4
Q
This medication is used to prevent vaso-occlusive pain episodes in patients with sickle cell disease.
A
Hydroxyurea
5
Q
Hydroxyurea acts by increasing the production of _______ _______, which reduces polymerization of sickle hemoglobin and sickling of RBCs.
A
Fetal Hemoglobin
6
Q
This is a major side effect of hydroxyurea that must be monitored for.
A
Myelosuppression
7
Q
This drug used for TB inhibits arabinosyl transferase III, which disrupts assembly of mycobacterial cell walls.
A
Ethambutol
8
Q
What is the major side effect of ethambutol, and how does it present?
A
Optic neuritis – presents as blurred vision and red-green color blindness
9
Q
What type of drug class should NOT be used in pts with a hx of reactive airway disease or other respiratory disorders?
A
Nonselective beta-adrenergic receptor blockers (ie, propranolol)
10
Q
What are the intestinal nematodes?
A
Enterobius vermicularis (pinworm) Ascaris lumbricoides (giant roundworm) Strongyloides stercoralis (threadworm) Necator americanus (hookworms) Trichuris trichiura (whipworm)
11
Q
What are the treatments for the intestinal nematodes?
A
Enterobus vermicularis (pinworm) = pyrantel pamoate or bendazoles
Ascaris lumbricoides (giant roundworm) = bendazoles
Strongyloides stercoralis (threadworm) = ivermectin or bendazoles
Necator americanus (hookworms) = bendazoles
Trichuris trichiura (whipworm) = bendazoles
12
Q
What are the tissue nematodes?
A
Toxocara canis
Onchocerca volvulus
Loa Loa
Wuchereria bancrofti
13
Q
What are the treatments for tissue nematodes?
A
Toxocara canis = bendazoles
Onchocerca volvulus = ivermectin
Loa Loa = diethylcarbamazine
Wuchereria bancrofti = diethylcarbamazine
14
Q
What are the cestodes?
A
Taenia solium
Diphyllobothrium latum
Echinococcus granulosus
15
Q
What are the treatments for the cestodes?
A
Taenia solium = praziquantel and albendazole (neurocysticercosis)
Diphyllobothrium latum = praziquantel
Echinococcus granulosus = albendazole
16
Q
What are the trematodes?
A
Schistosoma
Clonorchis sinensis
17
Q
What are the treatments for the trematodes?
A
Schistosoma = praziquantel
Clonorchis sinensis = praziquantel
18
Q
This medication is a 5-alpha reductase inhibitor that decreases dihydrotestosterone levels by decreasing its conversion from testosterone. Helps with BPH.
A
Finasteride
19
Q
Why should females of child-bearing age NOT handle finasteride?
A
Can cause feminization of the male fetus
20
Q
What are infants born to mothers with DM at increased risk for within the first few hours after birth?
A
Hypoglycemia – due to in utero hyperglycemia and overproduction of insulin in the infant immediately after delivery
21
Q
This is the most common thyroid malignancy and is strongly linked to hx of radiation exposures (especially in childhood).
A
Papillary carcinoma
22
Q
What can be seen on histology of papillary carcinoma?
A
Psammoma bodies
Ground-glass nuclei
23
Q
This disease presents with chronic crusting, eczema-like reaction, and ulcers around the nipple.
A
Paget disease
24
Q
Paget disease of the breast are often associated with what malignancy?
A
Invasive ductal carcinoma
25
This is an ovarian tumor consisting of ectopic thyroid tissue (causes elevation of thyroid hormones in some patients).
Struma ovarii
26
These are a type of cyst caused by luteinization and hypertrophy of the theca interna cells.
Theca lutein cysts
27
Theca lutein cysts form as a result of overstimulation of what?
Beta-hCG
28
MEN syndromes type 2A and 2B are caused by mutations in what?
RET
29
MEN syndromes type 2A and 2B are associated with what diseases?
Pheochromocytoma
| Medullary thyroid cancer
30
These tumors are ovarian metastases from GI tract primary cancers. They are poorly cohesive adenocarcinomas with signet ring cells.
Krukenberg tumors
31
This is secreted by squamous cell malignancies and increases calcium levels, resulting in suppression of endogenous PTH level secretion.
PTHrP (parathyroid hormone-related peptide)
32
This is one of the most common cardiac tumors in children and infants, composed of hamartomatous cardiac tissue.
Cardiac rhabdomyoma
33
What cardiac tumor is strongly associated with tuberous sclerosis (mainly in children)?
Cardiac rhabdomyoma
34
ECG reading showing steadily increasing PR intervals until a beat is dropped, then resets.
Mobitz Type I
35
What are the main characteristics of ToF?
Pulmonic valve stenosis
Right ventricular hypertrophy
Overriding aorta
VSD
36
What does ToF look like on CT?
Boot-shaped heart
37
What coronary artery and ECG leads are involved in the septal heart area?
LAD
| V1-V2
38
What coronary artery and ECG leads are involved in the anterior heart area?
LAD
| V3-V4
39
What coronary artery and ECG leads are involved in the lateral heart area?
Left circumflex
| I, aVL, V5, V6
40
What coronary artery and ECG leads are involved in the inferior heart area?
Right coronary
| II, III, aVF
41
What coronary artery and ECG leads are involved in the posterior heart area?
Posterior descending
| V1-V3, posterior leads V7-V9
42
This disease is characterized by ineffective erythropoiesis -- patients present within their first year of life with a nonmegaloblastic, macrocytic anemia and structural defects.
Diamond-Blackfan anemia
43
What lab studies will be seen with Diamond-Blackfan anemia?
Decreased reticulocytes
| Increased fetal hemoglobin
44
This disease has a classic presentation of an erythematous malar rash with circumoral pallor and a reticular rash that begins on the arms and spreads to trunk.
Erythema infectiosum (Fifth Disease)
***Rash is called "slapped cheek" rash
45
What causes erythema infectiosum?
Parvovirus B19
46
What can occur happen to a fetus upon infection of a seronegative pregnant female with erythema infectiosum?
May cause severe fetal anemia and hydrops fetalis
47
Gestational DM is caused by a production of what?
Human placental lactogen (HPL)
48
When is screening for gestational DM?
24-28 wks gestation via oral glucose tolerance test
49
This disease is a common, usually self-limited disease primarily of children. It is systemic IgA vasculitis that presents with a purpuric rash, arthritis, GI pain and perhaps bleeding.
Henoch-Schonlein purpura
50
What causes hematuria in Henoch-Schonlein purpura?
Mesangial IgA deposition in glomeruli
51
In embryonic development of the kidney, what forms from the metanephric mesenchyme?
Glomeruli
PCTs
Loop of Henle
DCTs
52
In embryonic development of the kidney, what forms from the ureteric bud structures?
```
Collecting tubules
Minor calyces
Major calyces
Renal pelvis
Ureters
```
53
This disease is caused by the absence of the stratum basalis layer of endometrial lining, resulting in endometrial lining that is inadequate for zygote implantation.
Asherman syndrome
54
What are common symptoms of Asherman syndrome?
Recurrent spontaneous abortion
| Secondary amenorrhea
55
This is a disorder that causes psychological distress and impairment in function due to one or more somatic symptoms not explained by another medical condition.
Somatic symptom disorder
56
In what stage does sleepwalking occur? What waves are predominate?
NREM stage 3 -- Delta waves
57
List the sleep stages and their corresponding EEG waveforms.
```
Awake (eyes open) = Beta
Awake (eyes close) = Alpha
NREM stage N1 = Theta
NREM stage N2 = Sleep spindles and K-complexes
NREM stage N3 = Delta
REM = Beta
```
58
This is a disorder of sleep-wake cycle involving a significant decrease in REM latency.
Narcolepsy
59
This disorder involves at least 4 days of elevated mood and increased energy. It also includes -->
- Pressure speech
- Increased psychomotor activity
- Decreased need for sleep
Hypomanic episode
60
How does a hypomanic episode differ from a manic episode?
Hypomanic episodes do NOT cause marked functional impairment, result in hospitalization, or involve psychosis
Manic is also 7 or more days
61
What is the equation for incidence in a treatment group?
A/(A+B)
62
What is the equation for incidence in a placebo group?
C/(C+D)
63
What is the equation for relative risk (RR)?
[A/(A+B)] / [C/(C+D)]
64
What is the equation for attributable risk (AR)?
[A/(A+B)] - [C/(C+D)]
65
What is the equation for odds ratio?
AD/BC
66
What is the equation for sensitivity?
TP/(TP + FN)
or
A/(A+C)
67
What is the equation for specificity?
TN/(TN + FP)
or
D/(D+B)
68
What is the equation for positive predictive value (PPV)?
TP/(TP + FP)
or
A/(A+B)
69
What is the equation for negative predictive value (NPV)?
TN/(FN + TN)
or
D/(C+D)
70
A patient presents with distal lymphangitis and occupation puts him or her at risk for skin injury from thorns. What is the microorganism?
Sporotrichosis
71
This is a childhood infection usually caused by human herpesvirus 6.
Roseola
72
What is the clinical presentation of roseola?
- 3 to 5 days high fever with abrupt defervescence
| - Macular or maculopapular rash on neck and trunk that spreads to extremities
73
This microorganism will present in sexually active females as frothy, foul-smelling, greenish-yellow discharge.
Trichomonas vaginalis
74
Trichomonas vaginalis is a (IMMOTILE/MOTILE) protozoan.
Motile
75
This is microorganism is a gram-positive, weakly acid-fast bacilli with a filamentous appearance in tissues and culture. It can cause pulmonary infections in immunocompromised pts.
Nocardia
76
What is the best treatment for Nocardia?
TMP-SMX
77
This presents as painful, vesicular genital lesions accompanied by painful lymphadenopathy.
HSV-2 (genital herpes)
78
How can HSV-2 be diagnosed? What will it show?
Tzanck smear -- shows multinucleated giant cells
79
This microorganism presents with nocturnal perianal itching and is usually seen in school-aged children.
Enterobius vermicularis (pinworm)
80
This microorganism is a nonenveloped, single-stranded RNA enterovirus that causes hand-foot-and-mouth disease.
Coxsackie Virus A
81
This is caused by a constellation of symptoms caused by a neuroendocrine tumor that secretes vasoactive substances (ie, serotonin).
Carcinoid Syndrome
82
What is the clinical presentation of carcinoid syndrome?
- Episodic upper body flushing
- Telangiectasias
- Diarrhea
- Bronchospasm
83
What is the treatment for carcinoid syndrome?
Octreotide or Lanreotide
84
What Abs are seen with SLE?
ANA
Anti-dsDNA
Anti-Smith
85
What Abs are seen with drug-induced lupus?
Anti-histone
86
What Abs are seen with polymyositis?
Anti-Jo-1
87
What Abs are seen with limited systemic sclerosis (CREST)?
Anti-centromere
88
What Abs are seen with diffuse systemic sclerosis?
Scl-70 (anti-DNA topoisomerase I)
89
What Abs are seen with RA?
- Rheumatoid factor
| - Anti-cyclic citrullinated peptide
90
What Abs are seen with mixed CT disease?
Anti-U1 ribonucleoprotein
91
What Abs are seen with Sjogren's disease?
- SSB/La
| - SSA/Ro
92
This disease presents with polyuria, polydipsia, and an inability to concentrate urine due to a lack of ADH secretion from the posterior pituitary.
Central diabetes insipidus
93
A supracondylar fracture of the humerus can result in injury to what nerve?
Median N.
94
This is a genetic disorder of the type IV collagen, resulting in basement membrane defects.
Alport Syndrome
95
What issues are caused due to the basement membrane defects in Alport syndrome?
- Hematuria
- Sensorineural hearing loss
- Vision loss from lens defects
***Hereditary nephritis can present in childhood
96
This is the term that refers to subjects modifying their behaviors based on knowing that they are being studied.
Hawthorne effect
97
Pemphigus vulgaris is an autoimmune disease caused by what?
IgG Abs against desmosomes (desmoglein 1 and desmoglein 3) located on surface of keratinocytes
98
Pemphigus vulgaris is (SUBEPIDERMAL/INTRAEPIDERMAL).
Intraepidermal
99
What disease presents with flaccid bullae, erosions on the skin and oral mucosa, and a positive Nikolsky sign (skin tears on bullae when slightly touched)?
Pemphigus vulgaris
100
Bullous pemphigoid is an autoimmune disease caused by what?
IgG Abs against hemidesmosomes (BP180 and BP230)
101
Bullous pemphigoid is (SUBEPIDERMAL/INTRAEPIDERMAL).
Subepidermal
102
What disease presents with tense bullae and a negative Nikolsky sign?
Bullous pemphigoid
103
What can a positive Homan sign indicate could be present?
DVT
***Dorsiflex foot, causes pain in calf
104
Homan test is unreliable for accurate diagnosis of DVT, so what is the first line imaging modality for accurate diagnosis of DVT?
Compression ultrasonography
105
This microorganism is a lactose-negative and oxidase-negative rod that produces H2S (hydrogen sulfide).
Salmonella typhimurium
106
How does Salmonella cause watery to bloody diarrhea?
Via direct adherence and invasion into both enterocytes and macrophages (utilizing a type III secretion system)
107
This is a polymorphic ventricular tachycardia and often occurs as a complication of treatment with QT-prolonging medications (including antipsychotics such as haloperidol).
Torsades de pointes
108
What is used to treat a hemodynamically stable patient with torsades de pointes?
IV magnesium
109
What is the pharmacology for Afib and Atrial flutter?
- Adenosine
- Amiodarone
- Beta blockers
- Calcium channel blockers (ie, diltiazem, verapamil)
- Digoxin
110
What is the pharmacology for Digoxin toxicity?
- Anti-digoxin Fab fragments
| - Magnesium sulfate
111
What is the pharmacology for monomorphic ventricular tachycardia?
- Amiodarone
| - Lidocaine
112
What is the pharmacology for paroxysmal supraventricular tachycardia?
Adenosine
113
What is the pharmacology for sinus brady?
Atropine
114
What is the pharmacology for TCA toxicity?
Sodium bicarbonate
115
Rabies virus can cause fatal encephalitis, resulting in what characteristic finding upon autopsy?
Negri bodies (neuronal eosinophilic cytoplasmic inclusions)
116
This is the most common organism that causes impetigo.
Staph aureus
117
Staph aureus most commonly causes a nonbullous form of impetigo, however there is a bullous form and it is due to what toxin?
Exfoliative toxin A
118
The MOA of exfoliative toxin A in bullous impetigo is similar to the pathophysiology of pemphigus vulgaris, which is what?
Auto-Abs are directed against desmoglein A
119
What is the ANCA staining pattern for GPA (granulomatosis with polyangiitis) and its most common ANCA Ag?
C-ANCA
| PR3
120
This disease is characterized by frequent ENT, pulmonary, and renal symptoms and has a C-ANCA staining pattern.
GPA (granulomatosis with polyangiitis)
121
What is the ANCA staining pattern and Ag for microscopic polyangiitis?
P-ANCA
| MPO
122
What is the ANCA staining pattern and Ag for Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)?
P-ANCA
| MPO
123
What is the ANCA staining pattern and Ag for Antiglomerular basement membrane-autoAb disease?
P-ANCA
| MPO
124
What is the ANCA staining pattern and Ag for drug-induced ANCA-associated vasculitis?
P-ANCA
| MPO
125
What is the ANCA staining pattern and Ag for ulcerative colitis?
P-ANCA
| Myeloid-specific nuclear envelope protein
126
What is the ANCA staining pattern and Ag for Primary sclerosis cholangitis?
P-ANCA
| Myeloid-specific nuclear envelope protein
127
Sickle cell disease is an autosomal (DOMINANT/RECESSIVE) disorder caused by a mutation of (ADULT/FETAL) hemoglobin.
Recessive
| Adult
128
What substitution occurs in Sickle Cell disease?
Valine replaces glutamic acid on the beta chain of adult Hgb
129
This is a self-limiting thyrotoxicosis caused by a release of pre-formed thyroid hormone from an inflamed thyroid gland. It classically follows a flu-like illness. Distinguishable from other hyperthyroid etiologies b/c it is the ONLY type with a painful, enlarged thyroid gland.
Subacute granulomatous thyroiditis (de Quervain thyroiditis)
130
This is a protozoan parasite that causes malodorous watery diarrhea.
Giardia lamblia
131
What is the 1st-line treatment for Giardia lamblia?
Metronidazole
Tinidazole
Nitazoxanide
132
What is the MOA of Metronidazole?
Creates free radical metabolites that damage DNA
133
Where is Histoplasmosis endemic to?
- Mississippi River Vally
| - Ohio River Valley
134
Where is Blastomycosis endemic to?
- Southeastern and South-Central US (bordering Miss. and Ohio River basins)
- Midwestern US and Canadian provinces bordering Great Lakes
- New York and Canada along the St. Lawrence River and the Nelson River
135
Where is Coccidiomycosis endemic to?
- Southwestern US
| - California
136
Where is Paracoccidioidmycosis endemic to?
- Certain regions of Mexico
| - Central and South America
137
Infection with Histoplasma capsulatum is the most common cause of _______ _______, ahead of TB and radiation therapy.
Chronic mediastinitis
138
The most common cause of respiratory distress in premature infants is neonatal RDS, which is caused by surfactant deficiency. A major component of surfactant is _________, the level of which would be decreased in the lungs of a neonate with RDS.
dipalmitoylphosphatidylcholine
139
What is the most common cause of sudden death within 24 hours after onset of MI symptoms?
Arrhythmia (primarily ventricular tachycardia or Vfib)
140
What is the most common cause of ASD?
Failure of the ostium secundum to close during formation of the atrial septum
141
What is the heart sound for an ASD?
Fixed splitting of the S2 heart sound (pulmonary valve closes after the aortic valve because of increased right ventricular blood volume)
142
When an ASD is large, right-to-left shunting may eventually develop, which is called what?
Eisenmenger syndrome
143
Sickle cell disease patients are at risk of having an _______ _______, often associated with parvovirus B19 infection, during which time erythropoiesis is suppressed.
Aplastic crisis
144
Ventilation, perfusion, and compliance differ in the lung because of gravitational forces. When standing, ventilation, perfusion, and compliance are (MORE/LESS) at the apex than at the base of the lungs.
Less
145
Cystine kidney stones are the rarest, and appear with what shape on microscopy?
Hexagon
146
What testing would be positive for cystine kidney stones?
Cyanide-nitroprusside testing
147
This type of dyslipidemia results in elevated serum triglycerides and affected patients are at risk of developing acute pancreatitis.
Hyperchylomicronemia (type I familial dyslipidemia)
148
In Hyperchylomicronemia, what would centrifugation of a blood sample look like?
There would be a creamy layer in the supernatant
149
This presents as a papulovesicular, pruritic skin rash on the elbows and knees and is associated with Celiac disease.
Dermatitis herpetiformis
150
What is the pathophysiology of dermatitis herpetiformis?
Development of IgA Abs that react against gliadin and cause micro abscess formation at the dermal papillae tips
151
Obstructive sleep apnea causes hypoxia, which can trigger pulmonary vasoconstriction and lead to what?
Pulmonary HTN
152
What is the best auscultatory location for the aortic valve?
Right upper sternal
| Second intercostal
153
What is the best auscultatory location for the pulmonic valve?
Left upper sternal
| Second intercostal
154
What is the best auscultatory location for the tricuspid valve?
Left lower sternal
| Fourth intercostal
155
What is the best auscultatory location for the mitral valve?
Left mid-clavicular
| Fifth intercostal
156
This murmur sound is a high-pitched blowing, early diastole decrescendo.
Aortic regurgitation
157
This murmur sound is a crescendo-decrescendo systolic ejection.
Aortic stenosis
158
This murmur sound is a mid-systolic high-pitched crescendo-decrescendo.
Pulmonary stenosis
159
This murmur sound is holosystolic and high-pitched.
Tricuspid valve regurgitation
160
This murmur sound has an opening snap with delayed rumble during late diastole.
Mitral stenosis
161
This murmur sound is a late systolic crescendo with mid-systolic click.
Mitral valve prolapse
162
This murmur sound is holosystolic, high-pitched, and radiates to the axilla.
Mitral valve regurgitation
163
What are the diastolic murmurs?
Aortic regurgitation
Pulmonic regurgitation
Mitral stenosis
Tricuspid stenosis
164
What are the systolic murmurs?
```
Aortic stenosis
Pulmonic stenosis
Mitral regurgitation
Tricuspid regurgitation
Mitral valve prolapse
```
165
What do the PFTs look like in obstructive lung diseases (ie, COPD)?
Decreased FEV1
Decreased FVC
Decreased FEV1/FVC ratio
Increased TLC
166
What are the recommended drugs for HTN in pregnancy?
Hydralazine
Labetalol
Nifedipine
Methyldopa
167
What is the DOC for panic disorder and/or agoraphobia?
Paroxetine (type of SSRI)
168
During menopause, a loss of sensitivity to gonadotropins results in an increase of what?
FSH
| LH
169
What levels are measured clinically to determine if a woman has reached menopause?
Elevated FSH
170
This is a parasite that causes the highly pathogenic Primary Amebic Meningoencephalitis (PAM) and is transmitted through contaminated water that contacts the nasal mucosa.
Naegleria fowleri
***Called the "Brain-eating amoeba"
