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Round 1 Review

Wrong Questions Round FA Part 1

QuestionAnswer
Which neurotransmitter is associated with REM sleep? ACh (acetylcholine)
What is a natural condition that lead to decreased levels of ACh and REM sleep? Aging
What is the most common cause of infection ventilation-associated and other hospital-acquired pneumonias? Pseudomonas aeruginosa
What is the third generation cephalosporin used to treat pneumonia due to Pseudomonas aeruginosa infection? Ceftazidime
What is a common use for Ceftazidime? Ventilator-associated pneumonia due to P. aeruginosa infection
List of treatment for Pseudomonas aeruginosa infection? Piperacillin-Tazobactam, Aztreonam, Meropenem, Doripenem, Ciprofloxacin, and some Cephalosporins such as Ceftazidime
Common electron carrier used in Steroid synthesis as supply of reducing equivalents: NADPH
Where is NADPH generated? Oxidative portion of the HMP (PPP) pathway
On which important anabolic processes is NADPH involved? 1. Steroid synthesis 2. Fatty acid synthesis
What are the treatments used for mild to moderate cases of Ulcerative colitis (UC)? Mesalamine and Sulfasalazine
Mesalamine is used to treat mild or severe cases of UC? Mild
What is the line of treatment for severe Ulcerative colitis? Infliximab
When is Infliximab used in IBD? Severe cases of Ulcerative colitis
How is Basal cell carcinoma of the skin manifested? Pink or flesh-colored pearly papules on sun exposed skin, that is locally invasive, but virtually never metastatic
Histological description of Basal cell carcinoma of the skin: Basaloid population with minimal stromal response, areas of Palisading nuclei, and small fusiform cells with little cytoplasm
Which personality disorder is "ok" with been alone and distance? Schizoid Personality disorder
How is a person with an Schizoid personality often described by others? Reclusive and emotionally cold
Indifferent to been secluded or alone. Schizoid or Avoidant? Schizoid
Avoidant Personality disorder: Characterized by pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation
What type of personality disorder is often found to be overly sensitive to criticism and is isolated by own decision out fear of been ridiculed? Avoidant Personality disorder
What is the major risk factor for Pseudomonas-induced Osteomyelitis? IV drug use
Which organism is often associated or causative for Osteomyelitis in an IV drug user? Pseudomonas aeruginosa
What is the pathogenesis of urticaria? IgE mediated degranulation of mast cells in response to allergens
What type of Hypersensitivity reaction is urticaria? Type 1
Which cells are involved in development of urticaria? Degranulation of MAST cells
Where are S cells located? Duodenum
What is secreted by S cell of the duodenum? Secretin
What is the result of Secretin secretion by duodenal S cells? Stimulation of bicarbonate secretin in response to acid and fatty acids in lumen of the duodenum
What contents arrive to the duodenum that cause Secretin to stimulate bicarbonate secretion? Acid from stomach and fatty acids
What is secreted by the secretion of Secretin by duodenal S cells? Bicarbonate
What cells and/or organs are known to secrete Bicarbonate? Mucosal cells in the stomach, duodenum, salivary glands, pancreas and Brunner glands in the duodenum
What important electrolyte is secreted by Brunner glands in the duodenum? Bicarbonate
What is the main function Bicarbonate? Neutralizing stomach acid in order for Pancreatic enzymes to function properly
Which enzymes' functionality is dependent of the neutralization of stomach acid by bicarbonate? Pancreatic enzymes
What is the mode of inheritance of Hunter syndrome? X-recessive
What enzyme is deficient in Hunter syndrome? Iduronate-2-sulfatase
Deficiency in Iduronate-2-sulfatase. Dx? Hunter syndrome
What are the common clinical features of Hunter syndrome? Coarse facial features, aggressive behavior, pearly skin lesions, adn clear corneas on fundoscopic exam
hurLer syndrome (missing enzyme) ---> a-L-iduronidase
hunTer syndrome (missing enzyme) ---> iduronate - 2 (Two) - sulfatase
What is the most common cause of chronic kidney disease in the USA? Diabetic nephropathy
What are the associated conditions of MCD? Kids; Hodgkin lymphoma and NSAIDs
Associated conditions of Focal Segmental Glomerulosclerosis: Morbid obesity, IV drug use, NSAIDs, and HIV
What conditions are often seen with Membranous nephropathy? - Chronic Hep C or Hep B infection - Syphilis, - Lupus - Solid tumors - Medications (NSAIDs), penicillamine, and gold-compounds
Trisomy 21 chromosomal defect occurs in which phase of cell division? Anaphase I or II of meiosis
What is the MCC of Down syndrome? Nondisjunction of homologous chromosomes (21) during Anaphase I or II or Meiosis
What is a confounding error? Error that occurs when a variable that is not being controlled occur ate different rates in different experimental groups and has an effect on the outcome
How is Central Retinal Artery occlusion presented? Painless unilateral vision loss that is permanent
What is found in Fundoscopic examination of Central Retinal artery occlusion? Cherry-red spot with surrounding pale retina and cotton-wool spots
What are the most common causes of Central Retinal artery occlusion? Cardioembolic events, atherosclerosis, and Giant cell arteritis
What is the key fundoscopic exam findings of Hypertensive Retinal hemorrhage? Flame-shaped hemorrhages, arteriovenous nicking, and thickening of arterial walls
What condition is seen with "flame-shaped hemorrhages" on fundoscopic exam? Hypertensive Retinal hemorrhage
TB has Caseating or Non-caseating granulomas? Caseating granulomas
How is the Ghon complex? Multinucleated giant cells and epithelial cells, and is associated with lymph node involvement
Multinucleated giant cells + Epithelial cells in a primary TB infection. Ghon complex
Is Ghon complex found most commonly in the upper or lower lobes of the lungs? Upper lobes
What enzyme is missing in Classic Galactosemia? Galactose-1-phosphate uridyltransferase (G1PUR)
What is the role of G1PUR? Converts Galactose-1-phosphate into Glucose-1-phosphate
What is accumulated in Classic Galactosemia? Galactose-1-phosphate and Galactitol
What is the treatment for Classic Galactosemia? Avoid Galactose and Lactose from diet
Lactose is made of: Galactose + Fructose
What are the most common pathogens cause infection to burn injuries? Staphylococcal, Staph aureus, Pseudomona aeruginosa, Klebsiella pneumoniae, Acinetobacter, and Candida albicans
What is the treatment of Pseudomonas infection to a burn? Piperacillin/ Tazobactam
What is the pentad of symptoms of TTP? 1. CNS symptoms 2. Renal insufficiency 3. Fever 4. Thrombocytopenia 5. Microangiopathic Hemolytic anemia
What type of abnormal RBCs are seen in TTP? Schistocytes
What are some causes of herniation of the brain? Due to ICP which may be caused by hemorrhage, mass lesions, or edema.
What is the Uncal herniation clinical features? 1. CN III palsy 2. Hemiplegia 3. Decreased level of consciousness
How are the pupils in CN III palsy? Ipsilateral fixed, dilated pupil with a down and out position of the eye and severely ptosis upper eyelid
MEN type 1 is seen with: Hyperparathyroidism leading to Hypercalcemia and hypophosphatemia
Levels of serum calcium in MEN type 1 Increased
Technique used to detect proteins by using Protein-Antibody hybridization. Western blot
What lab technique is used a confirmatory test for HIV? Western blot
What is Pernicious anemia? Autoimmune condition that can cause decreased production of Intrinsic Factor (IF) by Parietal cells in the stomach
What product of Parietal cells is necessary to absorb vitamin B12? Intrinsic Factor (IF)
What vitamin is absorbed with aid of the Intrinsic factor secreted by Stomach Parietal cells? Vitamin B12
Which type of study uses or calculates Relative Risk (RR)? Cohort studies
Which value or calculation is often seen in Cohort studies? Relative Risk (RR)
(Probability of Exposed)/ (Probability of non exposed) = Relative risk
What is the equation of RR using "a, b, c, d"? a/ (a+b) / c/(c+d)
What is the equation used to calculate RRR? 1- RR
1 - RR = Relative Risk Reduction
What is the MCC of nontraumatic SAH? Rupture of arterial aneurysm
What is the common onset of SAH? Abruptly and 1/3 of the times is during the middle of the night.
What are the clinical features of PCP intoxication? Aggression, psychomotor agitation, elevated temperature, tachycardia, hypertension, and nystagmus
Pupils in PCP intoxication Normal
Cocaine intoxication is presented with pupil dilation or constriction? Dilation
Location of the Internal Jugular vein with respect to Common Carotid artery and Vagus nerve? Lateral to the Common Carotid artery and anterior to the vagus nerve, all within the Carotid sheath
Which important vessels and/or nerves are located within the Carotid sheath? Internal jugular vein, Common Carotid artery, and Vagus nerve
On which part of the tRNA does amino acids attach? 3' CCA terminal
Amino acid binding or attachment to the 3' CCA terminal of tRNA is catalyzed by which enzyme? Aminoacyl-tRNA synthetase
What is the most common drug and first line of treatment of ADHD? Methylphenidate
What condition is treated with Methylphenidate? ADHD
How does Methylphenidate work? Stimulate the release of NE from presynaptic vesicles
Common indirect sympathomimetic used to treating ADHD? Methylphenidate
Indirect or Direct sympathomimetic. Methylphenidate? Indirect
The groups are divided on basis of where they have an exposure, and are followed to determine the effect of exposure Cohort studies
What are the common lab abnormalities of chronic liver disease? Elevated levels of AST/ALT and bilirubin
What hematologic abnormalities are seen with chronic liver disease? 1. Low platelet count from hypersplenism 2. Prolonged PT and PTT caused by decrease in clotting factors
Are PT and PTT prolonged, reduced, or normal in chronic liver disease? Prolonged
What is the reason for the low platelet count in chronic liver disease? Hypersplenism
Liver disease markers are subdivided in two major categories: 1. Enzymes released in liver (structure) damage 2. Functional liver markers
What liver markers indicate structural liver damage? 1. AST and ALT 2. Alkaline phosphatase 3. gamma-glutamyl transpeptidase
Which are the markers that indicate functional liver deficits? 1. Bilirubin 2. Albumin 3. PT (prolonged) 4. Low level of platelets
What is evaluated in Case-control studies? Odds of exposure to risk factors
What value is calculated in Case-Control studies? Odds ratio (OR)
In terms of "a,b,c, d" what is the equation of Odds ratio? (a d) / (c d)
ad --------- = cd Odds ratio (OR)
What is ELISA? Test used to detect a specific Antibody or Antigen
Common lab technique used to identify an specific antibody or antigen? ELISA
What is intended to identity by using ELISA? Specific antibody or antigen
What is identified by FISH? Specific gene site
If a genealogist want to identify an specific mutated gene site, which is a proper lab technique he/she can use? FISH
Which lab technique allow for the visualization of metaphase chromosomes? Karyotyping
In which stage of development or division are chromosomes visualized by Karyotyping? Metaphase
What type of conditions are diagnosed by Karyotyping? Chromosomopathies
Why is PCR used? To amplify a desired fragment of DNA
What conditions are often diagnosed with PCR? Neonatal HIV and HSV encephalitis
If a vignette indicates the presence of antibodies, which lab technique was probably used to dx the patient? ELISA
What is the approximate pressure of the Right Atrium ? 1-8 mm Hg
What is the cardiac chamber pressure of the Right Ventricle? 1-30 mm Hg
Which cardiac chamber would have a pressure of 1-8 mm Hg? Right atrium
Which of right sided cardiac chamber has an approximate pressure of 1-30 mm Hg? Right ventricle
What is the approximate range of pressure in the Pulmonary artery? 10-30 mm Hg
A series of cardiac chamber pressure are the following: 9, 10, and 12 mm Hg. What is the most likely pressure been taken? PCWP
What is the normal range of PCWP? 4-12 mm Hg
A pressure of 130/10 is probably found in which cardiac chamber? Left ventricle
What is the approximate pressure of LA? < 12 mm Hg
What is a common cause of Communicating hydrocephalus? Arachnoid scarring after meningitis
Which type of hydrocephalus, communicating or noncommunicating, is indicated by an increase ICP? Communicating hydrocephalus
What is the common presentation of Communicating hydrocephalus in young children? Bulging fontanelles, increased head circumference, vomiting and irritability
What is the indicated treatment for Communicating hydrocephalus? Ventriculoperitoneal shunt
What condition is often seen with elevated ICP and treated with a ventriculoperitoneal shunt? Communicating hydrocephalus
Serotonin syndrome is caused by: Usage of MAOIs in combination with SSRIs or TCAs
What are the clinical features of Serotonin syndrome? Fever, myoclonus, tremor , hyperreflexia, and mental status changes
MAOI + fluoxetine, increases the risk of developing which condition? Serotonin syndrome
Why is it contraindicated to co-administer TCA and Selegiline? Serotonin syndrome may develop
What i the common treatment for Serotonin syndrome? Cyproheptadine
What is the MOA of Cyproheptadine? 5-HT2 antagonist
How long is the usual wash-out time needed to change treatment from MOAIs to a SSRI or TCA? 14 days
What condition is due to the hemisection of the Spinal cord? Brown-Sequard syndrome
What is the contralateral deficit seen in Brown-Sequard syndrome? Loss of pain and temperature sensation (Spinothalamic tract) below the level of the lesion
Damage to the dorsal columns in Brown-Sequard syndrome causes? Ipsilateral loss of tactile, vibration, and proprioception sense below the level of lesion
Are the UMN and LMN injuries in Brown-Sequard syndrome, Ipsilateral or Contralateral? Ipsilateral
Description of motor deficits seen in Brown-Sequard syndrome? Ipsilateral loss of motor function due to injury to the Corticospinal tract with UMN signs below the lesion and LMN signs at the level of the lesion
What are the deficits seen at the level of lesion of Brown-Sequard syndrome? 1. Ipsilateral loss of sensation 2. Ipsilateral LMN signs
What are the deficits seen in Brown-Sequard syndrome ipsilateral below the level of lesion? 1. UMN signs 2. Loss of proprioception, vibration, light touch, and tactile sense
Which conditions is seen with contralateral impaired sense of pain, temperature, and crude touch sensation below the level of the lesion to the spinal cord? Brown-Sequard syndrome
What are the spinal cords tracts affected in Brown-Sequard syndrome? 1. Corticospinal tract 2. Dorsal column 3. Spinothalamic tract
B-ALL or T-ALLs are more commonly presented as childhood leukemias? B-ALL
How do T-ALL commonly present? Thymic lymphomas in adolescents
What do most (95%) of ALLs stain positive? Terminal deoxynucleotidyl transferase (TdT+)
What hematologic conditions are associated with ALL development? Anemia and Thrombocytopenia
What malignancy is suspected in a 17 year old male, in which the malignancy histological findings include positive stain for TdT +? T-ALL
What pathogen causes Lymphogranuloma venereum? Chlamydia trachomatis type L1, L2, and L3
How does Lymphogranuloma venereum present in the early stages? Painless genital ulcer
What is the late or developed clinical presentation of Lymphogranuloma venereum? Swollen, painful inguinal lymph nodes (inguinal lymphadenopathy) that ulcerate (buboes)
Treatment for Lymphogranuloma venereum (LGV)? Doxycycline
What contains the Lateral Corticospinal tract? Motor neurons that control descending voluntary movements of contralateral limbs
What condition often affects the Lateral Corticospinal tract? Hereditary Spastic Paraplegia
What ir the role in the neurons of Lateral Corticospinal tract? Descending voluntary movements of the contralateral limbs
What is affected by chronic autoimmune gastritis? Fundus and body of stomach and is mediated by CD4+ T cells reactive against gastric parietal cell components
What is an important substance secreted by Parietal cells that help for absorption of vitamin B12? Intrinsic factor (IF)
Which component of the parietal cells is targeted by autoantibodies of autoimmune gastritis? H+/K+ ATPase
Which autoimmune condition is characterized by destruction ofH+/K+ ATP in Parietal cells? Autoimmune gastritis
Which parts of the stomach are affected by autoimmune gastritis? Fundus and body
What is C. albicans? Yeast and common opportunistic pathogen
What are the vagnal symptoms of C. albicans vulvovaginitis? Vaginal itching, with a whitish, curd-like discharge
How is the vaginal discharge in C. albicans vulvovaginitis described? White and curd-like
What is a common complication of C. albican infection in immunocompromised patients? Esophagitis
What pathogen is known to cause inflammation of the esophagus in HIV/AIDS patients? Candida infection
Which organ is known to have B1-adrenergic receptors? Heart
WHat type of B-blockers are used in patient that has recently suffered a MI? Selective B1-receptor blockers
Which type of beta blockers are contraindicated in COPD patients? Non-selective B-blockers
Why do nonselective beta blockers are CI in COPD patients? These act on B-2 receptors, which are found in bronchial smooth muscle, leading to contraction (bronchoconstriction)
List of B1 (selective) blockers: Acebutolol, Atenolol, Betaxolol, Bisoprolol, Esmolol, and Metoprolol
Is Metoprolol a Selective or Non-selective Beta blocker? Selective
The B-blockers that commonly start name with a letter of the 1st half of alphabet, are selective or nonselective? Selective
Which are some common Non-selective beta blockers? Nadolol, Pindolol, Propanolol, and Timolol
Is propranolol a Selective or Nonselective beta blocker? Non-selective
MOA of Class IA antiarrhythmics: Block K+ and Na+ channels, leading to prolongation of the AP and effective refractory period
Which type of cardiac antiarrhythmics are known to prolong AP and effective refractory period? Class IA antiarrhythmics
Which antiarrhythmics are used in Wolff-Parkinson-White syndrome? Class IA antiarrhythmics
How is WPW syndrome clinically presented? Palpitations, lightheadedness, and SOB.
What ar the EKG changes in Wolff-Parkinson-White syndrome? PR shortening and delta wave
The inhibition of K+ channels causes --> Increase refractory period
The inhibition of Na+ channels causes ----> Slow phase 0 lead into to an increase of the QRS duration
Root from which the Ilioinguinal nerve arises from? L1
What is the course or pathway followed by the Ilioinguinal nerve? Arises from L1, passes through the inguinal ligament, and lies on top of the Spermatic cord
What sensory information is provided by the Ilioinguinal nerve? Sensation to the scrotum and labia and medial aspect of thigh
What nerve is part responsible for the Cremasteric reflex? Ilioinguinal nerve
What nerve is know to provide cutaneous sensation to the medial aspect of the thigh? Ilioinguinal nerve
What is the mode of action of Clarithromycin? Bind to the 23S rRNA of the 50S ribosomal subunit
Which are two common examples of antibiotics that works by halting protein synthesis by binding to the 23S rRNA of the 50S ribosomal subunit? Erythromycin and Clarithromycin
What type of pneumonia is treated with Macrolides? Atypical pneumonia
How are macrolides associated to development of muscle pain/aches? If combined with Statins, these macrolides inhibit the CYP450 system, leading to statin-induced muscle pain which can develop into Rhabdomyolysis
What are bacterial known to cause atypical pneumonia? Mycoplasma, Chlamydia, and Legionella
What are common uses for Macrolides? 1. Atypical pneumonias 2. STIs (chlamydia) 3. Gram (+) cocci (strep infections in penicillin allergic patients) 4. B. pertussis
What is Failure Mode and Effect Analysis (FMEA)? Step-by-step approach to identify all possible failure in design, a manufacturing or an assembly process.
Which surface of the hand has S. Lucidum layer? Palmar surface of hand
What is the Palmoplantar (glabrous) skin of the palm of the hand? Thicker and lacks hair follicles
What is the extra layer of the epidermis present in the palm of the hand? Stratum Lucidum
What are the layers that are on both palmar and dorsal surfaces of the hand? S. corneum, S. granulosum, S. Spinosum, and S. basale
Which layer of the epidermis consists of flattened keratinocytes? Stratum Lucidum
Description of the Stratum corneum: Several layers of dead, flat squamous cells known as keratinocytes
What is the function of the S. corneum? Prevent desiccation and microbial infiltration
Stratified squamous cells arranged in 1 to 3 rows containing lamellar granules; keratinocytes still have nuclei. Stratum granulosum
Description of the S. basale: Single layer of cuboidal to low columnar mitotically active cells, which form new keratinocytes
Which layer of the epidermis separates the the basement membrane from the dermis? Stratum basale
Which cells are found in the Stratum basale? Merkel cells, Langerhan cells, and melanocytes
What is the S. spinosum? Cuboidal or slightly flattened cells with central nucleus and cytoplasm filled with abundant keratin
Where do Keratin bundles terminate? At desmosomes located at the top of the Spinous processes
Recombinant human monoclonal antibody to ERBB2 and used to treat breast cancer. Trastuzumab
MOA of Trastuzumab: 1. Binding to extracellular domains of ERBB2 receptor on cancer cells, preventing receptor stimulation and inhibiting cell growth 2. Downregulation of receptors that causes cancer cells to slow growth and stay in G0 phase of cell cycle
What are the common physical exam finings of Spongatnoeus pneumothorax? 1. Hyperresonant lungs 2. Decreased breath sounds 3. Decreased or absent taactile fremitis
What is the MCC of Spontaneous pneumothorax? Rupture of apical blebs in the pleura of lung
How is Spontaneous pneumothorax commonly presented? Acute-onset pleuritic chest pain,and SOB
Which two conditions are seen with hyperresonant lungs? Tension and Spontaneous pneumothorax
Which Tension or Spontaneous pneumothorax, has if any, deviation toward the side of lesion? Spontaneous pneumothorax
What is the most common acid-fast organism that causes atypical pneumonia? Mycoplasma tuberculosis
Important virulence factor of M. tuberculosis? Cord factor
What pathogen has the virulence factor, known as "cord factor"? Mycoplasma tuberculosis
What is the result of the Cord factor in M. tuberculosis? Activates and induces release of TNF-alpha contributing the formation of caseating granulomas
What is the virulence factor of S. aureus? Protein A
What is the mode of action of Protein A in S. aureus? Binds to Fc region of IgG
Which organisms have IgA protease (virulence factor)? S. pneumoniae, H. influenza B, and Neisseria spps
What virulence factor is known to cleave IgA? IgA protease
Virulence factor of S. pyogenes: M protein
How does M protein work? Cuses molecular mimicry
Which organism has M protein as its virulence factor? S. pyogenes
Gram is the most common virulence factor of Gram negative organisms? Lipid A
Does Gram (-) or (+) organisms have Lipid A virulence factor? Gram negative
What is the MC organisms causing Post-influenza bacterial pneumonia? S. pneumoniae
Strep pneumoniae is: Gram (+) diplococci that is optochin sensitive; encapsulated
Is NPH a form of Communicating or Noncommunicating hydrocephalus? Communicating
How is NPH manifested clinically? 1. Chronically dilated ventricles in elderly 2. Classic triad of: Urinary incontinence, gait abnormalities, and mental decline
What are the 3 main categories of Hydrocephalus? 1. Communicating 2. Non-communicating 3. Mimics
What are the types of Communicating hydrocephalus? NPH and Communicating
Ex vacuo ventriculomegaly is what type of Hydrocephalus? Mimic; seen with normal ICP and no NPH triad
What is the cause for communicating hydrocephalus? Decreased CSF absorption by arachnoid granulations
What type of hydrocephalus is due to blockage of CSF flow within the ventricular system? Noncommunicating hydrocephalus
Created by: rakomi
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