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Notitas 120 ++
| Question | Answer |
|---|---|
| Antibiotic SYNERGISTIC (produce similar effect when combine the EFFECT is greater) to PENICILLIN the most likely moa of the additional antibiotic? | Gentamicin (aminoglycoside) |
| Interact with transpeptidase, inhibit PEPTIDOGLYCAN cell wall, used for Strep viridians | Penicillin |
| Binding to the 30s ribosomal protein, inhibiting PROTEIN synthesis. Used for pneumonia | Gentamicin, amikacin (aminoglycosides) side effect hearing loss ototoxicity and renal failure. |
| Inhibition of DNA gyrase, inhibit DNA gyrase topoisomerase | Fluoroquinolones (ciprofloxacin)prolong QT interval torsade de pointes |
| Viral reverse transcriptase inhibitors used in HIV | Lamivudine, Emtricitabine |
| Inhibits viral RNA polymerase RNA fragment initiation and elongation leading to VIRAL PROTEIN synthesis | Ribavirin |
| Intermittent yellow eyes and skin, total bilirubin 3mg, haptoglobin, AST and ALT within normal, additional finding? Decreased activity of UDP gluconosyltransferase | Gilbert Syndrome |
| Drug X (acetylcholine)increases drug produces effects more similar to? | Cholinesterase inhibitor |
| Stimulates muscarinic M3 receptors on bronchial smooth muscle increases intracellular calcium and triggers muscle contraction | Acetylcholine similar to cholinergic compound |
| Inhaled muscarinic antagonist used to promote bronchodilation in COPD, Asthma | Ipratropium and tiotropium inhaled |
| Alpha 1 receptor agonist that promotes contraction of vascular smooth muscle (vasoconstriction) | Phenylephrine |
| Administration of RhoGAM is to prevent ? | Formation of antibodies to RhD |
| It’s given to a RISK Rh- mother at 28 weeks and at delivery. | Rhogam |
| Low voltage Electrical alternan (means cardiac tamponade) the finding are? | ⬇️BP, ⬆️Pulse, ⬆️JVD, ⬆️Pulsus paradoxus |
| Hepatic glucose output is decreased and target tissue glucose uptake utilization is increase. Which drug to prescribe? | Metformin |
| HIV infection, ⬇️Hb, ⬇️platelets, physical finding? Petechiae | Low platelets place pt at risk of bleeding. Petechiae is common in thrombocytopenia |
| Fever, lymphadenopathy, arthralgias and erythema on hands and feet the most likely cause? Immune Complex deposition in tissues | Serum sickness, a type III immune complex hypersensitivity |
| Itchy red rash, used a new hair dye. Fever, respiration 22, which of the ligand receptor pairs primary role in proliferation of the T lymphocytes present in the rash? | CD28 on T lymphocytes leads to CD80 on epidermal langerhans cells |
| Type IV (cell mediated) hypersensitivity. T cell CD28 activation through binding CD80 (part of the B7 group) on the APC is the dominant interaction in T-cell hypersensitivity/allergies | Contact dermatitis |
| Increased malonyl-CoA concentration most likely inhibits. Malonyl-CoA inhibits the rate limiting step in beta oxidation. Resting muscle requires less energy than active muscle. | Fatty acid oxidation |
| Severe leg pain and swelling in calf, femoropopliteal venous clot. Most likely cause? | Hypercoagulability from advanced malignancy (pts with cancer are hypercoagulable) |
| Woman with temporal balding, coarse dark hair on upper chin, ⬆️testosterone, ovarian mass. What’s this mass? | SERTOLI LEYDIG tumor |
| SERTOLI leydig makes testosterone. | Granulomatous tumors make ESTROGEN |
| Epithelial cell are disrupted but the cell adhesion to the basement membrane remain intact. Function of a substance affected? | Catherins (adhesion molecules) |
| Edema around a fluctuant erythematous lesion, area tender to palpation. Primary mechanism of development edema? | Separation of endothelial junctions |
| Permeability is increased in response to injury and inflammation allowing migration of white blood cells and friends to the site of injury. | Endothelial tight junction |
| Hx of headache, nausea and vomiting. Fundoscopy shows bilateral papilledema. MRI shows pineal tumor (parinaud Sx) compressing the brain stem leading to hydrocephalus. Impairment of oculomotor? | Upward gaze |
| CT scan wedge shaped areas of hypodensity (wedge shape=vascular territory) | Renal infarcts(commonly caused by emboli from Atrial fibrillation) |
| Fracture of INFERIOR orbital wall affect ? | Infraorbital artery |
| Hx of progressive Epigastric pain, weight loss, severe at night. Stool occult blood +, bleeding ulcer at antrum of stomach what is the process involved? | Elaboration of protease and urease with local tissue destruction |
| Produces proteases, particularly urease, which allow to increase the pH of its local environment by cleaving urea into ammonia, which is toxic to gastric mucosa. | H pylori |
| Hit at the lateral side of leg below the knee, unable to Doris flex foot most likely injured? | Common fibulae (peroneal) |
| Secrete TESTOSTERONE in the presence of LH; homolog of female THECA interna cells | LEYDIG cells |
| Inability to convert testosterone into DHT, in MALE internal genitalia ambiguous external genitalia until puberty when ⬆️ testosterone causes masculinization | 5 alpha REDUCTASE deficiency |
| Produce 1-2 wks after antibody complexes form and deposit in tissue. Associated with drugs(haptens, penicillin, infections) antigen antibody complement | Serum sickness type III hypersensitivity IgG |
| Direct cell cytotoxicity CD8+ cytotoxic T cells kill targeted cells. Inflammatory reaction: effector CD4 + T cells recognize antigen and release inflammation inducing cytokines. Type IV hypersensitivity | Contact dermatitis, poison Ivy, nickel allergy and graft vs host disease. PPD for TB test, patch test for contact dermatitis. |
| Asymptomatic mild jaundice with stress illness or fasting. ⬆️unconjugated bitlirubin WITHOUT overt hemolysis | GILBERT Sx (⬇️UDP gluconosyltransferase conjugation and impaired bilirubin uptake) |
| Absent of UDP glucoronyltransferase. Present early in life, jaundice, kernicterus, bilirubin deposition in BRAIN, ⬆️ Unconjugated(indirect) bilirubin. Tx plasmapheresis,( type II respond to phenobarbital ) | Crigler Najjar Sx type I |
| Newborn wi the generalized edema, pleural effusion, ascites, hepatosplenomegaly, hypoproteinemia, low colloid osmotic pressure and congested heart failure | Hydrops fetalis |
| Is EXCRETED in the BILE and into duodenum. | Conjugated (direct) bilirubin |
| Newborn has STERILE bowel and POOR peristalsis much of the CONJUGATED bilirubin may be hydrolised in? | Glucoronidase back to unconjugated then absorbed in bowel and liver(enterohepatic circulation ) |
| ⬇️ in advance LIVER disease (⬇️ thrombopoietin, liver sequestration) and portal HTN (splenomegaly/splenic sequestration) | Platelets if LOW can cause |
| When HIGH bilirubin indicates | ⬆️ in various LIVER disease (biliary obstruction, alcoholic or viral hepatitis, cirrhosis), hemolysis |
| Increase ALP (alkaline phosphatase) in | ⬆️cholestasis (biliary obstruction), infiltrative disorders, bone disease. |
| Aggressive bone lesion(osteosarcoma, Ewing sarcoma, osteomyelitis) | Raised periosteum(codman triangle) |
| Space between the uterus and the rectum. The ampulla rupture the fluid is found in? | Pouch of Douglas that’s where the free fluid goes. |
| ⬇️ ability to break down FATTY acids into Acetyl-CoA leads to accumulation of fatty Acyl carnitines in the blood with hypoketotic hypoglycemia. | Medium Chain Acyl-CoA dehydrogenase deficiency (MCAD) |
| Disorder can be fatal as affected individuals CANNOT break down FATTY ACIDS into usable ENERGY during times of FASTING/STARVATION. | A fatty oxidation disorder MCAD (medium chain Acyl-CoA dehydrogenase deficiency |
| Inherited DEFECT in transport LCFA (long chain fatty acids) into MITOCHONDRIA leads to toxic accumulation causes weakness, hypotonia, hypoglycemia | Systemic primary CARNITINE deficiency (fatty acid metabolism) |
| Requires transport of citrate from mitochondria to cytosol, occurs in liver, lactating mammary glands and adipose tissue | FATTY ACID synthesis |
| DMARD(disease Modifying Antirheumatic Drug) Sulfasalazine, Etanercept, Adalimumab, Infliximab is for inflammatory conditions like ? | Ankylosing spondylitis, RA, Psoriasis, IBD (causes immune suppression) |
| DMARD when not improving must be given a drug that inhibits? | Tumor necrosis factor - alpha TNF-a |
| Blisters don’t break easily the blisters is the RESULT of adhesion failure involving? | Basement membrane (phemphigus bulluous, loss of HEMIDESMOSONES that bind keratinocytes to basement membrane) |
| They lose DESMOSOMES which bind keratinocytes to each other so the SKIN is super FRIABLE and result in ULCERATION, mouth ulcers mc. | Pemphigus Vulgaris |
| If you Don’t EAT enough CALORIES to run your metabolism your BODY will use it’s storage by? | Fatty acid oxidation (burn fat) |
| Overdose of acetaminophen, treatment of activated charcoal and acetylcysteine . After 48 hr pt develop jaundice ⬆️AST 3000 what explain the jaundice? | Decreased bilirubin conjugation(direct) |
| Organophosphate pesticide POISONING as Cholinesterase inhibitors, result in build of Acetylcholine and muscarinic/nocotinic receptor overstimulation which leads to ? | ATROPINE (anticholinergic) |
| Can cause FULMINANT hepatic failure in overdose? | Acetaminophen (Tylenol) |
| Old frail people and alcoholics, with SOB, dullness over Right Lower Lung is mc site of pneumonia with difficult swallowing due to? | ASPIRATION |
| CANNON (atrial) waves are prominent Jugular venous pulsation that occur when atria and ventricle contract simultaneously. When there’s NO relation between atrium P waves and QRS complex means | THIRD degree AV block (complete heart block) |
| Is mcc of SUDDEN cardiac DEATH immediately after MI? | Ventricular Fibrillation |
| Papillary muscle rupture occurs 2-7 days after MI and results in MASSIVE life threatening MITRAL regurgitation. FREE ventricular wall rupture after MI result in? | Cardiac tamponade (⬆️ JVD⬆️ HR, ⬇️HTN, electrical alternans) |
| Episodes of constipation, abdominal discomfort, mild fatigue, previous renal calculus, lazy gallbladder, ⬇️ phosphorus, ⬆️Ca the condition Is a small define nodule in which location? | Parathyroid gland |
| Can cause ⬆️PTH, which results in ⬆️Ca ⬇️PO4. Hypercalcemia (stones, renal, biliary) bones(bone pain to osteitis fibrosa cystica), groans abdominal pain, nausea, vomiting. Thrones(polyuria, constipation) and psych overtones(depression, coma) | Functional parathyroid adenomas |
| Left sided hemiparesis, tongue deviates to the RIGHT when protruded. Proprioception and sensation to light touch absent over LEFT upper and lower extremities. C | Cross section means BRAINSTEM lesion. Right (ipsilateral) tongue, left sided (contralateral) weakness means EXITING Right hypoglossal (CN XII) has been affected (within right Medulla). C is the PYRAMID where corticospinal tract control muscles. |
| Pyramid in crossed finding image is where corticospinal tract runs to control muscles (prior decussation) is known as | Medial medullary syndrome or Dejerine Sx |
| Used in immunological studies for the study of DNA alterations. | Southern blot |
| One gene configuration related to immune globulins demonstrate multiple different BANDS in bone marrow, indicative of | Gene rearrangement |
| Reactive processes are polyclonal (multiple bands) leukemia is monoclonal(single band). | The more lines (bands) within the specific organs means GENE rearrangement |
| Caused by a defective receptor. DHT is responsible for creating MALE genitalia. The lack of response to adrenal androgens prevent formation of hair during puberty. Default FEMALE genetically MALE | Androgen insensitivity |
| Stimulate sebaceous glands and causes acne. In girls is due to adrenarche (DHEA/DHEAS)androgen production by zona reticularis. BOYS blame testosterone from gonadal pubarche. | Androgens |
| Perforated appendix the peritoneal fluid will show? | E. coli is NORMAL gut flora, the body prefers intraluminal |
| Absolute risk reduction is the DECREASE in number affected per number exposed. 15 pt erythro, 5 pts azythro, 50 total pts exposed | ARR= (15 - 5) / 50 = 10/ 50 = 0.2 |
| Hepatitis C, Viral (foreign) peptides bind to class I MHC (endogenous/intracellular type) and then get attacked by | CD8+ killer T cells lymphocytes |
| Self peptides Class II MHC are those found in APC not regular TISSUES | CD4+ helper T cells do NOT cause direct cell injury. |
| Receptors that fire more frequently increase WALL stress/distention. In chronic HTN increases pressure if left untreated it causes to decrease | BARORECEPTOR output |
| Chronic inflammatory interstitial pneumonitis alveoli patterns? | ⬇️ type I pneumocytes. ⬆️ type II pneumocytes. ⬆️ Fibroblast |
| Lung parenchyma(composed of type I pneumocytes), type II makes surfactant and replicate in order to replace type I pneumocyte so they will increase. Fibrosis increase fibroblast | Chronic interstitial pneumonitis |
| Crepitus means GAS in tissue which is produced by a virulent alpha toxin, Gram positive rods in DM wound foot means? | Clostridium perfringens |
| Pulmonary embolism which is the specific indicator of Pulmonary arterial Hyoertension? | P2 louder than A2 |
| Left sided system of the heart is much higher pressure than right side. AORTIC Valve closing is usually louder than the pulmonic valve. | P2 louder than A2 means pulmonary arterial pressure is significant elevated. |
| Metronidazole and alcohol causes (Disulfiram-like reaction). By? | Accumulation of acetaldehyde. |
| Responsible for EXTERNAL rotation of the shoulder? | Infraspinatus (infraspinatus and supraspinatus innnervated by Suprascapular nerve) |
| Small cell lung carcinoma chemotherapeutic drug Vincristine, Bleomycin, Cyclophosphamide Moa? | Depolymerization of microtubules (induces axonal neuropathy) |
| Marian syndrome molecular FBN1 a genetic VARIATION in a particular nucleotide is called? | Polymorphism (DO not change the protein) |
| Pt shot in leg unconscious, pale, pulse 120, hypotensive, in compare to healthy adult shows? | ⬇️ arterial BARORECEPTOR firing rate, ⬆️ SVR, ⬆️PVR |
| Pts with hemorrhagic shock will see a ⬇️ decrease baroreceptor FIRING rate. Activation of RAAS result in ⬆️ vascular resistance (vasoconstriction) in order to maintain blood pressure and capillaries as in kidney. | Baroreceptor are stretch receptors |
| Likelihood a pt with Positive test has a tumor ? Positive predictive Value | PPV= TP/ (TP + FP) = 0.67. 40/60= .66666 |
| False negative test is negative but pt actually have cancer. Calculate sensitivity? | TP / (TP + FN) = 60 / (60 + 20) = 0.75 |
| If EFFERENT arteriole constricted with a clamp the changes in glomeruli are? | Increased Hydrostatic pressure |
| A screening needs (HIV Elisa), how good a test is at ruling out a disease | High sensitivity is a TRUE positive |
| A confirmatory test, (HIV western blot) | High specificity |
| Fluid keeps coming into glomerulus (VIA AFFERENT arteriole) but if you CLAMP the EXITING vessel (EFFERENT arteriole) then it’s going to build up fluid in glomerulus leading to | Increased Hydrostatic pressure (as increased filtration fraction) |
| Fragile X is a CGG, like Huntington CAG (AD). | Trinucleotide repeat expansion |
| Damage of which vessel caused ⬇️Ca and ⬆️PTH after a radical thyroidectomy? | Branch of the thyrocervical trunk |
| Vascular supply of the parathyroid glands? | Inferior thyroid arteries arise from thyrocervical trunk |
| Thiazides diuretics work on NaCl symporter. Like all diuretics EXCEPT (potassium sparing) they cause | ⬇️K hypokalemia (orhtostatic hypotension) |
| Immature defense mechanism often employed by pts with borderline personality disorder | Splitting (fails to see others positive and negative it’s all or nothing) |
| Can be prospective there’s no control group | Case series |
| Inability to form hypochlorite result in inefficient killing organism. Recurrent bacterial infections involves Candida. The cause is? | Myeloperoxidase |
| Toddler with oral vesicles, cervical lymphadenopathy, fever, the cause is? | DNA virus |
| Herpes (herpetic Whitlow) HSV-1 | Large dsDNA virus linear |
| Look like earthworm, no fever, mode of transmission? | Ingestion of soil |
| Typically from eating delicious MUD or contaminated farmstuff. Causes abdominal pain, diarrhea, result in pooping worms? | Ascariasis (hookworm) tx mebendazole |
| Urethral exudate gram stain negative diplococci, infecting organism reinfection? | Antigenic variation |
| DMD is X linked 50% x linked carrier depends on X inactivation | Patient DMD carrier status is uncertain due to random X inactivation. |
| Usually women have, the labs increase bleeding time, mc bleeding diasthesis | Women have vim willebrand disease MALE have hemophilia |
| Fracture of superior pubic ramps and retrograde urethrography. Greatest risk ? | Membranous |
| Most commonly injured fracture in urethra manifest as bleeding | Membranous |
| Urethra most likely to be injured during TRAUMATIC catheter insertion or in STRADDLE injury. | Spongy urethra |
| Neutrophil multilobed nucleus is the MAIN fighter of the immune system in acute inflammation and bacterial infection the likely mediator is? | C5a (chemotactic factor for PMN), LTB4, IL-8 |
| Proliferative phase of menstrual cycle is controlled by | Cyclin dependent kinases |
| Carbamazepine may affect which process? | Metabolism CYP450 |
| Below dentate hemorrhoids lymph nodes possible metastasis? | Superior inguinal |
| Above the dentate line lymph nodes mestastasis? | Superior rectal then internal iliac |
| Left orbital floor fracture involving the infra orbital foramen, this carries a branch of the ? | Maxillary nerve V2 the infra orbital nerve, responsible for sensation in upper lip. |
| Bulging specimen of the terminal ileum, most likely show? | Gastric mucosa |
| Anti mesenteric near terminal ileum, recurrent bleeding episode secondary to acid producing ectopic gastric mucosa. | Meckel diverticulitis |
| Olygohydramnios, full term fetus, Cause fetal renal damage. On first trimester organ dysgenesis, on second trimester and third injury unequivocal. | ACE inhibitors |
| Bilateral wheezing accumulation of which mediator? | Leukotrienes(montelukast) |
| Can exacerbate acute worsening of asthma after first dosage. | Aspirin exacerbation respiratory disease |
| Fasting physiology 6 to 24 hours after a meal a post absorptive phase is dominated? | GlycoGenolysis in the liver |
| Fasting physiology 24 to 2 days after a meal a post absorptive phase is dominated? | Ketosis |
| Intestine shows wall thickened loop of small intestine areas narrowed, skip lesions, fistulas, strictures the diagnosis is? | Crohn disease |
| Blood sample appear blood indicate poorly oxygenated CHOCOLATE brown blood sign of | Methemoglobinemia (reduced ferrous Fe2 state is oxidized to the ferric Fe3 because FERRIC iron is unable to bind transport oxygen |
| Biphosphonates work by? | Decreasing ⬇️ osteoclast activity (reducing BONE resorption) |
| Estrogen therapy works by RANKL found in OSTEOBLAST and its activation causes? | Increased ⬆️ receptor activator NF-kB ligand (RANKL) production(triggers osteoclast and stimulates bone resorption) |
| Conclusion about the effect of regular exercise on risk for hip fracture? Confidence interval 1.1 to 1.8 95%. | Statistically significant overall increase in RISK |
| Odd ratio greater >1 signifies increase ⬆️ ODDS/RISK/Likelihood. If 95% confidence interval range does NOT include 1 then.. | The difference is statistically SIGNIFICANT |
| Major tissue growth factor activated by injury, cytokine release (a infection, inflammation) and hypoxia that promotes ANGIOGENESIS and also increases vascular permeability (EDEMA) | VEGF (vacular endothelial growth factor ) |
| Some skull base fractures can be treated with (desmopressin) DDAVP. It works via activation of Aquaporin channels moved from intracellular to apical membrane | Diabetes insipidus |
| Desmopressin urine osmolality increases the beneficial effect is due to activation of? | Adenylyl cyclase (⬆️ adenylyl cyclase via Gs protein that increases intracellular cAMP) |
| RSV (bronchiolitis) is RNA (paramyxovirus) ss RNA linear that enters the cell via a FUSION protein (which is target of the prophylactic monoclonal drug?) | Palivizumab |
| TNF inhibitor is a monoclonal antibodies? | Adalimumab, Palivizumab (end in ab) |
| Bronchodilator ALBUTEROL help with wheezing. Epinephrine (pen) will also help. | b2 Adrenergic agonist (albuterol) |
| Important TUMOR suppressor gene it’s ability to cause CELL to undergo APOPTOSIS in the event of damage. | p53 |
| Mutation in p53 progression of tumor despite ofmirradiation is related to a defect in cell cycle arrest in which phase? | G1 phase S phase DNA synthesis |
| Bilateral hydroureter and hydronephrosis and Fock of calcification of the bladder which explains biopsy finding? | Schistosomiasis (chronic bladder infection with risk of squamous cell carcinoma bladder) |
| Parasitic worm in endemic AFRICA (egypt) most associated with chronic cystitis. Calcification said of the bladder WALL are pathognomonic? | Schistosomiasis |
| Microangiopathic hemolytic anemia, thrombotic purpura, fever, renal failure, neurological abnormalities, low platelets (indicate thrombocytopenia) | TTP classic Pentad (thrombotic thrombocytopenic purpura) |
| Mediastinum in the MIDLINE, air fluid (hydropneumothorax) in the Left of chest, elevation of stomach bubble, fluid is blood (stabbing), lack of mediastinal shift indicate that is not under tension diagnosis is? | Hemopneumothorax, not under tension |
| Raise ⬆️ HDL and ⬇️ decrease LDL and TG? | Statins (atorvastatin, simvastin) |
| Teenager with closed comedones over cheeks and forehead. Cause of acne? | Stimulation of the sebaceous glands by androgens |
| Can happen in Brazil as well as Africa (jaw lesion, puffy face). Tingible body macrophages ? | Apoptosis cells various degradation (burkitt lymphoma) |
| Many ORAL cavity lesions specially ANTERIORLY such as TIP of the tongue drain first to? | Submental (level 1) oropharyngeal squamous cell carcinoma drain at level 2 |
| Cyst and trophozoites portal of pathogen is? | Olfactory nerve |
| Caused by Naegleria Fowleri, found in fresh water bodies like ponds, lakes, it has 3 forms which ones? | Cyst, throphozoite (ameboid) and biflagellated (flagella) |
| Infection is via OLFACTORY cell axons through the cribriform plate to the brain? | CNS Amoebiasis (naegleria fowleri) |
| Are prone to relapse due to the ability to infiltrate and then lie dormant in the liver? | Malaria infection by Plasmodium VIVAX |
| Rigidity, blank stare, flat facial expression, incredible aggression, vertical nystagmus most likely ingested? | PCP (phencyclidine) |
| The alpha VALUE corresponds to the p-value (accepted as significant and reflect LIKELIHOOD of type I error (false positive). | An⬇️ lower alpha value means a LOWER acceptable LIKELIHOOD of obtaining the SAME results by chance and significant results can be reported more confidently (1% false positive rate INSTEAD of 5% rate) |
| If alpha is set at 0.01 instead of 0.05 which is the result ? | Significant finding can be reported with GREATER confidence |
| Leads to hypogonadotrophic hypogonadism as the body realizes that the possibility of nourishing a fetus is zero and gives up the pretense. If you see word gymnastic or dancer | Anorexia |
| Swallowing amniotic fluid is a critical component of lung development. Fetuses with severe OLIGOHYDRAMNIOS are plagued by? | Pulmonary hypoplasia |
| Pulmonary hypoplasia Causes death of fetuses born with? | Potter Sx (renal agenesis) |
| A reducing substance test result in urine positive and glucose oxidase test result is negative which metabolite in liver is most likely increased? | Galactose -1-phosphate |
| Congenital intolerance to BREAST milk. GalactoseMIA body cannot convert to GalactoSE to GlucoSE (resulting in accumulation of)? | Galactose-1-Phosphate |
| Erythematous solid tender mass on the underside of upper extremity above elbow, mass drained blood and necrotic material. Most effective antibiotic ? | Ribosomal assembly (30s ribosomal AMINOGLYCOSIDES gentamicin, streptomycin, doxycyclin) |
| Middle age person with PROGRESSIVE weakness including mix UMN/LMN sign (weakness, fasciculations) muscle atrophy the diagnosis is | ALS (amyotrophic lateral sclerosis/ motor neuron disease LOU Gehrig) |
| Killed vaccine relative to a LIVE vaccine is most appropriate rationale for killed vaccine? | Avoid the concern for reversion to virulence |
| Designed to prevent typically in immune compromised individual (either get vaccine or contact with someone who does ) | Live vaccines |
| During the last minute of exercise which is decreased? | Total peripheral resistance (as the arterioles supplying muscle and skin dilate) |
| Cushing Sx classic wide red steaks over lower trunk, abdominal striae, truncal obesity, moon facies. Increased levels of Cortisol often results in? | Hypertension and muscle weakness (due to catabolic process) |
| Apohysitis of the tibial tubercle. It’s due to chronic stress/irritation at the insertion of patellar tendon on tibial tubercle. Seen in teenagers repetitive movements (running, jumping) | Osgood-Schlatter (patellar ligament) |
| Sudden intense feeling of FEAR which area of the brain is stimulated? | Amygdala |
| Cystic fibrosis AR, you need a double HIT to express the disease. The genetic test only pick ONE ALLELE and missed the other mutation. | The second CFTR mutation was NOT detected by the testing obtained. |
| Early onset tremor is AD inheritance (anticipation) involves? | Basal ganglia particularly caudate (Huntington disease ) |
| Periorbital edema and rust colored urine for 2 days, honey crusted layer and removed with antibiotics which characteristic identify the bacteria? | Bacitracin sensitive strep pyogenes |
| Pruritic rash, women in 40 yr, bloating and weight loss (celiac disease) intestinal biopsy shows | Atrophy of intestinal villi CD8+ T cell lymphocytes in small intestine |
| Cobblestone mucosa and transmural inflammation | Crohn disease |
| Sudden death cardiac muscle change in cardiac hypertrophy? | High rate of MYOSIN mRNA synthesis |
| Family Hx of breast cancer, BRCA1, shows ovaries with polycystic ovary syndrome | Increase testosterone (androgen. Excess) ⬆️LH |
| Inhibit PROKARYOTIC protein 30s ribosomal include tetracyclines and aminoglycosides | Doxycycline, streptomycin |
| Function by binding specific DNA sequences promoting or blocking RNA polymerase Genes transferred by the retroviruses code for which proteins? | Transcription factors |
| Can cause pupillary constriction | Muscarinic cholinergic PILOCARPINE |
| Causes pupillary DILATION is alpha Adrenergic agonist a1 | Phenylephrine |
| Slowest to Fast action potential conduction velocity? | AV node speed conduction (0.05) this delay depolarization, Ventricular muscle, bundle of HIS located in the interventricular septum, Atrial muscle and Purjinke Fastest at 2.2 |
| Shows ST elevation in I, aVL, V5 - V6, supplies lateral and Posterior Walls of LV, anterolateral Papillary muscle. | Left circumflex coronary Artery |
| Occlusion show ST elevation more prominent V2-V4, supplies anterior 2/3 ofninterventricular septum | Left anterior Descending Artery (LAD) |
| How many FALSE positive would be expected per 100,000 individuals in this population. Disease X out of 1,000 affected 100 out of 1,000 healthy disease prevalence 10,000/100,000 | Prevalence 10,000/100,000 only 10,000 will have disease and 90,000 will NOT. False positive Rate of 10% X 90,000 = 9,000 false positive per 100,000 individuals False positive rate is (1 - specificity) and is independent of disease Prevalence |
| Women ages 30 and 40 all have mutation FGFR2 for 5yrs. 30 of the women develop cancer, 65 not. Second group no mutation 20 develop breast cancer 75 not in 5 yr. what’s the relative risk | RR= (30 / 95 ) / (20 / 95 ) = 30 / 20 = 1.5 Exposure / risk unexposed. 30/(30+65) = 30/95. Without 20/(20+95) = 20/95 |
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Lillianita
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