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UW2021
| Question | Answer |
|---|---|
| Dextromethorphan moa? | Activates medullary sigma receptors, cough suppressant. |
| Dextromethorphan moa? | Antitussive agent that acts on sigma receptors to suppress the medullary cough center. It has an off target action on SEROTONIN transports and receptors in the CNS. |
| It’s primary moa is inhibition of the medullary cough center through sigma (o) receptor activation? | Dextromethorphan (DXM) |
| Abuse can cause serotonin syndrome, manifest as muscular hypertonia, spasticity (clonus, hyperreflexia) autonomic instability (hyperthermia, hypertension) and encephalopathy. | Dextromethorphan |
| AD, mutation in TSC1 or TSC2 tumor suppressor gene? | Tuberous sclerosis complex |
| Defective tuberin hamartin complex causes unrestricted cellular proliferation? | Tuberous sclerosis complex |
| Classic findings of tuberous sclerosis complex are? | Skin (ash leaf spots, facial angiofibromas, Shagreen patches), neurologic (CNS hamartomas, subependymal nodules, seizures, intellectual disability), cardiac (rhadomyomas), renal (angiomyolipomas) |
| Promotes gene transcription of hormones such as erythropoietin? | JAK/STAT signaling |
| Associated with myeloproliferstive disorders such as polycythemia vera? | JAK2 mutation |
| Enzyme that maintains same length, when mutated rapidly divide cells, lose chromosomal integrity, triggering premature cell death. | Telomerase |
| Neurocutaneous disorder in which enhanced mTOR signaling due to defective tuberin hamartin complex results in uncontrolled cellular proliferation and tumor formation ? | Tuberous sclerosis complex |
| Hormone secreted by the placental syncytiotrophoblast after uterine invasion that signals the ovary to maintain the CORPUS luteum? | B-hCG |
| Host factor responsible for mediating response of the monoclonal antibody therapy? | Natural killer cells and granzymes |
| Epidermal growth factor receptor over expressed by aggressive breast cancers? | HER2 |
| Antibody dependent cellular cytotoxicity (ADCC) mechanisms? | Monoclonal IgG bonds surface antigen on a foreign cell, NK binds Fc portion of the attached IgG using CD16, NK release granules which contain perforin and granzymes (proteases) that induce apoptosis/osmotic lysis. |
| Release inflammatory cytokines display tumor associated antigens and generate tumor specific immunoglobulin? | Tumor infiltrating B cells |
| Release effector cytokines (INF-y, TNF) And cytotoxic granules (perforin, granzymes) that destroy tumor cells, they interact with MHC class I receptor? | CD8 cells |
| Partial or complete separation of previously approximated wound edges? | Wound dehiscence |
| Mechanism of wound dehiscence complication with bevacizumab? | Depletion of endothelial growth factor for angiogenesis |
| Monoclonal antibody that binds Vascular Endothelial Growth Factor(VEGF)? | Bevacizumab |
| Leads to inadequate blood supply to support collagen production during proliferation (3 days to 5 wks) phase and collagen remodeling and cross linking during maturation phase (3 wks to 2 yr).? | Lack of angiogenesis |
| Caused by proliferation of Epstein Barr virus in donor or host cells due to reduced cytotoxic T cell immunosurveillsnce from high dose immunosuppressive therapy? | Posttransplantation lymphoproliferative disorder |
| Cell membrane receptor that has ion channels that open directly upon ligand binding? | Ionotropic receptors |
| Neuromuscular junction is an example of a ligand gated ion channel receptor (ionotropic receptor)? | Nicotinic Cholinergic receptors |
| Found in CNS and on postganglionic neurons of autonomic ganglia? | Nicotinic cholinergic |
| ANS utilizes three types of signal pathways? | IP3, cAMP, and ion channels |
| Virus contain a bullet shaped envelope with knob like glycoprotein that attach to? | Nicotinic acetylcholine receptor at the neuromuscular junction |
| Presents with progressive agitation, disorientation and pharyngospasm suggest? | Rabies (neutrophic virus from Rhabdoviridae) |
| Virus travel retrograde through peripheral nerve axons to the dorsal root ganglia, ascends the spinal cord and infects diencephalon, hippocampus and brain stem. | Rabies (rhabdoviridae) |
| Characterized by sore throat, swollen lymph nodes, malaise and atypical lymphocytosis? | Epstein Barr virus bind CD21 (CR2) belongs to herpesviridae |
| Found in Nasopharyngeal and adenoid epithelial cells associated with common cold, not agitation, pharyngeal spasm and hallucinations? | Rhinovirus bind intracellular adhesion molecule-1 (ICAM1 (CD54)) |
| It has hemagglutinin glycoproteins that allow it to attach to sialic acids on the surface of the respiratory epithelium? | Influenza virus |
| Leads to replication within endothelial cells, infections are asymptomatic, it can develop mononucleosis (lethargy, fever, atypical lymphocytosis, disorientation)? | CMV binds vascular endothelial integrins (cellular integrins) |
| Failure of neural crest cells to migrate into the sigmoid colon/rectum, leads to absence of the myenteric and submucosal nervous plexuses, bilious emesis, failure to pass meconium? | Hirchsprung disease |
| Disrupt neuronal and glial development and low serotonin and other neurotransmitter? | High phenylalanine |
| Is a cofactor in the synthesis of serotonin? | BH4 |
| Formed through hydroxylation and decarboxylation of the amino acid tryptophan? | Serotonin (5-hydroxytryptamine or 5HT) |
| Formed by glutamate decarboxylation a reaction catalyzed by glutamate decarboxylase | Gamma-aminobutyric acid (GABA) |
| Inhibitor of presynaptic transmission in CNS? | GABA |
| Potentiate GABA activity to deacreased or cease seizure activity? | Phenobarbital |
| Carries AFFERENT information that enters the spinal cord BELOW T6 (lower half of the body) to gracile nucleus in medulla? | Gracile fasciculus |
| Located in posterior spinal cord and convey vibration, proprioception and light touch sensation? | Dorsal columns |
| It course through transverse foramina in the neck before entering the skull at the foramen Magnum that can be injured in a cervical spinal trauma? | Vertebral arteries |
| Parotid gland tumors compress and disrupt the ipsilateral facial nerve (CN VII) causing? | Facial droop |
| OST parotid gland tumors causing facial nerve paralysis are? | Malignant neoplasm |
| Unilateral optic neuritis demonstrate an AFFERENT pupillary defect due to? | Demyelination of optic nerve CNII |
| Nerve that can be compress by the inguinal ligament? | Lateral femoral cutaneous nerve |
| Is a compression mononeuropathy of the lateral femoral cutaneous nerve at the inguinal ligament, caused by tight clothing or by injury during surgery? | Meralgia paresthetica |
| Provide innervation to the hidgut, bladder, urinary sphincter and regulate peristalsis, bladder emptying,defecation? | Pelvic splanchnic nerves (S2-S4) |
| Presents with pain, paresthesia, numbness in the lateral thigh without motor weakness? | Meralgia paresthetica |
| Presents with facial pain, headaches, jaw dysfunction and ear pain/muffled hearing are characteristics of? | Temporomandibular disorder |
| Eye down and out is due to unopposed action on which muscles? | Superior Oblique (CN IV- trochlear) and lateral rectum (CN VI) abducens |
| Innervates the lateral rectum muscle, which originates at the annular tendon and inserts on the temporal globe? | Abducens nerve CN VI |
| It causes herniation of cingulate gyrus underneath falx cerebri, contralateral leg weakness (ipsilateral ACA compression)? | Subfalcine herniation |
| Presents as drooping of the shoulder, impaired abduction of the arm above 100 degrees, lateral displacement of scapula? | Trapezius weakness |
| Elevates and rotates the scapula upward (during arm abduction) and stabilize the shoulder? | Trapezius |
| Injury cause impaired sensation over the lateral shoulder and weakness in abduction of arm 30 tom100 degrees? | Deltoid |
| It can be damaged during axillary lymph node dissection? | Latissimus dorsi |
| Innervated by axillary nerve (C5-C6) | Deltoid |
| Causes winging of the scapula following axillary lymph node dissection? | Serratus anterior |
| Occur due to repetitive pronation/supination of the forearm (screw driver use, dislocation of the head of the radius? | Deep branch of the radial nerve |
| Nerve blocks can be performed at the mandibular foramen to provide anesthesia for dental procedures or at the mental foramen to facilitate laceration repair of the ? | Chin and lower lip |
| Originates from ventral rami of S2-S4 and passes between the piriformis and coccygeus muscle as it exit the pelvis? | Prudential nerve |
| Occur due to excessive stress on the pelvic floor during labor and delivery (prolonged second stage)? | Pudental nerve injury |
| Caused by periventricular white necrosis leads to a loss of descending inhibitory control from upper motor neurons? | Spastic cerebral palsy |
| Above the splenic flexors, peristalsis is controlled by parasympathetic innervation of? | Vagus nerve |
| Beyond splenic flexors it is controlled by parasympathetic innervation of? | S2-S4 nerve roots |
| Peripheral edema and heavy proteinuria has? | Nephrotic syndrome |
| Amyloidosis begins when which proteins misfold? | Light chain, beta 2 microglobulin, transthyretin (native proteins) |
| Reactant induced by cytokines, produced during chronic inflammatory states (RA, osteomyelitis)? | Serum amyloid A |
| Rapidly progressive glomerulonephritis present with GBM antibody disease, urine sediment, RBC cast? | Crescent formation in glomeruli |
| Seen in post streptococcocal glomerulonephritis, membranoproliferative glomerulonephritis and lupus nephritis? | Diffuse hypercellular glomeruli |
| Painless hematuria frequently provoked by upper respiratory tract infection? | IgA deposition in glomerular Mesangium |
| Inflammatory condition that begins in infancy or early childhood? | Atopic dermatitis(eczema) |
| Calcineurin inhibitors (tracolimus, pimecrolimus)a lymphocyte specific phosphatase to treat atopic dermatitis causes? | Inhibit T cell signaling leading to transcription of pro inflammatory cytokines IL-2. |
| Reduced IL-2 leads to? | Decreased T cell activation and proliferation and in turn inflammation. |
| Inhibits histamine granule release from mast cells used to treat allergic rhinitis and mastocytosis? | Cromolyn |
| Prevents binding of IgE to mast cells and basophils used to treat severe asthma? | Omalizumab |
| Stimulates IgE production and differentiation of naive CD4 T cells to Th2 cells, exacerbates atopic dermatitis? | IL-4 |
| Bind to cytoplasmic receptors and translocate to the nucleus, inhibiting transcription? | Corticosteroids |
| It happens when use aspirin in children during viral infection (influenza, varicella)? | Reye syndrome |
| Progressive disorder characterized by acute liver failure (hepatosplenomegaly, elevated transaminases, coagulopathy) encephalopathy? | Reye syndrome |
| Can damage mitochondria within hepatocytes and inhibit (impaired) fatty acid beta oxidation? | Salicylates (aspirin) |
| Induces a robust CD8 T cell response against infected hepatocytes which elevates aminotransferases? | Viral hepatitis |
| Overdose can cause acute liver failure through depletion of intracellular Glutathione? | Acetaminophen |
| Septic organ dysfunction is driven mainly by? | Poor tissue oxygen use |
| Cellular dysoxia is caused by 3 major mechanisms? | ⬇️ global oxygen delivery, ⬇️ micro circulatory oxygen extraction, ⬇️mitochondrial oxygen use |
| Causes tissue EFEMA(third spacing) which increases the diffusion distance for oxygen to reach mitochondria of target cells? | Increased capillary permeability |
| Causes BLOOD to shunt rapidly through organs, decreasing the opportunity for oxygen extraction? | Widespread microcirculatory failure with vasodilation |
| Is the mcc of acute unilateral upper and lower facial weakness is? | Bell palsy (acute peripheral neuropathy of CN VII) |
| Upper face receives bilateral input from the motor cortices, CNS lesions causes? | Unilateral lower facial weakness that spares the forehead. |
| It can cause decreased tear production, hyperacusis, reduced taste sensation? | Bell’s palsy (peripheral lesion) |
| The Th2 cytokines that trigger acute inflammation in Atopic dermatitis are? | IL-4 and IL-13 |
| Involved in neutrophil migration and activation in bacterial infections? | IL-8 and C3b |
| Attracts neutrophil to infect areas where C3b opsonizes pathogens for phagocytosis? | IL-8 |
| Involved in granuloma formation and host defense against mycobacterium (intracellular killing of tuberculosis) | IL-12 and INF-y |
| Involved in pathogenesis of psoriasis? | IL-17 and IL-23 |
| Lesion reveals mixed granulomatous and neutrophilic micro abscesses in the dermis? | Cigar shaped yeast (sporothrix schenckii) sporotrichosis |
| Histology shows sulfur granules dense inflammatory infiltrate? | Actinomycosis |
| Presents as FIRM cervicofacial(mandibular) mass with abscess and sinus tract formation after surgery (tooth extraction) or trauma? | Actinomycosis |
| Lesions are granulomatous inflammation and intracellular amastigote within macrophages? | Leishmaniasis |
| Antirheumatic drug fusion of CTLA4 with Fc position of IgG? | Abatacept |
| Atopic dermatitis when is chronic presents as? | Lichenified plaques |
| Proximal muscle weakness and heliotrope rash on the upper eyelids is? | Juvenile dermatomyositis |
| Epidermal growth factor receptor over expressed by aggressive breast cancer? | HER2 |
| Targets the HER2 receptor resulting in tumor regression? | Monoclonal antibody (trastuzumab) |
| Contain perforin and granzymes (proteases) that induce apoptosis/osmotic lysis of the antibody bound cell? | NK cell release it’s Granules |
| Have CD16 and engage in ADCC(antibody dependent cellular cytotoxicity) and CD16 mediated phagocytosis of foreign organism? | Macrophages and Neutrophils |
| Bevacizumab suppresses angiogenesis in healing wounds it can also cause? | Wound dehiscence |
| Lack of angiogenesis leads to inadequate blood supply to support collagen production during which phase? | Proliferation (3 days to 5 wks) |
| La k of angiogenesis leads to collagen remodeling and cross linking during which phase? | Maturation (3 wks to 2 yr) |
| Causes DNA damage resulting in apoptosis of susceptible (highly proliferative) cells, including local blood vessels and can result in ischemia (chronic skin ulcers)? | Radiation therapy |
| Suppress the inflammation, wound healing phase and can delay the progression of wound healing? | Glucocorticoid |
| Reduces the maximal tensile strength of the wound? | Vitamin C deficiency |
| Histopathology shows budding encapsulated yeast? | Cryptococcus Neoformans |
| Layers of the epidermis from skin to inner? | Stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale |
| Responsible for wound reepithelization? | Keratinocytes |
| In addition to synthesizing collagen FIBROBLAST are responsible for secreting? | Ground substance (amorphous gel of water and glycosaminiglycans |
| Induces some fibroblast to differentiate into myofibroblast? | Transforming growth factor beta |
| Produce intracellular contractile proteins (actin)? | Myofibroblast |
| migrate into a healing scar can lead to permanent scar hypopigmentation? | Failure of melanocytes |
| Characterized by gradual increase in ventilation perfusion mismatch and increased dead space (loss of alveolar surface area) | Normal aging |
| Changes during normal aging include chest wall compliance decreases (stiff rib cage) due to? | Degenerative changes (ossification, arthritis) of the sternocostal and costovertebral joints and kiphosis. |
| Dead space increases with age due to? | Progressive ELASTIN degeneration |
| Depress the mandible (open jaw)? | Lateral pterygoid muscle |
| Acts as sphincter to close the mouth and pucker lips? | Or ocular is oris |
| Increase the risk of chronic or recurrent acute otitis media? | Cleft palate |
| Dysfunction of which muscle contract against the soft palate to open the Eustachian tube? | Levator veli palatini |
| Closes and forms the lines Alba, a midline band of fibrous tissue? | Umbilical ring or congenital fascial opening for the umbilical cord |
| Caused by incomplete closure of the umbilical ring, allowing protrusion of bowel through the abdominal musculature? | Umbilical hernia |
| Midline herniation of abdominal content contained within a thin membranous sac? | Omphalocele |
| Full thickness abdominal wall defect that presents as evisceration of exposed abdominal content at birth? | Gastrochisis |
| Young woman, progressive dyspnea, fatigue and loud pulmonic S2 on examination it has? | Pulmonary arterial hypertension (PAH) |
| It results from progressive remodeling of the small and medium sized pulmonary arteries/arterioles? | Pulmonary arterial hypertension (PAH) |
| Increase ⬆️ vasoconstrictive, ⬆️ proproliferative mediators (endothelin, thromboxane A2) and a decrease ⬇️ in vasodilative, antiproliferative mediators (nitric oxide, protacyclin). Is caused by? | Endothelial dysfunction dysfunction leads to? |
| Proproliferative mediators are? | Endothelin, thromboxane A2 |
| Antiproliferative mediators are? | Nitric oxide, prostacyclin |
| Relative imbalance of these mediators leads to? | Vasoconstriction, and smooth muscle proliferation with intimal thickening of the vascular wall |
| Imbalance of mediators (proproliferative(endothelin, thromboxane A2) and antiproliferative (nitric oxide, prostacyclin) leads to? | Vasoconstriction and smooth muscle proliferation |
| Endothelin receptor antagonist used to reduce vasoconstriction? | Bosentan |
| Prostacyclin analogues are used to promote vasodilation? | Epoprostenol |
| Nitric oxide enhancing agents(sildenafil) is used to? | Promote vasodilation |
| Agents that help reduce tissue proliferation? | Endothelin, thromboxane A2, nitric oxide, prostacyclin |
| A major component of microfibrils that form a sheath around ELASTIN fibers? | Fibrillin-1 |
| Abundant in blood vessels (aortic media), periosteum and suspensory ligaments of the lens are? | Microfibrils |
| In Extracellular space acts as scaffold for deposition of ELASTIN extruded from connective tissue cells? | Fibrillin |
| Caused by inherited defect in FIBRILLIN-1 gene? | Marfan syndrome |
| Signs include ectopia Lentis, kyphosis or scoliosis, arachnodactyly, taller and slender, flat feet, breastbone dips inward? | Marfanoid habitus |
| Causes mechanical weakening in the connective tissues and abnormal activation of transforming growth factor beta? | Defect in Fibrillin-1 |
| Cause of death in Marfan syndrome is due to? | Cardiovascular complications (aortic root dilation, dissection and rupture) |
| Connective tissue that affect the formation and Extracellular structuring of COLLAGEN? | Ehlers Danlos syndrome |
| Ehlers danlos syndrome has a risk of? | Aortic rupture |
| Characterized by very high homocysteine, marfanoid habitus, increased risk for premature atherosclerotic cardiovascular disease? | Homocystinuria |
| Inherited metabolic disorder due to cystathionine synthase deficiency? | Homocystinuria |
| Defect in gene encoding type I collagen major component of bones? | Osteogenesis imperfecta |
| Disorder of tubular epithelial cells? | ADPKD polycystic kidney |
| Risk of cardiac valvular disorders and ruptured cerebral aneurysms, enlarged kidneys with parenchymal cyst? | ADPKD |
| Causes impaired hydroxylation of proline and lysine residues in collagen? | Deficiency of vitamin C (scurvy) |
| Clinical include skin fragility, easy bleeding and poor dentition? | Scurvy (vit C def) |
| Extracellular GLYCOPROTEINS it’s abundant in zonular fibers of the lens? | Fibrillin-1 |
| Unilateral headache, pulsatile and throbbing, duration 4-72 hrs? | Migraine |
| Headache associated with photophobia, phonophobia and nausea with or without aura? | Migraine |
| Headache that has a similar timing daily or occur during sleep, location behind one eye, excruciating, sharp and steady pain? | Cluster |
| Excruciating sharp and steady (ice pick) pain that last 15-180 min? | Cluster |
| Headache associated ipsilateral facial flushing, nasal congestion, pupillary changes and lacrimation? | Cluster |
| Headache that occur under stress, band like pattern around the head (bilateral), dull, tight and persistent pain? | Tension |
| Dull pain, tight, persistent last 30mmin to months to years? | Tension headache |
| Headache associated with muscle tenderness in the head, neck, or shoulders? | Tension |
| Cause facial pain and tenderness associated with nasal congestion and mucopurulent nasal drainage? | Chronic sinusitis |
| Acute headache accompanied by scalp tenderness, visual symptoms and jaw claudication? | Giant cell arteritis |
| Giant cell arteritis in older patients (>50) is associated with? | Polymyalgia rheumatica |
| Secreted by parietal cells in the fungus and body of the stomach | Gastric acid |
| Binds H2 receptors and increases intracellular cyclic AMP (cAMP) concentration? | Histamine |
| Binds M3 muscarinic receptor and leads to increase intracellular calcium? | Acetylcholine |
| Binds to the cholecystokinin B (CCKB) receptor and increases intracellular calcium? | GASTRIN |
| Stimulates histamine synthesis and release by enterochromaffin (ECL)like cells in the stomach? | GASTRIN |
| Activates protein kinases and lead to increased transport of H+ by H+/K ATPase into the gastric lumen? | Intracellular calcium and cAMP |
| Clonal mast cell proliferation occurs in the bone marrow, skin and other organs? | Systemic mastocytosis |
| Associated with mutation in the KIT receptor tyrosine kinase? | Mast cell proliferation |
| Mast cell mediated symptoms like? | Syncope, flushing, hypotension, pruritus and urticaria |
| Induces gastric acid secretion which can lead to gastric ulceration? | Histamine |
| Excess gastric acid inactivates pancreatic and intestinal enzymes causing ? | Diarrhea |
| Gastric mucosal atrophy can be caused. By autoimmune gastritis that leads to? | Pernicious anemia due to loss of intrinsic factor from parietal cells |
| Pancreatic endocrine tumors may secrete? | Gastrin, insulin, glucagon, somatostatin, vasoactive intestinal peptide |
| GASTRIN | Zollinger Ellison syndrome |
| Insulin | Hypoglycemia |
| Glucagon | Hyperglycemia, rash |
| Somatostatin | Diarrhea, cholelithiasis, hyperglycemia |
| Vasoactive intestinal peptide | Watery diarrhea, hypokalemia, achlorhydia |
| HIV genome encodes which structural genes? | Gag, pol and env (polyproteins) |
| Only glycosylated HIV polyprotein is? | .gp 160 product of env gene |
| Polyprotein gp 160 is glycolsylated in? | Rough endoplasmic reticulum and Golgi apparatus |
| Which envelope protein mediates viral attachment? | Protein gp 120 |
| Which p rote in mediates viral fusion with the host cell? | Protein gp 41 |
| Encodes for reverse transcriptase, integrate and protease crucial HIV enzymes? | Pol gene |
| 68% of observation lie within? | 1 SD : 220 +/- 10 = (210-230) |
| 95% of observation lie within? | 2 SD : 220 +/- 20 = (200-240) |
| 99.7% of observation lie within? | 3 SD : 220 +/- 30 = (190-250) |
| The distance of the MEAN is called? | Standard deviation SD, measure by degree of dispersion from MEAN |
| Used to treat acute gout by inhibiting micro tubular polymerization? | Colchicine |
| Inhibit phospholipase A2 which converts membrane phospholipids to arachnoid acid? | Glucocorticoid |
| Phospholipids to arachnoid acid needs.......... to inhibit phospholipase A2? | Glucocorticoid |
| Membrane phospholipids inhibit Phospholipase A2 to produce? | Arachidonic acid |
| Arachidonic acid divides into? | 5-Lipoxygenase and COX 1, COX2 |
| COX1,COX2 produces prostaglandin H2 which divides into? | thromboxane A2, Prostacyclin, Prostaglandin D2, Prostaglandin E2. |
| NSAID (indomethacin, ibuprofen) inhibit? | COX 1 and COX 2 (cyclooxygenase) |
| Selective COX 2 inhibitors (celecoxib) inhibit? | Only COX 2 |
| Pts with diabetic and hypertension are high long term risk for? | Chronic Kidney disease |
| Angiotensin converting enzyme (ACE) inhibitors (lisinopril) leads to elevated? | Bradykinin and substance P and non productive cough |
| Angiotensin receptor blockers (ARBs) (losartan,Valsartan) | Inhibit angiotensin II |
| Angiotensin converting enzyme (ACE) normally degrades? | Bradykinin and substance P |
Created by:
Lillianita
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