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| Question | Answer |
|---|---|
| How do you treat CN poisoning? | Amyl Nitrite (produces metHb which binds to CN) and Thiosulfate (CN to thiocyante) |
| What is Bosentan used to treat? How does it work? | Tx Pulmonary Hypertension; competitively antagonizes endothelin-1 receptors and decreases pulmonary vascular resistance |
| What is the most common type of lung CA in women/nonsmokers? | Adenocarcinoma: peripheral, develops at site of prior pulmonary injury |
| What is the pathophysiology of ARDS? | Diffuse alveolar damage, incr capillary permeability, protein-rich fluid leakage into alveoli, hyaline membrane formation |
| Which type of penumoconioses has incr susceptibility to TB, why? | Silicosis; the silica impairs macrophages |
| In RBCs, what maintains electrical neutrality as CO2 is transported in RBC as HCO3? | HCO3/Cl exchanger in red cell membrane |
| What is the formula for alveolar gas equation? | PAO2 = PIO2 - PACO2/0.8 |
| What causes primary pulmonary hypertension? | inactivating mutation in the BMPR2 (would normally inhibit vascular smooth muscle proliferation) |
| What is the typical tidal volume? | 500 mL |
| Where is the pulmonary artery situated in relation to the bronchus in the right lung? left lung? | RIGHT - artery ANTERIOR to bronchus; LEFT - artery SUPERIOR to bronchus |
| Which is last to disappear as you descend down the respiratory tract, cilia or goblet cells? | Cilia. (extend to respiratory bronchioles) while goblet cells extend only to terminal bronchioles |
| Which type of breast CA has the worst prognosis? | Invasive ductal; most common; tumor cells in cords, glands embedded in dense fibrous stroma (rock hard mass) |
| Define Meig's syndrome. | Triad of ovarian fibroma, ascites, and hydrothorax |
| Define Call-Exner bodies. | Small follicles filled with eosinophilic secretions; associated with Granulosa cell tumor |
| What are the hormone derangements in PCOS? | Increased LH, Decreased FSH, Increased Testosterone |
| Which type of hydatidiform mole contains some fetal parts? What is the typical karyotype? | Partial mole, 69 XXY (2 sperm + 1 egg) |
| Which type of hydatidiform mole can convert to choriocarcinoma? What is the typical karyotype? | Complete mole, 46 XX (2 sperm) |
| What are the hormonal derangements in Klinefelter's syndrome? | Decr inhibin, Incr FSH; Decr testosterone, Incr LH, Incr Estrogen |
| What are some of the prostate products of semen? | Zinc, citric acid, phospholipids, acid phosphatase, fibrinolysin (make up 20%) |
| What are some of the seminal vesicle products of semen? | Fructose, ascorbic acid, prostaglandins, phosphorylcholine, flavins (make up 60%) |
| What structures are contained within the broad ligament? | ovaries, fallopian tubes, and round ligament of the uterus |
| What is contained within the cardinal ligament, where does it attach? | Contains uterine vessels, attaches cervix to side wall of pelvis |
| What contributes to elastin's ability to recoil? | extracellular interchain crosslinks involving lysine |
| How are different sized particles removed from the lung? | Small, < 2 microns: phagocytossis Larger, 2.5-10 microns: mucociliary transport |
| How is Diptheria treated? | Diptheria antitoxin (passive immunity), penicillin, DPT vaccine (active immunity) |
| What is the most common cause of a continuous murmur in children? | cervical venous hum |
| Impaired filling of the R side of the heart will affect which portion of the JVP? | a wave will be exaggerated (atrial contraction) |
| What accumulates in the cusps of the mitral valve in MVP? | dermatan sulfate (myxomatous degeneration) |
| What is the cause of sudden death in a patient with hypertrophic cardiomyopathy? | v tach or v fib |
| What is the most common cause of sideroblastic anemia? Why? | chronic alcoholism, alcohol is mitochondrial toxin (1st and last steps of heme synthesis take place in the mitochondria) |
| Why does phenytoin cause folate deficiency? | inhibits intestinal conjugase (folate needs to be in monoglutamate form to be absorbed) |
| What is the most common cause of elevated homocysteine level (in the US)? | folate deficiency |
| What chromosomal mutation is associated with Polycythemia Vera and other MPDs? | JAK2 on chromosome 9 |
| Define smudge cells. In what disorder are they prominent? | fragile leukemic cells; CLL |
| Which of the leukemias is the only type with out lymphadenopathy? | Hairy cell leukemia, TRAP (+) |
| HPV causes laryngeal cancer on which vocal cords? | stat squam on TRUE vocal cords |
| At FRC of the lungs, is the intrapleural pressure positive or negative? | It is slightly (-) with a value of -5 mmHg (PVR is also lowest at this point) |
| Define Reed Sternberg cell | characteristic cell of HL; has two mirror image nuclei each with eosinophlic nucleolus surrounded by clear halo; CD 15 and CD 30 (+) |
| Which type of HL is most associated with EBV? | Mixed cellularity |
| Which type of HL has the poorest prognosis? | Lymphocyte depleted with frequent RS cells |
| What is the characteristic cell of Histiocytosis X? | Langerhans cell, CD 1 (+) with Birebeck granules in the shape of tennis rackets on EM |
| What causes lytic bone lesions in a MM pt? | myeloma cells (-) osteoblastic differentation and release IL-1 which activates osteoclasts |
| What is the most common cause of hypersplenism resulting in pancytopenia? | portal HTN associated w/ cirrhosis |
| In a pt with splenic dysfunction, loss of what protein leads increased susceptibility to infection with encapsulated organisms? | tuftsin(activates receptors on macs to increase phagocytic activity) |
| Which coagulation factors are consumed in the formation of a fibrin clot? | Fibrinogen, Prothrombin, V, VIII |
| What three diseases is vWF deficiency associated with? | Mitral valve prolapse, Marfan's, Angiodysplasia |
| Which Ab can cause hemolytic anemia in M. pneumoniae infection? | anti-I |
| Which Ab can cause hemolytic anemia in Mononucleosis infection? | anti-i |
| How much should one unit of pRBCs raise H&H? | 1 g/dl and 3% |
| What is the most contaminant of stored blood? | Yersinia entercolitica (loves Fe) |
| How do you tx DIC? What does it contain? | cryoprecipitate: factor 8, 13, fibrinogen |
| What is the most common bacterial cause of acute COPD exacerbation? | H. flu |
| What is the most likely cause of death in Acute Rheumatic Fever? | Heart failure due to severe myocarditis |
| What enzyme deficiency presents with maternal virilization during pregnancy and masculinization of the female fetus? | aromatase |
| What is the formula for RBF? | RBF = PAH Cl / 1 - Hct |
| In restrictive lung diseases, why is FEV1/FVC slightly increased? | loss of radial traction exerted on conducting airways by the fibrotic lung |
| What is Cilostazol used to tx and what is its MOA? | used to tx intermittent claudication in PVD; PDE (-) inhibits plt aggregation and is an arterial vasodilator |
| What is the significance of cord factor in mycobacteria? | 2 mycolic acid moleucles bound to disaccharide terhalose, correlates with virulence |
| What is the most potent cerebral vasodilator? | pCO2 which leads to increased ICP |
| What is mucicarmine stain red? | polysaccharide capsule of Cryptococcus neoformans? |
| What is caplan syndrome? | Rheumatoid nodules in lungs + pneumoconiosis |
| What is the pathogenesis of achalasia? | loss of NO synthase producing neurons leads to incomplete relaxation |
| What drug is used to tx pain associated with cholecystitis? | Meperidine (do not use morphin, it contracts sphincter of Oddi) |
| What is the pathogenesis of appendicitis in children? | lymphoid hyperplasia secondary to viral infection |
| What is Turcot's polyposis? | AR polyposis syndrome of the colon also associated with astrocytoma and medulloblastoma |
| What is Gardner's syndrome? | AD polyposis syndrome associated with benign osteomas and desmoid tumors |
| What is Angiodysplasia? | dilation of mucosal and submucosal venules in cecum and right colon leading to hematochezia; associated with vWD and aortic stenosis |
| What is the classic histologic finding in Psoriasis? | Munro abscesses - neutrophilic collections in the stratum corneum |
| What happens to the T cell profile in Sarcoidosis? | increased CD4:CD8 ratio |
| Define Familial Dysbetalipoproteinemia. | defects in ApoE3 and ApoE4 which are responsible for VLDL and chylomicron reuptake by liver cells |
| Which lipoprotein assembles chylomicrons for secretion by the intestine? | ApoB48 |
| Which lipoprotein activates lipoprotein lipase? | ApoCII |
| Which lipoprotein aids in cholesterol esterification? | ApoA-1 |
| Which lipoprotein aids in LDL particle uptake by non-hepatic cells? | ApoB100 |
| What is the formula for Plasma osmolarity? What is the nl range? | POsm = 2 (Na) + glucose/18 + BUN/2.8; nl 275-295 mOsm/kg |
| How does heart failure cause dyspnea (specific receptors)? | interstitial fluid accumulates and stimulates juxtacapillary J receptors innervated by vagus nerve |
| Why is sudden cardiac death associated w/ an MI most common in the morning hours? | hypercoaguability is at its peak |
| How is hydroxyurea used as a preventative measure for sickle cell crisis? | increases fraction of fetal hemoglobin |
| How does pyruvate kinase deficiency cause hemolysis? | no PEP --> pyruvate; lack of ATP causes membrane damage and dehydrated RBCs |
Created by:
ash0403
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