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Daniel's random 3
Week 2
| Question | Answer |
|---|---|
| porphryia cutanea tarda affected enzyme | urophorphrinogen decarboxylase |
| porphryia cutanea tarda accumulated substance | uroporphyin |
| blistering cutaneous photosensitivity | porphryia cutanea tarda |
| adult type coarctation of aorta associated with | berry anneurysms aortic arch HTN Cv failure, ruptured dissecting AA, intracranial hemorrhage |
| difference in immune response to live vs. killed vaccine | increased mucosal IgA in live |
| tb virulence factor | cord factor, a mycoside -> grow as "serpentine" cords causes neutrophil inhibition, mitochondrial destruction and increased TNF sulfatides are responsible for inhibiting fusion of lysosomes to phagosomes |
| seborrheic keratosis | tan to brown, round, flat, greasy coinlike lesion looks stuck on or pasted on head, trunk, extremities pigmented squamous epithelial proliferation with keratin filled cysts (horn cysts) melanoma on differential |
| Meyer's loop path | temporal lobe pie in teh sky loops around inferior horn of lateral ventricle -> inferior retina |
| dorsal optic radiation | parietal lobe shortest path via internal capsule superior retina |
| aresenic poisoning | garlic breath |
| lichen planus | piuritic, purple, planar, plaque, polyganal |
| area in brain most susceptible to ischemic damage | pyrimidal cells of hippocampus and neocortex purkinje cells of cerebellum |
| bleeding in abruptio placentae | 3rd trimester, painful |
| placenta accreta | massive, post deliveryh |
| placeta previa | painless, any trimester |
| genes affected in HPV 16 | E6 - inhibits p53 suppressor tumor |
| genes affected in hPv 18 | E7 - inhibits Rb suppressor tumor |
| endometritis tx | cefoxitin ticarcillin-clavulanate ampicillin sulbactam |
| endometriosis tx | danazol |
| adenomyosis tx | hysterectomy |
| struma ovarrii | contains functional thyroid tissue |
| follicular cyst | unruptured graafian follicle associated with increased estrogen and endometrial hyperplasia most common ovarian mass in young women |
| ovarian cancer | ca 125 |
| serious cystadenocarcinoma | 45% ovarian tumor bilateral psammoma bodies |
| serious cystadenoma | 20% ovarian tumor bilateral, fallopian tube like epithelium |
| dz associated with berry aneurysm | marfan ehler's danlos APDKD |
| charcot bouchard micro aneurysm | chronic htn basal ganglia, thalamus - small vessels |
| What is the risk of occuring 2-3 days post subarachnoid hemorrhage | vaspospasm due to blood breakdown tx. nimodipine |
| gliblastoma multiforme | stain GFAP pseudopalisading pleomorphic tumor cells -> border central necrosis and hemorrhage |
| meningioma | convexities of hemispheres and parasagital region arachnoid cells external to brain spindle cells concentrically arrange in a whorled pattern psammoma bodies |
| S 100 | melanoma schwannoma (3rd) |
| pilocytic atrocytoma | GFAP cystic and solid rosenthal fibers -> eosinophilic, corkscrew fibers good benign |
| sleep apnea | pulmonary HTN systemic HTN obesity arrythmia sudden death |
| 5 things in MS plaques | oligodendrocytic depletion monocytes and lymphocytes fibrillary atrocytosis -> reaction to injury lipid laden macrophage- > phagocytize products of myelin breakdown axon demyelination |
| gout | urate monosodium need shapeed negative birerifringent yellow on PARALLEL blue on perpindicular assymmetric big toe |
| pseudogout | calcium pyrophosphate rhomboid weakly positive birerifringent blue on parapllel light large joint knee |
| sarcoidosis | erythema nodosum bell's palsy granuklomas with Schaumann and asteroid bodies uveoparotitis interstitial fibrosis |
| what does chronic lymphadema predispose to | lymphangiosarcoma (angiosarcoma of skin) |
| sicca syndrome | dry eyes, dry mouth, nasal and vaginal dryness, chronic bronchitis, reflux esophagitis |
| osteopetrosis marble bone disease | abnormal osteoclasts -> thickened dense bones prone to fractures |
| paget's disease (osteitis deformans) | increased osteoclast and osteoblast activity abnormal bone architecture mosaic pattern long bone chalk stick fractures |
| osteoporosis | decreased bone mass trabecular spondy bone loses mass and interconnections normal bone mineralization and labs |
| protease inhibitor SE | lipodystrophy hyperglycemia P450 inhibition |
| on histology, where are parietal cells located in stomach | superficial gastric glands |
| endochondrial ossification | longitudinal bone chondrocytes -> cartilage -> woven bone -> lamellar bone |
| membranous ossification | flat bones (skull, facial bones, axial skeleton) woven bone formed directly w/o cartilage; then remodeled to lamellar bone |
| effect of NO on MLCK | NO -> cGMP inhibition of MLCK increased MLC phosphatase relaxation |
| affect of action potential on MLCK | AP -> SM mem depolarization -> open voltage gated Ca channels -> increased Ca cytoplasm -> ca binds calmoduli -> activates MLCK -> contraction |
| type 2 fibers | white fibers, fast twitch, increased anaerobic glycolysis |
| type 1 fibers | "one slow red ox" slow tiwtch red fibers increased mitochondria and myoglobin concentration; increased oxidative phosphorylation sustained contraction |
| tau protein | insoluble cytoskeletal elements |
| MS findings | increased protein IgG in CSF oligoclonal bands diagnostic MRI gold standard -> periventricular plaques (oligdendrocyte loss and reactive gliosis) -> preservation of axons |
| tx MS | beta interferon immunosupression natalizumab |
| natalizumab | crohn's and MS educing the ability of inflammatory immune cells to attach to BBB and itnestine |
| Guillain barre | increased CSF protein with normal cell count -> albuminocytologic dissociation increased protein -> papilledema |
| which enzyme is associated with increased adenomatous polyp formation | COX 2 |
| when is S3 heard best | end of expiration |
| where does facial nerve arise | caudal pons |
| where does hypoglossal arise | rostral medulla |
| occulomotor | rostral midbrain |
| trochlear | level of inferior colliculus, behind midbraine |
| trigeminal | level of middle cerebellar peduncle in pons |
| vitamin B5 | pentothenate cofactor for pyruvate dehdrogenase active form is coA cofactor for acyl transfers and fatty acid synthase oxaloacetate + CoA -> citrate |
| niacin SE | flushing hyperglycemia (acanthosis nigracans) hyperuricemia (gout) hepatitis |
| most common cause of E. coli bacteremia | UTI |
| which drugs for malignant HTN | nitroprusside fenoldopam diazoxide |
| increases renal perfusion used for malignant HTN | fenoldopam - selective D1 receptor agonist |
| triggers for candida vaginitis | antiobiotic use -> suppresses normal bacterial flora corticosteroids DM immunosuppression contraceptive use -> alters vaginal pH |
| GVHD is mediated by which cells against what? | T lymphocytes of donor tissues sensitizes against MHC antigens of recipient |
| what organs are often involved in GVHD? | skin, liver, intestine |
| what process is affected in hemochromatosis | iron absorption from GI tract |
| stimulation of which adrenergic receptor in uterus -> inhibition of uterin contractions (tocolysis) or relaxation | beta 2 |
| which causes mydriasis? | alpha 1 -> via contraction of occular pupillary dilator muscle |
| 3 drugs that cause seizure | imipenim buproprion INH -> give with pyridoxine |
| squamous cell carcinoma of skin causes | sun, arsenic |
| arsenic | inhibits lipoic acid -> garlic breath, rice water stools angiosarcoma SCC |
| SCC of skin associated wtih? | chronic draining sinuses |
| SCC skin varian | keratoacanthoma -> growth rapidly then regresses |
| ECG triad in WPW | delta waves wide QRS decreased PR interval |
| tuberous sclerosis | Hamartomas CNS and skin Adenoma sebaceum Mental retardation Ash leaf spots Rhabdomyoma Tubersous sclerosis autOsomal dominant mental retardation renal Angiomyolipoma Seizures VARIAble penetrANCE |
| type of penetrance for tuberous sclerosis | variable penetrance |
| migraine cause | irritation of CNV and release of substance P, CGRP, vasoactive peptides |
| tx for migraine | sumatriptan for acute propanolol nsAIDS |
| charcot marie tooth dsiease | hereditary motor and sensory neuropathy |
| metachromic leukodystrophy | AR lysosomal storage disease arylsulfatase A deficiency -> buildup of sulfatides -> impaired myelin sheath production |
| acute disseminated encephalomyelitis | multifocal perivenular infllmation demyelination after infection or vaccination |
| how does SVR respond to exercise | decreased vasodilation at muscle to shunt blood these note: BP only mildly goes up |
| on x ray how do you identify the lunate bone | the more medial of the 2 carpal bones that articular with the radius "thumb swings on the trapezium" |
| ethambutol | decreased carbohydrate polymerization in mycobacterium cell wall by blocking arabinosyltransferase Tb |
| ethambutol tox | optic neuropathy -> red/green color blindness -> central scotoma -> decreased vision |
| dysgerminoma histo, association, labs | sheet of uniform cells Turner's hCG, LDH |
| choriocarcinoma | trophoblastic tissue -> NO chorionic villi |
| choriocarcinoma increases frequency of? | theca lutein cysts |
| marker for choriocarcinoma | hCG |
| choriocarinoma can spread to? | lungs |
| yolk sac (endodermal sinus) tumor | yellow, friable, solid schiller-duval bodies (resemble glomeruli) |
| marker for yolk sac | AFP |
| constriction control | pupillary sphincter muscle (circular muscle) parasympathtetic CN3 from edinger-westphal nucleus -> ciliary ganglion |
| dilation myDRiasis control | pupillary dilator muscle (aka radial muscle) sympthatic T1 preganglionic sympathetic -> superior cervical ganglion -> postganglionic sympathetic -> long ciliary muscle |
| `on CN3 cross section, which part is output to ocular muscles | inside affected by vascular disease (i.e. DM sorbitol) ptosis, down and out, nonreactive pupils |
| `on CN3 cross section, which part is output to parasympathetic output | outside affected by compression (PCOM aneurysm, herniation) blown pupil use pupillary light reflex |
| peripheral vertigo | inner ear issue (most common) delayed horizontal nystagmus |
| ventral vertigo | brain stem or cerebrellar lesion immediate nystagmus in any direction, may change directions |
| in which compartment of the cell does the pentose phosphate pathway occur? aka HMP shunt | cytoplasm |
| cavernous hemangiomas bilateral RCC hemangioblastoma -> retina, brain stem cerebellum pheo AD | VHL on 3 |
| cafe au lait spots lisch nodules (pigmented iris harmartomas) skin neurofibromas optic gliomas | NF type 1 |
| 100% penetrance | NF type 1 |
| first line treatment of toxo | sulfadiazine pyrimethamine |
| sideroblastic anemia | x-linked detect in delta ALA synthase gene -> decreased heme synthesis |
| histo of sideroblastic anemia | ringed sideroblast with iron laden mitochondria |
| sideroblastic anemia labs | increased Fe, increased ferritin, normal TIbC |
| treatment of sideroblastic anemia | B6 |
| histology of prion disease | spongiform (vacuoles) changes in gray matter |
| change in PrP | PrPc -> PrPsc sheet resistant to proteases beta pleated |
| preferred drug in antipsychotic induced parkinsonism | antimuscarinic like benztropine |
| which one is contraindicated? | levodopa -> can precipitate psychosis |
| necrotizing fasciitis | deeper tissue injury anaerobic bacteria and s. pyogenes crepitus from methane and co2 production |
Created by:
ilovemusic007
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