Term
| Injury to what structure in the lung causes ARDS |
|
Definition
endothelium
(robbins says it's endothelium, epithelium, or, more commonly, both) |
|
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Term
For each cardiac conduction velocity, give the structure:
1) 1.1 m/s
2) 0.05 m/s
3) 2.2 m/s
4) 0.3 m/s |
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Definition
1) Atrial muscle
2) AV node
3) His-Purkinje system
4) Ventricular muscle
Remember, AV node is slowest, Purkinje cells are fastest |
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Term
| person with "lump in throat" and a normal physical exam (including barium swallow). May also complain of anxiety. |
|
Definition
Globus Hystericus
Can also be associated w/ GERD & achalasia, but this probably wouldn't be asked. |
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Term
| Electrophoresis of a cell indicates DNA fragments in multiples of 180 bases |
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Definition
| Apoptosis (called DNA laddering) |
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Term
| Is extreme thirst a symptom of antimuscarinic overdose (e.g. atropine) |
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Definition
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Term
| Children of a parent have a genetic disease that there is no family history for. |
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Definition
Germline mosaicism (i.e. Germ cells are mutated during embryogenesis, but the rest of the embryo is fine)
(only AD or X-linked diseases would work here) |
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Term
| Inheritence of osteogenesis imperfecta |
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Definition
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Term
| Daily foot inspection should be performed by diabetics? |
|
Definition
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Term
|
Definition
activated T-lymphocytes
Stimulates growth & differentiation of T, B, & NK cells |
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Term
Name each intercellular connection:
1) prevents passage of ions/water
2) Ca-dependent. Actin-linked
3) Colored. Keratin-linked
4) attaches to basement membrane |
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Definition
1) tight junction
2) Cadherens
3) Macula adherens (desmosomes)
4) Hemidesmosomes |
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Term
What stimulates:
1) Secretin release (inc pancr bicarb; inc bile; dec gastric acid)
2) CCK (inc pancreatic secretions & gallbaldder contractility; decrease gastric emptying & Oddi tone)
3) Somatostatin (decrease all GI actions) |
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Definition
1) Acid & FA in duodenum (S-cells)
2) FA & AA In duodenum & jejunum (I-cells)
3) Acid & FA in duodenum (D-cells) |
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Term
What artery gives the:
1) Dorsalis pedis pulse
2) Most susceptible to injury in knee dislocations (anterior & posterior) |
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Definition
1) anterior tibial (runs w/ deep peroneal, which innervates dorsiflexors of the foot)
2) Popliteal artery (runs deep in the popliteal fossa & is fixed in position by adductor magnus & soleus) |
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Term
| Tender uterus & foul-smelling sputum following delivery |
|
Definition
endometritis.
World says Bacteroides is most commonly implicated. Sherris says that clostridium perfringens can infect retained tissue.
Treatment seems to be Metronidazole, so bacteroides seems like a reasonable choice. |
|
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Term
1) Guy who gets pissed channels his anger into a workout
2) Guy who is angry at someone punches a hole in a wall |
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Definition
1) Sublimation
2) Displacement |
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Term
Name interview technique:
1) "I can understand your difficulties"
2) repeat back what the patient said to you to show you are listening
3) "This sounds like it has been very hard for you" (expressing concerns for well-being)
4) Draw attention to discrepancies in pts statements
5) Encourage pt to talk ("tell me how...") |
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Definition
1) Empathy
2) Reflection
3) Support
4) Confrontation
5) Facilitation |
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Term
| Headaches, chronic nasal discharge, atrophic nasal mucosa, thin nasal septum. Septum may perforate. oropharyngeal ulcers possible. Osteolytic sinusitis. |
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Definition
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Term
| Chronic nasal congestion worsens w/ abrupt changes in temperature or humidity; or exposure to odors or alcohol. Headaches, anosmia, and sinusitis are often reported |
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Definition
vasomotor rhinitis (aka perennial nonallergic rhinitis )
there is no tissue eosinophilia or allergic stimulus. |
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Term
| 2 main structures in the GI tract that secrete Bicarb-rich fluid? |
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Definition
Pancreatic duct & epithelial cells of the biliary tree.
Bruton's glands also secrete a bicarb rich mucus. This protects the proximal duodenal bulb (i.e. before the ampulla of vater). Since secretions here are decreased by sympathetic stimulation, Guyton hypothesizes this is why "excitable" people can get ulcers in the prox duodenum
NOTE: SI secretions are almost exactly extracellular fluid, except it's slightly alkaline (why you get met acidosis w/ diarrhea) |
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Term
| What is the cuttoff for acute stress disorder vs PTSD |
|
Definition
<1 month (4wks) of Sx = acute stress disorder
Acute stress disorder commonly has dissociative symptoms |
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Term
| Male w/ difficulty swallowing, facial&tongue fasciculations. Pedigree shows X-linked pattern & anticipation |
|
Definition
| Kennedy disease (X-linked bulbospinal musclar atrophy) |
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Term
| When the husband has hemophilia. What is the chance the kids will have it? |
|
Definition
0%
I can't believe you got this wrong. You are so dumb. |
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Term
|
Definition
LDH >0.6 serum LDH
Protein >0.5 serum protein |
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Term
| Old alcoholic w/ Lhermitte's sign & peripheral neuropathy? |
|
Definition
B12 deficiency
I put it was MS, but Lhermitte's sign can be associated with a ton of stuff, pretty much anything affecting the CNS or cervical spine area |
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Term
| 2 causes of myasthenia gravis |
|
Definition
Both are autoimmune:
70% have hyperplastic thymus glands (Goljan says there are actually germinal follicles in the thymus, but I can't substantiate that anywhere)
30% have thymomas (a paraneoplastic syndrome) |
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Term
| Na+, K+, NH3, & glucose [] in DKA? |
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Definition
UP: K+, NH3 (from protein breakdown), Glucose
Down: Na+ (Na drops 1.6 mEq/L every 100mg/dL rise in glucose; Na+ is wasted in urine from osmotic diuresis)
NOTE: total body K+ is depleted, but serum K+ is inc b.c. no insulin |
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Term
| 6 things causing hyperkalemia? |
|
Definition
1) Insulin def
2) Beta blocker
3) Acidosis
4) Hyperosmolarity
5) Digitalis
6) Lysis |
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|
Term
1) FSH levels in androgen insensitivity syndrome?
2) Klinefelters? |
|
Definition
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Term
| 3 complications of newborn infants that recover from RDS |
|
Definition
1) Necrotizing entercolitis
2) PDA
3) Interventricular hemorrhage
(NOTE: retinopathy of prematurity & bronchopulmonary dysplasia are consequences of treatment) |
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Term
| Infant gets RDS. Loses brainstem reflexes (suckling/swallowing). Bloody CSF. Dies in a few days. Autopsy shows clot in ventricle |
|
Definition
Intraventricular hemorrhage (germinal matrix hemorrhage)
This is common in kids w/ cerebral palsy
ASIDE: germinal matrix is important for development of the cerebral cortex. It is a highly vascularized tissue that lies just deep to the ependymal cells. Neurons & glia migrate out of it to populate the cortex. |
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Term
Name antiarrhythmic:
1) Person develops interstitial infiltration. If not discontinued, will progress to irreversible fibrosis.
2) Pleuritis (secondary to a syndrome cause by this drug) |
|
Definition
1) Amiodarone
2) Procainamide (b.c. of drug-induced SLE) |
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Term
| HR & end-systolic LV volume if given nitroglycerine acutely (no other meds on board) |
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Definition
HR increases LVESV decreases (inotropic effects)
Nitroglycerin is a venodilator>> arterial dilator; It increases blood flow to the coronary arteries & thus decreases angina. |
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Term
| Antibiotic resistance that lowers intracellular concentration |
|
Definition
pumps. These pumps are usually driven by the H+ gradient (cotransport w/ drug out of cell). Na & ATP may also be used.
Question was ridiculous: scientist makes media acidic & drug accumulates. I thought the drug would become uncharged & diffuse across. |
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Term
| 15-20 mostly hydrophobic amino acids at the N-terminal of a protein that targets it to the ER |
|
Definition
signal recognition particles
If this is lost, protein will accumulate in the cytoplasm |
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Term
| how is testosterone maintained at a high concentration in the seminferous tubules/epidymis? |
|
Definition
| Sertoli cells secrete androgen-binding-protein (ABP) into lumen. These bind tightly to testosterone & DHT secreted by the leydig cells |
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|
Term
| Red safrinin O stains what? |
|
Definition
Gives bright red color to:
1) Cartilage: binds ground substance (keratin sulfate & chondroiton sulfate), not collagen!
2) mucin
3) mast-cell |
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|
Term
|
Definition
both PaO2 & PaCO2 will be decreased (V/Q mismatch & hyperventilation)
PH will be increased |
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|
Term
Structure & function of platelet activating factor?
What does it signal through? |
|
Definition
PAF is glycerol-linked lipid. At low concentrations, it is a vasodilator & increases adhesion proteins on endothelium. It can also cause platelet activation & aggregation
It signals through Gq coupled GPCR |
|
|
Term
| penetrance & expressivity of NF1 |
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Definition
| 100% penetrance w/ variable expressivity |
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|
Term
| Mechanism of Red-man syndrome? |
|
Definition
| non-IgE mediated mast cell histamine release. Treat w/ antihistamines |
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Term
| Crampy abdominal pain, blood in stools, pain on palpation, decreased bowel sounds, weak pulses or cardiac decompensation |
|
Definition
Ischemic colitis
Early = mucosal hemorrhage w/ patchy necrosis
Middle = bowel wall becomes edematous
Late = transmural infarction & perforation |
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|
Term
| Inheritance of osteogenesis imperfecta? |
|
Definition
|
|
Term
| Prolonged fasting (>12 hrs, glycogen depleted) produces a hypoglycemic, hypoketotic state |
|
Definition
| Acyl-CoA dehydrogenase (medium chain variant is most common) |
|
|
Term
| change in Vmax & Km when more enzyme is added to a reaction? |
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Definition
| Vmax increases, Km stays the same |
|
|
Term
| what is the most important risk factor for developing DJD (osteoarthritis)? |
|
Definition
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|
Term
In eukaryotes:
28S, 18S, & 5.8S rRNA are created how? Which rRNA is the only one to be transcribed by RNApolIII? |
|
Definition
RNApol-1 transcribes a singe 45S rRNA which is subsequently cleaved into the different units
RNApolIII makes 5S rRNA. This is the only rRNA not to be made by RNApol-1 |
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Term
| pt w/ mouth ulcer, perineal abscesses & chronic diarrhea |
|
Definition
Crohn's disease; most commonly affects the terminal ileum (RLQ), but can cause transmural inflammation anywhere from the mouth to the anus.
No lymphadenopathy, arthritis, or skin rashes.
Complications include: Malabsorption, Ca-oxylate stones, fistulas, perineal abscesses.; Carcinoma only if colon is involved |
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Term
|
Definition
| 40 hrs. takes 4-5 1/2 lives to reach steady state = 160hrs |
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|
Term
| person w/ poor diet & no outdoor time gets a compression fracture |
|
Definition
| Osteomalacia (vitD deficiency) |
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|
Term
Name the pathology:
1) back pain that radiates to buttocks & legs that increases w/ extension & decreases w/ flexion
2) Radiating pain to legs, usually unilateral, no sexual dysfunction
3) Non-severe-non-radiating pain to legs. bilateral. Sexual dysfunction.
4) leg claudication, atrophic skin, ulcers on toe |
|
Definition
1) spinal stenosis
2) Cauda equina syndrome
3) Conus medularis syndrome
4) PVD (e.g. femoral artery; commonly from diabetic complications) |
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Term
| Gray rami house pre or post synaptic neurons? |
|
Definition
post-synaptic autonomic nerons; These neurons are UNMYLELINATED, thus the rami are gray
NOTE: white communicantes only exist where the intermediolateral cell column exists (i.e. T1-L2) |
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Term
1) Most common cause of aseptic meningitis?
2) Most common cause of viral encephalitis? |
|
Definition
1) Enterovirus (picornavirus) = 90%
2) probably HSV1, but it's not certain. It definitely is #1 in kids (remember temporal lobe preference) |
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|
Term
Differentiate:
1) Genetic/locus heterogeneity
2) Polyploidy
3) Pleiotropy
4) Heteroplasmy |
|
Definition
1) Mutations at different loci (genes) can produce same phenotype (e.g. marfanoid habitus in marfans, homocysteinuria, MEN2b)
2) Multiple chromosomes
3) 1 gene can cause mulitple effects (e.g. osteogenesis imperfecta)
4) variable expression in mitochondrial inheritance due to different amounts of affected mtDNA in zygote |
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|
Term
| about how many ATP from 1 glucose (w/ full TCA cycle) |
|
Definition
~38 (this is debatable)
you get 2 from glycolysis
2/38 = 1/19 =~5% |
|
|
Term
| bacteria associated w/ reiters |
|
Definition
| Chlamydia, Campylobacter, Salmonella, Shigella, Yersinia (all are GI, except first) |
|
|
Term
| Prader willi syndrome. Both Chr15's are from who? |
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Definition
| mother (i.e. paternal copy is lost) |
|
|
Term
| What layer is thickened in a callus? |
|
Definition
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|
Term
|
Definition
|
|
Term
| Serum gastrin levels in pernicious anemia? |
|
Definition
|
|
Term
| What anticoagulant do you use w/ artificial heart valve? |
|
Definition
| Warfarin (antiplatelet therapy may be used adjunctively) |
|
|
Term
| Nephrotic syndrome in HIV pt |
|
Definition
| FSGS most common. "collapsing" variant is specific to HIV pts. This variant is also the worst. |
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|
Term
Say Pax3 or HoxA-13 for each:
1) Part of a highly conserved gene family that guide development from early embryogenesis to final differentiation.
2) Short thumbs, small feet, short big toes, GU abnormalities (e.g. bicornate uterus, hypospadius)
3) Heterochromia irides, Poliosis (area of hypopigmentation, esp in hair), dystopia canthorum, and deafness |
|
Definition
1) Hox genes
2) HoxA-13: Hand-foot-genital syndrome
3) Pax-3: Waardenburg syndrome |
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|
Term
| This antidiabetic drug will increase Glut4 receptors on adiopose & cause the adipose to terminally differentiate |
|
Definition
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|
Term
| 2 sinuses affected in blowout fracture? |
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Definition
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|
Term
| MCA infarct would cause what visual disturbance? |
|
Definition
homonymous hemianopia
I put unilateral central scotoma b.c. I thought they were pointing to the choroidal artery); other things that can cause UCS are MS (optic neuritis), or unilateral macular disease |
|
|
Term
| does aspergillus invade vasculature? |
|
Definition
yes (route of dissemination in immunocompromised)
So does rhizopus/mucor |
|
|
Term
| why does octreotide decrease bleeding from varices? |
|
Definition
| b.c. it decreases splanchnic blood flow by inhibiting the hormones responsible for splanchnic vasodilation (e.g. VIP, glucagon) |
|
|
Term
| used to screen for carcinoid syndrome & medullary carcinoma of thyroid? |
|
Definition
pentagastrin:
Carcinoid = pentagastrin-stimulated serotonin test
Medullary thyroid: pentagastrin stimulated calcitonin test |
|
|
Term
| what 2 cytokines do Th1 cells secrete? |
|
Definition
| IL2 & IFN-gamma (IFN-gamma inhibits Th2) |
|
|
Term
For antibodies:
1) Which end is the C-terminus?
2) Where does complement bind?
3) Which segment has carbohydrate side-chains?
4) Which segment doesn't interact w/ the adjacent segment? |
|
Definition
1) Fc end
2) Hinge region
3) CH2 (hinge region)
4) CH2 (hinge region) |
|
|
Term
|
Definition
| it's a DNA polymerase that adds bases to the 3' end of DNA strands without a template during VJD recombination in order to produce junctional diversity (works alongside RAG, which cleaves the DNA to begin with) |
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|
Term
Define Ig:
1) Allotype
2) Isotype
3) Idiotype |
|
Definition
1) Species specific (match transplants)
2) Fc
3) FAB |
|
|
Term
Which cytokine:
1) Triggers acute phase protein synthesis?
2) Septic shock?
3) Cachexia?
4) Fever (2 + non-cytokine)?
5) Upregulate ICAM & VCAM |
|
Definition
1) IL6
2) TNF-alpha
3) TNF-alpha
4) IL1 & IL6 + PGE2
5) IL1 & TNF-alpha |
|
|
Term
| what 3 cytokines activate NK cells? |
|
Definition
|
|
Term
|
Definition
| coreceptor for the LPS TLR (found on macrophages) |
|
|
Term
Name bugs that rearrange their antigens to evade immunity:
1) Bacteria (3)
2) Virus (1)
3) Parasite (1) |
|
Definition
1) Salmonella (2 flagellar variants); Borrelia recurrentes (relapsing fever); N.gonorrhea (pilus protein)
2) Influenza
3) Trypanosome (programmed rearrangement) |
|
|
Term
| Things you give passive antibodies for: |
|
Definition
HepB
Tetanus
Botulism
Rabies (but is still fatal almost always) |
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