Term
| Risk factor for vaginal adenosis (squamous layer replaced by glandular epithelium, precursor for clear-cell carcinoma) |
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Definition
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Term
| Hepatitis from raw or steamed shellfish |
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Definition
HepA (common route of transmission in US; in underdeveloped countries, poor sanitation is the culprit)
this is a fecal-oral transmission (remember A & E are fecal-oral) |
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Term
| HIV drug that prevents RNA-dependent DNA synthesis & isn't in pro-drug form |
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Definition
NNRTI (e.g. Nevirapine, Efavirenz, Declaviridine)
NOTE: NRTIs need to be phosphorylated by thymidine kinase |
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Term
What innervates tensor tympani?
Stapedius? |
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Definition
TT = CN-V3
Stapedius = CN-VII
damage to either of these may lead to hyperacusis; Ipsilateral hyperacusis is a common finding w/ Bell's palsy |
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Term
2 antibiotics commonly assoicated w/ C.diff
What do Toxins A & B do? |
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Definition
- Clindamycin & Ampicillin
- Toxin A binds brush boarder (enterotoxic) --> diarrhea
- Toxin B causes cytoskeleton defects (cytotoxic) |
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Term
All skin from the umbillicus down (including anus under the dentate line) drains to which nodes?
What is the exception? |
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Definition
- Inguinal nodes
- Posterior calf drains to popliteal |
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Term
| Silicosis & coal workers pneumoconiosis has an increased risk for TB, cancer, or both? |
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Definition
Silicosis has increased risk for TB only
In silicosis macrophage killing is inhibited by silicon particles by an unknown mechanism
CWP has no increased risk for anything except restrictive lung disease (like all pneumoconioses) |
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Term
| Elevated ST segment in II, III, aVF. Which artery is occluded? Where is the ischemia? |
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Definition
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Term
Name ST-elevations for each infarct location:
1) Anterior wall (LAD)
2) Anteroseptal (LAD)
3) Anterolateral (LCX)
4) Lateral wall (LCX)
5) Inferior wall (LCA) |
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Definition
1) V1-V4
2) V1-V2
3) V4-V6
4) I, aVL
5) II, III, aVF |
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Term
| Which columns in the spinal cord are destroyed in Vit B12 deficiency? What other conditions have the same leasions? |
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Definition
Dorsal columns, corticospinal tract, & spinocerebellar tract
(VitE def & Friedrich's ataxia) |
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Term
| 2 enzymes needed to turn fructose-6-phosphate into ribose-5-phosphate |
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Definition
transketolase (x2) & transaldolase
Remember: transketolase needs B1
(this is tough, check out themedicalbiochemistrypage page on the pentose-phosphate pathway) |
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Term
| high unrine methylmalonic acid |
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Definition
B12 deficiency
methylmalonic acid comes from the VOMIT pathway (Valine, Odd-chain FA, Methionine, Isoleucine, Threonin) |
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Term
| How is PAH transported across proximal tubule? |
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Definition
| carrier-mediated transport. |
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Term
| Treatment for rat poison overdose (brodifacoum, a long acting 4-hydroxycoumarin) |
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Definition
| fresh frozen plasma (also give vitamin K1 |
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Term
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Definition
| used for heparin overdose (binds heparin) |
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Term
| deaminated forms of aspartate & glutamate |
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Definition
| oxaloacetate & alpha-ketoglutarate |
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Term
ALA synthase needs what cofactor?
Which product of heme synthesis is elevated in lead poisoning? |
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Definition
B6 (pyridoxal phosphate)
ALA synthase makes delta-ALA from glycine & succinyl-CoA
The next step (catalized by delta-ALA dehydratase) is inhibited by lead. Thus, in lead poisoning delta-ALA is elevated in lead poisoning. |
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Term
| Which is the step in heme synthesis where the individual molecules are covalently linked (i.e. becomes quatrimer) |
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Definition
Porphobilinogen deaminase (defective in acute intermittent porphyria)
This is important, because after this step, the porphyrias have cutaneous manifestations (rather than neurological)
NOTE: Uroporphyrinogen decarboxylase in inhibited in porphyria cutanea tarda |
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Term
Lesion in ALS
Lesion in polio/Wernig-Hoffmann |
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Definition
ALS: combined upper & lower motor neuron --> corticospinal & anterior horn
Polio/WH: anterior horn (LMN only) --> flaccid paralysis |
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Term
| most potent diuretic used to treat edema of many different etiologies? |
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Definition
| loop diuretics (e.g. furosemide, torsemide, bumetanide, ethacrynic acid) |
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Term
Name MOA & use of each:
1) Amifostine
2) N-acetyl cysteine
3) Leucovorin (i.e. folinic acid)
4) Filgrastim
5) Fomepizole
6) Dexrazoxane |
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Definition
1) Thiol-based free radical scavenger that prevents cisplatin induced nephrotoxicity
2) Tx for acetaminophen overdose (regenerates GSH in liver)
3) Prevent aplastic anemia in methotrexate use
4) G-CSF; use in chemo, etc
5) Alcohol dehydrogenase antagonist; treatment for methanol/ethylene glycol ingestion
6) Iron chelating agent; prevents anthracycline-induced cardiotoxicity (e.g. doxorubicin) |
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Term
who produced IFN alpha & beta?
Who produces IFN gamma? |
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Definition
alpha & beta = everything
Gamma = T cells & NK cells
interferons act to prevent viral replication & increase synthesis of antiviral proteins |
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Term
| decreased fetal swallowing or increased fetal urination causes ____hydramnios |
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Definition
polyhydramnios
- decreased swallowing: GI obstruction, anencephaly
- increased urination: high CO, twin-twin transfusion |
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Term
infant born has: pupillary dilation, rhinorrhea, sneezing, nasal stuffiness, diarrhea, nausea, vomiting, chills, tremors, "jittery movements". Rarely, seizures can occur.
What is your treatment? |
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Definition
give a tincture of opium
this child is suffering from opiate withdrawal. |
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Term
| Aortic regurgitation would lead to what type of hypertrophy? |
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Definition
concentric (this is a volume overload, not a pressure overload). Cardiac output is maintained because increased preload activates Frank-Starling
Pressure overload occurs with aortic stenosis/systemic hypertension |
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Term
| In noise induced hearing loss, which frequencies are lost first? |
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Definition
| high frequencies (regardless of what type of exposure) |
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Term
| Brain tumor with psammoma bodies |
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Definition
meningiomas
tumors w/ psammoma bodies: PSMM
Papillary carcinoma of thyroid
Serous cystadenocarcinoma of ovary
Meningioma
Mesothelioma |
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Term
| 3 causes of orotic aciduria. Which one has high ammonia? which ones have megaloblastic anemia? |
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Definition
1) orotic acid phosphoribosyltransferase
2) orotidine 5'-phosphate decarboxylase
3) Ornithine transcarbamoylase
1 & 2 are involved in purine synthesis --> megaloblastic anemia
3 is involved in the urea cycle --> high ammonia levels (resulting in severe neurological abnormalities due to high blood & tissue ammonia levels) |
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Term
| Low levels of N-acetylglutamate synthetase (NAGS) will result in? |
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Definition
High ammonia levels
NAG is a regulator for Carbamoyl phosphate synthase (CPS) --> deficiency in either of these enzymes will cause high blood-ammonia levels without orotic aciduria (in contrast to ornithine transcarbamoylase) |
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Term
| psychotic disorder that lasts less that 1 month & typically develops in direct response to psychological stress |
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Definition
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Term
Give the traditional descriptive term for each stage of lobar pneumonia:
1) first 24 hrs. Lobe is red, heavy, & boggy. Vascular dilation & alveoli contain mostly bacteria
2) 2-3 days. Lobe is red and firm. alveoli have erythrocytes, neutrophils, & fibrin
3) 4-6 days. Lobe is gray-brown and firm. RBCs disintegrate; neutrophils & fibrin persist
4) restoration of normal architecture by enzymatic digestion of exudate |
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Definition
1) Congestion
2) Red hepatization (RBCs intact)
3) Gray hepatization (RBCs fragmented)
4) Resolution |
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Term
| name the three types of RPGN (crescentic GN) |
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Definition
1) antibody mediated (e.g. goodpastures)
2) immune complex (e.g. SLE, IgA, HSP, post-strep)
3) Pauci-immune, ANCA-positive & no Ig/complement (e.g. wegners, microscopic polyangiitis) |
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Term
| What is the most likely outcome of a HCV infection? |
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Definition
Chronic, stable hepatitis
15% recover from acute infection; 85% become chronic;
Chronic carriers: <50% will get cirrhosis; <3% will get HCC
ASIDE: HCV is so hard to eliminate because it changes it's phenotype so readily (lots of mistakes in replication) --> any given person will have many different "species" at one time |
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Term
| What gonadotropin is elevated in postmenopausal women? Why? |
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Definition
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Term
| Child has a brain tumor with many primitive cells & mitotic figures |
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Definition
Medulloblastoma
although pilocytic astrocytoma is more common, it is well differentiated & has few mitoses
Medulloblastoma is a PNET (neuroectonermal) tumor (like ewing sarcoma)
presenting sx may occur b.c. tumor expands & closes off the cerebral aqueduct --> headache, vomiting, lethargy, papilledema. Cerebellar signs (ataxia) may occur due to adjacent cerebellar damage (remember, in kids, tumors are usually infratentorial) |
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Term
| Smoking around a kid predisposes them to get? |
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Definition
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Term
| another term for demyelination? |
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Definition
denudation. Axonal denudation occurs in MS.
Following white matter changes are seen in MS: axon demeylination --> oligodendrocyte depletion --> lipid-laden macrophages (from eating myelin) --> fibrillary astrocytosis (injury reaction) --> lymphocyte/monocyte infiltrate |
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Term
| What does fenphen do if used for >3 months? |
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Definition
| causes pulmonary HTN --> cor pulmonale |
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Term
ALA synthase catalyzes a reaction that combines which 2 molecules to form delta-aminolevulinic acid?
One of these molecules is an amino acid. Where does the other one come from? What molecules can be metabolized to this molecule? |
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Definition
Glycine & Succinyl-CoA
Succinyl-CoA comes from the TCA cycle (Glycolysis or methylmalonic acid breakdown). Methylmalonic acid comes from the VOMIT pathway: valine, odd-chain FA, methionine, Isoleucine, Threonine |
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