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105
Medical
Graduate
05/27/2012

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Term
Heterochromatin & euchromatin. Which one is condensed?
Definition
Heterochromatin is Highly condensed
Term
Name MOA for each:
1) Hydroxyuria
2) 6MP
3) 5FU
4) MTX
5) TMP
6) Pyrimethamine
Definition
1) Ribonucleotide reductase inhibitor (also ATP; mech of ADA def SCID)
2) Blocks de-novo purine biosynthesis
3) Blocks thymidylate synthase (TS)
4) Inhibits DHF reductase (can't make nucleic acids)
5) same as MTX in bacteria
6) same as MTX in protozoa
Term
3 things that can give you orotic aciduria (2 inherited)
Definition
1) Ornithine transcarbamoylase deficiency (hyperammonia state with this one); X-linked
2) Orotic acid phosphoribosyltransferase deficiency (megaloblastic anemia w/out hypersegmentation); Autosomal recessive
3) Drugs: azathioprin (6MP), Reyes syndrome
Term
Main DNA polymerase?

Which one degrades RNA primers?
Definition
1) III
2) I

keep in mind this is for prokaryotes only
Term
Define & give example of each:
1) Nucleotide excision repair
2) Base excision repair
3) mismatch repair
4) Double-strand break repair
Definition
1) segment is excised; XP
2) Single base is glycosylated & removed. DNA cut by AP endonuclease. Gap is filled in
3) Complex formed on free ends & joined. Ataxia-Telangiectasia
Term
Amanitin (from Amanita Phalloides, death mushroom cap) MOA?
Definition
inhibits RNA-pol II & causes fulminant hepatitis
Term
what part of protein synthesis is blocked by:
1) chloramphenicol
2) Macrolides & clindamycin
Definition
1) Peptidyltransferase
2) translocation
Term
ER or golgi:
1) Adds N-linked oligosaccharides
2) Adds O-linked oligosaccharides
3) Modifies N-linked oligosaccharides
4) Adds Mannose-6-phosphate (I-cell disease)
5) Proteoglycan assembly
6) Sulfation
Definition
1) ER
all the others are golgi
Term
Name function:
1) COP1
2) COP2
3) Clathrin
4) Mannose-6-phosphate addition to proteins in golgi
Definition
1) retrograde: Golgi -> ER
2) Anterograde: RER -> Golgi
3) Trans-Golgi budding & receptor-mediated endocytosis
4) Directs proteins to lysosomes

NOTE: I-cell disease = lysosomal enzymes secreted outside cell; course facies, clouded corneas, restricted joints, high serum lysosomal protein levels, often fatal in childhood
Term
GTP-bound microtubules are stable or unstable?

Name drug for each class that involves messing up microtubules:
1) Antihelminthic
2) Antifungal
3) Anticancer, prevents depolymerization
4) Anticancer, prevents polymerization
4) Anti-inflammatory
Definition
1) Mebendazole
2) Griseofulvin
3) Paclitaxel
4) Vincristine/Vinblastine
5) Colchicine (prevents polymerization)
Term
4 features of Kartagener's?
Definition
1) Situs inversus
2) Infertility (immotile sperm/defective fallopian tubes)
3) Recurrent sinusitis
4) Bronchiectasis
Term
structure of:
1) Cilia
2) Flagella
3) microvilli
Definition
1 & 2 are the same, they just beat differently
3) Made up of actin +/- myosin
Term
both Ouabain & Dig bind ___ at the ___ binding site
Definition
they bind the Na/K ATPase @ the K+ binding site
Term
What is fibrillin?
Definition
the matrix in which elastin is deposited.

Remember, elastin is connected by desmolysine bonds (4 lysines stuck together).

Tissues w/ elastin: lungs, large arteries, elastic ligaments, vocal cords, ligamenta flava
Term
Inheritance of hereditary spherocytosis
Definition
AD
Term
Inheritence of:
1) NF1, NF2, Tuberous sclerosis, VHL
2) Ataxia-telangiectasia, Friedrich's ataxia
Definition
1) AD
2) AR
Term
microcephaly, MR, high-pitched crying, epicanthal folds, cardiac abnormalities

Where is the deletion?
Definition
5p deletion

Cri-du-chat
Term
What electrolyte is messed up in williams syndrome?
Definition
hypercalcemia b.c. of vitamin D hyper-responsiveness.

7q microdeletion causing elvin facies, cardiac problems, hypercalcemia, extreme friendliness, & mild MR
Term
what donates the methyl group in the NE -> epi conversion?
Definition
SAM
Term
if an enzyme has "dehydrogenase" in the name, what do you probably get in the reaction?
Definition
production of an NADH
Term
4 things NADPH is used for
Definition
1) respiratory burst
2) Glutathione reductase
3) P-450 enzymes
4) anabolic processes (e.g. lipid & steroid synthesis)
Term
name steps in glycolysis where you use & get ATP
Definition
USE:
Glucose -> G6P
F6P -> F1,6BP

Get:
1,3 BPG -> 3PG
PEP -> pyruvate

NOTE: you get an NADH from Glyceraldehyde 3 P -> 1,3BPG
NOTE: shunting 1,3BPg ->2,3 BPG gives 0 net ATP
Term
rice water stools, garlic breath, vomiting
Definition
arsenic poisoning. Inhibits lipoic acid
Term
what do you treat pyruvate dehydrogenase deficiency with?
Definition
ketogenic AA (lysine, leucine)

this deficiency causes backup of pyruvate & creates a lactic acidosis

Sx: lactic acidosis & neurologic disturbances (b.c. brain needs glucose)
Term
what is the amino acid form of:
1) Pyruvate
2) Oxaloacetate
3) Alphaketoglutarate
Definition
1) alanine
2) Aspartate
3) Glutamate

NOTE: carboxylate pyruvate to get oxaloacetate (good way to remember structures)
Term
what step in TCA give FADH2? GTP?
Definition
FADH2: Succinate -> fumarate

GTP: SuccinylCoA -> Succinate
Term
Name mechanism of each uncoupling agent:
1) Rotenone, CN-, AntimycinA, CO
2) Oligomycin
3) 2,4-dinitrophenol, aspirin, EtOH
Definition
1) inhibits proton translocation (inhibit cytochrome C) -> decrease H+ gradient

2) inhibits ATP synthesis -> decrease ATP gradient

3) increases cell permiability -> decreases H+ gradient & can cause hyperthermia
Term
Gluconeogenesis needs 4 ATP & 2 GTP. Name the steps taht need these
Definition
GTP: Oxaloacetate -> PEP

ATP:
1) pyruvate -> oxaloacetate (also needs biotin)
2) 3PG -> 1,3BPG
Term
why are odd-chain FA gluconeogenic?
Definition
produce propionylCoA -> methylmalonylCoA -> Succinyl CoA
Term
cofactor required for transketolase rxn?
Definition
B1
Term
what 2 B vitamins can INH cause a deficiency in?
Definition
B6 (direct conjugation & inhibition of pyroxal kinase)

B3: b.c. B6 def will inhibit B3 synthesis from tryptophan
Term
SPACE for catalase-pos bugs
Definition
Staph aureus
Pseudomonas
Aspergillus
Candida
Enterobacteraciae
Term
hypoglycemia, jaunice, cirrhosis, vomiting in young child just weaned off breast
Definition
hereditary fructose intolerance (no aldolase B)

Note the jaunice & cirrhosis (prol b.c. the fructose osmotically kills the hepatocytes)

Very similar Sx can present w/ classic galactosemia. differentiate by when the kid gets sick (w/ breast feeding vs fructose intake)
Term
4 cells that get damaged by sorbitol?
Definition
Schwann cells
Pericytes of retina
Lens
Kidney
Term
mnemonic for essential AA?
Definition
PVT TIM HALL

phe, val, trp, thr, ile, met, his, arg, leu, lys
Term
what AA transports ammonium & substrates for gluconeogenesis to the liver?
Definition
alanine (after aminotransferase it makes pyruvate)
Term
used to treat hyperammonemic states?
Definition
Phenylbutyrate & Benzoate: they complex w/ glutamine & are rapidly lost in urine

NOTE: Sx of ammonia intox = flapping tremor, slurring of speech, somnolence, vomiting, cerebral edema, blurring of vision
Term
How does a hyperammonemic state inhibit the TCA cycle?
Definition
it depletes alpha-keto-glutarate by converting it:

AKG -> Glutamate

NOTE: Sx of ammonia intox = flapping tremor, slurring of speech, somnolence, vomiting, cerebral edema, blurring of vision
Term
inheritance of:
1) ornithine transcarbamoylase deficiency?
2) orotic acid PRT
Definition
1) X-linked recessive (tx w/ phenylbutyrate or benzoate & Arg sup)
2) AR
Term
Name AA (+/- immediate precursor) each thing comes from:
1) Thyroxine
2) Melanin
3) NE & Epi
4) Niacin
5) Melatonin
6) 5HT
7) Histamine
8) ALA
9) Creatine
10) GABA
11) Urea
12) Glutathione
13) NO
Definition
1) Phe (Tyrosine is precursor)
2) Phe (DOPA is precursor; "tyrosinase")
3) Phe
4) Trp
5) Trp (serotonin)
6) Trp
7) His
8) Gly (& succinylCoA)
9) Arg
10) Glu (needs B6)
11) Arg
12) Glu (+Cys & Gly)
13) Arg
Term
4 things you need BH4 for?
Definition
1) Phe -> Tyr (form of PKU)
2) Tyr -> DOPA
3) Serotonin synthesis
4) NO synthesis
Term
ocular albinism inheritance? regular albinism inheritence?
Definition
OA = X-linked

all other forms are variable. Tyrosinase def is AR
Term
How can exercising muscle increase glycogen breakdown w/out any increase in PKA signaling?
Definition
Ca++ acts as a positive modulator of Glycogen phosphorylase kinase (GPK; which is phosphorylated & activated by PKA)

GPK phosphorylates glycogen phosphorylase, which breaks down glycogen.
Term
For glycogen breakdown:
1) phosphorylation of alpha(1,4) bonds gives what?
2) (1,6)?
3) which one are branching bonds?
Definition
1) Glucose-1-phosphate
2) Glucose
3) the (1,6) linkages are branch points (Cori disease)
Term
what donates the methyl group in the NE -> epi conversion?
Definition
SAM
Term
orange tonsils, hazy corneal opacity
Definition
Tangier's disease

Absence of ABCA1 (cholesterol efflux regulator protein, CERP). This protein makes nascent HDL into mature HDL. AR

Neuropathies are most obvious Sx
Term
Name basic function of each gene in embryology:
1) Sonic Hedgehog
2) Wnt-7
3) FGF
4) HOX (homeobox genes)
Definition
1) Polarity
2) Limb/limb bud development
3) Signal for lengthening limbs
4) Segmental organization

NOTE: 2&3 produced @ "apical ectodermal ridge"
Term
Name major events for each date of development:
1) Day6
2) week2
3) week3
4) week4
5) week8
6) week10
7) when is the embryo most susceptible to teratogens?
Definition
1) Implantation (hCG detectible soon after (~day8)
2) bilaminar disk
3) trilaminar disk
4) limb buds, heart begins to beat, NT closes
5) fetal movement
6) M/F differentiation; Gut returns to abdominal cavity w/ a 270 rotation (herniates @ week 6)
7) before 3rd week = global; 3-8 week = organ specific (most susceptible here)
Term
Neural crest derivatives
Definition
- All peripheral nerve things: (PNS, Schwann cells, Ganglia, Adrenal medulla)
- Endocrine: C-cells
- Aorticopulmonary septum
- Odontoblasts
- Bones of face
- Pia & Arachnoid (dura is mesoderm)
Term
Define & give an ex of each cause of congenital anomaly:
1) malformation
2) deformation
3) disruption
4) sequence
5) agenesis
6) Aplasia
Definition
1) Intrinsic disruption in formation during embryogenesis (e.g. holoprosencephaly, syndactyly, polydactyly)
2) extrinsic disruption (e.g. clubbed feet, potters face)
3) Amnionic bands amputate
4) One problem causes many (e.g. potters)
5) Failure to develop any tissue (e.g. renal agenesis)
6) Primordial tissue exists, but doesn't develop (e.g. radial aplasia in VACTERL)
Term
name what each of these things become:
1) Urachus
2) Vitelline duct
3) Allantois
Definition
1) Thing connect to bladder. Normally is obliterated. Same thing as allantois. Can become a bladder diverticulum or vesico-umbilical fistula if not obliterated. The mesodermal covering of 1&3 becomes the umbillical arteries

2) normally obliterated. Can become meckel's diverticulum or an omphalomesenteric duct
Term
2 things elevated in NTDs?
Definition
AFP & acetylcholineesterase (in amniotic fluid)
Term
1) Things associated w/ Chiari2?
2) What is missing in Dandy Walker malformation?
Definition
1) always accompanied by meningomyelocele; Chiari 1&2 assoicated w/ hydrocephalus & syringomyelia
2) Cerebellar vermis; associated w/ NTDs & hydrocephalus
Term
1) D glutamate capsule
2) Polyribose-ribitol phosphate capsule
3) Antigenically poor sialic acid polymer that mimics brain tissue
Definition
1) Anthrax
2) H.flu serotype B (this is the one w/ the conjugate vaccine,and causes all the bad stuff, i.e. meningitis/epiglotitis)
3) N.meningitis groupB (same as Ki ecoli, the on that causes meningitis)
Term
Name the toxins that are transported by a phage
Definition
remember: ABCDE
- shigA-like toxin
- Botulinum toxin
- Cholera toxin
- Diphtheria toxin
- Erythrogenic toxin (strep pyo)
Term
what is the most common dermatophyte?
Definition
trichophyton rubrum
Term
live attenuated vaccines?
Definition
smallpox, yellow fever, VZV, Sabin polio, MMR
Term
Aerobic bacteria
Definition
Nagging Pests Must Breath:

Nocardia
Pseudomonas
Mycobacterium
Baccilus
Term
Urease producers?
Definition
PHUK

Proteus
H.pylori
Urease
Klebsiella
Term
cysticercosis pathogen & treatment
Definition
Taenia solium (cestode): praziquantel
Term
1) spaghetti & meatballs prep?
2) Cigar-shaped yeast forms (unequal budding)?
Definition
1) malasezia furfur
2) Sporothrix
Term
Rasberries are associated w/ what pathogen that can cause chronic diarrhea in AIDS pts
Definition
Cyclospora
Term
1) No duffy antigen protects against this species?
2) All other RBC things (e.g. sickle, thalassemia, G6PD) protect against this spp
Definition
1) Vivax
2) Falciparum
Term
Proteins on the capsid of HIV? The envelope?
Definition
Capsid = gag = p24

Envelope = env = gp120, gp41
Term
Bacterial or viral conjunctivitis:
1) <3 y.o.?
2) >3 y.o.?
Definition
1) bacterial
2) Viral (e.g. adenovirus)
Term
encapsulated organisms
Definition
S.pneumo
N.meningitidis
K.pneumonia
H.flu
Pseudomonas
Salmonella
Cryptococcus

"Some Nasty Killers Have Pretty Shiny Capsules"
Term
Name function & the bacteria who has each virulence factor:
1) Protein A
2) M protein
Definition
1) S.aureus: binds Fc & prevents phagocytosis
2) GAS: Binds factor H -> degrade C3 -> prevent opsonization
Term
Name 4 important G(+) beta-hemolytic strep
Definition
GAS
GBS
S.aureus
L.monocytogenese

NOTE: CAMP test = GBS produces CAMP factor, which increases hemolysis of S.aureus
Term
pyrimethamine MOA
Definition
inhibit DHF reductase (same as TMP)

Pyrimethamine-sulfadiazine is DOC for Toxo
Term
where do you detect the antigen for legionella?
Definition
in the urine

NOTE: there is no person-to-person transmission
Term
Sx of congenital syphilis?
Definition
Hutchinson teeth, saber shins, saddle nose, CN VIII deafness, mulberry molars
Term
someone has a headache, fever & rash. What bacteria do you think of?
Definition
rickettsial spp

Tick = R.rickettsiae, Ehrlichiosis
Louse = R.prowazekii
Flea = R.typhi
Chiggers = R.tsutsugamushi (scrub typhus)
Inhaled spores (tick feces, catal placenta) = Coxiella burnetii

RMSF rash starts on wrists & goes in; Typhus rash starts on trunk and goes out
Term
What antigens are used by weil Felix?
Definition
proteus (used to test for rickettsial infection, negative in Coxiella infection)
Term
What extra-intestinal manifestation can happen w/ E.histolytica?
Definition
Liver abscess: protozoa invade intestinal mucosa ("flask shaped ulcer") -> get into portal circulation -> encyst in liver

These can perforate & invade through diaphragm -> pulmonary abscess

REMEMBER: you treat all the protozoa w/ metronidazole (giardia, E.histolytica, trichomanas vaginalis)
Term
Tx for T.brucei
Definition
Suramin if not in CNS (inhibits enzymes in metabolism)

Melarsoprol if in CNS (arsenical; binds sulfhydryl groups)

(remember Testes fly, painful bite)
Term
If you got bit by an Ixodes tick & got the 4 things associated w/ it. What would you have to get treated with?
Definition
Doxycycline (B.burgdorferi, Ehrlichia, Anaplasmosis)

Quinine or Clindamycin (Babesia)
Term
Smelly vaginal discharge:
1) Thin Gray
2) Thin Greenish
Definition
1) Gardenella
2) Trichomonas

Treat both with metronidazole
Term
How do you treat:
1) Nematode in the gut?
2) D.medinesis
3) O.volvulus
4) LoaLoa
5) W.bancrofti
6) Toxocara canis (i.e. visceral larval migrans)
7) Tapeworms?
8) Dog Tapeworm?
9) Trematodes?
Definition
1) -Bendazoles (e.g. E.vermicularis, A.lumbricoides, S.stercoralis, A.duodenale, N.americanus)
2) Niridazole (ASIDE: nifurtimox used for chagas)
3) Ivermectin
4,5,6) Diethycarbamazine
7) Praziquantel (e.g. Taenia solium, D.latum)
8) -bendazole
9) Praziquantel (e.g. Schistosomiasis, P.westermani, C.sinensis)
Term
Give answer concerning viruses:
1) Which DNA viruses are SS?
2) DNA viruses circular?
3) Which RNA viruses aren't infectious when injecting the genomic material?
4) Same as 3, but for DNA viurses?
5) Segmented genomes?
Definition
1) Parvovirus
2) Papova & HepB
3) Reo, Retro, and all the SS(-)
4) Pox, HepB
5) Reo, Orthomyxo, Arena, Bunya
Term
croup pathogen
Definition
paramyxovirus
Term
What does paramyxoviruses have that allows them to form multinucleated giant cells?

What drug blocks this?
Definition
F protein ("fusion")

Palivisumab (used in RSV infections)
Term
coinfection or superinfection is worse w/ HDV?
Definition
Superinfection (i.e. infect someone already infected w/ HBV)
Term
What HIV antibody crosses the placenta?
Definition
anti-gp120 (gives false positive for the first few months after birth)
Term
PrPc or PrPsc is beta-pleated sheet?
Definition
PrPsc

PrPsc converts PrPc to PrPsc
Term
what stage of syphilis do you get condyloma lata?
Definition
2nd
Term
Name MOA for each:
1) Enfuvirtide
2) Efavirenz
3) Maraviroc
4) Raltegravir
Definition
1) gp41 inhibitor
2) NNRTI
3) CCR4 binder
4) Integrase inhibitor (pol gene)
Term
what Ig is deficient in:
1) Ataxia-Telangiectasia?
2) Wiskott-Aldrich?
Definition
1) IgA
2) IgE & IgA are up; IgM is down
Term
which MHC is most important in matching for a transplant?
Definition
DR
Term
Acute & chronic Sx of Iron poisoning?
Definition
Acute: GI bleeding

Chronic: Metabolic acidosis (a lactic acidosis from mitochondrial damage); GI obstruction (from scarring from ROS damage)
Term
Tuberous sclerosis Sx
Definition
Cardiac Rhabdomyomas
Astrocytomas
Kidney angiomyolipomas
Facial angiofibromas
Seizures & MR
Term
1) ras function
2) BRCA1 or 2 that is just for breast?
Definition
1) GTPase (oncogene)
2) BRCA2 (1 is for breast & ovarian)
Term
Bombesin is a marker for what tumors?
Definition
Neuroblastoma, Lung and gastric cancer

Bombesin is a peptide that stimulates gastrin secretion & has some effect in the CNS
Term
why is hyponatremia inotropic?
Definition
works similar to DIG: decreased Na gradient keeps more Ca in the cell (inhibition of Na/Ca antiporter)
Term
1) Is acidosis inotropic?
2) How do NDHP Ca-channel blockers decrease contractility?
Definition
1) No, it decreases contractility
2) Decreases Ca-induced Ca release in myocytes (remember, it's also chronotropic. These have essentially the same effect as beta-blockers)
Term
ejection fraction equation
Definition
SV/EDV
Term
3 states w/ increased viscosity
Definition
PCV
walstrom's/multiple myeloma
hereditary spherocytosis
Term
What can cause paradoxical splitting?
Definition
things that delay LV emptying (e.g. aortic stenosis, LBBB)
Term
Define:
1) First degree heart block
2) Wenckebach
3) Mobitz 2
4) 3rd degree heart block
Definition
1) PR interval is >1 large box (>200ms)
2) i.e. mobitz 1; Progressively longer PR until beat is dropped. Benign
3) Dropped beats, often in 2:1 ratio. May proceed to 3rd degree
4) No P-R coupling (remember lyme & congenital lupus)
Term
Aortic arch baroreceptors respond only to increase or decrease BP?
Definition
increase BP (act to decrease CO; just remember, it goes up & back down the vagus)
Term
@ what PO2 do the carotid chemoreceptors detect low O2?
Definition
<60mmHg
Term
what do you need to keep baby alive w/ tricuspid atresia?
Definition
both an ASD & VSD
Term
differential cyanosis w/ what?
Definition
PDA (when pulm vasculature becomes more resistant -> reverses shunt)

NOTE: Postductal
Term
define hypertension
Definition
>140/90 (stage 1)
>160/100

(<139/90 is prehypertension)

120/80 is normal; >200/120 is malignant
Term
ekg with prinzmetal's angina?
Definition
ST-elevation (not depression). This is b.c. the vasospasm causes a total occlusion -> transmural ischemia (vs atherosclerosis)
Term
larger form of osteoid osteoma that doesn't get better w/ ASA?
Definition
Osteoblastoma

Osteoid osteoma (<2cm) is usally in kids & in cortex of long bones

Osteoblastoma (>2cm) is usually in vertebra
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