-
what antihypertensive has dopamine antagonistic effects?
alpha-methyl dopa
-
2 endocrine disorders that can produce depression?
- hypothyrodism
- hyperparathyrodism
-
Ret oncogne is associated with what two thyroid cancers?
Ras oncogne is associated with what thyroid cancer?
- Papillary
- Medullary
- follicular
-
What drugs inhibit the following enzymes?
PRPP synthetase?
Dihydrofolate reductase
Ribonucleotide reductase
Thymidylate Synthetase?
- 6MP
- MTX
- Hydroxyurea
- 5FU and MTX
-
Which eukaryotic polymerase replicates leading strand?
lagging strand?
repairs DNA?
replicates mitochondrial polymerase?
- delta
- alpha
- beta, epsilon
- gamma
-
What causes Bloom syndrome?
- DNA repair defect
- sensitivity to sunlight
- leukemia, lymphoma
-
what are structural motifs present in Transcription factors?
- leucine zipper
- zinc finger
- turn loop turn
-
Marker of osteoblast activity?
osteoclast activity?
- alkaline phosphatase
- tartrate resistant acid phosphatase
-
Lymph drainage usually follows what?
blood supply
-
What vitamin aids in recovery from measles, pneumonia or diarrhea?
Vitamin A
-
What is the most common lung tumor in non smokers and women?
adenocarcinoma
-
What is the gross morphology of a pilocytic astrocytoma?
cystic lesions and solid lesions
-
What are the 2 places where nicotinic receptors are found?
skeletal muscle and preganglionic synapses
-
-
Migraine +aura you should not give what?
OCP
-
When do Theca-Lutein Cysts occur?
when there is high beta HCG as in choriocarcinoma and molar pregnancies, twins or triplet pregnancies
-
SHiller Duval bodie are seen in what cancer?
Yolk sac Tumor
-
Prior C section increases the risk for what?
-
What causes the following breast pathology?
breast tumor in women under 25?
Most common breast mass in post menpausal women?
most common breast mass in premenopausal women?
most common form of breast cancer?
small mobiile firm mass with sharp edges?
histological leaf like projections
signet ring cells
loss of e-cadherin cell adhesion gene
always Estrogen + and Progesterone
commonly presents with nipple discharge
eczematous patches on nipple
multiple bilateral fluid filled lesions with diffuse pain
firm fibrous mass in a 55 year old man
- Fibroadenoma
- invasive ductal
- fibrocystic change
- invasive ductal
- fibroadenoma
- phyllodies tumor
- invasive lobular
- invasive lobular
- invasive lobular insite
- ductal papilloma
- pagets suggestive of invasive ductal
- fibrocystic change
- invasive ductal
-
-
What are the 2 major side effects of Pioglitazones?
- LIver dysfunction
- Congestive heart failure in a susceptible patient
-
Vitteline duct gives rise to what?
Urachus(allontois remnant) gives rise to what?
- Meckel's diverticulum or discharge of feces from umbilicus
- discharge of urine from umbilicus
-
What enzyme is responsible for acute necrotizing pancreatitis?
Trypsin activation
-
What enzyme needs Riboflavin Vit B2?
succinate dehydrogenase
-
Transmural vasculitis with fibrinoid necrosis is characteristic of what vasculitis?
PAN
-
PAN never involves what structure?
LUNG
-
MOA of Bisphosphonates?
- pyrophosphate--component of hydroxyapetite
- pyrophosphate--inhibits osteoclasts
-
Which inhaled anesthetic has nephrotoxicity?
methoxyflurane
-
which IV anesthetic is proconvulsant?
enflurane
-
What vitamin deficiency produces posterior column and spino-cerebellar demyelination?
Vitamin E
-
What patients learn to squat to improve pulmonary blood flow and improve oxygenation?
TOGV
-
RPGN are of 3 types, what diseases make them up?
- type I-good pasture
- type II--immune complex deposition
- Type III-pauci immune..no complement deposition just crescents
-
What are the 7 titratabe amino acids with 3 protons?
a
l
h
a
g
t
c
- arginine
- lysine
- histidine
- aspartic acid
- glutamic acid
- tyrosine
- cysteine
-
Arginine gives rise to what 3 important products?
-
What is resposible for erection, emission, ejaculation?
- erection--para
- emissio--hypogastric--sympathetic
- ejaculation--visceral and somatic nerves
-
RET vs RAS?
- RET--tyrosine kinase
- RAS- GTPAse
-
What kind of fibers are responsible for the following?
1-pricking sharp pain
2-Burning or dull pain
3-Receptor for cold sensation
4-Receptor for warm sensation
5-Vibration and pressure
6-Dynamic/changing light, discriminatory touch
7-Static/changing light touch
8-Proprioception--muscle length monitoring
9-Proprioception-- Muscle tension monitoring
10-Resembles an onion in cross section
11- Robust spindle shaped found in soles of feet
12- Found only in areas of skin without hair
13-simplest sensory receptor for pain and thermoreception
14 Touch receptor that looks like melanocytes
15- Look like fried eggs under histologic staining
16- Forms multinucleated giant cells in HIV in CNS
- 1-A-delta
- 2- C
- 3-A delta
- 4- C
- 5-Pacinian
- 6-Meissners
- 7-Merkels
- 8- muscle spindle
- 9-golgi tendon
- 10 Pacinian corpuscle
- 11- ruffinin endings
- 12-Meissners
- 13-free nerve endings
- 14-Merkel cells
- 15--Oligodendrocytes
- 16- Microglia
-
In the basal ganglia, what does the Direct pathway of Striatum do?
Indirect?
Subthalamic?
Globus pallidus Internal?
- promotes movement
- Inhibits movement
- Inhibits movement
- Inhibits movement
-
The following is associated with ?
presents at birth as floppy baby?
Lewy Bodies
Dementia w/ frequent falls and syncope
dementia + visual hallucinations
dementia + personality changes or aphasia
Intranuclear inclusions called cowdry bodies caused by?
Eosinophilic rodlike inclusions in hippocampus of alzheimers?
- Wernig-Hoffman--LMN affected
- Lewy bodies--parkinssons, lewy body dementia, alzeihemer
- Lewy body
- Lewy Body
- Picks
- HSV and CMV
- Hirano bodies
-
3 drugs for tonic-clonic seizures?
- phenytoin
- carbamezapine
- valproic acid
-
WHat opiod induces withdrawal with a full opiod agonist?
Butorphanol
-
Which anesthetic?
nephrotoxic
used in endoscopy
convulsions/seizure
hepatotoxic
rapid anesthesia and short procedures
rapid anesthesia
decreases blood flow
does not induce histamine release like morphine
high triglyceride content increases risk of pancreatitis
- methoxyflurane
- midazolam with fentanyl
- enflurane
- halothane
- propofol
- NO
- Thiopental
- Fentanyl
- Propofol
-
What makes up SAM?
ATP + methionine
-
What 2 substrates inhibit Glucokinase? Promote
What 2 substrates inhibit pyruvate kinase? Promote
WHat 2 substrates inhibit Pyruvate dehydrogenase?
- ATP/citrate- F-2,6 Bisphophate
- ATP/alanine- F 1,6 Bisphosphate
- ATP/NADH/Acetyl coA
-
What are the 4 ways of getting biliary stones?
- too much cholesterol--estrogen
- FIbrates via 7 alpha hydroxylase
- Bile acid binding resins
- too much bilirubin--hemolysis
- infection with bacteria producing beta glucuronidase which breaks down conjugated bilirubin to unconjugated
-
In relation to ovarian and internal illiac vessels, where are the ureters?
- Medial to the ovarian
- Lateral to the internal illiac
-
Chronic alcoholics have a deficiency of what vitamin?
Folate
-
Ornithine transcarbamoylase is inherited how?
x-linked
-
Precursor to 6-MP?
May prevent nephrotoxicity with mannitol diuresis
Antibody that binds to CD3 on T cells
Antibody that binds IL-2 on activated T cells
Inhibits Inosine Monophosphate dehydrogenase
Inhibits calcineurin --loss of IL-2
binds Fk protein --no IL-2
Binds FKBP-12---inhibition of mTOR
used for Lupus nephritis
metabolized by xanthine oxidase and allopurinol increases its toxicity
- Azathioprine
- Cyclosporine
- Muronomab
- dacluzimab
- mycophenolate
- cyclosporine
- tacrolimus
- sarolimus
- mycophenolate
- 6MP and Azathioprine
-
Most common complication of cholelithasis?
cholecystitis
-
Cholecystitis in the setting of cholelithiasis is caused by what?
outflow obstruction caused by the stones
-
Which of the hereditary hyperbilirubinemias are fatal in the 1st few years?
Crigler Naijar Type I--due to gluconoryl transferase
-
Which hereditary Hyperbilirubinemia causes a black liver?
What is the defect there?
- Dubin-Johnson
- no transporter molecule for bilirubin
-
Alpha toxin of C. Perfringens is a what type of an enzyme?
lecithinase
-
What ratio is increased in COPD?
RV/TLC
-
What is the side effect of chronic topical corticosteroid use?
atrophy of connective tissue and muscle
-
2 Short acting insulins for Post-prandial Hyperglycemia?
-
What are the changes seen in ischemia to the brain parenchyma at
1 day?
2 days?
5 days?
10 days?
2 weeks?
- 1st day--red neurons
- 2 days-- neutrophils
- 5 days--macrophages
- 10 days--granulation tissue and neovascularization
- 12 weeks--collagen-glial scar--gliosis with astrocytes
-
Parts of the brain most susceptible to ischemia?
- hippocampus
- neocortex
- cerebellum
-
Short acting insulin?
Long acting insulin?
-
Reversible cell injury manifests itself how in the following organelles?
Plasma membrane
ER
mitochondria
Nucleus
- PM--blebbing, loss of microvilli, blunting
- ER--dilation, detachment of polysomes, myelin figures present
- Mitochondria--swelling, not vacuolization
- Nucleus--disaggregation of elemetns
-
WHat g Proteins sitmulate acid secretion in the stomach?
-
Sucralfate requires what kind of environment to work?
acidic to polymerize
-
Biopsy of pt with esophagitis shows large pink intranuclear inclusions with host cell chromatin pushed to the edge of the nucleus?
HSV
-
Stomach biopsy shows neutrophils above the basement memebrane, loss of surface epithelium an fibrin containing purulent exudate?
gastritis
-
Biopsy of parotid gland shows double layer of columnar epithelial cells resting on a dense lymphoid stroma?
warthin tumor
-
Small intestine biopsy shows small lymphocytes with irregular nuclear contours and proliferation of them into the mucosa and epithelial glands?
MALTOMA
-
Basal cell hyperplasia, eosinophilia and elongation of lamina propria see in the esophagus?
Chronic GERd
-
Goblet cells in the distal esophagus
Barret
-
Stomach biopsy shows lymphoid aggreagates in the lamina propria, columnar absorptive cells and atrophy of glandular structures?
chronic gastritis
-
Biopsy of esophagus shows enlarged cells and intranuclear cell inclusions?
CMV
-
Diffuse thickenin of gastric folds, high gastrin levels, biopsy shows glandular hyperplasia without foveolar hyperplasia?
Z/E
-
Protrusion of mucosa in the upper esophagus?
esophageal web
-
biopsy of parotid gland shows both epithelial and mesenchymal differentiation?
pleiomorphic
-
Biopsy of a parotid gland shows carcinoma composed mostly of mucus secreting cells and also some squamous cells and intermediate hybrids of both?
mucoepidermoid
-
pas stain showing hyphenated organisms in the esophagus wall?
candida albicans
-
Downs syndrome increases risk for what GI pathologies?
- Annular pancreas
- duodenal atresia
- hirshsprungs
- celiac disease
-
Drugs which lower seizure threshold?
- Bupropion
- cIlastatin
- Tramadol
- Enflurane
-
What vitamin is alpha- tocopherol?
vitamin E
-
What vitamin decreases symptoms of Hypercholesterolemia Type IIb?
niacin--decreases VLDL and so there is less LDL
-
-
When a factor alters the study outcome but is itself not a bias it is called?
Effect Modification
-
Insulin secretion is under the control of what adrenergic receptor?
Inhibited by what?
-
Which enterococci can grow in 6.5% NaCl and bile and which ones can only grow in NaCl?
- enterococci facieum can grow in both
- s. bovis can only grow in NaCl
-
Infection with which hepatitis virus produces a serum-sickness like reaction?
Hepatitis B
-
the Myc's code for what?
transcription factor
-
the ret, abl and erb code for what?
tyrosine kinase
-
c-kit codes for what?
cytokine receptor
-
Chronic rejection differs how in the lung from the kidney?
- lung---fibrosis of the airways--small called bronchiole obliterans
- kidney--fibrosis and occlusion of the vasculature
-
Whats responsible for the following proteinurias?
Tubular
overload
functional
selective
orthostatic
Isolated
- tubular--tubulointerstitial nephritis
- overload--MM
- functional-change in blood flow due to physical stress
- selective--Minimal change disease
-
What HIV drug can cause seizure bc it chelates calcium and increases magnesium secretion?
Foscarnet
-
Hypertension causes what kind of pathology in the brain?
interparenchymal hemorrhages
-
Difference in the presentation of an ischemic stroke vs a hemorrhagic stroke?
- ischemic stroke takes several hours to present
- hemorrhagic stroke is instantaneous
-
WHat malignant hypertension drug decreases TPR and increases blood flow to kidney?
Fenoldopam
-
How do you measure variability, heterogeneity?
using Standard deviation
-
WHat causes Mitral valve prolapse?
myxomatous degeneration--glycosaminoglycans
-
What drugs increase the serum levels of Lithium?
- Thiazides
- NSAIDS
- ACE Inhibitors
-
Kallman syndrome presents how?
- anosomia
- lack of secondary sexual characteristics due to low GnRH
-
Heteroplasmy presents with what kind of inherited disorders?
- mitochondrial inherited disorder--Leiber Optic neuropathy
- Mitochondrial disorder with rugged red muscle fibers
-
What causes coronary sinus dilation?
right atrial enlargement due to high pressures
-
SIde effect of acyclovir, gancyclovir and fosarnet?
nephrotocixity
-
acute intermittent porphyria is caused by what enzyme deficiency?
porphobilinogen deaminase
-
Porphyria cutanea tarda is caused by what enzyme deficiency?
uroporphobilinogen decarboxylase
-
Proteins secondary structure i.e alpha helices or beta pleated sheet is formed by what bonds?
hydrogen bonds
-
What virulence factor of e.coli promotes meningitis?
diarrha/uti?
- meningitis--- K1 capsular
- UTI--pili/fimbraie
-
What is a verotoxin?
Shiga-like toxin
-
Most common cause of death in a person with DM?
coronary artery disease
-
WHich of the pneumoconiosis affects only the lowe lobes of the lungs?
Asbestosis
-
What is the oxygen content?
hemoglobin + saturation of it + p02 of it
-
What is the most common child brain tumor?
Pilocystic astrocytoma
-
what is the 2nd most common brain tumor?
Medulloblastoma
-
Which brain vessels rupture in a hypertensive stroke/.
lenticulae striae arteries supplying basal ganglia and internal capsule
-
What are 2 causes of cholecystitis?
- cholelithiasis
- hypotension
-
What lesions have hyperkeratosis and parakeratosis?
actinic keratosis
-
Anions and cations of drugs are secreted where in the kidney?
anions are secreted using what?
cations?
- proximal tubule
- anions--alpha keto-glutarate
- cations
-
What 2 opiods produce withdrawal?
-
What is hibernating myocardium?
myocardium that is not active due to ischemia but is reversible if blood flow is restored
-
Among Verapamil, Diltiazem and nifedipine which one has the most effect on the heart?
heart--verapamil>diltiazem>nifedipine
-
Side effect of DIgoxin?
Cholinergic-----nausea, voming, diarrhea, blurry vision, bradycardia
-
Drug for herpes infection that does not require viral phosphorylation?
cidofovir
-
WHat is the triad of Wernicke's encephalopathy?
Korsakoff?
- ataxia
- anterograde amnesia
- opthalmoplegia
- nystagmus
- KORSAKOFF---
- retro and antero amnesia
- confabulation
- apathy
-
Appearance of an abundant amoutn of seborheic keratosis is indicative of what?
GI lymphoma
-
Based on the location, how are Glioblastoma Multiforme, Meningioma and shwannoma different?
- Glioblastoma Multiforme--in the cerebral hemisphere-necrosis and hemorrhage
- Meningioma--surface of brain, continuous with dura
- Shwannoma--cerebello-pontine angle
-
Adhesion molecules bind what?
Fibronectin
-
Where is epo made?
endothelial cells of peri-tubular capillaries
-
How does Addisons disease produce eosinophilia?
cortisol normally suppresses eosinophils but in absence of cortisol you get eosinophilia
-
What hormones produce neutrophilia?
- corticosteroids
- epinephrine
-
What protein kills parasites?
Major basic protein
-
Role of eosinophils in Hypersensitivity type I?
down regulat the reaction via histaminase and arylsulfatase which breaks down leukotrienes
-
What is the purpose of fever?
fever is high temp--which shift the oxygen dissociation curve to right..giving up oxygen which is used for the respiratory burst
-
What protein is important in granulation tissue?
Fibronectin
-
Decreased hydroxylation does what to collagen?
weak triple helix bc you can't cross bridge
-
3 Miochondrial diseases?
- MELAS---encephalopathy with lactic acidosis and stroke
- Myoclonic epilepsy with ragged red fiber
- Lebiers hereditary neuropathy
-
What is most outcome of Hep C infection?
Hep B?
- Stable chronic hepatitis
- complete resolution
-
During embryological development there is 3 sets of veins, umbilical, vitelline, and cardinal..what becomes of them?
- umbilical--degenerate
- vitelline--portal veins
- cardinal--all systemic veins
-
Hemorrhagic stroke in the basal ganglia is due to what?
Hemorrhagic stroke in the lobar hemispheres is due to what?
-
The following conditions result in what encephalopathy?
Carotid atherosclerosis/cardiac embolism
Hypoxic encephalopathy
HTN encephalopathy
Cereberal amyloid angiopathy
AVM
Saccular aneurysm
Charcot Bouchard Aneurysm
- ischemic stroke
- watershed areas
- basal ganglia
- lobar hemorrhagic strokes
- avm--arachnoid hemorrhage
- savvular aneurysm--hemorrhagic stroke
- charcot bouchard aneurysms--basal ganglia, thalamus, internal capsule
-
Erosion vs ulcer?
- erosion doesn't involve the muscularis mucosa
- ulcer involves the muscularis mucosa and submucosa
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