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Pan acinar emphysema vs centriacinar affects what part of the lung, apical or base?
- pan acinar--base
What is the mode of action of morphine?
- inhibit ca influx
- open K channels
- inhibit -ACH, NE, 5HT, Glutamate, Substance P
The coronary vasospasm following a subarachnoid hemorrhage is due to what?
breakdown products of the blood clot
Chemotherapy for testicular cancer?
Etoposide drugs inhibit which topoisomerase I or II?
Irinotecan and topotecan inhibit what topoisomerase, I or II?
Rx for orotic aciduria?
Uridine which block CP II
What does the marrow look like in aplastic anemia?
hypocellular filled with fat cells and fibrotic stroma
What is the most common outcome of HBV infected individuals?
What is the stool pH in lactose challenge?
- low pH
- high osmotic stool gap
- high breath hydrogen content
What are the Large vessel vasculitis?
- Giant Cell Arteritis
- Takayasu's Arteritis
- Large vessel
Medium vessel vasculitis?
What happens to the PPV if the prevalence of the disease is high?
PPV increases and NPV decreases
Rx for Restless leg syndrome?
- Dopamine agonists----
What kind of bacteria can you get from rat bites?
What kind of bacteria can you get from puppy feces?
MOA of atomoxetine?
NE reuptake inhibitor
RX for turettes?
Lewy bodies are made up of what?
alpha- synuclein defect
High potency neuroleptics?
Low potency neuroleptics?
What receptors due typical low potency neuroleptics block?
- alpha adrenergic
4 side effects of typical high potency neuroleptics/?
- tardive dyskinesia
What receptors do atypical neuroleptics block?
Antidepressants without sexual side effects?
What is use for WPW?
What causes SVT?
AV node firing too much
When do you cardiovert a-fib?
before 24 hrs
HTN medication for aortic dissection?
Crystal findings in gout?
negatively birifringent--yellow and parallel
What 2 things can cause peptic ulcers?
- accreta-- attached to myometrium--fails to seprate upon labor
- previa--low lying placenta
- abruptio-- detachment of placenta from implantation site
WHat is the function of the following hypothalamic nuclei?
Anterior and preoptic
Anterior and preoptic
Anterior and preoptic
Posterior and lateral
- circadian rhythm
- regulates the pns
- destruction leads to hyperthermia
- regulates sns
- produces adh
- mediates oxytocin production
- receives input from retina
- savage behavior and obesity result from stimulation
- savage behavior and obesity result from destruction
- stimulates leads to eating and destruction leads to starvatio
- regulates release of gonadotropic
- mediates sweating and cutaneous vasodilation
- mediates shivering and decrease cutaneous blood flow
- destruction leads to neurogenic DI
- destruction results in inability to stay warm
- releases hormones affecting the anterior pituitary
Cingulate (Subfalcine) herniation produces what?
compression of anterior cerebral artery---leg paralysis
Uncal herniation produces what?
- CN III palsy
- posterior cerebral artery--contralateral homonomys heminopsia
- compression of crus cerebri
Hereditary causes of ataxia?
- Vit E
- Metachromatic leukodystrophy
- Lysosomal storage diseases
Two reasons for pulmonary hypertesnion?
- Primary---mutation in BMPR2 which normally inhibits proliferation
- Secondary--due to COPD, restrictive lung diseases, hypoxia, vascular injury
What is the mode of action or Thaliozidadones?
- 1-increases the number of mature adipocytes by inducing differentiation from immature adipocytes
- 2-Increases insulin sensitivity by increasing GLUT- 4
What effect do bile salts have on bacteria?
Bile salts disrupt the cell walls of bacteria
What is the most significant risk factor for Osteoporosis?
- Osteoporosis--Family History/Genetics
Increasing enzyme concentration does what to the vmax?
it decreases it
Hypoglycemia and low ketone bodies during a fast suggest a deficiency of what enzyme?
Hypoglycemia and normal level ketone bodies during a fast indicates what?
- Medium chain acyl coa dehydrogenase
- Glucose 6 Phosphatase deficiency
2 reasons for ischemic colitis?
- hypoperfusion-during a cardiogenic shock/other shock
African American women are more likely to experience what 2 conditions?
Rationale for using lactulose to treat hepatic encephalopathy in cirhosis?
lactulose acidifies the gut lumen absorbing NH3 from circulation and decreasing the encephalopathy
Pharmacodynamic vs Pharmacokinetic effect?
- Pharmacodynamic is the interaction of 2 substances at the tissue level
- Pharmacokinetic has to do with one substance altering the metabolism of another substance
What is deficient in osteomalacia/rickets?
osteoids--they are unmineralized
What are the 4 kinds of nerve fibers that arent myelinated?
- slow pain
- heat sensation
- autonomic post ganglionic
During antigen processing of MHC II what is proteotically removed?
One gene has many phenotypic effects is called?
WHen 2 genes produces the same phenotypic effects it is called?
- Genetic Heterogeneity
White pruritic patches in the vagina are what?
Pathogenesis of Lichen Sclerosus?
What are the extrinsic and intrinsic toxins that cause ATN?
- extrinsic--aminoglycosides, amphotericin b, vancomycin, cisplatin
- intrinsic-myoglobinuria, hyperuriciemia, bence-jones proteins
How are protein post translationally modified to enhance their hydrophobicity?
What effect does nitroglycerin have on Heart Rate and End-systolic blood volume?
Heart Rate increases as a compensatory mechanism and since ventricles have less time to fill, the end -systolic blood volume also increases
What is Albright's hereditary Osteodystrophy characterized by?
- Resistance to PTH, TSH, LH/FSH resulsting in
- short stature, shortened 4th and 5th digits,, hypocalcemia, high LH/FSH, TSH
Differentiate between Alleic, Genetic heterogeneity and pleitrophy?
- Genetic--different genes cause similar phenotype
- Alleic-- mutations in same gene can cause different phenotype
- Pleitropy-- One gene causes many different phenotypes
Epidermal infection with a "crust " is what?
impetigo--bullous if caused by Staph
What is the most common mode of antibiotic resistance?
Pumping the drug out of the cell
Polypeptide destined for RER is going to have what kind of signal molecule on what end? N or C end?
3 different causes of microcytic anemia?
- iron deficiency
- Lead/sideroblastic anemia
How do sertoli cells maintain very high concentrations of testosterone in the semineforous tubules and epidydymys?
sertoli cells synthesize Androgen Binding Proteins (ABP) which concentrate testosterone in the lumens or S.T and Epidydimys
Red Safranin O stains what ?
Oil Red O /Sudan Black stains what?
The round and suspensory ligaments are derived from what?
What phospholipid and mineral activates caclium?
PAF--Ca via activating Gq
Prader-Willi Syndrome is caused by what?
- microdeletion from paternal ch 15
- inheritance of both maternal chromosomes 15
Levels of what hormone are high in Pernicious Anemia?
Gastrin because the negative feedback inhibition thru HCL is lost
Which of the scrotal masses decreases when laying down?
What anti-coagulant is used with mechanical heart valves?
Mode of action of Leuprolide?
- Leuprolide--GnRH agonist
- Flutamide/cyproterone-- Androgen receptor antagonist
What cardiac anomaly is present in DiGeorge Syndrome?
Which residues are preferentially methylated?
Which is the inducible/inflammatory responsive COX enzyme? COX1 or COX 2?
Which fungus has classically fruting bodies?
Mutation in what developmental genes causes the HFG syndrome?(Hand-Foot-Gential syndrome)?
Which sinuses are most commonly affected in URI?
maxillary due to poor drainage
DOC for bleeding varicose veins?
Lump in the throat without accompanying findings is called what?
DIC is common with what leukemia?
Anterior/posterior dislocation of the knee endangers what structure?
Trauma to the lateral knee joint endangers what structure?
Common Peroneal Nerve
Infection of the uterus in the post-partum period is commonly what?
What causes it?
- mixed flora--commonly Bacteriodes
What is sublimation?
channeling unacceptable feelings into socially acceptable activities
What happens to GFR after Nephroctemy?
initially reduced to 50% but with time to 80%
What enzyme is deficient in Acute Intermittent Porphyria?
What enzyme is deficient in Porphyria Cutanea Tarda?
Hallucinations +memory loss?
Lewy Body Dementia
3 most common locations for Tophi?
- external ear
- Olecranon bursa
- Achiles Tendon
What 3 factors stimulate Gastrin release?
M1 and M3 blockers rarely used for peptic ulcer treatment?
Which antacid causes constipation?
- Diarrhea-- Magnesium
2 Most common benign salivary tumors?
- Warthin--heterotropic salivary tissue in l. node
Malignant salivary Tumor?
What vitamin deficiency presents with stomatitis, glossitis and cheliosis?
- B vitamin deficiency
- iron deficiency
What decreases secretion of VLDL bc it inhibits lipolysis in adipose tissue?
Vitamin b6 deficiency?
- peripheral neuropathy
Where are cations and anions excreted in the nephron?
What do the principal and intercalated cells do?
- principal cells reabsorb water and excrete K
- Intercalated cells excrete K and H/HCO3
What are the effects of Aldosterone on the Principal and Intercalated cells?
increases Na reabsorption and K secretion in Principal cells and increases H excretion in the intercalated
Causes of metabolic acidosis with normal anion gap?
- glue sniffing
What 5 disorders produce Membrano-Proliferative Glomerulonephritis?
- subacute bacterial endocarditis
- Mixed Cryoglobulinemia
What 3 conditions produce hypocomplemetemia with glomerular disease?
- Lupus nephritis
- Membranoproliferative Type II
Most common Leukemia in children?
Most common Leukemia in adults?
Most common lymphoma in US
DIffuse large B- cell
AML a/w Down syndrome?
Leukemia with more mature cells and less than 5% blasts?
AML that are CD 13 and CD33 +
A/w long term celiac dz?
Intestinal T-cell lymphoma
Myeloproliferative disorders may progress to what?
AML that is CD41 and CD61 +?
PAS + acute leukemia?
Leukemia with a mediastinal mass??
Leukemia presents with Bone pain?
Numerous basophils, splenomegaly and negative for Leukocyte alkaline Phosphatase?
Most common Neonatal Leukemia?
A/w Sjogrena, Hashimotos thyroditis, and H. Pylori?
Marginal Cell MALToma
Acute leukemia positive for peroxidase?
Solid sheets of lymphoblasts in marrow?
Presentation of Menier's disease?
- Sensineuronal hearing loss
Cause of Menier's disease?
increase endolymph in the inner ear
Organisms using phase/antigenic variation?
- Strep. Pneumoniae
What do the 2 toxins of C. dif do?
- Toxin A attracts neutrophils and causes inflammation
- Toxin B causes actin depolymerization and disrupts cell integrity
Hepatic uptake or secretion of Bilirubin is an active process?
- secretion is active
- uptake is passive
What is the only class III antiarrhythmic with beta blocking abilities?
What 2 growth factors mediate the formation of an atherosclerotic plaque?
Cystic myxomatous degeneration of the media of the muscular arteries is seen in what genetic condition?
CD16 on NK cells binds what?
Fc region of Ig
What is the CRAB of MM?
- Renal insufficiency
- Bone Lesions--Lytic
What 2 immunomodulator drugs are affected by the cyt p450 system?
Subacute thyroditis vs Reidel's Thyroditis?
- Subacute--due to inflammation, has granulomas
- Reidels--replacement of thyroid wtih fibrous tissue
What is the pathological description of brain in Prion disease vs SSPE?
- Prion--spongiform vacuoles coalesce into cystic spaces
What 2 enzymes are needed to synthesize Ribose-5-Phosphate from the intermediates in glycolysis?
What is the main hemodynamic consequence of an A-V shunt?
What are the effects of Dobutamine?
- increases ionotropy--contraction
- increased conduction velocity
What 3 mediators increase gastric acid secretion?
- Histamine on H2 receptors
- ACH on M3 receptors
- Gastrin from G cells on parietal cells and + ESL cells to secrete Histamine
Which vaccine is made up of a polysaccharide conjugated to a diptheria toxoid?
H. Influenza type B
Use interferon alpha?
- hepatitis B and C
- kaposi sarcoma
- malignant lymphoma
Muscarinic antagonists used in cystitis and urge incontinence?
DOC for reversing Neuromuscular blockade ?
Anti-hypertensive DOC i aortic dissection?
Drugs causing erectile dysfunction?
- Dopamine blockers
- beta blockers
- H2 blockers
- anti depressants
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