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2 causes of Pure Red cell aplasia?
What is the most common complication of Ulcerative Colitis?
How do you diagnose Toxic Megacolon?
Glucocorticoid administration has what effect on the WBC count?
all depressed except Neutrophils
Presence of beta HCG in the plasma corresponds to what?
Implantation of the blastocyst in the endometrium which occurs at about 7 days post conception
What is the most common form of Non-Hodgkin Lymphoma?
How does it present?
- Follicular B cell lymphoma
- presents as an indolent mass with remitting periods
What is the pathogenesis of an aneurysm?
intimal streak in atherosclerosis
What is the pathogenesis of a dissecting aneurysm?
Which drugs decrease seizure threshold?
- INH without pyridoxine
What are the side effects of Thiazides?
- Lipidemia--high LDL and cholesterol
What are the growth factors that increase angiogenesis?
What produces degeneration of dosal columns and corticospinal tracts?
Vitamin B12 deficiency
What are the side effects of androgen abuse?
- Male Pattern Baldness
- Hepatic adenomas
What is the naturally derived peptide that causes dilations of the venous and arterial systems and increases diuresis?
What nerve exits thrut he obturator foramen?
Formation of which kidney stones is favored by alkaline pH?
What about all other stones?
- Ammonium Magnesium Phosphate--Struvite stones
- All other stones are favored by an acidic pH
The ventral pancreatic bud gives rise to what 3 structures?
- uncinate process
- main pancreatic duct
- part of the head of pancreas
Use of Sucralfate?
- improves ulcer dealing
- Traveler's diarrhea
IL-12 has what function?
it differentiates Th cells into Th1 subset
Cromolyn and Nedocromil have what function?
inhibit Mast cell Degranulation
What is the only vitamin that is stored in the liver for several years?
1st line Rx for status Epilepticus?
1st line Rx for absence seizures?
1st line Rx for Tonic clonic or absence + tonic clonic?
What is heteroplasmy?
variable clinical expression of mitochondrial DNA producing various manifestations
Rx for serotonin syndrome?
Use of apettite suppressants such as phenfluramine and phenteramine causes what?
What is responsible for the green color of sputum associated with pneumonia?
Myeloperoxidase enzyme found in the azurophilic granules of neutrophils
With what hereditary thrombotic disorder does warfarin cause skin necrosis?
Protein C deficiency
What are the hereditary thrombotic dz's?
- Protein C
- Factor V Leiden
What is the side effect of Chlorthiazine and Thioridazine?
- Chlorthiazine--corneal deposits
- Thioridazine--Retinal deposits
What are the levels of the following in a down syndrome pregnancy?
- Beta HcG--up
- AFP -down
What is the only antiarrhythmic that prolongs the QT interval but doesn not lead to Torsaides de Pointe?
What histological changes are observed in ischemic myocardium post MI at
- 1st day--neutrophils
- 5th day--macrophages
- 10th day--granulation tissue and neovascularization
- 15th day--- collagen deposition
In what 3 ways does pregnancy predispose to DVT?
- increased estrogen--more clotting factors and less protein S
- uterus pressing on teh IVC causes stasis leading to coagulopathy
WHat allosterically activates Pyruvate carboxylase in gluconeogenesis?
Membranous glomerulopathy is caused by what?
antibodies to transmembrane proteins of podocytes
Low levels of Ca, Na or K cause altered mental status?
Low levels of Ca, Na or K cause muscle spasms?
Chagas disease can casue what?
What 2 conditions cause hemathrosis?
- Vitamin C deficiency
1st Branchial arch is innervated by what ?
2nd branchial arch is innervated by what?
3rd branchial arch is innervated by what?
4th and 6th branchial arches are innervated by what nerve?
Male pseudohermaphrodite is a genetically male XY but has female external secondary characteristics, this is due to?
Androgen insensitivity syndrome
Female pseudohermaphrodite is genetically XX but has male external secondary sexual characteristics, this is due to what?
exposure to high testosterone could be due to CAH
What 3 conditions cause phlebitis?
- Pancreatic adenocarcinoma
What 2 antifungals cause liver toxicity?
Parasite + portal hypertension with granulomatous lesions is what?
2 causes of brain calcifications?
Rx of Resistant Malaria?
- Quinine and doxycycline
- Sulfadoxine and pyrimethamine
What antifungal depositis in keratin containing tissues?
Rx for pinworm, roundworm, hookworm?
Rx for flukes and tapeworms?
Phenobarbital is a derivative of what drug?
What are the polymerases that produce rRNA, mRNA, tRNA?
- mRNA--pol II
- rRNA--pol I
- tRNA--pol III
Which class I antiarrhythmic is selective for rapidly depolarizing cells?
What transcription factor is overexpressed in Crohn's disease leading to overstimulation of cytokine producing pathway?
NF-kappa B via NOD receptor
How is an S3 heart sound best heard?
in the left lateral decubitus position and on exhalation
Very long chain Fatty acids are metabolized where?
What 2 diseases present with inability to oxidize very long chain fatty acids in the peroxisomes and thus produce mental disturbances?
Most common amino acid in collagen?
What 2 post translational modifications occur in the cytosol and outside the cytosol in the synthesis of collagen molecule by a fibroblast?
- inside the cytosol---hydroxylation and glycosylation
- outside the cytosol- cleavage of terminal residues and crosslinking by lysyl oxidase
How are viridans group able to adhere to teeth forming plaque and to prosthetic heart valves?
by producing dextrans---extracellular polysaccharides
What HBV component is produced during its replication in the hepatocyte that is disproportionately produced?
How does INH cause Vit B6 deficiency?
- INH competes with pyridoxine for enzymes resulting in non functional products
- INH increases the excretion of pyridoxine
What is the anti-depressant without sexual side effects?
Glucocorticoids increase protein synthesis only in what organ?
Liver--enzymes involved in gluconeogenesis
How do glucocorticoids produce muscle weakness?
- catabolism of protein
- hypokalemia due to mineralcorticoid activity
Increased BUN due to protein breakdown
reverse or rT3 is produced how?
What does the Huntingtin protein do in Huntingtons disease?
it hypermethylates histones effectively repressing their transcritption
Hamartoma of the lung is composed of what kind of itssue?
Measles causing SSPE is missing what protein which allows it to escape immunological clearance?
Exposure to a DNA damaging agent needs what gene to be inactivated?
tumor suppressor such as p53
What enzyme most commonly converts pro-carcinogens to carcinogens?
microsomal monooxygenase aka cyt p450
Pudendal nerve block accomplishes what?
- anesthesia to the perianal and genitals
- urethral and anal sphincter tone is down
Deficiency of what vitamin leads to increased oxidative stress in RBC and neurons?
Vitamin E prevents oxidation of what compounds?
fatty compounds--in neurons..bc of myeling so you get neuropathy in a deficiency
What is urticaria(hives)?
dermal edema due to mast cell degranulation either as Type I hypersensitivity or indiependent of antibody stimulation
In order for nucleoside reverse Transcriptase inhibitors to be active what must be done?
they must be phosphorylated by thymidine kinase like acyclovir and gancyclovir
Which HIV drugs cause pancreatitis?
Which protease inhibitor causes nephrolithiasis?
What drug is a CCR5 antagonist?
What is an integrase inhibitor?
DOC in treating SVT?
What blocks effects of adenosine?
What drugs prolong QT interval?
- Class I
- Class III
- Protease Inhibitors
what are the 6 actions of ATII?
- 1- constricts blood vessels
- 2- secretes aldosterone
- 3-constricts efferent arteriole of glomerulus
- 4-- stimulates thirst
- 5-- secretes adh
- 6--increases Na reabsorption at PCT
DOC in vascular spasm pathologies like Prinzmetal angina or Raynauds' esophageal spasm?
Hypertension predisposes to what two aorta pathologies?
ST segment elevation in the following leads tells you which of the vessels is being infarcted?
- aVL, V5--LCX
- II, III, AVF--RCA-inferior wall MI
Motor dysfunction of what pharyngeal muscle can cause a Zenker's diverticulum?
What converts heme to biliverdin giving tissue a greenish color after a hematoma?
How do patients with SCID present?
- infections with Bacteria, viruses, fungi
- Chronic diarrhea
- Failure to thrive
What is Anergy?
failure to generate a response to a common antigen
2 aldosterone antagonists?
The anterior urethra is commonly injured how?
THe posterior urethra is commonly injured how?
- by falling on something
- in a pelvic fracture
All Class I antiarrhythimic prolong QRS but what do they individually do to AP and QT?
- IA--prolongs AP and QT
- IB-- shortens AP and QT
- IC--no effect on AP and QT
What environement is Legionella associated with?
water--that is aeroselized
which fungus colonizes old cavitary lesions formed by Tb?
How long after ischemia does the myocardium stop contracting?
How long after ischemia is the muscle injury irriversible?
The most common cause of aspiration pneumonia results from aspiration of contents from what anatomical area?
Whether it is in a medical setting or not, hypglycemia is treated by administering dextrose or glucagon how?
IV not IM
MOA of ethambutol?
stop polymerization of the cell wall
MOA of pyrazinamide?
acts in acidic phagolysosome of macrophages
What vitamin may prevent neurodegeneration see in Alzheimers?
What tumors have psammoma bodies?
- papillary thyroid carcinoma
- serous adenocarcinoma of ovary
What is the pathogenesis of Scleroderma?
activated T cells stimulat fibroblasts to laydown excess collagen
Coffee Ground Vomitus usually implies what origin of the bleed?
What kind of environment worsens the symptoms of MS?
What is seen in Dermatomyositis?
- Proximal muscle weaknes as in Poliomyosistis
- Heliotrope rash
- Gottron papules on the hands
What should be the balance of cholesterol, bile acids and phosphotidylcholine in the gall bladder to minimize the formation of gall stones?
Cholesterol should be low and biles acids and phosphotidylcholine levels should be high
Radical mastectomy predisposes to what kind of malignancy?
Glucose administration without thiamine to a thiamine deficient patient will cause what?
What are the 3 causes of metabolic alkalosis?
and what are the levels of chloride in each?
- getting rid of acid--causes low serum and urine chloride
- Diuretics--cause low serum and high urine chloride
- hyper-aldosteronism--low serum and high urine chloride
HLA predisposition is present in DM type I or II?
What causes the beta islet cell destruction in DM type II?
What 2 benzos are used for Delirium Tremens?
Why is the CNS excitability during etoh withdrawal?
bc of downregulation of gaba during chronic etoh use..low gaba receptor number increased cns excitability
What synthetic hormone is used for secretory diarrhea as seen in VIPoma?
non Enveloped viruses are resistant or sensitive to organic solvents such as ether?
How doe CO cause hypoxia?
- 1--CO binds to O2 binding sites on hemoglobin
- 2--CO shifts the O2 dissociation curve to the left
What is the normal A-a gradient?
What is the normal anion gap
What increases the A-a gap'?
- diffusion defect--pulmonary fibrosis--restrictive disease/obstructive
- right to left shunt
- v/q mismatch---pneumonia, COPD, pulmonary embolus
Where is there increased LDL, cholesterol and other lipids in nephrotic syndrome?
- 1-increased synthesis of protein(including lipprotein) due to hypoalbumenemia
- 2- decreased lipoprotein lipase in plasma leads to increased circulating levels of lipoproteins with lipids which leads to lipiduria
Ehlers danlos results from faulty what?
Marfans results from what?
- fibrillar collagen
- marfans--faulty glycoprotein fibrillin which makes up elastin
Whats responsible for amenorrhea in anorexia nervosa?
Rabies are acquired most commonly from bites from what animals?
What antibiotics are safe in pregnancy?
- metronidazole after 1st trimester
What antibiotics cause tinnitus?
Gram negative rods with renal insuffiency or allergic to penicillin/cephalosporins are treated with?
p53 acts thru what protein?\
p53 induces apoptosis by activating what protein?
Yolk sac tumor is also called what?
Endodermal sinus tumor
AFP are elevated in what 2 cancers?
- Hepatocellular carcinoma
- Yolk Sac tumor--Endodermal sinus tumor
WHat cancers can secret epo?
- hepatocellular carcinoma
- Renal Cell carcinoma
Vit D3 used in psoriasis?
WHere do K+ sparing diuretics work?
Cortical Collecting duct
3 Side effects of Protease Inhibitors?
- cytp450 inhibition
- cushing like distribution
What organism is commonly implicated in infections in asthmatics?
What kind of abnormalities are turner's patients born with?
D ala-D ala has what significance?
- penicllin is a structural analog of it
- vancomycin binds to it
- both inhibit cell wall synthesis
Transmural inflammation of an arteriolar wall with fibrinoid necrosis is characteristic of what vasculitis?
Rosenthal fibers + cystic spaces and malignant cells with glial like processes are what?
What virulence factor of N. Meningitidis correlates wtih morbidity and mortality?
Osteoclasts are activated by Osteoblasts thru what 2 receptors?