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what antihypertensive has dopamine antagonistic effects?
2 endocrine disorders that can produce depression?
Ret oncogne is associated with what two thyroid cancers?
Ras oncogne is associated with what thyroid cancer?
What drugs inhibit the following enzymes?
- 5FU and MTX
Which eukaryotic polymerase replicates leading strand?
replicates mitochondrial polymerase?
- beta, epsilon
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?
- alkaline phosphatase
- tartrate resistant acid phosphatase
Lymph drainage usually follows what?
What vitamin aids in recovery from measles, pneumonia or diarrhea?
What is the most common lung tumor in non smokers and women?
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?
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
- invasive ductal
- fibrocystic change
- invasive ductal
- 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?
What enzyme needs Riboflavin Vit B2?
Transmural vasculitis with fibrinoid necrosis is characteristic of what vasculitis?
PAN never involves what structure?
MOA of Bisphosphonates?
- pyrophosphate--component of hydroxyapetite
- pyrophosphate--inhibits osteoclasts
Which inhaled anesthetic has nephrotoxicity?
which IV anesthetic is proconvulsant?
What vitamin deficiency produces posterior column and spino-cerebellar demyelination?
What patients learn to squat to improve pulmonary blood flow and improve oxygenation?
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?
- aspartic acid
- glutamic acid
Arginine gives rise to what 3 important products?
What is resposible for erection, emission, ejaculation?
- 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
- 2- C
- 3-A delta
- 4- C
- 8- muscle spindle
- 9-golgi tendon
- 10 Pacinian corpuscle
- 11- ruffinin endings
- 13-free nerve endings
- 14-Merkel cells
- 16- Microglia
In the basal ganglia, what does the Direct pathway of Striatum do?
Globus pallidus Internal?
- promotes movement
- Inhibits movement
- Inhibits movement
- Inhibits movement
The following is associated with ?
presents at birth as floppy baby?
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
- HSV and CMV
- Hirano bodies
3 drugs for tonic-clonic seizures?
- valproic acid
WHat opiod induces withdrawal with a full opiod agonist?
used in endoscopy
rapid anesthesia and short procedures
decreases blood flow
does not induce histamine release like morphine
high triglyceride content increases risk of pancreatitis
- midazolam with fentanyl
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?
Ornithine transcarbamoylase is inherited how?
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
- 6MP and Azathioprine
Most common complication of cholelithasis?
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?
- no transporter molecule for bilirubin
Alpha toxin of C. Perfringens is a what type of an enzyme?
What ratio is increased in COPD?
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
- 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?
Short acting insulin?
Long acting insulin?
Reversible cell injury manifests itself how in the following organelles?
- 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?
Stomach biopsy shows neutrophils above the basement memebrane, loss of surface epithelium an fibrin containing purulent exudate?
Biopsy of parotid gland shows double layer of columnar epithelial cells resting on a dense lymphoid stroma?
Small intestine biopsy shows small lymphocytes with irregular nuclear contours and proliferation of them into the mucosa and epithelial glands?
Basal cell hyperplasia, eosinophilia and elongation of lamina propria see in the esophagus?
Goblet cells in the distal esophagus
Stomach biopsy shows lymphoid aggreagates in the lamina propria, columnar absorptive cells and atrophy of glandular structures?
Biopsy of esophagus shows enlarged cells and intranuclear cell inclusions?
Diffuse thickenin of gastric folds, high gastrin levels, biopsy shows glandular hyperplasia without foveolar hyperplasia?
Protrusion of mucosa in the upper esophagus?
biopsy of parotid gland shows both epithelial and mesenchymal differentiation?
Biopsy of a parotid gland shows carcinoma composed mostly of mucus secreting cells and also some squamous cells and intermediate hybrids of both?
pas stain showing hyphenated organisms in the esophagus wall?
Downs syndrome increases risk for what GI pathologies?
- Annular pancreas
- duodenal atresia
- celiac disease
Drugs which lower seizure threshold?
What vitamin is alpha- tocopherol?
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?
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?
the Myc's code for what?
the ret, abl and erb code for what?
c-kit codes for what?
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--tubulointerstitial nephritis
- 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?
Hypertension causes what kind of pathology in the brain?
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?
How do you measure variability, heterogeneity?
using Standard deviation
WHat causes Mitral valve prolapse?
What drugs increase the serum levels of Lithium?
- ACE Inhibitors
Kallman syndrome presents how?
- 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?
acute intermittent porphyria is caused by what enzyme deficiency?
Porphyria cutanea tarda is caused by what enzyme deficiency?
Proteins secondary structure i.e alpha helices or beta pleated sheet is formed by what bonds?
What virulence factor of e.coli promotes meningitis?
- meningitis--- K1 capsular
What is a verotoxin?
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?
What is the oxygen content?
hemoglobin + saturation of it + p02 of it
What is the most common child brain tumor?
what is the 2nd most common brain tumor?
Which brain vessels rupture in a hypertensive stroke/.
lenticulae striae arteries supplying basal ganglia and internal capsule
What are 2 causes of cholecystitis?
What lesions have hyperkeratosis and parakeratosis?
Anions and cations of drugs are secreted where in the kidney?
anions are secreted using what?
- proximal tubule
- anions--alpha keto-glutarate
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?
Side effect of DIgoxin?
Cholinergic-----nausea, voming, diarrhea, blurry vision, bradycardia
Drug for herpes infection that does not require viral phosphorylation?
WHat is the triad of Wernicke's encephalopathy?
- anterograde amnesia
- retro and antero amnesia
Appearance of an abundant amoutn of seborheic keratosis is indicative of what?
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?
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?
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?
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?
- Stable chronic hepatitis
- complete resolution
During embryological development there is 3 sets of veins, umbilical, vitelline, and cardinal..what becomes of them?
- 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
Cereberal amyloid angiopathy
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