Kaplan mock

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Kaplan mock
2012-11-02 21:32:36

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  1. AIDS-associated non-Hodgkin's lymphoma occurs most commonly in what male organ
  2. Nerve that passes around the medial malleolus
    • Saphenous (anterior tibial n)
    • Sensory to the sole of the foot
    • Motor to plantar flexion of toes and inversion
  3. Infusion of saline into a patient will increase what values
    Preload and SV - hence, CO increases (due to contractility of the heart increases)
  4. Which cells are large, ovoid cells with eccentric nuclei and have chromatin at their periphery
    Plasma cells
  5. What occurs in the space of Disse?
    Passing of bilirubin from sinusoid to the hepatocyte 
  6. Autism is what kind of developmental disorder
  7. Most common cause of post-coital bleeding
    • Invasive cervical squamous cell carcinoma
    • (not caused by dysplasia or high-grade invasive lesion)
  8. Histology of acute hepatitis
    Inflammatory cells, Councilman bodies, swollen hepatocytes, bile plugs in canaliculi
  9. Histology of chronic active hepatitis
    Inflammatory cells and piecemeal necrosis
  10. Findings of HUS in terms of hemolytic anemia
    • Reticulocyte count increases
    • Can get glomerular fibrosis/collapse
  11. Asparate is what kind of AA
    Acidic (-) charge will migrate to the positive pole

    n.b. histine and arginine are (+) and migrate to the negative pole
  12. Elevated uracil and glutamine levels, defect in what cycle?
    • Urea cycle
    • Ornithine transcarbomylase deficiency (as uracil made from carbomyl phosphate, hence, not a CP-I def.)
    • Increased orotic acid as it will go down the pyrimidine cycle
  13. Parkinson's patient develops a purple coloured rash on his leg. What drug causes this?
    • Amantidine 
    • (livedo reticularis)
  14. Blastomycoses = source of exposure
    Rotten wood
  15. What happens to viral load of HIV 6 months after being diagnosed without treatment?
    Stabilizes and slowly increases over many years
  16. Anthracycline Abx for metastatic breast cancer
  17. Where does pepsin cleave an Ab?
    • Disulfide bonds yielding a divalent Fab portion that can still bind an Ag
    • Fc portion of Ab crystallizes
  18. What happens to velocity and cross-sectional area as you move from the trachea to the alveoli
    Velocity decreases as cross-sectional area increases
  19. NSAID most likely to cause renal tubular acidosis
    Indomethacin (most potent)
  20. Husband is dx with Alzheimers and wife cannot handle him at home anymore. What to do?
    • Discuss in-home care options
    • (don't want to move patient to a facility as rapid decline in function would be seen and also want to help wife out)
  21. Patient dies of metastatic breast cancer, autopsy reveals small vegetations along the mitral valve
    • Marantaric endocarditis
    • (non-bacterial, thrombotic)
  22. Fertilization brings the egg to what stage completion
    • completion of meiosis 2 
    • (when the egg is released into the tube, its at metaphase 2)
  23. Antibody against B-hCG given to preggos a week after fertilization. Consequence of the fetus?
    • hCG needed in the first 3 months for continual secretion of estrogen and progesterone from the corpus luteum
    • Ab will descrease these hormones: progesterone cannot maintain endometrium, and fetus will abort
  24. Quinine is no longer used as an anti-malarial because it can produce hemolytic anemia by what role?
    Acting as a hapten binding to RBCs (carrier) and creating an immunological effect
  25. Femoral n. supplies what part of the thigh?
    • Anterior level
    • L2-L4
    • Extends the knee
  26. AR disease characterized by muscle aches and weakness after severe exercise, rhabdomyolysis, myoglobinuria, and red urine. 
    Dx and tx
    Carnitine acyltransferase deficiency (required for FA transport into mitochondria for B-oxidation)

    Cease activity and give glucose
  27. Equation for heritability index for twins
  28. Primaquine is affective against what kind of bug?
    • Dormant forms of P.vivax and P.ovale in the liver
    • (hypnozoites)
  29. Most common embryological cause of an ASD
    • Inadequate development of septum secundem
    • Excessive reabsorption of s.s. 
  30. Anemia complication of Paget's
    Myelophtisitic anemia (replacement of BM by fibrosis, tumors, or granulomas)
  31. Treatment for shock that presents with low BP, increased HR and RR
    • septic shock
    • tx: dopamine
  32. p450 inhibitors
    • ketoconazole
    • isoniazid
    • cimetidine
  33. Dx test for sore throat vs rhematic fever
    • Strep pyogenes
    • bacitracin sensitivity vs. ASO Ab titers
  34. When CO decreases, what happens to MAP and TPR?
    MAP decreases, TPR increases
  35. Neurotransmitter changes in REM sleep
    • Ach increases and NE decreases
    • (serotonin increases as you go to sleep, and decreases as you wake up - dopamine does the opposite)
  36. What factors can be independent risk factors for DVT
    Hyperhomocystinuria (folate and B12)
  37. Relative chance calculation associated with a case control study
    • Odds ratio
    • (a/b divided by c/d)
  38. Is the spouse's permission needed when a patient seeks sterilization or abortion
  39. Hallucination is schizophrenia (most commonly)
  40. Mutation in the glucokinase gene
    Defective insulin release from pancreas with elevated BG
  41. damage to urethra in the bulb of the penis would cause an accumulation of urine in what location
    superficial perineal space --> gains access to scrotal sacs --> then can rise under the scarpa's fascia of the skin of lower abdomen
  42. Mechanism of delayed type IV H.S. in TB
    • requires presentation of foreign molecules with MHC class II antigens
    • invariant chain blocks the groove for the foreign molecule, eventually digested leaving behind a CLIP molecule. CLIP is replaced only with a exogenous Ag.
  43. Cough, sore throat, and nasal decongestion during the winter time. Virus?
    Influenza A
  44. SCID (deficiency of B cells, T cells, and fungal cells). 
    Deficient enzyme and product?
    • Adenosine deaminase
    • product: inosine (from adenosine)
  45. Tx for performance anxiety (happens occassionally)
    • B1 selective blockers 
    • (not buspirone for GAD: also takes 2-4 weeks to work)
  46. which disease will produce a mutant allele the same size as the normal allele on a PCR
    sickle cell anemia

    CF has a three base pair deletion, so would be shorter; Huntington would be a longer band.
  47. Function of a toxoid molecule that's part of a vaccine such as H. influenza type B capsule polysaccharide
    • Carrier molecule and causes immunogenicity
    • hapten (=carbohydrate capsule of the organism) that elicits an immune response and can have Abs made against it
  48. Muscles involved in abduction of shoulder
    • Initiation: supraspinatus
    • Upto 90 degrees: deltoid
    • 90-180 degrees: serratus anterior and thoracodorsal (?)
  49. Dx of Lyme dz
    • ELISA followed by Western blot
    • (difficulty in culturing organism)
  50. Rheumatic heart fever patient presenting with pulmonary rales, pulmonary edema, pitting edema, b/l ankle edema, JVP
    Mitral stenosis (much further progressed to cause left side of the heart to fail)
  51. SLE presentation on histology (only has mild hematuria or proteinuria)
    Mesangial expansion of the matrix with no proliferation of mesangial cells
  52. Histology of RPGN
    • crescent formation
    • proliferation of cells within the urinary space (fibrin and macrophages due to parietal cell proliferation and glomerular damage)
  53. Changes in exercise with conductance, SNS system, and muscle oxygen tension
    • Muscle oxygen tension decreases (as muscles being used a lot)
    • blood flow increases to allow for more oxygen diffusion and increased vascular conductance in the muscle
    • (conductance is inverse to resistance)
    • SNS increases throughout body (vasoconstriction of arterioles elsewhere)
  54. without intervention, transplacental infection risk of HIV
    with drugs and reduced # of HIV RNA, transplacental infection risk
    • 25%
    • <2%
  55. calculating joint probabilities of 2 mutually exclusive events (e.g. type B and type AB)
    Add the two probabilities
  56. how does BG increase in pregnant women during later stages of pregnancy
    • placenta secretes a GH like molecule (hPL) which antagonizes action of insulin, yet increases its secretion
    • normal preggo: BG levels are normal because of increased insulin
    • gestational DM: additional insulin fails to maintain BG 
  57. Estrogen and progesterone levels in a preggo
    • levels secreted by the placenta are high, so suppress LH and FSH
    • hence, ovarian levels are low
  58. infective form of hookworm disease
    filiaform larvae
  59. infective form of trematodes such as schistosoma
  60. infective form of intestinal protozoa (entamoeba and giardia)
  61. Tx of acute pyelonephritis
    • Fluroquinolones
    • (TMP-SMX treat UTIs)
  62. blood supply to the head, body and tail of the pancreas
    • Head: from the inferior pancreaticoduodenal a. of the SMA
    • body and tail: splenic artery from the celiac trunk
  63. Mutation on the CCR5 gene on macrophages, affect on HIV prognosis
    protection against HIV as CCR5 (chemokine receptor) is needed for viral entry (along with CXCR4 on T cells)
  64. Anergy in the T-cell populations leads to?
    • dysfunctional T cells
    • (anergy does not prevent infection with HIV, but can increase its progression of dz)
  65. Generalized vs. specialized tranduction in terms of progeny
    generalized: bacterial parts cleaved and MAY incorporate with phage particles. when phage infects another bacterium, new progeny MAY show.

    specialized: phage infects bacterium as incorportated into its chromosome. when infected another bacterium, all new progeny can show.
  66. C.diptheria requires what molecule to become pathogenic?
    • tox gene encodes the exotoxin, and present in the genome of temperate phage
    • without temperate phage, diptheriod just acts like normal flora
  67. plasmids that enter the bacterial chromosome, via recombination
  68. AA unique to collagen
  69. patient presents with alexia without agraphia (cannot read but can still write) and can comprehend language. Damage to what area
    • occipital cortex and splenium of corpus callosum (PCA)
    • visual input to the language area is affected, but not the language area itself
    • cardiac tamponade (blood encases the heart)
    • can occur due to trauma or from pericarditis
    • cardiac contusion
    • muscle tear
    • occurs with trauma
  70. Tinea capitis
    • Microsporum canis (zoonotic form of ringworm)
    • transmitted directly from a dog or cat
    • dx: wood's lamp fluorescence
  71. organism to cause infection of skin and nails
  72. Adenoviruses characteristics
    • dsDNA
    • linear
    • naked
  73. typical antipsychotics inhibit what other receptors to produce additional side effects
    • anti-Ach: dry mouth, constipation
    • a-blockers: postural hypotension
    • histamine blockers: sedation
  74. tranylcypromine vs. desipramine
    MAO-inhibitor vs. TCA anti-depressant
  75. Few hypoesthetic plaques with surface numbness. what type of leprosy and cell types?
    • tuberculoid leprosy
    • Th1 (high cell-mediated immunity)
  76. pressures in the LA, LV, RA, RV, pulmonary artery
    • LA: <12
    • LV: 120/80 (like aorta)
    • RA: <5
    • RV: 25/0
    • pulmonary a: 25/10
  77. Person has a pacemaker inserted to determine his HR. His HR is doubled in a normal, sitting position - what happens to CO and SV?
    • CO won't increase unless venous return increases; hence, increases SV.
    • Sooooo.... SV decreases by half to maintain CO at normal levels.
  78. Ischemic myocardium uses what mechanism for E?
    Anaerobic glycolysis
  79. cremasteric reflex involves what spinal cord levels
    • L1-L2
    • genitofemoral nerve
  80. the notion of recognizing an experience while separating it from self (e.g. sleepwalking)
    defense mechanism?
  81. lab values for hereditary angioedema
    • deficiency of C1 esterase inhibitor
    • decreased levels of C4, C1 and C2
    • (early components of the classical pathway (i.e. C1 and C2) are used up more rapidly)
  82. what immunological effector mechanism is associated with hyperacute and acute graft rejection?
    • type II HS
    • Ab and complement
  83. Immunologic effector mechanism for graft vs. host disease
    sensitization of donor CD8+ T cells against recipient (host) cells
  84. Pathogenic feature of Giardia
    • ventral sucking disc
    • adheres to the mucosa of the small intestine

    n.b. giardia does cause cysts as it passes down the SI but not a pathogenic feature
  85. Low activity enzymes due to vitamin C deficiency
    proline and lysyl hydroxylase
  86. Albumin is a marker for what blood volume component, and its equation?
    plasma volume

    RBF = RPF/(1-Hct)
  87. Burkitt's lymphoma is what type of lymphoma?
    • small non-cleaved cell lymphoma
    • 8;14 translocation
  88. Interferons (a and B) inhibit viral growth via what mechanism
    Inhibit viral protein synthesis

    n.b. class II interferons (gamma) made by Th2 cells - stimulates macrophages, but no role in viral growth
  89. hallucinations associated with schizo
  90. BM aspirate reveals glycolipid-laden macrophages. Dx?
    • Gaucher's disease
    • enzyme: glucocerebrosidase
  91. A baby is found with myelomeningocele. Associated defect?
    Dandy-Walker (absent cerebellar vermis and enlarged posterior fossa)
  92. what does the pol gene of HIV code for?
    • RT (making DNA from RNA)
    • protease (cleaves viral protein to its specific length)
    • integrase (inserts into the host cell)