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2015-02-01 23:43:19

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  1. What is atelectasis? What causes it?
    • Alveolar collapse due to deficiency in type II pneumocytes.
    • Decreased in pulmonary surfactant -> Decreased surface tension -> alveolar collapse
    • Seen in neonatal respiratory distress syndrome
  2. Destruction of type II pneumocytes can result in?
    • Atelectasis- alveolar collapse due to decreased surface tension
    • Seen in neonatal respiratory distress syndrome
  3. Meckel diverticulum is composed of which intestinal wall layers?
    • 1. Mucosa
    • 2. Submucosa
    • 3. Muscularis
    • May contain ectopic acid- secreting gastric mucosa and/or pancreatic tissue.
    • Ectopic acid can cause ulceration of adjacent mucosa and lower GI bleeding.
  4. Zenker diverticulum is composed of which intestinal wall layers?
    • 1. Mucosa
    • 2. Submucosa
  5. This pathology is decribed as persistence of the omphalomesenteric duct.
    • Meckel's diverticulum
    • a.k.a vitelline duct
  6. Immunodeficiency disorder characterized by a defect in lysosomal trafficking regulator gene (LYST)
    Chédiak-Higashi syndrome
  7. Immunodeficiency characterized by defect in phagosome-lysosome fusion.
    Chédiak-Higashi syndrome
  8. Immunodeficiency disorder characterized by defect in phagosome-lysosome fusion.
    Chédiak-Higashi syndrome
  9. Giant granules in neutrophils and platelets are characteristic of which immunodeficiency disorder.
    Chédiak-Higashi syndrome
  10. Describe the presentation of Chédiak-Higashi syndrome.
    • Recurrent pyogenic infections by staphylococci and streptococci- skin, respiratory
    • Albinism- light skin, silvery hair
    • Peripheral neuropathy
    • Progressive neurodegeneration- nystagmus
  11. What is heteroplasmy?
    • Mitochonrdrially inherited diseases which may be expressed differently.
    • Presence of both normal and inherited mtDNA.

  12. What is mitochondrial myopathy? What genetic term is associated with it?
    • Mitochondrial myopathies
    • Present with myopathy, lactic acidosis and CNS disease.
    • Secondary to failure in oxidative phosphorylation.
    • Muscle biopsy often shows “ragged red fibers.”
    • HETEROPLASMY-  Variable expression in mitochondrially inherited disease.
  13. Label the image below.
    • 1 = Abdominal Aorta
    • 2 = Duodenum
    • 3 = Gallbladder
    • 4 = Head of Pancreas
    • 5 = Inferior Vena Cava
    • 6 = Left Kidney
    • 7 = Left Renal Vein
    • 8 = Liver
    • 9 = Psoas Muscle
    • 10 = Right Kidney
    • 11 = Stomach
    • 12 = Superior Mesenteric Artery
    • 13 = Tail of Pancreas
    • 14 = Transverse Colon
  14. What does the arrow point to?
    Erector spinae muscle
  15. This organism is transmitted by ingestion of eggs from dog faeces.
    • Echinococcus granulosus- cestodes (tapeworms)
    • Hydatid cysts in liver- causing anaphylaxis if antigens released.
  16. What is a case-control study? What does it measure?
    • Compares the exposure of people to the disease (cases) to the exposure of people without the disease (control).
    • Measured by ODDS RATIO:  Odds that the group with the disease was exposed to risk factor/ ordds that group without the disease were exposed.
  17. What is odds ratio?
  18. What is relative risk?
  19. Describe the menstrual cycle.
    • 1. FSH stimulates follicle to form in ovary.
    • 2. FSH stimulates estrogen production from ovaries.
    • 3. Increased estrogen stimulates LH.
    • 4. LH causes ovulation.
    • 5. Progesterone production increase with formation of corpus luteum.
    • 6. Progesterone maintains endometrium to allow for implantation.
  20. What is the effect of Handgrip on heart murmurs?
    • Handgrip increases afterload
    • So it increases the intensity of backflowing murmurs: MR, AR, VSD
    • It decreases the intensity of hypertrophic cardiomyopathy murmur (any maneuver that increases preload/afterload decreases this type of murmur because increased LV by these parameters reduce the LV outflow tract obstruction)
  21. Which of the following is the complement binding site for the immunoglobulin showed below?
    • D- complement binding (located on Fc portion, closer to hinge region)
    • A&B- hypervariable regions of Fab (antigen binding fragment)
    • E- macrophage binding
  22. What is the MOA and use of Donepezil?
    • AChE inhibitor
    • Alzheimers disease
  23. What is the MOA and use of Memantine?
    • NMDA receptor antagonist; helps prevent excitiotoxicity (mediated by Ca2+)
    • Alzheimer's disease
  24. How do we treat manic episodes?
    • Mood stabilizing agents: 
    • Lithium
    • Valporate
    • Carbamazepine
    • + Atypical antipsychoitc
  25. What is the MOA and use of Brupropion?
    • Increase NE and dopamine
    • Depression and Smoking addiction
  26. Describe the presentation of rubella.
    • Maculopapular rash that resolves in 3-5 days.
    • Spreads from head -> Trunk -> extremities.
    • Occipital/ postauricular lymphadenopathy.
  27. Describe the presentation of scarlet fever.
    • Fever
    • Sore throat
    • Diffuse erythematous rash with numerous small papules "sandpaper-like"
    • S.pyogenes (group
    • A)
  28. Which virus causes Roseola?
    HSV-6/ HSV-7
  29. Describe the clinical presentation of Roseola.
    High fever that lasts for 3-5 days, which resolves following the appearance of a maculopapular rash/ diffuse macular rash that starts on the trunk and spreads peripherally.
  30. What is this pathology?
  31. What is this pathology?
  32. What is this pathology?
    Erythema infectiosum (fifth disease)
  33. What is this pathology?
    • Scarlet fever
    • S.pyogenes
  34. Where does neonatal intraventricular hemorrage usually occur?
    • Bleeding (in ventricle) usually originates from the germinal matrix whcih is  highly vascularized and where neurons and glial cells migrate out during brain development.
  35. This pathology can result from the rupture of cortical bridging veins.
    • Subdural hematoma
  36. What causes a subdural hematoma?
    Rupture of bridging veins.
  37. What is ectopy? Which disease demonstrates this?
    • Normal tissues/ cells found in an abnormal loaction due to embryonic maldevelopment.
    • Meckel diverticulum-  ectopic acid secreting gastric mucosa and/ or pancreatic tissue
  38. What is hypoplasia?
    • Decrease in number of cells resulting in decreased volume/ size of organ.
    • e.g. Renal hypoplasia.
  39. What is hyperplasia?
    Increase in number of cells.
  40. What is hypertrophy?
    Increase in size of cells.
  41. What is metaplasia?
    Replacement of one cell type by another.
  42. What is dysplasia?
    • Abnormal growth with loss of cellular orientation, shape and size in comparison to normal tissue maturation. 
    • Commonly preneoplastic.
  43. What is the function of Golgi tendon organs? What innervates them?
    • Innervated by group 1b sensory axons.
    • Maintains MUSCLE TENSION- When a muscle exerts too much force, the golgi tendon organs inhibit contraction of the muscle, causing sudden muscle relaxation.
  44. What are A-delta fibers?
    • Fast, myelinated fibers whose free nerve endings detect temperature and nociceptive (pain) stimuli.
    • Associated with acute (sharp) pain that mediates reflex withdrawal from a noxiois stimuli (e.g retracting hand away from hot stove)
  45. Which sensory receptors are responsible for one retracing their hand away from hot stove?
    Free nerve endings- A-delta
  46. What is the function of muscle spindles? What innervates them?
    • Innervated by group Ia and group II sensory axons.
    • Sensitive to changes in muscle length (resists muscle stretch)
  47. How do opoids (eg morphine) block pain transmission?
    • Open K+ channels: INCREASING K+ EFFLUX
    • Close Ca2+ channels: DECREASE Ca2+ INFLUX
  48. What is confounding bias?
    Part of the exposure-disease relationship can be explained by another variable.
  49. What are the stop codons? What is their function?
    • UGA
    • UAA
    • UAG
    • They DO NOT code for amino acids.
    • Releasing factors stimulate release of the formed polypeptide chain from the ribosome and dissociated from the ribosome-mRNA complex
  50. What are the functions of small nuclear ribonucleoproteins?
    Splicing- removes introns from pre-mRNA/ hnRNA
  51. What is the function of releasing factors?
    Recognize stop codons (UGA, UAA, UAG) to terminate protein synthesis.
  52. What are the functions of Elongation factors?
    Facilitates tRNA binding and translocation.
  53. Which viridans group streptococci cause subacute bacterial endocarditis and how does it do so?
    S.sanguinis makes dextrans, which bind to fibrin-platelet aggregates on damaged heart valves.
  54. What is the pathology shown below? Causative agent?
    • Hydatid cyst in liver (can cause anaphylaxis if antigens released).
    • Echinococcus granulosus- ingestion of eggs from dog faeces. Sheep are intermediate host.
    • Tx: Abendazole
  55. What risk is associated with a hydatid cyst in liver?
    • Anaphylaxis if antigens released.
    • Hydatid cyst injected with ethanol or hypertonic saline to kill daughter cysts before removal.
  56. What is the function of major basic protein?
    Released by eosinophils to kill helminths. Also contribute to bronchial epithelial damage in atopic asthma.
  57. What so basophils contain in their granules?
    • Heparin (anticoagulant)
    • Histamine (vasodilator)
    • Leukotreines
  58. What type of cells are found in the bronchi?
    • 1. Pseudostratified columnar ciliated epithelium
    • 2. Goblet cells
    • 3. Submucosal mucoserous glands
    • 4. Cartilage
  59. Where is cartilage found in the respiratory airway?
    • Trachea + Bronchi
    • Goblet cells and cartilage extend to end of bronchi
  60. Where are goblet cells found in the respiratory airway?
    • Trachea + Bronchi
    • Goblet cells and cartilage extend to the end of bronchi
  61. What type of cells are found in the bronchioles?
    • 1. Pseudostratified ciliated columnar epithelium
    • 2. Smooth muscle
  62. What type of cells are found in the terminal/ respiratory bronchioles?
    • 1. Ciliated simple cuboidal cells
    • 2. Smooth muscle
  63. Where is pseudostratified ciliated columnar cells found in the respiratory airway?
    • Trachea + Bronchi + Bronchioles
    • They extend to the beginning of the terminal bronchioles, then transition to cuboidal cells
  64. Where is smooth muscle found in the airway?
    Trachea + Bronchi + Bronchioles + Terminal bronchioles
  65. Describe the presentation of mononucleosis.
    • Fever
    • Hepatospenomegaly
    • Pharyngitis
    • Posterior cervical lymphadenopathy
    • Caused by EBV (+Monospot) and CMV
  66. What is the pathology of this?
    • Mononucleosis
    • Posterior cervical lymphadenopathy, fever, pharyngitis, hepatosplenomegaly
  67. What is seen on this peripheral blood smear?
    • Atypical lymphocytes- reactive cytotoxic T cells (CD8)
    • Mononucleosis- EBV
  68. This cell surface marker serves as a receptor for lipopolysaccharides.
    CD14- on macrophages.
  69. What is the duration of a Brief psychotic disorder?
    Less than a month
  70. What is the duration of Schizophreniform disorder?
    1-6 months
  71. What is the duration of Schizoaffective disorder?
    lasting> 2 weeks
  72. What is the duration of Schizophrenia?
    More than 6 months.
  73. What is a delusional disorder?
    Unique, false beliefs about oneself or others that persist despite the facts.
  74. What gives elastin its ability to recoil?
    • Desmosine crosslinking involving lysine.
    • The crosslinking is accomplised by the action of lysl hydroxylase.
  75. What branch of the brachial plexus is the ulnar nerve derived from?
  76. Describe the sensory innervation of the ulnar nerve.
    • Sensory innervation to the fifth digit and the medial half of the fourth digit (palmar and dorsal surfaces)
  77. Fracture of the medial epicondyle of the humerus may cause an injury to which nerve?
    Ulnar nerve
  78. A fractured hook of hamate may cause an injury to which nerve?
    Ulnar nerve
  79. What are the causes of injury to the ulnar nerve?
    • Fracutre of medial epicondyle of humerus
    • Fracure of hook of hamate
    • Gyuon's canal
  80. Hypothenar emnience is affected in which nerve injury?
    • Ulnar nerve
  81. Which nerve is affected in carpal tunnel syndrome?
    • Median nerve
    • Difficulty in fine motor control of thumb.
  82. A fractured surgical neck of the humerus may cause injury to which nerve?
    • Axillary nerve
    • Fractured surgical neck of humerus
    • Anterior dislocation of humerus

  83. Anterior dislocation of the humerus may cause injury to which nerve?
    • Axillary nerve
    • Fracture of surgical neck of humerus
    • Anterior dislocation of humerus
  84. What can cause injury to the axillary nerve?
    • Fracture of surgical neck of humerus
    • Anterior dislocation of humerus
  85. Damage to this nerve causes atrophy of the deltoid muscle.
  86. Describe the presentation due to injurt to the axillary nerve
    • 1. Flattened deltoid
    • 2. Loss of arm abduction at shoulder
    • 3. Less of sensation over deltoid muscle and upper lateral arm
  87. How does the urease breath test work? In which disease is it used?
    • The patient consumes C-labeled urea and his breath is then monitored for the presence of C-labeled carbon dioxide, which would indicate the presence of H.pylori product urease in the stomach.
  88. Why is Valporate a teratogen?
    • Inhibit maternal folate absorption
    • Neural tube defects: Spina bifida, Meningocele, Meningomyelocele
  89. Which diseases are associated with Coarctation of the aorta?
    • Turner syndrome
    • Bicuspid aortic valve
    • Aortic narrowing near insertion of ductus arteriosus
  90. Bicuspid aortic valve is associated with which heart defect?
    Coarctation of the aorta.
  91. Describe the presentation of duodenal atresia. What other disease is it associated with?
    • Bilious vomiting- usually 1st day of life
    • Proximal stomach distention (double-bubble)
    • Associated with Down Syndrome
  92. What pathology is seen below?

    • Duodenal atresia
    • Double bubble - proximal stomach dilation
  93. Failure of small bowel recanalization results in?
    Duodenal atresia
  94. What causes duodenal atresia?
    Failure of small bowel recanalization.
  95. What is the cause of death in Potters syndrome?
    Pulmonary hypoplasia
  96. What are the causes of Potters syndrome?
    • ARPKD
    • Obstructive uropathy e.g. Posterior urethral valves
    • Bilateral renal agenesis
  97. What is Ebstein anomaly and what is a predisposing factor to the disease?
    • Characterized by "atrialized right ventricle" because of a downward displacement of the tricuspid valve.
    • Associated with the use of lithium during pregnancy.
  98. In which disease(s) is rocker bottom feet seen in?
    • Edwards syndrome (trisomy 18)
    • Pataus syndrome (trisomy 13)