NBME 15 Quizlet

NBME 15 review Study online at quizlet.com/_e5hgc 1.

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1st Brachial arch

Cartilage: Meckel's (Mandible, Malleus, Mandibular) Muscles: Muscles of mastication (Masseter, medial pterygoids, Mylohyoid) Nerves: CN V2, V3 -Chew

1st Brachial Pouch

Middle ear cavity Eustachian tube Mastoid air cells

2nd Brachial arch

Cartilage: Reichert's (Stapes, Styloid, Stylohyoid) Muscles:Stapedius, Stylohyoid Nerves:CN 7 -Smile

2nd Brachial Pouch

Epithelial lining of palatine tonsil

3rd Brachial arch

Cartilage: Greater horn of hyoid Muscles: Stylopharyngeus Nerves: CN 9 -Swallow stylishly

3rd Brachial Pouch

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African American, bilateral hilar adenopathy, righ paratracheal node enlargment, noncaseating granuloma =???

sarcoidosis (ethnicity is risk factor)

Albinism

Congenital deficiency in: Tyrosinase Defective tyrosine transporter (↓ tyrosine → ↓ melanin)

3 structures Thymus, right & left parathyroids 7.

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9.

4th Brachial Pouch

Dorsal wings -Superior parathyroid

4th-6th Brachial arches

Cartilage: Thyroid, cricoid, Muscles: 4 = pharyngeal constrictors 6 = intrinsic muscles of larynx Nerves: 4 = CN X (superior laryngeal branch) -Simply swallow 6 = CN X (recurrent laryngeal branch) -Speak

Absence seizure

Brief (usually less than 20 seconds), generalized epileptic seizures of sudden onset and termination

Clinically, the impairment of consciousness (absence) Electroencephalography (EEG) shows generalized spike-and-slow wave discharges ~3Hz 10.

acute ischemic injury = kidney findings?

Acute Tubular Necrosis - Muddy Brown Casts with epithelial cells

Method of separating biochemical mixtures -Based on a highly specific interaction such as that between antigen and antibody, enzyme and substrate, or receptor and ligand. Can be used to. 1. Purify and concentrate a substance from a mixture into a buffering solution 2. Reduce the amount of a substance in a mixture 3. Discern what biological compounds bind to a particular substance 4. Purify and concentrate an enzyme solution.

Dorsal wings -Inferior parathyroids Ventral wings -Thymus

Affinity column chromatography

Can result from lack of migration of neural crest cells Lack of melanin results in ↑ risk of skin cancer 14.

Ammonia source in ammonioagenesis

Aspartate & GLUTAMINE donate NH4 ( amonia ) in renal ammoniaagenesis

15.

Ammoniagenesis

Occurs within proximal tubular cells

23.

Bacillus subtilis

Glutamine made in the liver, is received from peritubular capillaries and is metabolized into 1. Alpha-keto glutarate (Metabolized further into two HCO3- ions, which then leave the cell and enter systemic circulation by crossing the basolateral membrane)

Only known to cause disease in severely immunocompromised patients 24.

Bacteroides fragilis

2. NH4+ (Secreted into renal tubules) 16.

Anabolic steroids

Leads to ↑ sex-hormone binding globulin ↓ free testosterone -Gynecomastia results

17.

Anemia

↓ Hb concentration causes ↓ O₂ content of blood → hypoxia

18.

aneurysm of PCA?

oculomotor nerve palsy (NOT Horner's)

19.

Arches 3 & 4

Posterior 1/3 of tongue

ATP concentration doesn't fall much dring normal twitches because?

ATP is quickly regenerated from creatine phosphate

Avoidant Personality Disorder

Consider themselves to be socially inept or personally unappealing and avoid social interaction for fear of being ridiculed, humiliated, rejected, or disliked

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baby, respiratory distress, cyanosis, narrow thorax, ears with periauricular skin tags, micrognathia, glossoptosis, mandibular cleft, short palate = which artch?

Gram-positive, catalase-positive bacterium Rod-shaped Has the ability to form a tough, protective endospore, allowing the organism to tolerate extreme environmental conditions

Gram-negative bacillus bacterium species Involved in 90% of anaerobic peritoneal infections Predominates in bacteremia associated with intraabdominal infections, peritonitis and abscesses following rupture of viscus, and subcutaneous abscesses or burns near the anus

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blast proliferation, eosinophils?

CML (9:22) responds to imatinib

Brachial Arches (Pneumonic)

When at the golden arches, 1. Chew 2. Smile 3. swallow stylishly or 4. simply swallow 6. speak There is no 5!

27.

Brachial pouch pneumonic

Ear, tonsils, bottom to top 1(ear) 2(tonsils) 3 dorsal (bottom for inferior thyroid) 3 ventral (to = thymus) 4 (top = superior parathyroids)

first arch (TreacherCollins) 28.

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Broca's aphasia

Nonfluent aphasia with intact comprehension.

brown-black, mottled, scaly, irregular borders, atypical melanocytes along basilar layer?

lentigo maligna (melanoma)

Carbaminohemoglobin

CO₂ bound to hemoglobin -Account for very small amount of CO₂ in blood

Carbon monoxide poisoning

↓ O₂ content of blood → hypoxia

32.

Carnitine deficiency

Inability to transport LCFA (Long chain fatty acids) into mitochondria Results in toxic accumulation in the cytoplasm

39.

Clostridium perfringens

Infections show evidence of tissue necrosis, bacteremia, emphysematous cholecystitis, and gas gangrene

Causes weakness, hypotonia, hypoketotic hypoglycemia 33.

34.

Case Control

Case series

Two existing groups differing in outcome are identified and compared on the basis of some supposed causal attribute Medical research descriptive study that: 1. Tracks patients with a known exposure given similar treatment 2. Examines their medical records for exposure and outcome Can be retrospective or prospective Usually involves a smaller number of patients than more powerful case-control studies or randomized controlled trials

Gram-positive, rod-shaped, anaerobic, sporeforming bacterium

Toxin involved in gas gangrene is known as -toxin -Inserts into the plasma membrane of cells, producing gaps in the membrane that disrupt normal cellular function 40.

41.

CML treatment

Imatinib. BCR-ABL 9:22

Complete hydatidiform mole

Caused by a single (90%) or two (10%) sperm combining with an egg which has lost its DNA The genotype is typically 46,XX (diploid)

May be consecutive or non-consecutive -Depends on whether all cases presenting to the reporting authors over a period were included, or only a selection

42.

Complex partial seizure

Aura may manifest itself as a feeling of dj vu, jamais vu, fear, euphoria or depersonalization.

May be confounded by selection bias -Limits statements on the causality of correlations observed

Seizure aura might also occur as a visual disturbance, such as tunnel vision or a change in the size of objects (macropsia or micropsia).

-Physicians who look at patients with a certain illness and a suspected linked exposure will have a selection bias in that they have drawn their patients from a narrow selection (Their hospital) 35.

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cervical cancer drains to?

internal iliac nodes

Chloroquine, primaquine MOA

Chloroquie kills malaria/ Primaquine kills hypnozoites

Chronic HTN, heavy heart?

Hypertrophy of heart

Chronic myelogenous leukemia (CML)

Myeloid stem cell proliferation (30-60 year olds) - ↑ neutrophils, metamyelocytes, basophils, t(9;22) Low leukocyte alkaline phosphatase (as opposed to leukemoid reaction)

Often preceded by a seizure aura. -A simple partial seizure.

Once consciousness is impaired, the person may display automatisms such as lip smacking, chewing or swallowing. There may also be loss of memory (amnesia) surrounding the seizure event. Person may still be able to perform routine tasks such as walking, although such movements are not purposeful or planned. Witnesses may not recognize that anything is wrong. 43.

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Congentio pharyngocutaneous fistula

Persistence of cleft and pouch → fistula between tonsillar area, cleft in lateral neck

Cyanide poisoning

↓ O₂ utilization by tissues → hypoxia

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Cytarabine

Pyrimidine analog → inhibition of DNA polymerase Leukemia, lymphomas Toxicity: Leukopenia, Thrombocytopenia, Megaloblastic anemia

defect in ihibitory NT = seizures, floppy baby

glycine receptor

defect in renal ammoniagenesis, which substrate is source of ammonia production?

glutamine (and aspartate donate NH4 in agenesis)

Density Gradient Centrifuge

Used to separate certain organelles from whole cells for further analysis of specific parts of cells 1. A tissue sample is first homogenised to break the cell membranes and mix up the cell contents. 2. The homogenate is then subjected to repeated centrifugations, each time removing the pellet and increasing the centrifugal force. 3. Finally, purification may be done through equilibrium sedimentation, and the desired layer is extracted for further analysis.

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57. 58.

DKA, give insulin, increases activity of which enzyme?

glucokinase

drug overdose?

respiratory acidosis

Dysostosis multiplex

Hereditary disease (autosomal recessive) consisting of an error is mucopolysaccharide metabolism Characterized by severe abnormalities in development of skeletal cartilage and bone and mental retardation

Dental procedure, bug?

Strep Mitis - alpha hemolytic

Deoxyhemoglobin

Better buffer for H⁺ than oxyhemoglobin -Advantageous that hemoglobin has been deoxygenated by the time it reaches the venous end of the capillaries

DEXA decreased bone density

increased osteoclast, RANKL, decreased osteoblast activity

Diabetic neuropathy pain?

burning pain

Diabetic neuropathy symptoms

Numbness, tingling, ED, Urinary incontinence, Vision changes, Dizziness, Muscle weakness *Burning or electric pain*

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Diaphoresis

Excessive sweating

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DiGeorge syndrome

Aberrant development of 3rd & 4th pouches: T-cell deficiency (thymic aplasia) Hypocalcemia (failure of parathyroid development)

Ejection Fraction equation

SV/EDV (EDV-ESV)/EDV

elevated verylong-chain FA, phytanic acid, pipecolic acid = absence of?

peroxisomes (causes hypotonia, poor feeding)

61.

EPO doping = ?

EPO will increase RBC's erythroid precursors

62.

Erythropoietin

Its primary effect on red blood cell progenitors and precursors (which are found in the bone marrow in humans) is promoting their survival through protecting these cells from apoptosis

Excess lymphoblasts

Age < 15 Found in acute lymphoblastic leukemia (ALL)

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TdT+ (Marker of pre-t & pre-b cells) CALLA+ t(12;21) = good prognosis Increased incidence in people with Down Syndrome 64.

Ferrochelatase

Lead poisoning Accumulates: Protoporphyrin, -ALA Microcytic anemia, GI and kidney disease. Children-exposure to lead paint -+ mental deterioration Adults-environmental exposure (battery/ ammunition/radiator factory) -+ headache, memory loss, demyelination

65.

Generalized tonic clonic

Generalized seizure that affects the entire brain

75.

heme biosynthesis pathway

glycine + succ (ALA synthase) 5-ALA (ALA dehydratase) porphobilinogen (PBG deaminase) Hydroxymethylbilane (uro synthase) Urophyrinogen III (Uro decarboxylase) Coproporphyrinogen III (Copro oxidase) protoporphyrinogen IX (proto oxidase) protophorphyrin (IX) ferrochelatase + Fe = HEME

Hemispatial neglect

Results most commonly from brain injury to the right cerebral hemisphere, causing visual neglect of the left-hand side of space

Divided into two phases, the tonic phase and the clonic phase. Preceded by aura Tonic = skeletal muscles tense Clonic = Rapid contraction and relaxation of muscles germline mosaicism

produces disease that is not carried by parent's somatic cells

67.

Glipizide

Sulfonylurea (stimulates endogenous insulin release) Close K+ channel in -cell membrane = insulin release via ↑ Ca2+ influx.

68.

glossoptosis

Downward displacement or retraction of the tongue

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Glucokinase

Liver and  cells of pancreas, induced by insulin

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76.

A stroke affecting the right parietal lobe of the brain can lead to neglect for the left side of the visual field, causing a patient with neglect to behave as if the left side of sensory space is nonexistent (although they can still turn left) -Extreme case, a patient with neglect might fail to eat the food on the left half of their plate, even though they complain of being hungry -Someone with neglect is asked to draw a clock, their drawing might show only numbers 12 to 6, or all 12 numbers on one half of the clock face, the other side being distorted or left blank

Low glucose = hexokinase sequesters glucose in the tissues High glucose = excess glucose is stored in the liver 70.

Glucose-6phosphatase

In ER of liver, Glucose-6-P → Glucose Deficient in Von Gierke's disease (fasting hypoglycemia, increased glycogen in liver, increased blood lactate, hepatomegaly)

71.

Glycogen phosphorylase

73.

guy with ulcers, what to do to improve symptoms?

stop smoking

H1 (Histamine)

Found on smooth muscle, endothelium, and central nervous system tissue Causes: Bronchoconstriction, Bronchial smooth muscle contraction, Vasodilation, Separation of endothelial cells (responsible for hives), Pain and itching due to insect stings; SE = sleep and appetite suppression.

74.

HDL with age in woman?

Histone deacetylase

HDL of a 25 year old vs. 55 year old, high in 25, low in 55 (estrogen)

Removes acetyl groups from AA -Allows histones to wrap DNA more tightly Actions are opposite to that of histone acetyltransferase

Rate determining enzyme for glycogenolysis Skeletal component deficient in McArdle's disease -↑ glycogen in muscle, but can't break it down -Painful muscle cramps, myoglobinuria w/ strenuous exercise

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These would affect transcription of DNA!!!! 78.

Homonymous hemianopsia

Visual field loss that respects the vertical midline, and usually affects both eyes Vascular and neoplastic (malignant or benign tumours) lesions from the optic tract, to visual cortex can cause -If lesion is in optic tract, will be pupillary reflex problem! The more posterior the cerebral lesion, the more symmetric (congruous) symptoms will be 1. Person who has a lesion of the right optic tract will no longer see objects on his left side 2. Person who has a stroke to the right occipital lobe will have the same visual field defect, usually more congruent between the two eyes, and there may be macular sparing

Homozygous for point mutation (GT->AT) causes skipping of exon 12, mech?

RNA Splice error

How to calculate A-a gradient

PAO2 - PaO2 (PAO2=150 PaCO2/0.8)

How to identify a variant protein?

immunohistochemistry

82.

Hydronephrosis causes?

Increased tubular hydrostatic pressure from blockage

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Hydroxyurea

Inhibits ribonucleotide reductase → ↓ DNA Synthesis (S-phase specific) Melanoma, CML, Sickle cell disease (↑ HbF)

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Imatinib

Treatment of CML (blasts, basophils) 92.

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Immunohistochemistry

Process of detecting antigens (e.g., proteins) in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in biological tissues

inclusion cell disease (I-cell disease)

Inherited lysosomal storage disorder Failure of addition of mannose-6phosphate to lysosome proteins -Enzymes are secreted outside the cell instead of being targeted to the lysosome

Toxicity: Bone marrow suppression, GI upset 84.

Hyperammonia

Presentation: Coarse facial features Clouded corneas Restricted joint movement High plasma levels of lysosomal enzymes

Can be acquired (e.g., liver disease) or hereditary (e.g., urea cycle enzyme deficiencies) excess NH4+ → depletes aketoglutarate → inhibition of TCA cycle

incomplete penetrance vs. variable expressivity

IP = not all with mutant genotype show mutant phenotype; VE = genotype SAME, phenotype varies

95.

Insulin increases?

glucokinase activity

96.

Insulin secretion

1. Glucose binds Glut2 receptor on -cells 2. Glucose oxidizes to ATP → closes K⁺ channels in cell membrane → depolarization of cells 3. Depolerizatino opens Ca⁺ channels → ↑ intracellular [Ca⁺] → [name of this card]

Internal iliac lymph nodes

Receive lymphatics from: All the pelvic viscera Deeper parts of the perineum -membranous and cavernous portions of the urethra Buttock and back of the thigh Cervix!

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Rx: limit protein in diet 85.

Hyperparathyroidism

Stone, Bones, and Groans Hypercalcemia Hypercalciuria (Stones) Hypophosphatemia ↑PTH, ↑Alk Phos, ↑cAMP in urine

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Hypokinesis of Posterior Left Ventricle?

Stenosis of the right coronary artery

Hypovolemic/cardiogenic shock

low-output failure, increased TPR, low CO, cold, clammy (hypovolemic = low volume, no JVD; cardiogenic = poor pumping, backflow, increased JVD)

Hypoxemia

↓Pao₂ causes ↓ %saturation of hemoglobin → hypoxia

I Cell Disease MOA

IkB function?

97.

Not: Ovary, testis, or superior half of the rectum

mannose 6 phosphate addition allows enzymes to go to lysosome, but this is defective = abnormal targeting of these enzymes to lysosomes releases NFkB after undergoing phosphorylation

A small molecular inhibitor of bcr-abl tyrosine kinase

Gonads drain to the paraaortic lymph nodes Superior half of the rectum drains to the pararectal lymph nodes 98.

Internal urethral orifice

Opening of the urinary bladder into the urethra

99.

Irradiated packed RBCs

Destroys DNA in WBCs -Prevents graft vs host disease occurring from transfusion

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long-chain-fattyacids?

LCFA - peroxisomes

Lorazepam

Facilitates GABAa action by ↑ frequency of Cl⁻ channel opening

Important if transfusion is from: 1. Close family relation 2. Someone who is immunocompromised (Di George Syndrome, Wiskott Aldrich, and SCID) 100.

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IB

Releases NF-B after undergoing phosphorylation

Left Axillary line holosytolic murmur

Mitral Regurg - Left Axillary line holosystolic murmur

Left sided heart failure signs

Tachypnea (increased rate of breathing) Increased work of breathing (nonspecific signs of respiratory distress) Rales or crackles, heard initially in the lung bases, and when severe, throughout the lung fields -Suggest the development of pulmonary edema (fluid in the alveoli) -Cyanosis which suggests severe hypoxemia, is a late sign of extremely severe pulmonary edema.

Leukemia

Use: Anxiety Spasticity Status epilepticus Detoxification 109.

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Unregulated growth of leukocytes in *bone marrow* ↑ or ↓ in # of circulating leukocytes in blood

Loss of left vision in both eyes =?

occipital lobe lesion

Low blood solubility = slow or fast induction?

141) low blood solubility --> rapid induction, low potency

lump in upper neck, mass moves up with swallowing and tongue protusion, uptake of technetium 99m pertechnetate, what type of cells?

thyroid follicles

Lymphoma

Discrete tumor masses arising from lymph nodes.

Lysosomal storage disease

Caused by lysosomal dysfunction usually as a consequence of deficiency of a single enzyme required for the metabolism of lipids, glycoproteins (sugar containing proteins) or so-called mucopolysaccharides

Marrow failure → anemia (↓RBC), infections (↓WBC), hemorrhage (↓platelets)

When a particular lysosomal enzyme exists in too small an amount or is missing altogether, substances accumulate in the cell.

Infiltrates in liver, spleen, and lymph nodes possible 104.

Leukocidin

Type of cytotoxin created by some types of bacteria

In other words, when the lysosome doesn't function normally, excess products destined for breakdown and recycling are stored in the cell.

Is a type of pore forming toxin Get their names by killing ("-cide") leukocytes Associated with increased virulence of certain strains (isolates) of Staphylococcus aureus Cause of necrotic lesions involving the skin or mucosa, including necrotic hemorrhagic pneumonia 105.

106.

Lithium induced Nephrogenic DI, where?

Collecting tubule

Loading dose

Cp x Vd/Bioavailability

114.

Maintenance dose

Cp x CL/F

115.

Megaloblastosis (Megaloblastic anemia)

Results from inhibition of DNA synthesis in red blood cell production -Most often due to hypovitaminosis, specifically a deficiency of vitamin B12 and/or folic acid Characterized by: Many large immature and dysfunctional red blood cells (megaloblasts) in the bone marrow Hypersegmented neutrophils (those exhibiting five or more nuclear lobes ("segments"), with up to four lobes being normal)

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Melanoma ABCDE

Asymmetry, Border irregularity, Color variation, Diameter >6 mm, Evolution over time

Mesoblastic nephroma

Type of kidney tumor that is usually found before birth by ultrasound or within the first 3 months of life.

124.

Nephroblastoma (Wilms tumor)

Contains embryonic glomerular structure. Presents with huge flank mass / hematuria. Deletion of WT1 on chromosome 11 Can be hypervascular 125.

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NF-B

Activation occurs when it's inhibitor, I-B, is phosphorylated by specific protein kinase (IKK) & degraded

normal heart weight (450), enlarged at 600g after poorly controlled HTN?

hypertrophy

Oculomotor palsy from aneurysm?

Posterior Communicating Artery Anuerysm

Olanzapine

Atypical antipsychotic

It contains fibroblastic cells (connective tissue cells), and may spread to the other kidney or to nearby tissue metabolic alkalosis with volume contraction

loop diuretic

metastaic colon cancer spread MOA

Hematogenous spread of Liver Tumor from Colon via Portal Venous System

Michaelis constant (Km) =?

Km = 1/2 Vmax

121.

micrognathia

Jaw is undersized

122.

MOA IKB

lkb --> NF-KB post phosphorylation for IL-1/IL-6 fever induction

123.

Myofibroblast

Cell that is in between a fibroblast and a smooth muscle cell in differentiation

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Most common renal malignancy of early childhood (Age 2-4)

Use: Schizophrenia - both +ve and -ve Bipolar, OCD, anxiety disorder, depression, mania Fewer extrapyramidal side effects than traditional antipsychotics 129.

Oligomenorrhea

increased estrogen in adipose tissue

130.

Optic chiasm lesion

Bitemporal anopia

optic nerve, Chiasm, optic tract

parietal lesion = optic tract lesion

Organophosphate poisoning- first antidote

Atropine first/Pralidoxime second

Oxytocin

Stimulates labour Uterine contraction Milk let down Controls uterine hemorrhage

Packed RBCs with adenine-saline added

Allows the blood to flow readily without the addition of saline

pain associated with diabetic neuropathy?

burning pain

pain in shoulder, reproduced with resisted abduction at 90, giving thumbs down

supraspinatus

Pain upper abdomen, refered to shoulder

Diaphram ulceration phrenic nerve

131.

Can contract by using smooth muscle type actin-myosin complex, rich in a form of actin called alpha-smooth muscle actin -These cells are then capable of speeding wound repair by contracting the edges of the wound

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Pain with thumbs down, shoulders up

Arm up Thumbs down sign... supraspinatus...

pancreatic cancer associated with?

depression

paraesophageal hernia

portion of gastric fundus herniates through the diaphragm

parathyroid adenoma, decreased?

calcium concentration in feces

Parietal lobe lesion

Lower quadrantic anopia

Partial hydatidiform mole

Occurs when an egg is fertilized by two sperm or by one sperm which reduplicates itself yielding the genotypes of 69,XXY

Partial vs complete mole

Partial 1 egg two sperm 69XXY vs paternal complete 46XX 2 sperm no egg

Peptic ulcers

Chronic inflammation due to Helicobacter pylori that colonizes the antral mucosa

151.

Pipecolic acid

Accumulates in Pipecolic acidemia - Very rare autosomal recessive metabolic disorder that is caused by a peroxisomal defect

152.

Placenta accreta

Abnormally deep attachment of the placenta to the myometrium without penetrating it. Placenta grows completely through the endometrium Great risk of haemorrhage during placental removal -Commonly requires surgery to stem the bleeding and fully remove the placenta -In severe forms can often lead to a hysterectomy or be fatal

153.

Porphobilinogen deaminase

Accumulates: Porphobilinogen, -ALA, uroporphyrin 5 P's 1. Painful abdomen 2. Port wine-colored urine 3. Polyneuropathy 4. Psychological disturbances 5. Precipitated by drugs

NSAIDs Some studies have found correlations between smoking and ulcer formation Caffeine and coffee, also commonly thought to cause or exacerbate ulcers, have not been found to affect ulcers to any significant exten 146.

Peroxisome

Irreversible enzyme in Gluconeogenesis

148.

Phosphorylase kinase

A component of Gluconeogenesis

149.

Phytanic acid

Branched chain fatty acid that humans can obtain through the consumption of dairy products, ruminant animal fats, and certain fish Undergoes -oxidation in the peroxisome, where it is converted into pristanic acid by the removal of one carbon

150.

pinpoint pupils, unconscious

154.

Posterior Communicating Artery

heroin OD

Common site ofsaccular (berry) aneurysm. CN III Palsy: Eye is "down and out" with ptosis and pupil dilation

Membrane-enclosed organelle involved in catabolism of very long fatty acids (VLFA) & amino acids

Phosphoenolpyruvate carboxykinase

147.

Acute intermittent porphyria

Lesions are typically aneurysms, not strokes 155.

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postpartum hemorrhage treated with?

oxytocin

Prenatal cocaine effects

Associated with premature birth, birth defects, attention deficit disorder

progestin challenge with withdrawal bleed?

low estrogen production = estrogen increased in adipose tissue

protease inhibitors (navirs)

protein processing (assmebling of virions = cleave of polypeptide products of HIV mRNA into functional parts)

159.

PTH

Ca+ resorption from Kidney (Inhibits PO4 resorption) Stimulates Vit D. synth (1,25 OH) -Increased Ca+ absorbed from intestine

166.

RTA2 ("proximal", Renal tubular acidosis)

Defect in proximal tubule HC03reabsorption Fanconi's syndrome urine pH < 5.5 hypokalemia

Ca+ release from bone ↑ risk for hypophosphatemic rickets ↑ serum calcium 160.

161.

162.

Recurrent severe mycobacterial diseases

INF-gamma receptor defect

renal failure causes loss of?

1,25-dihydroxycholecalciferol (from decreased conversion via 1a-hydroxylase in PCT)

Right Coronary Artery

Supplies blood to right ventricle & 25-30% of left ventricle In 85% of patients, gives off posterior descending artery

167.

RTA4 ("hyperkalemic", Renal tubular acidosis)

↓ buffering capacity and ↓ urine pH 168.

S. pyogenes (Group A)

169.

Salmonella enterica

164.

RNA splice error

skipping of exons

Rouleaux formation

Stacks of red blood cells (RBCs) which form because of the unique discoid shape of the cells in vertebrates

165.

RTA1 ("distal", Renal tubular acidosis)

170.

171.

Conditions which cause: Infections Multiple myeloma Inflammatory and connective tissue disorders Cancers Occurs in diabetes mellitus (one of the causative factors for microvascular occlusion in diabetic retinopathy) Defect in collecting tubule's ability to excrete H+ urine pH >5.5 hypokalemia ↑ risk for calcium phosphate kidney stones as a result of ↑ urine pH and bone resorption

Most cases of salmonellosis are caused by food infected with w/ this bacteria, which often infects cattle and poultry Usually does not need ABs (Only if complicated in people at risk such as infants, small children, the elderly) -Will lead to prolonged fecal excretion of bacteria

Give off branch to right marginal artery

163.

The bacteria behind post-streptococcal glomerulonephritis PHaryngitis can results in PHever & glomerulonePHritis

Supplies SA nodal artery in 60% of patients

If lungs are clear to auscultation, no LVF. Think RVF!

Hypoaldosteronism or lack of collecting tubule response to aldosterone Resulting hyperkalemia impairs ammoniagenesis in the proximal tubule

172.

Salmonella post antibiotic?

prolonged fecal excretement post antibiotic

Scaphoid bone

Most commonly fractured carpel bone, prone to avascular necrosis due to retrograde blood supply

Schizoid personality disorder

Characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness and apathy May simultaneously demonstrate a rich, elaborate and exclusively internal fantasy world

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Screening for CD markers?

Immunohistochemistry

Septic shock

high-output failure, decreased TPR, dilated arterioles, high venous return, hot patient

side effect of H1 blocker

drowsiness

176.

Simple partial seizures

Consciousness is not impaired Often precursors to larger seizures, where the abnormal electrical activity spreads to a larger area of (or all of) the brain, usually resulting in a complex partial seizure or a tonic-clonic seizure -In this case they are often known as an aura

177.

Slipped-strand mispairing

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SNoW DRoP

Southern = DNA Northern = RNA Western = Protein

Southwestern blot

Identifies DNA-binding proteins

Stain Drug effects

Upregulates LDL receptors

Staph -toxin

The major cytotoxic agent released by bacterium Staphylococcus aureus and the first identified member of the pore forming beta-barrel toxin family

Staphylococcus aureus

Statin MOA (upregulate what?)

NOT random, created to ensure a more representative sample of the population at large (ADHD more likely in boys than girls, therefore assigned differently)

Substance Abuse Teratogens

Alcohol: Leading cause of birth defects and mental retardation; fetal alcohol syndrome Cocaine: Abnormal fetal development and fetal addiction; placental abruption Smoking: Preterm labor, placental problems, IUGR, ADI-ID

186.

-Superantigens (TSST-1) induce toxic shock syndrome (TSS), usually from prolonged tampon use. Cause non-specific activation of T-cells resulting in polyclonal T cell activation and massive cytokine release (IFN) -Enterotoxin that is the causative of gastroenteritis that is self-limiting, characterized by vomiting and diarrhea one to six hours after ingestion of the toxin with recovery in eight to 24 hours. Symptoms include nausea, vomiting, diarrhea, and major abdominal pain. -Exfoliative toxins implicated in (SSSS), which occurs most commonly in infants and young children. Protease activity of the exfoliative toxins causes peeling of the skin observed with SSSS.

LDL receptors

Superficial inguinal lymph nodes

Anal canal (below pectenate line) Scrotum Thighs Ends up in these lymph nodes

187.

188.

Other -Protein A, an IgG-binding protein, binds to the Fc region of an antibody 183.

185.

stratified sample

Denaturation and displacement of the DNA strands, resulting in mispairing of the complementary bases. Can result in either insertions or deletions. Insertions are thought to be selfaccelerating: as repeats grow longer, the probability of subsequent mispairing events increases

178.

184.

suprasellar mass, hormone excess?

prolactin

Supraspinatus

Abduction of the arm at the shoulder joint -Main agonist muscle for this movement during the first 10-15 degrees of its arc Can test: Shoulder at 90% Empty can (Wrists pronated)

189.

190.

Temporal lobe lesion

Upper quadrantic anopia

Transfusion associated GVH

Results from transfusion of immunocompetent T cells capable of engrafting and initiating an immune response against recipient antigens The most susceptible patient groups are those who are severely immunocompromised Gamma irradiation abolishes the proliferative activity of the lymphocytes in the donor blood. Fresh frozen plasma and cryoprecipitate do not contain viable lymphocytes and thus do not need to be irradiated

191.

Treacher Collins Syndrome

1st arch neural crest fails to migrate -Mandibular hypoplasia -Facial abnormalities

Trisomy 21 associated with increased risk of which cancers?

ALL and AML

193.

Type I error

Stating there is an effect when none exist

194.

Type I error =

saw a difference when none existed = p-value (false positive error)

192.

204.

205.

Type II error

Stating there is not an effect when there is one

196.

Ubiquitin

Tags proteins for destruction by proteosome

ubiquitin tagged proteins go where?

proteosome for degradation

206.

Ureteric orifice

Placed at the postero-lateral angles of the trigonum vesicae, and are usually slit-like in form

207.

198.

199.

Uroporphyrinogen decarboxylase

Whole blood

Porphyria cutanea tarda

Why deoxyHB can carry CO2 better than OxyHB?

DeoxyHB = better buffer

Wound healing

1. Inflammatory (immediate) -Platelets, neutrophils, macrophages 2. Proliferative (2-3 days after wound) -Fibroblasts, myofibroblasts, endothelial cells, keratinocytes, macrophages -Granulation tissue depostion, angiogenesis, wound contraction (mediated by myofibroblasts)

Blistering cutaneous photosensitivity. Most common porphyria. Valproic acid

A wide spectrum seizure medication -1st line for tonic-clonic Not for status epilepticus

201.

202.

203.

Valproic Acid MOA

Vitamin C

Washed packed RBCs

inhibits HISTONE ACETYLASE Histones were in DNA transcription error Required fro the hydroxylation of specific purine and lysine residues -If deficient, will cause scurvy --Inadequate hydroxylation of collagen peptides

3. Remodeling (1 week after wound) -Fibroblasts -Type III collagen replaced by type I collagen 208.

209.

210.

Zanamavir MOA

Zanamivir MOA - inhibit virion release

zanamivir, oseltamivir MOA

inhibits virion release

-ALA dehydratase

Lead poisoning Accumulates: Protoporphyrin, -ALA

RBCs washed in sterile saline to remove: WBCs Lytic mediators Non-self antigens Most useful in IgA deficient persons who have circulating anti-IgA Abs -Use ↓ febrile, urticarial and anaphylactic reactions

Blood that is unmodified except for the presence of an anticoagulant Usually not used because the extra plasma can contribute to transfusion associated circulatory overload (TACO), a potentially dangerous complication

Accumulates: Uroporphyrin (tea colored urine)

200.

Fluent aphasia with impaired comprehension. Wernicke's area-superior temporal gyrus of temporal lobe. Wordy, but makes no sense

195.

197.

Wernicke's aphasia

Microcytic anemia, GI and kidney disease. Children-exposure to lead paint -+ mental deterioration Adults-environmental exposure (battery/ ammunition/radiator factory) -+ headache, memory loss, demyelination 211.

-ALA synthase

Sideroblastic anemia