PLE Recall March 2016

PLE Recall March 2016 Notes  The degree of difficulty of question varies each subject. There is a trend wherein you will be given a case and they will give a cascading type of questions. Two or three subjects asked approximately 50 percent of the total number of items. Can you be believed that? Lol  A lot of questions were duplicated twice or thrice  We advise that the students have a solid background in immunology and microbiology  Take note that one of the examiners is a pediatric immuno specialist so those two subjects is his forte and I think he also influenced the other examiners to asked about a lot of immune topics lol Biochemistry Note: One of the easiest subjects in the boards. Most of the answer can be found in the Topnotch Lecture Guide. Read DNA/ RNA because got a lot of questions from this topic. They love to ask about carbohydrate metabolism. - Hyperlipidemia due to defect in ldl receptor - type 2 - Type 2 hyperlipidemia - increase in LDL - I cell dse - Case of Fructosemia- def of aldolase b - Adenine and guanine- transition - Sorbitol- is a sugar alcohol, a ketone - Dm with cataract- accumulation of sorbitol - Accumulation of arginosuccinate, which ezyme is deficient- arginosuccinate synthase, arginosuccinase - Co factor of cps1 - N aga - PCR- amplification - Rxn of glutamate to GABA - Location of glycolysis- cytosol - Which AA is both ketogenic and glucogenic – isoleucine - Case of a pregnant woman with galactosemia - Case of infant with lactose intolerance - Central dogma – replication transcription and translation - Cell organelle responsible for ATP production – mitochondria (x3) - Which of the following can detect DNA? Pcr, Southwestern - What will be your brain’s source of energy after 48 hours of fasting? Fatty acids, glycogen, protein, ketone - ldl receptor deficiency what familial disease -type II familial - Where pathway happens in the cytoplasm? Glycolysis - Which of the following micronutrient is an antioxidant? Tocopherol, magnesium, selenium, vit d, magnesium - Site of ETC? mitochondria (up to 3 or more questions repeated again in anatomy or physiology)

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Which of the following are HMG co A reductase inhibitor? Simvastatin, rosuvastatin, fluvastatin, all of the above, a and b only What is the defect in I cell disease? Lysosomal storage, enzyme deficiency A t baby with fructosuria and failure to thrive. What is the enzyme def? fructokinase, aldolase B, galactokinase Adenine is replaced by guanine – transition What is activated by APO C II – lipoprotein lipase What is a sorbitol? Sugar alcohol Accumulation of arginosuccinate. What is the enzyme def? arginosuccinase What is the reaction for the conversion of glutamate to GABA? Degenerate – redundancy of genetic code Which of the following does not need vit B12 for its pathwat? Isoleucine, leucine, valine, methionine Which of the ffis not ketone bodies? Acetone, acetate, B hydroxybutyrate, acetyl co A Location for ETC and Glycolysis Which of the ff is x linked recessive - Hunter syndrome Adenine to Guanine Type of mutation - Transition Central Dogma - Replication-Transcription-translation Fructose Intolerance Aldolase B deficiency. Case of hypoglycemia with vomiting after drinking fruit juice Antioxidant effect and reducing property of Glutathione is due to this AA - Cysteine Aspirin inhibits cyclooxygenase required for synthesis of - Thromboxane from Arachidonic acid High LDL- Familial Hypercholesterolemia Vitamin C synthesis - Uronic acid pathway Characteristic of genetic code allow translation of same AA despite different codonRedundant Methylmalonicaciduria failure to metabolize these AA except Leucine Most abundant connective tissue in the skin, hair and nail

Anatomy Note: They didn’t asked a lot of questions about pelvic area! Read histology, they love to ask about parathyroid gland. Its secretion and its characteristic cell. A good background in histo will help to a lot . - Location of av bundle- left atrium, right atrium, interatrial septum, intervetricular septum - Homologue of major vestibular gland in male- bartholins, cowpers, skenes, prostate - Sellaturcica is located on what bone- sphenoid, ethmoid, frontal - Comprises pterion except- occipital, frontal, parietal, temporal - Sliding rib syndrome - Cingulate gyrus divides – - 1 motor area - pre central, post central - Deltopectoral groove - cephalic vein - Part of axial skeleton- hyoid, clavicle

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Greater petrosal nerve is a branch of- facial, hypoglossal, vagus Bones of orbit except- nasal, frontal, maxillary, zygomatic Subcostal nerve – T12 Azurophilic granules – neutrophils Thoracentesis done at what level Number of cranial nerves passing through internal jugular foramen Source of histamine – basophil, mast cell Components of levatorani Contents of superficial and deep perineal space Which sole nerve enters pelvis above the piriformis? Sciatic nerve, obturator nerve, superior gluteal Pectoralis minor function Part where calcitonin is secreted? Parafollicular cells Which of the following has longitudinal vertical crease? Limb, abdomen, breast, back Which of the following is part of axial skeleton? Hyoid, clavicle, pelvis, scapula When doing thoracentesis, what pleural space are you going to insert the needle? 5th, 7th 9th 2nd Greater petrosal nerve is a branch of? CN 7, CN 9, CN 8, CN 5 Bone comprising orbit Bones comprising pterion 2 questions on dermatomes - Acute Cholecystitis and Ureteral stone referred pain Lumbar disk herniation - most common location Axial skeleton - Hyoid bone Pituitary gland located in relation to sinuses (asked twice) Nerve supply of tympanic membrane Site for insertion of CTT Portosystemic anastomosis in Portal hypertension- Left gastric to azygous vein Main blood supply to tail of pancreas Median episiotomy - structures cut Homologue of Greater Vestibular glands for male (asked twice pinalitanlangngBartholins) Slipping rib syndrome Parafollicular cells produce Calcitonin - marker for Medullary Thyroid Carcinoma (3 or 4 questions)

Micro/ Para Note: The questions are difficult. Most of the questions are situational. Only 1 question was asked about agar. Like What is the colony morphology of E.Coli in LXD agar (oranges colonies, pink) - Most common cause of Viral Gastroenteritis in infants - double stranded RNA virus - Anaerobic infections - Metro and Clindamycin - Hydatid cyst - causative agent and treatment - Case: Malassezia furfur - Culture appearance? - Case: Scabies - treatment

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Case: Salmonella - treatment Case: Onychomycosis - Risk factor- recurrent tineapedis on history Case: Erythema multiforme - 'iris' lesion Case: Cryptococcus neoformans - history of exposure to pigeon droppings Case: Congenital Varicella Syndrome (asked twice) Case: Toxoplasmosis - intracranial calcification Case: Chikungunya - severe arthritis, Aedes (vector) Causative agent of Lymphogranulomainguinale - Klebsiellagranulomatis HIV Edward jenner used to discover vaccine for smll pox- cow pox, vaccinia, monkey pox Micro case of dengue, chikingunya, chromoblastomycosis Yersinia- bubonic, septicemic, pneumonic Mcc of infant diarrhea- ssrna, dsrna, ssdna, dsdna HIV- lentivirus, adeno, paramyxo, orthomyxo Treatment or Trichomonasvaginalis infection – oral metronidazole, topical metronidazole New world hookwork – NecatorAmericanus, Ancylostomaduodenale Pneumatocoele – caused by Staphylococcus aureus Case of Dengue and chikungunya Expected laboratory result in dengue fever – decrease wbc Diagnostic test for chikungunya – ELISA, PCR Case of clostridium perfringens – aerobe gram positive, aerobe gram negative, anaerobe gram positive, anaerobe gram negative Antibiotic not effective on Shigella infection – Ciprofloxacin, Penicillin Positive for lepromin test – tuberculoid Case of leprosy - mode of transmission – prolonged contact with patient, respiratory Mode of transmission of Kaposi sarcoma – airborne, sexual contact, vector Pathogenesis of Vibrio Cholera – increase adenylatecyclase which opens Cl channels Botulinum toxin – inhibits release of acetylcholine Case of chromoblastomycosis The following plagues were caused by Yersinia pestis except? Bubonic, septicemic, pneumonic if present what affects the virulence of bacteria: a. oxygen b. iron c. mg d. carbon A case of previous trauma with wart like lesion on site? What is your initial impression? What is your final diagnosis after sseing in the biopsy, granulomatous? Verruca vulgaris, tuberculous verruca Which of the following will least likely cause pid after no growth in aerobic medium? Bacteroidesfragilis, propionibacterium, pervotellabivis, pervotella What did Edward Jenner used for the vaccine that he made? Monkeypox, chickenpox, cowpox, vaccinia What is responsible for tuberculin positivity? Mycolic acid, sulfatides, protein What is responsible for the hypersensitivity reaction for tuberculin test? IgE mediated, cell cytoxicity, immune complex deposition, cell mediated

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2 hours prior to consult, 2 fishermen went on a drinking spree after they sold their catch. They were both brought to the emergency room due to a diagnosis of necrotizing fasciitis on their legs. What organism is reposnible for the disease? Streptoccocuspyogenes, Clostridium perfingens, Vibrio vulnificus, Salmonella typhi What system will HIV reside after the lymphatic system? GI, Nervous, Cardio, Renal Which of the following is the appearance of E.coli in XLD agar? A>red colonies, some with black centers B>red colonies C>yellow to orange colonies D>pink, flat, rough colonies What will you give in an anaerobic infection? Clindamycin and Metronidazole, Clindamycin, Metronidazole, Vancomycin What is the most common diseased entity caused by Salmonella? Enterocolitis, Typhoid fever, Septicemia, Arthritis Differences of Tuberculoid Leprosy and Lepromatous Leprosy Ring enhancing lesion in CT scan

Physiology Note: Some concept was lifted from Physio BRS. Like the V/Q ratio table and FVC, FEV1 table. The questions are average. Only 1 computation was asked. - Renal Tubular Acidosis- It’s a form of NAGMA - In an awake person, what is the level of epinephrine, norepinephrine and dopamine - Fetal Hemoglobin less responsive to 2,3 BPG - higher affinity to O2 - Computation for EDV - Diffusing capacity - COPD - Produced by Neurohypophysis - None of the above was not in the choices so best answer is ADH - Inhibits prolactin- dopamine - Hirschprungdse- sympha pre, sympha post, para pre, para post - Type C fiber- slowest in conduction - Apex of lung - highest v/q - Most negative- after expiration, before expiration, after inspiration, before inspiration - Diluting segment- thick ascending - Most abundant form of CO2- HCO3 - Surfactant produced by- type 1, type2, clara cells - ACE- converts angio 1 to angio 2 - What condition- inc PP, A-a grdient - Parafollicular cell – calcitonin (x4) - Ovarian cyst should not be removed during the 1st trimester because it secretes – progesterone only, progesterone and estrogen, progesterone and HCG - Computation for end diastolic volume volume given ejection fraction cardiac output and heart rate. - Which of the following is activated by heterotrimeric G protein? GABA receptors, 5Ht3, ANP, Cl channels - Which fiber has the slowest conduction? Type C - What is the difference of the apex from the base of the lung? Highes V/Q

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What is the most negative pressure at the end of expiration? What is responsible for dec in TPR during exercise? Local metabolites What is the diluting segment part of the nephron? Thick ascending limb Function of secretin and CCK Which of the following ABG values matches a patient with RTA? pH 7.1 anion gap 12 What cells of the lungs secretes surfactant? Type II What enzyme converts angiotensin I to II? ACE What constitutes with the PR interval?

Legal Medicine Note: Most of the questions were patterned to previous board exam questions. I preferred the APMC questions of UE and Cebu Doctors. Most of the questions came from Doctrines. - Doctrine on Continuing Negligence - A case foreign body left during an operation. (based on Dr. Solis book) - Corporate liability - defective wheelchair - Privilege communication - ethical? Professional? - Substantive law - Most useful and reliable in preserving evidence - Photograph - Post mortem vs Ante mortem clot - Sex crimes - Case of rape