Oct 30, 2015
1. 1st Brachial arch Cartilage: Meckel's (Mandible, Malleus,
Mandibular)
Muscles: Muscles of mastication
(Masseter, medial pterygoids, Mylohyoid)
Nerves: CN V2, V3
-Chew
2. 1st Brachial
Pouch
Middle ear cavity
Eustachian tube
Mastoid air cells
3. 2nd Brachial
arch
Cartilage: Reichert's (Stapes, Styloid,
Stylohyoid)
Muscles:Stapedius, Stylohyoid
Nerves:CN 7
-Smile
4. 2nd Brachial
Pouch
Epithelial lining of palatine tonsil
5. 3rd Brachial
arch
Cartilage: Greater horn of hyoid
Muscles: Stylopharyngeus
Nerves: CN 9
-Swallow stylishly
6. 3rd Brachial
Pouch
Dorsal wings
-Inferior parathyroids
Ventral wings
-Thymus
3 structures
Thymus, right & left parathyroids
7. 4th Brachial
Pouch
Dorsal wings
-Superior parathyroid
8. 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
9. 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
11. Affinity column
chromatography
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.
12. African American,
bilateral hilar adenopathy,
righ paratracheal node
enlargment, noncaseating
granuloma =???
sarcoidosis (ethnicity is risk
factor)
13. Albinism Congenital deficiency in:
Tyrosinase
Defective tyrosine transporter
( tyrosine melanin)
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
NBME 15 reviewStudy online at quizlet.com/_e5hgc
15. Ammoniagenesis Occurs within proximal
tubular cells
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)
2. NH4+ (Secreted into
renal tubules)
16. Anabolic steroids Leads to sex-hormone
binding globulin free
testosterone
-Gynecomastia results
17. Anemia Hb concentration causes
O content of blood
hypoxia
18. aneurysm of PCA? oculomotor nerve palsy
(NOT Horner's)
19. Arches 3 & 4 Posterior 1/3 of tongue
20. ATP concentration doesn't
fall much dring normal
twitches because?
ATP is quickly regenerated
from creatine phosphate
21. 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
22. baby, respiratory distress,
cyanosis, narrow thorax,
ears with periauricular skin
tags, micrognathia,
glossoptosis, mandibular
cleft, short palate = which
artch?
first arch (Treacher-
Collins)
23. Bacillus subtilis Gram-positive, catalase-positive
bacterium
Rod-shaped
Has the ability to form a tough,
protective endospore, allowing the
organism to tolerate extreme
environmental conditions
Only known to cause disease in
severely immunocompromised
patients
24. Bacteroides fragilis 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
25. blast proliferation,
eosinophils?
CML (9:22) responds to imatinib
26. 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)
28. Broca's aphasia Nonfluent aphasia with intact
comprehension.
29. brown-black, mottled,
scaly, irregular
borders, atypical
melanocytes along
basilar layer?
lentigo maligna (melanoma)
30. Carbaminohemoglobin CO bound to hemoglobin
-Account for very small amount of
CO in blood
31. Carbon monoxide
poisoning
O content of blood hypoxia
32. Carnitine
deficiency
Inability to transport LCFA (Long chain fatty
acids) into mitochondria
Results in toxic accumulation in the cytoplasm
Causes weakness, hypotonia, hypoketotic
hypoglycemia
33. Case Control Two existing groups differing in outcome are
identified and compared on the basis of some
supposed causal attribute
34. Case series 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
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
May be confounded by selection bias
-Limits statements on the causality of
correlations observed
-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. cervical
cancer
drains to?
internal iliac nodes
36. Chloroquine,
primaquine
MOA
Chloroquie kills malaria/ Primaquine kills
hypnozoites
37. Chronic
HTN, heavy
heart?
Hypertrophy of heart
38. 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)
39. Clostridium
perfringens
Gram-positive, rod-shaped, anaerobic, spore-
forming bacterium
Infections show evidence of tissue necrosis,
bacteremia, emphysematous cholecystitis,
and gas gangrene
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. CML
treatment
Imatinib. BCR-ABL 9:22
41. 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)
42. Complex
partial
seizure
Often preceded by a seizure aura.
-A simple partial seizure.
Aura may manifest itself as a feeling of dj
vu, jamais vu, fear, euphoria or
depersonalization.
Seizure aura might also occur as a visual
disturbance, such as tunnel vision or a
change in the size of objects (macropsia or
micropsia).
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. Congentio
pharyngo-
cutaneous
fistula
Persistence of cleft and pouch fistula
between tonsillar area, cleft in lateral neck
44. Cyanide
poisoning
O utilization by tissues hypoxia
45. Cytarabine Pyrimidine analog inhibition of
DNA polymerase
Leukemia, lymphomas
Toxicity: Leukopenia,
Thrombocytopenia, Megaloblastic
anemia
46. defect in ihibitory NT
= seizures, floppy baby
glycine receptor
47. defect in renal
ammoniagenesis,
which substrate is
source of ammonia
production?
glutamine (and aspartate donate
NH4 in agenesis)
48. 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.
49. Dental procedure,
bug?
Strep Mitis - alpha hemolytic
50. Deoxyhemoglobin Better buffer for H than
oxyhemoglobin
-Advantageous that hemoglobin
has been deoxygenated by the time
it reaches the venous end of the
capillaries
51. DEXA decreased bone
density
increased osteoclast, RANKL,
decreased osteoblast activity
52. Diabetic neuropathy
pain?
burning pain
53. Diabetic neuropathy
symptoms
Numbness, tingling, ED, Urinary
incontinence, Vision changes,
Dizziness, Muscle weakness
*Burning or electric pain*
54. Diaphoresis Excessive sweating
55. DiGeorge syndrome Aberrant development of 3rd & 4th
pouches:
T-cell deficiency (thymic aplasia)
Hypocalcemia (failure of
parathyroid development)
56. DKA, give
insulin,
increases
activity of which
enzyme?
glucokinase
57. drug overdose? respiratory acidosis
58. 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
59. Ejection
Fraction
equation
SV/EDV (EDV-ESV)/EDV
60. elevated very-
long-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
63. Excess
lymphoblasts
Age < 15
Found in acute lymphoblastic leukemia
(ALL)
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
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
66. 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
69. Glucokinase Liver and cells of pancreas, induced by
insulin
Low glucose = hexokinase sequesters
glucose in the tissues
High glucose = excess glucose is stored in
the liver
70. Glucose-6-
phosphatase
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
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
72. guy with
ulcers, what to
do to improve
symptoms?
stop smoking
73. 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?
HDL of a 25 year old vs. 55 year old, high in
25, low in 55 (estrogen)
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
76. Hemispatial
neglect
Results most commonly from brain injury to
the right cerebral hemisphere, causing visual
neglect of the left-hand side of space
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
77. Histone
deacetylase
Removes acetyl groups from AA
-Allows histones to wrap DNA more tightly
Actions are opposite to that of histone
acetyltransferase
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
79. Homozygous for point
mutation (GT->AT)
causes skipping of exon
12, mech?
RNA Splice error
80. How to calculate A-a
gradient
PAO2 - PaO2 (PAO2=150 -
PaCO2/0.8)
81. How to identify a variant
protein?
immunohistochemistry
82. Hydronephrosis causes? Increased tubular hydrostatic
pressure from blockage
83. Hydroxyurea Inhibits ribonucleotide
reductase DNA Synthesis
(S-phase specific)
Melanoma, CML, Sickle cell
disease ( HbF)
Toxicity:
Bone marrow suppression, GI
upset
84. Hyperammonia Can be acquired (e.g., liver
disease) or hereditary (e.g.,
urea cycle enzyme deficiencies)
excess NH4+ depletes a-
ketoglutarate inhibition of
TCA cycle
Rx: limit protein in diet
85. Hyperparathyroidism Stone, Bones, and Groans
Hypercalcemia
Hypercalciuria (Stones)
Hypophosphatemia
PTH, Alk Phos, cAMP in
urine
86. Hypokinesis of Posterior
Left Ventricle?
Stenosis of the right coronary
artery
87. Hypovolemic/cardiogenic
shock
low-output failure, increased
TPR, low CO, cold, clammy
(hypovolemic = low volume, no
JVD; cardiogenic = poor
pumping, backflow, increased
JVD)
88. Hypoxemia Pao causes %saturation of
hemoglobin hypoxia
89. I Cell Disease MOA mannose 6 phosphate addition
allows enzymes to go to
lysosome, but this is defective =
abnormal targeting of these
enzymes to lysosomes
90. IkB function? releases NFkB after undergoing
phosphorylation
91. Imatinib A small molecular inhibitor of
bcr-abl tyrosine kinase
Treatment of CML (blasts,
basophils)
92. 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
93. inclusion cell disease
(I-cell disease)
Inherited lysosomal storage
disorder
Failure of addition of mannose-6-
phosphate to lysosome proteins
-Enzymes are secreted outside the
cell instead of being targeted to
the lysosome
Presentation:
Coarse facial features
Clouded corneas
Restricted joint movement
High plasma levels of lysosomal
enzymes
94. 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]
97. 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!
Not: Ovary, testis, or superior half
of the rectum
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
Important if transfusion is from:
1. Close family relation
2. Someone who is
immunocompromised (Di George
Syndrome, Wiskott Aldrich, and SCID)
100. IB Releases NF-B after undergoing
phosphorylation
101. Left Axillary line
holosytolic
murmur
Mitral Regurg - Left Axillary line
holosystolic murmur
102. Left sided heart
failure signs
Tachypnea (increased rate of breathing)
Increased work of breathing (non-
specific 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.
103. Leukemia Unregulated growth of leukocytes in
*bone marrow*
or in # of circulating leukocytes in
blood
Marrow failure anemia (RBC),
infections (WBC), hemorrhage
(platelets)
Infiltrates in liver, spleen, and lymph
nodes possible
104. Leukocidin Type of cytotoxin created by some types
of bacteria
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. Lithium induced
Nephrogenic DI,
where?
Collecting tubule
106. Loading dose Cp x Vd/Bioavailability
107. long-chain-fatty-
acids?
LCFA - peroxisomes
108. Lorazepam Facilitates GABAa action by
frequency of Cl channel opening
Use:
Anxiety
Spasticity
Status epilepticus
Detoxification
109. Loss of left vision in
both eyes =?
occipital lobe lesion
110. Low blood solubility =
slow or fast induction?
141) low blood solubility --> rapid
induction, low potency
111. lump in upper neck,
mass moves up with
swallowing and tongue
protusion, uptake of
technetium 99m
pertechnetate, what
type of cells?
thyroid follicles
112. Lymphoma Discrete tumor masses arising
from lymph nodes.
113. 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
When a particular lysosomal
enzyme exists in too small an
amount or is missing altogether,
substances accumulate in the cell.
In other words, when the
lysosome doesn't function
normally, excess products
destined for breakdown and
recycling are stored in the cell.
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)
116. Melanoma
ABCDE
Asymmetry, Border irregularity, Color
variation, Diameter >6 mm, Evolution
over time
117. Mesoblastic
nephroma
Type of kidney tumor that is usually found
before birth by ultrasound or within the
first 3 months of life.
It contains fibroblastic cells (connective
tissue cells), and may spread to the other
kidney or to nearby tissue
118. metabolic
alkalosis with
volume
contraction
loop diuretic
119. metastaic colon
cancer spread
MOA
Hematogenous spread of Liver Tumor
from Colon via Portal Venous System
120. 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
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
124. Nephroblastoma
(Wilms tumor)
Most common renal malignancy
of early childhood (Age 2-4)
Contains embryonic glomerular
structure. Presents with huge
flank mass / hematuria. Deletion
of WT1 on chromosome 11
Can be hypervascular
125. NF-B Activation occurs when it's
inhibitor, I-B, is phosphorylated
by specific protein kinase (IKK) &
degraded
126. normal heart weight
(450), enlarged at
600g after poorly
controlled HTN?
hypertrophy
127. Oculomotor palsy
from aneurysm?
Posterior Communicating Artery
Anuerysm
128. Olanzapine Atypical antipsychotic
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
131. optic nerve, Chiasm,
optic tract
parietal lesion = optic tract lesion
132. Organophosphate
poisoning- first
antidote
Atropine first/Pralidoxime second
133. Oxytocin Stimulates labour
Uterine contraction
Milk let down
Controls uterine hemorrhage
134. Packed RBCs with
adenine-saline added
Allows the blood to flow readily
without the addition of saline
135. pain associated with
diabetic neuropathy?
burning pain
136. pain in shoulder,
reproduced with
resisted abduction at
90, giving thumbs
down
supraspinatus
137. Pain upper abdomen,
refered to shoulder
Diaphram ulceration phrenic
nerve
138. Pain with thumbs
down, shoulders up
Arm up Thumbs down sign...
supraspinatus...
139. pancreatic cancer
associated with?
depression
140. paraesophageal
hernia
portion of gastric fundus herniates
through the diaphragm
141. parathyroid
adenoma, decreased?
calcium concentration in feces
142. Parietal lobe lesion Lower quadrantic anopia
143. 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
144. Partial vs complete
mole
Partial 1 egg two sperm 69XXY vs
paternal complete 46XX 2 sperm
no egg
145. Peptic ulcers Chronic inflammation due to
Helicobacter pylori that colonizes
the antral mucosa
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 Membrane-enclosed organelle
involved in catabolism of very long
fatty acids (VLFA) & amino acids
147. Phosphoenolpyruvate
carboxykinase
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
heroin OD
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
Acute intermittent porphyria
Accumulates:
Porphobilinogen, -ALA, uroporphyrin
5 P's
1. Painful abdomen
2. Port wine-colored urine
3. Polyneuropathy
4. Psychological disturbances
5. Precipitated by drugs
154. Posterior
Communicating
Artery
Common site ofsaccular (berry)
aneurysm.
CN III Palsy: Eye is "down and out" with
ptosis and pupil dilation
Lesions are typically aneurysms, not
strokes
155. postpartum
hemorrhage
treated with?
oxytocin
156. Prenatal cocaine
effects
Associated with premature birth, birth
defects, attention deficit disorder
157. progestin
challenge with
withdrawal
bleed?
low estrogen production = estrogen
increased in adipose tissue
158. 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
Ca+ release from bone
serum calcium
160. Recurrent
severe
mycobacterial
diseases
INF-gamma receptor defect
161. renal failure
causes loss of?
1,25-dihydroxycholecalciferol (from
decreased conversion via 1a-hydroxylase
in PCT)
162. Right Coronary
Artery
Supplies blood to right ventricle & 25-30%
of left ventricle
In 85% of patients, gives off posterior
descending artery
Supplies SA nodal artery in 60% of
patients
Give off branch to right marginal artery
If lungs are clear to auscultation, no LVF.
Think RVF!
163. RNA splice
error
skipping of exons
164. Rouleaux
formation
Stacks of red blood cells (RBCs) which
form because of the unique discoid shape
of the cells in vertebrates
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)
165. RTA1 ("distal",
Renal tubular
acidosis)
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
166. RTA2
("proximal",
Renal tubular
acidosis)
Defect in proximal tubule HC03-
reabsorption
Fanconi's syndrome
urine pH < 5.5
hypokalemia
risk for hypophosphatemic rickets
167. RTA4
("hyperkalemic",
Renal tubular
acidosis)
Hypoaldosteronism or lack of collecting
tubule response to aldosterone
Resulting hyperkalemia impairs
ammoniagenesis in the proximal tubule
buffering capacity and urine pH
168. S. pyogenes
(Group A)
The bacteria behind post-streptococcal
glomerulonephritis
PHaryngitis can results in PHever &
glomerulonePHritis
169. Salmonella
enterica
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
170. Salmonella post
antibiotic?
prolonged fecal excretement post
antibiotic
171. Scaphoid bone Most commonly fractured carpel bone,
prone to avascular necrosis due to
retrograde blood supply
172. 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
173. Screening for CD
markers?
Immunohistochemistry
174. Septic shock high-output failure, decreased TPR,
dilated arterioles, high venous return,
hot patient
175. 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
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 self-
accelerating: as repeats grow longer, the
probability of subsequent mispairing
events increases
178. SNoW DRoP Southern = DNA
Northern = RNA
Western = Protein
179. Southwestern
blot
Identifies DNA-binding proteins
180. Stain Drug
effects
Upregulates LDL receptors
181. Staph -toxin The major cytotoxic agent released by
bacterium Staphylococcus aureus and the
first identified member of the pore forming
beta-barrel toxin family
182. Staphylococcus
aureus
-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.
Other
-Protein A, an IgG-binding protein, binds
to the Fc region of an antibody
183. Statin MOA
(upregulate
what?)
LDL receptors
184. stratified
sample
NOT random, created to ensure a more
representative sample of the population at
large (ADHD more likely in boys than
girls, therefore assigned differently)
185. 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. Superficial
inguinal
lymph nodes
Anal canal (below pectenate line)
Scrotum
Thighs
Ends up in these lymph nodes
187. suprasellar
mass,
hormone
excess?
prolactin
188. 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. Temporal lobe
lesion
Upper quadrantic anopia
190. 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
192. 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)
195. Type II error Stating there is not an effect when
there is one
196. Ubiquitin Tags proteins for destruction by
proteosome
197. ubiquitin tagged
proteins go where?
proteosome for degradation
198. Ureteric orifice Placed at the postero-lateral
angles of the trigonum vesicae,
and are usually slit-like in form
199. Uroporphyrinogen
decarboxylase
Porphyria cutanea tarda
Accumulates:
Uroporphyrin (tea colored urine)
Blistering cutaneous
photosensitivity. Most common
porphyria.
200. Valproic acid A wide spectrum seizure
medication
-1st line for tonic-clonic
Not for status epilepticus
201. Valproic Acid MOA inhibits HISTONE ACETYLASE -
Histones were in DNA -
transcription error
202. Vitamin C Required fro the hydroxylation of
specific purine and lysine residues
-If deficient, will cause scurvy
--Inadequate hydroxylation of
collagen peptides
203. Washed packed RBCs 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
204. Wernicke's
aphasia
Fluent aphasia with impaired
comprehension.
Wernicke's area-superior temporal gyrus of
temporal lobe.
Wordy, but makes no sense
205. Whole blood 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
206. Why deoxyHB
can carry CO2
better than
OxyHB?
DeoxyHB = better buffer
207. 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)
3. Remodeling (1 week after wound)
-Fibroblasts
-Type III collagen replaced by type I
collagen
208. Zanamavir
MOA
Zanamivir MOA - inhibit virion release
209. zanamivir,
oseltamivir
MOA
inhibits virion release
210. -ALA
dehydratase
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
211. -ALA
synthase
Sideroblastic anemia