Comlex Stuff 2015

ruhland2's version from 2015-06-21 20:27

Section 1

Question Answer
lung cancer lzcoin
eval lung cxcxr, fine needle aspiration, sputum cytology
lung cx complicationsdn recurr laryn nerve, SVC synd, paraneop (ie. pancoast)
up PTH labsup ca dn po4 (always when trying to increase ca)
female non smokeradenocx
adenocx is of what cellclaracell (T2 pnemo)
clara cell rolemucin, surfactant
adeno cx Prx(presentation)periph lz, ~pneumonia sx
adeno cx cxr and sputumconsolidation and copius
cx growth along wallsbronchioalveolar cx
up Lambert EatonSm cell cx
up ACTHSm Cell Cx
up ADHSm Cell Cx
Histo small dark cellKulchitsky cell (Small Cell Cx)
large cell cxanaplastic, gynecomastia and galatorrhea
mesotheliomapsammomas bodies, long slender microvilli, tono filament
gold dx mesotheliomae- micro
lung meta frombreast, colon, kidney

Section 2

Question Answer
C7 exitb/t C6-C7 (C1-C7 exit above corresponding vert)
C8 exitb/t C8-T1 (rest below corresponding vert)
Dura AttForamen Magnum, C2/3, S2
Spinal cord endsL1-L2
N damage of cauda equinasaddle distb (S2-S5)
Dorsal column subdivisions (2)Fasiculus cunnetus/gracilis
Fasic cunneatusDorsal Column Upper body/ UE
Fasic GracilisDorsal Column Lower body/LE (medial to cuneatus)
Dorsal column decussmedulla
Dorsal column synpase brainVPL thalmus
sensory cortex of thalmusVentral Posterior Lateral Nuc (VPL)
Spinothalamic tract decuss at ? in spinal cordant white comissure (immediate)
Spinal neuron of thalamus synapse in ? of brainVPL
Lateral Corticospinal tract functionmotor contra limb
corticospinal pathmotor cortex-> ipsi internal capsule-> pyramid decuss->contra anterior horn
caudal medulla=pyramid
lateral hornSNS T1-L2 only

Section 3

Question Answer
dermatatits heperitiformis thinkCeliac
Celiac Rash MOAanti IgA antigliadin dep (dermatitis hepetaformis)
Prostate Cx treatmentMeta + pain=flutamide + leiprolide
dn Ca PTH calcitonin up PO4hypoparathyroidism
digeorge endocrine changeabsent PTH glands
hypomg and calcium effectdn Mg * dn adenylate cyclase * dn PTH * dn Ca
psueodohypopararenal tubules do not respond PTH (AD)
where does PTH affectrenal tubule
short + shortend 4th/5th digits + round faciespsuedohypoPTH classic
Albright hereditary Osteodystrophy akapseudohypoPTH
short 5th digit onlyTurner
Vit D3 =active vit d (calcitriol)
teriPARAtiderecombinant PTH
(-) nitroblue tetraszoliumCGD dz dx confirm
CGD bugs SEAPStaph aure E coli Asper Psuedo (catalase +)

Section 4

Question Answer
Urease Contaminated Kidneys. Now Peeing Hurts (Urease + bugs)Ureaplama, Cryptoneo, Kleb. Norcadia, Proteus, Helico
Urease rxnUrea->CO2 + ammonia
Catalase NegativeAll Strep, All anerobes
Cata PosStaph, Norcadia, Serratia marcescens, Aspergillus
Coagulase PosStaph Aure
Coagulase PosYersinia pestis
Oxidase Posall Nessiria bugs and G- Bact
Oxidase PosMost G - bact
Oxidase NegEnterobact
Early HIV bindsCCR5 on M0
Late HIV bindsCXCR5
Tat pathos of virulenceinhibits cytokines
CD 4:8 ratio AIDsearly 2:1 middle 1:1 Aids 2:1
defect BTK gene * ?dn B-cell differentiaion/maturation (down # of mature B-cells, dn Ig all classes)= Bruton Agamma
Bruton Agammagloinemia LAB pro-B/T-cellnormal
B Agamma Txgamma globin infusion monthly
B Agamma onsetat 6 mo (when maternal IgG dies off)

Section 5

Question Answer
hypogammaglob and thymic hypoplasiaSCID
def IL-2 receptor Gamma proteinSCID defect
dn IL-2/IL-4/IL-7SCID deficien
SCID enzyme defADA (adeonisne deaminase)
how does deoxyadenosine cause SCIDit is toxic to lymphocytes
SCID marks on the ragRag gene association
SCID txBM transplant only tx
dn DNA repairdefect of Ataxic Telangeictasia (dn ATM gene)
dn cerebellum up small dilated capillaries and recurrent ear/sinus/lung infAtaxic Telange presentation
Ataxic Telange Labdn IgA, IgE, elevated AFP
Selective IgA def moadef of J-chain holding IgA together to make dimers
False Postive b-HCGfinding in Selective IgA Deficiency
LYST gene defectiveCHAIN
Chediak Higashi pathophysdef secretory granule and dysfunctional microtuble * dn phagocytosis
No natural killer activityChediak Higashi

Section 6

Question Answer
Kill via O2 and non O2Macrophage
kill via induce apopCytotoxic T cell =CTL, NK cells
Macrophage activatorsTH1, IFN gamma, TNF A/B
IFN-gamma def inJob Synd
Job Synd=hyper IgE
Th1 uses cytokines to activate Macrophages to do...cause a Type 4 HSN (PPD MOA)
blocks IL-2tacrolimus,cyclosporine,daclzumab,sirolimus
daclizumab moablock IL-2
How do TH1 cells enhance CTL prolifIL-2
when is TNA A/Beta releasedduring viral inf
NK activation2 step (lack of inhibitory signal, presence of activation signal(antigen))
myeloperoxidaseH202+Cl- ->bleach
NADPH oxidaseup H202
CTL granzyme moaserine protease that activates apop
Faas Ligand MOACTL method of the induction of capsases * up Apop
NK cell, why only 1st defense immuneactivity does NOT generate memory

Section 7

Question Answer
XX (paternal only, empty egg)complete mole, most common form
XXY/XXX (2 paternal, 1 mom)partial mole (fetus parts present)
abnormally lg uterus for gest agemole
Mole txD and C and MTX
Mole compliacationChoriocarcinoma (following incomplete removal), uterine rupture
Choriocx histologyavillous cytotrophoblast and syncitotrophoblast
Chorioc Cx weird factMetatsizes hematogenously (lung mc)
causes of micronodular cirrhosismetab insult (alcohol>wilson>hemochrom)
cause of "post-nec Cirr"viral hep
why cirr up boobiesdn degrade of estrogen
why cirr up spider angiomasdn degrade of estrogen
cause of spontaneous bact peritonitiscirr complication
why cirr up encephalopathydn excretion NH3
PCKD and brain assocberry aneurysm (up SAH)

Section 8

Question Answer
kid coarctation locationb/t subclav and ligamentum A
adult coarc locationdistal ligamentum arteiosum
coarctation dxsyst BP higher in UE and lower in LE (wk pulse)
what causes ribnotchingcollateral circ through intercostals (aortic coarc)
"3" signCXR coarctation
central cyan + clubbing + cogenitalEisenmeinger synd
Eisenmeinger auscultationRV heave + hi-pitched early diastolic murmor and right sided S4 (pulm insuff * up RVH)
Eisenmeinger Prxpulm htn, RVH, reversal of left to R shunt (L->R to R->L, bypass pulm) large cardiac defect
cogen plus pulm stenToF (VSD->overridingaora->pulmsten->RVH
ToFallot synd assocsDown, cri-du-chat, Trisomy 13/18
holopreencephalophy, punched out sclap, poly dactlyTrisomy 13 (Patau)
recurrent bleed, mucosal telangeictasia (muscosal AVM)Osler Weber Rendu (hered hemmoraghic telange)
location chole->anderostenedionetheca cell (desmolase)
ezyme chole ->androedtenedionedesmolae (theca cell)
enzyme androesteindione-> estrogenaromatase (granulosa cell)
synthesized during follicular phase17B-estradiol
synthesized during Luteal phaseprogestrone (Corpus Luteum= post ovulation follicle)
LH on theca cellup Desmolase activity (up androestendione)
FSH on granulosa cellup Aromatase activity (up estrogen)
Estrogen strength17B-estradiol>estrone>estriol
estrogen action on prolactinstimulates secrection, but blocks prolactin action on breasts
female hormone on body tempprogestorone increases hypothal temp set point

Section 9

Question Answer
cycloplegia causeanti musc (ciliary paralysis dn accom)
lithium DI moaup ADH resistance in kidney
DDVP test for DIosmolarity rises >50%=DI is central, x<50% DI is nephrogenic
Schilling test how it works(oral radio B12 +intramusc B12) inj B -12 saturates B12 rec so all B12 radio will go to urine, not to body tissue
Normal Schillingat least 10% radiolabled B12 in urine (indicates that intestinal B12 is being absorbed in GI)
Pernicious Anemia SchillingX<10% radio B12 in urine (dn GI abs)
pit para pancMEN1
cataplexystrong emo rxn causes syncopse
where is cataplexy seennarcolepsy (think of those goats that pass out)
skin fibrofollicunomabirt hogg dube (tuberscler all over body + lung ~)
OSA bad complicpulm htn
crucial for sleep initiationserotonin (raphe nuclei) why those who are depressed dont sleep
etoh,benzo,barb on sleepdn REM dn delta wave sleep (NREM3)
sleep stagesB->A->theta(NREM1)->k/spindle(2)->delta(enureisi,somambu,nightterror)->beta
regulates REMdopamine (why PD has REM sleep dysf)

Section 10

Question Answer
CTGMyotonic dystrophy
CAG chr4
CFTR chr7
CGGFragile X
Friedrich ataxiaGAA
anticipation + testi atrophy +arryth + cataracts prx inmyotonic dystrophy (CTG)
def spectrinHered Spherocytosis
def ankyrin/band 3.1Hered Sphero (fragile+ mem bleb)
rbc (liver dz/ abetalipoproteinemia cell)Acanthocyte
RBC G6PD cellbite cell
RBC DIC/TTP/HUS cellschistocyte
schistocyte=helmet cell
Acantocyte=spurr cell
RBC thallesemia celltarget cell
cell of aspleniatarget cell
Target cell present inHgbC disease
HbC dzglutamic acid -> lysine ( HbB turn into HbC)
Sickle cell anemiaGlutamic acid to Valine at positon 6 (up hydrophobic)