Kaplan 4

zomovefa's version from 2017-11-12 15:25


Question Answer
What is responsible of supplying blood to the lower extremities in Coarctation of AortaInternal thoracic (mammary) arteries
Only heart amylodosisTransthyretin
TPR(mean arterial pressure - right atrial pressure)/cardiac output
Small tumor in the wall of the right lateral ventricle -> shows numerous large ganglioid cells with prominent nucleiAstrocytoma -> Pathognominic for Tuberus sclerosis
Sperm developmentSpermatogonia(2N) -> Primary Spermatocytes(4N) -> Secondary Spermatocytes (2N) -> Spermatids (1N) -> Spermatozoa(1N)
MS in right eyeNo reflex in both and right when light shined on right eye / Reflex in both left & right when light is shined on left eye
Anemia -> HypoxiaVessel dilate -> Increase diameter -> Decrease resistance -> Decreased viscosity/tissue oxygen tension/splanchnic blood flow(GI)
Reassortment through segmentationShift -> Pandemics
Genetic driftMinor antigenic change -> Yearly vaccination
Generation of H202NADPH oxidase deficiency
All DNA viruses replicate in nucleus except forPoxvirus
All RNA viruses replicate in cytoplasm except forOrthomyxoviruses & Retroviruses
Transmissible spongiform encephalopathies (CJD)Steam at 132 degrees for 30 minutes
During pregnancy total serum thyroxine(t4) but normal TSHPregnancy -> Increase estrogen -> Increase thyroid-binding globulin
Schüffner's dots (the red granules) on enlarged erythrocytesMalerial infection
Pneumonia causesInequalities of ventilation and perfusion
Alar plate during ebryogenesis is related toSensory -> eg dorsal coulmn
Basal plate during embryogenesis is related toMotor -> eg ventral part of the cord or anterior horn cells
Nephrogenic vs Neurogenic DIABETIC INSIPIDUSADH High due to kidney failure VS ADH low -> BOTH HAVE HIGH SODIUM
Psychogenic polydipsiaLow Sodium -> diluting effect, NORMAL ADH -> usually in shizophrenia pts
Hives -> Type 1 hypersensitivityDegranulation and secretion of performed and newly formed mediators
Pt presenting with esophagitis immunocompromised with a positive MRI for ring enhancing lesionsToxoplasmosis Gondii Contaminated undercooked food
Diaphragmatic Hernia complication due to failure of pleuroperitoneal membrane to developPulmonary hypoplasia
PAS is also calledHyaline in Diabetic nephropathy
Tetralogy of fallot seen in what neonatesDigeorge
Transposition of arteries seen in what neonates?Diabetic mothers
Mitral valve prolapse seen in what neonates?Fragile X
Bone pain, Bone deformity, neurologic impingement, Increase HAT & SHOW sizePagets disease -> Osteoclastic+Osteoblastic
Microscopic examination may shows spongiosus (increased spacing of epidermal cells due to intercellular edema)Atopic Dermatits
Complete Androgen InsensitivityNormal male genotype BUT female phenotype, short vagina with no uterus or ovaries or cervix, BUT has undescended testes
DesensitizationReduces allergic responses -> Switching from Th2 to the Th1 increases IgG and decreases IgE
PNMT deleted causesHigh norepinephrine but Low Epinephrine
Varricela Zoster reactivation in a young person is usually due toHIV
Shigella causesBloody diarrhea with pus & mucus
Incident reportsVoluntary reporting -> Identify BOTH Latent & Active safety problems
Excess amino acid secretion in urine due to defective epithelial transport of neutral amino acidsHartnup Disease
small vascular neoplasms arising from retinal capillaries during ophthalmic examination Retinal hemangioblastomas with high hemoglobinVHL
NF 1CAFE-SPOT -> Café-au-lait macules, Axillary Freckling, Eye lesions (Lisch nodules of the iris), Scoliosis, Pheochromocytoma, Optic Tumors (gliomas)
Orhtostatic hypotension due to lack of fluidsIncrease HR, CONTRACTILITY, Vascular resistance, Venoconstriction
Cystic fibrosisATP-dependent chloride channel
Anion gap[Na+] – ([HCO3– + [Cl–]) normal range (3 to 12 mEq/L)
Erythematous, itchy, ulcerating lesion of her left nipple associated with an oozing, serosanguinous nipple dischargePaget's disease of breast -> DCIS
Important way to fight encapsulated organisms are throughIgG mediated opsonization since encapsulated organism are hard to kill due to polysaccharide capsule
Abscess if it invades common bile ductAscaris Lumbricoides
Most common healthcare infection75% UTI -> Urinary catheter induced -> Rsk factor is prolonged use
Negative sense single stranded RNA non segmented helical enveloped virusRSV
Phosphorus VS Calcium in kidneyPCT VS Distal tubule
Milky white pleural effusion in a pt with SOB & fatigueLymphoma -> Chylous effusions
threshold potential think ofDepolarization -> Voltage gated Na channels open between -62 - -70
Institutional review boardProtect safety, rights and general welfare of humans involved in a research study
Hemorrhage causesDecrease vagal nerve activity , Increase systemic vascular resistant but decreased Mean arterial pressure -> Stimulates epinephrine release - decreased renal perfusion leads to RAAS activation, Increase HR, Myocardial ionotropy,
Negative enveloped single stranded RNA virusRSV Infant with runny nose,cough fever, inspiratory and expiratory wheezes with central cyanosis
Viruses that undergo genetic shiftInfluenza, ROBA - Rota,orthomyxo,bunya,arena
50 yr old sees a dog picture but cannot recognize it is a dog is calledVisual agnosia temporo occipital cortex
What DNA virus replicates in the cytoplasm?POX virus
CFTR pick alwaysDeletion instead of frameshift
MS Acute plaqueLymphocytic Infiltration of myelin byproduct digestion
MS Older plaqueHyperplasia & hypertrophy of astrocytes transform -> Gliosis
Orchitis, ParotitisMumps -> paraMyxoviridae
Sublingual gladMucin
Parotid glandSerous
Submandibular glandMucin & serous
Sheehan syndrome causesLack of cortisol & acth due to pituitary affected & increased GnRH
Hospital Pneumonia(Klebsiella) risk factorOmeprazole or any drug decreasing acid in GI
Kimmelstiel Wilson nodulesPAS periodic acid shaff positive hyaline mass
Gastritis Type A vs Gastritis Type 2Pernicious anemia-> Low acid VS h.pylori -> High acid
Baby with hemolytic anemia, jaundice, coombs test +ABO incompatibility aka Rh incompatibility
The reasons histoplasmosis is not communicable because it isIntracellular
APACHE & SAPS scoreSeverity score predicts hospital mortality -> Based upon the worst variables during the initial 24 hrs in ICU
Rhythmic involuntary shaking of both hands, gradually worsening, especially during nervousness or when upset, tremor of upper extremity involves flexion and extension, tremor is accentuated when asked to outstretch hand and a finger to nose maneuverEssential tremor -> DOC antagonist b adrenergic receptor
SHiN organisms pickTransformation
Colon cancer anemia, what is most likely decreased?Decreased Arterial O2 content -> Reduces O2 carrying capacity of blood
Brachial plexus lateral cordMusculocutaneous & median C5-C6
Brachial plexus posterior cordAxillary & radial C6-C7-C8
Brachial plexus medial cordMedian & Ulnar C8-T1
Resting oxygen consumption formula(Arterial oxygen content - Venous oxygen content) X CO
Alveolar ventilation rate(Tidal volume - dead space) X RR
Injury to a pt as a result of medical interventionAdverse event
Vessel cross section area inversely proportion to velocityLow cross section (athersclerosis) -> High velocity (endothelial damage)
Femoral hernia ring landmarkAnterior- Inguinal ligament, Medial- Lacunar ligament, Lateral- Femoral vein, Posterior- Pubic
What weakens and strengthens the GIBile acids, histamine, NSAIDS -> Weakness mucosal barrier / Gastrin, Mucus, Misoprostoal, bicarbonate- Strengthens
Medial leminscus think ofProprioception,vibration, touch
COPD if they give you what increases in the spirometery testResidual volume
Reiters syndromeReactive arthritis usually after urogenital infection -> CANT SEE, PEE,CLIMB -> Aspiration of the joint is similar to Rheumatoid arthritis
Aortic pressure value look for the areaWhere aortic valve opens
ventricular tachycardia with varying QRS AmplitudesTorsade pointe
Cuboital are of arm injury isbicep brachi Tendon, Brachial Artery, median Nerve
EBV infectsB cells but is killed by t -lymphocytes
Normal appearing QRS complexes immediately followed by inverted p waves and RR interval of .4secWolff Parkinson white syndrome
Deep peroneal VS Common peronealBoth cause steppage gait VS Common peroneal nerve has steppage gait and sensation deficit of dorsum of foot & anterolateral aspect of knee
Pseudomonas produces something to prevent phagocytosisGlycocalyx, g- oxidase + lactose fermenter anaerobic bacilli
An outpouching in the sigmoid colon has eroded into an artery causing massive hemorrhageDiverticulosis
An outpouching in the sigmoid colon has become infected and inflamed and has rupturedDiverticulitis
Ureteral Reflux history complicationScarring of glomeruli -> lack of blood flow -> Activation of renin angiotensin -> Hypertension
Lethargy,constipation,depression, high bp, shortened qt interval, band keratopathy of eye, duodenal ulcerPrimary HYPERparathyroidism
Increased orotic acid + megaloblastic anemiaUMP synthase deficiency
Liddle syndromeHypertension, Hypokalemia, metabolic alkalosis, Low aldosterone Amiloride -> K sparring diuritic that blocks ENaC
SIADHHyponatremia, Increased extracellular and intracellular volume / Decrease extracellular and intracellular osmolarity
Parathyroid ectomy leads toLow 1-25 dihydroxyvitamin D
Treatment for Goodpasture syndromePlasma treatment to remove circulating antibodies and inflammatory mediators
Tinnitius, vertigo, hearing loss, sensation fullnessMeniere's disease Hearing loss can be permanent
Yellowish skin, bradycardi & hypoventilation, fasting hypoglycemia, hyponatremia due to lack of ability to get rid of water, hypercholestrolemiaHypothyroid Myxedema
HemochromatosisHigh Iron, Ferritin (IRON storage), Low transferttin, High Percent tranferrin saturation
S.pyogenesPencillin -> Bactericidal inhibits cell wall mucopeptide synthesis
Explain the plateau in renal gfr & RBFKidney autoregulation in glomerular vascular resistance
IV Drug pt has heart valve issue blood cultures n mannitol salt agar grow mannitol fermenting g+ cocci in clustersS.Aureus
NBT test negative -> NBT test shows no dye reductionPt has NADPH oxidase deficiency +
Cryptsporidum parvum is spreadthrough water source because it is resistant to chlorine treated water
Abduct thigh at hipSuperior Nerve injury -> Medius & Minimus
Anemia heart valuesCardiac Output Increased, Arterial PO2 Normal, Mixed venous Po2 decreased, 2,3 Diphophospho-glycerate Increased
Pleura plaques always pickMeothelioma
Persistent tender, reddish purple nodules in both armpits with discharging pusHidraadenitis supprative Lithium tends to cause this
Narcolepsy key isHypnagogic -> hallucination while falling asleep
Poultry working pt presenting with 3-day history of severe headache, dry cough, fever, high fever, diffuse rales scattered infiltrate with elevated liver enzymesC.Psittacosis -> Tetracycline Psitachio comes frombirdpoop
Achlasia VS GERDSwallowing problems VS NO swallowing problems
Ryanodine receptor mutation leadsMalignant hyperthermia(SUCCINYLCHOLINE, HALOTHANE,ISOFLURANE) -> tx with Dantrolene which blocks ryanodine receptors to release calcium from SR
Bone Marrow transplant containMultipotent stem cells
Abrupt stopping of chronic steroid use leads toSecondary adrenal insuficency -> Hypotension, hypoglycemia, hyponatremia, hyperkalemia
Multiple myelomaAL protein
In-frame mutation of X linked geneTurner syndrome also Duchenne muscular dystrophy
Secondary amyloidosis (RA, osteomyelitis, heroin & TB)AA protein -> Inflammation
White-gray matter junction tumor in brain, ring enhancing patternMetastasis brain tumor
Left side of the body and both lower extremity drains intoThoracic duct -> Damage to thoracic duct leads -> High triglyceride levels seen in blood
Thyroid is important inthe ability to heal, recover from serious infections -> elderly people may deteriorate faster to any disease if they are asymptomatically hypothyroid
Brucella abortus VS Brucella melitensisCattle VS Goat
A fib treatmentAmiodarone treat a fib aka supraventricular tachycardia -> Warfarin is given to prevent clots from A fib -> Amiodarone is inhibitor meaning warfarin levels increase causing GI bleeding, hematuria, easy bruising
ETEC is most similar toVibrio cholera
Anemia lab valuesArterial pO2(Breathing air oxygen) Normal , Arterial O2 saturation Normal, Venous pO2 & Arterial O2 content Decrease
Dwarf kids haveDecrease GH, IGF-1 -> Somatostatin

Skin biopsy

Question Answer
Accumulation of fluid within epidermisEzematous Dermatitis Spongiosis
Granular complement and IgG at the dermal/epidermal junctionSLE
Intradermal edema and superficial lymphaticsHives or urticaria
Microscopic blisters in dermal pappilaeDermatitis Herpetitformis
Microabscesses in the stratum corneumImpetigo, fungal infections, Impetigo
Nuclear atypia of basal keratinocytesActinic keratosis
Keratin filled cystsSeborrheic keratoses

Bones biopsy

Question Answer
Radiodense bony spike covered with a radiolucent cap of cartilageOsteochondroma
Small radiolucent zone surrounded by a larger sclerotic zoneOsteoid osteoma
Cyst in epiphysis with stippled calcificationachondroblastoma
Eccentric sharply cicrumcised lytic lesion near the end of a long boneChondromyxofibroma
Lytic area in the bone marrow with areas of stippled calcificationEnchondroma

Blood diseases

Question Answer
Idiopathic thrombocytopenic purpuradecreased platelets and normal red cells
Hemolytic uremic syndromedecreased platelets and presence of fragmented red cells
Microangiopathic hemolytic anemiapresence of fragmented red cells. Platelet levels may be low, but may vary depending upon the severity of platelet consumption and bone marrow response.
Thrombotic thrombocytopenic purpuradecreased platelets and presence of fragmented red cells
Thrombasthenia and von Willebrand diseasenormal platelet numbers with decreased platelet function; normal red cells