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Kaplan 5

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zomovefa's version from 2018-03-07 21:51

Red VS White

Question Answer
Red fibers (type I)Endurance and posture-maintaining muscles
Red fibers (type I)Increased myoglobin (red color)
Red fibers (type I)Increased mitochondrial content
Red fibers (type I)Increased capacity for aerobic metabolism
White fibers (type II)Fast responses; sprinter's legs
White fibers (type II)Decreased myoglobin
White fibers (type II)Decreased mitochondrial content
White fibers (type II)Decreased capacity for aerobic metabolism
White fibers (type II)Larger diameter and more hypertrophy with strength conditioning
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Cholestrol

Question Answer
What are the Triglyceride TransportersChylomicrons, VLDL, IDL
ChylomicronMade by Apo48 of the GI tract which transports triglycerides to endothelium and liver
VLDLMade in liver and scents triglycerides to adipose for storage
IDLTransport triglycerides from adipose to everywhere else
XanthomaCholesterol
Cholesterol synthesis enzymeHMG coA reductase -> Most active at 8pm -> Late night meals more likely to form cholesterol -> Take statins in the evening -> Hence why you pay night shift ppl more because you are cutting there life span short -> American indians have the highest concentration
Most common gall stone stuck inCystic duct
Common bile duct stone cluesPancreatitis, high wbc or fever, elevated alkaline phosphatase
LDL normal<100
LDL normal in diabetics<70
LDL 100-130Diet & Exercise,2 risk factor treat
LDL >130Treat
<200 CholesterolNormal
200-240 CholestrolDiet and exercise 20-30 mins 4 times a week / Treat if male or has hypertension
>240 CholesterolTreat
Less than 40 HDLLow -> Moderate Alcohol consumption, Diet and exercise, Weight loss, Estrogen
>60 HDLHigh
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Errors

Question Answer
Physician misdiagnosed a pt due to needle stick marks and assuming it was a drug withdrawal but it was a peptic ulcer bleedingFraming effects
A pt with a burning sensation in chest incorrectly treated for reflux esophagitis instead of MI despite having proof for MIAvailability heuristic
Despite the rapid test sowing false strep throat but the pt has all the sx for strep throat delaying txBlind obedience
Despite blood work showing diabetics due to high glucose, dr assumes he just ate a big meal hence why high glucoseAnchoring Heurisitc
Error done by person actually doing the job/assignmentSharp end error Active
Error done all of the parts of the process farther away from the action itself like work environmentBlunt end Latent -> Continued use of outdated computer system
Doing something wrong -> Prescribing furosemide to sulfa allergy pt with documented sulfa allergyError of commission
Failed to do the right thing -> Not prescribing insulin to a newly diagnosed type 1 diabetesError of omission
Near miss event is whenDr prescribes opiod to a opioid allergic pt and the nurse caught the mistake and did not administer it
No harm event isA opioid allergy pt was given a opioid drug but does not cause harm
Example of unpreventable adverse eventNeuroleptic malignant syndrome due to haloperidol
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Question Answer
SepticShockTNF TUMOR NECROSIS FACTOR
ComplianceArterial contractility or elastisity of vessels -> Decreased compliance in pts with age related arteriosclerosis
Adult with progressive weakness of his legs and arms with a hx of minor weakness of these muscles since childhood. No loss of sensationPoliomyelitis -> Ventral Horns
Sickle cell in african american community is due toNatural selection -> Increases the frequency of genes that promote survival
When do you check for a pts drug to drug interaction?Dispensing time
Primary follicles VS Secondary folliclesProphase(majority) VS Metaphase
Primary preventionDecreases incidencen -> which resuls in decreased mortality
Shingles aka varicella zoster produces messenger RNATranscribing the genomic DNA
Immune complexes(Type III) deposited in the body is removed byClassical Complement pathway
Burning tingling of hands and feet angiokeratomas, corneal opacitiesFabrys
Adductors are supplied byObturator nerve providing sensoring to medial thigh
Drug half life 3 hrs and if in 6 hr how much is drug is left?25%
Drugs half lifes50% 25% 12.5%
Large fungating mass 2cm gastroesophageal mass shows glands that invade into muscular areaEsophageal adenocarcinoma -> Risk factor Barrets esophagus
CoagulativeNecrosis in kidneyPapillary Necrosis -> POSTCARDS Pyelonephritis,Obstruction of urogenital tract, sickle cell, TB, chronic liver disease, analgesic/alcohol abuse, renal transplant rejection, diabetes mellitus, systemic vasculitis
Failure of Glucose administration to supress GH secretionAcromegaly
Macrolides areInducers - erythromycin & clarithomycin EXCEPT for Azithromycin
Colcheine MoaInhibits microtubules -> Leukocyte migration and pahgocytosis -> reduced inflammation
Family physician orders stnadard laboratory tests and schedules her a follow up evaluation with dieticianMedcare B plan
Acute Cholecystits inflmmation or ruptureAnerobes tx Cefotaxime+metrondiazole
Acinar cellsAmylase & lipase
Alpha cellsGlucagon
Beta cellsInsulin
Delta cellsSomatostatin
Guilian barre syndrome is similiar toAutoimmune condition such as Multiple sclerosis
Stable angina complicationLoss of myocytes with fibrosis in the sub endocardium
Addisons diseaseExtracellular volume down, Intracellular volume Increase, Intracellular and extracellular osmolarity decreases
Helium dilution technique measureRV or FRC
Amylodosis causesNephrotic syndrome Protenuria
Defective signaling between activated CD4+ T cells and B lymphocytesHyper IgM syndrome -> Cd40 Ligand issue
Ventilation defect without perfusion defectPulmonary edema or Pneumonia
Cyanide aka nitrite poisoning normal valuePartial pressure of oxygen in the arterial blood
Ureter stone stuck in the ureter causesNormal RBP, DECREASE GFR & FF
Teen found unconscious at house and then when IV tx is given the pt regains consciousness and wants to go home right awayOpioid overdose treated with Naloxone for MU receptor
Slow growing with fluctuating lymph node size isFollicular lymphoma -> Non-hodgkin lymphoma
Conditions that cause pure red aplasia AKA Aplastic crisesThymoma, Parvo B19 or Leukemias
Diffuse B cell lymphomadeadly non-hodgkin lymphoma -> grows rapidly
Uterus, bone, heartGap Junctions
MAture RBC unable to produce heme due to lack ofMitochondria -> heme synthesis occurs here
CryoglobulinemiaSmall to medium vessel vasculitis caused bu circulating immunoglobulin complement complexes -> seen in Hep C, SLE -> Present as cutaneous vasculitis
What is the two differences in the lagging strand?Okazaki fragments & Ligase
What causes the itching and swelling of a bee sting poison melittinHistamine
What causes phagocytic cell to enter the area of infectionLFA-1 & ICAM-1
Spherical quadrinucleate thin walled cysts causing bloody diarrheaEntamoeba histolytica
Oval or elliptical cysts that are thick walled causing non bloody diarrheaGiardia Lambia
Almond shaped asymmetrical parasiteIsospora Belli
Obese non smoker pt with respiratory distress, basilar atelectasis with minimal symmetric diaphragmatic elevation(NOT breathing-Hypoventilation), elevated d dimers, restrictive lung disease patternObesity Hypoventilation syndrome
Brain tumor with Round nuclei with clear cytoplasm (Fried egg appearance)Oligodendroglioma
Protein/Serum > 0.5Exudate -> Neutrophil rich -> Bacterial causes, Neoplasm,Chronic Inflammation
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Protein/Serum < 0.5 : Transudate -> less protein -> Nephrotic, Liver cirrhosis, CHF, Protein losing enteropathy
Question Answer
LDH significant marker forInflammation or Infection
Lichen Sclerosis VS Vulvular squamous cell carcinoma
Pt with white patch on her vulva with squamous epithelial lesion with well differentiated cells at the dermal epidermal junction is disrupted by squamous cell groups extending deep into the dermisVulvar squamous cell carcinoma
Aspirin Induced asthma attack is due toInhibition of Cyclooxygenase pathway leading to decreased prostaglandin bronchodilators to leukotriene constrictors
Headache, abdominal pain, fever, swelling of arm and wrist with blanching rash with macules after one week camping in the mountainsRocky mountain fever -> Rickettsia rickettsii -> g- intracellular bacteria that infect endothelial cells causing vasculitis
Limit drop in Preload during hemorrhage byConstricting veins & venules
Axonal transport that causes latency of HSV?Retrograde Dynein
Enlarged gastric rugal foldsMenetrier's disease -> Mucosal cell hyperplasia
Helium dilution technique measuresRV & FRC(ERV & RV)
RA synovial biopsyProliferative synovitis lymphocytes, plasma cells & macrophage
Blood agar grows h.influenza with the help of what bacteria?S.Aureus
Cirrhotic liver biopsyFibrosis and disorganization of hepatic parenchyma
Neuroectodermal small round blue cell tumor with onion skinning in the boneEwing Sarcoma 11-22
Supplemental oxygen does what?INCREASE PAO2y Alveoli oxygen, PaO2 Arterial oxygen / NORMAL lung diffusing capacity
White matter of spinal cordOligodendrocytes
Dark matter of spinal cordSchwann cells
Lethargy & sign of edema in a starving patientAcetoacetic acid OR 3-hydroxybutrate aka KETONES
Chorioretinitis, Hydrocephalus, Intracranial calcification in 1 week old?Congenital Toxoplasmosis -> Tx Pyrimethamine and Sulfadiazine -> Inhibit folic acid production
Abdominal mass that does not cross the midlineWilms tumor -> Nephroblastoma -> Embryonic glomerulus structure
Primitive cells with neuropilNeuroblastoma -> Crosses midline
Southeast asian with brown stone in biliary tree due to infectionClonorchis Sinensis -> SNAILS -> FISH -> HUMAN LIVER
Fluke in the lungParagonimus Westermani
Peaked T waves, Increased QRS with no p waveHyperkalemia
Neck mass due to radiation exposure, laminated concentric calcified spherules(PSAMMOMA)Papillary carcinoma
7yr old from south america(most likely not vaccinated), seizures, ataxia, neurological deterioration, spasms, quadrplegic, went into coma within a yearRubeola -> Late complication Subacute sclerosing panencephalitis
Pt with sore throat, pharyngeal erythema, tonsillar abscess, culture g+ cocci in sheep blood agar which has complete zone of hemolysis, grows well or turns yellow on salt mannitol agar, PYR- S.Aureus
Pt with Psoriasis plaques can also present with Psoriatic arthritis which is similar toRheumatoid arthritis
Infant experiences seizures, hypoglycemia, hypoketonemia, cardiomegaly, lab shows elevated carnitine esterase in both muscle and serumLong-chain acyl CoA dehydrogenase deficiency
Lack of ketones can causeCardiomegaly and weakness because both use ketones
Horner syndrome (PTOSIS, MIOSIS, ANHYDROUS)Bronchogenic carcinoma aka pancoast tumor
Pupillary reflex of eyeCN II afferent & CN III efferent
Afferent corneal blink reflexCN V Trigeminal
Efferent corneal blink reflexCN VII Facial
Headache worsens during valsalva in young obese women with bilateral papilledema with vision loss during bending forward (valsava)Pseudotumor cerebri -> ICP compresses optic nerve causing impaired axoplasmic flow and optic disc edema
Tinnitus, vertigo, hearing loss on one side that comes and goes from time to timeMeniere's disease
Vertigo with position changeBenign Paroxysmal Positional vertigo
Cupping of optic diskGlaucoma -> Increased intraocular pressure
Lecithinase -> Phospholipase C toxinC.perfringens -> Phospholipid splitting AKA gas gangrene
alpha helical proteins -> think ofAnchoring to the cell membrane
PPV & NPV is always affected inPopulation prevelances
Sensitivity, Specificity are NOT affected byPopulation prevelances
High amounts of dihydrouridine, pseudouridine, ribothymidine -> think oftRNA -> 3END CCA
Insulin is anabolic hormone working through -> Tyrosine kinase activates glycogen synthesis throughProtein Phosphatase
Kras active(MALIGNANT) vs inactive when bound toGTP vs GDP
What is essential to make diagnosis of TTP?Hemolytic Anemia & thrombocytopenia
Non- pathogenic strains gain pathogenicity through host -> Phage conversion permitting exotoxin productionC. Diphtheriae
Bacteriophage infects host bacterium and integrates its genome into the host bacterium genomeLysogeny
Oral glucose increase Insulin throughGlucagon like peptide-1
Granule containing and crystalloid massesCharcot Leyden crystals -> Asthma
MCC of aseptic meningitis(less severe form)Enteroviruses (coxsackievirus, echovirus, poliovirus)
Baby with High fever, seizures for 3-5 days followed by a maculopapular rash on the trunkHHV 6 Roseola
No shoulder pain with puffy faceMediastinal mass Cancer in smoker
Shoulder pain with horner syndrome Pancoast tumor
Translocation of oncogenesBurkitt lymphoma, follicular lymphoma
Insertional mutagenesisHuman immunodeficiency virus (HIV)
Viral oncogenesoncogenic retroviruses
Tumor suppressor gene inactivationhepatitis B virus (HBV) and human papillomavirus (HPV)
Integration of viral DNA into chromosomesHIV and many DNA viruses (HPV)
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Incidence vs Prevalence

CauseIncidenceMortality
Primary prevention leads toDecreased incidenceDecrease in mortality
New TreatmentNDecrease
New vaccineDecrease Decrease
Increased death from diseaseNDecrease
Decreased risk factorsDecreasedecrease
Increased recoveryNDecreased
Increased survivalNIncreased
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Face muscles

Question Answer Column 3
BuccinatorFacial nerveHolds food against the teeth while chewing
Masseter and temporalisTrigeminal mandibularElevation of mandible
PalatoglossisVagusDraw tongue and soft palate together during swallowing
PalatopharyngeusVagusElevates pharynx during swallowing
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Pharmokiniteics

Question Answer
Taking acid drug with food will causeLess absorption
If you want an acid drug to absorb then give it withEmpty stomach
If you want a base drug to absorb then give it withFood
Base drugNeutral, Fat soluble, Crosses membrane, Affects the liver p450, not to use in babies or elderly or liver cirrhosis
Acid drugCharged, Water soluble, Does not cross membrane, Affects kidney GFR, not used in diabetic, nephropathy
Base overdoseGive acid
Acid overdoseGive base
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