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Kaplan 6

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zomovefa's version from 2018-02-02 01:18

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Question Answer
PhosphatidylserineMarker for apoptosis by caspases
PhosphatidylcholineSurfactant
Urea cycle90% liver, 10% Kidney(BUN- Checks efferent flow)
Citrulline which is marker for Rheumatoid arthritis is made fromUrea cycle
Urea cycle defectHigh ammonia(Early enzymes), Serum ph High, Pyrimidine in urine( pick late enzymes)
Liver failure managementDecrease dietary protein, Neomycin to clean out urease producing bugs, 3. Lactulose flush out ammonia out of GI -> pulls more ammonia out of brain
Liver failure contraindicationFat soluble drugs, P-450 dependent drugs, Benzodiazepines, Barbs, Drugs that enhance GABA, Alcohol
Kid with S Pyogenes infection, fever and skin rash virulence factor is due toPyrogenic exotoxin A-C
S.pyogenes anti-phagocytic surface proteinM Protein
Immune system cannot recognize S.Pyogenes infection due what virulence factorHyaluronic acid capsule
Keloid VS Wound contractureFibroblast VS Myofibroblast
Necrotizing vasculitis of small and medium vessels except lungs is due to PAN and has a high risk forHepatitis B
Extracellular spirochetesLyme disease & Neurosyphilis
Enlarged oligodendrocytes nuclei with glassy amorphic virlal inclusionsPML
Microglial nodules containing multinucleated giant cellsHIV Encephalitis
Ribbon Non septate like hyphae branching at 90 degreesMucor
Septate hyphae branching at 45 degreesAspergillosis
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Familial adenomatous polyposis colon cancer chromosome?5q21
Wilms tumors11p13
Retinoblastoma13q14
NF222q12
p53 -> LiFraumeni17p13
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blastic+lytic bone lesionsBreast metastasis
blastic bone lesionsProstate metastasis
Lytic bone lesionsLung, renal, thyroid metastasis
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Black box warning of a drug isPHASE IV after the drug is in the market
Squamous vs Smooth cells of the esophagusTop(squamous cell carcinoma) VS Bottom
Chiar I vs Chiari IIMild/No meningomyelocele VS Worse/Meningomyelocele/Hydrocephalus/Syrinomelia
Polycythemia vera with high EPO levels think of secondaryAny paraneoplastic cancer
Primary polycythemia from other causesLow EPO
Pyruvate Kinase VS G6PD BOTH hemolyticAutosomal recessive VS X linked recessive
S3 heart sound in a iv drug abuserTricuspid regurgitation -> Right ventricular overload
Alpha 1 antitrypsin can causeEmphysema -> COPD
Double Stranded DNA virus envelopedHerpesviridae -> CMV
Cortisol effect on liverIncreased Transcription of glucogenic enzyme genes
Gestational diabetic babies will haveTransposition of great arteries
Aortic stenosis causesIncrease left ventricular pressure and increased left ventricular work / Increased oxygen consumption -> Decreased Cardiac Tissue oxygen concentration / Increased adenosine in cardiac tissue
Pregnant women presenting with carpal tunnel is due to Flexor retinaculum
Acute gastritis are usually due toStress, toxin, uremia, curling ulcers, cushing ulcer, smoking, trauma
Type A gastritisAutoimmune Pernicious anemia
Type B gastritisHy.Pylori
Ovary biopsy shows large cells with single layer of flat epithelial cellsProphase stage of the 1st meiotic division
Smooth part of the right atriumSinus venosus
Sunburst appearance in bones seen inOsteosarcoma & Pagets disease of bone
ST segment depressionSubendocardial infarction
ST segment elevationTransmural infarction
Drug overdose -> hypoventilation ->Respiratory acidosis
Most women (babies,girls, premenopausal women) eggs are arrested inProphase of the First meiotic divison
Sickle cell renal complication isRenal papillary Necrosis -> Sickling in the vasa recta
Hepatoduodenal ligament is damaged by removal of lesser omentumLigament contains -> Common bile duct, Proper hepatic artery, Portal vein
Medical residents get there stipend or salary fromFederal government
Type II sensitivity is 2 kinds 1) Cell mediated -> Autoimmune hemolytic anemia 2) Non-cell mediated -> Graves, Mysthenia Gravis
T cell mediated activation of macrophagesType IV hypersensitivity -> Intracellular organism -> TB, Listeria
Type III sensitivityImmune complex -> SLE, RA, PSGN
Increased Systolic & Low diastolic meansSubtracting and anything more than 30-50 is widened pulse pressure Aortic Regurgitation
Muscle weakness, difficulty speaking, swallowing, and palpitations with mydriasisBotulinum toxin
Breast pruritus, crusting and erythema of the mipple biopsy shows scattered individual atypical large cell with clear cytoplasm in the epithelium that are positive for mucin stain & cytokeratinAdenocarcinoma -> Pagets disease
Female with vagina but no uterus or fallopian tubes missingAndrogen insensitivity -> Can have tests in the inguinal canal
Adrenal cortex hyperplasiaCause virilization of female genitalia -> Enlarged clitoris
Pt with HIV or immunocompromised with meningitis infection thinkCryptococcus neoformans -> Monomorphic yeast
When CD 4 less than 200 its means immunocompromised and the only antibody isotype available isIgM -> Humoral component
Glucose oral vs IVOral produces more insulin because Ingested glucose increases duodenal secretion of GIP which stimulates insulin release
Sickle cell more common african americans due toNatural selection
MCC of bronchitis in smokers areH.influenza, Legionella, Moraxella Catarrhalis
Medicare DRGHospitals will limit the amount of money that the federal gov will pay each case by certain factors
Nose ligation due to bleedingSphenopalatine artery -> Maxillary Artery -> External cAROTID
Left Virchow nodeLEFT Supraclavicular node due to stomach cancer metastasis
Right Virchow nodeRIGHT Supraclavicular node due to Lung, breast, neck, medistanial cancer metastasis
Intracellular intracytoplasmic inclusions CHlamydiaeReticulate bodies
Resting oxygen consumption formula useFick principle -> CO(Arterial oxygen content - Venous oxygen content) -> 6L/min(97mL - 47L) -> 300mL O2/min
Half life formula(0.7 x Vd) / Cl
Sulfur containing amino acid diseaseHomocystinuria -> Accumulation of homocysteine
What enzyme is responsible for excessive vasoconstriction leading to anaerobic metabolism(Ischemia)Glycolysis -> Phosphofructokinase 1
ADH only retainsFREE WATER -> No Na causing sx HYPOnatremia
Volume depleted pt due to thiazide causeHyponatremia due to excessive ADH secretion
Testes secretes what kind of testosterone into blood?Testosterone bound to sex hormone binding globulin
Inhibin inhibitsFSH
Lacunar stroke (dysarthria, inability to move left arm and leg, difficulty to speak, hyperreflexia, +babunski, left facial weakness sparing forehead)Right Internal capsule -> Lenticulostriate arteries
Right Internal capsule -> Lacunar strokeLenticulostriate arteries Left sided hemiplegia, left babinski sign, left lower facial paralysis
C6 damageLong thoracic nerve -> Winged scapula
C.diptheriaIt Contains prophage DNA
Tumor cells exhibit follicle like structures(Call-Exner), stain positive for inhibin, yellow ovarian mass that causes precocious puberty in prepubertal girlsGranulosa cell tumors -> Endometrial hyperplasia
DNROnly cardiopulmonary stoppage can lead to no resuscitation
60yr old Abnormal curvature of lumbar and femur, back pain, fatigue, L4-L5 warm to touch with increased ALPPagets disease of the bone -> Increase shoe & Hat size
Poorly cooked pork in USA causesToxoplasma gondii -> Bright signal peripherally with a dark core (Ring enhancing lesion)
Whorling pattern on spindle shaped smooth muscle cellsLeiomyomas(Fibroids) Benign most common tumor in women reproductive tract
Somatostatins & Prostaglandin E2inhibits HCL
Gastrin, ACH, Histamineproduces HCL
Long term complication of constipation isVolvulus affecting Sigmoid colon due to poor support
Renal blood flow autoregulation "constant" is done byConstriction of Afferent arteriole
Metabolic acidosis with respiratory compensationLow ph, Low HCO3 ALSO LOW PCO2
Dipstick + for blood and red urine but NO RBC cells in microscopy is due toMyoglobinuria due to -> Medications, Crush injury, malignant hyperthermia, repetitive seizure
Glomerulosa of the adrenal cortex is not controlled byACTH
ANGIOTENSIN II & K controls what layers of the adrenal cortexGlomerulosa
ACTH controls what layers of the adrenal cortexFasciculata and reticularis
Causes of cerebral aqueduct stenosis (dilation of lateral & third ventricles) arePinealoma & Arnold-Chiari malformation
Addison's disease is also calledPrimary adrenocortical insufficiency -> LOW aldosterone
Primary adrenocortical insufficiency VS Secondary adrenocortical insufficiencyPigmentation & High ACTH VS NO Pigmentation & Low ACTH
Subacute lymphocytic thyroiditis VS Subacute Granulomatous thyroiditisHashimoto thyroiditis VS Dequerian thyroiditis
Cancer due to tumor suppressor gene isDeletion or loss of function APC or p53
Proto oncogenes causing cancer is due toGene amplification or Gain of function K-Ras
Gangrenous small intestine segment with dark red to brown edematous appearance, lesions ends abruptly on the distal and proximal edgesIschemic bowel disease
Hodgkin VS Non-HodgkinYoung(Mild) VS Elderly(deadly)
Scattered large cells with prominent nucleoli which are surrounded by clear spaceReed sternberg -> Hodgkin lymphoma
Linear deposits of IgGGoodpasture Kidney -> RPGN
Mesangial IgA depositsBerger disease aka IgA nephropathy
Blastocyst stage split 4-8 days after conceptionMonozygotic twins
Vomiting pt with a history of alcohol abuse completely passed out with low bpAcute hemorrhagic pancreatitis
How to effectively execute a action plan?Make sure to come up with strategies to measure the effectiveness
Protein responsible for relieving TpA actionFibrin
Protein responsible for targeting by TpA actionPlasminogen
P2Y12 inhibitors adenosine di-phosphate receptor MOAPrevents formation of new clots formation
Median nerve supplyDorsal surface of thumb, index finger & middle finger NAIL BEDS & Ventral surface of those 3 fingers
Cleido cranial dystoniaMessed Up face, skull, teeth abnormalities and clavicle
DTP vaccination boostersArtificial active
Natural passive immunityMother passes it to children
Reverse respiratory depression by fentanyl, propfolol, midazolamNaloxone & Flumazenil only because propofol redistributes to the body
Broca area called -> broken speech and frustratedInferior frontal gyrus
Wernicke area calledSuperior temporal gyrus
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Question Answer
Amyloid only in heartAA
Amyloid in older peopleAF
Amyloid in multiple organs for example multiple myeloma or cancerA light chain
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arteries the arise at T12?Celiac that is of mesoderm origin
Digeorge pts can haveType IV hypersensitivity due to lack of T cell used for delayed immunity aka cell mediated
Fluid or embolus is in the lungsV/q Mismatch
Exercise muscle levelsATP & Creatinine & Myoglobin oxygen decreased
Biceps femoris tendon rupture affects inferolateral nerve to popliteal fossaCommon Fibular nerve
Drug sx hepatotoxicity, pancreatitis, thrombocytopenia, alopecia, teratogenValporic acid
SIADHHYPONATREMIA due to peeing out sodium, Increased ANP, NORMAL body volume
Negative-sense, single stranded RNA, non segmented helical enveloped virusRSV
During skeletal muscle contractionDecreased blood flow with increased vascular resistance
NOT During skeletal muscle contraction INSTEADBlood flow increases due to vasodilation of arterioles
Nephritic condition after gastroenteritis with normal C3 levelsBerger disease ->IgA nephropathy -> Mesangial IgA deposits
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Charcot-Marie-Tooth disease commonly affectsDeep fibular nerve FOOT Drop only
Foot drop onlyDeep fibular(peroneal) nerve
Foot eversion onlySuperficial peroneal nerve
Foot drop (weakness in dorsiflexion) + Foot eversionCommon Peroneal
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Incident reports do what?Identifies both active and latent problems -> Protects both staff member & pts
Gastric band mealsEat smaller more frequent meals that are low in simple carbohydrates
Needle stick injury usuallyDuring process of using the needle on a patient
Chlamydia trachomatisIodine staining intraepithelial inclusion bodies
Sever anemia can causeReflex Vasodilation -> Decreased tissue oxygen tension -> Decreased systemic resistance
Catecholamines made from what amino acid?Tyrosine
Hyper ventilating pt labsArterial pH & Cerebral resistance INCREASED / Arterial PCO2 & Cerebral blood flow DECREASED
Pearly papules (BIG PIMPLE) with central ulceration and telangiectasiasBasal cell carcinoma of the skin on face Palisading nuclei periphery
Accumulation of fluid in the heart is betweenEpicardium & Parietal pericardium
South american pt with Red granules in enlarged young erythrocytes with a history of psoriasisMalaria tx- Proguanil+Atovaquone due to psoriasis / Chloroquine is associated with -> Used for malaria but causes reactivation of psoriasis & retinopathy
Left recurrent laryngeal nerve passes in betweenTrachea & Descending aorta (d)
Whorls of smooth muscle cells arranged in bundles, causing anemia abnormal bleeding in premenopausal womenLeiomyoma
Chronic COPD Pt complaining of altered mental status and confusion due toHypercapnia - Increase PCO2
Thumb print sign in on xray -> Epiglottitis -> Haemophilus Influenza B (HiB)HiB vaccine Toxoid+Polyribitolphosphate -> Attached to protein carrier diphtheria toxoid -> T-cell dependent vaccine and stimulating B cells to undergo isotype switching
2 gamma (Heavy-chain) + 2 kappa or lamda(Light-chain)Multiple Myeloma
Aortic regurg leadsBlood regurg through aorta -> Increase Preload -> LV hypertrophy/Ventricular dilation -> Increase ventricular compliance with no increase in EDP
Organism associated with IV Drug abuseS.Aureus
Organism associated with Catheter induced heart valve affectedS.epidermis
JVD with new holosystolic murmur not radiating to the axillaTricuspid Regurg
Medial circumflex arteryAvascular necrosis of femoral head
Lateral circumflex arteryFracture of neck of femur
EEG shows high voltage slow wavesCreutzfeldt-Jakob
Rapid memory loss,, dementia, myoclonusCreutzfeldt-Jakob
Accumulation of C8-C10 acylcarnitines & dicarboxylic acidmedium-chain, acyl CoA dehydrogenase deficiency -> hypoglycemia & hypoketonemia
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