wewovino's version from 2017-01-15 23:01

MacConkey agar G- Rods

Question Answer
Lactose fermenter FASTKEE -> Klebsiela, Enterbacter, E.coli
Lactose fermenter SLOW Citrobacter, Serratia
Lactose non-fermenter Oxidase-Salmonella,shigella,proteus
Lastose non-fermenter Oxidase+Pseudomonas, H.pylori


Question Answer
>1day & <1month sudden onsetBrief psychotic disorder
>1 & <6monthsSchizophreniform
At least 6 monthsSchizophrenia -> disorganized speech(clothes are dishievled), hallucinations(poor eye contact and responding to ppl who are not in room), delusions(cafeteria food posion)
One or more delusions>1monthDelusional disorder
Fever & sore throat in pt being treated with methimazole or propylthiouracilAgranulocytosis -> Check white blood cell count
Pt with severerheumatoid arthritis gets and intubation and leads to areflexic paralysis of all extremitiesVertebral subluxation due to til off the head backwords during intubation causing C1 damage
Pt has diabetes inspidious sx and was started on lithium a few days ago. Problem is at thecollecting duct
Medulla in adrenal histology has hollow circlesFat gobules
Radial Nerve is found in theSupinator canal of forearm -> Weakness of finger and thumb extension Finger drop
Anterior cerebral artery deficitClimbing stairs
Middle cerebral arteryhand gripping, whistling, swallowing
Best indicator of Mitral RegurgitationPresence of audible S3
Bacitracin sensitiveS.pyogenes -> PYR + Pyrrolidonyl arylamidase positivity
Best indicator of Mitral stenosisS2 to opening snap time interval
Impermeable to water(LACK OF WATER) in the kidney tubulesAscending loop of henle & early distal convoluted tubule
Left lung field is hyperresonant and breath sounds are diminished. DX?Pneumothorax
Colon cancer spread to liver how?Hematogenous spread of colonic tumor via the portal system
A baby born with increased hemoglobin and hematocrit later normalize with no symptomsCongenital Neutropenia
69yr old women presenting with 2 month histroy of memory problem, difficulty walking, urinary incontineceNot dementia BUT INSTEAD Normal Pressure Hydrocephalus
Where in your lymph node is TB oragnism foundMacrophages
A 62-year-old man undergoes cystoscopy and during the procedure, a cystoscope is inserted through the penis and into the bladder. Slit-like openings are then visualized near the lateral ends of the top of the trigone region of the bladder What is the name of these structures?Ureteric orifices
27yo F with 1mo hx of shortness of breath with exertion and swelling of her legs. P 90/min, rr 22/min, BP 120/80. S3, and a displaced apical pulse. Chest x-ray shows marked cardiomegaly and Kerley B lines. Echocardiography shows ejection fraction of 29%. Dx?Dilated cardiomyopathy
Orthostatic HypotensionVenous return, Carotid sinus baroreceptor activity, cerebral blood flow ALL DECREASE
60yo F with 6-month history of pain in her hips and knees. Osteoarthritis, recommends ibuprofen. Patient refuses and asks about using glucosaine. Which responses is most appropriate?"What have you heard about using glucosamine to treat arthritis?"
Vaccine agianst diptheria confers protective immunity by inducing the formation of antibodies agianst a preparation composed of?Purified inactivated toxin
Cells express class I MHC and show rearrangement of the T-lymphocyte receptor beta-chain gene D and J segments. What is the normal counterpart of these lymphocytes?T-lymphocyte thymocytes localized to the thymic cortex
Because ADHD is more common among boys, girls and boys are randomized into the two treatment groups separatelyStratification
25yo F with general malaise and a facial rash for 1 week. 10-year history of episodes of pleurisy and arthritic pain in peripheral joints. Malar rash that does not involve the nasolabial folds. Cardiolipin antibody, anti-dsDNA, and anti-Sm antibody assays are positive. Which hematologic abnormalities is most likely?SLE -> Thrombocytopenia
31yo F treated for Plasmodium vivax malaria with primaquine and chloroquine to prevent relapses. Which explains why primaquine is used with chloroquine in this patient?Primaquine kills dormant hypnozoites NOT dormant Parasites
During normal skeletal muscle twitches, the ATP concentration does not fall appreciably because of which?ATP is quickly regenerated from creatine phosphate
6yo boy with 3-month hx of pubic and axillary hair growth. Tanner stage 2. Mild enlargement of the testes If left untreated, which of the following combinations is course of growth in this patient?Fragile X syndrome -> Height Percentile: 1 year from now 75th, As an adult 25th
1mo male newborn with Pale skin, fine white hair on the scalp, and blue eyes. Biopsy specimen of the skin will show which findings?NORMAL number of Melanocytes, Decreased Melanin DUE to lack of tyrosinase
72yo M with hypertension with severe abdominal pain for 2 hours. Pale and lethargic. P 124/min rr 16, BP 95/60 S4. Abdominal guarding, rigidity, and a pulsatile periumbilical mass Additional findings?Ruptured abdominal aortic aneurysm -> Decreased femoral pulses
18yo F with 3-day history of pain with urination and urinary frequency. Urine culture grows an organism that is lactose fermenting and spot-indole test positive Resistant to ampicillin but sensitive to ceftriaxon. Mechanism of antimicrobial resistance exhibited?Beta-lactamase production
Alteration of the exisiting penicillin binding protein seen inMRSA
82yo F with alcohol dependence is admitted to the hospital after sustaining multiple injuries in a fall. Has a recent history of right hip fracture and multiple old and new ecchymoses, abrasions, and superficial lacerations. 3-cm laceration on her forehead, sutured after a fall 6 weeks ago, has dehisced. Has few teeth, hemorrhagic macules around hair follicles on upper/lower extremities. Cause?Scurvy -> Inadequate hydroxylation of collagen polypeptides
Male newborn has multiple congenital anomalies resulting from failure of migration of neural crest cells during embryonic development. Dies 3 weeks later. Autopsy of organs will show?Absence of the adrenal medulla
Treatment with valproic acid, which inhibits histone deacetylas. Drug is most likely to affect which?Transcription
52yo M 3 days after sudden onset of blindness of the left eye. No eye pain. Funduscopy shows a pale, opaque fundus and a bright red fovea centralis. Visual field shows dense scotoma of the entire visual field of the left eye; right eye normal. 6 months later, patient remains blind in the left eye. If left eye is illuminated, which reaction in the right pupil?No constriction because the retinal ganglion cells in the left eye have been destroyed
25yo F with palpitations and insomnia for 5 months; she also had 5-kg weight loss. P 125/min. Exopthalmos, thyromegaly, and hand tremors Thyroid-stimulating hormone concentration less than 0.1, thyroxine (T4) 18, triiodothyronine (T3) 250. Symptoms cause by hormones acting on which receptors?Nuclear/retinoid X binding to DNA
Newborn at 28 weeks' gestation in severe respiratory distress. Immature alveoli have a diminished ability to serve as sites of effective gas exchange. Increase in which explains this?Surfactant deficiency -> Lung elastic recoil
40yo F with breast cancer with 1-week history of progressive loss of peripheral vision to the left in both eyes Unable to count fingers or detect finger movements on the left. MRI will show a metastatic tumor in which locations?Occipital lobe
48yo M with 1-hour history of nausea and chest pain radiates to left arm. ECG and cardiac enzyme confirm myocardial infarction of anterior wall. 14 hours after he is in cardiac arrest Resuscitation efforts are successful after 30 minutes. Immediately develops severe oliguria. Studies show increased urea nitrogen and creatinine(Kidney damage). Patient's urine microscopically shows?Acute tubular necrosis due to hypoxia -> Degenerating epithelial cells and dirty brown granular casts
3yo girl with 1-year hx short stature. Below 3rd percentile for height and 10th percentile for weight. Physical shows course facial features and contractures of large joints. Xrays show dysostosis multiplex. Lysosomal enzymes analysis shows increased beta-hexosaminidase, beta-glucuronidase, beta-galactosidase, and alpha-fucosidase activities. Cause of lysosomal enzymes findings?Abnormal targeting into lysosomes -> I-cell disease
A defect in renal ammoniagenesis suspected. Which substrate is source of ammonia production?Glutamine
DMD Cause of defective or absent protein in which areas of muscle?Cytoskeleton
2YR girl brought in 20 minutes after ingesting insecticide. Physical shows copious oral secretions. In addition to securing airway, best next step is giving which medication?Atropine & THEN PRALIDOXIME
What is the mechanism that would most likely increase the amount of aortic regurgitation in a pt?Hypervolemia
43yo M with 10-year history alcoholism comes for changes in skin color. Patient taking 2 acetaminophen EVERY 3-6 hrs for 3 days for severe headache Physical: jaundice. Labs show increased prothrombin time and increased serum AST activity. Alternation in which metabolite in hepatocytes is a/w his illness?Decreased glutathione
55yo M with 2-month hx of increasing difficulty swallowing and regurgitation of undigested food Physical: halitosis. Videofluoroscopic swallowing study shows 4-cm, posterior midline pouch protruding between the thyropharyngeus and cricopharyngeus portions of the inferior pharyngeal constrictor muscle These muscles are innervated by which nerves?Parasympathetic fibers from the vagus nerve
47yo M with myocardial infarction Pulse oximetry shows oxygen saturation of 90%. Crackles heard at lung bases with grade 2/6 systolic murmur. ABG on 30% O2: pH 7.41, pCO2 36, pO2 60. What is the cause of patient's hypoxemia?Increased pulmonary capillary pressure
30yo M 1-day hx irrational behavior and severe abdominal pain 3 days ago started tx for UTI with trimethoprim-sulfamethoxazole. Urine light burgundy color during similar time 1 yr ago. Mother and maternal grandfather have sx. Anxious and restless, pulse 96. Physical shows diaphoresis. Serum shows increased 5-aminolevulinic acid (gamma-ALA) and porphobilinogen. Decreased activity which enzyme?Porphobilinogen deaminase
25yo F with hx of rheumatic fever and mitral valve dysfunction has 2-week hx of fever and fatigue. Had a root canal 1 month ago before which she took single dose amoxicillin. Temp 38.4 C (101.2 F). 4/6 blowing murmur heard at left axilla. Gram stain from blood culture shown. Blood agar plates shows alpha hemolysis Organism?Streptococcus mitis
H.pylori pts lifestyle change will decrease recurrence of symptoms?Decrease Smoking
Corticosteroids IncreasesNeutrophils & Decreases everything else
Study of lung cancer.40,000 physicians asked if they smoked cigarettes. The frequency of lung cancer was then assessed 10 years later, and the group of smokers and nonsmokers were compared Study design?Cohort Study
After a stoke, 68yo M has language problem. Speech is fluent but has many grammatical errors, word substitutions(WORDY) and neologisms. Unable to repeat words and unable to comprehend verbal requests. Which site labeled in picture of brain is damaged?(Wernicke's)
4 days after a hike(DELAYED) in forest, 40yo M develops multiple intensely pruritic areas on skin (photograph). The involved skin was not covered by clothing. Findings consistent with which condition?Delayed (type IV) hypersensitivity reaction
Angiography shows left dominant circulation, 90% narrowing of artery going to diaphragmatic surface and AV node Stent going to be placed, and catheter must be passed through which vessels to reach narrowed vessel? Left coronary, circumflex, posterior interventricular (posterior descending)
20yo cyclist taking recombinant human erythropoietin has polycythemia. Cause?Proliferation of erythroid precursors
Alcoholic is given a loading dose of an antidote is administered. Which of the following best describes the mechanism of action of the antidote in this patient?Fomepizole Inhibits alcohol dehydrogenase, blocking the conversion of methanol to formaldehyde
DisulframInhibits acetaldehyde dehydrogenase -> accumulation of of acetalhyde
Transforming growth factor-beta, the number of normal cells decreases, whereas the number of tumor cells remains unchanged. The tumor cells most likely express a mutation that inhibits which?Apoptosis
Carotid sinus massage is performed and sinus rhythm is restored. Which of the following is the most likely mechanism of the termination of the tachycardia in this patient?Increased cardiac parasympathetic activity
59 year-old man comes to the physician because of a 10-day history of shortness of breath, fatigue, and cough. Respirations 12/min. Lungs clear to auscultation and percussion. Labs show:LOWHemoglobin 11.8 g/dL/LOWHematocrit 36%/HIGHLeukocyte count 146,400/mm3/LOWSegmented neutrophils 47%/HIGHBands 12%/HIGHBasophils 5%/LOWLymphocytes 2%/LOWMonocytes 2%/HIGHPlatelet count 804,000/mm3. Which of the following is the most appropriate pharmacotherapy for this patient?Imatinib
Asleep after only three to five breaths. Which properties of the anesthetic is the most likely explanation for the rapid onset of action?Low blood solubility
A 67-year-old man comes to the physician with 2-month history of pain in his feet. The discomfort is more severe in bed at night and is relieved by taking a hot bath. He has type 2 diabetes mellitus treated with glipizid. His pulse is 60/mm, respirations are 1 2/mm, and blood pressure is 130/88 mm Hg. Strength is normal and symmetric in the distal and proximal upper and lower extremities. The Achilles deep tendon reflexes are decreased and quadriceps deep tendon reflexes are normal. Sensation to pinprick and vibration is decreased from just above the ankles distally. This patient is most likely to describe his pain as which of the following?Burning
24-year-old woman is admitted to the hospital because of acute pain in the left lower quadrant of the abdomen She has leukocytosis and an increased human chorionic gonadotropin concentration. Photograph of small fetus. Dx?Ectopic pregnancy