1.

1st Brachial arch: Cartilage: Meckel's (Mandible, Malleus,

Mandibular)
Muscles: Muscles of mastication (Masseter, medial pterygoids,
Mylohyoid)
Nerves: CN V2, V3
-Chew
2. 1st Brachial Pouch: Middle ear cavity
Eustachian tube
Mastoid air cells
3. 2nd Brachial arch: Cartilage: Reichert's (Stapes, Styloid,
Stylohyoid)
Muscles:Stapedius, Stylohyoid
Nerves:CN 7
-Smile
4. 2nd Brachial Pouch: Epithelial lining of palatine tonsil
5. 3rd Brachial arch: Cartilage: Greater horn of hyoid
Muscles: Stylopharyngeus
Nerves: CN 9
-Swallow stylishly
6. 3rd Brachial Pouch: Dorsal wings
-Inferior parathyroids
Ventral wings
-Thymus
3 structures
Thymus, right & left parathyroids
7. 4th Brachial Pouch: Dorsal wings
-Superior parathyroid
8. 4th-6th Brachial arches: Cartilage: Thyroid, cricoid,
Muscles:
4 = pharyngeal constrictors
6 = intrinsic muscles of larynx
Nerves:
4 = CN X (superior laryngeal branch)
-Simply swallow
6 = CN X (recurrent laryngeal branch)
-Speak
9. Absence seizure: Brief (usually less than 20 seconds),
generalized epileptic seizures of sudden onset and termination
Clinically, the impairment of consciousness (absence)
Electroencephalography (EEG) shows generalized spike-and-
slow wave discharges ~3Hz
10. acute ischemic injury = kidney findings?: Acute Tubular
Necrosis - Muddy Brown Casts with epithelial cells
11. Affinity column chromatography: Method of separating
biochemical mixtures
-Based on a highly specific interaction such as that between
antigen and antibody, enzyme and substrate, or receptor and
ligand.
Can be used to.
1. Purify and concentrate a substance from a mixture into a
buffering solution
2. Reduce the amount of a substance in a mixture
3. Discern what biological compounds bind to a particular
substance
4. Purify and concentrate an enzyme solution.
12. African American, bilateral hilar adenopathy, righ
paratracheal node enlargment, noncaseating
granuloma =???: sarcoidosis (ethnicity is risk factor)
13. Albinism: Congenital deficiency in:
Tyrosinase
Defective tyrosine transporter ( tyrosine melanin)
Can result from lack of migration of neural crest cells
Lack of melanin results in risk of skin cancer
14. Ammonia source in ammonioagenesis: Aspartate &
GLUTAMINE donate NH4 ( amonia ) in renal ammoniaagenesis
15. Ammoniagenesis: Occurs within proximal tubular cells
Glutamine made in the liver, is received from peritubular
capillaries and is metabolized into
1. Alpha-keto glutarate (Metabolized further into two HCO3-
ions, which then leave the cell and enter systemic circulation by
crossing the basolateral membrane)
2. NH4+ (Secreted into renal tubules)
16. Anabolic steroids: Leads to sex-hormone binding globulin
free testosterone
-Gynecomastia results
17. Anemia: Hb concentration causes O content of blood
hypoxia
18. aneurysm of PCA?: oculomotor nerve palsy (NOT Horner's)
19. Arches 3 & 4: Posterior 1/3 of tongue
20. ATP concentration doesn't fall much dring normal
twitches because?: ATP is quickly regenerated from creatine
phosphate
21. Avoidant Personality Disorder: Consider themselves to be
socially inept or personally unappealing and avoid social
interaction for fear of being ridiculed, humiliated, rejected, or
disliked
22. baby, respiratory distress, cyanosis, narrow thorax,
ears with periauricular skin tags, micrognathia,
glossoptosis, mandibular cleft, short palate = which
artch?: first arch (Treacher-Collins)
NBME 15 review
Study online at quizlet.com/_e5hgc
23. Bacillus subtilis: Gram-positive, catalase-positive bacterium
Rod-shaped
Has the ability to form a tough, protective endospore, allowing
the organism to tolerate extreme environmental conditions
Only known to cause disease in severely immunocompromised
patients
24. Bacteroides fragilis: Gram-negative bacillus bacterium
species
Involved in 90% of anaerobic peritoneal infections
Predominates in bacteremia associated with intraabdominal
infections, peritonitis and abscesses following rupture of viscus,
and subcutaneous abscesses or burns near the anus
25. blast proliferation, eosinophils?: CML (9:22) responds to
imatinib
26. Brachial Arches (Pneumonic): When at the golden arches,
1. Chew
2. Smile
3. swallow stylishly or 4. simply swallow
6. speak
There is no 5!
27. Brachial pouch pneumonic: Ear, tonsils, bottom to top
1(ear)
2(tonsils)
3 dorsal (bottom for inferior thyroid)
3 ventral (to = thymus)
4 (top = superior parathyroids)
28. Broca's aphasia: Nonfluent aphasia with intact
comprehension.
29. brown-black, mottled, scaly, irregular borders, atypical
melanocytes along basilar layer?: lentigo maligna
(melanoma)
30. Carbaminohemoglobin: CO bound to hemoglobin
-Account for very small amount of CO in blood
31. Carbon monoxide poisoning: O content of blood
hypoxia
32. Carnitine deficiency: Inability to transport LCFA (Long chain
fatty acids) into mitochondria
Results in toxic accumulation in the cytoplasm
Causes weakness, hypotonia, hypoketotic hypoglycemia
33. Case Control: Two existing groups differing in outcome are
identified and compared on the basis of some supposed causal
attribute
34. Case series: Medical research descriptive study that:
1. Tracks patients with a known exposure given similar
treatment
2. Examines their medical records for exposure and outcome
Can be retrospective or prospective
Usually involves a smaller number of patients than more
powerful case-control studies or randomized controlled trials
May be consecutive or non-consecutive
-Depends on whether all cases presenting to the reporting
authors over a period were included, or only a selection
May be confounded by selection bias
-Limits statements on the causality of correlations observed
-Physicians who look at patients with a certain illness and a
suspected linked exposure will have a selection bias in that they
have drawn their patients from a narrow selection (Their
hospital)
35. cervical cancer drains to?: internal iliac nodes
36. Chloroquine, primaquine MOA: Chloroquie kills malaria/
Primaquine kills hypnozoites
37. Chronic HTN, heavy heart?: Hypertrophy of heart
38. Chronic myelogenous leukemia (CML): Myeloid stem cell
proliferation (30-60 year olds)
- neutrophils, metamyelocytes, basophils, t(9;22)
Low leukocyte alkaline phosphatase (as opposed to leukemoid
reaction)
39. Clostridium perfringens: Gram-positive, rod-shaped,
anaerobic, spore-forming bacterium
Infections show evidence of tissue necrosis, bacteremia,
emphysematous cholecystitis, and gas gangrene
Toxin involved in gas gangrene is known as -toxin
-Inserts into the plasma membrane of cells, producing gaps in
the membrane that disrupt normal cellular function
40. CML treatment: Imatinib. BCR-ABL 9:22
41. Complete hydatidiform mole: Caused by a single (90%) or
two (10%) sperm combining with an egg which has lost its DNA
The genotype is typically 46,XX (diploid)
42. Complex partial seizure: Often preceded by a seizure aura.
-A simple partial seizure.
Aura may manifest itself as a feeling of dj vu, jamais vu, fear,
euphoria or depersonalization.
Seizure aura might also occur as a visual disturbance, such as
tunnel vision or a change in the size of objects (macropsia or
micropsia).
Once consciousness is impaired, the person may display
automatisms such as lip smacking, chewing or swallowing.
There may also be loss of memory (amnesia) surrounding the
seizure event.
Person may still be able to perform routine tasks such as
walking, although such movements are not purposeful or
planned.
Witnesses may not recognize that anything is wrong.
43. Congentio pharyngo-cutaneous fistula: Persistence of cleft
and pouch fistula between tonsillar area, cleft in lateral neck
44. Cyanide poisoning: O utilization by tissues hypoxia
45. Cytarabine: Pyrimidine analog inhibition of DNA
polymerase
Leukemia, lymphomas
Toxicity: Leukopenia, Thrombocytopenia, Megaloblastic anemia
46. defect in ihibitory NT = seizures, floppy baby: glycine
receptor
47. defect in renal ammoniagenesis, which substrate is
source of ammonia production?: glutamine (and aspartate
donate NH4 in agenesis)
48. Density Gradient Centrifuge: Used to separate certain
organelles from whole cells for further analysis of specific parts
of cells
1. A tissue sample is first homogenised to break the cell
membranes and mix up the cell contents.
2. The homogenate is then subjected to repeated centrifugations,
each time removing the pellet and increasing the centrifugal
force.
3. Finally, purification may be done through equilibrium
sedimentation, and the desired layer is extracted for further
analysis.
49. Dental procedure, bug?: Strep Mitis - alpha hemolytic
50. Deoxyhemoglobin: Better buffer for H than oxyhemoglobin
-Advantageous that hemoglobin has been deoxygenated by the
time it reaches the venous end of the capillaries
51. DEXA decreased bone density: increased osteoclast,
RANKL, decreased osteoblast activity
52. Diabetic neuropathy pain?: burning pain
53. Diabetic neuropathy symptoms: Numbness, tingling, ED,
Urinary incontinence, Vision changes, Dizziness, Muscle
weakness
*Burning or electric pain*
54. Diaphoresis: Excessive sweating
55. DiGeorge syndrome: Aberrant development of 3rd & 4th
pouches:
T-cell deficiency (thymic aplasia)
Hypocalcemia (failure of parathyroid development)
56. DKA, give insulin, increases activity of which enzyme?:
glucokinase
57. drug overdose?: respiratory acidosis
58. Dysostosis multiplex: Hereditary disease (autosomal
recessive) consisting of an error is mucopolysaccharide
metabolism
Characterized by severe abnormalities in development of skeletal
cartilage and bone and mental retardation
59. Ejection Fraction equation: SV/EDV (EDV-ESV)/EDV
60. elevated very-long-chain FA, phytanic acid, pipecolic
acid = absence of?: peroxisomes (causes hypotonia, poor
feeding)
61. EPO doping = ?: EPO will increase RBC's erythroid precursors
62. Erythropoietin: Its primary effect on red blood cell progenitors
and precursors (which are found in the bone marrow in humans)
is promoting their survival through protecting these cells from
apoptosis
63. Excess lymphoblasts: Age < 15
Found in acute lymphoblastic leukemia (ALL)
TdT+ (Marker of pre-t & pre-b cells)
CALLA+
t(12;21) = good prognosis
Increased incidence in people with Down Syndrome
64. Ferrochelatase: Lead poisoning
Accumulates:
Protoporphyrin, -ALA
Microcytic anemia, GI and kidney disease.
Children-exposure to lead paint -+ mental deterioration
Adults-environmental exposure (battery/ ammunition/radiator
factory) -+ headache, memory loss, demyelination
65. Generalized tonic clonic: Generalized seizure that affects the
entire brain
Divided into two phases, the tonic phase and the clonic phase.
Preceded by aura
Tonic = skeletal muscles tense
Clonic = Rapid contraction and relaxation of muscles
66. germline mosaicism: produces disease that is not carried by
parent's somatic cells
67. Glipizide: Sulfonylurea (stimulates endogenous insulin release)
Close K+ channel in -cell membrane = insulin release via
Ca2+ influx.
68. glossoptosis: Downward displacement or retraction of the
tongue
69. Glucokinase: Liver and cells of pancreas, induced by insulin
Low glucose = hexokinase sequesters glucose in the tissues
High glucose = excess glucose is stored in the liver
70. Glucose-6-phosphatase: In ER of liver, Glucose-6-P
Glucose
Deficient in Von Gierke's disease (fasting hypoglycemia,
increased glycogen in liver, increased blood lactate,
hepatomegaly)
71. Glycogen phosphorylase: Rate determining enzyme for
glycogenolysis
Skeletal component deficient in McArdle's disease
- glycogen in muscle, but can't break it down
-Painful muscle cramps, myoglobinuria w/ strenuous exercise
72. guy with ulcers, what to do to improve symptoms?: stop
smoking
73. H1 (Histamine): Found on smooth muscle, endothelium, and
central nervous system tissue
Causes:
Bronchoconstriction, Bronchial smooth muscle contraction,
Vasodilation, Separation of endothelial cells (responsible for
hives), Pain and itching due to insect stings;
SE = sleep and appetite suppression.
74. HDL with age in woman?: HDL of a 25 year old vs. 55 year
old, high in 25, low in 55 (estrogen)
75. heme biosynthesis pathway: glycine + succ (ALA synthase)
5-ALA (ALA dehydratase) porphobilinogen (PBG deaminase)
Hydroxymethylbilane (uro synthase) Urophyrinogen III (Uro
decarboxylase) Coproporphyrinogen III (Copro oxidase)
protoporphyrinogen IX (proto oxidase) protophorphyrin (IX)
ferrochelatase + Fe = HEME
76. Hemispatial neglect: Results most commonly from brain
injury to the right cerebral hemisphere, causing visual neglect of
the left-hand side of space
A stroke affecting the right parietal lobe of the brain can lead to
neglect for the left side of the visual field, causing a patient with
neglect to behave as if the left side of sensory space is
nonexistent (although they can still turn left)
-Extreme case, a patient with neglect might fail to eat the food on
the left half of their plate, even though they complain of being
hungry
-Someone with neglect is asked to draw a clock, their drawing
might show only numbers 12 to 6, or all 12 numbers on one half
of the clock face, the other side being distorted or left blank
77. Histone deacetylase: Removes acetyl groups from AA
-Allows histones to wrap DNA more tightly
Actions are opposite to that of histone acetyltransferase
These would affect transcription of DNA!!!!
78. Homonymous hemianopsia: Visual field loss that respects
the vertical midline, and usually affects both eyes
Vascular and neoplastic (malignant or benign tumours) lesions
from the optic tract, to visual cortex can cause
-If lesion is in optic tract, will be pupillary reflex problem!
The more posterior the cerebral lesion, the more symmetric
(congruous) symptoms will be
1. Person who has a lesion of the right optic tract will no longer
see objects on his left side
2. Person who has a stroke to the right occipital lobe will have
the same visual field defect, usually more congruent between the
two eyes, and there may be macular sparing
79. Homozygous for point mutation (GT->AT) causes
skipping of exon 12, mech?: RNA Splice error
80. How to calculate A-a gradient: PAO2 - PaO2 (PAO2=150 -
PaCO2/0.8)
81. How to identify a variant protein?: immunohistochemistry
82. Hydronephrosis causes?: Increased tubular hydrostatic
pressure from blockage
83. Hydroxyurea: Inhibits ribonucleotide reductase DNA
Synthesis (S-phase specific)
Melanoma, CML, Sickle cell disease ( HbF)
Toxicity:
Bone marrow suppression, GI upset
84. Hyperammonia: Can be acquired (e.g., liver disease) or
hereditary (e.g., urea cycle enzyme deficiencies)
excess NH4+ depletes a-ketoglutarate inhibition of TCA
cycle
Rx: limit protein in diet
85. Hyperparathyroidism: Stone, Bones, and Groans
Hypercalcemia
Hypercalciuria (Stones)
Hypophosphatemia
PTH, Alk Phos, cAMP in urine
86. Hypokinesis of Posterior Left Ventricle?: Stenosis of the
right coronary artery
87. Hypovolemic/cardiogenic shock: low-output failure,
increased TPR, low CO, cold, clammy (hypovolemic = low
volume, no JVD; cardiogenic = poor pumping, backflow,
increased JVD)
88. Hypoxemia: Pao causes %saturation of hemoglobin
hypoxia
89. I Cell Disease MOA: mannose 6 phosphate addition allows
enzymes to go to lysosome, but this is defective = abnormal
targeting of these enzymes to lysosomes
90. IkB function?: releases NFkB after undergoing
phosphorylation
91. Imatinib: A small molecular inhibitor of bcr-abl tyrosine kinase
Treatment of CML (blasts, basophils)
92. Immunohistochemistry: Process of detecting antigens (e.g.,
proteins) in cells of a tissue section by exploiting the principle of
antibodies binding specifically to antigens in biological tissues
93. inclusion cell disease (I-cell disease): Inherited lysosomal
storage disorder
Failure of addition of mannose-6-phosphate to lysosome
proteins
-Enzymes are secreted outside the cell instead of being targeted to
the lysosome
Presentation:
Coarse facial features
Clouded corneas
Restricted joint movement
High plasma levels of lysosomal enzymes
94. incomplete penetrance vs. variable expressivity: IP = not
all with mutant genotype show mutant phenotype; VE = genotype
SAME, phenotype varies
95. Insulin increases?: glucokinase activity
96. Insulin secretion: 1. Glucose binds Glut2 receptor on -cells
2. Glucose oxidizes to ATP closes K channels in cell
membrane depolarization of -cells
3. Depolerizatino opens Ca channels intracellular [Ca]
[name of this card]
97. Internal iliac lymph nodes: Receive lymphatics from:
All the pelvic viscera
Deeper parts of the perineum
-membranous and cavernous portions of the urethra
Buttock and back of the thigh
Cervix!
Not: Ovary, testis, or superior half of the rectum
Gonads drain to the paraaortic lymph nodes
Superior half of the rectum drains to the pararectal lymph nodes
98. Internal urethral orifice: Opening of the urinary bladder into
the urethra
99. Irradiated packed RBCs: Destroys DNA in WBCs
-Prevents graft vs host disease occurring from transfusion
Important if transfusion is from:
1. Close family relation
2. Someone who is immunocompromised (Di George Syndrome,
Wiskott Aldrich, and SCID)
100. IB: Releases NF-B after undergoing phosphorylation
101. Left Axillary line holosytolic murmur: Mitral Regurg - Left
Axillary line holosystolic murmur
102. Left sided heart failure signs: Tachypnea (increased rate of
breathing)
Increased work of breathing (non-specific signs of respiratory
distress)
Rales or crackles, heard initially in the lung bases, and when
severe, throughout the lung fields
-Suggest the development of pulmonary edema (fluid in the
alveoli)
-Cyanosis which suggests severe hypoxemia, is a late sign of
extremely severe pulmonary edema.
103. Leukemia: Unregulated growth of leukocytes in *bone
marrow*
or in # of circulating leukocytes in blood
Marrow failure anemia (RBC), infections (WBC),
hemorrhage (platelets)
Infiltrates in liver, spleen, and lymph nodes possible
104. Leukocidin: Type of cytotoxin created by some types of bacteria
Is a type of pore forming toxin
Get their names by killing ("-cide") leukocytes
Associated with increased virulence of certain strains (isolates)
of Staphylococcus aureus
Cause of necrotic lesions involving the skin or mucosa, including
necrotic hemorrhagic pneumonia
105. Lithium induced Nephrogenic DI, where?: Collecting
tubule
106. Loading dose: Cp x Vd/Bioavailability
107. long-chain-fatty-acids?: LCFA - peroxisomes
108. Lorazepam: Facilitates GABAa action by frequency of Cl
channel opening
Use:
Anxiety
Spasticity
Status epilepticus
Detoxification
109. Loss of left vision in both eyes =?: occipital lobe lesion
110. Low blood solubility = slow or fast induction?: 141) low
blood solubility --> rapid induction, low potency
111. lump in upper neck, mass moves up with swallowing
and tongue protusion, uptake of technetium 99m
pertechnetate, what type of cells?: thyroid follicles
112. Lymphoma: Discrete tumor masses arising from lymph nodes.
113. Lysosomal storage disease: Caused by lysosomal
dysfunction usually as a consequence of deficiency of a single
enzyme required for the metabolism of lipids, glycoproteins
(sugar containing proteins) or so-called mucopolysaccharides
When a particular lysosomal enzyme exists in too small an
amount or is missing altogether, substances accumulate in the
cell.
In other words, when the lysosome doesn't function normally,
excess products destined for breakdown and recycling are stored
in the cell.
114. Maintenance dose: Cp x CL/F
115. Megaloblastosis (Megaloblastic anemia): Results from
inhibition of DNA synthesis in red blood cell production
-Most often due to hypovitaminosis, specifically a deficiency of
vitamin B12 and/or folic acid
Characterized by:
Many large immature and dysfunctional red blood cells
(megaloblasts) in the bone marrow
Hypersegmented neutrophils (those exhibiting five or more
nuclear lobes ("segments"), with up to four lobes being normal)
116. Melanoma ABCDE: Asymmetry, Border irregularity, Color
variation, Diameter >6 mm, Evolution over time
117. Mesoblastic nephroma: Type of kidney tumor that is usually
found before birth by ultrasound or within the first 3 months of
life.
It contains fibroblastic cells (connective tissue cells), and may
spread to the other kidney or to nearby tissue
118. metabolic alkalosis with volume contraction: loop
diuretic
119. metastaic colon cancer spread MOA: Hematogenous
spread of Liver Tumor from Colon via Portal Venous System
120. Michaelis constant (Km) =?: Km = 1/2 Vmax
121. micrognathia: Jaw is undersized
122. MOA IKB: lkb --> NF-KB post phosphorylation for IL-1/IL-6
fever induction
123. Myofibroblast: Cell that is in between a fibroblast and a
smooth muscle cell in differentiation
Can contract by using smooth muscle type actin-myosin
complex, rich in a form of actin called alpha-smooth muscle
actin
-These cells are then capable of speeding wound repair by
contracting the edges of the wound
124. Nephroblastoma (Wilms tumor): Most common renal
malignancy of early childhood (Age 2-4)
Contains embryonic glomerular structure. Presents with huge
flank mass / hematuria. Deletion of WT1 on chromosome 11
Can be hypervascular
125. NF-B: Activation occurs when it's inhibitor, I-B, is
phosphorylated by specific protein kinase (IKK) & degraded
126. normal heart weight (450), enlarged at 600g after
poorly controlled HTN?: hypertrophy
127. Oculomotor palsy from aneurysm?: Posterior
Communicating Artery Anuerysm
128. Olanzapine: Atypical antipsychotic
Use:
Schizophrenia - both +ve and -ve
Bipolar, OCD, anxiety disorder, depression, mania
Fewer extrapyramidal side effects than traditional antipsychotics
129. Oligomenorrhea: increased estrogen in adipose tissue
130. Optic chiasm lesion: Bitemporal anopia
131. optic nerve, Chiasm, optic tract: parietal lesion = optic tract
lesion
132. Organophosphate poisoning- first antidote: Atropine
first/Pralidoxime second
133. Oxytocin: Stimulates labour
Uterine contraction
Milk let down
Controls uterine hemorrhage
134. Packed RBCs with adenine-saline added: Allows the
blood to flow readily without the addition of saline
135. pain associated with diabetic neuropathy?: burning pain
136. pain in shoulder, reproduced with resisted abduction
at 90, giving thumbs down: supraspinatus
137. Pain upper abdomen, refered to shoulder: Diaphram
ulceration phrenic nerve
138. Pain with thumbs down, shoulders up: Arm up Thumbs
down sign... supraspinatus...
139. pancreatic cancer associated with?: depression
140. paraesophageal hernia: portion of gastric fundus herniates
through the diaphragm
141. parathyroid adenoma, decreased?: calcium concentration
in feces
142. Parietal lobe lesion: Lower quadrantic anopia
143. Partial hydatidiform mole: Occurs when an egg is fertilized
by two sperm or by one sperm which reduplicates itself yielding
the genotypes of 69,XXY
144. Partial vs complete mole: Partial 1 egg two sperm 69XXY vs
paternal complete 46XX 2 sperm no egg
145. Peptic ulcers: Chronic inflammation due to Helicobacter
pylori that colonizes the antral mucosa
NSAIDs
Some studies have found correlations between smoking and ulcer
formation
Caffeine and coffee, also commonly thought to cause or
exacerbate ulcers, have not been found to affect ulcers to any
significant exten
146. Peroxisome: Membrane-enclosed organelle involved in
catabolism of very long fatty acids (VLFA) & amino acids
147. Phosphoenolpyruvate carboxykinase: Irreversible enzyme
in Gluconeogenesis
148. Phosphorylase kinase: A component of Gluconeogenesis
149. Phytanic acid: Branched chain fatty acid that humans can
obtain through the consumption of dairy products, ruminant
animal fats, and certain fish
Undergoes -oxidation in the peroxisome, where it is converted
into pristanic acid by the removal of one carbon
150. pinpoint pupils, unconscious: heroin OD
151. Pipecolic acid: Accumulates in Pipecolic acidemia
- Very rare autosomal recessive metabolic disorder that is caused
by a peroxisomal defect
152. Placenta accreta: Abnormally deep attachment of the placenta
to the myometrium without penetrating it.
Placenta grows completely through the endometrium
Great risk of haemorrhage during placental removal
-Commonly requires surgery to stem the bleeding and fully
remove the placenta
-In severe forms can often lead to a hysterectomy or be fatal
153. Porphobilinogen deaminase: Acute intermittent porphyria
Accumulates:
Porphobilinogen, -ALA, uroporphyrin
5 P's
1. Painful abdomen
2. Port wine-colored urine
3. Polyneuropathy
4. Psychological disturbances
5. Precipitated by drugs
154. Posterior Communicating Artery: Common site ofsaccular
(berry) aneurysm.
CN III Palsy: Eye is "down and out" with ptosis and pupil dilation
Lesions are typically aneurysms, not strokes
155. postpartum hemorrhage treated with?: oxytocin
156. Prenatal cocaine effects: Associated with premature birth,
birth defects, attention deficit disorder
157. progestin challenge with withdrawal bleed?: low estrogen
production = estrogen increased in adipose tissue
158. protease inhibitors (navirs): protein processing
(assmebling of virions = cleave of polypeptide products of HIV
mRNA into functional parts)
159. PTH: Ca+ resorption from Kidney (Inhibits PO4 resorption)
Stimulates Vit D. synth (1,25 OH)
-Increased Ca+ absorbed from intestine
Ca+ release from bone
serum calcium
160. Recurrent severe mycobacterial diseases: INF-gamma
receptor defect
161. renal failure causes loss of?: 1,25-dihydroxycholecalciferol
(from decreased conversion via 1a-hydroxylase in PCT)
162. Right Coronary Artery: Supplies blood to right ventricle &
25-30% of left ventricle
In 85% of patients, gives off posterior descending artery
Supplies SA nodal artery in 60% of patients
Give off branch to right marginal artery
If lungs are clear to auscultation, no LVF. Think RVF!
163. RNA splice error: skipping of exons
164. Rouleaux formation: Stacks of red blood cells (RBCs) which
form because of the unique discoid shape of the cells in
vertebrates
Conditions which cause:
Infections
Multiple myeloma
Inflammatory and connective tissue disorders
Cancers
Occurs in diabetes mellitus (one of the causative factors for
microvascular occlusion in diabetic retinopathy)
165. RTA1 ("distal", Renal tubular acidosis): Defect in
collecting tubule's ability to excrete H+
urine pH >5.5
hypokalemia
risk for calcium phosphate kidney stones as a result of urine
pH and bone resorption
166. RTA2 ("proximal", Renal tubular acidosis): Defect in
proximal tubule HC03- reabsorption
Fanconi's syndrome
urine pH < 5.5
hypokalemia
risk for hypophosphatemic rickets
167. RTA4 ("hyperkalemic", Renal tubular acidosis):
Hypoaldosteronism or lack of collecting tubule response to
aldosterone
Resulting hyperkalemia impairs ammoniagenesis in the
proximal tubule
buffering capacity and urine pH
168. S. pyogenes (Group A): The bacteria behind post-
streptococcal glomerulonephritis
PHaryngitis can results in PHever & glomerulonePHritis
169. Salmonella enterica: Most cases of salmonellosis are caused
by food infected with w/ this bacteria, which often infects cattle
and poultry
Usually does not need ABs (Only if complicated in people at risk
such as infants, small children, the elderly)
-Will lead to prolonged fecal excretion of bacteria
170. Salmonella post antibiotic?: prolonged fecal excretement
post antibiotic
171. Scaphoid bone: Most commonly fractured carpel bone, prone
to avascular necrosis due to retrograde blood supply
172. Schizoid personality disorder: Characterized by a lack of
interest in social relationships, a tendency towards a solitary
lifestyle, secretiveness, emotional coldness and apathy
May simultaneously demonstrate a rich, elaborate and
exclusively internal fantasy world
173. Screening for CD markers?: Immunohistochemistry
174. Septic shock: high-output failure, decreased TPR, dilated
arterioles, high venous return, hot patient
175. side effect of H1 blocker: drowsiness
176. Simple partial seizures: Consciousness is not impaired
Often precursors to larger seizures, where the abnormal electrical
activity spreads to a larger area of (or all of) the brain, usually
resulting in a complex partial seizure or a tonic-clonic seizure
-In this case they are often known as an aura
177. Slipped-strand mispairing: Denaturation and displacement
of the DNA strands, resulting in mispairing of the
complementary bases.
Can result in either insertions or deletions.
Insertions are thought to be self-accelerating: as repeats grow
longer, the probability of subsequent mispairing events increases
178. SNoW DRoP: Southern = DNA
Northern = RNA
Western = Protein
179. Southwestern blot: Identifies DNA-binding proteins
180. Stain Drug effects: Upregulates LDL receptors
181. Staph -toxin: The major cytotoxic agent released by
bacterium Staphylococcus aureus and the first identified member
of the pore forming beta-barrel toxin family
182. Staphylococcus aureus: -Superantigens (TSST-1) induce
toxic shock syndrome (TSS), usually from prolonged tampon use.
Cause non-specific activation of T-cells resulting in polyclonal T
cell activation and massive cytokine release (IFN)
-Enterotoxin that is the causative of gastroenteritis that is self-
limiting, characterized by vomiting and diarrhea one to six hours
after ingestion of the toxin with recovery in eight to 24 hours.
Symptoms include nausea, vomiting, diarrhea, and major
abdominal pain.
-Exfoliative toxins implicated in (SSSS), which occurs most
commonly in infants and young children. Protease activity of the
exfoliative toxins causes peeling of the skin observed with SSSS.
Other
-Protein A, an IgG-binding protein, binds to the Fc region of an
antibody
183. Statin MOA (upregulate what?): LDL receptors
184. stratified sample: NOT random, created to ensure a more
representative sample of the population at large (ADHD more
likely in boys than girls, therefore assigned differently)
185. Substance Abuse Teratogens: Alcohol:
Leading cause of birth defects and mental retardation; fetal
alcohol syndrome
Cocaine:
Abnormal fetal development and fetal addiction; placental
abruption
Smoking:
Preterm labor, placental problems, IUGR, ADI-ID
186. Superficial inguinal lymph nodes: Anal canal (below
pectenate line)
Scrotum
Thighs
Ends up in these lymph nodes
187. suprasellar mass, hormone excess?: prolactin
188. Supraspinatus: Abduction of the arm at the shoulder joint
-Main agonist muscle for this movement during the first 10-15
degrees of its arc
Can test:
Shoulder at 90%
Empty can (Wrists pronated)
189. Temporal lobe lesion: Upper quadrantic anopia
190. Transfusion associated GVH: Results from transfusion of
immunocompetent T cells capable of engrafting and initiating an
immune response against recipient antigens
The most susceptible patient groups are those who are severely
immunocompromised
Gamma irradiation abolishes the proliferative activity of the
lymphocytes in the donor blood.
Fresh frozen plasma and cryoprecipitate do not contain viable
lymphocytes and thus do not need to be irradiated
191. Treacher Collins Syndrome: 1st arch neural crest fails to
migrate
-Mandibular hypoplasia
-Facial abnormalities
192. Trisomy 21 associated with increased risk of which
cancers?: ALL and AML
193. Type I error: Stating there is an effect when none exist
194. Type I error =: saw a difference when none existed = p-value
(false positive error)
195. Type II error: Stating there is not an effect when there is one
196. Ubiquitin: Tags proteins for destruction by proteosome
197. ubiquitin tagged proteins go where?: proteosome for
degradation
198. Ureteric orifice: Placed at the postero-lateral angles of the
trigonum vesicae, and are usually slit-like in form
199. Uroporphyrinogen decarboxylase: Porphyria cutanea
tarda
Accumulates:
Uroporphyrin (tea colored urine)
Blistering cutaneous photosensitivity. Most common porphyria.
200. Valproic acid: A wide spectrum seizure medication
-1st line for tonic-clonic
Not for status epilepticus
201. Valproic Acid MOA: inhibits HISTONE ACETYLASE -
Histones were in DNA - transcription error
202. Vitamin C: Required fro the hydroxylation of specific purine
and lysine residues
-If deficient, will cause scurvy
--Inadequate hydroxylation of collagen peptides
203. Washed packed RBCs: RBCs washed in sterile saline to
remove:
WBCs
Lytic mediators
Non-self antigens
Most useful in IgA deficient persons who have circulating anti-
IgA Abs
-Use febrile, urticarial and anaphylactic reactions
204. Wernicke's aphasia: Fluent aphasia with impaired
comprehension.
Wernicke's area-superior temporal gyrus of temporal lobe.
Wordy, but makes no sense
205. Whole blood: Blood that is unmodified except for the presence
of an anticoagulant
Usually not used because the extra plasma can contribute to
transfusion associated circulatory overload (TACO), a potentially
dangerous complication
206. Why deoxyHB can carry CO2 better than OxyHB?:
DeoxyHB = better buffer
207. Wound healing: 1. Inflammatory (immediate)
-Platelets, neutrophils, macrophages
2. Proliferative (2-3 days after wound)
-Fibroblasts, myofibroblasts, endothelial cells, keratinocytes,
macrophages
-Granulation tissue depostion, angiogenesis, wound contraction
(mediated by myofibroblasts)
3. Remodeling (1 week after wound)
-Fibroblasts
-Type III collagen replaced by type I collagen
208. Zanamavir MOA: Zanamivir MOA - inhibit virion release
209. zanamivir, oseltamivir MOA: inhibits virion release
210. -ALA dehydratase: Lead poisoning
Accumulates:
Protoporphyrin, -ALA
Microcytic anemia, GI and kidney disease.
Children-exposure to lead paint -+ mental deterioration
Adults-environmental exposure (battery/ ammunition/radiator
factory) -+ headache, memory loss, demyelination
211. -ALA synthase: Sideroblastic anemia