nbme

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1/2500 incidence. What is the carrier

freq for CF

AR = 1/2500
(square root it) =
1/50 (multiply by
2) = 1/25

1 wk hx confusion, disorientation, talking

to himself, delusional ideas about his
landlord and incontinence, diag?

delirium

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1 wk hx of dizzy, warm water in left ear =

nystagmus to left, in rt ear = nothing.
Where is the damage?

vestibular = rt
side.

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1 yr old, multiple infection, partial

albinism, neutropenia, giant granules in
neutrophils. Diag and def?

chediak higashi.
Def in
phagolysosome
function

1yr old, v, copious D, dec urinary freq,

similar illness at schools. Resistant to
ether, contains double stranded
segmented RNA genome. Organism?

rotavirus

2cm^2 cross section aneurysm and

20cm/sec blood flow rate. What is the
flow rate in L/min through the
aneurysm?

20x2 = 40 ml/sec.
(40x60)/1000 =
2.4 L/min

2 day hx of low urine. Surg 2 wks ago

and gentamicin. Diag and damage to
nephron location?

acute tub
necrosis proximal tubule

3 boy, pain in legs, specially at night.

Cannot keep up with peers. Gluteal
muscle weakness bilaterally. Diag and
inc marker

DMD. Serum
creatine kinase
activity

3 day old, fever, stiff neck, gram neg

rods, neutrophils. Diag?

e. coli

3hr hx difficulty breathing, midl lt

shoulder paiin, htn, smoker, Po2-58.
diag?

pul edema

3 month, virus, lower rti. Multinucleated

cells in tissue. Rx?

RSV = ribavirin

3 wks post MI, accumulation of free fluid

in peritoneal space. Cause

inc capillary
hydrostatic
pressure

3 year old boy, CF, inc PT, PTT, pt

improves with cofactor for?

carboxylation of
prothrombin - Vit
K.

3 year old boy, only able to speak 20

words. Correct response?

further eval for

cause of
language delay

4 boy, macrocephaly, large ears,

prominent chin, 3 word vocab. Fragile x.
12 year old daughter - next best step

wait and let her

decide if she
wants to be
tested of her
carrier status

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4 boy, two bacterial UTI, marked

dilation of left ureter and renal
pelvis, minimal lt sided renal
function. Diag?

congenital ureteral
obstruction

4m boy, AR skeletal dysplasia or

dilated RER = can not
endochondral bones. Null mutation
go from RER to Golgi
in genes that control the traffic of
= achondroplasia
cesicles into the golgi. EM will show?
4th ventricles originate from

metencephalon

5 boy, flulike sxs treated by aspirin.

Diag? why is pt in coma?

reyes syndrome.
Cerebral edema. Inc
ammonia, lactate, PT,
transaminase activity.

5 boy, pharyngitis. Beta hemolytic

gram + coccus in chains. Wht gives it
its shape?

peptidoglycan

6 boy, two weeks after URI,

periorbital edema, peripheral
edema, normal labs, ASO is normal

minimal change

6m hx of hrt burn, difficult

swallowing, no n or v, swelling of
wrists and hands, no meds, no
wrincles on face and neck. Diag and
esophageal persistalsis and LES
tone.

CREST synd.
Peristalsis dec, LES
tone dec

6 month boy, sluggish, edematous,

coarse immature facies, poor muscle
tone

congenital
hypothyroidism

7 mm red scaly plaque on the helical

rim of left ear. Diag?

actinic keratosis =
know histo

8 boy, gen edema for 2 months, 4+

protein, oval fat bodies. Diag?
involves what part of kidney?

minimal change.
Glomerilar capillary
loops

8 m hx of burning chest pain, bitter

taste in mouth, sxs at night when pt
lies down. No pain radiation. No sob.
Dx? What is assocated with it?

barretts esophagus metaplasia of

esophageal
epithelium

8 wks after recovering from

pneumococcal pneumonia. Normal x
ray. Why?

maintenance of
basement membrane
integrity = normal BM
so nothing was
messed up = norma x
ray

8 yr hx of htn, tires easily, no family

hx of liver ds, inc AST and ALT. what
caised inc of serum liver enzymes?

nonalcoholic
steatohepatitis

10 boy, chronic iron def anemai,

improves with H2 antagonist.

meckel diverticulum

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10 day hx, yellow skin, abd

discomfort, fatigue, AST-320, ALT340. damaged to hepatocytes are
mediated by?

cytotoxic T
lymphocytes

10 month old. abd mass, 10cm mass

in upper pole. Diag?

nephroblastoma wilms tumor

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11 boy, extreme thirst, passing large ketones = B

amounts of urine, wt loss. Lethargic hydroxybutyric acid
and drowsy. What does the brain
use other than glucose for energy

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12 boy, 6m hx of difficulty walking

and leg pain. Hammer toes, high
stepping gain. Diag? nerve biopsy
would show?

charcot marie tooth.

Abnormal myelin
sheath

14 girl, palpitations, irregular pulse,

mig polyarthritis, low fever.
Prophylactic antistrep for?

mitral valve stenosis

15 boy, colors seemes bright,

sounds louder, desks appear to
move. Diag?

hallucinogen use

15 boy, gynacomastia. Cause?

normal for puberty

boys - resolve with
time

15 girl, redness day after

sunbathing. No welts, used
sunblock every few hours. Diag?

first degree burn

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16 female, never had period. Short

stature, little sexual development.
Ovaries would show?

atrophy

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24 black, red bumps on face and

chin, itchy, painful, hyperpigmented
papules. Diag?

psudofolliculitits
barbae = razor
burns.

24 female, intermittenet fevers, chest

x ray show diffuse interstitial nodular
densitites. Biopsy show, accumulation
of chronic inflammatory cells in
interstitium and noncaseating loosely
formed granulomas. Diag?

hypersensitivity
pneumonitis

24 female, v, fatigue, dizziness, Hb-6,

hematocrit 18%. What is most likely to
be decreased in artery?

arterial O2 carrying
capacity

24 male, hx eczema, recurrent

infections, dec platelets, low IgM.
Diag?

wiskott aldrich
syndrome

25 female, inc facial hair and chest

hair, irregular menses. Inc 17hydroxy. Bp - 116/62. def of ?

21-hydroxylase =
think normal vs
hyper. Is normal bp
then 21, if htn then
11b def.

25 female, inc LH and FSH. 6 m

amenorrhea. Diag?

primary ovarian
faliure

25 metformin pills. Se?

lactic acidosis

26 female, acute fever, chest pain,

sob, hypokinesis, virus related to
heart ds.

coxsackievirus

26, flank pain, palpitations, sweating,

recurrent headaches. Diag and where
in the adrenal anatomy?

pheochromocytoma.
Adrenal medulla catecholamines.
Very bottom layer layer with
chromaffin cells

27 female, f, malaise, abd pain, vag

discharge, bilat lower quad
tenderness with rebound and
guarding. Ink leukocytes. Diag?

PID = mc is
gonorrhea

28 black female, lesions on eyes,

nose, hilar lymphadenopathy, diag
and histo finding?

sarcoidosis,
granulomas with
foregin body giant
cells, inc ace levels

29 pregnant, wt gain, anxiety, poor

concentration, palpitations, loose
bowel movements. What to check
next?

thyroid glands

17 girl, ha, fading vision in both

papilledema
eyes, react to light and accomidate,
pic. Diag?
18 female, mild retard, dec vision in
dark, chronic D, dec muscle control
of arms and legs. Diag and def?

abetaliproproteinemia.
Apo B

18m old boy, lethargy for 3 hrs.

hypoglycemia and D for 10m.
Medium chain triglycerides are
adiministered daily for 6m. Def of?

LCAD = long chain

acyl coa
dehydrogenase

18 year old football and wrestler.

Gynacomastia. Next step?

ask if using steroids

19 boy, collapses at party, agitated,

disoriented, fever, hot flushed skin,
pupils dilated, responsive to light.
What rx?

ecstacy

19, schizophrenia, txt

olanzapine

20 female, weakness of legs, abd

pain, persistent v, port wine colored
urine, hx of 3 similar episodes.
What will be seen in urine

porphobilinogen =
acute intermittent
porphyria txt glucose and heme to
inh ALA synthase

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22, anxiety and depressed for 6wks. amitriptyline

Orthostatic hypotension. What rx?

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30 female, 7wk hx of palpitations and exogenouse use of

sob with exertion. Hr 16. tsh -0.01, T4 - levothyroxine
2.6, low iodine uptake, low
thyroglobulin, low thyroglobulin
antibodies. Caused by?
30 female, jogging what happens to
exp minute vent, cardiac output,
arterial PO2

inc, inc, unchanged

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30 female, ptosis, double vision,

weakness, deep tendon reflex
normal, neostigmine improves sxs.
Dec num of receptors on what?

plasma membrane

30 female, rt knee pain, gram stain

shows organisms in the cells

N. gonorrhoeae

30yr hx of DMt2, fasting

endogenous serum insulin
concentration would be?

low - below normal around 1uU/mL

31 female, retrosternal chest pain

while at rest for 6m. Few mins of ST
seg elevation. What caused this in
large epicardial artery?

endothelial cell
dysfunction

34 wk gestation, pul htn txt with

what drug while watching for
methemoglobinemia

nitric oxide

35 female, visual dist, weak radial

and rt carotid pulse, rt retinal
hemorrhage. Narrowing of the
brachiocephalic, rt carotid,
subclavian arteries. Diag>

takayasu arteritis

35lb wt gain despite diet, 156/96,

round ruddy face, hirsutism,
enlarged adrenal glands. Histo
changes?

cortical hyperplasia

35 male, 4d hx, high fever, muscle

aches, malaise, loss of appetite,
nonproductive cough. Similar for
wife and 2 kids. Replicates in cell's
nucleus. Diag?

influenza virus = ss
RNA E (-) could also
be retrovirus = HIV,
HTLV = E ss linear (+)

36 hours post MI would show?

coagulation necrosis
and neutrophilic
inflammation

37 female, 3year hx progressive

dementia and writhing movements
in all four limbs. Structure
involved?

neurons of striatum

38 female, 10wk hx epigastric pain

and freq stools. Hx renal calculi,
multiple superficial lipomas. Inc
serum gastrin. Next step in
management?

serum calcium
concentration = MEN 1
- associated with
zollinger = kidney
stones and stomach
ulcers

38 male, 9m hx dyspnea, chronic

interstitial inflammatory infiltrates
with hyperplasia of type 2
pneumocytes and irreular areas of
collagen deposits. Diag?

idiopathic pul fibrosis

(collegen - fibrosis restrictive)

40 female, 30 min afer sustaining

severe chest inj, 25 yr hx of
seizures. What caused seizures?

vascular malformation

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40 female, mole on back, black tan

pigment, ill defined margins, peomorphic,
hyperchromatic cells within clear islands
present on all levels of dermis and
extension into papillary dermis. Diag?

melanoma =
papillary dermis

40 male, gravel pit worker, x ray show

multiple calcified nodule on upper lobes.
Ppd negative

silicosis

40 male, sensitive to sunlight. Blisters

form right after sun exposure. Very
painful. Diag? what pathway is defective?

acute
intermitten
porphyria.
Heme synthesis

42 american, foul smelling stool, wt loss,

abd pain, diag?

alcoholic

45 female, 3m hx dec energy, impaired

concentration, tingling in both hands,
constipation, wt gain. Diag?

hypothyroidism

45 male, drinking 12+ beers for 10 days.

Jaundice. Inc total bilirubin, inc AST, inc
GGT. Liver biopsy would show?

Mallory haline.

45 male, intermitten bloody D, abd pain,

sigmoidoscopy and rectal biopsy show
IBD. MAB being used. Diag? ab directed
against?

UC. Think anti

inf = TNF

45 male, n, v, abd pain, tachycardia,

absent bowel sound, involuntay guading.
Cause?

peritonitis

45% on A with 2200pts, 49% on B with

1900pts. P<0.01. decided not to change
the program. Why?

statistical
significance and
practical
importance of
the difference in
success rates

45s rRNA is cleaved to 18, 5.8, 28s in?

nucleolus

48 female, excessive bleeding during and

between periods. Adnexae non palpable.
Curettage show abundant tissue. Diag?

endometrial
hyperplasia =
late 40's with
inc bleed and
inc cells

49 male, 1wk hx sob, no f, chills, cough.

Breath sounds dec in LLL, dec vocal
tactile gremitus, dullness to percussion.
Diag?

pleural effusion

50 male, 2m hx of pain on wrist, change in

skin color, prog fatigue. DMt2, cirrhosis,
bronze colored skin. Marked inc of
ferritin. Cause?

inc intestinal
iron absorption

50 male, gen tonic clonic seizure. Pins

and needles sensation around mouth,
hands and feet. Involuntary contraction
of muscels. Hyperreflexia. Abnormal
serum electrolyte of?

calcium hypocalcemia

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51 female, firm lump in neck for 5m, tires

easy, T4 - 1.8. serum findings?

presence of
antithyroid
peroxidase
antibodies

55 male, burning dysesthesias over latral substance P

aspect of leg. Caspaicin containing
cream. Substance caused dysesthesias
is?
55 male, spesis, txt with vanco and
septic shock.
ceftriax. Dec bp, inc temp, moist skin and Administer 0.9%
diaphoresis. Diag? what to administer?
saline
56 carcinoma of breast, tumor next to rt
side of heart, tumor invading
pericardium. What is most likely
involved?

rt phrenic nerve

56 female, first time to doctor in 5 yrs.

2x2.5cm mass outer upper quadrant of
left breast. Nontender, nonmobile, ill
defined borders, no discharge. Diag?

adenocarcinoma

56 male, inc confusion, memory loss,

cholinesterase inh improves memory by
targeting synaptic connection between?

basal forebrain,
neurons in
cerebral cortex

60 female, anorexia, reslessness,

irritability, confusion, paraneoplastic
syndrome. Abnoral finding where?

x ray film of the

chest = small
cell carcinoma

60 male, 1m hx of SOB. Right lung base

breath sounds dec, percussion dull, TF
dec, no adventitious sounds. Diag?

pleural effusion
( dec breath,
dull, dec TF)
could be
atelectasis

64 female, abd cramps, n, d, flushing of

skin, hrt palpitation. 24 hr urinary 5-hiaa
inc. neoplasm is located where?

small intestine

64 male, unable to sustain erection

during intercourse or masterbation. MI 2
months ago. Diag?

fear of sudden
death

65 male dies of bronchopneumonia, hx

of loss of facial expression, tremors,
rigidity and slowing voluntary mvmt.
Finding in brain?

eosinophilic
inclusions - lewy
body in neurons
on sibstantia
nigra

67 female, bone pain, hard of hearing,

kidney stones, normal Ca and
phosphorus, alk phos inc, urinary
hydroxyproline is increased. Diag?

osteitis
deformans =
pagets

68 female, gross hematuria, aphasia, rt

hemiplegia, coma, death. Diag (PIC)?

renal cell
carcinoma

70 male, easy fatigue, malaise, ataxic

gain, pale, sore tongue, absent bitratory
sense up to knees and bilat extensor
plantar reflex. Blood smear shows
macrocytosis. Diag

acquired def of
intrinsic factor
(can not be
congenital since
he is 70)

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72 female, 6m hx blurry near and

far vision of left eye, small blind
spots in center. PIC is shown. Diag?

macular
degeneration

72 male, 2 hr episode of vision loss,

high hemoglobin, high hematocrit,
high leukocyte. Diag? txt?

polycythemia vera.
Phlebotomy

73 female, hx of urinary freq and

urgency, 3m hx of difficulty
walking, and memory. Diag?

normal pressure
hydrocephalus

80% power, 15% mean, signicance

level of 5%. If there is no difference
btwn two groups, what is the
chance that study will find a
statistically significant difference?

type I error - 5%

83 male, bedridden and confused.

Bp 85/50, 1 liter of isotonic saline
does no change. CO - high, PCWP
low, SVR - low. Cause?

early septic shock no real fever yet.

500 of 2500 initially affected. Next

year 200 were affected. What is the
incidence?

2500-500 = 2000.
200/2000 = 10%

4000 people screened, 200 had

cataracs. What is the annual
incidence of cataracts in
population?

unable to calculate.
Insufficient data

aa that contribute to nitrogen or

carbon to purine ring.

gag = glycine,
aspartate, glutamine

abd cramp, bloody d, teacher, kids

at school also had it.

shigella

abd pain, alcoholic, amylase - 700,

lipase - 850, calcium - 7. mesenteric
fat seen in autopsy. Why?

action of pancreatic
enzymes on adipose
tissue

absence seizures. Mechanism?

synchronized
discharge ot
thalamocortical
neurons

achilles tendon nodules. Foamy

histiocytes. LDL is 980. diag?
cause?

familial
hypercholesterolemia
= AD. Absence of
functional LDL
receptors in
hepatocytes.

activity of what enzyme is inhibited glyceraldehyde 3

if; G6P(180%), G1,6BP (220%), G3P
phosphate
(210%), 1,3BPG (75%), pyruvate (70%) dehydrogenase
with percentage showing amount of
work compared to normal?
acustic schwanomma compression
of

lateral medulla.
Ipsilateral.

acute appendicitis. What type of

necrosis?

fat necrosis

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acute botulism would cause what to

epp, mepp, ach response ?

dec end plate

potential amplitude
but maintain normal
mepp and respnce to
ach

AD disease that is now showing

difference in strain only for father
and daughter and no other family
relitives

recombination

adipocyte triglycerides are used for

gluconeogenesis. Initiated by what
enzyme?

glycerol kinase

affects merkel cell lineage

tactile sentation =
large myelinated
fibers - pressure,
touch

afib - what drug is able to control

ventricular response that is too fast
during stress?

propranolol

after an excision, what is most likely

to reestablish epidermal continuity

basal cells

after diag of cancer pt is most at

risk of developing?

major depressive
disorder

after txt cancer cells remained

normal cells decreased. Why?

inhibits apoptosis

agonist mediated receptor

activation. Trigger the fastest
measurable response?

ligand coupled ion

channel receptors =
parasym.

alchoholic, confusion, serum Na 99, txt with 0.9% saline. 4 days later,
confuions, slurred speech, muscle
weakness, lesion where?

brainstem - central
contine myelinolysis

alcohol is used to sterilize. Disrupts

what structure?

membrane

allele freq of A and B are 20%. But

the haplotype feq is 16% why?

linkage disequilibrium

allergen. Inc eosinophilia. What is

the sequence of events?

t cells - cytokines IgE

allergic to aspirin. Rx for cerebral

infacrtion prophylaxis

clipidogrel

all four chambers of the heart are

dilated. Sob, fatigue. Diag

dialated
cardiomyopathy

altered reactivity to neurtalizing

antibody from influenza by
altering?

hemagglutinin

alveolitis w/ interstitial edema,

inflammatory cell accumulatioin, t2
epithelial cell hypertrophy and
hyperplasia. Diag?

pulmonary fibrosis

amenorrhea for 3 months, not

pregnant, 15 lb wt loss, not eating
well. Cause of amenorrhea?

alter GNRH pulses

anencephaly caused by?

failure of closure
fo rostral end of
neural tube

anesthesia over little finger, atrophy of

interosseous muscle. Nerve damage

ulnar = anterior
branch, lower
plexus

ARDS 1 year ago. What is likely to be

found in pts lungs?

inc concentration
of surfactant
protein D

ashkenazi jew, twitching in both eyes,

dev delay, cherry red spots in macula.
Hypotonia. Dx? Biopsy will show?

tay sachs. Gm2

ganglioside

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aspirin inhibits?

cox 1, 2 = dec
synth of
prostaglandin

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associated with temporal arteritis?

polymyalgia
rheumatica

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asthma. Inhibition of what will help?

5 lipoxygenase
to dec
leukotrienes

atypical cells in urine, lesion on rt

kidney. Exposure to?

2-naphthylamine.
Transitional cell
ca = aromatic
amines

autoimmine, proximal muscle weakness.

Diag

lambert eaton
synd.

basal cell carcinoma. Txt

cryotherapy

benzopyrene in cigarette are converted

to DNA damaging carcinogens. By
what?

oxidation by
cytochrome
p450

bicornuate uterus bc of

incomplete
fusion of
paramesonephric
of mullerian duct

bilat ankle edema. Inc interstitial

hydrostatic pressure - what kidney
syndrome?

nephrotic
syndrome

bilateral external oblique muscles.

Movement of vertebral column how?

flexion

bilat hydronephrosis, inc creatinine, inc

bun

urethral
obstruction

bilat loss of pain and temp on trunk and

upper limbs. No motor deficit. Long
pathway that is affected?

spinothalamic
tract

biopsy, prolif of irregular shaped

glands, hyperchromatic and
pleomorphic nuclei, invade pul
parenchyma and lymphovascular
spaces.

adenocarcinoma

biopsy shows congo red stain with

birefringent pattern under polariazed
light. Why the staining property?

B pleated sheet
structure amyloids (A or B)

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blisters of the finger on a 2

year old. What virus ?

coxsackie = ssRNA NE icosahedral

blood drawn 1 hr after eating

baked potato. What will be
inc?

glucose

bloody D, abd pain, watery

stool with red blood. Diag?

ischemic colitis

blur vision, weakness in left

extremity 18 hrs after accident,
6 hrs later pt is comatosed.
Extra axial hemorrhage over rt
cerebral hem. Diag?

laceration to middle
meningeal artery

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BM transplant. 2 wks later pt

has rash, D, inc liver enzymes,
inc bilirubin. Diag? cause?

graft vs host ds. Donor T

lymph reacting vs host
cells. = jaundice, liver
enzymes inc with BM or
liver transplant is usually
GvsH

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bone pain for 9 yrs, loose

dec, dec, inc, inc
bulky stools, muscle weakness,
disgended abd. What happens
to calcium, phosphorus, alk
phos, pth?
bosental. Blockade of?

endothlin receptor

boy, jaundice after fasting for

30 hours. No prior hx. Diag?

gilbert syndrome

bronchogenic cyst. Embryo

from?

foregut

b thalassemia mutation caused

by

spice site nucleotide

change

163.

bulimia. Txt?

cognitive behav therapy

and SSRI.

164.

bupivacaine injection. Moa?

dec Na permiability

Camp dep protein kinase are

activated by what mechanism?

binding of cAMP to
regulatory subunits, which
release the catatlytic
subunits.

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carcinoid synd. Primary

neoplasm is at?

GI = small intestine

cause of pericardial friction

rub 3 days post MI

fibrinoid pericarditis =
coag necrosis and
neutrophils

CD22, 19, cytoplasmic Igu, Igk,

no surface Ig, no CD3. acute
leukemia from?

pre B lymphocytes

CFTR mut. Alter which ion

transport?

camp stim Cl secretion

CFTR segment in CF that is

most likely located in
transmembrane segment

Ile-phe-val-leu-Ile-trpcys-leu (only one with

valine)

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chemo pt develops pinprich and

fine touch is dec in hands, wrist
and ankles. Sensory loss due to
chemo drug. What drug?

vincristine =
microtbules for axonal
transport = areflexia,
peripheral neuritis.

CHF, what does atrial myocytes

secrete and function?

atrian natruritic
peptides, inh renin
release

child w multiple frx, behind on dev osteopetrosis milstones, teeth errupted late, inc osteoclast
bone density, wideing of
metaphyses and diaphyses of long
bone. Diag and what is defective
chronic diarrhea leads to what in
acid base?

normal anion gap

metabolic acidosis dec pH, dec pCO2,
dec HCO3

chronic renal failure, unable to

covert what to its active form?

25hydroxycholecalciferol

chronic skin lesion, military in iraq,

irregular bur sharp borders on the
rt upper extremity. Giemsa stain inclusions within histiocytes.

leishmania major

chronic use leads to renal ds.

aspirin

cisplatin post surg. The rx

interacts with?

DNA

CML, bm transplant. 6 wks later, d,

cut rash, jaundince. Cell type
involved

t lymphocytes

cohort stidy for drug x shows

fewer deaths in transmural MI.
next step?

prospective,
randomized,
controlled study of
administration of drug
X vs. placebo

colon neoplasm, what protein is

type 4 collagenase
most likely involved in the process
of invasion
combination of two drugs will
decrease bacterial load better
than one alone. But it will not
double the outcome

tobramycin and
ampicillin = aminoglyco
and penicillin

compared to freshly secreted

hepatic bile, what is decreased in
bile stored in gallbladder?

water

component of bacterial cell

envelope exhibits endotoxin
activity

lipid a

compound taken up by bacterial

cells. Not concentrated in cells.
What transport was used?

facilitated = carrier
mediated diffusion

consequence of impaired
synthesis fo IL-1

impaired function of T
lymphocytes

cotton wool spots. Underlying

pathology?

microangiopathy

188.

189.

190.

191.

192.
193.

194.

195.

196.

197.

198.

199.

200.

201.

cough suppresnat.
Less abuse potential,
less cough
suppression, minimal
analgesia and
constipaiton
compared to codeine.
Rx?

dextromethorphan

C. perfringens evades
destruction by
neutrophils in pts with
clostridial
myonecrosis?

damaging neutrophil membranes

by means of a membrane
damaging toxin

crane operator comes

for seasonal allergy.
Txt?

2nd gen antihistamine = loratadine.

2nd gen antihistamine so he is not
sleepy. Remember en-ine, en-ate
(DiphENhydramINE,
dimENhydrinATE,chlorpheniramine)
is 1st gen. adine is 2nd gen

203.

204.

CVA in blacks, looking population based

at income and
education using the
national census
D2 rec agonist rx

202.

ropinirole , bromocriptine

damaged Y chrom. If a must have the same mutation

skin graft is to be
accepted ?
damage to
tegmentum of
midbrain

loss of consciousness

dec activity of TPMT in

population. What does
this mean if txt them
for ALL with 6-MP?

dec dose of 6-MP. If one pathway

is not working then the other
pathways will work extra hard
leading to over production of toxic
metabolites.

dec dietary nacl in pt

w hepatic ds

secondary hyperaldosteronism

dec pain at sites of

acute inflammation.
Antagonist to?

bradykinin

dec risk for ibuprofen

induced gastric ulcers

misoprostol

dec serum ca and

phosphate, bun, creat
are increased. Lab
values

25 hydoxycholecal - normal, 1, 25
dihydroxycholecal - dec, PTH - inc

deg of corticospinal
tractc and atrophy of
ventral roots?

both motor = ALS

develop from
primordial gut,
contain ganglia
innervated by enteric
neurons?

pancreas

205.

206.

207.

208.

209.

210.

211.

212.

213.

214.
215.

216.

217.
218.

219.

220.

diag ALL, txt, neutrophil <500,

left lower lobe infiltrate. Acid
schiff stain. Diag? txt?

mycosis. Amphotericin B.
Mycosis = sezary = lymph
node tumor that can
spread and infect.

diag of CF. defect of what in pts

bronchial epithelium?

protein structure

diag of crohn's. what is the most

likely site of the ds?

ileum

diag of duchenne. Changes in

muscle cell physiology?

fat cells = replacement

of muscle cells by
connective tissue
stromal cells

diag of legionella. What

mechanism clears this?

T lymph med immunity

diag of Multiple myeloma. What

additional finding in lab will be
present?

K light chain proteinuria

= bence jones proteinuria

diag with ehrlichiosis. Txt with?

Moa?

inhibit protein synthesis.

Doxycycline - binds to
30s

DIC. What change is seen in

blood coag process

inc plasmin generation

different phenytupes dep on

parental origin.

imprinting

difficulty walking. Dec muscle

bulk in lower extremity, dec
tendon reflex. Pain, temp,
position are normal. Cause?

degeneration of
motorneurons of lumbar
cord = must be LMN =
lesion of anterior horn

dif swallowing, regur of

undigested foods, halitosis,
midline pouch. Innervation by?

motor of vagus nerve

dilated cariomyopathy. What

happens to lt vent stroke
volume, lt atrial pressure,
peripheral vascular resistance?

dec, inc, inc

Diptheria vaccine?

toxoid

dizziness and ringing in ears.

Rx?

aspirin

dka pt. what happens to Bhydroxybutarate, osmolality,

anion gap?

increase, increase,
increase

DMD inheritance

x linked recessive

DMt1, 22lb wt loss, HbA1c from

5.8 to 8.4 in 6m. Wt loss caused
by?

dec amount of self

administered insulin
doses

DMt1. becomes unconsious after

not taking insulin for 24hrs.
What happens to HCO3, PCO2,
pH?

dec, dec, dec

DNA from e coli vs hib are

cleaved differently in a gel.
Why?

methylation of E colu

doctor will not help pt commit suicide

but will manage her pain. Why?

nonmaleficence
= first do no
harm

drooping of lt eye lid, ptosis, fixed and

out eye. Damage from where?

aneurysm of
PCA

drug for angina pectoris. Bp dec, hr dec.

what rx?

bb =
propranolol

drug halfs the length of symptomatic

outbreak of HSV. What does this do?

prev will dec by

half.

242.

drug is like what when dec force in Nepi,

phenylephrine, but no effect with
isoproterinol.

prazosin alpha
antagonist

243.

drug moved graph to right on response

and dec the efficacy by half.

noncompetitive
antagonist

drug stays in cytoplasm. This would

directly influence?

glycolysis

drug X @ 500mg and drug Y @20mg both

give pt pain free. Efficacy of the drugs
are?

X and Y are
equally
efficacious

dull lt side chest pain, sob, weakness,

nonproductive, installation worker.
Biopsy show anaplastic, biphasic,
calretinin, cytokeratin, no
carcinoembryonic antigen. Diag and what
else will you see?

asbestosis =
ferruginous
bodies.

E6 in HPV degrades p53 by what cellular

enzyme?

ubiquitin ligase
= proteasome

earliest response seen when treating

megaloblastic anemia

reticulocyte
count

easy fatuge, prox muscle weakness,

pruritis, constipation, lower abd pain,
mother had thyroid gland and adrenal
gland tumors. Pt has renal calculi and
parathyroid adenoma. Diag and gene
mut?

MEN 2A = ret
gene mutation

233.

E coli UTI. What caused the hypotension

lipid A

234.

EGFR and PDGF classified as

receptor TK

235.

endometrial hyperplasia caused by

inc estrogen =
ovarian tumor
secreting
estrogen

enlarged posterior fossa with large

midline cyst , abscent of cerebellar
vermis. Diag?

dandy walker
syndrome

254.

eosinophils in urine, rash, oral antibiotics,

fever. Diag?

interstitial
nephritis.

255.

episode of psychosis. Rx?

antipsychotics =
mainly atypical
= risperidone

221.

222.

223.

224.

225.

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237.

238.

239.

240.

241.

244.

245.

246.

247.

248.

249.

250.

251.

252.

episodic pain in joints and muscles. Diag + fibromyalgia,

txt
amitriptyline

253.

256.

equation for GFR using capillary

pressures

Kf (coefficent of
filtration) x((HPgcHPbs)-(oncotic gconcotic bs))

erros in genetic coding leads to

abnormal protein folding. What
happens to that protein?

faster degradation

erythromycin moa

einterferes with
translocation

excruciating ha, loss of consci, nuchal

rigidity, bilat extensor posturing

subarachnoid hem.

failure to migration of neural crest

cells

no adrenal
medulla

family hx of breast cancer. Most

likely?

germline
inactivation of the
BRCA 1 gene

family hx of hypothyroidism. 2 yr old

is being evaluated. What is the
definitive evidene for normal thyroid
function in this pt?

TSH

fanconi syndrom diag. what happens

to fractional reabsorption in kidneys
for AA, glucose, phosphate, HCO3?

all decrease = ds
of proximal renal
tubes of kidney.

fever, cough, chest pain, malaise for

2wks, moved to central cali. Diag?

coccidioides
immitis - spheroles
in endospores

fever, sob, confusion, postal worker,

nuchal rigidity, lg gram +, spore
forming bacilli. Virulence factor?

polyglutamic acid
= anthrax

fish oil group vs olive oil group to see

end stage renal ds. Type of study?

controlled trial

FMR1 gene. Heavily methylated? What dec transcription

does it cause?
(bc of methylation)
four black round papular lesions with
rim or erythema over the lower
extremity. What is causing pt's
hypotension?

lipopolysaccharide
stim prod of TNF.

four days after sex, male, dysuria,

epididymitis urethral discharge. Complication if left gonorrhea.
alone?
(urethritis,
prostatitis,
cervicitis, PID)
from subharan afcrica. 80/40. hr 150.
edema of face, abdomen, legs.
Findings in pt?

dec plasma
oncotic pressure

full term newborn, enlarged head

circumference, normal body wt, craial
sutures separated, maternal uncle
similar prob, what else will be seen?

stenosis of
aqueduct of
sylvius.

gastric acid secretion is dec in

response to histamine increase.

cimetidine

257.

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264.

265.

266.

267.

268.

269.

270.

271.

272.

273.

274.

gastric bypass, bloating, abd pain, rapid empyting of

cause?
hyperosmolar chyme
into the small bowel
gastrin stimulates?
G-CSF activity is for?

histo show small shrunken

hepatocytes, intense eosinophilic
cytoplasm, fram nuclear chromatin,
cytoplasmic bleb. Cause ?

apoptosis

HIV+, multiple enhancing lesions in

brain. What cancer is most likely?

lymphoma

HIV+, rash, diffuse tan lesion with

central umbilicus. Diag?

molluscum
contagiosum

HIV elisa and westenblot are positive.

CD4 count is 22. HIV viral load is less
than 50. infection from?

HIV 2 = subtype
HIV that viral load
comes back
negative

homologous pairing of chromosomes

in prophase I?

crossing over

hormone secreted by duodenum and

jejunum, stim release of pancreatic
juice

cholecystokinin

hormone that increases platelet count.

Where is the receptor located?

on cell membrane
of
megakaryocytes

282.

horse shoe kidney. Cause?

fusion of the
metanephric
masses

283.

how soon can b-hcg be detected

8 days

284.

how to calculate Km from Vmax?

1/2 Vmax = Km

htn, pain radiates to shoulder and

back, double lumen ascending aorta.
Death from

acute
hemopericardium

hx of CAD, falls, wants celecoxib. Why

C/I?

inh of prostacyclin
without inh of
thromboxane A2
in platelets

hx of cirrhosis. Why the splenomegaly

inc hydrostatic
pressure in
splenic vein

hx of paranoia, aud hallucination, tv

characters are out to get him. Txt w?

dopamin drugs

hx PE, stillborn, platelet count 250000,

PT-n, PTT-inc. diag?

antiphosphoilipid
antibody
syndrome - most
likely from SLE

hx T1DM, dec joint position in toes and

ankles, vibration sense dec in feet, dec
ankle jerk bilat. Damage to?

large diameter
axons of distal
portion of
peripheral nerves

hx vent tachy, come with ha, dizziness,

ringing in ears. Dec platelet count.
What drug?

quinidine

hydrochlorothiazide is added. Moa?

inhibits na cl
symporter

hypothyroidism, TSH inc with TRH

drug. Cause?

hypothalamus
problem

275.

paritetal cells = know

histo

276.

activation of specific
cell surface receptor

277.

genetic element catalyze its own

movement within and between
chromosomes.

complex transposons

genotype of cells of chorionic

villi that comprise the human
placenta is?

fetal

GE tube is places in newborn that

shows it does down and comes
back up to the lungs. Why is the
pt cyanotic?

incomplete formation
of pleuroperitoneal
membrane. Herniation
of stomach to lungs.

gold standard = 90. new

technique = 55, 57, 54, 56, 54, 55

precise but not

accurate.

gram positive organism, infecting

urinary sxs

enterococcus faecalis

grandmother wants to give

premature baby chamomile tea.
How do you deal with this?

negotiate a plan to give

the tea when child's GI
tract will allow
administration of liquids

278.

279.

graph shows a dec and movement against + non comp

to the right. What type of
antagonist. Nepi +
agonist/antagonist is this? What
phenoxybenzamine
would do this with Nepi?
gray membrane across pharynx.
Acqures its virulence through
which genetic events?

transduction

half take drug x, then other half

drug Y. then wait a while for wash
out, then switch the groups taking
each drug. Study?

crossover.

hand injury, flexor carpi radialis is palmaris longus

severed. What tendon is used to
as surgical bridge?
healthy, max inhalation, rate of
expiratory flow is highest at TLC
and decrease linearly. Why?

airway compression

heb B negative polyarteritis

nodosa. Biopsy of involved
muscle will show?

segmental ischemic
necrosis. = transmural
inflammation with
fibrinoid necrosis

helps fight free radicals, from

diet?

vitamin E

hexogonal crystals un the urine.

Made from?

cystine

high antibody titer that can cause

cancer

cervical cancer - HPV

16

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281.

285.

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288.

289.

290.

291.

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293.

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296.

297.

298.

299.

300.

301.

302.

303.
304.

305.

306.
307.

308.

I cell disease/ mucolipidosis defect in

phosphorylation
of mannose
residues

if confidence interval is being increased.

What will happen the size?

increase

if lt renal artery is clamped. What

substance will increase more in lt renal
vein more than rt renal vein?

renin

IgA from mother to child. This is called

transcytosis = in
colostrum
(breast milk)

immunosuppresive agents acts by

selectively binding to the epsilon chain
of the T lymphocyte antigen receptor
complex

OKT3
monoclonal
antibody

impaired neural crest migration on

cutaneous development?

albinism

inc activity of glycolysis by what

enzyme?

PFK-1 = 6
phosphofructo 1
kinase

inc AMP in muscles. Has what effect?

inc breakdown
of glycogen

inc cytoplasmic calcium and Dag.

Stimulated by?

phospholipase
C

inc dosage of dopamine agonist. Se?

psychosis

inc erythrocytes in urine. ASO neg, no

proteinuria, rare red cell casts. Diag?

IgA
nephropathy.

incoordination, ataxia, loss of sensation

on rt half of face and lf side of trunk and
extremities. What artery?

PICA

inc prolactin. Txt

bromocriptine

inc risk for ca of bladder that is

statistically sig at the 5% level

effect would
occur by
chance in less
than 5% of
repeated
samples of this
size

inc sample size will do what to CI?

316.

317.

318.

319.

320.

321.

322.

323.
324.

increase in
width
follicular
adenoma

310.

india ink test +, major virulence factor

polysaccharide
capsule

311.

ingest iron sulfate tablets leads to?

gastric bleed

inguinal adenopathy, LM shows

replacement of nodal tissues by cells
that form well defined, uniform
glandular structures. Nuclei are small an
nucleoli are inconspicuous. What is
grade and stage?

low grade, high

stage neoplasm

312.

314.

315.

inc uptake of radioactive iodine by

nodule. Diag?

309.

313.

325.

326.

327.

328.

329.

inject sodium hydroxide (lyle)

esophageal
stricture

in nucleotides, sugars are attached to

nitrogen containing bases by?

N-glycosidic
bonds

interaction of superantigen toxic shock

syndrome toxin

MHC 2 and T cell

receptor

iron sulfate supplements ingestion.

Finding from mechanism?

peroxidation of
membrane lipids
= free radical
injury

ischemic injury to kidneys. What would

indicate irreversible injury

disruption of
plasma
membrane

isolate has nine cytidine residues,

where original had eight. What
mechanism?

slipped strand
mispairing

KOH of silver stain shows large, round

budding yeast w. broat base. Diag?

blastomyces
dermatidis

labs showing all type. What would show

congenical neutropenia

low neutrophil
count - should be
around 50%

landmark to help locate deep inguinal

ring?

inferior epigastric
artery

levofloxacin used for klebsiella.

Resistance was formed. Why?

mut of
topoisomerase II,
dna gyrase =
fluoroquinolones

liver cirrohsis. Htn of what vein?

short gastric

long term pain, multiple docs, major

concerns and complaints. What is the
next best step?

assess main sxs

and schedule
monthly
appointments

loop diuretics. Acid base of?

metabolic
alkalosis volume
contraction

lt atrial mass that prolapses into the

mitral valve. Micro finding?

amorphous
extracellular
matrix

lt side weakness, lower 2/3 face on lt, lt

upper and very little lower ext
wekaness. Occlusion is at?

MCA on the rt

lungs show alveolar damage, distended

lymph, congested capillary, pink
staining homogenous proteinaceous
hyaline.

spetic shock

lyme ds target rash. What is

morphologically the same?

spirochetes borrelia (lyme),

leptospira,
treponema

330.

331.

332.

333.

334.

335.

336.

337.

338.

339.

340.

341.

342.

343.

344.

345.

machine gun like cough. Diag

and toxin?

pertussis, activates
adenylate cyclase by inh
Gi.

macrocephaly, poor skull

mineralization, shortened
extremities, misshapen long
bones, several fractures
during birth. Diag? defect in?

OI. Collagen type I =

impaired tiple helox in
RER = glycosylation ( do
not mistake for
achondroplasia - no fx at
dirth unless AD and most
die at birth)

maintenance therapy in pts

with moderate to severe
asthma for positive cardiac
inotropic effects. Prod
vasodilation. Diuretic action.
Diaphragmatic contraction.
Rx?

theophylline

mannitol is given. What

happens to plasma osmolality
and plasma ADH

plasma osm = inc. ADH =

inc

mass next to bifurcation of

carotid artery. + for
synaptophysin, chromogranin,
neuron specific neolase. Diag?

paraganglioma

mc mode of inheritance of
disorders caused bythe
mutation of genes that encode
enzymes

autosomal recessive

means of 3 dif groups are

compared?

anova = analysis of
variance

megaloblastic anemia. Marker

in serum?

antiparietal cell antibody

in serum

megaloblastic anemia. Vegan

strict diet for 5 years. What
cellular process is impaired?

dna synthesis

346.

MOA of alondronate?

bisphosphates inh osteoclast

med bone
resorption.

347.

MOA of cyclophosphamide.

crosslinks DNA
at N7 guanine =
stops DNA
replication

348.

moa of neuraminidase inh

release of virus
from the
infected
epithelial cells

molecule is injected and shown in

adjacent molecules. How?

gap junction

mom with T1DM. Baby is large and

become hypoglycemic. Why?

inc fetal
pancreatic
secretion of
insulin

monoclonal AB vs GP2b, 3a. Prevent

binding what to platelet?

fibrinogen

most important in protecting from

oxydation of oxyhemoglobin

g6pd catalyzed
generation of
NADPH

multi drug resistant E coli. What is

observed from in vitro studies.

transfer
requires cell to
cell contact

multiple sessile pedunculated polyps

through rectum and sigmoid. Poor
dentition and several osteomas in
mandible. Diag

gardern
syndrome

mumps in men can result to dec fertility.

Why?

affects testes =
orchitis

mut in calcium rec on cell surface of

parathyroid gland and basolateral blood
side of thick ascending limb of loop.
What happens to Ca, PTH, urine calcium.

hypocalcemia,
low PTH, high
urine calcium

mut in encoded seq of AATAAA leads to

?

cleavage and
polyadenylation

358.

myasthenia gravis diag. antibodies to?

nicotinic
acetylcholine
receptors. Post
synaptic ach rec

359.

myeloperoxidase def.

def prod of
hydroxy halide
radicals.

myoclonus and hyperreflexia. What nt

caused this?

serotonin.

n, abd pain, d. salmonella diag.

antibiotics would?

proling fecal
excretion of
organism

Na/K pump ATPase does what?

3 Na out and 2
K in

349.

350.

351.

352.

353.

354.

melanoma, superficial invasion t lymphocyte med

that is regressed. What is
cytotoxicity
causing the regression?
menopause, what hormone
valuses will be seen

inc FSH and LH

methotrexate inhibits (DHFR

not option)

thymidylate synthase

miconazole no longer
effective. Resistance to what
target?

lanosterol C14
demethylase active site

microinvasive cervical
carcinoma. Micro would show?

neoplastic cells in subbasement membrane

connective tissue.

MI, has stent placed, then inc

CK-MB and troponin I. what
cased this?

membrane lipid
perioxidation =
reperfusioin injury = free
radicals

MI, stent is placed. Develops

idioventricular rhythm. Why?

gen of reactive oxygen

species

355.

356.

357.

360.

361.

362.

363.

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365.

366.

367.

368.

369.

370.

371.

372.

373.

374.
375.

naloxone before morphine

does what to graph?

shift the graph to the right.

Inc affinity, dec Km

nephrectomy using
poserolateral approach
incision through?

transversalis fascia

376.

newborn dies at 12 days.

hyperbilirubinemia
Brain looks yellowish. Diag?
new born, harsh systolic
murmur, then a diastolic
murmur, then 12 hrs later no
murmur and ultrasound
show no cardiac
abnormalities. All heard at
left upper sternal border.
Diag

PDA

377.

378.

379.

newborn, resp distress,

potter sequence - posterior
oligohydramnios, lower abd urethral valves
mass. Underlying cause?
no abd or adduction of
finger. Nerve damaged?

ulnar

no B2 microglobulin
expression. What is
altered?

cytotoxic T lymphocytes

non dysjunction in first

mitotic division. Would lead
to possible number of
chromosomes?

22 or 24. miosis 2 = (normal,

normal, n-1, n+1)

nonhemolytic, catalase
negative, gram +, cocci in
pairs and chains. Diag?

enterrococcus. cAt= use the

A. strep (no A so neg), staph
(has A so +). Nonhemolytic is
only enterococcus (Growth
in bile and 6.5% NaCl) and
nonenterococcus (grow in
bile, NOT 6.5% NaCl).

NPV.

tn / (tn+fn) = horizontal row

of all that tested negative.

nucleosomal gaps
represent?

linker regions about 50bp

that connect nucleosomes

od on diazepam. Risk for?

resp depression

OD propranolol. To stim
same second messenger
what rx to inc hr?

glucagon

380.

381.

382.

383.

384.

385.

386.

on left lateral gaze

right eye does not
adduct past midline
but left eye is fine.
Both eyes coverges.
Diag? cause?
Location?

INO or MLF lesion/damage. Since it

is ipsi 6, contra 3 so it has to be on
the right eye CN3 or MLF. Since
convergence is fine it is MLF. MLF is
located on same side as CN3. so
MLF on the right side. MLF is located
just below the 4th ventricle on either
side of the central line.

oocytes are
released from what
arrested stage

1st meiotic prophase

orally administered
for serious systemic
infection?

ciprofloxacin

order for the

catheter to reach
uterine artery from
femoral artery

external iliac, internal iliac, uterine

artery

osteoarthritis. What
is the earliest stage
in development

cracking of the carilaginous surface

over a 1 year period

all woman with
established breast
cancer in a certain
zipcode are
identified. What is
this method?

period prevalence

ovoid macrocytic
b12 def. Parietal cell of stomach
anisocytosis and
dysfunction
some poikiolocytosis
of erythrocytes. Abd
pain, mucle
weakness, buring in
hands and tingling in
toes. Diag? cause?
oxydation of what
compound requires
carnitine?

palmitate

paclitaxel - binds to
microtubules.
Interfere with cell
cycle where?

M phase

painful anal mass for inferior rectal vein.

4 hours - 15mm blue
tinged rounded
mass. Thrombosis of
what blood vessel?
painful perianal
mass. What infl
mediators is
released from the
aggregated
platelets?

thromboxane A2

387.

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395.

396.

397.

398.

399.
400.

401.

402.
403.

404.

405.

pain in rt ear, irritability, 38.2 temp, ear

shows red, opaque, bulging. Organism?

strep
pneumoniae

pain in rt knee, episodes of pain in

great toe. Nodules are present in ear,
chin, rt shoulder, middle back, lower
back. Where will you find a tophus

ear

painless jaundice, dark urine, white

stools, CT show large soft tissue
density in head of pancreas. Diag?

common bile
duct obstruction

pain on rt hip, runner, pain with

flexsion, internal rot, direct palpation
of lateral hip. What bursa?

trochanteric
bursa.

406.

407.

408.

pain radiated down his back and severe ruputure of

lower back pain. Tried lifting wt from
intervertebral
ground over his head. Cause?
disc

409.

pain when resisting abduction at 90

degrees and thumb pointed down.
What tendon is damaged?

supraspinatus

410.

pancreatic calcification. This could lead

to a decrease in?

duodenal pH.
Most likely from
dec HCO3
secretion

paraesophageal hernai, burning chest

discomfort after meals. What is most
likely present?

protrusion of
fundus into the
chest above the
level of T10

paraxysmal svt txted with short acting

rx?

411.

412.

413.

adenosine

parkinson's to alleviate tremor the

globus pallidus
needle should be place in what location
penicillin G concentration in increased
in pt Y over pt X (healthy). Cause?

renal
insufficiency penicillin is
renally excreted

phosphate is being added. What is

doing this?

protein kinase

pic gap junction. Function?

comunication

PIC - golden brown fusiform rods

resembling dumbbells. Diag?

asbestos.

PKD. What mechanism explains the

increased urine output?

inc osmolarity in
tubular lumen

PKU. Aa supplementation

tyrosine

platelet count greater than 2 million.

Diag

essential
thrombocythemia

polydispia, polyuria, 6.5L of urine,

serum na - 148, serum osm - 315, urine
osm - 75, desmopressin shows no
change. what would be the tubular
osmolarity at PCT, jux, medullary
collecting ducts?

isotonic,
hypotonic,
hypotonic

portal htn, benefit from joining the

portal vein to what other vein?

inferior vena
cava

414.

415.

416.

417.

418.

419.

420.

421.

post accident with complete fracture

through lower jaw. What stucture would
be abnormal?

inferior alveolar
nerve = supplies
nerve to
mandible and
teeth

post carpal tunner release, numbness on

right thenar eminence. What nerve is
most likely injured.

palmar
cutaneous
branch of
median nerve

post dental murmur.

strep viridans
(not there),
strep mitis

post MI, after blood restoration, heart

cells show increase size. Why?

dec
sarcoplasmic
ATP

post MI. what causes the pain?

inc of
metabolic
products in the
heart

post MI. what finding best explains the

pleural fluid findings?

inc vascualr
hydrostatic
pressure

post mi. what personality disorder is

assoc w dec survivial

Major
depressive
episode

post sphincterotomy pt has no more

colic pain. What was the defect?

loss of enteric
inh motor
innervation

post vag delivery, heavy bleeding,

placenta cannot deliver bc attached to
uterine wall. Placenta found superficially
invading the myometrium. Diag?

placenta
accreta

pregnant female gets gurd. Why?

dec
competency of
lower
esophageal
sphincter

pregnant woman, inc T4, normal to low

TSH. Changes are caised by?

estrogen = inc
Thyroid
globulin
receptors

pregnant woman sees a small bump

enlargement. She had the bump all her
life. Diag

accessory
nipple

primaquines is used bc?

kills
hypnozoites

primary liver abscess from e coli, then

have fever and shaking chills. Why?

release of
leukocyte
cytokines into
the circulation

primary structural protein of the mitotic

spindle apparatus

tubulin

procedure to relief pain on rt side. Where lateral spinal

is the lesion
thalamic (know
cross section)

422.

423.

424.

425.

426.

427.

428.

429.

430.

431.

432.

433.

434.

435.

436.

437.

438.

prostate cancer met to

vertebrae. Biospy of bone
will show?

pleomorphic epithelial cells

forming duct like structures

proteins from RER and

secreted from eukaryotic
cells are shorter than
mRNA?

cleavage of 5' segments of

nascent polypeptides being
synthesized on
polyribosomes in the
endoplasmic reticulum

psoriasis. What is the cell

adaptation?

hyperplasia

pt always thirsty, drink a lot,

txt with lithium. Abnormal
function where in the
kidneys?

collecting duct - siadh

pt asks if the test results are

bad after cancer relapsed.
Best answer?

yes it is - don't evade

question

pt did not eat for a week.

Blood glucose is normal bc?

breakdown of skeletal
muscle protein

pt has dj vu before
seizures. What part of brain
is affected

temporal

445.

pt has sob but no chest pain.

Cause?

inc EDV

446.

pt takes metronidazole needs to avoid?

wine and alcohol

pt takes NSAIDS and has inc

creatinine. Why?

vasodilating prostaglandins
at the afferent arterioles.

439.

440.

441.

442.

443.

444.

447.

pt treated for DVT and now

heparin - potentiates the
has thrombocytopenia. What action of antithrombin III
drug? Moa?

448.

pt uses words and word like

utterances, makes no sense.
Follows command. Likely
diag?

temporal lobe lesions = HSV

encephalitis

449.

pt w alcoholism, htn, dmt2,

osteoarthritis, dyslipidemia
is given pravastatin. Rx must
be used with caution bc of?

alcoholism = hepatotoxicity

450.

pt with menapause sxs.

Why?

inc FSH, LH and dec

estrogen = failure of ovaries
to secrete 17b-estradiol

pt with RA. Antibodies bind

where?

FC portions. So the area

below the double bond.
Constant domain.

pt with RA calls bc she can

not do anything even turn
off faucet

have pt come in and give a

shot

pt with rheumatic fever.

Cardiac abnormalities?

myocardial edema with

aschoff bodies

451.

452.

453.
454.

455.

456.

pt with stable asthma wheezes when

exposed to cats. Txt

inhaled cromolyn =
inh mast cell
degradation

pt with urinary retension txt for

chronic neuropathic pain. Drug?

amitriptyline

pul htn. Lung transplant. What will be

increased in transplanted lung
compared to untransplanted lung?

blood flow

pulmonary circulation has what

compared to bronchial circulation

larger percentage
of cardiac output

pupillary constriction, ptosis,

vasodilation of lt side of face. What
nerve fiber was damaged?

post synaptic
sympathetics from
sup cervical
ganglion

pyloric stenosis. Is most likely is the

child is a male/female and if the next
born is a male/female?

more common in
males. So if a girl
has it now and has
a brother it is more
likley.

rate of transport depends on

concentration but does not exceed
10. why?

facilitated diffusion

rbc placed in NaCl (graph) size

doubles then settles around 1.5 times
original size. What is the
concentration of the solution it was
placed in?

75

recombination involves

homologous sites

recreational cocaine, sob, rr 25, lt

lung hyperresonant and breath
sounds dimished. Diag?

pneumothorax

recurrent headache, mri shows a

mass behind the brain stem at the
very top. What is constricted and
what does it cause?

sup caliculus vertical gaze

removed if passed through 0.45u

filter

s. aur. = bacteria
not virus

renal ammoniagenesis from

glutamine and
aspartate

renal artery shows strings of beads.

Inc ha, inc bp, bruit over left CVA.
Diag?

fibromuscular
dysplasia

resistance to ciprofloxacin

dna gyrase

resistant to ritonavir. Makes what

viral process?

protein processing

restless, irritability, perirectal itching,

celliphane tape test +, diag? txt?

enterobius,
mebendazole

results to help with cardiac arrests.

To see results in 1-2 years

defibrillators
placed in public
places of the city

457.

458.

459.

460.

461.

462.

retinoic acid can induce remission in

pts with acute promyelocytic leukemia.
Why?

differentiation of
leukemic cells

reverse neuromuscular blocking drugs.

Then dec hr. what rx was used

anticholinesterase
drug only

reversible hypoxic cell injury. Swelling

results from accumulation of?

sodium

RR is 0.3. 95% CI = 0.1-0.8. this means.

exposure has
lower risk of ds. =
RR <1 is lower, >1 is
higher

rt renal artery occluded 85%. What

would show that bp is reduced to
normal via renin inc at?

rt renal vein vs lt
renal vein

rx blocks calcium channels at synapse.

What is disrupted?

release of NT into
the cleft

477.
478.

479.

480.

481.

rx blocks viral entry into the cell in HIV. chemokine

What is the targe?
receptor - ENV CCR5

482.

rx dec risk for regurg, pul aspiration,

promotes gastric emptying, relieves
naisea and vomit. Rx?

metoclopramide

483.

rx for wt loss, se of oily fatty brown

stools. Diag

orlistat

rx inhibits 30S

doxycycline

rx of skeletal muscle relaxant that

works by direct action on excitation
contraction coupling rather than an
effect on cns

dantrolene

468.

Rx that helps increase potassium

ACE inhibitors - if
not there then
ARBs. = sartans

487.

469.

rx to prevent malaria

mefloquine or
chloroquine

488.

470.

rx to reverse tubocurare

atropine and
neostigmine

463.

464.

465.

466.
467.

471.

472.

473.

474.

475.

476.

salk and sabin for polio both do?

484.

485.

486.

neutralizing
antibodies in the
circulation

sampling red wine and cheese. Gets ha, MAO =

inc bp. What rx is pt taking?
tranylcypromine
scid get transfusion. What type of
blood?

irradiated packed
rbc

seasonal allergy. What is effective in

relieveing sxs?

A adrenergic
agonis =
vasoconstriction.

serum glucose from 175 tp 225

following exercise. What enzyme is
activated?

phosphorylase
kinase

servival percentage for pt with a ds.

multiply the
chance of
servivial after
each year

489.

490.

491.

492.

493.

494.

495.

severe dec in PTH is bc of dec in?

magnesium

sexually abused woman uses her

experience to express emotions as
an actress

sublimation

Sickle cell. What is the molecular

basis of sickling

gain of stabilizing
hydrophobic
interactions in the
deoxygenated form
of HbS

signal mechanism of T3?

bind and activate

DNA binding activity
of intracellular
receptor

sixth intercostal midaxillary after

skin what is pierced

intercostal muscle
then costal pleura
(parietal)

skin of rt hand, through rt cuneate to post central gyrus, lt

left vpl. Begins where in cortex?
side, more lateral
than medial
sleep walking

dela or slow wave

small asymmetric kidneys with

broad scars and blunted calyces
and vesicoureteral reflux. Diag?

chronic
pyelonephritis

small cell ca, what chemo is likely to cisplatin

produce nephrotoxicity and
ototoxicity in pt?
small right pupil, constricted, does
not react to light. Left is normal.
Diag?

horners = cervical
spinal cord

sob after cat exposure. What

happens to FEV1:FVC, residual
volume

dec, inc

sob, smoker, PA02 84. what

increases to maintain adequate
tissue oxygenation

2,3
bisphosphoglycerate

somatostatin prod tumor. What

all decrease.
would happen to insulin secretion,
gastric motility, glucagon secretion?
some cells have 46xy, others have
69xxy. Why/

mosaicism

splicing of primary gene trascript in

e coli means

inc repertoire of
gene products

squamous cell ca of lung. Fatigue,

weakness, rt flank pain, anorexia,
constipation, hamaturia. Sxs bc of
secretion of what substance?

PTH

study of two smoker vs non smoker

groups.

cohort study

substitution of alanine for serine

leads to dec activity of ?

phosphorylation of
enzymes

subtotal gastrectomy. Smears would macrocytosis of

show?
erythrocytes

496.

497.

498.

499.

500.

501.

502.

503.

504.

505.

506.

507.

508.

509.

510.

511.

512.

513.

succinyl coa to glycine is

rate limiting reaction for?

heme synthesis

514.

sudden blindness of lt eye,

no vision in lt eye. Light in lt
eye would cause?

no constriction bc retinal
ganglion cells in the lt eye
have been destroyed

515.

sudden loss of sensation

conversion disorder
and inablility to move. Pt
seems unconcerned about it
supplied by foregut but not
a foregut derivative

spleen

surface area of burn dec in

6 wks bc of?

myofibroblast activity

surgeons A and B from

different types of hospitals
are being compared. Why is
the power not accurate?

lack of control of case

complexity

surg repair of esophageal

atresia. Origin of cell that
fill lumen?

endoderm

swimming in 60F water.

What happens to central
BV, ADH, ANP?

inc, dec, inc

synthesized during S phase

of cell cycle

DNA = histones

T7 chromosomes prod 1000

copies then released. If one
of the copies has e coli
instead of T7 what
happens?

able to inject DNA but no T7

particles will be made

TB infection of the skin.

Diag? why in dermal rather
than visceral?

Mycobacterium leprae leprosy. Temperature

sensitive. Gloves and
stocking loss of sensation,
armadillo reservoirs.

technique to show two

bacterial dna are identical

polymerase chain reaction

terazoin causes what in

second messenger

dec IP 3

third trimester have inc

glucocorticoids but few
catabolic responses. Why?

inc steroid binding proteins

throwing up blood, hx of
hep B. why?

inc pressure in submucosal

esophageal veins

thymic aplasia. What other

sxs would be present?

congenital
hypoparathyroidism

TK mutation of TrkA gene.

Disrupts?

phosphorylatin of
downstream milecules in
response to nerve growth
factor

tonic clonic seizures and

mutliple skin bumps. What
else would be seen in hx?

516.

517.

518.

519.

520.

521.

522.

523.

tuberous sclerosis. = special

ed beginning in first grade

524.
525.

526.

527.

528.

529.

530.

531.

532.

tonic clonic seizures. Mutation affecting

GABA-a receptor. Leads to?

dec
presynaptic
chloride influx

too weak to stand, red swollen tenger

tongue, angular stomatitis, spoon shaped
nails, MCV is dec.

iron def

total esophagectomy and anastomosis of

stomach to lower pharynx. What nerve is
severed?

vagus

training for marathon for 6months. Muscle inc capillary to

adaptation?
fiber ratio
transplant 40 days ago. Has erythematous cell mediated maculopapular rash and jaundice. What
T cells HS?
delayed type
HS
triad of heroin od

coma, miosis,
cyanosis

twins that are fused together. What type

of placenta?

monochorionic
monoamniotic

txt for peptic ulcer. Then given diazepam

and pt sleeps faster and longer than
expected. What drug was originally
given?

cimetidine

txt with thyroxine. Se?

angina
pectoris =
arrythmia

type 1 diabetes. Stupor and dka, fever,

prod cough, taking cough syrup. What
caused DKA?

infection =
stress

ulcerative colitis txt

sulfasalazine

unable to concieve, 32 female, pelvic

pain, nodularity, scope shows 3-5 mm
diameter dark areas. Biopsy shows?

endometrial
glands and
stroma

unable to concieve. No abnormalities

found. Appropriate rx?

clomiphene

unimmunized, 2 girl, gen tonic clonic

seizure, f, urti, gram neg cocobacilli. What
vaccine?

Hib vaccine

unimmunized, photophobia,
nuchalrigidity, flaccid paralysis

single
stranded RNA
- polio

unresponsive to painful stimuli, 35.7 temp.

52 hrt, resp 5, 85/55, pinpoint pupils,
reactive to light. OD on?

opiates

urethral opening on underside of penis.

Cause?

failure of
urogenital
folds to fuse

ursodeoxycholic acid moa?

dec
concentration
of bile acid

vagus stim ach to stim HCL in second

messenger pathway when eating. What is
the second messenger involved?

inositol
triphosphate

533.

534.

535.

536.

537.

538.

539.

540.

541.

542.

543.

544.

545.

546.

547.

548.
549.

550.

551.

variability in liver hydroxylase?

multiple
polymorphisms

virus with RNA dep DNA

polymerase.

HIV = retrovirus

water D, dry mucous membrane,

no abd tenderness, CD4 <20, mod
acid fast show organisms.

cryptosporidium
parvum

552.

what rx inh IL 2 and gamma interferon

cyclosporin

553.

what rx stimulates leukocyte formation?

filgrastim = gcsf

what standard dev shows that the entire

population group was covered?

a larger SD that
covers a wider
variety

what structure is domapine innervated in

a movement disorder?

substantia nigra

what substance is injected to increase

volume from pancreas

secretin

what vaccine only activates IgM and not

IgG

killed =
bacterial
polysaccharides

what would increase flow of pulmonary

lymph?

inc blood flow

= IV saline 0.9%

where does furosemide work?

ascending loop
= hypocalcemia

where does nitric oxide action in

producing vasodilation?

media layer of
epithelium

which of the following reg of bowels is

likely to be most severly affected?

splenic flexure

why does ATP levels not fall during

muscle twitches

creatine
phosphate
regenerates
ATP

why does mitochondria encode their

own DNA

uses non
standard
genetic code

yellow green discharge in vag, markedly

erythematous, red cervix, motile
organism with flagella. Txt

oral
metronidazole

yellow vag discharge, foamy, itching,

burning,

trichomoniasis

zink atom that structured motif. What is

it?

zink finger motif

= transcription
factor

554.

555.

weak hip adduction. Dysfunction of ischium

adductor muscle inserting onto
femur from which location?
weakness and atrophy in upper
loss my myelin in lat
and lower limbs, dec stretch reflex, column white matter
no sensory def
and loss of ventral
horn motoneurons
what cell is involved in reepithelization?

basal layer
keratinocytes

what happens to mitochondrial

number, actin per myocte and
number of mycytes as a person wt
lifts for a long time?

increase, increase, no
change

what initiates molecular damage

after transient ischemia
reperfusion

superoxide anion

what initiates the repair to resolve

proteinuria and hematuria in
kidneys?

mesangial cells

what is likely to cause

osteoperosis

living in space station

for 6 months

what is likely to have increased

calcium after nerve contraction?

cytoplasm

what is likely to initiate

intracellular killing of a gram pos
diplococci?

NADPH oxidase = first

step in respiratory
burst

what is the result of low

aldosterone concentration?

inc sodium in urine

what is the role of IkB in the

nuclear factor kappa B pathway?

releases NF-kB after

undeergoing
phosphorylation

what is used if the the graph is

shifted to the right but the high is
unchanged?

competitive
antagonist

what makes type I collagen?

osteoblasts

what method is best to detect

necessary reagents for CD44
variants

immunohistochemistry

what plasma protein bound

clotting factor 12 and kininogen
allowing autocatalytic
amplification of inflammatory
system

kallikrein

what promotes milk secretion in

woman?

oxytocin

556.

557.

558.

559.

560.

561.

562.

563.

564.

565.

566.

567.

zvz. Moa of drug that increase resulution. acyclovir = inh

DNA synthesis