Study Stack - DIT HYQ's Table Review

DIT HYQ's

Question Answer
DIT HYQ's (Please note this material is copyrighted and
Answers
not authorized for distribution)
A gardener presents with SOB, salivation, miosis, and
Organophosphate poisen, anticholinesterase
diarrhea. What is the cause/ MOA?
Atropine is not effective in reversal of organophosphate
No effect on cholinesterase, use Pralidoxime
poisoning. Why? What helps?
What muscarnic agonist / antagonist is used in asthma /
Ipratropium (an antagonist)
COPD?
30 YO has urinary rentention due to neuroleptic, what do Cholinergic Agonist (problem is anti cholinergic
you treat with? s/e's
In Dark both pupils dialate. In light one pupil is miotic
Anticholinergic (atropine)
while another, given drug X, is mydratic. What is X?
What drug is most apropriate in a pt with shock in order to
Dopamine (although clinically doesn't really work)
maintain renal blood flow
60 YO male. Has a hard time driving at night due to
worsening vision and halos appearing around headlights. Cataracts
What is causing this?
A gymnast sustains and anterior sholder dislocation.
Axillary n.
What nerve is injured
A kid falls while skateboarding and injures his elbow. He
can't feel the medial part of his palm. What nerve is Ulnar N. Ulnar Claw (can't extend 4/5 digits)
injured? What "sign"?
A highschool athlete falls on his arm. Radiograph shows
midshaft break of humerous. Which nerve / artery are at Radioal n. Deep Brachial Art.
risk?
Immunocompromised, Neonates, Pregnant
What patients are suseptible to Listeria?
Women
What Organisms are implicatd in subacute endocarditis? S. Veridians, Staph Epi, Enterococci. Staph Aure
A woman is breast feeding develops swelling and redness
over her right breast. Exam reveals a warm, fluctuant Acute Mastitis -> Staph Aur
mass. What is this?
Most common aerobic skin flora? Staph Epi
6 month old child is given honey for a cough and cold and
C. Botulinum (Gm + Rod) inhibist Ach release
becomes flaccid. What causes this? Moa?
One hour after eating a potato salad at a picnic. Whole
Staph Aureus. Preformed toxin ingested (no
family vomits. 10hrs later they are better. Whats the
infection)
cause?
Which Complement is responsible for neutrophil
C5a (also leukotriene B4, IL8)

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chemotaxis
Child presents with tetany from hypocalcemia and
candidias due to immune suppression. What is defienent? Tcells, No Thymus
What Dz?
young child has recurrent lung infection and
granulomatous lesions. What defect in neutrophils causes Lack of NADPH oxidase
this?
Mother brings 2 YO child w/ Hx of multiple viral, fungal
infections and his hypo calcemic. Which Germ layer gives No Thymus, DiGeorge, Endoderm (from tongue)
rise to the missing structure? (Endo, Ecto, Meso)
A child with immune diorder w/ repeated Staph Abcesses.
Neutrophils do not respond to chemotactic stimuli. What Hyper IgE aka Job Syndrome
is diag?
A patient Suffers recurrent Neisseria Infections. What part
C5-C9, (LatE)
of complement is defective?
How does mechanism of Type 2 Hyper sensitivity differ
Type 2
from Type3
45 YO female, Malar rash and arthritis. Which Ab is
Anti dsDNA, Anti Smith. ANA is nonspecfic
specific for the dz?
After bone marrow transplant a patient suffers dermatitis,
Graft vs Host Dz.
enteritis, and hepatitis. What dz is this?
A physican is looking for a risk factor for Pancreatitis. He
interviews 100 w/ and 100 w/o pancreatitis. What kind of Case Control
study is this?
New glucose test arrives. You test it with a solution of
90mg of glucose. The test gives you thefollowing
High Precision low accuracy
readings: 54, 56, 55, 54, 53, 56, 55, 54. What is its
presions and accuracy?
A group of ppl who smoke and do not smoke are followed
over 10 years. Every two years they check who develops Cohort
cancer. What kind of study is this?
A certain screening test has a 1% false negative rate.
99%
What is the sensitivity?
Prevalence of varicella in Pop A is 2x that of Pop B. It has
the same incidence in both populations. Why is the Dz in Pop A has longer duration
prevalence different
Gm (-), oxidase (+), diplo cocci Niesseria
22 YO medical student. Burning feeling after meals. EGD
H. Pylori
shows gm (-) rods in gastric mucosa, what are they?
50 YO male smoker with new cough and flu like
symptoms. Gm stains shows nothing. Silver stains shows Legienella (atypical pneumonia)
rods. Daig?
40 Yo female. Acute unilateral knee pain and bilateral
Lyme Dz via Burreli Burgdorferi via Tick
Bells Palsy. What organism? How is it transmitted?
21 YO male. 5 day hx ofr fever chills and enlarged painful Gonorrhea -Ceftriaxone or Azithyromyocin if

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knee. What oranisim? And what treatement? allergy

After taking a course of Amoxicillin, and adult pts
develops toxic megacolon and diarrhea. What caused C. Diff
this?
25 YO with mycoplasma atypical pneumonia, exhibits
anemia due to cryoagglutinins. What type of Ig is IgM
responsible for anemia?
Homeless alcoholic pt vomited while intoxicated.
Klebsiella or anerobe
Develops foul smelling sputum. What organism?
65 YO ask husband to stay in hospital overnight b/c she
Regression
is afraid of being alone. What defnese mechanism is this?
Which defense mechanism underlies all others? Repression
60 Yo man admitted for chest pain, jumps out of bed and
does 50 push ups to show he has not had a heart attack. Denial
What is the defense mechanism?
4 Yo girl complains of painful genitalia. On exam
discharge with smear showing N. gonorrhoeae. What Sexual Abuse
happened?
72 YO patient is unable to recall 3 objects during mini
mental status exam. When asked what he would do if he
smelled smoke he says "yell fire". When asked what a Dementia
table can chair have in common he says both are made
of wood. Family reports he needs consta
72 YO brought to the clinic by family. Strange behaviors
in last week. Very agitated, naps frequently during the
Delerium
day, urinates on self, poor appetite. Unable to focus
during exam. Diag?
You are on call and receive a call from a nurse asking to
No diphenhydramine, no Benzos, use Trazadone
give sleep medication (diphenhramine) to an elderly pt.
or Haliperidol
with dementia. What do you do?
A patient tries to commit suicide by cutting wrists. After
What did she do after cutting her wrists? Call
beening cared for in the ER what question would you ask
someone? Lie in a bathtub?
to determine her level of commitment?
28 Yo female with mild depression for 6 yrs. What diag? Dysthamia
2 months after losing her spouse a 42 YO female is This is still with in normal. But you can tx the
having trouble eating, concentrating, and sleeping/ What insomnia and help with trazadone or something
do you do? else
A patient on whom you want an MRI tells you they are
Give two Benzos for during tx.
claustophobic. What can you do?
a young woman is anxious about her 1st pap smear and
is told to realx and to imagine what the steps are. What is Systamatic Desensitization
the process and example of?
A woman has flashbacks about her boy friends death one
monnth ago in a hit and run accident. She often cries and Normal Greif
wishes for justice. Diag?

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Nurse has hypoglycemia with no elevation of C-protein.

Malingering or Facistious depenidng on 2nd gain
Diag?
40 YO female tells you she is in love with you. You refer
her (which you should never do during USMLE) and she Splitting (Borderline )
attempts suicide. What is this personality disorder?
30 Yo woman tells you that you are the best doctor and
the nurses are very bad. On subsequent visit she
threatens to change doctors because you do not feel a Splitting (Borderline )
specific lab test is justified. You also notice several
"scartches" on her left arm. What persona
55 YO female wearing all black with a black feather boa
Histrionic
and excess lipstick. What type of personality disorder?
A pt. demands only the best most famous doctor in town.
Narcissistic
What personality disorder?
A patient returns from a trip to New Mexico, now has
Coccidioidomycocces
pneumonitis. What is fungal cause?
A 30 Yo female has "cauliflower" skin lesion. Tissue
biopsy shows broad based budding yeast. What is this Blastomycoisis
organism?
an HIV (+) pt with CSF showing 75/mm3 lymphocytes
suddenly dies. Yeast is identified in the CSF. What is the Cryptococcus
diag?
A pt presents with a "rose garden scenario" (thorn prick
Sporothrix
with ulcers along lymphatic drainage). What is infection?
A Pt who visted Mexico presents with Bloody Diarrhea. Cryptosporidium (usually filtered from city water
What infection could be found in the stool? supply....) more severe in AIDS
32 YO male went camping in N. California 2 wks ago. Pt
Entamoeba Histolytica (not Giardia b/c Jaundice is
had a 2 day stint of diarrhea and how has liver damage
present)
and Jaundice. What is diag?
Pt returns after 2 wk vacation in Africa. Typical malaria
Malaria cycle in RBS's causing lysis every 48-72
presentation and recurrent fever. what is the mechanism
hrs
for the cyclic?
Which Fetal Vessel has the highest 02 concentration? Umbilical Vein (1 verin, 2 arteries)
45 YO male with BP 160/90 on right arm and 170/92 on
Coarctation of the Aorta (adult type)
the left arm. No pulse in feet or ankle. What is diag?
Left to right shunt. (during pregnancy not called
Describe blood flow through a PDA? Just for fun what
"patent" so incorrect to say R-> L then becomes
keeps it open, what closes it?
L-> R). Hear a continuous machine murmer. Open
This is twin transfusion, mostly like due to
Monozygotic twins are delivered. One is pale and has a
monochorionic, mono amniotic pregnancy. Twin
hematocrit of 15% the other is flushed with hct of 55%.
with lower hct will do better due to "sludging" in
What caused this? who will do better?
the one with high hct.
Fusion of the maxillry process with the Medial
Nasal Process. Cleft lip is mostly a aesthetic
A child presents with Cleft lip. What process failed?
defect were cleft pallate has functional defiect as
well

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23 YO male presents with one testicle. what is he at risk

Germ Cell tumor of teste
for?
24 YO male develops testicular cancer. Mets spread
via Inguinal canal to para-aortic LN's
where?
16 Yo female with amenorhea. Pt lacks uterus and
uterine tubes. Has two round structures in midline just Androgen Insensitive (46XY)
superior to labia majora. What is diag?
While on an ACE-i a pts develops a cough. Why? what is
No Ang II
a replacement?
%0 yo male on lipid lower meds. Develops rash, puritis Niacin, not allergic due to prostaglandins (take
and diarrhea. What drug? Is this a allergic rxn? what asprin b4 hand to decrease) also dec with long
mediates this response? term therapy
Blocks the Na/K atpase pump. Na leaves cell via
What is mechanism of action of Cardiac Glycosides
Na/Ca counter transporter and increases
(Digoxin)?
intracellular Ca lvls
An abdominal Aortic aneurysm is most likley due to? Atheroscerois
a pt with poorly controlled HTN has actue sharp
substernal pain raidiating to the back. Death occurs within Disecting Aorta
a few hours. Diag?
During a high school football game a young althlete
Hypertrophic cardiomyopathy
collapses and dies immediately. What Dz?
What murmers are heard best in the Left Lateral
Mitral Stenosis/ Regurg. And Left sided S3 / S4
Decubitous Position?
80 yo male. systolic cresendo decresendo murmur. Diag? Aortic Stenosis (probabley due to calcified aorta
IV drug user presents with Chest pain, dyspnea, Bacterial Endocardidits -> PE (remeber drug
tachycardia, tachypnea. Diag? users get it on the right)
pt brought to ER after MVA presents with Chest pain, Tension Pneumothorax most likely, could be
dyspnea, tachycardia, tachypnea. Diag? CArdiac Tamponade too
Post-op pt presents with Chest pain, dyspnea,
PE
tachycardia, tachypnea. Diag?
A young girl with a congeital valve dz is given penicillin
IV Vancomyocin and possible echo to check
prophylactically. In the ER bacterial endocarditis is diag.
valves (might need replacement)
What is next?
An adult pt with hx of HTN presents with sudden sharp,
tearing pain, radiating to his back. What do you see on Widening of the mediastinum (Disecting Aorta)
CXR?
On auscultation of a patient you hear a pansystolic
Mitral Regurg (Aortic Stenosis is not PANsystolic)
murmur at the apex with radiation to the axilla. Cause?
A 25 yo pregnant woman in her 3rd trimester has normal
BP when standing and sitting but drops to 90/50 when Compression of IVC, dont lie on your back.
she lies supine. Diag?
45 YO male with squamous cell carcinoma of the penis.
HPV - 16 / 18
He had exposure to what Virus?
20 yo college student presents with LAD, fever, and
B Cells - EBV mononucleosis (+) monospot.
hepatosplenmegaly. His serum agglutinates sheep

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Cause of (-) monospot mononucleosis? CMV

RBC's. What cell is infected?
How does rabies travel through the CNS to cause fatal
Retrograde along neurons
encephalitis and seizures?
What is the characteristic shape of rabies? Bullet Shaped
An adolescent presents with cough and rust colored
Strep. Pneumo -> Gm (+) diplococci
sputum. What does gm stain show?
HIV (+) pt with a CD4 count of 250 presents with signs of
meningitis. CSF shows a heavily encapsulated organism. Cryptococcus Neoformans
What is it?
An older patient has blood in his urine and renal stones.
Proteus
What organism?
A 50 yo pt is recovering from Abd surgery from 2 days
ago. He has had an internal catheter in place since then. EColi (UTI)
He now has a fever of 100F. Most likely org?
Hemidesmisomes, cadherin, integrin, ICAM-1. Which
joins only cells of teh same type and does not attach to Cadherin
the basement membrane?
Where does new bone formation take place in growing
Epipseal Plate
long bones?
A football player was kick in the legs and suffered a
damaged medial meniscus. What else is likely to have ACL, MCL
been damaged?
A man presents with pain and swelling of the knees,
subcutaneous nodules around the joints and achilles
tendon, equisite pain in the metatarsophalangeal joint of Most likely Gout
his right big toe. Biopsy reveals needle like crystals.
DIag?
Treatment of Acute Gout exacerbation? NSAID, Colchicine
A patient has difficulty swallowing, distal cyanosis in cold
temp, anti-centromere antibodies. What other S/S will you CREST: Calcinosis, Sclerodactyly, Telangiectasia
see?
A patient presents with photosensitivity, arthritis, renal
disease and recurrent oral ulcers. She is taking Renal Fxn (SLE)
Primaquine and NSAIDS. What should be checked 2/yr?
30 yo woman presents with low grade fever, rash across
her nose and gets worse in the sun and widespread ANA - SLE
edema. What blood test would you use to screen?
A CT scan of the chest shows bilateral hilar LAD. Diag? Sarcoidosis
a 75 yo male presents with acute knee pain and swelling.
X ray reveals erosion of the joint space and calcium
PsuedoGout -> Calcium pyrophosphate
deposits in the menisci. What is Diag? What would be
found on FNA of joint?
a 50 YO female complains of double vision, amenorrhea
Prolactinoma
and headaches. What is likely diagnosis?
A patients MRI shows replacment of tissue in the sella Most likley asymptomatic or defieciency in

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tursica with CSF. What is presentation? Pituitary Hormones

What hormones come from the anterior pituitary? FSH, LH, ACTH, GH, prolactin, TSH
Which hormones share a common alpha unit? FSH, TSH, LH, bHCG
A young woman is found to have short stature and Albrights osteodystrophy
shortened 4th and 5th metacarpals. What endocrine (Pseudohypoparathydroiism) aka body not
disorder is this? responsive to PTH
35 yo female presents with diffuse goiter and
Low TSH High T3,T4
hyperthyroidism. What is TSH / T3/t4?
48 yo female presents with progressive lethargy, and Hypothyroid / Hasimotos most likely (High TSH
extreme cold sensitivity. What is Diag? Lab values? low T3/4)
And adult male with elevated serum cortisol and signs of
cushing syndrome undergoes dexamethasone
ACTH secreting pituitary adenoma
suppresion. 1mg does not decrease cortisol, 8mg does.
What is diag?
A very tan child with pale mother comes in and is found to
Addisons
be hypotensive. Diag?
28 yo male with normal well managed IDDM comes in
with DKA hae had recently been taking OTC cold Infection
medicine. What caused his DKA?
How is hemoglobin glycosylated in DM to make HA1c? Non enzymatically (slowlly do to glucose build up)
What are the sources of Carbon for Purine formation? For Co2, Glycine, tetrahydrofolate / CO2 and
pyrimidine? aspartate
How does UV light damage DNA? Causes Thymine Dimers to form
What ammino acid frequently has more coding
AUG - methione
sequences in mRNAt the represented in the peptide?
What happens to hnRNA before it leaves the nucleus? Spliced (remove introns), Poly A tail, and 5' Cap
Two pts have the same mutation on chromosome 15. but
they have different phenotypic expressions. One has a
Genetic Imprinting
mutation from the father the other from the mother. What
is this an example of?
Frequency of CFTR mutation X in pts with cystic fibrosis
is 0.1. CF is (in this scenario) caused by either mutation X P^2+2PQ+Q^2
or Y. What percent of pts are homozygotes for y?
an obese woman presents with amenorrhea and
Polycystic Ovarian Syndrome (stein-leventhaul)
increased serum testosterone. Diag?
What type of cancer are patients with polycystic ovarian
endometrial
dz are risk for?
Why is progesterone used in combo with estrogen in To protect Uterus / endometrium from unregulated
hormone replacement therapy? hyperplasia / cancer
Polycystic Ovarian Syndrome (stein-leventhaul),
What circustance would cause an elevated LH?
physiological LH surge, low estrogen lvls, turners,
A pregnant woman with previous C section is at
Placenta Accreta, Previa
increased risk for what pregnancy complications?
A pregnant women at 16 weeks gestation presents with
Hydatifrom Mole, increased beta HCG

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large abd and HTN. Diag? Lab values?

beta HCG (Really high in complete, slightly
What substance is elevated in hydatifrom moles
elevated in partial)
15 yo pt who normally comes in with her parents presents
Check for delayed puberty, talk about how you
alone. She states she is sexually active but knows she is
can get pregant on your first time even before you
not pregnant because she has never menstrated. What
menstrated, STDs and maybe contraceptives
should you tell her?
23 yo female is on rifampin for TB and OCP. She gets Rifampin increase Cyp450 metabolism of OCP,
pregnant. Why? decreasing their effectiveness
Medroxyprogesterone (injection q3 months) (and
What is the best option of birth control of mental retarted
what do you do if you find a mentally retard pt in a
pts?
room with a bat?)
A 58 yo post menopausal women is on Tamoxifen. What
Endometrial Carcinoma
is she at risk of aquiring?
What cells are responsible for maintaing a high Leydig Secrete, Sertoli - release ABG hold
testosterone concentration in the seminiferous tubules? testosterone in place
A 55 yo man undergoing tx for BPH has increased
testosterone and decreased DHT as well as Finasteride - 5 alpha reductase inhibitor
gynecomastia and edema. What medication is he on?
Where does testicular cancer first metastasize? Para Aorotic Lymph Nodes
What protein is involved in transporting an endocytosed
Clatherin
vesicle from the plasma membrane to the endosome?
What molecule targes proteins in the endoplasmic
mannose 6 phosphate
reticulum for lysosomes?
A patient with a corticol lesion is unaware of hi neurologic Located on his non Dominate parietal Lobe
deficiency. Where is the lesion? (usually right)
Ipsilateral UMN lesion below the lesion | Ipsilateral
loss of tactile, vibration and proprioception below
What are the findings of Brown Sequard Syndrome? lesion | Contralateral pain and temp loss below
lesion | ipsilateral all sension for a few levels
above lesion | LMN at level of lesion
A man in his 40s begins to develop early dementia and
uncontrolable movements of his upper extremities. where Caudate -> Huntingtons
in the brain do you expect to see atrophy?
A Male presents with involuntary flailing of one arm.
This is hemibalismus. Contral lateral thalamus
Where is the lesion?
28 yo chemist presents with MPTP exposure. What
Dopamine
neurotransmitter is depleted?
A patient cannot abduct her left yere on lateral gaze but
CN IV (MLF tract) + CN VII. Both are at level of
convergence is normal. She also has difficulty smiling.
Pontine
Where in the CNS is the lesion?
28 yo woman in a MVA. Initally feels fine then loses
consiousness. CT shows intracranial hemorrhage that
MMA, and temporal bone
does not cross suture lines. What bone and vessel where
damaged?

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85 yo man with alzheimers falls at home and presents 3

days later with severe headache and vomiting. What is Subdural hematomaBridging veins
the diag? What is dmg?
woman involved in a accident cannot turn her head to the
CN XI - accessory
left and has a right sholder droop. What is dmged?
a 19 yo pt presents with a furuncle on his philtrum and the
cavernous sinous becomes infected. What might you defects in CN 3, 4, 6
see?
a pt has a leftward deviation of the tongue on protusion
Left Medulla + corticospinal tract (happens before
and has a right sided spastic paralysis. Where is the
the tract decusates)
lesion?
A pt can not blink his right eye or seal his lips. What is the
CN7 due to bells palsy
diag and which nerve?
Pt falls off a motorcycle and lands on his right shoulder.
PE shoulder has abnormal configuration. X Ray shows
Axillary Nerve, Posterior circumflex artery
anterior dislocation. What artery and nerve are likley
dmg?
a pt fractures there humerous mid shaft. What nerve and
Radial nerve and Deep Brachial artery
artery are dmged?
A pt presents with decreased pain and temperature
Syringomylenia (congential defect, enlarged
sensation over the lateral aspects of both arms. Where is
central canal in SC)
teh lesino?
Exam shows decreased pin prick sensation over the
lateral aspect of foot and leg. What muscular defect is Dec Dorsal Flexion and Toe Flexion, Foot Drop
also present?
a pt falls while rollerblading hurts his elbow. He cant feel
Ulnar N via medial epicondyle
the medail part of his palm. What nerve is dmg?
an elderly womand complains of pain, numbness and a
tingling sensation over the lateral digits of her right hand. Median, Carpal Tunnel
Exam shows thenar wasting. What nerve is dmg?
20 yo dancer reports decreased planter flexion and
decreased sensation over the back of her thigh, calf and Tibial N.
lateral foot. What Spinal nerve?
a pt fractures her fibula neck. What nerve is dmg Deep perioneal
MS + internuclear opthalmoplegia. What is the
Can't abduct eye on lateral gaze but can converge
abnormality?
a pt can not look laterally but can converge. What is
Medial longituidinal Fasiculous
dmged?
Light stimulus in the pts right eye produces bilateral
Damage in afferent of affect eye (ishchemia of
constriction. When the light is shown in the left eye there
CN3)
is paradoxical bilateral pupilllary dilation. Defect?
Woman with headache, visual disturbance, amenorrhea. Pit Adenoma
43 yo man with dizziness and tinnitus. CT shows
Schwannoma
enlarged internal acoustic meatus
a child exhibits proximal muscle weakness and enlarged
Duschanes Muscular Dystrophy

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calfs
25 yo female with sudden uniocular vision loss and
slurred speech. Hx of weakness and paresthesia that MS (relapsing remitting)
resolved.
10 yo child spaces out in class and then continues as if
Abssence Sezuire
nothing has happened
Pt has vertigo, tinnitus and hearing loss Schwannoma
What is primary energy soucre in pt that has not eaten for
fatty acids
two days?
what is the equation for gibbs free energy? Delta G
Arrange the following in decreasing level of exergonic
PEP>ATP>AMP
energy. AMP, ATP, phosphoenol pyruvate
stressed physician comes home from work, consumes 7
to 8 shots of tequila in rapid succession, then becomes Increase in NADH/NAD ratio
hypoglycemic. What is mechanism?
A woman commenly develops intense muscle cramps
McArdels Dz
and darkening of her urine after exercise. Diag?
What histological changes occur in a smoker? (in the
Columnar epithelium -> squamous
trachea?
A pt in the ER is having anaphylaxis. Incision below
Criciothyroid
thyroid cartilage. What are you cutting through?
A young woman has infertility, recurrent URI and
Cilia, Dyien Arm
dextrocardia. What is defective?
Pt has the following Lung volumes. FRC 5, IRV
Chronic Dz / microcytic anemia. No change in O2
42 yo female with fibroids is chronically tired. what is
sat (normal lungs) no change in Concent. Only
diag? what changes to O2 content and saturation?
change in amount of hemoglobin being in blood
Pt has hypoxia and a CXR reveals and enlarged heart.
Pulmonary HTN -> poor lung perfusion
What is likley cause of hypoxia
A pt suffers a stroke after incurring multiple long bone
Fat Embolism + VSD or ASD
fractures in a skiing accident. What caused the infract?
A pt with a recent tibial fracture and no hx of COPD or
asthma presents with hypoxia. CXR is normal. What is PE
cause
a pt with asthma attack. What is the immune rxn Bronchoconstriction via Mast cell and IgE
occuring? histamine release
A pt has an extended expiratory phase. What type of dz? Obstructive lung dz
H&E of lung biopsy from a plumber shows elongated Asbestos -> Mesothelium + Bronchogenic
structures with clubbed ends. Diag? Risk? carcinoma
a preterm infant has difficulty breathing. X ray reveals
Neonatal ARDS -> steroids giving to mother prior
diffuse ground glass. Diag? What could have prevented
to birth
this?
pt develops ARDS from occupational inhalation of NO. Hylanien membrane, increase in type 2
What histological change is seen? pneomocytes (repair / replace dmg type 1 )

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Tall teenage male, abrupt onset dyspnea and left sided

chest pain. perccussion on the affected side reveals Phemothorax
hyperresonance and deminished breath sounds. Diag?
Dull resonance, dec. Breath sounds, dec.
CXR shows plueral effusions. What are PE findings?
Fremitus
CXR shows collapsed middle lobe of right lung and mass
in right bronchus. pt has hx or recurrent pneumonias. Lung cancer - bronchogenic
diag?
Pt developds brochogenic lung cancer but has never
smoked. He is a coal miner. What but him at increased Not coal, Radon (heavy element)
risk?
Exam on lung autopsy reveals peropheral lesion with
TB
caseous necrosis. Diag?
30 yo comatose man on ventilator support in ICU
develops and infection and dies. Autopsy shows pus filled Psuedomonis
cavity in right lung. Etiology?
55 yo who is smoker and heavy drinker. Presents wtih
new cough and flu like symptoms. Gm stain shows no Legionella
organisms, Silver stain shows gm (-) rods. Diag?
What deficiency causes familial hypercolesterolemia? Defect or lack of LDL receptor
Pt with PKU should have a diet low in phenylalanine.
Increase tyramine, replace THF and biotin
What other dietary modifications should a pt make?
Full term neonate becomes mentally retarded and
PKU
hyperactice, has a musty odor. Diag?
2 yo girl has an increase in abd girth, failure to thrive, and
Kwashiorkowr
skin/hair depigmentation. Diag?
middle aged man has dark spots on sclera and has noted
Alkaptouria
urine turns black on standing. Diag?
Tx for a pts genetic dz includes protein restriction to
prevent mental retardation, ketoacidosis, and death. Maple Syrup Urine dz
Diag?
18 yo female has moderate generalized abd pain, normal
WBC and no fever. Paresthesias in her lower extremities. Acute intermittent porphoria
Diag?
45 yo male alcholic gets blisters lesions in sun exposed
areas especially the dorsum of the hands. also has hyper Porphia Cutania
tichosis of the face. Diag?
Tx for homocystineuria Decrease methione, increase cystine and B6/B12
Pt taking NSAID for management of her gout, develops
anemia, pain on eating and (+) ocult blood. What drugs i Misopristol
best at treating the cause?
new born is having trouble feeding. vomits milk when fed
TE Fistula
and has gastric air pubble. What is diag?
a 60 yo man with chronic reflux presents with esogeal
Adenocarcinoma
cancer. What type?

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after loss of job a 35 you man has diarrhea and

hematochezia. Intestinal biopsy shows transmural Crohns.
inflammation. Diag?
Weightlifter undergoes emergency surgery for a life
threatening condintion. Exam of small bowel reveals focal Ibguinal hernia -> bowel incaruration
hemorrhages. What is responsible
a 40 yo woman presents with having to defecate 4x per
day for several months and a low grade abd pain. IBS
colonoscopy is normal. Diag?
50 YO man complains of diarrhea on exam his face is
Carcinoid tumor
plethoric and a heart murmur is detected. Diag?
young man presents with ataxia and tremor. brown
pigmentation in a ring around the periphery of cornea. Wilsons dz -> plasmaphoresis
Tx?
80 yo woman comes to your clinic b/c her family is
concerned about her yellowing skin. Yellowing skin of No Jaundice
palms and soles but no scleral icterus. Cause?
20 yo man contracts influenza then presents with an
Gilberts dz (infection caused flair)
idiopathic hyperpilrubinemia. Cause?
what is fate of bilirubin after it is conjugated and
Urobiliogen
secreated into GI tract?
pt complains of pain in URQ that is localized to one
Viserceral pain is usually diffuse (not locallized)
finger. Area is tender touch and pains is worse when pts
this is musculoskeletal, rectus abd tear
raises arms. Diag?
How does acidosis/alkalosis affect K+ lvls Acid
Pt is on cyclosporin post renal transplant and develops
and fungal infection. what antifungal would caused ketaconazole (p450)
problmes?
pt presents with renal insuffiency. What changes do
Decrease digoxin, no change to digitoxin
digoxin and digitoxin?
what effect does a renal stone ->hydronephros have on
Decreases both
GFR / FF?
What is maximal serum glucose conc that can be
Spill into urine at 200g/dl, max at 350
absorbed in renal?
what change in metabolic panel would you see in a young
Beta agonist
pt being treated for status asthmaticus
MUDPILES: Methanol, uremia, DKA,
Causes of Acidosis with anion Gap Paraldehyde/Phenformin, Iron tablets / INH, Lactic
Acidosis, Ethylene glycol, Salicylates
Pt is taking lisinopril complains of new onset constant
ARB
coughing. Medication alter?
Pt with CHF needs diauresis but is sulfa allergic. What
Ethacrynic Acid
drug>
pt presents with HTN, hypoK, metabolic alkosis and low
Conn Syndrome
plasma renin. Diag?

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Glomerular histology shows multiple mesangial nodules.

DM - kimmel wilson lesion
What dz?
teenager with nephrotic syndrome and hearing loss. Dz? Alports
4 yo boy with facial edema and proteinuria. Diag? Minimal Change Dz
Renal Stone (Phosphate, magneuisum,
UIT caused by proteus vulgaaris. What kidney problem?
ammonium)
pt with hx of acetaminophen use. Risk for? Papillary necrosis
What prevents a horseshoe kidney from ascending in the
IMA
abd
What electrolytes changes seen in kidney failure? Inc in K, PO4, BUN, Cr, dec in Ca
CT shows massive bilateral enlarged kidneys. Diag? ADPCKD
A child has been anemic since birth. Cured with
Hereditary spherocytosis
splenectomy. Dz?
Pt diag with macrocytic megaloblastic anemia. Danger of W/o co adminsitering B12 could hide concurring
folate? B12 defiency
Pt with anemia, hyper Ca and bone pain receives bone
marrow biopsy. Shows large plasma cells. Diag? found Multiple Myeloma. Bence Jones Protines
on urinalysis?
Heart failure pt is newly diag with cancer and is being
Doxrubucin
evaluated for chemo. What should be avoided?
chromosomal analysis of a leukemia pt reveals PHL
CML tx with imatinib
chromasome (9:22) Tx?
After a normal spontaneous vaginal delivery, new mom
DIC -> DDimer and Inc and PT/PTT
bleeds profusely. Lab abnormalities?
11 yo child presents with a chronic non healing ulcer on
Sickle cell (autosplenectomy) use hydroxyurea
his foot. img shows small calcified spleen. Diag / Drug?
NSAIDs inhibit what that leads to platetlet aggregation? Thromboxane A2
Does fetal hgb have more or less affinity for 23 BPG? Less affiinty for 2,3BPG

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