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

Mandibular)

Muscles: Muscles of mastication

(Masseter, medial pterygoids, Mylohyoid)

Nerves: CN V2, V3

-Chew

2. 1st Brachial

Pouch

Middle ear cavity

Eustachian tube

Mastoid air cells

3. 2nd Brachial

arch

Cartilage: Reichert's (Stapes, Styloid,

Stylohyoid)

Muscles:Stapedius, Stylohyoid

Nerves:CN 7

-Smile

4. 2nd Brachial

Pouch

Epithelial lining of palatine tonsil

5. 3rd Brachial

arch

Cartilage: Greater horn of hyoid

Muscles: Stylopharyngeus

Nerves: CN 9

-Swallow stylishly

6. 3rd Brachial

Pouch

Dorsal wings

-Inferior parathyroids

Ventral wings

-Thymus

3 structures

Thymus, right & left parathyroids

7. 4th Brachial

Pouch

Dorsal wings

-Superior parathyroid

8. 4th-6th Brachial

arches

Cartilage: Thyroid, cricoid,

Muscles:

4 = pharyngeal constrictors

6 = intrinsic muscles of larynx

Nerves:

4 = CN X (superior laryngeal branch)

-Simply swallow

6 = CN X (recurrent laryngeal branch)

-Speak

9. Absence seizure Brief (usually less than 20 seconds),

generalized epileptic seizures of sudden

onset and termination

Clinically, the impairment of

consciousness (absence)

Electroencephalography (EEG) shows

generalized spike-and-slow wave

discharges ~3Hz

10. acute ischemic

injury = kidney

findings?

Acute Tubular Necrosis - Muddy Brown

Casts with epithelial cells

11. Affinity column

chromatography

Method of separating

biochemical mixtures

-Based on a highly specific

interaction such as that

between antigen and

antibody, enzyme and

substrate, or receptor and

ligand.

Can be used to.

1. Purify and concentrate a

substance from a mixture into

a buffering solution

2. Reduce the amount of a

substance in a mixture

3. Discern what biological

compounds bind to a

particular substance

4. Purify and concentrate an

enzyme solution.

12. African American,

bilateral hilar adenopathy,

righ paratracheal node

enlargment, noncaseating

granuloma =???

sarcoidosis (ethnicity is risk

factor)

13. Albinism Congenital deficiency in:

Tyrosinase

Defective tyrosine transporter

( tyrosine melanin)

Can result from lack of

migration of neural crest cells

Lack of melanin results in

risk of skin cancer

14. Ammonia source in

ammonioagenesis

Aspartate & GLUTAMINE

donate NH4 ( amonia ) in

renal ammoniaagenesis

NBME 15 reviewStudy online at quizlet.com/_e5hgc

15. Ammoniagenesis Occurs within proximal

tubular cells

Glutamine made in the

liver, is received from

peritubular capillaries and

is metabolized into

1. Alpha-keto glutarate

(Metabolized further into

two HCO3- ions, which

then leave the cell and enter

systemic circulation by

crossing the basolateral

membrane)

2. NH4+ (Secreted into

renal tubules)

16. Anabolic steroids Leads to sex-hormone

binding globulin free

testosterone

-Gynecomastia results

17. Anemia Hb concentration causes

O content of blood

hypoxia

18. aneurysm of PCA? oculomotor nerve palsy

(NOT Horner's)

19. Arches 3 & 4 Posterior 1/3 of tongue

20. ATP concentration doesn't

fall much dring normal

twitches because?

ATP is quickly regenerated

from creatine phosphate

21. Avoidant Personality

Disorder

Consider themselves to be

socially inept or personally

unappealing and avoid

social interaction for fear of

being ridiculed, humiliated,

rejected, or disliked

22. baby, respiratory distress,

cyanosis, narrow thorax,

ears with periauricular skin

tags, micrognathia,

glossoptosis, mandibular

cleft, short palate = which

artch?

first arch (Treacher-

Collins)

23. Bacillus subtilis Gram-positive, catalase-positive

bacterium

Rod-shaped

Has the ability to form a tough,

protective endospore, allowing the

organism to tolerate extreme

environmental conditions

Only known to cause disease in

severely immunocompromised

patients

24. Bacteroides fragilis Gram-negative bacillus bacterium

species

Involved in 90% of anaerobic

peritoneal infections

Predominates in bacteremia

associated with intraabdominal

infections, peritonitis and

abscesses following rupture of

viscus, and subcutaneous

abscesses or burns near the anus

25. blast proliferation,

eosinophils?

CML (9:22) responds to imatinib

26. Brachial Arches

(Pneumonic)

When at the golden arches,

1. Chew

2. Smile

3. swallow stylishly or 4. simply

swallow

6. speak

There is no 5!

27. Brachial pouch

pneumonic

Ear, tonsils, bottom to top

1(ear)

2(tonsils)

3 dorsal (bottom for inferior

thyroid)

3 ventral (to = thymus)

4 (top = superior parathyroids)

28. Broca's aphasia Nonfluent aphasia with intact

comprehension.

29. brown-black, mottled,

scaly, irregular

borders, atypical

melanocytes along

basilar layer?

lentigo maligna (melanoma)

30. Carbaminohemoglobin CO bound to hemoglobin

-Account for very small amount of

CO in blood

31. Carbon monoxide

poisoning

O content of blood hypoxia

32. Carnitine

deficiency

Inability to transport LCFA (Long chain fatty

acids) into mitochondria

Results in toxic accumulation in the cytoplasm

Causes weakness, hypotonia, hypoketotic

hypoglycemia

33. Case Control Two existing groups differing in outcome are

identified and compared on the basis of some

supposed causal attribute

34. Case series Medical research descriptive study that:

1. Tracks patients with a known exposure

given similar treatment

2. Examines their medical records for

exposure and outcome

Can be retrospective or prospective

Usually involves a smaller number of patients

than more powerful case-control studies or

randomized controlled trials

May be consecutive or non-consecutive

-Depends on whether all cases presenting to

the reporting authors over a period were

included, or only a selection

May be confounded by selection bias

-Limits statements on the causality of

correlations observed

-Physicians who look at patients with a

certain illness and a suspected linked

exposure will have a selection bias in that they

have drawn their patients from a narrow

selection (Their hospital)

35. cervical

cancer

drains to?

internal iliac nodes

36. Chloroquine,

primaquine

MOA

Chloroquie kills malaria/ Primaquine kills

hypnozoites

37. Chronic

HTN, heavy

heart?

Hypertrophy of heart

38. Chronic

myelogenous

leukemia

(CML)

Myeloid stem cell proliferation (30-60 year

olds)

- neutrophils, metamyelocytes, basophils,

t(9;22)

Low leukocyte alkaline phosphatase (as

opposed to leukemoid reaction)

39. Clostridium

perfringens

Gram-positive, rod-shaped, anaerobic, spore-

forming bacterium

Infections show evidence of tissue necrosis,

bacteremia, emphysematous cholecystitis,

and gas gangrene

Toxin involved in gas gangrene is known as

-toxin

-Inserts into the plasma membrane of cells,

producing gaps in the membrane that disrupt

normal cellular function

40. CML

treatment

Imatinib. BCR-ABL 9:22

41. Complete

hydatidiform

mole

Caused by a single (90%) or two (10%) sperm

combining with an egg which has lost its

DNA

The genotype is typically 46,XX (diploid)

42. Complex

partial

seizure

Often preceded by a seizure aura.

-A simple partial seizure.

Aura may manifest itself as a feeling of dj

vu, jamais vu, fear, euphoria or

depersonalization.

Seizure aura might also occur as a visual

disturbance, such as tunnel vision or a

change in the size of objects (macropsia or

micropsia).

Once consciousness is impaired, the person

may display automatisms such as lip

smacking, chewing or swallowing.

There may also be loss of memory (amnesia)

surrounding the seizure event.

Person may still be able to perform routine

tasks such as walking, although such

movements are not purposeful or planned.

Witnesses may not recognize that anything is

wrong.

43. Congentio

pharyngo-

cutaneous

fistula

Persistence of cleft and pouch fistula

between tonsillar area, cleft in lateral neck

44. Cyanide

poisoning

O utilization by tissues hypoxia

45. Cytarabine Pyrimidine analog inhibition of

DNA polymerase

Leukemia, lymphomas

Toxicity: Leukopenia,

Thrombocytopenia, Megaloblastic

anemia

46. defect in ihibitory NT

= seizures, floppy baby

glycine receptor

47. defect in renal

ammoniagenesis,

which substrate is

source of ammonia

production?

glutamine (and aspartate donate

NH4 in agenesis)

48. Density Gradient

Centrifuge

Used to separate certain organelles

from whole cells for further

analysis of specific parts of cells

1. A tissue sample is first

homogenised to break the cell

membranes and mix up the cell

contents.

2. The homogenate is then

subjected to repeated

centrifugations, each time

removing the pellet and increasing

the centrifugal force.

3. Finally, purification may be

done through equilibrium

sedimentation, and the desired

layer is extracted for further

analysis.

49. Dental procedure,

bug?

Strep Mitis - alpha hemolytic

50. Deoxyhemoglobin Better buffer for H than

oxyhemoglobin

-Advantageous that hemoglobin

has been deoxygenated by the time

it reaches the venous end of the

capillaries

51. DEXA decreased bone

density

increased osteoclast, RANKL,

decreased osteoblast activity

52. Diabetic neuropathy

pain?

burning pain

53. Diabetic neuropathy

symptoms

Numbness, tingling, ED, Urinary

incontinence, Vision changes,

Dizziness, Muscle weakness

*Burning or electric pain*

54. Diaphoresis Excessive sweating

55. DiGeorge syndrome Aberrant development of 3rd & 4th

pouches:

T-cell deficiency (thymic aplasia)

Hypocalcemia (failure of

parathyroid development)

56. DKA, give

insulin,

increases

activity of which

enzyme?

glucokinase

57. drug overdose? respiratory acidosis

58. Dysostosis

multiplex

Hereditary disease (autosomal recessive)

consisting of an error is

mucopolysaccharide metabolism

Characterized by severe abnormalities in

development of skeletal cartilage and bone

and mental retardation

59. Ejection

Fraction

equation

SV/EDV (EDV-ESV)/EDV

60. elevated very-

long-chain FA,

phytanic acid,

pipecolic acid =

absence of?

peroxisomes (causes hypotonia, poor

feeding)

61. EPO doping = ? EPO will increase RBC's erythroid

precursors

62. Erythropoietin Its primary effect on red blood cell

progenitors and precursors (which are

found in the bone marrow in humans) is

promoting their survival through

protecting these cells from apoptosis

63. Excess

lymphoblasts

Age < 15

Found in acute lymphoblastic leukemia

(ALL)

TdT+ (Marker of pre-t & pre-b cells)

CALLA+

t(12;21) = good prognosis

Increased incidence in people with Down

Syndrome

64. Ferrochelatase Lead poisoning

Accumulates:

Protoporphyrin, -ALA

Microcytic anemia, GI and kidney disease.

Children-exposure to lead paint -+ mental

deterioration

Adults-environmental exposure (battery/

ammunition/radiator factory) -+

headache, memory loss, demyelination

65. Generalized

tonic clonic

Generalized seizure that affects the entire

brain

Divided into two phases, the tonic phase

and the clonic phase. Preceded by aura

Tonic = skeletal muscles tense

Clonic = Rapid contraction and relaxation

of muscles

66. germline

mosaicism

produces disease that is not carried by

parent's somatic cells

67. Glipizide Sulfonylurea (stimulates endogenous

insulin release)

Close K+ channel in -cell membrane =

insulin release via Ca2+ influx.

68. glossoptosis Downward displacement or retraction of the

tongue

69. Glucokinase Liver and cells of pancreas, induced by

insulin

Low glucose = hexokinase sequesters

glucose in the tissues

High glucose = excess glucose is stored in

the liver

70. Glucose-6-

phosphatase

In ER of liver, Glucose-6-P Glucose

Deficient in Von Gierke's disease (fasting

hypoglycemia, increased glycogen in liver,

increased blood lactate, hepatomegaly)

71. Glycogen

phosphorylase

Rate determining enzyme for glycogenolysis

Skeletal component deficient in McArdle's

disease

- glycogen in muscle, but can't break it

down

-Painful muscle cramps, myoglobinuria w/

strenuous exercise

72. guy with

ulcers, what to

do to improve

symptoms?

stop smoking

73. H1

(Histamine)

Found on smooth muscle, endothelium, and

central nervous system tissue

Causes:

Bronchoconstriction, Bronchial smooth

muscle contraction, Vasodilation,

Separation of endothelial cells (responsible

for hives), Pain and itching due to insect

stings;

SE = sleep and appetite suppression.

74. HDL with age

in woman?

HDL of a 25 year old vs. 55 year old, high in

25, low in 55 (estrogen)

75. heme

biosynthesis

pathway

glycine + succ (ALA synthase) 5-ALA (ALA

dehydratase) porphobilinogen (PBG

deaminase) Hydroxymethylbilane (uro

synthase) Urophyrinogen III (Uro

decarboxylase) Coproporphyrinogen III

(Copro oxidase) protoporphyrinogen IX

(proto oxidase) protophorphyrin (IX)

ferrochelatase + Fe = HEME

76. Hemispatial

neglect

Results most commonly from brain injury to

the right cerebral hemisphere, causing visual

neglect of the left-hand side of space

A stroke affecting the right parietal lobe of

the brain can lead to neglect for the left side

of the visual field, causing a patient with

neglect to behave as if the left side of sensory

space is nonexistent (although they can still

turn left)

-Extreme case, a patient with neglect might

fail to eat the food on the left half of their

plate, even though they complain of being

hungry

-Someone with neglect is asked to draw a

clock, their drawing might show only

numbers 12 to 6, or all 12 numbers on one

half of the clock face, the other side being

distorted or left blank

77. Histone

deacetylase

Removes acetyl groups from AA

-Allows histones to wrap DNA more tightly

Actions are opposite to that of histone

acetyltransferase

These would affect transcription of DNA!!!!

78. Homonymous

hemianopsia

Visual field loss that respects the vertical

midline, and usually affects both eyes

Vascular and neoplastic (malignant or

benign tumours) lesions from the optic tract,

to visual cortex can cause

-If lesion is in optic tract, will be pupillary

reflex problem!

The more posterior the cerebral lesion, the

more symmetric (congruous) symptoms will

be

1. Person who has a lesion of the right optic

tract will no longer see objects on his left side

2. Person who has a stroke to the right

occipital lobe will have the same visual field

defect, usually more congruent between the

two eyes, and there may be macular sparing

79. Homozygous for point

mutation (GT->AT)

causes skipping of exon

12, mech?

RNA Splice error

80. How to calculate A-a

gradient

PAO2 - PaO2 (PAO2=150 -

PaCO2/0.8)

81. How to identify a variant

protein?

immunohistochemistry

82. Hydronephrosis causes? Increased tubular hydrostatic

pressure from blockage

83. Hydroxyurea Inhibits ribonucleotide

reductase DNA Synthesis

(S-phase specific)

Melanoma, CML, Sickle cell

disease ( HbF)

Toxicity:

Bone marrow suppression, GI

upset

84. Hyperammonia Can be acquired (e.g., liver

disease) or hereditary (e.g.,

urea cycle enzyme deficiencies)

excess NH4+ depletes a-

ketoglutarate inhibition of

TCA cycle

Rx: limit protein in diet

85. Hyperparathyroidism Stone, Bones, and Groans

Hypercalcemia

Hypercalciuria (Stones)

Hypophosphatemia

PTH, Alk Phos, cAMP in

urine

86. Hypokinesis of Posterior

Left Ventricle?

Stenosis of the right coronary

artery

87. Hypovolemic/cardiogenic

shock

low-output failure, increased

TPR, low CO, cold, clammy

(hypovolemic = low volume, no

JVD; cardiogenic = poor

pumping, backflow, increased

JVD)

88. Hypoxemia Pao causes %saturation of

hemoglobin hypoxia

89. I Cell Disease MOA mannose 6 phosphate addition

allows enzymes to go to

lysosome, but this is defective =

abnormal targeting of these

enzymes to lysosomes

90. IkB function? releases NFkB after undergoing

phosphorylation

91. Imatinib A small molecular inhibitor of

bcr-abl tyrosine kinase

Treatment of CML (blasts,

basophils)

92. Immunohistochemistry Process of detecting antigens

(e.g., proteins) in cells of a tissue

section by exploiting the principle

of antibodies binding specifically

to antigens in biological tissues

93. inclusion cell disease

(I-cell disease)

Inherited lysosomal storage

disorder

Failure of addition of mannose-6-

phosphate to lysosome proteins

-Enzymes are secreted outside the

cell instead of being targeted to

the lysosome

Presentation:

Coarse facial features

Clouded corneas

Restricted joint movement

High plasma levels of lysosomal

enzymes

94. incomplete penetrance

vs. variable expressivity

IP = not all with mutant genotype

show mutant phenotype; VE =

genotype SAME, phenotype varies

95. Insulin increases? glucokinase activity

96. Insulin secretion 1. Glucose binds Glut2 receptor on

-cells

2. Glucose oxidizes to ATP

closes K channels in cell

membrane depolarization of -

cells

3. Depolerizatino opens Ca

channels intracellular

[Ca] [name of this card]

97. Internal iliac lymph

nodes

Receive lymphatics from:

All the pelvic viscera

Deeper parts of the perineum

-membranous and cavernous

portions of the urethra

Buttock and back of the thigh

Cervix!

Not: Ovary, testis, or superior half

of the rectum

Gonads drain to the paraaortic

lymph nodes

Superior half of the rectum drains

to the pararectal lymph nodes

98. Internal urethral

orifice

Opening of the urinary bladder

into the urethra

99. Irradiated

packed RBCs

Destroys DNA in WBCs

-Prevents graft vs host disease occurring

from transfusion

Important if transfusion is from:

1. Close family relation

2. Someone who is

immunocompromised (Di George

Syndrome, Wiskott Aldrich, and SCID)

100. IB Releases NF-B after undergoing

phosphorylation

101. Left Axillary line

holosytolic

murmur

Mitral Regurg - Left Axillary line

holosystolic murmur

102. Left sided heart

failure signs

Tachypnea (increased rate of breathing)

Increased work of breathing (non-

specific signs of respiratory distress)

Rales or crackles, heard initially in the

lung bases, and when severe,

throughout the lung fields

-Suggest the development of pulmonary

edema (fluid in the alveoli)

-Cyanosis which suggests severe

hypoxemia, is a late sign of extremely

severe pulmonary edema.

103. Leukemia Unregulated growth of leukocytes in

*bone marrow*

or in # of circulating leukocytes in

blood

Marrow failure anemia (RBC),

infections (WBC), hemorrhage

(platelets)

Infiltrates in liver, spleen, and lymph

nodes possible

104. Leukocidin Type of cytotoxin created by some types

of bacteria

Is a type of pore forming toxin

Get their names by killing ("-cide")

leukocytes

Associated with increased virulence of

certain strains (isolates) of

Staphylococcus aureus

Cause of necrotic lesions involving the

skin or mucosa, including necrotic

hemorrhagic pneumonia

105. Lithium induced

Nephrogenic DI,

where?

Collecting tubule

106. Loading dose Cp x Vd/Bioavailability

107. long-chain-fatty-

acids?

LCFA - peroxisomes

108. Lorazepam Facilitates GABAa action by

frequency of Cl channel opening

Use:

Anxiety

Spasticity

Status epilepticus

Detoxification

109. Loss of left vision in

both eyes =?

occipital lobe lesion

110. Low blood solubility =

slow or fast induction?

141) low blood solubility --> rapid

induction, low potency

111. lump in upper neck,

mass moves up with

swallowing and tongue

protusion, uptake of

technetium 99m

pertechnetate, what

type of cells?

thyroid follicles

112. Lymphoma Discrete tumor masses arising

from lymph nodes.

113. Lysosomal storage

disease

Caused by lysosomal dysfunction

usually as a consequence of

deficiency of a single enzyme

required for the metabolism of

lipids, glycoproteins (sugar

containing proteins) or so-called

mucopolysaccharides

When a particular lysosomal

enzyme exists in too small an

amount or is missing altogether,

substances accumulate in the cell.

In other words, when the

lysosome doesn't function

normally, excess products

destined for breakdown and

recycling are stored in the cell.

114. Maintenance dose Cp x CL/F

115. Megaloblastosis

(Megaloblastic

anemia)

Results from inhibition of DNA synthesis

in red blood cell production

-Most often due to hypovitaminosis,

specifically a deficiency of vitamin B12

and/or folic acid

Characterized by:

Many large immature and dysfunctional

red blood cells (megaloblasts) in the bone

marrow

Hypersegmented neutrophils (those

exhibiting five or more nuclear lobes

("segments"), with up to four lobes being

normal)

116. Melanoma

ABCDE

Asymmetry, Border irregularity, Color

variation, Diameter >6 mm, Evolution

over time

117. Mesoblastic

nephroma

Type of kidney tumor that is usually found

before birth by ultrasound or within the

first 3 months of life.

It contains fibroblastic cells (connective

tissue cells), and may spread to the other

kidney or to nearby tissue

118. metabolic

alkalosis with

volume

contraction

loop diuretic

119. metastaic colon

cancer spread

MOA

Hematogenous spread of Liver Tumor

from Colon via Portal Venous System

120. Michaelis

constant (Km)

=?

Km = 1/2 Vmax

121. micrognathia Jaw is undersized

122. MOA IKB lkb --> NF-KB post phosphorylation for

IL-1/IL-6 fever induction

123. Myofibroblast Cell that is in between a fibroblast and a

smooth muscle cell in differentiation

Can contract by using smooth muscle type

actin-myosin complex, rich in a form of

actin called alpha-smooth muscle actin

-These cells are then capable of speeding

wound repair by contracting the edges of

the wound

124. Nephroblastoma

(Wilms tumor)

Most common renal malignancy

of early childhood (Age 2-4)

Contains embryonic glomerular

structure. Presents with huge

flank mass / hematuria. Deletion

of WT1 on chromosome 11

Can be hypervascular

125. NF-B Activation occurs when it's

inhibitor, I-B, is phosphorylated

by specific protein kinase (IKK) &

degraded

126. normal heart weight

(450), enlarged at

600g after poorly

controlled HTN?

hypertrophy

127. Oculomotor palsy

from aneurysm?

Posterior Communicating Artery

Anuerysm

128. Olanzapine Atypical antipsychotic

Use:

Schizophrenia - both +ve and -ve

Bipolar, OCD, anxiety disorder,

depression, mania

Fewer extrapyramidal side effects

than traditional antipsychotics

129. Oligomenorrhea increased estrogen in adipose

tissue

130. Optic chiasm lesion Bitemporal anopia

131. optic nerve, Chiasm,

optic tract

parietal lesion = optic tract lesion

132. Organophosphate

poisoning- first

antidote

Atropine first/Pralidoxime second

133. Oxytocin Stimulates labour

Uterine contraction

Milk let down

Controls uterine hemorrhage

134. Packed RBCs with

adenine-saline added

Allows the blood to flow readily

without the addition of saline

135. pain associated with

diabetic neuropathy?

burning pain

136. pain in shoulder,

reproduced with

resisted abduction at

90, giving thumbs

down

supraspinatus

137. Pain upper abdomen,

refered to shoulder

Diaphram ulceration phrenic

nerve

138. Pain with thumbs

down, shoulders up

Arm up Thumbs down sign...

supraspinatus...

139. pancreatic cancer

associated with?

depression

140. paraesophageal

hernia

portion of gastric fundus herniates

through the diaphragm

141. parathyroid

adenoma, decreased?

calcium concentration in feces

142. Parietal lobe lesion Lower quadrantic anopia

143. Partial hydatidiform

mole

Occurs when an egg is fertilized by

two sperm or by one sperm which

reduplicates itself yielding the

genotypes of 69,XXY

144. Partial vs complete

mole

Partial 1 egg two sperm 69XXY vs

paternal complete 46XX 2 sperm

no egg

145. Peptic ulcers Chronic inflammation due to

Helicobacter pylori that colonizes

the antral mucosa

NSAIDs

Some studies have found

correlations between smoking and

ulcer formation

Caffeine and coffee, also commonly

thought to cause or exacerbate

ulcers, have not been found to

affect ulcers to any significant

exten

146. Peroxisome Membrane-enclosed organelle

involved in catabolism of very long

fatty acids (VLFA) & amino acids

147. Phosphoenolpyruvate

carboxykinase

Irreversible enzyme in

Gluconeogenesis

148. Phosphorylase kinase A component of Gluconeogenesis

149. Phytanic acid Branched chain fatty acid that

humans can obtain through the

consumption of dairy products,

ruminant animal fats, and certain

fish

Undergoes -oxidation in the

peroxisome, where it is converted

into pristanic acid by the removal

of one carbon

150. pinpoint pupils,

unconscious

heroin OD

151. Pipecolic acid Accumulates in Pipecolic acidemia

- Very rare autosomal recessive metabolic

disorder that is caused by a peroxisomal

defect

152. Placenta accreta Abnormally deep attachment of the

placenta to the myometrium without

penetrating it.

Placenta grows completely through the

endometrium

Great risk of haemorrhage during

placental removal

-Commonly requires surgery to stem the

bleeding and fully remove the placenta

-In severe forms can often lead to a

hysterectomy or be fatal

153. Porphobilinogen

deaminase

Acute intermittent porphyria

Accumulates:

Porphobilinogen, -ALA, uroporphyrin

5 P's

1. Painful abdomen

2. Port wine-colored urine

3. Polyneuropathy

4. Psychological disturbances

5. Precipitated by drugs

154. Posterior

Communicating

Artery

Common site ofsaccular (berry)

aneurysm.

CN III Palsy: Eye is "down and out" with

ptosis and pupil dilation

Lesions are typically aneurysms, not

strokes

155. postpartum

hemorrhage

treated with?

oxytocin

156. Prenatal cocaine

effects

Associated with premature birth, birth

defects, attention deficit disorder

157. progestin

challenge with

withdrawal

bleed?

low estrogen production = estrogen

increased in adipose tissue

158. protease

inhibitors

(navirs)

protein processing (assmebling of

virions = cleave of polypeptide products

of HIV mRNA into functional parts)

159. PTH Ca+ resorption from Kidney (Inhibits PO4

resorption)

Stimulates Vit D. synth (1,25 OH)

-Increased Ca+ absorbed from intestine

Ca+ release from bone

serum calcium

160. Recurrent

severe

mycobacterial

diseases

INF-gamma receptor defect

161. renal failure

causes loss of?

1,25-dihydroxycholecalciferol (from

decreased conversion via 1a-hydroxylase

in PCT)

162. Right Coronary

Artery

Supplies blood to right ventricle & 25-30%

of left ventricle

In 85% of patients, gives off posterior

descending artery

Supplies SA nodal artery in 60% of

patients

Give off branch to right marginal artery

If lungs are clear to auscultation, no LVF.

Think RVF!

163. RNA splice

error

skipping of exons

164. Rouleaux

formation

Stacks of red blood cells (RBCs) which

form because of the unique discoid shape

of the cells in vertebrates

Conditions which cause:

Infections

Multiple myeloma

Inflammatory and connective tissue

disorders

Cancers

Occurs in diabetes mellitus (one of the

causative factors for microvascular

occlusion in diabetic retinopathy)

165. RTA1 ("distal",

Renal tubular

acidosis)

Defect in collecting tubule's ability to

excrete H+

urine pH >5.5

hypokalemia

risk for calcium phosphate kidney

stones as a result of urine pH and bone

resorption

166. RTA2

("proximal",

Renal tubular

acidosis)

Defect in proximal tubule HC03-

reabsorption

Fanconi's syndrome

urine pH < 5.5

hypokalemia

risk for hypophosphatemic rickets

167. RTA4

("hyperkalemic",

Renal tubular

acidosis)

Hypoaldosteronism or lack of collecting

tubule response to aldosterone

Resulting hyperkalemia impairs

ammoniagenesis in the proximal tubule

buffering capacity and urine pH

168. S. pyogenes

(Group A)

The bacteria behind post-streptococcal

glomerulonephritis

PHaryngitis can results in PHever &

glomerulonePHritis

169. Salmonella

enterica

Most cases of salmonellosis are caused

by food infected with w/ this bacteria,

which often infects cattle and poultry

Usually does not need ABs (Only if

complicated in people at risk such as

infants, small children, the elderly)

-Will lead to prolonged fecal excretion of

bacteria

170. Salmonella post

antibiotic?

prolonged fecal excretement post

antibiotic

171. Scaphoid bone Most commonly fractured carpel bone,

prone to avascular necrosis due to

retrograde blood supply

172. Schizoid

personality

disorder

Characterized by a lack of interest in

social relationships, a tendency towards

a solitary lifestyle, secretiveness,

emotional coldness and apathy

May simultaneously demonstrate a rich,

elaborate and exclusively internal

fantasy world

173. Screening for CD

markers?

Immunohistochemistry

174. Septic shock high-output failure, decreased TPR,

dilated arterioles, high venous return,

hot patient

175. side effect of H1

blocker

drowsiness

176. Simple partial

seizures

Consciousness is not impaired

Often precursors to larger seizures, where

the abnormal electrical activity spreads to

a larger area of (or all of) the brain,

usually resulting in a complex partial

seizure or a tonic-clonic seizure

-In this case they are often known as an

aura

177. Slipped-strand

mispairing

Denaturation and displacement of the

DNA strands, resulting in mispairing of

the complementary bases.

Can result in either insertions or deletions.

Insertions are thought to be self-

accelerating: as repeats grow longer, the

probability of subsequent mispairing

events increases

178. SNoW DRoP Southern = DNA

Northern = RNA

Western = Protein

179. Southwestern

blot

Identifies DNA-binding proteins

180. Stain Drug

effects

Upregulates LDL receptors

181. Staph -toxin The major cytotoxic agent released by

bacterium Staphylococcus aureus and the

first identified member of the pore forming

beta-barrel toxin family

182. Staphylococcus

aureus

-Superantigens (TSST-1) induce toxic

shock syndrome (TSS), usually from

prolonged tampon use. Cause non-specific

activation of T-cells resulting in polyclonal

T cell activation and massive cytokine

release (IFN)

-Enterotoxin that is the causative of

gastroenteritis that is self-limiting,

characterized by vomiting and diarrhea

one to six hours after ingestion of the toxin

with recovery in eight to 24 hours.

Symptoms include nausea, vomiting,

diarrhea, and major abdominal pain.

-Exfoliative toxins implicated in (SSSS),

which occurs most commonly in infants

and young children. Protease activity of

the exfoliative toxins causes peeling of the

skin observed with SSSS.

Other

-Protein A, an IgG-binding protein, binds

to the Fc region of an antibody

183. Statin MOA

(upregulate

what?)

LDL receptors

184. stratified

sample

NOT random, created to ensure a more

representative sample of the population at

large (ADHD more likely in boys than

girls, therefore assigned differently)

185. Substance

Abuse

Teratogens

Alcohol:

Leading cause of birth defects and mental

retardation; fetal alcohol syndrome

Cocaine:

Abnormal fetal development and fetal

addiction; placental abruption

Smoking:

Preterm labor, placental problems, IUGR,

ADI-ID

186. Superficial

inguinal

lymph nodes

Anal canal (below pectenate line)

Scrotum

Thighs

Ends up in these lymph nodes

187. suprasellar

mass,

hormone

excess?

prolactin

188. Supraspinatus Abduction of the arm at the shoulder joint

-Main agonist muscle for this movement

during the first 10-15 degrees of its arc

Can test:

Shoulder at 90%

Empty can (Wrists pronated)

189. Temporal lobe

lesion

Upper quadrantic anopia

190. Transfusion

associated

GVH

Results from transfusion of

immunocompetent T cells capable of

engrafting and initiating an immune

response against recipient antigens

The most susceptible patient groups are

those who are severely

immunocompromised

Gamma irradiation abolishes the

proliferative activity of the lymphocytes in

the donor blood.

Fresh frozen plasma and cryoprecipitate do

not contain viable lymphocytes and thus do

not need to be irradiated

191. Treacher

Collins

Syndrome

1st arch neural crest fails to migrate

-Mandibular hypoplasia

-Facial abnormalities

192. Trisomy 21 associated

with increased risk of

which cancers?

ALL and AML

193. Type I error Stating there is an effect when

none exist

194. Type I error = saw a difference when none

existed = p-value (false positive

error)

195. Type II error Stating there is not an effect when

there is one

196. Ubiquitin Tags proteins for destruction by

proteosome

197. ubiquitin tagged

proteins go where?

proteosome for degradation

198. Ureteric orifice Placed at the postero-lateral

angles of the trigonum vesicae,

and are usually slit-like in form

199. Uroporphyrinogen

decarboxylase

Porphyria cutanea tarda

Accumulates:

Uroporphyrin (tea colored urine)

Blistering cutaneous

photosensitivity. Most common

porphyria.

200. Valproic acid A wide spectrum seizure

medication

-1st line for tonic-clonic

Not for status epilepticus

201. Valproic Acid MOA inhibits HISTONE ACETYLASE -

Histones were in DNA -

transcription error

202. Vitamin C Required fro the hydroxylation of

specific purine and lysine residues

-If deficient, will cause scurvy

--Inadequate hydroxylation of

collagen peptides

203. Washed packed RBCs RBCs washed in sterile saline to

remove:

WBCs

Lytic mediators

Non-self antigens

Most useful in IgA deficient

persons who have circulating

anti-IgA Abs

-Use febrile, urticarial and

anaphylactic reactions

204. Wernicke's

aphasia

Fluent aphasia with impaired

comprehension.

Wernicke's area-superior temporal gyrus of

temporal lobe.

Wordy, but makes no sense

205. Whole blood Blood that is unmodified except for the

presence of an anticoagulant

Usually not used because the extra plasma

can contribute to transfusion associated

circulatory overload (TACO), a potentially

dangerous complication

206. Why deoxyHB

can carry CO2

better than

OxyHB?

DeoxyHB = better buffer

207. Wound

healing

1. Inflammatory (immediate)

-Platelets, neutrophils, macrophages

2. Proliferative (2-3 days after wound)

-Fibroblasts, myofibroblasts, endothelial

cells, keratinocytes, macrophages

-Granulation tissue depostion,

angiogenesis, wound contraction (mediated

by myofibroblasts)

3. Remodeling (1 week after wound)

-Fibroblasts

-Type III collagen replaced by type I

collagen

208. Zanamavir

MOA

Zanamivir MOA - inhibit virion release

209. zanamivir,

oseltamivir

MOA

inhibits virion release

210. -ALA

dehydratase

Lead poisoning

Accumulates:

Protoporphyrin, -ALA

Microcytic anemia, GI and kidney disease.

Children-exposure to lead paint -+ mental

deterioration

Adults-environmental exposure (battery/

ammunition/radiator factory) -+ headache,

memory loss, demyelination

211. -ALA

synthase

Sideroblastic anemia