IMP TIPS TO BE REMEMBERED WHILE PREPARING FOR PRE PG EXAM

Discussion in 'Question Zone' started by Imperial, Mar 31, 2005.

  1. Imperial

    Imperial Guest

    The typical presentation of a thrombosed external hemorrhoid is an acute onset of very severe perianal pain, particularly when walking and sitting.
    2. You know that external hemorrhoid is below the dentate line. internal hemorrhoids arise above the dentate line.

    3. thrombosed external hemorrhoid requires immediate incision and evacuation of the clot to provide symptomatic relief. Pressure by compression is usually all that is needed to control the bleeding.
    4..Sitz baths, applying a topical steroid cream, and increasing fiber intake are the usual treatment for symptomatic external hemorrhoids that are not thrombosed.
    5..as a rule alwayes remember that external hemorrhoid s hurts but donot bleeding(opossit internal hemorrhoids)
    6.typical picture of pyloric stenosis.,Projectile non-bilious vomiting is seen in virtually all patients. Patients also often develop a hypokalemic, hypochloremic metabolic alkalosis from the persistent vomiting. remeber if they give a child with intermittent spitting up think about pyloric stenosis.
    7.abrupt onset of colicky abdominal pain in childeren <2 years ,think about intussusception! what's the etiology? The exact cause is unknown. However, it is associated with Meckel's diverticulum, cystic fibrosis, polyps, and Henoch-Schonlein purpura.
    remeber A barium enema or air enema is both diagnostic and therapeutic.
    8.Remember In any patient with dysphagia that is progressive for only solids, it suggests a growing and obstructive lesion. The history of tobacco and alcohol use, puts person at a much higher risk of carcinoma. The two ways to diagnose this are a barium swallow study, which will show the mucosal mass, or an upper endoscopy study to directly visualize and biopsy the lesion.
    9.Remember Esophageal manometry is used to evaluate dysphagia caused by motility disorders. These typically present with dysphagia for solids and liquids and may or may not be progressive.
    10.Incarcerated or strangulated hernias in an elderly patient can cause acute abdomen, dehydration, and altered mental status.
    11.. Frequent, greasy, malodorous stools are a result of steatorrhea from chronic pancreatitis. This happens from the lack of pancreatic enzymes. Non-enteric coated pancreatic enzyme supplements with concurrent H2 blockers will deliver active enzymes to the proximal small bowel and help reduce malabsorption and steatorrhea.
    12.. Acute acalculous cholecystitis is characterized by fever, nausea and vomiting, right upper quadrant abdominal pain, and inspiratory arrest on palpation of the right upper quadrant (Murphy's sign). An elevated leukocyte count is usually present. Gallstones are not present and it is usually associated with trauma, burn, surgery, diabetes mellitus, and bacterial infections of the gallbladder. BUT
    biliary colic, which is characterized by crampy, right upper quadrant abdominal pain that may radiate to the back and often follows a meal. Nausea and vomiting may be present. Fever, chills, and leukocytosis are notably absent. Gallstones are present on an ultrasound.

    13.Acute cholangitis is characterized by fever, right upper quadrant pain, and jaundice (Charcot's triad).
    14.The hallmark of mesenteric ischemia is pain out of proportion to physical exam findings. Mesenteric ischemia is especially likely in a patient with known vascular disease and a history of cigarette smoking. The next diagnostic step is a mesenteric angiogram. The superior mesenteric artery is the most often compromised vessel.
    15. Patients with ulcerative colitis are at high risk for toxic megacolon, which is also associated with Clostridium difficile colitis
    16.. Toxic megacolon presents clinically as abdominal distension and bowel motility disturbances. The next step in evaluation is an abdominal radiograph which will demonstrate a distended large bowel.

    17.spontaneous bacterial peritonitis. This diagnosis should be first on your list in any patient with ascites who presents with fevers, abdominal pain, change in mental status, or with other non-specific complaints. These patients need to have a paracentesis. This fluid is then sent to the lab for a cell count, culture, and Gram stain. The diagnosis of SBP can be made by seeing bacteria on a Gram stain, having more than 500 WBC or 250 PMNs in the cell count, or a positive peritoneal fluid culture. Patients with SBP need to be started on a third-generation cephalosporin

    18.. Lead levels over 10 mg/dL are considered abnormal.
    19.Remeber Fluoxetine is a serotonin reuptake inhibitor that requires 5 weeks to reach a steady state in the body and takes approximately 6-8 weeks to show an adequate response. This should be explained to patients before and during treatment to help them understand the importance of staying on the medication even though they do not feel any effects.
    20.congenital diaphragmatic hernia, which is when the abdominal contents herniate into the left hemithorax through a congenital defect in the left hemidiaphragm. This causes displacement of the heart into the right hemithorax and pulmonary hypoplasia.
    21 key finding for Esophageal atresia with distal tracheoesophageal fistula usually presents with a history of polyhydramnios, cyanosis with feeding, and increased oropharyngeal secretions.
    22.Remember in a traumatic lumbar puncture even though the CSF is initially red, the supernatant of the centrifuged cerebrospinal fluid is clear. This means that the red blood cells have not yet had a chance to lyse and release their intracellular contents into the cerebrospinal fluid.
    BUT in subarachnoid hemorrhage there would be blood in the CSF, the supernatant of the centrifuged fluid would be xanthochromatic (yellow) due to the lysis of red blood cells and the release of their intracellular contents into the cerebrospinal fluid.
    23.The symptoms of crampy abdominal pain and watery, explosive, secretory diarrhea are consistent with enterotoxic E. coli. the cause of traveler's diarrhea ,treatment ciprofloxacin if symptoms persistent.
    24.The symptoms of Giardiasis, which usually occur about a week after exposure, include flatus, loose stools, diarrhea, abdominal pain, bloating, and vomiting. The usual scenario for a healthy person that develops this infection is the onset of these symptoms after a camping trip. tx:metronidazole

    25.infectious mononucleosis typically presents with a few-week history of fatigue, malaise, and a sore throat. Examination often shows pharyngeal edema, erythema, and palatal petechiae, lymphadenopathy, and splenomegaly. Hepatomegaly may also occur.
    26.Hyperthyroidism during pregnancy is treated with propylthiouracil, which crosses the placenta less than other medicines such as methimazole. It should be given in the lowest effective dose and tapered as the patient becomes euthyroid. Untreated severe hyperthyroidism during pregnancy has been associated with spontaneous abortion and premature labor.

    27.Remember sudden onset of right upper quadrant pain associated with nausea and vomiting and history right upper quadrant and epigastric pain before, associated with food intake. These symptoms are classical for a perforated peptic ulcer. In a perforated peptic ulcer, a patient can still have right upper quadrant localized tenderness, a thickened gallbladder wall, and pericholecystic fluid from the perforated ulcer. Hence, with any abdominal pain associated with signs, abdominal x-rays both erect and supine are very essential in the initial evaluation to rule out any free air.
    28.The first line in treatment of panic disorder is selective serotonin reuptake inhibitors (SSRIs), a group of medications including sertraline, paroxetine, fluoxetine, and citalopram. .

    29.Remember Surveillance colonoscopies are generally recommended every 6 months for 2 years beginning after 8 to 10 years duration of ulcerative colitis.

    30.The presence of endocervical cells on a Pap test is regarded as evidence of adequate sampling of the transformation zone during cytologic screening of the cervix. When these cells are absent, it indicates that this area may not have been sampled. This is considered a satisfactory, but limited smear. In patients with no known risk factors (i.e., prior abnormal Pap test, multiple sexual partners, smoking) the American College of Obstetricians and Gynecologists recommends that the physician may defer to repeating the Pap test in 12 months even if the sample is not adequ

    31.in superior vena cava syndrome (SVCS), which is due to obstruction of the superior vena cava. The vast majority of cases of SVCS are caused by malignancies, with lung cancer being the most common. The most feared complication of SVCS is upper airway obstruction. Radiation therapy is the treatment of choice for most patients with SVCS.

    32.Remember in patients with known lung cancer, a biopsy of the mass causing the SVCS is usually not necessary and treatment can commence once the clinical diagnosis is made. In patients without a history of cancer, every effort should be made to obtain a diagnosis before starting treatment, as there are benign causes of SVCS (e.g., thyroid enlargement, thrombosis).
    33.Pregnancy is characterized by increased alkaline phosphatase being secreted from the placenta. Alkaline phosphatase is usually secreted by biliary canalicular cells, placenta, bone, and intestinal mucosal cells. Hence, raised alkaline phosphatase is a normal value in growing children and pregnant women.

    34.Acneiform eruptions is characterized by papules and pustules resembling acne lesions. The eruptions are distinguished by their sudden onset.
    Oral medications such as iodides, bromides, testosterone, cyclosporine, antiepileptic medications, lithium, and systemic corticosteroids are common agents that can lead to acneiform eruption. When medium or high doses of corticosteroids are taken for as short a time as 3-5 days, a distinctive eruption may occur, known as steroid acne. It is a sudden out-cropping of inflamed papules, most numerous on the upper trunk and arms, but also seen on the face. The lesions typically present as papules rather than comedones. Tretinoin cream applied once or twice daily may clear the lesions within 1-3 months, despite the continuation of high doses of corticosteroid.

    35.The management of hematuria associated with trauma differs in adults and children. In the adult population, imaging is performed only in those patients with gross hematuria or microscopic hematuria plus hypotension. This differs from the pediatric patient. In children, any degree of hematuria (gross or microscopic) should be investigated with imaging studies. One reason for this discrepancy is that large amounts of catecholamines released in injured children may sustain blood pressure in the face of hypovolemia. A CT scan is the most useful imaging modality in this setting. A CT is noninvasive, accurate and fast, and it can help in assessing the size and extent of retroperitoneal hematomas and renal parenchymal trauma.

    36. Remeber anterior uveitis is associated with sarcoidosis. Anterior uveitis is usually marked by the abrupt onset of pain and photophobia. Specifically anterior uveitis causes iritis and iridocyclitis. Constriction of the pupil causes increased pain. Slit-lamp examination is diagnostic, showing inflammatory cells in the aqueous humor or deposited along the corneal endothelium.
    37.Many diseases are associated with anterior uveitis, including sarcoidosis and the seronegative spondyloarthropathies, including ankylosing spondylitis, psoriasis, inflammatory bowel disease, and Behçet's disease. Infectious disease may also cause uveitis. Some of the associated infections include herpesviruses, tuberculosis, onchocerciasis, and leprosy. In the majority of cases, uveitis is idiopathic. Treatment should include topical corticosteroids to decrease inflammation and mydriatics because dilation of the pupil decreases pain and the formation of synechiae.

    38. hyperventilation causes a mild respiratory alkalosis and is experienced as acral and periorbital dysesthesias.(tingling sensation in the fingertips.)
    39.Remember treatment of CMV retinitis in HIV if Gancyvlovier dosen't work is FOSCARNET(can cuase renal toxicity).
    40.Asperger disorder
    it's characterized by defecits in interpersonal development,restricted patterns of interest&behaivior,and normal cognitive and speech development.
    41.Spondylolysis is a defect seen in the pars interarticularis portion of the lamina.Spondylolysis is believed to be caused by repeated microtrauma, resulting in stress fracture of the pars interarticularis. Heredity also is believed to be a factor. Patients with spina bifida occulta have an increased risk for spondylolysis. Approximately 95% of cases of spondylolysis occur at the L5 level.Athletes who participate in sports, such as soccer, baseball, football, wrestling, gymnastics, and tennis, are more likely to have symptomatic spondylolysis at some point(with hyperextension maneuvers)
    42.Patients with suspected spondylolysis should be evaluated initially with plain radiography, consisting of anteroposterior, lateral, and oblique views of the lumbar spine. The lateral views are most sensitive for detection of pars fractures, and the oblique views are most specific.


    43..Remember The sudden onset of tachycardia and hypotension in a patient who is being mechanically ventilated with positive pressure, is at increased risk of a bullous rupture from barotrauma, leading to a pneumothorax,
    44.young age, occurrence of pain at night, negativity of rheumatoid factor, and especially, bilateral involvement of sacroiliac joints are consistent with ankylosing spondylitis.
    45.Ankylosing spondylitis should be suspected in any young person complaining of chronic lower back pain and confirmed by radiographs or CT scans of sacroiliac joints. The disease usually progresses to involve the whole vertebral column, producing ankylosis and respiratory failure secondary to restrictive lung disease. Uveitis and aortic insufficiency are additional manifestations.
    46.Still disease is a rare systemic form of arthritis with onset before age 17. It manifests with spiking fever and systemic symptoms that usually antedate arthritis. Associated manifestations include a morbilliform rash, hepatosplenomegaly, serositis, anemia, and leukocytosis.
    47.whenever the terms "coin-shaped" or "discoid" are used to describe a patient's skin lesions in a question you should think about nummular dermatitis.
    48.Remeber symptoms of congestive heart failure and possible atrial fibrillation, as demonstrated by irregularly irregular heartbeat in question(they never mention stright forward A.F). In addition, are at high risk for the development of an embolic occlusion of the superior mesenteric artery. These patients will present with severe pain out of proportion to their objective physical findings. The diagnosis should be suspected clinically, and immediate superior mesenteric arteriogram should be performed. If evidence of ischemia is confirmed, the patient should proceed to exploratory laparotomy to evaluate for intestinal ischemia and possible gangrenous bowel.

    49.BUT Ischemic colitis will usually present as diarrhea, often bloody, in elderly patients with known atherosclerotic heart disease.
    50.malignant external otitis, This form is specifically caused by Pseudomonas aeruginosa, and tends to affect elderly diabetics and AIDS patients, causing the findings in the severe and persistent earache. Otoscopic examination demonstrates foul-smelling purulent otorrhea and a red mass lesion of the external ear canal. Biopsy of the mass demonstrates granulation tissue rather than tumor.

    51.Headache of sudden onset ("thunderclap" headache), rapid deterioration of mental status and blood in the CSF are virtually diagnostic of ruptured berry aneurysms. Note the characteristic hyperdensity on CT of the suprasellar cistern, indicating blood in the subarachnoid space. Rupture of a berry aneurysm is the most common cause of subarachnoid bleeding.
  2. Imperial

    Imperial Guest

    PBC is due to an autoimmune destruction of intrahepatic bile ductules, and the diagnosis is made by liver biopsy. The serology that should be checked is the antimitochondrial antibody. Primary biliary cirrhosis is often seen in individuals with other autoimmune diseases, such as Sjögren syndrome, pernicious anemia, and Hashimoto thyroiditis.
    53.Myasthenia gravis is an autoimmune disease in which antibodies directed against the acetylcholine receptor of the muscle side of the neuromuscular junction block the ability of the receptor to bind to acetylcholine. Remember insulin resistance is also produced by a similar mechanism, i.e. antibodies to insulin receptors block the receptors' ability to bind to insulin
    54.The first step in the approach to a patient with a community-acquired pneumonia is to categorize condition according to the American Thoracic Society guidelines (1993), which are based on severity of illness, age, comorbidities, and the need for hospitalization. the criteria for hospitalization (one of the following is needed: respiratory rate > 30 breaths/min, room air PaO2< 60 mm Hg, O2 saturation less than 90% on room air, or bilateral or multiple lobes involved), and older than 60 years.

    55.normal value for the anion gap is 12 ± 4 mEq/L. Causes of increased anion gap include conditions that produce ketoacidosis (diabetes mellitus, alcoholism, starvation), renal failure with retained sulfate and phosphate, drugs or metabolites (salicylate or ethylene glycol poisoning), alkalosis with increased negative charge of protein anions, and dehydration (hemoconcentration).

    56.Remember Subcutaneous unfractionated heparin is used for prevention of DVT in immobile patients or in hospitalized patients unable to ambulate. However, after orthopedic surgery, especially after joint procedures, its efficacy is very poor, given the increased venous stasis ,you should use warfarin.
    57.Remember Both chronic laxative use and chronic diuretic use can produce hypokalemia. Severe hypokalemia, with plasma potassium <3 mEq/L, can markedly affect skeletal, smooth, and cardiac muscles. Skeletal muscle effects can include weakness, cramping, fasciculations, paralysis (with risk of respiratory failure), tetany, and rhabdomyolysis. Smooth muscle effects include hypotension and paralytic ileus. Cardiac muscle effects include premature ventricular and atrial contractions, tachyarrhythmias, and AV block. Additional ECG changes can include ST segment depression, increased U wave amplitude, and T wave amplitude less than U wave.

    58.Basal cell carcinoma affects sun-exposed areas, particularly the mid and upper face, in patients lacking protective pigmentation. One of its morphologic forms is that of a raised, waxy, pale lesion that grows very slowly and doesn't metastasize to lymph nodes.
    59.Key for Keratoacanthoma : grows very rapidly in a matter of weeks and has a scaly, rough appearance, with a core of keratin. If untreated, it eventually sloughs off.
    60.Squamous cell carcinoma is usually an ulcer, rather than a nodule. In the face, it favors the lower lip. If present for several years, lymph node metastasis can sometimes occur.
    61.euthyroid sick syndrome, which occurs in many seriously ill patients who do not have clinical hypothyroidism. especially in ICU
    61. The TSH level is usually most helpful in distinguishing euthyroid sick syndrome from true hypothyroidism, as it often above 30 mU/mL in true hypothyroidism and may be below normal, normal, or minimally elevated in euthyroid sick syndrome. Disproportionately decreased T3 is also typical of euthyroid sick syndrome, and T4 may be normal or decreased.
    62.Remember hepatorenal syndrome occurs during the end stages of cirrhosis and is characterized by diminished urine output and low urinary sodium. In the setting of end-stage liver disease, renal vasoconstriction occurs, and the distal convoluted tubule responds by conserving sodium. Unless the renal function is allowed to deteriorate further, liver transplantation will reverse this vasoconstriction and kidney function will return to normal.
    then when ever you have cirrhosis with reanal faiuler the most appropriate treatment is LIVER TRANSPALNTION!
    63.In beta thalassemia, a reduced production of beta chains occurs with normal amounts of alpha production
    64.A shock-like pain upon percussion on the volar aspect of the wrist (Tinel sign) is a characteristic sign of Carpal tunnel syndrome ,,is most often idiopathic, but may represent a manifestation of underlying disorders such as rheumatoid arthritis, sarcoidosis, amyloidosis, acromegaly, and leukemia.

    65.Fibrositis , also known as fibromyalgia, refers to a poorly understood syndrome of widespread musculoskeletal pain associated with tenderness in multiple trigger points. Fatigue, headache, and numbness are also common. Women between 20 and 50 years of age are most commonly affected. Neck, shoulders, low back and hips are usually involved.
    66.Reflex sympathetic dystrophy describes a syndrome of pain and swelling of one extremity (most commonly a hand), associated with skin atrophy. It is thought to be secondary to vasomotor instability. Sometimes, it follows injuries to the shoulder (shoulder-hand variant).
    67.Femoral pseudoaneurysms represent an important vascular complication of cardiac catheterization. The combination of a pulsatile mass, femoral bruit, and compromised distal pulses make this diagnosis likely. The diagnosis can be confirmed by ultrasound of the groin.(it was exam question of one of my friend).
    68.Cholesterol emboli syndrome is also an important complication to recognize in the post-catheterization patient. It usually presents, however, with skin findings in the distal extremities of livedo reticularis, ischemic ulcerations, cyanosis, gangrene, or subcutaneous nodules.
    69.Remember Another important complication of cardiac catheterization via the femoral artery is a retroperitoneal bleed . This complication presents, however, as either new back pain, an unexplained drop in the hematocrit, or purpura over the flanks.
    70.what is piriformis syndrome??
    As you may recall from your anatomy, the piriformis is the small muscle that crosses the greater sciatic foramen, cutting it into two spaces as the muscle passes from the edge of the sacrum to the greater trochanter. The sciatic nerve comes out of the greater sciatic foramen below the piriformis, and is liable to compression by the muscle. Symptoms are as described above; bicycle riding and running may also set off the symptoms, which may take the form of chronic nagging ache, pain, tingling, or numbness. Treatment is usually to teach the patient to avoid maneuvers that set off the symptoms. Some patients have been helped by corticosteroid injection near the site where the piriformis muscle crosses the sciatic nerve; this therapy is thought to work by reducing the fat around the muscle and thereby increasing the available space in the area.
    71.in Adison disease Laboratory findings include hyponatremia (due to aldosterone deficiency), hyperkalemia, and normocytic anemia with eosinophilia and lymphocytosis. The diagnosis is made with the ACTH stimulation test. Cortisol and aldosterone levels do not increase when the ACTH is given. The treatment is glucocorticoid and mineralocorticoid replacement.

    72.HIV encephalitis, clinically known as AIDS dementia complex, . The pathologic substrate is a subacute inflammatory infiltration of the brain caused by direct spread of HIV to the CNS.
    73. The diagnosis of HIV encephalitis (or AIDS dementia complex) must be reached by exclusion of other infective and neoplastic conditions associated with AIDS. AIDS dementia complex is characterized by cognitive impairment, incontinence, impairment of motor skills, and confusion. MRI studies and CSF analysis are useful in excluding other CNS diseases .
    74.HIV myelopathy manifests mainly with spastic paraparesis. It is a complication similar in pathologic substrate to vitamin B12 deficiency, i.e., vacuolar degeneration of the posterior and lateral columns of the spinal cord.

    75.Progressive multifocal leukoencephalopathy consists of multifocal areas of myelin destruction. These changes would be visible on MRI. This complication is due to JC virus, a papovavirus that causes asymptomatic infections in immunocompetent individuals.
    76.Patients with longstanding extensive ulcerative colitis for at least 10 years' duration are at increased colon cancer risk. Appropriate surveillance involves annual or biannual colonoscopy with multiple biopsies at regular intervals, even of normal appearing mucosa, to check for dysplasia
    77.Individuals with herpes zoster are contagious and can spread the VZV virus.
    78.Decreased esophageal peristalsis and decreased LES pressure :SCLERODERMA , These patients are therefore at risk for severe GERD and subsequent complications of peptic stricture and Barrett's esophagus.

    79.Patients with this erythema infectiosum (Fifth disease) are only infectious before the onset of the rash, during the period with the nonspecific febrile illness. The virus typically only causes a significant, severe illness in individuals with sickle cell disease and other hemoglobinopathies. In rare cases, parvovirus contracted during pregnancy has been associated with fetal hydrops and death.
    80.If a pergnant woman was in contact with a patient with fifth disease during the phase of the illness before the onset of the rash, she should have serologic testing and a fetal ultrasound to evaluate the health of her and the baby. It should be mentioned that the complications of parvovirus in pregnant women typically occur during the first half of pregnancy.
    81.Most authorities think that it is appropriate to initiate a progestin-only method of contraception immediately postpartum. It has no impact on lactation or the quality of breast milk.

    82.The triad of miosis, respiratory depression, and coma is suggestive of opioid intoxication
    83.Phenelzine is an antidepressant monoamine oxidase inhibitor (MAOI) that causes hypertensive crises and the serotonin syndrome (hypertension, tachycardia, fever, coma, and possibly death) when combined with tyramine-containing food (cheese) and serotonin-altering drugs.Pseudoephedrine and other nasal decongestants, bronchodilators, amphetamines can cause severe hypertension when monoamine oxidase is inhibited and should be avoid.
    84.the classic signs of chronic plaque psoriasis are silvery or pink well-defined plaques, which can span the whole body from the scalp to the feet. The most classically involved areas include the scalp, ears, elbows, knees, sacrum and ankles.
    85.Fiberoptic bronchoscopy is part of the evaluation of a patient with hemoptysis, but it is typically performed after a chest x-ray. It is the next step if a chest x-ray shows a mass, if the chest x-ray is normal and there are major risk factors for cancer, or if the chest x-ray is normal and there are no risk factors for cancer, but there is a recurrence of hemoptysis after weeks to months of observation.
    then remeber if you have a patient with hemoptysis with past history of smoking ,your first step is CXR even if he/she is normal right now!but!!!!!!!Keep in mind that a chest x-ray is not part of a routine physical examination of an asymptomatic smoker.

    86.Complications of ovarian torsion include infection, peritonitis, sepsis, adhesions, chronic pelvic pain, and infertility due to the loss of the viability of the torsed ovary.
    87.Remember One of the most important considerations in evaluating patients with conjunctivitis is to rule out any vision-threatening conditions such as iritis, keratitis, glaucoma, or a corneal ulceration. Symptoms such as marked photophobia, decreased visual acuity, or globe pain suggest that ocular structures other than the conjunctiva are involved and should trigger immediate ophthalmologic evaluation.
    88.The pathophysiology of ITP:
    involves antibody (IgG or IgM) binding to platelets. These antibody- coated platelets are subsequently destroyed in the spleen.
    89.Remember an extremely important aspect of management of the asplenic patient includes permanent penicillin prophylaxis in addition to pneumococcal and Haemophilus influenza vaccines. These measures decrease the risk of morbidity and mortality associated with overwhelming sepsis by encapsulated organisms in asplenic patients.
    90.Multifocal glioblastoma multiforme (GBM) , the most frequent malignant primary brain neoplasm, manifests as an ill-defined mass in the white matter.
    91.Wernicke encephalopathy is characterized by nystagmus progressing to ophthalmoplegia, truncal ataxia and confusion.
    92.Korsakoff syndrome refers to alcohol-related amnesia and confabulation. Wernicke-Korsakoff syndrome is due to vitamin B1 deficiency, which is often seen in chronic alcoholics. This deficiency results in degeneration of periaqueductal gray matter.
    93.Remember Huntington disease autosomal dominant condition is caused by an unstable expansion of a CAG trinucleotide repeat and MRI examination of the brain reveals hyperintensity in the region of the caudate on T2-weighted images.
    94.The pathologic substrate of this condition(Huntington disease ) is degeneration of the striatal neurons, especially those in the caudate nucleus.
    95.the pathogenesis of stress-induced gastritis:Diffuse gastric mucosal vasoconstriction
    96.Right-sided endocardial fibrosis, with pulmonary stenosis and tricuspid regurgitation, is common in carcinoid patients and is the result of toxic damage to the heart
    97.Ondansetron, a 5-hydroxytryptamine3 antagonist, is the most potent antiemetic available for chemotherapy-induced vomiting.It has side effects only infrequently, the most common being constipation.
    98.Copper deficiency can present with anemia and neutropenia, Zinc deficeincy will present with alopecia, impaired wound healing , dermaititis, selenium def will present with dilated cardiomyopathy
    99.Bernard-Soulier syndrome is an autosomal recessive disease of platelet adhesion which causes prolonged bleeding times in the presence of normal platelet counts. These patients' platelets cannot bind to subendothelial collagen properly because of a deficiency or dysfunction of the glycoprotein Ib-IX complex. Clinically the patients have impaired hemostasis and recurrent severe mucosal hemorrhage. The only treatment for an acute episode is a transfusion of normal platelets. This patient has a slightly decreased hemoglobin due to blood loss.
    100.Von Willebrand's disease causes increased bleeding times with normal platelet counts. It is the most common inherited bleeding disorder, caused by a defect in von Willebrand factor, which aids the binding of platelets to collagen. Even though the platelets themselves are normal, binding is impaired, thus a platelet transfusion would not correct the problem. Cryoprecipitate, a plasma fraction rich in von Willebrand factor, would help in the case of von Willebrand's disease, but would not help with Bernard-Soulier syndrome.
    Coarctations account for approximately 7% of congenital cardiac abnormalities, occur more frequently (2x) in men than in women, and are associated with gonadal dysgenesis and bicuspid aortic valves. Adults will present with hypertension, manifestations of hypertension in the upper body (headache, epistaxis), or leg claudication. Physical examination reveals diminished and/or delayed lower extremity pulses, enlarged collateral vessels in the upper body, or reduced development of the lower extremities.
  3. Guest

    Guest Guest

    IMP. FACTS TO BE REMENBERED

    HIGH YIELD NOTES --

    Define anisocytosis.
    varying cell sizes
    Define poikilocytosis
    varying cell shapes
    From which cells do B cells arise?
    stem cells in bone marrow
    From which cells do plasma cells differentiate?
    B cells
    How can a Nissl stain be used to differentiate microglia from oligodendroglia?
    Microglia are not discernable in a Nissl stain while oligodendroglia appear as small dark nuclei with dark chromatin
    In what type of CNS tissue (white or grey) are oligodendroglia predominant?
    white matter
    Into what cell type does a monocyte differentiate in tissues?
    Macrophages
    Name 2 substances produced by an eosinophil.
    histiminase and arylsulfatase
    Name the three types of leukocytic granulocytes.
    basophils, eosinophils, and neutrophils
    Name the two types of mononuclear leukocytes.
    lymphocytes and monocytes
    What are 2 functions of T cell lymphocytes?
    - cellular immune response - regulation of B lymphocytes and macrophages
    What are 2 morphological features of microglia?
    - small irregular nuclei - and relatively little cytoplasm
    What are 3 examples of peripheral lymphoid tissue?
    - follicles of lymph nodes - white pulp of spleen - unencapsulated lymphoid tissue
    What are 3 functions of a macrophage?
    - pagocytosis of bacteria, cell debris, and senescent red cells - scavenges damaged cells and tissues - can function as an antigen presenting cell
    What are 3 morphological characteristics of monocytes?
    - Large - Kidney-shaped nucleus - Extensive 'frosted glass' cytoplasm
    What are 4 characteristics of the plasma cell morphology?
    - Off center nucleus - Clock face chromatin distribution - Abundant RER - Well developed Golgi apparatus
    What are 4 morphologic characteristics of lymphocytes?
    - Round - Small - Densely staining nucleus - Small amount of pale cytoplasm
    What are 4 substances contained within the lysosomes of neutrophils?
    - hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
    What are 4 types of cells into which T cells differentiate?
    - cytotoxic T cells (MHC I, CD8) - helper T cells (MHCII, CD4) - suppressor T cells - delayed hypersensitivity T cells
    What are the 5 important causes for eosinophilia in humans?
    Neoplastic, Asthma, Allergic process, Collagen vascular disease, and Parasites (pneumonic NAACP)
    What are the blood cell diffenentiation names of the ACTIVE T CELL line beginning with the pluripotent hematopoietic stem cell? (4)
    - Pluripotent hematopoietic stem cell - Lymphoblast - T cell - Active T cell
    What are the blood cell differentiation names of the ERYTHROCYTE cell line beginning with pluripotent hematopoietic stem cell? (4)
    - Pluripotent hematopoietic stem cell - Proerythroblast - Reticulocyte - Erythrocyte
    What are the blood cell differentiation names of the MONOCYTE cell lines beginning with the pluripotent hematopoietic stem cell? (3)
    - Pluripotent hematopoietic stem cell - Mono blast - Monocyte
    What are the blood cell differentiation names of the NEUTROPHIL, EOSINOPHIL, and BASOPHIL cell lines beginning with the myeloblast stage? (6)
    - Myeloblast - Promyelocyte - Myelocyte - Metamyelocyte - Stab cell - Neutrophil, eosinophil or basophil
    What are the blood cell differentiation names of the PLASMA CELL line beginning with the pluripotent hematopoietic stem cell? (4)
    - Pluripotent hematopoietic stem cell - Lymphoblast - B cell - Plasma cell
    What are the blood cell differentiation names of the PLATELET CELL line beginning with the hematopoietic stem cell? (4)
    - Pluripotento hematopoietic stem cell - Megakaryoblast - Megakaryocyte - Platelets
    What are the components of the air-blood barrier?
    - Type I pneumocyte - tight junction - endothelial cell
    What are the steps of maturation of a B cell? (2 points)
    - maturation in the marrow - migration to peripheral lymphoid tissue
    What are the substances contained within the densly basophilic granules of the basophil? (4)
    - Heparin (anticoagulant) - histamine (vasodilator) - vasoactive amines - Slow reacting substance of anaphylaxis
    What are two basic morphological characteristics of neutrophils?
    - multilobed nucleus - large, spherical azurophilic primary granules (lysosomes)
    What are two important functions of a neutrophil?
    - acute inflammmatory response of a cell - phagocytosis
    What are two names for an increased number of red cells?
    Erythrocytosis and polycythemia
    What cell type closely resembles a mast cell?
    basophil
    What cranial nerves are commonly involved in an acoustic neuroma?
    CN VII, VIII (association with internal acoustic meatus)
    What disease is characterized by destruction of oligodendroglia?
    Multiple sclerosis
    What does CD stand for?
    cluster of differentiation
    What drug prevents mast cell degranulation?
    Cromolyn sodium
    What immunoglobulin can bind to the membrane of a mast cell?
    IgE
    What is a reticulocyte?
    a baby (developing) erythrocyte
    What is an important example of a Schwannoma?
    Acoustic neuroma
    What is another name for pulmonary sufractant?
    DPPC (dipalmitoylphosphatidylcholine)
    What is percentage of leukocytes in the blood exist as basophils?
    less than 1%
    What is the 'gap' between the myelination segment of 2 Schwann cells called?
    Node of Ranvier
    What is the advantage of the large surface area:volume ratio in erythrocytes?
    easy gas exchange (Oxygen and Carbon dioxide)
    What is the basic morphologic structure of an erythrocyte?
    Anucleate, biconcave
    What is the basic morphology of an eosinophil? (2 things)
    - bilobate nucleus - packed with large eosinophilic granules of uniform size
    What is the embryologic origin of microglia?
    mesoderm
    What is the function of Interferon gamma with relation to macrophages?
    macrophage activation
    What is the function of microglia?
    phagocytosis in CNS
    What is the function of oligodendroglia?
    myelination of multiple CNS axons
    What is the function of pulmonary surfactant?
    lowers alveolar surface tension and prevents atelectasis
    What is the function of Schwann cells?
    myelination of PNS (a Schwann cell myelinates only one PNS axon)
    What is the importance of the lecithin:sphingomyelin ratio?
    > 2.0 in fetal lung is indicative of fetal lung maturity
    What is the importance of the physiologic chloride shift in erythrocytes?
    Membranes contain the chloride bicarbonate antiport allowing the RBC to transport carbon dioxide from the the lung periphery for elimination.
    What is the last segment of lung tissue in which ciliated cells are found?
    respiratory bronchioles
    What is the last segment of lung tissue in which goblet cells are found?
    terminal broncioles (remember ciliated cells sweep away mucous produced by goblet cells and therefore run deeper)
    What is the primary function of a basophil?
    Mediates allergic reactions
    What is the primary function of a leukocyte?
    Defense against infections
    What is the primary function of a mast cell?
    Mediates allergic reactions
    What is the primary function of a plasma cell?
    production of large amounts of a specific antibody to a particular antigen
    What is the primary source of energy for erythrocytes?
    glucose (90% anaerobically degraded to lactate, 10% by HMP shunt)
    What is the process of degranulation in mast cells?
    release of histamine, heparin, and eosinophil chemotactic factors
    What is the range of concentration for leukocytes in the blood?
    4,000 - 10,000 cells per microliter
    What is the response of an eosiniphil to antigen antibody complexes?
    high degree of phagocytosis
    What is the response of microglia to tissue dammage?
    transformation into large ameboid phagocytic cells
    What is the response to microglia infected with HIV?
    fusion to form multinucleated giant cells in CNS
    What is the survival time for an erythrocyte?
    120 days
    What pathognomonic change is seen in neutrophils of a person who is folate/vitamin B12 deficient?
    hypersegmented polys
    What percentage of leukocytes exist as eosinophils in the blood?
    1 - 6%
    What percentage of leukocytes exist as neutrophils in the blood?
    40 - 75%
    What percentage of leukocytes in blood are monocytes?
    2 - 10%
    What process occurs when type I pneumocytes are damaged?
    Type II pneumocytes develop into type I
    What substance in eosinophilic granules is primarily responsible for defense against helminths and protozoan infections?
    major basic protein
    Where is the site of maturation of T lymphocytes?
    Thymus
    Which cell type constituitively secretes pulmonary surfactant?
    Type II pneumocyte
    Which cell type lines the alveoli?
    Type I pneumocyte
    Which leukemia is the result of plasma cell neoplasm?
    Multiple myeloma
    Which type of hypersensitivity reaction is a mast cell involved in?
    Type I hypersensitivity reaction
    Which type of immunity do B cells exhibit?
    humoral immunity
    After arising from the floor of the primitive pharynx, where does the thryoid diverticulum go?
    It descends down into the neck
    After the first breath at birth, what causes closure of the ductus arteriosus?
    An increase in oxygen
    After the first breath at birth, what causes the closure of the foramen ovale?
    A decrease resistance in pulmonary vasculature causes increased left atrial pressure vs. right atrial pressure
    Although the diaphragm descends during development, it maintains innervation from ____?
    C3-C5
    An easy pneumonic to remember fetal erythropoiesis is?
    Young Liver Synthesizes Blood
    At what time in the course of development is the fetus most susceptible to teratogens?
    Weeks 3-8
    Deoxygenated blood from the SVC is expelled into the pulmonary artery and ____ ____ to the lower body of the fetus.
    ductus arteriosus
    Do the cardiovascular structures arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Do the chromaffin cells of the adrenal medulla arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the enterochromaffin cells arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the lungs arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Do the lymphatics arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Do the melanocytes arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the neural crest cells arise from mesoderm, ectoderm, or endoderm?
    Ectoderm
    Do the odontoblasts arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the parafollicular (C) cells of the thyroid arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the Schwann cells arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the urogenital structures arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does blood arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does bone arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does muscle arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the thyroid arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the adrenal cortex arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the ANS arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Does the celiac ganglion arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Does the dorsal root ganglion arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Does the dura connective tissue arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the gut tube epithelium arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the liver arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the pancreas arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the parathyroid arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the pia arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Does the serous linings of body cavities arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the spleen arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the thymus arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    From what does the ligamentum teres hepatis arise?
    Umbilical vein
    How does a bicornate uterus form?
    Results from incomplete fusion of the paramesonephric ducts
    How does a cleft lip form?
    Failure of fusion of the maxillary and medial nasal processes
    How does a cleft palate form?
    Failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine process
    How does a horseshoe kidney form?
    Inferior poles of both kidneys fuse, as they ascend from the pelvis during development they get trapped under the inferior mesenteric artery, and remain low in the abdomen
    How is meckel's diverticulum different than an omphalomesenteric cyst?
    Omphalomesenteric cyst is a cystic dilatation of the vitelline duct
    How long does full development of spermatogenesis take?
    2 months
    How many arteries and veins does the umbilical cord contain?
    - 2 umbilical arteries (carries deoxygenated blood away from fetus) - 1 umbilical vein (oxygenated blood to fetus)
    Is a primary spermatocyte 2N or 4N?
    4N
    Is a primary spermatocyte haploid or diploid?
    Diploid, 4N
    Is a secondary spermatocyte haploid or diploid?
    Haploid, 2N
    Is a secondary spermatocyte N or 2N?
    2N
    Is a speratogonium haploid or diploid?
    Diploid, 2N
    Is a spermatid haploid or diploid?
    Haploid, N
    Meiosis I is arrested in which phase until ovulation?
    Prophase
    Meiosis II is arrested in which phase until fertilization?
    Metaphase (an egg MET a sperm)
    Most oxygenated blood reaching the heart via IVC is diverted through the ____ ____ and pumped out the aorta to the head.
    foramen ovale
    The right common cardinal vein and right anterior cardinal vein give rise to what adult heart structure?
    Superior vena cava
    The stapedius muscle of the ear is formed by which branchial arch?
    2nd
    This type of bone formation consists of ossification of cartilaginous molds and forms long bones at primary and secondary centers.
    Endochondral
    True or False, blood in the umbilical vein is 100% saturated with oxygen?
    False, it is 80% saturated
    True or False, there are two types of spermatogonia?
    True, type A & type B
    What are the 1st branchial arch derivatives innervated by?
    CN V2 and V3
    What are the 2nd branchial arch derivatives innervated by?
    CN VII
    What are the 3rd branchial arch derivatives innervated by?
    CN IX
    What are the 4th and 6th branchial arch derivatives innervated by?
    CN X
    What are the cartilage derivatives (5) of the 4th and 6th branchial arches?
    - Thyroid - Cricoid - Arytenoids - Corniculate - Cuneiform
    What are the five 2's associated with meckel's diverticulum?
    - 2 inches long - 2 feet from the ileocecal valve - 2% of the population - Commonly presents in the first 2 years of life - May have 2 types of epithelia
    What are the rule of 2's for the 2nd week of development?
    - 2 germ layers: epiblast & hypoblast - 2 cavities: amniotic cavity & yolk sac - 2 components to the placenta: cytotrophoblast & syncytiotrophoblast
    What are the rule of 3's for the 3rd week of development?
    3 germ layers (gastrula): ectoderm, mesoderm, endoderm
    What can a persistent cervical sinus lead to?
    A branchial cyst in the neck
    What can be found in the cortex of the thymus?
    It is dense with immature T cells
    What can be found in the medulla of the thymus?
    It is pale with mature T cells, epithelial reticular cells, and Hassall's corpuscles
    What connects the thyroid diverticulum to the tongue?
    The thyroglossal duct
    What devlopmental contributions does the 5th branchial arch make?
    None
    What do the 2nd - 4th branchial clefts form, which are obliterated by proliferation of the 2nd arch mesenchyme?
    Temporary cervical sinuses
    What does aberrant development of the 3rd and 4th pouches cause?
    DiGeorge's syndrome
    What does the 1st aortic arch give rise to?
    Part of the maxillary artery
    What does the 2nd pharyngeal pouch develop into?
    Epithelial lining of the palantine tonsils
    What does the 3rd aortic arch give rise to?
    Common carotid artery and proximal part of the internal carotid artery
    What does the 4th pharyngeal pouch develop into?
    Superior parathyroids
    What does the 5th aortic arch give rise to?
    Nothing
    What does the 5th pharyngeal pouch develop into?
    C cells of the thyroid
    What does the 6th aortic arch give rise to?
    The proximal part of the pulmonary arteries and (on left only) ductus arteriosus
    What does the ductus arteriosus give rise to?
    Ligamentum arteriosum
    What does the ductus venosus shunt blood away from?
    Liver
    What does the first branchial cleft develop into?
    The external auditory meatus
    What does the foramen ovale give rise to?
    Fossa ovalis
    What does the left 4th aortic arch give rise to?
    Aortic arch
    What does the ligamentum venosum come from?
    Ductus venosus
    What does the notochord give rise to?
    Nucleus Pulposus
    What does the primitive atria give rise to?
    Trabeculated left and right atrium
    What does the primitive ventricle give rise to?
    Trabeculated parts of the left and right ventricle
    What does the right 4th aortic arch give rise to?
    Proximal part of the right subclavian artery
    What does the right horn of the sinus venosus give rise to?
    Smooth part of the right atrium
    What does the spleen arise from?
    Dorsal mesentery, but is supplied by the artery of the foregut
    What does the thymus arise from?
    Epithelium of the 3rd branchial pouch
    What does the thyroid diverticulum arise from?
    The floor of the primitive pharynx
    What does the truncus arteriosus give rise to?
    The ascending aorta and pulmonary trunk
    What does the umbilical arteries give rise to?
    Medial umbilical ligaments
    What ear muscle does the 1st branchial arch form?
    Tensor tympani
    What effect does 13-cis-retinoic acid have on the fetus?
    Extremely high risk for birth defects
    What effect does ACE inhibitors have on the fetus?
    Renal Damage
    What effect does iodide have on the fetus?
    Congenital goiter or hypothyroidism
    What effect does warfarin and x-rays have on the fetus?
    Multiple anomalies
    What effects does cocaine have on the fetus?
    Abnormal fetal development and fetal addiction
    What embryonic structure are the smooth parts of the left and right ventricle derived from?
    Bulbus cordis
    What embryonic structure does the coronary sinus come from?
    Left horn of the sinus venosus
    What embryonic structure does the median umbilical ligament come from?
    Allantois (urachus)
    What fetal landmark has developed within week 2 of fertilization?
    Bilaminar disk
    What fetal landmark has occurred within week 1 of fertilization?
    Implantation
    What fetal landmark has occurred within week 3 of fertilization?
    Gastrulation
    What fetal landmarks (2) have developed within week 3 of fertilization?
    Primitive streak and neural plate begin to form
    What five things arise from neuroectoderm?
    - Neurohypophysis - CNS neurons - Oligodendrocytes - Astrocytes - Pineal gland
    What four structures make up the diaphragm?
    - Septum transversum - pleuroperitoneal folds - body wall - dorsal mesentery of esophagus
    What four things arise from surface ectoderm?
    - Adenohypophysis - Lens of eye - Epithelial linings - Epidermis
    What four things does Meckel's cartilage (from the 1st arch) develop into?
    - Mandible - Malleus - Incus - Sphenomandibular ligament
    What four things does Reichert's cartilage (from the 2nd arch) develop into?
    - Stapes - Styloid process - Lesser horn of hyoid - Stylohyoid ligament
    What four things does the dorsal pancreatic bud become?
    Body, tail, isthmus, and accessory pancreatic duct
    What four things does the mesonephric (wolffian) duct develop into?
    - Seminal vesicles - Epididymis - Ejaculatory duct - Ductus deferens
    What induces the ectoderm to form the neuroectoderm (neural plate)?
    Notochord
    What is a hiatal hernia?
    Abdominal contents herniate into the thorax due to incomplete development of the diaphragm
    What is a hypospadias?
    Abnormal opening of penile urethra on inferior side of penis due to failure of urethral folds to close
    What is a single umbilical artery associated with?
    Congenital and chromosomal anomalies
    What is a urachal cyst or sinus a remnant of?
    The allantois
    What is an abnormal opening of penile urethra on superior side of penis due to faulty positioning of the genital tubercle?
    Epispadias
    What is associated with an epispadias?
    Exstrophy of the bladder
    What is Meckel's diverticulum?
    Persistence of the vitelline duct or yolk sac
    What is oligohydramnios associated with?
    Bilateral renal agenesis or posterior urethral valves (in males)
    What is oligohydramnios?
    < 0.5 L of amniotic fluid
    What is polyhydramnios associated with?
    Esophageal/duodenal atresia, anencephaly
    What is polyhydramnios?
    > 1.5-2 L of amniotic fluid
    What is Potter's syndrome?
    Bilateral renal agenesis, that results in ologohydramnios causing limb and facial deformities and pulmonary hypoplasia (Babies with Potter's can’t pee in utero)
    What is the acrosome of sperm derived from?
    Golgi apparatus
    What is the female homologue to the corpus spongiosum in the male?
    Vestibular bulbs
    What is the female homologue to the prostate gland in the male?
    Urethral and paraurethral glands (of Skene)
    What is the female homologue to the scrotum in the male?
    Labia majora
    What is the female homologue to the ventral shaft of the penis in the male?
    Labia minora
    What is the flagellum (tail) derived from?
    One of the centrioles
    What is the food supply of sperm?
    Fructose
    What is the male homologue to the glans clitoris in the female?
    Glans penis
    What is the male homologue to the greater vestibular glands (of Bartholin) in the female?
    Bulbourethral glands (of Cowper)
    What is the most common congenital anomaly of the GI tract?
    Meckel's diverticulum
    What is the most common ectopic thyroid tissue site?
    The tongue
    What is the normal remnant of the thyroglossal duct?
    Foramen cecum
    What is the postnatal derivative of the notochord?
    The nucleus pulposus of the intervertebral disc
    What is the site of T-cell maturation?
    Thymus
    What part of the gut is the pancreas derived?
    Foregut
    What suppresses the development of the paramesonephric ducts in males?
    Mullerian inhibiting substance (secreted by the testes)
    What teratogenic agent causes limb defects ('flipper' limbs)?
    Thalidomide
    What three structures does the 3rd pharyngeal pouch develop into?
    - Thymus - Left inferior parathyroid - Right inferior parathyroid
    What three things does the 1st pharyngeal pouch develop into?
    - Middle ear cavity - Eustachian tube - Mastoid air cells
    What three things does the paramesonephric (mullerian) duct develop into?
    - Fallopian tube - Uterus - Part of the vagina
    What three things does the ventral pancreatic bud become?
    - Pancreatic head - uncinate process - main pancreatic duct
    What two things occur during week 4 of fetal development?
    Heart begins to beat, upper and lower limb buds begin to form
    What type of bone formation is spontaneous without preexisting cartilage?
    Intramembranous
    What type of twins would have 1 placenta, 2 amniotic sacs, and 1 chorion?
    Monozygotic twins
    What type of twins would have 2 amniotic sacs and 2 placentas?
    Monozygotic or dizygotic twins
    What will DiGeorge's syndrome lead to?
    T cell deficiency & hypocalcemia
    When do primary oocytes begin meiosis I?
    During fetal life
    When do primary oocytes complete meiosis I?
    Just prior to ovulation
    When does fetal erythropoiesis occur in the bone marrow?
    Week 28 and onward
    When does fetal erythropoiesis occur in the liver?
    Weeks 6-30
    When does fetal erythropoiesis occur in the spleen?
    Weeks 9-28
    When does organogenesis occur in the fetus?
    Weeks 3-8
    Where does positive and negative selection occur in the thymus?
    At the corticomedullary junction
    Where does spermatogenesis take place?
    Seminferous tubules
    Where is the first place fetal erythropoiesis occurs and when does this take place?
    Yolk sac (3-8 wk)
    Which aortic arch does the stapedial artery and the hyoid artery come from?
    2nd aortic arch
    Which branchial arch are the greater horn of hyoid and the stylopharyngeus muscle derived from?
    3rd branchial arch
    Which branchial arch does Meckel's cartilage develop from?
    1st arch
    Which branchial arch forms the anterior 2/3 of the tongue?
    1st arch
    Which branchial arch forms the incus and malleus of the ear?
    1st arch
    Which ear bone(s) does the 2nd branchial arch form?
    Stapes
    Which embryonic tissue are branchial clefts derived from?
    Ectoderm
    Which embryonic tissue are branchial pouches derived from?
    Endoderm
    Which is more common a hypospadias or epispadias?
    Hypospadias
    Which muscles (3) are derivatives of the 4th branchial arch?
    - Most pharyngeal constrictors - Cricothyroid - Levator veli palatini
    Which muscles (4) are derivatives of the 2nd branchial arch?
    - Muscles of facial expression - Stapedius - Stylohyoid - Posterior belly of digastric
    Which muscles (8) are derivatives of the 1st branchial arch?
    - Temporalis - Masseter - Lateral pterygoid - Medial pterygoid - Mylohyoid - Anterior belly of digastric - Tensor tympani - Tensor veli palatini
    Which muscles are derivatives of the 6th branchial arch?
    All intrinsic muscles of the larynx, except the cricothyroid
    Which pharyngeal arch does Reichert's cartilage develop from?
    2nd arch
    Which teratogenic agent causes vaginal clear cell adenocarcinoma?
    DES
    Which two branchial arches form the posterior 1/3 of the tongue?
    3rd and 4th arches
    Which two embryonic tissues are branchial arches derived from?
    Mesoderm and neural crests
    Which week of fetal development have the genitalia taken on male/female characteristics?
    Week 10
    A common football injury caused by clipping from the lateral side will damage what structures (3 answers)?
    --Medial collateral ligament --Medial meniscus --Anterior cruciate ligament
    A lumbar puncture is performed at what landmark/
    Iliac crest
    A positive anterior drawer sign indicates damage to what structure?
    Anterior cruciate ligament(ACL)
    A pudendal nerve block is performed at what landmark?
    Ischial spine
    Abnormal passive abduction of the knee indicates damage to what structure?
    Medial collateral ligament(MCL)
    Anterior' in ACL refers to what attachment?
    Tibial
    At what level is a lumbar puncture performed?
    Between L3-L4 or L4-L5
    Common peroneal nerve damage manifests what deficit?
    Loss of dorsiflexion(Foot Drop)
    Common peroneal, Tibial, Femoral, and Obturator nerves arise from what spinal cord segments (4 answers)?
    --'L4-S2 (common peroneal) --L4-S3 (tibial) --L2-L4 (femoral) and (obturator)
    Coronary artery occlusion usually occurs where?
    Left anterior descending artery (LAD)
    Do the coronary arteries fill during systole or diastole?
    Diastole
    Erection and sensation of the penis is in what dermatomes?
    S2-S4
    Femoral nerve damage manifests what deficit?
    Loss of knee jerk
    How does the course of the left recurrent laryngeal nerve differ from that of the right?
    The left wraps around the arch of the aorta and the ligamentum arteriosum while the right wraps around the subclavian artery.
    How is the appendix located?
    2/3 of the way from the umbilicus to the anterior superior iliac spine
    How many lobes are in the right and left lungs and what are their names?
    --Right has three (superior,middle,inferior) --Left has two (superior and inferior) and the lingula
    Name five portal-systemic anastomoses.
    1.Left gastric-azygous vv. 2.Superior-Middle/Inferior rectal vv. 3.Paraumbilical-inferior epigastric 4.Retroperitoneal-renal vv. 5.Retroperitoneal-paravertebral vv.
    Name the 4 ligaments of the uterus.
    --Suspensory ligament of ovaries --Transverse cervical (cardinal) ligament --Round ligament of uterus --Broad ligament
    Name the hypothenar muscles.
    --Opponens digiti minimi --Abductor digiti minimi --Flexor digiti minimi
    Name the retroperitoneal structures (9).
    1.Duodenum(2nd-4th parts) 2.Descending colon 3.Ascending colon 4.Kidney & ureters 5.Pancreas 6.Aorta 7.Inferior vena cava 8.Adrenal glands 9.Rectum
    Name the rotator cuff muscles.
    --Supraspinatus --Infraspinatus --teres minor --Subscapularis
    Name the thenar muscles
    --Opponens pollicis --Abductor pollicis brevis --Flexor pollicis brevis
    Obturator nerve damage manifests what deficit?
    Loss of hip adduction
    Pain from the diaphragm is usually referred where?
    Shoulder
    Subarachnoid space extends to what spinal level?
    S2
    The area of the body that contains the appendix is known as what?
    McBurney's point
    The femoral triangle contains what structures from lateral to medial?
    --Femoral nerve --Femoral artery --Femoral vein --Femoral Canal (lymphatics)
    The inguinal ligament exists in what dermatome?
    L1
    The kneecaps exist in what dermatome?
    L4
    The male sexual response of ejaculation is mediated by what part of the nervous system?
    Visceral and somatic nerves
    The male sexual response of emission is mediated by what part of the nervous system?
    Sympathetic nervous system
    The male sexual response of erection is mediated by what part of the nervous system?
    Parasympathetic nervous system
    The nipple exists in what dermatome?
    T4
    The recurrent laryngeal nerve arises from what cranial nerve and supplies what muscles?
    1.CN X 2.All intrinsic muscles of the larynx except the cricothyroid muscle.
    The SA and AV nodes are usually supplied by what artery?
    Right Coronary Artery (RCA)
    The spinal cord ends at what level in adults?
    L1-L2
    The umbilicus exists in what dermatome?
    T10
    The xiphoid process exists in what dermatome?
    T7
    Tibial nerve damage manifests what deficit?
    Loss of plantar flexion
    What are hernias?
    Protrusions of peritoneum through an opening, usually sites of weakness.
    What are JG cells?
    Modified smooth muscle of afferent arteriole in the juxtaglomerular apparatus of the kidney
    What are the boundaries of the inguinal (Hesselbach) triangle?
    --Inferior epigastric artery --Lateral border of the rectus abdominus --Inguinal ligament
    What are the layers encountered from the outsided down to the brain?
    --Skin --Connective tissue --Aponeurosis --Loose connective tissue --Pericranium --Dura mater --Subdural space --Arachnoid --Subarachnoid space --Pia mater --Brain
    What are the manifestations of portal hypertension?
    --Esophageal varices --Hemorrhoids --Caput medusae
    What condition is usually associated with portal hypertension?
    Alcoholic cirrhosis
    What defect may predispose an infant for a diaphragmatic hernia?
    Defective development of the pleuroperitoneal membrane
    What gut regions and structures does the celiac artery supply?
    1.Foregut 2.--Stomach to duodenum --liver --gallbladder --pancreas
    What gut regions and structures does the IMA supply?
    1.Hindgut 2.--Distal 1/3 of transverse colon to upper portion of rectum
    What gut regions and structures does the SMA supply?
    1.Midgut 2.--Duodenum to proximal 2/3 of transverse colon
    What is a diaphragmatic hernia?
    Abdominal retroperitoneal structures enter the thorax
    What is a femoral hernia?
    entrance of abdominal contents through the femoral canal.
    What is a hiatal hernia?
    Stomach contents herniate upward through the esophageal hiatus of the diaphragm
    What is the arterial blood supply difference above and below the pectinate line?
    --Superior rectal a. (Above) --Inferior rectal a. (Below)
    What is the course of a direct inguinal hernia?
    Through weak abdominal wall, into the inguinal triangle, medial to the inferior epigastric artery, through the external inguinal ring only.
    What is the course of an indirect inguinal hernia?
    Through the internal (deep) inguinal ring and the external (superficial) inguinal ring lateral to the inferior epigastric artery and into the scrotum
    What is the course of the ureters?
    Pass under uterine artery and under the ductus deferens
    What is the function of Myenteric plexus? Submucosal plexus?
    1.Coordinates motility along entire gut wall 2.Regulates local secretions, blood flow, and absorption
    What is the function of the JG cells?
    --secrete renin and erythropoietin
    What is the innervation difference above and below the pectinate line?
    --Visceral innervation (Above) --Somatic innervation (Below)
    What is the innervation of the diaphram?
    Phrenic nerve (C3,4,5)
    What is the macula densa?
    Sodium sensor in part of the distal convoluted distal tubule in the juxtaglomerular apparatus of the kidney
    What is the Myenteric plexus also known as? Submucosal plexus?
    1. Auerbach's plexus 2. Meissner's plexus
    What is the pectinate line of the rectum?
    Where the hindgut meets ectoderm in the rectum
    What is the relationship of the two pulmonary arteries in the lung hilus?
    Right anterior Left superior
    What is the usual Pathology above the pectinate line of the rectum?
    Internal hemorrhoids (not painful) Adenocarcinoma
    What is the usual Pathology below the pectinate line of the rectum?
    External hemorrhoids (painful) Squamous cell carcinoma
    What is the venous drainage difference above and below the pectinate line?
    --Superior rectal v. to IMV to portal system (Above) --Inferior rectal v. to internal pudendal v. to internal iliac v. to IVC (Below)
    What layers of the gut wall contribute to motility (4)?
    --Muscularis mucosae --Inner circular muscle layer --Myenteric plexus --Outer longitudinal muscle layer
    What layers of the gut wall contribute to support (3)?
    --Serosa --Lamina propria --Submucosa
    What muscle opens the jaw?
    Lateral pterygoid
    What nerve innervates most of the 'glossus' muscles and which is the exception?
    1.Vagus Nerve (CNX) 2.Palatoglossus (innervated by hypoglossal n.)
    What nerve innervates most of the 'palat' muscles and which is the exception?
    1.Trigeminal Nerve, Mandibular branch 2.Tensor veli palatini (innervated by vagus n)
    What nerve innervates the muscles that close and open the jaw?
    Trigeminal Nerve (V3)
    What neurons do the GI enteric plexus contain?
    Cell bodies of parasympathetic terminal effector neurons
    What part of the heart does the LAD supply?
    anterior interventricular septum
    What spinal cord levels are vertebral disk herniation most likely to occur?
    Between L5 and S1
    What structure is in the femoral triangle but not in the femoral sheath?
    --Femoral nerve
    What structures are in the carotid sheath?
    1.Internal Jugular Vein (lateral) --2.Common Carotid Artery (medial) --3.Vagus Nerve (posterior)
    What structures are pierced when doing an LP?
    1.Skin/superficial fascia 2.Ligaments(supraspinatous,interspinous,ligamentum flavum) 3.Epidural space 4.Dura mater 5.Subdural space 6.Arachnoid 7.Subarachnoid space--CSF
    What structures do the broad ligament contain (4)?
    --Round ligaments of the uterus --Ovaries --Uterine tubules --Uterine vessels
    What structures make up the bronchopulmonary segment?
    --Tertiary bronchus --Bronchial artery --Pulmonary artery
    What structures perforate the diaphragm at what vertebral levels?
    --IVC at T8 --esophagus, vagal trunks at T10 --aorta, thoracic duct, axygous vein at T12
    What three muscles close the jaw?
    --Masseter --Temporalis --Medial pterygoid
    What usually provides the blood supply for the inferior left ventricle?
    Posterior descending artery (PD) of the RCA
    When do the JG cells secrete renin?
    in response to decreased renal BP, decreased sodium delivery to distal tubule, and increased sympathetic tone
    When is damage to the recurrent laryngeal nerve most likely to happen and what are its results(2 answers)?
    1.Thyroid surgery 2.Hoarseness
    Where is the CSF found?
    Subarachnoid space
    Where is the Myenteric plexus located? Submucosal plexus?
    1.Between the inner and outer layers of smooth muscle in GI tract wall 2.Between mucosa and inner layer of smooth muscle in GI tract wall.
    Which ligament contains the ovarian vessels?
    Suspensory ligament of the ovary
    Which ligament contains the uterine vessels?
    Transverse cervical (cardinal) ligament
    Which lung is the usual site of an inhaled foreign body?
    Right lung
    Which lung provides a space for the heart to occupy?
    Left lung (in the place of the middle lobe)
    Which meningeal layer is not pierced during an LP?
    Pia mater
    Who usually gets a direct inguinal hernia? indirect hernia (and why)?
    1.Older men 2.Infants (failure of processus vaginalis to close)
    What are the 3 layers of peripheral nerves? (inner to outer)
    1) Endoneurium 2) Perineurium 3) Epineurium
    Where is type I collagen found?(7)
    1. bone 2. tendon 3. skin 4. dentin 5. fascia 6. cornea 7. late wound repair
    Where is type II collagen found? (3)
    1. cartilage (including hyaline) 2. vitreous body 3. nucleus pulposus.
    What are the functions of the major structures of the inner ear bony labyrinth?
    1. Cochlea- hearing 2. vestibule- linear acceleration 3. semicircular canals- angular acceleration.
    What are the major structures of the inner ear bony labyrinth?
    1. Cochlea 2. vestibule 3. semicircular canals
    What are the major structures of the inner ear membranous labyrinth?
    1. Cochlear duct 2. utricle. 3. saccule 4. semicircular canals.
    Name two proteins involved in the structure of macula adherens.
    1. Desmoplakin 2.Keratin
    Name 6 functions of Golgi apparatus.
    1. Distribution center of proteins and lipids from ER to plasma membrane, lysosomes, secretory vessicles 2. Modifies N-oligosaccharides on asparagine 3. Adds O-oligosaccharides to Ser and Thr residues 4. Proteoglycan assembly from proteoglycan core proteins 5. Sulfation of sugars in proteoglycans and of selected tyrosine on proteins
    Name 6 functions of Golgi apparatus (continued answer)
    6. Addition of mannose-6-phosphate to specific lysosomal proteins, which targets the protein to the lysosome
    Name two proteins involved in the structure of zona adherens?
    1. E-cadherins 2. actin filaments
    Which cells are rich in smooth ER?
    1. liver hepatocytes, 2. steroid hormone-producing cells of adrenal cortex.
    Describe the immune response stimulated via Peyer's patches.
    1. M cells take up antigen. 2. stimulated B cells leave Peyer's patch and travel through lymph and blood to lamina propria of intestine. 3. In lamina propria B cells differentiate into IgA-secreting plasma cells. 4. IgA receives protective secretory component. 5. IgA is transported across epithelium to gut to deal with intraluminal Ag.
    Which cells are rich in rough ER?
    1. Mucus-secreting goblet cells of small intestine, 2. antibody-secreting plasma cells.
    What are the functions of the lymph node?
    1. Nonspecific filtration by macrophages. 2. storage/proliferation of B and T cells 3. Ab production.
    Where is type III collagen found? (5)
    1. skin 2.blood vessels 3.uterus 4.fetal tissue 5.granulation tissue
    Name five types of epithelial cell junctions.
    1. zona occludens 2.zona adherens 3.macula adherens 4.gap junction 5.hemidesmosome
    Describe microtubule arrangement of cilia.
    9+2 arrangement of microtubules.
    Describe the outer structure of a Peyer's patch.
    A Peyer's patch is 'covered' by single layer of cuboidal enterocytes, interspersed with specialized M cells (no goblet cells).
    What is a lymph node? Include information on structural components.
    A secondary lymphoid organ. Has many afferents, one or more efferents. With trabeculae. Major histological regions = Follicle, Medulla, Paracortex
    What is the primary regulatory control of zona fasciculata secretion?
    ACTH, hypothalamic CRH
    What is the primary regulatory control of zona reticularis secretion?
    ACTH, hypothalamic CRH
    What are/is the primary secretory product of the zona glomerulosa?
    aldosterone
    What do Brunner's glands secrete?
    alkaline mucus
    What is the function of liver sinusoids?
    Allow macromolecules of plasma full access to surface of liver cells through space of Disse.
    What is the function of a gap junction?
    Allows adjacent cells to communicate for electric and metabolic functions.
    What is produced by alpha cells of the Islets of Langerhans?
    alpha cells produce glucagon
    What three cell types are found in Islets of Langerhans?
    alpha, beta, and gamma cells
    What type of cells are Nissl bodies found? In what parts of the cell?
    Are found in neurons. Are not found in axon or axon hillock.
    IN what area of the spleen are B cells found?
    B cells are found within the white pulp of the spleen.
    What is type IV collagen found? (1)
    basement membrane or basal lamina
    What is produced by beta cells of the Islets of Langerhans?
    beta cells produce insulin
    What is the only GI submucosal gland?
    Brunner's glands
    Describe the histological layers of the adrenal glands (outside to in)
    Capsule, Zona glomerulosa, Zona fasciculata, Zona reticularis, Medulla.
    What are/is the primary secretory product of the adrenal medulla?
    Catecholamines (Epi, NE)
    Memo to you.
    Check out the picture in the book.
    Memo to you.
    Check out the picture in the book. p. 105
    What do the medullary cords consist of?
    Closely packed lymphocytes and plasma cells.
    What is the most common type of collagen?
    Collagen Type I - 90%
    What is the most abundant protein in the human body?
    Collagen.
    Define Islets of Langerhans.
    Collections of endocrine cells.
    What is the function of hemidesmosomes?
    Connect cells to underlying extracellular matrix.
    What are/is the primary secretory product of the zona fasciculata?
    cortisol, sex hormones.
    What is another name for macula adherens?
    Desmosome
    What is the effect of duodenal ulcers on Brunner's gland histology?
    Duodenal ulcers cause hypertrophy of Brunner's glands.
    How does dynein function in cilia function?
    Dynein causes the bending of cilium by differential sliding of doublets.
    What kind of protein is dynein?
    Dynein is an ATPase.
    Describe the role of dynein in cilia structure.
    Dynein links peripheral 9 doublets of microtubules.
    What makes endolymph?
    Endolymph is made by the stria vascularis.
    What is Endoneurium?
    Endoneurium invests single nerve fiber of the peripheral nerve.
    What is Epineurium?
    Epineurium (dense connective tissue) surrounds entire never (fascicles and blood vessels)
    What is type X collagen found? (1)
    epiphyseal plate
    Plasma is filtered on the basis of what properties?
    Filtration of plasma occurs according to net charge and size.
    How is the glomerular basement membrane formed?
    From the fusion of endothelial and podocyte basement membranes.
    What is produced by gamma cells of the Islets of Langerhans?
    gamma cells produce somatostatin.
    What is the mnemonic to remember layers and products of adrenal cortex?
    GFR (Glomerulosa, Fasciculata, Reticularis) corresponds to Salt (Na+), Sugar (glucocorticoids) and Sex (androgens) The deeper you go, the sweeter it gets.
    What is the function of hair cells?
    Hair cells are the sensory elements in both the cochlear and vestibular apparatus.
    Name a protein involved in the structure of hemidesmosomes.
    Integrin.
    What is another name for zona adherens?
    Intermediate junction.
    Describe the histological structure of sinusoids of the liver.
    Irregular 'capillaries' with round pores 100-200 nm in diameter and no basement membrane.
    What is the function of smooth ER?
    Is the site of steroid synthesis and detoxification of drugs and poisons
    What is the function of rough ER?
    Is the site of synthesis of secretory (exported proteins and of N-linked oligosaccharide addition to many proteins.
    What part of pancreas are the Islets of Langerhans concentrated?
    Islets of Langerhans are most numerous in the tail of pancreas.
    What structural defect causes Kartagener's syndrome? What is the consequence?
    Kartagener's syndrome is due to dynein arm defect. Results in immotile cilia.
    Define Pacinian corpuscles.
    Large, encapsulated sensory receptors found in deeper layers of skin at ligaments, joint capsules, serous membranes, mesenteries.
    Where are Brunner's glands located?
    Located in submucosa of duodenum
    Describe the histologic structure of sinusoids of the spleen.
    Long, vascular channels in red pulp. With fenestrated 'barrel hoop' basement membrane.
    What is the histologic change in lymph nodes during an extreme cellular immune response?
    Lymph node paracortex becomes enlarged during extreme cellular immune response.
    What is the histologic presentation of DiGeorge's syndrome?
    Lymph node paracortex is not well developed in patients with DiGeorge's syndrome.
    What kind of cells are found nearby the sinusoids of the spleen?
    Macrophages
    What are the major structures of the lymph node medulla?
    Medulla consists of medullary cords and medullary sinuses.
    What do medullary sinuses communicate with?
    Medullary sinuses communicate with efferent lymphatics.
    What do medullary sinuses consist of?
    Medullary sinuses contain reticular cells and macrophages.
    What is the function of Meissner's corpuscles?
    Meissner's corpuscles are involved in light discriminatory touch of glabrous skin.
    What is the histologic change in nephrotic syndrome? What is the consequence of this change?
    Negative charge is lost. Plasma protein is lost in urine
    What is the glomerular basement membrane coated with? (provides negative charge to filter).
    Negatively charged heparan sulfate.
    What is the most common tumor the adrenal medulla in children?
    Neuroblastoma
    What is the function of Pacinian corpuscles?
    Pacinian corpuscles are involved in pressure, coarse touch, vibration, and tension.
    What do the Islets of Langerhans arise from?
    Pancreatic buds.
    What specialized vascular structure is found in the lymph node paracortex? What is the function of this structure?
    Paracortex contains high endothelial venules (HEV). T and B cells enter from the blood through the HEV.
    What cells are found in the lymph node paracortex?
    Paracortex houses T cells.
    What is Perineurium?
    Perineurium (permeability barrier) surrounds a fascicle of nerve fibers.
    What is the most common tumor the adrenal medulla in adults?
    Pheochromocytoma
    Compare the consequences of pheochromocytoma vs. neuroblastoma on blood pressure
    Pheochromocytoma causes episodic hypertension Neuroblastoma does NOT cause episodic hypertension
    What is the space of Disse?
    Pores in liver sinusoids allowing plasma macromolecules access to liver cell surfaces.
    What is the primary regulatory control of adrenal medulla secretion?
    Preganglionic sympathetic fibers
    What is the function of zona occludens?
    Prevents diffusion across intracellular space.
    Describe the appearance and status of primary vs. secondary follicles.
    Primary follicles are dense and dormant. Secondary follicles have pale central germinal centers and are active.
    Describe the location of the lymph node paracortex.
    Region of cortex between follicles and medulla.
    What is the primary regulatory control of zona glomerulosa secretion?
    Renin-angiotensin
    What is the glomerular basement membrane responsible for?
    Responsible for the actual filtration of plasma.
    What is another name for type III collagen?
    reticulin
    What are Nissl bodies?
    rough ER
    Where in the inner ear are the ampullae found? What is the function of this structure?
    Semicircular canals contain ampullae Functions in detecting angular acceleration.
    What are/is the primary secretory product of the zona reticularis?
    sex hormones (e.g. androgens)
    What is the function of lymph node follicles?
    Site of B-cell localization and proliferation.
    Define macula adherens.
    Small, discrete sites of attachment of epithelial cells.
    Define Meissner's corpuscles.
    Small, encapsulated sensory receptors found in dermis of palm, soles and digits of skin.
    What is an M cell? What is it's function.
    Specialized cell interspersed between the cuboidal enterocytes covering a Peyer's patch. M cells take up antigens.
    Name the layers of epidermis from surface to base.
    stratum Corneum, stratum Lucidum, stratum Granulosum, stratum Spinosum, stratum Basalis.
    What is the location of zona adherens?
    Surrounds the perimeter just below zona occludens.
    What is the function of Nissl bodies?
    Synthesize enzymes (e.g. ChAT) and peptide neurotransmitters.
    In what area of the spleen are T cells found?
    T cells are found in the PALS and the red pulp of the spleen.
    Which part of the cochlea picks up high frequency sound? Which picks up low frequency?
    The base of the cochlea picks up high frequency sound the apex picks up low frequency sound
    What is the bony labyrinth filled with? Describe its composition.
    The bony labyrinth is filled with perilymph. Perilymph is Na+ rich, similar to ECF
    What is the cause of I cell disease? What is the consequence?
    The failure of addition of mannose-6-phosphate to lysosome proteins. These enzymes are secreted outside the cell instead of being targeted to the lysosome.
    What is the membranous labyrinth filled with? Describe its composition.
    The membranous labyrinth is filled with endolymph. Endolymph is K+ rich, similar to ICF.
    What layer of the peripheral nerve must be rejoined in microsurgery for limb reattachment?
    The perineurium must be rejoined in microsurgery for limb reattachment.
    Where in the inner ear are the maculae found? What is the function of this structure?
    The utricle and saccule contain maculae Functions in detecting linear acceleration.
    How is the function of gap junctions accomplished?
    Through a connection with central channels.
    What is another name for zona occludens?
    Tight junction.
    What are mnemonics for remembering locations for type I, II and IV collagen?
    Type ONE: bONE Type TWO: carTWOlage Type FOUR: under the FLOOR (basement membrane)
    What is a Peyer's patch?
    Unencapsulated lymphoid tissue found in lamina propria and submucosa of small intestine.
    What type of infection may induce an extreme cellular immune response? What happens to the lymph node during such an immune response?
    Viral response is an example. The paracortex enlarges.
    According to the Homunculus man, place the following in order (from medial to lateral). hand, foot, tongue, face, trunk
    foot, trunk, hand, face, tongue
    (T or F) Can Bell's palsy occur idiopathically?
    true
    (T or F) Can fasiculations be present in a LMN lesion?
    True
    (T or F) Is the anterior nucleus of the thalamus part of the limbic system?
    True
    (T or F) Is the cingulate gyrus part of the limbic system?
    True
    (T or F) Is the Entrorhinal cortex part of the limbic system?
    True
    (T or F) Is the hippocampal formation part of the limbic system?
    True
    (T or F) Is the mammillary body part of the limbic system?
    True
    (T or F) Is the septal area part of the limbic system?
    True
    (T or F) Thoracic outlet syndrome results in atrophy of the interosseous muscles?
    True
    (T or F) Thoracic outlet syndrome results in atrophy of the thenar and hypothenar eminences?
    True
    (T or F) Thoracic outlet syndrome results in disappearance of the radial pulse upon moving the head to the opposite side?
    True
    (T or F) Thoracic outlet syndrome results in sensory deficits on the medial side of the forearm and hand?
    True
    A lesion of the globus pallidus causes what disease?
    Wilson's disease
    A lesion of the mammillary bodies (bilateraly) produces what?
    Wernicke-Korsakoff's encephalopathy (confabulations, anterograde amnesia)
    A lesion of the optic chiasm produces?
    bitemporal hemianopsia
    A lesion of the right dorsal optic radiation (parietal lesion) produces?
    left lower quadrantic anopsia (a temporal lesion)
    A lesion of the right Meyer's loop (temporal lobe) produces?
    left upper quadrantic anopsia (a temporal lesion)
    A lesion of the right optic nerve produces?
    right anopsia
    A lesion of the right optic tract produces?
    left homonymous hemianopsia
    A lesion of the right visual fibers just prior to the visual cortex produces?
    left hemianopsia with macular sparing
    A lesion of the Striatum can cause which 2 diseases?
    Huntington's and Wilson's disease
    A positive Babinski is an indicator for a (UMN or LMN) lesion?
    UMN lesion
    A rupture of the middle menigeal artery causes what type of hematoma? (epidural or subdural)
    epidural hematoma
    A rupture of the superior cerebral veins causes what type of hematoma? (epidural or subdural)
    subdural hematoma
    An aneurysm of the anterior communicating artery may cause what type of defects?
    visual defects
    An aneurysm of what artery may cause CN III palsy?
    posterior communicating artery
    Are D1 neurons in the basal ganglia inhibitory or excitatory?
    Excitatory
    Are D2 neurons in the basal ganglia inhibitory or excitatory?
    Inhibitory
    Beginning with anterior communicating artery describe the path around the circle of Willis.
    ant. comm. - ACA - ICA - post. comm. - PCA - PCA - post. comm. - ICA - ACA - ant. comm.
    Bell's Palsy is seen as a complication in what 5 things?
    AIDS, Lyme disease, Sarcoidosis, Tumors, Diabetes (ALexander Bell with STD)
    Brodmann's area 17 is?
    principal visual cortex
    Brodmann's area 22 is?
    Wernicke's area (associative auditory cortex)
    Brodmann's area 3,1,2 is?
    principal sensory area
    Brodmann's area 4 is?
    principal motor area
    Brodmann's area 41, 42 is?
    primary auditory cortex
    Brodmann's area 44, 45 is?
    Broca's area (motor speech)
    Brodmann's area 6 is?
    premotor area
    Brodmann's area 8 is?
    frontal eye movement and pupilary change area
    CN I has what function?
    smell
    CN I passes through what 'hole'?
    cribriform plate
    CN II has what function?
    sight
    CN II passes through what 'hole'?
    optic canal
    CN III has what 4 functions?
    eye movement, pupil constriction, accommodation, eyelid opening
    CN III inervates what 5 muscles.
    medial rectus, superior rectus, inferior rectus, inferior oblique, levator palpebrae superioris
    CN III passes through what 'hole'?
    superior orbital fissure
    CN IV has what function?
    eye movement
    CN IV inervates what muscle.
    superior oblique
    CN IV passes through what 'hole'?
    superior orbital fissure
    CN IX has what 4 functions?
    posterior 1/3 taste, swallowing, salivation (parotid), monitoring carotid body and sinus
    CN IX passes through what 'hole'?
    jugular foramen
    CN V has what 2 functions?
    mastication, facial sensation
    CN V1 passes through what 'hole'?
    superior orbital fissure
    CN V2 passes through what 'hole'?
    foramen rotundum
    CN V3 passes through what 'hole'?
    foramen ovale
    CN VI has what function?
    eye movement
    CN VI inervates what muscle.
    lateral rectus
    CN VI passes through what 'hole'?
    superior orbital fissure
    CN VII has what 4 functions?
    facial movement, anterior 2/3 taste, lacrimation, salivation(SL, SM glands)
    CN VII passes through what 'hole'?
    internal auditory meatus
    CN VIII has what 2 functions?
    hearing, balance
    CN VIII passes through what 'hole'?
    internal auditory meatus
    CN X has what 5 functions?
    taste, swallowing, palate elevation, talking, thoracoabdominal viscera
    CN X passes through what 'hole'?
    jugular foramen
    CN XI has what 2 functions?
    head turning, shoulder shrugging
    CN XI passes through what 'hole'?
    jugular foramen (descending) -- foramen magnum (ascending)
    CN XII has what function?
    tounge movements
    CN XII passes through what 'hole'?
    hypoglossal canal
    Complete the muscle spindle reflex arc by placing the following in order: alpha motor, Ia afferent, muscle stretch, extrafusal contraction, intrafusal stretch.
    muscle stretch - intrafusal stretch - Ia afferent - alpha motor - extrafusal contraction
    Extrafusal fibers are innervated by what motor neuron?
    alpha motor neuron
    From which 3 spinal roots does long thoracic nerve arises?
    C5, C6, C7
    General sensory/motor dysfunction and aphasia are caused by stroke of the? (ant. circle or post. circle)
    anterior circle
    Give 3 characteristics of a LMN lesion.
    atrophy, flaccid paralysis, absent deep tendon reflexes
    Give 3 charateristics of internuclear ophthalmoplegia (INO)
    medial rectus palsy on lateral gaze, nystagmus in abducted eye, normal convergence.
    Give 4 characteristics of an UMN lesion.
    spastic paralysis, increased deep tendon reflexes, + Babinski, minor to no atrophy
    Golgi tendon organs send their signal via what nerve?
    group Ib afferents
    Horner's Syndrome is present if the lesion in Brown-Sequard is above what level?
    T1
    How are the fibers of the corticospinal tract laminated? (legs/arms medial or lateral?)
    arms- medial, legs-lateral
    How are the fibers of the dorsal column laminated? (legs/arms medial or lateral?)
    legs-medial, arms-lateral
    How are the fibers of the spinothalmic tract laminated? (sacral/cervical medial or lateral?)
    cervical-medial, sacral-lateral
    How do glucose and amino acids cross the blood-brain barrier?
    carrier-mediated transport mechanism
    How does the hypothalamus control the adenohypophysis?
    via releasing factors (ie. TRH, CRF, GnRF, etc.)
    Huntington's patients typically have what type of movements?
    Chorea
    If the radial nerve is lesioned, what 2 reflexes are lost?
    triceps reflex and brachioradialis reflex
    If you break your humerus mid-shaft, which nerve would likely injure?
    radial nerve
    If you break your medial epicondyle of the humerus, which nerve would likely injure?
    ulnar nerve
    If you break your supracondyle of the humerus, which nerve would likely injure?
    median nerve
    If you break your surgical neck of the humerus, which nerve would likely injure?
    axillary nerve
    In a lesion of the radial nerve, what muscle is associated with wrist drop?
    extensor carpi radialis longus
    Intrafusal fibers are encapsulated and make up muscle spindles that send their signal via what nerve?
    group Ia afferents
    Intrafusal fibers are innervated by what motor neuron?
    gamma motor neuron
    Is Bell's palsy an UMN or a LMN lesion?
    LMN
    Is the Babinski reflex (positive or negative) when the big toe dorsiflexes and the other toes fan-out?
    positive (pathologic)
    Name 2 locations for lesions in Syringomyelia?
    ventral white commissure and ventral horns
    Name 3 locations for lesions in Vit.B12 neuropathy(Friedreich's ataxia)?
    dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts
    Name 7 functions of the hypothalamus?
    Thirst/waterbalance, Adenohypophysis control, Neurohypophysis control, Hunger/satiety, Autonomic regulation, Temperature regulation, Sexual emotions. TAN HATS
    Name the 4 foramina that are in the posterior cranial fossa?
    internal auditory meatus, jugular foramen, hypoglossal canal, and foramen magnum.
    Name the 5 foramina that are in the middle cranial fossa?
    optic canal, superior orbital fissure, foramen rotundum, foramen ovale, and foramen spinosum.
    Name the 5 functions of the Limbic system?
    Feeding, Fighting, Feeling, Flight, sex (F--K) [the famous 5 F's]
    Name the 5 segments of the brachial plexus in order from proximal to distal.
    roots - trunks - divisions - cords - branches
    Name the type of movement with slow writhing movements (esp. the fingers)?
    Athetosis
    Name the type of movement with sudden, jerky, purposeless movements?
    Chorea
    Name the type of movement with sudden, wild flailing of one arm?
    Hemiballismus
    Neurons from the globus pallidus have what action on the ventral anterior nucleus?
    Inhibitory
    Neurons from the striatum have what action on the globus pallidus?
    Inhibitory
    Place the following in order (from light entering the eye to reflex). Pretectal nuclei, pupillary constrictor muscle, retina, ciliary ganglion, Edinger-Westphal nuclei, CN II, CN III.
    retina, CN II, pretectal nuclei, Edinger-Westphal nuclei, CN III, ciliary ganglion, pupillary constrictor muscle
    Stimulation from the paraventricular nucleus cause the release of what hormone?
    oxytocin
    Stimulation from the supraoptic nucleus cause the release of what hormone?
    ADH (vasopressin)
    The Blood-Brain Barrier is formed by what 3 structures?
    choriod plexus epithelium, intracerebral capillary endothelium, astrocytes. (First Aid says Arachnoid but the brains say that’s a typo)
    The central retinal artery is a branch off what larger artery?
    ophthalmic artery
    The embryologic defect of having a cervical rib can compress what 2 structures?
    subclavian artery and inferior trunk of the brachial plexus
    The fasciculus cuneatus contains fibers from the upper or lower body?
    upper extremities
    The fasciculus gracilis contains fibers from the upper or lower body?
    lower extremities
    The hippocampal formation is connected to the mammillary body and septal area via what structure?
    fornix
    The hippocampus has input from what two areas?
    entorhinal cortex, septal area
    The hippocampus has output to what two areas?
    mammillary body, septal area
    The infraorbital nerve is a branch off what larger nerve?
    CN V2
    The Nucleus Ambiguus has fibers from what 3 CNs?
    CN IX, X, XII
    The Nucleus Solitarius has fibers from what 3 CNs?
    CN VII, IX, X
    Traction or tear of the superior trunk of the brachial plexus causes what syndrome?
    Erb-Duchenne palsy (waiter's tip)
    Vertigo, ataxia, visual deficits, and coma are caused by stroke of the? (ant. circle or post. circle)
    posterior circle
    Visual fibers from the lateral geniculate body terminate on the upper and lower banks of what fissure?
    Calcarine fissure
    What 1 nerve root is assoc. with the achilles reflex?
    S1
    What 1 nerve root is assoc. with the biceps reflex?
    C5
    What 1 nerve root is assoc. with the patella reflex?
    L4
    What 1 nerve root is assoc. with the triceps reflex?
    C7
    What 2 areas have sensation deficit in a lesion of the median nerve?
    lateral palm/thumb and the radial 2 1/2 fingers
    What 2 areas have sensation deficit in a lesion of the ulnar nerve?
    medial palm and the ulnar 1 1/2 fingers
    What 2 cutaneus nerves are lost in a lesion of the radial nerve?
    posterior brachial cutaneous and posterior antebrachial cutaneous
    What 2 spinal roots make up the inferior trunk of the brachial plexus?
    C8, T1
    What 2 spinal roots make up the superior trunk of the brachial plexus?
    C5, C6
    What 2 structures pass through the internal auditory meatus?
    CN VII, VIII
    What 2 symptoms are seen with a lesion of the musculocutaneus nerve?
    difficulty flexing the arm, variable sensory loss
    What 2 symptoms are seen with a lesion of the ulnar nerve?
    weak intrinsic muscles of the hand, Pope's blessing
    What 3 blood barriers does the body have?
    blood-brain, blood-gas, blood-testis
    What 3 muscles are lost in a lesion of the musculocutaneous nerve?
    coracobrachialis, biceps brachii, and brachialis
    What 3 muscles are lost in a lesion of the radial nerve?
    triceps brachii, brachioradialis, and extensor carpi radialis longus
    What 3 structures pass through the foramen magnum?
    spinal roots of CN XI(ascending), brainstem, vertebral arteries
    What 3 structures pass through the optic canal?
    CN II, ophthalmic artery, central retinal vein
    What 4 'muscles' does the radial nerve innervate?
    Brachioradialis, Extensors of the wrist and fingers, Supinator, Triceps. (BEST)
    What 4 areas is there decreased output in Parkinson's?
    substantia nigra pars compacta, globus pallidus, ventral anterior nucleus, cortex
    What 4 movements are limpaired in a lesion of the ulnar nerve?
    wrist flextion, wrist addduction, thumb adduction, and adductiont of the 2 ulnar fingers
    What 4 movements are lost in a lesion of the median nerve?
    forearm pronation, wrist flexion, finger flexion, and several thumb movements
    What 4 structures pass through the jugular foramen?
    CN IX, X, XI(descending), jugular vein
    What 4 things do the lateral striate arteries supply?
    internal capsule, caudate, putamen, globus pallidus
    What 5 spinal nerves that make up the brachial plexus?
    C5, C6, C7, C8, T1
    What 5 structures pass through the supperior orbital fissure?
    CN III, IV, V1, VI, ophthalmic vein
    What 5 types of cells make up the suportive cells of the CNS/PNS?
    Astrocytes, Microglia, Oligodendroglia, Schwann cells, Ependymal cells.
    What are 2 characteristics of Tabes Dorsalis?
    impaired proprioception and locomotor ataxia
    What are 3 clinical findings of the arm in Erb-Duchenne palsy?
    arm hangs by the side, medially rotated, forearm is pronated
    What are the 2 classic causes of Erb-Duchenne palsy?
    blow to the shoulder and trauma during birth
    What are the 3 classic symptoms of Horner's syndrome?
    ptosis, miosis, anhydrosis
    Q: What are the 4 classic findings of Brown
  4. Imperial

    Imperial Guest

    Supine vs. prone body position Know SUPination is your hand while carrying a bowl of SOUP. Your face follows where your palm is facing [i.e. up]. Put a handpuppet on your hand while hand is in supination and the puppet will be the supine position.



    Cubital fossa contents "N-MAN":
    • From lateral to medial:
    Nerve
    Muscle
    Artery
    Nerve
    • Specifics are radial Nerve, biceps Muscle tendon, brachial Artery, median Nerve.



    Diaphram aperatures: spinal levels "Come Enter the Abdomen:
    Vena Cava [8]
    Esophagus [10]
    Aorta [12]



    Inversion vs. eversion direction in the foot Little INtroVERted boys roll their feet in when talking to girls.




    Perineal vs. peroneal Perineal is in between the legs.
    Peroneal is on the leg.



    lsrate.cfm?mnemonic_id=166')>
    ---Anonymous Contributor
    L4 landmark: 2 items "B4U" [before you]:
    Bifurcation of aorta
    L4
    Umbilicus




    Anatomical planes: coronal, horizontal, sagittal Coronal: A classic painting/stained glass window of a saint/angel has a corona radiating around the person's head. The plane of the glass/page is cutting their head in the coronal plane.
    Horizontal: Someone coming over the horizon has their abdomen cut in the horizontal plane.
    Sagittal: the remaining one by default.



    Supine vs. prone body position "Supine is on your spine.
    Therefore, prone's the "other" one.
    • Also, prone to suffocate in prone position.



    Retroperitoneal structures list SAD PUCKER:
    Suprarenal glands
    Aorta & IVC
    Duodenum (half)
    Pancreas
    Ureters
    Colon (ascending & descending)
    Kidneys
    Esophagus (anterior & left covered)
    Rectum



    Cubital fossa contents "My Bottoms Turned Red":
    • From medial to lateral:
    Median nerve
    Brachial artery
    Tendon of biceps
    Radial nerve




    Ankle: anterior compartment of leg contents "The Hamptons Are Never Dull Parties":
    • From medial malleolus:
    Tibialis anterior tendon
    (Extensor) Hallacus longus
    Artery (anterior tibial)
    Nerve (deep peroneal)
    (Extensor) Digitorum
    Peroneus tertius



    Cubital fossa contents "Really Need Booze To Be At My Nicest":
    • From lateral to medial:
    Radial Nerve
    Biceps Tendon
    Brachial Artery
    Median Nerve



    Cubital fossa contents MBBR:
    • From medial to lateral:
    Median nerve
    Brachial artery
    Biceps tendon
    Radial nerve



    Retroperitoneal organs (major) "AC/DC Rocker Kids Party Down":
    Ascending Colon
    Descending Colon
    Rectum
    Kidneys
    Pancreas
    Duodenum




    Superior mediastinum: contents PVT Left BATTLE:
    Phrenic nerve
    Vagus nerve
    Thoracic duct
    Left recurrent laryngeal nerve (not the right)
    Brachiocephalic veins
    Aortic arch (and its 3 branches)
    Thymus
    Trachea
    Lymph nodes
    Esophagus



    Inguinal canal: walls "MALT: 2M, 2A, 2L, 2T":
    • Starting from superior, moving around in order to posterior:
    Superior wall (roof): 2 Muscles:
    • internal oblique Muscle
    • transverse abdominus Muscle
    Anterior wall: 2 Aponeuroses:
    • Aponeurosis of external oblique
    • Aponeurosis of internal oblique
    Lower wall (floor): 2 Ligaments:
    • inguinal Ligament
    • lacunar Ligament
    Posterior wall: 2Ts:
    • Transversalis fascia
    • conjoint Tendon



    Mediastinums: posterior mediastinum structures There are 4 birds:
    The esophaGOOSE (esophagus)
    The vaGOOSE nerve
    The azyGOOSE vein
    The thoracic DUCK (duct)



    Internal pudendal branches "I Pee Pee But Don't Dump!":
    Inferior rectal
    Posterior scrotal (or labial)
    Perineal
    Bulb
    Deep artery
    Dorsal artery

    Aortic stenosis characteristics SAD:
    Syncope
    Angina
    Dyspnoea

    MI: basic management BOOMAR:
    Bed rest
    Oxygen
    Opiate
    Monitor
    Anticoagulate
    Reduce clot size


    ECG: left vs. right bundle block "WiLLiaM MaRRoW":
    W pattern in V1-V2 and M pattern in V3-V6 is Left bundle block.
    M pattern in V1-V2 and W in V3-V6 is Right bundle block.
    • Note: consider bundle branch blocks when QRS complex is wide.


    Pericarditis: causes CARDIAC RIND:
    Collagen vascular disease
    Aortic aneurysm
    Radiation
    Drugs (such as hydralazine)
    Infections
    Acute renal failure
    Cardiac infarction
    Rheumatic fever
    Injury
    Neoplasms
    Dressler's syndrome


    Murmurs: systolic types SAPS:
    Systolic
    Aortic
    Pulmonic
    Stenosis
    • Systolic murmurs include aortic and pulmonary stenosis.
    • Similarly, it's common sense that if it is aortic and pulmonary stenosis it could also be mitral and tricusp regurgitation].


    MI: signs and symptoms PULSE:
    Persistent chest pains
    Upset stomach
    Lightheadedness
    Shortness of breath
    Excessive sweating

    Heart compensatory mechanisms that 'save' organ blood flow during shock "Heart SAVER":
    Symphatoadrenal system
    Atrial natriuretic factor
    Vasopressin
    Endogenous digitalis-like factor
    Renin-angiotensin-aldosterone system
    • In all 5, system is activated/factor is released


    Murmurs: right vs. left loudness "RILE":
    Right sided heart murmurs are louder on Inspiration.
    Left sided heart murmurs are loudest on Expiration.
    • If get confused about which is which, remember LIRE=liar which will be inherently false.


    ST elevation causes in ECG, ELEVATION:
    Electrolytes
    LBBB
    Early repolarization
    Ventricular hypertrophy
    Aneurysm
    Treatment (eg pericardiocentesis)
    Injury (AMI, contusion)
    Osborne waves (hypothermia)
    Non-occlusive vasospasm


    Beck's triad (cardiac tamponade) 3 D's:
    Distant heart sounds
    Distended jugular veins
    Decreased arterial pressure

    11

    MI: therapeutic treatment ROAMBAL:
    Reassure
    Oxygen
    Aspirin
    Morphine (diamorphine)
    Beta blocker
    Arthroplasty
    Lignocaine

    CHF: causes of exacerbation FAILURE:
    Forgot medication
    Arrhythmia/ Anaemia
    Ischemia/ Infarction/ Infection
    Lifestyle: taken too much salt
    Upregulation of CO: pregnancy, hyperthyroidism
    Renal failure
    Embolism: pulmonary


    Murmurs: systolic vs. diastolic PASS: Pulmonic & Aortic Stenosis=Systolic.
    PAID: Pulmonic & Aortic Insufficiency=Diastolic.


    Murmurs: systolic vs. diastolic Systolic murmurs: MR AS: "MR. ASner".
    Diastolic murmurs: MS AR: "MS. ARden".
    • The famous people with those surnames are Mr. Ed Asner and Ms. Jane Arden.


    Mitral stenosis (MS) vs. regurgitation (MR): epidemiology MS is a female title (Ms.) and it is female predominant.
    MR is a male title (Mr.) and it is male predominant.


    Pericarditis: EKG "PericarditiS":
    PR depression in precordial leads.
    ST elevation.


    Jugular venous pressure (JVP) elevation: causes HOLT: Grab Harold Holt around the neck and throw him in the ocean:
    Heart failure
    Obstruction of venea cava
    Lymphatic enlargement - supraclavicular
    Intra-Thoracic pressure increase

    Depressed ST-segment: causes DEPRESSED ST:
    Drooping valve (MVP)
    Enlargement of LV with strain
    Potassium loss (hypokalemia)
    Reciprocal ST- depression (in I/W AMI)
    Embolism in lungs (pulmonary embolism)
    Subendocardial ischemia
    Subendocardial infarct
    Encephalon haemorrhage (intracranial haemorrhage)
    Dilated cardiomyopathy
    Shock
    Toxicity of digitalis, quinidine

    22

    Murmurs: innocent murmur features 8 S's:
    Soft
    Systolic
    Short
    Sounds (S1 & S2) normal
    Symptomless
    Special tests normal (X-ray, EKG)
    Standing/ Sitting (vary with position)
    Sternal depression


    Murmur attributes "IL PQRST" (person has ill PQRST heart waves):
    Intensity
    Location
    Pitch
    Quality
    Radiation
    Shape
    Timing


    Murmurs: locations and descriptions "MRS A$$":
    MRS: Mitral Regurgitation--Systolic
    A$$: Aortic Stenosis--Systolic
    • The other two murmurs, Mitral stenosis and Aortic regurgitation, are obviously diastolic.


    Betablockers: cardioselective betablockers "Betablockers Acting Exclusively At Myocardium"
    • Cardioselective betablockers are:
    Betaxolol
    Acebutelol
    Esmolol
    Atenolol
    Metoprolol


    Apex beat: abnormalities found on palpation, causes of impalpable HILT:
    Heaving
    Impalpable
    Laterally displaced
    Thrusting/ Tapping
    • If it is impalpable, causes are COPD:
    COPD
    Obesity
    Pleural, Pericardial effusion
    Dextrocardia


    MI: treatment of acute MI COAG:
    Cyclomorph
    Oxygen
    Aspirin
    Glycerol trinitrate


    Coronary artery bypass graft: indications DUST:
    Depressed ventricular function
    Unstable angina
    Stenosis of the left main stem
    Triple vessel disease


    Peripheral vascular insufficiency: inspection criteria SICVD:
    Symmetry of leg musculature
    Integrity of skin
    Color of toenails
    Varicose veins
    Distribution of hair


    Heart murmurs "hARD ASS MRS. MSD":
    hARD: Aortic Regurg = Diastolic
    ASS: Aortic Stenosis = Systolic
    MRS: Mitral Regurg = Systolic
    MSD: Mitral Stenosis = Diastolic


    33

    Mitral regurgitation When you hear holosystolic murmurs, think "MR-THEM ARE holosystolic murmurs".


    Sino-atrial node: innervation Sympathetic acts on Sodium channels (SS).
    Parasympathetic acts on Potassium channels (PS).


    Supraventricular tachycardia: treatment ABCDE:
    Adenosine
    Beta-blocker
    Calcium channel antagonist
    Digoxin
    Excitation (vagal stimulation)


    Ventricular tachycardia: treatment LAMB:
    Lidocaine
    Amiodarone
    Mexiltene/ Magnesium
    Beta-blocker


    Pulseless electrical activity: causes PATCH MED:
    Pulmonary embolus
    Acidosis
    Tension pneumothorax
    Cardiac tamponade
    Hypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ Hypovolemia
    Myocardial infarction
    Electrolyte derangements
    Drugs


    Sinus bradycardia: aetiology "SINUS BRADICARDIA" (sinus bradycardia):
    Sleep
    Infections (myocarditis)
    Neap thyroid (hypothyroid)
    Unconsciousness (vasovagal syncope)
    Subnormal temperatures (hypothermia)
    Biliary obstruction
    Raised CO2 (hypercapnia)
    Acidosis
    Deficient blood sugar (hypoglycemia)
    Imbalance of electrolytes
    Cushing's reflex (raised ICP)
    Aging
    Rx (drugs, such as high-dose atropine)
    Deep Anaesthesia
    Ischemic heart disease
    Athletes


    Rheumatic fever: Jones criteria • Major criteria: CANCER:
    Carditis
    Arthritis
    Nodules
    Chorea
    Erythema
    Rheumatic anamnesis
    • Minor criteria: CAFE PAL:
    CRP increased
    Arthralgia
    Fever
    Elevated ESR
    Prolonged PR interval
    Anamnesis of rheumatism
    Leucocytosis

    JVP: wave form ASK ME:
    Atrial contraction
    Systole (ventricular contraction)
    Klosure (closure) of tricusps, so atrial filling
    Maximal atrial filling
    Emptying of atrium
    • See diagram.

    Coronary artery bypass graft: indications DUST:
    Depressed ventricular function
    Unstable angina
    Stenosis of the left main stem
    Triple vessel disease

    41

    Exercise ramp ECG: contraindications RAMP:
    Recent MI
    Aortic stenosis
    MI in the last 7 days
    Pulmonary hypertension


    ECG: T wave inversion causes INVERT:
    Ischemia
    Normality [esp. young, black]
    Ventricular hypertrophy
    Ectopic foci [eg calcified plaques]
    RBBB, LBBB
    Treatments [digoxin]


    Rheumatic fever: Jones major criteria JONES:
    Joints (migrating polyarthritis)
    Obvious, the heart (carditis, pancarditis, pericarditis, endocarditis or valvulits)
    Nodes (subcutaneous nodules)
    Erythema marginatum
    Sydenham's chorea


    Myocardial infarctions: treatment INFARCTIONS:
    IV access
    Narcotic analgesics (eg morphine, pethidine)
    Facilities for defibrillation (DF)
    Aspirin/ Anticoagulant (heparin)
    Rest
    Converting enzyme inhibitor
    Thrombolysis
    IV beta blocker
    Oxygen 60%
    Nitrates
    Stool Softeners


    Atrial fibrillation: causes PIRATES:
    Pulmonary: PE, COPD
    Iatrogenic
    Rheumatic heart: mirtral regurgitation
    Atherosclerotic: MI, CAD
    Thyroid: hyperthyroid
    Endocarditis
    Sick sinus syndrome


    Atrial fibrillation: management ABCD:
    Anti-coagulate
    Beta-block to control rate
    Cardiovert
    Digoxin


    Anti-arrythmics: for AV nodes "Do Block AV":
    Digoxin
    B-blockers
    Adenosine
    Verapamil


    Murmurs: systolic MR PV TRAPS:
    Mitral
    Regurgitation and
    Prolaspe
    VSD
    Tricupsid
    Regurgitation
    Aortic and
    Pulmonary
    Stenosis


    Apex beat: differential for impalpable apex beat DOPES:
    Dextrocardia
    Obesity
    Pericarditis or pericardial tamponade
    Emphysema
    Sinus inversus/ Student incompetence
  5. Imperial

    Imperial Guest

    Measles: complications "MEASLES COMP" (complications):
    Myocarditis
    Encephalitis
    Appendicitis
    Subacute sclerosing panencephalitis
    Laryngitis
    Early death
    Sh!ts (diarrhoea)
    Corneal ulcer
    Otis media
    Mesenteric lymphadenitis
    Pneumonia and related (bronchiolitis-bronchitis-croup)


    Sturge-Weber syndrome: hallmark features Sturge-Weber:
    1. Seizures
    2. PortWine stain


    Guthrie card: diseases identified with it "Guthrie Cards Can Help Predict Bad Metabolism":
    Galactosaemia
    Cystic fibrosis
    Congenital adrenal hyperplasia
    Hypothyroidism
    Phenylketonuria
    Biotidinase deficiency
    Maple syrup urine disease


    Croup: symptoms 3 S's:
    Stridor
    Subglottic swelling
    Seal-bark cough


    Ataxia-Telangiectasia (AT): common sign AT:
    Absent
    Thymus


    Cerebral palsy (CP): most likely cause CP: Cerebral Palsy
    Child Premature
    • The premature brain is more prone to all the possible insults.


    Vacterl syndrome: components VACTERL:
    Vertebral anomalies
    Anorectal malformation
    Cardiac anomaly
    Tracheo-esophageal fistula
    Exomphalos (aka omphalocele)
    Renal anomalies
    Limb anomalies

    Guthrie card: diseases identified with it GUTHRIE:
    Galactosaemia
    Urine [maple syrup urine disease]
    THyRoid [hypothyroidism]
    Inborn Errors of metabolism [eg: PKU]


    Duodenal atresia vs. Pyloric stenosis: site of obstruction Duodenal Atresia: Distal to Ampulla of vater.
    Pyloric stenosis: Proximal to it.


    Bilirubin: phototherapy BiLirUbin absorbs light maximally in the
    BLUe range.

    11

    Williams syndrome: features WILLIAMS:
    Weight (low at birth, slow to gain)
    Iris (stellate iris)
    Long philtrum
    Large mouth
    Increased Ca++
    Aortic stenosis (and other stenoses)
    Mental retardation
    Swelling around eyes (periorbital puffiness)


    Russell Silver syndrome: features ABCDEF:
    Asymmetric limb (hemihypertrophy)
    Bossing (frontal)
    Clinodactyly/ Cafe au lait spots
    Dwarf (short stature)
    Excretion (GU malformation)
    Face (triangular face, micrognathia)


    Dentition: eruption times of permanent dentition "Mama Is In Pain, Papa Can Make Medicine":
    1st Molar: 6 years
    1st Incisor: 7 years
    2nd Incisor: 8 years
    1st Premolar: 9 years
    2nd Premolar: 10 years
    Canine: 11 years
    2nd Molar: 12 years
    3rd Molar: 18-25 years


    Cyanotic heart diseases: 5 types • Use your five fingers:
    1 finger up: Truncus Arteriosus (1 vessel)
    2 fingers up: Dextroposition of the Great Arteries (2 vessels transposed)
    3 fingers up: Tricuspid Atresia (3=Tri)
    4 fingers up: Tetralogy of Fallot (4=Tetra)
    5 fingers up: Total Anomalous Pulmonary Venous Return (5=5 words)


    Cyanotic congenital heart diseases 5 T's:
    Truncus arteriosus
    Transposition of the great arteries
    Tricuspid atresia
    Tetrology of Fallot
    Total anomalous pulmonary venous return


    Head circumference with age • Remember 3, 9, and multiples of 5:
    Newborn 35 cm
    3 mos 40 cm
    9 mos 45 cm
    3 yrs 50 cm
    9 yrs 55 cm


    Weights of children with age Newborn 3 kg
    6 mos 6 kg (2x birth wt at 6 mos)
    1 yr 10 kg (3x birth wt at 1 yr)
    3 yrs 15 kg (odd yrs, add 5 kg until 11 yrs)
    5 yrs 20 kg
    7 yrs 25 kg
    9 yrs 30 kg
    11 yrs 35 kg (add 10 kg thereafter)
    13 yrs 45 kg
    15 yrs 55 kg
    17 yrs 65 kg

    Hemolytic-Uremic Syndrome (HUS): components
    "Remember to decrease the RATE of IV fluids in these patients":
    Renal failure
    Anemia (microangiopathic, hemolytic)
    Thrombocytopenia
    Encephalopathy (TTP)


    Cough (chronic): differential When cough in nursery, rock the "CRADLE":
    Cystic fibrosis
    Rings, slings, and airway things (tracheal rings)/ Respiratory infections
    Aspiration (swallowing dysfunction, TE fistula, gastroesphageal reflux)
    Dyskinetic cilia
    Lung, airway, and vascular malformations (tracheomalacia, vocal cord dysfunction)
    Edema (heart failure)


    Cystic fibrosis: presenting signs CF PANCREAS:
    Chronic cough and wheezing
    Failure to thrive
    Pancreatic insufficiency (symptoms of malabsorption like steatorrhea)
    Alkalosis and hypotonic dehydration
    Neonatal intestinal obstruction (meconium ileus)/ Nasal polyps
    Clubbing of fingers/ Chest radiograph with characteristic changes
    Rectal prolapse
    Electrolyte elevation in sweat, salty skin
    Absence or congenital atresia of vas deferens
    Sputum with Staph or Pseudomonas (mucoid)

    21

    Cystic fibrosis: exacerbation of pulmonary infection CF PANCREAS:
    Cough (increase in intensity and frequent spells)
    Fever (usually low grade, unless severe bronchopneumonia is present)
    Pulmonary function deterioration
    Appetite decrease
    Nutrition, weight loss
    CBC (leukocytosis with left shift)
    Radiograph (increase overaeration, peribronchial thickening, mucus plugging)
    Exam (rales or wheezing in previously clear areas, tachypnea, retractions)
    Activity (decreased, impaired exercise intolerance, increased absenteeism)
    Sputum (becomes darker, thicker, and more abundant, forming plugs)


    Pyloric stenosis (congential): presentation Pyloric stenosis is 3 P's:
    Palpable mass
    Paristalsis visible
    Projectile vomiting (2-4 weeks after birth)


    Cyanotic heart diseases: 5 types • 5 T's:
    Tetralogy of Fallot
    Transposition of the great arteries
    Truncus arteriosus
    Tricuspid atresia, pulmonary aTresia
    Total anomalous pulmonary venous drainage


    Breast feeding: benefits ABCDEFGH:
    • Infant:
    Allergic condition reduced
    Best food for infant
    Close relationship with mother
    Development of IQ, jaws, mouth
    • Mother:
    Econmical
    Fitness: quick return to pre-pregnancy body shape
    Guards against cancer: breast, ovary, uterus
    Hemorrhage (postpartum) reduced


    Perez reflex Eliciting the PErEz reflex will make the baby PEE.


    WAGR syndrome: components WAGR:
    Wilm's tumor
    Aniridia
    Gential abnormalities
    Mental retardation


    Haematuria: differential in children ABCDEFGHIJK:
    Anatomy (cysts, etc)
    Bladder (cystitis)
    Cancer (Wilm's tumour)
    Drug related (cyclophosphamide)
    Exercise induced
    Factitious (Munchausen by proxy)
    Glomerulonephritis
    Haematology (bleeding disorder, sickle cell)
    Infection (UTI)
    In Jury (trauma)
    Kidney stones (hypercalciuria)


    Vitamin toxicities: neonatal Excess vitamin A: Anomalies (teratogenic)
    Excess vitamin E: Enterocolitis (necrotizing enterocolitis)
    Excess vitamin K: Kernicterus (hemolysis)


    Rubella: congenital signs "Rubber Ducky, I'm so blue!" (like the "Rubber Ducky" song):
    Rubber: Rubella
    Ducky: Patent Ductus Arteriosus, VSD and pulmonary artery stenosis.
    I'm: Eyes (cataracts, retinopathy, micropthalmia, glaucoma).
    Blue: "Blueberry Muffin" rash (extramedullary hematopoesis in skin +purpura)
    • Also, deafness, growth retardation, and some more.


    Pediatric milestones in development 1 year:
    -single words
    2 years:
    -2 word sentences
    -understands 2 step commands
    3 years:
    -3 word combos
    -repeats 3 digits
    -rides tricycle
    4 years:
    -draws square
    -counts 4 objects



    31

    Gastroschisis: usual location GasTRoscHIsis usually occurs on the
    RIGHT side of the umbilicus.
    (Unscramble the letters).


    Milk protein: women vs. cows Woman: Whey (mostly)
    Cow: Casein (mostly)


    Short stature: differential ABCDEFG:
    Alone (neglected infant)
    Bone dysplasias (rickets, scoliosis, mucopolysaccharidoses)
    Chromosomal (Turner's, Down's)
    Delayed growth
    Endocrine (low growth hormone, Cushing's, hypothyroid)
    Familial
    GI malabsorption (celiac, Crohn's)
  6. Imperial

    Imperial Guest

    Pulmonary infiltrations inducing drugs "Go BAN Me!":
    Gold
    Bleomycin/ Busulphan/ BCNU
    Amiodarone/ Acyclovir/ Azathioprine
    Nitrofurantoin
    Melphalan/ Methotrexate/ Methysergide

    MPTP: mechanism, effect MPTP:
    Mitochondrial Parkinson's-Type Poison.
    • A mitochondrial poison that elicits a Parkinson's-type effect.

    Antimuscarinics: members, action
    "Inhibits Parasympathetic And Sweat":
    Ipratropium Pirenzepine Atropine Scopolamine
    • Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic.

    Teratogenic drugs: major non-antibiotics TAP CAP:
    Thalidomide Androgens Progestins Corticosteroids Aspirin & indomethacin Phenytoin

    Steroid side effects CUSHINGOID:
    Cataracts
    Ulcers
    Skin: striae, thinning, bruising
    Hypertension/ Hirsutism/ Hyperglycemia
    Infections
    Necrosis, avascular necrosis of the femoral head
    Glycosuria
    Osteoporosis, obesity
    Immunosuppression
    Diabetes


    Beta blockers with CYP2D6 polymorphic metabolism
    "I Met Tim Carver, the metabolic polymorph":
    • The following beta blockers require dose adjustment due to CYP2D6 polymorphic metabolism:
    Metoprolol Timolol Carvedilol (in patients with lower or higher than normal CYP2D6 activity)

    Beta blockers with intrinsic sympathomimetic activity
    Picture diabetic and asthmatic kids riding away on a cart that rolls on pinwheels. Pindolol and Carteolol have high and moderate ISA respectively, making them acceptable for use in some diabetics or asthmatics despite the fact that they are non-seletive beta blockers.

    Muscarinic effects SLUG BAM:
    Salivation/ Secretions/ Sweating
    Lacrimation
    Urination
    Gastrointestinal upset
    Bradycardia/ Bronchoconstriction/ Bowel movement
    Abdominal cramps/ Anorexia
    Miosis

    Sulfonamide: major side effects
    • Sulfonamide side effects:
    Steven-Johnson syndrome
    Skin rash
    Solubility low (causes crystalluria)
    Serum albumin displaced (causes newborn kernicterus and potentiation of other serum albumin-binders like warfarin)

    Epilepsy types, drugs of choice:
    "Military General Attacked Weary Fighters Pronouncing 'Veni Vedi Veci' After Crushing Enemies":
    • Epilepsy types: Myoclonic Grand mal Atonic West syndrome Focal Petit mal (absence)
    • Respective drugs: Valproate Valproate Valproate ACTH Carbamazepine Ethosuximide

    Quinolones [and Fluoroquinolones]: mechanism
    "Topple the Queen": Quinolone interferes with Topoisomerase II.

    Beta blockers:
    B1 selective vs. B1-B2 non-selective
    A through N: B1 selective: Acebutalol, Atenolol, Esmolol, Metoprolol.
    O through Z: B1, B2 non-selective: Pindolol, Propanalol, Timolol.

    Ribavirin: indications RIBAvirin:
    RSV
    Influenza B
    Arenaviruses (Lassa, Bolivian, etc.)
    Hypertension: treatment ABCD:
    ACE inhibitors/ AngII antagonists (sometimes Alpha agonists also) Beta blockers
    Calcium antagonists
    Diuretics

    Narcotics: side effects "SCRAM if you see a drug dealer": Synergistic CNS depression with other drugs
    Constipation
    Respiratory depression
    Addiction
    Miosis
    Sex hormone drugs: male "Feminine Males Need Testosterone":
    Fluoxymesterone
    Methyltestosterone
    Nandrolone
    Testosterone

    Ca++ channel blockers: uses CA++ MASH:
    Cerebral vasospasm/ CHF
    Angina
    Migranes
    Atrial flutter, fibrillation
    Supraventricular tachycardia
    Hypertension
    • Alternatively: "CHASM":
    Cererbral vasospasm / CHF
    Hypertension
    Angina
    Suprventricular tachyarrhythmia
    Migranes

    Disulfiram-like reaction inducing drugs "PM PMT" as in Pre Medical Test in the PM:
    Procarbazine
    Metronidazole
    Cefo (Perazone, Mandole, Tetan).

    Delerium-causing drugs ACUTE CHANGE IN MS:
    Antibiotics (biaxin, penicillin, ciprofloxacin)
    Cardiac drugs (digoxin, lidocaine)
    Urinary incontinence drugs (anticholinergics)
    Theophylline
    Ethanol
    Corticosteroids
    H2 blockers
    Antiparkinsonian drugs
    Narcotics (esp. mepridine)
    Geriatric psychiatric drugs
    ENT drugs
    Insomnia drugs
    NSAIDs (eg indomethacin, naproxin)
    Muscle relaxants
    Seizure medicines

    Morphine: side-effects MORPHINE:
    Myosis
    Out of it (sedation)
    Respiratory depression
    Pneumonia (aspiration)
    Hypotension
    Infrequency (constipation, urinary retention)
    Nausea
    Emesis

    Therapeutic dosage: toxicity values for most commonly monitored medications
    "The magic 2s":
    Digitalis (.5-1.5) Toxicity = 2.
    Lithium (.6-1.2) Toxicity = 2.
    Theophylline (10-20) Toxicity = 20.
    Dilantin (10-20) Toxicity = 20.
    APAP (1-30) Toxicity = 200.

    Diuretics:
    thiazides: indications "CHIC to use thiazides":
    CHF
    Hypertension
    Insipidous
    Calcium calculi

    Migraine: prophylaxis drugs
    "Very Volatile Pharmacotherapeutic Agents For Migraine Prophylaxis":
    Verpamil
    Valproic acid
    Pizotifen
    Amitriptyline
    Flunarizine
    Methysergide
    Propranolol

    Adrenoceptors: vasomotor function of alpha vs. beta
    ABCD:
    Alpha = Constrict.
    Beta = Dilate.

    Antiarrhythmics: classification
    I to IV MBA College
    • In order of class I to IV:
    Membrane stabilizers (class I)
    Beta blockers
    Action potential widening agents
    Calcium channel blockers

    Opiods: mu receptor effects "MD CARES":
    Miosis
    Dependency
    Constipation
    Analgesics
    Respiratory depression
    Euphoria
    Sedation

    Cancer drugs: time of action between DNA->mRNA ABCDEF: Alkylating agents
    Bleomycin
    Cisplastin
    Dactinomycin/ Doxorubicin
    Etoposide
    Flutamide and other steroids or their antagonists (eg tamoxifen, leuprolide)

    Busulfan: features ABCDEF:
    Alkylating agent
    Bone marrow suppression s/e
    CML indication
    Dark skin (hyperpigmentation) s/e
    Endrocrine insufficiency (adrenal) s/e
    Fibrosis (pulmonary) s/e

    Tricyclic antidepressants: members worth knowing
    "I have to hide, the CIA is after me":
    Clomipramine Imipramine Amitrptyline
    • If want the next 3 worth knowing, the DNDis also after me:
    Desipramine Norrtriptyline Doxepin

    Torsades de Pointes: drugs causing APACHE:
    Amiodarone Procainamide Arsenium Cisapride Haloperidol Eritromycin

    Serotonin syndrome: components Causes HARM:
    Hyperthermia Autonomic instability (delirium) Rigidity Myoclonus

    Tetracycline: teratogenicity
    TEtracycline is a TEratogen that causes staining of TEeth in the newborn.

    Patent ductus arteriosus: treatment
    "Come In and Close the door": INdomethacin is used to Close PDA.

    Physostigmine vs. neostigmine LMNOP:
    Lipid soluble
    Miotic
    Natural
    Orally absorbed well
    Physostigmine
    • Neostigmine, on the contrary, is:
    Water soluble
    Used in myesthenia gravis
    Synthetic
    Poor oral absorption

    Beta 1 selective blockers
    "BEAM ONE up, Scotty":
    Beta 1 blockers:
    Esmolol
    Atenolol
    Metropolol

    Antirheumatic agents (disease modifying): members
    CHAMP:
    Cyclophosphamide
    Hydroxycloroquine and choloroquinine
    Auranofin and other gold compounds
    Methotrexate
    Penicillamine


    Auranofin, aurothioglucose: category and indication
    Aurum is latin for "gold" (gold's chemical symbol is Au).
    Generic Aur- drugs (Auranofin, Aurothioglucose) are gold compounds.
    • If didn't learn yet that gold's indication is rheumatoid arthritis, AUR- Acts Upon Rheumatoid.

    Antiarrhythmics: class III members BIAS:
    Bretylium
    Ibutilide
    Amiodarone
    Sotalol

    MAOIs: indications MAOI'S:
    Melancholic [classic name for atypical depression]
    Anxiety
    Obesity disorders [anorexia, bulemia]
    Imagined illnesses [hypochondria]
    Social phobias
    • Listed in decreasing order of importance.
    • Note MAOI is inside MelAnchOlIc.

    SIADH-inducing drugs ABCD:
    Analgesics: opioids, NSAIDs
    Barbiturates
    Cyclophosphamide/ Chlorpromazine/ Carbamazepine
    Diuretic (thiazide)

    K+ increasing agents K-BANK:
    K-sparing diuretic
    Beta blocker
    ACEI
    NSAID
    K supplement


    Reserpine action:
    Reserpine depletes the Reserves of catecholamines [and serotonin].

    Succinylcholine:
    action, use Succinylcholine gets Stuck to Ach receptor, then Sucks ions in through open pore. You Suck stuff in through a mouth-tube, and drug is used for intubation.
    Beta-blockers: side effects "BBC Loses Viewers In Rochedale": Bradycardia
    Bronchoconstriction
    Claudication
    Lipids
    Vivid dreams & nightmares
    -ve Inotropic action
    Reduced sensitivity to hypoglycaemia
    Cisplatin: major side effect, action "Ci-Splat-In":
    Major side effect: Splat (vomiting sound)--vomiting so severe that anti-nausea drug needed. Action: Goes Into the DNA strand.

    Vir-named drugs: use"-vir at start, middle or end means for virus": • Drugs:
    Abacavir,
    Acyclovir,
    Amprenavir,
    Cidofovir,
    Denavir,
    Efavirenz,
    Indavir,
    Invirase,
    Famvir,
    Ganciclovir,
    Norvir,
    Oseltamivir,
    Penciclovir,
    Ritonavir,
    Saquinavir,
    Valacyclovir,
    Viracept,
    Viramune,
    Zanamivir,
    Zovirax.

    Phenobarbitone: side effects
    Children are annoying (hyperkinesia, irritability, insomnia, aggression).
    Adults are dosy (sedation, dizziness, drowsiness).

    Prazocin: usage
    Prazocin sounds like an acronym of "praszz zour urine".
    Therefore Prazocin used for urinary retention in BPH.

    Opioids: effects BAD AMERICANS:
    Bradycardia & hypotension
    Anorexia
    Diminished pupilary size
    Analgesics
    Miosis
    Euphoria
    Respiratory depression
    Increased smooth muscle activity (biliary tract constriction) Constipation
    Ameliorate cough reflex
    Nausea and vomiting
    Sedation

    TB: antibiotics used
    STRIPE:
    STreptomycin Rifampicin Isoniazid Pyrizinamide Ethambutol

    Phenytoin: adverse effects PHENYTOIN:
    P-450 interactions
    Hirsutism
    Enlarged gums
    Nystagmus
    Yellow-browning of skin
    Teratogenicity
    Osteomalacia
    Interference with B12 metabolism (hence anemia)
    Neuropathies: vertigo, ataxia, and headache


    Narcotic antagonists
    The Narcotic Antagonists are NAloxone and NAltrexone. • Important clinically to treat narcotic overdose.

    Thrombolytic agents USA:
    Urokinase Streptokinase Alteplase (tPA)

    Routes of entry: most rapid ways meds/toxins enter body
    "Stick it, Sniff it, Suck it, Soak it":
    Stick = Injection
    Sniff = inhalation
    Suck = ingestion
    Soak = absorption

    Asthma drugs: leukotriene inhibitor action
    zAfirlukast: Antagonist of lipoxygenase
    zIlueton: Inhibitor of LT receptor

    Direct sympathomimetic catecholamines DINED:
    Dopamine
    Isoproterenol
    Norepinephrine
    Epinephrine
    Dobutamine

    Anticholinergic side effects
    "Know the ABCD'S of anticholinergic side effects":
    Anorexia
    Blurry vision
    Constipation/ Confusion
    Dry Mouth
    Sedation/ Stasis of urine

    Atropine use: tachycardia or bradycardia
    "A goes with B": Atropine used clinically to treat Bradycardia.

    Bleomycin: action
    "Bleo-Mycin Blows My DNA to bits": Bleomycin works by fragmenting DNA (blowing it to bits). My DNA signals that its used for cancer (targeting self cells).

    Aspirin: side effects ASPIRIN:
    Asthma
    Salicyalism
    Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/ Premature closure of PDA
    Intestinal blood loss
    Reye's syndrome
    Idiosyncracy
    Noise (tinnitus)

    Lupus: drugs inducing it HIP:
    Hydralazine
    INH
    Procanimide

    Vigabatrin: mechanism Vi-GABA-Tr-In:
    Via GABA Transferase Inhibition

    Morphine: effects at mu receptor PEAR:
    Physical dependence
    Euphoria
    Analgesia
    Respiratory depression

    Enoxaprin (prototype low molecular weight heparin): action, monitoring EnoXaprin only acts on factor Xa. Monitor Xa concentration, rather than APTT.

    Beta-1 vs Beta-2 receptor location "You have 1 heart and 2 lungs":
    Beta-1 are therefore primarily on heart. Beta-2 primarily on lungs.

    SSRIs: side effects SSRI:
    Serotonin syndrome
    Stimulate CNS
    Reproductive disfunctions in male
    Insomnia

    Ipratropium: action Atropine is buried in the middle:
    iprAtropium, so it behaves like Atropine.

    Warfarin: action, monitoring WePT:
    Warfarin works on the extrinsic pathway and is monitored by PT.

    Propranolol and related '-olol' drugs: usage"olol" is just two backwards lower case b's. Backward b's stand for "beta blocker". • Beta blockers include acebutolol, betaxolol, bisoprolol, oxprenolol, propranolol.

    Depression: 5 drugs causing it PROMS:
    Propranolol
    Reserpine
    Oral contraceptives
    Methyldopa
    Steroids

    Lead poisoning: presentation ABCDEFG:
    Anemia
    Basophilic stripping
    Colicky pain
    Diarrhea
    Encephalopathy
    Foot drop
    Gum (lead line)


    Myasthenia gravis: edrophonium vs. pyridostigmine
    eDrophonium is for Diagnosis.
    pyRIDostigmine is to get RID of symptoms.

    Morphine: effects MORPHINES:
    Miosis
    Orthostatic hypotension
    Respiratory depression
    Pain supression
    Histamine release/ Hormonal alterations
    Increased ICT
    Nausea
    Euphoria
    Sedation

    Inhalation anesthetics SHINE:
    Sevoflurane
    Halothane
    Isoflurane
    Nitrous oxide
    Enflurane
    • If want the defunct Methoxyflurane too, make it MoonSHINE.

    Cholinergics (eg organophosphates): effects
    If you know these, you will be "LESS DUMB":
    Lacrimation
    Excitation of nicotinic synapses
    Salivation
    Sweating
    Diarrhea
    Urination
    Micturition
    Bronchoconstriction

    Benzodiazapines: ones not metabolized by the liver (safe to use in liver failure) LOT: Lorazepam Oxazepam Temazepam

    Benzodiazepines: actions
    "Ben SCAMs Pam into seduction not by brain but by muscle":
    Sedation
    anti-Convulsant
    anti-Anxiety
    Muscle relaxant
    Not by brain: No antipsychotic activity.

    Botulism toxin: action, related bungarotoxin
    Action: "Botulism Bottles up the Ach so it can't be the released":
    Related bungarotoxin: "Botulism is related to Beta Bungarotoxin (beta-, not alpha-bungarotoxin--alpha has different mechanism).

    Teratogenic drugs "W/ TERATOgenic":
    Warfarin
    Thalidomide
    Epileptic drugs: phenytoin, valproate, carbamazepine
    Retinoid
    ACE inhibitor
    Third element: lithium
    OCP and other hormones (eg danazol)

    Gynaecomastia-causing drugs DISCOS:
    Digoxin
    Isoniazid
    Spironolactone
    Cimetidine
    Oestrogens
    Stilboestrol

    Benzodiazepenes: drugs which decrease their metabolism
    "I'm Overly Calm":
    Isoniazid
    Oral contraceptive pills
    Cimetidine
    • These drugs increase calming effect of BZDs by retarding metabolism.

    Anesthesia: 4 stages "Anesthesiologists Enjoy S & M":
    Analgesia
    Excitement
    Surgical anesthesia
    Medullary paralysis

    4-Aminopyradine (4-AP) use"4-AP is For AP":
    For AP (action potential) propagation in Multiple Sclerosis.

    Osmotic diuretics: members GUM:
    Glycerol
    Urea
    Mannitol

    Sodium valproate: side effects VALPROATE:
    Vomiting
    Alopecia
    Liver toxicity
    Pancreatitis/ Pancytopenia
    Retention of fats (weight gain)
    Oedema (peripheral oedema)
    Appetite increase
    Tremor
    Enzyme inducer (liver)

    Nitrofurantoin: major side effects NitroFurAntoin:
    Neuropathy (peripheral neuropathy)
    Fibrosis (pulmonary fibrosis)
    Anemia (hemolytic anemia)
    Zafirlukast, Montelukast, Cinalukast:
    mechanism, usage"Zafir-luk-ast, Monte-luk-ast, Cina-luk-ast": • Anti-Lukotrienes for Asthma.
    • Dazzle your oral examiner: Zafirlukast antagonizes leukotriene-4.
    Zero order kinetics drugs (most common ones) "PEAZ (sounds like pees) out a constant amount":
    Phenytoin
    Ethanol
    Aspirin
    Zero order
    • Someone that pees out a constant amount describes zero order kinetics (always the same amount out)

    Hepatic necrosis: drugs causing focal to massive necrosis
    "Very Angry Hepatocytes":
    Valproic acid
    Acetaminophen
    Halothane

    Steroids: side effects BECLOMETHASONE:
    Buffalo hump
    Easy bruising
    Cataracts
    Larger appetite
    Obesity
    Moonface
    Euphoria
    Thin arms & legs
    Hypertension/ Hyperglycaemia
    Avascular necrosis of femoral head
    Skin thinning
    Osteoporosis
    Negative nitrogen balance
    Emotional liability

    Amiodarone: action, side effects 6 P's:
    Prolongs action potential duration
    Photosensitivity
    Pigmentation of skin
    Peripheral neuropathy
    Pulmonary alveolitis and fibrosis
    Peripheral conversion of T4 to T3 is inhibited -> hypothyroidism


    Monoamine oxidase inhibitors:
    Members "PIT of despair":
    Phenelzine
    Isocarboxazid
    Tranylcypromine •
    A pit of despair, since MAOs treat depression

    Warfarin: metabolism SLOW:
    • Has a slow onset of action.
    • A quicK Vitamin K antagonist, though.
    Small lipid-soluble molecule
    Liver: site of action
    Oral route of administration.
    Warfarin


    Propythiouracil (PTU):
    Mechanism It inhibits PTU:
    Peroxidase/ Peripheral deiodination
    Tyrosine iodination Union (coupling)


    Antibiotics contraindicated during pregnancy MCAT:
    Metronidazole
    Chloramphenicol
    Aminoglycoside
    Tetracycline

    Beta-blockers:
    nonselective beta-blockers"Tim Pinches His Nasal Problem"
    (because he has a runny nose...):
    Timolol
    Pindolol
    Hismolol
    Naldolol
    Propranolol

    Methyldopa:
    side effects METHYLDOPA:
    Mental retardation
    Electrolyte imbalance
    Tolerance
    Headache/ Hepatotoxicity psYcological upset
    Lactation in female
    Dry mouth
    Oedema
    Parkinsonism
    Anaemia (haemolytic)

    Lithium: side effects LITH:
    Leukocytosis
    Insipidus [diabetes insipidus, tied to polyuria]
    Tremor/ Teratogenesis
    Hypothyroidism

    Respiratory depression inducing drugs "STOP breathing":
    Sedatives and hypnotics
    Trimethoprim
    Opiates
    Polymyxins


    Benzodiazepenes: antidote "Ben is off with the flu":
    Benzodiazepine effects off with Flumazenil
  7. Imperial

    Imperial Guest

    Premature ejaculation: treatment 2 S's:
    SSRIs [eg: fluoxitime]
    Squeezing technique [glans pressure before climax]
    • More detail with 2 more S's:
    Sensate-focus excercises [relieves anxiety]
    Stop and start method [5-6 rehearsals of stopping stimulation before climax]

    Keober-Ross dying process: stages
    "Death Always Brings Great Acceptance":
    Denial Anger Bargaining Grieving Acceptance

    Male erectile dysfunction (MED): biological causes MED: Medicines(propranalol, methyldopa, SSRI, etc.)
    Ethanol
    Diabetes mellitus

    Male Erectile Dysfunction (MED): drugs causing it
    "STOP erection":
    SSRI (fluoxtine)
    Thioridazone
    methyldOpa
    Propranalol

    Gain: primary vs. secondary vs. tertiary
    Primary: Patient's Psyche improved.
    Secondary: Symptom Sympathy for patient.
    Tertiary: Therapist's gain.

    Depression: major episode characteristics
    SPACE DIGS:
    Sleep disruption
    Psychomotor retardation
    Appetite change
    Concentration loss
    Energy loss
    Depressed mood
    Interest wanes
    Guilt
    Suicidal tendencies

    Depression: symptoms
    BAD CRISES:
    Behavioural change (slowing down or agitation)
    Appetite change (weight loss or weight gain in the young)
    Depressed look (looking down)
    Concentration decrease (does not do serial 7s well)
    Ruminations (constant negative thoughts, hopelessness good indicator of suicidality)
    Interest (reduced interest in what is normally pleasurable)
    Sleep change (insomnia or hypersomnia, sleeping early, waking up at night, waking up feeling tired)
    Energy change (fatigue)
    Suicide

    Autistic disorder: features
    AUTISTICS:
    Again and again (repetitive behavior)
    Unusual Abilities
    Talking (language) delay
    IQ subnormal
    Social development poor
    Three years onset
    Inherited component [35% concordance]
    Cognitive impairment
    Self injury

    Sleep stages: features
    DElta waves during DEepest sleep (stages 3 & 4, slow-wave). dREaM during REM sleep.

    Narcolepsy: symptoms, epidemiology
    CHAP: Cataplexy Hallucinations Attacks of sleep Paralysis on waking
    • Usual presentation is a young male, hence "chap".

    Cluster personality disorders
    Cluster A Disorder = Atypical. Unusual and eccentric.
    Cluster B Disorder = Beast. Uncontrolled wildness.
    Cluster C Disorder = Coward [avoidant type], Compulsive [obsessive-compulsive type], or Clingy [dependent type].

    Reinforcement schedules: variable ratio
    SLOT machines show SLOwesT extinction.

    AIDS Dementia Complex (ADC): features
    AIDS:
    Atrophy of cortex
    Infection/ Inflammation
    Demyelination
    Six months death

    HM: this classic patient's lesion
    HM had Hippocampus Missing.

    Middle adolescence (14-17 years): characteristics
    HERO:
    Heterosexual crushes/ Homosexual Experience
    Education regarding short term benefits
    Risk taking
    Omnipotence
    • And there is interest in being a Hero (popular).

    Impotence causes
    PLANE:
    Psychogenic: performance anxiety
    Libido: decreased with androgen deficiency, drugs
    Autonomic neuropathy: impede blood flow redirection
    Nitric oxide deficiency: impaired synthesis, decreased blood pressure
    Erectile reserve: can't maintain an erection

    REM: features
    REM:
    Rapid pulse/ Respiratory rate
    Erection
    Mental activity increase/ Muscle paralysis
  8. Imperial

    Imperial Guest

    Vitelline duct: closure time
    VItelline duct normally closes around week VI of intrauterine life.

    Potter syndrome: features POTTER:
    Pulmonary hypoplasia
    Oligohydrominios
    Twisted skin (wrinkly skin)
    Twisted face (Potter facies)
    Extremities defects
    Renal agenesis (bilateral)

    Placenta-crossing substances "WANT My Hot Dog": Wastes
    Antibodies
    Nutrients
    Teratogens
    Microorganisms
    Hormones/ HIV
    Drugs

    Cranial and spinal neural crest: major derivatives GAMES:
    Glial cells (of peripheral ganglia)
    Arachnoid (and pia)
    Melanocytes
    Enteric ganglia
    Schwann cells

    Mesoderm components MESODERM:
    Mesothelium (peritoneal, pleural, pericardial)/ Muscle (striated, smooth, cardiac)
    Embryologic Spleen/ Soft tissue/ Serous linings/ Sarcoma/ Somite
    Osseous tissue/ Outer layer of suprarenal gland (cortex)/ Ovaries
    Dura/ Ducts of genitalia
    Endothelium
    Renal Microglia
    Mesenchyme/ Male gonad

    Vasculogenesis vs. angiogenesis
    "Vascu is new. Angi is pre": Vasculogenesis is new vessels developing in situ from existing mesenchyme. Angiogenesis is vessels develop from sprouting off pre-existing arteries.

    Weeks 2, 3, 4 of development: an event for each
    Week Two: Bilaminar germ disc.
    Week Three: Trilaminar germ disc.
    Week Four: Four limbs appear.

    Teratogenesis: when it occurs
    TEratogenesis is most likely during organogenesis--between the: Third and Eighth weeks of gestation.

    Tetrology of Fallot "Don't DROP the baby":
    Defect (VSD)
    Right ventricular hypertrophy
    Overriding aorta
    Pulmonary stenosis

    Lung development phases "Every Premature Child Takes Air":
    Embryonic period
    Pseudoglandular period
    Canalicular peroid
    Terminal sac period
    Alveolar period

    Branchial arch giving rise to aorta
    "Aor- from Four": Aorta is from fourth arch.

    Neuroectoderm derivatives
    Neuroectoderm gives rise to:
    Neurons
    Neuroglia
    Neurohypophysis
    piNeurol (pineal) gland

    Tetrology of Fallot
    "IHOP-International House of Pancakes":
    Interventricular septal defect
    Hypotrophy of right ventricle
    Overriding aorta
    Pulmonary stenosis

    Woffian duct (mesonephric duct) derivatives.
    Gardener's SEED:
    • Female: Gartner's duct, cyst
    • Male:
    Seminal vesicles
    Epididymis
    Ejaculatory duct
    Ductus deferens

    Foregut derivatives
    "Little Embryo People Do Like Swallowing, Producing Gas": Lungs Esophagus Pancreas Duodenum (proximal) Liver Stomach Pancreas Gall bladder
  9. Imperial

    Imperial Guest

    Define anisocytosis.
    varying cell sizes
    Define poikilocytosis
    varying cell shapes
    From which cells do B cells arise?
    stem cells in bone marrow
    From which cells do plasma cells differentiate?
    B cells
    How can a Nissl stain be used to differentiate microglia from oligodendroglia?
    Microglia are not discernable in a Nissl stain while oligodendroglia appear as small dark nuclei with dark chromatin
    In what type of CNS tissue (white or grey) are oligodendroglia predominant?
    white matter
    Into what cell type does a monocyte differentiate in tissues?
    Macrophages
    Name 2 substances produced by an eosinophil.
    histiminase and arylsulfatase
    Name the three types of leukocytic granulocytes.
    basophils, eosinophils, and neutrophils
    Name the two types of mononuclear leukocytes.
    lymphocytes and monocytes
    What are 2 functions of T cell lymphocytes?
    - cellular immune response - regulation of B lymphocytes and macrophages
    What are 2 morphological features of microglia?
    - small irregular nuclei - and relatively little cytoplasm
    What are 3 examples of peripheral lymphoid tissue?
    - follicles of lymph nodes - white pulp of spleen - unencapsulated lymphoid tissue
    What are 3 functions of a macrophage?
    - pagocytosis of bacteria, cell debris, and senescent red cells - scavenges damaged cells and tissues - can function as an antigen presenting cell
    What are 3 morphological characteristics of monocytes?
    - Large - Kidney-shaped nucleus - Extensive 'frosted glass' cytoplasm
    What are 4 characteristics of the plasma cell morphology?
    - Off center nucleus - Clock face chromatin distribution - Abundant RER - Well developed Golgi apparatus
    What are 4 morphologic characteristics of lymphocytes?
    - Round - Small - Densely staining nucleus - Small amount of pale cytoplasm
    What are 4 substances contained within the lysosomes of neutrophils?
    - hydrolytic enzymes - lysozyme - myeloperoxidase - lactoferrin
    What are 4 types of cells into which T cells differentiate?
    - cytotoxic T cells (MHC I, CD8) - helper T cells (MHCII, CD4) - suppressor T cells - delayed hypersensitivity T cells
    What are the 5 important causes for eosinophilia in humans?
    Neoplastic, Asthma, Allergic process, Collagen vascular disease, and Parasites (pneumonic NAACP)
    What are the blood cell diffenentiation names of the ACTIVE T CELL line beginning with the pluripotent hematopoietic stem cell? (4)
    - Pluripotent hematopoietic stem cell - Lymphoblast - T cell - Active T cell
    What are the blood cell differentiation names of the ERYTHROCYTE cell line beginning with pluripotent hematopoietic stem cell? (4)
    - Pluripotent hematopoietic stem cell - Proerythroblast - Reticulocyte - Erythrocyte
    What are the blood cell differentiation names of the MONOCYTE cell lines beginning with the pluripotent hematopoietic stem cell? (3)
    - Pluripotent hematopoietic stem cell - Mono blast - Monocyte
    What are the blood cell differentiation names of the NEUTROPHIL, EOSINOPHIL, and BASOPHIL cell lines beginning with the myeloblast stage? (6)
    - Myeloblast - Promyelocyte - Myelocyte - Metamyelocyte - Stab cell - Neutrophil, eosinophil or basophil
    What are the blood cell differentiation names of the PLASMA CELL line beginning with the pluripotent hematopoietic stem cell? (4)
    - Pluripotent hematopoietic stem cell - Lymphoblast - B cell - Plasma cell
    What are the blood cell differentiation names of the PLATELET CELL line beginning with the hematopoietic stem cell? (4)
    - Pluripotento hematopoietic stem cell - Megakaryoblast - Megakaryocyte - Platelets
    What are the components of the air-blood barrier?
    - Type I pneumocyte - tight junction - endothelial cell
    What are the steps of maturation of a B cell? (2 points)
    - maturation in the marrow - migration to peripheral lymphoid tissue
    What are the substances contained within the densly basophilic granules of the basophil? (4)
    - Heparin (anticoagulant) - histamine (vasodilator) - vasoactive amines - Slow reacting substance of anaphylaxis
    What are two basic morphological characteristics of neutrophils?
    - multilobed nucleus - large, spherical azurophilic primary granules (lysosomes)
    What are two important functions of a neutrophil?
    - acute inflammmatory response of a cell - phagocytosis
    What are two names for an increased number of red cells?
    Erythrocytosis and polycythemia
    What cell type closely resembles a mast cell?
    basophil
    What cranial nerves are commonly involved in an acoustic neuroma?
    CN VII, VIII (association with internal acoustic meatus)
    What disease is characterized by destruction of oligodendroglia?
    Multiple sclerosis
    What does CD stand for?
    cluster of differentiation
    What drug prevents mast cell degranulation?
    Cromolyn sodium
    What immunoglobulin can bind to the membrane of a mast cell?
    IgE
    What is a reticulocyte?
    a baby (developing) erythrocyte
    What is an important example of a Schwannoma?
    Acoustic neuroma
    What is another name for pulmonary sufractant?
    DPPC (dipalmitoylphosphatidylcholine)
    What is percentage of leukocytes in the blood exist as basophils?
    less than 1%
    What is the 'gap' between the myelination segment of 2 Schwann cells called?
    Node of Ranvier
    What is the advantage of the large surface area:volume ratio in erythrocytes?
    easy gas exchange (Oxygen and Carbon dioxide)
    What is the basic morphologic structure of an erythrocyte?
    Anucleate, biconcave
    What is the basic morphology of an eosinophil? (2 things)
    - bilobate nucleus - packed with large eosinophilic granules of uniform size
    What is the embryologic origin of microglia?
    mesoderm
    What is the function of Interferon gamma with relation to macrophages?
    macrophage activation
    What is the function of microglia?
    phagocytosis in CNS
    What is the function of oligodendroglia?
    myelination of multiple CNS axons
    What is the function of pulmonary surfactant?
    lowers alveolar surface tension and prevents atelectasis
    What is the function of Schwann cells?
    myelination of PNS (a Schwann cell myelinates only one PNS axon)
    What is the importance of the lecithin:sphingomyelin ratio?
    > 2.0 in fetal lung is indicative of fetal lung maturity
    What is the importance of the physiologic chloride shift in erythrocytes?
    Membranes contain the chloride bicarbonate antiport allowing the RBC to transport carbon dioxide from the the lung periphery for elimination.
    What is the last segment of lung tissue in which ciliated cells are found?
    respiratory bronchioles
    What is the last segment of lung tissue in which goblet cells are found?
    terminal broncioles (remember ciliated cells sweep away mucous produced by goblet cells and therefore run deeper)
    What is the primary function of a basophil?
    Mediates allergic reactions
    What is the primary function of a leukocyte?
    Defense against infections
    What is the primary function of a mast cell?
    Mediates allergic reactions
    What is the primary function of a plasma cell?
    production of large amounts of a specific antibody to a particular antigen
    What is the primary source of energy for erythrocytes?
    glucose (90% anaerobically degraded to lactate, 10% by HMP shunt)
    What is the process of degranulation in mast cells?
    release of histamine, heparin, and eosinophil chemotactic factors
    What is the range of concentration for leukocytes in the blood?
    4,000 - 10,000 cells per microliter
    What is the response of an eosiniphil to antigen antibody complexes?
    high degree of phagocytosis
    What is the response of microglia to tissue dammage?
    transformation into large ameboid phagocytic cells
    What is the response to microglia infected with HIV?
    fusion to form multinucleated giant cells in CNS
    What is the survival time for an erythrocyte?
    120 days
    What pathognomonic change is seen in neutrophils of a person who is folate/vitamin B12 deficient?
    hypersegmented polys
    What percentage of leukocytes exist as eosinophils in the blood?
    1 - 6%
    What percentage of leukocytes exist as neutrophils in the blood?
    40 - 75%
    What percentage of leukocytes in blood are monocytes?
    2 - 10%
    What process occurs when type I pneumocytes are damaged?
    Type II pneumocytes develop into type I
    What substance in eosinophilic granules is primarily responsible for defense against helminths and protozoan infections?
    major basic protein
    Where is the site of maturation of T lymphocytes?
    Thymus
    Which cell type constituitively secretes pulmonary surfactant?
    Type II pneumocyte
    Which cell type lines the alveoli?
    Type I pneumocyte
    Which leukemia is the result of plasma cell neoplasm?
    Multiple myeloma
    Which type of hypersensitivity reaction is a mast cell involved in?
    Type I hypersensitivity reaction
    Which type of immunity do B cells exhibit?
    humoral immunity
    After arising from the floor of the primitive pharynx, where does the thryoid diverticulum go?
    It descends down into the neck
    After the first breath at birth, what causes closure of the ductus arteriosus?
    An increase in oxygen
    After the first breath at birth, what causes the closure of the foramen ovale?
    A decrease resistance in pulmonary vasculature causes increased left atrial pressure vs. right atrial pressure
    Although the diaphragm descends during development, it maintains innervation from ____?
    C3-C5
    An easy pneumonic to remember fetal erythropoiesis is?
    Young Liver Synthesizes Blood
    At what time in the course of development is the fetus most susceptible to teratogens?
    Weeks 3-8
    Deoxygenated blood from the SVC is expelled into the pulmonary artery and ____ ____ to the lower body of the fetus.
    ductus arteriosus
    Do the cardiovascular structures arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Do the chromaffin cells of the adrenal medulla arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the enterochromaffin cells arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the lungs arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Do the lymphatics arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Do the melanocytes arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the neural crest cells arise from mesoderm, ectoderm, or endoderm?
    Ectoderm
    Do the odontoblasts arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the parafollicular (C) cells of the thyroid arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the Schwann cells arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Do the urogenital structures arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does blood arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does bone arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does muscle arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the thyroid arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the adrenal cortex arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the ANS arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Does the celiac ganglion arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Does the dorsal root ganglion arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Does the dura connective tissue arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the gut tube epithelium arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the liver arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the pancreas arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the parathyroid arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    Does the pia arise from neural crest (ectoderm), mesoderm, or endoderm?
    Neural Crest (Ectoderm)
    Does the serous linings of body cavities arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the spleen arise from neural crest (ectoderm), mesoderm, or endoderm?
    Mesoderm
    Does the thymus arise from neural crest (ectoderm), mesoderm, or endoderm?
    Endoderm
    From what does the ligamentum teres hepatis arise?
    Umbilical vein
    How does a bicornate uterus form?
    Results from incomplete fusion of the paramesonephric ducts
    How does a cleft lip form?
    Failure of fusion of the maxillary and medial nasal processes
    How does a cleft palate form?
    Failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine process
    How does a horseshoe kidney form?
    Inferior poles of both kidneys fuse, as they ascend from the pelvis during development they get trapped under the inferior mesenteric artery, and remain low in the abdomen
    How is meckel's diverticulum different than an omphalomesenteric cyst?
    Omphalomesenteric cyst is a cystic dilatation of the vitelline duct
    How long does full development of spermatogenesis take?
    2 months
    How many arteries and veins does the umbilical cord contain?
    - 2 umbilical arteries (carries deoxygenated blood away from fetus) - 1 umbilical vein (oxygenated blood to fetus)
    Is a primary spermatocyte 2N or 4N?
    4N
    Is a primary spermatocyte haploid or diploid?
    Diploid, 4N
    Is a secondary spermatocyte haploid or diploid?
    Haploid, 2N
    Is a secondary spermatocyte N or 2N?
    2N
    Is a speratogonium haploid or diploid?
    Diploid, 2N
    Is a spermatid haploid or diploid?
    Haploid, N
    Meiosis I is arrested in which phase until ovulation?
    Prophase
    Meiosis II is arrested in which phase until fertilization?
    Metaphase (an egg MET a sperm)
    Most oxygenated blood reaching the heart via IVC is diverted through the ____ ____ and pumped out the aorta to the head.
    foramen ovale
    The right common cardinal vein and right anterior cardinal vein give rise to what adult heart structure?
    Superior vena cava
    The stapedius muscle of the ear is formed by which branchial arch?
    2nd
    This type of bone formation consists of ossification of cartilaginous molds and forms long bones at primary and secondary centers.
    Endochondral
    True or False, blood in the umbilical vein is 100% saturated with oxygen?
    False, it is 80% saturated
    True or False, there are two types of spermatogonia?
    True, type A & type B
    What are the 1st branchial arch derivatives innervated by?
    CN V2 and V3
    What are the 2nd branchial arch derivatives innervated by?
    CN VII
    What are the 3rd branchial arch derivatives innervated by?
    CN IX
    What are the 4th and 6th branchial arch derivatives innervated by?
    CN X
    What are the cartilage derivatives (5) of the 4th and 6th branchial arches?
    - Thyroid - Cricoid - Arytenoids - Corniculate - Cuneiform
    What are the five 2's associated with meckel's diverticulum?
    - 2 inches long - 2 feet from the ileocecal valve - 2% of the population - Commonly presents in the first 2 years of life - May have 2 types of epithelia
    What are the rule of 2's for the 2nd week of development?
    - 2 germ layers: epiblast & hypoblast - 2 cavities: amniotic cavity & yolk sac - 2 components to the placenta: cytotrophoblast & syncytiotrophoblast
    What are the rule of 3's for the 3rd week of development?
    3 germ layers (gastrula): ectoderm, mesoderm, endoderm
    What can a persistent cervical sinus lead to?
    A branchial cyst in the neck
    What can be found in the cortex of the thymus?
    It is dense with immature T cells
    What can be found in the medulla of the thymus?
    It is pale with mature T cells, epithelial reticular cells, and Hassall's corpuscles
    What connects the thyroid diverticulum to the tongue?
    The thyroglossal duct
    What devlopmental contributions does the 5th branchial arch make?
    None
    What do the 2nd - 4th branchial clefts form, which are obliterated by proliferation of the 2nd arch mesenchyme?
    Temporary cervical sinuses
    What does aberrant development of the 3rd and 4th pouches cause?
    DiGeorge's syndrome
    What does the 1st aortic arch give rise to?
    Part of the maxillary artery
    What does the 2nd pharyngeal pouch develop into?
    Epithelial lining of the palantine tonsils
    What does the 3rd aortic arch give rise to?
    Common carotid artery and proximal part of the internal carotid artery
    What does the 4th pharyngeal pouch develop into?
    Superior parathyroids
    What does the 5th aortic arch give rise to?
    Nothing
    What does the 5th pharyngeal pouch develop into?
    C cells of the thyroid
    What does the 6th aortic arch give rise to?
    The proximal part of the pulmonary arteries and (on left only) ductus arteriosus
    What does the ductus arteriosus give rise to?
    Ligamentum arteriosum
    What does the ductus venosus shunt blood away from?
    Liver
    What does the first branchial cleft develop into?
    The external auditory meatus
    What does the foramen ovale give rise to?
    Fossa ovalis
    What does the left 4th aortic arch give rise to?
    Aortic arch
    What does the ligamentum venosum come from?
    Ductus venosus
    What does the notochord give rise to?
    Nucleus Pulposus
    What does the primitive atria give rise to?
    Trabeculated left and right atrium
    What does the primitive ventricle give rise to?
    Trabeculated parts of the left and right ventricle
    What does the right 4th aortic arch give rise to?
    Proximal part of the right subclavian artery
    What does the right horn of the sinus venosus give rise to?
    Smooth part of the right atrium
    What does the spleen arise from?
    Dorsal mesentery, but is supplied by the artery of the foregut
    What does the thymus arise from?
    Epithelium of the 3rd branchial pouch
    What does the thyroid diverticulum arise from?
    The floor of the primitive pharynx
    What does the truncus arteriosus give rise to?
    The ascending aorta and pulmonary trunk
    What does the umbilical arteries give rise to?
    Medial umbilical ligaments
    What ear muscle does the 1st branchial arch form?
    Tensor tympani
    What effect does 13-cis-retinoic acid have on the fetus?
    Extremely high risk for birth defects
    What effect does ACE inhibitors have on the fetus?
    Renal Damage
    What effect does iodide have on the fetus?
    Congenital goiter or hypothyroidism
    What effect does warfarin and x-rays have on the fetus?
    Multiple anomalies
    What effects does cocaine have on the fetus?
    Abnormal fetal development and fetal addiction
    What embryonic structure are the smooth parts of the left and right ventricle derived from?
    Bulbus cordis
    What embryonic structure does the coronary sinus come from?
    Left horn of the sinus venosus
    What embryonic structure does the median umbilical ligament come from?
    Allantois (urachus)
    What fetal landmark has developed within week 2 of fertilization?
    Bilaminar disk
    What fetal landmark has occurred within week 1 of fertilization?
    Implantation
    What fetal landmark has occurred within week 3 of fertilization?
    Gastrulation
    What fetal landmarks (2) have developed within week 3 of fertilization?
    Primitive streak and neural plate begin to form
    What five things arise from neuroectoderm?
    - Neurohypophysis - CNS neurons - Oligodendrocytes - Astrocytes - Pineal gland
    What four structures make up the diaphragm?
    - Septum transversum - pleuroperitoneal folds - body wall - dorsal mesentery of esophagus
    What four things arise from surface ectoderm?
    - Adenohypophysis - Lens of eye - Epithelial linings - Epidermis
    What four things does Meckel's cartilage (from the 1st arch) develop into?
    - Mandible - Malleus - Incus - Sphenomandibular ligament
    What four things does Reichert's cartilage (from the 2nd arch) develop into?
    - Stapes - Styloid process - Lesser horn of hyoid - Stylohyoid ligament
    What four things does the dorsal pancreatic bud become?
    Body, tail, isthmus, and accessory pancreatic duct
    What four things does the mesonephric (wolffian) duct develop into?
    - Seminal vesicles - Epididymis - Ejaculatory duct - Ductus deferens
    What induces the ectoderm to form the neuroectoderm (neural plate)?
    Notochord
    What is a hiatal hernia?
    Abdominal contents herniate into the thorax due to incomplete development of the diaphragm
    What is a hypospadias?
    Abnormal opening of penile urethra on inferior side of penis due to failure of urethral folds to close
    What is a single umbilical artery associated with?
    Congenital and chromosomal anomalies
    What is a urachal cyst or sinus a remnant of?
    The allantois
    What is an abnormal opening of penile urethra on superior side of penis due to faulty positioning of the genital tubercle?
    Epispadias
    What is associated with an epispadias?
    Exstrophy of the bladder
    What is Meckel's diverticulum?
    Persistence of the vitelline duct or yolk sac
    What is oligohydramnios associated with?
    Bilateral renal agenesis or posterior urethral valves (in males)
    What is oligohydramnios?
    < 0.5 L of amniotic fluid
    What is polyhydramnios associated with?
    Esophageal/duodenal atresia, anencephaly
    What is polyhydramnios?
    > 1.5-2 L of amniotic fluid
    What is Potter's syndrome?
    Bilateral renal agenesis, that results in ologohydramnios causing limb and facial deformities and pulmonary hypoplasia (Babies with Potter's can’t pee in utero)
    What is the acrosome of sperm derived from?
    Golgi apparatus
    What is the female homologue to the corpus spongiosum in the male?
    Vestibular bulbs
    What is the female homologue to the prostate gland in the male?
    Urethral and paraurethral glands (of Skene)
    What is the female homologue to the scrotum in the male?
    Labia majora
    What is the female homologue to the ventral shaft of the penis in the male?
    Labia minora
    What is the flagellum (tail) derived from?
    One of the centrioles
    What is the food supply of sperm?
    Fructose
    What is the male homologue to the glans clitoris in the female?
    Glans penis
    What is the male homologue to the greater vestibular glands (of Bartholin) in the female?
    Bulbourethral glands (of Cowper)
    What is the most common congenital anomaly of the GI tract?
    Meckel's diverticulum
    What is the most common ectopic thyroid tissue site?
    The tongue
    What is the normal remnant of the thyroglossal duct?
    Foramen cecum
    What is the postnatal derivative of the notochord?
    The nucleus pulposus of the intervertebral disc
    What is the site of T-cell maturation?
    Thymus
    What part of the gut is the pancreas derived?
    Foregut
    What suppresses the development of the paramesonephric ducts in males?
    Mullerian inhibiting substance (secreted by the testes)
    What teratogenic agent causes limb defects ('flipper' limbs)?
    Thalidomide
    What three structures does the 3rd pharyngeal pouch develop into?
    - Thymus - Left inferior parathyroid - Right inferior parathyroid
    What three things does the 1st pharyngeal pouch develop into?
    - Middle ear cavity - Eustachian tube - Mastoid air cells
    What three things does the paramesonephric (mullerian) duct develop into?
    - Fallopian tube - Uterus - Part of the vagina
    What three things does the ventral pancreatic bud become?
    - Pancreatic head - uncinate process - main pancreatic duct
    What two things occur during week 4 of fetal development?
    Heart begins to beat, upper and lower limb buds begin to form
    What type of bone formation is spontaneous without preexisting cartilage?
    Intramembranous
    What type of twins would have 1 placenta, 2 amniotic sacs, and 1 chorion?
    Monozygotic twins
    What type of twins would have 2 amniotic sacs and 2 placentas?
    Monozygotic or dizygotic twins
    What will DiGeorge's syndrome lead to?
    T cell deficiency & hypocalcemia
    When do primary oocytes begin meiosis I?
    During fetal life
    When do primary oocytes complete meiosis I?
    Just prior to ovulation
    When does fetal erythropoiesis occur in the bone marrow?
    Week 28 and onward
    When does fetal erythropoiesis occur in the liver?
    Weeks 6-30
    When does fetal erythropoiesis occur in the spleen?
    Weeks 9-28
    When does organogenesis occur in the fetus?
    Weeks 3-8
    Where does positive and negative selection occur in the thymus?
    At the corticomedullary junction
    Where does spermatogenesis take place?
    Seminferous tubules
    Where is the first place fetal erythropoiesis occurs and when does this take place?
    Yolk sac (3-8 wk)
    Which aortic arch does the stapedial artery and the hyoid artery come from?
    2nd aortic arch
    Which branchial arch are the greater horn of hyoid and the stylopharyngeus muscle derived from?
    3rd branchial arch
    Which branchial arch does Meckel's cartilage develop from?
    1st arch
    Which branchial arch forms the anterior 2/3 of the tongue?
    1st arch
    Which branchial arch forms the incus and malleus of the ear?
    1st arch
    Which ear bone(s) does the 2nd branchial arch form?
    Stapes
    Which embryonic tissue are branchial clefts derived from?
    Ectoderm
    Which embryonic tissue are branchial pouches derived from?
    Endoderm
    Which is more common a hypospadias or epispadias?
    Hypospadias
    Which muscles (3) are derivatives of the 4th branchial arch?
    - Most pharyngeal constrictors - Cricothyroid - Levator veli palatini
    Which muscles (4) are derivatives of the 2nd branchial arch?
    - Muscles of facial expression - Stapedius - Stylohyoid - Posterior belly of digastric
    Which muscles (8) are derivatives of the 1st branchial arch?
    - Temporalis - Masseter - Lateral pterygoid - Medial pterygoid - Mylohyoid - Anterior belly of digastric - Tensor tympani - Tensor veli palatini
    Which muscles are derivatives of the 6th branchial arch?
    All intrinsic muscles of the larynx, except the cricothyroid
    Which pharyngeal arch does Reichert's cartilage develop from?
    2nd arch
    Which teratogenic agent causes vaginal clear cell adenocarcinoma?
    DES
    Which two branchial arches form the posterior 1/3 of the tongue?
    3rd and 4th arches
    Which two embryonic tissues are branchial arches derived from?
    Mesoderm and neural crests
    Which week of fetal development have the genitalia taken on male/female characteristics?
    Week 10
    A common football injury caused by clipping from the lateral side will damage what structures (3 answers)?
    --Medial collateral ligament --Medial meniscus --Anterior cruciate ligament
    A lumbar puncture is performed at what landmark/
    Iliac crest
    A positive anterior drawer sign indicates damage to what structure?
    Anterior cruciate ligament(ACL)
    A pudendal nerve block is performed at what landmark?
    Ischial spine
    Abnormal passive abduction of the knee indicates damage to what structure?
    Medial collateral ligament(MCL)
    Anterior' in ACL refers to what attachment?
    Tibial
    At what level is a lumbar puncture performed?
    Between L3-L4 or L4-L5
    Common peroneal nerve damage manifests what deficit?
    Loss of dorsiflexion(Foot Drop)
    Common peroneal, Tibial, Femoral, and Obturator nerves arise from what spinal cord segments (4 answers)?
    --'L4-S2 (common peroneal) --L4-S3 (tibial) --L2-L4 (femoral) and (obturator)
    Coronary artery occlusion usually occurs where?
    Left anterior descending artery (LAD)
    Do the coronary arteries fill during systole or diastole?
    Diastole
    Erection and sensation of the penis is in what dermatomes?
    S2-S4
    Femoral nerve damage manifests what deficit?
    Loss of knee jerk
    How does the course of the left recurrent laryngeal nerve differ from that of the right?
    The left wraps around the arch of the aorta and the ligamentum arteriosum while the right wraps around the subclavian artery.
    How is the appendix located?
    2/3 of the way from the umbilicus to the anterior superior iliac spine
    How many lobes are in the right and left lungs and what are their names?
    --Right has three (superior,middle,inferior) --Left has two (superior and inferior) and the lingula
    Name five portal-systemic anastomoses.
    1.Left gastric-azygous vv. 2.Superior-Middle/Inferior rectal vv. 3.Paraumbilical-inferior epigastric 4.Retroperitoneal-renal vv. 5.Retroperitoneal-paravertebral vv.
    Name the 4 ligaments of the uterus.
    --Suspensory ligament of ovaries --Transverse cervical (cardinal) ligament --Round ligament of uterus --Broad ligament
    Name the hypothenar muscles.
    --Opponens digiti minimi --Abductor digiti minimi --Flexor digiti minimi
    Name the retroperitoneal structures (9).
    1.Duodenum(2nd-4th parts) 2.Descending colon 3.Ascending colon 4.Kidney & ureters 5.Pancreas 6.Aorta 7.Inferior vena cava 8.Adrenal glands 9.Rectum
    Name the rotator cuff muscles.
    --Supraspinatus --Infraspinatus --teres minor --Subscapularis
    Name the thenar muscles
    --Opponens pollicis --Abductor pollicis brevis --Flexor pollicis brevis
    Obturator nerve damage manifests what deficit?
    Loss of hip adduction
    Pain from the diaphragm is usually referred where?
    Shoulder
    Subarachnoid space extends to what spinal level?
    S2
    The area of the body that contains the appendix is known as what?
    McBurney's point
    The femoral triangle contains what structures from lateral to medial?
    --Femoral nerve --Femoral artery --Femoral vein --Femoral Canal (lymphatics)
    The inguinal ligament exists in what dermatome?
    L1
    The kneecaps exist in what dermatome?
    L4
    The male sexual response of ejaculation is mediated by what part of the nervous system?
    Visceral and somatic nerves
    The male sexual response of emission is mediated by what part of the nervous system?
    Sympathetic nervous system
    The male sexual response of erection is mediated by what part of the nervous system?
    Parasympathetic nervous system
    The nipple exists in what dermatome?
    T4
    The recurrent laryngeal nerve arises from what cranial nerve and supplies what muscles?
    1.CN X 2.All intrinsic muscles of the larynx except the cricothyroid muscle.
    The SA and AV nodes are usually supplied by what artery?
    Right Coronary Artery (RCA)
    The spinal cord ends at what level in adults?
    L1-L2
    The umbilicus exists in what dermatome?
    T10
    The xiphoid process exists in what dermatome?
    T7
    Tibial nerve damage manifests what deficit?
    Loss of plantar flexion
    What are hernias?
    Protrusions of peritoneum through an opening, usually sites of weakness.
    What are JG cells?
    Modified smooth muscle of afferent arteriole in the juxtaglomerular apparatus of the kidney
    What are the boundaries of the inguinal (Hesselbach) triangle?
    --Inferior epigastric artery --Lateral border of the rectus abdominus --Inguinal ligament
    What are the layers encountered from the outsided down to the brain?
    --Skin --Connective tissue --Aponeurosis --Loose connective tissue --Pericranium --Dura mater --Subdural space --Arachnoid --Subarachnoid space --Pia mater --Brain
    What are the manifestations of portal hypertension?
    --Esophageal varices --Hemorrhoids --Caput medusae
    What condition is usually associated with portal hypertension?
    Alcoholic cirrhosis
    What defect may predispose an infant for a diaphragmatic hernia?
    Defective development of the pleuroperitoneal membrane
    What gut regions and structures does the celiac artery supply?
    1.Foregut 2.--Stomach to duodenum --liver --gallbladder --pancreas
    What gut regions and structures does the IMA supply?
    1.Hindgut 2.--Distal 1/3 of transverse colon to upper portion of rectum
    What gut regions and structures does the SMA supply?
    1.Midgut 2.--Duodenum to proximal 2/3 of transverse colon
    What is a diaphragmatic hernia?
    Abdominal retroperitoneal structures enter the thorax
    What is a femoral hernia?
    entrance of abdominal contents through the femoral canal.
    What is a hiatal hernia?
    Stomach contents herniate upward through the esophageal hiatus of the diaphragm
    What is the arterial blood supply difference above and below the pectinate line?
    --Superior rectal a. (Above) --Inferior rectal a. (Below)
    What is the course of a direct inguinal hernia?
    Through weak abdominal wall, into the inguinal triangle, medial to the inferior epigastric artery, through the external inguinal ring only.
    What is the course of an indirect inguinal hernia?
    Through the internal (deep) inguinal ring and the external (superficial) inguinal ring lateral to the inferior epigastric artery and into the scrotum
    What is the course of the ureters?
    Pass under uterine artery and under the ductus deferens
    What is the function of Myenteric plexus? Submucosal plexus?
    1.Coordinates motility along entire gut wall 2.Regulates local secretions, blood flow, and absorption
    What is the function of the JG cells?
    --secrete renin and erythropoietin
    What is the innervation difference above and below the pectinate line?
    --Visceral innervation (Above) --Somatic innervation (Below)
    What is the innervation of the diaphram?
    Phrenic nerve (C3,4,5)
    What is the macula densa?
    Sodium sensor in part of the distal convoluted distal tubule in the juxtaglomerular apparatus of the kidney
    What is the Myenteric plexus also known as? Submucosal plexus?
    1. Auerbach's plexus 2. Meissner's plexus
    What is the pectinate line of the rectum?
    Where the hindgut meets ectoderm in the rectum
    What is the relationship of the two pulmonary arteries in the lung hilus?
    Right anterior Left superior
    What is the usual Pathology above the pectinate line of the rectum?
    Internal hemorrhoids (not painful) Adenocarcinoma
    What is the usual Pathology below the pectinate line of the rectum?
    External hemorrhoids (painful) Squamous cell carcinoma
    What is the venous drainage difference above and below the pectinate line?
    --Superior rectal v. to IMV to portal system (Above) --Inferior rectal v. to internal pudendal v. to internal iliac v. to IVC (Below)
    What layers of the gut wall contribute to motility (4)?
    --Muscularis mucosae --Inner circular muscle layer --Myenteric plexus --Outer longitudinal muscle layer
    What layers of the gut wall contribute to support (3)?
    --Serosa --Lamina propria --Submucosa
    What muscle opens the jaw?
    Lateral pterygoid
    What nerve innervates most of the 'glossus' muscles and which is the exception?
    1.Vagus Nerve (CNX) 2.Palatoglossus (innervated by hypoglossal n.)
    What nerve innervates most of the 'palat' muscles and which is the exception?
    1.Trigeminal Nerve, Mandibular branch 2.Tensor veli palatini (innervated by vagus n)
    What nerve innervates the muscles that close and open the jaw?
    Trigeminal Nerve (V3)
    What neurons do the GI enteric plexus contain?
    Cell bodies of parasympathetic terminal effector neurons
    What part of the heart does the LAD supply?
    anterior interventricular septum
    What spinal cord levels are vertebral disk herniation most likely to occur?
    Between L5 and S1
    What structure is in the femoral triangle but not in the femoral sheath?
    --Femoral nerve
    What structures are in the carotid sheath?
    1.Internal Jugular Vein (lateral) --2.Common Carotid Artery (medial) --3.Vagus Nerve (posterior)
    What structures are pierced when doing an LP?
    1.Skin/superficial fascia 2.Ligaments(supraspinatous,interspinous,ligamentum flavum) 3.Epidural space 4.Dura mater 5.Subdural space 6.Arachnoid 7.Subarachnoid space--CSF
    What structures do the broad ligament contain (4)?
    --Round ligaments of the uterus --Ovaries --Uterine tubules --Uterine vessels
    What structures make up the bronchopulmonary segment?
    --Tertiary bronchus --Bronchial artery --Pulmonary artery
    What structures perforate the diaphragm at what vertebral levels?
    --IVC at T8 --esophagus, vagal trunks at T10 --aorta, thoracic duct, axygous vein at T12
    What three muscles close the jaw?
    --Masseter --Temporalis --Medial pterygoid
    What usually provides the blood supply for the inferior left ventricle?
    Posterior descending artery (PD) of the RCA
    When do the JG cells secrete renin?
    in response to decreased renal BP, decreased sodium delivery to distal tubule, and increased sympathetic tone
    When is damage to the recurrent laryngeal nerve most likely to happen and what are its results(2 answers)?
    1.Thyroid surgery 2.Hoarseness
    Where is the CSF found?
    Subarachnoid space
    Where is the Myenteric plexus located? Submucosal plexus?
    1.Between the inner and outer layers of smooth muscle in GI tract wall 2.Between mucosa and inner layer of smooth muscle in GI tract wall.
    Which ligament contains the ovarian vessels?
    Suspensory ligament of the ovary
    Which ligament contains the uterine vessels?
    Transverse cervical (cardinal) ligament
    Which lung is the usual site of an inhaled foreign body?
    Right lung
    Which lung provides a space for the heart to occupy?
    Left lung (in the place of the middle lobe)
    Which meningeal layer is not pierced during an LP?
    Pia mater
    Who usually gets a direct inguinal hernia? indirect hernia (and why)?
    1.Older men 2.Infants (failure of processus vaginalis to close)
    What are the 3 layers of peripheral nerves? (inner to outer)
    1) Endoneurium 2) Perineurium 3) Epineurium
    Where is type I collagen found?(7)
    1. bone 2. tendon 3. skin 4. dentin 5. fascia 6. cornea 7. late wound repair
    Where is type II collagen found? (3)
    1. cartilage (including hyaline) 2. vitreous body 3. nucleus pulposus.
    What are the functions of the major structures of the inner ear bony labyrinth?
    1. Cochlea- hearing 2. vestibule- linear acceleration 3. semicircular canals- angular acceleration.
    What are the major structures of the inner ear bony labyrinth?
    1. Cochlea 2. vestibule 3. semicircular canals
    What are the major structures of the inner ear membranous labyrinth?
    1. Cochlear duct 2. utricle. 3. saccule 4. semicircular canals.
    Name two proteins involved in the structure of macula adherens.
    1. Desmoplakin 2.Keratin
    Name 6 functions of Golgi apparatus.
    1. Distribution center of proteins and lipids from ER to plasma membrane, lysosomes, secretory vessicles 2. Modifies N-oligosaccharides on asparagine 3. Adds O-oligosaccharides to Ser and Thr residues 4. Proteoglycan assembly from proteoglycan core proteins 5. Sulfation of sugars in proteoglycans and of selected tyrosine on proteins
    Name 6 functions of Golgi apparatus (continued answer)
    6. Addition of mannose-6-phosphate to specific lysosomal proteins, which targets the protein to the lysosome
    Name two proteins involved in the structure of zona adherens?
    1. E-cadherins 2. actin filaments
    Which cells are rich in smooth ER?
    1. liver hepatocytes, 2. steroid hormone-producing cells of adrenal cortex.
    Describe the immune response stimulated via Peyer's patches.
    1. M cells take up antigen. 2. stimulated B cells leave Peyer's patch and travel through lymph and blood to lamina propria of intestine. 3. In lamina propria B cells differentiate into IgA-secreting plasma cells. 4. IgA receives protective secretory component. 5. IgA is transported across epithelium to gut to deal with intraluminal Ag.
    Which cells are rich in rough ER?
    1. Mucus-secreting goblet cells of small intestine, 2. antibody-secreting plasma cells.
    What are the functions of the lymph node?
    1. Nonspecific filtration by macrophages. 2. storage/proliferation of B and T cells 3. Ab production.
    Where is type III collagen found? (5)
    1. skin 2.blood vessels 3.uterus 4.fetal tissue 5.granulation tissue
    Name five types of epithelial cell junctions.
    1. zona occludens 2.zona adherens 3.macula adherens 4.gap junction 5.hemidesmosome
    Describe microtubule arrangement of cilia.
    9+2 arrangement of microtubules.
    Describe the outer structure of a Peyer's patch.
    A Peyer's patch is 'covered' by single layer of cuboidal enterocytes, interspersed with specialized M cells (no goblet cells).
    What is a lymph node? Include information on structural components.
    A secondary lymphoid organ. Has many afferents, one or more efferents. With trabeculae. Major histological regions = Follicle, Medulla, Paracortex
    What is the primary regulatory control of zona fasciculata secretion?
    ACTH, hypothalamic CRH
    What is the primary regulatory control of zona reticularis secretion?
    ACTH, hypothalamic CRH
    What are/is the primary secretory product of the zona glomerulosa?
    aldosterone
    What do Brunner's glands secrete?
    alkaline mucus
    What is the function of liver sinusoids?
    Allow macromolecules of plasma full access to surface of liver cells through space of Disse.
    What is the function of a gap junction?
    Allows adjacent cells to communicate for electric and metabolic functions.
    What is produced by alpha cells of the Islets of Langerhans?
    alpha cells produce glucagon
    What three cell types are found in Islets of Langerhans?
    alpha, beta, and gamma cells
    What type of cells are Nissl bodies found? In what parts of the cell?
    Are found in neurons. Are not found in axon or axon hillock.
    IN what area of the spleen are B cells found?
    B cells are found within the white pulp of the spleen.
    What is type IV collagen found? (1)
    basement membrane or basal lamina
    What is produced by beta cells of the Islets of Langerhans?
    beta cells produce insulin
    What is the only GI submucosal gland?
    Brunner's glands
    Describe the histological layers of the adrenal glands (outside to in)
    Capsule, Zona glomerulosa, Zona fasciculata, Zona reticularis, Medulla.
    What are/is the primary secretory product of the adrenal medulla?
    Catecholamines (Epi, NE)
    Memo to you.
    Check out the picture in the book.
    Memo to you.
    Check out the picture in the book. p. 105
    What do the medullary cords consist of?
    Closely packed lymphocytes and plasma cells.
    What is the most common type of collagen?
    Collagen Type I - 90%
    What is the most abundant protein in the human body?
    Collagen.
    Define Islets of Langerhans.
    Collections of endocrine cells.
    What is the function of hemidesmosomes?
    Connect cells to underlying extracellular matrix.
    What are/is the primary secretory product of the zona fasciculata?
    cortisol, sex hormones.
    What is another name for macula adherens?
    Desmosome
    What is the effect of duodenal ulcers on Brunner's gland histology?
    Duodenal ulcers cause hypertrophy of Brunner's glands.
    How does dynein function in cilia function?
    Dynein causes the bending of cilium by differential sliding of doublets.
    What kind of protein is dynein?
    Dynein is an ATPase.
    Describe the role of dynein in cilia structure.
    Dynein links peripheral 9 doublets of microtubules.
    What makes endolymph?
    Endolymph is made by the stria vascularis.
    What is Endoneurium?
    Endoneurium invests single nerve fiber of the peripheral nerve.
    What is Epineurium?
    Epineurium (dense connective tissue) surrounds entire never (fascicles and blood vessels)
    What is type X collagen found? (1)
    epiphyseal plate
    Plasma is filtered on the basis of what properties?
    Filtration of plasma occurs according to net charge and size.
    How is the glomerular basement membrane formed?
    From the fusion of endothelial and podocyte basement membranes.
    What is produced by gamma cells of the Islets of Langerhans?
    gamma cells produce somatostatin.
    What is the mnemonic to remember layers and products of adrenal cortex?
    GFR (Glomerulosa, Fasciculata, Reticularis) corresponds to Salt (Na+), Sugar (glucocorticoids) and Sex (androgens) The deeper you go, the sweeter it gets.
    What is the function of hair cells?
    Hair cells are the sensory elements in both the cochlear and vestibular apparatus.
    Name a protein involved in the structure of hemidesmosomes.
    Integrin.
    What is another name for zona adherens?
    Intermediate junction.
    Describe the histological structure of sinusoids of the liver.
    Irregular 'capillaries' with round pores 100-200 nm in diameter and no basement membrane.
    What is the function of smooth ER?
    Is the site of steroid synthesis and detoxification of drugs and poisons
    What is the function of rough ER?
    Is the site of synthesis of secretory (exported proteins and of N-linked oligosaccharide addition to many proteins.
    What part of pancreas are the Islets of Langerhans concentrated?
    Islets of Langerhans are most numerous in the tail of pancreas.
    What structural defect causes Kartagener's syndrome? What is the consequence?
    Kartagener's syndrome is due to dynein arm defect. Results in immotile cilia.
    Define Pacinian corpuscles.
    Large, encapsulated sensory receptors found in deeper layers of skin at ligaments, joint capsules, serous membranes, mesenteries.
    Where are Brunner's glands located?
    Located in submucosa of duodenum
    Describe the histologic structure of sinusoids of the spleen.
    Long, vascular channels in red pulp. With fenestrated 'barrel hoop' basement membrane.
    What is the histologic change in lymph nodes during an extreme cellular immune response?
    Lymph node paracortex becomes enlarged during extreme cellular immune response.
    What is the histologic presentation of DiGeorge's syndrome?
    Lymph node paracortex is not well developed in patients with DiGeorge's syndrome.
    What kind of cells are found nearby the sinusoids of the spleen?
    Macrophages
    What are the major structures of the lymph node medulla?
    Medulla consists of medullary cords and medullary sinuses.
    What do medullary sinuses communicate with?
    Medullary sinuses communicate with efferent lymphatics.
    What do medullary sinuses consist of?
    Medullary sinuses contain reticular cells and macrophages.
    What is the function of Meissner's corpuscles?
    Meissner's corpuscles are involved in light discriminatory touch of glabrous skin.
    What is the histologic change in nephrotic syndrome? What is the consequence of this change?
    Negative charge is lost. Plasma protein is lost in urine
    What is the glomerular basement membrane coated with? (provides negative charge to filter).
    Negatively charged heparan sulfate.
    What is the most common tumor the adrenal medulla in children?
    Neuroblastoma
    What is the function of Pacinian corpuscles?
    Pacinian corpuscles are involved in pressure, coarse touch, vibration, and tension.
    What do the Islets of Langerhans arise from?
    Pancreatic buds.
    What specialized vascular structure is found in the lymph node paracortex? What is the function of this structure?
    Paracortex contains high endothelial venules (HEV). T and B cells enter from the blood through the HEV.
    What cells are found in the lymph node paracortex?
    Paracortex houses T cells.
    What is Perineurium?
    Perineurium (permeability barrier) surrounds a fascicle of nerve fibers.
    What is the most common tumor the adrenal medulla in adults?
    Pheochromocytoma
    Compare the consequences of pheochromocytoma vs. neuroblastoma on blood pressure
    Pheochromocytoma causes episodic hypertension Neuroblastoma does NOT cause episodic hypertension
    What is the space of Disse?
    Pores in liver sinusoids allowing plasma macromolecules access to liver cell surfaces.
    What is the primary regulatory control of adrenal medulla secretion?
    Preganglionic sympathetic fibers
    What is the function of zona occludens?
    Prevents diffusion across intracellular space.
    Describe the appearance and status of primary vs. secondary follicles.
    Primary follicles are dense and dormant. Secondary follicles have pale central germinal centers and are active.
    Describe the location of the lymph node paracortex.
    Region of cortex between follicles and medulla.
    What is the primary regulatory control of zona glomerulosa secretion?
    Renin-angiotensin
    What is the glomerular basement membrane responsible for?
    Responsible for the actual filtration of plasma.
    What is another name for type III collagen?
    reticulin
    What are Nissl bodies?
    rough ER
    Where in the inner ear are the ampullae found? What is the function of this structure?
    Semicircular canals contain ampullae Functions in detecting angular acceleration.
    What are/is the primary secretory product of the zona reticularis?
    sex hormones (e.g. androgens)
    What is the function of lymph node follicles?
    Site of B-cell localization and proliferation.
    Define macula adherens.
    Small, discrete sites of attachment of epithelial cells.
    Define Meissner's corpuscles.
    Small, encapsulated sensory receptors found in dermis of palm, soles and digits of skin.
    What is an M cell? What is it's function.
    Specialized cell interspersed between the cuboidal enterocytes covering a Peyer's patch. M cells take up antigens.
    Name the layers of epidermis from surface to base.
    stratum Corneum, stratum Lucidum, stratum Granulosum, stratum Spinosum, stratum Basalis.
    What is the location of zona adherens?
    Surrounds the perimeter just below zona occludens.
    What is the function of Nissl bodies?
    Synthesize enzymes (e.g. ChAT) and peptide neurotransmitters.
    In what area of the spleen are T cells found?
    T cells are found in the PALS and the red pulp of the spleen.
    Which part of the cochlea picks up high frequency sound? Which picks up low frequency?
    The base of the cochlea picks up high frequency sound the apex picks up low frequency sound
    What is the bony labyrinth filled with? Describe its composition.
    The bony labyrinth is filled with perilymph. Perilymph is Na+ rich, similar to ECF
    What is the cause of I cell disease? What is the consequence?
    The failure of addition of mannose-6-phosphate to lysosome proteins. These enzymes are secreted outside the cell instead of being targeted to the lysosome.
    What is the membranous labyrinth filled with? Describe its composition.
    The membranous labyrinth is filled with endolymph. Endolymph is K+ rich, similar to ICF.
    What layer of the peripheral nerve must be rejoined in microsurgery for limb reattachment?
    The perineurium must be rejoined in microsurgery for limb reattachment.
    Where in the inner ear are the maculae found? What is the function of this structure?
    The utricle and saccule contain maculae Functions in detecting linear acceleration.
    How is the function of gap junctions accomplished?
    Through a connection with central channels.
    What is another name for zona occludens?
    Tight junction.
    What are mnemonics for remembering locations for type I, II and IV collagen?
    Type ONE: bONE Type TWO: carTWOlage Type FOUR: under the FLOOR (basement membrane)
    What is a Peyer's patch?
    Unencapsulated lymphoid tissue found in lamina propria and submucosa of small intestine.
    What type of infection may induce an extreme cellular immune response? What happens to the lymph node during such an immune response?
    Viral response is an example. The paracortex enlarges.
    According to the Homunculus man, place the following in order (from medial to lateral). hand, foot, tongue, face, trunk
    foot, trunk, hand, face, tongue
    (T or F) Can Bell's palsy occur idiopathically?
    true
    (T or F) Can fasiculations be present in a LMN lesion?
    True
    (T or F) Is the anterior nucleus of the thalamus part of the limbic system?
    True
    (T or F) Is the cingulate gyrus part of the limbic system?
    True
    (T or F) Is the Entrorhinal cortex part of the limbic system?
    True
    (T or F) Is the hippocampal formation part of the limbic system?
    True
    (T or F) Is the mammillary body part of the limbic system?
    True
    (T or F) Is the septal area part of the limbic system?
    True
    (T or F) Thoracic outlet syndrome results in atrophy of the interosseous muscles?
    True
    (T or F) Thoracic outlet syndrome results in atrophy of the thenar and hypothenar eminences?
    True
    (T or F) Thoracic outlet syndrome results in disappearance of the radial pulse upon moving the head to the opposite side?
    True
    (T or F) Thoracic outlet syndrome results in sensory deficits on the medial side of the forearm and hand?
    True
    A lesion of the globus pallidus causes what disease?
    Wilson's disease
    A lesion of the mammillary bodies (bilateraly) produces what?
    Wernicke-Korsakoff's encephalopathy (confabulations, anterograde amnesia)
    A lesion of the optic chiasm produces?
    bitemporal hemianopsia
    A lesion of the right dorsal optic radiation (parietal lesion) produces?
    left lower quadrantic anopsia (a temporal lesion)
    A lesion of the right Meyer's loop (temporal lobe) produces?
    left upper quadrantic anopsia (a temporal lesion)
    A lesion of the right optic nerve produces?
    right anopsia
    A lesion of the right optic tract produces?
    left homonymous hemianopsia
    A lesion of the right visual fibers just prior to the visual cortex produces?
    left hemianopsia with macular sparing
    A lesion of the Striatum can cause which 2 diseases?
    Huntington's and Wilson's disease
    A positive Babinski is an indicator for a (UMN or LMN) lesion?
    UMN lesion
    A rupture of the middle menigeal artery causes what type of hematoma? (epidural or subdural)
    epidural hematoma
    A rupture of the superior cerebral veins causes what type of hematoma? (epidural or subdural)
    subdural hematoma
    An aneurysm of the anterior communicating artery may cause what type of defects?
    visual defects
    An aneurysm of what artery may cause CN III palsy?
    posterior communicating artery
    Are D1 neurons in the basal ganglia inhibitory or excitatory?
    Excitatory
    Are D2 neurons in the basal ganglia inhibitory or excitatory?
    Inhibitory
    Beginning with anterior communicating artery describe the path around the circle of Willis.
    ant. comm. - ACA - ICA - post. comm. - PCA - PCA - post. comm. - ICA - ACA - ant. comm.
    Bell's Palsy is seen as a complication in what 5 things?
    AIDS, Lyme disease, Sarcoidosis, Tumors, Diabetes (ALexander Bell with STD)
    Brodmann's area 17 is?
    principal visual cortex
    Brodmann's area 22 is?
    Wernicke's area (associative auditory cortex)
    Brodmann's area 3,1,2 is?
    principal sensory area
    Brodmann's area 4 is?
    principal motor area
    Brodmann's area 41, 42 is?
    primary auditory cortex
    Brodmann's area 44, 45 is?
    Broca's area (motor speech)
    Brodmann's area 6 is?
    premotor area
    Brodmann's area 8 is?
    frontal eye movement and pupilary change area
    CN I has what function?
    smell
    CN I passes through what 'hole'?
    cribriform plate
    CN II has what function?
    sight
    CN II passes through what 'hole'?
    optic canal
    CN III has what 4 functions?
    eye movement, pupil constriction, accommodation, eyelid opening
    CN III inervates what 5 muscles.
    medial rectus, superior rectus, inferior rectus, inferior oblique, levator palpebrae superioris
    CN III passes through what 'hole'?
    superior orbital fissure
    CN IV has what function?
    eye movement
    CN IV inervates what muscle.
    superior oblique
    CN IV passes through what 'hole'?
    superior orbital fissure
    CN IX has what 4 functions?
    posterior 1/3 taste, swallowing, salivation (parotid), monitoring carotid body and sinus
    CN IX passes through what 'hole'?
    jugular foramen
    CN V has what 2 functions?
    mastication, facial sensation
    CN V1 passes through what 'hole'?
    superior orbital fissure
    CN V2 passes through what 'hole'?
    foramen rotundum
    CN V3 passes through what 'hole'?
    foramen ovale
    CN VI has what function?
    eye movement
    CN VI inervates what muscle.
    lateral rectus
    CN VI passes through what 'hole'?
    superior orbital fissure
    CN VII has what 4 functions?
    facial movement, anterior 2/3 taste, lacrimation, salivation(SL, SM glands)
    CN VII passes through what 'hole'?
    internal auditory meatus
    CN VIII has what 2 functions?
    hearing, balance
    CN VIII passes through what 'hole'?
    internal auditory meatus
    CN X has what 5 functions?
    taste, swallowing, palate elevation, talking, thoracoabdominal viscera
    CN X passes through what 'hole'?
    jugular foramen
    CN XI has what 2 functions?
    head turning, shoulder shrugging
    CN XI passes through what 'hole'?
    jugular foramen (descending) -- foramen magnum (ascending)
    CN XII has what function?
    tounge movements
    CN XII passes through what 'hole'?
    hypoglossal canal
    Complete the muscle spindle reflex arc by placing the following in order: alpha motor, Ia afferent, muscle stretch, extrafusal contraction, intrafusal stretch.
    muscle stretch - intrafusal stretch - Ia afferent - alpha motor - extrafusal contraction
    Extrafusal fibers are innervated by what motor neuron?
    alpha motor neuron
    From which 3 spinal roots does long thoracic nerve arises?
    C5, C6, C7
    General sensory/motor dysfunction and aphasia are caused by stroke of the? (ant. circle or post. circle)
    anterior circle
    Give 3 characteristics of a LMN lesion.
    atrophy, flaccid paralysis, absent deep tendon reflexes
    Give 3 charateristics of internuclear ophthalmoplegia (INO)
    medial rectus palsy on lateral gaze, nystagmus in abducted eye, normal convergence.
    Give 4 characteristics of an UMN lesion.
    spastic paralysis, increased deep tendon reflexes, + Babinski, minor to no atrophy
    Golgi tendon organs send their signal via what nerve?
    group Ib afferents
    Horner's Syndrome is present if the lesion in Brown-Sequard is above what level?
    T1
    How are the fibers of the corticospinal tract laminated? (legs/arms medial or lateral?)
    arms- medial, legs-lateral
    How are the fibers of the dorsal column laminated? (legs/arms medial or lateral?)
    legs-medial, arms-lateral
    How are the fibers of the spinothalmic tract laminated? (sacral/cervical medial or lateral?)
    cervical-medial, sacral-lateral
    How do glucose and amino acids cross the blood-brain barrier?
    carrier-mediated transport mechanism
    How does the hypothalamus control the adenohypophysis?
    via releasing factors (ie. TRH, CRF, GnRF, etc.)
    Huntington's patients typically have what type of movements?
    Chorea
    If the radial nerve is lesioned, what 2 reflexes are lost?
    triceps reflex and brachioradialis reflex
    If you break your humerus mid-shaft, which nerve would likely injure?
    radial nerve
    If you break your medial epicondyle of the humerus, which nerve would likely injure?
    ulnar nerve
    If you break your supracondyle of the humerus, which nerve would likely injure?
    median nerve
    If you break your surgical neck of the humerus, which nerve would likely injure?
    axillary nerve
    In a lesion of the radial nerve, what muscle is associated with wrist drop?
    extensor carpi radialis longus
    Intrafusal fibers are encapsulated and make up muscle spindles that send their signal via what nerve?
    group Ia afferents
    Intrafusal fibers are innervated by what motor neuron?
    gamma motor neuron
    Is Bell's palsy an UMN or a LMN lesion?
    LMN
    Is the Babinski reflex (positive or negative) when the big toe dorsiflexes and the other toes fan-out?
    positive (pathologic)
    Name 2 locations for lesions in Syringomyelia?
    ventral white commissure and ventral horns
    Name 3 locations for lesions in Vit.B12 neuropathy(Friedreich's ataxia)?
    dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts
    Name 7 functions of the hypothalamus?
    Thirst/waterbalance, Adenohypophysis control, Neurohypophysis control, Hunger/satiety, Autonomic regulation, Temperature regulation, Sexual emotions. TAN HATS
    Name the 4 foramina that are in the posterior cranial fossa?
    internal auditory meatus, jugular foramen, hypoglossal canal, and foramen magnum.
    Name the 5 foramina that are in the middle cranial fossa?
    optic canal, superior orbital fissure, foramen rotundum, foramen ovale, and foramen spinosum.
    Name the 5 functions of the Limbic system?
    Feeding, Fighting, Feeling, Flight, sex (F--K) [the famous 5 F's]
    Name the 5 segments of the brachial plexus in order from proximal to distal.
    roots - trunks - divisions - cords - branches
    Name the type of movement with slow writhing movements (esp. the fingers)?
    Athetosis
    Name the type of movement with sudden, jerky, purposeless movements?
    Chorea
    Name the type of movement with sudden, wild flailing of one arm?
    Hemiballismus
    Neurons from the globus pallidus have what action on the ventral anterior nucleus?
    Inhibitory
    Neurons from the striatum have what action on the globus pallidus?
    Inhibitory
    Place the following in order (from light entering the eye to reflex). Pretectal nuclei, pupillary constrictor muscle, retina, ciliary ganglion, Edinger-Westphal nuclei, CN II, CN III.
    retina, CN II, pretectal nuclei, Edinger-Westphal nuclei, CN III, ciliary ganglion, pupillary constrictor muscle
    Stimulation from the paraventricular nucleus cause the release of what hormone?
    oxytocin
    Stimulation from the supraoptic nucleus cause the release of what hormone?
    ADH (vasopressin)
    The Blood-Brain Barrier is formed by what 3 structures?
    choriod plexus epithelium, intracerebral capillary endothelium, astrocytes. (First Aid says Arachnoid but the brains say that’s a typo)
    The central retinal artery is a branch off what larger artery?
    ophthalmic artery
    The embryologic defect of having a cervical rib can compress what 2 structures?
    subclavian artery and inferior trunk of the brachial plexus
    The fasciculus cuneatus contains fibers from the upper or lower body?
    upper extremities
    The fasciculus gracilis contains fibers from the upper or lower body?
    lower extremities
    The hippocampal formation is connected to the mammillary body and septal area via what structure?
    fornix
    The hippocampus has input from what two areas?
    entorhinal cortex, septal area
    The hippocampus has output to what two areas?
    mammillary body, septal area
    The infraorbital nerve is a branch off what larger nerve?
    CN V2
    The Nucleus Ambiguus has fibers from what 3 CNs?
    CN IX, X, XII
    The Nucleus Solitarius has fibers from what 3 CNs?
    CN VII, IX, X
    Traction or tear of the superior trunk of the brachial plexus causes what syndrome?
    Erb-Duchenne palsy (waiter's tip)
    Vertigo, ataxia, visual deficits, and coma are caused by stroke of the? (ant. circle or post. circle)
    posterior circle
    Visual fibers from the lateral geniculate body terminate on the upper and lower banks of what fissure?
    Calcarine fissure
    What 1 nerve root is assoc. with the achilles reflex?
    S1
    What 1 nerve root is assoc. with the biceps reflex?
    C5
    What 1 nerve root is assoc. with the patella reflex?
    L4
    What 1 nerve root is assoc. with the triceps reflex?
    C7
    What 2 areas have sensation deficit in a lesion of the median nerve?
    lateral palm/thumb and the radial 2 1/2 fingers
    What 2 areas have sensation deficit in a lesion of the ulnar nerve?
    medial palm and the ulnar 1 1/2 fingers
    What 2 cutaneus nerves are lost in a lesion of the radial nerve?
    posterior brachial cutaneous and posterior antebrachial cutaneous
    What 2 spinal roots make up the inferior trunk of the brachial plexus?
    C8, T1
    What 2 spinal roots make up the superior trunk of the brachial plexus?
    C5, C6
    What 2 structures pass through the internal auditory meatus?
    CN VII, VIII
    What 2 symptoms are seen with a lesion of the musculocutaneus nerve?
    difficulty flexing the arm, variable sensory loss
    What 2 symptoms are seen with a lesion of the ulnar nerve?
    weak intrinsic muscles of the hand, Pope's blessing
    What 3 blood barriers does the body have?
    blood-brain, blood-gas, blood-testis
    What 3 muscles are lost in a lesion of the musculocutaneous nerve?
    coracobrachialis, biceps brachii, and brachialis
    What 3 muscles are lost in a lesion of the radial nerve?
    triceps brachii, brachioradialis, and extensor carpi radialis longus
    What 3 structures pass through the foramen magnum?
    spinal roots of CN XI(ascending), brainstem, vertebral arteries
    What 3 structures pass through the optic canal?
    CN II, ophthalmic artery, central retinal vein
    What 4 'muscles' does the radial nerve innervate?
    Brachioradialis, Extensors of the wrist and fingers, Supinator, Triceps. (BEST)
    What 4 areas is there decreased output in Parkinson's?
    substantia nigra pars compacta, globus pallidus, ventral anterior nucleus, cortex
    What 4 movements are limpaired in a lesion of the ulnar nerve?
    wrist flextion, wrist addduction, thumb adduction, and adductiont of the 2 ulnar fingers
    What 4 movements are lost in a lesion of the median nerve?
    forearm pronation, wrist flexion, finger flexion, and several thumb movements
    What 4 structures pass through the jugular foramen?
    CN IX, X, XI(descending), jugular vein
    What 4 things do the lateral striate arteries supply?
    internal capsule, caudate, putamen, globus pallidus
    What 5 spinal nerves that make up the brachial plexus?
    C5, C6, C7, C8, T1
    What 5 structures pass through the supperior orbital fissure?
    CN III, IV, V1, VI, ophthalmic vein
    What 5 types of cells make up the suportive cells of the CNS/PNS?
    Astrocytes, Microglia, Oligodendroglia, Schwann cells, Ependymal cells.
    What are 2 characteristics of Tabes Dorsalis?
    impaired proprioception and locomotor ataxia
    What are 3 clinical findings of the arm in Erb-Duchenne palsy?
    arm hangs by the side, medially rotated, forearm is pronated
    What are the 2 classic causes of Erb-Duchenne palsy?
    blow to the shoulder and trauma during birth
    What are the 3 classic symptoms of Horner's syndrome?
    ptosis, miosis, anhydrosis
    What are the 4 classic findings of Brown-Sequard syndrome?
    ipsi mo
  10. Imperial

    Imperial Guest

    A common side effects of INF treatment is?
    Neutropenia
    Antimicrobial prophylaxis for a history of recurrent UTIs
    TMP-SMZ
    Antimicrobial prophylaxis for Gonorrhea
    Ceftriaxone
    Antimicrobial prophylaxis for Meningococcal infection
    Rifampin (DOC), minocycline
    Antimicrobial prophylaxis for PCP
    TMP-SMZ (DOC), aerosolized pentamidine
    Antimicrobial prophylaxis for Syphilis
    Benzathine penicillin G
    Are Aminoglycosides Teratogenic?
    Yes
    Are Ampicillin and Amoxicillin penicillinase resistant?
    No
    Are Carbenicillin, Piperacillin, and Ticarcillin penicillinase resistant?
    No
    Are Cephalosporins resistant to penicillinase?
    No, but they are less susceptible than the other Beta lactams
    Are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant?
    Yes
    Clinical use of Isoniazid (INH)?
    Mycobacterium tuberculosis, the only agent used as solo prophylaxis against TB
    Common side effects associated with Clindamycin include?
    Pseudomembranous colitis (C. difficile), fever, diarrhea
    Common toxicities associated with Fluoroquinolones?
    GI upset, Superinfections, Skin rashes, Headache, Dizziness
    Common toxicities associated with Griseofulvin are…...?
    Teratogenic, Carcinogenic, Confusion, Headaches
    Describe the MOA of Interferons (INF)
    Glycoproteins from leukocytes that block various stages of viral RNA and DNA synthesis
    Do Tetracyclines penetrate the CNS?
    Only in limited amounts
    Does Ampicillin or Amoxicillin have a greater oral bioavailability?
    AmOxicillin has greater Oral bioavailability
    Does Amprotericin B cross the BBB?
    No
    Does Foscarnet require activation by a viral kinase?
    No
    Foscarnet toxicity?
    Nephrotoxicity
    Ganciclovir associated toxicities?
    Leukopenia, Neutropenia, Thrombocytopenia, Renal toxicity
    How are INFs used clinically?
    Chronic Hepatitis A and B, Kaposi's Sarcoma
    How are Sulfonamides employed clinically?
    Gram +, Gram -, Norcardia, Chlamydia
    How are the HIV drugs used clinically?
    Triple Therapy' 2 Nucleoside RT Inhibitors with a Protease Inhibitor
    How are the Latent Hypnozoite (Liver) forms of Malaria (P. vivax, P.ovale) treated?
    Primaquine
    How can Isoniazid (INH)-induced neurotoxicity be prevented?
    Pyridoxine (B6) administration
    How can the t1/2 of INH be altered?
    Fast vs. Slow Acetylators
    How can the toxic effects fo TMP be ameliorated?
    With supplemental Folic Acid
    How can Vancomycin-induced 'Red Man Syndrome' be prevented?
    Pretreat with antihistamines and a slow infusion rate
    How do Sulfonamides act on bacteria?
    As PABA antimetabolites that inhibit Dihydropteroate Synthase, Bacteriostatic
    How do the Protease Inhibitors work?
    Inhibt Assembly of new virus by Blocking Protease Enzyme
    How does Ganciclovir's toxicity relate to that of Acyclovir?
    Ganciclovir is more toxic to host enzymes
    How does resistance to Vancomycin occur?
    With an amino acid change of D-ala D-ala to D-ala D-lac
    How is Acyclovir used clinically?
    HSV, VZV, EBV, Mucocutaneous and Genital Herpes Lesions, Prophylaxis in Immunocompromised pts
    How is Amantadine used clinically?
    Prophylaxis for Influenza A, Rubella ; Parkinson's disease
    How is Amphotericin B administered for fungal meningitis?
    Intrathecally
    How is Amphotericin B used clinically?
    Wide spectrum of systemic mycoses: Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor
    How is Chloramphenical used clinically?
    Meningitis (H. influenza, N. meningitidis, S. pneumoniae), Conserative treatment due to toxicities
    How is Foscarnet used clinically?
    CMV Retinitis in IC pts when Ganciclovir fails
    How is Ganciclovir activated?
    Phosphorylation by a Viral Kinase
    How is Ganciclovir used clinically?
    CMV, esp in Immunocompromised patients
    How is Griseofulvin used clinically?
    Oral treatment of superficial infections
    How is Leishmaniasis treated?
    Pentavalent Antimony
    How is Ribavirin used clinically?
    for RSV
    How is Rifampin used clinically?
    1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone when used of Leprosy 3. Used in combination with other drugs
    How is Trimethoprim used clinically?
    Used in combination therapy with SMZ to sequentially block folate synthesis
    How is Vancomycin used clinically?
    For serious, Gram + multidrug-resistant organisms
    How would you treat African Trypanosomiasis (sleeping sickness)?
    Suramin
    In what population does Gray Baby Syndrome occur? Why?
    Premature infants, because they lack UDP-glucuronyl transferase
    Is Aztreonam cross-allergenic with penicillins?
    No
    Is Aztreonam resistant to penicillinase?
    Yes
    Is Aztreonam usually toxic?
    No
    Is Imipenem resistant to penicillinase?
    Yes
    Is Penicillin penicillinase resistant?
    No - duh
    IV Penicillin
    G
    Mnemonic for Foscarnet?
    Foscarnet = pyroFosphate analog
    MOA for Penicillin (3 answers)?
    1)Binds penicillin-binding proteins 2) Blocks transpeptidase cross- linking of cell wall 3) Activates autolytic enzymes
    MOA: Bactericidal antibiotics
    Penicillin, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metronidazole
    MOA: Block cell wall synthesis by inhib. Peptidoglycan cross-linking (7)
    Penicillin, Ampicillin, Ticarcillin, Pipercillin, Imipenem, Aztreonam, Cephalosporins
    MOA: Block DNA topoisomerases
    Quinolones
    MOA: Block mRNA synthesis
    Rifampin
    MOA: Block nucleotide synthesis
    Sulfonamides, Trimethoprim
    MOA: Block peptidoglycan synthesis
    Bacitracin, Vancomycin
    MOA: Block protein synthesis at 30s subunit
    Aminoglycosides, Tetracyclines
    MOA: Block protein synthesis at 50s subunit
    Chloramphenicol, Erythromycin/macrolides, Lincomycin, Clindamycin, Streptogramins (quinupristin, dalfopristin)
    MOA: Disrupt bacterial/fungal cell membranes
    Polymyxins
    MOA: Unkown
    Pentamidine
    MOA:Disrupt fungal cell membranes
    Amphotericin B, Nystatin, Fluconazole/azoles
    Name common Polymyxins
    Polymyxin B, Polymyxin E
    Name several common Macrolides (3)
    Erythromycin, Azithromycin, Clarithromycin
    Name some common Sulfonamides (4)
    Sulfamethoxazole (SMZ), Sulfisoxazole, Triple sulfas, Sulfadiazine
    Name some common Tetracyclines (4)
    Tetracycline, Doxycycline, Demeclocycline, Minocycline
    Name the common Aminoglycosides (5)
    Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin
    Name the common Azoles
    Fluconazole, Ketoconazole, Clotrimazole, Miconazole, Itraconazole
    Name the common Fluoroquinolones (6)
    Ciprofloxacin, Norfloxacin, Ofloxacin, Grepafloxacin, Enoxacin, Nalidixic acid
    Name the common Non-Nucleoside Reverse Transcriptase Inhibitors
    Nevirapine, Delavirdine
    Name the common Nucleoside Reverse Transcriptase Inhibitors
    Zidovudine (AZT), Didanosine (ddI), Zalcitabine (ddC), Stavudine (d4T), Lamivudine (3TC)
    Name the Protease Inhibitors (4)
    Saquinavir, Ritonavir, Indinavir, Nelfinavir
    Name two classes of drugs for HIV therapy
    Protease Inhibitors and Reverse Transcriptase Inhibitors
    Name two organisms Vancomycin is commonly used for?
    Staphlococcus aureus and Clostridium difficile (pseudomembranous colitis)
    Oral Penicillin
    V
    Resistance mechanisms for Aminoglycosides
    Modification via Acetylation, Adenylation, or Phosphorylation
    Resistance mechanisms for Cephalosporins/Penicillins
    Beta-lactamase cleavage of Beta-lactam ring
    Resistance mechanisms for Chloramphenicol
    Modification via Acetylation
    Resistance mechanisms for Macrolides
    Methylation of rRNA near Erythromycin's ribosome binding site
    Resistance mechanisms for Sulfonamides
    Altered bacterial Dihydropteroate Synthetase, Decreased uptake, or Increased PABA synthesis
    Resistance mechanisms for Tetracycline
    Decreased uptake or Increased transport out of cell
    Resistance mechanisms for Vancomycin
    Terminal D-ala of cell wall replaced with D-lac; Decreased affinity
    Side effects of Isoniazid (INH)?
    Hemolysis (if G6PD deficient), Neurotoxicity, Hepatotoxicity, SLE-like syndrome
    Specifically, how does Foscarnet inhibit viral DNA pol?
    Binds to the Pyrophosphate Binding Site of the enzyme
    The MOA for Chloramphenicol is ……………..?
    Inhibition of 50S peptidyl transferase, Bacteriostatic
    Toxic effects of TMP include………?
    Megaloblastic anemia, Leukopenia, Granulocytopenia
    Toxic side effects of the Azoles?
    Hormone synthesis inhibition (Gynecomastia), Liver dysfunction (Inhibits CYP450), Fever, Chills
    Toxicities associated with Acyclovir?
    Delirium, Tremor, Nephrotoxicity
    What additional side effects exist for Ampicillin?
    Rash, Pseudomembranous colitis
    What antimicrobial class is Aztreonam syngergestic with?
    Aminoglycosides
    What are Amantadine-associated side effects?
    Ataxia, Dizziness, Slurred speech
    What are Aminoglycosides synergistic with?
    Beta-lactam antibiotics
    What are Aminoglycosides used for clinically?
    Severe Gram - rod infections.
    What are common serious side effects of Aminoglycosides and what are these associated with?
    Nephrotoxicity (esp. with Cephalosporins), Ototoxicity (esp. with Loop Diuretics)
    What are common side effects of Amphotericin B?
    Fever/Chills, Hypotension, Nephrotoxicity, Arrhythmias
    What are common side effects of Protease Inhibitors?
    GI intolerance (nausea, diarrhea), Hyperglycemia, Lipid abnormalities, Thrombocytopenia (Indinavir)
    What are common side effects of RT Inhibitors?
    BM suppression (neutropenia, anemia), Peripheral neuropathy
    What are common toxic side effects of Sulfonamides? (5)
    -Hypersensitivity reactions -Hemolysis -Nephrotoxicity (tubulointerstitial nephritis) -Kernicterus in infants Displace other drugs from albumin (e.g., warfarin)
    What are common toxicities associated with Macrolides? (4)
    GI discomfort, Acute cholestatic hepatitis, Eosinophilia, Skin rashes
    What are common toxicities associated with Tetracyclines?
    GI distress, Tooth discoloration and Inhibition of bone growth in children, Fanconi's syndrome, Photosensitivity
    What are common toxicities related to Vancomycin therapy?
    Well tolerated in general but occasionally, Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing='Red Man Syndrome'
    What are Fluoroquinolones indicated for? (3)
    1.Gram - rods of the Urinary and GI tracts (including Pseudomonas) 2.Neisseria 3. Some Gram + organisms
    What are major side effects of Methicillin, Nafcillin, and Dicloxacillin?
    Hypersensitivity reactions
    What are Methicillin, Nafcillin, and Dicloxacillin used for clinically?
    Staphlococcus aureus
    What are Polymyxins used for?
    Resistant Gram - infections
    What are the Anti-TB drugs?
    Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid (INH)
    What are the clinical indications for Azole therapy?
    Systemic mycoses
    What are the clinical uses for 1st Generation Cephalosporins?
    Gram + cocci, Proteus mirabilis, E. coli, Klebsiella pneumoniae (PEcK)
    What are the clinical uses for 2nd Generation Cephalosporins?
    Gram + cocci, Haemophilus influenza, Enterobacter aerogenes, Neisseria species, P. mirabilis, E. coli, K. pneumoniae, Serratia marcescens ( HEN PEcKS )
    What are the clinical uses for 3rd Generation Cephalosporins?
    1) Serious Gram - infections resistant to other Beta lactams 2) Meningitis (most penetrate the BBB)
    What are the clinical uses for Aztreonam?
    Gram - rods: Klebsiella species, Pseudomonas species, Serratia species
    What are the clinical uses for Imipenem/cilastatin?
    Gram + cocci, Gram - rods, and Anerobes
    What are the Macrolides used for clinically?
    -Upper respiratory tract infections -pneumonias -STDs: Gram+ cocci (streptococcal infect in pts allergic to penicillin) -Mycoplasma, Legionella,Chlamydia, Neisseria
    What are the major structural differences between Penicillin and Cephalosporin?
    Cephalosporin: 1) has a 6 member ring attached to the Beta lactam instead of a 5 member ring 2)has an extra functional group ( attached to the 6 member ring)
    What are the major toxic side effects of Imipenem/cilastatin?
    GI distress, Skin rash, and Seizures at high plasma levels
    What are the major toxic side effects of the Cephalosporins?
    1) Hypersensitivity reactions 2) Increased nephrotoxicity of Aminoglycosides 3) Disulfiram-like reaction with ethanol (those with a methylthiotetrazole group, e.g., cefamandole)
    What are the side effects of Polymyxins?
    Neurotoxicity, Acute renal tubular necrosis
    What are the side effects of Rifampin?
    Minor hepatotoxicity, Drug interactions (activates P450)
    What are toxic side effects for Metronidazole?
    Disulfiram-like reaction with EtOH, Headache
    What are toxicities associated with Chloramphenicol?
    Aplastic anemia (dose independent), Gray Baby Syndrome
    What conditions are treated with Metronidazole?
    Giardiasis, Amoebic dysentery (E. histolytica), Bacterial vaginitis (Gardnerella vaginalis), Trichomonas
    What do Aminoglycosides require for uptake?
    Oxygen
    What do you treat Nematode/roundworm (pinworm, whipworm) infections with?
    Mebendazole/Thiabendazole, Pyrantel Pamoate
    What drug is given for Pneumocystis carinii prophylaxis?
    Pentamidine
    What drug is used during the pregnancy of an HIV + mother?, Why?
    AZT, to reduce risk of Fetal Transmission
    What drug is used to treat Trematode/fluke (e.g., Schistosomes, Paragonimus, Clonorchis) or Cysticercosis
    Praziquantel
    What is a common drug interaction associated with Griseofulvin?
    Increases coumadin metabolism
    What is a mnemonic to remember Amantadine's function?
    Blocks Influenza A and RubellA; causes problems with the cerebellA
    What is a prerequisite for Acyclovir activation?
    It must be Phosphorylated by Viral Thymidine Kinase
    What is a Ribavirin toxicity?
    Hemolytic anemia
    What is an acronym to remember Anti-TB drugs?
    RESPIre
    What is an additional side effect of Methicillin?
    Interstitial nephritis
    What is an occasional side effect of Aztreonam?
    GI upset
    What is Clindamycin used for clinically?
    Anaerobic infections (e.g., B. fragilis, C. perfringens)
    What is clinical use for Carbenicillin, Piperacillin, and Ticarcillin?
    Pseudomonas species and Gram - rods
    What is combination TMP-SMZ used to treat?
    Recurrent UTIs, Shigella, Salmonella, Pneumocystis carinii pneumonia
    What is combined with Ampicillin, Amoxicillin, Carbenicillin, Piperacillin, and Ticarcillin to enhance their spectrum?
    Clavulanic acid
    What is Fluconazole specifically used for?
    Cryptococcal meningitis in AIDS patients and Candidal infections of all types
    What is Imipenem always administered with?
    Cilastatin
    What is Ketoconazole specifically used for?
    Blastomyces, Coccidioides, Histoplasma, C. albicans; Hypercortisolism
    What is Metronidazole combined with for 'triple therapy'? Against what organism?
    Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori
    What is Metronidazole used for clinically?
    Antiprotozoal: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis Anaerobes: Bacteroides, Clostridium
    What is Niclosamide used for?
    Cestode/tapeworm (e.g., D. latum, Taenia species Except Cysticercosis
    What is Nifurtimox administered for?
    Chagas' disease, American Trypanosomiasis (Trypanosoma cruzi)
    What is the chemical name for Ganciclovir?
    DHPG (dihydroxy-2-propoxymethyl guanine)
    What is the clinical use for Ampicillin and Amoxicillin?
    Extended spectrum penicillin: certain Gram + bacteria and Gram - rods
    What is the clinical use for Nystatin?
    Topical and Oral, for Oral Candidiasis (Thrush)
    What is the clinical use for Penicillin?
    Bactericidal for: Gram + rod and cocci, Gram - cocci, and Spirochetes
    What is the major side effect for Ampicillin and Amoxicillin?
    Hypersensitivity reactions
    What is the major side effect for Carbenicillin, Piperacillin, and Ticarcillin?
    Hypersensitivity reactions
    What is the major toxic side effect of Penicillin?
    Hypersensitivity reactions
    What is the memory aid for subunit distribution of ribosomal inhibitors?
    Buy AT 30, CELL at 50'
    What is the memory key for Isoniazid (INH) toxicity?
    INH: Injures Neurons and Hepatocytes
    What is the memory key for Metronidazole's clinical uses?
    GET on the Metro
    What is the memory key for organisms treated with Tetracyclines?
    VACUUM your Bed Room'
    What is the memory key involving the '4 R's of Rifampin?'
    1. RNA pol inhibitor 2. Revs up P450 3. Red/orange body fluids 4. Rapid resistance if used alone
    What is the MOA for Acyclovir?
    Inhibit viral DNA polymerase
    What is the MOA for Amphotericin B?
    Binds Ergosterol, forms Membrane Pores that Disrupt Homeostatis
    What is the MOA for Ampicillin and Amoxicillin?
    Same as penicillin. Extended spectrum antibiotics
    What is the MOA for Carbenicillin, Piperacillin, and Ticarcillin?
    Same as penicillin. Extended spectrum antibiotics
    What is the MOA for Clindamycin?
    Blocks Peptide Bond formation at the 50S subunit, Bacteriostatic
    What is the MOA for Methicillin, Nafcillin, and Dicloxacillin?
    Same as penicillin. Act as narrow spectrum antibiotics
    What is the MOA for Metronidazole?
    Forms toxic metabolites in the bacterial cell, Bactericidal
    What is the MOA for Nystatin?
    Binds ergosterol, Disrupts fungal membranes
    What is the MOA for Rifampin?
    Inhibits DNA dependent RNA polymerase
    What is the MOA for the Aminoglycosides?
    Inhibits formation of Initiation Complex, causes misreading of mRNA, Bactericidal
    What is the MOA for the Azoles?
    Inhibit Ergosterol synthesis
    What is the MOA for the Cephalosporins?
    Beta lactams - inhibit cell wall synthesis, Bactericidal
    What is the MOA for the Fluoroquinolones?
    Inhibit DNA Gyrase (topoisomerase II), Bactericidal
    What is the MOA for the Macrolides?
    Blocks translocation, binds to the 23S rRNA of the 50S subunit, Bacteriostatic
    What is the MOA for the Tetracyclines?
    Binds 30S subunit and prevents attachment of aminoacyl-tRNA, Bacteriostatic
    What is the MOA for Trimethoprim (TMP)?
    Inhibits bacterial Dihydrofolate Reductase, Bacteriostatic
    What is the MOA for Vancomycin?
    Inhibits cell wall mucopeptide formation, Bactericidal
    What is the MOA of Amantadine?
    Blocks viral penetration/uncoating; may act to buffer the pH of the endosome
    What is the MOA of Aztreonam?
    Inhibits cell wall synthesis ( binds to PBP3). A monobactam
    What is the MOA of Foscarnet?
    Inhibits Viral DNA polymerase
    What is the MOA of Ganciclovir?
    Inhibits CMV DNA polymerase
    What is the MOA of Griseofulvin?
    Interferes with microtubule function, disrupts mitosis, inhibits growth
    What is the MOA of Imipenem?
    Acts as a wide spectrum carbapenem
    What is the MOA of Isoniazid (INH)?
    Decreases synthesis of Mycolic Acid
    What is the MOA of Polymyxins?
    Bind cell membrane, disrupt osmotic properties, Are Cationc, Basic and act as detergents
    What is the MOA of Ribavirin?
    Inhibits IMP Dehydrogenase (competitively), and therefore blocks Guanine Nucleotide synthesis
    What is the MOA of the RT Inhibitors?
    Inhibit RT of HIV and prevent the incorporation of viral genome into the host DNA
    What is the most common cause of Pt noncompliance with Macrolides?
    GI discomfort
    What is treated with Chloroquine, Quinine, Mefloquine?
    Malaria (P. falciparum)
    What microorganisms are Aminoglycosides ineffective against?
    Anaerobes
    What microorganisms are clinical indications for Tetracycline therapy?
    Vibrio cholerae Acne Chlamydia Ureaplasma Urealyticum Mycoplasma pneumoniae Borrelia burgdorferi (Lyme's) Rickettsia Tularemia
    What microorganisms is Aztreonam not effective against?
    Gram + and Anerobes
    What musculo-skeletal side effects in Adults are associated with Floroquinolones?
    Tendonitis and Tendon rupture
    What neurotransmitter does Amantadine affect? How does it influence this NT?
    Dopamine; causes its release from intact nerve terminals
    What organism is Imipenem/cilastatin the Drug of Choice for?
    Enterobacter
    What organisms does Griseofulvin target?
    Dermatophytes (tinea, ringworm)
    What parasites are treated with Pyrantel Pamoate (more specific)?
    Giant Roundworm (Ascaris), Hookworm (Necator/Ancylostoma), Pinworm (Enterobius)
    What parasitic condition is treated with Ivermectin?
    Onchocerciasis ('river blindness'--rIVER-mectin)
    What populations are Floroquinolones contraindicated in? Why?
    Pregnant women, Children; because animal studies show Damage to Cartilage
    What should not be taken with Tetracyclines? / Why?
    Milk or Antacids, because divalent cations inhibit Tetracycline absorption in the gut
    What Sulfonamides are used for simple UTIs?
    Triple sulfas or SMZ
    When is HIV therapy initiated?
    When pts have Low CD4+ (< 500 cells/cubic mm) or a High Viral Load
    When is Rifampin not used in combination with other drugs?
    1. Meningococcal carrier state 2. Chemoprophylaxis in contacts of children with H. influenzae type B
    Where does Griseofulvin deposit?
    Keratin containing tissues, e.g., nails
    Which Aminoglycoside is used for Bowel Surgery ?
    Neomycin
    Which antimicrobial classes inhibit protein synthesis at the 30S subunit? (2)
    1) Aminoglycosides = bactericidal 2) Tetracyclines = bacteriostatic
    Which antimicrobials inhibit protein synthesis at the 50S subunit? (4)
    1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomycin = bacteriostatic 4)cLindamycin = bacteriostatic
    Which individuals are predisposed to Sulfonamide-induced hemolysis?
    G6PD deficient individuals
    Which RT inhibitor causes Megaloblastic Anemia?
    AZT
    Which RT inhibitors cause a Rash?
    Non-Nucleosides
    Which RT inhibitors cause Lactic Acidosis?
    Nucleosides
    Which Tetracycline is used in patients with renal failure? / Why?
    Doxycycline, because it is fecally eliminated
    Who's your daddy?
    B.W. !!!, Ha. Good Luck on Boards
    Why are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant?
    Due to the presence of a bulkier R group
    Why is Cilastatin administered with Imipenem?
    To inhibit renal Dihydropeptidase I and decrease Imipenem inactivation in the renal tubules
    List the mechanism, clinical use, & toxicity of 5 FU.
    -S-phase anti-metabolite Pyr analogue -Colon, solid tumors, & BCC/ -Irreversible myelosuppression
    List the mechanism, clinical use, & toxicity of 6 MP.
    -inhibits HGPRT (pur. Syn.) - Luk, Lymph,
    List the mechanism, clinical use, & toxicity of Bleomycin.
    -DNA intercalator -testicular & lymphomas -Pulmonary fibrosis mild myelosuppression.
    List the mechanism, clinical use, & toxicity of Busulfan.
    -Alkalates DNA -CML -Pulmonary fibrosis hyperpigmentation
    List the mechanism, clinical use, & toxicity of Cisplatin.
    -Alkalating agent -testicular,bladder,ovary,&lung -Nephrotoxicity & CN VIII damage.
    List the mechanism, clinical use, & toxicity of Cyclophosphamide.
    -Alkalating agent -NHL, Breast, ovary, & lung. - Myelosuppression, & hemorrhagic cystitis.
    List the mechanism, clinical use, & toxicity of Doxorubicin.
    -DNA intercalator -Hodgkin's, myeloma, sarcoma, and solid tumors -Cardiotoxicity & alopecia
    List the mechanism, clinical use, & toxicity of Etoposide.
    -Topo II inhibitor(GII specific) -Oat cell of Lung & prostate, & testicular -Myelosuppression & GI irritation.
    List the mechanism, clinical use, & toxicity of Methotrexate.
    -S-phase anti-metabolite folate analogue -Luk, Lymp, sarc, RA, &psoriasis / -Reversible myelosuppression
    List the mechanism, clinical use, & toxicity of Nitrosureas.
    -Alkalate DNA -Brain tumors -CNS toxicity
    List the mechanism, clinical use, & toxicity of Paclitaxel.
    -MT polymerization stabilizer -Ovarian & breast CA -Myelosupperession & hypersensitivity.
    List the mechanism, clinical use, & toxicity of Prednisone.
    -Triggers apoptosis -CLL, Hodgkin's in MOPP -Cushing-like syndrome
    List the mechanism, clinical use, & toxicity of Tamoxifen.
    -Estrogen receptor antagonist -Breast CA -increased endometrial CA risk
    List the mechanism, clinical use, & toxicity of Vincristine.
    -MT polymerization inhibitor(M phase) -MOPP, lymphoma, Willm's & choriocarcinoma -neurotoxicity and myelosuppression
    Which cancer drugs effect nuclear DNA (4)?
    -Alkalating agents+cisplatin -Doxorubicin+Dactinomycin -Bleomycin -Etoposide
    Which cancer drugs inhibit nucleotide synthesis(3)?
    - Methotrexate - 5 FU - 6 mercaptopurine
    Which cancer drugs work at the level of mRNA(2)?
    -Steroids -Tamoxifen
    Which cancer drugs work at the level of proteins(2)?
    -Vinca alkaloids(inhibit MT) -Paclitaxel
    ACE inhibitors- clinical use?
    hypertension, CHF, diabetic renal disease
    ACE inhibitors- mechanism?
    reduce levels of Angiotensin II, thereby preventing the inactivation of bradykinin (a potent vasodilator); renin level is increased
    ACE inhibitors- toxicity?
    fetal renal damage, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)
    Acetazolamide- clinical uses?
    glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness
    Acetazolamide- mechanism?
    acts at the proximal convoluted tubule to inhibit carbonic anhydrase. Causes self-limited sodium bicarb diuresis and reduction of total body bicarb stores.
    acetazolamide- site of action?
    proximal convoluted tubule
    Acetazolamide- toxicity?
    hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy
    Acetazolamide causesÉ?
    ACIDazolamide' causes acidosis
    Adenosine- clinical use?
    DOC in diagnosing and abolishing AV nodal arrhythmias
    ADH antagonists- site of action?
    collecting ducts
    adverse effect of Nitroprusside?
    cyanide toxicity (releases CN)
    adverse effects of beta-blockers?
    impotence, asthma, CV effects (bradycardia, CHF, AV block), CNS effects (sedation, sleep alterations)
    adverse effects of Captopril?
    fetal renal toxicity, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)
    adverse effects of Clonidine?
    dry mouth, sedation, severe rebound hypertension
    adverse effects of ganglionic blockers?
    severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
    adverse effects of Guanethidine?
    orthostatic and exercise hypotension, sexual dysfunction, diarrhea
    adverse effects of Hydralazine?
    nausea, headache, lupus-like syndrome, reflex tachycardia, angina, salt retention
    adverse effects of Hydrochlorothiazide?
    hypokalemia, slight hyperlipidemia, hyperuricemia, lassitude, hypercalcemia, hyperglycemia
    adverse effects of Loop Diuretics?
    K+ wasting, metabolic alkalosis, hypotension, ototoxicity
    adverse effects of Losartan?
    fetal renal toxicity, hyperkalemia
    adverse effects of Methyldopa?
    sedation, positive Coombs' test
    adverse effects of Minoxidil?
    hypertrichosis, pericardial effusion, reflex tachycardia, angina, salt retention
    adverse effects of Nifedipine, verapamil?
    dizziness, flushing, constipation (verapamil), nausea
    adverse effects of Prazosin?
    first dose orthostatic hypotension, dizziness, headache
    adverse effects of Reserpine?
    sedation, depression, nasal stuffiness, diarrhea
    Amiodarone- toxicity?
    pulmonary fibrosis, corneal deposits, hepatotoxicity, skin deposits resulting in photodermatitis, neurologic effects, consitpation, CV (bradycardia, heart block, CHF), and hypo- or hyperthyroidism.
    antidote?
    slowly normalize K+, lidocaine, cardiac pacer, and anti-Dig Fab fragments
    Beta Blockers- CNS toxicity?
    sedation, sleep alterations
    Beta Blockers- CV toxicity?
    bradycardia, AV block, CHF
    Beta Blockers- site of action?
    Beta adrenergic receptors and Ca2+ channels (stimulatory)
    BP?
    decrease
    BP?
    decrease
    Bretyllium- toxicity?
    new arrhythmias, hypotension
    Ca2+ channel blockers- clinical use?
    hypertension, angina, arrhythmias
    Ca2+ channel blockers- mechanism?
    block voltage dependent L-type Ca2+ channels of cardiac and smooth muscle- decreasing contractility
    Ca2+ channel blockers- site of action?
    Cell membrane Ca2+ channels of cardiac sarcomere
    Ca2+ channel blockers- toxicity?
    cardiac depression, peripheral edema, flushing, dizziness, constipation
    Ca2+ sensitizers'- site of action?
    troponin-tropomyosin system
    Cautions when using Amiodarone?
    check PFTs, LFTs, and TFTs
    class IA effects?
    increased AP duration, increased ERP increased QT interval. Atrial and ventricular.
    class IB- clinical uses?
    post MI and digitalis induced arrhythmias
    class IB- effects?
    decrease AP duration, affects ischemic or depolarized Purkinje and ventricular system
    class IB- toxicity?
    local anesthetic. CNS stimulation or depression. CV depression.
    class IC- effects?
    NO AP duration effect. useful in V-tach that progresses to V-fib and in intractable SVT LAST RESORT
    class IC- toxicity?
    proarrhythmic
    class II- effects?
    decrease the slope of phase 4, increase PR interval (the AV node is particularly sensitive)
    class II- mechanism?
    blocking the beta adrenergic receptor leads to decreased cAMP, and decreased Ca2+ flux
    class II- toxicity?
    impotence, exacerbation of asthma, CV effects, CNS effects, may mask hypoclycemia
    Class III- effects?
    increase AP duration, increase ERP, increase QT interval, for use when other arrhythmics fail
    class IV- clinical use?
    prevention of nodal arrhythmias (SVT)
    class IV- effects?
    decrease conduction velocity, increase ERP, increase PR interval
    class IV- primary site of action?
    AV nodal cells
    class IV- toxicity?
    constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression), and torsade de pointes (Bepridil)
    classes of antihypertensive drugs?
    diuretics, sympathoplegics, vasodilators, ACE inhibitors, Angiotensin II receptor inhibitors
    clinical use?
    angina, pulmonary edema (also, erection enhancer)
    clinical use?
    CHF, atrial fibrillation
    contractility?
    increase (reflex response)
    contractility?
    decrease
    contraindications?
    renal failure, hypokalemia, pt on quinidine
    decrease Digitoxin dose in renal failure?
    NO
    decrease Digoxin dose in renal failure?
    YES
    Digitalis- site of action?
    Na/K ATPase
    Digoxin v. Digitoxin: bioavailability?
    Digitoxin>95% Digoxin 75%
    Digoxin v. Digitoxin: excretion?
    Digoxin=urinary Digitoxin=biliary
    Digoxin v. Digitoxin: half life?
    Digitoxin 168hrs Digoxin 40 hrs
    Digoxin v. Digitoxin: protein binding?
    Digitoxin 70% Digoxin 20-40%
    ejection time?
    decrease
    ejection time?
    increase
    EKG results?
    inc PR, dec QT, scooping of ST, and T wave inversion
    end diastolic volume?
    decrease
    end diastolic volume?
    increase
    Esmolol- short or long acting?
    very short acting
    Ethacrynic Acid- clinical use?
    Diuresis in pateints with sulfa allergy
    Ethacrynic Acid- mechanism?
    not a sulfonamide, but action is the same as furosemide
    Ethacrynic Acid- toxicity?
    NO HYPERURICEMIA, NO SULFA ALLERGY; same as furosemide otherwise
    Furosemide- class and mechanism?
    Sulfonamide Loop Diuretic. Inhibits ion co-transport system of thick ascending loop. Abolishes hypertonicity of the medulla, thereby preventing concentration of the urine.
    Furosemide- clinical use?
    edematous states (CHF, cirrhosis, nephrotic syndrome, pulm edema), HTN, hypercalcemia
    Furosemide- toxicity? (OH DANG)
    Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout
    Furosemide increases the excretion of what ion?
    Ca2+ (Loops Lose calcium)
    HDL effect?
    no effect
    HDL effect?
    increase
    HDL effect?
    moderate increase
    HDL effect?
    increase
    HDL effect?
    DECREASE
    how do we stop angina?
    decrease myocardial O2 consumption by: 1-decreasing end diastolic volume 2- decreasing BP 3- decreasing HR 4-decreasing contractility 5-decreasing ejection time
    HR?
    increase (reflex response)
    HR?
    decrease
    Hydralazine- class and mechanism?
    vasodilator- increases cGMP to induce smooth muscle relaxation (arterioles>veins; afterload reduction)
    Hydralazine- clinical use?
    severe hypertension, CHF
    Hydralazine- toxicity?
    compensatory tachycardia, fluid retention, lupus-like syndrome
    Hydrochlorothiazide- clinical use?
    HTN, CHF, calcium stone formation, nephrogenic DI.
    Hydrochlorothiazide- mechanism?
    Inhibits NaCl reabsorption in the early distal tubule. Decreases Ca2+ excretion.
    Hydrochlorothiazide- toxicity? (hyperGLUC, plus others)
    Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia, sulfa allergy.
    Ibutilide- toxicity?
    torsade de pointes
    K+- clinical use?
    depresses ectopic pacemakers, especially in digoxin toxicity
    K+ sparing diuretics- clinical use?
    hyperaldosteronism, K+ depletion, CHF
    K+ sparing diuretics- site of action?
    cortical collecting tubule
    K+ sparing diuretics- toxicity?
    hyperkalemia, endocrine effects (gynecomastia, anti-androgen)
    LDL effect?
    moderate decrease
    LDL effect?
    large decrease
    LDL effect?
    moderate decrease
    LDL effect?
    decrease
    LDL effect?
    decrease
    loop diuretics (furosemide)- site of action?
    thick ascending limb
    Mannitol- clinical use?
    ARF, shock, drug overdose, decrease intracranial/intraocular pressure
    Mannitol- contraindications?
    anuria, CHF
    Mannitol- mechanism?
    osmotic diuretic- increase tubular fluid osmolarity, thereby increasing urine flow
    mannitol- site of action?
    proximal convoluted tubule, thin descending limb, and collecting duct
    Mannitol- toxicity?
    pulmonary edema, dehydration
    mechanism?
    vasodilate by releasing NO in smooth muscle, causing and increase in cGMP and smooth muscle relaxation (veins>>arteries)
    mechanism?
    inhibits the Na/K ATPase, increasing intracellular Na+ decreasing the function of the Na/Ca antiport causing an increase in intracellular Ca2+
    mechanism?
    Na+ channel blockers. Slow or block conduction. Decreased slope in phase 4 and increased threshold for firing in abnormal pacemaker cells.
    Mg+- clinical use?
    effective in torsade de pointes and digoxin toxicity
    MVO2?
    decrease
    MVO2?
    decrease
    name five in class II?
    propanolol, esmolol, metoprolol, atenolol, timolol
    name four HMG-CoA reductase inhibitors.
    Lovastatin, Pravastatin, Simvastatin, Atorvastatin
    name four in class IA.
    Quinidine, Amiodarone, Procainamide, Disopyramide
    name four in class III.
    Sotalol, Ibutilide, Bretylium, Amiodarone
    name three ACE inhibitors?
    Captopril, Enalapril, Lisinopril
    name three calcium channel blockers?
    Nifedipine, Verapamil, Diltiazem
    name three in class IB.
    Lidocaine, Mexiletine, Tocainide
    name three in class IC.
    Flecainide, Encainide, Propafenone
    name three in class IV.
    Verapamil, Diltiazem, Bepridil
    name three K+ sparing diuretics?
    Spironolactone, Triamterene, Amiloride (the K+ STAys)
    name two bile acid resins.
    cholestyramine, colestipol
    name two LPL stimulators.
    Gemfibrozil, Clofibrate
    Nifedipine has similar action to?
    Nitrates
    preferential action of the Ca2+ channel blockers at cardiac muscle?
    cardiac muscle: Verapamil>Diltiazem>Nifedipine
    preferential action of the Ca2+ channel blockers at vascular smooth muscle?
    vascular sm. Mus.: Nifedipine>Diltiazem>Verapamil
    Procainamide- toxicity?
    reversible SLE-like syndrome
    Quinidine- toxicity?
    cinchonism: HA, tinnitus, thrombocytopenia, torsade de pointes due to increased QT interval
    Ryanodine- stie of action?
    blocks SR Ca2+ channels
    selectivity?
    slectively depress tissue that is frequently depolarized (fast tachycardia)
    side effects/problems?
    tastes bad and causes GI discomfort
    side effects/problems?
    expensive, reversible increase in LFTs, and myositis
    side effects/problems?
    red, flushed face which is decreased by ASA or long term use
    side effects/problems?
    myositis, increased LFTs
    side effects/problems?
    DECREASED HDL
    Sotalol- toxicity?
    torsade de pointes, excessive Beta block
    Spironolactone- mechanism?
    competitive inhibirot of aldosterone in the cortical collecting tubule
    TG effect?
    slight increase
    TG effect?
    decrease
    TG effect?
    decrease
    TG effect?
    large decrease
    TG effect?
    no effect
    thiazides- site of action?
    distal convoluted tubule (early)
    toxicity?
    tachycardia, hypotension, headache - 'Monday disease'
    toxicity?
    nausea, vomiting, diarrhea, blurred vision, arrhythmia
    Triamterene and amiloride- mechanism?
    block Na+ channels in the cortical collecting tubule
    Verapamil has similar action to?
    Beta Blockers
    what two vasodilators require simultaneous treatment with beta blockers to prevent reflex tachycardia and diuretics to prevent salt retention?
    Hydralazine and Minoxidil
    which diuretics cause acidosis?
    carbonic anhydrase inhibitors, K+ sparing diuretics
    which diuretics cause alkalosis?
    loop diuretics, thiazides
    which diuretics decrease urine Ca2+?
    thiazides, amiloride
    which diuretics increase urine Ca2+?
    loop diuretics, spironolactone
    which diuretics increase urine K+?
    all except the K+ sparing diuretics Spironolactone, Triamterene, Amiloride
    which diuretics increase urine NaCl?
    all of them
    Acetaminophen has what two clinical uses and lacks what one clinical use of the NSAIDs?
    Acetaminophen has antipyretic and analgesic properties, but lacks anti-inflammatory properties.
    Can Heparin be used during pregnancy?
    Yes, it does not cross the placenta.
    Can Warfarin be used during pregnancy?
    No, warfarin, unlike heparin, can cross the placenta.
    Does Heparin have a long, medium, or short half life?
    Short.
    Does Warfarin have a long, medium, or short half life?
    Long.
    For Heparin what is the 1. Structure 2. Route of administration 3. Onset of action 4. Mechanism of action 5. Duration of action 6. Ability to inhibit coagulation in vitro 7. Treatment for overdose 8. Lab value to monitor 9. Site of action
    Heparin 1. Structure - Large anionic polymer, acidic 2. Route of administration - Paranteral (IV, SC) 3. Onset of action - Rapid (seconds) 4. Mechanism of action - Activates antithrombin III 5. Duration of action - Acute (hours) 6. Ability to inhibit coagulation in vitro - Yes 7. Treatment for overdose - Protamine sulfate 8. Lab value to monitor-aPTT (intrinsic pathway) 9. Site of action - Blood
    For Warfarin what is the 1. Structure 2. Route of administration 3. Onset of action 4. Mechanism of action 5. Duration of action 6. Ability to inhibit coagulation in vitro 7. Treatment for overdose 8. Lab value to monitor 9. Site of action
    Warfarin 1. Structure - Small lipid-soluble molecule 2. Route of administration -Oral 3. Onset of action - Slow, limited by half lives of clotting factors 4. Mechanism of action - Impairs the synthesis of vitamin K-dependent clotting factors 5. Duration of action - Chronic (weeks or months) 6. Ability to inhibit coagulation in vitro - No
    For Warfarin what is the (continued):
    7. Treatment for overdose - IV vitamin K and fresh frozen plasma 8. Lab value to monitor - PT 9. Site of action - Liver
    Is toxicity rare or common whith Cromolyn used in Asthma prevention?
    Rare.
    List five common glucocorticoids.
    1. Hydrocortisone 2. Predisone 3. Triamcinolone 4. Dexamethasone 5. Beclomethasone
    Secretion of what drug is inhibited by Probenacid used to treat chronic gout?
    Penicillin.
    The COX-2 inhibitors (celecoxib, rofecoxib) have similar side effects to the NSAIDs with what one exception?
    The COX-2 inhibitors should not have the corrosive effects of other NSAIDs on the gastrointestinal lining.
    What are are the Sulfonylureas (general description) and what is their use?
    Sulfonylureas are oral hypoglycemic agents, they are used to stimulate release of endogenous insulin in NIDDM (type-2).
    What are five advantages of Oral Contraceptives (synthetic progestins, estrogen)?
    1. Reliable (<1% failure) 2. Lowers risk of endometrial and ovarian cancer 3. Decreased incidence of ectopic pregnancy 4. Lower risk of pelvic infections 5. Regulation of menses
    What are five disadvantages of Oral Contraceptives (synthetic progestins, estrogen)?
    1. Taken daily 2. No protection against STDs 3. Raises triglycerides 4. Depression, weight gain, nausea, HTN 5. Hypercoagulable state
    What are five possible toxic effects of Aspirin therapy?
    1. Gastric ulceration 2. Bleeding 3. Hyperventilation 4. Reye's syndrome 5. Tinnitus (CN VIII)
    What are five toxicities associated with Tacrolimus (FK506)?
    1. Significant: nephrotoxicity 2. Peripheral neuropathy 3. Hypertension 4. Pleural effusion 5. Hyperglycemia.
    What are four advantages of newer low-molecular-weight heparins (Enoxaparin)?
    1. Better bioavailability 2. 2 to 4 times longer half life 3. Can be administered subcutaneously 4. Does not require laboratory monitoring
    What are four clinical activities of Aspirin?
    1. Antipyretic 2. Analgesic 3. Anti-inflammatory 4. Antiplatelet drug.
    What are four clinical uses of glucocorticoids?
    1. Addison's disease 2. Inflammation 3. Immune suppression 4. Asthma
    What are four conditions in which H2 Blockers are used clinically?
    1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger-Ellison syndrome
    What are four H2 Blockers?
    1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine
    What are four Sulfonylureas?
    1. Tolbutamide 2. Chlorpropamide 3. Glyburide 4. Glipizide
    What are four thrombolytics?
    1. Streptokinase 2. Urokinase 3. tPA (alteplase), APSAC (anistreplase)
    What are four unwanted effects of Clomiphene use?
    1. Hot flashes 2. Ovarian enlargement 3. Multiple simultaneous pregnancies 4. Visual disturbances
    What are nine findings of Iatrogenic Cushing's syndrome caused by glucocorticoid therapy?
    1. Buffalo hump 2. Moon facies 3. Truncal obesity 4. Muscle wasting 5. Thin skin 6. Easy bruisability 7. Osteoporosis 8. Adrenocortical atrophy 9. Peptic ulcers
    What are signs of Sildenafil (Viagra) toxicity?
    Headache, flushing , dyspepsia, blue-green color vision.
    What are the clinical uses for Ticlopidine, Clopidogrel?
    Acute coronary syndrome; coronary stenting. Decreases the incidence or recurrence of thrombotic stroke.
    What are the four conditions in which Omeprazole, Lansoprazole is used?
    1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger-Ellison syndrome
    What are three clinical uses of the Leuprolide?
    1. Infertility (pulsatile) 2. Prostate cancer (continuous: use with flutamide) 3. Uterine fibroids
    What are three clinical uses of the NSAIDs?
    1. Antipyretic 2. Analgesic 3. Anti-inflammatory
    What are three common NSAIDS other than Aspirin?
    Ibuprofen, Naproxen, and Indomethacin
    What are three complications of Warfarin usage?
    1. Bleeding 2. Teratogenicity 3. Drug-drug interactions
    What are three possible complications of Heparin therapy?
    1. Bleeding 2. Thrombocytopenia 3. Drug-drug interactions
    What are three possible toxicities of NSAID usage?
    1. Renal damage 2. Aplastic anemia 3. GI distress
    What are three toxicities of Leuprolied?
    1. Antiandrogen 2. Nausea 3. Vomiting
    What are three toxicities of Propylthiouracil?
    1. Skin rash 2. Agranulocytosis (rare) 3. Aplastic anemia
    What are three types of antacids and the problems that can result from their overuse?
    1. Aluminum hydroxide: constipation and hypophosphatemia 2. Magnesium hydroxide: diarrhea 3. Calcium carbonate: Hypercalcemia, rebound acid increase - All may cause hypokalemia
    What are three unwanted effects of Mifepristone?
    1. Heavy bleeding 2. GI effects (n/v, anorexia) 3. Abdominal pain
    What are two Alpha-glucosidase inhibitors?
    1. Acarbose 2. Miglitol
    What are two clinical uses of Azathioprine?
    1. Kidney transplantation 2. Autoimmune disorders (including glomerulonephritis and hemolytic anemia)
    What are two conditions in which COX-2 inhibitors might be used?
    Rheumatoid and osteoarthritis.
    What are two Glitazones?
    1. Pioglitazone 2. Rosiglitazone.
    What are two mechanisms of action of Propythiouracil?
    Inhibits organification and coupling of thyroid hormone synthesis. Also decreases peripheral conversion of T4 to T3.
    What are two processes Corticosteroids inhibit leading to decreased inflammation?
    1. Phospholipase A2 is prevented from releasing arachidonic acid 2. Decreases protein synthesis thus lowering amount of Cyclooxygenase enzymes
    What are two toxicities associated with Cyclosporine?
    1. Predisposes to viral infections and lymphoma 2. Nephrotoxic (preventable with mannitol diuresis)
    What are two toxicities of the Glitazones?
    1. Weight gain 2. Hepatotoxicity (troglitazone)
    What are two toxicities of the Sulfonylureas?
    1. Hypoglycemia (more common with 2nd-generation drugs: glyburide, glipizide) 2. Disulfiram-like effects (not seen with 2nd-generation drugs).
    What are two types of drugs that interfere with the action of Sucralfate and why?
    Sucralfate cannot work in the presence of antacids or H2 blockers because it requires an acidic environment to polymerize.
    What can result due to antacid overuse?
    Can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.
    What enzyme does Zileuton inhibit?
    Lipoxygenase
    What enzymes are inhibited by NSAIDs, acetaminophen and COX II inhibitors?
    Cyclooxygenases (COX I, COX II).
    What is a common side effect of Colchicine used to treat acute gout, especially when given orally?
    GI side effects. (Note: Indomethacin is less toxic, more commonly used.)
    What is a common side effect of Misoprostol?
    Diarrhea
    What is a possible result of overdose of Acetaminophen?
    Overdose produces hepatic necrosis; acetaminophen metablolite depletes glutathione and forms toxic tissue adducts in liver.
    What is a possible toxicity of Alpha-glucosidase inhibitors used in type-2 diabetes?
    GI disturbances.
    What is a possible toxicity of Ticlopidine, Clopidogrel usage?
    Neutropenia (ticlopidine); reserved for those who cannot tolerate aspirin.
    What is a sign of toxicity with the use of thrombolytics?
    Bleeding.
    What is action of insulin in the liver, in muscle, and in adipose tissue?
    1. In liver, increases storage of glucose as glycogen. 2. In muscle, stimulates glycogen and protein synthesis, and K+ uptake. 3. In adipose tissue, facilitates triglyceride storage.
    What is are two clinical uses of Cyclosporine?
    1. Suppresses organ rejection after transplantation 2. Selected autoimmune disorders.
    What is the category and mechanism of action of Zafirlukast in Asthma treatment?
    Antileukotriene; blocks leukotriene receptors.
    What is the category and mechanism of action of Zileuton in Asthma treatment?
    Antileukotriene; blocks synthesis by lipoxygenase.
    What is the category of drug names ending in -ane (e.g. Halothane)
    Inhalational general anesthetic.
    What is the category of drug names ending in -azepam (e.g. Diazepam)
    Benzodiazepine.
    What is the category of drug names ending in -azine (e.g. Chlorpromazine)
    Phenothiazine (neuroleptic, antiemetic).
    What is the category of drug names ending in -azol (e.g. Ketoconazole)
    Antifungal.
    What is the category of drug names ending in -barbital (e.g. Phenobarbital)
    Babiturate.
    What is the category of drug names ending in -caine (e.g. Lidocaine)
    Local anesthetic.
    What is the category of drug names ending in -cillin (e.g. Methicillin)
    Penicillin.
    What is the category of drug names ending in -cycline (e.g. Tetracycline)
    Antibiotic, protein synthesis inhibitor.
    What is the category of drug names ending in -ipramine (e.g. Imipramine)
    Tricyclic antidepressant.
    What is the category of drug names ending in -navir (e.g. Saquinavir)
    Protease inhibitor.
    What is the category of drug names ending in -olol (e.g. Propranolol)
    Beta antagonist.
    What is the category of drug names ending in -operidol (e.g. Haloperidol)
    Butyrophenone (neuroleptic).
    What is the category of drug names ending in -oxin (e.g. Digoxin)
    Cardiac glycoside (inotropic agent).
    What is the category of drug names ending in -phylline (e.g. Theophylline)
    Methylxanthine.
    What is the category of drug names ending in -pril (e.g. Captopril)
    ACE inhibitor.
    What is the category of drug names ending in -terol (e.g. Albuterol)
    Beta-2 agonist.
    What is the category of drug names ending in -tidine (e.g. Cimetidine)
    H2 antagonist
    What is the category of drug names ending in -triptyline (e.g. Amitriptyline)
    Tricyclic antidepressant.
    What is the category of drug names ending in -tropin (e.g. Somatotropin)
    Pituitary hormone.
    What is the category of drug names ending in -zosin (e.g. Prazosin)
    Alpha-1 antagonist
    What is the category, desired effect, and adverse effect of Isoproterenol in the treatment of Asthma?
    Nonspecific beta-agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Adverse effect is tachycardia (Beta 1).
    What is the category, desired effect, and period of use of albuterol in the treatment of Asthma?
    Beta 2 agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Use during acute exacerbation.
    What is the category, desired effect, and possible mechanism of Theophylline in treating Asthma?
    Methylzanthine; desired effect is bronchodilation, may cause bronchodilation by inhibiting phosphodiesterase, enzyme involved in degrading cAMP (controversial).
    What is the category, mechanism of action, and effect of Ipratroprium in Asthma treatment?
    Muscarinic antagonist; competatively blocks muscarinic receptors, preventing bronchoconstriction.
    What is the category, mechanism of action, and particular use of beclomethasone and prednisone in Asthma treatment?
    Corticosteroids; prevent production of leukotrienes from arachodonic acid by blocking phospholipase A2. Drugs of choice in a patient with status asthmaticus (in combination with albuterol.)
    What is the category, method of use, and adverse effects of Salmeterol in Asthma treatment?
    Beta 2 agonist; used as a long-acting agent for prophylaxis. Adverse effects are tremor and arrhythmia.
    What is the clincial use for Misoprostol?
    Prevention of NSAID-induced peptic ulcers, maintains a PDA.
    What is the clinical use for Clomiphene?
    Treatment of infertility.
    What is the clinical use for Heparin?
    Immediate anticoagulation for PE, stroke, angina, MI, DVT.
    What is the clinical use for Sildenafil (Viagra)?
    Erectile dysfunction.
    What is the clinical use for Sucralfate?
    Peptic ulcer disease.
    What is the clinical use for Warfarin?
    Chronic anticoagulation.
    What is the clinical use of Mifepristone (RU486)?
    Abortifacient.
    What is the clinical use of Tacrolimus (FK506)?
    Potent immunosuppressive used in organ transplant recipients.
    What is the effect of the Glitazones in diabetes treatment?
    Increase target cell response to insulin.
    What is the enzyme inhibited, the effect of this inhibition, and the clinical use of the antiandrogren Finasteride?
    Finasteride inhibits 5 Alpha-reductase, this decreases the conversion of testosterone to dihydrotestosterone, useful in BPH
    What is the lab value used to monitor the effectiveness of Heparin therapy?
    The PTT.
    What is the lab value used to monitor the effectiveness of Warfarin therapy?
    The PT.
    What is the main clinical use for the thrombolytics?
    Early myocardial infarction.
    What is the mecanism of action of Sucralfate?
    Aluminum sucrose sulfate polymerizes in the acid environment of the stomach and selectively binds necrotic peptic ulcer tissue. Acts as a barrier to acid, pepsin, and bile.
    What is the mecanism of action of the COX-2 inhibitors (celecoxib, rofecoxib)?
    Selectively inhibit cyclooxygenase (COX) isoform 2, which is found in inflammatory cells nad mediates inflammation and pain; spares COX-1 which helps maintain the gastric mucosa.
    What is the mecanism of action, effective period, and ineffective period of use for Cromolyn in treating Asthma?
    Prevents release of mediators from mast cells. Effective only for the prophylaxis of asthma. Not effective during an acute attack.
    What is the mechanism of action and clinical use of the antiandrogen Flutamide?
    Flutamide is a nonsteroidal competitive inhibitor of androgens at the testosterone receptor, used in prostate carcinoma.
    What is the mechanism of action and clinical use of the antiandrogens Ketoconazole and Spironolactone?
    Inhibit steroid synthesis, used in the treatment of polycystic ovarian syndrome to prevent hirsutism.
    What is the mechanism of action of Acetaminophen?
    Reversibly inhibits cyclooxygenase, mostly in CNS. Inactivated peripherally.
    What is the mechanism of action of Allopurinol used to treat chronic gout?
    Inhibits xanthine oxidase, decresing conversion of xanthine to uric acid.
    What is the mechanism of action of Aspirin?
    Acetylates and irreversibly inhibits cyclooxygenase (COX I and COX II) to prevent the conversion of arachidonic acid to prostaglandins.
    What is the mechanism of action of Clomiphene?
    Clomiphene is a partial agonist at estrogen receptors in the pituitary gland. Prevents normal FEEDBACK inhibition and increses release of LH and FSHfrom the pituitary, which stimulates ovulation.
    What is the mechanism of action of Colchicine used to treat acute gout?
    Depolymerizes microtubules, impairing leukocyte chemotaxis and degranulation.
    What is the mechanism of action of Cyclosporine?
    Binds to cyclophilins (peptidyl proline cis-trans isomerase), blocking the differentiation and activation of T cells mainly by inhibiting the production of IL-2 and its receptor.
    What is the mechanism of action of Heparin?
    Heparin catalyzes the activation of antithrombin III.
    What is the mechanism of action of Mifepristone (RU486)?
    Competitive inibitor of progestins at progesterone receptors.
    What is the mechanism of action of Misoprostol?
    Misoprostol is a PGE1 analog that increases the production and secretion of the gastic mucous barrier.
    What is the mechanism of action of NSAIDs other than Aspirin?
    Reversibly inhibit cyclooxygenase (COX I and COX II). Block prostaglandin synthesis.
    What is the mechanism of action of Omeprazole, Lansoprazole?
    Irreversibly inhibits H+/K+ ATPase in stomach parietal cells.
    What is the mechanism of action of Probenacid used to treat chronic gout?
    Inhibits reabsorption of uric acid.
    What is the mechanism of action of Sildenafil (Viagra)?
    Inhibits cGMP phosphodiesterase, casuing increased cGMP, smooth muscle relaxation in the corpus cavernosum, increased blood flow, and penile erection.
    What is the mechanism of action of the Alpha-glucosidase inhibitors?
    Inhibit intestinal bursh border Alpha-glucosidases; delayed hydrolysis of sugars and absorption of sugars leading to decresed postprandial hyperglycemia.
    What is the mechanism of action of the glucocorticoids?
    Decrease the production of leukotrienes and protaglandins by inhibiting phospholipase A2 and expression of COX-2.
    What is the mechanism of action of the H2 Blockers?
    Reversible block of histamine H2 receptors
    What is the mechanism of action of the Sulfonylureas?
    Close K+ channels in Beta-cell membrane leading to cell depolarization causing insulin release triggered by increase in Calcium ion influx.
    What is the mechanism of action of the thrombolytics?
    Directly of indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots. (It is claimed that tPA specifically converts fibrin-bound plasminogen to plasmin.)
    What is the mechanism of action of Ticlopidine, Clopidogrel
    Inhibits platelet aggregation by irreversibly inhibiting the ADP pathway involved in the binding of fibrinogen.
    What is the mechanism of action of Warfarin (Coumadin)?
    Warfarin interferes with the normal synthesis and gamma-carboxylation of vitamin K-dependent clotting factors II, VII, IX, and X, Protein C and S via vitamin K antagonism.
    What is the mechanism of Azathioprine?
    Antimetabolite derivative of 6-mercaptopurine that interferes with the metablolism and synthesis of nucleic acid.
    What is the mechanism of Leuprolide?
    GnRH analog with agonist properties when used in pulsatile fashion and antagonist properties when used in continuous fashion, causing a transient initial burst of LH and FSH
    What is the mechanism of Tacrolimus (FK506)?
    Similar to cyclosporine; binds to FK-binding protein, inhibiting secretion of IL-2 and other cytokines.
    What is the memory key for the action of Sildenafil (Viagra)?
    Sildenafil fills the penis
    What is the memory key for the effect of aluminum hydroxide overuse?
    AluMINIMUM amount of feces.
    What is the memory key for the effect of magnesium hydroxide overuse?
    Mg = Must go to the bathroom.
    What is the memory key to remember which pathway (extrinsic vs. intrinsic) and which lab value Warfarin affects?
    WEPT: Warfarin affects the Extrinsic pathway and prolongs the PT.
    What is the possible mechanism and effect of Metformin in treating diabetes?
    Mechanism unknown; possibly inhibits gluconeogenesis and increases glycolysis; effect is to decrease serum glucose levels
    What is the specific clinical use of Indomethacin in neonates?
    Indomethacin is used to close a patent ductus arteriosus.
    What is used to reverse the action of Heparin?
    Protamine Sulfate is used for rapid reversal of heparinization (positively charged molecule that binds to negatively charged heparin).
    What patients are at risk for life threatening hypotension when taking Sildenafil (Viagra)?
    Those patients who are taking nitrates.
    What process does Zafirlukast interfere with?
    Leukotrienes increasing bronchial tone.
    What type of gout is treated with Allopurinol?
    Chronic gout.
    What type of gout is treated with Colchicine?
    Acute gout.
    What type of gout is treated with Probenacid?
    Chronic gout.
    What type of patient should not take Misoprostol and why?
    Misoprostol is contraindicated in women of childbearing potential because it is an abortifacient.
    Which H2 Blocker has the most toxic effects and what are they?
    Cimetidine is a potent inhibitor of P450; it also has an antiandrogenic effect and decreases renal excretion of creatinine. Other H2 blockers are relatively free of these effects.
    Why are the Sulfonylureas inactive in IDDM (type-1)?
    Because they require some residual islet function.
    Acetaldehyde is metabolized by Acetaldehyde dehydrogenase, which drug inhibs this enzyme?
    -Disulfram & also sulfonylureas, metronidazole
    Explain pH dependent urinary drug elimination?
    -Weak Acids>Alkinalize urine(CO3) to remove more -Weak bases>acidify urine to remove more
    How do you treat coma in the ER (4)?
    -Airway -Breathing -Circulation -Dextrose(thiamine &narcan) -ABCD
    In coma situations you rule out what (7)?
    -Infections -Trauma -Seizures -CO -Overdose -Metabolic -Alcohol (IT'S COMA)
    List some specifics of lead poisoning(4)?
    -A57Blue lines in gingiva& long bones -Encephalopathy & Foot drop -Abdominal colic / -Sideroblastic anemia
    List the specific antidote for this toxin: Acetaminophen
    -N-acetylcystine
    List the specific antidote for this toxin: Amphetamine
    -Ammonium Chloride
    List the specific antidote for this toxin: Anticholinesterases (organophosphate.)
    -Atropine & pralidoxime
    List the specific antidote for this toxin: Antimuscarinic (anticholinergic)
    -Physostigmine salicylate
    List the specific antidote for this toxin: Arsenic (all heavy metals)
    -Dimercaprol, succimer
    List the specific antidote for this toxin: Benzodiazepines
    -Flumazenil
    List the specific antidote for this toxin: Beta Blockers
    -Glucagon
    List the specific antidote for this toxin: Carbon monoxide
    -100% oxygen, hyperbaric
    List the specific antidote for this toxin: Copper
    -Penicillamine
    List the specific antidote for this toxin: Cyanide
    -Nitrate, hydroxocobalamin thiosulfate
    List the specific antidote for this toxin: Digitalis
    -Normalize K+, Lidocaine, & Anti-dig Mab
    List the specific antidote for this toxin: Heparin
    -Protamine
    List the specific antidote for this toxin: Iron
    -Deferoxamine
    List the specific antidote for this toxin: Lead
    -EDTA, dimercaprol, succimer, & penicillamine
    List the specific antidote for this toxin: Methanol & Ethylene glycol
    -Ethanol, dialysis, & fomepizole
    List the specific antidote for this toxin: Methemoglobin
    -Methylene blue
    List the specific antidote for this toxin: Opioids
    -B51Naloxone / naltrexone (Narcan)
    List the specific antidote for this toxin: Salicylates
    -Alkalinize urine & dialysis
    List the specific antidote for this toxin: TPA & Streptokinase
    -Aminocaproic acid
    List the specific antidote for this toxin: Tricyclic antidepressants
    -NaHCO3
    List the specific antidote for this toxin: Warfarin
    -Vitamin K & fresh frozen plasma
    What are the products and their toxicities of the metabolism of ethanol by / alcohol dehydrogenase?
    -Acetaldehyde -Nausea, vomiting, headache, & hypotension
    What are the products and their toxicities of the metabolism of Ethylene Glycol by / alcohol dehydrogenase?
    -Oxalic acid -Acidosis & nephrotoxicity
    What are the products and their toxicities of the metabolism of Methanol by / alcohol dehydrogenase?
    -Formaldehyde & formic acid -severe acidosis & retinal damage
    Which drug(s) cause this reaction: Adrenocortical Insufficiency
    -Glucocorticoid withdrawal
    Which drug(s) cause this reaction: Agranulocytosis (3)?
    -Cloazapine -carbamazapine -colchicine -PTU
    Which drug(s) cause this reaction: Anaphylaxis?
    -Penicillin
    Which drug(s) cause this reaction: Aplastic anemia (5)?
    -Chloramphenicol -benzene -NSAIDS -PTU -phenytoin
    Which drug(s) cause this reaction: Atropine-like side effects?
    -Tricyclic antidepressants
    Which drug(s) cause this reaction: Cardiac toxicity?
    -Daunorubicin & Doxorubicin
    Which drug(s) cause this reaction: Cinchonism (2)?
    -Quinidine -quinine
    Which drug(s) cause this reaction: Cough?
    -ACE inhibitors (Losartan>no cough)
    Which drug(s) cause this reaction: Cutaneous flushing (4)?
    -Niacin -Ca++ channel blockers -adenosine -vancomycin
    Which drug(s) cause this reaction: Diabetes insipidus?
    -Lithium
    Which drug(s) cause this reaction: Disulfram-like reaction (4) ?
    -Metronidazole -certain cephalosporins -procarbazine -sulfonylureas
    Which drug(s) cause this reaction: Drug induced Parkinson's (4) ?
    -Haloperidol -chlorpromazine -reserpine -MPTP
    Which drug(s) cause this reaction: Extrapyramidal side effects (3)?
    -Chlorpromazine -thioridazine -haloperidol
    Which drug(s) cause this reaction: Fanconi's syndrome?
    -Tetracycline
    Which drug(s) cause this reaction: Focal to massive hepatic necrosis (4)?
    -Halothane -Valproic acid -acetaminophen -Amantia phalloides
    Which drug(s) cause this reaction: G6PD hemolysis(8)?
    -Sulfonamides -INH -ASA -Ibuprofen -primaquine -nitrofurantoin /-pyrimethamine -chloramphenicol
    Which drug(s) cause this reaction: Gingival hyperplasia?
    -Phenytoin
    Which drug(s) cause this reaction: Gray baby syndrome?
    -Chloramphenicol
    Which drug(s) cause this reaction: Gynecomastia (6) ?
    -Cimetidine -ketoconazole -spironolactone -digitalis -EtOH -estrogens
    Which drug(s) cause this reaction: Hepatitis?
    -Isoniazid
    Which drug(s) cause this reaction: Hot flashes?
    -Tamoxifen
    Which drug(s) cause this reaction: Neuro and Nephrotoxic?
    -polymyxins
    Which drug(s) cause this reaction: Osteoporosis (2)?
    -Corticosteroids -heparin
    Which drug(s) cause this reaction: Oto and Nephrotoxicity (3)?
    -aminoglycosides -loop diuretics -cisplatin
    Which drug(s) cause this reaction: P450 induction(6)?
    -Barbiturates -phenytoin -carbamazipine -rifampin -griseofulvin -quinidine
    Which drug(s) cause this reaction: P450 inhibition(6)?
    -Cimetidine -ketoconazole -grapefruit juice -erythromycin -INH -sulfonamides
    Which drug(s) cause this reaction: Photosensitivity(3)?
    -Tetracycline -amiodarone -sulfonamides
    Which drug(s) cause this reaction: Pseudomembranous colitis?
    -Clindamycin
    Which drug(s) cause this reaction: Pulmonary fibrosis(3)?
    -Bleomycin -amiodarone -busulfan
    Which drug(s) cause this reaction: SLE-like syndrome
    -Hydralazine -Procainamide -INH -phenytoin
    Which drug(s) cause this reaction: Stevens-Johnson syn. (3) ?
    -Ethosuxamide -sulfonamides -lamotrigine
    Which drug(s) cause this reaction: Tardive dyskinesia?
    -Antipsychotics
    Which drug(s) cause this reaction: Tendonitis and rupture?
    -Fluoroquinolones
    Which drug(s) cause this reaction: Thrombotic complications?
    -Oral Contraceptives
    Which drug(s) cause this reaction: Torsade de pointes (2) ?
    -Class III antiarrhythmics (sotalol) -class IA (quinidine)
    Which drug(s) cause this reaction: Tubulointerstitial Nephritis (5)?
    -Sulfonamides -furosemide -methicillin -rifampin -NSAIDS (ex. ASA)
    Describe first-order kinetics?
    Constant FRACTION eliminated per unit time.(exponential)
    Describe Phase I metabolism in liver(3)?
    -reduction, oxy, & hydrolysis -H2O sol. Polar product -P450
    Describe Phase II metabolism in liver(3)?
    -acetylation, glucuron.,& sulfat
  11. Imperial

    Imperial Guest

    Q: Define renal failure.
    A: Failure to make urine and excrete nitrogenous wastes

    Q: How do you calculate anion gap?
    A: Na-(Cl + HCO3) = 8-12 mEq/L

    Q: How do you treat minimal change disease?
    A: Responds well to steroids

    Q: How does acute poststreptococcal glomerulonephritis resolve?
    A: Spontaneously

    Q: How does renal cell carcinoma spread metastically?
    A: Invades the IVC and spreads hematogenously

    Q: How does transitional cell carcinoma present?
    A: Hematuria

    Q: How does Wilms' tumor present?
    A: Huge, palpable flank mass

    Q: In what epidemiological group is renal cell carcinoma most common?
    A: Men ages 50-70

    Q: T/F: Ammonium magnesium phosphate kidney stones are radiopaque
    A: TRUE

    Q: T/F: Calcium kidney stones are radiopaque.
    A: TRUE

    Q: T/F: Calcium kidney stones do not recur.
    A: FALSE

    Q: T/F: Cystine kidney stones are radiopaque.
    A: FALSE, cystine stones are radiolucent

    Q: T/F: Transitional cell carcinoma is cured by surgical removal.
    A: False, transitional cell carcinoma often recurs after removal

    Q: T/F: Uric acid kidney stones are radiopaque
    A: FALSE, uric acid stones are radiolucent

    Q: What additional sx are seen in a pt with acute streptococcal glomerulonephritis?
    A: Peripheral and periorbital edema

    Q: What age group is poststreptococcal glomerulonephritis most common?
    A: Children

    Q: What are 4 causes of hypoventilation?
    A: 1. Acute lung disease
    A: 2. Chronic lung disease
    A: 3. Opioids, narcotics, sedatives
    A: 4. Weakening of respiratory muscles

    Q: What are the 2 forms of renal failure?
    A: Acute and chronic

    Q: What are the 2 main symptoms present in Goodpasture's syndrome?
    A: Hemoptysis, hematuria

    Q: What are the 4 major types of kidney stones?
    A: 1. Calcium
    A: 2. Ammonium magnesium phosphate
    A: 3. Uric acid
    A: 4. Cystine

    Q: What are the 5 nephritic syndromes?
    A: Acute poststreptococcal glomerulonephritis
    A: Rapidly progressive (crescentic) glomerulonephritis
    A: Goodpasture's syndrome
    A: Membranoproliferative glomerulonephritis
    A: Berger's disease

    Q: What are the 5 nephrotic syndromes?
    A: 1. Membranous glomerulonephritis
    A: 2. Minimal change disease (lipoid nephrosis)
    A: 3. Focal segmental glomerular sclerosis
    A: 4. Diabetic nephropathy
    A: 5. SLE

    Q: What are the causes and signs of calcium ion deficiency?
    A: -Kids- rickets
    A: -Adults- osteomalacia
    A: -Contributes to osteoporosis
    A: -Tetany

    Q: What are the causes and signs of phosphate toxicity?
    A: -Low serum calcium ion
    A: -can cause bone loss
    A: -renal stones

    Q: What are the causes of chloride ion deficiency?
    A: Secondary to emesis, diuretics, renal disease

    Q: What are the causes of metabolic acidosis?
    A: -Diabetic ketoacidosis
    A: -Diarrhea
    A: -Lactic Acidosis
    A: -Salicylate OD
    A: -Acetazolamide OD

    Q: What are the causes of respiratory acidosis?
    A: -COPD
    A: -Airway obstruction

    Q: What are the causes of respiratory alkalosis?
    A: -High altitude
    A: -Hyperventilation

    Q: What are the characteristics of acute poststreptococcal glomerulonephritis seen with immunofluorescence?
    A: Granular pattern

    Q: What are the characteristics of acute poststreptococcal glomerulonephritis seen with the electron microscope?
    A: Subepithelial humps

    Q: What are the characteristics of acute poststreptococcal glomerulonephritis seen with the light microscope?
    A: Glomeruli enlarged and hypercellular
    A: neutrophils
    A: 'lumpy-bumpy'

    Q: What are the characteristics of rapidly progressive (crescentic) glomerulonephritis seen on LM and IF?
    A: Crescent-moon shape

    Q: What are the clinical features of renal cell carcinoma?
    A: -Hematuria
    A: -Palpable mass
    A: -Secondary polycythemia
    A: -Flank pain
    A: -Fever

    Q: What are the clinical symptoms of a nephritic syndrome?
    A: I' = inflammation; hematuria, hypertension, oligouria, azotemia

    Q: What are the clinical symptoms of nephrotic syndromes?
    A: O = proteinuria
    A: Hypoalbuminuria
    A: Generalized edema
    A: Hyperlipidemia

    Q: What are the consequences of renal failure?
    A: 1. Anemia
    A: 2. Renal osteodystrophy
    A: 3. Hyperkalemia
    A: 4. Metabolic acidosis
    A: 5. Uremia
    A: 6. Sodium and water excess
    A: 7. Chronic pyelonephritis
    A: 8. HTN

    Q: What are the factors associated metabolic alkalosis?
    A: -Increased pH
    A: -Increased PCO2
    A: -Increased HCO3-

    Q: What are the factors associated with metabolic acidosis?
    A: -Decreased pH
    A: -Decreased PCO2
    A: -Decreased HCO3-

    Q: What are the factors associated with respiratory acidosis?
    A: -Decreased pH
    A: -Increased PCO2
    A: -Increased HCO3-

    Q: What are the factors associated with respiratory alkalosis?
    A: -Increased pH
    A: -Decreased PCO2
    A: -Decreased HCO3-

    Q: What are the functions of calcium ion?
    A: -Muscle contraction
    A: -Neurotransmitter release
    A: -Bones, teeth

    Q: What are the functions of sodium ion?
    A: -Extracellular fluid
    A: -Maintains plasma volume
    A: -Nerve/muscle function

    Q: What are the functions of the chloride ion?
    A: -Fluid/electrolyte balance
    A: -Gastric acid
    A: -HCO3/Cl shift in RBC

    Q: What are the functions of the magnesium ion?
    A: -Bones, teeth
    A: -Enzyme cofactor

    Q: What are the functions of the phosphate ion?
    A: -ATP
    A: -nucleic acids
    A: -Phosphorylation
    A: -Bones, teeth

    Q: What are the functions of the potassium ion?
    A: -Intracellular fluid
    A: -Nerve/muscle function

    Q: What are the signs of magnesium ion deficiency?
    A: -Diarrhea
    A: -Alcoholism

    Q: What are the signs of magnesium ion toxicity?
    A: -Decreased reflexes
    A: -Decreased respirations

    Q: What are the signs of phosphate deficiency?
    A: -Kids- rickets
    A: -Adults- osteomalacia

    Q: What are the signs of potassium ion toxicity?
    A: -EKG changes
    A: -Arrhythmia

    Q: What bugs cause ammonium magnesium phosphate kidney stones?
    A: Urease-positive bugs such as Proteus vulgaris or Staphylococcus

    Q: What calcium molecules form calcium kidney stones?
    A: Calcium oxalate or calcium phosphate or both

    Q: What can excess Na and water cause?
    A: CHF and pulmonary edema

    Q: What can the hyperkalemia associated with renal failure lead to?
    A: Cardiac arrhythmias

    Q: What causes metabolic alkalosis?
    A: 1. Vomiting
    A: 2. Diuretic use
    A: 3. Antacid use
    A: 4. Hyperaldosteronism

    Q: What causes renal osteodystrophy?
    A: Failure of active vitamin D production

    Q: What characteristics of Berger's disease are seen with IF and EM?
    A: Mesangial deposits of IgA

    Q: What characteristics of focal segmental glomerular sclerosis are seen with the LM?
    A: Segmental sclerosis and hyalinosis

    Q: What characteristics of Goodpasture's syndrome are seen with IF?
    A: Linear pattern
    A: Anti-glomerular basement membrane antibodies

    Q: What characteristics of Membranoproliferative glomerulonephritis are seen with the EM?
    A: subendothelial humps
    A: 'tram track'

    Q: What characteristics of membranous glomerulonephritis are seen with IF?
    A: Granular pattern

    Q: What characteristics of membranous glomerulonephritis are seen with the EM?
    A: Spike and Dome'

    Q: What characteristics of membranous glomerulonephritis are seen with the LM?
    A: Diffuse capillary and basement membrane thickening

    Q: What characteristics of minimal change disease are seen with the EM?
    A: Foot process effacement

    Q: What characteristics of minimal change disease are seen with the LM?
    A: Normal glomeruli

    Q: What characteristics of SLE are seen with the LM?
    A: Wire-loop appearance with extensive granular subendothelial basement-membrane deposits in membranous glomerulonephritis pattern

    Q: What defines metabolic acidosis?
    A: -pH less than 7.4
    A: -PCO2 less than 40 mm Hg

    Q: What defines metabolic alkalosis with compensation?
    A: -pH greater than 7.4
    A: -PCO2 greater than 40 mm Hg

    Q: What defines respiratory acidosis?
    A: -pH less than 7.4
    A: -PCO2 greater than 40mm Hg

    Q: What defines respiratory alkalosis?
    A: -pH greater than 7.4
    A: -PCO2 less than 40 mm Hg

    Q: What diseases often cause uric acid kidney stones?
    A: Diseases with increased cell proliferation and turnover, such as leukemia and myeloproliferative disorders

    Q: What disorders can lead to hypercalcemia and thus kidney stones?
    A: 1. Cancer
    A: 2. Increased PTH
    A: 3. Increased vitamin D
    A: 4. Milk-alkali syndrome

    Q: What disorders cause an increased anion gap?
    A: 1. Renal failure
    A: 2. Lactic acidosis
    A: 3. Ketoacidosis (DM )
    A: 4. Aspirin ingestion

    Q: What disorders cause metabolic acidosis and normal anion gap?
    A: 1. Diarrhea
    A: 2. Glue sniffing
    A: 3. Renal tubular acidosis
    A: 4. Hyperchloremia

    Q: What disorders make up the WAGR complex?
    A: Wilms' tumor
    A: Aniridia
    A: Genitourinary malformation
    A: mental-motor Retardation

    Q: What does potassium deficiency cause?
    A: -Weakness
    A: -Paralysis
    A: -Confusion

    Q: What factors are associated with transitional cell carcinoma?
    A: Exposure to cyclophosphamide, smoking, phenacetin, and aniline dyes

    Q: What genetic disorder and mutation are associated with renal cell carcinoma?
    A: Renal cell carcinoma is associated with von Hippel-Lindau and gene deletion in chromosome 3

    Q: What genetic disorder is associated with Wilms' tumor?
    A: Deletion of tumor suppression gene WT-1 on chromosome 11

    Q: What is a common cause of adult nephrotic syndrome?
    A: Membranous glomerulonephritis

    Q: What is acute renal failure often due to?
    A: Hypoxia

    Q: What is Berger's disease?
    A: IgA nephropathy
    A: -Mild disease
    A: -Often postinfectious

    Q: What is chronic failure due to?
    A: HTN and diabetes

    Q: What is the 2nd most common type of kidney stone?
    A: Ammonium magnesium phosphate

    Q: What is the cause of magnesium ion deficiency?
    A: Secondary to malabsorption

    Q: What is the cause of metabolic alkalosis?
    A: Vomiting

    Q: What is the cause of potassium ion deficiency?
    A: Secondary to injury, illness or diuretics

    Q: What is the cause of sodium deficiency?
    A: Secondary to injury or illness

    Q: What is the compensatory mechanism of metabolic alkalosis?
    A: Hypoventilation

    Q: What is the compensatory mechanism of respiratory alkalosis?
    A: Renal HCO3- secretion

    Q: What is the compensatory response to metabolic acidosis?
    A: Hyperventilation

    Q: What is the compensatory response to respiratory acidosis?
    A: Renal HCO3- reabsorption

    Q: What is the course of membranoproliferative glomerulonephritis?
    A: Slowly progresses to renal failure

    Q: What is the course of rapidly progressive (crescentic) glomerulonephritis?
    A: Rapid course to renal failure from one of many causes

    Q: What is the Henderson-Hasselbalch equation?
    A: pH = pKa + log [(HCO3-)/(0.03*PCO2)]

    Q: What is the most common cause of childhood nephrotic syndrome?
    A: Minimal change disease (lipoid nephrosis)

    Q: What is the most common renal malignancy of early childhood (ages 2-4)?
    A: Wilms' tumor

    Q: What is the most common renal malignancy?
    A: Renal cell carcinoma

    Q: What is the most common tumor of the urinary tract system?
    A: Transitional cell carcinoma

    Q: What is the primary disturbance in respiratory acidosis?
    A: Increased PCO2

    Q: What is the primary disturbance of metabolic acidosis?
    A: HCO3- decrease

    Q: What is the primary disturbance of metabolic alkalosis?
    A: Increased HCO3-

    Q: What is the primary disturbance of respiratory alkalosis?
    A: Decreased PCO2

    Q: What is the sign of calcium ion toxicity?
    A: Delirium

    Q: What is the sign of sodium ion toxicity?
    A: Delirium

    Q: What lesions are seen on the LM in diabetic nephropathy?
    A: Kimmelstiel-Wilson lesions

    Q: What might an elevated anion gap indicate?
    A: MUD PILES
    A: 1. Methanol
    A: 2. Uremia (chronic renal failure)
    A: 3. Diabetic ketoacidosis
    A: 4. Paraldehyde or Phenformin
    A: 5. Iron tablets or INH
    A: 6. Lactic acidosis (CN-, CO, shock)
    A: 7. Ethanol or Ethylene glycol
    A: 8. Salicylates

    Q: What paraneoplastic syndromes are associated with renal cell carcinoma?
    A: Ectopic EPO, ACTH, PTHrP, and prolactin

    Q: What severe complications may kidney stones lead to?
    A: Hydronephrosis
    A: Pyelonephritis

    Q: What social factor increases the incidence of renal cell carcinoma?
    A: Smoking

    Q: What type of hypersensitivity contributes to the pathogenesis of Goodpasture's syndrome?
    A: Type II hypersensitivity

    Q: Where can transitional cell carcinoma occur?
    A: -Renal calyces
    A: -Renal pelvis
    A: -Ureters
    A: -Bladder

    Q: Where does renal cell carcinoma originate?
    A: Renal tubule cells, polygonal clear cells

    Q: Which kidney stone is often secondary to cystinuria?
    A: Cystine

    Q: Which kidney stone is strongly associated with gout?
    A: Uric acid kidney stones

    Q: Which of the nephrotic syndromes are worse in HIV pts?
    A: Focal segmental glomerular sclerosis

    Q: Which type of kidney stones constitute the majority of kidney stones (80-85%)?
    A: Calcium

    Q: Why are ammonium magnesium phosphate kidney stones often associated with UTIs?
    A: Ammonium magnesium phosphate stones can form large struvite calculi that can be a nidus for UTIs

    Q: Why does renal failure cause anemia?
    A: Failure of EPO production

    Q: Why does renal failure cause metabolic acidosis?
    A: Due to decreased acid secretion and decreased generation of HCO3-
  12. Imperial

    Imperial Guest

    : 3 main roles of Ig binding to bacteria
    A: - opsonization
    A: - neutralization
    A: - complement activation

    Q: A defect in phagocytosis of neutrophils owing to lack of NADPH oxidase activity or similar enzymes is indicative of what immune deficiency disease?
    A: Chronic granulomatous disease

    Q: After exposure to what 4 things are preformed (passive) antibodies given?
    A: Tetanus toxin, Botulinum toxin, HBV, or Rabies.

    Q: All nucleated cells have what class of MHC proteins?
    A: class I MHC proteins

    Q: Anaphylaxis, asthma, or local wheal and flare are possible manifestations of which type of hypersensitivity?
    A: Type I

    Q: Anti-gliadin autoantibodies are associated with what disease?
    A: Celiac disease

    Q: Anti-Scl-70 autoantibodies are associated with what disease?
    A: diffuse Scleroderma

    Q: Autoimmune hemolytic anemia, Rh disease (erythroblastosis fetalis), and Goodpasture's syndrome are examples of what kind of hypersensitivity reaction?
    A: type II hypersensitivity

    Q: Class I major histocompatibilty complex consists of …
    A: 1 polypeptide, with B2-microglobulin

    Q: Class II major histocompatibilty complex consists of …
    A: 2 polypeptides, an a and a B chain

    Q: Cytotoxic T cells have CD(?), which binds to class (?) MHC on virus-infected cells.
    A: CD8 binds to class I MHC

    Q: Define acute transplant rejection.
    A: Cell-mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation.

    Q: Define adjuvant.
    A: Adjuvants are nonspecific stimulators of the immune response but are not immunogenic by themselves.

    Q: Define chronic transplant rejection.
    A: Antibody-mediated vascular damage (fibrinoid necrosis)--irreversible. Occurs months to years after transplantation.

    Q: Define hyperacute transplant rejection.
    A: Antibody-mediated due to the presence of preormed anti-donor antibodies in the transplant recipient. Occurs within minutes after transplantation.

    Q: Define Ig allotype.
    A: Ig epitope that differs among members of the same species (on light or heavy chain)

    Q: Define Ig idiotype.
    A: Ig epitope determine by the antigen-binging site (specific for a given antigen-binding site)

    Q: Define Ig isotype.
    A: Ig epitope common to a single class of Ig (5 classes, determined by the heavy chain)

    Q: Give 3 classic examples of bacteria with antigen variation.
    A: (1) Salmonella (2 flagellar variants)
    A: (2) Borrelia (relapsing fever)
    A: (3) Neisseria gonorrhoeae (pilus protein)

    Q: Give 3 examples of possibly causes for SCID?
    A: (1) failure to synthesize class II MHC antigens
    A: (2) defective Il-2 receptors
    A: (3) adenosine deaminase deficiency

    Q: Goodpasture's syndrome is associated with what kind of autoantibodies?
    A: anti-basement membrane antibodies.

    Q: Helper T cells have CD(?) which binds to class (?) MHC on antigen-presenting cells.
    A: CD4 binds to class II MHC

    Q: How does Bruton's agammaglobulinemia usually present?
    A: as bacterial infections in boys after about 6 months of age, when levels of maternal IgG antibody decline

    Q: How is active immunity acquired?
    A: Active immunity is induced after exposure to foreign antigens. There is a slow onset with long-lasting protection.

    Q: How is passive immunity acquired?
    A: by receiving preformed antibodies from another host. Antibodies have a short life span, but the immunity has a rapid onset.

    Q: IL-4 promotes the growth of B cells and the synthesis of what 2 immunoglobulins?
    A: IgE and IgG

    Q: In what immune deficiency do neutrophils fail to respond to chemotactic stimuli?
    A: Job's syndrome

    Q: In what T-cell deficiency do the thymus and parathyroids fail to develop owing to failure of development of the 3rd and 4th pharyngeal pouches?
    A: Thymic aplasia (DiGeorge syndrome)

    Q: Job's syndrome is associated with high levels of what immunoglobulin?
    A: IgE

    Q: MHC I Ag loading occurs in __(1?)__ while MHC II Ag loading occurs in __(2?)__?
    A: (1) in rER (viral antigens)
    A: (2) in acidified endosomes.

    Q: Primary biliary cirrhosis has what kind of autoantibodies?
    A: anti-mitochondrial antibodies

    Q: Role of TH1 cells?
    A: produce IL-2 (activate Tc cells and further stimulate TH1 cell) and g-interferon (activate macrophages)

    Q: Role of TH2 cells?
    A: produce IL-4 and IL-5 (help B cells make Ab)

    Q: Sensitized T lymphocytes encounter antigen and then release lymphokines which leads to macrophage activation' in what hypersensitivity reaction?
    A: Type IV

    Q: TB skin test, transplant rejection, and contact dermatitis are examples of what type of hypersensitivity reaction?
    A: Type IV

    Q: The 3 kinds of MHC class I genes are…
    A: A, B, and C

    Q: The 3 kinds of MHC class II genes are…
    A: DP, DQ, DR

    Q: The Fc portion of immunoglobulins are at the __?__ terminal.
    A: The carboxy terminal

    Q: What 2 cytokines are secreted by macrophages?
    A: IL-1 and TNF-a

    Q: What 2 kinds of autoantibodies are specific for systemic lupus?
    A: Anti-dsDNA and anti-Smith

    Q: What 3 cytokines are classified as 'acute phase cytokines'?
    A: IL-1, IL-6, and TNF-a

    Q: What 3 ways do interferons interfere with viral protein synthesis?
    A: (1) alpha and beta interferons induce production of a second protein that degrades viral mRNA
    A: (2) gamma interferons increase MHC class I expression and antigen presentation in all cells
    A: (3) activates NK cells to kill virus-infected cells.

    Q: What affect do the acute phase cytokines have on fat and muscle?
    A: mobilization of energy reserves to raise body temperature

    Q: What affect do the acute phase cytokines have on the bone marrow?
    A: Incr. Production of Colony stim. Factor (CS) which leads to leukocytosis

    Q: What affect do the acute phase cytokines have on the hypothalamus?
    A: increase body temperature

    Q: What antibody isotype can cross the placenta?
    A: IgG

    Q: What are 3 types of antigen-presenting cells?
    A: macrophages, B cells, and dendritic cells

    Q: What are the maim symptoms of serum sickness an at what period of time following Ag exposure?
    A: fever, urticaria, arthralgias, proteinuria, lymphadenopathy 5-10 days after Ag exposure

    Q: What are the major symptoms of graft-vs.-host disease?
    A: maculopapular rash, jaundice, hepatosplenomegaly, and diarrhea.

    Q: What B- and T- cell deficiency, assoc. with IgA deficiency, presents with cerebellar problems and spider angiomas?
    A: ataxia-telangiectasia

    Q: What causes the tissue damage associated with Serum sickness?
    A: formation of immune complexes of foreign particles and Abs that deposit in membranes where they fix complement

    Q: What class of MHC proteins are the main determinants of organ rejection?
    A: class II MHC

    Q: What complement components can cause anaphylaxis?
    A: C3a and C5a

    Q: What components of the alternative complement pathway make the C3 convertase?
    A: C3b, Bb

    Q: What components of the alternative complement pathway make the C5 convertase?
    A: C3b, Bb, and 3b

    Q: What components of the classic complement pathway make the C3 convertase?
    A: C4b, C2b

    Q: What components of the classic complement pathway make the C5 convertase?
    A: C4b, 2b, and 3b

    Q: What components of the complement pathway are deficient in Neisseria sepsis?
    A: The MAC complex--(C5b, C6, C7, C8, C9)

    Q: What cytokines attract and activate neutrophils?
    A: TNF-a and B

    Q: What disease is associated with a X-linked defect in a tyrosine-kinase gene associated with low levels of all classes of immunoglobulins?
    A: Bruton's agammaglobulinemia

    Q: What disease is associated with anti-epithelial cell autoantibodies?
    A: Pemphigus vulgaris

    Q: What disease is associated with anti-microsomal autoantibodies?
    A: Hashimoto's thyroiditis

    Q: What does a deficiency of C1 esterase inhibitor cause (in the complement cascade)?
    A: angioedema because of overactive complement

    Q: What does a deficiency of C3 cause (in the complement cascade)?
    A: can lead to severe, recurrent pyogenic sinus and respiratory tract infections.

    Q: What does deficiency of decay-accelerating factor (DAF) in the complement cascade cause?
    A: leads to paroxysmal nocturnal hemoglobinuria (PNH)

    Q: What does Job's syndrome classically present with?
    A: recurrent 'cold' (noninflamed) staphylococcal abscesses

    Q: What does TNF-a stimulate dendritic cells to do during the acute phase response?
    A: TNF-a stimulates their migration to lymph nodes and their maturation for the initiation of the adaptive immune response.

    Q: What elements of the complement cascade made the Membrane Attack Complex (MAC)?
    A: C5b, C6, C7, C8, and C9

    Q: What Ig is found in secretions as a monomer or a dimer?
    A: IgA

    Q: What Ig is found in secretions as a monomer or a pentamer?
    A: IgM

    Q: What immune deficiency disease has an autosomal-recessive defect in phagocytosis that results from microtubular and lysosomal defects of phagocytic cells?
    A: Chediak-Higashi disease

    Q: What immune deficiency is associated with elevated IgA levels, normal IgE levels, and low IgM levels?
    A: Wiskott-Aldrich syndrome

    Q: What immune deficiency presents with tetany owing to hypocalcemia, congenital defects of the heart and great vessels, and recurrent viral, fungal, and protozoal infections?
    A: Thymic aplasia (DiGeorge syndrome)

    Q: What immunoglobulin isotype has the lowest concentration in serum?
    A: IgE

    Q: What immunoglobulin isotype is involved in type-I hypersensitivity reactions?
    A: IgE

    Q: What immunoglobulin isotype is produced in the primary response to an antigen and is on the surface of B cells?
    A: IgM

    Q: What immunoglobulin isotype mediates immunity to worms?
    A: IgE

    Q: What immunoglobulin isotype prevents the attachment of bacteria and viruses to mucous membranes?
    A: IgA

    Q: What immunoglobulins bind and activate the classic complement pathway?
    A: IgG and IgM (the Fc portion)

    Q: What interleukin induces naive helper T-cells to become TH1 cells?
    A: IL-12

    Q: What interleukin induces naive helper T-cells to become TH2 cells?
    A: IL-4

    Q: What interleukin stimulates the growth of both helper and cytotoxic T-cells?
    A: IL-2

    Q: What is Chronic mucocutaneous candidiasis?
    A: T-cell dysfunction specifically against Candida albicans.

    Q: What is important about the CD3 complex?
    A: It is a cluster of polypeptides associated with a T-cell receptor and is important in signal transduction.

    Q: What is the cellular process that causes type I hypersensitivity?
    A: Ag cross-links IgE on presensitized mast cells and basophils, triggering the release of vasoactive amines.

    Q: What is the cellular process that causes type II hypersensitivity?
    A: IgM, IgG bind to Ag on 'enemy' cell, leading to lysis (by complement) or phagocytosis (its cytotoxic).

    Q: What is the main antibody in the secondary immune response?
    A: IgG

    Q: What is the most abundant immunoglobulin isotype?
    A: IgG

    Q: What is the most common selective immunoglobulin deficiency?
    A: selective IgA deficiency

    Q: What is the rise in temperature during the acute phase response help do (3 things?)
    A: (1) increase specific immune response
    A: (2) increase antigen processing
    A: (3) decrease viral and bacterial replication

    Q: What is the triad of symptoms seen with Wiskott-Aldrich syndrome?
    A: recurrent pyogenic infections, eczema, and thrombocytopenia

    Q: What kind of autoantibodies are associated with CREST/Scleroderma?
    A: anti-centromere antibodies

    Q: What kind of autoantibodies are known as rheumatoid factor?
    A: anti-IgG antibodies

    Q: What kind of immunity (antibody-mediated or cell mediated) is involved in autoimmunity?
    A: antibody-mediated immunity (B cells)

    Q: What kind of immunity (antibody-mediated or cell mediated) is involved in graft and tumor rejection?
    A: cell mediated immunity (T cells)

    Q: What kind of transplant rejection is reversible with immunosuppressants such as cyclosporin and OKT3?
    A: acute transplant rejection

    Q: What kinds of adjuvants are included in human vaccines?
    A: aluminum hydroxide or lipid

    Q: What kinds of cells have class II MHC proteins?
    A: antigen-presenting cells (e.g. macrophages and dendritic cells)

    Q: What parasites have antigen variation?
    A: trypanosomes (programmed rearrangement)

    Q: What symptoms characterize the Arthus reaction and what causes them?
    A: edema, necrosis, and activation of complement due to the Ag-Ab complexes that form in the skin following intradermal injection of Ag.

    Q: What type of cell secretes IL-3?
    A: activated T-cells

    Q: What type of cells does gamma interferon stimulate?
    A: macrophages

    Q: What type of hypersensitivity reaction is the Arthus reaction?
    A: type III

    Q: Where does the alternative complement pathway occur?
    A: On microbial surfaces

    Q: Where does the classic complement pathway occur?
    A: antigen-antibody complexes

    Q: Where is the defect in SCID?
    A: the defect is in early stem-cell differentiation, leading to B- and T-cell deficiency

    Q: Which interleukin causes fever?
    A: IL-1

    Q: Which interleukin enhances the synthesis of IgA?
    A: IL-5

    Q: Which interleukin stimulates the production and activation of eosinophils?
    A: IL-5

    Q: Which interleukin supports the growth and differentiation of bone marrow stem cells?
    A: IL-3

    Q: Which is the only type of cell-mediated hypersensitivity reaction, and thus not transferable by serum?
    A: Type IV

    Q: Wiskott-Aldrich syndrome is a defect in the ability to mount what immune response?
    A: an IgM response to capsular polysaccharides of bacteria.

    Q: With what disease are anti-histone autoantibodies associated?
    A: drug-induced lupus

    Q: With what disease are anti-nuclear antibodies associated?
    A: systemic lupus
  13. Imperial

    Imperial Guest

    Q: Name 5 species of bacteria that are transmitted to humans from animals.(Acronym: BBugs From Your Pet.)
    A: Borrelia burgdorferi
    A: - Brucella spp.
    A: - Francisella tularensis
    A: - Yersinia pestis
    A: - Pasteurella multocida

    Q: All Rickettsiae (except one genus) are transmitted by what type of vector?
    A: arthropod (Coxiella is atypical: transmitted by aeresol)

    Q: Are G(-) bugs resistant to Pen G? to ampicillin? to vancomycin?
    A: G- bugs are resistant to PenG but may be susceptible to pen. derivative like ampicillin. The G- outer mb inhibits entry of PenG and vancomycin.

    Q: Are Strep. pneumoniae sensitve to optochin? Are Viridans strep.?
    A: Strep. pneumoniae is optochin-Sensitive
    A: - Viridans streptococci is optochin-Resistant

    Q: Are Strep. pyogenes Bacitracin-sensitive?>
    A: YES. both are catalase +

    Q: Are Viridans strep. alpha, beta, or non-hemolytic?
    A: alpha

    Q: Because of drug resistance, what in an alternate treatment combination for leprosy?
    A: rifampin with dapsone and clofazimine

    Q: Besides the rash, what other body systems are affected by Lyme disease? (3)
    A: joints
    A: -CNS
    A: -heart

    Q: Describe lab-findings for Pseudomonas aeruginosa.
    A: Aerobic, G(-) rod.
    A: - Non-lactose fermenting
    A: - Oxidase positive
    A: - Produces pyocyanin (blue-green pigment)

    Q: Describe the disease associated with M. avium-intracellulare.
    A: often resistant to multiple drugs; causes disseminated disease in AIDS.

    Q: Describe the H. flu vaccine. When is it given?
    A: contains type b capsulare polysaccharide conjugated to diphtheria toxoid or other protein.
    A: -Given b/t 2m and 18m.

    Q: Describe the typical findings with diarrhea caused by enterotoxigenic E. coli. (3)
    A: 1) Ferments lactose
    A: 2) watery diarrhea
    A: 3) no fever/leukocytosis

    Q: Describe the typical findings with Vibro cholerae. (3)
    A: 1) Comma-shaped organisms
    A: 2) rice-water stools
    A: 3) no fever/leukocytosis

    Q: Do Streptococcus pneumonia have catalase? Do Viridans Strep. have catalase?
    A: YES. both are catalase +

    Q: Enterococci are hardier than nonenterococcal group D bacteria. What lab conditions can they grow in?
    A: 6.5% NaCl (used as lab test)

    Q: Following primary infection with TB, if preallergic lymphatic or hematogenous dissemination occurs, what follows?
    A: -dormant tubercle bacilli form in several organs
    A: - REACTIVATION can occur in adult life

    Q: Following primary infection with TB, if severe bacteremia occurs, what follows?
    A: Miliary tuberculosis and possibly death

    Q: Following primary infection with TB, if the lesion heals by fibrosis, what is the result?
    A: Immunity and hypersensitivity---> tuberculin positive

    Q: Following primary infection with TB, under what conditions would the lesion likely progress to lung disease?
    A: HIV, malnutrition. This progressive lung disease can rarely lead to death.

    Q: Following primary infection with TB, what are 4 possible courses the disease could take?
    A: 1) Heals by fibrosis
    A: 2) Progressive lung disease
    A: 3) Severe bacteremia
    A: 4) Preallergic lymphatic or hematogenous dissemination

    Q: Give 3 examples of obligate anaerobes.
    A: Clostridium
    A: - Bacteroides
    A: - Actinomyces

    Q: Give 3 types of infection Pseudomonas aeruginosa is commonly responsible for.
    A: 1) burn wound infection
    A: 2) nosocomial pneumonia
    A: 3) pneumonia with cystic fibrosis

    Q: Give 4 examples of encapsulated bacteria.
    A: 1) Strep. pneumoniae
    A: 2) Haemophilus influenza (especially b)
    A: 3) Neisseria memingitidis
    A: 4) Klebsiella pneumoniae

    Q: H. flu causes what? (4)
    A: Epiglottitis
    A: -Meningitis
    A: -Otitis media
    A: -Pneumonia (haEMOPhilus)

    Q: How are Borrelia visualized?
    A: using aniline dyes (Wright's or Giemsa stain) in light microscopy

    Q: How are Mycobacteria visualized in the lab?
    A: acid-fast stain =Ziehl-Neelson

    Q: How are Treponema visualized?
    A: by dark-field microscopy

    Q: How can secondary tuberculosis in the lung occur?(2)
    A: 1) Reinfection of partially immune hypersensitized hosts (usu. adults) =exogenous source
    A: 2) Reactivation of dormant tubercle bacilli in immunocompromised or debilitated hosts =endogenous source

    Q: How can you remember that Viridans strep are resistant to optochin?
    A: they live in the mouth and are not afraid of the (opto-)CHIN

    Q: How does primary syphilis present?
    A: with a painless chancre (localized disease; 2-10 wks).

    Q: How does secondary syphilis present?
    A: disseminated disease (1-3m later) with constitutional symptoms, maculopapular rash, condylomata lata (genital lesions)

    Q: How does tertiary syphilis present?
    A: gummas (granulomas), aortitis, neurosyphilis (tabes dorsalis), Argyll-Robertson pupil

    Q: How does the bacterium cause the disease?
    A: via exotoxin encoded by beta-prophage; exotoxin inhibits protein synthesis via ADP-ribosylation of EF-2

    Q: How does the rash with typhus differ from the rash with RMSF?
    A: typhus: maculopapillary rash BEGINS ON TRUNCK, moves peripherally
    A: -RMSF: macules progressing to petichiae BEGIN ON HANDS &FFET and move inward.

    Q: How is Brucellosis/Undulant fever transmitted?
    A: dairy products, contact with animals

    Q: How is Cellulitis transmitted?
    A: Animal bite; cats, dogs

    Q: How is H. flu transmitted?
    A: aeresol

    Q: How is Legionnaires' disease diagnosed in lab?
    A: use silver stain (doesn't Gram stain well)
    A: -culture with charcoal yeast extract with iron and cysteine.

    Q: How is Legionnaires' disease transmitted?
    A: aeresol transmission from envirnomental water source habitat (NO human-to-human transmission).

    Q: How is Lyme disease transmitted?
    A: Tick bite; Ixodes ticks that live of deer and mice

    Q: How is Shigella spread?
    A: food, fingers, feces, and flies'

    Q: How is the Plague transmitted?
    A: Flea bite; rodents, especially prairie dogs

    Q: How is Tuleremia transmitted?
    A: Tick bite; rabbits, deer

    Q: Is Bacillus anthracis G+ or G-? What is its morphology?
    A: It is a G+, spore-forming rod

    Q: Is there an animal reservoir for leprosy?
    A: Yes, armadillos in the US

    Q: List 5 findings associated with rheumatic fever. (Hint: PECCS)
    A: Polyarthritis
    A: - Erythema marginatum
    A: -Chorea
    A: - Carditis
    A: - Subcutaneous nodules

    Q: List the 'ABCDEFG' of diphtheria.
    A: ADP ribosylation
    A: -Beta-prophage
    A: -Corynebacterium
    A: - Diphtheria
    A: - Elongation Factor 2
    A: - Granules

    Q: Name 2 alpha-hemolytic bacteria.
    A: Strep. pneumoniae
    A: - Viridans streptococci

    Q: Name 2 bugs that cause diarrhea but NOT fever and leukocytosis?
    A: E. coli and Vibro cholerae

    Q: Name 2 disease processes that can be caused by enterococci.
    A: 1) UTI
    A: 2) subacute endocarditis

    Q: Name 2 species of enterococci.
    A: Enterococcus faecalis
    A: -Enterococcus faecium

    Q: Name 2 symptoms of diphtheria.
    A: pseudomembraneous pharyngitis (grayish white membrane)
    A: - lymphadenopathy

    Q: Name 3 spore forming bacteria.
    A: Bacillus anthracis
    A: - Clostridium perfringens
    A: - C. tetani

    Q: Name 4 beta-hemolytic bacteria.
    A: 1) Staph. aureus
    A: 2) Strep. pyogenes (GAS)
    A: 3) Strep. agalactiae (GBS)
    A: 4) Listeria monocytogenes

    Q: Name 4 lactose-fermenting enteric bacteria.
    A: Klebsiella
    A: -E. coli
    A: -Enterobacter
    A: Citrobacter
    A: (think Lactose is KEE for first three listed)

    Q: Name 4 obligate aerobic bacteria.
    A: Norcardia
    A: - Pserudomonas aeruginosa
    A: - Mycobacterium tuberculosis
    A: - Bacillus

    Q: Name 5 bugs that cause watery diarrhea.
    A: 1) Vibrio cholerae
    A: 2) enterotoxigenic E. coli
    A: 3) viruses (rotavirus)
    A: 4) protozoa (Cryptosporidium and (5) Giardia)

    Q: Name 6 bugs that cause bloody diarrhea.
    A: 1) Salmonella
    A: 2) Shigella
    A: 3) Campylobacter jejuni
    A: 4) enterohemorrhagic/enteroinvasive E.coli
    A: 5) Yersinia enterocilitica
    A: 6) Entamoeba histolytica (a protozoan)

    Q: Name 7 faculatative intracellular bacteria.
    A: 1) Mycobacterium
    A: 2) Brucella
    A: 3) Francisella
    A: 4) Listeria
    A: 5) Yersinia
    A: 6) Legionella
    A: 7) Salmonella

    Q: Name three genera of spirochetes.
    A: Borrelia (big size)
    A: - Leptospira
    A: -Treponema
    A: (think: BLT; B is big)

    Q: Name two lab tests used to detect syphilis?
    A: VDRL and FTA-ABS

    Q: Name two non-lactose fermenting bacteria that invade intestinal mucosa and can cause bloody diarrhea.
    A: Salmonella and Shigella

    Q: Name two obligate intracellular bacteria.
    A: Rickettsia and Chlamydia (Hint: 'stay inside when its Really Cold.')

    Q: RMSF is endemic to what part of the US?
    A: the East Coast (in spite of the name)

    Q: Spore are formed by certain species of what type of bacteria?
    A: Gram+ rods, usually in soil; form spores only when nutrients are limited

    Q: T/F Chlamydia are obligate intracellular parasites that cause mucosal infections.
    A: TRUE

    Q: T/F Chlamys means cloak.
    A: TRUE (intracellular)

    Q: T/F Enterobacteriaceae are oxidase negative and are glucose fermenters.
    A: TRUE

    Q: T/F H. pylori infection is a risk factor for peptic ulcer and gastric carcinoma.
    A: TRUE

    Q: T/F Penicillin is not an effective treatment against Mycoplasma pneumoniae.
    A: TRUE Mycoplama are naturally resistant b/c they have no cell wall.

    Q: T/F Pseudomonas produces both endotoxin and exotoxin.
    A: TRUE: endotoxin---> fever, shock
    A: -exotoxin---> inactivates EF-2

    Q: T/F Rickettsiae are obligate intracellular parasites and need CoA and NAD.
    A: TRUE

    Q: T/F Some enterococci are resistant to PenG.
    A: FALSE: ALL enterococci are naturally resistant to Pen/cephlosporins.

    Q: T/F Spores have no metabolic activity.
    A: TRUE

    Q: T/F: S. aureus food poisoning is due to the ingestion of bacteria that rapidly secrete toxin once they enter the GI tract.
    A: FALSE: rapid onset of S. aureus food poisoning is due to injestion of PREFORMED toxin

    Q: The Weil-Felix reaction usually tests positive for what two diseases? Negative for what? Cross reacts with what?
    A: Positive: typhus and RMSF
    A: -Negative: Q fever
    A: -Cross-reacts: with Proteus antigen

    Q: Think COFFEe for Enterobacteriaceae. What does that stand for?
    A: Capsular
    A: -O-antigen
    A: -Flagellar antigen
    A: -Ferment glucose
    A: -Enterobacteriaceae

    Q: What's a pneumonic for remembering 4 obligate aerobes?
    A: Nagging Pests Must Breath (=Norcardia
    A: - Pserudomonas aeruginosa
    A: - Mycobacterium tuberculosis
    A: - Bacillus

    Q: What (6) infections can Pseudomonas aeruginosa cause?
    A: burn-wound infections
    A: -Pneumonia (esp. in cystic fibrosis)
    A: -Sepsis (black skin lesions)
    A: -External Otitis (swimmer's ear)
    A: - UTI
    A: -hot tub folliculitis

    Q: What 2 bugs can cause bloody diarrhea, fever, and leukocytosis, but do not ferment lactose?
    A: Salmonella and Shigella

    Q: What animals carry Lyme disease?
    A: The Ixodes tick transmits it.
    A: - Deer are required for tick life cycle.
    A: - Mice are important resservoirs.

    Q: What anitbody class is necessary for an immune response to encapsulated bacteria?
    A: IgG2.

    Q: What are 2 disease processes caused by Viridans strep and what species are responsible?
    A: 1) dental caries: Strep. mutans
    A: 2) bacterial endocarditis: Strep. sanguis

    Q: What are 2 options for triple thearpy treatment of H. pylori?
    A: (1) bismuth (Pepto-Bismal), metronidazole, and tetracyclin or amoxicillin. OR
    A: (2) metronidazole, omeprazole, and clarithromycin (#2 is more expensive)

    Q: What are 3 advantages/differences between VDRL and FTA-ABS?
    A: FTA-ABS is 1) more specific
    A: 2) positive earlier in disease
    A: 3) remains positive longer than VDRL

    Q: What are 3 disease processes caused by Strep. pyogenes?
    A: 1) Pyogenic--pharyngitis, cellulitis, skin infection
    A: 2) Toxigenic--scarlet fever, TSS
    A: 3) Immunologic--rheumatic fever, acute glomerulonephritis

    Q: What are 4 biological false positives for VDRL?
    A: 1) Viruses (mono, hepatitis)
    A: 2) Drugs
    A: 3) Rheumatic fever and rheumatic arthritis
    A: 4) Lupus and leprosy
    A: (=VDRL)

    Q: What are 4 clinical symptoms of 'walking' pneumonia?
    A: 1) insidious onset
    A: 2) headache
    A: 3) nonproductive cough
    A: 4) diffuse interstitial infiltrate

    Q: What are 4 clinical symptoms of TB?
    A: 1) fever
    A: 2) night sweats
    A: 3) weight loss
    A: 4) hemoptysis

    Q: What are 5 areas that can be affected by extrapulmonary TB?
    A: 1) CNS (parenchmal tuberculoma or meningitis)
    A: 2) Vertebral body (Pott's disease)
    A: 3) Lymphadenitis
    A: 4) Renal
    A: 5) GI

    Q: What are the culture requirement for H. flu?
    A: culture on chocolate agar with factor V (NAD) and X (hematin). [Think: 'Child has 'flu'; mom goes to five (V) and dime (X) store to buy chocolate.']

    Q: What are the lab findings with Chlamydia?
    A: cytoplasmic inclusions on Giemsa fluorescent antibody-stains smear

    Q: What are the symptoms of RMSF? (3)
    A: 1) rash on palms and soles (migrating to wrists, ankles, then trunck)
    A: 2) headache
    A: 3) fever

    Q: What are the three stages of Lyme disease?
    A: 1) erythema chronicum migrans, flu-like symptoms
    A: 2) neurologic and cardiac manefestations
    A: 3) autoimmune migratory polyarthritis

    Q: What are the two forms of chlamydia?
    A: 1) Elementary body (small, dense): Enters cell via endocytosis
    A: 2) Initial or Reticulate body: Replicates in the cell by fission

    Q: What are the two forms of leprosy (or Hansen's disease)?
    A: 1) lepromatous- failed cell-mediated immunity, worse
    A: 2) tuberculoid- self-limited.

    Q: What are two drugs that could be used to treat 'walking' pneumonia?
    A: tetracycline or erythromycin

    Q: What are two drugs that could treat Chlmydia?
    A: erythromycin or tetracycline

    Q: What are two lab findings associated with 'walking' pneumonia?
    A: 1) X-ray looks worse than patient
    A: 2)High titer of cold agglutinins (IgM)

    Q: What are usually associated with pseudomembraneous colitis?
    A: Clostridium difficile; it kills enterocytes, usu. is overgrowth secondary to antibiotic use (esp. clindamycin or ampicillin)

    Q: What bacteria are G+, spore-forming, anaerobic bacilli?
    A: Clostridia

    Q: What bacteria causes a malignant pustule (painless ulcer); black skin lesions that are vesicular papules covered by a blak eschar?
    A: Bacillus anthracis

    Q: What bacteria exhibits a 'tumbling' motility, is found in unpasteurized milk, and causes meningitis in newborns?
    A: Listeria monocytogenes

    Q: What bacteria is catalase(-) and bacitracin-resistant?
    A: Strep. agalactiae

    Q: What bacteria is catalase(-) and bacitracin-sensitive?
    A: Strep. pyogenes

    Q: What bacteria is catalase+ and coagulase+?
    A: Staph. aureus

    Q: What bacteria produces alpha-toxin, a hemolytic lecithinase that causes myonecrosis or gas gangrene?
    A: Clostridium perfringens

    Q: What bacterium causes Cellulitis?
    A: Pasteurella multocida

    Q: What bacterium causes leprosy?
    A: Mycobacterium leprae

    Q: What bacterium causes Lyme disease?
    A: Borrelia burgdorferi

    Q: What bacterium causes the Plague?
    A: Yersinia pestis

    Q: What bacterium causes Tularemia?
    A: Francisella tularensis

    Q: What bacterium causes Undulant fever?
    A: Brucella spp. (a.k.a. Brucellosis)

    Q: What bug causes atypical 'walking' pneumonia?
    A: Mycoplama pneumoniae

    Q: What bug causes gastroenteritis and up to 90% of duodenal ulcers?
    A: Helicobacter pylori

    Q: What bug causes Legionnaire's disease?
    A: Legionella pneumophila

    Q: What bug is associated with burn wound infections?
    A: Pseudomonas aeruginosa

    Q: What bug is comma- or S-shaped and grows at 42C, and causes bloody diarrhea with fever and leukocytosis?
    A: Campylobacter jejuni

    Q: What bug that causes diarrhea is usually transmitted from pet feces (e.g. puppies)?
    A: Yersinia enterocolitica

    Q: What causes tetanus? (give bacteria and disease process)
    A: Clostridium tetani: exotoxin produced blocks glycine release (inhibitory NT) from Renshaw cells in spinal cord

    Q: What causes the flu?
    A: NOT H. flu
    A: -it is caused by influenza virus

    Q: What chemical is found in the core of spores?
    A: dipicolinic acid

    Q: What coccobacillus causes vaginosis: greenish vaginal discharge with a fishy smell; nonpainful?
    A: Gardnerella vaginalis

    Q: What disease does Bordetella perussis cause? How?
    A: Whooping cough: toxin permanently disables G-protein in respiratory mucosa (turns the 'off' off);ciliated epithelial cells are killed; mucosal cells are overactive.

    Q: What disease does Vibrio cholerae cause? How?
    A: Cholera: toxin permanently activates G-protein in intestinal mucosa (turns the 'on' on) causing rice-water diarrhea

    Q: What disease is caused by Borrelia?
    A: Lyme Disease

    Q: What disease is caused by Clostridium botulinum? What pathophys. does it cause?
    A: Botulism: associated with contaminated canned food, produces a preformed, heat-labile toxin that inhibits ACh release---> flaccid paralysis.

    Q: What diseases (2) are caused by Treponema?
    A: Syphilis (T. pallidum)
    A: -yaws (T. pertenue; not and STD)

    Q: What diseases can be caused by Staph. aureus?
    A: Inflammatory disease: skin infections, organ abcess, pneumonia
    A: - Toxin-mediated disease: Toxic Shock Syn., scalded skin syndrome (exfoliative toxin), rapid onset food poisoning (enterotoxins)

    Q: What do Chlamydia trachomatis serotypes A, B, and C cause?
    A: chronic infection, cause blindness in Africa (ABC= Africa / Blindness / Chronic

    Q: What do Chlamydia trachomatis serotypes D-K cause? (3)
    A: urethritis/ PID
    A: - neonatal pneumonia
    A: -neonatal conjuctivitis

    Q: What do Chlamydia trachomatis serotypes L1,L2, and L3 cause?
    A: lymphogranuloma venereum (acute lymphadentis: positive Frei test)

    Q: What do RMSF, syphilis, and coxsackievirus A infection have in common?
    A: rash on palm and sole is seen in each (coxasackievirus A =hand, foot, and mouth disease)

    Q: What does catalase do? Which bacteria have it?
    A: it degrades H2O2, an antimicrobial product of PMNs.
    A: - Staphlococci make catalase; Strep. do NOT.

    Q: What does the H-antigen represent?
    A: H: flagellar antigen, found on motile species

    Q: What does the K-antigen represent?
    A: K: capsular, relates to virulence

    Q: What does the O-antigen represent?
    A: O-antigen is the polysaccharide of endotoxin (found on all species)

    Q: What does VDRL detect? (It detects non-specific antibody that reacts with what?)
    A: detects antibody that reacts with beef cardiolipin

    Q: What drug of choice is used to treat Norcardia? Actinomyces? (Acronym: SNAP)
    A: Sulfa for
    A: Norcarida,
    A: Actinomyces gets
    A: Penicillin

    Q: What enteric bacterial infection may be prolonged with antibiotic treatment?
    A: Salmonellosis

    Q: What enzyme allows H. pylori to creat an alkaline environment?
    A: urease (cleaves urea to ammonia); used in urease breath test

    Q: What family includes E. coli, Salmonella, Klebsiella, Enterobacter, Serratia, and Proteus?
    A: Enterobacteriaceae

    Q: What family of bacteria uses the O-, K-, and H-antigen nomenclature?
    A: Enterobacteriaceae

    Q: What function does the capsule serve? (A: one for the bacterium, one other)
    A: 1) antiphagocytic
    A: 2) antigen in vaccines (Pneumovax, H. flu b, meningococcal vaccines)

    Q: What G+ anaerobe causes oral/facial abscesses with 'sulfur granules' that may drain through sinus tracts in skin?
    A: Acinomyces israelii

    Q: What G+ and also weakly acid fast aorobe found in soil causes pulmonary infections in immunocompromised patients?
    A: Norcardia asteroides

    Q: What general type of bacteria are normal flora in GI tract but pathogenic elsewhere?
    A: Anaerobes

    Q: What general type of bacteria grow pink colonies on MacConkey's agar?
    A: Lactose-fermenting enteric bacteria

    Q: What is a Ghon complex and in whom does it occur?
    A: Occurs in Primary TB (usually a child)
    A: -Ghon complex= draining Hilar nodes and Ghon focus, exudative parenchymal lesion (usu. in LOWER lobes of lung)

    Q: What is a lab diagnosis of diphtheria based on?
    A: G+ rods with metachromatic granules; grows on tellurite agar. (Coryne=club shaped)

    Q: What is a major difference between Salmonella and Shigella observable in the lab?
    A: Salmonella are motile; Shigella are nonmotile

    Q: What is a positive Quellung reaction?
    A: if encapsulated bug is present, capsule SWELLS when specific anticapsular antisera are added.

    Q: What is notable about Chrmydia psittaci?
    A: has an avian reservoir

    Q: What is one reason M. leparae infects skin and superficial nerves?
    A: It likes cool temperatures

    Q: What is the classic symptom of Lyme Disease?
    A: erythema chronicum migrans, an expanding 'bull's eys' red rash with central clearing.

    Q: What is the classic triad of symptoms associated with Rickettsiae?
    A: 1) headache
    A: 2) fever
    A: 3) rash (vasiculitis)

    Q: What is the common manifestation of secondary TB?
    A: Fibrocaseous cavitary lesion usu. in APICIES of lung

    Q: What is the common site of infection for Mycobacterium tuberculosis?
    A: the apicies of the lung (which have the highest PO2)

    Q: What is the D.O.C. to treat Gardnerella vaginalis?
    A: Metroidazole

    Q: What is the DOC for treating rickettsial infections?
    A: tetracycline

    Q: What is the DOC for treatment of most rickettsial infections?
    A: tetracycline

    Q: What is the DOC to treat Lyme Disease?
    A: tetracycline

    Q: What is the DOC to treat syphilis?
    A: Penicillin G

    Q: What is the drug of choice for H. flu meningitis? What DOC for prophylaxis in close-contacts?
    A: Treat meningitis with CEFTRIAXONE; Rifampin for prophylaxis.

    Q: What is the drug of choice for Legionaires' disease?
    A: Erythromycin

    Q: What is the morphology of H. flu?
    A: Small G(-) (coccobacillary) rod

    Q: What is the morphology of H. pylori?
    A: Gram (-) rod

    Q: What is the primary drug used to treat leprosy?
    A: dapsone (toxicity is hemolysis and methemoglobinemia)

    Q: What is the recommended treatment for Pseudomonas aeruginosa infection?
    A: aminoglycoside plus extended-spectrum penicillin (e.g. piperacillin or ticarcillin)

    Q: What is the source of infection and the bacterium that causes endemic typhus?
    A: R. typhi; from fleas

    Q: What is the source of infection and the bacterium that causes epidemic typhus?
    A: R. prowazekii; from human body louse

    Q: What is the source of infection and the bacterium that causes Q fever?
    A: Coxiella burnetii; from inhaled aersols

    Q: What is the source of infection and the bacterium that causes Rocky Mountain Spotted Fever?
    A: Rickettsia rickettsii; from tick bite

    Q: What is the toxin responsible for TSS is Staph. aureus?
    A: TSST-1; it is a superantigen that binds to class II MHC and T-cell receptors---> polyclonal T-cell activation

    Q: What is the unique component found in Mycoplamsa bacterial membranes?
    A: cholesterol

    Q: What is the unique feature of Chlamydiae cell walls?
    A: its peptidoglycan wall lacks muramic acid

    Q: What is woolsorter's disease?
    A: inhalation anthrax; can cause life-threatening pneumonia

    Q: What lab test assays for antirickettsial antibodies?
    A: Weil-Felix reaction

    Q: What Lancefield Antigen Group are enterococci in?
    A: Group D

    Q: What Lancefield Antigen Group are Viridans strep in?
    A: They are non-typealbe. They do not have a C-carbohydrate on their cell wall to be classified by.

    Q: What level of disinfection is required to kill spores?
    A: autoclaving; they are highly resistant to destruction by heat and chemicals

    Q: What populations are most likely to get Mycoplama pneumoniae infection?
    A: patients younger than age 30
    A: - military recruits
    A: - prisons

    Q: What rickettsial disease is atypical in that it has no rash, no vector, negative Weil-Felix reaction, and its causative organism can survive outside for a long time?
    A: Q fever (Coxiella burnetii)

    Q: What species are associated with food poisoning in contaminated seafood?
    A: Vibrio parahaemolytica and Virbrio vulnificus

    Q: What species causes diphtheria?
    A: Corynebacterium diptheriae

    Q: What species is associated with food poisoning in improperly canned foods (bulging cans)?
    A: Clostridium botulinum

    Q: What species is associated with food poisoning in meats, mayonnaise, and custard?
    A: Staphylococcus aureus (this food poisoining usu. starts quickly and ends quickly)

    Q: What species is associated with food poisoning in poultry, meat, and eggs?
    A: Salmonella

    Q: What species is associated with food poisoning in reheated meat dishes?
    A: Clostridium perfringens

    Q: What species is associated with food poisoning in reheated rice?
    A: Bacillus cereus ('Food poisoning from reheated rice? Be serious!')

    Q: What species is associated with food poisoning in undercooked meat and unpasteurized juices?
    A: E. coli 0157-H7

    Q: What species of Mycobacteria causes pulmonary, TB-like symptoms?
    A: M. kansasii

    Q: What strain of Haemophilus influenza causes most invasive disease?
    A: capsular type b

    Q: What symptoms are associated with M. scrofulaceum
    A: cervical lymphadenitis in kids

    Q: What test differentiates Viridans from S. pneumoniae?
    A: Viridans are resistant to optochin; S. pneu. are sensitive to optochin

    Q: What two bugs secrete exotoxins that act via ADP ribosylation of G-proteins, permanently activating adenyl cyclase (resulting in increased cAMP)?
    A: Vibrio cholerae
    A: - Bordetella pertussis

    Q: What two genera of G+ rods form long branching filaments resembling fungi?
    A: Acinomyces and Nocardia

    Q: What type of bacteria are difficult to culture, produce gas in tissue (CO2 and H2), and are generally foul-smelling?
    A: Anaerobes

    Q: What type of bacteria is associated with rusty sputum, sepsis in sickle cell, and splenectomy?
    A: Pneumoccocus

    Q: What type of E. coli are associated with bloody diarrhea?
    A: enterohemmoragic/ enteroinvasive E. coli

    Q: What type of immunologic response is elicited by a Salmonella infection?
    A: monocyte response

    Q: What types of infection can chlamydia cause? (4)
    A: arthritis
    A: - conjunctivitis
    A: - pneumonia
    A: - nongonococcal urethritis

    Q: What virulence factor of Staph. aureus binds Fc-IgG, inhibiting complement fixation and phagocytosis?
    A: Protein A

    Q: What virulence factor of Strep. pyogenes also serves as an antigen to which the host makes antibodies?
    A: M-protein

    Q: What will likely be visible under the microscope in the case of Gardnerella vaginallis infection?
    A: Clue cell, or vaginal epithelial cells covered with bacteria

    Q: Where are Viridans strep. found (reservoir)?
    A: normal flora of oropharynx

    Q: Where are when is Lyme disease common?
    A: common in northeast US in summer months

    Q: Which disease/toxin causes lymphocytosis? (Cholera or Pertussis)
    A: Pertussis toxin: by inhibiting chemokine receptors

    Q: Which has an animal reservoir? (Salmonella or Shigella)
    A: Salmonella: poultry, meat, eggs

    Q: Which is more specific for syphilis: VDRL or FTA-ABS?
    A: FTA-ABS is more specific

    Q: Which is more virulent? (Salmonella or Shigella)
    A: Shigella (10^1 organisms vs. Salmonella 10^5 organisms)

    Q: Which is motile? (Salmonella or Shigella)
    A: Salmonella (think: salmon swim)

    Q: Which species of chlamydia causes and atypical pneumonia? How is it transmitted?
    A: C. pneumonia
    A: -transmitted via aeresol

    Q: Which two species of chlamydia infect only humans?
    A: C. trachomatis
    A: -C. pneumoniae

    Q: Why are anaerobes susceptible to oxygen?
    A: they lack catalase and/or oxidase and are susceptible to oxidative damage

    Q: Why does TB usually infect the upper lobes of the lung?
    A: M.tuberculosis is an aerobe; there is more oxygen at the apicies

    Q: Why must rickettsia and chlamydia always be intracellular?
    A: they can't make their own ATP
  14. Imperial

    Imperial Guest

    Q: What are the 3 layers of peripheral nerves? (inner to outer)
    A: 1) Endoneurium
    A: 2) Perineurium
    A: 3) Epineurium

    Q: Where is type I collagen found?(7)
    A: 1. bone
    A: 2. tendon
    A: 3. skin
    A: 4.dentin
    A: 5.fascia
    A: 6.cornea
    A: 7.late wound repair

    Q: Where is type II collagen found? (3)
    A: 1. cartilage (including hyaline)
    A: 2. vitreous body
    A: 3.nucleus pulposus.

    Q: What are the functions of the major structures of the inner ear bony labyrinth?
    A: 1. Cochlea- hearing
    A: 2.vestibule- linear acceleration
    A: 3. semicircular canals- angular acceleration.

    Q: What are the major structures of the inner ear bony labyrinth?
    A: 1. Cochlea
    A: 2. vestibule
    A: 3. semicircular canals

    Q: What are the major structures of the inner ear membranous labyrinth?
    A: 1. Cochlear duct
    A: 2. utricle.
    A: 3. saccule
    A: 4. semicircular canals.

    Q: Name two proteins involved in the structure of macula adherens.
    A: 1. Desmoplakin
    A: 2.Keratin

    Q: Name 6 functions of Golgi apparatus.
    A: 1. Distribution center of proteins and lipids from ER to plasma membrane, lysosomes, secretory vessicles
    A: 2. Modifies N-oligosaccharides on asparagine
    A: 3. Adds O-oligosaccharides to Ser and Thr residues

    Q: Next 3 functions of golgi
    A: 4. Proteoglycan assembly from proteoglycan core proteins
    A: 5. Sulfation of sugars in proteoglycans and of selected tyrosine on proteins
    A: 6. Addition of mannose-6-phosphate to specific lysosomal proteins, which targets the protein to the lysosome

    Q: Name two proteins involved in the structure of zona adherens?
    A: 1. E-cadherins
    A: 2. actin filaments

    Q: Which cells are rich in smooth ER?
    A: 1. liver hepatocytes, 2. steroid hormone-producing cells of adrenal cortex.

    Q: Describe the immune response stimulated via Peyer's patches.
    A: 1. M cells take up antigen.
    A: 2. stimulated B cells leave Peyer's patch and travel through lymph and blood to lamina propria of intestine.

    Q: Peyer's patches cont.
    A: 3. In lamina propria B cells differentiate into IgA-secreting plasma cells.
    A: 4. IgA receives protective secretory component.
    A: 5. IgA is transported across epithelium to gut to deal with intraluminal Ag.

    Q: Which cells are rich in rough ER?
    A: 1. Mucus-secreting goblet cells of small intestine, 2. antibody-secreting plasma cells.

    Q: What are the functions of the lymph node?
    A: 1. Nonspecific filtration by macrophages.
    A: 2. storage/proliferation of B and T cells
    A: 3. Ab production.

    Q: Where is type III collagen found? (5)
    A: 1. skin
    A: 2.blood vessels
    A: 3.uterus
    A: 4.fetal tissue
    A: 5.granulation tissue

    Q: Name five types of epithelial cell junctions.
    A: 1. zona occludens
    A: 2.zona adherens
    A: 3.macula adherens
    A: 4.gap junction
    A: 5.hemidesmosome

    Q: Describe microtubule arrangement of cilia.
    A: 9+2 arrangement of microtubules.

    Q: Describe the outer structure of a Peyer's patch.
    A: A Peyer's patch is 'covered' by single layer of cuboidal enterocytes, interspersed with specialized M cells (no goblet cells).

    Q: What is a lymph node? Include information on structural components.
    A: A secondary lymphoid organ.
    A: Has many afferents, one or more efferents.
    A: With trabeculae.
    A: Major histological regions = Follicle, Medulla, Paracortex

    Q: What is the primary regulatory control of zona fasciculata secretion?
    A: ACTH, hypothalamic CRH

    Q: What is the primary regulatory control of zona reticularis secretion?
    A: ACTH, hypothalamic CRH

    Q: What are/is the primary secretory product of the zona glomerulosa?
    A: aldosterone

    Q: What do Brunner's glands secrete?
    A: alkaline mucus

    Q: What is the function of liver sinusoids?
    A: Allow macromolecules of plasma full access to surface of liver cells through space of Disse.

    Q: What is the function of a gap junction?
    A: Allows adjacent cells to communicate for electric and metabolic functions.

    Q: What is produced by alpha cells of the Islets of Langerhans?
    A: alpha cells produce glucagon

    Q: What three cell types are found in Islets of Langerhans?
    A: alpha, beta, and gamma cells

    Q: What type of cells are Nissl bodies found? In what parts of the cell?
    A: Are found in neurons.
    A: Are not found in axon or axon hillock.

    Q: IN what area of the spleen are B cells found?
    A: B cells are found within the white pulp of the spleen.

    Q: What is type IV collagen found? (1)
    A: basement membrane or basal lamina

    Q: What is produced by beta cells of the Islets of Langerhans?
    A: beta cells produce insulin

    Q: What is the only GI submucosal gland?
    A: Brunner's glands

    Q: Describe the histological layers of the adrenal glands (outside to in)
    A: Capsule, Zona glomerulosa, Zona fasciculata, Zona reticularis, Medulla.

    Q: What are/is the primary secretory product of the adrenal medulla?
    A: Catecholamines (Epi, NE)

    Q: Memo to you.
    A: Check out the picture in the book.



    Q: What is the most common type of collagen?
    A: Collagen Type I - 90%

    Q: What is the most abundant protein in the human body?
    A: Collagen.

    Q: Define Islets of Langerhans.
    A: Collections of endocrine cells.

    Q: What is the function of hemidesmosomes?
    A: Connect cells to underlying extracellular matrix.

    Q: What are/is the primary secretory product of the zona fasciculata?
    A: cortisol, sex hormones.

    Q: What is another name for macula adherens?
    A: Desmosome

    Q: What is the effect of duodenal ulcers on Brunner's gland histology?
    A: Duodenal ulcers cause hypertrophy of Brunner's glands.

    Q: How does dynein function in cilia function?
    A: Dynein causes the bending of cilium by differential sliding of doublets.

    Q: What kind of protein is dynein?
    A: Dynein is an ATPase.

    Q: Describe the role of dynein in cilia structure.
    A: Dynein links peripheral 9 doublets of microtubules.

    Q: What makes endolymph?
    A: Endolymph is made by the stria vascularis.

    Q: What is Endoneurium?
    A: Endoneurium invests single nerve fiber of the peripheral nerve.

    Q: What is Epineurium?
    A: Epineurium (dense connective tissue) surrounds entire never (fascicles and blood vessels)

    Q: What is type X collagen found? (1)
    A: epiphyseal plate

    Q: Plasma is filtered on the basis of what properties?
    A: Filtration of plasma occurs according to net charge and size.

    Q: How is the glomerular basement membrane formed?
    A: From the fusion of endothelial and podocyte basement membranes.

    Q: What is produced by gamma cells of the Islets of Langerhans?
    A: gamma cells produce somatostatin.

    Q: What is the mnemonic to remember layers and products of adrenal cortex?
    A: GFR (Glomerulosa, Fasciculata, Reticularis) corresponds to Salt (Na+), Sugar (glucocorticoids) and Sex (androgens)
    A: The deeper you go, the sweeter it gets.

    Q: What is the function of hair cells?
    A: Hair cells are the sensory elements in both the cochlear and vestibular apparatus.

    Q: Name a protein involved in the structure of hemidesmosomes.
    A: Integrin.

    Q: What is another name for zona adherens?
    A: Intermediate junction.

    Q: Describe the histological structure of sinusoids of the liver.
    A: Irregular 'capillaries' with round pores 100-200 nm in diameter and no basement membrane.

    Q: What is the function of smooth ER?
    A: Is the site of steroid synthesis and detoxification of drugs and poisons

    Q: What is the function of rough ER?
    A: Is the site of synthesis of secretory (exported proteins and of N-linked oligosaccharide addition to many proteins.

    Q: What part of pancreas are the Islets of Langerhans concentrated?
    A: Islets of Langerhans are most numerous in the tail of pancreas.

    Q: What structural defect causes Kartagener's syndrome? What is the consequence?
    A: Kartagener's syndrome is due to dynein arm defect.
    A: Results in immotile cilia.

    Q: Define Pacinian corpuscles.
    A: Large, encapsulated sensory receptors found in deeper layers of skin at ligaments, joint capsules, serous membranes, mesenteries.

    Q: Where are Brunner's glands located?
    A: Located in submucosa of duodenum

    Q: Describe the histologic structure of sinusoids of the spleen.
    A: Long, vascular channels in red pulp. With fenestrated 'barrel hoop' basement membrane.

    Q: What is the histologic change in lymph nodes during an extreme cellular immune response?
    A: Lymph node paracortex becomes enlarged during extreme cellular immune response.

    Q: What is the histologic presentation of DiGeorge's syndrome?
    A: Lymph node paracortex is not well developed in patients with DiGeorge's syndrome.

    Q: What kind of cells are found nearby the sinusoids of the spleen?
    A: Macrophages

    Q: What are the major structures of the lymph node medulla?
    A: Medulla consists of medullary cords and medullary sinuses.

    Q: What do medullary sinuses communicate with?
    A: Medullary sinuses communicate with efferent lymphatics.

    Q: What do medullary sinuses consist of?
    A: Medullary sinuses contain reticular cells and macrophages.

    Q: What is the function of Meissner's corpuscles?
    A: Meissner's corpuscles are involved in light discriminatory touch of glabrous skin.

    Q: What is the histologic change in nephrotic syndrome? What is the consequence of this change?
    A: Negative charge is lost.
    A: Plasma protein is lost in urine

    Q: What is the glomerular basement membrane coated with? (provides negative charge to filter).
    A: Negatively charged heparan sulfate.

    Q: What is the most common tumor the adrenal medulla in children?
    A: Neuroblastoma

    Q: What is the function of Pacinian corpuscles?
    A: Pacinian corpuscles are involved in pressure, coarse touch, vibration, and tension.

    Q: What do the Islets of Langerhans arise from?
    A: Pancreatic buds.

    Q: What specialized vascular structure is found in the lymph node paracortex? What is the function of this structure?
    A: Paracortex contains high endothelial venules (HEV).
    A: T and B cells enter from the blood through the HEV.

    Q: What cells are found in the lymph node paracortex?
    A: Paracortex houses T cells.

    Q: What is Perineurium?
    A: Perineurium (permeability barrier) surrounds a fascicle of nerve fibers.

    Q: What is the most common tumor the adrenal medulla in adults?
    A: Pheochromocytoma

    Q: Compare the consequences of pheochromocytoma vs. neuroblastoma on blood pressure
    A: Pheochromocytoma causes episodic hypertension
    A: Neuroblastoma does NOT cause episodic hypertension

    Q: What is the space of Disse?
    A: Pores in liver sinusoids allowing plasma macromolecules access to liver cell surfaces.

    Q: What is the primary regulatory control of adrenal medulla secretion?
    A: Preganglionic sympathetic fibers

    Q: What is the function of zona occludens?
    A: Prevents diffusion across intracellular space.

    Q: Describe the appearance and status of primary vs. secondary follicles.
    A: Primary follicles are dense and dormant.
    A: Secondary follicles have pale central germinal centers and are active.

    Q: Describe the location of the lymph node paracortex.
    A: Region of cortex between follicles and medulla.

    Q: What is the primary regulatory control of zona glomerulosa secretion?
    A: Renin-angiotensin

    Q: What is the glomerular basement membrane responsible for?
    A: Responsible for the actual filtration of plasma.

    Q: What is another name for type III collagen?
    A: reticulin

    Q: What are Nissl bodies?
    A: rough ER

    Q: Where in the inner ear are the ampullae found? What is the function of this structure?
    A: Semicircular canals contain ampullae
    A: Functions in detecting angular acceleration.

    Q: What are/is the primary secretory product of the zona reticularis?
    A: sex hormones (e.g. androgens)

    Q: What is the function of lymph node follicles?
    A: Site of B-cell localization and proliferation.

    Q: Define macula adherens.
    A: Small, discrete sites of attachment of epithelial cells.

    Q: Define Meissner's corpuscles.
    A: Small, encapsulated sensory receptors found in dermis of palm, soles and digits of skin.

    Q: What is an M cell? What is it's function.
    A: Specialized cell interspersed between the cuboidal enterocytes covering a Peyer's patch.
    A: M cells take up antigens.

    Q: Name the layers of epidermis from surface to base.
    A: stratum Corneum, stratum Lucidum, stratum Granulosum, stratum Spinosum, stratum Basalis.

    Q: What is the location of zona adherens?
    A: Surrounds the perimeter just below zona occludens.

    Q: What is the function of Nissl bodies?
    A: Synthesize enzymes (e.g. ChAT) and peptide neurotransmitters.

    Q: In what area of the spleen are T cells found?
    A: T cells are found in the PALS and the red pulp of the spleen.

    Q: Which part of the cochlea picks up high frequency sound? Which picks up low frequency?
    A: The base of the cochlea picks up high frequency sound
    A: the apex picks up low frequency sound

    Q: What is the bony labyrinth filled with? Describe its composition.
    A: The bony labyrinth is filled with perilymph.
    A: Perilymph is Na+ rich, similar to ECF

    Q: What is the cause of I cell disease? What is the consequence?
    A: The failure of addition of mannose-6-phosphate to lysosome proteins.
    A: These enzymes are secreted outside the cell instead of being targeted to the lysosome.

    Q: What is the membranous labyrinth filled with? Describe its composition.
    A: The membranous labyrinth is filled with endolymph.
    A: Endolymph is K+ rich, similar to ICF.

    Q: What layer of the peripheral nerve must be rejoined in microsurgery for limb reattachment?
    A: The perineurium must be rejoined in microsurgery for limb reattachment.

    Q: Where in the inner ear are the maculae found? What is the function of this structure?
    A: The utricle and saccule contain maculae
    A: Functions in detecting linear acceleration.

    Q: How is the function of gap junctions accomplished?
    A: Through a connection with central channels.

    Q: What is another name for zona occludens?
    A: Tight junction.

    Q: What are mnemonics for remembering locations for type I, II and IV collagen?
    A: Type ONE: bONE
    A: Type TWO: carTWOlage
    A: Type FOUR: under the FLOOR (basement membrane)

    Q: What is a Peyer's patch?
    A: Unencapsulated lymphoid tissue found in lamina propria and submucosa of small intestine.

    Q: What type of infection may induce an extreme cellular immune response? What happens to the lymph node during such an immune response?
    A: Viral response is an example.
    A: The paracortex enlarges.
  15. Imperial

    Imperial Guest

    Q: According to the Homunculus man, place the following in order (from medial to lateral). hand, foot, tongue, face, trunk
    A: foot, trunk, hand, face, tongue

    Q: (T or F) Can Bell's palsy occur idiopathically?
    A: true

    Q: (T or F) Can fasiculations be present in a LMN lesion?
    A: True

    Q: (T or F) Is the anterior nucleus of the thalamus part of the limbic system?
    A: True

    Q: (T or F) Is the cingulate gyrus part of the limbic system?
    A: True

    Q: (T or F) Is the Entrorhinal cortex part of the limbic system?
    A: True

    Q: (T or F) Is the hippocampal formation part of the limbic system?
    A: True

    Q: (T or F) Is the mammillary body part of the limbic system?
    A: True

    Q: (T or F) Is the septal area part of the limbic system?
    A: True

    Q: (T or F) Thoracic outlet syndrome results in atrophy of the interosseous muscles?
    A: True

    Q: (T or F) Thoracic outlet syndrome results in atrophy of the thenar and hypothenar eminences?
    A: True

    Q: (T or F) Thoracic outlet syndrome results in disappearance of the radial pulse upon moving the head to the opposite side?
    A: True

    Q: (T or F) Thoracic outlet syndrome results in sensory deficits on the medial side of the forearm and hand?
    A: True

    Q: A lesion of the globus pallidus causes what disease?
    A: Wilson's disease

    Q: A lesion of the mammillary bodies (bilateraly) produces what?
    A: Wernicke-Korsakoff's encephalopathy (confabulations, anterograde amnesia)

    Q: A lesion of the optic chiasm produces?
    A: bitemporal hemianopsia

    Q: A lesion of the right dorsal optic radiation (parietal lesion) produces?
    A: left lower quadrantic anopsia (a temporal lesion)

    Q: A lesion of the right Meyer's loop (temporal lobe) produces?
    A: left upper quadrantic anopsia (a temporal lesion)

    Q: A lesion of the right optic nerve produces?
    A: right anopsia

    Q: A lesion of the right optic tract produces?
    A: left homonymous hemianopsia

    Q: A lesion of the right visual fibers just prior to the visual cortex produces?
    A: left hemianopsia with macular sparing

    Q: A lesion of the Striatum can cause which 2 diseases?
    A: Huntington's and Wilson's disease

    Q: A positive Babinski is an indicator for a (UMN or LMN) lesion?
    A: UMN lesion

    Q: A rupture of the middle menigeal artery causes what type of hematoma? (epidural or subdural)
    A: epidural hematoma

    Q: A rupture of the superior cerebral veins causes what type of hematoma? (epidural or subdural)
    A: subdural hematoma

    Q: An aneurysm of the anterior communicating artery may cause what type of defects?
    A: visual defects

    Q: An aneurysm of what artery may cause CN III palsy?
    A: posterior communicating artery

    Q: Are D1 neurons in the basal ganglia inhibitory or excitatory?
    A: Excitatory

    Q: Are D2 neurons in the basal ganglia inhibitory or excitatory?
    A: Inhibitory

    Q: Beginning with anterior communicating artery describe the path around the circle of Willis.
    A: ant. comm. - ACA - ICA - post. comm. - PCA - PCA - post. comm. - ICA - ACA - ant. comm.

    Q: Bell's Palsy is seen as a complication in what 5 things?
    A: AIDS, Lyme disease, Sarcoidosis, Tumors, Diabetes (ALexander Bell with STD)

    Q: Brodmann's area 17 is?
    A: principal visual cortex

    Q: Brodmann's area 22 is?
    A: Wernicke's area (associative auditory cortex)

    Q: Brodmann's area 3,1,2 is?
    A: principal sensory area

    Q: Brodmann's area 4 is?
    A: principal motor area

    Q: Brodmann's area 41, 42 is?
    A: primary auditory cortex

    Q: Brodmann's area 44, 45 is?
    A: Broca's area (motor speech)

    Q: Brodmann's area 6 is?
    A: premotor area

    Q: Brodmann's area 8 is?
    A: frontal eye movement and pupilary change area

    Q: CN I has what function?
    A: smell

    Q: CN I passes through what 'hole'?
    A: cribriform plate

    Q: CN II has what function?
    A: sight

    Q: CN II passes through what 'hole'?
    A: optic canal

    Q: CN III has what 4 functions?
    A: eye movement, pupil constriction, accommodation, eyelid opening

    Q: CN III inervates what 5 muscles.
    A: medial rectus, superior rectus, inferior rectus, inferior oblique, levator palpebrae superioris

    Q: CN III passes through what 'hole'?
    A: superior orbital fissure

    Q: CN IV has what function?
    A: eye movement

    Q: CN IV inervates what muscle.
    A: superior oblique

    Q: CN IV passes through what 'hole'?
    A: superior orbital fissure

    Q: CN IX has what 4 functions?
    A: posterior 1/3 taste, swallowing, salivation (parotid), monitoring carotid body and sinus

    Q: CN IX passes through what 'hole'?
    A: jugular foramen

    Q: CN V has what 2 functions?
    A: mastication, facial sensation

    Q: CN V1 passes through what 'hole'?
    A: superior orbital fissure

    Q: CN V2 passes through what 'hole'?
    A: foramen rotundum

    Q: CN V3 passes through what 'hole'?
    A: foramen ovale

    Q: CN VI has what function?
    A: eye movement

    Q: CN VI inervates what muscle.
    A: lateral rectus

    Q: CN VI passes through what 'hole'?
    A: superior orbital fissure

    Q: CN VII has what 4 functions?
    A: facial movement, anterior 2/3 taste, lacrimation, salivation(SL, SM glands)

    Q: CN VII passes through what 'hole'?
    A: internal auditory meatus

    Q: CN VIII has what 2 functions?
    A: hearing, balance

    Q: CN VIII passes through what 'hole'?
    A: internal auditory meatus

    Q: CN X has what 5 functions?
    A: taste, swallowing, palate elevation, talking, thoracoabdominal viscera

    Q: CN X passes through what 'hole'?
    A: jugular foramen

    Q: CN XI has what 2 functions?
    A: head turning, shoulder shrugging

    Q: CN XI passes through what 'hole'?
    A: jugular foramen (descending) -- foramen magnum (ascending)

    Q: CN XII has what function?
    A: tounge movements

    Q: CN XII passes through what 'hole'?
    A: hypoglossal canal

    Q: Complete the muscle spindle reflex arc by placing the following in order: alpha motor, Ia afferent, muscle stretch, extrafusal contraction, intrafusal stretch.
    A: muscle stretch - intrafusal stretch - Ia afferent - alpha motor - extrafusal contraction

    Q: Extrafusal fibers are innervated by what motor neuron?
    A: alpha motor neuron

    Q: From which 3 spinal roots does long thoracic nerve arises?
    A: C5, C6, C7

    Q: General sensory/motor dysfunction and aphasia are caused by stroke of the? (ant. circle or post. circle)
    A: anterior circle

    Q: Give 3 characteristics of a LMN lesion.
    A: atrophy, flaccid paralysis, absent deep tendon reflexes

    Q: Give 3 charateristics of internuclear ophthalmoplegia (INO)
    A: medial rectus palsy on lateral gaze, nystagmus in abducted eye, normal convergence.

    Q: Give 4 characteristics of an UMN lesion.
    A: spastic paralysis, increased deep tendon reflexes, + Babinski, minor to no atrophy

    Q: Golgi tendon organs send their signal via what nerve?
    A: group Ib afferents

    Q: Horner's Syndrome is present if the lesion in Brown-Sequard is above what level?
    A: T1

    Q: How are the fibers of the corticospinal tract laminated? (legs/arms medial or lateral?)
    A: arms- medial, legs-lateral

    Q: How are the fibers of the dorsal column laminated? (legs/arms medial or lateral?)
    A: legs-medial, arms-lateral

    Q: How are the fibers of the spinothalmic tract laminated? (sacral/cervical medial or lateral?)
    A: cervical-medial, sacral-lateral

    Q: How do glucose and amino acids cross the blood-brain barrier?
    A: carrier-mediated transport mechanism

    Q: How does the hypothalamus control the adenohypophysis?
    A: via releasing factors (ie. TRH, CRF, GnRF, etc.)

    Q: Huntington's patients typically have what type of movements?
    A: Chorea

    Q: If the radial nerve is lesioned, what 2 reflexes are lost?
    A: triceps reflex and brachioradialis reflex

    Q: If you break your humerus mid-shaft, which nerve would likely injure?
    A: radial nerve

    Q: If you break your medial epicondyle of the humerus, which nerve would likely injure?
    A: ulnar nerve

    Q: If you break your supracondyle of the humerus, which nerve would likely injure?
    A: median nerve

    Q: If you break your surgical neck of the humerus, which nerve would likely injure?
    A: axillary nerve

    Q: In a lesion of the radial nerve, what muscle is associated with wrist drop?
    A: extensor carpi radialis longus

    Q: Intrafusal fibers are encapsulated and make up muscle spindles that send their signal via what nerve?
    A: group Ia afferents

    Q: Intrafusal fibers are innervated by what motor neuron?
    A: gamma motor neuron

    Q: Is Bell's palsy an UMN or a LMN lesion?
    A: LMN

    Q: Is the Babinski reflex (positive or negative) when the big toe dorsiflexes and the other toes fan-out?
    A: positive (pathologic)

    Q: Name 2 locations for lesions in Syringomyelia?
    A: ventral white commissure and ventral horns

    Q: Name 3 locations for lesions in Vit.B12 neuropathy(Friedreich's ataxia)?
    A: dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts

    Q: Name 7 functions of the hypothalamus?
    A: Thirst/waterbalance, Adenohypophysis control, Neurohypophysis control, Hunger/satiety, Autonomic regulation, Temperature regulation, Sexual emotions. TAN HATS

    Q: Name the 4 foramina that are in the posterior cranial fossa?
    A: internal auditory meatus, jugular foramen, hypoglossal canal, and foramen magnum.

    Q: Name the 5 foramina that are in the middle cranial fossa?
    A: optic canal, superior orbital fissure, foramen rotundum, foramen ovale, and foramen spinosum.

    Q: Name the 5 functions of the Limbic system?
    A: Feeding, Fighting, Feeling, Flight, sex (F--K) [the famous 5 F's]

    Q: Name the 5 segments of the brachial plexus in order from proximal to distal.
    A: roots - trunks - divisions - cords - branches

    Q: Name the type of movement with slow writhing movements (esp. the fingers)?
    A: Athetosis

    Q: Name the type of movement with sudden, jerky, purposeless movements?
    A: Chorea

    Q: Name the type of movement with sudden, wild flailing of one arm?
    A: Hemiballismus

    Q: Neurons from the globus pallidus have what action on the ventral anterior nucleus?
    A: Inhibitory

    Q: Neurons from the striatum have what action on the globus pallidus?
    A: Inhibitory

    Q: Place the following in order (from light entering the eye to reflex). Pretectal nuclei, pupillary constrictor muscle, retina, ciliary ganglion, Edinger-Westphal nuclei, CN II, CN III.
    A: retina, CN II, pretectal nuclei, Edinger-Westphal nuclei, CN III, ciliary ganglion, pupillary constrictor muscle

    Q: Stimulation from the paraventricular nucleus cause the release of what hormone?
    A: oxytocin

    Q: Stimulation from the supraoptic nucleus cause the release of what hormone?
    A: ADH (vasopressin)

    Q: The Blood-Brain Barrier is formed by what 3 structures?
    A: choriod plexus epithelium, intracerebral capillary endothelium, astrocytes. (First Aid says Arachnoid but the brains say that’s a typo)

    Q: The central retinal artery is a branch off what larger artery?
    A: ophthalmic artery

    Q: The embryologic defect of having a cervical rib can compress what 2 structures?
    A: subclavian artery and inferior trunk of the brachial plexus

    Q: The fasciculus cuneatus contains fibers from the upper or lower body?
    A: upper extremities

    Q: The fasciculus gracilis contains fibers from the upper or lower body?
    A: lower extremities

    Q: The hippocampal formation is connected to the mammillary body and septal area via what structure?
    A: fornix

    Q: The hippocampus has input from what two areas?
    A: entorhinal cortex, septal area

    Q: The hippocampus has output to what two areas?
    A: mammillary body, septal area

    Q: The infraorbital nerve is a branch off what larger nerve?
    A: CN V2

    Q: The Nucleus Ambiguus has fibers from what 3 CNs?
    A: CN IX, X, XII

    Q: The Nucleus Solitarius has fibers from what 3 CNs?
    A: CN VII, IX, X

    Q: Traction or tear of the superior trunk of the brachial plexus causes what syndrome?
    A: Erb-Duchenne palsy (waiter's tip)

    Q: Vertigo, ataxia, visual deficits, and coma are caused by stroke of the? (ant. circle or post. circle)
    A: posterior circle

    Q: Visual fibers from the lateral geniculate body terminate on the upper and lower banks of what fissure?
    A: Calcarine fissure

    Q: What 1 nerve root is assoc. with the achilles reflex?
    A: S1

    Q: What 1 nerve root is assoc. with the biceps reflex?
    A: C5

    Q: What 1 nerve root is assoc. with the patella reflex?
    A: L4

    Q: What 1 nerve root is assoc. with the triceps reflex?
    A: C7

    Q: What 2 areas have sensation deficit in a lesion of the median nerve?
    A: lateral palm/thumb and the radial 2 1/2 fingers

    Q: What 2 areas have sensation deficit in a lesion of the ulnar nerve?
    A: medial palm and the ulnar 1 1/2 fingers

    Q: What 2 cutaneus nerves are lost in a lesion of the radial nerve?
    A: posterior brachial cutaneous and posterior antebrachial cutaneous

    Q: What 2 spinal roots make up the inferior trunk of the brachial plexus?
    A: C8, T1

    Q: What 2 spinal roots make up the superior trunk of the brachial plexus?
    A: C5, C6

    Q: What 2 structures pass through the internal auditory meatus?
    A: CN VII, VIII

    Q: What 2 symptoms are seen with a lesion of the musculocutaneus nerve?
    A: difficulty flexing the arm, variable sensory loss

    Q: What 2 symptoms are seen with a lesion of the ulnar nerve?
    A: weak intrinsic muscles of the hand, Pope's blessing

    Q: What 3 blood barriers does the body have?
    A: blood-brain, blood-gas, blood-testis

    Q: What 3 muscles are lost in a lesion of the musculocutaneous nerve?
    A: coracobrachialis, biceps brachii, and brachialis

    Q: What 3 muscles are lost in a lesion of the radial nerve?
    A: triceps brachii, brachioradialis, and extensor carpi radialis longus

    Q: What 3 structures pass through the foramen magnum?
    A: spinal roots of CN XI(ascending), brainstem, vertebral arteries

    Q: What 3 structures pass through the optic canal?
    A: CN II, ophthalmic artery, central retinal vein

    Q: What 4 'muscles' does the radial nerve innervate?
    A: Brachioradialis, Extensors of the wrist and fingers, Supinator, Triceps. (BEST)

    Q: What 4 areas is there decreased output in Parkinson's?
    A: substantia nigra pars compacta, globus pallidus, ventral anterior nucleus, cortex

    Q: What 4 movements are limpaired in a lesion of the ulnar nerve?
    A: wrist flextion, wrist addduction, thumb adduction, and adductiont of the 2 ulnar fingers

    Q: What 4 movements are lost in a lesion of the median nerve?
    A: forearm pronation, wrist flexion, finger flexion, and several thumb movements

    Q: What 4 structures pass through the jugular foramen?
    A: CN IX, X, XI(descending), jugular vein

    Q: What 4 things do the lateral striate arteries supply?
    A: internal capsule, caudate, putamen, globus pallidus

    Q: What 5 spinal nerves that make up the brachial plexus?
    A: C5, C6, C7, C8, T1

    Q: What 5 structures pass through the supperior orbital fissure?
    A: CN III, IV, V1, VI, ophthalmic vein

    Q: What 5 types of cells make up the suportive cells of the CNS/PNS?
    A: Astrocytes, Microglia, Oligodendroglia, Schwann cells, Ependymal cells.

    Q: What are 2 characteristics of Tabes Dorsalis?
    A: impaired proprioception and locomotor ataxia

    Q: What are 3 clinical findings of the arm in Erb-Duchenne palsy?
    A: arm hangs by the side, medially rotated, forearm is pronated

    Q: What are the 2 classic causes of Erb-Duchenne palsy?
    A: blow to the shoulder and trauma during birth

    Q: What are the 3 classic symptoms of Horner's syndrome?
    A: ptosis, miosis, anhydrosis

    Q: What are the 4 classic findings of Brown-Sequard syndrome?
    A: ipsi motor paralysis(spastic), ipsi loss of dorsal column, contra loss of spinothalamic, ipsi loss of ALL sensation at the level of the lesion

    Q: What are the input and output of the anterior nucleus of the thalamus?
    A: input - mammillary body, output - cingulate gyrus

    Q: What are the input and output of the cingulate gyrus?
    A: input - anterior nucleus of the thalamus, output - entorhinal cortex

    Q: What are the input and output of the entorhinal cortex?
    A: input - cingulate gyrus, output - hippocampal formation

    Q: What are the input and output of the mammillary body?
    A: input - hippocampal formation, output - anterior nucleus of the thalamus

    Q: What are the input and output of the septal area?
    A: input - hippocampal formation, output - hippocampal formation

    Q: What artery do the lateral striate branch off of?
    A: internal carotid artery

    Q: What artery does the anterior inferior cerebellar artery branch off of?
    A: basilar artery

    Q: What artery does the anterior spinal artery branch off of?
    A: vertebral artery

    Q: What artery does the posterior inferior cerebellar artery branch off of?
    A: vertebral artery

    Q: What artery does the superior cerebellar artery branch off of?
    A: basilar artery

    Q: What artery supplies Broca's and Wernicke's speech areas?
    A: middle cerebral artery

    Q: What artery supplies the medial surface of the brain (foot-leg area)?
    A: anterior cerebral artery

    Q: What bone do all the foramina of the middle cranial fossa pass through?
    A: sphenoid bone

    Q: What CN arises dorsally?
    A: CN IV trochlear

    Q: What CN is the afferent limb of the pupillary light reflex?
    A: CN II

    Q: What CN is the efferent limb of the pupillary light reflex?
    A: CN III

    Q: What CNs lie medially at the brain stem?
    A: CN III, VI, XIII (3 - 6 - 12)

    Q: What CNS/ PNS supportive cell has the following functions: central myelin production?
    A: Oligodendroglia

    Q: What CNS/ PNS supportive cell has the following functions: inner lining of the ventricles?
    A: Ependymal cells

    Q: What CNS/ PNS supportive cell has the following functions: peripheral myelin production?
    A: Schwann cells

    Q: What CNS/ PNS supportive cell has the following functions: phagocytosis?
    A: Microglia

    Q: What CNS/ PNS supportive cell has the following functions: physical support, repair, K+ metabolism?
    A: Astrocytes

    Q: What disease does Tabes Dorsalis result from?
    A: tertiary syphilis

    Q: What disorder results from a lesion in the medial longitudinal fasciculus (MLF).
    A: Internuclear ophthalmoplegia (INO)

    Q: What embryologic defect is thoracic outlet syndrome caused by
    A: by having a cervical rib.

    Q: What happens if a swinging light test is performed on a Marcus Gann pupil (afferent pupil defect)?
    A: results in pupil dialation of the defective eye as the light is swung from the normal eye to the defective eye

    Q: What happens if you illuminate one pupil in a normal patient?
    A: both eyes constrict (consensual reflex)

    Q: What hypo/hyper-kinetic disorder is marked by decreased serum ceruloplasm and Keyser-Fleischer rings in the eyes.
    A: Wilson's disease

    Q: What is a Argyll Robertson pupil?
    A: the eyes DO NOT constrict to light, but DO accommodate to near objects

    Q: What is affected in a central VII lesion (lesion above the facial nucleus - UMN)?
    A: paralysis of the contralateral lower quadrant

    Q: What is affected in a peripheral VII lesion (lesion at or below the facial nucleus - LMN)?
    A: paralysis of the ipsilateral face both upper and lower.

    Q: What is the common name for a peripheral VII lesion?
    A: Bell's palsy

    Q: What is the consequence when your CNS stimulates the gamma motor neuron and the intrafusal fibers contract?
    A: increased sensitivity of the reflex arc

    Q: What is the direct pathway from the striatum to the cortex?
    A: The striatum to the substantia nigra pars reticularis /medial globus pallidus to the thalamus to the cortex (excitatory path)

    Q: What is the embryologic tissue origin of Microglia (ecto/meso/edo)?
    A: Mesoderm

    Q: What is the indirect pathway from the striatum to the cortex?
    A: The striatum to the lateral globus pallidus to the subthalamic nucleus to the substantia nigra/medial globus pallidus to the thalamus to the cortex (inhibitory pathway but still increases the thalamic drive)

    Q: What is the lesion in Brown-Sequard syndrome?
    A: hemisection of the spinal cord

    Q: What is the most common circle of Willis aneurysm?
    A: anterior communicating artery

    Q: What is the name for the small muscle fiber type that regulates muscle length?
    A: Intrafusal fibers

    Q: What lesion produces coma?
    A: reticular activating system

    Q: What lesion produces conduction aphasia, poor repetition w/ poor comprehension, and fluent speech?
    A: Arcuate fasiculus

    Q: What lesion produces Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)?
    A: Amygdala (bilateral)

    Q: What lesion produces motor(expressive) aphasia with good comprehension?
    A: Broca's area (motor speech)

    Q: What lesion produces personality changes and deficits in concentration, orientation, judgement?
    A: frontal lobe - these are frontal release signs

    Q: What lesion produces sensory(fluent/receptive) aphasia with poor comprehension?
    A: Wernicke's area (associative auditory cortex)

    Q: What lesion produces spatial neglect syndrome?
    A: right parietal lobe -- contralateral neglect.

    Q: What lobe of the brain is the Broca's area in?
    A: frontal

    Q: What lobe of the brain is the frontal eye movement and pupillary change area in?
    A: frontal

    Q: What lobe of the brain is the premotor area in?
    A: frontal

    Q: What lobe of the brain is the primary auditory cortex area in?
    A: temporal

    Q: What lobe of the brain is the principal motor area in?
    A: frontal

    Q: What lobe of the brain is the principal sensory area in?
    A: parietal

    Q: What lobe of the brain is the principal visual cortex area in?
    A: occipital

    Q: What lobe of the brain is the Wernicke's area in?
    A: temporal

    Q: What midbrain structure is important in mitigating voluntary movements and making postural adjustments?
    A: Basal Ganglia

    Q: What mineral causes the Pathology of Wilson's disease
    A: copper

    Q: What muscle depresses and extorts the eye?
    A: inferior rectus

    Q: What muscle elevates and intorts the eye?
    A: superior rectus

    Q: What muscle extorts, elevates, and adducts the eye?
    A: inferior oblique

    Q: What muscle fiber type makes up the muscle bulk and provides the force for contraction?
    A: Extrafusal fibers

    Q: What muscle intorts, depresses, and abducts the eye?
    A: superior oblique

    Q: What muscle sensor senses tension and provides inhibitory FEEDBACK to alpha motor neurons?
    A: golgi tendon organs

    Q: What muscular disorder is a medial longitudinal fasciculus syndrome associated with?
    A: Multiple Sclerosis (MLF=MS)

    Q: What nerve is known as the great extensor nerve?
    A: radial nerve

    Q: What neurotransmitter is decrease in Parkinson's disease
    A: dopamine

    Q: What nucleus if typically lesioned in hemiballismus?
    A: contralateral subthalamic nucleus

    Q: What nucleus of the hypothalamus controls circadian rhythms?
    A: suprachiasmatic nucleus

    Q: What nucleus of the hypothalamus controls hunger?
    A: lateral nucleus

    Q: What nucleus of the hypothalamus controls satiety?
    A: ventromedial nucleus

    Q: What nucleus of the hypothalamus controls sexual emotions?
    A: septate nucleus

    Q: What nucleus of the hypothalamus controls thirst and water balance?
    A: supraoptic nucleus

    Q: What part of the hypothalamus (ant./post.) controls autonomic regulation?
    A: anterior hypothalamus

    Q: What part of the hypothalamus (ant./post.) controls cooling when hot?
    A: anterior hypothalamus

    Q: What part of the hypothalamus (ant./post.) controls heat conservation when cold?
    A: posterior hypothalamus

    Q: What part of the ventral spinal cord is spared with complete occlusion of the ventral artery?
    A: dorsal columns

    Q: What passes through the cavernous sinus? (nerves and artery
    A: CN III, IV, V1, V2, VI, post-ganglionic SNS and the Internal carotid artery

    Q: What reflex is lost in a lesion of the musculocutaneous nerve?
    A: biceps reflex

    Q: What structure passes through the foramen ovale?
    A: CN V3

    Q: What structure passes through the foramen rotundum?
    A: CN V2

    Q: What structure passes through the foramen spinosum?
    A: middle meningeal artery

    Q: What structure passes through the hypoglossal canal?
    A: CN XII

    Q: What symptom is seen with a lesion of the axillary nerve?
    A: Deltoid paralysis

    Q: What symptom is seen with a lesion of the median nerve?
    A: decreased thumb function

    Q: What syndrome is seen with a lesion of the long thoracic nerve?
    A: Winged scapula

    Q: What syndrome is seen with a lesion of the lower trunk of the brachial plexus?
    A: Claw hand

    Q: What syndrome is seen with a lesion of the posterior cord of the brachial plexus?
    A: Wrist drop

    Q: What syndrome is seen with a lesion of the radial nerve?
    A: Saturday night palsy

    Q: What syndrome is seen with a lesion of the upper trunk of the brachial plexus?
    A: Waiter's tip (Erb-Duchenne palsy)

    Q: What two bones do all the foramina of the posterior cranial fossa pass through?
    A: temporal and occipital bones

    Q: What two hypothalamic nuclei does the posterior pituitary(neurohypophysis) receive neuronal projections from?
    A: supraoptic nucleus and paraventricular nucleus.

    Q: What type of fibers do the corticospinal tracts carry?
    A: motor

    Q: What type of fibers do the dorsal columns carry?
    A: sensory - pressure, vibration, touch, proprioception

    Q: What type of fibers do the spinothalmic tracts carry?
    A: sensory - pain and temperature

    Q: What type of function does CN I have? (sensory, motor, or both)
    A: sensory

    Q: What type of function does CN II have? (sensory, motor, or both)
    A: sensory

    Q: What type of function does CN III have? (sensory, motor, or both)
    A: motor

    Q: What type of function does CN IV have? (sensory, motor, or both)
    A: motor

    Q: What type of function does CN IX have? (sensory, motor, or both)
    A: both

    Q: What type of function does CN V have? (sensory, motor, or both)
    A: both

    Q: What type of function does CN VI have? (sensory, motor, or both)
    A: motor

    Q: What type of function does CN VII have? (sensory, motor, or both)
    A: both

    Q: What type of function does CN VIII have? (sensory, motor, or both)
    A: sensory

    Q: What type of function does CN X have? (sensory, motor, or both)
    A: both

    Q: What type of function does CN XI have? (sensory, motor, or both)
    A: motor

    Q: What type of function does CN XII have? (sensory, motor, or both)
    A: motor

    Q: What type of lesion is seen in Amyotrophic Lateral Sclerosis?
    A: combo of UMN and LMN lesions with no sensory deficit

    Q: What type of lesion is seen in Multiple Sclerosis?
    A: random asymmetric lesions in mostly white matter of the cervical region

    Q: What type of lesion is seen in Poliomyelitis and is it genetic or acquired?
    A: acquired LMN lesion causing flaccid paralysis

    Q: What type of lesion is seen in Werdnig-Hoffmann disease and is it genetic or acquired?
    A: genetic LMN lesion causing flaccid paralysis (aka. Floppy infant disease)

    Q: What type of molecule can cross the blood-brain barrier most easily? (lipid/nonlipid, polar/nonpolar)
    A: Lipid-soluable/nonpolar molecules

    Q: What vagal nuclei controls motor innervation to the pharynx, larynx, and upper esophagus?
    A: Nucleus Ambiguus (Motor=aMbiguus)

    Q: What vagal nuclei controls visceral sensory in formation like taste and gut distention?
    A: Nucleus Solitarius (Sensory=Solitarius)

    Q: What vagal nuclei sends parasympathetic fibers to the heart, lungs, and upper GI?
    A: dorsal motor nucleus of CN X

    Q: What would happen temperature regulation if you lesioned your posterior hypothalamus?
    A: lose the ability to conserve heat

    Q: What would happen temperature regulation if you lesioned your ventromedial nucleus of the hypothalamus?
    A: have hyperphagia and become obese

    Q: When is a positive Babinski a normal reflex?
    A: during the first year of life

    Q: Where is the lesion in a patient with hemiballismus?
    A: Subthalamic nucleus

    Q: Where is the lesion in Parkinson's?
    A: Substantia nigra pars compacta

    Q: Which CN is the only nerve that does not abut the wall in the cavernous sinus?
    A: CN VI (abducens)

    Q: Which CNs pass through the middle cranial fossa?
    A: CN II - VI

    Q: Which CNs pass through the posterior cranial fossa?
    A: CN VII - XII

    Q: Which division of the facial motor nucleus has duel innervation? (upper or lower)
    A: upper division

    Q: Which thalamic nucleus has a visual function?
    A: Lateral Geniculate Nucleus (LGB)

    Q: Which thalamic nucleus has an auditory function?
    A: Medial Geniculate Nucleus (MGB)

    Q: Which thalamic nucleus has pre-motor function?
    A: Ventral Anterior Nucleus (VA)

    Q: Which thalamic nucleus has the function of body senses(proprioception, pressure, pain, touch, vibration)?
    A: Ventral Posterior Lateral Nucleus (VPL)

    Q: Which thalamic nucleus has the function of facial sensation and pain?
    A: Ventral Posterior Medial Nucleus (VPM)

    Q: Which thalamic nucleus is the primary motor cortex?
    A: Ventral Lateral Nucleus (VL)

    Q: Which way does the head deviate in a unilateral lesion (LMN) of CN XI? (toward or away)
    A: toward the lesion -- note: First-Aid is wrong in the book)

    Q: Which way does the jaw deviate in a unilateral lesion (LMN) of CN V? (toward or away)
    A: toward the lesion

    Q: Which way does the patient tend to fall in a unilateral lesion (LMN) of the cerebellum? (toward or away)
    A: toward the lesion

    Q: Which way does the tongue deviate in a unilateral lesion (LMN) of CN XII? (toward or away)
    A: toward the lesion

    Q: Which way does the uvula deviate in a unilateral lesion (LMN) of CN X? (toward or away)
    A: away from the lesion

    Q: Why does the arm hang by the side in Erb-Duchenne palsy?
    A: paralysis of shoulder abductors

    Q: Why is L-dopa use for parkinsonism instead of dopamine?
    A: L-dopa crosses the blood-brain barrier while dopamine does not.

    Q: Why is the arm medially rotated in Erb-Duchenne palsy?
    A: paralysis of the lateral rotators

    Q: Why is the forearm pronated in Erb-Duchenne palsy?
    A: loss of the biceps brachii
  16. Sourabh

    Sourabh Guest

    For small bowel capsule endoscopy, the patient swallows a disposable capsule that contains a CMOS chip camera. What does CMOS mean?

    2) Dubin Jhonson syndrome results in the mutation of this particular canalicular membrane protein. This protein is involved in the ATP dependent process by which bilirubin mono- and diglucuronides are excreted across the canalicular plasma membrane into the bile canaliculus. Name the protein I am speaking about!

    3) What is entecavir?

    4) Which cells bind to IgD via Fc?

    5) Hemochromatosis affects which joints of the hand?

    6) Anserine bursitis is an inflammation of ____ bursa?

    7) What is adhesive capsulitis better known as?

    8) Which is better in acute MT? PCI or fibrinolysis?

    9) What is the enzyme deficiency in Wolman disease and what is the specific treatment?

    10) What is the molecule which inhibits the differentiation of macrophages into osteoclasts? And thus experimentally used to protect against osteoporosis and in PTHrp producing paraneoplastic syndromes?

    ----


    Answers:



    1) ANs: Ref: Harri 17ed, page 1837
    CMOS: means complementary metal oxide silicon... Its a camera chip and comes under the domain of electronics rather than medicine. But when AIIMS could ask about PACS , they can ask about this too!

    2) Ans: Ref: Harri 17 ed, page 1927
    MRP2 (multidrug resistance associated protein 2)

    3) Ans: ref: Harri 17 ed, page 1960
    Entecavir is an oral guanosine analogue polymerase inhibitor, appears to be the most potent of the HBV antivirals and is as well tolerated as lamivudine. Proven to be superior to lamivudine in a 709 subject trial

    4) Ans: ref: harri 17 ed page 2036
    None!

    5) Ans: ref: harri 17 ed page 2153
    Metacarpophalangeal joints. Look at the beautiful illustration! (fig 325-4)

    6) Ans: ref: harri 17 ed page 2184
    Sartorius bursa inflammation is anserine bursitis

    7) Ans: ref: harri 17 ed page 2185
    Frozen shoulder

    8) Ans: ref: saw it in harrison DVD.
    Braunwald the cardiologist one of the editor of harrison says- "PCI easily beats fibrinolysis as a better option for management of MI. However, only 20% of hospitals in USA are able to conduct a PCI (primary coronary intervention)

    9) Ans: ref: harri 17 ed page 2454
    Wolman disease is a disorder of neutral lipids. Enzyme defect is of acid lysosomal lipase. Specific treatment is bone marrow transplantation.

    10)Ans: http://en.wikipedia.org/wiki/Osteoprotegerin
    Osteoprotegerin, also known as osteoclastogenesis inhibitory factor (OCIF), is a cytokine, which can inhibit the production of osteoclasts. It is a member of the tumor necrosis factor (TNF) receptor superfamily. It is found as either a 60 kDa monomer or 120 kDa dimer linked by disulfide bonds.Osteoprotegerin inhibits the differentiation of macrophages into osteoclasts and also regulates the resorption of osteoclasts in vitro and in vivo
  17. Sourabh

    Sourabh Guest

    ) δ-aminolevulinate (ALA) synthase deficency causes which porphyria?

    2) δ-aminolevulinate (ALA) dehydratase deficiency causes which porphyria?

    3) What happens to the oxygen-Hb dissociation curve in methemoglobinemia?

    4) What is symmastia?

    5) Which is the most important determinant of operability in patients who have a VSD?

    6) The most common non-atherosclerotic disease of internal carotid artery?

    7) The most common ovarian malignancy diagnosed during pregnancy?

    8) Which is the initial toxicity of most local anesthetics?

    9) What is the major disease connection associated with fractalkine?

    10) What is the bacteria linked with SAPHO syndrome?


    ---

    Answers:

    1) Ref: http://en.wikipedia.org/wiki/Porphyria
    X-linked sideroblastic anemia (XLSA) is caused by deficiency of delta-ALA synthetase

    2) Ref: http://en.wikipedia.org/wiki/Porphyria
    Doss porphyria is caused by deficiency of delta-ALA dehydratase deficiency

    3) Ref: Schwartz pretest.8th ed Page 93
    Shifts to left in methemoglobinemia

    4) Ref: Schwartz pretest.8th ed Page 116
    Webbing of breasts across the midline

    5) Ref: Schwartz pretest.8th ed Page 139
    Pulmonary vascular resistance

    6) Ref: Schwartz pretest.8th ed Page 163
    Fibromuscular dysplasia

    7) Ref: Schwartz pretest.8th ed Page 296
    Dysgerminoma

    8) Ref: Schwartz pretest.8th ed Page 332
    Neural first. Cardiac second

    9) Ref harri 17ed page 2028
    Atherosclerosis

    10)Ref:harri 17ed page 2118
    SAPHO stands for synovitis, acne, pustulosis , hyperostosis and osteitis. Bacteria most commonly cultured from none biopsy specimens in this condition is Propionibacterium acnes (!)
  18. Sourabh

    Sourabh Guest

    1) Which is the most common symptom of pulmonary embolism?

    2) Which is the most common sign of pulmonary embolism?

    3) Which medium yields quicker growth of c.diphtheriae? Loeffler or Tellurite?

    4) In which muscle is Zenker diverticulum found?

    5) How many millions of RBCs are normally excreted per day in urine?

    6) By what age does port wine stain regress?

    7) By what age does salmon patch (macular stain/stork bite) regress?

    8) _______ stone is seen only in acidic urine?

    9) What is cement kidney?

    10) What is putty kidney?

    -----------------

    Answers:

    1) Dyspnoea

    2) Tachypnoea

    3) Loeffler serum slope gives growth in 6-8hrs. Wheras tellurite takes 36-48hrs

    4) A pulsion pseudo diverticulum that lies between the oblique and horizontal fibers of inferior pharyngeal constrictor

    5) Upto 2million per day

    6) It is known to NOT regress

    7) By 1 year

    8) Cysteine stones are seen only in acidic urine

    9) Seen in renal TB, kidney is calcified

    10) Seen in renal TB, kidney tissue replaced by caseous material
  19. Sourabh

    Sourabh Guest

    41. Enumerate the stages of TB hip?

    42. What is 'observation hip'?

    43. What is o'donoghue sign?

    44. Overall, which is the most common cause of aortic aneurysm?

    45. Most common cause of ASCENDING aortic aneurysm?

    46. Most common cause of DESCENDING aortic aneurysm?

    47. Which part of aorta does syphilis affect?

    48. Which part of aorta does Takayasu arteritis affect?

    49. What is Gerstmann Stransfer syndrome?

    50. By how many fold does serum AFP increase in fibrolamellar ca of liver?


    ----------------
    Answers:

    41)
    Stage 1 : Stage of Synovitis [FABER]
    Stage 2 : Stage of Arthritis [FADIR]
    Stage 3 : Stage of Erosion [Exaggerated FADIR]

    42) Observation hip Also known as transient synovitis. Benign, non-traumatic, selflimited disorder that mimics septic hip in clinical presentation. Treatment is just observation, so the name

    43) Also known as 'terrible triad'. A twisting force in a weight bearing knee often tears the medial meniscus, causing a well recognised triad of injury to MCL, ACL and medial meniscus.

    44) Atherosclerosis- overall most common cause of aortic aneursysm

    45) Cystic medial necrosis-Most common cause of ASCENDING aortic aneurysm

    46) Atherosclerosis-Most common cause of DESCENDING aortic aneurysm

    47) Syphilis affects ascending aorta

    48) Takayasu arteritis affects arch of aorta

    49) Gerstmann Stransfer syndrome is a prion disease. [Not to be confused with the parietal lobe syndrome Gerstmann syndrome.]

    50) It wont increase
  20. Sourabh

    Sourabh Guest

    51. What are the features of GIT perforation? Clinical and X-ray...

    52. Most common type of primary hydrocele?

    53. What is the treatment of choice for small and medium sized hydrocele?

    54. What is the treatment of choice for large hydrocele?

    55. What is the treatment of choice for hematocele or in case of infected hydrocele?

    56. Treatment of choice for congenital hydrocele?

    57. What is synpharyngitic hematuria?

    ------------------------

    Answers:


    51. Clinical sign is replacement of liver dullness by resonance. X-ray sign is free air under diaphragm

    52. Most common type of primary hydrocele is vaginal type

    53. Jaboulay's method is the treatment of choice for small and medium sized hydrocele

    54. Lord's procedure is the treatment of choice for large hydrocele

    55. Excision of the sac is the treatment of choice for hematocele or in case of infected hydrocele

    56. Herniotomy is done for congenital hydrocele

    57. Synpharyngitic hematuria is seen in IgA nephropathy (Berger's disease). Patients with IgA nephropathy present with gross hematuria often 24 to 48 hours after an URI (unlike post streptococcal GN which takes a relatively long time for hematuria to be seen)
  21. Sourabh

    Sourabh Guest

    58. What is the drug of choice for primary generalised tonic clonic seizues?

    59. What is the drug of choice for status epilepticus?

    60. Drug of choice for VT/VF induced by digoxin?

    61. Drug of choice for AV block bradycardia induced by digoxin?

    62. Name the ECG changes of digoxin medication.


    ---------------------

    Answers:

    58. Read the question carefully. The answer is valproate

    59. Lorazepam/Diazepam

    60. Lignocaine for VT/VF induced by digoxin

    61. Atropine for AV block bradycardia induced by digoxin

    62. ST depression and T wave inversion in V5,V6 in a reversed tick pattern. Prolonged PR, shortened QT
  22. Sourabh

    Sourabh Guest

    63. Name two conditions where LAP score is characteristically decreased

    64. Name the best screening method for hemochromatosis

    65. Name the most common childhood SOLID tumor and name its most common location.

    --------------------------


    Answers:


    63. PNH and CML

    64. Serum ferritin

    65. Most common childhood solid tumour is neuroblastoma. The most common site of neuroblastoma is adrenal medulla.
  23. Sourabh

    Sourabh Guest

    66. Name a stain for iron

    67. Name a stain for calcium

    68. Skin graft survives transplantation because of three processes which occur in a sequence and lead to 'take in' of the graft. Name the three processes.

    ----------------------



    Answers:

    66. Prussian blue

    67. Von Kossa

    68. Skin graft survives transplantation because of three processes which occur in a sequence and lead to 'take in' of the graft.
    a) Plasma imbibition
    - graft survival for first 48hours is due to imbibition
    - involves free absorption of nutrients into graft

    b) Inosculation
    - designates the period in which the donor and recipient capillaries become aligned

    c) Revascularisation
    - after approximately 5 days, revascilarisation occurs and the graft demonstrates both arterial inflow and venous outflow
  24. Sourabh

    Sourabh Guest

    69. Name the three signs named 'Hutchinson's sign'!

    70. What is hutchinson's triad?

    ------------

    Answers:

    69.
    Hutchinson's sign: periungual extension of brown-black pigmentation from longitudinal melanonychia onto the proximal and lateral nailfolds, is an important indicator of subungual melanoma.

    Hutchinson's sign: involvement of tip of nose in Herpes Zoster ophthalmicus often precedes involvement of eye

    Hutchinson's sign: with oculomotor nerve pals, pupillary inequality appears first followed by failure of reaction to light
  25. Sourabh

    Sourabh Guest

    71. What is the difference between Abadie's sign and Abadie's symptom?

    72. What is Aaron's sign?

    73. What is Addis count?

    74. Where are 'Dawson's fingers' seen?

    75. What is Boston's sign?

    76. Name the test done in thoracic outlet syndrome

    77. Name the test done to test integrity of palmar arch
  26. Sourabh

    Sourabh Guest

    78. Child Pugh scoring is done to assess the status of patients with liver cirrhosis. Name the five criteria taken into scoring consideration.

    79. What is the 'dangerous area of the hand'?

    80. In which of this is breastfeeding currently contraindicated in India. Hepatitis B or HIV or both?


    Answers:

    78. For child pugh scoring, these five criteria are used for scoring:
    *Ascites, *Encephalopathy, *Bilirubin, *Albumin, *Prothromin time

    79. The dangerous area of the hand is also known as 'no man's land' and also as 'the area of the pulleys'. It is the area between distal palmar crease and proximal interphalangeal joint. Tendon injuries here have worst prognosis.

    80. HIV - breast feeding contraindicated
    But in hepatitis B, breast feeding NOT contraindicated.
  27. Sourabh

    Sourabh Guest

    81. Phospholamban is an important molecule in which type of muscle? What is its function?

    82. For retinopathy of prematurity, name to predisposing factor and the precipitating factor.

    83. What is Pannes disease?

    84. What is Kohlar's disease?

    85. What is Keinbock's disease?


    ----------------------

    --------

    Answers:

    81. Phospholamban is an integral membrane protein embedded in the sacroplasmic reticulum that regulates the Calcium pump in cardiac muscle cells. "cAMP dependant PKA phosphorylates phospholamban. This causes activation of the calcium pump thereby increasing the uptake of calcium by sarcoplasmic reticulum, thus accelerating the rate of relaxation. This also causes increased calcium in SR to be released during future contraction, thus increasing contractility too.

    82. For ROP, predisposing factor is prematurity, and precipitating factor is hypoxia

    83. Osteochondritis of capitulum

    84. Osteochondritis of navicular

    85. Osteochondritis of lunate
  28. Sourabh

    Sourabh Guest

    86. What is Myerson's sign?

    87. What is Unterberger stepping test?

    88. What is Wada's test? Name the drug used and the procedure and indications.

    89. What is Beevor's sign?

    90. Where are Siegrist streaks seen?



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    Answers:

    86. Myerson's sign the condition where a patient is unable to resist blinking when tapped on the glabella. An early symptom of Parkinson's disease.

    87. Unterberger's stepping test is used to help assess whether a patient has a vestibular Pathology . The patient is asked to walk on the spot with their eyes closed. If the patient rotates to one side they have a labyrinthine lesion on that side.

    88. Wada's test. Into ONE internal carotid artery, a barbiturate (usually sod. amobarbital) is introduced. This causes unilateral cerebral hemisphere shutdown, allowing the researcher to study the other cerebral hemisphere without interference. DOnt prior to neurosurgery to study loss of a hemisphere beforehand.

    89. Beevor's sign is the movement of the navel towards the head on flexing the neck. It is caused by weakness of the lower abdominal muscles.It is characteristic of spinal cord injury at the T10 level. It has also been described in amyotrophic lateral sclerosis and facioscapulohumeral muscular dystrophy.

    90. Siegrist streaks are a rare manifestation of hypertensive choroidopathy. They are described as hyper-pigmented flecks that are arranged in a linear fashion along the choroidal vessels of the eye. Although they are usually indicative of fibrinoid necrosis associated with malignant hypertension, Siegrist streaks also occur in patients with temporal arteritis.
  29. Sourabh

    Sourabh Guest

    86. What is Myerson's sign?

    87. What is Unterberger stepping test?

    88. What is Wada's test? Name the drug used and the procedure and indications.

    89. What is Beevor's sign?

    90. Where are Siegrist streaks seen?





    Answers:

    86. Myerson's sign the condition where a patient is unable to resist blinking when tapped on the glabella. An early symptom of Parkinson's disease.

    87. Unterberger's stepping test is used to help assess whether a patient has a vestibular Pathology . The patient is asked to walk on the spot with their eyes closed. If the patient rotates to one side they have a labyrinthine lesion on that side.

    88. Wada's test. Into ONE internal carotid artery, a barbiturate (usually sod. amobarbital) is introduced. This causes unilateral cerebral hemisphere shutdown, allowing the researcher to study the other cerebral hemisphere without interference. DOnt prior to neurosurgery to study loss of a hemisphere beforehand.

    89. Beevor's sign is the movement of the navel towards the head on flexing the neck. It is caused by weakness of the lower abdominal muscles.It is characteristic of spinal cord injury at the T10 level. It has also been described in amyotrophic lateral sclerosis and facioscapulohumeral muscular dystrophy.

    90. Siegrist streaks are a rare manifestation of hypertensive choroidopathy. They are described as hyper-pigmented flecks that are arranged in a linear fashion along the choroidal vessels of the eye. Although they are usually indicative of fibrinoid necrosis associated with malignant hypertension, Siegrist streaks also occur in patients with temporal arteritis.
  30. Sourabh

    Sourabh Guest

    91. What is measured in Arneth count?

    92. What is bastian-bruns sign?

    93. What are the components of Beck's triad? In which condition is it seen?

    94. What is Bekhterev- Jacobsohn reflex?

    95. What is Bekhterev-Mendel reflex?



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    Answers:

    91. The number of lobes in the neutrophil nucleus. A left-shift (reduction in number of lobes) happen in infections etc. Whereas a right-shift, increase in number of lobes is seen in folate/cobalamine deficiency

    92. The eponym for loss of muscle tone and reflexes below lesion level in spinal cord transection

    93. Beck's triad seen in cardiac tamponade. Triad is of increased JVP, hypotension, and muffled heart sounds.

    94. Bekhterev Jacobson reflex : stroking dorsal radial skin, with forearm in supination, elicits wrist and finger flexion

    95. Bekhterev Mendel reflex seen in pyramidal tract lesions. Toe flexion
  31. Sourabh

    Sourabh Guest

    96. What is Bjerrum scotoma?

    97. What is Blumberg sign? In which condition is it seen?

    Where is Boas point?

    99. What is Boas sign?

    100. Bracht-Wachter bodies are seen in which condition?

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    Answers:

    96) Bjerrum scotoma is the comet shaped visual field defect,extending temporally from the physiological blind spot

    97) Blumberg sign is the eponym for the rebound tenderness seen in peritonitis

    Boas' point is the point of dermal hyperesthesia just left of T12. Seen in gastric ulcer.

    99) Boas' sign is the dermal hyperaesthesia seen at inferior angle of rt scapula. Seen in aute cholecystitis

    100) Bracht-Wachter bodies are seen in infective endocarditis. They are yellow-white spots in the myocardium
  32. Sourabh

    Sourabh Guest

    101) What are Brewer infarcts?

    102) What is the Brissaud reflex?

    103) What is Cardarelli's sign?

    104) Describe Charcot's triad OF multiple sclerosis

    105) Describe Charcot's triad OF ascending cholangitis

    106) What is Claybrook's sign? Where is it seen?

    107) What is Crowe sign?

    108) In which condition is Cruveilhier Baumgarten sign seen?

    109) What is Dance sign?

    110) What is Dahl's sign? Which group of patients show this sign?
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    Answers:


    101) Brewer infacts are not infarcts. They look like infarcts. Are dark wedge shaped objects seen in pyelonephritis

    102) Brissaud's reflex: plantar stimulation elicits contraction of tensor fasciae latae

    103) Cardarelli's sign: seen in aortic aneurysm or arch dilatation. Displacing the trachea to the left elicits palpable pulsation of the same.

    104) Charcot's triad of Multiple sclerosis: scanning(staccato) speech, intention tremors and nystagmus

    105) Charcot's triad of ascending cholangitis. Jaundice, fever, RUQ pain

    106) Claybrook sign: heart and/or breath sounds heard through abdominal wall indicate rupture of viscus

    107) Crowe sign: is the axillary freckling seen in NF1

    108) Cruveilhier Baumgarten sign is the perihumbilical hum seen in cirrhosis/portal hypertension

    109) Dance's sign: is the empty left lower quadrant (left iliac fossa retracted) in patients with ileo-cecal intussusecption

    110) Dahl's sign: pigmented calluses on anterior surface of pages due to COPD patients leaning elbows on pages
    _________________
  33. Sourabh

    Sourabh Guest

    101) What are Brewer infarcts?

    102) What is the Brissaud reflex?

    103) What is Cardarelli's sign?

    104) Describe Charcot's triad OF multiple sclerosis

    105) Describe Charcot's triad OF ascending cholangitis

    106) What is Claybrook's sign? Where is it seen?

    107) What is Crowe sign?

    108) In which condition is Cruveilhier Baumgarten sign seen?

    109) What is Dance sign?

    110) What is Dahl's sign? Which group of patients show this sign?
    --------------


    Answers:


    101) Brewer infacts are not infarcts. They look like infarcts. Are dark wedge shaped objects seen in pyelonephritis

    102) Brissaud's reflex: plantar stimulation elicits contraction of tensor fasciae latae

    103) Cardarelli's sign: seen in aortic aneurysm or arch dilatation. Displacing the trachea to the left elicits palpable pulsation of the same.

    104) Charcot's triad of Multiple sclerosis: scanning(staccato) speech, intention tremors and nystagmus

    105) Charcot's triad of ascending cholangitis. Jaundice, fever, RUQ pain

    106) Claybrook sign: heart and/or breath sounds heard through abdominal wall indicate rupture of viscus

    107) Crowe sign: is the axillary freckling seen in NF1

    108) Cruveilhier Baumgarten sign is the perihumbilical hum seen in cirrhosis/portal hypertension

    109) Dance's sign: is the empty left lower quadrant (left iliac fossa retracted) in patients with ileo-cecal intussusecption

    110) Dahl's sign: pigmented calluses on anterior surface of pages due to COPD patients leaning elbows on pages
    _________________
  34. Sourabh

    Sourabh Guest

    111) What is Destot's sign?

    112) What is Mc Donald's sign?

    113) What is Fothergill's sign?

    114) What are 'Hippocratic fingers'?

    115) What is John thomas sign/ Throckmorton sign?

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    Answers:




    111) Destot's sign is seen in pelvic fracture. There is ecchymosis superior to inguinal ligament, in scrotum or in thigh.

    112) Mc Donald's sign: (Forensic Psychiatry ) enuresis, firesetting and animal torture predictive of future criminal behaviour

    113) Fothergills sign: to check if the patient's abdominal pain is due to abdominal wall origin or intraabdominal origin. Patient is made to touch his chest using his chin. Then, press the patient's abdomen. If there is increased intensity due to this maneuver, that means the pain is due to abdominal wall pain. However if the pain reduces, that means it is intraabdominal origin.

    114) Clubbing of fingers is another name for 'hippocratic fingers'

    115) The John Thomas sign, also known as the Throckmorton sign, is a joke in the medical community which involves the position of a penis as it relates to Pathology on an x-ray of a pelvis. When the penis (visible on the x-ray as a shadow) points towards the same side as a unilateral medical condition (such as a broken bone), this is considered a "positive John Thomas sign", and if the shadow points to the other side, it is a negative John Thomas sign. This sign is of no medical significance and is employed as a humorous aside, regarded to be a cruel joke.
  35. Sourabh

    Sourabh Guest

    116) In which patients is the Levine's sign seen?

    117) What is Lisker sign?

    118) What is Mentzer's index? How and for what is it used?

    119) What is Muller sign?
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    Answers:



    116) Levine's sign is a clenched fist held over the chest to describe ischemic chest pain. Eg patients with MI or angina

    117) Lisker's sign is tenderness when the front, middle (anterior medial) part of the tibia is tapped (percussion). It is often present in people who have deep venous thrombosis

    118) Mentzer index is used to differentiate iron deficiency anemia from beta thalassemia. It is calculated from the results of a complete blood count. If the quotient of the mean corpuscular volume divided by the red blood cell count is less than 13, thalassemia is more likely. If the result is greater than 14, then iron-deficiency anemia is more likely.

    119) Mulder's sign is a feature of morton's metatarsalgia/morton's neuroma.

    120) Muller sign of aortic insufficiency. Visible pulsation or bobbing of uvula
  36. vgkumar

    vgkumar Guest

    PBC is due to an autoimmune destruction of intrahepatic bile ductules, and the diagnosis is made by liver biopsy. The serology that should be checked is the antimitochondrial antibody. Primary biliary cirrhosis is often seen in individuals with other autoimmune diseases, such as Sjögren syndrome, pernicious anemia, and Hashimoto thyroiditis.
    53.Myasthenia gravis is an autoimmune disease in which antibodies directed against the acetylcholine receptor of the muscle side of the neuromuscular junction block the ability of the receptor to bind to acetylcholine. Remember insulin resistance is also produced by a similar mechanism, i.e. antibodies to insulin receptors block the receptors' ability to bind to insulin
    54.The first step in the approach to a patient with a community-acquired pneumonia is to categorize condition according to the American Thoracic Society guidelines (1993), which are based on severity of illness, age, comorbidities, and the need for hospitalization. the criteria for hospitalization (one of the following is needed: respiratory rate > 30 breaths/min, room air PaO2< 60 mm Hg, O2 saturation less than 90% on room air, or bilateral or multiple lobes involved), and older than 60 years.

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