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NMBE 25
Second Review of Wrong answers
| Question | Answer |
|---|---|
| What is the most common transplant in which GVHD is development? | HLA-unrelated bone marrow transplant |
| Are T-lymphocytes or B-lymphocytes involved in the pathogenesis of GVHD? | Donor T-lymphocytes |
| What is the target purpose of GVHD treatment? | Directly or indirectly prevent T cell proliferation, actiation, and function |
| Which cells should be depleted in a donor before receiving a bone marrow transplant? | T- lymphocytes |
| What condition or disease is expected to develop in a recipient that was not depleted of T-lymphocytes prior Bone Marrow transplant? | Graft-versus-Host disease |
| A common function or role of Vitamin D | Serum Calcium and phosphate homeostasis |
| How does Vitamin D provides serum homeostasis of Calcium and phosphate levels? | Promoting the intestinal absorption of calcium and phosphate |
| What are some consequences of Vitamin D deficiency? | 1. Decreased intestinal Ca2+ absorption 2. Hypocalcemia 3. Increased PTH secretion 4. Increased PTH-mediated bone resorption |
| Proportion of positive test result that are true positive | PPV |
| TP ------------------- (TP + FP) | PPV |
| What is NPV? | Proportion of negative test results that are true negative |
| What is the equation for calculating NPV? | TN / ( TN + FN) |
| What are the features of a skin lesion that might indicate Melanoma? | Asymmetry, border irregularity, variable coloration, diameter >6mm, or other changing features |
| What is the most common site of metastasis in a patient with RCC and Hx of smoking? | Brain |
| What is the most common profile of RCC? | Older man with a hx of cigarette smoking |
| What is the histology of RCC? | Polygonal, clear cells frelted to accumulation of lipid and carbohydrate content in cells |
| What are the lab finding of RCC? | Hematuria along with hypercalcemia or polycythemia secondary to paraneoplastic syndromes |
| Which trimesters are most commonly Syphilis infection passed to fetus? | 2nd and 3rd trimester |
| What are the clinical features of Congenital Syphilis? | Syphilis rhinitis, rhagades, dental malformation, and organomegaly |
| What is the most common subtype of centrally located lung cancer? | Squamous cell cancer of the lung |
| What is the most common associated paraneoplastic syndrome of Squamous cell cancer of the lung? | Hypercalcemia due to PTHrP production |
| A patient with central lung mass, and a high level of serum calcium due to elevated PTHrP production. What is the most likely diagnosis? | Squamous cell lung cancer with PTHrP paraneoplastic syndrome |
| What is the key for maintenance of bone mineral density? | Balance of osteoblast and osteoclast interactions |
| What is another name of IL-1? | Osteoclast activating factor |
| What is the result on bone due to increased level of IL-1? | Bone mineral density loss |
| Which nerve is responsible for eversion of the foot? | Superficial Fibular nerve |
| A person unable to evert foot. Which is the most likely injured nerve? | Superficial Fibular nerve |
| Which nerve dorsiflexes the foot? | Deep Fibular nerve |
| Inability to dorsiflex the foot is due to damage to which peripheral nerve? | Deep Fibular nerve |
| Which nerve is responsible for plantarflexion of the foot? | Tibial nerve |
| Which nerve is most likely damaged in a patient unable to plantarflex the foot? | Tibial nerve |
| What is seen in the overall course of a viral disease such as Yellow fever? | Initially an asymptomatic period while infectious agent is reproduced, followed by a symptomatic period peak, and then improves with resolution of the infection |
| What are Granulosa cell tumors? | Malignant ovarian sex cord-stromal tumor in women that produces estrogen |
| What is a very common symptom of a Granulosa cell tumor? | Abnormal postmenopausal uterine bleeding |
| What are some local mediator of muscle blood flow? | Adenosine, lactate, hydrogen ions, and the PaCO2 and PaO2 |
| What is the purpose of autoregulatory meditators of local muscle blood flow? | Increase skeletal muscle blood flow during exercise |
| What is a common complication of Meningiomas? | Compress brain or spinal cord and cause focal neurologic deficits as well as seizures |
| Benign CNS tumor that arises from the meninges. Dx? | Meningioma |
| What is the typical description of MRI findings on a Meningioma? | Spherical and well-circumscribed mass that indents the parenchyma |
| What are the deficits due to a Posterior Communicating artery aneurysm? | Ipsilateral oculomotor nerve compression, resulting in diplopia, mydriasis, exotropia, and hypotropia |
| Which CN is compressed with a Posterior Communicating artery aneurysm? | Ipsilateral Oculomotor nerve |
| Description the CONTEMPLATION stage of behavioral change | Ambivalence about changing a behavior, in which the patient expresses knowledge of the consequences of their detrimental behavior but are not yet prepared to make plans to change it |
| Which stage is described by a patient that knows that smoking may cause cancer, and acknowledges the fact that in case he does stop smoking, he will most likely develop lung cancer, but still not make any plans to change it? | Contemplation |
| Which artery is often constricted in duodenal volvulus? | Superior Mesenteric artery |
| SMA, is related to the midgut, hindgut or foregut? | Midgut |
| Which part of the GI tract is often affected by volvulus associated with the SMA? | Duodenum |
| What CN is associated with Acoustic neuromas? | Vestibulocochlear nerve |
| What is often compressed by Acoustic neuromas? | Cerebellar peduncles |
| What are some features caused by Acoustic neuromas? | Ipsilateral hearing loss, positional dizziness, and if compression of peduncles is seen it can lead to ipsilateral dysmetria |
| What structures are attached by the Uterosacral ligament? | Extend bilaterally from the cervical regions to the sacrum, helping support the uterus in the pelvis |
| What is the common histology of Cryptococcus neoformans? | Narrow-based budding yeast cells and bright red capsules with mucicarmine or periodic acid-Schiff staining |
| What causes Pyloric stenosis? | Hypertrophy of the pyloric sphincter, resulting in gastric outlet obstruction |
| What is the acid-base disturbance associated with Pyloric stenosis? | Dehydration and a hypochloremia, hypokalemic metabolic alkalosis |
| Is repeated vomiting associated with alkalosis or acidosis? | Alkalosis |
| What neonatal condition often leads to hypochloremic, hypokalemic metabolic alkalosis? | Pyloric stenosis |
| What imaging findings should raise suspicion of a Primary CNS lymphoma? | Solitary brain lesions, especially if the patient is HIV/AIDS |
| What autoimmune condition is associated with mutations involving "complement system"? | SLE |
| What are complement levels low in SLE? | Due to immune activation and complex deposition |
| What is a common example of DPP-4 inhibitor? | Sitagliptin |
| How do DPP-4 inhibitors work? | Prevent early breakdown of incretins, which promote endogenous insulin release |
| What is the MCC of Primary Hyperparathyroidism? | PTH adenoma |
| How is amniotic fluid recycled? | Fetal swallowing |
| What is the result of failed fetal swallowing of amniotic fluid? | Polyhydramnios |
| What are common craniofacial anatomy malformation due to Polyhydramnios? | Anencephaly or Esophageal atresia |
| On which phase of the menstrual cycle increases FSH? | Follicular phase |
| What is the result of increased FSH levels during follicular phase? | Support develop ovarian follicle |
| Which part of the GI tract are amino acids produced from broken proteins? | Brush border of the intestinal mucosa |
| Which part of the GI tract are proteins broken down into dipeptides and tripeptides? | Lumen of the duodenum |
| What enzymes break down proteins into dipeptides in the duodenum? | Trypsin and chymotrypsin |
| What adrenergic receptor is stimulated by nasal decongestant? | Alpha-1 adrenergic receptor |
| What are the diseases caused by opportunistic CMV infection? | Retinitis, esophagitis, and pneumonia |
| What is the main histological finding of CMV infection? | Intranuclear inclusion bodies within infected cells |
| How much percentage lies within 2 SD in Gaussian distribution? | 95% |
| What are the symptoms of excess ACh ? | Vomiting, diarrhea, increased urination, diaphoresis, salivation, lacrimation , and bronchospasm |
| What enzyme is inhibited by Anticholinesterase? | ACh |
| What is a common source for Anticholinesterase poisoning? | Insecticides (organophosphates) |
| Which muscarinic receptors is antagonized in treatment of Anticholinesterase poisoning? | M2 receptor |
| What is a common M2-antagonistes used in anticholinesterase poisoning treatment? | Pralidoxime |
| Which receptor is inhibited by Pralidoxime? | M2 receptor |
| What is reperfusion injury? | It occurs as tissue oxygenation is restored following a period of ischemia |
| What causes the "injury" in reperfusion injury? | Generation of free oxygen radicals and peroxides, which result in lipid peroxidation, protein modification, and DNA strand breaks |
| What is the MCC of Gout? | Underexcretion of uric acid, which then crystalizes in synovial spaces |
| Which enzyme is inhibited by Allopurinol? | Xanthine oxidase (XO) |
| Which derivates are halt from producing with the use of Allopurinol? | Hypoxanthine and Xanthine |
| What muscle feature is seen REM sleep behavior disorder? | Absent muscle atonia |
| What are features of REM sleep behavior disorder? | Patients act out their dreams in a coordinated, and at times violent manner |
| What is the most likely diagnosis in a person that while sleeping acts out their dream in a coordinated and violent manner? | REM sleep behavior disorder |
| What is the effect on TRH and TSH in setting of increased T3 and T4 levels? | Decreased production due to negative feedback to hypothalamus and pituitary |
| Bartonella henselae is a gram______________________________ | Gram-negative coccobacillus |
| What are the histological findings of lymphoid nodes infected by Bartonella henselae? | Necrotizing granulomas with stellate (star-shaped) microabscesses |
| What is the most common cause of Reye syndrome? | Salicylate use (aspirin) in children during or preset viral infection |
| What organelle dysfunction is associated with Reye syndrome? | Mitochondrial dysfunction |
| Rare but fatal encephalopathy, seen in children treated with aspirin to reduce a fever | Reye syndrome |
| What is disrupted in a LMN injury that ultimately leads to hyporeflexia? | Reflex arc |
| What is a "reflex arc"? | Special type of neural circuit that begins with a sensory neuron at a receptor (e.g., a pain receptor in the fingertip) and ends with a motor neuron at an effector (e.g., a skeletal muscle). |
| What rib is the best one to perform a thoracentesis? | 9th rib |
| Where is the correct location for a thoracentesis if the patient is the patient is supine? | Above 9th rib along the midaxillary line on affected side |
| Which "line" is followed to place the needle in the 9th rib if the patient is sitting up? | Midscapular line |
| Is the needle of a thoracentesis placed above or below the 9th rib? | Above |
| Why is the needle for a thoracentesis placed above the 9th rib on the midaxillary or midscapular line? | To avoid damage to the lung parenchyma |
| What ratio is increased by closing K+ -ATP channels in islet pancreatic cells? | ATP:ADP |
| What is the fetal ultrasound finding of a Down syndrome fetus on the 1st trimester of gestation? | Nuchal translucency |
| Is HCG elevated or decreased in ammonitic fluid of Down syndrome fetus? | Elevated |
| What MHC class is expressed by Natural Killer cells? | No MCH class |
| What enzymes are used by NK cells to kill virally infected or neoplastic cells? | Perforin and Granzyme |
| What condition impairs the realeased of bicarbonate by the pancreas? | Pancreatitis |
| What are the common symptoms of CNS depressants? | Restlessness, tachycardia and hypertension, tremors, nausea, and vomiting |
| What are some specific heroin withdrawal symptoms? | Lacrimation, rhinorrhea, piloerection, and yawning |
| What causes the symptoms of seasonal allergies? | Vasodilation and increased capillary permeability caused by histamine |
| What is a common rejection disorder occurring months after transplant? | T-lymphatic-mediated rejection (TCMR) |
| What type of WBC is seen infiltrated in a TCMR? | Leukocytes |
| How long after initiation of drug, if allergic, a rash would develop? | 7-10 days |
| What are the most common drug culprits for adverse rashes? | Antibiotics, sulfa-containing drugs, and antiepileptics |
| What pathway of apoptosis is induced by acute hepatitis? | Extrinsic pathway of apoptosis |
| What is the histological description of hepatocytes in acute hepatitis? | Balloting hepatocytes with apoptotic bodies |
| What enzyme is breast milk essential for digestion of triglycerides? | Lingual lipase |
| How does lingual lipase in Breast milk work? | Hydrolyzes triglycerides into free fatty acids and aminoglycosides |
| What cells absorbed the digested infant triglycerides products? | Intestinal enterocytes |
| What does a high Km indicate in respect to affinity? | Decreased affinity of an enzyme active site for the substrate |
| In cartilage disease, are the levels of proteoglycans increased or decreased? | Decreased |
| What is the function of ADH (Vasopressin)? | Increase water reabsorption without increasing sodium reabsorption |
| What are some expected values when exogenous ADH is administered? | 1. Decreased urine output 2. Increased urine osmolality 3. Decrease serum osmolality |
| Which catecholamine plays a significant role in glucose homeostasis? | Epinephrine |
| Which catecholamine has a SELECTIVE activation of the medulla of the adrenal gland to be activated and secreted in setting of hypoglycemia? | Epinephrine |
| What is the definition of Prevalence? | Number of existing cases of a disease or condition as a percentage of the number of people in the population under study who are at risk for that condition |
| Common depolarizing neuromuscular blocker? | Succinylcholine |
| What enzyme is known to degrade Succinylcholine? | Pseudocholinesterase |
| Which enzyme deficiency is known to cause a prolongation of activity of Succinylcholine? | Pseudocholinesterase |
| Which brain lobe is known to control the lower extremity? | Paracentral lobe |
| Which specific parts of the brain are known to control the lower extremities? | Medial aspect of the precentral (motor) and postcentral (sensory) gyri in the paracentral lobe |
| What part of the body may be affected by injury to the medial aspect of the paracentral lobe? | Contralateral lower extremity |
| Does a stroke in the paracentral lobe of the brain cause contralateral or ipsilateral deficits in the lower extremity? | Contralateral |
| Which phase is acetaminophen metabolized by the liver? | Phase II conjugation |
| What are the resulting metabolites of acetaminophen metabolism? | Sulfates and glucuronides |
| What is hallmark of acetaminophen toxicity? | Depletion of glutathione |
| What does the depletion of glutathione most likely indicate? | Acetaminophen toxicity |
| What is the key activating signal for fatty acid synthase following a meal? | Insulin |
| What are two common storages of energy-rich molecules? | Glycogen and fatty acids |
| The increased production of glycogen and fatty acids would indicate a fed or fasting state? | Fed state |
| Which cells function and effects are inhibited by glucocorticoids? | T-lymphocytes |
| What are three common adverse effects of prolonged use of glucocorticoids? | Impaired lipid metabolism, Insulin resistance, and, Deleterious effects on bone health |
| MOA of B-lactamases | Inactivate B-lactam antibiotics and are a common mode of resistance of some gram-negative bacteria |
| What is a common site for a central venous catheter close to the common carotid artery? | Internal Jugular vein |
| Which neck vein is commonly used to place a Central Venous Catheter? | Internal Jugular vein |
| What are common structures near the Internal Jugular vein? | Common Carotid artery and Lungs |
| What are some possible complications of misplaced an Internal Jugular vein central catheter? | Pneumothorax and hematoma/hemorrhage |
| What immune disease is known to cause multiple venous and arterial thrombosis? | Antiphospholipid antibody syndrome |
| What is a common obstetric complication associated with Antiphospholipid antibody syndrome? | Recurrent pregnancy loss |
| RR = | a/ (a+b) ---------- c / (c+d) |
| What is the main mediator of vasodilation caused by Nitroglycerin? | cGMP in smooth muscle cells |
| How does Nitroglycerin treat angina pectoris? | Vasodilation of coronaries, as it increases the cGMP in smooth muscle cells |
| What is rare complication of a Vasectomy? | Spermatozoa may lead to the surrounding interstitium |
| What is the possible consequence of sperm leakage to the interstitum after a vasectomy? | May elicit immune foreign body granulomatosis reaction and production of antibodies |
| What is the problem with TAP mutations? | Prevention of presenting antigens to MHC-I to CD8+ T cells |
| How much of the population (%) has VSD? | 2-3% |
| On which phase of Meiosis is "Recombination" performed? | Prophase I of meiosis |
| What is the Recombination of gametes? | Proces by which two alleles closely located on the same chromatid can be separated |
| What is a common complication of excessive Nicotinic acid supplementation? | Facial flushing secondary to increased prostaglandin production |
| Which drug is used to prevent flushing caused by Nicotinic acid? | Aspirin |
| What type of anemia is often produced by Colorectal Carcinoma? | Microcytic anemia |
| Why is CRC less commonly seen with symptoms of Obstruction such as abdominal pain or stool caliber change? | It is typically exophytic in nature |
| Which arterial body manipulation creates greater risk for an embolus? | Aorta |
| What type of emboli is often produced by manipulation of the aorta by a procedure? | Cholesterol emboli |
| What are some cutaneous signs or symptoms of an emboli? | Localized petechiae, livedo reticulitis, and blue toe syndrome, with needle-shaped clefts on histologic examination |
| What is the histologic characteristic of cholesterol embolus? | Needle-shaped clefts |
| For which actions is Vitamin C an essential element? | Collagen synthesis, Iron absorption, Immune function, and Conversion of Dopamine into NE |
| Which vitamin is essential for the conversion of Dopamine into Norepinephrine? | Vitamin C |
| Which condition is due to Vitamin C deficiency? | Scurvy |
| What are the physical symptoms and features of Scurvy? | Swollen gums, bruising, poor wound healing, petechiae, perifollicular and subperiosteal hemorrhages and short fragile, curly hair |
| What vitamin deficiency is known to cause "corkscrew hair"? | Vitamin C |
| What is the histologic feature of muscle denervation and innervation? | Muscle fibers grouping by type, in which type I and type II fibers group together |
| What is the statistical measure calculated in a Case-control study? | Odds ratio |
| If the odds ratio is known, what is the type of study conducted? | Case-Control study |
| What featured cell type is seen muscle cell repair? | Stellate cells |
| What is the function of stellate cells in skeletal muscle? | Repair damaged myofibrils |
Created by:
rakomi
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