Sim 1 Review
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| What are some clinical signs of acute stress disorder? | Intrusive memories, flashbacks, avoidance, sense of detachment from reality, negative mood, impaired concentration, and hyperarousal following exposure to a life-threating event
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| What is the timeframe of an acute stress disorder? | Symptoms last > days and less than 4 months
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| What is Sublimation? | Mature defense mechanism in which a person channel unacceptable thoughts or impulses into socially acceptable behavior
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| Mature or Immature self defense mechanism. Sublimation? | Mature defense mechanism
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| A person channelling emotional anger in the form of playing sports is an example of what kind of defense mechanism? | Sublimation
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| What is the role of endoproteases? | Removal of non-functional polypeptide sequences to yield smaller functional protein
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| What is a common procedure taking place posttranscriptional that causes the development of a functional protein? | Removal of non-functional polypeptides sequences by endoproteases
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| What is the result of a ligand binding to a tyrosine kinase receptor? | Formation of receptor dimers and a conformational change that exposes tyrosine kinase-active sites
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| What is the simplified equation for False rate? | (1- specificity)
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| 1-(specificity) = | False rate
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| Is False rate dependent or independent form disease prevalence? | Independent
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| Presence of multiple, genetically different gamete cell lines | Germline mosaicism
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| What scenario shall raise suspicion o f Germline mosaicism? | In cases a genetic mutation is identified in the offspring but not in the parents
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| What are Cadherins? | Calcium-dependent adhesion molecules that bind epithelial cells within tissues
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| What is bound by Cadherins? | Epithelial cells to each other
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| What is a common example of a cell adhesion molecule? | Cadherin
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| Which common cell junctions are formed by Cadherin molecules binding to each other? | Adherens junctions and desmosomes
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| What is the main adhesion cell protein in Desmosomes and Adherens junctions. | Cadherin
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| What is caused with Phosphodiesterase-5 inhibitor? | Increase intracellular concentrations of cGMP in the vascular smooth muscle of the corpora cavernosa
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| Which part of the penis anatomy is Sildenafil targeted to? | Corpora cavernosa
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| What is the result of PDE-5 inhibition in the vascular smooth muscle? | Penile smooth muscle relaxation and subsequent engorgement
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| What is the definition of Endometriosis? | Presence of endometrial glands and stroma in extrauterine location such as the ovary
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| What is the most common location for Endometriosis? | Ovary
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| What does the cyclic shedding of ectopic endometrial tissue causes in a person with Endometriosis? | Dysmenorrhea, intraperitoneal inflammation, and release of hemosiderin
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| What is a histological finding of Endometriosis? | Hemosiderin-laden macrophages, which are usually brownish pigments
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| What is postpartum endometritis? | Infection of the endometrium after delivery, usually due to microbial organisms or foreign bodies (products of conception) in the cavity.
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| What are the signs and symptoms of Endometritis? | Fever, leukocytosis, uterine tenderness, and foul-smelling vaginal discharge.
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| What is DNA laddering? | Sensitive indicator of apoptosis and refers to the appearance of DNA fragments in multiples of 180 base pairs on gel electrophoresis
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| What process is described or characterized by 180 base pairs on gel electrophoresis? | DNA laddering
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| Common anti-apoptotic protein associated with Follicular B cell lymphoma? | BCL-2
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| What condition if characterized by excessive and disordered bone formation? | Pagets disease of bone
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| What are main skeletal structures affected by Paget's disease of the bone? | Skull (headaches), spine, and long bones
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| What are the long term complications of Paget's disease of the bone? | Fracturess, hearing loss, and malignant transformation leading to osteosarcoma
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| What malignancy is often derived from Paget's disease of bone? | Osteosarcoma
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| What is Oseltamivir? | Inhibitor of neuraminidase of influenza A and Influenza B viruses
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| What virus is treated with Oseltamivir? | Influezae
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| What is mode of action of Oseltamivir? | Prevents the release of newly formed viral particles
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| What is caused by a Anticholinergic intoxication? | Fever, dry skin and mucous membranes, flushing, blurred vision, and altered mental status
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| What is Jimson weed? | Drug of abuse that can cause anticholinergic toxicity
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| What is the common name of Datrura stramonium? | Jimson weed
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| What are some adverse effects seen with Benzodiazepine toxicity? | Confusion, anterograde dementia, ataxia, and falls
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| Which population is known to have a slower benzodiazepine metabolism, leading to more common development of adverse effects? | Elderly
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| Which muscarinic receptors activity lead to bronchial smooth muscle contraction? | M3 receptors
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| What is the result of muscarinic M3 receptor activation? | Bronchial smooth muscle contraction
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| What drug is used to actively compete with Muscarinic effects? | Atropine
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| What is achieved by atropine in the lungs? | Competitively inhibits muscarinic receptors on bronchial smooth muscle, leading to smooth muscle relaxation
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| What is the result on pancreatic exocrine secretions by the release of Secretin? | Increase flow of pancreatic exocrine secretions
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| What is the effect on Bicarbonate and Chloride in high flow levels of pancreatic exocrine secretions? | Bicarbonate concentration increases and Cl- concentration is low
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| Is it low or high flow of exocrine pancreas secretions, if the level of bicarbonate is low and chloride is high? | Low flow
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| At which surface of the pancreatic cells is the Cl-HCO3 exchanges located? | Apical surface of ductal cells
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| What is a vestige of the gubernaculum? | Round ligament of the Uterus
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| What surgical procedure can affect the Round Ligament of the Uterus? | Hysterectomy
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| What is the path and connectivity role of the Round ligament of the uterus? | Projects from the Uterus, travels through the inguinal canal, and attached to the labia majora
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| Which female genitourinary ligament passes through the inguinal canal? | Round ligament of the Uterus
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| What structures are "connected" by the Round ligament of the Uterus? | Uterus and labia majora
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| Why does cirrhosis cause Portal hypertension? | Due to distortion of the hepatic vascular beds
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| What are common complications of Portal hypertension? | Splenic vein hypertension and splenomegaly
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| What is a common cause of Splenic vein hypertension and splenomegaly in an alcoholic patient? | Portal hypertension
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| What is tested with an ELISA? | Test to identify specific antibodies in a patient's serum
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| What is the first step in an ELISA? | A known antigen, is fixed to a surface and patient serum is added
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| What is the second step in performing an ELISA? | Addition of anti-human immunoglobulin antibodies, each coupled wo an enzyme such as peroxidase
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| What are the "detecting" antibodies referred in an ELISA? | Anti-human immunoglobulin antibodies
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| Onto which kind of receptors does Glucagon bind in the liver cells? | G protein-coupled receptors
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| What is activated by glucagon binding to GPCR in the hepatocytes? | Gs is activated, which in turn stimulates adenylate cyclase to increase intracellular cAMP
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| In the Gs-pathway, cAMP is known to activate what product? | Protein kinase A
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| What metabolic processes are stimulated by Protein Kinase A in the end result of the Gs-pathway? | Enzymes of glycogenolysis and gluconeogenesis
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| What are key enzymes of Glycogenolysis? | Glycogen phosphorylase and Phosphorylase kinase
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| What common key enzymes of Gluconeogenesis? | Pyruvate carboxylase and PEP carboxykinase
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| What is glycogenolysis? | Breakdown of glycogen to glucose-1-phosphate and glycogen
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| What is gluconeogenesis? | Metabolic pathway that results in the generation of glucose from certain non-carbohydrate carbon substrates
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| What is the main product produced by both, glycogenolysis and gluconeogenesis? | Glucose
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| What is glucagon? | Peptide hormone, produced by alpha cells of the pancreas. It raises concentration of glucose and fatty acids in the bloodstream
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| How is Complete Androgen Insensitivity characterized? | A male genotype with a female phenotype with external female genitalia and a vaginal ending in a blind pouch
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| Normal looking female, with XY genotype, and a blind pouch ending of the vagina. Dx? | Complete Androgen Insensitivity
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| Which hormones are elevated in Complete Androgen insensitivity? | Serum testosterone and LH are elevated
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| How is the level of FSH in Complete Androgen insensitivity? | Normal serum FSH
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| What is a possible diagnosis of a person with elevated serum testosterone and LH, and normal serum FSH? | Complete Androgen Insensitivity
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| What is a characteristic of proteins destined for the RER? | Posses a hydrophobic, N-terminal peptide signal sequence that identified them
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| What is the result of the removal of N-terminal sequence signals in proteins? | Accumulation of protein in cytoplasm, as it does not reach the RER
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| What is a Retinoblastoma? | Childhood tumor that results form separate, mutagenic events that inactive both copies of the RB1 tumor suppressor gene
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| On which chromosome is the RB1 gene? | Chromosome 13
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| What other malignancy is strongly associated with Hereditary Retinoblastoma due to Germline mutations? | Osteosarcoma
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| Which tumor suppressor gene is associated with development of Osteosarcoma and Retinoblastoma? | RB1 gene on chromosome 13
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| What is a characteristic of the peripheral blood cells in the recipient of a bone marrow transplant? | Peripheral blood cell will be genetically different to the ones of the rest of the body
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| Why is it common to for a BM recipient to have blood cells of different genders? | The peripheral blood cells are genetically different to those of the rest of the body, and if the donor is of the opposite sex, the recipient will have then both types of sex cells
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| What is the description of the SWEAT glands in Cystic Fibrosis? | Mutated CFTR prevents salt reabsorption, producing seat with higher levels of Na+ and Cl-
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| What does the mutated CFTR cause in the respiratory epithelium? | Thick, viscous secretions that are low in both, Na+ and Cl- levels
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| If the sample of a CF patient demonstrate high levels of sodium and chloride, it most likely is from the sweat glands (skin) or respiratory epithelium? | Sweat glands
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| Which fluid sample in a CF patient would yield low levels of NaCl? | Respiratory epithelium
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| What is the pathology of Pseudohypoparathyroidism? | Endo-organ resistance to PTH due to PTH receptor mutation and downstream signaling pathways
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| What condition is due to PTH resistance due to PTH-receptor mutation? | Pseudohypoparathyroidism
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| What condition is suspected in a patient with hypocalcemia and hyperphosphatemia despite elevated levels of PTH? | Pseudohypoparathyroidism
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| What is a common form of Pseudoparathyroidism? | Albright Hereditary Osteodystrophy
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| What is Albright Hereditary Osteodystrophy? | Form of pseudohypoparathyroidism further associated with short stature, and short metacarpals and metatarsal bones
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| Which condition is associated with short stature, metatarsal and metacarpal bone deformities, and elevated PTH levels in blood? | Albright Hereditary Osteodystrophy
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| What is splicing? | Removal of introns from mRNA
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| What is the purpose of mRNA splicing? | Formation of mature mRNA before leaving the nucleus
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| What does the "loops of DNA" on hybridized mRNA represent? | Regions of the gene that code for introns
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| Removal of introns from mRNA, or splicing, is needed to avoid appearance of which structures? | Loops of unbound DNA, representing regions of the gene that code for introns
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| Is "splicing" of immature mRNA (pre-mRNA) a postrantcriotonal or pre-transcriptional action? | Post Transcriptional modification
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| What type of collagen is affected in Osteoarthritis? | Collagen type II
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| Osteoarthritis: | Characterized by degradation of Collagen II and proteoglycans within articular cartilage
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| What are major contributions factors for development of Osteoarthritis? | 1. Excessive biochemical stress
2. Increased intraarticular metalloprotease activity
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| What effect is characteristic of Chondrocytes in advanced osteoarthritis? | Apoptosis of chondrocytes lead to fragility and fragmentation of the articular cartilage, resulting in formation of loose bone
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| What is Impetigo? | Superficial skin infection associated with erythema and a yellow "honey crust"
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| What are the two most common pathogens that cause impetigo? | Staph aureus and Group A streptococcus
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| Staph aureus infection causing impetigo --> | Bullae may form due to toxin production (bullous impetigo)
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| Bullous impetigo is due Staph aureus or Strep pyogenes infection? | Staph aureus
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| Which organism causative of impetigo, causes bullae due to toxin production? | Staph aureus
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| What condition is to be suspected with presence of bacteria and PMN leukocytes in the joint space? | Septic arthritis
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| What are the most common organisms (pathogens) that are involved in developing Septic arthritis? | Staph aureus and N. gonorrhoeae
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| Is Achondroplasia due to a gain-of-function or loss-of-function point mutation? | Gain-of-function
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| Which gene is mutated in Achondroplasia? | FGFR-3 gene
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| Gain-of-function point mutation of the FGFR-3 gene. Dx? | Achondroplasia
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| What are the clinical features of Achondroplasia? | Proximal limb shortening with resultant short stature, midface hypoplasia, and frontal bossing
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| What is the pathogenesis of Atypical asthma? | Mast cells and eosinophils release cysteinyl-containing leukotrienes (LT4, LD4, and LF4).
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| What are clinical signs of Atypical Asthma? | Bronchospasm, bronchial mucus secretion, and bronchial edema
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| What are common Cysteinyl Leukotriene receptor antagonists? | Montelukast and Zafirlukast
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| What is the MOA of Cysteinyl Leukotriene receptor antagonists? | Block these leukotriene-mediated effects to improve asthma symptoms
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| What are general features of alpha-Thalassemia? | Mild anemia with hypochromic and microcytic red blood cells
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| What is the most severe form of alpha-Thalassemia? | Hb Barts
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| What causes Hb Barts? | Absent alpha globin production
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| What is MCC of death in utero in patient with Hb Barts? | Hydrops fetalis
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| Which hemoglobin condition is associated with Hydrops Fetalis? | Hb Barts
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| Autoimmune disease that affects the postsynaptic ACh receptors in the NMJ and presents with proximal muscular fatigue. Dx? | Myasthenia gravis
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| Which receptors are affected in Myasthenia gravis? | Postsynaptic ACh receptors
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| Which autoimmune condition is due to antibodies attacking postsynaptic acetylcholine receptors? | Myasthenia gravis
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| Which muscles or tissues are most affected in Myasthenia gravis? | Eye and bulbar musculature
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| What are the thymic abnormalities seen with Myasthenia gravis? | Hyperplasia of thymus and thymomas
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| What clinical profile is suggestive of Pulmonary Embolism (PE)? | Sudden-onset of SOB and chest pain in combination with unilateral leg swelling
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| What is the cause of hypoxemia in Pulmonary Embolism? | Increased dead-space ventilation with worsening V/Q mismatch
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| How is respiratory alkalosis developed in acute pulmonary embolism? | HYPERVENTILATION leads to hypocapnia with respiratory alkalosis.
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| What is the effect on PaCO2 in a person hyperventilating? | Decreased PaCO2 as it is expired
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| Is the pH in acute pulmonary embolism increased or decreased? | pH is increased (alkalotic)
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| What is the function of Bacterial antibiotic efflux pumps? | Actively transport antibiotics out of the bacterial into the external environment using ATP, sodium gradients, or proton electrochemical gradients for energy
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| What bacterial mechanism is often a cause of drug or multidrug resistance development? | Bacterial Antibiotic Efflux pumps
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| What is the first-line of treatment for rapid relief of angina symptoms? | Sublingual nitroglycerin
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| Nitroglycerin causes more vasodilation or arterial dilation? | Venodilation
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| What are the anti-ischemic effects produced by Sublingual nitroglycerin? | 1. Vasodilation (veins >>arteries)
2. Decreased left ventricular volume
3. Decreased ventricular wall stress
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| Which anginal treatment option produces a decrease in myocardial oxygen demand despite a reflexive increase in heart rate? | Sublingual nitroglycerin
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| What are the metabolic derangements of DKA? | 1. Metabolic acidosis
2. Ketonemia
3. Hyperglycemia
4. Hyperkalemia, and,
5. Hyponatremia
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| Which condition is associated with a serum hyperkalemia, but a total body K+ store depletion? | DKA
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| Pseudohyperkalemia and hyponatremia are commonly seen with: | DKA
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| Where is Androgen-Binding protein (ABP) synthesized and secreted? | Synthesized by Sertoli cells of the seminiferous epithelium and secreted into the seminiferous tubule lumen
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| What is the role of Androgen-Binding protein? | Maintain the high local concentration of testosterone necessary for normal sperm production and maturation
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| What are the most common organisms that cause Prostatitis? | E. coli and Enterococci
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| How is Prostatitis characterized? | Condition with constitutional and urinary symptoms with prostate gland tenderness on digital rectal exam
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| Which nerve is damage leading to hoarseness of the voice? | Recurrent Laryngeal nerve
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| The recurrent laryngeal nerve branches off with major nerve? | Vagus nerve
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| What is innervated by the Recurrent laryngeal nerve? | All intrinsic muscles of the larynx responsible for sound production, except for the Cricothyroid
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| What nerve is often damaged in Aneurysmal dilation of the aortic arch? | Left recurrent laryngeal nerve, as it loops below the artic arch
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| Which nerve is known to "loop" below the aortic arch? | Left Recurrent Laryngeal nerve
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| What is caused by damage to the Left Recurrent Laryngeal nerve? | Hoarseness
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| In Michaelis-Menten kinetics, what are the effects on Km and Vmax, in case of an increase in amount of enzyme? | Increase in Vmax and no change in Km
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| What would be the effects of increase enzyme amount to Vmax and Km, in a Lineweaver-Burk plot? | 1. Decrease in y-intercept (1/Vmax)
2. No change in x-intercept (-1/Km)
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| What is mode of inheritance of Duchenne dystrophy? | X-linked recessive
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| How many male offspring of a carrier mother with Duchenne dystrophy would be affected? | 50% of male children affected
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| What does a inactivating mutation in a tumor suppressor gene entails? | Malignant transformation occurs when a single somatic cell subsequently acquires a "second hit"
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| What occurs to MHC in macrophages during antigen presentation? | The INVARIANT chain is removed from MHC II molecule and replaced with an extracellular peptide
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| What cells recognize the MHC II- Peptide Complex? | CD4T cells
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| Where is the MHC II - Peptide complex expressed for later CD4 T cell recognition? | Cell surface
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| What is Coccidioidomycosis? | Dimorphic soil fungus endemic to San Joaquin Valley, SW USA, Mexico and S. America
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| What is caused by Coccidioidomycosis infection? | Mild pneumonia and thin walled cavity in the lung leading to hemoptysis in addition to fever and cough
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| E. coli is a: | Gram negative bacterium with a haploid genome and peptidoglycan cell wall sandwiched between outer membrane and an inner plasma membrane
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| Is the genome of E. coli, diploid or haploid? | Haploid genome
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| What is another name for Uterine fibroids? | Leiomyomas
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| What are the Uterine fibroids? | Common, bening, uterine smooth muscle tumors that can cause heavy menstrual bleeding and anemia
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| Why do submucosal and intracavitary fibroids are more likely to cause bleeding? | By impairment of uterine contractility and distorting the endometrial cavity, thereby increasing endometrial surface area
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| What is the histological description of cells of Carcinoid tumors? | Polygonal, eosinophilic cells that stain (+) for neuropeptides such as chromogranin and synaptophysin
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| What is the most important vasoactive compound seen elevated in Carcinoid tumors? | Serotonin
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| What are the clinical features of Carcinoid syndrome? | Episodic flushing and diarrhea
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| Which are the most common locations in which carcinoid tumors arise from? | GI tract and bronchus
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| How is early colonic ischemia clinically characterized? | Mucosal hemorrhage and patchy areas of necrosis
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| How is late colonic ischemia presented? | Bowel thickens and becomes edematous, and transmural infarction develops
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| What is achalasia? | Esophageal motility disorder characterized by the absence of esophageal peristalsis in the distal esophagus and incomplete relaxation of hypertensive lower esophageal sphincter
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| What causes Achalasia? | Degeneration of inhibitory ganglion cells in the myenteric (Auerbach) plexus
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| What disorder is due to degeneration of the inhibitory ganglion cells in the myenteric cells (Auerbach) plexus of the esophagus? | Achalasia
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| What are Atherosclerotic plaques? | Eccentric intimal thickening, with a fibrous cap, smooth muscle proliferation, local inflammatory infiltrate and lipid-filled core
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| What are symptoms of Peripheral artery stenosis? | Exertional leg pain, dermal atrophy, and arterial ulcers
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| What is the most common clinical presentation of G6PD deficiency? | Acute-onset anemia of an African, Asian, or Mediterranean descent that is likely been treated with a sulfonamide
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| What are some common proto-oncogenes? | Ras, MYC, ERBB1 (EGFR), ERBB2 (HER2), ABL, and BRAF
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| What type of protein is "Ras"? | GTP-binding protein
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| What malignancies are associated with Ras oncogene? | - Cholangiocarcinoma
- Pancreatic adenocarcinoma
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| What type of protein is MYC? | Transcription factor
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| What malignancy is associated with MYC? | Burkitt lymphoma
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| What is a common Receptor Tyrosine kinase associated with Lung adenocarcinoma? | ERBB1 (EGFR)
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| What type of oncogene protein is HER-2? | Tyrosine Receptor kinase
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| What protein is ABL? | Non-receptor tyrosine kinase
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| What oncogene is a Ras signal transduction? | BRAF
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| What malignancy is associated with ABL? | CML
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| What malignancies are associated with BRAF oncogene? | 1. Hairy cell leukemia and,
2. Melanoma
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| What are some common Tumor suppressor genes? | BRCA1/2, APC/B-catenin, TP53, RB, WT1, and VHL
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| What type of protein are BRCA1 and BRCA2? | DNA repair genes
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| Which malignancies are associated with BRCA1/2? | Breast and ovarian cancers
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| What is the common Wnt signaling pathway tumor suppressor gene? | APC/B-catenin
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| Which malignancies are associated with APC/B-catenin tumor suppressor gene? | 1. Colon, Gastric, and Pancreatic cancers
2. FAP
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| What is the role or function of TP53? | Genomic stability
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| Which syndrome is associated with a mutated TP53? | LI-Fraumeni syndrome
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| Which tumor suppressor gene is associated with Retinoblastoma and Osteosarcoma? | RB
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| What type of protein (role) does RB have? | G1/S transition inhibitor ; gtp
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| Which tumor suppressor gene is associated with Urogenital differentiation? | WT1
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| What gene is mutated in Wilms tumor? | WT1
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| What type of gene is VHL tumor suppressor? | Ubiquitin ligase component
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| What malignancies and illnesses are associated with VHL gene? | 1. Renal cell carcinoma
2. Von-Hippel-Lindau syndrome
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| Common drug used in Hepatic Encephalopathy? | Lactulose
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| What is the MOA of Lactulose? | Acidification of the contents of the GI tract, by converting NH3 into NH4
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| What medication is known to acidify GI contents by converting NH3 into NH4? | Lactulose
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| What condition is often treated with Lactulose? | Hepatic encephalopathy
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| Does Lactulose causes alkalosis or acidosis of the GI tract contents? | Acidosis
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| What is Osteomalacia? | Decreased mineralization of newly deposited osteoid and presents with bone pain, muscle weakness, and increase risk of fracture
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| What is MCC of Osteomalacia? | Vitamin D deficiency
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| What is the result of serum phosphate due to Vitamin D deficiency? | Hypophosphatemia
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| Is Osteomalacia seen with Hyper- or Hypo-phostatemia? | Hypophosphatemia
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| Is Osteomalacia presented with bone pain or painless bone? | Bone pain
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| What is a common Thiazolidinedione? | Pioglitazone
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| PPAR-gamma activators that decrease insulin resistance | Thiazolidinediones
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| What is the main effect of Thiazolidinediones? | Increase expression of GLUT-4 in adipocytes and skeletal myocytes, and increased differentiation of preadipocytes into insulin-responsive adipocytes
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| Which GLUT is increased in expresitivity by the use of Pioglitazone? | GLUT-4
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| To which receptors do B-2 agonists bind? | Gs protein-coupled receptors
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| What occurs after B-2 agonists bind to Gs protein-coupled receptors? | Activation of adenylyl cyclase, and production of cAMP as an intracellular second messenger
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| Which protein is activated by cAMP in the Gs protein-coupled receptor second messenger system? | Protein kinase A
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| What does activation of protein kinase A by B-2 agonist help in treating asthma? | Relaxes bronchial smooth muscle cells
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| What respiratory condition is treated with B-2 agonists? | Asthma
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| Is asthma treated with B-2 agonists or B-2 antagonists? | Agonists
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| Which nerve fibers conduct action potential faster, unmyelinated or myelinated? | Myelinated
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| What are some features of unmyelinated nerve fibers? | Slow pain, heat sensation and olfaction
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| What is a directional form to refer to Primary Sensory fibers ahta are unmyelinated? | Afferent
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| Which tend to be more commonly myelinated, afferent or efferent nerve fibers? | Efferent
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| What is the exception of efferent nerve fibers that are UNMYELINATED? | Fibers that originated from postganglionic autonomic neurons
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| What is a special feature of the fibers originated postganglionic in the autonomic nervous system? | Only efferent fibers that are unmyelinated
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| Where are the Maxillary sinuses located (anatomically)? | Inferior to each ocular orbit
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| Which sinuses are the most common to be affected by acute rhinosinusitis? | Maxillary sinuses
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| Why are the Maxillary sinuses most commonly affected by acute rhinosinusitis? | Poor drainage
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| Which protein, Gq or Gs or Gi, is activated by alpha-1 adrenergic stimulation? | Gq
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| Which second messenger is activated by Gq activation by alpha-1 stimulation? | Phosphatidylinositol (PIP2)
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