QId: 7 Pathology - Renal, Urinary Systems & Electrolytes

Goodpasture syndrome is a type 2 hypersensitivity, which is caused by auto antibodies against

alpha3chain of type IV collagen found in GBM and pulmonary capillary membrane (anti-GBM antibodies).
Can cause nephritic sindrome (Rapidly progressive glomerulonephritis) On light micro: glomerular
crescent (consisting of fibrin and plasma proteins) form. IF. linear deposits of igG and c3.
QId: 28 Pathology - Renal, Urinary Systems & Electrolytes
Nephritic syndrome: Inc. glom capillary perm-> inc protein urine loss (mostly albumin)-->loss of colloid
osm pressure in blood ---> edema(shift from intravasc to interstitium)---> low vasc volume sensed by
mac densa activates RAAS---. High aldost, Sodium ret (ADH also stim by low intravasc volume) water
ret---. inc edema---> to comp low albumin liver increases prot synthesis (including lipoprot)
QId: 62 Microbiology - Gastrointestinal & Nutrition
Hepatic abcess is commonly caused by parasitic infections in underdeveloped countries (entamoeba h,
echinococcus) In developed countries 80% are caused by bacterial infection. access gained by: -Biliary
tract inf -Portal vein pyemia (due to bowel or peritoneal sources) -Hepatic artery (sistemic hematogenous
seeding) -direct invasion from adjacent source (cholecystitis, peritonitis). -Penetrating trauma.
QId: 105 Microbiology - Infectious Diseases
Aspergillus can mainly cause 3 conditions: 1)ABPA(allergic bronchopulm aspergillosis): Assoc w asthma
and CF. HSR type 1: IgE med, w eosinophilia. Cough, wheezing, fever and migratory pulm infiltrates. 2)
Aspergillomas (fungus balls) in previously formated pulmonary cavities(TB, bronchiectasis, fungus found
in base of cavity bc gravity). 3)Invasive aspergillosis (hematogenous spread) mainly lung, forms
granulomas, cough, hemoptisis, fever, pleuritic pain. Kidney failure, endocarditis, ring enh lesions on
brain (CT).
QId: 145 Pharmacology - Cardiovascular System
In patients with HTN+resting bradycardia Dihydropyridines are useful as they cause reflex tachy due to
peripheralvasodilation.
QId: 152 Pharmacology - Renal, Urinary Systems & Electrolytes
Primary Hyperaldosteronism Remember aldosterone reabsorbs NA and H2O, Wastes K and H So
Hypokalemia, alkalosis high water and Na increases volume-- HTN At the same time dec. renin secretion.
Treatment surgery or with aldost antagonist spironolactone or eplerone (less side eff)less gynecomastia
QId: 189 Pathophysiology - Cardiovascular System
Paradoxical embolism is when a venous thrombous disease, make an emboli that instead of lodging in
lungs causing a PE, they go to arterial circulation, via intracardiac or intrapulmonary shunts (ASD, VSD,
pulmonary art venous malformations). Can cause cerebrovasc events.
QId: 193 Pathophysiology - Cardiovascular System
>Hours after the MI: most common cause of death are ventricular arrythmias, up to even 72 hrs after
MI. Within the first 4 hrs pt can present HF or cardiogenic shock. >1-3 days after MI. Pts can present
Fibrinous Pericarditis (bc migration of inflamatory tissue) >3-14 days after. Free wall rupture, leading to
tamponade. Papillary muscle rupture, lead to mitral regurg. IVseptum rupt. due to macroph-mediated
degradation. 2 wk to months. Dressler syndrome (AB against pericard)
QId: 244 Pathophysiology - Cardiovascular System
Severe Aortic stenosis patients have reduced cardiac output that can be exacerbated by loss of normal
atrial contraction. As the LV becomes hypertrophic, due to increased syst pressure needed to go against
stenosis, it becomes less compliant, making the Lv filling dependant on atrial contraction. If preload
(atrial conttraction on these cases) is lowered, severe hypotension can occur, as well as increased
pulonary venous pressure, leading to pulm edema.
QId: 256 Genetics - Female Reproductive System & Breast
Turner Syndrome: Low hairline Narrow, high arched palate webbed neck Shield chest Coarctation of the
aorta Bicuspid aortic valve Horseshoe kidney Streak ovaries
QId: 321 Embryology - Gastrointestinal & Nutrition
Meckel divert, rule of 2's. Can present with tissues from other parts (ectopy)as: Gastric (most common)
pancreatic, colonic, jejunal, duodenal and endometrial. Gastric is the most common and can cause
ulceration that leads to lower GI bleeding. Ectopy unlike metaplasia, is congenital. Metaplasia are changes
that occur as compensatory process in the adult.
QId: 326 Pathology - Gastrointestinal & Nutrition
Celiac disease is a malabsorptive disease, caused by an autoimmune intolerance to gluten. Gliadin, a
protein found in gluten, triggers inflamation. Lab findings: Elevated IgA tissue transglutaminase. Elev,
Antiendomysial antibodies. Duodenal biopsy w intraepith lymphocytes and flattened villi.
QId: 408 Pathophysiology - Gastrointestinal & Nutrition
Normally Ca bind to oxalate to promote excretion. In chrohns, Ca binds to lipids, due to impaired fat
absorption, this makes Ca unavailable for binding to oxalate, increasing oxalate absorption promoting
formation of oxalate stones. Fat malabsorption dur to loss of bile acids, which are not reabsorbed in
terminal ileum(mot common site of chrohns).
QId: 446 Pathophysiology - Cardiovascular System
Endothelial injury increases endoth permeability, allowing lipids into the intima and other leukocytes, lipids
are oxidized and consumed by macrophages, turning to foam cells. Platelets that adhere in site of injury,
dysfx endoth cells and foamy macrophages secrete PDGF which increaces SMuscCells prolif and
migration from media to intima. Plts also release TGF-b (chemotactic for SMCs and induces collagen
synth
QId: 480 Histology - Pulmonary & Critical Care
Mucus prod goblet cells end at the smallest bronchi, just before bronchioles begin, to precent mucus
obstruction. same endpoint for cartilage, mucous and serous glands that end at the smallest bronchi.
QId: 520 Behavioral science - Psychiatric/Behavioral & Substance Abuse
Drugs that can cause hypothyroidism: Lithium, sulfas and amiodarone.
QId: 531 Pathology - Pulmonary & Critical Care
Lobar pneumonia has 4 stages 1) Consolidation (first 24 hrs), here you have a red soft lobe, bc
vasodialtion, you also find alveolar exudate and mostly bacteria. 2)Red hapatization (days 2-3), Red firm
lobe(liverlike), with RBC, alveolar exudate, neutrophils and fibrin. 3) Gray hepatization, (days 4-6), Gray
brown firm lobe, with fragmented rbc, neutrophils and fibrin. 4) Resolution, lobe architecture back to
normal, ezymes digest the exudate.
QId: 537 Immunology - Hematology & Oncology
Wiskott Aldrich syndrome triad WATER: Wiskott Aldrich Thrombocytopenia Eczema Recurrent inf.
Xlinked recessive
QId: 538 Immunology - Rheumatology/Orthopedics & Sports
Recurrent skin and mucosal inf, with no pus formation and poor wound healing, is suggestive of
Leukocyte adhesion deficiency. Absence of CD18, leukocytosis w neutrophilia.
QId: 639 Physiology - Rheumatology/Orthopedics & Sports
Osteoclast are derived from monoblasts, diferentiated by macroph-colony stim factor(M-CSF) they're dif
into osteoclast precursor, these have a receptor for activated nuclear factor kappa-b ligand (RANKL),
which binds to osteoclast (RANK) and produce mature multinucleated osteoclasts. OSteoprotegerin is a
decoy receptor for RANKL, which reduces diferentiation of osteoclasts. A mutation on OPG can cause
Juvenile PAget's. Deno-s-u-mab acts as OPG (tx for osteoporosis)
QId: 687 Pharmacology - Renal, Urinary Systems & Electrolytes
Spironolactone is a competitive aldosterone receptor antagonist. Can also act as androgen receptor
antagonist and inh. testosterone synthesis, causing gynecomastia unilat or bilat. dec libido and impotence.
QId: 834 Pathology - Renal, Urinary Systems & Electrolytes
Renal papillary necrosis is assoc with: Sickle cell or trait Acute pyelonephritis Analgesics Diabetes
mnemonic: SAAD papa
QId: 889 Histology - Hematology & Oncology
Spherocytosis due to defect in spectrin and akyrin. (scaffolding proteins) Presents with hemol amenia,
jaundice and splenomegaly. Infections can trigger hemolysis
QId: 963 Microbiology - Infectious Diseases
Haemoph. Influenza Requires Factors X (hematin)and V(NAD+) for growth. S. aureus secrete V factor
(NAD+) and facilitates release of X factor from beta hemolysis-induced erythrocyte lysis.
QId: 980 Biochemistry - Endocrine, Diabetes & Metabolism
Thiazides inh the NA/cl cotransporter leading to inc Na excretion, low intracel Na act Na/Ca pump which
causes inc Ca reabsorption. Leading to hypercalcemia (decreasing PTH) and hypo calciuria. In contrast
with Familial hypocalciuric hypercalcemia, an AD disorder with defective Ca sensing by parathyroid and
renal tubule cells. Preventing PTH to be supressed, resulting in hypercalcemia, with normal or high PTH,
with low Ca excretion, due to impaired renal Ca sensing.
QId: 989 Biochemistry - Endocrine, Diabetes & Metabolism
In hypoglicemia counter regulatory hormones help mantain normal blood glucose. Insulin dec, Glucagon
inc, Epineph inc. Cortisol increases. (in this order)
QId: 1038 Microbiology - Nervous System
Congenital toxoplasmosis tirad: Hydrocephalus Intracranial caldifications and chorioretinitis (Inflamation
of choroids and retina, leaves cotton white/yellow scars on retina visible on fundoscopy)
QId: 1055 Pathology - Male Reproductive System
Klinefelter pts have damaged leydig cells, resulting in low testosterone levels. They have atrophied
hyalinized seminiferous tubules, resulting in low inhibin. All of this results in lack of feedback
inhibition---. Excess gonadotropins (LH FSH)---> inc estrogen.
QId: 1065 Physiology - Endocrine, Diabetes & Metabolism
Hypercalcemia due to Sarcoidosis (or other granulomatous diseases, tb) is caused by a pth independent
expression of 1-a-hydroxylase (hydroxylases 25-hydroxyvit d to 1,25-dihydroxyvit d)this expression is
seen on activated macrophages
QId: 1338 Biochemistry - Hematology & Oncology
Acute intermittent porphyria, caused by deficient Porphobilinogen deaminase (PBG deaminase). Inc. PBG
and ALA cause AIP Attacks Treatment, you need to decrease formation of both by downregulating ALA
synthase. Glucose and Hemin inhibit this enzyme. Careful with CYP450 inducers, as they stimulate
ALAS, can kill the pt
QId: 1374 Microbiology - Infectious Diseases
Hydrops fetalis can be caused by Parvovirus B19 (SSDNA) a Thallasemia Syphilis (spirochete
Treponema pallidum)
QId: 1464 Microbiology - Pregnancy, Childbirth & Puerperium
Triad cong Rubella: Cong cataracts Sensory-neural deafness PDA
QId: 1538 Anatomy - Cardiovascular System
In pts with contraindication to anticoagulation you use Inferior vena Cava filters. They prevent
propagation of dvt from legs to lung vasculature.
QId: 1583 Physiology - Pulmonary & Critical Care
Central chemoreceptors in medulla/pons sense increased co2 Peripheral sense decr O2
QId: 1590 Physiology - Pulmonary & Critical Care
With excercise, O2 muscel consumption is increased this will lower 02 content and will generate more
co2 (in venous blood)
QId: 1750 Embryology - Cardiovascular System
First aortic arch: Maxillary art Second aortic arch:Stapedial and hyoid art. Third: Common carotid and
proximal internal carotid. Fourth: aortic arch and proximal right subclavian. No fifth. Sixth: Pulmonary
arteries and ductus art.
QId: 1751 Anatomy - Cardiovascular System
Older patients with PDA usually require surgical ligation or percutaneous PDA occlusion, when PGE2
inhibitors (indomethacin) arent enough.
QId: 1757 Pathology - Hematology & Oncology
Heterophil antibodies react to animal erythocytes. Paul Bunnell test (sheep erythrocytes) Monospot test
(horse)
QId: 1809 Embryology - Female Reproductive System & Breast
Sexually undifferentiated embryo Starts with 2 pair of genital ducts: Mullerian and Wolffian. In female the
mullerian develops, and give rise to fallopian tubes, uterus, cervix and upper vagina. While the wolffian
duct is degenerated due to lack of testosterone. Mullerian aplasia: hypoplastic or aplastic uterus, short
vagina with normal ovaries.
QId: 1876 Pathology - Pulmonary & Critical Care
Trauma dislodges fat globules from bone marrow, which travel to pulmonary microvessels. Can release
free FA and cause toxic injury to endothelium and can cause ARDS. Some fat globules can escape via
capillary AV shunts created due to inc pulm art pressure. and create a ANS fat emboli microvasc
oclussion causing neurolog impairment, and can also travel to dermal capillaries causing petechiae.
QId: 1886 Biochemistry - Endocrine, Diabetes & Metabolism
Hypoglycemia is normally accompained by ketone bodies. If there is hypoketotic hypoglycemia, think of
fatty acid oxidation disorders
QId: 1978 Physiology - Cardiovascular System
ANP effects Kidney: dilates afferent arterioles, which inc GFR, inh renin secretion and inc na and water
excretion. Adrenals: restriction of aldost secretion by dec RAAS Blood vessels: Relaxes smooth musc in
arterioles and venules, producing vasdilation.
QId: 2011 Physiology - Renal, Urinary Systems & Electrolytes
Net renal excretion rate= Total filtration rate-Tubular reab. rate TFR=GFR*Plasma concent of substance
A
QId: 2053 Behavioral science - Psychiatric/Behavioral & Substance Abuse
Not displacement bc, in displacement the person does not express feelings to the one who causes the
damage. (the patient confronted the father, and then the doctor, as if he was the father) which makes
transference more likely (which in this case is negative) Positive transference would be admiring the
doctor as if he was a parent ( if the pt had a good relation with his father)
QId: 7752 Behavioral science - Psychiatric/Behavioral & Substance Abuse
Frontal lobe associated with personality and executive function (complex tasks, motivation, organization,
planning and purposeful action) Injury to left side are associated with apathy and depression. Ijury to
right side is associated with disinhibited behavior.
QId: 8424 Histology - Endocrine, Diabetes & Metabolism
GFR, from saltiest to sweetest. Glomerulosa-Aldosterone (secretes mineralocorticoids)SALT
Fasciculata-Cortisol(sec. glucocorticoids)SUGAR Reticularis-AndrogensSEX ---------------------
Chromaffin cells are modified post ganglionic neurons, This means that they are stimulated by
Acetylcholine, to secrete cateholamines.
QId: 8455 Pharmacology - Gastrointestinal & Nutrition
Ribavirin has multiple MOA: Is a nucleoside antimetabolite. Gets phosphorilated intracellular Inhibits HCV
RNA polymerase by ribavarin triphosphate Inhibits inosine monophosphate dehydrogenase--> depleting
pools of gtp Inhibist RNA guanylyltransferase and methyltransferase, resulting in defective 5cap
formation--> inefective translation. Enhances TH1 CMI, inhibits TH2 cytokine prod.
QId: 8523 Pharmacology - Rheumatology/Orthopedics & Sports
Suffix -mab: monoclonal antibody -nib: kinase inhibitor -cept: receptor molecule
QId: 8632 Biochemistry - Hematology & Oncology
Tyrosine Kinase and Janus kinase are RECEPTORS!! and can activate different pathways: MAP kinase
PI3K/ATK/mTOR JAK/STAT
QId: 10401 Microbiology - Gastrointestinal & Nutrition
FIDAXOMICIN A marcocyclic atb (related to macrolides) Inhibits sigma subunit of rna polymerase-->
Protein synth inhibition and cell death (bacteriocidal) Has lesser effect on normal colonic flora than
metronidazole or vancomycin (all used in C. diff. treatment) Choice in tx of recurrent c. diff inf.
QId: 11038 Pathophysiology - Renal, Urinary Systems & Electrolytes
Urinary incontinence has 3 types: 1)Stress UI: Due to loss of urethral sphincter tone or urethral
hypermobility, leakage with cough, sneezing, lifting. 2)urge: Due to detrussor hyperactivity, can cause a
sudden urge to urinate, usually late to bathroom. 3) Overflow, due to detrussor hypoactivity, low
contractility, incomplete emptying with continuous leak.
QId: 11596 Microbiology - Infectious Diseases
Parotitis, infection of the parotid gland can be caused by anticholinergics (dec salivation), obstruction of
gland (sialolithiasis), endotrachial intubation, dehydration. Most often caused by Staph aureus Can present
with pain and swelling that can extend to mandible, fever and chills, trismus (can't open jaw freely) ,
dysphagia. DX. CT can check amylase(high), with normal lypase (to exclude pancreatitis)
QId: 11627 Pathology - Nervous System
Cavernous hemangioma are vascular malformations that occur in the brain parenchyma. Can cause
seizures due to mass effect. Tendency to bleed (intra cerebral hemorrage
QId: 11633 Microbiology - Infectious Diseases
Candida usually colonizes skin and in pts with central lines or in drug users can create a bloodstream
infection
QId: 11680 Pharmacology - Nervous System
Capsaicin Releases substance P which is a neurotransmitter that is involved in the transmission of pain,
that's why at first in topical aplication you can feel burning pain, but after it depletes substance P which
can make pain, even from other sites go away. Neuropeptide Y is involved in apetite and pain perception.
QId: 11859 Microbiology - Infectious Diseases
Coxiella Burnetii Causes Qfever an often self limited, obligate intracellular bact infection, transmitted by
spores in cattle and sheeo feces. can cause fever, headache(retroorbital), with photophobia. More severe
forms can cause pneumonia w lobar consolidation, w normal wbc count, elevated liver enzymes and
thrombocytopenia. Chronic is rare, and if untreated can cause infective endocarditis in pts with valvular
disease.
QId: 11888 Histology - Female Reproductive System & Breast
Gap junctions are intracellular communicating sites, mainly constituted by connexin proteins. Adherens
junctions and desmosome, which serve as anchors between cells, are composed of cadherins.
Hemidesmosomes, anchor cells to basement memb, composed of integrins. tight junctions, barrier to
water and solute, composed of occludins and claudins.
QId: 12024 Physiology - General Principles
High altitude: same fio2, dec po2 Dec po2 in blood, stim peripheral chemoreceptors, causing
hyperventilation--> decreases PCO2, increasing pH (resp Alk) Renal bicarb compensates within 48 hrs.