Where does the N-terminal sequence send stuff to? <ul><li>Mitochondria </li></ul>
How do you treat lithium OD? <ul><li>Sodium polystyrene sulfonate </li></ul>
AD: who is affected most? How does it manifest? Who can transmit? <ul><li>M=F </li></ul><ul><li>Manifests in the heterozyg...
What two enzymes are needed for synthesis of B12? <ul><li>Methylmalonyl CoA Mutase </li></ul><ul><li>Homocysteine Methyl T...
What is the deficiency caused by this vitamin B6? <ul><li>Neuropathy </li></ul><ul><li>seizures </li></ul>
What does a deficiency in Zinc cause? <ul><li>Dysgusia </li></ul><ul><li>Decreased sperm </li></ul><ul><li>Dry skin </li><...
What is vitamin A a cofactor for? What is the other cofactor needed? <ul><li>PTH </li></ul><ul><li>The other cofactor is M...
Synthesis of 1,25-D-hydroxycholecalciferol requires? <ul><li>Vit D </li></ul>
What are loose associations? <ul><li>Ideas switch subjects, incoherent </li></ul>
What is double depression? <ul><li>Depression followed by dysthymia </li></ul>
How does myopathic muscle dz present? <ul><li>Proximal weakness and pain </li></ul>
What is illusion <ul><li>Misinterprets stimulus (magician) </li></ul>
What is atonic cerebral palsy? <ul><li>No muscle tone </li></ul><ul><li>floppy </li></ul>
What does warfarin inhibit? <ul><li>Vitamin K </li></ul>
Why should you wait 30 min after a meal before swimming? <ul><li>All the blood in gut and skeletal mm have ran out of ATP ...
What is Klinefelter’s? <ul><li>XXY 47 </li></ul><ul><li>Tall </li></ul><ul><li>Gynecomastia </li></ul><ul><li>Infertility ...
What are the most common non-cyanotic heart dzs? <ul><li>VSD </li></ul><ul><li>ASD </li></ul><ul><li>PDA </li></ul><ul><li...
What values do you see in obstructive pulmonary dz? <ul><li>pO2 nl </li></ul><ul><li>pCO2 ↑ </li></ul><ul><li>pH ↓ </li></ul>
Where is CK-BB found? <ul><li>Brain </li></ul>
What do you think when you see both serum Ca and Phosphate ↓ <ul><li>Vit D deficiency </li></ul>
With Inflammation…what happens <24 hours? <ul><li>swelling </li></ul>
What are the enzymes that show after an MI? <ul><li>Troponin I </li></ul><ul><li>CKMB </li></ul><ul><li>LDH </li></ul>
What do you see in the serum with the low volume state? <ul><li>K+ decreases </li></ul><ul><li>Na+ decreases </li></ul><ul...
AR: who does it show in? When is the onset? What is the penetrance? <ul><li>Does not show up in parents </li></ul><ul><li>...
What pathway does warfarin affect? <ul><li>Extrinsic pathway </li></ul>
What cyanotic heart dz is associated with mom taking lithium during preg? <ul><li>Ebstein’s anomaly </li></ul>
Why do we only have 6 hours to use tPA? <ul><li>Body has irreversible cell injury </li></ul>
What does a deficiency in Vit E cause in newborns? <ul><li>Retinopathy </li></ul>
What is the third MI enzyme to appear? When does it appear/peak/gone <ul><li>LDH </li></ul><ul><li>Appears in 1 day </li><...
What are the different second messenger systems? <ul><li>cAMP </li></ul><ul><li>cGMP </li></ul><ul><li>IP3/DAG </li></ul><...
What dzs have pulmonary eosinophilia? <ul><li>Aspergillosis </li></ul><ul><li>strongyloides </li></ul>
Where is a Bokdalek hernia located? <ul><li>Back of diaphragm </li></ul>
Where is a Morgagni hernia located? <ul><li>Middle of diaphragm </li></ul>
What dzs have respiratory alkalosis? <ul><li>Restrictive lung dz </li></ul>
What dzs have metabolic acidosis <ul><li>MUDPILES </li></ul><ul><li>Methanol </li></ul><ul><li>Uremia </li></ul><ul><li>DK...
What does grunting tell you <ul><li>Restrictive lung dz </li></ul><ul><li>Blowing collapsed alveoli open </li></ul>
What is bronchitis <ul><li>Lots of sputum </li></ul><ul><li>Blue bloater </li></ul>
What is aspergillosis <ul><li>Allergy to mold, dead plants, compost piles </li></ul>
Who gets silicosis? <ul><li>Sandblasters </li></ul><ul><li>glassblowers </li></ul>
Who gets beryliosis <ul><li>Radio </li></ul><ul><li>TV </li></ul><ul><li>welders </li></ul>
Who gets anthracosis <ul><li>Coal workers </li></ul><ul><li>Massive fibrosis </li></ul><ul><li>Does not ↑ CA risk </li></ul>
What are the clues for squamous cell CA <ul><li>Smoker </li></ul><ul><li>High PTH </li></ul><ul><li>High calcium </li></ul>
What does bronchealveolar CA look like? What is it due to? <ul><li>Looks like pneumonia </li></ul><ul><li>Due to pneumocon...
On an EKG, ST means… <ul><li>Ventricle contraction </li></ul><ul><li>Phase 2 </li></ul><ul><li>Calcium </li></ul>
What is the second MI enzyme to appear? When does it appear/peak/gone <ul><li>CK-MB </li></ul><ul><li>Appears in 6 hours <...
Where is CK-MM found? <ul><li>muscle </li></ul>
What causes lateral bowing of the legs? <ul><li>Rickets </li></ul>
What is cyclothymia? <ul><li>Dysthymia w/ hypomania </li></ul>
What is the vitamin pneumonic? <ul><li>The Rich Never Lie  about Panning Pyrite Filled Creeks </li></ul><ul><li>Thiamine, ...
How is heparin administered? What is it the DOC for? <ul><li>Administer via IV </li></ul><ul><li>DOC for DVT </li></ul>
What are the essential fatty acids? <ul><li>Linolenic </li></ul><ul><li>Linoleic </li></ul>
What can Wilson’s dz be confused with? <ul><li>Huntingtons </li></ul><ul><li>HD has anticipation, trinucleotide repeats (C...
Cofactor for all transaminases? <ul><li>B6 </li></ul>
What is chromium needed for? <ul><li>Insulin action </li></ul>
Diptheria: what does it cause? What do you give for tx? <ul><li>Causes heart block </li></ul><ul><li>Give antitoxin </li><...
What is the clue for cGMP? <ul><li>Parasympathetic </li></ul><ul><li>Anabolic </li></ul>
What is Ebstein’s Anomaly? <ul><li>Tricuspid prolapse </li></ul><ul><li>Due to mom taking lithium in pregnancy </li></ul>
What dz looks like B3 deficiency? <ul><li>Hartnup Dz </li></ul><ul><li>Tryptophan deficiency, which is needed to make niac...
What is a heavy chain composed of? <ul><li>myosin </li></ul>
What is Chovstek’s sign? <ul><li>Tap on facial nerve    muscle spasm </li></ul>
How is warfarin activated? <ul><li>Tissue activated </li></ul>
What is Myasthenic syndrome? <ul><li>Aka Lambert-Eaton </li></ul><ul><li>Get stronger as the day goes on </li></ul><ul><li...
What do Ca channel blockers do to the EKG <ul><li>Widen P </li></ul><ul><li>PR interval is longer </li></ul>
What are the toxicities of Warfarin? <ul><li>Bleeding </li></ul><ul><li>Teratogenic </li></ul><ul><li>Drug-drug interactio...
What values do you see in restrictive pulmonary dz? <ul><li>pO2 ↓ </li></ul><ul><li>pCO2 ↓ </li></ul><ul><li>pH ↑ </li></ul>
Cofactor for all carboxylases? <ul><li>biotin </li></ul>
What band of the sarcomere does not change length? <ul><li>A band </li></ul>
What happens when a pt is on prednisone for >7 days? <ul><li>Immunocompromised </li></ul>
What is the MOA of Methotrexate? <ul><li>Inhibits dihydrofolate reductase </li></ul><ul><li>Inhibits DNA synthesis in the ...
What does heparin inhibit? <ul><li>Protamine Sulfate </li></ul>
Deficiency in Methylmalonyl CoA Mutase leads to…and why! <ul><li>Neuropathy </li></ul><ul><li>Recycles myelin </li></ul>
What is uses tyrosine kinase? <ul><li>Used by insulins </li></ul><ul><li>used by all growth factors </li></ul>
What dzs have cherry red macula? <ul><li>Niemann Pick </li></ul><ul><li>Tay Sachs </li></ul><ul><li>Sandhoffs </li></ul>
What is the most common cause of meningitis in : 0-2 months <ul><li>#1 - Group B strep (agalactiae) </li></ul><ul><li>#2 –...
What is the function of CN V2? What if lesioned? <ul><li>Mixed function </li></ul><ul><li>General sensation of palate, nas...
Which direction does the jaw deviate in CN V3 lesion? <ul><li>Towards the weak side </li></ul>
What is trigeminal neuralgia? <ul><li>Intractable pain in V2 or V3 territory </li></ul>
What happens if VI is lesioned? Where does it enter/exit the cranium? What does it innervate? <ul><li>Lesioned   </li></u...
What do we call a lesion of VII? <ul><li>Bell Palsy </li></ul>
Where does CN VII enter/exit the cranium? Where do the branches leave? What does it innervate? <ul><li>Internal auditory m...
What muscle does IX go to? What happens if lesioned? Where does it enter/exit the cranium? <ul><li>Goes to stylopharyngeus...
CN X –sympathetics to head: what is it’s function? <ul><li>Motor </li></ul><ul><li>Rasies eyelid (superior tarsal muscle) ...
Where does the sympathetic portion of X enter/exit cranium? What does it innervate? <ul><li>Carotid canal on internal caro...
What is CN XII? What is it’s funciton? What happens if lesioned? <ul><li>Hypoglossal </li></ul><ul><li>Moves the tongue </...
What happens if there is a lesion to the optic nerve? <ul><li>Unilateral blindness </li></ul>
What happens if there is a lesion to the optic chiasm? <ul><li>Bitemporal hemianopia </li></ul>
What is a berry aneurysm due to in the circle of willis? <ul><li>SUBARACHNOID hemorrhage </li></ul>
What is the clue for a Subarachnoid hemorrhage <ul><li>Worst headache of my life! </li></ul>
What does the diencephalon originate from <ul><li>forebrain </li></ul>
Where does the telencephalon originate from? <ul><li>Forebrain (prosencephalon) </li></ul>
What originates from the mesencephalon? <ul><li>Midbrain </li></ul><ul><li>aqueduct </li></ul>
What originates from the metencephalon <ul><li>Pons </li></ul><ul><li>cerebrum </li></ul>
What does the jugular foramen contain? <ul><li>CN IX </li></ul><ul><li>CN X </li></ul><ul><li>CN XI </li></ul><ul><li>Inte...
What does the hypoglossal canal contain? <ul><li>CN XII </li></ul><ul><li>Hypoglossal nerve </li></ul>
What does the carotid canal contain? <ul><li>Internal carotid artery </li></ul>
What does malunion mean? <ul><li>A fracture that heals in an abnormal position </li></ul>
Which CN is responsible for turning the head and shrugging the shoulders? <ul><li>CN XI </li></ul>
What CN controls sensory fibers for vision? <ul><li>CN II </li></ul>
If there is a lesion in the frontal lobe will you have motor or sensory defects? <ul><li>motor </li></ul>
What is B3 deficiency? <ul><li>Pellegra </li></ul><ul><li>4D’s </li></ul><ul><li>Dementia </li></ul><ul><li>Diarrhea </li>...
Name the ion that goes with: P wave? QRS? ST? <ul><li>Ca </li></ul><ul><li>Na </li></ul><ul><li>Ca </li></ul>
In EKG, Q wave means… <ul><li>Septum </li></ul><ul><li>Phase 0 </li></ul><ul><li>sodium </li></ul>
What is required for the conversion of methylmalonyl CoA to Succinyl CoA <ul><li>B12 </li></ul>
What is hallucination? <ul><li>False sensory perception </li></ul><ul><li>Usually auditory </li></ul><ul><li>Formication =...
What can lithium do to mom? <ul><li>Nephrogenic DI </li></ul>
What do you need Cu for? <ul><li>Collagen synthesis </li></ul>
What is perseveration <ul><li>Keeps repeating same word </li></ul>
What do tPA, Streptokinase, and Urokinase inhibit <ul><li>Aminocaproic acid </li></ul>
What is Duchenne’s Muscular Dystrophy <ul><li>Dystrophin frameshift </li></ul><ul><li>Gower sign </li></ul><ul><li>Calf ps...
What is the light chain composed of? <ul><li>Actin </li></ul>
What are the symptoms of the low energy state? <ul><li>Everything slows down! </li></ul><ul><li>Mental retardation, dement...
What is MS? <ul><li>Anti-myelin Ab </li></ul><ul><li>Young woman w/vision problems </li></ul><ul><li>Sxs come and go </li>...
What is the first MI enzyme to appear? When does it appear/peak/gone <ul><li>Troponin I </li></ul><ul><li>Appears in 2 hou...
What is the typical incidence with 2 risk factors <ul><li>50% </li></ul>
What is trisomy 13? <ul><li>P atau’s </li></ul><ul><li>P olydactyly </li></ul><ul><li>High arch  P alate </li></ul><ul><li...
What do you think if serum Ca and Phosphate change in opposite directions? <ul><li>PTH problems </li></ul><ul><li>↑  Ca  ...
What is myotonic dystrophy? <ul><li>Bird beak face </li></ul><ul><li>Can’t let go when they shake hands </li></ul>
What murmur has bounding pulses? <ul><li>Head bobbing </li></ul><ul><li>Wide pulses </li></ul><ul><li>Bounding pulse </li>...
MCC pneumonia 18-40 years <ul><li>Mycoplasma </li></ul><ul><li>Chlamydia pneumonia </li></ul><ul><li>Strep pneumonia </li>...
What is Adrenal Leukodystrophy? <ul><li>Carnitine shuttle problem </li></ul><ul><li>Adrenal failure </li></ul>
What are the causes of restrictive cardiomyopathy <ul><li>Sarcoid </li></ul><ul><li>Amyloid </li></ul><ul><li>Hemochromato...
What murmur has fixed wide splitting? <ul><li>ASD </li></ul>
What is B5? <ul><li>Pantothenic acid </li></ul><ul><li>No deficiency </li></ul>
AR: how is it transmitted? Are there malformation present? What type of defect? <ul><li>Horizontal transmission </li></ul>...
Inflammation: What happens on day 7? <ul><li>Fibroblasts show up </li></ul>
What is B12? <ul><li>Cyanocobalamine </li></ul>
What are the 3 main concepts causing a widened S2 splitting? <ul><li>↑ pO2 </li></ul><ul><li>Delayed opening/closing of th...
What has a machine like murmur? <ul><li>PDA </li></ul>
What is asthma in a child less than 2 called <ul><li>bronchiolitis </li></ul>
What is seen in every restrictive lung dz and low volume state? <ul><li>Tachypnea </li></ul><ul><li>↓  pCO2 </li></ul><ul>...
AD: how is it transmitted? Is there a malformation present? What type of defect? <ul><li>Vertical transmission </li></ul><...
What is pernicious anemia? <ul><li>Anti-IF AB </li></ul><ul><li>Vit B12 def   megaloblastic anemia </li></ul>
On an EKG, what is the p wave representing? <ul><li>atrial contraction </li></ul><ul><li>Phase 0 </li></ul><ul><li>Calcium...
What are the antioxidants? <ul><li>Vitamin E (#1) </li></ul><ul><li>Vitamin A </li></ul><ul><li>Vitamin C </li></ul><ul><l...
What is vit B1 called? <ul><li>Thiamine </li></ul>
What is the most common cause of vit C deficiency? <ul><li>Diet deficient in citrus fruit, green veggies or just overcooki...
What are the atypicals? <ul><li>Chlamydia </li></ul><ul><li>Ureoplasma </li></ul><ul><li>Mycoplasma </li></ul><ul><li>legi...
What organ needs selenium? <ul><li>heart </li></ul>
What murmurs increase on expiration? <ul><li>VSD </li></ul><ul><li>Mitral </li></ul><ul><li>Aortic </li></ul>
Synthesis of Rhodopsin requires…? <ul><li>Vit A </li></ul>
What is the incidence of rare disease in the general population <ul><li>1-3% </li></ul>
What are the most common cyanotic heart dzs? <ul><li>Transposition of the great arteries </li></ul><ul><li>Tetrology of Fa...
What are the vitamin K dependent clotting factors? <ul><li>10 </li></ul><ul><li>9 </li></ul><ul><li>7 </li></ul><ul><li>2 ...
What trace element is an enzyme in glycolysis <ul><li>Manganese </li></ul>
What is Wernicke’s Encephalopathy? <ul><li>Alcoholic thiamine deficiency of the temporal lobe </li></ul>
What is clanging? <ul><li>Words that sounds alike </li></ul>
What is the best source of B2? <ul><li>Milk </li></ul><ul><li>Also from FAD </li></ul>
Why do we stop CPR after 20 minutes? <ul><li>Brain has irreversible cell injury </li></ul>
Is Warfarin long acting or short acting? <ul><li>Long half life, 8-10 hours to act. </li></ul>
What is metachromatic leukodystrophy? <ul><li>Arylsulfatase deficiency </li></ul><ul><li>Kid with MS presentation </li></ul>
What is circumstanciality <ul><li>Digresses, but finally gets back to the point </li></ul>
What are the 2 enzymes used by B12? <ul><li>Homocystine methyl transferase </li></ul><ul><li>Methyl malonyl-coA mutase </l...
What is ALS? <ul><li>Middle age male </li></ul><ul><li>Fasiculations </li></ul><ul><li>Descending paralysis (check on this...
What is neologisms? <ul><li>New words </li></ul>
Deficiency in homocysteine methyl transferase leads to…and why is that bad? <ul><li>Megaloblastic anemia </li></ul><ul><li...
What is word salad? <ul><li>Unrelated combination of words </li></ul>
How is major depression diagnosed? <ul><li>Need 5 of the “SIGE CAPS”, lasts >2 weeks </li></ul><ul><li>S leep disturbances...
Decarboxylation of α ketoacids requires… <ul><li>thiamine </li></ul>
When does the carboxylation of glutamic acid occur? What is needed? <ul><li>Used in synthesis of blood clotting factors </...
What are the mitochondrial dzs? <ul><li>Leber’s – atrophy of the optic nerve </li></ul><ul><li>Leigh’s – subacute necrotiz...
What is vitamin C needed for? <ul><li>Collagen synthesis </li></ul>
What do you use for rapid reversal of heparin? <ul><li>Protamine sulfate </li></ul>
What is Guillane-Barre <ul><li>Ascending paralysis </li></ul><ul><li>2 weeks post UTI </li></ul>
What is the typical incidence of dz with 3 risk factors? <ul><li>90% </li></ul>
What are the 4 D’s of pellegra? <ul><li>Diarrhea </li></ul><ul><li>Dementia </li></ul><ul><li>Dermatitis </li></ul><ul><li...
What is Freidrich’s ataxia? <ul><li>Retinitis pigmentosa </li></ul><ul><li>scoliosis </li></ul>
What is required for the conversion of methionine from homocysteine? <ul><li>B12 </li></ul>
What is Myasthenia gravis? <ul><li>Gets weaker as day goes </li></ul><ul><li>Stronger w/ edophonium </li></ul><ul><li>Weak...
What is the clue for rusty colored sputum? <ul><li>Strep pneumonia (pneumococcus) </li></ul>
What is Ataxia Telangectasia? <ul><li>Spider veins </li></ul><ul><li>IgA deficiency </li></ul>
What is the MCC of atypical pneumonia in 0-2 months? <ul><li>Chlamydia pneumonia </li></ul>
Can you use heparin in pregnancy? <ul><li>Yes, does not cross placenta </li></ul>
What needs B1 as a cofactor? <ul><li>3 DHs </li></ul><ul><li>Pyruvate DH </li></ul><ul><li>Alpha ketoglutarate DH </li></u...
What is werdnig-Hoffman? <ul><li>Fasciculations in a newborn </li></ul><ul><li>No anterior horns </li></ul>
AR: how are they acquired? When does that occur? <ul><li>Almost all are inborn error of metabolism </li></ul><ul><li>Occur...
Where is CK-MB found? <ul><li>heart </li></ul>
Who do you need to give B6 to? <ul><li>Pts on INH! </li></ul>
What symptoms does the “less likely to depolarize” state have? <ul><li>Brain: lethargy, confusion, depression </li></ul><u...
What is trisomy 18? <ul><li>Edward’s </li></ul><ul><li>Rocker bottom feet </li></ul>
What is schizoid personality disorder? <ul><li>Recluse, don’t want to fit in </li></ul>
What will you see on xray with croup? What is clue symptom? <ul><li>Steeple sign </li></ul><ul><li>Barking cough </li></ul>
What do you get with ↓ thiamine? <ul><li>Beri Beri </li></ul><ul><li>Wet = high CO HF </li></ul><ul><li>Dry = no HF </li><...
Mitochondrial dzs: who are affected? Who passes it on? Who has no transmission? <ul><li>All offspring affected </li></ul><...
What is Becker’s MD? <ul><li>Dystrophin missense </li></ul><ul><li>Sxs appear >5yo </li></ul>
What is PLAN F? <ul><li>T P P – Thiamine – B1 </li></ul><ul><li>L ipoic Acid – B4 </li></ul><ul><li>Co A  – Pantothenic ac...
Another name for Vit C? <ul><li>Ascorbic Acid </li></ul>
What is cystic fibrosis? <ul><li>Meconium ileus </li></ul><ul><li>Steatorrhea </li></ul><ul><li>bronchiectasis </li></ul>
What organs do not require insulin? <ul><li>BRICKLE </li></ul><ul><li>Brain </li></ul><ul><li>RBC </li></ul><ul><li>Intest...
What do Na channel blockers do to the EKG? <ul><li>Widen QRS </li></ul>
What dzs have respiratory acidosis? <ul><li>Obstructive lung dz </li></ul>
What are the plasma catecholamines <ul><li>Epi </li></ul><ul><li>NE </li></ul><ul><li>Dopamine </li></ul>
What type of anemia is seen in B6 deficiency? <ul><li>sideroblastic </li></ul>
MCC of pneumonia 40-65 <ul><li>Strep pneumonia </li></ul><ul><li>H. influenza </li></ul><ul><li>anaerobes </li></ul>
What are the periods of rapid growth (rapid dividing cells) <ul><li>Birth-2 months </li></ul><ul><li>4-7 years </li></ul><...
What is Ca+ needed for? <ul><li>Muscle contraction </li></ul><ul><li>Axonal transport </li></ul><ul><li>2 nd  messenger </...
Inflammation: What happens at 24 hours? <ul><li>Neutrophils show up </li></ul>
What dzs have trinucleotide repeats? <ul><li>Huntington’s </li></ul><ul><li>Fragile X </li></ul><ul><li>Myotonic Dystrophy...
What is required for the degradation of cystathionine? <ul><li>Vitamin B6 </li></ul>
What is the clue for Wilson’s dz? <ul><li>Hepato/lenticular degeneration </li></ul><ul><ul><li>hepato = liver </li></ul></...
Name some causes for a widened S2 split <ul><li>Blood transfusion </li></ul><ul><li>↑  tidal volume </li></ul><ul><li>Givi...
What are the 5 hormones produced by small cell (oat cell) lung CA <ul><li>ACTH </li></ul><ul><li>ADH </li></ul><ul><li>PTH...
What will you see on xray with epiglotitis? What is key symptom? <ul><li>Thumb sign on xray </li></ul><ul><li>drooling </l...
What is Turners? <ul><li>XO </li></ul><ul><li>Web neck </li></ul><ul><li>Cystic hygroma </li></ul><ul><li>Shield chest </l...
When is angular stomatitis seen? <ul><li>B2 deficiency </li></ul>
What organ needs tin? <ul><li>hair </li></ul>
What is the clue for NO? <ul><li>Nitrates </li></ul><ul><li>Viagra </li></ul><ul><li>ANP </li></ul><ul><li>LPS </li></ul>
What is function? What if lesioned? Where enter/exit cranium? What does it innervate? CN II <ul><li>Optic </li></ul><ul><l...
What do you measure for carcinoid syndrome <ul><li>Serotonin </li></ul><ul><li>5-HIAA </li></ul>
What metabolizes fat soluble drugs? <ul><li>liver </li></ul>
What is Bipolar II <ul><li>Depression with Hypomania (no psychosis) </li></ul>
What dz do you get if you have too much Cu? <ul><li>Wilson’s dz </li></ul>
What is tracheitis? <ul><li>Look toxic </li></ul><ul><li>Grey pseudomembrane </li></ul><ul><li>leukocytosis </li></ul>
Where enter/exit cranium? What does it innervate? CN IV <ul><li>Superior orbital fissure </li></ul><ul><li>Innervates the ...
Where enter/exit cranium? What does it innervate? CN III <ul><li>Superior orbital fissure </li></ul><ul><li>Innervates the...
What is Vitamin E needed for? <ul><li>Hair </li></ul><ul><li>Skin </li></ul><ul><li>Eyes </li></ul><ul><li>Protect against...
What drugs cause pulmonary eosinophilia? <ul><li>Nitrofurantoin </li></ul><ul><li>sulfonamides </li></ul>
What is Mg a cofactor for? <ul><li>All kinases </li></ul><ul><li>Also, for the parathyroid (along with vit A) </li></ul>
What does CN IX innervate? <ul><li>Neck </li></ul><ul><li>Pharynx/tongue </li></ul>
What is stable angina? <ul><li>Pain with exertion (atherosclerosis) </li></ul>
MCC of pneumonia in the elderly <ul><li>Strep pneumonia </li></ul><ul><li>Viruses </li></ul><ul><li>Anaerobes </li></ul><u...
What are the most common symptoms of the low energy state? <ul><li>Weakness and SOB </li></ul>
What is CN VIII? What is it’s function? <ul><li>Vestibulocochlear </li></ul><ul><li>Sensory function </li></ul><ul><li>Hea...
What will happen if V3 is lesioned? <ul><li>Loss of general sensation in skin over mandible, mandibular teeth, tongue, wea...
CN V1: what does it innervate? Where does it enter/exit the cranium? <ul><li>Innervates orbit and scalp </li></ul><ul><li>...
What does Vit D do with Ca+ <ul><li>Controls Ca+ </li></ul><ul><li>Absorbs Ca+ from GI </li></ul><ul><li>Reabsorbs Ca+ in ...
What is hyaluronic acid? <ul><li>Glycosaminoglycan chain that helps form proteoglycans </li></ul>
What does the foramen spinosum contain? <ul><li>Middle meningeal artery </li></ul><ul><ul><li>Branch of the maxillary arte...
What is bronchiectasis <ul><li>Bad breath </li></ul><ul><li>Purulent sputum </li></ul><ul><li>Hemoptysis </li></ul><ul><li...
What are the toxicities of Warfarin? <ul><li>Bleeding </li></ul><ul><li>Teratogenic </li></ul><ul><li>Drug-drug interactio...
CF: what test is used to detect CF? what is nl value? Abnl value? Heterozygous value? <ul><li>Pilocarpine sweat test </li>...
What ion corresponds with: T wave? U wave? <ul><li>K </li></ul><ul><li>Na </li></ul>
What are the most common signs of the low energy state? <ul><li>Tachypnea and dyspnea </li></ul>
What is Trousseau’s sign? <ul><li>BP check causes carpal spasm    migratory thrombophlebitis </li></ul>
What happens if X is lesioned? <ul><li>Nasal speech </li></ul><ul><li>Nasal regurgitation </li></ul><ul><li>Dysphagia </li...
What is Prinzmetal’s angina? <ul><li>Intermittent pain (coronary artery spasm) </li></ul>
What is dysthymia? <ul><li>Low level sadness >2 yrs </li></ul><ul><li>“ Eor” </li></ul>
MCC of pneumonia in 6 wks to 18 years? <ul><li>RSV (infants only) </li></ul><ul><li>Mycoplasma </li></ul><ul><li>Chlamydia...
What is B4? <ul><li>Lipoic Acid </li></ul><ul><li>No problems with deficiency </li></ul>
When does Physis disappear? <ul><li>Once growth is complete </li></ul>
What is Pellagra? <ul><li>Niacin deficiency </li></ul><ul><li>Dermatitis </li></ul><ul><li>Diarrhea </li></ul><ul><li>Deme...
What is sinusitis symptom? <ul><li>Teeth pain worse with bending forward </li></ul>
What are the clues for asthma? <ul><li>Wheeze on expiration </li></ul><ul><li>IgE </li></ul><ul><li>eosinophils </li></ul>
What metabolizes Water soluble drugs? <ul><li>kidney </li></ul>
Where do you fine: janeway lesions <ul><li>toes </li></ul>
What are drugs that blast the BM? <ul><li>V inblastine  A nilate  B one  C ells </li></ul><ul><li>V inblastine </li></ul><...
What things make the membrane LESS likely to depolarize? <ul><li>HypOKalemia </li></ul><ul><li>Hypermagnesemia </li></ul><...
What is CN XI? What is it’s function? <ul><li>Accessory </li></ul><ul><li>Functions to </li></ul><ul><ul><li>Turn head to ...
What originates from the myerencephalon? <ul><li>Medulla </li></ul>
Where does V3 enter/exit cranium? What does it innervate? <ul><li>Foramen ovale </li></ul><ul><li>Infratemporal fossa </li...
What is a characteristic feature of cancellous (spongy) bone? <ul><li>trabeculae </li></ul>
What is XXX syndrome? <ul><li>47 XXX </li></ul><ul><li>Nl female </li></ul><ul><li>Two barr bodies </li></ul>
What dz corresponds with this inclusion body… <ul><li>Barr body </li></ul><ul><li>Nl female </li></ul>
What cyanotic heart dz is boot shaped? <ul><li>Tetrology of fallot </li></ul>
What is Korsakoff psychosis? <ul><li>Alcoholic thiamine deficiency </li></ul>
What is vitamin C deficiency? <ul><li>Scurvy! </li></ul>
What does Vit D deficiency cause? <ul><li>Kids = Ricketts </li></ul><ul><li>Adults = osteomalacia </li></ul>
What does Vit A deficiency cause? <ul><li>Nightvision problems (night blindness) </li></ul><ul><li>Hypoparathyroidism    ...
What is delusion <ul><li>One falsely held belief </li></ul>
What is a paranoid personality disorder? <ul><li>Suspicious about everybody, use projection </li></ul>
What is the clue for cAMP <ul><li>It is the 90% </li></ul><ul><li>Sympathetic </li></ul><ul><li>CRH (cortisol) </li></ul><...
What CN senses smelling? <ul><li>CN I </li></ul>
What is CN VI? What is it’s function? <ul><li>Abducens nerve </li></ul><ul><li>Motor function </li></ul><ul><li>Lateral re...
What is CN X? What is it’s function? <ul><li>Vagus </li></ul><ul><li>Mixed function </li></ul><ul><li>Muscles of palate an...
What is laryngomalacia? <ul><li>Epiglottis rolls in from side-to-side </li></ul>
Newborn meningitis is caused by <ul><li>Group B strep (agalactiae) </li></ul><ul><li>E. coli </li></ul><ul><li>Listeria </...
Inflammation: what happens at 3-6 months? <ul><li>Fibroblasts are gone </li></ul>
Where are the T-tubules located? <ul><li>Cardiac muscle: Z line </li></ul><ul><li>Skeletal muscle: A-I junction </li></ul>
What pathway does heparin affect? What should you follow? <ul><li>Intrinsic pathway </li></ul><ul><li>Follow the PTT </li>...
What drugs dilate veins and arteries? <ul><li>ACE inhibitors </li></ul><ul><li>Nitrates </li></ul>
What does Zinc do? <ul><li>Taste buds </li></ul><ul><li>Hair </li></ul><ul><li>Sperm function </li></ul>
What is Kwashiorkor? <ul><li>Malabsorption </li></ul><ul><li>Big belly (ascites) </li></ul><ul><li>Protein deficiency </li...
What is a nonunion fracture <ul><li>Fracture that does not heal within 6 months </li></ul>
What are THF derivatives used in? <ul><li>Purine nucleotide synthesis </li></ul><ul><li>Methylation of dUMP   dTMP </li><...
What are the 3 low volume states with acidosis rather than alkalosis <ul><li>RTA </li></ul><ul><li>Diarrhea </li></ul><ul>...
What are the cells of neural crest origin <ul><li>Parafollicular cells of thyroid </li></ul><ul><li>Odontoblasts (predenti...
What must you rule out with ↓ AVO2? <ul><li>AV fistula </li></ul><ul><li>vasodilation </li></ul>
Where does the mannose-6-P send stuff to? <ul><li>lysosome </li></ul>
What is the clinical use of warfarin? <ul><li>Chronic anticoagulation </li></ul>
What is Marasmus? <ul><li>Starvation </li></ul><ul><li>Skinny </li></ul><ul><li>Calorie deficiency </li></ul>
What is another name for sertoli cells <ul><li>Sustentacular cells </li></ul>
What are the different types of emphysema and their causes <ul><li>Bullous: s. aureus, pseudomonas </li></ul><ul><li>Centr...
How is heparin activated? <ul><li>By the blood </li></ul>
What is the clue for Ca:Calmodulin <ul><li>Used by smooth muscle for contraction by distention </li></ul>
What is the function of CN V3?  <ul><li>Mixed function </li></ul><ul><li>General sensation of anterior 2/3 of tongue, mand...
What is B6? <ul><li>Pyridoxine </li></ul>
What is variable expression? <ul><li>Phenotype is different in different individuals with the same gene </li></ul>
What things make the membrane MORE likely to depolarize? <ul><li>Hyperkalemia </li></ul><ul><li>HypOMagnesia </li></ul><ul...
Where does the Pre label send stuff to? <ul><li>ER </li></ul>
What type of acidosis do you see with obstructive pulmonary dz? <ul><li>Respiratory acidosis </li></ul>
What is tracheomalacia? <ul><li>Soft cartilage </li></ul><ul><li>Stridor since birth </li></ul>
What is CN IX? What is it’s function? <ul><li>Glossopharyngeal </li></ul><ul><li>Mixed function </li></ul><ul><li>Sense ph...
What CN has sensory fibers for Face and motor fibers for muscles of mastication? <ul><li>CN V </li></ul>
What originates from the hindbrain? <ul><li>Metencephalon </li></ul><ul><li>myerencephalon </li></ul>
What tracts are affected by a deficiency in methyl malonyl coA mutase? <ul><li>Dorsal columns </li></ul><ul><li>Cortical s...
What is Bipolar I? <ul><li>Depression with Mania (psychosis) </li></ul>
What is CN V called <ul><li>Facial </li></ul>
What is CN VII? What is it’s function? <ul><li>Facial </li></ul><ul><li>Mixed function (motor and sensory) </li></ul><ul><...
What are physical signs of B2 deficiency <ul><li>Angular stomatitis </li></ul><ul><li>Angular cheliosis </li></ul><ul><li>...
Which CNs control eye movement? <ul><li>CN III </li></ul><ul><li>CN IV </li></ul><ul><li>CN VI </li></ul>
What are the toxicities of Heparin? <ul><li>Bleeding </li></ul><ul><li>Thrombocytopenia </li></ul><ul><li>Drug-drug intera...
6 hormones produced by the placenta <ul><li>hCG </li></ul><ul><li>Inhibin </li></ul><ul><li>Human Placental lactogen (HPL)...
What is the MOA of heparin? <ul><li>Catalyzes the activation of antithrombin III </li></ul><ul><li>Decreases thrombin and ...
Most common cause of death in the low energy state? <ul><li>Heart failure </li></ul>
On an EKG, U wave means… <ul><li>Ventricle resetting </li></ul><ul><li>Phase 4 </li></ul><ul><li>sodium </li></ul>
What originates from the diencephalon? <ul><li>Thalamus </li></ul><ul><li>3 rd  ventricle </li></ul>
What are the trace elements? <ul><li>Chromium </li></ul><ul><li>Selenium </li></ul><ul><li>Tin </li></ul><ul><li>Manganese...
Is heparin long acting or short acting? <ul><li>Short half life </li></ul><ul><li>Starts acting immediately </li></ul>
What is Hartnup’s? <ul><li>No tryptophan    Niacin + serotonin </li></ul><ul><li>Presents like pellagra </li></ul><ul><li...
What are signs of tamponade <ul><li>↓ breath sounds </li></ul><ul><li>↓ BP </li></ul><ul><li>↑ JVD </li></ul>
On an EKG, PR interval means… <ul><li>AV node (the pause) </li></ul><ul><li>Phase 2 </li></ul><ul><li>sodium </li></ul>
What is function of CN III <ul><li>Oculomotor </li></ul><ul><li>Moves eyeball in all directions </li></ul><ul><li>Adductio...
Who is affected in the family with an x-linked dz <ul><li>Maternal grandfather </li></ul><ul><li>Maternal uncles </li></ul>
What does calcium do? <ul><li>Neuronal function </li></ul><ul><li>Atria depolarization </li></ul><ul><li>Smooth m contract...
What vitamin is deficient with pernicious anemia and has a neuropathy? <ul><li>B12 </li></ul>
What are the different branches of CN V? <ul><li>V1 = opthalmic </li></ul><ul><li>V2 = maxillary </li></ul><ul><li>V3 = ma...
Inflammation: what happens in 1 month? <ul><li>Fibroblasts peak </li></ul>
What is Nihilism? <ul><li>The world has stopped! </li></ul>
Inflammation: what happens on day 4? <ul><li>T cells and macrophages show up </li></ul>
What needs B6 as a cofactor? <ul><li>All transaminases! </li></ul>
What does the optic canal contain? <ul><li>Opthalmic artery </li></ul><ul><li>Central retinal vein </li></ul><ul><li>CN II...
What are the risk factors for lung cancer? <ul><li>Smoking </li></ul><ul><li>Radon </li></ul><ul><li>2 nd  hand smoke </li...
What is MS? <ul><li>Anti-myelin Ab </li></ul><ul><li>Middle aged female with vision problems </li></ul>
What is myasthenia gravis? <ul><li>Anti-AChr Ab </li></ul><ul><li>Female w/ ptosis </li></ul><ul><li>Weaker as the day goe...
What is IP3/DAG used by and for? <ul><li>Smooth muscle for contraction </li></ul>
What is XYY syndrome? <ul><li>47 XYY </li></ul><ul><li>Tall aggressive male </li></ul>
What dzs do we screen for at birth? <ul><li>Please Check Before Going Home </li></ul><ul><li>PKU </li></ul><ul><li>CAH </l...
When is warfarin absolutely contraindicated? <ul><li>Pregnancy, because it can cross the placenta </li></ul>
What CN controls tongue movement? <ul><li>CN XII </li></ul>
What is Choreoathetosis? <ul><li>Dance like movements </li></ul><ul><li>Wringing of hands </li></ul><ul><li>Quivering voic...
What is the most common cause of B12 deficiency? <ul><li>Pernicious Anemia </li></ul>
What are the macrocytic anemias? <ul><li>B12 </li></ul><ul><li>Folate </li></ul><ul><li>Reticulocytosis </li></ul><ul><li>...
What disease manifest with Cu deficiency? <ul><li>Minky kinky hair syndrome </li></ul>
What are the x linked dominant diseases? <ul><li>Na-resistant rickets (kidney leaks phosphorus), waddling gait </li></ul><...
What are the most common causes of meningitis in: 2 months – 10 years <ul><li>#1 – strep pneumonia </li></ul><ul><li>#2 – ...
What does the posterior condylar canal contain? <ul><li>Large emissary vein </li></ul>
What part of the brain deals with problem solving? <ul><li>Frontal lobe </li></ul>
What is polio? <ul><li>Child </li></ul><ul><li>Asymmetrical fasiculations </li></ul><ul><li>2 weeks after gastroenteritis ...
On an EKG, R means… <ul><li>Anterior wall of ventricles </li></ul><ul><li>Phase 0 </li></ul><ul><li>Sodium </li></ul>
What is penetrance? <ul><li>The % of people who have the gene that also exhibit the phenotype. </li></ul><ul><li>If they h...
What are the clues for epiglottitis? What is the MCC? <ul><li>Stridor </li></ul><ul><li>Fever </li></ul><ul><li>Thumb sign...
What are the causes of eosinophilia <ul><li>Neoplasms </li></ul><ul><li>Allergies/asthma </li></ul><ul><li>Addison’s dz </...
What are the vit K dependent clotting factors? Shortest ½ lives? <ul><li>2,7,9,10 </li></ul><ul><li>Protein C and S </li><...
What is the max heart rate (for anybody…) <ul><li>220-age </li></ul>
What is function? What if lesioned? Where enter/exit cranium? What does it innervate? CN I <ul><li>Olfactory </li></ul><ul...
What are the only 3 pansystolic murmurs and when are they heard? <ul><li>MR – ↓ on insp, ↑ on exp </li></ul><ul><li>TR - ↑...
What does chlamydia pneumonia cause? <ul><li>Interstitial pneumonia </li></ul>
What is the only cause of ICP that does not cause herniation? <ul><li>Pseudotumor cerebri </li></ul>
What originates from the telencephalon? <ul><li>Cerebral hemispheres </li></ul><ul><li>Lateral ventricles </li></ul>
What are the vitamins from the GI that are nl flora? <ul><li>Folate </li></ul><ul><li>Vit K </li></ul><ul><li>Biotin </li>...
What if lesioned? CN IV <ul><li>Weakness looking down with adducted eye </li></ul><ul><li>Trouble going down stairs </li><...
CN V2: where does it enter/exit the cranium? What does it innervate? <ul><li>Exit enter: foramen rotundum </li></ul><ul><l...
If pt has a visual field defect with cognitive disturbance? What part of the brain will be affected? <ul><li>Temporal or p...
How is warfarin administered? <ul><li>PO </li></ul>
On an EKG, S means… <ul><li>Posterior wall </li></ul><ul><li>Phase 0 </li></ul><ul><li>sodium </li></ul>
What enzyme does Zanthein Oxidase need? <ul><li>Maganese </li></ul>
What happens if the sympathetic part of CN X is lesioned? What do we call this? <ul><li>Eyelid droop (ptosis) </li></ul><u...
What is good about new LMWH? <ul><li>Act more on Xa </li></ul><ul><li>Have better bioavailability </li></ul><ul><li>2-4 ti...
Where does the Pro label send stuff to? <ul><li>golgi </li></ul>
What is the dosage for streptokinase (push and drip) <ul><li>750K IV push </li></ul><ul><li>750K drip </li></ul>
Where do you find Small cell CA? what are other features <ul><li>Most common at carina </li></ul><ul><li>Malignant </li></...
What is the triad of carcinoid syndrome <ul><li>Flushing </li></ul><ul><li>Wheezing </li></ul><ul><li>diarrhea </li></ul>
What is the dosage of tPA? (push and drip) <ul><li>20 mg IV push </li></ul><ul><li>40 mg drip </li></ul>
How does a neurogenic muscle dz present? <ul><li>Distal weakness and fasiculations </li></ul>
What is the first vitamin to run out with dz of rapidly dividing cells? <ul><li>Folate </li></ul>
What does hyperresonance tell you <ul><li>Air in lungs </li></ul>
What does it mean to see a physis on radiograph? <ul><li>Means the skeleton is not fully mature </li></ul>
What are the causes of croup and bronchiolities <ul><li>Parainfluenza </li></ul><ul><li>Adenovirus </li></ul><ul><li>Influ...
What are the clues to scurvy? <ul><li>Bleeding gums </li></ul><ul><li>Bleeding hair follicles </li></ul>
Inflammation: What happens at day 3? <ul><li>Neutrophils peak </li></ul>
What happens if VII is lesioned <ul><li>Corner of mouth droops </li></ul><ul><li>Can’t close eye </li></ul><ul><li>Can’t w...
What are the clinical uses of heparin? <ul><li>Immediate anticoagulation of pulmonary embolism, stroke, angina, MI, DVT </...
Who gets asbestosis <ul><li>Shipyard workers </li></ul><ul><li>Pipe fitters </li></ul><ul><li>Brake mechanics </li></ul><u...
What is the MOA of Warfarin? <ul><li>Interferes with nl synthesis and γ carboxylation of Vit K dependent clotting factors ...
How do you detect pulmonary embolus? <ul><li>Tachypnea </li></ul><ul><li>↑  V/Q scan </li></ul><ul><li>EKG: S1 Q3 T3 </li>...
Pyruvate decarboxylase requires what as a cofactor? <ul><li>thiamine </li></ul>
What is B3 called? <ul><li>Niacin </li></ul>
What does the hydroxylation of purines require? <ul><li>Vitamin C </li></ul>
Where does CN X enter/exit cranium? What does it innervate? <ul><li>Exits jugular foramen </li></ul><ul><li>Innervates </l...
What is B2 called? <ul><li>Riboflavin </li></ul>
What type of receptors do all sphincters in the body have? <ul><li>alpha-receptors </li></ul>
What does warfarin do to the PT? <ul><li>Prolongs it </li></ul>
On an EKG, T wave means… <ul><li>Ventricle repolarization </li></ul><ul><li>Phase 3 </li></ul><ul><li>K </li></ul>
What happens if you lesion CN XI? Where does it enter/exit crainum? What does it innervate? <ul><li>Lesioned: </li></ul><u...
Cofactor for all kinases? <ul><li>Magnesium </li></ul>
Cystic Fibrosis: What is the treatment? <ul><li>Pilocarpine (which is also used for glaucoma) </li></ul>
What dzs have metabolic alkalosis <ul><li>Low volume states </li></ul><ul><li>Vomiting </li></ul><ul><li>Diuretics </li></...
What does the foramen ovale contain? <ul><li>CN V3 </li></ul>
AD: where is the new mutation? When is the onset? <ul><li>New mutation is often in germ cells of older fathers </li></ul><...
What if lesioned? CN III <ul><li>Diplopia </li></ul><ul><li>Loss of parallel gaze </li></ul><ul><li>Dilated pupil </li></u...
What are the clues for IP3/DAG <ul><li>Neurotransmitter </li></ul><ul><li>GHRH </li></ul><ul><li>All hypothalamic hormones...
What does the foramen magnum contain? <ul><li>Vertebral arteries </li></ul><ul><li>Brain stem </li></ul><ul><li>Spinal roo...
What do you need to know about large cell CA? <ul><li>Large cells! </li></ul>
What is the function of CN V1? If lesioned? <ul><li>Mixed function </li></ul><ul><li>General sensation (touch, pain, temp)...
What are the most common causes of meningitis corresponding with >21 yo? <ul><li>N. meningitidis </li></ul>
Where does CN XII enter/exit the cranium? What does it innervate? <ul><li>Hypoglossal canal </li></ul><ul><li>tongue </li>...
What are the mitochondrial dzs? <ul><li>Leigh’s (progressively ↓ IQ, seizure, ataxia, deficiency of cytochrome oxidase) </...
What symptoms does the “more likely to depolarize state” have <ul><li>Brain: psychosis, seizures, jitteriness </li></ul><u...
What gives you differential pulses? <ul><li>coarctation </li></ul>
What is schizotypal personality disorder? <ul><li>Magical thinking, bizarre behavior </li></ul>
Too much Vit A will cause… <ul><li>Hyperparathyroid   ↑Ca, ↓Phosphate </li></ul><ul><li>Moans and Groans (pancreatitis) <...
What is the deficiency caused by this vitamin(B12)? What deficiency causes it? <ul><li>Neuropathy </li></ul><ul><li>Pernic...
What streptococcus causes SBE? <ul><li>viridans </li></ul>
Facts about diphtheria <ul><li>ADP ribosylates EF-2 </li></ul><ul><li>Stops cell synthesis </li></ul><ul><li>G+ </li></ul>...
Clue for Ricketts? <ul><li>Lateral bowing of the legs </li></ul><ul><li>X linked dominant </li></ul>
What causes a neuropathy when deficient and also needed for transaminase? <ul><li>B6 </li></ul>
What systems does mitochondrial inheritance affect? Why does it affect these? <ul><li>CNS </li></ul><ul><li>Heart </li></u...
Who gets byssinosis <ul><li>Cotton workers </li></ul>
What happens if CN VIII is lesioned? Where does it enter/exit cranium? What does it innervate? <ul><li>Lesion = loss of ba...
How is warfarin activated? <ul><li>Tissue activated </li></ul>
What is biotin a cofactor for? <ul><li>All carboxylases </li></ul>
What are the most common causes of meningitis corresponding with 10-21 yo? <ul><li>N. meningitidis </li></ul>
What is unstable angina? <ul><li>Pain at rest (transient clots) </li></ul><ul><li>Meds don’t help </li></ul><ul><li>Pain i...
What is tangentiality? <ul><li>Wanders off topic </li></ul>
What is the typical incidence of a rare dz w/ 1 risk factor <ul><li>10% </li></ul>
What type of anemia is seen with folate deficiency? <ul><li>Megaloblastic </li></ul><ul><li>No neuropathy </li></ul>
What drugs cause dysgeusia? <ul><li>Li (?) </li></ul><ul><li>Metronidazole </li></ul><ul><li>Clarithromycin </li></ul><ul>...
What electrolytes does the low volume state have? <ul><li>↑  total Na </li></ul><ul><li>↓  serum Na (dilutional effect) </...
What is folate used for? <ul><li>Nucleotide synthesis (THF) </li></ul>
What are the 4 facts of Fanconi syndrome <ul><li>Problem in proximal tubule </li></ul><ul><li>Can’t reabsorb </li></ul><ul...
What is function? CN IV <ul><li>Trochlear </li></ul><ul><li>Motor </li></ul><ul><li>Superior oblique </li></ul><ul><li>Dep...
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  1. 1. Where does the N-terminal sequence send stuff to? <ul><li>Mitochondria </li></ul>
  2. 2. How do you treat lithium OD? <ul><li>Sodium polystyrene sulfonate </li></ul>
  3. 3. AD: who is affected most? How does it manifest? Who can transmit? <ul><li>M=F </li></ul><ul><li>Manifests in the heterozygote and homozygote </li></ul><ul><li>Both parents can transmit the dz </li></ul>
  4. 4. What two enzymes are needed for synthesis of B12? <ul><li>Methylmalonyl CoA Mutase </li></ul><ul><li>Homocysteine Methyl Transferase </li></ul>
  5. 5. What is the deficiency caused by this vitamin B6? <ul><li>Neuropathy </li></ul><ul><li>seizures </li></ul>
  6. 6. What does a deficiency in Zinc cause? <ul><li>Dysgusia </li></ul><ul><li>Decreased sperm </li></ul><ul><li>Dry skin </li></ul><ul><li>Dry hair </li></ul>
  7. 7. What is vitamin A a cofactor for? What is the other cofactor needed? <ul><li>PTH </li></ul><ul><li>The other cofactor is Mg+ </li></ul>
  8. 8. Synthesis of 1,25-D-hydroxycholecalciferol requires? <ul><li>Vit D </li></ul>
  9. 9. What are loose associations? <ul><li>Ideas switch subjects, incoherent </li></ul>
  10. 10. What is double depression? <ul><li>Depression followed by dysthymia </li></ul>
  11. 11. How does myopathic muscle dz present? <ul><li>Proximal weakness and pain </li></ul>
  12. 12. What is illusion <ul><li>Misinterprets stimulus (magician) </li></ul>
  13. 13. What is atonic cerebral palsy? <ul><li>No muscle tone </li></ul><ul><li>floppy </li></ul>
  14. 14. What does warfarin inhibit? <ul><li>Vitamin K </li></ul>
  15. 15. Why should you wait 30 min after a meal before swimming? <ul><li>All the blood in gut and skeletal mm have ran out of ATP </li></ul>
  16. 16. What is Klinefelter’s? <ul><li>XXY 47 </li></ul><ul><li>Tall </li></ul><ul><li>Gynecomastia </li></ul><ul><li>Infertility </li></ul><ul><li>↓ testosterone </li></ul>
  17. 17. What are the most common non-cyanotic heart dzs? <ul><li>VSD </li></ul><ul><li>ASD </li></ul><ul><li>PDA </li></ul><ul><li>coarctation </li></ul>
  18. 18. What values do you see in obstructive pulmonary dz? <ul><li>pO2 nl </li></ul><ul><li>pCO2 ↑ </li></ul><ul><li>pH ↓ </li></ul>
  19. 19. Where is CK-BB found? <ul><li>Brain </li></ul>
  20. 20. What do you think when you see both serum Ca and Phosphate ↓ <ul><li>Vit D deficiency </li></ul>
  21. 21. With Inflammation…what happens <24 hours? <ul><li>swelling </li></ul>
  22. 22. What are the enzymes that show after an MI? <ul><li>Troponin I </li></ul><ul><li>CKMB </li></ul><ul><li>LDH </li></ul>
  23. 23. What do you see in the serum with the low volume state? <ul><li>K+ decreases </li></ul><ul><li>Na+ decreases </li></ul><ul><li>Cl- decreases </li></ul><ul><li>pH increases </li></ul><ul><li>BP increases </li></ul>
  24. 24. AR: who does it show in? When is the onset? What is the penetrance? <ul><li>Does not show up in parents </li></ul><ul><li>Might be in siblings/2 nd degree relatives </li></ul><ul><li>Onset early in life </li></ul><ul><li>Complete penetrance </li></ul>
  25. 25. What pathway does warfarin affect? <ul><li>Extrinsic pathway </li></ul>
  26. 26. What cyanotic heart dz is associated with mom taking lithium during preg? <ul><li>Ebstein’s anomaly </li></ul>
  27. 27. Why do we only have 6 hours to use tPA? <ul><li>Body has irreversible cell injury </li></ul>
  28. 28. What does a deficiency in Vit E cause in newborns? <ul><li>Retinopathy </li></ul>
  29. 29. What is the third MI enzyme to appear? When does it appear/peak/gone <ul><li>LDH </li></ul><ul><li>Appears in 1 day </li></ul><ul><li>Peaks in 2 days </li></ul><ul><li>Gone in 3 days </li></ul>
  30. 30. What are the different second messenger systems? <ul><li>cAMP </li></ul><ul><li>cGMP </li></ul><ul><li>IP3/DAG </li></ul><ul><li>Ca:Calmodulin </li></ul><ul><li>Ca+ </li></ul><ul><li>Tyrosine Kinase </li></ul><ul><li>NO </li></ul>
  31. 31. What dzs have pulmonary eosinophilia? <ul><li>Aspergillosis </li></ul><ul><li>strongyloides </li></ul>
  32. 32. Where is a Bokdalek hernia located? <ul><li>Back of diaphragm </li></ul>
  33. 33. Where is a Morgagni hernia located? <ul><li>Middle of diaphragm </li></ul>
  34. 34. What dzs have respiratory alkalosis? <ul><li>Restrictive lung dz </li></ul>
  35. 35. What dzs have metabolic acidosis <ul><li>MUDPILES </li></ul><ul><li>Methanol </li></ul><ul><li>Uremia </li></ul><ul><li>DKA </li></ul><ul><li>Paraldehyde </li></ul><ul><li>Infxn </li></ul><ul><li>Lactic acidosis </li></ul><ul><li>Ethylene glycol </li></ul><ul><li>salicylates </li></ul>
  36. 36. What does grunting tell you <ul><li>Restrictive lung dz </li></ul><ul><li>Blowing collapsed alveoli open </li></ul>
  37. 37. What is bronchitis <ul><li>Lots of sputum </li></ul><ul><li>Blue bloater </li></ul>
  38. 38. What is aspergillosis <ul><li>Allergy to mold, dead plants, compost piles </li></ul>
  39. 39. Who gets silicosis? <ul><li>Sandblasters </li></ul><ul><li>glassblowers </li></ul>
  40. 40. Who gets beryliosis <ul><li>Radio </li></ul><ul><li>TV </li></ul><ul><li>welders </li></ul>
  41. 41. Who gets anthracosis <ul><li>Coal workers </li></ul><ul><li>Massive fibrosis </li></ul><ul><li>Does not ↑ CA risk </li></ul>
  42. 42. What are the clues for squamous cell CA <ul><li>Smoker </li></ul><ul><li>High PTH </li></ul><ul><li>High calcium </li></ul>
  43. 43. What does bronchealveolar CA look like? What is it due to? <ul><li>Looks like pneumonia </li></ul><ul><li>Due to pneumoconiosis </li></ul>
  44. 44. On an EKG, ST means… <ul><li>Ventricle contraction </li></ul><ul><li>Phase 2 </li></ul><ul><li>Calcium </li></ul>
  45. 45. What is the second MI enzyme to appear? When does it appear/peak/gone <ul><li>CK-MB </li></ul><ul><li>Appears in 6 hours </li></ul><ul><li>Peaks in 12 hours </li></ul><ul><li>Gone in 24 hours </li></ul>
  46. 46. Where is CK-MM found? <ul><li>muscle </li></ul>
  47. 47. What causes lateral bowing of the legs? <ul><li>Rickets </li></ul>
  48. 48. What is cyclothymia? <ul><li>Dysthymia w/ hypomania </li></ul>
  49. 49. What is the vitamin pneumonic? <ul><li>The Rich Never Lie about Panning Pyrite Filled Creeks </li></ul><ul><li>Thiamine, Riboflavin, Niacin, Lipoic Acid, Pantothenic acid, Pyridoxine, Folate, Cyanocobalamine </li></ul>
  50. 50. How is heparin administered? What is it the DOC for? <ul><li>Administer via IV </li></ul><ul><li>DOC for DVT </li></ul>
  51. 51. What are the essential fatty acids? <ul><li>Linolenic </li></ul><ul><li>Linoleic </li></ul>
  52. 52. What can Wilson’s dz be confused with? <ul><li>Huntingtons </li></ul><ul><li>HD has anticipation, trinucleotide repeats (CAG) and affects the caudate. </li></ul><ul><li>Accounts for 90% of movement disorders </li></ul>
  53. 53. Cofactor for all transaminases? <ul><li>B6 </li></ul>
  54. 54. What is chromium needed for? <ul><li>Insulin action </li></ul>
  55. 55. Diptheria: what does it cause? What do you give for tx? <ul><li>Causes heart block </li></ul><ul><li>Give antitoxin </li></ul><ul><li>Never scrape membrane! </li></ul>
  56. 56. What is the clue for cGMP? <ul><li>Parasympathetic </li></ul><ul><li>Anabolic </li></ul>
  57. 57. What is Ebstein’s Anomaly? <ul><li>Tricuspid prolapse </li></ul><ul><li>Due to mom taking lithium in pregnancy </li></ul>
  58. 58. What dz looks like B3 deficiency? <ul><li>Hartnup Dz </li></ul><ul><li>Tryptophan deficiency, which is needed to make niacin! </li></ul>
  59. 59. What is a heavy chain composed of? <ul><li>myosin </li></ul>
  60. 60. What is Chovstek’s sign? <ul><li>Tap on facial nerve  muscle spasm </li></ul>
  61. 61. How is warfarin activated? <ul><li>Tissue activated </li></ul>
  62. 62. What is Myasthenic syndrome? <ul><li>Aka Lambert-Eaton </li></ul><ul><li>Get stronger as the day goes on </li></ul><ul><li>Stronger w/ EMG </li></ul><ul><li>Not small cell CA </li></ul>
  63. 63. What do Ca channel blockers do to the EKG <ul><li>Widen P </li></ul><ul><li>PR interval is longer </li></ul>
  64. 64. What are the toxicities of Warfarin? <ul><li>Bleeding </li></ul><ul><li>Teratogenic </li></ul><ul><li>Drug-drug interactions </li></ul>
  65. 65. What values do you see in restrictive pulmonary dz? <ul><li>pO2 ↓ </li></ul><ul><li>pCO2 ↓ </li></ul><ul><li>pH ↑ </li></ul>
  66. 66. Cofactor for all carboxylases? <ul><li>biotin </li></ul>
  67. 67. What band of the sarcomere does not change length? <ul><li>A band </li></ul>
  68. 68. What happens when a pt is on prednisone for >7 days? <ul><li>Immunocompromised </li></ul>
  69. 69. What is the MOA of Methotrexate? <ul><li>Inhibits dihydrofolate reductase </li></ul><ul><li>Inhibits DNA synthesis in the S phase of cycle </li></ul><ul><li>Prevents reduction of folic acid needed to produce THF </li></ul>
  70. 70. What does heparin inhibit? <ul><li>Protamine Sulfate </li></ul>
  71. 71. Deficiency in Methylmalonyl CoA Mutase leads to…and why! <ul><li>Neuropathy </li></ul><ul><li>Recycles myelin </li></ul>
  72. 72. What is uses tyrosine kinase? <ul><li>Used by insulins </li></ul><ul><li>used by all growth factors </li></ul>
  73. 73. What dzs have cherry red macula? <ul><li>Niemann Pick </li></ul><ul><li>Tay Sachs </li></ul><ul><li>Sandhoffs </li></ul>
  74. 74. What is the most common cause of meningitis in : 0-2 months <ul><li>#1 - Group B strep (agalactiae) </li></ul><ul><li>#2 – E. coli </li></ul><ul><li>#3 - Listeria </li></ul>
  75. 75. What is the function of CN V2? What if lesioned? <ul><li>Mixed function </li></ul><ul><li>General sensation of palate, nasal cavity, maxiallry face and maxiallary teeth </li></ul><ul><li>If lesioned: loss of general sensation in skin over maxilla and maxiallary teeth </li></ul>
  76. 76. Which direction does the jaw deviate in CN V3 lesion? <ul><li>Towards the weak side </li></ul>
  77. 77. What is trigeminal neuralgia? <ul><li>Intractable pain in V2 or V3 territory </li></ul>
  78. 78. What happens if VI is lesioned? Where does it enter/exit the cranium? What does it innervate? <ul><li>Lesioned  </li></ul><ul><ul><li>Diplopia (internal strabismus) </li></ul></ul><ul><ul><li>Loss of parallel gaze (pseudoptosis) </li></ul></ul><ul><li>Exits the superior orbital fissure </li></ul><ul><li>Innervates the orbit </li></ul>
  79. 79. What do we call a lesion of VII? <ul><li>Bell Palsy </li></ul>
  80. 80. Where does CN VII enter/exit the cranium? Where do the branches leave? What does it innervate? <ul><li>Internal auditory meatus </li></ul><ul><li>Branches leave through the skull in stylomastoid foramen, petrotympanic fissure, or hiatus of facial canal </li></ul><ul><li>Innervates </li></ul><ul><ul><li>Face </li></ul></ul><ul><ul><li>Nasal and oral cavity </li></ul></ul>
  81. 81. What muscle does IX go to? What happens if lesioned? Where does it enter/exit the cranium? <ul><li>Goes to stylopharyngeus </li></ul><ul><li>If lesioned  loss of gag reflex with X </li></ul><ul><li>Exits jugular foramen </li></ul>
  82. 82. CN X –sympathetics to head: what is it’s function? <ul><li>Motor </li></ul><ul><li>Rasies eyelid (superior tarsal muscle) </li></ul><ul><li>Dilates pupil </li></ul><ul><li>Innervates sweat glands of face and scalp </li></ul><ul><li>Constricts blood vessels in head </li></ul>
  83. 83. Where does the sympathetic portion of X enter/exit cranium? What does it innervate? <ul><li>Carotid canal on internal carotid artery </li></ul><ul><li>Innervates </li></ul><ul><ul><li>Orbit </li></ul></ul><ul><ul><li>Face </li></ul></ul><ul><ul><li>scalp </li></ul></ul>
  84. 84. What is CN XII? What is it’s funciton? What happens if lesioned? <ul><li>Hypoglossal </li></ul><ul><li>Moves the tongue </li></ul><ul><li>Tongue points toward pathology on protrusion </li></ul>
  85. 85. What happens if there is a lesion to the optic nerve? <ul><li>Unilateral blindness </li></ul>
  86. 86. What happens if there is a lesion to the optic chiasm? <ul><li>Bitemporal hemianopia </li></ul>
  87. 87. What is a berry aneurysm due to in the circle of willis? <ul><li>SUBARACHNOID hemorrhage </li></ul>
  88. 88. What is the clue for a Subarachnoid hemorrhage <ul><li>Worst headache of my life! </li></ul>
  89. 89. What does the diencephalon originate from <ul><li>forebrain </li></ul>
  90. 90. Where does the telencephalon originate from? <ul><li>Forebrain (prosencephalon) </li></ul>
  91. 91. What originates from the mesencephalon? <ul><li>Midbrain </li></ul><ul><li>aqueduct </li></ul>
  92. 92. What originates from the metencephalon <ul><li>Pons </li></ul><ul><li>cerebrum </li></ul>
  93. 93. What does the jugular foramen contain? <ul><li>CN IX </li></ul><ul><li>CN X </li></ul><ul><li>CN XI </li></ul><ul><li>Internal jugular vein </li></ul><ul><li>Spinal accessory nerves </li></ul>
  94. 94. What does the hypoglossal canal contain? <ul><li>CN XII </li></ul><ul><li>Hypoglossal nerve </li></ul>
  95. 95. What does the carotid canal contain? <ul><li>Internal carotid artery </li></ul>
  96. 96. What does malunion mean? <ul><li>A fracture that heals in an abnormal position </li></ul>
  97. 97. Which CN is responsible for turning the head and shrugging the shoulders? <ul><li>CN XI </li></ul>
  98. 98. What CN controls sensory fibers for vision? <ul><li>CN II </li></ul>
  99. 99. If there is a lesion in the frontal lobe will you have motor or sensory defects? <ul><li>motor </li></ul>
  100. 100. What is B3 deficiency? <ul><li>Pellegra </li></ul><ul><li>4D’s </li></ul><ul><li>Dementia </li></ul><ul><li>Diarrhea </li></ul><ul><li>Dermatitis </li></ul><ul><li>Death </li></ul>
  101. 101. Name the ion that goes with: P wave? QRS? ST? <ul><li>Ca </li></ul><ul><li>Na </li></ul><ul><li>Ca </li></ul>
  102. 102. In EKG, Q wave means… <ul><li>Septum </li></ul><ul><li>Phase 0 </li></ul><ul><li>sodium </li></ul>
  103. 103. What is required for the conversion of methylmalonyl CoA to Succinyl CoA <ul><li>B12 </li></ul>
  104. 104. What is hallucination? <ul><li>False sensory perception </li></ul><ul><li>Usually auditory </li></ul><ul><li>Formication = bugs crawling under skin…see in alcohol withdrawal and cocaine OD </li></ul>
  105. 105. What can lithium do to mom? <ul><li>Nephrogenic DI </li></ul>
  106. 106. What do you need Cu for? <ul><li>Collagen synthesis </li></ul>
  107. 107. What is perseveration <ul><li>Keeps repeating same word </li></ul>
  108. 108. What do tPA, Streptokinase, and Urokinase inhibit <ul><li>Aminocaproic acid </li></ul>
  109. 109. What is Duchenne’s Muscular Dystrophy <ul><li>Dystrophin frameshift </li></ul><ul><li>Gower sign </li></ul><ul><li>Calf pseudohypertrophy (fat deposition) </li></ul>
  110. 110. What is the light chain composed of? <ul><li>Actin </li></ul>
  111. 111. What are the symptoms of the low energy state? <ul><li>Everything slows down! </li></ul><ul><li>Mental retardation, dementia, HF, pericardial effusion, WEAKNESS, SOB , vasodilation, impotence, urinary retention, constipation, dry skin, brittle nails, hair loss, suppressed BM, vascular endothelium breaks, lung infxns, PCT breakdown, N/V/D, oliguria, ↓ sperm, germ cells  CA, atrophic breasts and endometrium </li></ul>
  112. 112. What is MS? <ul><li>Anti-myelin Ab </li></ul><ul><li>Young woman w/vision problems </li></ul><ul><li>Sxs come and go </li></ul>
  113. 113. What is the first MI enzyme to appear? When does it appear/peak/gone <ul><li>Troponin I </li></ul><ul><li>Appears in 2 hours </li></ul><ul><li>Peaks in 2 days </li></ul><ul><li>Gone in 7 days </li></ul>
  114. 114. What is the typical incidence with 2 risk factors <ul><li>50% </li></ul>
  115. 115. What is trisomy 13? <ul><li>P atau’s </li></ul><ul><li>P olydactyly </li></ul><ul><li>High arch P alate </li></ul><ul><li>P ee problems </li></ul><ul><li>holoprosencephaly </li></ul>
  116. 116. What do you think if serum Ca and Phosphate change in opposite directions? <ul><li>PTH problems </li></ul><ul><li>↑ Ca  HyperPTH </li></ul><ul><li>↓ Ca  HypoPTH </li></ul>
  117. 117. What is myotonic dystrophy? <ul><li>Bird beak face </li></ul><ul><li>Can’t let go when they shake hands </li></ul>
  118. 118. What murmur has bounding pulses? <ul><li>Head bobbing </li></ul><ul><li>Wide pulses </li></ul><ul><li>Bounding pulse </li></ul><ul><li>Quinkes pulse </li></ul><ul><li>Aortic regurgitation </li></ul>
  119. 119. MCC pneumonia 18-40 years <ul><li>Mycoplasma </li></ul><ul><li>Chlamydia pneumonia </li></ul><ul><li>Strep pneumonia </li></ul>
  120. 120. What is Adrenal Leukodystrophy? <ul><li>Carnitine shuttle problem </li></ul><ul><li>Adrenal failure </li></ul>
  121. 121. What are the causes of restrictive cardiomyopathy <ul><li>Sarcoid </li></ul><ul><li>Amyloid </li></ul><ul><li>Hemochromatosis </li></ul><ul><li>Cancer </li></ul><ul><li>Fibrosis </li></ul>
  122. 122. What murmur has fixed wide splitting? <ul><li>ASD </li></ul>
  123. 123. What is B5? <ul><li>Pantothenic acid </li></ul><ul><li>No deficiency </li></ul>
  124. 124. AR: how is it transmitted? Are there malformation present? What type of defect? <ul><li>Horizontal transmission </li></ul><ul><li>Physical malformations are uncommon </li></ul><ul><li>Enzyme defect </li></ul>
  125. 125. Inflammation: What happens on day 7? <ul><li>Fibroblasts show up </li></ul>
  126. 126. What is B12? <ul><li>Cyanocobalamine </li></ul>
  127. 127. What are the 3 main concepts causing a widened S2 splitting? <ul><li>↑ pO2 </li></ul><ul><li>Delayed opening/closing of the pulmonary valve </li></ul><ul><li>↑ volume in the right ventricle </li></ul>
  128. 128. What has a machine like murmur? <ul><li>PDA </li></ul>
  129. 129. What is asthma in a child less than 2 called <ul><li>bronchiolitis </li></ul>
  130. 130. What is seen in every restrictive lung dz and low volume state? <ul><li>Tachypnea </li></ul><ul><li>↓ pCO2 </li></ul><ul><li>↓ pO2 </li></ul><ul><li>↑ pH </li></ul>
  131. 131. AD: how is it transmitted? Is there a malformation present? What type of defect? <ul><li>Vertical transmission </li></ul><ul><li>Physical malformation is common </li></ul><ul><li>Structural defect </li></ul>
  132. 132. What is pernicious anemia? <ul><li>Anti-IF AB </li></ul><ul><li>Vit B12 def  megaloblastic anemia </li></ul>
  133. 133. On an EKG, what is the p wave representing? <ul><li>atrial contraction </li></ul><ul><li>Phase 0 </li></ul><ul><li>Calcium </li></ul>
  134. 134. What are the antioxidants? <ul><li>Vitamin E (#1) </li></ul><ul><li>Vitamin A </li></ul><ul><li>Vitamin C </li></ul><ul><li>Betakeratine </li></ul>
  135. 135. What is vit B1 called? <ul><li>Thiamine </li></ul>
  136. 136. What is the most common cause of vit C deficiency? <ul><li>Diet deficient in citrus fruit, green veggies or just overcooking the green veggies! </li></ul>
  137. 137. What are the atypicals? <ul><li>Chlamydia </li></ul><ul><li>Ureoplasma </li></ul><ul><li>Mycoplasma </li></ul><ul><li>legionella </li></ul>
  138. 138. What organ needs selenium? <ul><li>heart </li></ul>
  139. 139. What murmurs increase on expiration? <ul><li>VSD </li></ul><ul><li>Mitral </li></ul><ul><li>Aortic </li></ul>
  140. 140. Synthesis of Rhodopsin requires…? <ul><li>Vit A </li></ul>
  141. 141. What is the incidence of rare disease in the general population <ul><li>1-3% </li></ul>
  142. 142. What are the most common cyanotic heart dzs? <ul><li>Transposition of the great arteries </li></ul><ul><li>Tetrology of Fallot </li></ul><ul><li>Truncus Arteriosus </li></ul><ul><li>Tricuspid Atresia </li></ul><ul><li>Total anomalous pulmonary venous return </li></ul><ul><li>Hypoplastic left heart syndrome </li></ul><ul><li>Ebstein’s anomaly </li></ul><ul><li>Aortic atresia </li></ul><ul><li>Pulmonary atresia </li></ul>
  143. 143. What are the vitamin K dependent clotting factors? <ul><li>10 </li></ul><ul><li>9 </li></ul><ul><li>7 </li></ul><ul><li>2 </li></ul><ul><li>Protein C </li></ul><ul><li>Protein S </li></ul>
  144. 144. What trace element is an enzyme in glycolysis <ul><li>Manganese </li></ul>
  145. 145. What is Wernicke’s Encephalopathy? <ul><li>Alcoholic thiamine deficiency of the temporal lobe </li></ul>
  146. 146. What is clanging? <ul><li>Words that sounds alike </li></ul>
  147. 147. What is the best source of B2? <ul><li>Milk </li></ul><ul><li>Also from FAD </li></ul>
  148. 148. Why do we stop CPR after 20 minutes? <ul><li>Brain has irreversible cell injury </li></ul>
  149. 149. Is Warfarin long acting or short acting? <ul><li>Long half life, 8-10 hours to act. </li></ul>
  150. 150. What is metachromatic leukodystrophy? <ul><li>Arylsulfatase deficiency </li></ul><ul><li>Kid with MS presentation </li></ul>
  151. 151. What is circumstanciality <ul><li>Digresses, but finally gets back to the point </li></ul>
  152. 152. What are the 2 enzymes used by B12? <ul><li>Homocystine methyl transferase </li></ul><ul><li>Methyl malonyl-coA mutase </li></ul>
  153. 153. What is ALS? <ul><li>Middle age male </li></ul><ul><li>Fasiculations </li></ul><ul><li>Descending paralysis (check on this) </li></ul><ul><li>No sensory problems </li></ul>
  154. 154. What is neologisms? <ul><li>New words </li></ul>
  155. 155. Deficiency in homocysteine methyl transferase leads to…and why is that bad? <ul><li>Megaloblastic anemia </li></ul><ul><li>Need it for nucleotide synthesis! </li></ul>
  156. 156. What is word salad? <ul><li>Unrelated combination of words </li></ul>
  157. 157. How is major depression diagnosed? <ul><li>Need 5 of the “SIGE CAPS”, lasts >2 weeks </li></ul><ul><li>S leep disturbances: wake in am </li></ul><ul><li>I nterest/libido lost </li></ul><ul><li>G uilt </li></ul><ul><li>E nergy loss </li></ul><ul><li>C oncentration lost </li></ul><ul><li>A ppetite lost </li></ul><ul><li>P sychomotor agitation </li></ul><ul><li>S uicide (hopelessness) </li></ul>
  158. 158. Decarboxylation of α ketoacids requires… <ul><li>thiamine </li></ul>
  159. 159. When does the carboxylation of glutamic acid occur? What is needed? <ul><li>Used in synthesis of blood clotting factors </li></ul><ul><li>Requires vit K </li></ul>
  160. 160. What are the mitochondrial dzs? <ul><li>Leber’s – atrophy of the optic nerve </li></ul><ul><li>Leigh’s – subacute necrotizing encephalomyelopathy </li></ul>
  161. 161. What is vitamin C needed for? <ul><li>Collagen synthesis </li></ul>
  162. 162. What do you use for rapid reversal of heparin? <ul><li>Protamine sulfate </li></ul>
  163. 163. What is Guillane-Barre <ul><li>Ascending paralysis </li></ul><ul><li>2 weeks post UTI </li></ul>
  164. 164. What is the typical incidence of dz with 3 risk factors? <ul><li>90% </li></ul>
  165. 165. What are the 4 D’s of pellegra? <ul><li>Diarrhea </li></ul><ul><li>Dementia </li></ul><ul><li>Dermatitis </li></ul><ul><li>Death </li></ul><ul><li>B3 deficiency! </li></ul>
  166. 166. What is Freidrich’s ataxia? <ul><li>Retinitis pigmentosa </li></ul><ul><li>scoliosis </li></ul>
  167. 167. What is required for the conversion of methionine from homocysteine? <ul><li>B12 </li></ul>
  168. 168. What is Myasthenia gravis? <ul><li>Gets weaker as day goes </li></ul><ul><li>Stronger w/ edophonium </li></ul><ul><li>Weaker w/ EMG </li></ul><ul><li>Rule out Thymoma </li></ul>
  169. 169. What is the clue for rusty colored sputum? <ul><li>Strep pneumonia (pneumococcus) </li></ul>
  170. 170. What is Ataxia Telangectasia? <ul><li>Spider veins </li></ul><ul><li>IgA deficiency </li></ul>
  171. 171. What is the MCC of atypical pneumonia in 0-2 months? <ul><li>Chlamydia pneumonia </li></ul>
  172. 172. Can you use heparin in pregnancy? <ul><li>Yes, does not cross placenta </li></ul>
  173. 173. What needs B1 as a cofactor? <ul><li>3 DHs </li></ul><ul><li>Pyruvate DH </li></ul><ul><li>Alpha ketoglutarate DH </li></ul><ul><li>Branch chain amino acid DH </li></ul><ul><li>Transketolase </li></ul>
  174. 174. What is werdnig-Hoffman? <ul><li>Fasciculations in a newborn </li></ul><ul><li>No anterior horns </li></ul>
  175. 175. AR: how are they acquired? When does that occur? <ul><li>Almost all are inborn error of metabolism </li></ul><ul><li>Occur only when both alleles at a locus are mutant </li></ul>
  176. 176. Where is CK-MB found? <ul><li>heart </li></ul>
  177. 177. Who do you need to give B6 to? <ul><li>Pts on INH! </li></ul>
  178. 178. What symptoms does the “less likely to depolarize” state have? <ul><li>Brain: lethargy, confusion, depression </li></ul><ul><li>Skeletal M: weakness, SOB </li></ul><ul><li>SM: constipation  diarrhea </li></ul><ul><li>Cardiac: hypotension, bradycardia </li></ul>
  179. 179. What is trisomy 18? <ul><li>Edward’s </li></ul><ul><li>Rocker bottom feet </li></ul>
  180. 180. What is schizoid personality disorder? <ul><li>Recluse, don’t want to fit in </li></ul>
  181. 181. What will you see on xray with croup? What is clue symptom? <ul><li>Steeple sign </li></ul><ul><li>Barking cough </li></ul>
  182. 182. What do you get with ↓ thiamine? <ul><li>Beri Beri </li></ul><ul><li>Wet = high CO HF </li></ul><ul><li>Dry = no HF </li></ul><ul><li>Wernicke’s Encephalopathy </li></ul><ul><li>Wernicke’s Korsakoff </li></ul>
  183. 183. Mitochondrial dzs: who are affected? Who passes it on? Who has no transmission? <ul><li>All offspring affected </li></ul><ul><li>Mom passes it on </li></ul><ul><li>Dad has no transmission </li></ul>
  184. 184. What is Becker’s MD? <ul><li>Dystrophin missense </li></ul><ul><li>Sxs appear >5yo </li></ul>
  185. 185. What is PLAN F? <ul><li>T P P – Thiamine – B1 </li></ul><ul><li>L ipoic Acid – B4 </li></ul><ul><li>Co A – Pantothenic acid – B5 </li></ul><ul><li>N AD – Niacin – B3 </li></ul><ul><li>F AD – Riboflavin – B2 </li></ul>
  186. 186. Another name for Vit C? <ul><li>Ascorbic Acid </li></ul>
  187. 187. What is cystic fibrosis? <ul><li>Meconium ileus </li></ul><ul><li>Steatorrhea </li></ul><ul><li>bronchiectasis </li></ul>
  188. 188. What organs do not require insulin? <ul><li>BRICKLE </li></ul><ul><li>Brain </li></ul><ul><li>RBC </li></ul><ul><li>Intestine </li></ul><ul><li>Cardiac, cornea </li></ul><ul><li>Kidney </li></ul><ul><li>Liver </li></ul><ul><li>Exercising muscle </li></ul>
  189. 189. What do Na channel blockers do to the EKG? <ul><li>Widen QRS </li></ul>
  190. 190. What dzs have respiratory acidosis? <ul><li>Obstructive lung dz </li></ul>
  191. 191. What are the plasma catecholamines <ul><li>Epi </li></ul><ul><li>NE </li></ul><ul><li>Dopamine </li></ul>
  192. 192. What type of anemia is seen in B6 deficiency? <ul><li>sideroblastic </li></ul>
  193. 193. MCC of pneumonia 40-65 <ul><li>Strep pneumonia </li></ul><ul><li>H. influenza </li></ul><ul><li>anaerobes </li></ul>
  194. 194. What are the periods of rapid growth (rapid dividing cells) <ul><li>Birth-2 months </li></ul><ul><li>4-7 years </li></ul><ul><li>puberty </li></ul>
  195. 195. What is Ca+ needed for? <ul><li>Muscle contraction </li></ul><ul><li>Axonal transport </li></ul><ul><li>2 nd messenger </li></ul>
  196. 196. Inflammation: What happens at 24 hours? <ul><li>Neutrophils show up </li></ul>
  197. 197. What dzs have trinucleotide repeats? <ul><li>Huntington’s </li></ul><ul><li>Fragile X </li></ul><ul><li>Myotonic Dystrophy </li></ul><ul><li>Friedreich’s ataxia </li></ul>
  198. 198. What is required for the degradation of cystathionine? <ul><li>Vitamin B6 </li></ul>
  199. 199. What is the clue for Wilson’s dz? <ul><li>Hepato/lenticular degeneration </li></ul><ul><ul><li>hepato = liver </li></ul></ul><ul><ul><li>lenticular = basal ganglia (putamen and globus pallidus) </li></ul></ul><ul><li>Kayser Fleishner rings </li></ul><ul><li>Ceruloplasmin deficiency </li></ul>
  200. 200. Name some causes for a widened S2 split <ul><li>Blood transfusion </li></ul><ul><li>↑ tidal volume </li></ul><ul><li>Giving oxygen </li></ul><ul><li>R sided heart failure </li></ul><ul><li>Pregnancy </li></ul><ul><li>IV fluids </li></ul><ul><li>ASD/VSD </li></ul><ul><li>Deep breathing </li></ul><ul><li>Hypernatremia </li></ul><ul><li>SIADH </li></ul><ul><li>Pulmonary regurg </li></ul><ul><li>Pulmonary stenosis </li></ul><ul><li>RBBB </li></ul>
  201. 201. What are the 5 hormones produced by small cell (oat cell) lung CA <ul><li>ACTH </li></ul><ul><li>ADH </li></ul><ul><li>PTH </li></ul><ul><li>TSH </li></ul><ul><li>ANP </li></ul>
  202. 202. What will you see on xray with epiglotitis? What is key symptom? <ul><li>Thumb sign on xray </li></ul><ul><li>drooling </li></ul>
  203. 203. What is Turners? <ul><li>XO </li></ul><ul><li>Web neck </li></ul><ul><li>Cystic hygroma </li></ul><ul><li>Shield chest </li></ul><ul><li>Coarctation of aorta </li></ul><ul><li>Rib notching </li></ul>
  204. 204. When is angular stomatitis seen? <ul><li>B2 deficiency </li></ul>
  205. 205. What organ needs tin? <ul><li>hair </li></ul>
  206. 206. What is the clue for NO? <ul><li>Nitrates </li></ul><ul><li>Viagra </li></ul><ul><li>ANP </li></ul><ul><li>LPS </li></ul>
  207. 207. What is function? What if lesioned? Where enter/exit cranium? What does it innervate? CN II <ul><li>Optic </li></ul><ul><li>Sensory for sight </li></ul><ul><li>Anopsia if lesioned (visual field defect) </li></ul><ul><li>Loss of light reflex with CN III </li></ul><ul><li>Only nerve affected by MS </li></ul><ul><li>Exit/Enter via optic canal </li></ul><ul><li>Innervates the orbit </li></ul>
  208. 208. What do you measure for carcinoid syndrome <ul><li>Serotonin </li></ul><ul><li>5-HIAA </li></ul>
  209. 209. What metabolizes fat soluble drugs? <ul><li>liver </li></ul>
  210. 210. What is Bipolar II <ul><li>Depression with Hypomania (no psychosis) </li></ul>
  211. 211. What dz do you get if you have too much Cu? <ul><li>Wilson’s dz </li></ul>
  212. 212. What is tracheitis? <ul><li>Look toxic </li></ul><ul><li>Grey pseudomembrane </li></ul><ul><li>leukocytosis </li></ul>
  213. 213. Where enter/exit cranium? What does it innervate? CN IV <ul><li>Superior orbital fissure </li></ul><ul><li>Innervates the orbit </li></ul>
  214. 214. Where enter/exit cranium? What does it innervate? CN III <ul><li>Superior orbital fissure </li></ul><ul><li>Innervates the orbit </li></ul>
  215. 215. What is Vitamin E needed for? <ul><li>Hair </li></ul><ul><li>Skin </li></ul><ul><li>Eyes </li></ul><ul><li>Protect against free radicals </li></ul><ul><li>#1 antioxidant </li></ul>
  216. 216. What drugs cause pulmonary eosinophilia? <ul><li>Nitrofurantoin </li></ul><ul><li>sulfonamides </li></ul>
  217. 217. What is Mg a cofactor for? <ul><li>All kinases </li></ul><ul><li>Also, for the parathyroid (along with vit A) </li></ul>
  218. 218. What does CN IX innervate? <ul><li>Neck </li></ul><ul><li>Pharynx/tongue </li></ul>
  219. 219. What is stable angina? <ul><li>Pain with exertion (atherosclerosis) </li></ul>
  220. 220. MCC of pneumonia in the elderly <ul><li>Strep pneumonia </li></ul><ul><li>Viruses </li></ul><ul><li>Anaerobes </li></ul><ul><li>H. influenza </li></ul><ul><li>G- rods </li></ul>
  221. 221. What are the most common symptoms of the low energy state? <ul><li>Weakness and SOB </li></ul>
  222. 222. What is CN VIII? What is it’s function? <ul><li>Vestibulocochlear </li></ul><ul><li>Sensory function </li></ul><ul><li>Hearing </li></ul><ul><li>Linear acceleration (gravity) </li></ul><ul><li>Angular acceleration (head turning) </li></ul>
  223. 223. What will happen if V3 is lesioned? <ul><li>Loss of general sensation in skin over mandible, mandibular teeth, tongue, weakness in chewing </li></ul>
  224. 224. CN V1: what does it innervate? Where does it enter/exit the cranium? <ul><li>Innervates orbit and scalp </li></ul><ul><li>Exit/enters at superior orbital fissure (ophthalmic division) </li></ul>
  225. 225. What does Vit D do with Ca+ <ul><li>Controls Ca+ </li></ul><ul><li>Absorbs Ca+ from GI </li></ul><ul><li>Reabsorbs Ca+ in kidneys </li></ul><ul><li>Controls osteoblastic activity </li></ul>
  226. 226. What is hyaluronic acid? <ul><li>Glycosaminoglycan chain that helps form proteoglycans </li></ul>
  227. 227. What does the foramen spinosum contain? <ul><li>Middle meningeal artery </li></ul><ul><ul><li>Branch of the maxillary artery </li></ul></ul>
  228. 228. What is bronchiectasis <ul><li>Bad breath </li></ul><ul><li>Purulent sputum </li></ul><ul><li>Hemoptysis </li></ul><ul><li>Dissolving the alveoli by bacteria </li></ul>
  229. 229. What are the toxicities of Warfarin? <ul><li>Bleeding </li></ul><ul><li>Teratogenic </li></ul><ul><li>Drug-drug interactions </li></ul>
  230. 230. CF: what test is used to detect CF? what is nl value? Abnl value? Heterozygous value? <ul><li>Pilocarpine sweat test </li></ul><ul><li>Measures Cl- </li></ul><ul><li>test value of >60 indicates presence of dz </li></ul><ul><li>Nl test value is <20 </li></ul><ul><li>Heterozygous person is 30-60 </li></ul>
  231. 231. What ion corresponds with: T wave? U wave? <ul><li>K </li></ul><ul><li>Na </li></ul>
  232. 232. What are the most common signs of the low energy state? <ul><li>Tachypnea and dyspnea </li></ul>
  233. 233. What is Trousseau’s sign? <ul><li>BP check causes carpal spasm  migratory thrombophlebitis </li></ul>
  234. 234. What happens if X is lesioned? <ul><li>Nasal speech </li></ul><ul><li>Nasal regurgitation </li></ul><ul><li>Dysphagia </li></ul><ul><li>Palate drop </li></ul><ul><li>Uvula points AWAY from pathology </li></ul><ul><li>Hoarseness/fixed vocl cord </li></ul><ul><li>Loss of gag reflex (with IX) </li></ul><ul><li>Loss of cough reflex </li></ul>
  235. 235. What is Prinzmetal’s angina? <ul><li>Intermittent pain (coronary artery spasm) </li></ul>
  236. 236. What is dysthymia? <ul><li>Low level sadness >2 yrs </li></ul><ul><li>“ Eor” </li></ul>
  237. 237. MCC of pneumonia in 6 wks to 18 years? <ul><li>RSV (infants only) </li></ul><ul><li>Mycoplasma </li></ul><ul><li>Chlamydia pneumonia </li></ul><ul><li>Strep pneumonia </li></ul>
  238. 238. What is B4? <ul><li>Lipoic Acid </li></ul><ul><li>No problems with deficiency </li></ul>
  239. 239. When does Physis disappear? <ul><li>Once growth is complete </li></ul>
  240. 240. What is Pellagra? <ul><li>Niacin deficiency </li></ul><ul><li>Dermatitis </li></ul><ul><li>Diarrhea </li></ul><ul><li>Dementia </li></ul><ul><li>Death </li></ul>
  241. 241. What is sinusitis symptom? <ul><li>Teeth pain worse with bending forward </li></ul>
  242. 242. What are the clues for asthma? <ul><li>Wheeze on expiration </li></ul><ul><li>IgE </li></ul><ul><li>eosinophils </li></ul>
  243. 243. What metabolizes Water soluble drugs? <ul><li>kidney </li></ul>
  244. 244. Where do you fine: janeway lesions <ul><li>toes </li></ul>
  245. 245. What are drugs that blast the BM? <ul><li>V inblastine A nilate B one C ells </li></ul><ul><li>V inblastine </li></ul><ul><li>A ZT </li></ul><ul><li>B enzene </li></ul><ul><li>C hloramphenicol </li></ul>
  246. 246. What things make the membrane LESS likely to depolarize? <ul><li>HypOKalemia </li></ul><ul><li>Hypermagnesemia </li></ul><ul><li>Hypercalcemia (except atrium) </li></ul><ul><li>Hypernatremia </li></ul>
  247. 247. What is CN XI? What is it’s function? <ul><li>Accessory </li></ul><ul><li>Functions to </li></ul><ul><ul><li>Turn head to opposite side (sternocleidomastoid) </li></ul></ul><ul><ul><li>Elevate and rotate scapula (trapezius) </li></ul></ul>
  248. 248. What originates from the myerencephalon? <ul><li>Medulla </li></ul>
  249. 249. Where does V3 enter/exit cranium? What does it innervate? <ul><li>Foramen ovale </li></ul><ul><li>Infratemporal fossa </li></ul>
  250. 250. What is a characteristic feature of cancellous (spongy) bone? <ul><li>trabeculae </li></ul>
  251. 251. What is XXX syndrome? <ul><li>47 XXX </li></ul><ul><li>Nl female </li></ul><ul><li>Two barr bodies </li></ul>
  252. 252. What dz corresponds with this inclusion body… <ul><li>Barr body </li></ul><ul><li>Nl female </li></ul>
  253. 253. What cyanotic heart dz is boot shaped? <ul><li>Tetrology of fallot </li></ul>
  254. 254. What is Korsakoff psychosis? <ul><li>Alcoholic thiamine deficiency </li></ul>
  255. 255. What is vitamin C deficiency? <ul><li>Scurvy! </li></ul>
  256. 256. What does Vit D deficiency cause? <ul><li>Kids = Ricketts </li></ul><ul><li>Adults = osteomalacia </li></ul>
  257. 257. What does Vit A deficiency cause? <ul><li>Nightvision problems (night blindness) </li></ul><ul><li>Hypoparathyroidism  ↓Ca, ↑Phosphate </li></ul>
  258. 258. What is delusion <ul><li>One falsely held belief </li></ul>
  259. 259. What is a paranoid personality disorder? <ul><li>Suspicious about everybody, use projection </li></ul>
  260. 260. What is the clue for cAMP <ul><li>It is the 90% </li></ul><ul><li>Sympathetic </li></ul><ul><li>CRH (cortisol) </li></ul><ul><li>Catabolic </li></ul>
  261. 261. What CN senses smelling? <ul><li>CN I </li></ul>
  262. 262. What is CN VI? What is it’s function? <ul><li>Abducens nerve </li></ul><ul><li>Motor function </li></ul><ul><li>Lateral rectus  abducts eye </li></ul>
  263. 263. What is CN X? What is it’s function? <ul><li>Vagus </li></ul><ul><li>Mixed function </li></ul><ul><li>Muscles of palate and pharynx for swallowing EXCEPT tensor palate (V) and stylopharyngeus (IX) </li></ul><ul><li>All muscles of larynx (phonates) </li></ul><ul><li>Senses larynx and laryngopharynx </li></ul><ul><li>Senses Larynx and GI tract </li></ul><ul><li>To GI tract smooth muscles and glands in foregut and midgut </li></ul>
  264. 264. What is laryngomalacia? <ul><li>Epiglottis rolls in from side-to-side </li></ul>
  265. 265. Newborn meningitis is caused by <ul><li>Group B strep (agalactiae) </li></ul><ul><li>E. coli </li></ul><ul><li>Listeria </li></ul>
  266. 266. Inflammation: what happens at 3-6 months? <ul><li>Fibroblasts are gone </li></ul>
  267. 267. Where are the T-tubules located? <ul><li>Cardiac muscle: Z line </li></ul><ul><li>Skeletal muscle: A-I junction </li></ul>
  268. 268. What pathway does heparin affect? What should you follow? <ul><li>Intrinsic pathway </li></ul><ul><li>Follow the PTT </li></ul>
  269. 269. What drugs dilate veins and arteries? <ul><li>ACE inhibitors </li></ul><ul><li>Nitrates </li></ul>
  270. 270. What does Zinc do? <ul><li>Taste buds </li></ul><ul><li>Hair </li></ul><ul><li>Sperm function </li></ul>
  271. 271. What is Kwashiorkor? <ul><li>Malabsorption </li></ul><ul><li>Big belly (ascites) </li></ul><ul><li>Protein deficiency </li></ul>
  272. 272. What is a nonunion fracture <ul><li>Fracture that does not heal within 6 months </li></ul>
  273. 273. What are THF derivatives used in? <ul><li>Purine nucleotide synthesis </li></ul><ul><li>Methylation of dUMP  dTMP </li></ul>
  274. 274. What are the 3 low volume states with acidosis rather than alkalosis <ul><li>RTA </li></ul><ul><li>Diarrhea </li></ul><ul><li>DKA </li></ul>
  275. 275. What are the cells of neural crest origin <ul><li>Parafollicular cells of thyroid </li></ul><ul><li>Odontoblasts (predentin) </li></ul><ul><li>Pseudounipolar cells </li></ul><ul><li>Spiral membrane of heart </li></ul><ul><li>Chromaffin cells </li></ul><ul><li>All ganglion cells (schwann, adrenal medulla) </li></ul><ul><li>Melanocytes </li></ul><ul><li>Laryngeal/tracheal cartilage </li></ul>
  276. 276. What must you rule out with ↓ AVO2? <ul><li>AV fistula </li></ul><ul><li>vasodilation </li></ul>
  277. 277. Where does the mannose-6-P send stuff to? <ul><li>lysosome </li></ul>
  278. 278. What is the clinical use of warfarin? <ul><li>Chronic anticoagulation </li></ul>
  279. 279. What is Marasmus? <ul><li>Starvation </li></ul><ul><li>Skinny </li></ul><ul><li>Calorie deficiency </li></ul>
  280. 280. What is another name for sertoli cells <ul><li>Sustentacular cells </li></ul>
  281. 281. What are the different types of emphysema and their causes <ul><li>Bullous: s. aureus, pseudomonas </li></ul><ul><li>Centroacinar: smoking </li></ul><ul><li>Distalacinar: aging </li></ul><ul><li>Panacinar: α-1-antitrypsin def </li></ul>
  282. 282. How is heparin activated? <ul><li>By the blood </li></ul>
  283. 283. What is the clue for Ca:Calmodulin <ul><li>Used by smooth muscle for contraction by distention </li></ul>
  284. 284. What is the function of CN V3? <ul><li>Mixed function </li></ul><ul><li>General sensation of anterior 2/3 of tongue, mandibular face and mandibular teeth </li></ul><ul><li>Motor: muscles of mastication and anterior belly of digastric, mylohyoid, tensor tympani, tensor palatine </li></ul>
  285. 285. What is B6? <ul><li>Pyridoxine </li></ul>
  286. 286. What is variable expression? <ul><li>Phenotype is different in different individuals with the same gene </li></ul>
  287. 287. What things make the membrane MORE likely to depolarize? <ul><li>Hyperkalemia </li></ul><ul><li>HypOMagnesia </li></ul><ul><li>HypOCalcemia (except atrium) </li></ul><ul><li>HypONatremia </li></ul>
  288. 288. Where does the Pre label send stuff to? <ul><li>ER </li></ul>
  289. 289. What type of acidosis do you see with obstructive pulmonary dz? <ul><li>Respiratory acidosis </li></ul>
  290. 290. What is tracheomalacia? <ul><li>Soft cartilage </li></ul><ul><li>Stridor since birth </li></ul>
  291. 291. What is CN IX? What is it’s function? <ul><li>Glossopharyngeal </li></ul><ul><li>Mixed function </li></ul><ul><li>Sense pharynx </li></ul><ul><li>Carotid sinus/body </li></ul><ul><li>Salivates (parotid glands) </li></ul><ul><li>Tastes and senses posterior 1/3 of tongue </li></ul>
  292. 292. What CN has sensory fibers for Face and motor fibers for muscles of mastication? <ul><li>CN V </li></ul>
  293. 293. What originates from the hindbrain? <ul><li>Metencephalon </li></ul><ul><li>myerencephalon </li></ul>
  294. 294. What tracts are affected by a deficiency in methyl malonyl coA mutase? <ul><li>Dorsal columns </li></ul><ul><li>Cortical spinal tracts </li></ul><ul><li>Affected because they are the longest and need the most myelin </li></ul>
  295. 295. What is Bipolar I? <ul><li>Depression with Mania (psychosis) </li></ul>
  296. 296. What is CN V called <ul><li>Facial </li></ul>
  297. 297. What is CN VII? What is it’s function? <ul><li>Facial </li></ul><ul><li>Mixed function (motor and sensory) </li></ul><ul><li>Muscles of facial expression </li></ul><ul><li>Posterior belly of diagastric </li></ul><ul><li>Stylohyoid and stapedius </li></ul><ul><li>Taste anterior 2/3 of tongue/palate </li></ul><ul><li>Salivates (submandibular and sublingual glands) </li></ul><ul><li>Tears (lacrimal glands) </li></ul><ul><li>Mucous (nasal and palatine glands) </li></ul>
  298. 298. What are physical signs of B2 deficiency <ul><li>Angular stomatitis </li></ul><ul><li>Angular cheliosis </li></ul><ul><li>Corneal neurovascularizations </li></ul>
  299. 299. Which CNs control eye movement? <ul><li>CN III </li></ul><ul><li>CN IV </li></ul><ul><li>CN VI </li></ul>
  300. 300. What are the toxicities of Heparin? <ul><li>Bleeding </li></ul><ul><li>Thrombocytopenia </li></ul><ul><li>Drug-drug interactions </li></ul>
  301. 301. 6 hormones produced by the placenta <ul><li>hCG </li></ul><ul><li>Inhibin </li></ul><ul><li>Human Placental lactogen (HPL) </li></ul><ul><li>Oxytocin (drug lactation, pit gland produces it also) </li></ul><ul><li>Progesterone </li></ul><ul><li>Estrogen </li></ul><ul><li>Relaxin </li></ul>
  302. 302. What is the MOA of heparin? <ul><li>Catalyzes the activation of antithrombin III </li></ul><ul><li>Decreases thrombin and Xa </li></ul>
  303. 303. Most common cause of death in the low energy state? <ul><li>Heart failure </li></ul>
  304. 304. On an EKG, U wave means… <ul><li>Ventricle resetting </li></ul><ul><li>Phase 4 </li></ul><ul><li>sodium </li></ul>
  305. 305. What originates from the diencephalon? <ul><li>Thalamus </li></ul><ul><li>3 rd ventricle </li></ul>
  306. 306. What are the trace elements? <ul><li>Chromium </li></ul><ul><li>Selenium </li></ul><ul><li>Tin </li></ul><ul><li>Manganese </li></ul>
  307. 307. Is heparin long acting or short acting? <ul><li>Short half life </li></ul><ul><li>Starts acting immediately </li></ul>
  308. 308. What is Hartnup’s? <ul><li>No tryptophan  Niacin + serotonin </li></ul><ul><li>Presents like pellagra </li></ul><ul><li>Can mimic corn-rich diet </li></ul>
  309. 309. What are signs of tamponade <ul><li>↓ breath sounds </li></ul><ul><li>↓ BP </li></ul><ul><li>↑ JVD </li></ul>
  310. 310. On an EKG, PR interval means… <ul><li>AV node (the pause) </li></ul><ul><li>Phase 2 </li></ul><ul><li>sodium </li></ul>
  311. 311. What is function of CN III <ul><li>Oculomotor </li></ul><ul><li>Moves eyeball in all directions </li></ul><ul><li>Adduction most important action </li></ul><ul><li>Constricts the pupil (sphincter pupillae) </li></ul><ul><li>Accomodation (ciliary muscle) </li></ul><ul><li>Raises eyelid (levator palpebrae) </li></ul>
  312. 312. Who is affected in the family with an x-linked dz <ul><li>Maternal grandfather </li></ul><ul><li>Maternal uncles </li></ul>
  313. 313. What does calcium do? <ul><li>Neuronal function </li></ul><ul><li>Atria depolarization </li></ul><ul><li>Smooth m contractility </li></ul>
  314. 314. What vitamin is deficient with pernicious anemia and has a neuropathy? <ul><li>B12 </li></ul>
  315. 315. What are the different branches of CN V? <ul><li>V1 = opthalmic </li></ul><ul><li>V2 = maxillary </li></ul><ul><li>V3 = mandibular </li></ul>
  316. 316. Inflammation: what happens in 1 month? <ul><li>Fibroblasts peak </li></ul>
  317. 317. What is Nihilism? <ul><li>The world has stopped! </li></ul>
  318. 318. Inflammation: what happens on day 4? <ul><li>T cells and macrophages show up </li></ul>
  319. 319. What needs B6 as a cofactor? <ul><li>All transaminases! </li></ul>
  320. 320. What does the optic canal contain? <ul><li>Opthalmic artery </li></ul><ul><li>Central retinal vein </li></ul><ul><li>CN II </li></ul>
  321. 321. What are the risk factors for lung cancer? <ul><li>Smoking </li></ul><ul><li>Radon </li></ul><ul><li>2 nd hand smoke </li></ul><ul><li>Pneumoconiosis (except anthracosis) </li></ul>
  322. 322. What is MS? <ul><li>Anti-myelin Ab </li></ul><ul><li>Middle aged female with vision problems </li></ul>
  323. 323. What is myasthenia gravis? <ul><li>Anti-AChr Ab </li></ul><ul><li>Female w/ ptosis </li></ul><ul><li>Weaker as the day goes on </li></ul>
  324. 324. What is IP3/DAG used by and for? <ul><li>Smooth muscle for contraction </li></ul>
  325. 325. What is XYY syndrome? <ul><li>47 XYY </li></ul><ul><li>Tall aggressive male </li></ul>
  326. 326. What dzs do we screen for at birth? <ul><li>Please Check Before Going Home </li></ul><ul><li>PKU </li></ul><ul><li>CAH </li></ul><ul><li>Biotinidase </li></ul><ul><li>Galactosemia </li></ul><ul><li>Hypothyroidism </li></ul>
  327. 327. When is warfarin absolutely contraindicated? <ul><li>Pregnancy, because it can cross the placenta </li></ul>
  328. 328. What CN controls tongue movement? <ul><li>CN XII </li></ul>
  329. 329. What is Choreoathetosis? <ul><li>Dance like movements </li></ul><ul><li>Wringing of hands </li></ul><ul><li>Quivering voice </li></ul>
  330. 330. What is the most common cause of B12 deficiency? <ul><li>Pernicious Anemia </li></ul>
  331. 331. What are the macrocytic anemias? <ul><li>B12 </li></ul><ul><li>Folate </li></ul><ul><li>Reticulocytosis </li></ul><ul><li>EtOH </li></ul><ul><li>Hemolytic anemias </li></ul><ul><li>Chemo </li></ul><ul><li>Anticonvulsants </li></ul><ul><li>myelodysplasia </li></ul>
  332. 332. What disease manifest with Cu deficiency? <ul><li>Minky kinky hair syndrome </li></ul>
  333. 333. What are the x linked dominant diseases? <ul><li>Na-resistant rickets (kidney leaks phosphorus), waddling gait </li></ul><ul><li>Pseudohypoparathyroidism: sausage digits, osteodystrophy </li></ul>
  334. 334. What are the most common causes of meningitis in: 2 months – 10 years <ul><li>#1 – strep pneumonia </li></ul><ul><li>#2 – neisseria meningitidis </li></ul>
  335. 335. What does the posterior condylar canal contain? <ul><li>Large emissary vein </li></ul>
  336. 336. What part of the brain deals with problem solving? <ul><li>Frontal lobe </li></ul>
  337. 337. What is polio? <ul><li>Child </li></ul><ul><li>Asymmetrical fasiculations </li></ul><ul><li>2 weeks after gastroenteritis </li></ul>
  338. 338. On an EKG, R means… <ul><li>Anterior wall of ventricles </li></ul><ul><li>Phase 0 </li></ul><ul><li>Sodium </li></ul>
  339. 339. What is penetrance? <ul><li>The % of people who have the gene that also exhibit the phenotype. </li></ul><ul><li>If they have the gene but not the dz  ↓ penetrance </li></ul>
  340. 340. What are the clues for epiglottitis? What is the MCC? <ul><li>Stridor </li></ul><ul><li>Fever </li></ul><ul><li>Thumb sign on xray </li></ul><ul><li>MCC = H. influenza type B </li></ul>
  341. 341. What are the causes of eosinophilia <ul><li>Neoplasms </li></ul><ul><li>Allergies/asthma </li></ul><ul><li>Addison’s dz </li></ul><ul><li>Collagen vascular dz </li></ul><ul><li>parasites </li></ul>
  342. 342. What are the vit K dependent clotting factors? Shortest ½ lives? <ul><li>2,7,9,10 </li></ul><ul><li>Protein C and S </li></ul><ul><li>Protein C has shortest ½ life: 6 hours </li></ul><ul><li>Protein 7 has next shortest: 2 days </li></ul>
  343. 343. What is the max heart rate (for anybody…) <ul><li>220-age </li></ul>
  344. 344. What is function? What if lesioned? Where enter/exit cranium? What does it innervate? CN I <ul><li>Olfactory </li></ul><ul><li>Sensory for smell </li></ul><ul><li>Anosmia if lesioned </li></ul><ul><li>Enter/exit cribriform plate </li></ul><ul><li>Innervates nasal cavity </li></ul>
  345. 345. What are the only 3 pansystolic murmurs and when are they heard? <ul><li>MR – ↓ on insp, ↑ on exp </li></ul><ul><li>TR - ↑ on insp, ↓ on exp </li></ul><ul><li>VSD - ↓ on insp ↑ on exp </li></ul>
  346. 346. What does chlamydia pneumonia cause? <ul><li>Interstitial pneumonia </li></ul>
  347. 347. What is the only cause of ICP that does not cause herniation? <ul><li>Pseudotumor cerebri </li></ul>
  348. 348. What originates from the telencephalon? <ul><li>Cerebral hemispheres </li></ul><ul><li>Lateral ventricles </li></ul>
  349. 349. What are the vitamins from the GI that are nl flora? <ul><li>Folate </li></ul><ul><li>Vit K </li></ul><ul><li>Biotin </li></ul><ul><li>Panothenic acid </li></ul><ul><li>Helps with absorption of B12 </li></ul>
  350. 350. What if lesioned? CN IV <ul><li>Weakness looking down with adducted eye </li></ul><ul><li>Trouble going down stairs </li></ul><ul><li>Head tilts away from lesioned side </li></ul>
  351. 351. CN V2: where does it enter/exit the cranium? What does it innervate? <ul><li>Exit enter: foramen rotundum </li></ul><ul><li>Innervates pterygopalatine (leaves by openings to face, oral and nasal cavity) </li></ul>
  352. 352. If pt has a visual field defect with cognitive disturbance? What part of the brain will be affected? <ul><li>Temporal or parietal lobe </li></ul>
  353. 353. How is warfarin administered? <ul><li>PO </li></ul>
  354. 354. On an EKG, S means… <ul><li>Posterior wall </li></ul><ul><li>Phase 0 </li></ul><ul><li>sodium </li></ul>
  355. 355. What enzyme does Zanthein Oxidase need? <ul><li>Maganese </li></ul>
  356. 356. What happens if the sympathetic part of CN X is lesioned? What do we call this? <ul><li>Eyelid droop (ptosis) </li></ul><ul><li>Constricted pupis (miosis) </li></ul><ul><li>Loss of sweating (anhydrosis) </li></ul><ul><li>Flushed face </li></ul><ul><li>Called: Horners syndrome </li></ul>
  357. 357. What is good about new LMWH? <ul><li>Act more on Xa </li></ul><ul><li>Have better bioavailability </li></ul><ul><li>2-4 times longer half life </li></ul><ul><li>Can be administered subQ and don’t need lab monitoring </li></ul>
  358. 358. Where does the Pro label send stuff to? <ul><li>golgi </li></ul>
  359. 359. What is the dosage for streptokinase (push and drip) <ul><li>750K IV push </li></ul><ul><li>750K drip </li></ul>
  360. 360. Where do you find Small cell CA? what are other features <ul><li>Most common at carina </li></ul><ul><li>Malignant </li></ul><ul><li>Cushing’s </li></ul><ul><li>SIADH </li></ul><ul><li>SVC syndrome </li></ul>
  361. 361. What is the triad of carcinoid syndrome <ul><li>Flushing </li></ul><ul><li>Wheezing </li></ul><ul><li>diarrhea </li></ul>
  362. 362. What is the dosage of tPA? (push and drip) <ul><li>20 mg IV push </li></ul><ul><li>40 mg drip </li></ul>
  363. 363. How does a neurogenic muscle dz present? <ul><li>Distal weakness and fasiculations </li></ul>
  364. 364. What is the first vitamin to run out with dz of rapidly dividing cells? <ul><li>Folate </li></ul>
  365. 365. What does hyperresonance tell you <ul><li>Air in lungs </li></ul>
  366. 366. What does it mean to see a physis on radiograph? <ul><li>Means the skeleton is not fully mature </li></ul>
  367. 367. What are the causes of croup and bronchiolities <ul><li>Parainfluenza </li></ul><ul><li>Adenovirus </li></ul><ul><li>Influenza </li></ul><ul><li>RSV </li></ul>
  368. 368. What are the clues to scurvy? <ul><li>Bleeding gums </li></ul><ul><li>Bleeding hair follicles </li></ul>
  369. 369. Inflammation: What happens at day 3? <ul><li>Neutrophils peak </li></ul>
  370. 370. What happens if VII is lesioned <ul><li>Corner of mouth droops </li></ul><ul><li>Can’t close eye </li></ul><ul><li>Can’t wrinkle forehead </li></ul><ul><li>Loss of blink reflex </li></ul><ul><li>Hypeacusis </li></ul><ul><li>Loss or alteration of taste (ageusia or dysgusia) </li></ul><ul><li>Eyes dry and red </li></ul>
  371. 371. What are the clinical uses of heparin? <ul><li>Immediate anticoagulation of pulmonary embolism, stroke, angina, MI, DVT </li></ul>
  372. 372. Who gets asbestosis <ul><li>Shipyard workers </li></ul><ul><li>Pipe fitters </li></ul><ul><li>Brake mechanics </li></ul><ul><li>Insulation installers </li></ul>
  373. 373. What is the MOA of Warfarin? <ul><li>Interferes with nl synthesis and γ carboxylation of Vit K dependent clotting factors via Vit K antagonism </li></ul>
  374. 374. How do you detect pulmonary embolus? <ul><li>Tachypnea </li></ul><ul><li>↑ V/Q scan </li></ul><ul><li>EKG: S1 Q3 T3 </li></ul>
  375. 375. Pyruvate decarboxylase requires what as a cofactor? <ul><li>thiamine </li></ul>
  376. 376. What is B3 called? <ul><li>Niacin </li></ul>
  377. 377. What does the hydroxylation of purines require? <ul><li>Vitamin C </li></ul>
  378. 378. Where does CN X enter/exit cranium? What does it innervate? <ul><li>Exits jugular foramen </li></ul><ul><li>Innervates </li></ul><ul><ul><li>Neck </li></ul></ul><ul><ul><li>Pharynx/larynx </li></ul></ul><ul><ul><li>Thorax/abdomen </li></ul></ul>
  379. 379. What is B2 called? <ul><li>Riboflavin </li></ul>
  380. 380. What type of receptors do all sphincters in the body have? <ul><li>alpha-receptors </li></ul>
  381. 381. What does warfarin do to the PT? <ul><li>Prolongs it </li></ul>
  382. 382. On an EKG, T wave means… <ul><li>Ventricle repolarization </li></ul><ul><li>Phase 3 </li></ul><ul><li>K </li></ul>
  383. 383. What happens if you lesion CN XI? Where does it enter/exit crainum? What does it innervate? <ul><li>Lesioned: </li></ul><ul><ul><li>Weakness turning head to opposite side </li></ul></ul><ul><ul><li>Shoulder droop </li></ul></ul><ul><li>Enters via Jugular foramen </li></ul><ul><li>Innervates the neck </li></ul>
  384. 384. Cofactor for all kinases? <ul><li>Magnesium </li></ul>
  385. 385. Cystic Fibrosis: What is the treatment? <ul><li>Pilocarpine (which is also used for glaucoma) </li></ul>
  386. 386. What dzs have metabolic alkalosis <ul><li>Low volume states </li></ul><ul><li>Vomiting </li></ul><ul><li>Diuretics </li></ul><ul><li>GI blood loss </li></ul>
  387. 387. What does the foramen ovale contain? <ul><li>CN V3 </li></ul>
  388. 388. AD: where is the new mutation? When is the onset? <ul><li>New mutation is often in germ cells of older fathers </li></ul><ul><li>Onset is often delayed (ex. Huntingtons) </li></ul>
  389. 389. What if lesioned? CN III <ul><li>Diplopia </li></ul><ul><li>Loss of parallel gaze </li></ul><ul><li>Dilated pupil </li></ul><ul><li>Loss of light reflex </li></ul><ul><li>Loss of near response </li></ul><ul><li>ptosis </li></ul>
  390. 390. What are the clues for IP3/DAG <ul><li>Neurotransmitter </li></ul><ul><li>GHRH </li></ul><ul><li>All hypothalamic hormones except cortisol </li></ul>
  391. 391. What does the foramen magnum contain? <ul><li>Vertebral arteries </li></ul><ul><li>Brain stem </li></ul><ul><li>Spinal roots of CN XI </li></ul><ul><li>Spinal cord </li></ul>
  392. 392. What do you need to know about large cell CA? <ul><li>Large cells! </li></ul>
  393. 393. What is the function of CN V1? If lesioned? <ul><li>Mixed function </li></ul><ul><li>General sensation (touch, pain, temp) of forehead, scalp and cornea </li></ul><ul><li>If lesioned: </li></ul><ul><li>Loss of general sensation of the forehead/scalp </li></ul><ul><li>Loss of blink reflex w/ VII </li></ul>
  394. 394. What are the most common causes of meningitis corresponding with >21 yo? <ul><li>N. meningitidis </li></ul>
  395. 395. Where does CN XII enter/exit the cranium? What does it innervate? <ul><li>Hypoglossal canal </li></ul><ul><li>tongue </li></ul>
  396. 396. What are the mitochondrial dzs? <ul><li>Leigh’s (progressively ↓ IQ, seizure, ataxia, deficiency of cytochrome oxidase) </li></ul><ul><li>Leber’s Hereditary optic atrophy </li></ul>
  397. 397. What symptoms does the “more likely to depolarize state” have <ul><li>Brain: psychosis, seizures, jitteriness </li></ul><ul><li>Skeletal muscle: spasms, tetany </li></ul><ul><li>SM: diarrhea  constipation </li></ul><ul><li>Cardiac: tachycardia, arrhythmias </li></ul>
  398. 398. What gives you differential pulses? <ul><li>coarctation </li></ul>
  399. 399. What is schizotypal personality disorder? <ul><li>Magical thinking, bizarre behavior </li></ul>
  400. 400. Too much Vit A will cause… <ul><li>Hyperparathyroid  ↑Ca, ↓Phosphate </li></ul><ul><li>Moans and Groans (pancreatitis) </li></ul><ul><li>Bones (PTH munches bones) </li></ul><ul><li>Stones </li></ul><ul><li>Pseudotumor cerebri (↑ CSF production from chorichoid plexus) </li></ul>
  401. 401. What is the deficiency caused by this vitamin(B12)? What deficiency causes it? <ul><li>Neuropathy </li></ul><ul><li>Pernicious anemia </li></ul>
  402. 402. What streptococcus causes SBE? <ul><li>viridans </li></ul>
  403. 403. Facts about diphtheria <ul><li>ADP ribosylates EF-2 </li></ul><ul><li>Stops cell synthesis </li></ul><ul><li>G+ </li></ul><ul><li>Gets exotoxin from virus via transduction </li></ul><ul><li>Heart block </li></ul><ul><li>Its toxoid therefore give antitoxin </li></ul>
  404. 404. Clue for Ricketts? <ul><li>Lateral bowing of the legs </li></ul><ul><li>X linked dominant </li></ul>
  405. 405. What causes a neuropathy when deficient and also needed for transaminase? <ul><li>B6 </li></ul>
  406. 406. What systems does mitochondrial inheritance affect? Why does it affect these? <ul><li>CNS </li></ul><ul><li>Heart </li></ul><ul><li>Skeletal muscles </li></ul><ul><li>These have uneven cytokinesis during meiosis or oogenesis </li></ul>
  407. 407. Who gets byssinosis <ul><li>Cotton workers </li></ul>
  408. 408. What happens if CN VIII is lesioned? Where does it enter/exit cranium? What does it innervate? <ul><li>Lesion = loss of balance, nystagmus </li></ul><ul><li>Enters in the internal auditory meatus </li></ul><ul><li>Innervates the inner ear </li></ul>
  409. 409. How is warfarin activated? <ul><li>Tissue activated </li></ul>
  410. 410. What is biotin a cofactor for? <ul><li>All carboxylases </li></ul>
  411. 411. What are the most common causes of meningitis corresponding with 10-21 yo? <ul><li>N. meningitidis </li></ul>
  412. 412. What is unstable angina? <ul><li>Pain at rest (transient clots) </li></ul><ul><li>Meds don’t help </li></ul><ul><li>Pain is more severe </li></ul><ul><li>Pain is more frequent </li></ul>
  413. 413. What is tangentiality? <ul><li>Wanders off topic </li></ul>
  414. 414. What is the typical incidence of a rare dz w/ 1 risk factor <ul><li>10% </li></ul>
  415. 415. What type of anemia is seen with folate deficiency? <ul><li>Megaloblastic </li></ul><ul><li>No neuropathy </li></ul>
  416. 416. What drugs cause dysgeusia? <ul><li>Li (?) </li></ul><ul><li>Metronidazole </li></ul><ul><li>Clarithromycin </li></ul><ul><li>Mg </li></ul>
  417. 417. What electrolytes does the low volume state have? <ul><li>↑ total Na </li></ul><ul><li>↓ serum Na (dilutional effect) </li></ul><ul><li>↓ Cl </li></ul><ul><li>↓ K </li></ul>
  418. 418. What is folate used for? <ul><li>Nucleotide synthesis (THF) </li></ul>
  419. 419. What are the 4 facts of Fanconi syndrome <ul><li>Problem in proximal tubule </li></ul><ul><li>Can’t reabsorb </li></ul><ul><li>Low energy state causing anemia </li></ul><ul><li>Can be due to old tetracycline </li></ul>
  420. 420. What is function? CN IV <ul><li>Trochlear </li></ul><ul><li>Motor </li></ul><ul><li>Superior oblique </li></ul><ul><li>Depresses and abducts the eyeballs </li></ul><ul><li>intorts </li></ul>
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