EMQ Year 1 Sem 1 PDF

Listed encapsulated organism (Hemophilus, Neissera, etc.) Polysaccharide In outer membrane of salmonella, cause diarrhea Lipopolysaccharide à endotoxin of gram (-) Exoskeleton of arthropod bacter...

Listed encapsulated organism (Hemophilus, Neissera, etc.) Polysaccharide In outer membrane of salmonella, cause diarrhea Lipopolysaccharide à endotoxin of gram (-) Exoskeleton of arthropod bacteria Paromyxovirus and orthomyxovirus use host cell membrane to Chitin make capsule Phospholipid à from lipid bilayer of budding Creutzfeld-Jacobs disease (prion) from host cell Protein Cushing’s mediated bone damage Cortisol Synthesized in kidney from precursor 1, 25 dihydroxycholecalciferol (Calcitriol) Activates osteoclasts, produced by multiple small glands Parathyroid hormone Given as supplementation to person with osteoporosis Calcium and vitamin D Increased risk in elderly women to decrease of this hormone Estrogen Pain around jaw, hurts when touches face (describing trigeminal Blocks Na+ channels neuralgia); how does medication used to treat this work? Abductor pollicis brevis (carbamazepine) First two lumbricals Moves thumb away perpendicular (i.e. thumb abduction) Palmar Interossei Damage to median nerve; ring finger and pinky move more when Dorsal Interossei trying to make a fist Hold piece of paper between index and middle finger (i.e. adduction) Hand flat on a table and move fingers away (i.e. abduction) Stratum corneum Stratum Granulosum Stratum Spinosum à Breaking of the cellular adhesions called Acantholysis; Acantholysis occurs as a result of cadherin C antibodies, Langerhans found here Stratum Basale (germinativum) Papillary Dermis à Provides mechanical support **Spinosum = keratoinocytes + Langerhans **Basale = melanocytes, merkel cells, stem cells Loss of lacrimation, hyperacusis, loss of taste and paralysis of face Internal acoustic meatus with no other neurological loss à specifically lesion after the Lesion after geniculate nucleus internal acoustic meatus and before the geniculate nuclei Merges from ponto-medullary junction and Hyperacusis and metallic taste, etc. à lesion after geniculate cerebellum nucleus Distal to parotid Loss of muscles of facial expression and hypotonia, upper limb Within parotid gland affected etc. àlesion at the middle cerebral artery at the anterior superior branch Loss of facial muscle expression, but no effect on posterior auricular à after posterior auricular branch ie. at or after parotid Swollen mass on side of face and loss of facial expression àparotid gland tumor/lesion Tendency to over or underestimate Biased measurement Same measure, same outcome, same method Repeatable measurement Same measure, same outcome, different methods Reproducible measurement Same measure, same outcome, by different users Reproducible measurement Relevant and appropriate Valid measurement  Black stool and on joint pain medication (probably an NSAID) Bleeding gastric ulcer Koilonychias, atrophy of tongue, etc. Iron deficiency anemia Yellow and MCV greater than 100 (i.e. macrocytic) Pernicious anemia Just finished treatment of chemotherapy for treating small cell Myelodysplasia carcinoma Erythropoietin deficiency Diabetic with renal impairment is fatigued and short of breath Stimulates IgE production Il-4 On antigen presentation cells MHC II Digest peptide fragments and present to T cells; on all cells MHC-1 Co-stimulatory molecule, T-cell becomes anergic without CD28 Macrophages release to cause fever Il-6 Hypersensitivity 1 IgE Responsible for fast secondary immune response Memory cells Secretes antibodies Plasma cells Releases mediator that causes vasodilation (i.e. histamine) Basophil Matures in the thymus T lymphocytes Agranular phagocyte Macrophage (or Langerhan cells?) Lines the venous sinusoids Kupffer cells Between endothelial cells and sinusoids Perisinusoidalspce (space of Disse) Drains to bile duct Cannaliculi Removes excess fluid Terminal lymphatics Classical organization around Central veins Rolling Selectins Firm binding Integrins Guy with long arms, mobile joints due to mutation/gene defect, Elastin (gene defect of fibrillin involved in aortic aneurysm (i.e. Marfan syndrome) formation of elastin) Low vegetable intake, teeth fall out (i.e. scurvy) Collagen (vit. C required for collagen syn.) Joins cells together Cadherins Releases progesterone during secretory phase Cells of the corpus luteum Phagocytoses spermatids Sertoli cells Produces testosterone in response to LH Leydig cells Secretes hCG in the beginning of pregnancy Syncytiotrophoblast Converts androstenedione to estrogens Granulosa cells Loss of this indirectly leads to excessive osteoclast activity 1,25 dihydroxycalcitriol (active form of vitamin Released from osteoblasts and inhibits clasts D) Synthesized in the liver and stimulates chondrocytes OPG Released from osteoclasts in Howships lacuna to degrade bone Insulin-like growth factor 1 matrix Cathepsin K Decreases renal reabsorption and inhibits osteoclasts Calcitonin During chronic renal failure, indirectly increases/acts on PTH osteoclasts HCl Dissolves hydroxylapatite at the ruffled border MMPs Type IV collage à degraded by? Neisseria gonorrhea Gram negative aerobic cocci Clostridium difficile Gram positive anaerobic bacillus Streptococcus pyogenes Gram positive aerobic cocci Corynebacterium diphtheria Gram positive aerobic bacillus Klebseilla pneumoniae Gram negative facultative anaerobe bacillus  Flexor carpi ulnaris inserts here Pisiform Injury to this bone while holding handlebars on a bike results in Hamate inability to flex MCP and extend PIP/DIP joints of medial 2 Scaphoid fingers Woman falls on her hand with her wrist extended and abducted leading to fracture of this bone UVB DNA Dimer Chemical carcinogens DNA Adduct Burkitt’s lymphoma Epstein Barr Virus Gastric adenocarcinoma H. Pylori Eating rice with overgrowth of Aspergillus Flavus Aflatoxin B Cervical cancer HPV Prolonged (> 7 days) or excessive bleeding at regular intervals Menorrhagia Bleeding at irregular intervals Metrorrhagia Bleeding occurring at intervals < 21 days Polymenorrhea Increased bleeding at usual menstrual periods and at other irregular Menometrorrhagia intervals Oligomenorrhea Bleeding occurring at intervals > 35 days Regulator in G1>S phase, binds CDK Cyclin D Is hyperphosphorylated to release oncogene in G1>S RB Mutation in colon cancer APC Inhibit CDK 1,2 P21 Germline mutations cause LiFrameni syndrome P53 Patient is asked to show his/her teeth Branchial efferent à special visceral efferent Patient is asked to clench their teeth Branchial efferent à special visceral efferent Sialogogue is given to increase salivation General visceral efferent A tuning fork is used at the ear Special somatic afferent Light touch to the face General somatic afferent A drop of something is applied to the tongue to assess taste Special visceral afferent Glandular epithelium Adenoma Squamous epithelium Papilloma Smooth muscle Leiomyosarcoma Skeletal muscle Rhabdomyosarcoma Multiple cell types Teratoma Loss of opposition and ability to flex metacarpophalyngeals (1 Median and 2) Common Peroneal nerve Soccer player gets kicked in leg and loses ability to dorsiflex Radial proximal to elbow Loss of sensation on dorsal part of arm/hand, and loss of Axillary (C5, C6) extensors of forearm Ulnar Loss of sensation in the regimental badge area and ability to Ulnar abduct arm Loss of sensation in palmar aspect of medial 1.5 digits. Wasting of all small muscles of hand. Acts on DNA gyrase Fluoroquinolones Works on the 50s unit Erythromycin Works on the 30s unit Aminoglycosides + Tetracyclines Is a cell wall inhibitor? Flucoxacillin Is a potent anti-fungal Flucytosine  A peptide present in women but also acts on sertoli cells FSH Causes ovulation LH Main hormone of the luteal phase Progesterone Secreted by granulosa cells Estradiol Present at the onset of labour but doesn’t have any effect until Oxytocin later on in the stages of labour. Nodule on nose, (sloped border, rolled edge ???) Basal/squamous cell carcinoma Nodule on side of cheek, bleeding BCC Diabetic patient comes in and has a ulcer on sole of foot, highly Neuropathic OR Ischemic/Arterial sensitive to pain in the region (I thought this was the neuropathic Ischemic/Arterial Ulcer one where there was no pain sensation but there was pain) Venous ulcer Patient with pale cold ulcer on big toe Posterior to the medial malleolus ulcer Protein located on chromosome 13, recessive mutation (2 alleles RB need to be mutated to lose function), releases a growth factor, P53 allowing G1 à S progression Cyclin B Tumour suppressor protein becomes activated when DNA E2F à Rb bound to E2F… when Rb gets damaged/ not repaired, activates CDK inhibitors, on chromosome phosphorylated, E2F then released and binds to 17, mutations in neoplasia cyclin E… cyclin E stimulates DNA replication Involved in G2 M, binds to CDK-1 Cyclin D Protein bound to second protein, when latter is phosphorylated it releases this factor for G1 à S progression **Cyclin + CDK à DEAB 4, 2, 2, 1 Binds to CDK4 and CDK6, etc. Arrested in oogenesis in embryo Meiosis I, prophase Arrested in oogenesis prior to ovulation Meiosis II, metaphase Last phase after secondary oocyte undergoes fertilization Meiosis II, telophase Last phase when primary spermatocyte forms 20 spermatocyte Meiosis I, telophase Last phase when spermatogonium becomes 10 spermatocyte Mitosis, Telophase Prolonged cough, coughing up blood, hoarse voice, bovine cough Left recurrent laryngeal nerve (can be Hoarse voice and is a singer and can no longer reach high pitch compressed/ damaged with bronchogenic cancer) sounds External branch of superior laryngeal nerve à Soft palate not moving properly, could not swallow properly, Motor to cricothyroid muscle that tenses the vocal nasally voice cords to raise pitch Pharyngeal constrictors Pharyngeal plexus à Consists of sensory and Making plosives p and b and fricatives f and v motor vagus and glossopharyngeal fibres Pharyngeal plexus Facial nerve – to move muscles of facial expression/ lips to pronounce??? à Hypoglossal nerve – require tongue movements to pronounce? Pharyngeal plexus – involve soft palate movements? Granulosa cells that protect the oocyte Corona radiata (Innermost layer of cumulus Glycoprotein layer surrounding oocyte oophorous) Helps sperm penetrate Zona pellucida 2 cell layers plus fluid-filled cavity Acrosome Part of bilaminar embryo Blastocyst Epiblast  Cephalosporin Inhibits transpeptidase Vancomycin – can’t remember options Inhibits peptidoglycan polymerase Rifampicin Inhibits bacterial RNA polymerase Gentamicin, aminoglycoside Binds 30s subunit Quinolone Inhibits bacterial DNA gyrase (topoisomerase II) 30s à Aminoglycosides (gentamicin, neomycin, streptomycin), tetracyclines (doxycycline) 50s à Macrolides (azithromycin, clarithromycin, erythromycin), linezolid, clindamycin Shine a light in the left eye, nothing happens, shine a light in right Optic nerve afferent eye, both pupils constrict Oculomotor nerve efferent Shine a light in the left eye, right eye constricts, shine a light in Facial nerve efferent, branchial the right eye, right eye constricts Sympathetic Eyelid doesn't close Trigeminal Ptosis corneal reflex Tumor in the scrotum? Superficial inguinal Tumor in prostatic urethra? Internal iliac Tumor in testes? Para-aortic Tumor in anal canal below pectinate line? Superficial inguinal Tumor in anal canal above pectinate line? Internal iliac Tumor in the bladder? Fundus of bladder = internal iliac Tumor in the labia majora? Superficial Inguinal proportion of individuals with a positive test result who have positive predictive value the disease incidence 37 mean in 1000 have a disease in a year odds ratio? in a study, with one variable what determines the risk...? ? something like that ? definition of incidence/prevalence – something like – the total prevalence amount of people in a precision? population who carry a disease at any one point in time. The confidence interval span tells you about what Answer choices: attributable risk relative risk absolute risk sensitivity Incidence Prevalence lesion in facial and vestibulocochlear nerve right Some questions with Rinne positive and negative, facial + vestibulocochlear left and with Weber tests SNHL left One with women with loss over X Hz = SNHL both SNHL right SNHL both Saliva out of mouth, food stuck & loss of hearing Conductive both on one side Conductive right Rinne AC > BC both ears, weber lateralizes to the Conductive left left = SNHL in right Labyrinth right Labyrinth left Girls has two barr bodies, with low self-esteem and speech 47XXX defects Robertsonian Translocation Couple has child with Down’s, likely to have another due to Trisomy 18 their age Trisomy 13  Kid has been diagnosed with Edwards 45XO Child dies shortly after birth, only has one cerebral hemisphere, small jaw, heart defects, etc Girl born has short limbs, webbed neck This molecule is important in opsonisation Cb3 This molecule binds to LPS of negative bacteria which then Toll-like receptor 4 stimulates pro-inflammatory? IL-6 This cytokine can cross the blood brain barrier and trigger IL-1 fever Eosinophils This cytokine is main player for stimulating the immune Neutrophils response Person has pneumonia due to a parasitic cause, what innate cells would be found? Cells of first response of innate Lack of AER formation, no limbs develop Amelia There’s no humerus, radius, ulna, but hands present Meromelia Mermaid legs Sirenomelia Misexpression of SHH and RA in rostral border of ZPA leads Polydactyly to Syndactyly Failure of apoptosis in AER leads to 19-year-old man with green penile discharge Gonorrhoea Women with lower abdominal pain, small amount of bleeding Chlamydia and discharge Syphylis (Treponma Pallidum) Man with solid ulcers on genitals, reappears 9 weeks later Candidiasis Girl take antibiotics, vulva itchiness, white cheesy discharge HPV Weird cervical smear Q1. Woman travels to Africa and becomes sick experiencing Sickness from Africa - vomiting, diarrhoea, … à vomiting and diarrhea protozoa Q2. Man has a 30cm worm in his GI tract 30cm worm in GI Tract à helminth Q3. Woman is infected with a spherical organism and cells Cocci, thick peptidoglycan layer, no outer cell have a thick peptidoglycan layer layer à Gram positive cocci Q4. Man is infected with a rod-shaped organism and cells have Peptidoglycan layer is the cell wall, which is a periplasmic space and lipopolysaccharide layer thick in gram positive and thin in gram negative Q5. Woman presents with blisters in mucocutaneous junctions Cell has periplasmic space, LPS outer layer, form rod à Gram-negative bacillus caused by organism that uses thymine Periplasmic space is space between inner cell Q6. Thick vaginal discharage membrane layer and outer lipopolysaccharide cell layer presence in gram negative bacteria Bacillus are rods Uses thymine, causes blister in mucocutaneous junction à DNA virus DNA uses thymine as a base whereas RNA uses uracil Fungus causing thrush (candida) What gives rise to all tissues of embryo? Epiblast Where do primordial germ cells reside before going to gonadal Primary/secondary yolk sac ridge? Syncitiotrophoblast This layer has lacunae; eventually fills with maternal blood Chorionic cavity This layer accumulates fluid in mesoderm between Amniotic cavity cytotrophoblast and yolk sac eventually obliterates? This cavity completely surrounds the embryo  What structure usually equalizes atmospheric pressure in middle Eustachian Tube ear? Tegmen tympani Abscess of chlostetoma has moved to the temporal lobe, what has Stapes spread route through? Stylomastoid foramen Bone that comes from second pharyngeal arch? Internal acoustic meatus Where does the facial nerve leave skull? The neoplasm of neurilemmal, where do the facial and CN VIII come in proximitiy together? when menses ends when menses ends (day 4) when peak of LH, medium estradiol and low progesterone when peak of LH, medium estradiol and low peak of progesterone progesterone (day 14 or 11? LH surge happens 24- start of menses 36hrs before ovulation) peak of progesterone (day 21) ovulation at start of menses (day 0) ovulation at (day 14) Below will be a bunch of people that have a malformation in development, NCC based on their symptoms, identify what layer has the abnormal development. intermediate mesoderm 1.Person has problem with mandible and maxillary parts of jaw bones, neural tube they have aorta and pulmonary issues, they have issues of the external parietal layer lateral mesoderm ears, what embryonic layer has abnormally developed? 2. person has problems with the pulmonary bronchi issues? What development layer fucked up? 3. Patient has only one kidney 4. there is a lateral deviation of the vertebral column due to an absence of some vertebral bodies? 5. has an issue with limb growth? 1. Supinates powerfully when partially flexed, flexes when supinated 1. Biceps elbow, weak shouldere flexor) 2. Brachialis 3. Brachioradialis 2. Flexes elbow 4. Supinator 3. Flexes, supinates already pronated, pronates already supinated 5. Pronator 4. Supinates in all positions 5. Pronates especially when flexed at 90) 1. Arachnoid mater, cranial nerves, myenteric plexus, pia mater, schwann 1. A. NCC derivatives = CAMPS. cells. C: craniofacial, cranial nerves, cardiac (endocardial 2. EEM, cytotrophoblast, synctiotrophoblast. cushions) 3. External auditory meatus and temporary cervical sinuses. A: adrenal glands, arachnoid mater M: melanocytes, myenteric plexus 4. Meckel's cartilage & Reicharts cartilage P: post-ganglionic (sympathetics), pia mater 5. Kidneys, superior ureters, testes & ovaries. S: sensory neurons (dorsal root ganglion), Schwann cells 6. Cardiovascular system -> primary heart field, endocardial tubes. 2. L. Chorion. 3. M. Clefts derivatives 4. K. Arch derivatives 5. D. Intermediate mesoderm -> Urogenital ridge = kidneys, adrenal cortex (medulla is from NCC), superior ureters, superior 1/3 of vagina, testes, ovaries. 6. F. Splanchnic mesoderm Lateral plate mesoderm -> CVD (splanchnic), limb buds, dorsal mesentery (spleen), parietal serous lining of body cavities (parietal)  Paraxial mesoderm -> somites -> sclerotome (cartilage + bone of axial skeleton), myotome, dermatome Arthritis Septic arthritis Psoriatic arthritis Neutrophil count > 50,000 RA Psoriasis and arthritis OA Morning stiffness Reactive arthritis? Joints after use Guy goes to majora, gets ulcer on penis and something else Meiosis & Mitosis Meiosis I anaphase Meiosis II anaphase Separation of homologous chromosomes Meiosis I telophase Separation of chromatids Meiosis II metaphase Last phase before secondary spermatocyte Phase when egg ovulated 1. Definition of encapsulated bacteria (what makes it up?) 1. has polysaccharide capsule 2. What kind of infection is in the pars tensa vs. pars flaccida? 2. Answer was cholesteatoma... in pars flacida? 3. Mutation in DNA à glycine gets replaced by hydrophilic one 3. Mutation would change the protein layout à very 4. What kind of receptor do androgens bind to? different amino acids 5. Asbestos causes what kind of lung cancer 4. 6. What is the encephalocele if there’s brain tissue and CSF? 5. mesothelium 7. What are the 2 organs associated with the spleen 6. myelomeningocele 8. MOA of endophonium (myasthenia gravis) 7. splenorenal and gastrosplenic ligamnets 9. Drug used to treat spasticity in cerebral palsy 8. Acetylcholinesterase inhibitor short term 10. Where is this sample from (normal sodium, glucose levels, etc.) 9. Botulin toxin cleaves synaptic proteins 11. Low hemoglobin levels 10. Bowman’s capsule à Not PCT because question 12. Fever in pneumonia stem said distal end of PCT and all glucose would 13. Starts in sacro-iliac joint, then ZPA joint affected and bone fusion be absorbed by end of PCT 14. Old age hearing loss 11. No effect on percent saturation or change in 15. Function of p53 dissociation of curve, but oxygen content will be 16. Leads to spina bifida reduced à O2 content of arterial blood ↓ as Hb 17. Vasectomy performed, what are the layers the doctor cuts through falls, but O2 saturation and arterial P02 don’t 18. Glycine (neutral) to glutamic acid (charged/ hydrophilic) 12. Endotoxin released by bacteria causes Il-1 release 19. Patient was drooling has lacrimation intact, but loss of taste from which leads to prostaglandin release that acts on anterior 2/3 of tongue and reports sounds are really loud in one ear (ie. the hypothalamus hyperacusis)… where is the lesion? 13. Ankylosing spondylitis 20. Loss of adduction of thumb, inability to adduct/ abduct index finger, 14. Between frequencies 4000 – 6000 Hz (4-6 kHz) but flexion of ring and little finger still intact 15. Induces p21 to inhibit phosphorylation of RB 16. Failure of caudal neuropore to close in week 4 of 21. In the cell cycle what is the role of p53? development 22. What is the pathogenesis of osteoporosis in post-menopausal woman? 17. Internal spermatic fascia continuous with 23. Definition of encapsulated bacteria (what makes it up?) transversalis fascia, cremasteric fascia continuous 24. What kind of infection is in the pars tensa vs. pars flaccida? with internal oblique aponeurosis, external 25. Mutation in DNA à glycine gets replaced by hydrophilic one spermatic fascia continuous with external oblique 26. What kind of receptor do androgens bind to? 18. Insertion of bases leads to amino acid that is 27. Asbestos causes what kind of lung cancer dissimilar resulting in a protein with different 28. What is the encephalocele if there’s brain tissue and CSF? shape and function à Missense, non- 29. What are the 2 organs associated with the spleen conservative mutation 30. MOA of endophonium (myasthenia gravis) 19. Distal to geniculate ganglion but proximal to nerve to stapedius and chorda tympani 20. Ulnar nerve lesion, at the wrist 21. growth arrest, DNA repair and apoptosis à activates p21 (G1/S phase) 22. loss of estrogen (therefore activate pro-inflamm & osteoclasts) 23. has polysaccharide capsule 24. Answer was cholesteatoma... in pars flacida? 25. Mutation would change the protein layout à very different amino acids 26. Androgen receptors 27. mesothelium 28. myelomeningocele 29. splenorenal and gastrosplenic ligamnets 30. Acetylcholinesterase inhibitor short term