MED5 BLOCK2

Biochem
1. Marfan’s = lens dislocation
2. Pic of chromosomes, trisomy 21, what is this called on karyotyping? = aneuploidy
a. Chromosomes in Down syndrome, the most common human condition due
to aneuploidy.. Aneuploidy is the presence of an abnormal number of chromosomes
in a cell, for example a human cell having 45 or 47 chromosomes instead of the usual
46…
3. Retinoblastoma = which of the following causes this in both brothers? Answer = Germ Cell mutation
a. RB mutation- it is a germ line Mutation
4. Picture of eye with copper ring = Wilsons disease
a. Kay-fascher ring- straight up wilsons
5. UV light repair= Pyrimidine dimers
6. Pedigree = answer: X-linked recessive
a. 2 pedigrees total: One was trying to trick you asking about likelihood someone will have an AD…
but the issue was the it was a mutation gene therefore incidence= the likelihood he will have it.
(AD- no carrier have it or DON’T)….
b. Other pedigree was asking about a disease.. I thought it was X-link Dominant. I found this pic
on google. The males who got the disease (it was fatal) so I think it was the right answer. Ie
Rett.

7. Cyanide poison= inhibits ETC

Behavioral
1. Ethics Q = Pt’s husband passed away. What’s the first thing you say to patient? We don’t know answer
2. Person diagnosed with terminally ill disease and he said he was expecting it. What response would you
give him?
3. Pt comes in and sexually active with multiple females, about to go to college, what is one thing you should
test for? Answer = HIV/std’s
4. Sexually active teen who had a fracture in the past, now he had another bone problem what do you do?
Rehab for tx of leg or will you do an x-ray. Answer for screen for HIV (asymptomatic)
5. There’s a disease with incidence with 1 in 3000. What Is the chance of the kid having this disease? Answer
= 1 in 3000
6. Person can not be in a relationship for a long time, she cuts herself. Options: borderline personality
disorder, histrionic, narcissist

Micro
1. Grey pseudomembranous can be easily scraped off the inside of mouth = c. diphtheria
2. diphtheria toxin = answer = inhibits protein synthesis via ef2
3. Neisseria - asked which cells are infected = B cells. neutrophils?
a. N. meningitis was describing the adrenal hemorrhage and insufficiency–was asking what vaccine is
administered and what would have happened to prevent death I put Bcell are stimulated (cause of
memory)
4. E. coli infection = how does it attach to uroepithelial layer = p-fimbriae
a. Ecoli will use Fimbrae to attach to uroepithelial
5. RSV = what does it effect? Cilia
6. Why would you give inhaled polio vaccine instead of a intravenous polio vaccine? Options: one has longer
immunity..etc… basically had to know the difference between inhaled (inactivated) and IV (live) vaccine…

Pharm
1. Pt with BPH with hypertension = give prozocain = Alpha blocker
2. What receptor would you block, alpha1 antagonist
3. Give anesthetics , mac value = 1. Give diff coefficients for each drug. Plotted them on a graph. Which
represents drug A. answer = was C in the middle
4. Graph of first order kinetics and zero kinetics. Answer= first order
5. Give half life is 12 hours. How many half lives would it take to get to a conc between 10-15. Answer = 24
hrs
6. Graph: drug A with a big jump, and drug B with half jump. Answer = drug B is a partial agonist
7. Graph showing drugs. Know effect of non-competitive inhibitor on the drug in terms of Vmax and Km
a. noncompetitive = decreases Vmax, no effect on Km
b. competitive = increases Km, no effect Vmax
8. Graph asking about intervals – answer = X to Y
9. ANS.. Alpha one antagonist for Tx of BP, Prostate
10. potency curve
11. One about the mac value, fastest is at the top lowest solubility,

Cardio
1. Cardiac Action potential graph shown and asked what correlates with the T wave? The repolarization
phase
2. Guy had a MI, dies 10 days later = cause of death is cardiac tamponade
3. Administered a drug and it increased muscle tension, and another drug which had no effect on muscle
tension. All the answer options were antimuscarinics and anticholinesterases. Don’t know answer
4. SA node action potential pic. Asks where parasymp and sympathetic would affect = funny Na channels
5. Carbamazepine = acts on the Na channels
6. LA—how it will look on Xray answer was Mitral Valve

7. Female had an appendectomy and suddenly dies. shows a Cardiac function curve.. Contractility went
down, Must have been an MI
8. Why NO3- better then nitropusside? answer was cause they don’t affect the afterload, only veins affected

Endo
1. TSH increases, t3 and t4 goes down = Hashimoto
2. Person got hit in the head and started having excessive thirst. What would you do? Check urine / plasma
osmolality and give (ADH)
3. Gave symptoms of hyperthyroidism. Answer = Graves disease
4. Where does vitamin D act on to reabsorb both calcium and phosphate? Intestine
5. In the kidney, which of the following occurs? Activation of vitamin D
6. Pt has a glucagonoma, what would be seen in the patient? Options: Increase lipolysis, inhibition of insulin,
decrease in gluconeogenesis
7. Hashimotos.. had a graph , answer was autoimmune destruction and the TSH is going to be high T3,T4 is
low.
8. Lab values of Graves… due to amiodarone? High TSH , Low T3/4
9. Prolactinoma, Lab? Increase prolactin and decrease LH(inhibits Gnrh)

GIT
1. Pt who was vomitting bile = answer = annular pancreas
a. Someone with a constriction in 2nd part of duodenum = annular pancreas
2. Ondansetron = GI drug for Gerd or PUD
3. Steatorrhea fat smelling stools, what is the cause of this? Pancreatitis
4. Ileum transected from the patient, what complications would he have? Answer = Malabsorption
5. Blood Supply to Ileum- SMA (origin)
6. Saying about a kid with gastric glands in the ileum answer was meckels diverticulum
7. Cut the Vagas nerve what will happen? Will get a Decrease in gastrin, because ACHà is responsible
8. CEA was positive and Occult Blood was found found—He had Colon cancer … asking about the mutation
that caused it I wrote RAS

Heme
1. Gave high hematocrit & hemoglobin level. answer = PCV
2. High RBCs but had EPO as well = secondary polycythemia vera
3. Pic of CML cells
4. One was CML( Low LAP) + It was a blast crisis m/c in the elderly
5. Translocation of 15 and 17 = so you have to know its AML – aeur rods
6. AML--- TX is ATRA ( Vit A deritive)
7. Leukomoid reactions vs. CML = know the differences between them
8. Pt with ulcer on hard palate of the mouth also gave CD4 count= kaposi’s sarcoma
9. What causes a left shift in oxygen dissociation graph? HbF
10. Why is hbF primarily found in fetus? Not affected by 23bpg
11. Baby has the disease, what antigen crosses the placenta? Answer = IgG

MSK
1. Person with hand against wall and winged scapula, whats the nerve? Long thoracic nerve
2. Tracheal tube constricts whenever you cough what causes that? Smooth muscle contraction
3. Myasthenia gravis: what causes it = Antibodies to the post-synaptic acetylcholine receptor
4. Chronic gout, they gave a drug = Allopurinol
5. Was asking about someone who falls over. painful at location.. I put Achiles Tendon

Neuro
1. Liquefactive necrosis of the brain. Answer = GBM
2. Pituitary adenoma which cells would be enlarged? Lactotrophs
3. Pic of CT scan of brain = anterior cerebral artery
4. Angiogram pic asking to identify middle meningeal artery
5. Diabetic pt with ulcer on her foot. Answer = Autonomic neuropathy
6. Histology pic of a receptors in the hand, the biggest receptor on finger? Answer options: pressure, light
touch, temperature, pain
7. Sebaceous glands was pointing to hair follicle/ hairshaft asking for what AP will be affected. 1) soft touch
2) temp 3) cold 4) vibration
8. Where was it pointing? Pons or cerebellum.. etc. don’t know Neuro pic then how it was going to manifest
in a patient
9. Picture of angiogram- Answer was contralateral leg weakness because it was ACA

a.

10. Asking about someone who fell down.. showed a hematoma, was an Epidural hemorrhage, answer was
Middle Meningeal Artery
Renal
1. Acid base question= asked which would be respiratory alkalosis
2. Calculate serum anion gap with given values
3. Flank pain, hematuria = Renal cell carcinoma
4. Patient has hyperglucosuria, hypophosphaturia. Answer = Damage to kidney in the PCT
5. They described a patient that had high potassium and asked what you would see a increase in?
Aldosterone
6. Where does aldosterone work? Collecting duct
7. Where does ADH work in the kidney?? Answer = Collecting duct
8. EPO- will increase in RCC
a. However in bone marrow proliferation – EPO is decreased… due to negative feedback
9. Proximal tubule is affected == VIT D rickets = Causes excretion of P043-
10. What is a change in the kidney that happens in the aging process? I put increase GFR… don’t know if its
right no

Repro
1. 14-year-old pt, high b-HCG, fetal tissue and microscopy pic = hytadiform mole answer
2. 4 yr old desmin positive = embryonal rhabdomyosarcoma
3. Leiomyoma complications= answer = spontaneous abortion
4. Pt who has Amenorrhea and galactorrhea what would be their prolactin and LH levels? Prolactin goes up,
LH goes down
5. What do thecal cells secrete? Testosterone
6. What causes acne formation in a guy? Testosterone
7. Gave graph of LH peak and all the peaks- asked which peak is estrogen
8. Asked when the corpus luteum would be degenerated. Answer = 21 days
9. Pic of an ovary with a lot of cysts inside of it = PCOS
10. Pt with hair on her thigh and Amennorhea = answer PCOS
11. Female external genitalia and male internal genitalia = 5a reductase deficiency
12. androstenolone-causes acne
13. Papilloma of the breast bloody discharge
14. Prozasin(BP and BPH) à Tamsulosin – ONLY BPH
15. Female Repro was kinda tricky… One asking about estrogen and how it looks on the graph compared to
other hormones released at menstruation

a.

16. One was talking about PCOD, due to the history of obesity and anovulation
17. One was PCKD- answer was Autosomal Dominant
18. One was showed pictures of small masses coming out of the vagina, and HCG was increased answer was
Molar pregnancy—showed a picture
19. One was talking about a female, + for desmin answer was rhabdomyoblastoma
20. One was asking about Theca Cells, I put Progesterone.. but don’t know Answer was Testosterone
21. Another one asking about when the corpus luteum sheds, ie which phase, I think it’s the last day … cause
then it becomes corpus albicans.. (28thday)

22.

Resp
1. Acute change to a person who goes to a high altitude? Answer = Decreased co2
2. Respiratory graph and asks which point is the peak expiratory flow
3. COPD lady and asked what happens to FRC, compliance, and vital capacity
4. Someone who can’t remove mucus out of lungs. What is affected = dynein
5. Pt got stabbed in the back on the right side = right LOWER lobe of lung was stabbed
6. Peak expiratory flow, first one on the top of this pic

10.

Skin
1. Biopsy said they saw horned pearls = squamous cell carcinoma
2. Pic of a red dot on persons back = basal cell carcinoma
3. Fever, butterfly rash on face, what should they avoid? Sunlight
4. Rash on left and right thigh- what would you do? Skin biopsy
5. What is the first thing you would see in a patient that had been struck by lightning? Answer options:
neutrophilic infiltration, vesicles and edema
6. Skin path—A LOT; ie basal cell, Squamous cell, melanoma and how it looks under microscope
7. Atopic dermatitis, because he had asthma and his brother has allergies
8. One was asking the first changes you expect to see on inflammation – answer was fluid + papules
9. Person has AIDS (CD is 150 or so) and a big dark red lesion on the Hard palate – HHV8 (Kaposi)