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34 y/o scientist is exposed to aerosolized 125Iodine while synthesizing a radiolabeled compound; What is the best treatment?
Potassium Iodide
A Diabetic has sensation to pinprick and vibration decreased from just above the ankles distally; The patient is most likely to describe the pain as?
Burning
Explain why deoxygenated blood can carry more carbon dioxide for a given PCO2 than oxygenated blood?
Deoxyhemoglobin is a better buffer of hydrogen ions than oxyhemoglobin
What is the equation for ejection fraction?
EF = (Stroke Volume/EDV)
23 y/o woman has a 3 day history of a drooping eyelid + right pupil is larger than the left + Right eye is looking down and to the right; Where is the lesion?
Oculomotor nerve
Methylprednisolone
binds intracytoplasmic steroid receptor; alter gene transcription
3 y/o girl is infected with Mycobacterium avium intracellulare; This patient most likely has a defective function of what protein?
Interferon gamma
22 y/o basketball player who uses cocaine recreationally suddenly develops severe shortness of breath + Lung fields are hyperresonant and breath sounds are diminshed; Diagnosis
Pneumothorax
23 y/o man has a depressed mood, decreased energy, and dry skin + T4 and TSH concentrations are decreased; Diagnosis
Secondary Hypothyroidism;

Low TSH b/c the Pituitary is not sending it

1 hour after uncomplicated vaginal delivery, a women has continued heavy blood loss from the vagina + The uterus is soft and contractions have stopped; What drug would be most helpful?
Oxytocin
15 y/o boy presents w/ right wrist pain that began when he landed on his hands after falling backward while skateboarding + Point tenderness to palpation of the radial aspect of the wrist between the abductor pollicus longus and extensor pollicus brevis tendon; This patient is at increased risk for what sequelae
Avascular necrosis of the proximal aspect of the scaphoid bone
Patient brings her grandmother in who has Alzheimers and is refusing to eat + The granddaughter appears worried and exhausted and is intermittently tearful; What intervention is most appropriate?
Dicuss the stresses of the patients care with granddaughter and provide info regarding possible assistance
Fetal ultrasonography shows that ductus arteriosus has closed. Inhibition of what enzyme is most likely?
Cyclooxygenase;

Prostaglandins keep the PDA open;
Indometicin (prostaglandin inhibitor) closes PDA

What property of an anesthetic explains rapid onset of action?
Low blood solubility
Man presents w/ a 2 day history of abdominal pain + Consumed large amounts of alcohol over the past few days + Lab shows serum amylase activity of 700 and serum lipase of 850 and serum Ca2+ of 7.5; Diagnosis
Acute Pancreatitis
What is the role of IkB in the nuclear factor-kappa B (NF-kB) signal transduction pathway from IL-1 binding to IL-6 induction?
Releases NF-kB after undergoing phosphorylation
Define Stratification
The arrangement or classification of something into different groups
9 y/o boy has mild mental retardation + frequent motor seizures + Pink to yellow papules in a butterfly distribution on the bridge of his nose, malar prominences + CT scan shows calcified nodules on the crest of gyri + ECG shows LV hypertrophy w/ associated narrowing of the aortic valve
Tuberous Sclerosis
Treatment with valproic acid, which inhibits histone deacetylase is started; What process does this affect?
Transcription
Old man has sudden onset of blindness in the left eye + If patient remains to be blind in the left eye 6 months later, what will happen when the eye is illuminated?
No constriction b/c the retinal ganglion cells in the left eye have been destroyed
A food handler has a fresh furuncle on his face as he prepares meat loaf; Eight of the 10 people who eat the meat loaf become ill within 4 hours, what symptom will they most likely have?
Vomiting
Woman presents with 6 month history of cutaneous flushing and diarrhea + X-ray of chest shows solitary nodule in the left lower lung; What compound is being secreted from this nodule?
Serotonin
18 month old boy with SCIDs requires a blood transfusion for severe anemia; What blood product should be given?
Irradiated packed red blood cells
What hematologic abnormality is associated w/ SLE?
Thrombocytopenia
Shoulder pain is reproduced with resisted abduction of the shoulder when the shoulder is abducted 90 degrees and the arm is giving “thumbs down” sign; What tendon is injured?
Supraspinatus
1 month old boy is Albino; Skin biopsy would most likely show?
Number of melanocytes: normal;
Melanin: decreased
Patient has bilateral hydronephrosis; Describe the pressures in the kidney.
Increased GC hydrostatic pressure;
Increased tubular hydrostatic pressure
Woman develops a secreting adenoma of the parathyroid gland; What is most likely to be decreased?
Calcium concentration in feces
An organism is resistant to ampicillin but sensitive to ceftriaxone; What is the most likely mechanism of this antimicrobial resistance?
Beta-lactamase production
Patient is hypotension + Abdominal examination shows guarding and a pulsatile periumbilical mass; What additional finding is most likely?
Decreased femoral pulses;

Abdominal aortic aneurysms

DiGeorge Syndrome is due to the aberrant development of the?
3rd and 4th branchial POUCHES!
Slit like openings are visualized near the lateral ends of the top of the trigone region of the bladder; What describes this structure?
Ureteric orifices
Patient has a 1 week history of loss of peripheral vision to the left in both eyes; Where is the lesion?
Occipital lobe
Man has BPH and develops urinary retention + A drug is admin that increases phosphoinositide turnover in the smooth muscle cells of bladder and has no effect on nicotinic synapses; What drug is this?
Bethanechol
During skeletal muscle twitches, the ATP concentration does not fall appreciably because of what?
ATP is quickly regenerated from creatine phosphate
Newborn with NRDS has lungs with diminished ability to serve as sites of effective gas exchange; An increase in what parameter would explain this?
Lung elastic recoil
PPD test is positive in this patient; The casual organism is most likely to be present in what cell?
Macrophages
Where does lymph from cervix drain to?
Internal iliac
Organophosphate poisoning treatment
Atropine > Pralidoxine
Myasthenia Gravis patients have antibodies to?
Nicotnic POSTsynaptic acetylcholine receptors
20 y/o cyclist taking recombinant human erythropoietin has polycythemia; How?
Proliferation of erythroid precursors
Acetaminophen toxicity
Hepatic necrosis -> Acetaminophen metabolite (NAPQI) depletes glutathione and forms toxic tissue byproducts in liver;
Treatment: N-acetylcysteine
Swallowing study shows a 4 cm posterior midline pouch protruding between the thyropharyngeal and circopharyngeus portions of the inferior pharyngeal constrictor muscle; What innervates these muscles?
Motor fibers of vagus
Women is found unconscious + PE shows cool pale extremities, JVD, faint peripheral pulses, and crackles over the bottom two 3rds of both lung fields + Heart sounds are normal; What type of shock is this patient experiencing?
Cardiogenic
4 y/o boy has DMD; The most likely cause is a defective or absent protein in what area of muscle?
Cytoskeleton
A defect in renal ammoniagenesis is suspected; What substrate is most likely the source of ammonia now?
Glutamine
43 y/o presents with altered consciousness + During the interview she stops talking mid sentence and has a blank look + She has repetitive lip smacking and picking movements of the hands + It last for 30 seconds; Diagnosis
Complex partial seizure
Locate Arcuate Fasciculus on Brain image
Female patient is consuming cocaine while pregnant; The patients fetus is at increased risk for what?
Prematurity
Genomic typing shows that HIV strain has become resistant to ritonavir/lopinavir; The cause of this resistance is acquisition of of a mutation in a gene critical for what process?
Protein processing
5 y/o boy is stung on his foot by a bee + The area becomes edematous; The extravascular accumulation of fluid is most directly related to?
Gap formation between endothelial cells
Stool culture grows Salmonella + Symptoms resolve within 36 hours but persist in milder forms for several more days; What would occur if the patient was treated with antibiotics?
Prolonged fecal excretion of the organism
Stress echocardiography shows hypokinesis of the posterior left ventricle w/ increasing activity levels; What is the most likely cause?
Stenosis of the right coronary artery
A metal worker collapses after exposure to unknown chemical + He smells like burnt almonds; What should you admin?
Amyl nitrite
Patient is found to be homozygous for the phenylalanine hydroxylase gene at a point mutation (GT->AT) in intron 12 of the effected gene causing skipping of exon 12; What is the explanation for exon skipping in this patients affected gene?
RNA splice error
Women comes to the physician because her menstrual period is 1 week late + She had unprotected sex with her bf 20 days ago; What describes the stage of development of the embryo at this time?
Neural plate is present, but the neural tube is not yet complete
Vaccine against diphtheria confers protective immunity by inducing the formation of antibodies against a preparation composed of?
Purified inactivated toxin
Microscopic examination of a biopsy specimen of the lesion shows atypical melanocytes spread along the basilar layer in the epidermis; What is the most likely cause of this finding?
Lentigo maligna
Greatest risk factor for Sarcoidosis?
Ethnicity
Leukemic cells that express class 1 MHC molecules and show rearrangement of the T-lymphocyte receptor Beta-chain gene D and J segments normally counterparts with?
T-lymphocyte thymocytes localized to the thymic cortex
Man participates in a clinical trial of a newly developed loop diuretic; What is the acid/base volume status after 3 days of treatment?
Metabolic alkalosis;
Volume contraction: yes
During induction of anesthesia, isoflurane is admin along with a second compound + Patient develops muscle rigidity and increased temps; What drug was most likely paired?
Succinylcholine
3 cm laceration orientated transversely over the palmer aspect of the distal forearm and located 2 cm proximal to the distal palmar wrist crease + Patient is unable to abduct left thumb + Sensation to pinprick is decreased over the palmar aspect of the thumb, index and middle fingers; What nerve is injured
Median
Serum studies show increased concentrations of very long chain fatty acids, phytanic acid, and pipecolic acid; If hepatocytes were analyzed using electron microscopy, results would show absence of what organelle?
Peroxisome
A man has a 4 month history of weight loss, abdominal pain, diarrhea + Stool analysis shows increased excretion of neutral fat and muscle fiber + Examination of tissue obtained on intestinal biopsy shows no abnormalities; This patient would respond favorably to?
Pancreatic enzymes
What germ cell layer is the Esophagus derived from?
Endoderm
Patient has been taking warfarin since receiving an artifical heart valve 6 years ago because of endocarditis secondary to IV drug use; During the next 6 weeks, warfarin dosage required to maintain prothrombin time progressively decreases; What explains this finding?
Vitamin K def caused by depletion of normal gut flora
36 y/o man heterozygous for LDL receptor def has a cholesterol conc of 330 mg/dl + After taking a drug, his cholesterol goes down to 200 mg/dl; What proteins would be upregulated as a result?
LDL receptor
Vision screening is performed on 4000 people who are older than 65 years + Cataracts are found in 200.; Which of the following best describes the annual incidence of cataracts in this population?
Unable to calculate due to insufficient data
Patient ingested 100 aspirin tablets in a suicide attempt; What additional hematologic finding is most likely abnormal in this patient?
Bleeding time

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