Q1AnswerTipo de ErroOnde est2 no FAFrase Ant3doto1759DFr4gilPathology - celular injuryAnaplasia significa c5llulas pouco diferenciadas 6n7o se parecem com tecido original8 9 alto grau1611FAusenteBiochemistry- cilia structureSd de Kartagener 10 causada por def de Dynein11754BFr11gilMSK - Bone metastasisMet12stase 13ssea14 osteol15tica 16 mm 17radiolucente1819 osteobl20stica 21escler22tica no rx23 24 pr25stata18628CAusentePATHO - Tumor supressor geneshpv e6 impede p5326 hpv e7 inibe rb. 6 before 727 p before r22656EAusentePatho - Imune checkpoint page 218Il2 estimula o sistema imune e est28 suprimido quando pd1l se liga ao pd1 em alguns canceres22635BAusentePatho - Hallmarks of cancerO tumor invade a membrana basal por a2930o das metaloproteinases 31ex32 colagenase331AFr34gilN35o est36. Genetics.Sd de Waardenburg vem fa falha de migra3738o nas neural crest cells.TRUE1MSKGeneticsWaardenburg syndrome is a disorder characterized by patchy depigmentation of the skin39 hair40 and irises41 along with cochlear dysfunction. It results from a defect in the differentiation of neural crest cells into melanocytes. Patients typically present with a white forelock and eyelashes42 depigmented patches of skin43 iris heterochromia44 and sensorineural hearing loss2DAusenteGastro - Physio - page 378Pept45deo insunlonotr46pico depentende de glicose 47 secretado quando h48 presen49a de 50cidos graxos51 aa e glicose.0GITPathoGlucose-dependent insulinotropic peptide 52GIP53 is secreted by K cells in the duodenum and jejunum. It functions to decrease gastric acid production and stimulate insulin release from the pancreas. Insulin promotes peripheral tissue uptake of glucose and hepatic glucose storage54 resulting in a decreased serum glucose concentration3CAusenteResp - HistologyOs pores de Kohn formam conex55es entre os alv56olos e permitem a passagem de fluido e microorganismos0RespoAnatomyPores of Kohn57 Small openings between adjacent alveoli Allow air and pathogen spread between alveoli Enable contiguous spread of infection58 which is why pneumococcal pneumonia can involve an entire lobe rapidly4FFr59gilBioc - MetabolismoPKU consiste na def de fenilalanina hidroxilase60 que converte fenilalanina em tirosina.TRUE1BiochemPhenylketonuria 61PKU62 commonly results from a deficiency in the enzyme phenylalanine hydroxylase63 which converts phenylalanine to tyrosine. Tyrosine is64 in turn65 required for the synthesis of the catecholamines dopamine66 norepinephrine67 and epinephrine. Supplementation with tyrosine effectively bypasses the defective enzyme and allows for normal catecholamine synthesis. PKU typically presents with a characteristic 68musky69 body odor5BFr70gilRenal - AnatomUreteres passam acima das il71cas e abaixo da ponte 72art uterina e vas def73TRUE1RenalAnatomy6BFr74gilRep - PregnancyO corpo l75teo produz progesterona na gesta7677o at78 a d79cima semana.TRUE1ReproPhysioCorpus luteum maintains early pregnancy through progesterone secretion80 sustained by 81-hCG from the embryo82s syncytiotrophoblast83 after 10 weeks syncitiotropoblast takes over9CFr84gilNeuro - StrokesNa Sd de Weber tem paralisia ipsilateral do cn3 e hemiparesia contralateral. 85Confundi com Wallenberg860NeuroAnatomyIn Weber syndrome87 a stroke involving the paramedian branches of the posterior cerebral artery affects the cerebral peduncle88 which contains the corticospinal tract89 as well as the nearby oculomotor nerve. Patients typically present with ipsilateral oculomotor nerve palsy 90manifesting as diplopia91 ptosis92 impaired primary gaze93 and pupillary constriction deficits94 and contralateral hemiparesis with an upper motor neuron pattern of dysfunction10EAusenteEndoc - Diab insipDiabetes insipidus central pode ser devido a um tumor envolvendo os n95cleos hipotal96micos supra97pticos e paraventriculares.0EndoPatho11CFr98gilMicro - FungosCoccidioidomicose 99 uma infec100101o end102mica do sudoeste dos eua com esporos na l103mina.FALSE0MicroFungus12EFr104gilNeuro - FisioO potencial de a105106o na c107l mskdepende da entrada de Calcio no terminal pr108 sin109ptico.TRUE1NeuroPhysio14DFr110gilMicro - HIV ENCEPHALOPATHYHIV encephalopathy presents with multinucleated giant cells.0MicroVirusHIV encephalopathy is typically a diagnosis of exclusion. Patients commonly present with subacute to chronic memory and language impairment111 along with psychomotor deficits. MRI reveals symmetrically distributed112 poorly defined T2 hyperintense lesions in the subcortical white matter. Brain biopsy shows multinucleated giant cells and microglial nodules15BFr113gilImuno - tcd8O clearance de v114rus acontece atrav115s de tcd8TRUE1ImmunoViral clearance during the acute phase of infection is primarily mediated by CD8116 cytotoxic T cells117 which recognize viral peptides presented via MHC class I on infected cells16CFr118gilCardio - FisioNitroprussiato reduz afterload e fa taquicardia reversa. Achata curva de pxv e diminui vol sist119lico final.0CardioPhysioPressure-volume loops provide information about cardiac mechanics. The shape and position of the loop depend on preload120 afterload121 and cardiac contractility. A decrease in afterload results in a shorter loop that is shifted to the left122 as a lower ventricular pressure is needed to open the aortic valve123 and a greater volume of blood is ejected18AFr124gilHemato - AnemiasPacientes com dieta veg e sangramento tem anemia por def de ferro antes de def de b120Heme OncPathoPatients who follow a strict vegetarian diet and have clinically significant menstrual blood loss are at risk for iron deficiency anemia 125IDA126127 as iron is required for the normal synthesis of heme. IDA presents with hypochromic128 microcytic erythrocytes on peripheral blood smear. Treatment includes controlling the underlying source of bleeding and oral iron supplementation20AFr129gilMSK - FisioA dif de melanina entre as pessoas se d130 pela diferen131a de n132mero de melanossomos.0MSKPhysioMelanin is a pigment produced by melanocytes within a specialized cellular organelle called a melanosome. The number of melanosomes and the density of melanin are what determine variation in skin tone.21BFr133gilHemato - FarmacoBortezonib inibe proteassomos e impede a apresenta134135o de mhc 1 a cd80Heme OncPharmaBortezomib136 by inhibiting the proteasome137 disrupts the processing of intracellular antigens required for MHC class I presentation138 thereby impairing the activation of CD8139 cytotoxic T cells23CFr140gilEndocrino - AcromegaliaAcromegalia 141 aumento gh 142 igf1 aumentado 143 resist insulina144 aument lip145lise146 aument gliconeogenese hep0EndoPathoAcromegaly 147 Metabolic Effects of GH 148 Muscle glucose uptake 149 Lipolysis 150 Hepatic gluconeogenesis 151 GH antagonizes insulin 152 insulin resistance153 hyperglycemia26AFaltaNeuro - NeoplasmsMeningioma s154o os tumores neurol155gicos mais comuns em adultos e aparecem como massas extraxiais.0NeuroPathoMeningiomas are the most common primary brain tumors in adults. Malignant meningiomas may grow rapidly and cause symptoms of increased intracranial pressure156 such as headache. On imaging157 meningiomas appear as well-circumscribed158 extra-axial masses that compress the adjacent brain parenchyma27AInterpretei errado159pressaRenal - FisioHipoperfus160o renala tiva o sist renina at2 aldostetorna -161 vasoconstri162163o da art ef0RenalPhysio28CInterpretei errado164pressaPsychiatry - FactitiousM165ltiplos procedimentos e sintomas -166 factitious disorder0NeuroPatho30BFaltaMSK - Patho - OsteopetroseOsteopetrosis pode ser devido a muta167168o no gene que codifica os macr169fagos0MSKPathoOsteopetrosis is a disease characterized by excessive mineralization of bone170 leading to abnormally dense and brittle bones. It results from a failure of osteoclastic bone resorption. Osteoclasts arise from the monocyte-macrophage lineage171 and defects in the signaling of macrophage colony-stimulating factor 172M-CSF173 may contribute to the pathogenesis of the disease32BFr174gilResp - NeoplasmsAsbestose 175 fator de risco para carinoma broncog176nico e mesotelioma maligno. Shipbuilding 177 fator de risco para asbestose.0RespoPathoAsbestosis is a chronic178 progressive pulmonary disorder associated with interstitial fibrosis and an increased risk for both primary bronchogenic carcinoma and malignant mesothelioma. Occupational risk factors for asbestos exposure include shipbuilding179 roofing180 and plumbing35EFaltaRep - AnatomyEstiramento do ligamento redondo l181eva a dor na gravidez0ReproAnatomyThe round ligament of the uterus is a fibromuscular band of tissue that extends from the superolateral part of the uterus182 where the fallopian tubes insert183 passes through the inguinal canal184 and ends in the labia majora. Stretching of the round ligament commonly leads to pain during pregnancy36AFaltaRenal - PhysioO rim recebe 11855 do sangue do DC. Tem mais Po2.0RenalPhysioThe kidney186s relatively low metabolic demands187 combined with its high blood flow188 result in only a small difference between renal arterial and venous Po189. As a result190 the Po191 in the renal vein remains relatively high compared to other organs that rely on blood flow to meet their local metabolic demands38BFaltaReumato - LupusPacientes com l192pus podem ter teste de rapid plasma renin and vdrl para s193ifilis falso posutuvi1940MSKPathoRPR and VDRL can be falsely positive in SLE due to anticardiolipin antibodies195 which are a type of antiphospholipid antibody39BFaltaBioch - Metabolism 196 alcohol x acetaminophen197Alcool induz p450 -198 converte acetaminofeno em napqi 199metab200lito t201xico2020BiochemPharmaAlcohol leads to the induction of cytochrome P450 enzymes 203specifically CYP2E1204 that convert acetaminophen to N-acetyl-p-benzoquinone imine 205NAPQI206207 a toxic metabolite. In the setting of acetaminophen overdose208 excessive NAPQI accumulation can cause hepatotoxicity40AFaltaBioch - Metabolismo - VitaminasMalnutrition pode ser marasmus 209sem edema210 ou kwashiorkor 211com edema2120BiochemAcute protein-energy malnutrition includes a non-edematous type 213marasmus214 and an edematous type 215kwashiorkor216. Both are clinically characterized by muscle wasting and consumption of body fat stores217 leading to emaciation. Nearly every organ system in the body is affected by this severe form of malnourishment41EFaltaMSK - Patho - Osgood SchlatterApofisite da tub218rcula da t219bia220 dor na inser221222o do tend223o patelar em atletas jovens 224 osgood schlatter0MSKPathoApophysitis of the tibial tubercle225 known as Osgood-Schlatter disease226 is a common cause of knee pain at the insertion of the patellar tendon in young athletes. It presents with focal pain and tenderness that worsens with tension applied to the tibial tubercle227 such as during running228 jumping229 or kneeling42EFaltaHeme - PorfisiriaPorfiiria cutanea tarda 230 fotossenssibilidade com bolhas e hiperpigmenta231232o 233 def na s234ntese do heme0Heme OncPathoPorphyria cutanea tarda235 the most common of the porphyrias236 is characterized by severe cutaneous photosensitivity237 leading to blistering and hyperpigmentation after sunlight exposure. It is caused by decreased activity of uroporphyrinogen decarboxylase238 an enzyme involved in the production of heme45BFaltaBioc - Mollecular transformationTransformation 239 Uptake of naked plasmid DNA by competent bacteria 240e.g.241 E. coli242 Used in molecular cloning to propagate and express recombinant genes0BiochemTransformation 243 Uptake of naked plasmid DNA by competent bacteria 244e.g.245 E. coli246 Used in molecular cloning to propagate and express recombinant genes47BFr247gilPato - Cicatriza248249oFibronectina guia os fibroblastos para s250tio de les251oTRUE1ImmunoPathoDuring wound healing252 fibroblasts migrate into the wound area to lay down extracellular matrix and collagen 253 crucial for tissue repair. The key molecule that directs and anchors this migration is254 255 Fibronectin48EFr256gilCHS - Study typesCase control - do outcome para fator de risco257 cohort - do fator de risco para o outcome0CHSCase-control studies group patients according to their disease outcome status and then analyze the odds of exposure to a particular hazard. The appropriate statistical measure used in case-control studies is the odds ratio 258OR259.49DFaltaBiochmestry - MollecularTransloca260261o 262 a falha de transrecever dna.0BiochemTranslocation may result in failure to transcribe RNA due to disruption of a regulatory element 263e.g.264 a promoter265 within a gene. As a result266 the affected gene may either not be expressed at all or be expressed in a dysregulated manner267 differing from the normal phenotype53AFr268gilRep - Dev milestonesCom 3 m269 crian270as sorriem271 begam objetos e balbuciam0ReproPhysioBy the age of 3 months272 infants are typically able to hold their head up273 grasp toys274 smile socially275 and babble or coo55AFr276gilHemato - Tromb277lisePlasmina cliva fibrinaTRUE1Heme OncPharma57BFr278gilGenetics - NF1NF1 tem penetr279ncia completa e expressividade vari280vel0Biochem58DFaltaResp - Mechanical ventVentila281282o mec283nica com press284o expirat285ria positiva 286 287til para impedir atelectasias0RespoPatho59DFr288gilHemato - AnemiasAnemia por def intoxc por chumbo leva a hiperatividade em crian289as. Inibe a enzima ferroquelatase.0Heme OncPathoLead inhibits the enzymes ferrochelatase and 290-aminolevulinic acid 2915-ALA292 dehydratase293 leading to decreased heme synthesis. Clinical manifestations of lead poisoning include encephalopathy294 cognitive dysfunction295 peripheral neuropathy296 hearing loss297 renal tubular dysfunction298 interstitial nephritis299 vomiting300 abdominal pain301 constipation302 and anemia61BFr303gilMSK - VasculiteVasculite granulomatosa com poliange304te 305 c-anca positiva0MSKPathoGranulomatosis with polyangiitis 306GPA307 presents with necrotizing granulomatous vasculitis308 c-ANCA positivity309 and involvement of the sinuses310 lungs311 and kidneys63CFaltaResp - Anatomy312PhysioVocal cords are closed while swallowing0RespoAnatomy64AFaltaBioc - Metabolismo de lip313deosHiperquilomicronemia 314 causada pela def de quilomicrons. apo a est315 no hdl0BiochemFamilial chylomicronemia syndrome 316Type I hyperlipoproteinemia317 presents in childhood with recurrent pancreatitis318 milky plasma319 xanthomas320 and lipemia retinalis321 due to massively elevated chylomicrons caused by LPL or ApoC-II deficiency65BFr322gilMsk - dermaMelanoma vem de nevos323 carcinoma espinocelular vem de keratosis actinic0MSKPathoMelanoma most often arises from nevocellular nevi that undergo dysplastic transformation. Sudden changes in size324 shape325 or color of a mole warrant biopsy to rule out melanoma69BFr326gilMicro TBa rea327328o da tb 329 do tipo iv0MicroBacteriaTissue damage in tuberculosis is caused by a Type IV 330delayed-type331 hypersensitivity reaction332 in which Th1 lymphocytes activate macrophages333 leading to granulomatous inflammation and caseating necrosis.70AFr334gilResp - NeoplasmMetaplasia do pulmao 335 colunar -336 escamosa337 esofago 338 escamoso -339 colunar340 e do genito urinario 341 transicional -342 escamoso0RespoPathoChronic smoking causes metaplasia of respiratory epithelium from pseudostratified columnar to stratified squamous epithelium343 which is more durable but less functional344 leading to impaired mucociliary clearance and increased infection risk71EFr345gilCardio - IsquemiaAltera346347o precoce do cardiomi348cito na isquemia 349 o edema das organelasTRUE1BiochemOne of the earliest manifestations of cardiomyocyte injury is swelling of the cell and its organelles350 which occurs due to intracellular accumulation of sodium that alters the osmotic gradient. If blood flow is not restored351 the injury progresses352 ultimately leading to apoptosis73EFr353gilResp - NeoplasmSquamous Cell carcinoma - centrally located354 small cell - centrally355 adeno - periphery356 non small cell - peripheryTRUE1RespoPathoCentrally located primary lung cancers include squamous cell carcinoma and small cell carcinoma of the lung. Squamous cell carcinoma is the more common subtype and is associated with polygonal cells357 intercellular bridges358 and keratin pearls on histology75BFaltaNeuro - Ataxia TelangectasiaAtaxia telangectasia acontece por muta359360o no gene atm que leva a um defeito no reparo do dna0NeuroBiochemAtaxia-telangiectasia is an autosomal recessive disorder caused by a DNA repair defect. As a result361 somatic mutations accumulate362 leading to protein dysfunction and an increased risk of hematologic malignancies363 such as Hodgkin lymphoma. Patients typically present with progressive ataxia364 telangiectasias365 abnormal eye movements366 and decreased immunoglobulin concentrations367 which predispose them to recurrent sinopulmonary infections77EInterpretei errado368pressa0Ethics80DFr369gilMSK - Displasia cleidocranialMuta370371o no gene cbfa1 na displasia cleidocranial leva a falha na diferencia372373o de osteoblastosTRUE1MSKPathoA CBFA1 gene mutation in cleidocranial dysplasia leads to impaired osteoblast differentiation374 resulting in defective ossification of membranous bone. Clinical features include frontal bossing375 facial bone malformations376 supernumerary teeth377 and absent or underdeveloped clavicles83EFr378gilCHSExternal validity refers to the extent to which the results of an experiment can be generalized and applied to populations beyond the study sample0CHSExternal validity refers to the extent to which the results of an experiment can be generalized and applied to populations beyond the study sample84DFr379gilGI - ChronInflama380381o no Chron faz perder as tigh junctions0MSKAnatomyTight junctions are responsible for creating a tight seal that prevents the paracellular movement of solutes and water through epithelial or endothelial linings. Inflammation often impairs the function and integrity of tight junctions382 reducing their effectiveness88DFr383gilNeuro - ParkinsonAlzheimer - degenera384385o do c386rtex e lobo frontal387 parkinson - subst388ncia negra e globo pallidum0NeuroPathoAlzheimer disease is characterized by degeneration of cholinergic neurons in the basal forebrain that project to the cerebral cortex389 and cholinesterase inhibitors improve memory by enhancing synaptic transmission in this pathway89CFaltaNeuro - FarmacoTriptanos s390o agonistas serotonin391rgicos0NeuroPatho91DFr392gilCardio - Sd seio carot393deoEst394mulo do seio carot395deo leva a bradiarritmia refelxa0CardioPatho94BFaltaBioc - Metabolism 396Zellweger397Sd de Zellveger 398 causada pela falta de peroxissomos0BiochemZellweger syndrome is caused by a genetic absence of peroxisomes and classically presents with seizures399 intellectual disability400 hypotonia401 hepatomegaly402 kidney disease403 cataracts404 hearing loss405 and craniofacial abnormalities. Laboratory studies typically show elevated very long-chain fatty acids 406VLCFAs407408 increased hepatic transaminases409 and elevated direct bilirubin95CFr410gilNeuro - Neuralgia do trig411mioPode ser causada por compressao do trigemio devido a placa de esclerose 412mais sintomas413414 osso ou vaso sangu415neo0NeuroPatho96AFaltaHemato - Neutropenia cong416nitaNeutropenia cong417nita 418 causada quando h419 menos de 1500 neutr420filos0Heme OncPatho98DFaltaGIT - HepatiteHepatite cr421nica leva a apoptose 422councilman bodies4230GITPathoIn chronic viral hepatitis 424like hepatitis C425426 hepatocyte damage is primarily due to apoptosis triggered by cytotoxic T cells recognizing viral antigens427 leading to cell shrinkage428 eosinophilic cytoplasm429 and nuclear pyknosis102DFr430gilImunoRinite al431rgica 432 eosin433filos0ImmunoAllergic rhinitis is characterized by IgE-mediated inflammation 434type I hypersensitivity435 of the nasal mucosa. Inciting allergens cause cross-linking of IgE on the surface of basophils and mast cells436 leading to degranulation and release of cytokines437 especially histamine438 prostaglandins439 and leukotrienes. This results in the recruitment of a variety of inflammatory cells440 predominantly eosinophils441 to the nasal mucosa103EFr442gilResp - def de alfa 1 antitripsinadef de alfa 1 antitripsina leva a enfisema sem hist de tabagismo e acometimento hep443ticoTRUE1RespoPatho444445-Antitrypsin deficiency should be suspected in young patients who present with bibasilar emphysematous lung changes in the absence of a smoking history. 446447-Antitrypsin is a protease inhibitor responsible for regulating neutrophil elastase. Patients are also at risk for chronic liver inflammation and cirrhosis due to the accumulation of misfolded 448449-antitrypsin polymers in hepatocytes107AFr450gilHemato - PTIIntoxica451452o por aspirina n453o faz plaquetopenia0Heme OncPathoImmune thrombocytopenic purpura 454ITP455 results from immune-mediated destruction of circulating platelets. It commonly presents with severe thrombocytopenia456 mucosal bleeding457 and petechiae or purpura from cutaneous hemorrhage. Other features such as anemia458 renal failure459 and fever 460seen in conditions like TTP or HUS461 are absent. Platelets appear normal on peripheral blood smear462 lowering the likelihood of congenital platelet disorders. Coagulation studies are typically normal463 although bleeding time may be prolonged. Treatment options include steroids464 intravenous immunoglobulin 465IVIG466467 or splenectomy if refractory110AFr468gilNeuro - OtorrinoImplante de coclea s469 470 poss471vel se nervo n472o estiver danificado. Auditory hair cells est473o danificadas na perda auditiva sensorial0NeuroAnatomy111EFaltaBioc -MetaboInsulina faz glic474lise hep475tica e s476ntese de glicog477nio. Estimula glicokinase.0Biochem112AFaltaEndocrino - TireoideA maioria do t4 existe ligado a t4 binding protein0EndoPhysioAfter radioactive iodide 478479480481I482 is taken up by the thyroid483 it is incorporated into T484 485 released into circulation 486 binds TBG in plasma.113CFaltaBioc - MetabMutaC487es no gene que codificam complex i est488o na patog489nese da leber hereditary optic neuropathy0Biochem116DFr490gilResp - sd do desconforto resp do rec491m nascidoFalta de surfactante leva a atelectasia. Fibrose e hiperplasia de pneum492cito II 493 fibrose pulmonar0RespoPatho119DFr494gilCardio - imagem de aortic valve replacAortic valve replacemnt is superior495 mitral valve is inferior0CardioAnatomy120EFr496gilneuro - Anesthesiapseudocholinesterase def 497 prolongamento da anestesia498 ryanodine def 499 malignant hyperthermia0NeuroPharmaPseudocholinesterase 500butyrylcholinesterase501 metabolizes succinylcholine502 a depolarizing neuromuscular blocker. In pseudocholinesterase deficiency503 succinylcholine is broken down slowly504 leading to505 Prolonged neuromuscular blockade Extended apnea despite regained consciousness122CFr506gilPharmaco - receptoresUma droga bloqueada por atropina507 mas nao bloqueada por acetilcolinesterase deve ser um agonista muscar508nico direto0MSKPharmaWhen a drug509s action510 Is blocked by atropine 511 it512s acting on muscarinic receptors Is not reduced by cholinesterase 513 it is not degraded by acetylcholinesterase 514or endogenous acetylcholine isn515t the main actor516 Then the drug is most likely a direct-acting muscarinic agonist124BFr517gilCHS - Tipos de estudoInttention to treat analysis mant518m os participantes no mesmo grupo519 mesmo que haja croos-over ou desistencia0CHS125FFr520gilMicro - Ehrlichia chaffeensisErquiliose trata com doxiciclina521 que 522 um inibidor de s523ntese proteicaTRUE1MicroBacteriaEhrlichiosis is caused by the intracellular pathogen Ehrlichia chaffeensis. Treatment consists of 7 to 14 days of doxycycline524 an antibiotic that works by binding to the 30S ribosomal subunit and inhibiting bacterial protein synthesis127AFr525gilEndoc - HormonesSteroid hormones bind in the cytosol0EndoBiochemSteroid hormones commonly bind to intracellular receptors. Most steroid hormones 526e.g.527 estrogen528 androgens529 glucocorticoids530 bind their receptor in the cytosol531 then move to the nucleus532 where they act as transcription factors at the level of DNA. Other similar hormones 533e.g.534 thyroid hormone535 bind their receptor within the nucleus536 where they also bind to DNA to exert their effects.129EFr537gilBioch - molleculardegenera538539o acontece quando m540ltiplas esp541cies de rna t existem para a maioria dos aa0BiochemDegeneracy refers to a unique property of the genetic code542 where different codons can encode the same amino acid. Since multiple codons can correspond to a single amino acid543 multiple types of transfer RNA 544tRNA545 exist for most amino acids as well.130DFaltaCHS - Tipos de errop - value 546 erro tipo 10CHS131DFr547gilGI - Carcinoid tumorCarcinoid tumors acontecem no intestino deago e s548o tumores neuroendocrinos0GITPathoCarcinoid tumors are neuroendocrine cell neoplasms that commonly occur in the gastrointestinal tract549 most often in the small bowel. If metastatic550 they can cause weight loss551 flushing552 diarrhea553 bronchospasm554 right-sided cardiac valvular disease555 and abdominal pain due to increased levels of circulating serotonin133EFaltaMSK - DermatoPurpura actinica 556 causada por atrofia de col557geno da dermis0MSKPathoActinic purpura is common on the dorsal hands and forearms of elderly individuals. It is caused by dermal collagen atrophy due to aging and chronic sun exposure558 which leads to blood vessel fragility134BFr559gilRenal - EmbryoMetanephron 560 a unica estrutura que contribui para o desenvolvimento dos rinsTRUE1RenalPathoDuring embryologic development561 several primitive renal structures form562 the pronephros563 mesonephros564 and metanephros. Only the metanephros contributes to the ultimate formation of the kidney565 while the two more primitive structures undergo degeneration. The ureteric bud forms as an outpouching of the mesonephric duct and induces the development of mature renal tissue from the surrounding metanephros138DInterpretei errado566pressa0CardioPhysioA reduction in cardiac contractility leads to decreased cardiac output567 mean arterial pressure568 and aortic systolic pressure. It also causes an increase in central venous pressure and pulmonary capillary wedge pressure569 due to the reduced forward flow of blood144EInterpretei errado570pressa0Ethics145AFaltaBioc - ADA deficiencyAdenosine deaminase def 571 a causa principal de severe combined immunodeficiency. Converte adenosina a inosina0Biochem147CFaltaMicro - SalmonelaO tto com antibi572tico visa prolongar a excre573574o fecal do organismo. SHU 575 DA Shigella0MicroBacteriaSalmonella enteritis is characterized by nausea576 vomiting577 diarrhea578 fever579 and abdominal cramping. After resolution of the disease580 individuals can asymptomatically shed organisms in the stool. Antibiotic therapy has been associated with a longer duration of asymptomatic bacterial shedding150GInterpretei errado581pressa0CardioPathoHemorrhagic shock and hypotension lead to increased tissue oxygen extraction582 greater arteriovenous PO583 difference584 anaerobic metabolism585 elevated serum lactic acid concentration586 increased ADH release587 and net capillary reabsorption151CFaltaMicro - tetraciclinasfototoxicidade 588 comum com tetraciclinas. Se fosse l589pus induzido por drogas590 teriam outro sintomas sist591micos e a droga seria minociclina0MSKPathoPhototoxic reactions are common with drugs like tetracyclines592 sulfonamides593 and amiodarone594 and resemble an exaggerated sunburn due to UV-A595induced damage of drug-sensitized skin152EFaltaCardio - anti arr596tmicosEsmolol 597 o agente mais r598pido0CardioPharmaEsmolol is fastest acting beta blocker so use it in SVT159AFaltaNeuro - farma 599benzos600Benzodiazep601nicos s602o moduladores allot603ricos do receptor gaba a0NeuroPharma161EFaltaBioc - Metabolismo de glicoseGlucagon age nos hepat604citos via amp c605clico -606 adenylys cyclase -607 protein kinase A608 ativa glicogen609lise e gliconeog610nese. Glicose 6 fosfatase age para quebrar glicog611nio0EndoPathoHypoglycemia triggers the release of glucagon612 which in turn stimulates hepatic adenylyl cyclase and glycogenolysis to help maintain serum glucose homeostasis163EFaltaBioc - Doen613as lisossomiaisHurler sd 614 uma mucopolissacaridose 615doen616a de dep617sito lisossomal618619 coarse features620 corneal clouding621 hepatosplenomegaly622 intelect disability623 developmental delay624 heart failure0Biochem166DFr625gilMicro - HIV DRUGSReverse transcriptase 626 rna dpenedant dna polymerase. Protease 627 navir0MicroPharmaReverse transcriptase is Rna dependant DNA polymerase167DFaltaCHS - lei de probabilidade geneticaa probabilidade de dominantes 628 p2629 recessivo q2 e heterozigoto 630 2pq0CHS168EFaltaBioc metabolMcardle se d631 pela deficiencia de myophosphorylase. Impede libera632633o de glicose do glicog634nio muscular durante exercicio.0BiochemMcArdle disease results from absent or deficient myophosphorylase635 impairing glycogen breakdown in muscle. This prevents release of glucose during exercise636 leading to early fatigue and muscle cramping. Lab findings include elevated ammonia and absent lactate rise after exercise due to impaired glycolysis169CInterpretei errado637pressa0ReproPatho176BFaltaCHS - Types of studySe desfecho e exposi638639o sao medidos ao mesmo tempo640 cross sectional0CHSif exposure and outcome measured at same time641 cross sectional177CInterpretei errado642pressa0RenalPathoReflux nephropathy causes focal renal scarring643especially at the upper and lower poles644due to chronic vesicoureteral reflux and recurrent UTIs179CFaltaRep - OcitocinaOcitocina ativa os receptores gq0ReproPathoOxytocin reduces postpartum hemorrhage by activating Gq-coupled receptors on uterine smooth muscle645 increasing calcium and promoting contraction181CFaltaGastro - AnatomyTrauma contuso pode levar a propuls646o das veias hep647ticas da veia cava inferior0GITAnatomy182EFaltaRep - Altera648649es hormonaisEstr650geno aumenta a produ651652o de proteinas transportadoras durante gesta653654o0ReproPhysioEstrogen655 whether endogenous or exogenous656 increases the plasma concentration of transport proteins such as thyroid hormone-binding globulin 657TBG658. This leads to an increased total thyroid hormone concentration659 while free thyroxine and TSH concentrations remain unchanged.183BFaltaHemato - LeucemiasA despropor660661o de kappa662lambda fala a favor de multiplica663664o monoclonal0Heme OncPathoCLL 665Chronic Lymphocytic Leukemia666 is a malignancy of mature B lymphocytes. Normally667 B cells express a diverse mix of immunoglobulins with a balanced distribution of kappa and lambda light chains. However668 flow cytometry showing a skewed distribution 669predominance of either kappa or lambda670 indicates a clonal expansion of B lymphocytes671 each with the same immunoglobulin molecule672consistent with malignancy185AInterpretei errado673pressa0MSKPathoChronic glucocorticoid use increases the risk of osteoporosis by impairing calcium metabolism and disrupting the balance between osteoclast and osteoblast activity. As a result674 even routine daily activities can lead to fragility fractures in patients with osteoporosis187BFr675gilMicro - virus - ebvebv infecta c676lulas b677 mas o que vemos como linf678citos at679picos na amostra de sangue perif680rico 681 tcd8 reagindo a infec682683o0MicroVirusInfectious mononucleosis is a viral illness most commonly caused by Epstein-Barr virus 684EBV685. Although EBV infects B lymphocytes via the CD21 receptor686 the atypical lymphocytes seen on peripheral blood smear are actually cytotoxic CD8687 T cells responding to the viral infection188BFr688gilMicro - quinolonoasQuinolonas inibem dna girase689 anti retrovirais inibem dna polimerase0MicroPharma189EFr690gilRenal - neoplasiaFator de risco para carcinoma de c691lulas transicionais692 tabagismo693 tintas com anilina694 naftalina. Vynyl cloride 695 angiosarcoma hep696tico0RenalPathoPapillary transitional cell carcinoma is the most common tumor of the urinary tract system and typically presents with painless gross hematuria. Cigarette smoking is a strong risk factor for this cancer. Additional carcinogens associated with urothelial cancer include phenacetin697 cyclophosphamide698 and 2-naphthylamine196DFr699gilHemato - Antineopl700sicoCiclosporina 701 inibidor de calcineurina0Heme OncPharmaCyclosporine 702and also tacrolimus703 works by inhibiting calcineurin704 a key signaling protein required for IL-2 transcription and T-cell activation.197FFr705gilResp - COPDcopd faz policitemia vera devido a hip706xia cr707nica0Heme OncPathoChronic hypoxemia in COPD stimulates erythropoietin production708 leading to secondary polycythemia198FFaltaMSK709neuro - NF1Caf710 au lait spot pode aparecer em recem nascido0MSKPatho199AInterpretei errado711pressa0RespoPatho200BFr712gilendo - hormonios e receptoreshormonios tiroidianos s713o lipof714licos tem a715716o nuclear0EndoPathoThyroid hormones are lipophilic and act intracellularly by binding to nuclear receptors717 specifically the thyroid hormone receptor 718TR719720 which heterodimerizes with retinoid X receptor 721RXR722 to regulate gene transcription at the DNA levelFalta1BTRUETRUE1Biochem723724725Confundi4ATRUE0BiochemBile acid resins decrease serum cholestrol by inhibiting reabsorbtion through the intestnal lumen. this decreases intrahepatic cholestrol hence increasing LDL receptors intra hepatic.Falta5ETRUE0ReproPharmaTamoxifen is a selective estrogen receptor modulator that is used in the tx of breast cancer. acts as an estrogen receptor antagonist in the breast and an agonist in endometrium and bone. increases risk of endometrial hyperplasia726 dvt727 PE.Elimina728729o6CTRUE1CHSControlled trialConfundi8FTRUE0EndoPathocONTITUTIONAL GROWTH DELAY IS WHEN THERE IS SLOW BUT CONSISTENT GROWTH AND A BONE AGE LESS THAN CHRONOLOGICAL AGE AND IS NORMAL ONCE PT REACHES PUBERTYConfundi9A0MSKPathoType 3 hypersensitivity include circulating antigen antibody complement complexes that deposit in tissues and cause inflammation and destruction. SLE730 Serumsickness reaction731 polyarteritis nodosa732 PSGN are all examplesElimina733734o10ETRUETRUE1Heme OncPathoAnemia of chronic disease735 shows increased hepcidin736 which results in increased retention of iron within the RES and impaired exportation for use in erythropoiesis with consequent anemia. serum iron and TIBC are decreasedFalta11CTRUE0GITPathoGastric volvulus occurs when the stomach rotates along either its short or long axis to cause gastric outlet obstruction. It may be caused by anatomic abnormalities 737secondary gastric volvulus738739 the most common of which is a paraesophageal hernia. Gastric volvulus classically presents with a combination of severe abdominal pain740 dry heaving741 and inability to pass a nasogastric tube 742referred to as the Borchardt triad743.Confundi13BTRUE0ImmunoType IV hypersensitivity reactions like the PPD skin test are mediated by Th1 cells that activate macrophages744 which predominate at the site of inflammation.Falta15ATRUE0Heme OncPathoAML commonly presents with malaise745 fever746 weight loss747 thrombocytopenia748 anemia749 and leukocytosis. Peripheral blood smear shows circulating myeloblasts750 which are characterized by a lower nuclear to cytoplasmic ratio than lymphoblasts. Auer rods are occasionally also seen.Confundi17BTRUE0RenalPathoPCT reabsorbs alot of electrolytes hence increased activity of Na751K ATPase hence sensitive to hypoxiaConfundi19ETRUE0NeuroPathoParkinson disease has Alpha synuclein protien deposition in subtantia nigraElimina752753o20ETRUE1CHSFalta21BTRUE0BiochemTyrosine hydroxylase deficiency leads to dopamine deficiency with low CSF homovanillic acid and childhood-onset dystonia.Falta28A0GITPhysioSGLT-1 is the cotransporter that absorbs galactose and glucose through the intestinal enterocytes. Fructose is absorbed by GLUT-5 transporter. GLUT-4 is located in adipose tissue and skeletal muscleConfundi31C0MSKPathoDecubitus ulcers are caused by prolonged pressure on a single point such as the buttocks754 heels755 occipital scalp. to prevent we offload pressure points. Arterial blood flow are a component of ischemic ulcers while venous stenosis is a componenet of venous insufficency ulcersConfundi33D0MSKPhysioChondroitin sulfate is a highly polar molecule with many negative charges. because of it756s polar nature it has a strong affinity with water. In solution757 it is heavily hydrated758 which increases the overall volume of the complex759 in contrast to it760s closer packed form when it761s a dehydrated solidConfundi36D0Heme OncPathoITP is a diagnosis of exclusion and it presents with mucocutaneous bleeding and thrombocytopenia ofthen following a viral illness. it is caused by antibody mediated destruction of circulating platelets and bone marrow biopsy will disclose an increased number of megakaryocytes.Falta38D0Heme OncPharmaAspirin exacerbated respiratory disease is defined by asthma762 exacerbation of respiratory symptoms by aspirin and nasal polyps.Elimina763764o40ATRUE1MicroBacteriaListeria monocytogenes is an aerobic765 gram positive rot that is catalase positive766 b hemolytic and shows characteristic tumbling motility under light microscopy. common in preg767 neonates and elderly. cause gastroenteritis768 meningitis769 bacterimia and encephalitis. taken in from unpasturized cheese or cold delicatessen meats.Falta43BTRUE0EndoPharmaPioglitazone is an oral thiazolidione that is used in Tx of type 2 diabetes melitus. it binds to ppar which act as transcription factors to regulate metabolism and promote insulin sensitivity.Falta44CTRUE0MSKPathoAcral lentiginous melanoma is a subtype of melanoma tat occurs in distal extremiti. its development is associated with UV radiation and it is the most common subtype of melanoma in individuals with darker skin.Falta48CTRUE0ImmunoImmunoglobulin isotype switching occurs after a particular IgM on the surface of a B lymphocyte recognizes its matching antigen. This induces exchange of the constant region of IgM for the constant region of another Ig subclass that is tissue and target specific. The variable region remains unchanged.Falta49FTRUE0Heme OncPharmaIn acetaminophen overdose770 saturation of phase II metabolic pathways leads to excess acetaminophen metabolized by CYP-mediated reactions to N-acetyl-p-benzoquinoneimine 771NAPQI772773 which has strong oxidizing properties and is directly hepatotoxic. Oxidizing free radicals damage hepatocytes through peroxidation of lipids in cell membranes774 oxidative damage to intracellular proteins775 and strand breaks in DNA.Falta57C0MicroFungusFluconazole treats Candida infections by inhibiting fungal cytochrome P450776dependent 14-777-demethylase778 preventing ergosterol synthesis and disrupting the fungal cell membrane.Elimina779780o58ATRUE1MSKPathoBullous phemphigoid is caused by antibodies against the hemidesmosome781 which anchors basal keratinocytes to the extracellular matrix of the dermis at the dermal-epidermal junctionFalta59B0MSKAnatomyDesmin is the primary component of intermediate filaments in muscle tissueFalta60E0MicroBacteriaThe introduction of pathogenic bacteria into the normally sterile environment of the peritoneum induces a robust inflammatory response with the secretion of fibrin that subsequently traps and encases bacteria. While important in limiting the spread of infection782 it can also predispose to the formation of abscesses.Confundi62BTRUE0Heme OncPathoIron deficency anemia presents with hypochromic microcytic anemiaElimina783784o65DTRUE1MSKPathoSlipped capital femoral epiphysis presents with hip785 thigh786 and knee pain with limited range of motion and an antalgic gait787 generally in an overweight child or teenager. It is a Salter-Harris type I fracture of the physis788 and treatment includes surgical fixation. If untreated789 complications include avascular necrosis of the femoral head790 limited range of motion791 gait impairment792 and premature osteoarthritis.Falta66DTRUE0BiochemI cell disease is Autosomal recessive inherited lysosomal storage disease that results from a defect in N acetylglucosaminyl-1-phosphotransferase enzymes. this results in failure of mannose residue phosphorylation of lysosomal hydrolases.Confundi67A0ReproPhysioInhibin in released by granulosa cells 793ovary794 and sertoli cells 795testis796 and primarily acts to stop FSH production and releaseFalta68ATRUE0RenalPathoAutosomal dominant polycystic kidney disease 797ADPKD798 is caused by genetic mutations in polycystin 799PKD1 or PKD2800 that result in the development of multiple cysts in the kidney due to structural abnormalities of the renal tubules.Confundi71C0CardioPathoVSD presents with harsh801 holosystolic murmur best heard at lower left sternal borderFalta72ATRUE0NeuroPharmaMonoamine oxidase degrades biogenic amine neurotransmitters 802e.g.803 serotonin804 dopamine805 norepinephrine806 epinephrine807. Monoamine oxidase inhibitors 808MAOIs809 inhibit the enzymatic activity of monoamine oxidase and thereby increase the synaptic concentrations of these neurotransmitters810 which target depressive and anxiety symptoms. MAOIs increase the risk for serotonin syndrome and hypertensive crisis from dietary tyramine.Falta73DTRUE0BiochemGenetic heterogeneity explains how two parents with the same phenotype 811e.g.812 albinism813 due to mutations in different genes can have unaffected children.Falta77E0GITPathoIt is a congenital anomaly due to incomplete rotation of the midgut around the superior mesenteric artery 814SMA815 during embryologic development. This leads to abnormal placement of intestines and risk of midgut volvulus 816twisting 817 ischemia818.Falta79D0BiochemMetabolism of tetrahydrobiopterin 819BH820821 is deficient in a small subset of patients with phenylketonuria 822PKU823. Most PKU patients have a deficiency in phenylalanine hydroxylase 824PAH825826 the enzyme responsible for converting phenylalanine to tyrosine. Deficiency results in accumulation of phenylalanine and its metabolites phenylacetate and phenyllactate.Falta81A0MSKPathoOsteoporosis is characterized by reduced bone mass with normal mineralization827 showing thinned trabeculae and increased fracture risk828 especially in trabecular bone like the vertebrae.Falta82C0BiochemConfundi84B0NeuroPathoSchizoid is a cluster A personality disorder with social indifference829 social isolation and decreased range of emotionsConfundi85A0RespoPathoSquamous cell and small cell carcinoma are most common centrally located primary lung cancer. squamous cell is cause of tobacco smoke830 secondhand smoke831 asbestos832 radon exposure and family history of lung cancer. feature associated include pulmonary cavitations833 central location and hypercalcemia caused by paraneoplastic PTHrP production.Confundi89A0MSKAnatomyLateral 834external835 rotation of the thigh rotates the knee836 foot837 and ankle away from the midline. The prime movers of this rotation comprise the lateral rotator group838 including the piriformis839 obturator internus and externus840 gemelli841 and quadratus femoris.Falta93A0Heme OncPhysioE an P selectin are expressen on surface endothelial cell in local infection. leukocyte has receptors such as sialyl lewis x which bind to themFalta94ATRUE0BiochemIn the fasting state842 enzymes and regulatory molecules that promote gluconeogenesis843 glycogen degradation844 fatty acid degradation845 protein degradation846 and ketogenesis are upregulated or increased in concentration. Those related to gluconeogenesis include the upregulation of glucose 6-phosphatase and phosphoenolpyruvate carboxykinase.Falta96C0MSKPathoImmobilization leads to muscle disuse 847 decreased metabolic activity 848 downregulation of angiogenic factors 849e.g.850 VEGF851 852 decreased capillary density in the affected muscles.Confundi99A0GITPhysioMotilin is a neurotransmitter that acts on G protien coupled receptors and increased GI motilityFalta100D0RespoPhysioPI02853FI02854Patm-Ph20855. FiO28560.21 . Ph2085747Falta102B0ImmunoAn elderly patient with an incidental IgG monoclonal spike 8583 g859dL860 no symptoms861 and normal labs likely has MGUS862 a benign plasma cell disorder with risk of progression to multiple myeloma.Falta109B0BiochemHeavily hydrogenated molecules can undergo oxidation to create FADH863 and NADH for use in the generation of ATP. Any partially oxidized group cannot contribute as much hydrogen as a completely reduced group864 and therefore865 cannot generate as much ATP.Confundi110D0RespoPathoTension pneumothorax occurs when air is able to enter the pleural space but is prevented from exiting. causes hypotention866 low breath sounds and hyperresonance to percussionFalta112B0Heme OncPathoNormal human hemoglobin A consists of two 867- and two 868-globin subunits. Mutations in both 869-globin alleles lead to 870-thalassemia and a relative excess of 871-globin molecules872 which pair with other 873-globin molecules to form 874-globin tetramers. These are insoluble in erythrocytes875 do not carry oxygen effectively876 and interfere with erythropoiesis877 thereby contributing to anemia.Falta114E0Heme OncPathoRetroviral gene therapy can cause leukemia by integrating near proto-oncogenes878 leading to their activation and monoclonal proliferation of transformed cells.Falta117BTRUE0NeuroPharmaSerine proteases such as AChE contain a serine residue at their active site. Diisopropyl fluorophosphate is a potent and irreversible inhibitor of AChE and serine proteases because it binds directly to the serine residue in the active site.Confundi121D0ImmunoCMV pneumonia or pneumonitis is occasionally encountered following stem cell transplant as a result of the prolonged use of immunosuppressant medications that preferentially target T lymphocytes. Characteristic features on lung biopsy include infected cells with prominent basophilic nuclear inclusions.Falta122E0PharmaPharmaCooperativity is the mechanism by which a ligand binding to a receptor increases the receptor879s affinity to bind to additional ligandConfundi124A0MicroBacteriaEBV is associated with nasopharyngeal carcinoma in ASiansConfundi125D0MSKPathoOsteoarthritis is a noninflammatory arthropathy that occurs secondary to deterioration of articular cartilage. It is commonly associated with the fingers and wrists because of repetitive use and the hips and knees because of weight-bearing and obesity. Arthrocentesis typically shows leukocytes of less than 2880000881mm882 with no additional abnormalities.Confundi126A0GITPathoUlcerative colitis shows diffuse ulceration and inflamation and can present with bloody diarrhea883 abdominal pain and abdominal tenderness on examinationFalta130E0BiochemClathrin-coated pits are the main structures on the cell membrane involved in receptor-mediated endocytosis. Binding of a ligand to a receptor884 such as LDL to the LDL-receptor on hepatocytes885 results in vesicle formation and transport of the ligand-receptor complex into the cell.Falta131E0MicroBacteriaTerminal complement deficency causes recuurant neisseria infectionsFalta138A0MicroBacteriaAcute otitis media is an acute infection of the middle ear and usually spreads to this space via the eustachian tubes from the nasopharynx. Commonly implicated pathogens include Streptococcus pneumoniae and Haemophilus influenzae. Treatment is with antibiotics886 typically amoxicillin.Falta142A0NeuroPharmafLUOXETINE IS AND ssri. lOCUS CAERULEUS PRODUCES neFalta144E0MSKPhysioThe rate of shortening within a muscle is governed by interactions between actin and myosin via cross-bridge contraction cycling. The more rapid the rate of cross-bridge recycling887 the more rapid the rate of shortening.Falta145E0NeuroAnatomyMetencephalon is the embryologic origin of pons888 cerebellum889 4th ventricle. affected in dandy walker.Falta146BTRUE0BiochemXeroderma pigmentosum is caused by defective nucleotide excision repair890 leading to photosensitivity891 skin atrophy892 and pigmentation changes due to inability to remove UV-induced thymine dimers.Falta151EFALSE0ReproPathoTurner syndrome can result from nondisjunction during mitosis or meiosis whereby one copy of the X chromosome is lost. if non disjunction occurs post fertilization there will be two distinct populations of daughter cells893 this is called mosaicismFalta152AFALSE0CHSFalta156D0ImmunoLangerhans cell histiocytosis is a proliferation of Langerhans cells and histiocytes 894activated dendritic cells and macrophages895 and includes syndromes and subtypes such as Hand-Sch896ller-Christian disease and histiocytosis X. The presentation can include isolated bone lesions or diffuse897 multisystemic898 invasive disease. Hematoxylin and eosin staining shows Langerhans cells and eosinophils899 Birbeck granules may be present on electron microscopy900 and cytologic markers include CD1901 CD1a902 and S-100.Falta157A0CHSFalta159CFALSE0NeuroAnatomyThe subthalamus modulates basal ganglia output thus mediates voluntary movements. damage to subthalamus leads to hemiballismusFalta164E0ImmunoBee venom contains several active peptides that cause direct cellular membrane damage to endothelial cells903 resulting in the formation of gaps between cells with subsequent extravasation of fluid into the extravascular space.Falta170E0BiochemBWS is caused by abnormal imprinting of one or more different genes in the 11p15 region904 resulting in biallelic expression of genes that are normally expressed in a monoallelic fashion. This results in an overgrowth syndrome with hemihyperplasia and predisposition to malignancies905 including Wilms tumors.Falta171I0CHSRR computations for which the CI includes 1.0 are not statistically significant. below 1 is sig low906 and above 1 is sig highConfundi175D0MSKPathoOsteomalacia is characterized by bone demineralization and often results from vitamin D deficiency. Hypocalcemia may be observed on laboratory analysis907 with resultant appropriate increases in serum PTH as a means of compensation via feedback regulationFalta177A0RespoAnatomyThe lungs contain a dual circulatory supply from the bronchial and pulmonary systems. The pulmonary circulation is a low-pressure system involved in gas exchange with the alveoli and oxygenation of blood returning from the systemic venous circulation. The bronchial circulation branches from the systemic arterial system and perfuses the bronchi908 lung parenchyma909 and visceral pleura.Confundi184B0Heme OncPhysioFibrinogen acts as a crosslink between platelets using GpIIb910IIIa receptor. thrombin changes fibrinogen to fibrinInterpretei errado911pressa190E0RenalPhysioRenal artery stenosis causes secondary hypertension through abnormal activation of the renin912angiotensin913aldosterone system. Angiotensin II is a potent vasoconstrictor that is produced from angiotensin I by ACE in the pulmonary vasculature.Falta198A0BiochemMaple syrup urine disease is characterised by buildup of branched chain amino acid914 leucine915 isoleucine and valine916 due to deficency of branched chain alpha keto acid dehydrogenase deficency. it presents with characteristic maple urine smell and neurologic manifestations.Falta199F0MSKAnatomyFlexor digitorum profundus flexes the DIP. Flexor digitorum superficialis act on middle phalangeFalta200A0ImmunoFollicular lymphoma is an indolent B-lymphocyte lymphoma that typically presents with a slowly enlarging lymph node. Immunophenotype shows cells with kappa or lambda restriction. There is positive staining for CD10 and CD19917 but the absence of CD5 and CD45918 which sets follicular lymphoma apart from other B-lymphocyte lymphomasthe anterior lobe of the cerebellum mediates unconscious proprioception919 whereas conscious proprioception is controlled by the dorsal column-medial lemniscus pathwayFragile X syndrome is caused by a CGG trinucleotide repeat expansion in the FMR1 gene on the X chromosome920 leading to intellectual disability921 long face922 large ears923 and macroorchidism.Exercise-induced asthma 924also called exercise-induced bronchoconstriction925 often presents with cough926 wheezing927 or shortness of breath during or after physical activity.Androgen-binding protein is secreted by Sertoli cells under the influence of FSH. It binds testosterone and keeps it concentrated within the seminiferous tubules by preventing its diffusion away. This high intratubular testosterone level is essential for spermatogenesisThe sigmoid colon is the most common location for acquired diverticulosisCeils of the respiratory epithelium arise fromt he embryonic endoderm germ layer. This includes typeI pneumocytes. which form the simple squamous epithelium of the alveoli928 and typeII pneumocytes929 which secrete surfactanFecal occult blood testing has low sensitivity and may miss colorectal cancer930 especially in high-risk patients like those with a family historyIn hemophilia B 931Factor IX deficiency932933 PTT is prolonged and corrects with plasma that contains normal factor IX934 such as plasma from a hemophilia A patientAnemia presents with normal pO935 but low oxygen content and low venous oxygen delivery due to reduced hemoglobin levelsEnzymes required for DNA replication are synthesized during the G936 phase of the cell cycle937 prior to the S phase when replication occursExcessive intake of hypotonic fluid during endurance exercise can lead to dilutional hyponatremia and cerebral edema938 presenting with neurologic symptomsDonors and recipients of transplants should ideally match at all HLA loci. In a mixed lymphocyte reaction939 recipient T lymphocytes will react to donor HLA types that are absent in the recipient.Abciximab directly inhibits platelet binding with fibrinogen through the blockade of glycoprotein IIb940IIIa on the platelet surface.Colorectal cancer 941CRC942 is a common malignancy that metastasizes to the liver. As compared to primary malignancies of the liver943 which generally appear as solitary lesions944 metastases from CRC are often spread diffusely throughout the liver and appear as innumerable masses on imaging and gross examination.Subclavian steal syndrome occurs when atherosclerotic disease of one subclavian artery leads to retrograde945 collateral blood flow from the vertebrobasilar system946 thus decreasing cerebral blood flow from the basilar artery. Symptoms of transient vertebrobasilar insufficiency947 such as vertigo and lightheadedness948 may result.Motor fibers from the vagus nerve innervate all the muscles of the pharynx except the stylopharyngeus muscle. Disruption of this plexus of nerves can contribute to poor coordination of the swallow reflex949 leading to the development of a Zenker diverticulum.The AATAAA sequence is essential for 3950 mRNA cleavage and polyadenylation951 mutation reduces mRNA stability and decreases gene expression.Achalasia results from the destruction of neurons in the myenteric plexus952 resulting in dysfunctional peristalsis and a chronically increased LES tone. Presenting symptoms include dysphagia and regurgitation953 progressive dilation of the esophagus is seen on imaging. Treatment is with pneumatic dilation or botulinum toxin.Somatic symptom disorder involves chronic954 distressing physical symptoms without a clear medical cause955 often beginning in adolescence and involving multiple organ systemsRelative risk compares the probability of disease in exposed vs unexposed individuals in cohort studies956 an RR 9571 means the exposure increases riskHIV medications that inhibit the RNA-dependent DNA polymerase 958HIV reverse transcriptase959 are either NRTIs or NNRTIs.Axonal regeneration in peripheral nerves is limited by the slow anterograde transport of cytoskeletal proteins required for axon elongationCOPD results in loss of the normal elastance of the lung with a consequent increase in compliance. During expiration960 dynamic airway collapse manifests as a reduced FEV961962 while chronic air trapping and loss of elastance are reflected as increased RV and TLC.Recombination takes place in prophase I of meiosis and is the process by which two chromatids exchange a small portion of genetic material and separate963 or unlink964 two traits previously present on the same chromatid.A cohort study follows groups based on exposure status 965e.g.966 exercise967 to assess the incidence of outcomes 968e.g.969 myocardial infarction970 over timeAndrogen insensitivity syndrome occurs due to a defect in the androgen receptor and results in persons with 46971XY chromosomes developing phenotypically female characteristics.Hereditary hemochromatosis is a genetic disorder of iron overload due to increased absorption of dietary iron972primarily due to mutations in the HFE gene973 which regulates hepcidinDeficiency of the enzyme argininosuccinate lyase results in the autosomal recessive disease argininosuccinic aciduria974 which is characterized by the accumulation of argininosuccinate975 citrulline976 and ammonia. Patients typically present in infancy with lethargy977 vomiting978 poor feeding979 hepatomegaly980 seizures981 and coma.The buccal branch of the facial nerve innervates several perioral muscles such as the orbicularis oris and buccinator muscles. Damage to the buccal branch of the facial nerve leads to difficulty pursing the lips and masticating.Bordetella pertussis impairs neutrophil function by increasing adenylyl cyclase activity via inhibition of Gi proteins by pertussis toxinTubular adenomas can predispose to the development of colorectal cancer 982CRC983984 which may present with occult985 chronic lower GI bleeding. Tubular adenomas are classified by size and histologic features986 with the type of intervention 987e.g.988 colonoscopic removal vs surgical989 based upon these features.Sildenafil enhances erection by inhibiting PDE5 in the corpora cavernosa990 increasing cGMP and promoting smooth muscle relaxationAutosomal dominant mutations in ankyrin991 spectrin992 and band erythrocyte membrane proteins cause hereditary spherocytosis through loss of the normal connection between the inner membrane skeleton and the outer lipid bilayer. Clinical symptoms can include jaundice993 splenomegaly994 and hemolytic anemia. A peripheral blood smear typically exhibits spherocytes and reticulocytes.The pathophysiology of disuse atrophy is related to an imbalance between protein production and protein degradation.The right phrenic nerve courses along the pericardium in the region of the right atrium. Infiltrative lesions in this area may result in phrenic nerve dysfunction.Viridans streptococci995 such as Streptococcus mitis996 are commensal organisms of the human oropharynx.IUDs are one of the most reliable forms of contraception because they do not depend on patient compliance. The use of an IUD may slightly increase the chance of infertility later997 but most women are able to conceive after removal of the device.An injury to the lateral lower extremity can result in a proximal fibular fracture. The common peroneal nerve wraps around the fibular neck as it enters the lateral compartment of the lower leg. Injury to this area can lead to peroneal nerve injury and a consequent foot drop.Ursodeoxycholic acid treats cholesterol gallstones by inhibiting biliary cholesterol secretion998 promoting gradual stone dissolution.The AV node delays the electrical impulse conducted from the atria in order for atrial contraction to complete and the ventricles to fill entirely prior to ventricular depolarization.Acute pyelonephritis in pregnancy is most commonly caused by obstructive uropathy due to mechanical compression of the ureters and hormonal relaxation leading to urinary stasis and ascending infection.Lipofuscin is a yellow-brown perinuclear pigment that accumulates in aging cells like cardiac myocytes due to oxidative damage and lysosomal digestion.Cat scratch disease is caused by infection with the gram-negative pleomorphic coccobacillus Bartonella henselae. It is a common cause of pediatric lymphadenitis. Histologic examination shows necrotizing granulomas with stellate 999star-shaped1000 abscesses. Multinucleated giant cells may or may not be present.Endothelin is released from injured endothelial cells to cause rapid vasoco

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