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Question Answer

What word describes the

phenomenon of a single gene

having more than one effect on an

individual\\\'s phenotype?

Pleiotropy

\\\"A patient has inherited a

mutation in a tumor suppressor

gene. Mutation of the remaining

(previously normal) copy of the

tumor suppressor gene represents

a loss of _____

which may lead to the development

of cancer.\\\"

A genetic disease that shows

_____ _____ will have mutations

at different loci that produce the

same phenotype.

Locus heterogeneity

\\\"What term describes the

presence of both normal andmutated mitochondrial DNA

(mtDNA)

resulting in variable expression inmitochondrial inherited diseases?

\\\"

Name the genetic phenomenon that

occurs when the offspring receives

2 copies of a chromosome from 1

parent and no copies from theUniparental disomy


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other parent.

\\\"In Leber\\\'s hereditary optic

neuropathy

vision loss is _____

(central/peripheral).\\\"

What is the pattern of inheritance

of hypophosphatemic rickets?X-linked dominant

Autosomal-recessive patterns of

inheritance are often found in

diseases caused by defects in

_____.

Enzymes

Autosomal-dominant patterns of

inheritance are often found in

diseases caused by defects in

_____ genes.

Structural

\\\"Fatty acid oxidation occurs in

the _____(mitochondria/cytoplasm)

whereas fatty acid synthesis occurs

in the _____(mitochondria/cytoplasm).\\\"

Name the three pathways that

occur in both the cytoplasm and

the mitochondria.

\\\"Heme synthesis

Four pathways that occur in the

mitochondria \\\"Fatty acid oxidation

What is the rate-determining

enzyme of de novo pyrimidine

synthesis?

Carbomyl phosphate synthetase II


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enzyme of de novo purine

synthesis?

Glutamine-PRPP amidotransferase


enzyme of glycolysis? PFK-1


enzyme of gluconeogenesis?\\\"Fructose-1


enzyme of the TCA cycle?Isocitrate dehydrogenase


enzyme of glycogen synthesis?Glycogen synthase


enzyme of glycogenolysis?Glycogen phosphorylase


enzyme of the HMP shunt?G6PD


enzyme of fatty acid synthesis?Acetyl-CoA carboxylase


enzyme of fatty acid oxidation?Carnitine acetyltransferase I


enzyme of ketogenesis?HMG-CoA synthase


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enzyme of cholesterol synthesis?HMG-CoA reductase


enzyme of the urea cycle?

Carbamoyl phosphate synthetase

How many ATP molecules are

produced from the aerobic

metabolism of glucose via the

malate-aspartate shuttle?

32; occurs in the heart and liver

How many ATP molecules areproduced from the aerobic

metabolism of glucose via the

glyceraldehyde-3-phosphate

shuttle?

30; this occurs in the muscle

What compounds are used as

single-carbon donors in various

reactions?

Tetrahydrofolates (THFs)

What vitamin is the donor of the

carboxyl group used in many

biochemical reactions in the body?

Biotin

What molecule donates methylgroups?

S-adenosylmethionine (SAM)

What enzyme deficiency is seen in

Fabry\\\'s disease?-Galactosidase A

\\\"A patient presents with


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progressive neurodegeneration hepatosplenomegaly

\\\"A patient presents with

peripheral neuropathydevelopmental delay

A deficiency of the enzyme -

galactosidase A leads to what

disease?

Fabry\\\'s disease

What substrate is accumulated in

Fabry\\\'s disease?Ceramide trihexose

\\\"A patient shows mild symptoms

similar to Hurler\\\'s syndrome

but no corneal clouding; what kind

of behavior patterns do you

expect?\\\"

What type of inheritance does

Fabry\\\'s disease demonstrate?X-linked recessive

\\\"A patient has peripheral

neuropathy of the hands and feetangiokeratomas of the skin

Name six types of sphingolipidosis. \\\"Fabry\\\'s disease

What enzyme deficiency leads to

Gaucher\\\'s disease?-Glucocerebrosidase

What is the most common

lysosomal storage disease?Gaucher\\\'s disease


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What three lysosomal storage

disorders are Ashkenazi Jews at

increased risk for?\\\"Tay-Sachs

\\\"A patient has

hepatosplenomegalyaseptic necrosis of the femur


Niemann-Pick disease?Sphingomyelinase

\\\"A child has progressive

neurodegeneration hepatosplenomegaly


Tay-Sachs disease?GM2 ganglioside

\\\"A child has progressive

neurodegenerationdevelopmental delay

Name two lysosomal storage

diseases that may present with a

cherry-red spot on the macula.

Niemann-Pick disease and Tay-

Sachs disease


Krabbe\\\'s disease?Galactocerebrosidase

\\\"A patient has peripheral

neuropathydevelopmental delay

What are the names of the cells

that may serve as histologic


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confirmation of Niemann-Pick

disease?

Foam cells

What are the names of the cells

that may serve as histologic

confirmation of Krabbe\\\'sdisease?

Globoid cells


metachromatic leukodystrophy?Arylsulfatase A


metachromatic leukodystrophy? Cerebroside sulfate

A patient has central and

peripheral demyelination with

ataxia and dementia. These

characteristics are typical of which

lysosomal storage disease?

Metachromatic leukodystrophy


Hurler\\\'s syndrome?-L-iduronidase

\\\"A patient has developmental

delaygargoylism

What substances accumulate in

mucolipodosis?

Heparan sulfate and dermatan

sulfate


Hunter\\\'s syndrome?Iduronate sulfatase


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What pattern of inheritance does

Hunter\\\'s syndrome demonstrate?X-linked recessive

\\\"A patient has mild

developmental delaygargoylism

Name the two lysosomal storage

diseases that show x-linked

recessive inheritance.

Fabry\\\'s disease and Hunter\\\'s

syndrome

In which direction does the citrate

shuttle move acetyl coenzyme Abetween the cytoplasm and the

mitochondria?

From the mitochondria to thecytoplasm

What is the intracellular location of

the citrate shuttle?The inner mitochondrial membrane

\\\"In acyl-CoA dehydrogenase

deficiency

dicarboxylic acid levels _____

(increase/decrease) and glucose

and ketone levels _____

(increase/decrease).\\\"

What two blood vessels and one

nerve run along the spine at the

level of the umbilicus?

\\\"aorta

True or False: The latissimus dorsi

is more superficial than the

quadratus lumborum.

true

True or False: The transversalis


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fascia runs superficially to the

transversus abdominis muscle.

false

True or False: The rectus sheath

wraps around the outside of the

rectus abdominis.

true

What is the most superficial muscle

group making up the lateral

abdominal wall?

external oblique

What is the deepest muscle group

making up the lateral abdominalwall?

transversus abdominis

\\\"What lies between the bilateral

rectus abdominis musclesformed by the rectus sheath?\\\"

Name two major organs that lie

completely in the retroperitoneal

space.

kidneys and adrenal glands

What part of the pancreas is not

found in the retroperitoneal space?the tail

True or False: The rectum lies inthe retroperitoneal space.

true

Keep the lesser and greater

curvatures of the stomach straight!

Which two parts of the urinary


10/28



system are retroperitoneal? kidneys and ureters

Which parts of the colon are found

in the retroperitoneal space?ascending and descending colon

\\\"In the gastrointestinal tractthe falciform ligament connects

which two structures?\\\"

\\\"In the gastrointestinal tractthe gastrohepatic ligament connects


\\\"In the gastrointestinal tractthe gastrocolic ligament connects


\\\"In the gastrointestinal tractthe splenorenal ligament connects


The hepatoduodenal ligamentcontains what structures?

\\\"portal artery

The gastrohepatic ligament

contains what structures?gastric arteries

The gastrocolic ligament containswhat structures? gastroepiploic arteries

The splenorenal ligament contains

what structures?splenic artery and vein


11/28



Name the ligament in the

gastrointestional tract which is

dervived from the fetal umbilical

vein.

falciform ligament

The portal triad can be

compressed through what opening

to control bleeding?

omental foramen (also known asthe epiploic foramen of Winslow)

What gastrointestinal ligament can

be cut to access the lesser sac

during surgery?

gastrohepatic ligament (it separates

the RIGHT greater and lesser

sacs)

The gastrosplenic ligament

separates what two structures?LEFT greater and lesser sacs

\\\"Don\\\'t forget where the greater

and lesser sacs are! And

remember that the lesser sac may

also called the omental bursa.\\\"

You must pound this abdominalcross-section into your

head...especially the important GI

ligaments!

Pound the layers of the abdominal

wall into your brain!

What structure attaches the

digestive tract to the abdominal

wall?

the mesentery

remember the histological layers of

the GI tract!


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Which layer of the muscularis

externa is closer to the lumen: the

circular layer or the longitudinal

layer?

the circular layer

What is another name for the

serosa?the adventitia

List three components of the gut

wall mucosa.\\\"epithelium

What is the primary function of the

lamina propria of the gut wall

mucosa?

support

What structure is found within the

submucosa of the gut wall?Meissner\\\'s plexus

What lies between the inner

circular and outer longitudinal

layers of the muscularis externa?

the myenteric nerve (Auerbach\\\'s)

plexus

\\\"List the four main layers of the

gut wall

starting from the inside and going

out.\\\"

What is the rate of basal electrical

rhythm in the duodenum?12 waves/min


rhythm in the stomach?3 waves/min


13/28




rhythm in the ileum?8-9 waves/min

In what portion of the gut does the

myenteric plexus coordinate

motility?

along the entire gut wall

The submucosal plexus is located

between what two layers?

mucosa and the innner (circular)

layer of smooth muscle

True or False: The vagus nerve

innervates structures at the L3

vertebral level.

False; the L3 vertebral level is

innervated by the pelvic

parasympathetics (hindgut region)

\\\"What is the parasympathetic

innervation for the livergallbladder and pancreas?\\\"

Where is the division between the

foregut and the midgut?\\\"Middle of the duodenum

Where is the division between the

midgut and the hindgut?

2/3rds of the way through the

transverse colon it changes from

midgut to hindgut

Name the 3 brances of the celiac

trunk.\\\"Common hepatic artery

True or False: The cystic artery is a

branch of the hepatic artery

proper.\\\"False


14/28



What are the two branches of the

gastroduodenal artery?

Superior pancreaticoduodenal and

right gastroepiploic arteries

True or False: The right and leftgastroepiploic arteries anastamose

along the lesser margin of the

stomach.

\\\"False

The short gastric arteries have

poor anastomoses if the _____

artery is blocked.

Splenic

Strong anastomoses exist between

what two sets of arteries of the

celiac trunk?

L & R gastroepicloics and L & R

gastrics

Know the branches of the celiac

trunk

The internal thoracic/mammary

(subclavian) can anastamose with

the inferior epigastric (external

iliac) via what arterial connection?

superior epigastric (internal

thoracic)

\\\"If the abdominal aorta is

blocked

the superior pancreaticoduodenal(celiac trunk) artery can

anastamose with what vessel?\\\"

\\\"If the abdominal aorta is

blocked

which artery can anastamose with

the left colic artery (IMA)?\\\"


15/28



The superior rectal artery (IMA)

can anastamose with what artery? middle rectal artery (internal iliac)

Esophageal varices result from

anastomoses between the

_______ vein and the _______vein.

left gastric vein; esophageal vein

Caput medusae results from

anastomoses between the ____

vein and ____/_____ veins.

paraumbilical vein; superior and

inferior epigastric veins

Hemorrhoids result from

anastomoses between the ______

vein and _____ and _____ veins.

superior rectal vein; middle and

inferior rectal veins

Portocaval shunt placement

between the ______ _____ and

______ _____ veins relieves

portal hypertension by shuntingblood from the ______ circulation

to the ______ circulation.

splenic vein; left renal vein; portal;

systemic

Be sure to know all the layers

involved in the inguinal canal

What fluid drains through the spaceof Disse?

lymph (in the liver)

\\\"In the liver

bile flows from zone ___

(centrilobular zone) to zone _____

(periportal zone).\\\"


16/28



\\\"In the liver venous blood flows from the ___

zone to the ___ zone.\\\"

\\\"In the liverhepatocytes secrete bile into the

bile _____

Are the zones of the liver

numbered according to the flow of

venous blood or of bile

According to the flow of venous

blood - zone I is where the blood

enters (periportal region) and zone

III is where the blood exits the liver

(centrilobular region)

True or False: Zone I (periportal

zone) of the liver is affected first by

viral hepatitis.

True - remember that viral hepatitis

is a BLOOD-BORNE illness

Zone III (pericentral

zone/centrilobular zone) is the first

site affected by ______

(alcoholic/viral) hepatitis.

centrilobular zone; ALCOHOLIC

hepatitis (most sensitive to toxins)

\\\"Name two characteristics of the

sinusoids of the liver that make

them \\\"\\\"irregular

capillaries.\\\"\\\"\\\"

fenestrated epithelium and lack of a

basement membrane

\\\"En route from the liver sinusoids

to the hepatocytes

plasma macromolecules must pass

through what space?\\\"

A patient presents with right upper

quadrant abdominal pain. Further

work-up reveals a gallstone

obstructing the common bile duct.cystic duct and common hepatic

duct


17/28



Which two biliary ducts drain

directly into the common bile duct?

Know the anatomy of the bile

ducts

What is the name of the structure

formed by the common bile duct

and the pancreatic duct as they

empty into the duodenum?

the ampulla of Vater

What structure forms the lateral

border of the femoral triangle? the sartorius muscle

What structure forms the medial

border of the femoral triangle?the adductor longus muscle

What three main structures are

contained within the femoralsheath?

\\\"femoral artery

What does the femoral canal

contain?the deep inguinal lymph nodes

What femoral triangle structure lies

outside of the femoral sheath? the femoral NERVE

What acronym do you use to

remember the structures in the

femoral triangle?

\\\"NAVEL - lateral to medial

contents of the femoral triangle -

Nerve


18/28



Know indirect inguinal hernias

Know direct inguinal hernias

What acronym do you use for the

contents of the carotid sheath?

\\\"VAN - think of someone with

VAN Morrison tattooed on their

neck - Vein

What structure is described in

relation to inguinal hernias?inferior epigastric artery

What acronym do you use for the

contents of the carotid sheath?

\\\"VAN - think of someone with

VAN Morrison tattooed on their

neck - Vein

What structure is described in

relation to inguinal hernias?inferior epigastric artery

What is the site of protrusion of an

indirect hernia in the inguinal canal?

the INternal inguinal ring is the

structure through which an

INdirect inguinal hernia protrudes

\\\"Which runs more mediallythe medial umbilical ligament or the

median umbilical ligament?\\\"

\\\"Name the layers that compose

the spermatic cord

from the most superficial to the

deepest layer.\\\"

True or False: The rectus

abdominis muscle is deep to the

pyramidalis muscle and superficialTRUE


19/28



to the medial/median umbilical

ligaments.

\\\"From the most superficial layer

to deep

what are the three muscles that

cover the internal (deep) inguinal

ring?\\\"

What cells produce the hormone

gastrin?G cells

Where within the gastrointestinal

tract are G cells located?the antrum of the stomach

\\\"What hormone causes the

following three effects: increased

hydrogen secretion

increased growth of the gastric

mucosa

The presence of what substance

within the stomach leads toincreased gastrin release?

amino acids (or peptides) -

especially phenylalanine andtryptophan

What cells in the gastrointestinal

tract make cholecystokinin?I cells

\\\"In cholelithiasis

the worsened pain experienced

after the ingestion of fatty foods isthe result of the increased release

of what substance?\\\"

Secretin is produced by what

cells?S cells


20/28



Where in the gastrointestinal tract

are S cells located?duodenum

What two types of GI hormone

secreting cells are found in the

duodenum and jejunum but not in

the ileum

\\\"I cells (secrete cholecystokinin

Secretin has what effect on the

pancreas?increased bicarbonate secretion

Which two substances stimuatesecretin release within the

duodenum?

acid and fatty acids

True or False: There are clinically

useful inhibitors for the gastrin

receptors on the parietal cells.

false

Acetylcholine and gastrin act

through which second messenger

system in parietal cells?

Gq / IP3 / Ca signaling

What transporter is required for

glucose and galactose uptake? SGLT1 and it\\\'s Na+ dependent


fructose uptake?GLUT-5

What is the only monosaccharide

with Na independent uptake? fructose


21/28




monosaccharide transport into the

blood?

GLUT-2

Fracture of the surgical neck of the

humerus damages what nerve?

axillary nerve - may also hit the

posterior circumflex humoral artery

Fracture of the midshaft of the

humerus damages what nerve?

radial nerve (lies in the radial

groove) - may also hit the profunda

brachial/brachii artery

Fracture of the supracondylar

humerus damages what nerve?median nerve

Fracture of the medial epicondyle

of the humerus damages what

nerve?

ulnar nerve

\\\"Know where a

\\\"\\\"Colles\\\"\\\" fracture is...most

common fracture seen in little only

ladies w/ osteoporosis...distal 2 cm

of the radius\\\"

Know your humeral fractures and

what arteries and nerves may be

damaged with each

Match these up correctly:

Apolipoproteins B-100 and B-48 /

Liver and Intestine\\\"B-100 in the liver


22/28



Can the liver use ketones for fuel?NO! it\\\'s missing a key enzyme in

the mito

What congenital defect produces asimilar symptom to those seen in an

infant with PKU who consumes

phenylalanine?

congenital pyloric stenosis - will

have projectile vomiting

Into what two monomers is lactose

degraded?glucose + galactose

Into what two monomers is

sucrose degraded?glucose + fructose

A patient has an anterior hip

dislocation and can no longer

adduct the thigh. She has a sensory

deficit along the medial thigh. What

nerve has been damaged?

obturator n.

A patient has a pelvic fracture. He

can no longer flex his thigh or

extend his leg. He has a sensory

deficit along the anterior thigh and

medial leg. What nerve has been

damaged?

femoral n.

\\\"A patient has a pelvic fracture

and has damaged his femoral

nerve. On physical exam one

would expect that he can no longer

_____ (flex/extend) his thigh

nor can he _____ (flex/extend) his

leg.\\\"


23/28



A patient has a pelvic fracture and

has damaged his femoral nerve. On

physical exam one would expect

decreased sensation along the

_____ (anterior/posterior/medial)

thigh and along the _____

(anterior/posterior/medial) leg.

anterior thigh; medial leg

\\\"A patient experiences trauma to

his lateral leg and can no longer

evert or dorsiflex his foot

nor can he extend his toes. What

nerve has been injured

A patient has damaged his

common peroneal nerve. What

sensory deficit would be expected

on physical exam in the foot?

decreased sensation in theDORSUM of the foot

A patient has damaged his tibial

nerve. What sensory deficit would

be expected on physical exam in

the foot?

decreased sensation in the SOLE

of the foot

\\\"A patient has had trauma to his

knee and can no longer invert or

plantar flex his foot

nor can he flex his toes. He has

decreased sensation in the sole of

his foot. What nerve has been

damaged?\\\"

A patient has a posterior hipdislocation and cannot abduct his

thigh (positive Trendelenburg sign).

What nerve has been damaged?

superior gluteal n.

\\\"A patient has a posterior hip

dislocation. She can\\\'t jumpclimb stairs


24/28



What two nerves may be damaged

if a patient sustains a posterior hip

dislocation?

superior gluteal and inferior gluteal

nerves

\\\"Loss of foot eversion is due to

damage of the _____ _____nerve

while loss of foot inversion is due

to damage of the _____ nerve.\\\"

\\\"Loss of dorsiflexion of the foot

is due to damage of the _____

_____nerve

while loss of plantar flexion of the

foot is due to damage of the _____

nerve.\\\"

\\\"If a patient has foot drop

his ______ _____nerve is

damaged; but if a patient cannot

stand on his tiptoes

What nerve innervates the

posterior compartment of the

lower extremity?

tibial n.

\\\"During skeletal muscle signal

conduction

postsynaptic ligand binding leads to

the depolarization of what type of

cell?\\\"

Where are Dihydropyridine

receptors located? Where areRyanodine receptors located?

Dihydropyridine receptors in on

the skeletal muscle membrane

deep in the T-tubules; Ryanodinereceptors are in the sarcoplasmic

reticulum membrane

\\\"During skeletal muscle

contraction

which band(s) of the sarcomere

shorten in length?\\\"


25/28



\\\"During skeletal muscle

contraction

which bands of the sarcomere

remain(s) the same length?\\\"

\\\"In the sarcomeredoes the A-band correspond to

the length of actin or myosin?\\\"

\\\"In the sarcomere

does the I band correspond to the

area that is only actin or only

myosin?\\\"

\\\"In the sarcomere

does the H-band correspond to

the area that is only actin or only

myosin?\\\"

\\\"In the sarcomereis the Z line the site of actin or

myosin attachment?\\\"

\\\"In the sarcomereis the M line the site of actin or

myosin attachment?\\\"

A sarcomere is defined as the area

between one ______ _____to the

next ______ _____.

z line; z line

\\\"In skeletal muscle contraction ATP binds to what molecule?\\\"

The release of ADP allows for

what process in actin/myosin

cross-bridging?

release of the myosin head from

it\\\'s binding site on actin

\\\"After a smooth muscle voltage-gated _____ _____ will


26/28



membrane is depolarized open.\\\"

\\\"In the process of smooth muscle

cell contractioncalcium binds to what?\\\"

\\\"With the binding of calcium to

calmodulin in smooth muscle

contraction

the activation of _____ _____-

_____ kinase takes place.\\\"

Don\\\'t forget what microglia look

like!

Don\\\'t forget what an astrocyte

looks like!

Don\\\'t forget what

oligodendrocytes look like!FRIED EGGS!!!

Know structures of the brain stem

in a ventral view

Know the structures of the brain

stem in a dorsal view (with the

cerebellum removed)

Know the structures that pass

through the cavernous sinus

Know the structures of the inner

ear


27/28



Know the structures of the eye and

retina

Know the locations of extraocular

muscles and related nerves as they

exit the bony ocular orbit

Know the pathway of aqueous

humor secretion and reabsorption

What are the three first-line drug

classes for the treatment ofanxiety?

\\\"SSRIs


classes (all mood stabilizers) for

the treatment of bipolar disorder?

\\\"Lithium


classes for the treatment of

depression?

\\\"NSRIs

What are the two first-line drugs

used for the treatment of

depression with insomnia?

trazadone and mirtazapine

What two drug classes are used in

the treatment of atypical

depression?

MAOIs and SSRIs

What drug classes are used in the

treatment of panic disorder? \\\"SSRIs


28/28


What two drugs or drug types are

used in the treatment of obsessive-

compulsive disorder?

SSRIs and clomipramine

What two drugs or drug types are

used in the treatment of obsessive-

compulsive disorder?

Antipsychotics (Haloperidol)

\\\"Which has mainly neurological

side effects

high or low potency

antipsychotics?\\\"

\\\"Which is better at addressing

the negative S/S of schizophrenia

typical or atypical antipsychotics?

\\\"

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