87- Q 4. Inheritance pattern of androgenic alopecia?
polygenic with variable expressity
87- Q 31. Side effect on skin for topical glucocorticoid?
atrophy of DERMIS
88- Q 2. Explain why kids have bowing leg in rickets
lack of Ca2+ leads to UNMINERALIZED OSTEOID. Incomplete mineralization of osteoid leads to poor quality soft bone.
- normal bone mineralization requires Ca2+ and phosphate
88- Q 7. Describe bone biopsy finding in Paget
MOSAIC pattern of woven and lamellar bone with prominent CEMENT LINE
- buzzwords: MOSAIC and CEMENT LINE
88- Q 9. monoclonal antibody drugs, after that vasculitis with fibrinoid necrosis: What is going on?
serum sickness: type 3 hypersensitivity reaction
- hallmark of type 3 hypersensitivity reaction are systemic symptoms (fever, urticaria) and vasculitis
- buzzwords:
1. MONOCLONAL ANTIBODY DRUG (or penicillin, these two can be haptens)
2. VASCULITIS
88- Q 23. How UVA induces photoaging of skin?
UVA -> decreased collagen FIBRIL production
-> wrinkling
88- Q 27. Supracondylar humeral fracture with anterolateral displacement: what nerve is damaged?
Radial n.
- this is tricky question. normally supracondylar fracture is associated with median n. damage. but with ANTEROLATERAL dislocation of fracture humerus, it is RADIAL N. that is getting damaged.
88-Q 37. Difference between UV and radiation in terms of DNA damage? repair mechanism?
UV: thymine dimerization -> nucleotide excision repair
Radiation: double strand break-> non-homologous end joining
89- Q 3. Ehlers-Danlos vs. Marfan: What is similarity and difference between these two?
Similarity
- BOTH hypermobile joints
- aortic aneurysm
Differences
- Ehlers-Danolos: collagen cross-linking defect, easy bruising, berry aneurysm
- Marfan: fibrillin (glycoprotein sheaths around elastin) defect, long extremities, MVP, pectus excavatum, lens sublaxation
- BOTTOM LINE: Ehlers-Danlos is unique in terms of EASY BRUISING and BERRY ANEURYSM (which makes sense as vascular type collagen defect (collagen 3) is involved, while Marfan is fucked up in many other ways
89- Q 16. Joint pain, previous history of polycythemia vera. Diagnosis?
gout!
myeloproliferative disorder is one of causes of gout. More cell proliferation, more purine breakdown, more uric acid production
89- Q 29. What is exocrine? vs. endocrine?
Define three types of exocrine below, example of each?
- merocrine
- holocrine
- apocrine
Exocrine: release through duct
Endocrine: release into blood stream
- merocrine: exocytosis, ex- salivary gland
- holocrine: burst! lysis, ex- sebaecus gland (acne)
- apocrine: membrane bound vesicles, ex- mammary gland (think milk in vesicles-마시는 캡슐 요구르트)
90-Q 8. Which nerve innervates latissimus dorsi?
thoracodorsal n.
- thoracoDORSal= latissimus DORSi
90- Q 15. Leser-Trelat sign is what type of skin disorder?
seborrheic keratosis
90- Q 16. Which nevi extends to dermis?
compound nevi
also melanoma for sure
90- Q 18. Where does quadriceps muscle attach to distally?
tibial tuberosity
91- Q 2. Bilateral pain in lower extremities and bak, pain relieved by leaning forward. What is diagnosis? Commonly due to what?
spinal stenosis
- commonly due to thickening of ligamentum flavum ( spinal ligament in posterior side)
- buzzword: pain relieved by leaning forward
91- Q 3. How drugs involved in drug-induced SLE are get metabolized?
hepatic acetylation
91- Q 9. What is molecular target of anti-Jo-1 (polymyositis??
histidyl tRNA synthase
91- Q 28. skin changes after food consumption: two differential diagnosis? how do they grossly look different?
- eczema (atopic dermatitis): pruritic eruption (spongiosis)
- dermatitis herpetiformis: GROUPED vesicles, pruritic papules, sometimes bullae
- key difference is basically whether it is vesicles or not. They BOTH are pruritic
91- Q 30. Two differential diagnosis for mast cell mediated skin manifestations? how do they grossly look different?
- eczema: pruritic eruptions
- urticaria (hives): smooth papule or plaque (big)- superficial dermal edema
93- Q 1. What vasculitis can cause wrist/foot drop?
eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
95- Q 7. Patient shows weakness, papules on hands. what disease is this? What another disease may be associated with it?
dermatomyositis
* papules on hands= mechanics hands
- associated with OCCULT MALIGNANCY (OVARIAN CANCER is most common)
- NOTE: I picked the porphyria cutaneous tarda
Two mistakes I made:
- Q was asking ASSOCIATED disease, not disease itself
- I overlooked patient’s history of weakness. They just showed hand picture, for which porphyria cutaneous tarda also may present similarly (photosensitivity)
98- Q 14. Key difference in back pain due to degenerative vs. malignancy?
dengenerative- pain relieved by rest
maliganancy- constant pain, not relieved by rest
98- Q 38. Bone metastasis findings in imaging studies have two possible cases- sclerotic and osteolytic. What is each? example?
- sclerotic: osteoblastic activity, bone metastasis like prostate cancer
- osteolytic: osteoclastic activity, paraneoplastic syndrome like squamous cell carcinoma of lung or renal cell carcinoma
