一旦復習終了。
UWはみなさんが言っているように少し問題文は長いですよね。
1.甲状腺病理。
Anaplastic thyroid carcinoma：undifferentiated and aggressive tumor that tends to occur in older patients and presents with a rapidly enlarging neck mass and regional or metastatic spread.
病理）Pleomorphic spindle cell
甲状腺未分化癌は高齢者で急速に腫大する。
2.lymphogranuloma venereum(LGV) is caused by C trachomatis serotype L1-L3 and initially presents as a self-limited, painless genital ulcer that can progress to ulcerated tender lymphadenopathy (buboes) after 4 to 6 weeks.
クラミジア感染。鼡径部潰瘍。痛い...
3.Although Haemophilus ducreyi (chancroid) can also present with bilateral inguinal lymphadenopathy, the initial lesion of chancroid is painful.
軟性下疳は痛みはあるが、潰瘍はなし。
Klebsiella granulomatis・Treponema pallidumは痛みなし。
4.TTP is the result of a decreased amount or an absence of the normal vWF protease ADAMTS13.
TTPはADMTS13．
Antibodies directed against platelets are found in immune thrombocytopenic purpura.
ITPは血小板抗体。
5.Sensorineural hearing loss can occur anywhere from the cochlea, the bony, spiraling structure containing hair cells with stereocilia, to the cochlear nerve (cranial nerve VIII), all the way to the cochlear nuclei in the brain.
Cochlear damage due to loud noises is a common cause of sensorineural hearing loss. The cochlea is responsible for converting vibrations into nerve impulses perceived as sound.
感音性難聴の人は蝸牛から有毛細胞、内耳神経のどこかで障害がある。
6.Chromogranin stain is used in immunohistochemical evaluation of neuroendocrine neoplasm/tumor NEN/NET.
クロモグラニン染色
7.Giemsa stain can visualize a range of bacteria and parasites including Borrelia, Plasmodium, Trypanosoma, Giardia lamblia, and Helicobacter pylori.
ギムザ染色
8.Periodic acid–Schiff stain stains carbohydrates (eg, glycogen) and fungi, as well as amoebae and bacilli-laden macrophages characteristic of Whipple disease, caused by Tropheryma whipplei.
PAS染色でアメーバ、ウィップル
9.Erection is mediated by the parasympathetic nervous system via the pelvic splanchnic nerves, which arise from the S2-S4 nerves.
S2-S4 nerve fibers (through the pudendal nerve) are also responsible for anal and penile sensations (via inferior rectal and dorsal nerves, respectively).
10.The two main calcineurin inhibitors are cyclosporin and tacrolimus (FK-506).
Both are common parts of antirejection drug regimens after transplantation. Tacrolimus acts by complexing with FK-binding protein 12, an immunophilin, creating a complex that inhibits T-cell calcineurin.
This inhibition leads to the downstream effect of inhibiting IL-2 production and T-lymphocyte signaling. Tacrolimus is metabolized by CYP-450 enzyme 3A.
カルシニューリン阻害薬；シクロスポリンとタクロリムス。
11.Wernicke aphasia is caused by a lesion in the left posterior superior temporal lobe, which is supplied by the inferior terminal branches of the middle cerebral artery.
ウェルニッケは左側頭葉
12.Ethylene glycol toxicity causes elevated serum osmolality, high anion gap metabolic acidosis, confusion, hematuria, and crystalluria.
エチレングリコール中毒なら血漿浸透圧高値
Methanol poisoning：lactic acidosis, visual disturbances, as well as normal urine findings.
メタノールは尿異常なし。
13.Cystitis presents with urinary urgency.
Fluoroquinolones：inhibiting DNA gyrase.
Significant adverse effects of quinolones) gastrointestinal disturbances such as diarrhea, rash, tendinitis, and (in children) myalgia.
膀胱炎治療キノロン。副作用で有名なのは腱炎、多いのは下痢
14.A mnemonic you can use to remember inactivated vaccines is RIP Always: Rabies, Influenza (injection), Polio (Salk), hepatitis A.
不活化ワクチン
15.Löwenstein-Jensen agar is used to culture Mycobacterium tuberculosis, an acid-fast bacteria, and Ziehl-Neelsen stain is used to visualize M tuberculosis.
16.L pneumophila grows best on buffered charcoal yeast extract agar with iron and cysteine.
高齢者の肺炎、レジオネラ。
チャコール培地で培養。
17.LDL cholesterol receptor dysfunction is characteristic of familial hypercholesterolemia, also known as type II hyperlipidemia.
家族性はLDL受容体の障害
18.Type 1 familial dyslipidemia is the result of impaired triglyceride degradation due to a deficiency of lipoprotein lipase. It is characterized by high levels of chylomicrons in the blood.
high TG→risk of pancreatitis.
膵炎起こす。
19.Hydroxyurea：treatment of sickle cell disease
Hydroxyurea increases fetal hemoglobin production, which lowers the risks of RBC sickling and sickling-related complications.
鎌状赤血球の治療薬ハイドロキシウレア。
機序はfetal hemoglobin production。
20.Pure RBC aplasia：characterized by a reduced hemoglobin and reticulocyte count in the presence of a normocytic, normochromic anemia.
・Phenytoinの副作用pure RBC aplasia。
21.β1agonist：causes an increase in heart rate, contractility, and renin release.
22.β1blocker：cause decreased heart rate, contractility, and renin release.
β1ブロッカー。
23.Retained placental tissue results in excessive postpartum bleeding. Placenta accreta：an abnormally adherent placenta that can cause retained placenta and is most common in patients with a history of uterine trauma (eg, cesarean section, dilation and curettage, myomectomy).
胎盤組織残存で出産後出血。
24.giardiasis
Tx) Metronidazole：associated with disulfiram-like reactions. Patients should be advised against drinking alcohol while undergoing treatment.
ジアルジアの治療はメトロニダゾール。
ジスルフィラム様反応を起こすため、アルコールは禁忌！
Albendazole and nitazoxanide are second-line drugs for giardiasis.
アルベンダゾール、ニタソキサニドはジアルジアの第2選択薬
25.HLA-DR4 is strongly associated with RA.
26.Metamyelocytes：increased in leukemias of myeloid lineage, such as CML and AML.
・Plasma cells→multiple myeloma
・Promyelocytes：increased in APL t(15;17)
・T lymphoblasts：increased in T lymphoblastic leukemia/lymphoma, a disorder most common in teenage males who typically present with a high lymphoblast count and a mediastinal mass.
T細胞のリンパ腫は子供で縦隔腫瘍が特徴！
27.Regression is an immature ego defense in which children or adults revert to an earlier developmental stage, often in times of great stress. Regressive behaviors can include actions like bedwetting and tantrums.
両親離婚、9歳の子供がおねしょのケース。
28.CFはADで主な原因はMisfolding of a protein.
The most common mutation of CFTR protein, delta F508 (class II) is on chromosome 7
29.At plasma levels between 200 and 375 mg/dL, glucose begins to appear in the urine, and at levels exceeding 375 mg/dL, transport becomes saturated.
近位尿細管での再吸収の限界が血糖が375。
30.Delta waves are seen in WPW syndrome, but this syndrome does not lead to torsades de pointes.
31.Obesity is a risk factor for endometrial carcinoma.
In addition, any condition that increases estrogen exposure increases the risk for the development of endometrial hyperplasia or carcinoma.
肥満は内膜癌のリスク。
32.Patients with CLL have an increased risk of autoimmune hemolytic anemia, as well as infection due to hypogammaglobulinemia.
CLLでは自己免疫性溶血性貧血のリスクが高い。
33.Hyper IgE syndrome has two forms.
・autosomal dominant form is caused by a mutation in the STAT3 gene
・autosomal recessive form is caused by a mutation in the DOCK8 gene.
Both mutations result in impaired T-helper (Th) 17 cell development, which has a role in eliminating extracellular bacterial and fungal pathogens.
Hyper IgEはSTAT3遺伝子とDOCK8遺伝子の異常→Th17細胞の障害で細胞外の病原菌を排除できない。
34.Invasive ductal carcinoma of the breast is characterized by a growing, painless mass in the breast, combined with biopsy findings of tubules and solid sheets of malignant epithelium infiltrating into a desmoplastic stroma.
Klinefelter syndrome (47,XXY genotype) ：9-fold increased risk for developing breast cancer.
クラインフェルター症候群は乳がんのリスク9倍。
35.脳発生
forebrain→telencephalon/diencephalon
midbrain→mesencephalon
hindbrain→metencephalon/myelencephalon
36.Dextroamphetamine increases the release of serotonin.
used for narcolepsy and ADHD.
セロトニン症候群起こしやすい薬。アンフェタミン。
ADHDとナルコレプシーに使う。
37.
・Tuft cells：chemosensory cells in the intestinal epithelium.
・Goblet cells：secrete mucus into the gastrointestinal tract.
・Paneth cells：in the crypts of Lieberkühn
・Parietal cells：in the gastrointestinal tract；secrete hydrochloric acid and intrinsic factor.
38.Microfold cells
Shigellosis：common cause of bloody diarrhea in low-income countries.
Shigella flexneri, a nonmotile, gram-negative bacterium.
S flexneri uses microfold cells (M cells) to invade the gastrointestinal tract.
低所得国において血便の原因に赤痢がある。
39.Duodenal ulcers are associated with hyperplasia of Brunner glands.
十二指腸潰瘍はブルンナー腺の過形成と関連あり。
喫煙とNSAIDs内服歴が重要。
・Idiopathic hyperplasia or hypertrophy of the muscularis layers in the gastrointestinal tract usually manifests with abdominal discomfort and weight loss.
・The mucosa of the antrum of the stomach consists of mucus-secreting cells, as well as neuroendocrine cells that secrete gastrin.
・Tubular glands in the fundus of the stomach consist primarily of neck cells, which secrete mucus; parietal cells, which secrete hydrochloric acid and intrinsic factor; and chief cells, which secrete pepsin.
40.Small dark blue cells would be seen in tissue from a patient with small cell carcinoma; on CT, small cell carcinoma would be seen as a distinct lung nodule, often with spiculations.
Red-purple partial consolidation of parenchyma is seen in the congestive stage of lobar pneumonia.
CT of the chest of a patient with lobar pneumonia would demonstrate diffuse opacities of the lung parenchyma in a lobular distribution.
Interdigitating areas of pink and red that form the "lines of Zahn" are characteristic of a thrombus, such as a pulmonary embolism.
Caseating granulomas with central necrosis and Langhans giant cells are characteristic of secondary tuberculosis.
41.Chlamydial conjunctivitis has an onset of approximately 5 to 14 days after birth.
クラミジア結膜炎は出生後1,2週間で発症。
42.Gonococcal conjunctivitis typically occurs from birth to around the fifth day of life.
淋菌性結膜炎は出生後5日程度。
43.Drug-induced myopathy presents in the setting of medication use.
・cholesterol-lowering drugs
・glucocorticoids, colchicine.
CK↑ but inflammation will typically be absent on biopsy.
炎症はなし！！
44.Aprepitant acts through NK-1 receptor antagonism to inhibit substance P stimulation of the emesis pathway.
アフレピタントはサブスタンスP阻害
45.Antibodies against the ADAMTS13 enzyme are seen in TTP.
inhibition leads to decreased breakdown of von Willebrand factor (vWF).
Large vWF multimers then line the capillaries and cause damage to circulating RBCs (schistocytes).
46.A common adverse effect of anthracyclines such as doxorubicin is congestive HF, caused by dilated cardiomyopathy.
Anthracyclines intercalate DNA, thereby disrupting DNA replication and causing cell death.
47.Cohort studies：useful in measuring the effects of rare exposures.
コホート研究は希な暴露の効果を判定するのに役に立つ
48.Fanconi anemia
the most common cause of hereditary aplastic anemia.
an inherited bone marrow failure syndrome in which cells are at increased susceptibility to chromosomal breakage due to defects in DNA repair.
Diamond-Blackfan anemia：a congenital erythroid aplasia that is characterized by progressive normochromic, macrocytic anemia with no other significant cytopenias.
49. Neurofibromatosis type 1 (NF1) is an AD neurocutaneous syndrome characterized by café-au-lait macules, axillary and/or inguinal freckling, Lisch nodules (iris hamartomas), osseous dysplasias, and neurofibromas
50.Cilastatin is used with imipenem.
→inhibiting renal deactivation of imipenem by inhibiting dehydropeptidase-1 at the proximal tubule.
シラスタチンはイミペネムと使用、イミペネムの不活化を防ぐ。
