1

dPreclinical
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.

C
C
A
D
E
E
B
D
B
A
C
D,E
E
B
B
A
C
C
B
C
A
C
C
A
C
D
A
A,B

29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.

A
B
E
C
E
E
D
E
D
A
B
C,B
D
C
A
C
B
C
E
A
D
E
C
C
D
A,E
E
E

Comprehensive Examination 2007

57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
82.
83.
84.

E
A
A

D
E
C
B
A
C
A
C
D
D
E
B
A
B
D
C
B
C
D
D
B
A
D

85.
86.
87.
88.
89.
90.
91.
92.
93.
94.
95.
96.
97.
98.
99.
100.
101.
102.
103.
104.
105.
106.
107.
108.
109.
120.
121.
122.

B
A
B
E
C
C
C
D
C
B
A
A
E
B
C
A
C
A
E
B
E
B
C
D
C
A
B
A

123.
124.
125.
126.
127.
128.
129.
130.
131.
132.
133.
134.
135.
136.
137.
138.
139.
140.
141.
142.
143.
144.
145.
146.
147.
148.
149.
150.

D
E
B
C
D
E
B
A,D
B
B
B
E
A
D
A
C
B
B
B
C
D
D
C
C
A
C
C
D

151.
152.
153.
154.
155.
156.
157.
158.
159.
160.
161.
162.
163.
164.
165.
166.
167.
168.
169.
170.
171.
172.
173.
174.
175.
176.
177.
178.

A
E
A
E
A
D
D
A
A
E
B
E
C
D
E
D
E
B
A
B
A
D
E
E
E
C
C

Preclinical Comprehensive Examination 2007 by Med SWU 22

179.
180.
181.
182.
183.
184.
185.
186.
187.
188.
189.

D
C
B
D
A
D
E
A
D
D
D

190.
191.
192.
193.
194.
195.
196.
197.
198.
199.
200.

A
A
D
D
B
B
C
E
A
C

201.
202.
203.
204.
205.
206.
207.
208.
209.
210.
211.

A
0.05
E
E
C
A
A
B
B
E

212.
213.
214.
215.
216.
217.
218.
219.
220.
221.
222.

C
E
C
105
A
C
C
B
D
A
C

241.
242.
243.
244.
245.
246.
247.
248.
249.
250.
251.
252.
253.

2agonist,corticosteroid 254. Burkitt's lymphoma,

Patent ductus arteriosus
nasopharyngeal carcinoma
10th rib, paravertebral line
255. antipsychotic, block D2
CN III, CN XI
256. macrolide
sternocleidomastoid
257. rheumatic fever
fibrosis
258. HIV,
produces a depolarizing block
259.
inh. cholinesterase irreversible 260. neural tube defect
metformin
261. metaplasia
neutrophillic & peritoneal abscess 262. esophageal atresia/stenosis
oxytocin
263. EBV
CA colon
264. pancreas
cancer
265. gastrin

223.
225.
225.
226.
227.
228.
229.
230.
231.
232.
233.

A
B
B
A
D
E
C

A
C

234.
235.
236.
237.
238.
239.
240.

vit. K
A
A
A

266.
267.
268.
269.
270.
271.
272.
273.
274.
275.
276.
277.

bcl-2
hemochromatosis
pancreatitis

down regulation
Enterobius vermicularis
inhibit DNA gyrase
ureter
ST elevate

succinylcholine

O. viverrini

A
C

Preclinical Comprehensive Examination 2007 by Med SWU 22

1)

2)

3)

c. histiocyte ( 46)
silicone hydrophobic nonspecific
foreign body response typical macrophage invasion giant cell
formation scar (histiocyte = tissue macrophage)
c. pancreas ( 17,264)
epigastirc pain
pancreas retroperitoneal
structure pancreatic lipase

a. ( 24)
achalasia = LES tone tone
LES LES tone

Esophageal manometry is the criterion standard in helping to diagnose the

classic findings of achalasia. These findings include the following:
- Incomplete relaxation of the LES in response to swallowing
- Increase resting LES pressure
- Absent esophageal peristalsis
Esophageal manometry

An esophageal manometry test measures the motility and function of the

esophagus and esophageal sphincter. A tube is usually inserted through the
nose and passed into the esophagus. The pressure of the sphincter muscle is
recorded and also the contraction waves of swallowing are recorded. The
manometry test is a tool used to help evaluate swallowing disorders.
Preclinical Comprehensive Examination 2007 by Med SWU 22

4)

5)

6)

7)

d. aspartic acid
kwarsiokor marasmus
kwarsiokor essential amino
acids non-essential amino acids essential amino acids Leu,
Lys, Ile, Phe, Tyr, Thr, Met, Val, Arg*, His* (*=
)
aspatatic acid
e. external anal sphinter
mediolateral episiotomy surgical incision perineum inferoposterior
vagina
perineum external anal sphincter (the ACOG
recommended in 2006 that its use be restricted to maternal or fetal indications.
Studies have also shown that routine episiotomy does not decrease the risk of
severe perineal lacerations during forceps or vacuum-assisted vaginal deliveries)
e. testicular feminizing syndrome
testicular feminizing syndrome androgen insensitivity syndrome (46,XY)
defect androgen receptor vagina
(rudimentary vagina) uterus uterine tubes testis
labia majora testosterone, estrogen, LH
a. Turner syndrome - short stature, ovarian dysgenesis, web neck, preductal
coarctation of aorta, amenorrhea, normal pubic hair secondary
sex characteristic
c. adrenogenital syndrome congenital adrenal hyperplasia
cortisol aldosterone 21-hydroxylase
deficiency pregnenolone pathway sex
steroid hormone testosterone
d. female pseudohermaphrodite ovaries external genitalia
b. inactivation of p53 gene ( 191,223)
glioma inactivation of p53 gene p53 tumour
suppression gene over expression of PDGF-A major
mitogen for glial cells by binding to the PDGF receptor (PDGFR) tumor

Preclinical Comprehensive Examination 2007 by Med SWU 22

8)

9)

10)

11)

12)

DNA tumor p53 gene

activate apoptotic protein inactivate p53

d. competitive inhibition

(hyperventilation, impaired vision, blindness) methanol
gastric mucosa metabolize alcohol dehydrogenase
formaldehyde metabolized aldehyde dehydrogenase formic
acid ethanol alcohol
dehydrogenase affinity 10-20 methanol product
b. T-cell
cyclosporine cyclophilin complex differentiation & activation of
T cell calcineurin IL-2 receptor
a. retinol
vitamin A deficiency keratinizing metaplasia
(xerophthalmia)
- 1 xerosis of conjunctiva
- 2 bitots spot abnormal squamous cell proliferation and
keratinization of the conjunctiva
epithelial cell
- 3 xerosis of cornea
4 keratomalacia
c. 16.00 .
2
4oC 14.00 . 16.00 .
d. sym activity / e. efferent arteriole resistant ( 232)
volume baroreceptor
impulse vasomotor center medulla
sympathetic activity renin JG cell
angiotensin II Na+ water absorption volume
angiotensin II efferent arteriole resistance

Preclinical Comprehensive Examination 2007 by Med SWU 22

13)

14)

e. collecting duct ( 50)

proximal tubule 67%
67%
isotonic
e.collecting duct Na+
rennin angiotensin aldosterone system aldosterone
principal cell collecting duct Na+ K+
K+ K+-H+ exchanger intercalated cell
collecting duct K+ H+
2 long acting aldostrone

b. Krebs cycle
- deep tendon reflex
(neuropathy) thiamine (vitamin B1)
nutritional deficiencies chronic alcoholism direct toxic alcohol
- pyruvate dehydrogenase complex TPP (thiamine pyrophosphate
coenzyme form thiamine), lipoamide, FAD, NAD+/NADH CoA
enzyme pyruvate acetyl CoA mitochondrial matrix Krebs
cycle thiamine acetyl CoA Krebs cycle
metabolic pathway

Preclinical Comprehensive Examination 2007 by Med SWU 22

15)

thiamine deficiency pyruvate (substrate), lactate

( pyruvate anaerobic), citrate, -ketoglutarate
(intermediate Krebs cycle) Ach

b. purine
hyperuricemia tumor lysis syndrome

spontaneous tumor lysis syndrome ALL
metabolic

uric acid purine metabolism

nucleus uric acid end product purine catabolism

uric acid (hyperuricemia)
Preclinical Comprehensive Examination 2007 by Med SWU 22

16)

17)

18)

19)

20)

a.
urinary bladder transitional cell carcinoma
- cigarette smoking
- diets high in saturated fat
- exposure to workplace carcinogens
- exposure to anti-neoplastic drugs (used in chemotherapy) or radiotherapy
c. pancrease ( 2,264)
epigastrium referred pain pancreas
pancreas pancreatic lipase

c. minute ventilation ( 109)

respiratory rate
minute ventilation 1
1 x RR
A. TV 500 mL
B. RR

D. dead space ventilation
E.
RR
b. 8
rib 8 anterior axillary line pleural border
pleural reflection rib 8
c. vasopressin ( 79,80)
16 . (dehydration)
urine sp.gr. > 1.020 rennin
angiotensin II ( 12) angiotensin II thirst
center hypothalamus vasopressin (ADH) pituitary gland
late distal tubule collecting duct insertion
aquaporin water channel
dehydration
Preclinical Comprehensive Examination 2007 by Med SWU 22

21)

22)

23)

24)
25)

26)

27)

a. anti-dsDNA antibody

SLE antinuclear antibodies (ANA)
lab test screen SLE specific double stranded
DNA (dsDNA) antibodies ( SLE 50-60%) Smith (Sm)
antibodies (specific SLE SLE 30-35%)
c. 5
70 = 0.1+0.08+0.02 = 0.2
0.2 (20%) 1
1 (100%) 1/0.2 = 5
life expectation 70 5
c. 1 FEV1 0.244 liter
FEV1(liter) = (1.052 x height) - (0.244 x age) - 0.561
age -1, -0.244, 1, 0.244 a, b, c, d c
c. ( 3)
c.
heat stoke

(Ref. )
d. carboxyhemoglobin

carbon monoxide
carbon monoxide

cherry red carboxyhemoglobin

a. FEV1/FRC
Forced expiratory volume: FEV1 = 1
functional residual capacity: FRC = expiratory reserve volume + residual volume
COPD (obstructive lung disease) FEV1, FRC
FEV1/FRC

Preclinical Comprehensive Examination 2007 by Med SWU 22

10

28)

29)

30)

31)

32)

a. / b. flex, medial rotate, adduct

posterior dislocation dislocation of the hip flexion, adduction,
internal rotation
dash board dislocation sciatic nerve
posterior dislocation
a. Staphylococcus aureus
catalase positive = Staphylococci and Micrococci
- coagulase positive = Staphylococcus aureus (only)
- coagulase negative ex. Staphylococcus epidermidis
catalase negative = Streptococci and Enterococci
b. chylomicron
serum
chylomicron TG
e. esophageal atresia
NG tube (nasogastric tube) NG
tube
a. midgut volvulus midgut fetal development 270
bile
b. duodenal atresia duodenum bile
c. annular pancrease pancreas dorsal pancreatic bud
ventral pancreatic bud duodenum

d. hypertrophic pyrolic stenosis pylorus
pyloric canal
duodenum
(projectile vomiting)
e. esophageal atresia
hydramnios
c. PaCO2
tidal volume
anatomical dead space respiratory tract

Preclinical Comprehensive Examination 2007 by Med SWU 22

11

33)

34)

35)

36)

PaCO2 CO2
alveolar ventilation = (tidal volume - anatomical dead space) x RR
alveolar ventilation 1 = (500 - 200) x 15 = 4,500 ml/min
alveolar ventilation 2 = (350 - 200) x 30 = 4,500 ml/min
2 PaCO2
e. FEV1 ( 103)
emphysema obstructive lung disease (COPD) alveolar wall
obstruction air flow air trapping
residual volume, FEV1, FVC , FEV1/FVC (hallmark),
V/Q mismatch, lung compliance, intrapleural pressure, airway resistance
e. cholesterol
cholesterol bile salt bile salt
cholesterol bile salt cholesterol
bile salt
cholesterol cholesterol
d. fragmentation plasma membrane
acute myocardial infarction
irrivervsible plasma membrane damage, lysosomal rupture, Ca2+
influx, nuclear pyknosis, karyorrhexis, karyolysis, mitochondrial permeability
reversible cellular swelling, decrease ATP synthesis, nuclear
chromatin clumping, ribosomal detactment, glycogen depletion, fatty change
e. ruptured cerebral aneurism
sign increase intracranial pressure
a. brain abscess
b. hydrocephalus stiff neck
c. thrombotic stroke weakness
d. acute bacterial meningitis
(Ref. , )

Preclinical Comprehensive Examination 2007 by Med SWU 22

12

37)

38)

39)

40)

d. middle cerebral artery left ( 63)

d e
motor aphasia (Broca, Wernicke or conduction)
left middle cerebral artery
e

show
language function 2

middle cerebral artery
- spastic paresis of the contralateral lower face and upper limb
- anesthesia of contralateral face and upper limb
- aphasia (left)
- left-sided neglect (right)
proximal part of visual radiations lateral geniculate
nucleus thalamus Meyers loop
contralateral superior quadrantanopsia
a. HSV
- erythematous papules. often painful
- thin-walled, intraepidermal vesicles that become pustular and ulcerate
- herpetic vesicles appear on the external genitalia, labia majora, labia minora,
vaginal vestibule, and introitus.
- multinucleated giant cells and epithelial cells containing eosinophilic
intranuclear inclusion bodies distinguish the lesions of herpes viruses
b. glycolytic enzyme
200 () - stored ATP, creatine phosphate, anaerobic glycolysis
( ) - glycogen oxidation, fatty acid oxidation
glycolytic enzyme glycolysis
d. LN
metastasis sign malignancy

Preclinical Comprehensive Examination 2007 by Med SWU 22

13

40)

41)

42)

43)

b. skin ulcer
cell injury
1. resolution 100% labile cell

2. regeneration stable cell
injury hepatocyte
3. repair CNT scar
permanent cell cardiac muscle cell
d. TSH
hyperthyroidism primary, secondary
tertiary hyperthyroidism thyroid gland ( T3,T4),
pituitary gland ( TSH) hypothalamus ( TRH)
TSH hyperthyroidism
TSH thyroid gland secondary tertiary
cause TSH thyroid gland
primary cause TRH hypothalamus pituitary
gland hormone most common
cause hyperthyroidism Graves disease
autoimmune disease thyroid stimulating immunoglobulin antibody
TSH receptor thyroid gland hormone
3 (triad) hyperthyroidism - diffuse enlargement of thyroid
gland , exopthalmos - pretibial myxedema - nonpitting
edema and thickening of the skin
c. Na+ reabsorption ( 101)
Na+ blood pressure rennin
angiotensin activating system angiotensin II potent efferent
arteriole constriction, aldosterone ADH
aldosterone Na+ reabsorption collecting duct
a. hyponatremia
BP buffalo hump (steroid) steroid
hypothalamus-pituitary-adrenal gland axis adrenal gland

Preclinical Comprehensive Examination 2007 by Med SWU 22

14

44)

45)

46)
47)

48)

hormone maintain BP fat metabolism

adrenal insufficiency steroid BP
fat buffalo hump electrolyte imbalance
hyponatremia, hyperkalemia hypercalemia weakness and
fatigue (99%), anorexia (99%), orthostatic hypertension (90%), nausea (86%),
vomiting (75%), hyponatremia (88%) Cushings syndrome
steroid steroid hypertension, hypokalemia,
hypernatremia hyporcalcemia (Ref. , )
c. fibropurulent inflammation
acute appendicitis serosa fibrin

fibropurulent inflammation
b. follicular hyperplasia
follicular hyperplasia etiology
- Lymph nodes react to inflammatory processes in the area they drain.
- Any infectious agent, including bacterial, viral, rickettsia, protozoan, parasitic
and Chlamydia. The pathogens can cause follicular hyperplasia.

c. histiocyte ( 1)
e. hydrostatic pressure
Na+ volume hydrostatic
pressure baroreceptor sympathetic activity
rennin (Ref. )
a. Na+
= = Na+

Preclinical Comprehensive Examination 2007 by Med SWU 22

15

49)

50)
51)
52)

53)

54)

55)

d. phase IV clinical trial

clinical trial
phase 0 designation for expiratory
phase I human subject (healthy volunteers 20 - 80 )
safety, phamacodynamic, phamacokinetics
phase II human subject (healthy volunteers+ patients 20 - 300 )
phase III human subject (patients 300 - 3000 )
phase IV post marketing surveillance trial
phase IV clinical trial
e. collecting duct ( 13)
c. coronary heart disease
estrogen triglyceride & glucose
c.
Hct
compensate RBC
hematocrit
d. transversalis fascia
structure : external abdominis muscle, internal abdominis muscle,
transversus abdominis, transversalis fascia, peritoneum rectus abdominis
anterior and posterior rectal sheath
a. hypoxia / e. pneumothorax
- decompression sickness peripheral hypoxia (Ref. )
- pneumothorax
pressure volume expansion of gas volume
pnuemothorax (Ref. )
e. peripheral vasoconstriction ( 136)
head injury brain edema intracranial pressure
Cushing reaction (Cushing reflex)
cerebral ischemia compensate peripheral
vasoconstriction BP intracranial pressure
pulse
Preclinical Comprehensive Examination 2007 by Med SWU 22

16

56)

57)

58)

59)

60)

61)
62)

e. H. aphrophilus
Haemophilus aphrophilus endocarditis
mitral valve
e. iliac spine
In both adults and children, aspiration and biopsy are most commonly performed
on the rear bone of the hip (posterior iliac crest). In adults, sampling from the
sternum is sometimes done. The latter location is technically easier, but is
somewhat more painful for the patient and presents the risk of heart injury. On
rare occasions, a long bone of the leg may be used as a sample site for an infant.
a. 5
relative risk = 60, relative risk = 80
absolute risk reduction = 80 60 = 20% = 0.2
number need to treat = 1/ 0.2 = 5
a. epithelium 10, WBC 40 ( 61)
adequate sputum = acceptable sputum = true sputum epithelium 10
cells/LPF, WBC 25 cells/LPF
epithelial cell unacceptable sputum
compensate metabolic alkalosis
- pH 7.58 (7.35 - 7.45) alkalosis
- furosemide Na+, K+, Cl- K+
compensate H+-K+ shift H+ primary cause
metabolic alkalosis
- PCO2 50 mmHg (35-45) compensate
compensate metabolic alkalosis
epithelium 10 cells/LPF, WBC 25 cells/LPF ( 59)
d. beta-2 agonist
terbutaline sulfate fast-acting bronchodilator beta-2 agonist
short term asthma tocolytic delay
15 6 stop
contraction
FDA
Preclinical Comprehensive Examination 2007 by Med SWU 22

17

63)
64)

65)

66)

67)

e. left middle cerebral artery ( 37)

c. gamma 4
-thalassemia 1 0-thalassemia
2 loci -thalassemia 1
SEA (Southeast Asia type)
19 kb Med (Mediterranean
type) 18 kb 10
Thai 34
(homozygote) 1 (--/--)
(Hb
Bart's hydrops fetalis)
24
b. erythropoietin
MCV, WBC , creatinine (normal values serum: 0.5 - 2.5
mg/dl) reticulocyte
renal failure erythropoietin RBC
a. Ach
botulinum toxin presynaptic nerve terminal
neurotransmitter acetylcholine




c. pineal gland
melatonin N-acetyl-5-methoxytryptamine N-[2(5-Methoxy-1H-indol-3-yl) ethyl] acetamide
Pineal gland
Melatonin

Melatonin
Melatonin
Preclinical Comprehensive Examination 2007 by Med SWU 22

18

68)

69)

70)

71)

72)

73)

74)

a. lung compliance
surfactant type II pneumocyte alveolar surface tension,
compliance work of respiration
c. hippocampus ( 149)
Alzheimers disease most common demantia
diffuse cerebral atrophy senile
amyloid plaque tau protein hippocampus
(tempotal lobe) parietal lobe frontal lobe subcortical
acetylcholine (Ref. )
d. delay type hypersensitivity
delayed type hypersensitivity (type IV) = Teffector Tdth
tuberculin test 48-72
d. Ab-cytotoxic hypersensitivity
myasthenia gravis involve thymoma antibody
acetylcholine receptor NMJ Ab-cytotoxic hypersensitivity (type II)
e. tetanus neonatorum
tetanus neonatorum
Clostridium tetani

b. desmosome
acantholysis suprabasal bullae pemphigus vulgaris
IgG desmosome
a. nerve growth hormone /
- Alzheimer ACh ACh nerve growth hormone
(Ref. )
- 100%
neurodegenerative direct toxic effect amyloid
beta protein deposit cell Ca homeostasis,
inflammatory cell reaction definite pathogenesis
(Ref. )

Preclinical Comprehensive Examination 2007 by Med SWU 22

19

75)

76)

77)

78)

79)
80)
81)

82)

83)
84)

b. oxytocin
oxytocin

d. progesterone
progesterone endometrium glandular secretion, maintance
pregnancy, production of thick cervical mucus, body temperature
c. erythromycin
gram stain Neisseria gonorrhea
aminopenicillin ampicillin, amoxicillin
penicillin macrolide erythromycin
b. radial nerve ( 142)
posterior surface of humerus radial groove radial nerve
humerus radial nerve wrist drop
c. vasopressin ( 20,80)
a. ADH ( 20,79)
d. herpes simplex infection
- erythematous papules. often painful
- thin-walled, intraepidermal vesicles that become pustular and ulcerate
- herpetic vesicles appear on the external genitalia.
- multinucleated giant cells and epithelial cells containing eosinophilic
intranuclear inclusion bodies distinguish the lesions of herpesviruses
b. PaCO2 55 mmHg
barbiturate phenobarbital pentobarbital thiopental sedative for anxiety,
seizure, insomnia, induction of anesthesia (thiopental) toxic
respiratory acidosis arterial blood gas pH < 7.4, PaCO2 > 40
mmHg, HCO3 > 32 mEq/L
a. familial institute
d. compensated metabolic alkalosis
furosemide Na+,K+,2Cl- pump thick ascending limb of loop of Henle
hypokalemia K+ H+
metabolic alkalosis compensate
CO2 PaCO2
Preclinical Comprehensive Examination 2007 by Med SWU 22

20

85)

86)

87)

b. rheumatoid arthritis
3 (synovial fluid) ( CSF)
group 1
group 2
group 3
normal
non-inflam. inflammatory
purulent
WBC/mm3
< 200
200-2,000 2,000-50,000 > 50,000
%PMN
< 25
<25
> 50
> 75
Glucose mg/dl
Normal
Normal
70-90
< 50
serum SF
0
0
10-30
> 50
group 1 - non inflammatory osteoarthritis, traumatic arthritis, SLE
group 2 - inflammatory
rheumatoid arthritis, rheumatic fever
group 3 - purulent
septic arthritis
a. testicular feminizing syndrome
XY
labia
labia majora
b. female pseudohermaphrodite ovary external genitalia
androgenic steroid
d. cryptorchism
e. hypospadias penile urethra ventral side of penis
b. hydroxylation of proline ( 106)

(scurvy) vitamin C ascorbic scid
vitamin C cofactor hydroxylation of proline
collagen collagen

Preclinical Comprehensive Examination 2007 by Med SWU 22

21

88)

89)

90)

91)

92)

e. total peripheral resistance

decompensate shock
(PR 110 beat/min)
c. central venous pressure d. end diastolic pressure
decompensate shock
(Ref. )
c. spinal cord ( 146)
sign
UMN lesion LMN lesion
weakness
+
+
atrophy
+
fasciculation
+
reflex

tone

Babinski
+
spastic palalysis
+
LMN lesion UMN lesion
lower motor neuron
upper motor neuron
c. erythropoietin
Hb & Hct erythropoietin
erythropoietin
c. consistency ( 233)
consistency =
systematic review

consistency amoxicillin
co-amoxiclav sinusitis 2
consistency (Ref. )
d. muscarinic receptor
vagus nerve
acetylcholine muscarinic receptor (M3) parietal cell
Preclinical Comprehensive Examination 2007 by Med SWU 22

22

93)

c.

94)

95)

96)

local
:
:
(tissue necrosis)
:
:

(blister)
(hemorrhagic bleb)

(ecchymosis)


lymphangitis thrombophlebitis

systemic

b. RR interval
RR interval heart rate HR

a. migration
neural crest parasympathetic
(migration) 1-1.5 . dentate line
neural crest rectum
propulsive movement v
48




a. hydrocele
- Epispadias is a rare type of malformation of the penis in which the urethra
ends in an opening on the upper aspect (the dorsum) of the penis.
- Hypospadias is a birth defect of the urethra in the male that involves an
abnormally placed urinary meatus (opening). Instead of opening at the tip of
Preclinical Comprehensive Examination 2007 by Med SWU 22

23

97)

98)

99)

the glans of the penis, a hypospadic urethra opens anywhere along a line (the
urethral groove) running from the tip along the underside (ventral aspect) of
the shaft to the junction of the penis and scrotum or perineum. A distal
hypospadias may be suspected even in an uncircumcised boy from an
abnormally formed foreskin and downward tilt of the glans.
- Inguinal hernias are protrusions of abdominal cavity contents through the
inguinal canal.
- hydrocele inguinal hernias hydrocele


inguinal hernias
content
e. HPV
The number one predisposing factor for cervical cancer is infection with the
Human Papilloma Virus (HPV). Any factor which increases a woman's risk of
contracting Human Papilloma Virus will increase the risk of cervical cancer.
b. tuberculosis
TB location apex
secondary TB apex lesion (Ref.
)
c. Neisseria meningitides ( 240)
stiffness of neck meningitis
CSF exam bacteria infection
Neisseria meningitides
CSF
color
Glucose
Protein
opening pressure
leukocytes

normal

bacterial meningitis
clear
cloudy
50-80 mg/dl
much less than 50
20-45 mg/dl
much greater than 45
100-200
increased >200
no neutrophils and markedly increased
under 6 lymphocytes neutrophils

viral meningitis
clear to cloudy
normal
> 45
normal or increased
increased CSF
lymphocytes

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24

100) a. glomerulus
protein 2+ protein glomerulus
proteinuria glomerulus
101) c. Na+ reabsorption ( 42)
102) a. Esterichia coli
ureteral calculi obstruction infection
urine flushing colonization bacteria most common
urinary tract infection (UTI) ascending infection Esterichia coli
103) e. FEV1 ( 33)
104) b. 10
Y max 25 mg 2
Y max 50 mg 1
X max 5 mg 1 hr
Y 50/5 = 10 X
105) e. absence of metanephrogenic tissue
a. oligohydramnios
b. polycystic kidney cyst
c. ureteric bud duplication
d. degeneration of mesonephros nephros
metanephros
106) b. hydroxylation of proline ( 87)
107) c. apoptosis
characterize apoptosis programmed cell death cell shrinkage,
pyknosis (chromatin condensation), karyorrhexis (DNA fragmentation), karyolysis
(nuclear fragmentation), membrane blebbing apoptotic body
cell inflammation
108) d. ordinal ( 195)
4
1. nominal:
blood group

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25

109)
120)

121)

122)
123)
124)
125)

2. ordinal:
CA staging
3. interval:


4. ratio:

c. minute ventilation ( 18)
a. aveoli
crepitation crackle
elastic recoil
3
- corarse:
- medium:
- fine:
terminal bronchiole pulmonary edema
a. fluid alveoli pulmonary edema
b. airways resistance
emphysema bronchietasis obstructive lung disease (COPD)
obstruction air flow air trapping FEV1, FVC
, RV, FEV1/FVC (hallmark), V/Q mismatch, airway resistance
a. basophil
hypersensitivity type I basophil IgE
d. hemochromatosis
hemochromatosis
e. cell differentiate
stem cell cell differentiate (Ref. )
b. precipitate hemoglobin
precipitate hemoglobin oxidation of reactive sulfhydryl groups on globin
chains, which become denatured and form membrane-bound precipitates known
as Heinz bodies.

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26

126) c.
pancytopenia
thrombocytopenia upper GI bleeding
127) d. neural crest

melanin neural crest neural crest
melanocyte melanin
128) e. hCG
hCG syncytiotrophoblast placenta
129) b. papillary carcinoma
grossly discernible papillary foci malignant nodule cold
nodule hyperthyroidism or hypothyroidism
130) d. glutathione conjugate / a. N-acetylation
d. glutathione conjugate
paracetamol toxic metabolites
glutathione sulfhydryl group
reducing toxic metabolites NAC
sulfhydryl group glutathione toxic
metabolites NAC 24 paracetamol
NAC

paracetamol (Ref. )
a. N-acetylation
NAC acetylation
paracetamol (Ref. )
131) b.

1 - HBsAg / anti-HBc, anti-HBs acute infection
2 - HBsAg, anti-HBc / anti-HBs carrier

Preclinical Comprehensive Examination 2007 by Med SWU 22

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- HBsAg = hepatitis-B virus surface antigen

- Anti-HBs = anti-hepatitis B virus surface antigen = antibody

(HBsAg)
- Anti-HBc = anti-hepatitis B virus core antigen = antibody

132) b. pleural effusion
breath sound
dullness
density

a. pneumothorax hyper-resonance
c. pneumonia fluid consolidation
d. atelectasis ()
Preclinical Comprehensive Examination 2007 by Med SWU 22

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133) b. AST (SGOT) > 2000

AST enzyme cytoplasm mitochondria
acute hepatitis AST cell
enzyme AST

ALP enzyme case
enzyme
134) e. brochogenic CA

engorge jugular venous dilate superficial vein on chest
superior vena cava syndrome
(SVCS) relate malignancy brochogenic CA tumor
SVC CA
metastasis hilar lymph node lymph node
135) a.
meningitis CSF gram negative
diplococcic bacterial meningitis Neisseria meningitidis

136) d. vasoconstriction of peripheral vessels ( 55)

137) a. metformin
DM type 2
metformin glucose
lipid profile

138) c. peripheral chemoreceptor
partial pressure O2
peripheral chemoreceptor receptor carotid
body partial pressure O2 CO2
peripheral chemoreceptor
- peripheral chemoreceptor PO2, PCO2, H+
- central chemoreceptor PCO2, H+
Preclinical Comprehensive Examination 2007 by Med SWU 22

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139) b. K+
Cushing syndrome cortisol
case cortisol
mieralocorticoid hypokalemia hypernatremia glucocorticoid
Ca2+ Ca2+
serum Ca2+
140) b. bcl-2 ( 266)
bcl-2 18 mitochondrial membrane
apoptosis aging B-cells mitochondrial
permeability gene proto-oncogene

141) b. pyrimidine salvage pathway

a. first MTP joint uric acid gout
c. nucleic acid purine uric acid
d. uric acid acidosis
b. uric acid end product purine salvage pathway
142) c. radial nerve ( 78)
143) d. furosemide
potassium spinoloractone, amiloride eplereone
K+- sparing K+
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144) d. Guillain-Barr syndrome

Guillain-Barre syndrome weak distal limb progress proximal
limb, CSF protein normal cell count WBC sugar
145) c. basal ganglia
rigidity, resting tremor mask-like face Parkinsons
disease dopamine basal ganglia
146) c. spinal cord ( 89)
147) a. inhibit dopaminergic
haloperidol D2-blocker (inhibit dopaminergic)
dopamine Pakinsons-like symptom
148) c.
0/E = beta-thalassemia/HbE disease ()
E/E = HbE homozygote ()

149) c. hippocampus ( 69)
150) d. pluroperitoneal membrane
congenital diaphragmatic hernia (CDH) defect
diaphragm most common posterolateral pluroperitoneal
membrane abdominal viscera
trachea
151) a. Clostridium difficile
antibiotic
antibiotics normal flora C. difficile overgrowth
152) e. glycolysis
mature RBC nucleus mitochondria aerobic
metabolism glucose
glycolysis cytoplasm
153) a. chronic renal failure
waxy casts d ilate chronic renal failure
b. renal cell carcinoma hematuria CRF
c. acute tubular necrosis muddy brown cast
d. renal tubular acidosis urine osmolarity
Preclinical Comprehensive Examination 2007 by Med SWU 22

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154)

155)
156)

157)

158)

e. rapid progressive glomerulus nephritis proteinuria, red cells

waxy cast CRF crepitation
CRF Urine analysis non function kidney
specific gravity concentrate urine 1 protein cell
membrane (Ref. )
e. serum direct Bilirubin
bilirubin
conjugated bilirubin stercobilin
biliary tract conjugated bilirubin

a. prolactin
d. Mycobacterium chelone
a. Nocardia asteroids
pneumonia
b. Penicillium manesfii
HIV
c. Clostidium perfringen food poisoning gram positive
d. Mycobacterium chelone nonhealing leg ulcers
e. Streptomyces spp.
antibiotics
d.
d. e.
STD STD
PID complication adhesion fallopian tube
d.
a. oxytocin
a. oxytocin - mammary glands oxytocin
contraction uterine smooth muscle

b. ritrodine - used for smooth muscle relaxation (other types are used in
asthma or other pulmonary diseases)
c. ergotarmine -

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d. vasopressin antidiuretic hormone (ADH) reabsorption rate

kidney tubule cells urine
e. bromocriptine - Prolactin
159) a. plasmin
form blood clot clot
activity plasmin fibrin FDP

160) e. activation glycoprotein vWF

primary hemostasis platelet vessel vasoconstriction
platelet adhesion platelet activation platelet aggregration
platelet adhesion platelet glycoprotein (GP) receptor
exposed subendothelial layer (collagen & other extracellular matrix proteins) GP
GP Ia/IIa collagen GP Ib/IX von Willebrand factor
161) b. minute ventilation
respiratory center minute ventilation
respiratory acidosis
minute ventilation (Ref. )
162) e. alveoli
pneumoconioses interstitial lung disease (occupational
lung disease) silicosis, asbestosis, antracosis chronic expose
inorganic dust alveolar macrophage
inorganic dust toxic macrophage local inflammation
cytokine fibrosis interstitial lung disease
4 silicosis
Preclinical Comprehensive Examination 2007 by Med SWU 22

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163) c. apocrine gland

Apocrine sweat glands are coiled tubular glands that produce a viscous, cloudy,
and potentially odorous secretion. Theyre release their secretions into hair
follicles in the axillae (armpits), around the nipples (areolae), and in the groin.
They begin secreting at puberty; the sweat produced may be acted upon by
bacteria, causing a noticeable odor.
164) d. 95 ( 164,165 )
odds ratio = 0.05
= (1 - 0.05) x 100 = 95%
166) e. attitude

(Ref. )
167) d. cobalamine
vitamin B12 (cobalamin)
vitamin B12
vitamin B12 terminal ileum
intrinsic factor (glycoprotein)
vitamin B12 megaloblastic anemia vitamin B12 cofactor
DNA neurologic symotom
megaloblastic anemia folate
168) e. carcinoembriogenic antigen
carcinoembriogenic antigen CEA first identified colon cancer CEA
cancers pancreas, stomach,
lung, breast
169) b. lysosome ( 219)
lysosome organelle hydrolytic enzyme
lysosomal enzyme nucleic
acid, fat polysaccharides

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170) a. 6.25

171)

172)

173)

174)

175)

r4
Q = P x
8 l
Q = , P = , r = , = , l =
r4 Q
r;
r4 100 ml/min
r/2; (r/2)4 100/24 = 100/16 = 6.25 ml/min
b. vitamin D
rickets mineralization
calcification osteoid vitamin D calcium (
10 mg/dl) PTH serum phosphate ( 4 mg/dl)
reversible vitamin D osteomalacia
a.
(Hook worm ex. Necator americanus)
filariform larva

occult blood positive
d. infertility
endometrial hyperplasia atypia
CA endometrium risk factor CA endometrium
estrogen , (mean 59 y), ,
postmenopausal bleeding, chronic anovulatory, nulliparity (), early
menarche, late menopause, infertile, obesity, DM (Ref. )
e. ovary
ovary hormone estrogen bone resorption
estrogen bone resorption osteoporosis
a. purine
gout monosodium urate crytals
hyperuricemia MTP joint
uric acid end product purine catabolism

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176) e. ATP

3 ATP myosin head cross bridge

detach ATP
rigor mortis
177) c. delusional disorder
delusion ()

paranoid delusion


178) c. spina bufida occulta
spina bifida occulta spinal cord hair patch
sacral region
a. rachischisis - neural tissue 2
b. spina bifida cystica -

c. spina bifida meningomyelocele - spinal cord

spinal cord ( spina bifida cystica)

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179) d.
atropine anticholinergic agent parasympathetic nervous
system sympathetic nervous system
sympathetic nervous system
180) c. vasovagal attack
vasovagal attack vasovagal syncope
hypotension, bradycardia hypovolumic
shock hypovolumic shock HR
decompensated shock (Ref. )
181) b. clotimazole
hyaline septate hyphae
dermatophyte () clotimazole
182) d. TACGGTTT
DNA probe DNA A=T
CG ATGCCAAA probe TACGGTTT
183) a. DNA stability
telomere DNA DNA
DNA stable telomerase telomere
telomerase
DNA CA enzyme DNA
(immortality) X telomerase DNA stability CA
184) d. breast abscess with scar
infection
fibrosis scar acute mastitis
abscess (Ref. , )
185) e. estrogen
estrogen 1-hydroxylase
vitamin D active form mineralization estrogen

186) a. urachal fistula

urachal fistula urachus fetus
bladder allantois
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187) d. reabsorb water collecting duct

(5000 ml)
ADH reabsorb water
collecting duct
188) d. CCK
CCK
gastric emptying
189) d. Bacillus cereus
6 onset toxin
Bacillus cereus Staphylococcus
aureus S. aureus normal flora
190) a. /- Hb H disease genotype --/-
-thalassemia -trait
genotype /-- (Ref. )
191) a. inactivation of p53 ( 7,223)
192) d. vitamin B12 ( 167)
193) d.
pancytopenia RBC, WBC platelet
aplastic anemia
RBC WBC platelet fatigue, malaise,
pallor, purpura, mucosal bleeding, petechia, infection bone
marrow biopsy hypocellular bone marrow with fatty infiltration
CBC
- RBC (varies with altitude)
- 4.7 to 6.1 million cells/mcL
- 4.2 to 5.4 million cells/mcL
- WBC : 4,500 to 10,000 cells/mcL
- platelet : 150,000 to 400,000 /mm3
- hematocrit (varies with altitude)
- 40.7 to 50.3 %

Preclinical Comprehensive Examination 2007 by Med SWU 22

38

- 36.1 to 44.3 %
- hemoglobin (varies with altitude)
: 13.8 to 17.2 gm/dL
: 12.1 to 15.1 gm/dL
- MCV: 80 to 95 femtoliter
- MCH: 27 to 31 pg/cell
- MCHC: 32 to 36 gm/dL
194) b. cryoprecipitate
hemophilia A Factor VIII cryoprecipitate
FFP fibrinogen, von Willebrand factor, factor VIII,
factor XIII fibronectin
a. aged plasma cryo-remove plasma (CRP) Factor II, VII, IX,
X plasma expander
c. fresh Frozen Plasma (FFP) coagulation factor
plasma volume
d. platelet platelet
e. fresh whole blood volume
195) b. ordinal ( 108)
196) c. 1/3 ASIS
McBurney's point

197) e. PDA
indomethacin NSAID murmur
patent ductus arteriosus (PDA) indomethacin prostaglandin
E2 ductus arteriosus murmur
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198) Oxidase
199) a. autoimmune
anemia bone marrow response
a. autoimmune intra/extravascular hemolysis
extravascular hemolysis
b. Vit.B12 megaloblastic anemia MCV > 100
c. Hb thalassemia MCV < 80
d. enzyme G6PD deficiency
e. post hemorrhage
200) c. translocation
Down syndrome 3
- trisomy 21 47,XY,+21 47,XX,+21
- mosaicism 1 cell
cell
Turner syndrome Down syndrome
(46,XY) mosaic Down syndrome
- translocation t(21q,21q), t(13q,21q) t(14q,21q)
21 3 Down
syndrome
karyotype 46,XY non-disjunction
non-disjunction chromosome 21 karyotype 47,XY,+21
mosaicsm chromosome 1
translocation Robertsonian translocation Chr.21
Chr.21 Chr. Chr.14 Chr.13
201) a. serum complement
serum sickness hypersensitivity thpy III
Ab Ag serum immune complex
complement serum complement
203) 0.05
case fatality rate = mortality rate / incidence rate = 0.02 / 0.4 = 0.05

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204) e. stimulate growth of H. pylori

gastric biopsy neutrophil Helicobacter pylori (H. pylori lymphocyte aggregation and neutrophil infiltrate) alcoholic gastritis
direct mucosal toxicity erosion edema hemorrhage
neutrophils H. pylori infection (Ref. )
205) e. erythromycin
a. cloxacillin (penicillins)
inhibit cell wall synthesis
b. ceftriaxone (cephalosporins) inhibit cell wall synthesis
c. norfloxacin (quinolone)
inhibit DNA gyrase
d. tetracycline
inhibiting action of 30S ribosome
e. erythromycin
inhibiting action of 50S ribosome
206) c. small artery
Raynauds disease affect small artery
arteriolar vasospasm blood flow
(Ref. )
207) a. nodular glomerulosclerosis
diabetic nephropathy 2 type
- diffuse glomerulosclerosis
- nodular glomerulosclerosis: mesangial nodular glomerulosclerosis
Kimmelstiel-Wilson lesion
208) a. paraquat
paraquat dipyridil
-xone gramoxone paraquat caustic
oxygen
nascent oxygen oxidize
20% 10-15 ml
paraquat 24
paraquat
patch
rupture esophagus
pneumomediastinum, pneumothorax subcutaneous

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emphysema 1-4 systemic paraquat

acute tubular necrosis uremia
hepatocellular damage SGOT, SGPT
3-14
progressive respiratory failure pulmonary hemorrhage,
pulmonary edema fibrosis 3
60 ml onset
multiple organ failure coma
esophageal perforation ventricular arrhythmias
24-48 hemolysis methemoglobinemia
209) b. helper T cell
neutrophil T-cell mediated
immune response helper T cell cytokine macrophage

210) b. varicella vaccine
varizella vaccine live attenuated vaccine
prednisolone steroid
live attenuated vaccine
a. tetanus toxoid
toxiod
IM
b. varizella vaccine
live attenuated vaccine
SC
c. influenza vaccine
inactivated virus
IM, SC
d. hepatitis B vaccine
inactivated virus
IM
e. JE vaccine
inactivated virus
SC
211) e. antibody dependent cytotoxicity
antibody dependent cytotoxicity fever, chill,
hypotension, nausea, uneasiness, substernal pain ()
ABO-incompatibility 30 cc.
anaphylaxis
urticaria erythrema

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212) c. DA, cholinergic

(Parkinsons disease) dopamine
substantia nigra dopamine DA ACh

- (resting tremor)
- (rigidity)
- (bradykinesia)
- (postural instability)
-
-
-
DA ACh DA : ACh
- levodopa (L-dopa) BBB
( dopamine ) enzyme decarboxylase
dopamine dopamine
bradykinesia rigidity
- anticholinergic agent ACh artane, congentin
tremor rigidity
213) e.
anterograde amnesia hippocampus
memory 3
- recall 3 3-5
- recent
- remote
recall recent (ex. )
remote (ex. )
214) c. chemotaxis
corticosteroid chemotaxis phagocytosis
215) 100,000 CFU/ml

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216) a. E. Coli
screen UTIs (urinary tract infection)
- leukocyte esterase activity WBC urine
- nitrite bacteriuria gram-negative bacteria
urine nitrite gram-negative bacteria E. coli
nitrate nitrite gram-positive bacteria
217) c. squamous cell carcinoma
squamous cell carcinoma malignant tumor esophagus
(75%) esophagus
lumen
218) c. ACh esterase
organophosphate acetylcholinesterase
(AChE) irreversible (
inhibiting the action of acetylcholinesterase )
acetylcholine synaptic cleft acetylcholine

219) b. lysosome ( 169)

220) d.
anemia hematocrit (viscosity)
total peripheral resistance (v)
anemia viscosity velocity turbulent flow
velocity aortic valve ejection
systolic murmur
221) a. teratoma
teratoma primordial germ cell mature teratoma
embryonic layer 3
( 2 3 )
d. chondroma benign tumor mesodermal cell
form cartilage
e. cystadenoma cyst serous
cystadenoma mucous cystadenoma

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222) c. hypothalamus
hypothalamus TRH pituitary TSH thyroid gland
T3,T4 TSH
pituitary hypothalamus TRH stimulation test
TRH TSH pituitary
TSH hypothalamus
223) a. inactivation p53 gene ( 7,191)
225) b. stroke volume
preload stroke volume
pool lower limb venous return preload stroke
volume BP
225) b. albendazol
(Trichuris trichiura) albendazole
a. praziquentel trematode ex. Schistosome
c. metronodazole antiprotozoal agent
d. ivermectin combination
e. amphoteracin B antifungal agent
226) a. Ca2+
hyperventilation washout CO2 respiratory
alkalosis albumin H+ Ca2+ free Ca2+
CO2
respiratory alkalosis free Ca2+ (Ref. )
227) d. thyroid glossal duct cyst
thyroglossal duct cyst brachial chelf cyst
228) e. hCG
hCG growth hormone
229) c. zona fasciculata
adrenal gland 2
1. adrenal cortex
- zona glomerula mineralocorticoids (aldosterone)
- zona fasciculata glucocorticoids (cortisol)
- zona reticularis weak androgen
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230)

231)

232)
233)
234)
235)

2. adrenal medulla catecholamine

Cushings syndrome cortisol
zona fasciculate
mitral stenosis
rheumatic heart disease -hemolytic streptococci group A
mitral > aortic >> tricuspid valve
neural tube defect ( 260)
alpha-fetoprotein (AFP) oncofetal antigen

13
2-3
AFP ()
2
(neural tube defect) AFP
2 - 3.5
AFP AFP
/ embryonal cell carcinoma
AFP
AFP
AFP
AFP
tumor marker

3 - 6 /
a. sympathetic activity ( 12)
c. consistency ( 91)
vitamin K
vitamin K antidote warfarin
a. insulin
15 diabetic nephropathy
insulin insulin (Ref. , )
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236) a. alveolar hypoventilation

midbrain respiratory center
(10 /min) alveolar hypoventilation wash out CO2
PaCO2 (55 mmHg) pH (7.25) compensate
HCO3- HCO3- (20 mEq/l)
237) a. Bacteroides fragilis
Bacteroides fragilis is an obligate anaerobe of the gut. It is involved in 90% of
anaerobic peritoneal infections.
238) Opisthorchis viverrini







239) a. duodenal stenosis
duodenal stenosis transient relaxive lower esophageal sphincter (GERD)
GERD (Ref. )
240) c. Neiseria meningitides ( 99)
241) 2 agonist, corticosteroids
asthma
1. 2 agonist
acute asthma selected b2-agonist inhale albuterol,
terbutaline , salmeterol SE tachycardia, hyperglycemia, hypokalemia,
hypomagnesemia *B2-agonist inflammation associated with asthma
2. corticosteroids
inhaled beclomethasone, triamcinolone, flunisolide effect
inflammatory cell airway severe IV methylprednisolone SE
inhale corticosteroid systemic steroid use SE
oral candidiasis osteoporosis

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242) patent ductus arteriosus (PDA)

patent ductus arteriosus PDA VSD

ductus arteriosus

2
aorta pulmonary ductus arteriosus

PDA

close surgery
(ligation) (clipping)

243) lobe 10th rib paravertebral line

244) CN III, CN XI
CN XI sternocleidomastoid
CN III medial (diplopia)
superior rectus, medial rectus, inferior rectus, inferior
oblique
Note
CN IV diplopia with downward gaze superior oblique
CN VI diplopia with medially directed eye lateral rectus
245) sternocleidomastoid
muscle 2
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246) fibrosis
fibrosis atelectasis
247) produces a depolarizing block
succinylcholine
mechanism : produces a depolarizing block
rapid onset of action (1-1.5 min) & short duration (5-8 min)
used for intubation
SE: stimulate the autonomic ganglia
Phase I
- depolarizes the end-plate & adjacent muscle twitching &
fasciculation
- continuous depolarization without periodic repolarization depolarization muscle relaxation and paralysis
Phase II
- gradual repolarization desensitize the end-plate to depolarization
- mechanism is still unclear
succinylcholine ( suxamethonium)
(muscle relaxation) curare
(apnoea)
(anaesthelist) 2-3
succinylcholine metabolize pseudocholinesterase plasma
succinylcholine enzyme
gene
autosomal recessive
248) inhibit enzyme cholinesterase irreversible
organophosphate inhibit enzyme cholinesterase irreversible
acetylcholine synapses
muscarinic effect salivation, lacrimation, vomiting, diarrhea, micturition,
dyspnea (stimulation of parasympathetic nervous system)
nicotinic effect skeletal muscle
paralysis CNS depression, stimulation, seizure

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249) metformin
- metformin first line drug: enchances tissue sensitivity to insulin and
inhibits liver gluconeogenesis
- sulfonylureas: stimulate insulin release
- acarbose: inhibits intestinel alpha-glucosidase >> slowing glucose
absorption and decreasing insulin demand (SE: gastrointestinal distress)
- thiazolidinediones (glitazones): act via peroxisome proliferation activating
receptor that control insulin-responsive genes
- repaglinide: stimulate B-cell secretion of insulin
250) neutrophillic abscess, peritoneal abcess
251) oxytocin
hormone oxytocin

252) CA colon
tumor marker ex. carcinoembryonic antigen (CEA) protein cell
tumors the developing fetus CEA first
identified colon cancer CEA cancers
pancreas, stomach, lung, breast detect benign
conditions cirrhosis, inflammatory bowel disease, chronic lung disease
pancreatitis CEA 19% CEA test
pathological diagnosis
253) cancer
cellular tumor antigen p53 = tumor protein 53 transcription factor
cell cycle tumor suppressor p53
p53 "the guardian of the
genome" "the guardian angel gene" "master watchman"
mutation p53 suppress
254) Burkitt's lymphoma nasopharyngeal carcinoma
- Burkitt's lymphoma Non-Hodgkin's lymphoma affects
the jaw bone and forming a huge tumor
chemotherapy (cyclophosphamide) EBV virus
- nasopharyngeal carcinoma upper respiratory tract EBV virus
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255) antipsychotic drug, block D2 receptor

:

action: block dopamine (D2) receptor anticholinergic
256) macroride
beta-lactam
1. penicillins : beta-lactam ring thiazolidine
ring side chain 1 penicillin, aminopenicillin (
amoxicillin, ampicillin) oxacillin ( cloxacillin, dicloxacillin)
penicillin beta-lactam ring
thiazolidine ring beta-lactam ring
penicilloyl determinant
antigen antibody
2. cephalosporins : beta-lactam ring
penicillin beta-lactam
ring dihydrothiazine ring side chain 2
beta-lactam ring penicillin
cephalosporin dihydrothiazine ring
penicilloyl determinant penicillin
side chain
hapten protein antigenic determinant
3. carbapenems : imipenem, meropenem, ertapenem
beta-lactam ring modified thiazolidine ring side
chain 2 antigenic determinant
imipenem penicillin
antigenic determinant beta-lactam
beta-lactam

1. IgE antibody
maculopapular rash erythematous
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rash beta-lactam
antigenic determinant
side chain
2. anaphylaxis IgE

1
beta lactam IgE
beta-lactam ring antigen
(cross reaction)
beta-lactam macrolide
257) rheumatic fever
Aschoff bodies Aschoff nodules painless nodules rheumatic fever
(Fully developed Aschoff bodies consist of fibrinoid change in connective tissue,
lymphocytes, occasional plasma cells, and abnormal characteristic histiocytes.
They are Aschoff cell granulomas with a fibrinoid necrotic centre found in the
myocardium surrounding blood
vessels, and other regions of the
body. Myocytes in the myocardium
can merge with the Aschoff cells to
form giant cells of Aschoff. In
addition, there are lymphocytes,
eosinophils and plasma cells.)
258) HIV,
Western blot assay (confirmatory test) HIV
ELISA
Western Blot
ELISA
Western Blot


Western Blot
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259)

260)
261)

262)

(transfer) nitrocellulose
membrane
substrate



Thymectomy = thymus gland + ectomy thymus
(mediastinum)
Myasthenia gravis
1. plasma cell antibody ACh receptor
ACh neuromuscular paralysis
2. plasma cell B cell Thelper cell Thymus
3. 75% MG thymus gland
25% thymoma
CT scan Myasthenia gravis thymus
gland thymectomy
thymus gland
neural tube defect ( 231)
metaplasia
Barretts esophagus tissue lining esophagus
tissue lining statified squamous epithelium
columnar epithelium gastric metaplasia
columnar epithelium with globlet cell intestinal metaplasia
GERD esophagus
esophageal atresia or esophageal stenosis
- esophagus atresia fistula
aspiration pneumonia
- esophagus stenosis fibrosis
(regurgitation)
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263) EBV
EBV oropharyngeal secretion glycoprotein
envelope virus epithelial cel l lymphoid tissue
receptor (CD21) B lymphocyte infected B-cel l T-cell
infected B-cell chronic infection
epithelium turn squamous cell carcinoma
264) pancreas ( 2,17)
(acute pancreatitis)




265) gastrin
gastro-colic reflex gastrin mediator
266) bcl-2 ( 140)
267) Hemochromatosis ( 123)
268) pancreatitis
60

abdominal guarding
ecchymosis (Grey-Turners sign) (Cullens sign)
retroperitoneum alcohol
alcoholic liver disease jaundice, hepatomegaly,
ascites, encephalopathy gallstone pancreatitis
jaundice
269)


Herpes simplex () ()
( 3 )

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270) down regulation

down regulation
271) Enterobius vermicularis
Enterobius vermicularis pin worm oral shape
D
perianal scraping scotch
tape technic
272) inhibit DNA gyrase
ciprofloxacin fluoroquinolone (pregnancy catagory C)
DNA gyrase DNA
(bactericidal) gram-negative
bacilli gram-positive bacilli
273) ureter
uterus uterine artery ureter
274) ST elevate
275) EKG

276) emphysema obstructive lung disease (COPD) alveolar wall

obstruction air flow air trapping
residual volume, FEV1, FVC , FEV1/FVC (hallmark),
V/Q mismatch, lung compliance, intrapleural pressure, airway resistance
277) Succinylcholine

Special thanks:
027, 105

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