Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
1588 Cards in this Set
- Front
- Back
what immunosuppresant matches the following:
Derivative of 6-MP: Nephrotoxic in 75% of pts: Inhibits dihydrofolate reductase: |
Derivative of 6-MP: Azathropine
Nephrotoxic in 75% of pts: Cyclosporine (prevent with mannitol) Inhibits dihydrofolate reductase: MTX |
|
what is the triad of sx of Wernicke's encephalopathy?
Triad for Korsakoff? |
Wernicke:
Confusion Opthalmoplegia Ataxia Korsakoff: Memory Loss Confabulation Personality change |
|
what enzyme is deficient in the following dz's?
Fructose intolerance: essential fructosuria: classic galactosemia: |
Fructose intolerance: aldolase B
essential fructosuria: fructokinase classic galactosemia: galactose-1-phosphate uridyltransferase |
|
common unerlying cause of intussusception?
no milk production in postpartum period? Pigmented hamartomas in the iris Howell-Jolly bodies: |
common underlying cause of intussusception: Meckel's diverticulum; adenovirus infection of Peyer's patches
no milk production in postpartum period: Sheehan Pigmented hamartomas in the iris: NF Howell-Jolly bodies: Asplenia |
|
what might you see in a first trimester ultrasound of a fetus with Downs
|
increased nucal translucency
|
|
Anti-smooth muscle Abs are assoc with what?
|
Autoimmune hepatitis
|
|
which protozoa fits the following:
Ixodes tick is the vector: Sodium stibogluconate is the tx: Maltese cross seen in RBC: severe diarrhea in AIDS: |
Ixodes tick is the vector: bebesia
Sodium stibogluconate is the tx: Leschmania Maltese cross seen in RBC: Babesia severe diarrhea in AIDS: cryptosporidium note: babesia is often a co-infection of Lyme and gives malaria like sx |
|
What genes are responsible for skeletal development?
|
HOX
|
|
what is the result of a glycolytic enzyme def? What is the result of a def in pyruvate dehydrogenase
|
RBC hemolysis
Neurologic defects |
|
to which lymph nodes does ca in the following areas met to?
Stomach: Doudenum: Sigmoid colon: Rectum: Testes: Scrotum: |
Stomach: Celiac
Doudenum: Superior mesenteric Sigmoid colon: Colonic Rectum: Inf iliac Testes: para aortic Scrotum: superficial inguinal |
|
what is responsible for the release of renin?
|
JG apparatus, specifically the JG cells secrete it, while the macula densa senses the amount of Na
|
|
Owl's eye inclusions:
Owl's eye nucleus: Owl's eye protazoan: |
Owl's eye inclusions: CMV
Owl's eye nucleus: Hodgkins Owl's eye protazoan: Giardia |
|
give the breakdown of your % body water
|
60% total body water
40% ICF 20% ECF |
|
what ligament contains the portal triad
|
hepatoduodenal
|
|
what is the water under the bridge idea?
|
ureters pass under the uterine artery or ductus deferens
|
|
What happens to CO, BP and GFR in pregnancy
|
CO: increase
BP: decrease then normalizes GFR: increase |
|
CL=
|
UV/P
u-urine conc of X p=plasma conc of X v=urine flow rate |
|
what plexus in the digestive tract is responsible for glandular release?
what does motility |
glands: Meissner's (submucosal)
motility: Auerbach's (myenteric) |
|
FF=?
|
GFR/RPF
|
|
Name the drug class
Venlafaxine: Fluvoxamine: Terbinafine: |
Venlafaxine: SNRI
Fluvoxamine: SSRI Terbinafine: anti fungal for nails |
|
GFR can be estimated with?
RPF? |
GFR--creatinine
RPF--PAH |
|
what are Brunner's glands and where are they located? what pathology are they assoc with
|
secrete alkaline mucus to neutralize acid
located in doudenum hypertrophy of brunner's glands is seen in PUD |
|
what segment of the renal tubule matches the following statement
reabsorbs 67% of fluid and electrolytes filtered by the glomerulus: segment responsible for concentrating urine: site of secretion of organic anions and cations: always impermeable to water permeable to water only in the presence of ADH |
reabsorbs 67% of fluid and electrolytes filtered by the glomerulus: Prox tub
segment responsible for concentrating urine: Collecting duct site of secretion of organic anions and cations: Prox always impermeable to water: ascending loop permeable to water only in the presence of ADH: collecting duct |
|
most common cause of meningitis for the following age ranges--
newborn-6mo: 6m-6yr: 6y-60: 60+: |
newborn-6mo: group b strep, ecoli, listeria
6m-6yr: strep pneumo, n. meningitis, enterovirus 6y-60: n. meningits, s. pneumo, hsv 60+: strep pneumoniea, listeria, G- rods |
|
what segment of the renal tubule matches the following statement
site of Na/2Cl/K cotransport: site of isotonic fluid reabsorption: site responsible for diluting urine: only site where glucose and amino acids are reabsorbed: water reabsorption in the loop of henle: |
site of Na/2Cl/K cotransport: ascending loop
site of isotonic fluid reabsorption: prox tub site responsible for diluting urine: thick ascending only site where glucose and amino acids are reabsorbed: prox tub water reabsorption in the loop of henle: thin descending |
|
what are Peyer's Patches? where are they
|
produce IgA to protect gut from pathogens
found only in the ileum |
|
where are Ca and Mg reabsorbed? What happens with water here
|
Thick ascending limb
water cannot get in |
|
CL=
|
(Vd x .7)/halflife
|
|
where in the kidney does PTH have its effect on Ca?
|
leads to calcium reabsorption in the early distal tubule
|
|
describe where the nerve,artery, vein, and lymph are in the femoral region
|
from Lateral to medial
Nerve-Artery-Vein-Empty Space-Lymph NAVEL venous near the penis |
|
what is the role of principle cells and intercalated cells? where does this occur
|
Principle: reabsorb H2O/Na, secrete K
Intercalated cells: secrete H/HCO3, reabsorb K collecting duct |
|
underlies all other defense mechanisms
|
Repression
|
|
What are the 2 types of intercalated cells
|
Alpha: secrete Acid
Beta: secrete bicarb |
|
describe where hernias occur with respect to the appropriate vessel
|
MDs don't LIe
Medial to the inferior epigastric=Direct hernia Lateral to the inferior epigastric artery=Indirect |
|
what affect does aldosterone have on the intercalated cells and principle cells of the collecting duct?
|
intercalated: stimulates H secretion
principle: Na reabsorption and K secretion |
|
LD=?
MD=? |
LD= Css x Vd
MD= Cl x Css |
|
tx for hyperkalemia?
|
Insulin to shift K into cells
must also give glucose to prevent hypoglycemia |
|
which type of hernia goes through the inguinal (Hesselbach's) triangle? what rings does it go through? who is it seen in more often?
|
Direct
external (superficial) ring only older men |
|
what diuretic would you use for a woman with HTN and osteoporosis?
|
Thiazide
saves Ca |
|
what type of vasculitis is associated with young asthmatics?
necrotizing immune complex inflammation of visceral/renal vessels: |
Churg Strauss
necrotizing immune complex inflammation of visceral/renal vessels: PAN |
|
what is the acid base disorder
pH: 7.42 HCO3: : 32 pCO2: 64 |
Mixed
normal pH: 7.35-7.4 normal pCO2: 35-45 normal HCO3: 22 |
|
which type of hernia goes into the scrotum? what rings does it go through? who is it seen in more often?
|
Indirect
internal (deep) and external (superficial) inguinal rings infants |
|
what is the acid base disorder
pH: 7.66 HCO3: 36 pCO2: 30 |
combined alk
normal pH: 7.35-7.4 normal pCO2: 35-45 normal HCO3: 22 |
|
Vd=
|
drug IV / [drug in plasma]
|
|
what is the acid base disorder
pH: 7.10 HCO3: : 15 pCO2: 50 |
Combined acidosis
normal pH: 7.35-7.4 normal pCO2: 35-45 normal HCO3: 22 |
|
What do G cells make?
I cells? S cells? D cells? what does each do (in general) |
What do G cells make: Gastrin
I cells: CCK (protein/Fatty acids) S cells: Secretin (anti-acid) D cells: Somatostatin (anti-everything) |
|
what is the acid base disorder
pH: 7.34 HCO3: : 31 pCO2: 62 |
resp acid with compensation
normal pH: 7.35-7.4 normal pCO2: 35-45 normal HCO3: 22 |
|
TX for the following:
Trypanosoma: Leishmania: Entamoeba: Toxoplasma: |
Trypanosoma: Nifurtimox
Leishmania: sodium stiboglugonate Entamoeba: Met Toxoplasma: Sulfdiazine Pyrimethamine |
|
what is the acid base disorder
pH: 7.39 HCO3: : 12 pCO2: 22 |
mixed
normal pH: 7.35-7.4 normal pCO2: 35-45 normal HCO3: 22 |
|
what is necessary to take up B12? where does this occur
|
Intrinsic factor
ileum |
|
what is the equation of anion gap?
|
Na - (Cl + HCO3)
|
|
antidote for t-PA streptokinase
|
amniocarpoic acid
|
|
what are the causes of increased anion gap
|
MUDPILES
Methanol (formic acid) Uremia Diabetic ketoacidosis Paraldehyde/phenformin Iron tablets or INH Lactic acidosis Ethylene glycol (oxalic acid) Salicylates |
|
what 3 things can lead to acid release in a gastric parietal cell? What are their 2nd messangers?
|
ACh: Gq/IP3
Gastrin: Gq/IP3 Histamine: cAMP |
|
where do type 1, 2, and 4 RTA occur? what are K levels like
|
1: distal (collecting tubule can't excrete H); hypokalemia
Type 2: proximal (defect in prox tubule HCO3 reabsorption); hypokalemia type 3: hypoaldosteronism or lack of collecting tubule response to aldosterone, hyperkalemic |
|
tx for TCA cardiotox?
theophylline cardiotox? |
TCA: alakalinize the urine/plasma
Theophylline: B-blocker |
|
what effect will a renal stone that obstructs the ureter have on GFR and FF?
|
decrease both
|
|
hypercalcemia
Phenylalanine Tryptaphan can all activate what type of GI cell leading to release of what? |
G cell
Gastrin |
|
what is the maximal serum glucose conc at which glucose can be absorbed in the tubules
|
350micro grams/dL
|
|
where does fetal erythropoiesis take place
|
yolk sac
liver/spleen marrow |
|
what change in the metabolic panel might you see in a young pt on a B-agonist for status asthmaticus?
|
B-agonists will lead to hypokalemia
|
|
MOA of cimetidine?
Use? Tox? |
H2 blocker
PUD, gastritis, GERD inhibit P450, gynecomastia |
|
What diuretic can be used in the following situations:
Edema a/w nephrotic syndrome: Increased intracranial pressure: |
Edema a/w nephrotic syndrome: Loop
Increased intracranial pressure: Mannitol |
|
what class of drug is :
Lamivudine: Cefprozil |
Lamivudine: NRTI
Cefoprozil: 2nd gen ceph |
|
what type of diuretic are the following
Bumetanide: Metolazone: |
Bumetanide: Loop
Metolazone: Thiazide |
|
MOA of omeprazole
|
Irreversibly inhibit H/K/ATPase in stomach/parietal cells
PUD, gastritis, GERD, ZE |
|
if you have casts in the urine what does this tell you in general
|
that the problem is in the kidney
|
|
what is dipalmitoyl phosphatidylcholine?
|
surfactant
|
|
most common glomerular dz in HIV pts
|
FSGS
|
|
What is the triple therapy for H. pylori
|
MCAT
Metronidazole Cimitidine Amoxicillin Tetracycline FA also says Bismuth |
|
EM shows tram-track. what is this and what is it associated with?
|
type I MPGN--associated with HBV and HCV
(also: SLE, subacute bacterial endocardititis, mixed cryoglobulinemia) |
|
classic clinical presentation of thyroglossal duct cyst (where is it and does it move)
|
midline
moves on swallowing |
|
EM shows dense deposits. What is this an what is it associated with?
|
MPGN type II
C3 nephritic factor |
|
Prevention of NSAID induced peptic ulcers
|
Misoprostol
|
|
what 3 things can lead to using up complement?
|
Post strep
MPGN type II SLE |
|
a pregnant mom has eclampsia and appears that she is close to death. What might you measure in a baby to try and access fetal lung maturity? what shows that they are mature
|
lecithin-to-sphinogmyelin ratio of >2.0
|
|
which glomerular dz causes the following:
IF: granular pattern of immune complex deposition; LM: hyperceullar glomeruli: LM: Segmental sclerosis and hyalinosis: |
IF: granular pattern of immune complex deposition; LM: hyperceullar glomeruli: Acute post strep
LM: Segmental sclerosis and hyalinosis: FSGS |
|
the following are antacids, what are the key side effects associated:
Aluminum hydroxide: Magnesium hydroxide Calcium carbonate |
Aluminum hydroxide: constipation, seizure
Magnesium hydroxide: diarrhea, cardiac arrest Calcium carbonate: hyerpcalcemia, and chelation of other drugs (tetracyclines) |
|
GLomerular histology reveals multiple mesangial nodules. What is this indicactive of?
|
Diabetic glomerulonephropathy
|
|
what nerve is responsible for erection
|
pelvic
remember this is parasympathetic Pelivic, Parasymp, Point |
|
4 yo with facial edema and proteinuria. Tx?
|
this is MC
Corticosteroids |
|
what provides parasympathetic innervation to the following:
Parotid: Submandibular: Sublingual: |
Parotid: CN IX (tympanic nerve branch)
Submandibular: CN VII Sublingual: CN VII |
|
proteus causes stag horn calculi, what is the content of these stones
|
Ammonium magnesium phosphate
|
|
where are you most likely to aspirate a peanut
|
right lung
shorter, wider, taller bronchus |
|
pt with gout or leukemia is likely to get what kind of kidney stone
|
uric acid
|
|
what is the most common location of malignant salivary tumor? benign?
|
ca: Sublingual
benign: parotid |
|
what happens in acute interstitial nephritis? what will you see? what is it due to?
|
acute renal failure
will see eosinophillia due to drugs (1-2 weeks after administration kids: ABX adults: NSAIDs tx: 2 weeks corticosteroids |
|
what 2 aneurysms causes the eye to look down and out
|
post cerebral artery (Weber syndrome)
posterior communicating both cause CN III palsy |
|
+4 blood in urine, no RBC on urine cell count...
|
Rhabdomyolysis / myoglobinuria
|
|
what makes up Hesselbach's triangle?
|
Inguinal ligament
Inferior epigastric a Lateral border rectus abdominus |
|
what causes prerenal azotemia? what will BUN/Cr be like?
|
decreased RBF (hypotension: dehydration,shock,renal vasoconstriction, hepatorenal syndrome)
BUN/Cr >20 (BUN is really high because you are trying to hang on to everything) |
|
what perforates the diaphragm at different levels
|
I ate ten eggs at 12
T8: IVC T10: Esophagus T12: Aortic hiatus |
|
what causes intrinsic renal failure? BUN/cr lvls?
|
acture tubular necrosis or ischemia/toxins
<15 |
|
treatment to this problem includes plasmapheresis and phototherapy
|
Criegler najar I
|
|
what causes post renal azotemia? what is BUN/Cr like?
|
outflow obstruction (stones, BPH, neoplasia, congenital anomalies)
>15 |
|
currant jelly stool
|
Intusucception
|
|
sorry, i couldn't help myself...
what are the 2 most common causes of chronic kidney dz |
HTN
Diabetes |
|
PAS (Periodic acid-Schiff stain) positive macrophages in intestial lamina propria. Man with joint pain, and neurologic and cardiac sx
|
Whipple's dz (Tropheryma whipplei--Gram-positive Actinobacteria)
Abx 10 days, 1 year TMP-SMX |
|
ADPKD vs ARPKD
leads to potters: hepatic fibrosis: polycystic liver dz: Berry aneurysms: death can be due to malignant HTN: |
leads to potters: AR
hepatic fibrosis: AR polycystic liver dz: AD Berry aneurysms: AD death can be due to malignant HTN: (i had a question on this, it was an adult, and this is what killed him, so I am saying AD for now) |
|
HYQ: pt in ER is having anaphylaxis--> you make an incision beneath thyroid cartilage to establish airway--> what strucutre was cut
|
Cricothyroid membrane
|
|
U waves on ECG is due to what
|
Low K
|
|
antibody to tissue translutaminase body
|
Celiac sprue
also antibodies to gliadin leads to blunting of villi can't eat wheat assoc with dermatitis herpetiformis increased T cell lymphoma risk primarily affects jejunum (increase folate) |
|
disoreintation stupor, or coma is assoc with what ion?
|
Na
|
|
aneurysm may cause bilateral loss of lateral visual fields
|
ant communicating
|
|
pt is getting an infusion with substance X. Later the pt has decreased DTRs, delirium, and cardiopulmonary arrest. What was substance X
|
Mg
|
|
describe type A and type B chronic gastritis (cause, location)
|
A: Autoimmune, fundus/body
B: H. pylori, antrum (increased risk of MALT lymphoma) |
|
most common tumor of the urinary tract system?
histological appearance of renal cell ca? histological appearance of chronic pyelonehpritis? can assoc with schistosoma haematobium? |
most common tumor of the urinary tract system: TCC
histological appearance of renal cell ca: Polygomal Clear Cell histological appearance of chronic pyelonehpritis: Thyroidsim can assoc with schistosoma haematobium: Bladder SCC |
|
what is the protein problem in Kartageners
|
Dynenin arm defect
messes up cillia look for sinus invertus |
|
IF granular pattern of immune complex deposition; LM: diffuse capillary thickening
|
Membranous
|
|
Rugae are hypertrophied to look like brain gyri
|
Menetrier's dz
|
|
IF granular pattern of immune complex deposition; LM: hypercellular glomeruli
|
Post strep glomerulinephritis
|
|
what nerve is responsible for emission?
what about ejac? |
emission: hypogastric
ejac: pudendal both are sympathetic |
|
HYQ: CT scan reveals massively enlarged kidneys bilaterally. Diagnosis?
|
ADPCKD
|
|
pain worse with meals, pt will be anorexic...what type of ulcer
|
Gastric
(doudenal is soothed by eating, will see weight gain) |
|
what is responsible for the biconcave shape and flexibility of RBCs
|
spectrin
|
|
why do ACEi cause cough
|
ACE normally breaks down bradykinin
ACEi inhibits this and increased bradykinin leads to cough |
|
Anisocytos=
Poikilocytosis= |
Anisocytos= varying RBC size
Poikilocytosis= varying RBC shape |
|
aside from reflux and chemicals, what 3 things can cause esophagitis
|
HSV
CMV Candida |
|
survival time of RBCs?
platelets? |
RBC=120
Platelets=8-10 days |
|
contralateral spastic hemiparesis
contralateral tactile and kinesthetic defect tongue deviates toward lesion where is the lesion? what artery is affedted |
medial medullary syndrome
anterior spinal artery |
|
what is the DNAAACP for eosinophils
|
Drugs
Neoplasm Asthma Allergic process Addisons Collagen vascular dz Parasites |
|
LLQ pain, fever, leukocytosis with bright red bleeding
|
Diverticulitis
tx is Abx (think about TMP-SMX + Met) |
|
what type of cell are barr bodies in?
|
Neutrophils
|
|
|
|
|
What are the phagocytes for the following locations:
Brain: Liver: Joint: Lung: |
Brain: microglia
Liver: kupffer cell Joint: A cells Lung: Dust cells |
|
3 common causes of small bowel obstruction
|
Adhesions (previous surgery)
Bluge/Hernia Cancer/Tumors |
|
what cell traditionally has memory and plays a role in immunizations
* |
B lymphocyte
|
|
protozoal.helminth that matches the following:
Most common protozoal infection in US: Most common helminithic in US: snail host: swimmers itch: transmitted in raw meat or infected cat feces |
Most common protozoal infection in US: Giardia
Most common helminithic in US: Pinworm; enterobuis vermicularis snail host: swimmers itch: Schistosoma transmitted in raw meat or infected cat feces: toxoplasmosis |
|
what is the bridge btw coagulation and complement pathway
|
factor XII
|
|
besides idiopathic what is another major cause of intussusception
|
Adenovirus--infects the Peyer's patches
look for red currant jelly stool (yummy) |
|
why do you get purple toes etc with starting Warfarin
|
while warfarin will eventually inhibit 10,9,7,2, they accutely inhibit C and S leading to hypercoaguability
give Heparin for first few days to prevent this |
|
contralateral loss of pain and temp, hoarseness, Horner;s...what is this due to?
|
PICA--Wallenbergs
lateral medullary syndrome |
|
MOA of heparin
|
inhibits thrombin (factor II)
co factor of antithrombin |
|
what is the embroylogic reason for Hirschsprungs dz?
|
Failure of neural crest cell
|
|
warfarin or heparin
which if either can be used in pregnancy |
Heparin
|
|
how do you calculate physiologic dead space
|
VD= Tidal volume x (PaCO2-PeCO2)/PaCO2
|
|
pt is on anticoagulant and develops thrombocytopenia which was it?
Tx? MOA? |
heparin- Heparin induced thrombocytopenia (causes hypercoaguable state)
Lepiruidn or bivalirudin--directly inhibit thrombin |
|
pt has stomach distention with "double bubble". What would you see as a sx? what is this associated with
|
bilious vomiting
Down Syndrome this is duodenal atresia |
|
what drug inhibits ADP induced expression of GpIIb/IIIa
|
Clopidogrel
Ticlopidine |
|
what does pulmonary fibrosis , insufficient surfactant, and pulmonary edema do to lung compliance?
Emphysema? |
Decrease
Emphysema: increase |
|
what are the following RBCs seen in
Basophilic stippling: Bite Cells: Schistocyte/helmet cell: Target Cells: Heinz bodies: Howell-Jolly bodies: |
Basophilic stippling: Lead
Bite Cells: G6PD Schistocyte/helmet cell: DIC/TTP/HUS/traumatic hemolysis Target Cells: HbC dz, Asplenia, liver dz, thalassemia (THAL) Heinz bodies: G6PD def Howell-Jolly bodies: asplenia (sickle cell, ITP, splenic trauma) |
|
what 2 things can cause failure to pass meconium?
|
Hirschsprungs
CF |
|
what is the change in the Hb of sickle cell
|
Glu-->Val in B chain
|
|
what structure in the seminiferous tubule secretes androgen binding protein, anti-mullerian hormone, and inhibin?
what hormone activates these |
Sertoli cell
makes the blood testis barrier support sperm synthesis FSH |
|
4 causes of microcytic hypochromic anemia...what is the MCV
|
MCV<80
Iron def Thalassemia Lead poisoning sideroblastic CKD -apparently starts normocytic |
|
old man with pain after eating and bloody stool
|
ischemic colitis
|
|
marrow hyperplasia leading to chipmunk facies and crew cut xray
|
B-thal major
|
|
which form of hemoglobin is better for carrying O2? dumping it?
what factors lead to dumping O2? what way does this move the O2 curve |
carry: relaxed
dump: taut -low pH/increase H, 2,3 BPG, increased temp & CO2 shift to the right |
|
tx for lead poisoning in adults/kid
|
adult: dimercaprol
kid: succimer |
|
What drug is used for the tx of diabetic and post surgery gastroparesis? MOA? Tox?
* |
Metaclopramide
D2 receptor antagonist (increase resting tone, contractility, LES tone, motlility) Tartive dyskinesia (also lowers seizure threshold) |
|
hypocellular bone marrow with fatty infiltration....
|
Aplastic anemia
(pancytopenia--anemia, neutropenia, and thrombocytopenia) |
|
Ipsilateral facial n paralysis, ipsilateral loss of taste from ant 2/3 tongue, ipsilateral dearness and tinnitus, nystagmus. Ipsilateral loss of pain/temp with ipsilateral horners
what is this and what artery |
Lateral inferior pontine syndrome
AICA |
|
if you have sickle cell or hereditary spherocytosis, what can lead to aplastic crisis?
|
parvo B19
|
|
pt with hyperpigmented mouth, lips, hands and genitalia. What else will you see? How is this dz inherited? Increased risk of?
|
This is Peutz-Jeghers
nonmalignant hamartomas throughout the GI tract AD increased risk of CRC and other visceral malignancies |
|
what can you use in the treatment of sickle cell anemia?
|
Hydroxyurea to increase HbF
bone marrow transplant is curative |
|
what treats Methemoglobin
|
Methylene blue (or vit C)
|
|
what are the 5 causes of megaloblastic anemia
|
Methotrexate
AZT Phenytoin Liver dz Ethanol MAPLE |
|
list was is altered btw each step
Normal colon --( )-->Colon at risk-( )-->Adenoma--( )-->Carcinoma |
normal colon
LOSS of APC colon at risk K-RAS MUTATION adenoma LOSS of p53 Caricinoma |
|
what is the cause of anemia given the following statement:
Microcytic anemia reversible with B6: HIV positive pt with macrocytic anemia: normocytic anemia and elevated creatinine : |
Microcytic anemia reversible with B6: sideroblastic anemia
HIV positive pt with macrocytic anemia: Zidovudine normocytic anemia and elevated creatinine : kidney failure |
|
what anti-hypertensive drug cause the following:
Dry mouth, sedation, severe rebound HTN: Metabolic alkalosis: |
Dry mouth, sedation, severe rebound HTN: Clonidine
Metabolic alkalosis: Loop diuretic |
|
pt presents with painful abdomen, port red urine, polyneuropathy, and psychological disturbances. What is this and what drug might they be on? enzyme affected
|
Acture intermittent porphyria
Barbiturates porphobilinogen deaminase |
|
what causes FAP? What does it lead to? What is always involved? What other physical symptom will you see
|
AD mutation of APC gene
100% progress to CRC always involves rectum Pigmented lesions on retina |
|
man presents with blisters on sun exposed areas of his body and he has darkening of his face with a large amount of hair. What does he have? affected enzyme?
|
Porphyria cutanea tarda
Uroporphyrinogen decarboxylase |
|
how can methemoglobin tx cynaide poisoning? how do you get this methemoglobin
|
Nitrites oxidize hemoglobin to methemoglobin (Fe 3)
this then binds up cyanide |
|
decreased Gp1b-->defect in platelet to collagen adhesions
|
Bernard soulier dz
|
|
FAP + osseous and soft tissue tumors, retinal hyperplasia
|
Gardner's syndrome
|
|
GpIIb/IIIa antibodies-->peripheral platelet destruction
|
Idiopathic thrmobocytopenic purpura (ITP)
|
|
contralateral hemianopia with macular sparing
|
posterior cerebral artery
|
|
decreased GpIIb/IIIa -->defect in platelet to platelet aggregation
|
Glanzmann's thrombasthenia
|
|
HYQ: 40 year old woman presents wtih having to defecate 4 times a day for several months with a constant low grade abdominal pain that is somewhat relieved by defectaion. Colonoscopy is normal. What is the most likely diagnosis?
|
IBS
|
|
pt has neurologic and renal sx, fever, thrombocytopenia, and microangiopathic hemolytic anemia...what does he have? what is deficient?
|
Thrombotic thrombocytopenic purpura (TTP)
def of ADAMTS 13 (vWF metalloprotease)-->degrades vWF thrombosis |
|
HYQ:
42 yo woman with fibroids is chronically tired. Most likely diagnosis? changes that have occured in the O2 content and sat? |
Anemia
No change in O2 content or sat |
|
what are some of the causes of DIT
|
STOP Making New Thrombi
Sepsis (G-) Trauma Obstetric Pancreatitis Malignancy Nephrotic syndrome Transfusion |
|
HYQ: 50 yo man complains of diarrhea. On exam, his face is plethoric and a heart murmur is detected. What is diagnosis
|
Carcinoid
|
|
What is the rate-limiting step in heme synthesis
|
aminolevulinic acid synthase
|
|
what cell in men secretes testosterone
what hormone activates these cells |
leydig
LH |
|
what are the following tests associated with:
Hams: DEB: Heinz body: D-Dimer: Basophilic stippling: Osmotic fragility test: (+) ristocetin test: |
Hams: Paroxsymal nocturnal hemoglobinuria
DEB: Fanconi's anemai Heinz body: G6PD D-Dimer: DIC Basophilic stippling: Thalassemia, ACD, Iron def, LEAD POISONING Osmotic fragility test: hereditary spherocytosis (+) ristocetin test: vWF dz |
|
tx for esophageal varicies?
|
B-blockers
(propranolol or nadolol) |
|
Hodgkin vs Non-Hodgkin
Reed-Sternberg Cells Bimodal distribution: Assoc with HIV B symptoms: Mostly involves B cells: Peripheral nodes, noncontiguous spread: Local nodes: contiguous spread: |
Reed-Sternberg Cells: H
Bimodal distribution: H Assoc with HIV: NH B symptoms: H Mostly involves B cells: NH Peripheral nodes, noncontiguous spread: NH Local nodes: contiguous spread: H |
|
HTN Pt is shown to have hypoxia and CXR reveals an enlarged heart..most likely cause of hypoxia?
|
Heart failure
|
|
what is the most common type of AML and the translocation associated?
|
M3 type
t(15,17) |
|
increased PT/INR, decreased LDL/HDL, and decreased platelets...what might be the cause
|
Liver failure
|
|
Leukemia buzzwords:
Smudge cell: Children: TRAP: Philadelphia chromosome: Auer Rods: |
Smudge cell: CLL
Children: ALL TRAP: Hairy cell Philadelphia chromosome: CML Auer Rods: AML |
|
what cerebral artery can lead to bitemporal hemianopia?
|
Anterior communicating a
|
|
What is most likely to cause progression to AML
|
CML
|
|
what is the size cut off for micro and macronodular cirrhosis? what is the cause for each
|
micro: nodules <3mm, metabolic insult (alcohol, hemochromatosis, wilsons)
macro: >3mm, liver injury (postinfectious or drug induced hepatitis) |
|
What drug targets the Philadelphia chromosome? what is this treating?
|
Imatinib
CML |
|
what constitutes pulmonary HTN (pressures)
|
resting >25mmHg
or >35 during exercise |
|
what leukemia/lymphoma is most likely to cause bone pain
|
ALL
|
|
ALT>AST =
AST>ALT = |
ALT>AST = viral hepatitis
AST>ALT = alcoholic hepatitis |
|
Birbeck granules ("tennis rackets" on EM)
|
Langerhans cell histiocytosis
|
|
what thalamic nuclei is assoc with the following:
cerebellum (dentate nuc) and basal ganglia--> motor cortex mamillothalamic tract--> cingulate gyrus integration of visual auditory, and somesthetic input: Memory loss results if destroyed |
cerebellum (dentate nuc) and basal ganglia--> motor cortex: VL
mamillothalamic tract--> cingulate gyrus: anterior nucleus integration of visual auditory, and somesthetic input: pulvinar Memory loss results if destroyed: medial dorsal |
|
woman says she itches when she is in the shower. She says she has pain in her hands/fingers that is relieved with aspirin. what does she have
|
polycythemia vera
|
|
how do kids get reyes syndrome
|
have viral infection (especially VZV or influenza B) and they are given salicylates
causes hepatoencephalopathy |
|
give the hematological dz that matches the following:
AML assoc with Downs: Leukemia with more mature cells and less than 5% blasts: PAS + acute leukemia: |
AML assoc with Downs: M7 AML
Leukemia with more mature cells and less than 5% blasts: Chronic leukemia PAS + acute leukemia: ALL |
|
inactivation of the BMPR2 gene will lead to what?
** |
Primary pulmonary HTN
this gene normally inhibits vascular smooth muscle proliferation poor prognosis |
|
give the hematological dz that matches the following:
Greater than 20% blasts in marrow: myleodysplastic/proliferative disorders may progress to: numerous basophils, splenomegaly, and negative for leukocyte alkaline phosphatase (LAP): |
Greater than 20% blasts in marrow: acute leukemia
myleodysplastic/proliferative disorders may progress to: AML numerous basophils, splenomegaly, and negative for leukocyte alkaline phosphatase (LAP): CML |
|
what causes nutmeg liver
|
right sided HF and Budd-Chiari syndrome
|
|
give the hematological dz that matches the following:
most common neonatal leukemia: associated with the BCR-ABL genes: assoc with sjogren, hashimoto's thyroiditis, and h pylori: |
most common neonatal leukemia: M7 AML
associated with the BCR-ABL genes: CML assoc with sjogren, hashimoto's thyroiditis, and h pylori: Marginal cell MALToma |
|
Patient is aware and awake but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for the eyes
|
Basilar
locked in syndrome CN III is spared |
|
give the hematological dz that matches the following:
acute leukemia positive for peroxidase: solid sheets of lymphoblasts in marrow: PAS (-) acute leukemia: |
give the hematological dz that matches the following:
acute leukemia positive for peroxidase: AML solid sheets of lymphoblasts in marrow: ALL PAS (-) acute leukemia: AML |
|
What is Budd-Chiari syndrome
|
occlusion of the IVC or hepatic veins leading to congestive liver dz
absence of JVD distinguishes it from CHF |
|
describe the following in DIC
BT: PT: PTT: Platelet count: |
BT: increase
PT: increase PTT: increase Platelet count: decrease |
|
MOA of Bosentan?
Use |
competitively antagonize endothelin 1 receptors
decrease pulmonary vascular resistance (Pulmonary HTN) |
|
HYQ: 11 year old child presents with a chronic non-healing ulcer on his foot and imaging shows a small calcified spleen. What drug can improve his sx?
|
This is sickle cell
Hydroxyurea |
|
alpha 1 antitrypsin def leads to 2 problems...where
|
lungs (panacinar emphysema)
and hepatocellular ER |
|
what accumulates if you have a failure of Meiosis I? II?
|
I: primary spermatocytes
II: secondary spermatocytes |
|
compare primary biliary cirrhosis and primary sclerosing cholangitis in the following ways
Autoimmune: p-ANCA AMA: Men: Women Assoc with autoimmune: Increased risk of cholangiocarcinoma: |
Autoimmune: PBC
p-ANCA: PSC AMA: PBC Men: PSC Women: PBC Assoc with autoimmune: PBC Increased risk of cholangiocarcinoma: PSC |
|
PAO2=
|
150 - (PACO2/.8)
|
|
Cirrhosis
Diabetes mellitus Skin pigmentation what is this? what can lead to this? |
Hemochromatosis
chronic transfusion therapy (B-thal or sickle cell) increased ferritin, iron, and decreased TIBC |
|
Nimodipine is a CCB that can be used to tx what
|
vasospasm of blood vessels due to subarachnoid hemorrhage
|
|
60 year old female with rheumatoid arthritis and no alcohol history presents with fatigue and right abdominal pain, lab studies reveal high levels of ANA and ASMA, elevated serum IgG lvls, and no viral serologic markers
|
Autoimmune hepatitis
|
|
What is the difference btw hypoxemia and hypoxia and ischemia?
|
Hypoxemia: decreased alveloar O2 content
Hypoxia: decreased O2 delivery to tissue Ischemia: loss of blood flow |
|
LKM1 antiboides=
|
Autoimmune hep
Anti-liver kidney microsome type 1 antibody |
|
inhibits ribonucleotide reductase
|
hydroxyurea
|
|
total or subtotal atrophy of the small bowel villi, plasma cells, and lymphocyte infiltration into the lamina propria and epithelium and hyperplasia/elongation of crypts
|
Celiac sprue
|
|
compare V/Q at the base and apex of the lung
|
Base=.6 (wasted perfusion)
Apex=3 (wasted ventilation) note: both ventialation and perfusion are greater at the base of the lung than at the apex |
|
ERCP reveals alternating strictures and dilation
|
Primary sclerosing cholangitis
|
|
shaken baby syndrome will cause what type of hematoma
|
subdural
also associated with falls |
|
What type of stone is seen in pts with alcoholic cirrhosis, advanced age and biliary infection?
what about obesity, chrons, cystic fibrosis, native american origin: |
What type of stone is seen in pts with alcoholic cirrhosis, advanced age and biliary infection: Pigment stones
what about obesity, chrons, cystic fibrosis, native american origin: Cholesterol stones |
|
what is going on when V/Q approaches zero? can you tx with O2?
what is going on when V/Q is near infinity? can you tx with O2? |
what is going on when V/Q approaches zero: airway obstruction (shunt) can you tx with O2: NO
what is going on when V/Q is near infinity: blood flow obstruction (physioloic dead space) can you tx with O2: yes |
|
Murphy's sign will show what
|
Cholecystitis-inflammation of the gallbladder
insipratory arrest on deep palpation due to pain |
|
MOA of flutamide?
Use? |
competitive inhibitor of androgens at the testosterone receptor
prostate cancer |
|
air seen in biliary tree imaging...cause?
|
gallstone
|
|
Opening snap
|
mitral stenosis
|
|
what causes acute pancreatitis
2 major complications? |
GET SMASHED
Gallstones Ethanol Trauma Steroids Mumps Autoimmune dz Scorpion sting Hypercalcemia/Hyperlipidemia ERCP Drugs DIC and ARDS |
|
what leads to parenchymal hematoma?
where do they occur? |
HTN
basal ganglia and internal capsule |
|
pt comes in with steatorrhea, vitamin D deficiency, and DM. What would you likely see in his history
|
Alcoholism
this is chronic pancreatitis |
|
most common opportunistic infection in AIDS
|
pneumoncystis jiroveci pneumonia
|
|
what is Courvoisier's sign? what is it associated with?
|
obstructive jaundice with palpable gallbladder
pancreatic adenocarcinoma note: this is assoc with cigs, but not EtOH |
|
use of macrolides
|
Pneumonia
URI STDS |
|
MOA of ondansetron?
use? tox? |
5HT3 antagonist
post op vomiting (or cancer pts doing chemo, or morning sickness) headache (remember sumatriptan relieved headaches) |
|
osteomyelitis with IV drug use
|
pseudomonas or S. aureus
|
|
DOC for morning sickness in preggo lady
|
Ondansetron
5HT3 antagonist |
|
what type of hemorrhage would be seen in a newborn
|
Intraventricular hemorrhage in the newborn
|
|
what are the tumor markers for pancreatic cancer (2)
|
Ca 19-9
CEA |
|
most common malignant ovarian tumor? marker? histo finding?
|
Serous Cystadenocarcinoma
CA125 Psommoma body |
|
most common salivary tumor? second? most common location?
|
pleomorphic adenoma
mucoepidermoid carcinoma parotid gland (warthin is second most common benign) |
|
T/F with BPH you have hypertrophy of the prostate
|
FALSE
Hyperplasia |
|
triad of hemochromatosis?
|
Cirrhosis
DM Skin pigmentation |
|
give the most common pt with
ALL CLL AML CML |
ALL: child
CLL: adult over 60 AML: adult over 60 CML: adult 35-50 |
|
difference btw wet and dry beri beri?
what are they due to? |
Dry: neuopathy with myelin degeneration (toe drop, wrist drop foot drop, muscle weakness)
Wet: peripheral vasodilation-->high-output cardiac failure-->peripheral edema (cardiomegaly) B1 thiamine deficiency |
|
a young obese female with headaches that are worst in the morning and papilledema....How do you diagnose this problem
|
elevated CSF pressure
Pseudotumor cerebri first line tx is acetazolamide (also consider removing vitamin A) |
|
give the name of the following vitamins:
B1: A: B5: B6: E: |
B1: thiamine
A: retinal B5: pantothenic acid B6: pyridoxine E: alpha-tocopherol |
|
Philideplphia chromosome t(9;22) (bcr-abl)
|
CML
|
|
give the other name:
B9 B3 B2 C B12 |
B9: Folic acid
B3: Niacin B2: Riboflavin C: ascorbic acid B12: cobalamin |
|
ligament that connects ovary to lateral pelvic wall:
ligament that connects uterine fundus to labia majora: connectes uterus, fallopian tubes, and ovaries to side wall ovary to lateral uterus cervix to side wall of pelvis |
ligament that connects ovary to lateral pelvic wall: Suspensory
ligament that connects uterine fundus to labia majora: Round connectes uterus, fallopian tubes, and ovaries to side wall: Broad ovary to lateral uterus: Ligament of the ovary cervix to side wall of pelvis: Cardinal |
|
pt has fissuring at the corner of the mouth along with glossitis and dermatitis...what is deficient
|
Riboflavin
iron niacin folate B12 |
|
most common Primary tumor arising in bone (adults)
|
multiple myeloma
|
|
small child with swollen belly...what is the problem
|
Kwashiorkor--protein malnutrition
will have skin lesions and edema Kwashi is squashy (edema) |
|
Oligoclonal bands are seen in what?
what is the gold standard of diagnosing this problem? |
Multiple sclerosis
MRI |
|
energy malnutrition resulting in tissue and muscle wasting
|
marasmus
complete nutrient deficiency |
|
most common cause of primary hyperaldosteronism
|
adenoma of adrenal cortex
|
|
HYQ: vitamin c is necessary for the hydroxylation of which amino acids in collagen synthesis?
|
Proline and Lysine
|
|
alpha 1 antagonist used to treat BPH?
|
Tamsulosin
hits the alpha 1AD receptor specific to prostate |
|
What vitamins have a function similar to reduced gluathione?
|
E
A C |
|
top 3 causes of primary hyperparathyroidism
|
Adenoma
Hyperplasia Carcinoma |
|
HYQ: an alcoholic develops a rash, diarrhea, and altered mental status. What does he have and what is the causes
|
Pellegra
B3 deficiency (could be hartnups!) |
|
muscle weakness and atrophy with CSF showing lymphocytic pleocytosis with elevation of protein
|
Poliomyelitis
|
|
which vitamin deficiency matches the following description:
Increased RBC fragility: Peripheral neuropathy, angular cheliosis, glossititis: Bitot's spots, keratomalacia, xerophthalmia: |
Increased RBC fragility: E
Peripheral neuropathy: B12 Bitot's spots, keratomalacia, xerophthalmia: vitamin A |
|
most common cause of pulmonary HTN
|
COPD
|
|
Which vitamin matches the following statement:
Can be used to treat acne and psoriasis: used in oxidation/reduction reactions: given prophylactically to newborns: can be sued to elevate HDL and lower LDL: |
Can be used to treat acne and psoriasis: vitamin A
used in oxidation/reduction reactions: Niacin/ riboflavin (b3) given prophylactically to newborns: vitamin K can be sued to elevate HDL and lower LDL: Niacin |
|
melanocytes and chromafin cells are made from what?
|
Neural crest
|
|
what are the sx of zinc deficiency
|
poor wound healing, hair loss
|
|
recurrent inflammation/thrombosis of small/medium vessles in extremities
|
Buerger's dz (smoking)
|
|
what vitamins should vegetarian hippies supplement in their diet
|
B12
|
|
tx for acute scanning speech, intention tremor, and nystagumus?
chronic |
this is acute MS
acute: corticosteroids chronic: B-interferon |
|
S3 is associated with what
|
Increased ventricular filling (L->R shunt, mitral regurg, LV failure, CHF)
Think ventricular dilation dilated cardiomyopathy |
|
what BPH drugs work fastest? Which will lower your PSA
|
fastest: alpha blockers
lower PSA: 5alpha reductase inhibitors |
|
S4 is associated with what
|
Stiff/hypertrophic ventricle
(aortic stenosis, restrictive cardiomyopathy) |
|
What happens in internuclear ophthalmoplegia?
what is this associated with? will convergence be normal? |
lesion in the medial longitudinal fasiculus
medial rectus palsy on attempted lateral gaze assoc with MS convergence is normal, the medial rectus works, its just a problem in the MLF |
|
major cause of secondary hyperparathyroidism
|
hypocalcemia of chronic kidney dz (can't make vit D)
|
|
what cell is affected by LH and FSH respectively in females? Which does each make
|
LH-->Theca-->Androstendione (has 17alpha)
FSH-->Granulosa-->Estrogen (has aromatase) |
|
most common cause of SIADH
|
small cell carcinoma of the lung
|
|
defect in superoxide dismutase 1 is associated with what?
tx? |
ALS (upper and lower MN dmg)
Riluzole |
|
most common site of diverticula
|
sigmoid colon
|
|
what will happen with PSA in prostate cancer
|
decreased fraction of free PSA
|
|
most common sites of atherosclerosis
|
abdomina aorta
coronory a popliteal carotid |
|
pt with staggering gait, frequent falling, nsytagmus, hammertoes.
|
Autsomal recessive trinucleotide repeat...
Freidreich's ataxia (frataxin gene--FRAT) |
|
most common stomach ca
|
adenocarcinoma
|
|
Hemosiderinuria + thrombosis =
|
Paraoxysmal nocturnal hemoglobinuria
|
|
T(14,18):
t (8; 14): t(9;22): t(11,14): |
T(14,18): follicular lymphoma (bcl 2)
t (8; 14): Burkkits (c myc) t(9;22): Philadelphia (bcr-abl; assoc with CML) t(11,14): Mantle cell lymphoma |
|
What happens in Brown-Sequard syndrome
|
hemisection of spinal cord
ipsilater UMN signs ipsilateral loss of dorsal column Contralateral pain and temp loss ipsilateral loss of all sensations at lvl of lesion LMN signs at level of lesion |
|
most important sequale of temporal arteritis
|
ipsilateral blindness due to thrombosis of ophthalmic artery
can also lead to polymyalgia rheumatica |
|
What consideration must you make when evaluating prostatitis
|
<35 --> Gonorrhea/ Chlamydia cause
>35-->UTI bugs |
|
what is a tumor marker for seminoma
|
Placental Alkaline Phosphatase
|
|
40 yr man gets early dementia and uncontrollable movements of his upper extremities. What portion of his brain do you expect to see atrophy
|
Caudate
this is Huntingtons |
|
tumor of the adrenal medulla in kids
|
adrenal neuroblastoma (homer-wright rosettes)
|
|
what is an indicator of fetal well being
|
estriol
|
|
most common type of hodkins? non-hodgkins
|
Hodgkins: Nodular sclerosis
Non: Diffuse large cell |
|
male pt presents with involuntary flailing of one arm...where is the lesion
|
hemiballismus--> contralateral subthalamic nucleus
|
|
Viral encephalitis affecting temporal lobe
|
HSV
|
|
malignant, painless testicular enlargement with fried egg appearance
|
Seminoma
|
|
t(11, 22)
|
Ewing
|
|
pt cannot abduct her left eye on lateral gaze and convergence is normal. She is also having trouble smiling. In what part of the CNS is there a lesion
|
Pontine lesion
|
|
tachypnea, tachycardia and confusion in a hospital setting
|
PE
|
|
lytic bone lesions on xray
|
Multiple myeloma
|
|
HYQ: pt suffers a stroke after incurring multiple long bone fractures in a skiing accident. What caused the infarct
|
Fat embolism
|
|
when does babinski sign disappear in babies?
|
1st year of life
|
|
Hallmark of COPD
|
Decreased FEV1/FVC
(I say less than .8... I know you said a different number) |
|
Schiller Duval bodies
|
Yolk Sac
young kids (3 y) |
|
productive cough for 3 consecutive months in 2 years. What is this? histologically what can you see
|
Chronic Bronchitis
Gland depth/total thickness of bronchial wall (Reid index >50) |
|
what is the moro reflex?
rooting? |
moro: hang on for life, abduct then draw together
rooting: move head toward side if you stroke cheek (looking for nipple) |
|
what causes centriacinar and panacinar emphysema respectively
|
centriacinar: smoking
panacinar: alpha-1-antitrypsin def (look for a 20 yo with ephysema) |
|
pt presents with vertigo, tinnitus, and hearing loss?
|
Meniere's dz
|
|
how long does the corpus luteum maintain pregnancy with progesterone in the presence of bHCG?
|
6-7 weeks
after this the placenta runs house |
|
what hormones use steroid receptors?
|
VET CAP
Vit D Estrogen Testosterone Corisol Aldosterone Progesterone also T3/4 |
|
DD for eosinophilla
|
DNAAACP
Drugs Neoplasm Atopy (allergy, asthma, churg strauss) Addisons Acute interstitial nephritis Collagen vascular dz Parasites |
|
Lactulose is used for what?
MOA? |
tx for urea cycle related hyperammonemia
broken down by bacteria and makes an acidic pH. Traps the ammonia in the gut and takes it out with it (can also pull it from the blood) |
|
Triad of MS
|
Intention tremor
Scanning speech Nystagmus |
|
what drug can help treat Crigler Najar syndrome
|
Phenobarbital
increases glucuronyl transferase activity |
|
what crainial nerve nuclei are in the midbrain?
|
CN III and CN IV
|
|
inability to export absorbed lipids as chylomicrons leading to failure to thrive, steatorrhea, acanthocytosis, ataxia, and night blindness
|
Abetalipoproteinemia
tx: vitamin E |
|
what drugs tend to cause tardive dyskinesia
|
Typical antipsychotics
|
|
what hormones use cAMP?
|
FLAT CHAMP
FSH LH ACTH TSH CRH hCG ADH MSH PTH |
|
what is the long acting B-agonist for asthma? tox?
|
Salmeterol
can lead to desensitization of B receptors |
|
What amino acid is the precursor to the following molecule:
HIstamine: Porphyrin, heme: NO: |
HIstamine: histidine
Porphyrin, heme: glycine NO: arginine |
|
what kind of drug is butorphanol?
use? |
Partial agonist at opioid mu receptor
used for pain |
|
1st line tx for trigeminal neuralgia
|
Carbamazepine
|
|
Reinke crystals, androgen producing, gynecomatia in men, precocious puberty in boys...
|
Leydig cell tumor
|
|
What amino acid is the precursor to the following molecule:
GABA: SAM: Creatine: |
GABA: glutamate
SAM: methionine Creatine: arginine |
|
pt with abnormal uterine bleeding leading to iron def anemia. You biopsy and see whorled pattern of smooth muscle bundles
|
Leiomyoma
|
|
Methicillin, NSAIDs, and furosemide can cause what
|
interstitial nephritis
|
|
MOA of Theophylline
|
inhibits phosphodiesterase decreasing cAMP hydrolysis
metabolized by P450, blocks actions of adenosine |
|
rate limiting enzyme for the following:
HMP shunt: Bile acid synth: Heme synth: |
HMP shunt: Glucose-6-P-dehydrogenase
Bile acid synth: 7-alpha-hydroxylase Heme synth: aminolevulanic synthase |
|
MOA of Tramadol
|
weak opioid agonist and inhibits 5HT and NE (tram it all in)
chronic pain |
|
MOA of Sumatriptan?
Use? Tox? |
5HT1B/1D agonist (vasoconstriction)
acute migraine, cluster headache tox: coronary vasospasm, contraindicated in ppl with angina |
|
what crainial nerve nuclei are in the pons?
|
CN V, VI, VII, VIII
|
|
HYQ: pt with PKU shouldn't have phenylalanine, what else should you do to the diet
|
increase tyrosine
|
|
pt with tinnitus, dizziness, headaches, and GI distress. What drug caused this
|
Quinine
Quinadine |
|
severe menstrual related pain
|
endometriosis
often results in infertility seen most commonly on ovary--chocolate cyst |
|
MOA of ipratropium
use? |
competitive blocker of M receptors
asthma/COPD |
|
1st line tx of cluster headache
|
O2
|
|
Low MAC does what to potency? what does this do to Km
|
raises potency
lowers Km |
|
HYQ: 2 yo girl with increased abdominal girth, failure to thrive, and skin/hair depigmentation...
|
Kwashiorkor
|
|
what changes in to vmax and or Km do you see in the following:
competitive antag: noncompetitive antag: |
competitive antag: increase Km (decrease potency)
noncompetitive antag: decrease vmax and efficacy |
|
nephrogenic Diabetes insipidus can be caused by what
|
Lithium (demeclocycline too)
|
|
what kind of drug is atomoxetine? use?
|
SNRI
ADHD |
|
HYQ: pt with genetic dz in which the tx includes protein restriction to prevent mental retardation, ketoacidosis, and death. Diagnosis?
|
Maple syrup urine dz
|
|
MOA of cromoyln...?
can you use it for acute attacks? |
prevents release of histamine from mast cells
NO, takes days to start working |
|
blown pupil should make you think
|
Uncal herniation
|
|
name the major side effect of the following inhaled anesthetics
Halothane: Methoxyflurane: Enflurane: |
Halothane: hepatotox
Methoxyflurane: nephrotox Enflurane: proconvuslant |
|
HYQ: 18 yo F has moderate generalized abdominal pain, normal WBC, no fever. She has paresthesias in lower extremities. Dg?
|
Acute intermittent prophyria
|
|
what crainial nerve nuclei are in the medulla?
|
CN IX, X, XI, XII
|
|
neutrophils fail to respond to chemotactic stimuli
|
Job or leukocyte adhesion def
|
|
most common herediatry bleeding disorder
|
vWillebrand disease
|
|
HYQ: 45 yo male alcoholic gets blistering lesions in sun exposed areas especially the dorsum of the hands. He also has hypertrichosis of the face. Diagnosis
|
Porphyria cutanea tarda
|
|
1st line tx of chronic asthma
|
corticosteroids
|
|
what primary brain tumor is assoc with polycythemia?
|
Hemangioblastoma
(VHL) |
|
what drug would you consider using for a pt that is going to have endoscopy
|
Midazolam
|
|
MOA of cyclosporine?
use? tox? |
inhibits calcineurin and prevents production of IL-2
suppresses organ rejection predisposes to viral infections and lymphoma; nephrotox (preventable with mannitol) |
|
Old man with tumor on the ball
|
testicular lymphoma
|
|
what anti-depressant lowers the seizure threshold
|
Buproprion
smoking cessation |
|
MOA of Leuprolide?
3 uses |
GnRH analog with agonist properties when used pulsatile, antag when used continuous
1. infertility (pulsitile) 2. prostate cancer (continuous) 3. uterine fibroids (continuous) |
|
MOA of tacrolimis
use? tox? |
binds to FK binding protein and inhibits IL2 secretion
organ transplant (or topically for eczema) tox: nephro tox and peripheral neuropathy |
|
what drugs are good for aspirin induced asthma?
which can be used in 1 year olds? |
Lukast drugs
block leukotriene receptors lil guys can use Montelukast |
|
what allele is assoc with Alzheimer's dz?
why is it so common in Downs |
APP gene
found on chrom 21, downs has 3 copies |
|
Thiopental vs ketamine:
Cerebral bloodflow |
Thiopental: decreased cerebral blood flow
ketamine: increased cerebral bloodflow |
|
MOA of sirolimus?
use? |
binds mTOR, inhibits IL2
immunosuppression after kidney transplant |
|
if the vagus is lesioned, what can you look at to observe this? how will it move
|
uvula will deviate away
(one side of the palate is working and pulling it up, the other side is not, so it deviates away) |
|
post menopausal vaginal bleeding
|
endometrial hyperplasia or endometrial carcinoma
|
|
HLA b27 associations
|
PAIR
Psoriasis Ankylosing sponylitis IBD (ulcerative colitis) Reiters |
|
MOA of Azathoprine?
tox |
precursor of 6MP, interferes with metabolism and synth of nucleic acid
remember allopurinol will prevent breakdown |
|
CF and Kartagener's dz can predispose people to this form of COPD
|
Bronchiectasis: chronic necrotizing infection of bronchi->permanently dilated airways, purulent sputum, recurrent infections hemoptysis
|
|
43 yo man with dizziness and tinnitus. CT shows enlarged internal acoustic meatus....
|
acoustic schwanoma
|
|
DOC for rapid anesthesia induction?
|
Propofol
|
|
Muromonab MOA?
use? |
MAB that binds CD3 of T cells
immunosuppresion after kidney transplant |
|
where are Meiosis I and II arrested in? until what happens
|
Meiosis I: prophase until ovulation
Meiosis II: metaphase until fertilization |
|
what TB drug has an increased risk of seizure?
|
Isoniazid
|
|
what effect does sex hormone binding globulin have in males and females respectively
|
if SHBG is increased in men-->gynecomastia
decreased SHBG in female-->hirsutism |
|
which immunosuppressant fits the following:
Precursor of 6MP: may prevent nephrotox with mannitol: inhibits calcinuerin: metabolized by xanthine oxidase: |
Precursor of 6MP: Azathroprine
may prevent nephrotox with mannitol: Cyclosporine inhibits calcinuerin: Cyclosporine metabolized by xanthine oxidase: Azatthoprine |
|
mom looks like she might die and you are considering delivering the baby early. What could you give mom to help prevent neonatal respiratory distress syndrome
|
steroids to mature the type II pneumocytes
note: can give the preemie baby artificial surfactant after birth |
|
High triglycerides causes what
|
pancreatitis
|
|
if the hypoglossal n. is damaged, what will indicate the lesion?
|
tongue will deviate towards the side of the lesion
|
|
HLA DR3/4
|
DM 1
RA SLE |
|
Coal miners, silicosis, asbestosis
Affects upper lobes: Likely to become cancer: Eggshell calcification of hilar lymph node: Affects lower lobes: Golden-brown fusiform rods: |
Affects upper lobes: Coal, Silicosis
Likely to become cancer: Asbestosis (bronchogenic or mesothelioma) Eggshell calcification of hilar lymph node: Silicosis Affects lower lobes: Asbestosis Golden-brown fusiform rods: Asbestosis |
|
nerve blockade
which is knocked out first small or large? myelinated or unmyelinated? size or myelin? |
Small> large
myelin> un size> myelin |
|
what testicular tumor fits the following
composed of cytotrophoblasts and synctiotrophoblasts: histologic appearance similar to kiolocytes: histologically may have alveolar or tubular appearance sometimes with papillary convolutions: |
composed of cytotrophoblasts and synctiotrophoblasts: choriocarcinoma
histologic appearance similar to kiolocytes: seminoma histologically may have alveolar or tubular appearance sometimes with papillary convolutions: Embryonal |
|
definitive diagnosis and tx of this uterine pathology is by laproscopy
|
endometriosis
look for pelvic pain with menstruation |
|
in a tension pneumo, what way will the trachea deviate
|
away from the lesion
|
|
side effect of bupivicaine?
|
severe cardiotox
local anesthetic |
|
2 things that can lead to bilateral Bell's palsy
|
Guillan Barre and Lyme
|
|
holosystolic murmur
|
VSD, tricuspid regurg, mitral rgurg
|
|
most common lung cancer in a non-smoking female? where is it located
|
Adenocarcinoma
Peripheral |
|
Opiod used for cough suppresant:
tx diarrhea? |
Dextramathorphan
loperamide |
|
where are the following hormones secreted:
Progesterone: Parathyroid hormone: Estadiol Estriol Estrone |
Progesterone: ovary
Parathyroid hormone: chief cells of the parathyroid Estadiol: ovary Estriol: placenta Estrone: fat |
|
defective tyrosine kinase genes (what immunodef)
|
Bruntons
|
|
decreased breath sounds, dullness and decreased fremitus. what does this pt have?
|
Plueral effusion
|
|
what drug is IV and does not induce histamine release like morphine
|
fentnyl
|
|
what nerve does the following:
monitors the carotid body and baroreceptors sensation to ant. tongue: |
monitors the carotid body and baroreceptors: IX
sensation to ant. tongue: V3 |
|
most common cause of secondary HTN
|
Renal dz
chronic kidney dz or renal a. stenosis |
|
Common bacterial cause of COPD exacerbation
|
H. influ
|
|
give Rate limiting enzyme of the following:
Glycolysis Gluconeogenesis TCA cycle Glycogen synthesis Glycogenolysis: |
Glycolysis: Phosphofructokinase 1
Gluconeogenesis: Fructose 1-6 bisphosphate TCA cycle: Isocitrate dehydrogenatse Glycogen synthesis: glycogen sythnase Glycogenolysis: glycogen phosphorylase |
|
55 yo man on tx for BPH has increased testosterone and decreased DHT as well as gynecomastia and edema...medication?
|
Finasteride
|
|
infertility, obestiy, amenorrhea, hirsutism...
what are LH, FSH, and testosterone lvls like? tx? |
LH increased
FSH decreased Testosterone increased this is PCOS tx: clomiphine, OCPs, weight loss |
|
tx for atypical pneumonia
** |
Macrolide
|
|
give Rate limiting enzyme of the following:
HMP shunt: De novo pyrimidine synth: De novo purine synth: Urea cycle: |
HMP shunt: G6PD
De novo pyrimidine synth: Carbamoyl phosphate synthetase II De novo purine synth: Glutamine PRPP amidotransferase Urea cycle: Carbamoyl phosphate synthetase I |
|
Weber: Right
Rinne L: AC>BC Rinne R: BC>AC Diagnosis? |
conductive hearing loss R
|
|
young female with HTN
|
OCPs
|
|
3 most common locations of lung cancer mets?
|
brain
bone liver |
|
give Rate limiting enzyme of the following:
Fatty acid synth: fatty acid oxidation ketogenesis: cholesterol sythesis: |
Fatty acid synth: Acetyl-CoA carboxylase (ACC)
fatty acid oxidation: Carnitine acyltransferase I ketogenesis: HMG-CoA synthase cholesterol sythesis: HMG CoA reductase |
|
what is premature ovarian failure
|
menopause before age 40
|
|
what hormones have an alpha and beta subunit? which makes it unique
|
alpha: TSH, LH, FSH, hCG
Beta makes it unique |
|
common causes of ARDS
|
shock
infection toxic gas inhalation acute pancreatitis aspiration heroin OD |
|
this is used to transfer methyl units and is required for the conversion of NE to EPI
|
S-adenosyl-methionine (SAM)
|
|
Weber: Left
Rinne L: AC>BC Rinne R: AC>BC Diagnosis? |
sensory neural hearing loss R
|
|
infection secondary to blood transfusion
|
hepatitis C
|
|
what is pulsus paradoxus? causes?
|
systolic BP drops by >10mmHg with inspiration
Asthma COPD Croup Tamponade |
|
what turns PEP (phosphoenol pyruvate) into pyruvate
|
Pyruvate kinase
|
|
infertile pt with bag of worms
|
varicocele
vericose vein of the balls |
|
pt with hirsutism obesity and amenorrhea has an increased risk of what
|
endometrial cancer
this is PCOS |
|
HYQ: 75 year old has 60 pack year history has difficulty standing up from bed when he wakes and has difficulty raising his arms in the AM to wash his hair. What is going on?
|
Lambert Eaton due to small cell lung Ca
|
|
what enzyme is def in von Gierkes dz...what cant you do then?
|
Glucose-6-phosphatase
this is the last enzyme to make glucose in gluconeogenesis |
|
Weber: midline
Rinne L: BC>AC Rinne R: BC>AC Diagnosis? |
bilateral conductive hearing loss
|
|
what is eisenmenger's syndrome
|
late cyanotic shunt (uncorrected L->R becomes R->L)
|
|
what is the tx for CML
|
Imatinib
|
|
pt with severe fasting hypoglycemia, glycogen in liver, increased blood lactate and hepatomegaly. What enzyme is def?
|
this is Von Gierke's dz
glucose-6-phosphatase |
|
tx for pediculosis capitis
|
permithrin
pyrethin lindane |
|
CO=
what is it via the Fick principle? |
SV x HR
via fick: Rate of O2 consumption / (arterial O2 content - venous O2 content) |
|
what is the cause of G (-) rod in 80 man
|
E. coli
|
|
pt with cardiomegaly and systemic findings leading to early death....this is a glycogen storage dz that has what enzyme def?
|
Pompe's dz
lysosomal alpha 1,4 glucosidase |
|
in conductive hearing loss, which side will the sound lateralize to?
what about sensorinuerual |
conductive: same side
sensorineural: opposite |
|
malignancy associated with noninfectious fever
|
Hodgkins
|
|
describe the morphology of Listeria
** |
Gram positive bacilli
|
|
you think a guy has von gierke's dz but find that he does not have increased blood lactate and is not def in glucose 6 phosphate. What does he have? enzyme def?
|
Cori's dz
debranching enzyme (alpha 1,6, glucosidase) |
|
what is the MOA of clomiphene
use? |
partial agonist at pituitary estrogen receptor in the hypothalamus
ends up preventing normal feedback inhibition leads to increased release of LH and FSH which stimulates ovulation used to tx infertility and PCOS |
|
what kind of cyst is associated with choriocarcinoma, moles, or twins
|
Theca-lutein cyst
|
|
Describe the FEV1, FVC, and FEV1/FVC ratio for both obstructive and restrictive dz
*** |
Obstructive:
FEV1: decreased FVC: Decreased FEV1/FVC: decreased (<.8) Restrictive FEV1: decreased FVC: even more Decreased FEV1/FVC: normal or increased (>.80) |
|
pt has pain after working out with cramps. what enzyme is deficient
|
McArdle's dz
skeletal muscle glycogen phosphorylase |
|
what causes congenital cataracts
|
rubella
|
|
most common malignant skin tumor
|
Basal Cell
|
|
what is the hallmark of restrictive lung dz
* |
Decreased total lung capacity
|
|
What glycogen storage dz matches the following:
Glycogen phosphorylase deficiency: Glucose 6 phosphatase def: lactic acidosis, hyperlipidemia, hyperuricemia: alpha 1,6 glucosidase def alpha 1, 4 glucosidase def |
Glycogen phosphorylase deficiency: McArdle
Glucose 6 phosphatase def: Von Gierke lactic acidosis, hyperlipidemia, hyperuricemia: von Gierke alpha 1,6 glucosidase def: Cori alpha 1, 4 glucosidase def: Pompe |
|
what will prevent the LH surge?
|
OCP prevents estrogen surge, thus preventing LH surge and ovulation
|
|
what hormone stimulates release of prolactin
|
TRH
|
|
Phenylalanine is the precursor for what
* |
Tyrosine
Dopa-->Mealnin Dopamine NE Epi |
|
What glycogen storage dz matches the following:
cardiomegaly diaphragm weakness increased glycogen in the liver, severe fasting hypoglycemia hepatomegaly, hypoglycemia, hyperlipidemia, normal kidneys and lactate |
cardiomegaly: Pompe (kid)
diaphragm weakness: Pompe (adult) increased glycogen in the liver, severe fasting hypoglycemia: von Gierkes hepatomegaly, hypoglycemia, hyperlipidemia, normal kidneys and lactate: Cori |
|
Sudden painless onset of flashing light
|
retinal detachment
|
|
Most common causes of MR
|
FAS
Downs F X |
|
Tyrptophan is the precursor to what 2 things? what do they make?
* |
Niacin--->NAD/NADP
Serotonin-->Melatonin |
|
What glycogen storage dz matches the following:
Painful muscle cramps, myoglobinuria with strenous exercise: Severe hepatosplenomegaly, enlarged kidneys: |
Painful muscle cramps, myoglobinuria with strenous exercise: McArdle
Severe hepatosplenomegaly, enlarged kidneys: von Gierkes |
|
what is the male homologue of the following female structure:
Vestibular bulbs: labia minora: bartholin glands: |
Vestibular bulbs: corpus spongiosum
labia minora: ventral shaft of penis bartholin glands: bulbourethral |
|
tumor marker for dysgerminoma?
|
hCG, LDH
|
|
Glycine is a precursor for what
* |
poryphrin-->heme
|
|
what are the 4 fates of pyruvate
|
Alanine
Lactate Oxaloacetate Acteyl-CoA |
|
dementia often a/w frequent falls and or syncope
|
Dementia with Lewy bodies
|
|
mets to bone
|
PT barnum loves kids
Prostate thyroid Testes Breast Lung Kidney |
|
Arginine is a precursor for what 3 things
* |
Creatine
Urea NO |
|
in the electron transport, how many ATPs do you get from NADH and FADH2?
|
NADH: 3
FADH2: 2 |
|
A
B D cells of the pancreas release what |
A: glucagon
B: insulin D: somatostatin |
|
Cat scratch:
Dog/cat bite: Puppy feces: |
Cat scratch: Bartonella
Dog/cat bite: Pasturella Puppy feces: Yersinia |
|
Glutamate is a precursor for what 2 things
* |
GABA
Glutathione |
|
Use of NAD?
NADPH? |
NAD: Catabolic processes
NADPH: anabolic processes (steroid and FA synth; resp burst, P450, glutahione reductase) |
|
Dementia + visual hallucinations=
dementia + personality changes and/or aphasia |
Dementia + visual hallucinations= Lewy Body Dementia
dementia + personality changes andor aphasia= Picks dz |
|
mets to brain
|
Lung
Breast Skin kidney GI |
|
enzyme for phenyalanine to tyrosine?
|
phenyalanine hydroxylase
|
|
what is the purpose of the HMP shutn (pentose phosphate pathway)
|
produce NADPH
|
|
mucin secreting signet cell adenocarcinoma of the ovary...where did it come from
|
Krunkenberg tumor
GI |
|
Furosemide and thiazides can cause what problem
|
gout
|
|
woman develops intense muscle cramps and darkening of her urine after exercise...what does she have
|
McArdels dz
Glycogen 6 phosphatase |
|
tumor that contains cells from 2 or 3 germ layers
|
Teratoma
dermoid cyst-most frequent benign ovarian tumor |
|
what three amino acids are used in the golgi
|
SAT
serine asparagine threonine |
|
enzyme for tyrosine to dopa
|
tyrosine hydroxylase
|
|
what type of murmur will be louder with inspiration
|
tricuspid
more blood flow into RA mitral will get worse with EXPIRATION |
|
what enzyme takes Glucose 6 P to NADPH?
|
Glucose-6-P dehydrogenase
|
|
coarse facial features, clouded corneas, restricted joint movement due to failure of addition of mannose-6-phosphate
|
I-cell dz
will see Inclusion bodies |
|
what usually precedes Guillain Barre
|
resp or GI illness
|
|
what are the components (consider sperm/egg) for
complete mole: partial: |
complete mole: 2 sperm empty egg
partial: 2 sperm 1 egg |
|
most common cause of mitral valve stenosis
|
Rheumatic heart dz
|
|
COPI vs COPII with respect to the Golgi
|
COPI: Golgi --> ER (retrograde)
COPII: RER-->cis-Golgi (anteriograde) |
|
dopamine to NE? (enzyme
|
Dopamine B hydroxylase
|
|
pts MRI reveals replacement tissue in the sella turcica with CSF...
|
Empty cella syndrome
pituitary is mostly gone somehow it is subclinical |
|
what are Heinz bodies and what are they seen in?
|
Oxidized Hemoglobin precipitated within RBC
G6PD |
|
what protein is involved in transporting an endocytosed vesicle from the plasma membrane to the endosome?
|
Clathrin
|
|
MOA of mifepristone...use?
|
Competitive inhibitor of progestins at progesterone receptor
termination of pregnancy |
|
HTN, bruising or bleeding from the gums and jaundice
|
HELLP
Hemolysis Elevated LFTs Low Platelets |
|
what common drug class can lead to stimulation of prolactin release
what is the major sx associated with this? |
antipsychotics (DA antagonists)
due to the tonic inhibition of prolactin by dopamine major sx: HYPOGONADISM (inhibits GnRH) |
|
what molecule targets proteins in the ER for lysosomes
|
Mannose-6-phosphate
failure of addition leads to I cell dz |
|
pt has pheneylacetate, phenyllactate in the urine and tissues. also has mousy body odor, fair skin, and MR. Enzyme responsible
|
phenylalanine hydroxylase def
this is PKU (AR) must begin tx in the 1st 3 weeks of life note: maternal PKU is lack of proper diet during preggo, kid gets microcephaly, MR, growth retardation, and congenital heart defects |
|
demyelinating dz in young women
|
MS
|
|
pt has benign essential fructosuira...what enzyme is defective?
|
fructokinase
|
|
what effect do ACE/ARBs have on preload and afterload
|
decrease both
|
|
What is Marcus Gunn disorder
|
inability to constrict the pupil when light shone in the eye
afferent pupillary n damage |
|
what supplies both wernikie and broacas area
|
middle cerebral
|
|
mixed UMN/LMN dz
|
ALS
|
|
immotile cilia due to a dynein arm defect. Results in male and female infertility, bronchiectasis, and reucrrent sinusitis. What does this pt have? what else might you see
|
Kartagener's syndrome (primary cilliary diskinesia)
Situs inversus the kindergarten cop hit you so hard your organs are reversed |
|
pt with dark connective tissue, brown pigmented sclera, urine black on standing. Enzyme problem?
|
Homogentisic acid Oxidase
this is Alkaptonuria (ochronosis) |
|
continuous machine like murmur
|
PDA
|
|
pt has hypoglycemia, jaundice, cirrhosis, and vomiting after eating fruit. What do they have, what enzyme is the problem, and what is the tx?
|
Fructose intolerance
Aldolase B decrease intake of fructose and sucrose (fructose+glucose) |
|
first line tx for pre-eclampsia seizures
|
Magnesium sulfate
|
|
corticosteroids and heparin can cause what
|
Osteoprosis
|
|
where is the lesion
agraphia and acalculia eyes look away from side of lesion Dysarthria Intention tremor |
agraphia and acalculia: left parietal
eyes look away from side of lesion: PPRF Dysarthria: cerebellar vermis Intention tremor: cerebellar hemisphere |
|
benign ovarian tumor that looks like bladder tissue
|
Brenner tumor
|
|
microtubule polymerization defect resulting in decreased phagocytosis. Pt will have pyogenic infections, partial albinism, and peripheral neuropathy
|
Chediak Higashi syndrome
|
|
enzyme def in albinism?
|
Tyrosinase
|
|
causes of DIC
|
STOP Making New Thrombi
Sepsis Trauma Obstetric Pancreatitis Malignancy Nephrotic syndrome Transfusion |
|
pt with failure to thrive, jaundice, hepatomegaly, and infantile cataracts with MR. What does this pt have, what enzyme is absent, and what is the tx
|
Classic galactosemia
galactose-1-phosphate uridyltransferase exclude galactose and lactose (galactose + glucose) from diet |
|
4 major actions of PTH
|
increase bone resorption of calcium and phosphate
increase kidney resorption of Ca decrease kidney reabsorption of phosphate increase 1,25 OH2 vit D production in the kidney |
|
what antiepileptic drugs are teratogens? 3
|
Phenytoin
Carbamazepine Valproic acid |
|
child with hydrocephalus, what 2 tumors could it be? what distinguishes
|
Medulloblastoma: Homer wright rosettes
Ependymoma: Perivascular pseudorosettes |
|
most common cause of myocarditis?
|
Coxsackie B
or echovirus |
|
what cell membrane lipid is converted to arachidonic acid by phospholipase A2
|
Phosphatidylinostitol
|
|
pt has increased homocysteine in the urine, MR, tall stature, kyphosis, lens sublux...
what enzyme is def? (2 possible) tx? * |
this is homocystinuria
2 enzymes: Cystathionine synthase deficiency Homocysteine methyltransferase tx: decrease methionine, increase cystiene, increase B12/folate, increase B6 |
|
Extremely tender thyroid gland:
Pretibial myxedema: palpation of single thyroid nodule: Recent study using IV contrast dye: |
Extremely tender thyroid gland: De Quervian's subacute thyroiditis
Pretibial myxedema: Graves palpation of single thyroid nodule: Toxic thyroid adenoma Recent study using IV contrast dye: Jod-basedow phenomenon |
|
osmotic diarrhea, cramps, and bloating following diary products
|
Lactase deficiency: lactose intolerance
|
|
painless bleeding in any trimester...
|
placenta previa--attachment of placenta to lower uterine segment
Multiparity adn prior C section predispose |
|
what portion of the heart can enlarge leading to compression of the recurrent laryngeal n.
|
Left atrium
|
|
bitemporal hemianopia in a child...supratentorial
|
Craniopharyngioma
calcification is common |
|
neuropathy + AV node block
|
2nd stage lyme dz
|
|
what enzyme do corticosteroids inhibit that prevents the formation of arachidonic acid?
|
Phospholipase A2
|
|
what enzyme is missing in the dz that causes maple syrup urine dz? what amino acids aren't degraded
|
alpha-ketoacid dehydrogenase
I Love Vermont Ile, Leu, Val |
|
most common dietary deficiency
|
iron
microcytic anemia most common vitamin def (folate/B9) |
|
why do you get hypoglycemia in ethanol metabolism?
|
can't undergo gluconeogenesis
NADH is produced when you drink and converts pyruvate to lactate and oxaloacetate to malate so you dont have any products for gluconeogenesis |
|
what 5 things can lead to mitral regurg?
|
ischemic heart dz
mitral valve prolapse LV Dilation endocarditis Rhematic fever |
|
what antiseizure drug causes agranulocytosis
|
Carbamazepine
(others: clozapine, colichine, PTU/metimazole) |
|
what primary brain tumor fits the following description:
polycythemia a/w VHL foamy cells high vascularity |
Hemangioblastoma
|
|
most common neoplasm in kids?
|
1. ALL
2. cerebellar astrocytoma |
|
MOA of Zileuton
|
inhibits lipoxygenase from making leukotrienes
|
|
Hartnup dz leads to what? how
|
Pellagra (niacin B3 def); Diarrhea, dementia, dermatitis
causes tryptophan excretion in urine-->tyrptophan is a precursor to Niacin (B3) |
|
what are the X-linked immunodeficiencies ?
|
WBC
Wiskot Bruton CGD SCIDS and hyper IgM |
|
1 g of protein = how many kcal?
carb= fat= ethanol= |
protein: 4
carb: 4 fat: 9 booze: 7 |
|
massive bleeding after delivery
|
placenta accreta
placenta attached to myometrium. Have to take out the uterus |
|
what drugs are assoc with SJS
|
Seizure
Sulfa -cillin drugs |
|
what primary brain tumor fits the following description:
Pseudopalisading necrosis (what else has this appearance) |
Glioblastoma multiforme
(basal cell ca) |
|
Call-Exner bodies are seen in what
|
Granulosa cell tumor
causes precocious puberty in kids or endometrial hyperplasia in adults |
|
MOA of Zafrilukast and montelukast
|
inhibit leukotrienes from causing bronchoconstriction
|
|
Deficiency of aldolase B:
Deficiency of cystathione synthase: Inherited defect in tubular amino acid transporter: |
Deficiency of aldolase B: Fructose intolerance
Deficiency of cystathione synthase: Homocystinuria Inherited defect in tubular amino acid transporter: Cystinuria/hartnups |
|
diverticulum of the pharynx
|
Zenkers
|
|
acetoacetate and b-hydroxybutyrate are what? seen when? rate limiting enzyme?
|
Keytone bodies
fasting (low blood sugar) rate limiting enzyme: HMG Co-A synthase |
|
what is renal osteodystrophy
|
secondary hyperparathyroidism due to renal failure
Renal dz Decrease Vit D Decrease Ca Increase PTH (pull it from bone) Phosphate increase because kidney can't get rid of it |
|
what are the haptotoxic antiepileptics
|
Carbimazibine
Valproic acid |
|
Most common type of thyroid cancer? histologic finding?
Hashimotos thyroiditis is a risk factor Cancer arising from parafollicular C cells |
Papillary; Little orphan annie eyes
Hashimotos thyroiditis is a risk factor: Lymphoma Cancer arising from parafollicular C cells:Medullary |
|
most common cause of nephrotic syndrome in kids? adults?
|
kid: MC
Adults: Membranous |
|
COX will lead to the formation of endoperoxides which can then lead to 3 things, one of them is the following. What does it do:
Prostacyclin (PGI2) |
decrease platelet aggregation/vasodilation
decrease uterine tone |
|
tx-decreased dietary methionine increased cystine and B6:
hypoglycemia, jaundice, cirrhosis: tx- acetazolamide to alkalinize urine: |
tx-decreased dietary methionine increased cystine and B6: Homocystinuria
hypoglycemia, jaundice, cirrhosis: fructose intolerance tx- acetazolamide to alkalinize urine: cystinuria (to prevent stones) |
|
Ejection click
|
aortic/pulmonic stenosis
|
|
How many ATP are generated during aerobic metabolism?
anaerobic? |
Aerobic (32/30)
Anaerobic (2 ATP and lactate) |
|
pregnant woman with previosu c-sectoin is at increased risk for what
|
placenta accreta and previa
grows into the scar |
|
girl under the age of 4 with spindle shaped tumor cell that is desmin positive
|
Sarcoma botryoides
|
|
what heart sounds are considered benign when there is no evidence of dz? 4
|
split S1
split S2 on inspiration S3 in a pt younger than 40 (or preggo) early quiet systolic murmur |
|
how do you diagnose Acromegaly
|
measure serum IGF (GH is pulsatile, not helpful)
|
|
COX will lead to the formation of endoperoxides which can then lead to 3 things, one of them is the following. What does it do:
Prostaglandins (PGE2) |
decrease vascular tone
increase pain Increase uterine tone increase temp |
|
tx-increased intake of ketogenic nutrients (fats):
tx-exclude galactose and lactose from diet: |
tx-increased intake of ketogenic nutrients (fats): pyruvate dehydrogenase def
tx-exclude galactose and lactose from diet: galactosemia |
|
Food poisoning due to exotoxin, happens quickly 24 hours
|
S. aureus
B. Cerus |
|
primary energy source in a pt who hasn't eaten in 2 days
|
FA
|
|
what type of study compares a group of ppl with a dz to a group w/o
|
Case control
measures Odds ratio |
|
antileptics that work via GABA? give 3
|
phenobarbital
benzos gabapentin (valproic acid, topiramate, tiagabine,vigabatrin, levetiracetam) |
|
what thyroid cancer has the most common mutation in the BRAF gene (serine/threonine kinase)
|
Papillary carcinoma
|
|
which ER is associated with synthesis of secretory proteins, and thus are found in mucus secreting goblet cells and antibody secreting cells?
Which is used for steroid synth and detoxification of drugs/poison |
secretory: Rough
Detox: Smooth (seen in liver and adrenal cortex) |
|
COX will lead to the formation of endoperoxides which can then lead to 3 things, one of them is the following. What does it do:
Thromboxane (TXA2) |
increase platelet aggregation and vasoconstriction
|
|
this is the most common urea cycle disorder. It is x-linked and you will see tremor, slurring of speech, somnolence, vomiting. What do they have?
|
ornithine transcarbamoylase def (OTC)
orotic acid will be increased in blood and BUN will be decreased |
|
most common gynecologic malignancy in US
|
endometrial carcinoma
|
|
arrange the following molecules from most exergonic with loss of phosphate to least exergonic loss of phosphate: AMP, ATP, PEP
|
PEP>ATP>AMP
|
|
what is dinoprostone
|
PGE2 analog causing cervical dilation and uterine contraction
induce labor |
|
Expired tetracyclines can lead to what problem
|
Fanconi syndrome
peeing out stuff you shouldn't (glucose, phos, etc) Heavy metals and Wilson's can do this too |
|
When is S4 heard? what does it mean
|
atrial kick in late diastole
due to high atrial pressure associated with ventricular hypertrophy |
|
arachadonic acid is made into what from COX and LPO (immediate step after)
|
LPO: Hydroperoxides
COX: Endoperoxides |
|
most common Heart murmur, congenital
|
mitral valve prolapse
|
|
pt with High PTH, hypocalcemia, short 4/5th digits, short stature. What does the pt have. How is it inherited?
|
Pseduohypoparathyroidism (albrights herditary osteodystrophy)
AD kidney is unresponsive to PTH |
|
which vein drains directly into the IVC, Right adrenal or left?
|
Right
same is true for gonads |
|
What hormones use cAMP
|
FLAT CHAMP
FSH LH ACTH TSH CRH hCG ADH MSH PTH |
|
top 2 helminth infections in the US
tx? |
1. enterobius vermicularis (pin worm)
2. ascaris lumbricoides use bendazoles to tx |
|
Ritodrine/terbutaline do what
|
B2 agonists that relax uterus
reduce premature uterine contractions |
|
early diastolic murmur heard best along the left side of the sternum
|
pulmonic regurg
|
|
what uses cGMP as secondary signal
|
vasodilators
ANP, NO |
|
multiple blood transfusion or hereditary HFE mutation (can result in CHF, "bronze diabetes" and increased risk of hepatocelluar carcinoma)
|
Hemochromatosis
|
|
crescendo-decrescendo systolic ejection murmur following ejection click
S1 ----CLICK---murmur----S2 |
aortic stenosis
will have weak pulses compared to the heart sounds and syncope |
|
what is the precursor to cholesterol?
what makes cholestrol into pregnenolone |
Acetate
Desmolase |
|
what uses IP3 as secondary messanger
|
posterior pituitary stuff
GnRH, Oxytocin, ADH, TRH |
|
most common cause of hepatocellular carcinoma
|
Cirrhotic liver (oftern assoc with hepatitis B and C)
|
|
bloody nipple discharge
|
intraductal papilloma
|
|
What are the 3 acute phase cytokines
|
IL-1
IL-6 TNF alpha |
|
IGF, FGF, and PDGF use what 2ndary messenger? what else uses this
|
intrinsic tyrosine kindase
Insulin |
|
what passes through the cavernous sinus
|
Things that go through the superior orbital fissure + foramen rotundum
CN III, IV, V1, V2, VI also the cavernous portion of the internal carotid artery pituitary |
|
What are the 3 functions of vitamin D
|
increase gut absorption of Ca
increase gut absorption of Phosphate increase bone resorption of Ca and phosphate |
|
what are the 5 functions of cortisol
|
maintains BP (upregulates alpha 1 receptors on arterioles)
decrease bone formation anti-inflammatory decrease immune function increase gluconeogenesis/lipolysis/proteolysis |
|
what type of collagen are the following--
tendon skin: cartilage: uterus: nucleus pulposis: bone: granulation tissue: basement membrane: fetal tissue: |
tendon: 1
skin: 1/3 cartilage:2 uterus: 3 nucleus pulposis: 2 bone: 1 granulation tissue:3 basement membrane: 4 fetal tissue: 3 |
|
injury to CN III will lead to the eye resting in what direction
|
down and out (still have SO, and LR)
|
|
rock hard mass, worst and most invasive, also most common breast malignant tumor
|
Invasive ductal
|
|
late diastolic murmur heard best along the left side of the sternum
|
tricuspid stenosis
|
|
hydroxylation of specific proline and lysine residues requires what in order to synthesize collagen
|
Vitamin C
|
|
pt gets a furruncle on the filtrim...what can this lead to
|
Carvernous sinus syndrome
can affect any of the structures within the sinus Things that go through the superior orbital fissure + foramen rotundum CN III, IV, V1, V2, VI also the cavernous portion of the internal carotid artery pituitary |
|
why does pregnancy lead to increased contractility?
|
increased preload
|
|
what is Cushing's disease
|
pituitary adenoma leading to increased ACTH and thus cortisol
|
|
what inhibits collagen synthesis
|
glucocorticoids
this is why you can use them to tx keloids |
|
where would you get pain for the following sinuses
sphenoid: ethmoid: frontal: maxillary: |
sphenoid: deep in the head
ethmoid: behind you eye frontal: eyebrow maxillary: cheeks |
|
Peau d'orange
|
Inflammatory
|
|
dilated cardiomyopathy
CHF mitral regurg can all lead to what |
S3 heart sound
|
|
what type of collagen is affected in Ehlers-Danlos
|
Type III
|
|
what does ELISA test
|
determine if a particular antibody is present
|
|
2 most common causes of primary hyperparathyroidism
|
solitary parathyroid adenoma
parathyroid hyperplasia |
|
describe what happens with a low and high dose dexamethasone suppression test in the following:
Cushing dz: Ectopic ACTH: Adrenal: |
Cushing dz:
low-increase cortisol high-decreased cortisol Ectopic ACTH: neither suppress cortisol release (increase cortisol) Adrenal: neither suppress cortisol release (increase cortisol) |
|
male with hearing problem and visual disturbances is peeing blood. collagen effected?
|
Type IV
Alports |
|
what is locus heterogeneity?
|
mutations at different loci can produce the same phenotype
|
|
Bilateral malignant breast tumor
where does it met to? |
invasive lobular
mets to peritoneum |
|
rumbling late diastolc murmur with opening snap
|
mitral stenosis
|
|
what normally inhibits elastase
|
alpha-1-antitrypsin
|
|
ragged red muscle fibers seen on biopsy
|
mitochondrial myopathy
|
|
what 5 things can aortic stenosis be due to
|
congenital bicuspid valve (clinically important after age 40)
senile or degenerative calcification (after age 60) chronic Rheumatic valve dz congenital unicuspid aortic valve syphillis |
|
aside from pheochromocytoma, what can be seen in both MEN 2A and 2B?
|
Medullary thyroid carcinoma
|
|
what is a cysteine protease the cleaves after aspartic residues (and executes apoptosis)
|
Caspase
|
|
osmolar fragility with RBCs
|
Hereditary spherocytosis
|
|
breast dimpling suggests
|
suspensory ligament involvement
|
|
sense of emptiness, loneliness, impulsiveness
|
borderline personality disorder
|
|
which of the following is associ w/ extrinsic or intrinsic apoptosis
Mitochondrial: Ligand: utilizes caspase: utilizes bcl and bax: |
Mitochondrial: Intrinsic
Ligand: Extrinsic utilizes caspase: Extrinsic utilizes bcl and bax: Intrinsic |
|
sublux of the lens:
retinal detachment: |
sublux of the lens: marfans
retinal detachment: ehlers danlos |
|
what cancers are assoc with hypercalcemia
|
SCC (lung, head neck, esophagus, cervix)
renal cacrcinoma Multiple myeloma Breast cancer |
|
actinic (solar) keratosis predisposes to
|
precursor to squamous cell carcinoma
5-FU can treat this |
|
post surgical why do you keep bandages on for 24 hours
|
to let epithelialization occur (heal the skin)
|
|
adenoma sebaceum, cardiac rhabdomyoma, astrocytoma
|
Tuberous sclerosis
|
|
nipple retraction suggests
|
lactiferous duct involvement
|
|
pansystolic murmur best heard at the 4th-6th left ICS
|
tricuspid regurg
|
|
What are 2 important supplements for wound healing
|
Zinc
Vitamin C |
|
what happens in
NF1: NF2: |
NF1: neural tumors and pigmented iris hamartoma
NF2: bilateral acoustic scwhanomas (neuromas) |
|
painless jaundice
|
cancer on the head of the pancreas
|
|
acute gastric ulcer assoc with CNS injury
|
Cushing ulcer
|
|
compare trasudate vs exudate in the following manners--
Protein: Due to hydrostatic pressure Due to lymph obstruction |
Protein:
Transudate: low protein Exudate: high protein Due to hydrostatic pressure: Transudate Due to lymph obstruction: Exudate |
|
a/w mitral valve prolapse, liver dz, berry aneurysms
|
ADPCKD
|
|
signet ring cells and ER+ and PR+ breast pathology
|
Lobular carcinoma insitu
|
|
hypertrophic cardiomyopathy
aortic stonosis chronic HTN with LV post MI what might you hear |
S4 heart sound
|
|
What are the 3 major things you should think of when you see apple green birefringence?
|
Restrictive cardiomyopathy
Alzheimers Multiple Myeloma all amyloid |
|
you suspect a pt to have CF. How is it inherited? Common infection? another effect in males? diagnosis is made how (numbers please). Tx?
|
AR
Pseudomonas Infertility Sweat test Cl>60mEq tx: N-acetylcysteine |
|
4Bs of T3?
|
Brain maturation
Bone Growth Beta-adrenergic effects BMR increased |
|
acute gastric ulcer associated with severe burns
|
Curling ulcer
|
|
Which arachidonic acid product causes the following effect
Increased bronchial tone: decreased bronchial tone: increased platelet agg: decreased platelet agg: increased uterine tone: decreased uterine tone: increased vascular tone: decreased vascular tone: |
Increased bronchial tone: leukotrienes
decreased bronchial tone: PGE2 increased platelet agg: thromboxane decreased platelet agg: PGI increased uterine tone: PGE2 decreased uterine tone: PGI increased vascular tone: Thromboxane decreased vascular tone: Cyclin/glandin |
|
which lysosomal storage dz is assoc with renal failure
|
Fabrys
tx: dialysis |
|
moa of Anastrozle/exemestane
use? |
aromatase inhibitors
postmenopausal women with breast cancer |
|
high pitched diastolic murmur with a widened pulse pressure
|
aortic regurg
|
|
what is responsible for rolling, tight binding and diapedis
|
rolling: selectins
Tight bind: integrins: diapedis: PECAM |
|
what are the only 2 x linked recessive lysosomal storage dz?
how are the others inherited |
Fabry's and Hunters
all others are AR |
|
mid systolic click with late systolic crescendo murmur
|
mitral prolapse
|
|
alternating areas of transmural inflammation and normal colon
|
Skip lesions of Chron's dz
|
|
GFAP is a marker for what
|
Glioblastoma
|
|
most common lysosomal storage dz
|
Gauchers
|
|
state if the following are due to progesterone or estrogen:
makes thick mucus to prevent sperm entry: induces LH surge: Uterine smooth muscle relax: Follicle growth: maintenance of preggo: hepatic synthesis of transport proteins: withdrawal leads to menstruation: |
makes thick mucus to prevent sperm entry: P
induces LH surge: E Uterine smooth muscle relax: P Follicle growth: E maintenance of preggo: P hepatic synthesis of transport proteins: E withdrawal leads to menstruation: P |
|
dude has an MI. gets out of bed and does 50 push ups to show the nurses he hasn't. What defense mech?
|
Denial
|
|
in the CNS, what cells fuse to form multinucleated giant cells in an HIV pt
|
Microglia
|
|
what forms the ANS, DRG, cranial nerves, celiac ganglian, and melanocytes?
|
Neural crest
|
|
which lysosomal storage dz's are a/w early death (by age 3)
|
Tay Sach
Neimann Pick Krabbe |
|
enlarged epithelial cells with excessive eosinophilc granular cytoplasm= Hurthle cell...seen in?
|
Hypothyroidism
|
|
how is hnRNA processed b4 it leaves the nucleus (3)
|
Poly A tail
5' Cap Splicing introns |
|
most common cause of dissecting aneurysm
|
HTN
|
|
what neural cell looks like fried eggs on HE
|
oligodendroglia
|
|
skin papule in AIDS pt caused by bartonella
|
Bacillary angiomatosis
|
|
describe the inheritence pattern for the following
Albinism: Hereditary spherocytosis: Duchennes NF1: Hemophilia A: Hemophilia B: CF: Tuberus sclerosis: PKU: Thalessemias: Sickle Cell: hemochromatosis: G6PD: |
Albinism: AR
Hereditary spherocytosis: AD Duchennes: X NF1: AD Hemophilia A: X Hemophilia B: X CF: AR Tuberus sclerosis: AD PKU: AR Thalessemias:AR Sickle Cell:AR hemochromatosis: AR G6PD: X |
|
what ovarian tumor matches the following statement:
estrogen secreting-->precocious puberty Lined with fallopian tube like epithelium: Call-exner bodies: |
estrogen secreting-->precocious puberty: granulosa-theca
Lined with fallopian tube like epithelium: serous cystadenoma Call-exner bodies: granulosa-theca |
|
given the drug reaction, give the causal agent
atropine like side effects |
TCAs
|
|
person with abnormal valves has to get prophylactic tx for what bug when they get dental procedures?
|
strep viridans
|
|
what cells are destroyed in Guillain barre syndrome and NF2
|
schwann cells
|
|
enlarged thyroid cells with ground-glass nuclei
|
ophan annie eye nuclue
papillary carcinoma of the thyroid |
|
elfin facies, MR, super nice to strangers
|
Williams syndrome
microdeletion of long arm of chrom 7 Will Ferrel in Elf |
|
Ejection Fraction =
|
SV/EDV
|
|
given the drug reaction, give the causal agent
coronary vasospasm (2) |
cocaine
sumatriptain |
|
most common cause of aortic aneurysm
|
Atherosclerosis
|
|
what nervous system cell matches the following:
damaged in MS macrophages of the CNS Form multinucleated giant cells in the CNS when infected with HIV |
damaged in MS:
macrophages of the CNS: microglia Form multinucleated giant cells in the CNS when infected with HIV: Microglia |
|
hypochromic microcytic anemia
|
iron def
lead poisoning thalassemia ACD |
|
Excess fibro fatty deposits amongst muscle
|
Duchennes Muscular Dystrophy
|
|
which cell type has aromatase and 17alpha respectively
|
aromatase: Granulosa (estrogen)
17 alpha: theca (androsteindione) |
|
given the drug reaction, give the causal agent
flushing (4) |
VANC
vancomycin adenosine niacin CCB |
|
what is the c wave of jugular venous pulse
|
RV contraction (closed tricuspid valve bulging into atrium)
|
|
What type of sensory corpuscle does the following---
Position sense, static touch, adapts slow: Position sense, dynamic fine touch, adapts quick: vibration and pressure: pain and temp: |
Position sense, static touch, adapts slow: Merkel
Position sense, dynamic fine touch, adapts quick: Meissner's vibration and pressure: Pacinian pain and temp: Free nerve endings |
|
what type of bacteria is periplasm found in? What is important about it
|
Gram negative
includes B-lactams |
|
two pts have the same mutation on chrom 15 but have diff phenotypic expressions. One pt received the mutation from the father while the other got it from the momma. What is this an example of?
|
Imprinting
|
|
pot bellied, pale, puffy caced kid with protruding umbilicus and protuberant tongue
|
Cretinism
|
|
given the drug reaction, give the causal agent
agranulocytosis (6) |
clozapine
carbamazepine colchicine propylthiouracil methimazole dapsone |
|
ascending aoritc aneurysm is associated with what
|
3 syphillis
marfans |
|
muscle length monitoring:
muscle tension: |
length: spindle
tension: golgi |
|
increased alpha fetoprotein in amniotic fluid
|
anencephaly
spina bifida gastrochesis and omphalocele |
|
which lysosomal storage dz is a demyelinating dz?
|
Metachromatic leukodystrophy
|
|
when does bHCG show up in the urine
|
2 weeks post conception
4 weeks LMP |
|
given the drug reaction, give the causal agent
Aplastic anemia (5) |
chloramphenicol
benzene NSAIDs Propylthiouracil methimazole |
|
pt has colon cancer, later gets splinter hemorrhages and janeway lesions. cause?
|
endocarditis due to S. bovis
|
|
what pathway do you target when treating for psychosis with drugs? (positive sx)
|
mesolimbic pathway
|
|
eosinophilic cytoplasmic inclusion in the liver
|
mallory body (alcoholic liver dz)
|
|
Which lysosomal storage dz is characterized by the following enzyme def:
alpha L iduronidase |
Hurler's and Scheies
|
|
pt has wide pulse pressure with a diastolic mumur heard right after S2
|
aortic regurg
|
|
given the drug reaction, give the causal agent
Hemolysis in G6PD pts (6) |
IS PAIN
Isoniazid Sulfonamides Primaquine (all quine drugs) Aspirin Ibuprofen Nitrofurantoin |
|
atrophy of the mamillary bodies
|
Wenicke's encephalopathy (thiamine def causing confusion)
|
|
what 2 things are needed to make GABA
|
Glutamate and B6
|
|
intranuclear eosinophilic droplet-like bodies
|
cowdry type A bodies (HSV, CMV, yellow fever)
|
|
Which lysosomal storage dz is characterized by the following enzyme def:
Iduronate sulfatase |
Huniters
|
|
congenital adrenal hyperplasia + hypotension
|
21 hydroxylase def
|
|
given the drug reaction, give the causal agent
Megaloblastic anemia (3) |
have a blast with PMS
Phenytoin, Methotrexate, Sulfa drugs |
|
CD 16:
CD 19: CD 3: |
CD 16: macrophage + NK
CD 19: B-cells CD 3: All T cells minus NK |
|
what hypothalamic nuclei are responsible for the following:
Hunger: Satiety: Cooling/Parasympathetic: Heating, sympathetic: Circadian rhythm: |
Hunger: Lateral area
Satiety: Ventromedial Cooling/Parasympathetic: Anterior Heating, sympathetic: Posterior (her hot posterior makes me wanna shoot my load) Circadian rhythm: Suprachiasmatic |
|
what forms the aorticopulmonary septum?
|
neural crest
|
|
Which lysosomal storage dz is characterized by the following enzyme def:
Arylsulfatase A |
metachromic leukodystrophy
|
|
pt has flu and later gets hypothyroid
|
Subacute thyroiditis (De Quervains)
|
|
given the drug reaction, give the causal agent
Cough |
ACI inhibitor
give an ARB! |
|
autosplenectomy (fibrosis and shrinkage)
|
sickle cell anemia
|
|
what are the motor nuclei of the thalamus
|
VA/VL
|
|
iron containing nodules in alveolar septum
|
ferruginous bodies (asbestos: increase chance of mesothelioma)
|
|
Which lysosomal storage dz is characterized by the following enzyme def:
alpha galactosidase A |
Fabres
|
|
congenital conjugated hyperbilirubinemia (black liver)
|
Dubin Jonhnson
|
|
given the drug reaction, give the causal agent
Thrombotic complications |
OCPs
|
|
what causes Libman-Sacks endocarditis?
|
SLE causes LSE
|
|
a cerebellar lesion will affect what side of the body
|
ipsilateral
|
|
esoinophilic cytoplasmic inclusion in the nerve cell
|
lewy body
|
|
Which lysosomal storage dz is characterized by the following enzyme def:
Galactocerebrosidase |
Krabbes
|
|
what defense mech underlies all other defense mechs?
|
Repression
|
|
given the drug reaction, give the causal agent
Pulmonary fibrosis |
Bleomycin
Amiodarone Busulfan |
|
bacterial meningitis-
adult/elderly: newborns and kids: |
adult/elderly: N. meningitidis
newborns and kids: Group B strep/e.coli (newborns) kids: strep pneumo |
|
which portion of the cerebellum is associated w/ voluntary movements of extremities?
balance? |
voluntary move: Lateral
balance: medial |
|
large lysosomal vesicles in phagocytes
|
Chediak higashi dz
|
|
Which lysosomal storage dz is characterized by the following enzyme def:
Glucocerebrosidease |
Gauchers
MOST COMMON |
|
cause of Constrictive pericarditis in developing worlds
|
TB
|
|
given the drug reaction, give the causal agent
Thrombocytopenia (2) |
Heparin
H2 Blockers |
|
what is the v wave of jugular venous pulse
|
increased atrial pressure due to filling against a closed tricuspid
|
|
what happens with activation of the substantia nigra pars compacta
|
activates the direct pathway
which inhibits GPi which then allows for movement (inhibit the inhibitory path) |
|
vouluntarily choosing not to think about a piece of bad news...
|
suppression
|
|
Which lysosomal storage dz is characterized by the following enzyme def:
Hexosaminidase |
Tay Sachs
|
|
fixed rock hard painless goiter
|
Riedel's thyoiditis
thyroid replaced by fibrous tissue |
|
given the drug reaction, give the causal agent
Acute cholestatic hepatitis |
Macrolides (erythromycin)
|
|
benign melanocytic nevus
|
spitz nevus (most common in first 2 years)
|
|
what happens in the indirect pathway
|
inhibits GPe (which was inhibiting the GPi)
this leads to activation of the GPi which then inhibits movement INDIRECT INHIBITS MOVEMENT |
|
low serum ceruloplasmin
|
wilson's dz
|
|
Which lysosomal storage dz is characterized by the following enzyme def:
Sphingomyelinase |
Neimann Pick
|
|
most common cause of early cyanosis
|
TOF, Trans great veseels, TA
|
|
given the drug reaction, give the causal agent
Focal to massive hepatic necrosis (4) |
halothane
valproic acid acetaminophen amanita phalloides (mushroom) |
|
major criteria for RF?
|
Joints (migratory polyarthritis)
Heart (pancarditis) Nodules (subcutaneous) Erythema marginatum (serpinginous skin rash) Sydenham's chorea (chorea of face, tongue, upper limb) |
|
what effect does the subthalamic nucleus have on movement
|
inhibits it
(by activating GPi, which inhibits movement) |
|
eosionphilic globule in the liver
|
councilman body (viral hepatitis or yellow fever)
|
|
Characterized by accumulation of GM2 ganglioside
|
Tach sachs
due to def in hexosaminidase |
|
this murmr follows an opening snap and is best heard at the 5th ICS mid clavicular line
|
Mitral stenosis
|
|
given the drug reaction, give the causal agent
Gynecomastia (5) |
Some Drugs Create Awesome Knocers
Spironolacatone Digitalis Cimitidine Alcohol (chronic use) Ketoconazole |
|
bleeding disorder with GpIb def
|
Bernard soulier dz
|
|
the lenticulostriate arteries (which come from the middle cerebral a.) supply what
|
the basal ganglia
|
|
lumpy bumpy appearance of glomeruli
|
poststrep glomerulonephritis
|
|
Dermatin suflate accumulates in what
|
hurlers,
hunters, scheies |
|
most common cause of death in CML
|
blast crisis
AML |
|
given the drug reaction, give the causal agent
Hypothyroidism (2) |
Lithium
Amiodarone |
|
what type of study compares a group w a given exposure or risk factor ro a group without
|
Cohort
measures relative risk |
|
pt has a stroke and then has sudden wild flailing of the left arm
what is this and where is the lesion |
Hemiballismus
right subthalamic nucleus |
|
what will form the lungs, liver, pancreas, and thymus?
|
endoderm
|
|
which lysosomal storage dz's are common among ashenzi jews
|
tay sachs
neimann pick gaucher |
|
tx for thyroid storm?
|
B blocker (propranolol)
|
|
what is primidone
|
anticonvulsant
used to treat resting tremor |
|
brain tumor (adults)
location most common causes |
supratemporal
mets>astrocytoma (glioblastoma multiforme)>meningioma>schwannoma |
|
motor and sensor loss to the legs...what artery
|
ant cerebral
|
|
lytic ("hole punched") bone lesions on xray
|
multiple myeloma
|
|
crinkled paper cytoplasm
|
Gauchers
|
|
Death in SLE
|
lupus nephropathy
|
|
eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
|
rabies virus
|
|
EKG showing electrical alternans tells you what
|
cardiac tamponade
|
|
motor and sensory loss to the face...what artery
|
middle cerebral a
|
|
mammary gland "blue domed" cyst
|
fibrocystic change of breast
|
|
Cherry red spot on retina (3)
|
Tay Sachs
Neimann Pick Central retinal a. occlusion |
|
When does S3 heart sound occur. What does it mean?
|
early diastole during rapid ventricular filling phase. Associated with increased filling pressures and dilated ventricles
normal in children and preggo women |
|
proportion of all ppl WITHOUT the dz who test negative=
|
specificity
T/(TN+FP) |
|
most common cause of breast cancer
|
Infiltrating ductal carcinoma
|
|
vision...what artery
|
posterior cerebral a
|
|
monocolonal Ab spike (4)
|
Multiple myeloma (m protein IgG or IgA)
monoclonal gammaopathy of undertermined significance Waldenstroms macroglobulinemia primary amyloidosis |
|
wide splitting of S2=?
Fixed splitting? |
wide splitting of S2= pulmonic stenosis or RBBB
Fixed splitting= ASD |
|
2 greatest causes of dementia
|
AZ
Multiple infarcts |
|
extracellular amyloid deposition in gray matter of brain
|
senile plaques (Az dz)
|
|
brain tumor (kids)
location most common |
Infratentorial
Astro>medullo>epindyoma |
|
a lesion where would cause the following:
can't write, calculate or distinguish L/R: reduced levels of arousal and wakefulness: Wernicke Koraskoff: |
can't write, calculate or distinguish L/R: left parietal lobe
reduced levels of arousal and wakefulness: reticular activating system Wernicke Koraskoff:: mammillary bodies |
|
monoclonal globulin protein in blood/urine
|
bence jones proteins
|
|
what is the underlying mech and cause of the following:
Kussmauls vs Pulsus paradoxus |
Kussmal:
Mech: decreased RV capacity Dz: constrictive pericarditis Pulusus paradoxis Mech: decreased capacity of LV Dz: tamponade |
|
which anti hyperthyroid drug can you give to a preggo lady
|
Propylthiouracil
methimazole is a teratogen |
|
What makes the spleen?
|
mesoderm
also makes muscle, bones, CT, and serous linings of the body |
|
most common benign breast tumor
|
Fibroadenoma
|
|
pt is hypovolemic. He is given an IV and then gets acute paralysis, dysarthria, dysphagia, and diplopia. What happened?
|
Central pontine myelinolysis
caused by rapid correction of hyponatremia |
|
mucin filled cell with peripheral nucleus
|
signet ring (gastric carcinoma)
|
|
HOXD13 mutation leads to what
|
synpolydactyly (extra fused digit btw 3rd and 4th fingers)
|
|
cardiac primary tumor in kids
|
rhabdomyoma
|
|
giant B cells with bilobed nuclei with prominent inclusions
|
Reed sternberg cells (hodgkins lymphoma)
|
|
man comes in with multiple syncopal episodes. MRI shows a ball valve obstruction of the LA
|
Myxoma (tumor)
primary in adult |
|
cardiac manifestation of lupus
|
Libman-Sacks endocarditis
|
|
narrowing of bowel lumen on barium radiograph
|
"string sign" (chron dz)
|
|
paradoxic splitting (where P2 is heard before A2) is associated with what?
|
LBBB
|
|
primary Cardiac tumor of adults
|
Myxoma
|
|
What is the key btw Binge Eating Disorder and Compulsive eating disorder?
|
neither have purging, both have loads of eating
Binge: defense mech, have negative feelings towards food Compulsive: think about food constantly, form of obsessive compulsive disorder |
|
most frequent primary cardiac tumor in kids
|
Rhabdomyomas (tuberous sclerosis)
|
|
chronic atrophic gastritis predisposes you to what
|
gastric carcinoma
also pernicious anemia |
|
needle shaped negatively birefringent crystals
|
gout
|
|
what is the dif btw conduct disorder and oppositional defiant disorder
|
conduct: behavior violating social norms
oppositional: against authority |
|
describe the GLUT that is used for the following, list if insulin responsvie
RBC: Adipose tissue: Brain: Liver: B islet cells: |
RBC: GLUT 1
Adipose tissue: GLUT 4 (insulin responsive) Brain: GLUT 1 Liver: GLUT 2 B islet cells: GLUT 2 |
|
glomerulus like structure surrounding vessel in germ cells
|
chiller duval bodies (yolk sac tumor)
|
|
pt in MVA presents with chest pain, dyspnea, tachycardia, tachypnea what is going on
|
tension pneumo
|
|
nodular hylanie deposits in glomeruli
|
Kimmelstiel-Wilson nodules (diabetic nephropathy)
|
|
what are the 2 mechanisms of damage associated with diabetes
|
Nonenzymatic glycosylation (small and large vessle dz)
Osmotic dmg (neuropathy, cataracts) |
|
leading caus of birth defects and mental retardation?
|
ALCOHOL
FAS |
|
what antiaryhthmic is used for WPW
|
procainamide and amiodarone
|
|
nutmeg appearance of liver
|
Chronic passive congestion of liver due to RHF
|
|
what enzyme takes glucose to sorbitol?
sorbitol to fructose? |
Aldose reductase
sorbitol dehydrogenase |
|
"hair on end" crew cut appearance xray
|
B-thalassemia, sickle cell anemia
|
|
prophylactic tx for bacterial endocarditis?
|
IV Vancomycin
|
|
psuedopalisading tumor cells on brain biopsy
|
glioblastoma multiforme
|
|
tx for neuropathic pain assoc with diabetes
|
gabapentin
pregabalin (also txs fibromyalgia) |
|
what will a competitive inhibitor do to Km?
what will a noncompetetiive inhibitor do to V max? |
increase it (decreases potency)
decrease (decrease efficacy |
|
when can you see bHCG in the urine?
what developmental stage will the baby be in |
within 2 weeks
2 germ layers: bilaminar disk |
|
RBC casts in urine
|
acute glomerulonephritis
|
|
compare type 1 DM vs 2 in the following ways
Strong genetic disposition: insulin needed for tx: HLA DR3/4 Ketoacidosis: increased resistance to insulin |
Strong genetic disposition: 2
insulin needed for tx: 1 HLA DR3/4: 1 Ketoacidosis: 1 increased resistance to insulin: 2 |
|
inflammatory heart nodules
|
Aschoff bodies
focal myocardial inflammation with multinucleated giant cells |
|
what heart path fits the following-
Diffuse myocardial inflammation with necrosis and mononuclear cells: ST elevations in all leads: Disordered growth of myocytes |
Diffuse myocardial inflammation with necrosis and mononuclear cells: myocarditis
ST elevations in all leads: Pericarditis Disordered growth of myocytes: hypertrophic cardiomyopathy |
|
onion skin periosteal reaction
|
ewing sarcoma
|
|
what kind of infection are you susceptible to in DKA
|
rhizopus
|
|
aminoglycosides will cause what fetal problem
|
CN VIII tox
|
|
what class antiarythmia are the following:
disopyramide procainamide quinidine |
IA
Police department questioned |
|
periosteum raised from bone creating triangular area
|
codmans triangle on xray (osteosarcoma, pyogenic osteomylitis)
|
|
MOA of glyburide?
Use Tox? |
close K channel in B-cell membrane--> LEADS TO INSULIN RELEASE
early type 2 DM tox: hypoglycemia |
|
hexagonal double pointed needle like crystals in broncial secretions
|
Charcot Leyden crystals; eosinophilic granules
bronchial asthma |
|
focal myocardial inflammation with multinucleate giant cells
|
aschoff cells of RF
|
|
podocyte fusion on EM
|
minimal change dz
child with nephrotic syndrome |
|
MOA of Glipizide?
Use Tox? |
close K channel in B-cell membrane--> LEADS TO INSULIN RELEASE
early type 2 DM tox: hypoglycemia |
|
what is the diff btw
Transsexualism Transvestisms |
Transsexualism: desire to live as opposite sex, feel trapped in wrong body
Transvestisms:parahilia; wearing clothes of the opposite sex (wear it for sexual arousal) |
|
what is Km? assoc with affinity?
|
Km is concentration at 1/2 Vmax
decreased Km-->increased affinity |
|
polished ivory like appearance of bone at cartilage erosion
|
eburnation (osteoarthritis resulitng in bony scleorsis)
|
|
MOA of Glimepiride?
Use tox |
close K channel in B-cell membrane--> LEADS TO INSULIN RELEASE
early type 2 DM tox: hypoglycemia |
|
high levels of D dimer
|
DVT, PE, DIC
fibrin breakdown products |
|
pt has a granuloma on the hard palate, hematuria, and hemoptysis
|
Wegner's granulomatosis
c-ANCA tx: cyclophosphamide + corticosteriod) |
|
protein aggregates in neurons from hyperphosphorylation of protein tau
|
neurofibrillary tangles (Az, CJD)
|
|
MOA of metformin?
tox? |
decrease gluconeogenesis for diabetes 2
lactic acidosis |
|
what problem will valproate or carbamazepine cause in preggo
|
inhibition of intestinal folate absorption
Neural Tube defect |
|
what class antiarythmia are the following:
Mexiletine Tocainide Lidcaine |
IB
The Little Man |
|
25 year old pregnant lady in 3rd trimester has normal BP when standing/sitting. When supine her BP drops to 90/50. Diagnosis?
|
compression of IVC
|
|
MOA of pioglitazone?
tox? |
increase insulin sensitivity viar PPAR gamma
tox: weight gain, edema (rare hepatotox) |
|
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
|
Ghon complex (primary TB)
|
|
perforation of the nasal seputm has 2 causes
|
wegner's granulomatosis
COCAINE (like it was 1980) |
|
where does HSV 1 lay dormant?
2? VZV? |
1: trigeminal ganglia
2: S2/S3 ganglia VZV: DRG |
|
MOA of rosiglitazone?
tox? |
increase insulin sensitivity viar PPAR gamma
major tox is MI |
|
proportion of all ppl with dz who test positive=
|
Sensitivity
TP/(TP+FN) |
|
what does the notochord devlop into?
what do these structures give rise to? |
neuroectoderm and neural plate
Neural plate gives rise to neuroal tube (CNS) and neural crest cells Notochord becomes nucleus pulposus of the IV disk |
|
doctor gives amoxacillin to a pt with suspected strep. Later the pt gets a rash. Why
|
he had mono not strep
|
|
MOA of sitagliptin/saxagliptin
|
decrease glucagon secretion and increase insulin
used in DM2 by affecting GLP1 |
|
honeycomb lung on xray
|
Interstitial fibrosis
|
|
granulomatous vasculitis with eosinophilia
|
Churg-Strauss syndrome
p-ANCA |
|
3-5 days of fever in a child followed by rash. What HHV is this?
|
Roseola: HHV 6
|
|
given the following characteristic list the DM 2 drug
lactic acidosis: most common side effect is hypoglycemia: not assoc with weight gain, often used in overweight diabetics: |
lactic acidosis:
most common side effect is hypoglycemia: Sulfonylurea not assoc with weight gain, often used in overweight diabetics: Metformin |
|
what vessel do the umbilical arteries come off of?
|
Internal illliac
remember this is blood back to the momma |
|
what class antiarythmia are the following:
Encainide Propafenone Flecainide |
IC
For Pushing Ectasy |
|
HHV 8=
|
kaposi
|
|
given the following characteristic list the DM 2 drug
Also helps lower triglycerides and LDL cholestrol levels: not safe in hepatic dysfunction or CHF: should not be used in pts with serum creatinine elevation: Metabolized by liver, excellent choice for pts with renal dz: |
Also helps lower triglycerides and LDL cholestrol levels: Metformin
not safe in hepatic dysfunction or CHF: Metformin/Glitazone should not be used in pts with serum creatinine elevation: Metformin Metabolized by liver, excellent choice for pts with renal dz: Glitazone |
|
hypersegmented neutrophils
|
megaloblastic anemia (B12 or folate def)
|
|
vasculitis in young asthmatic
|
Churg strauss syndrome
p-ANCA |
|
MOA of acyclovir
|
phospohrylated by thymidine kinase and inhibits viral DNA polymerase
Ganciclovir has similar mech |
|
3 side effects of insulin administration
|
Lipodystrophy
Weight gain Hypoglycemia |
|
what NT changes will you see in:
depression |
decresase NE, 5HT, and dopamine
|
|
female is born and has no issues for the first 6 mo of life. Later you see a delay in head growth and social withdrawal. You start to see constant repetitive hand movements. Pt progresses to have limited mobility. What do they have? Genetics
|
Rett disorder
X linked dominant |
|
2 tx for Hep C
|
Alpha interferon
ribaviron |
|
three drugs that you can use to treat nephrogenic diabetes?
|
Hydrochlorothiazide
Indomethacin Amiloride |
|
MAP=
|
2/3 diastolic + 1/3 systolic
|
|
lower extremity palpable purpura, arthralgia of the knees, and abdominal pain...what is it and what does it follow?
|
Henoch-schonlein purpura
follows URI note: can also have IgA Nephropathy |
|
what do the s, c, and e Ab mean in hepatitis
|
s: Hep B infection
c: core, history of active dz e: active viral replication, high transmissibility |
|
in Diabetes insipidus...
Urine specific gravity< serum osmolaility> |
Urine specific gravity<1.006
serum osmolaility>290 |
|
what do the 1-6 aortic arches become
|
1: maxillary artery (branch of external carotid)
2: stapedial artery and hyoid 3: common carotid and proximal part of internal carotid 4: on left-arotic arch; on righ-proximal part of right subclavian 6: proximal part of pulmonary arteries and on left only the ductus arteriosus |
|
side effects of amiodarone
|
pulmonary fibrosis
hepatotox hypothroid/hyperthyroid blue man photosens |
|
what Ag will be seen in early hep B infection that is assoc with Anti-HBcAb
late? |
early: IgM
late: IgG |
|
what heart problem is associated with carcinoid syndrome? what will be raised in the urine? tx?
|
Right sided valvular dz
5-HIAA octreotide |
|
1. heart sound with congestive HF
2. Chronic HTN |
1. S3
2. S4 |
|
little asian baby with fever, conjunctivitis, cracking lips, and strawberry tongue. Where else will they have rash?
why is it so severe? tx? |
Kawaskai dz
peeling of the hands (desquamation) so severe: coronary aneurysm tx: IVIG and high dose aspirin to prevent coronary problems mneomonic: CRASH and Brun Conjuctivitis Rash Adenopathy Strawberry Hand and feet swelling Burning fever for 5 days |
|
when is the only time you can have positive Anti-HBsAb and negative E and C?
|
Immunization
|
|
loss of pain and temp, hoarseness, horners syndrome. What is this? due to?
|
Wallenburg's syndrome
due to occlusion of one of the posterior inferior cellebellar arteries (PICA) |
|
what test shows if you have a capsule on a bacterium
|
quelling
|
|
when is a baby highly susceptible to teratogens?
what is going on here |
3-8
organogensis |
|
pink eye cause
|
adenovirus
|
|
what tumors are assoc with MEN2A
|
Medullary ca of thyroid, pheo, parathyroid
|
|
What is the heart ejection fraction=
|
EF= SV/EDV
|
|
hepatitis B with vasuclitis
|
polyarteritis nodosa
|
|
what DNA virus causes the following
gingivostomatitis human progressive multifocal leukoencephalopathy Oral hairy leukoplakia |
gingivostomatitis: HSV 1/2
human progressive multifocal leukoencephalopathy: JC virus oral hairy leukoplakia: EBV |
|
2 cancers assoc with RET gene mutation
|
MEN 2A/B
|
|
What developmental structure matches the following:
fetal plancental structure that secretes hCG: maternal component of the placenta: |
fetal plancental structure that secretes hCG: syncytiotrophoblast
maternal component of the placenta: decidua basalis |
|
desquamated epithelium casts in sputum
|
Curschmann's spirals (bronchial asthma; whorled mucous plugs)
|
|
child with aseptic meningitis after swimming in a pool...cause
|
echovirus
|
|
G-C bond has how many H bonds?
A-T? which has higher melting temp |
G-C: 3
A-T: 2 G-C higher melting temp |
|
with what type of congenital heart defect would increasing afterload be beneficial
|
R->L shunt
|
|
young asian female with poor pulses in extremity
|
Takayasu's arteritis
|
|
fever, black vomitus, jaundice
what piece of anatomy will look weird |
yellow fever
tongue:red at the tip, white on the sides |
|
rate limiting enzyme in pyrimidine synthesis
|
Carbamoyl phosphate synthetase II (CPS2)
|
|
what NT changes will you see in:
Anxiety |
Increase NE, decrease GABA, decrease 5HT
|
|
what type of study collects data from a group of ppl to assess frequency of dz at a particular point in time
|
Cross sectional study
measures dz prevalence |
|
break bone fever, muscle joint pain, headache, retro orbital pain....what is the test for this?
|
Dengue Fever
Tourniquet Test: put BP cuff on, leave it there for 10 min, look for excess petichae |
|
what drug inhibits ribonucleotide reductase for cancer or sickle cell anemia
|
hydroxyurea
|
|
what deviation is assoc with the following-
Inferior wall MI: Acute right heart strain (PE): |
Inferior wall MI: Left axis
Acute right heart strain (PE): Right axis |
|
elderly female, unilateral headache, jaw pain on chewing
|
Temporal arteritis
assoc with molymyalgia rheumatica (severe joint pain) |
|
what is the role of hemagglutinin and nueraminidase
|
hemagglutinin: promotes viral entry
neuraminidase: promotes progeny virion release for influenza virus |
|
megaloblastic anemia that cannot be treated w B12 or folic acid =
|
Orotic aciduria
can't make UMP (erotic hUMP) failure to thrive no hyperammonemia |
|
what structure divides the trunucus arteriosus into the pulmonary trunks and aortic trunks. derivative of?
|
aorticopulmonary septum
neural crest |
|
disarrayed granulosa cells in eosinophilic fulid
|
call-exner bodies (granulosa-theca cell tumor of the ovary)
|
|
high pitched brassy cough in a young kid with asthma like sx
|
RSV bronchiolitis
|
|
Lesch-Nyhan is due to defective purine salvage owing to absence of what
|
HGPRT
He's got purine recovery trouble X linked recessive |
|
what can show you a normal axis
|
positive deflection in limb lead I and II
|
|
what is the diff btw strawberry and cherry hemangioma
|
Strawberry: benign, in kids, outgrow it
Cherry: bening, elderly, does not regress |
|
what drug is OK to use in adults (esp after bone marrow transplant) but is NOT good for kids with RSV
|
Ribavirin
|
|
how does UV light damage DNA
|
creates thymine dimers on same strand of DNA
cannot repair it (no nucleotide excision repair) AR |
|
what kind of test do you want for screening? diagnosis?
|
screen: high sensitivity
diagnose: high specificity |
|
what embryological structure leads to formation of the adenohypophysis?
|
surface ectoderm
(ant pituitary) also you get gland formation |
|
pt has cough, rhinitis, and conjunctivits. what do they have? what else could you see
|
rubeola (measles)
look for koplik spots: due to immune response |
|
what are the stop codons
|
UGA
UAG UAA |
|
what bug can cause AV nodal block
|
Lyme dz: bb
|
|
cystic hygroma is associated with what
|
Turners
cavernous lymphangioma of the neck |
|
parotitis orchitis, and meningitis
|
Mumps
|
|
mutations of TATA or CAAT lead to what
|
these are promotors
decreasing them will lead to decreased amount of gene transcribed |
|
what is the order of fetal erythropoiesis?
|
yolk sac
liver spleen bone marrow |
|
dysplastic squamous cervical cells with muclear enlargement and hyperchromasia
|
koiliocytes (HPV: predisposes to cervical cancer)
|
|
MOA of amantadine
|
blocks viral penetration and uncoating (M2 protein)
|
|
alpha amantin, which is found in death cap mushrooms, can lead to problems in what organ? how
|
Liver failure
inhibit RNA polymerase II (can't make mRNA) |
|
in the aortic arch, what do the baroreceptors respond to? what nerve does it use? where does the message go to?
|
responds only to increased BP
vagus to medulla |
|
necrotizing immune complex inflammation of visceral/renal vessles
|
primary pauci immune cresentic glomerulonephritis
|
|
MOA of Zanamivir?
Use? |
inhibit neuraminidase, decreasing release of progeny virus
Influenza A and B |
|
what do the different RNA polymerases make
|
RMT
I: rRNA II: mRNA III:tRNA |
|
what NT changes will you see in:
AZ? |
Decrease ACh
|
|
man yells at his family when he has a bad day at work...
|
displacement
|
|
MOA of oseltamivir?
Use? |
inhibit neuraminidase, decreasing release of progeny virus
Influenza A and B |
|
which are expressed, exons or introns
|
Exons
done by spliceosomes |
|
in the carotid sinus, what do the baroreceptors respond to? what nerve does it use? where does the message go to?
|
responds to increase or decrease in BP
glossopharyngeal n to solitary nucleus of medulla |
|
polypoid red lesion found in pregnancy or after trauma
|
Pyogenic granuloma
|
|
MOA of Ribavirn?
use? 2 |
inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase
RSV (in adults), chronic hep c |
|
what is the role of Aminoacyl-tRNA synthetase?
|
responsible for accuracy of amino acid selection
|
|
Match the following:
Truncus arteriosus Bulbus cordis Primitive ventricle Primitive atria Left horn of sinus venosus Right horn of SV Right common cardinal vein and right anterior cardinal vein With the following: Portion of the left ventricle Trabeculated left/right atrium Ascending aorta/pulmonary trunk SVC Coronary sinus Smooth part of RA Right ventricle and smooth parts of L/R ventricle |
Truncus arteriosus:
ascending aorta and pulmonary trunk Bulbus cordis RV and smooth parts of L/R ventricle Primitive ventricle portion of left ventricle Primitive atria trabeculated left and right atrium Left horn of sinus venosus coronary sinus Right horn of SV smooth part of RA Right common cardinal vein and right anterior cardinal vein SVC |
|
cowdry type A bodies aka enlarged cells with intranuclear inclusion bodies
|
owls' eye appearance on CMV
|
|
milk maid blisters, due to?
|
Cowpox
|
|
what 2 drugs inhibit 50s peptidyltransferase?
|
chloremphenocol
streptogramins |
|
what is a plasmid?
|
DNA particle separate from normal bacterial DNA. Makes abx resistance enzymes
|
|
benign painful red blue tumor under fingernails
|
Glomus tumor
|
|
what is Cushings Triad
|
HTN, bradycardia, respiratory depression
occurs after intracranial pressure constricts arterioles leading to cerebral ischemia-->HTN-->reflex brady think about an intracranial hemorrhage! |
|
What amino acid frequently has more coding sequences in the mRNA than are represented in the peptide that is created from that mRNA
|
methione
it is the start sequence that gets cleaved |
|
Antidote for TCAs?
Theophylline? Heparin |
TC: NaHCO3 (plasma alkalinization)
Theophylline: B-Blocker Heparin: Protamine |
|
what allows HIV to bind to macrophage (what does the HIV have and what receptor does it use)
what does it bind on CD4 cells? |
gp120
binds the CCR5 on macrophages CXCR4 on CD4 |
|
which of the following makes cleft lip vs palate
1. failure of fusion of the lateral palatine process, nasal septum and/or the median palatine process 2. Failure of fusion of the maxillary and medial nasal process |
1. Palate
2. Lip |
|
Vd=?
|
amount of drug given iv/[drug plasma]
|
|
antidote for Ethanol, methanol, and ethylene glycol
|
Fomepizole
inhibits alcohol dehydrogenase |
|
what is an R5 virus
|
HIV that only uses CCR5 receptor
|
|
what is brief psychotic disorder?
|
schizophrenia for less than 1 month, usually stress related
|
|
what is pulmonary capillary wedge pressure?
|
approximation of left atrial pressure
in mitral stenosis, PCWP>LV diastolic pressure measured with Swan-Ganz catheter |
|
oxalate crystals makes you think of what
|
ethylene glycol (antifreeze)
|
|
candida, toxoplamosis, and histoplasmosis are things you have to worry about in AIDS at what CD4 level?
|
<100
|
|
what nerves innervate the branchial arches?
|
1: V2/V3
2: VII 3: IX 4&6: X and superior laryngeal n. |
|
what is an adult type coarctation of the aorta commonly associated with?
|
bicuspid aortic valve
|
|
Antidote for cyanide posioning
|
Nitrite, hydroxocobalamin, thiosulfate
|
|
MOA of the navir drugs?
|
Protease drugs
assembly of virons depends on HIV 1 protease, blocking this, they can't recognize their own rNA--> can't make new virus tox: GI intolerance, P450 inhibition (but actually helps keep other meds around longer) |
|
if a screening test has a 1% false-negative rate. What is the sensitivity of the test?
|
1-FN
so 99% |
|
Nitroglycerine helps treats angina how
|
causes decrease in preload so that you decrease the O2 demand
|
|
which spinal tract does the following
voluntary motor command from motor cortex to head/neck: alternate routes for the mediation of voluntary movement: important for postural adjustments and head movements: Proprioceptive info for the cerebellum: |
voluntary motor command from motor cortex to head/neck: corticobulbar tract
alternate routes for the mediation of voluntary movement: reticulospinal tract/rubrospinal tract important for postural adjustments and head movements: vestibulospinal Proprioceptive info for the cerebellum: dorsal/ventral spinocerebellar tracts |
|
MOA of zidovudine and didanosine
|
NTRI
competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain |
|
What CN innervates the tongue in the following ways:
Taste in anterior 2/3 taste in post 1/3 motor sensation ant 2/3 sensation post 1/3 |
Taste in anterior 2/3: VII
taste in post 1/3: IX motor: XII sensation ant 2/3: V3 sensation post 1/3: IX |
|
what NT changes will you see in:
huntington |
decrease GABA and ACh
|
|
schizophreniform disorder?
|
1-6 months
|
|
what drug can be used to prevent HIV in the fetus
|
zidovudine
can cause Bone marrow suppression |
|
how does the presentation of a branchial cleft cyst differ from that of a thyroglossal duct cyst?
|
branchial clef: in lateral neck
thyrogolossal: midline neck, moves with swallowing |
|
how does LPS cause vasodilation
|
activates iNOS leading to NO activation
this activates Guanylyl cyclase leads to activated mysoin phophatase which leads to myosin relaxation |
|
Maintenance dose=
|
MD= Css x CL
|
|
what anti HIV drug has the side effect of pancreatitis and peripheral neuropathy
|
didanosine
NTRI competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain |
|
failure of the lateral fold to close can cause what 2 problems
|
Gastroschisis
Omphalocele note: omphalocele has way more associated abnormalities AFP will be elevated |
|
loud S1 and wide fixed split S2 =
|
ASD
|
|
schizoaffective disorder
|
2 weeks of stable mood + psychotic sx plus a major depressive, manic, or mixed episode
|
|
what kind of drugs are nevirapine, declavirdine, and efavirenz?
class tox? |
NNRTI
bind to reverse transcriptase at diff site then NRTI. RASH |
|
what does a horseshoe kidney get caught under
|
the inferior mesenteric artery
function is normal |
|
first line therapy for HTN in pregnancy? MOA?
what are the 3 other drugs you can use |
Hydralazine- vasodilates arterioles>veins; reduces afterloads
(nifedipine, labetalol, methyldopa) |
|
physician looking for risk factors for pancreatitis. he interviews 100 hospitalized pts with pancreatitis, and 100 without. What type of study?
|
Case control
|
|
what kind of drug is Enfuvirtide? MOA
|
Fusion inhibitor
bind viral gp41, inhibit fusion with CD4 cells |
|
bilateral renal agenesis-->oligohydraminos-->pulmonary hypoplasia
|
Potter's syndrome
|
|
write out the TP TN chart
|
+ -
+ TP FP - FN TN |
|
what can happen at the following time periods after using an antipsychotic:
4 hr: 4 d: 4: wk: 4 mo: |
4 hr: acute dystonia
4 d: akineisia 4: wk: akathisia (restlessness) 4 mo: tar dive dyskinesia |
|
miraviroc MOA?
|
binds CCR5 and inhibits GP120
used in HIV |
|
what gene is responsible for inhibiting mullerian development
|
SRY on Y chromosome
|
|
what anti HTN drug causes hypertrichosis
|
Minoxidil
|
|
what gram + organism has LPS?
|
Listeria
|
|
list the antiretroviral drug classes/drugs that cause the following:
SE-lactic acidosis: SE-GI intolerance SE-megaloblastic anemia SE-rash SE-bone marrow suppression SE-occupational HIV exposure tx: |
SE-lactic acidosis: NRTIs
SE-GI intolerance: Protease inhibitors SE-megaloblastic anemia: Zidovudine (NRTI) SE-rash: NNRTI SE-bone marrow suppression: Zidovudine (NRTI) SE-occupational HIV exposure tx: Zidovudine (NRTI) |
|
what is exstrophy of the bladder assoc with?
|
Epispadias
|
|
baby is born with a widely split S2 and tricuspid regurg. What drug was mom likely on?
|
Lithium
this kid has ebsteins anomaly |
|
pt with mental issue is started on new drug. They get rigidity, myoglobinuria, ANS instability, hyperpyrexia. What do they have? Tx?
|
Neuroleptic malignant syndrome
dantrolene (or bromocriptine) |
|
what HIV drugs can cause rearrangement of fat and hyperglycemia
(you could see a buffalo hump) |
Protease inhibitors
(Navirs) |
|
woman comes with 2 lumps in the labia majora....
|
Androgen insensitivity syndrome
those lumps weren't lady humps, they were balls. |
|
what drug causes first dose orthostatic HTN?
|
alpha 1 blockers
|
|
group of ppl that smoke and do not smoke are followed over 20 years, every 2 years is determined who develops cancer and who does not. Type of study?
|
cohort
|
|
staph a can be normal flora where?
normal flora of oropharynx: dental plaque: colon: |
staph a: nose
normal flora of oropharynx: viridans strep dental plaque: strep mutans colon: bacteroides fragilis |
|
34 year old male w/ testicular ca. Metastatic spread occurs by what route
|
para-aortic lymph nodes
|
|
what NT changes will you see in:
SZ |
increase dopamine
|
|
in addition to malignant hyperthermia and NMS what can dantrolene tx?
|
Serotonin syndrome
|
|
clostridium perfringes can cause food poisoning from eating what?
can lead to? |
from reheated meat dishes
gas gangrene |
|
what is the female homolog of
prostate gland: corpus spongiosum: |
prostate gland: Glands of scene
corpus spongiosum: vestibular bulb |
|
what drug will cause dry mouth sedation and severe rebound HTN? MOA
|
clonidine
alpha 2 agonist |
|
pt has a kidney problem and clearance is reduced with unchanged Vd. What effect will this have on loading dose and maintenance dose?
|
LD stays the same
maintenance dose goes down |
|
give the cause of the following:
most common cause of atypical pneumonia: most common cause of pneumonia in 1 year or younger: most common cause of pneumonia in college, military, and prision: most common cause of viral pneumonia: pontiac fever: |
most common cause of atypical pneumonia: Mycoplasma
most common cause of pneumonia in 1 year or younger: RSV most common cause of pneumonia in college, military, and prison: Mycoplasma most common cause of viral pneumonia: RSV pontiac fever: Legionella |
|
what germ layer gives rise to the following:
retina: salivary glands: tyhmus: anterior pit: cranial nerves: |
retina: neuro ectoderm
salivary glands: surface ectoderm thymus:endoderm anterior pit: surface ectoderm cranial nerves: neural crest |
|
what 2 heart defects are seen with 22q11 disorders
|
TA
Tetrology |
|
what atypical antipsychotics are assoc with weight gain and diabetes? (3)
|
quetiapine, olanzapine, clozapine
|
|
meningitis + purpura
|
N. meningitis
|
|
anticentromere abs
|
CREST
|
|
at what point must you surgically repair an abdominal aorta aneurysm ?
|
5cm or >
|
|
What does it mean if your relative risk (RR) is <1
RR>1? RR=1? |
RR<1: dz is less likely to occur in the exposed group
RR>1: dz more likely to occur in exposed group RR=1 : no difference in risk btw the 2 groups |
|
which has a higher opening pressure, bacterial or viral meningitis
|
bacterial
everything is worse in bacterial |
|
antihistone abs
|
drug induced SLE
|
|
which bugs hinflux capsule
|
Strep pneumo
Kleb H influ Neisseria Salmonella Group B strep |
|
atypcial antipsychotic that causes agranulocytosis
|
clozapine
|
|
positive nitrite test shows what?
|
gram negative bacterial UTI
|
|
c-ANCA:
p-ANCA: |
c-ANCA: wegener's
p-ANCA: microscopin polyangitis, churg-strauss |
|
primary effect of Statins? MOA? major tox?
|
decrease LDL
HMG-CoA reductase inhibitor hepatotox and rhabdomyolysis |
|
what complement mediates anaphylactic shock
|
C3a
hypotension and edema |
|
neonate born with chorioretinitis, hydrocephalus, and intracranial calcifications, what did mom have
|
toxoplasma
|
|
antiplatelet abs
|
ITP
|
|
heart defects seen in congenital rubella? 3
|
septal defects, PDA, pulmonary artery stenosis
|
|
SZ + mood disorder
|
schizoaffective
|
|
3 things that happen in a baby who has congenital rubella
|
PDA
Cataracts Deafness |
|
anti-toposomerase abs
|
diffuse systemic scleroderma
|
|
drug of choice to raise HDL?
side effect of this drug |
Niacin
flushing of the face (can be treated with aspirin) |
|
what is the difference btw reliability and validity
|
reliability: reproducible test
validity: accuarcy |
|
unilateral hearing loss is due to what TORCH infection
|
CMV
can also cause seizures |
|
azurophilic granular needles in leukemic blasts
|
auer rods (AML)
|
|
what NT changes will you see in:
Parkinson's dz |
decrease dopamine
increase 5HT and ACh |
|
what is dissociative fugue?
|
abrupt change in geographic location with inability to recall past, confusion about personal identity
assoc with traumatic circumstances |
|
neonatal manifestation of baby who was born to a mom with vesicular painful lesions on the vagina
|
Temporal lobe enchephalitis
due to HSV |
|
basophillic nuclear remnants in RBCs
|
Howell-jolly bodies (splenectomy or nonfunctional spleen)
|
|
best drugs to lower Triglycerides
moa? tox? |
"Fibrates" (gemfibrozil, clofibrate, bezafibrate, fenofibrate)
upregulate LPL to increase TG clearance causes hepatotox (don't use with statin!) |
|
how many half lives does it take to get to 94%?
|
4 half lives
(at one half life: 50%, 2: 75%, 3:87.5%,) |
|
baby has snuffles (what are these) and metaphyseal dystrophy and periostitis. What do they have?
|
congenital syphilis
snuffles=desquamation of hands and feet |
|
bloody tap on LP
|
subarachnoid hemorrhage
|
|
increased alpha fetoprotein = (2)
|
Neural tube defect
or anterior abdominal wall defects |
|
what must you have to diagnose bipolar (I v II)
|
I: at least 1 manic episode
II: at least 1 hypomanic episode |
|
what are the W's of fever in the post op period
|
Wind: collapse lung
Water: UTI Wound: infection Walking: DVT Wonder Drugs: Abx |
|
Brown tumor of bone
|
hemorrhage (hemosiderin) causes brown color of osteolystic cysts. Due to:
Hyperparathyroidism Osteitis fibrosa cystica |
|
use for gemfibrozil? MOA? tox?
|
lowers triglycerides
upregulate LPL to increase TG clearance causes hepatotox (don't use with statin!) |
|
what is Berkson's bias
|
study on pts that have been hospitalized ...bias of sx
|
|
total parenteral feeding can lead to what nosocomial infection
|
candidia
|
|
cardiomegaly with apical atrophy
|
chagas
trypanosoma cruzi |
|
prevalence vs incidence:
looks at new and old cases |
Prevalence
Prevalence= incident x dz duration Prevalence>for chronic dz (incidence is NEW incidents) |
|
what is cyclothymic disorder
|
dysthymia and hypomania; midler form of bipolar lasting 2 years
|
|
what are the following like for TB/fungal meningitis:
Opening pressure: protein: glucose: lymph or PNS: |
Opening pressure: increase
protein: increase glucose: decrease lymph or PNS: increase lymphocytes this is the same as bacterial but with increased lymphocytes instead of PMNs |
|
anticentromere abs
|
CREST
|
|
what lipid lowering agent matches the following:
GI discomfort, bad taste: Best effect on HDL Best effect on triglycerides Best effect on LDL |
GI discomfort, bad taste: bile acid resins
Best effect on HDL: Niacin Best effect on triglycerides: Fibrates Best effect on LDL:Statin |
|
neutrophil chemotactic facto?
|
C5a
|
|
list the following as protease inhibitor, NRTI, or NNRTI:
Ritonavir: Didanosine Declavirdine: Zidovudine: Abacavir: Lamivudine: Nelfinavir: Efavirinz: |
Ritonavir: PI
Didanosine: NRTI Declavirdine:NNRTI Zidovudine:NRTI Abacavir: NRTI Lamivudine: NRTI Nelfinavir: PI Efavirinz: NNRTI |
|
antihistone abs
|
drug induced SLE
|
|
cape like bilateral loss of pain and temp sensation in upper extremities and preservation of touch
|
Syringomyelia
seen with Chiari II |
|
what are 3 important side effects of lithium
|
Hypothyroid
Ebsteins anomaly Nephrogenic diabetes insidious |
|
what will xray show on aortic dissection?
|
medialstinal widening
look for tearing chest pain radiating to the back |
|
c-ANCA:
p-ANCA: |
c-ANCA: wegener's
p-ANCA: microscopin polyangitis, churg-strauss |
|
what NT changes will you see in:
Mania |
increase NE, 5HT, DA
opposite of depression |
|
What is Lead-time bias?
what is the Hawthorn effect? |
early detection confused with increased survival
Hawthorn: changing your behavior because you know you are being studied |
|
anti-hypertensive drug of choice for aortic dissection
|
B-blocker
|
|
antiplatelet abs
|
ITP
|
|
branchial clefts, arches, and pouches are derived from what?
|
CAP covers outside from inside:
Clefts=ectoderm Arches=mesoderm Pouches=endoderm |
|
What are some of the mood stabilizers used to treat bipolar? 5
|
lithium
valproate carbamazepine lamatrigine olanzapine (atypical antipsychotics) |
|
DOC for prinzmetal angina
|
CCB (DHP-nifidipine)
|
|
anti-toposomerase abs
|
diffuse systemic scleroderma
|
|
CL=
|
(.7xVd)/t1/2
|
|
do charged or uncharged species get urinated out?
|
charged
|
|
likely cause of the following chest pain:
rapid onset sharp pain in 20 yo w/ dyspnea: sharp pain lasting hours-days and is somewhat relieved by sitting forward: most common cause of non-cardiac chest pain: acute onset dyspnea, tachycardia, and confusion in a hospitalized pt: |
rapid onset sharp pain in 20 yo w/ dyspnea: spontaneous pneumo
sharp pain lasting hours-days and is somewhat relieved by sitting forward: pericarditis most common cause of non-cardiac chest pain: GERD acute onset dyspnea, tachycardia, and confusion in a hospitalized pt: PE |
|
azurophilic granular needles in leukemic blasts
|
auer rods (AML)
|
|
what does the 1st branchial cleft make?
2-4? |
1: external auditory meatus
2-4: temporary cervical sinuses |
|
how long must you have sx to be diagnosed with:
manic episode: major depressive episode: Schizophrenia: |
manic episode: 1 week
major depressive episode: 2 weeks Schizophrenia: 6 months |
|
Goal of antianginal therapy
|
reduction of myocardial O2 consumption
|
|
basophillic nuclear remnants in RBCs
|
Howell-jolly bodies (splenectomy or nonfunctional spleen)
|
|
compare delirium and dementia in the following way:
change in consiousness: reversible: onset: associated with memory change: EEG: |
change in consiousness:
delirium: wax/wane of consciousness Dementia: no change in consciousness reversible: delirium is onset: delirium: rapid dementia: gradual associated with memory change: Dementia EEG: delirium: abnormal dementia: normal |
|
what is a positive skew
|
mean>median>mode
asymmetry with tail on the right |
|
in an evolution of MI:
0-4 hours: 4-24 hours: 2-4 days: 5-10 days: 10+ days: |
0-4 hours: no visible change
4-24 hours: contraction bands 2-4 days: Hyperemia, Neutrophils, extensive coag necrosis 5-10 days: yellowing, risk for free wall rupture, tamponade, papillary muscle rupture, and interventricular septal rupture due to macrophage degradation; granulation tissue 10+ days: risk for ventricular aneurysm due to contracted scar |
|
bloody tap on LP
|
subarachnoid hemorrhage
|
|
what does the 1st branchial arch make
|
M's & T's
Meckels cartilate, mandible, malleus, madibular ligament muscles of amstication CN V2 and V3 |
|
what is dysthymia?
|
milder form of depression lasting 2 years
normally only have 2 sx |
|
most specific protein marker for MI?
|
Cardiac troponin I
rises after 4 hours, around for 7-10 days |
|
Brown tumor of bone
|
hemorrhage (hemosiderin) causes brown color of osteolystic cysts. Due to:
Hyperparathyroidism Osteitis fibrosa cystica |
|
what is the equation for relative risk? what study was this for?
|
a/(a+b) / (c/(c+d))
cohort |
|
Diptheria toxin does what?
|
inactivates elongation factor (EF-2)
causes pharyngitis and pseudomembrane in throat |
|
Autoimmune phenomenon resulting in fibrinous pericarditis
|
Dressler's syndrome
|
|
cardiomegaly with apical atrophy
|
chagas
trypanosoma cruzi |
|
what branchial arch are derived from the following:
stapes styloid stylohoid what CN nerve does this do? |
2
CN VII (smile) |
|
drugs that end in -pramine are what? MOA
|
TCA
block reuptake to NE and 5HT |
|
pt has MI, then later gets severe mitral regurg. What happened
|
papillary muscle rupture
|
|
circular grouping of dark tumor cells surrounding pale neurofibrils
|
Homer Wright rosettes (adrenal neuroblastoma, medulloblastoma, Ewing sarcoma)
|
|
2 major causes of delirium?
|
anti ACh drugs
UTI |
|
what is a negative skew
|
mode>median>mean
asymmetry with tail on left |
|
given the following artery, give the wall perfused and EKG leads
LAD: Left circumflex Right coronary (inf wall) Right coronary (post wall) |
LAD:
Wall-Anterior Leads: V1-V4, V5 Left circumflex: Wall-lateral Leads: aVL, V5, V6 Right coronary (inf wall) wall-Inferior leads: II, III, aVF Right coronary (post wall) wall-Posterior leads: R precordial EKG: V4 |
|
perivascular rosette: circular cell grouping with vessel in the middle
|
ependymoma
Ependymoma is a tumor that arises from the ependyma, a tissue of the central nervous system. Usually, in children the location is intracranial, while in adults it is spinal. The common location of intracranial ependymoma is the fourth ventricle. Rarely, ependymoma can occur in the pelvic cavity. Syringomyelia can be caused by an ependymoma. Ependymomas are also seen with Neurofibromatosis Type II. |
|
what brachial arch?
stylo-pharyngeus, glossopharyngeal and CN IX |
3
|
|
if you had to pick btw nortriptyline or amitryptiline, for an elderly pt which would you use? why?
what are the side effects of these drugs |
nortriptyline: less anticholinergic effects (less chance of causing delirium)
tox: Convulsions, Coma, Cardiotox |
|
what degrades fibrin? what drugs activate this?
|
Plasmin
Streptokinase, urokinase, tPA (alteplase), The thrombolytics! |
|
tx for superficial candida infection
|
nystatin
|
|
which organisms can form spores
|
bacillus and clostridium
|
|
Geriatric pts lose what form of metabolism first?
|
phase I: P450
|
|
what do you use to treat thrombolytic OD?
|
aminocaproic acid
inhibits fibrinolysis |
|
soap bubble in the brain
|
cryptococcus neoformans
AIDS pts |
|
what brachial arch: cricothyroid
|
4
|
|
tx for serotonin syndrome?
|
Cooling + benzo + cyproheptadine (5HT2 receptor antagonist)
|
|
MOA for clopidogrel?
|
inhibit platelet aggregation by irreversibly blocking ADP receptors
|
|
what does the following describe:
1. acute angle branching hyphae 2. psuedohyphae+ budding yeast, dimorphic 3. nonseptate hyphae, wide-angle branching |
1. acute angle branching hyphae: Aspirgillus
2. psuedohyphae+ budding yeast, dimorphic: candida 3. nonseptate hyphae, wide-angle branching: mucor |
|
what is pseudo dementia
|
pt will have awareness that they are losing stuff
assoc with depression in elderly pt |
|
what is a type I (alpha) error?
|
stating that there IS an effect or difference WHEN NONE EXISTS
false Positive error |
|
MOA of Abciximab? use?
|
binds to IIb/IIIa preventing platelet aggregation (similar to clopidogrel, minus the ADP inhibition)
acute coronary syndrome (NSTEMI) and percutaneous transluminal coronary angioplasty |
|
what fungi can be found with ketoacidotic diabetics and leukemic pts
|
Mucor
note: can also penetrate the cribiform plate and enter the brain, you will see a black necrotic eschar on the face |
|
what brachial arch: all intrinsic muscles of larynx except cricothyroid
|
6
|
|
what kind of drug is venlafaxine? MOA? use
|
SNRI
inhibit serotonin and NE reuptake depression or GAD |
|
side effects of aspirin?
|
ASPIRIN
Asthma Salicylism Peptic ulcer Intestinal blood loss Reyes Syndrome Idiosyncratic Noise (tinnitus) |
|
tx for tinea ungium?
|
terbinafine
|
|
what is the equation of Odds ratio? what study was this for?
|
ad/bc
case-control |
|
MOA of vibrio toxin?
|
ADP ribosylation of G protein stimulates adenylyl cyclase
pumps Cl into gut, water follows rice water stool |
|
what has a balloon appearance on chest x ray? heart sound heard?
|
Dilated cardiomyopathy
S3 |
|
where will you see histoplama in the body?
environment? in the US? |
Histo Hides in MACROPHAGES
bird/bat droppings Mississippi and Ohio river valley |
|
What pouch:
middle ear, eustachian tube mastoid air cells |
1
|
|
what kind of drug is duloxetine? MOA? use?
|
SNRI
inhibit serotonin and NE reuptake depression or diabetic peripheral neuropathy |
|
major cause of mycarditis?
|
Coxsackie virus
|
|
latin american with a Captain Wheel yeast
|
Paracoccidioidomycosis
|
|
What is Memantine? use/moa
|
stops over stimulation of NMDA receptors which can be toxic to neurons
AZ dz |
|
what is a type II (beta) error?
|
stating that there IS NOT an effect or difference WHEN ONE EXiSTS
false Negative error |
|
heart sound in hypertrophic cardiomyopathy
|
S4
look for the words "myocyte disarray" to describe this pts drop dead b/c they cannot profuse the thick ventricle |
|
30 yo biddie with cauliflower skin lesions. Tissue biopsy shows broad based budding yeasts. Cause?
|
Blastomyces
|
|
What pouch:
epithelial lining of palatine tonsil |
2
|
|
pt is trying to quit smoking. He has a seizure. why?
|
he was likely on buproprion, which lowers the seizure threshold
|
|
tx for hypertrophic cardiomyopathy?
|
B-blocker or non-dihydropyridine CCB (verapamil)
|
|
MOA of amphotericin B
|
Binds ergosterol; forms membrane pores
use in serious systemic mycoses (cryptococcus, blastomyces, candida, etc...) |
|
loading dose=
|
LD= Css x Vd
|
|
what is the difference btw efficacy and potentcy?
|
Efficacy: max effect a drug can produce
Potency: amount of drug for a given effect |
|
2 most common causes of decreased LV contractility
|
MI and chronic HTN
|
|
swish and swallow for thrush
|
Nystatin
|
|
What pouch:
inferior parathyroid |
3
|
|
what kind of drug is doxepin
|
TCA
|
|
what leads to tree bark appearance of the aorta
|
syphilitic heart dz
|
|
used for cryptococcal meningitis in AIDS?
MOA |
Fluconazole
inhibit fungal sterol synthesis by inhibiting the P450 enzyme that converts lanosterol to ergosterol |
|
pt presents with dementia. their spouse said that prior to this they had marked changes in their personality and now are aphasic. What do they have?
|
Pick's dz (frontotemporal dementia)
(aggregated tau protein) |
|
what does a p value show you? what is a significant value
|
likelihood that alpha error is present (alpha error is false positive)
if p<.05 there is a less than 5% chance that the data will show something that is not really there (that you have made an alpha error) |
|
tx for acute CHF
|
LMNOP
Loop diuretic Morphine Nitrates O2 Positioning (sit on edge of bed so blood pools in legs not lungs) / Pressors (get off B-blocker add dobutamine) |
|
what drug inhibits the fungal enzyme squalene epoxidase?
use? |
Terbinafine
tineas |
|
What pouch:
superior parathyroid |
4
|
|
what kind of drug is tranylcypromine
|
MAOi
|
|
antidote for salicylates?
amphetamines? |
sal: NaHCO3 (alkalinize the urine)
amphetamine: NH4Cl (acidify urine) |
|
MOA of griseofulvin?
use? |
interferes with microtubule function; disrupts mitosis; deposits in keratin containing tissues (nails)
use: oral tx of superficial infections, inhibits growth of dermatophytes (tinea ringworm) |
|
what is the equation for attributable risk
|
a/(a+b) - c/(c+d)
|
|
heat labile toxin is seen in what bug? what does it cause
|
ETEC
watery diarrhea |
|
antidote for
B-blockers and verpamil |
Glucagon
or Calcium or Atropine |
|
cell wall synthesis inhibitor used in invasive aspergillosis
|
Caspofungin
|
|
most common ectopic site for thyroid?
|
tongue
|
|
what kind of drug is citalopram
|
SSRI
|
|
antidote for iron tox
SAY IT RIGHT TAUBE |
Deferoxamine
|
|
what 2 drugs inhibit ergosterol synthesis?
|
Azoles and terbinifine
|
|
dementia + visual hallucinations + repeated falls/syncope =
|
lewy body dementia
(alpha synuclein defect) |
|
what does one standardization on either side of the mean contain?
2? 3? 1.465? |
1: 68% o the population
2: 95% 3: 99.7% 1.645: 90% |
|
antidote for copper
|
Penicillamine
penny made of copper! |
|
antifungal that inhibits hormone synth and P450s
|
Ketoconazole
|
|
which is a bigger deal, cleft lip or palate
|
palate
can't breast feed |
|
what kind of drug is sertaline
|
SSRI
|
|
antidote for Methemoglobin
|
Methylene blue, vitamin C
|
|
this causes brain abscess in the HIV. Triad of chorioretinitis, hydrocephalus, and intracranial calcification
|
Toxoplasma gondii
|
|
Therapeutic index=?
|
LD50/ED50
LD50=lethal dose to 50 % of population ED50=effective dose TILE want a high TI value |
|
pt with rapidly fatal meningoencephalitis after swimming in a lake
|
Naegleria fowleri
|
|
which antidepressant matches the following statements
works well with SSRIs and increases REM sleep: appetite stimulant that is likely to result in weight gain: |
works well with SSRIs and increases REM sleep: Trazodone
appetite stimulant that is likely to result in weight gain: Mirtazapine |
|
tx for trypansoma cruzi
|
nifurtimox
|
|
what does it mean if the 95% confidence interval between 2 variables includes zero, what does this mean?
|
that this is no significant difference and the nul hypothesis is NOT rejected
|
|
pt has spiking fevers, hepatosplenomegaly and pancytopenia. Organism and transmission?
|
org: leishmania donovani
sandfly |
|
4 things seen in atypical depression
|
hyperphagia
hypersomnia mood reactivity psychomotor retardation |
|
what form is plamodium in when it causes rupture of the hepatocytes?
|
Merozoites
(sporozoites are in blood, trophozoites are in RBCs) |
|
MOA of pertussis toxin?
|
increases cAMP by inhibiting Galpha i
|
|
what is the mech responsible for malaria induced fever
|
rupture of merozoite
|
|
mech of actoin of MAOi?
SNRI? |
MAOi: increase NE, 5HT, DA
SNRI: NE and 5HT reuptake inhibition |
|
what is the name of the following stage in malaria life cycle:
looks like diamond ring: Ruptures the cell host: replicating intracellularly: form injected by mosquito: banana shaped: |
looks like diamond ring: trophozoite
Ruptures the cell host: merozoite replicating intracellularly: schizont form injected by mosquito: sporozoite banana shaped: falicpurum gamete |
|
what is ABCD of medicare
|
A=inpatient (hospital, nursing, hospice, home health)
B= outpatient care, doc services C=combination of A&B D=drug coverage |
|
red urine in the morning fragile RBCs
|
paroxysmal nocturnal hemoglobinuria
|
|
camper with diarrhea and liver damage and jaundice. Cause?
|
Entamoeba histolytica
|
|
prophylacti tx for m. TB?
|
Isoniazid
|
|
what happens if you ingest tyramine while on MAOi
|
hypertensive crisis
|
|
gram positive clusters=
chains= |
cluster=STAPH
chain=strep |
|
what bug that is due to contaminated food can be diagnosed with a scotch tape test? tx?
|
enterobius vermiicularis
bendazoles |
|
side effect of ethambutol
|
Red-green color blindness
optic neuropathy/decreased visual acuity |
|
Describe the phases of clinical Trials
|
I: Is it safe? (healthy pts)
II: Does it work? (pts with the dz) III: Does it work better IV: post market survallence |
|
Renal cell ca, hemangioblastomas, angiomatosis, phochromocytoma
|
von hippel lindau disease
|
|
pt is pooping out eggs and has pneumonia
|
ascaris lumbricoides
|
|
MOA of isoniazid?
tox? prevent this how? |
decrease synth of my colic acids in TB
neurotic, hepatotox lupus. prevent with pyridoxine (vitamin b6) |
|
how long must a pt have sx for PTSD
|
1 month
if less: acute distress disorder |
|
renal effect of DA?
|
increase renal profusion in shock
|
|
due to undercooked pork, leads to larvae cysts in the muscles
|
trichinella spiralis
|
|
MOA of rifampin?
tox? |
RNA polymerase inhibitor
red orange body fluids, revs up P450 |
|
what is the Tarasoff decision?
|
law requiring physician to directly inform and protect potential victims from harm, may breach confidentiality
|
|
Restrictive cardiomyophaty (juvenile form: cardio megaly) exercise intolerance
deficiency in what? |
pompe's dz
lysoomal alpha 1,4 glucosidase deficiency 1 heart 4 chambers |
|
larvae in soil penetrate the skin, intestinal infection leading to vomiting diarrhea and anemia
|
strongyloides stercoralis
|
|
drug of choice for meningococal or h influenza B infection prophylaxis?
|
Rifampin
|
|
how long does GAD last? tx? MOA
what if it is less than this time? |
6 months
busprone less than 6 mo= adjustment disorder (follows identifiable psychosocial stressor) 5HT1A receptor agonist |
|
Protein A is a virulence factor that binds Fc-IgG inhibiting complement fixation and phagocytosis...what bugs have it?
|
staph A
|
|
larvae penetrate the skin of the feet; intestinal infection can cause anemia (sucks blood from intestinal walls)
|
ancylostoma duodenale
Necator americanus |
|
MOA of pyrazinamide?
|
effective in acidic pH of phagolysosomes, where TB engulfed by macrophages is found
|
|
what toxin includes edema factor, a bacterial aenylate cyclase (increasing cAMP)
|
bacillus anthraces
|
|
retinal hemorrhages with pale centers
|
Roth's spots (bacterial endocarditis)
|
|
leads to elephantiasis
|
Wuchereria bancrofti
from female mosquito bite |
|
MOA of ethambutol
|
decrease carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase
|
|
sudden loss of sensory or motor function often following an acute stressor. pt is indifferent about sx
|
Conversion disorder
(form of somatoform disorder) |
|
Dobutamine is used for what type of shock
|
cardiogenic
hits B1 receptors (and some B2) |
|
undercooked pork leading to intestinal tapeworms. Can eventually lead to swiss cheese appearance lesions in the brain
|
taneia solium
tx praziquantel or bendazoles |
|
prophylaxis for mycobacterium avium intracellulare?
when do you give it |
Azithromycin
AIDS CD<100 |
|
family member ask for information about the patient;s prognosis...what do you do?
|
avoid discussing issues with relatives without the permission of the pt
|
|
short stature, increase incidence of tumors/leukemia aplastic anemia
|
Fancoin's anemia (genetically inherited, often progress to AML)
|
|
causes cysts in the liver, associated with sheep dogs
|
echinococcus granulosus
|
|
tx for VRE? 2
|
linezolid and streptogramins
|
|
what are the cluster A personality disorders? 3
|
Paranoid
schizoid Schizotypal |
|
M protein helps prevent phagocytosis of what bug?
|
group A strep
|
|
Schistosoma haematobium can lead to what
|
SCC of the bladder
|
|
drugs that can cause lupus
|
SHIPP
Sulfonamides hydrazaline Isonizid procainamide phenytoin |
|
What kind of drugs are:
Doepezil Galantamine Rivastigmine use? |
AChEi
Alzheimer |
|
situs inverses, chronic sinusitis, bronchiectasis
|
Kartagener's syndrome (dyne in defect affecting cilia)
kinetics sucks kindergarden cop hits you so hard your organs are backwards |
|
inflammatoin of the gall bladder with pigmented gallstones due to what fluke?
|
clonorchis sinensis
|
|
clinical usese for the macrocodes
|
atypical pneumonias
URIs STDs |
|
what are the cluster B personality disorders
|
antispocial
Narcissistic Histrionic Borderline |
|
What are the selective B2 agonists?
|
MAST:
Metaproterenol, albuterol, salmeterol, terbutaline |
|
undercooked crab meat leading to inflammation and 2ndary bacterial infection of the lung
|
paragonimus westermani
|
|
what family do clarithromycin and clindamycin belong to respectively?
|
clarithromycin: macrolide
clindamycin: own class |
|
child wishes to know more about his illness....what do you do
|
ask the parents what to do
|
|
slow progressive muscle weakness in boys
|
Becker's muscular dystrophy (x-linked, defective dystrophin, less severe than Duchenne's)
|
|
what is a hookworm?
round? |
hook: necator americanus
round: ascaris lumbricoides |
|
increases the nephrotox of amnioglycosides
|
Cephalosporins
|
|
what are the cluster C personality
|
Avoidant
Obsessive compulsive dependent |
|
what is strep mutans?
|
most prominent organism in dental plaque
form of Viridans strep can lead to subacute endocardiitis in those with turbulent flow heart prolems |
|
tx for chagas dz?
leishmaniasis resistant malaria |
chagas: nifurtinox
Leish: sodium gluconate resistant malaria: mefloquin |
|
small irregular red spots on buccal/lingual mucosa with blue whit centers
|
koplik spots (measles)
Cough, coryza, crazy |
|
what are the obligate intracellular bug?
|
Rickettsia and Chlamydia
can't make own ATP stay inside (cells) when its Really Cold |
|
woman with premature uterine contraction can be given what?
|
Terbutaline
selective B2 agonist |
|
tx for pediculosis capits or pubis
|
permethrin cream
|
|
smooth flat moist white lesions on genitals
|
condylomata lat a (2ndary syphilis)
|
|
unexplained complaints in multiple organ systems is what?
false belief of being prgoo? |
somatization disorder
pseudocyesis |
|
what bugs are anaerobes
|
Clostridium
bacterioides Actinomyces can't use amino glycosides to treat this |
|
2 antifungals that inhibit ergosterol synth
|
azoles and terbinafine
|
|
what is the definition of low birth weight
|
<2500g
|
|
depressed vs elderly:
amount of REM sleep: REM latency |
amount of REM sleep:
in elderly-Less Depressed-More REM latency: elderly-longer to get to REM depressed-shorter |
|
BP drug to use in pregnancy
|
Alpha methadopa and hydralazine
|
|
what fungi:
mold form contains barrel shaped arthroconidia |
coccidiodes
|
|
at what age can kids stop using a booster seat
|
8-12 years (4'9")
|
|
40 year old woman tells you during one of her office visits that she is in love with you. you refer her to someone else, and she attempts suicide. What type of personality disorder does this pt have?
|
Borderline
|
|
DOCs for anaerobes?
|
Metronidazole
Clindamycin |
|
most all flukes and tapeworms are tx with what
|
praziquantal
|
|
what EEG waveforms correspond to the different stages of sleep
|
1: theta
2: spindles and K complex 3/4: low freq high amplitude (Delta) REM: beta |
|
oxybutynin
tolterodine darifenacin and solifenacin trospium MOA? Use? |
M blockers
stress incontinence |
|
what drug can you give to a pt with asthma and heart failure
|
levalbuterol
only hits B2 receptor (no effect on B1 so safe in CHF) |
|
what organism is transmitted by the following:
ixodes tick (not lyme): tsetse fly: |
ixodes tick (not lyme): babesia
tsetse fly: trypanosoma brucci (african sleeping sickness) |
|
what controls extra ocular movements during REM?
|
PPRF
|
|
pt has tactile hallucinations, seiuzres, autonomic instability... what is going on? tx?
|
alcohol withdrawal
tx: benzos or alcohol |
|
how often should you get a tetnus booster
|
every 10 years
|
|
What are the 5 stages of Kubler-ross grief
|
Denial
Anger Bargaining Grieving Acceptance |
|
what is the pathway by which retinal info induces the release of melatonin
|
darkness increases melatonin release
NE released from suprachiasmatic nucleus stimulates pineal gland to release melatonin |
|
what is suboxone?
|
naloxone + buprenorphine (partial agnoist) used for heroin addiction
|
|
what 2 b-blockers decrease mortality post MI?
|
Metoprolol and labetalol
|
|
what do we stain Legionella with?
|
Silver stain
it is a facultative intracellular bug note this is also used for Fungi (such as pneumocystis) |
|
what is clavulanic acid?
|
given with amoxicillin to prevent breakdown by penicillinase activity
|
|
stomach cramps, hunger and hyper somnolence can be seen with what
|
amphetamine withdrawal
|
|
what causes gas gangrene
|
clostridium perfringens
|
|
what antihypertensive is well known for causing limp dick
|
b-blocker
|
|
major clinical use for Aztreonam
|
G- rods
good for pts with renal insufficiency and cannot tolerate amino glycosides |
|
pt comes to ER with belligerence fever, psychomotor agitation, horizontal nystagmus..
|
PCP intox
can also have homicidality. |
|
why don't you give B-blockers to a pt on cocaine
|
cocaine works on ALL adrenergic receptors
if you block B receptors this will further raise BP (unopposed alpha 1 activity) |
|
in what pt population is atropine contraindicated? 6
|
Glaucoma
BPH (or any urinary retention) ileus Dementia (elderly/delirious) infant with fever--causes hyperthermia |
|
what is first line tx for c diff
|
metronidazole
|
|
what ilicit drug can lead to flashbacks?
|
LSD
|
|
tx for c. diff
|
metronidizole or oral vancomycin
|
|
what is the key to initiating sleep?
what reduces REM sleep? |
key= serotonergic predominance of raphe nucleus
reduces: NE reduces REM sleep |
|
resistance to vancomycin?
|
D ala to D lac
|
|
pt presents with tachycardia, tremors, anxiety and seizure. He later has hallucinations and confusion. what does he have? tx?
|
delirium tremens associated with alcohol
benzos |
|
anti hypertensive DOC for aortic dissection
|
B-blocker
|
|
What is a Ziehl-Neelsen stain?
India ink stain use? |
Ziehl-Neelsen=acid fast (for mycobacteria)
India ink: cryptococcus neoformans |
|
next step in tx of otitis media if resistant to amoxicillin
|
cefdnir (3rd gen ceph)
|
|
what drug is causing the following sx:
anxiety, piloerection, yawning, fever, rhinorrhea, nausea, diarrhea |
opiod withdrawal
|
|
what type of food should pregnant woman avoid? Why
|
unpasteurized milk
deli meat due to listeria |
|
what is responsible for extra ocular movements during REM due to?
|
PPRF (paramedic pntinue reticular formation/conjugate gaze center)
|
|
broad spectrum coverage for appendicitis
|
Imipenem
|
|
severe depression, headache, fatigue, insomnia/hypersomnia, hunger...due to what drug?
|
amphetamine withdrawal
|
|
what is the cup to disc ratio in glaucoma
|
greater than 1:2
|
|
What is hexamethonium?
|
Nicotinic antagonist
blocks both sympathetic and parasympathetic activity used for experiments |
|
prophylaxis against bacterial endocarditis
|
1st gen cephs
|
|
belligerence impulsiveness, nystagmus, homicidal ideations psychosis...due to what drug
|
PCP OD
|
|
what IL or IFN is responsible for the following:
Inhibits T-cells and macrophages T cell stimulator: stimulates B cells stimulates macrophages: |
Inhibits T-cells and macrophages: IL-10
T cell stimulator: IL-2 stimulates B cells: IL4/5 stimulates macrophages: IFN gamma |
|
how is imipramine used to treat enuresis?
|
TCA that decreases stage 4 sleep
|
|
prophylaxis for meningococci meningitis
|
Rifampin
|
|
streak ovaries, congenital heart dz, horseshoe kidney
|
turner syndrome
|
|
60 y.o man with difficulty driving at night because he sees halos around the oncoming headlights. what does he have
|
Catarax
|
|
what grows on chocolate agar?
Lowenstein-Jensen? MacConkey's agar? Sabouraud's agar? |
chocolate: H. influenzae
Lowenstein-Jensen: m. TB note: pt with TB MUST be kept in airborne isolation MacCokneys: Lactose-fermenting enterics (note: ecoli grows on this, but can also grow on eosin-methylene blue agar) Sabouraud: Fungi |
|
what do you grow haemophilus on? what does it require?
what do you grow legionella on? |
chocolate agar
factors V and X Legionella: Charcol yeast (CYE) |
|
sudden swollen/painful big toe joint, tophi
|
Gout (podagra)
hyperuricemia |
|
how do NK cells and Cytotoxic T cells recognize virus infected cells respectively?
|
NK: lack of MHC I
Cytotoxic T: MHC I on virus infected |
|
what effect do alcohol, benzos, and barbs do to sleep?
|
reduce REM and delta sleep
|
|
cause of diabetic osteomyeltis
|
psedomonas
|
|
swollen gums, mucous bleeding, poor wound healing, spots on skin
|
Scurvy (vitamin C)
|
|
What prostaglandin is used in glaucoma? Side effecs
|
Latanoprost (PGF 2 alpha)
lengthens eye lashes, darkens pigment of the eye |
|
what type of receptors are the N and M ACh receptors?
|
N: ligand gated (Na/K)
M: G-protein |
|
this bug produces no toxin but adheres to apical surface, flattens the villi, and prevents absorption causing diarrhea in kids
|
EPEC
|
|
swollen hard painful finger joints
|
Osteoarthritits
|
|
what induces a helper T cell to TH1 and TH2 respectively
|
TH1: IL 12
TH2: IL 4 |
|
whay can be used to tx night terrors and sleep walking? why
|
Benzos
affect stage 3/4 sleep |
|
what is the triad seen in Hemolytic-uremic syndrome (HUS)? cause?
|
Anemia, thrombocytopenia and acute renal failure
cause: O157 |
|
systolic ejection murmur
|
aortic valve stenosis
|
|
side effect of a1 blockers?
|
first dose orthostatic hypotension
so give first dose laying down at night |
|
in what bacterial growth phase does spore formation occur?
|
Stationary phase
|
|
2 treatments for Ecoli that causes diarrhea?
|
FQs and TMP SMX
|
|
thyroid and parathyroid tumors, pheochromocytoma
|
MEN 2A
(medullary thyroid carcinoma) |
|
co stimulatory signal that is given by interaction of B7 and CD28 will help activate what
|
helper T cells (CD4)
|
|
when can you diagnose nocturnal enuresis?
|
5 years (chronological and developmental
|
|
most common cause of G- sepsis?
|
e. coli
|
|
toe extension, fanning upon plantar scrape
|
babinski's sign
|
|
what kind of drug is mirtazapine? use? tox?
|
a2 blocker
Depression tox: sedation, increased serum cholesterol, increased appetite |
|
enzyme responsible for conversion of tyrosine to L dopa?
|
Tyrosine hydroxylase
(inhibited my metryrosine) |
|
if a pt has salmonella what might you not want to do
|
use an abx...can prolong the dz
|
|
unilateral facial drooping involving forehead
|
Bell's palsy
|
|
What CD on a B cell is a receptor for EBV?
|
CD21
|
|
during what sleep stage would a man have variable BP, penile turnescence and variable EEG?
|
REM
|
|
usually transmitted from puppies, contaminated milk, or pork. Causes mesenteric adenines that can mimic Crohn's or appendicitis
|
yersinia enterocolitica
|
|
vasculitis from exposure to endotoxin causing glomerular thrombosis
|
Shwartzman reaction
|
|
surgical neck fracture of the humerous can lead to what n damage?
|
axillary
look for loss of sensation or movement on deltoid this can happen with dislocation too |
|
gram positive clusters=
chains= |
cluster=STAPH
chain=strep |
|
unpasteurized dairy giving you undulant fever...bug?
|
Brucella
|
|
what can be assoc with bilateral bell's palsy
|
Guillan berre
lyme dz |
|
unpasteurized dairy giving you undulant fever...bug?
|
Brucella
|
|
man comes in with sensation of unpleasant paresthesias that compels the man to have voluntary spontaneous continous lower limb movements. What does he have? Possible cause? Tx?
|
Restless Leg Syndrome
usually idiopathic, can be due to iron def tx: pramipexole or ropinrole or levodopa (parkinsons drugs) |
|
CD 14 is a major marker for what kind of cell
|
Macrophage
|
|
vasculitis from exposure to endotoxin causing glomerular thrombosis
|
Shwartzman rxn (following second expousre to endotoxin)
|
|
cellulitis or osteomyelitis from a cat bight
|
pasturella multocida
|
|
a1, M1, M3 all activate what G protein? what downstream messenger is activated
|
Gq
Phospholipase C (Cutesy-Q C) |
|
cellulitis or osteomyelitis from a cat bight
|
pasturella multocida
|
|
waxy casts with very low urine flow
|
chronic end-stage renal dz
|
|
mid shaft fracture of the humerus leads to damage of what n?
|
radial
|
|
what is an Apgar score
|
appearance
Pulse Grimace Activity Respiration |
|
life threatening meningitis + purpura
|
neisseria meningitis
|
|
WBC casts in urine
|
acute pyelonephritis
|
|
life threatening meningitis + purpura
|
neisseria meningitis
|
|
Protein A is a virulence factor that binds Fc-IgG inhibiting complement fixation and phagocytosis...what bugs have it?
|
staph A
|
|
CD55 and 59 are on what? role?
|
WBC, RBC, and platelet
prevents degradation by complement |
|
weight loss, diarrhea, arthritis, fever, adenopathy
|
Whipple's dz (tropheryma whippelii)
|
|
corneal infections in contact lens wearer due to?
|
psuedomonas
|
|
polyuria, acidosis, growth failure, electrolyte imbalances
|
Fanconii Syndrome
proximal tubular reabsorption defect |
|
corneal infections in contact lens wearer due to?
|
psuedomonas
|
|
Worst headache of my life
|
subarachnoid hemorrhage
|
|
hypertrophy of the anterior scalene can lead to what problem? what is it?
|
Klumpke palsy (thoracic outlet)
1. atrophy of the thnar and hypothenar eminence 2. atrophy of the interosseous muscles 3. sensory deficits on the medial side of the forearm 4. disappearance of the radial pulse upon moving head toward ipsilateral side TOTAL CLAW HAND |
|
B1, B2, D1 all activate what G protein? what is the downstream messenger?
|
Gs
Adenylyl Cyclase |
|
enzymes that obligate anaerobes lack?
|
catalase
superoxidase dismutase |
|
What is Pott's dz?
|
TB in vertebral bodys
|
|
enzymes that obligate anaerobes lack?
|
catalyze
superoxidase dismutase |
|
pupil accommodates but doesn't react
|
Argyll Robertson pupil (neurosyphilis)
|
|
3 things for neutrophil chemotaxis
|
IL 8
C5a Leukotriene B4 |
|
2 uses for dapsone
|
leprosy and PCP pneumonia
|
|
what 3 drugs have photosensitivity?
|
SAT for a photo
Sulfonamides, amiodarone, tetracyclines |
|
M protein helps prevent phagocytosis of what bug?
|
group A strep
|
|
supercondylar fracture of the humerous can damage what nerve
|
median
|
|
bacteria associated with water contaminated by animal urine
|
Leptospira interrogans
remember this was the question about the swimmers |
|
what do you use to treat atypical pnuemonias such as mycoplasma, chlamydia, and legionella?
|
macrolides
|
|
Rash on palms and soles (2 potential)
|
2ndary syphillis
Rocky Mountain spotted fever |
|
clinical uses for alpha interferon? 5
|
hep B/C
Kaposi sarcoma leukemia malignant melanoma |
|
strawberry tongue + peeling of palms and soles
|
Kawasaki dz
|
|
what drug is safe in pregnant ladies with upper respiratory infections
|
macrolides
|
|
M2, a2, D2 all activate what G protein? what is the downstream messenger?
|
Gi
inhibit adenylyl cyclase |
|
fracture of medial epicondyle leads to what n damage
|
ulnar
|
|
what does coxiella burnettii cause? what family is it from? what is the vector?
|
Q fever: fever +pneumonia
Rickettsia NO VECTOR, NO RASH It is Queer |
|
what can you use for MRSA, VRE, and staph/strep skin infections?
|
streptogramins
Quinupristin/Dalfopristin |
|
Recurrent colds, unusual eczema, high serum IgE
|
Job's syndrome (hyper-IgE syndrome, neutrophils chemotaxis abnormality
|
|
clinical use for B inteferon?
|
Multiple sclerosis
|
|
what bacteria is the only one with a membrane containing cholesterol
|
Mycoplasma pneumoniae
remember cold agglutinings (IgM) |
|
what is a good tx for anaerobic infections? what kind of bug would this tx?
|
Clindamycin
bactericides, clostridium |
|
what is strep mutans?
|
most prominent organism in dental plaque
form of Viridans strep can lead to subacute endocardiitis in those with turbulent flow heart prolems |
|
fracture of the hook of hamate leads to what n damage
|
ulnar
|
|
this causes pulmonary TB like sx in COPD pts
|
mycoplasma kansaii
|
|
which causes of vaginal discharge/vaginitis will pH be high?
low? |
high: Gardenella, Trich
Low: physiologic, candida |
|
red itchy swollen rash of nipple/areola
|
paget's dz of the breast represent underlying neoplasm
|
|
pt has a mild UTI in pregnancy... tx
|
nitrofurytoin (sp)
|
|
what is the tx for the following:
mycoplasma pneumonia Late lyme dz: |
mycoplasma pneumonia: tetracyline/erythromycin
Late lyme dz: ceftriaxone |
|
HIV meds that cause the following
Pancreatitis: Rash: Peripheral Neuropathy: Lactic Acidosis: |
Pancreatitis: Didanosine
Rash: NNRTI Peripheral Neuropathy: Didanosine Lactic Acidosis: NRTI |
|
DOC for septic shock?
|
NE
|
|
clinical use for gamma interferon
|
chronic granulomatous disease
|
|
Rickettsial triad?
|
Headache
fever rash |
|
what is the difference btw conversion and somatozation disorder
|
conversion: motor/sensory sx
somatization: multiple organ sx (moves all over the place) |
|
pt has a UTI and later has hemolysis of their RBCs what drug were they on and why did this happen
|
Sulfonamide
G6PD deficient |
|
2 neoplasms assoc with Down syndrome
|
ALL
AML |
|
What is a tensilon test?
|
Edrophonium test for MG
|
|
ash leaf spots=
majore neoplasm assoc |
Tuberous sclerosis
cardiac rhabdomyoma |
|
what drugs should be avoided in pts with an allergy to sulfa (9)
|
celecoxib
furosemide probenecid thiazides TMP SMX sulfasalazine sulfonylureas acetazolamide sulfonamides |
|
pt with atrophic glossitis, esophageal webs, anemia...what neoplasm are they at risk from
|
SCC of esophagus
this was Plummer-Vinson |
|
what structure on an antibody defines the idiotype?
|
Fab fragment- what it can bind
(2 ight chain and 2 heavy chain regions) |
|
Acanthosis nigricans can lead to what
|
visceral malignancy (stomach, lung, breast, uterus)
|
|
what drugs can cause SJS? 8
|
Ethosuximide
lamotrigine carbamazepine phenobarbital phenytoin sulfa drugs penicillin allopurinol |
|
what is the neoplasm assoc with the following conditions-
Achalasia: Srojens: Ataxia telangectasia |
Achalasia: SCC of esophagus
Srojens: B-cell lymphoma (mantle) Ataxia telangectasia:Lymphoma/acute leukemia |
|
First Gen H1 blockers, typical antipsychotics, tricyclics, and amantidine have what in common?
|
All have anticholinergic side effects
|
|
Homer-Wright pseudorosettes=
|
Adrenal Neuroblastoma
|
|
MOA of floroquinolones?
what happens if used in pregnancy what does it do to adults? what dz can you use it in for kids? |
inhibit DNA gyrase (topoisomerase II)
bactericidal damages cartilage in bones of kids...don't give to preggos remember tendon rupture in adults note: cipro can be used in kids for CF |
|
describe the heritable form of retinoblastoma
|
first mutation from parent
other is sporadic |
|
what does the FC region of the Ab do
|
determines the isotype (IgG/M etc)
binds complement |
|
APC gene can lead to what?
|
Colorectal cancer (assoc with FAP)
|
|
metronidizole, clindamycin, imipenam can all tx what
|
anaerobic infections
|
|
what gene is deleted in pancreatic cancer?
Colon? |
DPC-Deleted in Pancreatic Cancer
DCC-Deleted in Colon Cancer |
|
what kind of drug is tolterodine? use?
|
M blocker
Urge incontinence |
|
Major tumor marker for colorectal and pancreatic cancer
|
CEA for both
also Ca19-9 for pancreatic |
|
what penicillin drug would you use to treat a neonatal infection
|
ampicillin
|
|
alpha fetoprotein is a tumor marker for what 2 cancers
|
Hepatocellular carcinoma (hep B/C pts)
nonseminomatous germ cell tumor of the testis (yok sac) |
|
half life of IgG?
|
21 days
CROSSES THE PLACENTA--gives baby passive immunity |
|
CA 125 is a tumor marker for what?
|
Ovarian malignant epithelial tumor
|
|
what cell wall inhibitor matches the following statement:
use to tx otitis media if resistant to amoxicillin: prophylaxis against bacterial endocarditis: increases the nephrotox of aminoglycosides: broad spectrum coverage for appendicitis: |
use to tx otitis media if resistant to amoxicillin: cefdnir (3rd gen)
prophylaxis against bacterial endocarditis: 1st gen cephs increases the nephrotox of aminoglycosides: cephalosporins broad spectrum coverage for appendicitis: imipenem |
|
tumor marker seen in obstructive biliary dz and Paget's dz?
|
Alkaline phosphatse
|
|
what kind of drug is trospium? use?
|
M blocker
urge incontinence |
|
TRAP is a tumor marker for what
|
Hairy Cell
|
|
what G - bug matches the following:
life threatening meningitis + purpura= |
neisseria meningitis
|
|
Ca-19-9 is the tumor marker for what
|
pancreatic adenocarcinoma
|
|
What is the initial Antibody? delayed?
|
initial: M
Delayed |
|
oral hairy leukoplakia is due to what?
|
EBV
|
|
how old is a child who can do the following:
pass a cube |
6m
|
|
strep bovis causes what ca?
clonarchis sinesis? |
strep bovis causes what ca: colon
clonarchis sinesis: biliary |
|
what kind of drug is darifenacin?
|
M blocker
|
|
1. What does the following paraneoplasm release:
a. Small cell lung carcinoma: b. Small cell lung carcinoma nad intracranial neoplasms: c. Squamous cell lung carcinoma, renal cell carcinoma, and breast carcinoma: d. Renal cell carcinoma, hemangioblastoma: e. Thymoma, small cell lung carcinoma: f. Leukmia/lymphoma: |
1. What does the following paraneoplasm release:
a. Small cell lung carcinoma: ACTH=Cushing b. Small cell lung carcinoma nad intracranial neoplasms: ADH=SIADH c. Squamous cell lung carcinoma, renal cell carcinoma, and breast carcinoma: PTH-related peptide=Hypercalcimeia d. Renal cell carcinoma, hemangioblastoma: EPO e. Thymoma, small cell lung carcinoma: Abs against Ca channels at NMJ= Lambert Eaton f. Leukmia/lymphoma: hyperuricemia=Gout |
|
how old is a child who can do the following:
put a cube in a cup |
12m
|
|
Psammoma bodies can be seen in what 4 things
|
Papillary adenocarcinoma
Serous adenocarcinoma (ovary) Meningioma Mesothelioma |
|
classic pathway is stimulated by what
alternative? |
classic: atigen antibody complexes
alternative: microbial surfaces (nonspecific activators) |
|
if you have met to the bone, given the following clue, where did it come from
Lytic= Blastic= Both lytic and blastic= |
Lytic= Lung
Blastic= Prostate Both lytic and blastic= Breast |
|
how old is a child who can do the following:
make a 2 cube tower |
15m
|
|
what drugs are used for testicular cancer
|
Eradicated Ball Cancer
Etoposide Bleomycin Cisplatin |
|
List the G protein class for the following:
a1: A2: B1: B2: M1: M2: M3 D2: |
a1: Gq
a2: Gi B1: Gs B2: Gs M1: Gq M2: Gi M3: Gq D2: Gi |
|
what neoplasm are assoc with the following:
Tuberous sclerosis Ataxia telangectasia Pagets dz |
Tuberous sclerosis: Cardiac rhabdomyoma
Ataxia telangectasia: Leukemia lymphoma Pagets dz: osteosarcoma |
|
how old is a child who can do the following:
hands together |
3m
|
|
which neoplasm is assoc with the following:
Nitrosamines: Arsenic: Naphthalene: |
Nitrosamines: esophagus and stomach
Arsenic: skin/liver Naphthalene: Bladder |
|
what makes up the MAC?
|
C5b-9
|
|
most common cause of hypercalcemia? cancers that cause this?
|
primary hyperparathyroidism
Cancers: SCC of the lung, renal, breast |
|
how old is a child who can do the following:
make a 4 cube tower |
18m
|
|
which tumor marker would help with the following:
melanoma: Astrocytoma: Hepatocellular ca: |
melanoma: s-100
Astrocytoma: s-100 Hepatocellular ca: alpha fetoprotein |
|
what sympathetic is given SubQ for asthma?
|
terbutaline
B2 agonist |
|
what step in the cell cycle do p.53 and Rb prevent
|
movement from G1 to S
|
|
how old is a child who can do the following:
make a 6 cube tower |
2y
|
|
what stops G2 to M in the cell cycle
|
p.53
|
|
what complement proteins are involved in anaphylaxis?
|
C3a
C5a |
|
Use of Methotrexate (2)
MOA? tox? |
Uterine pathology (choriocarcinoma, ectopic preg, abortion)
immunosupression inhibits dihydrofolate reductase tox: myelosuppresion reversible with leucovorin |
|
how old is a child who can do the following:
copy a circle or dash |
3 y
|
|
MOA of 5-FU
|
pyrimidine analog-->inhibits THYMIDYLATE SYNTHASE
|
|
what will cause increase tox of 6MP? why?
|
allopurinol
6MP is broken down by xanthine oxidase, which allopurinol inhibits |
|
what receptors are stimulated by the following
Clonidine: Dopamine: Phenylephrine: Albuterol Norepinephrine: Isoproterenol: Epinephrine: Dobutamine: Terbutaline |
Clonidine: a2
Dopamine: D1=D2 >B>a Phenylephrine: a1>a2 Albuterol: B2>B1 Norepinephrine: a1, a2> B1 Isoproterenol:B1=B2 Epinephrine: a1, a2, B1, B2 Dobutamine: B1>B2 Terbutaline: B2>B1 |
|
what drug uses leucovorin rescue?
thymidine? |
leucovorin: MTX
thymidine: 5FU |
|
how old is a child who can do the following:
copy a + or make a stick figure |
4 y
|
|
what drug do you use for childhood tumors such as Ewings, rhabdomyosarcoma and Wilms
|
Dactinomycin (intercalates DNA)
|
|
deficiency of C1 esterase inhibitor leads to what?
|
hereditary angioedema
|
|
MOA of doxorubicin?
tox? |
generates free radicals to destroy DNA
Cardiotox |
|
how old is a child who can do the following:
copies a square |
5y
|
|
MOA of bleomycin
Tx: Tox? |
free radical damage of DNA
Tx: Testicular cancer Tox: Pulmonary fibrosis |
|
list what class of drug the following are:
-azine: -ipramine: -tidine: -navir: -phylline: -triptyline: |
-azine: neuroleptic
-ipramine: TCA -tidine: H2 antag -navir: Protease inhibitor -phylline: Methylxanthine -triptyline: TCA |
|
MOA of Etoposide
tx? |
inhibits topoisomerase II
tx: testicular |
|
how old is a child who can do the following:
ride a tricycle or jump forward |
3 y
|
|
deficiencey of C3 leads to what?
|
severe recurrent pyogenic sinus and respiratory tract infections (strep pnuemo and h. influ)
also type III HS rxn (glomerulonephritits) |
|
what cancer drug causes hemorrhagic cystitis? how can you prevent this?
what does this drug have an increased risk of? |
Cyclophosphamide
Mesna (binds up toxic metabolite) increased risk of TCC of bladder |
|
how old is a child who can do the following:
have an imaginary friend |
4 y
|
|
tox of Busulfan?
|
pulmonary fibrosis
|
|
pronator of the arm
|
median n
|
|
MOA of vincristine and vinblastine?
Tox? |
Block polymerization of microtubules
Vincristine: neurotox Blastine: bone barrow suppression |
|
how old is a child who can do the following:
same sex friends |
6-11
|
|
MOA of paclitaxel?
|
hyperstabilize microtubule spindle (can't break it down)
|
|
deficiency of the MAC will lead to what
|
neisseria bacteremia
|
|
Tox of cisplatin?
use? |
Nephrotox, acoustic nerve damage
testicular, bladder, ovary cancer |
|
when is potty training done
|
btw 2-3 years
|
|
MOA of prednisone in Cancer?
Tox? |
Trigger apoptosis
Cushing, immunosuppression, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis |
|
Tamoxifen vs raloxifine..
what do they treat? which is better |
osteoperosis (SERM)
raloxifine: no risk of endometrial carcinoma (which tamoxifen does) |
|
Nerve for wiping your ass:
Nerve(s) to raise arm above horizontal: What nerve runs with the following blood: Posterior circumflex: deep brachial: brachial: |
Nerve for wiping your ass: Thoracodorsal
Nerve(s) to raise arm above horizontal: spinal accessory and LTN What nerve runs with the following blood: Posterior circumflex: axillary deep brachial: radial brachial: median |
|
MOA of trastuzumab
tox? |
MAB against HER-2
kills breast cancer cells that express HER2 cardiotox |
|
describe the following Tanner stage:
male tanner 2 |
enlargement of scrotum and testes
|
|
deficiency of DAF leads to what
|
paroxsymal nocturnal hemoglobinuria
DAF=decay accelerating factor DAF is made of CD 55 and 59 |
|
give the cancer drug that fits the following
Alkylates DNA, tox pulmonary fibrosis: DNA alkylating agents for brain cancer: Inhibits thymidlayte synthase: MOA similar to antivirals acyclovir and foscarnet: Inhibitor of PRPP synthetase: |
Alkylates DNA, tox pulmonary fibrosis: Busulfan
DNA alkylating agents for brain cancer: -stines Inhibits thymidlayte synthase: 5FU MOA similar to antivirals acyclovir and foscarnet: Cytarabine Inhibitor of PRPP synthetase: 6MP |
|
describe the following Tanner stage
male 3 |
enlargement of penis (length first)
|
|
what nerve is likely to get injured with the following injuries:
shaft of humerus: surgical neck of humerus: supracondyle of humerus: medial epicondyle: anterior shoulder dislocation: |
shaft of humerus: Radial
surgical neck of humerus: Axillary supracondyle of humerus: median medial epicondyle: ulnar anterior shoulder dislocation: axillary |
|
give the cancer drug that fits the following
Treatment for choriocarcinoma: Tx for AML: tx CML: applied topically for AKs and Basal cell ca: Antibody against Philadelphia chromosome: |
Treatment for choriocarcinoma: MTX
Tx for AML: Cytarabine tx CML: Busulfan applied topically for AKs and Basal cell ca:5FU Antibody against Philadelphia chromosome: Imatinib |
|
describe the following Tanner stage
stage 4 male |
penis: growth in breadth and development of the glans
testes: enlarge scrotum: larger and darker |
|
what is a Ham's test?
shows what? tx? |
when RBC lyse at low pH
diagnostic of Paroxysmal Nocturnal Hemoglobinuria tx: iron, anticoagulant (warfarin), bone marrow transplant |
|
Spinothalamic and DCML uses what thalamic nucleus
|
VPL
pain, temp, position and proprioception |
|
describe the following Tanner stage
female 2 |
breast bud with elevation of breast and papilla
areola enlargment |
|
abdominal pain, ascites, hepatomegaly
|
Bud Chiari syndrome
lookslike CHF w/ no JVD |
|
trigeminal and gustatory pathway uses what thalamic nucleus
|
VPM
face sensation and tast |
|
which tanner stage is the following:
areola and papilla form a secondary mound above the level of the breast |
female 4
|
|
Coombs test shows you what type of HS rxn?
|
Type II
|
|
CN II uses what thalamic nucleus
|
LGN
vision Lateral light |
|
at what age does female breast development occur?
growth spurt? menarche? |
breast: 11
growth: 12 menarche: 13 |
|
achilles tendon xanthoma
|
familial hypercholesterolemia
|
|
the superior olive and inferior colliculus of the pons uses what thalamic nucleus
|
MGN
Hearing Medial music |
|
when does male sexual development occur
|
age 12
growth spurt 14-15 |
|
what type of HSN rxn are:
Post strep glomerulonephritis: Rheumatic Fever: PAN: |
Post strep glomerulonephritis: II
Rheumatic Fever: II PAN: III |
|
what happens to the stratum granulosum and spinosum in psoriasis
|
Granulosum: decreased
Spinosum: increase |
|
what car seat consideration should you make for the following:
<1 year and <20 lbs |
infant seat in back seat facing backwards
|
|
adrenal hemorrhage, hypotension, DIC
|
Waterhouse Friderichsen syndrome
Nesseria leading to sepsis |
|
what helps rolling of neutrophils along the endothelium?
what allows for neutrophil tight binding? |
what helps rolling of neutrophils along the endothelium: E-selectin
what allows for neutrophil tight binding: ICAM-1 (integrin) |
|
what car seat consideration should you make for the following:
1-4 and >20lbs |
sits in back seat with car seat, can face forward
|
|
antihistone Ab=
anticentromere= Anti-Scl 70: Antimitochondrial ab: anti-desmoglein antimicrosomal, antithyroglobulin: anti Jo: anti Ro (SSA) Ani La (SSB): anti-U1 RNP: anti smooth muscle: anti-glutamate decarboxylae: c-ANCA: |
antihistone Ab= drug induced lupus
anticentromere= CREST Anti-Scl 70: diffuse scleroderma Antimitochondrial ab: primary biliary cirrhosis anti-desmoglein: pemphigus vulgaris antimicrosomal, antithyroglobulin: Hashimoto anti Jo: Polymyositis/dermatomyositis anti Ro (SSA): sjogrnes Ani La (SSB): sjogrens anti-U1 RNP: mixed CT disease anti smooth muscle: autoimmune hepatitis anti-glutamate decarboxylae: type 1 Diabetes mellitus c-ANCA: Wegners granulomatosis |
|
what are the neutrophil chemotactic factors
|
IL 8
C5a Leukotriene B4 |
|
what car seat consideration should you make for the following:
4 years and 40lbs |
booster seat in the back
|
|
hyperplasia of statum spinosum, associated with hyperinsulinemia or visceral malignancy
|
acanthosis nigrans
|
|
back pain, fever, night sweats, weight loss
|
Pott's dz (vertebral TB)
|
|
Herald patch followed by christmas tree distribution
|
Pityriasis rosea
|
|
acute phase cytokines
|
IL1
IL6, TNF alpha |
|
what skin cancer has a rolled edge with cental ulcer
|
basal cell carcinoma
|
|
what car seat consideration should you make for the following:
4' 9'' and 8-12 |
belted with lap shoulder belt in back seat until 13
|
|
what skin cancer has keratin pearls
|
SCC
|
|
what is the deficiency in SCIDs
|
Adenosine deaminase deficiency
will not have thymic shadow on CXR in newborn |
|
Depth of tumor correlates with risk of metastasis with what tumor
|
Melanoma
|
|
where do you do a lumbar puncture
|
L3/L4 or L4/L5
|
|
what are the ABCDs of Melanoma
|
Asymmetry
Border irregularity Color Diameter |
|
how old is the following kid:
jumps up, 6 cube tower, eats with spoon, 2-3 word sentence |
2 years
|
|
T/F Acetaminophen is useful in tx of inflammation
|
FALSE
|
|
bilateral hilar adenopathy, uveitis
|
sarcoidosis
|
|
what skin disorder are the following-
Pruitis associated with asthma: Thickened scar : Sand-paper, predispostion to SCC: Histology shows palisading nuclei: |
Pruitis associated with asthma: Eczema
Thickened scar : keloid Sand-paper, predispostion to SCC: actinic keratosis Histology shows palisading nuclei: Basal Cell |
|
what is a Bankart Lesion? what is it seen with usually?
|
injury of the anterior (inferior) glenoid labrum due to repeated (anterior) shoulder dislocation. It is an indication for surgery and often accompanied by a Hill-Sachs lesion, damage to the posterior humeral head.
|
|
rectangular crystal like cytoplasmic inclusions in Leydig Cells
|
Reinke Cyrstals (leydig cell tumor)
|
|
how old is the following kid:
regards face, responds to sound, not yet able to roll over |
<3 months
|
|
renal epithelial cell casts in urine
|
Acute toxic/viral nephrosis
|
|
what is seen in WAS?
|
eczema
Thrombocytopenia and purpura recurrent pyogenic infections TRUNCAL eczema |
|
Rhoboid crystals, positively birefringent
|
pseudogout (calcium pyrophosphate dihydrate)
|
|
what inhibits the Ryanodine receptor
|
Dantrolene
|
|
sheets of medium sized lymphoid cells ("starry sky" appearance on histology)
|
Burkitts lymphoma
|
|
how old is the following kid:
stands with support, 1-3 words, stranger anxiety, drinks from a cup |
1 year
|
|
Silver-staining spherical aggregation of tau proteins in neurons
|
Pick bodies
|
|
bone pain, bone enlargment, increased hat size, fractures...
what would be elevated? |
Paget's dz
Alk phos |
|
spikes on basement membrane, dome like endothelial deposits
|
Membranous glomerulonephritis
|
|
genetics associated with achondroplasia?
|
AUTOSOMAL DOMINANT
FGFR3 gene |
|
stippled vaginal epithelial cells
|
"clue cells" Gardnella vaginalis
|
|
todler with poor smooth pursuit of moving target with eyes. What do they have? increased risk of what?
|
Ataxia-telangiectasia
Ca risk: lymphoma and acute leukemias increased radiation sensitivity |
|
"tennis-racket" shaped cytoplasmic organelles (EM) in Langerhans cells
|
Birbeck granules (histiocytosis X: eosinophilic granuloma)
|
|
bounding pulses, diastolic heart murmur, head bobbing
|
aortic regurgitation
diastolic goes down then it goes up |
|
Thrombi made of white/red layers
|
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
|
|
if a pt is on corticosteroids for 3 months, what drug should they be given prophylactically
|
bispohosphonate
watch out for osteoporosis |
|
Thumb sign on lateral xray
|
epiglottitis (h influ)
|
|
why is it important to diagnose IgA deficiency
|
possible anaphylaxis to blood transfusions and blood products
|
|
thyroid like appearance of kidney
|
chronic bacterial pyelonephritis
|
|
Cafe-au-lait spots, Lisch nodules (iris hamartoma), phoechromocytoma, optic gliomas
|
NF I
|
|
Tram track appearance on LM
|
Membranoproliferative glomerulonephritis
|
|
what coagulation drug can lead to osteoporosis
|
heparin
|
|
Triglyceride accumulation in liver cell vacuoles
|
Fatty liver disease (alcoholic or metabolic syndrome)
|
|
in CGD what are ppl susceptible to?
how do you diagnose? |
Cat +
s aureus kelp aspergillus candida Diagnosed by: nitroblue tetrazolium dye (no yellow to lue black oxidation) give TMP-SMX prophylactic tx |
|
WBCs that look smudged
|
CLL (almost always B cell, elderly)
|
|
Cafe-au-lait spots, Lisch nodules (iris hamartoma), bilateral acoustic neuromas
|
NF II
chrom 22 |
|
Wire loop glomerular appearance on LM
|
Lupus nephropathy
|
|
why can't you take bisphosphonates before bed
|
cause corrosive esophagitis, so you don't want to be laying down
|
|
Yellow CSF
|
xanthochromia (subarachnoid hemorrhage)
|
|
what is the triad in Chediak-Higashi dz?
|
partial albinism
recurrent respiratory tract and skin infections neurologic disorders |
|
Keratin filled cysts
|
Seborrheic Keratosis
|
|
Cafe-au-lait spots,polystotic fibrous dysplasia, precoucious puberty
|
McCune-Albright syndrome (mosaic G-protein signaling mutation)
|
|
signet ring cells in ovary=
in RBCs= |
ovary= Krunkenberg
RBC= Trophozoite of malaria |
|
what is teriparatide?
|
drug for osteoporosis, decreases hip fracture rate by 53%
can only use for 2 years |
|
pt with eczema, recurrent cold staph a abscesses, broad nose, prominent forehead, deep set eyes and doughy skin. what does he have? what would his mouth have going on
|
Job syndrome (hyperimmunoglobulin E syndrome)
2 rows of teeth (retained primary teeth) |
|
Cherry red spot on macula (3)
|
Tay Sachs (ganglioside)
Neimann pick (sphingomyelin) central retinal artery occlusion |
|
pt has erlenmeyer flask bones. What is serum calcium, phos, and alkaline phosphates levels like?
|
Osteopetrosis
all are normal |
|
infant with failure to thrive, hepatosplenomegaly, neurodegeneration
|
niemann pick dz (genetic shingomyelinase deficiency)
|
|
Chest pain, pericarial effusion/friction rub, persistent fever following MI
|
Dressler's syndrome
autoimmune mediated post MI fibrinous pericarditis, 1-12 weeks post |
|
cafe au lait spots, short stature, precocious puberty
|
McCune Albright
|
|
infant with hypoglycemia failure to thrive, and hepatomegaly
|
Cori's dz (deb ranching enzyme deficiency)
could be Von Geirke's dz |
|
Chronic exercise intolerance with myalgia, fatigue, painful cramps
|
McArdle's dz (muscle phosphorylase def)
|
|
what causes brown tumors?
|
Osteitis fibrosa cystica
increased Ca decreased Phos increases ALP increased PTH |
|
large rash with bulls eye appearance
|
erythema choronicum migraines from ixodes tick bite (lyme dz: borrelia)
|
|
conjugate lateral gaze palsy, horizontal diplopia
bilateral: unilateral: |
internuclear opthalmoplegia (damage to MLF)
bilateral: MS unilateral: stroke |
|
lucid interval after traumatic brain injury
|
epidural hematoma
|
|
what causes the following:
failure of bone resorption--> thickened and dense bones also due to genetic deficiency of carbonic anhydrase II |
osteopetrosis
|
|
machine heart murmur
|
PDA
|
|
bone is replaced by fibroblasts, collagen, and irregular bony trabeculae
|
polyostotic fibous dysplasia
|
|
male child recurrent infections, no mature B cells
|
Bruton's x linked agammaglobulinemia
|
|
please list if there is an increase, decrease or no change for the following in Osteoporosis
Serum Ca: Phosphate: ALP: PTH: |
All normal
|
|
cutaneous/dermal edema due to CT deposition
|
myxedema (hypothyroid or Graves)
|
|
mucosal bleeding and prolonged bleeding time
|
Glanzmann's thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
|
|
pt with colon polyp, lipomas, and osteoma in the skull
|
Gardner's syndrome
|
|
Dermatitis, dementia, diarrhea
|
Pellegra (niacin, B3, def)
|
|
no lactation post partum, absent mensturation, cold intolerance
|
Sheehan's syndrome (pituitary infarction)
|
|
knee pain with soap bubble appearance on x ray
|
giant cell tumor (osteoclastoma)
|
|
dilated cardiomyopathy, edema, polyneuropathy
|
Beriberi (thiamine, B1, def)
|
|
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
|
MS
|
|
please list if there is an increase, decrease or no change for the following in Osteopetrosis
Serum Ca: Phosphate: ALP: PTH: |
all normal
|
|
dog or cat bite infection
|
Pasteurella multocida
|
|
necrotizing vasculitis of the lungs and necrotizing glomerulonephritis
sinus+c-anca: anti-bm: |
sinus: wegner
anti-bm: good pastures |
|
please list if there is an increase, decrease or no change for the following in Osteomalacia/rickets
Serum Ca: Phosphate: ALP: PTH: |
Serum Ca: decrease
Phosphate: decrease ALP: normal PTH: increase soft bones |
|
erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
|
Sezary syndrome or mycosis fungoides
|
|
oscillating slow fast breathing
|
cheyne stokes respirations (central apnea in CHF or increased intracranial pressure)
|
|
please list if there is an increase, decrease or no change for the following in osteitis fibrosa cystica
Serum Ca: Phosphate: ALP: PTH: |
Serum Ca: increase
Phosphate: decrease ALP: increase PTH: increase brown tumors |
|
Facial muscle spasm upon tapping:
|
Chvostek's sign
|
|
painful raised red lesions no palms and soles
|
osler's nodes (infective endocarditis)
|
|
please list if there is an increase, decrease or no change for the following in Pagets
Serum Ca: Phosphate: ALP: PTH: |
Serum Ca: normal
Phosphate: normal ALP: increase PTH: normal |
|
fat female forty and fertile
|
gall stones
|
|
painless erythematous lesions on palms and soles
|
Janeway lesions (infective endocarditis)
|
|
What is sicca syndrome
|
basically sjogren's minus the arthritis
dry eyes, mouth, vagina, etc |
|
Fever chills headache, myalgia, following abx tx for syphilis
|
Jarisch-Herxheimer rxn (rapid lysis of spirochetes results in toxin release)
|
|
painless jaundice
|
cancer of the pancreatic head obstructing bile duct
|
|
this gout drug can be used acutely or for prophylaxis. MOA?
|
Colchicine
Microtubule inhibitor |
|
fever, cough, conjuctivitis, coryza, diffuse
|
Measles (morbillivirus)
|
|
Palpable purpura, joint pain, abdominal pain (child)
|
Henoch schonlein purpura (IgA vasculitis affecting skin and kidneys)
affects Lower limb |
|
What is the drug of choice for acute gout attacks?
|
NSAIDs
Indomethacin |
|
green-yellow rings around peripheral cornea/iris
|
Kayser-Fleischer rings (copper accumulation from Wilson's dz)
|
|
pancreatic, pituitary, and parathyroid tumor
|
MEN I
|
|
what is chondrocalcinosis?
what is it seen in? |
Calcification of articular cartilage
diagnostic of pseudogout |
|
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands
|
Peutz-Jeghers syndrome
polyps are benign but increased risk of cancer |
|
multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth
|
Gardner's syndrome (subtype of FAP) APC gene
|
|
young sexually active person with a swollen knee
|
neisseria gonnorhea
|
|
hepatosplenomegaly, osteoporosis, neurologic sx
|
gaucher's dz (glucocerebrosidase def)
crumpled tissue paper cytoplasm |
|
painful blue fingers/toes hemolytic anemia
|
cold agglutinin dz (autoimmune hemolytic anemia caused by mycoplasma pneumonia infections mononucleosis
IgM |
|
Sacroilitis=
|
anklyosing spondylitis
|
|
hereditary nephritis, sensorineural hearing loss, catarax
|
Alports
|
|
what immunopatholgy matches the following statements:
antiplatelet antibodies: newborn with chronic diarrhea, failure to thrive and chronic candida: child with eczema, course facial features, and cold abscesses: child with partial albinism, peripheral neuropathy and recurrent infections |
what immunopatholgy matches the following statements:
antiplatelet antibodies: ITP newborn with chronic diarrhea, failure to thrive and chronic candida: SCIDS child with eczema, course facial features, and cold abscesses: Job's syndrome child with partial albinism, peripheral neuropathy and recurrent infections: Cediak higashi |
|
Dactylitits, pencil-in-cup deformity
|
psoriatic arthritis
look for joint pain + psoriasis |
|
Hyperphagia, hypersexuality, hyperorality, hyperdocility
|
Kluver Bucy syndrome (bilateral amygdala lesion)
|
|
hypercoagulability (leading to migrating DVTs and vasculitis)
|
Trousseau's sign (adenocarcinoma of pancreas or lung)
|
|
kidneys with flea bite or ectasia
|
SLE
wire-loop |
|
hypoemia, polycythemia, hypercapnia
|
Blue bloater
chornic bronchitis |
|
indurated ulcerated genital lesion
painful: painless: |
painful: chancre (1 syphillis, teponema pallidum)
painless: chancroid (haemophilius ducreyi) |
|
black lady with restrictive heart disease associated with non caseating granulomas
|
sarcoidosis
|
|
pt has increased ACE, and erythema nodosum. What can you biopsy for diagnosis
|
lacrimal gland or conjunctivia
Sarcoidosis |
|
pt has stiffness in shoulder and hips, no weight loss and is associated with temporal arteritis. CK levels are normal
|
Polymalgia rheumatica
|
|
heliotrope rash, positive ANA, anti-jo-1
what is it with no rash? |
Dermatomyositis
no rash: polymoyositis (shoulder weakness) |
|
what paraneoplastic dz is Lambert Eaton associated with
|
small cell
|
|
what is CREST
|
it is a scleroderma (excessive fibrosis and collagen deposition throughout the body)
Calcinosis Raynauds Esophageal dysmotility Sclerodactyly Telangiectasia |
|
parakeratotic scaling
|
Psoriasis
|
|
what has a positive Nikolsky's sign and what is it?
|
Pemphigus vulgaris
separation of the epidermis upon manual stroking of the skin |
|
which affects the mouth, pemphigus vulgaris or bullus pemphigoid
|
Vulgaris
|
|
what is Toxic epidermal necrolysis
|
SJS that covers 30 % of the body
|
|
what will you see in Lichen Planus? What is it associated with
|
Pruitic, Purple, Polygonal Papules
associated with hepatitis C |