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82 Cards in this Set
- Front
- Back
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Cluster A personality disorders |
paranoid schizoid schizotypal - more likely with first degree relative - more likely to develop schizophrenia |
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Frozen Shoulder/Adhesive Capsulitis |
Follows Trauma, Joint immobilization, Hypothyroidism; typically an insult resulting in inflammtion |
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Loss of Eversion and dosiflexion of the foot |
Common Peroneal (fibular) nerve - Can be damaged with posterior fibular head - Waddling gait, swing-out, steppage gait - dropPED: Peroneal Everts and Dorsiflexes |
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Loss of inversion and plantar flexion |
Tibial nerve |
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Pityriasis rosea |
Exanthematous eruption Primary lesion = herald patch: oval slightly raised 2-5 cm plaque with peripheral scaly appearance Secondary lesion = Christmas tree pattern 1-2 weeks later - supportive tx - HHV 6,7 |
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Increases Digoxin Toxicity |
- Quinidine decreases renal clearance; Lidocain can be utilized for treatment of dysrhythmias caused by digoxin toxicity - Hypomagnesium, Hypercalcemia, Hyper/Hypokalemia increases digoxin toxicity (Hypokalemia enhances probability of digoxin binding which will enhance toxicity possibility |
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Somatostatinoma: which cells syndrome what enzyme is most effected by decreased gastrin |
- Delta cell tumor - Syndrome: DM, Cholelithiasis, Steatorrhea, Hypochlorphydria dt decreased gastrin - Pepsin is most effected since gastrin secreted from G cells hits Parietal. Release H. Acidity is needed for pepsinogen to change to pepsin |
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what causes telangiectasia? |
Chronic liver diseases causes excess estrogen dt the livers inability to properly metabolize it. - Gynecomastia is also a manifestation |
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Retrograde vs Anterograde amnesia |
- Retrograde: can't remember stuff right before the amnesia but CAN make new memories Can regain memory - Anterograde: loss of the ability to make new memories, leading to a partial or complete inability to recall the recent past; long term memories are still intact CANNOT regain memory for the ones that were not encoded properly |
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MC ankle ligament tear |
- Anterior talofibular ligament - Calcaneofibular ligament - Posterior talofibular ligament ATF - Always Tears First |
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effects of OC on breast, ovarian, endometrial cancer |
- increase breast - decrease endometrial - decrease ovarian - potentially slight increase in cervical cancer |
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Lab studies found in polymyositis |
elevated creatine kinase, lactate dehydrogenase, aldolase - Anti-Jo-1 antibodies |
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PUD Benign ulcer on endoscopy |
- smooth, flat erosion filled with exudate seen on endoscopy; regular rounded edges with a smooth ulcer base filled with exudate |
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PUD treatment |
H. pylori: - PPI to reduce gastric acid secretion by inhibiting the HKATP pump in parietal cells - clarithromycin, Amoxicillin antibiotic |
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Anxietolytic that decreases risk of dependence |
Buspirone - no sedation, CNS depression, dependence - good for those with alcoholism and substance abuse - binds serotonin and dopamine D2 receptors |
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increased CRI |
Systemic fever, strenuous exercise, OMT |
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Decreases CRI |
Depression, Chronic fatigue, Chronic infection |
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Crush Syndrome |
Elevated creatine kinase, myoglobin, phosphate - myoglobin causes AKI dt ATN - Hypovolemic shock, hyperkalemia, HF, Arrhythmia, ARD, sepsis, DIC |
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Drug administered for hyperkalemia in a crush patient |
Calcium gluconate - cardioprotective; doesn't directly effect potassium levels |
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Serotonin Syndrome Symptoms |
Hyperthermia Confusion Myoclonus CV instability Flushing Diarrhea Seizures |
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Treatment for Serotonin Syndrome |
Cyproheptadine (5-HT2 Receptor Antagonist) |
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Tricyclic Antidepressant OD |
Cardiotoxicity CNS Toxicity AntiCholinergic Sx |
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Tricyclic Antidepressant OD Treatment |
Sodium Bicarbonate - raises the pH and makes more drug protein bound and thus less likely to cause problems |
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Tyramine - what breaks it down - what is released dt tyramine |
- Tyramine causes release of Norepi from nerve terminals - MAO is normally found in the but and therefore breaks down tyramine; thus inactivating and metabolizing catecholamines |
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Metolazone |
Thiazide
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Chlorthalidone |
Thiazide |
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Bumetanide |
Loop |
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Top Treatments for HTN |
Thiazide ACEinhibitor ARB Calcium Channel Blocker |
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Increases CHF survival |
Beta Blocker ACEinhibitor ARB Aldosterone Antagonist |
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Pollagra |
Diarrhea Dermatitis Disturbances Niacin deficiency, Nicotinic Acid |
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Gene mutation in Autosomal Recessive Polycystic Kidney Disease |
PKHD1 - the gene for fibrocystin * Fibrocystin is found on epithelail cells of renal tubules and bile ducts * Autosomal Recessive or spontaneous |
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Complication of a newborn with ARPKD |
Respiratory Distress Oligohydramnios Reduced amniotic fluid leads to Potter Syndrome |
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Potter syndrome |
Flattened Facies, Limb deformities, Pulmonary hypoplasia dt fetal compression - Due to Oligohydramnios - PKD, No ureteric bud formation, bilateral renal agenesis, obstructive uropathy causes the oligohydramnios - cause of death: pulmonary hypoplasia |
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Complication with Autosomal Dominant PKD |
Cerebral aneurysm - not associated with the recessive! |
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Red ragged fibers |
Gomori trichome stain of a muscle biopsy of muscle fibers with a blotchy red appearance - Mitochondrial inheretance - EM: Increased number of enlarged, abnormally shaped mitochondria |
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Mitochondrial Myopathies |
- myoclonic epilepsy with ragged red fibers - Leber optic neuropathy (blindness) - Mitochondrial encephalopathy with stroke like episodes and lactic acidosis |
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Palpable purpura |
Henoch-Schonlein Purpura |
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Triad in Henoch-schonlein purpura |
Palpable purpura on but and legs Arthralgias GI: Abdominal pain Vasculitis secondary to IgA Immune complex deposition (Type III) - Follows URI - MC childhood vasculitis - Mechanism: circulating immune complexes |
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majority of OD in the USA |
Opioids ( Benzos cause less respiratory distress) |
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Blood supply to the femoral head which will lead to avascular necrosis |
Ascending Cervical and Retinacular branches of Medial Circumflex artery - Medial and Lateral Circumflex come from the Deep Femoral Artery, but the DFA is more hidden - Lateral Circumflex provides only a small amount |
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Where is ADH synthesized |
Paraventricular and Supraoptic Nuclei of the Hypothalamus; Transported to the POSTERIOR pituitary for storage |
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pH >5.5 (unexpected) Hypokalemia Kidney stones |
Type I RTA
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Type I RTA |
pH >5.5 (unexpected) Hypokalemia Kidney stones Defect in alpha intercalated cells to secrete H Metabolic Acidosis Dt: Amphotericin B toxicity, analgesic nephropathy, congenital anomalies |
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Urine pH < 5.5 Hypokalemia |
Type 2 RTA |
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Type 2 RTA - Defect: - Causes: |
Urine pH < 5.5 Hypokalemia - Defect in PCT HCO3 reabsorption - Fanconi Syndrome, Carbonic Anhydrase Inhibitors |
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Urine pH <5.5 Hyperkalemia |
Type 4 RTA |
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Type 4 RTA Defect: Causes: |
Urine pH <5.5 Hyperkalemia - Decreased aldosterone production - Cause: diabetic hyporeninism, ACE inhibitors, ARB, NSAIDS, Heparin, Cyclosporine, Adrenal insufficiency or aldosterone reisstence |
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Causes of Metabolic Acidosis with Increased Anion Gap |
M - Methanol U - Uremia D - DKA P - Propylene glycol I - Iron tablets, Isoniazid L - Lactic acidosis E - Ethylene Glycol S - Salycilates (late) *** Adding Acid |
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Causes of Metabolic Acidosis with Normal Anion Gap |
HARD ASS Hyperalimentation Addison Disease RTA Diarrhea Acetazolamide Spironolactone Saline Infusion |
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Shifts K out of Cells = Hyperkalemia |
- Cell Lysis - Low Insulin (High blood sugar) - Beta Blockers - Acidosis - Digoxin |
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Shifts K into cells = Hypokalemia |
- Insulin (INto Cells) - Beta AGONIST - Alkylosis - Cell Creation/Cancer |
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Electrolyte: that decreases DTRs, lethargy, bradycardia, hypotension, Cardiac arest, Hypocalcemia |
Increased Mg |
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Electrolyte: causes tetany |
Decreased Ca, Mg |
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What is elevated and decreased in Poststrep GN? |
Elevated Antistrptolysin O for just strep pharyngitis, not impetego. - Elevated Anti-DNAse B for BOTH - Decreased Complement (C3) levels |
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Mutation on Chromosome 17 |
NF-1 - tumor suppressor gene that causes neurofibromatomas
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Mutation on Chromosome 3p |
VHL gene |
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Mutation on Chromosome 13 that's a tumor supporesor |
RB - lead to retinoblastoma and osteosarcoma |
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Mutation on Chromosome 11 Tumor suppressor |
WT-1: Wilm's Tumor |
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What does the ureteric bud give rise to? |
Collecting system of the kidney: Collecting tubules, ducts, major and minor calyces, renal pelvis and ureters |
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What does the metaneprhic mesoderm (blastema) give rise to? |
Glomeruli, Bowman's space, proximal tubules, loop of henle, Distal convoluted Tubule |
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3 rate limiting enzymes of Glycolysis |
Hexokinase/Glucokinase Phosphofructokinase-1 Pyruvate Kinase |
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Rate Limiting for De Novo Pyrimidine synthesis |
carbamoyl phosphate syntheatase-2 |
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Rate Limiting de novo purine synthesis |
Glutamine PRPP amidotransferase |
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Rate limiting Glycolysis |
PFK-1 (Phosphofructokinase-1) |
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Rate Limiting Gluconeogenesis |
Fructose-1,6-Bisphosphatase |
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Rate limiting Glycogen Synthesis |
Glycogen Synthase |
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Rate limiting Glycogenolysis |
Glycogen Phosphorylase |
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Rate Limiting TCA Cycle |
Isocitrate Dehydrogenase
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Rate Limiting Hexose Monophosphate Shunt |
Glucose-6-Phosphate Dehydrogenase |
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Retroperotoneal Organs |
A DUCK PAIR A - Aorta and IVC D - Duodenum (2-4) U - Ureters C - Colon (ascending, descending) K - Kidneys P - Pancrease (head, not tail) E - Esophagus (thoracic past diaphragm) A - Adrenals R - Rectum |
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Enzymes for Gluconeogenesis |
Glucose-6-Phosphatase Fructose 1,6 bisphosphatase Pyruvate carboxylase + BIotin PEP carboxykinase |
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What are the two main nitrogen transporters in the blood? |
alanine and glutamine |
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What are teh major regulatory enzymes of the TCA? |
Citrate Synthase Isocitrate Dehydrogenase (rate limiting) |
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What is the landmark for the pudendal nerve block? |
Palpate the Ischial Spine |
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Uncoupling agents: |
increase permeability of the inner mitochondrial membrane and decrease the proton gradient thus produce heat - 2,4 Dinitrophenol (used for weight loss) - Aspirin OD - Termogenin in brown fat (hibernation) |
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Position of ease for nursemaid elbow |
Flexion of elbow, Adduction, and pronation |
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Mechanism of injury during nusemaid elbow? |
Longitudinal traction on a pronated, extended elbow |
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Treatment position for nursemaid elbow |
Flex elbow to 160 and supinate |
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H2S positive, Black colonies on Hektoen Agar |
Salmonella typhi |
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Green colonies on Hektoin Agar No Hydrogen Sulfide |
Shigella |
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Contaminated Peanut Butter |
Salmonella |
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q |
q |
