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219 Cards in this Set
- Front
- Back
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Chemoreceptor Trigger zone is related to vomiting. Where is it located?
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Dorsal surface of the medulla at the caudal end of the 4th ventricle
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What is the structure of a bisphosphonate?
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Structural analogs of pyrophosphate (an important component of hydroxyapatite)
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What is the capitation payment plan?
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-Physicians paid fixed amount per patient, not per service
-Incentives to contain costs due to the fixed budget allocated to them -Patients are motivated to provide more preventative care to catch illnesses early so that patients stay healthier and need fewer tests and procedures as they age |
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Fee for service payment plan?
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-Paid fixed amount for every service & diagnostic test they provide
-No incentive to avoid costly tests & procedures |
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Salary payment plan?
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-Fixed amount payment
-Payment not tied to # of patients or services -No financial incentive to change their treatment patterns |
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Drug-induced parkinsonism is what kind of side effect? Which drugs produce these side effects?
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-EPS
-Caused by medications that block D2 receptors |
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Important side effect of isoniazid?
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Hepatotoxicity
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How does carbamazepine work?
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-Used for simple partial, complex partial, generalized seizures
-Acts by blocking V-gated Na+ channels |
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Side effects of carbamazepine?
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-Bone marrow suppression
-Hepatotoxicity -SIADH |
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Where on the tRNA molecule is the site for AA binding?
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3' end
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What are the components of the VACTERL syndrome?
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Vertebral defects
Anal atresia Cardiac abnormalities Tracheoesophageal fistula Esophageal atresia Renal anomalies Limb anomalies |
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Is VACTERL more common than isolated urogenital tract anomalies?
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NO
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Timeline of changes in the brain following thrombosis/embolism:
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12 to 48 hours: Red neurons
24 to 72 hours: Necrosis, neutrophils 3-5 days: Macrophages 1 to 2 weeks: Reactive gliosis; Liquefactive necrosis > 2 weeks: Glial scar; Cystic area surrounded by gliosis |
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Antisocial vs Avoidant Personality Disorders?
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Avoidant: socially uncomfortable, want acceptance
Antisocial: Conduct disorder in person > 18 |
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What causes an S3?
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-Forceful, rapid filling of a ventricle that has normal or elevated compliance
-Blood flowing into an overfilled ventricle w/ high end-systolic volume |
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Early serum marker of HCC?
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AFP
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Diagnostic marker for CRC?
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CEA
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What is acute acalculous cholecystitis?
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Inflammation of the gallbladder in the absence of gallstones
Most commonly seen in the hospitalized & severely ill |
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Which drugs are narrow spectrum anticonvulsants? What do we use them for?
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-Carbamazepine
-Gabapentin -Phenobarbitol -Phenytoin Use for focal onset seizures |
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Which drugs are broad spectrum anticonvulsants? What do we use them for?
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Valproic acidLamotrigineTopiramateLevetiracetam
Use for most seizure types |
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Methadone is the drug of choice for treating heroin addiction & abuse. How does it act?
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-Long half life allows for prolonged effects to suppress withdrawal symptoms in heroin dependent patients
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For the probably of independent events happening simultaneously, do we add their individual probabilities or multiply them?
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Multiply
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Bilateral parotid gland enlargement
Erosion of tooth enamel Irregular menses ------------------------- Diagnosis? |
Bullimia nervosa
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Polyethylene glycol & Magnesium Hydroxide are what kinds of drugs?
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Osmotic Laxatives
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Is uptake of unconjugated bilirubin into the liver an active or passive process?
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Passive
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Is secretion of conjugated bilirubin into the biliary system an active or passive process?
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Active transport by ATP-binding cassette protein MRP2
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Is unconjugated or conjugated bilirubin more water soluble?
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Conjugated
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Cardivascular dysphagia usually results from compression on the esophagus by which structure?
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LEFT atrium
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Stomach vasculature
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Impaired absorption of which amino acids is seen in cystinuria?
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COLA:
-Cysteine -Ornithine -Lysine -Arginine |
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What is a commonly associated condition w/ temporal arteritis?
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Polymyalgia rheumatica
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Alternative equation for calculation of RBF? (if hematocrit is provided)
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PAH clearance/(1-hematocrit)
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Long vs short acting insulins
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Long = NPH, Glargine, Detemir
Short = Regular, Lispro, Aspart, Glulisine |
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Which nerve innervates the muscles of mastication?
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CN V3 (mandibular nerve)
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Within 12 to 18 hours of fasting, what is the primary source of the body's glucose? What about after 18 hours?
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1. Glycogen breakdown
2. Gluconeogenesis |
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How do OCPs inhibit ovulation?
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Decrease synthesis of FSH & LH in the anterior pituitary
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Isolated transient numbness & tingling in an extremity:
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Transient ischemic attack
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SVC syndrome vs brachiocephalic vein compression?
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Brachiocephalic vein compression = unilateral
SVC compression = bilateral |
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Adrenal medulla is located where?
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Deep to the zona reticularis of the cortex
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Fates of TB
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In terms of kidney development, what does the mesonephros form? |
1. Wolffian ducts 2. Uteric bud |
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What does the uteric bud become? |
- Collecting tubules, ducts - Major & minor calyces - Renal pelvis - Ureters |
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What does the metanephros become? |
- Glomeruli - Bowman's space - PCT --> Loop --> DCT |
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Counts of this cell type increase following glucocorticoid administration -- why? |
- Neutrophil count increases - This is the result of "demargination" of leukocytes previously attached to the vessel wall |
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PCOS patients are at an increased risk of development of which 2 diseases? |
- Endometrial adenocarcinoma - Type II diabetes |
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MOA of ticlodipine? Rare side effect of ticlopidine? |
- ADP blocker (like clopidogrel) - S/E: Neutropenia, mouth ulcers, fever |
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What is Meniere's disease? What is its pathogenesis? |
Episodic vertigo, tinnitius Eventual hearing loss ------------- Related to increased volume & pressure of endolymph in the vestibular apparatus |
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Treatment for adenoma secreting ALDO? |
Aldosterone antagonists (Spirinolactone, Eplerenone) |
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Which bacteria produce IgA proteases? Where does IgA protease act? |
- N. meningitidis - N. gonorrhoeae - Strep pneumoniae - H. flu ------------------------------- IgA protease cleaves secretory IgA at its hinge region |
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Which type of tumor is often associated w/ past arsenic or polyvinyl chloride exposure? Hint: this tumor also stains positive for CD31 cell marker |
Liver angiosarcoma - CD31 = PECAM 1 |
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Staph epidermis -- what is the most important virulence mechanism by which it causes disease? |
Biofilm synthesis Biofilm = extracellular polysaccharide matrix |
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What does this stain show? |
Cryptococcus neoformans w/ India ink stain (thick polysaccharide capsule is seen as peripheral clearing) |
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Which diuretics do we most commonly use in acute settings? |
IV Loop Diuretics |
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When trying to cool down body temperature emergently, what is the order of treatment? |
- Cool down body (cold towels) - THEN give antipyretics (eg: acetaminophen) |
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Effect of carbon monoxide? |
- No effect on methemoglobin - No effect on PaO2 - DECREASE to amount of hemoglobin available to bind O2 - Leftward shift of Hemoglobin-oxygen dissociation curve; reflecting a decreased tendency for oxygen to unload in the tissues |
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Sucrose = Lactose = Maltose = |
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Diabetic CN III neuropathy vs Aneurysmal compression of CN III |
In diabetic CN III -- eye is down & out In aneurysmal compression -- early sign is dilated pupil & loss of accommodation (hitting the superficial parasympathetic efferents first) |
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Cross section of the cerebrum; anatomy |
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Pancreatic pseudocysts are complications of acute pancreatitis (4 to 6 weeks after). What is it made of? |
Collection of fluid rich in enzymes & inflammatory debris Its walls consist of granulation tissue & fibrosis |
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What is the coronary steal phenomenon? |
Administration of certain drugs can cause a redistribution of blood flow away from ischemic areas & thus exacerbating existing myocardial ischemia |
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Which drugs are selective vasodilators of coronary vessels? |
- Adenosine - Dipyridamole |
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What are the 2 ways to differentiate between CML & Leukemoid reaction? |
Both cause WBC to increase... but in a Leukemoid reaction: - Neutrophil alkaline phosphatase is normal or elevated - Leukocyte alkaline phosphatase is LOW |
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Complication of patients receiving equivalent of more than one body blood volume (5 to 6 liters) of whole blood or packed RBCs over a period of 24 hours: |
- Elevated plasma levels of citrate - Citrate chelates Ca2+ & Mg2+ & reduces their plasma levels - This causes paresthesias |
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Tissue damage & resultant abscess formation is primarily caused by what pathologic process? |
Lysosomal enzyme release from neutrophils & macrophages |
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Local defense against fungal infections is performed by which cells? What about against systemic fungal infections? |
Local -- T cells Systemic -- Neutrophils |
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Etiology of serum sickness? |
Following administration of: - Chimeric monoclonal antibodies (2 is) - Nonhuman immunoglobulins (eg: venom antitoxins) - Certain nonprotein drugs (penicillin, TMP-SMX) |
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Symptoms of serum sickness? |
Fever, pruritic skin rash, arthralgias that begin 1 to 2 weeks after exposure to an antigen Patient could also have lymphadenopathy & proteinuria |
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Histologic examination of someone w/ serum sickness shows: |
Small vessel vasculitis w/ fibrinoid necrosis & intens neutrophil infiltration |
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Rare complication of measles that occurs several years after apparent recovery from initial infection |
Subacute sclerosing panenecephalitis - Accumulatino of viral nucleocapsids within neurons & oligos --> results in formation of intranuclear inclusions & eventually leads to inflammation, demyelination, and gliosis in many cerebral areas |
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Cell marker of hematopoietic stem cell |
CD 34 |
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Causes of aplastic anemia |
- Autoimmune - Infections (PVB19, EBV) - Drugs (Carbamazepine, chloramphenicol, sulfonamides, linezolid) - Exposure to radiation of toxins (Benzene, solvents) |
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What is the most common clinical manifestation of primary HSV1 infection? |
Herpetic gingivostomatitis |
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How do acetylcholine & adenosine work on pacemaker cells? |
Reduce the rate of spontaneous depolarization |
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Important complication of concentrated O2 therapy for neonatal respiratory distress syndrome |
Retinopathy of prematurity; abnormal retinal neovascularization (major cause of blindness in developed nations) |
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What is the most common site of injury in the aorta secondary to blunt trauma? |
Aortic isthmus; is tethered by the ligamentum arteriosum & is relatively fixed and immobile compared to the adjacent descending aorta |
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Timeline of events in sudden cardiac death: |
Acute MI --> Vfib --> Sudden cardiac death |
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NSAIDs & colchicine inhibit which type of cells? |
Neutrophils |
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Primary VZV vs Reactivation VZV |
Primary -- chickenpox Reactivation -- Dermatome-centered vesicular painful rash (shingles) |
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Locations of the 3 different groin hernias |
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How is work of breathing minimized in restrictive vs obstructive disease? |
Restrictive: Fast, shallow breaths Obstructive: slow, deep breaths |
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Summary of location of antifungal action sites: |
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3 main associations w/ pure red cell aplasia? |
- Thymoma - Lymphocytic Leukemias - Parvovirus B19 infection |
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What is Busiprone? What's it used for? How are its side effects? |
- 5HT1A receptor agonist - Used for generalized anxiety disorder - No muscle relaxant, sedative, or euphoric effects |
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Common locations for ischemic ATN injury? |
PCT & Loop of Henle |
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Requirement for referral to hospice care? |
- Survival prognosis of ≤ to 6 months |
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Charcot Bouchard aneurysm vs Hypertensive arteriolar sclerosis |
BOTH involve the internal capsule - Charcot bouchard = hemorrhagic stroke; will show up on initial CT - Hypertensive arteriolar sclerosis = No abnormalities on initial CT; weeks later shows lakelike cavitary lesion |
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Locations that would result in the following stroke scenarios: 1. Pure motor hemiparesis 2. Pure sensory stroke 3. Ataxia-hemiplegia syndrome 4. Dysarthria-clumsy hand syndrome |
1. Posterior limb of internal capsule or basal pons 2. VPL or VPM thalamus 3. Posterior limb of internal capsule or basal pons 4. Genu of internal capsule or basal pons |
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Factors that promote renal calculi formation: |
- Increased Ca, phosphate, oxalate, uric acid - Acidic pH for uric acid & cystine stones |
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Factors that help prevent calculi formation: |
- Increased citrate
- High fluid intake |
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Acetaminophen toxicity is treated by N-acetyl cysteine. How does this drug work? (2 ways) |
1. Provides sulfhydryl group to enhance non-toxic sulfation elimination of acetaminophen 2. Acts as a glutathione substitute and binds to the toxic metabolite |
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2 things you can do to accentuate an S3 sound? |
- Patient li in left lateral decubitus position - Fully exhale & listen at end exhalation |
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Metyrapone stimulation test is used for... |
Indicator of HPA axis integrity - Inhibits 11 beta hydroxylase --> blocking cortisol synthesis - Reduction in cortisol levels causes an increase in ACTH secretion - Look for rise in serum 11 deoxycortisol & urinary 17 hydroxycorticosteroid levels --> indicating intact HPA axis |
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Define some general principle terms: 1. Reassortment 2. Recombination 3. Transformation 4. Interference 5. Phenotypic mixing |
1. Changes in genomic composition that occur when host cells are co-infected w/ 2 segmented viral strains 2. Exchange of genes btwn 2 chromosomes 3. Uptake of naked DNA 4. Inhibition by one virus of replication/release of 2nd virus 5. Coinfection of host cell by 2 viral stains -- resulting in progeny virions that contain nucleocapsid proteins from one strain & genome of the other |
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Is risk of sexual transmition greater w/ Hep B or Hep C? |
Hep B!! |
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EBV is associated w/ lymphomas. These are B cell in origin. But just to clarify: - EBV causes reactive CD8+ T cells to be weird - BUT EBV infects B cells |
Yep. |
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Summary of Catalase negative Strep |
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What is hydrocephalus ex vacuo? |
Ventricular enlargement secondary to atrophy of the brain (eg: in Alzheimers, Pick disease) NOTE: CSF pressure is not increased in hydrocephalus ex vacuo |
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Explanation of Erythroblastosis fetalis |
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Innervation of the larynx: |
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Most common subtype of lung cancer? |
Adenocarcinoma |
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Central chemoreceptors (medulla) sense... Peripheral chemoreceptors (carotid & aortic bodies) sense... |
Central... PaCO2 Peripheral... PaO2 |
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Major virulence factor of Salmonella? |
Vi antigen capsule -- protects it from opsonization |
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Describe the molecular process of liquefactive necrosis |
Lysosomal digestion of tissue |
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Malignant HTN effects on vessels: |
Hyperplastic arteriosclerosis: - Homogenous, onion-like concentric thickening of the walls of the arterioles |
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Long standing nonmalignant HTN OR Diabetes effects on vessels: |
Hyaline arteriosclerosis: - Homogenous deposition of eosinophilic hyaline material in the intima & media of small arteries & arterioles |
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Killed bacterial vaccines: |
- Oral cholera vaccine |
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Live attenuated bacterial vaccines: |
- BCG - Oral Typhoid - Varicella |
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Recombinant surface protein vaccine |
Hep B |
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Inactivated (Toxoid) vaccines: |
- Diptheria - Tetanus |
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Capsular polysaccharide vaccines: |
- N. meningitidis - H. influenzae (+ diptheriae toxoid) - Strep pneumoniae |
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Sacral |
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Cervical |
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Lumbar |
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Thoracic |
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Factors that decrease likelihood of gallstone formation: |
- Low cholesterol - High bile salts - High phosphatidylcholine |
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Group A Strep (Strep pyogenes) is Beta hemolytic, bacitracin, susceptible, and _____ positive |
Pyrrolidonyl arylamidase-positive (PYR positive) |
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What is the one "intermediate" acting Benzo: |
Lorazepam |
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Individual subunits of hemoglobin are structurally analogous to _______ |
Myoglobin |
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The radial nerve divides into motor (deep) & sensory (superficial) components at which of the following locations |
Head of the radius |
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Before reaching the wrist, the median nerve courses between the: |
Flexor digitorum superficialis |
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Genes related to early & late onset Alzheimers: |
Early: - APP (21) - Presenilin 1 (14) - Presenilin 2 (1) Late: - E4 allele of Apo E -- involved in formation of senile plaques |
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This enzyme has a molecular weight of 72 kD |
COX 2 |
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Enzyme that is deficient in: 1. Tay Sachs 2. Metachromatic Leukodystrophy 3. Fabry 4. Farber disease |
1. Beta Hexosaminidase A 2. Arylsulfatase A 3. Alpha-galactosidase 4. Ceramidase |
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Level of fluid volume in SIADH patients: |
Normal |
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Fluid Compartments of the body: |
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When taking 1st generation H1-histamine antagonists (diphenhydramine, chlorpheniramine) -- avoid these medications: |
Benzodiazapines -- risk of significant sedation when used in combo |
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PCR amplifies regions of DNA that are: |
Complementary, flanking DNA |
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Converting Alanine to glucose requires this enzyme: |
Alpha ketoglutarate |
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Describe the changes that cause amenorrhea in a patient suffering from anorexia: |
1. Body fat decreases to abnormally low levels 2. Normally cyclic LH surge is lost 3. Hypogonadotropic amenorrhea develops ------------ LOW levels of LH, FSH, estradiol, estrone |
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Class 1C antiarrhythmics exhibit use-dependence; what is this phenomenon? |
- Sodium blocking effects intensify as the heart rate increases due to less time between APs for the medication to dissociate from the receptor (IC stay attached to their receptor the longest) |
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These class of antiarrhythmics exhibit reverse use dependence; what does this mean? |
Class III antiarrhythmics - The slower the heart rate, the more the QT interval is prolonged There is no effect on QRS duration; only the QT interval |
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Typically, how does exercise effect QRS complex duration? |
Slightly reduced during exercise in response to the increase in cardiac conduction velocity that accompanies faster heart rates |
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When does each manifest? 1. ADPKD 2. ARPKD |
1. ADPKD -- in 40s/50s 2. ARPKD -- at birth |
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MAIN difference between anorexia & bulimia: |
-Bulimia patients maintain body weight BUT BOTH THROW UP |
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Most likely long-term complicatino of hydrocephalus |
Muscle hypertonicity |
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Use this drug for motion sickness. What is its MOA? |
Scopolamine; muscarinic antagonist |
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Long term corticosteroids has this effect on the HPA axis: |
Suppression: LowCRH, ACTH, Cortisol |
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High mortality rate observed in infected pregnant women is a concerning feature of this virus: |
Hepatitis E |
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Physicians are justified in obtaining a court injunction to proceed w/ life-saving medical treatment of a child |
Fact. |
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Pancreatic enzymes are not required for absorption of... |
Monosaccharides (eg: glucose, galactose, D-xylose) |
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Digoxin, ACE inhibitors improve ____ in CHF |
Morbidity |
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Beta blockers (particularly carvedilol) decrease ____ in CHF |
Mortality |
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Hoarseness & breathlessness in cardiomyopathy is due to: |
Left atrial enlargement causing laryngeal nerve impingement |
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Immunohistochemical markers for: 1. Lymphoid 2. Epithelial 3. Myeloid 4. Mesenchymal 5. Neuroendocrine |
1. CD20 for B cells, CD3 for T cells 2. Cytokeratin 3. MPO 4. Vimentin 5. Chromogranin A |
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Tryptophan is a precursor for these 3 AAs: |
- Nicotinic acid - Serotonin - Melatonin |
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Symptomatic Hartnup disease: |
- Photosensitivity - Pellagra-like skin rashes - Neurologic involvement --> ataxia |
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What are the 3 genetic mechanisms that can cause Down's Syndrome? |
- Trisomy 21 - Unbalanced Robertsonian translocation - Mosaicism |
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If child abuse is suspected... |
Contact child protective services immediately |
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How to treat paroxysmal supraventricular tachycardia (non-pharmacologically) |
- Carotid massage - Valsalva maneuver |
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How to execute a Valsalva maneuver? |
-Forcibly exhale against closed glossitis - the rectus muscles are recruited in this process; they play the biggest role in development of the resultant elevated intra-abdominal & intrathoracic pressure during this movement |
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High levels of ____ & ____ prevent lactogenesis while also promoting breast growth & development during pregnancy |
Estrogen & progesterone |
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Most negative to positive Hemogoglobin types |
A >>> S >>> C (A is most negative) |
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Gel electrophoresis findings for multiple hemoglobinopathies |
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Treatment w/ statins causes an increase in ____ |
Hepatocyte LDL receptor density as a means of increasing their uptake of circulating LDL |
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In tumor lysis syndrome, the principal site of uric acid precipitation is ______ |
Collecting ducts due to low urine pH (uric acid is soluble at physiologic pH but can precipitate in the normally acidic environments of the DCT & collecting ducts) |
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Effects of verapamil on Cardiac pacemaker cells vs cardiac myocytes |
Pacemakers: slows diastolic depol Cardiac Myocyte: Decreases amount of intracellular calcium available for excitation-contraction coupling |
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Inflammatory macrophages in the intima may reduce plaque stability by secreting _____, which degrade collagen |
Metalloproteinases |
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NPH pathophysiology: |
- Decreased CSF absorption --> increase in CSF Vol - Accommodation by ventricular enlargement - Stretching of descending cortical fibers |
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Treatment of PCOS: describe each component |
- Spirinolactone (androgen receptor antagonist); used to treat hirsutism & acne - OCPS; protect against unopposed estrogen - Clomiphene (estrogen receptor modulator that decreases negative feedback inhibition on the hypothalamus); fertility |
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Presentation of a patient w/ vaginal agenesis: |
- No upper vagina - Variable uterine development - XX females w/ normal ovaries & secondary sexual characteristics |
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We can use this exam method to identify Kayser-Fleischer rings in Wilson disease patients |
Slit lamp examination |
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Most rat poisons contain 4-hydroxycoumarin derivatives. What would we give as an antidote here? |
FFP & Vit K |
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Cryoprecipitate is composed of what? |
- Factors 8, 13, vWF, Fibrinogen |
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Things that predispose to cholesterol gallstones: |
- Estrogen (increases HMG-CoA reductase activity) - Fibrate use (inhibits cholesterol 7alpha hydroxylase -- reducing the conversino of cholesterol to bile acid) - Octreotide, ceftriaxone |
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Urinary content of DKA patients: |
Low PH Low Bicarb High H2PO4 |
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Nonpathogenic C. diptheriae can cause severe pseudomembranous pharyngitis after_____ |
Acquiring Tox gene via lysogenization by a temperate bacteriophage --> permitting exotoxin production |
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Treatments of Psoriasis: |
- Cyclosporine (NFAT inhibitor... can't enter nucleus & modulate transcription activity... can't produce IL-2... can't activate T cells) - Vitamin D analogs (calcipotriene/calcipotriol, calcitriol, tacalcitol) -- bind to & activate Vit D receptor (nuclear transcription factor) ---> causes inhibition of keratinocyte proliferation & stimulation of keratinocyte differentiation |
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Function of Theca interna & granulosas cells |
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Mutations of genes that code for epidermal growth factor receptors are associated w/: |
- erbB1 (non-small cell lung carcinoma) -erbB2 OR HER2/neu (breast cancer) -Some ovarian & gastric tumors |
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Abnormal Rb gene predisposes to development of ... |
Retinoblastoma Osteosarcoma |
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Round acidophilic bodies stain pink on H & E -- they indicate which pathologic process? |
Apoptosis |
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Cross sectional study vs ecological study |
Cross section: evaluates exposures & outcomes in individuals Ecologic: evaluates exposures 7 outcomes in populations |
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Symptoms of Legionaire's disease: |
- Often affects smokers - High fever, diarrhea, headache, confusion - Often shows hyponatremia |
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These drugs can often produce the same abnormal lab results as an insulinoma (high insulin, C peptide) |
Sulfonylurea, Meglitinide (like sulfonylureas) - both cause increase in endogenous insulin release |
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Clue cell vs Koilocyte |
Clue cell: bacterial vaginosis Koilocyte: HPV |
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When LAD is occluded... use the ____ for bypassing graft |
Left internal mammary (thoracic) artery
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When multiple coronary arteries or vessels other than the LAD require revascularization, use the ____ vein This vein can be best harvested where? |
Great saphenous vein
Best harvested just superior to the inguinal ligament |
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CFTR is a ____ -binding casette transmembrane ion transporter |
ATP |
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Sheehan's syndrome is what type of pathologic problem? |
Ischemic necrosis |
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Axial cut up by the heart. Which structure is most likely to be damaged in a stab wound at the 4th intercostal space? |
Right Ventricle |
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Is mitochondria vacuolization reversible or irreversible cell injury? |
Irreversible; signifies that the involved mitochondria are permanently unable to generate ATP |
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Which drugs have a risk of QT prolongation? Which drug has the LOWEST risk of torsades de pointes development? |
- Type III antiarrhythmics - Type I antiarrhythmics - Macrolides LOWEST risk of torsades: Amiodarone |
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What is Beck's triad observed on physical exam of a patient w/ cardiac tamponade? |
- JVD - Hypotension - Distant or muffled heart sounds |
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Fixing an ASD is to avoid irreparable damage to the: |
Pulmonary vessels |
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Power = 1 - beta What is beta? |
Beta = Type II error (false negative -- concluding there is no difference when there is one in reality) |
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Prevent neonatal tetanus by: |
Vaccination of pregnant women |
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Diffuse thickening of pleura + columnar cells joined by desmosomes + long microvilli = |
Mesothelioma |
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Romantic relationships with current patients is always unethical. Relationships with former patients may be acceptable on a case-by-case basis |
Fact |
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Basic interviewing techniques: - Facilitation - Empathy - Reflection - Confrontation - Support |
Facilitation: "And then what happened?" Empathy: "I can imagine how ___" Reflection: "So you're telling me ___" Confrontation: Draw discrepancies in responses Support: express concern independent of understanding |
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These cytokines help stimulate acute phase reactants (eg: fibrinogen); thus these would elevate ESR |
IL-1, TNF alpha, IL-6 |
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CMV has increased sensitivity to ganciclovir b/c of differences in ____ |
Viral DNA pol structure |
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Acyclovir & related drugs are more effective against HSV 1, 2 & VZV than CMV & EBV b/c of ____ |
Differences in drug phosphorylation rates |
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TCA-associated cardiac abnormalities include _____ They are treated w/ _____ |
QRS prolongation, PVCs, Tachycardia Treat w/ Na+ Bicarb |
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"Blotchy red muscle fibers on Gomori technique stain" are characteristic of ____ Same as "red ragged" muscle fibers |
Mitochondrial myopathies Abnormal mitochondria accumulation under the sarcolemma Mitochondrial diseases show maternal inheritance |
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RCC tumor cells show rounded/polygonal cells w/ abundant clear cytoplasm b/c of accumulation of _____ |
Glycogen & lipids |
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Elevated levels of ____ confirm menopause |
FSH (& LH too but is later & less prominent phenomenon) |
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Crescent formation is seen on _____ C3, IgG deposition are seen on ____ |
- Light microscopy - Immunofluorescence |
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Crescent formation in RPGN consists of: |
- Fibrin - Macrophages/monocytes - Glomerular parietal cells |
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Subacute bacterial endocarditis is caused by Viridans streptococci. They adhere to pre-damaged valves by adhering to |
Fibrin-platelet aggregates |
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N-myc protein is a ____ |
transcription factor |
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Axial cut demonstrating differences between SVC, descending aorta, ascending aorta |
The esophagus courses between the trachea & vertebral bodies; It is typically collapsed w/ no visible lumen |
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Vascular reaction to endothelial & intimal injury is intimal hyperplasia & fibrosis This reaction is predominantly mediated by ________ that migrate from the media to the intima |
Reactive smooth muscle cells |
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What is commonly the first symptom reported by women suffering from Primary Biliary Cirrhosis (PBC)? |
Pruritis (especially at night) Diagnosis is confirmed via Anti-mitochondrial antibodies in serum |
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This image indicates a diagnosis of: |
Cocciodes immitis: large spherule filled w/ small round endospores |
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Types of urinary incontinence: |
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This drug is a phosphodiesterase inhibitor used in patients w/ intermittent claudication In addition, this drug also inhibits platelet aggregation |
Cilostazol |
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The portal triad runs through the _____ ligmanet. It is composed of: |
Hepatoduodenal ligament Composed of: - Hepatic Artery - Portal vein - Common bile duct |
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Effects on nicotinic & muscarinic ACh receptors by: 1. Muscarinic antagonists 2. Botulinum neurotoxin 3. Organophosphates |
1. Inhibit postsynaptic action of ACh 2. Blocks presynaptic excosytosis of ACh vesicles 3. Prevent degradation of ACh within the synaptic cleft |
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Loss of consciousness brought on by severe hypoglycemia is treated w/ ____ |
IM glucagon in the nonmedical setting IV dextrose in the medical setting |
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Normal pressures in the cardiac chambers & pulmonary artery |
- L side pressure > R side pressure - Atria pressure max about = to 10 -RV pressure max = 25 - Aortic & LV pressures = close to systolic BP |
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Brown pigment stones typically arise secondary to infection of the biliary tract, which results in the release of ______ by injured hepatocytes & bacteria Presence of this enzyme increases amount of unconjugated bilirubin in bile |
Beta glucuronidase |
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Upper GI ulcerations (jejunal ulcers are specific), abdominal pain, and diarrhea |
Symptoms of gastrinoma |
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Common cause of orthostatic hypotension in a pregnant woman > 20 weeks gestation? |
Compression of IVC by uterus while in supine position --> reduced venous return & CO |
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Cephalic & gastric phases stimulate ____ |
Gastric acid secretion |
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The H. flu type b vaccine is composed of _____, a component of the organism's capsule, conjugated w/ diphteria or tetanus toxid |
Polyribosyl-ribitol-phosphate (PRP) |
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NFKB is elevated in Crohn's. This protein is responsible for.... |
Cytokine production |
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Most serious s/e of digoxin? |
Life-threatening Ventricular Arrhythmia |
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Phenobarbital is a metabolite of this drug used first-line for the treatment of benign essential tremor |
Primidone |
