10/3/12 b Flashcards
How are coagulation times affected by TTP?
Only bleeding time increased.
What coagulation time is increased in vWF disease?
Only PTT – factor VII def!
What are the differences in clinical presentation of DIC and TTP?
DIC - bleeding
TTP - neurological manifestations, purpura
What immune components mediate hemolysis in paroxysmal nocturnal hemoglobinuria?
Complement
What blood cells are depleted in PNH?
All - plts, leukocytes, and rbcs.
What is the histological change that results in the Esophageal dysmotility of CREST syndrome?
replacement of smooth muscle w/ fibrous tissue –> dilation of esophagus and LES
What are the clinical manifestations of the esophageal dysmotility of CREST?
heartburn, reflux, dysphagia
What does a “bird’s beak” esophagus on barium swallow indicate?
Achalasia (clamped shut LES)
What causes a barium esophagogram with a “corkscrew” esophagus?
diffuse esophageal spasm (DES)
Abdominal and flank bruits, during both systole and diastole are pathognomonic for …
renal artery stenosis
Why should you be cautious about giving ACE-I’s to pts w/ renal artery stenosis?
Glomerular filtration dependent on angiotensin II
What would cause renal artery stenosis in a young woman?
fibromuscular dysplasia
If an infection causes the release of beta-glucuronidase, what might be formed in the biliary tract? What did the enzyme do?
pigment stones; unconjugated bilirubin
Young pt w/ recurrent kidney stones and hexagonal crystals in urine. Sodium cyanide-nitroprusside test turns pee purple. Dx?
cystinuria
“A solid mass that projects into the stomach lumen (and may become ulcerated), consisting of columnar or cuboidal mucus-secreting cells” describes which type of gastric adenocarcinoma?
intestinal-type
What are the type of cells found in “linitis plastica” (leather bottle stomach)? What are they filled with?
signet-ring cells; mucin
What is the Arnold-Chiari malformation?
Underdeveloped posterior fossa causes pts of cerebellum (e.g. tonsils) and/or medulla to herniate through the foramen magnum.
What is phenoxybenzamine?
an irreversible, non-selective α-receptor antagonist
What is phentolamine?
a reversible, non-selective α-antagonist
Do right- or left-sided murmurs increase on inspration?
right (more action going on in the RV)
Do right- or left-sided murmurs increase on expiration?
left
What is the effect of the Valsalva manoeuvre on intrathoracic pressure? Intrapulmonary pressure? Stroke volume?
all up
What is the effect of the Valsalva manoeuvre on heart murmurs?
most diminish, except HCM and MVP
What is the effect of the Valsalva manoeuvre on systemic venous return to the heart?
decreased
What other manoeuvre causes most murmurs to diminish, except HCM and MVP?
standing
What is the effect of squatting or passive leg raising on murmurs?
most inrease, except HCM and MVP
Which murmurs become louder w/ hand squeezing?
mitral and aortic regurg and VSD
Which murmur diminishes w/ hand grip exercise?
hypertrophic cardiomyopathy
