10/3/12 b

Question 1

How are coagulation times affected by TTP?

Answer 1

Only bleeding time increased.

Question 2

What coagulation time is increased in vWF disease?

Answer 2

Only PTT – factor VII def!

Question 3

What are the differences in clinical presentation of DIC and TTP?

Answer 3

DIC - bleeding

TTP - neurological manifestations, purpura

Question 4

What immune components mediate hemolysis in paroxysmal nocturnal hemoglobinuria?

Answer 4

Complement

Question 5

What blood cells are depleted in PNH?

Answer 5

All - plts, leukocytes, and rbcs.

Question 6

What is the histological change that results in the Esophageal dysmotility of CREST syndrome?

Answer 6

replacement of smooth muscle w/ fibrous tissue –> dilation of esophagus and LES

Question 7

What are the clinical manifestations of the esophageal dysmotility of CREST?

Answer 7

heartburn, reflux, dysphagia

Question 8

What does a “bird’s beak” esophagus on barium swallow indicate?

Answer 8

Achalasia (clamped shut LES)

Question 9

What causes a barium esophagogram with a “corkscrew” esophagus?

Answer 9

diffuse esophageal spasm (DES)

Question 10

Abdominal and flank bruits, during both systole and diastole are pathognomonic for …

Answer 10

renal artery stenosis

Question 11

Why should you be cautious about giving ACE-I’s to pts w/ renal artery stenosis?

Answer 11

Glomerular filtration dependent on angiotensin II

Question 12

What would cause renal artery stenosis in a young woman?

Answer 12

fibromuscular dysplasia

Question 13

If an infection causes the release of beta-glucuronidase, what might be formed in the biliary tract? What did the enzyme do?

Answer 13

pigment stones; unconjugated bilirubin

Question 14

Young pt w/ recurrent kidney stones and hexagonal crystals in urine. Sodium cyanide-nitroprusside test turns pee purple. Dx?

Answer 14

cystinuria

Question 15

“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?

Answer 15

intestinal-type

Question 16

What are the type of cells found in “linitis plastica” (leather bottle stomach)? What are they filled with?

Answer 16

signet-ring cells; mucin

Question 17

What is the Arnold-Chiari malformation?

Answer 17

Underdeveloped posterior fossa causes pts of cerebellum (e.g. tonsils) and/or medulla to herniate through the foramen magnum.

Question 18

What is phenoxybenzamine?

Answer 18

an irreversible, non-selective α-receptor antagonist

Question 19

What is phentolamine?

Answer 19

a reversible, non-selective α-antagonist

Question 20

Do right- or left-sided murmurs increase on inspration?

Answer 20

right (more action going on in the RV)

Question 21

Do right- or left-sided murmurs increase on expiration?

Answer 21

left

Question 22

What is the effect of the Valsalva manoeuvre on intrathoracic pressure? Intrapulmonary pressure? Stroke volume?

Answer 22

all up

Question 23

What is the effect of the Valsalva manoeuvre on heart murmurs?

Answer 23

most diminish, except HCM and MVP

Question 24

What is the effect of the Valsalva manoeuvre on systemic venous return to the heart?

Answer 24

decreased

Question 25

What other manoeuvre causes most murmurs to diminish, except HCM and MVP?

Answer 25

standing

Question 26

What is the effect of squatting or passive leg raising on murmurs?

Answer 26

most inrease, except HCM and MVP

Question 27

Which murmurs become louder w/ hand squeezing?

Answer 27

mitral and aortic regurg and VSD

Question 28

Which murmur diminishes w/ hand grip exercise?

Answer 28

hypertrophic cardiomyopathy