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Final FA review > 2/18 > Flashcards

2/18 Flashcards

1
Q

Satiety center of hypothalamus

A
  • Ventromedial area.
  • “If you zap your ventromedial area, you will grow both ventrally and medially”.
  • stimulated by leptin.
  • damage may be caused by craniopharyngioma.
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2
Q

Hunger center of hypothalamus

A
  • Lateral area.
  • “If you zap your lateral nucleus, you will shrink laterally.”
  • inhibited by leptin.
  • Lat makes you Fat.
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3
Q

Ant. hypothalamus

A

-cooling, parasymp.

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4
Q

Post. hypothalamus

A

-heating, sym.

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5
Q

Stroke to PCA

A
  • occipital cortex, visual cortex.

- contralat. hemianopia w/macular sparing.

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6
Q

Where can the great saphenous vein be harvested from?

A

-just inferolateral to the pubic tubercle.

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7
Q

Whats a common way to get Klumpke palsy and what are symptoms?

A
  • grabbing tree branch while falling.
  • Lower trunk (C8-T1) of brachial plexues.
  • total claw hand. clumsiness of hand.
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8
Q

What is the only muscle innervated by the ext. branch of the sup. laryngeal nerve?

A

Cricothyroid muscle

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9
Q

What nerve is at risk during a thyroidectomy?

A

External branch of superior laryngeal nerve. Due to its proximity to the superior thyroid a/v.
-this nerve inn. the cricothyroid muscle. Which is the only muscle of the larynx not inn. by the reccurent laryngeal.

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10
Q

Where does thoracic duct enter thorax?

A
  • aortic hiatus

- so does azygos vein.

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11
Q

Where does vagus n. enter abdominal cavity?

A

-T10, esophageal hiatus.

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12
Q

Portocaval anastomoses (PCAs): esophageal varices

A
  • portal circ: left gastric vein

- systemic circ: esophageal vein

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13
Q

PCAs: hemorrhoids

A
  • portal circ: superior rectal vein

- systemic circ: middle & inferior rectal veins

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14
Q

PCAs: caput medusae

A
  • portal circ: paraumbilical veins

- systemic circ: superficial & inferior epigastric veins

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15
Q

Obturator n.

  • nerve roots
  • muscules
A
  • L2-L4. “Kobe is a smooth obturator”.

- adductors

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16
Q

Common peroneal (fibular) n.

  • nerve roots
  • muscles
  • how to injure?
A

-L4–S2
-tibialis anterior = only need to know muscle.
-Trauma or compression of lateral aspect of leg,
fibular neck fracture
-you get foot drop.

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17
Q

Tibial n.

  • roots
  • how to injure
  • problems s/p injury
A

-L4-S3
-Knee trauma, Baker cyst (proximal lesion); tarsal tunnel syndrome (distal lesion).
-Inability to curl toes and loss of sensation on sole
of foot. In proximal lesions, foot everted at rest
with loss of inversion and plantarflexion.

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18
Q

Diseaes that can damage superior gluteal nerve?

A

Polio

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19
Q

PED

A

Peroneal Everts and Dorsiflexes; if injured, foot drop PED

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20
Q

TIP

A

Tibial Inverts and Plantarflexes; if injured, can’t stand on TIPtoes.

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21
Q

Which responds to aspirin (pain-wise):

Osteoid osteoma or osteoblastoma?

A

osteoid osteoma.

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22
Q

Whats the only tumor we need to know about that arises in the epiphysis of bone?

A

Giant cell tumor.

  • locally aggressive yet benign tumor often around the knee.
  • “Soap bubble” appearance on x-ray.
  • Multinucleated giant cells.
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23
Q

Where to find osteosarcoma?

A 
-Metaphysis of long bones, often around 
knee.
-malignant prolif. of osteoblasts.
-region of growth plate = metaphysis.
-codman triangle (elevation of periosteum)
-sunburst pattern on x ray
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24
Q

What are the 2 most common bone malignancies in children?

A

Osteosarcoma & ewings sarcoma.

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25
Q

Ewings sarcoma

  • who gets it?
  • where does it appear?
  • what do cells look like?
  • is it responsive to chemo?
A
  • boys <15 yo
  • diaphysis
  • Anaplastic small blue cell malignant tumor
  • it IS responsive to chemo

-“Onion skin” appearance in bone.
-Associated with t(11;22) translocation.
(11 + 22 = 33 (Patrick Ewing’s jersey number).

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26
Q

juvenile rheumatoid (idiopathic) arthritis

  • is rheumatoid factor always present?
  • ANA still positive?
A

rheumatoid factor is often absent. ANA still positive.

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27
Q

RA can get bakers cyst in popliteal fossa

-what are other possible Sxs?

A

subQ rheumatoid nodules = fibrinoid necrosis.

  • fever, fatigue, pleuritis, pericarditis.
  • spiking/remitting fevers = possible.
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28
Q

Whats the most specific test for RA?

A

anti–cyclic citrullinated peptide antibody test.

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29
Q

HLA association w/RA?

A

HLA-DR4

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30
Q

Physical finding in Sjogrens

A
  • dry eyes
  • dry mouth
  • bilateral parotid gland enlargement.
  • dental caries
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31
Q

Gout: joints problems due to which cell?

A

neutrophils

32
Q

Gout: birefringence?

A

neg. birefringence
- yellow under parallel light
- blue under perpendicular light.

33
Q

Psuedogout

-what type of crystals?

A
  • calcium pyrophosphate crystals

- rhomboid crystals

34
Q

Infectious arthritis vs lyme disease?

-what distinguishes them apart?

A

Lyme disease = polyarthritis
Infectious arthritis = mono
-IA: S. aureus, Streptococcus, and Neisseria gonorrhoeae

35
Q

Psoriatic arthritis

  • symmetics or asymmetric?
  • other Sxs?
A
  • Asymmetric and patchy involvement.

- Dactylitis (“sausage fingers”), “pencil-in-cup” deformity on x-ray.

36
Q

Ankylosing spondylitis

-other Sxs

A
  • uveitis
  • aortitis/aortic regurg.
  • bamboo spine (vertebral fusion)
37
Q

3 common drugs that induce lupus?

A

hydralazine, procainamide, isoniazid

38
Q

2 types of nephritis caused by SLE

A
  • Nephritic—diffuse proliferative glomerulonephritis.

- Nephrotic—membranous glomerulonephritis.

39
Q

-10-30% of lupus pts have Lupus Anticoagulant = the
most frequent cause of prolonged PTT & false pos.
VDRL test.

A

Lupus anticoagulant can cause an
antiphospholipid Ab syndrome leading to
hypercoaguability & repeated miscarriages.

40
Q

Drug induced lupus: which auto-ab?

A

anti-histone Ab

41
Q

SLE: C3 and C4 levels?

A

dec. C3, C4, and CH50 due to immune complex

formation.

42
Q

hydroxychloroquine

A
  • Treatment for lupus.

- anti-malarial

43
Q

Sarcoidosis

-associated Sxs

A
  • restrictive lung disease (interstitial fibrosis),
  • erythema nodosum
  • lupus pernio
  • Bell palsy
  • epithelioid granulomas containing microscopic Schaumann and asteroid bodies
  • uveitis
  • hypercalcemia
44
Q

Is there muscle weakness in Polymyalgia rheumatica?

A

no

-also, normal CK

45
Q

Lab values in Polymyalgia rheumatica (50+yo)

A
  • inc. ESR
  • inc. CRP
  • normal CK
46
Q

Fibromyalgia (20-50yo)

  • better or worse w/exercise?
  • emotion/sleep disturbances
  • Tx?
A
  • worse w/exercise
  • treat w/exercise, anti-depressants, anti-convulsants

*multiple, symmetric tender spots.

47
Q

Polymyositis

-CD8 or CD4?

A

CD8

  • shoulders
  • cant brush hair.
48
Q

Dermatomyositis

-CD8 or CD4?

A

CD4

  • malar rash (similar to SLE),
  • Gottron papules
  • heliotrope (erythematous periorbital) rash
  • “shawl and face” rash ,
  • “mechanic’s hands.” 
  • risk of occult malignancy.
49
Q

serum chemistry in polymyositis/dermatomyositis

A

inc.CK, (+) ANA, (+) anti-Jo-1, (+) anti-SRP,

(+) anti-Mi-2 antibodies.

50
Q

LEMS

-dont forget about autonomic problems.

A

dry mouth, impotence.

51
Q

Diffuse scleroderma, Ab?

A

Scl-70 antibody (anti-DNA topoisomerase I antibody)

52
Q

Freckle

A

macule

53
Q

Acanthosis

A

-diffuse epidermal hyperplasia with increased thickness of the stratum spinosum.

54
Q

Hyperkeratosis

A

-thickening of the stratum corneum, often associated with a qualitative abnormality of the keratin.

55
Q

Parakeratosis

-seen in what?

A
  • keratinization with retained nuclei in the stratum corneum. On mucous membranes, parakeratosis is normal.
  • psoriasis, actinic keratosis.
56
Q

Spongiosis

A

-Epidermal accumulation of edematous fluid in

intercellular spaces.

57
Q

Acantholysis

A

Separation of epidermal cells

58
Q

melanin protects against which type of light?

A

UVB

59
Q

Melasma (chloasma)

A

-Hyperpigmentation associated with pregnancy (“mask of pregnancy) or OCP use.

60
Q

Melanin production is stimulated by:

A
  1. Sun exposure
  2. MSH (Melanocyte Stimulating Hormone)
  3. ACTH (Adrenocorticotropic Hormone)
  4. Estrogen
  5. Progesterone
61
Q

Verrucae

A

warts (HPV)

62
Q

congenital nevus vs. melanoma

A

congenital nevus can have hair.

-melanoma will never have hair growing from it.

63
Q

Ephelis

A

freckle

  • normal # of melanocytes.
  • too much melanin/too many melanosomes.
64
Q

Bullous pemphigoid

  • spares which mucosa?
  • blisters contain which cell type?
A
  • oral mucosa

- eosinophils

65
Q

Erythema multiforme

  • most commonly associated w/which infection?
  • which drugs?
A
  • HSV

- sulfa drugs, phenytoin, beta-lactams.

66
Q

Acanthosis nigricans

-associated w/too much of what hormone?

A
  • insulin

- also w/visceral malignancy.

67
Q

Erythema nodosum

  • classic location?
  • associated with?
A

-ant. shins.
-sarcoidosis, coccidioidomycosis, histoplasmosis, TB,
streptococcal infections, leprosy, and Crohns disease.

68
Q

Lichen Planus

  • what are 6 Ps?
  • what virus is it associated with?
A
  • Pruritic, Purple, Polygonal, Planar, Papules, and Plaques
  • Wickham striae (reticular white lines).
  • Sawtooth infiltrate of lymphocytes at dermal-epidermal
    junction.
  • Associated with hepatitis C.
69
Q

PABA containing sunscreens only protect against ____

A
  • UVB (sunburn)

- on another note, UVA = tanning & photoaging.

70
Q

Whats the most common skin cancer?

A

Basal cell carcinoma

71
Q

Basal cell

  • how would you describe their nuclei?
  • upper or lower lip?
A
  • “palisading” nuclei

- upper lip

72
Q

Melanoma

  • tumor marker?
  • common mutation?
  • treatment for BRAF V600E?
A
  • S-100
  • BRAF kinase mutation
  • vemurafenib (BRAF kinase inhibitor)
73
Q

Do you give an asthmatic aspirin or tylenol?

A

aspirin is contraindicated in asthma b/c stops COX so everything goes to lipooxygenase, which means lots of leukotrienes which are cause bronchoconstriction (Gq pathway). So tylenol given instead of aspirin to asthmatics.

74
Q

Side effects of bisphosphonates

A
  • corrosive esophagitis
  • osteonecrosis of jaw

*remember to administer Ca w/bisphosphonates.

75
Q

Give aspirin to gout pts?

A

-Do not give salicylates
-all but the highest doses depress uric acid clearance. Even high doses (5–6 g/day) have only minor uricosuric
activity.
*low doses prevent secretion of uric acid into renal tubules. Its a weak acid so it competes for secretion.

76
Q

Infliximab

-whats another TNF-alpha mab?

A

adalimumab

Final FA review (52 decks)

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