3/27 Flashcards
leukocytoclastic vaculitis
microscopic polyangiitis is an example
- only in small vessels
timeline after anemia correction
reticulocytes peak around 1 week, hemoglobin takes 8 weeks to correct
stimulus control therapy of sleeping
dissociate bed from any other activities besides sleep and sex
eplerenone
aldosterone antagonist (like spironolactone with fewer side effects)
indication for narrow spectrum seizures
focal (involving only one hemisphere)
bacterial meningitis not covered by third gen cephalosporins
listeria (altered penicillin binding proteins)
risks for parotitis
decreasing saliva flow - anticholinergics, intubation, dehydration
GGT
secondary test to distinguish high alkaline phosphatase from liver vs bone sources (high in liver)
sensitivity to everyday sounds
problem with the stapedius muscle, innervated by the facial nerve
- common in Bells palsy
treatment for essential hypertension
beta blockers
persistent depressive disorder timeline
greater than two years
medications with negative chronotropic effects
- beta blockers
- non-D CCBs
- digoxin
- amiodarone/sotalol
- cholinergic agonists
granulomas in bowel disease
Chrons
recommendations for putting in central line
- hand hygiene
- barrier precaution
- chlorhexidine antiseptic
- subclavian vein use
- prompt removal
Eisenmenger syndrome with differential clubbing in hands and feet
PDA - normal blood is delivered to hands but deoxygenated blood is delivered to feet
mechanism for peeing in normal pressure hydrocephalus
stretching of descending cortical fibers
worst prognostic factor in PSGN
older age
BRAF
melanoma
location of fibrinoid necrosis
has to be in vessels
Councilman bodies
apoptotic bodies in hepatitis that a strongly eosinophilic
splitting
something is all bad or all good
anemia with low reticulocytes
pure red cell aplasia (antibodies against RBC precursors)
- due to thymoma
infections acquired during birth
chlamydia and neisseria (can cause blindness), group B strep
when is toxoplasmosis acquired
before birth (in utero)
constipation due to mass in uterus
fibroids
mechanism of cyanide poisoning
lower peripheral oxygen consumption by inhibiting oxygen dependent phosphorylation of cytochrome c in mitochondria
borderline personality disorder
unstable relationships with marked impulsivity (you know who)
clue cells
epithelial cells covered in gram variable rods (bacterial vaginosis)
heart block increaser with severe constipation
CCBs
in patient with afib, what prevents the use of a beta blocker
history of COPD (beta blocker would make it worse)
severity of mitral stenosis
length of time between S2 and opening snap
signs of hypothyroidism in neonate
slow, umbilical hernia, poor brain development (needed for myelination), puffy face, intellectual disability
cells that can not use ketone bodies
RBCs, no mitochondria
treatment for male pattern baldness
finasteride
major complication of lamotrigine
SJS
elevated hepatic enzymes with concurrent neurologic disease
Wilsons (elevated copper)
- due a slit lamp exam
histology in MS
perivenular inflammatory infiltrates (T cells and macrophages)
microglial nodules
HIV encephalitis
sponiform encephalopathy
prion disease
blood flow in right ventricle
relatively constant because pressure are not as high
psuedogout
calcium pyrophosphate crystals
most common cause of spontaneous lobar hemorrhage
cerebral amyloid angiopathy
common type of inheritance in enzyme deficiencies
autosomal recessive
pressure tracing of mitral regurgitation
high increase in atrial pressure
differences between neuroleptic malignant syndrome and serotonin syndrome
NMS = diffuse rigidity and bradyreflexia serotonin = neuromuscular hyperactivity
carboxyhemoglobin
measure of CO bound to oxygen
cause of methemoglobin
drugs (dapsone and nitrites), enzyme deficiencies and hemoglobinopathies (not CO!)
duration of headaches
cluster = shortest
migraine = 4-72 hours
tension (band) = variable
changes with GFR and FF over increasing efferent contrictions
low constriction = high FF and high GFR because blood is diverted through kidney
high constriction = high FF, low GFR (higher oncotic pressure pulls flow back, decreasing GFR)
side of speech areas in brain
left
two types of CGD tests
- nitroblue tetrazolium (turns dark blue in normal)
- Dihydrorhodamine flow cytometry (green)
lipid A
same thing as LPS, endotoxin
three parts of LPS
- O antigen (out membrane polysaccharide)
- core polysaccharide
- Lipid A (cause of toxic properties)
renal cell carcinomas come from what cell type
PCT
oncocytomas come from what cell type
collecting duct
why would an RBC not make ATP in glycolysis
to form 2,3 BPG
2,3 BPG
increased in hypoxia and chronic anemia
- promotes oxygen delivery to tissues
what not to assume in vein compression due to lung tumor
SVC
- pay attention to signs
- one sided = brachiocephalic
- only arm = subclavian
- both sides = SVC
cause of clubbing
chronic hypoxia
second hand smoking can lead to….
- SIDS, otitis media and asthma
blueish neoplasm under nail bed
glomus tumor or subungual melanoma
glomangioma
tumor of modified smooth muscle cells
- these are found in nail beds, pads of fingers and toes and ears
- used for thermoregulation to prevent heat loss
suprasellar lesions with three components
- craniopharyngioma
- solid tumor cells, cystic machine oil and calcified portion
myxomatous degeneration
- pathological weakening of connective tissue
seen in Marfans and mitral valve prolapse
things causing papillary necrosis
acute pyelonephritis, sickle cell, diabetes, or analgesic nephropathy
equation for resistance in parallel
1/R = 1/R1 + 1/R2….
- key is all terms are inverted
three most important predisposing factors in DM1
- too much insulin
- not enough food
- exercise
mechanism for low glucose in DM1 after exercise
in normal individuals, insulin production stops during exercise
- in DM1, exogenous insulin can’t be controlled, so blood sugars drop
primary causes of lacunar infarcts
lipohyalinosis and microatheroma due to hypertension
vessels associated with factor V Leiden
veins
etiology of mass in old TB lesion
colonization by aspergillus (fungus ball)
cor pulmonale
right heart failure due to a lung cause
rotavirus vs norovirus
there is vaccination against rotavirus, other than that they can present the same
medications to avoid in hypertrophic cardiomyopathy
- want to avoid lowering ventricular volumes
- vasodilators - decrease afterload leading to decrease in afterload
- diuretics
aqueous humor in eye is produced from…
ciliary epithelium
muscarinic agonists increase outflow in what part of eye?
trabecular meshwork outflow (Schlemm canal)
prostaglandins increase outflow from what part of eye
uveoscleral outflow
curling ulcers
ulcers in duodenum due to stress, due to local ischemia
cushing ulcers
vagus nerve stimulation by increase in intracranial pressure leads to increase in acid and ulcer
systolic vs diastolic dysfunction
systolic = dilated diastolic = hypertrophic
important clinical indicator in MR and MS
MR = S3 heart sound (too much volume) MS = time between closure and opening snap
channels that fish toxins act on…
sodium
drugs revealing G6PD
bactrim, dapsone, malarials , nitrofurantoin
cholesterol 7alpha hydroxylase
rate limiting step of bile acid synthesis
achalasia can arise secondary too.
Chagas
menetrier disease
hyperplasia of gastric mucosa, excess mucus, protein loss, parietal call atrophy
types of stomach cancer
intestinal - h pylori, tobacco, smoked foods, gastritis
diffuse - not h pylori, signet rings, linitis plastica
d-xylose test
to test for mucosal defects or bacterial overgowth syndrome
- presents with low levels in blood and urine
