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STEP1 Flashcards > 4/1 Neuro, Endocrine, Psych > Flashcards

4/1 Neuro, Endocrine, Psych Flashcards

1
Q

Acne, infertility, anovulation

A

PCOS

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2
Q

Myasthenic crisis

A

Intubate them!

triggered by infection or other stressor–> profound weakness of respiratory muscles

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3
Q

old man with acute unilateral pain in eye with decreased vision, pupil dilation, conjunctival injection and tearing

A

Acute angle closure glaucoma

tx: beta antagonist (carteolol, timolol)

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4
Q

What do the boxes mean on EKG?

A

small box=0.04 sec
large box=0.2 sec

(300, 150, 100, 75, 60, 50)

Normal QT interval 2 large boxes

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5
Q

Prolonged QT interval DD

A

Drugs
Genetic:
-Romano-ward syndrome (AD)
–Jervell and lange-Nielsen syndrome (AR + deafness)

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6
Q

contraindication for sumatriptan

A

ischemic heart disease, stroke, prinzmetal angina, uncontrolled HTN
(vasoconstrictive MOA)

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7
Q

LLQ pain, focal colonic thickening, increased soft tissue density of pericolonic fat, fever, leukocytosis

A

Acute diverticulitis

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8
Q

Glomus body

A

small encapsulated neuromuscular organ found in dermis of nail bed, pads of fingers and toes and ears

thermoregulation

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9
Q

physiology of urticaria

A

increased perm of microvasculature leading to edema of the superficial dermis

mixed inflammatory infiltrate surrounding superficial dermal venules

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10
Q

Spongiosis

A

intercellular epidermal edema

eczematous dermatitis

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11
Q

What are janeway lesions?

A

Associated with infective endocarditis

contender macular erythematous lesions on palms and soles

Cause: septic embolization from valvular vegetation’s
i.e. microabscesses

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12
Q

what causes osler nodes?

A

IE
immune complex deposition in the skin

PAINFUL

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13
Q

Renal metabolism of what aa maximizes acid excretion in the setting of acidosis ?

A

Glutamine to glutamate–> producing ammonium and bicarb to buffer acids in blood

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14
Q

goal of a granuloma?

A

wall off offending agent

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15
Q

Left frontal lobe injury

A

apathy and depression along with changed personality

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16
Q

Right frontal lobe injury

A

disinhibited behavior with changed personality

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17
Q

Treatment for delirium

A

Haloperidol if necessary

delirium is acute onset and waxing and waining

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18
Q

mechanism of action of PCP

A

N-methyl-D-aspartate receptor antagonist

inhibit reuptake of NE, DA, 5-HT

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19
Q

treatment for phobia

A

CBT

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20
Q

Psychodynamic psychotherapy

A

developing insight into unresolved conflicts that started in childhood

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21
Q

major depression criteria

A 
SIG E CAPS
Sleep disturbances
decreased Interest
Guilt or worthlessness
Energy decreased
Concentration 
Appetite/weight changes
decreased Psychomotor 
Suicidal ideations

depressed mood

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22
Q

Mania criteria

A 
DIG FAST
Distractibility 
Irresponsibility
Grandiosity 
Flight of ideas
Activity towards a goal increased
decreased need Sleep
Talkative or pressured speech
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23
Q

tx for tourette syndrome

A

Atypical antipsychotics, tetrabenazine, clonidine

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24
Q

TCAD suffix

A

-ipramine, -iptiline, -oxepin

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25
Q

tx for serotonin syndrome

A

cyproheptadine

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26
Q

RA, neck pain, stiffness, radicular pain

A

Atlantoaxial joint subluxation

Chronic RA can involve the cervical spine

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27
Q

What can worsen cervical spine subluxation?

A

extension of the neck during endotracheal intubation

compression of the spinal cord and/or vertebral arteries

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28
Q

What sites degenerate in Friedrich ataxia?

A

Spinocerebellar and lateral corticospinal tract–>ataxia and spastic muscle weakness

Degeneration of dorsal columns and dorsal root ganglia

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29
Q

Mutations in SOD1

A

familial ALS

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30
Q

what is broken down to make propionic acid

A

Valine, Isoleucine, threonine, methionine, cholesterol, odd-chain FA

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31
Q

MAOIs

A

Tranylcypromine
Phenelzine
Isocarboxozid
Selegiline

SE: Hypertensive crisis

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32
Q

When is K+ ion permeance highest in the neuron?

A

During the repolarization phase

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33
Q

what is the length constant for an axon?

A

Also called the space constant
measure of how far along an axon an electrical impulse can propagate

Myelin increases space constant by decreasing charge dissipation (increasing membrane resistance)

myelin also increases conduction velocity

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34
Q

Lateral nucleus of the hypothalamus

A

mediates hunger

damage=anorexia

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35
Q

ventromedial nucleus of the hypothalamus

A

mediates satiety

damage=hyperphagia

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36
Q

Arcuate nucleus of the hypothalamus

A

secretes DA, GHrH and GnRH

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37
Q

supraoptic nucleus of the hypothalamus

A

ADH and oxytocin

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38
Q

Decerebrate posture

A

Injury below the red nucleus (midbrain, pons)

extensors predominate

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39
Q

Treatment for malnourished alcoholic

A

Give Thiamine with glucose

Thiamine is cofactor for enzymes involved in glucose metabolism–> glucose w/o thiamine can make wernicke worse

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40
Q

kid with severe intellectual disability, seizures and hypo pigmented substantia viagra, locus ceruleus, vagal nucleus dorsalis

A

PKU

decreased melanin synthesis
catecholaminergic brain nuclei produce neuromelanin

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41
Q

Ulcerative colitis

A 
ULCCCERS
Ulcers
Large intestines
Continuous
Carcinoma
Crypt abscess
Extends proximally
Red diarrhea
Sclerosing choliangitis
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42
Q

Smooth muscle contraction vs. skeletal muscle

A

Smooth muscle uses voltage gated ca channels to activate calmodulin and then myosin light chain kinase–> phosphorylates myosin–> contraction

In skeletal muscle there is no phosphorylation of myosin instead the actin binds directly to the myosin in order to contract

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43
Q

Side effects of PPI

A

Atrophic gastritis (hypergastrinemia)
GI issues
carcinoid tumors
HA

44
Q

Which drug is contraindicated in the presence of cholesterol gallstones?

A

Fibrates

increase the amount of cholesterol in the bile

45
Q

Where are VIPomas usually found?

A

In the tail of the pancreas

VIP increases water and electrolyte secretions in the small intestines and relaxes smooth muscle

46
Q

Primary treatment for Enterococcus

A

Ampicillin

HHELPSS kill enterococci 
H. influenza
H. pylori
E. coli
Listeria
Proteus mirabilis 
Salmonella 
Shigella
47
Q

Trendelenburg gait

A

superior gluteal

48
Q

Treatment for B. cereus

A

Supportive because it is a preformed toxin

49
Q

Vasogenic cerebral edema vs. cytotoxic

A

Vasogenic–> BBB damaged (Trauma tumors, inflammation, HTN, high altitude)

Cytotoxic–> BBB intact, disruption of metabolism
ischemic stroke, Reye’s, toxins, hypothermia, encephalopathy
Swelling of cells

50
Q

treatment for Huntington

A

Tetrabenazine and reserpine–> inhibit VMAT–> less dopamine release

Haloperidol–> D2 receptor antagonist

51
Q

Synaptophysin

A

transmembrane glycoprotein found in presynaptic vesicles of neurons, neuroectodermal and neuroendocrine cells.

52
Q

Galactocerebroside accumulation

A

Krabbe dz

progressive neurodegenreation with peripheral neuropathy and optic atrophy

53
Q

what is responsible for the the toxic effects of N. meningitis?

A

Lipooligosaccharide (LOS)

levels of LOS in the blood correlate with morbidity and mortality

54
Q

Where does the rabies virus bind?

A

Nicotinic ACh receptor

55
Q

SE of inhaled anesthetics

A

Halothane–hepatotoxicity

Methoxyflurane–neprhotoxicity

enflurane–proconvulsant

N2O–expansion in body cavity

Malignant hyperthermia

56
Q

MAO of ketamine

A

block NMDA R

57
Q

MOA Propofol

A

potentiates GABAa and inhibits NMDA R

used for sedation in ICU, rapid anesthesia and short procedures

58
Q

Esters

A

procaine, cocaine, tetracaine

59
Q

Amides

A

-Caine with an extra i

nerve block in small myelinated first

1)pain, 2)temperature 3)touch 4)pressure

60
Q

Vitamin E deficiency

A

ataxia (degeneration of spinocerebellar tracts)
loss of position and vibration sense (degeneration of dorsal columns)
loss of deep tendon reflexes (peripheral nerves)

hemolysis

can look like Friedreich ataxia

61
Q

Poliomyelitis

A

damage to anterior horn–> asymmetrical flaccid paralysis and hyporeflexia

sensation preserved

62
Q

mandibular nerve function

A

Motor and sensory!

muscles of mastication + tensor veil palatine and tensor tympani
sensation to TMJ and teeth and floor of mouth

63
Q

Maxillary nerve function

A

mainly sensory to cheeks, nares, upper lip and teeth and the pharyngeal palate and max sinus

64
Q

optic tract lesions

A

contralateral homonymous hemianopia

afferent pupillary defect
swinging flashlight test

65
Q

Lesion to lateral geniculate nucleus

A

contralateral homonymous hemianopia

NORMAL pupillary light reflex

66
Q

Kulchitsky cells

A

Enterochromaffin cells

Activated by gastrin to produce Histamine to activate acid secretion in the stomach

67
Q

ANP, BNP

A

released in response to increased volume
check on RAAS

relaxes smooth muscle via cGMP–> increases GFR decreases renin

68
Q

Metoclopramide

A

D2 agonist
treat nausea and vomiting

increases gastric motility

69
Q

Metolazone

A

thiazide like drug for CHF and HTN

70
Q

Rosacea

A

inflammatory facial skin redness with papule and pustules

facial flushing with alcohol and heat

71
Q

Pityriasis rosea

A

“Herald patch” followed by scaly erythematous plaques

self resolves

72
Q

Warm agglutinin

A

IgG (warm weather is Greater)

chronic hemolytic anemia seen in SLE and CLL

73
Q

Cold agglutinin

A

IgM
acute anemia triggered by cold (periphery)
mycoplasma pneumonia and mono

74
Q

Renal cell carcinoma pathogenesis

A

Loss of VHL–> increased IGF-1 (growth) and HIF (increase VEGF and PDGF) (angiogenesis)

75
Q

Regulation of Hormone-sensitive lipase

A

Activated by catecholamines (epi) and ACTH

inhibited by insulin

releases TGs from adipose tissue

76
Q

Where is glucose synthesized?

A

Liver
Kidney

(from odd chain fatty acids)

77
Q

Mutation causing beta thalassemia

A

point mutation in splice site and promoter sequences–> decreased beta globin synthesis

mRNA defect

78
Q

21-hydroxylase deficiency

A

usually early onset but can be late onset and less severe

high renin and 17-hydroxyprogesterone

hypotension and hyperkalemia

Infancy–salt wasting
childhood–precocious puberty
adulthood–clitoral enlargement and hirsutism

79
Q

Blistering cutaneous photosensitivity

A

Porphyria cutanea tarda

Deficiency in uroporphyrinogen decarboxylase

increased uroporphyrin (tea-colored urine)

(defect in heme synthesis)

80
Q

Pathophys of Hemochromatosis

A

Mutation C282Y or H63D on HFE gene (A3)

increased intestinal absorption of iron (over active transferrin)

81
Q

Post MI complications day 1-3

A

fibrinous pericarditis

friction rub

82
Q

Post MI complications day 4-7

A

Rupture!
ventricular wall (cardiac tamponade)
inter ventricular septum
papillary muscle

83
Q

Effects of hCG in men

A

stimulates leydig cells to synthesize testosterone

tx for hypogonadism or fertility

84
Q

lesion in internuclear ophthalmoplegia

A

ipsilateral medial longitudinal fasciculus

85
Q

first sign of puberty in females

A

breast bud development

THEN pubic hair

86
Q

First sign of puberty in males

A

testicular enlargement

87
Q

Pelvic splanchnic

A

Parasympathetic to rectum and sigmoid colon

damage–constipation

88
Q

where does heme synthesis take place?

A

mitochondria and the cytoplasm

89
Q

Which nerves are in the anterior compartment of the leg?

A

Deep peroneal

Anterior tibial

90
Q

Endothelin

A

Vasoconstrictor that increases BP

increased in pulmonary hypertension and hypertrophic cardiomyopathy (along with c-jun and beta-mysocin heavy chain)

balanced by NO and prostacyclin

91
Q

Lab findings for primary hyperaldosteronism

A

Normal Na (aldo escape)
HTN
Hypokalemia
metabolic alk

92
Q

effect of hypokalemic alkalosis

A

weakness and paresthesias

93
Q

In pancreatic beta cells what activates the potassium channels?

A

ATP made from glycolysis

94
Q

What is Reverse T3

A

in active form of T3 that is made from conversion or T4

95
Q

Immune effects of corticosteroids

A

Neutrophilia (due to degranulation
Immunosuppression
increased risk of infection

96
Q

MOA meglitinides

A

block the closing of ATP-dependent K+ channel in pancreatic beta cells

increase insulin release

97
Q

role of DHT

A

Development of the external male genitalia
prostate
male pattern baldness

produced via 5-alpha reductase

deficiency=male pseudohermaphroditism

98
Q

Role of human parental lactogen (hPL)

A

modifies metabolic state of mother during pregnancy to supply baby with energy

anti-insulin–>Insulin resistance!!!

99
Q

Squamous cell carcinoma paraneoplastic syndromes

A

PTHRP and dermatomyositis

hypercalcemia–> kidney stones

100
Q

effect of hypocalcemia

A

QT prolongation
tetany
seizures

101
Q

treatment for severe hypocalcemia

A
  1. Mg (need to replace otherwise won’t absorb Ca)
  2. Ca2+
  3. activated Vit D (calcitriol)
102
Q

Small cell lung cancer paraneoplastic syndromes

A

ADH, ACTH, GH

103
Q

Membranous nephropathy on histology

A

Sub epithelia spikes and domes

104
Q

Diabetic eye injury

A

Retinopathy
Vitreous Hemorrhage

Causes: trauma, retinal tear, vitreous detachment
or retinal neovascularization (DM)

diminished red reflex

105
Q

treatment for vitreous hemorrhage

A

partial or total vitrectomy

106
Q

Child with lytic bone lesion and skin rash or recurrent otitis media

A

Langerhans cell histiocytosis
proliferation of DC
s-100+

Birbeck granules

STEP1 Flashcards (9 decks)

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