4/5 star topics DIT Flashcards
1
Q
RA
- charas of joint
- abs
- presentation
- tx acute
- tx long-term
- joints: hand, wirst, elbow, knee, post knee, ankle/forefoot/subtalar, upper cervical
A
- synovium overgrows bone (pannus), rheum nodules,
- RF (IgM agains IgG), anti-citrinulated protein ab
- morning stiffness, imporve w use, symm, symmetric, systemic (fever, fatigue, pleural effusion, pericarditis)
- acute: NSAIDs, COX2 inhib, steroids
- long: DMARDs: MTX, hydrdroxychoroquine, sulfasalazineTNFa inhibs (enteracept, infilximab, adalumumab, golinumab, certulizumab
2
Q
components fo tetralogy of fallot
A
- RV outflow tract obs (pulm stenosis)
- RV hpertrophy
- VSD
- overriding aorta
**looks like boot shaped <3**
3
Q
chronic mucocutaneous candidiasis
- how aries
- tx
A
- t cell dysf
- ketoconazole
4
Q
chediak higashi synd
- pathogenesis
- s/s
A
- defectice LYST gene –> defective phagocyte lysosomes –> giant cytoplasmic granules in PMNs
- triad: (PAIN)
- partial abinism
- recurrent respiratory tract and skin infxns
- neuro disorders
5
Q
aortic regurg
- location
- systolic or diastolic
- assoc w:
- d/t:
- pic
A
- L sternum
- diastolic
- wide pulse pressure (water-hammer pulse - bounding peripheral); head bob
- aortic root dialtion (syphilis, marfans), BAV, RF
6
Q
diffs btwn scc, bcc, melanoma of skin
A
squamous:
- sun exposed
- scaly plaque, ulcerative red lesion
- keratin pearls
basal:
- sun exp
- roleld edge
- central nuc
- pearly
- telangiectasias
- palasadig nuclei
melanoma:
- s-100 marker
- depth ~ mets
- Asymm, Border, Color, Diameter
- melanocytes in epidermis
7
Q
- neurotoxin:
- what?
- which prod?
- enterotoxin:
- what?
- which prod?
- super antigens:
- what?
- which prod?
A
- neurotoxin:
- interfere w neural transmission
- botulinim, tetanus
- enterotoxin:
- affect intestines
- shigella, cholera
- super antigens:
- simult bind MHC2 and t cell receptor –> t cell expansinon –>cytokines
- staph a and strep pyogenes
8
Q
- label Vmax, 1/2Vmax, Km, and the velocities on a MM graph
- label x and y int on L-B plot
- how do these change with competitive and noncompetitive inhibitors
A
pgs 136-& DIT
9
Q
label the parts of the pressure-volume loop for the <3 and how does incraesed preload, afterload, and contractility affect it
A
10
Q
selective immunoglobulin deficiencies - IgA deficinecy
- s/s
A
- appear healthy, but sinus and lung infxns, atopy, asthma, anaphylaxis to blood trnsfusions and blood prods
11
Q
delirium vs dementia:
- onset
- daily course
- level of consciousness
- thought production
- psychotic features
- prognosis
A
12
Q
label the circle of willis and the the fuctions that the aca, mca and pca supply
A
pg 38 dit
13
Q
what are the m’s that compose the rotator cuff and what are their fcts
A
- supraspinatus - initial 15deg abd shoulder
- infraspinatus - ext rotation
- teres minor - ext rotation
- subscapularis - inernal rotation
14
Q
hemispatial neglect synd
A
=parietal cortex lesion of nondominant gyrus
–> results in neglect of body or surroundings c/l to lesion
15
Q
DiGeorge Synd
- how arise?
- s/s:
- genetics
A
- no 3/4 pharyngeal pouch
- no thymus –> no mature t cells
- no parathyroids –> decr PTH –> hypocalcemia, tetany
- ss
- viral, fungal, protozoal infxns
- heart, great vessel defect
- 22q11 deletion
16
Q
hyper IgE synd (Job)
- pathogenesis
- s/s
A
- mutation STAT3 –> impaired Th17 diff and recruitment of nfs; also high legesl IgE and eos
- triad
- czema
- cold staph a abcess
- course facial features: broad nose, prominent forehead, deep eyes, doughy skin
- (also 2 rows teeth)
17
Q
what structures come from neural crest cells?
A
MAGIC COPS -melanocytes -aorticopulmonary septum -ganglia: autonomic, dorsal root, enteric (PNS!) -iris stroma -chromaffin cells -CNs -odontoblasts and ossicles -parafollicular (C) cells -sclerae
18
Q
mitral stenosis
- location
- systolic or diastolic
- what you hear
- heard best when
- d/t:
- pic
A
- apex
- diastolic
- opening snap
- L lat decubitus; expiration
- RHD ==> scarring
19
Q
Gerstmann synd
A
= a parietal cortex lesion of the dominant angualr gyrus resulting in:
- agraphia
- acalculia
- R-L disorientatio
- finger agnosia
20
Q
patent ductus arteriosus
- systolic or diastolic
- what sound like
A
- diastolic
- machine like
21
Q
what drugs increase contractility
A
chatecholammies (B1 agonists)
22
Q
A
23
Q
VSD
- systolic or diastolic
- who has?
A
- systolic
- newborns
24
Q
Kleinfelter synd
- genes
- presnet
- hormones
A
- 47 XXY
- testiculr atrophy –> decr T, less musc body, less facial hair, broad hips, tall, long ext, gynecomastia, F hair distrib, reduced fertility
- decr inhibin, incr FSH
25
T4HST
* how work
* --\>
* ex:
* t cells bind ag --\> release cytokines
* activate mfs --\> tissue damage
* ex:
* PPD
* hashimotos thyroiditis
* MS
* GVHD
* contact dermatitis
26
how are male repro structures formed? female?
male:
* mesonephric duct forms everything except prostate
* SRY in y chromo --\> testis determinig factor
* Sertoli cells --\> mullerian inhibiting factor
* leydig cells --\> T (which encourages Wolff to stick around) --\> DHT (which induces UG sinus and genital tubercle to become male
female:
* Paramesonephric (mullerian) duct --\> fallopian tubes, uterus, upper vag
* UG sinus --\> sinovag bulbs --\> lower vag
* dev issue: vaginal atresia
* if not fuse = bicornate uterus --\> infertile and misscarriage
27
PCOS
* hormone abns
* s/s to dx:
* other assoc symp
* tx
* increased LH, androgens, insulin, estrone; decresed SHBG
* oligoovulaiton, hyperandrogenism, polycystic ovaries
* obesity, insulin reisstance, infertility, endometrial hyperplasia
* diet/exercise, OCPs, cyclic progestins, spironolactone, metformin, clomiphene (blocks E receptors in hypo --\> incr FSH and LH --\> ovulation
28
what are the starling forces and how does edema result
29
mycoplasma pneumoniae
* transmission
* who gets it
* symp
* dx
* tx
* resp
* school age, college, military
* malaise, HA, low fever, nonproductive cough, diffuse interstitial infiltrates, patchy reticular xray
* cold agglutins
* macrolides, deoxycycline, flouroquinloones
30
T2HST
* how work
* causes what kind of damage?
* exs
* ab against cellular ags
* via compliment, mf phago, NK destruction
* Exs
* AI hemoytic anemia,
* acute hemolytic transfusion rxn
* erythroblastosis fetalis
* immune thrombocytopenia
* pernicious anemia
* MG
* guillan barre
* graves dis
* phemphigus vulgaris
* bullous phemphigoid
* goodpasture
* acute RF
31
Bruton agammaglobulinemia
* transmission
* pathogenesis
* s/s
* x linked
* b cell def --\> defective TK gene = low levels all Ig's
* recurrent bac infxns after 3-6 mos
32
genital homologues
* glans penis
* corpus callosum and spongiosum
* bulbourethral glands
* prostate gland
* ventral shaft
* scrotum
* glans penis - glans clitoris
* corpus callosum and spongiosum - vestibular bulb
* bulbourethral glands - greater vestibular gland
* prostate gland - urethral and paraurethral glands
* ventral shaft - labia minora
* scrotum - labia majora
33
describe the process of collagen synthesis
preprocollagen a-chains (gly and pro) --\> hydroxylation of lys and pro (req vitc) --\> glycosylation of the hydroxlated lys = procollagen (triple helix) --\> exocytosis --\> cleave ternial regions procollagen = tropocollagen) --\> crosslink tropocollagen
34
Gout
1. aka
2. joint aspiration results:
3. causes
4. presentation
5. precipating factors:
6. assoc w serum uric acid levels
1. monosodium urate crystal deposition dis
2. needle-shaped crystals, - birefringence
3. decreased excretion of uric acid: thiazide or loop diuretic; incerased prod of uric acid: purine-rich foods, lesch-nyhan synd, tx for leukemia or lymphoma
4. asymmetric joint inflammation, inflammation of the 1st mtp (podagra), tophi
5. dietary excess, alch consumption
6. not necessarily predict gout
35
leukocyte adhesion deficiency synd
* pathogeneis
* s/s
* abn integinrs --\> inability of phagocytes to exit circ
* delayed separation of umbilical cord
36
Severe combined immunodeficiency (SCID)
* pathogenesis
* s/s
* deceft in early stem cell: adenosine deaminase def
* triad:
* receurrent infxns
* mucocutaneous candida
* RSV, VZV, HSV, measels, flu, parainfluenza
* PCP
* chronic drh
* failure to thirve
* also no thymic shadow
37
- how does increase in afterload affect SV?
- how does increase preload affect SV?
- decrease SV
- increase SV
38
describe the effects competitive and noncompetitive antagonists have on effecacy and potency
competitive drugs: decrease potency
noncompetitve drugs: decrease efficacy
39
symp of lateral medullary synd (Wallenberg synd)
- loss c/l p/t (spinothalamic)
- loss i/l temp in face (spinal trigeminal nuc)
- hoarseness, difficults swallowing, loss gag (nuc ambiguus: CN9, 10)
- i/l horners (descending sympathetic)
- vertigo, nystagmus, n/v (vestibulat nuc)\*\*\*
- i/l cerebellar defects (ataxia) (inf cerebellat peduncle)
40
Lymphatic drainage to which LN:
* arm/lateral breast
* posterior calf, dorsolateralfoot
* thigh
* stomach, upper duidenum
* lower duodenum, jejunu, ileum, proximal 2/3 colon
* distal 1/3 colon, upper rectum
* lower rectum (above pectinate line)
* anal canal (below pectinate line)
* testes, ovaries, uterus, kidneys
* scrotum, vulva
* arm/lateral breast --\> axillary
* posterior calf, dorsolateralfoot --\>popliteal
* thigh --\>superficial inguinal
* stomach, upper duidenum --\> celiac
* lower duodenum, jejunu, ileum, proximal 2/3 colon --\> superior mesenteric
* distal 1/3 colon, upper rectum --\>inferior mesenteric
* lower rectum (above pectinate line) --\>internal iliac
* anal canal (below pectinate line) --\> superficial inguinal
* testes, ovaries, uterus, kidneys --\> paraaortic
* scrotum, vulva --\> superfiical inguinal
41
wiskott aldrich synd
* gnetic transmission
* pahtogenesis
* s/s
* x linked
* low IgM, high IgA
* immunideficiency, thrombocytopenia dn purpura, eczema, receurrent pyogenic infxns (WAITER)
42
label the parts of an ab and the main fcts of :
* IgG
* IgA
* IgE
* IgM
* IgD
* IgG - mian circulating; fix comp; cross placenta; opsonizes bac; neutralizes toxins
* IgA - secreted by MALT; monomer in circ, dimer in secreted; secretory component to protect form environ
* IgE - immunity to parasites by activating eos; bine to mast cells and basos
* IgM - monomer on B cells; pentamer in circ; primary immune resp
* IgD - mostly on surface b cells, some in circ
43
chronic granulomatous dis
* genetic transmission
* pathogenesis
* susceptable to
* tx
* s linked
* lack NADPH oxidase --\> phagocytes cannot destroy catalase+ microbes
* esp susceptable to stapha and aspergillus
* prophylactic TMP-SMXand itraconazole, and IFNy
44
MVP
1. systolic or diastolic
2. chara
3. how valsalva affect
1. systolic
2. midsystolic click
3. click earlier and softer
45
ataxia telangiectasia
* pathogenesis
* s.s
* incr risk of
* labs
* die
* IgA deficiency and t cell deficiency
* sinus and lung infections, atasia, poor moving eyes on target, telangetasias on face (+5yo), radiation insensativity,
* risk of lymphoma, leukemia
* incr AFP
* die b4 25yo
46
T1HST
* how work
* --\>
* ex
* free ag binds IgE on mast cells and basos
* --\> elease preformed granules of HST and bradykinin --\> vasodilate, incr vasc permeability = wheel and flare urticaria
* Ex: anaphylaxis, asthma, allergic rhinitis, eczema
47
osteoporosis:
1. how dx
2. assoc
3. tx
1. dexa scan
2. colles fx, vertebral compression fx
3. stop smoking/steroids/increase wt bearing; Ca/vitD supplement; bisphosphonates; estrogen; SERMs; teriparatide; denosumab
48
draw out the arachidonic acid pathway including the drugs that inhib certain enzs
(pg 16 DIT)
49
Turner synd
* genes
* present
* conseq
* hormones
* 45xo
* short, broad chest, low hair/ears, web neck, streak ovaries
* amenorrhea/infertile, BAV, coarc aorta
* decr estrogen, incr FSH/LH
50
IL-12 receptor deficiancy
* how arise
* s/s
* no Th1
* mycobacterial and fungal infxns
51
52
mitral regurg
1. systolic or diastolic
2. describe it
3. radiate? heard when
4. causes
5. pic
1. systolic
2. high pitched, blowing
3. to axilla; heard when L lat recumbent, squat, hand grip
4. RHD, endocarditis, ischemic heart dis, LV dilation, MVP
53
what decreases contractility?
- B1 blockade
- HF
- acidosis
- hypoxemia
- hypercapnea
- NDP CBB
54
T3HST
* how work
* --\> what causes the damage
* ab against soluable ags in free blood
* ag-ab complexes in tissues --\> activate compliment and recruit nfs
* ex
* SLE
* RA
* PAN
* PSGN
* serum sickness
* arthus rxn
55
tricuspid regurg
1. systolic or diastolic
2. louder w
3. causes
4. pic
1. systolic
2. inspiration
3. RHD, endocarditis (drug user)
56
describe the signal transmission pathwways for GPCRs and TKs
pg 133 DIT
57
hyper-IgM synd
* pathogenesis
* genetic transmission
*
* incr IgM, others decr
* AR --\> no CD40 on B cells
* X linked --\> no CD40 ligand on Th (MC)
58
Vd =
CL =
LD =
MD =
pg 138 DIT
59
cause and symp of Weber synd
cause: anterior midbrian infarction from occlusion of paramedian branches PCA
- cerebral a peduncle lesion: dysphagia, dystonia, dysarthria (corticobulbar tract damage); c/l spastic hemiparesis (corticospinal tract damage)
- CN3palsy = i/l ptosis, pupillary dilation, lateral strabismus(down and out)
60
how does exercise effect CO?
increase CO
61
T4HST
* jpw
62
aortic stenosis
1. systolic or diastolic
2. chara
3. radiate
4. symp
5. cause
1. systolic
2. creascendo decrescendo
3. to carotids
4. weak, delayed peripheral pulses, syncope, angina, dyspnea,
5. BAV, senile calcification, RHD, UBV, tertiary syphilis
63
label the arteries coming off the abdominal aorta
64
65
label on this ct:
* vert
* kidney
* bowel
66
label on this ct:
* fat
* liver
* GB
* panc
* stomach
* spleen
* kidney
* IVC
* aorta
67
Celiac
* pathogenesis
* antbs
* histo
* s/s
* immuno:
* risk of:
* in what part GI
* AI to gliadin: wheat react w SI --\> inflamm
* abs to glaidin and TTG
* histo: blunted villi and microvilli
* see foul, pale stools, stunt grth, fail thrive
* HLADq2 and 8
* risk t cell lymphoma, GI CA,breast CA
* in prox SI
68
Chrons dis:
* through what
* where
* pathogenesis
* dx
* GI probs
* systemic probs
* tx
* tranmural
* everywhere;skip; usu terminal ileum; spare rectum
* reaction w GI flora
* barium swallow: string sign; histo: noncaseating granulomas
* strictures, drh, malabs, wt loss, colon CA, fissures, fistulas
* arth, joint dis,immuno, erythema nodosum
* 5-ASA (mesalamine, sulfasalazine), azithropine/mercaptopurine/MTX, anti-TNF, steroids
69
Ucerative colitis
* where
* through
* pathogenesis
* dx
* GI probs
* systemic probs
* tx
* only colon, distal --\> prox, continuous, retum alays
* mucosa and submucosa
* AI
* lead pipe; crypt abcess, ulcerations, bleed
* bloody drh, malnutrition, rly increased colon CA
* PSC, pyoderma gangrenosum, sacroilitis, uveitis
* 5-ASA, 5-mercaptopurine, infliximab, TNF-a inhib, colectomy
70
V/q:
* in apex
* in base
* when will ration be zero
* when will ratio be infinity
* +1
* -1
* low ventilation, high perfusion
* airway obstruction:
* pnemonia
* pulm edema
* lumg CA
* supp O2 not do much
* high ventilation, low perfusion
* blood flow obstruction of phys dead space
* supp O2 effective
71
Coal workers pheumoconiosis
* Anthracosis
* simple:
* complicated
* Anthracosis: blackpigment in lung
* simple: small fibrotic lung nodules in upper lung
* complicated: progressive massive fibrosis
72
Silicosis
* what field?
* where
* buzzword
* result
* increase risk of
* mining, sandblast, construction, demolition, foundry, etc
* calcified nodules in upper lung
* eggshell calcifications near hilar nodes
* result in fibrosis
* incr susceptability to TB and lung CA
73
Asbestosis
* what feild
* pathology
* histology
* CXR
* increase risk of
* esp if...
* shipyard, roofing, pipe fitting, plumbing
* fibers directly toxic to lung and mf release inflamm
* histology: ferruginous bodies: coated w iron: dumbbelsls.. seen w prussian blue
* CXR: pleural plaques and effusions and fibrosis
* increase risk of
* laryngeal CA
* malig mesothelioma
* lung CA (adeno and SCC)
* esp if. smoke
74
Berylliosis
* what field
* histo
* incr risk of
* high tech electronics
* noncaseating granulomas
* incr risk of lung CA
75
Sarcoid
* word vomit...
* ACE enz increase
* gammaglobulinemia
* RF
* Uveitis
* erythemo nodosum
* LAD (b/l hilar)
* idiopathic
* noncaseating granulomas
* vit D incr
* ts: corticosteroids
76
adenocarcinoma of lung
* where
* RFs (genes too)
* peripheral
* smoking, MET, ALK, RET, KRAS, EGFR, ROS (MARKER)
77
Squamous cell carcinoma of the lung
* where
* RF
* histology
* assoc
* central
* smoking
* keratin pearls
* secrete PTH-rP --\> hypercalcemia
78
Large cell carcinoma of the lung
* where
* RF
* histo
* prog
* peripheral
* smoking
* anaplastic and undifferentiated, giant cells w various pleomorphisms
* poor
79
Small cell carcinoma
* histo
* RF
* where
* assoc w
* genes
* prog
* high nuc:cyto
* smoking
* central
* hormone secretion:
* ACTH --\> cushing
* ADH --\> SIADH
* LE = antb's against presynaptic Ca channels
* TP53, rb, myc oncogenes
* poor
80
carcinoid tumor
* secretes
* --\> location
* seratonin --\> carcinoid synd (only if out of GI) (bronchospasm, flushing, drh, R sided murmur)
* lung, GI, appendix
81
pancoast tumor
* ocation
* cuases --\>
* apex
* horner synd (ptosis, miosis, anhidrosis), compress recurrent laryngeal n --\> hoarseness
82
meothelioma
* location
* RF
* prog
* pleura
* asbestos (NOT SMOKING)
* poor prog
83
Takayso vasculitis
* granuloma inflammation of aortic branches = head and arms
* decreased pulses in arms
* young asain F
* elevated ESR
84
Giant cell vasculitits
* temporal
* inflamm of external carotid branches
* old F
* u/l HA, jaw claudication
* occlude opthalmic a --\> vision loss
* elevated ESR
* palpable, temporal a and m wasting
* assoc w polymyalgia rheumatica
* dx: temporal a bx
* tx: steroids
85
Kawasaki vasculitis
* kids
* E asian
* 5 days fever AND 4 of:
* conjunctivitis
* trunk rash
* adenopathy
* strawberry tongue
* hand and feet desquamation
* CRASH and Burn
* potential coronary a aneurysms - rupture, thrombosis
* tx: IVIG and ASA
86
Thromboangitis Obliterans
* beurger dis
* smoker
* intermittentl claudication
* superficial nodular phlebitis
* cold sensativity
87
Polyarteritis nodosa
* kidneys
* skin
* GI
* heart
* assoc hep B and C
* tx: steroids and cyclosporine
88
Henoch Scholen Purpura
* IgA vasculitis
* kids
* recent resp infection
* palpable purpura LE
* arthralgias
* abd pain
* renal dis
89
Eosinophilic granulomoatosis w polyangitis
* churg strauss
* assoc asthma
* ainusitis
* skin lesions
* peripheral neuropathy
* p anca (MPO)
90
Microscopic polyangitis
* lungs
* p anca
91
Granulomatosis w polyangitis
* =wegners
* facial necrotizing vasculitis
* granulomas in lungs and upper airway
* saddle nose
* c-anca
* tx: cyclosporine and corticosteroids
92
eqns:
* sensitivity:
* specificity:
* PPV:
* NPV:
* OR:
* RR:
* ARR:
* NNT:
* sensitivity: a / (a+c) OR 1-FN
* specificity: d / (b+d) OR 1-FP
* PPV: a / (a+b)
* NPV: d / (c+d)
* OR: AD / CB
* RR: (A / (A+B)) / (C / C+D))
* ARR: (C / C+D)) - (A / (A+B))
* NNT: 1/ARR
93
standard deviations:
* 1: 68%
* 2: 95%
* 3: 99.7%
94
Confidence interval eqn
CI = mean - Z(SEM) to mean + Z(SEM)
* Z for 90% CI: 1.645
* Z for 95% CI: 2
* Z for 99% CI: 2.57
to calc SEM: st dev / sq root(sample size)
95
+ and - skew:
* tail:
* mean median mode rela
+ skew:
* tail R
* mean \> median \> mode
- skew:
* tail L
* mode \> median \> mean
96
What is the diff btwn T1 and T2 error
T1 (alpha) = refects null but there is no assoc
T2 (beta) = null is accepted, but really there is an assoc
97
what is power?
1-B
the probability that a test will reject the null
98
CSF findings in meningitis of bac, TB/fungal, and viral
* opening pressure
* WBC ct
* cell type you see
* protein
* glucose
* gs
99
UTI
* Cyctitis
* s/s
* UA findings
* Pyelonephritis
* s/s
* UA findings
* cuases
* Cyctitis
* sys
* dysuria
* freq
* ugency
* suprapubic pain
* hematuria
* UA findings
* bac
* WBC/RBC
* leukocyte esterase
* nitrite
* Pyelonephritis
* s/s
* cyctitis +
* fever/chills
* n/v
* flank pain/CVAT
* UA findings
* cyctits +
* WBC casts
* cuases
* e coli
* proteus
* klebsiella
* enterobacter
* staph saphrociitisu
* serratia
* pseudomonas
100
