6 Flashcards
Carpal spasm
Trousseau sign (hypocalcemia)
Twitching of the nose and lips
Chvostek sign (hypocalcemia)
Cotruncal abnormalities (interrupted aortic arch, truncus arteriosus)
DGS
Other DGS if first and second pouches involved
hypertelorism, short palpebral fissures, micrognathia, bifid uvula, cleft palate
Familial Hyopcalciuric hypercalcemia (FHH) inheritance
AD
FHH defect
CaSR hyposensitivity in parathyroid gland and kidneys. Higher levels of calcium are needed to suppress PTH
Mild asymptomatic hypercalcemia, reduced urinary excretion of calcium and high normal or mildly elevated PTH
Familial Hypocalciuric hypercalcemia (AD)
GH, prolactin and EPO
Transmembrane receptor activation of Janus kinase-STAT pathway
Ach (nicotinic), serotonin, NMDA, GABA
transmembrane ligand gated ion channels (ionotropic receptors)
Insulin and insulin-like GF
Transmembrane receptors with tyrosine kinase activity
Vitamin D
Intracellular receptor (like steroid hormones)
Without ApoE3 and E4
liver cannot remove chylomicrons and VLDLs leading to increased cholesterol and TGs
ApoC2
Activates lipoprotein lipase on chylomicrons and VLDL
ApoA1
required for esterfication of free cholesterol in HDL particles by lecithin-cholesterol acyltransferase (LCAT)
LCAT or Apo1 deficiencies
low HDL and increased circulating free cholesterol levels
Inositol monophosphate inhibition is hypothesized to be one of the mechanisms by which ______ exerts its antidepressant and antimanic effects
lithium
FMR1 loss of function mutation
Fragile X
Neurophsychiatric issues, development delay, hyperlaxity of joints in hand, large testes, prominent forehead and chin, long and narrow face
Fragile X
1) Fibromyalgia cause
2) proven pain reduction method that improves function
1) Abnormal central processing of pain
2) Gradual incremental aerobic exercise
Bilateral muscle weakness and associated skin (malar rash, violaceous eruptions on the eyelids, knuckles and elevated Creatine kinase
Dermatomysitis
Inflammatory disorder that affects patients >50 and causes subacute pain and stiffness in the shoulders, hips, weight loss, fever and malaise
Polymyalgia rheumatica
Really bad in morning and gets better during the day
RA
Federal socialized medical insurance program: Covers 65 and older who have worked and paid taxes. Covers younger individuals with disabilities, ESRD, ALS
Medicare
Covering inpatient hospital visits
Medicare Part A
Covering a select number of outpatient services and medical devices
Medicare Part B
An optional capitated plan with additional benefits (vision, dental)
Medicare Part C
Optional prescription drug plan
Medicare Part D
State-run medical insurance program: covers homeless, undocumented immigrants, prego women, and low-income familes
Medicaid
Fever, pruritic skin rash, and arthralgias that begin 7-14 days after exposure to an antigen
Serum sickness (Type III) w/ fibrinoid necrosis and intense neutrophil infiltration (labs will show neutropenia, low C3 and C4)
TNF-alpha inhibitors ADR
neutropenia
Prevention of atelectasis
Breathing exercises
Prevention of contrast-induced nephropathy
Adequate hydration
physical exam reveals pulsatile mass with a thrill on palpation. Auscultation reveals a constant bruit over the site.
AV fistula
Increase preload (End diastolic volume) and decrease after-load
AV shunts
Gingivostomatitis (see multinucleated giant cells) = HSV. What is the reason for hospitalization ?
Pain often results in dehydration (this is the reason for hospitalization)
Surgical landmark during appendicitis
teniae coli (similar function to outer layer of muscularis externa in GI)
Injury to the base of the pons
contralateral weakness and ataxia (corticospinal and corticobulbar) and pontocerebellar fibers
Frontal cortex lesions
social disinhibition and deficits in attention and executive functions (planning, organizing, decision making)
Anterior 2/3 of the posterior limb of the internal capsule=
mainly motor fibers (corticospinal tract)
Posterior 1/3 of posterior limb of internal capsule=
sensory (thalamocortical)
occurs secondary to leakage of plasma proteins through damaged vascular wall and is characterized by collagenous sclerosis, and accumulation of mural foamy marcrophages
Lipohyalinosis
Microatheromas
atherosclerotic accumulation of lipid-laden macs within intimal layer of penetrating artery near its origin off parent vessel
Result of small vessel occlusion (due to lipohyalinosis and microatheroma formation) in penetrating vessels supplying the deep brain structures
Lacunar infarcts (Uncontrolled HTN and diabetes = risk factors
Ateriovenous concentration
indirect measurement of the solubility of the anesthetic in the body tissue
High AV concentration = ________ time of onset
slow b/c more anesthetic is extracted from the blood by the body tissues, increasing the time it takes for the blood to become saturated and slowing the onset of action
High blood/gas partition coefficient (solubility of anesthetic in blood)
slower onset of action (absorbed to a greater extent by the blood)
Steeper arterial tension curve
less soluble anesthetic (partial pressure in the blood rises more rapidly with less soluble anesthetics)
Lower the MAC
the more potent the anesthetic
Prolonged untreated sleep apnea increases risk for
pulmonary hypertension and right heart failure
Small VSD produces what kind of murmur and where?
Loud holosystolic best heard over left sternal boarder at 3rd/4th intercostal space
Larger (nonrestrictive VSDs) produce what kind of murmur
Maybe absent due to decreased resistance across the VSD and lower transseptal pressure grandient
Fixed, wide splitting S2
ASD
________ can be caused by severe hypomagnesemia (double decrease), which can be seen in prolonged diarrhea
hypoparathyroidism
Single decrease would increase PTH
Aromatase inhibitors that reduce the synthesis of estrogen from androgens, suppressing estrogen levels in post-menopausal women and slowing progression of ER-positive tumors.
Anastrozole, letrozole, exemestane
Epidermal growth factor receptor 2
HER2
Inhibits MAPK and PI3K/Akt signaling pathways, increased degradation of HER2, and facilitates antibody-mediated destruction of tumor cells
Trastuzumab
Dopamine agonist used in growth hormone-secreting pituitary tumors or prolactinoma
Cabergoline
Uses of leuprolide?
Management of prostate cancer, precocious puberty and endometriosis
located near the 3’ end of the mRNA (post-translational modification) = Poly-A-tail. What is its role
to protect mRNA from degradation within the cytoplasm after it exits the nucleus
Consensus sequence
AAUAAA
Where should thoracentesis be performed in midclavicular line, midaxillary, posterior scapular?
above the 8th
above the 10th
above the 12th
