6.27.16 Flashcards
hypocretin: what is? fx?
hypocretin-1 (orexin A), hypocretin-2 (orexin B) –> neuropeptides produced in lat hypo
- promote wakefulness
- inh REM sleep-related phenomena
factitious disorder: key feature
intentional falsification or inducement of ssx to assume sick role
Dx: pseudopalisading tumor cells around areas of necrosis
glioblastoma multiforme
CA-125: use
cancer marker for epithelial ovarian CA –> dx & fu tx
varicose vein: comp
- superficial venous thrombosis
- venous stasis ulcer –> usu over medial malleolus
NOT thromboembolism
Meyer’s loop injury –> leads to?
contralat sup quadrantanopia
Dx: hypocretin-1 def
narcolepsy
illness anxiety disorder: key feature
fear of having serious illness despite few/no ssx + consistently neg evals
cancer antigen 125 (CA-125): assoc dz
epithelial ovarian CA
Hashimoto thyroiditis: histology
- lymphocyte infiltrate w germinal centers
- Hurthle cells (eosinophilic epithelial cells)
ethylene glycol ingestion: clinical findings
- anion gap metab acidosis
- increased osmolar gap
- calcium oxalate crystals in urine
what is: cataplexy
- conscious, brief episodes of sudden bilat muscle tone loss –> precipitated by emotion (laugh, joke)
- spont, abnormal facial mvmt w/out emotional trigger
Dx: pt from Central/South America –> sz
neurocystocercosis
what is: dorsal optic radiation
upper fibers of optic radiation –> carry info from upper retina (lower contralat visual field)
how is isoniazid metab?
by acetylation
what is the signifiance of glycerol kinase in DKA?
gluconeogenesis:
1) adipose –> brkdown TG –> glycerol
2) liver, kidney –> glycerol kinase –> glycerol –> glucose
Meyer’s loop: what route?
LGN –> temporal lobe –> lingual gyrus of striate cortex
what is another name for cobalamin?
vitB12
Dx: painless thyroiditis
Hashimoto thyroiditis
what is the most common urea cycle disorder?
ornithine transcarbamylase def
subacute granulomatous (de Quervain) thryoiditis: onset
following viral illness
congenital hypothyroid: cause
- thyroid dysgenesis
- iodine def
cutaneous post calf: drains to what LN?
deep inguinal
spongiform encephalopathy: histology
- vacuoles in gray matter
- no inflamm changes
interstitial lung dz: why increased expiratory flow rate?
fibrotic interstitial tissue –> decrease lung vol, increase lung elastic recoil –> increase radial traction (outward pulling) on airway –> airway widen –> decrease airflow resistance –> increase expiratory flow rate
Dx: hyperammonemia –> vomit, tachypnea, confuse/coma
urea cycle disorder
Blastomyces dermatitidis is endemic to?
SE USA
what is: myocardial stunning
reversible contractile dysfx
glioblastoma multiforme: gross appearance
areas of necrosis & hemorrhage
monoclonal Ab against PD-1: MOA
prevent PD-1 blind PD-L1 –> block T cell inh –> restore cytotoxic response –> tumor cell apoptosis
what is: Meyer’s loop
lower fibers of optic radiation –> carry info from lower retina (upper contralat visual field)
intracranial mass –> dx?
glioblastoma multiforme
hypoK: ssx
- muscle weak
- cramp
- possible rhabdomyolysis
diabetes during preg –> neonatal comp –> transient hypoglycemia –> pathophys?
exposed to high maternal glucose levels in utero –> excessive fetal insulin production, islet hyperplasia –> hyperinsulinemia persist for several days after birth
epithelial ovarian CA: who?
postmenopause
what is another name for vitB12?
cobalamin
mitral stenosis: when do you hear the opening snap?
early diastole
glans penis: drains to what LN?
deep inguinal
conversion disorder: key feature
fxal neurologic symptom disorder:
- neuro ssx incompatible w neuro dz
- acute onset assoc w stress
Dx: eczema, intell disability, abnormal gait, musty body odor
PKU
tumor –> effect on PD-1?
increase expression of programmed death receptor 1 ligand (PD-L1) –> inh cytotoxic T cell –> downreg immune response against tumor cell
what is: optic radiation
LGN axons that project to striate (1ary visual) cortex
Tourette disorder: who?
6-15yo M
epistaxis: most common location
ant nasal septum –> Kiesselbach plexus
optic tract fibers go to?
lat genticulate nucleus
what muscles are used to sit up from supine position?
- external abd obliques
- rectus abdominis
- hip flexors
congenital hypothyroid: comp
irrev intell disability
Dx: hyponia, large ant fontanelle, lrg tongue, reducible umbilical hernia
congenital hypothyroid
diabetes during preg –> neonatal comp –> what congenital malformation?
- neural tube defect
- CV anomaly
- caudal regression synd
dietary lipid: digested where?
duodenum via pancreatic enzymes
rabies vaccine: what type?
inactivated
diabetes during preg: neonatal comp
- premature
- fetal macrosomia
- congenital malformation
- resp distress
- transient hypoglycemia
- polycythemia & hyperviscosity
Hashimoto thyroiditis: what Ab will you find?
TPO
Hashimoto thyroiditis: cause
autoimmune
superficial inguinal LN: drains to what LN?
deep inguinal
what muscles make up the hip flexors?
- rectus femoris
- iliopsoas
- tensor fascia lata
what is: scolex
head of tapeworm w hooklets
somatic ssx disorder: key feature
excessive anxiety & preoccupation w >1 unexplained ssx
ornithine transcarbamylase def: charact
- hyperammon (medical emergency!)
- elevated orotic acid in urine
PD-1: location
surface of activated T cells
what is most common ovarian malig?
epithelial ovarian CA
vitB12 def –> trt w folate –> what happen?
- mod improve Hb level
- can worsen neuro dysfx
obstructive sleep apnea –> tx –> nerve stim –> what N? MOA?
hypoglossal N –> electrical stim –> tongue mv forward –> increase oropharyngeal airway diameter –> decrease freq of apneic events
what is: cysticeri
neurocystocercosis: fluid-filled larval cysts surrounding the invaginated scolex
malingering: key feature
falsification of exaggeration of ssx to obtain external incentives (2ndary gain)
testes: drains to what LN?
abd para-aortic (retroperitoneal)
how do you differentiate bw tuberculoid vs lepromatous leprosy?
lepromin skin test :
+ –> tuberculoid (strong CD4+ TH1 cell-med immune reponse to myco leprae)
- –> lepromatous (weak TH1 cell-med immune response)
DHP CCB: AE
- HA
- flushing
- dizzy
- peripheral edema
why is hyperammon a medical emergency?
ammonia –> neurotoxic:
- episodes of vomit
- confuse/coma
- cerebral edema –> tachypnea –> hypervent, resp alk
what occurs at Kiesselbach plexus?
anatomosis of:
- ant ethmoidal A
- sphenopalatine
- sup labial
what is: Anti-Rh immune globulin
IgG anti-D Ab –> opsonize Rh+ fetal RBC –> cleared by maternal reticuloendothelial macrophages –> prevent maternal Rh sensitization
total myocardial ischemia: when is there loss of cardiomyocyte contractility?
60 sec
what strongly suggests rabies encephalitis?
exposure –> w/in wks –> agitation & spasm –> progress to coma
epithelial ovarian CA: histology
- epithelial cell anaplasia
- invasion of ovarian stroma
- mult papillary formations w cell atypia
congenital hypothyroid: onset
asymp at birth –> dev ssx after maternal T4 wanes
superficial inguinal LN: drains what?
all skin from umbilicus down –> including anus (blow dentate/pectinate line)
Except: testes, glans penis, post calf
amlodipine: drug class
DHP CCB
Anti-Rh immune globulin: given to who? when admin?
Rh- F:
- 28wk gestation
- immed postpartum
dietary lipid: absorbed where?
jejunum
what drugs inh dihydrofolate reductase?
- trimethoprim
- methotrexate
- pyrimethamine
Dx: acute renal fail, proximal tubular cell ballooning, vacuolar degen
acute tubular necrosis
temporal lobe lesion –> can damage what part of visual pathway?
Meyer’s loop
neurocystocercosis: diagnostic findings
- CT/MRI: cyst, scolex
- eosinophilia
urea cycle: rate limiting enzyme
carbamoyl phosphate synthetase
PKU: mode of inheritance
AR
can cholescystectomy pt tolerate fatty food? why?
yes: no gallbladder ==> bile constant released into duodenum
congenital hypothyroid: ssx
- constipation
- lethargy
- hypotonia
- macroglossia
- umbilical hernia
- lrg ant fontanelle
what is the most important hip flexor?
iliopsoas
subacute granulomatous (de Quervain) thryoiditis: histology
inflamm infiltrate w macrophage & giant cells
obstructive sleep apnea: pathogenic mech
neuromusc weakness
differentiate: vitB12 vs folate def
vitB12: megaloblastic anemia + neuro dysfx
folate: megaloblastic anemia
acute tubular necrosis: histology
proximal tubule cells:
- vacuolar degen
- ballooning
congenital hypothyroid: tx
levothyroxine by age 2wk
thiazide diuretic: AE? how?
decrease intravasc fluid vol –> stim aldos –> increase excrete K, H –> hypoK, metab alk
sex hormones –> effect on bone growth
- bone growth
- epiphyseal plate closure
pyrimethamine: use
- malaria
- toxoplasmosis
what is: CA-125
protein expressed by epithelial cells lining Mullerian organs (ovary, FT) & peritoneum
what is: PrP
prion protein –> CJD, bovine spongiform encephalopathy
DHP CCB: drugs
“-dipine” suffix: amlodipine, nifedipine
PKU: ssx
- intell disability
- gait, posture abnormality
- eczema
- musty body odor
dorsal optic radiation: what route?
LGN –> parietal lobe –> cuneus gyrus of striate cortex
what is the main source of rabies in the USA?
bat
glioblastoma multiforme: histology
pseudopalisading tumor cells around areas of necrosis
Dx: painful thyroiditis
subacute granulomatous (de Quervain) thryoiditis
differentiate: trimethoprim vs methotrexate vs pyrimethamine
- trimethoprim: bact
- methotrexate: human cell
- pyrimethamine: some protozoa
ornithine transcarbamylase def: pathophys
excess carbamoyl phosphate –> stimulate pyrimidine syn –> orotic acid accum
differentiate: chronic tic disorder vs Tourette
chronic tic disorder: >1yr –> 1 or more motor or verbal tics (but not both)
Tourette: >1yr –> mult motor tics + at least 1 verbal tic
