6.30.16 Flashcards
hypervent –> leads to?
decrease arterial pCO2 –> hypocapnia –> cerebral vasoconstrict –> decrease cerebral blood flow
dev milestones: 12mo
- gross motor: stand, walk first steps indep, throw ball
- fine motor: 2 finger pincer grasp
- lang: first words (not mama, dada)
- social/cog: sep anxiety, follow 1 step command w gesture
hereditary hypothalamic diabetes insipidus: #1 etiology
pt mutation in neurophysin II –> insuff ADH release into systemic circ
endometriosis: ssx
- asymptomatic
- dysmenorrhea, dyspareunia, infertile
dev milestones: 3yo
- social/cog: imaginative play
- lang: 3 word sentences
- fine motor: copy a circle, use utensils
- gross motor: ride a tricycle
Hodgkin lymphoma: histology
LN bx: Reed-Sternberg cell –> abundant cyto, bilobed/double nuclei, inclusion-like eosinophilic nucleoli
when is west nile virus usu transmitted?
summer
what is: thrombotic thrombocytopenic purpura
impaired ADAMTS13 (wWF cleaving protease) fx –> uncleaved multimers that are significantly more prothrombotic –> diffuse microvasc thrombosis –> microangiopathic hemolytic anemia, thrombocytopenia
total filtration rate: calc
GFR x plasma [A]
differentiate: TTP vs DIC
- TTP: thrombosis –> increased bleeding time, normal PT/PTT
- DIC: thrombosis + bleed –> increased PT/PTT
thiazolidinedione: MOA
bind PPAR-gamma –> upreg GLUT4, adiponectin –> decrease insulin resistance
west nile virus –> how dx?
1) clinical findings
2) CSF –> anti-WNV Ab
Whipple dz: histology
small intestine mucosa containing enlarged, foamy macrophage packed w rod-shaped bacilli & PAS+ diastase-resistant granules
net renal excretion rate of subst: calc
total filtration rate - total tubular resorption rate
what is: acute rheumatic fever
autoimmune rxn following an untreated GAS pharyngitis
subarachnoid hemorrhage: tx
nimodipine (CCB) –> prevent cerebral vasc spasm –> decrease morbidity, mortality
acute promyelocytic leukemia: cytogenetic abnormality
t(15; 17)
dev milestones: 2yo
- gross motor: stairs w both feet on each step, jump
- fine motor: build 6-cube tower, copy a line, turn page
- lang: 50+ vocab, 2word phrase
- social/cog: follow 2step command, parallel play, begin toilet training
MEN1: clinical features
- 1ary PTH –> hyperCa –> renal stone
- pit tumor –> prolactin, bitemporal visual defect
- pancreatic tumor –> usu gastrinoma
what are the mult endocrine neoplasias?
- MEN1: 3 P’s –> tumors of pit, PTH, pancreas
- MEN2A: medullary thyroid CA, pheo, PTH hyperplasia
- MEN2B: medullary thyroid CA, pheo, mucosal neuroma/marfanoid habitus
dev milestones: 5yo
- gross motor: skip, walk backward
- fine motor: copy a triangle, tie shoelace, indep dress/bath, print letters
- lang: count to 10, 5word sentence
- social/cog: has friends, complete toilet training
streptomycin: use
- TB
- plague
- tularemia
where do most gastric ulcers occur?
lesser curvature of stomach –> border bw acid-secreting & gastrin-secreting mucosa
subarachnoid hemorrhage: comp
vasospasm –> altered mental status, focal neuro deficits
leuprolide: MOA?
gonadotropin-releasing hormone analog –> transient increase in LH –> increase testosterone –> continuous leuprolide use –> suppress LH release –> decrease testosterone production
what is: granulosa cell tumor
sex cord stromal tumor of ovary that secrete estrogen –> endometrial hyperplasia
serum sickness: clinical findings
- fever
- pruritic skin rash
- arthralgia
- low serum C3, C4
DRESS synd: ssx
- fever
- gen LAD
- facial edema
- diffuse skin rash
- eosinophilia
- internal organ dysfx
what happens when severe aortic stenosis pts get A-fib?
sudden loss of normal atrial contraction that contribute to V filling:
- decrease LV preload –> severe hypotension
- blood build up in LA & pulm veins –> increase pulm venous pressure –> acute pulm edema
dev milestones: 18mo
- gross motor: run, kick ball
- fine motor: build tower of 2-4 cubes, remv clothing
- lang: 10-25 word vocab, ID >1 body part
- social/cog: understand “mine”, begin pretend play
west nile virus –> can lead to?
neuroinvasive dz:
- encephalitis
- meningitis
- flaccid paralysis
differentiate: 1ary vs 2ndary hemostasis disorder –> clinical features
- 1ary: skin & mucosal bleed –> epistaxis, menorrhagia, GI bleed, hematuria, easy bruise
- 2ndary: deep tissue bleed into muscles & jts, rebleed after surg procedures
Dx: normal PT, normal aPTT, low platelet, increased bleeding time
immune thrombocytopenia
serum sickness: histology
small vessel vasculitis w fibrinoid necrosis & intense neutrophil infiltration
granulosa cell tumor: histology? gross?
gross: unilat yellow tumor –> lipid in theca cells
histology: Call-Exner bodies –> cells arranged in microfollicular/rosette pattern around a pink eosinophilic center; coffee bean nuclei
streptomycin: what is? MOA?
aminoglycoside –> inactivate 30S ribosomal subunit –> inh protein syn
dev milestones: 4yo
- gross motor: balance & hop on 1 foot
- fine motor: copy a square
- lang: ID colors, speech 100% intelligible
- social/cog: cooperative play
fibroids: ssx
- heavy menses w or w/out clots
- constipation, urinary freq, pelvic pain/heaviness
- irreg enlarged uterus
endometriosis: pathophys
extrauterine endometrium –> bleed & shed –> blood collections in ectopic locations –> eventually hemolysis –> induce inflamm –> adhesion formation –> distort organ struct & fx:
- adhesion interfere w ovulation & FT fx –> infertile
- uterosacral lig –> fixed, retroverted uterus
- post cul de sac –> painful intercourse
- shed ectopic tissue –> dysmenorrhea
Dx: normal PT, normal aPTT, normal platelet, increased bleeding time
uremic platelet dysfx
damage lat corticospinal tract –> leads to?
spastic weakness
why is there hyperCa in sarcoidosis?
activated macrophage –> form 1,25-dihydroxyvitD (indep of PTH) –> intestine –> increase absorb Ca
what is: serum sickness
type III HSN to nonhuman proteins –> immune complex –> deposit in tissues –> vasculitis
acute rheumatic fever: clinical manifestations
- arthritis
- carditis
- Sydenham chorea
- erythema marginatum
- subcut nodules
what are the hemodynamics of severe aortic stenosis?
1) severe stenosis impairs LV output
2) higher systolic pressure cause LV hypertrophy
3) atrial contraction necess for filling of stiffened LV
RET mutation –> what thyroid CA?
medullary thyroid CA (MEN2)
Thayer-Martin selective medium: what is? for what?
chocolate (heated blood) agar w:
- vancomycin –> G+
- colistin (polymyxin) –> G-
- nystatin –> fungus
- trimethoprim –> G-
used to isolate Neisseria from clinical cultures
acute rheumatic fever: what Ab form? what do they do?
anti-group A strep Ab:
- M protein: attack myosin (cardiac protein)
- N-acetyl-beta-D-glucosamine: attack lysoganglioside (neuronal cell surface protein)
what is: neurophysin
carrier protein –> carry oxytocin & vasopressin –> from site of production at hypo –> to site of release at post pit
trauma, sustained pressure to neck of fibular –> leads to?
common peroneal N injury as it courses superficially & laterally to this struct
vWF def: clinical presentation
lifelong h/o mucosal bleeding –> gingival bleed, epistaxis, menorrhagia
what is: subacute cerebellar degen
paraneoplastic synd assoc w:
- small cell lung CA
- breast, ovary, uterine CA
endometrial CA/hyperplasia: ssx
- hx of obesity, nulliparity, or chronic anovulation
- irreg, intermenstrual, or postmenopausal bleed
- small, nontender uterus
paraneoplastic cerebellar degen: ssx
- progressively worsening dizzy
- limb & truncal ataxia
- dysarthria
- visual disturb
Dx: normal PT, normal/high aPTT, normal platelet, increased bleeding time
vWF def
what can you use to estimate GFR? why?
inulin clearance –> neither secreted nor resorbed
DRESS synd: cause
- anticonvulsant –> phenytoin, carbamazepine
- allopurinol
- sulfonamide –> sulfasalazine
- abx –> minocycline, vancomycin
LE: superficial lymphatic system
- medial track: superficial inguinal LN
- lateral track: popliteal –> deep inguinal
Dx: increased PT, increased aPTT, low platelet, increased bleeding time
DIC
what is: metrorrhagia
bleed at irreg intervals
friedreich ataxia: degen of?
- spinocerebellar tract
- dorsal column, DRG
auer rod –> indicates?
acute myeloblastic leukemia
what is: Whipple dz
rare systemic illness that involve small intest, jt, CNS caused by actinomycete Tropheryma whippelii
what is: Sydenham chorea
non-rhythmic mvmts of hands, feet, face
what is: transport maximum
kidney tubule: max rate at which subst can be resorbed
common peroneal N injury: ssx
weak foot:
- dorsiflexion
- eversion
sensory loss:
- dorsal foot
- lat shin
what is the M3 variant of AML?
acute promyelocytic leukemia
p53 mutation –> what thyroid CA?
anaplastic thyroid CA
Dx: normal PT, increase aPTT, normal platelet, normal bleeding time
hemophilia A & B
what is: erythema marginatum
faintly erythematous, circular lesions w central clearing that come and go on trunk & extremities
adenomyosis: ssx
- dysmenorrhea, pelvic pain
- heavy menses
- bulky, globular & tender uterus
DRESS synd: onset
2-8wk after exposure to drug
paraneoplastic cerebellar degen: pathophys
immune response against tumor cells –> cross react w Purkinje neuron antigens –> acute onset rapid cerebellar degen
granulosa cell tumor: who?
postmenopause
what is: menometrorrhagia
prolonged or excessive uterine bleeding occurs irregularly and more frequently
what is: infliximab
chimeric monoclonal antibody biologic drug that works against tumor necrosis factor alpha (TNF-α) and is used to treat autoimmune diseases
gastric ulcers can penetrate what BV?
L & R gastric A
RAS mutation –> what thyroid CA?
- follicular thyroid CA
- some follicular adenomas
hepatic encephalopathy: pathophys
adv liver fail –> can’t metabolize N waste products –> hyperammonemia –> cross blood-brain barrier –> taken up by astrocytes –> ammonia + glutamate –> glutamine –> increase intracell osmolarity –> astrocyte swell –> can’t release glutamine –> no glutamine for neurons –> no glutamate –> disrupt excitatory neurotransmission
prostate cancer: tx
androgen deprivation tx:
- surgical orchiectomy
- pharm suppression of testosterone production –> leuprolide
thiazolidinedione: onset of axn
several days - few weeks: bc dep on alter gene expression & subseq protein syn
what is: menorrhagia
heavy flow
Dx: normal PT, increased aPTT, normal platelet, normal bleeding time
heparin admin
what is: adiponectin
cytokine secreted by fat tissue:
- increase # of insulin-responsive adipocytes
- reg ffa oxidation
what are the Ab involved in paraneoplastic cerebellar degen?
anti-Yo, anti-P/Q, anti-Hu Ab
Dx: increased PT, increased aPTT, normal platelet, normal bleeding time
warfarin use
friedreich ataxia: ssx
- cerebellar ataxia
- loss of position/vibration sense
- kyphoscoliosis
- hypertrophic cardiomyopathy
- foot abnormal
- DM
