8/31/12 pt. IV

Question 1

What are the 5 T’s of congenital cyanotic heart disease?

Answer 1

ToF Transposition of the great vessels Truncus arteriosus, persistent Tricuspid atresia Total anomolous pulmonary venous return

Question 2

What are the main effects of aldo at the distal tubules and collecting duct?

Answer 2

retention of Na+ and water excretion of K+ and H+

Question 3

What causes muscle weakness in hyperaldosteronism?

Answer 3

hypokalemia

Question 4

Pathogenesis of hyporeflexic paralysis in poliomyelitis.

Answer 4

damage to anterior horn motor neurons

Question 5

What is unusual about the capsule of Bacillus anthracis?

Answer 5

It contains D-glutamate instead of polysaccharide.

Question 6

What is the major finding on CXR in woolsorters’ disease?

Answer 6

Widened mediastinum –> hemorrhagic mediastinitis

Question 7

Do benzos increase the frequency or duration of GABA-A receptor CL- channel opening?

Answer 7

frequency (Benzos are zippy!)

Question 8

Whatare the 4 drugs used to treat M. tuberculosis?

Answer 8

RIPE Rifampin Isoniazid Pyrazinamide Ethambutol

Question 9

What are the major side effects of the TB drugs?

Answer 9

Rifampin - orange fluids; induce CYP450 Isoniazid - B6 def; CYP450 inhib; hepatitis Pyrazinamide - hepatotoxicity Ethambutol - optic neuritis

Question 10

What are the Sx of B6 deficiancy?

Answer 10

peripheral neuropathy, megaloblastic anemia, seizures

Question 11

What renal toxicity is caused by aminoglycoside Abx?

Answer 11

acute tubular necrosis

Question 12

What is substance P? What opposes its action in the PNS?

Answer 12

11-polypeptide pain neurotransmitter; capsaicin

Question 13

What are the main side effects of nicotinic acid (niacin), used to treat hyperlipidemia? How do yoou prevent them?

Answer 13

cutaneous flushing, warmth, itching; aspirin

Question 14

What mediates “red-man syndrome” assoc’ed w/ vancomycin tx?

Answer 14

histamine

Question 15

What are the 2 ways amphotericin B causes renal toxicity?

Answer 15

1. renal vasoconstriction –> low GFR 2. ATN

Question 16

What 2 ions should be supplemented in amphotericin B tx?

Answer 16

Mg ++, K+

Question 17

Which cells are directly responsible for vascular intimal thickening, e.g. in atherosclerosis?

Answer 17

smooth muscle cells

Question 18

PTU vs. methimazole for hyperthyroidism tx.

Answer 18

Methimazole: inhibits thyroperoxidase only; harm to fetus PTU: also inhibits T4–>T3 BOTH may cause agranulocytosis

Question 19

What drugs competitively inhibit iodine uptake by the thyroid?

Answer 19

perchlorate and pertechnate

Question 20

How does parvovirus B19 infection manifest in adults?

Answer 20

mimics rheumatoid arthritis but resolves spontaneously.

Question 21

In subfalcine herniation, the _______ may herniate under the flx cerebri, poterntially compressing the _______.

Answer 21

cingulate gyrus; Ant. Cerebral A.

Question 22

The _______ is the brain structure most likely to herniate through the foramen magnum.

Answer 22

cerebellar tonsil(s)

Question 23

What visual field defect would result from compression of the PCA on one side (as might occur in uncal herniation)?

Answer 23

Contralateral homonymous hemianopsia w/ macular sparing

Question 24

What would result from one cerebellar peduncle being compressed against the tentorium cerebelli? Why?

Answer 24

ipsilateral hemiparesis d/t compression of the contralateral corticospinal tract.

Question 25

Thyroid biopsy shows branching papillae w/ a fibrovascular stalk lined by cuboidal epithel, as well as Psammoma bodies and “ground glass” nuclei. Dx?

Answer 25

Papillary thyroid cancer

Question 26

Thyroid biopsy shows normal histology but is invasive / contains sheets of follicular cells / conatins large cells w/ eosinophilic cytoplasm. Dx?

Answer 26

Follicular thyroid cancer

Question 27

What stain would you use to identify medullary carcinoma of the thyroid? Why?

Answer 27

Congo red; excess calcitonin becomes amyloid deposits

Question 27

What are the characteristic features of papillary carcinoma of the thyroid 9used to differentiate from follicular cancer)?

Answer 27

Psammoma bodies, ground glass nuclei

Question 28

What is the Reid index for severity of chronic bronchitis?

Answer 28

thinkness of mucus gland layer:thickness of bronchial wall (minus cartilage)

Question 29

What are the main Sx of early syringomyelia?

Answer 29

Loss of pain and temperature sensation above the level of the lesion.

Question 30

What intraspinal structure is typically destroyed in syringomyelia? What is this structure?

Answer 30

ventral white commissure; decussation of the 2nd order sensory neurons of pain and temp