Amboss Flashcards
What usually occurs prior to muscle weakness in Lambert-Eaton Myasthenic Syndrome?
Symptoms of autonomic dysfunction (e.g., dry mouth, constipation) are prominent and usually precede the muscle weakness, while muscle reflexes are typically absent or reduced.
Paraneoplastic autoantibodies against presynaptic voltage-gated calcium channels cause Lambert-Eaton myasthenic syndrome
At what age does indomethacin stop inducing closure of a Patent Ductus Arteriosus?
At full term.
NSAIDs only induce PDA closure in pre-term infants,
ie, in infants born prior to 37 weeks gestation.
What is a major possible side effect of Natalizumab?
PML infection.
Natalizumab is a biologic treatment for MS
Natalizumab decreases migration of lymphocytes to the CNS and thus increases the risk of progressive multifocal leukoencephalopathy.
How does the A-a gradient change during a PE
Alveolar Arterial
It increases
What is Hamann’s sign
Crepitus that is heard when auscultating the chest, that correlates to heart beats.
Associated with pneumomediastinum
What does pronator drift indicate when the arm drops down and pronates?
What about when it drifts up and pronates?
Down: Upper motor neuron lesion.
Up: Cerebellar lesion.
what is the target of the antibodies in pemphigus vulgaris
desmogleins. the cadherin proteins joining cell to cell epitelials, which form desmosomes.
What drugs are used for pharmacologic cardiac stress tests
Dipyridamole Dobutamine
What is the Whipple triad
fasting hypoglycemic episodes. labs showing hypoglycemia, symptom relief from consuming or receiving glucose
What are the histologic traits seen in lichen planus
Hyperkeratosis - increased stratum corneum
and especially
Hypergranulosis - increased stratum granulosum
and very specifically,
Lymphocytic infiltration of the dermoepidermal junction.
oral lesions - Wickhkam Stria.
Histology change in psoriasis
DECREASED thickness of stratum granulosum.
plus
Acanthosis: Increased st. Corneum
and most specifically
Parakeratosis - Nuclear retention in the st. Croneum.
Difference in muscle activity between NMS and Serotonin syndrome
NMS = Rigidity and Tremors
Serotonin Syn = Myoclonus and Hyper-reflexia.
Inducers and Inhibitors of CYP
CYP Inducers: start of with chronic alcohol, this is a clear inducer.
Chronic Alcoholics Steal Phen Phen and never refuse Greasy Carbs.
CYP inhibitors:
SICKFACES.COM
What pathogen can cause erysipelas and/or lymphangitis following an insect bite?
Strep Pyogenes. Group A Strep.
It infects the insect wound following the bite, not necessarily carried or transmitted by the bite itself.
How is eRPF calculated?
= Urine[PAH] x Urine flow rate/Plasma[PAH]
How is RBF calculated?
= RPF/(1-HCT)
What condition OTHER than hereditary spherocytosis do we find spherocytes?
Autoimmune hemolytic anemia.
AIHA.
What vitamin deficiency can carcinoid tumors lead to?
Carcinoid syndrome depletes Tryptophan, which is needed for Niacin.
So Carcinoid syndrome can deplete Niacin and lead to Pellagra.
What is used to determine if a patient with pneumonia needs hospitalization?
the CURB-65
Confusion Urea Respiratory rate Blood pressure Age over 65
- Confusion
- Urea (blood) > 7 mmol/L (20 mg/dL)
- Respiratory rate ≥ 30/min
- Blood pressure (systolic) ≤ 90 mm Hg or diastolic BP ≤ 60 mm Hg
- ≥ 65 years (of age)
If the CURB-65 score is ≥ 2, hospitalization is indicated
What other systemic disease is commonly associated with Giant Cell Arteritis/Temporal Arteritis?
Polymyalgia Rheumatica.
What are macula communicans another word for?
Gap junctions.
Is the 12;21 translocation favorable or unfavorable in pediatric B-ALL
It is favorable
Kids FLIP back to health!
12 is 21 flipped
What genetic deficiency is a contraindication to ACE inhibitors
C1 inhibitor deficiency
What condition causes Lupus Pernio
Sarcoidosis
What other major organ pathology is present early on in Autosomal Recessive Polycystic Kidney disease?
The Liver,
Periportal Liver fibrosis.
What autimmune condition is toxic megacolon associated with?
Ulcerative Colitis.
What is the Thompson test?
Patient lays supine with legs flat. Squeeze the calf muscle. Foot should plantar flex. Absence of flexion = positive test Indicates a Achilles tendon rupture.
What is the Uhthoff phenomenon?
The worsening of neurological symptoms in MS patients with increasing body temperatures.
ie after a hot bath.
What are the “lateral anlagen”
the ultimobranchial bodies
Form the parafollicular C cells of the thyroid
The ‘medial anlangen’ form the thyroid follicular cells.
Both are of endodermal origin.
How does lupus anticoagulant affect coagulation labs?
It increases the aPTT
What other disorder has a single palmar crease besides downs?
Cri du chat syndrome
which macrolide drug is NOT an inhibitor of CYP enzymes?
Azithromycin
What drugs are contraindicated in acute gout?
Allopurinol
and
ASPIRIN. It is contraindicated always in gout, bc it inhibts Uric acid excretion at low doses.
Other NSAIDs are indicated like indomethacin or acetominophen.
What drug is is indicated to treat WPW syndrome patients with atrial fibrillation?
What are contraindicted drugs?
Procainamide is the drug of choice.
Drugs that inhibit SA and AV nodal activity are contraindicated bc they increase the alternate pathway conduction.
ie NO CCBs, NO Beta Blockers, NO Adenosine.
Which beta blocker with the name A-M is NOT cardioselective?
Labetalol
What other conditions does nephrotic syndrome presidopse patients to having?
Patients with nephrotic syndrome are at high risk of developing infections (due to urinary loss of IgG), hypocalcemia (due to vitamin D deficiency), and venous thrombus formation (due to urinary loss of antithrombin III and loss of fluid into the extravascular space).
