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STEP > Anatomy Review > Flashcards

Anatomy Review Flashcards

1
Q

Presence of hemivertebra

A

Possible cause of scoliosis

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2
Q

Spinal tap (layers penetrated)

A
  1. Skin
  2. Superficial Fascia
  3. Supraspinous ligament
  4. Interspinous ligament
  5. Ligamentum flavum (first pop)
  6. Epidural space (stop here for anesthesia)
  7. Dura mater (second pop)
  8. Arachnoid mater
  9. Subarachnoid space
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3
Q

Cleft lip

A

Failure of fusion of the medial nasal and maxillary processes

Tx: Surgery

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4
Q

Cleft palate

A

Failure of fusion of the maxillary processes; occur posterior to the incisive foramen

Tx: Surgery

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5
Q

Malformation of nasolacrimal duct

A

Cords that connect the lacrimal sac to the nasal cavity fail to form

=»Continuous flow of tears down the face

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6
Q

Thyroglossal duct cysts

A

Cystic tissue develops in the duct that the gland descends thru (from the foramen cecum to the cricothyroid region); presents as a midneck mass that moves with swallowing

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7
Q

Treacher-Collins Syndrome

A

Failure of neural crest cells to migrate from the first brancial arch

Causes mandibular hypoplasia, conductive hearing loss, and facial malformation

Tx: Surgery

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8
Q

First Branchial Arch Derivatives

A

CN: V

Bones: Malleus, incus

Ligaments: Anterior ligament of the malleus, sphenomandibular ligament

Muscles: Muscles of mastication, tensor tympani, tensor palati, mylohyoid, anterior belly of the digastric

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9
Q

Second Branchial Arch Derivatives

A

CN: VII

Bones: Stylohyoid, stapes,

Ligaments: Stylohyoid ligament

Muscles: Muscles of facial expression, stepdius, stylohyoid, posterior belly of the digastric (“S’s)

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10
Q

Third Branchial Arch Derivatives

A

CN: IX

Bones: Greater horn (upper half) of the hyoid

Muscles: Stylopharyngeus

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11
Q

Fourth Branchial Arch Derivatives

A

CN: X

Muscles: All the muscles of the larynx, the pharynx (ex. stylopharyngeus), and the soft palate (ex. tensor palati)

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12
Q

Fifth Branchial Arch Derivatives

A

CN: XI

Muscles: SCM, Trapezius

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13
Q

First branchial cleft/pouch derivatives

A

Auditory tube, tympanic cavity, the ***tympanic membrane

*Can form cysts near the external auditory meatus anterior to SCN

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14
Q

Second Branchial Cleft/Pouch Derivatives

A

Crypts of the palatine tonsils

*Cysts near the tonsils (MCC of branchial cysts)

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15
Q

Third Branchial Pouch Derivatives

A

Inferior parathyroid glands, thymus

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16
Q

Fourth Branchial Pouch Derivatives

A

Superior parathyroid glands, C-cells of the thyroid

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17
Q

Fracture of the cribiform plate

A

Produces continuity b/w subarachnoid space and the nasal cavity

=» Leakage of CSF from the nose; possible lose of smell since CN I travels thru the cribiform plate of the ethmoid bone

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18
Q

Fracture of the cribiform plate

A

Produces continuity b/w subarachnoid space and the nasal cavity

=» Leakage of CSF from the nose; possible lose of smell since CN I travels thru the cribiform plate of the ethmoid bone

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19
Q

Cavernous sinus thrombosis

A

Structures passing thru include CN III, IV, V1, V2, VI and ICA

  • Possible spread of infxn thru this area
  • Sx include diplopia and engorged retinal veins
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20
Q

Calcification of the arachnoid villi

A

Communicating hydrocephalus; usually occurs in the elderly

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21
Q

Damage to superior gluteal nerve

A

Trendelenburg gait; damaged gluteus medius and minimus

  • Hip will fall down towards injured side when noninjured leg is lifted
  • think of this if anyone puts a shot in someones butt
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22
Q

Fracture in neck of the femur

A

Avascular necrosis of the head of the femur (damaged medial circumflex)

-Leg will be rotated laterally and appear shorter; needs hip replacement

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23
Q

Ankle sprain

A

Excess inversion damages the anterior talofibular ligament and the calcaneofibular ligament

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24
Q

Pott’s Fracture

A

Excess eversion of the ankle produces a tibia and fibula fracture due to strength of deltoid ligament

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25
Q

Erb-Duchenne Palsy

A

Damage to the upper trunks of the brachial plexus; possibly due to excess traction on the head during childbirth

-Arm is medially rotated and extended
=»Due to loss of lateral rotators of arm and flexors (musculocutaneous nerve)

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26
Q

Klumpke’s Palsy

A

Excessive abduction of the arm causing lower trunk damage (C8, T1)

  • Pt. will present with a claw hand due to unopposed action of flexors (unopposed median nerve action)
  • Loss of cutaneous innervation of the arm and forearm (damaged ulnar nerve)
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27
Q

Radical mastectomy OR Knife wound to lateral chest

A

Winged Scapula

  • Pts. can also not raise their arm over their head
  • Damaged long thoracic nerve
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28
Q

Fracture of the neck of the humerus

A

Axillary nerve damage

-Loss of sensation over shoulder; inability to abduct arm past 15 degrees

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29
Q

Damage to radial nerve in the axilla

A

Saturday Night Palsy

-Loss of extension at elbow (damage to triceps), loss of extension at wrist (wrist drop), loss of sensation on the posterior arm and forearm

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30
Q

Fracture of the midshaft of the humerus

A

Pure wrist drop with lost of sensation of the posterior hand

-May also have damage to the brachial artery

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31
Q

Supracondylar fracture of the humerus

A

Weak flexion of the wrist due to damage to the median nerve; loss of finger flexion of the first 3 digits; thenar atrophy

-Loss of pronator teres as well =» supinated hand

“Hand of benediction”

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32
Q

Damage to the ulnar nerve at the medial epicondyle

A

Loss of sensation in lateral 2 fingers, loss of interosseus muscles, some loss of finger flexion (Claw-hand)

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33
Q

Corpus cavernosum

A

Contains deep artery of the penis and becomes engorged with blood mediating erection

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34
Q

Ejaculation

A

A sympathetic action, unlike erection, that compresses the ductus deferens, seminal vesicle, and prostate gland to eject semen into the urethra

-Mediated by the pudendal nerve

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35
Q

Pudendal nerve block

A

Palpate ischial spine thru the vaginal wall and insert the anesthetic just medial to it

-But, you can damage the inferior pudendal artery so careful ya dingus

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36
Q

Problems with urination and defecation after childbirth

A

Torn perineal body/ episiotomy gone wrong

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37
Q

Cystocele

A

Herniation of pelvic organs due to damaged pelvic floor muscles

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38
Q

Varencicline

A

Partial Nicotinic agonist that doesnt cause euphoric effects but also prevents withdrawal

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39
Q

High altitude adjustments

A

Decreased PaO2 ➡️ Increased firing of the carotid body stimulating respiration

-Will eventually cause a metabolic alkalosis (compensated after 48hrs)
Decreased PaO2 will remain tho

Other findings: ⬆️ 2,3 DPG
⬆️Hb prod.
⬆️ VEGF
Hemoconcentration

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40
Q

DOC for PTSD

A

SSRIs

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41
Q

Slow pain nerve fibers

A

IV (c)

-un myelinated

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42
Q

Fast pain nerve fibers

A

A-delta

-touch, pressure, temperature, fast pain

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43
Q

Merkel discs

A

Unencapsulated, light touch receptors

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44
Q

MC spinal cord tumor

A

Ependymoma; look for the perivascular pseudo rosettes on histo

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45
Q

failure of the choroid fissure to close

A

Coloboma iridis

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46
Q

Hydrocephalus ex vacuo

A

Appearance of the ventricles following degeneration of the caudate nuclei

(In Huntington’s usually)

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47
Q

Subfalcine herniation

A

Herniation of the brain under the falx cerebri

-May cause headache or compression of the ACA

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48
Q

RCC origin

A

Proximal tubular cells

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49
Q

MC GI abnormality assoc. w/ Down’s

A

Duodenal atresia

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50
Q

Aneurysm of the PCA

A

Second most common site in the circle of Willis

=» decreased perfusion of the thalamus and hypothalamus

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51
Q

Lenticulostriate arteries

A

MC arteries involved in stroke; are branches of the MCA

-Would damage…

The interior capsule

Caudate nucleus

Putamen

Globus pallidus

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52
Q

Blood supply to the internal capsule

A

Lenticulostriate arteries and the anterior choroidal arteries

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53
Q

Great cerebral vein of Galen

A

Drains to the straight sinus

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54
Q

Foramen spinosum

A

Opening in the skull which allows the passage of the middle meningeal artery

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55
Q

Calcarine artery

A

Branch of the PCA that supplies the visual cortex

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56
Q

Interomedial cell column

A

Fond from T1-L3 and contain the synapses for sympathetic fibers

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57
Q

Projection

A

Attributing undesirable/unacceptable feelings or thoughts to others

Man who wants to have an affair thinks his wife is cheating on him

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58
Q

Social smile

A

3 months

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59
Q

6 months

A

Sits up unassisted, turn over, recognize faces

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60
Q

8-12 months

A

Crawls, stranger anxiety, pincer grasp, simple instruction

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61
Q

12-15 months

A

Walks, say first words, separation anxiety, object permanence

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62
Q

1.5 years (Ainsley mostly)

A

10 words, knows name, uses mom as base

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63
Q

2 years

A

Kick ball, understanding “no”, 2 word sentences and 250 words, parallel play

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64
Q

3 years old

A

Boy/girl sense, bladder control, talks in understandable sentences

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65
Q

4 years

A

Cooperative play, imaginary friends, phobias, body curiosity

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66
Q

7-11 years (elementary school)

A

Identify w/ same gendered parent, same sex play, logical thought, *best age to perform elective surgery

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67
Q

11-14 years

A

Peers are important influence, personalities become more fleshed, first menses and ejaculation

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68
Q

14-17 years

A

Body image concerns, identity development, development of abstract thinking

MC age at first intercourse = 16

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69
Q

Difference b/w conditioned and unconditioned response

A

Unconditioned= natural response (Dwight getting a mint in response to a bell)

Conditioned= Dwight wants a mint when his doorbell rings

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70
Q

Learned helplessness

A

When someone no longer tries to escape a negative influence

  • giving up on escaping new beatings
  • famous study was dogs in the pen who got zapped regardless of their actions so they gave up
  • is essentially just “being broken”
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71
Q

Most likely ages to engage in risky behavior

A

14-17; teens

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72
Q

Focus on one part of a toy, impaired communication, lack of fear at the doctor’s office

A

ASD Level III

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73
Q

Intense interests, abnormal social relationships

A

Ben Smith (ASD I)

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74
Q

White coat hypertension

A

HTN in the office but not at home

-Is a type of conditioned response

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75
Q

Inheritable form of Downs Syndrome

A

46 XX t(14;21)

Robertsonian translocation

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76
Q

Apparent damage to all 3 major spinal tracts

A

Think Brown-Sequard

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77
Q

Caude equina syndrome

A

-Usually caused by a nerve root tumor, ependymoma, or even a lipoma of the terminal SC (L3-C0)

Clinical: Distributed in a UNILATERAL, SADDLE-SHAPED AREA

  • Severe, unilateral radicular pain
  • Unilateral muscle atrophy

***Absent quadriceps (L3-L4) and ankle jerk (S1) reflexes

-Normal continence and sexual fnxn

***Gradual onset

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78
Q

Conus medullaris syndrome

A

Intramedullary tumor (ependymoma) from ***S3-C0)

Clinical: BILATERAL PAIN and NOT SEVERE in saddle distribution

-No changes in muscles or reflexes

***SEVERELY IMPAIRED SEXUAL FNXN AND INCONTINENCE

***SUDDEN, BILATERAL ONSET

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79
Q

Urachal remnant

A

May present as urine discharge from the umbilicus (patent urachus), pus and tenderness (urachal sinus), or an intrabdominal cyst

-Results from failure of the duct connecting the bladder and the yolk sac in the developing embryo to completely obliterate

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80
Q

Pancoast Tumor

A

Tumor on the superior sulcus of the lungs that causes compression of the brachial plexus (arm parasthesias and weakness) and an ipsilateral Horner’s syndrome

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81
Q

SVC Syndrome

A

Swelling of the face and JVD

-More commonly due to a mediastinal tumor rather than a pancoast tumor)

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82
Q

Opioid painkiller effect

A

Mu opioid receptors bind to K+ channels and increase their efflux

=»hyperpolarization

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83
Q

Meglitinides

A

Inhibit pancreatic B-cell K+ channels

=»depolarization and increased release of insulin

-Very similar to sulfonylurea mechanism of action

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84
Q

ANP/BNP signaling

A

Activates GC =»increased cGMP and vasodilation of the renal artery

=»Increased GFR

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85
Q

Vessel used for CABG when there are multiple blockages

A

Saphenous vein; commonly accessed in the superficial, medial thigh

-Starts in the femoral triangle (inferolateral to the pelvic tubercle) where it coasts medially down the thigh down anterior to the malleous and along the medial foot

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86
Q

Femoral Triangle

A

Contains NAVL (nerve not included in sheath)

Borders: Superior= inguinal ligament

Lateral= sartorious

Medial= adductor longus

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87
Q

Fibrous bands connecting the retroperitoneum to the RLQ in a newborn

A

Obstruct the duodenum and are a sign of midgut malrotation

88
Q

Aromatase deficiency

A

Presents in the newborn as ambiguous external genitalia, normal internal (usually female) genitalia

***Also causes MATERNAL VIRILIZATION due to decreased aromatase present in the placenta

89
Q

GVHD

A

Immunocomponent donor T-cells attack host MCH-Ags; can occur with liver transplants as well as BM transplants

Clinical: Diffuse maculopapular rash
Diarrhea, abdominal pain
Abnormal liver fnxn tests

90
Q

Wet beriberi

A

Chronic malnourishment and decreased thiamine cause

Peripheral neuropathy

AND

Dilated cardiomyopathy (S3, displaced apical pulse, CHF)

91
Q

Dermatomyositis can indicate what?

A

Underlying cancer

-Usually ovarian, lung, or colorectal

92
Q

Diffuse esophageal spasm

A

Disorganized, non-peristaltic contractions of the esophagus in response to a bolus due to impaired inhibitory neurotransmission

Clinical: Dysphagia
Chest pain/ heart burn
Regurgitation

93
Q

Confirmatory test for cholecystitis

A

Hepatobiliary radionuclide scan

-Gallbladder will not be visualized

94
Q

4 Rules of the brainstem

A
  1. 4 structures in the midline that begin w/ “M”
    - Motor pathway (corticospinal tract)
    - Medial lemniscus
    - Medial longitudinal fasciculus (lesion produces internal opth)
    - Motor nucleus and nerve (which ones?)
  2. 4 side structures start w/ “S”
    - Spinocerebellar pathway (ipsilateral ataxia)
    - Spinothalamic pathway
    - Sensory nucleus of CN V (altered pain and temp on face)
    - Sympathetic pathway (tiny, tiny nucleus next to CN V)
  3. 4 nuclei below the pons, 4 nuclei in the pons, 4 nuclei above the pons
  4. 4 motor nuclei in the midline are those that divide evenly into 12 (3,4,6,12)
95
Q

Uniformly enlarged uterus, hypermenorrhea

A

Adenomyosis

96
Q

ALA synthase deficiency

A

Sideroblastic anemia

-Could also occur due to pyridoxine deficiency since ALA synthase requires this B6

97
Q

Potential severe ADR of bupropion `

A

Seizure

-Will not cause the usual weight gain or sexual dysfnxn tho

98
Q

Location of action of HCTZ

A

Proximal DCT

99
Q

Repressor protein in the lac operon binds to…

A

The operator region

  • In high glucose conc., there is decrease cAMP and decreased repression of the operon
  • Increased binding of the catabolite activator protein (CAP)
100
Q

BLABS (Li-fraumeni)

A

Brain tumors

Leukemia

Adrenocortical carcinoma

Breast cancer

Sarcomas

101
Q

Pulvinar

A

Largest Thalami Nucleus that fnxns to integrate sensory, visual, and auditory input

102
Q

Pure sensory loss on a general area

A

Thalamic stroke; could be in the anterior Choroidal or PCA

103
Q

Hypothalamic nuclei that synthesizes ADH and oxytocin

A

Paraventricular Nucleus (gives rise to Neurohypophysis; destruction produces DI)

and the Supraoptic nuclei

104
Q

Paneth cells

A

Cells found at the base of small intestinal glands that secrete lysozyme, TNF-a, and defensins (increase bacterial/parasitic membrane permeability)

105
Q

Secretin

A

Secreted by S cells and causes HCO3- release from the pancreas

106
Q

K cells

A

Secrete GIP which is responsible for oral glucose producing greater insulin response

107
Q

L cells

A

Secrete Glucagon-Like Peptide (GIP) that increases insulin secretion

108
Q

Meissner’s plexus

A

Found in the submucosa of the intestines

109
Q

Gushing of fecal material upon DRE of newborn baby

A

Probs Hirschsprung’s Disease

110
Q

Adenomatous polyp histology

A

Torturous glands w/ multiple mitotic figures

111
Q

Performance anxiety tx

A

Alprazolam, Lorazepam (short-acting benzos)

Propanolol

112
Q

Agoraphobia

A

Fear of being ALONE IN PUBLIC PLACES where rapid exit is unavailable

113
Q

Dissociative Fugue

A

Presents as sudden travel away from home w/ loss of autobiographic memory

-Pts. confused about their identity and often form new ones

114
Q

Person in car wreck with hurt hip

A

Posterior hip dislocation; hip is driven through the weak posterior ischiofemoral ligament

-Limb appears shortened and MEDIALLY rotated

115
Q

Injury to inferior gluteal nerve

A

Weakened gluteus maximus; most notable when someone is climbing stairs or getting up from a sitting position

116
Q

Torn hamstrings

A

Avulsed at the ischial tuberosity; weakened flexion of the knee and extension of the hip

-Could also be due to damaged tibial nerve since it innervates the biceps femoris, semitendinosus, and semimembranosus

117
Q

Femoral hernia danger

A

Strangulation possible; during surgical repair, also need to pay attention to location of obturator artery

118
Q

Achilles tendon

A

Contains insertions for the gastrocnemius, the soleus, and the plantaris if present

119
Q

Plantar fasciitis

A

Tenderness at the attachment of the plantar aponeurosis connection at the medial calcaneus

-Common in runners……………

120
Q

Erosion of a posterior gastric ulcer

A

Affects the spleen causing referred back pain and possibly the splenic artery causing internal hemorrhage

121
Q

Sliding hiatal hernia

A

Cardia slides thru a widened esophageal hiatus with possible compression of the vagal trunks

➡️ hypochlorydia

122
Q

Inferior pancreaticoduodenal arteris

A

Come off the SMA and form anastamoses with the superior pancreaticoduodenal arteries

123
Q

Right hepatic love necrosis post cholecystectomy

A

Accidental ligation of the right hepatic artery with the cystic artery

124
Q

Ulcer at the distal duodenum

A

ZES

125
Q

DOC for status epilepticus

A

Phenytoin

Benzodiazepine

126
Q

Behcet’s syndrome

A

Aphthous ulcers, genital ulcers, and uveitis

-Generally arises after nonspecific viral infxn

127
Q

Erythroplakia

A

Red, vascularized leukoplakia representative of underlying Dysplasia

128
Q

Hairy cell leukoplakia

A

White, rough patch on the lateral tongue seen in IC pts; due to EBV related hyperplasia

129
Q

Pleomorphic Adenoma

A

MC tumor of the parotid gland; high rate of recurrence due to incomplete revision

  • Can transform to carcinoma w/ CN VII involvement
  • Is composed of stromal and epithelial tissue
130
Q

Warthin tumor

A

Benign cystic tumor of the parotid w/ abundant lymphocytes and ️Germinal centers

-Looks like a lymph node

131
Q

Location of the common bile duct

A

Hepatoduodenal ligament

132
Q

DOC for Tx. Resistant Schizophrenia

A

Clozapine

133
Q

Period representing complete ventricular repolarization

A

ST segment

134
Q

Monocular scotoma

A

Small, pinpoint visual field defect caused by macular degeneration or optic neuritis

135
Q

Porcelain Gallbladder

A

Often arises due to chronic cholecystitis or cholelithiasis

Micro: Calcified plaques and spotty calcifications

***Increased risk of adenocarcinoma of the gallbladder

136
Q

IBD associated colorectal carcinoma

A
  • Younger patients
  • Flat, non-polypoid
  • Early p53 and late APC mutations
  • Multifocal
  • Proximal involvement more likely
137
Q

Perfusion-limited respiration

A

Will see increased PaO2 and decreased PaCO2

138
Q

Orotic aciduria tx.

A

Uridine

139
Q

Diptheria vaccine

A

Produces IgG against circulating protein (exotoxin)

140
Q

PRP capsule

A

VF for Hib, no matter what the pathologic manifestation is

141
Q

DOC for Tx. Resistant Schizophrenia

A

Clozapine

142
Q

Period representing complete ventricular repolarization

A

ST segment

143
Q

Monocular scotoma

A

Small, pinpoint visual field defect caused by macular degeneration or optic neuritis

144
Q

Porcelain Gallbladder

A

Often arises due to chronic cholecystitis or cholelithiasis

Micro: Calcified plaques and spotty calcifications

***Increased risk of adenocarcinoma of the gallbladder

145
Q

IBD associated colorectal carcinoma

A
  • Younger patients
  • Flat, non-polypoid
  • Early p53 and late APC mutations
  • Multifocal
  • Proximal involvement more likely
146
Q

Perfusion-limited respiration

A

Will see increased PaO2 and decreased PaCO2

147
Q

Orotic aciduria tx.

A

Uridine

148
Q

Diptheria vaccine

A

Produces IgG against circulating protein (exotoxin)

149
Q

PRP capsule

A

VF for Hib, no matter what the pathologic manifestation is

150
Q

Both eave syndrome

A

Rupture of esophagus leading to air in the mediastinum; ️Appears widened on CXR

151
Q

Blood type with increased risk of gastric adenocarcinoma

A

A

-Also increased risk with chronic h.pylori and nitrosamines

152
Q

Chronic AI gastritis

A

Usually affects the body and Fundus; destruction of parietal cells leads to g-cell hyperplasia, Achlorrydia, B12 deficiency, increased risk for Cancer

153
Q

Double bubble sign

A

Duodenal atresia

154
Q

Myenteric plexus cell origins

A

Neural crest

155
Q

Coelomic angiodysplasia

A

Acquired malformation of mucosal capillary beds.

-Presents as hematochezia; involves the cecum and right colon

156
Q

Serrated appearing polyp on microscopy

A

Hyperplastic; benign

157
Q

Polyps with greater risk for malignant progression

A

> 2 cm big

Sessile growth pattern

Villous histology

158
Q

Coelomic angiodysplasia

A

Acquired malformation of mucosal capillary beds.

-Presents as hematochezia; involves the cecum and right colon

159
Q

Serrated appearing polyp on microscopy

A

Hyperplastic; benign

160
Q

Polyps with greater risk for malignant progression

A

> 2 cm big

Sessile growth pattern

Villous histology

161
Q

Deep perineal pouch

A

Contains the sphincter urethrae, deep transverse perineal muscle, and the Bulbourethral glands

-Also the membranous part of the urethra

162
Q

Superficial perineal pouch

A

Contains:

Ischiocavernosus- related to the crus of the penis/clitoris

Bulbospongiosus

Superficial transverse perineal muscle- related to the perineal body

163
Q

Strucutre that keeps urine from entering the abdominal wall after rupture of the spongy urethra

A

Superficial perineal fascia

164
Q

Ischiorectal abscess

A

Surgical emergency occurring due to spread of infection thru the external sphincter muscles into the ischiorectal Fossa

-Must be careful not to damage the pudendal nerve or artery

165
Q

Lepromin skin test

A

(+)- indicates Tuberculoid type
-Good immune response; lesions show increased IFN-y, IL-1

(-) - indicates Lepromatous type
-Bad response; lesions are filled w/ bacteria

166
Q

Important steps of TCA

A

Citrate =» a-ketoglutarate

NADH

a-ketoglutarate =» Succinyl-CoA

NADH

Succinyl-Coa =» Succinate

GTP

Succinate =» Fumarate

FADH

Malate =» Oxaloacetate

NADH

167
Q

Filtration of a substance (calculation)

A

Total filtration = (GFR)(plasma conc.)

168
Q

Child w/ recently resolved abdominal infxn now presenting w/ oliguria, hematuria, and increased Creatinine

A

HUS

-AKI occurring due to microangiopathic hemolytic anemia

169
Q

Diltiazem

A

Nondihydropyiridine CCB

ADRs: Constipation
Decreased inotropy

170
Q

Cerebellar hemangioblastomas, RCC, Pheochromocytomas

A

VHL

-altered chromosome 3p

171
Q

Area always involved in Hirschsprung’s Disease

A

The rectum

-Neurons migrate caudally

172
Q

Biopsy showing large, round yeast cells w/ doubly-refractile wall and SINGLE broad-based bud

A

Blastomyces dermatidis

-Immunocompetent pt. presenting w/ pneumonia-like sx.

173
Q

What metabolites will build-up in classic galactosemia?

A

Galactilol

Galactose-1-phosphate (disease is due to deficient G1P-uridyl transferase)

174
Q

GI site of greatest lipid absorption

A

Jejunum

175
Q

Chronic smoker who comes w/ acute exacerbation of SOB

A

Possible collapsed lung due to centrally located bronchial tumor

Clinical: Tracheal deviation TOWARDS the lung
Hemothorax opacification; loss of all radiolucent air
Decreased breath sounds

176
Q

Small Intestinal Bacteria Overgrowth

A

Bacterial proliferation in the GI tract presenting w/ watery diarrhea and upset stomach

-Can happen after gastric bypass due to increased delivery of nutrients to the bacteria

***Pts. have increased Vitamin K and Folate

177
Q

Specific sign’s assoc. w/ Grave’s (and not just hyperthyroidism)

A

Pretibial myxedema

Exopthalamos

178
Q

Drugs w/ increased HEPATIC clearance

A

Increased lipid solubility; increased volume of distributino

179
Q

Drugs w/ increased KIDNEY clearance

A

Increased water solubility; decreased volume of distribution

180
Q

Homocystinuria tx.

A

Pyridoxine; somehow increases CBS fnxn

-Also restrict methionine in diet

181
Q

Inhaled anesthetic characteristics

A

Increased plasma concentration of drug means….

Increased blood/gas partition coefficient which means…

Slow onset

182
Q

K+ and HCO3- in response to insulin

A

K+ shifts into cells

HCO3- increases due to decreased ketone production

183
Q

Main cells Gastrin affects

A

Enterochromaffin cells

-These then release histamine onto parietal cells to induce acid secretion

184
Q

Chain of lakes pattern on abdominal contrast study

A

Chronic pancreatitis; forms due to dilatation and Fibrosis of pancreatic ducts from dystrophic calcification

-Same Pathophysiology as PSC

185
Q

Damaged cytokeratin filaments within hepatocytes

A

Mallory bodies

Formed due to damage from acetaldehyde from ALCOHOLIC HEPATITIS

186
Q

Lateral pterygoid

A

Protrudes the jaw; deviation towards home damaged side with V3 damage

187
Q

Tonsillar branch of the facial artery

A

Supplies the tonsils; can be damaged during tonsillectomy

188
Q

Gag reflex

A

Afferent: CN IX
-damage to this nerve results in loss of reflex

Efferent: CN X

189
Q

Blow out fracture of the floor of the orbit

A

Damages the inferior rectus muscle, the Infraorbital nerve (V2), and the Infraorbital artery

190
Q

Dangers of otitis media

A

Spread posteriorly ➡️➡️ mastoiditis

Spread thru middle cranial Fossa ➡️➡️ temporal lobe abscess, meningitis

Spread inferiorly ➡️➡️ Sigmoid sinus thrombosis

191
Q

Muscle damaged by recurrent laryngeal nerve damage

A

Posterior cricoarytenoids

-normally abduct the vocal cords allowing for speech

192
Q

Axillary sheath

A

Investing fascia of the brachial plexus and the subclavian artery as they emerge from the scalene muscles and continues until the axilla

-Derived from the prevertebral fascia

193
Q

Menetrier disease

A

Hyperplasia of gastric mucosa with excess mucous production

Rugae are enlarged and parietal cells atrophy

⭐️ Stomach looks like a brain on CT

-Precancerous condition

194
Q

MCC of small bowel obstruction

A

Adhesions; due to surgeries

195
Q

Serrated polyp

A

Possibly pre-malignant

  • Mutations in BRAF and via CpG hypermethylation
  • Could also just be the histo of a hyperplastic polyp
196
Q

Zone III of the liver

A

Affected in alcoholic hepatitis, ischemia, metabolic toxins

-Contains cytochrome p450 system

197
Q

Host defense against Candida

A

Superficial infxn: mediated by Tcells

⭐️ Disseminated infxn: Prevented by PMNs

198
Q

Diplopia, dysphagia, Dysphonia

A

Symptoms of botulism

-Repeated nerve stimulation will finally cause contraction of muscle

199
Q

Aspirin OD tx.

A

Alkalinize the urine; changes aspirin to its A- form trapping it in the tubules

200
Q

Pt. w/ symptoms of CN III damage BUT have normal pupil size and reflexes

A

Ischemic nerve damage to CN IIII; only damages the CORE of the nerve

-Autonomic part of CN III that mediates pupillary constriction and accommodation is located PERIPHERALLY

201
Q

Screening test for hypothyroidism

A

TSH

202
Q

Chorda tympani contains what nerves?

A

V3

203
Q

Part of the spine involved in RA

A

Cervical spine

204
Q

Part of the spine involved in osteoarthritis

A

Lumbar

205
Q

Part of the spine involved in HLA-B27 disorders

A

Sacroiliac

206
Q

Hydronephrosis changes to the kidney

A

Produces atrophy and scarring of the parenchyma due to increased hydrostatic pressure

207
Q

Thyroid Peroxidase

A

Oxidizes iodide, iodinates TBG, and couples iodized tyrosine residues

-PTU inhibits all of these

208
Q

Time for irreversible injury in myocardial ischemia

A

30 mins

  • Will see an immediate decrease in contractility tho
  • If less than 30 mins, myocardial stunning still occurs so itll take a while to get back into the swing of things
209
Q

Chronic PPI used can cause…

A

Osteoporosis

210
Q

Child with an enlarged tongue, gray-white pharyngeal exudate, circumoral pallor, and rash on the neck spreading to the trunk

A

Scarlet fever

-Strep. pyogenes

211
Q

Stenosis of the subclavian artery

A

Leads to Subclavian Steal Syndrome

-Blood flows up the contralateral vertebral artery and comes back down the ipsilateral artery to supply the limb

Clinical: Arm ischemia 
             Vertebrovascular insufficiency (vertigo, drop attacks)
212
Q

Transpeptidase

A

Bacterial protein that crosslinks D-ala-D-ala residues to form cell walls

-Penicillins mimic D-ala-D-ala in order to bind and inhibit transpeptidase

213
Q

Reducing Central Venous Catheter Infxns

A

Use alcohol to sterilize hands

Sterilize site w/ chlorhexidine

Maximal barrier protections

Use subclavian/jugular vein

Prompt removal (doesn’t need switched unless signs of infxn)

214
Q

Renal Ammoniagenesis

A

Glutamine =» Glutamate + NH4 + HCO3-

NH4 is excreted and HCO3- is reabsorbed during acidosis

215
Q

Pulmonary sx. of CREST syndrome

A

Pulmonary HTN due to increased TGF-B causing intimal fibrosis of the vessels

=»signs of right heart failure

216
Q

Diabetic pt. w/ severe diuresis and comma

A

Hyperosmolar non-ketotic coma

-Increased glucose osmotically draws H2O into the tubule

217
Q

Liddle Syndrome

A

Decreased degradation of Na+ channels in the collecting tubules

Clinical: HTN, hypokalemia, metabolic alkalosis

Tx: Amiloride; triamterene

***Mimics hyperaldosteronism

STEP (11 decks)

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