Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

0001 STEP ONE RAPID REVIEW DX > Area of Opp review > Flashcards

Area of Opp review Flashcards

1
Q 
What do
ACTH
MSH
Beta-endorphin
all have in common
A

Their precursor is POMC polypeptide :0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Internal hemorrhoids drain via

A

middle and superior rectal to internal iliac and inferior mesenteric, respectively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

External hemorrhoids drain via

A

inferior rectal veins to internal iliac veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Glucocorticoids effect on muscle

A

increase breakdown - oppose effect of insulin in skeletal muscle to increase glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The splenic red pulp is for? (2)

A

destroying abnormal erythrocytes

clearance circulating bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tick born infection - thrombocytopenia with intraerythrocytic parasites -

A

babesiosis

caused by babesia microti

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

3 treatments for C Diff

A

metronidazole (DNA damage via toxic free radicals - good for anaerobes and also antiprotazoal)
Vancomycin
fidaxomicin (macrolide like)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diphtheria toxin

A

A/B toxin
B bind
A - ADP ribosylation of EF2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Most common cause of hair loss -

A

androgenic alopecia
meaning androgen + genes
polygenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MEN Type I

A 
Primary hyperPTH (hypercalcemia)
Pituitary tumors (prolactinomas)
Pancreatic tumors (gastrinomas - think Zollinger Ellison)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

MEN Type IIa

A

Medullary thyroid
Pheo
HyperPTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MEN Type IIB

A

Medullary thyroid
Pheo
Marfanoid / Mucosal Nueromas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

3’ end of tRNA

A

CCA tail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If i have enlarged popliteal and inguinal nodes, did I have a sore on my medial or lateral foot?

A

lateral drain through popliteal

medial drain direct up to inguinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

in the citric acid cycle, which is the only enzyme that use FAD (rather than NAD)

A

Succinate dehydrogenase uses FAD to convert succinate to fumerate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PPAR-gamma

A

peroxisome proliferator-activated receptor-gamma alters gene transcription by binding the promoter region or target genes and improves insulin sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Gq activates?

A

phospholipase C, which then cleaves PPB into IP3-DAG - IP3 then increases calcium while DAG activates PKC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Blood smear showing intraerythrocyte pleomorphic ring forms and cross sign in someone who has anemia?

A

babesiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If my patient has esophageal varices because of liver cirrhosis, through which vein is their blood being diverted from the portal ciruclation

A

left gastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

if my patient has hemorrhoids because of liver cirrhosis, through which vein is their blood being diverted from the portal circulation

A

superior rectal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

if my patient has caput medusa because of liver cirrhosis, through which vein is my patients blood being diverted from their protal circulation

A

paraumbilical veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is methylmalonic acid

A

substrate for methylmalonyl-CoA mutase in making succinyl CoA,
Elevated in B12 deficiency because B12 cofactor of enzyme
rxn important for myelin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

elevated homocystein in VitB12 deficiency?

A

need B12 as cofactor for conversion of homocysteine to methionine using methyl-tetrahydrofolate (m-THF) -
Results in impaired DNA synthesis and megaloblastic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

main effects of marijuana (4)

A

conjunctival injection
tachycardia
hyperphagia
dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what would i give someone with listeria?

A

ampicillin or amoxiicllin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is alkaptouria

A

AR disorder lack or homogentisic acid dioxygenase –> blocks the metabolism of tyrosine - leads to black urine, black pigmentation, ochronotic arthorpathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what would we see in the acid schiff stain of someone with AAT?

A

we would see the accumulation of the antitypsin protein in the hepatocytes and it would not be destroyed by diastase - which breaks down glycogen - cirrhosis second leading cause of death?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Crutch palsy

A

radial nerve - wrist drop - weakness of triceps reflex - c5-t1 - supination - thumb abduction - sensation dorsal forearm dorsal aspect of hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

when do you hydroxylate proline for collagen synthesis

A

rer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

ehlers danlos is a defect in

A

type v collagen defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Zenker diverticulum

A

abnormal spasm or diminished relaxation of cricopharyngeal muscle when swallow can evenutally lead to herniation of the back of the pharyngeal mucosa and food accumulates in this little pouch :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

achalasia -

A

degenerative changes in myenteric plexus with impaired lES relaxation - bird beak esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

when you ingest too much inorganic phosphate what do i give you immediately

A

atropine and pralidoxime (AChE reactivator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is dangerous in insecticides? and why

A

arsenic

inhibits pyruvate dehydrogenase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

signs and symptoms of arsenic poisoning

A

watery diarrhea
hypotension (from dehydration)
QT prolongation
garlic odor of breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

first line therapy for arsenic poisoning

A

dimercaprol - chelator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

lead poisoning - signs

A

constipation / anemia / irritablity and confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

lead poisoning - tx

A

CaNa2EDTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Iron poisoning - tx

A

Deferoxamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Cyanide poisoining - signs and treatment

A

cherry red skin
give
hydroxycolbalmin -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

methylene blue is indicated treatment for

A

methemoglobinemia - which presents as gray or blue colored skin - chocolate colored blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what oxidaiton state shouldl iron be in?

A

Fe2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

in a patient with mitral regurg - holosystolic radiating to axilla - the most reliable auscultory finding indicating high regurgitant volume (severe MR) would be?

A

S3

note: the bigger the regurgitant volume the quieter the murmur so don’t use that!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

In the medical setting hypoglycemia is treated with IV glucose (50% dextrose ampule) what about in emergency outide hospital?

A

glucagon - IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Orotic aciduria

presentatation

A

physical and mental retardation
megaloblastic anemia
evelated urinary orotic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

orotic aciduria

cause?

A

AR defect in de novo pyrimidine synthesis -

defect in 5-UMP synthase *makes ump from orotic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Orotic acid tx?

A

uridine supplemantion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

calcipotriene

A

used to treat psoriasis - vitamin D analog that increases keratinocyte differenation while inhibiting prolifeartion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

most common cause of lacunar stroke

A

HTN and DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Hemiballism

A

damage to subthalamic nucleus –> decrease excitiation to GPin –> decrease inhibition of Thalamus –> incrased exciation of contralateral movement
Frequent consequent of lacunar stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

rate limiting enzyme in bile acid synthesis

A

7alpha hydroxylase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

which two things increase cholesterol solubility and decrease risk of gallstones

A

phosphates/phosphatidylcholine

bile acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Cocaine mechanism?

A

monoamine reuptake inhibitor - can also cause vasospasm and platelet aggregation :( - coronary artery vasospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Ovarian torsion typically involves twisting of the ____, often due to the weight of a large adnexal mass. resulting in?

A

infundibular ligament (Suspensory ligament)

resulting in occlusion of blood and nerve supply to ovary and leading acute ischemia and pain :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

c-Jun and c-Fos

A

leucine zipper TFs

proto-oncogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Ras codes for?

A

a membrane-bound g protein

activates transcription via activation of MAP kinase pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

B1 receptor messenger?

A

Gs–>AC–>increased cAMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

lymphatic drainage proximal to dentate line?

A

internal iliac and inferior mesenteric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

lymphatic drainage distal to the dentate line?

A

inguinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

5 basic steps in Nucleotide excision repair in order

A 
glycosylase
endonuclease
lyase
prolimerase
ligase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what does lyase do?

A

cleave the 3’ sugar phosphate after glycosylase removes the base leaving the apurinic site
(i.e. its a phosphodiesterase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

phenoxybenzamine

A

treat pheos

irreversibly block alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

right sided frontal lobe lesions lead to?

A

disinhibited behavior results from these lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

left sided frontal lobe lesions lead to?

A

apathy results from lesions to this area :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

why is citalopram tricky

A

because it is an ssri

it sounds like a benzo though :/

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what specific gestationally produced thing :) causes a state of insulin resistance in preggos, which can lead to gestational diabetes

A

human placental lactogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

HELLP

A

Hemolysis
elevated liver enzymes
Low platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

ARE noncaseating granulomas found in ulcerative colitis?

A

no - they are found in crohns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

children with rhabdomyosarcoma - may increase likelihood they have?

A

tuberous sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

NF2

A

Bilateral acoustic schwammomas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Von Hippel Lindaue patients often have cerebellar hemangioblastomas, retinal hemangiomas, and livers cysts, but they are at uber increased risk of?

A

bilateral renal cell carcinomas
von hippel lindaue disease
AD
C3 VHL deletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

hereditary hemorrhagic telangiectasia - osler weber rendu syndrome

A

AD
multiple telangiectasias on skin and mucosa
recurrent epistaxis and gi bleeding (melena)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

sign of basilar skull fracture?

A

battle sign - brusing behind ear at mastoid and periorbital ecchimoisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what makes bile acids?

A

the liver via cholesterol catabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

where are bile acids reabsorbed? and what blocks this?

A

terminal ileum

cholestyramine - via binding resin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Cholesterol 7alpha hydroxylase

A

catalyzes the rate limiting step in bile acid biosynthesis (in liver for cholesterol excretion)
note - that it is inhibited by fibrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

what doe fibrates do?

A

upregulate lipoprotein lipase resulting in incrased fatty acid oxidation - note though that they also inhibit cholesterol 7-alpha-hydroxylase and thus might increase risk for gall stones (cholesterol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what is beta-glucuronidase?

A

it is an enzyme that deconjugates bilirubin - free bilirubin then precipitates with calicum in bile to form pigmented gallstones

released by damaged hepatocytes and bacteria in infected bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

thiolase

A

catalyzes the first step in cholesterol synthesis via condensation of 2 acetyl-coa
note - third acetyl-coa yields HMG-CoA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Inhibition of uterine contractions - tocolysis - is a result of _______ receptor stimulation?

A

Beta - 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Beta 1 receptor agonists?

A

dobutamine
dopamine
epinephrine
isoproteranol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q 
Beta 2 receptor agonists 
effect on 
heart
lung
uterus
A

vasodilate
bronchodilate
relax (tocolysis)

e.g. isoproteronol
torbutiline
ritodrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q 
alpha 1 - agonist 
effect on
peripheral vasculature
bladder
eye
A

vasoconstriction
internal urethral sphincter contraction
mydriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

methoxamine

A

alpha-1 agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

fundal varices are caused by thromboses in which vein?

A

splenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

rx of choice for dvts in preggos??

A

lmwh

e.g. enoxaparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

dabigatran

A

direct thrombin inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

apixaban

A

factor x inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

clopidogrel

A

blocks ADP receptor - limiting platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

asprin given to preggos with preeclampsia - why?

A

i dont know look

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

rx for narcolepsy?

A

modafinil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

amatoxins - in death mushrooms

A

liver - concentrate - halt mRNA synthesis via binding rna pol ii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

ricin

A

cleaves rRNA component of 60s ribosome - halts protein synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

who has EF2 toxin via ADP-ribosylation

A

diphtheria

psuedomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

giardiasis rx

A

metronidazole

96
Q

why doesn’t metronidazole hurt me?

A

because it has to be reduced to active form by pyruvate ferrodoxin oxidoreductase - which is only in bugs :)

97
Q

octreotide

A

somatostatin analog that decreases gut motility / gi functions

98
Q

sulfasalazine

A

5-aminosalicylate that blocks cytokine / prostaglandin and leukotriene synthesis during inflammation - used for chrohns and ulcerative colitis

99
Q

5-aminosalicylate

A

sulfasalazine and mesalamaine

100
Q

my patient smells like garlic - what do you think

A

arsenic - insecticide

101
Q

what do you give to patient with arsenic poisoning

A

dimercaprol - chelating agent

102
Q

how does arsenic fuck you up?

A

binds to sulfhydryl groups - specifically inhibiting pyruvate dehydrogenase

103
Q

what is hydroxycobalamin used for

A

B12 precursor

can be used for cyanide poisoning - binds and forms non-toxic excretable form - theme

104
Q

Methimazole

A

Inhibits thyroid peroxidase

105
Q

I am thyroid peroxidase, what are my responsibilities and who inhibits me

A

I organify iodine - i.e. couple it with Tyrosine in thyrogloublin and I also couple iodotyrosines :) to make thyronines

I am blocked by thionamides - methimazole and propylthiouracil

106
Q

propylthiouracil

A

thionamide - inhibits thyroid peroxidase

also decreases conversion of T4 to T3

107
Q

Perchlorate and pertechenetate

A

inhibit Na couples I transport into thyroid cell

108
Q

ipodate

A

contrast agent that inhibits conversion of t4 to t3

109
Q

common drugs that inhibit t4 to t3

A

beta blockers

110
Q

Stewart Treves

A

angiosarcoma / lymphosarcoma - in ipsilateral arm of mastectomy many years later :(

111
Q

ferrochelatase -

A

attaches iron to protophorphyrin ring in mitochondria -

note - if limitation in protoporphyrin (e.g. synthsis problemo) or inhibition of attachment via lead poison - you will have sideroblasts - iron ringed mitochondria in rbcs

112
Q

here is a really good question :) why would we see sideroblastic anemia in isoniazid treatment?

A

because the metabolite of isoniazid form complexes with b6 that are excreted when we pee -
b6 is a cofactor for ALA synthase -
ALA synthase is necessary for protoporphyrin production -
not enough protoporphyrin to attach to iron in mitochondria -
get sideroblastic anemia

113
Q

Why would you not see sideroblasts in blood smear in lead poisoning when i just explained why you would have them?

A

because they are in the bone marrow not the peripheral blood

114
Q

Basophilic stypling???

A

lead poisoning
or
thalassemias and myelodysplastic syndrome
buildup of RNA

115
Q

what effect to anasthetics have on my heart

A

they decrease me heart output - can lead to hypotension

116
Q

what effects do anasthetics (inhaled) have on my breathing?

A

they decrease my respiratory drive :( - may also inhibit mucociliary clearance –> post-atelectasis

117
Q

why are halothane and sevoflurane preferred for anasthesia in pateints with asthma?

A

bronchodilate so minimize effect of post-op atelectasis from inhibited mucociliary clearance

118
Q

what do inhaled anasthetics do to my cabeza?

A

increased Cerebral BF - can lead to increased ICP

119
Q

What do inhaled anesthetics do to my kidney

A

decrease all desirable things :( increased renal vascular resistance

120
Q

what do inhaled anesthetics do to my liver?

A

decrease its blood flow :(

121
Q

5 Undesirable effects of volatile anesthetics/

A 
increased ICP
myocardial depression
decreased renal BF
decreased hepatic BF
decreased respiration
122
Q

potency of anesthetic?

A

determined by minimum alveolar concentration (MAC)

potency = 1/MAC

123
Q

What is meant by the minimum alveolar concentration of an inhaled anesthetic?

A

concentration of the anesthetic in the alveoli that renders 50% of patients unresponsive to painful stimuli (ED50) inversely proportional to potency

124
Q

Common extradermal mainfestations of psoriasis

A

nail pitting
psoriatic arthritis
uveitis
hla-b27

125
Q

common locale of dermatitis herpetiformis?

A

knees / elbows but also butt and upper back

126
Q

retinitis in AIDS?

A

CMV

127
Q

Macrophages loaded with PAC positive granules in lamina propria?

A

Tropheryma whippelli - gram positive actinomycete - penicillin :)
whipples disease

128
Q

I have ipsilateral sensorineural hearing loss and tinnitus -
i might also have vertigo, dysequilirbium and nystagmus

A

acoustic neuroma - schwann cell tumor

129
Q

bilateral acoustic neuroma?

A

NF2

130
Q

why would a lesion to cranial nerve VII make you hyperacusis?

A

because you lose innervation to the stapedius, which helps prevent damage to ear durm

131
Q

inability to elevate soft palate?

A

X

132
Q

head rotation direction when XI damaged?

A

turn toward leasion and ipsilateral shoulder droop

133
Q

a. indirect inguinal
presentation
pathos
anatomy

A

p - male infants
pa - patent processues vaginalis
a - content protrudes through deep inguinal ring traveling lateral to inf epigastrics
- only covered by external spermatic fascia

134
Q

direct inguinal
presentation
pathos
anatomy

A

older men
weakness of transversalis fascia
ana - content protrudes through hasselbach trianlge - medial to inf. epigastrics
- covered by all three layers of spermatic fascia

135
Q

femoral groin hernia
presentaiton
pathos
anatomy

A

p - wommen
pathos - weakness of proximal femoral canal
ana - content protrudes through the femoral ring
- travels inferior to inguinal ligament

136
Q

6 key complications of prematurity

A

respiratory distress syndrome

patent ductus arteriosus

bronchopulmonary dysplasia

intraventricular hemorrhage - germinal matrix

necrotizing enterocolitis

retinopathy of prematurity

137
Q

germinal matrix

A

highly cellular and vascularized layer in the subventricular zone from which neurons and glial cells migrate out during brain development - risk of hemorrhage in pre-me

138
Q

signs of intravascular hemorrhage in pre me

A 
altered conscious
hypotonia
bulging anterior fontanelle 
hypotension 
etc
139
Q

ovarian torsion ligament?

A

infundibular ligament (suspensory)

140
Q

Aneurysms causing CNIII palsy most frequently involve ???

A

PCA - compressive

141
Q

Vancomycin red man syndrome mediated by?

A

non IgE mediated mast cells releasing histamine

142
Q

what distinguishes conduct from oppositional defiant disorder?

A

aggression -

Conduct disorder - the behaviors are more severe and aggressive - steal/lie/destroy/creulty

143
Q

Drugs associated with drug induced ANCAs associated vasculitis (3)

A

porpylthiuracil
methimazole
(both used to treat hyperthyroidism)
and hydralazine

144
Q

gas in biliary tree in an old person with a tympanic abdomen likely tells you they have?

A

gallstone ileus - fistula allowed passage into duodenum then moved to ileum and lodged

145
Q

Charcot triad for cholangitis

A

fever
jaundice
RUQ pain

146
Q

Cirrhosis causes boobs because

A

it causes a state of hyperestrinism - this can also lead to testicular atrophy and decreased body hair AS WELL AS SPIDER ANGIOMATA

147
Q

Spider angiomata
associated with
consequence of

A

liver cirrhosis

elevated estrogen

148
Q

Landmark for lumbar puncture

A

iliac crest

L3,4,5 keeps the spinal cord alive

149
Q

Works by blocking PDE-3 – increasing inotropy and leading to vasodilation

A

Milrinone

150
Q

Trauma to knee resulting in injury to tibial n - l4-s3 - presenation

A

lot of sensation to plantar surface of foot

  • foot inversion
  • plantar flexion
  • toe flexion
151
Q

Trauma to the lateral leg resulting in injury to the common peroneal n -

A 
foot drop 
- loss of dorsiflexion
- loss of sensation on dorsum 
- foot eversion
loss of sensation to external frontal calf
- loss of toe extension
152
Q

hematoma or mass involving iliopsoas/iliacus muscle - compressing femoral - l2-l4 - consequence

A

flexion of thigh
extension of leg
medial frontal surface of leg

153
Q

anterior hip dislocation disrupting obturator n - l2-l4 consequence

A

loss of thigh abduction and a little sensation of the superior internal thigh

154
Q

Retroperitoneal organs

A 
SADPUCKER
Superior adrenals
Aorta and IVC
Duodenum 
Pancreas (head and body)
Ureters
Colon (ascending and descending)
Kidneys
Esophagus
Rectum
155
Q

Lesions of the jugular foramen would fuck with CN IX X and XI what would you see

A

this is called Vernet syndrome

  1. loss of gag reflex (aff - ix eff - x)
  2. loss of taste to post 1/3 tongue (ix little x)
  3. deviation uvula to effected side (x)
  4. dysphagia (ix x)
  5. dysphonia / hoarse (x)
  6. sternocleidomastoid and trapezius paralysis (xi)
156
Q

Wilson’s disease target which area of brain?

A

lentiform nucleus (globus pallidus and putamen)

157
Q

Lateral striate arteries emerge from the middle meningeal and supply the internal capsule and basal ganglia - how would we harm them with hemorrhage / why would we hemorrhage here?

A

HTN increased risk of hemorrhage here

158
Q

Restless leg syndrome has been associated with what vitamin deficiency

A

iron

159
Q

restless leg syndrome rx

A

dopamine agonists

  • pramipexole
  • ropinirole
160
Q

rx for antipsych induced akathisisa

A

beta agonist - propanolol

161
Q

Cataplexy???

A

key feature of narcolepsy = sudden loss of muscle tone and often triggered by strong emotions

162
Q

compression causing Horner - likely under which two common circumstances

A

pancoast tumor

internal carotid arter dissections

163
Q

in danger during thyroid surgery???

A

recurrent laryngeal - hoarseness if nicked -

stridor if bilateral because paralyze vocal cords

164
Q

TREATMENT OF PANIC disorder

A

ssri

165
Q

how does milrinone work/

A

PDE 3 inhibiitor so increases cAMP which has positive inotropic effect on heart and also causes vasodilation systemically

166
Q

how can amitryptyline kill you?

A

it inhibits fast sodium channel conduction, (in cardiac myocytes and His Perkinje system) slowing down myocardial depolarizaiton and leading to cardiac arrhythmias - decreased cardiac contractility

167
Q

why does amitryptiline make you faint?

A

peripheral alpha-1 adrenergic receptors are antagonized –> peripheral vasodilation

168
Q

why does amitryptiline make you hungry and tired

A

inhibit histamine receptors H1

169
Q

Gerstmann syndrome - damage to the angular gyrus of predominate parietal lobe - 4

A

agraphia
acalculia
finger agnosia
left-right disorientation

supplied by MCA

170
Q

Wallenberg syndrome - dorsolateral medulla

A

supplied by pICA
- loss of P/T ipsilateral face and contralateral body - spinal trigeminal and spinothalamic tracts
- ipsilateral bulbar muscle weakness - nucleaus ambiguus
Ipsilateral limb ataxia - inferior cerebellar peduncle
horner syndrome - descedning sympathetic
vertigo - vestibular nuclei

171
Q

strokes to dorsolateral thalamus present as

A

contralateral hemisensory loss - usually

172
Q

superior colliculus strokes

A

upward gaze palsy
absent pupillary reflex
imparied convergence
= prinaud syndrome

173
Q

Mechanism of tetracylcine resistance?

A

Efflux pumps or altered proteins (30s)

174
Q

Mechanism of aminoglygocisde resistance?

A

incactivation by aminoglycoside-modifying enzymes

pseudomonas can decrease cell entry :(0

175
Q

Tzanck smear

A

multinucleated giant cells with and keritinocytes with intranuclear inclusions - herpes

acantholysis would also be seen and intraepidermal vesicles

176
Q

Two markers of biliary tract intactness

A

alkaline phosphatase

gamma-glutamyl transferase

177
Q

if a patient has an elevated alkaline phosphatase, you dont know if it is from a neoplasm, a bone problemo, etc. so what test would you order

A

gamma-glutamyl transpeptidase

178
Q

what is gamma glutamyl transpeptidase? GGTP

A

enzyme predominately present in hepatocytes and biliary epithelia - useful in determining whether elevated alk phos is of bone or hepatic origin

179
Q

schizophreniform

A

same symptoms as schizophrenia but lasting between 1-6 months

180
Q

schizoaffective disorder

A

major depressive or manic episode concurrent with schizophrenia
BUT
Also lifetime history of delusions or hallucinations >2 weeks in the absence of major depressive / manic episode

181
Q

Child - female - regression at 10 . months - stereotyped hand ringing - ataxia?

A

Rett syndrome
X linked
MECP2 gene

182
Q

Obturator nerve
passes through?
comes from?
is responsible for?

A

passes through obturator canal
comes from l2-l4
responsible for adduction of thigh
sensation distal medial thigh

183
Q

Locus Ceruleus - NT?

A

Norepinephrine

184
Q

Patient comes in with difficult releasing grip
you also not that they have cataracts
what are you thinking?
what would you see on histo?

A

Myotonic dystrophy
AD DMPK gene
Trinucleotide repeat
Selective atrophy type I fibers - slow twitch
frontal balding and gonadal atrophy common
My tone my testicles my toupee

185
Q

If a patient presents with pure motor weakness of unilateral leg, arm, and lower face - what are you thinking?

A

internal capsule stroke - presentation - contralateral side effected

186
Q

Craniopharyngioma - found in ?
derived from ?
signs and symptoms

A

found in you people
remnants of rathkes pouch
often cystic with brownish yellow oily cholesterol crystals

187
Q

High characteristic finding of craniopharyngiomas on imaging

A

calcified cysts

188
Q

what makes a post pancreatitis cyst a pseudo?

A

not lined by epithelium - lined by granulation tissue!

189
Q

at low dose does alpha-1 or beta-2 stimulation predominately effect diastolic blood pressure?

A

beta-2 induced dilation of skeletal muscle vasculature wins at low doses -
at high doses - alpha-1 constriction of visceral and cutaneous wins and you get elevated blood pressure

***remember this when giving people epinephrine who are on beta blockers

190
Q

tinea versicolor

A

Caused by Malassezia - yeast like fungus - (not a dermatophyte) -
causes degradation of lipid membrane via acid secretion which fucks with melanocytes
which leads to hypopigmentation of the skin
Spaghettic and Metaball on microscope

191
Q

Tinea Veriscolor rx

A 
topical antifungals or oral
nystatin
clortrimazole 
miconazole 
or
selenium sulfide
192
Q

how do azole work again

A

they disrupt ergosterol biosynthesis (cell membrane component via p450 enzyme inhibition)

193
Q

if you are looking for clues as to whether a child has group A strep or Kawasakis disease… what could clue you into Kawasakis?

A

fever last 5 days or longer
bilateral nonexudative conjunctivitis
erythema or edema of hands / feet

194
Q

Putaminal hemorrhage - likely due to a bleed involving HTN induced Charcot bouchard anuerysm from the lenticulostriate arteries of the middle cerebral - almost always involve?

A

the adjacent internal capsule - leading to contralateral hemiparesis and hemianesthesia due to disruption of the corticospinal and somatosensory fibers in the posterior limb

195
Q

lobar hemorrhages are most frequently associated with?

A

amyloid angiopathy in the elderly (cortical branches of the major cerebral - usually parietal and occipital)

196
Q

Rett gene

A

MECP2

197
Q

Aflatoxn of aspergillosis associated with hepatocellular carcinoma and mutation

A

b1
p53
codon 249
G:C –> T:A

198
Q

Nuer-endocrine associations with small cell lung cancer

A

SIADH
Cushings
Also Lambert Eaton!!

199
Q

Lambert Eaton is associated with which lung cancer?

A

small cell

200
Q

which lung cancer shows hypercalcemia?

A

squamous cell

201
Q

locations of lung cancer?

A

small cell and squamous - central - makes sense since associated with smoking

adeno and large cell - periphery

202
Q

associations with large cell lung cancer

A

gynecomastia
galactorrhea -
large ladies :)

203
Q

associations with adenocarcinoma of the lung?

A

clubbing and

hypertrophic osteoarthropathy

204
Q

precarious placement of pudendal?

A

curving course around ischeal spine to return to pelvis can stretch

205
Q

If you are going to intubate someone with rheumatoid arthritis what should you consider?

A

They may have subluxation of the atlanto-axial joint and then when you put the tube in, you may make this worse and then the spine may get compressed and then you will have spinal shock!!! oh no

206
Q

The most characteristic biochemical feature of huntingtons?

A

decreased GABAergic neurons in the caudate nucleus :(
they have elevated dopamine as well?
HD gene on chromosome 4

207
Q

modafinil

A

narcolepsy rx (non-amphetimine)

208
Q

my patient comes in and has hypertriglycerides - but can’t tolerate fibrates - what should i DO?

A

Niacin - lowers Hyperlipidemia / raises HDL

TEll him to also take aspirin because Niacin effect of PGD2 and PGE2 can cause flushing warmth and itching :

209
Q

Red man syndrome

A

non-IgE mediated histamine response to vanco

210
Q

substance p?

A

polypeptide neurotransmitter - mediates pain signals in the PNS and CNS - topical capsaicin causes release of substance P

211
Q

chronic lung rejection ???

A

brochiolitis obliterans - targets the airways not the vasculature

212
Q

If we take macrophages from our patients lungs (or anywhere i suppose) and they turn dark blue with prussian blue staining - what can we conclude???

A

They are hemosiderin laden macrophages - i.e. they are siderophages - i.e. they have been chomping up red blood cells and are now filled with iron - thus he was likely experiencing LHF with subsequent pulmonary edema

213
Q

Ribavirin

A

used in HepC - inhibits synthesis of guanine nucleotides and interferes with viral RNA dependent RNA polymerase
remember
HCV is a flavivirus - enveloped +ssRNA

214
Q

where does the axonal reaction occur and what does it look like?

A

proximal to the transection (i.e. the neuronal body) - see swollen and rounded body - nucleus displaced to periphery - nissle substance dispersion - preparing to produce protein to regrow

215
Q

where does wallerian degeneration occur?

A

distal to the transection
- degeneration of axon and myelin distal to point of injury - fragments are digested by schwann cells and macs (i.e. only pNS)

216
Q

What differentiates wallerian degeneration from neuron cell death :(

A

neurons manifest with shrinkage of the neuronal body
deep eosinophilia of cytoplasm
pyknosis of the nucleus
loss of Nissle

217
Q

cytokine secreted by hyperactive T cells in crest syndrome that cause?

A

TGF-Beta

collagen deposition - particularly effecting small arterioles and capillaries early

218
Q

characteristic finding in ion channel myopathy

A

positive PAS vacuoles in cytoplasm

219
Q

what causes subcortical dementia in non-compliant AIDS?

A

Microglial nodules - resulting from inflammatory activation of microglial cells - inflammatory cytokine release

220
Q

Pulsion diverticula

A

false diverticula usually in the colon due to pressure pushing the mucosa and submucosa through a weakness in the muscle wall - most common in diverticula of old people - and also same as zenker diverticula of upper esophagus

221
Q

where are diverticula most common

A

sigmoid colon

222
Q

what is a true diverticula

A

a traction diverticula where inflammation and subsequent scarring of the gut wall yields outpouching of all gut layers - may occur in the midesophagus due to medistinal lymphadentitis caused by TB or fungal infection

223
Q

Ground glass hepatocytes with homogeneous pale eosinophilic cytoplasm?

A

characteristic histopath of HepC

224
Q

Clumped amorphous eosinophilic intracytoplasmic inclusions in hepatocytes?

A

mallory bodies

alcoholic steothepatitis

225
Q

small vesicles of fat within hepatocytes

A

hepatic steatosis - characteristic histo

226
Q

where is acetylcholine decreased in alzheimers

A

hippocampus
nucleus basalis of meynert
deficiency in choline-acetyltransferase

227
Q

depleted in Huntington

A

NMDA receptors are depleted in the striatum

228
Q

characteristic histopath of reyes

A

microvesicular steatosis without inflammation

229
Q

Cushing’s triad - brainstem compression

A

hypertension
bradycardia
respiratory depression

230
Q

Mid brain and upper pons compression?

A

flexural posturing and fixed dilated pupils - loss of inhibition to upper limb flexors

231
Q

At or below red nucleus (midbrain tegmentum / pons) = compression?

A

extensor posturing - loss of excitation to upper limb flexors - so extensory predominate

232
Q

schwannomas may aris within any cranial nerve except

A

ii

233
Q

location usually of brain mets

A

grey white border

234
Q

tension pneumothorax or pleural effusion can efface the x-ray in a manner similar to a lung collapse do to a right mainstem bronchus obstruction- how would you be able to distinguish?

A

tension pneumothorax wil push mediastinal structure and trachea away (so will a pleural effusion)

lung collapse from bronchus obstructions will pull mediastinal structures toward side

235
Q

PRIMARY defense mechanism in giardia?

A

IgA

236
Q

Riedel thyroiditis

A

thyroid replaced by fibrous tissue

IgG4 related systemic disease - autoimmune pancreatitis / retroperitoneal fibrosis, non-infectious aortitis

0001 STEP ONE RAPID REVIEW DX (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions