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Board Qs Flashcards

1
Q

Wernicke-Korsakoff

A

Wernicke: oculomotor dysfunction, ataxia, encephalopathy; mamillary bodies; alcoholics; thiamine (B1) def
Korsakoff: chronic deficiency = amnesia, confabulation, apathy

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2
Q

Fragile X

A

Fragile X syndrome is caused by an increased number of CGG trinucleotide repeats on the fragile X mental retardation 1 (FMR1) gene on the long arm of the X chromosome. This leads to hypermethylation and inactivation of FMR1; macroorchidism, large jaw, intellectual disability

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3
Q

Huntington disease

A

CAG repeat on chromosome 4 caused by looping and repair during replication, unequal crossing over during meiosis

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4
Q

Friedreich’s ataxia

A

FXN gene encoding for frataxin (GAA)

stumbling, childhood kyphoscoliosis, hammertoes, pes cavus, dysarthria, nystagmus

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5
Q

direct bilirubin disorders

A

Rotor (NML liver histology, elevated total urine coproporphyrin) and Dubin Johnson (black liver, NML total coproporphyrin)

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6
Q

SCID

A

recurrent infections, FTT, diarrhea

ADA deficiency

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7
Q

William Syndrome

A

elfin face, hypercalcemia, developmental delay, well-developed skills, cardiac issues

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8
Q

encephalopathy secondary to liver cirrhosis pathophys

A

ammonia is metabolized in liver > when it’s not, it causes swelling in the brain > somnolence, asterixis (hand-flapping tremor), coma

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9
Q

Kartagener

A

AKA primary ciliary dyskinesia
AR
defect in dynein
chronic resp infections, recurrent OM, infertility, situs inversus (point of maximal impulse may be on right), bronchiectasis

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10
Q

presentations of SCD

A

vaso-occlusive crisis (dactylitis most often)
stroke (pediatric)
acute chest syndrome (fever, chest pain, hypoxemia, resp distress)
splenic sequestration (SM, decreased Hb, thrombocytopenia)

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11
Q

Lesch Nyhan

A

XL
deficiency of HGPRT
developmental delay, self-mutilation, gout, choreiform movements

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12
Q

Lassa fever

A

arenaviridae (grains of sand appearance on EM) > 2 segmented ambisense ssRNA genome; hemorrhagic fever (pharyngitis, cough, N/V/D, myalgia, retrosternal chest pain, back pain, abd pain; face swelling, pulm edema, mucosal bleeding ,hypotension, deafness if severe

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13
Q

adenovirus

A

swimming pool conjunctivitis (fever, sore throat, coryza, red eyes, pharyngitis)

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14
Q

Hartnup

A

def in tryptophan > precursor to niacin (B3) > pellagra (4 Ds = dermatitis, diarrhea, dementia, death)

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15
Q

how do you decrease type II error?

A

increase power by increasing sample size or decreasing variability

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16
Q

carcinoid syndrome

A

secretes high levels of serotonin; hydroxyindoleacetic acid (5-HIAA) is metabolite of serotonin found in urine of these pt

Presentation: wheezing, diarrhea, flushing, right-sided valvular lesions (esp tricuspid regurg)

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17
Q

DIC

A

low platelets, low plasminogen, high PT (activation of both coagulation and fibrinolytic system > excessive consumption of clotting factors and platelets)

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18
Q

ITP

A

low platelets, elevated bleeding time, NML PT, PTT; idiopathic meaning there’s not really anything besides low platelets and high bleeding time consequently to tell you anything

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19
Q

VWD

A

NML platelets, high bleeding time and PTT (VIII stabilized by vwf)

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20
Q

vitelline duct abnormalities

A

persistent vitelline duct (fistula) = meconium discharge from umbilicus
Meckel diverticulum = most common
vitelline sinus
vitelline duct cyst

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21
Q

West Nile

A

fever, headache, rash, neuroinvasive sx (Parkinsonian, asymmetric flaccid paralysis)

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22
Q

where are lipophilic drugs (like anesthesia) absorbed quickly?

A

Well-vascularized tissue > brain, kidney, liver, lungs, heart

delayed distribution in skeletal m, bone, fat

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23
Q

chronic bronchitis most commonly caused by…

A

smoking

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24
Q

type I pneumocytes

A

form alveolar capillary barrier with endothelial cells

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25
Q

Reye pathophys

A

aspirin use during viral infxn > mitochondrial toxicity > impaired FA metabolism > microvesicular fat deposits in liver > hepatic dysfunction > hyperammonemia > diffuse astrocyte swelling (cerebral edema)

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26
Q

sirolimus MOA

A

binds FKBP that inhibits mTOR to stop IL-2 signaling

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27
Q

cyclosporine and tacrolimus MOA

A

binds cyclophilin or FKBP (respectively) which then inhibits calcineurin and stops IL-2 gene transcription

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28
Q

what can’t use ketones in the body?

A

RBCs

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29
Q

+ membrane potentials

A

Na or Ca

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30
Q
  • membrane potentials
A

K or Cl

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31
Q

1 SD, 2 SD, 3 SD

A

68%, 95%, 99.7%

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32
Q

normal AG causes

A 
simply d/t loss of bicarb > HARDASS
Hyperchloremia
Addison
RTA
Diarrhea
Acetazolamide
Spironolactone
Saline infusion
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33
Q

elevated AG causes

A 
d/t accumulation of unmeasured acidic compounds > MUDPILES (CAT)
Methanol
Uremia
DKA
Paraldehyde
Iron, Isoniazid
Lactic acidosis
Ethanol, ethylene glycol
Salicylate/ASA/Aspirin

Carbon Monoxide
Aminoglycosides
Theophylline

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34
Q

NML AG

A

10-14

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35
Q

montelukast and zafirlukast MOA

A

inhibit leukotrienes (“lukast” = LEUKOtriene)

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36
Q

CV abnormalities in Turner

A

Aortic coarctation, bicuspid aortic valve

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37
Q

pathogenesis of preeclampsia

A

ABNML placental development that results in high resistance, low perfusion vessels leading to ischemia > triggers widespread maternal endothelial dysfunction (vasospasm), increased vascular permeability, and decreased end-organ perfusion > classic presentation is HA and visual changes

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38
Q

what psych medication is CI in binge eating?

A

BUPROPION REMEMBER IT DAMMIT

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39
Q

schizotypal personality disorder

A

magical beliefs, social anxiety, eccentric behavior, odd perceptual experiences

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40
Q

type IIa dyslipidemia (hypercholesterolemia)

A

high total cholesterol, high LDL, everything else NML

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41
Q

type I dyslipidemia (hyperchylomicronemia)

A

NML to high cholesterol, super high TGs, CM elevated

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42
Q

type IIb dyslipidemia (hypercholesterolemia)

A

LDL and VLDL high, high cholesterol, high TGs

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43
Q

type III dyslipidemia (dysbetalipoproteinemia)

A

IDL high, high cholesterol, high TGs

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44
Q

type IV dyslipidemia (hypertriglyceridemia)

A

VLDL high, NML to high cholesterol, high TGs

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45
Q

type V dyslipidemia

A

VLDL and CM high, high to moderately high cholesterol, super high TGs

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46
Q

subacute granulomatous thyroiditis

A

AKA de Quervain thyroiditis; often after viral URI, only form that results in painful thyroid gland

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47
Q

Courvoisier’s sign

A

painless palpation of distended, obstructed gallbladder in pancreatic CA

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48
Q

signs of pancreatic cancer

A

Courvoisier’s, Trosseau (migratory and recurrent thrombophlebitis), Virchow’s node (L supraclavicular)

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49
Q

digoxin toxicity and MOA

A

bradycardic, visual disturbances (yellow halo), N/V

MOA: inhibit myocardial Na/K ATPase

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50
Q

why are local anesthetics less effective at sites of infection and thus require a higher dose for infected sites?

A

Local anesthetics are alkaline and infection results in an acidic environment

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51
Q

tuberous sclerosis

A

seizures, intellectual disability, subependymal astrocytoma, ash leaf spots, ungual fibromas, angiomyolipomas

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52
Q

identification

A

adopts and models behaviors of another person

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53
Q

idealization

A

only focuses on + traits of self or others and overlooks flaws

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54
Q

ToF

A

PROVe: pulmonary stenosis (left USB harsh systolic murmur), RVH (boot-shaped heart), overriding aorta, VSD

Cyanotic spells (often caused by crying, fever, exercise d/t exacerbation of RV outflow obstruction) > squatting increases SVR > decreases R-L shunt > improves cyanosis; a/w 22q11 syndromes

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55
Q

hemochromatosis

A

DM, liver failure, skin hyperpigmentation, cardiac sx (dilated CM, restrictive CM, arrhythmias), arthritis

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56
Q

thiazide diuretics MOA (hydrochlorothiazide, metolazone, chlorthalidone, indapamide)

A

inhibit NaCl reabsorption from luminal side of epithelial cells in DCT by blocking Na/Cl transporter

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57
Q

berry aneurysm b/w anterior communicating and anterior cerebral can cause what visual field defect?

A

bitemporal hemianopia

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58
Q

what nerve is most likely injured in fibular fracture

A

common peroneal n > inability to dorsiflex foot (foot drop) > tibialis anterior, extensor digitorum longus and hallucis

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59
Q

where does prolactin come from?

A

anterior pituitary

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60
Q

what hormones come from posterior pituitary?

A

vasopressin and oxytocin

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61
Q

epiglottitis

A

fever, sore throat, dysphagia, drooling, muffled voice, respiratory distress (tripod position opens airway), thumbprint sign on XR

3Ds: dysphagia, drooling, distress are hallmark

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62
Q

albuterol MOA

A

beta 2 agonist > activates AC > increases cAMP > increased PKA > smooth muscle relaxation > bronchodilation

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63
Q

hypertrophic CM

A

syncope in athletic setting; AD condition caused by missense mutation in genes for beta-myosin heavy chain

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64
Q

NK cells induce apoptosis by…

A

perforin and granzyme production; Fas/FasL binding on cell surface

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65
Q

Lambert-Eaton

A

presynaptic disorder of NM transmission in which there is reduced ACh release d/t Ab against voltage-gated Ca channels; paraneoplastic; leg weakness, general weakness, pain, stiffness, arm weakness, ptosis, dry mouth, constipation, impotence

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66
Q

Hashimoto

A

signs of hypothyroidism, hx of autoimmune disorders, germinal centers w/ lymph infiltrate and follicular destruction; anti-TPO

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67
Q

schizoid personality disorder

A

no desire for close relationships, flat affect, prefers solitary activities, little or no interest in sexual experiences, enjoys few or no activities, indifferent to criticism, praise, or other people’s opinions of them, no close friends

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68
Q

Wallenberg syndrome

A

lateral medullary syndrome; PICA; ipsilateral loss of pain and temp in face, contralateral loss of pain and temp in body, dysarthria, dysphagia, ataxia

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69
Q

lateral pontine syndrome

A

AICA; ipsi face analgesia, contra body analgesia, ipsi face hemiparesis, ipsi deafness

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70
Q

MCA stroke

A

contra hemianesthesia, contra hemiplegia, contra homonymous hemianopia, ipsi horizontal gaze preference

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71
Q

mid-shaft humerus fractures most commonly injure what nerve

A

radial > brachioradialis, extensors of the wrist and fingers, supinator, triceps (BEST)

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72
Q

borderline personality disorder

A

instability of relationships, self-image, and affect, marked impulsivity, avoid abandonment; initial tx is CBT/DBT, psychodynamic therapy

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73
Q

hereditary fructose intolerance

A

hypoglycemia, tiredness, vomiting, diaphoresis since introducing fruit; deficiency in aldolase B > buildup of F1P

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74
Q

Marcus Gunn pupil

A

alternating constriction and dilation of both pupils with swinging flashlight test; when directed into NML eye, pupils constrict like NML, but when directed into affected eye they appear to dilate; damage to either optic n or retina

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75
Q

what happens to increase blood flow to muscles during exercise?

A

local metabolites (Co2, H+, K+, adenosine) and decreased O2 > dilate arterioles and recruit capillaries

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76
Q

ankylosing spondylitis

A

low back pain that gets better with exercise, worse @ night, SI joint, enthesitis, restrictive lung disease, aortic insufficiency, uveitis, systemic sx

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77
Q

cocaine MOA

A

inhibits reuptake of DA, 5-HT, NE into presynaptic neurons > increased risk of preterm delivery

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78
Q

heparin MOA

A

potentiates action of antithrombin III

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79
Q

what layer of bowel is most susceptible to ischemia?

A

Innermost > mucosa

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80
Q

MHC II function

A

Present antigens to the CD4 helper T cells

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81
Q

atrial myxoma

A

constitutional sx; often in left atrium > impaired blood flow through mitral valve and reduce preload > low CO > syncope > early diastolic murmur that changes in frequency with changes in pt body position > can develop embolic stroke, mesenteric ischemia, arterial insufficiency, AKI

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82
Q

COPD path from smoking

A

increases oxidants in lungs

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83
Q

Ebstein anomaly

A

tricuspid regurg, downward displacement of TV leaflets into RV, RHF can occur > JVD, peripheral edema, and/or HM; hypoxemia, cyanosis

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84
Q

cecum supplied by branches of …

A

SMA (lower duodenum, jejunum, ileum, cecum, ascending colon, transverse colon to splenic flexure)

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85
Q

tx of phthirus pubis and scabies

A

topical permethrin

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86
Q

cleft lip results when…

A

maxillary prominence fails to fuse with intermaxillary segment

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87
Q

MCC of renal infarction

A

Systemic thromboembolism from LA or LV; common complication of afib

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88
Q

age-related changes to resp system

A

decreased chest wall compliance/expansion, decreased alveolar elastic recoil (increases compliance and increased air trapping), increased a-A gradient (increased deadspace)

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89
Q

GVHD

A

graft immunocompetent T cells migrate into host tissues, where they recognize host MHC antigens as foreign and become sensitized > destroy host cells

will get diffuse response w/ rash, jaundice, diarrhea, HSM

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90
Q

P-glycoprotein

A

efflux pump found in brain that prevents many substances from entering

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91
Q

PTH function

A

increase bone resorption > Ca and P release > increase Ca in blood

kidneys increase Ca reabsorption and decrease P reabsorption > increase Ca in blood, increase P in urine

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92
Q

Pott disease

A

progressive back pain, intermittent fever, vertebral bone destruction w/ abscess > M tuberculosis spondylitis (infection spreads behind ALL to vertebrae and IVD space > abscess)

D/t hematogenous seeding of vertebrae from primary pulmonary infxn; months to years later

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93
Q

REM sleep behavior disorder

A

parasomnia characterized by dream-enactment behaviors d/t loss of atonia; a/w alpha-synuclein neurodegeneration like Parkinson, Lewy body dementia

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94
Q

Catheter pressures

A

RA = <10
RV = <10-25
PA = 10-25
PA wedge = ~10

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95
Q

what portion of the nephron absorbs the most water?

A

PCT

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96
Q

severe mitral regurgitation can result in…

A

L-sided volume overload with S3 gallop d/t large volume of regurgitant flow reentering ventricle mid-diastole

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97
Q

digoxin toxicity

A

GI distress, arrhythmias, fatigue, confusion, weakness, color vision alterations, high K (from inhibition of Na/K pumps)

Tx for HF

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98
Q

lesion in internal carotid artery of TIA

A

contralateral leg weakness, ipsilateral vision loss (amaurosis fugax); internal carotid supplies EXTERNAL brain (hemispheres)

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99
Q

alcohol withdrawal effects on receptors

A

decreased GABA activity, increased glutamate activity d/t increased # of NMDA receptors

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100
Q

Berger/IgA nephropathy

A

MCC of glomerulonephritis; painless hematuria accompanied by URI

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101
Q

lung abscess antibiotic tx should cover…

A

facultative and strict anaerobes (often present)

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102
Q

what part of the posterior urethra is more prone to injury following pelvic fx in male?

A

membranous

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103
Q

tibial n injury

A

inability to plantarflex, invert, and flex toes; sensory loss over sole

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104
Q

oculomotor n injury

A

down and out eye, diplopia, dilation of pupil and loss of accommodation, ptosis; SR, MR, IR, IO, LPS

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105
Q

what amino acid is a/w folate?

A

Thymidine

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106
Q

mitochondrial diseases

A

“red ragged muscle fibers”; maternal inheritance

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107
Q

femoral nerve block site

A

below inguinal lig

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108
Q

saphenous nerve block site

A

adductor canal or medial tibial condyle

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109
Q

pudendal nerve block site

A

ischial spine tip

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110
Q

obturator nerve block site

A

obturator canal

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111
Q

apolipoprotein E risk

A

late-onset alzheimer’s

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112
Q

NNH

A

1 / ARI

ARI = rate AE (drug) - rate AE (placebo)

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113
Q

best approach to somatic symptom disorder

A

regular visits with the same provider

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114
Q

what determines need to abx tx in a person with GAS?

A

swab for GAS antigens; gram stain isn’t effective because the mouth contains other g+ cocci

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115
Q

cerebellar injury

A

motor planning and coordination of ipsilateral extremities

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116
Q

Crohn

A

prolonged diarrhea, abd pain, constitutional sx, malabsorption, weight loss, a/w ankylosing spondylitis, arthritis

terminal ileum commonly involved where bile acids are normally reabsorbed and recycled (vit K is a fat-soluble vitamin so can have coagulation issues)

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117
Q

inadequate thyroid hormone levels in infants being treated for congenital hypothyroidism..

A

rapid growth > increasing need for thyroid hormone
decreased absorption of levothyroxine
coadministration with certain foods or drugs can lead to poor intestinal absorption

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118
Q

EF=

A

SV / EDV

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119
Q

WPW

A

caused by accessory conduction pathway (bundle of Kent)

Triad: short PR, wide QRS, delta wave (slurred upstroke into QRS)

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120
Q

atopic dermatitis

A

pruritic, lichenified plaque; often flares w/ low humidity; genetically-mediated epidermal barrier dysfunction and immune dysfunction part of pathogenesis; Th2 response > IL-4 and IL-13 trigger IgE production

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121
Q

propionic acidemia

A

congenital def in propionyl-CaA carboxylase (converts propionyl to methylmalonyl) > met acid, hypoglycemia, ketosis

uses valine, isoleucine, methionine, threonine for energy

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122
Q

MEN1

A

primary hyperparathyroidism
pituitary tumors
pancreatic tumors (esp. gastrinomas)

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123
Q

MEN2A

A

medullary thyroid cancer (calcitonin)
pheochromocytoma
primary hyperparathyroidism

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124
Q

MEN2B

A

medullary thyroid cancer (calcitonin)
pheochromocytoma
mucosal neuromas/marfanoid habitus

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125
Q

HPV affects _____ vocal cords

A

true

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126
Q

dantrolene MOA

A

blocks RYR1 to prevent Ca release from SR into cytoplasm of skeletal muscles

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127
Q

prolonged muscle weakness after receiving succinylcholine

A

plasma pseudocholinesterase def > genetic polymorphism in BCHE gene > lot of drug reaches NMJ

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128
Q

STEMI tx w/o percutaneous coronary intervention

A

thrombolytics (alteplase) > reperfusion related arrhythmia

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129
Q

pt with low HDL levels…

A

should focus on lowering LDL with HMG-CoA reductase inhibitors (statins); niacin is most effective for raising HDL but doesn’t reduce risk of CV events and is a/w AE (flushing, hyperglycemia)

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130
Q

elderly w/ myopia…

A

can actually have improved vision with age d/t age-related presbyopia

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131
Q

carcinoid syndrome develops when a carcinoid tumor has

A

metastasized

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132
Q

abd pain/distension, bloody diarrhea, fever, shock in setting of untreated UC

A

Toxic megacolon > XR

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133
Q

Common hepatic artery gives off…

A

R gastric (inferior lesser curvature) and gastroduodenal (supplies pylorus, prox duodenum, and head of pancreas)

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134
Q

Eisenmenger

A

cyanosis, pulmonary HTN, reversal of blood through a defect (VSD, ASD, or PDA), 2nd or 3rd decade w/ s/s of RHF, diffuse cyanosis, and clubbing

VSD alone doesn’t produce cyanosis

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135
Q

Dandy Walker malformation

A

congenital brain anomaly involving posterior fossa and cerebellum; begins w/ cystic enlargement and posterior extension of 4th ventricle; causes hypoplasia and cephalad rotation of cerebellar vermis

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136
Q

tx for acute pulm edema in setting of decompensated HF

A

loop diuretic

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137
Q

SCC of the lung

A

centrally located; hypercalcemia of malignancy; keratin pearls w/ intracellular bridging; strong a/w smoking

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138
Q

AIHA

A

spherocytes, elevated reticu, reduced haptoglobin, and +direct Coombs

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139
Q

where do the nerve roots exit the spinal cord?

A

above the corresponding vertebrae; so a herniated C6/7 disc corresponds to C7

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140
Q

middle meningeal artery

A

enters through foramen spinosum and is terminal branch of maxillary a (arises from external carotid)

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141
Q

language aphasia affected based on location

A

arcuate fasciculus: conduction, intact fluency, impaired repitition, intact comprehension

primary motor cortex: no aphasia (dysarthria), intact rest

Broca: impaired fluency and repetition, intact comprehension

Wernicke: intact fluency, impaired repetition and comprehension

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142
Q

Systolic HF (HFrEF) loop

A

decreased SV and increased ESV and EDV

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143
Q

Whipple disease

A

arthralgias, weight loss, steatorrhea, abd pain

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144
Q

CYP450 inducers

A

carbamazepine, rifampin, griseofulvin, phenobarbital, phenytoin, St John’s wort, chronic alcohol

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145
Q

Inhibitors of CYP450

A

Diltiazem, itraconazole, ketoconazole, erythromycin, clarithromycin, grapefruit juice, protease inhibitors, nefazodone, acute alcohol

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146
Q

common cause of bleeding in ped patient w/ no hemorrhoids or anal fissures…

A

Meckel diverticulum

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147
Q

duodenal ulcers should suspect…

A

ZES > overproduction of gastrin in G cells of pyloric antrum and duodenum

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148
Q

Parinaud syndrome (dorsal midbrain syndrome)

A

impaired vertical gaze, NML to lg pupils, light-near dissociation, convergence-retraction nystagmus, and eyelid retraction (Collier sign); caused by pineal gland tumor, hydrocephalus, MS, brainstem infarction

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149
Q

diabetic neuropathy findings

A

mesangial expansion, GBM thickening, podocyte injury, glomerulosclerosis (Kimmelstiel-Wilson nodules)

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150
Q

primary hyperaldosteronism (Conn)

A

HTN, unexplained hypokalemia, metabolic alkalosis, low renin; d/t adrenal hyperplasia or adrenal adenoma

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151
Q

blastomycosis

A

inflammatory lung disease, verrucous skin lesions, lytic bone lesions

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152
Q

t-PA MOA

A

degradation of fibrin through conversion of plasminogen to plasmin

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153
Q

bone spurs

A

osteophytes seen in osteoporosis

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154
Q

spinal cord hemisection (Brown Sequard)

A

ipsi spastic paralysis, ipsi loss of touch and sensation , contra loss of pain and temp about 2 levels below lesion

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155
Q

biggest complaint after being on an estrogen agonist years later…

A

postmenopausal bleeding > endometrial hyperplasia and cancer

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156
Q

tx of acute chest pain in angina pectoris

A

nitroglycerin > stimulate GC > increase cGMP > activate myosin light chain phosphatase > vasodilation

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157
Q

anterior spinal cord syndrome

A

paraplegia below, loss of temp and pain bilaterally, intact pinpoint and vibration

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158
Q

tx of HTN in pregnant pt

A

methyldopa (alpha-2 agonist), hydralazine (reduce afterload by increased cGMP), labetalol, nifedipine

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159
Q

medullary CA of thyroid

A

high calcitonin d/t prolif of parafollicular C-cells

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160
Q

oligodendroglioma

A

MC primary CNS tumor in 4th-6th decades; HA, seizure, confusion, cognitive dysfunction, focal weakness, sensory abnormalities, aphasia; fried egg appearance, chicken wire appearance; frontal lobes MC

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161
Q

tx of organophsphate poisoning

A

atropine and pralidoxine

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162
Q

Horner =

A

damage to sympathetics; ptosis, miosis, and anhidrosis

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163
Q

NSAIDs MOA

A

conversion of AA to PGDs by COX

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164
Q

“-zosins”

A

alpha-1 receptor blockers > treat HTN and BPH

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165
Q

trazodone

A

atypical antidepressant weak inhibitor of 5-HT2A receptor; se = priapism

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166
Q

temporal arteritis

A

tenderness @ temporal region, jaw claudication, HA, visual impairment; granulomas w/ giant cells; a/w polymyalgia rheumatica (both a/w HLA-DR4)

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167
Q

menopause

A

decline in sensitivity of ovaries to stimulation by gonadotropins > high FSH, LH

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168
Q

ADPKD association

A

berry aneurysms > rupture = subarachnoid hemorrhage

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169
Q

increased prevalence of disease…

A

increases PPV, reduces NPV

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170
Q

decreasing the cutoff value for a test…

A

increases NPV, reduces PPV

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171
Q

type II pneumocytes

A

make up the largest # of alveolar cells (although type I make up the largest SA) and act as progenitor cells for type I, which cannot regenerate on their own; produce surfactant

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172
Q

gonadal arteries arise from…

A

abdominal aorta

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173
Q

H pylori infection = increased risk of…

A

gastric ulcers, gastric adenocarcinoma, and MALT lymphoma

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174
Q

mild galactosemia..

A

def in galactokinase > cataracts d/t buildup of galactitol

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175
Q

postpartum blues (i.e. normal postpartum rxn)

A

resolves w/i 2 weeks; mild depression, tearfulness, irritability

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176
Q

postpartum depression

A

onset w/i 4-6 weeks; >2w of moderate to severe depression, sleep, or appetite disturbance, low energy, guild, difficulty concentrating, suicidal ideation

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177
Q

overflow incontinence

A

impaired detrusor contractility or bladder outlet obstruction; involuntary and continuous leakage when bladder is full w/ incomplete emptying

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178
Q

AIN

A

drugs > rash, fever, AKI, pyuria, hematuria, WBC casts, urinary eosinophils

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179
Q

anemia

A

PaO2 and % sat would be NML but O2 content would be low d/t lower Hb

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180
Q

HAPE

A

high-altitude pulmonary edema; reduced PiO2 > hypoxic pulm vasoconstriction > increased pulm arterial pressure > unbalanced hypoxic vasoconstriction > alveolar-capillary membrane disruption

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181
Q

DNA polymerase I in prokaryotes

A

5’ to 3’ exonuclease activity

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182
Q

DNA polymerase III

A

3’ to 5’ exonuclease activity, 5’ to 3’ polymerase activity

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183
Q

tRNA

A

contains modified bases; CCA sequence at 3’ end > serves as AA binding site

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184
Q

Rickettsia ricketsii

A

RMSF > nonspecific sx followed by macular-petechial rash that moves distal to central > tx w/ doxy

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185
Q

major RFs for AAA

A

age >65, smoking, male

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186
Q

metabolites of morphine

A

glucoronide > renal elimination > w/ renal dysfunction, metabolites accumulate and opioid toxicity results

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187
Q

pharyngeal arch 1

A

trigeminal; maxillary a

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188
Q

pharyngeal arch 2

A

facial n

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189
Q

pharyngeal arch 3

A

glossopharyngeal n; common carotid, proximal ICA

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190
Q

pharyngeal arch 4

A

superior laryngeal branch of vagus; true aortic arch, subclavian aa

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191
Q

pharyngeal arch 6

A

recurrent laryngeal branch of X; pulmonary aa, ductus arteriosis

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192
Q

ghrelin

A

produced in response to fasting; stimulates appetite and promotes weight gain

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193
Q

leptin

A

produced in response to short-term food intake > acts on hypothalamus to decrease appetite (obesity blunts this)

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194
Q

what viruses are capable of reassortment?

A

segmented - orthomyxo (flu), reo (rota), bunya, arena

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195
Q

how is copper excreted?

A

through bile

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196
Q

amniotic fluid embolism

A

pregnancy complication that results from amniotic fluid entering maternal circulation; hypotensive shock > fetal squamous cells seen in pulmonary vasculature

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197
Q

sympathomimetic weight loss drugs

A

phentermine, diethylpropion, benzphetamine > short-term tx of obesity; stimulate release and inhibit reuptake of NE

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198
Q

prevention of neonatal tetanus

A

vaccination of mother and those of childbearing age; hygienic delivery and cord care

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199
Q

permissiveness in pharmacology

A

hormone has no direct effect on a physiologic process but allows another hormone to exert its maximal effect on that process

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200
Q

meds ineffective in MRSA

A

oxacillin, methicillin, cephalosorins, and other beta-lactams

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201
Q

type I HS

A

IgE degranulates mast cells > following repeat exposure IgE can release preformed histamine and LTs (wheal and flare) > late phase stimulate Th2 cells to activate eosinophils > proteins (MBP, peroxidase) cause tissue damage > indurated lesion 2-10 hours following

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202
Q

glioblastoma multiforme

A

MC primary brain tumor in adults; increased vascularity, pseudopalisading tumor cells around necrotic areas

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203
Q

radial n action

A

extends the wrist > “Radial n Reaches back”

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204
Q

idiopathic pulmonary fibrosis

A

patchy lymphoplasmacytic infiltrates, focal fibroblastic proliferation, fibrosis, honeycombing, hyperplasia of T2 pneumocytes > inhibit TGF-beta and other GFs

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205
Q

glucocorticoid MOA

A

bind cytosolic receptor, translocate to nucleus, alteration in transcription (in immune cells inhibit NF-kB)

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206
Q

P falciparum

A

predominant in Africa; chloroquine-resistant > atovaqoune-proguanil, artemisinins) > no primaquine required d/t no dormant liver form

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207
Q

kinesin

A

anterograde transport (toward +, distant from nucleus)

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208
Q

Asherman syndrome

A

intrauterine adhesions mostly d/t D&C; secondary amenorrhea w/ no other signs

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209
Q

hydatidiform mole

A

proliferation of chorionic epithelium and cystic swelling of villi

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210
Q

DPP-4 inhibitors

A

“-gliptins” increase levels of endogenously secreted GLP-1 (increased insulin release and satiety, decreased glucagon release and gastric emptying)

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211
Q

psoriasis

A

hyperkeratosis, parakeratosis, acanthosis, elongated rete pegs, hypervascular dermal papillae

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212
Q

sarcoidosis

A

immune-mediated disease characterized by widespread noncaseating granulomas, restrictive lung disease, bilateral hilar LAD, Bell’s palsy, rash, erythema nodosum, blurry vision; causes rise in ACE, hypercalcemia, hypervitaminosis D

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213
Q

Kallmann

A

lack of puberty development, lack of secondary sex characteristics, decreased sense of smell

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214
Q

Klinefelter

A

Hypogonadism, gynecomastia, psychosocial problems, and infertility, 47 XXY karyotype

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215
Q

prophylactic tx for seizures in HELLP

A

mag sulf > evaluate DTRs for hypermagnesemia

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216
Q

macrolides severe side effect

A

prolonged QT

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217
Q

type I HS in sensitized individual

A

binding of antigen to IgE antibodies on surface of mast cells and basophils

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218
Q

cytokine that activates CD4 and 8 cells

A

IL-2

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219
Q

DIC

A

simultaneous thrombolysis and clot formation > D-dimer high d/t thrombolytic effect, but fibrinogen is low d/t formation of clots > “consumption of clotting factors and platelets”

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220
Q

anterior talofibular

A

always tears first; inversion ankle sprain; lateral malleolus to neck of talus

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221
Q

conivaptan

A

vasopressin receptor antagonist; prevents ADH action in CD

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222
Q

Whipple

A

similar presentation to IBD, but steatorrhea not common in IBD

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223
Q

dermatomyositis associations

A

increased risk of adenocarcinoma, particularly ovarian cancer

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224
Q

hyperthyroidism

A

overactive body > IgG antibodies against TSH in Graves

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225
Q

papillary carcinoma appearance

A

papillary growth with optically clear nuclei (ground-glass chromatin/orphan-annie eyes)

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226
Q

scabies

A

irritated rash common in the webbing of fingers and toes; low hygiene and overcrowding (homeless shelters) facilitate spread

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227
Q

ACEI is DOC for hypertensive pt w/…

A

diabetic nephropathy

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228
Q

Thiazide diuretics are DOC in hypertensive pt w/….

A

no other comorbidities

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229
Q

BB are DOC in hypertensive pt w/…

A

angina or hx of MI

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230
Q

alpha-blockers are DOC in hypertensive pt w/…

A

BPH

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231
Q

Friedreich ataxia is a/w what cardiac abnormality?

A

HOCM

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232
Q

“worst headache of my life”

A

subarachnoid hemorrhage

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233
Q

Ehler Danlos is a/w what vascular pathology

A

berry aneurysm

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234
Q

Holstein-Lewis fractures commonly injure what nerve

A

Radial n

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235
Q

tibial n innervates…

A

posterior leg mm

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236
Q

chylothorax

A

milky fluid composed of TGs within pleural space a/w trauma or lymphoma

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237
Q

Turner

A

45, XO; short stature, broad chest, primary amenorrhea

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238
Q

Swan-Ganz catheters measure pulmonary artery occlusion pressure which closely reflects…

A

left atrial and left ventricular ED pressures

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239
Q

TAP proteins

A

Load cytoplasmic proteins onto MHCI > activate CD8 cells

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240
Q

lactase def can be caused by…

A

inflammatory or infectious processes that damage microvilli

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241
Q

matching variables in a case-control study controls…

A

confounding bias

242
Q

VSD murmur

A

harsh, holosystolic murmur at left lower sternal border > L>R shunting

243
Q

taking exogenous thyroid hormone will show…

A

diffuse atrophy of thyroid follicles w/ decreased colloid d/t suppressed TSH

244
Q

pericardial effusion

A

h/o URI > pericarditis; chest tightness, DOE, tachy, low voltage QRS and diminished heart sounds, enlarged globar cardiac silhouette on CXR

245
Q

cofactors for branched chain alpha-ketoacid dehydrogenase

A

Tender Loving Care For Nancy = Thiamine, Lipoate, CoA, FAD, NAD

246
Q

most common mechanisms of aminoglycoside resistance

A

antibiotic-modifying enzymes that add chemical groups (acetyl, adenyl, phosphate) to target drug

247
Q

causes of supratherapeutic INR in warfarin

A

disruption to intestinal flora > destruction of vitamin K-producing bacteria in the gut > reduce vitamin K production > what little vitamin K is available is being inhibited by warfarin > increased INR

248
Q

calcium oxalate stones

A

octahedron (square w/ X in center) (oxalate = octahedron)

249
Q

calcium phosphate stones

A

wedge-shaped, form rosettes

250
Q

mag ammonium phosphate (struvite) stones

A

coffin lids

251
Q

uric acid stones

A

diamond or rhombus (4 letters in uric, 4 sides)

252
Q

cystine stones

A

flat, yellow, hexagonal (six-tine)

253
Q

acyclovir MOA

A

nucleoside analog > converted to monophosphate via thymidine kinase > convert to triphosphate which competes w/ deoxyguanosine triphosphate for viral DNA polymerase > when acyclovir becomes incorporated into replicating viral DNA, viral DNA synthesis is terminated

254
Q

when does vitamin B12 deficiency start showing neurological signs

A

4-5 years after complete absence of intake; a lot of B12 can be stored

255
Q

NRTI MOA

A

block PDE bond formation

256
Q

succinylcholine blockade

A

phase I blockade prevents repolarization of motor endplate and shows equal reduction of all 4 twitches during TOF stimulation; phase II blockade Ach receptors become desensitized

257
Q

TTP

A

decreased ADAMTS-13 > uncleaved vWF > platelet trapping and activation; hemolytic anemia (MAHA), thrombocytopenia, sometimes w/ renal failure, neurologic manifestations, fever

FATRN: fever, anemia (MAHA), thrombocytopenia, renal failure, neurologic manifestations

258
Q

liquefactive necrosis

A

severe bacterial infxn, CNS infarcts

259
Q

fibrinoid necrosis

A

HTN, vasculitis

260
Q

fat necrosis

A

acute pancreatitis, trauma

261
Q

caseous necrosis

A

mycobacterial infxn, fungal infxn

262
Q

coagulative necrosis

A

irreversible ischemic injury outside CNS

263
Q

what should be used in pt with stable angina w/ aspirin allergy to prevent CV events

A

clopidogrel

264
Q

method for resistance in ESBL E Coli

A

plasmid w/ drug resistance gene

265
Q

serum sickness is a type ____ HS reaction

A

III; deposition of immune complexes in tissue

266
Q

kids with communicating hydrocele are at risk of what?

A

indirect inguinal hernia

267
Q

lymph drainage in male anatomy

A

superficial inguinal nodes from scrotum > deep inguinal nodes from glans penis and superficial nodes > para-aortic nodes from testis

268
Q

rickets =

A

excess unmineralized matrix d/t less calcium and phosphorus for the bone

269
Q

medicare covers…

A

those 65+ and younger individuals w/ disabilities

270
Q

HSP

A

think IgA nephropathy + petechiae

271
Q

gigantism

A

hypersecretion of GH during childhood > excessive liver production of IGF-1

272
Q

transudative effusions

A

HF, cirrhosis, nephrotic syndrome > changes in hydrostatic or oncotic pressure

273
Q

exudative effusions

A

infxn, malignancy, rheumatologic disease > increased vascular membrane permeability from inflammation

274
Q

atheroembolic disease

A

common after vascular procedure; cholesterol clefts; kidneys, skin, GI, CNS

275
Q

isoniazid w/o pyridoxine

A

pyridoxine is cofactor for ALA synthase (catalyzes rate limiting step in heme synthesis) > typically prescribe both to prevent microcytic anemia

276
Q

tx of priapism

A

alpha-adrenergic agonists > induce contraction of cavernosus smooth m

277
Q

prerenal injury

A

BUN:Cr >20
Fractional excretion of Na <1%
Urine osmolality >500
microscopy hyaline casts

278
Q

ALS

A

loss of neurons in anterior horn, atrophy of LCSTs, denervation atrophy, LMN and UMN sx, diaphragmatic atrophy

279
Q

CN III PNS nucleus

A

Edinger-Westphal > miosis, accomodation

280
Q

CN VII PNS nucleus

A

Superior Salivary > salivation in submandibular gland

281
Q

CN IX PNS nucleus

A

Inferior Salivary > salivation in parotid

282
Q

CN X PNS nucleus

A

Dorsal Vagal > secretions in GI tract/lungs

283
Q

causes of metastatic bone cancer

A

Prostate > Breast > Kidney > Thyroid > Lung

Painful Bones Kill The Lungs

284
Q

Kawasaki

A 
CRASH and burn on a Kawasaki
Conjunctival injection, CV risks
Rash
Adenopathy
Strawberry tongue
Hand-foot changes (edema, erythema)
fever
285
Q

microglial cells

A

macrophages for the CNS; derived from monocytes (mesoderm)

286
Q

hydroxychloroquine

A

DMARD that causes retinal deposits

287
Q

acute diverticulitis

A

inflamed colonic outpouching commonly seen w/ stranding; mimics left-sided appendicitis; most commonly in sigmoid region

288
Q

hcg is produced by…

A

syncytiotrophoblast of placenta (maintains CL during early pregnancy)

289
Q

ZES

A

multiple peptic ulcers, rugal thickening, diarrhea

290
Q

REM is initiated by… and reduced by…

A

ACh, NE

291
Q

trisomy 18

A

PRINCE Edward
Prominent occiput, Rocker bottom feet, Intellectual disability, Nondisjunction, Clenched fists w/ overlapping fingers, low-set Ears

292
Q

mercury toxicity

A

tremor, behavioral, gingivo-stomatitis, neuropathy, etc.

Tx w/ chelation: dimercaprol, penicillamine, unithiol, succimer

293
Q

alprostadil

A

PGE1 analog used to keep ductus arteriosus patent until surgical repair for TGA

294
Q

Sheehan

A

pituitary ischemia following postpartum bleed > global decrease in ALL hormones produced from anterior pituitary

295
Q

common manifestation of blastomycosis infection

A

verrucal skin lesions

296
Q

migraine headaches with aura predisposes someone to…

A

CVAs

297
Q

MG

A

muscle fatigue, difficulty swallowing, eyelid drooping, worsening of sx throughout day > tx w/ pyridostigmine

298
Q

site of NE synthesis and linked to clinical depression

A

locus ceruleus

299
Q

Ewing sarcoma

A

onion-skin layering, t(11;22) translocation; MC in boys

300
Q

FOOSH injury often presents with _______ radial head

A

posterior

301
Q

Job (hyperimmunoglobulinemia E)

A

eczema, eosinophilia, recurrent skin and pulm infections

302
Q

Trendelenburg gait

A

weak hip abductors

303
Q

for an RNA molecule purified from a virus to be infectious on its own, it must act as mRNA capable of using host’s cell machinery for translation, meaning…

A

+ssRNA

304
Q

crossover study

A

subjects randomly allocated to a sequence of 2+ tx given consecutively (often spaced by a washout period where no tx is given to limit confounding effects of prior tx)

305
Q

hemiballism can involve what nucleus

A

subthalamic nucleus (modulates basal ganglia output)

306
Q

mechanism of Zenker diverticulum formation

A

cricopharyngeal motor dysfunction

307
Q

NK1 receptor antagonists used in chemo-induced N/V

A

aprepitant, fosaprepitant

308
Q

skin condition a/w GI malignancy

A

seborrheic keratosis

309
Q

metronidazole MOA

A

produces highly reactive radical anions

310
Q

metformin MOA

A

decrease hepatic gluconeogenesis via inhibition of mitochondrial gylcerphosphate dehydrogenase (mGPD), increase glycolysis, increase insulin sensitivity

311
Q

Brown-Sequard

A

Everything ipsilateral, except spinothalamic (pain, temp)

312
Q

zileuton MOA

A

5-lipoxygenase inhibitor

313
Q

serum sickness can be d/t

A

antitoxin tx (response to horse antibody), biologics

314
Q

serum sickness is a type ____ HS

A

III

315
Q

what type of shock should be assumed in a pt who has had an MVA and is hypotensive?

A

Hypovolemic/hemorrhagic

316
Q

Schistosomiasis presents as…

A

swimmer’s itch

317
Q

phenytoin use in pregnancy presents as what in the baby

A

fetal hydantoin > skull, face abnormalities, hypoplasia of fingernails and toenails

318
Q

Tx of Guillian Barre

A

plasmapheresis

319
Q

which drugs have been shown to improve long-term survival in pt w/ systolic HF

A

ACEI, BB, ARB, aldosterone antagonists

320
Q

heparin reversal agent

A

protamine sulfate

321
Q

brachial plexus runs b/w

A

anterior and middle scalene mm

322
Q

when do you administer RhoGam?

A

28w, immediately following invasive procedures like amniocentesis, elective abortion or spontaneous miscarriage, ectopic pregnancy, w/i 74h after delivery of Rh+ fetus, as soon as any kind of vaginal bleeding is present

323
Q

what artery supplies Brocas and Wernickes area?

A

MCA most often in left hemisphere (dominant)

324
Q

Moro reflex

A

startle reflex

325
Q

histology of AIDS dementia

A

multinucleated giant cells

326
Q

onchocerca volvulus

A

river blindness; transmitted by black fly; ivermectin

327
Q

trypanosoma

A

African sleeping sickness; tsetse fly

328
Q

pericardial tamponade

A

Beck’s triad: hypotension, JVD, distant or muffled heart sounds

329
Q

Job syndrome

A

hyper IgE; mutation in STAT3 on ch 17

330
Q

osteoporotic fractures

A

compression fractures most common > show anterior wedging of vertebrae

331
Q

patients with severe, symptomatic aortic stenosis should be treated w/…

A

valve replacement

332
Q

nitrates MOA

A

activate guanylate cyclase > increase cGMP > relax smooth muscle > decrease preload, decrease venous return > reduced cardiac work and O2 demand

333
Q

VHL

A

hematuria, polycythemia, palpable flank masses, hemangioblastomas, angiomatosis, bilateral RCCs, pheochromocytomas; AD mutation from deletion of VHL gene on chromosome 3

334
Q

MS

A

young female, neurological sx separated by time and space; increased oligoclonal bands in CSF

335
Q

RTA type 1

A

defect in distal tubule resulting in acidosis (hypercalciuria, autoimmune disease, hereditary defects in kids), increased risk of calcium phosphate stones

336
Q

RTA type 2

A

defect in PCT resulting in impaired bicarb reabsorption (acetazolamide, Fanconi, and MM causes it, non-AG met acid, hypophosphatemia)

337
Q

RTA type 4

A

problem w/ aldosterone (hyperkalemic)

338
Q

ARDS

A

severe hypoxemia and bilateral pulmonary infiltrates in absence of evidence of cardiogenic pulmonary edema; acute inflammatory damage at alveolar-capillary interface; progresses to interstitial fibrosis

339
Q

SIRS criteria (2 of the 4)

A

temp >100.4 or <96.8
HR >90
RR >20 or PaCO2 <32
WBC >12,000 or <4000 or band forms

340
Q

exudative phase of lung injury

A

macrophages release cytokines > attract neutrophils to cause capillary damage > leakage of exudate > hyaline membranes

341
Q

proliferative phase of lung injury

A

type II pneumocytes and fibroblasts proliferate

342
Q

fibrotic phase of lung injury

A

collagen produced and deposited

343
Q

tophi

A

chalky uric acid crystal deposits under the skin

344
Q

joint aspiration for gout/pseudogout

A

gout = negative birefringence; pseudo = positive (“p’s”)

345
Q

RNA polymerase function is limited to…

A

the nucleolus

346
Q

pathogenesis of decompensated HF

A

increased SNS, RAAS activation, ADH secretion all to maintain BP

347
Q

mechanisms of antianginal therapy

A

increase coronary vasodilation (CCBs, nitrates)
decrease HR (BB, nondihydropyridines)
venodilation (reduce preload > nitrates)
arterial dilation (reduce afterload > dihydropyridines)

348
Q

leads I, avL

A

lateral limb leads > left circumflex MI

349
Q

leads II, III, avF

A

inferior limb leads > right coronary MI

350
Q

leads V1-4

A

anterior chest leads > LAD (proximal = V1,2)

351
Q

morphine MOA

A

potassium efflux at postsynaptic membrane, reduced calcium influx at presynaptic membrane

352
Q

a monoclonal antibody binds to…

A

a single epitope on an antigen

353
Q

infective endocarditis

A

mitral regurg, petechiae, splinter hemorrhages, Roth spots, janeway lesions (embolization of valvular vegetations on palms/soles), Osler nodes (immune complex deposition in pulp of fingers/toes)

354
Q

best agents for chemo-induced emesis

A 
DA antagonists (prochlorperazine, metoclopramide)
5-HT3 antagonists (ondansetron, granisetron)
NK1 antagonists (aprepitant, fosaprepitant)
355
Q

acetazolamide MOA

A

block reabsorption of NaHCO3 in PCT > excrete HCO3 > alkalinizes urine
increased K excretion d/t distal Na reabsorption

356
Q

vasospastic/prinzmetal angina patho

A

hyperreactivity of coronary smooth muscle d/t endothelial dysfunction and autonomic imbalance

357
Q

vitamin E def

A

NM disease and hemolytic anemia

358
Q

primary infection with HSV…

A

herpetic gingivostomatitis

359
Q

when can serum beta-hCG first be detected?

A

8 days after fertilization; 14 days for urine pregnancy tests

360
Q

what important energy carrying coenzyme contains riboflavin?

A

FAD

361
Q

Buerger disease

A

small and medium vasculitis
SMOKING
middle-aged men

362
Q

what vitamin synthesizes NAD? what amino acid provides an alternate path?

A

niacin; tryptophan

363
Q

thyroid antibody diseases

A 
thyrotropin receptor antibody > Graves
thyroid peroxidase (TPO) antibody (anti-mirosomal) > Hashimoto, other thyroiditis
364
Q

where does the pupillary reflex occur?

A

midbrain

365
Q

NMS

A

fever, altered mental status, muscle rigidity, autonomic instability

366
Q

PDA

A

from pulm artery to aorta

367
Q

fenoldapam is useful in…

A

hypertensive emergency

368
Q

pneumatosis intestinalis

A

air in bowel well > curvilinear areas of lucency on XR; w/ abd distension and bloody stools > necrotizing enterocolitis

369
Q

pulmonary edema histology

A

engorged capillaries and alveoli filled with acellular pink material

370
Q

congenital long QT syndrome

A

syncope, family hx, decreased outward K flow with prolonged AP > at risk of vtach and sudden death

371
Q

CK-MB levels after MI

A

rise 6-12 h after and peak at 20h > useful in dx reinfarction (return to NML in 48h whereas troponins will remain elevated for 7d)

372
Q

antidote for acetaminophen

A

N-acetylcysteine

373
Q

antidote for iron

A

deferoxamine

374
Q

antidote for digoxin

A

digifab and electrolyte management

375
Q

antidote for theophylline

A

BB

376
Q

antidote for methanol and ethylene glycol

A

ethanol or fomepizole

377
Q

antidote for benzos and Z drugs

A

flumazenil

378
Q

antidote for opioids

A

naloxone

379
Q

antidote for organophosphates, neostigmine, physostigmine

A

pralidoxime and atropine

380
Q

antidote for anti-muscarinics

A

physostigmine

381
Q

antidote for warfarin and rat poison

A

vit K, FFP

382
Q

ethylene glycol toxicity

A

N/V, AG met acid, coma, seizures, CV depression

383
Q

AAT deficiency

A

panacinar emphysema, younger pt with sx of COPD w/o hx of smoking and signs of liver cirrhosis

384
Q

theca lutein cell hormone production

A

cholesterol > pregnenolone > progesterone via 3-beta-HSD OR > androstenedione via 17-alpha-OH

385
Q

granulosa lutein cell hormone production

A

androstenedione from theca cells > estradiol via aromatase

386
Q

tx of prolactinoma

A

D2 agonists (cabergoline and bromocriptine)

387
Q

cluster HA tx

A

oxygen, sumatriptan, removal of offending agent (alcohol common trigger)

388
Q

De Quervain tenosynovitis

A

All Peanut Lovers Eat Peanut Butter > Abductor Pollicis Longus, Extensor Pollicis Brevis; Finkelstein maneuver dx (pain w/ ulnar deviation of wrist with thumb inside fist)

389
Q

subfalcine herniation

A

medial frontal lobe (cingulate gyrus) herniates across midline > mental status changes and reappearance of primitive reflexes

390
Q

threatened abortion

A

bleeding and closed cervix in setting of viable pregnancy

391
Q

inevitable abortion

A

bleeding and pain w/ dilated cervix

392
Q

incomplete abortion

A

bleeding and pain w/ closed or dilated cervix and partial expulsion of pregnancy tissue

393
Q

missed abortion

A

nonviable fetus, intact on US, closed cervix and no hx of passage of tissue

394
Q

complete abortion

A

contents completely expelled and cervix closed

395
Q

MS MRI

A

multiple ovoid, periventricular white matter lesions

396
Q

anthrax tx

A

cipro (or doxy in kids/allergies to fluoroquinolones) + vaccine

397
Q

ITP

A

recent viral infection, IgG antibodies against GpIIb/IIIa platelet membrane glycoprotein, signaling platelet destruction by spleen > increased platelet production in bone marrow (increased megakaryocytes)

398
Q

somatostatinoma

A

DM, cholelithiasis, steatorrhea

399
Q

LAD1

A

def in CD18; delayed umbilical cord separation, recurrent infxn w/o pus

400
Q

infraspinatus action

A

external rotation

401
Q

subscapularis action

A

internal rotation

402
Q

H2 blockers

A

table for 2: take H2 blockers before you DINE > “-dine”

403
Q

BB overdose

A

bradycardia, hypotension, hypoglycemia, fatigue

404
Q

CCB overdose

A

bradycardia, hypotension, tachycardia w/ dihydro, hyperglycemia, dizziness

405
Q

pathognomonic sign of familial dysbetalipoproteinemia

A

xanthomas (accumulations of cholesterol-laden macrophages)

406
Q

21-hydroxylase deficiency

A

inability to produce glucocorticoids and mineralocorticoids > hypotension d/t salt-wasting > activation of RAAS

407
Q

finasteride

A

5-alpha reductase inhibitor (prevents formation of DHT from T > DHT causes hyperplasia of prostate)

408
Q

seronegative spondylarthropathies

A

AS, Reiter’s, psoriatic arthritis

409
Q

clomiphene

A

selective estrogen receptor modulator that inhibits feedback on gonadotropins to treat anovulation in PCOS

410
Q

what drugs improve survival in CAD?

A

SABA > Statin, ACEI, BB, ASA

411
Q

dextromethorphan

A

cough suppressant w/o significant opioid receptor agonism; risk of serotonin syndrome, NMDA receptor inhibition

412
Q

anaphylaxis results in _____ and ____ release

A

histamine and tryptase

413
Q

acute cervicitis

A

purulent cervical discharge and friable cervix that bleeds easily w/ contact > risk for PID, ectopic pregnancy, infertility

414
Q

CF

A

thick, viscous clogging secretions in MANY organs > pancreatic insufficiency, chronic sinusitis, nasal polyps, chronic bronchitis, steatorrhea, meconium ileus at birth, a/w DM

415
Q

DiGeorge is failure of neural crest to migrate into

A

3rd and 4th pharyngeal pouches

416
Q

thyroid peroxidase

A

iodine organification and coupling of iodotyrosines > methimazole and PTU inhibit

417
Q

sterile platelet-rich thrombi on mitral valve leaflets

A

nonbacterial thrombotic endocarditis most commonly a/w advanced malignancy and SLE (Libman-Sacks)

418
Q

TOF O2 sats

A

Acyanotic: LA 98, LV 98, RV 85, RA 75

Cyanotic Tet episode: LA 98, LV 80, RV 75, RA 75

419
Q

duodenal atresia

A

failure of recanalization > double bubble sign > Down

420
Q

jejunal/ileal atresia

A

vascular injury > bilious emesis w/ abd distension > gastroschisis

421
Q

colonic atresia

A

constipation and abd distension > Hirschsprung

422
Q

peripheral chemoreceptors ______ and _______ ________ are sites for sensing PaO2 (stimulated by hypoxemia)

A

carotid and aortic bodies

423
Q

transient global amnesia

A

sudden-onset confusion, memory loss, and anterograde amnesia resolving w/i 24 hours > hippocampus

424
Q

purpose of carotid sinus massage in paroxysmal supraventricular tachy

A

stretches baroreceptors and mimics increased pressure > increases afferent activity in carotid sinus nerves > increased PNS, decreased SNS > decreased conduction in AV node

425
Q

zero-order elimination kinetics

A

rate of elimination is constant regardless of plasma concentration of a drug; phenytoin, ethanol, salicylates, fluoxetine, omeprazole, cisplatin

426
Q

myelofibrosis histo will commonly show _________ cells

A

tear drop

427
Q

Tx of nephrogenic DI w/ lithium use

A

Amiloride > blocks epithelial Na channels (ENaC)

428
Q

in skeletal muscle, Ca binds to….

A

troponin > conformational change in troponin

429
Q

spina bifida

A

failure of caudal neuropore to close

430
Q

maternal hyperglycemia induces _______ in the fetus

A

hyperinsulinemia

431
Q

SCD mutation

A

point mutation replacing glutamic acid w/ valine

432
Q

Kluver-Bucy

A

bilateral amygdala damage > visual agnosia (inability to recognize familiar people or objects), hyperorality/hyperphagia, hypersexuality, docility > HSV encephalitis (temporal lobe damage)

433
Q

functional residual capacity

A

amount of air in lungs at end of NML exhalation

434
Q

residual volume

A

amount of air in lungs at end of forced exhalation

435
Q

DOC for UTI during pregnancy

A

amoxicillin

436
Q

adjuvant therapy in Alzheimer’s

A

memantine > NMDA receptor antagonist

437
Q

speed of conduction down an axon depends on 2 constants

A

length and time; myelination increases length and decreases time

438
Q

labetalol

A

nonselective vasodilatory BB > B1 > A1 > B2

get decreased SVR and decreased HR w/o affecting SV

439
Q

BPH can cause….. in the kidney

A

parenchymal atrophy and scarring d/t bladder obstruction > hydronephrosis

440
Q

during catherization of L atria, what structure is passed through?

A

interatrial septum > fossa ovalis covered by thin membrane that is easily pierced to allow entry of catheter from RA directly to LA

441
Q

anterior humerus dislocation

A

flattening of deltoid prominence, protrusion of acromion, anterior axillary fullness; axillary n most commonly injured by anterior shoulder dislocations

442
Q

medulloblastoma

A

sheets of primitive cells and many mitotic figures; kids

443
Q

selective cox-2 inhibitor

A

celecoxib

444
Q

acute management of Tet spell

A

oxygen, fluids, phenylephrine, propranolol, sodium bicarb, emergency shunt

445
Q

small bowel obstruction

A

air-fluid levels on XR; smooth muscle contraction against resistance; high pitched bowel sounds

446
Q

thiazides for kidney stones

A

decrease Ca excretion by inhibiting NaCl in DCT

447
Q

disulfiram-like reactions

A

cefoperazone, cefamandole, metronidazole, procarbazine, first generation sulfonylureas

448
Q

DOC for SVT

A

adenosine

449
Q

tx of latent TB (+ TB test, +IGRA, - CXR)

A

isoniazid

450
Q

complex regional pain syndrome type 1

A
  1. pain out of proportion to event
  2. at least 1 sx present from 3+ of the categories
    Sensory: hyperesthesia and/or allodynia
    Vasomotor: temp asymmetry, skin color asymmetry, and/or skin changes
    Sudomotor/edema: edema, sweating changes and/or sweating asymmetry
    Motor/trophic: decreased ROM, motor dysfunction and/or trophic changes (hair, nail, skin)
  3. dx of exclusion, no evidence of nerve damage (type 2 = evidence)
451
Q

Beckwith-Wiedemann

A

Wilms tumor in a/w organomegaly, macroglossia, neonatal hypoglycemia

452
Q

conus medullaris syndrome

A

think cauda equina but with UMN signs

453
Q

anterior hypothalamic nucleus

A

stimulation: panting, sweating
lesion: difficulty lowering body temp

454
Q

dorsomedial hypothalamic nucleus

A

stimulation: sham rage
lesion: decreased aggression and feeding

455
Q

lateral hypothalamic nucleus

A

stimulation: increased feeding

456
Q

supraoptic hypothalamic nucleus

A

stimulation: increased blood volume, BP, metabolism
lesion: DI

457
Q

ventromedial hypothalamic nucleus

A

stimulation: decreased feeding

458
Q

DOC for onychomycosis

A

terbinafine

459
Q

DOC for RLS

A

dopamine agonists (pramipexole, ropinirole)

460
Q

DOC for carcinoid syndrome

A

octreotide (mimics SST and inhibits release of vasoactive substances from tumor cells)

461
Q

Tx of hookworm infxn

A

albendazole

462
Q

PGD analogs side effects in glaucoma

A

darkening of iris, lengthen and darken eyelashes, ocular irritation

463
Q

hereditary spherocytosis

A

normocytic anemia, increased LDH, increased bilirubin (hemolytic anemia), splenomegaly, spherocytes, mutations in ankyrin and spectrin (cytoskeleton abnormalities)

464
Q

what med can precipitate opioid withdrawal?

A

buprenorphine

465
Q

tx of acute adrenal insufficiency

A

hydrocortisone or dexamethasone

466
Q

meconium ileus association

A

CF

467
Q

anterior pituitary (Rathke pouch) derivative of

A

surface ectoderm

468
Q

mechanisms of inheritance of Down

A

mostly meiotic nondisjunction

can have unbalanced translocation (Robertsonian) and mosaicism

469
Q

dsDNA replication of HepB

A

dsDNA > +RNA > partially dsDNA progeny

470
Q

rare but life-threatening complication of some drugs (phenytoin, carbamazepine, allopurinol, sulfonamides, vanco, minocycline)

A

DRESS > drug-induced herpesvirus reactivation > clonal expansion of T cells that cross-react w/ the drug

fever, LAD, facial edema, diffuse skin rash, etc. > eosinophilia, elevated ALTs

471
Q

Ehler-Danlos is a defect in…

A

collagen synthesis

472
Q

clear cell RCC

A

originates from epi of PCT; lipid-filled mass w/ areas of necrosis and hemorrhage

473
Q

pityariasis rosea

A

Herald patch (oval, raised plaque or patch with peripheral scales) then Christmas tree pattern eruption

474
Q

tx of hypoglossal n in poor suckling infant

A

condylar decompression

475
Q

intraperitoneal structures

A

stomach, jejunum, ileum, cecum, appendix, transverse and sigmoid colon, liver, spleen, gallbladder

476
Q

chronic kidney disease findings

A 
edema
hyperkalemia
met acid
hyperphosphatemia
hypocalcemia
renal osteodystrophy
HTN
pulm edema
CHF
uremia
peripheral neuropathy
pruritus
477
Q

tx for progression of MS

A

beta-interferon

478
Q

statins can cause….

A

rhabdomyolysis

479
Q

vitamin B12 def

A

spasticity w/ gastrectomy > loss of parietal cells that secrete IF

480
Q

tx of primary hyperaldosteronism (Conn)

A

spironolactone > inhibits androgen receptor > gynecomastia and decreased libido in males; menstrual irregularities in females

481
Q

hemiballism

A

unilateral flailing of a limb > disruption to contralateral subthalamic nucleus MC d/t lacunar infarct

482
Q

smooth ER makes

A

lipids, phospholipids, chol derivatives (steroid hormones = sex steroids, cortisol, aldosterone)

483
Q

type B dissection

A

originates near left subclavian a. (involves descending aorta)

484
Q

prostate gland is located…

A

anterior to anal canal and posterior to bladder

485
Q

bacteria can produce…

A

vit K and folate

486
Q

cricothyrotomy goes through…

A

superficial cervical fascia and cricothyroid membrane

487
Q

XP is a def in

A

endonuclease (involved in excision repair)

488
Q

status epilepticus tx

A

IV benzo

489
Q

tx for ascites

A

spironolactone (aldosterone antagonist)

490
Q

empyema

A

purulent fluid > bac translocation from alveoli into pleural space

491
Q

field defect

A

initial embryonic disturbance > multiple malformations by disrupting adjacent tissues (holoprosencephaly leads to multiple midline defects)

492
Q

struma ovarii

A

ovarian germ cell tumor in setting of thyrotoxicosis

493
Q

Thiamine cofactor for…

A

PDH, alpha-ketoglutarate dehydrogenase, BCAA, transketolase

494
Q

21 OH converts…

A

progesterone to 11-deoxycorticosterone

495
Q

TB is associated with CD_ T cells

A

4

496
Q

TCA overdose

A

inhibits NE and serotonin, inhibits GABA, inhibits H1, inhibits alpha-1, inhibits muscarinic receptors, blocks Na channels > coma, seizures, cardiac conduction abnormalities (wide QRS, prolonged PR or QT intervals, bundle branch blocks), anticholinergic toxicity

497
Q

TCA overdose tx of cardiac abnormalities

A

sodium bicarb

498
Q

bubonic plague

A

fever, cough, dyspnea, hemoptysis, LAD (buboes), DIC, necrosis of fingertips and tip of nose; Yersinia pestis

499
Q

Behcet

A

recurrent oral aphthous ulcers, genital ulcers, uveitis, joint involvement, panniculitis (erythema nodosum); Middle Eastern; HLAB51; autoimmune vasculitis

500
Q

Colles fracture

A

distal radius; dinner fork appearance

501
Q

Huntington affects…

A

caudate nucleus

502
Q

Meissner corpuscles

A

transient tactile stimuli

503
Q

Ruffini corpuscles

A

skin stretch (changes in finger position, movement allowing alterations in grip, deformations w/i joint capsule)

504
Q

perivascular pseudorosettes

A

ependymoma

505
Q

meds that lower tone of LES

A

anticholinergics, alpha-blockers, B-agonists, CCBs

506
Q

17-alpha-hydroxylase deficiency

A

low sex hormones and cortisol production; increased ACTH; HTN, hypokalemia > volume expansion > inhibits renin and synthesis of aldosterone; estrogens low, FSH, LH high secondary to deficient sex production

507
Q

metformin SE

A

lactic acidosis, decreased folate and B12 absorption > megaloblastic anemia, neurological sx

508
Q

Dupuytren contracture

A

inability to extend 4th and 5th digits

509
Q

dorsal interossei fxn

A

abducting fingers

510
Q

bosentan MOA

A

competitively antagonizes endothelin-1 receptors

511
Q

seborrheic dermatitis

A

greasy-looking, yellow scales on a red base; cradle cap

512
Q

Whipple disease is caused by…

A

a bacteria

513
Q

tetanus

A

intracellular Ca accumulates > extends cross-bridge cycling and disables muscle relaxation

514
Q

attachments of dura for craniosacral motion

A

axis, C3, foramen magnum, S2

515
Q

5-alpha reductase def

A

males born with ambiguous genitalia but when puberty happens T increases greatly which can compensate for lack of DHT

516
Q

osteoarthritis findings

A

osteophytes (heberden and bouchard nodes in fingers), subchondral sclerosis, joint space narrowing

517
Q

Menetrier disease

A

diarrhea, weight loss, edema, rugae increased in size (cerebral), corkscrew shaped glands w/ mucous cells and less parietal and chief cells

518
Q

schistosomiasis causes…

A

SCC of the bladder

519
Q

tricuspid regurgitation

A

increases during inspiration > more blood into heart

520
Q

Marburg

A

think Ebola with evidence of spread from bats

521
Q

Bruton’s aggamaglobulinemia

A

defect in BTK gene responsible for development of B cells and antibody function; increased bacterial infxn w/o increase in fungal or viral

522
Q

constrictive pericarditis

A

can present w/ TB infxn; fibrotic calcifications around thickened pericardium

523
Q

mandibular branch of V passes through

A

foramen ovale

524
Q

eversion ankle injuries injure the _____ ligament

A

deltoid

525
Q

ketorolac

A

NSAID

526
Q

CGD has a ______ NBT test

A

negative; detects ROS produced by NADPH oxidase > defect in NADPH oxidase = no ROS = negative test

527
Q

urge incontinence

A

involuntary and uninhibited detrusor contractions

528
Q

brown pigmented gallstones caused by release of…

A

beta-glucoronidases

529
Q

myxoma

A

constitutional sx (d/t IL-6 prod), diastolic murmur that changes in frequency as pt shifts positions, syncope, at risk for embolic stroke

530
Q

median n can become compressed b/w

A

pronator teres

531
Q

polyarteritis nodosa a/w

A

hep B

532
Q

hematopoiesis in fetus

A

yolk sac until about 3m, then liver and spleen midway, bone marrow is present at the highest levels starting around month 7

533
Q

what case ruled that the physician is mandated to inform someone who is in danger

A

Tarasoff v. Regents of University of California

534
Q

infective endocarditis

A

petechiae, subungual hemorrhages, osler nodes (SC nodules on distal pads of digits), Janeway lesions (nontender maculae on palms and soles), Roth spots (retinal hemorrhages w/ small, clear centers)

535
Q

double effect

A

action that has both negative and positive consequences can be ethically justified if the intention is to achieve the positive effect (i.e. providing morphine to a terminally ill patient even though it can kill them because you’re providing symptom control)

536
Q

Meniere disease

A

vertigo, sensorineural hearing loss, tinnitus; excess endolymph in inner ear

537
Q

BRCA genes have impaired DNA repair mechanism in…

A

homologous recombination

538
Q

lateral geniculate of thalamus

A

visual

539
Q

medial geniculate of thalamus

A

auditory

540
Q

ventral lateral of thalamus

A

basal nuclei and cerebellum related to control and coordination of movement

541
Q

VPL of thalamus

A

somatosensory for body

542
Q

VPM of thalamus

A

somatosensory for face

543
Q

MM

A

anemia, elevated protein (diff b/w protein and albumin is >4.5 = large amount of Igs), ltyic lesions, hypercalcemia, renal impairments, constitutional sx

544
Q

PCOS will have a LH:FSH ratio of…

A

> 2

545
Q

Gardner

A

GI polyps, desmoid tumors, osteomas, epidermoid cysts, lipomas, dental abnormalities, congenital hypertrophy of retinal pigment epi

546
Q

syphilitic aneurysm

A

obliterative endarteritis of vasa vasorum of media; aortic dilation and aortic valve insufficiency

547
Q

danazol

A

synthetic androgenic steroid that acts by inhibiting pituitary gonadotropin secretion and blocking ovarian enzymes that produce estrogen (suppresses FSH and LH release)

548
Q

when do you see dyskinesia in a Parkinson’s pt?

A

when they’re “on” and able to move d/t medication rather than when they’re “off” and bradykinetic

549
Q

3 Ps of MEN1

A

pituitary adenoma, parathyroid adenoma, pancreatic endocrine tumor (gastrinoma, VIPoma etc)

550
Q

2 Ps, 1 M of MEN2A

A

Pheochromocytoma
parathyroid adenoma
Medullary thyroid cancer

551
Q

1 P, 3Ms of MEN2B

A

pheochromocytoma
medullary thyroid cancer
mucosal neuromas
marfanoid habitus

552
Q

mannitol

A

osmotic diuretic - acts to draw water out where water is permeable (PCT, thin descending limb, CD)

553
Q

first sign of magnesium toxicity

A

decreased DTRs

554
Q

what case determined pt have the right to refuse life-sustaining tx?

A

cruzan v. director

555
Q

when treating post-op ileus and similar conditions, what order should tx be done in?

A

sympathetics, parasympathetics, visceral (i.e. paraspinal inhibition > sacral rocking > mesenteric lift)

556
Q

waxy casts seen in…

A

advanced renal failure

557
Q

hyaline casts are seen in…

A

NML states or dehydration

558
Q

C. jejuni infxn causing ascending paralysis would cause CSF to have…

A

elevated protein w/ NML WBCs

559
Q

triple therapy for H pylori

A

PPI, clarithromycin, amoxicillin or metronidazole

560
Q

bismuth quadruple therapy for H pylori

A

bismuth, H2 blocker, metronidazole, tetracycline

561
Q

MC adverse effect of ECT

A

HA

562
Q

first line for stable angina

A

nitrate and BB (second line CCB)

563
Q

MC location of endometriosis

A

ovaries > chocolate cysts

564
Q

somatostatinoma

A

SST from delta cells in pancreas; inhibits insulin, glucagon, gastrin, GH > DM, cholelithiasis, steatorrhea, hypochlorhydria

565
Q

Hawthorne effect

A

results altered by the fact that the subjects are aware they’re being studied

566
Q

Pygmalion effect

A

the fact that when research participants know the expected outcome, they tend to modify their behaviors to favor the outcome

567
Q

MCC of bacterial parotitis

A

staph aureus (don’t get confused with presentation thinking strep mutans)

568
Q

iron intoxication

A

hematemesis, N/V, met acid; tx w/ deferoxamine

569
Q

arsenic poisoning

A

acute: GI, garlic breath, rice water stools
chronic: skin changes in a raindrop pattern, pallor, loss of hair

Think of a vampire = garlic, skin changes, pallor, etc.
Tx: a vampire sucks (succimer) blood out of a damsel (dimercaprol) with a pencil (penicillamine)

570
Q

lead poisoning

A

acute: GI, tremor
chronic: anemia, wrist drop, nephropathy, hepatitis

Tx: dimercaprol, succimer

571
Q

mercury poisoning

A

acute: hemorrhagic gastroenteritis, shock
chronic: ataxia, hearing and vision loss, paresthesias

Tx: dimercaprol, succimer

572
Q

Menkes syndrome

A

disorder of copper uptake in GI tract > copper def

fine, silver hair, depigmentation, muscle weakness, neurological abnormalities, HSM

573
Q

selenium def

A

CM, MSK abnormalities, immune function impairment, mood disorders, male infertility

574
Q

zinc def

A

acrodermatitis enteropathica (perioral dermatitis, alopecia, diarrhea), mood changes, recurrent infxn

575
Q

pyridoxine def

A

angular cheilitis, seborrheic dermatitis, glossitis and stomatitis, confusion, depression

576
Q

biotin def

A

perioral dermatitis, conjunctivitis, mental status changes

577
Q

tx of gastroparesis

A

metoclopramide

578
Q

MOA of spironolactone and eplerenone

A

inhibits aldosterone in CD

579
Q

MOA of triamterene and amiloride

A

inhibits ENaC in distal tubule to CD

580
Q

Angelman

A

methylation of paternal chromosome 15 and gene deletion on maternal chromosome 15

581
Q

tx of Huntingtons

A

tetrabenazine first line for chorea; second gen antipsychotic for schizophrenic sx and chorea

582
Q

angiotensin II acts at…

A

efferent arteriole > Angiotensin II Constricts Efferent (ACE) > ACE inhibitors work to decrease GFR, increase RPF and decrease FF

583
Q

FAs a/w CPT def

A

LCFA (13-21)

584
Q

substrates of CYP450

A

theophylline, OCPs, anti-epileptic, warfarin (the OCPs are anti-war)

585
Q

CYP450 inducers

A

CRAP GPS induces my rage (Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin, Phenobarbital, St. John’s Wort)

586
Q

CYP450 inhibitors

A

azoles, valproate, INH, chloramphenicol, macrolides, sulfonamides, cipro, omeprazole, metro, amiodarone, ritonavir, grapefruit juice, cimetidine

587
Q

gestational DM increases risk of…

A

NRDS, shoulder dystocia (macrosomia > others related to this = postpartum hemorrhage, laceration, increased risk of C-section, birth trauma, polycythemia, meconium aspiration, etc.)

588
Q

what contraception has the highest rate of efficacy?

A

copper IUD

589
Q

what can be used for emergency contraception?

A

levonorgestrel (plan B), combined OCPs w/i 72h

copper IUD and ulipristal (antiprogestin) pill w/i 120h

590
Q

ASA toxicity

A

tinnitus, severe abd pain, mixed acid-base of AG met acid and resp alkalosis (NML pH), hyperthermia

591
Q

initial diagnostic test for postmenopausal bleeding woman

A

endometrial biopsy

592
Q

Kallmann syndrome

A

hypogonadotropic hypogonadism > defective migration of neurons and failure of olfactory bulbs to develop > decreased synthesis of GnRH, anosmia, infertility; MRI done to r/o other pituitary etiologies

593
Q

Klinefelter

A

male, 47 XXY

testes atrophy, tall stature, gynecomastia, female hair distribution, developmental delay

dysgenesis of semi tubules > low inhibin B > elevated FSH

ABNML Leydig cell fxn > low T > elevated LH > elevated estrogen (increased risk of breast cancer)

inactivated X chromosome (Barr body)

594
Q

Turner

A

female 45, XO;
short, ovarian dysgenesis, shield chest, bicuspid aortic valve, coarctation, lymphatic defects, horseshoe kidney

MCC primary amenorrhea

no Barr body like in Klinefelter

595
Q

RFs for preeclampsia

A

nulliparity, age > 40y, chronic preexisting HTN or renal disease, pregestational or gestational DM, obesity, antiphospholipid syndrome, twins

596
Q

branches from the ____ supply the subthalamic nucleus leading to hemiballismus

A

PCA

597
Q

heart disease is the leading cause of death in those

A

> 65

598
Q

leading cause of death in those 45-64

A

malignancy

599
Q

RFs for RCC

A

smoking, asbestos, acetaminophen, chronic hep C, PCKD, VHL

600
Q

paradoxical splitting is heard in…

A

LBBB, AS where AV closure is delayed and instead pulmonic valve closes first

601
Q

lowering the cutoff value for a test…

A

increased FP and decreased FN
increased sensitivity and NPV
decreased specificity and PPV

602
Q

raising the cutoff value for a test

A

increased FN and decreased FP
increased specificity and PPV
decreased sensitivity and NPV

Board Review (9 decks)

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