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Combank Q facts > Combank Assessment #2 P1 > Flashcards

Combank Assessment #2 P1 Flashcards

1
Q

What is a confounding variable?

A

an extraneous variable that correlates positively or negatively with both the dependent and independent variables

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2
Q

What is Berkson bias?

A

A type of selection bias that is created by selecting hospitalized patients as a control group; this type of bias occurs when the control group does not represent the population being studied

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3
Q

What is the most common form of congenital hydroxylase deficiency?

A

21-hydroxylase deficiency

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4
Q

How does 21-hydroxylase deficiency affect the secretory products of the adrenal gland?

A

decreased glucocorticoids and minteralcorticoids; increased sex hormones

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5
Q

The reduction of minteralcorticoids caused by 21-hydroxylase deficiency causes the activation of what system?

A

renin-angiotensin system is activated due to hypotension from salt wasting; thus, angiotensin II levels are elevated

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6
Q

Name the murmur: crescendo-decrescendo, systolic ejection murmur, heard best at left upper sternal border 2nd intercostal space; increases in intensity with inspiration

A

pulmonic stenosis

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7
Q

Name the murmur: high-pitched holosystolic murmur, blowing quality, best heard over apex, radiates to axilla

A

mitral valve regurgitation

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8
Q

Hypertrophic obstructive cardiopmyopathy results in what type of murmur?

A

a systolic ejection murmur that has a crescendo-decrescendo quality; best heard along left sternal border

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9
Q

how does the systolic ejection murmur caused by hypertrophic obstructive cardiomyopathy change with preload and afterload?

A

murmur diminishes with increased preload (squatting or lay supine); murmur diminishes with increased afterload (hand grip)

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10
Q

How does preload affect the murmur caused by aortic stenosis?

A

murmur increases with increased preload (squatting); decreases with decreased preload (vaslsalva, handgrip)

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11
Q

What is a common cause of aortic stenosis in patients in the 6th decade of life?

A

congenital biscupid valve

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12
Q

right sided heart murmurs increase with?

A

inspiration

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13
Q

left sided heart murmurs increase with?

A

expiration

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14
Q

What is the MOA of sildenafil?

A

inhibit phosphodiesterase 5, causing increased cGMP, smooth muscle relaxation in the corpus cavernosum, increased blood flow and thus increased penile erection

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15
Q

Sildenafil also weakly inhibits PDE-6, what AE can this cause?

A

b/c it is required for the transformation of light into electrical signals inhibition of PDE-6 can cause cyanopsia or blue vision

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16
Q

What is the DOC for a UTI during pregnancy?

A

Amoxicillin

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17
Q

What class of anti-microbials does doxycycline belong in?

A

Tetracyclines

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18
Q

Why should fluoroquinolones and tetracyclines be avoided in pregnancy?

A

fluoroquinolones damage cartilage in growing fetus; tetracyclines damages growing bones

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19
Q

Osler-Weber-Rendu syndrome is also known as?

A

hereditary hemorrhagic telangiectasia

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20
Q

What is Osler-Weber-Rendu syndrome?

A

AD d/o; presents with recurrent, severe epitaxis, multiple telangiectasias, and AV malformations

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21
Q

What is Sturge Weber syndrome?

A

congenital d/o associated with port-wine stains, usually in V1 ophthalmic distribution and also ipsilateral arteriovenous malformations in the meninges

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22
Q

What characterizes neurofibromatosis type I d/o?

A

AD neurocutaneous d/o; presents with cafe-au-lait spots, lische nodules, neurofibromas, optic gliomas, and pheochromocytomas

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23
Q

What characterizes tuberous sclerosis?

A

AD d/o; may present with mental retardation and seizures in infancy, along with angiofibromas of the face, ash leaf lesions, hemartomatous lesions, and cardiac rhabdomyomas

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24
Q

In what way can squamous cell carcinoma cause hypercalcemia?

A

Squamous cell carcinomas of the lung can cause a paraneoplastic syndrome in which the tumor secretes PTH-related peptides; this increases calcium and decreases PTH secretion from the parathyroid glands via negative feedback

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25
Q

Hypertensive strokes tend to form what type of infarcts in the basal ganglia? what is the most commonly affected arterial supply?

A

lacunar infarcts; lenticulostriate branches of the middle cerebral artery

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26
Q

The ureters lie directly on what muscle as they course from the kidney on their way to the bladder?

A

psoas muscles

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27
Q

What is the major blood supply to the occipital lobe containing the primary visual cortex?

A

posterior cerebral artery

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28
Q

Occlusion of the PCA causes?

A

contralateral hemianopsia with macular sparing

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29
Q

Occlusions of what artery will cause contralateral hemianopsia without macular sparing as it results in ischemia to the optic radiations?

A

MCA

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30
Q

A LBBB can present with what type of splitting?

A

Paradoxically split S2 – on inspiration, P2 closes later and moves closer to A2, thereby paradoxically eliminating the split

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31
Q

Hyperglycemia is a common cause of what type of electrolyte imbalance? how does it occur?

A

hypertonic hyponatremia; since glucose is osmotically active, it acts as a concentrated solute in the extracellular compartment and draws water from the intracellular compartment, this causes a drop in sodium

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32
Q

Diuretics, esp. thiazide diuretics is one of the principle causes of what type of electrolyte imbalance? how does it occur?

A

hypovolemic hypotonic hyponatremia; thiazide diuretics inhibit Na+ reabsorption in the DCT by blocking a sodium-chloride symporter – this leads to an increased excretion of Na+ and water

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33
Q

T/F cases of CMV are not required to be reported to CDC on a national level

A

T

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34
Q

Diseases that are reportable to the CDC on a national level

A

AIDS, TB, meningococcal meningitis, hepatitis A-C, gonorrhea, tetanus, lyme disease, syphilis, rabies, measles, salmonella, mumps, shigella, rubella, polio

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35
Q

Signs of hypocalcemia

A

tingling in lips, abdominal pain, Trousseau sign (occlussion of brachial artery with BP cuff causes carpal spasm), Chvostek sign (tapping of facial nerve causes contraction of facial muscles)

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36
Q

Function of PTH

A

increase serum calcium and decrease serum phosphate levels

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37
Q

What is the presentation of pseudohypoparathyroidism?

A

body tissues do not respond to PTH; serum calcium stays low and serum phosphate is high; low serum calcium leads to an elevated PTH level

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38
Q

What is trigger finger aka flexor tenosynovitis?

A

inflammation of the flexor tendon sheath of the finger; tendon may catch or lock at the metacarpophalangeal joint, causing the finger to lock in flexion

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39
Q

What test is used to dx de Quervain’s syndrome?

A

Finkelstein’s test

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40
Q

What is De Quervain’s tenosynovitis?

A

a tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons that located at the styolid process of the radius

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41
Q

What are the symptoms of De Quervain’s tenosynovitis?

A

radial sided wrist and thumb pain, tenderness, and swelling, which may cause difficulty with grip

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42
Q

What causes herpetic whitlow and how does it present?

A

herpes simplex virus infection causing erythematous papules of the distal finger; it is a self-limiting condition

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43
Q

What is jersey finger?

A

rupture of the flexor digitorum profundus tendon at its point of attachment to the distal phalanx; injury often occurs in football when the tip of the finger is hyperextended at the distal interphalangeal joint

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44
Q

What is the cause of mallet finger?

A

results from a traumatic blow to the distal phalanx causing hyperflexion of the extensor digitorum tendon; patient is unable to actively exten the distal interphalangeal joint

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45
Q

What are first line agents for patients suffering from dysmenorrhea?

A

NSAIDs

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46
Q

What class of drugs is Losartan in? what is it used for?

A

angiotensin II receptor blocker; used to treat hypertension; blocks the vasoconstrictor and aldosterone secreting effects of angiotensin II

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47
Q

ARBs and ACE inhibitors have similar effects but what is one significant difference?

A

ARBs (“–sartans”) do not increase bradykinin so there is no resultant cough or angiodema

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48
Q

What is a common contraindication of losartan?

A

it is contraindicated in pregnancy because it may cause damage to the fetal kidney

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49
Q

What are the classic signs of carcinoid syndrome?

A

flushing, diarrhea, bronchospasm due to elevated 5-hydroxyindoleacetic acid (5-HIAA), serotonin and other vasoactive substances in systemic circulation

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50
Q

Carcinoid tumor does not necessarily lead to carcinoid syndrome, why?

A

If tumor is limited to the GI tract 5-HT undergoes first pass metabolism in the liver; if the tumor exists or metastasizes (usually to the liver) outside the GI system then carcinoid syndrome occurs

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51
Q

What is the most common tumor of the appendix?

A

carcinoid tumor

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52
Q

An increase in serum pH causes what change between calcium and albumin?

A

increases the binding of calcium to albumin

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53
Q

What protein produced in the liver is the body’s predominant serum-binding protein responsible for transporting various substances, such as bilirubin, fatty acids, metals, ions, hormones and exogenous drugs?

A

Albumin!

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54
Q

Calcium exists in two forms, protein bound and free ionized form; what form does Calcium predominantly exist in?

A

majority of circulating calcium is bound to albumin in its inactive form; thus total calcium fluctuates with albumin concentration

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55
Q

The physiologically active free ionized form of calcium is regulated by what?

A

PTH; this form is independent of albumin levels

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56
Q

Brain natriuretic peptide (BNP) is secreted fro the ventricles in response to?

A

stretch

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57
Q

BNP has similar effects as ANP in that they both are …

A

diuretics, natriuretics and anti-hypertensives

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58
Q

Constriction of what will decrease renal plasma flow and increase GFR?

A

efferent arteriole

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59
Q

What is the MOA of cilostazol and what is it used for?

A

phosphodiesterase III inhibitor – increases cAMP in platelets to inhibit platelet aggregation, results in vasodilation; used for angina prophylaxis, intermittent claudication and coronary vasodilation

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60
Q

Naproxen is in what category of drug?

A

NSAID

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61
Q

What is placenta accreta?

A

placenta adheres to the myometrium of the uterus

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62
Q

Failure to deliver the placenta within 30 minutes of birth should lead to suspect what condition?

A

placenta accreta

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63
Q

What is Asherman’s syndrome?

A

a condition characterized by adhesions and/or fibrosis of the endometrium most often associated with dilation and curettage of the intrauterine cavity.

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64
Q

What is placenta previa?

A

occurs when the placenta is low lying and covers part of or all of the cervical os

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65
Q

What is placenta increta?

A

placental tissue invasion all the way through the myometrium; more severe than placenta accreta

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66
Q

What is placenta percreta?

A

placenta tissue invasion through the entire uterine wall

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67
Q

What is placenta abruptio?

A

placenta detaches prematurely from the uterine wall

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68
Q

What is the causative agent for Kaposi sarcoma? what condition is it associated with? how does it present?

A

caused by HHV-8; it is an AIDs-associated infection; manifests as painless red-violet lesions caused by endothelial proliferation

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69
Q

What is the blood supply to the lateral medulla?

A

posterior inferior cerebellar artery

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70
Q

What is Wallenberg’s syndrome?

A

an infarction of the lateral medulla of the brainstem; acute onset of vertigo and disequilibrium; PE reveals nystagmus, ipsilateral Horner’s syndrome, ipsilateral limb ataxia, sensory loss of pain and temperature on the ipsilateral face and contralateral trunk; hoarseness and dysphagia often present

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71
Q

What is subclavian steal syndrome?

A

flow reversal in the vertebral artery ipsilateral to the occlusion; subclavian artery stenosis proximal to the origin of the vertebral artery results in lower pressure in the distal subclavian artery – as a result blood flows from the contralateral vertebral artery to the basilar artery and then flows in a retrograde direction down the ipsilateral vertebral artery and away from the brainstem

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72
Q

What is amaurosis fugax?

A

acute and painless onset of monocular visual loss in the background of atherosclerosis; results in episodes of transient monocular blindness due to retinal ischemia

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73
Q

visual loss that is described as a dark curtain falling down over the eyes and that progresses toward the center of vision is most likely?

A

Amaurosis fugax

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74
Q

Reinke’s crystals are found in what type of testicular non-germ cell tumor?

A

Leydig cell tumors

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75
Q

Where are leydig cells found and what do they produce?

A

in the interstitium of the testis adjacent to the seminiferous tubules in the testicle; they produce testosterone in the presence of LH

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76
Q

How does choriocarcinoma, a testicular germ cell tumor present?

A

associated with the development of gynecomastia due to the secretion of beta hCG, which has similar properties as LH; patients also present with precocious puberty, gynecomastia, impotence or loss of libido

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77
Q

What is diffuse large B-cell lymphoma and what age group is most commonly affected?

A

a non-hodgkin lymphoma; occurs in patients 70-80 y.o.; presents with systemic symptoms of fever, night sweats, weight loss, fatigue; typically present with rapidly enlarging mass in the neck

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78
Q

What are sertoli cell tumors? most commonly affects what population?

A

testicular non-germ cell tumor; derived from cells located within the seminiferous tubules; can occur in both children and middle aged adults

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79
Q

What is a yolk sac tumor? who does it commonly affect? how does it present?

A

testicular germ-cell tumor; most common testicular neoplasm in infants; usually present with a painless testicular mass

80
Q

What is histologically pathognomonic for yolk sac tumors?

A

Schiller-Duvall bodies — contain a central vessel that is surrounded by flattened tumor cells in a cystic space (resembles primitive glomeruli)

81
Q

What is pathognomonic for squamous cell carcinoma on biopsy results?

A

a keratin pearl

82
Q

What compound increases the risk of endometrial cancer, abnormal vaginal bleeding and enhances blood coagulation?

A

estrogen

83
Q

Patients with CF can develop insulin dependent diabetes due to?

A

chronic destruction of the pancreas

84
Q

What is silo filler’s disease?

A

a type of irritant lung disease caused by exposure to nitrogen dioxide; this gas exists in 2 forms at equilibrium (NO2 and N2O4 = nitric acid); exposure to the acid form causes direct alveolar damage; symptoms include wheezing, tachypnea, and tachycardia within 2 hours of exposure

85
Q

Silicosis is seen in what population of people? what does it cause in the lung?

A

seen in sandblasters and silica miners; d/o causes fibrotic nodules in the lung

86
Q

Berylliosis is seen in what population? what does this disease cause?

A

seen in aerospace workers due to exposure to beryllium; disease causes non-caseating granulomas in lung and hilar lymph nodes

87
Q

What is Farmer’s lung?

A

a type of hypersensitivity pneumonitis; it is due to exposure to thermophilic actinomyces in moldy hay

88
Q

Primary biliary cirrhosis is an autoimmune related condition classically seen in what population of patients?

A

40 year old women

89
Q

Primary sclerosing cholangitis is seen in what population of patients?

A

40-50 year old males

90
Q

What are the symptoms that are commonly seen in both primary biliary cirrhosis and primary sclerosing cholangitis

A

pruritis, jaundice, dark urine, light stools, hepatosplenomegaly

91
Q

Cellulitis on the hands of salt-water shellfish handlers should lead you to think of?

A

Vibrio vulnificus

92
Q

Name the organism: lives in warm, high salt waters, gram negative, motile, curved rod; can infect via puncture wound, eating contaminated shellfish or exposure through swimming or wading; cellulitis and bullae are aggressive and rapidly expanding

A

Vibrio vulnificus

93
Q

Name the organism: acid fast rod, can cause fish tank granuloma in patients who handle salt water fish; does not form cellulitis or bullae

A

Mycobacterium marinum

94
Q

Nephrotic syndrome presents with?

A

massive proteinuria (>3.5 g/day, frothy urine), hyperlipidemia, fatty casts, edema

95
Q

Nephritic syndrome is characterized by?

A

inflammatory process; glomeruli involvement leads to hematuria and RBC casts in urine; associated with azotemia, oliguria, hypertension and proteinuria (<3.5 g/day)

96
Q

How does acute poststreptococcal glomerulonephritis present on LM?

A

glomeruli enlarged and hypercellular with neutrophils displaying a “lumpy bumpy” appearance

97
Q

How does acute poststreptococcal glomerulonephritis present on EM?

A

subepithelial immune complex humps

98
Q

How does acute poststreptococcal glomerulonephritis present on IF?

A

granular appearance due to IgG, IgM, and C3 deposition along the GBM and mesangium

99
Q

How does focal segmental glomerulosclerosis present on LM?

A

segmental sclerosis and hyalinosis

100
Q

How does focal segmental glomerulosclerosis present on EM?

A

effacement of foot processes similar to minimal change disease

101
Q

What is the most common cause of nephrotic syndrome in adults?

A

Focal segmental glomerulosclerosis

102
Q

What conditions are associated with focal segmental glomerulosclerosis?

A

HIV infection; heroin abuse; massive obesity; interferon treatment; chronic kidney disease due to congenital absence or surgical removal

103
Q

How does minimal change disease present on LM and EM?

A

normal glomeruli; foot processes effacement

104
Q

What is loss in minimal change disease?

A

selective loss of albumin, not globulins, caused by GBM polyanion loss

105
Q

What is the most common finding in children post infection without symptoms?

A

minimal change disease

106
Q

How does membranous nephropathy present on LM?

A

diffuse capillary and GBM thickening

107
Q

How does membranous nephropathy present on EM?

A

“spike and dome” appearance with subepithelial deposits

108
Q

How does membranous nephropathy present on IF?

A

granular; this is SLE’s nephrotic presentation

109
Q

What causes membranous nephropathy?

A

can be idiopathic or caused by drugs, infections, SLE, solid tumors; this is the 2nd most common cause of primary nephrotic syndrome in adults

110
Q

How does rapidly progressive (crescentic) glomerulonephritis present on LM and IF?

A

crescent moon shape; crescents consist of fibrin and plasma proteins with glomerular parietal cells, monocytes and macrophages

111
Q

What can cause rapidly progressive (crescentic) glomerulonephritis?

A

Goodpasture’s syndrome; Wegener’s granulomatosis or microscopic polyangiitis

112
Q

What is a known risk factor for all testicular germ cell tumors?

A

Cryptorchidism (failure of the testes to descend into the scrotum)

113
Q

What are the most common testicular tumors in young adult males aged 15-35?

A

seminomas

114
Q

How do seminomas present histologically?

A

large cells in lobules with watery cytoplasm and a “fried egg appearance”

115
Q

AFP is the tumor marker for what two conditions?

A

yolk sac tumor and hepatocellular carcinoma

116
Q

hCG is the tumor marker for what condition?

A

choriocarcinoma

117
Q

bird’s beak appearance seen on barium swallow test indicates?

A

achalasia

118
Q

What is achalasia?

A

failure of relaxation of the LES due to lost of the myenteric (Auerbach’s plexus)

119
Q

In what layer of the digestive tract wall is the myenteric (Auerbach’s) plexus found?

A

between the longitudinal and circular layers of muscularis externa

120
Q

In what layer of the digestive tract wall is Meissner’s plexus found?

A

the submucosa – located between the mucosa and muscularis externa

121
Q

What is Nikolsky’s sign?

A

separation of epidermis upon manual stroking of skin

122
Q

Name the blistering skin d/o: AI disease characterized by tense sub-epidermal bullae; caused by IgG Abs specific for hemidesmosomes; skin biopsy reveal linear deposits of IgG immunoglobulin and C3 located at the dermoepidermal junction

A

Bullous pemphigoid

123
Q

Pemphigus vulgaris is an AI skin d/o with IgG antibody against?

A

desmoglein 3

124
Q

Nikolsky sign is positive in Pemphigus vulgaris or Bullous pemphigoid?

A

Pemphigus vulgaris

125
Q

Granular IgA deposits at the tips of dermal papillae indicate what skin d/o?

A

dermatitis herpetiformis

126
Q

Linear IgA deposits along the basement membrane zone with clear or hemorrhagic ovular vesicles or bullae on normal, erythematous or urticarial skin indicates?

A

linear IgA dermatosis - an AI subepidermal vesiculobullous disease that may be idiopathic or drug induced

127
Q

What are calcium kidney stones made of?

A

calcium oxalate, calcium phosphate or both

128
Q

Calcium kidney stones can form under what conditions?

A

under conditions of hypercalcemia (ex. hyperparathyroidism); can also result from ethylene glycol or vitamin C abuse

129
Q

What is unique about uric acid kidney stones?

A

they are radiolucent; all other are radiopaque!

130
Q

Staghorn calculi most commonly contain?

A

ammonium magnesium phosphate

131
Q

Congenital albinism is often due to a deficiency in what enzyme?

A

tyrosinase - converts tyrosine to melanin

132
Q

Roseola is caused by which virus?

A

human herpes virus 6 (HHV6)

133
Q

How does roseola present?

A

common in children 6-15 mos; presents with high fever for 3-5 days and a rash that appears as the fever breaks

134
Q

Describe the rash for roseola

A

faint macular rash that begins on the trunk and spreads to the extremities and face; does not usually itch; will go away on its own in a few days

135
Q

Describe the exanthema seen in varicella

A

vesicular rash starting on the trunk and spreading out to the face and extremities with lesions in different stages of healing

136
Q

Describe the rash seen in measles caused by the rubeola virus

A

maculopapular rash that begins at the head and moves down the body; rash is preceded by cough, coryza, conjunctivitis and blue-white (koplik) spots on buccal mucosa

137
Q

Describe the rash caused by parvovirus B19

A

initially causes a slapped cheek appearance then the rash spreads over the body in a lacy, reticulated pattern

138
Q

Name the 3 P’s that are indicative of MEN Type 1

A

pituitary, parathyroid, pancreatic involvement

139
Q

How does MEN Type 1 present clinically?

A

watery diarrhea, recurrent peptic ulcer disease refractory to medication and vision problems or headaches; gastrinomas stimulate acid release from the stomach, leading to ulcers

140
Q

How does L5 relate to sacrum dx?

A

L5 rotates opposite sacrum; L5 sidebends to the same side as the oblique axis of the sacral torsion; forward sacral torsions correspond with type 1 dysfunctions at L5; backward sacral torsions correspond to type 2 dysfunctions at L5

141
Q

What nerve provides sensation to the cornea?

A

nasociliary branch of the ophthalmic nerve (V1)

142
Q

What provides sensation to the lacrimal gland?

A

lacrimal nerve – a branch of the ophthalmic nerve (V1)

143
Q

What are the three branches to the ophthalmic nerve (V1)?

A

Nasociliary, frontal, lacrimal (NFL!)

144
Q

What nerve provides sensory innervations to the lower eyelid, side of nose and upper lip?

A

infraorbital nerve – a branch of the maxillary division (V2) of the trigeminal nerve

145
Q

Increased DTRs, positive babinski sign and normal pain discrimination, which represent motor pathology without sensory involvement is most indicative of what condition?

A

Lou Gehrig’s disease (aka amyotrophic lateral sclerosis)

146
Q

Anterior cord syndrome which leads to ischemia of the anterior 2/3 of the cord presents clinically as?

A

bilateral motor and temperature/pain sensory deficits, with intact pinpoint and vibratory sensation due to the preserved dorsal column medial lemniscus pathways

147
Q

Inulin, which is freely filtered by the kidney and is neither reabsorbed nor actively-secreted is the gold standard to calculate?

A

GFR

148
Q

Where is glucose reabsorbed?

A

proximal tubule

149
Q

What compound is most commonly used in clinical practice to estimate GFR? in what way is it less accurate than inulin?

A

urinary creatinine; it is less accurate than inulin because a small amount is secreted thereby overestimating the GFR slightly

150
Q

PAH, which is freely filtered, secreted and not reabsorbed is best use to estimate?

A

renal plasma flow

151
Q

What is the DOC to treat Francisella tularrensis (gram negative rod)?

A

Streptomycin

152
Q

Streptomycin is part of what family of antimicrobials? what is the MOA?

A

Aminoglycosides; inhibit formation of initiation complex and cause misreading of mRNA; binds to 30S ribosome

153
Q

What is tetrabenazine used to treat and what is the MOA?

A

Huntington’s disease; inhibits vesicular monoamine transporter and limits dopamine vesicle packaging and release

154
Q

Second generation atypical anti-psychotics such as olanzapine has been shown to improve symptoms of what disease?

A

chorea like symptoms in Huntington’s

155
Q

What is the DOC for genital herpes caused by HSV-2?

A

Acyclovir

156
Q

What is the MOA of acyclovir?

A

purine analog (Guanosine) that inhibits the viral DNA polymerase

157
Q

What is rifampin used for and what is the MOA?

A

tuberculosis; inhibits DNA dependent RNA polymerase

158
Q

What is Fitz-Hugh-Curtis syndrome?

A

inflammation of the liver capsule caused by spread of pelvic inflammatory disease

159
Q

Name the hormone imbalance: cold intolerance, decreased appetite with weight gain, lethargy, weakness, constipation, decreased reflexes, facial and periorbital myxedema, dry, cool skin, coarse hair, bradycardia, dyspnea on exertion, increased TSH

A

hypothyroidism

160
Q

Name the hormone imbalance: heat intolerance, increased appetite with weight loss, hyperactive, diarrhea, increased reflexes, pretibial myxedema in Graves disease, warm, moist skin, fine hair, chest pain and palpitation, decreased TSH

A

Hyperthyroidism

161
Q

Name the thyroid condition: most common cause of hypothyroidism; result of AI, anti-microsomal, anti-thyroglobulin antibodies; can be transiently hyperthyroid; associated with HLA-DR5

A

Hashimoto’s Thyroiditis

162
Q

Name the thyroid condition: hypothyroidism occurring in young children; children present as pale, puffy faced, with protuberant tongue and pot bellied; associated with mental retardation and stunted growth

A

Cretinism

163
Q

Name the thyroid condition: fibrous tissue replacement of the thyroid gland, leading to hypothyroidism; patients will have fixed, rock-hard and painless goiter

A

Riedel thyroiditis

164
Q

Name the thyroid condition: self limited hypothyroidism that is typically seen following a viral, flu-like illness; common signs are jaw pain, very tender thyroid and increased ESR

A

De Quervain disease

165
Q

In myasthenia gravis the antibody to acetylcholine receptors binds specifically in what location?

A

acetylcholine receptors in the post-synaptic membrane

166
Q

Name the syndrome: characterized by antibody binding to calcium channels on the PRESYNAPTIC membrane, weakness is relieved by repeated muscle stimulation

A

Lambert-Eaton syndrome

167
Q

Name the nephrotic syndrome: characterized by mesangial proliferation on light microscopy and “tram track” splitting of the basement membrane on electron microscopy

A

membranoproliferative glomerulonephritis

168
Q

What and where is the binding site for hydrochlorothiazide?

A

Na/Cl symporter of the early DCT

169
Q

How do thiazide diuretics affect the electrolyte profile?

A

causes hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia and hypercalcemia

170
Q

The ANOVA test is used to?

A

determine if there is a difference in means between 2 or more groups

171
Q

Chronic bronchitis is characterized by?

A

respiratory acidosis (low pH, high PaCO2) and obstructive breathing pattern (low FEV1/FVC)

172
Q

What hormonal changes occur during menopause and what is used to clinical confirm menopause?

A

Loss of sensitivity to gonadotropins results in increased FSH and LH levels; elevated FSH is used to clinically determine if a woman has reached menopause

173
Q

Describe the effects of Creutzfeldt-Jakob Disease (CJD)

A

causes degeneration of the entire cerebellum; clinical decline of mental status occurs quickly and is rapidly progressive; gross pathology shows spongiform encephalopathy of entire cortex

174
Q

Alzheimer’s disease is associated with what type of atrophy?

A

generalized atrophy of the cerebral cortex – seen as an increased space between the brain and skull

175
Q

What is the MOA of Donepezil and what is it used to treat?

A

acetylcholinesterase inhibitor; used particularly in Alzheimer’s disease

176
Q

T/F virtually all Down syndrome patients will develop Alzheimer’s disease by the age of 40

A

T

177
Q

Side effects of aminoglycosides (Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin) are?

A

nephrotoxicity and ototoxicity

178
Q

Name the loop diuretic that does not contain a sulfa moiety

A

Ethacrynic acid

179
Q

Loop diuretics inhibit which transporter on the thick ascending limb of the LOH?

A

Na/K/Cl

180
Q

Common side effects of loop diuretics are?

A

hypokalemia, hypocalcemia, alkalosis

181
Q

What is a significant AE caused by ethacrynic acid?

A

ototoxicity

182
Q

Chlorthalidone and Indapamide are what type of diuretic?

A

thiazide diuretic

183
Q

Measles is in what viral class?

A

Paramyxovirus

184
Q

Name the viruses that are part of the paramyxovirus family

A

Parainfluenza; RSV; Measles; Mumps

185
Q

What physiologic changes occur at high altitude?

A

at high altitude, alveolar PO2 is decreased due to decrease atmospheric pressure and oxygen content; this causes a decrease in hemoglobin saturation and stimulates ventilation; hyperventilation causes respiratory alkalosis

186
Q

What is the MOA of Amantadine and what is it used to treat?

A

antiviral that prevents viral uncoating in the early phase of the replication cycle; used to treat influenza A virus

187
Q

Name the virus: main cause of the common cold, belongs to picornavirus family, non-enveloped, single stranded, positive sense RNA

A

Rhinovirus

188
Q

increased TLC and RV is characteristic of what general lung pathology?

A

obstructive lung disease

189
Q

a reduction of all lung volumes in pulmonary function testing is characteristic of what general lung pathology?

A

restrictive lung disease

190
Q

Thiazide diuretics can cause an increase excretion of what electrolyte?

A

potassium; leads to metabolic alkalosis; binding of chloride portion of Na/Cl symporter in the DCT blocks Na absorption, this causes increased action at Na/K pump in CD which causes the increase in potassium excretion

191
Q

Schizophreniform d/o presents like schizophrenia, but last only for how long?

A

1-6 months

192
Q

This is a common cause of impetigo that presents with pustules and honey-colored crusting

A

Streptococcus pyogenes

193
Q

This is a toxin mediated disease caused by staph aureus exfoliative toxin; it causes painful blistering due to splitting of the epidermis at the stratum granulosum

A

Bullous impetigo

194
Q

Ulnar neuropathy presents with?

A

sensory loss and parathesias over the 4th and 5th digits; worsened grip and clumsiness in affected hand due to weakness of interosseous muscles

195
Q

Where is the chapman point for the bladder?

A

periumbilical region

196
Q

The long thoracic nerve arises from which nerve roots and what does it innervate?

A

C5-C7; innervates serratus anterior muscle

197
Q

The dorsal scapular nerve innervates which muscles?

A

major and minor rhomboid muscles

Combank Q facts (11 decks)

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