Combank Assessment #2 P1 Flashcards
What is a confounding variable?
an extraneous variable that correlates positively or negatively with both the dependent and independent variables
What is Berkson bias?
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
What is the most common form of congenital hydroxylase deficiency?
21-hydroxylase deficiency
How does 21-hydroxylase deficiency affect the secretory products of the adrenal gland?
decreased glucocorticoids and minteralcorticoids; increased sex hormones
The reduction of minteralcorticoids caused by 21-hydroxylase deficiency causes the activation of what system?
renin-angiotensin system is activated due to hypotension from salt wasting; thus, angiotensin II levels are elevated
Name the murmur: crescendo-decrescendo, systolic ejection murmur, heard best at left upper sternal border 2nd intercostal space; increases in intensity with inspiration
pulmonic stenosis
Name the murmur: high-pitched holosystolic murmur, blowing quality, best heard over apex, radiates to axilla
mitral valve regurgitation
Hypertrophic obstructive cardiopmyopathy results in what type of murmur?
a systolic ejection murmur that has a crescendo-decrescendo quality; best heard along left sternal border
how does the systolic ejection murmur caused by hypertrophic obstructive cardiomyopathy change with preload and afterload?
murmur diminishes with increased preload (squatting or lay supine); murmur diminishes with increased afterload (hand grip)
How does preload affect the murmur caused by aortic stenosis?
murmur increases with increased preload (squatting); decreases with decreased preload (vaslsalva, handgrip)
What is a common cause of aortic stenosis in patients in the 6th decade of life?
congenital biscupid valve
right sided heart murmurs increase with?
inspiration
left sided heart murmurs increase with?
expiration
What is the MOA of sildenafil?
inhibit phosphodiesterase 5, causing increased cGMP, smooth muscle relaxation in the corpus cavernosum, increased blood flow and thus increased penile erection
Sildenafil also weakly inhibits PDE-6, what AE can this cause?
b/c it is required for the transformation of light into electrical signals inhibition of PDE-6 can cause cyanopsia or blue vision
What is the DOC for a UTI during pregnancy?
Amoxicillin
What class of anti-microbials does doxycycline belong in?
Tetracyclines
Why should fluoroquinolones and tetracyclines be avoided in pregnancy?
fluoroquinolones damage cartilage in growing fetus; tetracyclines damages growing bones
Osler-Weber-Rendu syndrome is also known as?
hereditary hemorrhagic telangiectasia
What is Osler-Weber-Rendu syndrome?
AD d/o; presents with recurrent, severe epitaxis, multiple telangiectasias, and AV malformations
What is Sturge Weber syndrome?
congenital d/o associated with port-wine stains, usually in V1 ophthalmic distribution and also ipsilateral arteriovenous malformations in the meninges
What characterizes neurofibromatosis type I d/o?
AD neurocutaneous d/o; presents with cafe-au-lait spots, lische nodules, neurofibromas, optic gliomas, and pheochromocytomas
What characterizes tuberous sclerosis?
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
In what way can squamous cell carcinoma cause hypercalcemia?
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
Hypertensive strokes tend to form what type of infarcts in the basal ganglia? what is the most commonly affected arterial supply?
lacunar infarcts; lenticulostriate branches of the middle cerebral artery
The ureters lie directly on what muscle as they course from the kidney on their way to the bladder?
psoas muscles
What is the major blood supply to the occipital lobe containing the primary visual cortex?
posterior cerebral artery
Occlusion of the PCA causes?
contralateral hemianopsia with macular sparing
Occlusions of what artery will cause contralateral hemianopsia without macular sparing as it results in ischemia to the optic radiations?
MCA
A LBBB can present with what type of splitting?
Paradoxically split S2 – on inspiration, P2 closes later and moves closer to A2, thereby paradoxically eliminating the split
Hyperglycemia is a common cause of what type of electrolyte imbalance? how does it occur?
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
Diuretics, esp. thiazide diuretics is one of the principle causes of what type of electrolyte imbalance? how does it occur?
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
T/F cases of CMV are not required to be reported to CDC on a national level
T
Diseases that are reportable to the CDC on a national level
AIDS, TB, meningococcal meningitis, hepatitis A-C, gonorrhea, tetanus, lyme disease, syphilis, rabies, measles, salmonella, mumps, shigella, rubella, polio
Signs of hypocalcemia
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)
Function of PTH
increase serum calcium and decrease serum phosphate levels
What is the presentation of pseudohypoparathyroidism?
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
What is trigger finger aka flexor tenosynovitis?
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
What test is used to dx de Quervain’s syndrome?
Finkelstein’s test
What is De Quervain’s tenosynovitis?
a tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons that located at the styolid process of the radius
What are the symptoms of De Quervain’s tenosynovitis?
radial sided wrist and thumb pain, tenderness, and swelling, which may cause difficulty with grip
What causes herpetic whitlow and how does it present?
herpes simplex virus infection causing erythematous papules of the distal finger; it is a self-limiting condition
What is jersey finger?
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
What is the cause of mallet finger?
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
What are first line agents for patients suffering from dysmenorrhea?
NSAIDs
What class of drugs is Losartan in? what is it used for?
angiotensin II receptor blocker; used to treat hypertension; blocks the vasoconstrictor and aldosterone secreting effects of angiotensin II
ARBs and ACE inhibitors have similar effects but what is one significant difference?
ARBs (“–sartans”) do not increase bradykinin so there is no resultant cough or angiodema
What is a common contraindication of losartan?
it is contraindicated in pregnancy because it may cause damage to the fetal kidney
What are the classic signs of carcinoid syndrome?
flushing, diarrhea, bronchospasm due to elevated 5-hydroxyindoleacetic acid (5-HIAA), serotonin and other vasoactive substances in systemic circulation
Carcinoid tumor does not necessarily lead to carcinoid syndrome, why?
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
What is the most common tumor of the appendix?
carcinoid tumor
An increase in serum pH causes what change between calcium and albumin?
increases the binding of calcium to albumin
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?
Albumin!
Calcium exists in two forms, protein bound and free ionized form; what form does Calcium predominantly exist in?
majority of circulating calcium is bound to albumin in its inactive form; thus total calcium fluctuates with albumin concentration
The physiologically active free ionized form of calcium is regulated by what?
PTH; this form is independent of albumin levels
Brain natriuretic peptide (BNP) is secreted fro the ventricles in response to?
stretch
BNP has similar effects as ANP in that they both are …
diuretics, natriuretics and anti-hypertensives
Constriction of what will decrease renal plasma flow and increase GFR?
efferent arteriole
What is the MOA of cilostazol and what is it used for?
phosphodiesterase III inhibitor – increases cAMP in platelets to inhibit platelet aggregation, results in vasodilation; used for angina prophylaxis, intermittent claudication and coronary vasodilation
Naproxen is in what category of drug?
NSAID
What is placenta accreta?
placenta adheres to the myometrium of the uterus
Failure to deliver the placenta within 30 minutes of birth should lead to suspect what condition?
placenta accreta
What is Asherman’s syndrome?
a condition characterized by adhesions and/or fibrosis of the endometrium most often associated with dilation and curettage of the intrauterine cavity.
What is placenta previa?
occurs when the placenta is low lying and covers part of or all of the cervical os
What is placenta increta?
placental tissue invasion all the way through the myometrium; more severe than placenta accreta
What is placenta percreta?
placenta tissue invasion through the entire uterine wall
What is placenta abruptio?
placenta detaches prematurely from the uterine wall
What is the causative agent for Kaposi sarcoma? what condition is it associated with? how does it present?
caused by HHV-8; it is an AIDs-associated infection; manifests as painless red-violet lesions caused by endothelial proliferation
What is the blood supply to the lateral medulla?
posterior inferior cerebellar artery
What is Wallenberg’s syndrome?
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
What is subclavian steal syndrome?
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
What is amaurosis fugax?
acute and painless onset of monocular visual loss in the background of atherosclerosis; results in episodes of transient monocular blindness due to retinal ischemia
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?
Amaurosis fugax
Reinke’s crystals are found in what type of testicular non-germ cell tumor?
Leydig cell tumors
Where are leydig cells found and what do they produce?
in the interstitium of the testis adjacent to the seminiferous tubules in the testicle; they produce testosterone in the presence of LH
How does choriocarcinoma, a testicular germ cell tumor present?
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
What is diffuse large B-cell lymphoma and what age group is most commonly affected?
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
What are sertoli cell tumors? most commonly affects what population?
testicular non-germ cell tumor; derived from cells located within the seminiferous tubules; can occur in both children and middle aged adults
What is a yolk sac tumor? who does it commonly affect? how does it present?
testicular germ-cell tumor; most common testicular neoplasm in infants; usually present with a painless testicular mass
What is histologically pathognomonic for yolk sac tumors?
Schiller-Duvall bodies — contain a central vessel that is surrounded by flattened tumor cells in a cystic space (resembles primitive glomeruli)
What is pathognomonic for squamous cell carcinoma on biopsy results?
a keratin pearl
What compound increases the risk of endometrial cancer, abnormal vaginal bleeding and enhances blood coagulation?
estrogen
Patients with CF can develop insulin dependent diabetes due to?
chronic destruction of the pancreas
What is silo filler’s disease?
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
Silicosis is seen in what population of people? what does it cause in the lung?
seen in sandblasters and silica miners; d/o causes fibrotic nodules in the lung
Berylliosis is seen in what population? what does this disease cause?
seen in aerospace workers due to exposure to beryllium; disease causes non-caseating granulomas in lung and hilar lymph nodes
What is Farmer’s lung?
a type of hypersensitivity pneumonitis; it is due to exposure to thermophilic actinomyces in moldy hay
Primary biliary cirrhosis is an autoimmune related condition classically seen in what population of patients?
40 year old women
Primary sclerosing cholangitis is seen in what population of patients?
40-50 year old males
What are the symptoms that are commonly seen in both primary biliary cirrhosis and primary sclerosing cholangitis
pruritis, jaundice, dark urine, light stools, hepatosplenomegaly
Cellulitis on the hands of salt-water shellfish handlers should lead you to think of?
Vibrio vulnificus
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
Vibrio vulnificus
Name the organism: acid fast rod, can cause fish tank granuloma in patients who handle salt water fish; does not form cellulitis or bullae
Mycobacterium marinum
Nephrotic syndrome presents with?
massive proteinuria (>3.5 g/day, frothy urine), hyperlipidemia, fatty casts, edema
Nephritic syndrome is characterized by?
inflammatory process; glomeruli involvement leads to hematuria and RBC casts in urine; associated with azotemia, oliguria, hypertension and proteinuria (<3.5 g/day)
How does acute poststreptococcal glomerulonephritis present on LM?
glomeruli enlarged and hypercellular with neutrophils displaying a “lumpy bumpy” appearance
How does acute poststreptococcal glomerulonephritis present on EM?
subepithelial immune complex humps
How does acute poststreptococcal glomerulonephritis present on IF?
granular appearance due to IgG, IgM, and C3 deposition along the GBM and mesangium
How does focal segmental glomerulosclerosis present on LM?
segmental sclerosis and hyalinosis
How does focal segmental glomerulosclerosis present on EM?
effacement of foot processes similar to minimal change disease
What is the most common cause of nephrotic syndrome in adults?
Focal segmental glomerulosclerosis
What conditions are associated with focal segmental glomerulosclerosis?
HIV infection; heroin abuse; massive obesity; interferon treatment; chronic kidney disease due to congenital absence or surgical removal
How does minimal change disease present on LM and EM?
normal glomeruli; foot processes effacement
What is loss in minimal change disease?
selective loss of albumin, not globulins, caused by GBM polyanion loss
What is the most common finding in children post infection without symptoms?
minimal change disease
How does membranous nephropathy present on LM?
diffuse capillary and GBM thickening
How does membranous nephropathy present on EM?
“spike and dome” appearance with subepithelial deposits
How does membranous nephropathy present on IF?
granular; this is SLE’s nephrotic presentation
What causes membranous nephropathy?
can be idiopathic or caused by drugs, infections, SLE, solid tumors; this is the 2nd most common cause of primary nephrotic syndrome in adults
How does rapidly progressive (crescentic) glomerulonephritis present on LM and IF?
crescent moon shape; crescents consist of fibrin and plasma proteins with glomerular parietal cells, monocytes and macrophages
What can cause rapidly progressive (crescentic) glomerulonephritis?
Goodpasture’s syndrome; Wegener’s granulomatosis or microscopic polyangiitis
What is a known risk factor for all testicular germ cell tumors?
Cryptorchidism (failure of the testes to descend into the scrotum)
What are the most common testicular tumors in young adult males aged 15-35?
seminomas
How do seminomas present histologically?
large cells in lobules with watery cytoplasm and a “fried egg appearance”
AFP is the tumor marker for what two conditions?
yolk sac tumor and hepatocellular carcinoma
hCG is the tumor marker for what condition?
choriocarcinoma
bird’s beak appearance seen on barium swallow test indicates?
achalasia
What is achalasia?
failure of relaxation of the LES due to lost of the myenteric (Auerbach’s plexus)
In what layer of the digestive tract wall is the myenteric (Auerbach’s) plexus found?
between the longitudinal and circular layers of muscularis externa
In what layer of the digestive tract wall is Meissner’s plexus found?
the submucosa – located between the mucosa and muscularis externa
What is Nikolsky’s sign?
separation of epidermis upon manual stroking of skin
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
Bullous pemphigoid
Pemphigus vulgaris is an AI skin d/o with IgG antibody against?
desmoglein 3
Nikolsky sign is positive in Pemphigus vulgaris or Bullous pemphigoid?
Pemphigus vulgaris
Granular IgA deposits at the tips of dermal papillae indicate what skin d/o?
dermatitis herpetiformis
Linear IgA deposits along the basement membrane zone with clear or hemorrhagic ovular vesicles or bullae on normal, erythematous or urticarial skin indicates?
linear IgA dermatosis - an AI subepidermal vesiculobullous disease that may be idiopathic or drug induced
What are calcium kidney stones made of?
calcium oxalate, calcium phosphate or both
Calcium kidney stones can form under what conditions?
under conditions of hypercalcemia (ex. hyperparathyroidism); can also result from ethylene glycol or vitamin C abuse
What is unique about uric acid kidney stones?
they are radiolucent; all other are radiopaque!
Staghorn calculi most commonly contain?
ammonium magnesium phosphate
Congenital albinism is often due to a deficiency in what enzyme?
tyrosinase - converts tyrosine to melanin
Roseola is caused by which virus?
human herpes virus 6 (HHV6)
How does roseola present?
common in children 6-15 mos; presents with high fever for 3-5 days and a rash that appears as the fever breaks
Describe the rash for roseola
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
Describe the exanthema seen in varicella
vesicular rash starting on the trunk and spreading out to the face and extremities with lesions in different stages of healing
Describe the rash seen in measles caused by the rubeola virus
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
Describe the rash caused by parvovirus B19
initially causes a slapped cheek appearance then the rash spreads over the body in a lacy, reticulated pattern
Name the 3 P’s that are indicative of MEN Type 1
pituitary, parathyroid, pancreatic involvement
How does MEN Type 1 present clinically?
watery diarrhea, recurrent peptic ulcer disease refractory to medication and vision problems or headaches; gastrinomas stimulate acid release from the stomach, leading to ulcers
How does L5 relate to sacrum dx?
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
What nerve provides sensation to the cornea?
nasociliary branch of the ophthalmic nerve (V1)
What provides sensation to the lacrimal gland?
lacrimal nerve – a branch of the ophthalmic nerve (V1)
What are the three branches to the ophthalmic nerve (V1)?
Nasociliary, frontal, lacrimal (NFL!)
What nerve provides sensory innervations to the lower eyelid, side of nose and upper lip?
infraorbital nerve – a branch of the maxillary division (V2) of the trigeminal nerve
Increased DTRs, positive babinski sign and normal pain discrimination, which represent motor pathology without sensory involvement is most indicative of what condition?
Lou Gehrig’s disease (aka amyotrophic lateral sclerosis)
Anterior cord syndrome which leads to ischemia of the anterior 2/3 of the cord presents clinically as?
bilateral motor and temperature/pain sensory deficits, with intact pinpoint and vibratory sensation due to the preserved dorsal column medial lemniscus pathways
Inulin, which is freely filtered by the kidney and is neither reabsorbed nor actively-secreted is the gold standard to calculate?
GFR
Where is glucose reabsorbed?
proximal tubule
What compound is most commonly used in clinical practice to estimate GFR? in what way is it less accurate than inulin?
urinary creatinine; it is less accurate than inulin because a small amount is secreted thereby overestimating the GFR slightly
PAH, which is freely filtered, secreted and not reabsorbed is best use to estimate?
renal plasma flow
What is the DOC to treat Francisella tularrensis (gram negative rod)?
Streptomycin
Streptomycin is part of what family of antimicrobials? what is the MOA?
Aminoglycosides; inhibit formation of initiation complex and cause misreading of mRNA; binds to 30S ribosome
What is tetrabenazine used to treat and what is the MOA?
Huntington’s disease; inhibits vesicular monoamine transporter and limits dopamine vesicle packaging and release
Second generation atypical anti-psychotics such as olanzapine has been shown to improve symptoms of what disease?
chorea like symptoms in Huntington’s
What is the DOC for genital herpes caused by HSV-2?
Acyclovir
What is the MOA of acyclovir?
purine analog (Guanosine) that inhibits the viral DNA polymerase
What is rifampin used for and what is the MOA?
tuberculosis; inhibits DNA dependent RNA polymerase
What is Fitz-Hugh-Curtis syndrome?
inflammation of the liver capsule caused by spread of pelvic inflammatory disease
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
hypothyroidism
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
Hyperthyroidism
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
Hashimoto’s Thyroiditis
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
Cretinism
Name the thyroid condition: fibrous tissue replacement of the thyroid gland, leading to hypothyroidism; patients will have fixed, rock-hard and painless goiter
Riedel thyroiditis
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
De Quervain disease
In myasthenia gravis the antibody to acetylcholine receptors binds specifically in what location?
acetylcholine receptors in the post-synaptic membrane
Name the syndrome: characterized by antibody binding to calcium channels on the PRESYNAPTIC membrane, weakness is relieved by repeated muscle stimulation
Lambert-Eaton syndrome
Name the nephrotic syndrome: characterized by mesangial proliferation on light microscopy and “tram track” splitting of the basement membrane on electron microscopy
membranoproliferative glomerulonephritis
What and where is the binding site for hydrochlorothiazide?
Na/Cl symporter of the early DCT
How do thiazide diuretics affect the electrolyte profile?
causes hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia and hypercalcemia
The ANOVA test is used to?
determine if there is a difference in means between 2 or more groups
Chronic bronchitis is characterized by?
respiratory acidosis (low pH, high PaCO2) and obstructive breathing pattern (low FEV1/FVC)
What hormonal changes occur during menopause and what is used to clinical confirm menopause?
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
Describe the effects of Creutzfeldt-Jakob Disease (CJD)
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
Alzheimer’s disease is associated with what type of atrophy?
generalized atrophy of the cerebral cortex – seen as an increased space between the brain and skull
What is the MOA of Donepezil and what is it used to treat?
acetylcholinesterase inhibitor; used particularly in Alzheimer’s disease
T/F virtually all Down syndrome patients will develop Alzheimer’s disease by the age of 40
T
Side effects of aminoglycosides (Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin) are?
nephrotoxicity and ototoxicity
Name the loop diuretic that does not contain a sulfa moiety
Ethacrynic acid
Loop diuretics inhibit which transporter on the thick ascending limb of the LOH?
Na/K/Cl
Common side effects of loop diuretics are?
hypokalemia, hypocalcemia, alkalosis
What is a significant AE caused by ethacrynic acid?
ototoxicity
Chlorthalidone and Indapamide are what type of diuretic?
thiazide diuretic
Measles is in what viral class?
Paramyxovirus
Name the viruses that are part of the paramyxovirus family
Parainfluenza; RSV; Measles; Mumps
What physiologic changes occur at high altitude?
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
What is the MOA of Amantadine and what is it used to treat?
antiviral that prevents viral uncoating in the early phase of the replication cycle; used to treat influenza A virus
Name the virus: main cause of the common cold, belongs to picornavirus family, non-enveloped, single stranded, positive sense RNA
Rhinovirus
increased TLC and RV is characteristic of what general lung pathology?
obstructive lung disease
a reduction of all lung volumes in pulmonary function testing is characteristic of what general lung pathology?
restrictive lung disease
Thiazide diuretics can cause an increase excretion of what electrolyte?
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
Schizophreniform d/o presents like schizophrenia, but last only for how long?
1-6 months
This is a common cause of impetigo that presents with pustules and honey-colored crusting
Streptococcus pyogenes
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
Bullous impetigo
Ulnar neuropathy presents with?
sensory loss and parathesias over the 4th and 5th digits; worsened grip and clumsiness in affected hand due to weakness of interosseous muscles
Where is the chapman point for the bladder?
periumbilical region
The long thoracic nerve arises from which nerve roots and what does it innervate?
C5-C7; innervates serratus anterior muscle
The dorsal scapular nerve innervates which muscles?
major and minor rhomboid muscles
