Combank Assessment #2 P2 Flashcards
How does PCOS present clinically?
increased LH, decreased FSH, increased testosterone, increased androgens and increased estrogens; manifests clinically with amenorrhea, infertility, obesity and hirsutism
How does PCOS cause infertility?
elevated LH levels and elevated LH:FSH ratio; high levels of LH cause down regulation of the LH receptors at the ovaries this prevents the LH surge needed to trigger ovulation during the menstrual cycle
How is schistosomiasis acquired and how may it present?
exposure to contaminated water; can present with severe itching after exposure to the skin
What is the DOC for shistosomiasis and how does it work?
Praziquantel; causes calcium influx that depolarizes the tough outer tegument of the worm leading to paralysis and death
Mebendazole and albendazole both inhibit?
beta-tubulin polymerization, which inhibits microtubule formation thereby damaging the structural integrity of helminthic parasites
This is an NSAID that closes a PDA
Indomethacin
This is a prostaglandin PGE1 analog used to keep the PDA open
Alprostadil
What are first line medications to treat PTSD?
SSRIs
Transmural inflammation with “creeping fat” is hallmark of which inflammatory bowel disease?
Crohn’s disease
Crypt abscesses (clusters of neutrophils within damaged epithelium) are a distinguishing characteristic of which inflammatory bowel disease?
ulcerative colitis
What is the MOA of Doxepin?
first generation TCA; blocks reuptake of NE and serotonin at the synapse
What is the classic presentation of DiGeorge syndrome?
a triad of conotruncal cardiac abnormalities, hypocalcemia and thymic hypoplasia
What is a well known paraneoplastic syndrome of small cell lung cancer which causes hyponatremia?
SIADH
In what portion of the nephron does ADH act on?
collecting tubule
Polymyalgia rheumatica most commonly presents in what population of patients?
females over the age of 50 years old
How does polymylgia rheumatica present?
causes myalgias and stiffness of the shoulder and hip girdle muscles; commonly associated with giant cell arteritis
What causes panlobular emphysema and how does it present??
involves entire respiratory lobule; occurs in patients with alpha 1 antitrypsin deficiency which leads to destruction of lung elastin
Smoking causes what kind of emphysema?
centrilobular emphysema
What is DIC and what characterizes it?
a complicated d/o that involves both excess bleeding and widespread thrombosis; fibrinogen is decreased while fibrin split products are increased
The ventral posterior medial nucleus of the thalamus receives sensory information from?
face; thalamus then sends this information to the primary sensory cortex
The ventral posterior lateral nucleus of the thalamus receives sensory input from?
the body and projects it to the primary sensory cortex
What should be checked when oral potassium fails to increase serum levels of potassium in a hypokalemic patient?
check for an underlying hypomagnesemia condition; this is b/c magnesium is a cofactor in potassium channel function within the kidney, acting to close channels in the absence of aldosterone, in cases of low serum Mg, these channels can remain open causing potassium wasting
What is Still’s murmur?
a benign pediatric murmur that commonly presents in healthy children 2-8 y.o.; typically heard as a mid-systolic murmur of musical quality between the apex of the heart and left sternal border
Where are indirect inguinal hernias located?
lateral to the inferior epigastric artery
Where are direct inguinal hernias located?
medial to the epigastric artery
Indirect hernias result from?
a patent processus vaginalis – this can lead to formation of a hydrocele
What type of hernia is most common in women and what does it result from?
femoral hernias are most common in women; these result from a defect in the femoral canal
Direct inguinal hernias involve penetration into?
Hesselbach’s Triangle
What is sensitivity?
% of known positives that actually test positive
How do you calculate sensitivity?
true positive / [true positives + false negatives]
How do you calculate specificity?
true negatives / [true negatives + false positives]
Tuberous sclerosis has what inheritance pattern?
autosomal dominant
Ash leaf spots (hypopigmented macules) are associated with?
Tuberous sclerosis
What is the most common manifestation of tuberous sclerosis in the kidneys?
Angiomyolipoma
Tetany is a sign of?
hypocalcemia
Which syndrome has an increased association with horseshoe kidney development?
Turner Syndrome (XO)
Major hormone responsible for gallbladder contraction and pancreatic enzyme secretion
CCK
CCK is produced by endocrine cells that line the mucosa of the small intestine in response to?
ingested fats and proteins
Secretin is produced by cells in the small intestine in response to?
acidity that results from the secretion of chyme into the small intestine
Pepsinogen secreted by the chief cells of the stomach is converted to the active form of pepsin in what conditions?
low gastric pH; thus hydrochloric acid is responsible for the conversion of pepsinogen to pepsin, which breaks down proteins in food
When is trypsinogen secreted into the duodenum?
when the pancreas is stimulated by CCK
Which enzyme acts to convert trypsinogen into the active form of trypsin in the small intestine?
enteropeptidase
What is primarly lateral sclerosis?
a benign condition that manifests as a disturbance of upper motor neurons
What is Patau syndrome?
a trisomy 13 that leads to rocker-bottom feet, microphthalmia, microcephaly, cleft lip, holoprosencephaly and polydactyly
What is Edwards syndrome?
a trisomy of chromosome 18 that results in mental developmental delay, rocker-bottom feet, micrognathia, clenched hands, and congenital heart disease
Microdeletions of chromosome 5 leads to what syndrome?
cri-du-chat syndrome - results in microcephaly, mental developmental delay and a high pitched cry or mewing
What characterizes Williams syndrome?
Elfin facies, mental retardation, hypercalcemia, and extreme friendliness towards strangers; due to a deletion on chromosome 7
Risk factors for endometrial hyperplasia and endometrial adenocarcinoma are factors that?
increase exposure of the endometrial lining of the uterus to unopposed estrogen throughout one’s life
This drug induces the expression of insulin-responsive genes
Rosiglitazone
Pancreatic head tumors most commonly present with?
pain, obstructive jaundice, dark urine, steatorrhea, clay colored stools and weight loss
Which vaccines are egg-based?
MMR, influenza vaccine, yellow fever vaccine
What are the three major branches that originate from the celiac trunk (a major branch of the abdominal aorta)?
left gastric artery, common hepatic artery, splenic artery
Sheehan syndrome – ischemic necrosis of the anterior pituitary is a complication of?
massive blood loss during delivery
What is the DOC for Chagas Disease?
Nifurtimox
S3 is associated with what type of cardiomyopathy?
dilated cardiomyopathy
What is Leigh syndrome?
caused by pyruvate dehydrogenase deficiency; cannot convert pyruvate to acetyl coA so excess pyruvate becomes lactate causing lactic acidosis; patients present with poor feeding, developmental delay, seizures, abnormal eye movements, ataxia and mental delays
Diffuse large B cell lymphoma has what age of onset? what manifestation is a common presenting symptom?
onset during 7th to 8th decades of life; extranodal manifestations are a common presenting symptom and can lead to enlarging mass seen in the testicle
What causes a varicocele?
dilatation of the pampiniform plexus of the spermatic veins
What is known as a “bag of worms”?
varicocele
What is a hydrocele?
collection of peritoneal fluid in the tunica vaginalis - a layer that surrounds the testes and spermatic cord
What is a unique finding of a hydrocele during examination?
fluid in the hydrocele transilluminates
Tay-Sachs disease involves a deficiency in what enzyme?
Hexosaminidase A – leads to accumulation of GM2 ganglioside
What enzyme is deficient in Niemann-Pick disease?
Sphingomyelinase
Epidermis, nerves, and melanocytes all stem from what embryological layer?
Ectoderm
What is Korsakoff psychosis characterized by?
amnesia, hallucinations, and confabulation due to thiamine deficiency; it is associated with alcoholism
A blowing holosystolic murmur loudest at the left 4th intercostal space is descriptive of?
VSD
Trichomonas vaginalis causes what type of discharge?
foul-smelling greenish discharge
How is trichomonas vaginalis best visualized?
via a wet mount slide
What is the indicated treatment for Trichomonas, Giardia, Gardnerella, anaerobes
Metronidazole
Name the cluster A personality disorders
paranoid, schizoid, schizotypal
Name the cluster B personality disorders
antisocial, borderline, histrionic, narcissistic
Name the cluster C personality disorders
avoidant, dependent, obsessive-compulsive
What disease is characterized by hemangioblastomas of the CNS, retina, pancreas, kidneys and adrenal glands?
Von-Hippel-Lindau disease
Von Hippel Lindau disease is due to error on what chromosome?
Chromosome 3
What is the most common primary renal tumor in children? what chromosome is affected?
Wilm’s tumor; chromosome 11
La Crosse virus a member of the Bunyaviradae family causes?
California encephalitis
What does retroperitoneal mean?
located between the posterior parietal peritoneum and posterior abdominal wall
Primary retroperitoneal structures include….
adrenal glands, kidneys, ureters, bladder, aorta, IVC and rectum
Secondary retroperitoneal structures include….
head, neck, and body of pancreas, ascending colon, descending colon, duodenum (except first portion)
What does secondary retroperitoneal mean?
structures that were once suspended by mesentery but migrated posterior
