Complete Clue Deck (Advance Edit) Flashcards
1
Q
When should Intercourse be avoided during Pregnancy?
A
Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes
2
Q
What is Type 2 RTA?
A
Proximal RTA: bad Carbonic Anhydrase, lost all HCO3-
3
Q
What is Heavy Chain Disease?
A
IgA and Multiple Myeloma of the GI tract
4
Q
What is Nihilism?
A
Feeling of “life is meaningless”
5
Q
What is Forward Typing?
A
Uses Antibodies to detect Antigens
6
Q
What is associated with Vibrio Vulnificus?
A
Raw Oyster - common in workers shucking the oysters, cellulitis in swimmer’s cuts
7
Q
What is the MOA of Propranolol, Timolol?
A
B1 and B2 Blockers
8
Q
What is Hand-Foot-Mouth Disease?
A
Mouth ulcers
Will not eat or drink
Palm and sole rash caused by Coxsackie A
9
Q
What are the 2 kinds of partial seizures?
A
Simple (aware), complex (not aware)
10
Q
What is an Omphalocele?
A
Intestines protrude out of the umbilicus covered by peritoneum
11
Q
What is Clanging?
A
Words that sound alike
12
Q
What is exudate?
A
Effusion of mostly proteinToo much protein: Will have —Purulent (from Bacteria),Hemorrhagic (from trauma, CA, PE)Fibrinous (from collagen vascular disease), Granulomatous (non-bacterial)
13
Q
What are the Mimetic drugs?
A
Pramlintide
14
Q
What is Lewy Body Dementia?
A
Stiff with visual hallucinations
15
Q
What type of problem is there if serum Ca2+ and Serum PO4- change in same directions?
A
This is a secondary problem
16
Q
What is the Pool Test?
A
Fluid in the vagina
17
Q
What are the indications for Odansetron?
A
Control vomiting in patients undergoing chemo therapy and postoperatively
18
Q
What is Kd?
A
Concentration of drug that binds 50% of receptors
19
Q
What is associated with H. Aegyptius?
A
Swollen eyeball with pus
20
Q
What is Overflow Incontinence?
A
Cannot completely empty bladder
21
Q
How does Gonorrhea present?
A
Palmar pustules, arthritis/joint pain, urethral discomfor
22
Q
What makes Achalasia unique?
A
Decreased Peristalsis and increased LES pressure
23
Q
What is the MOA of Pseudoephedrine, phenylephrine?
A
Sympathomimetic alpha-agonistsnon-prescription nasal decongestants
24
Q
Where does DHT come from?
A
Testicles at puberty
25
What is Intraductal Papilloma?
Bleeding from the nippleMost common Breast CA
26
How does temporal arteritis present?
Pain with chewing, blind in one eye
27
What diseases have PIE syndrome?
Aspergillus, Loeffler's, Churg-Strauss
28
What is associated with Fusobacterium?
Painful mouth ulcers, gum pus, Vincent's angina
29
What is the MOA of ACE inhibitors?
Inhibits conversion of Ang I to Ang II, decreases Ang II
30
What is Central (neurogenic) diabetes insipidus?
Brain not making or producing enough ADH
31
What is Arnold-Chiari?
Foramen Magnum obstruction
32
What is 1st-order kinetics?
Constant drug percentage metabolism over time depends on drug concentration (rate of elimination is directly proportional to drug concentration)
33
What does Vit B2 do?
FAD cofactor
34
Clues for atypical pneumonia?
Atypical pneumonia: prolonged illness, low fever, usually \>40 y/oX-ray: diffuse, H. Influenza, Mycoplasma, Chlamydia
35
What does giving DDAVP during the Water deprivation tests tell you?
\>50% increase (central complete DI),10-50% increase (central partial DI),\<10% (psychogenic polydipsia),no change (nephrogenic DI)
36
What will you see with Alpha Thalassemia?
Seen in African Americans and Asian Americans (Chromosome 16- deletion)
37
What are the simple Gram Negative Bugs?
They lack Lipopolysaccharides,"Simple HE"H - H. InfluenzaE - E. Coli
38
What is a Neutrophil?
The Phagocyte (it has Antimicrobials, most abundant)
39
What is the MOA of Glucocorticoids?
Decrease production of Leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2
40
What is Transference?
Patient views doctor as parent
41
Where is the most common site of a Clavicle fracture due to birth?
Middle third of the Clavicle
42
What are the indications for Niacin?
Decrease LDL and TriglyceridesStrong increase HDL
43
What is Perseveration?
Keeps repeating the same words
44
What does the parathyroid cells secrete?
PTH
45
What is associated with Actinomyces?
Face Fistulas, Sulfur Granules
46
What is a Rolling Hiatal Hernia?
Bowel Protruded through a defect in the Diaphragm. This can strangulate the bowel and can cause Atelectasis
47
What is Mesenteric Ischemia?
Abdominal pain of of proportion to physical exam
48
What is the MOA of Diazoxide?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
49
What is Primary Sclerosing Cholangitis?
Anti-smooth muscle antibody (20-50%), bile ducts are scarred from inflammation, there is beading and onion skinning, it's associated with UC and P-ANCA (80%)
50
What does the viral load tell you?
Progression of HIV
51
Which enlarged lymph nodes are most likely malignant?
Supraclavicular, Epitrochlear (above the elbow), inguinal
52
What is Velamentous Cord Insertion?
Fetal vessels insert between chorion and amnion
53
What is Common Variable Immuno. Def?
Young adults with B cells that do not work
54
What are the Indications for Oxytocin?
Induces labor and Controls uterine hemorrhage
55
What does Mg2+ do?
PTH and kinase cofactor
56
What are the risk factors for Lung CA?
Smoking, Radon, second hand smoke, pneumoconiosis (except Anthracosis)
57
What is the Adverse Effect for first generation Sulfonylureas?
Disulfiram like effects
58
What is Multiple Myeloma?
Multiple osteolytic lesionsIncreased IgG and kappa light chainsRouleaux formation seen on slide
59
Clues for Typical pneumonia?
Typical pneumonia: short illness, high fever, usually \>40 y/o, X-ray: one lobe, Streptococcus Pneumonia
60
What is Polycythemia Vera?
Hematocrit (Hct) \>60% Decreased EPO, Budd-ChiariPruritis after bathing
61
What is the MOA of Mimetics?
Decreases Glucagon
62
What is Ascending Cholangitis?
Common bile duct infection due to stones
63
What does Growth Hormone (GH) do?
Stimulates growth, sends Somatomedin to growth plates, Gluconeogenesis by proteolysis
64
What is Anderson's?
Branching enzyme deficiency, long chains of glycogen
65
What is the Sympathetic System?
Fight -or- Flight, speeds stuff up
66
What is a Double Footling Breech?
Two feet sticking outside the cervical OS
67
What vessel has the thickest layer of smooth muscle?
Aorta
68
What is Competitive Inhibition?
Fights for active site, no change in Vmax, potency decreases
69
What does blood type O tell you?
They have no antigens (Universal donor)
70
What does high WBC and B Cells tell you?
Bacterial infection
71
What are the Rapidly Dividing Cells of the Energy State?
Skin: dryNails: BrittleHair: AlopeciaLow Bone Marrow: SuppressedVasculature: Endothelium breaks downLungs: Infection / SOBKidney: PCT effecfted firstGI: N/V/DBladder: Decreased toneSperm: DecreasedGerm Cells: Predisposed to cancerBreasts: AtrophicEndometrium: Amenorrhea
72
What diseases are cause by the Ixodes Ticks?
Lyme Disease - bull's eye lesionBabesiosis - Hemolytic AnemiaEhrlichiosis - puncture near eye
73
What does a Dehydrogenase do?
Catalyzes Oxidation-Reduction reactions (gaining or losing an electron)
74
What is Unconjugated Bilirubin?
Fat soluble and indirect Bilirubin
75
What is a transition?
Changes one purine to another purine
76
What is Crigler-Najjar Type I?
Unconjugated bilirubin buildupNewborn or infantsNo UDP-GTPhenobarbital yields no change
77
What organ has the highest AVO2 difference after excercise?
Muscle
78
What are the bugs that cause gastroenteritis within 8 hours of eating the preformed toxin?
Staph Aureus (potato salad)Clostridium Perfringens (holiday turkey/ham)Bacillus Cereus (fried rice syndrome)
79
What are the most common places to metastasize to the brain?
From the lung, breast, and skin, present at the White-Grey Junction
80
What is Polyhydramnios?
Too much amniotic fluid (baby can't swallow)
81
What is the function of GnRH?
Stimulates release of LH & FSH
82
What are the risk factors for Esophageal / Gastric CA?
Smoking, alcohol and nitrates
83
What is Slipped Capital Femoral Epiphysis?
Gradual or acute separation of the proximal femoral growth plate with femur head slipping off femoral neck and rotating into inferior-posterior position. Most common during puberty and more in overweight individuals, present with a limp and pain recurring often to the kneeLimited hip internal rotation and outward rotation of lump with hip flexionx-ray: epiphyseal displacement
84
FEV1/FVC in Restrictive lung disease
Normal or elevated
85
What has Waxy Casts?
Chronic Renal Failure
86
What are the only Gram-negative diplococci?
Neisseriamoraxella
87
How does a VIPoma present?
Watery diarrhea
88
What are the indications for the Class IB antiarrhythmic?
Decrease AP duration, acute ventricular Arrhythmias, local anesthesia
89
What defines Diarrhea?
\>200 grams of stool per day
90
What defines constipation?
Less than 3 bowel movements per week
91
What defines ALL?
0-15 year old males, bone pain, + PAS stain and +TdT. CALLA antigen positiveT (12;21)
92
What is the MOA of Class IB antiarrhythmic?
Na+ channel blocker
93
What is a Duodenal Ulcer?
Pain 20-30 minutes after eating, relieved with food, caused by H. Pylori infection 80-90% of the time and weight gain
94
What is a Female Pseudohermaphrodite?
XX with LOW 21-OHase and HIGH Testosterone
95
What are the adverse effects of Acid Resins?
Tastes bad and causes GI discomfortbile decreases absorption of fat soluble vitaminscholesterol gallstones
96
What is Hurler's?
Alph-L-Iduronidase deficiencyworse formGargoylismCorneal cloudingaccumulation of Heparin and Dermatan Sulfate
97
What are the indications for fibrates?
Strong decrease of triglyceridesslight decrease of LDLslight increase in HDL
98
What are the classifications of MHC-2?
HLA-DP, HLA-DQ, HLA-DR
99
What is Cori's?
Debranching, a-1,6 glucosidase enzyme deficiencyshort branches of glycogenmilder form of von Gierke with normal lactate levelslimit-dextrin's accumulate
100
How does Choanal Atresia Present?
Baby turns blue with feeding, pinks up when breast of bottle is removed (blocked nasal passages)
101
What is the job of the Proximal Convoluted Tubule?
Reabsorb Glucose, Amino Acids, Salt, Bicarb. \>60-80% Reabsorption occurs here
102
What is Bronchiectasis?
Bad breath, purulent sputum, and hemoptysis
103
What electrolytes does the low volume state have?
Increased total Na+ (NET)Decreased serum Na (dilution effect)Decreased serum K+Increased serum pH
104
In what layers does a pseudo aortic aneurysm occur?
Intima and media layers
105
Who makes the Syncytiotrophoblast?
Mom and baby production of HCG and HPL
106
What is Metorrhagia
Bleeding or spotting in btwn periods
107
How does Spastic Colon present?
Intermittent severe cramps
108
What is selective IgG2 Deficiency?
Seen in patients with recurrent encapsulated infections
109
What diseases have respiratory acidosis?
Obstructive lung diseases
110
What is Prinzmetal's angina?
Coronary Artery Spasm
111
What does high WBC and High PMN's tell you?
Stress demargination. (Stress response - post trauma)
112
What causes a Cleft Palate?
Maxillary shelves did not fuse
113
What is Rouleaux formation?
Seen in Multiple Myeloma (Stacked coin look)
114
What is Neologisms?
New words
115
What is Nephrotic Kidney Disease?
Lostbasement membrange chargeProteinuria \>3.5hypercoagulablelipiduria
116
What does a Phosphatase do?
Removes Phosphate from substrate
117
What bug loves the parietal lobe?
Toxoplasma
118
What bug is associated with Cat Scratch?
Bartonella Henselae
119
What is Selective IgA Deficiency?
Seen in transfusion, anaphylaxis, and mucus membrane infections
120
What is the Trough level?
2 hours before next dose (too high - give less often)
121
What is VHL?
Predisposes individuals to bnign and malignant tumors, AVM in the head, and retina (AD inheritance in Chromosome 3)
122
What causes a Cleft Lip?
Medial nasal prominence did not fuse
123
What is the MOA of Reserpine?
Prevents the storage of monoamines in synaptic vesicle
124
What are the 3 tests used to screen for HIV?
ELISA: Detects IgG Ab to p24 AgWestern Blot: ProteinsPCR: Detects Virus (used in babies)
125
What is Materninty Blues?
Postpartum crying and irritability
126
What are the inidications for PPIs?
Peptic ulcer, gastritis, mid-esophageal Reflux and Zollinger-Ellison syndrome
127
What are the Ca2+ channel blockers?
Verapamil, Diltiazem
128
What is Conn's Syndrome?
High Aldosterone (primary tumor), Cpatopril test makes it worse, and increase's secretin hormone
129
What color is stool with a Lower GI Bleed?
Bright Red Blood (Hematochezia)
130
What is Type 5 Hypderlipidemia?
Defective enzyme and receptor (C-II) Elevated VLDL and ChylomicronsAssociated with DM
131
What is the RBC lifespan when there is a problem?
60-90 days (same time as the shelf life of blood bank units)
132
What sound radiates to the back?
Pulmonic stenosis
133
What is the MOA of Prazosin?
Alpha 1-Blocker, vasodilation, decreases TPR
134
What is Sandhoff's?
Hexosaminidase A/B deficiency
135
What is the MOA of Octreotide (Synthetic analog of Somatostatin)?
Decreases release of GH, Gastrin, CCK, Carcinoid, VUP, Glucagon and Insulin
136
How is Smallpox different from Chickenpox?
Smallpox is on the face, same stage of development and fever
137
What is Diffusion?
From high to low concentration No ATP
138
What are the Fibrates?
Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate
139
What is Anthracosis?
Coal workers, extensive fibrosis
140
What is Conduct Disorder?
Younger than 18 y/o with traits of antisocial disorder: aggressive, disregard for authority/rules, no sense of guilt/remorse, harms animals, illegal activity "bite is worse than bark". Behavioral therapy and antipsychotic
141
What are the names of the B vitamins?
"The Rich Never Lie about Panning Pyrite Filled Creeks"Vit B1 = ThiamineVit B2 = RiboflavinVit B3 = NiacinVit B4 = Lipoic acidVit B5 = Pantothenic acidVit B6 = PyridoxineVit B7 = BiotinVit B9 = FolateVit B12 = Cobalamin
142
What 5 bugs cause heart block infections?
"**D**on't **T**e**LL** **C**haga"
D- Diphtheria
T- Typhoid Fever (Salmonella Typhi)
L- Legionella
L- Lyme Disease
C- Chagas Disease (Whipple's)
143
What is a Complete Abortion?
Cervix is closed, no fetal remnants, check B-HCG level
144
What is a "Blue Bloater"?
Chronic Bronchitis
145
What are the Indications for ACE inhibitors?
HTN, CHF, post MI and vasodilation
146
What is the MOA osmotic Laxatives?
Provide osmotic load to draw water outLactulose treats Hepatic encephalopathy: gut flora degrades it into metabolites (lactic acid and acetic acid) that promote Nitrogen excretion as NH4+
147
What is the treatment for hypercholesterolemia?
Statins
148
What are the adverse effects of Minoxidil?
Hypertrichosis and Pericardial Effusion
149
What are the adverse effects of adenosine?
flushing, hypotension, and chest pain very short acting
150
What are the Glucocorticoid drugs?
Hydrocortisone, Triamcinolone, Dexamethasone, Prednisone, Beclomethasone
151
Whatis Pheochromocytoma?
Adrenal medulla tumor in adults, they will have five P's: Palpitations, Perspiration, Pallor, Pressure (HTN), and Pain (headache)
152
What is Byssinosis?
Cotton workers, textile workers
153
What is Chediak Higashi?
Lazy Leukocyte Syndrome(Lysosomes are slow to fuse around bacteria)
154
What is Korsakoff Psychosis?
Alcoholic Thiamine deficiency. Presents with confusion, Opthalmoplegia, ataxia, memory loss, confabulation and personality changeTx: Vit B1
155
What type of Kidney Stones have Coffin-Lid Crystals?
Triple Phosphate (Struvite)
156
What is the difference between carotid body and carotid sinus?
Carotid Body: ChemoreceptorCarotid Sinus: Baroreceptor
157
What is Meconium?
Green baby poop (first poop)
158
What does Insulin do?
Pushes glucose into cells and K+ follows
159
What causes Granuloma Inguinale?
CalymmatobacteriumGranulomatosisKlebsiella Granulomatis
160
What is the MOA of Carvedilol?
Alpha and B-Blocker
161
What is the MOA of Levothyroxine (T4)/Triiodothyronine (T3)?
Thyroxine replacement
162
What is Anisocytosis?
RBC's with different sizes
163
What is Pain Disorder?
Prolonged pain not explained by physical causes
164
What causes Congenital Blindness?
CMV
165
What is Plummer-Vinson Syndrome?
Esophageal webs, Iron-deficiency anemia, dysphagia
166
What is Neurofibromatosis?
Cafe' au laut spots (hyperpigmentation)Peripheral nerve tumors, axillary frecklesType 1: Von Recklinghausen's-- Chromosome 17, peripheral, optic glioma, Lisch nodules, scoliosisType 2: Acoustic Neuroma, Central, Chromosome 22, cataracts, bilateral deafness
167
What is associated with Strep Viridans, Strep Mutans, and Strep Salivarius?
Subacute bacterial Endocarditis, green pigment, Alpha HemolyticStrep Mutans - dental cariesStrep Salivarius - cold agglutinates
168
What are the adverse effects of Dextromethorphan?
Mild opioid effect so mild abuse potential
169
What is the most common cause of Epididymitis?
Chlamydia Trachomatis, N. Gonorrhea, E. Coli
170
What is Charcot's Triad?
Jaundice, Fever (usually with rigors) and RUQ pain
171
What is seen with Manganese deficiency?
Lose xanthine oxidase function
172
What is Psychogenic Polydipsia?
Drinking a lot of water, diluting Na in blood
173
What is seen in newborns with Syphilis in utero infection?
Rhages (lip fissue), Saber shin legs (anterior bowing of the tibia), Hutchinson's Razor teeth,Mulberry Molars
174
What is the afferent arteriole's job?
Monitor pressure (JG cells-Renin release)
175
How do you detect a Pulmonary Embolus?
Tachypneaincreased V/Q scanECG may show signs of right heart strain or acute cor pulmonale in cases of Large Pes - large S wave in lead I, a large Q wave in lead III and an inverted T wave in lead IIIS1Q3T3
176
What is a frameshift mutation?
Insert or delete any number of bases, not divisible by 3, causes misreading of all downstream nucleotides
177
What is the Isoelectric Point?
The pH at which there is no net charge
178
What does an opening snap tell you?
Mitral or Tricuspid Stenosis
179
What is the rate-limiting enzyme in FA synthesis?
Acetyl-CoA Carboxylase (ACC)
180
What does a Phosphorylase do?
Adds inorganic Phosphate to substrate, No ATP used
181
What is associated with EHEC?
Hemorrhagic = renal failure
182
What are the Bile acid resins?
CholestyramineColestipolColesevelam
183
What is associated with Enterococcus?
UTI, infective Endocarditis post GI/GU procedure
184
What is Voyeurism?
Watching other people without their permission
185
What does CCK (Cholecystokinin) do?
Stimulates bile release and gallbladder contraction, inhibits gastric motility (closes sphincters), and made by I-cell of duodenum
186
What does LDL do?
It carries Cholesterol (only one to do this)
187
What is TORCH Infection?
Toxoplasmosis: Hydrocephalus with generalized intracranial calcification and choriogenesis.Others= HIV, Syphilis, Varicella, B-19HIV= Most infected are asymptomatic, clinical symptoms-- Lymphadenopathy/HepatosplenomegalySyphilis= Osteochondritis and Peridotites; skin rash on palms and soles, snufflesVaricells = Pneumonia (neonatal); limb hypoplasia, cutaneous scar, seizure, MRB-19 = Hydrops FetalisRubella = Cataracts, deafness and heart defects, blueberry muffin spotsCMV = Microcephaly with periventricular calcification, petechia with thrombocytopenia, sensorineural hearing lossHerpes = 1st week: Pneumonia/shock2nd week: Skin vesicles, keratoconjunctivitis3rd week: Acute Meningoencephalitis
188
What does Dopamine (DA) do?
Inhibits Prolactin (PRL) release
189
What is Bipolar II?
Depression and Hypomania (no psychosis)
190
What is the Capacitation reaction?
Allow binding btwn sperm & egg
191
What is associated with Klebsiella Pneumonia?
Alcoholics, Currant Jelly Sputum, UTI, Lung fissures
192
What is the Indication for Demeclocycline?
SIADH
193
What lysosomal diseases have a Gargoyle face?
Gaucher'sHurler's
194
What is a Footling Breech/Incomplete breech?
Butt down. Thigh flexed, one toe is sticking out of the cervical OS
195
What is the MOA of Glitazones/Thiazolidinedione's?
Increases Insulin sensitivity in peripheral tissues. Transaction modulation by Peroxisome Proliferator Activated Receptor Gamma in Nuclus
196
What makes B-HCG?
Placenta (synctiotrophoblast)
197
What does erythropoietin (EPO) do?
Makes RBC's (prolong RBC life)
198
What is Erythrasma?
Rash in the skin folds, coral-red under Wood's Lamp
199
What do stomach chief cells secrete?
Pepsin
200
What are the Adverse Effects of Sulfasalazine?
Malaise, nausea, Sulfonamide toxicity, reversible Oligospermia
201
What are the indications for Class IC antiarrhythmic?
Ventricular tachy progressing to V. fib, last resort
202
What is Tracheomalacia?
Soft cartilage and stridor since birth
203
What is the MOA of Sulfasalazine?
A combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammtory) activated by colonig bacteria
204
What are the Indications for Biguanides?
First line therapy in Type 2 DM
205
What is Choledocholithiasis?
Gallstone obstructs the bile duct
206
What bug loves the frontal lobe?
Rubella
207
What is a Platelet?
The clotter (has no nuclei and smallest cells)
208
How do I know the patient has a Vitamin E Deficiency?
Increased free radical damage, hemolytic anemia, ataxia gait, impaired position and vibration sense
209
What is Pseudohermaphrodite?
external genitalia problem
210
What is Niemann-Pick?
Sphingomyelinase deficiencyAreflexiaHepatosplenomegalyfoam cells (Lipid Laden macrophages)
211
What is Efficacy?
Maximal effect drug can produce regardless of dose (lower w/ non-competitive antagonist)
212
What are the Indications for Alpha-Glucosidase inhibitors?
NIDDM. (Type 2)
213
What type of kidney stones have hexagonal crystals?
Cysteine
214
What does Oxytocin do?
Milk letdown and uterine contractions
215
What is sinusitis?
Inflammation of the paranasal sinuses, tooth pain worsens upon bending forward
216
What is duodenal Atresia?
Bilious vomiting with first feeding, double bubble sign on x-ray, associated with Downs Syndrome
217
What is Multiple Endocrine Neoplasia I?
"Wermer's" 3 P's: Pancreas, Pituitary, Parathyroid adenoma
218
What GI diseases has a RLQ Sausage mass?
Intussusception
219
What is a Dohle Body?
PMN Leukocytosis(caused by infections, steroids, tumor)
220
What does an ejection click tell you?
Aortic or Pulmonic Stenosis
221
What is associated with Clostridium Perfringens?
Holiday ham and turkey - left out on counter and Clostridium jumps on and waits, enterotoxin causes Gastroenteritis, food gets reheated - bug is loving life, DM patients get Gas Gangrene due to the alpha toxin, also found in soil and feces
222
What Is Lesch-Nyhan?
HGPRT deficiencygrout neuropathyself-mutilationDystoniaXLRPrange sand crystals in diaper
223
What is a Bite Cell?
Unstable Hb inclusions (seen in G6PD Deficiency)
224
What is Antisocial Personality Disorder?
Lie, cheat, steal, destroy property, impulsive without remorse, illegal activity, aggressive towards others. Must be over 18 y/o
225
What are the Adverse Effects of Odansetron?
Headache, constipation, dizziness
226
What does Southwestern blot detect?
DNA-binding Proteins (combines south and western blots)
227
What does a paradoxical S-2 split tell you?
Aortic Stenosis or LBBB
228
What is Pre-Eclampsia?
Ischemia to the placenta causes HTN greater than 140/90
229
What is the MOA of FIbrates?
Upregulate LPL, increase triglyceride clearance
230
What is the Crystallization reaction?
Wall formed after one sperm enters to prevent polyspermy
231
What does auscaltation of wheezing tell you?
Intrathoracic narrowing (seen on expiration on x-ray)
232
What are Ideas of Reference?
Believes the media is monitoring you
233
What does the Citrate shuttle do?
FA transport out of the mitochondria
234
What conditions cause weight gain?
Obesity, Hypothyroidism, Depression, Cushing's, Anasarca
235
What does Vit B5 do?
Part of Acetyl-CoA, no known diseases
236
What is Spina bifida aperta?
Has opening (High AFP)
237
What is HELLP Syndrome?
Hepatic injury causing:H- HemolysisEL- Elevated Liver EnzymeLP- Low Platelets
238
What is the MOA of Class IA antiarrhythmic?
Na+ channel blocker
239
What is the fucntion of LH (Luteinizing hormone)?
Stimulates Testosterone release from the testis, Androgens and Progesterone release from the ovary
240
What is the Parasympathetic System?
Rest and digest, slows stuff down
241
When do you see silent thyroiditis?
Post-partum patients
242
What are the adverse effects of Reserpine?
Mental depression
243
What is associated with Paseurella Multocida?
Cat/Dog saliva =\> Cellulits with lymphadenitis
244
What is Gigantism?
Childhood form of Acromegaly
245
What form of Estrogen is highest at Menopause?
E1: Estrone (Made by Fat)E2: Estradiol (Made by the ovaries)E3: Estriol (Made by the placenta)
246
What are the adverse effects of Losartan?
Fetal renal toxicityHyperkalemia
247
What is pulse pressure?
Systolic minus diastolic pressure
248
What is Addison's disease?
Autoimmune destruction of adrenal cortex, causes hyperpigmentation (looks tan), and increased ACTH
249
What is the muscarinic antagonist drug used for asthma?
Ipratropium
250
What is the function of Prolactin (PRL)?
Milk production
251
What is associated with Chlamydia Trachomatis?
Neonatal in-turned eyelashes, Corneal Ulcers
252
How do I know the patient has a Vitamin D Deficiency?
Rickets (children), Osteomalacia (adults)
253
What is Zenker's Diverticulum?
Cough up undigested food from above the UES, Halitosis, motor dysfunction problem
254
What is a Male Hermaphrodite?
XY with no MIF
255
What is Dissociative Fugue?
No past memory at all, even if they see someone from the past - they have no ideaTravel to a new place, usually due to trauma
256
What is an Allograft?
Human to human transplant
257
What are the indications for the Class IA antiarrhythmic?
Increase AP duration, icnrease effective refractory period (ERP) QT interval, affect reentrant and ectopic SVT and ventricular tachy
258
What is Ovarian Hyperstimulation syndrome?
Weight gain and enlarged ovaries after clomiphene use for infertility
259
What is the first generation Sulfonylureas?
Chlorpropamide and Tolbutamide?
260
What is the difference between Myeloid and Lymphoid Leukemia's?
Myeloid: increased RBC, WBC, platelets, macrophages (decreased Luymphoid cells) and bone marrow biopsyLymphoid: increased NK, T, B cells (decreased Myeloid cells) and do lymph node biopsy
261
What are the indications for corticosteroids?
Chronic asthma, COPD
262
What are the acidic amino acids?
Asp, Glu
263
What is the Indication for GLP-1 Analogs?
NIDDM. (Type 2)
264
What does Fremitus, Egophony and Bronchophony tell you?
Consolidation (pathognomonic for pneumonia)
265
What diseases have high eosinophils?
"NAACP"N - Neoplasm (Lymphoma)A - Allergy/ AsthmaA - Addison's disease (no cortisol -relative eosinophilia)C - Collagen Vascular diseaseP - Parasites
266
What does "Penia" tell you?
Low Levels - (Usually due to virus or drugs)
267
What happens with Rubella infections in utero?
Cataracts, hearing loss, PDA, "blueberry muffin" rash (Rash on face that spreads to trunk)
268
What is a complete molar pregnancy?
2 Sperm and no egg (46, XX) both are paternal, bunch of graps, dad eats grapes, no embryo(GROSS!)
269
Where does Testosterone come from?
Adrenal gland and testicles
270
What antibody shows past Hep A infection?
IgG
271
What hepatitis B labs indicate recent immunization within \>2/52wks?
HBsAg+
272
What is Thought Blocking?
Stops mid-sentence
273
What is Chronic Mucocutaneous Candidiasis?
T-cell defect against Candida Albicans and chronic fatigue
274
What is Budd-Chiari
Hepatic vein obstruction
275
What does "Cythemia" tell you?
High levels
276
What are the degrees of Vaginal Lacerations?
1st Degree: Skin2nd Degree: Muscle3rd Degree: Anus4th Degree: Rectum
277
What are the Indications for GH?
GH deficiency in children, Turner syndrome, and Burn victims
278
What does a Kinase do?
Adds Phosphate group to substrate using ATP
279
What will Ranson's criteria tell you and what will you see at 48 hours?
Prognosis of Pancreatitis patients BUN \>5 mg/dL (decreased RBF)Calcium \<8mg/dL (saponification)HCT drops \>10% (bleeding into pancreas)sequester \> 6 liters of fluid (3rd spacing)Oxygen pO2 \<60 mmHg (fluid/protein leak, leads to ARDS)base deficit \>4 mEq/L (diarrhea due to no pancreatic enzymes)
280
What is Cushing's Triad?
HTN, Bradycardia, irregular breathing
281
What is Seborrheic Dermatitis?
Red rash with oily skin and dry flaky hairline, crusty lesion
282
What receptors do Steroid Hormones use?
Nuclear membrane receptors (except cortisol cytoplasmic receptor)
283
What is the MOA of Antileukotriene?
5-lipoxygenase inhibitor -\> inhibits conversion of arachidonic acid to leukotriene -\> prevents bronchoconstriction and inflammatory cell infiltrate
284
What lysosomal diseases have a cherry-red macula?
Tay-sachs, Niemann-Pick
285
What is a Meduloblastoma?
Pseudorosettes compressing the brain, early morning vomiting
286
What antibody shows current Hep A infection?
IgM
287
What does Vit B3 do?
NAD cofactor
288
What are the essential amino acids?
Phynlalanine, Valine, Threonine(PVT)Tryptophan, Isoleucine, Methionine(TIM)Histidine, Arginine, Leucine, Lysine(HALL)
289
What is the Dawn Phenomenon?
Morning hyperglycemia secondary to Growth Hormone
290
What is Hepatorenal Syndrome?
High urea from the Liver leads to: increased Glutaminase, Ammonia, GABA- Kidney shuts down
291
What is Nevus Flammeus?
Port Wine Stain - Permanent- Unilateral of face or neck- Vascular malformation - Sturge - Weber syndrome - Vasculitis- Mgt: Pulsed laser therapy
292
What defines CML?
30-50 y/o females t(9;22)Philadelphia Chromosomebcr-abl
293
What is a Kleihauer-Betke Test?
Detects percentage of fetal blood in maternal circulation (Dilution test)
294
What is Kallmann's Syndrome?
No GnRH and Anosmia. (They can't smell)
295
What are the aromatic amino acids?
Phe, Tyr, Trp
296
What structures have one-way valves?
Urethra and ejaculatory duct
297
How fast should fundal height change?
Uterus grows 1 cm/week
298
What GI disease has an Abrupt Cut off on X-Ray?
Volvulus
299
What is associated with Pseudomonas Aeruginosa?
Otitis Externa, Ecthyma Gangrenosum, loves rubber, Whirlpool Folliculitis, exotoxin (ADP ribosylates EF-2)
300
What is normal blood loss during a Vaginal Deliver?
500 mL
301
What is Achalasia?
Increased LES Pressure (no Auerbach's Plexus), Bird's Beak on X-Ray and also seen in Chagas Disease
302
What are the most common causes of Oligohydramnios?
Abdominal Muscle Problem: Prune Belly Renal Agenesis: Potters Syndrome
303
What causes anterior leg bowing?
Neonatal syphilis
304
What are the Intravascular Hemolytic Anemias?
IgM G6PD deficiencycold autoimmune
305
What are the adverse effects of the Class IA antiarrhythmic?
Quinidine: CinchonismProcainamide: Torsades de Pointes
306
What does Trypsin cut?
Arg, Lys
307
What is a Dandy Walker malformation?
No cerebellum, distended 4th and lateral ventricles
308
What is Synesthesia?
Smells colors
309
Where is a Bochdalek Hernia?
Occur more commonly on the posterior left side (diaphragm), most common congenital Diaphragmatic Hernia (CDH)
310
What is Menetrier's Disease?
Loss of protein through the rugal folds. Causes generalized edema. CMV association in children and H. Pylorus in Adults
311
What is a True Hermaphrodite?
Internal genitalia problem (has both sexes)
312
What gives urine its yellow color?
Urobilinogen being oxidized to urobilin
313
What is a Schistocyte?
Broken RBC (seen in DIC and artificial heart vlaves and others)
314
What does vasoactive intestinal peptide (VIP) do?
Inhibits secretin, motilin, and CCK, and opens Sphincters
315
What are the adverse effects of Digoxin?
Cholinergic, ECG: icnrease PR, decrease QT worsened by renal failureQuinidine displaces Digoxin from tissue binding sites
316
What is Amnesia?
Can't recall important facts
317
What is Type A gastritis?
Upper GI bleed, autoimmune (anti-parietal cell antibodies), Atrophic / Achlorhydria and increased risk for adenocarcinoma (body & fundus region of the stomach)
318
What organ has the highest AVO2 difference after a meal?
GI tract
319
What is Inflammatory Carcinoma?
Infiltrates Lymphatics, pulls on Cooper's Ligaments "Peau d'Orange"
320
What is associated with Propionibacterium acnes?
Acne, Progesterone =\> Propionic acid
321
What type of immunity does TH2 provide?
Enhances humoral immunity
322
What is Multiple Myeloma?
Male \>40 with lower back painSerum M protein (IgG)Bence-Jones Proteins in the urineRouleaux formationPunched out lesions on x-ray
323
What is the function of TRH?
Stimulates TSH release
324
What are some causes of G6PD Deficiency?
Sulfa drugs, mothballs, fava beans, sudden drop in Hb
325
What is Erythema Toxicum?
White wheal on red area rash has Eosinophils
326
What is Pseudocyesis
Fake pregnancy with all the signs and symptoms
327
How does Herpes present?
Primary: Painful grouped vesicles on red baseSecondary: Painful solitary lesion
328
What is squamous cell CA?
Seen in smokers, high PTH and Ca2+
329
What is the cell-mediated immune response?
T-cells and Macrophages patrol the tissues looking for non-bacteria
330
What is a Thyrotrope?
TSH
331
What is seen / causes in Aplastic Anemia?
PancytopeniaAutoimmuneBenzeneAZTChloramphenicolRadiation
332
What is the function of CRH?
Stimulates ACTH release
333
What is the Gram Positive Capsule?
S. Pneumonia
334
What does Thyroid Peroxidase (TPO) and Thymosin do?
Help T-cells mature
335
What is the rate-limiting enzyme in Heme synthesis?
Delta-ALA Synthase
336
What is Borderline Personality Disorder?
"Perpetual Teenager", splitting (love/hate), projection, acting out, self-mutiliation, unstable relationships, impulsive
337
What does Rh+ tell you?
Has D Antigen
338
Can you die during ETOH withdrawal?
Yes
339
What Kidney complications can Lithium cause to the person taking the drug?
Destroy the collecting ducts V2 aquaporin receptors, causing Nephrogenic DI
340
What is a Biophysical Profile (BPP)?
By US look for:Non-stress testAFIFetal heart toneFetal ActivityBreathing Movement
341
What do you see in Grave's Disease?
Exophthalmos, Pretibial myxedema, anti-TSH receptor antibodies
342
What bug loves the hippocampus?
Rabies
343
What diseases have metabolic acidosis?
"MUDPILES" and diarrhea
344
What unstable angina?
Pain at rest (transient clots MCC)
345
What is a Pinealoma?
Loss of upward gaze, loss of circadian rhythms lead to precocious puberty
346
What does THF donate methyl groups for?
Nucleotides
347
What is the MOA of Misoprostol?
PGE1 analog, increase production and secretion of gastric mucous barrier, decreased acid production
348
What is Lichen Sclerosis?
Paper like vulva, itching, CA risk
349
What is an Eosinophil?
The parasite destroyer and allergy inducer
350
What is seen in Paroxysmal Cold Auto Autoimmune?
Bleeds after cold exposure Donath-Landsteiner Ab
351
What does the E Ag tell you?
Transmissibility/ Infectivity
352
What is Intussusception?
Currant Jelly Stool, Stacked Coin Enema, sausage shaped mass and knees to chest for comfort
353
What is Type 1 Hyperlipidemia?
Defective Liver Lipoprotein Lipase (chylomicrons are elevated)
354
What is Uterus Rupture?
Tearing sensation, halt of delivery
355
What is associated with (PCP) Pneumocystis Carinii pnemonia?
AIDS and preemies, rusty sputum, silver stains the lungs, increased LDH, Treat with steroids
356
Why do pregnant women get Anemia?
Due to the dilution effect: RBC rises 30%, but body volume rises 50%
357
What is associated with Vibrio Cholera?
Rice Water Diarrhea, ADP- Ribosylates Gs = High cAMP, Turning the on... on
358
What vessel has the highest compliance?
Veins
359
What is the smallest amino acid?
Gly
360
What is a point mutation?
Changes one base
361
What are Esophageal Varices?
Due to Portal HTN, vomit large amounts of blood when they rupture
362
What is MGM?
BM spikes, granular/linear supepithelial spikes and closes
363
What type of kidney stones have Rosette Crystals?
Uric acid
364
What is Multiple Endocrine Neoplasia II (2A)?
"Sipple's" Pheochromocytoma, Medullary Carcinoma of the Thyroid, Parathyroid Adenoma. (tumor marker RET)
365
What are Spur Cells / Acanthocytes?
Lipid bilayer disease
366
How does Irritable Bowel Syndrome (IBS) present?
Alternating diarrhea/ constipationHistory of stressNo abnormalities on colonoscopy
367
What is Creutzfeldt-Jakob?
Prion induced disease, death within 1 year, post cornea transplant
368
What bug causes Acute Bacterial Endocarditis?
Staphylococcus aureus (attacks healthy valves)
369
What are the spore forming Gram-positive bacteria?
BacillusClostridium
370
What is the function of B-HCG?
Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)
371
What disease has Iridocyclitis?
Juvenile TA
372
What is the Rapid Acting Insulin drug?
Regular Insulin
373
What are the Class IB antiarrhythmic?
Lidocaine, Mexiletine, Tocainide
374
What is Sarcoma Botryoides?
Vaginal CA, looks like a ball of grapes
375
What is Hidradenoma?
Sweat gland cysts
376
What is Variable Deceleration?
Cord Compression
377
What is a Traction Diverticulum?
Out pouch between the UES and LES
378
What are the adverse of Methyldopa?
Sedation and Hemolytic Anemia(+) Coombs test
379
What is Intellectualization?
Act like a "know it all" to avoid feeling situational emotions, gets all information available to be over-informed
380
What bugs cause Monocytosis?
"STELS"S - SyphilisT - TBE - EBVL - ListeriaS - Salmonella
381
What is Spina bifida occulta?
Covered by skin with a tuft of hair
382
What is PKU?
No Phe -\> Tyr (via decreased Tetrahydrobiopterin Cofactor or decreased Phe Hydroxylase)NutraSweet (Aspartame) sensitivitymental retardationpaleblond hairblue eyesmusty odor
383
What is Wright's Stain?
Detects nucleated fetal RBC in mom's vagina
384
What is Hemophilia A?
Defective Factor VIII (\<40% Activity)Bleed into cavities (head, abd, etc)
385
What hepatitis B labs indicate infectious state?
HBeAg+
386
What organ has the highest AVO2 Difference at rest?
heart
387
What is Narcissistic Personality Disorder?
Pompous, no empathy, thinks they deserve everything
388
What does a Carboxylase do?
Transfers CO2 groups with the help of Biotin
389
What does Indirect Coombs Test tell you?
The Antibody is freely circulating in the serum
390
What are the ACE inhibitors?
Captopril, Enalapril, Fosinopril, Lisinopril
391
What does the Carnitine shuttle do?
FA transport into the mitochondria
392
What are the Adverse Effects of Glucocorticoids?
Iatrogenic Cushing's syndrome. (Adrenal insufficiency when drug stopped after chronic use)
393
What is the function of HPL?
Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)
394
What is Thought Insertion?
Believes that others are putting thoughts into his head
395
What is Benign Positional Vertigo?
Sensation of room spinningNausea/VomitingNystagmus without hearing loss or tinnitusOnset of symptoms when change position
396
What is Inflammatory Diarrhea?
Diarrhea with blood and pus
397
What does a mutase do?
Relocates a functional group within a moleculre (intrachain)
398
What is Gaucher's?
Glucocerebrosidase (Beta-Glucosidase) deficiencywrinkled tissue Macrophage'sBone painpancytopenia
399
What are the Indications for Octreotide?
Acromegaly; Glucagonoma; Insulinoma; Carcinoid Syndrome
400
What causes non-bacterial Fetal infections?
"TORCHST- ToxoplasmaO - Others (HIV, Measles, B-19)R - RubellaC - CMVH - HSV-2S - Syphilis
401
What are the adverse effects of the Class IB antiarrhythmic?
CNS stimulation and depressionCardiovascular depressionHyperkalemia increases toxicity
402
What is Sublimation?
Where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior
403
What is Phimosis?
Foreskin scarred at penis head
404
How do I know the patient has a Vitamin C (Ascorbic Acid) Deficiency?
Scurvy
405
What defines CLL?
50+ y/o males with lymphadenopathysoccer ball nucleiPresent with autoimmune Hemolytic anemia
406
What does Vit B12 do?
Cofactor for HMT & MMA
407
What GI disease has an Apple Core on X-Ray?
Colorectal Cancer
408
What are Burr Cell/ Echinocyte?
Seen in Pyruvate Kinase deficiencyLiver diseasePost splenectomy
409
What does a Synthetase do?
Consumes two substrates, uses ATP
410
What is a silent mutation?
Changes leave the same amino acid
411
What does blood type AB tell you?
Have both Antigens (universal recipient)
412
What are the adverse effects of Diazoxide?
Hypoglycemia (reduces insulin release) and hypotension
413
What is Delusion?
Fixed false belief for more than one month and no effect to his normal livingTx: Atypical antipsychotic and psychotherapy
414
How do you know it's an anaerobic infection?
gas and bad odor
415
What is SHeehan Syndrome?
Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk
416
What is the most common eye infection in New Born
First day - Clear discharge due to Silver NitrateFirst week - Gonorrhea (purulent discharge)Second week - ChlamydiaThird week - Herpes
417
What is Cystic Fibrosis?
Defective chloride transportermeconium ileussteatorrheaBronchiectasisChromosome 7
418
What is the MOA of adenosine?
Increase K+ efflux, hyperpolarizes the cell
419
What does Vit C do?
Collagen synthesisantioxidanthelps absorb FE++, necessary for Dopamine & hydroxylase for NE
420
What is assocaited with H. Pylori?
95% causative agent in Duodenal Ulcers
421
What organs have the most CD4 receptors?
Blood vesselsbraintesticlescervixrectum
422
What is the RBC normal lifespan?
120 days
423
What is a Somatotrope?
Growth hormone
424
What is Separation Anxiety Disorder?
Kid screams when mom leaves
425
What are the adverse effects of H2 blockers?
Prolactin release: Gynecomastia, decreased libido, impotence in malesCimetidine inhibits P450
426
What are Fibroids (Leiomyoma's)?
Benign uterus smooth muscle tumorsubmucosal type: they bleedSubserosal type: they cause pain
427
What is Metabolic Syndrome X?
"Pre-DM" due to HTN, Dyslipidemia, Hyperinsulinemia, and Acanthosis Nigricans
428
Which cells express MHC-2?
Antigen presenting cells (macrophages, dendritic cells, and neutrophils)
429
What is Non-competitive Inhibition?
Binds a regulatory site, no change in Km, Efficacy decreases, decreased Vmax
430
What is Fifth's disease?
Erythema Infectiosum "Slapped Cheeks"B-19 ParvovirusAplastic anemia, in sickle cell patientsHydrops Fetalis
431
What are the adverse effects of Nesiritide?
Hypotension
432
What are the adverse effects of Class IC antiarrhythmic?
Prolongs refractory period in AV node Hyperkalelmia increases toxicity
433
What is a Basophil?
The allergy helper (IgE receptor - histamine release)
434
What is SCID?
No Thymus (no T-cells)frayed long bones (no B-cells)baby dies by 18 months
435
What does the Macula Densa do?
Measures osmolality (osmoles of solute-kg)
436
What type of people does Hep E like to infect?
Pregnant women (3rd trimester), Asians
437
What is Lobular Carcinoma?
Cells line up single file, contralateral breast is primary site of CA
438
Which stage of the Menstrual Cycle has the highest Estrogen levels?
Follicular stage (Has proliferative endothelium)
439
What is seen in Sickle Cell Anemia?
Crew-cut on x-rayAvascular Necrosis of femur
440
What is Croup?
Respiratory condition that is usually triggered by an acute viral infection of the upper airway, steeple sign on x-ray, barking cough
441
What do T cell deficiency patients die of?
Viral infections, fungal, etcexcept bacterial
442
What can high Cholesterol Cause?
Atherosclerosis
443
How do tension headaches present?
"Band-like" pain starts in posterior neck, increases throughout the day, sleep disturbance
444
What are the Big Mama Anaerobes?
Bacteroides fragilisStreptococcus BovisC. MelanagosepticusC. Diff
445
What is Vascular "multi-infarct" dementia?
Sudden onset, uneven progression of deficits, "stair step" decline
446
What is Cephalohematoma?
Bleeding under bone (blood does not cross suture lines)
447
What bugs cause hospital abscesses?
Day 1-3: S. Aureus (lots of O2 present)Day 4-7: S. Viridans - no enzymeDay \>7: Anaerobes - PMN's
448
What is a Paranoid Personality Disorder?
Suspicious about everything, they use projection
449
What is Selective Mutism?
Kid talks sometimes
450
What is Schizotypal Personality Disorder?
"Magical Thinking", odd/bizarre behavior, people leave them alone because they are weird but they will interact if approached. Brief psychotic episode
451
What is Menorrhagia?
Heavy menstrual bleeding
452
What causes Syphilis?
Treponema Pallidum (Spirochete)
453
What is the only Gram-positive Endotoxin?
Listeria
454
What are the Adverse Effects of Misoprostol?
Diarrhea; Contraindicated in women of childbearing potential abortion inducing drug
455
What is EC50?
Concentration of drug that produces 50% of maximal response
456
What is Oppositional Defiant Disorder?
Breaking the rules, defiant, noncompliant, resists authority, "bark is worse than bite". Teach appropriate child management skills
457
What is Virilization?
Female that is Man like
458
What are the Microcytic Hypochromic Anemias?
Defect in Hb synthesis (RBC small and pale) "FAST lead"F - Fe DeficiencyA - Anemia of Chronic DiseaseS - Sideroblastic AnemiaT - Alpha and Beta Thalassemia'sL - Lead poisoning
459
What organ has the highest AVO2 difference during a test?
Brain
460
What is associated with Staph Saprophyticus?
Seen in young girls / women who became sexually active, E. Coli is still the #1 cause of UTI's
461
What is an Ependymoma?
Rosettes present in the 4th Ventricle, Hydrocephalus
462
What is Zellweger's?
Neonatal Seizures
463
What does Atrial Natriuretic Peptide do?
Inhibits aldosterone and dilates the afferent arteriole
464
What is the most common type of Gallstone?
Cholesterol stone (not see on X-ray)
465
What is associated with N. Gonorrhea?
Pili, Urethritis, Tenosynovitis, Septic arthritis
466
What is a Xanthoma
Cholesterol build up (common at the elbow or Achilles tendon)
467
What is Berylliosis?
Radio, TV repair, aerospace manufacturing, Beryllium mining, or manufacturing of fluorescent light bulbs
468
What are the indications for Guaifenesin?
Minor upper respiratory tract infections, common cold w/ cough
469
What diagnosis has secondary hyperparathyroidism?
Renal failure
470
How does Chancroid present?
Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)"School of Fish" pattern
471
What is Placenta Abruptio?
Severe pain due to premature separation of the placenta
472
What produces Currant Jelly Sputum
Klebsiella
473
What are the IgA protease bugs?
S. PneumoniaeH. InfluenzaM. Catarrhalis
474
What are the GLP-1 Analog drugs?
Exenatide and Liraglutide
475
What bug is associated with cat pee?
Toxoplasmosis
476
What does PTH do?
Stimulates osteoblast to activate osteoclasts, stimulates the reabsorption of Ca+ and the excretion of phosphate in the kidneys, and activation of vitamin D
477
What is FSGS?
Most common in IVDA, AA, Hispanics and HIV patients
478
What is the only statin to undergo renal excretion?
Pravastatin
479
What does hyperresonance tell you?
Air in that region of the lungs`
480
What has WBC Casts ONLY?
Pyelonephritis
481
What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?
Selective B1-Blockers
482
What is the MOA of PTU and Methimazole?
Inhibits peroxidase enzyme in Thyroid and Decreases synthesis of Thyroid Hormones
483
What is associated with Corynebacterium Diphtheriae?
Chinese letters under microscope, gray Pseudomembrane, heart block, suffocation = death, ADP Ribosylates EF2, Elek's Test
484
What is Epididymitis?
Unilateral scrotal pain decreased by support
485
What is the Adverse effect of Biguanides?
Lactic Acidosis (Contraindicated in renal failure) Stop use in patients undergoing studies using contrast
486
What is the Autonomic Nervous System?
Automatic stuff... i.e. breathing, heartbeat
487
What causes Neonatal Blindness
Chlamydia
488
What is Eclampsia?
HTN with seizures
489
What is Condylomata Lata?
Flat fleshy warts, ulcerate = secondary syphilis
490
How much weight should a woman gain during Pregnancy?
1 lb/ week
491
What is Obsessive-Compulsive Personality Disorder?
Perfectionist, doesn't show feelings, detail oriented, uses isolation
492
Which cytokine is released when a macrophage is activated?
IL-1
493
How does an epidural hematoma present?
Intermittent consciousness (lucid interval)
494
What has a friction rub while holding breath?
Pericarditis
495
What does biotin donate methyl groups for?
Carboxylation
496
What is associated with H. Influenzae?
Gram-negative Pleomorphic Rod, Factors V and X, 5 carbon Ribose capsule, HiB type causes Meningitis, Epiglottitis, and Sepsis
497
What is Tuberous Sclerosis?
Ashleaf spots (hypopigmentation)Primary brain tumorsHeart RhabdomyolysisRenal cell CAShagreen spots (leathery)
498
What is Vernix?
Cheesy baby skin. (protects the baby's skin from the outside world and helps with passage through the birth canal)
499
What is Postpartum Depression?
Depression post-delivery for more than 2 weeks
500
What does Vit B1 do?
Dehydrogenasestransketolase (PPP)cofactors
501
What does DES taken by Mom cause in her Daughter?
Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions
502
What are the Osmotic Laxatives?
Magnesium hydroxide, mag citrate, polyethylene glycol, Lactulose
503
What diseases have metabolic alkalosis?
Low volume state: vomiting, diuretics, GI blood loss
504
What are the Class IA antiarrhythmic?
Quinidine, Procainamide, Disopyramide
505
What bacteria cause diarrhea \<8 hours after introduction?
"CBS"C - ClostridiumB - Bacillus CereusS - Staphylococcus aureus
506
What is Maple Syrup Urine disease?
Defective metabolism of branched aa (Leu, Iso, Val) -\> aa leak out, urine smells like Maple syrup/ burnt sugar, defect of branched chain alpha Keto acid Dehydrogenase
507
What is Milia?
Neonatal white or pale yellow heads on malar area
508
What is Toxoplasmosis?
Multiple ring enhancing lesions, loves parietal love, from cat urine and feces
509
What is Apocrine?
Apex of the cell is secreted
510
What states have increased Estrogen?
Pregnancy, liver failure, P-450 inhibition, and obesity
511
What are the adverse effects of Pseudoephedrine, phenylephrine?
HTN, CNS stimulation/ anxiety
512
What is von Gierke?
G-6 Phosphatase deficiencysevere fasting hypoglycemiahepatomegalyincreased lactase and uric acid levels
513
What hormones produce Basophila?
"B FLAT": Basophils, FSH, LH, ACTH, and TSH
514
What is Huntington's?
Occurs in the caudate/putamen, Trinucleotide repeat disorder (Chromosome 4, CAG), choreiform movements, changes in personality, anticipation
515
What is Oligomenorrhea?
Too few periods
516
What bug loves the temporal love?
HSV
517
What is an Encephalocele?
Brain tissue herniation
518
What is Karyolysis?
Nucleus dissolves
519
What is Dysfunctional Uterine Bleeding?
Diagnosis of exclusion, usually due to anovulation
520
What has a friction rub while breathing?
Pleuritic
521
What is Hemochromatosis?
Fe deposit in organs
522
What is an Acute Rejection?
Occurs 4 days to months later. T-cell and macrophage response
523
What are the indications for Methyldopa?
HTN
524
What does secretin do?
Secretion of bicarbonate, inhibit gastrin, tighten Pyloric Sphincter, and secreted by S-cell Duodenum
525
When does Implantation occur?
1 week after fertilization
526
What is Comedocarcinoma?
Multiple focal areas of necrosis (blackheads) DCIS
527
What is Vestibular Neuritis?
Inflammation of the vestibular portion (CN8), Could be associated with viral infection, characterized by vertigo and dizziness
528
What is the MOA of Potassium on the heart?
Depresses ectopic pacemaker in hypokalemia
529
What is a Nephroblastoma?
Abdominal mass due to enlarged "Wilm's Tumor", hemihypertrophy and Aniridia
530
What is the most common cause of delayed speech developement?
Hearing loss
531
What is the Peripheral Nervous System?
Everything except the brain and spinal cord. Myelination by the schwann cells
532
What is Imitation?
Replicating another's behavior
533
What is Cholelithiasis?
Formation of gallstones
534
What is the most common cause of Vaginal Bleeding in Post-menopausal women?
Endometrial CA
535
Can you die during Opiod Withdrawal?
No, just very painful
536
What are the symptoms of Amniotic Fluid Emboli?
Mom just delivered Baby and mom has SOB, due to PE, leads to death
537
What is Nephritic Kidney Disease?
Inflammation with protein loss \<3.5 in urineIncreased size of Fenestrations, RBC casts, HTN
538
What is your maximum heart rate?
220 minus the person's age
539
What are the indications for Reserpine?
HTN
540
What is seen in Calcium deficiency?
Poor bone and teeth development
541
What is Eisenmenger's Syndrome?
Physiological shunt from left to right now changes right to left
542
What are some PPIs?
Omeprazole, Lansoprazole
543
What kind of Patients does Staph and Pseudomonas like to attack?
DM, CF, Burn Patients, Neutropenic patients
544
What does a Transferase do?
Relocates a functional group from one molecule to another
545
What is associated with P. Mirabilis?
Staghorn Calculus, UTI, Urease Positive, Treat with Norfloxacin
546
What is Emphysema?
Obstructive diseaseAlpha-1-antitrypsin deficiency
547
What is PSGN?
Most common in kids. Subepithelial humps (IgG/C3/C4 deposition) lumpy bumpy on EM and ASO antibodies
548
What is Sixth's DIsease?
Roseola, Exanthema Subitum (fever disappears then rash appears)
549
What is a Lymphocyte?
The warrior - T, B, and NK cells
550
What disease has a "3" shape on x-ray?
Coarctation of the aorta
551
What is MPGN
Tram tracks seen (Type II has low C3) on LM
552
What is Peutz Jegher Syndrome?
Hyper-pigmented lower lip, patients will have dark gyms and vagina, and small bowel polyps
553
What is Chronic Granulomatous Disease?
NADPH Oxidase deficiency - they have recurrent Staph / Aspergillus infections (Nitro-blue Tetrazolium Stain Negative) or Dihydrorhodamine flow and Cytometry test
554
What is Type 2B Hyperlipidemia?
Deficiency of adipose receptors and LDL receptors (Increased LDL and VLDL levels)
555
What is the MOA of Nitroprusside?
Direct release of NO, increases cGMP, vasodilator
556
What is a Tear Drop Cell/ Dacrocyte?
RBC's squeezed out of bone marrow. (Seen in Hemolytic Anemia and bone marrow CA)
557
What is Decreased beat-to-beat variability?
Acidemia
558
What does Gastric Inhibitory Peptide (GIP) do?
Increases insulin action, responsible for post-prandial hypoglycemia
559
What is the difference between norepinephrine and epinephrine?
NE: NeurotransmitterEPI: Hormone
560
What are the adverse effects of ACE inhibitors?
Hyperkalemia, cough, angioedemacontraindicated in pregnancy (fetal renal malformations)
561
What is Cataplexy?
Loss of muscle tone due to strong emotions
562
What does dullness to percussion tell you?
Something between the airspace and chest wall absorbing sound, can be solid or fluid
563
What hepatitis B labs indicate a chronic carrier state?
HBsAg+, (\>6 months), HBsAb (+/-)
564
What are the Diastolic Blowing murmurs?
Aortic regurgitation, pulmonic regurgitation
565
What is the MOA of Isoproterenol?
Non-specific, Beta-agonists;relates bronchial smooth muscle (B2)
566
What does Exocrine mean?
Secreted into a duct
567
What is Apoptosis?
Programmed cell death, no inflammation, and cell membrane dissolved first. Nucleus guides death & destroyed last
568
What are theh Renin-angio system effectors?
ACE inhibitors and ARBs
569
What are the most common symptoms of the Low Energy State?
Weakness and SOB
570
What is Reynold's Pentad?
Jaundice, Fever (usually with Rigors), RUQ Pain, Hypotension and change in mental status
571
What does Ca2+ do?
Neuronal function, atrial depolarization, smooth muscle contractility
572
What diseases have Granulomas?
"HiTTSS"Hi - Histiocytosis XT - TBT - The -Ella'sS - SarcoidosisS - Syphilis
573
What is a Complete Breech?
Butt down, thighs, and legs flexed
574
What is Grey-Turner's Sign?
Bleed into Flanks and caused by Hemorrhagic Pancreatitis (early signs)
575
What is associated with Francisella Tularensis?
Ulcers at rabbit or deer tick bite siteRx: Streptomycin
576
What is associated with Bartonella Henselae?
Cat Scratch = Single painful lymph node, Stains silver
577
What is Avoidant Personality Disorder?
Socially withdrawn, afraid of rejection but wants to fit in
578
What is a Sister Mary Joseph Nodule?
Ovarian CA that has spread to the umbilicus(Also GI cancers can cause) (Indicates metastasis)
579
What does the Core Ab tell you?
Past infection
580
What is associated with Clostridium Melangosepticus?
Colon CA
581
What is a Neuroblastoma?
Adrenal medulla tumor in kids, dancing eyes and feet and secretes catecholamine's
582
What are the inidcations for Cromolyn?
Asthma prophylaxis
583
What is Rationalization?
Make excuses for behavior in advance, (because of...)
584
What are the indications for Nesiritide?
Acute decompensated heart failure
585
How do you measure afferent renal function?
Creatinine or Inulin
586
What is a Spherocyte?
Old RBC
587
What is Thought Broadcasting?
Believes that everyone can read his thoughts
588
What is associated with Chlamydia psittaci?
Parakeets and Parrots are the carrier agent
589
What does high WBC and \>5% Blasts tell you?
Leukemia
590
What does a high WBC and \<5% Blasts tell you?
Leukemoid reaction - seen in burn patients or any extreme stress (extreme demargination looks like Leukemia), Metamyelocytes =\> Myelocytes
591
What is Displacement?
Take anger out on an object or someone else. Not related with situation
592
What is Turcot's Syndrome?
Familial Polyposis with Brain Tumors
593
What is Central Pontine Myelinolysis?
This happens when you correct serum sodium faster than 0.5 mEq/hr. (infarct the PONS- patient can only blink)
594
How does trigeminal neuralgia (Tic Douloureux) present?
Sharp, shooting face pain, recurrent episodes
595
What does an AFI \<5 indicate?
Oligohydramnios (Cord compression)
596
What is the rate-limiting enzyme in Glycogenesis?
Glycogen Synthase. Occurs in the Cytoplasm of Liver and muscle
597
What is Bronze diabetes?
Fe deposit in pancreas
598
What does Aldosterone do?
Reabsorbs Na+ and three waters
599
What is Chronic Pelvic Pain?
Endometriosis until proven otherwise
600
What is Late Deceleration?
Due to uteroplacental because the placenta cannot provide oxygen and nutrients
601
What are the CSF lab values for Meningitis?
PMN's -\> BacteriaT cells / Macrophages -\> Non-bacterialNormal Glucose -\> Viral
602
What is the Clotting Cascade?
The cascade that stops you when you bleed
603
What is the MOA of Statins?
Inhibit HMG CoA reductase
604
What are the Holosystolic murmurs?
Tricuspid RegurgMitral RegurgVSD
605
What is Stage 1 of Labor?
Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm
606
What are the Vasculitis associated with LOW C3?
"PMS in Salt Lake City"Post-Strep GNMembranoproliferativeGlomerulonephritis Type IISub Bacterial endocarditisSerum SicknessLupusCryoglobulinemia
607
What is the MOA of albuterol?
B2 agonist; relaxes bronchial smooth muscle
608
What is Factitious?
Fake illness to get attention, seeks medical treatment, have a lot of medical knowledge.Tx: Supportive psychotherapy
609
What is Condyloma Acuminata?
Verrucous "cauliflower" warts, koilocytes, due to HPV 6 and 11
610
What is Osmotic Diarrhea?
High osmolality in the bowel pulling water into the lumen
611
What defines Hodgkin's Lymphoma?
EBV and may have Reed-Sternberg cells
612
What is Hemolytic Disease of the Newborn?
Rh+ mom's blood mixes the Rh- fetal blood in first pregnancyNo risk to this childAll pregnancies to follow will be a risk, leading to a fetal demise
613
What is associated with Chlamydia Pneumonia?
Staccato coughing, parasite with DNA and RNAs:Elementary body (Infectious phase) Reticulate Body (resting phase - can't divide)
614
What is the only Gram-positive Diplococci?
Streptococcus Pneumonia
615
What is the humoral immune response?
B-cells and PMN's patrol the blood looking for bacteria
616
What are the Adverse Effects of Infliximab?
Respiratory infection (including reactivation of latent TB) fever, hypotension
617
What are the indications for HMG-CoA reductase inhibitors?
Strong decrease LDLDecrease TriglyceridesIncrease HDL
618
What does a Galactokinase deficiency cause?
Cataracts
619
What is the most common extracellular buffer?
Bicarb
620
What is associated with Bacillus Cereus?
Fried rice syndrome, preformed toxin
621
What is Compensation?
Doing something different of what you used to do
622
What is the color of air on X-ray?
Black "radiolucent"
623
What stage of the menstrual cycle has the highest Temperature?
Ovulatory stage, body temp will rise One degree during ovulation
624
What bug loves the DCML tract?
Treponema
625
What are the indications for 2nd generation H1 Blockers?
Allergies
626
Who Makes the Trophoblast?
Baby
627
Waht is the rate-limiting enzyme in Cholesterol syntesis?
HMG CoA Reductase
628
What makes an adequate sputum sample?
\<10 epithelial cells and \>25 leukocytes per low power field
629
What are the indications from Magnesium?
Effective in Torsades and Dig toxicity
630
What are the adverse effects of Salmeterol?
Tremor and arrhythmia
631
What is the indication for Isoproterenol?
Bronchoconstriction due to sympathetic tone
632
What is Pathological Gambling?
Can't stop gambling, affects others
633
What is the sign of a Clavicle Fracture?
Asymmeteric Moro reflex
634
What is an Astrocytoma?
Rosenthal fibers - #1 in kids with occipital headache
635
What is Heavy Chain Disease?
Increased IgA
636
What GI disease has a Bird's Beak on X-Ray?
Achalasia (Think Chagas disease)
637
What is Carcinoid syndrome?
Flushing, wheezing, diarrhea
638
What are the Indications for Glitazones/Thiazolidinedione's?
NIDDM. (Type 2)
639
What is Polycystic Ovarian Syndrome?
Increased cysts. No ovulation due to no Progesterone, leads to increased Endometrial CA, they cannot inhibit LH, obese, hairy, acne
640
What is the CBC for every basculitis?
Decreased: RBC and plateletsIncreased: WBC, T-Cells, Monocytes, Schistocytes, ESR
641
What is associated with Mycoplasma Pneumoniae?
Bullous myringitis, Ground Glass CXR, P-1 Protein, Erythema Multiforme
642
What are the risk factors for Primary Liver Cancer?
Hepatitis B & C, Aflatoxin, Alcohol, Smoking and Hemochromatosis
643
What are the Pyrimidines?
C, U, T
644
What are the Adverse Effects of Desmopressin (DDAVP)/ADH?
Over hydration and allergic reaction
645
What is a Sliding Hiatal Hernia?
Fundus of the stomach herniates through the Esophageal Hiatus into the Thorax
646
What is t1/2?
Half-life, the time it takes the body to use half of the drug ingested
647
What is the job of the early distal tubule?
Concentrate urine by reabsorbing NaCl
648
What is the thyroid hormone levels during Pregnancy?
Increased TBG - leads to increased total T4 (Bound and free)
649
What is seen with Varicella (Chickenpox)?
Red macule clear vesicle on red dotPus and scabbingvarious stages of healing
650
What is Cabot's Ring body?
Seen in Vitamin B12 Deficiency and lead poisoning
651
What is intra-Renal Failure?
Damaged Glomerulus or tubules; BUN: Creatinine Ratio \<20/1
652
What is Tetralogy of Fallot?
Overriding aorta: Aorta sits on intraventricular Septum giving rise to a VSD, this in turn causes Pulmonary Stenosis and ultimately right heart failure (boot shape x-ray)
653
What organs do not require insulin to absorb glucose?
"BRICKLE": Brain, RBC, Intestine, Cardiac / Cornea, Kidney, Liver and Exercising muscle
654
What receptors do Protein Hormones use?
Cell membrane receptors
655
What is an Esophageal Atresia with a TE Fistula (C-Type)?
Baby vomits with first feeding, large gastric bubble and distended abdomen (failure of apoptosis)
656
What is Metachromatic Leukodystrophy?
Arylsulfatase A defieciencychildhood multiple sclerosis with Ataxia/Dementiaaccumulation of Cerebroside Sulfate
657
What are the catabolic pathways that create energy? (Occur in the Mitochondria)
Acetyl-CoA production, Beta-oxidation, citric acid cycle, Ketogenesis, Ox Phos
658
What are Plasma Neoplasms?
They produce many antibodies
659
What does the Direct Coombs Test tell you?
ANtibody on surface (seen in hemolytic anemia)
660
What are the Adverse Effects of Metoclopramide?
Increased Parkinsonian effects, restlessness, drowsiness, fatigue, depression, nausea, diarrheaDrug interaction with digoxin and diabetic agentscontraindicated in small bowel obstruction
661
What does Glucagon do?
Active in Gluconeogenesis, Glucogenolysis, Lipolysis, and Ketogenesis
662
What is the rate-limiting enzyme in Purine synthesis?
Glutamine - PRPP
663
What is Alzheimer's disease?
Decreased ach in nucleus basalis of Meynert, bad Apo-E4, Amyloid Plaques, Neurofibrillary Tangles of Tau proteins
664
What is Essential Thrombocythemia?
Very high platelets increased RBC's and WBC's
665
What does Antidiuretic hormone (ADH) do?
Conserves water (V2 aquaporin receptors) and vasoconstriction
666
What does Tracheal deviation tell you?
Moves away from tensionPneumothorax moves towards Atelectasis
667
What CA risk does VHL have?
RCC
668
What GI disease has a Corkscrew on X-Ray?
Esophageal spasm and Volvus
669
What is Carcinoid Syndrome (Triad)?
Diarrhea, flushing and wheezing
670
Can you try a Vaginal Delivery on a woman who had a LOW Transverse C-Section previously?
Yes, 70% are okay, Potential for uterine wall rupture
671
What is Crohn's Disease?
Transmural, Cobblestones, Melena, Creepig Fat, Fistula, Skip lesions
672
What are Loose Associations?
Ideas switch subjects, incoherent
673
What is Idealization?
They see only the good in someone despite evidence to the contrary
674
What GI disease has a stacked coin on X-Ray?
Intussusception
675
What is Tangentiality?
Wanders off the point
676
What is Graft vs. Host Disease?
When the graft attacks the body (T-Killer cells and macrophages responded)
677
What are the Indications for Infliximab?
Crohn's Disease, Rheumatoid arthritis
678
What is the time course of the inflammatory response?
1 hour: swellingDay 1: PMN's show upDay 3: PMN's peakDay 4: Monocytes/Macrophages and T-cells show upDay 7: Monocytes/ Macrophages and T-cells peak, Fibroblasts arriveDay 30: Fibroblasts peakMonth 3-6: Fibroblasts complete scar formation
679
What has Tubular Casts?
Acute Tubular Necrosis (ATN)
680
What is the risk of Chorionic Villus Sampling?
Fetal limb defects. (Done at 9-12 weeks)
681
What is Karyorrhexis?
Nucleus fragments
682
What is Waldenstrom Macroglobulinemia?
IgM and Hyperviscosity of the blood
683
What are Pencil Cell/ Cigar Cell?
Seen in iron deficiency anemia
684
What is Primary Biliary Cirrhosis?
Anti-Mitochondrial antibody Bile ducts are destroyedXanthelasmas present and pruritis
685
What is factitious hypoglycemia?
Exogenous insulin use, labs show elevated insulin and decreased C-peptide
686
What are the adverse effects of the Ca2+ channel blockers?
Flushing, edema, constipation, CHF, AV block
687
What disease does Coxsackie B cause?
Endocarditis, DM Type I
688
When do you give RhoGam?
1st Dose: Week 28 gestation2nd Dose: 72 hours post-deliveryAny time a procedure would mix mom and fetal blood
689
What are the IgA Nephropathies?
HSPBerger'sAlport Syndrome
690
What is Paracrine?
Works on its neighbor. (except sweat gland)
691
What does "Cytosis" tell you?
High levels
692
What is Justification?
Making excuses for behavior afterwards
693
What are the Biguanides drugs?
Metformin
694
What are the glycogenic amino acids?
His, Met, Val
695
What are the indications for Hydralazine?
Severe HTN, 1st line treatment for HTN in pregnancy
696
What are the hormones with disulfide bonds?
"PIIG": Prolactin, Insulin, Inhibin, GH (growth hormone)
697
How do i know the patient has a Vitamin B2 (Riboflavin) Deficiency?
Angular Cheilosis
698
What does Vit B9 do?
Nuclear division (Synthesis of Nitrogenous bases for RNA and DNA)
699
What is Glanzmann's?
Baby with bleeding from skin and mucosa (LOW GP-2b3a)
700
What is Exhibitionism?
Exposure to others
701
How does the Sympathetic System behave?
Opposite of Parasympathetic:ConstipationUrinary retentionMydriasis - "Eyes wide with fright"TachycardiaBronchodilateEjaculation "Shoot"Xerophthalmia (dry eyes)Xerostomia (Dry mouth)
702
What is the Mechanism of Action of Sulfonylureas?
Closes K+ channel in the pancreatic Beta cell membrane, Reduces K+ efflux & increases Ca (2+) influx, and cell depolarize to increase secretion of insulin
703
What does the Progesterone Challenge Test tell you?
Vaginal bleeding if she has estrogen. If she does not bleed, she has no E2 or ovariesIncreased FSH: Ovary problemDecreased FSH: Pituitary problem
704
What are the classifications of MHC-1?
HLA-A, HLA-B and HLA-C
705
How does chlamydia present?
Cervicitis (Yellow pus), conjunctivitis, PID
706
What is Total Anomalous Pulmonary return?
All pulmonary veins enter into the right atrium (Snowman x-ray)
707
What is the rate-limiting enzyme in Ketogenesis?
HMG CoA Synthase
708
What is Herpes?
ds DNA virus
709
What is the Stage II of Labor?
Continues after the cervix is dilated to 10 cm until the delivery of the baby
710
What is the difference between Heterochromatin and Euchromatin?
Hererochromatin = tightly coileddarkerTranscriptionally inactiveEuchromatin = loose (10nm fibers)lighter
711
What are the LIVE Vaccines?
"Bring Your Own Very Small Virus and MMR"B - BCGY - Yellow FeverO - OPV (Sabin) = oral polioV - VaricellaS - SmallpoxV - RotavirusM - Measles = RubeolaM - MumpsR - Rubella = German 3 day measles
712
What murmur has a regular-irregular pulse?
PVC
713
What disease has a Thumb Sign on neck films?
Epiglottitis
714
What is Restrictive Lung disease?
small still lungs, can't get air in
715
What symptoms does a "less likely to depolarize" state have?
Brain: lethargic, mental status changes, depressionSkeletal Muscle: weakness, SOBSmooth Muscle: constipation then diarrheaCardiac: hypotension, bradycardia
716
What are the indications for Ezetimibe?
Decrease LDL
717
What are the Class IC antiarrhythmic?
Flecainide, Encainide, Propafenone
718
What is the effect of Alcohol on the fetus?
FASSmooth philtrumshortpolyclonalmidface hypoplasiathin superior Vermilion border
719
What is the Mechanism of Action of Insulin?
Pushes K+ into the cell,Liver: Increases Glucose storage as Glycogen, Increases Triglyceride synthesis.Muscle: Increases protein and glycogen synthesis.Adipose Tissue: Improves Triglycerde storage by activating Lipoprotein Lipase, Decrease circulating Free Fatty Acids
720
What causes Chancroid?
Haemophilus Ducreyi
721
What is Telephone Scatologia?
Phone Sex
722
What is the MOA of ARBS?
Ang II blockers, prevernt alpha 1 vasoconstriction from Ang II
723
What is a Missed Abortion?
Cervix is closed, no fetal remnantsTx. D&C
724
What type of kidney stones have envelope or dumbbell-shaped crystals?
oxalate
725
What does the E Ab tell you?
Low transmissibility
726
What is the cause of large babies?
DM or twin-twin transfusions
727
What are the indications for Nitroprusside?
Hypertensive emergency, CHF, Angina
728
What is the MOA of cromolyn?
Prevents release of mediators from mast cells
729
What is Bismuth and Sucralfate used for?
Increase ulcer healing, traveler's diarrhea
730
What is a SIderoblast?
Macrophages pregnant with Iron (caused by genetics and or multiple transfusions)
731
What is the MOA of Bile Acid resins?
Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more
732
What are the sympathoplegics?
Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine
733
What is the MOA of Salmeterol?
B2 agonist; relaxes bronchial smooth muscle
734
What is Bronchitis?
Increased sputum production "Blue Bloater"
735
What is Type 2A Hyperlipidemia?
Defective LDL-Clathrin Pit or B-100 (LDL are elevated)
736
What will you see with Anemia of Chronic Disease?
Decreased TIBC
737
What will you see with Sideroblastic Anemia?
Decreased dALA synthase common with blood transfusions
738
What are the adverse effects of Hexamethonium?
Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
739
What is the MOA of the K+ channel blockers?
Increase AP duration, increase effective refractory period (ERP), increase QT interval
740
What is Plummer-Vinson Syndrome?
esophageal webbing at the UES, spoon nails from iron deficiency anemia
741
What is Cholestasis?
Obstructed bile ductHigh Alk Phos (if in the common bile duct)
742
What is transposition of the great arteries?
Aorticopulmonary septum did not spiral, most common congenital cyanotic heart disease in the first month of life (Neural crest cell migration problem)
743
What is Trichotillomania?
They pull out their own hair and eat it
744
What is McCune-Albright?
Precocious sexual development, polyostotic fibrous dysplasia "whorls of connective tissue", "coast of Maine" pigemented skin macules
745
What is associated with Vibrio Parahaemolyticus?
Raw Fish, Gs Stimulation via ADP- ribosylation = HIGH cAMP, Turns the on... on
746
How fast should B-HCG rise?
Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed
747
What are the indications for Methacholine?
Asthma challenge test
748
What are some causes of Vitamine B12 deficiency?
TapewormsVeganismType A gastritisPernicious Anemia
749
What does Vit D do?
Mineralization of bones and teeth
750
What are the newborn screening tests?
"Please Check Baby Before Going Home"P - PKUC - CAH/ CFB - Biotinidase/ Beta- ThalassemiaG - GalactosemiaH - Hypothyroidism/ Homocystinuria
751
What are the most common causes of mental retardation in the US?
FAS, Fragile X and Down's Syndrome
752
What is Wiskott-Aldrich?
Low IgM, Low PlateletsHigh IgAEczemaPetechiaeX-linked
753
What is achondroplasia (Laron Dwarf)?
Patient with abnormal FGF receptors in exremities. (abnormal FGF3)
754
What is Hemosiderosis?
Fe overload in bone marrow
755
What is Poikilocytosis?
RBC's of different shapes
756
What are the Adverse Effects of Mimetics?
Hypoglycemia, Nausea, Diarrhea
757
What can high Triglycerides Cause?
Pancreatitis
758
What is the MOA of a muscarinic antagonist?
competitively block muscarinic receptors preventing bronchoconstriction
759
What are the methylxanthines?
Theophylline
760
What is the function of T3 and T4?
Growth and differentiation
761
What is Histrionic Personality Disorder?
Theatrical, sexually provocative, use repression
762
What diseases have Respiratory Alkalosis?
Restrictive Lung diseaseAnxietyPregnancyGram neg sepsisPE
763
What does Fe2+ do?
Hb function, electron transport
764
What is RhoGam?
Anti-D IgG
765
What is Pyromania?
Sets fires for the fun of it
766
How does DKA present?
Kussmaul respirations, fruity breath (acetone), and altered mental status
767
What is assocaited with Strep Bovis?
Colon Cancer, black pigment
768
What hepatitis B labs indicate non-infectious state?
HBeAg-
769
What bugs cause Bloody Diarrhea?
"CASES": Campylobacter, AMoeba (Entamoeba Histolytica), Shigella, E. coli and Salmonella
770
What are the only arteries with deoxygenated blood?
Pulmonary and umbilical arteries
771
What are the Long Acting Insulin drugs?
Ultralente, Glargine, and Protamine
772
What is Sarcoidosis?
Non-caseating granulomas, eggshell calcification around lymph nodes
773
What sound radiates to the axilla?
Mitral regurgitation
774
How is Major Depression diagnosed?
Need 5 of 8 "SIGECAPS" for over 2 weeksSleep disturbance: wake in early or wake up lateInterest/ libido lossGuiltEnergy LossConcentration LossAppetite LossPsychomotor AgitationSuicidal Ideation (hopelessness)
775
What does somatostatin do?
Inhibits secretin, motilin, and CCK
776
What is the Adverse Effect of Sulfonylureas?
Hypoglycemia, GI disturbances, Muscle weakness, mental confusion, Sulfur allergy
777
What is the MOA of N-acetylcysteine?
loosen mucus plugs by breaking disulfide bonds
778
What has Epithelial Casts?
Normal sloughing
779
What is INR ratio determined by?
Measured PT/ Control PTtherapeutic level is between 2-3Normal level is 1
780
What are the Water shed areas?
Hippocampus, splenic flexure
781
What is Stress Incontinence?
Weak pelvic floor muscles, urinating when coughing, laughing, etc. Estrogen effect
782
What is an Arnold-Chiari Malformation?
Herniation of cerebellum through Foramen MagnumType 1: Cerebellar tonsils (asymptomatic)Type 2: Cerebellar vermis/ medulla -- Hydrocephalus, Syringomyelia (loss of pain and temerature)
783
What is a Vertex Presentation?
Posterior Fontanel (triangle shape) presents first (normal)
784
What is associated with C. Diff
Explosive diarrhea = Pseudomembranous Colitis
785
What are the antileukotriene drugs?
Zileuton, Zafirlukast, montelukast:aspirininduced asthma
786
What are the Purines?
A, G
787
What is a Septic Abortion?
Fever greater than 100.4 F, malodorous discharge
788
What is a Pappenheimer body?
Iron inside cell (sideroblastic anemia)
789
What does Seminal Vesicle give to Sperm?
Food (Fructose) and clothes (semen)
790
What GI diseases are the causes of liquid Dysphagia?
Scleroderma and Achalasia
791
What does IDL do?
It takes TG's from adipose to tissue
792
What type of Gallstone can be seen on X-Ray?
Calcium Bilrubinate stone
793
What is Legg-Calve-Perthes Disease?
A vascular necrosis of femoral head, more often in young children (4-8 y/o), mildly painful limb that develops insidiously. Range of motion is limited especially internal rotation and abduction, x-ray join effusion
794
What are the Production Anemias?
Diamond-BlackfanAplastic Anemia
795
Where is VLDL made?
Liver
796
What is associated with C. Botulinum?
Canned food, honey, inhibits ACh release, respiratory failure, stool toxin, treat with Penicillin
797
What is SIADH?
Too much ADH present causes plasma volume to expand Serum Na+ less than 120
798
What is the Somogyi Effect?
Morning hyperglycemia secondary to evening hypoglycemia
799
What are Identical Twins?
Eggs split into perfect halves "Monochorionic"
800
What is the symptoms of Loeffler Syndrome?
Pulmonary Eosinophilia
801
What is the MOA of H1 Blockers?
Reversible inhibitors of H1 histamine receptors
802
What is associated with Group C Strep?
Pharyngitis
803
What is HPV?
ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD
804
What is the function of FSH
Male: sperm, MIF, inhibin BFemale: Stimulates Estradiol (E2)
805
What vesels have the most smooth muscle?
Arterioles
806
What are the symptoms of a Low Energy State?
CNS: Mental retardation, dementiaCV: heart failure, pericardial effusionMuscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation
807
What are the signs of child abuse?
Multiple EcchymosisRetinal HemorrhageEpidural / Subdural HemorrhageSpiral Fractures (twisted)Multiple fractures in different stages of healing
808
What is Nitrazine?
Detects presence of amniotic fluid. (pH indicator - strip will turn blue if pH is greater than 6.0)
809
What is Pyknosis?
Nucleus turns into blobs. (shrinkage)
810
What organs have resistance in parallel?
All the rest of the organs (except liver and kidneys)
811
What are the indications for Losartan?
HTN
812
What is PIE Syndrome?
Pulmonary Infiltrate with Eosinophilia
813
What stage of the Menstrual Cycle has the highest level of Progesterone?
Luteal stage (Has secretory endothelium)
814
What makes Progesteron \<10 week gestation?
Corpus Luteum
815
What is assocaited with Salmonella?
Loves to hide in the gallbladder if treated.Do not treat this infection medically, raw chicken and eggs, turtles, rose typhoid spots, H2S (sulfur producing), Sickle Cell patients with Salmonella infection leads to Osteomyelitis
816
What is Euthyroid Sick Syndrome?
LOW T3 Syndrome and decreased conversion of T4 to T3 (increased T3r)
817
What is Albinism?
No Tyr -\> Melanin (via Tyrosinase)
818
What is Endometritis?
Postpartum uterine tenderness
819
What is seen with Tin deficiency?
Poor hair growth
820
What does an Isomerase do?
Creates and isomer
821
What is the MOA of Odansetron?
5-HT3 antagonist, powerful central acting antiemetic
822
What is Rotor's?
Defective Bilirubin storage and Elevated Conjugated Bilirubin
823
What vessels have the largest cross-sectional area?
Capillaries
824
How does Lymphogranuloma Venereum present?
Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis
825
What is Ataxia Telangiectasia?
Patients have low IgA and neurological problems, difficulty ambulating and spider like blood vessels
826
What are the side effects of Estrogen?
Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins
827
What is Stage III of Labor?
Delivery of the placenta
828
What hormones are released from the posterior pituitary?
ADH (supraoptic nucleus), Oxytocin (Paraventricular nucleus) by the Neurophysins
829
What is Anencephaly?
Notochord did not make contact with the brain - only have the medulla
830
What is Cholangitis?
Inflamed bile duct
831
What does the Coombs Test Tell you?
Antibody involved
832
What is Dependent Personality Disorder?
Clingy, submissive, low self-confidence, uses regression
833
What hepatitis B labs indicate previous infection and now immunity?
HBcAb+, HBsAb+, HBsAg-
834
What are the physical signs of Alcoholic Cirrhosis?
Spider Angioma, Palmar Erythema, Gynecomasatia and Dupuytren's Contracture
835
What is Bruton's Agammaglobulinemia?
Kids ( \< 1 y/o) with defective tyrosine kinase; they have no antibodies and have x-linked transmission
836
What are the indications for Sulfalazine?
UC, Crohn's disease
837
What is a Drepanocyte?
Seen in Sickle cell Anemia
838
Negative high dose Dex. and High ACTH levels?
Ectopic ACTH- small cell CA of the lungs
839
What are the indications for Clonidine?
HTNSmokingCocaineHeroin withdraw
840
What is Type and Match?
Blood type and Wait
841
What is Wolff-CHaikoff?
Transient hypothyroidism
842
What is Pyloric Stenosis?
Non-bilious projectile vomiting (3-4 week old) and RUQ Olive Mass on Palpation
843
What is Lichen Simplex Chronicus?
Raised white lesions, chronic scratching
844
What is the MOA of Clonidine?
Alpha 2 agonist = decreases peripheral resistance
845
Which part of the Nephron concentrates urine?
medulla
846
What is the Adverse Effect of Insulin?
Hypoglycemia
847
What are the sulfur-containing amino acids?
Cys, Met
848
What is Bartter's Syndrome?
JG cell hyperplasia with renin excess, no increase in blood pressure, defect in kidney's ability to reabsorb potassium
849
What is Drug Induced Hypersensitivity?
Eosinophils in the urine
850
What is increased beat-to-beat variability?
Fetal Hypoxia
851
What is the MOA of Bismuth and Sucralfate?
Bind to ulcer base, providing physical protection allows bicarbonate ion secretion to reestablish pH gradient in the mucous layer
852
What causes lateral leg bowing?
Rickets
853
What is Undoing?
Doing exact opposite of what you used to do to fix a wrong
854
What bugs disrupt G Proteins?
Pertussis: Inhibits Gi (Turning the off to off allows for stimulation)Chloera: Stimulates Gs (Keeping the on ... on)E. Coli: Stimulates Gs (Keeping the on ... on)
855
What is Myelofibrosis?
Megakaryocytes, fibrotic bone marrow, teardrop cells (RBC's) and extramedullary Hematopoiesis
856
What disease states have increased Anion Gap?
"MUDPILES"MethanolUremiaDKAParaldehyde/PhenoforminINH/ Iron tabletsLactic AcidosisEthylene GlycolSalicylates
857
What is CD8?
T-killer or T-suppressor cellResponds to MHC-1 complex (self)
858
What causes Gonorrhea?
Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort
859
What are some causes of Folate Deficiency?
Old food, you will see Glossitis with the patient
860
What is Cretinism?
Mom and baby are hypothyroid
861
What do you see in DeQuervain's disease?
Viral origin, painful jaw, hypothyroid
862
What is Epstein's anomaly?
Small right ventricle and very large right atrium (in fetus due to mom taking Lithium during pregnancy)
863
What murmur has an irregular-irregular pulse?
A fib (no P waves)
864
What is Kleptomania?
Steals for the fun of itTx: Psychotherapy
865
What is a normal BPP?
\>8-10
866
What is an Oligodendroglioma?
Fried egg appearance, Nodular Calcification
867
What does high WBC and Bands tell you?
Left shift - they have an infection
868
What are the pulmonary infiltrates with eosinophilia (PIE) syndromes?
Churg-Straus, Loeffler's, allergic Bronchopulmonary Aspergillosis
869
Waht is Vasa Previa?
Babies blood over OS
870
What is the Average IQ?
85-100
871
What are the indications for Octreotide?
Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
872
What is Loss of Ego Boundaries?
Where we lose sight and sense of our mind and body and its influences
873
What is seen in Magnesium deficiency?
Loss of kinase function, hypoparathyroidism
874
What is Vater Syndrome?
V - Vertebral abnormalityA - AnalTE - Tracheal Esophageal FistulaR - Renal
875
What is associated with Listeria?
Raw cabbage, hot dogs, cold cuts, and spoiled milk, likes cold environmentMust avoid these foods in pregnancy, also seen in migrant workersCauses: abortions, Meningitis, and heart block
876
What is the Most common type of Kidney Stone?
Calcium Phosphate and Calcium Oxalate
877
What is the risk of Amniocentesis?
Abortion (2% risk)
878
What is Potency?
Amount of drug needed to produce effect (lower w/ comp antagonist)
879
What is the indication for Methylxanthines?
Asthma
880
What does Galactosemia cause?
Cataracts, mental retardation, liver damage
881
What is a Neuroblastoma?
Adrenal Medulla tumorHypsarrthymiaOpsoclonusIncreased urinary VMA
882
What is Pre-Renal Failure?
Low flow to kidney; BUN; Creatinine ratio \>20/1 in the serum
883
What is the function of PRH?
Stimulates Prolactin (PRL) release
884
What disease has a Selenium deficiency?
Dialted cardiomyopathy
885
How do I know the patient has a Vitamin B3 (Niacin) Deficiency?
Pellagra (4 D's: Diarrhea, dermatitis, dementia, death)
886
What is Small Cell Cancer?
Located at the Carina, Malignant, Cushing's syndrome, SIADH, and SVC syndrome
887
What is Type B gastritis?
Upper GI bleed, associated with eating spicy foods, loss of barrier protection and H. Pylori infections (antrum of stomach)
888
What GI diseases are the causes of solid and liquid dysphagia?
Schatzki's Rings, Stricture, Cancer
889
What is associated with E. Coli?
Raw hamburger, ADP- Ribosylates Gs (increased cAMP)Verotoxin, HUS in kids and elderly
890
FEV1/FVC in Obstructive lung disease
Lower than normal (N: 0.75-0.80)
891
What are the bacteria associated with Colon CA?
Clostridium Melanogosepticus and Streptococcus Bovis
892
What is the Adverse Effect of Alpha-Glucosidase Inhibitors?
GI disturbances and may reduce absorption of iron
893
What does VLDL do?
It takes TG's from liver to adipose
894
What is Bipolar I?
Mania with or without depression for at least 1 week, as well as period of normal moodTx: First line - Lithium, Lamotrigine or RisperidoneSecond line - Aripripezole, Divalproex, Quetiapine, Olanzapine, Psychotherapy and cognitive behavioralAcute Mania: Hospitalize, mood stabilizer (Lithium), acute antipsychotic (Risperidone) and IM phenothiazine - non compliant
895
What bug causes Subacute Bacterial Endocarditis?
Steptococcus viridans. (attacks damages valves)
896
What are the indications for the channel blockers?
WPW, Torsades, pulmonary fibrosis, hepatotoxicity, Hypo/hyperthyroidism
897
What is a transversion?
Changes one purine to a pyrimidine
898
What is Reaction Formation?
Unconsciously act opposite to how you feel, "Tears on a clown"
899
What is the MOA of Nesiritide?
Recombinant BNP, increase in cGMP and vasodilation
900
What is Cystosarcoma Phylloides?
Exploding Mushroom
901
What is cardiac tamponade?
Pressure equalized in all 4 chambers, quiet Precordium, no pulse or BP, Kussmaul's Sign, Pulsus Pardoxus (Decrease in BP greater than 10 mm Hg with inspiration)
902
What is a Stomatocyte?
Seen in liver disease
903
What does Rh- tell you?
Does not have the D Antigen
904
What is associated with Yersinia Enterocolitica?
Presents like appendicitis and Reiter'sBloody Diarrhea
905
What are the layers of the Adrenal Cortex and what do they produce?
Zona Glomerulosa (Aldosterone),Zona Fasciculate (Cortisol),Zona Reticularis (Androgens)
906
What does a Southern blot detect?
DNA, "Snow, Drop"
907
How do you test efferent arteriole function?
Renal plasma flow (RPF) or PAH
908
What adds color to Stool?
Stercobilinogen being oxidized to stercobilin
909
What is a Heinz body?
Seen when Hb precipitates and sticks to cell membranes in G6PD deficiency
910
What is the difference between DI and SIADH?
DI: diluted urineSIADH: concentrated urine
911
What is a Blast?
Baby hematopoietic cell
912
What are the branched amino acids?
"Can't LIVe w/o them", Leu, Ile, Val
913
What is the Indication for Mimetics?
NIDDM. (Type 2)
914
What are the adverse effects of Nitroprusside?
Cyanide Toxicity, hypotension, short acting
915
What is Isolation of Affect?
Isolate feelings to keep on fucntioning
916
What is Hirsutism?
Hairy female (Excess growth in normal male areas)
917
What is associated with Strep Pyogenes?
Rheumatic Fever, PSGN, Impetigo, Pharyngitis, Nec Fasc
918
What is stable angina?
Pain with exertion that is relieved with rest (Athersclerosis MCC)
919
What are the indications for 1st generation H1 blockers?
Allergy, motion sickness, sleep aid
920
What ion has the least movement at rest?
Chloride
921
What is associated with S. Pneumoniae?
Gram-positive diplococci, rusty sputum, IgA Protease, vaccine covers 23 strains
922
What is cyclothymia?
Dysthymia with hypomania for more than 2 yearsTx: Lithium, Valproic Acid or Carbamazepine and psychotherapy
923
What is Oligohydramnios?
Too little amniotic fluid (baby can't pee)
924
What does the Water Deprivation Test tell you?
If the patient fails to concentrate urine, they do not have Primary DI
925
What effects Efficacy?
Vmax
926
What defines AML?
15-30 y/o males Sudan StainAuer Rods, (CD30)T (15;17) - D M3 AML subtypetreat with ATRA
927
What organs have resistance in series?
Liver and Kidneys
928
How do I know the patient has a Vitamin B4 (Lipoic Acid) Deficiency?
No deficiency state
929
What is Type I RTA?
Distal RTA: H/K in collecting duct is broken, high urine pH
930
What is Autocrine?
Works on itself. (except T-cell activation)
931
What is Hypochondriasis?
They worry about having a serious illness (specific disease) they seek medical attention. For constant reassuranceTx: Psychotherapy
932
What does the JGA do?
Measures volume, secretes renin (low volume state)
933
What is Testicular Feminization (Androgen Insensitivity Syndrome)?
Males with defective / bad DHT receptor, they are XY with a blind pouch vagina
934
What does Vit B6 do?
Transaminase cofactor, myelin integrity
935
What is Paraphimosis?
Foreskin scarre at penis baseforeskin will strangulate the gland
936
What is Glioblastoma multiforme?
Pseudopalisading necrosis, worst prognosisintralesional hemorrhage
937
What does Zn2+ do?
Taste buds, hair, sperm function
938
What Diseases have a low LAP?
CML & PNH (paroxysmal nocturnal hemoglobinemia)
939
What is Hyper IgM Syndrome?
High IgM and all other Ig's are low
940
What is Waterhouse-Friderichsen syndrome (WSF) or Hemorrhagic Adrenalitis or Fulminant Meningococcemia?
Adrenal hemorrhage most commonly due to Meningococcus Neisseria Meningitides
941
What disease has a steeple sign on neck films?
Croup (or Laryngotracheobronchitis)
942
What are the Indications for Insulin?
DM Type 1; DM Type 2; Hyperkalemia; Stress induced Hyperglycemia; Gestational Diabetes
943
What is Type 3 Hyperlipidemia?
Defective ApoE (Elevated ILD)
944
What is the Osler-Weber-Rendu?
AVM (Atrial-Venous Malformation)in lung, GI, CNSthe AVM sequesters platelets and causes acquired Telangiectasia's
945
What is a Howell-Jolly Body?
The spleen or bone marrow should have removed nuclei fragments.(Seen in Hemolytic Anemia, spleen trauma, and CA)
946
What is associated with N. Meningitidis?
DIC, Pili, Only bug that releases toxin in the log phase
947
What is a Gastric Ulcer?
Loss of protective barrier, pain during the meal, associated with NSAIDs, H. Pylori infection and weight loss
948
What is Type 2 Diabetes Mellitus and associations?
Insulin receptor insensitivity, HONK coma, Acanthosis Nigricans
949
What can you measure to test afferent arteriole's function?
Glomerular filtration rate (GFR) or Inulin
950
What is an incomplete Abortion?
Cervix is open, fetal remnantsTx: D&C to prevent placenta infection
951
What is seen in Hashimoto's Thyroiditis?
Antimicrosomal antibody and Anti-TPO antibody
952
What is the definition of AIDS?
CD4 count less than 200 or defining illness
953
What is Schizoid Personality Disorder?
Recluse, they don't want to interact with others, emotional coldness
954
What are the 2nd generation H1 Blockers?
Loratadine, fexofenadine, Desloratadine, Cetirizine
955
What is the most common cause of no red reflex?
Cataracts - Increased incidence with high glucose or galactose, Rubella, Failure of light stimulating the retina by 3 months of life and if this does not occur the child will be blind
956
What is Bronze cirrhosis?
Fe deposit in liver
957
What is associated with S. Aureus?
Cellulitis, Dairy products, Gold pigment, Endocarditis, Styes, Hordeolum (on eyelid)
958
What is Associated with M. Catarrhalis?
It loves Mucus: it attacks the respiratory tract
959
What is MCD?
Most common nephrotic in kids, fused foot processes, no renal failure, loss of charge barrier
960
What is Jod-Basedow Disease?
Transient hyperthyroidism due to increased iodine
961
What is the MOA of Nifedipine and verapamil?
Ca+ channel antagonists
962
What are the continuous Murmurs?
PDA or AVM's
963
What is Bronchoalveolar CA?
Looks like pneumoniadue to pneumoconiosis, nonsmoker
964
How does a Subarachnoid hemorrhage present?
"Worst headache of my life", hx. of Berry aneurysm
965
What is a Gonadotrope?
LH and FSH
966
What is Bronze pigmentation?
Fe deposit in skin
967
What are the indications for Diazoxide?
HTN
968
What is a Female Hermaphrodite?
Impossible because female is the default formation
969
Negative high dose Dex. and low ACTH levels?
Adrenal CA (high cortisol)
970
What disease has Aniridia?
Wilms Tumor
971
How do I know the patient has a Vitamin B6 (Pyridozine) Deficiency?
Peripheral Neuropathy
972
What are the Extravascular Hemolytic anemias?
Spherocytosiswarm autoimmuneParoxysmal cold autoimmuneSickle cell anemia
973
What is Monoclonal Gammopathy of undetermined significance?
Old Person with Gamma Spike (from years of building up)
974
In what layers does a true aortic aneurysm occur?
Intima, media, and adventitia
975
What is a Male Pseudohermaphrodite?
XY with LOW 17-OHase and LOW Testosterone
976
What is Azotemia?
Increased BUN/Creatinine ratiorenal failure
977
What disease does Coxsackie A cause?
Hand-foot-mouth disease
978
What do low Retics tell you?
Decreased production of bone marrow - not working right
979
What is Kleine Rechnung?
Scant bleeding at ovulation
980
What is the MOA of Niacin?
Inhibits lipolysis in adipose tissuereduces hepatic VLDL secretion into circulation
981
What is diastole?
Heart ventricles fillingincreased blood to Coronary arteriesless extraction of oxygenPhase 4 and 5 Korotkoff
982
What is the MOA of Biguanides?
Decrease Gluconeogenesis, Increase Glycolysis, and Increase peripheral Glucose uptake. (Insulin sensitivity)
983
What is Normal Pressure Hydrocephalus?
Incontinence, ataxia "magnetic gait" dementia
984
What is the Most Common Cause of Kidney Stones?
Dehydration
985
What does Somatostatin (SS) do?
Inhibits growth hormone (GH) release
986
What is the function Oxytocin?
Milk and baby ejection
987
What is the job of the Thin Descending Loop of Henle?
Reabsorbs Water
988
What is Hemophilia B?
Factor IX deficiencyBleed into joints (knee, etc)
989
What is a threatened Abortion?
Cervix is closed, baby is intact, treat with bed rest
990
What disease has multiple lung aneurysms?
Osler-Weber-Rendu (AD Ped disease -- thin vessels in nose, GI, and lungs)
991
What is the MOA of Bosentan?
Competitively antagonizes endothelium-1 receptors decreasing pulmonary vascular resistance
992
Why is Nagele's Rule Inaccurate?
Because it does not start from Ovulation date
993
What is the MOA of Metoclopramide?
D2 receptor antagonist; increase resting tone, contractility LES tone, motility
994
What is a Band?
Baby Neutrophil
995
What is Asbestosis?
Shipyard workers, pipe fitters, brake mechanics, insulation installers
996
What is Chronic Rejection?
Occurs months to years later and fibroblasts are present
997
What does Vit B7 do?
Carboxylation (Avidin in egg whites (raw) binds Biotin)
998
What is Savage's Syndrome?
Ovarian resistance to LH/FSH
999
How does Factor 13 Deficiency present?
Umbilical stump bleeding(this is the first time a baby has to stabalize a clot)
1000
What are the B cell Non-Hodgkin's Lymphomas?
Follicular: t(14;18) and bcl-2Burkitt: t(8;14), c-myc, Starry sky, Macrophagesin american kids: abdominal massin african kids: jaw mass
1001
What are the Stress Hormones and when do they appear?
Immediately Epinephrine, Glucagon (20 minutes), Insulin & ADH (30 minutes), Cortisol (2-4 hours), and growth hormone (24 hours)
1002
What are Fraternal Twins?
Multiple eggs fertilized by different sperm
1003
What is the efferent arteriole's job?
To secrete
1004
What are the Adverse Effects of Demeclocycline?
Nephrogenic DI, Photosensitivity and Abnormalities of Bone and Teeth
1005
What are the hyperthyroid diseases?
Grave'sDeQuervain'sSilent ThyroiditisPlummer'sJod-Basedow
1006
What are the Macrophages called in areas of the body?
Blood: MonocytesBrain: MicrogliaLung: Type 1 PneumocytesLiver: Kupffer cellsSpleen: RES cellsLymph: Dendritic cellsKidney: Mesangial cellsPeyer's Patch: M cellsSkin: Langerhan cellsBone: Osteoclast cellsConnective Tissue: Histiocytes, Giant cells, Epithelioid cells
1007
What is the MOA of PPIs?
Irreversibly inhibit H+/K+ ATPase in stomach parietal cellsDecreases proton secretion by parietal cells
1008
Who makes the Cytotrophoblast?
Mom production of GnRH, CRH, TRH, and Inhibin
1009
What are the indications for N-acetylcysteine?
CF patients and antidote for Acetaminophen overdose
1010
What is Goldblatt's Kidney?
Flea-bitten kidney (ruptured capillaries from high blood pressure)
1011
What does MPO deficiency cause?
Catalase positive infections
1012
What is Tay-Sachs?
Hexosaminidase A deficiencyHyperreflexia developmental delay"onion skin" Lysosomes
1013
What does Growth Hormone (GH) do?
Stimulates Insulin Growth Factor-1 (IGF-1) release from the liver
1014
What is the MOA of Dextromethorphan?
Antitussive (antagonizes NMDA glutamate receptors)
1015
What are the indications for digoxin?
CHF (increase contractility)A fib (decrease conduction at the AV node)depression of the SA node
1016
How does Tetrology of Fallot (TOF) present differently from Choanal Atresia?
TOF Babies... Turns blue with crying and has No feeding issues
1017
What does a Lyase do?
Cuts C-C bonds w/ ATP
1018
What is the MOA of Desmopressin (DDAVP)/ADH?
Recruits water channels to Luminal Membrane in collecting duct
1019
What is Asherman's Syndrome?
Uterine scars from multiple D&Cs
1020
What are the breakdown products of VLDL?
IDL and LDL
1021
What is the difference between Plasma and Serum?
Plasma: No RBC'sSerum: No RBC's or Fibrinogen
1022
What is Gilbert's Syndrome?
Stress induced elevatedUnconjugated BilirubinIncreased load saturates Glucuronyl Transferase
1023
What is Secretory Diarrhea?
Water pushed from cells into the gastric lumen (increased cAMP)
1024
How does Diverticulosis Present?
Gross blood
1025
What is Rett's
Only in girls, decreased head growth, lose motor skills, hand-wringing, they are normal until 5 months of ageTx: Behavioral therapy and physiotherapy
1026
What is Fructosemia?
"Fructose intolerance" (Aldolase B deficiency)kidney and liver damageoccurs in infants after introduction of fruits, honey, and juices
1027
What is Pellagra?
Niacin (B3) deficiencyDermatitis, Diarrhea, Dementia, Death
1028
What are the corticosteroid drugs?
Beclomethasone, Prednisone
1029
What does the surface Ab tell you?
Vaccination has occurred
1030
When will you see Plummer's Disease?
Patients with benign adenoma and or patients over 50 yrs. old. In an iodine scan, it looks like a nodular patter
1031
How does Von Willebrand Disease (VWD) present?
Heavy menstrual bleeding
1032
What is the receptor problem with Midgets?
Patient with decreased Somatomedin receptor sensitivity
1033
What is Dysthymia?
Low level sadness \>2 years, looks like depressionTx: Psychotherapy and SSRI
1034
What is a Tracheoesophageal (TE) Fistula (H-Type)?
Chokes with each feeding and is Congenital
1035
How do cluster headaches present?
Rhinorrhea, unilateral orbital pain, suicidal, facial flushing, worse with lying down
1036
What should you rule out when child abuse is suspected?
Osteogenesis Imperfecta, bleeding disorders, Fifth's disease and Mongolian spots
1037
What is a Compound Presentation?
Arm or hand on head, vaginal delivery. (Mean's Prolapse of fetal extremity with presenting part)
1038
Egg-shape on x-ray?
Transposition of the great arteries
1039
What makes Progesterone in \>10 weeks gestation?
Placenta
1040
Can you try a Vaginal Delivery on a woman who has had a Classic Horizontal C-Section previously?
No, they must have C-Section for all future pregnancies
1041
What is the MOA of GLP-1 Analogs (glucagon like peptides)?
Increase Insulin and Decrease Glucagon release
1042
What are the Urease Positive Bugs?
"Urease PPUNCHSB"P - ProteusP - PseudomonasU - UreaplasmaN - NocardiaC - CryptococcusH - H. PyloriS - Staphylococcus SaprophyticusB - Brucellosis
1043
What are the K+ channel blockers?
Sotalol, Ibutilide, Bretylium, Amiodarone
1044
Where does a Type B thoracic aortic dissection occur?
Descending Aorta, (occurs in trauma and Atherosclerosis)
1045
What is Boerhaave Syndrome?
Transmural tearing of the Esophagus. Left Sided most common, pneumonia/Pain/Effusion
1046
What is a Sinciput Presentation?
Anterior Fontanel (Diamond shape) presents first
1047
What is associated with Coxiella Burnetii?
Dusty Barn = Q fever
1048
What is Placenta Percreta?
Placenta perforates through serosa
1049
What is the cause of Asymmetrically Small babies?
In Late onset: Poor maternal nutrition and vascular disease
1050
What is normal blood loss during a C-section?
1000 mL
1051
What is the fucntion of AFP?
Regulates intravascular volume
1052
What is Basophilic Stippling?
Lots of immature cells increased mRNA (seen in lead poisoning)
1053
What is a Lactotrope?
PRL -- Prolactin
1054
What disease has a chromium deficiency?
Diabetes
1055
What is the function of TSH (Thyroid stimulating hormone)?
Stimulates release of T3 and T4 from the thyroid.T3= TriiodothyronineT4= Thyroxine
1056
How do migraines present?
Auro, photophobia, numbness and tingling, throbbing headache, nausea
1057
What diseases provide malarial protection?
Sickle Cell Anemia: African descentG-6PD: Mediterranean's
1058
What is Epididymitis?
Chlamydia Trachomatis. Unilateral scrotal pain decreased by support
1059
How would you know the patient has a Vitamin B1 (Thiamine) Deficiency?
Beriberi, Wernicke's Encephalopathy, Wenicke-Korsakoff Syndrome
1060
What is the Psychogenic Polydipsia?
Pathologic water drinking will have low plasma osmolality
1061
What is Chorioamnionitis?
Fever, uterine tenderness, decreased fetal HR
1062
What is the MOA of Demeclocycline?
ADH antagonist
1063
What is the MOA of Methacholine?
Muscarinic receptor agonist
1064
What is transudate?
An effusion with mostly waterIf too much water: Heart or Renal failure....Or not enough protein: Cirrhosis (can't make protein), and Nephritic Syndrome (spilling out protein in urine)
1065
What is Rubella (German 3-day Measles)
Trunk rashLymphadenopathy behind earsthey don't look sick
1066
What is the fucntion of MSH (melanocyte-stimulating hormones)?
Provides skin pigmentation
1067
What sound radiates to the neck?
Aortic stenosis
1068
What are the glycogenic & ketogenic amino acids?
"PITT" Phe, Iso, Thr, Trp
1069
What is Bronchiolitis?
Athma in kids less than 2 years old
1070
What is Sturge-Weber?
Port wine stain (big purple spot) on foreheadangioma of retinaEpilepsyMental retardation
1071
What is the function of GRH?
Stimulates GH release
1072
What is the MOA of Hydralazine?
increases cGMP, smooth muscle relaxation, vasodilates arterioles, afterload reduction
1073
What is Cholecystitis?
Inflammation of the gallbladder
1074
What determines the prognosis of Cancer?
Depth of invasion, any choice that has to do with depth - the deeper it is= the worse the prognosis
1075
What will you see in Beta Thalassemia?
Seen in Mediterranean's(chromosome 122- point mutation)
1076
What serum pH does the low volume state have?
Alkalotic (due to H+/K+ exchanger)
1077
What is associated with R. Prowazekii?
Lice = Starts on body
1078
What is Gastroschisis?
Wall defect lateral to midline - off center, abdominal wall with no sac covering
1079
What is the MOA of Minoxidil?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
1080
What are the adverse effects of Ezetimibe?
Rare increase LFT's
1081
What are the adverse effects of Niacin?
Red flushed face which is decreased by aspirin, hyperglycemia, hyperuricemia
1082
What is a Beastophile?
Someone who has sex with animals, women prefer dogs, they can smell their estrogen
1083
What is the rate-limiting enzyme in Pyrimidine synthesis?
Carbamoyl Phosphate Synthetase-2 (CPS-2)
1084
What is seen in Spherocytosis?
Defective Spherin or AnkyrinPositive Osmotic Fragility testHigh level of MCHCteardrops
1085
What is Otitis Media?
Fluid in the middle ear
1086
What is the most common transplant?
Blood transfusion
1087
What are the effects of 2nd generation H1 Blockers?
Far less sedating than the 1st generation because of decreased entry into the CNS
1088
Boot-shape on x-ray?
RVH
1089
What causes increased PTT and Bleeding Time?
Von Willebrand disease and SLE
1090
How do you treat A2 Gestational DM?
Insulin
1091
What are the adverse effects of Isoproterenol?
Tachycardia (B1)
1092
What is the Treatment for Pre-Eclampsia?
Delivery, MgSO4 (seizures), Hydralazine (BP)
1093
What are the adverse effects of Clonidine?
Drowsiness, dry mouth, and rebound HTN after abrupt withdraw
1094
What is the Treatment for Eclampsia?
4mg MgSO4 IV (Seizure prophylaxis)
1095
How do you monitor Baby's Heart Rate?
Doppler or scalp electrode
1096
What do high Retics (\>1%) tell you?
RBC is being destroyed peripherally
1097
What is Fanconi Syndrome?
Due to old Tetracycline useProduces Urine phosphates, Glucose, and Amino Acids
1098
What is seen why Molybdenum deficiency?
Lose xanthine oxidase function
1099
How do you monitor the Uterus?
Tocodynamics, uterine pressure catheter. (Measure frequency and duration of contractions)
1100
What is Hartnup's?
No tryptophan-cannot make niacin or seratoninPresents like PellagraGenetic, not nutritional disorder
1101
What is a Frank Breech?
Butt down, thigh flexed, legs extended (Pancake)
1102
What has high LAP?
Leukemoid reaction
1103
What is Subgaleal Hemorrhage?
Prolonged jaundice in newborns due to birthing trauma
1104
What disease has pulsus bisferiens?
IHSS- Idiopathic Hypertrophic Subaortic Stenosis
1105
What is Intermittent Explosive Disorder?
Loses self-control, disproportional to circumstances?
1106
What Bacteria cause UTI's and Prostatitis?
E. ColiProteusKlebsiellaPseudomonas
1107
What can cause Cushing's syndrome?
High cortisol produced from an adrenal tumor
1108
What bug is associated with cat feces?
Toxocara Cati
1109
What is Fabry's
alpha-galactosidase A deficiencyattacks baby's kidneys and heartXLRaccumulation of CeramideTrihexoside
1110
What are the indications for Nifedipine and verapamil?
HTN, angina, arrhythmia (not Nifedipine) Prinzmetal Angina, Raynaud's
1111
What hepatitis B labs indicate that the patient is in the window period?
HBeAb+, HBcAb+, HBsAg-
1112
What is Amyloidosis and what stain is used?
Amyloid deposits that stain Congo red: Apple-Green Birefringence (AA-chronic disease)
1113
What is Job's Syndrome?
Seen in red headed femalesthey are stuck in the IgE stage
1114
What has Hyaline Casts?
Normal sloughing
1115
What is Conduct Disorder Personality Disorder?
Younger than 15 years old who have Antisocial personality disorder
1116
What are the SYmptoms of Pre-eclampsia?
Headaches, changes in vision, and epigastric pain
1117
What is Childhood Disintegrative Disorder?
Kid stops talking and walking. (They lose all their milestones)
1118
Which hormones have the same Alpha Subunits?
LH, FSH, TSH, and B-HCG
1119
What murmur has a water hammer pulse?
Aortic regurgitation
1120
What is the MOA of Infliximab?
Monoclonal antibody to TNF-alpha
1121
What is Pompe's?
Lysosomal a-1, 4-glucosidase deficiencyDie early/young due to heart failure
1122
What is the Peak level?
4 hours after dose (too high - decrease dose)
1123
What do Platelet problems cause?
Bleeding from skin and mucosa
1124
What bugs cause Meningitis?
0-2 months: "baby BEL" B - Group B strep E - E. Coli L - Listeria2 months to 10 years old: S. Pneumoniae N. Meningitidis10-21 years old: N. Meningitidis21 years and up: S. Pneumoniae
1125
How does the Parasympathetic System behave?
"DUMBBELS"DiarrheaUrinationMiosis "Constrict"BradycardiaBronchoconstrictionErection "Point"LacrimationSalivation
1126
What does Vit A do?
Night vision, CSF production, PTH cofactorantioxidants
1127
What is an Incomplete Molar Pregnancy?
2 Sperm + 1 egg (69, XXY) mom "cooks the parts" has embryo parts
1128
What is Adenomyosis?
Growth of the Endometrium, Myometrium, and patients will have an enlarged "boggy" uterus with cystic areas
1129
What is the function of Cortisol in Pregnancy?
Decreases immune rejection of the baby out of mom and for lung maturation
1130
What are the Indications for Glucocorticoids?
Addison's disease; inflammation; immune suppression; asthma
1131
What has WBC casts and eosinophils?
Interstitial Nephritis (Allergies)
1132
What is seen in Copper deficiency?
Menky Kinky Hair Syndrome
1133
What are the Systolic Ejection Murmurs?
Aortic Stenosis, Pulmonic Stenosis, Hypertrophic Cardiomyopathy
1134
What is Isocarboxazid?
Atypical depression: Hypersomnia, anxiety, sensitivity to rejection, hypochondriasis
1135
What is Necrosis?
Non-programmed cell death. Nucleus destroyed first
1136
What is the 1st generation H1 Blockers?
Diphenhydramine, Dimenhydrinate, Chlorpheniramine
1137
How does Syphilis present?
Primary: Painless Chancre (1-6 weeks)Secondary: Rash and Condyloma Lata (After 6 weeks)Tertiary: Neurological and Cardiac issues, in Bone (after 6 years)
1138
What are the hypothyroid diseases?
Hashimoto's, Riedel's, Cretinism, Euthyroid SIck syndrome, Wolff-Chaikoff
1139
What is obstructive lung disease?
Mucus filled lungs, cannot get air out
1140
What are the anabolic & catabolic pathways? (Occurs in both Cytoplasm and Mitochondria)
"HUG" Heme synthesisUrea cycleGluconeogenesis
1141
What are the indications for the Ca2+ channel blockers?
SVT/ prevent nodal arrhythmias
1142
What is Type 4 Hyperlipidemia?
Defective Adipose Lipoprotein Lipase, elevated VLDL
1143
What are Hallucinations?
False sensory perception with absence of external stimuli, seen commonly in ETOH withdraw and cocaine intoxication
1144
What valves make noise at the end of diastole?
Mitral and Tricuspid
1145
What is Closed-angle glaucoma?
Obstruction of canal of Schlemm, there is a sudden onset pain, emergency
1146
What is the Platelet lifespan?
7 days
1147
What is Ulcerative Colitis?
Starts at the rectum and ascends,1%/year risk for CAIBD with Pseudopolyps, hematochezia, Lead pipe colon and Toxic Megacolon
1148
What is Pick's Disease?
Frontal lobe atrophy, disinhibition
1149
What is Endometriosis?
Painful cyclical heavy menstrual bleeding"Powder burns and chocolate cysts" due to ectopic endometrial tissue. (Endometrial Tissue outside of uterus)
1150
What is a Pedophile?
Attracted to children sexually, watching child pornography
1151
What disease process is present when both Serum Ca2+ and Serum Phosphate (PO4-) are decreased?
Vitamin D deficiency
1152
What does Cu2+ do?
Collagen Synthesis
1153
What is the rate-limiting enzyme of Glycolysis?
PFK-1
1154
How do I know the patient has a Vitamin B9 (Folate) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, neural tube defects
1155
What is Essential Fructosuria?
Fructokinase deficiencyExcrete fructose in blood/urine (still have hexokinase)
1156
What is a "Pink Puffer"?
Emphysema
1157
What is Gardener's Syndrome
Familial Polyposis with Bone Tumors
1158
What is the rate-limiting enzyme in the HMP shunt?
Glucose-6-Phosphate Dehydrogenase (G-6PD)
1159
What are the T-cell Non-Hodgkin Lymphomas?
Mcosis Fungoides: total body rashSezary Syndrome: Cerebreform cells in the blood
1160
What bug causes multiple Cerebral Abscesses?
Citrobacter
1161
What is Labyrinthitis?
Inflammation of the Cochlear portion of the inner ear, present with hearing loss and tinnitus
1162
What is Nephrogenic diabetes insipidus?
ADH (V2 aquaporin) is blocked or broken. Lithium association and Demeclocycline
1163
What is Meningioma?
Located parasagittalPsammoma bodies presentwhirling patternbest prognosis
1164
What happened if your pulse drops more than 10 bpm on standing?
Autonomic dysfunction
1165
What are the basic amino acids?
Lys, Arg, His
1166
What does Vitamin D do?
Helps in calcium absorption from the GI tract
1167
What is an Apt Test?
Detects HbF in the Vagina, detects baby's hemoglobin (Alkali denaturation test)
1168
What is seen in Zinc deficiency?
Dysgeusia, anosmia, Poor wound healing
1169
What cardiomyopathy has Pulsus Alternans?
Dilated cardiomyopathy
1170
What is a Monocyte?
The destroyer - macrophage (has hydrolytic enzymes and a coffee bean nucleus)
1171
How do I know the patient has a Vitamin B12 (Cyanocobalamin) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, Neuropathy
1172
What are the indications for Metoclopramide?
Diabetic and post-surgery gastroparesis
1173
What is a Target Cell/ Codocyte?
These have less Hb (seen in Thalassemias or iron deficiency)
1174
What is seen in Diamond-Blackfan Anemia?
They have low RBCs and double jointed thumbs
1175
What is associated with Yersinia Pestis?
Rats & Flease = Bubonic Plague
1176
What is cor-pulmonale?
Pulmonary HTN leads to Right ventricular failure
1177
What is associated with EPEC?
Pathogenic = newborn diarrhea
1178
What is Chlamydia?
Obligate intracellular bacteria. Can present asymptomatic or PID Cervicitis (yellow pus)Conjunctivitis
1179
What do Clotting problems cause?
Bleeding into cavities
1180
Waht is associated with S. Saprophyticus?
Female with UTI's (2nd cause), honeymooner's cystitis
1181
What are the adverse effects of fibrates?
Myositis, hepatotoxicity (increase LFT's) cholesterol gallstones
1182
What is Depersonalization Disorder?
"Out of Body" experiences, Deja Vu
1183
What is the most common cause of death in the Low Energy State?
Heart Failure
1184
What is assocaited with Campylobacter Jejuni?
Raw chicken and eggs, dog poop, bloody diarrhea, comma, "seagull" shaped buginactivated by gastric juice and can precipitate Guillain BarreTreat with Erythromycin
1185
What are the adverse effects of 1st generation H1 blockers?
Sedation, antimuscarinic, anti-alpha-adrenergic
1186
What do Chylomicrons do?
They take Triglycerides (TG) from GI to liver and endothelium
1187
What diseases have high Monocytes (\>15%)?
"STELS"Syphilis: chancre, rash, wartsTB: Hemoptysis, night sweatsEBV: Teen sick for a monthListeria: Sick babySalmonella: Food poisoning
1188
What is Active Transport?
Goes against concentration gradientRequires ATP
1189
What are the diastolic rumbling murmurs?
Tricuspid StenosisMitral Stenosis
1190
What is Face Presentation?
Mentum Anterior preform forceps delivery
1191
What is Zero-order kinetics?
Metabolism independent of concentration (rate of elimination is constant)
1192
What is Mumps?
Parotitis (Red Stenson's Duct)
1193
What does the Bulbourethral/ Cowper's Glands secrete?
Bicarb to neutralize lactobacilli, if sperm is too acidic. (Infertility until corrected)
1194
What is Type and Cross?
Blood that is matched by blood type and cross-reacted with the patient's blood for rejection
1195
How do you treat A1 Gestational DM?
Diet
1196
What is the rate-limiting enzyme in Glycogenolysis?
Glycogen Phosphorylase. Occurs in the Cytoplasm of Liver and Muscle
1197
What bugs cause Loeffler Syndrome?
"NASSA"N - Necator AmericanusA - Ancylostoma DuodenaleS - SchistosomiasisS - StrongyloidesA - Ascaris Lumbricoides
1198
What has Fat Casts?
Nephrotic Syndrome
1199
What is Paget's disease of the Breast?
Rash and ulcer around the nipple, breast CA
1200
What is the only Crescent Shaped Protozoa?
Giardia Lamblia
1201
What produces Currant Jelly stool?
Intussusception
1202
What is associated with R. Akari?
Mites
1203
What are Braxton-Hicks Contractions?
Irregular contractions with closed cervix. (preparing for birth)
1204
What is Krabbe's?
Galactocerebrosidase deficiencyperipheral neuropathyoptic atrophygloboid bodiesaccumulation of Galactocerebroside and Psychosine
1205
What are the adverse effects of methylxanthines?
Cardiotoxicity, Neurotoxicity
1206
How do I know the patienthas a Vitamin K Deficiency?
Bleeding, Loss of gamma-carboxylation
1207
What is a Meningomyelocele?
Sacral pocket with meninges and nerves in it
1208
What are the Adverse Effects of Osmotic Laxatives?
Diarrhea, dehydration, may be abused by bulimics
1209
What is the color of fluid or a solid on X-ray?
White "radiopaque"
1210
What is the MOA of a Growth Hormone?
Stimulates liver production of insulin-like growth factors and gastric emptying
1211
What is Ferning?
Estrogen crystallizes on slide. (Amniotic fluid)
1212
What are the essential fatty acids?
Linolenic, Linoleic
1213
What is Hunter's?
Iduronate Sulfatase deficiencymilder formXLRno corneal cloudingaggressive behaviorAccumulation of Heparin and Dermatan Sulfate
1214
What does a Western blot detect?
Protein, "snoW, droP"
1215
What are the four Painful Genital Lesions?
HerpesChancroid (It makes you cry... H. Ducreyi) Lymphogranuloma VenereumLymphogranuloma Inguinale
1216
What are the indications for Bile Acid Resins?
Slightly increase HDL and triglyceridesDecrease LDL
1217
What is Dubin-Johnson?
Defective Bilirubin storageBLACK LIVERIncreased conjugated bilirubin
1218
Snowman-shape on x-ray?
Total anomalous pulmonary venous return
1219
What is the MOA of H2 blockers?
Reversible block of histamine H2 receptors to decrease H+ secretion by parietal cells
1220
What are the Alpha-Glucosidase Inhibitors?
Acarbose and Miglitol
1221
What is Early Deceleration?
Normal due to head compression
1222
What is Hepatorenal Syndrome?
Build up of liver toxins that cause renal failure
1223
What organ has the lower AVO2 difference?
Kidney
1224
What bug causes multiple liver abscesses?
Entamoeba Histolytica
1225
What is Conversion?
Neurological manifestations of internal conflict, indifferent to disability, blindness/mutism triggered by a stressor. Patient is unconcerned about his impairmentTx: Psychotherapy
1226
What is a Xanthelasma?
Triglyceride build up and is seen under the eyes (Xanthoma subtype)
1227
What are the indications for Prazosin?
Pheochromocytoma, HTN
1228
What is Cystinuria?
Defect of AA transporter in PCT and GIm prevents reabsorption of Cysteine, Ornithine, Lysine, Arginine (COLA)Hexagonal (Cysteine) stones in urine (urinary Cyanide nitroprusside test is Dx)
1229
What are the indications for antileukotriene?
Asthma, aspirin induced asthma
1230
What is Regression?
Immature behavior, go back in development
1231
What are the sounds made from diastolic murmurs?
Blowing and rumbling
1232
what is the Central Nervous System?
Brain and spinal cord, Myelination by the oligodendrocytes
1233
What is Laryngomalacia?
Epiglottis rolls in from side to side
1234
Where does a Type A thoracic aortic dissection occur?
Ascending Aorta, (occurs in Cystic medial necrosis and Syphilis)
1235
What diagnosis has primary hyperparathyroidism?
Parathyroid Adenoma
1236
What does a mid-systolic click tell you?
MVP- Mitral valve prolapse
1237
What is a Schwannoma?
CN-8 tumor, unilateral deafness
1238
What does auscultation of stridor tell you?
Extrathoracic narrowing (seen on inspiration on X-Ray)
1239
What is ADHD?
Over activity, short attention span, difficulty in school, must be identified in two different locations (home and school). Tx: First line- methylphenidate and dectroamphetamine; Second line- Atomoxetine (SNRI)
1240
What are the indications for Sulfonylureas?
NIDDM (Type 2)
1241
When is Beta HCG found in Urine?
2 weeks after fertilization
1242
What does auscultation of crackles tell you?
Blowing collapsed alveoli open (restrictive lung disease)
1243
What is a Xenograft?
1 species to another species (pig heart into humans)
1244
What makes Esophageal Spasms Unique?
Increased Peristalsis
1245
What is the rate-limiting enzyme in Gluconeogenesis?
Fructose - 1,6 Bisphophatase
1246
What is the most common cause of first trimester maternal death?
Ectopic pregnancy
1247
What does Vit K do?
ClottingSynthesized by intestinal flora
1248
What serum pH does emesis have?
Alkalotic because you vomit out HCl-
1249
What is the MOA of coricosteroids?
Inhibits leukotriene synthesis -\> reduces inflammation and leads to bronchodilation
1250
What bugs can cause walking pneumonia?
"Come My Love for a Walk"0-2 mos: Chlamydia Pneumonia10-30 years old: Mycoplasma Pneumonia\>40 years old: Legionella pneumoniaAIDS and PREMIES: Pnemonia Carinii
1251
What is associated with R. Tsutsugamushi?
Chiggers (Mites) = Scrub Typhus
1252
What is the MOA of Hexamethonium?
Nicotinic Ganglionic blocker
1253
What is the rate-limiting enzyme in TCA Cycle?
Isocitrate dehydrogenase
1254
What are the Gram Negative Capsules?
"Some Killers Have Pretty Nice Capsules"S - SalmonellaK - KlebsiellaH - H. Influenza B (HiB)P - PseudomonasN - NeisseriaC - Citrobacter
1255
What causes Cryoglobulinemia?
"I AM He"I - InfluenzaA - AdenovirusM - MycoplasmaH - Hepatitis B and C
1256
What is the indication for muscarinic antagonist?
Asthma, COPD
1257
What are the Adverse Effects of Octreotide?
Nausea, cramps, steatorrhea
1258
What serum pH does diarrhea have?
Acidosis because stool has bicarb
1259
What are the indications for adenosine?
Dx. and tx. of AV nodal arrhythmias
1260
What is Word Salad?
Unrelated combinations of words
1261
What are the Vasodilators?
Hydralazine, Minoxidil, Nifedipine, Verapamil, Nitroprusside, Diazoxide
1262
What is Frotteurism?
Rubs penis against fully clothed women
1263
What is the rate-limiting enzyme in Urea cycle?
Carbamoyl Phosphate Synthetase-1 (CPS-1)
1264
What are the Adverse Effects of PTU and Methimazole?
Agranulocytosis, skin rash and Aplastic Anemia
1265
What is Molluscum Contagiosum
Flesh colored papules with a central dimple
1266
What is the indication for Albuterol?
Acute exacerbation
1267
What does Gastrin do?
Stimulates parietal cells to release intrinsic factor (IF) and H+
1268
What is Turner's Syndrome (XO)?
High FSH, LOW E2, Ovarian Dysgenesis, Webbed Neck, Coarctation of the Aorta, Cystic Hydroma, bicuspid Aortic valve
1269
What murmur has Pulsus Tardus?
Aortic stenosis
1270
How do you predict a due date with Nagele's rule?
Subtract 3 mo. from LMP (last menstrual period)Add 7 days, if her cycle is 28 days (i.e: LMP Jan 7, 2016 would have an estimated date of Oct. 14, 2016)If her cycle is more than 28 days add 1 day for each extra day of the cycle
1271
What is the Acrosomal reaction?
Sperm release enzymes to eat the Corona Radiata
1272
Function of what cells is necessary for the action of Sulfonylureas?
Requires some islet cell function so drugs used less in Type 1 DM
1273
What is Conjugated Bilirubin?
Water soluble and direct Bilirubin
1274
What is the MOA of the Ca2+ blockers?
Decreases conduction velocity of the AV node, increases ERP and PR interval
1275
What is associated with Legionella Pneumoniae?
Found in AC ducts, silver stains lung, CYEAPontiac Fever, Legionnaire'sPneumonia
1276
What are the Megaloblastic Anemias?
Vitamin B-12 Deficiencyfolate deficiencyalcohol
1277
What is Double Depression?
Depression followed by dysthymia
1278
What is familial Hypocalciuria Hypercalcemia?
Patients with decreased calcium excretion
1279
What are some causes of Cold Autoimmune?
MonoMycoplasma infectionAntibody (IgM) bind to RBC's membranecold temp and causes agglutination
1280
What has Muddy Brown Casts?
Acute Tubular Necrosis (ATN)
1281
What are the indications for Bosentan?
Pulmonary HTN
1282
What is Circumstantiality?
Digresses but finally gets back to the point
1283
What are the adverse effects of B-blockers?
Impotence, asthma, bradycardia, AV block, heart failure, sedation, sleep alterations
1284
What are the Steroid Hormones?
Progesterone, Estradiol (E2), Testosterone, Cortisol, and Aldosterone
1285
What is associated with Bacteroides Fragilis?
Post Op bowel abscess, grows in blood clots
1286
Explain Restrictive Lung Disease:
Restrictive: Interstitial problem that causes trouble breathing in (small stiff lungs)Pulmonary Function Test's: FEV1/FVC greater than 0.8, decrease vital capacityABG: decreased pH, decreased PO2, decreased PcO2 (increased respiratory rate)Chest X-Ray: reticulonodular pattern, ground glass appearanceMost common cause of death is Cor-pulmonaleTreatment: PEEP ventilator, increased O2, increased respiratory time
1287
When performing a high dose dex. Test, if positive...
Patient has a pituitary tumor
1288
What does the Prostate Secrete?
The prostate HAZ it.H- HyaluronidaseA- Acid PhosphataseZ- Zinc
1289
What are the Gram-negative exotoxins?
H. InfluenzaBordatella Pertussis
1290
What is Meniere's Disease?
Same presentation as Labyrinthitis but is a chronic condition with remitting and relapsing episodes
1291
How does Granuloma Inguinale present?
Spreading ulcer, Donovan bodies, due to Klebsiella Granulomatis (rod shaped), oval organism that can be seen in the Cytoplasms of Phagocytes or in tissue of people with grauloma inguinale
1292
What are the Glitazones/Thiazolidinedione's drugs?
Pioglitazone and rosiglitazone
1293
What is Concrete Thinking?
Can't interpret abstract proverbs, only sees the facts
1294
Explain Obstructive Lung Disease:
Obstructive: Airway structure problem that causes trouble breathing out (mucus filled lungs)PFT's: FEV/FVC is less tha 0.8, increased RV; Reid index increased (thick airway)ABD: decreased pH, normal to low PO2, increased PCO2Most common cause of Death is BronchiectasisTreatment: ventilator to increase respiratory rate and expiratory time, increase oxygen only if needed
1295
What is the MOA of Methyldopa?
Alpha 2 agonist = decreases peripheral resistance
1296
What drugs cause Pulmonary Eosinophilia?
Nitrofurantoin and Sulfonamides
1297
What is Hirschprungs Disease?
Failure of innervation to the rectum (No Auerbach's Plexus), lack of meconium passage in the newborn, Neural crest cell migration problem
1298
What is the MOA of Guanethidine?
Interferes with norepinephrine release
1299
What is pseudo-pseudo-hypoparathyroidsm?
G-Protein defect, and there is no calcium problem
1300
What is Malingering?
Fake illness for monetary gain or getting out of jail, avoids medical treatmentTx: Supportive Psychotherapy
1301
What does alpha one anti-trypsin do?
Inhibits Elastase
1302
What GI disease has a String Sign on X-Ray?
Pyrloric Stenosis and Crohn's Disease
1303
What is DiGeorge Syndrome?
No Thymus, inferior Parathyroid and low calcium
1304
What is a Meningocele?
Sacral pocket with meninges in it
1305
What does auscultation of rhonchi tell you?
Mucus in the airway (obstructive airway disease)
1306
What is the indication for Osmotic Laxatives?
Constipation
1307
What is Suppression?
Consciously block memory
1308
What is Placenta Previa?
The placenta is implanted wholly or partially in lower uterine segment
1309
Which of your cells express MHC-1?
All nucleated cells except the immune-privileged cells/tissues, RBC's and Platelets
1310
What are the Indications for Desmopressin (DDAVP)/ADH?
Antidiuresis and Central (pituitary) DI
1311
What are the atypical (no cell wall) Bacteria?
"CLUMsy"C - ChlamydiaL - LegionellaU - UreaplasmaM - Mycoplasma
1312
When performing a low does dexamethasone test, a depression in ACTH levels occur, what does that tell you?
Patient is either depressed, obese, or it's a normal variant, if the low dose Dexamethasone test does not suppress...
1313
What is seen in Warm Autoimmune?
Anti-Rh Ab Dapsone, PTU, antimalarials, and sulfa drugsAntibody (IgG) binds to RBC's membrane in warm temp
1314
What is a nonsense mutation?
Early stop codon
1315
What bug loves the posterior fossa?
TB
1316
Banana-shape on x-ray?
IHSS
1317
What is a Hyperacute Rejection?
Autoimmune response within 12 hours, preformed antibodies respondedThis is a Type 2 hypersensitivity reaction
1318
What is Sadism?
Gives physical and psychological pain
1319
What is persistent eye drainage since birth usually due to?
Blocked Duct
1320
What is a Tamponade?
Decreased breathe sounds and blood pressure, distant muffled heart soundsicnreased JVD
1321
What is Whipple's Disease?
Tropheryma Whipplei (T. Whipplei) destroy the GI tractCausing Malabsorption/Arthralgia, PAS (+)
1322
What is Pneumonia?
Consolidation of airway
1323
What are the HMG-CoA reductase inhibitors?
Lovastatin, Pravastatin, Simvastatin, Atorvastatin, Rosuvastatin
1324
What is associated with S. Pneumoniae?
Otitis Media, red bulging TM
1325
What is the MOA of Alpha-Glucosidase Inhibitors?
Inhibits intestinal brush border Alpha-Glucosidases, Delays sugar hydrolysis and Glucose absorption from the guy, Decreases postprandial hyperglycemia
1326
What do white diaper crystals suggest?
Excess Orotic acid
1327
Where is a Morgagni Hernia?
Anterior/middle of diaphragm, bowel sounds in thorax, seen on US in uterosurgery to fix immediately after birth
1328
How do you measure efferent renal function?
BUN or PAH
1329
What is Pityriasis Rosea?
Herald Patch that migrates along skin lines in a Christmas Tree appearance
1330
What are the indications for B-blockers
HTN, Angina, MI, Antiarrhythmic
1331
What is Multiple Endocrine Neoplasia III (2B)?
Pheochromocytoma, Medullary Carcinoma of the Thyroid, Mucosal Neuromas/ Marfanoid body habitus. (tumor marker RET)
1332
What is Congenital Hip Dysplasia?
Hip dislocation may be developed in uterus during delivery, found during new born eval, gluteal fold asymmetricThe Barlow/Ortolani maneuver test: there is a palpable "clunk: or click as the hip is dislocated in a posterior-superior direction
1333
What does a Northern blot detect?
RNA, "sNow, dRop"
1334
What is associated with EIEC?
Inflammatory = loose stool
1335
What is Cullen's SIgn?
Bruising around the umbilicusCaused by hemorrhagic pancreatitis (late sign)
1336
What Hepatitis B labs indicate an acute recent infection?
HBcAg+, HBsAg+, (HBcAb+/-)
1337
What is Bernard-Soulier?
Baby with bleeding from skin and mucosa(Big platelets and LOW GP-1b)
1338
What does cortisol do?
Gluconeogenesis by proteolysis and thins the skin, prevents and immune response, and decrease bone mass
1339
What are the most common infections of the Low Energy State?
UTI and respiratory infections
1340
What are the Comma (curved) shaped bugs?
Vibrio, Campylobacter, Listeria, H. Pylori
1341
What is Dysmenorrhea?
PG-F causes painful menstrual cramps. (Teenagers miss school / work)
1342
What is Asperger's?
Good communication skills, impaired relationships, no mental retardation
1343
What is the most common cause of first trimester spontaneous abortions?
Chromosomal abnormalities
1344
What is Familial Polyposis?
100% ridk of Colon Cancer, APC gene defect and annual Colonoscopy start at 5 years of age
1345
What is Parkinson's disease?
Located in the Substantia Nigra, bradykinesia, pill rolling tremor, shuffling gait, Lewy Bodies
1346
What is associated with Bordetella Pertussis?
Whooping cough, ADP ribosylates Gi
1347
When can you tell the sex of the baby by US?
Week 16
1348
What is Type 1 Diabetes Mellitus?
Anti-islet cell antibody /GAD (Glutamic Acid Decarboxylase) antibody.
1349
What hormones produce Acidophilus?
"GAP": GH, Acidophilus, and Prolactin
1350
What are the most common causes of third trimester spontaneous abortions?
Anti-Cardiolipin Ab, placenta probelms, infection, incompetent cervix
1351
What is the most common cause of a White Reflex?
Retinoblastoma
1352
What is Truncus arteriosus?
Spiral membrane did not develop, there is one Aortic Pulmonary trunk, mixed blood, needs PDA
1353
What is an Epstein's Pearl?
White pearls on hard palate
1354
What is seen in RPGN?
Crescents
1355
What does a Synthase do?
Consumes two substrates
1356
What is asthma?
Chronic inflammatory disease of the airwayscharacterized by variable and recurring symptoms, wheezing on expiration, elevated IgE and Eosinophils
1357
What is Autism?
Poor eye contact, repetitive movements, lack of verbal skills and bonding, symptoms since birthTx: Behavioral modification, use antipsychotic if have aggressive behavior
1358
What are Mongolian spots?
Melanocytes on lower back
1359
What is a Factor V - Leiden?
Protein C cannot break down Factor V
1360
What disease has exophthalmos?
Grave's disease
1361
When can you first detect fetal heart tones?
Week 20
1362
What is Multiple Personality Disorder?
They have 5-10 alters, usually associated with incest
1363
What is the job of the TAL of Henle?
Makes the concentration gradient by reabsorbing Na, K, Cl, Mg, and Ca without water. (Impermeable to H2O)
1364
What is the most common Nephrotic disease complication with cancer?
Amyloidosis
1365
What are CD4 cells?
T-helper cell - Responds to MHC-2 (foreign attack)
1366
What is the APGAR test?
Neonatal Rating Scale (0-10) Greater than 7Test @ 1 minute and 5 minutesA - Appearance (Color)P - PulseG - GrimaceA - ActivityR - Respiration
1367
What symptoms does a "more likely to depolarize" state have?
Brain: Psychosis, seizures, jitterinessSkeletal Muscle: muscle spasms, tetanySmooth Muscle: diarrhea, then constipationCardiac: tachycardia, arrhythmia
1368
Whata re the anabolic pathways that store energy? (occur in the cytoplasm)
Fatty acid synthesis, Glycolysis, HMP shunt, translation
1369
Whata re the indications for Guanethidine?
Severe HTN
1370
Which cytokines do T-helper cells stimulate?
All IL's except IL-1
1371
What is seen in newborn with HSV-2 in utero infections?
Temporal Lobe encephalitis, must offer C-section to mom with active lesions
1372
What is the Primary Diabetes Insipidus (DI)?
Too much water (urinates a lot)
1373
What is Merocrine?
Cell is maintained. (exocytosis)
1374
What is the most common cause of primary hypoparathyroidism?
Thyroidectomy
1375
What are the Silver Stainer's?
"HaLV-C"H - H. PyloriL - ListeriaV - VicrioC - Campylobacter
1376
What has WBC Casts and RBC Casts?
Glomerulonephritis
1377
What are the 3 kinds of generalized seizures?
Tonic-clonic "Grand Mal"Absence "Petit Mal"Status Epilepticus
1378
What are the side effects of Progesterone?
Acne, depression, HTN, increase appetite, acne causes dilution anemia, quiescent uterus, PICA, hypotension, melisma (AKA Chloasma)
1379
What is Ficticious Disorder by Proxy?
Mom makes the child or another person ill for emotional support, noted to move frequently
1380
What is associated with ETEC?
Traveler's Diarrhea = rice water diarrhea
1381
What are the Adverse Effects of Levothyroxine (T4)/Triiodothyronine (T3)?
Tachycardia, heat intolerance, tremors and Arrhythmias
1382
What is the Somatic Nervous System?
Moving your muscles
1383
What state does Estrogen mimic?
The Neuromuscular disease stateEstrogen is a muscle relaxant
1384
What is the most common Nephrotic disease in diabetics?
Nodular Sclerosis
1385
What is Placenta Accreta?
Placenta is attached to the endometrium
1386
What is Polymenorrhea?
Too many periods
1387
What do you see in CMV in utero infections?
Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications
1388
What diseases have Hemoptysis?
Bronchiectasis, Bronchitis, Pneumonia, TB, Lung CA, Goodpasture's, Wegener's
1389
What are the Immuno-privileged sites?
Areas of the body that have no lymphatic flow, no antigens, and these areas can be transplanted without fear of rejection (brain, cornea, thymus, and testes) they do not express MHC-1
1390
What is the difference between Acute and Chronic Leukemia's?
Acute: started out in the bone marrow, squeezes RBC out of the marrowChronic: started in the periphery, not constrained and will expand
1391
What is Lochia?
Endometrial slough. (normal discharge and uterus after birth)
1392
What does fixed wide S-2 splitting tell you?
ASD
1393
What is Cryptorchidism?
Testes never descended out of abdomen, sterility after 15 months, predisposed to seminomas and CA
1394
What is the MOA of Class IC antiarrhythmic?
Na+ channel blocker
1395
What is the function of ACTH (Adrenocorticotropic hormone)?
Stimulates Cortisol and Androgen releases from the adrenal gland
1396
What is the indication for Salmeterol?
Long acting agent for prophylaxis
1397
What is the rate-limiting enzyme in Beta Oxidation?
Carnitine Acyltransferase -1 (CAT-1)
1398
What do the IgA protease bugs cause?
Sinusitis, Otitis Media, Pneumonia/Bronchitis
1399
What are the causes of Hyperbilirubinemia?
Sepsis, ABO Incompatibility, Hypothyroidism and Breast-feeding
1400
What does a Hydroxylase do?
Adds-OH group onto substrate
1401
What is Mittelschmerz
Pain with ovulation
1402
What is the MOA of Ezetimibe?
Prevents cholesterol reabsorption at small intestine brush border
1403
What is Barrett's Esophagus?
Metaplasia of the lower esophagus increased risk of Adenocarcinoma
1404
How do you diagnose Rheumatic Fever?
JONES Criteria
J - Joint Involvement
O - Myocarditis
N- Nodules, subcutaneous
E - Erythema Marginatum
S- Sydenham Chorea
1405
What is a missense mutation?
Mistaken amino acid substitution (i.e. SS disease Valine for Glutamic Acid)
1406
What are the adverse effects of HMG-CoA reductase inhibitors?
Hepatotoxicity (increase LFT's)Rhabdo
1407
What is Masochism?
Receives pain (Humiliation)
1408
What other diseases can have exophthalmos?
Horner's and Marfan's
1409
What vessels have the highest capacitance?
Veins and Venules
1410
Waht does the Surface Ag tell you?
Alone it means it's been occupied/ with other markers it means it is a current infection, if present for \> 6 months it's chronic
1411
What is seen in iron deficiency?
Anemia
1412
What is Celiac Sprue?
Found in the JejunumWheat AllergyVillous atrophAnti-gluter-gliadin antibodies
1413
What is uremia?
Azotemia (renal failure) with symptoms
1414
What is Urge incontinence?
Urgency leads to complete voiding detrusor spasticity leads to small bladder volume
1415
What does epinephrine (Epi) do?
Drives gluconeogenesis and glycogenolysis
1416
What bug is associated with cat saliva?
Pasteurella Multocida
1417
What is a Corticotrope?
ACTH
1418
What is Ductal Carcinoma?
Worst prognosis Breast CA
1419
What is associated with C. Tetani?
Rusty nail wounds - inhibits GLY release, respiratory failure, Risus Sardonicus, tennis racquet shaped appearance
1420
What is Meig's Syndrome?
Pleural effusion, ovarian fibroma, ascites
1421
What blood level should be monitored in patients taking statins?
Liver enzymes every 3 months and Serum Cr
1422
What is the most common cause of Polyhydramnios?
Neuromuscular problem: Werdnig HoffmanGI problem: Duodenal atresia
1423
What is Hairy Cell Leukemia?
Cells have a fried egg/ Sunburst appearance and TRAP +
1424
What does motilin do?
Stimulates segmentation, primary peristalsis, and migrating motor complexes (MMC)
1425
What is Pneumothorax?
Absent breath sounds on one side
1426
What is Identification?
To be like or to become like another (aspect, property or attribute of another)
1427
What is the most common cause of post-coital Vaginal Bleeding in Pregnant women?
Placenta previa
1428
What are the adverse effects of Hydralazine?
Compensatory tachycardia, fluid retention, Lupus like syndrome, contraindicated in Angina/CAD because of compensatory tachy
1429
What does an AFI \>20 indicate?
Polyhydramnios (DM)
1430
What is Somatization?
Psychological trigger gets them sick, but no medical finding (Pain in 4 parts, 2 GI problems)Tx: Psychotherapy
1431
What is the second generation Sulfonylureas?
Glyburide, Glimepiride, and Glipizide
1432
What can you measure to test afferent arteriole's function?
Glomerular filtration rate (GFR) or Inulin
1433
What does a wide S-2 split tell you?
Increases OxygenIncreased right ventricular volumeDelayed pulmonic vlave opening
1434
What are the indications for administering Potassium?
Digoxin toxicity, activated charcoal: binds digoxin in the intestineDigibind: binds to digoxin in the bloodstream
1435
What is Tracheitis?
"Acute URI"Patients look toxicGrey PseudomembraneLeukocytosis
1436
What is the common side effect of the ERCP procedure?
Pacreatitis from blocking the pancreatic duct during the procedure
1437
What amino acid turns yellow on Ninhydrin reaction?
Pro
1438
What is the job of the late Distal Tubule and Collecting Duct?
Final concentration of urine by reabsorbing water and excretion of acid
1439
What separates unconjugated bilirubin from albumin?
Sulfur (no Sulfur Rx in pregnancy)
1440
What is Caput Succedaneum?
Bleeding under scalp (edema will cross suture lines)
1441
What are the indications for Levothyroxine (T4)/Triiodothyronine (T3)?
Hypothyroidism and Myxedema
1442
What is an Autograft?
Twin to twin (spare parts)
1443
What are the H2 blockers?
Cimetidine, Ranitidine, Famotidine, and Nizatidine
1444
How does a Subdural Hematoma present?
Headache 4 weeks after trauma, elderly (loose brain)
1445
What GI disease has a RUQ Olive Mass?
Pyloric Stenosis
1446
How would you know the patient has a Vitamin A (retinoic Acid) Deficiency?
Poor night vision, Hypoparathyroidism, dry skin
1447
What is Histiocytosis X?
Histiocyte proliferation Kid with Eczema, skill lesionsHand-Schuller-Christian disease
1448
What is Body Dysmorphic Disorder?
Imagined physical defect, causing impaired function in a social or occupational activityTx: SSRI
1449
What happens when there is a biotin Deficiency?
Loss of carboxylase function
1450
What is the MOA of Methylxanthines?
Inhibit Phosphodiesterase -\> decreases cAMP hydrolysis promoting bronchodilation
1451
How does a Somatostatinoma present?
Constipation
1452
What are the types of VWD?
Type 1 (AD): Decreased VW FActor ProductionType 2 (AD): Decreased VW Activity(+ Ristocetin Aggregation test)Type 3 (AR): No VWF
1453
What does Calcitonin do?
Inhibits Osteoclasts and binds to calcium
1454
What is Countertransference?
Doctor views patient as child
1455
What does Sudan Black Stain test for?
Steatorrhea (fat malabsorption), patient seen with chronic pale, greasy, malodorous diarrhea and no evidence of infection
1456
What tests are used for following Pancreatitis?
Amylase (sensitive) breaks down Carbohydrates and Lipase (specific) breaks down Triglycerides
1457
What is Postpartum Psychosis
Hallucinations, suicidal/infaticidal thoughts
1458
What color is stool with an Upper GI Bleed?
Black (Dark Red) (Melena)
1459
What are the most common signs of the Low Energy State?
Tachypnea and Dyspnea
1460
What is the Adverse Effect of Glitazones/Thiazolidinedione's?
Weight gain, edema, hepatotoxicity, increases LDL and triglycerides, CHF and Contraindicated
1461
What is the MOA of Octreotide?
Long-acting somatostatin analog
1462
What is Plummer's Syndrome?
Hyperthyroid adenoma
1463
What is aspergillosis?
Mold, compost piles, associated with peanuts
1464
How does Diverticulitis present?
Pain in LLQ, no visible blood and may cause peritonitis
1465
What has WBC Casts?
Nephritis
1466
What are the cholesterol Absorption blockers?
Ezetimibe
1467
What murmurs occur during systole?
Holosystolic or pansystolic
1468
What is Acting out?
expression of impulse, "Temper Tantrums"
1469
What is the Intermediate Acting Insulin drug?
NPH and Lente
1470
What is Schatzki's Ring?
Esophageal webs in the lower EsophagusDysphagia (mucosal tissue)
1471
What is McArdle's?
Myophosphorylase deficiency(skeletal muscle Glycogen Phosphorylase)muscle cramps w/ exercise, increased Glycogen in muscle only, blood glucose NLSecond wind phenomenon
1472
What is inevitable Abortion?
Cervix is open, baby is intact
1473
What is pseudo-hypoparathyroidism?
Bad kidney, PTH receptor, decreased urinary, cAMP
1474
What is hemochromatosis?
Iron deposits in organsleads to hyperpigmentation, bronze diabetes, and arthritis
1475
What do B cell deficiency patients die of?
Bacterial infection?
1476
What are the adverse effects of Guanethidine?
Contraindicated in patients taking TCA's
1477
What affects Potency?
Km (EC50)
1478
What does blood type A tell you?
They have the A antigen and B antibodies
1479
What does Vit B4 do?
Glycolysis, no known diseases
1480
What is Illusion?
Misinterprets stimulus
1481
What is Repression?
Subconsciously block memory
1482
What is Thought Withdrawal?
Believes that others are taking thoughts out of his head
1483
What does S-2 splitting tell you?
Normal on inspirationPulmonic valve closing later
1484
What is open-angle glaucoma?
Overproduction of fluid, painless Ipsilateral dilated pupil, gradual tunnel vision, optic disc cupping
1485
What is Pseudomembranous Colitis?
Overgrowth of C. DiffDue to normal flora being killed off from long term antibiotic use
1486
What are the indications for H2 blockers?
Peptic ulcer, gastritis and esophageal reflux
1487
What is a Necrophile?
Someone who has sex with corpses
1488
What is associated with R. Rickettsii?
Ticks = Rocky Mountain spotted fever
1489
What is associated with Shigella?
Day care outbreaks, seizures, destroys the 60S ribosome, infects M-cells
1490
What is Post-Renal Failure?
Obstruction (hydronephrosis)
1491
What is a Bezoar?
Mass of non-digestible product (i.e. Hair) causing an occlusion at the pylorus
1492
What is a Hemangioblastoma?
In the cerebellum, associated with VHL
1493
What will you see with Iron Deficiency Anemia?
Increased TIBC associated with menses, GI bleeding, and Koilonychia
1494
How do I know the patient has a Vitamin B5 (Pantothenic Acid) Deficiency?
No deficiency state
1495
What is a fetish?
High attraction for inanimate objects
1496
What is a possible cause if pulse rises more than 10 bpm in repositioning from lying to sitting?
Hypervolemia
1497
What does the Hep B Core Ag tell you?
Gone before patient has symptoms (present from 0-2 months)
1498
What is Mallory-Weiss?
Tearing of the lower esophageal sphincter (LES), associated with chronic vomiting, cough up a little blood and possible visible varices
1499
What is Cushing's disease?
High ACTH due to pituitary tumor or Small cell carcinoma of the lungs
1500
What is a Craniopharyngioma?
Motor oil biopsy, tooth enamel, Rathke's Pouch, ADH problem, Bitemporal Hemianopsia
1501
What Does Vit E do?
Antioxidantacts as an tagonist to Vit K in high levels
1502
What are the Foot Ulcer Risk Factors?
Poor glycemic control (HbA1C \>7), smoking, bony abnormalities, previous ulcers
1503
What GI disease has a Thumb Print on X-Ray?
Toxic Megacolon
1504
What is Silicosis?
Sandblasters and glassblowers
1505
What is Tropical Sprue?
Found in the distal iliumCaused by bacterial or viral, amoeba or parasitic infectionVillous atrophy
1506
What are the adverse effects of corticosteroids?
Osteoporosis, Cushingoid reaction, psychosis, glucose intolerance, infection, HTN, cataracts
1507
What is Holocrine?
The whole cell is secreted. (except sebaceous gland)
1508
What is Acromegaly?
Growth hormone tumor producing increased IGF-1 causing: bone growth in adults, coarse facial features, large furrowed tongue, deep husky voice, jaw protrusion
1509
When is B-HCG found in Blood?
8-10 days after fertilization
1510
What does Chymotrypsin cut?
Phe, Tyr, Trp
1511
What is Backward Typing?
Used Antigens to detect Antibodies
1512
What are the ketogenic amino acids?
Lys, Leu
1513
What are the Adverse Effects of GLP-1 Analogs?
Nausea, Vomiting and Pancreatitis
1514
What makes Scleroderma Unique?
Can have a decreased LES pressure or and increased LES pressure
1515
What is epiglottitis?
inflammation of the epiglottisthumb sign on x-rayexcessive drooling
1516
Waht is associated with Brucella?
Seen in farmers/ Vets, Animal placentas are the vector, Spiking fever 5 times a day
1517
What GI disease has Barium Clumping on X-Ray?
Celiac Sprue
1518
What are the Short Acting Insulin drugs?
Aspart and Lispro
1519
What is seen in Measles (Rubeola)?
CCCK: Cough, Coryza (runny nose), Conjunctivitis, Koplik SpotMorbilliform blotchy rash
1520
What is an Insulinoma?
Insulin secreting tumor, labs show increased insulin and C-peptide
1521
What ion has the greatest movement at rest?
Potassium
1522
What is seen with Fluoride deficiency?
Poor teeth and bone growth
1523
What hepatitis B labs indicate immunization \>2/52 weeks?
HBsAb+
1524
What valves make noise at the end of systole?
Aortic and Pulmonic
1525
What is Riedel's Struma?
"Woody" connective tissue in neck, death due to suffocation and must rule out CA
1526
What is the MOA of Digoxin?
Direct inhibition of Na+/K= ATPase leads to indirect inhibition of Na+/Ca2+ exchanger, positive inotrope, stimulates vagus nerve
1527
What does a Thio do?
Breaks S bonds
1528
What is Hungry Bone Syndrome?
Removal of PTH and the bone sucks in calcium
1529
What do high GABA levels lead to?
Bradycardia, lethargy, constipation, impotence, memory loss
1530
What is Shoulder Dystocia?
Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)
1531
What structures have Fake sphincters?
Ureters, LES, Ileocecal valve
1532
What does Endocrine mean?
Secreted into bood
1533
What are the indications for Misoprostol?
Prevents NSAID-induced peptic ulcers, maintenance of a Patent Ductus ArteriosusInduce labor
1534
What is the Indication for PTU and Methimazole?
Hyperthyroidism
1535
What are the expectorants?
Guaifenesin, N-acetylcysteine
1536
What does an epimerase do?
Creates an epimer, which differs around one chiral carbon
1537
What is the MOA of Guaifenesin?
Removes excess sputum but does not suppress cough reflex
1538
What are the indications for Pseudoephedrine, Phenylephrine?
Reduces Hyperemesis, edema, nasal congestion, and opens obstructed Eustachian tubes
1539
What has Crescents?
RPGN
1540
What are wide sutures due to?
Hypothyroidism and Down's Syndrome
1541
What is a Transvestite?
Dress up as opposite sex, no identity crisis
1542
What does SAM donated methyl groups for?
All other reactions
1543
When do valves make noise under normal physiology?
When the valves close
1544
What is systole?
Ejection of blood from the heart, Decreased blood flow to Coronary arteries, more extraction of Oxygen Phase 1 Korotkoff
1545
What is Homocystinuria?
No Homocysteine -\> Cysteine(Cystathionine Synthase Deficiency)or Homocysteine Methyltransferase(Methionine Synthase) Deficiency or decreased Affinity of Cystathionine Synthase for Pyridoxal PhosphateIncreased Homocysteine in urinMarfanoid Habitusdownward dislocation of lensincreased risk stroke/MI
1546
What is associated with Bacillus Anthracis?
Black Eschar, Wool Sorter's Lung diseaseD-Glu, boxcar-like spore, treat with Cipro
1547
What type of immunity does TH1 provide?
Enhances cell mediated immunity
1548
What are the adverse effects of Prazosin?
Orthostatic Hypotension
1549
What is the most common cause of post-coital Vaginal Bleeding?
Cervical CA
1550
What are the Leopold Maneuvers?
To determine the position of the babyFeel the fundusFeel the baby's neckFeel the pelvic inletFeel the baby's head
1551
What is the function of Inhibin?
Inhibits FSH so there is no menstruation
1552
What is a Transsexual?
Gender Identity crisis
1553
What are the Survival Hormones?
Cortisol: permissive under stress. TSH: permissive under normal
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What is the cause of Symmetrically small babies?
In Early onset: Chromosomal Abnormalities or TORCHES
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What will you see in Lead Poisoning?
Decreased dALA dehydrogenasedecreased Ferrochelataseblue lines on x-rayhistory of eating old paint chips
