Complete Clue Deck (Advance Edit) Flashcards
When should Intercourse be avoided during Pregnancy?
Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes
What is Type 2 RTA?
Proximal RTA: bad Carbonic Anhydrase, lost all HCO3-
What is Heavy Chain Disease?
IgA and Multiple Myeloma of the GI tract
What is Nihilism?
Feeling of “life is meaningless”
What is Forward Typing?
Uses Antibodies to detect Antigens
What is associated with Vibrio Vulnificus?
Raw Oyster - common in workers shucking the oysters, cellulitis in swimmer’s cuts
What is the MOA of Propranolol, Timolol?
B1 and B2 Blockers
What is Hand-Foot-Mouth Disease?
Mouth ulcers
Will not eat or drink
Palm and sole rash caused by Coxsackie A
What are the 2 kinds of partial seizures?
Simple (aware), complex (not aware)
What is an Omphalocele?
Intestines protrude out of the umbilicus covered by peritoneum
What is Clanging?
Words that sound alike
What is exudate?
Effusion of mostly proteinToo much protein: Will have —Purulent (from Bacteria),Hemorrhagic (from trauma, CA, PE)Fibrinous (from collagen vascular disease), Granulomatous (non-bacterial)
What are the Mimetic drugs?
Pramlintide
What is Lewy Body Dementia?
Stiff with visual hallucinations
What type of problem is there if serum Ca2+ and Serum PO4- change in same directions?
This is a secondary problem
What is the Pool Test?
Fluid in the vagina
What are the indications for Odansetron?
Control vomiting in patients undergoing chemo therapy and postoperatively
What is Kd?
Concentration of drug that binds 50% of receptors
What is associated with H. Aegyptius?
Swollen eyeball with pus
What is Overflow Incontinence?
Cannot completely empty bladder
How does Gonorrhea present?
Palmar pustules, arthritis/joint pain, urethral discomfor
What makes Achalasia unique?
Decreased Peristalsis and increased LES pressure
What is the MOA of Pseudoephedrine, phenylephrine?
Sympathomimetic alpha-agonistsnon-prescription nasal decongestants
Where does DHT come from?
Testicles at puberty
What is Intraductal Papilloma?
Bleeding from the nippleMost common Breast CA
How does temporal arteritis present?
Pain with chewing, blind in one eye
What diseases have PIE syndrome?
Aspergillus, Loeffler’s, Churg-Strauss
What is associated with Fusobacterium?
Painful mouth ulcers, gum pus, Vincent’s angina
What is the MOA of ACE inhibitors?
Inhibits conversion of Ang I to Ang II, decreases Ang II
What is Central (neurogenic) diabetes insipidus?
Brain not making or producing enough ADH
What is Arnold-Chiari?
Foramen Magnum obstruction
What is 1st-order kinetics?
Constant drug percentage metabolism over time depends on drug concentration (rate of elimination is directly proportional to drug concentration)
What does Vit B2 do?
FAD cofactor
Clues for atypical pneumonia?
Atypical pneumonia: prolonged illness, low fever, usually >40 y/oX-ray: diffuse, H. Influenza, Mycoplasma, Chlamydia
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)
What will you see with Alpha Thalassemia?
Seen in African Americans and Asian Americans (Chromosome 16- deletion)
What are the simple Gram Negative Bugs?
They lack Lipopolysaccharides,”Simple HE”H - H. InfluenzaE - E. Coli
What is a Neutrophil?
The Phagocyte (it has Antimicrobials, most abundant)
What is the MOA of Glucocorticoids?
Decrease production of Leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2
What is Transference?
Patient views doctor as parent
Where is the most common site of a Clavicle fracture due to birth?
Middle third of the Clavicle
What are the indications for Niacin?
Decrease LDL and TriglyceridesStrong increase HDL
What is Perseveration?
Keeps repeating the same words
What does the parathyroid cells secrete?
PTH
What is associated with Actinomyces?
Face Fistulas, Sulfur Granules
What is a Rolling Hiatal Hernia?
Bowel Protruded through a defect in the Diaphragm. This can strangulate the bowel and can cause Atelectasis
What is Mesenteric Ischemia?
Abdominal pain of of proportion to physical exam
What is the MOA of Diazoxide?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
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%)
What does the viral load tell you?
Progression of HIV
Which enlarged lymph nodes are most likely malignant?
Supraclavicular, Epitrochlear (above the elbow), inguinal
What is Velamentous Cord Insertion?
Fetal vessels insert between chorion and amnion
What is Common Variable Immuno. Def?
Young adults with B cells that do not work
What are the Indications for Oxytocin?
Induces labor and Controls uterine hemorrhage
What does Mg2+ do?
PTH and kinase cofactor
What are the risk factors for Lung CA?
Smoking, Radon, second hand smoke, pneumoconiosis (except Anthracosis)
What is the Adverse Effect for first generation Sulfonylureas?
Disulfiram like effects
What is Multiple Myeloma?
Multiple osteolytic lesionsIncreased IgG and kappa light chainsRouleaux formation seen on slide
Clues for Typical pneumonia?
Typical pneumonia: short illness, high fever, usually >40 y/o, X-ray: one lobe, Streptococcus Pneumonia
What is Polycythemia Vera?
Hematocrit (Hct) >60% Decreased EPO, Budd-ChiariPruritis after bathing
What is the MOA of Mimetics?
Decreases Glucagon
What is Ascending Cholangitis?
Common bile duct infection due to stones
What does Growth Hormone (GH) do?
Stimulates growth, sends Somatomedin to growth plates, Gluconeogenesis by proteolysis
What is Anderson’s?
Branching enzyme deficiency, long chains of glycogen
What is the Sympathetic System?
Fight -or- Flight, speeds stuff up
What is a Double Footling Breech?
Two feet sticking outside the cervical OS
What vessel has the thickest layer of smooth muscle?
Aorta
What is Competitive Inhibition?
Fights for active site, no change in Vmax, potency decreases
What does blood type O tell you?
They have no antigens (Universal donor)
What does high WBC and B Cells tell you?
Bacterial infection
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
What diseases are cause by the Ixodes Ticks?
Lyme Disease - bull’s eye lesionBabesiosis - Hemolytic AnemiaEhrlichiosis - puncture near eye
What does a Dehydrogenase do?
Catalyzes Oxidation-Reduction reactions (gaining or losing an electron)
What is Unconjugated Bilirubin?
Fat soluble and indirect Bilirubin
What is a transition?
Changes one purine to another purine
What is Crigler-Najjar Type I?
Unconjugated bilirubin buildupNewborn or infantsNo UDP-GTPhenobarbital yields no change
What organ has the highest AVO2 difference after excercise?
Muscle
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)
What are the most common places to metastasize to the brain?
From the lung, breast, and skin, present at the White-Grey Junction
What is Polyhydramnios?
Too much amniotic fluid (baby can’t swallow)
What is the function of GnRH?
Stimulates release of LH & FSH
What are the risk factors for Esophageal / Gastric CA?
Smoking, alcohol and nitrates
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
FEV1/FVC in Restrictive lung disease
Normal or elevated
What has Waxy Casts?
Chronic Renal Failure
What are the only Gram-negative diplococci?
Neisseriamoraxella
How does a VIPoma present?
Watery diarrhea
What are the indications for the Class IB antiarrhythmic?
Decrease AP duration, acute ventricular Arrhythmias, local anesthesia
What defines Diarrhea?
>200 grams of stool per day
What defines constipation?
Less than 3 bowel movements per week
What defines ALL?
0-15 year old males, bone pain, + PAS stain and +TdT. CALLA antigen positiveT (12;21)
What is the MOA of Class IB antiarrhythmic?
Na+ channel blocker
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
What is a Female Pseudohermaphrodite?
XX with LOW 21-OHase and HIGH Testosterone
What are the adverse effects of Acid Resins?
Tastes bad and causes GI discomfortbile decreases absorption of fat soluble vitaminscholesterol gallstones
What is Hurler’s?
Alph-L-Iduronidase deficiencyworse formGargoylismCorneal cloudingaccumulation of Heparin and Dermatan Sulfate
What are the indications for fibrates?
Strong decrease of triglyceridesslight decrease of LDLslight increase in HDL
What are the classifications of MHC-2?
HLA-DP, HLA-DQ, HLA-DR
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
How does Choanal Atresia Present?
Baby turns blue with feeding, pinks up when breast of bottle is removed (blocked nasal passages)
What is the job of the Proximal Convoluted Tubule?
Reabsorb Glucose, Amino Acids, Salt, Bicarb. >60-80% Reabsorption occurs here
What is Bronchiectasis?
Bad breath, purulent sputum, and hemoptysis
What electrolytes does the low volume state have?
Increased total Na+ (NET)Decreased serum Na (dilution effect)Decreased serum K+Increased serum pH
In what layers does a pseudo aortic aneurysm occur?
Intima and media layers
Who makes the Syncytiotrophoblast?
Mom and baby production of HCG and HPL
What is Metorrhagia
Bleeding or spotting in btwn periods
How does Spastic Colon present?
Intermittent severe cramps
What is selective IgG2 Deficiency?
Seen in patients with recurrent encapsulated infections
What diseases have respiratory acidosis?
Obstructive lung diseases
What is Prinzmetal’s angina?
Coronary Artery Spasm
What does high WBC and High PMN’s tell you?
Stress demargination. (Stress response - post trauma)
What causes a Cleft Palate?
Maxillary shelves did not fuse
What is Rouleaux formation?
Seen in Multiple Myeloma (Stacked coin look)
What is Neologisms?
New words
What is Nephrotic Kidney Disease?
Lostbasement membrange chargeProteinuria >3.5hypercoagulablelipiduria
What does a Phosphatase do?
Removes Phosphate from substrate
What bug loves the parietal lobe?
Toxoplasma
What bug is associated with Cat Scratch?
Bartonella Henselae
What is Selective IgA Deficiency?
Seen in transfusion, anaphylaxis, and mucus membrane infections
What is the Trough level?
2 hours before next dose (too high - give less often)
What is VHL?
Predisposes individuals to bnign and malignant tumors, AVM in the head, and retina (AD inheritance in Chromosome 3)
What causes a Cleft Lip?
Medial nasal prominence did not fuse
What is the MOA of Reserpine?
Prevents the storage of monoamines in synaptic vesicle
What are the 3 tests used to screen for HIV?
ELISA: Detects IgG Ab to p24 AgWestern Blot: ProteinsPCR: Detects Virus (used in babies)
What is Materninty Blues?
Postpartum crying and irritability
What are the inidications for PPIs?
Peptic ulcer, gastritis, mid-esophageal Reflux and Zollinger-Ellison syndrome
What are the Ca2+ channel blockers?
Verapamil, Diltiazem
What is Conn’s Syndrome?
High Aldosterone (primary tumor), Cpatopril test makes it worse, and increase’s secretin hormone
What color is stool with a Lower GI Bleed?
Bright Red Blood (Hematochezia)
What is Type 5 Hypderlipidemia?
Defective enzyme and receptor (C-II) Elevated VLDL and ChylomicronsAssociated with DM
What is the RBC lifespan when there is a problem?
60-90 days (same time as the shelf life of blood bank units)
What sound radiates to the back?
Pulmonic stenosis
What is the MOA of Prazosin?
Alpha 1-Blocker, vasodilation, decreases TPR
What is Sandhoff’s?
Hexosaminidase A/B deficiency
What is the MOA of Octreotide (Synthetic analog of Somatostatin)?
Decreases release of GH, Gastrin, CCK, Carcinoid, VUP, Glucagon and Insulin
How is Smallpox different from Chickenpox?
Smallpox is on the face, same stage of development and fever
What is Diffusion?
From high to low concentration No ATP
What are the Fibrates?
Gemfibrozil, Clofibrate, Bezafibrate, Fenofibrate
What is Anthracosis?
Coal workers, extensive fibrosis
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
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
What 5 bugs cause heart block infections?
“Don’t TeLL Chaga”
D- Diphtheria
T- Typhoid Fever (Salmonella Typhi)
L- Legionella
L- Lyme Disease
C- Chagas Disease (Whipple’s)
What is a Complete Abortion?
Cervix is closed, no fetal remnants, check B-HCG level
What is a “Blue Bloater”?
Chronic Bronchitis
What are the Indications for ACE inhibitors?
HTN, CHF, post MI and vasodilation
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+
What is the treatment for hypercholesterolemia?
Statins
What are the adverse effects of Minoxidil?
Hypertrichosis and Pericardial Effusion
What are the adverse effects of adenosine?
flushing, hypotension, and chest pain very short acting
What are the Glucocorticoid drugs?
Hydrocortisone, Triamcinolone, Dexamethasone, Prednisone, Beclomethasone
Whatis Pheochromocytoma?
Adrenal medulla tumor in adults, they will have five P’s: Palpitations, Perspiration, Pallor, Pressure (HTN), and Pain (headache)
What is Byssinosis?
Cotton workers, textile workers
What is Chediak Higashi?
Lazy Leukocyte Syndrome(Lysosomes are slow to fuse around bacteria)
What is Korsakoff Psychosis?
Alcoholic Thiamine deficiency. Presents with confusion, Opthalmoplegia, ataxia, memory loss, confabulation and personality changeTx: Vit B1
What type of Kidney Stones have Coffin-Lid Crystals?
Triple Phosphate (Struvite)
What is the difference between carotid body and carotid sinus?
Carotid Body: ChemoreceptorCarotid Sinus: Baroreceptor
What is Meconium?
Green baby poop (first poop)
What does Insulin do?
Pushes glucose into cells and K+ follows
What causes Granuloma Inguinale?
CalymmatobacteriumGranulomatosisKlebsiella Granulomatis
What is the MOA of Carvedilol?
Alpha and B-Blocker
What is the MOA of Levothyroxine (T4)/Triiodothyronine (T3)?
Thyroxine replacement
What is Anisocytosis?
RBC’s with different sizes
What is Pain Disorder?
Prolonged pain not explained by physical causes
What causes Congenital Blindness?
CMV
What is Plummer-Vinson Syndrome?
Esophageal webs, Iron-deficiency anemia, dysphagia
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
What is associated with Strep Viridans, Strep Mutans, and Strep Salivarius?
Subacute bacterial Endocarditis, green pigment, Alpha HemolyticStrep Mutans - dental cariesStrep Salivarius - cold agglutinates
What are the adverse effects of Dextromethorphan?
Mild opioid effect so mild abuse potential
What is the most common cause of Epididymitis?
Chlamydia Trachomatis, N. Gonorrhea, E. Coli
What is Charcot’s Triad?
Jaundice, Fever (usually with rigors) and RUQ pain
What is seen with Manganese deficiency?
Lose xanthine oxidase function
What is Psychogenic Polydipsia?
Drinking a lot of water, diluting Na in blood
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
What is the afferent arteriole’s job?
Monitor pressure (JG cells-Renin release)
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
What is a frameshift mutation?
Insert or delete any number of bases, not divisible by 3, causes misreading of all downstream nucleotides
What is the Isoelectric Point?
The pH at which there is no net charge
What does an opening snap tell you?
Mitral or Tricuspid Stenosis
What is the rate-limiting enzyme in FA synthesis?
Acetyl-CoA Carboxylase (ACC)
What does a Phosphorylase do?
Adds inorganic Phosphate to substrate, No ATP used
What is associated with EHEC?
Hemorrhagic = renal failure
What are the Bile acid resins?
CholestyramineColestipolColesevelam
What is associated with Enterococcus?
UTI, infective Endocarditis post GI/GU procedure
What is Voyeurism?
Watching other people without their permission
What does CCK (Cholecystokinin) do?
Stimulates bile release and gallbladder contraction, inhibits gastric motility (closes sphincters), and made by I-cell of duodenum
What does LDL do?
It carries Cholesterol (only one to do this)
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
What does Dopamine (DA) do?
Inhibits Prolactin (PRL) release
What is Bipolar II?
Depression and Hypomania (no psychosis)
What is the Capacitation reaction?
Allow binding btwn sperm & egg
What is associated with Klebsiella Pneumonia?
Alcoholics, Currant Jelly Sputum, UTI, Lung fissures
What is the Indication for Demeclocycline?
SIADH
What lysosomal diseases have a Gargoyle face?
Gaucher’sHurler’s
What is a Footling Breech/Incomplete breech?
Butt down. Thigh flexed, one toe is sticking out of the cervical OS
What is the MOA of Glitazones/Thiazolidinedione’s?
Increases Insulin sensitivity in peripheral tissues. Transaction modulation by Peroxisome Proliferator Activated Receptor Gamma in Nuclus
What makes B-HCG?
Placenta (synctiotrophoblast)
What does erythropoietin (EPO) do?
Makes RBC’s (prolong RBC life)
What is Erythrasma?
Rash in the skin folds, coral-red under Wood’s Lamp
What do stomach chief cells secrete?
Pepsin
What are the Adverse Effects of Sulfasalazine?
Malaise, nausea, Sulfonamide toxicity, reversible Oligospermia
What are the indications for Class IC antiarrhythmic?
Ventricular tachy progressing to V. fib, last resort
What is Tracheomalacia?
Soft cartilage and stridor since birth
What is the MOA of Sulfasalazine?
A combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammtory) activated by colonig bacteria
What are the Indications for Biguanides?
First line therapy in Type 2 DM
What is Choledocholithiasis?
Gallstone obstructs the bile duct
What bug loves the frontal lobe?
Rubella
What is a Platelet?
The clotter (has no nuclei and smallest cells)
How do I know the patient has a Vitamin E Deficiency?
Increased free radical damage, hemolytic anemia, ataxia gait, impaired position and vibration sense
What is Pseudohermaphrodite?
external genitalia problem
What is Niemann-Pick?
Sphingomyelinase deficiencyAreflexiaHepatosplenomegalyfoam cells (Lipid Laden macrophages)
What is Efficacy?
Maximal effect drug can produce regardless of dose (lower w/ non-competitive antagonist)
What are the Indications for Alpha-Glucosidase inhibitors?
NIDDM. (Type 2)
What type of kidney stones have hexagonal crystals?
Cysteine
What does Oxytocin do?
Milk letdown and uterine contractions
What is sinusitis?
Inflammation of the paranasal sinuses, tooth pain worsens upon bending forward
What is duodenal Atresia?
Bilious vomiting with first feeding, double bubble sign on x-ray, associated with Downs Syndrome
What is Multiple Endocrine Neoplasia I?
“Wermer’s” 3 P’s: Pancreas, Pituitary, Parathyroid adenoma
What GI diseases has a RLQ Sausage mass?
Intussusception
What is a Dohle Body?
PMN Leukocytosis(caused by infections, steroids, tumor)
What does an ejection click tell you?
Aortic or Pulmonic Stenosis
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
What Is Lesch-Nyhan?
HGPRT deficiencygrout neuropathyself-mutilationDystoniaXLRPrange sand crystals in diaper
What is a Bite Cell?
Unstable Hb inclusions (seen in G6PD Deficiency)
What is Antisocial Personality Disorder?
Lie, cheat, steal, destroy property, impulsive without remorse, illegal activity, aggressive towards others. Must be over 18 y/o
What are the Adverse Effects of Odansetron?
Headache, constipation, dizziness
What does Southwestern blot detect?
DNA-binding Proteins (combines south and western blots)
What does a paradoxical S-2 split tell you?
Aortic Stenosis or LBBB
What is Pre-Eclampsia?
Ischemia to the placenta causes HTN greater than 140/90
What is the MOA of FIbrates?
Upregulate LPL, increase triglyceride clearance
What is the Crystallization reaction?
Wall formed after one sperm enters to prevent polyspermy
What does auscaltation of wheezing tell you?
Intrathoracic narrowing (seen on expiration on x-ray)
What are Ideas of Reference?
Believes the media is monitoring you
What does the Citrate shuttle do?
FA transport out of the mitochondria
What conditions cause weight gain?
Obesity, Hypothyroidism, Depression, Cushing’s, Anasarca
What does Vit B5 do?
Part of Acetyl-CoA, no known diseases
What is Spina bifida aperta?
Has opening (High AFP)
What is HELLP Syndrome?
Hepatic injury causing:H- HemolysisEL- Elevated Liver EnzymeLP- Low Platelets
What is the MOA of Class IA antiarrhythmic?
Na+ channel blocker
What is the fucntion of LH (Luteinizing hormone)?
Stimulates Testosterone release from the testis, Androgens and Progesterone release from the ovary
What is the Parasympathetic System?
Rest and digest, slows stuff down
When do you see silent thyroiditis?
Post-partum patients
What are the adverse effects of Reserpine?
Mental depression
What is associated with Paseurella Multocida?
Cat/Dog saliva => Cellulits with lymphadenitis
What is Gigantism?
Childhood form of Acromegaly
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)
What are the adverse effects of Losartan?
Fetal renal toxicityHyperkalemia
What is pulse pressure?
Systolic minus diastolic pressure
What is Addison’s disease?
Autoimmune destruction of adrenal cortex, causes hyperpigmentation (looks tan), and increased ACTH
What is the muscarinic antagonist drug used for asthma?
Ipratropium
What is the function of Prolactin (PRL)?
Milk production
What is associated with Chlamydia Trachomatis?
Neonatal in-turned eyelashes, Corneal Ulcers
How do I know the patient has a Vitamin D Deficiency?
Rickets (children), Osteomalacia (adults)
What is Zenker’s Diverticulum?
Cough up undigested food from above the UES, Halitosis, motor dysfunction problem
What is a Male Hermaphrodite?
XY with no MIF
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
What is an Allograft?
Human to human transplant
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
What is Ovarian Hyperstimulation syndrome?
Weight gain and enlarged ovaries after clomiphene use for infertility
What is the first generation Sulfonylureas?
Chlorpropamide and Tolbutamide?
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
What are the indications for corticosteroids?
Chronic asthma, COPD
What are the acidic amino acids?
Asp, Glu
What is the Indication for GLP-1 Analogs?
NIDDM. (Type 2)
What does Fremitus, Egophony and Bronchophony tell you?
Consolidation (pathognomonic for pneumonia)
What diseases have high eosinophils?
“NAACP”N - Neoplasm (Lymphoma)A - Allergy/ AsthmaA - Addison’s disease (no cortisol -relative eosinophilia)C - Collagen Vascular diseaseP - Parasites
What does “Penia” tell you?
Low Levels - (Usually due to virus or drugs)
What happens with Rubella infections in utero?
Cataracts, hearing loss, PDA, “blueberry muffin” rash (Rash on face that spreads to trunk)
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!)
Where does Testosterone come from?
Adrenal gland and testicles
What antibody shows past Hep A infection?
IgG
What hepatitis B labs indicate recent immunization within >2/52wks?
HBsAg+
What is Thought Blocking?
Stops mid-sentence
What is Chronic Mucocutaneous Candidiasis?
T-cell defect against Candida Albicans and chronic fatigue
What is Budd-Chiari
Hepatic vein obstruction
What does “Cythemia” tell you?
High levels
What are the degrees of Vaginal Lacerations?
1st Degree: Skin2nd Degree: Muscle3rd Degree: Anus4th Degree: Rectum
What are the Indications for GH?
GH deficiency in children, Turner syndrome, and Burn victims
What does a Kinase do?
Adds Phosphate group to substrate using ATP
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)
What is Cushing’s Triad?
HTN, Bradycardia, irregular breathing
What is Seborrheic Dermatitis?
Red rash with oily skin and dry flaky hairline, crusty lesion
What receptors do Steroid Hormones use?
Nuclear membrane receptors (except cortisol cytoplasmic receptor)
What is the MOA of Antileukotriene?
5-lipoxygenase inhibitor -> inhibits conversion of arachidonic acid to leukotriene -> prevents bronchoconstriction and inflammatory cell infiltrate
What lysosomal diseases have a cherry-red macula?
Tay-sachs, Niemann-Pick
What is a Meduloblastoma?
Pseudorosettes compressing the brain, early morning vomiting
What antibody shows current Hep A infection?
IgM
What does Vit B3 do?
NAD cofactor
What are the essential amino acids?
Phynlalanine, Valine, Threonine(PVT)Tryptophan, Isoleucine, Methionine(TIM)Histidine, Arginine, Leucine, Lysine(HALL)
What is the Dawn Phenomenon?
Morning hyperglycemia secondary to Growth Hormone
What is Hepatorenal Syndrome?
High urea from the Liver leads to: increased Glutaminase, Ammonia, GABA- Kidney shuts down
What is Nevus Flammeus?
Port Wine Stain - Permanent- Unilateral of face or neck- Vascular malformation - Sturge - Weber syndrome - Vasculitis- Mgt: Pulsed laser therapy
What defines CML?
30-50 y/o females t(9;22)Philadelphia Chromosomebcr-abl
What is a Kleihauer-Betke Test?
Detects percentage of fetal blood in maternal circulation (Dilution test)
What is Kallmann’s Syndrome?
No GnRH and Anosmia. (They can’t smell)
What are the aromatic amino acids?
Phe, Tyr, Trp
What structures have one-way valves?
Urethra and ejaculatory duct
How fast should fundal height change?
Uterus grows 1 cm/week
What GI disease has an Abrupt Cut off on X-Ray?
Volvulus
What is associated with Pseudomonas Aeruginosa?
Otitis Externa, Ecthyma Gangrenosum, loves rubber, Whirlpool Folliculitis, exotoxin (ADP ribosylates EF-2)
What is normal blood loss during a Vaginal Deliver?
500 mL
What is Achalasia?
Increased LES Pressure (no Auerbach’s Plexus), Bird’s Beak on X-Ray and also seen in Chagas Disease
What are the most common causes of Oligohydramnios?
Abdominal Muscle Problem: Prune Belly Renal Agenesis: Potters Syndrome
What causes anterior leg bowing?
Neonatal syphilis
What are the Intravascular Hemolytic Anemias?
IgM G6PD deficiencycold autoimmune
What are the adverse effects of the Class IA antiarrhythmic?
Quinidine: CinchonismProcainamide: Torsades de Pointes
What does Trypsin cut?
Arg, Lys
What is a Dandy Walker malformation?
No cerebellum, distended 4th and lateral ventricles
What is Synesthesia?
Smells colors
Where is a Bochdalek Hernia?
Occur more commonly on the posterior left side (diaphragm), most common congenital Diaphragmatic Hernia (CDH)
What is Menetrier’s Disease?
Loss of protein through the rugal folds. Causes generalized edema. CMV association in children and H. Pylorus in Adults
What is a True Hermaphrodite?
Internal genitalia problem (has both sexes)
What gives urine its yellow color?
Urobilinogen being oxidized to urobilin
What is a Schistocyte?
Broken RBC (seen in DIC and artificial heart vlaves and others)
What does vasoactive intestinal peptide (VIP) do?
Inhibits secretin, motilin, and CCK, and opens Sphincters
What are the adverse effects of Digoxin?
Cholinergic, ECG: icnrease PR, decrease QT worsened by renal failureQuinidine displaces Digoxin from tissue binding sites
What is Amnesia?
Can’t recall important facts
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)
What organ has the highest AVO2 difference after a meal?
GI tract
What is Inflammatory Carcinoma?
Infiltrates Lymphatics, pulls on Cooper’s Ligaments “Peau d’Orange”
What is associated with Propionibacterium acnes?
Acne, Progesterone => Propionic acid
What type of immunity does TH2 provide?
Enhances humoral immunity
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
What is the function of TRH?
Stimulates TSH release
What are some causes of G6PD Deficiency?
Sulfa drugs, mothballs, fava beans, sudden drop in Hb
What is Erythema Toxicum?
White wheal on red area rash has Eosinophils
What is Pseudocyesis
Fake pregnancy with all the signs and symptoms
How does Herpes present?
Primary: Painful grouped vesicles on red baseSecondary: Painful solitary lesion
What is squamous cell CA?
Seen in smokers, high PTH and Ca2+
What is the cell-mediated immune response?
T-cells and Macrophages patrol the tissues looking for non-bacteria
What is a Thyrotrope?
TSH
What is seen / causes in Aplastic Anemia?
PancytopeniaAutoimmuneBenzeneAZTChloramphenicolRadiation
What is the function of CRH?
Stimulates ACTH release
What is the Gram Positive Capsule?
S. Pneumonia
What does Thyroid Peroxidase (TPO) and Thymosin do?
Help T-cells mature
What is the rate-limiting enzyme in Heme synthesis?
Delta-ALA Synthase
What is Borderline Personality Disorder?
“Perpetual Teenager”, splitting (love/hate), projection, acting out, self-mutiliation, unstable relationships, impulsive
What does Rh+ tell you?
Has D Antigen
Can you die during ETOH withdrawal?
Yes
What Kidney complications can Lithium cause to the person taking the drug?
Destroy the collecting ducts V2 aquaporin receptors, causing Nephrogenic DI
What is a Biophysical Profile (BPP)?
By US look for:Non-stress testAFIFetal heart toneFetal ActivityBreathing Movement
What do you see in Grave’s Disease?
Exophthalmos, Pretibial myxedema, anti-TSH receptor antibodies
What bug loves the hippocampus?
Rabies
What diseases have metabolic acidosis?
“MUDPILES” and diarrhea
What unstable angina?
Pain at rest (transient clots MCC)
What is a Pinealoma?
Loss of upward gaze, loss of circadian rhythms lead to precocious puberty
What does THF donate methyl groups for?
Nucleotides
What is the MOA of Misoprostol?
PGE1 analog, increase production and secretion of gastric mucous barrier, decreased acid production
What is Lichen Sclerosis?
Paper like vulva, itching, CA risk
What is an Eosinophil?
The parasite destroyer and allergy inducer
What is seen in Paroxysmal Cold Auto Autoimmune?
Bleeds after cold exposure Donath-Landsteiner Ab
What does the E Ag tell you?
Transmissibility/ Infectivity
What is Intussusception?
Currant Jelly Stool, Stacked Coin Enema, sausage shaped mass and knees to chest for comfort
What is Type 1 Hyperlipidemia?
Defective Liver Lipoprotein Lipase (chylomicrons are elevated)
What is Uterus Rupture?
Tearing sensation, halt of delivery
What is associated with (PCP) Pneumocystis Carinii pnemonia?
AIDS and preemies, rusty sputum, silver stains the lungs, increased LDH, Treat with steroids
Why do pregnant women get Anemia?
Due to the dilution effect: RBC rises 30%, but body volume rises 50%
What is associated with Vibrio Cholera?
Rice Water Diarrhea, ADP- Ribosylates Gs = High cAMP, Turning the on… on
What vessel has the highest compliance?
Veins
What is the smallest amino acid?
Gly
What is a point mutation?
Changes one base
What are Esophageal Varices?
Due to Portal HTN, vomit large amounts of blood when they rupture
What is MGM?
BM spikes, granular/linear supepithelial spikes and closes
What type of kidney stones have Rosette Crystals?
Uric acid
What is Multiple Endocrine Neoplasia II (2A)?
“Sipple’s” Pheochromocytoma, Medullary Carcinoma of the Thyroid, Parathyroid Adenoma. (tumor marker RET)
What are Spur Cells / Acanthocytes?
Lipid bilayer disease
How does Irritable Bowel Syndrome (IBS) present?
Alternating diarrhea/ constipationHistory of stressNo abnormalities on colonoscopy
What is Creutzfeldt-Jakob?
Prion induced disease, death within 1 year, post cornea transplant
What bug causes Acute Bacterial Endocarditis?
Staphylococcus aureus (attacks healthy valves)
What are the spore forming Gram-positive bacteria?
BacillusClostridium
What is the function of B-HCG?
Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)
What disease has Iridocyclitis?
Juvenile TA
What is the Rapid Acting Insulin drug?
Regular Insulin
What are the Class IB antiarrhythmic?
Lidocaine, Mexiletine, Tocainide
What is Sarcoma Botryoides?
Vaginal CA, looks like a ball of grapes
What is Hidradenoma?
Sweat gland cysts
What is Variable Deceleration?
Cord Compression
What is a Traction Diverticulum?
Out pouch between the UES and LES
What are the adverse of Methyldopa?
Sedation and Hemolytic Anemia(+) Coombs test
What is Intellectualization?
Act like a “know it all” to avoid feeling situational emotions, gets all information available to be over-informed
What bugs cause Monocytosis?
“STELS”S - SyphilisT - TBE - EBVL - ListeriaS - Salmonella
What is Spina bifida occulta?
Covered by skin with a tuft of hair
What is PKU?
No Phe -> Tyr (via decreased Tetrahydrobiopterin Cofactor or decreased Phe Hydroxylase)NutraSweet (Aspartame) sensitivitymental retardationpaleblond hairblue eyesmusty odor
What is Wright’s Stain?
Detects nucleated fetal RBC in mom’s vagina
What is Hemophilia A?
Defective Factor VIII (<40% Activity)Bleed into cavities (head, abd, etc)
What hepatitis B labs indicate infectious state?
HBeAg+
What organ has the highest AVO2 Difference at rest?
heart
What is Narcissistic Personality Disorder?
Pompous, no empathy, thinks they deserve everything
What does a Carboxylase do?
Transfers CO2 groups with the help of Biotin
What does Indirect Coombs Test tell you?
The Antibody is freely circulating in the serum
What are the ACE inhibitors?
Captopril, Enalapril, Fosinopril, Lisinopril
What does the Carnitine shuttle do?
FA transport into the mitochondria
What are the Adverse Effects of Glucocorticoids?
Iatrogenic Cushing’s syndrome. (Adrenal insufficiency when drug stopped after chronic use)
What is the function of HPL?
Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)
What is Thought Insertion?
Believes that others are putting thoughts into his head
What is Benign Positional Vertigo?
Sensation of room spinningNausea/VomitingNystagmus without hearing loss or tinnitusOnset of symptoms when change position
What is Inflammatory Diarrhea?
Diarrhea with blood and pus
What does a mutase do?
Relocates a functional group within a moleculre (intrachain)
What is Gaucher’s?
Glucocerebrosidase (Beta-Glucosidase) deficiencywrinkled tissue Macrophage’sBone painpancytopenia
What are the Indications for Octreotide?
Acromegaly; Glucagonoma; Insulinoma; Carcinoid Syndrome
What causes non-bacterial Fetal infections?
“TORCHST- ToxoplasmaO - Others (HIV, Measles, B-19)R - RubellaC - CMVH - HSV-2S - Syphilis
What are the adverse effects of the Class IB antiarrhythmic?
CNS stimulation and depressionCardiovascular depressionHyperkalemia increases toxicity
What is Sublimation?
Where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior
What is Phimosis?
Foreskin scarred at penis head
How do I know the patient has a Vitamin C (Ascorbic Acid) Deficiency?
Scurvy
What defines CLL?
50+ y/o males with lymphadenopathysoccer ball nucleiPresent with autoimmune Hemolytic anemia
What does Vit B12 do?
Cofactor for HMT & MMA
What GI disease has an Apple Core on X-Ray?
Colorectal Cancer
What are Burr Cell/ Echinocyte?
Seen in Pyruvate Kinase deficiencyLiver diseasePost splenectomy
What does a Synthetase do?
Consumes two substrates, uses ATP
What is a silent mutation?
Changes leave the same amino acid
What does blood type AB tell you?
Have both Antigens (universal recipient)
What are the adverse effects of Diazoxide?
Hypoglycemia (reduces insulin release) and hypotension
What is Delusion?
Fixed false belief for more than one month and no effect to his normal livingTx: Atypical antipsychotic and psychotherapy
How do you know it’s an anaerobic infection?
gas and bad odor
What is SHeehan Syndrome?
Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk
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
What is Cystic Fibrosis?
Defective chloride transportermeconium ileussteatorrheaBronchiectasisChromosome 7
What is the MOA of adenosine?
Increase K+ efflux, hyperpolarizes the cell
What does Vit C do?
Collagen synthesisantioxidanthelps absorb FE++, necessary for Dopamine & hydroxylase for NE
What is assocaited with H. Pylori?
95% causative agent in Duodenal Ulcers
What organs have the most CD4 receptors?
Blood vesselsbraintesticlescervixrectum
What is the RBC normal lifespan?
120 days
What is a Somatotrope?
Growth hormone
What is Separation Anxiety Disorder?
Kid screams when mom leaves
What are the adverse effects of H2 blockers?
Prolactin release: Gynecomastia, decreased libido, impotence in malesCimetidine inhibits P450
What are Fibroids (Leiomyoma’s)?
Benign uterus smooth muscle tumorsubmucosal type: they bleedSubserosal type: they cause pain
What is Metabolic Syndrome X?
“Pre-DM” due to HTN, Dyslipidemia, Hyperinsulinemia, and Acanthosis Nigricans
Which cells express MHC-2?
Antigen presenting cells (macrophages, dendritic cells, and neutrophils)
What is Non-competitive Inhibition?
Binds a regulatory site, no change in Km, Efficacy decreases, decreased Vmax
What is Fifth’s disease?
Erythema Infectiosum “Slapped Cheeks”B-19 ParvovirusAplastic anemia, in sickle cell patientsHydrops Fetalis
What are the adverse effects of Nesiritide?
Hypotension
What are the adverse effects of Class IC antiarrhythmic?
Prolongs refractory period in AV node Hyperkalelmia increases toxicity
What is a Basophil?
The allergy helper (IgE receptor - histamine release)
What is SCID?
No Thymus (no T-cells)frayed long bones (no B-cells)baby dies by 18 months
What does the Macula Densa do?
Measures osmolality (osmoles of solute-kg)
What type of people does Hep E like to infect?
Pregnant women (3rd trimester), Asians
What is Lobular Carcinoma?
Cells line up single file, contralateral breast is primary site of CA
Which stage of the Menstrual Cycle has the highest Estrogen levels?
Follicular stage (Has proliferative endothelium)
What is seen in Sickle Cell Anemia?
Crew-cut on x-rayAvascular Necrosis of femur
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
What do T cell deficiency patients die of?
Viral infections, fungal, etcexcept bacterial
What can high Cholesterol Cause?
Atherosclerosis
How do tension headaches present?
“Band-like” pain starts in posterior neck, increases throughout the day, sleep disturbance
What are the Big Mama Anaerobes?
Bacteroides fragilisStreptococcus BovisC. MelanagosepticusC. Diff
What is Vascular “multi-infarct” dementia?
Sudden onset, uneven progression of deficits, “stair step” decline
What is Cephalohematoma?
Bleeding under bone (blood does not cross suture lines)
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
What is a Paranoid Personality Disorder?
Suspicious about everything, they use projection
What is Selective Mutism?
Kid talks sometimes
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
What is Menorrhagia?
Heavy menstrual bleeding
What causes Syphilis?
Treponema Pallidum (Spirochete)
What is the only Gram-positive Endotoxin?
Listeria
What are the Adverse Effects of Misoprostol?
Diarrhea; Contraindicated in women of childbearing potential abortion inducing drug
What is EC50?
Concentration of drug that produces 50% of maximal response
What is Oppositional Defiant Disorder?
Breaking the rules, defiant, noncompliant, resists authority, “bark is worse than bite”. Teach appropriate child management skills
What is Virilization?
Female that is Man like
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
What organ has the highest AVO2 difference during a test?
Brain
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
What is an Ependymoma?
Rosettes present in the 4th Ventricle, Hydrocephalus
What is Zellweger’s?
Neonatal Seizures
What does Atrial Natriuretic Peptide do?
Inhibits aldosterone and dilates the afferent arteriole
What is the most common type of Gallstone?
Cholesterol stone (not see on X-ray)
What is associated with N. Gonorrhea?
Pili, Urethritis, Tenosynovitis, Septic arthritis
What is a Xanthoma
Cholesterol build up (common at the elbow or Achilles tendon)
What is Berylliosis?
Radio, TV repair, aerospace manufacturing, Beryllium mining, or manufacturing of fluorescent light bulbs
What are the indications for Guaifenesin?
Minor upper respiratory tract infections, common cold w/ cough
What diagnosis has secondary hyperparathyroidism?
Renal failure
How does Chancroid present?
Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)”School of Fish” pattern
What is Placenta Abruptio?
Severe pain due to premature separation of the placenta
What produces Currant Jelly Sputum
Klebsiella
What are the IgA protease bugs?
S. PneumoniaeH. InfluenzaM. Catarrhalis
What are the GLP-1 Analog drugs?
Exenatide and Liraglutide
What bug is associated with cat pee?
Toxoplasmosis
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
What is FSGS?
Most common in IVDA, AA, Hispanics and HIV patients
What is the only statin to undergo renal excretion?
Pravastatin
What does hyperresonance tell you?
Air in that region of the lungs`
What has WBC Casts ONLY?
Pyelonephritis
What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?
Selective B1-Blockers
What is the MOA of PTU and Methimazole?
Inhibits peroxidase enzyme in Thyroid and Decreases synthesis of Thyroid Hormones
What is associated with Corynebacterium Diphtheriae?
Chinese letters under microscope, gray Pseudomembrane, heart block, suffocation = death, ADP Ribosylates EF2, Elek’s Test
What is Epididymitis?
Unilateral scrotal pain decreased by support
What is the Adverse effect of Biguanides?
Lactic Acidosis (Contraindicated in renal failure) Stop use in patients undergoing studies using contrast
What is the Autonomic Nervous System?
Automatic stuff… i.e. breathing, heartbeat
What causes Neonatal Blindness
Chlamydia
What is Eclampsia?
HTN with seizures
What is Condylomata Lata?
Flat fleshy warts, ulcerate = secondary syphilis
How much weight should a woman gain during Pregnancy?
1 lb/ week
What is Obsessive-Compulsive Personality Disorder?
Perfectionist, doesn’t show feelings, detail oriented, uses isolation
Which cytokine is released when a macrophage is activated?
IL-1
How does an epidural hematoma present?
Intermittent consciousness (lucid interval)
What has a friction rub while holding breath?
Pericarditis
What does biotin donate methyl groups for?
Carboxylation
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
What is Tuberous Sclerosis?
Ashleaf spots (hypopigmentation)Primary brain tumorsHeart RhabdomyolysisRenal cell CAShagreen spots (leathery)
What is Vernix?
Cheesy baby skin. (protects the baby’s skin from the outside world and helps with passage through the birth canal)
What is Postpartum Depression?
Depression post-delivery for more than 2 weeks
What does Vit B1 do?
Dehydrogenasestransketolase (PPP)cofactors
What does DES taken by Mom cause in her Daughter?
Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions
What are the Osmotic Laxatives?
Magnesium hydroxide, mag citrate, polyethylene glycol, Lactulose
What diseases have metabolic alkalosis?
Low volume state: vomiting, diuretics, GI blood loss
What are the Class IA antiarrhythmic?
Quinidine, Procainamide, Disopyramide
What bacteria cause diarrhea <8 hours after introduction?
“CBS”C - ClostridiumB - Bacillus CereusS - Staphylococcus aureus
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
What is Milia?
Neonatal white or pale yellow heads on malar area
What is Toxoplasmosis?
Multiple ring enhancing lesions, loves parietal love, from cat urine and feces
What is Apocrine?
Apex of the cell is secreted
What states have increased Estrogen?
Pregnancy, liver failure, P-450 inhibition, and obesity
What are the adverse effects of Pseudoephedrine, phenylephrine?
HTN, CNS stimulation/ anxiety
What is von Gierke?
G-6 Phosphatase deficiencysevere fasting hypoglycemiahepatomegalyincreased lactase and uric acid levels
What hormones produce Basophila?
“B FLAT”: Basophils, FSH, LH, ACTH, and TSH
What is Huntington’s?
Occurs in the caudate/putamen, Trinucleotide repeat disorder (Chromosome 4, CAG), choreiform movements, changes in personality, anticipation
What is Oligomenorrhea?
Too few periods
What bug loves the temporal love?
HSV
What is an Encephalocele?
Brain tissue herniation
What is Karyolysis?
Nucleus dissolves
What is Dysfunctional Uterine Bleeding?
Diagnosis of exclusion, usually due to anovulation
What has a friction rub while breathing?
Pleuritic
What is Hemochromatosis?
Fe deposit in organs
What is an Acute Rejection?
Occurs 4 days to months later. T-cell and macrophage response
What are the indications for Methyldopa?
HTN
What does secretin do?
Secretion of bicarbonate, inhibit gastrin, tighten Pyloric Sphincter, and secreted by S-cell Duodenum
When does Implantation occur?
1 week after fertilization
What is Comedocarcinoma?
Multiple focal areas of necrosis (blackheads) DCIS
What is Vestibular Neuritis?
Inflammation of the vestibular portion (CN8), Could be associated with viral infection, characterized by vertigo and dizziness
What is the MOA of Potassium on the heart?
Depresses ectopic pacemaker in hypokalemia
What is a Nephroblastoma?
Abdominal mass due to enlarged “Wilm’s Tumor”, hemihypertrophy and Aniridia
What is the most common cause of delayed speech developement?
Hearing loss
What is the Peripheral Nervous System?
Everything except the brain and spinal cord. Myelination by the schwann cells
What is Imitation?
Replicating another’s behavior
What is Cholelithiasis?
Formation of gallstones
What is the most common cause of Vaginal Bleeding in Post-menopausal women?
Endometrial CA
Can you die during Opiod Withdrawal?
No, just very painful
What are the symptoms of Amniotic Fluid Emboli?
Mom just delivered Baby and mom has SOB, due to PE, leads to death
What is Nephritic Kidney Disease?
Inflammation with protein loss <3.5 in urineIncreased size of Fenestrations, RBC casts, HTN
What is your maximum heart rate?
220 minus the person’s age
What are the indications for Reserpine?
HTN
What is seen in Calcium deficiency?
Poor bone and teeth development
What is Eisenmenger’s Syndrome?
Physiological shunt from left to right now changes right to left
What are some PPIs?
Omeprazole, Lansoprazole
What kind of Patients does Staph and Pseudomonas like to attack?
DM, CF, Burn Patients, Neutropenic patients
What does a Transferase do?
Relocates a functional group from one molecule to another
What is associated with P. Mirabilis?
Staghorn Calculus, UTI, Urease Positive, Treat with Norfloxacin
What is Emphysema?
Obstructive diseaseAlpha-1-antitrypsin deficiency
What is PSGN?
Most common in kids. Subepithelial humps (IgG/C3/C4 deposition) lumpy bumpy on EM and ASO antibodies
What is Sixth’s DIsease?
Roseola, Exanthema Subitum (fever disappears then rash appears)
What is a Lymphocyte?
The warrior - T, B, and NK cells
What disease has a “3” shape on x-ray?
Coarctation of the aorta
What is MPGN
Tram tracks seen (Type II has low C3) on LM
What is Peutz Jegher Syndrome?
Hyper-pigmented lower lip, patients will have dark gyms and vagina, and small bowel polyps
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
What is Type 2B Hyperlipidemia?
Deficiency of adipose receptors and LDL receptors (Increased LDL and VLDL levels)
What is the MOA of Nitroprusside?
Direct release of NO, increases cGMP, vasodilator
What is a Tear Drop Cell/ Dacrocyte?
RBC’s squeezed out of bone marrow. (Seen in Hemolytic Anemia and bone marrow CA)
What is Decreased beat-to-beat variability?
Acidemia
What does Gastric Inhibitory Peptide (GIP) do?
Increases insulin action, responsible for post-prandial hypoglycemia
What is the difference between norepinephrine and epinephrine?
NE: NeurotransmitterEPI: Hormone
What are the adverse effects of ACE inhibitors?
Hyperkalemia, cough, angioedemacontraindicated in pregnancy (fetal renal malformations)
What is Cataplexy?
Loss of muscle tone due to strong emotions
What does dullness to percussion tell you?
Something between the airspace and chest wall absorbing sound, can be solid or fluid
What hepatitis B labs indicate a chronic carrier state?
HBsAg+, (>6 months), HBsAb (+/-)
What are the Diastolic Blowing murmurs?
Aortic regurgitation, pulmonic regurgitation
What is the MOA of Isoproterenol?
Non-specific, Beta-agonists;relates bronchial smooth muscle (B2)
What does Exocrine mean?
Secreted into a duct
What is Apoptosis?
Programmed cell death, no inflammation, and cell membrane dissolved first. Nucleus guides death & destroyed last
What are theh Renin-angio system effectors?
ACE inhibitors and ARBs
What are the most common symptoms of the Low Energy State?
Weakness and SOB
What is Reynold’s Pentad?
Jaundice, Fever (usually with Rigors), RUQ Pain, Hypotension and change in mental status
What does Ca2+ do?
Neuronal function, atrial depolarization, smooth muscle contractility
What diseases have Granulomas?
“HiTTSS”Hi - Histiocytosis XT - TBT - The -Ella’sS - SarcoidosisS - Syphilis
What is a Complete Breech?
Butt down, thighs, and legs flexed
What is Grey-Turner’s Sign?
Bleed into Flanks and caused by Hemorrhagic Pancreatitis (early signs)
What is associated with Francisella Tularensis?
Ulcers at rabbit or deer tick bite siteRx: Streptomycin
What is associated with Bartonella Henselae?
Cat Scratch = Single painful lymph node, Stains silver
What is Avoidant Personality Disorder?
Socially withdrawn, afraid of rejection but wants to fit in
What is a Sister Mary Joseph Nodule?
Ovarian CA that has spread to the umbilicus(Also GI cancers can cause) (Indicates metastasis)
What does the Core Ab tell you?
Past infection
What is associated with Clostridium Melangosepticus?
Colon CA
What is a Neuroblastoma?
Adrenal medulla tumor in kids, dancing eyes and feet and secretes catecholamine’s
What are the inidcations for Cromolyn?
Asthma prophylaxis
What is Rationalization?
Make excuses for behavior in advance, (because of…)
What are the indications for Nesiritide?
Acute decompensated heart failure
How do you measure afferent renal function?
Creatinine or Inulin
What is a Spherocyte?
Old RBC
What is Thought Broadcasting?
Believes that everyone can read his thoughts
What is associated with Chlamydia psittaci?
Parakeets and Parrots are the carrier agent
What does high WBC and >5% Blasts tell you?
Leukemia
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
What is Displacement?
Take anger out on an object or someone else. Not related with situation
What is Turcot’s Syndrome?
Familial Polyposis with Brain Tumors
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)
How does trigeminal neuralgia (Tic Douloureux) present?
Sharp, shooting face pain, recurrent episodes
What does an AFI <5 indicate?
Oligohydramnios (Cord compression)
What is the rate-limiting enzyme in Glycogenesis?
Glycogen Synthase. Occurs in the Cytoplasm of Liver and muscle
What is Bronze diabetes?
Fe deposit in pancreas
What does Aldosterone do?
Reabsorbs Na+ and three waters
What is Chronic Pelvic Pain?
Endometriosis until proven otherwise
What is Late Deceleration?
Due to uteroplacental because the placenta cannot provide oxygen and nutrients
What are the CSF lab values for Meningitis?
PMN’s -> BacteriaT cells / Macrophages -> Non-bacterialNormal Glucose -> Viral
What is the Clotting Cascade?
The cascade that stops you when you bleed
What is the MOA of Statins?
Inhibit HMG CoA reductase
What are the Holosystolic murmurs?
Tricuspid RegurgMitral RegurgVSD
What is Stage 1 of Labor?
Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm
What are the Vasculitis associated with LOW C3?
“PMS in Salt Lake City”Post-Strep GNMembranoproliferativeGlomerulonephritis Type IISub Bacterial endocarditisSerum SicknessLupusCryoglobulinemia
What is the MOA of albuterol?
B2 agonist; relaxes bronchial smooth muscle
What is Factitious?
Fake illness to get attention, seeks medical treatment, have a lot of medical knowledge.Tx: Supportive psychotherapy
What is Condyloma Acuminata?
Verrucous “cauliflower” warts, koilocytes, due to HPV 6 and 11
What is Osmotic Diarrhea?
High osmolality in the bowel pulling water into the lumen
What defines Hodgkin’s Lymphoma?
EBV and may have Reed-Sternberg cells
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
What is associated with Chlamydia Pneumonia?
Staccato coughing, parasite with DNA and RNAs:Elementary body (Infectious phase) Reticulate Body (resting phase - can’t divide)
What is the only Gram-positive Diplococci?
Streptococcus Pneumonia
What is the humoral immune response?
B-cells and PMN’s patrol the blood looking for bacteria
What are the Adverse Effects of Infliximab?
Respiratory infection (including reactivation of latent TB) fever, hypotension
What are the indications for HMG-CoA reductase inhibitors?
Strong decrease LDLDecrease TriglyceridesIncrease HDL
What does a Galactokinase deficiency cause?
Cataracts
What is the most common extracellular buffer?
Bicarb
What is associated with Bacillus Cereus?
Fried rice syndrome, preformed toxin
What is Compensation?
Doing something different of what you used to do
What is the color of air on X-ray?
Black “radiolucent”
What stage of the menstrual cycle has the highest Temperature?
Ovulatory stage, body temp will rise One degree during ovulation
What bug loves the DCML tract?
Treponema
What are the indications for 2nd generation H1 Blockers?
Allergies
Who Makes the Trophoblast?
Baby
Waht is the rate-limiting enzyme in Cholesterol syntesis?
HMG CoA Reductase
What makes an adequate sputum sample?
<10 epithelial cells and >25 leukocytes per low power field
What are the indications from Magnesium?
Effective in Torsades and Dig toxicity
What are the adverse effects of Salmeterol?
Tremor and arrhythmia
What is the indication for Isoproterenol?
Bronchoconstriction due to sympathetic tone
What is Pathological Gambling?
Can’t stop gambling, affects others
What is the sign of a Clavicle Fracture?
Asymmeteric Moro reflex
What is an Astrocytoma?
Rosenthal fibers - #1 in kids with occipital headache
What is Heavy Chain Disease?
Increased IgA
What GI disease has a Bird’s Beak on X-Ray?
Achalasia (Think Chagas disease)
What is Carcinoid syndrome?
Flushing, wheezing, diarrhea
What are the Indications for Glitazones/Thiazolidinedione’s?
NIDDM. (Type 2)
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
What is the CBC for every basculitis?
Decreased: RBC and plateletsIncreased: WBC, T-Cells, Monocytes, Schistocytes, ESR
What is associated with Mycoplasma Pneumoniae?
Bullous myringitis, Ground Glass CXR, P-1 Protein, Erythema Multiforme
What are the risk factors for Primary Liver Cancer?
Hepatitis B & C, Aflatoxin, Alcohol, Smoking and Hemochromatosis
What are the Pyrimidines?
C, U, T
What are the Adverse Effects of Desmopressin (DDAVP)/ADH?
Over hydration and allergic reaction
What is a Sliding Hiatal Hernia?
Fundus of the stomach herniates through the Esophageal Hiatus into the Thorax
What is t1/2?
Half-life, the time it takes the body to use half of the drug ingested
What is the job of the early distal tubule?
Concentrate urine by reabsorbing NaCl
What is the thyroid hormone levels during Pregnancy?
Increased TBG - leads to increased total T4 (Bound and free)
What is seen with Varicella (Chickenpox)?
Red macule clear vesicle on red dotPus and scabbingvarious stages of healing
What is Cabot’s Ring body?
Seen in Vitamin B12 Deficiency and lead poisoning
What is intra-Renal Failure?
Damaged Glomerulus or tubules; BUN: Creatinine Ratio <20/1
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)
What organs do not require insulin to absorb glucose?
“BRICKLE”: Brain, RBC, Intestine, Cardiac / Cornea, Kidney, Liver and Exercising muscle
What receptors do Protein Hormones use?
Cell membrane receptors
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)
What is Metachromatic Leukodystrophy?
Arylsulfatase A defieciencychildhood multiple sclerosis with Ataxia/Dementiaaccumulation of Cerebroside Sulfate
What are the catabolic pathways that create energy? (Occur in the Mitochondria)
Acetyl-CoA production, Beta-oxidation, citric acid cycle, Ketogenesis, Ox Phos
What are Plasma Neoplasms?
They produce many antibodies
What does the Direct Coombs Test tell you?
ANtibody on surface (seen in hemolytic anemia)
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
What does Glucagon do?
Active in Gluconeogenesis, Glucogenolysis, Lipolysis, and Ketogenesis
What is the rate-limiting enzyme in Purine synthesis?
Glutamine - PRPP
What is Alzheimer’s disease?
Decreased ach in nucleus basalis of Meynert, bad Apo-E4, Amyloid Plaques, Neurofibrillary Tangles of Tau proteins
What is Essential Thrombocythemia?
Very high platelets increased RBC’s and WBC’s
What does Antidiuretic hormone (ADH) do?
Conserves water (V2 aquaporin receptors) and vasoconstriction
What does Tracheal deviation tell you?
Moves away from tensionPneumothorax moves towards Atelectasis
What CA risk does VHL have?
RCC
What GI disease has a Corkscrew on X-Ray?
Esophageal spasm and Volvus
What is Carcinoid Syndrome (Triad)?
Diarrhea, flushing and wheezing
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
What is Crohn’s Disease?
Transmural, Cobblestones, Melena, Creepig Fat, Fistula, Skip lesions
What are Loose Associations?
Ideas switch subjects, incoherent
What is Idealization?
They see only the good in someone despite evidence to the contrary
What GI disease has a stacked coin on X-Ray?
Intussusception
What is Tangentiality?
Wanders off the point
What is Graft vs. Host Disease?
When the graft attacks the body (T-Killer cells and macrophages responded)
What are the Indications for Infliximab?
Crohn’s Disease, Rheumatoid arthritis
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
What has Tubular Casts?
Acute Tubular Necrosis (ATN)
What is the risk of Chorionic Villus Sampling?
Fetal limb defects. (Done at 9-12 weeks)
What is Karyorrhexis?
Nucleus fragments
What is Waldenstrom Macroglobulinemia?
IgM and Hyperviscosity of the blood
What are Pencil Cell/ Cigar Cell?
Seen in iron deficiency anemia
What is Primary Biliary Cirrhosis?
Anti-Mitochondrial antibody Bile ducts are destroyedXanthelasmas present and pruritis
What is factitious hypoglycemia?
Exogenous insulin use, labs show elevated insulin and decreased C-peptide
What are the adverse effects of the Ca2+ channel blockers?
Flushing, edema, constipation, CHF, AV block
What disease does Coxsackie B cause?
Endocarditis, DM Type I
When do you give RhoGam?
1st Dose: Week 28 gestation2nd Dose: 72 hours post-deliveryAny time a procedure would mix mom and fetal blood
What are the IgA Nephropathies?
HSPBerger’sAlport Syndrome
What is Paracrine?
Works on its neighbor. (except sweat gland)
What does “Cytosis” tell you?
High levels
What is Justification?
Making excuses for behavior afterwards
What are the Biguanides drugs?
Metformin
What are the glycogenic amino acids?
His, Met, Val
What are the indications for Hydralazine?
Severe HTN, 1st line treatment for HTN in pregnancy
What are the hormones with disulfide bonds?
“PIIG”: Prolactin, Insulin, Inhibin, GH (growth hormone)
How do i know the patient has a Vitamin B2 (Riboflavin) Deficiency?
Angular Cheilosis
What does Vit B9 do?
Nuclear division (Synthesis of Nitrogenous bases for RNA and DNA)
What is Glanzmann’s?
Baby with bleeding from skin and mucosa (LOW GP-2b3a)
What is Exhibitionism?
Exposure to others
How does the Sympathetic System behave?
Opposite of Parasympathetic:ConstipationUrinary retentionMydriasis - “Eyes wide with fright”TachycardiaBronchodilateEjaculation “Shoot”Xerophthalmia (dry eyes)Xerostomia (Dry mouth)
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
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
What are the classifications of MHC-1?
HLA-A, HLA-B and HLA-C
How does chlamydia present?
Cervicitis (Yellow pus), conjunctivitis, PID
What is Total Anomalous Pulmonary return?
All pulmonary veins enter into the right atrium (Snowman x-ray)
What is the rate-limiting enzyme in Ketogenesis?
HMG CoA Synthase
What is Herpes?
ds DNA virus
What is the Stage II of Labor?
Continues after the cervix is dilated to 10 cm until the delivery of the baby
What is the difference between Heterochromatin and Euchromatin?
Hererochromatin = tightly coileddarkerTranscriptionally inactiveEuchromatin = loose (10nm fibers)lighter
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
What murmur has a regular-irregular pulse?
PVC
What disease has a Thumb Sign on neck films?
Epiglottitis
What is Restrictive Lung disease?
small still lungs, can’t get air in
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
What are the indications for Ezetimibe?
Decrease LDL
What are the Class IC antiarrhythmic?
Flecainide, Encainide, Propafenone
What is the effect of Alcohol on the fetus?
FASSmooth philtrumshortpolyclonalmidface hypoplasiathin superior Vermilion border
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
What causes Chancroid?
Haemophilus Ducreyi
What is Telephone Scatologia?
Phone Sex
What is the MOA of ARBS?
Ang II blockers, prevernt alpha 1 vasoconstriction from Ang II
What is a Missed Abortion?
Cervix is closed, no fetal remnantsTx. D&C
What type of kidney stones have envelope or dumbbell-shaped crystals?
oxalate
What does the E Ab tell you?
Low transmissibility
What is the cause of large babies?
DM or twin-twin transfusions
What are the indications for Nitroprusside?
Hypertensive emergency, CHF, Angina
What is the MOA of cromolyn?
Prevents release of mediators from mast cells
What is Bismuth and Sucralfate used for?
Increase ulcer healing, traveler’s diarrhea
What is a SIderoblast?
Macrophages pregnant with Iron (caused by genetics and or multiple transfusions)
What is the MOA of Bile Acid resins?
Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more
What are the sympathoplegics?
Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine
What is the MOA of Salmeterol?
B2 agonist; relaxes bronchial smooth muscle
What is Bronchitis?
Increased sputum production “Blue Bloater”
What is Type 2A Hyperlipidemia?
Defective LDL-Clathrin Pit or B-100 (LDL are elevated)
What will you see with Anemia of Chronic Disease?
Decreased TIBC
What will you see with Sideroblastic Anemia?
Decreased dALA synthase common with blood transfusions
What are the adverse effects of Hexamethonium?
Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
What is the MOA of the K+ channel blockers?
Increase AP duration, increase effective refractory period (ERP), increase QT interval
What is Plummer-Vinson Syndrome?
esophageal webbing at the UES, spoon nails from iron deficiency anemia
What is Cholestasis?
Obstructed bile ductHigh Alk Phos (if in the common bile duct)
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)
What is Trichotillomania?
They pull out their own hair and eat it
What is McCune-Albright?
Precocious sexual development, polyostotic fibrous dysplasia “whorls of connective tissue”, “coast of Maine” pigemented skin macules
What is associated with Vibrio Parahaemolyticus?
Raw Fish, Gs Stimulation via ADP- ribosylation = HIGH cAMP, Turns the on… on
How fast should B-HCG rise?
Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed
What are the indications for Methacholine?
Asthma challenge test
What are some causes of Vitamine B12 deficiency?
TapewormsVeganismType A gastritisPernicious Anemia
What does Vit D do?
Mineralization of bones and teeth
What are the newborn screening tests?
“Please Check Baby Before Going Home”P - PKUC - CAH/ CFB - Biotinidase/ Beta- ThalassemiaG - GalactosemiaH - Hypothyroidism/ Homocystinuria
What are the most common causes of mental retardation in the US?
FAS, Fragile X and Down’s Syndrome
What is Wiskott-Aldrich?
Low IgM, Low PlateletsHigh IgAEczemaPetechiaeX-linked
What is achondroplasia (Laron Dwarf)?
Patient with abnormal FGF receptors in exremities. (abnormal FGF3)
What is Hemosiderosis?
Fe overload in bone marrow
What is Poikilocytosis?
RBC’s of different shapes
What are the Adverse Effects of Mimetics?
Hypoglycemia, Nausea, Diarrhea
What can high Triglycerides Cause?
Pancreatitis
What is the MOA of a muscarinic antagonist?
competitively block muscarinic receptors preventing bronchoconstriction
What are the methylxanthines?
Theophylline
What is the function of T3 and T4?
Growth and differentiation
What is Histrionic Personality Disorder?
Theatrical, sexually provocative, use repression
What diseases have Respiratory Alkalosis?
Restrictive Lung diseaseAnxietyPregnancyGram neg sepsisPE
What does Fe2+ do?
Hb function, electron transport
What is RhoGam?
Anti-D IgG
What is Pyromania?
Sets fires for the fun of it
How does DKA present?
Kussmaul respirations, fruity breath (acetone), and altered mental status
What is assocaited with Strep Bovis?
Colon Cancer, black pigment
What hepatitis B labs indicate non-infectious state?
HBeAg-
What bugs cause Bloody Diarrhea?
“CASES”: Campylobacter, AMoeba (Entamoeba Histolytica), Shigella, E. coli and Salmonella
What are the only arteries with deoxygenated blood?
Pulmonary and umbilical arteries
What are the Long Acting Insulin drugs?
Ultralente, Glargine, and Protamine
What is Sarcoidosis?
Non-caseating granulomas, eggshell calcification around lymph nodes
What sound radiates to the axilla?
Mitral regurgitation
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)
What does somatostatin do?
Inhibits secretin, motilin, and CCK
What is the Adverse Effect of Sulfonylureas?
Hypoglycemia, GI disturbances, Muscle weakness, mental confusion, Sulfur allergy
What is the MOA of N-acetylcysteine?
loosen mucus plugs by breaking disulfide bonds
What has Epithelial Casts?
Normal sloughing
What is INR ratio determined by?
Measured PT/ Control PTtherapeutic level is between 2-3Normal level is 1
What are the Water shed areas?
Hippocampus, splenic flexure
What is Stress Incontinence?
Weak pelvic floor muscles, urinating when coughing, laughing, etc. Estrogen effect
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)
What is a Vertex Presentation?
Posterior Fontanel (triangle shape) presents first (normal)
What is associated with C. Diff
Explosive diarrhea = Pseudomembranous Colitis
What are the antileukotriene drugs?
Zileuton, Zafirlukast, montelukast:aspirininduced asthma
What are the Purines?
A, G
What is a Septic Abortion?
Fever greater than 100.4 F, malodorous discharge
What is a Pappenheimer body?
Iron inside cell (sideroblastic anemia)
What does Seminal Vesicle give to Sperm?
Food (Fructose) and clothes (semen)
What GI diseases are the causes of liquid Dysphagia?
Scleroderma and Achalasia
What does IDL do?
It takes TG’s from adipose to tissue
What type of Gallstone can be seen on X-Ray?
Calcium Bilrubinate stone
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
What are the Production Anemias?
Diamond-BlackfanAplastic Anemia
Where is VLDL made?
Liver
What is associated with C. Botulinum?
Canned food, honey, inhibits ACh release, respiratory failure, stool toxin, treat with Penicillin
What is SIADH?
Too much ADH present causes plasma volume to expand Serum Na+ less than 120
What is the Somogyi Effect?
Morning hyperglycemia secondary to evening hypoglycemia
What are Identical Twins?
Eggs split into perfect halves “Monochorionic”
What is the symptoms of Loeffler Syndrome?
Pulmonary Eosinophilia
What is the MOA of H1 Blockers?
Reversible inhibitors of H1 histamine receptors
What is associated with Group C Strep?
Pharyngitis
What is HPV?
ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD
What is the function of FSH
Male: sperm, MIF, inhibin BFemale: Stimulates Estradiol (E2)
What vesels have the most smooth muscle?
Arterioles
What are the symptoms of a Low Energy State?
CNS: Mental retardation, dementiaCV: heart failure, pericardial effusionMuscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation
What are the signs of child abuse?
Multiple EcchymosisRetinal HemorrhageEpidural / Subdural HemorrhageSpiral Fractures (twisted)Multiple fractures in different stages of healing
What is Nitrazine?
Detects presence of amniotic fluid. (pH indicator - strip will turn blue if pH is greater than 6.0)
What is Pyknosis?
Nucleus turns into blobs. (shrinkage)
What organs have resistance in parallel?
All the rest of the organs (except liver and kidneys)
What are the indications for Losartan?
HTN
What is PIE Syndrome?
Pulmonary Infiltrate with Eosinophilia
What stage of the Menstrual Cycle has the highest level of Progesterone?
Luteal stage (Has secretory endothelium)
What makes Progesteron <10 week gestation?
Corpus Luteum
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
What is Euthyroid Sick Syndrome?
LOW T3 Syndrome and decreased conversion of T4 to T3 (increased T3r)
What is Albinism?
No Tyr -> Melanin (via Tyrosinase)
What is Endometritis?
Postpartum uterine tenderness
What is seen with Tin deficiency?
Poor hair growth
What does an Isomerase do?
Creates and isomer
What is the MOA of Odansetron?
5-HT3 antagonist, powerful central acting antiemetic
What is Rotor’s?
Defective Bilirubin storage and Elevated Conjugated Bilirubin
What vessels have the largest cross-sectional area?
Capillaries
How does Lymphogranuloma Venereum present?
Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis
What is Ataxia Telangiectasia?
Patients have low IgA and neurological problems, difficulty ambulating and spider like blood vessels
What are the side effects of Estrogen?
Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins
What is Stage III of Labor?
Delivery of the placenta
What hormones are released from the posterior pituitary?
ADH (supraoptic nucleus), Oxytocin (Paraventricular nucleus) by the Neurophysins
What is Anencephaly?
Notochord did not make contact with the brain - only have the medulla
What is Cholangitis?
Inflamed bile duct
What does the Coombs Test Tell you?
Antibody involved
What is Dependent Personality Disorder?
Clingy, submissive, low self-confidence, uses regression
What hepatitis B labs indicate previous infection and now immunity?
HBcAb+, HBsAb+, HBsAg-
What are the physical signs of Alcoholic Cirrhosis?
Spider Angioma, Palmar Erythema, Gynecomasatia and Dupuytren’s Contracture
What is Bruton’s Agammaglobulinemia?
Kids ( < 1 y/o) with defective tyrosine kinase; they have no antibodies and have x-linked transmission
What are the indications for Sulfalazine?
UC, Crohn’s disease
What is a Drepanocyte?
Seen in Sickle cell Anemia
Negative high dose Dex. and High ACTH levels?
Ectopic ACTH- small cell CA of the lungs
What are the indications for Clonidine?
HTNSmokingCocaineHeroin withdraw
What is Type and Match?
Blood type and Wait
What is Wolff-CHaikoff?
Transient hypothyroidism
What is Pyloric Stenosis?
Non-bilious projectile vomiting (3-4 week old) and RUQ Olive Mass on Palpation
What is Lichen Simplex Chronicus?
Raised white lesions, chronic scratching
What is the MOA of Clonidine?
Alpha 2 agonist = decreases peripheral resistance
Which part of the Nephron concentrates urine?
medulla
What is the Adverse Effect of Insulin?
Hypoglycemia
What are the sulfur-containing amino acids?
Cys, Met
What is Bartter’s Syndrome?
JG cell hyperplasia with renin excess, no increase in blood pressure, defect in kidney’s ability to reabsorb potassium
What is Drug Induced Hypersensitivity?
Eosinophils in the urine
What is increased beat-to-beat variability?
Fetal Hypoxia
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
What causes lateral leg bowing?
Rickets
What is Undoing?
Doing exact opposite of what you used to do to fix a wrong
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)
What is Myelofibrosis?
Megakaryocytes, fibrotic bone marrow, teardrop cells (RBC’s) and extramedullary Hematopoiesis
What disease states have increased Anion Gap?
“MUDPILES”MethanolUremiaDKAParaldehyde/PhenoforminINH/ Iron tabletsLactic AcidosisEthylene GlycolSalicylates
What is CD8?
T-killer or T-suppressor cellResponds to MHC-1 complex (self)
What causes Gonorrhea?
Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort
What are some causes of Folate Deficiency?
Old food, you will see Glossitis with the patient
What is Cretinism?
Mom and baby are hypothyroid
What do you see in DeQuervain’s disease?
Viral origin, painful jaw, hypothyroid
What is Epstein’s anomaly?
Small right ventricle and very large right atrium (in fetus due to mom taking Lithium during pregnancy)
What murmur has an irregular-irregular pulse?
A fib (no P waves)
What is Kleptomania?
Steals for the fun of itTx: Psychotherapy
What is a normal BPP?
>8-10
What is an Oligodendroglioma?
Fried egg appearance, Nodular Calcification
What does high WBC and Bands tell you?
Left shift - they have an infection
What are the pulmonary infiltrates with eosinophilia (PIE) syndromes?
Churg-Straus, Loeffler’s, allergic Bronchopulmonary Aspergillosis
Waht is Vasa Previa?
Babies blood over OS
What is the Average IQ?
85-100
What are the indications for Octreotide?
Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
What is Loss of Ego Boundaries?
Where we lose sight and sense of our mind and body and its influences
What is seen in Magnesium deficiency?
Loss of kinase function, hypoparathyroidism
What is Vater Syndrome?
V - Vertebral abnormalityA - AnalTE - Tracheal Esophageal FistulaR - Renal
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
What is the Most common type of Kidney Stone?
Calcium Phosphate and Calcium Oxalate
What is the risk of Amniocentesis?
Abortion (2% risk)
What is Potency?
Amount of drug needed to produce effect (lower w/ comp antagonist)
What is the indication for Methylxanthines?
Asthma
What does Galactosemia cause?
Cataracts, mental retardation, liver damage
What is a Neuroblastoma?
Adrenal Medulla tumorHypsarrthymiaOpsoclonusIncreased urinary VMA
What is Pre-Renal Failure?
Low flow to kidney; BUN; Creatinine ratio >20/1 in the serum
What is the function of PRH?
Stimulates Prolactin (PRL) release
What disease has a Selenium deficiency?
Dialted cardiomyopathy
How do I know the patient has a Vitamin B3 (Niacin) Deficiency?
Pellagra (4 D’s: Diarrhea, dermatitis, dementia, death)
What is Small Cell Cancer?
Located at the Carina, Malignant, Cushing’s syndrome, SIADH, and SVC syndrome
What is Type B gastritis?
Upper GI bleed, associated with eating spicy foods, loss of barrier protection and H. Pylori infections (antrum of stomach)
What GI diseases are the causes of solid and liquid dysphagia?
Schatzki’s Rings, Stricture, Cancer
What is associated with E. Coli?
Raw hamburger, ADP- Ribosylates Gs (increased cAMP)Verotoxin, HUS in kids and elderly
FEV1/FVC in Obstructive lung disease
Lower than normal (N: 0.75-0.80)
What are the bacteria associated with Colon CA?
Clostridium Melanogosepticus and Streptococcus Bovis
What is the Adverse Effect of Alpha-Glucosidase Inhibitors?
GI disturbances and may reduce absorption of iron
What does VLDL do?
It takes TG’s from liver to adipose
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
What bug causes Subacute Bacterial Endocarditis?
Steptococcus viridans. (attacks damages valves)
What are the indications for the channel blockers?
WPW, Torsades, pulmonary fibrosis, hepatotoxicity, Hypo/hyperthyroidism
What is a transversion?
Changes one purine to a pyrimidine
What is Reaction Formation?
Unconsciously act opposite to how you feel, “Tears on a clown”
What is the MOA of Nesiritide?
Recombinant BNP, increase in cGMP and vasodilation
What is Cystosarcoma Phylloides?
Exploding Mushroom
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)
What is a Stomatocyte?
Seen in liver disease
What does Rh- tell you?
Does not have the D Antigen
What is associated with Yersinia Enterocolitica?
Presents like appendicitis and Reiter’sBloody Diarrhea
What are the layers of the Adrenal Cortex and what do they produce?
Zona Glomerulosa (Aldosterone),Zona Fasciculate (Cortisol),Zona Reticularis (Androgens)
What does a Southern blot detect?
DNA, “Snow, Drop”
How do you test efferent arteriole function?
Renal plasma flow (RPF) or PAH
What adds color to Stool?
Stercobilinogen being oxidized to stercobilin
What is a Heinz body?
Seen when Hb precipitates and sticks to cell membranes in G6PD deficiency
What is the difference between DI and SIADH?
DI: diluted urineSIADH: concentrated urine
What is a Blast?
Baby hematopoietic cell
What are the branched amino acids?
“Can’t LIVe w/o them”, Leu, Ile, Val
What is the Indication for Mimetics?
NIDDM. (Type 2)
What are the adverse effects of Nitroprusside?
Cyanide Toxicity, hypotension, short acting
What is Isolation of Affect?
Isolate feelings to keep on fucntioning
What is Hirsutism?
Hairy female (Excess growth in normal male areas)
What is associated with Strep Pyogenes?
Rheumatic Fever, PSGN, Impetigo, Pharyngitis, Nec Fasc
What is stable angina?
Pain with exertion that is relieved with rest (Athersclerosis MCC)
What are the indications for 1st generation H1 blockers?
Allergy, motion sickness, sleep aid
What ion has the least movement at rest?
Chloride
What is associated with S. Pneumoniae?
Gram-positive diplococci, rusty sputum, IgA Protease, vaccine covers 23 strains
What is cyclothymia?
Dysthymia with hypomania for more than 2 yearsTx: Lithium, Valproic Acid or Carbamazepine and psychotherapy
What is Oligohydramnios?
Too little amniotic fluid (baby can’t pee)
What does the Water Deprivation Test tell you?
If the patient fails to concentrate urine, they do not have Primary DI
What effects Efficacy?
Vmax
What defines AML?
15-30 y/o males Sudan StainAuer Rods, (CD30)T (15;17) - D M3 AML subtypetreat with ATRA
What organs have resistance in series?
Liver and Kidneys
How do I know the patient has a Vitamin B4 (Lipoic Acid) Deficiency?
No deficiency state
What is Type I RTA?
Distal RTA: H/K in collecting duct is broken, high urine pH
What is Autocrine?
Works on itself. (except T-cell activation)
What is Hypochondriasis?
They worry about having a serious illness (specific disease) they seek medical attention. For constant reassuranceTx: Psychotherapy
What does the JGA do?
Measures volume, secretes renin (low volume state)
What is Testicular Feminization (Androgen Insensitivity Syndrome)?
Males with defective / bad DHT receptor, they are XY with a blind pouch vagina
What does Vit B6 do?
Transaminase cofactor, myelin integrity
What is Paraphimosis?
Foreskin scarre at penis baseforeskin will strangulate the gland
What is Glioblastoma multiforme?
Pseudopalisading necrosis, worst prognosisintralesional hemorrhage
What does Zn2+ do?
Taste buds, hair, sperm function
What Diseases have a low LAP?
CML & PNH (paroxysmal nocturnal hemoglobinemia)
What is Hyper IgM Syndrome?
High IgM and all other Ig’s are low
What is Waterhouse-Friderichsen syndrome (WSF) or Hemorrhagic Adrenalitis or Fulminant Meningococcemia?
Adrenal hemorrhage most commonly due to Meningococcus Neisseria Meningitides
What disease has a steeple sign on neck films?
Croup (or Laryngotracheobronchitis)
What are the Indications for Insulin?
DM Type 1; DM Type 2; Hyperkalemia; Stress induced Hyperglycemia; Gestational Diabetes
What is Type 3 Hyperlipidemia?
Defective ApoE (Elevated ILD)
What is the Osler-Weber-Rendu?
AVM (Atrial-Venous Malformation)in lung, GI, CNSthe AVM sequesters platelets and causes acquired Telangiectasia’s
What is a Howell-Jolly Body?
The spleen or bone marrow should have removed nuclei fragments.(Seen in Hemolytic Anemia, spleen trauma, and CA)
What is associated with N. Meningitidis?
DIC, Pili, Only bug that releases toxin in the log phase
What is a Gastric Ulcer?
Loss of protective barrier, pain during the meal, associated with NSAIDs, H. Pylori infection and weight loss
What is Type 2 Diabetes Mellitus and associations?
Insulin receptor insensitivity, HONK coma, Acanthosis Nigricans
What can you measure to test afferent arteriole’s function?
Glomerular filtration rate (GFR) or Inulin
What is an incomplete Abortion?
Cervix is open, fetal remnantsTx: D&C to prevent placenta infection
What is seen in Hashimoto’s Thyroiditis?
Antimicrosomal antibody and Anti-TPO antibody
What is the definition of AIDS?
CD4 count less than 200 or defining illness
What is Schizoid Personality Disorder?
Recluse, they don’t want to interact with others, emotional coldness
What are the 2nd generation H1 Blockers?
Loratadine, fexofenadine, Desloratadine, Cetirizine
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
What is Bronze cirrhosis?
Fe deposit in liver
What is associated with S. Aureus?
Cellulitis, Dairy products, Gold pigment, Endocarditis, Styes, Hordeolum (on eyelid)
What is Associated with M. Catarrhalis?
It loves Mucus: it attacks the respiratory tract
What is MCD?
Most common nephrotic in kids, fused foot processes, no renal failure, loss of charge barrier
What is Jod-Basedow Disease?
Transient hyperthyroidism due to increased iodine
What is the MOA of Nifedipine and verapamil?
Ca+ channel antagonists
What are the continuous Murmurs?
PDA or AVM’s
What is Bronchoalveolar CA?
Looks like pneumoniadue to pneumoconiosis, nonsmoker
How does a Subarachnoid hemorrhage present?
“Worst headache of my life”, hx. of Berry aneurysm
What is a Gonadotrope?
LH and FSH
What is Bronze pigmentation?
Fe deposit in skin
What are the indications for Diazoxide?
HTN
What is a Female Hermaphrodite?
Impossible because female is the default formation
Negative high dose Dex. and low ACTH levels?
Adrenal CA (high cortisol)
What disease has Aniridia?
Wilms Tumor
How do I know the patient has a Vitamin B6 (Pyridozine) Deficiency?
Peripheral Neuropathy
What are the Extravascular Hemolytic anemias?
Spherocytosiswarm autoimmuneParoxysmal cold autoimmuneSickle cell anemia
What is Monoclonal Gammopathy of undetermined significance?
Old Person with Gamma Spike (from years of building up)
In what layers does a true aortic aneurysm occur?
Intima, media, and adventitia
What is a Male Pseudohermaphrodite?
XY with LOW 17-OHase and LOW Testosterone
What is Azotemia?
Increased BUN/Creatinine ratiorenal failure
What disease does Coxsackie A cause?
Hand-foot-mouth disease
What do low Retics tell you?
Decreased production of bone marrow - not working right
What is Kleine Rechnung?
Scant bleeding at ovulation
What is the MOA of Niacin?
Inhibits lipolysis in adipose tissuereduces hepatic VLDL secretion into circulation
What is diastole?
Heart ventricles fillingincreased blood to Coronary arteriesless extraction of oxygenPhase 4 and 5 Korotkoff
What is the MOA of Biguanides?
Decrease Gluconeogenesis, Increase Glycolysis, and Increase peripheral Glucose uptake. (Insulin sensitivity)
What is Normal Pressure Hydrocephalus?
Incontinence, ataxia “magnetic gait” dementia
What is the Most Common Cause of Kidney Stones?
Dehydration
What does Somatostatin (SS) do?
Inhibits growth hormone (GH) release
What is the function Oxytocin?
Milk and baby ejection
What is the job of the Thin Descending Loop of Henle?
Reabsorbs Water
What is Hemophilia B?
Factor IX deficiencyBleed into joints (knee, etc)
What is a threatened Abortion?
Cervix is closed, baby is intact, treat with bed rest
What disease has multiple lung aneurysms?
Osler-Weber-Rendu (AD Ped disease – thin vessels in nose, GI, and lungs)
What is the MOA of Bosentan?
Competitively antagonizes endothelium-1 receptors decreasing pulmonary vascular resistance
Why is Nagele’s Rule Inaccurate?
Because it does not start from Ovulation date
What is the MOA of Metoclopramide?
D2 receptor antagonist; increase resting tone, contractility LES tone, motility
What is a Band?
Baby Neutrophil
What is Asbestosis?
Shipyard workers, pipe fitters, brake mechanics, insulation installers
What is Chronic Rejection?
Occurs months to years later and fibroblasts are present
What does Vit B7 do?
Carboxylation (Avidin in egg whites (raw) binds Biotin)
What is Savage’s Syndrome?
Ovarian resistance to LH/FSH
How does Factor 13 Deficiency present?
Umbilical stump bleeding(this is the first time a baby has to stabalize a clot)
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
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)
What are Fraternal Twins?
Multiple eggs fertilized by different sperm
What is the efferent arteriole’s job?
To secrete
What are the Adverse Effects of Demeclocycline?
Nephrogenic DI, Photosensitivity and Abnormalities of Bone and Teeth
What are the hyperthyroid diseases?
Grave’sDeQuervain’sSilent ThyroiditisPlummer’sJod-Basedow
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
What is the MOA of PPIs?
Irreversibly inhibit H+/K+ ATPase in stomach parietal cellsDecreases proton secretion by parietal cells
Who makes the Cytotrophoblast?
Mom production of GnRH, CRH, TRH, and Inhibin
What are the indications for N-acetylcysteine?
CF patients and antidote for Acetaminophen overdose
What is Goldblatt’s Kidney?
Flea-bitten kidney (ruptured capillaries from high blood pressure)
What does MPO deficiency cause?
Catalase positive infections
What is Tay-Sachs?
Hexosaminidase A deficiencyHyperreflexia developmental delay”onion skin” Lysosomes
What does Growth Hormone (GH) do?
Stimulates Insulin Growth Factor-1 (IGF-1) release from the liver
What is the MOA of Dextromethorphan?
Antitussive (antagonizes NMDA glutamate receptors)
What are the indications for digoxin?
CHF (increase contractility)A fib (decrease conduction at the AV node)depression of the SA node
How does Tetrology of Fallot (TOF) present differently from Choanal Atresia?
TOF Babies… Turns blue with crying and has No feeding issues
What does a Lyase do?
Cuts C-C bonds w/ ATP
What is the MOA of Desmopressin (DDAVP)/ADH?
Recruits water channels to Luminal Membrane in collecting duct
What is Asherman’s Syndrome?
Uterine scars from multiple D&Cs
What are the breakdown products of VLDL?
IDL and LDL
What is the difference between Plasma and Serum?
Plasma: No RBC’sSerum: No RBC’s or Fibrinogen
What is Gilbert’s Syndrome?
Stress induced elevatedUnconjugated BilirubinIncreased load saturates Glucuronyl Transferase
What is Secretory Diarrhea?
Water pushed from cells into the gastric lumen (increased cAMP)
How does Diverticulosis Present?
Gross blood
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
What is Fructosemia?
“Fructose intolerance” (Aldolase B deficiency)kidney and liver damageoccurs in infants after introduction of fruits, honey, and juices
What is Pellagra?
Niacin (B3) deficiencyDermatitis, Diarrhea, Dementia, Death
What are the corticosteroid drugs?
Beclomethasone, Prednisone
What does the surface Ab tell you?
Vaccination has occurred
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
How does Von Willebrand Disease (VWD) present?
Heavy menstrual bleeding
What is the receptor problem with Midgets?
Patient with decreased Somatomedin receptor sensitivity
What is Dysthymia?
Low level sadness >2 years, looks like depressionTx: Psychotherapy and SSRI
What is a Tracheoesophageal (TE) Fistula (H-Type)?
Chokes with each feeding and is Congenital
How do cluster headaches present?
Rhinorrhea, unilateral orbital pain, suicidal, facial flushing, worse with lying down
What should you rule out when child abuse is suspected?
Osteogenesis Imperfecta, bleeding disorders, Fifth’s disease and Mongolian spots
What is a Compound Presentation?
Arm or hand on head, vaginal delivery. (Mean’s Prolapse of fetal extremity with presenting part)
Egg-shape on x-ray?
Transposition of the great arteries
What makes Progesterone in >10 weeks gestation?
Placenta
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
What is the MOA of GLP-1 Analogs (glucagon like peptides)?
Increase Insulin and Decrease Glucagon release
What are the Urease Positive Bugs?
“Urease PPUNCHSB”P - ProteusP - PseudomonasU - UreaplasmaN - NocardiaC - CryptococcusH - H. PyloriS - Staphylococcus SaprophyticusB - Brucellosis
What are the K+ channel blockers?
Sotalol, Ibutilide, Bretylium, Amiodarone
Where does a Type B thoracic aortic dissection occur?
Descending Aorta, (occurs in trauma and Atherosclerosis)
What is Boerhaave Syndrome?
Transmural tearing of the Esophagus. Left Sided most common, pneumonia/Pain/Effusion
What is a Sinciput Presentation?
Anterior Fontanel (Diamond shape) presents first
What is associated with Coxiella Burnetii?
Dusty Barn = Q fever
What is Placenta Percreta?
Placenta perforates through serosa
What is the cause of Asymmetrically Small babies?
In Late onset: Poor maternal nutrition and vascular disease
What is normal blood loss during a C-section?
1000 mL
What is the fucntion of AFP?
Regulates intravascular volume
What is Basophilic Stippling?
Lots of immature cells increased mRNA (seen in lead poisoning)
What is a Lactotrope?
PRL – Prolactin
What disease has a chromium deficiency?
Diabetes
What is the function of TSH (Thyroid stimulating hormone)?
Stimulates release of T3 and T4 from the thyroid.T3= TriiodothyronineT4= Thyroxine
How do migraines present?
Auro, photophobia, numbness and tingling, throbbing headache, nausea
What diseases provide malarial protection?
Sickle Cell Anemia: African descentG-6PD: Mediterranean’s
What is Epididymitis?
Chlamydia Trachomatis. Unilateral scrotal pain decreased by support
How would you know the patient has a Vitamin B1 (Thiamine) Deficiency?
Beriberi, Wernicke’s Encephalopathy, Wenicke-Korsakoff Syndrome
What is the Psychogenic Polydipsia?
Pathologic water drinking will have low plasma osmolality
What is Chorioamnionitis?
Fever, uterine tenderness, decreased fetal HR
What is the MOA of Demeclocycline?
ADH antagonist
What is the MOA of Methacholine?
Muscarinic receptor agonist
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)
What is Rubella (German 3-day Measles)
Trunk rashLymphadenopathy behind earsthey don’t look sick
What is the fucntion of MSH (melanocyte-stimulating hormones)?
Provides skin pigmentation
What sound radiates to the neck?
Aortic stenosis
What are the glycogenic & ketogenic amino acids?
“PITT” Phe, Iso, Thr, Trp
What is Bronchiolitis?
Athma in kids less than 2 years old
What is Sturge-Weber?
Port wine stain (big purple spot) on foreheadangioma of retinaEpilepsyMental retardation
What is the function of GRH?
Stimulates GH release
What is the MOA of Hydralazine?
increases cGMP, smooth muscle relaxation, vasodilates arterioles, afterload reduction
What is Cholecystitis?
Inflammation of the gallbladder
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
What will you see in Beta Thalassemia?
Seen in Mediterranean’s(chromosome 122- point mutation)
What serum pH does the low volume state have?
Alkalotic (due to H+/K+ exchanger)
What is associated with R. Prowazekii?
Lice = Starts on body
What is Gastroschisis?
Wall defect lateral to midline - off center, abdominal wall with no sac covering
What is the MOA of Minoxidil?
K+ channel opener, hyperpolarizes and relaxes smooth muscle
What are the adverse effects of Ezetimibe?
Rare increase LFT’s
What are the adverse effects of Niacin?
Red flushed face which is decreased by aspirin, hyperglycemia, hyperuricemia
What is a Beastophile?
Someone who has sex with animals, women prefer dogs, they can smell their estrogen
What is the rate-limiting enzyme in Pyrimidine synthesis?
Carbamoyl Phosphate Synthetase-2 (CPS-2)
What is seen in Spherocytosis?
Defective Spherin or AnkyrinPositive Osmotic Fragility testHigh level of MCHCteardrops
What is Otitis Media?
Fluid in the middle ear
What is the most common transplant?
Blood transfusion
What are the effects of 2nd generation H1 Blockers?
Far less sedating than the 1st generation because of decreased entry into the CNS
Boot-shape on x-ray?
RVH
What causes increased PTT and Bleeding Time?
Von Willebrand disease and SLE
How do you treat A2 Gestational DM?
Insulin
What are the adverse effects of Isoproterenol?
Tachycardia (B1)
What is the Treatment for Pre-Eclampsia?
Delivery, MgSO4 (seizures), Hydralazine (BP)
What are the adverse effects of Clonidine?
Drowsiness, dry mouth, and rebound HTN after abrupt withdraw
What is the Treatment for Eclampsia?
4mg MgSO4 IV (Seizure prophylaxis)
How do you monitor Baby’s Heart Rate?
Doppler or scalp electrode
What do high Retics (>1%) tell you?
RBC is being destroyed peripherally
What is Fanconi Syndrome?
Due to old Tetracycline useProduces Urine phosphates, Glucose, and Amino Acids
What is seen why Molybdenum deficiency?
Lose xanthine oxidase function
How do you monitor the Uterus?
Tocodynamics, uterine pressure catheter. (Measure frequency and duration of contractions)
What is Hartnup’s?
No tryptophan-cannot make niacin or seratoninPresents like PellagraGenetic, not nutritional disorder
What is a Frank Breech?
Butt down, thigh flexed, legs extended (Pancake)
What has high LAP?
Leukemoid reaction
What is Subgaleal Hemorrhage?
Prolonged jaundice in newborns due to birthing trauma
What disease has pulsus bisferiens?
IHSS- Idiopathic Hypertrophic Subaortic Stenosis
What is Intermittent Explosive Disorder?
Loses self-control, disproportional to circumstances?
What Bacteria cause UTI’s and Prostatitis?
E. ColiProteusKlebsiellaPseudomonas
What can cause Cushing’s syndrome?
High cortisol produced from an adrenal tumor
What bug is associated with cat feces?
Toxocara Cati
What is Fabry’s
alpha-galactosidase A deficiencyattacks baby’s kidneys and heartXLRaccumulation of CeramideTrihexoside
What are the indications for Nifedipine and verapamil?
HTN, angina, arrhythmia (not Nifedipine) Prinzmetal Angina, Raynaud’s
What hepatitis B labs indicate that the patient is in the window period?
HBeAb+, HBcAb+, HBsAg-
What is Amyloidosis and what stain is used?
Amyloid deposits that stain Congo red: Apple-Green Birefringence (AA-chronic disease)
What is Job’s Syndrome?
Seen in red headed femalesthey are stuck in the IgE stage
What has Hyaline Casts?
Normal sloughing
What is Conduct Disorder Personality Disorder?
Younger than 15 years old who have Antisocial personality disorder
What are the SYmptoms of Pre-eclampsia?
Headaches, changes in vision, and epigastric pain
What is Childhood Disintegrative Disorder?
Kid stops talking and walking. (They lose all their milestones)
Which hormones have the same Alpha Subunits?
LH, FSH, TSH, and B-HCG
What murmur has a water hammer pulse?
Aortic regurgitation
What is the MOA of Infliximab?
Monoclonal antibody to TNF-alpha
What is Pompe’s?
Lysosomal a-1, 4-glucosidase deficiencyDie early/young due to heart failure
What is the Peak level?
4 hours after dose (too high - decrease dose)
What do Platelet problems cause?
Bleeding from skin and mucosa
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
How does the Parasympathetic System behave?
“DUMBBELS”DiarrheaUrinationMiosis “Constrict”BradycardiaBronchoconstrictionErection “Point”LacrimationSalivation
What does Vit A do?
Night vision, CSF production, PTH cofactorantioxidants
What is an Incomplete Molar Pregnancy?
2 Sperm + 1 egg (69, XXY) mom “cooks the parts” has embryo parts
What is Adenomyosis?
Growth of the Endometrium, Myometrium, and patients will have an enlarged “boggy” uterus with cystic areas
What is the function of Cortisol in Pregnancy?
Decreases immune rejection of the baby out of mom and for lung maturation
What are the Indications for Glucocorticoids?
Addison’s disease; inflammation; immune suppression; asthma
What has WBC casts and eosinophils?
Interstitial Nephritis (Allergies)
What is seen in Copper deficiency?
Menky Kinky Hair Syndrome
What are the Systolic Ejection Murmurs?
Aortic Stenosis, Pulmonic Stenosis, Hypertrophic Cardiomyopathy
What is Isocarboxazid?
Atypical depression: Hypersomnia, anxiety, sensitivity to rejection, hypochondriasis
What is Necrosis?
Non-programmed cell death. Nucleus destroyed first
What is the 1st generation H1 Blockers?
Diphenhydramine, Dimenhydrinate, Chlorpheniramine
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)
What are the hypothyroid diseases?
Hashimoto’s, Riedel’s, Cretinism, Euthyroid SIck syndrome, Wolff-Chaikoff
What is obstructive lung disease?
Mucus filled lungs, cannot get air out
What are the anabolic & catabolic pathways? (Occurs in both Cytoplasm and Mitochondria)
“HUG” Heme synthesisUrea cycleGluconeogenesis
What are the indications for the Ca2+ channel blockers?
SVT/ prevent nodal arrhythmias
What is Type 4 Hyperlipidemia?
Defective Adipose Lipoprotein Lipase, elevated VLDL
What are Hallucinations?
False sensory perception with absence of external stimuli, seen commonly in ETOH withdraw and cocaine intoxication
What valves make noise at the end of diastole?
Mitral and Tricuspid
What is Closed-angle glaucoma?
Obstruction of canal of Schlemm, there is a sudden onset pain, emergency
What is the Platelet lifespan?
7 days
What is Ulcerative Colitis?
Starts at the rectum and ascends,1%/year risk for CAIBD with Pseudopolyps, hematochezia, Lead pipe colon and Toxic Megacolon
What is Pick’s Disease?
Frontal lobe atrophy, disinhibition
What is Endometriosis?
Painful cyclical heavy menstrual bleeding”Powder burns and chocolate cysts” due to ectopic endometrial tissue. (Endometrial Tissue outside of uterus)
What is a Pedophile?
Attracted to children sexually, watching child pornography
What disease process is present when both Serum Ca2+ and Serum Phosphate (PO4-) are decreased?
Vitamin D deficiency
What does Cu2+ do?
Collagen Synthesis
What is the rate-limiting enzyme of Glycolysis?
PFK-1
How do I know the patient has a Vitamin B9 (Folate) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, neural tube defects
What is Essential Fructosuria?
Fructokinase deficiencyExcrete fructose in blood/urine (still have hexokinase)
What is a “Pink Puffer”?
Emphysema
What is Gardener’s Syndrome
Familial Polyposis with Bone Tumors
What is the rate-limiting enzyme in the HMP shunt?
Glucose-6-Phosphate Dehydrogenase (G-6PD)
What are the T-cell Non-Hodgkin Lymphomas?
Mcosis Fungoides: total body rashSezary Syndrome: Cerebreform cells in the blood
What bug causes multiple Cerebral Abscesses?
Citrobacter
What is Labyrinthitis?
Inflammation of the Cochlear portion of the inner ear, present with hearing loss and tinnitus
What is Nephrogenic diabetes insipidus?
ADH (V2 aquaporin) is blocked or broken. Lithium association and Demeclocycline
What is Meningioma?
Located parasagittalPsammoma bodies presentwhirling patternbest prognosis
What happened if your pulse drops more than 10 bpm on standing?
Autonomic dysfunction
What are the basic amino acids?
Lys, Arg, His
What does Vitamin D do?
Helps in calcium absorption from the GI tract
What is an Apt Test?
Detects HbF in the Vagina, detects baby’s hemoglobin (Alkali denaturation test)
What is seen in Zinc deficiency?
Dysgeusia, anosmia, Poor wound healing
What cardiomyopathy has Pulsus Alternans?
Dilated cardiomyopathy
What is a Monocyte?
The destroyer - macrophage (has hydrolytic enzymes and a coffee bean nucleus)
How do I know the patient has a Vitamin B12 (Cyanocobalamin) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, Neuropathy
What are the indications for Metoclopramide?
Diabetic and post-surgery gastroparesis
What is a Target Cell/ Codocyte?
These have less Hb (seen in Thalassemias or iron deficiency)
What is seen in Diamond-Blackfan Anemia?
They have low RBCs and double jointed thumbs
What is associated with Yersinia Pestis?
Rats & Flease = Bubonic Plague
What is cor-pulmonale?
Pulmonary HTN leads to Right ventricular failure
What is associated with EPEC?
Pathogenic = newborn diarrhea
What is Chlamydia?
Obligate intracellular bacteria. Can present asymptomatic or PID Cervicitis (yellow pus)Conjunctivitis
What do Clotting problems cause?
Bleeding into cavities
Waht is associated with S. Saprophyticus?
Female with UTI’s (2nd cause), honeymooner’s cystitis
What are the adverse effects of fibrates?
Myositis, hepatotoxicity (increase LFT’s) cholesterol gallstones
What is Depersonalization Disorder?
“Out of Body” experiences, Deja Vu
What is the most common cause of death in the Low Energy State?
Heart Failure
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
What are the adverse effects of 1st generation H1 blockers?
Sedation, antimuscarinic, anti-alpha-adrenergic
What do Chylomicrons do?
They take Triglycerides (TG) from GI to liver and endothelium
What diseases have high Monocytes (>15%)?
“STELS”Syphilis: chancre, rash, wartsTB: Hemoptysis, night sweatsEBV: Teen sick for a monthListeria: Sick babySalmonella: Food poisoning
What is Active Transport?
Goes against concentration gradientRequires ATP
What are the diastolic rumbling murmurs?
Tricuspid StenosisMitral Stenosis
What is Face Presentation?
Mentum Anterior preform forceps delivery
What is Zero-order kinetics?
Metabolism independent of concentration (rate of elimination is constant)
What is Mumps?
Parotitis (Red Stenson’s Duct)
What does the Bulbourethral/ Cowper’s Glands secrete?
Bicarb to neutralize lactobacilli, if sperm is too acidic. (Infertility until corrected)
What is Type and Cross?
Blood that is matched by blood type and cross-reacted with the patient’s blood for rejection
How do you treat A1 Gestational DM?
Diet
What is the rate-limiting enzyme in Glycogenolysis?
Glycogen Phosphorylase. Occurs in the Cytoplasm of Liver and Muscle
What bugs cause Loeffler Syndrome?
“NASSA”N - Necator AmericanusA - Ancylostoma DuodenaleS - SchistosomiasisS - StrongyloidesA - Ascaris Lumbricoides
What has Fat Casts?
Nephrotic Syndrome
What is Paget’s disease of the Breast?
Rash and ulcer around the nipple, breast CA
What is the only Crescent Shaped Protozoa?
Giardia Lamblia
What produces Currant Jelly stool?
Intussusception
What is associated with R. Akari?
Mites
What are Braxton-Hicks Contractions?
Irregular contractions with closed cervix. (preparing for birth)
What is Krabbe’s?
Galactocerebrosidase deficiencyperipheral neuropathyoptic atrophygloboid bodiesaccumulation of Galactocerebroside and Psychosine
What are the adverse effects of methylxanthines?
Cardiotoxicity, Neurotoxicity
How do I know the patienthas a Vitamin K Deficiency?
Bleeding, Loss of gamma-carboxylation
What is a Meningomyelocele?
Sacral pocket with meninges and nerves in it
What are the Adverse Effects of Osmotic Laxatives?
Diarrhea, dehydration, may be abused by bulimics
What is the color of fluid or a solid on X-ray?
White “radiopaque”
What is the MOA of a Growth Hormone?
Stimulates liver production of insulin-like growth factors and gastric emptying
What is Ferning?
Estrogen crystallizes on slide. (Amniotic fluid)
What are the essential fatty acids?
Linolenic, Linoleic
What is Hunter’s?
Iduronate Sulfatase deficiencymilder formXLRno corneal cloudingaggressive behaviorAccumulation of Heparin and Dermatan Sulfate
What does a Western blot detect?
Protein, “snoW, droP”
What are the four Painful Genital Lesions?
HerpesChancroid (It makes you cry… H. Ducreyi) Lymphogranuloma VenereumLymphogranuloma Inguinale
What are the indications for Bile Acid Resins?
Slightly increase HDL and triglyceridesDecrease LDL
What is Dubin-Johnson?
Defective Bilirubin storageBLACK LIVERIncreased conjugated bilirubin
Snowman-shape on x-ray?
Total anomalous pulmonary venous return
What is the MOA of H2 blockers?
Reversible block of histamine H2 receptors to decrease H+ secretion by parietal cells
What are the Alpha-Glucosidase Inhibitors?
Acarbose and Miglitol
What is Early Deceleration?
Normal due to head compression
What is Hepatorenal Syndrome?
Build up of liver toxins that cause renal failure
What organ has the lower AVO2 difference?
Kidney
What bug causes multiple liver abscesses?
Entamoeba Histolytica
What is Conversion?
Neurological manifestations of internal conflict, indifferent to disability, blindness/mutism triggered by a stressor. Patient is unconcerned about his impairmentTx: Psychotherapy
What is a Xanthelasma?
Triglyceride build up and is seen under the eyes (Xanthoma subtype)
What are the indications for Prazosin?
Pheochromocytoma, HTN
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)
What are the indications for antileukotriene?
Asthma, aspirin induced asthma
What is Regression?
Immature behavior, go back in development
What are the sounds made from diastolic murmurs?
Blowing and rumbling
what is the Central Nervous System?
Brain and spinal cord, Myelination by the oligodendrocytes
What is Laryngomalacia?
Epiglottis rolls in from side to side
Where does a Type A thoracic aortic dissection occur?
Ascending Aorta, (occurs in Cystic medial necrosis and Syphilis)
What diagnosis has primary hyperparathyroidism?
Parathyroid Adenoma
What does a mid-systolic click tell you?
MVP- Mitral valve prolapse
What is a Schwannoma?
CN-8 tumor, unilateral deafness
What does auscultation of stridor tell you?
Extrathoracic narrowing (seen on inspiration on X-Ray)
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)
What are the indications for Sulfonylureas?
NIDDM (Type 2)
When is Beta HCG found in Urine?
2 weeks after fertilization
What does auscultation of crackles tell you?
Blowing collapsed alveoli open (restrictive lung disease)
What is a Xenograft?
1 species to another species (pig heart into humans)
What makes Esophageal Spasms Unique?
Increased Peristalsis
What is the rate-limiting enzyme in Gluconeogenesis?
Fructose - 1,6 Bisphophatase
What is the most common cause of first trimester maternal death?
Ectopic pregnancy
What does Vit K do?
ClottingSynthesized by intestinal flora
What serum pH does emesis have?
Alkalotic because you vomit out HCl-
What is the MOA of coricosteroids?
Inhibits leukotriene synthesis -> reduces inflammation and leads to bronchodilation
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
What is associated with R. Tsutsugamushi?
Chiggers (Mites) = Scrub Typhus
What is the MOA of Hexamethonium?
Nicotinic Ganglionic blocker
What is the rate-limiting enzyme in TCA Cycle?
Isocitrate dehydrogenase
What are the Gram Negative Capsules?
“Some Killers Have Pretty Nice Capsules”S - SalmonellaK - KlebsiellaH - H. Influenza B (HiB)P - PseudomonasN - NeisseriaC - Citrobacter
What causes Cryoglobulinemia?
“I AM He”I - InfluenzaA - AdenovirusM - MycoplasmaH - Hepatitis B and C
What is the indication for muscarinic antagonist?
Asthma, COPD
What are the Adverse Effects of Octreotide?
Nausea, cramps, steatorrhea
What serum pH does diarrhea have?
Acidosis because stool has bicarb
What are the indications for adenosine?
Dx. and tx. of AV nodal arrhythmias
What is Word Salad?
Unrelated combinations of words
What are the Vasodilators?
Hydralazine, Minoxidil, Nifedipine, Verapamil, Nitroprusside, Diazoxide
What is Frotteurism?
Rubs penis against fully clothed women
What is the rate-limiting enzyme in Urea cycle?
Carbamoyl Phosphate Synthetase-1 (CPS-1)
What are the Adverse Effects of PTU and Methimazole?
Agranulocytosis, skin rash and Aplastic Anemia
What is Molluscum Contagiosum
Flesh colored papules with a central dimple
What is the indication for Albuterol?
Acute exacerbation
What does Gastrin do?
Stimulates parietal cells to release intrinsic factor (IF) and H+
What is Turner’s Syndrome (XO)?
High FSH, LOW E2, Ovarian Dysgenesis, Webbed Neck, Coarctation of the Aorta, Cystic Hydroma, bicuspid Aortic valve
What murmur has Pulsus Tardus?
Aortic stenosis
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
What is the Acrosomal reaction?
Sperm release enzymes to eat the Corona Radiata
Function of what cells is necessary for the action of Sulfonylureas?
Requires some islet cell function so drugs used less in Type 1 DM
What is Conjugated Bilirubin?
Water soluble and direct Bilirubin
What is the MOA of the Ca2+ blockers?
Decreases conduction velocity of the AV node, increases ERP and PR interval
What is associated with Legionella Pneumoniae?
Found in AC ducts, silver stains lung, CYEAPontiac Fever, Legionnaire’sPneumonia
What are the Megaloblastic Anemias?
Vitamin B-12 Deficiencyfolate deficiencyalcohol
What is Double Depression?
Depression followed by dysthymia
What is familial Hypocalciuria Hypercalcemia?
Patients with decreased calcium excretion
What are some causes of Cold Autoimmune?
MonoMycoplasma infectionAntibody (IgM) bind to RBC’s membranecold temp and causes agglutination
What has Muddy Brown Casts?
Acute Tubular Necrosis (ATN)
What are the indications for Bosentan?
Pulmonary HTN
What is Circumstantiality?
Digresses but finally gets back to the point
What are the adverse effects of B-blockers?
Impotence, asthma, bradycardia, AV block, heart failure, sedation, sleep alterations
What are the Steroid Hormones?
Progesterone, Estradiol (E2), Testosterone, Cortisol, and Aldosterone
What is associated with Bacteroides Fragilis?
Post Op bowel abscess, grows in blood clots
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
When performing a high dose dex. Test, if positive…
Patient has a pituitary tumor
What does the Prostate Secrete?
The prostate HAZ it.H- HyaluronidaseA- Acid PhosphataseZ- Zinc
What are the Gram-negative exotoxins?
H. InfluenzaBordatella Pertussis
What is Meniere’s Disease?
Same presentation as Labyrinthitis but is a chronic condition with remitting and relapsing episodes
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
What are the Glitazones/Thiazolidinedione’s drugs?
Pioglitazone and rosiglitazone
What is Concrete Thinking?
Can’t interpret abstract proverbs, only sees the facts
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
What is the MOA of Methyldopa?
Alpha 2 agonist = decreases peripheral resistance
What drugs cause Pulmonary Eosinophilia?
Nitrofurantoin and Sulfonamides
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
What is the MOA of Guanethidine?
Interferes with norepinephrine release
What is pseudo-pseudo-hypoparathyroidsm?
G-Protein defect, and there is no calcium problem
What is Malingering?
Fake illness for monetary gain or getting out of jail, avoids medical treatmentTx: Supportive Psychotherapy
What does alpha one anti-trypsin do?
Inhibits Elastase
What GI disease has a String Sign on X-Ray?
Pyrloric Stenosis and Crohn’s Disease
What is DiGeorge Syndrome?
No Thymus, inferior Parathyroid and low calcium
What is a Meningocele?
Sacral pocket with meninges in it
What does auscultation of rhonchi tell you?
Mucus in the airway (obstructive airway disease)
What is the indication for Osmotic Laxatives?
Constipation
What is Suppression?
Consciously block memory
What is Placenta Previa?
The placenta is implanted wholly or partially in lower uterine segment
Which of your cells express MHC-1?
All nucleated cells except the immune-privileged cells/tissues, RBC’s and Platelets
What are the Indications for Desmopressin (DDAVP)/ADH?
Antidiuresis and Central (pituitary) DI
What are the atypical (no cell wall) Bacteria?
“CLUMsy”C - ChlamydiaL - LegionellaU - UreaplasmaM - Mycoplasma
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…
What is seen in Warm Autoimmune?
Anti-Rh Ab Dapsone, PTU, antimalarials, and sulfa drugsAntibody (IgG) binds to RBC’s membrane in warm temp
What is a nonsense mutation?
Early stop codon
What bug loves the posterior fossa?
TB
Banana-shape on x-ray?
IHSS
What is a Hyperacute Rejection?
Autoimmune response within 12 hours, preformed antibodies respondedThis is a Type 2 hypersensitivity reaction
What is Sadism?
Gives physical and psychological pain
What is persistent eye drainage since birth usually due to?
Blocked Duct
What is a Tamponade?
Decreased breathe sounds and blood pressure, distant muffled heart soundsicnreased JVD
What is Whipple’s Disease?
Tropheryma Whipplei (T. Whipplei) destroy the GI tractCausing Malabsorption/Arthralgia, PAS (+)
What is Pneumonia?
Consolidation of airway
What are the HMG-CoA reductase inhibitors?
Lovastatin, Pravastatin, Simvastatin, Atorvastatin, Rosuvastatin
What is associated with S. Pneumoniae?
Otitis Media, red bulging TM
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
What do white diaper crystals suggest?
Excess Orotic acid
Where is a Morgagni Hernia?
Anterior/middle of diaphragm, bowel sounds in thorax, seen on US in uterosurgery to fix immediately after birth
How do you measure efferent renal function?
BUN or PAH
What is Pityriasis Rosea?
Herald Patch that migrates along skin lines in a Christmas Tree appearance
What are the indications for B-blockers
HTN, Angina, MI, Antiarrhythmic
What is Multiple Endocrine Neoplasia III (2B)?
Pheochromocytoma, Medullary Carcinoma of the Thyroid, Mucosal Neuromas/ Marfanoid body habitus. (tumor marker RET)
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
What does a Northern blot detect?
RNA, “sNow, dRop”
What is associated with EIEC?
Inflammatory = loose stool
What is Cullen’s SIgn?
Bruising around the umbilicusCaused by hemorrhagic pancreatitis (late sign)
What Hepatitis B labs indicate an acute recent infection?
HBcAg+, HBsAg+, (HBcAb+/-)
What is Bernard-Soulier?
Baby with bleeding from skin and mucosa(Big platelets and LOW GP-1b)
What does cortisol do?
Gluconeogenesis by proteolysis and thins the skin, prevents and immune response, and decrease bone mass
What are the most common infections of the Low Energy State?
UTI and respiratory infections
What are the Comma (curved) shaped bugs?
Vibrio, Campylobacter, Listeria, H. Pylori
What is Dysmenorrhea?
PG-F causes painful menstrual cramps. (Teenagers miss school / work)
What is Asperger’s?
Good communication skills, impaired relationships, no mental retardation
What is the most common cause of first trimester spontaneous abortions?
Chromosomal abnormalities
What is Familial Polyposis?
100% ridk of Colon Cancer, APC gene defect and annual Colonoscopy start at 5 years of age
What is Parkinson’s disease?
Located in the Substantia Nigra, bradykinesia, pill rolling tremor, shuffling gait, Lewy Bodies
What is associated with Bordetella Pertussis?
Whooping cough, ADP ribosylates Gi
When can you tell the sex of the baby by US?
Week 16
What is Type 1 Diabetes Mellitus?
Anti-islet cell antibody /GAD (Glutamic Acid Decarboxylase) antibody.
What hormones produce Acidophilus?
“GAP”: GH, Acidophilus, and Prolactin
What are the most common causes of third trimester spontaneous abortions?
Anti-Cardiolipin Ab, placenta probelms, infection, incompetent cervix
What is the most common cause of a White Reflex?
Retinoblastoma
What is Truncus arteriosus?
Spiral membrane did not develop, there is one Aortic Pulmonary trunk, mixed blood, needs PDA
What is an Epstein’s Pearl?
White pearls on hard palate
What is seen in RPGN?
Crescents
What does a Synthase do?
Consumes two substrates
What is asthma?
Chronic inflammatory disease of the airwayscharacterized by variable and recurring symptoms, wheezing on expiration, elevated IgE and Eosinophils
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
What are Mongolian spots?
Melanocytes on lower back
What is a Factor V - Leiden?
Protein C cannot break down Factor V
What disease has exophthalmos?
Grave’s disease
When can you first detect fetal heart tones?
Week 20
What is Multiple Personality Disorder?
They have 5-10 alters, usually associated with incest
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)
What is the most common Nephrotic disease complication with cancer?
Amyloidosis
What are CD4 cells?
T-helper cell - Responds to MHC-2 (foreign attack)
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
What symptoms does a “more likely to depolarize” state have?
Brain: Psychosis, seizures, jitterinessSkeletal Muscle: muscle spasms, tetanySmooth Muscle: diarrhea, then constipationCardiac: tachycardia, arrhythmia
Whata re the anabolic pathways that store energy? (occur in the cytoplasm)
Fatty acid synthesis, Glycolysis, HMP shunt, translation
Whata re the indications for Guanethidine?
Severe HTN
Which cytokines do T-helper cells stimulate?
All IL’s except IL-1
What is seen in newborn with HSV-2 in utero infections?
Temporal Lobe encephalitis, must offer C-section to mom with active lesions
What is the Primary Diabetes Insipidus (DI)?
Too much water (urinates a lot)
What is Merocrine?
Cell is maintained. (exocytosis)
What is the most common cause of primary hypoparathyroidism?
Thyroidectomy
What are the Silver Stainer’s?
“HaLV-C”H - H. PyloriL - ListeriaV - VicrioC - Campylobacter
What has WBC Casts and RBC Casts?
Glomerulonephritis
What are the 3 kinds of generalized seizures?
Tonic-clonic “Grand Mal”Absence “Petit Mal”Status Epilepticus
What are the side effects of Progesterone?
Acne, depression, HTN, increase appetite, acne causes dilution anemia, quiescent uterus, PICA, hypotension, melisma (AKA Chloasma)
What is Ficticious Disorder by Proxy?
Mom makes the child or another person ill for emotional support, noted to move frequently
What is associated with ETEC?
Traveler’s Diarrhea = rice water diarrhea
What are the Adverse Effects of Levothyroxine (T4)/Triiodothyronine (T3)?
Tachycardia, heat intolerance, tremors and Arrhythmias
What is the Somatic Nervous System?
Moving your muscles
What state does Estrogen mimic?
The Neuromuscular disease stateEstrogen is a muscle relaxant
What is the most common Nephrotic disease in diabetics?
Nodular Sclerosis
What is Placenta Accreta?
Placenta is attached to the endometrium
What is Polymenorrhea?
Too many periods
What do you see in CMV in utero infections?
Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications
What diseases have Hemoptysis?
Bronchiectasis, Bronchitis, Pneumonia, TB, Lung CA, Goodpasture’s, Wegener’s
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
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
What is Lochia?
Endometrial slough. (normal discharge and uterus after birth)
What does fixed wide S-2 splitting tell you?
ASD
What is Cryptorchidism?
Testes never descended out of abdomen, sterility after 15 months, predisposed to seminomas and CA
What is the MOA of Class IC antiarrhythmic?
Na+ channel blocker
What is the function of ACTH (Adrenocorticotropic hormone)?
Stimulates Cortisol and Androgen releases from the adrenal gland
What is the indication for Salmeterol?
Long acting agent for prophylaxis
What is the rate-limiting enzyme in Beta Oxidation?
Carnitine Acyltransferase -1 (CAT-1)
What do the IgA protease bugs cause?
Sinusitis, Otitis Media, Pneumonia/Bronchitis
What are the causes of Hyperbilirubinemia?
Sepsis, ABO Incompatibility, Hypothyroidism and Breast-feeding
What does a Hydroxylase do?
Adds-OH group onto substrate
What is Mittelschmerz
Pain with ovulation
What is the MOA of Ezetimibe?
Prevents cholesterol reabsorption at small intestine brush border
What is Barrett’s Esophagus?
Metaplasia of the lower esophagus increased risk of Adenocarcinoma
How do you diagnose Rheumatic Fever?
JONES Criteria
J - Joint Involvement
O - Myocarditis
N- Nodules, subcutaneous
E - Erythema Marginatum
S- Sydenham Chorea
What is a missense mutation?
Mistaken amino acid substitution (i.e. SS disease Valine for Glutamic Acid)
What are the adverse effects of HMG-CoA reductase inhibitors?
Hepatotoxicity (increase LFT’s)Rhabdo
What is Masochism?
Receives pain (Humiliation)
What other diseases can have exophthalmos?
Horner’s and Marfan’s
What vessels have the highest capacitance?
Veins and Venules
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
What is seen in iron deficiency?
Anemia
What is Celiac Sprue?
Found in the JejunumWheat AllergyVillous atrophAnti-gluter-gliadin antibodies
What is uremia?
Azotemia (renal failure) with symptoms
What is Urge incontinence?
Urgency leads to complete voiding detrusor spasticity leads to small bladder volume
What does epinephrine (Epi) do?
Drives gluconeogenesis and glycogenolysis
What bug is associated with cat saliva?
Pasteurella Multocida
What is a Corticotrope?
ACTH
What is Ductal Carcinoma?
Worst prognosis Breast CA
What is associated with C. Tetani?
Rusty nail wounds - inhibits GLY release, respiratory failure, Risus Sardonicus, tennis racquet shaped appearance
What is Meig’s Syndrome?
Pleural effusion, ovarian fibroma, ascites
What blood level should be monitored in patients taking statins?
Liver enzymes every 3 months and Serum Cr
What is the most common cause of Polyhydramnios?
Neuromuscular problem: Werdnig HoffmanGI problem: Duodenal atresia
What is Hairy Cell Leukemia?
Cells have a fried egg/ Sunburst appearance and TRAP +
What does motilin do?
Stimulates segmentation, primary peristalsis, and migrating motor complexes (MMC)
What is Pneumothorax?
Absent breath sounds on one side
What is Identification?
To be like or to become like another (aspect, property or attribute of another)
What is the most common cause of post-coital Vaginal Bleeding in Pregnant women?
Placenta previa
What are the adverse effects of Hydralazine?
Compensatory tachycardia, fluid retention, Lupus like syndrome, contraindicated in Angina/CAD because of compensatory tachy
What does an AFI >20 indicate?
Polyhydramnios (DM)
What is Somatization?
Psychological trigger gets them sick, but no medical finding (Pain in 4 parts, 2 GI problems)Tx: Psychotherapy
What is the second generation Sulfonylureas?
Glyburide, Glimepiride, and Glipizide
What can you measure to test afferent arteriole’s function?
Glomerular filtration rate (GFR) or Inulin
What does a wide S-2 split tell you?
Increases OxygenIncreased right ventricular volumeDelayed pulmonic vlave opening
What are the indications for administering Potassium?
Digoxin toxicity, activated charcoal: binds digoxin in the intestineDigibind: binds to digoxin in the bloodstream
What is Tracheitis?
“Acute URI”Patients look toxicGrey PseudomembraneLeukocytosis
What is the common side effect of the ERCP procedure?
Pacreatitis from blocking the pancreatic duct during the procedure
What amino acid turns yellow on Ninhydrin reaction?
Pro
What is the job of the late Distal Tubule and Collecting Duct?
Final concentration of urine by reabsorbing water and excretion of acid
What separates unconjugated bilirubin from albumin?
Sulfur (no Sulfur Rx in pregnancy)
What is Caput Succedaneum?
Bleeding under scalp (edema will cross suture lines)
What are the indications for Levothyroxine (T4)/Triiodothyronine (T3)?
Hypothyroidism and Myxedema
What is an Autograft?
Twin to twin (spare parts)
What are the H2 blockers?
Cimetidine, Ranitidine, Famotidine, and Nizatidine
How does a Subdural Hematoma present?
Headache 4 weeks after trauma, elderly (loose brain)
What GI disease has a RUQ Olive Mass?
Pyloric Stenosis
How would you know the patient has a Vitamin A (retinoic Acid) Deficiency?
Poor night vision, Hypoparathyroidism, dry skin
What is Histiocytosis X?
Histiocyte proliferation Kid with Eczema, skill lesionsHand-Schuller-Christian disease
What is Body Dysmorphic Disorder?
Imagined physical defect, causing impaired function in a social or occupational activityTx: SSRI
What happens when there is a biotin Deficiency?
Loss of carboxylase function
What is the MOA of Methylxanthines?
Inhibit Phosphodiesterase -> decreases cAMP hydrolysis promoting bronchodilation
How does a Somatostatinoma present?
Constipation
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
What does Calcitonin do?
Inhibits Osteoclasts and binds to calcium
What is Countertransference?
Doctor views patient as child
What does Sudan Black Stain test for?
Steatorrhea (fat malabsorption), patient seen with chronic pale, greasy, malodorous diarrhea and no evidence of infection
What tests are used for following Pancreatitis?
Amylase (sensitive) breaks down Carbohydrates and Lipase (specific) breaks down Triglycerides
What is Postpartum Psychosis
Hallucinations, suicidal/infaticidal thoughts
What color is stool with an Upper GI Bleed?
Black (Dark Red) (Melena)
What are the most common signs of the Low Energy State?
Tachypnea and Dyspnea
What is the Adverse Effect of Glitazones/Thiazolidinedione’s?
Weight gain, edema, hepatotoxicity, increases LDL and triglycerides, CHF and Contraindicated
What is the MOA of Octreotide?
Long-acting somatostatin analog
What is Plummer’s Syndrome?
Hyperthyroid adenoma
What is aspergillosis?
Mold, compost piles, associated with peanuts
How does Diverticulitis present?
Pain in LLQ, no visible blood and may cause peritonitis
What has WBC Casts?
Nephritis
What are the cholesterol Absorption blockers?
Ezetimibe
What murmurs occur during systole?
Holosystolic or pansystolic
What is Acting out?
expression of impulse, “Temper Tantrums”
What is the Intermediate Acting Insulin drug?
NPH and Lente
What is Schatzki’s Ring?
Esophageal webs in the lower EsophagusDysphagia (mucosal tissue)
What is McArdle’s?
Myophosphorylase deficiency(skeletal muscle Glycogen Phosphorylase)muscle cramps w/ exercise, increased Glycogen in muscle only, blood glucose NLSecond wind phenomenon
What is inevitable Abortion?
Cervix is open, baby is intact
What is pseudo-hypoparathyroidism?
Bad kidney, PTH receptor, decreased urinary, cAMP
What is hemochromatosis?
Iron deposits in organsleads to hyperpigmentation, bronze diabetes, and arthritis
What do B cell deficiency patients die of?
Bacterial infection?
What are the adverse effects of Guanethidine?
Contraindicated in patients taking TCA’s
What affects Potency?
Km (EC50)
What does blood type A tell you?
They have the A antigen and B antibodies
What does Vit B4 do?
Glycolysis, no known diseases
What is Illusion?
Misinterprets stimulus
What is Repression?
Subconsciously block memory
What is Thought Withdrawal?
Believes that others are taking thoughts out of his head
What does S-2 splitting tell you?
Normal on inspirationPulmonic valve closing later
What is open-angle glaucoma?
Overproduction of fluid, painless Ipsilateral dilated pupil, gradual tunnel vision, optic disc cupping
What is Pseudomembranous Colitis?
Overgrowth of C. DiffDue to normal flora being killed off from long term antibiotic use
What are the indications for H2 blockers?
Peptic ulcer, gastritis and esophageal reflux
What is a Necrophile?
Someone who has sex with corpses
What is associated with R. Rickettsii?
Ticks = Rocky Mountain spotted fever
What is associated with Shigella?
Day care outbreaks, seizures, destroys the 60S ribosome, infects M-cells
What is Post-Renal Failure?
Obstruction (hydronephrosis)
What is a Bezoar?
Mass of non-digestible product (i.e. Hair) causing an occlusion at the pylorus
What is a Hemangioblastoma?
In the cerebellum, associated with VHL
What will you see with Iron Deficiency Anemia?
Increased TIBC associated with menses, GI bleeding, and Koilonychia
How do I know the patient has a Vitamin B5 (Pantothenic Acid) Deficiency?
No deficiency state
What is a fetish?
High attraction for inanimate objects
What is a possible cause if pulse rises more than 10 bpm in repositioning from lying to sitting?
Hypervolemia
What does the Hep B Core Ag tell you?
Gone before patient has symptoms (present from 0-2 months)
What is Mallory-Weiss?
Tearing of the lower esophageal sphincter (LES), associated with chronic vomiting, cough up a little blood and possible visible varices
What is Cushing’s disease?
High ACTH due to pituitary tumor or Small cell carcinoma of the lungs
What is a Craniopharyngioma?
Motor oil biopsy, tooth enamel, Rathke’s Pouch, ADH problem, Bitemporal Hemianopsia
What Does Vit E do?
Antioxidantacts as an tagonist to Vit K in high levels
What are the Foot Ulcer Risk Factors?
Poor glycemic control (HbA1C >7), smoking, bony abnormalities, previous ulcers
What GI disease has a Thumb Print on X-Ray?
Toxic Megacolon
What is Silicosis?
Sandblasters and glassblowers
What is Tropical Sprue?
Found in the distal iliumCaused by bacterial or viral, amoeba or parasitic infectionVillous atrophy
What are the adverse effects of corticosteroids?
Osteoporosis, Cushingoid reaction, psychosis, glucose intolerance, infection, HTN, cataracts
What is Holocrine?
The whole cell is secreted. (except sebaceous gland)
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
When is B-HCG found in Blood?
8-10 days after fertilization
What does Chymotrypsin cut?
Phe, Tyr, Trp
What is Backward Typing?
Used Antigens to detect Antibodies
What are the ketogenic amino acids?
Lys, Leu
What are the Adverse Effects of GLP-1 Analogs?
Nausea, Vomiting and Pancreatitis
What makes Scleroderma Unique?
Can have a decreased LES pressure or and increased LES pressure
What is epiglottitis?
inflammation of the epiglottisthumb sign on x-rayexcessive drooling
Waht is associated with Brucella?
Seen in farmers/ Vets, Animal placentas are the vector, Spiking fever 5 times a day
What GI disease has Barium Clumping on X-Ray?
Celiac Sprue
What are the Short Acting Insulin drugs?
Aspart and Lispro
What is seen in Measles (Rubeola)?
CCCK: Cough, Coryza (runny nose), Conjunctivitis, Koplik SpotMorbilliform blotchy rash
What is an Insulinoma?
Insulin secreting tumor, labs show increased insulin and C-peptide
What ion has the greatest movement at rest?
Potassium
What is seen with Fluoride deficiency?
Poor teeth and bone growth
What hepatitis B labs indicate immunization >2/52 weeks?
HBsAb+
What valves make noise at the end of systole?
Aortic and Pulmonic
What is Riedel’s Struma?
“Woody” connective tissue in neck, death due to suffocation and must rule out CA
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
What does a Thio do?
Breaks S bonds
What is Hungry Bone Syndrome?
Removal of PTH and the bone sucks in calcium
What do high GABA levels lead to?
Bradycardia, lethargy, constipation, impotence, memory loss
What is Shoulder Dystocia?
Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)
What structures have Fake sphincters?
Ureters, LES, Ileocecal valve
What does Endocrine mean?
Secreted into bood
What are the indications for Misoprostol?
Prevents NSAID-induced peptic ulcers, maintenance of a Patent Ductus ArteriosusInduce labor
What is the Indication for PTU and Methimazole?
Hyperthyroidism
What are the expectorants?
Guaifenesin, N-acetylcysteine
What does an epimerase do?
Creates an epimer, which differs around one chiral carbon
What is the MOA of Guaifenesin?
Removes excess sputum but does not suppress cough reflex
What are the indications for Pseudoephedrine, Phenylephrine?
Reduces Hyperemesis, edema, nasal congestion, and opens obstructed Eustachian tubes
What has Crescents?
RPGN
What are wide sutures due to?
Hypothyroidism and Down’s Syndrome
What is a Transvestite?
Dress up as opposite sex, no identity crisis
What does SAM donated methyl groups for?
All other reactions
When do valves make noise under normal physiology?
When the valves close
What is systole?
Ejection of blood from the heart, Decreased blood flow to Coronary arteries, more extraction of Oxygen Phase 1 Korotkoff
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
What is associated with Bacillus Anthracis?
Black Eschar, Wool Sorter’s Lung diseaseD-Glu, boxcar-like spore, treat with Cipro
What type of immunity does TH1 provide?
Enhances cell mediated immunity
What are the adverse effects of Prazosin?
Orthostatic Hypotension
What is the most common cause of post-coital Vaginal Bleeding?
Cervical CA
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
What is the function of Inhibin?
Inhibits FSH so there is no menstruation
What is a Transsexual?
Gender Identity crisis
What are the Survival Hormones?
Cortisol: permissive under stress. TSH: permissive under normal
What is the cause of Symmetrically small babies?
In Early onset: Chromosomal Abnormalities or TORCHES
What will you see in Lead Poisoning?
Decreased dALA dehydrogenasedecreased Ferrochelataseblue lines on x-rayhistory of eating old paint chips
