Complete Deck Part 2 Flashcards
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