Complete Deck Part 3 Flashcards
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