Complete Deck Part 3 Flashcards
1
Q
What are the basic amino acids?
A
Lys, Arg, His
2
Q
What does Vitamin D do?
A
Helps in calcium absorption from the GI tract
3
Q
What is an Apt Test?
A
Detects HbF in the Vagina, detects baby’s hemoglobin (Alkali denaturation test)
4
Q
What is seen in Zinc deficiency?
A
Dysgeusia, anosmia, Poor wound healing
5
Q
What cardiomyopathy has Pulsus Alternans?
A
Dilated cardiomyopathy
6
Q
What is a Monocyte?
A
The destroyer - macrophage (has hydrolytic enzymes and a coffee bean nucleus)
7
Q
How do I know the patient has a Vitamin B12 (Cyanocobalamin) Deficiency?
A
Megaloblastic anemia, hypersegmented neutrophils, Neuropathy
8
Q
What are the indications for Metoclopramide?
A
Diabetic and post-surgery gastroparesis
9
Q
What is a Target Cell/ Codocyte?
A
These have less Hb (seen in Thalassemias or iron deficiency)
10
Q
What is seen in Diamond-Blackfan Anemia?
A
They have low RBCs and double jointed thumbs
11
Q
What is associated with Yersinia Pestis?
A
Rats & Flease = Bubonic Plague
12
Q
What is cor-pulmonale?
A
Pulmonary HTN leads to Right ventricular failure
13
Q
What is associated with EPEC?
A
Pathogenic = newborn diarrhea
14
Q
What is Chlamydia?
A
Obligate intracellular bacteria. Can present asymptomatic or PID Cervicitis (yellow pus)Conjunctivitis
15
Q
What do Clotting problems cause?
A
Bleeding into cavities
16
Q
Waht is associated with S. Saprophyticus?
A
Female with UTI’s (2nd cause), honeymooner’s cystitis
17
Q
What are the adverse effects of fibrates?
A
Myositis, hepatotoxicity (increase LFT’s) cholesterol gallstones
18
Q
What is Depersonalization Disorder?
A
“Out of Body” experiences, Deja Vu
19
Q
What is the most common cause of death in the Low Energy State?
A
Heart Failure
20
Q
What is assocaited with Campylobacter Jejuni?
A
Raw chicken and eggs, dog poop, bloody diarrhea, comma, “seagull” shaped buginactivated by gastric juice and can precipitate Guillain BarreTreat with Erythromycin
21
Q
What are the adverse effects of 1st generation H1 blockers?
A
Sedation, antimuscarinic, anti-alpha-adrenergic
22
Q
What do Chylomicrons do?
A
They take Triglycerides (TG) from GI to liver and endothelium
23
Q
What diseases have high Monocytes (>15%)?
A
“STELS”Syphilis: chancre, rash, wartsTB: Hemoptysis, night sweatsEBV: Teen sick for a monthListeria: Sick babySalmonella: Food poisoning
24
Q
What is Active Transport?
A
Goes against concentration gradientRequires ATP
25
What are the diastolic rumbling murmurs?
Tricuspid StenosisMitral Stenosis
26
What is Face Presentation?
Mentum Anterior preform forceps delivery
27
What is Zero-order kinetics?
Metabolism independent of concentration (rate of elimination is constant)
28
What is Mumps?
Parotitis (Red Stenson's Duct)
29
What does the Bulbourethral/ Cowper's Glands secrete?
Bicarb to neutralize lactobacilli, if sperm is too acidic. (Infertility until corrected)
30
What is Type and Cross?
Blood that is matched by blood type and cross-reacted with the patient's blood for rejection
31
How do you treat A1 Gestational DM?
Diet
32
What is the rate-limiting enzyme in Glycogenolysis?
Glycogen Phosphorylase. Occurs in the Cytoplasm of Liver and Muscle
33
What bugs cause Loeffler Syndrome?
"NASSA"N - Necator AmericanusA - Ancylostoma DuodenaleS - SchistosomiasisS - StrongyloidesA - Ascaris Lumbricoides
34
What has Fat Casts?
Nephrotic Syndrome
35
What is Paget's disease of the Breast?
Rash and ulcer around the nipple, breast CA
36
What is the only Crescent Shaped Protozoa?
Giardia Lamblia
37
What produces Currant Jelly stool?
Intussusception
38
What is associated with R. Akari?
Mites
39
What are Braxton-Hicks Contractions?
Irregular contractions with closed cervix. (preparing for birth)
40
What is Krabbe's?
Galactocerebrosidase deficiencyperipheral neuropathyoptic atrophygloboid bodiesaccumulation of Galactocerebroside and Psychosine
41
What are the adverse effects of methylxanthines?
Cardiotoxicity, Neurotoxicity
42
How do I know the patienthas a Vitamin K Deficiency?
Bleeding, Loss of gamma-carboxylation
43
What is a Meningomyelocele?
Sacral pocket with meninges and nerves in it
44
What are the Adverse Effects of Osmotic Laxatives?
Diarrhea, dehydration, may be abused by bulimics
45
What is the color of fluid or a solid on X-ray?
White "radiopaque"
46
What is the MOA of a Growth Hormone?
Stimulates liver production of insulin-like growth factors and gastric emptying
47
What is Ferning?
Estrogen crystallizes on slide. (Amniotic fluid)
48
What are the essential fatty acids?
Linolenic, Linoleic
49
What is Hunter's?
Iduronate Sulfatase deficiencymilder formXLRno corneal cloudingaggressive behaviorAccumulation of Heparin and Dermatan Sulfate
50
What does a Western blot detect?
Protein, "snoW, droP"
51
What are the four Painful Genital Lesions?
HerpesChancroid (It makes you cry... H. Ducreyi) Lymphogranuloma VenereumLymphogranuloma Inguinale
52
What are the indications for Bile Acid Resins?
Slightly increase HDL and triglyceridesDecrease LDL
53
What is Dubin-Johnson?
Defective Bilirubin storageBLACK LIVERIncreased conjugated bilirubin
54
Snowman-shape on x-ray?
Total anomalous pulmonary venous return
55
What is the MOA of H2 blockers?
Reversible block of histamine H2 receptors to decrease H+ secretion by parietal cells
56
What are the Alpha-Glucosidase Inhibitors?
Acarbose and Miglitol
57
What is Early Deceleration?
Normal due to head compression
58
What is Hepatorenal Syndrome?
Build up of liver toxins that cause renal failure
59
What organ has the lower AVO2 difference?
Kidney
60
What bug causes multiple liver abscesses?
Entamoeba Histolytica
61
What is Conversion?
Neurological manifestations of internal conflict, indifferent to disability, blindness/mutism triggered by a stressor. Patient is unconcerned about his impairmentTx: Psychotherapy
62
What is a Xanthelasma?
Triglyceride build up and is seen under the eyes (Xanthoma subtype)
63
What are the indications for Prazosin?
Pheochromocytoma, HTN
64
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)
65
What are the indications for antileukotriene?
Asthma, aspirin induced asthma
66
What is Regression?
Immature behavior, go back in development
67
What are the sounds made from diastolic murmurs?
Blowing and rumbling
68
what is the Central Nervous System?
Brain and spinal cord, Myelination by the oligodendrocytes
69
What is Laryngomalacia?
Epiglottis rolls in from side to side
70
Where does a Type A thoracic aortic dissection occur?
Ascending Aorta, (occurs in Cystic medial necrosis and Syphilis)
71
What diagnosis has primary hyperparathyroidism?
Parathyroid Adenoma
72
What does a mid-systolic click tell you?
MVP- Mitral valve prolapse
73
What is a Schwannoma?
CN-8 tumor, unilateral deafness
74
What does auscultation of stridor tell you?
Extrathoracic narrowing (seen on inspiration on X-Ray)
75
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)
76
What are the indications for Sulfonylureas?
NIDDM (Type 2)
77
When is Beta HCG found in Urine?
2 weeks after fertilization
78
What does auscultation of crackles tell you?
Blowing collapsed alveoli open (restrictive lung disease)
79
What is a Xenograft?
1 species to another species (pig heart into humans)
80
What makes Esophageal Spasms Unique?
Increased Peristalsis
81
What is the rate-limiting enzyme in Gluconeogenesis?
Fructose - 1,6 Bisphophatase
82
What is the most common cause of first trimester maternal death?
Ectopic pregnancy
83
What does Vit K do?
ClottingSynthesized by intestinal flora
84
What serum pH does emesis have?
Alkalotic because you vomit out HCl-
85
What is the MOA of coricosteroids?
Inhibits leukotriene synthesis -> reduces inflammation and leads to bronchodilation
86
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
87
What is associated with R. Tsutsugamushi?
Chiggers (Mites) = Scrub Typhus
88
What is the MOA of Hexamethonium?
Nicotinic Ganglionic blocker
89
What is the rate-limiting enzyme in TCA Cycle?
Isocitrate dehydrogenase
90
What are the Gram Negative Capsules?
"Some Killers Have Pretty Nice Capsules"S - SalmonellaK - KlebsiellaH - H. Influenza B (HiB)P - PseudomonasN - NeisseriaC - Citrobacter
91
What causes Cryoglobulinemia?
"I AM He"I - InfluenzaA - AdenovirusM - MycoplasmaH - Hepatitis B and C
92
What is the indication for muscarinic antagonist?
Asthma, COPD
93
What are the Adverse Effects of Octreotide?
Nausea, cramps, steatorrhea
94
What serum pH does diarrhea have?
Acidosis because stool has bicarb
95
What are the indications for adenosine?
Dx. and tx. of AV nodal arrhythmias
96
What is Word Salad?
Unrelated combinations of words
97
What are the Vasodilators?
Hydralazine, Minoxidil, Nifedipine, Verapamil, Nitroprusside, Diazoxide
98
What is Frotteurism?
Rubs penis against fully clothed women
99
What is the rate-limiting enzyme in Urea cycle?
Carbamoyl Phosphate Synthetase-1 (CPS-1)
100
What are the Adverse Effects of PTU and Methimazole?
Agranulocytosis, skin rash and Aplastic Anemia
101
What is Molluscum Contagiosum
Flesh colored papules with a central dimple
102
What is the indication for Albuterol?
Acute exacerbation
103
What does Gastrin do?
Stimulates parietal cells to release intrinsic factor (IF) and H+
104
What is Turner's Syndrome (XO)?
High FSH, LOW E2, Ovarian Dysgenesis, Webbed Neck, Coarctation of the Aorta, Cystic Hydroma, bicuspid Aortic valve
105
What murmur has Pulsus Tardus?
Aortic stenosis
106
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
107
What is the Acrosomal reaction?
Sperm release enzymes to eat the Corona Radiata
108
Function of what cells is necessary for the action of Sulfonylureas?
Requires some islet cell function so drugs used less in Type 1 DM
109
What is Conjugated Bilirubin?
Water soluble and direct Bilirubin
110
What is the MOA of the Ca2+ blockers?
Decreases conduction velocity of the AV node, increases ERP and PR interval
111
What is associated with Legionella Pneumoniae?
Found in AC ducts, silver stains lung, CYEAPontiac Fever, Legionnaire'sPneumonia
112
What are the Megaloblastic Anemias?
Vitamin B-12 Deficiencyfolate deficiencyalcohol
113
What is Double Depression?
Depression followed by dysthymia
114
What is familial Hypocalciuria Hypercalcemia?
Patients with decreased calcium excretion
115
What are some causes of Cold Autoimmune?
MonoMycoplasma infectionAntibody (IgM) bind to RBC's membranecold temp and causes agglutination
116
What has Muddy Brown Casts?
Acute Tubular Necrosis (ATN)
117
What are the indications for Bosentan?
Pulmonary HTN
118
What is Circumstantiality?
Digresses but finally gets back to the point
119
What are the adverse effects of B-blockers?
Impotence, asthma, bradycardia, AV block, heart failure, sedation, sleep alterations
120
What are the Steroid Hormones?
Progesterone, Estradiol (E2), Testosterone, Cortisol, and Aldosterone
121
What is associated with Bacteroides Fragilis?
Post Op bowel abscess, grows in blood clots
122
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
123
When performing a high dose dex. Test, if positive...
Patient has a pituitary tumor
124
What does the Prostate Secrete?
The prostate HAZ it.H- HyaluronidaseA- Acid PhosphataseZ- Zinc
125
What are the Gram-negative exotoxins?
H. InfluenzaBordatella Pertussis
126
What is Meniere's Disease?
Same presentation as Labyrinthitis but is a chronic condition with remitting and relapsing episodes
127
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
128
What are the Glitazones/Thiazolidinedione's drugs?
Pioglitazone and rosiglitazone
129
What is Concrete Thinking?
Can't interpret abstract proverbs, only sees the facts
130
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
131
What is the MOA of Methyldopa?
Alpha 2 agonist = decreases peripheral resistance
132
What drugs cause Pulmonary Eosinophilia?
Nitrofurantoin and Sulfonamides
133
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
134
What is the MOA of Guanethidine?
Interferes with norepinephrine release
135
What is pseudo-pseudo-hypoparathyroidsm?
G-Protein defect, and there is no calcium problem
136
What is Malingering?
Fake illness for monetary gain or getting out of jail, avoids medical treatmentTx: Supportive Psychotherapy
137
What does alpha one anti-trypsin do?
Inhibits Elastase
138
What GI disease has a String Sign on X-Ray?
Pyrloric Stenosis and Crohn's Disease
139
What is DiGeorge Syndrome?
No Thymus, inferior Parathyroid and low calcium
140
What is a Meningocele?
Sacral pocket with meninges in it
141
What does auscultation of rhonchi tell you?
Mucus in the airway (obstructive airway disease)
142
What is the indication for Osmotic Laxatives?
Constipation
143
What is Suppression?
Consciously block memory
144
What is Placenta Previa?
The placenta is implanted wholly or partially in lower uterine segment
145
Which of your cells express MHC-1?
All nucleated cells except the immune-privileged cells/tissues, RBC's and Platelets
146
What are the Indications for Desmopressin (DDAVP)/ADH?
Antidiuresis and Central (pituitary) DI
147
What are the atypical (no cell wall) Bacteria?
"CLUMsy"C - ChlamydiaL - LegionellaU - UreaplasmaM - Mycoplasma
148
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...
149
What is seen in Warm Autoimmune?
Anti-Rh Ab Dapsone, PTU, antimalarials, and sulfa drugsAntibody (IgG) binds to RBC's membrane in warm temp
150
What is a nonsense mutation?
Early stop codon
151
What bug loves the posterior fossa?
TB
152
Banana-shape on x-ray?
IHSS
153
What is a Hyperacute Rejection?
Autoimmune response within 12 hours, preformed antibodies respondedThis is a Type 2 hypersensitivity reaction
154
What is Sadism?
Gives physical and psychological pain
155
What is persistent eye drainage since birth usually due to?
Blocked Duct
156
What is a Tamponade?
Decreased breathe sounds and blood pressure, distant muffled heart soundsicnreased JVD
157
What is Whipple's Disease?
Tropheryma Whipplei (T. Whipplei) destroy the GI tractCausing Malabsorption/Arthralgia, PAS (+)
158
What is Pneumonia?
Consolidation of airway
159
What are the HMG-CoA reductase inhibitors?
Lovastatin, Pravastatin, Simvastatin, Atorvastatin, Rosuvastatin
160
What is associated with S. Pneumoniae?
Otitis Media, red bulging TM
161
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
162
What do white diaper crystals suggest?
Excess Orotic acid
163
Where is a Morgagni Hernia?
Anterior/middle of diaphragm, bowel sounds in thorax, seen on US in uterosurgery to fix immediately after birth
164
How do you measure efferent renal function?
BUN or PAH
165
What is Pityriasis Rosea?
Herald Patch that migrates along skin lines in a Christmas Tree appearance
166
What are the indications for B-blockers
HTN, Angina, MI, Antiarrhythmic
167
What is Multiple Endocrine Neoplasia III (2B)?
Pheochromocytoma, Medullary Carcinoma of the Thyroid, Mucosal Neuromas/ Marfanoid body habitus. (tumor marker RET)
168
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
169
What does a Northern blot detect?
RNA, "sNow, dRop"
170
What is associated with EIEC?
Inflammatory = loose stool
171
What is Cullen's SIgn?
Bruising around the umbilicusCaused by hemorrhagic pancreatitis (late sign)
172
What Hepatitis B labs indicate an acute recent infection?
HBcAg+, HBsAg+, (HBcAb+/-)
173
What is Bernard-Soulier?
Baby with bleeding from skin and mucosa(Big platelets and LOW GP-1b)
174
What does cortisol do?
Gluconeogenesis by proteolysis and thins the skin, prevents and immune response, and decrease bone mass
175
What are the most common infections of the Low Energy State?
UTI and respiratory infections
176
What are the Comma (curved) shaped bugs?
Vibrio, Campylobacter, Listeria, H. Pylori
177
What is Dysmenorrhea?
PG-F causes painful menstrual cramps. (Teenagers miss school / work)
178
What is Asperger's?
Good communication skills, impaired relationships, no mental retardation
179
What is the most common cause of first trimester spontaneous abortions?
Chromosomal abnormalities
180
What is Familial Polyposis?
100% ridk of Colon Cancer, APC gene defect and annual Colonoscopy start at 5 years of age
181
What is Parkinson's disease?
Located in the Substantia Nigra, bradykinesia, pill rolling tremor, shuffling gait, Lewy Bodies
182
What is associated with Bordetella Pertussis?
Whooping cough, ADP ribosylates Gi
183
When can you tell the sex of the baby by US?
Week 16
184
What is Type 1 Diabetes Mellitus?
Anti-islet cell antibody /GAD (Glutamic Acid Decarboxylase) antibody.
185
What hormones produce Acidophilus?
"GAP": GH, Acidophilus, and Prolactin
186
What are the most common causes of third trimester spontaneous abortions?
Anti-Cardiolipin Ab, placenta probelms, infection, incompetent cervix
187
What is the most common cause of a White Reflex?
Retinoblastoma
188
What is Truncus arteriosus?
Spiral membrane did not develop, there is one Aortic Pulmonary trunk, mixed blood, needs PDA
189
What is an Epstein's Pearl?
White pearls on hard palate
190
What is seen in RPGN?
Crescents
191
What does a Synthase do?
Consumes two substrates
192
What is asthma?
Chronic inflammatory disease of the airwayscharacterized by variable and recurring symptoms, wheezing on expiration, elevated IgE and Eosinophils
193
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
194
What are Mongolian spots?
Melanocytes on lower back
195
What is a Factor V - Leiden?
Protein C cannot break down Factor V
196
What disease has exophthalmos?
Grave's disease
197
When can you first detect fetal heart tones?
Week 20
198
What is Multiple Personality Disorder?
They have 5-10 alters, usually associated with incest
199
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)
200
What is the most common Nephrotic disease complication with cancer?
Amyloidosis
201
What are CD4 cells?
T-helper cell - Responds to MHC-2 (foreign attack)
202
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
203
What symptoms does a "more likely to depolarize" state have?
Brain: Psychosis, seizures, jitterinessSkeletal Muscle: muscle spasms, tetanySmooth Muscle: diarrhea, then constipationCardiac: tachycardia, arrhythmia
204
Whata re the anabolic pathways that store energy? (occur in the cytoplasm)
Fatty acid synthesis, Glycolysis, HMP shunt, translation
205
Whata re the indications for Guanethidine?
Severe HTN
206
Which cytokines do T-helper cells stimulate?
All IL's except IL-1
207
What is seen in newborn with HSV-2 in utero infections?
Temporal Lobe encephalitis, must offer C-section to mom with active lesions
208
What is the Primary Diabetes Insipidus (DI)?
Too much water (urinates a lot)
209
What is Merocrine?
Cell is maintained. (exocytosis)
210
What is the most common cause of primary hypoparathyroidism?
Thyroidectomy
211
What are the Silver Stainer's?
"HaLV-C"H - H. PyloriL - ListeriaV - VicrioC - Campylobacter
212
What has WBC Casts and RBC Casts?
Glomerulonephritis
213
What are the 3 kinds of generalized seizures?
Tonic-clonic "Grand Mal"Absence "Petit Mal"Status Epilepticus
214
What are the side effects of Progesterone?
Acne, depression, HTN, increase appetite, acne causes dilution anemia, quiescent uterus, PICA, hypotension, melisma (AKA Chloasma)
215
What is Ficticious Disorder by Proxy?
Mom makes the child or another person ill for emotional support, noted to move frequently
216
What is associated with ETEC?
Traveler's Diarrhea = rice water diarrhea
217
What are the Adverse Effects of Levothyroxine (T4)/Triiodothyronine (T3)?
Tachycardia, heat intolerance, tremors and Arrhythmias
218
What is the Somatic Nervous System?
Moving your muscles
219
What state does Estrogen mimic?
The Neuromuscular disease stateEstrogen is a muscle relaxant
220
What is the most common Nephrotic disease in diabetics?
Nodular Sclerosis
221
What is Placenta Accreta?
Placenta is attached to the endometrium
222
What is Polymenorrhea?
Too many periods
223
What do you see in CMV in utero infections?
Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications
224
What diseases have Hemoptysis?
Bronchiectasis, Bronchitis, Pneumonia, TB, Lung CA, Goodpasture's, Wegener's
225
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
226
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
227
What is Lochia?
Endometrial slough. (normal discharge and uterus after birth)
228
What does fixed wide S-2 splitting tell you?
ASD
229
What is Cryptorchidism?
Testes never descended out of abdomen, sterility after 15 months, predisposed to seminomas and CA
230
What is the MOA of Class IC antiarrhythmic?
Na+ channel blocker
231
What is the function of ACTH (Adrenocorticotropic hormone)?
Stimulates Cortisol and Androgen releases from the adrenal gland
232
What is the indication for Salmeterol?
Long acting agent for prophylaxis
233
What is the rate-limiting enzyme in Beta Oxidation?
Carnitine Acyltransferase -1 (CAT-1)
234
What do the IgA protease bugs cause?
Sinusitis, Otitis Media, Pneumonia/Bronchitis
235
What are the causes of Hyperbilirubinemia?
Sepsis, ABO Incompatibility, Hypothyroidism and Breast-feeding
236
What does a Hydroxylase do?
Adds-OH group onto substrate
237
What is Mittelschmerz
Pain with ovulation
238
What is the MOA of Ezetimibe?
Prevents cholesterol reabsorption at small intestine brush border
239
What is Barrett's Esophagus?
Metaplasia of the lower esophagus increased risk of Adenocarcinoma
240
How do you diagnose Rheumatic Fever?
JONES CriteriaJ - Joint InvolvementO - MyocarditisN- Nodules, subcutaneousE - Erythema MarginatumS- Sydenham Chorea
241
What is a missense mutation?
Mistaken amino acid substitution (i.e. SS disease Valine for Glutamic Acid)
242
What are the adverse effects of HMG-CoA reductase inhibitors?
Hepatotoxicity (increase LFT's)Rhabdo
243
What is Masochism?
Receives pain (Humiliation)
244
What other diseases can have exophthalmos?
Horner's and Marfan's
245
What vessels have the highest capacitance?
Veins and Venules
246
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
247
What is seen in iron deficiency?
Anemia
248
What is Celiac Sprue?
Found in the JejunumWheat AllergyVillous atrophAnti-gluter-gliadin antibodies
249
What is uremia?
Azotemia (renal failure) with symptoms
250
What is Urge incontinence?
Urgency leads to complete voiding detrusor spasticity leads to small bladder volume
251
What does epinephrine (Epi) do?
Drives gluconeogenesis and glycogenolysis
252
What bug is associated with cat saliva?
Pasteurella Multocida
253
What is a Corticotrope?
ACTH
254
What is Ductal Carcinoma?
Worst prognosis Breast CA
255
What is associated with C. Tetani?
Rusty nail wounds - inhibits GLY release, respiratory failure, Risus Sardonicus, tennis racquet shaped appearance
256
What is Meig's Syndrome?
Pleural effusion, ovarian fibroma, ascites
257
What blood level should be monitored in patients taking statins?
Liver enzymes every 3 months and Serum Cr
258
What is the most common cause of Polyhydramnios?
Neuromuscular problem: Werdnig HoffmanGI problem: Duodenal atresia
259
What is Hairy Cell Leukemia?
Cells have a fried egg/ Sunburst appearance and TRAP +
260
What does motilin do?
Stimulates segmentation, primary peristalsis, and migrating motor complexes (MMC)
261
What is Pneumothorax?
Absent breath sounds on one side
262
What is Identification?
To be like or to become like another (aspect, property or attribute of another)
263
What is the most common cause of post-coital Vaginal Bleeding in Pregnant women?
Placenta previa
264
What are the adverse effects of Hydralazine?
Compensatory tachycardia, fluid retention, Lupus like syndrome, contraindicated in Angina/CAD because of compensatory tachy
265
What does an AFI >20 indicate?
Polyhydramnios (DM)
266
What is Somatization?
Psychological trigger gets them sick, but no medical finding (Pain in 4 parts, 2 GI problems)Tx: Psychotherapy
267
What is the second generation Sulfonylureas?
Glyburide, Glimepiride, and Glipizide
268
What can you measure to test afferent arteriole's function?
Glomerular filtration rate (GFR) or Inulin
269
What does a wide S-2 split tell you?
Increases OxygenIncreased right ventricular volumeDelayed pulmonic vlave opening
270
What are the indications for administering Potassium?
Digoxin toxicity, activated charcoal: binds digoxin in the intestineDigibind: binds to digoxin in the bloodstream
271
What is Tracheitis?
"Acute URI"Patients look toxicGrey PseudomembraneLeukocytosis
272
What is the common side effect of the ERCP procedure?
Pacreatitis from blocking the pancreatic duct during the procedure
273
What amino acid turns yellow on Ninhydrin reaction?
Pro
274
What is the job of the late Distal Tubule and Collecting Duct?
Final concentration of urine by reabsorbing water and excretion of acid
275
What separates unconjugated bilirubin from albumin?
Sulfur (no Sulfur Rx in pregnancy)
276
What is Caput Succedaneum?
Bleeding under scalp (edema will cross suture lines)
277
What are the indications for Levothyroxine (T4)/Triiodothyronine (T3)?
Hypothyroidism and Myxedema
278
What is an Autograft?
Twin to twin (spare parts)
279
What are the H2 blockers?
Cimetidine, Ranitidine, Famotidine, and Nizatidine
280
How does a Subdural Hematoma present?
Headache 4 weeks after trauma, elderly (loose brain)
281
What GI disease has a RUQ Olive Mass?
Pyloric Stenosis
282
How would you know the patient has a Vitamin A (retinoic Acid) Deficiency?
Poor night vision, Hypoparathyroidism, dry skin
283
What is Histiocytosis X?
Histiocyte proliferation Kid with Eczema, skill lesionsHand-Schuller-Christian disease
284
What is Body Dysmorphic Disorder?
Imagined physical defect, causing impaired function in a social or occupational activityTx: SSRI
285
What happens when there is a biotin Deficiency?
Loss of carboxylase function
286
What is the MOA of Methylxanthines?
Inhibit Phosphodiesterase -> decreases cAMP hydrolysis promoting bronchodilation
287
How does a Somatostatinoma present?
Constipation
288
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
289
What does Calcitonin do?
Inhibits Osteoclasts and binds to calcium
290
What is Countertransference?
Doctor views patient as child
291
What does Sudan Black Stain test for?
Steatorrhea (fat malabsorption), patient seen with chronic pale, greasy, malodorous diarrhea and no evidence of infection
292
What tests are used for following Pancreatitis?
Amylase (sensitive) breaks down Carbohydrates and Lipase (specific) breaks down Triglycerides
293
What is Postpartum Psychosis
Hallucinations, suicidal/infaticidal thoughts
294
What color is stool with an Upper GI Bleed?
Black (Dark Red) (Melena)
295
What are the most common signs of the Low Energy State?
Tachypnea and Dyspnea
296
What is the Adverse Effect of Glitazones/Thiazolidinedione's?
Weight gain, edema, hepatotoxicity, increases LDL and triglycerides, CHF and Contraindicated
297
What is the MOA of Octreotide?
Long-acting somatostatin analog
298
What is Plummer's Syndrome?
Hyperthyroid adenoma
299
What is aspergillosis?
Mold, compost piles, associated with peanuts
300
How does Diverticulitis present?
Pain in LLQ, no visible blood and may cause peritonitis
301
What has WBC Casts?
Nephritis
302
What are the cholesterol Absorption blockers?
Ezetimibe
303
What murmurs occur during systole?
Holosystolic or pansystolic
304
What is Acting out?
expression of impulse, "Temper Tantrums"
305
What is the Intermediate Acting Insulin drug?
NPH and Lente
306
What is Schatzki's Ring?
Esophageal webs in the lower EsophagusDysphagia (mucosal tissue)
307
What is McArdle's?
Myophosphorylase deficiency(skeletal muscle Glycogen Phosphorylase)muscle cramps w/ exercise, increased Glycogen in muscle only, blood glucose NLSecond wind phenomenon
308
What is inevitable Abortion?
Cervix is open, baby is intact
309
What is pseudo-hypoparathyroidism?
Bad kidney, PTH receptor, decreased urinary, cAMP
310
What is hemochromatosis?
Iron deposits in organsleads to hyperpigmentation, bronze diabetes, and arthritis
311
What do B cell deficiency patients die of?
Bacterial infection?
312
What are the adverse effects of Guanethidine?
Contraindicated in patients taking TCA's
313
What affects Potency?
Km (EC50)
314
What does blood type A tell you?
They have the A antigen and B antibodies
315
What does Vit B4 do?
Glycolysis, no known diseases
316
What is Illusion?
Misinterprets stimulus
317
What is Repression?
Subconsciously block memory
318
What is Thought Withdrawal?
Believes that others are taking thoughts out of his head
319
What does S-2 splitting tell you?
Normal on inspirationPulmonic valve closing later
320
What is open-angle glaucoma?
Overproduction of fluid, painless Ipsilateral dilated pupil, gradual tunnel vision, optic disc cupping
321
What is Pseudomembranous Colitis?
Overgrowth of C. DiffDue to normal flora being killed off from long term antibiotic use
322
What are the indications for H2 blockers?
Peptic ulcer, gastritis and esophageal reflux
323
What is a Necrophile?
Someone who has sex with corpses
324
What is associated with R. Rickettsii?
Ticks = Rocky Mountain spotted fever
325
What is associated with Shigella?
Day care outbreaks, seizures, destroys the 60S ribosome, infects M-cells
326
What is Post-Renal Failure?
Obstruction (hydronephrosis)
327
What is a Bezoar?
Mass of non-digestible product (i.e. Hair) causing an occlusion at the pylorus
328
What is a Hemangioblastoma?
In the cerebellum, associated with VHL
329
What will you see with Iron Deficiency Anemia?
Increased TIBC associated with menses, GI bleeding, and Koilonychia
330
How do I know the patient has a Vitamin B5 (Pantothenic Acid) Deficiency?
No deficiency state
331
What is a fetish?
High attraction for inanimate objects
332
What is a possible cause if pulse rises more than 10 bpm in repositioning from lying to sitting?
Hypervolemia
333
What does the Hep B Core Ag tell you?
Gone before patient has symptoms (present from 0-2 months)
334
What is Mallory-Weiss?
Tearing of the lower esophageal sphincter (LES), associated with chronic vomiting, cough up a little blood and possible visible varices
335
What is Cushing's disease?
High ACTH due to pituitary tumor or Small cell carcinoma of the lungs
336
What is a Craniopharyngioma?
Motor oil biopsy, tooth enamel, Rathke's Pouch, ADH problem, Bitemporal Hemianopsia
337
What Does Vit E do?
Antioxidantacts as an tagonist to Vit K in high levels
338
What are the Foot Ulcer Risk Factors?
Poor glycemic control (HbA1C >7), smoking, bony abnormalities, previous ulcers
339
What GI disease has a Thumb Print on X-Ray?
Toxic Megacolon
340
What is Silicosis?
Sandblasters and glassblowers
341
What is Tropical Sprue?
Found in the distal iliumCaused by bacterial or viral, amoeba or parasitic infectionVillous atrophy
342
What are the adverse effects of corticosteroids?
Osteoporosis, Cushingoid reaction, psychosis, glucose intolerance, infection, HTN, cataracts
343
What is Holocrine?
The whole cell is secreted. (except sebaceous gland)
344
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
345
When is B-HCG found in Blood?
8-10 days after fertilization
346
What does Chymotrypsin cut?
Phe, Tyr, Trp
347
What is Backward Typing?
Used Antigens to detect Antibodies
348
What are the ketogenic amino acids?
Lys, Leu
349
What are the Adverse Effects of GLP-1 Analogs?
Nausea, Vomiting and Pancreatitis
350
What makes Scleroderma Unique?
Can have a decreased LES pressure or and increased LES pressure
351
What is epiglottitis?
inflammation of the epiglottisthumb sign on x-rayexcessive drooling
352
Waht is associated with Brucella?
Seen in farmers/ Vets, Animal placentas are the vector, Spiking fever 5 times a day
353
What GI disease has Barium Clumping on X-Ray?
Celiac Sprue
354
What are the Short Acting Insulin drugs?
Aspart and Lispro
355
What is seen in Measles (Rubeola)?
CCCK: Cough, Coryza (runny nose), Conjunctivitis, Koplik SpotMorbilliform blotchy rash
356
What is an Insulinoma?
Insulin secreting tumor, labs show increased insulin and C-peptide
357
What ion has the greatest movement at rest?
Potassium
358
What is seen with Fluoride deficiency?
Poor teeth and bone growth
359
What hepatitis B labs indicate immunization >2/52 weeks?
HBsAb+
360
What valves make noise at the end of systole?
Aortic and Pulmonic
361
What is Riedel's Struma?
"Woody" connective tissue in neck, death due to suffocation and must rule out CA
362
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
363
What does a Thio do?
Breaks S bonds
364
What is Hungry Bone Syndrome?
Removal of PTH and the bone sucks in calcium
365
What do high GABA levels lead to?
Bradycardia, lethargy, constipation, impotence, memory loss
366
What is Shoulder Dystocia?
Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)
367
What structures have Fake sphincters?
Ureters, LES, Ileocecal valve
368
What does Endocrine mean?
Secreted into bood
369
What are the indications for Misoprostol?
Prevents NSAID-induced peptic ulcers, maintenance of a Patent Ductus ArteriosusInduce labor
370
What is the Indication for PTU and Methimazole?
Hyperthyroidism
371
What are the expectorants?
Guaifenesin, N-acetylcysteine
372
What does an epimerase do?
Creates an epimer, which differs around one chiral carbon
373
What is the MOA of Guaifenesin?
Removes excess sputum but does not suppress cough reflex
374
What are the indications for Pseudoephedrine, Phenylephrine?
Reduces Hyperemesis, edema, nasal congestion, and opens obstructed Eustachian tubes
375
What has Crescents?
RPGN
376
What are wide sutures due to?
Hypothyroidism and Down's Syndrome
377
What is a Transvestite?
Dress up as opposite sex, no identity crisis
378
What does SAM donated methyl groups for?
All other reactions
379
When do valves make noise under normal physiology?
When the valves close
380
What is systole?
Ejection of blood from the heart, Decreased blood flow to Coronary arteries, more extraction of Oxygen Phase 1 Korotkoff
381
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
382
What is associated with Bacillus Anthracis?
Black Eschar, Wool Sorter's Lung diseaseD-Glu, boxcar-like spore, treat with Cipro
383
What type of immunity does TH1 provide?
Enhances cell mediated immunity
384
What are the adverse effects of Prazosin?
Orthostatic Hypotension
385
What is the most common cause of post-coital Vaginal Bleeding?
Cervical CA
386
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
387
What is the function of Inhibin?
Inhibits FSH so there is no menstruation
388
What is a Transsexual?
Gender Identity crisis
389
What are the Survival Hormones?
Cortisol: permissive under stress. TSH: permissive under normal
390
What is the cause of Symmetrically small babies?
In Early onset: Chromosomal Abnormalities or TORCHES
391
What will you see in Lead Poisoning?
Decreased dALA dehydrogenasedecreased Ferrochelataseblue lines on x-rayhistory of eating old paint chips
