Complete Deck Part 4 Flashcards
1
Q
What does Indirect Coombs Test tell you?
A
The Antibody is freely circulating in the serum
2
Q
What are the ACE inhibitors?
A
Captopril, Enalapril, Fosinopril, Lisinopril
3
Q
What does the Carnitine shuttle do?
A
FA transport into the mitochondria
4
Q
What are the Adverse Effects of Glucocorticoids?
A
Iatrogenic Cushing’s syndrome. (Adrenal insufficiency when drug stopped after chronic use)
5
Q
What is the function of HPL?
A
Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)
6
Q
What is Thought Insertion?
A
Believes that others are putting thoughts into his head
7
Q
What is Benign Positional Vertigo?
A
Sensation of room spinningNausea/VomitingNystagmus without hearing loss or tinnitusOnset of symptoms when change position
8
Q
What is Inflammatory Diarrhea?
A
Diarrhea with blood and pus
9
Q
What does a mutase do?
A
Relocates a functional group within a moleculre (intrachain)
10
Q
What is Gaucher’s?
A
Glucocerebrosidase (Beta-Glucosidase) deficiencywrinkled tissue Macrophage’sBone painpancytopenia
11
Q
What are the Indications for Octreotide?
A
Acromegaly; Glucagonoma; Insulinoma; Carcinoid Syndrome
12
Q
What causes non-bacterial Fetal infections?
A
“TORCHST- ToxoplasmaO - Others (HIV, Measles, B-19)R - RubellaC - CMVH - HSV-2S - Syphilis
13
Q
What are the adverse effects of the Class IB antiarrhythmic?
A
CNS stimulation and depressionCardiovascular depressionHyperkalemia increases toxicity
14
Q
What is Sublimation?
A
Where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior
15
Q
What is Phimosis?
A
Foreskin scarred at penis head
16
Q
How do I know the patient has a Vitamin C (Ascorbic Acid) Deficiency?
A
Scurvy
17
Q
What defines CLL?
A
50+ y/o males with lymphadenopathysoccer ball nucleiPresent with autoimmune Hemolytic anemia
18
Q
What does Vit B12 do?
A
Cofactor for HMT & MMA
19
Q
What GI disease has an Apple Core on X-Ray?
A
Colorectal Cancer
20
Q
What are Burr Cell/ Echinocyte?
A
Seen in Pyruvate Kinase deficiencyLiver diseasePost splenectomy
21
Q
What does a Synthetase do?
A
Consumes two substrates, uses ATP
22
Q
What is a silent mutation?
A
Changes leave the same amino acid
23
Q
What does blood type AB tell you?
A
Have both Antigens (universal recipient)
24
Q
What are the adverse effects of Diazoxide?
A
Hypoglycemia (reduces insulin release) and hypotension
25
What is Delusion?
Fixed false belief for more than one month and no effect to his normal livingTx: Atypical antipsychotic and psychotherapy
26
How do you know it's an anaerobic infection?
gas and bad odor
27
What is SHeehan Syndrome?
Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk
28
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
29
What is Cystic Fibrosis?
Defective chloride transportermeconium ileussteatorrheaBronchiectasisChromosome 7
30
What is the MOA of adenosine?
Increase K+ efflux, hyperpolarizes the cell
31
What does Vit C do?
Collagen synthesisantioxidanthelps absorb FE++, necessary for Dopamine & hydroxylase for NE
32
What is assocaited with H. Pylori?
95% causative agent in Duodenal Ulcers
33
What organs have the most CD4 receptors?
Blood vesselsbraintesticlescervixrectum
34
What is the RBC normal lifespan?
120 days
35
What is a Somatotrope?
Growth hormone
36
What is Separation Anxiety Disorder?
Kid screams when mom leaves
37
What are the adverse effects of H2 blockers?
Prolactin release: Gynecomastia, decreased libido, impotence in malesCimetidine inhibits P450
38
What are Fibroids (Leiomyoma's)?
Benign uterus smooth muscle tumorsubmucosal type: they bleedSubserosal type: they cause pain
39
What is Metabolic Syndrome X?
"Pre-DM" due to HTN, Dyslipidemia, Hyperinsulinemia, and Acanthosis Nigricans
40
Which cells express MHC-2?
Antigen presenting cells (macrophages, dendritic cells, and neutrophils)
41
What is Non-competitive Inhibition?
Binds a regulatory site, no change in Km, Efficacy decreases, decreased Vmax
42
What is Fifth's disease?
Erythema Infectiosum "Slapped Cheeks"B-19 ParvovirusAplastic anemia, in sickle cell patientsHydrops Fetalis
43
What are the adverse effects of Nesiritide?
Hypotension
44
What are the adverse effects of Class IC antiarrhythmic?
Prolongs refractory period in AV node Hyperkalelmia increases toxicity
45
What is a Basophil?
The allergy helper (IgE receptor - histamine release)
46
What is SCID?
No Thymus (no T-cells)frayed long bones (no B-cells)baby dies by 18 months
47
What does the Macula Densa do?
Measures osmolality (osmoles of solute-kg)
48
What type of people does Hep E like to infect?
Pregnant women (3rd trimester), Asians
49
What is Lobular Carcinoma?
Cells line up single file, contralateral breast is primary site of CA
50
Which stage of the Menstrual Cycle has the highest Estrogen levels?
Follicular stage (Has proliferative endothelium)
51
What is seen in Sickle Cell Anemia?
Crew-cut on x-rayAvascular Necrosis of femur
52
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
53
What do T cell deficiency patients die of?
Viral infections, fungal, etcexcept bacterial
54
What can high Cholesterol Cause?
Atherosclerosis
55
How do tension headaches present?
"Band-like" pain starts in posterior neck, increases throughout the day, sleep disturbance
56
What are the Big Mama Anaerobes?
Bacteroides fragilisStreptococcus BovisC. MelanagosepticusC. Diff
57
What is Vascular "multi-infarct" dementia?
Sudden onset, uneven progression of deficits, "stair step" decline
58
What is Cephalohematoma?
Bleeding under bone (blood does not cross suture lines)
59
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
60
What is a Paranoid Personality Disorder?
Suspicious about everything, they use projection
61
What is Selective Mutism?
Kid talks sometimes
62
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
63
What is Menorrhagia?
Heavy menstrual bleeding
64
What causes Syphilis?
Treponema Pallidum (Spirochete)
65
What is the only Gram-positive Endotoxin?
Listeria
66
What are the Adverse Effects of Misoprostol?
Diarrhea; Contraindicated in women of childbearing potential abortion inducing drug
67
What is EC50?
Concentration of drug that produces 50% of maximal response
68
What is Oppositional Defiant Disorder?
Breaking the rules, defiant, noncompliant, resists authority, "bark is worse than bite". Teach appropriate child management skills
69
What is Virilization?
Female that is Man like
70
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
71
What organ has the highest AVO2 difference during a test?
Brain
72
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
73
What is an Ependymoma?
Rosettes present in the 4th Ventricle, Hydrocephalus
74
What is Zellweger's?
Neonatal Seizures
75
What does Atrial Natriuretic Peptide do?
Inhibits aldosterone and dilates the afferent arteriole
76
What is the most common type of Gallstone?
Cholesterol stone (not see on X-ray)
77
What is associated with N. Gonorrhea?
Pili, Urethritis, Tenosynovitis, Septic arthritis
78
What is a Xanthoma
Cholesterol build up (common at the elbow or Achilles tendon)
79
What is Berylliosis?
Radio, TV repair, aerospace manufacturing, Beryllium mining, or manufacturing of fluorescent light bulbs
80
What are the indications for Guaifenesin?
Minor upper respiratory tract infections, common cold w/ cough
81
What diagnosis has secondary hyperparathyroidism?
Renal failure
82
How does Chancroid present?
Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)"School of Fish" pattern
83
What is Placenta Abruptio?
Severe pain due to premature separation of the placenta
84
What produces Currant Jelly Sputum
Klebsiella
85
What are the IgA protease bugs?
S. PneumoniaeH. InfluenzaM. Catarrhalis
86
What are the GLP-1 Analog drugs?
Exenatide and Liraglutide
87
What bug is associated with cat pee?
Toxoplasmosis
88
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
89
What is FSGS?
Most common in IVDA, AA, Hispanics and HIV patients
90
What is the only statin to undergo renal excretion?
Pravastatin
91
What does hyperresonance tell you?
Air in that region of the lungs`
92
What has WBC Casts ONLY?
Pyelonephritis
93
What is the MOA of Metoprolol, Atenolol, Acebutolol, Esmolol?
Selective B1-Blockers
94
What is the MOA of PTU and Methimazole?
Inhibits peroxidase enzyme in Thyroid and Decreases synthesis of Thyroid Hormones
95
What is associated with Corynebacterium Diphtheriae?
Chinese letters under microscope, gray Pseudomembrane, heart block, suffocation = death, ADP Ribosylates EF2, Elek's Test
96
What is Epididymitis?
Unilateral scrotal pain decreased by support
97
What is the Adverse effect of Biguanides?
Lactic Acidosis (Contraindicated in renal failure) Stop use in patients undergoing studies using contrast
98
What is the Autonomic Nervous System?
Automatic stuff... i.e. breathing, heartbeat
99
What causes Neonatal Blindness
Chlamydia
100
What is Eclampsia?
HTN with seizures
101
What is Condylomata Lata?
Flat fleshy warts, ulcerate = secondary syphilis
102
How much weight should a woman gain during Pregnancy?
1 lb/ week
103
What is Obsessive-Compulsive Personality Disorder?
Perfectionist, doesn't show feelings, detail oriented, uses isolation
104
Which cytokine is released when a macrophage is activated?
IL-1
105
How does an epidural hematoma present?
Intermittent consciousness (lucid interval)
106
What has a friction rub while holding breath?
Pericarditis
107
What does biotin donate methyl groups for?
Carboxylation
108
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
109
What is Tuberous Sclerosis?
Ashleaf spots (hypopigmentation)Primary brain tumorsHeart RhabdomyolysisRenal cell CAShagreen spots (leathery)
110
What is Vernix?
Cheesy baby skin. (protects the baby's skin from the outside world and helps with passage through the birth canal)
111
What is Postpartum Depression?
Depression post-delivery for more than 2 weeks
112
What does Vit B1 do?
Dehydrogenasestransketolase (PPP)cofactors
113
What does DES taken by Mom cause in her Daughter?
Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions
114
What are the Osmotic Laxatives?
Magnesium hydroxide, mag citrate, polyethylene glycol, Lactulose
115
What diseases have metabolic alkalosis?
Low volume state: vomiting, diuretics, GI blood loss
116
What are the Class IA antiarrhythmic?
Quinidine, Procainamide, Disopyramide
117
What bacteria cause diarrhea <8 hours after introduction?
"CBS"C - ClostridiumB - Bacillus CereusS - Staphylococcus aureus
118
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
119
What is Milia?
Neonatal white or pale yellow heads on malar area
120
What is Toxoplasmosis?
Multiple ring enhancing lesions, loves parietal love, from cat urine and feces
121
What is Apocrine?
Apex of the cell is secreted
122
What states have increased Estrogen?
Pregnancy, liver failure, P-450 inhibition, and obesity
123
What are the adverse effects of Pseudoephedrine, phenylephrine?
HTN, CNS stimulation/ anxiety
124
What is von Gierke?
G-6 Phosphatase deficiencysevere fasting hypoglycemiahepatomegalyincreased lactase and uric acid levels
125
What hormones produce Basophila?
"B FLAT": Basophils, FSH, LH, ACTH, and TSH
126
What is Huntington's?
Occurs in the caudate/putamen, Trinucleotide repeat disorder (Chromosome 4, CAG), choreiform movements, changes in personality, anticipation
127
What is Oligomenorrhea?
Too few periods
128
What bug loves the temporal love?
HSV
129
What is an Encephalocele?
Brain tissue herniation
130
What is Karyolysis?
Nucleus dissolves
131
What is Dysfunctional Uterine Bleeding?
Diagnosis of exclusion, usually due to anovulation
132
What has a friction rub while breathing?
Pleuritic
133
What is Hemochromatosis?
Fe deposit in organs
134
What is an Acute Rejection?
Occurs 4 days to months later. T-cell and macrophage response
135
What are the indications for Methyldopa?
HTN
136
What does secretin do?
Secretion of bicarbonate, inhibit gastrin, tighten Pyloric Sphincter, and secreted by S-cell Duodenum
137
When does Implantation occur?
1 week after fertilization
138
What is Comedocarcinoma?
Multiple focal areas of necrosis (blackheads) DCIS
139
What is Vestibular Neuritis?
Inflammation of the vestibular portion (CN8), Could be associated with viral infection, characterized by vertigo and dizziness
140
What is the MOA of Potassium on the heart?
Depresses ectopic pacemaker in hypokalemia
141
What is a Nephroblastoma?
Abdominal mass due to enlarged "Wilm's Tumor", hemihypertrophy and Aniridia
142
What is the most common cause of delayed speech developement?
Hearing loss
143
What is the Peripheral Nervous System?
Everything except the brain and spinal cord. Myelination by the schwann cells
144
What is Imitation?
Replicating another's behavior
145
What is Cholelithiasis?
Formation of gallstones
146
What is the most common cause of Vaginal Bleeding in Post-menopausal women?
Endometrial CA
147
Can you die during Opiod Withdrawal?
No, just very painful
148
What are the symptoms of Amniotic Fluid Emboli?
Mom just delivered Baby and mom has SOB, due to PE, leads to death
149
What is Nephritic Kidney Disease?
Inflammation with protein loss <3.5 in urineIncreased size of Fenestrations, RBC casts, HTN
150
What is your maximum heart rate?
220 minus the person's age
151
What are the indications for Reserpine?
HTN
152
What is seen in Calcium deficiency?
Poor bone and teeth development
153
What is Eisenmenger's Syndrome?
Physiological shunt from left to right now changes right to left
154
What are some PPIs?
Omeprazole, Lansoprazole
155
What kind of Patients does Staph and Pseudomonas like to attack?
DM, CF, Burn Patients, Neutropenic patients
156
What does a Transferase do?
Relocates a functional group from one molecule to another
157
What is associated with P. Mirabilis?
Staghorn Calculus, UTI, Urease Positive, Treat with Norfloxacin
158
What is Emphysema?
Obstructive diseaseAlpha-1-antitrypsin deficiency
159
What is PSGN?
Most common in kids. Subepithelial humps (IgG/C3/C4 deposition) lumpy bumpy on EM and ASO antibodies
160
What is Sixth's DIsease?
Roseola, Exanthema Subitum (fever disappears then rash appears)
161
What is a Lymphocyte?
The warrior - T, B, and NK cells
162
What disease has a "3" shape on x-ray?
Coarctation of the aorta
163
What is MPGN
Tram tracks seen (Type II has low C3) on LM
164
What is Peutz Jegher Syndrome?
Hyper-pigmented lower lip, patients will have dark gyms and vagina, and small bowel polyps
165
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
166
What is Type 2B Hyperlipidemia?
Deficiency of adipose receptors and LDL receptors (Increased LDL and VLDL levels)
167
What is the MOA of Nitroprusside?
Direct release of NO, increases cGMP, vasodilator
168
What is a Tear Drop Cell/ Dacrocyte?
RBC's squeezed out of bone marrow. (Seen in Hemolytic Anemia and bone marrow CA)
169
What is Decreased beat-to-beat variability?
Acidemia
170
What does Gastric Inhibitory Peptide (GIP) do?
Increases insulin action, responsible for post-prandial hypoglycemia
171
What is the difference between norepinephrine and epinephrine?
NE: NeurotransmitterEPI: Hormone
172
What are the adverse effects of ACE inhibitors?
Hyperkalemia, cough, angioedemacontraindicated in pregnancy (fetal renal malformations)
173
What is Cataplexy?
Loss of muscle tone due to strong emotions
174
What does dullness to percussion tell you?
Something between the airspace and chest wall absorbing sound, can be solid or fluid
175
What hepatitis B labs indicate a chronic carrier state?
HBsAg+, (>6 months), HBsAb (+/-)
176
What are the Diastolic Blowing murmurs?
Aortic regurgitation, pulmonic regurgitation
177
What is the MOA of Isoproterenol?
Non-specific, Beta-agonists;relates bronchial smooth muscle (B2)
178
What does Exocrine mean?
Secreted into a duct
179
What is Apoptosis?
Programmed cell death, no inflammation, and cell membrane dissolved first. Nucleus guides death & destroyed last
180
What are theh Renin-angio system effectors?
ACE inhibitors and ARBs
181
What are the most common symptoms of the Low Energy State?
Weakness and SOB
182
What is Reynold's Pentad?
Jaundice, Fever (usually with Rigors), RUQ Pain, Hypotension and change in mental status
183
What does Ca2+ do?
Neuronal function, atrial depolarization, smooth muscle contractility
184
What diseases have Granulomas?
"HiTTSS"Hi - Histiocytosis XT - TBT - The -Ella'sS - SarcoidosisS - Syphilis
185
What is a Complete Breech?
Butt down, thighs, and legs flexed
186
What is Grey-Turner's Sign?
Bleed into Flanks and caused by Hemorrhagic Pancreatitis (early signs)
187
What is associated with Francisella Tularensis?
Ulcers at rabbit or deer tick bite siteRx: Streptomycin
188
What is associated with Bartonella Henselae?
Cat Scratch = Single painful lymph node, Stains silver
189
What is Avoidant Personality Disorder?
Socially withdrawn, afraid of rejection but wants to fit in
190
What is a Sister Mary Joseph Nodule?
Ovarian CA that has spread to the umbilicus(Also GI cancers can cause) (Indicates metastasis)
191
What does the Core Ab tell you?
Past infection
192
What is associated with Clostridium Melangosepticus?
Colon CA
193
What is a Neuroblastoma?
Adrenal medulla tumor in kids, dancing eyes and feet and secretes catecholamine's
194
What are the inidcations for Cromolyn?
Asthma prophylaxis
195
What is Rationalization?
Make excuses for behavior in advance, (because of...)
196
What are the indications for Nesiritide?
Acute decompensated heart failure
197
How do you measure afferent renal function?
Creatinine or Inulin
198
What is a Spherocyte?
Old RBC
199
What is Thought Broadcasting?
Believes that everyone can read his thoughts
200
What is associated with Chlamydia psittaci?
Parakeets and Parrots are the carrier agent
201
What does high WBC and >5% Blasts tell you?
Leukemia
202
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
203
What is Displacement?
Take anger out on an object or someone else. Not related with situation
204
What is Turcot's Syndrome?
Familial Polyposis with Brain Tumors
205
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)
206
How does trigeminal neuralgia (Tic Douloureux) present?
Sharp, shooting face pain, recurrent episodes
207
What does an AFI <5 indicate?
Oligohydramnios (Cord compression)
208
What is the rate-limiting enzyme in Glycogenesis?
Glycogen Synthase. Occurs in the Cytoplasm of Liver and muscle
209
What is Bronze diabetes?
Fe deposit in pancreas
210
What does Aldosterone do?
Reabsorbs Na+ and three waters
211
What is Chronic Pelvic Pain?
Endometriosis until proven otherwise
212
What is Late Deceleration?
Due to uteroplacental because the placenta cannot provide oxygen and nutrients
213
What are the CSF lab values for Meningitis?
PMN's -> BacteriaT cells / Macrophages -> Non-bacterialNormal Glucose -> Viral
214
What is the Clotting Cascade?
The cascade that stops you when you bleed
215
What is the MOA of Statins?
Inhibit HMG CoA reductase
216
What are the Holosystolic murmurs?
Tricuspid RegurgMitral RegurgVSD
217
What is Stage 1 of Labor?
Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm
218
What are the Vasculitis associated with LOW C3?
"PMS in Salt Lake City"Post-Strep GNMembranoproliferativeGlomerulonephritis Type IISub Bacterial endocarditisSerum SicknessLupusCryoglobulinemia
219
What is the MOA of albuterol?
B2 agonist; relaxes bronchial smooth muscle
220
What is Factitious?
Fake illness to get attention, seeks medical treatment, have a lot of medical knowledge.Tx: Supportive psychotherapy
221
What is Condyloma Acuminata?
Verrucous "cauliflower" warts, koilocytes, due to HPV 6 and 11
222
What is Osmotic Diarrhea?
High osmolality in the bowel pulling water into the lumen
223
What defines Hodgkin's Lymphoma?
EBV and may have Reed-Sternberg cells
224
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
225
What is associated with Chlamydia Pneumonia?
Staccato coughing, parasite with DNA and RNAs:Elementary body (Infectious phase) Reticulate Body (resting phase - can't divide)
226
What is the only Gram-positive Diplococci?
Streptococcus Pneumonia
227
What is the humoral immune response?
B-cells and PMN's patrol the blood looking for bacteria
228
What are the Adverse Effects of Infliximab?
Respiratory infection (including reactivation of latent TB) fever, hypotension
229
What are the indications for HMG-CoA reductase inhibitors?
Strong decrease LDLDecrease TriglyceridesIncrease HDL
230
What does a Galactokinase deficiency cause?
Cataracts
231
What is the most common extracellular buffer?
Bicarb
232
What is associated with Bacillus Cereus?
Fried rice syndrome, preformed toxin
233
What is Compensation?
Doing something different of what you used to do
234
What is the color of air on X-ray?
Black "radiolucent"
235
What stage of the menstrual cycle has the highest Temperature?
Ovulatory stage, body temp will rise One degree during ovulation
236
What bug loves the DCML tract?
Treponema
237
What are the indications for 2nd generation H1 Blockers?
Allergies
238
Who Makes the Trophoblast?
Baby
239
Waht is the rate-limiting enzyme in Cholesterol syntesis?
HMG CoA Reductase
240
What makes an adequate sputum sample?
<10 epithelial cells and >25 leukocytes per low power field
241
What are the indications from Magnesium?
Effective in Torsades and Dig toxicity
242
What are the adverse effects of Salmeterol?
Tremor and arrhythmia
243
What is the indication for Isoproterenol?
Bronchoconstriction due to sympathetic tone
244
What is Pathological Gambling?
Can't stop gambling, affects others
245
What is the sign of a Clavicle Fracture?
Asymmeteric Moro reflex
246
What is an Astrocytoma?
Rosenthal fibers - #1 in kids with occipital headache
247
What is Heavy Chain Disease?
Increased IgA
248
What GI disease has a Bird's Beak on X-Ray?
Achalasia (Think Chagas disease)
249
What is Carcinoid syndrome?
Flushing, wheezing, diarrhea
250
What are the Indications for Glitazones/Thiazolidinedione's?
NIDDM. (Type 2)
251
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
252
What is the CBC for every basculitis?
Decreased: RBC and plateletsIncreased: WBC, T-Cells, Monocytes, Schistocytes, ESR
253
What is associated with Mycoplasma Pneumoniae?
Bullous myringitis, Ground Glass CXR, P-1 Protein, Erythema Multiforme
254
What are the risk factors for Primary Liver Cancer?
Hepatitis B & C, Aflatoxin, Alcohol, Smoking and Hemochromatosis
255
What are the Pyrimidines?
C, U, T
256
What are the Adverse Effects of Desmopressin (DDAVP)/ADH?
Over hydration and allergic reaction
257
What is a Sliding Hiatal Hernia?
Fundus of the stomach herniates through the Esophageal Hiatus into the Thorax
258
What is t1/2?
Half-life, the time it takes the body to use half of the drug ingested
259
What is the job of the early distal tubule?
Concentrate urine by reabsorbing NaCl
260
What is the thyroid hormone levels during Pregnancy?
Increased TBG - leads to increased total T4 (Bound and free)
261
What is seen with Varicella (Chickenpox)?
Red macule clear vesicle on red dotPus and scabbingvarious stages of healing
262
What is Cabot's Ring body?
Seen in Vitamin B12 Deficiency and lead poisoning
263
What is intra-Renal Failure?
Damaged Glomerulus or tubules; BUN: Creatinine Ratio <20/1
264
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)
265
What organs do not require insulin to absorb glucose?
"BRICKLE": Brain, RBC, Intestine, Cardiac / Cornea, Kidney, Liver and Exercising muscle
266
What receptors do Protein Hormones use?
Cell membrane receptors
267
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)
268
What is Metachromatic Leukodystrophy?
Arylsulfatase A defieciencychildhood multiple sclerosis with Ataxia/Dementiaaccumulation of Cerebroside Sulfate
269
What are the catabolic pathways that create energy? (Occur in the Mitochondria)
Acetyl-CoA production, Beta-oxidation, citric acid cycle, Ketogenesis, Ox Phos
270
What are Plasma Neoplasms?
They produce many antibodies
271
What does the Direct Coombs Test tell you?
ANtibody on surface (seen in hemolytic anemia)
272
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
273
What does Glucagon do?
Active in Gluconeogenesis, Glucogenolysis, Lipolysis, and Ketogenesis
274
What is the rate-limiting enzyme in Purine synthesis?
Glutamine - PRPP
275
What is Alzheimer's disease?
Decreased ach in nucleus basalis of Meynert, bad Apo-E4, Amyloid Plaques, Neurofibrillary Tangles of Tau proteins
276
What is Essential Thrombocythemia?
Very high platelets increased RBC's and WBC's
277
What does Antidiuretic hormone (ADH) do?
Conserves water (V2 aquaporin receptors) and vasoconstriction
278
What does Tracheal deviation tell you?
Moves away from tensionPneumothorax moves towards Atelectasis
279
What CA risk does VHL have?
RCC
280
What GI disease has a Corkscrew on X-Ray?
Esophageal spasm and Volvus
281
What is Carcinoid Syndrome (Triad)?
Diarrhea, flushing and wheezing
282
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
283
What is Crohn's Disease?
Transmural, Cobblestones, Melena, Creepig Fat, Fistula, Skip lesions
284
What are Loose Associations?
Ideas switch subjects, incoherent
285
What is Idealization?
They see only the good in someone despite evidence to the contrary
286
What GI disease has a stacked coin on X-Ray?
Intussusception
287
What is Tangentiality?
Wanders off the point
288
What is Graft vs. Host Disease?
When the graft attacks the body (T-Killer cells and macrophages responded)
289
What are the Indications for Infliximab?
Crohn's Disease, Rheumatoid arthritis
290
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
291
What has Tubular Casts?
Acute Tubular Necrosis (ATN)
292
What is the risk of Chorionic Villus Sampling?
Fetal limb defects. (Done at 9-12 weeks)
293
What is Karyorrhexis?
Nucleus fragments
294
What is Waldenstrom Macroglobulinemia?
IgM and Hyperviscosity of the blood
295
What are Pencil Cell/ Cigar Cell?
Seen in iron deficiency anemia
296
What is Primary Biliary Cirrhosis?
Anti-Mitochondrial antibody Bile ducts are destroyedXanthelasmas present and pruritis
297
What is factitious hypoglycemia?
Exogenous insulin use, labs show elevated insulin and decreased C-peptide
298
What are the adverse effects of the Ca2+ channel blockers?
Flushing, edema, constipation, CHF, AV block
299
What disease does Coxsackie B cause?
Endocarditis, DM Type I
300
When do you give RhoGam?
1st Dose: Week 28 gestation2nd Dose: 72 hours post-deliveryAny time a procedure would mix mom and fetal blood
301
What are the IgA Nephropathies?
HSPBerger'sAlport Syndrome
302
What is Paracrine?
Works on its neighbor. (except sweat gland)
303
What does "Cytosis" tell you?
High levels
304
What is Justification?
Making excuses for behavior afterwards
305
What are the Biguanides drugs?
Metformin
306
What are the glycogenic amino acids?
His, Met, Val
307
What are the indications for Hydralazine?
Severe HTN, 1st line treatment for HTN in pregnancy
308
What are the hormones with disulfide bonds?
"PIIG": Prolactin, Insulin, Inhibin, GH (growth hormone)
309
How do i know the patient has a Vitamin B2 (Riboflavin) Deficiency?
Angular Cheilosis
310
What does Vit B9 do?
Nuclear division (Synthesis of Nitrogenous bases for RNA and DNA)
311
What is Glanzmann's?
Baby with bleeding from skin and mucosa (LOW GP-2b3a)
312
What is Exhibitionism?
Exposure to others
313
How does the Sympathetic System behave?
Opposite of Parasympathetic:ConstipationUrinary retentionMydriasis - "Eyes wide with fright"TachycardiaBronchodilateEjaculation "Shoot"Xerophthalmia (dry eyes)Xerostomia (Dry mouth)
314
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
315
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
316
What are the classifications of MHC-1?
HLA-A, HLA-B and HLA-C
317
How does chlamydia present?
Cervicitis (Yellow pus), conjunctivitis, PID
318
What is Total Anomalous Pulmonary return?
All pulmonary veins enter into the right atrium (Snowman x-ray)
319
What is the rate-limiting enzyme in Ketogenesis?
HMG CoA Synthase
320
What is Herpes?
ds DNA virus
321
What is the Stage II of Labor?
Continues after the cervix is dilated to 10 cm until the delivery of the baby
322
What is the difference between Heterochromatin and Euchromatin?
Hererochromatin = tightly coileddarkerTranscriptionally inactiveEuchromatin = loose (10nm fibers)lighter
323
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
324
What murmur has a regular-irregular pulse?
PVC
325
What disease has a Thumb Sign on neck films?
Epiglottitis
326
What is Restrictive Lung disease?
small still lungs, can't get air in
327
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
328
What are the indications for Ezetimibe?
Decrease LDL
329
What are the Class IC antiarrhythmic?
Flecainide, Encainide, Propafenone
330
What is the effect of Alcohol on the fetus?
FASSmooth philtrumshortpolyclonalmidface hypoplasiathin superior Vermilion border
331
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
332
What causes Chancroid?
Haemophilus Ducreyi
333
What is Telephone Scatologia?
Phone Sex
334
What is the MOA of ARBS?
Ang II blockers, prevernt alpha 1 vasoconstriction from Ang II
335
What is a Missed Abortion?
Cervix is closed, no fetal remnantsTx. D&C
336
What type of kidney stones have envelope or dumbbell-shaped crystals?
oxalate
337
What does the E Ab tell you?
Low transmissibility
338
What is the cause of large babies?
DM or twin-twin transfusions
339
What are the indications for Nitroprusside?
Hypertensive emergency, CHF, Angina
340
What is the MOA of cromolyn?
Prevents release of mediators from mast cells
341
What is Bismuth and Sucralfate used for?
Increase ulcer healing, traveler's diarrhea
342
What is a SIderoblast?
Macrophages pregnant with Iron (caused by genetics and or multiple transfusions)
343
What is the MOA of Bile Acid resins?
Prevent intestinal reabsorption of bile acids, Liver must use cholesterol to make more
344
What are the sympathoplegics?
Metoprolol, Atenolol, Acebutolol, Esmolol, Propranolol, Timolol, Carvedilol, Prazosin, Clonidine, Methyldopa, Hexamethonium, Reserpine, Guanethidine
345
What is the MOA of Salmeterol?
B2 agonist; relaxes bronchial smooth muscle
346
What is Bronchitis?
Increased sputum production "Blue Bloater"
347
What is Type 2A Hyperlipidemia?
Defective LDL-Clathrin Pit or B-100 (LDL are elevated)
348
What will you see with Anemia of Chronic Disease?
Decreased TIBC
349
What will you see with Sideroblastic Anemia?
Decreased dALA synthase common with blood transfusions
350
What are the adverse effects of Hexamethonium?
Severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
351
What is the MOA of the K+ channel blockers?
Increase AP duration, increase effective refractory period (ERP), increase QT interval
352
What is Plummer-Vinson Syndrome?
esophageal webbing at the UES, spoon nails from iron deficiency anemia
353
What is Cholestasis?
Obstructed bile ductHigh Alk Phos (if in the common bile duct)
354
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)
355
What is Trichotillomania?
They pull out their own hair and eat it
356
What is McCune-Albright?
Precocious sexual development, polyostotic fibrous dysplasia "whorls of connective tissue", "coast of Maine" pigemented skin macules
357
What is associated with Vibrio Parahaemolyticus?
Raw Fish, Gs Stimulation via ADP- ribosylation = HIGH cAMP, Turns the on... on
358
How fast should B-HCG rise?
Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed
359
What are the indications for Methacholine?
Asthma challenge test
360
What are some causes of Vitamine B12 deficiency?
TapewormsVeganismType A gastritisPernicious Anemia
361
What does Vit D do?
Mineralization of bones and teeth
362
What are the newborn screening tests?
"Please Check Baby Before Going Home"P - PKUC - CAH/ CFB - Biotinidase/ Beta- ThalassemiaG - GalactosemiaH - Hypothyroidism/ Homocystinuria
363
What are the most common causes of mental retardation in the US?
FAS, Fragile X and Down's Syndrome
364
What is Wiskott-Aldrich?
Low IgM, Low PlateletsHigh IgAEczemaPetechiaeX-linked
365
What is achondroplasia (Laron Dwarf)?
Patient with abnormal FGF receptors in exremities. (abnormal FGF3)
366
What is Hemosiderosis?
Fe overload in bone marrow
367
What is Poikilocytosis?
RBC's of different shapes
368
What are the Adverse Effects of Mimetics?
Hypoglycemia, Nausea, Diarrhea
369
What can high Triglycerides Cause?
Pancreatitis
370
What is the MOA of a muscarinic antagonist?
competitively block muscarinic receptors preventing bronchoconstriction
371
What are the methylxanthines?
Theophylline
372
What is the function of T3 and T4?
Growth and differentiation
373
What is Histrionic Personality Disorder?
Theatrical, sexually provocative, use repression
374
What diseases have Respiratory Alkalosis?
Restrictive Lung diseaseAnxietyPregnancyGram neg sepsisPE
375
What does Fe2+ do?
Hb function, electron transport
376
What is RhoGam?
Anti-D IgG
377
What is Pyromania?
Sets fires for the fun of it
378
How does DKA present?
Kussmaul respirations, fruity breath (acetone), and altered mental status
379
What is assocaited with Strep Bovis?
Colon Cancer, black pigment
380
What hepatitis B labs indicate non-infectious state?
HBeAg-
381
What bugs cause Bloody Diarrhea?
"CASES": Campylobacter, AMoeba (Entamoeba Histolytica), Shigella, E. coli and Salmonella
382
What are the only arteries with deoxygenated blood?
Pulmonary and umbilical arteries
383
What are the Long Acting Insulin drugs?
Ultralente, Glargine, and Protamine
384
What is Sarcoidosis?
Non-caseating granulomas, eggshell calcification around lymph nodes
385
What sound radiates to the axilla?
Mitral regurgitation
386
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)
387
What does somatostatin do?
Inhibits secretin, motilin, and CCK
388
What is the Adverse Effect of Sulfonylureas?
Hypoglycemia, GI disturbances, Muscle weakness, mental confusion, Sulfur allergy
