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Test reviews DEDICATED > Day 2 June 22 > Flashcards

Day 2 June 22 Flashcards

1
Q

will patients with turner syndrome have normal internal and external genitalia?

A

YES except for STREAK ovaries

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2
Q

what causes a decreased maternal serum alpha fetal protein?

A

aneuploidies

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3
Q

what causes an increased maternal serum alpha fetal protein?

A
  • open neural tube defects (spina bifida, anencephaly)
  • ventral wall defects (omphalocele)
  • multiple gestations
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4
Q

What is theophylline?

A

Methylxanthine derivative - stimulant used for asthma, COPD and bronchospasm (causes bronchodilation)

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5
Q

How does theophyline cause toxicity?

A

Overdose can lead to tacchyarrythmias or SEIZURES since it has stimulant activity on the heart

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6
Q

why doesnt menstruation and breast development occur in turner syndrome?

A

these process are estrogen dependent and the ovaries may be streak ovaries (replaced by fibrous tissue, atrophic)

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7
Q

what embryologically goes wrong in tetrallogy of fallot?

A

abnormal neural crest migration -> anterior deviation of the infundibular septum

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8
Q

pathogenesis of ankylosing spondylitis

A
  • defects in mucosal barrier and abnormal intestinal microbiome induce IL-17 via t cells/lymph and IL-17 induces other inflammatory factors, specifically TNF alpha and prostaglandins
  • > bony lesions and abnormal bone growth

RISK INCREASED IN HLA B27

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9
Q

presentation of ankylosing spondylitis?

A

<40 years old

  • insidious onset of bone/buttock pain
  • nocturnal pain, pain releived with movement
  • dactylitis
  • enthesitis (inflammation at tendon insertion point)
  • anterior uveitis
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10
Q

leading cause of bacterial meningitis in adults?

A

S. pneumonia

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11
Q

what is focal nodular hyperplasia?

A

non-malignant lesion in liver most commonly in young women. Found incidentally

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12
Q

FNH pathophys

A

hepatic vascular abnormality causes local hyperperfusion followed by hyperplastic response, resulting in small solitary pale nodules with central stellate scar and fibrous bands

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13
Q

most lung abscesses are ____

A

polymicrobial

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14
Q

what is attrition bias?

A

A type of SELECTION bias where loss-to-follow up is disproportionate between exposure groups

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15
Q

how do you treat a patient with toxoplasmosis gondii?

A

sulfadiazine and pyrimethamine

ADD leucovorin

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16
Q

how do you treat a patient with toxoplasmosis gondii who has a sulfa allergy?

A

clindamycin and pyrimethamine

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17
Q

what is a common cause of ring enhancing brain lesions in an HIV patient, OTHER than toxo?

A

primary central nervous system lymphoma - B cell origin from EBV

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18
Q

EBV usually causes abnormal ___ cells, except for in the ____ where it causes abnormal B cells

A

T

brain

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19
Q

what is derealization/depersonalization disorder?

A

Disorder where patient has at least one of the following:

  • depersonalization (detachment and unreality of self)
  • derealization (detachment and unreality of environment)
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20
Q

what is dissociative identity disorder?

A

two or more distinct personalities

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21
Q

what is a common mechanism of chemo resistance in tumour cells?

A

The development of P-glycoprotein

22
Q

How does p-glycoprotein work?

A

It uses ATP to pump out the chemo drugs

23
Q

presentation of babesia infection?

A

flu-like symptoms - fatigue, myalgias, headache, respiratory symptoms

24
Q

how is babesia spread?

A

bite of ixodes tick

25
Q

what is seen on a blood smear of babesia?

A

maltese crosses - intracellular inclusions in RBCs

26
Q

Presentation of cyanide poisoning

A

reddish skin discolouration, tachypnea, headache, tacyycardia, nausea/vomiting and can progress to seizures and cardiovascular collapse

27
Q

how to treat cyandine poisoning?

A

nitrites

28
Q

how do nitrites treat cyanide poisoning?

A

They convert hemoglobin to methemaglobin which has a high affinity for cyanide- it binds and sequesters cyanide away from cyt C

29
Q

how does cyanide cause poisoning?

A

it binds Fe3+ thus inhibiting cyt C and blocking ETC -> lactic acidosis and death

30
Q

flutamide MOA

A

competitively blocks androgen receptor binding

31
Q

what will be found on urine electrophoresis of someone with multiple myeloma?

A

lambda light chains - kidney disease in multiple myeloma is often caused by light chain cast nephropathy

32
Q

where is ribosomal RNA transcribed?

A

the nucleolus

33
Q

all stages of syphillis are effectively treated with what?

A

penicillin - give slow release since treponoma divides slowly over time

34
Q

what is the shape of treponema pallidum?

A

corkscrew shaped

35
Q

high exposure to aflatoxins is related to which type of cancer?

A

hepatocellular carcinoma

36
Q

ehrlichia chafeensis demonstrates what on microscopic investigation of monocytes?

A

mulberry shaped intracytoplasmic inclusions in monocytes

37
Q

how is ehrlichia chafeensis spread?

A

by tick bites, but lives harboured by white-tailed deer and then spreads to mononuclear cells (such as those in bone marrow)

38
Q

how does central retinal artery occlusion present?

A

acute, painless, monocular vision loss

39
Q

fundoscopic findings of central retinal artery occlusion?

A

cherry red macula and retinal whitening

40
Q

antisocial personality disorder clinical features?

A
  • violates social norms, rights of others and laws
  • impulsive, aggressive
  • consistently irresponsible
  • lack of remorse
  • age >18
  • evidence of conduct disroder before 15
41
Q

what are the same clinical signs of antisocial personality disorder, in someone under 15, called?

A

conduct disorder

42
Q

what is oppositional defiant disorder?

A

-these patients have irritability, vindictiveness and lack of personal accountability but dont necessarily break the law

43
Q

what is disruptive mood dysregulation disorder?

A
  • only diagnosed in those <18

- severe, persistant irritability in childhood with frequent verbal/aggressive outburts

44
Q

pathophys of acute hemolytic transfusion reaction

A

type II hypersensitivity
-PREexisting anti ABO antibodies bind to donor cells resulting in lysis via complemement, vasodilation (C5a) and symptoms of shock

45
Q

what is paroxysmal atrial fibrillation and what does it look like on an ECG?

A

atrial fibrillation that comes and goes on its own

ECG will show lack of p waves and irregularly spaced QRS complexes

46
Q

where should ablation take place in someone with paroxysmal atrial fibrillation?

A

near the pulmonary veins (ectopic electrical foci are commonly found here in Afib)

47
Q

where are bile acids usually reabsorbed?

A

terminal ileum via transporters

48
Q

patients with crohns disease are at increased risk for what gallbladder pathology?

A

gallstones, due to increased cholesterol to bile ratio (lost bile in terminal ileum)

49
Q

what is the most common complication of chagas disease?

A

chronic chagas heart disease - chronic low grade myocarditis leads to destructions of fibers and fibrosis -> heart failure, arythmias, etc.

50
Q

what is seen on a blood smear of someone infected with T. cruzi?

A

tryptomastigotes

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