Deck 2

Question 1

Wernicke/ Korsakoff are from destruction to what brain structure?

Answer 1

Mamillary bodies. Thiamine deficiency. Korsakoff = inability to form new memories, confusion, ataxia, nystagmus, ophthalmoplegia

Question 2

NF type one chromosone and signs?

Answer 2

Chromosone 17- autosomal dominant. Decreases activity of Ras. Cutaneous neurofibromas, café-au-lait spots, pheochromocytoma, lisch node (eye)

Question 3

Distant hearts sounds indicative of what?

Answer 3

Tamponade. Can occur from ventricular wall rupture 3-14 days post-MI

Question 4

Aschoff bodies?

Answer 4

focal areas of granulomatous inflammation from rheumatic fever

Question 5

What are seen with sarcoidosis?

Answer 5

Hypercalcemia, non-caseating granulomas, bilateral hilar lymphadenopathy, erythema nodosum, incr. ACE

Question 6

Smoker with hilar mass with cavitation and hypercalcemia?

Answer 6

Squamous cell carcinoma. Paraneoplastic syndrome = excessive PTH related peptide which can cause hypercalcemia leading to urolithiasis

Question 7

Beck triad of cardiac tamonade?

Answer 7

Hypotension, incr. JVP, distant heart sounds

Question 8

How does allopurinol work?

Answer 8

Blocks xanthine oxidase.

Question 9

Where does gout occur

Answer 9

Fingersm, joints, achilles tendon, ears

Question 10

TRAP symptoms of parkinsons?

Answer 10

Tremor, Rigidity, Akinesia, Postural instability

Question 11

Parkinsons: Loss of what signal to where?

Answer 11

Loss if inhibitory dopamine from substantia nigra to putamen and excitation of inhibitory pathway in basal ganglia

Question 12

Lyme disease stage II signs?

Answer 12

LMN paralysis of facial nerve (inability to close eye or seal corner of mouth) + new heart block. Treat with doxycyclin- SE of photosensitivity, GI, discoloration of teeth in kids

Question 13

What is the name of lyme tick?

Answer 13

Ixodes

Question 14

MS presentations?

Answer 14

Neurologic problems demyelinating plaques (can be transient). Depletion of myelin-producing oligodendrocytes. Increased immunoglobulin (IgG) in CSF

Question 15

Optical property of gout crystals?

Answer 15

Negative birefringent crystals

Question 16

Where do the branches of the trigeminal nerve exit skull?

Answer 16

SRO (standing room only)- superior orbital fissure, rotundum, ovale

Question 17

Damage to left MLF would cause what? (medial longitudinal fasciculus)

Answer 17

Paralysis of left eye when gazing right

Question 18

What nerve innervates intrinsic muscles of larynx? And what pharyngeal arch?

Answer 18

recurrent laryngeal off vagus. 6th. Results in hoarsness and trouble speaking

Question 19

What problem would you see from injury to muscles from 4th pharyngeal arch?

Answer 19

Difficulty swallowing, absent gag test

Question 20

What problem would you see from injury to muscles from 2nd pharyngeal arch? 1st?

Answer 20

Smile; chew

Question 21

What neuropeptide is deficient in narcoplepsy?

Answer 21

Orexin-A, Orexin-B produced in lateral hypothalamus to help regulate REM and sleep. 90% people can have cataplexy (loss of muscle tone to strong emotion). Treated with stimulants and SSRI’s

Question 22

Patient has normal speech and comprehension but can’t repeat back. Wheres the problem?

Answer 22

Conduction aphasia = arcuate fasciculus. Connects Broca (frontal) to Wernicke (temporoparietal)

Question 23

People with Downs are at increased risk of what?

Answer 23

Alzheimers, ALL, AML

Question 24

What medication can cause hepatic adenoma?

Answer 24

Oral contraceptives, anabolic steroids

Question 25

Symptoms of addisons?

Answer 25

isufficiency of adrenal cortex. Skin hyperpigmentation, hypotension, abd pain, weakness, weight loss, salt craving (hyponatremia), N/V, depression, women (loss of pubic hair/ libido. But not men because androgens are in testes)

Question 26

Patients who undergo splenectomy are more susceptible to encapsulated organisms like…?

Answer 26

Please SHINE my SKiS = pseudomonas, Strep pneumo, Haemophilus, Influenza, Neisseria, E coli, Salmonella, Klebsiella, group b Strep

Question 27

Why give nitroprusside with heart failure?

Answer 27

Reduces afterload

Question 28

Chvosteks sign?

Answer 28

Tapping CN VII and seeing twitching- sign of hypocalcemia. Pancreatitis, hypoPTH, vitamin deficiency, CKD

Question 29

Medication for concurrent hypertension & BPH symptoms?

Answer 29

A1 antagonist like doxazosin

Question 30

What lab values do loop diuretics cause?

Answer 30

hypokalemia, hypocalcemia, mild hypochloremia

Question 31

What substance is a product of "wear and tear" and old age seen in histology and brown pigmented?

Answer 31

Lipofuscin

Question 32

How does digoxin work?

Answer 32

Block Na/K pump -> more sodium in cell -> more calcium released -> stronger contraction -> incr. ejection fraction. Also directly inhibits AV node and increases vagal tone -> decreased heart rate and greater filling time. SE = blurry yellow vision, N/V, diarrhea, arrythmia

Question 33

What are the essential amino acids? What two are needed during growth?

Answer 33

look it up. Arginine and histidine

Question 34

Indications for acute dialysis?

Answer 34

AEIOU: acidosis refractory to bicarbonate, electrolyte abnormalities refractory to medical intervention, Intoxication with some drugs, overload refractory to diuretics, Uremic symptoms (cardiac friction rub, altered mental status)

Question 35

Signs and symptoms of whipple disease

Answer 35

Weightloss, diarrhea, arthralgias, abd pain. Intestinal biopsy- shows PAS staining macrophages in lamina propria. Is gram + bacilli. Can exist in intestinal, lymphoreticular, CNS track from exposure to soil. Can occur with immunosuppresion.

Question 36

How does sensitivity affect positive/ negative predictive values?

Answer 36

Higher sensitivity = more false positives (lower PPV) and fewer false negatives (higher NPV)

Question 37

What is more common in small cell than large cell lung cancer?

Answer 37

SIADH (you'll see lower sodium)

Question 38

What cancer are Kulchitsky cells found in?

Answer 38

small cell lung cancer

Question 39

Mnemonic for CML?

Answer 39

a 9 and 22 year old are in philadephia eating cream cheese with a breakable nibble (9:22, philadephia chromosone, CML, imatinib, BCL gene)

Question 40

Mnemonic for APL?

Answer 40

your in AP classes from ages 15-17, use vitamin A (all trans retinoid acid) for acne

Question 41

What is given with cyclophosphamide to neutralize urine metabolites and help with cystitis?

Answer 41

Mesna

Question 42

What is DIGFAST for Bipolar 1 disorder?

Answer 42

Distractibility, Irresponsibility, Grandiosity, Flight of ideas, Activity/ psychomotor agitation, decreased Sleep, Talkativeness

Question 43

Bipolar II?

Answer 43

History of major depressive episode and hypomanic episode