Deck 3

Question 1

What are the ANCA positive vasculitides?

Answer 1

Microscopic polyangitis, GAP (wegeners), Churg-Strauss

Question 2

What happens when taking epinephrine after Phentolamine?

Answer 2

Phent = reversible a antagonist so epi only stimulates B receptors –> decreased blood pressure

Question 3

Signs of Kawasaki’s and possible complications?

Answer 3

Conjunctival erythema, high fever, oral blisters (strawberry tongue), edema of hands and feet, desquamative rash, enlarged cervical lymph nodes. Ages < 4 years. Acute necrotizing vasculitis of small/ medium vessels. Complication = HEART (changes in coronary arteries- coronary aneurysms with MI)

Question 4

Dresslers syndrome?

Answer 4

Fibrinous pericarditis post MI. friction rub and chest pain- “DRESS in your FIBER PETTYCOAT”

Question 5

Amiodarone is used in Vfib. What are side effects?

Answer 5

Pulmonary fibrosis, hypotension, thyroid, hepatotoxicity, occular changes, other arrythmias

Question 6

Lesions of right side of heart? Aorta?

Answer 6

Right- carcinoid? Aorta- syphilis, endocarditis?

Question 7

What heart medication causes blurry or yellow vision? Don’t take with what else?

Answer 7

Digoxin. Don’t take with loop diuretics (cause severe hypokalemia)

Question 8

What happens with Wolff parkinson white? Characteristics of ECG?

Answer 8

Accessory path that goes to ventricles and bipasses AV node leading to AVRT. ECG = delta wave, short PR, long QRS

Question 9

How do you accentuate mitral valve prolapse?

Answer 9

Decrease LV return (Valsava, standing). Mid systolic click with crescendo-decrescendo murmor …………. Seen in Marfans!

Question 10

Mnemonic for causes of dilated cardiomyopathy?

Answer 10

ABCCCD: alcohol, Beri beri, Cocksackie, cocaine, Chagas dz, doxorubicin

Question 11

Symptoms of Hodgkins lymphoma

Answer 11

Asymptomatic lymphadenopathy, fever, night sweats, fatigue, pruritus, unintentional weightloss (B symptoms). More common in young men. Reed sternberg cell

Question 12

ABVD regimen for Hodgkins lymphoma

Answer 12

Adriamycin, Bleomycin, Vinblastine, Dacarbazine

Question 13

What medication combined with statins worsens myopathy?

Answer 13

Fibrates- use ezetimide instead

Question 14

Histology associated with RF?

Answer 14

Aschoff bodies= lymphocytes, plasma cells, activated macrophages called Anitschkow cells

Question 15

Blood pressure medications indicated for pregnancy?

Answer 15

HCTZ, Bblockers, methyldopa, CCB’s, hydralazine. No ACEI’s or ARB’s!!!

Question 16

Patent ductus arteriosus is associated with what maternal infection?

Answer 16

Rubella

Question 17

Classic pentad of thrombotic thrombocytopenic purpura?

Answer 17

fever, thrombocytopenia, microangiopathic hemolysis, neurologic symptoms, renal insufficiency

Question 18

What can be taken with methotrexate to reduce myelosuppression?

Answer 18

Leucovorin (folinic acid)- derivative of THF

Question 19

Mnemonic for meds that cause hemolytic anemia in G6PD?

Answer 19

PAINS: Primaquine, Aspirin, Ibuprofen, Nitrofurantoin, Sulfonamides

Question 20

What is mechanism of TMP-SMX?

Answer 20

Blocks nucleotide synthesis by dihydropteroate synthetase

Question 21

EBV is associated with what lymphomas?

Answer 21

Hodgkins, Burkitts

Question 22

Vit B12 is coenzyme for what enzymes?

Answer 22

Methymalonyl CoA mutase (converts methylmalonic acid to succinyl-CoA) and methyltransferase (formation of methionine from homocysteine)

Question 23

What condition causes smudge cells, or fragile lymphocytes that break in slide preparation?

Answer 23

Chronic lymphocytic leukemia - low grade malignancy of B cells in old people. Can cause autoimmune hemolytic anemia, and hypogammaglobulinemia leading to infections.

Question 24

ToRCHes organisms that cross the placenta?

Answer 24

Toxoplasmosis, Rubella, CMV, Herpesvirus/ HIV, Syphilis

Question 25

What does protamine reverse the effects of?

Answer 25

heparin

Question 26

What about N-acetylcysteine?

Answer 26

Tylenol toxicity

Question 27

What about methylene blue?

Answer 27

Methemoglobinemia

Question 28

Tx for lead poisoning?

Answer 28

Dimercaprol and EDTA, or Succimer in kids

Question 29

What could be complication of large blood transfusion?

Answer 29

Hypocalcemia- blood has citrate to prevent clotting which can cause metabolic alkalosis and bind free Ca. Look for cramping, tingling around mouth, and Chvostek sign (tapping in front of ear)

Question 30

Symptoms of tuberous sclerosis?

Answer 30

Triad: seizures, intellectual disablity, facial angiofibromas (papules on face). Half will have rhabdomyoma

Question 31

Which blood malignancy has mediastinal mass?

Answer 31

Lymphoblastic lymphoma

Question 32

Whats mutated in factor V leiden?

Answer 32

mutation - arginine -> glutamine substitution in factor V makes it resistant to cleavage by protein C. most common inherited cause of hypercoaguability

Question 33

MOA of doxorubicin?

Answer 33

Generates free radicals and noncovalently intercalates DNA. Can cause dilated cardiomyopathy

Question 34

What is Wiskott-Aldrich syndrome?

Answer 34

Thrombocytopenia, recurrent infections, eczema. X linked recessive

Question 35

Roleaux formation?

Answer 35

Stacked RBCs seen in multiple myeloma

Question 36

M spike on urine electrophoresis is indicative of what?

Answer 36

Multiple myeloma

Question 37

Gilbert syndrome symptoms?

Answer 37

Decreased expression of uridine glucoronyl transferase that is generally asymptomatic but causes jaundice in times of stress. Higher indirect (unconjugated) bilirubin. Compare to Crigler-Najjar

Question 38

Deficiency of hexosaminidase A?

Answer 38

Tay Sachs

Question 39

Deficiency of B-glucocerebrosidase

Answer 39

Gaucher. Also femur is erlenmeyer flask

Question 40

What drug do you not take with digoxin?

Answer 40

Quinidine- decreases digoxin clearance and displaces it from tissue binding sites