DIT 1 Flashcards
MC malignancy in children
Acute lymphocytic leukemia (ALL)
MC solid tumor location in children
brain tumor
2 MC brain tumors in children
1 astrocytoma and #2 medulloblastoma
MC supratentorial brain tumor in children
craniopharyngioma
MC malignant bone tumor in children
Osteosarcoma
MC malignant bone tumor overall
Multiple Myeloma
2nd MC primary bone malignancy overall
Osteosarcoma
MC tumor of adrenal medulla in children
Neuroblastoma
MC renal tumor in children
Wilms tumor
MC primary cardiac tumor in kids
rhabdomyoma
Calf pseudohypertrophy is assoc with
Duchenne’s Muscular Dystrophy
Gower maneuver is characteristic of
Duchenne’s Muscular Dystrophy
Subluxation of lenses is seen in
Marfans syndrome
Lung CAs assoc w/ NON-smokers & their location
MC is bronchial adenocarcinoma; also mesothelioma and bronchioalveolar adenocarcinoma; All located in PERIPHERY
Lung CAs assoc w/ SMOKERS & their location
Squamous cell and small cell carcinomas; both located CENTRALLY (C is for central and cigarettes)
Proto-oncogene MC assoc with Hirschsprung disease
RET gene mutation
Fungal infection that causes diaper rash
Candida albicans
OPPORTUNISTIC mold with SEPTATE hyphae that branch at <45deg angle
Aspergillus fumigatus (A is Acute Angles)
OPPORTUNISTIC mold with irregular NONSEPTATE hyphae that branch at angles >90deg
Mucor
Dimorphic fungi common to SW USA or “valley” fever
Coccidioides immitis
Fungal infection that causes thrush in immunocompromised pts
Candida albicans
Fungal infection that causes vulvovaginitis in women
Candida albicans
Dimporphic fungi with Broad-Based Budding yeast
Blastomycosis (B B B)
Fungal infection known for causing pneumonia in AIDS pts
Pneumocystis jirovecii
Prophylaxis for P jirovecii in AIDS pts
Start TMP-SMX when CD4 < 200
Fungal infection common to Mississippi and Ohio river valleys; found in bird and bat feces
Histoplasma
Dimorphic fungi that causes a skin infection in those pricked by a thorn
Sporothrix schenckii (SporoTHORN)
Yeast known for causing meningitis in AIDS pts
Cryptococcus neoformans
MC cause of Osteomyelitis
S. aureus (always assume S. aureus causes osteomyelitis if no other info is available)
Cause of osteomyelitis in SEXUALLY ACTIVE pt
Neisseria gonorrhoeae (rare), N. gonorrhoeae is more likely to cause septic arthritis
Cause of osteomyelitis in DIABETICS and IV DRUG users
Pseudomonas aeruginosa & Serratia
Cause of osteomyelitis in SICKLE CELL pts
Salmonella
Cause of osteomyelitis in PROSTHETIC REPLACEMENT pts
S. aureus and S. epidermidis
Cause of osteomylitis in pts with VERTEBRAL DISEASE
TB (Pott’s disease)
Cause of osteomyelitis in pts with CAT AND DOG bites or scratches
Pasteurella multocida
Classic findings in OSTEOMYELITIS
Elevated CRP and ESR (not specific); most often occurs in children
Peripheral smear finding in LEAD POISONING
BasoPhilic stippling of RBCs (Pb –> BP)
Tx for LEAD POISONING in KIDS
Succimer
Tx for LEAD POISONING in ADULTS
EDTA and Dimercaprol
Systemic SE of Atropine
Antichol effects - Hot as a hare (increased temp), dry as a bone (dry mouth and decreased secretions), red as a beet (flushing), blind as a bat (cycloplegia, mydriasis), mad as a hatter (confusion, disorientation), bloated as a toad (constipation, urinary retention) and heart runs alone (rapid pulse)
Ophthalm SE of Atropine
Mydriasis and Cycloplegia
Function of Vitamin A
Vit A = RETINOL –> CONSTITUENT OF VISUAL PIGMENTS (retinal), antioxidant, essential for normal differentiation of epithelial cells into specialized tissue, prevents squamous metaplasia, treats measles and AML
Function of Vit B3
Vit B3 = NIACIN –> Constituent of NAD+; B3 = 3 ATP
Function of Vit B2
Vit B2 = RIBOFLAVIN –> Cofactor in oxidation and reduction - FADH2 and FMN (B2 = 2 ATP)
Function of Vit B5
Vit B5 = Pantothenate (PENTOthenate); essential component of CoA
MC Renal malignancy in adults & assoc gene deficiency
RENAL CELL CARCINOMA - gene deletion in chromosome 3
Classic presentation of RENAL CELL CARCINOMA
HEMATURIA, PALPABLE MASS, FLANK PAIN
Enzyme responsible for Glucose –> Sorbitol
Aldose reductase
Enzyme responsible for Sorbitol –> Fructose
Sorbitol Dehydrogenase
Diabetic complications assoc with SORBITOL INDUCED OSMOTIC DAMAGE
Osmotic damage to Schwann cells –> diabetic NEUROPATHY; damage to lenses –> CATARACTS
MC locations of LUNG CA METS
Liver, bones, adrenal glands and brain
Toxin in fugu sashimi?
Tetrodotoxin
Tetrodotoxin MOA?
binds voltage-gated Na channels and prevents depolarization –> coma, respiratory arrest, or cardiovascular collapse
When is a fetus most susceptible to damage from teratogens?
wks 3-8
Anti-hypertensives that are also teratogens?
ACE inhibitors and ARBs –> fetal kidney damage
What do SERTOLI CELLS RELEASE to prevent formation of female structures in male fetus?
they release MULLERIAN INHIBITORY FACTOR which acts on paramesonephric ducts (Mullerian ducts) to prevent the formation of fallopian tubes, uterus and proximal vagina
Innervation of SERRATUS ANTERIOR
Long thoracic nerve
Injury to LONG THORACIC NERVE
WINGED SCAPULA
40yo male presents with MI, receives normal meds and a few days later his platelets are down to 30,000. Why?
Acute MI pts get aspirin, beta blockers, statins and heparin (or LMWH) - platelet level likely caused by HEPARIN-INDUCED THROMBOCYTOPENIA; d/c heparin and switch to Lepirudin
Anatomy of FEMORAL SHEATH
tube of fascia deep to inguinal ligament - CONTAINS FEMORAL ARTERY AND VEIN; DOES NOT CONTAIN FEMORAL NERVE; from lateral –> medial: NAVEL
Which drugs cause GYNECOMASTIA?
Some Drugs Cause Awesome Knockers - Spironolactone, Dig, Cimetidine, Alcohol, Ketoconazole
Which ANTIFUNGAL causes GYNECOMASTIA? And its MOA?
Ketoconazole; MOA - inhibits desmolase in first step of steroid synthesis preventing cholesterol –> pregnenolene; this will decrease testosterone –> GYNECOMASTIA
Which DIURETIC causes GYNECOMASTIA? And its MOA?
Spironolactone; MOA - Aldosterone antagonist and K+ sparing diuretic; Spironolactone increases conversion of testosterone –> estradiol and blocks testosterone
What cell type releases IFN-gamma?
TH1 cells
What is the Z value for 95% CI? 99%?
Z = 1.96 for 95% CI and Z=2.58 for 99% CI
Standard Error of the Mean Equation
SEM = SD/sqrt(n)
Toxic SIDE EFFECTS of PHENYTOIN?
Lupus-like syndrome, induces p450, megaloblastic anemia, GINGIVAL HYPERPLASIA, HIRSUTISM, STEVENS-JOHNSON SYNDROME, Fetal hydantoin syndrome; neuro - diplopia, sedation, ataxia, nystagmus, and dizziness
What is responsible for VENOUS A WAVE?
ATRIAL contraction
What is responsible for VENOUS C WAVE?
VENTRICULAR contraction
What is responsible for VENOUS V WAVE?
ATRIAL FILLING AGAINST CLOSED TRICUSPID
NARCOLEPTIC SLEEP EPISODES begin during which STAGE OF SLEEP?
REM sleep
Order of stages of normal sleep?
Awake(alert) –> Awake(relaxed) –> N1(light sleep) –> N2(deeper sleep) –> N3(slow-wave sleep) –> REM
EEG Findings in AWAKE(ALERT) stage of sleep?
BETA waves (high frequency, low amplitude)
EEG Findings in AWAKE (RELAXED) stage of sleep?
ALPHA waves
EEG Findings in N1 (light sleep) stage?
THETA waves
EEG Findings in N2 (deeper sleep) stage?
SLEEP SPINDLES and K COMPLEXES
EEG Findings in N3 (slow-wave) stage?
DELTA waves (low frequency, high amplitude)
EEG Findings during REM?
BETA waves (high frequency, low amplitude)
LUNG CA assoc with COIN-SHAPED LESION
Bronchogenic adenocarcinoma
Appearance of ASBESTOS FIBERS in lung
Golden-brown rods that resemble dumbbells