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1
Q

Cos’è una zoonosi

A

Con il termine zoonosi si intende una qualsiasi malattia infettiva che può essere trasmessa dagli animali (escluso l’uomo) all’uomo, direttamente o indirettamente

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2
Q

il vettore della Leishmania donovani

A

Flebotomo

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3
Q

tattamento della dissenteria amebica

A

metronidazolo

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4
Q

Quale test diagnostico conferma il tifo addominale

A

Reazione di widal

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5
Q

Corretta profilassi malarica con clorochina

A

2 settimane prima della partenza per la zona malarica e protraendolo per 4-6 settimane dopo l’arrivo

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6
Q

Quale esame fareste eseguire nel sospetto di teniasi

A

esame coproparassitologico

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7
Q

How long does the colera vaccination last

A

6 months

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8
Q

Antibiotici di prima scelta nella brucellosi

A

tetracicline

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9
Q

Terapia del Morbo di Hansen forma tubercoloide

A

dapsone + rifampicina

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10
Q

Corretta profilassi malarica con meflochina

A

1 settimana prima della partenza per la zona malarica e per 4 settimane dopo l’arrivo

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11
Q

Cosa sono i dermatofagoidi

A

Principali costituenti allergenici della polvere domestica

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12
Q

What class of drug is divided into ergot and not ergot derived?

A

dopamino-agonisti

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13
Q

Bioavailaibility

A

Fraction of administered drug reaching systemic circulation unchanged. For an i.v. dose, F = 100%.

Orally: F typically < 100% due to incomplete absorption and first-pass metabolism.

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14
Q

Volume di distribuzione

A

Theoretical volume occupied by the total amount of drug in the body relative to its plasma concentration.

Vd =amount of drug in the body/plasma drug concentration

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15
Q

Half-life t1/2

A

The time required to change the amount of drug in the body by 1⁄2 during elimination.
In first-order kinetics, a drug infused at a constant rate takes 4–5 half-lives to reach steady state. It takes 3.3 half-lives to reach 90% of the steady-state level.

t1/2 =(0.7 × Vd)/CL in first-order elimination

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16
Q

Zero order drug elimination

A

rate of elimination is constant regardless of Cp. Cp decreases LINEARLY with time. examples of drugs (Phenytoin, Ethanol, and Aspirin).

[PEA (a pea is round, shaped like the “0” in
zero-order)]

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17
Q

First order elimination

A

Rate of First-order elimination is directly proportional to the drug concentration. Cp decreases EXPONENTIALLY with time.

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18
Q

Metabolism first order reactions

A

Reduction, Oxidation, Hydrolysis with cytochrome p-450.

R-OH

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19
Q

Metabolism second order reactions

A

conjugation (Methylation, Glucuronidation, Acetylation, Sulfation).
usually yields very polar, inactive metabolites (renally excreted).

[More GAS]

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20
Q

Whipple desease most important symptoms

A

Cardiac symptoms, Arthralgias, and Neurologic symptoms are common. Diarrhea/steatorrhea occur later.

FOAMY Whipped cream in a CAN

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21
Q

REYE syndrome features

A

[REYE of sunSHINE]

Steatosis of liver/hepatocytes
Hypoglycemia/Hepatomegaly
Infection (VZV, influenza)
Not awake (coma)
Encephalopathy

Avoid aspirin in children except in those with kawasaki disease

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22
Q

Terapia clostridium (posologia)

A

Vancomicina 2 g (500 mg ogni 6 ore)

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23
Q

Most specific antibody in rheumatoid arthritis

A

anti cyclic cytrullinated peptide antibody

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24
Q

Differences between artrosi e artrite reumatoide clinicamente

A

Artrosi: Pain in weight-bearing joints after use (eg,
at the end of the day), improving with REST.
Asymmetric joint involvement.

Artrite Reumatoide: pain, swelling and morning stiffness > 1 hour, improving with USE. Symmetric joint involvement.

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25
Joint findings and joint involvement in artrosi
Osteophytes (bone spurs), joint space narrowing, subchondral sclerosis and cysts. ``` DIP (distal interphalangeal joint)-(Heberden nodes B ) PIP (proximal interphalangeal joint)-(Bouchard nodes) 1st CMC (carpometacarapal joint) not MCP (metacarpophlangeal) ```
26
Joint involvement in rheumatoid arthritis
``` MCP (metacarpophlangeal) PIP (proximal interphalangeal joint) wrist not DIP (distal interphalangeal joint) not 1st CMC (carpometacarapal joint) ```
27
Terapia artrosi
``` FANS intra articular glucocorticoid injection for temorary relief weight loss physical therapy (joint substitution) ```
28
What are the seronegative spondyloarthritis?
[PAIR] Psoriasic arthritis Ankylosing spondylitis Inflammatory bowel disease Reactive arthritis
29
Symptoms in reactive arthritis (Reiter syndrome)
[can't see, can't pee, can't bend my knee] Conjunctivitis Urethritis Arthritis
30
Eziologia reactive artritis
[ShY ChiCS] ``` Shygella Yersinia Chlamydia Campylobacter Salmonella ```
31
LES features
[RASH OR PAIN] Rash (malar or discoid) Arthritis (non erosive) Serositis (eg, pleuritis, pericarditis) Hematologic disorders (eg, pancytopenias) Oral/nasopharyngeal ulcers (usually painless) Renal disease Photosensitivity Antinuclear antibodies Immunologic disorder (anti-dsDNA, anti-Sm, antiphospholipid) Neurologic disorders (eg, seizures, psychosis)
32
Most common death causes in LES
[patients die with Redness In their Cheeks] Renal failure (mosto common) Infections Cardiovasculare disease
33
Libman Sacks Endocarditis (LSE)
LES
34
Gout involvements
first MTP joint (podagra) and the midfoot, knees ankles wrists the hips and shoulders are generally spared.
35
Difference between Cushing Syndrome and Cushing Disease
Cushing’s syndrome = too much cortisol. Cushing’s disease = too much cortisol from an ACTH-producing pituitary adenoma.
36
Most frequent cause of Cushing syndrome
Iatrogenic
37
Differences between ENDOGENOUS insulin and EXOGENOUS insulin
EXOGENOUS insulin lacks of C-peptides
38
Farmaco anti diabetico spesso associato a ipoglicemie
Sulfaniluree
39
Oral drugs in diabetes
[Be Sure My Grey Dog Swallows ALFA] ``` Biguanidi Sulfoniluree Metglinidi Glitiazioni/tiazolidinedioni DPP-4 inibitori Sodio-Glucosio cotrasporto (SGLT2) inibitori Alfa glucosidasi inibitori ```
40
Patogenesi dell'anemia di Kwasharkior
anemia da carenza proteica
41
Cos'è lo hiatus leucaemicus
assenza di forme di maturazione intermedia nel sangue periferico
42
Differences between Direct Coombs test and Indirect Coombs test
Direct Coombs test—anti-Ig antibody (Coombs reagent) added to patient’s RBCs. RBCs agglutinate if RBCs are coated with Ig. Indirect Coombs test—normal RBCs added to patient’s serum. If serum has anti-RBC surface Ig, RBCs agglutinate when Coombs reagent added. The indirect Coombs’ test detects antibodies to RBCs in the patient’s serum. The direct Coombs’ test detects sensitized erythrocytes.
43
Pulse pressure
sistolic pressure-diastolic pressure Pulse pressure is proportional to SV (gittata sistolica), inversely proportional to arterial compliance PP increases: - hyperthyroidism, - aortic regurgitation, - aortic stiffening (systolic hypertension in elderly), - obstructive sleep apnea - anemia, - exercise (transient). PP decreases - aortic stenosis, - cardiogenic shock, - advanced heart failure (HF). - cardiac tamponade,
44
Cardiac Contractility when does increase and decrease? What is the best contractility index?
Contractility INCREASES - Catecholamine stimulation via β1 receptor: - intracellular Ca2+ - LESS extracellular Na+ - Digitalis Contractility DECREASES - β1-blockade - HF with systolic dysfunction - Acidosis - Hypoxia/hypercapnia ( Po2/  Pco2) - Non-dihydropyridine Ca2+ channel blockers FE is the best index contractility
45
Frazione di eiezione
EF = gittata sistolica/EDV(end diastolic volume) | = (EDV-ESV)/EDV
46
Cardiac sounds features
S1—mitral and tricuspid valve closure. S2—aortic and pulmonary valve closure. S3—in early diastole during rapid ventricular filling phase. Associated with increased filling pressures (eg, mitral regurgitation, HF) and more common in dilated ventricles (but can be normal in children, young adults, and pregnant women). S4—in late diastole (“atrial kick”). (Best heard at apex with patient in left lateral decubitus position). High atrial pressure. Associated with ventricular noncompliance (eg, hypertrophy). Left atrium must push against stiff LV wall. Consider abnormal, regardless of patient age.
47
Jugular venous pulse
A WAVE—Atrial contraction (absent in atrial fibrillation). C WAVE—right ventricol Contraction (closed tricuspid valve bulging into atrium). X DESCEND—downward displacement of closed tricuspid valve during rapid ventricular ejection phase (reduced or absent in tricuspid regurgitation and right heart failure) V WAVE—increasing right atrial pressure due to filling (“Villing”) against closed tricuspid valve. Y DESCEND—right atrial emptYing into right ventricole. (prominent in constrictive pericarditis, absent in cardiac tamponade)
48
Filtro di Kim Ray Greenfield
Filtro per la prevenzione dell'embolia polmomonare
49
Manovre cliniche per la trombosi venosa profonda
-Segno di Homan: flessione dorsale forzata del piede evoca dolore al polpaccio. -Segno di Bauer: dolore evocato comprimendo la muscolatura surale contro la membrana interossea Segno di Laurel: dolore al polpaccio durante il colpo di tosse
50
Terapia TVP
``` -Use unfractionated heparin or low-molecularweight heparins (eg, enoxaparin) for prophylaxis and acute management. -Use oral anticoagulants (eg, warfarin, rivaroxaban) for treatment (long-term prevention). ```
51
Doppia aggregazione profilattica post intervento di angioplastica coronarica con BMS (bare metal stent) e con stent medicato
BMS: 1 mese | Stent medicato: 1 anno
52
Definizione spondilolistesi
Scivolamento di una vertebra su quella sottostante
53
Valgismo e Varismo
Alterato rapporto tra gli ossi di due segmenti ossei contigui che vengono a formare un angolo ottuso aperto all'esterno vaRismo=Rombo valgismo=imbuto
54
Malattia di Pott (sintomi)
Paraplegia, dolore, gibbo (marcata sporgenza dorsale di una o più vertebre)
55
Malattia di De Quervain (def)
Tenosinovite cronica stenosante della guaina comune dei muscoli: breve estensore e lungo abduttore del pollice
56
Onde e intervalli ecg
-Onda P (depolarizzazione atri) 0,05-0,12 sec -QRS (depolarizzazione ventricoli) <0,12 sec -Onda T: (ripolarizzazione ventricoli) 0,18-0,20 sec -Onda U: prominent in hypokalemia (think hyp“U”kalemia), bradycardia. - Inter. PR: 0,16-0,20 sec - Inter. ST: 0,27 – 0,33 sec - Inter. QT: <0,44 sec (QTc>0,44 QT lungo) -Inter RR: 0,8-0,9 sec
57
Drug-induced long QT
[ABCDE] ``` AntiArrhythmics (class IA, III) AntiBiotics (eg, macrolides) Anti“C”ychotics (eg, haloperidol) AntiDepressants (eg, TCAs) AntiEmetics (eg, ondansetron) ```
58
Congenital long QT syndrome
- Romano-Ward syndrome—autosomal dominant, pure cardiac phenotype . - Jervell and Lange-Nielsen syndrome— autosomal recessive, sensorineural deafness.
59
Brugada syndrome
- Autosomal dominant - ECG: pseudo blocco di branca destra e sopraST in V1-V3 - Prevent SCD with implantable cardioverter-defibrillator (ICD)
60
Wolff-Parkinson-White syndrome
- DELTA wave with widened QRS complex and shortened PR interval on ECG. - Reentry circuit - Supraventricular tachycardia
61
Q waves in trasmural infarct
Onda Q>0,40 sec o di ampiezza >1/3 del complesso QRS
62
Blocco di branca SINISTRA e DESTRA
SINISTRA - QRS>0,12 sec - no R, ma S ampie in V1, - R alte e ampie in D1, V5, V6 DESTRA - QRS>0,12 sec, RSR' (rabbit ears) - qR o ampie R in V1 - ampie S in D1, V5, V6
63
Segno di Trendelemburg
Displasia congenita dell'anca
64
Artrodesi
Azione chirurgica che trasforma una qualsiasi articolazione da mobile a statica .Può essere definita come una "anchilosi chirurgica".
65
Constant-Murley score
Determines the functionality after the treatment of a shoulder injury

Medicina (10 decks)

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