Fri Aug 7 Flashcards
what stage of syphilis has a chancre?
primary
what stage of syphilis has a gumma?
tertiary
what stage of syphilis has condyloma lata?
secondary
what stage of syphilis has a rash?
secondary
are gummas painful?
no
when does neurosyphilis occur?
more commonly as a late manifestation but it can occur at any stage
which organism causes ecythma gangrenosum?
pseudomonas
how is the distal esophagus normally attached to the diaghram?
it is normally attached circumferentially via the phrenoesophageal membrane
what causes sliding hiatal hernias?
-laxicity of the phrenoesophageal membrane - usually results from repetitive stress and allows sliding of the GE junction/proximal stomach into the thoracic cavity
what causes paraesophageal hiatal hernias?
-defect in the phrenoesophageal membrane and laxicity gastrocolic and gastrosplenic ligaments
inheritance of fabry disease?
X linked
what enzyme is deficient in fabry disease?
alpha-galactosidase A -> buildup of globotriaosylceramide
globotriaosylceramide AKA
ceramide trihexidase
early presentations of fabry disease?
triad of episodic peripheral neuropathy, angiokeratomas, hypohidrosis
late presentations of fabry disease?
progressive renal failure, cardiovascular disease
inheritance of tay-sachs disease?
AR
which enzyme is deficiency in tay sachs
hexosaminidase
what builds up in tay sachs?
GM2 ganglioside
presentation of tay sachs disease?
- cherry red spot
- progressive neurodegeneration
- hyperreflexia
- lysosomes with onion skin
- NO HEPATOSPLENOMEGALY
are sterile gloves used for contact precautions?
no - you can use nonsterile gloves for contact precations with patients
advantages of using propofol for anesthesia?
-it can be used for both induction and maintanence
-it reduces airway resistance
-
disadvantages of using propofol for anestheisa?
-may cause vasodilation resulnting in hypotension
advantages of using etomodate for anesthesia?
-hemodynamically neutral - can be used in patients with hemodynamic instability
disadvantages of using etomodate for anesthesia?
-can lead to adrenocortical suppression -shouldnt be used in patients with septic shock and only used to induce anesthesia
advantages of using ketamine for anesthesia?
- preserves respriatory drive and has analgesic effects
- stimulates catelcholamine release which can lead to bronchodilation
other effects of ketamine?
-increases HR, myocardial contractility and cerebral blood flow
how may the distribution of a drug differ in neonates?
-they have more total body water compared to adults so water soluble drugs have greater volumes of distribution and may need different dosing to be as effective
name two types of water soluble antibiotics?
vancomycin, aminoglycosides
how do neonates differ in their level of plasma proteins compared to adults?
they have LESS plasma proteins, thus protein bound drugs may have an increased effect leading to toxicity
treatment of neuroleptic malignant syndrome?
- dantrolene or bromocriptine
- stop antipsychotics + supportive care
normal LV pressures?
120/10
normal aortic pressures?
120/80
which type of muscle fibers are postural muscles?
type I - slow twitch
how can you identify pseudogout on fluid aspiration?
RHOMBOID shaped crystals of calcium pyrophosphate
when copper leaks from the liver in wilsons disease, where will it deposit?
basal ganglia and the cornea
does diabetes mellitus commonly occur in wilsons disease?
NO - thats associated with hemochromatosis
epithelium of the ovary?
simple cuboidal
epithelium of the peritoneum?
simple squamous
treatment of orotic aciduria?
uridine
diagnostic weight for anorexia?
<18.5
saw tooth rete ridges are characteristic of…
lichen planus
5 P’s of lichen planus
Pruritic
Purple/pink
Polygonal papules
Plaques
where does the greatest airway resistance occur in the lower respiratory tract?
medium-sized bronchioles
how is oxalate eliminated in a healthy bowel?
-dietary calcium binds to dietary oxalate producing an insoluble complex that is excreted in the feces
why is there an increased risk of oxalate kidney stones in crohns diseaes?
-calcium forms soap complexes with the excecss fat in the intestine, and thus cannot complex with oxalate. More oxalate is reabsorbed instead leading to an increased risk for oxalate stones
why are non-selective beta blockers (propranolol not used for MI)?
they can cause bronchospasm in patients with underlying lung disease
in watery diarhea (non-inflammatory diarrhea) what will be found in the stool?
NO rbcs and NO leukocytes
in dysentary (inflammatory diarhhea) what will be found in the stool?
Fecal polymorphonuclear leukocytes, with our without RBCs
medial border of femoral triangle?
adductor longus
presentation of huntingtons disease?
- uncontrollable jerking movements
- dementia
- hallucinations
- facial movements
- speech impairment
- mood changes
presentation of parkinsons disease?
Muscle rigidity
bradykinesia
resting tremor
postural instability
what is the most common arythmia in someone with an infeior wall MI?
sinus bradycardia
If a patient with an MI develops bradycardia what can you give them?
atropine
what arythmia is adenosine useful for?
paroxysmal supraventricular tachycardia
which organs cannot use ketones for energy?
- the liver
- RBCs
can the brain use ketones?
yes
how does ionizing radiation cause cell death to cancer cells?
- DNA double stranded breaks
- produces oxygen free radials that cause cell death
which type of radiation causes thymidine dimers?
non-ionizing
what causes malignant nephrosclerosis of the kidneys?
hypertensive emergency
histopathology of kidneys with malignant nephrosclerosis?
- Fibrinoid necrosis-cell death and fibrin deposition in the arteriolar cell walls
- hyperplastic arteriolosclerosis-onion skin appearance -activated platelets and injured cells release growth factors leading to concentric hyperplasia and intimal thickening
how is chikungunya spread?
aedes mosquito
what is the hallmark of chikungunya ?
severe joint symptoms such as polyarticular arthralgia
most common cause of mitral stenosis?
previous rheumatic fever
