General 2 Flashcards
A case control study is descriebd as
what is the outcome measured by
looking at the cases (people with the dz) vs the controsl (people without the diz)
Odds ratio (what are the odds of the dz
COHORT is RISKY
where in the nephron is the lowest oms?
DCT
in familial dyspbetalipoproteineimia III, what is dysfunctional?
APOE 3 or 4
can’t reuptake VLDL or chylomicrons so they acucmulate
aortocavitary fistulas are an uncommon side efect of what?
what does the blood flow look like?
IVDA
flows from aortic root to r ventricle continuously (high pr essure to low pressure, L-R shunt)
leads to continous murmur
psuedomonas looks like
is tx with?
cefipime (amonf others)
In e coli HUS, what type of bilirubin is elevated?
serum indirect bilirubin is eelvated
besides metronidazole, how can you treat BV?
clindamycin
(metro below the diaphragm, clinda above, except for BV)
in a subarachnoid hemorrhage, willm you see intracerebral hemorrahge or blood in the sulci?
blood in the sulic
what normal process in the liver is inhibited in alcoholics leading to hypoglucemia?
gluconeogenesis
pyruvate to acoa is thiamine depednent
aKG to succinyl coa is thiamine depdenent
NADH is required throughout
both these are oftend depldeted in alcoholics
what are the main complications of sjogrens?
dental caires, corneal damage
NHL
what are the findings of hyperIgM syndrome?
where is the SI biopsied if worried about celiac dz?
if theyre describing 3syphilis to you and they tell you the pt has a genital lesion, will it be a chancre or a gumma?
a gumma if it’s 3’
a condyloma lata if it’s 2’
a chancre if its 1’
schistocytes indicate what dz?
what occurs to haptoglobin levels in this state?
hemolytic anemia
haptoglobin decreases
a floppy baby with little hard poops, enlarged fontanelleae, umbilical hernia, protruding tongue , ? juandice can indicate what?
hypothyroidism
what are the s/s of hyperphosphatemia?
what can cause it?
hypocalcemia
CKD
crytpococcus neofrormans will have a + what test
india ink stain
latex agglutination
cx on SArbourd agar
think of Dr. Sarbourd in india cleaning the crypts with latex gloves on
a lesion to the inferior pons will compress which nerves?
V
VI
VII
VIII–nystagmus
is EF preserved in hypertrophic cardiomyopathy?
yes, weirdly
what are some common causes of NAGMA and HAGMA
how do triptans work?
5HT1b1d agonists that bind to trigeminal r and inhibit CGRP and cause vasoconstriction
what class of drugs in Alzheimers can precipitate bradycardia and AV block?
anti cholinergics, donespil, rivastigmine, etc.
what is the defense against Giardia?
IgA and CD4 celsls
alanine is converted to what to make glucose?
aKG
is the muscularis thick or thin in Chron’s disease?
Thick!
C-chrons, C-thiccc
in diverticulosis, what are the muscle laywers involved?
there is no muscularis propia in the diverticulm
high frequency deep brain stimulation can be done where in the brain for Parkinson’s?
subthalamic nucleus
results in thalamocortical disinhibition
what is the cause of jejunal/ileal atresia?
vascular occlusion/anomaly
where is collagen synthesized?
in the RER
what is the PaO2, SaoO2, and O2 content in chronic blood loss?
PaO2 andSaO2 are normal
O2 content is decreased
what demarcates indirect vs direct inguinal hernia
the inferior epigastric vessels
what nonvesciular rash can be seen with HSV?
erythema multiforme
remmeber the edward cullen looking guy from sketchy with his rash
Azithioprine has what effect on B and t cells?
Decreases B and T cell count, decreases Ig and Il2
what pathogenic mechanism causes the cavitary lesions in TB?
leukocyte aggregation (activatED()
what is the MOA of sevelmer
oral phosphate binding resin that reduces systemic absorption of pO, typically used in CKD
what is the only prokaryotic ploymerase to have 5-3’ exonuclease activity?
DNA polymerase 1
where is the binding site for complement on Ig?
Fc region near the hinge
wht is a contraindication to testosteorne therapy/
hematocrit >50%
how does congenital hypothyroidism occur?
transplacental trasnfer of thyroxine
hypermobile joints and elastic skin think
ED-collagen synthesis defect
it’s never marfans, elizabeth. really. it’s not.
anterior nose bleeds occur where?
in the septum in Kesselbauchs plexus made up of
anterior ethmoidal
sphenopalatine
superior labial arteries
activation of which receptor type leads to immedaite flux of Na, Ca, and K?
nichotinic cholinergic R
most sporadic colorectal carinomas are due to mutation in what?
APC tumor supressor
learn this babe
h pylor might be described as what
an ulcer that when tested for pH turns red (high pH)
pH is high because of ammonia (urease)
Lactate Dehydrogenase is high in infections/injury and causes acidosis. under ischemic conditions, what is inhibited, causing this build up?
pyruvate dehydrogenase
what do eosiniphils look like?
what is their function?
destruction of helmonuths
how does prostate cancer metastasize to the lumbar spine?
prostatic venous plexus
what can you give with methotrexate to mitigate some of the folate related side effects?
whats another name that could be used because UW is a butthole?
leucovorin
folinic acid
strep pneumo is described how
what is it’s virulence factor?
how does the VF work?
gram + in pairs (+- lancet shape)
polysaccharide capsuel (armor in skeychy)
makes it resistant to phagocytosis
facial pain, headache and a nasal eschar in a pt with redcent DKA, what is the dx?
how do you dx?
mucor or rhizopus
nasal mucosal biopst
how do you calculate TPR
describe the pathogenesis of b12 def in autoimmune gastritis?
autoimmune response that makes B cells which make autoab
autoimmuune response activates CD 4 T cells which attack the parietal cells and decrease them
this decreases gastric acid secretion and intrinsic factor
this leads to increase gastrin secretion by G cells in antrum and B12 def.
what might a pilocytic astrocytoma look like on mri
what are some other features?
rosenthal fibers, hair like projections, GFAP + frequently in the cerebellum, present with cerebellar signs/sx
if you think it sounds like a cushing syndrome, what else could it be?
lipodystrophy from antiretrovirals
what action does the supraspinatus primarily do
EXTENSION
S-for Sextension supraspinatus
s/s of dermatitis herpetiformis
steatorrhea
erythema and pruritis on the extensor surfaces with bullae and vesicles
IgA deposits
increased intestinal intraepithelial lymphocte s
low levels of what in the urine are found in those with increased calium oxalate stones?
low urinary citrate
what enzymes are antioxidants?
which aare proxidants?
superoxide dismutase, glutathione peroxidase, catalase
NADPH oxidase
what drug class is used to treat priaprism /prolonged erection?
a1 adrenergic agonism
it’s agonizing to have A boner for tht long
you got this one babe
what does a fluid volume sqaure look like with DI?
know the different eting disorders
tbh this question was kinda stupud
biotin is used in the conversion of what to what
and others
pyrivate to OXA
describe coronary autoregulation in the setting of significant stenosis (>50%)
perfusion pressure decreases but vasodilation allows blood flow to stay relative constant
what vein can be occluded by pancoast tumor or trombosis leading to unilateral venous dilation, facial plethora?
brachiocephalic vein
where are central lines placed?
what embryo does SVC come ffomr?
into the IJV or Sbclavian V until they reache the SVC
cardinal vins
ICS increase the responsiveness to what other asthma drug?
B2 R agonists (buy upregulating B2R)
nitroprusside does what to preload and afterload in CHF?
decreses preload and decreases afterload
what is the histology of a myxoma?
amorphous extracellular material
warfin indujced skin necrosis can be precipitated by underlying
protein C def.
leads to transient hypercoag state and microocclusions
is VQ ratio increased or decreased in exercise?
increased~
is the serpentine cord in TB related to acid-fastnes or virulendce?
virulence (lassoing the cells)
defect in CD18 means
what will you see on cbc?
leukocyte adhesion deficiency
persistent leukocytosis
what glucose metabolism disorder is symptomess?
fructokinase def.
gets shunted over by hexokinase
sertoli cells make ___ stimulated by ____
Ledig cells make ___ stimulated by ___
inhibin; FSH
Testosterone, LH
atelectasis (white out lung) will have tracheal deviation
towards the affected side
what is a type of PBP?
transpeptidases
describe FGF23 and phosphate metabolism?
suppresses vit D
inhibits renal reabsorption of phost.
does heparin prolong both pt and ptt?
apparently
in aplastic anemia, what is the MCV and the haptoglobin?
normal and normal
h pylori can lead to what
which can cause what?
multifocal atrophy
Maltoma
what does mitral stenosis look/sound like?
antiPLARy2 ab in the setting of nephrotic synfomr mean wha?
membranous nephropahy
what is pathonuemonic for dibaetic nephropathy on histology?
kellemer wilson lesions
understand mosaicism
what to auer rods look like?
what cancer is this most seen in?
AML, especially APML 15;17
what type of cell makes IL2?
t cells
more stats stuff that my brain STRUGGLES with
ope ya missed a AIP quest, who’s surprirsed?
you got this one wrong before—
blind vag, bulge in inguinal area, looks like a female
high testosterone
x linked mutation in androgen receptor
what do you treat pheochromocytoma with?
phenoxybenzamine (names sound similar)
a difference in phenotype despite same genes measn what?
variable expreability
how do nitrates effect HR and EDV of the LV?
increases HR
decreases EDV
this reduces O2 demand on the heart by decreasing preload
describe Albright’s herediary osteodystrophy?
what is the endocrine issue?
what is that?
short stature with short fingers and toes
hypocalcemia, hyperphosphatemia
high PTH
psuedohypoparathyroidism
resistance to PTH in the end orfans
allelic heterogenity describes what?
same phenotype
different genotype
hepatomegaly, gonadal dystrophy, and joint pains in the setting of hyperpigmentation indicates hwat?
hemochromotasis
elevated dermal hemosiderin deposition
portal hypertension can lead to blood backup in what vessel?
splenic vein
splenic congestion and splenomegay
due to retrograde flow from the liver
if you see yellow/tan honey crusting over skin, even if it’s a burn, what bacteria is it?
staph aureus causing impetico
what mechanism does psudomonas use to be abx resistant?
efflux pumos
where is preproinsuline found?
cytosl (N-terminal)
a-ketoacid dehydrogenase def is seen in waht?
what cofactor is needed for this reaction?
maple syrup urine dz
thiamine
if testosterone is low in the smeiniferous tubules and epipdiymis, what is missing?
sertoli cells that secrete ABP and bind up the testosterone in that space
glucagon is mediat4ed by what recepotr?
GPCR
what causes hypoglycemic, hypoketotic syndrome after prolonged fast?
ACoA dehydrogenase deficiency
last minute memorize list
how do you treat hepatic encephalopathy?
wjat is the MOA?
lactulose
acidifies the intestinal lymen
NH3 converts to NH4
if warfin does stuff to cypc19, does cyp450 still change it>
yes
the two hit hypothesis
germline has one inactivaated allele
secondhit happens during life
know these!
if recurrent laryngeal nerve is affected, which muscles are affected?
posterior cricoarytenois
lateral cricoarytenois
oblique orytenoid
transverse areythenoid
thyroarytenoid
ALL the arytenoids
DNA viruses besides except poxviruses, replicate where?
RNA viruses, except orthomixo and retro, replicate where?
in the nucleus
in the cytoplasm
what does hashimotos look like?
wwhere is broca’s area?
post-ganglionic autonomic nerves are myelinated or nonmyelinated?
nonmyelinated!
what are some weird less common sx of iron def. anemia?
reduced taste sensation, burning sensation in mouth and lip dryness
stop getting this wronggggg
prader willi
deletion
duplication
paternal deletion
maternal duplication (disomy)
opposite for angelmans
if it doesnt transiliminate and disappears when you lie down, what is it?
varicocele
when using antiandrogen, what happens do testosterone,
it decreases in synthesis (over time)
CATCH-22 in Digeorge syndrome, what does the first C stand for?
conotruncal caridac defects
incluide truncus arteriosus
last minue memoriziation
aspergillus can look like what
can stain with what?
methenamine silver
i dont understand vit d and phosphate
damage to the middle cerebral artery can cause what vision defect?
homonymious hemianopia
know the sleep disturbances
what is an example of developmental field defect?
holoprosencepahly due to trisomy 13 or other mutations and environment like ETOH or reintoids
initlial defect leads to a bunch of issues
what’s more common in down syndrome, duodenal atresia or pyloric stenosis?
duodenal atresia (D-Downs. D-duodenal)
What part of the tibia is affected in Osgood Schlatter syndrome?
the tibial tubercle
what test do you order if you think someone has trichomonas?
wet mount
n-MPO antibodies are the same as
PANCA
(eosinophilic granulomatosis with polyangitis is one example)
which cholesterol drug class can increase triglycerides?
bile acid binding resins (cholesturamine)
deos maternal IgM cross the placenta?
can neonate make own IgM and IgG?
no, but IgG can
yes
what type of transporter is GLUT4?
facilitated diffusion (carrrier mediated transpot)
helpfu; HIV drugs
RBF and GFR increase or decrease in pregnanct?
creatinine increases or decreases in pregnancy?
increase
decrease
total vascular systemic resistance increases or decreases during stress/exercise?
decreases to help get blood to more places
in atrial fibrillation, clots are likely to get thrown. what organs are susceptible to these infarctS?
brain and kidneys
which branch of tirgeminal will cause muffled hearing and pain with mastication (pterygoid syndrome?)
mandibular branch V3
what parameters are changed with vsd?
which part of the pancrease is derived from the ventral pancreatic primoridum?
main pancreatic duct
know these correlation coefficient graphs
in addition to proteus, what else can cause large staghorn calculi?
KLBSIELLA (like the horn on the dinosaur in sketchy)
besides pseudomonas and staph aureus what else likes to wreak havoc in CF patients?
Burkholderia cepacia sinopulmonary infection
someone who hasn’t traveled/drank bad water, and has a liver absecess, what is the likely cause?
staph aureus hematogenous spread
most liver absdcesses in the usa are from bacterial sources
what type of immunity and which cytokine is the primary driver of giant cell arteritis?
cell mediated, IL6 (not MPO anca)
inhbition of what is very good at targeting T and B cells cancers?
ADA inhibitoin (cladrinbine)
what sort of defect can lead to increased risk of testicular torsion?
anatomical defect increasing mobility (bellclapper abnormalitiy)
know these elizabethhhh
what are the manifestations of sciatic nerve injury?
weakness in dorsiflexion and plantar flexion
weak knee flexion
cranial nerve palsies in diabetics can be caused by?
diabetic mononeuropathy due to vacular ischemia suplping the nerve
in pt’s taking large amounts of albuterol, what can happen to K?
large intracellular shifts of K leading to hypokalemia
addtive efects and synergysim mean what?
by comparison, permissiveness means what?
two drugs function towards the same end goal and increase towards that same goal when used together
permisiveness is when one drug doesn’t do anything to achieve X goal but when given with a drug that does achieve X goal, it increases the efficacy
in doing surgery of the right atrium, what nerve is most at risk of injury?
the phrenic nerve
reccurent laryngeal is most at risk during thyroid surgery
what do the extra ocular muscles look like on MRI?
what nerve supplies lateral rectus? ABDUCENS
subacute thyroiditis aka
granulomatous, De Quervians
thyroid pain, fever, initially hyperthyroid then hypothyroid
elevated thyroglobulin
decreased radioactive iodine uptake
pt’s with bleeding, bruising, swollen gums, ecchymoses, etc, what is the porblem?
what is the problem in scurvy?
scurvy (vit c defi)
collagen synthesis is messed up
can’t undergo hydroxylation of proline and ;ysine
asymetric breathsounds in a neonate should make you think of what right away?
diaphragmatic hernia leading to pulmonary hypoplasia
“slapped cheek” rash, is what virus?
what cell is infected in parvo?1
parvo
erythrocytes
how does bacterial resistance develop for aminoglycosides (streptomucin)
mutation in ribosomal proteins
transferase mutations
porin mutations
what is increased/decreased in TOF?
RVOT causes blood thru pulm artery to be blocked, leading to decreased pressure in the pulm artery (cuz no blood), but the R ventricle presure is increased cuz its’ stuck. L atrial pressure is decreased because blood can’t get form r to l very well.
1st gen antipsychotics
2nd gen antipsychotics
EPS
metabolic syndromes
what are the s/s of osteomyelitis?
fever, refusal to bear weight
inflammation and icnrased uptake of radiotracer
affects long bone metaphysis
if it says there is no immune complex deposition or immunoglobulin depsition, what must it be?
pauci immune (ANCA)
what is the cardiotoxic pathology ot trazutizumab?
decreased cardiac contractility with no fibrosis or necrosis
often reversible
what do you treat PAH with?
endothelin receptor antagonist-bonsentan
elvated AFP in serum and Achesterase in amnio can indicate what?
anencephaly
failure of fusion of the edges of the neural plate
chorioretinitis, brain calcifications, hepatomegaly, juanice, all inidcate which TORCHES?
toxoplasmosis- can get form undercooked meat
misclassification bias is a type of what?
recall bias
what is the most common bacteria and virus in COPD exacerbations
h flu and rhiniovirus
vertebral factures are pretty pathonumo for what>
PTH and Ca levels are what in this dz?
osteoporisus
normal
pericardial knock is heard when?
acute pericarditis is indicated when
early diastole, shortly after S2, easy to confus with S3
assoz with constrictive pericarditis
pain improves with leaning forard, hear a friction rub
unfractionated heparin and direct thrombin inhibitors (gabatrans) will prolong what time?
direct Xa inhibitors will prolong
trhombin time
PT and PTT but not thrombin time
if BMI is <18.5, what is the likely dianosis
anorexia (could be binge purge, so don’t think it’s bulimeia )
antigenic variation allows
bacteria to reinfect the host, esp if only IgA and IgG ab are formed which aren’t great long term
PEs can cause right ventricular cavity to increase or decrease in size?
increase in cavity zise (dilation) rather than hypertrophy
what are the s/s of TCA overdose?
tachycardia, delirium, dialed pupils
orthostatic hypotension
conduction defects/arrhythmias
SZ/tremros
sedation, increased apetite
a pt just had a stroke because of peripheral artery stenosis in the carotid, what drug may be added?
what is a complication of said drug?
Aspirin
gi bleed
waht changes with old age in reference to dixogin?
liver or kidney?
renal clearnace of the drug can diminish with age and cause yelow vision amon ogher s/s
porcelain gallbladder is assox with which gallbladder Ca?
adenocarcinoma
cholangiocarcinoma is assox with fibrosis from fluke or pimrary sclerosing cholangitis
diphtheria can undergo what process to incresae what kind of toxin?
phage to make exptoxin
features of TTP?
can you be aware during focal onset seizures?
yes
what is teh defect in alkaptonuria?
def of homoginstic acid diogenase
can’t turn tyrosine into fumarate for teh TCA
black pee
posteruir rostral pons in the near the lateral floor of the 4th ventricle, waht is secerete ther?
NE from locus ceruilis
is clubbing significant for COPD?
no unless there is underling malignancy
more assoc withn malignangy
mutliloped nutrophils are assox with cobalamin or folate def. ?
folate def.
Folate-4-8 lobed neutrophils (more like 6-8)
injury to the plantar foot can injure which enrve?
tibial nerve
loss of plantar flexion, stuch in dorsiflexion/feversion
live attenuated polio virus will lead to accumualtion of what ab?
duodena limunila igA because likes ot replicate in pyeers patches
fluid hydrothorax can occur in cirhosisi because of fluid movement where?
across the daipharem
first generation antihistamines can have what affects on what receptor?
muscaronic r antagonism leading to anticholinergic effects like dialted pupils and flushed chekes
aromatase inhitors include
these cantreat what?
letrozole, anastrozole, exemestane
ER+, HER- breast cancer
what makes the red stuff PAS + in whipple disease
glycoprotien
homebirth babies being brought in with downward gaze, AMS, bluging fontanel could have what?
ICH due to lack of vit K
spike and dome with sulver stain assox with lupus and diffuse thickening with neprhotic sx what is it?
membranous nephropahty
what does FSGS look like
what does membranoproliferative glomerulonephritis look like
what part of the ventricles is enlarged in huntingtons?
enlarged frontal horn of lateral ventricle
atrophy of caudarte nucleus
