GOLJANFINAL Flashcards
INC ESR in elderly - normal or abnormal?
Most likely disease released
VIt E tox presentation?
DEC VitK - INC risk of hemorrhagem =- potentiates warfarin effect
Chance of male/female w/ CF to have kid?
Male - less than 5%Female - possible - but still thick cervical mucus
Laurence moon biedl?
Hyogonadism, MR, retiniits pigmentosum
Noonan syndrome
Turners in a male (webbed neck, short stature MR, hypogonadism etc)
3 major tox of cyclophosphamide?
SIADH, Hemorrhagic cystitis, transitional CA of bladder.
What is goats milk deficient in? (compared to cow milk)
Goat is low in Folate, B6, and Iron.
Tx of black widow bite?
Muscle relaxant (calcium gluconate) - tetanus prophylaxis, antivenin in serious cases.
Tx for aspirin tox in kids?
gastric lavage, activated charcoil - alkaline urine for INC excretion of acid.
Angiosarcoma of LIver - 3 risks factors?
Vinyl chloride, Arsenic, Thorotrast.
Age dependentsenile changes?
Senile emphysema, DEC FEV1, osteoarthritis, cataract,s presbycus (inner ear degen), INC synth of autoab. INC CD4 and DEC CD8.DEC in GFR - care it avoid tox.
Bombesin seen in ? 2
Small cell CA of lung, Neuroblastoma. Neuro marker?
CA19-9CA125CEA?
19-9 - Pancraetic CA 125 - ovaries surface epithelialCEA - Colorectal, pancreas and more.
Where are zebra bodies found? What do they look like?
See in nieman picks - look like lamellar bodies in T2 pneumocytes.
Vit A tox?
INC ICP, hypercalcemia.
Diff between rickets and osteomalacia?
Both are due to ICN unmieralized osteoidAdult - do NOT have craniotabes and rachitic rosary (rickets)
B6 def? Most common?In babies?
IsoniazuidBabies - switching to goats milk (lacks B6)
Menckes kinky hair syndrome
Sex linked recessive - impaired utilization of COPPER. (different presentation than wilsons)
Wilsons copper levels?
Total levels are DEC (lower ceruplasmin carrier)But serum free levels are INC.
Selenium 2 major functions?
Anti-oxidant that destroys peroxides.Enzyme cofactor for T4 to T3 converstion
Zinc def can lead to ? 3 thiungs
Hypogonadism, infertilityDEC tastePoor wound healing (needed for collagenases to make T3 conert to T1)Acrodermatitis enteropathica (Recessive disease w/ DEC intestinal abs or zinc)
Tx for methemoglobinemia?
Nitrites in wataer (camping trip) oxidizes iron=.Methylene blue plus Vit C.
Councilman bodies? Where and why are they seen?
Seen in liver - acidophilic - seen in yellow fever and other viral (heptitis)
Fanconi Syndrome
DEF in DNA repair - cross linking agents
Barbituates and porphyrin disease?
Barbiturates
Levels of alk phos in kids?
INC in kids - due to osteoblasts and boen growth.
3 things that DEC adhesion molecule synthesis?
Steroids, Lithium, Catecholamines. (INC by c5a, LTB4, IL1, TNF, endotox)
Cri-du -chat organ findings?
VSD
T2 tubular acidosis?T1 acidosis?
T2 - proxmial - unable to make bicarbT1 distal - cant secrete H as well.
Nickel can cause?
Lung CA, Nasa Cavity CA
Uranium (Rardon)
Lung CA
Woodworking
Nasal cavity CA
Cadmium
Prostate CA, lung CA (fossil fuels, iron, steel, fertilizer, cement)
Tars, soot, oils
Squamous CA of skinAlso scrotum in chimney sweeps
EKG findingsHypoKHyperK?
HypoK - U wavesHyperK - peaked T waves
Breast primary CA mets to where?> 3
LN, Lung, BOne - most likely from breast
Lung primary CA mets to where ? 3
Liver, Adrenals, Brain
CO poisoning -w here would you see it on neuroanatomy?
Globus pallidus
Most common bone metastazied to? Why?
Vertebra - Batson vertebral plexus communicates w/ vena cava.
Detection of Rotavirus?
Rotazyme test of stool.Elisa test w/ ab against virus.
Achalasia vs Hirschprungs?
Achalasia is just myenteric ganglionHirhsc - submucosa (meissners) and myenbteric)
Most common cause of blindness in AIDS?
CMV retinitis
Metyrapone does?
Blcoks 11 hydroxylase DEC cortisolWhich should INC ACTH. Excellent check for ACTH reserve and adrenal function.
When is rupture most common acute mI?
3rd to 7th day.
Sepsis in Aids pt usually due to?
Disseminated mAI
Baby w/ icterus and edema - form which virus?
usu CMV.
ALS can be due to?
defective superoxide dismutase - intrinsic hands are first starting point
What does the fewver in malaria coincide w/
rupture of RBC
Best protection against syph?
condom
Most common cause of esophageal CA?
smoking
Aschoff body
pathognomonic for RF.coffee bean
Tetracycline in a soccer or baseball player?
basically photodermatitis - face, neck, forearms etc.
Necrobiosis lipoidica diabeticorum
diabetic lower leg w/ pigemnted lesions.
First step of menarche?
breast budding - thelarche.
Senile purpura
normal age dependnet finding - not a sign of pt abuse. can be on hands.
Kid with rash and CD1 positive cells?
histiocytosis X - lorib Ketterer Siew
Elderly male w/ lower back pain? do?
rectal eam to rule out prostate CA before any other test.
String tests - AIDs pt w/ diarrhea -w aht can be identified?
Giardia, strongyloides, cryptosporidum.
Hammans sign?
subcutaneous emphysema from rupture esophagus (boorehave)
Most commonc ause of alopeica?
Hereditary - more common in males.
Irregular patche of hair loss in kid?
trichotillomania - pulling out onhes own hair - esp near dominant hand.
lactic acid levels do not rise afte exercise w/ cramps?
Mcardles
Most common cause of juandice in first 24 hours
ABO incompatibility. mom and baby
Most common cause of folate def?
alcohol abuse (not beer)
Role of fiber in DEC Colon CA?
DEc tranist time of stool - lithocholic acid has less chance of producting a mutation
Asymptomatic AA w/ hematuria ? what next?
do sickle cell screen rule out trait.
Gold standard of AAA?
ultrasound -
Burkitts most common location?
ab cavity - most common lymphoma in children.
Antimicrosomal AB in 2 disease?
Hashimotos and Graves.
HTN in young woman?
birth control pills INc synth of angiotensinogen in liver HTN.
Feltys syndrom
RA + autoimmune neutropenia and splenomegaly
Most common breast CA?
infiltrating ductal
Only leukemia to have thrombocytosis?
CML
Hemangioma on face of kid
leave it alone
Anemia since birth, splenomegally
congenital spherocytosis. do splenectomy
aplastic anemia bone looking?
hypocellular w/ predominantly fat
fatty casts w/ maltese crosses
neprhotic syndrome
4 locations of psamomma
meningioma, papillary thyroid, serous cystadenoCA, mesothelioma
DM most common cuase of 5?
blindnes,s chronic renal disease, peripheral neuropathy, nontramuamatic amputation of lower leg.
Hamman Rich LUng
honeycomb lung - end stage alveolitis syndrome - internstiail pneumonitis.
Most common cause of fever 24 hours surgery
?atelectasis. Elevated diaphragm
Choanal atresia presentation?
baby breaks away from breast and cyanosis is relieaved w/ crying.
Smokeless tobacco leads to?
verrucoid squamous CA of mouth
5 causes of gum hyperplasia?
phenytoin, cyclosporin, verapamil, pregnancy, scurvy, Acute monocytic leukemia
Most common tumor of GI tract?
Leiomyoma - usu in stomach.
Bowel obstruction most likley due to?
adhesions from previous surgery - if no previous histoyry - indirect inguinal.
Zone 3 necrosis?
CCl4, acetaminophen, amanita, alcoholic, ischemicZone 1- viral, cocaine
Granulomatous hepatitis
Tb if infectivesarcoid if noninfective
Schiller duval bodies
yolk sac tumor in kids - INC AFP. endodermal sinus tumor.
IUD infection
actinomycosis w/ sulfur granules.
Duffy antigenI antigen
uncommon in blacks.Surface receptor for P vivax - so blacks are protected. I antigen - antiI is cold agglutinin IgM from M pneumonia.
Osgood schlatters
inflam of proxmial tibial at insertion of patellar tendon
Glucagonoma classic sign?SomatostatinomaVIPoma?
Glucagonoma- necrolytic migratory erythema. Somatosiatinoma - achlorhydria, cholethiiasis, steatorrhea (inhbits secretin, CCK)VIPoma - severe secretory diarrhea - VUIp stims cAMP - hypokalemia w/ normal gap metabolic acidosis
Oligodendrioglioma findings?
egg like - CALCIFIED SHELLS.
Kidneys w/ irregular white patches on cortical surface?
pale infarts from embolization of left heart.
Number of glucose to make 16 chain carbon fatty acid?
4 glucose - 8 pyruvate - 2 carbons each.
3 major uncupling agents
alcohol, slaicylate,s 24bnp
Glucokinase
only in liver - not inhibited by glucose 6 phosphate (can just keep bringing more in)
Why cant liver use ketones for fuel?
Liver cannot activate acetoacetate in mitchondria
Energy source for protein synth?
GTP
hair loss in young woman
may be due to oral contraceptives
7 fold memrane psannning protein
Propanolol - B blocker
Negative charge in GBM due to?
heparan sulfatealthough protamine suflate is Positive(heparin is negative)
Gap junction
dye passes from cell to cellosteoblast/cytes + intercalated, cardiac
Nosebleed and rhinorrhea
fracture of cribirofrm plate in ethnoid isnus.
Artery in femoral neck fracture
medial femoral circumflex
Type of colalgen in epiphyseal plate?
Collagen T10.
Vertical diplopia assoc w/
CN4 palsy
Bilateral Lateral rectus (Cn6) weakness suggests
INC in ICP - classic sign - papilledema
Paralysis of Upward gaze?
In infants - hyderocephalus - secondary to stenosis of aqueduct of sylvius. (parinauds syndrome)
Multiple ocular motor nerve disorders
DM
IMpairments of L3-L4L4 - L5L5-S1
L3-L4 - weak quads and absent knee jerk L4-,5 Numbness of great two webbed space, normal knee L5,s1, - lateral and posterior calf numbness.
Weber syndrome
lesion of oculomotor nerve w/ UMN signs w/ midline midbrain lesion.
Damage to ear in rock and roll palyers
injury to cochlea
Hanta virus
New mexico - deer mice/rodents - ARDS, hemorrhage, renal failure. Viral RNA in lung tissue (PCR test)
Cells taht attack protozoa
CD4 T.
Immunizations contraindicated in pt w/ anaphylactic reactions against eggs
MMR
Pruritic skin lesion in gulf war vet
cutaneous leishmania - bite of sandfly.
Which live vaccines can be given to Aids PT
MMR - measles is worse than what could happen w/ attenuated virus.
If you have rx to neomycin, then will have anaphylacitc rx to
MMR, Varicella - neomycin is used as preservative.
HLA coded on what chr?
6
Graft vs host is mediated by?
NK cell mediated - I am assuming some T cells too..