HIGHEST YIELD 3 Flashcards
“cup-in-pencil or cup-and-pencil deformity”
- Psoriatic Arthritis
- Almost always accompanies skin disease, especially nail changes
- Mostly involves DIP joints of hands > feet
- Classical deformity is called “cup-in-pencil or cup-and-pencil deformity”
Erosion of one end of bone with expansion of the base of the contiguous metacarpal
There is often resorption of terminal phalanges
There is usually no osteoporosis
Most are HLA-B27 positive, RA factor negative
Characteristic findings
Tends to involve smaller joints of hand and foot more than larger joints
Asymmetrical joint involvement
Affects both the juxta-articular and articular margins of joint
PAIN ON THE LATERAL ASPECT OF THE ELBOW
- extensor carpi radialis brevis
largest nerve of the body
- L4, L5, S1, S2, S3
malignant mass at the scapular area opposite to 7th thoracic vertebra. lymph nodes affecting the back
- POSTERIOR AXILLARY LYMPHNODES
EJACULATION
- bulbospongiosus muscle contracts
proximal convoluted tubule; bowman’s capsule
- cuboidal/ low columnar epithelium; squamous epithelium
endothelium of cornea lined by
- simple squamous epithelium
cell lines influenced by by growth factors
- progenitor cells
synthesis of secretory proteins
- rough ER
fall on elbow, elbow dislocation
- most likely affected ULNAR NERVE
- least likely affected MEDIAN NERVE
INTERNAL SPERMATIC FASCIA
- fascia transversalis
vessel supply the adrenal gland
- abdominal aorta
- renal artery
- inferior phrenic artery
inferior mesenteric artery
- not involved in vessel supplying the adrenal gland
innervates the mediastinal pleura
- phrenic nerve
nerve blocked during circumcision
- pudendal nerve block
levator ani muscles
- pubococcygeous
- puborectalis
- iliococcygeus
- anococcygeal body
coccygeus
- is not part of levator ani muscle
gram (+)
- has no periplasmic space
too much lipid on the cell wall
- acid fast stain
have super oxide dismutase
- microaerophiles
isolate vibrio cholera
- thiosulfate citrate bile salts
virulence factor of stap aureus
- protein A
Enterohemorrhagic E.coli
EHEC
- microangiopathic hemolytic anemia
- thrombocytopenia
- renal failure
TB bacilli vs Mycobacterium species
- NIACIN
VIRULENCE FACTOR OF mycobacterium tuberculosis bacilli
- CORD FACTOR
TREATMENT OF LEPROSY
- DAPSONE
- RIFAMPIN
- CLOFAZIMINE
hereditary spherocytosis with pancytopenia
- ss naked linear icosahedral DNA virus
AIDS
CD4
- KAPOSIS SARCOMA
most dangerous type of dengue
- Serotype B
T- wave in the ECG
- ventricular repolarization
causes muscle to relax
- binding to ATP
control of respiration
- chemoreceptors group in the aortic bodies
responsible mainly of gastrointestinal secretion
- Parietal cells
blood transfusion reaction
- patient has antibodies which may lyse the type A RBC
sperm cell obtain their motility and ability to fertilized when they reach
- EPIDIDYMIS
aRt of studying fingerprints as means of identification
- dactygRaphy
physical injury which is located at the site of the application of force
- COUP-INJURY
JARRING OR STUNNING OF THE BRAIN
- Commotio Cerebri
preserving evidence
- Embalming
homicide wound
- site of wound of entrance has no point of election
body delay its rate of cooling
- acute pyrexial disease
not a proof that a victim is alive before burned to death
- scanty albumin/chlorides
should we waive our professional fees
- our colleague’s spouse
HEREDITARY SPHEROCYTOSIS
there is a defect in ANKYRIN in the RBC membrane
- progressive weakness
- associated with pallor and jaundice
- normocytic normochromic anemia
- wide RDW
- MCHC elevated
HEREDITARY SPHEROCYTOSIS
- HALLMARK HOWELL- JOLLY BODIES
- gold standard in diagnosis
OSMOTIC FRAGILITY TEST - TX SPLEENECTOMY
acute myeloblastic leukemia (AML)
- hypercellular marrow with scattered macrophage with abundant wrinkled green blue cytoplasm
- anemia (progressive weakness with pallor)
- jaundice
- night sweats and fever
- hemopoiesis (easy bruisability)
- hemorrhage EXTRA VASCULAR HEMOLYSIS (occasional gum bleeding)
Hereditary spherocytosis
- is the most common disorder of the red cell membrane and affects 1 in 2,000 people
- ANKYRIN
MYELODYSPLASTIC SYNDROME
- PANCYTOPENIA
- BMA result hyper cellular marrow with neutrophils that has 2 nuclear lobes
Acute lymphoblastic leukemia, also known as acute lymphocytic leukemia or acute lymphoid leukemia (ALL)
- Frequent or unexplained fever and infection
- MEDIASTINAL MASS
- BMA hypercellular marrow packed with lymphoblasts
multiple myeloma
- monoclonal gammopathy
- tumorous masses scattered throughout the skeletal system
- plasma cells (WBC that secretes antibodies)
MGUS may also progress to
Waldenström’s macroglobulinemia
primary amyloidosis
B-cell lymphoma
chronic lymphocytic leukemia.
common symptoms of multiple myeloma is
CRAB: C = Calcium (elevated), R = Renal failure, A = Anemia, B = Bone lesions. Myeloma has many other possible symptoms, including opportunistic infections (e.g., pneumonia). CRAB symptoms and proliferation of monoclonal plasma cells in the bone marrow are part of the diagnostic criteria of multiple myeloma.
- Bone pain affects almost 70% of patients and is the most common symptom
- is due to the overexpression of Receptor Activator for Nuclear Factor κ B Ligand (RANKL) by bone marrow stroma. RANKL activates osteoclasts, which resorb bone.
hamartomas
- young adult that has ROUND OPACITY SEEN ON CXR (most common location occurs in the lung 75% are benign)
ACUTE MYOCARDIAL INFARCTION
- coronary artery involved LEFT CIRCUMFLEX CORONARY ARTERY
Tertiary hyperparathyroidism
high blood calcium level
- uncontrolled diabetes
- neuropathy
- nephropathy
- retinopathy
- abdominal pain
- irritability
- hypercalcemia
- blood sugar 136
- (-) ketones
- increase parathyroid hormone
The basis of treatment is still prevention in chronic kidney failure
Tertiary hyperparathyroidism
high blood calcium level
hallmark in diagnosis of RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS
- EPITHELIAL CREASCENT
LONG STANDING GERD with dysphagia
- columnar metaplasia at the distal third of the esophagus
Oat cell lung cancer is
one type of pulmonary neoplasm that is common in persons who have smoking habits or in persons who frequent room with smokers as what happens with persons working in smoking permitted zones such as bars.
nodular hyperthyroidism spreads mainly via
- lymphatics
type IV hypersensitivity reaction
- erythema of underarm after changing deodorant
benign nephrosclerosis
- hyalinization of afferent arterioles with ischemic atrophy of nephrons
Fibroadenoma
- underwent cystectomy
- well encapsulated mass
- composed of elongated ductile structures surrounded by loose FIBROUS CONNECTIVE TISSUES
- arise in the terminal duct lobular unit of the breast
DERMATOLOGICAL MALIGNANCY WITH THE WORST PROGNOSIS
- Acral Lentiginous Melanoma
severe chest pain after binge drinking vomited 10x crackling sound at R lung hyperresonance absent breath sound ( SIGNS OF PLEURAL EFFUSION)
- BOERHAAVE SYNDROME
esophageal rupture
AV malformation
most common cause cerebral AVM
hemorrhage 45% of cases (acute onset severe headache) worst headache of patients life
epilepsy 46% of cases (loss of vision)
progressive neurologic deficit 21% (loss of consciousness due to venous dilatation)
- CT scan revealed SUBARACHNOID HEMORRHAGE
organophosphate poisoning
- parasympathetic effect
- ANTIDOTE PRALIDOXIME PLUS ATROPINE
- NO CONTRAINDICATION
AMPICILLIN-SULBACTAM
- The addition of sulbactam to ampicillin enhances the effects of ampicillin. This increases the antimicrobial activity by 4- to 32-fold when compared to ampicillin alone
Ampicillin/sulbactam should be given with caution in infants less than a week old and premature neonates. This is due to the underdeveloped urinary system in these patients, which can cause a significantly increased half-life for both drugs. - Based on its elimination, ampicillin/sulbactam is typically given every 6 to 8 hours.
Slowed clearance of both drugs has been seen in the elderly, renal disease patients, and critically ill patients on renal replacement therapy.
Reduced clearance has been seen in both pediatric and post-operative patients. Adjustments in dosing frequency may be required in these patients due to these changes.
KETOCONAZOLE
- GYNECOMASTIA
The less toxic and generally more effective triazole antifungal agents FLUCONAZOLE and ITRACONAZOLE are usually preferred for systemic use
FOSCARNET (foscavir)
-an antiviral medication used to treat herpes viruses, including drug-resistant cytomegalovirus (CMV) and herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2).
It is particularly used to treat CMV retinitis.
Foscarnet can be used to treat highly treatment-experienced patients with HIV as part of salvage therapy.
- DOES NOT NEED VIRAL ENZYME ACTIVATION
prove to have survival benefit in CHF
- CARVEDILOL (beta blocker B1 and B2)
hyper pigmentation of gingiva/ vermillion border
- addison’s disease
- treatment
prednisone
fluticasone
Smith–Lemli–Opitz syndrome (also SLOS, or 7-dehydrocholesterol reductase deficiency)
is an inborn error of cholesterol synthesis.[1] It is an autosomal recessive, multiple malformation syndrome caused by a mutation in the enzyme 7-Dehydrocholesterol reductase, or DHCR7.
The distal convoluted tubule (DCT)
is a portion of kidney nephron between the loop of Henle and the collecting duct system.
It is partly responsible for the regulation of potassium, sodium, calcium, and pH. It is the primary site for the kidneys’ hormone based regulation of calcium (Ca).
Cisplatin
It is used to treat various types of cancers, including sarcomas, some carcinomas (e.g. small cell lung cancer, and ovarian cancer), lymphomas, bladder cancer, cervical cancer,[4] and germ cell tumors.
Cisplatin
is particularly effective againstTESTICULAR CANCER; the cure rate was improved from 10% to 85%.
- tissue obtained for diagnosis ORCHIECTOMY
LIDOCAINE
treatment in digitalis induced arrhythmias
treatment for exercise induced asthma
- MONTERLUKAST
average annual growth of abdominal aortic aneurysm
- 3mm
MECKEL’S DIVERTICULUM
- Gastric mucosa
indication for TONSILLECTOMY
- > 3 INFECTION in ONE year
non smoker
solitary pulmonary nodule on plain radiograph with corona radiata sign
MALIGNANT NEOPLASM
most common premalignant lesion of the stomach
- ATROPHIC GASTRITIS
6 cm hepatic cyst of the left lobe
best treatment
- CT guided aspiration and sclerotherapy
Biliary colic is the term used
- to describe a type of pain related to the gallbladder that occurs when a gallstone transiently obstructs the cystic duct and the gallbladder contracts.
- most common form cholesterol gallstones
- treatment dietary changes
treatment for cholelithiasis and choledocholithiasis
- ERCP and endoscopic sphincterectomy
most common location of superior parathyroid gland
- dorsal recurrent laryngeal nerve, within 1 cm of the junction of the RLN and inferior thyroid artery
treatment of complete urethral injury after high speed motor vehicle accident
- suprapubic catheter
DIAGNOSIS and estimate PROGNOSIS of IHD
- Treadmill
hyperthyroidism
- low TSH
- normal FT3, FT4
most common cause of cerebral embolism
- ATRIAL FIBRILLATION
chronic HBV infection high replication state
- (+) HBsAg
- (+) IgG anti-HBc
- (+) HBeAg
- (-) anti- HBe and HBs
highest rate of rebleeding of peptic ulcer
- an ulcer with PLATELET PLUG SEEN FROM VESSEL WALL IN ITS BASE
sensitive indicator for DIABETES
- thickening of glomerular basement membrane
most common lesion on renal biopsy in HIV infection
- focal segmental glomerulosclerosis
A Pancoast tumor
also called a pulmonary sulcus tumor or superior sulcus tumor, is a tumor of the pulmonary apex.
It is a type of lung cancer defined primarily by its location situated at the top end of either the right or left lung.
It typically spreads to nearby tissues such as the ribs and vertebrae.
Most Pancoast tumors are non-small cell cancers.
The growing tumor can cause compression of a brachiocephalic vein, subclavian artery, phrenic nerve, recurrent laryngeal nerve, vagus nerve, or, characteristically, compression of a sympathetic ganglion resulting in a range of symptoms known as Horner’s syndrome.
most frequent sign of pulmonary embolism
- tachypnea
PTB re-treatment or relapse cases
- 2HRZES/1HRZE/5HRE
MOST COMMON CAUSE OF DEATH IN PATIENT WITH SYSTEMIC SCLEROSIS (SCLERODERMA)
- PULMONARY
“Erythema multiforme major” (Stevens–Johnson syndrome); which resembles “erythema multiforme”
- BARBITURATES
- CARBAMAZEPINE
- PENICILLIN
- PHENYTOIN
LEFT LOWER PARASTERNAL HEAVE
- Critical MS
high risk of developing ectopic pregnancy
- tubal sterilization
FHR deceleration contraction >90 secs.
- EQUIVOCAL HYPER STIMULATORY
biparietal diameter greatest transverse diameter in occiput presentation passes through the pelvic inlet
- ENGAGEMENT
most common cause of CHORIOAMNIONITIS
- ascending infection from the genital tract
hypertensive pregnancy treatment
- IV hydralazine
prevent pre-eclampsia
MgSO4 administration
- loading dose 4g IV and 5mg on EACH buttock then 5mg in alternating buttock every 4 hours up to 24 hours post delivery
monozygotic twins
- diamniotic, monochorionic
valvular disease may have improvement during pregnancy
- aortic insufficiency
PICA in pregnancy
- lack IRON
PAP SMEAR revealed atypical squamous cell
can be pre-malignant lesion
- IMMEDIATE COLPOSCOPY to diagnose and prevent cancer
most frequently missed gynecological exam
- breast examination
FULLY IMMUNIZED CHILD
- 1 BCG, 3DPT, 3 OPV, 3HiB, 1 MEASELS, 3 HEPATITIS B vaccine before age 1
recurrent respiratory infection
low IgG
negative Schick test
reduced B cell
- transient hypogammaglobinemia in infancy
Transient hypogammaglobulinemia of infancy
is a form of hypogammaglobulinemia appearing after birth, leading to a reduction in the level of IgG, and also sometimes IgA and IgM. (The ratios of immunoglobulins vary rapidly in all infants, and the term dysgammaglobulinemia, although theoretically applicable, isn’t usually used in this context.)
It can result in increased infections, but it can also present without symptoms
trachea the coin in the esophagus
- edge of the coin on lateral view
- flat surface in AP view
Breast milk jaundice
Whereas breast feeding jaundice
is a mechanical problem, breast milk jaundice is a biochemical occurrence and the higher bilirubin possibly acts as an antioxidant. Breast milk jaundice occurs later in the newborn period, with the bilirubin level usually peaking in the sixth to 14th days of life. This late-onset jaundice may develop in up to one third of healthy breastfed infants.
leading cause of death among infants
- congenital abnormalities
probability of rejecting null hypothesis
- alpha error
Bile duct cancer or
cholangiocarcinoma are tumors that occur in the bile duct.
Two major types of bile duct tumors are found
Distal bile duct tumors: tumors affecting the bottom half of the bile duct
Klatskin’s tumors: Tumors affecting the upper part of the bile duct
Klatskin’s tumors
Bile duct cancer of the upper part of the bile duct is also called Klatskin’s tumor. Klatskin’s tumors involve the upper part of the bile duct as divides to enter the right and the left parts of the liver. The bile ducts in the liver are called right and left hepatic ducts. The tumor may involve one or both right and left sides of the hepatic ducts as they enter the liver. The hepatic ducts are closely associated with the blood vessels that supply blood to the liver. Klatskin’s tumors are closely associated with liver and as they grow invasion into the blood vessels that supply blood to the liver is often found.