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Board exam > internal med > Flashcards

internal med Flashcards

1
Q

beriberi

A

vit B1 def, can induce dilated cardiomyopathy

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2
Q

Amyloidosis

A

precipitate restrictive infiltrative cardiomyopathy

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3
Q

furosemide and chlortalidone

A

provoke gout by reducing uric acid excretion

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4
Q

etacrynic acid (and furosemide)

A

can lead to temporary or permanent hearing loss

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5
Q

Ivabradine

A

blocking funny Na-K channel, used to decrease resting sinus heart rate in ischemic heart disease

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6
Q

ST elevation can be caused by

A

pericarditis
myocarditis
acute pancreatitis
pulmonary embolism

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7
Q

hypertrophic cardiomyopathy

A

beta-blockers are recommended as first-line therapy

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8
Q

Proarrhythmia

A

anti-arrhythmic drugs in some cases can cause different type, often worse arrhythmia than the arrhythmia which made the use of these types of drugs reasonable

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9
Q

congenital long QT syndrome

A

can be associated with deafness

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10
Q

suspected intracardiac thrombus

A

transesophageal echocardiography

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11
Q

post myocardial infarction, detection of viability

A

cardiac MRI

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12
Q

mitral valve prolapse

A

2D, color Dippler-echocardiography

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13
Q

systemic use of nitrates

A

causes small vein expansion, their arterial effect develop at intracoronary delivery

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14
Q

level of CK

A

elevated 3hrs after MI

troponin T and troponin I level are slightly earlier and more sensitively to myocardial necrosis

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15
Q

transesophageal and transthoracic echocardiography

A

TEE is more sensitive and more specific: examines the heart more closely and very little absorption and diffusion medium between the heart and transducer probe

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16
Q

fever and “big silent heart”

A

typical for pericarditis

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17
Q

vulnerable plaque

A

high lipid content, the exist of inflammatory cells and thin fibrotic “cap”. Content of whitewash of these plaques are typically low and don’t necessarily cause stenosis in the lumen

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18
Q

cephalic phase

A

gastric secretion is triggered by stimulation of the taste receptors in the mouth

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19
Q

Menetrier disease

A

exsudative gastropathy of unknown origin, characterized by diffuse thickening of the gastric wall caused by excessive proliferation of the mucous membrane

loss of protein through gastric lesions, lead to edema formation

complain of epigastric pain and diarrhea

no multiple ulcers in the stomach, unlike ZES

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20
Q

pentagastric test

A

reveals the acidity of the stomach

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21
Q

NSAIDs

A

cause gastric mucosal damage by inhibiting the synthesis of protective prostaglandins

chronic NSAID users develop “silent ulcers” and are diagnosed only when complications occur (perforation, bleeding)

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22
Q

PPI

A

inhibit H+/K+ ATPase

cause inhibition of HCl acid secretion, which leads to an increase in serum gastrin levels

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23
Q

somatostatin

A

inhibits gastric acid secretion and the release of several GI hormones, including gastrin

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24
Q

hepatic encephalopathy can be provoked by

A

GI bleeding, aggressive diuretic therapy, spontaneous bacterial peritonitis, after TIPS procedure

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25
Q

hepatic encephalopathy

A

confusion, increased blood ammonia level, foetor, asterixis

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26
Q

PBC (primary biliary cholangitis)

A

remains asymptomatic for a long time, pruritus might be the first symptoms, AMA (anti-mitochondrial antibody), inc IgM level, middle-aged women

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27
Q

PSC (primary sclerosing cholangitis)

A

more frequent in males, can be associated with ulcerative colitis, increase the risk of cholangiocellular carcinoma, ANCA positivity

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28
Q

autoimmune hepatitis

A

inc serum igG, good response to corticosteroid, affects young women

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29
Q

hepatitis E virus

A

can be transmitted with consumption of undercooked pork meat, become chronic infection in immunocompromised patients, can cause CNS symptoms

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30
Q

Courvoisier-sign

A

tactile, not painful enlarged gallbladder

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31
Q

Klatskin tumor

A

extra-hepatic cholangiocarcinoma arising in the junction of the main right or left hepatic ducts to form the common hepatic duct

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32
Q

Caroli syndrome

A

congenital cystic dilatation of the intrahepatic biliary tree

typical symptoms: recurring cholangitis, shaking chills, fever

fusiform dilation of intrahepatic bile ducts and bile duct stenosis

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33
Q

Mirizzi’s syndrome

A

characterized by obstructive icterus and dilated hepatic duct
because the stone in the gallbladder fundus presses the common bile duct

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34
Q

Juxtapapillary diverticulum

A

Raises the risk of bile duct stone by a supposed bile flow obstruction

doesn’t cause chronic liver disease, endoscopic papillotomy is not contraindicated anymore

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35
Q

SPINK1 gene

A

encodes a protein called pancreatic secretory trypsin inhibitor

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36
Q

metformin and contrast agent

A

administration of metformin should be suspended by 2 days prior to the examination

can be continued after 48hrs from the examination only if the GFR is >30ml/min/1.73m2

IV iodinated contrast agents may be nephrotoxic and the deterioration of renal function may lead to accumulation of metformin to toxic levels and lead to lactic acidosis

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37
Q

in severely declined kidney function

A

thiazide-like diuretics are ineffective, loop diuretics could be used to decrease hypovolemia

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38
Q

MEN1

A

primary hyperparathyroidism, pituitary adenoma, neuroendocrine tumor of the pancreas

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39
Q

acromegaly

A

investigate GH concentration during oral glucose tolerance test

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40
Q

Primary aldosteronism and primary hyperparathyroidism cause polyuria

A

due to prolonged hypercalcemia causes the insensitivity of the vasopressin receptors of the kidney tubules

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41
Q

pheochromocytoma

A

only in MEN2 and not in MEN1

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42
Q

glycoprotein hormones

A

TSH, LH, hCG, FSH

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43
Q

chromogranin

A

protein stored in the secretory granules of neuroendocrine cells

chromogranin A examination is used as a specific serum marker of neuroendocrine tumors, can be found in high concentration in carcinoid tumors, gastrinoma, insulinoma, pheochromocytoma

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44
Q

Nelson disease

A

aggressive ACTH-producing adenoma evolving after bilateral adrenalectomy performed because of Cushing’s disease

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45
Q

diuretic treatment can cause secondary gout

A

due to inhibition of the tubular secretion of urate

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46
Q

android obesity

A

waist to hip ratio >1.0 in men or >0.8 in women in obese individuals

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47
Q

gynoid obesity

A

waist to hip ratio <1.0 in men or <0.8 in women in obese individuals

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48
Q

exercise in DM

A

In T2DM: dec blood glucose via decreasing insulin resistance and helps reach the optimal body weight

In T1DM: optimal time to exercise is the afternoon (afternoon down phenomenon), but in case of insulin deficiency, exercise alone doesn’t decrease blood glucose levels, but shifts the metabolism towards ketosis

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49
Q

Charcot joint

A

severe joint destruction is caused by the overextension of the joint due to lack of pain sensation and the associated trophic disorder

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50
Q

Shilling test

A

Examine B12 absorption

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51
Q

HAM test

A

traditional screening method paroxysmal nocturnal hemoglobinuria

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52
Q

beta2-microglobulin

A

reflect B cell proliferation and immuno reaction

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53
Q

bone marrow PAS stain

A

traditional bone marrow cytochemistry in ALL

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54
Q

antidote for unfractionated heparin

A

protamin

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55
Q

CLL

A

appearance of 5G/L or more CD19/CD5 co-expressed lymphocytes in peripheral blood is the official diagnostic criterium

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56
Q

Alarcon-Segovia diagnostic criteria for mixed connective tissue disorder

A

serology criterion (positive antibodies to U1 RNP antibodies) + clinical criteria: edema of the hands, synovitis, myositis, Raynaud phenomenon, Sclerodactyly

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57
Q

Schirmer test

A

For Sjogren’s syndrome: less than 5mm/5mins

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58
Q

Belimumab

A

The only agent for SLE therapy which inhibits B-cell activating factor

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59
Q

HSP (Henoch-Schonlein purpura)

A

ANCA-negative, palpable purpura, abdominal angina, age <21, neutrophil granulomcytes in the wall of small vessels

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60
Q

PAN (polyarteritis nodosa)

A

not ANCA-associated

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61
Q

packed red blood cell transfusion

A

improve oxygen delivery

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62
Q

oxygen dissociation curve

A

shifted to the right by acidosis, inc PaCO2 and inc temp

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63
Q

Succinylcholine

A

depolarizing muscle relaxant
bind to nicotinic ACh receptors of the end plates results in sustained depolarization

SE: muscle pain, bradycardia, malignant hyperthermia

hyperkalemia, extensive burns, muscle dystrophy can leads to inc potassium levels => contraindications

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64
Q

continuous thoracic epidural analgesia

A

most efficient analgesic method and induces symphaticolysis and improves visceral blood flow

can mask symptoms of acute abdomen, but 24-hourly analgesic breaks can minimize the risks

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65
Q

morphine

A

contraindicated because of its spasmic effect on the Oddi sphincter

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66
Q

Nitrate

A

veno- and coronary dilating effect and improves symptoms of cardiac decompensation in acute coronary syndrome and reduces ischemia

its use however is contraindicated in hypotension, because further reduction in diastolic pressure diminished coronary flow

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67
Q

thiopental

A

barbiturate type IV anesthetic which has a tendency to cumulate: best used for induction or short operation

most common side effects: histamine release => asthma is a contraindication

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68
Q

normal arterial blood gas values

A

pH 7.35-7.45
PaCO2: 35-45mmHg
PaO2: 80-100mmHg
HCO3-: 22-26mEq/L

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69
Q

high anion gap metabolic acidosis

A

AG = (Na+K) - (HCO3 + Cl): normal value 8-16mmol/L

in uremia, diabetic ketoacidosis, intoxication of ethylene glycol, paraldehyde, isoniazide, salicylate

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70
Q

mechanical ventilation weaning failure

A

pulmonary causes: reduction of FRC and dystelectasis
cardiac causes: decompensation, since spontaneous breathing increases right heart preload and left heart afterload
energetic causes: muscle weakness

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71
Q

Thrombolysis

A

indication: in AMI within 12hrs, ischemic stroke within 3 hrs, pulmonary embolism

not contraindicated in ages above 75 or in menstrual bleeding

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72
Q

distributive shock

A

sepsis, toxic shock syndrome, chemical intoxications, anaphylaxia, neurogenic shock, endocrine shock (thyrotoxicosis, diabetic ketoacidosis)

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73
Q

aspirin intoxication

A

causes CNS stimulation, vasoconstriction in the inner ear and decoupling of intracellular oxidative phosphorylation

severe cases: cerebral and pulmonary edema, platelet dysfunction and inc bleeding time

most common symptoms: hyperpnea, tachycardiac, hyperthermia or hypotonia, arrhythmias, N/V, GI bleeding, perforation, pancreatitis, hepatic failure

CNS Sx: tinnitus, dec consciousness, seizure

blood gas values: respiratory alkalosis with high anion gap acidosis

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74
Q

Gardner syndrome

A

predisposes to GI polyposis doesn’t predispose to pheochromocytoma

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75
Q

compound heterozygosity

A

two different mutations are present on the two different alleles of the same gene in AR inherited diseases

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76
Q

genomic imprinting

A

in the pathogenesis of Prader-Willi syndrome, Angelman syndrome and Beckwith-Wiedemann syndrome

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77
Q

Trinucleotide repeat disorder

A

fragile X syndrome
myotonic dystrophy
Huntington’s disease
Friedreich’s ataxia

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78
Q

Associated with breast cancer

A

Li-Fraumeni syndrome (mutation of p53)
Mutation of BRCA1/2 gene
Cowden syndrome (mutations of PTEN)

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79
Q

von Hippel-Lindau disease

A

renal cancer, pancreatic cysts and cancer, retinal and cerebellar hemangioblastomas

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80
Q

associated with chromosomal instability arising from deficient DNA repair

A

ataxia teleangiectasia, Bloom syndrome, xeroderma pigmentosum and Fanconi anemia

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81
Q

Fragile X syndrome

A

moderate mental retardation in affected boys and mild mental retardation in affected girls

caused by mutations of FMR1 gene, belongs to trinucleotide repeat disorders

enlarged testicles is a characteristic of the disease in affected boys

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82
Q

tumor growth depends on

A

time of cell cycle, growth fraction (proliferating tumor cell ratio), time to duplicate tumor volume and tumor cell loss (cell death rate)

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83
Q

RECIST-staging system

A

RECIST (response evaluation criteria in solid tumors) is used for evaluating the therapeutic response in solid tumors

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84
Q

Forrest-Classification

A

evaluate the bleeding activity of the ulcer

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85
Q

Bismut-Classification

A

provide an anatomical description of hilar biliary tract cancer

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86
Q

Duke classification

A

staging of colorectal carcinoma

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87
Q

Adalimumab

A

human monoclonal antibody used to treat IBD and has no indications in treatment of solid tumor

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88
Q

targeted therapies

A

imatinib: GIST (gastrointestinal stromal tumor)
sorafenib: hepatocellular carcinoma, kidney cancer
cetuximab: colorectal carcinoma, NSCLC
sunitinib: kidney cancer, GIST

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89
Q

most common primary tumor site in Krukenberg tumor

A

gastric cancer

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90
Q

NPI

A 
Nottingham prognostic index
below 3: excellent prognosis
below 3.14: good prognosis 
3.14-5.4: moderate long-term prognosis 
>5.4: poor prognosis
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91
Q

breast cancer that typically affects both sides

A

Lobular carcinoma

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92
Q

Colorectal cancer staging

A

TNM staging
MAC (Modified Astler-Coller) classification
Dukes classification

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93
Q

FIGO position

A

ovarian cancer

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94
Q

Imatinib (Glivec)

A

For GIST and CML

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95
Q

DeGramont chemotherapy protocol

A

used in colorectal cancer, not breast cancer

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96
Q

Trastuzumab

A

in HER-2 positive tumors

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97
Q

Gleason-score

A

for prostate cancer

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98
Q

non-seminomas

A

chemotherapy sensitive and less responsive to radiotherapy

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99
Q

isolated ascites

A

pathological fluid accumulation occurs only in the abdominal cavity without being part of a generalized edema

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100
Q

Bernstein test

A

To confirm that retrosternal pain is caused by reflux disease

serves for the evaluation of the esophageal acid sensitivity

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101
Q

ZES (Zollinger-Ellison syndrome)

A

associated with hyperparathyroidism

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102
Q

Repair of an inguinal hernia

A

Lichtenstein surgery

103
Q

Trendelenburg test

A

assess the condition of the valves in the greater saphenous vein

104
Q

Perthes test

A

assess the rate of blood flow towards the deep veins (clinical test for assessing the patency of the deep femoral vein)
After placing a rubber compression band on the leg of the standing patient, ask the patient to walk, and emptying of the superficial beins means a good flow towards the deep veins (negative Perthes test)

105
Q

Homan’s sign

A

Sign of deep-vein thrombosis when dorsalflexion of the foot induces calf pain

106
Q

surgical indication

A

immediate (vital) indication: medical condition where the life of the patient can only be saved with an immediate surgery

absolute surgical indication: disease is to be treated surgically, although not necessarily immediately

107
Q

Inguinal hernia

A

Lateral (indirect): prone to incarceration since the hernia has to pass through the long, curvy and relatively narrow inguinal canal => develop in the persisting tunica vaginalis (congenital hernia) and thus the hernia sac can reach the scrotum itself

medial (direct) hernias: only a short hernial sac, orifice is usually wide

intermittent pain or discomfort associated with inguinal hernias is caused by the stretching of the mesentery of the trapped bowel loop

108
Q

Requirements of primary wound healing

A

Sharp wound edges, non-tight edhes, lack of foreign or contaminated parts in the cavity

109
Q

Classic signs of inflammation

A

tumor, rubor, calor, dolor, functio laesa

bulge, erythema, warm, pain and loss of function

110
Q

Post-thrombotic syndrome

A

chronic insufficiency of venous circulation in the lower extremities, which develops years after DVT

111
Q

GEA & EST

A

GEA: gastroenteroanastomosis
EST: endoscopic sphincterotomy

112
Q

“Resectability” and “Operability”

A

resectability is related to the tumor: resectable or unresectable (technically cannot be removed by the surgeon)

Operability: refers to the patient
varies from patient to patient, depending on the patient’s condition and reserves and the progression of the disease

113
Q

Symptoms of post-thrombotic syndrome

A

progressive edema, indurations, thickening of the subcutaneous tissue, development of secondary varicosity, crural ulcers due to impaired localized tissue nutrition, brownish pigmentation caused by hemosiderin deposition, eczema and dermatosis

114
Q

treatment of secondary varicosity

A

crossectomy, stripping, subfascial ligature of perforator veins

115
Q

degloving injury

A

skin and its underlying tissues are torn off the fascia
significant amount of bleeding can develop into the recessed area and the blood supply to the skin above the injury is severed, therefore skin necrosis is common

116
Q

Bennett fracture

A

Fracture of the base of the first metacarpal bone which extends into the carpometacarpal joint

intra-articular fracture is the most common type of fracture of the thumb

117
Q

V-shaped phlegmon

A

the type of pyogenic tenosynovitis extending between the thumb and the little finger

because the tendon sheaths reach the level of the wrist, but on the 2nd-4th fingers, they extend only to the distal palmar crease

118
Q

Triangular fibrocartilage complex

A

cartilage structure located on the small finger side of the wrist that, cushions and supports the small carpal bones in the wrist

119
Q

Cubital tunnel syndrome

A

area of sensory innervation and muscles of motor innervation by the ulnar nerve are affected

120
Q

Dupuytren’s contracture

A

One or more fingers become permanently bent in a flexed position
usually begins as small, hard nodules just under the skin of the palm, then worsens over time until the fingers can no longer be straightened

cannot be treated with conservative methods (splinting, cast fixation and redressing bandaging techniques)

121
Q

Periappendicular infiltration

A

Complicated form of advanced appendicitis, which requires 5-7 days to develop

122
Q

Anus preternaturalis

A

colostomy

123
Q

UICC

A

international anti-cancer organization (Union Internationale Contre le Cancer)

124
Q

Blumer’s shielf

A

hard resistance that is palpable in the pouch of Douglas with rectal examination in advanced gastric cancer

it develops as a result of the fact that the tumor has metastasized to the peritoneum => patient already has ascites, which is the consequence of peritoneal cancer

125
Q

PTC: percutaneous transhepatic cholangiography

A

penetrating an intrahepatic bile duct through the skin

126
Q

complications of GERD

A

esophagitis
peptic stricture
esophageal ulcer: bleed, penetrate, perforate
Barrett’s esophagus: can lead to esophageal adenocarcinoma
lung infections due to aspiration
Schatzki ring: narrowing of the lower esophagus that can cause difficulty swallowing
reglux laryngitis
esophageal motility disorders
reflux stomatitis

127
Q

Terminal ileum resection

A

anaemia (due to vit B12 def) and loss of biliary acids (absorbed primarily in terminal ileum)

128
Q

Tenesmus

A

continual or recurrent inclination to evacuate the bowels

129
Q

choledochus

A

common bile duct

130
Q

Heller operation

A

an operation for achalasia of the cardia (can try Botox injections or balloon dilatation before)

131
Q

Torek operation

A

resect the thoracic part of the esophagus, can be used in esophageal perforation

132
Q

Decortication

A

medical procedure involving the surgical removal of the surface layer, membrane or fibrous cover of an organ

133
Q

Mitral stenosis treatment

A

mitral commissurotomy and prosthetic heart valve implantation

134
Q

mitral regurgitation treatment

A

implantation of artificial chordae and the use of annuloplasty rings

135
Q

polyneuropathy

A

more commonly cause lower limb hypesthesia/paresthesia and rarely manifests in lower limb weakness

136
Q

Parinaud’s syndrome

A

inability (paresis or palsy) of upgaze and it often comes with retraction nystagmus

a sign of compression of the quadrigeminal lamina

137
Q

Strumectomy

A

surgical removal of all or a portion of a goitrous tumor

138
Q

Suxamethonium (same as succinylcholine)

A

neuromuscular blocker family of medication and of depolarizing type

depolarization is caused by succinylcholine mimicking the effect of acetylcholine but without being rapidly hydrolysed by acetylcholinesterase

highly potent agonist at the NMJ nicotininc acetylcholine receptors

139
Q

PEEP (positive end expiratory pressure)

A

decrease venous return due to increased mean intrathoracic pressure
altered left ventricular geometry
circulating, negative inotropic mediators

140
Q

Agoraphobia

A

fear of being in situations where escape might be difficult or that help wouldn’t be available if things go wrong

141
Q

Transcortical aphasia

A

disables spontaneous speech, but have echolalia

142
Q

TMS and TDCS

A

TMS: transcranial magnetic stimulation
TDCS: transcranial direct current stimulation

143
Q

WAIS

A

Wechsler Adult Intelligence Scale
verbal and performance IQ
The level of intelligence measured by it predicts the level of life competence

144
Q

tests

A 
Rorschach probe: projective test
MMPI: personality inventory 
BPRS: clinical rating scale 
Raven matrices: measure intellectual performance
Szodi test: projective personality
145
Q

For dementias

A

MMSE, clock drawing test, WAIS for level of cognitive decline

146
Q

Perceptions without objective stimuli

A

hallucination

147
Q

Alexithymia

A

personal trait characterized by the subclinical inability to identify and describe emotions experienced by one’s self or others.
The core characteristics of alexithymia are marked dysfunction in emotional awareness, social attachment and interpersonal relating

characterized by difficulties in expressing and verbalizing emotions

148
Q

Delusions of infestation

A

a condition where an individual has a firmly fixed false belief that they have an infection
aka Ekbom symptom

149
Q

Rumination

A

focused attention on the symptoms of one’s distress, and on its possible causes and consequences

can also be the action of chewing the cud

150
Q

negativism

A

behaviour that is the opposite of that suggested by others

in active negativism: the individual does the opposite of what is asked for. can be associated in psychosis

In passive negativism: the person fails to cooperate, this occurs in schizophrenia and depression

151
Q

Delusion of the double

A

Capgras syndrome

152
Q

Pseudologia Fantastica

A

aka pathological lying, deception syndrome, mythomania

153
Q

Fregoli syndrome

A

false identification of strangers as familiar people

154
Q

can be seen in a motor disorder in schizophrenia

A

catatonia, negativism, waxy flexibility, automatic obedience

155
Q

Nihilistic delusions

A

specific psychopathological entities characterized by the delusional belief of being dead, decomposed or annihilated, having lost one’s own internal organs or even not existing entirely as a human being

156
Q

Cotard syndrome

A

rare condition marked by the false belief that you or your body parts are dead, dying or don’t exist

157
Q

Bleuler’s 4 A’s in schizophrenias

A

disturbance of affect, association, ambivalence and autism

158
Q

phobia

A

claustophobia (fear of closed spaces)
acrophobia (fear of heights)
hydrophobia (fear of water)
arachnophobia: fear of spiders

159
Q

delirium tremens

A

signs of autonomic hyperactivity: hypertension, fever, tachycardia, global confusion, disorientation, perceptual disorders as a result of withdrawal from alcohol

160
Q

Wernicke’s encephalopathy

A

consequence of long-term alcohol abuse
associated with periaqueductal gray hemorrhages at the level of lamina quadrigemina

symptoms: sudden onset, nystagmus and ophthalmoplegia, confusion along with somnolence, lesions of the mammillary bodies

161
Q

polysomnography

A

sleep study, a test used to diagnose sleep disorders

162
Q

Rapid cycling in bipolar disorder

A

4 episodes within one year

163
Q

cyclothymia and dysthymia

A

cyclothymia: mood disorder causes emotional ups and downs that are less extreme than bipolar disorder

164
Q

dysthymia

A

chronic form of mild depression

165
Q

Narcomania

A

a pathological craving for or addiction to narcotics or alcohol

166
Q

Hypochondriasis

A

illness anxiety disorder

167
Q

Ambivalence

A

inability to make decisions

a division of all states or operations of mind into contradictory tendencies

168
Q

Pick disease

A

aka frontotemporal dementia or frontotemporal lobar degeneration (affects parts of the brain that control emotions, behaviour, personality and language)

169
Q

Conversion disorder

A

resemble a somatic illness
in definite connection with some outside event (psychotrauma)

Freudian primary illness-benefit: the patient can escape from a conflict

Freudian secondary illness-benifit: evoke increased attention and sympathy of others

patient cannot control these symptoms

limb paralyses and sensory deficits don’t follow anatomical innervations

170
Q

Dissociative fugue

A

sudden and unplanned travel away from home

inability to recall past events or important information from the person’s life

confusion or loss of memory about his or her identity, possibly assuming a new identity to make up for the loss

171
Q

Adaptation disorder (Adjustment disorder)

A

symptoms (stress, feeling sad/hopeless, physical symptoms) that can occur after you go through a stressful life event

172
Q

trichotillomania

A

patients are unable to resist pulling out their own hair

173
Q

pyromania

A

the person commits arson intentionally for pleasure

174
Q

kleptomania

A

an irresistible urge to steal worthless objects

175
Q

Akathisia

A

movement disorder characterized by a feeling of inner restlessness and inability to stay still

early adverse effect of antipsychotic medication

176
Q

tardive dyskinesia

A

permanent side effect of antipsychotic medications that involve involuntary muscle

rapid blinking, waving of the arms or hands, sticking out the tongue

177
Q

Trancranial megnetic stimulation

A

Can be used in depression and in the presence of acoustic hallucinations

178
Q

Disengagement

A

describes the traits of a family or the current type of family interaction or functioning

disengaged families lack intimacy between the members

179
Q

countertransference

A

occurs when a therapist transfers emotions ot a person in therapy

180
Q

Tranference

A

process of projecting one’s feelings toward an important figure in your life onto someone else

181
Q

Unconditional positive regard

A

means that the therapist accepts the client totally for who he or she is without evaluating or censoring, and without disapproving of particular feelings, actions, or characteristics

“I’ll accept you as you are”

182
Q

Person-Centered therapy

A

By Carl Rogers

Congruence (Genuineness): the ability for the therapist to be genuine, no façade, require self-awareness, deliberate self-disclosure. Therapist’s openness and genuinessness to relate to clients without hiding behind a professional facade

unconditional positive regard

empathy: ability to understand what the client is feeling

183
Q

Oezema

A

disease of the nose in which the bony ridges and mucous membranes of the nose waste away

it’s a form of atrophic rhinitis
involves foul-smelling lesion of the mucosa
unknown etiology
becomes better with aging

184
Q

Osteoma

A

Most common benign tumor of the nose and paranasal sinuses

should be surgically removed

185
Q

Pollakiuria

A

benign idiopathic urinary frequency

refers to frequent daytime urination in children without specific cause

can be caused by urine retention in the bladder and urethritis

186
Q

continent urinary diversion

A

performed by incorporating segments of both the small and large intestine into the urinary tract to create a urinary reservoir in the suitably selected patient

E.g. Orthotopic bladder formation (bladder replacement from an isolated intestinal tract) and Mainz II pouch

187
Q

urologic procedure

A

internal urethrotomy: incision of the urethral stenosis

epicystostomy: percutaneous bladder puncture

188
Q

Nephroptosis

A

rare condition where a person’s kidney drops down into the pelvis when they stand up

189
Q

Verruca vulgaris

A

common warts, which are caused by infection with HPV

190
Q

Anergy

A

Describes a lack of reaction by the body’s defense mechanisms to foreign substances

191
Q

Condyloma acuminatum

A

single genital wart, usually due to HPV 6 and 11

192
Q

Promiscuous

A

having multiple sexual partners

193
Q

White dermographism

A

blanching response resulting from capillary vasoconstriction after skin stroking and more pronounced in patients with atopic dermatitis

194
Q

pityriasis rosea

A

exact cause of pityriasis rosea is unknown but most likely due to a viral cause

acute, self-limited, exanthematous skin disease by slightly inflammatory, oval, papulosquamous lesions on the trunk and proximal areas of the extremities

195
Q

Sezary syndrome

A

aggressive form of cutaneous T-cell lymphoma

occur when T cells become cancerous, typically affect the skin

196
Q

hidradenitis suppurativa (acne inversa)

A

inflammatory skin disease that affects apocrine gland-bearing skin in the axillae/groin/under the breasts

recurrent boil-like nodules and abscesses that culminate in pus-like discharge, difficult-to-heal open wounds and scarring

197
Q

Methimazole

A

treat hyperthyroidism, also used before thyroid surgery or radioactive iodine treatment

Can cause aplasia cutis

198
Q

thelarche

A

occurs for a low amount of estrogen
present also in testicular feminization
usually this is the first somatic change during puberty

199
Q

Female pseudohermaphroditism

A

individual with ovaries but with male secondary sexual characteristics or external genitalia
can be caused by androgen-producing tumors, CAH

200
Q

male pseudohermaphroditism

A

individuals whose gonads are testes but whose secondary sexual characteristics or external genitalia resemble those of a female

usually a AR genetic defects

201
Q

testicular feminization

A

androgen insensitivity

202
Q

pubertal preaecox

A

precocious puberty

203
Q

Adenomyosis

A

endometrial tissue infiltrates the myometrium deeply, causing dysmenorrhea and hypermenorrhea

204
Q

Dysmenorrhea

A

painful periods or menstrual cramps

205
Q

Menorrhagia

A

Heavy menstrual bleeding

Hypermenorrhea : longer menstruation with more bleeding than usual

206
Q

Hypomenorrhea

A

Regular, but shorter menstruation with light bleeding

207
Q

Oligomenorrhea

A

more than 35 days between two menstruation

208
Q

Polymenorrhea

A

less than 21 days between two menstruation

209
Q

Metrorrhagia

A

irregular bleeding, which can last long

210
Q

Postpartum galactorrhea-amenorrhea syndrome

A

Chiari-Frommel syndrome

211
Q

Stein-Leventhal syndrome

A

PCOS: polycystic ovary syndrome

212
Q

POPs

A

Progesteron-only pill

213
Q

Clomiphene citrate

A

for ovaluation induction
widely used to treat infertility

SERM: selective estrogen receptor modulator
competitive inhibitors of estrogen binding to estrogen receptors

214
Q

Cyproteron-acetate

A

Anti-androgen used in hypersexuality in males, as a palliative in prostatic carcinoma and in combination with estrogen, for the therapy of severe acne and hirsutism in females

215
Q

LNG-IUS (Levonorgestrel-releasing Intrauterine system)

A

effectiveness are almost as high as the effectiveness of tubal ligation
release usually daily 20ug progestin

commonly cause strophic endometrial changes
primarily affects menstrual bleeding patterns and amenorrhea

216
Q

CTG

A

cardiotocography: monitor fetal heartbeat

217
Q

Spinnbarkeit test

A

Spinnbarkeit mucus: stretchy, egg white quality of cervical fluids around ovulation

218
Q

Sims Huhner test (postcoital test)

A

test in the evaluation of infertility

evaluate the sperm’s interaction within cervical mucus postcoitally

219
Q

Parlodel

A

Aka Bromocriptine

treat hyperprolactinemia or pituitary gland tumor that produces too much growth hormone

220
Q

Oradexon

A

Aka Dexamethasone

can treat infertility with increased testosterone and/or DHEAS

221
Q

Pyelectasia

A

dilatation of the renal pelvis

222
Q

vena cava inferior syndrome

A

when the pregnant woman lays back the uterus overlies and compresses the vena cava inferior

due to decline in venous backflow, a fast maternal BP drop occurs, dizziness, sweating and tachycardia may lead to collapse

decrease in the placental circulation causes fetal bradycardia

can cause faintness of the pregnant woman

223
Q

IDDM

A

insulin-dependent diabetes mellitus

224
Q

Menstrual regulation

A

Menstrual extraction, another type of manual vacuum aspiration

induction of uterine bleeding that has been delayed either to 14 days beyond expected onset or 42 days from the start of the last menstrual period

225
Q

Synclitism

A

parallelism between the pelvic plane and the plane of the fetal head

in asynclitism, the sagittal suture is in the transverse diameter of the pelvic inlet and not between the symphysis pubis and sacral promontory

226
Q

Naegele obliquity

A

presentation of the anterior parietal bone to the birth canal during vaginal delivery with the biparietal diameter being oblique to the brim of the pelvis

is a type of asynclitism

227
Q

Litzmann obliquity

A

posterior asynclitism

can lead to cephalopelvic disproportion and normal vaginal delivery cannot take place

228
Q

Deflexion presentations

A

When the head is hyperextended: brow presentation and face presentation

229
Q

Apraxia

A

motor disorder caused by damage to the brain in which the individual has difficulty with the motor planning to perform tasks or movement when asked, provided that the request or command is understood and the individual is willing to perform the task

230
Q

amaurosis fugax

A

transient monocular blindness
caused by thromboembolisation of the ophthalmic artery (Terminal branch) from the ulcerated plaque of the ipsilateral internal carotid artery

231
Q

Parinaud-syndrome

A

disturbance of gaze (vertical upwards) with vertical nystagmus

232
Q

Weber syndrome

A

alternating motor brainstem syndrome: ipsilateral oculomotor nerve lesion, contralateral hemiparesis

233
Q

Ticlopidine

A

Anti-platelet drug as ADP (adenosine diphosphate) receptor inhibitor

useful for preventing strokes and coronary stent occlusions

234
Q

Diaschisis

A

sudden change of function in a portion of the brain connected to a distant, but damaged, brain area

235
Q

Thalamic lesions

A

ventrolateral nucleus: cloely related to the cerebellum, its damage causes hemihypesthesia with hemihyperkinesis (choreoathetosis-like involuntary movements)

thalamic hand: basic joints are in flexion while the interphalangeal joints are in extension

thalamic pain: burning, shooting pain that is difficult to localise and occurs in attacks

236
Q

Gerstmann syndrome

A

Left-to-right confusion, finger agnosia, agraphia and acalculia

237
Q

abdominal lancinating pain

A

symptom of syphilis when granulomatous inflammation infiltrate posterior roots of thoracic spine and ganglion coeliacum and cause pain with sharp quality and very short duration

238
Q

Vegetative symptoms

A

Weight loss and anorexia (loss of appetite), insomnia, fatigue and low energy, inattention

239
Q

Cervicogenic headache

A

pain that develops in the neck, though a person feels the pain in the head

240
Q

Meralgia paresthetica

A

numbness or pain in the outer thigh not caused by injury to the thigh, but injury to a nerve that extends from the spinal column to the thigh

241
Q

Prosopalgia

A

facial or Trigeminal neuralgia

242
Q

Causalgia

A

severe burning pain in a limb caused by injury to a peripheral nerve

known as complex regional pain syndrome type II

median nerve lesion often causes causalgia

243
Q

Froment’s sign

A

physical examination of the hand to test for palsy of the ulnar nerve which results in reduced functionality and muscle weakness of the pinch grip

it tests the strength of the adductor pollicus of the thumb, which is innervated by the ulnar nerve and is weakened in ulnar nerve palsy

244
Q

Neuromyelitis optica

A

aka Devic disease

autoimmune disorder in which WBCs and antibodies primarily attack the optic nerves and the spinal cord, but may also attack the brain

the damage to the optic nerves produces swelling and inflammation that cause pain and loss of vision

the damage to the spinal cord causes weakness or paralysis in the legs or arms, loss of sensation and problems with bladder and bowel function

presence of aquaporin-4 antibodies in serum

245
Q

Adrenoleukodystrophy

A

rare genetic condition that causes the buildup of VLCFAs (very long chain fatty acids) in the brain

When VLCFAs accumulate, they destroy the protective myelin sheath around nerve cells, responsible for brain function

246
Q

Convulsive syncope

A

Like syncope, can precede by fainting sensation, pallor or sweating

during the unconsciousness, a brief tonic phase, myoclonic or clonic jerking can occur

in contrast to grand mal, convulsive syncope never begins with a tonic phase (starts with a loss of muscle tone)

tongue biting can also occur in convulsive syncope, but it never affects the lateral part of tongue, rather the tip of tongue (apical tongue biting)

247
Q

Disulfiram

A

support the treatment of chronic alcoholism by producing an acute sensitivity to ethanol

the first medication approved by the FDA to treat chronic alcohol dependence

248
Q

Epilepsy

A

recurrent unprovoked epileptic seizures

however, epileptic seizures can occur in healthy people (known as the provoked seizure)

249
Q

Eaton-Lambert syndrome

A

neuromuscular presynaptic disorder with paraneoplastic etiology

production of antibodies against a presynaptic calcium-ion channel protein

plasmapheresis or immunosuppression can be effective in the treatment of this disease

250
Q

Drusen

A

small yellow deposits of fatty proteins (lipids) that accumulate under the retina

251
Q

Ectropion

A

condition in which your eyelid turns outward and leaves the inner eyelid exposed and prone to irritation

tearing (epiphora) is the consequence

252
Q

Odds ratio

A

typically used in case-control studies

the odds of a certain exposure given an event v.s. the odds of exposure in the absence of that event

if odds-ratio is exactly 1, then there is no relationship between the risk factors and the disease

can be calculated from contigency tables

253
Q

Stochastic effects

A

those affects the frequency and probability of which increases on elevating the doses, more precisely the dose equivalent value

Board exam (1 decks)

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