jan 9 2021 Flashcards
what is chronic granulomatos disease?
X linked recessive disease leading to recurrent pulmonary and cutaneous infections by catalase positive pathogens
name 4 catalase positive organisms
- staph aureus
- serratia
- burkolderia
- aspergillis
path of chronic granulomatous disease?
defect in NADPH oxidase complex - > inability to form hydrogen peroxide
leukocyte, platelet, b and t cell numbers are normal in CGD, TRUE OR FALSe
TRUe
what is chediak-higashi?
autosomal recessive disorder with recurrent cutaneous infecitons and partial oculocutaneous albinism
which organisms commonly cause infections in chediak-higashi?
staph aureus and strep pyogenes
cutaneous infecitons
what will be seen on a blood count of someone wiht digeorge syndrome?
decreased t cells
inheritance of wiskott-aldrich syndrome?
X-linked
characteristics of wiskott-aldrich syndrome?
- eczema
- thrombocytopenia
- reccurrent infections
how to diagnose chronic granulomatous disease?
- nitroblue tetrazolium test
- dihydrorhodamine 123 test
GI functions of VIP
- suppress gastric acid secretion
- relaxes smooth muscle
- stimulates pancreatic bicarb secretion
- stimulates secretion of water and electrolytes
clinical presentation of a VIPoma
- watery diarrhea
- flushing, lethargy, nausea, vomiting, muscle weakness/cramps
lab findings of VIPoma
- hypokalemia
- hypercalcemia (increased bone resorption)
- hyperglycemia (increased glycogenolysis)
- stool increased sodium and with high oslmolar gap
were are VIPomas commonly located?
pancreatic tail
where do most carcinoid tumours occur?
small intestine
spondylolisthesis =
the slippage of a vertebra directly onto the bone beneath (can be from fracture)
spondylolysis =
pars interarticularis defects
why is spondylolisthesis more common in adolescents?
growth spurt -> increased lumbar lordosis
why are athletes more at risk for spondylolisthesis?
-repetitive back extension/rotation
characteristic exmaination finding of spondylolisthesis?
a palpable ‘step off’ in the spine
clinical features of apnea of prematury?
- intermittent apnea often associated with bradycardia and oxygen desaturation
- baby appears well between episodes
prognosis of apnea of prematury?
-self resolving
diagnosis of apnea of prematurity?
- clinical
- no other investigations needed unless concerning featuures (baby appears unwell, needs resuscitation, etc).
you should investigate apnea of prematurity if it persists past…
term
what is adhesive capsulitis of the shoulder?
-loss of normal distensibility of the shoulder due to chronic inflammation, fibrosis and contracture
XRAY findings in adhesive capsulitis?
normal
presentation of adhesive capsulitis?
- stiffness and pain
- decreased active and passive movements
intention tremor is a symptom of…
cerebellar degeneration
babinski sign is characteristic of …
an upper motor neuron lesion
organophosphate poisoning MOA
inhibits acetylcholinesterase - > acetylcholine toxiciity
pres of acetylcholine toxicity
Muscarinic:
DUMBELLS
Nicotinic:
muscle weakness, paralysis, fasciculations
management of organophosphate poisoning?
- remove patients close and irrigate skin
- Atropine - to reverse muscarinic symptoms
- Pralidoximine - reverses nicotinic and muscarinic symptoms
physostigmine can be used to treat…
anti-muscarinic poisoning
MOA of physostigmine
AChE inhibitor
Early onset hypertension + bilateral abdominal masses =
ADPKD
ideal location for the distal tip of an endotracheal tube?
2-6 cm above the carina
Transient synovitis most commonly occurs in young children (3-8) after a…
mild viral illness
What is the second most common cause of primary adrenal insufficiency (after autoimmune - addisons disease)
infectious adrenalitis
Someone with a severe asthma attack has a normal pCO2, is this good or bad?
It’s bad, the body should respond by hyperventiliation leading to decreased CO2 and alkalosis. Normal PH or CO2 indicates muscle fatigue and impending respiratoyr collapse
what is miliary TB
massive lymphohematogenous spread of TB
causes of peripheral vertigo?
- BPPV
- Menieres disease
- Vestibular neuritis
causes of central vertigo?
- stroke
- MS
- Migraine
which type of vertigo can be inhibited by fixation of gaze?
PERIPHERAL (NOT CENTRAL)
whcih type of vertigo is fatiguable?
PERIPHERAL
which type of vertigo is associated with severe postural instability?
central
you need consent from both parents to treat a child under joint-custody, TRUE or FALSE?
FALSE - consent from just one is fine
Management of heat stroke?
-rapid cooling (cold water immersion, cold water dousing, etc.)
-fluid rescuscitation
-
quietapine is an…
antipsychotic
antipyretic therapy is useful in heat stroke T or F
FALSE
ischemic changes in leads II, III and aVF suggest…
inferior wall MI
what investigation should be done to confirm right-sided ventricular MI?
right-sided precordial ECG
