Kaplan Flashcards
What is cyclobenzaprine? What is a potential side effect
Spasmolytic, which is a centrally acting muscle relaxant. They are structurally related to the tricyclic antidepressants and thus can have anticholinergic effects such as dry mouth, impairment of urination, and tachycardia.
Blood supply to the bladder is from the superior and inferior vesicle arteries: describe where the vesical arteries arise from
Superior vesicle arteries are branches of the umbilical arteries, which are branches of the internal iliac arteries.
Inferior vesicle are direct branches of the internal iliac arteries.
What kind of stones would you see in a HbS patient or hereditary spherocytosis?
Calcium bilirubinate
Klumke palsy/Thoracic outlet syndrome are due to injury/cpmpression of what structures respectively?
Klumke: traction/tear of Lower trunk (C8-T1)
Thoracic outlet syndrome: compression of lower trunk and subclavian vessels
Get klumpke from either upward force on arm during delivery, or grabbing tree limb while falling
Cirgarettes, aromatic amines, cyclophosphamide, radiation are risk factors for what type of bladder cancer?
Transitional cell
Goiter that is non-tender, stony hard, limited gland mobility, extensive fibrosis, dyspnea/dysphagia/hoarseness (mimics malignancy)
Riedel thyroiditis
Where is the BRCA-1 gene located?
17q
Gilbert vs Crigler-Najjar
Gilbert is a mild decrease in UDP-glucuronysyltransferase activity; results in asymptomatic or mild jaundice (INDIRECT bili)that is often due to stress, illness, etc.
Crigler is absent UDP-Glucuronysyltranserase. This is more severe, presents early in life with jaundice, kernicterus. Treat w/ plasmapharesis/phototherapy. Liver transplant curative
How do you calculate SVR?
SVR=(MAP-RAP)/CO
MAP=diastolic +1/3 of pulse pressure (systolic - diastolic)
What does a larger y intercept on a MM plot mean?
Decreased vMax
Tumor with elongated astrocytes w/ long bipolar processes and numerous eosinophilic intracellular inclusions with a twisted appearance.
Pilocytic astrocytoma (Rosenthal fibers are corkscrew-shaped, intensely eosinophilic strucutres derived from accumulation of aB-crystallin within astrocytic processes)
- low grade tumor in children/young adults. Usually in posterior fossa, cerebellar hemispheres.
- CYST W/ MURAL NODULE
What mutation is seen with familial isolated glucocorticoid deficiency? What levels are low, what levels are high?
ACTH receptor (melanocortin-2 receptor; MC2R) gene. ACTH normally stimulates corticosteroid and androgen production, so an ACTH receptor defect results in low adrenal glucocorticoid and androgen levels. Aldosterone will be normal as its synthesis and release is stimulated by ATII and hyperkalemia, nut not ACTH
Multinucleated giant cells found in painful goiter that was proceeded by a viral illness
de Quervain thyroiditis
What is human granulocytic anaplasmosis?
What is the bacteria, and vector?
Presentation?
Intracellular bacterium transmitted by Ixodes tick (also tansmits lyme/babesia)
Presents similar to RMSF but does not have a rash
PATHOGNOMONIC: presence of MORULAE inside the patients GRANULOCYTES. Tx w/ doxycycline
What is the mutation seen in Cri-du-chat? What are some features of this disorder?
Deletion of the short arm of chromosome 5 (5p-)
Short stature, distorted laryngeal anatomy, profoudn intellectual disability, wide set eyes, downward slanting eyes
ventricular septal defects
What is the histology of a rash in SLE?
deposition of autoreactive IgG and complement at the dermoepidermal junction
What anti-pseudomonal beta lactam can you give a patient who is allergic to beta-lactams?
Aztreonam
Brain tumor with fried egg appearance: round nuclei with clear cytoplasm?
Oligodendroglioma
Invasion of dermal lymphatic spaces—> painful breast with warm, swollen, erythematous skin, peau d’ orange
Inflammatory carcinoma.
CTG repeat, Auto Dominant
Cataracts,Toupee (early balding), Gonadal atrophy
This is myotonic dystrophy, which is a defect in the myotonic dystrophy Protein kinase; DMPK
Mobitz type I (wenckebach)
Increasing PR interval length until QRS wave is lost
Does not require tx
How do you calculate incidence rate?
of new cases/ # of people at risk
What are the labs for Paget disease of bone?
Serum alk phos is high, but serum calcium, phosphorus, and pth levels are normal. Can also hydroxyproline in urine
What class of lipid-lowering agents upregulates LPL and activates PPAR-a to induce HDL synthesis? What does this put patients at risk for?
Fibrates; puts patients at risk of cholesterol gallstones via inhibition of 7a-hydroxylase
OTC deficiency inheritance
X-linked; although there is significant, though milder, symptomatology in heterozygous females.
When would you see falsely elevated HbA1c?
When patients have low rates of RBC erythropoiesis, such as patients w/ iron or vitamin b12/folate anemia, renal failure (lack of EPO), bone marrow suppression w/ alcohol, and splenectomy (increased RBC survival)
What are the parts of:
Medicare A-D
Medicare A: room/board while in hospital
Medicare B: outpatient medical services
Medicare C: Medicare advantage (private) plans (similar to PPO/HMO)
Medicare D: Retail prescription drug coverage
What disease is the result of defective crosslinking of the triple helix of collagen molecules due to loss of Copper cofactor?
Menkes
ATP7A gene; results in ATP dependent copper transporter deficiency.
X-Linked Recessive
Sparse depigmented hair, seizures, FTT, neurodegeneration