Kaplan2 Flashcards
What is metabolic syndrome?
Metabolic syndrome is characterized by three of the following traits:
- abdominal obesity
- elevated serum triglycerides
- low HDL, blood pressure greater than or equal to 130/85 mmHg
- fasting plasma glucose greater than or equal to 100 mg/dL.
- patient being on drug treatment for any of the above mentioned traits.
Oxidative metabolism, many mitochondria, many capillaries describe muscles that are best used for what type of exercise?
Endurance exercise
The binding of _________ to its receptor activates adenylate cyclase, which increases the intracellular concentration of cAMP and ultimately promotes glycogenolysis and gluconeogenesis.
glucagon
The binding of glucagon to its receptor activates adenylate cyclase, which increases the intracellular concentration of _____ and ultimately promotes glycogenolysis and gluconeogenesis.
cAMP
The binding of glucagon to its receptor activates adenylate cyclase, which increases the intracellular concentration of cAMP and ultimately promotes what processes?
glycogenolysis and gluconeogenesis.
type I glycogen storage disease (Von Gierke’s), which is caused by a deficiency in what enzyme?
glucose-6-phosphatase
______________ deficiency prevents the liver from releasing glucose into the blood and therefore leads to hepatic glycogen accumulation, causing hepatomegaly.
Glucose-6-phosphatase
von Gierke
Serum angiotensin converting enzyme has relatively poor sensitivity and specificity for what disease? (however if elevated it is also suggestive of the disease)
sarcoidosis
asymmetric upper and lower motor neuron disease (suggested by weakness with both hyporeflexia and hyperreflexia), along with fasciculations (particularly of the tongue) and cramping with a preservation of cognitive function are highly suggestive of what neurological disease?
ALS
What neuro disease results from a progressive degeneration of the lateral corticospinal tracts as well the neurons of the anterior horns.
ALS
What is seen on pathology of ALS?
inclusion bodies that stain positive for superoxide dismutase 1 (SOD1) and ubiquitin.
What are the S/Sx of Brown-Séquard syndrome, which results from hemisection of the spinal cord?
Below the level of the lesion, patients demonstrate ipsilateral signs of upper motor neuron damage (hyperreflexia, positive Babinski sign) due to the severing of the lateral corticospinal tract.
ipsilateral loss of proprioception, fine touch, and vibration sensation due to damage of the dorsal columns.
Contralaterally, patients experience a loss of pain and temperature sensation below the lesion due to spinothalamic tract trauma.
The external spermatic fascia containing the mass is ~w/ with ?
Direct Inguinal hernia
The external spermatic fascia is continuous with the external abdominal oblique, and this is the outer covering of a direct inguinal hernia as it herniates through the superficial inguinal ring.
What type of hernia is most often found penetrating the abdominal wall MEDIAL to the inferior epigastric artery?
Direct Inguinal hernia
~w/ older men
What type of hernia is most often found penetrating the abdominal wall LATERAL to the inferior epigastric artery?
Indirect Inguinal hernia
Antibodies ~w/ primary biliary cirrhosis (PBC)???
anti-mitochondrial antibodies (AMA)
Pt. typically present with itching, fatigue, jaundice, unexplained weight loss, right-upper-quadrant pain, and hepatosplenomegaly in what disease?
biliary cirrhosis (PBC)
What are the Labs ~w/ biliary cirrhosis (PBC)?
abnormal liver biochemical tests that show a cholestatic pattern of injury with elevated alkaline phosphatase, direct and total bilirubin, IgM, and cholesterol.
Antibodies ~w/ type 1 autoimmune hepatitis ?
Anti-Smooth muscle
- liver biochemical tests typically show a hepatocellular pattern of injury with elevated transaminases and normal or slightly elevated alkaline phosphatase and total bilirubin.
Antibodies ~w/ type 2 autoimmune hepatitis.
Anti-Liver/Kidney Microsomal antibodies are positive in type 2 autoimmune hepatitis.
__________ an autosomal recessive defect in a membrane transporter in the renal proximal tubule for the amino acids cysteine, ornithine, arginine, lysine (COAL).
cystinuria
Tx for cystinuria?
Treatment includes alkalization of the urine and hydration.
Zenker diverticulum is a ______ diverticulum.
False
What Leser-Trélat sign and what malignancy is it ~w/?
Leser-Trélat sign, a sudden eruption of multiple seborrheic keratoses.
What type of stool is intussuception ~w/?
“red currant jelly” stools in peds.
*** “red currant jelly” stools in adults = Mesenteric ischemia
false diverticulum involves only what?
mucosa and submucosa.
_______________ is a mucosal herniation through Killian triangle, which is a weakness in the musculature between the transverse fibers of the cricopharyngeus muscle and the oblique fibers of the inferior pharyngeal constrictor muscle (lower inferior constrictor).
Zenker diverticulum
Zenker diverticulum is a mucosal herniation through Killian triangle, which is a weakness in the musculature between the transverse fibers of the ______1______ muscle and the oblique fibers of the ______2_______ muscle (lower inferior constrictor).
- cricopharyngeus
2. inferior pharyngeal constrictor
Meckel diverticulum is also associated with ____________ and _____________.
intussusception and volvulus
What two tumor markers are ~w/ Gastric Cancers?
Carcinoembryonic antigens (CEA)
Carbohydrate antigen (CA 19–9)
adiograph classically shows the coffee-bean sign, where the dilated portion of the bowel resembles a coffee-bean.
= ???
sigmoid volvulus
_________________ is a true diverticulum characterized by a persistent vitelline (omphalomesenteric) duct, the long narrow tube that joins the yolk sac to the midgut lumen of the developing fetus.
Meckel diverticulum
Hypertrophy of Peyer’s patches leading to invagination of one segment of bowel into a neighboring, distal segment ==> ???
intussuception
Where do you find Zenker (esophageal) diverticulum?
proximal to the cricopharyngeus muscle. The cricothyroid membrane is part of the trachea.
PT w/ LLQ pain, fever, and early diarrhea followed by constipation; what is high on your ddX?
Diverticulitis
Diverticulitis is inflammation of the wall of a diverticulum due to irritation by stool impaction in the diverticulum sac, potentially leading to ulceration and ischemia.
In adults, what is the most common cause of intussusception?
tumor within the intestinal tract.
Palpable skin lesions on butt in a peds pt. == ??
Henoch-Schonlein purpura (HSP);
_______________ is the only drug that slows heart rate (negative chronotropic effect) with no effect on cardiac contractility (inotropy) and/or relaxation (lusitropy). It slows the rate of sinoatrial node firing by selective inhibition of funny sodium channels (If), thereby prolonging the slow depolarization phase (phase 4).
Ivabradine
What drug is the major anti-epileptic drug that bloacks T-Type calcium channels in thalamic neurons?
Ethosuximide,
What is the first line Tx for essential tremor?
Propranolol.
Essential tremor is a tremor that gets worst as you are trying to hold a posture, like holding out a cup.
Resting tremor ~w/ ?
Parkinsons L-DOPA/levodopa
Migratory thrombophebitis should increase suspicion for what?
CANCER
Migratory thrombophlebitis should raise suspicion for cancer. Hypercoagulability is a very common paraneoplastic syndrome seen most frequently in visceral adenocarcinomas of the pancreas, colon, and lung. Hypercoagulability develops because adenocarcinomas produce a thromboplastin-like substance capable of causing chronic intravascular coagulations that can disseminate and tend to migrate.
The malabsorption resulting from celiac sprue can result in __________ deficiency.
Vitamin K def.
What is Trousseau Sign?
hand/forearm muscle spasms.
~w/ visceral cancer
(bilateral) wedge-shpaed strips of necrosis ~w/ ?
Hypoxic-ischemic encephalopathy.
Profound cerebral hypoperfusion may lead to global cerebral ischemia (also called ischemipc-hyoxic encephalopathy).
Watershed infarcts occur between the zones of perfusion of the anterior, middle, and posterior cerebral arteries.
These infarcts typically appear as bilateral wedge-shaped strips of necrosis over the cerebral convexity, parallel and adjacent to the longitudinal cerebral fissure.
uterine curettage with findings of dilated, coiled endometrial glands and edematous stroma == ???
An ectopic pregnancy is characterized by implantation outside of the uterus. Uterine curettage would reveal decidual changes in the endometrium due to progesterone secretion but no embryonic or trophoblastic tissue (eg, no villi).
A precordial continuous, machine-like murmur that occurs during both systole and diastole indicates what?
patent ductus arteriosus.
Patent ductus arteriosus would produce isolated pulmonary artery SpO2 elevation.
What produces a loud holosystolic murmur best heard over the left sternal border in the third or fourth intercostal space.
VSD
What causes a chronic disease that leads to cardiomyopathy, achalasia, megacolon, and megaureter.
Trypanosoma cruzi causes Chagas disease (American trypanosomiasis).
What pathogen causes a disease that is typically characterized endoscopically by large, shallow linear ulcerations (most commonly in the distal esophagus) with intranuclear and cytoplasmic inclusions seen microscopically.
CMV
CMV esophagitis
HIV pt. with linear ulcerations on endoscopic findings?
CMV
HIV pt. with small vesicles, “punched-out” ulcers on endoscopy = ?
HSV-1
delirium, tremors, agitation, = ??
Alcohol withdraw
What important vitamin is NOT in breast-milk?
Vitamin D
The filtration fraction always increases with increasing _______________ constriction.
efferent arteriole constriction
The presence of erythroid precursors in organs such as the liver and spleen is indicative of what disease process?
extramedullary hematopoiesis, a condition characterized by erythropoietin-stimulated, hyperplastic marrow cell invasion of extramedullary organs. Extramedullary hematopoiesis is most frequently caused by severe chronic hemolytic anemias, such as β-thalassemia
What never provides sensory innveration to the plantar side of the foot?
Tibial N.
What is the only pathogenic fungus that has a polysaccharide capsule. The capsule appears red on mucicarmine stain and as a clear unstained zone with India ink.
Cryptococcus neoformans
Candida albicans is a normal inhabitant of the _____________ in up to 40% of the population
the GI tract (including the oral cavity)
Type B aortic dissections involving the descending aorta typically originate close to the origin of the __________ artery
left subclavian artery.
Obstructive sleep apnea presents in obese individuals with excessive daytime sleepiness and signs of nocturnal upper airway obstruction (eg, snoring, gasping). The condition is associated with systemic hypertension. Prolonged, untreated obstructive sleep apnea can also cause what?
pulmonary hypertension and right heart failure.
_____________ pulmonary disease is characterized by markedly reduced expiratory airflow velocity, increased residual volume, and limitation of tidal volume due to hyperinflation
Chronic obstructive pulmonary disease
Harse, crescendo-decrescendo systolic ejection murmur at right second intercostal space with radiation to carotids = ?
aortic stenosis.
Communicating hydroceles and indirect inguinal hernias are caused by what???
Communicating hydroceles and indirect inguinal hernias are caused by an incomplete obliteration of the processus vaginalis. The resultant connection between the scrotum and abdominal cavity can allow for fluid leakage (hydrocele) or the passage of abdominal contents (indirect inguinal hernia).
What are the most effective agents for the treatment of hypertriglyceridemia.
Fibrates (eg, fenofibrate) are the most effective agents for the treatment of hypertriglyceridemia.
Binding to mu receptors on the postsynaptic membrane causes opening of __________ channels and membrane ____________.
K+ channels and membrane hyperpolization
Opiate analgesics reduce pain by binding to mu receptors and inhibiting synaptic activity in the central nervous system. Activation of presynaptic mu receptors on the primary afferent neuron leads to closure of voltage-gated calcium channels and reduced excitatory neurotransmitter release. Binding to mu receptors on the postsynaptic membrane causes opening of potassium channels and membrane hyperpolarization.
What syndrome consists of the triad of eczema, thrombocytopenia and combined B-lymphocyte and T-lymphocyte deficiency.
Wiskott-Aldrich syndrome
What drug tends to bind to inactivated sodium channels and rapidly dissociates. As a result, it is effective in suppressing ventricular tachyarrhythmias induced by rapidly depolarizing and ischemic myocardium.
Lidocaine is a class IB antiarrhythmic
What are the class III antiarrhythmic drugs?
Amiodarone
Sotalol
Dofetilide
Black K+ ch. blocked outward K+ current in phase 3 ==> prolonging repolarazation and total AP duration.
Hospitalized and postoperative patients are at risk for ____________, which presents with tachypnea, tachycardia, cough, and pleuritic chest pain
pulmonary embolism
Hypoxemia develops in patients with pulmonary embolism due to what?
ventilation/perfusion mismatch.
Where do long-chain fatty acids under oxidation?
Peroxisomes
Lung cancers are prone to early local and distant spread. Intrathoracic expansion of a tumor can cause a number of distinctive syndromes, including irritation and palsy of what nerve?
phrenic nerve
Left ventricular leads in biventricular pacemakers course through the coronary sinus, which resides in the _____________ on the posterior aspect of the heart.
atrioventricular groove
______________ mutations are single base substitutions that result in the placement of an incorrect amino acid in a protein sequence. These mutations occur within the coding region of a gene and do not alter protein length.
Missense
What is the uptake of naked DNA by prokaryotic or eukaryotic cells called?
Transformation
In virology, transformation also describes incorptation of viral DNA into a host cell chromosome (LYSOGENY)
Does genetic transformation cause genomic change in progeny virions?
NO!!!
Transformation alters the genetic composition of the host cell but typically causes no genomic change in progeny virions.
What is the mixing of genome segments in segmented viruses that infect the same host cell called?
Genetic Reassortment
What refers to changes in genomic composition that occur when host cells are coinfected with 2 segmented viruses that exchange whole genome segment?
Reassortment.
Must have a segmented genome
(Herpes Virus cannot undergo genetic reassortment b/c it has a nonsegmented genome)
What refers to the exchange of genes between 3 chromosomes via CROSSING OVER within homologies regions?
Genetic recombination.
virus strains that have non-segmented, double-stranded DNA genomes can do this b/c they have similar sequence similarity, allowing cross over to occur with rel. high freq.
What type of muscle fibers are seen in mitochondrial diseases?
“Red ragged” muscle fibers.
Mitochondrial diseases who maternal inheritance.
X-inactivation occurs in genetically normal females and results in conversion of the inactivated X chromosome into what?
compact heterochromatin (Barr body)
Flat facies
Protruding tongue
Small ears
Upslanting palpebral fissures
== ?
Down Syndrome; Trisomy 21
Early-onset familial Alzheimer disease is associated with what three gene mutations:
- APP (chromosome 21)
- Presenilin 1
- Presenilin 2.
Late-onset familial Alzheimer disease is associated with what genotype?
apolipoprotein E4 genotype.
What describes instances where multiple phenotypic manifestations result from a SINGLE genetic mutation?
Pleiotrophy
What is Locus Heterogeneity?
Locus heterogeneity refers to the ability of one disease or trait to be caused by mutations in multiple different genes.
An example is familial hypercholesteremia, which can be caused by different mutations affecting cholesterol metabolism genes (eg, LDL receptor, apo B-100).
___________ describes the tendency of alleles located near one another on the same chromosome to be inherited jointly.
Genetic linkage
Describe Dominant negative mutations.
Dominant negative mutations occur when an abnormal gene negatively affects the product of the wild-type gene in the same cell.
For example, certain oncogene p53 mutations can lead to translation of a protein product that prevents wild-type p53 from binding to the promoter of its target genes.
Multiple mutations affects cholesterol metabolism genes (eg, LDL receptors, apo B-100) results in Familial Hypercholesteremia.
This is an example of what genetic principle?
Locus heterogeneity
c-MYC is an oncogene located on chromosome ___. Mutations are associated with Burkitt lymphoma and diffuse large B cell lymphoma.
c-MYC ~ Chr. 8
NF-1 is a tumor suppressor gene located on chromosome ___. Mutations of this gene cause neurofibromatosis type 1.
NF-1 ~ Chr. 17
The RB tumor suppressor gene (anti-oncogene) is located on chromosome ___. Mutations of this gene lead to the development of retinoblastoma and osteosarcoma.
RB tumor suppressor gene ~ Chr. 13
Mutations of the WT-1 tumor suppressor gene are associated with the development of Wilms tumor. This gene is located on what chromosome?
WT-1 ~ Chr. 11
Fragile X syndrome is caused by an increased number of CGG trinucleotide repeats on the fragile X mental retardation 1 (FMR1) gene on the long arm of the X chromosome.
What does this lead to?
This leads to hypermethylation and inactivation of FMR1.
Gene methylation ==> inactivation
Viruses with segmented genomes (eg, orthomyxoviruses, rotaviruses) are capable of genetic shifts through what?
Reassortment
Reassortment (genetic _____) involves exchange of entire genomic segments,
SHIFT
a far more dramatic process than the point mutations responsible for genetic drift.
The vignette states that the patient’s mutation affects an exon, meaning that the mutation will be detectable in the ???
mRNA sequence.
Point mutations (and non-sense mut; b/c they are fucked single base) in the exons of a gene (such as those responsible for causing nonsense mutations) are unlikely to affect what?
total mRNA (cDNA) size.
The lack of cremaster reflex is a result of damage to the ____________ nerve; the effector nerve of the cremasteric muscle.
genitofemoral nerve (L1 ventral ramus),
What major vein of the leg empties into the femoral vein just inferior to the medial border of the inguinal ligament?
great saphenous vein
where does the small saphenous vein joins the popliteal vein?
Popliteal fossa
What nerves make the Detrusor contract and begin micturition?
PNS (S2-S4)
What nerves makes the internal sphincter relax and permit micturition?
PNA (S2-S4)
What nerves causes contraction of the internal sphincter and inhibits micturition?
SNS (L1-L3)
What nerves causes Detrusor m. to relax and allow bladder filling?
SNS (L1-L3)
What syndrome can occur in the case of a lesion in the sympathetic trunk/ganglia supplying the eye, head, and neck
Horner’s syndrome is characterized by a triad miosis, anhidrosis, and ptosis
when the left renal vein is compressed by the SMA and the aorta as the vein travels from the left kidney to the inferior vena cava,
this is called?
Nutcracker Synd.
The _____________ muscle belongs to the posterior compartment of the leg
tibialis posterior m.
The cranial nerve most commonly affected by comminuted occipital condyle fractures is ???
XII, due to the close relationship of the hypoglossal canal to the occipital condyles.
In a posterior dislocation (the majority of hip dislocations), the ________ nerve can be damaged.
sciatic n.
Melanocytes, odontoblasts, pia and arachnoid mater, Schwann cells, cells of the ganglia, parafollicular C cells of the thyroid, chromaffin cells, the aorticopulmonary septum, pharyngeal arch skeletal components, and the neurocranium are all derived from :????
neural crest cells, a specific portion of the neuroectoderm.
congenital T-lymphocyte deficiency, known as DiGeorge syndrome, will have which part of the Lymph node underdeveloped?
Paracortex
What type of lymphocytes are concentrated in lymphoid follicles located in the superficial cortex
B
____________ of lymph nodes drain lymph from cortical sinuses. They connect to efferent lymphatic vessels.
Medullary sinuses
A follicle that has a central pale area is called a _______________ and consists of actively proliferating B lymphocytes
germinal center
The ______________ consist primarily of plasma cells in their final stage of maturation into immunoglobulin-secreting cells.
medullary cords
The muscles that elevate the palate and the pharynx are derived from which branchial arches?
The muscles that elevate the palate and the pharynx are derived from:
- branchial arch 1 (tensor veli palatini)
- branchial arch 3 (the stylopharyngeus)
- branchial arch 4 (levator veli palatini).
These are innervated by cranial nerves V3, IX, and X, respectively.
The Wolffian ducts develop into most of the male internal genital structures in response to testosterone; what are they? (5)
mnemonic BEEDS:
- trigone of the Bladder
- Epididymis
- Ejaculatory duct
- Ductus deferens
- Seminal vesicles.
Which type of bone formation is fucked in achondroplasia?
Endochondral ossification
Intramembranous ossification is unaffected.
Cleft palates = ?
Failure of the palatine processes to fuse
bilateral acoustic neuromas (also known as vestibular schwannomas). Bilateral lesions of this sort can only be caused by ??? On what Chromosome?
neurofibromatosis type 2 ~ Chr. 22q.
Embryological origin of pancreatic adenocarcinoma?
Ventral pancreatic bud
During Prego; Mom has Fever, arthralgias, and lymphadenopathy followed by a rash that spreads from face caudally to the rest of the body.
What congenital condition?
An important risk factor for PDA is congenital rubella.
Maneuvers that decrease preload (i.e., decrease ventricular size), such as the Valsalva maneuver or standing, increase the intensity of what murmur?
Hypertrophic cardiomyopathy
What actions increases preload? (with respect to murmurs)
- Straight Leg Raise
- inspiration (increases venous return)
What actions decrease preload? (with respect to murmurs)
Valsalva
standing up from a sited position.
What is the Tx for minimal change disease in peds?
prednisone
What is the MOA of succinylcholine?
depolarizing paralytic;
Succinylcholine acts by binding to the postsynaptic nicotinic ACh (nACh) receptors and produces sustained depolarization.
The depolarization opens sodium channels, but after a brief period of time, continued depolarization will cause inactivation of the sodium channels, producing accommodation. The result is complete muscle paralysis.
What is the classic timeline for the pathogenesis of Stevens-Johnson syndrome (SJS)?
SJS is characterized by fever and malaise 1-3 days prior to the appearance of skin and mucocutaneous lesions.
What is the histopath of Stevens-Johnson syndrome (SJS)?
keratinocyte necrosis and detachment of skin at the dermal-epidermal junction.
*( Toxic epidermal necrolysis is a more severe form of SJS that involves more than 30% of the body surface area.)
Pemphigus vulgaris and Bullous pemphigoid are autoimmune skin disorders that are NOT ~w/ what S/Sx?
Fevers!
Bullous pemphigoid is an autoimmune skin disorder with IgG autoantibodies against hemidesmosomes. It is not associated with fevers and rarely involves the mucous membranes.
What pathway is the enzyme homogentisic-acid dioxygenase involved in? and a defect in this enzyme is called?
homogentisic-acid dioxygenase involved degradation of tyrosine to fumarate.
Defect in homogentisic-acid dioxygenase = alkaptonuria
Acutely, a patient with rheumatic fever would most likely show signs of a _____________ because rheumatic fever causes all parts of the heart to be inflamed (myocarditis and endocarditis), which can lead to valvular insufficiency.
mitral regurgitation
Increase sed rate is one of the jones criteria.
Characteristic physical exam findings; is what?
central obesity
dorsocervical fat pad
striae
moon facies
Cushing syndrome results from elevated cortisol levels. Signs and symptoms of Cushing syndrome include weight gain, fat redistribution, hypertension, hyperglycemia, amenorrhea, and impotence.
Pt. presents with paroxysmal headache, sweating, and tachycardia. Hypertension is present in half of cases.
????
pheochromocytoma (epinephrine-secreting tumor)
extremely high fever and confusion are not characteristic of a pheochromocytoma.
blasztocyst implanted into the ampulla ==> ???
ectopic prego
reuptured –> huge ongoing blood loss, leading to decreased hematocrit and unstable vital signs. The most common risk factors are pelvic inflammatory disease, prior appendicitis or endometriosis, and previous abdominal surgery.
The third aortic arch gives rise to the ???
common carotids as well as the proximal part of the internal carotids.
Thyroid tissue initially develops at the ___________ near the base of the tongue, before beginning its descent to the thyroid cartilage.
foramen cecum
Exotoxin A is produced by what pathogen?
Streptococcus pyogenes (group A Streptococcus).
C. difficile produces
______1_____, which binds to the intestinal brush border
&
______2_____, a cytotoxin that causes cytoskeletal disruption and pseudomembranous colitis.
- toxin A
2. toxin B
C. difficile produces
toxin A, which == ???
&
toxin B, a cytotoxin that causes == ???
toxin A, which binds to the intestinal brush border.
&
toxin B, a cytotoxin that causes cytoskeletal disruption and pseudomembranous colitis.
“high-pitched” sound following S2 describes what?
the “low-pitched flow murmur” is another way to describe a what?
“opening snap” of mitral stenosis,
“diastolic rumble.”
What supplies blood to the pylorus and proximal duodenum?
gastroduodenal artery; which branches from the common hepatic artery (one of the major branches of the celiac trunk),
The “dead space” in the lungs refers to what?
the volume of air that is not participating in gas exchange.
ex. PE
due to HDL loss in the urine., what is ~w/ with nephrotic syndrome?
Decreased high-density lipoprotein (HDL) and atherosclerosis are associated with nephrotic syndrome due to HDL loss in the urine.
urinalysis with erythrocyte casts suggestive of what?
glomerulonephritis
African American patients with SLE are commonly affected by what kidney patho?
proliferative lupus nephritis
_______________, an autosomal dominant disorder in which the ossicles of the middle ear become fused. This is the most common cause of conduction hearing loss in the elderly.
otosclerosis
The axillary nerve travels through the quadrangular space with the _____________ artery, which can also be damaged by fractures to the surgical neck of the humerus.
posterior circumflex humeral a.
Fracture at the surgical neck of the humerus classically produces injury to the axillary nerve. This injury affects several muscles, most notably the deltoid and teres minor.
Fracture at __________________ classically produces injury to the axillary nerve. This injury affects several muscles, most notably the deltoid and teres minor.
the surgical neck of the humerus
The treatment for methanol poisoning is administration of ___________.
fomepizole.
Fomepizole inhibits alcohol dehydrogenase, which further prohibits methanol metabolism.
ketoconazole ________ the cytochrome P450 (CYP450) system
inhibitor
A presentation of combined asymmetric upper and lower motor neuron disease (suggested by weakness with both hyporeflexia and hyperreflexia), along with fasciculations (particularly of the tongue) and cramping with a preservation of cognitive function are highly suggestive of what disease pathology?
amyotrophic lateral sclerosis (ALS)
Endolymphatic sac tumors are a rare tumor type occasionally seen within the context of ____________ Syndrome.
von Hippel-Lindau
patients suffer from transient bouts of peripheral vertigo and hearing abnormalities accompanied by a “feeling of fullness” in the ear ==>
Ménière’s disease.
caused by a paroxysmal accumulation of endolymph fluid, and is generally treated with diuretics.
. At rest, the patient presents with “claw hand.” In median claw hand, the loss of lumbrical function results in an inability to flex the second and third MCP joints and extend the DIP and PIP joints. When attempting to make a fist, the patient is unable to flex her first and second digits resulting in the “Pope’s blessing” hand, or “hand of benediction.”
What nerve is damaged and where?
median nerve injury d/t Supracondylar Fracture
An _________ is a misperception of external stimuli
An illusion is a misperception of external stimuli
The belief that normal external occurrences have deeply personal significance to the individual. An example of an idea of reference is a patient who believes that the people on TV are talking directly to or about him. Ideas of reference can be considered a subset of delusions, and are one possible symptom of schizophrenia, bipolar disorder, and other psychiatric illnesses.
???
An idea or delusion of reference
What is the drug prophalaxis for cluster headaches?
Verapamil, a calcium channel blocker.
patients often present with nonspecific symptoms such as fatigue, pruritus, abdominal pain, fever, weight loss, and intermittent jaundice. Physical exam shows scleral icterus, jaundice, and hepatomegaly. Laboratory evaluations are notable for an elevated alkaline phosphatase, direct and total bilirubin, and gamma globulin.
Transaminases are normal or mildly elevated.
primary sclerosing cholangitis (PSC); associated with ulcerative colitis.
What drug/drug class can be used to decrease the breakdown of dopamine in the brain. It may be used to potentiate the effect of levodopa in the treatment of Parkinson’s, but does not cause anticholinergic side effects.
Selegiline is a monoamine oxidase (MAO) inhibitor
What drug is used to treat the tremors of Parkinson’s disease? And what are the ADRs?
Benztropine (acetylcholine antagonist)
dry-mouth, constipation, blurry-vision, flushing, and tachycardia – are classically associated with anticholinergic medications.
_________ azotemia: BUN:Cr ratio is increased (>15) due to the renal tubule reabsorbing BUN along with other solutes in the setting of intravascular volume depletion. Creatinine is not reabsorbed, so the BUN:Cr ratio is high.
Prerenal azotemia
___________ azotemia: Tubule dysfunction prevents BUN being reabsorbed, so the BUN:Cr ratio falls (<15).
Intrinsic renal azotemia
________ azotemia: Obstruction of the urinary tract can initially cause an increased BUN:Cr ratio (>15) as a result of the back pressure increasing the time available for BUN reabsorption. However, as this progresses to tubular damage (late stages), the BUN:Cr ratio drops (<15) since BUN reabsorption is reduced.
Postrenal azotemia
increased protein catabolism does what to the BUN and the Cr.
iincreases BUN while the Cr is normal
