LAST STRETCH Flashcards
internal carotid artery aneurysm can affect which part of the optic tract?
the lateral part of optic chiasm
small bowel cancer at the 3rd part of duodenum, which structure would it invade? how about 1st part /2nd part?
SMA. 1st part is gastroduodenal artery. 2nd part is common bile duct
left lower sternal border murmur that DECREASES on hand grip, dx?
HOCM
older guy with back pain, worse at night, position change and medications don’t help, dx?
spinal mets
papules on tongue and lips. calcitonin increased. marfanoid habitus. what other complication?
pheochromocytoma leading to headaches. MEN2A has marfanoid. Calcitonin is medullary CA of thyroid
brain infarction, what kind of necrosis? other tissue infarction?
liquefactive necrosis. all other tissues is coagulative- maintaining the structure of the cell because lytic enzymes are inactivated
integrin binds to what in extracellular matrix
fibronectin
12 yo boy with brain tumor, biopsy shows cysts with cholesterol crystals, dx?
craniopharyngioma
hives in elderly guy, rx? why?
2nd gen antihistamines, loratidine/cetirizine. cannot cross BBB
recovery phase of ATN, what to look out for?
hypokalemia
12 yo boy with PMH of eczema, presents with intermittent solid dysphagia, biopsy shows ringlike indentations, linear furrowing scattered small whitish papules, dx?
eosinophilic esophagitis
pure red cell aplasias, 3 ddx?
parvovirus b19, thymoma, lymphocytic leukemias
coarse facial features, corneal clouding, defective phosphorylation of mannose residues in the Golgi, where do this proteins usually go?
lysosome. I-cell disease
rabies virus preexposure and postexposure treatment?
pre- inactivated vaccine. post- inactivated vaccine and immunoglobulin
link between pancreatitis and respiratory distress
ARDS because of cytokine and enzymes
councilman bodies
eosinophilic due to hepatocyte apoptosis
VLCFA oxidation happens in the?
peroxisome
immunodeficiency, absent thymic shadow, but calcium level is normal
SCID
clostridium septicum risk factor
colon CA
diabetic gastroparesis rx, 1st line and 2nd line
metoclopramide then erythromycin
what drug to give for boobies in men? danazol, tamoxifen, or bicalutamide
tamoxifen
what is essential for HBV replication and life cycle?
reverse transcription of RNA to DNA. it first enters as partially double strand DNA, uses host machinery to “repair” this then makes RNA, then uses RT to make its own DNA
pathophysiology of aortic calcific stenosis
like atherosclerosis at first then fibroblasts transform to osteoblasts and lay down bone matrix
intermittent explosive vs mood dysregulation
latter is in kids
PPV sigh….
TP/TP and FN
pelvic fracture in a man with urinary retention, where is the injury?
urethra at the membranous portion after the prostatic part
cavernous sinus thrombosis/internal carotid artery/pituitary adenoma, what nerve is affected?
6th nerve lacteral rectus
anaphylaxis, what else is released together with histamine?
tryptase
what causes mast cell degranulation?
receptor aggregation
EBV associated lymphoma, greatest risk factor for this?
HIV
COPD patient with low grade fever and chronic cough, sputum culture shows budding yeast form at 37 degrees, organism?
candida, found in normal oral flora.
orotic aciduria and ammonemia, enzyme deficiency?
ornithine transcarbamylase. the other one is UMP synthase, in pyrimidine synthase pathway that one the ammonia is not high
expanding aneuyrsm of the ICA, what nerve is affected?
abducens. the orbicularis oculi is controlled by facial nerve
drug in heart failure that increases systolic BP, diastolic BP and decreases heart rate, dx?
phenylephrine
CNS tumor, dilation of ventricles and found in the ventricles, dx? and hallmark
ependymoma, perivascular pseudorosettes
mu opiate affect on spinal neurons to exert effect (2)
presynaptic- block influx of voltage gated Ca, inhibiting NT release. postsynaptic- efflux of potassium to hyperpolarize
what kind of polyp in colon have malignancy potential?
villous, adenomatous. lymphoid, hamartomatous, hyperplastic all are low
confusion ataxia opthalmoplegia, what krebs cycle reaction is inhibited?
a-KG dehydrogenase (uses thiamine). pyruvate dehydrogenase too, but EtOH makes Acetyl CoA directly
describe flow of CSF
choroid plexus, monroe, cerebral aqueduct of sylvius, magendie and lushka
p-value and CI. CI of relative risk is 1.02-1.89. what is p-value
less than 0.05 because significant
post lung transplant, pneumonia like illness, organism?
CMV
overdose on methotrexate, rx?
leucovorin- folinic acid
3 mechanisms of Down’s inheritance
nondisjunction, translocation, mosaicism
COPD pneumonia. pick one bacterial and one viral
H. influenza, rhinovirus. Staph is postinfluenza pneumonia
garlic breath and diarrhea after eating insectide for suicide attempt. dx and rx?
arsenic poisoning, dimercaprol
yellow-tinting of objects, dx?
digoxin tox
tremor, benztropine or propranalol?
propranalol for essential tremor, benz for parkinsons
multiple ulcers penis of sexually active guy, biopsy shows big cells with a lot of nuclei, rx?
acyclovir
rx for chancroid, lymphogranuloma venereum?
azithromycin, doxycycline
germ cell tumor in a guy with enlarged thyroid, dx?
b-HCG causing TSH like sxs
ovarian mass in a 23 yo woman, dx?
teratoma
young guy with STDs, maculopapular rash and wart-like raised lesions in scrotum and perineal region, dx?
syphillis, plasma cell infiltrate with endarteritiis
sister yanked her brothers arm, now holding it flexed and pronated, dx?
raidial head sublaxation out of the annular ligament
MAO inhibitors used when in depression
atypical features: increased appetite hypersomnia mood reactivity, leaden paralysis, rejection sensitivity
ASD. what changes in heart are irreversible?
pulmonary htn leading to Eisenmengers
erythema nodosum, hilar LAD and ACE is elevated, dx?
sarcoidosis
influenza virus prev not able to affect humans now are. change of what specifically allows for this?
surface glycoproteins. mechanism: maybe genetic reassortment
frequent infections, mutation on TAP1 gene, normal T B cells and Ig levels. dx?
MHC class I cannot be displayed, leading to CD8 activation defect
north south west southwest, what does it detect
mRNA/DNA/protein/DNA bound protein
primary cilliary dyskinesia triad
bronchiectasis, sinusitis, situs-inversus. and also no flagella on sperm
infection by bacteria, the LPS activates TLR, then transcription factor is freed by inactivating IkB. what is this?
NFkB. TNF-a is the effector
lung cancer, ex smoker, woman, histo shows irregular glands, dx?
adenoCA
paraneoplastic for RCC
PTHrP, EPO
older uncle with hematuria, renal mass and hypercalcemia, firm and enlarged prostate dx?
RCC
precocious puberty, fibrous dysplasia of bone, cafe au lait, dx and mechanism?
mccune albright syndrome, activation of CAMP/Gs/Adenyl cyclase pathway
bell’s palsy, associated with?
decreased tearing (facial nerve has parasympathetic branches to lacrimal gland)
cardiogenic vs non-cardiogenic pulmonary edema can be distinguished by?
PCWP
DMD, what is defect
dystrophin- something that links sarcolemma to cytoskeleton
rupture of intracranial aneuyrsm in young man, a/w?
coarctation of aorta , HTN and vascular abnormalities
post- hysterectomy pain and fever but you can still pee what is injured
ureter
pregnant mother who had arthralgia gives birth to stillborn at 18 weeks. dx?
parvovirus- Single strand DNA naked virus
aortic valve replacement, afterwards has increased LVEDP and decreased aortic diastolic pressure, complication?
aortic regurg
RPGN, what is deposited in the crescents
fibrin
freiderich’s ataxia signs
pes cavus, kyphoscoliosis, ataxia, loss of position sense, a/w HOCM and DM. spinocerebellar tracts. trinucleotide repeat of frataxin gene
eptifibatide and tirofiban and cilostozol and dipyramidole moa?
first 2 are GPII/III a inhibitors. latter 2 are PDE inhibitors, cause vasodilation
tuberin hamartin merlin EGFR
first two are tuberous sclerosis, then NF2 then GBM
