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Step One > Learn from your mistakes 2 > Flashcards

Learn from your mistakes 2 Flashcards

1
Q

mountain alkalosis

A

hyperventilation causes hypocapnia in addition to hypoxia

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2
Q

hyperosmotic contraction

A

loss of free water

diabetes insipidus

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3
Q

identify appendix

A

teniae coli

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4
Q

combined beta blockers and non-dihydropyridine ca channel blockers

A

additive negative chronotropic effects

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5
Q

xanthelesma

A

seen in primary biliary cirrhosis

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6
Q

spinal stenosis

A

most common in lumbar region

usually due to disc herniation, ligamentum flavum hypertrophy and osteophyte formation

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7
Q

buildup of pressure in idiopathic intracranial hypertension

A

leads to impaired axoplasmic flow

optic nerve compression

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8
Q

prevention of gynecomastia in prostate patients

A

tamoxifen

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9
Q

saccular vs charcot

A

charcot from HTN leads to intracerebral hemorrhage

saccular subarachnoid hemorrhage

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10
Q

posterior view of knee prominent

A

posterior cruciate ligament

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11
Q

desire hepatic clearance

A

high lipophilicity

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12
Q

schizo without mood symptoms

A

schizoaffective

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13
Q

injured during appendectomy

A

iliohypogastric nerve

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14
Q

conversion of sorbitol

A

into fructose by sorbitol dehydrogenase

when it doesnt happen in diabetes leads to fluid accumulation

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15
Q

AA that become propionyl CoA

A

valine
isoleucine
methionine
threonine

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16
Q

glucose transport into adipocytes

A

carrier-mediated transport

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17
Q

rapid relief to RA

A

glucocorticoids and NSAIDs

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18
Q

atrial fib

A

loss of atrial contraction decreases preload and can exacerbate aortic stenosis

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19
Q

inferior wall MI

A

decrease CO and PCWP

increase CVP due to RV dysfunction and impaired forward flow

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20
Q

no heme synthesis in RBC

A

no mitochondria

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21
Q

repeated infarct in sickle cell

A

fibrosis and atrophy

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22
Q

pathogenesis hepatic seatosis

A

due to decreased beta oxidation and excess NADH

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23
Q

CREST in esophagus

A

fibrous replacement of lower esophagus

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24
Q

v wave on left atrial tracing

A

mitral regurg

upsloping atrial pressure

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25
Q

influenza vaccination

A

inhibition of viral entry into cells

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26
Q

risk factors nephrolithiasis

A 
low fluid
low calcium
high oxalate
high protein
high sodium
high fructose
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27
Q

retroperitoneal hematoma from warfarin

A 
injures femoral (passes through psoas)
loss of sensation anterior aspect or thigh
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28
Q

adverese cholorthalidone

A

hypercholestrolemia

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29
Q

ischemic colon

A

problem with pyruvate dehydrogenase

leads to lactic acidosis due to anaerobic conditions

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30
Q

no edema

A

increased lymph drainage

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31
Q

alter inositol in alpha1

A

change PKC because PLC comes before IP3 so unaffected

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32
Q

inhibited by F26BP

A

alanine to glucose

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33
Q

result of demyelination

A

change in length constant

demyelination increases time constant

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34
Q

renal angiomyolipoma

A

TS

association with brain hamartomas and ash leaf skin patches

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35
Q

dimpling breast cancer

A

impact suspensory ligament

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36
Q

limited language proficiency

A

have an interpreter

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37
Q

mediator acute hemorrhagic transfusion reaction

A

complement mediated cell lysis

type II HSR

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38
Q

placement of pacemaker

A

place in atrioventricular groove

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39
Q

ablation for arrhythmia

A

interartial septum near opening of the coronary sinus

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40
Q

abnormal ABG in obese pation

A

obesity hypoventilation syndrome

hypoxemia and normal A-a gradient

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41
Q

3’ end of tRNA

A

CCA

contains chemically modified bases

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42
Q

theophylline toxicity

A

from cipro, macrolides, verapamil, or cimetidine due to altered hepatic cytochrome oxidases

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43
Q

formation of fibrous cap in atheroma

A

from vascular smooth muscle cells

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44
Q

findings of serum sickness

A

type III HSR with low c3 and c4

rash and arthralgias

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45
Q

cholesterol stone fromation

A

gemfibrozil

fibrates reduce bile acid synthesis

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46
Q

target of adrenal hyperplasia

A

ACTH

androgen not testosterone from reticularis-contributes very little to overall virilization-testosterone

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47
Q

arthritis and rash

A

Parvo infection

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48
Q

deep brain stim for parkinson

A

target subthalamic nucleus

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49
Q

bleeding esophageal varices

A

portal vein thrombosis

causes hypertension, splenomegaly, and varices

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50
Q

cause of AAA

A

chronic transmural inflammation
oxidative stress and smooth muscle apoptosis
(cystic medial in Marfan)

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51
Q

lactose intolerance stool

A

decrease pH
short chain FA acidify the stool
elevated stool osmolality

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52
Q

dermatomyositis

A

paraneoplastic from carcinoma (ovarian, lung, colorectal, non-Hodgkin lymphoma)

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53
Q

AV shunts

A

increase preload and decrease afterload

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54
Q

paraneoplastic small cell lung cancer to the brain

A

degeneration

autoimmune from anti-Yo, P/Q, and Hu antibodies

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55
Q

increased substance in overgrowth from bypass

A

folate and vitamin K

due to production from enteric bacteria

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56
Q

increased wedge

A

wedge estimates LA pressure

increase in wedge would be seen in mitral stenosis

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57
Q

Rosenthal fibers

A

seen pilocytic astrocytoma

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58
Q

cause of vitiligo

A

loss of epidermal melanocytes

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59
Q

anterolateral fracture of humerus

A

radial nerve injury
results in wrist drop
brachial artery runs with median nerve and could be injured in anteromedial fracture

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60
Q

putamen location

A

lateral to basal ganglia in cross section

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61
Q

artery with radial nerve

injured in mid-humerus fracture

A

deep branch of brachial artery

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62
Q

gluconeogenesis

A

glycerol kinase

important in DKA

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63
Q

endogenous synthesis niacin

A

from tryptophan

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64
Q

serpentine pattern

A

virulence

responsible for inactivating neutrophils, damaging mitochondria, and inducing release of TNF

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65
Q

NE to epi

A

PMNT

stimulated by cortisol

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66
Q

benzos vs SSRI for panic disorder

A

avoid benzos in patients with history of drug abuse

can give SSRI instead

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67
Q

tabes dorsalis and light that does not react to light

A

spirochete infection

tertiary syphilis

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68
Q

treatment primary psychogenic polydipsia

A

water deprivation

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69
Q

ARP

A

100(RR-1)/RR

70
Q

nitroglycerin

A

decrease SVR, increase venous capacitance, decrease LV EDV

71
Q

MOA carbamazepine

A

decrease Na

72
Q

ureter obstruction

A

decrease GFR and FF

73
Q

maturity onset diabetes

A

mutation in glucokinase

74
Q

normal in ARDS

A

PWCP

75
Q

diabetic mononeuropathy

A

ischemic injury

76
Q

enterococcus

A

important cause of UTI
similar to strep/staph-gram positive cocci
cause gamma hemolysis

77
Q

labs vitamin D def

A

decreased Ca and phosphate but increased PTH

78
Q

RNA polymerase order

A

rmt

inhibition of RNAP II by toxin leads to inhibition of mRNA

79
Q

hepatotoxicity from inhaled anesthetic

A

leads to prolonged PT due to def in factor VII

80
Q

gallstone ileus

A

leads to air in the ducts and biliary tree

81
Q

aortic dissection

A

from HTN

82
Q

GTP production

A

succinyl CoA synthetase

use the GTP for formation of PEP from oxaloacetate

83
Q

eosinophilia in the presence of parasitic infection

A

antibody mediated killing

immediate HSR mediated more by mast cells and basophils

84
Q

anti-citrullated Ab

A

found in RA

more specific

85
Q

eosinophilic casts

A

seen in multiple myeloma

86
Q

chronic lymphedema post lymph node dissection

A

leads to angiosarcoma

87
Q

derivation of Schwannoma

A

CN VIII

88
Q

first line in generalized anxiety disorder

A

SSRI

citalopram

89
Q

uric acid stone in the context of diarrhea

A

leads to increased H excretion in the kidney

metabolic alkalosis from the diarrhea

90
Q

increased CK

A

seen in hypothyroid

check TSH to determine the etiology

91
Q

increased in COPD/emphysema

A

RV/TLC

92
Q

dietary intake of fructose in essential fructosuria

A

hexokinase allows for some conversion

93
Q

disypyramide

A 
class I channel blocker 
used as an anti-arrhythmic
94
Q

gemfibro

A

stone formation by decreasing cholesterol solubility and also decrease formation of bile acids

95
Q

geniculate nucleus

A

ipsilateral

96
Q

B cell lymphoma in context of HIV

A

associated with EBV

Burkitt lymphoma-Ki67

97
Q

superior vena cava

A

seen in the context of a mediastinal mass

can occur with superior sulcus tumor but less likely

98
Q

gallstones without alcohol consumption

A

check TG

could be result of hypertriglyceridemia

99
Q

increased thyroid hormones in context of male germ cell tumor

A

due to production of hCG

100
Q

basophilic structure in cell

A

nucleolus
RNAPI is restricted to the nucleus to make ribosomal components
increased in malignant cells

101
Q

reciting months backwards

A

concentration

102
Q

cause of gastric varices

A

splenic thrombosis

short gastric on fundus

103
Q

no pyruvate dehydrogenase

A

increase lactic acid

104
Q

ESR

A

impacted by acute phase reactants causing an increase in fibrinogen

105
Q

treatment resistant schizophrenia

A

clozapine

watch out for agranulocytosis

106
Q

net excretion

A

inulin(plasma)-reabsorption

107
Q

injury at 12th rib

A

kidney injury

spleen is at 9-11

108
Q

severity of mitral stenosis

A

time to snap from A2

109
Q

rhabdomyolysis

A

no full RBC (only trace amounts) and increased CK

110
Q

target deep stim parkinson

A

subthalamic nucleus

111
Q

MOA glitinides

A

work on membrane ion channel

ATP dependent K channel

112
Q

septic abortion infection

A

staph

113
Q

detection mRNA

A

RT-PCR

114
Q

location hydroxylation of proline

A

RER

115
Q

lowest concentration PAH

A

Bowmans space

majority secreted in PCT

116
Q

phosphatidylcholine in gallstones

A

decreased along with bile acids

117
Q

AV gradient of anesthetics

A

reflects solubility

high solubility, high graidnet, slow onset of action

118
Q

PT

A

VII

119
Q

result of gallbladder hypomotility

A

increase in biliary sludge

can become concentrated leading to stone

120
Q

retroperitoneal hematoma

A

from pancreas rupture

adrenal glands not spleen retroperitoneal

121
Q

yellow theca in mass

A

estrogen

122
Q

Wallerian degeneration

A

axonal reaction

123
Q

sandpaper texture skin lesion

A

actinic keratosis

124
Q

blood transfusion

A

complement mediated lysis

antibody mediated type II reaction

125
Q

direct inguinal hernia

A

weakness in transversalis fascia

126
Q

blunt aortic injury

A

usually to arch at aortic isthmus-tethered by ligamentum arteriosum

127
Q

intermediate acting benzos

A

lorazepam, al and tez

128
Q

reduction in VLDL production

A

fibrates

129
Q

obstructive lesion

A

collapse

mediastinal shift towards the collapsed lung

130
Q

v wave

A

mitral regurg

131
Q

proteasome inhibitors

A

leads to apoptosis

can be used as treatment for MM

132
Q

labs in klinefelter

A

increase FSH due to loss of feedback inhibition

leads to gynecomastia

133
Q

appearance acalculus cholecystitis

A

inflamed gallbladder

134
Q

avoid increase in lactate

A

ketogenic AA-lysine and leucine

135
Q

orotic acid crystals

A

supplement uridine

136
Q

AV canal defect

A

Down syndrome

137
Q

decrease CO curve

A

MI

138
Q

increased parasympathetic tone

A

digoxin

139
Q

immediate relief COPD

A

beta agonists

increase cAMP

140
Q

cephalosporin coverage of Pseudomonas

A

cefepime (moxi as FQN does not cover it)

141
Q

S4

A

decreased compliance

hypertrophy of LV and restrictive heart diseases

142
Q

platelet rich thrombi

A

malignancy

143
Q

wrinkled cells on smear

A

Gaucher disease

beta glucocerebroside def

144
Q

normal CT but neuro signs and HTN

A

hypertension

if abnormal CT then charcot-bouchard

145
Q

palpable purpura

A 
associated with medications (penicillin)
see vasculitis (leukocytic vasculitis)
146
Q

necrolytic migratory erythema

A

seen in glucagonoma

147
Q

ovarian torsion

A

twisting on infundibulopelvic

148
Q

treat blanching of NE

A

phentolamine

149
Q

denervation deltoid

A

axillary

150
Q

bronchiolitis obliterans

A

chronic rejection to small airways

151
Q

Henoch-Scholein

A

joint pain from the vasculitis

152
Q

necrosis and eosin staining in skin lesion

A

PAN

seen in hepatitis B

153
Q

oxalate crystals

A

methylene glycol poisoning

leads to acute tubular necrosis

154
Q

clots in hemophilia

A

from thrombin

155
Q

clasp knife

A

from internal capsule stroke

UMN

156
Q

MSH2

A

Lynch

157
Q

supplement homocystinuria

A

pyridoxine

158
Q

cause of spinal stenosis

A

ligamentum flavum

159
Q

formation of abscess in the lung

A

from lysosomes (release lysosome contents from macrophages)

160
Q

RV infarct

A

leads to decrease CO, decreased wedge pressure

increased central venous pressure (due to RV dysfunction and feed forward pressure)

161
Q

labs Celiac

A

malabsorption of fat soluble vitamins-vitamin D

leads to increased PTH and decreased PO4 and Ca

162
Q

MOA fondiparinux

A

binds anti-thrombin III

163
Q

child with high fever

A

supportive care only

active cooling only in setting of heat stroke-no proven benefit in febrile seizures

164
Q

eosinophils in urine

A

suggestive of acute interstitial nephritis

165
Q

loss of pulsatile GnRH

A

weight loss, strenuous exercise

functional hypothalamic amenorrhea

166
Q

polycythemia vera

A

cytoplasmic tyrosine kinase

167
Q

increased glycogenolysis in muscle

A

from presence of Ca

168
Q

wedge shaped infarcts

A

global ischemia from hypoxic-ischemia

happens in watershed regions of the brain

169
Q

most common site kidney cancer met

A

lung

170
Q

pulmonary emboli

A

wedge shaped

can occur after tricuspid endocarditis

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