NBME 7 Flashcards
fever, pyuria s/p prostatectomy w/catheter
p. aeruginosa
anticentromere Ab
CREST
which MHC is used to display antigens by macrophages?
MHC II
MHC II peptide loading affected by metabolite concentration (inc. pH) in:
endosomes, liposomes, phagolysosomes
deep brain stimulation for parkinson’s in the:
globus pallidus (also thalamus and subthalamic nucleus)
placenta accreta
invasion of 75% of the myometrium
placenta percreta
invasion of ENTIRE myometrium
hot tub folliculitis
p. aeruginosa
duchenne’s
X-linked recessive
I cell disease (inclusion)
no urine mucopolysaccharide, skin fibroblasts w/dense inclusion bodies, defect in Golgi complex GlcNAc phosphotransferase (transfers P to mannose for lysosomal targeting)
BUN/creat ratio > 15
prerenal azotemia: kidney hypoperfusion–> dec. GFR–> inc. ratio
decreased BUN/creat ratio <10, FeNa 3%
intrarenal azotemia
after some exhalation, air flow is limited by __________ and determined by elastic recoil and resistance upstream
airway compression
restrictive disease
max flow decreases as total V expired; abnormally high flow in latter expiration b/c of inc. recoil
oxidase positive, nonlactose-fermenting, gm neg bacillus, unipolar motility, pyocyanin (blue-green)
p. aeruginosa
obstructive disease
low flow, scooped after point of max flow
neuro sx similar to botulinum, small cell ca
lambert eaton myasthenic syndrome: dec. Ca–> dec. Ach in NMJ affects skeletal m., autonomics, cerebellum
coarse facial features, hip dislocation, inguinal hernia, hypotonia
I cell disease
incoordination, ataxia, loss of sensation of ipsi half of face, contra trunk/ext., loss of CN V, IX, X, XI
lateral medullary/PICA syndrome (Wallenberg’s)
fever, catatonia, muscle rigidity, delirium, myoglobinemia, inc. CK w/hx of chlorpromazine
NMS
chlorpromazine
typical antipsychotic; dopamine antagonist
addison’s disease (primary adrenal insuff.)
dec. aldosterone and cortisol–> hypotension, skin pigmentation (POMC–> ACTH–> alpha-MSH), calcified pinna
secondary or tertiary hypocortisolism
dec. CRH or ACTH; no skin pigmentation
von gierke’s disease
glucose 6 phosphatase def.–> hypoglycemia; inc. glycogen in liver/kidneys; lactic acidosis, hyperlipidemia–> fat cheeks; inc. uric acid; tx: continuous feeds of carbs
winter’s formula for metabolic acidosis
expected pCO2 = (1.5 x HCO3) + 8 +/-2………. If actual pCO2 >, primary resp. acid.; if actual pCO2 <, primary resp. alk.
intrarenal azotemia w/muddy casts and tubulorrhexis
ATN of PCT
how does alcohol kill bacteria?
disintegrates cell membrane (making lipids water soluble), then denatures proteins
mutation in HbS
glutamate (hydrophilic) to valine (hydrophobic)
why do RBCs sickle w/HBS?
to gain stabilizing hydrophobic interactions
spinothalamic tract
decussates at spinal cord; P&T
decussates at medulla
posterior column medial lemniscus, corticospinal tract
lateral corticospinal tract
voluntary motor
dorsal columns
pressure, vibration, fine touch, proprioception
tophi locations
external ear, olecranon bursa, achilles tendon
botulinum toxin
heavy chain (endocytosis); light chain (protease); toxin A degrades SNAP-25 protein (SNARE normally fuses vesicle for NT release) to inh. Release of Ach into synaptic cleft
schizoid personality d/o
no interest in relationships, solitary, secretive, emotionally cord
high SD = high variability = homo or hetero population?
heterogeneous
cingulate gyrus herniation
limbic system; abnormal posturing and coma
uncal herniation
ipsi pupillary dilation 1st (parasymp fibers on outside of CN III), eyes down and out; ipsi primary visual cortex (PCA) and contra homonymous hemianopia
duret hemorrhages
midbrain, pons–> reticular formation
decorticate posturing, respiratory depression, lethargy, dec. HR
uncal herniation
adenylyl cyclase activation requires:
GTP binding
dec. SV, inc. LAP and PVR
mitral regurgitation
MR murmur increases with:
inc. TPR: squat, handgrip; inc. VR: expiration
inc. preload and dec. afterload does what to SV?
increases SV
S3
ischemia, MVP, LV dilation
synchronized d/c (spike and wave) of thalamocortical neurons
absence seizures (similar to delta SWS in stage 3 and 4)
MLF lesion
internuclear ophthalmoplegia- one eye won’t cross midline; integrates CN III, IV, VI, VIII, FEF
multiple sclerosis
internuclear opthalmoplegia w/contra nystagmus, diplopia
dec. diffusing capactiy for CO (DLco)
ARDS
inc. Na intake leads to:
inc. PV, wt, cardiac/SV index, kidney failure
budding yeast, soil, pigeon droppings
cryptococcus
india ink w/latex agg test for cryptococcus looks for:
polysaccharide capsular antigen
hypotension w/gm neg rods
LPS stim. TNF-alpha and IL-1 via TLR-4 binding CD14 on monocytes/macrphages/PMNs
vertebral mets w/pleomorphic epithelial cells forming duct-like structures
prostate adenocarcinoma
asymmetric gluteal folds in newborn
hip dislocation
congenital hip dislocation without tx
erosive arthropathy
strongest hip ligament
iliofemoral
generalized tonic-clonic seizure tx:
valproate: inh. VG Na and T-type Ca channels, inc. GABA; carbamazepine: stabilizes inactive Na channels, inc. GABA; phenytoin: stabilizes inactiv. Na channels