neuro, pscy, repro, endo crine Flashcards
Short/ long(3) acting benzos =
Short/ long acting benzos = olams/ diazepam, chlordiazepoxide, flurazepam…others intermediate(lorazepam)
Paranoid personality(2)
Paranoid personality: distrust & susupicious
_ confirm is person is a patient: confidentiality
Cannot confirm is person is a patient: confidentiality
Report elder, child abuse when patient _ says it(if unable to say due to intidation then _interview)
Report elder, child abuse when patient outright says it(if unable to say due to intidation then separate interview)
TCA’s overdose that cause cardiac arrthymia is due to inbhibiton of _sodium channels which can lead to refractory _.
TCA’s overdose that cause cardiac arrthymia is due to inbhibiton of fast sodium channels which can lead to refractory hypotension.
Volatile (inhaled anesthetics, halothane) eliminated by _
Volatile (inhaled anesthetics, halothane) eliminated by lungser
Adjustment disorder(
Adjustment disorder( <3mths following an event) but if meet criteria for MDD, diagnosis is MDD over adjustment.
Bipolar 2 is _mania
Bipolar 2 is hypomania
Immature: Displacement/ Projection/rationalization:? Mature-Sublimation (channel to acceptable form) ?
Immature: Displacement/ Projection/rationalization: act out feelings to less threating person/attribution one’s feels unto others/ justify to avoid difficult truths; Mature-Sublimation (channel to acceptable form)
Acoustic neuromas are in _ angle-> presents (2)
Acoustic neuromas are in cerebellopontine angle->tinnitus & hearing loss.
_ is first line for anxiety and depression
SSRI is first line for anxiety and depression
Seizures:
focal [simple or complex (2)]
generalized[tonic clonic, myoclonic, absence) .
treatment with / spectrum
if kid with both absence and generalized seizures use_spectrum( ie _ instead of _)
Seizures: focal [simple or complex (postictal state, lip smacking)] /generalized[tonic clonic, myoclonic, absence) treatment with narrow/broad spectrum) : if kid with both absence and generalized seizures use broad spectrum( ie valproate)
Confidentialy above all else unless (4)
Confidentialy above all else unless abuse, knife/gun wonds, communicable disease, risk of self/other harm.
Generalized seizures involve _ hemisphere(ie _) must use _spectrum
Generalized seizures involve both hemisphere: ie both arms moving must use broad spectrum
Severe hypoglycemia with loss of consciousness treatment: / = non/medical setting.
Sever hypoglycemia with loss of consciousness treatment: intramuscular glucagoin /IV dextrose = non/medical setting.
Central DI/Nep DI complete/= s_/_ inc with DDAVP/
Nep DI partial/Primary poly dpsia ?
Norm urine osmolarity 500
Central DI/Nep DI complet/= sharp inc with DDAVP/ no increase ; Nep DI partial/Primary poly dpsia both inc with water deprivation with no change in rate with DDAVP but pp is more rapid and returns to more normal levels. Norm urine osmolarity 500
_hemangiomas are in old people, inc with age
Acrochordons/ cystic hygromas/ cavernous hemangiomas/ spider angiomas/ strawberry: _/ _/ VHL/ estrogen/ regress, baby
Cherry hemangiomas are in old people, inc with age……Acrochordons/ cystic hygromas/ cavernous hemangiomas/ spider angiomas/ strawberry: pedunculated skin outgrouwth/ down’s syndrome/ VHL/ estrogen/ regress, baby
Primary polydipsia: present tih _ disorder or _-induced xerostomia
Primary polydipsia: present tih psychiatric disorder or medication-induced xerostomia
Insulin has renal & hepatic clearance so if with diabetes or _, can have hypoglycemia.
Insulin has renal & hepatic clearance so if with diabetes or ckd, can have hypoglycemia.
MG: / to nondepolarizing/depolarizing neuromuscular blocking agents( _) due to even more dec in ACHR/ less ACHR to deploraizing cell
MG: extremely sensitive/resistant to nondepolarizing/depolarizing neuromuscular blocking agents( curiums) due to even more dec in ACHR/ less ACHR to deploraizing cell
Trinucleotide repeats _ in presentation due to anticipation occurs more frequently with _ transmission
hungtingtons(HTT) has _ penetrance because is dorminant.
Trinucleotide repeats difference in presentation due to anticipation; occurs more frequently with paternal transmission: hungtingtons(HTT) has complete penetrance because is dorminant.
Ovulation @ metaphase _( follicles made at _)
Ovulation @ metaphase 2( follicles made at prophase 1)
Down syndrome meoisis _ nondisjunction( 2 inherit _ chromatid)
Down syndrome meoisis 1 nondisjunction( 1/2 inherit both homologous chorme/ sister chromatid)
Dandy-Walker: _ of cerebella vermis with cytic _of 4th ventricle with _ hydrocephalus
Dandy-Walker: hypoplasia/absence of cerebella vermis with cytic dilation of 4th ventricle with noncommunicating hydrocephalus
Inhib T3-T4 conversion which treat(3) hyperthyridsm
Inhib T3-T4 conversion: PTU, BB, ipodate( contrast) which treat hyperthyridsm
Judgement vrs physician fatigue error=
Judgement vrs physician fatigue error= wrong decision/ neglect,forget
Sringomyleia: loose of pain and temp + some _strength too
Sringomyleia: loose of pain and temp + some moto strength too cause of ant horn cells;
Neoplastic cord compression presents? Metastasis symptoms (severe back pain worse at _, cancer symptoms) + / deficits( due to extension into _space)
Neoplastic cord compression presents? Metastis symptoms (severe back pain worse at night, cancer symptoms) + motor/sensory deficits( due to extension into epidural space)
!!!!Lems vrs C.botulinum: proximal extremities & autonomic symptoms vrs autonomic symptoms &; skeletal ( 3D’s) )…so
c.bot = lems + mg= aut + skeletal symtoms
Lems vrs C.botulinum: proximal extremities & autonomic symptoms vrs autonomic symptoms & skeletal (diploplia, dysphagia and dysphonia( 3D’s) )…so c.bot = lems + mg= aut + skeletal symtoms
Axonal reactiib: _ nucleolus with _nucleus and _ cell body
Axonal reactiib: enlarged nucleolus with peripheraral nucleus and enlarged cell body
Astrocytomas vrs ependymomas on imaging?where in brain? on histo?
Astrocytomas vrs ependymomas on imaging? Astrocytomas will be parenchymal (ependymomas will be within ventricles with pervascular psuedorosettes on histology)
Kallmann syndrome: _ GnRH due to defective _; present (2)?
Kallmann syndrome: no GnRH due to defective migration from olfactoray placode; present hypogonadosm(delayed puberty) with anosmia( no smell).
Pathogenesis of ovarian cancer ? protective factors? 3 Risk factors( brca, nulliparity, infertility(?))
Pathogenesis of ovarian cancer due to trauma and repair so protective factors? Multiparity, contraceptivves, breast feeding( cause no ovulation) Risk factors( brca, nulliparity, infertility)
If tumor having thyroid effects release _cause ?
If tumor having thyroid effects release HCG cause ? similar to FSH, LH, TSH
TCA overdose: prolong QRS, _ arrhythmias and _ uses sodium bicarb as antidote
TCA overdose: prolong QRS, ventricular arrhythmias and anticholinergics uses sodium bicarb as antidote
Wallenberg syndrome presents with _( loss pain & temp in ipsi/contra face/body, nystagmus/vertigo, ipsi horner) can occur with vertebral _
Wallenberg syndrome presents with PICA( loss pain & temp in ipsi/contra face/body, nystagmus/vertigo, ipsi horner) can occur with vertebral dissection.
JAK/STAT for 3
JAK/STAT for erythropoietin, growth hormone and prolactin
_ in due to defective Casr which uses _ signaling
Familial hypocalciuric hypercalcemia in due to defective CASr which uses cAMP signaling
Intracellular receptors for
Intracellular receptors for steroid hormones, thyroid hormone and vitamin D
Synaptophysin stain for _
Synaptophysin stain for neurons
Down syndrome can be due to meiotic nondisjunction/ nondisjunction _(aka mocaism / unbalanced translocation =
risk of recurrence due to maternal age/ _/ like normal pop
Down syndrome can be due to meiotic nondisjunction/ nondisjunction mitosis: mocaism / unbalanced translocation = risk of recurrence due to maternal age/ high/ like normal pop
_ syndrome (defect in _ of prechordal _) presents with P’s midline defects( omphalocele, micropthalmia, polydactyly, cutis aplasia
Patau syndrome (defect in fusion of prechordal mesoderm) presents with P’s midline defects( omphalocele, micropthalmia, polydactyly, cutis aplasia
Negative symptoms of psychosis: eg; _ between episodes
Negative symptoms of psychosis: flat affect , monotone voice, lack of facial expression, etc persist between episodes
Tigerminal nerve Is at _( _ oeduncle)
Tigerminal nerve Is at mid pons (middle cerebella peduncle)
!!!!Subacute combined degeneration happens with viit? spinal cord section areas?
Subacute combined degeneration happens with vit? On spinal cord section areas? B12, SCD=spinocerebellar, cortispinal, dorsal colums
Diabetic(hyperglycemia) + Necrolytic migratory erythema(blistering erythematous plaques with central clearing) diagnosis?
Diabetic(hyperglycemia) + Necrolytic migratory erythema(blistering erythematous plaques with central clearing) diagnosis? Glucagonoma
Broca / wernekie area?
Broca / wernekie area? Past motor cortex/ in cradle of sylvian fissure
IF physician concluded patient bad candidate for something due to high risk, do not prescribe.
IF physician concluded patient bad candidate for something due to high risk, do not prescribe.
209 Leuprolide used for? effects?
209 Leuprolide continuosly administration effect on test & DHT? even when given continuossly initially transient rise in hormone level then if continuously falls.
Glaucoma? treatments? (4 and mech ) _ &_/ _ & _ = dec production by cillary epithelium/ inc outflow
psuedotumor cerebri: daily headaches, obese women -> hi ICP->papipledema( swollen optic disk) ->impaired axonal flow
Glaucoma? treatments? Loss of peripheral vision due to hi IOP-> atrophy of optic nerve @ disc Timolol & acetazolamide/ PGF2a(prost) & cholinomimetics = dec production by cillary epithelium/ in outflow
Difference between bulima & binge eating vrs anorexia? Difference between bulimia and binge-eating?
Difference between bulima & binge eating vrs anorexia? Difference between bulimia and binge-eating? Anorexia has low body weight, Bulimia has compensatory behavior
Endometrial tissue does not need to be in uterus to bleed( can also bleed if in fallopian tube).
Endometrial tissue does not need to be in uterus to bleed( can also bleed if in fallopian tube).
Why does MCA occlusion affect contralate face?
Why does MCA occlusion affect contralate face? Brain infact is contralat but CN infact is ipsilate.
Elder person presents with many falls?
Elder person presents with many falls? Medication review( especially psycho & cardio)
If patient without AA what happens? ; even basic life support(like chest compression, mouth to mouth) _ given
If patient without AA what happens? Designated Surrogate decision maker-> spouse->kin->friend; even basic life support(like chest compression, mouth to mouth) not given
(PCP & LSD) , (Cocaine & methamphetamine) Marijuana, heron are? overdose Presents? Treat?
(PCP & LSD) , (Cocaine & methamphetamine) Marijuana, heron are? overdose Presents? Treat? Halucinogen . stimulants, cannabis, opiod = (nystagmus for PcP not LSD), (siezures, mydrisis, chest pain vrs. Not), conjunctival injection & inc apeptite, sketchy= NMDA antagonist
_ On/off phenomena in parkension _ therapeutic window for l-DOPA
Unpredictable On/off phenomena in parkension decrease therapeutic window for l-DOPA
_ deep hemorrahges are lenticulostriate vessels.
Hypertensive deep hemorrahges are lenticulostriate vessels.
Patient admitted to hospital who develop tremulousness, agitation, inced BP & pluse: consider _l redrawal. Treat?
Patient admitted to hospital who develop tremulousness, agitation, inced BP & pluse: consider alcohol redrawal. Treat: chlordiazepoxide is a benxodiazapem
2076Contralateral pure sensory/ motor los?
2076Contralateral pure sensory/ motor loss: Ventral posterior (VPl & VPM) damage cause/ Ant posterior limb of internal capsule lesion
Opoid mu recepters do what to sm cells? So may lead to ?
Opoid mu recepters do what to sm cells? So may lead to ? Cause contration of sphincter of oddi so may present with upper quadrant tenderness.
Drug induced vrs weightloss induced amenorrhea?
Drug induced vrs weightloss induced amenorrhea? Yes/no breast tenderness.
Disinhibion happens with lesion in what cortex? _( for _ & _ regulation ( _ is for executive); Which side of brain is dormant?
!!Dormant & non dormant lesions of cortex
Disinhibion happens with lesion in what cortex? Orbitofrontal-behavral & emotional regulation ( lat prefrrotal is for executive); Which side of brain is dormant? Left Dormant & non dormant lesions of cortex
Spinal cord features(3)? : T& early-l with prominent horn(IML), cuneate @ T; _ white matter(think Cauda equina) so dec gray;
Spinal cord features(3)? : T& early-l with prominent lateral horn(IML), cuneate @ T7; inc white matter(think Cauda equina) so dec gray;
2 Thioamides to treat hypothyroidism are? Mech via 2 ?
2 Thioamides to treat hypothyroidism are? Mech via 2 ? PTU & methimazole; inhib thyroid peroxidase which does(2) Iodination & coupling of iodinated tyrosines, and dec peripheral conversion( PTU only!)?
Which thioamide inhibs peripheral conversion?
Which thioamide inhibs peripheral conversion? PTU
Delivering bad news: SPIKE
Delivering bad news: SPIKE ( set state, gag perception, get invite to release info, knowledge, empathy, summary& plan)
Piriform recess has _ nerve (if from _ nerve) which mediates _reflex
Salivation: nerves?
Piriform recess has internal laryngeal(f rom superior langeal) which mediates cough reflex
Salivation: 9-7CN?
_ closure of epiphyseal plate since women shorter
Estrogen closure of epiphyseal plate since women shorter
IF exercise/weightloss, illness or abnormal eating induced amenorrhea, due to _
IF exercise/weightloss, illness or abnormal eating induced amenorrhea, due to hypothalamic not pituitary
Topical glucocorticoid cause dermis due to dec in matric & _
Topical glucocorticoid cause atrophy/thin dermis due to dec in matric collagen and glycosaminoglycans
In BPH, can bleed duet to ? bladder shows _due to hyperplasia as opposed to bladder cancer that will be a _
In BPH, can bleed duet to ? bladder shows _due to hyperplasia as opposed to bladder cancer that will be a _
(due to new blood vessels that are friable); bladder has trabeculations due to hypertrophy ( bladder cancer will present with mass)
ADHD(_ have impulsivity, before _yrs old) vrs conduct disorder ?
ADHD(impulsivity, before 12 yrs old) vrs conduct disorder : violates major societal norms or basic rights of others.
Young healthy adult come to ER with unexplained chest pain? Differential and treatment?
Young healthy adult come to ER with unexplained chest pain? Differential and treatment?
panic attack give benzo
Hypothyroid myopathy presents?
_ tendon reflexes; myopathy(_ CK, _ muscle weakness)
Hypothyroid myopathy presents?
Delayed tendon reflexes; myopathy(hi CK, proximal muscle weakness)
Appendectomy can damage what nerve?
_ nerve within spermacord
Appendectomy can damage what nerve? Abdominal surgery(ie appendectomy) can damage illiohypogastric nerve( sensation to suprapubic + gluteal regions + motor to anterolat abd wall)
Illioinguinal nerve within spermacord
Cognitive testing for concentration:
Cognitive testing for concentration:
Ability to recite things backwards
!!!!Friedrich ataxia present? SCD + 3
Charcot-Marie-tooth presents(3)
!!!!Friedrich ataxia present? Cerebella ataxia(spinocerebellar), loss of sensation/proprioception(dorsal colums), kyphoscoliosis, hypertrophic cardiomyopathy , diabetes
Charcot-Marie-tooth presents
Sensory deficits in distal leg, pes cavus, kyphoscoliosis
Treatment for Delirum if nonpharm does not work?
Treatment for Delirum if nonpharm does not work?
Antipsychotic(haloperidol) if risk of acute harm( to self or others)
Doxepin what drug class?
Doxepin what drug class?
TCA
Loud noise damages? Regardless of requency of sound which lost first?
Loud noise damages? Regardless of requency of sound which lost first? Cupula
Sterocillia; high frequency; apex
Diabetic neuropathy due to _of vasa nervorum with nerve ischemia cause small/large fiber injury?
Diabetic neuropathy due to _of vasa nervorum with nerve ischemia cause small/large fiber injury?
Small/large = positive/negative symptoms= gains/ losses =pain, paresthesia/ numbness
Gigantism can present? 3
Gigantism can present? Prognathism(jaw protrusion) , bony enlargement of hands and feet, linear growth
Narcolepsy also presents with hypnagogic & pompic _ & sleep _.
Narcolepsy also presents with hypnagogic & pompic hallucinations & sleep paralysis.
Treat essential tremor with _
Treat essential tremor with propanol.
baclophen for spasticity
Dying lady has AA to not intubate but daughter is preg thinks mom might want to see baby?
Dying lady has AA to not intubate but daughter is preg thinks mom might want to see baby: If Advance directive exist, follow it. Ethic if no advance directive & fam disagree.
Prostatectomy can cause? _ because_?
Prostatectomy can cause? Erectile dysfunction because prostastic plexus innervate Corupus cavenosa (penile erection)
Avascular necrosis present in ? (
_ arthritis will be red, hot and angry)
Avascular necrosis present in ? CAST BEND LEGS( septic arthritis will be red, hot and angry)
Methadone what type of opoid? Why can it suppress craving and reduce withdrawal symtoms?
Burpropion is _agonist .
Methadone what type of opoid? Why can it suppress craving and reduce withdrawal symtoms? Full, methadone is long acting. Burpropion is partial agonist .
Informed consent?
Informed consent? Taken only if with sufficenit knowledge( not textbook)
Treat motion sickness: 2 -> _side effects( like)
Treat motion sickness: Antimuscarinic and antihistamines -> anticholinergic side effects( like)
Best way to help reduce medical prescription errors?
Best way to help reduce medical errors? In order form (avoid trailing zeros & abreviations)
Visceral(GI)/vestibular(motion)/migrane nausea treatments? 1/2/`1
Visceral(GI)/vestibular(motion)/migrane nausea treatments? 5-HT3 antagonist/ antihis & antichol/ dopamine antagonist
(bromocriptine is DA ago
Conversion vrs somatic disorder?
Conversion vrs somatic disorder? Conversion is neurologic symptom; somatic is anxiety about unexplained symptom
Erectal dysfunction organic/pshycogenic causes differences(2)? are / onset, / nocturnal erections
Erectal dysfunction organic/pshycogenic causes differences(2)? are slower/sudden onset, absent/present nocturnal erections
!!!!diabetes drugs mech
PPar-Y is an _ recepter that increases _->2
ppar-Y is an intracelluar transcription recepter that increases adiponectin->inc insulin sensitivity & fatty acid oxidaization
diabetes drugs mech
Intracelluar receptors bind
Intracelluar receptors bind steroids, thyroid homone and fat-soluble vitamins
Adrenal hyperplasia can present _ ->_depending on severity level with increase linear growth
Adrenal hyperplasia can present @ birth ->puberty depending on severity level with increase linear growth
Graves disease opthamalopathy from _ so _( also dec T4-3 conversion) treat
Graves disease opthamalopathy from GAG from ab stimulating fibroblast TSH receptors so steroids( also dec T4-3 conversion) treat
Thyroid medications
Thyroid medications
PTU/methamidazole
Postoperative _ with thyroid surgery
Postoperative hypoPTH with thyroid surgery
Papillary thyroid cancer looks?(2)
4 thyroid cancers
Papillary thyroid cancer: empty/ground glass nuclei( orphan annie), most common: Papi and mommy adopt orphan annie
4 thyroid cancers
_inhibitors ( Anas/letrozole + exemestane)
permanent central DI is from _
calcitonin vrs calcitrol
Adrenal insufficeny (acute present as _) treat with _
Aromatase inhibitors ( Anas/letrozole + exemestane)
permanent central DI is from hypthalamous
calcitonin vrs calcitrol
Diabetes: high free fatty acids rather than LDL
Adrenal insufficeny (acute present as hypotensiveness) treat with steroids
Exogenous hyperthyroidism has _TG
Exogenous hyperthyroidism has low TG
graves/harsh/subacute look like?
UW check: medullary thyroid cancer presents _, _ + thyroid _
graves/harsh/subacute =scalopping/ germinal centers/ granulomas micro look like
medullary thyroid cancer presents flushing diarrhea + thyroid nodules
Insulin peaks ?
Insulin peaks : LAG ->Regular(4hr peak)->NPH->Don’t Go
Ketones is for type _ diabetes ( free fatty acid for type _)
Diabetes: high free fatty acids rather than LDL
Ketones is for type 1 diabetes ( free fatty acids for type 2)
Diabetes: high free fatty acids rather than LDL
Patent processus vaginalis->what type of inguinal hernias? + _ hydrocells(transilluminates)
Patent processus vaginalis-> indirect(lat to inf epigastric) inguinal hernias + communicating hydrocells(transilluminates)
Hypospadias due to ?
Hypospadias: urethral folds
Menotropin(like _) to _ then HCG(mimic ) administration triggers.
LH surge due to high _
Menotropin(like FSH) allow folliclue to form then HCG(mimic LH) administration triggers ovulation.
LH surge due to high estrogen
Polyhyraminosis: 4 causes
Polyhyraminosis: maternal diabetes, multiple gestations, and inability to swallow problems
_ deficiency presents with maternal virilization.
Aromatase deficiency presents with maternal virilization.
Amniotic fluid embolism: has _ cells
Amniotic fluid embolism: has fetal squamous cells
Ureter injury during hysterectomy: presents with (2), typically _ still urinate
Ureter injury during hysterectomy: presents with flank pian & fever, typically only one so can still urinate
Midline episiotomy: ?
Midline episiotomy: vertical incision frompost. Vag opening to perineal body( does not get to anal sphincter)
Treat PID?
wet mount = saline microscopy/ cervical cytology/ KOH =
Treat PID( clam and gono so treat for both) wet mount = saline microscopy/ cervical cytology/ KOH = vaginosis/ cancer/ whiff test for vaginosis
tersticular torsion: gonadal arteries arise from _
tersticular torsion: gonadal arteries arise from abdominal aorta
DHT/testesteron for / =2/ 2 development
all have gonad, mesonephric parameso
DHT/testesteron for ext/ int = prostate, penis/ vans,epidiymus
all have gonad, mesonephric & parameso
_produces antimullerian
Sertoli produces antimullerian
Triple screen test( need acurate dating: ex if has irregular menses )
trisomies/ GI & multiple gestation defect with / AFP
Triple screen test( need acurate dating: ex if has irregular menses )
trisomies/ GI & multiple gestation defect with low AFP / high
tobacco -> fetal _
tobacco -> fetal growth restriction
PCK vrs CFTR = infertility due to ?
PCK vrs CFTR = infertility due to cilia vrs absent vas deferens( high CL level in sweat)
Valporate, ACEI, Phenytoin has tetratogenic effects?
Valporate, ACEI, Phenytoin has tetratogenic effects( neural tube/ renal hypoplasisa/neural tube)
Fetal alchohol syndrom presents=3
Fetal alchohol syndrom presents= short palpebral fissures, smooth philrum, think vermillion
DS: 2
DS: flat faces, eipicantal folds
Turner’s loss of _X
Turner’s loss of paternal X
Trisomy 13(1)/18(2) ->p
omphalocele for _
Trisomy 13/18 ->p’s -> rocker bottom feet, clenched fist,
omphalocele for both
pCOS can get _ cancer(so treat with oral contraceptives) due to 3. Treat with _ for ovulation ; _(to reverse insulin resistance)
pCOS can get endometral cancer(so treat with oral contraceptives) due to estrogen, irregular periods, dec progesterone. Treat with clomiphene (A serm that dec negative feedback inhibition of estrogen on hypothalamus) for ovulation ; weight loss(to reverse insulin resistance)
methyrapone inhibs 11B hydroxylase( blocks_ synthesis)
methyrapone inhibs 11B hydroxylase( blocks cortisol synthesis)
doxycycline tetratogeneic for _ so if lyme disease give _
TMX?SM effect?
doxycycline tetratogeneic for teeth so if lyme disease give amoxiclillin TMX?SM has neural tube effects
pelvic floor muscles: Levator ani( target of _exercises for _ incontinence)
pelvic floor muscles: Levator ani( target of kegel exercises for stress incontinence)
Cervical /endometrial cancers: _/ _ mediated so predisposing factors are 2 / 1
Cervical /endometrial cancers: HPV/ estrogen mediated so predisposing factors are lack of barrier protection & + STI history / too much estrogen
moles: all _ that duplicates with ovum so has _if maternal genes present so partial) or double chromesomes( _ mole)
moles: all paternal that duplicates with ovum so with triple( if maternal genes present so partial) or double chromesomes( complete mole)
CA125by _tumors
CA125 by epithelia tumors
congenital torticollis due to ?
congenital torticollis due to malposition in utero
Klinefelter: labs are due to atrophied_(small & firm)-> _ inhihin & test-> _ FSH/LH
Klinefelter: labs are due to atrophied testicular cells(small & firm)-> low inhihin & test-> high FSH/LH
ovarian tumours:
Sertoli-leydic/ granulosa(_ bodies aka coffee been nuclei, yellow) produces _( so virilization in females)/ _->endometrial hyperplasis
ovarian tumours:
Sertoli-leydic/ granulosa(exener bodies aka coffee been nuclei, yellow) = testosterone( so virilization in females)/ estrogen->endometrial hyperplasis
ovarian tumours:
Sertoli-leydic/ granulosa(exener bodies aka coffee been nuclei, yellow) = testosterone( so virilization in females)/ estrogen->endometrial hyperplasis
ovarian tumours:
Sertoli-leydic/ granulosa(exener bodies aka coffee been nuclei, yellow) = testosterone( so virilization in females)/ estrogen->endometrial hyperplasis
Interscalene nerve block can injure nerve?-> _paralysis
Interscalene nerve block injures phrenic nerve->diaphragmatic paralysis
BBB is made of _junction does not allow some substances through like dopamine but allows l-dopa
BBB is made of tight junction does not allow some substances through like dopamine but allows l-dopa
Untreated hydrocephalus->periventricular pyramidal tracts_-> signs of _ injury -> _ incontinence
Untreated hydrocephalus->periventricular pyramidal tracts stretch-> signs of UMN injury
how myelin affect length and time constant?
Velocity=length/time and myelin increase velocity so increase length and dec time.
Wilms vrs Neuroblastoma labs(1), marker(1) ?
Wilms tumor vrs Neuroblastoma labs: neuroblastoma has inc catecholamine0->opsoclonus-myoclonus, N-myc
Status epilepticus initial treat?
Status epilepticus initial treat? IV benzo cause fast then phenytoin
POMC which makes 3
POMC which makes ACTH & MSH makes b-endorphin (an opiod)
Locus ceruleus is in _ of brain and makes_
Locus ceruleus is in posterior rostral pons to make NE
_ + _ are oxidized in peroxisome
Zellweger and X-linked adrenoleukodystrophy problem?
VLCFA( very long chain fatty acids) + branched-chain are oxidized in peroxisomes…in Zellweger and X-linked adrenoleukodystrophy no perisomes/problem with fatty acid transport to perisomes
!!!!Huntington disease: loss of GABA
UW!!!!on CT transverse cut
Huntington disease: loss of GABA
Ant. Choroidal/ PCA supplies = 1/4
Ant. Choroidal/ PCA supplies = post. Limb of internal capsule/ thalamus(artery of percheron branch), medial temporal lobe, splenium of corpus callosum, midbrain
Lacunar infacts/charcot anerysm infacts are _/ _ due to hypertensive arteriolar sclerosis(hylination)/ pressure
Lacunar infacts/charcot anerysm infacts are ischemic/ hemorrhagic due to hypertensive arteriolar sclerosis(hylination)/ pressure
Cerebral amyloid angiopathy->number 1 lobar _ in elderly
Cerebral amyloid angiopathy->number 1 lobar hemorrhage in elderly
Pure motor/sensory=
Pure motor/sensory= post internal capsule/ ventropost thalamus
Alnod chari 1/ 2 present in _/neonate
Alnod chari 1/ 2 present in adult/ neonate
Stiffness and cyanotic skin mottling after surgery : ?
Stiffness and cyanotic skin mottling after surgery : malignant hyperthermia
Arcuate/pv give ant pituitary hormones
Arcuate/pv give ant pituitary hormones
Contralateral homonymous hemianopia? is a optic _ lesion which may produce ?
Marcs Gun pupil=?
Contralateral homonymous hemianopia= opposite of brain same visual field, half of visual field= is a optic tract lesion which may produce marcs Gun pupil=both pupils seems to dilate if shin in affected eye
In Diffuse axonal injury : _proteins (amyloid precursor and alpha-synuclein) _
In Diffuse axonal injury : transport proteins (amyloid precursor and alpha-synuclein) accumulate
_ diagnose with transketolase activity
Weirnekie encephalopathy: diagnose with transkelolase activity
Solubility_ proportional to blood/gas coefficient:
NO has _ blood/gas coefficient so l_ soluble and more in gas so _onset with _ halflife
Solubility directly proportional to blood/gas coefficient: NO has least blood/gas coefficient so least soluble and more in gas so faster onset
Femoral nerve block @ _
Orbital floor fractures injure_ nerve.
Femoral nerve block @ inguinal crease
Orbital floor fractures injure infraorbital nerve.
Cocaine mech? Presents(4)Causes (2) Causes(3)
Cocaine mech? Causes (2) Cocaine is a stimulant(inc sympathetic activity: tachycardia, mydriasis, hypetension, diaphoresis) that inhibits the presynaptic reuptake of catecholamines can cause coronary vasospam and mucosal atrophy with septal perforation via vasoconstriction
Withdrawal: stimulanats(cocaine)/ alcohol(delirum) + benzo/ Heroin(like opiod redrawal) / nicotine/ cannabis =
Withdrawal: stimulanats(cocaine)/ alcohol(delirum) + benzo/ Heroin(like opiod redrawal) / nicotine/ cannabis = psychomotor retardation, severe depression/ seizures/ dilated pupils, yawning, lacrimation/ inc appetite/ dec appetite
Acute stress disorder(days to _ mth) < PTSD(>_mth) = flashbacks
Acute stress disorder(days to 1 mth) < PTSD(>1mth) = flashbacks
Agoraphobia/ panic =
Agoraphobia/ panic = fear not being able to escape/ without clear precipitant
_(methylphenidate and amphetamines) for treating ADHD mech? Inc 2 in _ cortex
Stimulants(methylphenidate and amphetamines) for treating ADHD mech? Inc NE and dopamine in prefrontal cortex
Marijuana is a _ presents with 4
Marijuana is a carbinoid presents with conjunctival injection(red eyes), tachycardia, inc apepetite and dry mouth
(PCP LSD), heroin, .
Benzodiazpin withdrawal similar to _
Benzodiazpin withdrawal similar to alcohol
Best/ appropriate step? ie: depressive patient with firearm( best step/appropriate step?
Best/ appropriate step: the most absolute/ the small step ie: depressive patient with firearm( best step/appropriate step: advise on firearms/ initiate treatment)
Premature ejaculation: early(within _min) ejaculation for _ with a sense of lack of _.
Premature ejaculation: early(within 1 min) ejaculation for 6 mth with a sense of lack of control.
For a kid hallucinations of recently deceased relatives is part of_grief
For a kid hallucinations of recently deceased relatives is part of normal grief
Classical conditioning example?
Classical =white coat hypertension operant is when begin to use rewards/punishment to favor some behaviour
Sleep ecg findings:
Alpha/beta/ theta/ sleep spindles and k complexes=_/ delta/ alpha=
If recall dream?
Sleep ecg findings:
Alpha/beta/ theta/ sleep spindles and k complexes=N2/ delta/ alpha=
If recall dream? nREM/REM = sleep terror are incomplete arousal and lack of recall of dream content/ nightmares with during final 3rd of night with vivid dreaming.
_= patient to doctor
Transfererence= patient to doctor
_ is strongest risk factor for completed suicide
Attempted suicide is strongest risk factor for completed suicide
Anorexia(may have binge/purgin type) vrs others= _ ; bulimia vrs binge: bulimia _
Anorexia(may have binge/purgin type) vrs others= lower body weight ; bulimia vrs binge: bulimia compensate
Panic disorder: _ are first line( cause benzo’s although _ have risk of _)
Panic disorder: SSR’s are first line( cause benzo’s although faster have risk of physiologic dependence and abuse)
Fancy meats and cheeses lunch then present with hypertensive emergency?how? treat ?
Fancy meats and cheeses lunch then present with hypertensive emergency? Tryamine( displaces NE from vesicles) overdose treat with moa inhibitors
Student Preparing for exams was normal now presenting with paranoa: might be _ abuse
Student Preparing for exams was normal now presenting with paranoa: might be substance use abuse
In DKA why replace K? total serum K _ but hyperkalemia & _ intracellular stores(due to_ of insulin and _ plasma osmolarity)
In DKA why replace K? total serum K dec but hyperkalemia & low intracellular stores(due to lack of insulin and inc plasma osmolarity)
Near miss/ adverse / sentinel event/ malpractice?
Near miss/ adverse / sentinel event/ malpractice?
No harm to patient/ harm can be preventable or non preventable/ death or serious injury/ legal.
Hyperparathyroidism cours corticol bone osteoporosis( aka_ erosions)
Hyperparathyroidism cours corticol bone osteoporosis( aka subperiosteal erosions)
Osteosarcoma mutation in _ and _(li-fraumer syndrome)
Osteosarcoma mutation in RB1 and TP53(li-fraumer syndrome)
To reduce risk of wrong site surgery use?
To reduce risk of wrong site surgery use dual identifiers (independent ID)
ppar-Y is an intracelluar recepter that increases _->inc insulin sensitivity & fatty acid oxidation
Endocrine
ppar-Y is an intracelluar recepter that increases adiponectin->inc insulin sensitivity & fatty acid oxidaization
diabetes drugs mech
Adrenal hyperplasia can present @ birth ->_ depending on severity level with increase_ growth
Adrenal hyperplasia can present @ birth ->puberty depending on severity level with increase linear growth
Graves disease ophthalmopathy from _ so steroids( also dec T4-3 conversion) treat
Graves disease opthamalopathy from GAG from ab stimulating fibroblast TSH receptors so steroids( also dec T4-3 conversion) treat
Postoperative hypo_ with thyroid surgery
Postoperative hypoPTH with thyroid surgery
Papillary thyroid cancer: looks
- Papillary thyroid cancer: empty/ground glass nuclei( orphan annie), most common: Papi and mommy adopt orphan annie
4 thyroid cancers
_ inhibitors( Anas/letrozole + exemestane)
Aromatase inhibitors( Anas/letrozole + exemestane)
permanent central DI is from _
permanent central DI is from hypthal
Diabetes: _ free fatty acids
Diabetes: high free fatty acids rather than LDL
Adrenal insufficeny (acute present as _) treat with _
Adrenal insufficeny( acute present as hypotensiveness) treat with steroids
acid base algorythm
- acid base
compensation: metabol acidosis/alk(inc) =1.5(bicarb) + 8/ .7(per bicarb)
resp acid(inc)/alk(dec) = 1(per 10 paco2) -> 4( per 10 pco2)/ 2(per 10 paco2) ->5 (per 10 pco2)
Exogenous hyperthyroidism has _ TG
graves/harsh/subacute = -// micro look like
medullary thyroid cancer presents _ , _ + thyroid nodules
Exogenous hyperthyroidism has low TG
medullary thyroid cancer presents flushing diarrahea + thyroid nodules
graves/harsh/subacute =scalopping/ germinal centers/ granulomas micro look like
Hyperparathyroidsm may presents with signs of hypercalcemia?
Hyperparathyroidsm may presents with constipation, kidney stones
Major cause of overdose death in US?
Major cause of overdose death in US? Opiods( prescription & herion)
DKA initially treated with? Pharmacokinetics of insulin preps?
DKA initially treated with? Pharmacokinetics of insulin preps? Reg insulin; LAG->reg(peaks 3hrs)->NPH->DG
Genital ulcer differential(4) evaluate based on 2 characteristic? 1/multiple ulcer = syphilis/others not/painful ?
(Clam and gono are _ not ulcers!)
Genital ulcer differential(4) evaluate based on 2 characteristic? 1/multiple ulcer = syphilis/others not/painful = syphiless, granuloma inguinale(klebsiella) looks? Heaped up borders/ eythematous base/deep & pus w/ lymphadenitis/ red (Clam and gono are discharge not ulcers!)
Children know gender by age _(permanent by age _. Must left parent know that gender exploration is normal.
Children know gender by age 4(permanent by age 6. Must left parent know that gender exploration is normal.
If someone presents with brain damage: Wallerian denegation in PNS but in CNS non because(3)
If someone presents with brain damage: Wallerian denegation in PNS but in CNS non because(3)
myelin debris persist, inhibitory factors and glial scars
Glioblastoma has increased _ experession.
Glioblastoma has increased epgf experession.
If with presbyopia and myopia with aging what happens to vison?
If with presbyopia and myopia with aging what happens to vison? Gets better.
1st gen antihistamins (2) are anti- chol, alpha-1, serotinin and should be avoided in older patients.
1st gen antihistamins(Chlorpheniramine, zines) are anti- chol, alpha-1, serotinin and should be avoided in older patients.
syringomyelia: upper/lower extremity LMN/UMN signs with _
syringomyelia: upper/lower extremity LMN/UMN signs with scoliosis
supressing activity of _ or globus pallidus _ to treat medically intractible parkinson disease
internus has the direct connection to Thalamus
Sudan stain(fat) for_ disorders
malabsortive
