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