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Boards First Aid and Kaplan > Practice Test 3 > Flashcards

Practice Test 3 Flashcards

1
Q

What are the sleep stages and what are the characteristics of each?

A

Non-REM
-1-Theta wave, light sleep
-2-Spindles, K complexes, bruxism (involuntary teeth grinding)
-3-Delta wave, nocturnal enuresis, sleepwalking, night terrors
REM-Beta wave, loss of muscle tone, changing pulses/BP, inc O2 to brain, dreaming/nightmares,

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2
Q

What effect do benzos have on sleep?

A

Increase stage 2 sleep

decrease stage 3

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3
Q

When is the beta wave seen other than during REM?

A

When eyes open

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4
Q

Abnormalities in REM are associated with what disorders?

A

Narcolepsy and obstructive sleep apnea

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5
Q

Nocturnal enuresis

A
  • Typically due to developmental delay
  • Primary-never had a dry period
  • Secondary-had a dry period then regressed
  • Tx-desmopressin
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6
Q

Choroid plexus papilloma

A
  • Benign neoplasm of choroid plexus villi (produce CSF)
  • Increase CSF prod. and obstruct CSF outflow ->hydrocephalus
  • Also likely impact the hypothalamus
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7
Q

Hypothalamus

A

-Controls hunger, thirst, anterior and posterior pituitary regulation, autonomics, temperature, sexual urges, osmolarity regulation, and nausea from area postrema

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8
Q

Anterior hypothalamic nucleus

A
  • Heat loss center (especially pre-optic area)
  • controls body temp through vasodilation and sweating
  • Damage-> hyperthermia
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9
Q

Posterior hypothalamic nucleus

A

Produces body heat and controls body temp through vasoconstriction and shivering

  • No input from central thermoreceptors
  • Inhibited by anterior hypothalamus when body temp increases
  • Damage -> poikilothermia (inability to regulate body temp)
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10
Q

Ventromedial nucleus

A
  • Controls satiety

- Damage -> hyperphagia, weight gain

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11
Q

Amygdala

A

Located beneath the medial temporal lobe of cerebral cortex

  • Memory and emotional reactions, erection, ejaculation
  • Damage-> Kluver-Bucy syndrome
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12
Q

Kluver-Bucy syndrome is associated with infection by what pathogen?

A

HSV-1

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13
Q

Basal ganglia

A

Important for voluntary movements and postural adjustments

  • Composed of the caudate nucleus, putamen, globus pallidus, SN, and subthalamic nucleus
  • Damage -> resting tremor, chorea, and purposeless movements of athetosis (slow writhing of the fingers)
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14
Q

Cerebellum

A
  • Located above the 4th ventricle
  • Responsible for balance and fine motor movements
  • Damage of the cerebellar hemisphere -> ipsilateral deficits such as falling toward the side of the lesion
  • Can also cause intention tremor, limb ataxia, and ataxic gait
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15
Q

Hippocampus

A
  • Adajacent to the inferior temporal horn of the lateral ventricle
  • Forms the ventral surface of the inside of the lateral ventricle (elongated portion of the cerebral cortex)
  • Plays a major role in the limbic system (responsible for feeding, fleeing, fighting, feeling, and sex drive)
  • Damage -> anterograde amnesia (inability to make new memories)
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16
Q

Fibrocystic changes

A
  • Occur in women of childbearing age
  • Sx-breast tenderness and masses that change in size during menses
  • Nodular breast tissue
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17
Q

Fibroadenoma

A
  • Most common benign breast tumor
  • Characteristics-Firm, painless, mobile, solitary mass
  • Usually found in women between 15 and 35 y/o
  • Contain glandular and fibrous tissue
  • Usually regresses after menopause
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18
Q

Intraductal papilloma

A
  • Present with nipple discharge and breast pain

- Occasionally there will be a palpable mass but it does not change with menses

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19
Q

Lipoma

A
  • Benign tumor composed of adipose tissue
  • Freely mobile with well-defined borders
  • Non-tender
  • Does not change with menses
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20
Q

Lobular carcinoma

A
  • Palpable immobile mass with possible nipple discharge, nipple retraction, or peau d’orange
  • Can be asymptomatic until late stages
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21
Q

Anti-cholinergic OD

A
  • Atropine, ipratropium
  • Sx-“Dry as a bone, mad as a hatter, blind as a bat, hot as a hare”
  • Antidote-physostigmine (AchE inhibitor)
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22
Q

What is the antidote for ethylene glycol toxicity?

A

Fomepizole

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23
Q

Ventral posterior medial nucleus

A

Relays taste and face sensation to the primary sensory cortex
-pain from face -> trigeminal nerve -> pons (brainstem) -> spinal trigeminal tract -> medulla -> second neuron crosses midline -> contralateral VPMN of thalamus -> PSC

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24
Q

Lateral geniculate nucleus

A

Relays info regarding vision from the optic nerve to the calcarine sulcus via the optic radiations

25
Q

Medial geniculate nucleus

A

Relays info regarding hearing from the inferior colliculus to the auditory cortex

26
Q

Posterior part of VLN

A
  • Receives input from deep cerebellar nuclei and projects to the primary motor area of the cortex
  • Relays info regarding regulation of movement from the cerebellum
27
Q

Ventral part of posterior lateral nucleus

A

Receives sensory input from the body and projects it to the primary sensory cortex
-Transmits info regarding pain and temp and proprioception via the spinothalamic and dorsal columns/ML pathways

28
Q

What is the effect of hypovolemic shock (excessive blood loss) on diastolic time?

A

Hypovolemic shock -> decreases diastolic (more than systolic)
-Decreased preload relates to a decrease in CO and increased SVR

29
Q

What is the HLA subtype associated with MS?

A

HLA-DR2

30
Q

Hereditary hemochromatosis

A
  • AR, assoc. with HLA-A3
  • Inc intestinal absorption of Fe
  • S/Sx-inc Fe deposition in tissues, (liver, heart, pancreas, and pituitary)
  • Liver dz, skin pigmentation, DM (bronze diabetes), arthropathy, male impotence, cardiac enlargement and possible HF/conduction defects
31
Q

Grave’s disease

A
  • HLA-B8
  • Hyperthyroidism, goiter, eye dz and pretibial or localized myxedema, proptosis/exophthalmos, periorbital edema
  • Abs to the TSH receptor -> hyperthyroidism, inc thyroid hormone production
32
Q

What diseases are associated with HLA-B27?

A
  • Psoriatic arthritis
  • Ankylosing spondylitis
  • Inflammatory Bowel Disease
  • Reiter’s syndrome
33
Q

Psoriatic arthritis

A
  • Inflammatory arthritis assoc. with psoriasis
  • Morning stiffness, >30 mins
  • Alleviated by physical activity
  • Skin lesions present before arthritis
  • Characteristic features affecting the nail bed-nail pits, onycholysis, hyperkeratosis, and splinter hemorrhages
34
Q

Ankylosing spondylitis

A
  • A form of spondyloarthritis
  • Chronic inflammatory disease affecting the axial skeleton-back pain/stiff spine, hips, and shoulders
  • Assoc. with uveitis
35
Q

Crohn’s disease

A
  • Usually affects the terminal ileum (never affects the rectum)
  • Non-caseating/non-necrotizing granulomas, transmural inflammation, possible perforation
  • Sx-non-bloody diarrhea
36
Q

Ulcerative colitis

A
  • Usually involves the distal GI tract (rectum)
  • Collections of neutrophils within crypts of Lieberkuhn (abscesses)
  • Sx-Bloody diarrhea, fatigue, anemia
37
Q

Reiter’s syndrome

A
  • AKA reactive arthrits
  • Arthritis that arises following an infx (c trachomatis, yersinia, salmonella, shigella, campylobacter, e coli, c difficile, and c pneumo)
  • Asymmetric oligoarthritis, 1-4 weeks after infx
38
Q

T1DM

A
  • HLA-DR3
  • Insulin deficiency following the destruction of pancreatic beta cells
  • Present with insidious onset of polyuria, thirst, and weakness but can also present with DKA (AMS, dehydration, and respiratory failure)
39
Q

What is interferon-beta used to treat?

A

Multiple sclerosis

40
Q

What is interferon-alpha used to treat?

A

Hepatitis B and C

41
Q

What is interferon gamma used to treat?

A

Chronic granulomatous disease

42
Q

What is muronomab-CD3 (OKT3) used for?

A

Immunosuppression after renal transplant

43
Q

What is trastuzumab used to treat?

A

HER-2 overexpressing breast cancer

44
Q

Hirschsprung disease is associated with what genetic abnormality?

A

Trisomy 21

45
Q

Cholestyramine

A
  • Bile acid sequestering resin
  • Decreases LDL by preventing reabsorption of LDL from the brush border of the small intestine
  • Common side effects-GI discomfort and foul taste
46
Q

Colestipol

A
  • Bile acid sequestering resin

- Major side effects-GI discomfort and foul taste

47
Q

Ezetimibe

A
  • Involved in preventing the absorption of cholesterol

- Can cause elevated LFTs (rare)

48
Q

Niacin

A
  • Most effective in increasing HDL
  • Common side effect-redness and flushing of face (can typically be prevented with co-administration of aspirin and/or slow titration of effective dose)
49
Q

Allen’s test

A

Occlusion of the radial and ulnar arteries with the pumping of the fist then releasing one artery
-positive test is a delay or absence of blood returning to the palm, suggestive of compromised flow of blood within the released artery

50
Q

A positive phalen’s test is indicative of?

A

Carpal tunnel syndrome

51
Q

Watson’s test

A

Pushing of the scaphoid anteroposterior with the wrist in radial or ulnar deviation
-If the scaphoid subluxes or reduces, this suggests carpal ligament injury

52
Q

What are the tendons involved in deQuervain’s tenosynovitis?

A

AKA radial styloid tenosynovitis

Abductor pollicis longus and extensor pollicis brevis

53
Q

Abductor pollicis brevis

A
  • Largest muscle in the thenar eminence

- Commonly atrophied in severe carpal tunnel

54
Q

Extensor pollicis longus

A

-Forms the ulnar border of the anatomical snuff box (the other borders are the abductor pollicis longus and extensor pollicis brevis)

55
Q

What is the protocol when a patient presents with pain in the anatomical snuff box?

A
  • Fracture until proven otherwise
  • Need urgent x-ray to rule out scaphoid (navicular) fracture because this region has poor blood supply and can result in necrosis
56
Q

What is the underlying mechanism of the production of struvite renal stones?

A
  • Gram negative rods capable of splitting urea into ammonium (proteus, pseudomonas, and klebsiella) (NOT e coli)
  • Associated with chronic UTIs
  • Struvite stones are composed of Mg-ammonium-phosphate
57
Q

Compare the pH of the urine in a patient with a uric acid stone to the pH of a patient with a struvite stone

A
  • Urine pH with a uric acid stone-acidic

- Urine pH with a struvite stone-basic

58
Q

What is montelukast?

A

Leukotriene receptor antagonist

-Used for maintenance therapy

Boards First Aid and Kaplan (19 decks)

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