prometric practice Flashcards
role of ADH (2)
1: responds to high osmolarity
V2 receptors: decrease serum osmolarity, increase urine osmolarity
2: respond to low BP
V2 receptors: vasoconstriction
what drains to the popliteal lymph nodes? (2)
- dorsolateral foot
2. posterior calf
rx for cluster headaches
oxygen and sumatriptan
rx for migraine abortive?
sumatriptan, NSAID
rx for migraine prophylaxis?
propanolol, topiramate, amitryptaline, Ca2+ channel blockers
rx for tension headaches
NSAID, analgestics, amitryptaline, acetaminophen
acute megakaryocytic leukemia
proliferation of megakaryoBLASTS
AML M7
ITP etiology
antibodies against GpIIbIIIa
SPLENIC macrophage destruction!
ITP blood / bone marrow smear
blood -> thrombocytopenia
marrow -> many mature megakaryocytes
TTP & HUS vs. ITP
all three = thrombocytopenia
TTP / HUS: schistocytes
ITP: splenic destruction
TTP etiology
deficiency of ADAMSTS-13
large platelet vWF -> abnormal platelet aggregation
microthrombi –>
schistocytes & thrombocytopenia
normal anion gap
8-12 mEq/dl
what columns are affected by B12 deficiency?
- dorsal column: SENSORY
- lateral corticospinal: MOTOR
(spinocerebellar can be too)
dry beri beri
B1 thiamine deficiency
peripheral polyneuritis, symmetric muscle wasting
vomit pathway
valine odd chain fatty acids methionine isoleucine threonine
branched amino acids & odd chain fatty acids breakdown into..
methylmalonyl-CoA
—> (methylmalonyl-CoA mutates
succinyl-CoA
- either TCA, myelin synthesis
or. . heme synthesis!
- either TCA, myelin synthesis
acid/base disturbance after salicylate ingestion
first: respiratory alkalosis (hyperventilate)
then SUPERIMPOSED by.. metabolic acidosis (anion-gap)
ultimately: low bicarb (metabolic acidosis) low pH (acidemia) low CO2 (still hyperventilate)
colchicine used for…
GOUT
not RA
etanercept used for..
rheumatoid arthritis
caudal medulla: location of hypoglossal nuc? where does n. leave?
nuc is dorsal
BUT
n. leaves between medial lemniscus & olive! (ventral)
skin ulceration after a vaccine (i.e. tetanus immunization)
due to arthus reaction
edema, necrosis, activation of complement
type III HSR
deposition of antibody, antigen complex
“localized” serum sickness
when does serum sickness occur?
5-10 days post-exposure
antibody against foreign protein –> deposits in membranes
fever, urticaria, arthralgia, proteinuria, lymphadenopathy
wiskot-aldrich vs. chediak-higashi
wiskot-aldrich
- actin issues
- combined T cell/B cell
- x-linked recessive
chediak-higashi
- microtubule issue
- neutrophil
- autosomal recessive
wiskot-aldrich syndrome presentation
x-linked recessive
defect in actin reorganization
WATER
thrombocytopenic purpura
eczema
recurrent infxn
increased risk of malignancy
and autoimmune disease
B cell immunodeficiency presenting later in life ~20-30 y/o associate w/ autoimmune & RA?
common variable deficiency
Job syndrome presentation
Th17 deficiency due to less STAT3
impaired recruitment of neutrophils
FATED
abnormal facies abscesses (cold, no neutrophils) RETAINED TEETH hyper IgE dermatologic problems (eczema)
chediak-higashi presentation
autosomal recessive
neutrophil problem
defective LYST gene (lysosomal trafficking regulator gene)
microtubule dysfunction in phagosome-lysosome fusion
BALIN
bleeding and bruising (platelet problem)
partial albinism
leukopenia & infiltrative lymphohistiocytosis
recurrent infxn (staph, strep)
PERIPHERAL NEUROPATHY & NEURODEGENERATION
lots of neutrophils, but have giant granules
pancytopenia
pre-eclampsia criteria
20wk -> 6 wk postpartum
- HTN (>140/90)
- proteinuria (>300mg/24hr)
severe would be 1. HTN (>160/110) w/ or w/o end-organ damage: headache, scotoma, oligouria & HEELP: hemolysis, elevated liver enzymes, low platelets
cause of pre-eclampsia
abnormal formation of placental spiral arteries –> maternal endothelial dysfunction
key things an infant can do (0-12)
Parents Start Observing
motor: primitive reflexes disappear posture: crawl by 8, stand by 10, walk by 12-18 pincer grasp points
social:
smile by 2mo
stranger anxiety by 6mo
separation anxiety by 9mo
observing:
oriten to voice, name, gestures
object permanence by 9
oratory: mama dada by 10mo
key things a toddler can do (12-36 month)
child rearing working
motor
climb stairs, stack cubes, feeds self, kicks
social
recreationg: parallel play
rapproachment: leave but comes back to mom
realization: core gender identity
working:
200 works by 2
(2 zeroes)
2-word sentences
key things a preschooler can do (3-5)
Don’t Forget they’re still Learning
motor
drive (tricycle), draw (copies, stick figure), dexterity (hop on a foot, groom)
social:
freedom: spend time from mom
friends: cooperative play
learning:
1000 words by 3 (3 zeroes)
legends: detailed stories
adalimumab
antibody against TNF-a
infliximab
antibody against TNF-a
