prometric practice Flashcards by Nashid Chaudhury

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

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what drains to the popliteal lymph nodes? (2)

dorsolateral foot

2. posterior calf

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rx for cluster headaches

oxygen and sumatriptan

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rx for migraine abortive?

sumatriptan, NSAID

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rx for migraine prophylaxis?

propanolol, topiramate, amitryptaline, Ca2+ channel blockers

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rx for tension headaches

NSAID, analgestics, amitryptaline, acetaminophen

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acute megakaryocytic leukemia

proliferation of megakaryoBLASTS

AML M7

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ITP etiology

antibodies against GpIIbIIIa

SPLENIC macrophage destruction!

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ITP blood / bone marrow smear

blood -> thrombocytopenia

marrow -> many mature megakaryocytes

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TTP & HUS vs. ITP

all three = thrombocytopenia
TTP / HUS: schistocytes
ITP: splenic destruction

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TTP etiology

deficiency of ADAMSTS-13

large platelet vWF -> abnormal platelet aggregation

microthrombi –>

schistocytes & thrombocytopenia

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normal anion gap

8-12 mEq/dl

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what columns are affected by B12 deficiency?

dorsal column: SENSORY
lateral corticospinal: MOTOR
(spinocerebellar can be too)

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dry beri beri

B1 thiamine deficiency

peripheral polyneuritis, symmetric muscle wasting

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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!

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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 1. HTN (>140/90) 2. 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