pros Flashcards

Question

healthy aging - definition - determinants of healthy ageing

Answer 1

definition: functioning at the highest level possible for as long as possible - determinants of healthy ageing SEE HPB 1. social 2. environmental 3. ECONOMIC 4. health 5. personal 6. behaviour

Answer 2

nutrition active lifestyle vaccination smoking cessation screening (for any early impairments)

Answer 3

1. max brain reserves - exercise the mind = do cognition exercises (IQ puzzles) - avoid doing.3 things at once 2. min risk factors - decrease stroke risk factors (e.g. eating healthier, decreasing smoking, diabetes, obesity)

Answer 4

- build social networks = meet new people + go out with more people! - avoid learned dependency (don't keep asking other people to do it for you)

Answer 5

1. life long learning --> cooking classes 2. diversity of experiences --> religion 3. mindset and philosophy --> self efficacy mentality

Answer 6

medisave: compulsory savings medifund: govt give you a bit medishield: covers LARGE hosp bills + outpatient (eg. chemo) (for all singaporeans) eldershield: long term disability for elderly people

Answer 7

definition: acquired syndrome of decline in memory + other cognitive domains = sufficient to affect daily functioning assessment of cognitive function (ACE) 1. AMT (abbreviated mental test) - screening, but not a confirmatory test - 2. CMMSE (chinese mini mental state exam) 3. ECAQ (elderly cognitive assessment questionnaire)

Answer 8

diagnosis of delerium: CAM (confusion assessment method) - acute change in mental status + fluctuating course - inattention - disorganised thinking - altered LoC

Answer 9

1. caregiver support 2. opthalamology --> make sure that there are no vision problems 3. walking aids --> improve gait 4. underlying risk factors --> any medications to stop? 5. occupational therapist/ podiatrist 6. home environment modification

Answer 10

medisave: to build up savings medishield: help with large healthcare bills medifund: government gives funds to needy singaporeans

Answer 11

1. polypharmacy 2. liver failure --> affects metabolism of drugs (esp for drugs with high first pass effect) 3. kidney failure --> affects the clearance/ excretion of drugs = accumulation of toxic concentration 4. cognitive impairment/ poor eyesight --> patient may see and take the wrong drug

Answer 12

benzodiazepines - dose related drowsiness - increased reaction time - decreased motor skills

Answer 13

HPV LM 1. hearing --> cannot hear the pharmacist's instructions clearly 2. language impairment 3. polyharmacy 4. vision 5. memory

Answer 14

1. superior saggital sinus 2. transverse sinus

Answer 15

1. non-communicating (obstructive) = blocked CSF flow in foramen of monroe or aqueduct of sylvius = ventricles upstream are enlarged = increased risk of herniation 2. communicating = decrease in absorption of CSF fluid by arachnoid granulations = all ventricles are symmetrically enlarged = brain parenchyma is stretched, expanded and white symptoms: - urinary incontinence - cognitive decline - issues with gait

Answer 16

chronic demylinating disease = antibodies attack the myelin in the CNS (oligodendrocytes) = dead oligodendrocytes present as WHITE PLAQUES IgG antibodies present as OLIGOCLONAL bands in the CSF

Answer 17

acute demylinating disease previous infection (eg. campylobacter jejuni, EBV, CMV) = molecular mimicry = antibodies produced which attack the axons and myelin in the PNS (schwaan cells) = myelin destruction = decrease nerve conduction = LMN symptoms

Answer 18

AChRAb production (IgG) = AChR gets broken down = more free floating ACh in the synaptic cleft = ACh gets broken down by acteylcholinesterases treatment: acetylcholinesterase inhibitors --> pyridostigmine = ACh not broken down = more ACh what happens if too much medication: too much ACh = overstimualtion of muscuranic receptors = cholingergic crisis = diarrhoea, bradycardia, smooth muscle contractions, excessive secretions, nausea and vomiting, bronchospasms, bronchorrhea (think of organophosphates, and what happened to the north korean president's brother)

Answer 19

definition: MENTAL HEALTH disorder characteristed by low mood, low interest, which can cause problems with physical, cognitive, ,and affective symptoms diagnosis: GDS-15 (geriatric depression scale) ABCs: - affective - behaviour - cognitive devline

Answer 20

definition: acute, non-specific neuropsych manifestation of disorder of CEREBRAL METABOLISM + NEUROTRANSMISSION why impt: potentially reversible and preventable causes: Drugs Environment Little water (dehydration) INTERNAL BLEEDING Restraints Infection Urine or fecal retention --> pain Metabolic disturbances Sleep SAH treatment: antipsychotics - typical vs atypical (ROCQ) EPS: 1. tardive dyskinesia 2.

Answer 21

seizure: sudden, uncontrolled electrical disturbance in the brain, leading to abnormal movements, behaviour, sensations, or LoC epilepsy: chronic condition, predisposed to spontaneous seizures

Answer 22

gluteus maximus INFERIOR gluteal nerve

Answer 23

tibialis anterior

Answer 24

triceps surae tibial nerve

Answer 25

quadriceps femoris (knee extension) femoral nerve

Answer 26

subtalar joint anterior and posterior tibial muscle flexor digitorium & brevis longus

Answer 27

adult: medial circumflex A (femoral A) child: acetabular branch of obturator A

Answer 28

boundaries - inguinal ligament lateral: sartorius medial: adductor longus contents: NAVL (lateral --> medial) femoral nerve femoral artery femoral vein lymph nodes importance: site for femoral nerve palpation medical procedure: aim medially to prevent femoral artery puncture

Answer 29

common fibular nerve (which comes from the sciatic nerve, S4-L3)

Answer 30

PCL: prevent femur from moving too far forward ACL: prevent tibia from moving too far forwards

Answer 31

front V: iliofemoral --> prevent hyperextension midddle: pubofemoral --> prevent lateral dislocation posterior: ischiofemoral --> prevent hyperflexion rmb ILIUM --> ISCHIUM --> PUBIS

Answer 32

L4-S3 exit lumbosacral plexus = greater sciatic foramen (below piriformis) = between lesser trochanter of femur and ischial tuberousity (**ischial tuberousity is where people sit on the floor) =

Answer 33

femoral artery = passes through adductor hiatus = turns into poplitheal artery =

Answer 34

T3: lio|thyroNine T4: levo|thyroXine

Answer 35

thioamides (agranulocytosis) - carbimazole (cholestatic jaundice) - propyluracil (hepatoxotic) radioactive iodine i131 (may cause hypothyroid later on) iodides - lugols solution - potassium iodide tablets

Answer 36

T3: triiodothyronine T4: thyroxine active form: T3, but T4 more abundant due to longer half life process of thyroid hormone synthesis: 1. iodine oxidation 2. organification (aka. iodination) 3. coupling

Answer 37

1. thioamides = intefere with organification and coupling = no conversion of T4 --> T3 - carbimazole - PTU 2. cholestyramine - bile acid sequestrant = decrease reabsorption of bile = decrease T4 reabsorption 3. beta blockers = prevents additional sympathetic activity due to excessive T3/4 - propanolol 4. glucocorticoids = supress the immune response

Answer 38

1. graves 2. non-toxic & toxic multinodular goiter 3. de quervains thyroditis 4. follicular adenoma 5. follicular carcinoma 6. oncocytic adenoma

Answer 39

genetics: HLA-DR3, B8 autoimmune disease = TSI pdtn (thyroid stimulating immunoglobin) = overstimulate thyroid = high T3/4, low TSH gross: 1. hypervascularised = red meat cut 2. hyperplasia = diffused symmetrical enlargement histology: 1. thyroid hyperplasia = tall columnar crowded pseudopapillae 2. colloid used up = pale scalloped colloid clinical: 1. goiter 2. exopthalmos 3. pretibial myxedema 4. staring gaze, lidlag 5. bruits 6. diffused goiter

Answer 40

chronic iodine deficiency = decrease T3/4 synthesis (since iodine is needed in iodinification) = increase TSH produced = asymmertrical follicular growth, since some TSH receptors are more receptive than others = thyroid enlargement toxic MNG: after time, the hyperplasia results in a genetic mutation of the TSH receptors = constituitive activation of TSH receptors = too much T3/4 produced = hyperthyroid = asymmetrical enlargement of thyroid = compress recurrent laryngeal nerve = hoarseness of voice gross: 1. assymetrical enlargement of thyroid 2. nodules of diff sizes histo: 1. large follicles WITH NO TRUE CAPSULE 2. cystic changes

Answer 41

viral infection = virus enters bloodstream = enters follicular cells in thyroid = CD8+ recognises follicular cells as infected = inflammation = T3/4 spills out from follicular cells = thyrotoxicosis = HYPERthyroid = damaged thyroid can no longer produce T3/4 histo: 1. inflammation = macrophages, multinucleated giant cells around colloid (trying to clear up the colloid) 2. follicular cell destruction gross: 1. thyroid enlgargement (inflammation) 2. patchy pale yellow parenchyma (due to lymphocytic infiltrate)

Answer 42

benign RAS mutation = constuitive activation of MAPK pathway = uncontrolled proliferation of uniform cubodial follicular cells = well encapsultaed fibrous capsule = thyroid enlargement = press on recurrent laryngeal nerve = hoarseness of voice

Answer 43

malignant starts off with follicular adenoma = other gene mutations = tumour breaks through the capsule = hematogenous spread (capsular + vascular invasion) = cellular stress = oncocytic changes histo: (think: cancer histo) 1. salt and pepper chromatin 2. oncocytic changes 3. microfollicles

Answer 44

thyroglobulin

Answer 45

follicular adenoma = extra inflammation and oxidative stress = to compensate for energy deficit, cells proliferate mitochondria excessively = follicular cells accumulate mitochondria --> granular = acidic proteins stain H&E stain pink = mitochondrial damage accumulates = follicular cells lose their original function = cells undergo metaplasia = become hurthle cells

Answer 46

1. hashimotos thyroditis 2. iodine deficiency

Answer 47

genetic: HLA DR3 , 5 autoimmune disease = molecular mimicry = immune system identifies thyroid antigens as foreign = attacks thyroid = IFN-gamma recruited = follicular cells undergo ADCC (antibody dependent cellular cytotoxicity) = B cells produce anti TPOs = inflammation = follicular cells destroyed = hypothyroid gross: 1. chronic inflammation = fibrosis 2. pale and diffusely enlarged 3. lymphocytic infiltrate histo: 1. destroyed thyroid follicles 2. dense lymphocytic infiltrate 3. later: oncocytic changes

Answer 48

P(o)FMA 1. papillary (lymphatic spread) 2. follicular (hematogenous) 3. medullary (familial MEN 2) 4. anaplastic

Answer 49

**MOST COMMON thyroid carcinoma - lymphatic spread BRAF or RET mutation in thyroid follicular cells = MAPK pathway constituitively activated = - uncontrolled cell division - inhibition of apoptosis - no cellular differentiation - disrupted cellular architecture 1. chromatin pushed to the side = orphan annie eye effect 2. nucleus envelope folds inwards = chromatin dumbing along grooves = coffee bean nuclei 3. portion of the cytoplasm pushes into the nucleus = cytoplasm trapped in the nucleus = pseudoinclusion

Answer 50

**second most common thyroid carcinoma - hematogenous spread RAS mutation in follicular cells = MAPK contituitively active = loss of cell cycle regulation = uncontrolled cell proliferation and differentiation = tumour breaks through capsule = hematogenous spread = BBL (bone, brain, lungs) = cellular stress = oncocytic changes histo: (think: cancer histo) 1. salt and pepper chromatin 2. oncocytic changes 3. microfollicles

Answer 51

neuroendocrine tumour (since C cells function as neuroendocrine cells) - hematogenous + lymphatic spread MEN-2 = RET mutation = hyperactive parafollicular C cells = excessive calcitonin production = protein overload = misfolded calcitonin = abnormal aggregates of calcitonin = amyloid deposits = congo red stains histo: 1. amyloid deposits, congo red stains 2. loss of E cadherin = spindle shaped cells

Answer 52

**rarest, but most lethal long standing PTC/ FTC = TP53 mutation (or literally any mutation) = rapid proliferation and necrosis = tumour outgrows its blood supply = local invasion of trachea and esophagus, CAROTID ARTERY = spread via hematogenous and lymphatic spread

Answer 53

ICA --> ACA + MCA vetebral artery --> basillar + pontine --> PCA right side: aortic arch = brachiocephallic branch = subclavian artery = CCA = ICA = ACA + MCA from subclavian artery = vetebral artery left side: aortic arch = CCA = ICA = aortic arch = subclavian artery

Answer 54

C4: thyroid cartildge, carotid canal, CCA bificurates C6: cricoid cartildge, trachea and oesophagus start, larynx and pharynx end

Answer 55

predisposing factors: 1. RF (rheumatoid factor) 2. anti citrullinated peptide Ab 3. HLA DR 1, 4 APC recognise self antigens = self antigens brought to lymph node = inflammatory attack = pro inflammatory cytokines go to joints = attract macrophages = synovial membrane inflammation = PPOC 1. proteases released by synovial cells = break down articular cartildge 2. pannus (abnormally thickened granulation tissue) 3. osteoclast activation 4. chondrocytes release MMPs (1. proteases - synovial cells secrete proteases = break down articular cartildge 2. pannus - chronic inflammation = abnormally thickened synovial tissue = pannus formation 3. osteoclast activation 4. chondrocytes (cartildge cells) = release matrix melloproteineases (in ECM) = destroy cartildge) ++ RF and ACPAb target Fc portion of IgG = immune complexes formed = immune complex accumulates in synovial fluid = joint inflammation X ray findings 1. Swan neck deformity 2. Ulnar deviation 3. Boutonniere deformity drugs: 1. synthetic csDMARDs - methotrexate = inhibit DHFR = no DHF --> THF conversion = no DNA synthesis = decrease inflammation + inhibit AICAR transformylase = decrease purine synthesis (nucleotide) = decrease DNA synthesis = decrease inflammation 2. NSIADS - diclofenac - indomethacin

Answer 56

X ray findings: 1. Loss of joint space 2. Osteophyte formation - destruction of articular cartildge = osteophyte formation 3. Subchondral cyst formation exposed subchondral bone with gaps = SYNOVIAL FLUID LEAKS THROUGH THE GAPS = intraosseous accumulation of synovial fluid 4. Subarticular sclerosis = constant friction = eburnation (smooth bone surface) = thickening of bone to fill the space nodules: PIPJ: bouchard's nodes DIPJ: herbeden's nodes thumb = carpometacaarpal = saddle joint

Answer 57

1. ewing's sarcoma <10yo, but can also be 10-20yo - diaphysis - t(11,22) EWS + FLI1 fusion - onion skin - swelling at night - CD99 2. osteosarcoma (most common malignancy of osteoblasts) --> OSTEO = bone 10-25yo - metaphysis - hematogenous spread to lungs - sunburst pattern - codman's triangle - lace like pattern of osteoid 3. chondroSARCOMA --> CHONDRO = cartildge - 40-60yo - uncontrolled proliferation of cartildge producing chondrocytes = cartildge matrix production BENIGN: 4. OSTEO|CHONDROMA displaced growth cell cartildge = cartildge capped bony outgrowth (exostosis)from metaphysis of long bones

Answer 58

LH binds to theca cells = theca cells stimulated to produce androgens = androgens are transported to granulosa cells = FSH binds to granulosa cells = granulosa cells produce aromatase = andogen is converted to estriadol by aromatase = follicles release estrogen = higher estrogen sends positive feedback to AP = increase FSH and LH (increase FSH to mature follicle) = LH surge = ovulation after ovulation: ruptured follicle becomes corpus lutheum = cholesterol becomes progestrone = increase progestrone signals to body that there is no need for LH and FSH anymore = progesterone maintains the uterine lining = if no fertilisation, CL degenerates = drop in hormones = menstruation

Answer 59

S2-4 sacral plexus = greater sciatic foramen = posterior to sacrospinous ligament, which attaches to ischial spine --> GIVE PUDENDAL NERVE BLOCK HERE = lesser sciatic notch = perinerium = enters the pudendal canal (which is the fascia of the obturator internus) = give off 3 major nerves 1. inferior rectal/ anal nerve 2. perineal nerve --> perineal muscles, EUS 3. dorsal nerve of clit

Answer 60

CONTRACT DETRUSOR MUSCLE = urinate = PNS (rest and relax) pelvic sphlanic nerve (S2-4) = ACh = contracts detrusor muscle RELAX DETRUSOR MUSCLE = fill urine = SNS (fight or flight) = cannot pee when stressed hypogastric nerve (T11-L2) = NE = relax detrusor muscle + contract internal urethral sphinccter somatic control of EUS: pudendal nerve = continence

Answer 61

non-invasive: DCIS, LCIS 1. DCIS mutation in TSG in epithelial cells in lactiferous duct - comedo = microcalcifications - no breach of basement membrane pagets disease: DCIS = malignant ductal carcinoma cells spread to lactiferous ducts = invade epidermis = spread within epidermis = nipple erosion, ulceration, scaling, and crusting invasive: TMML 1. tubular (low grade) - best prognosis - well formed tubules, well differentiated - minimal atypia - prominent nucleoli 2. mucinous - tumour cells floating in mucin - 70yo women 3. medullary - lymphocytic infiltrate - pleomorphic cells - BRCA 1/2 mutation 4. lobular (high grade) - loss of E cadherin - signet ring cells - cocentric layering --> diffuse infiltrative pattern with minimal desmoplaia

Answer 62

DNA repair: BRCA 1/2 --> checkpoint TSG: p53, PTEN --> promote apoptosis, chceckpoint regulation Oncogene: HER2, ER --> disrupt cell growth and survival

Answer 63

1. intraductal papilloma benign proliferation of epithelium in lactiferous ducts = central fibrovascular stalk growth = stalk is prone to rupture = rupture causes bloody nipple discharge 2. fibroadenoma (breast mouse) - benign, fibrous growth = compress ducts 3. phyllodes tumour (leaf like tumour) hypercellular overgrowth - INTRAlobular stromal hyperplasia - increased mitotic activity, high cellularity - fibroepithelial tumour - hematogenous, NOT lymphatic spread treatment: wide local excision

Answer 64

affrent: (all the stuff i already know) efferent: pre tectal nucleus = EWN = ciliary ganglion = short ciliary nerves (post ganglionic) = pupil: sphincter pupillae (constrict) lens: ciliary muscle (accomodation reflex) pathologies: affrent: 1. RAPD 2. visual field defects 3. retinal detachment efferent: 1. agryll robertson - neurosyphillis - lesion at pre tectal nucleus 2. adie's tonic pupil - ciliary ganglion lesion - slow accomodation - have light reflex 3. CN3 - no accomodation 4. horner's syndrome

Answer 65

1. uncal: uncus herniates through tentorial notch - compress PCA - compress CN2, 3 2. subfalcine: cingulate gyrus herniates below falx cerebri - compress ACA - obstruct foramen of monroe 3. tonsillar: cerebral penduncles herniate through foramen magnum - compress MO - coning = compress pons and medulla = cardiorespi arrest - CN6

Answer 66

1. cardiac - arrhythmias - cardiomyopathy - defects 2. vasovagal - emotions - reflex mediated

Answer 67

1. abcess bacterial/fungal = localised infection = compress surrounding structures = focal neurological deficits 2. meningitis - bacterial nesseria meningities (younger adults) streptococcus pneumoniae (elderly, neonates) - viral echovirus, cocksackie, mumps, HSV - SAH ------------ test for meningitis (A) brudzinski's sign (bend head towards chest, patient likely to move legs up as well) (B) kernig's sign (point leg straight up) ==> Knee Extension is painful 3. encephalitis (inflammation of parenchyma) - bacterial spread from meninges to parenchyma - viral (HSV) HSV directly invades brain tissue = neuronal destruction and inflammation = temporal lobe involvement

Answer 68

1. ischemic (WTEL) ==> windsor TEL - watershed = border zone between 2 major arteries - thrombotic chronic plaque formation in cerebral arteries = clot formation = vessel occlusion - embolic AFib/ endocarditis/ carotid plaque rupture = clot travels to ACA/ MCA/ PCA - lacunar ==> occlusion of smalll penetrating arteries that provide blood to deep brain structures (A) HTN = lipohyaloinosis (B) artheroscleosis = microarethoma (C) A Fib/ carotid sternosis = small emboli 2. hemorrhagic - ICH (**LAH) (A) Lobular elderly have beta amyloid deposits in small vessels = cerebral amyloid angiopathy = fragile vessels = vessel rupture at cortical areas (B) AVM no capillary bed between artery and vein = high pressure flow = veins enlarge over time = prone to rupture = supratentorial FPT (C) HTN = lipohyalinosis = weak small arteries = microaneurysms (charcot bouchard aneurysm) - SAH (berry anneurysm) = at bificuration of major arteries in the circle of willis ---------------------------------- TOAST: (ACL) - atherosclerosis - cardioembolic - lacunar ICF: [BAP] body function and structure activity limitations participation limitations ischemic: statins, tPA haemorrhagic: antihypertensives, beta blockers, ACEInhibitors ---------------------------- how do statins work: inhibit HMG-CoA reductase = liver removes LDL from blood = lower LDL, higher HDL = improve atherosclerosis, prevent risk of future clots

Answer 69

1. temporal artheritis - genetic: HLA DR4 / B1 genetic/ environmental triggers = activate DENDRITIC CELLS = recruit macrophages = multinucleated giant cells, granulomatous inflam = DISRUPT INTERNAL ELASTIC LAMINA = thickened INTIMA = lumen narrowing of middle-large arteries = decrease blood flow = jaw claudication + BILATERAL BLINDNESS **be careful of skip lesions when doing biopsy 2. carotid artery dissection Hx of head manipulation = tear in intima = TEARING NECK PAIN + neurological defiicts = give antiPLATELET 3. venous sinus thrombosis virchow's triad = thrombus formation = venous congestion = increase ICP = thunderclap headache, seizures, neuro deficits - empty delta sign at superior saggital sinus (on VENOGRAPHY) 4. papilloedema increase ICP = compress central retinal vein = venous congestion = capillary engorgenment = microhaemorrhage of fragile retinal artery = disrupted vasculature, micrphaemorrahages = disrupt endothelial integrity = fluid leaks into retina = optic disc has blurred margins

Answer 70

1. turner's syndrome (XO) 45 X ==> ovarian failure = high levels of estrogen non dysfunction during meiosis/ mosaic = decrease estrogen pdtn no SHOX gene = decrease GH sensitivity = decrease skeletal growth = short stature 2. klienfelter's syndrome (XXY male) 47 XXY ==> testicular failure = low levels of testosterone non dysjunction in males = extra X chromosome = increase FSH, LH = low levels of testosterone = small penis, gyanecomastia extra SHOX gene = tall stature

Answer 71

1. AIS androgen recpeotrs are insensitive = testosterone has nowhere to bind = no wolffian duct , no DHT conversion = no internal or external male structures = blind ended vagina, appears female (but actually male) 2. 5 alpha reductase deficiency testosterone produced = no alpha reductase to convert it to DHT = no external structures = externally appears female, but actually male structures inside 3. kallman's syndrome (can be male, can be female) **plus impaired smell impaired GnRH neuronal migration = no GnRH = no LH and FSH = low levels of testosterone/ estrogen = poor sexual development

Answer 72

colles: fall on outstretched wrist = distal radius fracture = dinner fork deformity = smith's: fall on flexed wrist =

Answer 73

best felt: lateral to FCR (artery runs superficial and lateral to FCR)

Answer 74

1. superior thoracic SPLIT BY TERES MINOR 2. - lateral thoracic - thoracoacromial 3. - subscapular - ant and post circumflex

Answer 75

anterior: pect minor and major posterior: scapularis, teres major, lat dorsi medial: serratus anterior, thoracic wall lateral: humerus contents: axillary nerve and artery

Answer 76

biceps: supraglenoid tubercle triceps: infraglenoid tubercle

Answer 77

lateral: musculocutaneous medial: ulnar post: axillary, radial median: both lateral and medial

Answer 78

0-30: supraspinatus (suprascapular nerve) 30-90: deltoid (axillary) 90-180: trapezius and SA (long thoracic)

Answer 79

profunda brachii artery

Answer 80

sterncostal head: medial pectoral nerve (C8-T1) clavicular head: lateral pectoral nerve (C5-7)

Answer 81

made of the tendons of extensor digitorium muscles

Answer 82

SCM - CN11 trapezius - CN11 (shrugging)

Answer 83

shrugging shoulders if damaged, will have drooped shoulders

Answer 84

digastric (CN 5, 7) mylohyoid (CN V3) geniohyoid (hypoglossal nerve)

Answer 85

C1-3 ansa cervicalis sterno~ - thyroid - hyoid omohyoid thyrohyoid

Answer 86

~pharynx: nasal (CNV2) oro (CN 9) laryngo (CN10)

Answer 87

cricothyroid (CN 10) --> external laryngeal nerve tenses vocal cords

Answer 88

cricoid muscles recurrently laryngeal nerve = hoarseness

Answer 89

MMTL (mom makes tasty lagsana) masseter MEDIAL PTERYGOID temporalis lateral pterygoid CN V3

Answer 90

1. muscles of mastication 2. V3 3. maxillary artery

Answer 91

(gag reflex) CN9 salivatory nucleus --> otic ganglion

Answer 92

PCF = IAM = facial canal = stylomastoid foramen = enters parotid gland = splits into 5 branches (two zebras bit my cock)

Answer 93

cerebreum 1, 2 midbrain 3, 4 pons 5, 6, 7 pontomedullary junction 8 medulla 9-12

Answer 94

type 3 hypersensittivity dsDNA, ANA complement activation = inflammation and tissue damage = loss of self tolerance = increase B cell activation INF alpha, TNF alpha

Answer 95

type 2 IgG targets hemidesmosomes (BP 180, 230) in basement membrane = complement activation = inflammation = blister formation C3 deposition on basement membrane tense blisters, subepidermal bullae treatment: corticosteroids

Answer 96

type 1 inteferon driven anti Mi2 anti Jo 1 muscle inflammation

Answer 97

C acne proliferation - comedomees (open - blackheads, closed - white heads)

Answer 98

CN3 sympathetic pathway disruption = loss of sweat gland innervation, unilateral ptosis, miosis, anhidrosis do coccaine test

Answer 99

entire face affected - HSV related - need to differentiate from stroke 'FACE' Facial droop (entire half of face) Absent forehead movement Closing eye is difficult Eyes & mouth droop

Answer 100

down and out pupil ptosis diplopia (double vision) pupil involvement