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STEP Flash Cards > PT1 > Flashcards

PT1 Flashcards

1
Q

Pt. bleeding from his venous puncture sites in ER when he comes in with bacterial meningitis. WHAT WOULD YOU SEE ON PERIPHERAL BLOOD SMEAR?

A

Schistiocytes- Pt. is in DIC and schistiocytes are fragented RBC - indicates trauma/micro emboli

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2
Q

How do FA Oxidation inhibitors work?

A

They shift energy production to glucose oxidation, thus promoting oxygen efficiency. This helps cardiac function (decreases oxygen demand - helpful for stable angina)

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3
Q

What lung parameter is usually NORMAL in ARDS?

A

Capillary wedge pressure: ARDS is characterized by ABSENCE of cardiogenic pulmonary edema which means that the wedge pressure should be normal (cap perm is inc, inc. V/Q mismatch, inc. work in breathing, and dec. lung compliance in ARDS)

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4
Q

What happens during the RECOVERY phase of acute tubular necrosis (ATN)?

A

Polyuric phase- pt. can become very dehydrated and lose important ions - especially POTASSIUM - become hypokalemic

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5
Q

Consequence of maternal diabetes DURING pregnancy?

A

Fetal hyperglycemia (glucose crosses placenta) in utero

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6
Q

Consequence of maternal diabetes (uncontrolled) AFTER birth?

A

Neonatal transient HYPOglycemia - the hyperglycemia in utero stim. hyperinsulinemia in fetus and this remains after birth even when fetus isn’t exposed to mom’s high glucose levels - leads to transient HYPOglycemia in neonate (and macrosomia)

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7
Q

What do you use to treat alcohol withdrawal symptoms

A

Benzodiazepenes (ex: Diazepam)

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8
Q

5mo. boy with hypoxia, bilateral wheezing, scattered rales, low-grade fever, runny nose, cough…DIAGNOSIS and CAUSE?

A

Viral bronchiolitis - probably caused by RSV

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9
Q

Treatment for pretty severe viral bronchiolitis? And MOA for drug

A

Ribavirin: nucleoside analog that inhibits synth. of guanine nucleotides; used against RSV and hepatitis C

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10
Q

Pathogenesis of Guillan Barre

A

Abs against infectious antigens thought to cross-react with myelin of spinal roots & peripheral nerves; see demyelination & endoneural inflammatory infiltrates (lymphocytes & macrophages)

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11
Q

Endomysial inflamm. infiltration characteristic of….

A

Polymyositis (bilateral & symmetrical weakness of proximal muscles)

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12
Q

Hyalinization of nerve arterioles characteristic of…

A

Diabetes mellitus (diabetic microangiopathy); narrowing of arterial lumen & ischemic nerve injury - can lead to peripheral neuropathy

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13
Q

Toxin penetration through blood-nerve barrier, leading to peripheral neuropathy characteristic of…

A

Diphtheria

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14
Q

Burr cells & helmet cells on peripheral blood smear (in a pt. with prosthetic valves & anemia) are characteristic of….

A

MECHANICAL TRAUMA: schistiocytes, burr, and helmet cells are consistent with traumatic hemolysis (can come from valve/mechanical damage or microangiopathic hemolytic anemia) - valves cause shear & turbulence in circulation

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15
Q

What you’d see in periph. blood smear in megaloblastic anemia

A

Hypersegmented neutrophils & ovalo-macrocytes

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16
Q

What you’d see in periph. blood smear in beta thalassemia

A

Target cells

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17
Q

What you’d see in periph. blood smear with GI blood loss

A

Hypochromic, microcytic anemia (due to iron def.)

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18
Q

Main effect of nitrates (nitroglycerin)

A

DECREASES preload (LV volume during diastole) - causes VENO-dilation &retention of blood in venous system)

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19
Q

Pt. complaining of visual problems - both left and right side, also has headaches - hormone likely in INC. quantities?

A

PROLACTIN - think pituitary tumor! ~60% are prolactin-secreting adenomas - characteristic bitemporal hemianopsia

20
Q

One mechanism by which bacteria become resistant to cephalosporins

A

Change in protein structure of the penicillin-binding proteins

21
Q

Describe hepatocytes in viral Hep B infection…

A

filled with spheres and tubules of HBsAg - appears finely granular & eosinophilic (ground glass appearance)

22
Q

Poor intestinal abs. of cysteine leads to?

A

Kidney stones - cystine is not very soluble in urine so it will ppt out and form cystine crystals

23
Q

Most common benign vascular tumor in children

A

Strawberry (infantile) hemangioma - grwo rapidly and then regress usually

24
Q

Trousseau syndrome

A

migratory thrombophlebitis - can be seen with disseminated cancers

25
Q

NBTE pathogenesis (nonbacterial thrombotic endocarditis)

A

see sterile vegetations on heart - can lead to h ypercoagulability (has procoagulant effects from the cancer in the body)

26
Q

Drug of choice to control gestational diabetes (if diet can’t control it)

A

Insulin

27
Q

LMWH vs. unfractionated Heparin mechanisms

A

Both bind antithrombin and inactivate factor Xa but only unfractionated heparin is long enough to also bind thrombin and inactivate it

28
Q

Enoxaparin mechanism

A

LMWH (inactivates Xa, NOT thrombin)

29
Q

Fondaparinux mechanism

A

synthetic Xa inhibitor

30
Q

Halothane toxicity

A

highly lethal fulminant hepatitis (histologically INdistinguishable from acute viral hepatitis) - inc. AST, prolonged PT, eosinophilia

31
Q

Side effect of acyclovir & how to manage

A

Nephrotoxicity - adequate hydration

32
Q

Atyp. lymphocytosis on peripheral blood smear indicates…

A

Infectious Mononucleosis - commonly from EBV

33
Q

EBV infection associated with:

A
  1. Burkitt’s & 2. Nasopharyngeal carcinoma
34
Q

Effect of BPH on bladder & Kidneys

A

Can cause bladder outflow obstruction (BOO) - this then causes backup of urine into kidneys and parenchymal pressure atrophy: pelvis, ureters, calyces dilate - hydronephrosis & ultimately parenchyma becomes atrophic & scarred due to reflux

35
Q

Small cell carcinoma markers

A

Neuroendocrine markers: synaptophysin & chromogranin

36
Q

Acetazolamide MOA

A

Used to treat closed-angle glaucoma; inhibits carbonic anhydrase (found in eye and responsible for aqueous humor formation) - side effect? Also inhib the enzyme from reabs bicarb fro the PROXIMAL TUBULE of kidney - can result in alkaline urine & inc. urination (more water)

37
Q

Hemophilia A

A

factor VII deficiency

38
Q

Hemophilia B

A

Factor IX deficiency (Chrismas disease)

39
Q

What will you see with hemophilia (A&B)

A

Increased PTT (PT and TT and bleeding time are normal) - characterized by bleeding into large joints (hemathrosis) and prolonged bleeding after surgical procedures

40
Q

Warfarin increases PTT or PT?

A

PT

41
Q

What factors cause PT prolongation?

A

II, V, VII, X, fibrinogen

42
Q

What causes prolonged BLEEDING time?

A

Quantitative/qualitative defects in platelets; signs include recurring nose bleeds, gingival hemorrhages, bruises, vWF deficiencies

43
Q

Type 1 RP(cresentic)GN

A

characterized by anti-glom basement membrane (anti-GBM) deposits of IgG and C3; associated with Goodpasture syndrome

44
Q

Type 2 RPGN

A

immune-complex mediated; lumpy bumpy granular pattern; complication of post strep glomerulonephritis, SLE, IgA nephropathy

45
Q

Type 3 RPGN

A

Pauci-immune = no Ig or complement deposits in BM; most have ANCA in serum; often associated with Wegener’s

STEP Flash Cards (14 decks)

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