PT1 Flashcards
Pt. bleeding from his venous puncture sites in ER when he comes in with bacterial meningitis. WHAT WOULD YOU SEE ON PERIPHERAL BLOOD SMEAR?
Schistiocytes- Pt. is in DIC and schistiocytes are fragented RBC - indicates trauma/micro emboli
How do FA Oxidation inhibitors work?
They shift energy production to glucose oxidation, thus promoting oxygen efficiency. This helps cardiac function (decreases oxygen demand - helpful for stable angina)
What lung parameter is usually NORMAL in ARDS?
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)
What happens during the RECOVERY phase of acute tubular necrosis (ATN)?
Polyuric phase- pt. can become very dehydrated and lose important ions - especially POTASSIUM - become hypokalemic
Consequence of maternal diabetes DURING pregnancy?
Fetal hyperglycemia (glucose crosses placenta) in utero
Consequence of maternal diabetes (uncontrolled) AFTER birth?
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)
What do you use to treat alcohol withdrawal symptoms
Benzodiazepenes (ex: Diazepam)
5mo. boy with hypoxia, bilateral wheezing, scattered rales, low-grade fever, runny nose, cough…DIAGNOSIS and CAUSE?
Viral bronchiolitis - probably caused by RSV
Treatment for pretty severe viral bronchiolitis? And MOA for drug
Ribavirin: nucleoside analog that inhibits synth. of guanine nucleotides; used against RSV and hepatitis C
Pathogenesis of Guillan Barre
Abs against infectious antigens thought to cross-react with myelin of spinal roots & peripheral nerves; see demyelination & endoneural inflammatory infiltrates (lymphocytes & macrophages)
Endomysial inflamm. infiltration characteristic of….
Polymyositis (bilateral & symmetrical weakness of proximal muscles)
Hyalinization of nerve arterioles characteristic of…
Diabetes mellitus (diabetic microangiopathy); narrowing of arterial lumen & ischemic nerve injury - can lead to peripheral neuropathy
Toxin penetration through blood-nerve barrier, leading to peripheral neuropathy characteristic of…
Diphtheria
Burr cells & helmet cells on peripheral blood smear (in a pt. with prosthetic valves & anemia) are characteristic of….
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
What you’d see in periph. blood smear in megaloblastic anemia
Hypersegmented neutrophils & ovalo-macrocytes
What you’d see in periph. blood smear in beta thalassemia
Target cells
What you’d see in periph. blood smear with GI blood loss
Hypochromic, microcytic anemia (due to iron def.)
Main effect of nitrates (nitroglycerin)
DECREASES preload (LV volume during diastole) - causes VENO-dilation &retention of blood in venous system)
Pt. complaining of visual problems - both left and right side, also has headaches - hormone likely in INC. quantities?
PROLACTIN - think pituitary tumor! ~60% are prolactin-secreting adenomas - characteristic bitemporal hemianopsia
One mechanism by which bacteria become resistant to cephalosporins
Change in protein structure of the penicillin-binding proteins
Describe hepatocytes in viral Hep B infection…
filled with spheres and tubules of HBsAg - appears finely granular & eosinophilic (ground glass appearance)
Poor intestinal abs. of cysteine leads to?
Kidney stones - cystine is not very soluble in urine so it will ppt out and form cystine crystals
Most common benign vascular tumor in children
Strawberry (infantile) hemangioma - grwo rapidly and then regress usually
Trousseau syndrome
migratory thrombophlebitis - can be seen with disseminated cancers
