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STEP Flash Cards > PT9 > Flashcards

PT9 Flashcards

1
Q

Pregnancy chances for woman with Turner’s

A

Lack of 2nd X chr leads to “streak gonads” - ovaries with small amounts of connective tissue and either no follicles or a few atretic follicles - majority develop ovarian failure by teens

Can only become pregnant after in vitro fertilization using DONOR OOCYTES - also require supplementation with oxygen & progesterone

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2
Q

Septic shock caused by…

A

Release of endotoxins into bloodstream (pretty much regardless of bacterial strain)
Endotoxins are found in the outer membrane of Gm-negative bacteria (composed of LPS)

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3
Q

Describe LPS from Gm- bacteria

A

Heat-stable, arranged into three regions:

  1. O antigen (used for classification purposes)
  2. Core polysaccharide
  3. Lipid A
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4
Q

What is responsible for the toxic properties of LPS that lead to Gm-neg sepsis and endotoxic septic shock?

A

Lipid A - induces shock by activation of macrophages and granulocytes - results in endogenous pyrogen synth (IL-1, prostaglandins, TNF-alpha, IFN)

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5
Q

How to decrease calcium, phosphate, oxalate crystallization in urine?

A

Saturation of the solution with citrate - it will bind free/ionized calcium to prevent its precipitation (facilitates excretion)

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6
Q

STD associated with cytoplasmic inclusion bodies

A

CHLAMYDIA!

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7
Q

Abrupt onset of gross hematuria in a patient with family hx of sickle cell suggests…

A

Renal papillary necrosis caused by:

  • Sickle cell disease or trait (predisposes to ischemia of small kidney vessels)
  • Diabetes (compromises renal vasculature due to non-enzymatic glycosylation)
  • Acute pyelo and tract obstruction (edematous interstitium compresses vasculature - ischemia)
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8
Q

Hawthorne effect

A

Tendency of study population to affect an outcome due to the knowledge of being studied - awareness leads to change in behavior thereby affecting VALIDITY

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9
Q

Berksonian bias

A

Selection bias created by selecting hospitalized patients as control group

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10
Q

Functions of eosinophils

A
  1. Defense against parasitic infections: when IgE bound to the parasite binds to an IgE Fc receptor on eosinophil surface, MBP is released via granules to kill the antibody-bound parasites antibody-dependent cytotoxicity (ADCC)
  2. Regulation of type 1 hypersensitivity rxns = eosinophilic granules contain enzyme that degrades histamine (help reduce severity)
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11
Q

Course of ureters from kidney to bladder

A
  1. Course inferior initially over psoas muscle
  2. Midway, gonadal artery and vein cross OVER anterior surface of ureter
  3. Enter pelvic cavity by crossing over external iliac/vein (even a little higher like the common iliac)
  4. Ureter now is MEDIAL to gonadal vessels and LATERAL to internal iliac vessels
  5. Course DEEP to uterine vessels (in females) just before entering bladder
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12
Q

Indirect inguinal hernias: 1) most common presentation and 2) anatomy

A
  1. male infants
  2. lateral to inferior epigastric vessels, caused by persistent processus vaginalis & failure of internal inguinal ring to close; goes through deep and superficial rings; covered by all 3 spermatic fascial layers
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13
Q

Direct inguinal hernia: 1) most common presentation 2) anatomy

A
  1. older men
  2. seen in Hasselbach’s triangle; medial to inferior epigastric vessels; caused by weakness of transversalis fascia; do NOT pass through deep inguinal ring, but only through superficial; only covered by external spermatic fascia
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14
Q

Stop codons

A

UAA, UAG, UGA

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15
Q

Muscarinic 1 (M1) receptor

  1. G-protein class
  2. Target organ
  3. Effect of stim.
  4. Effect of inhibition
A
  1. Gq
  2. Brain
  3. Memory formation/cognitive functioning
  4. Confusion
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16
Q

M2 receptor

  1. G-protein class
  2. Target organ
  3. Effect of stim.
  4. Inhibition
A
  1. Gi
  2. Heart
  3. Decreases heart rate & decreased atrial contraction
  4. Inc. HR and contractility
17
Q

M3 receptor

  1. G protein class
  2. Target organ
  3. Effect of stim
  4. Inhibition
A
  1. Gq
  2. Lung, bladder, eyes, GI, skin
  3. Bronchial constriction, detrusor contraction, pupillary contraction (miosis), inc. peristalsis & salivary secretions, increased sweat
  4. bronchodilation, detrusor relaxation (urinary retention), mydriasis, constipation, dry mouth, decreased sweating (inc. body temp)
18
Q

PCOS

A

combination of obesity, hirsutism, and oligomenorrhea
Androgen and LH levels elevated, FSH normal (LH:FSH > 3:1) - tendency towards insulin resistance

Unopposed estrogen - inc. risk for endometrial hyperplasia and adenocarcinoma

19
Q

Schistosoma haematobium (S. haematobium)

A

Location: North Africa, sub-Saharan Africa, Middle east
Sx: URINARY schistosomiasis - hematuria, dysuria, frequent urination, pyelonephritis, hydronephrosis, SCC of bladder

Acquire from freshwater habitat of SNAILS and larvae travel to liver and mature and then migrate to specific destinations - stay in veins and release eggs (adhere to vessel wall)

S. haemotobium eggs tend to appear in urine (vs. masoni & japonicum)

20
Q

S. masoni

A

Location: Sub-Saharan Africa, Middle East, South America, Caribbean
Intestinal and hepatic schistosomiasis: diarrhea, abd pain, ulceration (iron def. anemia), hepatomegaly, splenomegaly, PERIPORTAL FIBROSIS, subsequent portal HTN

21
Q

S. japonicum

A

Location: Asia (China), Japan, Philippines
Sx: hepatic and intestinal schistosomiasis

Eggs have tendency to penetrate bowel wall and excreted in feces

22
Q

Clinical manifestations of schistosomiasis result from:

A

Th2-mediated immune response against the eggs - granulomatous inflammation & fibrosis - leads to ulceration and scarring

23
Q

Pathognomonic for hepatic schistosomiasis

A

Periportal “pipestem” fibrosis which eventually results in restriction of portal venous flow and portal HTN

24
Q

Echinococcus granulosus

A

Dog tapeworm; most common cause of hydatid cysts in humans

25
Q

Diphyllobothrium latum

A

Human tapeworm due to ingestion of larvae from raw freshwater fish; B12 deficiency and megaloblastic anemia

26
Q

T. solium

A

Consumption of larvae in infected, undercooked PORK - causes cysticercosis

27
Q

Type of renal stones NOT visible on normal X-ray but seen through ultrasound

A

Uric acid stones (not as common) - RADIOLUCENT - yellow/brown diamond/rhombus shape

28
Q

Acute hemolytic transfusion reaction

A

Occur within minutes of infusion; due to ABO incompatibility; antibody-mediated (type II) hypersensitivity rxn; anti-ABO Abs bind donor RBC - activate complement which leads to cell lysis

Anaphylatoxins (C3a/C5a) produce vasodilation & shock while MAC causes RBC lysis

29
Q

Most common helminthic infection in the US

A

Enterobiasis - Enterobius vermicularis (pinnworm)

Treat with: Albendazole/mebendazole

30
Q

Praziquantel treats…

A

Schistosomiasis, Clonorchis sinesis, Paragonimus westermani

STEP Flash Cards (14 decks)

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