Quiz 60 Flashcards
What is atrophic gastritis?
Autoimmune disease associated with pernicious anemia
Hypertrophic gastropathy is also known as what?
Menetrier disease
Thickened gastric rugae and hyperplastic mucosa is seen in what disease?
Menetrier disease
What gastric disease can result in protein loss?
Menetrier disease
Prolactinoma usually presents with what symptoms?
Loss of libido/amenorrhea - hypogonadism
Prolactin inhibits what hormones?
GnRH
What are early toxic effects of digoxin?
Anorexia, nausea and ECG changes
What are later signs of digoxin toxicity?
Visual effects (blurred vision, yellow green halos), cardiac arrhythmias
What is cross tolerance?
Tolerance to one drug develops as a result of exposure to another (eg alcoholic has cross tolerance to benzos)
What is the MOA midazolam?
Potentiates GABA at the GABA-A receptor by increasing the frequency of channel opening
Retinal pallor sparing the macula with hepatosplenomegaly is seen in what disease?
Niemann-Pick disease
Niemann-Pick disease is due to a deficiency in what enzyme?
Sphingomyelinase
Sphingomyelin accumulation in histiocytes is seen in what disease?
Niemann-Pick disease
Progressive neurodegeneration, HSM, with lipid-laden macrophages on biopsy is seen in what disease? What other PE finding may be present?
Niemann-Pick disease; cherry-red spot
Zebra bodies are seen in what disease?
Lysosomal storage diseases - eg Niemann Pick and Fabry
Niemann-Pick disease is common in what population?
Ashkenazi Jews
What does the enzyme separase doe?
During anaphase, it degrades cohesin molecules that hold sister chromatids together, resulting in segregation of chromosomes
Berry aneurysms most commonly involve what vessels?
Circle of willis - commonly anterior cerebral artery close to the takeoff of the anterior communicating artery
What part of the circle of willis is the 2nd most common location for aneurysms? Symptoms?
Posterior communicating artery; will see ipsilateral 3rd nerve palsy (mydriasis, ptosis “down and out” eye)
At what age can children start to tell stories and alternate feet going downstairs?
Four
At what age does cooperative play begin?
Four
At what age does stranger anxiety begin?
7 months
At what age does one see separation anxiety?
12 months
How many words should a one year old use?
10
How many words should be used by age 2?
250
How many words should be used by age 3?
900
At what age do kids begin asking the meaning of words?
Five
How do patients with age related macular degeneration present?
Loss of central vision
Baby with burnt orange colored urine is seen in what disease?
Branched chain ketoaciduria - maple syrup urine disease
What is the defective enzyme in maple syrup urine disease?
Branched chain ketoacid dehydrogenase
What amino acids should be restricted in the diet of a patient with maple syrup urine disease?
Leucine, isoleucine, valine
Punched out lesions in lower esophagus of a patient with HIV is caused by what organism?
Herpes simplex virus
Infective esophagitis in immunocompromised patient is most commonly caused by what organism?
Herpes simplex virus
Punched out ulcers with glassy eosinophilic intranuclear inclusions on esophageal biopsy is caused by what organism?
Herpes simplex virus
What is seen on a biopsy in a patient with HIV and infective esophagitis due to HSV?
Punched out ulcers
Patient presents with hypothyroidism, on thyroid biopsy, dense fibrosis and replacement of the thyroid gland with fibrous tissue is seen. What is the disease?
Riedel thyroiditis
Patient has tender thyroid and was seen a few weeks ago for a viral infection. What is the diagnosis?
De Quervain thyroiditis (subacute granulomatous thyroiditis)
How does De Quervain thyroiditis present?
Painful thyroid after viral infection
Why is ICP increased when there is a tumor in the 4th ventricle?
Tumor in the 4th ventricle can block flow of CSF
What are the symptoms of increased ICP?
Bilateral papilledema, nausea/vomiting, nuchal rigidity, mental status changes
What is the only lysosomal storage disease that is X linked recessive?
Fabry disease
Fabry disease is due to absence of what enzyme?
Alpha-galactosidase A
Young boy presents with burning sensations in the hands (worse with exercise) and small, raised reddish-purple blemishes on the skin. What lysosomal storage disease are you concerned about?
Fabry
How does acute pancreatitis present?
Severe acute abdominal pain that radiates to the back
What are predisposing factors to acute pancreatitis?
Alcohol and gallstones
A deficiency of lipoprotein lipase causes what substance in the blood to be elevated after a fatty meal?
Chylomicrons
What is starling’s equation?
(Pc-Pif) - (oncotic cap - oncotic intersitial)
What three basic types of cognitive impairment are seen with ECT?
Acute confusion, anterograde amnesia, retrograde amnesia
What is Reye syndrome?
Recent viral illness and ASA intake in children
What organelle is most affected in Reye syndrome?
Mitochondria
What type of steatosis is seen in Reye syndrome?
Microvesicular steatosis
Chiari II malformation is commonly associated with what other defect(s)?
Myelomeningocele and syringomyelia
What is Chiari II malformation?
Downward displacement of cerebellar vermis, tonsils and medulla through the foramen magnum
What regions of the brain are commonly affected by Picks disease?
Frontal and temporal lobes
What are Pick bodies?
Cytoplasmic inclusions that are highlighted by silver stain - seen in Pick disease
What antibiotics are used in acute cholecystitis treatment?
Third gen cephalosporin (ceftriaxone, cefotaxime) + metronidazole
What is familial gestation hyperthyroidism?
Increased responsiveness of TSH receptors to hCG or LH
Presence of 3rd hearth sound best heard over the apex is evidence of what?
Congestive heart failure, mitral regurg
What might be heard on heart auscultation in CHF?
S3
Loss of sensation to the lateral aspect of the forearm is due to what nerve injury?
Musculocutaneous
What nerve crosses the wrist immediately lateral to the hook of hamate?
Ulnar
What nerve can be injured in a hook of hamate fracture?
Ulnar
What benzodiazepines are preferred in liver disease? Why?
“LOT” lorazepam, oxazepam, temazepam; metabolized by phase II processes
Woman wants to know who her baby daddy is, what lab test is used for this?
PCR probes that amplify microsatellite repeats
High-pitched “tinkly” bowel sounds heard over the abdomen, distended abdomen and nausea/vomiting are signs of what?
Intestinal obstruction
What intestinal organism is able to form a bowel obstruction?
Ascaris lumbricoides
Reed-Sternberg cells are seen in what disease?
Hodgkin lymphoma
What cytokine plays an important role in increasing hepcidin expression?
IL-6