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Maddy - First Aid > Random II > Flashcards

Random II Flashcards

1
Q

symptoms of fibrinous pericarditis

A
  • pleuritic chest pain that decreases when sitting up
  • pericardial friction rub (often triphasic)
  • diffuse ST elevation
  • pericardial effusion on echocardiogram
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2
Q

EKG findings for pericarditis

A

diffuse ST elevation

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3
Q

causes of fibrinous pericarditis

A
  • viral
  • SLE
  • uremia
  • post-MI
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4
Q

describe the two phases of diabetic retinopathy

A

early (non-proliferative)

  • scattered retinal aneurysms
  • dot and blot hemorrhages
  • cotton wool spots

late (proliferative)
- new blood vessel formation

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5
Q

symptoms of diabetic retinopathy

A

painless vision loss

no redness, headache, focal weakness, or sensory loss

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6
Q

budesonide MOA and indications

A

glucocorticoid –> inhibits NFkB –> reduction in cytokines and inflammation

can be used in crohn’s disease

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7
Q

pulmonary AE of osmotic diuretic therapy (mannitol)

A

pulmonary edema

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8
Q

describe the path of aqueous humor flow

A

produced in ciliary epithelium –> posterior chamber –> anterior chamber –> trabecular meshwork –> either the canal of schlemm or the uvea and sclera

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9
Q

where do beta blockers work on the eye for glaucoma

A

on the ciliary epithelium (to decrease aqueous humor production)

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10
Q

what is the effect of prostaglandin agonists on aqueous humor flow

A

increases drainage into the uvea and sclera (increase outflow)

increases drainage into the uvea and sclera by decreases resistance of flow through uveoscleral pathway

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11
Q

MOA and indications for latanoprost and bimatoprost

A

prostaglandin agonists

increases drainage into the uvea and sclera by decreases resistance of flow through uveoscleral pathway

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12
Q

what Is the effect of M3 agonists on aqueous humor flow

A

increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabceular meshwork

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13
Q

what is the effect of alpha agonists on aqueous humor flow

A

decrease aqueous humor synthesis via vasoconstriction

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14
Q

what is the first line treatment for trigeminal neuralgia

A

carbamazepine

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15
Q

MOA carbamazepine

indications

A

blocks Na+ channels

trigeminal neuralgia, epilepsy, bipolar disorder

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16
Q

symptoms trigeminal neuralgia

A

repetitive, unilateral, shooting/shock like pain in the distribution of CN V

triggered by chewing, touching certain parts of face

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17
Q

sx of ebstein anomaly

A

apical displacement of tricuspid valve leaflets

decreased volume of right ventricle

atrialization of right ventricle

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18
Q

what causes ebstein anomaly

A

maternal lithium use in pregnancy

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19
Q

what layer is missing in a false diverticulum of the intestines

A

muscularis propria

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20
Q

what is peri-infarction pericarditis

A

a fibrinous or serofibrinous pericarditis that develops 2-4 days after a transmural MI

a reaction to the necrosis of the myocardium near the epicardial surface

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21
Q

what do homeobox genes usually code for

A

transcription factors

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22
Q

what is the treatment for enterococcus endocarditis

A

an aminoglycoside + cell wall synthesis inhibitor

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23
Q

adverse effects of aminoglycosides

A

hearing loss and tinnitus

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24
Q

what is wolf parkinson white

A

caused by an accessory conduction pathway causing preexcitation of the ventricles

(AV conduction that bypasses the AV node)

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25
Q

symptoms of benzo withdrawal

A

rebound anxiety

tremor

insomnia

sympathetic hyperactivity

seizures

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26
Q

where does the AV nodal artery arise from

A

the dominant coronary artery

right dominant: RCA

left dominant: LCX

codominant: both

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27
Q

symptoms of Meniere disease

A
  • low frequency tinnitus
  • vertigo
  • sensorineural hearing loss
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28
Q

what causes Meniere disease

A

increase volume and pressure of endolymph in inner ear

thought to be due to defective resorption of endolymph

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29
Q

in fructokinase deficiency (essential fructosuria), what enzyme compensates by metabolizing fructose?

A

hexokinase

converts dietary fructose to fructose-6-phosphate

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30
Q

hemorrhage occurring in neonates after vacuum delivery is most often located where

A

between periosteum and galea aponeurosis

subgaleal hemorrhage

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31
Q

what is acute intermittent porphyria

A

autosomal dominant disease with porphobilinogen deaminase deficiency

causes accumulation of porphobilinogen and ALA

32
Q

symptoms of acute intermittent porphyria

A

5 Ps

  • painful abdomen
  • port wine colored pee
  • polyneuropathy
  • psychological disturbances
  • precipitated by drugs (cytochrome P450 inducers)
33
Q

what is the management for acute intermittent porphyria

A

infusion of hemin –> downregulates hepatic aminolevulinate (ALA) synthase

34
Q

effects of secretin

A

increase bicarbonate secretion

decrease gastric acid secretion

increase bile secretion

35
Q

effects of cholecystokinin

A

increase pancreatic secretion

increase gallbladder contraction

decrease gastric emptying

increase sphincter of Oddi relaxation

36
Q

effects of somatostatin

A

decrease gastric acid and pepsinogen

decrease pancreatic and small intestine secretions

decrease gallbladder contraction

decrease insulin and glucagon

37
Q

exocrine and endocrine effects of GIP (glucose dependent insulinotropic peptide)

A

exocrine: decrease gastric H+ secretion
endocrine: increase insulin release

38
Q

what antimicrobial also stimulates motilin

A

erythromycin

39
Q

what is phenotypic mixing

A

occurs with simultaneous infection of a cell with 2 viruses

progeny virions will contain unchanged parental genome from one strain and nucleocapsid proteins from the other strain

subsequent progeny will revert to having original parent type

40
Q

ring enhancing lesions with mass effect in HIV patient:

  • what are the ddx
A

toxoplasmosis

primary central nervous system lymphoma

41
Q

sx west nile virus

A

fever, headache

rash

meningitis, encephalitis, flaccid paralysis

parkinsonian sx (rigidity, bradykinesia, tremor)

42
Q

what is the mecA gene, and what does it mean for bacteria that have it

A

encodes for penicillin-binding protein 2a

allows for resistance to beta lactam antibiotics (penicillins and cephalosporins)

43
Q

compare immune response to superficial and disseminated candidiasis

A

superficial: T cells
disseminated: neutrophils

44
Q

what is stasis dermatitis

A

erythema, induration, fibrosis, and deposition of hemosiderin in lower extremities of patients with venous insufficiency

(prolonged standing, pregnancy, obesity)

45
Q

active RAS is bound to _____

A

GTP

46
Q

what is parinaud syndrome

A

pineal gland mass

47
Q

what are the sx of parinaud syndrome

A

limited upward gaze with a downward gaze preference

bilateral eyelid retraction

light-near dissociation (pupils that react to accommodation but not to light)

48
Q

MOA vecuronium and rocuronium

A

competitive antagonists of nicotinic acetylcholine receptors

49
Q

MOA succinylcholine

A

competitive agonists of nicotinic acetylcholine receptors –> persistent depolarization –> desensitization of motor end plate

50
Q

sx of neuroblastoma

A

nonrhythmic conjugate eye movements and involuntary jerking movements of trunk and limbs (opsoclonus-myoclonus syndrome)

firm abdominal mass (most often involving adrenal gland)

periorbital ecchymoses

51
Q

lab findings in neuroblastoma

A

elevated catecholamine metabolites (due to neural crest origin)

52
Q

what expression indicates poor prognosis in neuroblastoma

A

N-myc amplification

53
Q

what is the effect of B blockers on ECG

A

they prolong the PR

54
Q

what is intermittent claudication

A

muscle pain with exercise that remits with rest

smoking is important risk factor

usually due to atherosclerosis of large arteries

55
Q

causes of concentric left ventricular hypertrophy

A

pressure overload

  • chronic HTN
  • aortic stenosis
56
Q

causes of eccentric left ventricular hypertrophy

A

volume overload

  • aortic or mitral regurgitation
  • ischemic heart disease
  • dilated cardiomyopathy
57
Q

sx of Gaucher disease

A
  • anemia
  • abd distension due to hepatosplenomegaly
  • pancytopenia
  • bone pain due to bone marrow invasion/inflammation
58
Q

what is eisenmenger syndrome

A

uncorrected left to right shunt –> increases pulmonary blood flow –> pathologic remodeling of vasculature –> pulmonary arterial HTN

59
Q

what is congenital torticollis

A

child born with sternocleidomastoid injury and fibrosis

usually due to birth trauma or malposition of head in utero

head tilted toward affected side chin pointed away

60
Q

why does propofol have a rapid onset and rapid recovery

A

propofol is rapidly cleared from plasma and preferentially distributed to organs receiving high blood flow (brain)

over time, propofol is redistributed to organs receiving less blood flow (fat, muscle tissue) causing rapid termination of drug action (since the brain is the site of action)

61
Q

cromolyn and nedocromil MOA

A

inhibits mast cell degranulation and prevents release of preformed chemical mediators

62
Q

what is the mutation in maturity onset diabetes of the young (MODY)

A

glucokinase mutation

63
Q

why can supplemental oxygen in the setting of COPD cause decreased respiratory rate

A

due to reduction in peripheral chemoreceptor stimulation

64
Q

what are the primary sites for sensing PaO2 and thus are stimulated by hypoxemia

A

peripheral chemoreceptors in carotid and aortic bodies

65
Q

a lesion affecting both the spinothalamic tract and the dorsal column medial lemniscus tract is most likely located:

A

in the ventral posterior thalamus

both tracts cross through the VPL

66
Q

how can crohn’s disease cause easy bleeding

A

crohn’s disease affects terminal ileum –> loss of bile acid resorption –> fat malaborption –> deficiencies in fat-soluble vitamins (including vitamin K) –> loss of vitamin K dependent coagulation factors

67
Q

affect of glucocorticoids on adipose tissue

A

lipolysis

altered fat distribution

68
Q

affect of glucocorticoids on adrenal cortex

A

atrophy

69
Q

affect of glucocorticoids on bone

A

osteoporosis

70
Q

affect of glucocorticoids on liver

A

increased gluconeogensis and glycogenesis

71
Q

affect of glucocorticoids on skeletal muscle

A

atrophy

72
Q

affect of glucocorticoids on skin

A

thinning

stria

impaired wound healing

73
Q

where does heme synthesis occur in the cell

A

mitochondria

74
Q

spontaneous cases of Clostridium septicum indicates what underlying pathology

A

colonic malignancy

it creates a portal of entry for the bacteria

75
Q

46,XY newborn with hypospadias and small phallus, testes developed but in the inguinal area, testosterone normal

what is the enzyme deficiency

A

5a-reductase

it converts T to DHT

76
Q

initial stages of diabetic nephropathy have what changes in GFR

A

increased GFR

Maddy - First Aid (23 decks)

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