Random Q set 3 Flashcards
What does bullous impetigo look like? What are the 2 organisms associated with this? Which is more serious & why?
golden yellow crust periorally
staph aureus or strep pyogenes
**strep can turn into acute post strep glomerulonephritis
T/F A child could get rheumatic fever from a strep pyogenes bullous impetigo.
False. This can only arise from strep pharynx infection. Not the skin infection.
What is the equation for positive predictive value?
PV=True Positives/(True Positives + False Positives)
Is it possible to increase sensitivity & decrease positive predictive value?
Yes, b/c the false positives increase with greater sensitivity as well as true positives.
Which cranial nerve arises from the pons @ the level of the middle cerebellar peduncle?
trigeminal nerve
What are the advantages to using COX2 selective inhibitors over NSAIDs for a chronic inflammatory condition? Give an example of a COX2 selective inhibitor.
celecoxib
COX1 inhibition can mess with the GI tract & platelet aggregation, whereas COX2 is only expressed in inflammatory tissues
Describe the characteristics of a partial hydatidiform mole.
69XXX or 69XXY higher beta hCG some fetal parts & villi normal uterine size cramping & bleeding
Describe the characteristics of a complete hydatidiform mole.
46XX **basically mother's chromosomes disappear, and the sperm that enters doubles. **if 46YY nonviable no fetal parts present big uterus bleeding & cramping super high beta hCG huge villi, trophoblastic tissue "friable mass of cystic, thin-walled, grape-like structures"
What is ethambutol used to treat? What is a very neg. potential side effect?
TB, with a bunch of other drugs
optic neuritis
The internal & external pathways of apoptosis converge at which step?
activation of caspases
initiator caspases activate effector caspases
break down the proteins etc of the cell.
What kind of pathology would be present with occlusion of the anterior cerebral artery?
supplies medial frontal & parietal lobes
it would mess with sensory & motor function of the contralateral leg & foot
could cause behavioral problems or urinary incontinence
will spare the contralateral face & arm.
What kind of pathology would be present with occlusion of the middle cerebral artery?
loss of motor function of hand, face, throat.
maybe Broca’s aphasia
contralateral homonymous hemianopsia
other things too…
Which nerves come off of the lower trunk of the brachial plexus?
start off as C8-T1
gives rise to median & ulnar nerves
damage to lower trunk will affect hand function
What is Potter Syndrome?
results from oligohydramnios, typically bilateral renal agenesis
club feet
classic facies
pulmonary hypoplasia
Respiratory failure is the cause of death.
What is the function of the ventromedial hypothalamic nuclei?
mediates satiety
stimulated by leptin
What is the function of the lateral hypothalamic nuclei?
mediates hunger
inhibited by leptin
What is the function of anterior hypothalamic nuclei?
heat dissipation via parasympathetics
What is the function of the posterior hypothalamic nuclei?
heat conservation via sympathetics
What is the function of the arcuate hypothalamic nuclei?
secretion of dopamine
GHRH
gonadotropin
What is the function of the paraventricular hypothalamic nuclei?
secretion of ADH, CRH, TRH, oxytocin
What is the function of the supraoptic hypothalamic nuclei?
secretion of ADH & oxytocin
What is the function of the suprachiasmatic nuclei?
circadian rhythm regulation
pineal gland function (modulate body temp & hormone secretion)
What are the fine motor & social expectations of a 3 yo?
fine motor–copies a circle, uses utensils
social–imaginative play, knows age/gender
NOT necessarily cooperative play
What is the name of the skin condition that often results from immunocompromised patients with pseudomonas?
ecythema gangrenosum
What is the inheritance pattern of xeroderma pigmentosum? Which enzyme is messed up? What is the mechanism of damage?
autosomal recessive
symptoms–photosensitivity, increased risk for skin cancer, poikiloderma, hyper pigmentation w/ sun exposure
UV-specific endonuclease deficiency which recognizes thymine dimers from UV radiation & excises them so that DNA pol can lay down fresh DNA
Once again, what are the findings of Down’s syndrome?
flattened facies epicanthal folds oblique palpébral fissure single palmar crease shortened fifth digit large tongue sometimes congenital heart defects involving the endocardial cushion
What does COPD do to expiratory flow rate, FEV1/FVC ratio, FRC, RV afterload, EPO?
expiratory flow rate (FEV1) decreases
FEV1/FVC decreases
FRC increases
RV afterload increases & can get pulmonary HTN & Right sided heart failure
the hypoxia can sometimes be sufficient to trigger EPO production
Describe the urea cycle.
CO2, NH4, 2 ATP form carbamoyl phosphate (rate-limiting step) in the mitochondria. Form citrulline & transferred to cytosol.
Then argininosuccinate–>arginine–ornithine + urea. Ornithine transferred into mitochondria for another round.
Describe the details of the rate-limiting step of the urea cycle. Note: if this cycle is dysfunctional get buildup of ammonia & protein intolerance.
CO2 + NH4+ + 2ATP–>carbamoyl phosphate
Enzyme: carbamoyl phosphate synthetase I
Essential activator: N-acetylglutamate
What are some of the symptoms of too much ammonia in the body?
lethargy
vomiting
seizures
Give a Class III anti arrhythmic (K+ channel blocking) drug that can result in QT interval prolongation & PR interval prolongation.
Sotalol
also has beta adrenergic blocking properties
used for ventricular tachycardia & a fib
Why do patients taking nitrates need a nitrate-free period? when should they take this time off?
to prevent tolerance
nighttime is best b/c cardiac work is least at this time.
What is the most common cause of meningitis in adults? Shape of this organism?
Strep pneumonia
lancet shaped, gram + cocci in pairs
What is the MOA of aspirin & clopidogrel?
aspirin–irreversible cyclooxygenase inhibitor, inhibits thromboxane A2 synthesis, platelet aggregation
clopidogrel–antiplatelet by inhibiting platelet surface ADP receptors–no aggregation.
**can work synergistically or clopidogrel is good when patients have an aspirin allergy
What forms of HTN can obstructive sleep apnea cause?
systemic HTN most common
longstanding OSA can lead to pulmonary HTN
What are the 3Ds of botulism?
diplopia
dysphonia
dysphagia
**inhibits release of Ach from nerve terminals
What negative side effect do you sometimes see with trazodone? What is a good antidepressant when you want to avoid sexual dysfunction?
priapism!!
Wellbutrin is good/Bupropion
If you see a kid squatting to cure shortness of breath…what do you think of?
increasing systemic vascular resistance to decrease R–>L shunting & increase pulmonary blood flow
Which interleukin is responsible for isotype switching to IgE?
IL4 produced by Th2 cells
Which interleukins are made by macrophages? T cells?
macrophages–IL1, IL12
T cells–IL2, IL3, IL10
What is a good initial test to see if you have the sickle cell trait, HbS?
hemoglobin electrophoresis
HbS will travel more slowly than other hemoglobin b/c it has lost its neg. charge from loss of glutamate
What is the paradoxical effect associated with nitrate use? How can this be fixed?
long-term use of nitrates can cause reflex tachycardia.
beta blocker can fix this
Describe infliximab.
IgG1 monoclonal antibody to TNFalpha
management of rheumatoid arthritis, ankylosing spondylitis, Crohn’s
Describe rituximab.
monoclonal antibody targets CD20
treatment of some lymphomas
Give the equation for the A-a gradient & PAO2.
A-a gradient = PAO2 - PaO2
PAO2 = [FiO2 X (Pb-PH2O)] - (PaCO2/R)
R=0.8
FiO2 usu 0.21
Describe the findings & usual causative organism for bacterial vaginosis.
What is the med to treat?
grayish-white vaginal discharge fishy odor clue cells lose lactobacilli & get overgrowth of mixed anaerobes Usual organism: gardnerella vaginalis treatment: metronidazole
Describe a hamartoma benign lung tumor.
asymptomatic
coin lesion in patients 50-60 yo
composed of disorganized cartilage, fibrous, and adipose tissue
Describe some of the weird symptoms of Conn’s syndrome?
hyperaldosteronism
keep Na+, lose K+ & H+
get metabolic alkalosis & hypokalemia
**these 2 things can cause muscle weakness & paresthesias
What can happen with gestational diabetes after the baby is born?
baby in utero exposed to excessively high blood sugar from mom & baby makes a bunch of insulin to compensate (doesn’t come from mom)
get a big baby (macrosomia) & transient hypoglycemia as the baby is no longer exposed to high blood glucose but still has some insulin rolling around in their system.
