Set 11 Flashcards
What conditions are associated with oligohydramnios, and what conditions are associated with polyhydramnios?
Oligohydramnios: profound - can cause Potter sequence
Polyhydramnios: >1.5-2L of amniotic fluid; associated with fetal malformations (esophageal/duodenal atresia, anencephaly; both result in inability to swallow amniotic fluid), maternal diabetes, fetal anemia, multiple gestations
Potter sequence: Oligohydramnios —> compression of developing fetus —> limb deformities, facial anomalies (low-set ears and retrognathia) and compression of the chest —> pulmonary hypoplasia (cause of death)
What pulmonary artery pressures indicate pulmonary hypertension?
Normal pulmonary artery pressure = 10-14 mmHg (8-20)
Pulmonary HTN greater than or equal to 25 mmHg at rest, or 35 during exercise
What is the most common tumor of the urinary tract? What is the usual presenting complaint of a patient with this tumor? What substance exposures increase the risk of developing this tumor?
Transitional cell carcinoma (can occur in renal calyces, renal pelvis, ureters and bladder)
Presents as painless hematuria (no casts suggest bladder cancer)
Associated with problems in your Pee SAC: Phenacetin, Smoking, Aniline dyes, and Cyclophosphamide
What is conductive hearing loss, and what are some causes?
Sound is not conducted to cochlear apparatus
Causes: wax, ear infection, ruptured TM, otosclerosis (abnormal growth of ossicles in middle ear)
Which cancers can cause the paraneoplastic syndrome Lambert-Eaton syndrome?
Small cell lung carcinoma
A patient complains of intense thirst and profuse urination. After further testing, you suspect diabetes insipidus. What urine specific gravity and serum osmolarity findings would you see in a patient with diabetes insipidus?
SG high serum osm
Serum osmolarity >290 mOsm/L (HIGH)
Which phase of drug metabolism do geriatric patients lose first? Which phase of drug metabolism makes a slightly polar metabolite by oxidation, reduction, or hydrolysis?
Geriatric patients lost phase I first. Phase I: reduction, oxidation, hydrolysis with cytochrome P450 usually yields slightly polar, water-soluble metabolites (often still active)
What is phase II of drug metabolism?
Phase II: Conjugation (Glucoronidation, Acetylation, Sulfation) usually yields very polar, inactive, metabolites (renally excreted) —> Geriatric patients have GAS (phase II)
What is the difference between malingering and factitious disorder?
Malingering: patient consciously fakes, profoundly exaggerates, or claims to have a disorder in order to attain a specific (secondary/external) gain (e.g., avoiding work, obtaining compensation). Poor compliance with treatment or follow-up diagnostic tests. Complaints cease after gain (vs. factitious disorder)
Factitious disorders: patient consciously creates physical and/or psychological symptoms in order to assume “sick role” and to get medical attention (primary/internal gain)
A 3-year-old girl presents with a fever of 102°F for the last three days. On the fourth day, the patient develops a red macular rash over the entire trunk and her fever resolves abruptly. What viral infection is most likely in this case?
HHV-6 (Roseola)
What are the mechanisms of action of each of the following toxins?
Strychnine
Glycine antagonist (important inhibitory NT in spinal cord - widespread muscle spasms and asphyxia)
What are the mechanisms of action of each of the following toxins?
Tetanus toxin
Blocks inhibitory function of glycine and GABA —> muscle spasm and tetanus
What are the mechanisms of action of each of the following toxins?
Black widow spider toxin
Causes excessive release of ACh —> muscle cramping and pain
What are the mechanisms of action of each of the following toxins?
Botulinum toxin
Inhibits release of ACh at the NMJ —> flaccid paralysis
What are the mechanisms of action of each of the following toxins?
α-bungarotoxin
Antagonizes postsynaptic ACh receptors at NMJ —> flaccid paralysis
