Set 2 Flashcards
When performing a femoral arterial line placement or femoral venous catheter placement, it is important to palpate the femoral artery to determine where the inguinal structures are located. What structures are found under and just inferior to the inguinal ligament? List them in order from lateral to medial.
Nerve-Artery-Vein-Empty space-Lymphatics
You must go lateral to medial to find your NAVEL
Sertoli cells release a substance that acts on the paramesonephric ducts in order to prevent the formation of what structures in a normal male fetus? What other name is given to the paramesonephric ducts?
Sertoli cells secrete Mullerian inhibitory factor (MIF) that supresses the development of paremesonephric ducts
The paramesonephric duct is also called the Mullerian duct. It develops into female internal structures - fallopian tubes, uterus, and upper portion of the vagina (lower portion from urogenital sinus).
What are the causes of iatrogenic Creutzfeldt-Jacob disease (CJD)? What measures can be taken to avoid iatrogenic CJD?
Neurodegenerative prion disease (most common). Infectious protein particles that are misfolded - make host proteins misfold forming more proteins
Iatrogenic: transplant procedures (cornea or liver), dural grafts, cadaveric pituitary hormone, surgical procedures
Preventive measures:
Automated surgical instrument washer
Autoclave and sodium hydroxide (NaOH)
Keeping surgical instruments in a moist environment after use
A 54-year-old man presents with blood pressure of 200/160 mm Hg, and the examination reveals right-sided abdominal bruit suggestive of renal artery stenosis. What is the mechanism by which renal artery stenosis causes hypertension? What are some other common causes of secondary hyperaldosteronism?
Mechanism: The kidneys perceiving low intravascular volume -> activation of RAAS
Secondary causes - renal perception of low intravascular volume results in an overactive renin-angiotensin system.
DUE to renal artery stenosis, CHF, cirrhosis or nephrotic syndrome
Associated with HIGH plasma renin.
Treatment: spironolactone
A 38-year-old man’s AIDS is being managed by his infectious disease physician, who has decided to start him on trimethoprim-sulfamethoxazole (TMP-SMX). Why would you place an AIDS patient on TMP-SMX when his CD4 count drops below 200?
With a CD4 count below 200 you need to start prophylaxis against Pneumocystis jirovecii pneumonia (PCP)
What is the mechanism of action for methylphenidate?
Methylphenidate is a CNS stimulant that increases catecholamines at the synaptic cleft (especially NE and DA). Indirect sympathomimetic, releases stored catecholamines. sUsed for ADHD, narcolepsy, and appetite control.
What are the signs of intoxication of amphetamine?
Signs of intoxication of amphetamine include euphoria, grandiosity, pupillary dilation, prolonged wakefulness and attention, HTN, tachycardia, anorexia, paranoia, fever. Severe: cardiac arrest, seizure. Signs specific to amphetamine include impaired judgement, pupillary dilation, prolonged wakefulness/attention, delusions, hallucinations and fever.
What are the effects of stimulating the amygdala?
Increases and decreases of arterial BP, HR, GI motility and secretion
Defecation and micturition
Pupillary dilation or constriction
Piloerection
Secretion of various anterior pituitary hormones
Movements related to eating (licking, chewing, swallowing)
Negative emotions (rage, escape, punishment, severe pain, fear)
Sexual responses (erection, copulatory movements, ejaculation, ovulation, uterine activity, premature labor)
What anatomical structure is implicated in hematoma formation as sequelae of vulvar trauma?
Caused by blunt trauma/saddle trauma (bicycling injuries, track hurdle injuries, sexual assault)
*Bulb of vestibule: highly vascular, deep to labia majora. Fat pad protects adults but not children. Full of erectile tissue, if damaged can leak blood -> hematoma. Localized area of edema, echemmosis, fluctuance of labia majora. Similar swelling with bartholin gland cysts - ask about trauma history.
A 50-year-old roofing worker develops a cough for the past month that is now associated with hemoptysis. The patient denies a smoking history or prolonged exposure to second-hand smoke. An X- ray reveals a left-sided lower lung coin-shaped lesion. What type of lung cancer is suspected in this individual? What is the appearance of asbestos fibers in the lung? What cancers are associated with asbestosis?
Asbestosis is associated with shipbuilding, roofing and plumbing. “Ivory white” calcified pleural plaques are pathognomonic of asbestos exposure but are not precancerous.
**Associated with an increased incidence of bronchogenic adenocarcinoma and mesothelioma (less common).
Asbestos (ferruginous) bodies are golden-brown fusiform rods resembling dumbells)
Asbestos is from the roof (was common in insulation) but affects the base (lower lobes)
Affected artery?
Loss of motor and sensation of leg and foot
VF defects
Aphasia with generalized sensory and motor dysfunction
Loss of motor and sensation of the face
Loss of motor and sensation of the arms
Loss of motor and sensation of leg and foot = ACA
VF defects = anterior communicating
Aphasia with generalized sensory and motor dysfunction = MCA, anterior communicating, ACA
Loss of motor and sensation of the face = MCA
Loss of motor and sensation of the arms = MCA
