Test 31 Flashcards
grayish white vaginal discharge with a fish odor
bacterial vaginosis
Gardnerella vaginalis
sq epithelial cells covered w bacterial organisms
Clue cells
seen on wet mt of vaginal discharge
penetrating injury to the left sternal border in the 4th intercostal space
right ventricle
penetrating injury to the 2nd intercostal space
pulmonary trunk
makes up most of the heart’s posterior surface
left atrium
stab wound in the 4th intercostal space in the midclavicular iline
could strike the ventricle but only after passing through lung
when the effect of hte main exposure on hte outcome is modified by the presence of another variable
effect modifcation
smoking status modifies the effect of the new estrogen receptor agonist on DVT incidence
DIC, hemorrhagic destruction of the bilateral adrenal gladns (acute adrenal insufficiency) associated w/ sepsis
waterhouse friederichsen syndrome
organism most likely responsible for WFS
n meningitidis
degrades 6- mercaptopurine
xanthine oxidase
what drug can increase hte concentration of 6 mercap
allopurinol
both 6 mercapa nd 6 thioguanin are prodrugs that require activation by this enzyme
HGPRT
hypoglycemia following fructose ingestion d/t phosphate trapping in fruc 6 phosphate
fructose intolerance
casued by aldolase B def
*remove fructose and sucrose from diet
tremors agitation
anxiety
delirium
psychosis
(AUTONOMIC HYPERACTIVITY)
SEIZURES
alcohol w/drawal
tremors rebound anxiety perceptual disturbances psychosis insomnia depression
SEIZURES
benzo w/drawal
N/V abdominal cramping muscle aches DILATED PUPILS YAWNING LACRIMATION HYPERACTIVE BOWEL SOUNDS
heroin w/ drawal
increased appetite, hypersomnia, intesne psychomotor retardation severe depression (CRASH)
cocain
amphetamines
dysphoria
irritablity
anxiety
increased appetite
nicotine
lesion that produces contralateral homonymous hemianopia w/ macular sparing
lession of ocipital cortex
sudden painless complete loss of vision in affected eye
occlusion of retinal artery
MC cause of viral aseptic meningitis
enteroviruses (coxsackie, echoviruses, polioviruses)
affect of AV shunts on preload and afterolad
INCREASE preload and decrease afterload by routing blood directly from the arterial system to the venous system and bypassing the arterioles
cleft palate
polydactyllyl
rocker bottom feet
trisomy 13
macroorchidism
tall stature
large ears
long face
fragile X syndrome
have increased risk of developing AML-M7 and ALL in childhood, and early Alz in adulthood
trisomy 21
recurrent sinopulmonary (sinus media) and GI tract infections
anaphylactic response to transfused blood products d/t IR agianst trasfused IgA that pt’s body recognizes as foreign
Selective IgA def
failure of B cells to switch from IgM to IgA production
selective IgA def
Asymptomatic Airway/gi infections Autoimmune disease Atopy Anaphylaxis to IgA
MC cause of community acquired pneumonia in immunocompetent hosts (HIV pt w/ normal CD 4)
s. pneumoniae
normal CD4 count for adult
400-1400 cells/uL
CD4<200
increased risk of p. jiroveci
candida EBV bartonella HHV-8 cryptosporidium HPV
<500
<200
P. jiroveci
toxo
HIV
JC virus
<100
aspergillus cryptococcus candida CMV EBV histoplasma myobacterium avium, intracellulare
location of immune rejection to lung transplant
causes dyspnea, nonproductive dry cough, low grade fever
small airway> bronchiolitis obliterans syndrome
Occurs w/in MINUTES of transplant. Preformed Ab against ABO or HLA are cause. Graft blood vessel spasm and diffuse intravascular coagulation leads to ischemia.
Hyperactue rejection
WHITE GRAFT
1-2 weeks after transplant
recipient rejects HLA of graft
Cell mediated response, CD8 T cells cause vascular damage
ACute rejection
occurs months to years after transplant and is the major cause of mortality in lung transplantation
chronic rejection
Prolonged untreated sleep apnea can cause….
pulmonary HTN and RHF
**decrease in O2 leads to pulmonary vasoconstriction and SNS stimulation
digital clubbing
associated w/ prlonged hypoxia
found in pts w/ large cel cancer, TB, CF, empyema, bronchiectasisa nd chronic lung abscesses
koilonychia
IDA
spoon shaped nails NO clubbing
drugs that can INDUCE MANIA in susceptible pts, especially those w/ unrecognized bipolar
anti-depressants
*TCA (-ines) and venlafaxine (SNRI)
used to treat acute mania
carbamezepine
li
valproate
what is helpful in establishing a differential for metabolic alkalosis
High vs low urine chloride
metabolic acidosis that is saline responsive
vomiting/nasogastric suctioning and thiazide loop diuretic use>
volume and Cl depletion
saline unresponsive met alkalosis
hyperaldosteronism
diffuse musculoskeletal pain
insomnia
emotional disturbances (women 20-50)
tx w/ regular exercise
fibromyalgia
*multiple symmetrical tender spots over pt’s muscles, joints, tendons
symmetric pain
morning stiffness
MP , PIP joint pain
warm, swollen, tender to palpation
rheumatoid arthritis
bilateral proximal muscle weakeness difficulty climbing stairs/combing hair heliotrope rash on eyelids gottron papules on knuckles elevated CK
dermatomyositis
low back pain stiffness that resolves w/ exercise
decreased anteiror flexion of spine
ankylosing spondylitis
pts over 50
morning stiffness of muscles of neck, shoulder, pelvic girdle
weightloss, fever, increased ESR
polymyalgia rheumatica
*occurs in pts w/ temporal arteritis
anastrazole
selective inhibiotr of aromatase
*aromatase converts androgens to estrogens
inhibits androgen synthesis by inhibiting MULTIPLE enzyme pathways involved in synthesis of androgens
ketoconazole
what is the first step of pathogenesis in a pt w/ coronary artery disease?
repetitive endothelial cell injury
every pt using inhaled corticosteroids should be instructed to do this to prevent oropharyngeal candidiasis
rinse
vitamine that maintains orderly differentiation of specialized epihtleia (muscous secreting epithelia, respiratory tracts, ducts)
vit A
*w/out can lead to sq metaplasia of epithelia to a keritinizing epitelium
what sxs of opoids is most resistant to tolerance development?
opoid induced constipation and miosis (constriction)
