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Step 1 > Test 31 > Flashcards

Test 31 Flashcards

1
Q

grayish white vaginal discharge with a fish odor

A

bacterial vaginosis

Gardnerella vaginalis

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2
Q

sq epithelial cells covered w bacterial organisms

A

Clue cells

seen on wet mt of vaginal discharge

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3
Q

penetrating injury to the left sternal border in the 4th intercostal space

A

right ventricle

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4
Q

penetrating injury to the 2nd intercostal space

A

pulmonary trunk

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5
Q

makes up most of the heart’s posterior surface

A

left atrium

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6
Q

stab wound in the 4th intercostal space in the midclavicular iline

A

could strike the ventricle but only after passing through lung

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7
Q

when the effect of hte main exposure on hte outcome is modified by the presence of another variable

A

effect modifcation

smoking status modifies the effect of the new estrogen receptor agonist on DVT incidence

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8
Q

DIC, hemorrhagic destruction of the bilateral adrenal gladns (acute adrenal insufficiency) associated w/ sepsis

A

waterhouse friederichsen syndrome

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9
Q

organism most likely responsible for WFS

A

n meningitidis

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10
Q

degrades 6- mercaptopurine

A

xanthine oxidase

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11
Q

what drug can increase hte concentration of 6 mercap

A

allopurinol

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12
Q

both 6 mercapa nd 6 thioguanin are prodrugs that require activation by this enzyme

A

HGPRT

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13
Q

hypoglycemia following fructose ingestion d/t phosphate trapping in fruc 6 phosphate

A

fructose intolerance

casued by aldolase B def

*remove fructose and sucrose from diet

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14
Q

tremors agitation
anxiety
delirium
psychosis

(AUTONOMIC HYPERACTIVITY)

SEIZURES

A

alcohol w/drawal

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15
Q 
tremors 
rebound anxiety
perceptual disturbances
psychosis
insomnia
depression

SEIZURES

A

benzo w/drawal

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16
Q 
N/V
abdominal cramping
muscle aches
DILATED PUPILS
YAWNING
LACRIMATION
HYPERACTIVE BOWEL SOUNDS
A

heroin w/ drawal

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17
Q 
increased appetite, hypersomnia, intesne psychomotor retardation
severe depression (CRASH)
A

cocain

amphetamines

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18
Q

dysphoria
irritablity
anxiety
increased appetite

A

nicotine

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19
Q

lesion that produces contralateral homonymous hemianopia w/ macular sparing

A

lession of ocipital cortex

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20
Q

sudden painless complete loss of vision in affected eye

A

occlusion of retinal artery

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21
Q

MC cause of viral aseptic meningitis

A

enteroviruses (coxsackie, echoviruses, polioviruses)

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22
Q

affect of AV shunts on preload and afterolad

A

INCREASE preload and decrease afterload by routing blood directly from the arterial system to the venous system and bypassing the arterioles

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23
Q

cleft palate
polydactyllyl
rocker bottom feet

A

trisomy 13

24
Q

macroorchidism
tall stature
large ears
long face

A

fragile X syndrome

25
Q

have increased risk of developing AML-M7 and ALL in childhood, and early Alz in adulthood

A

trisomy 21

26
Q

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

A

Selective IgA def

27
Q

failure of B cells to switch from IgM to IgA production

A

selective IgA def

Asymptomatic
Airway/gi infections
Autoimmune disease
Atopy
Anaphylaxis to IgA
28
Q

MC cause of community acquired pneumonia in immunocompetent hosts (HIV pt w/ normal CD 4)

A

s. pneumoniae

29
Q

normal CD4 count for adult

A

400-1400 cells/uL

30
Q

CD4<200

A

increased risk of p. jiroveci

31
Q 
candida
EBV
bartonella
HHV-8
cryptosporidium
HPV
A

<500

32
Q

<200

A

P. jiroveci
toxo
HIV
JC virus

33
Q

<100

A 
aspergillus
cryptococcus
candida
CMV
EBV
histoplasma
myobacterium avium, intracellulare
34
Q

location of immune rejection to lung transplant

causes dyspnea, nonproductive dry cough, low grade fever

A

small airway> bronchiolitis obliterans syndrome

35
Q

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.

A

Hyperactue rejection

WHITE GRAFT

36
Q

1-2 weeks after transplant

recipient rejects HLA of graft

Cell mediated response, CD8 T cells cause vascular damage

A

ACute rejection

37
Q

occurs months to years after transplant and is the major cause of mortality in lung transplantation

A

chronic rejection

38
Q

Prolonged untreated sleep apnea can cause….

A

pulmonary HTN and RHF

**decrease in O2 leads to pulmonary vasoconstriction and SNS stimulation

39
Q

digital clubbing

A

associated w/ prlonged hypoxia

found in pts w/ large cel cancer, TB, CF, empyema, bronchiectasisa nd chronic lung abscesses

40
Q

koilonychia

A

IDA

spoon shaped nails NO clubbing

41
Q

drugs that can INDUCE MANIA in susceptible pts, especially those w/ unrecognized bipolar

A

anti-depressants

*TCA (-ines) and venlafaxine (SNRI)

42
Q

used to treat acute mania

A

carbamezepine
li
valproate

43
Q

what is helpful in establishing a differential for metabolic alkalosis

A

High vs low urine chloride

44
Q

metabolic acidosis that is saline responsive

A

vomiting/nasogastric suctioning and thiazide loop diuretic use>
volume and Cl depletion

45
Q

saline unresponsive met alkalosis

A

hyperaldosteronism

46
Q

diffuse musculoskeletal pain
insomnia
emotional disturbances (women 20-50)

tx w/ regular exercise

A

fibromyalgia

*multiple symmetrical tender spots over pt’s muscles, joints, tendons

47
Q

symmetric pain
morning stiffness
MP , PIP joint pain
warm, swollen, tender to palpation

A

rheumatoid arthritis

48
Q 
bilateral proximal muscle weakeness
difficulty climbing stairs/combing hair
heliotrope rash on eyelids
gottron papules on knuckles
elevated CK
A

dermatomyositis

49
Q

low back pain stiffness that resolves w/ exercise

decreased anteiror flexion of spine

A

ankylosing spondylitis

50
Q

pts over 50
morning stiffness of muscles of neck, shoulder, pelvic girdle

weightloss, fever, increased ESR

A

polymyalgia rheumatica

*occurs in pts w/ temporal arteritis

51
Q

anastrazole

A

selective inhibiotr of aromatase

*aromatase converts androgens to estrogens

52
Q

inhibits androgen synthesis by inhibiting MULTIPLE enzyme pathways involved in synthesis of androgens

A

ketoconazole

53
Q

what is the first step of pathogenesis in a pt w/ coronary artery disease?

A

repetitive endothelial cell injury

54
Q

every pt using inhaled corticosteroids should be instructed to do this to prevent oropharyngeal candidiasis

A

rinse

55
Q

vitamine that maintains orderly differentiation of specialized epihtleia (muscous secreting epithelia, respiratory tracts, ducts)

A

vit A

*w/out can lead to sq metaplasia of epithelia to a keritinizing epitelium

56
Q

what sxs of opoids is most resistant to tolerance development?

A

opoid induced constipation and miosis (constriction)

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