Test 72 Flashcards
Trendelenburg gait
when the HIP drops down as the IPSILATERAL foot is lifted off the ground
injury to the OCNTRALATERAL superior gluteal nerve (L4-S1 ventral rami)
injections into WHAT quadrant have a high probability of injuring the superior gluteal nerve>
Trendelenburg gait
Superomedial quadant
safest place for dorsogluteal ijections
superolateral quadrant of the buttocks
**MOST injections should target the ANTEROLATERAL gluteal area (von Hochstetter triangle) to minage possibility of nerve damage
heart condition that is considered a normal variant in 20-30% of adults
Foramen ovale
Any condition that raises RA pressure above left can produce right to left shunt> hypoxemia and paradoxical embolization
what is the most likely cause of SVC syndrome
mediastinal mass from the intrathoracic spread of BRONCHIOGENIC CARCINOMA>
compression of SVC>
impaired venous return from upper part of body
dyspnea
facial swelling
dilated collateral veins in upper trunk
SVC syndrome
arise at lung APEX
cause SHOULDER pain d/t compression of brachial plexus
HORNERS syndrome from involvement of cervical ganglia
Superior sulcus tumors (Pancoast tumors)
Morphine
opoid AGONIST
binds to MU opoid receptors
GPCR
Mechanism of Morphine
Morphine> binds MU> GPCR> activation of K channels> INCREASE in K efflux> HYPERpolarization of postynaptic neurons and termination of pain transmission
inappropriate laughter
increased appetite
slowed reaction time/motor speed
cognitive impairment
Marijuana
2 most immediate physical sxs of marijuana use
Tachycardia (FAST)
conjunctival injection
*increaed appetite
dry mouth
opiate intoxication
MYOSIS (pinpoint pupils)
Cocaine
intoxication/opoid w/drawal
Mydriasis (DILATED)
PCP intoxicatin
Nystagmus
Transmission parvo B19
Respiratory route
Mild fevere
discrete maculopapular rash that resolves in 3-5 days
occipital and posterior cervical lymphadenopathy
spreads from head to trunk and extremities
Rubella (German measles)
GAS strep infection Fever sore throat diffuse erythematous rash small papules (sandpaper like)
Scarlet fever
affects children 6-15
high fever that lasts 3-5 days that resolves following appearance of maculopapular rash that starts on TRUNK and spreads peripherally
roseola infantum
fever
ulcers on tongue/oral mucosa
vesicular rash on palms and soles
hand foot and mouth
Cox A
Acute intermittent porphyria
AD disorder of heme synthesis
PBG deaminase def
ACUTE onset: abdominal pain neurological manifestations NO photosensitivity PORTWINE (reddish) colored urine that darkens on expsoure to light PBG and ALA in urine
AIP
Tx for AIP
intravenous glucose or heme to DOWNREGULATE ALA synthase activity
important for preventing acute attacks of AIP
Cyp450 inducers (antieleptics, griseofulvin, sulfonamides, rifampin)
alcohol
smomking
Gradual onset of sxs
cresent shaped mass
elder falls
SUBdural hematoma
rupture of cortical bridging veins
Recurrent sinopulmonary infections
Giardia lamblia gastroenteritis
FTT
low Ig levels
X linked aggamaglobulinemia
Bruton Tyrosine kinase gene mutation>
failure of BONE Marrow pre B cells to develop into circulating B lymphocytes
XLA
LOW CD19>
increased risk for PYOGENIC (encapsulated) bacteria), Giardia (don’t have neutralziaign abs)
SE of nitrates
HA
facial flushing
benign epidermal tumor tan to brown round flat greasy coin like STUCK ON
Seborrheic keratosis
yellowish macule/papule/plaque
often found on eyelid
Xanthelesma
*hyperlipidemia
benign
pruritic infiltration of the SKIN by MAST cells
SCRATCHING of lesions> degranulation of mast cells urticaria flushing syncope
mastocytosis
polygonal
planar
pruritic
purplish
Wickham’s striae on plaque surface
Lichen planus
thick
scaly
discoid plaques taht erupt on unexposed scin> scarring
Discoid lupus erythematousus
seizure that involves ONE area of the body
partial
simple seizure
NO aimpairment of conscoius ness after event
complex seizure
LOC
tx for simple and complex partial seizures
carbamazepine
MOA of carbamazepine
blocks VG Na channels in CORTICAL neurons>
INACTIVATES>
decreases abnormal AP
adverse effects of Carbamazepine
Bone marrow suppression> agranulocytosis (monitor CBC regularly)
hepatotoxic
increase in ADH> SIADH
Blocks T type Ca channels>
decreased Ca current in THALAMIC neurons
Ethosuximide
Bilateral acoustic neuromas
AD
NF2 gene on chrom 22
Neurofibromin chrom 17 cafe au lait spots multiple neurofibromas lisch nodules
NF1
mutation APC
CRC
FAP
mutation RB1 TSG
osteosarcoma
retinoblastoma
mutation of VHL on chrom 3
Von Hippel Lindau disease
renal cysts
RCC
hemangioblastomas of cerebellum and retina
how do ACE inhibitors cause ACUTE rise in serum Cr and can lead to acute renal failure
BLOCK Angiotensin mediated eff arteriole vasonconstriction>
dilated>
reduced renal filtration fraction
histone 1
OUTSIDE nucleosomem core
helps to package nucleosomes int omore COMPACT structures by binding and linking DNA
toxins of C. DIFF
toxin A (enterotoxin) toxin B (cytotoxin)
inactivate RHO regulatory proteins involved in ACTIN CYTOSKELETON maintenance>
disruption of INTRACELLUALR TIGHT JUNCTIONS> apoptosis
ST elevation and subsequent Q wave formation
Acute transmural MI
MCC of acute transmural MI
fully OBSTRUCTIVE thrombus superimposed on a ruptrue datherosclerotic coronary artery plaque
lesser occlusion by thrombus superimposed on acute plaque
unstable angina
stable stheromatous lesion w/out overlying thrombus but obstructing > 75 of coroanry artery lumen
stable angina
acute plaque chagne leading to acute myocardial ischemia>
precipitate v. fib
MCC of death in MI pts during prehospital phase
Cardiac arrythmia
MCC of death during hte IN hospital phase
ventricular failure
aschoff bodies
Acute rheumatic carditis
interstitial myocardial granulomas
(contain plump mphages w/ abundant cytoplasm and central round-ovoid nuclei w/ central slender ribbons of chromatin)
lymphcytic interstitial inflammatory infiltrate w/ focal necrosis of myocytes
viral myocarditis
recent travel to Latin america
distension of individual myofibers w/ intracellular trypansomes
Chagas disease
pleomorphic interstitial infiltrate of mphages w//out distinct aschoff body type granulomas
diptehritic myocarditis