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Step 1 > Test 85 > Flashcards

Test 85 Flashcards

1
Q

RVH

A

Cor pulmonale

caused by pulmonary HTN seen in F 20-40

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2
Q

Essential HTN and aortic stenosis cause what type of hypertrophy

A

LEFT VH

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3
Q

Pica

A

compulsive consumption of nonfood

common in pregnancy

usually ice

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4
Q

CGD inheritance

A

X linked mutation that affects NADPH oxidase

reccurent bacterial and fungal infections

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5
Q

dx CGD

A

ABSENCE of normal BLUE and fluroscent GREEN pigment produced by NITROBLUE TETRAZOLIUM test and DIHYRORHODAMINE flow cytometry

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6
Q

Nitroblue tetrazolium testing

A

Add NBT to sample of pt’s neutrophils

properly functioning neutrophils produce ROS that can REDUCE the yellow NBT to DARK BLUE that preceipitates in cells

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7
Q

Dihydrorhodamine

A

assesses production of superoxide radicals by measuring conversion of DHR to RHOdamine which shoiuld come out fluorescent green

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8
Q

ADA def

A

AR

SECOND MC cause of SCID

PROFOUND decrease in B and T cells

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9
Q

mutlisubunit complex that acts as terminal enzyme of mitochondrial respiratory chain

A

Cyt C oxidase

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10
Q

MPO

A

Enzyme found in neutrophil azurophilic granules

catalyzes production of BLEACH from hydrogen peroxide and chlorine

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11
Q

Tx HIGH LDL
Hepatitis
myopathy

A

Statins

HMG CoA reductase

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12
Q 
Tx LOW HDL
Cutaneous vasodilation (Red flushed face)
hyperglycemia (acanthosis nigricins)
Hyperuricemia/ GOUT
Hepatitis
A

Niacin

INHIBITS lipolysis in adipose

REDUCES hepatic VLDL synthesis

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13
Q

Tx HIGH TG
Gallstones
Myopathy (WORSE w/ Statins)

A

Fibrates (gemfibrozil, and ‘brates)

Upregulate LPL> increase TG clearance

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14
Q

Tx high LDL

Gi upset
hypertriglyceridemia
malabsorption

A

cholestyramine, colestipol, coleselvam

prevent intestinal esorption of bile acids, so liver must use choleseterol to make more

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15
Q

MO of Nitrate drugs

A

Mimic actions of NO

transformed to NO at SM membrane> INCREASED cGMP> DECREASEd intracellular Ca and myosin dephosphorylation

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16
Q

Receptor for insulin and ILGF

A

TK

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17
Q

leads to TRANSIENT recurrent pulmonary infiltrates and eventual proximal BRONCHIECTASIS that can complicate asthma

A

Aspergillus fumigatus

*often occurs in STEROID DEPENDENT asthmatics

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18
Q

pulmonary pathogen in pts w/ CF or neutropenia

A

p. aeruginosa

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19
Q

Colchicine

A

inhibits LEUKOCYTE migration and phagocytosis by blocking TUBULIN polymeratization

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20
Q

TX for acute gouty arthritis in ELDERLY pts or those w/ renal failure by INHIBITING phospholipiase A2

A

Glucocorticoids

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21
Q

Zieluton

A

blocks 5 lipoxygenase and inhibits leukotriene formation

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22
Q

Why does urinary pH DECREASE in metabolic acidosis?

A

Bicar is combletely resorbed from teh tubular fluid

to excrete H you need to the two most important renal buffers (NH3 and H2PO4)

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23
Q

CEREBELLAR HEMANGIOBLASTOMAS

CYSTS/CANCER in kidney, liver, pancrease

incrased risk for RCC (can be bilateral)

A

VHL disease

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24
Q

Neurofibromas
optic nerve gliomas
Lisch nodules
cafe au lait spots

A

NF1

AKA Von Recklinghaunsen’s disease

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25
Q

bilateral cranial nerve II SCHWANNOMAS

multiple MENINGIOMAS

A

NF 2

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26
Q

cutaneous FACIAL ANGIOMAS and LEPTOMENINGEAL ANGIOMAS

usually inolved V1 and V2 distribution of trigemnial nerve

TRAM TRACK calcifications on skull

A

Sturge Weber syndrome

think about weber test being on the head….

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27
Q

AD syndrome
cutaneous ANGIOFIBROMAS
HAMARTOMAS
CARDIAC RHABDOMYOMAS

RENAL ANIGIOMYOLIPOMAS

….seizures are major complication

A

Tuberous sclerosis

28
Q

AD inhertiance of CONGENITAL TELANGIECTASIAS

A

osler weber rendu syndrome

rupture> epistaxis, GI bleeding, hematuria

29
Q

Increase PT and PTT but DO NOT affect thrombin time

A

Direct factor XA inhibitors (apixaban, rivaroxaban)

30
Q

Direct thrombin inhibotrs (dabigatran, bivalirudin, dabigatran)

A

prevent formation of THROMBIN (factor IIa) and lead to prolongation of aPTT, PT and TT

31
Q

binds to ANTITHROMBINa nd causes inactivation of SEVERAL coag factors (THRoMBIN and FACTOR X)

Both PTT and TT are prolonged

A

Unfractionated heparin

32
Q

Brain tumors in a child

A

Please take me to….
Animal kindgdom
Magic kingdom
Epcot

i’m dying of a brain tumor

pilocystic astrocytoma
medulloblastoma
ependyoma
craniopharyngioma

33
Q

Cerebellar tumor in a child

A

Pilocytic astrocytoma (cystic and solid components)

Meduloblastomma (always solid)

34
Q

MC brain tumor in child
arise from astrocytes

ROSENTHAL FIBERS

A

pilocytic astrocytomas

35
Q

Second MC brain tumor of childhood

solid
composed of sheets of SMALL BLUE cells w/ hyperchromatic nuclei

malignant w/ poor prog

HOME WRIGHT ROSEETESS

A

Medulooblastoma

36
Q

third MC brain tuor in children

Ependymal lining of 4th ventricle

obstruct CSF

hydrocephalus

PERIVASCULAR ROSSETES

37
Q

MC SUPRATENTORIAL TUMOR IN CHILDHOOD

causes bitemporal hemianopia

A

craniopharyngioma

38
Q

multiple ring enhancing lesions w/ mass effect in pt w/ HIV

A

toxoplasmosis

39
Q

tx for toxoplasmosis

A

pyrimethamine

sulfadizazine

40
Q

cryptococcocal meningitis tx

A

amphotericin

41
Q

listeria tx

A

ampicillin

42
Q

CMV tx

A

gnciclovir

43
Q

second MC cause of ring enhancing lesions w/ mass effect in pt w/ HIV

A

primary central nervous system lymphoma

B cell ORIGION d/t EBV infection

44
Q

Nephrotic syndrome

A

INCREASED permeability of glomerular capillary wall

MASSIVE urine protein loss> decrase in serum albumin > DECREASE In OSMOTIC PRESSURE> EDEMA

SHIFT of water into interstitium> RAAS> Na nad Water retention

INCREASED liver lipoprotein syntehsis

45
Q

Cyp450 INducers

A 
Griseolfulvin
Carbamezabine
Phenobarbital (BARBS)
Phenytoin
Barbs)
Rifampin
St. JoHns Wort
46
Q

CYP 450 inhibiotors

A 
CImetidine
Ritonavir
Amiodarone
Cipro
Ketoconoazole
Acute ETOH use
Macrolides
Isoniazid
Grapefruit Juice
Omeprazole
Sulfonamides
47
Q

What leads to a low Vd (3-5L)?

A

HIGH MW
HIGH PPB
HIGH charge
hydrophilicity

48
Q

Gastrojejunostomy

49
Q

Diagnostic for B12 def

A

Increased methylmalonic Acid

50
Q

decreased in thiamine deficiency

A

RBC transketaolase levels

51
Q

PE…

A

HYPOXEMIA

Respiratory alkalosis

52
Q

ANG I to ANG II in HF

A

HF stimulates SNS and the RAAS to maintain effective intravascular volume

Ang I is converted to ANG II by ACE enzyme in the lungs

53
Q

thunder clap HA seen in pt w/ ADPKD

A

Intracrnaial berry aneuryms in circle of WILLIS> subarachnoid hemorrhage

54
Q

virus that can mimic RA but is usually self resolving

A

Parvo B 19

55
Q

Congenital torticolis

A

noteted by 204 wks of age

child prefers to hold head tilted to one side

result of malposition of the head in utero or BIRTH TRAUMA

56
Q

pathognomonic for acute pyelonephritis

A

WBC casts in tububules

57
Q

MC cardiac abnormality that predisposes you to NVBE

A

mitral valve prolapse

58
Q

Retroperitoneal hematoma in a stable pt

A

pancreatic injury

59
Q

Rup[ture of abdominal aorta

A

massive nad rapid blood loss > hemorrhagic shock

60
Q

Extrapyramidal SE of antipsychotic meds:

inner restlessness
inability to sit/stand in one positoin

61
Q

involuntary and potentially irreversible movement disorder d/t prolonged antipsychoitc expsure

A

Tardive dyskonisia

62
Q

relationship betweeen xanthelasma and yellowish eyelid papule

A

Primary biliary cirrhosis> hypercholesterolemia

63
Q

Differential cyanosis restricted to the LOWER body in a child

64
Q

Whole body cyanosis in a child

A

Septal defect

TOF

65
Q

Coaractation of aorat

A

can limite exercise intolerance but does NOT cause cyanosis in children/adults

66
Q

innervates the stapedius muscle and paralysis of hteis msucle can lead to hyperascusis (icnrased sensitivity to sound)

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