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WELL > U world Review 6/12/23 > Flashcards

U world Review 6/12/23 Flashcards

1
Q

What organisms are cephalosporin resistant organisms

A

Listeria Monocytogenes
Methicillin resistant staphylococcous (MRSA)
Enterococci
Atypical like mycoplasma or chlamydia (no cell wall)

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2
Q

what can you use to treat listeria monocytogenes

A

ampicillin ( remember the amp that was in the background skethcy)

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3
Q

what is a septic abortion

A

this is when pregnancy termination does not remove all products of conception and leads to retained POCs which causes fever, uterine tenderness, and malorodrous cervical discharge. Bacteria colonizes and gives symptomatology

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4
Q

what are the most common organisms to cause a septic abortion?

A

anaerobes, group A strep and Staph aures

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5
Q

what is the treatment of septic abortions?

A

broad spectrum antibiotics and also urgent surgical and uterine evacuatio to remove the necrotic tissue and infection

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6
Q

clinical symptoms of a septic abortion

A

fever, abdominal pain, uterine tenderness, and malodorous discharge after pregnant termination

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7
Q

what are the systemic mycoses

A

histoplasmosis, blastomycosis, coccidiomycosis, paracoccidiomycosis

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8
Q

all systemic mycoses are _morphic in the cold they are _ and in the heat they are _ (the only exception to this is coccidoides)

A

dimrophic

mold in the cold and yeast in the heat

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9
Q

treatment of systemic mycoses includes

A

flucanzaole or itraconazole for local infections, amphotericin B for systemic infection

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10
Q

histoplasmosis is endemic to what location and what are its pathological features

A

it is endemic to the ohio river valleys and mississippi it appears as hiding inside of macrophages. it is associated with bird or bat droppings and can cause granulomas, pneumoniae, palatal/tongue ulcers, splenomegaly, pancytopenia, and erythema nodosum

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11
Q

where is blastomycosis endemic to, what are its pathological features

A

endemic to eastern and central US great lakes it appears as a broad based bud that can disseminate to bone. and the skin and cause verrucous lesions.

It can also cause granulomas, pneumonia, and inflammatory lung disease

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12
Q

coccidiomycosis is endemic where and what are its pathological features

A

endemic in southwestern US and california it is spheryle that is filled with endospores

it is associated with dust exposures (earthquakes) and can disseminate to bone, cause erythema nodosum, arthralgias, and memningitis

still can cause pneumonia, granulomas etc.

causes san joaquin valley fever

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13
Q

paracoccidiomycosis is endemic where and what are its pathological features

A

endemic to latin america and it is similar to blastomycosis but affects males more than females and looks like a captains wheel

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14
Q

what is the pathogenesis of mycobaterium tuberculosis causing tuberculosis

A

the bacteria is transmitted via aerosolized droplets and is inhaled into the lower lobe of the lung where it replicates and in the alveoli. The alveolar macrophages phagocytose the organism but cant eliminate it because sulfatides prevent phagolysosome fusion so m. tuberculosis will replicate unchecked in the alveolar macrophages for the first few weeks

after a few weeks APCs in the lymphatic system will display mycobacterial antigens and release IL-12 which will stimulate CD4+ lymphocytes to become TH1 cells. TH1 will then release IFN-y which activates macrophages to differenitate into epithelioid multinucleated langhans giant cells and form granulomas.

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15
Q

esophageal varices and splenomegaly are signs of?

A

portal hypertension

(underlying hepatic fibrosis)

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16
Q

what is the pathogenesis of schistosoma spp

A

when humans swim in fresh water in sub-saharan africa and contaminated snals release parasitic blood flukes that penetrate human skin and migrate to the liver where they mature ( they spread through the portal circulation) and release eggs.

can cause periportal fibrosis and cause portal hypertension with eosinophilia ***

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17
Q

what is a hint for a shistomasis infection on CBC

A

eosinophilia

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18
Q

pyrrolidonyl arylamidase ezyme (PYR) is used for?

A

Pyrrolidonyl arylamidase (PYR) enzyme testing is used to differentiate beta- and gamma-hemolytic streptococci. S pyogenes and enterococci are PYR positive (ie, can hydrolyze with PYR), whereas S agalactiae and S gallolyticus are PYR negative (ie, do not produce PYR).

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19
Q

which organisms produce pyrrolindnyl arylamidase

A

Group A strep and entercococous (faceium etc. )

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20
Q

what are contact precautions

A

wearing nonsterile gloves for all patient contact and gowns during substantail contact with infective material this is indicated for multidrug resistant bacteria like MRSA

methicillin sensitive does not require contact percautions

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21
Q

isolation precautaions

A

if there is an airborne infectious disease like tuberculosis with negative air pressure, closed doors and use of respirator masks

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22
Q

what is the single most important measure to reduce the risk of transmissionof hospital acquired infections

A

hand hygiene

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23
Q

walking pneumonia is usually caused by and what are the symptoms

A

mycoplasma pneumoniae and there is a low grade fever, malaise,chronic and dry nagging cough, on X ray there will be findings WAY WORSE than clinical apperance of the patient.

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24
Q

Mycoplama pneumoniae requires what to grow

A

cholesterol

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25
Q

haemophilus influenze requires what to be grown

A

chocolate agar (heat lysed blood_ and factor X (hematin) and factor V (NAD+)

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26
Q

leginella pneumophilia requires what to be grown

A

L-cysteine supplemeted agar

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27
Q

staphylococcal foodborne ilnesses can be prevented by?

A

washing hands before preparing food and proper storage of refridgerated food

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28
Q

chronic hypertension can lead to progressive _ and firbinoid necrosis weakening the vessel wall and predisposing to the formation of _ aneurysms

A

arteriolar hyalinization

charcot bouchard aneurysms

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29
Q

the most common sites of intracranial hemorrhage is?

A

deep brain structures like the basal ganglian, thalamus, pons (lenticulostriate arteries)

Deep intraparenchymal hemorrhage is most commonly caused by hypertensive vasculopathy of the small penetrating branches of the cerebral arteries (Charcot-Bouchard aneurysm rupture). This is in contrast to rupture of saccular aneurysms, which typically cause subarachnoid hemorrhage.

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30
Q

injury to the internal capsule

A

contralateral weakness/numbness, externosir plantar response,

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31
Q

acute bleeding appears as hyperattentuated or bright lesions on _ CT

A

non contrast head CT

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32
Q

what is the most common cause of intracanial hemorrhage in children

A

ateriovenous malformations

abnromal connection between arteries and veins bypassing cappularies which develop due to distrupted angiogenesis

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33
Q

what are the associated conditions with saccular or berry aneurysms

A

ADPKD, ehlers danlos syndrome, hypertension

loacted in the circule of willis ( severe sudden headache)

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34
Q

shoulder flexion cause _ rotation of the clavicle at the SC joint

A

posterior rotation

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35
Q

shoulder extension causes _ roation of the clavicle and the SC joint

A

anterior

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36
Q

clavicle rotation occurs with shoulder _

A

flexion/extension

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37
Q

shoulder elevation causes _ displacement of the distal clavicle and _ displacement of the proximal clavicle

A

superior

inferior

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38
Q

clavicle superior/inferior displacement occurs with shoulder_

A

elevation and depression

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39
Q

shoulder depression causes _ displacement of the distal clavicile and _ displacement of the proximal clavicle

A

inferior

superior

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40
Q

clavicle anterior/posterior displacement occurs with shoulder _

A

internal/external rotation

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41
Q

shoulder external rotation causes _ displacement of the distal clacivle and _ displacement of the proximal clavicle

A

posterior

anterior

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42
Q

shoulder internal rotation cause _ displacement of the distal clavicle and posterior displacement of the proximal clavicle

A

anterior

posterior

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43
Q

psoas syndrome signs

A

pelvic shift to the opposite side

non neutral lumbar dysfunction

positive thomas test’

L1 SP tenerpoint, medial ASIS tednerpoint

Positive Thomas test: Flexing the hip and knee on the unaffected side in the supine position causes the opposite leg (with the hypertonic psoas) to elevate off the table.

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44
Q

spondyloisthesis osteopathic test

A

positive step off sign

obvious forward displacement when palpating the spinous processes at the area of the slippage)

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45
Q

iliolumbar ligament sprain tenderpoint location

A

posterior iliac crest

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46
Q

L4 radiculopathy signs

A

low radiating low back pain with parathesias of the lateral thigh and medial knee

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47
Q

piriformis syndrome

A

buttock pain that radiates down the posterior thigh

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48
Q

symptoms of uremia

A

weakness, nausea, and anorexia with elevated creatinine and blood urea nitrogen

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49
Q

GFR is reduced in chronic kidney disease due to _ and acute kidney injury due to _

A

loss of functional nephrons

due to decreased renal profusion

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50
Q

the GFR can be directly measured by

A

a freely filtered not metabolized, secreted or reabsorbed filtration marker (inulin, creatinine)

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51
Q

a portion of creatine is actively secreted by the

A

proximal tubules

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52
Q

uncorrected creatine clearance _ the GFR by 10-20 %

A

overestimates

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53
Q

attack rate equation

A

number of those who become ill divided by those who are at risk of contrating the illness

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54
Q

what is a specific phobia

A

marked anxiety about an object or situation with avoidance behaviors that has been going on for 6 months or more

Specific phobia is a common anxiety disorder characterized by high levels of anxiety and panic attacks triggered by exposure, or anticipation of exposure, to a feared stimulus. As a result, these patients try to avoid the phobic stimulus whenever possible.

blood, animals, heights

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55
Q

what is the treatment of specific phobias

A

congnitive behavior therapy with repetitive graded exposure to the fear inducing stimulus

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56
Q

lactose is convereted into

A

galactose and glucose

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57
Q

lactase synthase converts _ to _ within the _ glands during milk formation

A

UDP-galactose to lactose

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58
Q

galactose kinase def

A

can transform glactose into galactose 1 phosphate and galacitol will accumulate

it is autosomal recessive and and galactose will appear in the blood and the urine children may have infantile cataracts and may have failure tracking objects and or failure to develop a social smile

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59
Q

classic galactosemia is a def in?

A

galactose-1 phosphate uridyltransferase (GALT)

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60
Q

classic galactosemia damage and genetic pattern

A

autosomal recessive damage caused by accumulation of toxic substances like galactitol that accumulates in the lens of the eye

symptoms begin when the infant is feeding ( lactose in breast milk) can cause FTT, heptomegaly, and infantile cataracts

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61
Q

classic glactosemia predisposes infants to?

A

E coli sepsis

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62
Q

essential fuctosuria

A

def in fructokinase (AR) cant convert fructose into Fructose 1-phosphate

fructose is not trapped in cells and hexokinase become the prinmary mechanism of convertinf fructose into fructose 6 phosphate

ASYMPTOMATIC

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63
Q

hereditatry fructose intolerance def

A

aldolase B def, where fructose 1- phosphate accumulates and decreases available phosphate and inhibits gluconeogenesis and glycogenolysis

symptoms present after consuption of fruit, juice, or honey

will have glucose in urine and reducing sugars in the urine as well

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64
Q

symptoms of hereditary fructose intolerance

A

hypoglycemia, jaundice, cirrhosis, vomiting

decrease fructose, sucrose, and sorbitol

65
Q

what should you eliminate to treat hereditary fructose intolerance

A

fructose, sucrose (fructose + glucose) and sorbitol

66
Q

what should you eliminate to treat classic galactosemia

A

galactose and lactose (galactose and glucose)

67
Q

an alternative method of trapping glucose in the cell is to convert it to its _ counterpart _

A

alcohol

sorbitol

via aldose reductase

68
Q

some tissues convert sorbitol to _ using sorbitol dehydrogenase

A

fructose

69
Q

intracellular sorbitol accumulation causes _ damage

A

osmotic

cataracts, retinopathy, peripheral neuropathy

70
Q

what tissues have the enzyme sorbitol dehydrogenase to convert it into fructose

A

liver, ovaries, and seminal vesicles

71
Q

what tissues only have aldose reductase (glucose to sorbitol)

A

LARKS

lens, retina, kidney, and schwann cells

72
Q

non stimulate ADHD medications

A

norepineprhine reuptake inhibitors (atomoxetine and viloxazine) or alpha 2 adrenergic agnosits (clonidine guanfacine)

atomoxetine is the first line non stimulate

73
Q

pathological changes associated with alzheimer disease

A

neurofibrillary tangles and amyloid beta plaques

74
Q

neurofibrillary tangles are composed of

A

hyperphosphorylated tau protein (intracellular microtubule component)

75
Q

amyloid beta is an abnormal fragment of?

A

amyloid precursor protein which is normally involved in synaptic formation and repair

76
Q

the amyloid precuror protein (APP) is located on chromosme _ and the estra copy leads to accelerated accumulation and earlt onset alzhemier disease

A

21

(down syndrome0

Patients with trisomy 21 (Down syndrome) have 3 copies of the amyloid precursor protein gene located on chromosome 21. This increases amyloid-beta accumulation in the brain, placing these patients at high risk for developing early-onset Alzheimer disease.

77
Q

amyloid A protein is?

A

acute phase reactant associaed with AA amylodisosis in chronic disease states

78
Q

huntington disease mutation

A

CAG on HTT gene

79
Q

islet amyloid polypeptide

A

beta cells prduce this and can form cytotoxic deposits in type 2 diabetes and impairs beta cell function

80
Q

neprilysin what is it and what its into MOA

A

neprylysin is a metalloprotease that inactivates ANP and BNP leading to vasocontriction and retention of water, it also inactivates angiotensin II

81
Q

neprylipsin inhibitors can be used in heart failure with reduced ejection fraction, what is the MOA

A

inhibts neprylysin which increases ANP and BNP (diuresis and vasodilation) and increases angiotensin II activities ( vasoconstriction)

82
Q

why are angiotensin II receptor blockers usually used in combination with a neprylisin inhibitor

A

because inhibitors inactivate neprylisin which increases angiotensin II activities which is not what we want in heart failure so we use it to offest this deleterious effect

Neprilysin is responsible for the breakdown of the natriuretic peptides and angiotensin II; therefore, inhibition of neprilysin increases the activity of these peptides. For treatment of heart failure, neprilysin inhibition is combined with angiotensin II receptor blockade to optimize the positive effects of the natriuretic peptides (eg, vasodilation, diuresis) while blocking the negative effects of angiotensin II (eg, vasoconstriction, fluid retention).

83
Q

protease inhibitors in HIV MOA and side effects

A

inhibit viral protease needed for HIV polyprotein cleavage to form viral proteins

lipodystrophy, hyperglycermia, inhbition of cytocrhome p450

Inhibition of cytochrome P450 may cause interactions with other drugs. Rifampin increases P450 activity and will therefore decrease PI serum levels; as a result, rifampin can be replaced with rifabutin in the treatment of tuberculosis in patients on PIs.

84
Q

what are the protease inhibitors use to treat HIV

A

atazanavir, darunavir, indinavir (navir)

85
Q

what are the NNRTs used to treat HIV

A

efavirenz, nevirapine

allosteric reverse transcriptase inhibitor

86
Q

what are the NRTI’s used to treat HIV

A

tenofovir, emtricitabine, lamivudine, abacavir, zixovudine

competitive nucleoside/nucleotide reverse transcriptas inhbitor

87
Q

what are the integrase inhibitors that are used to treat HIV

A

dolutegravir and raltegravir ( gravir)

inhibit HIV DNA integration into host genome

88
Q

what are the fusion inhibitors that are used to treat HIV

A

Enfuvirtide

inhits HIV fusion with target cell by binding to HIV gp41

89
Q

what are the CCR5 antagonsits used to treat HIV

A

maraviroc

blocks gp120 interaction with CCR5

90
Q

what is the most common side effect of zidovudine

A

bone marrow toxicity (anemia)

91
Q

centriacinar emphysema

A

smoking induced empysema with exertional dyspnea and dilated airspaces

92
Q

pathogenesis of smoking induced emphysema

A

oxidative injury to the respiratory bronchioles and acivation of resident macrophages from smoke. Then inflammatory recruitment of neutrophils into the affected airspaces ensues

activated macrophages and neutrophils release proteases like elastase that degraded the ECM

93
Q

pan acinar emphysea

A

caused by alpha 1 antitrypsin deficency

94
Q

expectorated sputum cultures are often contiminated by?

A

normal oral flora

candida albicans : budding yeast that forms true hyphae (germ tubes) at warmer temps.

95
Q

fetal circulation is characterized by _ pulmonary vascular resistance and _ systemic vascular resistance

A

high

low

there are right to left shunts which means the right ventricle contributes to 60 % of systemic flow

96
Q

neonatal circulation is characterized by _ PVR and _ SVR

A

low pulmonary vascualr resistance ( pulmonary aeration–> vasodilation)

and increases systemic vascular resistance (clamping of cord abruptly removes the low resistance placenta from neonatal circulation)

left to right shunts with eventual closure of them and the left ventricle contrinutes to all of systemic blood blow

97
Q

the 3 main arteries in the GI tract

A

celiac trunk (stomach, duodenum, gallbladder, liver, spleen, pancreas)
SMA (collateral to colon)
IMA

marginal artery of drummon is the principal anatomosis

98
Q

DNA MMR impairment increases the rate of _ mutations resulting in alrge quantities of _

A

frameshift

neoantigens

neoantigens are displayed on MHC I on the cancer cell surface and activates a diverse polyclonal pool of antitumor cytotoxic T cells

Because tumors with defective DNA mismatch repair generate high levels of neoantigens, they are particularly dependent on adaptations (eg, overexpression of immune checkpoints) to avoid cytotoxic T-cell destruction. Treatment with immune checkpoint inhibitors restore antitumor cytotoxic T-cell activity and often dramatically reduce tumor burden.

99
Q

metalloproteinases allow tumor cells

A

to open a channel through the basement membrane and disloidge from their site of origin which is important for metastasis

100
Q

damage to the subthalamic nucleus can decrease excitation of the _ _ _ therby reducing inhibition of the _ this may result in contralateral _

A

globus pallidus internus

thalamus

hemiballism (flinging movement disorder)

101
Q

hemiballism usually occurs in the setting of a _ stroke

A

lacunar

102
Q

atrophy of the caudate nucleus occurs in _ disease which is characterized by what movement disorder

A

huntingtons disease

chorea ( involuntary low amplitude movements involving the distal limbs)

103
Q

damage to the internal capsule would present with?

A

contralateral pure motor or combined sensorimotor deficits

104
Q

atrophy of the lentifrom nucleus (putamen and globus pallidus) occurs in _ disease

A

wilson disease

(liver, psychatric, and neurologic abnormalities

105
Q

stroke in the VPL (ventral posterior lateral nucleus) and VPM (ventral posterior nucleus ) result in

A

complete contralateral sensory loss

106
Q

thalamic syndrome

A

contralteral burning or stabbing pain over 1 side of the body

107
Q

_ are the most common cause of E. Coli bacteremia

A

UTIs

108
Q

what is the first like treatment of familial hypercholesterolemia

A

HMG-COA reductase inhibitors (rate limiting step in cholesterol synthesis)

109
Q

what are the serious side effects of statins and therefore what tests should you condut prior to starting your patient on a statin

A

Myopathy and hepatitis

get liver function tests done (ALT/AST)

Common side effects of HMG-CoA reductase inhibitors (statins) include muscle and liver toxicity. Hepatic transaminases should be checked prior to initiating therapy and repeated if symptoms of hepatic injury occur.

110
Q

methotrexate MOA

A

competitively innhbits dihydrofolate reductase

folate antagonist

affect rapidly dividng cells by limiting precursors essential to DNA synthesis and repair.

111
Q

what are the side effects of methotrexate

A

neural tube defects, cardiovascular and urinary tract defects

112
Q

branchial arches differentiate under _ control

A

HOX (homeobox) genes

113
Q

what durg during pregnancy interferes with HOX signaling pathways and can cause branchial arch abnormalities

A

vitamin A (retinoids)

114
Q

what is a complication of using Ace inhiitors in the second or third trimester of pregnancy

A

renal dysplasia

115
Q

what is a rare malformation that occurs almost exclusively in infants of diabetic mothers

A

sacral agenesis (caudal regression syndrome)

incomplete development of the sacrum, lumbar vertebrae and lower extremities

116
Q

thryoid hypoplasia is a complication of inadvertant fetal expsoure to _

A

radioactive iodine (in moms recieving treatment for hyperthyroidism or thyroid cancer)

117
Q

what drug can be used in ganciclovir resistant cytomegalovirus

A

foscarnet

118
Q

what is foscarnet

A

a pyrophosphate analong that is used for ganiciclovir resistant CMV infections and can chelate calcium

Foscarnet is an analog of pyrophosphate that can chelate calcium and promote nephrotoxic renal magnesium wasting. These toxicities can result in hypocalcemia and hypomagnesemia, which can cause seizures.

119
Q

foscarnet side effects

A

hypomagnesium and reduced parathyroid hormone release leading to hypocalcemia

120
Q

cidovir is

A

used in CMV retinitis

can cause nephrotoxicity with proteinuria or elevated creatinine

121
Q

how does positive end expiratory pressure (PEEP) helo treat acute respiratory distress syndrome

A

opening collapsed alveoli (increase alveolar pressure), reduce intrapulmonary shunting and increase intrapleural pressurem and increase functional residual capacity (and therefore oxygen stores)

purpose is to reopen collapsed alveoli and decrease time beneath critical closing of alveoli during exhalation

122
Q

intrapleural pressure is normally _ throughout the respitatory cycle

A

negative

123
Q

risk factors for acute respiratory distress syndrome

A

sepsis, pneumonia, trauma, pancreatitis

124
Q

pathophysiology of ARDS

A

cytokine release activates the endothelium and recruits neutrophil to mast cell degranulation in the lung leading to increased capillary permeability, alveolar fluid accumulation and formation of hyaline membranes

125
Q

clinical features of acute respiratory distress syndrome

A

hypoxia, bilateral pulmonary infiltrates and normal capillary wedge pressure

126
Q

acute renal failure and hypertension with red blood cell casts, hematuria , sterile pyuria, and proteinuria suggests

A

glomerulonephritis

127
Q

white blood cell casts, sterile pyruia, and urine eosinophils suggest

A

acute intersitial neprhtitis after new medication

usually has a rash, fever, and eosinophilia

128
Q

what medication causes neddly shaped cyrstals in the urine

A

acyclovir

129
Q

what are transporter associated antigen processing (TAP) proteins

Transporter associated with antigen processing (TAP) proteins are necessary for loading of cytoplasmic (eg, viral) proteins onto major histocompatibility complex (MHC) class I molecules. The MHC class I–peptide complex can then activate CD8+ cytotoxic T cells through interaction with the T cell receptor and CD8 coreceptor.

A

transmembrane proteins that are necessary for the presentation of cystosolic antigens on major histocompatibility complex molecules

proteins degraded by proteosomes can be transfered into the ER via TAP proteins and then loaded onto MHC I molecules

130
Q

symptoms of benign intracranail hypertension

A

headache, vomiting, papilledema with a negative head CT scan

131
Q

symptoms of vitamin A toxicity

A

benign intracranial toxicity, bone pain, hepatomegaly, dry skin and mucosa (alopecia) and is teratogenic

132
Q

vitamin A def symptoms

A

night blindness, dry eyes, bitot spots, hyperkeratosis, diminished immune response

133
Q

vitamin A is stored in the _

A

liver (too much can cause hepatomegaly)

134
Q

how can vitamin A affect babies in pregnancy

A

neural crest cell toxicity, microcephaly, craniofacial defects and cardac anomalies

135
Q

large doses of vitamin E are associated with?

A

increased risk of bleeding (hemorrhagic stroke)

136
Q

how is the leg positioned in a posterior hip dislocation

A

shortened, internally rotated , flexed and adducted

rom will be limited and painful

137
Q

femoral neck fracture will have the leg in what position

A

shortened and externally roated

138
Q

the _ nerve runs posterior to the hip joint and is vulnerable to injury with a posterior hip dislocation

A

sciatic

139
Q

sciatic nerve injury signs

A

weakness on ankle dorsiflexion, decreased ankle reflex and decreased sensation

140
Q

the _ artery runs anterior to the hip and can be injured in anterior dislocation

A

femoral

abduction and external rotation of the hip

141
Q

what is the greatest determinant of symptom severity in tetralogy of falot

A

degree of right ventricular outflow obstruction

142
Q

what is tetrology of falot

A

PROVe (pulmonary stenosis, right ventricule hypertrophy, overrighing aorta, VSD

right ventricular outflow tract obstruction, VSD, overriding aorta, ventricular hypertrophy

Tetralogy of Fallot is a congenital heart defect characterized by right ventricular outflow tract (RVOT) obstruction, a large ventricular septal defect (VSD), an overriding aorta, and right ventricular hypertrophy. The degree of RVOT obstruction is the greatest determinant of symptom severity because it regulates pulmonary arterial blood flow and the magnitude and direction of shunting through the VSD.

143
Q

glioblastoma

A

abnormal astrocytes with psuedopalisading , necrosis and microvascular proliferation

-glial origin

associated with EGFR

144
Q

what is EGFR

A

epidermal growth factor receptor that is a tyrosine kinase signal transduction system that conducts external growth signals into the nucelus and promotes cellular survival and proliferations

145
Q

symptoms of glioblastoma

A

slowly worsening headache, seizures, focal neurological issues

146
Q

thoracenesis yeilding high erythrocyte concentration and atrypical mucin cells is consistent with

A

adenocarcinoma

147
Q

what are the two m ost common causes of malignant pleural effusions

A

lung and breast

148
Q

malignant effusions are _ by light criteria

A

exudative

149
Q

how can malignancy cause exudative effusions (3 different ways)

A

lung inflammation can cause increased vascular permeability and increased inflow into the pleural space

malignant cells can go to the pleural space and occlude the plueral lymphatic stroma and prevent pleural fluid reabsorption

the thoracic lymphatic duct disruption which is most commonly seen in lymphoma with a chylothorax

150
Q

what are the lab findings in hypovolemia due to salt and water loss

uric acid-
plasma volume-
hematocrit-
serum albumin-

A

uric acid- increased
plasma volume- decreased
hematocrit-increased
serum albumin-increased

Hypovolemia due to loss of sodium and/or water causes increased concentration of red blood cells (ie, hematocrit) and albumin as both of these blood components are trapped within the intravascular space. Hypovolemia also triggers increased absorption of uric acid in the proximal renal tubule, resulting in an increased serum uric acid leve

151
Q

what artery supplies blood to the cerebral hemispheres including the motor cortez, and controls the contralateral limbs

A

internal carotid artery

152
Q

the opthalmic artery which gives rise to the _ artery originates from the. ispilateal _ artery

A

retinal artery

internal carotid artery

cause same sided vision loss

153
Q

what are the branches of the aortic arch

A

on the left: left common carotid and subclavian artery

on the right: brachiocephalic

154
Q

the brachiocephalic splits into

A

right subclavian and right common carotid

the right common carotid goes to split into the right external carotid artery and the right internal carotid artery

155
Q

the external carotid artery supplies blood to the

A

face and neck

156
Q

the vertebral arteries supply the

A

upper spinal cord, brainstem, cerebellum and posterior part of the brain

157
Q

herpes zoster ophthalmicus is caused by?

A

reactivation of latent varicellar zoster virus in the V1 division (opthalmic)

Herpes zoster ophthalmicus is caused by reactivation of varicella-zoster virus in the ophthalmic division of the trigeminal nerve (CN V1). It is characterized by a painful, dermatomal rash and ocular involvement (eg, acute keratitis, corneal ulceration). It most commonly occurs in elderly and immunosuppressed patients.

158
Q

the weight bearing stance phase of gait engases what axis

A

sacral oblique axis

(the the pelvis rotates about allowing the opposite leg to swing foward and induce forward sacral rotation

159
Q

the right oblique axis is engaged when the _ leg is in stance phase. The other leg swings forward causing the sacrum to rotate to the _

A

right

right

all stance phases of gait are foward torsions

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