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USMLE Goljan 2 Flashcards

1
Q

What murmur is heard in MV/TV regurgitation?

A

Pansystolic murmur

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2
Q

What murmur is heard in AV/PV regurgitation?

A

high pitched diastolic murmur directly after S2

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3
Q

What is the MC cardiomyopathy?

A

congestive (dilated) cardiomyopathy

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4
Q

What causes congestive cardiomyopathy? MC Drug? MC vitamin. def?

A
  • idiopathic (MC)
  • doxorubicin/cocaine
  • thiamine deficiency (Alcoholics)
  • hypothyroidism
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5
Q

What is the MCC of sudden death in young people?

A

Hypertrophic cardiomyopathy

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6
Q

What is the MCC of infective endocartitis?

A

Strep. viridians

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7
Q

What is the MCC of infective endocartitis in I.V. drug user?

A

Staph. aureus

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8
Q

What is the MCC of infective endocartitis in colon cancer and ulcerative colitis?

A

Strep. bovis

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9
Q

What is the MCC of infective endocartitis in prosthetic devices?

A

Staph. epidirmidis

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10
Q

What is the MCC valve involved in infective endocartitis?

A

mitral valve

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11
Q

What are the clinical findings in infective endocarditis?

A

1) type III; HS
- Roth Spots retina
- splinter hemorrhage
- glomerulonephritis w/ RBC casts

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12
Q

What is associated w/ Libman Sacks endocarditis?

A

SLE

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13
Q

What DZ has sterile vegetations covered on valvular surfaces?

A

SLE

-libman sacks endocarditis

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14
Q

What two diseases are involved w/ mucin-producing sterile vegetations?

A

tumors of colon and pancreas

Marantic vegetations

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15
Q

What is the MCC of viral myocarditis?

A

Coxsackievirus

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16
Q

What other pathogens cause myocarditis?

A

Borrelia (Lyme Dz)
T. cruzi (Chagas)
Tichinella spiralis (trichinosis)

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17
Q

What is the difference between myocarditis and pericarditis?

A

pericarditis adds AMI and Dressler’s syndrome

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18
Q

What is the MCC of pericarditis?

A

Coxsackievirus again!

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19
Q

What disease involves hypotension assciated w/ pulsus paradoxus?

A

pericarditis

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20
Q

What is pulsus paradoxus?

A

decrease in >10mmHG in systole during inspiration

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21
Q

What other sign is seen in pericarditis?

A

Kussmaul’s Sign

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22
Q

What is Kussmaul’s sign?

A

neck vein distension on inspiration

blood refluxes to jugular vein instead of entering RA

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23
Q

What is the MCC of constrictive pericarditis?

A

TB worldwide

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24
Q

What is the problem in hypertrophic cardiomyopathy?

A

mutation in heavy chain of beta-myosin and troponins

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25
What kind of genetics does hypertrophic cardiomyopathy have?
autosomal dominant
26
What is the MC site of metastasis to cardiac tissue?
pericardium
27
MC benign tumor of cardiac origin? Location?
Cardiac Myxoma | Left atirum
28
What is a benign tumor of the heart that arises from cardiac muscle? MC in age?
Cardiac Rhabdomyoma | infants and children
29
What disease is associated with cardiac rhabdomyoma?
Tuberous Sclerosis
30
What is associated w/ Alzheimer's Dz?
Depression
31
What is the pathogenesis of mitral valve prolapse?
increase/accumulation of dermatan sulfate
32
What is the characteristic murmur of mitral valve prolapse?
mid-systolic click
33
When does the murmur approach to S1?
decrease in preload less blood
34
How do you calculate the A-a gradient?
Alveolar PO2= 21%O2(Atm. P-47) - pCO2/0.8 A= (.21)(713)- 40/0.8) Usually A=100 A-a a=95 Normal A-a grad= 5-30
35
When is A-a gradient indicative of pulmonary pathology?
when A-a grad = >30
36
Where is ventilation most prominent in the lungs?
Apex
37
What is more prominent at the base of the lungs? Vent. or Perf.
Perfusion
38
Where do infactions of the lung occur?
Lower lobes i.e. more perfusion
39
What is the diagnosis of a child w/ Nasal Polyps? Test for?
Sweat Test ``` Cystic Fibrosis (CF) until proven otherwise ```
40
Patient w/ fibromyalgia and develops asthma, what is the cause of this?
Aspirin induced asthma block PG but still produce Leukotriene build up LT C-D-E4 buildup (potent bronchoconstrictors)
41
Causes of Hypoxemia w/ normal A-a gradient?
- barbiturates OD - epiglottitis (Upper Airway Obstr.) - Amyotrophics Lat. Sclerosis (ALS)
42
Newborn that turns cyanotic when breast feeding; cries and turns back to pink. Diagnosis?
Choanal Atresia
43
What is the complication of Sleep Apnea?
Pulmonary Hypertension - vasoconstrictive effects of chronic hypoxemia and respiratory acidosis called COR-PULOMONALE
44
What sinus is involved in adults w/ sinusitis? children?
mAxilary ADULTS ethmoid children ethmall
45
What is a common finding of sinusitis in diabetics?
Mucor sinusitis
46
Why does Mucor species prevail in sinusitis of Diabetic patients?
Ketoacidosis cuases proliferation
47
What does Mucor sp. invade?
frontal lobes
48
What is the cause of Nasopharyngeal Carcinoma?
EBV common in Chinese
49
What three compounds increase surfactant?
1) thyroxin 2) prolacitn 3) glucocorticoid
50
What happens when no primary cancer is found in cervical lymph node metastasis?
nasopharynx should be biopsied
51
Risk factor for Laryngeal CA?
smoking
52
What is synergistic with smoking in Laryngeal CA?
Alcohol ingestion smoking + alcohol = bad combo
53
What is found in the physical exploration of Atelectasis?
- dullness to percussion | - absent tactile fremitus
54
When do you see atelectasis?
usually 24-36 hrs post surgery
55
What three compounds increase surfactant?
thyroxin prolactin glucocorticoids that's why glucocorticoids given to mother before 32 weeks
56
What is the pathogenesis of Respiratory Distress Syndrome in Newborns?
Atelectasis due to loss of surfactant
57
Where is surfactant made?
Type II neumocytes
58
Where is surfactant stored?
lamellar bodies
59
When does synthesis of surfactant begin?
28th week
60
When is surfactant at it's peak?
35 weeks
61
What disease is common to dysphagia fro solids? (lower esophagus)
Achalasia MC progressive systemic sclerosis/CREST Sx
62
What Dz is involved in dyspaghia for solids but in the Upper esophagus?
polymyositis myasthemia gravis
63
Why is myasthemia gravis on the upper esophagus?
Upper 1/3 of esophagus is striated muscle
64
What three diseases have disphagia for liquids?
really bad... 1) plummer vinson 2) esophageal CA 3) Barrett's Esophagus (ulceration and stricture)
65
What is associated with iron deficiency and dysphagia for solids?
Plummer-Vinson
66
What does it mean when you have dysphagia for solids but not liquids?
Mechanical Obstruction
67
What does it mean when you have dysphagia for both solids and liquids?
peristalisis problem
68
What is the MCC of odynophagia in HIV?
esophagitis caused by Candida albicans | Aids Defining
69
MC congenital esophageal disorder?
Tracheoesophageal fistula
70
What is wrong in tracheosophageal fistula? (what ends blindly?)
Proximal esophagus ends blindly
71
What are the common signs and symptoms of fistula in pregnancy?
Polyhydramnios (excess fluid) fetus is not reabsorbing it through mouth
72
What are signs/symptoms (S/S) of Trachesophageal Fistula (TE) in babies?
apsiration of milk into trachea | - abdominal distention
73
What is connected in TE fistula?
Trachea and Stomach!!! Distal Esophagus arises from Trachea
74
What is the VATER Sx?
Vertebral Abnormalities Anus Imperforated TE fistula Renal Disease/Radius abnormality
75
What are the causes of polyhydramnios?
- TE fistula - Anacephaly - duodenal atresia (Down/ALL)
76
What is weakness in the esophageal wall called?
Zenker's Diverticulum
77
What is weak in Zenker's Diverticulum?
cricopharyngeus muscle weakness
78
What are the S/S of Zenker's Diverticulum?
bad breath | food collects in pouches
79
What is the pathogenesis of achalasia?
failure of relaxation of LES sphincter
80
What is absent in achalasia?
absent relaxation | absent myenteric ganglion cells
81
What is substance is missing in the myenteric ganglion of achalasia?
VIP (vasointestinal peptide)
82
What is the function of VIP?
relax the LES
83
What sign do we see in the X-ray of achalasia?
bird's beak in barium study | dilation of proximal esophagus
84
HOw are achalasia and progressive systemic sclerosis (PSS)/ CREST Sx similar?
both have relaxation of LES absence of esophageal motility manometry best diagnostic measure
85
What does CREST stand for?
``` Calcinosis Raynaud's Phenomenum Esophageal Motility Dysfunction Sclerodactyly Telangiectasias ```
86
What laboratory test do you use to diagnostie CREST Sx?
ANA (70-90%) anti-SCL-70 (70%) topoisomerase I anti-centromere antibodies (30%)
87
What is the problem in GERD?
relaxed LES | acid injury leads to Barrett's esophagus and then distal AdenoCA
88
What vein is most likely to have varices in esophagus?
left gastric coronary vein (from portal) | azygous vein
89
What is the MC organism causes esophagitis?
Candida
90
What are other causes of esophagitis?
Herpes (multinucleated cells w/ intranuclear inclusions) CMV (single nucleurs w/ largo basophilic inclusion)
91
What is the name of the TEAR of the DISTAL esophagus?
Mallory Weiss Sx
92
When does Mallory Weiss Sx occur?
Alcoholics | bulimia
93
What is the name of the RUPTURE of the DISTAL esophagus?
Boerhaave's Sx
94
What is the MCC of Boerhaave's Sx?
Endoscopy procedure!!!
95
What is the MCC of primary cancer in the esophagus in the U.S.? What part of the esophagus?
Adenocarcinoma of distal esophagus
96
What is the MC esophageal CA in developing countries and where is it located in the esophagus?
Squamous CA Mid-esophagus
97
MCC of hematemesis?
duodenal ulcer 2) gastric ulcer 3) esophageal varices
98
Main difference between congenital pyloric stenosis and duodenal atresia?
Bile containing fluid in Duodenal Atresia Also duodenal atresia associated w/ Down Sx polyhydramnios seen in mother in Duodenal Atresia
99
What are the three functions of PGE2?
1) increase blood flow to mucosa 2) increase secretion of mucous 3) increase HCO3- cytoprotective
100
What is an analog of PGE2?
Misoprostol cytoprotective
101
What part of the stomach is affected by pernicious anemia?
Body and Fundus
102
What type of gastritis is pernicious anemia?
Type A atrophic gastitis
103
What part of the stomach does H. pylori infect?
pyloric antrum
104
What does H. pylori predispose to/cause? 2 things
AdenoCA of stomach | Malignant Lymphoma
105
What type of gastritis does H. pylori cause?
Type B Atrophic Gastritis
106
Where is the ulcer and cancer located in gastric ulcer?
lesser curvature of antum
107
Does gastric ulcer predispose to CA?
NO! Gastic CA may bleed and may be confused w/ gastric ulcer!
108
What must be done w/ gastric ulcer?
Biopsy to rule out gastric CA!
109
When is the pain in duodenal ulcer?
Decreases w/ meal/eating
110
When is pain in gastric ulcer?
Greater fater eating
111
What is the malignant potential for a duodenal ulcer?
0% malignancy so never biopsied!
112
What blood group is associated w/ duodenal ulcer?
Blood group O
113
What other pathologies are associated w/ dudoneal ulcer?
MEN I | Zollinger-Ellison Sx
114
What is the MC complication of duodenal ulcer?
Bleed and perforation
115
What is the presentation of duodenal ulcer w/ perforation?
patient w/ epigastric pain that irradiates to the left shoulder
116
What is the first step in managemente of duodenal ulcer that has perforated?
Flat X-ray
117
Why is the pain referred to the shoulder in perforated duodenal ulcer?
because the diaphragm is irritated and has the same dermatome and embryology at C4 (phrenic nerve)
118
Patient that wakes up at night w/ epigastric pain?
Most likely duodenal ulcer
119
What is Zollinger Ellison's (ZE) Sx?
malignant islet cell tumor
120
What does ZE secrete?
gastrin increases acid in stomach
121
Why is there black melena?
Acid acts on HB and converts it into Hematin Hematin is black pigment that stains fecal matter
122
What is a picture of a stomach that is really hard petrified almost?
Linitis plastica | Stomach Cancer diffuse type
123
What type of cells do you see in linitis plastica?
Signet Ring Cells
124
Where else can you find signet ring cells?
both ovaries since linitis plastica metastasizes via hematogenous route
125
What is a kind of diffuse type linitis plastica? attacks the ovaries as well?
Krukengerg Tumor
126
What is the MC extranodal site of extranodal lymphoma?
stomach
127
What is the 2nd MC extranodal site of extranodal lymphoma?
peyer's patches
128
What is the MC benign tumor of GI tract?
Leiomyoma
129
What is the MC location for Leiomyoma?
stomach
130
What is the main symptom of leiomyoma?
bleeding
131
What is associated with dermatitis herpetiform?
Celiac Dz
132
What is the best test to detect Celiac Dz?
anti-gliadin Ab
133
What is another Dz that involves malabsorption?
Whipple Dz
134
What is the pathology of Celiac Dz?
Atrophy of villi in Duodenum and Jejunum
135
What is the pathology of Whipple's Dz?
blunting of villi in jejunum and ileum
136
What is the best (cheapest) screening test to determine malabsorption problem?
stool for fat
137
What are the three classifications of diarrhea?
1) invasive 2) secretory 3) osmotic
138
What is the best test for invasive diarrhea?
fecal leukocytes (+)
139
What is the #1 organism in invasive enterocolitis?
Campylobacter
140
What diarrhea's are low volume?
Invasive diarrhea
141
What diarrhea is high volume?
secretory and osmotic
142
What is secretory diarrhea?
high volume w/ osmolality similar to plasma
143
What is osmotic diarrhea?
high volume w/ osmolality lower than that of plasma
144
What are some disease that cause secretory diarrhea?
Vibrio cholerae (via adenylate cyclase) E. coli (via guanylate cyclase) Rotavirus Carcinoid Sx
145
Is there mucosal inflammation in secretory diarrhea?
No mucosal inflammation
146
What are some common diseases that cause osmotic diarrhea?
lactase deficiency | laxatives
147
What is the MCC of diarrhea, cholecystitis and pancreatitis in AIDS?
Cytomelagolvirus (CMV)
148
What organism is associated w/ HLA-B27 spondyloarthropathy and uremic Sx?
Shigella
149
What is the MC contaminant of blood transfusions?
Yersenia enterocolitica
150
What are trophozoites phagocytosed RBCs?
Entameba histolytica (Ameba)
151
What is the MCC of diarrhea in AIDS?
Cryptosporidium parvum
152
What test is used to detect C. parvum?
String Test
153
What is the MCC of diarrhea from protozoa in the U.S.?
Giardia lamblia
154
What is the life cycle of G. lamblia?
cysts attach to small intestine mucosa
155
What organism causes rectal prolapse in children?
Trichuris trichura
156
What is the Tx of Trichuris trichura?
Albendazol
157
What is the reservoir of diphyllobothrium latum?
fish--- lake trout
158
What does D. latum cause?
Vitamin B12 deficiency
159
What is the Tx fro D. latum?
praziquantel
160
What is seen in the stool of Strongyloidse stercoralis?
rhabditiform larvae
161
What parasite causes bowel obstruction?
Ascaris Lumbricoides
162
What is the reservoir for Dyphyllobotrium latum?
Fish --- lake trout
163
What problems does D. latum give humans?
Vitamin B12 deficiency
164
What is the Tx for D. latum?
Praziquantel got the prize for the fish!
165
What parasite in the soil penetrates the skin?
Strongyloides stercoralis he is strong!!!
166
What is the MCC of hematochezia?
Diverticulosis
167
What is the 2nd MCC of hematochezia?
angiodysplasia
168
What is asscoaited w/ angiodysplasia?
von Willebrand's Dz Aortic Stenosis
169
What is the MCC of iron deficiency in newborn?
Mecke's Diverticulum bleeding GI
170
What disease has the term left sided apendicitis?
sigmoid diverticula
171
MC place of pathology in entire GI tract?
``` Sigmoid colon includes: - cancer - polyps (except Peutz-Jegher's) - diverticular disease ```
172
What is associated with embolism of transmural small bowel?
hear disease and atrial fibrillation
173
What is the MCC of fistulas in the GI tract?
diverticula
174
What is the MC fistula?
Colovesical Fistula
175
Ulcerative Colitis vs. Cronh's Dz
UC vs. Crohn's
176
What layers does UC comprise?
musocal and submucosal
177
What layers does Cronh's Dz comprise?
all layers | it is transmural
178
What does UC primarily target?
rectum
179
What is involved in Cronh's Dz in 80%?
Terminal Ileum Affected
180
What segment does UC attack?
rectum; | does not involve other areas of GI tract
181
What segment does Cronh's attack?
Cronh=Complete all layers and also all the GI tract mouth to anus
182
What marker do you get after HBV vaccine?
anti-HBs
183
What is the first serology to appear in HBV?
HBsAg
184
What is the marker that the patient will recover from HBV?
HBV-DNA poymerase leaves before HBsAg
185
Markers for HBV infection is active?
HBe and HBV-DNA antigens are excellent markers of infectivity
186
What is considered when anti-HBcIgM is converted to HBcIgG?
patient has old infection
187
What marker for HBV determines a chronic carrier?
HBsAg for more than 6 months
188
What is a healthy carrier?
carries HBsAg but is negative for HBeAg/HBV-DNA
189
What two viruses are associated w/ hepatocellular CA?
B and C hepatitis
190
What organism causes spontaneous peritonitis in adults?
E. coli
191
What organism causes spontaneous peritonitis in children?
Step. pneumoniae
192
What causes a single abscess in the right lobe of the liver?
E. histolytica
193
Tx for Hepatic Amebiasis?
Metronidazole
194
Who is the definitive host of Echinococcosis?
Sheep Dog
195
Humans are what type of host for Echinococcosis?
intermediate host
196
Tx for Echinococcosis?
Albendazole
197
What organism causes cholangiocarcinoma?
Clonorchis sinensis
198
What is another name for Clonorchis sinensis?
Chinese Liver Fluke
199
How do you get Clonorchiasis?
Ingestion of infected fish w/ larvae
200
What is the Tx of Clonorchiasis?
Praziquantel
201
What is the main characteristic in the laboratory of Clonorchiasis?
Eosinophilia
202
What organism causes cholangiocarcinoma?
Clonorchis sinensis
203
What is another name for Clonorchis sinensis?
Chinese Liver Fluke
204
How do you get Clonorchiasis?
Ingestion of infected fish w/ larvae
205
What is the Tx of Clonorchiasis?
Praziquantel
206
What is the main characteristic in the laboratory of Clonorchiasis?
Eosinophilia
207
What causes portal hypertension, hepatosplenomegaly, ascites and esophageal varices?
Schistosomiasis
208
What is the definitive host of Schistosoma mansoni?
Snails imagine photographer taking pics of snails (he is a mason!)
209
Tx for Schistosomiasis?
Praziquantel
210
What is the MCC of congestive hepatomegaly?
Right Heart Failure (H.F.)
211
What are two clinical manifestations of PRE-hepatic obstruction?
1) portal vein thrombosis | 2) ascites/varices
212
Do you find hepatomegaly in pre or post-hepatic obstruction?
Post-hepatic!!!
213
What is a cause of post-hepatic obstruction?
1) Budd-Chiari syndrome 2) Polycythemia vera 3) Oral Contraceptives
214
What is Budd-Chiari Sx?
hepatic vein thrombosis
215
What is the MCC of post-hepatic obstruction?
Polycythemia vera!
216
Symmptoms of post-hepatic obstruction?
1) painful liver 2) congested liver 3) ascites 4) portal hypertension
217
What are dead hepatocytes called?
Councilman Bodies
218
When do we find Councilman Bodies?
Hepatitis
219
What alcoholic disease is irreversible?
cirrhosis
220
Are fatty change and alcoholic hepatitis reversible or irreversible?
reversible
221
What are the factors of Alcholo liver disease?
1) amount of OH 2) duration of intake 3) more damage in females
222
Where is the most important site of metabolism of OH in liver?
cytosol
223
What causes disulfiram reaction?
acetaldehyde build up
224
What is disulfiram rx?
nausea/vomiting, flushing after ingestion of alcohol
225
What drug is used in Tx of alcoholism?
Antabuse or Disulfiram
226
What enzyme is inhibited by disulfiram?
an alcohol dehydrogenase Acetaldehyde Dehydrogenase
227
Where is alcohol dehydrogenase found?
in cytosol and mitochondria
228
Why is there a build up of lactate in alcoholics?
high levels of NADH make pyruvate go into lactate (increases anion gap)
229
Why does hypoglycemia occur in alcoholics?
again increase in NADH makes conversion of pyruvate to lactate decrease in pyruvate can't go back to gluconeogenesis
230
Why is there esteatosis?
alcohol is converted to acetaldehyde and acetate and acetyl coA which makes free fatty acids - increase in NADH2 favors glycerol-3-p
231
What is the sequence to make TG (VLDL) from 1,3 DPG?
1,3 DPG to Glyceraldehyde-3-P to DHAP to Glycerol-3-P + FA makes TG
232
Why is ketoacidosis sometimes present in alcoholics?
NADH once again favors conversion of: | Acetoacetate to B-Hydroxybutyrate (ketoacids)
233
Why are alcoholics prone to gout?
Ketoacids and Lactic Acid compete w/ uric acid for excretion in the kidneys so Uric Acid Accumulates!
234
What is the ratio of ALT and AST in alcoholics?
You are an ASS because you drink AST > ALT
235
What is seen in alcoholic hepatitis?
mallory bodies you will have a bad body!! Mal (lory) Body!
236
What is very characteristic microscopically?
fibrosis aroudn terminal hepatic venules
237
MCC of obstructive jaundice?
stone in common bile duct
238
What are the symptoms in obstructive jaundice?
- hypercholesterolemia - light colored stools - urine w/ conjugated bilirubin - increase alkaline phosphatase (AP) and gamma-glutamyltransferas (GGT)
239
What are the symptoms of primary biliary cirrhosis?
- pruritus - increase AP and GGT - no jaundice until later
240
What immunoglobulins and markers detect primary biliary cirrhosis?
- increase anti-mitochrondrial Ab | - increase IgM
241
How do you acquire primary biliary cirrhosis?
autoimmune, granulomatous destruction of bile ducts in triads
242
What disease causes primary slcerosing pericholangitis?
ulcerative colitis - complication of
243
What is the clinical picture of 1ry sclerosing pericholangitis?
jaundice
244
What cancer is related to 1ry sclerosing pericholangitis?
MCC of cholangiocarcinoma
245
Name drug that causes acute hepatitis? (4)
1) Isoniazid 2) Halothane 3) acetaminophen 4) methyldopa
246
Name two drugs that cause cholestasis?
1) oral contraceptives | 2) anabolic steroids
247
What drugs cause steatosis? fatty liver... 2
1) Amiodarone | 2) Methotrexate
248
What drug causes fibrosis in the liver?
methotrexate
249
What drug causes angiosarcoma of the liver?
Vinyl Chloride
250
What drug causes Liver Cell Adenoma?
Oral Contraceptives
251
What drugs (3) causes hepatocellular carcinoma?
1) Vinyl Chloride 2) Aflatoxin (Aspergillus mold) 3) Thorotrast
252
Can O.C. cause hepatocellular CA?
Yes
253
What is fulminant hepatic failure (FHF)?
acute liver failure w/ encephalopathy within 8 weeks of hepatic dysfunction
254
What is the MCC of FHF? (drug)
acetaminophen
255
What is the MCC of FHF? (organism)
virus
256
Other cause of FHF?
Reye's Sx
257
What is hemochromatosis?
unrestricted reabsorption of IRON (small bowel)
258
What is the mode of inheritance of hemochromatosis?
autosomal recessive
259
What are the laboratory findings of hemochromatosis?
- increase serum iron - decrease TIBC - increase % saturation - increase serum ferritin
260
What is the best screening test?
increase serum ferritin
261
What are the manifestations of hemochromatosis?
- bronze skin - pancreas (malabsorption and DM) - restrictive cardiomyopathy - liver anormalities including hepatocellular CA in 30%
262
What is the Tx of hemochromatosis?
phlebotomy
263
What is Wilson's Dz?
defect in Copper (Cu+) secretion into bile - bile is Copper deficient or - defect in synthesis of ceruloplasmin
264
What is ceruloplasmin?
protein that binds to Copper low ceruloplasmin so can't bind Copper - so increase of Cu in blood
265
What are some of the clinical manifestations of Wilson's Dz?
Kayser-Fleishcher rings in eye
266
What is the Tx of Wilson's Dz?
penicillamine
267
What nuclei is attacked in Wilson's Dz?
lenticular nuclei degeneration
268
What are the symptoms of degeneration of the lenticular nuclei?
- chorea - rigidity - basal ganglia dementia
269
What part of the eye is affected w/ Kayser-Fleischer rings?
outer part of decemet | cornea
270
What organism causes chorioamnionitis?
Step. agalactiae
271
When does pre-eclampsia and eclampsia occur? trimester...
3rd trimester
272
What is the Diagnosis if pregnant woman presents w/ pre-eclampsia in first trimester?
hydatidiform mole
273
What two substances are increased in pre-eclampsia?
Angiotensin II | TXA2
274
What substances are decrease in pre-eclampsia?
PGE1 and NO
275
What are two substances in pre-eclampsia that are vasoconstrictors?
Angiotensin II | TXA2
276
What two substances are vasodilators in pre-eclampsia?
PGE1 | N.O.
277
Tx for Eclampsia?
Magnesium Sulfate
278
What is the clinical presentation of pre-eclampsia?
hypertension proteinuria pitting edema
279
What is the clinical picture of eclampsia?
same as pre-eclampsia but w/ seizures or convulsions
280
Should BUN be increase or decreased in normal pregnancy?
decreased in normal pregnancy
281
Should GFR be increased or decreased in normal pregnancy?
Increased
282
``` What do we find in lab. for pre/eclampsia? BUN Uric Acid Serum Creatinine GFR transaminases ```
``` BUN increased uric acid increased creatinine increased GFR decreased transaminases increased ``` Schistocytes/anemia/thrombocytopenia
283
What kind of plancenta do Siamese twins have?
Monochorionic Monoamniotic planceta

USMLE (13 decks)

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