UW13 Flashcards
What does the VRDL, RPR evaluate for?
Presence of cardiolipin, a byproduct of treponemal infection
Low dose vs High dose ASA
Low doses: inhibits COX-1, high doses: inhibits COX-1 and COX-2
How does COX-1 inhibition lead to GI bleeding?
inhibition of TXA2 mediated platelet aggregation and impairment of PGE2 and PGI2 dependeant protection of GI mucosa
PGI2
inhibits platelet aggregation, vasodilation, inhibits proliferation of smooth muscle cells
Vertigo, tinnitus, hearing loss with asa
high dose asa causes salicylism. Stimulates respiratory drive= hyperpnea causing respiratory alkalosis and metabolic acidosis
ovaries with connective tissue and no follicles
Streak ovaries (Turners)
Turner Syndrome
High arched palate, low set ears, coarctation of the aorta, bicuspid valve, streak ovaries, short stature, horseshoe kidney, broad chest with widely spaced nipples, webbed neck, low hairline
Most common childhood brain tumor
Pilocytic astrocytoma
Most common location of a pilocytic astrocytoma
Cerebellum
which childhood tumor has solid and cystic components
Pilocytic Astrocytoma
Recurrent sinopulmonary and GI infections that develops an anaphylactic reaction after transfused blood
IgA deficiency
how does salicylate cause metabolic acidosis
increases lipolysis, uncouple oxidative phosphorylation, inhibits TCA causing an increase in ketoacids, lactate and pyruvate
What does acute transplant rejection cause
Vascular damage (vasculitis) 1-2 weeks after transplant due to Host immune response (CD8T) against donor
dyspnea, nonproductive cough, wheezing months after lung transplant
Brochiolitis obliterans: inflammation of small bronchioles
characteristic finding in acute transplant rejection
perivascular infiltration
Glucocorticoids
Increase gluconeogenesis, glycogenesis, increase muscle and fat break down,inhibits fibrobast proliferation, immunosuppressant, decrease bone mass
Dephosphorylation of glycogen synthase
activates protein and increases glycogen synthesis
Dephosphorylation of 1,BPatase
inactivates enzyme to inhibit gluconeogenesis
“knee buckling”
Femoral Nerve L2-L4 (flexion of thigh and extension of leg)
Femoral nerve compression
weakness of quadriceps, loss of patellar reflex, loss of sensation over anterior and medial thigh and medial leg
Superior gluteal
thigh abduction
Inferior gluteal
thigh extension
Obturator
thigh adduction (anterior hip dislocation)
Peau d’orange
Cooper’s ligament infiltration by invasaive breast cancer. Seen often in inflammatory breast cancer
How is SLE managed?
Glucocorticoids. Risk for Cushing’s syndrome
What can lead to diffuse adrenal hyperplasia?
Chronic hypersecretion of ACTH (Cushing Disease)
Alendronate
Bisphosphoate analog of pyrophosphate. Inhibits bone resorption. Tx for osteoporosis d/t corticosteroid use
how does lowering a cutoff value affect the sensitivity of a test?
Increases sensitivity. Increase in FP, decreases PPV, and decrease FN. Specificity= TN/(TN+FP)
Sensitivity
ability of a test to rule out those with disease. High sensitivity identifies most patients with the disease
Specificity
test to exclude those without the disease. High specificity= low false positive rate
How can you prevent reccurent HSV infections?
continuously daily valcyclovir
Ulceration and necrosis in a hospitalized pt with ANC
Ecthyma grangrenosum (P aeruginosa bacteremia)
Most common cause of gram negative sepsis after UTI
E. Coli
Risk for pseudomonas infections
neutropenia, hospitalized, burns, indwelling catheters
What drug decrease the activity of platelet phosphodiesterase to prevent platelet aggregation
Cilostazol (also a vasodiltor), Dipyridamol
lung tumor seen as hilar mass (arising from major bronchi). Synaptophysin and chromogranin positive
Small cell lung cancer
How does dobutamine change a cardiac pressure volume loop
increases contractility. Higher pressures would be reached during ventricular ejection, increase in SV
How does clamping the aortic change a pressure volume loop?
increase in afterload leading to increase pressures and decrease SV
How would loss of myocardial mass change a pressure volume loop?
decreased contractility. Decrease in ventricular ejection and decrease SV
Pioglitazone
binds to PPAR-gamma to increase transcription of adiponectin to decrease insulin resistance
Glipizide
Sulfonylurea that close K(ATP) channel that causes insulin release
Repaglinide and Metaglinide
non-sulfonylurea that act by binding K(atp) and increase insulin release (shorter acting)
Exenatide, Liragluide
incretin (increases insulin secretion) TIIDM
Loss of pain and temperature involving arms and hands. Preserved touch, vibration and position sense
Syringomyelia (ventral white commissure)
What is TGF-B involved in?
Growth factor in Tissue regeneration and repair
What does interferon gamma do?
Activate macrophages
Differntial cyanosis in a child
PDA
Corkscrew esophagus
periodic non-peristaltic esophageal muscle contractions seen in diffuse esophageal spasm
Hx of headache decreased libido. B/l loss of temporal visual fields. Hypotensive and loses consciouness
Pituitary apoplexy (cardiovascular collapse due to loss of ACTH)
High orotic acid
OTC deficiency, citrullinemia
What is a short acting benzodiazepine?
Triazolam (
Dyspnea, hypotension, tachycardia after Beta lactam
Anaphylatic shock. Give Epinephrine. DUH.
Myastenia gravis is associated with what tumor
thymoma or thymic hyperplasia
Eczema, immunodeficiency, thrombocytopenia
Wiskott-aldrich syndrome (WATER)
colicky flank pain, gross hematuria, passage of tissue fragments in urine
Papillary necrosis
Hypertension, proteinura, edema in pregnancy
pre-eclampsia
Treatment for depression leading to QRS prolongation
TCA
Treat TCA overdose
sodium bicarbonate
initial resistance to passive extension followed by sudden release ( Clasp-knife spasticity)
UMN lesion
Pure motor neuron weakness affecting arm, leg, lower face
Internal capsule
Strongyloides diagnosis
larvae in the stool
Schistosoma diagnosis
Eggs in the stool
T. Solium (other tapeworms) diagnosis
Proglottids in the stool
Giardia diagnosis
Cysts and trophozoites in stool
Cast of leg causing weakness in inversion and dorsiflexion
Common peroneal at the neck of the fibula
Lateral compartment of the leg is innervated by
Superficial peroneal
Anterior compartment of the leg is innervated by
Deep peroneal
what structures course through the popliteal fossa?
tibial nerve, popliteal artery and vein
Main site of lipid absorption
jejunum
key landmark for locating trigeminal nerve
middle cerebral peduncle
what are some causes of B12 malabsorption
Pancreatic insufficiency, intestinal bacterial overgrowth, ileal disease
Trabecular thinning with fewer interconnections
Osteoporosis
Subperiosteal resorption with cystic degeneration
Hyperparathyroidism
Persistence of primary unmineralized spongiosa in medullary canals
Osteopetrosis
Infertility, oligomenorrhea, hyperandrogenism
PCOS. Usually starts in teenage years
Amenorrhea, hypoestrogenism, increased gonadotrophin levels.
Premature ovarian failure
Triptans
Serotonin AGONISTS
Polycystic kidney disease
think berry aneurysms. Nimodipine shown to decrease cerebral vasospasms
positive copper reduction test but negative urine dipstick
Essential Fructoseuria (defective fructokinase)
acid a-glucosidase deficiency
Pompe disease (cardiomyopathy, muscle weakness, hypotonia)
galactosemia is caused by a defect in what enzyme
Galactose 1 phosphate uridyl transferase
What medications are contraindicated in mania?
SSRI (precipatate mania)
Tx for acute mania
Valproic acid, lithium, or carbazepine
Blowing, holosystolic murmur over cardiac apex with radiation to the axilla
Mitral regurgitation
Mid systolic ejection mumur heard over r. second intercostal space with radiation to the neck
Aortic stenosis
Opening snap at diastolic with low pitched mid diastolic rumble
Mitral stenosis
most common cause of spontaneous lobar hemorrhage in elderly
Cerebral amyloid angiopathy (occipital and parietal lobes)
