UW13 Flashcards by Unknown Unknown

What does the VRDL, RPR evaluate for?

Presence of cardiolipin, a byproduct of treponemal infection

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Low dose vs High dose ASA

Low doses: inhibits COX-1, high doses: inhibits COX-1 and COX-2

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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

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PGI2

inhibits platelet aggregation, vasodilation, inhibits proliferation of smooth muscle cells

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Vertigo, tinnitus, hearing loss with asa

high dose asa causes salicylism. Stimulates respiratory drive= hyperpnea causing respiratory alkalosis and metabolic acidosis

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ovaries with connective tissue and no follicles

Streak ovaries (Turners)

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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

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Most common childhood brain tumor

Pilocytic astrocytoma

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Most common location of a pilocytic astrocytoma

Cerebellum

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which childhood tumor has solid and cystic components

Pilocytic Astrocytoma

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Recurrent sinopulmonary and GI infections that develops an anaphylactic reaction after transfused blood

IgA deficiency

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how does salicylate cause metabolic acidosis

increases lipolysis, uncouple oxidative phosphorylation, inhibits TCA causing an increase in ketoacids, lactate and pyruvate

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What does acute transplant rejection cause

Vascular damage (vasculitis) 1-2 weeks after transplant due to Host immune response (CD8T) against donor

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dyspnea, nonproductive cough, wheezing months after lung transplant

Brochiolitis obliterans: inflammation of small bronchioles

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characteristic finding in acute transplant rejection

perivascular infiltration

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Glucocorticoids

Increase gluconeogenesis, glycogenesis, increase muscle and fat break down,inhibits fibrobast proliferation, immunosuppressant, decrease bone mass

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Dephosphorylation of glycogen synthase

activates protein and increases glycogen synthesis

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Dephosphorylation of 1,BPatase

inactivates enzyme to inhibit gluconeogenesis

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“knee buckling”

Femoral Nerve L2-L4 (flexion of thigh and extension of leg)

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Femoral nerve compression

weakness of quadriceps, loss of patellar reflex, loss of sensation over anterior and medial thigh and medial leg

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Superior gluteal

thigh abduction

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Inferior gluteal

thigh extension

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Obturator

thigh adduction (anterior hip dislocation)

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Peau d’orange

Cooper’s ligament infiltration by invasaive breast cancer. Seen often in inflammatory breast cancer

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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)