UW3 Flashcards
1
Q
Reversal of opiod
A
Naloxone
2
Q
loss of coordination, nystagms and acute brain syndrome (disorientatin, poor judgement, memory loss). Associated with trauma
A
Substance induced psychosis from PCP abuse
3
Q
endocardial cushion defect (ASD, regurgitant AV valves) is seen in what developmental disorder
A
Down syndrome
4
Q
Hypertrophic cardiomyopathy is seen in what developmental defect
A
Friedreich ataxia
5
Q
Situs inversus
A
Kartagener
6
Q
Cystic medial necrosis (aortic dissection), Mitral valve prolapse
A
Marfan
7
Q
valvular obstruction due to cardiac rhabdomyoma
A
Tuberous sclerosis
8
Q
Aortic coarctation and bicuspid valve
A
Turner syndrome
9
Q
difficulty rising from chairs and combing hair are examples of
A
Proximal muscle weakness
10
Q
bilateral stiffness of shoulder and pelvic girdle muscles, fever, weight loss and increased sed rate. Associated with temporal arteritis
A
Polymyalgia Rheumatica
11
Q
Drug abuse: violent, dissociations, nystagmus, ataxia
A
PCP
12
Q
Drug abuse: visual hallucinations
A
LSD
13
Q
Drug abuse: Chest pain, seizures, mydriasis
A
Cocaine
14
Q
Drug abuse: violent, psychosis, choreiform movements, tooth decay
A
Methamphetamine
15
Q
Drug abuse: increased appetite, impaired time perception, conjuctival injection
A
Marijuana
16
Q
Drug abuse: Depressed mental status, Miosis, Respiratory depression
A
Heroin
17
Q
course of the Median nerve in the forearm
A
Between the flexor digitorium superficialis and flexor digitorum profundus
18
Q
Denervation of Median nerve leads to what deformity
A
loss of thenar eminence and “ape hand”
19
Q
Course of the musculocutaneous nerve
A
Between the biceps brachi and coracobrachialis. Injury results in inability to flex
20
Q
Course of the ulnar nerve
A
Between the flexor carpi ulnaris and flexor digitorium profundus in forearm. Between olecranon and medial epicondyle of humerus
21
Q
Injury to ulnar nerve
A
claw hand deformity due to paralysis of intrinsic hand muscles
22
Q
Course of the radial nerve
A
through the supinator near the head of the radius. Injury causes wrist drop (loss of extensors)
23
Q
Number of people who must be treated before an adverse event occurs
A
Number needed to harm= 1/attributable risk
24
Q
Attributable risk
A
Event rate of treatment - control
25
How is flow related to the radius in a vessel?
Inversly proportional raised to the 4th power
26
Mechanism of Digoxin
Block NaK ATPase and decrease AV nodal conduction by increased PS tone (vagal)
27
Low plasma sodium and osmolality, inappropriately concentrated urine, increased urinary sodium and normal body volume ( RAS intact)
SIADH ( small cell lung cancer)
28
What can be used to determine if malabsorption is due to pancreatic or intestinal pathology?
D-xylose (can be absorbed without amylase)
29
What does the deep peroneal nerve innervate?
Extensors and great dorsiflexors
30
What does the superficial peroneal n. innervate?
Peroneal muscles and skin of the toes
31
Compression or leg fracture causing foot drop
Damage to the common peroneal n ( crosses lateral neck of fibula)
32
Damage to femoral nerve
Loss of knee jerk
33
Damage to tibial nerve
Loss of plantar flexion (motor to popliteus and flexors of the foot)
34
Overflow incontinence
Impaired detrusor contractility or bladder outlet obstruction
35
Stages of lobar pneumonia
Congestion (24 hr), Red hepatization (2-3 days), Gray hepatization ( 4-6 dyays), resolution
36
High doses of ACHEi with no improvement with edrophonium
Cholinergic Crisis
37
What is the mechanism of cholinergic crisis?
High doeses of ACHEi increases AcH in synapases causes excessive stimulation that results in muscles that are refractory to future impulses. Presents as muscle weakness that does not improve with edriphonium
38
vitamin deficiency that appears similar to B12 but without megaloblastic anemia, hypersegmented neutrophils or increased serum methylmalonic acid
Vitamin E
39
PKU
Phenylalanine hydroxylase. Requires BH4
40
Maple syrup urine disease
branched chain ketoacid dehydrogenase
41
Alkaptonuria
Deficiency of homogentisic acid oxidase
42
splitting of S2 that does not change with respiration
ASD
43
Systolic ejection murmur that increases with standing
Hypertrophic cardiomyopathy ( decreased in size of left ventricular outflow tract)
44
Splitting of S1 accenutated on inspiration
delayed closure of tricuspid. Seen in Right BBB or tricuspid stenosis
45
Power of a study
Ability to detect a difference between groups when a different truly exists. Increases when sample size
46
Full bladder sensation and inability to pass a foley
Urethral injury
47
Autoregulation of BP in coronary arteries is mostly controlled by
Nitric oxide and adenosine
48
Impaired balance, difficulty speaking with elevated transaminases
Wilsons disease. Kayser Flesicher ring
49
Treatment of DKA
Insulin and normal saline ( drops potassium due to intracellular shift of K)
50
Mitochondrial diseases display variability in clincal findings. What explains this?
Heteroplasmy ( condition of having different organellar genomes in a single cell)
51
Monoclonal antibody that binds IgE
Omalizumab
52
Monoclonal antibody that binds TNF
Infiximab, adalimumab
53
Decoy TNF receptor
Etanercept
54
Monoclonal antibody that binds HER2/neu
Trastuzumab
55
Hydrocephalus, intracranial calcifications and chorioretinitis
Congential Toxoplasma
56
What determines the potency of an anesthetic?
Minimal alveolar concentration (MAC) percentage that renders 50 percent of patients unresponsive to stimuli
57
What determines the onset of action for an anesthetic?
Blood/gas partition
58
SE of statins
hepatitis and myopathy
59
SE of niacin
cutaneous vasodilation, hyperglycemia (acanthosis nigricans), hyperuricemia, Hepatitis
60
SE of Fibric acid
Gallstones, myopathy
61
Bile acid binding resins
GI upset, Hypertrigyceride, malabsorption
62
peripheral displacement of nuclei, dispersion of Nissl substance in neurons indicate
Axonal regeneration
63
Burkitt lymphoma is a proliferation of what type of cells?
B cell proliferation. EBV can increase c-myc translocation (8,14)
64
Atrophic skin changes, cold induced vasospasm
CREST Syndrome (sclerodactylyl and Raynaud)
65
CREST Syndrome
Calcinosis, Raynaud, Esophageal dysmotility, Sclerodactyly, Telangietasia (anti-centromere antibody)
66
What does an accented heart sound over left sternal border suggest
pulmonary coponent of second heart sound suggests increase in pulmonary artery pressure and pulmonary hypertension
67
Diffuse injury to pulmonary microvasculature or alveolar epithelium, resulting in increased pulmonary capillary permeability and leaky alveolocapillary membrane
ARDS
68
ARDS
increased pulmonary capillary permeability leads to interstitial and alveolar exudate and edema. Decreases lung compliance, increases work of breathing and V/Q mismatch. Normal capillary wedge pressure.
69
tall stature, gynecomastia and small, firm teste
Klinefelter
70
Arachnodactyly, scoliosis, aortic root dilation
Marfan
71
Short broad fingers, transverse palmar crease
Down Syndrome
72
Macrosomia, large jaw, large ears, thin face, macroorchidism, mental retardation
Fragile X (CGG)
73
If the 95% CI for the mean difference between 2 variables includes 0
Null hypothesis is not rejected so there is no significant difference
74
If the Cl between 2 groups overlap, is there a significant difference?
no
75
If 95% CI for a RR or OR includes 1 is the null hypothesis rejected?
no
76
Percentage indicating the actual difference in event rate between control and treatment groups
Absolute risk reduction
77
Percentage indicating relative reduction in treatment event rate compared to control
Relative risk reduction (ARR/ control rate)
78
Ratio of the probability of an event occurring in the treatment group compared to the control group
Treatment rate/ Control rate
79
number of individuals that need to be treated to prevent a negative outcome in one patient
Number needed to treat (NNT= 1/ARR)
80
treat anemia due to chronic renal failure
Epo
81
Koilonychia
Spoon nails seen in iron deficiency
82
polyuria, polydipsia, volume depletetion, hyperglycemia, low bicarb, high anion gap, decrease sodium
DKA
83
What electrolyte must you monitor in DKA?
Potassium
84
Plantar flexion
Tibial (Gastrocnemius, soleus, plantaris)
85
Inversion of the foot
Tibal n (tibialis posterior)
86
Tibial nerve innervates
Flexors of the lower leg, flexors of the toes and skin of the sole of the foot
87
Course of the tibial nerve
Branch of the sciatic that goes through the popliteal foxxa
88
Key findings of DIC
Prolonged PT and PTT, Thrombocytopenia, microangiopathic hemolytic anemia, low fibrinogen, elevated fibrin split products, low factor 5 and 8
89
Penetrating injury to the second intercostal space at L. sternal border
Pulmonary trunk
90
Penetrating injury to the 4th intercostal space in the midclavicular line
left lung and left ventricle
91
stab would to the back immediate right of the vertebral body
IVC
92
penetrating injury at left sternal border at 4th intercostal space
Right ventricle
93
Gastric erosions
Do not penetrate the muscularis mucosa
94
Gastric ulcer
Extend into the submucosal layer and the muscularis propria
95
Basement membrane splitting
Membranoproliferative GN and alport syndrome
96
Diffuse thickening of glomerular capillary walls
Membranous glomerulopathy
97
Linear IgG and C3 deposits on IF
Goodpasture
98
narrow, high arched palate, low hairline, low set ears, bicuspid aortic valve, horseshoe kidney, cubitus valgus
Tuners Syndrome
99
individual inherits 2 copies of a chromosome from one parent and no copies from the other
Uniparental disomy (Prader Willi and Angelman)
100
Infection + hypotension, tachycardia, tachypnea and temperature
Septic shock
101
Early sepsis
Increased cardiac output, peripheral vasodilation and warm extremities
102
stimulates neutrophil migration to site of inflammation
Leukotriene B4
103
Stimulates growth and differentiation of stem cells in bone marrow
IL 3
104
Stimulates growth of B cells and increases TH2 t helper T cel
IL 4
105
Anti-inflammatory cytokine produced by macrophages and TH2 helper T cell
IL 10
106
Produced by T cells and recruits leukocytes and activate phagocytosis
INF gamma
107
Function of the 16s rRNA
initiation of protein synthesis. Binds Shine Dalgarno sequence in mRNA and allow mRNA and 30 risomal subunit to bind
108
Midshaft humerus fracture
Deep brachial artery and radial nerve
109
Short acting BZD
Alprazolam, Triazolam, Oxazepam
110
Medium acting BZD
Estazolame, Lorazepam, Temazepam
111
Long acting BZD
Chlordiazepoxide, clorezepam, Diazepam, Flurazepam
112
Transference
unconscious shifting of emotions associated with one person to another
113
Acting out
unconcious wishes or impulses are expressed through actions
114
Projection
misattributing ones own unacceptable thoughts and feelings to another
115
Pancreatitis with respiratory distress
ARDS from diffuse injury to pulmonary microvasculature and kealy alveolocapillary membranes ( exudate and necrotic tissue make up hyaline membrane)
116
Crackles (rales)
Alveolar edema and atelectasis
117
Cytokeratin is used as IHC marker for what cells
Epithelial cells
118
MPO is used as a marker for what type of cells?
Myeloid cells
119
Vimentin is used as a marker for what type of cell?
Vimentin
120
Chromogranin is used as a marker for what type of cell?
Neuroendocrine
121
stimulated by decrease in pH of CSF ( increased paCO2) increases respiration
Central chemoreceptors
122
Senses PaO2 and stimulated by hypoxemia
Peripheral chemoreceptor
123
C fibers that regulate duration of inspiration depending on degree of lung distension to prevent from hyperinflation
Pulmonary stretch receptors (Hering Bruer reflex)
124
TCA toxicity
sodium bicarbonate
125
Barbituate poisoning
Diuretic with urinary alkalization
126
Salicylate (asa)
alkalinization
127
Unique histology of duodenum
Brenner's glands (secrete alkaline mucus), cryts of lieberkuhn
128
unique histolory of jejunum
plicae circulares
129
unique histology of ileum
peyers patches
130
unique histology of colon
no villi
131
Obesity, hirsutism, oligomenorrhea
PCOS
132
Ambiguous genitalia, hypotension, hyponatremia
21 hydroxylase deficiency
133
Mechanism of action of terbinafine
Squalene epoxidase inhibitor
134
Mechanism of action of amphotericin B and Nystatin
Binds to ergosterol
135
Mechanism of action of caspofungin
blocks synthesis of Beta D-glucan (Candida and Aspergillus)
136
Mechanism of Griseofulvin
binds polymerized microtubules and discupts fungal mitotic spindle to prevent mitosis
137
Where is secretin secreted from?
S cells in duodenum in response to acid. Increases bicarb secretion from pancreas
138
What hormones are secreted by the pancreas
Insulin, glucagon, somatostatin
139
Characteristics of anaplasia
Loss of cellular polarity with disruption of normal architecture. Pleomorphism. High N to C ratio. Mitotic figures. Giant Multinucleated tumor cells
140
Role of HIV gp120
viral adherence
141
Role HIV gp41
Fusion
142
Unilatera hearing loss with facial numbness and weakness
Intracranial schwannoma (cerebellowpontin angle)
143
Obstructive hydrocephalus ( headache, vomiting, AMS) and Parinaud syndrome (upward gaze palsy)
Pineal tumor ( dorsal midbrain)
144
Dermatitis, diarrhea, dementia
Pellagra (Niacin deficiency)
145
Phenylalanin derivatives
Tyrosine, Dopa (melanin), Dopamine, NE, Epi
146
Tryptophan derivatives
Niacin, Serotonin
147
Glycine derivative
Porphyrin, Heme
148
Arginine derivatives
Creatinine, Urea, Nitric oxide
149
Cofactor in Heme synthesis for ALAS
B6 pyridoxine
150
17a hydroxylase deficiency
no androgens, hypertension
151
21a hydroxylase deficiency
lots of androgens, low sodium
152
hyperdensity in sulci on CT with headache
Subarachnoid hemorrhage
153
Mechanism of action of thiazolidinediones
Bind to PPAR-y which increases expression of adiponectin and increase lipid metabolism and increase insulin sensitivity in tissues
154
which DNA polymerase inhibitor does not require phosphorylation by viral kinase?
Cidofovir
155
How do you calculate power?
1- Beta ( type II error) No difference even though one exists
156
Type I error
probability of seeing a difference when no difference exists ( p- value)
157
Accumulation found in Tay Sach
GM2 ganglioside, no hepatosplenomegaly
158
palpable swelling in newborn that is only comfortably when held sideways. Favors looking in one direction
Congenital Torticollis
159
Angiokeratoma, painful neuropathy, cardiovascular, renal disease
Fabry disease, a-galactosidase, ceramide trihexoside
160
Gaucher cells, hepatosplenomegaly, pancytopenia, severe bone and joint pain
Gaucher disease, B-glucocerebrosidase, Glucocerebroside
161
Gargoylism, corneal clouding, hepatosplenomegaly, developmental delay
Hurler syndrome, a-L-iduronidase, Dermatan and heparan sulfate
162
Gargoylism, NO corneal clouding, hepatosplenomegaly
Hunter syndrome, Induronate sulfatase. Dermatan and heparan sulfate
163
Hepatosplenomegaly, cherry-red spot in macula, foam cells, progressive neurodegeneration
Niemann Pick, sphingomyelinase. Shpingomyelin
164
Cherry red spot, progressive neurodengeration, NO hepatosplenomegaly
Tay sachs. B-hexosaminidase A. GM2 gangliside
165
Progressive neurodegeration, optic atrophy
Krabbe disease, Galactocerebrosidase. Galactosylsphingosine and galactocerebroside
166
Muscle wasting, dementia, ataxia
Metachromatic leukodystrophy. Arylsulfatase A. Cerebroside sulfate
167
which cancer drug can cause burning on urination and urgency?
Cyclophosphamide
168
Which cancer drug can cause leg swelling and orthopnea?
Doxorubicin associated CHF
169
Which cancer drug can cause dry cough and exertional dyspnea?
bleomycin
170
Which cancer drug can cause tarry stool and fatigue?
alkalating agents
171
which cancer drug can cause abdomina pain and jaundice?
mercaptopurine
172
What percentage of values lie within 1 standard deviation?
68
173
what percentage of values lie within 2 standard deviations?
95
174
what percentage of valules like within 3 standard deviations
99.7
175
non-rhythmic conjugate eye movements associated with myoclonus
opsoclonus-myoclonus syndrome
176
opsoclonus, 2 year old, hypotonia, myoclonus, abdominal mass
Neuroblastoma
177
teenagers, malignant bone tumor
Ewing sarcoma
178
2 year old, palpable flank mass. Tumor that resembles primitive metanephric tissue
Wilms tumor
179
2 yr old, brain tumor, gait and limb ataxia
Medulloblastoma
180
type of sensitivity in acute hemolytic transfusion reaction
Type II antibody mediated (complement mediated cell lysis)
181
type of sensitivity reaction in Rh incompatibility
Type II antibody mediated
182
urticaria or itching after transfused blood
Allergic reaction (type I) IgE mediated. Seen in IgA deficient patients with anti-IgA antibodies
183
Mutations associated with early alzheimer
APP on chr 21, Presenilin 1 (chr 14) and presenilin 2 ( chr 1)
184
Mutations associated with late onset familial alheimer
E4 allel on apoE
185
Mutation in hyptrophic cardiomyopathy
Beta myosin heavy chain
186
Findings in cholestasis
acholic stools and dark urine ( obstruction of biliary tree)
187
Juandice, unconjugated hyperbilirubinemia, positive combs test, hemolytic anemia
Rh+ born to Rh - mothers
188
liver biopsy shows oval to round intracytoplasmic hepatocyte inclusions that appear eosinophilic and PAS positive
Alpha 1 antitrypsin
189
centrilobar necrosis (hepatic vein)
drugs, ischemic injury, toxins, hepatitis
190
periportal hepatitic fibrosis
chronic viral hepatitis
191
which nerves are affected in saddle anesthesia
S3-S5
192
Low back pain radiating to one or both legs, saddle anesthesia, loss of anocuaneous reflex, bowel or bladder dysfunction and loss of ankle jerk reflex with plan flexion weakness of feet
Cauda equina syndrome
193
anesthesia or parathesias in the glutea region inferior to the iliac crest and anteriorly on the thigh inferior to the femoral triangle and inguinal ligment
L2 lesion
194
Decreased knee jerk reflex and patellar reflex. Paresthesias and weakness over anterior thigh
L3-4 lesion
195
loss of sensory or parethesias over posterior leg and thigh
S1-2 (sciatic nerve) loss of achilles reflex
196
Bone pain, elevated alk phos. Biopsy showing lamellar bone
Paget disease
197
MEN 1
parathyroid, pancreas, pituitary
198
MEN 2A
Medullary carcinoma of thyroid, pheo, parathyroid
199
MEN 2B
Medullary carcinoma of thyroid, pheo, mucosal neuroma
200
MEN 2A and 2B are associated with what mutation
RET proto-oncogene affecting neural crest cells
201
Primary cells responsible for inflammatory response in gout
neutrophils
202
Ulcers on the anterior wall of the duodenum are more like to cause
Perforation
203
Ulcers on the posterior wall are more likely to cause
Hemorrhage (erosion into GDA)
204
From which artery does the common hepatic arise from?
celiac trunk and bifurcates into proper hepatic and GDA
205
the inferior pancreacticoduodenal artery is a branch of
the SMA. Supplies the lower duodenum and head of pancreas
206
Metheamine silver or mucicarmine stains are use for what organism
Cryptococcus
207
TB like pulmonary disease. Dimorphic fungi found intracellularly in macrophages
Histoplasma
208
large, thick walled spherules that contain endospores
Coccidioides
209
bronchiectasis with eosinophilia
Aspergillus
210
Crescents in IF of renal biopsy
Rapidly progressive GN
211
Diffuse granular pattern of IgG and C3 in capillary walls and mesangium
Post strep GN
212
Linear deposits of IgG and C3
Goodpasture (type I RPGN)
213
down and out gaze with normal light and accommodation
Diabetic mononueropathy
214
Where is the area postrema located?
Dorsal medulla
215
Intraepidermal vesicles, superficial epidermal hyperkeratosis producing scales, epidermal hyperplasia (ancanthosis) or chronic inflammatory infiltrate
Active eczema
216
what are the local cutaneous adverse effects of chronic topical corticosteroid administration?
atrophy, thinning of dermis associated with loss of dermal collagen (drying, cracking or tightening of skin, telangiectasia and ecchymoses)
217
what is the polyadenylation signal?
AAUAAA
218
how can you tell if a cell is a blast cell?
large cell size (compared to RBC) with high nucleus to cytoplasm ratio
219
What is the criteria for diagnosing AML?
\>20% blast cells
220
Spike and dome on EM
Membranous glomerulopathy
221
hypercellular glomeruli
membranoproliferative
222
Painless hematuria after URI with IgA deposits
Berger disease
223
Effacement of foot processes
Minimal change and FSGN
224
Hypertrophic cardiomyopathy is associated with which murmur?
Mitral regurgitation
225
what enzyme contributes to pigment stones?
Beta glucuronidase
226
small cells with dark, round nuclei and small rim of cytoplasm
Lymphocytes
227
asthmatic with wrist drop, eosinophils,anti neutrophil myeloperoxidase
Churg strauss
228
Eosinophils, elevated IgE and IgG antibodies to aspergillus
Allergic bronchopulmonary aspergillosis
229
Direct thrombin inhibitors
Lepirudin and agatroban
230
primary use for lepirudin and agatroban
heparin induced thrombocytopenia
231
Inhibits ADP mediate platelet aggregation
Ticlopidine and clopidogrel
232
Use for Ticlopidine and clopidogren
unstable angina and non-Q wave MI
233
Mechanism of finbrinolysis agents
Covert plasminogen to plasmin
234
Use for TPA
acute MI, PE and arterial thrombosis
235
mechanism for aspirin
irreversibly acetylates platelet COX-1 to decrease formation of TXA2
236
what part of the heart does the RCA perfuse?
Sinoatrial and AV node
237
How can inferior MI change heart rate?
Bradycardia due to decreased perfusion of SA and AV node
238
What is an effective treatment for inferior MI?
atropine due to vagal influence on SA and AV nodes increases heart rate (inferior MI can cause bradycardia due to decreased SA and AV node perfusion)
239
Why can atropine result in glaucoma?
Mydriasis results in narrowing of anterior chmaber angle and decreased outflow of aqueous humor
240
Scopolamine
Anticholinergic used for motion sickness. SE: sedation
241
Benztropine
Anticholinergic for Parkinsons
242
oxybutynin
anticholinergic for neurogenic (spastic) bladder
243
Ipratropium
Anticholinergic for Asthma and COPD (bronchodilation)
244
ground glass infiltrates diagnosis with silver staining of fluid collected during bronchoscopy
Pneumocystis jiroveci
245
Requires L-cysteine to grow
Legionella
246
Renal angiomyolipoma, seizures, patches of skin that lack pigment
Tuberous sclerosis (brain hamartoma, ash leaf spot)
247
Neurofibroma, optic glioma, pigmented nodules of iris (Lisch nodules), café au lait
Neurofibromatosis type I
248
Cerebellar hemangioblastima, retinal hemangioma, liver cysts
Von Hippel Lindau
249
Port wine stain, leptomeningeal capillary venous malformation
Sturge Weber
250
Hemorrhagic telangiectasia with recurrent GI bleed
Osler Rendu Weber
251
at what age do children understand the finality of death?
age 6
252
Recurrent otitis medi, chronic diarrhea, pneumocystis
SCID (humoral and T cell deficiency)
253
Reccurent infections with extracellular, encapsulated organisms
Agammaglobulinemia
254
recurrent cutaneous abscesses
Phagocytic defects (chronic granulomatous disease)
255
Increased susceptibility to Neisseria
Complement deficiency ( associated with lupus like syndrome)
256
cells in cell mediated immunity
CD4, CD8, NK, macrophages
257
what is anergy?
lack of response to foreign substances
258
components of humoral immunity
antibodies, B cells
259
pulses paradoxus, arterial hypotension
cardiac tamponade
260
cardiogenic shock
Cardiac output becomes insufficient to provide necessary oxygen to patient's tissues
261
Paloating radial pulse that disappears with inspiration
cardiac tamponade
262
Beat to beat variation in magnitiude of pulse pressure in presence of regular cardiac rhythm
Pulsus alternans in pts with left ventricular dysfunction
263
two distinct peaks during systole and diastole palpated in carotid arteries in pts with severe systolic function
Dicrotic pulse
264
Low magnitude pulse with delayed peak of aortic stenosis
Pulsus Parvus et tardus
265
rapid ejection of large stroke volume against decreased afterload seen in high output conditions (PDA) or AV fistula
Hyperkinetic pulse
266
Ferments mannitol
S. aureus
267
Novobiocin resistance
S. saprophyticus
268
Prolonged QT with neurosensory deafness, autosomal recessive
Jervell and Lange-Nielsen
269
Prolonged QT no deafness, autosomal dominant
Romano-ward
270
sudden syncopal episode
sudden cardiac arrhythmia
271
mutations in dilated cardiomyopathy
cardiac cell cytoskeletal proteins or mitochondrial enzymes
272
Mutations in hypertrophic cardiomyopathy
cardiac sarcomere proteins
273
Vasopressin increases permeability to what substances in the collecting duct?
water and urea
274
Biopsy shows central collecting of epithelioid macrophages surrounded by rim of mononuclear cells
Non-caseating granuloma
275
Bronchial challenge testing
Methacholine assesses bronchial hyperreactivity
276
Forceful blow to lateral kneed while low extremity is fully extended and foot is planted
ACL, MCL, meniscal tear
277
Forceful blow to medial knee while leg is extended
Lateral (fibular) collateral ligament
278
Abnormal pressur gradient between LV and aorta
Aortic stenosis
279
holosystolic heard at apex that radiates to axilla
Mitral regurgitation
280
ventricular volumne overload is associated with what mumur?
Mitral regurgitation
281
S3 is an indicator of
large regurgitant volume (CHF)
282
Fever for 5 days, bilateral nonexudative conjunctivitis, mucositis, coronary artery aneurysm, swelling an erythema of palms and soles, cerival lymph node
Kawasaki Disease
283
What enzyme catalyzes translocation?
Elongation factor 2
284
What enzyme catalyzes peptide bond formation
Peptidyl transferase
285
Mutation in thalassemia intermdia
Kozak sequence of beta globin chain causing hypochromic, microcytic anemia
286
which enzyme in glyconeogenesis is only present in liver cells?
Glu 6 phosphatase ( muscles don’t make glucose!)
287
What enzyme is deficiency in McArdle's syndrome
Glycogen phosphorylase leads to decreased breakdown of glycogen during exercise
288
muscle cramping, pain and myoglobinuria during exercise
McArdles failure of glycogenolysis (glygocen phosphorylase deficiency)
289
Early systolic, high frequency click over right second interspace
Bicuspid aortic valve
290
cardiac anomalies in down syndrome
ASD, VSD, complete Atrioventricular canal
291
cardic mumur in Maran
Mitral prolapase (mid systolic click)
292
insufficiently cooked boiled eggs
Salmonella
293
Side effets which diuretic: hypokalemia, hypomagnesemia, hypocalcemia, volume depletetion, hyponatremia, decreased GFR, hypotension, ototoxicity
Loop diuretic
294
Side effects of which diuretic: hypokalemia, hyponatremia, hypomagnesemia, hypotention, volume depletion and hypercalcemia
HCTZ
295
Side effects of which diuretic: hyperkalemia
Spironolactone
296
Side effect of which diuretic: nausea, vomiting, headache and hypernatremia
Mannitol
297
Side effect of which diuretic: somonolence, parethesias and urine alkalinization
acetazolamide
298
caput medusae and esophageal varices, acites
portal hypertension
299
secretory diarrhea
Bacterial toxins or VIPoma
300
which viruses do not produce thymidine kinase?
CMV and EBV
301
Acyclovir, famciclovir and valaciclovir are effective in which viruses
HSV and VZV which encode thymidine kinase
302
What is use dependence
affinity for activated and inactivated channels and little affinity for resting sodium channels
303
Lichtenberg figure
fern leaf pattern on skin pathognomonic of lightening strike
304
severe nosebleeds, pink spider like lesions in oral and nasal mucosal, face and arms
Osler weber Rendu
305
cutaneous facial angioma, leptomeningeal angioma, metal retardation, hemiplegia, skull radiopacities. Tram track calcification
Sturge weber
306
recurrent nephrolithiasis, hexagonal shaped crystals
Cystinuria, cystine stones
307
stones that are octahedron with x in center
Calcium oxalate
308
stones that are rectangualar prisms
Struvite stones
309
Stones that are rhombus or diamond
Uric acid
310
Stones that are hexagonal
Cystine
311
How does an AV shunt change pressure volumne loop
Increase preload and decrease afterload
312
Increase preload on Pressure Volume loop
Increase end diastolic volume and increase stroke volume
313
Increase Afterload on pressure volumn loop
decrease stroke volume, increase end systolic volume
314
Increase contractility on pressure volume loop
Increase stroke volume, increase ejection fraction and decrease End systolic volume
