UW8 Flashcards
1
Q
what L/S ratio indicates that the lung is mature?
A
>2
2
Q
When do you sample amniotic fluid for AFP?
A
fetal neural tube defect (elevated in spina bifida)
3
Q
When do you sample amniotic fluid for bilirubin?
A
Erythroblatosis fetalis
4
Q
dense pigments composed of epinephrine metabolites in lysosomes on liver biopsy
A
Dubin Johnson
5
Q
how does erythromycin affect cytochromes
A
inhibits 3A4
6
Q
Cyp Inducers
A
Carbazepine, Phenobarbitol, Phenytoin, Rifampin, Griseofulvin
7
Q
Cyp inhibitors
A
Cimetidine, Ciprofloxacin. Errythromycin, Azoles, Grapefruit juice, isonizid, Ritonavir
8
Q
chronic giardia infection
A
IgA deficiency, X-linked agammaglobulinemia, Common variable
9
Q
Ataxia, Telangiectasia, sinuopulmonary infections
A
Ataxia-telangiectasia
10
Q
Oculocutaneous albinism, pyogenic infections, progressive neurologic dysfunction
A
Chediak Higashi
11
Q
Severe bacterial and fungal infections, granuloma formation
A
Chronic granulomatous disease
12
Q
congenital heart disease, dysmorphic facies, hypocalcemia
A
DiGeorge
13
Q
Severe bacterial and viral infections, Chronic diarrhea, candidiasis
A
SCID
14
Q
Recurrent infections that worsen with age, easy bleeding, eczema
A
Wiskott Aldrich syndrome
15
Q
Absent thymic shadow
A
Digeorge, SCID
16
Q
What is the difference between HUS and DIC?
A
DIC the coagulation system is activated so PT and PTT are elevated
17
Q
conjunctival injection, tachycardia, increased appetite and dry mouth
A
Marijuana intoxification (THC acts on CB receptors which causes euphoria, sedation, slow reflexes, distorted perceptions)
18
Q
Drug intoxication: nystagmus
A
PCP
19
Q
Drug intoxidation: miosis
A
Opiate (pinpoint pupil)
20
Q
Drug intoxidation: mydriasis
A
cocaine
21
Q
4 phases of menstrual cycle
A
Follicular, ovulatory, luteal, menstruation
22
Q
Tx of anovulation
A
Menotropin (menopausal gonadotropin that acts like FSH) and hCG (acts like LH)
23
Q
Plueral plaques along lower lungs and diaphragm
A
asbestos
24
Q
Risk for gastric carcinoma
A
H. pylori, nitrosamines, smoking
25
Risk for bladder cancer
Aniline dyes, rubber industry
26
drugs with low volume of distribution tend to be confined to bloodstream why?
highly plasma protein bound and hydrophilic
27
Chest pain, seizures, mydriasis
Cocaine intoxication
28
violent behavior, psychosis, tooth decay, choreiform movements
Methamphetamines
29
increased appetite, impaired time perception, conjunctival injection
Marijuana
30
Depressed mental status, miosis, repiratory depression
Heroin (opioid)
31
Visual hallucinations, euphora, panic
LSD (hallucinogen)
32
Violent bheavior, hallucination, amnesia, nystagmus, ataxia
PCP
33
mechanism of cocaine
inhibits presynaptic uptake of monoamines. Potent vasoconstrictor
34
Entacapone and tolcapone
COMT inhibitors that prevent degradation of catecholamines
35
location of the heart
Apex is covered by Left lung beind the 5th intercostal space at the left midclavicular line. Anterior surface is mainly the RV. Inferior surface is LV and RV. Posterior surface is mainly LA
36
vomiting, lethargy, failure to thrive after initiation of breast feeding
Galactosemia due to Galactose 1 phosphate uridyl transferase (GALT) deficiency
37
bilateral cataracts
Galactokinase deficiency. Excess galactose is converted to galactitol (aldose reductase)
38
Deficient enzyme in fructose intolerance
Aldolase B
39
Hypoglycemia, lactic acidosis, hepatomegaly, hypertriglyeridemia
Von Gierke (glucose 6 phosphatase deficiency)
40
CN poisoning syndrome
Cutaneous flushing, tachypnea, headache, tachycardia, nausea, vomiting, weakness
41
CN antidote
Nitrates, Sodium thiosulfate
42
Increased white count, immature cells, and few blast cells. Low leukocyte alk phos.
Chronic myelogenous leukemia ( dx requires demonstration of t(9;22)
43
Eye down and out
CN III lesion
44
Eye deviated upward
CN IV (superior oblique)
45
Eye deviated medially
CN VI (lateral rectus)
46
Bulbus cordis
smooth portion of left and right ventricles
47
Widening of the pulse pressure
aortic regurgitation
48
M1 receptor
Brain (Gq) memory formation and cognitive functioning
49
M2 receptor
Heart (Gi): decreases HR and atrial contraction
50
M3 receptors (Lung, bladder, eyes, GI, Skin)
Gq: Bronchocontriction, detrusor contraction, miosis, ciliary m. contraction ( accomodation), peristalsis, gastric secretions, increased sweat)
51
angular stomatitis, cheilitis, glossitis, seborrheic dermatitis, keratitis, corneal neovascularization, anemia
Riboflavin deficiency (Succinate dehydrogenase)
52
t(9:22)
BCR-ABL tyrosine kinase activity leads to proliferation of granulocytic precursor (CML)
53
t(8:14)
Burkitt lymphoma makes c-myc (transcription activator)
54
t(14:18)
Follicular lymphoma causes overexpression of BCL2 (anti-apoptotic)
55
t(11;14)
Cyclin D1 on Ig heavy chain leads to increase cyclin D (mantle cell lymphoma)
56
endocardial cushion defect
Downs (ASD)
57
Ataxia, falling, loss of DTR
Friedreich ataxia
58
What is the cardiac problem in Friederich ataxia?
Hypertrophy cardiomyopathy
59
Cardovascular defect in Marfans
Cystic medial necrosis of aorta
60
3 cytogenic abnormalities in Down Syndrome
Trisomy 21, unbalanced Robertsonian translocations, Mosaicism (2 cell lines)
61
Uniparental diosmy
fetus inherits 2 copies of homologous chromosomes and no copy from the other parent. Paternal disomy exists in complete hydatidiform mole
62
vaginal bleeding with fundal size greater than dates
Hydadiform mole
63
young female with infertility, acne, hirsuitism, insulin resistance, central obesity
Polycystic ovary disease
64
elevated alk phos. What next?
Gamma-glutamyl transpeptidase to determine bone vs heptic origin (GGTP not present in bone)
65
What reactions require NADPH
anabolic reactions for fatty acid, cholesterol, steroid synthesis (electron donor= reducing agent) and is used to reduce glutathione for repairing oxidative damage
66
coin lesion with popcorn calcifications
lung hamartoma on cxr (contain mature hyaline cartilage, fat, smooth muscule, clefts lined by respiratory epithelium)
67
lung lesion along periphery along alveolar septae without invasion
Bronchoalveolar carcinoma (adenocarcinoma)
68
Abdominal pain, fever, diarrhea, shock in a patient with UC
Toxic megacolon. Get an X eay
69
What are some circumstances where minors do not require consent
Emergency care, Sexually transmitted infections, substance abuse, prenatal care
70
clock face chromatin, eccentrically placed nuclei, basophillic cytoplams
plasma cell
71
anemia, hypercalcemia, increased susceptibility to infection, AL amyloid, renal failure
Multiple myeloma
72
Chronic hypertension, intraparenchymal hyperdensity on CT
Charcot Bouchard aneurysm (deep brain structures)
73
Hypertensive arteriolosclerosis of deep brain structures and internal capsule, corona radiata are a risk for
Lacunar infarct
74
Nodular densities, eggshell calcifications of hilar nodes
Silicosis
75
electrical impulses generated by SA node
60-100 bpm
76
electrical impulse generated by AV node
45-55 bpm
77
electrical impulses below the AV node
can be as slow as 20 bpm and will show abnormal QRS due to aberrant impulse through ventricles
78
Mechanism of Fenoldopam
Dopamine D1 receptor agonist. Stimulates Gs increaes cAMP and Causes vasodilation in renal, mesenteric and coronary beds. Increased sodium and water excretion
79
What drug is used for hypertensive crisis in a patient with renal failure
Fenoldopam (vasodilator that increase renal perfusion and increases naturiesis)
80
what is the mutation in PKU
phenylalanine hydroxylase due protein misfolding
81
mutation In marfan
defect in fibrillin prevents normal formation of microfibrils
82
mutation in Friedreich's ataxia
Frataxin gene codes for mitochondrial protein. GAA repeat disrupts transcription
83
fever, malaise, dark urine, n/v with ballooning degeneration of hepatocytes
viral hepatitis
84
prolonged pruritis and fatigue
primary sclerosing cholangitis
85
Upper GI bleed and ascities
portal hypertension
86
acholic stools and bone pain
primary biliary cirrhosis
87
course of the ureters
cross over the common/ external iliac vessels and under the gonadal (uterine) vessels. Anterolateral to the internal iliac and medial to the ovarian vessels.
88
PaO2, Oxygen saturation, total O2 content in CO poisoning
Normal PaO2, decrease O2 sat. decrease total O2 content
89
what is a maneuver that can improve symptoms of paroxysmal supraventricular tachycardia
Carotid sinus massage and the valsalva maneuver can slow heart rate by slowing conduction through the AV node (abolishes re-entrant circuit)
90
tx for PSVT
adenosine
91
when do neurotube defects occur?
4th week
92
Signs of neural tube defects in amniocentesis
increased AFP and acetylcholinesterase
93
Reverse beta blocker overdose
Glucagon (works through Gs)
94
half life
Vd x0.7/ clearance)
95
RA
Symmetric polyarthritis (MCP and PIP), morning stiffness \>30 min
96
collagen synthesis
procollagen synthesized in ER (flanked by globular extensions) Transported to golgi apparatus and released into extracellular space where it is converted into tropocollagen by procollagen peptidases which then self assembly into collage fibrils that are crosslinked by lysyl oxidase
97
what affects liklihood ratios
sensitivity and specificity (not prevalence)
98
What do liklihood ratios indicate
how a positive or negative test result influences the probability of having a disease. LR\>1 presence of disease and
99
LR +
Sensitivity (1-specificity)
100
LR-
1-sensitivity/ specificity
101
JVP: x descent
relaxation of right atrium
102
JVP: y- descent
abrupt decrease in R atrial pressure during early diastole after tricuspid opens
103
JVP: a-wave
atrial contraction
104
JVP: C wave
RV contraction ( closed tricuspid bulging into atrium)
105
JVP: v- wave
increase right atrial pressue due to filing aginst a closed tricuspid valve
106
thickening and calcification of pericardium
constrictive pericarditis
107
5' to 3' exonuclease activity
DNA polymerase I (can be used to remove RNA primer and repair DNA)
108
how do BZD affect cl- channels?
increased fequency of opening
109
Diphenhydramine
reversible inhibition of H1 receptor
110
TCA
inhibit NE and serotonin reuptake
111
Barbiturates
increase the DURATION of GABA receptor Cl channel
112
Serotonin is synthesized from what amino acid
tryptophan
113
Spindle shaped tumor cells with small vessel proliferation on biopsy. Small reddish/violet maculopapular rash on colonoscopy
Kaposi sarcoma
114
inflammatory infiltrate involving mucosa and submucosa with crypt abscesses on biopsy
Ulcerative Colitis
115
hypertension, hypokalemia, metabolic alkalosis and decreased plasma renin
hyperaldosterone (Conn Syndrome)
116
Treatment for thyrotoxicosis
PTU (inhibit thyroid peroxidas), Beta blockers (decrease sympathethic outflow and decrease peripheral conversion of T4 to T3 by inhibiting iodothyronine deiodinase)
117
Hemorrhoids
Superior rectal --- middle and inferior rectal veins
118
Caput medusae
Paraumbilical veins-- superficial and inferior epigastric veins
119
signet ring carcinoma
diffuse involvement of stomach wall, plaque like appearance and cause a leather bottle stomach (gastric adenocarcinoma)
120
stomach cancer that causes a polypoid mass that can become ulcerated
intestinal type gastric adenocarcinoma
121
Rugal thickening with acid hypersecretion
Zollinger Ellison Syndrome
122
Mechanism of Neisseria meningitis
Pharynx, blood, choroid plexus, meninges
123
Mechanism of H. flu meningitis
Pharynx, lymphatics, meninges
124
risk of untreated prolactinoma
increased prolactin dereases GnRH which decreases estrogen (leading to an increase in bone loss)
125
MEN I
Parathyroidism (hyper), Peptic ulcer (gastrin secreting tumor in Pancreas), Pituitary adenoma
126
interstitial myocardial granuloma with macrophages that have slender chromatin ribbons
Aschoff bodies and Anitshow cells seen in Acute Rheumatic Carditis
127
Medial band like calcification
Monckeberg's medial calcific sclerosis (medial Calcinosis)
128
Homogenous acculluar thickening of arteriolar walls
Deposition of hyaline material is seen in hypertension
129
Granulomatous inflammation of the media
Giant cell arteritis
130
Transmural inflammation of arterial wall with fibrinoid necrosis
Polyarteritis nodosa
131
Enzyme defect in albinism
Tyrosinase
132
Reduced transfer of melanin to keratinocytes
post inflammatory hypopigmentation
133
increased melanosome aggregates in melanocyte cytoplasm
Café au lait
134
benign linear melanocytic hyperplasia
Lentigo
135
Loss of epidermal melanocyte
Vitiligo
136
foul smelling, bulky, floating stool
Malabsorption. Sudan III stool stain to assess for fat in stool
