Uworld 3 Flashcards
complete contralateral sensory loss =
right side of the face and right side of body
(often with severe proprioceptive defeacts that lead to unsteady gait and falls)
lesion to VPL or VML thalamic nuclei
thalamic syndrome!
lesions frontal cortex lesions
deficits in higher brain function: alters patterns of spontaniety, creativity, social behavior, sexual interst
lesion in internal capsule
motor deficiet
lesion to pons
coma, bilateral paralysis, pinpoint lesions, rigidity, death
lesion to caudate nucleaus
transient hemiparesis + frontal lobe symptoms (eg. inattentiveness, abulia, forgetfullness)
primary causes of lacunar infarcts
lipohyalinosis and microatheromas
common causes of lipohyalinosis and microatheromas?
hypertension and DM
how do varicose veins happen?
prolonged increases in intraluminal pressure or loss of vessel wall tensile strength ==> causes venous dilation ==> retrograde flow from incompetant valves ==> venous stasis/ congestion with lower extremity edema.
what are common complications of varicose veins?
from poor blood flow, painful thromboses, stasis dermatitis, skin ulcerations, poor wound healing, superficial infections
what is phlegmasia alba dolens and what is it caused by?
“painful white leg” from iliofemoral venous thrombosis in preggers
because DVTs ==> from uterine pressure on the deep pelvic veins (causing venous stasis) and incr hypercoag
dmg to central portion of spinal cord
syringomyelia
dmg to dorsal columns and dorsal roots of spinal cord
tabes dorsalis (neurosyphilis) –lateral corticospinal tract NOT involved
dmg to upper and lower motor neurons
ALS
dmg to anterior horn of spinal cord
poliomyleitis
bilateral loss of DCML, hyperreflexia, babinski +, numbness
B12 deficiency –> degeneration to dorsal columns, lateral corticospinal tracts, perpipheral axonal degeneration
bilateral pain and temp loss, flaccid paralysis and atrophy of intrinsic hand muscles
syringomyelia
loss of position and vibration, ataxia, pain and paresthesias of extremities
tabes dorsalis
spasticity and hyperreflexia, flaccid paralysis, atrophy, fasiculations
ALS
lower motor neuron weakness …progressive?
poliomyelitis
complete loss of strength below level of injury with loss of pain and temp, but vibratory intact
anterior spinal artery syndrome! (compression of artery running along front of spinal cord)
high PTT, normal PT, platelet count, bleeding time
Hemohilia A or B
high bleeding time, normal or high PTT, normal PC and PT
von Willebrand factor deficiney
high PT, PTT, bleeding time, and decreased platelets
DIC
high bleeding time, normal PC, PT, PTT
Uremic platelet dysfunction (HUS?)
high PTT, normal PT, PC, Bleeding time
Heparin
high PT, super weak incr PTT, normal platelets, and bleeding time
warfarin
high bleeding time, low platelets, normal PT and PTT
Immune thrombocytopenia
what does vWF do?
promotes platelets adhesion by binding and crosslinking GP1b with exposed collagen under the damaged endothelum.
what does protein C do?
acts with protein S to inactivate the activated forms of factors 5 and 8.
when is heme: alpha 2, delta 2 found?
normal variant. makes hemoglobin A2. makes up 2-5 % of hemoglobin
when is heme: zeta 2, epsilon 2?
earliest hb. from yolk sac.
recurrent cyanotic spells counteracted by squatting
tetralogy of fallot –> to increase the amount going through the stenotic pulm valve
-prils do what to GFR?
decr it!
Have strep. bovis. what’s the next step?
Check for colon CA!!
mitral stenosis with low grade fevers neg. blood cultures
acute rheumatic fever
fatigue and exertional dyspnea 3 weeks after a tooth extraction
Strep viridans subacute bacterial endocarditis
repeated negative blood cultures with a small mitral vegetation on transesophageal echocardiogram
culture negative endocarditis
what are the culture negative endocarditis organisms?
bartonella, coxiella, mycoplasma, histoplasma, chlamydia, HACEK organism ==> H flu, actinobacillus, cardiobacterium, eikenella, kingella
persistent fever with trcuspid vegetations and tricuspid regurg on echo
IV drug use–> S. aureus
Legionella culture
buggered charcoal yeast extract (BCYE) agar supplemented with L-cysteine and iron
budding yeast that form germ tuebs at 37 degrees C.
Candida alibcans
presence of candida in sputum…what is it?
normal…contaminant. upt o 40% of population has it in GI tract (and oral cavity)…so it will contaminate sputum cultures. doesn’t indicate disease
what are the receptors in the carotid sinus innervated by?
baroreceptors in carotid sinus (and carotid body chemosensors) travel up the glossopharyngeal nerve to brainsem.
what are the receptors in the aortic arch innervated by
baroreceptors in aortic arch and chemor. in aortic body travel up vagus! to brainstem
drug or HTN/ tia causes mouth ulcers and fever
TIclopidine causes neutropenia. monitor complete blood count biweekly for the first 3 months.
antiplatelet drug with mechanism: block formation of ligands
asprin. decr. thromboxande A2
antiplatelet drug with mech: ADP antagonists
clopidogrel and ticlopiine
antiplatelet drug mech: incr cAMP by decr phosphodiesterase activity
cilostazol and dipyridamole
hyperthermia, extreme generalized rigidity, autonomic instability, altered mental status
neuroleptic malighnant syndrome
anaerobic bacteria in alcoholics with pneumonia
bacteroides, prevotella, fusobacterium, peptostreptococcus
