uWorld 41 Flashcards
what are the signs of digoeroge (22q11.2 micro deletion)
hypocalcemia (tetany, carpopedal spasms, or seizures)
loss of thymic shadow (no thymus due to 3rd pouch fucked)
recurrent viral, fungal, protozoan infections
conotruncal anomalies (interrupted aortic arch, truncus arteriosus)
what are the Ckvostek and Trousseau signs
due to HYPOCALCEMIA
Chvostek sign: twitching of the nose and lips when tapping on the facial nerve
Trousseau sign: inflation of BP cuff leads to CARPASL SPASM
what needs to be known in order to perform the amplification part of PCR
the nucleotide sequence of the regions flanking the target exon
these are used to make the PRIMERS necessary to start PCR
thermostable DNA pol, deoxynucleotide tirphosphates, and a source DNA template strand are also necessary
what is the best initial approach to someone who has drug seeking behaviors (clearly asking for specific drug and getting frustrated when you suggest otherwise)
clarify the patients medication history to determine which drugs have been prescribed, by whom, and at what frequency
state-based, online prescriptions, clarify prescription patterns, and identify patients who obtain prescriptions from multiple providers
by identifying potential opioid misuse, providers can make more informed decisions regarding pain prescriptions
hematogenous osteomyelitis is predominantly a disease of children that most frequently affects the long bones. what are the most common causes
- Staph Aureus
2. Strep pyogenes
in what phases do oocytes arrest
childhood-puberty: meiosis I arrested in PROPHASE
-chromosome pairs arranged in tetrad and in close proximity allowing for RECOMBINATION
monthly, from puberty to menopause: meiosis II arrested in METAPHASE until fertilization
when during the membrane potential is the membrane most permeable to POTASSIUM, what about sodium
potassium: during the depolarization phase (halfway down, before the undershoot)
sodium: at the peak of the membrane potential the sodium permeance is the greatest
during aerobic exercise what increased in terms of blood gas values
skeletal muscle CO2 production increased PCO2 of mixed venous blood but homeostatic mechanisms maintain arterial blood gas levels and arterial pH near the resting values
most common lung cancer in female nonsmoker
adenocarcinoma
CLUBBING and HYPERTROPHIC OSTEOARTHROPATHY
BRADYCARDIA with regular rhythm and NARROW QRS complexes but complete DESYNCHRONIZATION b/w P waves and QRS
where the beat coming from
AV NODAL CELLS (become pacemakers when conduction b/w SA and AV node gets fucked)
can occur in complete (THIRD-DEGREE) AV block: impulses from SA node cause ATRIAL contraction while AV node causes VENTRICULAR contractions
pace is about 45-55bpm
boy with left sternal murmur that accentuates with the handgrip exercise (most likely diagnosis)
VSD (often asymptomatic and detected incidentally during routine cardiac auscultation)
proly gna have a sound clip with a low pitch holosystolic murmur
they systolic ejection murmur of hypertrophic cardiomyopathy decreases when
maneuvers that INCREASE AFTERLOAD and PRELOAD (b/c increasing these attenuate the left ventricular outflow tract obstruction, and associated mitral regurgitation, by increasing left ventricular volume)
handgrip increases after load thus decreased this murmur
straining phase of the VALSALVA (decreases preload) will INCREASE IT
when would one see POPLITEAL and INGUINAL lymph node enlargement from the same thing
LATERAL lesions of the foot (drain via lateral superficial lymphatic system)
medial lesions follow the medial superficial lymphmatic system which go straight to superficial inguinal lymph nodes with no connection to the popliteal lymph nodes
where does the glans penis lymph drain
DEEP INGUINAL NODES
different from the rest of the skin of the penis and scrotum which go to the superficial inguinal nodes
what cytokines cause bacteremia and shock
IL-1, IL-6 and TNF-alpha
facial pain, headache, and nasal eschar in a patient with likely diabetic ketoacidosis
what the fuck they got
MUCORMYCOSIS
rhino cerebral infection from some spore inhalation
broad ribbon-like nonseptate hyphae with right-angle branching
tissue invasion i seen along blood vessels; vascular thrombosis and tissue necrosis can occur
to visualize do a MUCOSAL BIOPSY as this shit won’t grow in a blood culture
C5-C6 spinal nerves innervate what
biceps and brachioradialis reflexes
via musculocutanous nerve
high serum levels of what is diagnostic for 21-hydroxylase deficiency
17-HYDROXYPROGESTERONE
all patients with 17-hydroxylase deficiency appear how
phenotypically female
what is cheyne-stokes breathing and when is it seen
commonly seen in patients with advanced CONGESTIVE HEART FAILURE (CHF)
cyclic breathing pattern in which APNEA is followed by GRADUALLY INCREASING THEN DECREASING TIDAL volumes UNTIL the NEXT APNEIC period
what causes KUSSMAUL BREATHING
deep and labored breathing pattern often associated with severe metabolic acidosis
KUSSMAUL: Ketones Uremia Sepsis Salicylates Methanol Aldehydes U Lactic acidosis