uWorld 48 Flashcards
high doses of folate can antagonize what drug
PENYTOIN- can precipitate seizures in a select group of patients
what are signs suggestive of self induced vomiting in bulimia
pharyngeal erythema, PAROTID ENLARGEMENT, hypokalemia, and hyperamylasemia, erosion of dental enamel
describe junctional, compound, and intradermal nevi
junctional: aggregates at dermoepidermal junction, FLAT, black- to brown pigmented macules with darker coloration in the CENTER than periphery, preserved skin markings
compound: aggregates extend INTO DERMIS, RASIED papule with UNIFORM brown pigment
intradermal: EPIDERMAL NESTS of nevus cells have been LOST, dermal cells lose TYROSINASE activity and produce little to no pigment, skin- to take-colored, dome-shaped, and sometimes pedunculated
what are fibrillary waves (f waves)
seen in some patients with atrial fibrillation
irregular, low-amplitude waves b/w the QRS completes that represent the chaotic atrial activation
what is “holiday heart syndrome”
A fib in people after extensive alcohol consumption
what is neuropeptide y
polypeptide neurotransmitter found in the central and autonomic nervous systems
though tot play a role in appetite and pain perception
NPY antagonists have been investigated as potential anti obesity drug
how do you visualize trichamoniasis
wet mount (saline microscopy)
daytime sleepiness and naps that are NON-RESTORATIVE are seen in what
OBSTRUCTIVE SLEEP APNEA
what is obesity hypoventilation syndrome (PICKWICKIAN SYNDROME)
caused by restricted expansion of the chest wall due to severe obesity
leads to hypoventilation and chronically elevated PCO2 and decreased PO2
damage to the common peroneal (for drop and loss of sensation to dorsum of foot and lateral shin) happens where
FIBULAR NECK
what nerve gets injured from compression of the popliteal fossa
TIBIAL
- innervates skin of posterior calf and lateral foot
- tissues of knee joint
- muscles of plantar flexion and inversion (gastrocnemius, soleus, tibialis posterior)
antibodies to alpha3-chain of collagen type IV are seen in what
GOOD PASTURE SYNDROME
what is the VALSALVA maneuver
increase VAGAL TONE and can be used to abolish paroxysmal supraventriucalr tachycardia
RECTUS ABDOMINIS is most important muscle in achieving the increased intraabdominal and intrathoracic pressure of the Valsalva maneuver
done by FORCIBLE EXHALING against CLOSED GLOTTIS
thin stratum granulosum and prominent parakeratotic status corneum with occasional foci of neutrophil accumulation
PSORIASIS
describe psoriasis
salmon-colored rounded plaques covered in loosely adherent, silvery scale
elbows, knees, gluteal cleft, lumbrosacral area, glans penis, and scalp
caused by CD4 cells activation CD8 cells in the epidermis after interacting with antigen presenting cells in the skin
-results in production of cytokines and keratinocyte growth factors
HYPERPARAKERATOSIS, ACANTHOSIS, ELONGATION of RETE ridges, mitotic activity above epidermal basal cell layer, reduced or absent stratum granulosum
AUSPITZ SIGN- bleeding when you scratch at the scaly surface
MUNRO MICROABSCESSES- neurophils mat form spongiotic clusters in the superficial dermis and the parakeratotic stratum corneum
what property of methadone makes it good at what it do
LONG HALF LIFE (surpasses trains and withdrawal for over 24 hours)
what is synthesized by most human cells in response to viral infections
TYPE I INTERFERONS (ALPHA and BETA)
results in transcription of antiviral enzymes capable of HALTING PROTEIN SYNTHESIS, such as RNase L and protein kinase R
-enxymes are only active in presence of dsRNA (selectivity for virally infected cells)
PROMOTES APOPTOSIS
include MHC class I expression on cells (stimulates NK and CD8 killing)
fluid filled cavity in liver in conjunction with fevers, chills, and right upper quadrant pain
HEPATIC ABSCESS
developed countries: BACTERIAL INFECTION
underdeveloped countries: PARASITIC INFECTION (enamoeba, echinococcal)
how do pyogenic bacteria gain access to liver
BILIARY TRACT INFECTION (ascending cholangitis- GRAM NEG like e coli or klebsiella)
PORTAL VEIN PYEMIA (bowel or peritoneal sources- gram neg and enterococci)
hepatic artery (systemic hemorrhagic seeding)
direct invasion form an adjacent source (peritonitis, cholecystitis)
penetrating trauma or injury (mixed anaerobic and aerobic)
CA 19-9 is a marker for what
pancreatic cancer
what is seen in REYES SYNDROME
MITOCHONDIRA fucked (aspirin metabolites fuck up beta oxidation by reversible inhibition of mitochondria enzymes) MICROVESICULAR STEATOSIS hypoglycemia vomiting hepatomegaly coma
ENCEPHALOPATHY from HYPERAMMONEMIA
apoptosis of hepatocytes, acinar necrosis and periportal mononuclear inflammatory infiltration are characteristic LM finding of what
VIRAL HEPATIITS
bile duct destruction, periductal granulomatous inflammation and bile duct proliferation are seen in what
primary biliary cirrhosis
what is a pure motor nerve that passes through the POSTERIOR TRIANGLE OF THE NECK
SPINAL ACCESSORY NERVE (CN XI)
what does the trapezius do
elevate scapula, rotate it upward, stabilize shoulder
originates from the spinous processes and ligaments of the cervical and thoracic vertebra down to T12 and then inserts on lateral 1/3 of clavicle, acromion, and spine of scapula
if its FUCKED: DROPPING of SHOULDER, impaired ABduction of arm ABOVE HORIZONTAL, and winging of scapula
injury to the deltoid fucks up abduction of the arm when
blow horizontal
C5-C6 axillary nerve
what does serratus anterior do
ortingates on first 8 ribs and inserts on medial border of scapula
rotates scapula upward, allowing abduction of the arm over the head
innervated by long thoracic nerve
injury: impaired abduction and winging of scapula
what are the hallmark sings of acute viral hepatitis historically
hepatocyte necrosis- CELLULAR SWELLING and CYTOPLASMIC EMPTYING (“BALLOONING DEGENERATION”)
apoptosis- CELLULAR SHRINKAGE and nuclear fragmentation with intense EOSINOPHILIA (COUNCILMAN BODIES)
Mononuclear infiltrate- presence of virally infected and dying hepatocytes promotes mononuclear inflammation in the sinusoids and portal tracts
amebic liver abscesses caused by ENTAMOEBA histolytica infection can produce what kind of necrosis
LIQUIFACTIVE
if events are independent, the probability that all events will turn out the same is the product of the separate probabilities for each even. the probably of at least 1 event turning out differently is given as
1 - P(all events being the same)
so if test is negative in 95% of patients who dont have disease, the odds of getting a positive result in a group of 8 people withOUT the disease is:
(1-(0.95)^8)
how is copper normal excreted
hepatic excretion into the bile
when does presbyopia star
40-50
what are skin rhytides
WRINKLES
directly causes by chronological aging (with a contribution form the harmful effects of UV light)
with aging skin becomes atrophic and fragile, with reduced elasticity and subdemral fat
dermal and epidermal thinning, flattening of dermoepidermal junction, a decreased number of fibroblasts, reduced synthesis and increased breakdown of collagen and elastin
patients with MYOPIA (increased eye axial length so image focuses before retina) see improvements with aging why
PRESBYOPIA compensates for the myopia by displacing the image backward
what causes presbyopia
denaturation of structural proteins in lens
loss of lens elasticity
acute lesion of the cerebellar vermis cause what
trucnal and gait ataxia (impaired modulation of medial-descding motor systems)
involvement of lower vermis and flocculonoudlar lobe causes vertigo/nystagmus due to dysregulation of vestibular nuclear complex
