uWorld 56 Flashcards
what are the most important mitochondrial myopathyies
myoclonic epilepsy with ragged red fibers (MERRF- seizures are short lived and triggered by startle with proximal muscle weakness)
leber optic neuropathy (blindness)
mitochondria encephalopathy with stroke-like episodes and lactic acidosis (MELAS)
nephrotic syndromes are associated with a hyper coagulable state why
loss of ANTITHROMBIN III in urine leads to RENAL VEIN TROMBOSIS
patient with membranous nephropathy, flank pain, hematuria, and right-sided varicocele likely has what
RENAL VEIN THROMBOSIS from loss of ANTITHROMBIN III in urine causing hyper coagulable state
ELEVATED LACTATE DEHYDROGENASE, FLANK PAIN, HEMATURIA
ISOLATED RIGHT-SIDED VARICOCELE indicates what
IVC OCCLUSION
MALIGNANT TUMOR or THROMBUS
following IV administration, highly lipophilic drugs will be rapidly distributed to organs with high blood flow (brain, liver, kidneys, lungs), they are then REDESTRIBTED WHERE
tissues with relatively lower blood flow (SKELETAL MUSCLE, FAT, BONE)
seen in PROPOFOL USE (short duration of action)
vesicles, ulcers, then crusting in the genetialia or buttocks
HSV
INGUINAL LYMPHADENOPATHY
itchy, painful, vesciular
what is locomotor ataxia
seen in neurosphyillis due to tabes dorsalis
what is the Kehr sign
referred pain to C3-C5 shoulder region from any abdominal process (ruptured spleen, peritonitis, hemoperitoneum) irritating the phrenic nerve sensory fibers around the diaphragm
what are caspases
proteolytic enzymes that destroy cell components
contain cysteine and care able to cleave aspartic acid residues (Cysteine-ASPartic-acid-proteASES)
what are some complications of diphtheria
submucosal edema and pseudomembrane aspiration can obstruct respiratory tract, causing SUFFOCATION
systemic absorbed diphtheria toxin had prediction for brain and heart tissue:
- MYOCARDITIS/HEART FAILURE
- NEUROLOGIC TOXICITY
what is the most common cause of postpartum hemorrhage
UTERINE ATONY- failure of uterus to contract adequately after delivery
usually respond to utertotonic agent
removal of placenta in pieces manually after delivery and post part hemorrhage suggests what
PLACENTA ACCRETA
scar tissue from previous urger (c-section) can result in malformed or ABSENT DECIMAL LAYER b/w placenta and myometrium, allowing for direct MYOMETIRAL ATTACHMENT by the villous tissue and preventing normal placental separation after fetal delviery
what is Guyon’s canal
fibroosseous tunnel between HOOK of HAMATE and PISIFORM bone that the ULNAR NERVE (C8-T1) runs through
subluxation of the radial head can injury can fuck up what
deep branch of the RADIAL NERVE during its passage through the SUPINATOR CANAL
weakness during finger and thumb extension (“finger drop”)
what causes alcohol-induced hepatic statosis
decrease in free fatty acid oxidation secondary to excess NADH proaction by the 2 major alcohol metabolism enzymes alcohol dehydrogenase and aldehyde dehydrogenase
what is seen in Mockebergs
medial band-like calcifications
DOES NOT NARROW VESSEL LUMEN
seen on x-ray or as palpable mass
what are c-Jun and c-Fos
nuclear transcription factors that directly bind DNA via a leucine zipper motif
what is S-100
homodimeric calcium-binding proteins, similar in structure to calmodulin and important in intracellular functions such as protein phosphorylation and cell growth and differntiation
elevated initial CEA levels indicates what
WORSE PROGNOSIS
endoneurial inflammatory infiltration of peripheral neves is characteristic of what
guillian-barre syndrome
mutation of a myelin protein gene is the pathogenesis of what
CHARIOT-MARIE-TOOTH disease (a neural form of muscular atrophy)
weakness of foot dorsiflexion due to involvement of the common peritoneal nerve
what causes diabetic neuropathy
diabetic microangiopathy which leads to nerve ischemia
accumulation fo sorbitol, leading to osmotic nerve injury
what is seen in OVARIAN VEIN THROMBOSIS
example of septic pelvis thombophelbitis, a complication that can occur via vaginal or cesarean birth
FEVER and LOCALIZED ABDOMINAL PAIN ONE WEEK after delivery
what does the paraventricular nucleus of the hypothalamus do
ADH, CTRH, oxytocin, TRH secretion
what doe the arcuate nucleus of the hypothalamus do
secretion of dopamine (inhibits prolactin), GHRH and GnRH
what does the supraoptic nucleus of the hypothalamus do
ADH and oxytocin secretion
what signifies irreversible injury in myosites
appearance of vacuoles and phospholipid-containing amorphous densities within mitochondria
implies permanent inability to generate further ATP via oxidative phosphorlyaiton
what ulcers are rarely malignant and thus do not require biopsy
DUODNEAL
gastric ulcers can be associated with MALTOMA or gastric adenocarcinoma
what is the most common benign liver tumor
CAVERNOUS HEMANGIOMA
congenital malformation that ELARGE by ECTASIA, not hyperplasia or hypertrophy
occur singly or in multiples and are well-circumscribed masses of spongy consistency, typically measuring less than 5cm in width
consist of cavernous, blood-filled vascular spaces of variable side lined by a single epithelial layer
collagenous scars or fibrous nodules may be seen in association with tomboys
abdominal pain and RUQ fullness moisture symptomatic though
why dont you biopsy a suspected cavernous hemangioma of the liver
DO NOT BIOPSY A HEMANGIOMA it has been known to cause fatal hemorrhage and is of low diagnostic yield
what are lightning related complications
cardiac: cardiac arrest, ARRYHTMIAS (FATAL)
neurologic: peripheral nerve damage, seizures, confusion, RESPIRATORY ARREST (FATAL), autonomic dysfunction
dermatologic: LICHTENBERG FIGURES (pathognomonic)- FERN LEAF PATTERN, superficial burns
MSK: rhabdo, bone fractures, compartment syndrome
other: cataracts, ruptures tympanicmembranes, curling ulcers
bluish neoplasm under the nail bed
GLOMUS TUMOR (GLOMANGIOMA) or subungal melanoma
GLOMUS is modified SMOOTH MUSCLE CELLS that are used for THERMOREGULATORY- shunts blood away from skin surface in cold temperatures in order to prevent heat loss
what are risk factors for pre-eclampsia
nulliparity
personal or family history of pre-eclampsia
obesity
chronic hypertension
what is gestational HTN
new-onset elevated blood pressure at more than 20 weeks gratin
NO PROTEINURIA or END-ORGAN DAMAGE (this is seen in pre-eclampsia)
what causes pre-eclampsia
abnormal placentation
abnormal planental vasculature leads to placental hypoxia and ischemia, which in turns results in release of antiangiogenic factors into material circulation- causes endothelial injury increasing permaibiltiy and causing proteinuria
what is arteriovenous nicking
FUNDOYCOPIC finding in CHRONIC HYPERTENSION
an early manifestation of retinopathy
