UWorld part 2 Flashcards
what does the middle meningeal artery branch off of
Maxillary artery
What does the maxillary artery branch off of
External carotid artery.
What is tachyphylaxis
Rapidly declining effect after a few days of use
alpha adrenergic agonists have tachyphlaxis, resulting in..
rebound rhinorrhea (which is nasal congestion w/o cough, sneezing, or post nasal drip. Rhinorrhea may or may not be present)
Nitroglycerine and tachyphylaxis
Dimished release of NO from target cells. ergo why you need drug free intervals of 8-10 hours.
How is fibromyalgia dx?
Dx made in pt with chronic pain and fatigue for >3 months in absence of physical or laboratory findings suggestive of an inflammatory etiology
tx of fibromyalgia
gradual incremental aerobic exercise
TCA
SNRI
Ankylosing spondylitis
Chronic inflammatory disease of the axial skeleton characterized by progressive pain and stiffness of the spine, sacroiliitis, and positive HLA-B27 serology
Dermatomyositis
autoimmune condition causing bilateral proximal muscle weakness assoc with violaceous eruption on the eyelids and knuckles and elevated creatine kinase levels
Polymalgia rheumatica is what
frequently assoc with what
Inflammatory disorder that affects patients >=50 yo and causes bilateral pain and morning stiffness in the shoulders and hips, weight loss, fever, malaise, and an elevated ESR
Freq assoc with giant cell (temporal) arteritis
Lichen planus
What might be on the plaque surface
5 Ps -Polygonal -Planar -Pruritic -Purplish -Plaques on the wrists, hands, trunk, and legs
Finely reticulated scale termed Wickham’s striae may be present on the plaque surface.
Dermatitis herpetiformis presents how?
Strong association?
erythematous pruritic papules, vesicles, and bullae ahtat appear bilaterally and symetrically on the extensor surfaces.
Strongly assoc with celiac disease
why is dietary fructose rapidly metabolized compared to other sugars (glucose/galactose/mannose)
Dietary fructose is phosphorylated in the liver to F1P and is rapidly metabolized b/c it bypasses PFK-1, the major RLS of glycolysis.
Bone specific alk phos reflects ___ activity
osteoblastic activity.
what markers for osteoclastic activity and which is most reliable?
Urinary deoxypyridinoline (most reliable)
tartrate resistant acid phosphatase
Urinary hydroxyproline
How is bone specific ALK phos differentiated from liver alk phos
Bone specific is easily denatured by heat (bone=boil)
how to treat post operative urinary retention w/ incomplete bladder emptying?
Muscarinic agonist (bethanechol)
or
Alpha1 blocking drug
Enfuvirtide mechanism
binds to heptad repeat 1 (HR1) of gp41, preventing from undergoing conformational changes necessary for the viral membrane to fuse w/ the target cellular membrane. as a result HIV genome denied entry into uninfected CD4+ t cells
why does left ventricular ruptured free wall cause death
profound hypotension from cardiact tamponade, restriction of ventricular filling during diastole.
cardiac tamponade triad
- elevated jugular venous pressure
- profound hypotension
- muffled heart sounds
First step in dx malabsorption
Sudan III stain of stool identifying fecal fat >7 g/day
schistocytes are dx of
traumatic mechanism, either Microangiopathic hemolytic anemia
or
Mechanical damage
HUS vs. DIC
in HUS, Coag system is not activated so coag tests are normal (pt and ptt)
causes of microangiopathic hemolytic anemia
- HUS
- TTP
- DIC
- Malignant hypertension
- Metastatic carcinoma