UWorld_4.5 Flashcards
Cardiac consequences of chronic arteriovenous fistula
- acutely: decreased TPR ==> increased CO and increased venous return
- over time ==> increased sympathetic nervous system ==> increased cardiac contractility, vascular tone, and circulating blood volume
Characteristics of Paget Disease of the Bone
- problem w/overactive osteoclasts
- osteoclasts originate from hematopoietic progenitor cells
- RANK-L and M-CSF play an important role in osteoclast differention
Presentation of HepB
- “serum-like sickness”
- malaise, fever, skin rash, pruritis, lymphadenopathy and joint pain
- anorexia, nausea, jaundice and RUQ pain may ensue
- ALT > AST + bilirubin, alk phos
- vs. Hep C = mild, usually asymptomatic
Phenoxybenzamine: MOA
- irreversible alpha 1 & 2 antagonist
Listeria characteristics + immune defense
- gram + rods
- tumbling motility @ 22C, can be cultured @ as low as 4C
- narrow zone of beta-hemolysis
- intact cell-mediated immunity is essential for elimination
Cells of origin of SCC
- neuroendocrine origin
- markers
- neuron-specific enolase
- chromogranin
- synaptophysin
- neurofilaments
Neurblast tumor in children
- non-rhythmic conjugate eye movements + myoclonus
- arises from adrenal medulla
- increased n-myc copies
Characteristics of medullary carcinoma of thyroid
- extracellular deposits of amyloid <== formed by calcitonin secreted by parafollicular c-cells
- amyloid stains with congo red
- nests of uniform/spindle or polygonal cells
Migratory thrombophlebitis association
cancer (hypercoag is common paraneoplastic)
Extended consumption of appetite suppressants ==>
pulmonary HTN, cor pulmonale, RVH
Nitroprusside toxicity + antidote
- nitroprusside ==> cyanide ==> thiocyanate by liver rhodanase
- sodium thiosulfate = antidote for cyanide toxicity
- donates sulfar to help liver rhodanase
Drug that can induce prinzmetal angina
- Ergonovine ==> vasoconstriction via alpha-adrenergic and serotonergic mechanisms
- can be used to dx prinzmetal
Important tx guideline for hospital tx of alcoholics
No glucose without thiamine in thiamine-deficient patients
Characteristics of syndenham’s chorea
- possible sequelae from rheumatic fever
- restless and purposeless jerking movement a few months after sore throat
Cause of increased risk for gallstones in Crohn’s patient
- decreased bile reabsorption ==> increased loss in feces
- ==> increased lithogenicity of bile
Most common elbow injury in children
- radial head subluxation ==> annular ligament injury
- commonly in younger children (<5)
- little distress unless moving elbow
- hold arm close, extended with pronation
MG antibodies =
MS antibodies =
- MG = anti-ACh receptor
- MS = anti-presynp Ca channel
- assoc. with Lambert-Eaton paraneoplastic syndrome
Gastric ulcer vs. erosion
- ulcer extends through muscularis mucosa and erosion does not
Myoclonus vs. Dystonia
- myoclonus = sudden, brief shock-like contraction
- dystonia = prolonged muscle contraction
facial pain + H/A + black necrotic eschar @ pt. w/diabetic ketoacidosis ==> dx?
- mucormycosis
- rhizopus
- mucor
- absidia
- dx via biopsy
- broad, nonseptate hyphae w/right angle branching
Median n. course
between humeral and ulnar head of pronator teres ==> between flexor digitorum superficial and flexor digitorum profundus =+> carparl tunnel
Bell’s palsy =
- CN VII palsy
- facial m. paralysis
- decreased lacrimation
- decreased taste from ant. 2/3
Increasing/decreased LVO obstruction murmur intensity
- decreased preload ==> decreased EDV ==> increased intesity
- increased preload/afterload ==> increased EDV ==> decreased intensity
Type I vs. Type II Famililal hypercholsterol
- Type I = chylomicrons
- LP lipase is low
- elevated TGs
- increased risk for acute pancreatitis
- skin lesions
- Type II = LDL receptor/apoB100
- tendon xanthomas
- xanesthesas (e/g/ on eyelids)
- early CAD
