W5D2 Flashcards
40F
headaches + insomnia + diaphoresis + unintentional wt loss
neoplastic mass = excessive hormone excretion
Tumor cells = electron-dense + membrane secretory granules
IH = synaptophysin + chromogranin + neuro-specific enolase
Pheochromocytoma
headaches + insomnia + diaphoresis + unintentional wt loss = catecholamine secretion
IH = synaptophysin + chromogranin + neuro-specific enolase = MEN2A/B
32M
Self-limiting watery diarrhea post travels
Enterotoxins
E. coli = promotes fluid + electrolyte secretion from intestinal epithelium
9month
High fever breaks
rash
HHV3
Roseola
9month
cough, coryza, conjunctivitis
Koplik spots
Measles
9month
rash started on face and has spread to trunk
Rubella
Linkage disequillibrium
inherited haplotype more or less often than expected
22F
Ab pain
tingling in limbs
anxiety + difficulty concentration + insomnia
Tx: heme preparation
Dx
Acute intermittent porphyria
5P’s
Painful ab
Port-wine pee
Polyneuropathy
Psychological disturbances
Precipitants = ALA increased + CYP inducers + EtOH
MOA: precipitants or congenital (AD - porphobilinogen deaminase)
64M
LE pain + swelling + redness
100.4F
erythema = midcalf w/ indistinct border
neutrophilic leukocytosis
Dx
Cellulitis =
nonpurulent cellulitis = B-hemolytic streptococci
Nerve that is irritated
external auditory canal - close contact with posterior wall
Vagus
Nerve that is irritated
external auditory canal - excluding the posterior wall
mandibular branch of trigeminal
depression of the nasal bridge
bulging forehead
short upper & lower extremities
normal torso
Achondroplasia
AD - FGFR3 gene (chondrocytes)
endochondral ossification = long bones affected
Congenital rubella sx
Growth restriction
Sensorineural hearing loss
Heart + Eye + CNS issues
Congenital rubella syndrome prevention
Maternal LIVE attenuated vax before conception
52F
B/L tremor
Mother had a similar issue
Essential tremor (AD) improves w/ EtOH consumption
Tx: Propranolol
Sjogren syndrome increases the risk of
Non-Hodgkins lymphoma
Scleroderma increases the risk of
glomerulonephritis
Single-stranded DNA binding protein
Stabilization of unwound template strands
DNA polymerase III
DNA synthesis (5′ → 3′ polymerase activity)
Proofreading (3′ → 5′ exonuclease activity)
DNA polymerase III DNA synthesis
5′ → 3′ polymerase activity
DNA polymerase III Proofreading
3′ → 5′ exonuclease activity
DNA polymerase I
Same as DNA polymerase III
Removal of RNA primer (5′ → 3′ exonuclease activity) & replacement with DNA
DNA polymerase I Removal of RNA primer
5′ → 3′ exonuclease activity
Bordetella pertussis pathogenesis
Tracheal cytotoxin = destroys ciliated epithelial cells
pertussis toxin = AB toxin = increase cAMP = inhibits phagocytosis = lymphocytosis
tx for neonatal w/d from opioids
Morphine
lowering alpha from .05 to .01 =
greater confidence
8M
Sickle cell anemia
infection
causes
encapsulated bacteria
MOST COMMON: Strep pneumo
N. meningitides + H. influ
Mitochondrial inheritance pattern –> what genetic variability
Heteroplasmy = normal + mutant genomes coexist on the same genome
68M
persistent back pain
metastatic cancer
Prostate cancer
RV vs LV
RV =
1. more collateral circulation
2. increased ischemic preconditioning
3. receives perfusion during systole & diastole
62M
biopsy prostate
might cause injury to
inferior hypogastric + splanchnic nerve = erectile dysfunction
Plasma concentration in reduced when
there is delayed absorption or high 1st pass metabolism
Mushroom toxin inhibits
Amatoxin inhibits RNA poly 2 = mRNA is inhibited
Synovial cell hyperplasia
RA
Fissuring & flaking of articular cartilage
OA
Poor night vision
optic disc pallor
areas of dark discoloration in retina
attenuation of retinal vessels
Genetic progressive retinal dystrophy (pigmented epithelium + photoreceptors)= Retinitis pigmentosa
7M
epistaxis
BM = fat
pancytopenia
Aplastic anemia
High FSH & LH
Low testosterone
Azoospermia
Klinefelter syndrome
Media grows=
1. round to oval budding yeast
2. germ tubes incubated a 37 C serum
Candida albicans = normal oral flora
Periductal lymphocytic infiltration of labial glands
Sjogren syndrome = dry people
32F
6 months of persistent diarrhea
tea-colored odorless watery stools
lack of gastric acid secretion
Somatostatin relieves sx
Vasoactive Intestinal Peptide (VIP) = stimulates bicarbonate + chloride secretion (increase cAMP) = loss of Na+/Cl-/H2O
Pancreatic islet cells = VIPoma
26F
Swallows pills
Pupils <2m
Temp, BP, Tidal vol?
ALL LOW
opioids causes hypothermia
Tx for manic features
Valproate + Carbamazepine + Lithium
Lamotrigine = for depressive features
Which hyperlipidemia rx combination is more likely to cause myopathy
Statins + Fibrates
Fibrates impair hepatic clearance of statins
54M
splenomegaly
pancytopenia
dry tap
dx
Hairy cell leukemia (lymphocytes w/ cytoplasmic projections)
Gerstmann syndrome affects
angular gyrus (dominant parietal lobe = usually Left)
How does Fibrates increase formation of cholesterol gallstones
inhibits 7a-hydroxlase
Oxidases cholesterol & plays a role in bile synthesis
Vegans are at risk for which deficiencies
B12 & Iron
40F
elevated Alkaline Phosphatase
what should you check next
GGTP = biliary tract test
Difference between Clotrimazole vs Nystatin vs Mupirocin
All topicals
Clotrimazole = dermatophytes
Nystatin = Candida
Mupirocin = Impetigo
Tinea pedis tx
microazole
clotrimazole
terbinafine
tolnaftate
6hour
drooling + coughing
perioral cynosis
failure of foregut to separate from airway
Increase prevalence chances PPV and NPV by
increasing PPV and decrease NPV
