Week 4 Flashcards
What are the vitamin K dependent factors?
2, 7, 9, and 10
What stops the horseshoe kidney from rising?
Inferior Mesenteric Artery
What is the most common cause of osteomyelitis?
Staph Aureus
A woman is having difficulty recognizing faces, central vision, and needs increased light to read. What is the most likely Dx?
Macular Degeneration
What is the ideal test specificity?
100%
What class of diuretics is known to limit calcium loss?
Thiazides save calcium and LOOps LOOse calcium.
What vitamin deficiency is associated with night blindness, dry skin, keratin debris on conjunctiva?
Vitamin A
55 year old female is diagnosed with HER2+ breast cancer. After 1 month on chemo she is SOB and finds it difficult to lay flat. What medication probably caused this?
Trustuzumab (side effect: cardiotoxicity)
What HLA subtypes are associated with DM1?
HLA-DR3, HLA-DR4
What is the most common cause of hypoparathyrodism?
Thyroidectomy
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle antibodies
- 40 yo f with no PMH presenting with altered mental status. Unable to obtain history, but you have labs. Na 138, K 6.0, Cl 108, CO2 18, BUN 120, Cr 5.9, Gluc 128. What is the next best step in management?
Calcium gluconate to prevent arrhythmia due to hyperkalemia.
what is the MOI of achondroplasia?
AD
13 year old boy w/ autism comes to you for evaluation. He tends to be moody and has a learning disability. He has macrognathia as well as large ears. He won’t let you inspect his genitalia. What is his condition?
Fragile X Syndrome (Trinucleotide repeat CGiantGonads [CGG])
What is the treatment for diarrhea caused by giardia?
Metronidazole
Cardiac abnormality where you hear an S2 split?
atrial septal defect
Patient w/ MI. 4 days later he developed pulmonary edema. What happened?
Papillary muscle rupture w/ mitral regurgitation
What is the treatment for temporal arteritis?
High dose steroids
25 year old female noticed easy bruising, heavy menstrual periods, and gum bleeding. She is not on any medications. FHx neg for bleeding disorders. Normal PE except petechia. Labs have HB 9.8, WBC 2500, PLT 20k, RET count 0.8. Bone marrow is hypocellular. What is the most likely dx?
Aplastic anemia
What hormone prevents uterine contraction?
Progesterone
What is the Tx of choice for social phobia disorders?
CBT & SSRI
What encapsulated pathogen is most common organism responsible for osteomyelitis in sickle cell patients?
salmonella
35 yo female w/ h/o myalgia in needs. Neg for erosions. Low grade fever, urinalysis shows dysmorphic red blood cells. CBC shows leukopenia. Most likely Dx?
SLE
What are brunner glands found?
In the duodenum
What is the Tx of choice for carbon monoxide poisoning?
Oxygen.
What malignancy can actinic keratosis lead to?
Squamous Cell Carcinoma
what is this arrhythmia?
Atrial flutter
You are studying T2DM in a small community of 5,000 adults. If survival time was increased, would that increase or decrease prevalence of diabetes?
Increase.
What liver tumor is associated with oral contraceptive?
Hepatic adenoma.
What is a hormone that inhibits prolatin release?
Dopamine
What AB isotype is able to cross the placenta?
IgG
A 40 yo female complaining of dysphagia to solids and liquids for the past several months. Associated with intermittent chest pain and reflux. The GI series and EGD are consistent with acalacia, no tumor was found, magnometry shows peristalsis. What is the best Tx of choice?
Myotemy.
Patients with chronic granulomatous disease have increased susceptibility to what organisms?
Catalase positive organisms. Nocardia, staph, serratia, candida, listeria, e.coli, bercolderia, pseudomonas, aspergillosis, bordetella pertussis.
What medication would you use to treat Graves’ disease in a patient who was pregnant in her 1st trimester?
PTU.
what is the most likely diagnosis in a patient w/ chovausier sign on physical exam?
Pancreatic cancer.
What pelvic structures are at risk during complete hysterectomy?
Ureters
2mo old infant with congenital cardiac defect, failure to thrive from birth, micrognathia, prominent occiput, contractures of hips and fingers, small pelvis, and rocker bottom feet. What abnormality does this infant most likely have?
Edward’s Syndrome (Trisomy 18)
Cryoglobulinemia presents with purpura, arthralgia, and glomerular nephritis. What is the likely viral pathogen?
Hepatitis C
Which calcium channel blockers have an effect on cardiac contractility?
Diltiazem and Isoniazid (Nondihydroperidines)
What is the MOA of isoproterenol?
B1=B2 agonist
Which thyroid cancer has a very poor prognosis?
Anaplastic
A 12 yo boy w/ mass under nipple that began when going through puberty. What action do you take?
Monitor. Gynocomastia is physiologic with boys going through puberty.
Which dopaminergic pathway is associated with the positive (delusions and hallucinations) symptoms with increased activity?
Mesolimbic pathway
Patient with SLE complaining of pain in left hip and limping. She has been on prednisone and mycophenalate. Physical exam, pain on active and passive motions of the left hip. What is most likely diagnosis?
Osteonecrosis of femoral head.
Most likely dx in previously healthy 35 year old patient with painful rectal bleeding?
External hemorrhoids
What hernia has higher risk of strangulation and bowel infarction?
Indirect hernias
What common structure in the urethral glands in females and the prostrate in males derived from fetal development?
Urogenital sinus
What is the most appropriate treatment to combat organophosphate poisoning w/ CNS symptoms?
Atropine
what hormone do the cells involved in medullary carcinoma secrete?
Calcitonin
Name one adverse effect of clozapine.
Agranulocytosis, metabolic syndrome, seizures
Most likely diagnosis if the biopsy showed lymphocytic infiltration and eosinophilic hurthle cells?
Hashimoto thyroiditis
What pharyngeal arches of posterior third of the tongue derived from and which cranial nerves innervate the majority of the sensation and taste?
Tongue is 3rd and 4th pharyngeal arches for posterior third of tongue and majority of sensation and taste is cranial nerve 9.
Name 3 electrolyte abnormalities seen in tumor lysis syndrome
Hyperphosphatemia, hyperkalemia, hyperuricemia
- 35 yo female with acute diarrheal illness diagnosed w/ campylobacter infection and 10 days later complains of weakness in her lower and upper extremities, mild paresthesia, on physical exam generalized physical exam muscle weakness with hyporeflexia, but no sensory changes in the sphincter or incontinence. What is the most likely diagnosis?
Guillan-barre
What hormone is directly responsible for ovulation?
LH
What is an indication for ranolazine?
Angina
If there is an infarct that effected the superior olivary nucleus in the brainsteam, what would be the presentation of the patient?
Hearing loss
- You are a well respect psychiatrist in your community. You fully treated a patient for general anxiety disorder so they no longer need your services. Your patient tells you they are attracted to you and you are attracted to them. Can you date them?
no you cannot date your patient
Would the murmur of a hypertrophic obstructive cardiomyopathy increase or decrease when the patient squats?
It will decrease
Philadelphia chromosome is most commonly associated with what?
CML
What pigmented skin disorder is caused by destruction of melanocytes?
Ventiligo
What is the embryologic origin of common carotid arteries and proximal part of the internal carotids?
Third aortic arch
What is the MOI demonstrated by the pedigree shown?
If all women who have it give it to their children it is mitochondrial.
What vision defect do you expect to see in a patient with gigantism secondary to growth hormone secreting adenoma?
Bitemporal hemianopsia
What is the mechanism of action of sildenafil?
cGMP phosphodiesterase inhibitor
PT w/ occasional exertional syncope. On PE there is a loud P2, wide S2 split and a tricuspid regurgitation. Right heart cath is done and pressures obtained. Normal PCWP, elevated right atrial pressure. What is the most likely dx?
Pulmonary Hypertension
Where in the female reproductive tract would you find simple cuboidal epithelium?
Ovaries
what is the mechanism of action of medication used to reduce nightmares in PTSD?
Prazosin is used and it is an alpha antagonist.
A young Asian patient develops flushing whenever he drinks alcohol. What enzyme is the patient deficient in?
Aldehyde dehydrogenase
A defect in what part of the conduction system is responsible for first degree heart block and Mobitz Type I?
AV node
32 yo f w/ pain and swelling in PIP and MCP joints on both hands. In the morning she feels very stiff lasting about an hour. No rash, no fever, no mouth ulcers. Pain in both knees. Sed rate and CRP are elevated. RF is neg. What is the most specific test you can order?
Anti-CCP
What is the target of auto-antibodies in Lambert Eaton syndrome?
Presynaptic voltage gated calcium channels
Flutamide is used in what prostate disease?
Prostate cancer
what is paroxysmal noctural dyspnea
Breathless awakenings from sleep
- 21 yo sexually active college student presents w/ odorous green vaginal discharge and itchiness, multiple oval flagellated motile organisms are seen on wet mouth. What is the most likely diagnosis?
Trichomoniasis
What pigmented skin disorder is caused by decreased tyrosinase activity or defective tyrosine transport?
Albinism
What is the first initial test to order for a pt w/ chest pain?
EKG
What causes the blue sclera in a pt w/ osteogenesis imperfecta?
From translucent connective tissue over choroidal veins.
What structures are supplied by the superior mesenteric artery>
Distal duodenum to splenic flexure
what vitamin deficiency leads to osteomalacia?
Vitamin D
a carciac myxoma is most commonly found in what heart chamber?
Left atrium
What part of the nephron do loop diuretics work on?
thick ascending limb
You are asked to start an IV in the antecubital fossa. If you go too far, what artery can you injure?
Brachial
What pathogen is associated with endocarditis after a tooth extraction?
Strep viridans
A man who wants to cheat on his wife accuses his wife of being unfaithful. This is an example of what defensive mechanism?
Projection
what drugs (and in what order) must you give a patient with pheochromocytoma prior to a tumor resection?
Alpha blocker, then a beta blocker to avoid a hypertensive crisis
What is the mode of inheritance of hemophilia A?
XLR
An 8 yo girl presents to the ED with CC of frequent urination, constant thirst, and new, strange “straining” of her teeth. She recently had a cold, and her pediatrician prescribed an antibiotic. Which medication was this patient most likely prescribed?
Demecocycline
By what mechanism does breastfeeding suppress ovulation?
Increase in prolactin, which decreases GnRH which suppresses ovulation.
What pathogen is most common cause of meningitis in adults?
Strep pneumo
What NSAID does not have the adverse effect of gastric ulcer?
Celecoxib
Would DLCO be high, normal, or low in emphysema?
Low
What antibodies are found in a patient with drug-induced lupus?
anti-histone
What condition is associated with RBC morphology shown? (Image shows spherocytes) Heriditary spherocytosis.
Heriditary spherocytosis. Autoimmune hemolytic anemia.
What is the target of antibodies associated with Goodpasture syndrome?
Anti Basement Membrane
14 yo boy who presents to physician with recurrent pyogenic infxns. Physical exam shows that the boy has eczema. Bloodwork shows a markedly low platelet count and an elevated IgA. What is the diagnosis?
Wiscott-Aldritch (wAtEr mnemonic: Wiscott-Aldritch Thrombocytopenia Eczema Recurrent infections. A and E are capitalized because IgA and IgE are elevated)
What effect does calcitonin have on bone?
Decreases bone resorption
What is MoA of omalizumab?
Anti IgE monoclonal therapy used in asthma
What is the ratio of liver enzymes in alcoholic cirrhosis?
AST>ALT 2:1 [TOAST] Two-to-One AST
What pathogen is responsible for gas gangrene?
Clostridium Perfringens