Week 6 Flashcards
What is the most common cause of hyperthyroidism?
Graves’ Disease
What is the mode of inheritance of Friedrichs Ataxia?
Autosomal Recessive
What drug class used to treat type 2 diabetes is contraindicated in heart failure?
Glitazones or Thiazolidiones
Which congenital defect is characterized by protrusion of abdominal contents into the umbilical cord as evidenced by the contents being covered by peritoneum ?
Omphalacele
A 40 year old male is diagnosed with rapidly progressing meningoencephalitis after swimming in a fresh-water lake. What protozoa was likely the cause of this man’s illness?
Naegleria Fowleri
Duodenal atresia is associated with what congenital disorder?
Down syndrome
Pruritic papules, vesicles, and bullae due to deposits of IgA at the tips of dermal papalae are associated with what disease?
Celiac Disease
What are the five stages of grief per the Kubler-Ross model?
Denial, anger, bargaining, depression, acceptance
What lysosomal storage disorder is characterized by progressive neurodegeneration, low hepatosplenomegaly and a (cherry red macula)?
Tay-sachs [if there was hepatosplenomegaly it would be nieman-picks]
What is the antidote for heparain?
Protamine Sulfate
Name a cancer drug that inhibits the M phase of the cell cycle
Microtubule inhibitors
Ureters course under what retroperitoneal structure in males and females?
Males vas deferens, females uterine artery
A bicuspid aortic valve is associated with what congenital disorder?
Turner syndrome
What drug works as a mucolytic in chronic bronchopulmonary diseases by disrupting disulfide bonds?
N-acetylcystine [NAC, Nephrotoxicity, Acetaminophen toxicity, cystic fibrosis because it is a mucolytic]
A 24 yo female with no PMH presents with abdominal pain, vomiting, non bloody diarrhea. She last ate chicken and rice 6 hours ago at a restaurant. What is the most likely pathogen for food poisoning in this case?
Bacillus aureus
What disorder is caused by congenital deficiency of homogentisate oxidase in the degradative pathway of tyrosine to fumarate and can present with bluish black connective tissue and urine turning black on prolonged exposure to air?
Alkaptonuria
What tumor marker is used to monitor and confirm hepatoma?
AFP - alpha fetoprotein
You are working in the ED and see a female baby who was born 2 weeks ago who was brought in by her anxious mother. The mother tells the student that the baby seemed purple, especially her fingers and toes and looks extremely blue while crying. What is the most common cause of cyanosis within the first few weeks of life?
Tertalogy of Fallot
What complement disorder causes hereditary angioedema?
C1 esterase inhibitor deficiency
what drug inhibits vitamin k epoxide reductase?
Warfarin
Which hormone is known to stimulate prolactin release?
thyroid releasing hormone
A 27 yo male develops a DVT in his left lower leg in a 4 hour car ride. His 59 yo father had a thrombosis in the mesenteric vein last year and his 52 yo mother has had repeated superficial veinous thrombosis. What is the most likely diagnosis?
Factor V Leiden, Autosomal Dominant
What is the MOA of carmustine?
Alkylates and cross-links DNA and RNA
What is the most common bacterial pathogen isolated in blood cultures of patients w/ acute right sided bacterial endocarditis?
Staph aureus
An 8 year old boy returns from a camping trip complaining of abdominal cramping, diarrhea, and excessive gas. A duodenal aspirate reveals the organism shown in the image. What pathogen is most likely responsible for his symptoms?
Giardia Lamblia
75 yo female presents with history of headache for the past two weeks. No fever, nausea, or visual changes. Vital signs WNL. Tenderness on temporal area. Labs show elevated ESR and a CBC with mild anemia. What is the next step in management?
High dose predinisone
For chronic disease in a population, would you expect the incidence or prevalence to be higher?
Prevalence
What is the MOA of ipatropium?
Muscarinic antagonist
what disorder is caused by a defect in fibrillin?
marfan syndrome
What vitamin deficiency presents with swollen gums, easy bruising, and poor wound healing?
vitamin c deficiency scurvy
What is the MOI of tuberous sclerosis?
AD
An 18yo female comes to your office because she has not begun menstruating. She reports abdominal cramping that occurs every 4-5 weeks. On pelvic exam you notice hematocolpos. What is the most likely diagnosis?
Imperforate hymen
In what part of the GI tract can Peyer’s patches be found in?
Ilium
What immunodeficiency presents with recurrent pyogenic infection, albinism, and peripheral neuropathy?
Chediak-higashi syndrome
central diabetes insipidus results from the decreased production of what hormone?
ADH
What changes would you expect to see on an ECG in a patient with hypokalemia?
U Waves
What effect does progesterin have on gallbladder motility?
Inhibits
A 70 year old current smoker with history of 30 pack years is asymptomatic requests a lung screening. What test should you order if any?
Low-dose CT
What prophylaxis is started on an HIV patient when the CD4 count drops below 200?
Bactrim TMP-SMX
What autoantibodies are associated with Sjogren Syndrome?
Anti-Ro (SSA) and Anti-La (SSB)
What cell is responsible for the production and secretion of surfactant?
Type 2 pneumocyte
what muscle is responsible for the arm abduction up to 15 degrees?
Supraspinatus
What type of cancer is known to be the leading cause of mortality in both men and women?
Lung cancer.
What antibiotics is not used in pneumonia because it is avidly bound to and inactivated by surfactant?
Daptomysin
(Image shown is palpable purpura) An adolescent had a URI two weeks ago and is now complaining of arthralgias, abdominal pain, and has developed a rash in the lower extremities. What is the most likely diagnosis?
henoch-shenlen purpura
what disorder presents with classic triad of cirrhosis, diabetes mellitus, and skin pigmentation?
Hemachromatosis (bronze diabetes)
What chamber of the heart is the most posterior?
LA
What is the rate determining enzyme in glycogenolysis?
Glycogen phosphorylate
After receiving a transfusion of pRBC your patient hemoglobin goes from 5.5 to 7.8. How many units of pRBC did the patient receive?
2 units
What is the condition when the placenta attaches to the myometrium without penetrating it?
Placenta acretia
A lesion in the medial longitudinal fasciculus leads to what ophthalmologic disorder?
Inter nuclear ophthalmoplegia
what antibodies would you find in a patient with blood type AB?
No antibodies
Name two of three of the diagnostic criteria for acute pancreatitis?
Epigastric pain radiating to the back, elevated serum amylase or lipase 3x upper limit of normal, characteristic imaging findings
A mutation of what tumor suppressor gene leads to familial adenomatous polyposis?
APC
What drug class blocks renal protective prostaglanding synthesis leading to the constriction of afferent arterial and decreased GFR of the kidney?
NSAID
What acid base abnormality would you see decreased pH, decreased PCO2, and decreased bicarbonate?
Metabolic acidosis
In fetal circulation, blood entering the fetus through the umbilical vein goes through what shunt to reach the IVC?
Ductus venosus
A 14 yo patient continually harms the neighbors cats, randomly keys cars in public parking lots, and gets into fights with classmates regularly. what is the most likely diagnosis?
conduct disorder [if over 18 it is antisocial personality disorder]
Detrussor muscle overactivity leading to leakage of urine with an urge to void immediately is the mechanism behind what type of urinary incontinence?
Urge incontinence
Where in the GI tract is iron absorbed?
Duodenum [iron fist bro] [iron duodenum, folate jejunum. b12 ileum]
What neurodegenerative disorder is characterized by cognitive impairment, shuffling gait, cogwheel rigidity, and visual hallucinations?
Lewy body dementia
what leads would show ST segment elevations in an inferior MI?
Leads II, III, avF
Primary sclerosing cholangitis is classically associated with what disease?
Ulcerative colitis
What is the name of the finding in the chest x-ray?
Image shows air under diaphragm. Pneumoperitoneum, which can be caused by duodenal ulcer perforation.
What is the first line treatment for hypertrophic obstructive cardiomyopathy?
Beta blockers
4 classic clinical features of multiple myeloma
CRAB - hyperCalcemia, Renal involvement, Anemia, Backpain
What class of antiarrhythmic is dositilide?
Class III potassium channel blocker
What disorder is caused by defective minieralization of osteoid?
Osteomalacia
What parasitic infection is associated with B12 deficiency?
Diphilobothrium latum
Which drug is used in a challenge test for asthma?
Methacholine challenge
What congenital heart disease is due to the failure of the aortico-pulmonary septum to spiral?
Transposition of the great vessels
60 year old man diagnosed with community acquired pneumonia. He developed flu-like symptoms after a cruise. His labs are significant for neutrophilic leukocytosis and hyponatremia. What pathogen is most likely cause of this patient’s pneumonia?
Legionella pneumophilia
what is the treatment for arsenic poisoning?
Dimercaprol and succimer
the USPSTF recommends screening for colorectal cancer for low risk individuals at what age?
60 years old
What condition is associated with situs inversus?
Kartagener’s Syndrome
30 yo female who is Dx with major depressive disorder recently started on fluoxetine. 2 weeks later she reports no improvement in her symptoms and wants to increase dose or try a new medication. What is the next best step in management?
Deny her request because it takes 4-6 weeks for maximum benefit
What is the MOA of the drug bosentan?
Endothelin receptor antagonist
A 3 week old male is brought to ED by his mother because he has been projectile vomiting after every feed. On PE you notice a palpable olive shaped mass in the epigastric region. What is the most likely diagnosis?
Pyloric stenosis
Nutcracker syndrome is the compression of what vessel between the SMA and the aorta?
left renal vein
What antibody is associated with mucus membranes and is produced by the GI tract?
IgA
in the setting of hemolysis would you expect haptoglobin to be high or low?
low
CAGA trinucleotide repeats is seen in what disease?
Huntington’s [CAG = caudate, acetylcholine, GABA]
Image shows barium swallow with classic bird beak. What is the Dx?
Achalasia
G6PD is necessary to produce what cofactors that will keep glutathione reduced?
NADPH
A 63 yo female presents to ED two days after taking 14 hour flight. She has pain in left calf. On examination her left calf is found to be erythematous, warm, and swollen. What is the imaging test of choice for her most likely diagnosis?
Compression ultrasound w/ doppler
what is the most effective emergency contraception?
Copper IUD
A 55 yo m was recently started on a medication for his newly diagnosed HTN now unable to get an erection. What drug was he started on?
Beta blocker
Alport syndrome is most commonly what mode of inheritance?
XLD
Bilateral renal agenesis results in what amniotic fluid abnormality?
Oligohydramnios
Malabsorption w/ steatthorrea syndromes can lead to deficiencies of what vitamin?
ADEK
Which enzyme is deficient in congenital adrenal hyperplasia that presents with hypertension and virilization in females?
11-beta hydroxylase deficiency [1 in first digit = hypertention, 1 in second digit = virilization]
28 yo female presents to your office 1 month postpartum because she is unable to produce breast milk. ROS reveals polydipsia, fatigue, and cold intolerance. PE has no abnormalities except scant axillary hair. Her labs are significant for serum Na+ of 150. What is the most likely diagnosis?
Sheehan syndrome
Which bug is an aerobic, nonlactose fermenting, oxidase positive, gram negative bacillis?
Pseudomonas
What vessels make up the portal systemic anastomoses at the rectum?
Superior rectal vein anastomoses with middle and inferior rectal veins
T or F? Decreased surfactant production results in increased airway compliance.
False
Name the 3 parts of virshow’s triad.
Statis, hypercoaguability, endothelial damage
Uvular deviation to the right side indicates lower motor neuron in which cranial nerve?
Left cranial nerve X
A 16 yo female brought to your office because she suspects her daughter has an eating disorder. Her mother has caught her sticking her finger in her mouth to induce vomiting and she has a BMI of 16. What is the Dx?
Anorexia nervosa
If a twin pregnancy is determiend to be monochorionic biamniotic are they identical?
Yes [anything monochorionic is identical]
How is cardiac output calculated?
Heart rate X stroke volume
