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54 Cards in this Set
- Front
- Back
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Your patient has recently returned from Africa and develops severe illness which lands him in the hospital. Eventually he develops R-sided paralysis & splenomegaly. What is the most likely diagnosis?
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P. Falciparum (malaria)
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This protozoan causes dysentery. It may also cause abscesses of the liver & brain.
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Entamoeba Histolytica
Rx: Metronidazole for liver stage Iodoquinol for dormant stage in Lg. intestine |
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This protozoan causes hepatosplenomegaly and deepening skin pigmentation. It is also transmitted by the Phlebotomine Fly.
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Leishmania Donovani
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This organism can cause heart disease and megaesophagus/megacolon.
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Trypanosoma Cruzi (Chagas Disease)
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This roundworm causes elephantiasis by blocking lymphatics.
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Wucheria Bancrofti
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Define indirect muscle energy.
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Moving the muscle AWAY from the restrictive barriers while the antagonist muscle is contracted, causing the dysfuncitonal agonist muscle to relax/lengthen
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What is the mechanism of indirect muscle energy
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Reciprocal Inhibition
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Which parasitic worm causes serpingous eruptions?
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Ancylostoma Brazilense (hookworm)
Penetrates the skin, transmitted in dog/cat feces |
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Which parasitic worm causes pneumonitis after the skin is penetrated?
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Necator Americanus (hookworm)
Filariform larvae penetrate the skin and the larvae migrate to the lungs, causing a dry cough, low-grade fever, and pneumonitis Ascaris Lumbricoides also causes "asthma-like" symptoms |
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Identify the liver fluke:
Clonorchis Sinensis Fasciolopsis Buski Paragonimus Westermani Schistosoma Japonicum Schistosoma Mansoni |
Clonorchis Sinensis is a liver fluke
Associated w/ eating raw fish in SE Asia Causes Cholangitis (clono-....chola) Looks like a small leaf |
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Identify the blood fluke:
Clonorchis Sinensis Fasciolopsis Buski Paragonimus Westermani Schistosoma Japonicum Schistosoma Mansoni |
Schistosoma Japonicum & Schistosoma Mansoni are both blood flukes
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Identify the intestinal fluke:
Clonorchis Sinensis Fasciolopsis Buski Paragonimus Westermani Schistosoma Japonicum Schistosoma Mansoni |
Fasciolopsis Buski
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Identify the lung fluke:
Clonorchis Sinensis Fasciolopsis Buski Paragonimus Westermani Schistosoma Japonicum Schistosoma Mansoni |
Paragonimus Westermani
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Describe Ca2+, Phos, & PTH levels in Familial Hypocaliuric Hypercalcemia
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Ca2+ = High
Phos = High PTH = Low (feedback due to Ca2+) |
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Describe Ca2+, Phos, & PTH levels in Hypervitaminosis D
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Ca2+ = High
Phos = High PTH = Low (feedback) |
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Describe Ca2+, Phos, & PTH levels in Secondary Hyperparathyroidism
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Ca2+ = High (bone resorption)
Phos = High PTH = Low (feedback) |
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Describe Ca2+, Phos, & PTH levels in Primary Hyperparathyroidism
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Ca2+ = High
Phos = Low PTH = High |
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Describe Ca2+, Phos, & PTH levels in Malignancy from the lung
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Ca2+ = High
Phos = Low PTH = Low (feedback inhibition) |
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Name the signs & symptoms of Cushing's Syndrome
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Striae, HTN, Immune suppression, Truncal obesity, Hyperglycemia, Wt. gain, Osteoporosis, Moon facies, Buffalo hump
"SHIT tHe WOMB" |
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Which disease is associated w/ immunoglobulins directed against TSH receptors?
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Grave's Disease (hyperthyroidism)
Immunoglobulins actually ACTIVATE the receptors and stimulate T3 & T4 production |
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Describe congenital adrenal hyperplasia
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Congenital adrenal hyperplasia is a result of deficient 21-hydroxylase resulting in decreased Cortisol production
Lower Cortisol levels stimulate ACTH release which further exacerbates the problem Without 21-Hydroxylase, ACTH stimulates androgen synthesis instead |
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Compare Hashimoto's & Grave's Disease
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HashimotO's = HypOthyroidism resulting in HIGH TSH (feedback)
Graves = Hyperthyroidism resulting in LOW TSH (feedback) |
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Describe Hashimoto's thyroiditis...identify T3, T4, & TSH levels...describe the antibodies involved
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Hashimoto's = HypOthyroidism
Antiperoxidase antibodies are directed against Thyroid peroxidases Results in decreased T3 & T4 production Resulting in a feedback loop to stimulate TSH (increased TSH) leading to Goiter |
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What would be the treatment of choice for thyroid storm?
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Beta Blocker
Propranolol |
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Type 1 diabetic pt. presents to the ED unconscious following a flu-like illness. His blood glucose is 550 mg/dL, what is the most appropriate therapy?
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Crystalline Zinc Insulin
IV Insulin with the fastest activity Pt. is having a ketoacidotic attack and needs rapid treatment Attack likely stemmed from the flu (may also be caused by exercise, stress, infection or drastic change in diet) |
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If you have a pt. who has high insulin levels but low C peptide levels, which follow up procedure would be best for the pt?
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Psychiatric eval
Insulin levels higher than C peptide levels indicate the patient has been taking exogenous insulin for secondary gain |
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Acute Adrenal Crisis
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AKA Waterhous-Friderichsen Syndrome
Adrenocortical insufficiency leading to decreased production of all adrenal hormones Results in hypotension & possibly hypoglycemia Caused by adrenal hemorrhage associated w/ N. Meningitidis septicemia |
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Conn's Disease
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Primary Hyperaldosteronism
Aldosterone-secreting tumor HTN, Hypokalemia, LOW Renin Secondary hyperaldosteronism would result in HIGH renin |
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Pt. presents w/ rapidly progressing dementia. Path report shows spongiform changes in the brain w/ out any inflammation. What is the most likely causative agent?
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Creutzfeldt-Jakob Disease (rapid progression of dementia)
Gerstmann-Straussler-Scheinker syndrome (inherited prion defect) Caused by a PRION Prions do NOT cause inflammation Amebas, Bacteria, Fungi, & Viruses all can cause inflammation |
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Pt. presents w/ jaundice, hepatosplenomegaly & ring-shaped structures inside her RBCs. What is the most likely diagnosis?
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Plasmodium Falciparum (malaria)
Not Babesiosis: That would have MALTESE CROSS structures inside the RBCs |
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Describe Babesia
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Clinical presentation similar to Malaria; but capable of developing in the US
No liver stage & less severe Carried by the Deer tick "Maltese Cross" formation inside RBCs |
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Describe Leishmania
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Skin ulcerations, hepatosplenomegaly, fever
Transmitted by the Sandfly Lives inside macrophages |
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Describe Toxoplasma
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Fever, chills, hepatosplenomegaly
Seizures, confusion, lethargy, visual impairments in immunocompromised Stillbirth & hydrocephalus in kids Transmitted by CATS |
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Describe Trypanosoma
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African Sleeping Sickness & Chaga's Disease
African: Transmitted by the Tsetse Fly Chagas: Megacolon, megaesophagus |
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What is the 1st line drug for prophylaxis treatment of TB?
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Isoniazid
Rifambin may be used in those who can't tolerate isoniazid TB Rx = StRIPE Streptomycin Rifampin Isoniazid Pyrazinamide Ethambutol |
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Which organism is responsible for causing "periosteal elevation on bones?" Is the organism G+/G-, Catalase +/- & Coagulase +/-?
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Staph Aureus:
G+ Catalase + Coagulase + The question is describing OSTEOMYELITIS |
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Pt. presents w/ painful vesicular lesions w/ surrounding erythema on her labia that were preceded by 2 days of fever & malaise. Lab reports intranuclear inclusion bodies and/or multinucleated giant cells. What is the diagnosis?
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Herpes Simplex 2
Painful vesicular lesions w/ satellite erythema = "dew drops on a rose petal" Outbreak is preceded by a prodrome of fever & malaise Diagnosis = Intranuclear inclusion bodies and/or multinucleated giant cells |
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What is the MOA of Acyclovir?
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Inhibition of viral DNA polymerase by being phosphorylated by thymidine kinase
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What is the medium of choice to culture syphillis?
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None, trick question
It can't be cultured instead diagnosis is based upon the presence of a spirochete in material biopsied from the chancre |
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What is the treatment of choice for syphillis?
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Pen G
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Which virus would be described as:
Naked capsid RNA virus in the Picornavirus family? |
Picornaviruses = "PERCH"
Polio Echovirus Rhinovirus Coxsackie Virus Hepatitis A |
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Which virus would be described as:
Enveloped DNA virus in the Hepadnavirus family? |
HBV
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Which virus would be described as:
Enveloped RNA virus in the Flavivurs family? |
HCV
Yellow fever Dengue fever St. Louis Encephalitis Flavi has the fevers and Hep C West Nile Virus |
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Which virus would be described as:
Enveloped circular RNA virus that is a defective virus? |
Hep D
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Which virus would be described as:
Naked capsid RNA virus in the Calcivirus family? |
Norwalk Virus
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Which step in the gram staining process gives G- bacteria their PINK hue?
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Safranin stain
Steps: Complexed iodine & Crystal violet Alcohol or acetone wash Safranin counterstain |
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Which step in the gram staining process gives G+ bacteria their BLUE hue?
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Crystal violet and complexed iodine
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What is the Rx of choice for:
Gonrrhea? |
Cefixime
N. Gonorrheae = G-, Cocci, Maltose - Most G- are resistant to Pen G & other Penicillin derivatives |
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What is the Rx of choice for:
Chlamydia? |
Doxycycline (tetracycline)
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What is the Rx of choice for:
Candidal Vaginitis? |
Fluconazole
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What is the Rx of choice for:
Bacterial Vaginosis? |
Metronidazole
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Which classes of drugs inhibit 30s ribosomes?
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Tetracyclines
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Which classes of drugs inhibit 50s ribosomes?
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Chloramphenicol, Clindamycin, Erythromycin
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A 10 day old infant presents in the ED w/ multiple skin lesions, nuchal rigidity, temperature instability, lethargy, hypotonia, and numerous small vesicles on the skin. What is the most likely causative agent?
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HSV-2
Most likely transmitted during the birthing process Neonatal herpes localizes to the skin, eyes, and mouth |
