Bbc Assignments 62-71

Front 1

Diff b/t blowing murmur and harsh murmur?

Back 1

blowing murmur- blood flowing wrong way across valves

harsh murmur- blood hitting tissue, such as stenotic valve

Front 2

Where are aortic murmurs best heard?

Back 2

2nd right intercostal space

Front 3

Where are mitral murmurs best heard?

Back 3

apex of heart, often refer to left axilla

Front 4

Aortic stenosis is a ____ murmur

Back 4

harsh systolic

(aortic space is above the mitral space, systolic is above diastole in BP)

Front 5

Aortic regurgitation is a _____ murmur

Back 5

blowing diastolic murmur

Front 6

Mitral stenosis is a ____ murmur

Back 6

harsh, diastolic murmur

(Mitral space is BELOW aortic space)

Front 7

Mitral regurg is a _____ murmur

Back 7

blowing systolic murmur

due to advanced MVP, RHD, damage from infective endocarditis, papillary muscle rupture

Front 8

What heart sound is heard in Mitral Valve Prolapse?

Back 8

Midsystolic click

Common with Marfans, Ehlers-Danlos, Fragile X

Front 9

What are the 2 types of ASD?

Which one comprises 90% of them?

Back 9

1) Ostium primum

2) Ostium secundum (90%)

Front 10

Persistent Truncus Arteriosus?

Back 10

great vessels arent separated

Front 11

What is Eisenmengers syndrome?

Back 11

REVERSAL of Left to Right shunt to a Right to Left shunt (i.e from RVH)

Front 12

Coarctation of aorta

Back 12

2 types:
infant- preductal
adult- postductal

Front 13

Two types of MI?

Back 13

1) Subendocardial- nonQwave, NSTEMI (inner 1/3 to 1/2 wall infarcted)

2) Transmural- Qwave, STEMI, whole wall infarcted

Front 14

The acute coronary syndromes are:

Back 14

Unstable angina, NonQwave MI, Qwave MI

Front 15

Stable angina, Unstable angina, NonQwave MI all have ST Segment ____

Back 15

depression

Front 16

Qwave MI and Prinzmetals angina have ST seg ___

Back 16

elevation

Front 17

How many weeks s/p MI does scar tissue form?

Back 17

8 weeks

Front 18

3 major signs of Left Heart Failure

Back 18

Dyspnea, orthopnea, fatigue

Front 19

3 major signs of Right Heart Failure

Back 19

ankle edema, ascites, JVD

Front 20

What path sign occurs to liver in RHF?

Back 20

"Nutmeg liver" from venous engorgement

Front 21

What are Roth spots?

Back 21

small retinal hemorrhages in infective endocarditis

Front 22

Acute infective endocarditis

Back 22

staph or strep
acute onset, fever, chills
most common in IV drug users, diabetics

Front 23

Which type of endocarditis occurs in those with prior valve pathology?

Back 23

subacute infective endocard.

Front 24

Which strep can later cause Acute Rheumatic Fever?

Back 24

Group A Beta Hemolytic Strep Pyogenes

Front 25

How does Acute Rheumatic Fever manifest?

Back 25

Molecular mimicry- AB attack of heart following strep pyogenes infection

Front 26

Libman-Sacks Endocarditis only occurs in:

Back 26

SLE patients

Front 27

#1 type of pericarditis worldwide?

Back 27

Fibrinous!

Due to transmural MI or Dressler syndrome

Front 28

#1 type of pericarditis in US?

Back 28

Serous!

Due to Coxsackie B, uremia, Acute RhFever, scleroderma, RHD, SLE

Front 29

Aschoff bodies are pathognomonic for.....

Back 29

Acute Rheumatic Fever

Front 30

Which criteria are used to diagnose Acute RhF?

Back 30

Major and Minor Jones criteria
Need either 2 Major or
1 Major and 2 Minor

Front 31

Major Jones Criteria?

Back 31

migratory polyarthritis
Carditis
subcutaneous nodules
erythema marginatum
sydenhams chorea (st vitus' dance)

Front 32

pursed lip breathing, barrel chest, and dyspnea are all signs of:

Back 32

emphysema

Front 33

Rhonchi with wet productive cough and dyspnea points to:

Back 33

chronic bronchitis

Front 34

"Cant hear, cant rear" is seen in what disease?

Back 34

Kartagener syndrome- recurrent bronchial infections --> bronchiectasis +situs inversus + male sterility + hearing deficit

Front 35

Low FEV1 which improves after albuterol, this is?

Back 35

asthma (reversible)

Front 36

Four types of asthma?

Back 36

1) intrinsic- URI or stress
2) extrinsic- #1 form, type 1 HS
3) exercise induced (poor sympathetic NS tone)
4) drug induces (sulfites, BBs, NSAIDs)

Front 37

non-caseating granulomas in lung that are replaced with fibrosing scars. Dyspnea, night sweats, cough.

Bilateral hilar adenopathy on CXR
Most common in blacks..

What is it?

Back 37

Sarcoidosis

Front 38

What causes adult ARDS?

Back 38

diffuse injury to the lung endothelium (sepsis, chest trauma, massive blood transfusion, heroin)

Front 39

What is the eventual result of endothelial damage in adult ARDS?

Back 39

SEVERE interstitial fibrosis

Front 40

Neonatal ARDs is due to:

Back 40

insufficient surfactant (lecithin) as a result of immaturity (premie) born before 33-34 weeks

Preterm is before 37 weeks

Front 41

Neonatal ARDs occurs when L:S (lecithin:sphingomyelin) ratio is:

Back 41

below 2 as measured in amniotic fluid

Front 42

What is the pathophys of Pneumoconiosis?

Back 42

macrophages phagocytose substance --> release ROS, enzymes --> macrophage eventually dies --> fibrosis occurs --> repeat over and over

Front 43

Which type of pneumoconiosis increases risk of SqC lung ca and malignant mesothelioma?

Back 43

Asbestosis

Front 44

Which pneumoconiosis is also known as Coal Workers P?

Back 44

Anthracosis, or Black Lung Disease

Front 45

What is Goodpastures syndrome?

Back 45

autoimmune dz with antiGBM ABs
ABs destroy glomerular and pulmonary BM -> fibrosis

Front 46

Didanosine, Lamivudine, Tenofovir, Zidovudine are all:

Back 46

NRTIs or Nukes

Front 47

Efavirenz and Nevirapine are:

Back 47

NNRTIs or Non-Nukes

Front 48

Ritonavir, atazanavir, darunavir, indinavir, nelfinavir are all:

Back 48

Protease inhibitors

They inhibit protease which cleaves viral protein products into functional structures

Front 49

When should HIV therapy be started? (5 examples)

Back 49

Anyone who is HIV+ with:
1) AIDs defining illness
2) CD4 count less than 350
3) HIV assoc nephropathy
4) current Hep B infection
5) pregnant

Front 50

What meds are included in HAART therapy for a new patient?

Back 50

2 Nukes +
(1 boosted protease inhibitor OR 1 integrase inhibitor OR 1 CCR5 antagonist)

Front 51

What is the drug of choice for treatment or Pneumocystis or prophylaxis against Toxoplasmosis in HIV patients?

Back 51

TMP/SMX

Front 52

Trimethoprim, pyrimethamine and methotrexate all inhibit this enzyme:

Back 52

Dihydrofolate reductase

Front 53

Chloramphenicol blocks this enzyme:

Back 53

peptidyl transferase, the enzyme needed to form the peptide bond b/t AAs

Front 54

Severe side effects of chloramphenicol?

Back 54

Grey baby syndrome
severe aplastic anemia

Front 55

What is the drug of choice in PCN allergic patients?

Back 55

Erythromycin

Front 56

What is the drug of choice for mycoplasma pneumoniae?

Back 56

Macrolides

Front 57

Clindamycin vs. metronidazole

Back 57

Clinda used for anaerobic infections ABOVE the diaphragm

Metro used for anaerobic infections BELOW diaphragm

Front 58

MOA of Dapsone?

Back 58

similar to sulfonamides, inhibit dihydropteroate synthetase

Front 59

6-mercaptopurine is used for this cancer:

Back 59

ALL

Front 60

Cytarabine is used in:

Back 60

non-lymphocytic leukemia

Front 61

How do bleomycin and doxorubicin work?

Back 61

creates ROS that cause DNA breaks

Front 62

What is the big side effect of bleomycin?

Back 62

Fibrosis of lung

Blake Lively and Leo broke up, leo was a bitch and kept coughing

Front 63

Why is there weakness in posterolateral aspects of the Lumbar bodies and IV discs?

Back 63

the Posterior longitudinal ligament begins to narrow in the lumbar spine!

Front 64

In the lumbar spine, a disc herniation affects the nerve root ____

Back 64

below

Front 65

What is the primary flexor of the hip?

Back 65

Iliacus

Front 66

Where does the spinal cord end and cauda equina begin?

Back 66

L1-L2

Front 67

What is the normal lumbosacral angle?

Back 67

25-35 degrees

Front 68

What are the 4 types of spina bifida?

Back 68

1) Spina bifida occulta
2) Spina bifida meningocele
3) Spina bifida myelomeningocele
4) Rachischisis- completely open spine

Front 69

Intense pain, saddle anesthesia, and urinary/fecal incontinence point to:

Back 69

Cauda equina syndrome (a really bad HNP)

Front 70

Diff bt spondylolysis and spondylolisthesis

Back 70

Spondylolysis = pars interarticularis fracture (collar on the Scotty dog)

Spondylolisthesis= anterior displacement of one vertebra with respect to the vert inferior to it

Front 71

Most common type of spondylolisthesis?

Back 71

Type II- Isthmic Spondy

Always involves pathology of pars interarticularis
Subtype A- fatigue fx of pars
Subtype B- intact but elongated pars
Subtype C- trauma, acute fx of pars

Front 72

What is POMP?

Back 72

a chemo combo for ALL

Prednisone, Oncovin, Methotrexate, Purimethol

Oncovin = vincristine
Purimethol = 6-MP

Front 73

Drug combo for Wilms Tumor?

Back 73

Dactinomycin and Vincristine

Front 74

Unique ADR of cyclophosphamide?

Back 74

hemorrhagic cystitis