Bbc Session 2

Front 1

Cyanide overdose treatment

Back 1

amyl nitrate

Front 2

Person exposed to pesticides with excess salivation, urination, defecation, GI symptms and emesis, Tx?

Back 2

atropine and pralidoxime (restores cholinesterase activity)

Front 3

patient has a microcytic anemia from lead, treatment

Back 3

EDTA

Front 4

When would you use aminoglycosides?

Back 4

bactericidal to gram negative aerobes, inhibts RNA to make protein in the bacterium

Front 5

What causes a prolonged bleeding time?

Back 5

dependant on platelet funciton so... VW disease

Front 6

Diseases causing aPPT prolongation?

Back 6

hemophilia A and B and VWD

Front 7

Coumadin depenednat clotting factors?

Back 7

II, VII, IX, X, 1972, derived from viatmin K, monitor PT prolongation usually INR

Front 8

What can lead to hemolytic anemia in G6PD deficiency?

Back 8

hemolysis d/t oxidative stress, viral infections, fava beans, sulfa drugs, quinine and nitrofurantoin

See Heinz bodies- Hb degradation products

Front 9

What antibodies are considered cold antibodies?

Back 9

Active at low temperatres, clump together causing stuff like Raynauds, seen in mycoplasma pneumiona, mono, lymphoma

Front 10

causes of aplastic anemia?

Back 10

deficient in all cell lineages, bone marrow failure, seen with viral infections, toxins and drugs such as alkylating agents and chloramphenicol

Front 11

Patient comes in with anemia, atrophic glossitis and esophageal web. Diagnosis?

Back 11

Plummer-Vinson syndrome

Front 12

What is the inheritance pattern of someone who presents with hypoplastic thums, absent radii, aplastic anemia?

Back 12

Autosomal recesive, Fanconi anemia

Front 13

what is the significance of basophillic stippling on peripheral smear?

Back 13

lead poisoning

Front 14

Common abnormal intracellular inclusions on peripheral smear?

Back 14

Heinz bodies- G6PD denatured Hb, Howell, Jolly oides (nuclear fragments after splenectomy), reticulocytes (rRNA remains from increased production of RBCs)

Front 15

What are the nonmalignant causes of lymphocytosis?

Back 15

Tb, viral infections

Front 16

Child with fever, petichiae, echymosses, CNS infiltrates. Prognosis?

Back 16

Good, ALL, see lymphoblasts

Front 17

Person presents with fevere, peteichiae, echymosses and lympadenophathy, see Auer rods in myeloblasts. Diagnosis?

Back 17

AML

Front 18

Young adult, fever, night sweats, splenomegaly, has philadelphia chromosome

Back 18

CML, poor prognosis

Front 19

Elederly patient, few symptoms but low Ig and infections with lymphoctyic predmominant smear.

Back 19

CLL, fair prognosis

Front 20

Hepatomegally, splenomegaly and pnacytopenia?

Back 20

It's a TRAP! hairy cell leukemia, poor rognosis

Front 21

Differentiation between Hodgkin's and Nopn-Hodkin's lymphoma.

Back 21

HD- spreads in continguity, no leukemic component and have Reed-Sterneerg cells

NHD- all opposite of that

Front 22

"Starry sky pattern" of beningn macrophages with rapidly proliferating neoplastic B cells

Back 22

Burkitt lymphoma, NHD

Front 23

Significance of Bence-Jones proteins?

Back 23

excess light chains produced from MM, usually IgG or IGA, increased osteollcast activity

Front 24

ArteriOLOsclerois (hyaline) is associated with...

Back 24

DM, thickened basement membrane

Front 25

Pathogenesis of arterioscleorsis

Back 25

1. injury to vascular endothelium leads to lipid and platelet adhereance
2. leukocytes and platelets release growth factors leading to smooth muscle proligeration, macrophages become foam cells whcih aggregate to fatty streaks

Front 26

Japanese child resents with fever, conjunctivitis and maculopapular rash, what are you most conerned about?

Back 26

Coronary artery aneurysms (Kawasaki Disease)

Front 27

polycystic kidney disease is associated with what kind of aneurysm?

Back 27

Berry aneurysm, in the circle of Willis, can rupture casuing subarachnoid bleed

Front 28

How would you treat a neonate with a continuous "machine like" murmur?

Back 28

Patent ductus arteriosiusus, kept open by PGE2

Front 29

Aortic stenosis presentation:

Back 29

systolicmurmur, pulsus tardus, murmur transmitted to carotids

Front 30

Common causes of cyanosis d/t congenital heart defects:

Back 30

Tetralogy of fallot, transposition of vesses, persisetnat truncus arteriosus, most common though is reversal of left to right shunt d/t pulmonary HTN

Front 31

Consequences of neonatal infection with syphillis:

Back 31

heart defects, bullous skin lesions, Hutchinson's teeth, saber shins

Front 32

Prinzmetal's angina

Back 32

occurs at rest, ST elevation, treated with Calcium channel blockers

Front 33

Patient presents iwth an MI, what micrscopic cnahges would you expect at 24 hours

Back 33

neutrophilic inifiltrated, rpogresses over days to ocoagulative necorsis, and then fibrosis

Front 34

Complications of MI

Back 34

most common cause of death a few hours post MI is arrhythmia

myocadial rupture occurs 1-2 weeks after MI

Front 35

Patient presents with high fever, chills and hematuria. Also note non-tneder, macular pathces on palms and soles (Janeway lesions): Diagnosis?

Back 35

Acute endocarditis due to staph or strep

Front 36

Patient has low grade fever, pericardial friction rub, and pulsus paradoxus (accentuation of insporatory fall in BP)

Back 36

Pericarditis

Front 37

Migtatory polyarthritis lasting 2-3 weeks with fever, also some erythema and sub Q nodules. Tx and concerns

Back 37

Acute rheumatic fever, treat with PCN, concerned about carditis leading to rhematic heard disease and colcifcation of mitral valve

Front 38

Findings of restritive lung disease on spirometry

Back 38

large elastic recoil so... decreased FRC, VC, and TLC, looks like normal curve except smaller

Front 39

Cruciform ligament

Back 39

4 compnents, tranverse ligament, superior band (transverse ligament to occiput) and inferior (trasverse ligament to the body of C2

Front 40

Functions of the Scalene muscles

Back 40

if contracted bilaterally flex the neck, unilaterally sidebend the neck, Anterior and middle scalenes raise rib 1 in respiration, posterior scalene rib 2

Front 41

C8 nerve root emerges

Back 41

below T1

Front 42

OA and AA movements

Back 42

OA - is yes, assessment is by translation, rotates and sidebends in opposite

AA- is no, rotation and sidebending oppsoite, assessed by rotation

other cervicals rotate and sidebend in same direction

Front 43

what antibody with oral and skin erosions, Nikolsky's sign and older patient?

Back 43

anti-keratinocyte junction. AS opposed to bullous pemphigoid anti-epidermal BM (bullae, pruritis seen in elderly)

Front 44

proximal muscle weakness, elevated muscle enzymes and myoglobin. What autoantibody?

Back 44

spekcled ANA, seen in polymyositis

Front 45

Facial tightening, sclerodactly, visceral organ fibrosis. Autoantibody?

Back 45

progressive systemic sclerosis, anti scl-70

Front 46

Criteria for RA

Back 46

Need 4 of these:
Morning stiffness . 1 hr
Arthritis in 3 or more joints
Arthritis in hand joints
Symmeetrical arthritis
Rheumatoid nodules
Serum RF
ERosions of bony decalcification on X-ray

Front 47

Patient with sinusitis, glomerulnephritis lung lesions... =

Back 47

Wegener's granulomatosis - ANCA antibody (anti-neutrophil cytoplasm

Front 48

Presentation and autoantibody for primary biliary cirrhosis

Back 48

pruritis, jaundice, anti-mitochondrial antibody, seen more in females

Front 49

Someone just got lupus like symptoms after taking hydralazine, autoantibody?

Back 49

Anti-histone, drug induced lupus

vs. CREST anti-centromere

Front 50

Amyloidosis local vs. systemic, 3 types of deposits

Back 50

local AB protein seen in Alzheimer's, amyloid light chains from MM and Waldenstrom's or amyloid associated protein associated with chronic inflammation and aging

Front 51

Hypersenstitivity Reactions

Back 51

Type I- IgE mediated, ex. asthma
Type II- antibody mediated cytotoxicity, ex. Autoimune disease, hemoltyic rxns
Type III- immune complexes- RA, SLE
Type IV- cell mediated (T cells), contact dermaititis after posion ivy, PPD test

Front 52

C-myc, c-abl, ras

Back 52

ONCOGENES

c-myc- Burkitt's lymphoma
c-abl- CML
ras- colon carcinoma

Front 53

CD25 tumor marker

Back 53

hairy cell leukemia, adult T cell leukemia

CD 30= Hodgkin's

Front 54

Alk phos produced by

Back 54

bone- indicates growing bone (tumors, fractures, metastatic bone disease)
Kidneys- renal cell carcinoma
Placenta- elevated in pregos
Also in bilary system

Front 55

Common metastases

Back 55

Lung goes to brain and bone, breast goes to bone and brain

Front 56

Rule for reading a pedigree

Back 56

1. list XLR, XLD, AR, AD
2. generations skipped? R/o AD and XLD
3. male-male transmission? R/o X-linked
4. ID based on what;s left, do a Punnet's square
5. if none of these fit, de novo or mitochondrial

Front 57

hyperphosphatemic rickets

Back 57

XLD, inherited Vit D resistance, bowed legs

Front 58

Leber's optic neuropathy

Back 58

bilateral blindness after 15 years of age, mitochondrial inheritance

Front 59

Phenylketonuria

Back 59

unable to metabolize phenylalanine, build up of byproducts and inability to make melanin, norepi and dopamine -> neurotox and light complexion

Front 60

Glycogen storage diseases

Back 60

von Gierke, Pompe and McArdle Diseases

inability to utilize glycogen

Front 61

alpha-1-antitrypisn deficiecny

Back 61

inhibits elastase, liver makes it, with deficiency unnable to release from liver resulting in liver destruction and lung destruction causing emphysema

Front 62

Mucopolysaccardioses

Back 62

lymssosomal storage disease, componens of CT, can cause MR or corneal clouding inculdes, Hurler, Scheie and Hunter (XLR)

Front 63

Sphingolipidoses

Back 63

lysosomal storge disease, can't meatbolize sphingolipdis (involved with myelin in CNS)

Niemman Pick, Gaugher's, Tay-Sachs, Metachromatic dystrophy, Fabry (XLR)