Boards Boot Camp Comprehensive Flashcards: Segment 13

Front 1

Drug that blocks the reabsorption of Na+ at the late distal convoluted tubule. ADR are hyperkalemia, metabolic acidosis, menstrual irregularities and gynecomastia

Back 1

spironolactone

Front 2

Drug approved for the prevention and treatment of migraines by stimulating 5-HT1 receptors. CI in Prinzmetal's angina (vasospasm), uncontrolled HTN, and may produce seritonin syndrome if taken with an SSRI

Back 2

Sumatriptan and the triptans

Front 3

DOC for moderate to severe migraines by blocking 5-HT2 receptors inducing VC. CI in pregnancy, PVD, and CAD

Back 3

Ergotamine

Front 4

5-HT4 agonist used as an anti-emetic. Increases GI motility, minimizes gastroparesis and vomiting

Back 4

Metroclopramide

Front 5

-setrons

Back 5

anti-emetics that block 5-HT3 receptors in the CNS

Front 6

Potential use of this drug is adjunct in the management of transplant patients because of its effects to inhibit T cell stimulation. What is the ADR profile?

Back 6

bromocriptine - dopamine agonist
hallucinations, confusion, delirium, nausea, orthostatic hypotension and generally worsens any pre-existing mental conditions

Front 7

Drug used in the treatment of open angle glaucoma and also in the treatment of elevation sickness by decreasing CSF fluid production in the choroid plexus. ADR are hypokalemia, renal stone formation, drowsiness, and metatabolic acidosis.

Back 7

carbonic anhydrase inhibitors
acetozolamide

Front 8

Thiazides cannot be used if the patient has

Back 8

complete renal failure, need a functional kidney to work

Front 9

The most potent diauretic, works at the ascending loop of Henle by blocking the Na+/K+/Ca++ co-transport system. ADR are ototoxicity (esp if used with an aminogylcoside). CI in pts with sulfa allergy

Back 9

Torsemide

Front 10

MOA and ADR profile for triamterene and amiloride

Back 10

Directly block the Na+/K+ exchange
leg cramp, hyperkalemia, hyperuricemia, and high BUN

Front 11

Indicated for acute renal failure d/t shock or trauma and ingestion of toxic substances and to decrease intracranial pressure

Back 11

Osmotic agents
mannitol and urea
maintains urine flow and decreases CSF pressure

Front 12

Name the action of the muscles that move the tongue, innervated by CN 12:
genioglossus
stylogossus
hyoglossus

Back 12

pulls tongue out
pulls tongue in and up
pulls tongue down

Front 13

Damage to hypoglossal nerve presents clinically

Back 13

genioglossus mm (stick tongue out) of healthy side becomes dominant and tongue will deviate TOWARDS side of damage
originates on the spine of the mandible and inserts on the hyoid bone

Front 14

Damage to the aortic arch may damage the ________ nerve, while damage to the right subclavian artery may damage the _______ nerve

Back 14

left recurrent laryngeal nerve
right recurrent laryngeal nerve

Front 15

How does tennis elbow present?

Back 15

inflammation of the LATERAL epicondyle, which is the common origin of the extensor mm of the forearm
pt will prob say something about a wicked backhand

Front 16

Fracture of the radius near the wrist

Back 16

Colles' fracture
ML a fall on a hard surface bracing the fall with outstretched hand

Front 17

What position of the leg places it in greatest risk for a fracture of the head of femur?

Back 17

leg is ABDucted and externally rotated

Front 18

pt presents after grand piano fell on fibula and he cannot dorsiflex foot, watcha say?

Back 18

injury to the common peroneal nerve
winds around the neck of fibula
"foot drop"

Front 19

occlusion of the left coronary artery, which branches into the circumflex and LAD would damage which areas of the heart?

Back 19

left atrium
left ventricle
anterior septum

Front 20

the testis receives blood supply from three arteries:
aorta-->
internal iliac artery-->
inferior epicgastric artery-->

Back 20

testicular artery
artery to vas deferens
cremasteric artery

Front 21

pt can understand everything you are saying, but when asked to respond he produces non-fluent speech

Back 21

Broca's aphasia

Front 22

pt cannot comprehend what you are say and when asked to respond his speech is fluent but makes no sense

Back 22

Wernicke's aphasia

Front 23

Occlusion to the anterior cerebral aa results in..

Back 23

motor and sensory loss to the contralateral legs and feet

Front 24

Occlusion to the middle cerebral aa results in...

Back 24

motor and sensory loss to the contralateral upper body and face

Front 25

MALE:
yolk sac tumor _______ always elevated
Choriocarcinoma __________ always elevated

Back 25

αFP
HCG

Front 26

Sertoli or leydig tumors produce endocrine abnormalities?

Back 26

leydig, all day long

Front 27

Nematode (helminth) that can cause squamous carcinoma of the bladder

Back 27

Schistosoma haematobium

Front 28

Carcinoma of the bladder that presents with broad yellow plaques in mucosa. Mico see foamy macrophages and multi-nucleated giant cells with a calculus or inorganic mass

Back 28

Malakoplakia
(Michaelis-Gutman bodies)

Front 29

Chronic prostatits is usually non-bacterial, but can be d/t_________. While acute prostatitis is usually caused by gram____________ bacteria, usually ______________.

Back 29

Chlamydia; negitive; E. coli

Front 30

What is the most common area of the prostate to hypertrophy and why? Most common area of adenocarcinoma and why?

Back 30

anteromedial because it is estrogen sensitive (alcoholics?)
posterolateral because it is angrogen sensitive (palpate through the pooper)

Front 31

Basic explanation of the Gleason grading scale?

Back 31

urologist takes a FNA of prostate through rectum. Grades the cells based on the most common tumor pattern and adds to that score the next most common pattern.
i.e. if the tumor pattern matches tumor pattern 4, he then adds 5 and the score is 9. Max is 10 (5 + 5 bc 5 is the highest grade)

Front 32

The Gleason grading scale is based on 5 patterns, match number to description:
Cancerous prostate closely matches normal tissue. Glands are small, well-formed and closely packed
Tissue has well formed glands, but larger with more tissue between them
Tissue has recognizable glands, but cells are darker, some cells are beginning to invade surrounding tissue
Few recognizable glands, many cells are are invading surrounding tissue
No recognizable glands, sheets of cells in surrounding tissue

Back 32

1
2
3
4
5

Front 33

pt presents with trouble voiding bladder, DRE + for prostate hyperplasia. pt goes on a 10 year medical hiatus then returns with low back pain and states his bones hurt. What will serology likely show?

Back 33

↑total PSA, ↓fraction of free PSA
↑serum alkaline phosphatase
↑prostatic acid phosphatase
He is in late stage AEB metastasis to bone

Front 34

Most cases of UTIs are d/t? A close second?

Back 34

E. coli
Black bitches wiping back to front and "poop-cooch" occurs
Staphylococcus saprophytocus - Novobiocin resistant (epidermis = senstitive), phosphatase negitive, urase and lipase positive

Front 35

Whats the story with acute bacterial pyelonephtitis?
PE
causative agent
kidney involvement
Labs

Back 35

tender costovertebral angle, fever
gram negative rod, don't pick enterococcus (it tends to cause UTIs)
WBC casts in urine (PN for renal inflammation)

Front 36

Pt complains of vauge flank pain. Urogram shows dilated calyces with overlying scar. Dx?

Back 36

Chronic bacterial pyelonephritis

Front 37

Sexually active female presents with growth on her lady parts. Biopsy shows kilocytes and large epithelial cells with clear cytoplasmic halo around an atypical nucleus. There is aberrant growth of the keritinocytes in the stratum germiinativum

Back 37

condyloma acuminata (genital wart) via HPV

Front 38

Mothers who were exposed to diethylstilbestrol (DES) will have daughters that are at an increased risk for what?

Back 38

Clear cell carcinoma

Front 39

The three D's of endometriosis

Back 39

dyspareunia
dyschezia
dysmenorrhea

Front 40

The most common tumor of women. sxs

Back 40

fibroids (leiomyoma)
ectopic growth of endometrial tissue
severe cyclical pain and ectopic bleeding

Front 41

What are the 5 types of epithelial ovarian neoplasms (75% of all ovarian tumors)

Back 41

cystadenomas (benign)
-Serous
-Mucinous
Serous cystadenocarcinoma
Mucinous cystadenocarcinoma
Clear cell
Brenner

Front 42

Epithelial ovarian tumor that can lead to pseudomyxoma peritonei? what is it again?

Back 42

Mucinous cystadenocarcinoma
d/t peritoneal seeding of the cancer
peritoneum becomes engorged with mucinous material

Front 43

Dysgerminoma (F) =seminoma (M)
Tralse

Back 43

T

Front 44

endodermal sinus tumor = yolk sac tumor. Whats elevated again?
Tralse

Back 44

T
αFP

Front 45

Which tumor can cause Meigs' syndrome?

Back 45

Fibroma (stromal neoplasm)
tumor seeds pleura and peritoneal cavities and secretes fliud
Meigs' sd = ascities, hydrothorax, fibroma

Front 46

Stromal neoplasm (female) that produces estrogen. In adults = endometrial hyperplasia, kids = precocious puberty. Histo shows follicles with eosinophlic secretions

Back 46

Granulosa cell tumor
Call-Exner bodies

Front 47

# 1 cause of salpingitis and how to recognize it clinically

Back 47

Chlamydia trachomatis
Onset follows menses with acute abdomen, + rebound tenderness and vag discharge. On bimanual, if it hurts to move cervix to left-->left salpingitis

Front 48

Only treatment of a tubo-ovarian abcess lead to by PID

Back 48

Surgical removal
rupture can quickly lead to septic shock and infertility

Front 49

Two big players in vulvovaginitis and clinical presentation

Back 49

Gardnerella 50% (Mobiluncus is associated)
Trichomonas
pain, burning sensation, itching

Front 50

The placenta things that I keep getting confused:
Abruptio placentae
Placenta accreta
Placenta previa

Back 50

Abruptio placentae - separation of placenta and uterine wall MC in 3rd tri. Fetal death and DIC in Mom (d/t seepage of fetal thromboplastin)
Placenta accreta - adhesion of placenta to the myometrium, leads to massive maternal bleeding
Placenta previa - implantation at the bottom of uterus, may obstruct cervical os (PN sudden painless vaginal bleeding) in any trimester

Front 51

Long term effect of untreated kernicterus?

Back 51

mental retardation and deafness

Front 52

Treatment of eclampsia

Back 52

MgSO4
Diazepam (for seizures that don't respond to MgSO4)

Front 53

Classic eclampsia sxs (HELLP)

Back 53

Seizures +
Hemolytic anemia
Elevated Liver enzymes
Low platlets

Front 54

Pt in early pregnancy presents with vaginal bleeding and rapid swelling of the uterus. Ultrasound of placenta appears like a large, bloody bunch of grapes (snowstorm pattern). HCG is through the roof. What is she at risk for and what is treatment?

Back 54

Hydatiform mole
Risk for choriocarcinoma
tx with methotrexate or evacuate

Front 55

Slutty female pt presents with small ulcerating papules and lymph node swelling in the inguinal region, with a "groove-like" skin fold over the inguinal ligament. Tx? If she were to give birth to a slutty kid, what is he at risk for?

Back 55

This is lymphogranuloma venereum caused by Chlamydia trachomatis
treat with doxycyline or azithromycine
kid could develop conjunctivitis or pneumonia with "straccato cough" d/t eosinophilia

Front 56

Can a pregnant hoebag Mon with syphilis transfer her kooties to the fetus? If so, when?

Back 56

Yup
ALWAYS after the 1st trimester

Front 57

So you are treating a female with syphilis with penicillin and an hour later she presents to the ER with septic-like sxs. WTF

Back 57

Penicillin killed all the treponemes and they released their endotoxin-like substances with caused a cytokine storm. This could have been prevented with prophylactic administration of antihistamines or NSAIDS

Front 58

pt presents with painful ulcers on the frank and beans with local lymphadenitis. Gram stain of pus shows multiple fastidious gram-negative coccobacillus. Tx?

Back 58

this is a painful chancroid caused by H. ducrei
tx with azithromycin, cephalosporin/ciprofloxin

Front 59

pt presents with genital ulcers and soft tissue destruction and suspicion of bone destruction. Gram stain shows stained organism in macrophages. Tx?

Back 59

This is granuloma inguinale caused by Klebsiella granulomatis
tx with tetracycline
PN Donovan bodies - Klebsiella within large macrophages)

Front 60

Kid comes in with recurrent pyogenic infections with staph and strep. PE shows peripheral neuropathy and albinism

Back 60

Chediak-Higashi syndrome
defect in microtubular function that impairs phagocytosis

Front 61

Causes mono with a negative mono-spot test

Back 61

CMV`

Front 62

Positive heterophile abs

Back 62

EBV

Front 63

IgE binds to mast cells and what other cell?

Back 63

Basophils bitches

Front 64

This is a tad embarrassing, but what does a basophil do again?

Back 64

Mediates allergic rxns
granules release heparin, histamine
vasoactive amines
leukotrines

Front 65

PAP smear shows characterized cytologically by multineculeated giant cells with viral inclusions

Back 65

HSV