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89 Cards in this Set

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Skin lesions on lower abdomen+buildup of ceramide trihexoside+IR of renal failure
Fabry's disease
What enzyme is lacking in Fabry's disease?
alpha galactosidase A

note: get a buildup of ceramide hexoside
MC lysosomal Dx presents w/ aseptic necrosis of the femur+ MACS that look like crumpled tissue paper
gaucher's disease

note: deficient in glucocerebrosidase
What enzyme is missing in gaucher's disease?
glucocerebrosidase

note: get a buildup of glucocerebroside
MC cause of morbidity and death in pts recovering from SAH?
vasospasm
What is given to prevent vasospasm in pts with SAH?
nimodipine
Associated with neutrophilic inflammation into renal interstitium and white cell casts in the urine?
acute pyelonephritis
Most likely cause of acute pyelonephritis?
gram - rods that ascend from the bladder
Female infant w/ ambiguous genitalia + mom with masculinization
aromatase deficiency
Enzyme that converts androstenedione to estrone...and testosterone to estradiol?
aromatase
Leads to estrogen excess w/ gynecomastia in boys and precocious puberty in girls?
increased aromatase levels
Leads to decreased production of DHT in male fetus & feminized external genitalia at birth w/ virilization at puberty?
5 alpha reductase deficiency
Increased estrogen in cirrhotic pt causes what physical findings?
(1) gynecomastia
(2) testicular atrophy
(3) spider angiomas
(4) decreased body hair
MC site of aortic rupture from a motor vehicle accident?
aortic isthmus

note: distal to where the left subclavian artery branches off of the aorta
Hepatomegaly+cardiomegaly+a decrease in lysosomal alpha 1,4 glucosidase
pompe's disease
What enzyme is deficient in pompe's disease?
lysosomal alpha 1,4 glucosidase
RX for CMV retinitis in AIDS pts?
gangciclovir
Rx of cornybacterium diptheriae in order of importance?
(1) diptheria antitoxin (passive immunity)
(2) penicillin or erythromycin
(3)DPT vaccine
Amino groups off AA are transferred to this molecule to form glutamate?
alpha ketoglutarate
Blanching of a vein w/ pallor surrounding the IV injection site of NE
NE extravasation
RX for NE extravasation?
alpha 1 blockers-phentolamine
What characteristic does a drug need to undergo hepatic metabolism and to not be excreted by the kidney( Non renal clearance)?
drug must be hyperphilic
This drug is an opiate that can be used as an antidiarrheal agent to slow gut motility
diphenoxylate
Causes a prolongation of the QT interval but does not predispose to torsades de pointes?
amiodarone
First line therapy RX high cholestrol?
statins
Main 2 SEs seen with the statins?
liver damage and myopathy
What is the mneumonic for obligate aerobes?
"Nagging Pests Must Breathe"
(1) nocardia
(2) pseudomonas
(3)mycobacterium TB
(3) bacillus
Encapsulated bacteria that asplenic pts cannot opsonize?
"SHIN SKiS"
(1)strep pneumo
(2)H inlfuenza type b
(3) N. meningitidis
(4)salmonella
(5) klebsiella
(6) Group B strep
Catalase positive orgs that cause trouble for CGD pts?
you need SSPACE for your CATs"
(1) Staph aureus
(2)serratia
(3)pseudomonas
(4)actinomyces
(5)candida
(6)Ecoli
Presents w/ gray vaginal discharge with a fishy smell?
gardnerella vaginalis
Vaginal epithelial cells covered with bacteria-associated with gardnerella vaginalis?
clue cells
Presents with a bull's eye rash leading to bells palsy, av nodal blockade, and polyarthritis?
Lyme disease

note: caused by borrelia burgdorferi
Binge eating, +/- purging, with normal body weight?
bulimia nervosa
Excessive dieting, +/- purging, leading to BW< 85% of ideal BW?
anorexia nervosa
Pt CONSCIOUSLY creates physical -psychological sxs in order to assume sick role and to get medical attention?
factitious disorder
Preoccupation w/ minor or imagined defect in appearance...pt often seeks cosmetic surgery?
body dysmorphic disorder
Preoccupation w/ and fear of having a serious illness despite medical evaluation and reassurance?
hypochondriasis
What substance is placed in whole blood & can cause hypocalcemia in transfused pts?
citrate
Which cytokines inhibit inflammation?
IL 10 and TGF beta
Characterized by being hypersensitive to rejection, socially inhibited, timid, feelings of inadequacy, but desires relationships w/ others?
avoidant personality
voluntary social withdrawal, limited emotional expression & content w social isolation?
schizoid
Disregard for & violation of rights of others?
antisocial personality
Type of transplant rejection that occurs in months to years and is associated with obliterative vascular fibrosis?
chronic transplant rejection
Type of transplant rejection that occurs in weeks & is associated w/ vasculitis of graft vessels w/ dense interstitial lymphocytic infiltrate?
acute rejection
This is when grafted BM cells attack the host as foreign ag?
graft vs host disease
presents w/ sharp pain, aggravated by inspiration, and is relieved by sitting up and leaning forward?
acute pericarditis
presents w/ a loud friction rub?
fibrinous acute pericarditis
MC viral cause of acute hemorrhagic cystitis in children?
adenovirus
What is the abnormal process that takes place in cystic fibrosis?
abnormal posttranslational processing

note: the TM receptor is degraded in the cytosol
Mutations in this HIV gene is responsible for resistance to HIV RTVIs and PIs?
pol gene
mutations in this HIV gene enable escape from host neutralizing abs?
env gene
Renal papillary necrosis is associated with what 4 conditions?
(1) DM
(2) acute pyelonephritis
(3) chronic phenacetin use
(3) sickle cell anemia and trait
Abrupt onset of gross hematuria in a pt w/ a FH of sickle cell disease?
renal papillary necrosis
First sx of alcohol withdrawal?
tremulousness (tremors)
Unilateral chest pain+hyperresonance+absent breath sounds+decreased tactile fremitus
pneumothorax
MCC of spontaneous pneumothorax?
rupture of apical blebs

note: trachea deviates TOWARD affected lung
Parvovirus B19 has tropism for what tissue?
bone marrow
Virus which is highly tropic for erythrocytes in the BM?
parvovirus B19
Appearance of "slapped cheeks"
erythema infectiosum-fifth disease

Note: causes by parvovirus B19
What can slow the development of hemochromatosis in women?
loss of iron through menstruation and pregnancy
Rx for hemachromatosis
phlebotomy or deferoxamine
Sheets of basohilic lymphocytes w/ interspersed macrophages?
burkitt lymphoma
Associated w/ a jaw lesion in the endemic form...& the pelvis or abdomen in the sporadic form?
burkitt lymphoma
name 4 conditions associated with EBV?
(1)mononucleosis
(2)hodgkins
(3)Burkitt lymphoma
(4) nasopharyngeal carcinoma
Serotonin metabolite detected in the urine?
5hydroxyindoleacetic acid
RT sided valvular disease + 5HIAA in the urine
carnicoid syndrome
rupture of bridging veins+ CRESCENT shaped hemorrhage on CT?
subdural hematoma
Rupture of an aneurysm+worst HA of my life+risk of vasospasm 2-3 days later
SAH
Rupture of middle meningeal artery+ lucid interval
epidural hematoma
Occurs in infants b/c of failure of the processes vaginalis to close?
indrect hernias and hydroceles
Protrusion of peritoneum through the inguinal triangle covered by external spermatic fascia?
direct inguinal hernia
Type of hernia that is medial to the inferios epigastric artery?
direct inguinal hernia
Type of hernia that is lateral to the inferior epigastric artery?
indirect inguinal hernia
Flat facies+excess skin of posterior neck+transverse palmar creases+duodenal atresia
trisomy 21
Older BP medicine that blocks the storage of both NE and serotonin INTO vesicles & therefore can cause depression?
reserpine
Drug that ihibits the conversion of tyrosine----> DOPA
metyrosine
Inhibits the release of NE from from vesicles at the nerve terminal?
guanethidine
Sxs are identical to PTSD except sxs last for only four weeks?
acute stress disorder
CO poisoning has what two effects on oxygen?
(1) decreases the oxygen carrying capacity in the blood-SaO2
(2)LFT shifts the hb-O2 dissociation curve
What is the mechanism of rheumatoid factor associated with RA?
IgM that binds to the Fc portion of IgG
Defect in hepatic excretion of conjugated bilirubin+black liver+dense pigment of EPI metabolites within lysosomes?
dubin johnson syndrome
Occurs when the transverse portion of the duodenum is entrapped between the SMA and the aorta...leading to sxs of partial bowel obstruction?
SMS syndrome
What can cause SMA syndrome?
diminished mesenteric fat (wt loss)
Retrperitoneal hematoma in a stable MVA pt is most likely associated with what structure?
pancreas
Its long half life allows for prolonged effects to supress withdrawal sxs in heroin addicts
methadone
Enzyme increased in Lesch Nyhan syndrome?
PRPP amidotransferase

note: due to increased de novo purine synthesis
Hormone that promotes milk production/lactation?
prolactin
Which hormones inhibit lactation during pregnancy?
progesterone and estrogen
Where in the gut are LIPIDS digested and absorbed?
digested--->duodenum

absorbed--> jejunum