Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
78 Cards in this Set
- Front
- Back
|
The lone star tick transmits what? |
Francisella tularensis - tularemia Amblyomma americanum - the tick spp. |
|
|
Aedes aegypti vector? |
Yellow fever virus and Dengue virus a/w travel outside of US |
|
|
Type 2 diabetic complains of sweating, sizziness, palpitations and tremor 30mina fter taking meds. Her appetite is increased. What med is causing this? |
A 2nd gen sulfonylurea is the most likely diabetic drug to cause hypoglycemia symptoms in Type II pt. Glyburide, Glimepiride, and Glipizide |
|
|
Ixodes tick vector transmits what? |
Lyme dz (Borrelia) Babesia microti (can coinfect with Lyme) Bartonella Francisella Ehrlichia |
|
|
Dog ticks |
Rickettsia rickettsii - Rocky Mtn Spotted Fever (intracellular gram -) |
|
|
Which ligament is NOT contained in the broad ligament of a woman? |
Cardinal ligament (cervix to pelvic side wall) |
|
|
Squamous cell carcinoma of lung - what kind of neoplastic syndrome? |
Secretes PTH, causing hypercalcemia. Bone pain may occur d/t taking calcium out of bones. Histo: presence of keratin production and/or intercellular desmosomes (bridges) |
|
|
Large cell carcinoma |
Histo: sheets of round polygonal cells w prominent nucleoli and abundant pale staining cytoplasm Dx of exclusion |
|
|
Small cell lung carcinoma (SCLC) |
Histo: round, oval, angulated "oat cell" w/ little cytoplasm; can secrete ACTH --> Cushing's can secrete ADH --> SIADH (euvolemic hyponatremic patient) |
|
|
MAC deficiency (C5-9) makes a pt susceptible to which infection |
Neisseria can cause DIC, Waterhouse-Friderichson |
|
|
87 y/o with episodes of abdominal pain and sitention, constipation over past year with prior pancolitis and dolichocolon, been treated with mesalazine for few yrs. PE shows abdominal distention, tympanic sounds on percussion. No signs of toxicity |
Volvulus is common in ~80y/o who are bedridden and institutionalized. Sigmoid - MC Sx: Hx of constipation, pain/nausea/distention, tympanic abdomen |
|
|
Colorectal CA presentation |
Bowel obstruction, iron deficiency anemia, rectal bleeding, abdominal pain, change in bowel habits; ~65yrs |
|
|
Toxic megacolon seen in which pt? |
Ulcerative colitis |
|
|
Diverticulitis |
Sx: LLQ pain, n/v/d, constipation/bloating ~65yrs to >85yrs |
|
|
MCC of CAH? |
21-hydroxylase deficiency note: 11 has more mineralocorticoid effect than 21, so 11 presents with HTN (how to differentiate) either 21 or 11 cause virilization 17-hydroxylase causes increase in mineralocorticoid only - HTN, hypocortisolism.. |
|
|
What is medial tibial stress syndrome |
shin splints - tenderness over anterior tibia |
|
|
Pt w/ runner's knee with the J sign, crepitus with extension.
|
Patellofemoral pain syndrome |
|
|
Corneal reflex |
afferent - CNV - V1 (opthalmic; upper eye sensation..) efferent - facial nerve (closes the eye( |
|
|
The infraorbital nerve controls: |
SENSORY nerve from lower eyelid, side of nose, upper lip it is a branch of the maxillary division V2 of the trigeminal (CNV) |
|
|
Motor output to facial muscles including orbicularis oculi of the eye: |
Facial nerve! |
|
|
Anti centromere and anti DNA topoisomerase I (anti-Scl70) |
Scleroderma (CREST) |
|
|
Anti-histone Ab |
drug-induced lupus (DLE) |
|
|
Anti-U1 RNP |
Mixed connective tissue disorder |
|
|
Anti-Ro Ab & Anti-La Ab |
Sjrogens syndrome (dry eye, mouth) |
|
|
Several elderly pts present with breathing, high fever, intermittent diarrhea. They all shopped at the grocery and purchased fresh veggies under mist machines. What sample should be obtained? |
Urine sample (Ag test) Dx: Legionnaires disease d/t Legionella pneumophila Sx: mild, flu with fever, respiratory Sx and diarrhea; affects immunocompromised Source: contaminated water machines (mis, water park, aerosols, air conditioning unites, etc( |
|
|
Gestational diabetes (new onset) can cause a baby to become: |
1. hypoglycemic AFTER birth glucose source is gone and baby has developed lots of insulin in the womb 2. intrapulmonary shunting b/c of atelectasis; d/t lack of surfactant --> high insulin during pregnancy decreases synthesis of surfatant |
|
|
32 y/o G1P0 female at 34 wks gestation complains of abdominal pain and HA for a week. BP is 142/100 mmHg, lower extremity edema, and 3+ DTR. A urine dipstick is obtained and results in 3+ proteinuria. What is the greatest risk factor? |
Nulliparity (others: >40, renal dz, diabetes, obesity, twins, antiphospholipid syndrome) Pt has Preeclampsia Dx: HTN (BP > 140/90) and proteinuria (>0.3gm/day) after 20 wks gestation Sx: HTN, proteinuria, and non-dependent edema in the hands and feet; HA, visual disturbance, ab pain, N/V, oliguria, altered mentation. |
|
|
A 35-year-old female presents to the Emergency Department for nausea, malaise, and a low-grade fever. Clinical history reveals recurrence of esophageal varices and melena. Physical examination reveals right upper quadrant tenderness and hepatomegaly. Social history reveals alcohol abuse. Laboratory studies are most likely to reveal |
Elevated BUN:creatinine (blood gets digested in GI - urea byproduct); creatinine remains same this can be expected in any upper GI bleed Other results: leukocytosis d/t inflammation platelets low (bc liver makes thrombopoietin) elevated bilirubin (d/t hepatocellular dz by alc hepatitis) |
|
|
Etiology of appendicitis |
Caused by obstruction of the appendix lumen; which increases pressuer inside and causes secretion of fluids/mucus from mucosa that becomes stagnant. Intestinal bacteria multiply inside the appendix, and as pressure inside rises d/t WBC, it becomes greater than appendiceal veins --> venous outflow obstruction. No outflow --> ischemia of the wall --> loss of epithelial integrity, bacterial invsaion of the WALL. |
|
|
AFP marker is for? |
hepatocellular carcinoma (liver) yolk sac tumors (and endodermal sinus) also elevated in open neural tube defect |
|
|
S-100 marker? |
melanoma |
|
|
Positive schillings test for pernicious anemia |
Oral radiaoctive B12 with intrinsic factor (+/- intramuscular B12) --> NORMAL urinary excretion Oral radioactive B12 withOUT IF --> LOW urinary excretion (not absorbed!) |
|
|
Correlation coefficient (r) |
r is always between -1 and +1 if -, there is an inverse correlation (increases, decreases) if +, there is a direct correlation (increases, increases) note: assume the statistic is significant if p value is NOT given! statistic p is <0.05 |
|
|
53 y/o male has weakness and stiffness in legs and difficulty balancing. He reports that it began a year ago and has gotten worse. There are no muscle fasciculations, muscle bulk is symmetric with strength intact. He has increased tone with passive range of motion in lower extremities, and the condition is ruled benign. |
Primary lateral sclerosis benign disturbance of Upper Motor Neurons only; no lower motor (muscle fasciculations/atrophy) begins in lower extremities and affects trunk then upper limbs then bulbar muscles. Hyperreflexia and Babinski's - great toe extends and other toes fan out when sole of foot is stroked. Tx: baclofen, tizanidine (oral anti-spasticity meds) |
|
|
Sickle cell pts are at higher risk for what infection d/t asplenia -- |
encapsulated bacteria, most notably: S pneumonia- pneumonia N. meningitidis Salmonella (including S typhi)- osteomyelitis |
|
|
46 y/o male has 5 week history of worsening ataxia and involuntary muscle contractions. He has progressive memory loss and difficulty concentrationg. EEG shows periodic paroxysms of sharp waves on a slow background. |
Parenchymal vacuolation due to misfolded protein proliferation; rapidly progressive dementia with myoclonus Creutzfeldt Jakob Disease! Sx: dementia, ataxia, myoclonus, sharp waves on EEG |
|
|
Cutoff for prematurity |
<37weeks! |
|
|
Erythromycin is used off-label for? |
Gastroparesis because it enhances GI motility. |
|
|
Mannitol is an osmotic diuretic that has its effects on what parts of the nephron? |
proximal convoluted tubule, thin descending limb, collecting duct |
|
|
Forward sacral torsions are a/w which L5 dysfxn? |
Forward torsion- Type I L5 dysfxn Backward torsion- Type II L5 dysfxn |
|
|
APGAR Score |
Appearance: blue/pink trunk/all pink Pulse: none/<100/>100 Grimace: none/grimace/grimace+cough Activity: limp/some/active Respirations: none/irregular/regular 0/1/2 points 10 total |
|
|
A neonate male is examined after birth, during which he undergoes a unilateral R-side body seizure. PE shows bupthalmos and an irregularly shaped pink birthmark on forehead on the left side of his face. R-sided muscle weakness is noted. Assoc finding? |
MR/ID
Dx: Sturge-Weber Syndrome Hallmark: Port wine stain (facial capillary malformation), ipsilateral (to stain) choroidal hemangioma of eye, eye defects, generalized motor seizures, MR |
|
|
How to prevent infant respiratory distress syndrome (IRDS)? |
Give the mother corticosteroids - mimic the increase in cortisol by fetus in late preg to develop lungs and surfactant. |
|
|
Where can spinal accessory nerve be injured? Which muscles affected? |
Posterior triangle of the neck- the middle 1/3 (base) ipsilateral Trapezius - retraction of scapula SCM- ipsi SB, contra Rot |
|
|
Large majority of pulmonary emboli originate from? |
Femoral vein |
|
|
37 y/o presents with sudden-onset dyspnea. He's from NYC and flew in to California. No significant med history, drinks 2 beers/day, 10-pack-year history. PE shows tachycardia, tachypnea, and work fo breathing increasing. |
Pulmonary embolism (blocked lung perfusion) Sx: sudden onset dyspnea, tachycardia, tachypnea A/w long plan or car ride with venous stasis. Respiratory alkalosis, increased A-a gradient[?] |
|
|
2 y/o black male with malaise and mild ab pain for one day. Hx shows 5 days prior he has cough, coryza, and fever, which then were Tx and improved. On PE, has yellow sclera and mucus membranes. Ab exam mshows mild diffuse tenderness w/o masses or hepatosplenomegaly. |
G6PD deficiency; no generation of glutathione reductase. Pts typically present with sudden anemia and jaundice, often with normal-sized spleen; ab pain/malaise. Histo: bite cells and Heinz bodies (erythrocyte inclusions of denatured Hb) Tx: avoid oxidant stressors (infection-MC,drugs, fava beans) |
|
|
Steady state |
4-5 half lives |
|
|
Does placental abruption have painful beleding? |
YES, painful unlive placenta previa and accreta |
|
|
Central vs nephrogenic diabetes insipidus? |
Central: water deprivation test with desmopressin yields >50% urine osmolality (ADH is working to retain water, and urine is more concentrated) Nephrogenic: water deprivation test with desmopression yields <50% urine osmolality (not working, kidneys don't respond to ADH) |
|
|
Nephrogenic DI treatment |
hydrochlorothiazide, indomethacin, or amiloride paradoxical! |
|
|
Central DI treatment |
intranasal desmopressin |
|
|
SIADH treatment |
fluid restriction or demeclocycline |
|
|
Hypercalcemia of SCC results in what level of PTH? |
LOW PTH it secretes a PTH-LIKE peptide, doesnt show up as PTH. |
|
|
Seizures commonly in temporal lobe |
Compex partial Visual and auditory changes, lip smacking, chewing, walking, postictal confusion LOC |
|
|
Anterior tenderpoints for lumbar spine |
L1 - medial to ASIS L2- medial to AIIS L3- L4-inferior to AIIS L5- ant: 1 cm lateral to pubic symphysis just inferior to prominence, post: over PSIS L1 is medial to ASIS, L2-4 is around AIIS, L5 near pubic symphysis Note: posterior points are on vertebrae itself; the transverse and spinous processes. |
|
|
Prolactinoma treatment |
Bromocriptine or cabergoline (dopa agonists)
|
|
|
How to treat Chagas disease (trypanosoma cruzi) |
Nifurtimox |
|
|
Niridazole is for... |
Schistosoma (trematode) or Dracunculus medinensis (nematode) |
|
|
Fatty casts a/w: |
Nephrotic syndrome |
|
|
Hyaline casts a/w |
prerenal acute renal failure burns, dehydration, vomiting, diarrhea, CHF, sepsis, cirrhosis etc etc - anything decreasing blood volume |
|
|
Which Ig crosses the placenta, directly opsonizes pathogens, and indirectly enhances phagocytosis by activating complement (opsonization)? |
IgG! |
|
|
C1,3,5 deficiency C5b-9 deficiency |
both complement deficiency has increased susceptibility to bacterial infections C5b-9(MAC) is specific to Neisseria |
|
|
Medial geniculate nucleus (of the thalamus) |
hearing receive input from inf colliculus and sup olive ---> auditory cortex |
|
|
Lateral genticulate nucleus |
vision from sup colliculus and optic nerve --> calcarine sulcus |
|
|
Ventral lateral nucleus |
coordinating movement from basal ganglia --? primary motor cortex and premotor cortex |
|
|
Ventral posterior medial nucleus |
taste and sensation from face to Brodmann's areas 3, 1, 2 of the primary somatosensory cortex |
|
|
Ventral posterior lateral nucleus |
pain, temp, proprioception from spinothalamic and dorsal column/medial lemniscus pathways --> Brodmann's areas 3, 1, 2 of primary somatosensory cortex |
|
|
33 y/o female has left eye pain and blurry vision of one week. Hx shows recurrent oral and genital ulcers, the most recent resolving two weeks ago. She denies being sexually active, or having HA, N/V. PE shows bilateral tender, erythematous pre-tibial nodules. Pathophysiology? |
Activation of complement by circulating Ab complexes -- autoimmune vasculitis with complexes attacking large and small BVs in the body --- Behcet syndrome: characterized by recurrent oral aphthous, ulcers, genital ulcers, and uveitis. also- joint arthropathy and panniculitis (inflammation of subQ fat- erythema nodosum) Type IV HST; increased CD4 T cells |
|
|
Syphilis presentation |
primary: painless chancre that regresses after weeks secondary: macular/papular rash from trunk to extremities (palms/soles), copper colored tertiary: gummas, aortic aneurysm secondary to obliteration of vasa vasorum, or tabes dorsalis (locomotor ataxia); Argyll Robertson pupil HIV pts more susceptible |
|
|
Tularemia
|
ulceroglandular (MC): local cutaneous ulcer (skin wound contamination), regional lymphadenopathy (transmission from rabbit or tick) oculoglandular: get into eye by infected blood or rubbing eyes oropharyngeal: contaminated rabbit eaten pneumonic: inhaled --> atypical pneumonia like legionella typhoidal: bacteria in bloodstream can follow any of the routes; usually pneumonia gram - francisella someone HUNTING, tick borne, or rabbit eaten |
|
|
Lepromatous Leprosy |
loss of eyebrows, nasal collapse, lumpy earlobe = "Leonine facies" extensive bilateral symmetric cutaneous involvement (macules/nodules/plaques/papules) Mycobacterium leprae |
|
|
Post-streptococcal glomerulonephritis |
lumpy bumpy appearance hypercellular glomeruli with neutrpohils starry sky appearance |
|
|
Focal segmental glomerulosclerosis |
segmental sclerosis w hyalinosis |
|
|
Minimal Change Disease |
kids with post-infection normal glomeruli |
|
|
Membranous glomerulonephritis |
diffuse capillaries and glomerular basement membrane thickening d/t drugs, SLE, tumors, infections |
|
|
Rapidly Progressive Crescentic Glomerulonephritis causes |
Goodpasture's Wegener;s micro polyangiitis |
|
|
Artial Natriuretic Peptide |
released from right atrial cells decreases sodium absorption (opposes aldosterone effects) |
