Dit Pt 1 Set 1

Front 1

5-a reductase deficiency leads to what physical findings (ext. and int) in a male

Back 1

5-a reductase is necessary to convert DHT (from leydig cells) to testosterone
- with deficiency you see ambiguous external genitalia until puberty and normal internal genitalia

Front 2

Start a pt on drug that has been on market for 5 yrs. With excellent efficacy, but your pt begins to have annoying S/E after one month... Contact manufacturer who contacts you what phase of the clinical trial would this fall?

Back 2

phase IV studying- post marketing surveillance trial of patients after approval
- this detects rare or long-term adverse effects

Front 3

12 yr old male in ER for vomiting and abd pain + confusion experiencing rapid breathing with a fruity odor. Blood glucose= 522mg/dl
1. What condition is this?
2. What condition does pt have that most likely caused this? 3. What ketone body is detected in urine test?

Back 3

1. DKA Most important complication of type 1 diabetes
2. pt most likely has type one diabetes
3. 2 main ketone bodies are acetoacetate and B-hydroxybutyrate but urine test only detects acetoacetate

Front 4

Aztreonam and PCN bind to PCN-binding proteins... Can aztreonam be used in patients with PCN allergy?
2. Which patients would you use aztreonam and against which organisms?

Back 4

1. yes due to different binding site
2. PCN allergic patients and renal insufficeint pts which can not take aminoglycosides...
- used only for gram negative bugs

Front 5

32 yr old male in for mvc all of a sudden overnight becomes hypertensive bp shoots from 125/80 to 201/111 and becomes diaphoretic, and tachcardic... pt says this happens 1-2 times a week... what is most likely diagnosis? What orders? What tx?

Back 5

most likely pheochromacytoma-->
5 P's Pressure, pain, pallor, perspirations, palpitations
- abdominal Ct shows adrenal mass
tx- - a-blocker - phenoxybenzamine then remove tumor

Front 6

with primary and secondary hyperaldosteronism... how do plasma renin levels differ in the two?

Back 6

pimary- low plasma renin
secondary- high plasma renin levels
tx is surgery to remove tumor and or spironolactone to increase K levels and decrease aldosterone

Front 7

35 yr old G1P0 has been hospitalized for observation of vaginal bleeding from a placental abruption... labs show increased BT, Pt, PTT
You are concerned pt is at risk for DIC. What are risk factor for having DIC and what additional risk factors and lab findings are associated with DIC?

Back 7

Risk factors= STOP Making New Thrombin= Sepsis, Trauma, Obstetric complication, acute Pancreatitis, Malignancy, Nephrotic syndrome, Transfusion
- additional tests- Plateles decrease, schistocytes, increased D-dimers, decreaed fibrinogen, decreased factors 5, and 8

Front 8

43 yr old male complains of R sided facial droop. Exam shows upper and lower face drooping...
Is this a lower or upper motor neuron lesion?
What diseases are associated with Bell's palsy?

Back 8

This is a LMN problem of the face
LMN- ipsilateral paralysis of upper and lower face
- Diseases associated with Bell's palsy.... (ALexander graHam bell with STD)- AIDS, Lyme Disease, Herpes Simplex, Sarcoidosis, Tumors, Diabetes

Front 9

What are the important functions of Vit. C?

Back 9

Antioxidant
1. facilitates iron absorption by keeping iron in Fe2 reduced state
2. Necessary for hydroxylation of proline and lysine in collagen synthesis
3. necessary for dopamine B-hydroxylase which converts dopamine to NE

Front 10

30 yr old pt with HIV in Africa complains of fever, weight loss, and a cough associated with hemoptysis over the past 2 months. Chest xray reveals perihilar lymphadenopathy and left lower lobe granulomatous formation....
What is name for xray findings? What other mycobacteria cause pulmonary disease?
What are potential extrapulmonary manifestations of mycobacterium TB?

Back 10

Xray findings are called ghone focus on lower lobe and together with hilar nodes is known as a ghon complex
- M. kansasii- TB like symptoms
- TB extrapulmonary= CNS parenchymal or meningitis, vertebral body (Pott's disease), renal, GI, lymphadenitis

Front 11

Neonatologist suspsects newborn to have DiGeorge syndrome. What is the underlying cause of DiGeorge syndrome?
Manifestations?

Back 11

Cause- 22q11 deletion results in failure to develop 3rd and 4th pharyngeal pouches
- Hypocalcemia, recurrent viral/fungal infections (t-cell deficeincy), congenital heart defects, great vessel defects
also cleft palate

Front 12

Amyloidosis and sarcoidosis are associated with which cardiomyopathy?
What are some other diseases or conditions associated with this cardiomyopathy?

Back 12

Restrictive/obliterative cardiomyopathy
- also associated with post radiation fibrosis, endocardial fibroelastosis, Loffler's syndrome, and hemochromatosis...

Front 13

MC viral causes of myocarditis?

Back 13

a. Coxsackie virus (MCC)
b. Echovirus

Front 14

Pt has recent complaints of weakness, pallor, craving for ice chips, and tachcardia, with hx of hemorrhoids. What do you immediately suspect is the cause of the pt's condition and how do you treat it?

Back 14

Iron def. anemia- PIKA (craving of non-food substances)

Iron replacement with Vit. C and maybe colonoscopy if over 50 yrs old

Front 15

How is body affected by a prolonged stay in space at zero gravity?

Back 15

decreases in:
Blood volume
RBC mass
muscle strength and work capacity
max cardiac output
loss of bone mass (loss of Ca and phosphate from bone)