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15 Cards in this Set
- Front
- Back
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You are performing a radical mastectomy and exercise extreme caution as you dissect laterally along the serratus anterior muscle. You do this in order to avoid severing which motor nerve, which would result in what squalae?
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Long thoracic nerve C5-C7- connects the scapula to the thoracic cage
-->winged scapula |
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How does standard deviation differ from standard error of the mean?
Which is used in calculating confidence intervals? |
- standard deviation = variation between data point in a sample
1SD= 68% of values 2 SD= 95% of values 3 SD= 99.7% standard error of the mean- (SEM) how well the mean of a sample will predict the mean of the entire population - CI- calculated using standard error of the mean Formula?- CI= [mean- Z(SEM)] to [mean + Z(SEM)] For CI: 95% Z= 1.96, for 99% Z= 2.58 |
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A 23yr old G1P0 slut refused to take any medications during her pregnancy despite having a mild, constant nausea. When is a fetus most susceptible to damage from teratogens?
What drug used in the treatment of hypertension is a teratogen? What effect does this have on the fetus? |
Embryonic period week 3-8 is most susceptible to damage from teratogens
- ACE inhibitors is a teratogen causing renal damage |
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A young man presents with gynecomastia secondary to heavy marijuana use. Other drugs are known to cause gynecomastia. Which anti-fungal drugs do this and by what mechanism? What diuretic drug does this and by what mechanism?
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Azoles (specifically KETOCONAZOLE)- inhibit fungal steroid synthesis (desmolase), by inhibiting P-450 enzymes that converts lanosterol to ergosterol, and causes hormone sythesis disfunction
- Diuretic- spironolactone by anti-androgen effects it increases testosterone to estradiol |
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During morning rounds you check on a 70-yr old man with congestive heart failure. You observe marked jugular venous distention. What gives rise to the jugular venous a, c, and v waves?
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a- atrial contraction
c- RV contraction (tricuspid closed) v- increased right atrial pressure due to filling against a closed tricuspid valve |
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A loser patient of yours was diagnosed with DM 30 yrs ago and comes to you today for a general wellness exam. What would you pay particular attention to on your physical exam of this patient (i.e. chronic manifestations of diabetes?)
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Eye problems- need yearly dilated eye exam
1. Retinopathy- neovascularization, hemorrhages, exudates, cotton- wool spots. 2. Glaucoma. 3. Cataracts Diabetic nephropathy- 1. proteinuria 2. Chronic renal insufficiency 3. Renal failure Diabetic Neuropathy- painful peripheral neuropathy, loss of sensation to the feet, autonomic neuropathy (gastroparesis) Diabetic Atherosclerosis- MI, Stroke, Peripheral vascular disease (wounds, gangrene) |
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Three days ago, you hospitalized a fuckin 40-yr old male for myocardial infarction. He has been given all of the usual medications. Today you notice that his platelet count is 30,000. What do you suspect is the cause of his low platelets?
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Due to HIT (heparin induced thrombocytopenia)- heparin binds to Platelet factor IV, causing antibody production that binds to and activates platelets leading to their clearance and resulting in a thrombocytopenia, but still at risk for thrombosis
- Tx- Lepirudin, bivalarudin |
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A patient suffers a traumatic brain injury after a motor cycle crash, and the neurosurgery resident (who is a giant dueche) orders phenytoin for seizure prophylaxis. What are the toxic side effets of phenytoin?
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tons of shit!
Nystagmus, diplopia, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenesis (fetal hydantoin syndrome), SLE- like syndrome, induction of cytochrome P-450, Stevens- Johnson syndrome |
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A 35-yr old male develops hallucinations just before sleep, episodes of excessive sleepiness, and cataplexy during times of laughter and sadness. Narcoleptic sleep episodes begin with what state of sleep? What are the different stages of normal sleep? How do they differ from one another?
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Narco sleep- start in REM sleep
Different sleep/alert stages: a1 (awake alert)- beta waves with high frequency but low amplitude a2 (awake relaxed eyes closed)- alpha waves 1. Light sleep (theta waves) 2. Deeper sleep (sleep spindles and K complexes) 3. Deepest non-REM sleep (also night terrors, sleepwalking, bedwetting)- Delta waves (low frequency and high amplitude) 4. REM - dreaming, loss of motor tone, erections, increase brain O2 (Beta- waves) |
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Sertoli cells release a substance that acts on the paramesonephric ducts in order to prevent the formation of what structures in a normal male fetus? What other name is given to the paramesonephric ducts?
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MIF (mullerian inhibitory factor) from sertoli cells suppresses development of paramesonephric ducts (i.e. mullerian duct) which would become the fallopian tube, uterus, and upper 1/3 vagina
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INF-gamma stimulates macrophages and inhibits T2 helper cells. What cell type releases IGN-gamma?
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Th1 cell
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A 3-day old ugly female infant is diagnosed with transposition of the great vessels. While she awaits surgical correction of the congenital defect, it is imperative that the patent ductus arteriosus remains open. What substance is used to close a patent ductus arteriosus? What substance is used to keep it open?
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To maintain a shunt you give PGE and to get rid of shunt you give Endomethacin (indomethacin)
- ENDomethacin ENDs patency of PDA - PGEE kEEps it open |
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A trauma patient is rushed to the ER. She has a cervical collar in place, and there is high suspicion she broke her neck, as well as bilateral clavicular fractures. The patient has bled a lot, and ventral venous access is needed to resuscitate. Because of her injuries the best location for such a line is the groin. Describe the anatomy of the femoral sheath. When placing a femoral line for central venous access you palpate a femoral pulse. Where do you place the guide needle in relation to this pulse: medially or laterally?
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Femoral sheath- fascial tube 3-4 cm below inguinal ligament... has femoral artery, vein, and canal but NO nerve
- Place it medial to pulse |
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How does MRI differ from CT?
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MRI- more expensive, no radiation, better for soft tissue, bones show gray
CT- better for bone and blood, metal is no problem, bones are white, take 10 mins |
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A Jew who eats fugu sashimi in Japan is at risk for what toxicity?
What is the mechanism of toxifying the Jew? |
fugu sashimi (i.e. blow fish) contains a Tetrodotoxin (TTX) which is a potent neurotoxin that shuts down electrical signaling in nerves by binding to the pores of sodium channel proteins in nerve cell membranes.
Causes- coma, resp arrest, cardiovascular collapse 17 mins to 4 hrs after ingestion |
