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30 Cards in this Set

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Dr. Clare, your mentor, is letting you assist on your first mastectomy! Yay! She warns you not to cut the nerve of the serratus anterior! Which nerve is this and why?
long thoracic nerve- causes winged scapula
variation between data points in a sample or the middle of the curve=
standard deviation
standard deviation/ (square root of sample size) or how well the mean of the sample will preduct the mean of the entire population
standard error of the mean
if you increase the standard deviation what do you do to the standard error of the mean?
increase it!
if the sample population increases what happens to the standard error of the mean?
decreases
1 SD= __%
2SD=__%
3 SD=__%
1 SD= 68%
2 SD= 95%
3 SD=99.7%
what is the mean - Z (SEM) to mean + Z (SEM)
confidence interval
confidence interval = what number usually? and what number is z usually?
95% and z= 1.96
if Confidence interval = 99%; z = 2.58
Angelina Jolie gets pregnant again and refused to take any medications during her pregnancy. When is her celebrifetus most susceptible to teratogens?
weeks 3-8
Why should you not give captopril to Angelina Jolie?
teratogen will cause renal damage to fetus
What antifungal will cause gynecomastia?
Ketoconazole! it inhibits hormone synthesis and is a weak androgen receptor antagonist. its MOA is inihibiting fungal sterol synthesis.
Spironolactone a K-sparing diuretic causes what unfortunate side effect?
Gynecomastia! - increased conversion of testosterone to estradiol; blocks testosterone synthesis and binds to androgen receptors
92 year old sweet grandpa from Brooklyn has CHF which jugular venous distention. What is the jugular venous pulse?
Upward= a,c,v
a= atrial contraction
c= right ventricle contraction
v= atrial pressure due to filling against closed tricuspid valve
downward contractions= x and y descent
x= atrium relaxing and tricuspid valves move downward
y= filling of ventricle after tricupsid is open
A stoic pig farmer from England has had diabetes mellitus for 30 years. He comes to you because youre the best family med doctor in the world! What will you check on your physical exam?
small vessel disease- retinopathy- cotton wool spots, exudate, hemorraghe; glaucoma, nephropathy- chronic renal failure
large vessel- artherosclerosis, CAD
gangrene- loss of limb,
cerebrovascular disease
What are Kimmelsteil-Wilson nodules?
acellular ovoid nodules in glomerulus periphery in diabetic nephropathy
A 55 year old father of 3 has a MI 3 days ago. You followed the typical post MI protocol and prescribed him several medications. Today is platelet count is 30,000. Why?
HIT- heparin induced thrombocytopenia-
heparin binds to platelet factor IV and causes antibody production so you have all platelets in one area- hypercoagulable and low platelets everywhere else in body
What is the treatment for HIT?
stop heparin and prescribe lepirudin or bivalirudin
side effects/ toxicity:
ataxia, diplopia, dizziness, sedation
SLE-like symptoms
gingival hyperplasia in kids
hirtuism
megaloblastic anemia
teratogenic
steven johnson's syndrome
phenytoin!
"messed up hair, messed up gums, messed up baby!"
what stage of sleep gives you beta waves
REM and awake- eyes open
what stage of sleep do narcoleptics start at?
REM
when do night terrors occur
stage 3-4
what stage of sleep do you get sleep spindles and k complexes?
stage 2
when do you get delta waves?
stage 3-4
What do sertoli cells release to inhibit paramesonephric ducts?
mullerian inhibitory factor because paramesonephric ducts= mullerian ducts
what cells secrets IFN-gamma?
TH1 cells
what do IFN-gamma cells do?
stimulate macrophages and inhibit Th2 cells
a 3-­‐day-­‐old female infant is diagnosedwith 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 keep a patent ductus arteriosus?
Prostaglandin E keeps it open
indomethocin ends it (inhibits prostaglandins)
A trauma patient is rushed to the ER. She has a cervical collar in place, and there is high suspicion that the patient has a broken neck, as well as bilateral clavicle fractures. The patient has bled a lot,and
Central 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?
go medially to pulse! NAVEL- from lateral to medial- nerve, artery, vein, empty space, lymphatics
Whats the difference between MRI and CT scan
MRI-
- no radiation
-more expensive
-protons used
-look at soft tissues
-bones look grey
- watch out for claustrophobia
CT
- xrays
-radiation-shit ton!
-less expensive
-look at bones and blood
-metal is ok here
-bones look white
A person eating fugu sashimi in Japan is at risk of what toxicity? What is the mechanism of this
toxicity
tetrodotoxin- lethal to liver, ovaries and skin. it blocks Na channels and paralyzes muscles causing people to die of asphyxiation while fully conscious. watch first charlies angels movie. scene with bill murray and tim curry and just before sumo suits. actually just keep studying for boards