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28 Cards in this Set
- Front
- Back
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A 50--‐year--‐old man crashes on a motorcycle on the highway and obtains a right anterior hip dislocation and knee trauma. Now he cannot adduct his hip or plantar flex on that side. Which nerves are injured?
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anterior hip dislocation injured obturator nerve (L2-L4) can't adduct hip
knee injury injured tibal nerve (L4-S2) problems plantar flexing with foot drop, sensory deficit on sole of foot |
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What is a type 1 (alpha) error?
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• Stating that there is an effect or difference when non exists ( to mistakenly reject the null hypothesis). False positive error
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The dorsal root ganglion is considered gray matter within the spinal cord. From what embryological derivative are the dorsal root ganglia derived?
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From Dr. Ward's favorite- neural crest cells! which are from ectoderm! YAY
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A 55--‐year--‐old female patient with recurrent UTIs is prescribed TMP--‐SMX as prophylaxis. Describe the mechanism of action of this drug combination.
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SMX- sulfonamide works by inhibiting dihydropterate synthetase in the THF pathway so no thymidine is made- no DNA for bacteria
TMP- inhibits dihydrofolate reductase so you can't make THF= no thymidine = no DNA for bacteria |
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What anticancer drug works in the same way as TMP?
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methotrexate also inhibits dihydrofolate reductase to prevent THF and thymidine. methotrexate works in fastest replicating cells in the body
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A 67--‐year--‐old male CHF patient lost his job and medical insurance, so he stops buying and taking his digoxin, and develops dyspnea. What will this do to his cardiac output (CO)?
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decreases CO! because his digoxin was increasing contractility and increasing CO
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Why would your old male patient with CHF be having dyspnea?
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blood is pooled into left atrium backing up the pulmonary veins and arteries and causing dyspnea ( left sided heart failure becomes right sided heart failure)
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You are treating a 63--‐year--‐old female with small cell lung cancer who develops SIADH. She becomes disoriented secondary to hyponatremia. Consequently, you rapidly correct the low serum
Sodium with demeclocycline and water restriction. The patient’s sodium level and disorientation improve; however, soon after the patient develops diplopia. What is the cause of this patient’s diplopia? |
You didn't listen to Dr. Thomas' lecture and fixed the hyponatremia too fast! pt developed central pontine myelinolysis- causing diplopia and loss of consciousness. get MRI and look at increased signal in the pons.
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What are some causes of SIADH?
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ectopic ADH from small cell lung cancer
CNS disorders/head trauma pulmonary disease-like pneumonia and TB drugs like cyclophosphamide, fluoxetine and carbamazipine major surgery HIV infection |
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In polycythemia vera what happens to plasma volume?
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increased plasma volume
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In polycythemia vera what happens to RBC mass
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elevated like a lot!
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In polycythemia vera what happens to O2 saturation?
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no change
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endogenous erythropoeitin levels?
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decreased due to feedback system (high RBC)
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What is polycythemia vera?
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abnormal clone of hematopoeitc stem cells are increasingly sensitive to growth factors- pretty much bone marrow disease that leads to way too many RBCs
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. An 18--‐year--‐old female is told by her boyfriend that sometimes she just “zones out” for about 15 seconds and does not respond to anything he says. He says that she picks at her shirt during this time, and that she doesn’t remember it, nor does she to have any decreased mental status afterward. What anticonvulsants are used to treat her?
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she has absence seizures!!!
DOC= ethosuximide! or valproic acid |
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If a patient had status epilepticus right now what would you give them? If a patient had it in the past what would you give them to prevent it?
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Benzodiazipine- acutely like lorazepam or diazepam
phenytoin for prophylaxis |
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What is in a nucleosome?
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histone octomer of 2x- H2A,H2B, H3 and H4. histones have lysine and arginine amino acids (positive charge) to attract negatively charged DNA
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What histone ties nucleosomes together?
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H1 ties nucleosomes together and is the only histone outside the nucleosome core
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You are educating the parents of an 8--‐month--‐old male patient with cryptorchidism. During
Your explanation you use an anatomic diagram, and you point to the fibrous band attached between Each testis and the scrotum that aids in normal testicular descent. In an adult female, what does that band of tissue become? |
gubernaculum! becomes ovarian ligament and round ligament in uterus.
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. A 22--‐year--‐old female patient suffers from recurrent purulent upper respiratory tract infections. She is at your clinic for evaluation. Which complement protein is an opsonin?
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The complement protein she's deficient in -C3b!
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Which complement protein aids in neutrophil chemotaxis?
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C5a
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Which complement proteins form the membrane attack complex?
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C5-C9
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At the completion of an annual physical exam in a 40--‐year--‐old male smoker, you are providing some patient education on atherosclerosis. Which risk factors might you discuss with this patient?
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smoking, hypertension, diabetes mellitus, hyperlipidemia, family history
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Where are the most common locations for atherosclerosis? Vessels not geography
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abdominal aorta>coronary artery>popliteal artery> carotid artery
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A 55 year--‐old patient is admitted for IV fluid resuscitation secondary to diarrhea. He also has gastric reflux and a peptic ulcer, which even prescription proton pump inhibitors cannot control.
What drugs regulate the secretion of gastric acid? |
proton pump inhibitors like omeprazole
H2 blockers like cimetidine antimuscarinic drugs like atropine somatostatin- octreotide-inhibits ECL cells |
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A 55 year--‐old patient is admitted for IV fluid resuscitation secondary to diarrhea. He also has gastric reflux and a peptic ulcer, which even prescription proton pump inhibitors cannot control.
What endogenous hormones regulate the secretion of gastric acid? |
activates acid- gastrin, histamine, acetylcholine
inhibits acid= somatostatin, prostaglandin, secretin, GIP |
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A central line is often placed in the subclavian vein to administer fluids and medications or to measure central venous pressure. What landmarks are used when placing a subclavian central line?
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Place Thumb on midclavicle and index finger on jugular notch; puncture by thumb and advanced medially to index finger
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What landmarks are used when placing an internal jugular central venous catheter?
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Use right internal jugular vein! Palpate the common carotid artery and go laterally to it insert needle into IJV at 30 degree angle aim for the apex of the triangle between sterna and clavicular heads of SCM
aim at ipsilateral nipple Carotid is medial to needle (IJV) |
