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99 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
lens shaped lesion on CT
epidural hematoma
Pigmented hamartomas in the iris
Lisch Nodules
What disease?
NF 1
Owl's Eye associations
Owl's Eye Inclusions - CMV
Owl's Eye Nucleus - Hodgkins(Reed Sternberg Cell)
Owl's Eye protozoan - Giardia Lamblia
Painless jaundice
Pancreatic cancer in head of pancreas
Venlafaxine
SNRI antidepressant
What is special about Cholestyramine
Can bind C.diff toxin
Fluphenazine
High potency typical neuroleptic similar to haloperidol
Trazodone
Anti-depressants

classic side effect?
Priapism
Carteolol
beta blocker for glaucoma
Clozapine
atypical antipsychotic
Clarithromycin
Macrolide
Famotidine
H2 blocker
Fluvoxamine
SSRI
Selegeline
MAO for Parkinsons
Terbinafin
Antifungal
VPL
Somatosensory for body from...?
spinothalamic and dorsal column/medial lemniscus
LGN
Vision from....?
Visual Retina to occipital lobe
VPM
somatosensory and taste from face via...?
trigeminal and gustatory
MGN
Hearing via?
Superior olive and inferior colliculus of pons
Copper, Gold, Arsenic
Penicillamine

"copper pennies, monetary unit, etc."
Arsenic, Mercury, Gold
Dimercaprol
tPA, streptokinase
Aminocaproic acid which decreases fibrin
Digitalis OD
stop dig, normalize K+ and Mg+, Anti-dig Ab
if bradycardia?
If tachyarrhythmia?
Bradi -- Atropine
Tachy -- Lidocaine

Clearance equation
0.7 * Vd / Half life
Loading Dose? Maintenance Dose?
Css = LD/Vd
or
LD = Css * Vd

Css = MD / Cl
MD = Css * Cl
inhibit Warfarin catabolism
TMP-SMX, Metronidazole, Cholestyramine,
aspirin induced asthma
nasal polyps due to excess shunting of arachadonic acid to leukotrienes
What is Wallenberg syndrome? What nucleus is only damaged in Wallenberg Syndrome?
Occlusion of PICA - nucleus ambiguus - AKA Lateral Medullary syndrome
Symptoms?
Don't PICA horse(hoarseness) that can't eat(dysphagia)

CONTRALATERAL loss of pain and temperature(spinothalamic)

IPSILATERAL loss of CN 5, 8, 9, 10, 11 and Horner's
Lateral Inferior Pontine Syndrome
Occlusion of AICA
Hemineglect arises from?
MCA stroke of non-dominant(right) side
Ant Circulation of Brain derives from?
Int. Carotid

Post circulation derives from?
Subclavian
Omalizumab
Anti-IgE antibody used for moderate to severe asthma
Each bronchopulmonary segment has...
A tertiary bronchus and two arteries(bronchial and pulmonary) in the center. What drains along the borders?
Veins and lymphatics
What is the largest contributor of functional dead space?
Apex of lung
Drug induced Methemoglobinemia
Chloroquine, Primaquine, Dapsone, Sulfonamides, Lidocaine, Metoclopromide, Nitrates
How do you cure cyanide poisoning?
Give nitrates to oxidize hemoglobin which binds CN. Then give thiosulfate which will make thiocyanate allowing for renal excretion.
Normal A-a gradient
10-15

PAO2 - PaO2
normal PAO2 = 104
normal PaO2 = 40
Alveolar Gas Equation
PAO2 = PIO2 - PaCO2/R

Alveolar PO2 = PO2 in inspired air - arteriolar CO2/R

Where R = CO2 produced/ O2 consumed
Where is ventilation quantitatively greater?
Base of the lung. Perfusion also.

WHere is V/Q greatest?
Apex
How does exercise change the V/Q mismatch of the apex of the lung?
It increases perfusion, bringing V/Q closer to 1(normally it is 3)
Haldane effect
It is the release of H+ in lungs that causes shift of H2CO3 to CO2 and H2O.
False vocal cords histology
squamous epithelium
True vocal cords histology
ciliated pseudostratified columnar epithelium
Most common symptom of laryngeal cancer
hoarseness
inspiratory stridor in epiglottis?
in epiglottis is H.flu

in Trachea is?
Parainfluenza
What decreases surfactant production?
C-section(stress)
Insulin(diabetic mothers)
What is surfactant produced by?
lamellar bodies of Type II pneumocytes
What congenital defect will occur with hypoxemia due to respiratory distress due to lack of surfactant?
PDA doesn't close due to hypoxemia
Signs of Consolidation(CA Pneumonia, lobar pneumonia)
decreased percussion, increased fremitus, egophany(e to A), whispering pectoriloquey(patients whisper, you hear loudly on stethoscope)

How do you differentiate pleural effusion from consolidation?
only have decreased percussion
Most common cause of bronchiolitis
RSV or pneumonia
Chlamydia Trachomatis
whizzing a week after birth, increased AP diameter, conjunctivitis, infective cervix
Green cod discoloration sputum
Pseudomonas
mucoid appearing sputum
Klebsiella

can cause cavitations in?
upper lobe
Legionella
atypical pneumonia(no productive cough), can disseminate to kidneys causing hyponatremia due to interstitial nephritis

word association?
water cooler
spherule with endospore
coccidioides
fungus inside macrophages
histoplasmosis
Treats histoplasmosis and cryptococcus
Actinomycin
Right upper lobe massive cavitary lesion with massive hemoptysis
Aspergillosis

What other disease presentations?
Invasive vascular disease

Asthma Associated Aspergillosis
Silver Stain
Legionella
Bartonella Henselae
Pneumocystic Carinii
Bacillary Angiomatosis
Ping pong ball on silver stain
PCP
CD<200 pneumonia on HIV?
PCP
TMP-SMX treats?
PCP and Toxoplasmosis(Ring enhancing lesions)
Cavitating lesions of the lung?
Fungus -- Histoplasmosis
Cancer -- Squamous Cell Carcinoma
Bacteria -- Klebsiella
Caplan's Syndrome
Rheumatoid Arthritis in the lung + Pneumoconiosis

Rheumatoid nodules in the lung
Sarcoidosis classic presentation
Black person, 35 yrs old, dyspnea with some kind of face involvement(uveitis -- blurry vision, sacrimal or lacrimal gland involvement)

What do you treat with?
Steroids
ACE enzyme is very high
anything with non-caseating granulomas

Sarcoidosis, Berylliosis, etc.
What enzyme do non-caseating granulomas have?
ACE as well as
1 alpha hydroxylase -- leads to hypercalcemia secondary to Vit D production
Hypersensitivity Pneumonitis is what type of hypersensitivity?
Mixed Type III, IV hypersensitivity

Farmer's Lung
Disease of TERMINAL bronchioles
Chronic Bronchitis(also asthma and bronchiolitis)
The pathology is proximal to that where you have?
Mucous gland hypertrophy
Muscles of inspiration
EXTERNAL intercostals, Scalene muscles, sternomastoids
Muscles of expiration
INTERNAL intercostals, obliques, rectus and transverus abdominus
Largest contributor of functional dead space?
Apex of lung
Determine physiologic dead space
Tidal volume x percent CO2 consumed

or

Vd = Vt x (Alveolar/Arteriolar CO2 - Expired CO2) / Alveolar/Arteriolar CO2
What gene is inactivated in primary pulmonary fibrosis?
BMPR2
even loss of ventilation and perfusion
emphysema -- this means?
no CO2 retention
cupfuls of pus
bronchiectasis
most common cause in US?
3rd world?
CF in US
TB in 3rd world
Describe MC pathogenesis of ARDS
Sepsis leads to neutrophil invasion causing leaky capillaries which can then cause hyaline membrane disease. Neutrophils also destroy surfactant causing alveolar collapse. This all causes sepsis in about a day.

What follows sepsis?
DIC on day 2-3
What kind of disease will you avoid the use of ACE inhibitors?
bilateral renal stenosis

this is because they decrease GFR by preventing constriction of efferent arterioles
Aldosterone effect on various ions
Wastes K+, Cl-, H+

Retains Na+ and H20
Chloride response to loop and thiazide diuretics
Cl- is paradoxically increased
fruity breath odor
diabetic ketoacedosis(acetone)

a/w what infections?
mucormycosis, rhizopus
What ion is lost in DKA?
Potassium is depleted from intracellular stores but is circulating in extracellular space which is then diuresed. If insulin is given, can cause hypopotassiumemia in blood due to the re-entry into IC space.
hyponatremia associated pneumonia
Legionella
bilateral infiltrates that appear more severe than expected based on mild clinical presentation
Mycoplasma Pneumonia
Pneumonia a/w increased IgE
Aspergillus
Influenza A pneumonia clinical presentation
fulminant fever, headache, myalgia, malaise that gradually improves over 2-5 days

Can develop secondary bacterial infection usually from?
Staph aureus
Superinfects on influenza pneumonias
Strep Pneumo, Staph, H flu
Histology of Large Cell Carcinoma
Pleomorphic Giant Cells with leukote fragments in cytoplasmcy
Kulchitsky cells
small dark blue cells

from which cancer?
Small Cell Cancer
Lambert-Eaton Syndrome
Small Cell Carcinoma
Other PNS?
ACTH or ADH secretion
PTHrP PNS
Squamous Cell Carcinoma
Squamous cell carcinoma histology
Keratin pearls and intercellular bridges
Bronchioloalveolar adenocarcinoma
hypertrophic osteoarthropathy
N-acetylcysteine MOA as a mucolytic
breaks apart disulfide bonds which loosens thick mucus.
Used in CF
Location of Neurons in Spinothalamic Tract
Pain and Temperature
1st - Sensory nerve(nerve type?)
2nd - IPSILATERAL grey matter of dorsal horn which then DECUSSATES and ascends and...
Synapses in VPL of Thalamus where it goes to 3rd order neuron in primary somatosensory cortex.
Location of Neurons in Corticospinal Tract
1st - UMN in primary motor cortex that travels through ipsilateral internal capsule and DECUSSATES in caudal medulla and descends to synapse on an ventral horn neuron on a LMN
Location of Neurons in Dorsal Column Tract
Sensory neuron synapses on dorsal horn neuron which ascends ipsilaterally on dorsal horn(gracilis and cuneatus tract), DECUSSATES at medulla and travels to synapse on VPL. That neuron then synapses on primary somatosensory cortex.
What kind of nerve fibers are primary neuron in spinothalamic pathway?
A-delta and C-fibers

Which fiber is unmyelinated?
C fibers
Fasciculations are a...
LMN sign