Dit Week 12 Monday

Front 1

What is the most common cause of nephrotic syndrome in adults? In children?

Back 1

Nephrotic syndrome: proteinuria >3.5 g/day
Minimal change disease is most common in kids
Foot process effacement, albumin loss
Membranous glomerulonephritis most common in adults
Spike and dome with subepithelial deposits

Front 2

What physiology accounts for the automaticity of the AV and SA nodes?

Back 2

Pacemaker action potential
Phase 4 is a slow diastolic depolarization with a membrane potential that spontaneously depolarizes as Na conductance increases. The slope of phase 4 in the SA node determines heart rate. Ach decreases depolarization and rate, catecholamines increase depolarization and rate. Sympathetic stimulation increases the chance that the If channels are open (funny channels).

Front 3

Which antifungal drug and diuretic drug inhibit steroid synthesis?

Back 3

Spironolactone is an androgen antagonist.
Azoles (inhibit ergosterol synth) and inhibit hormone synthesis.

Front 4

What is the clinical use for the drug Tamoxifen? What is the main concern when using this drug? What other agent may be a better choice?

Back 4

Mech: SERM-receptor antagonist in breast, agonist in bone blocking the binding of estrogen to estrogen receptor-positive cells
Use: breast cancer and osteoperosis prevention
Tox: increases risk of endometrial carcinoma via partial agonist affects
Raloxifene (also a SERM) does not act as an endometrial antagonist

Front 5

What are the signs and symptoms of diabetic ketoacidosis (DKA)? What is the treatment?

Back 5

Sx: Kussmaul respirations (rapid deep breathing), N/V, abdominal pain, psychosis, delirium, dehydration, fruity breath odor
Tx: fluids, insulin, K, glucose to prevent hypoglycemia

Front 6

What is the most common malignancy in children?

Back 6

acute lymphocytic leukemia

Front 7

What is the most common solid tumor location in children?

Back 7

brain tumor

Front 8

What are the 2 most common brain tumors in children?

Back 8

astrocytoma and medulloblastoma

Front 9

What is the most common supratentorial brain tumor in children?

Back 9

craniopharyngioma

Front 10

What is the most common extracranial solid tumor in children?

Back 10

neuroblastoma

Front 11

What is the most common malignant bone tumor in children?

Back 11

osteosarcoma

Front 12

What is the most common tumor of adrenal medulla in children?

Back 12

neuroblastoma

Front 13

What is the most common renal tumor in children?

Back 13

Wilm’s tumor

Front 14

What is the most common primary cardiac tumor in kids?

Back 14

Rhabdomyoma

Front 15

What hormone is detected in a positive urine pregnancy test? How long after conception will this hormone first appear in the urine?

Back 15

Beta HCG
Detectable in blood tests 1 week after conception and in urine tests 2 weeks after conception

Front 16

What test is used to confirm the diagnosis of hereditary spherocytosis? What findings are associated with hereditary spherocytosis?

Back 16

Labs: positive osmotic fragility test
Findings: splenomegaly, aplastic crisis (B19 infection), howell jolly bodies after splenectomy

Front 17

Which type of lymphoma has a presentation that is very similar to CLL?

Back 17

Hodgkin's lymphoma

Front 18

What patient population is more prone to transposition of the great vessels? What substance should be given when a newborn is diagnosed with transposition of the great vessels?

Back 18

Infants of diabetic mothers are predisposed to transposition
Newborns should be given PGE to maintain patency of the shunt until surgical correction

Front 19

What structures can be found in the cavernous sinus?

Back 19

Internal carotid, sella turcica, pituitary stalk, pituitary gland, CN 3, 4, 5-1, 5-2, 6

Front 20

What is the rule of 2’s associated with Meckel’s diverticulum?

Back 20

2 inches long
2 feet from the ileocecal valve
2% of the population
Presents in first 2 years of life
May have 2 types of epithelia (gastric/pancreatic)

Front 21

What breast pathology is suggested in a firm fibrous mass of a 55 year old woman?

Back 21

Invasive ductal carcinoma
Worst and most invasive cancer
Most common (76%)

Front 22

What breast pathology presents as a small, mobile, firm mass with sharp edges in a 24 year old woman?

Back 22

Fibroadenoma
Increases in size and tenderness with increasing estrogen
Not a precursor to breast cancer

Front 23

What breast pathology has a histologic "leaflike appearance"?

Back 23

Phyllodes tumor
Large bulky mass of connective tissue and cysts
Most common in 6th decade
Benign but may become malignant.

Front 24

What breast pathology commonly presents with nipple discharge?

Back 24

Intraductal papilloma
Small tumor that grow in lactiferous ducts, typically below areola
Serous or bloody discharge
Benign with slight increase in cancer risk

Front 25

What breast pathology presents with eczematous patches on the nipple?

Back 25

Paget's disease
Large cells in epidermis with clear halo
Suggests underlying carcinoma, also seen on vulva

Front 26

What breast pathology presents with multiple bilateral fluid-filled lesion with diffuse cyclical breast pain?

Back 26

Fibrocystic disease, cystic variant
Most common cause of breast lumps from 25-menopause
Does not indicate increased risk of carcinoma

Front 27

What common over the counter medication is used to remove excess thick sputum by stimulating the vagus nerve to generate low viscosity secretions in the bronchial tree?

Back 27

Guaifenesin: removes excess sputum but large doses are necessary and it does not suppress the cough reflex
N-acetylcysteine: mucolytic which can loosen mucous plugs in CF patients and is also used as an antidoe to acetominophen overdose

Front 28

What anticonvulsants are used to treat absence seizures? What anticonvulsants are used to treat status epilepticus?

Back 28

Absence seizures: Ethosuxamide (1st line), valproic acid
Status epilepticus: phenytoin (1st line for prophylaxis), benzodiazepam (1st line for acute)