Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

154 Cards in this Set

  • Front
  • Back
branchial arch 1 nerve and derivatives
CN V2 and V3: Muscles of Mastication, Mylohyoid, ANTERIOR 2/3 of tongue (sensation from V3, taste from VII), ANTERIOR belly of digastric, TENSOR tympani, TENSOR veli palatini
three clinical presentations of glucagonoma
1) DM; 2) necrolytic erythema (erythematous blisters across abdomnen/groin); 3) anemia
histo appearnce of medullary carcinoma of the thyroid
uniform polygonal / spindle-shaped cells w/ extracellular amyloid deposits; secreted calcitonin forms AMYLOID
histo appearance of anaplastic thyroid cancer
pleomorphic giant cell nests w/ occasional multinucleated cells
pathogenesis of ARDS
diffuse alveolar damage --> NEUTROPHILS --> leaky alveolar capillaries --> protein-rick fluid in alveoli ==> intra-alveolar hyaline membrane
rapid involuntary eye movements and bring, involuntarily twitching muscles; a/w NEUROBLASTOMA
myotonic dystrophy findings
Type I fibers more affected; skeletal myotonia (inability to release handshake, doorknob); CATARACTS in almost all pts. Frontal balding, gonadal atrophy
first signs of normal pressure hydropcephalus (NPH)
gait abnormality and urinary incontinence ==> eventually leads to progressive dementia and emotional blunting; order of sx helps distinguish NPH from alzheimers
Sx of porphyria
5Ps: Pink urine, Painful abdomen, Polyneuropathy, Psych disturbances, Precipitated by drugs
antidote for iron
antidote for lead
CaEDTA, dimercaprol (heavy metal poisoning including Wilson's), succimer, penicillamine (also used for Cu)
antidote for TCAs
NaHCO3 (nonspecific)
antidote for tPA, streptokinase
Aminocaproic acid
Caused by which drugs? Cutaneous Flushing (4)
Niacin, Ca2+ channel blockers, adenosine, vancomycin (red man syndrome)
Caused by which drugs? Torsades de Pointes (4)
TCAs, Class III (sotalol) & class IA (quinidine) anti-arrythmics; cisapride (prokinetic agent, used for GERD, like metaclopramide but diff mech)
Caused by which drugs? Focal to massive hepatic necrosis (4)
Halothane, valproic acid, acetaminophen, Amanita phalloides
Caused by which drugs? Osteoporosis (2)
Steroids, heparin
Caused by which drugs? Fanconi Syndrome
Expired Tetracycline
Caused by which drugs? Hemorrhagic Cystitis (2)
Cyclophosphamide, ifosfamide (can be partially prevented with adjuvant use of Mesna)
Caused by which drugs? Disulfiram-like reaction (5)
Metronidazole, some cephalosporins, nitrofurantoin, griseofulvin, sulfonylureas
clinical signs of infective endocarditis
OSLER nodules (purplish/red subq nodules on fingers/toes); JANEWAY lesions (hemorrhagic painless plaques on palms/soles); PETECHIAE; SPLINTER hemorrhages
methyldopa use, s/e
sympathoplegic used for HTN; can result in positive Coombs test
obesity management; inhibits pancreatic lipase; mimics pancreatitis --> fat malabsorption --> steatorrhea, ADEK defic, OBESITY MANAGEMENT
obesity management; 5-HT/NE reuptake inhibitor --> satiety
pirenzapine, propantheline
antimuscarinic antacids: two actions: 1) --| M1 (ECL cells) --> histamine; 2) --| M3 (parietal cells) --> H+
Ab for HER2/neu -- used in specific breast cancer
valproic acid tox
"george costanza syndrome:" alopecia, weight gain, hepatotoxicity, neural tube defects, nystagmus
phenytoin tox
gingival hyperplasia, hirsutism, megaloblastic anemia (dec folate/b12), p450 induction (Queen Barb uses Phenphen and Refuses Greasy Carbs)
endoderm derivatives
gut tube epithelium and derivatives (lungs, liver, pancreas, thymus, parathyroid, thyroid follicular cells)
ectoderm divisions
surface ectoderm, neuroectoderm, neural crest
surface ectoderm derivatives
epidermis, epithelium of sensory (eyes, nose, ears)
neuroectoderm derivatives
CNS neurons, neuroglia
neural crest derivatives
PERIPHERAL NERVOUS SYSTEM: (ANS, dorsal root ganglia, CRANIAL NERVES, schwann cells, chromaffin cells of adrenal medulla); melanocytes, parafollicular (C) cells of thyroid, odontoblasts (make enamel)
mesoderm derivatives
blood, bones, muscles, connective tissue, lymphatics; SPLEEN, ADRENAL CORTEX, KIDNEYS (organs you could live without)
fetal erythropoesis
3-8wks: yolk sac; 8-28wks: liver and spleen; 28+ wks: bone marrow
aortic arch derivatives
1st: MAXillary; 2nd: Stapedial (Second) and Hyoidal; 3rd: Carotids (C is the 3rd letter of the alphabet): 4th: aortic arch + proximal r. subclavian; 6th: proximal pulm artery (L) and ducturs areteriosus
cleft palate
failure of (medial/lateral) palatine process fusion or nasal septum formation (secondary palate)
embyonic components of diaphgragm
"Several Parts Build Diaphragm": Septum transversum, Pleuroperitoneal folds, Body wall, Dorsal esophageal mesoderm
congenital cardiac defects a/w Child of diabetic mother
Transposition of the great vessels
findings in rheumatic fever
FEVERSS (Fever, Erythema marginatum, Valvular damage, Elevated ESR, Red-hot joints (polyarthritis), Subq nodules, Sydenham chorea)
time of presentation of ostium secundum ASD
late childhood -> 20s; systolic ejection murmur (increased RV volume) and wide fixed splitting of 2nd heart sound
duodenal vs gastric ulcer
DUODENAL: decreased pain after meals/antacids, a/w inc acid production; GASTRIC: pain persists, dec/nl acid production;
"gastric inhibitory peptide / glucose-dependent insulin peptide": secreted by K cells of duodenum in response to all three nutrient classes; EFFECTS: increased insulin release, decreased gastric H+ secretion;
Weil disease/ icterohemorrhagic fever: jaundice, renal failure, hemorrhage
alpha-1-antitrypsin deficiency
A1AT produced in liver, protects lungs from elastase; defienciency causes panacinar emphysema + liver cirrhosis (improperly secreted A1AT accumulates in liver)
side effects of statins
myopathy and hepatitis
germ cell tumors with elevated AFP
yolk sac (endodermal sinus) tumors, maybe embryonal carcinoma; YOLK SAC: aggressive malignancy in babies/kids; histo: Schiller-Duval bodies (primative glomeruli)
schiller-duval bodies
primitive glomeruli-like structures found in YOLK-SAC tumors
name the three benign breast tumors and their defining features
1) FIBROADENOMA (F<25yo, small firm welldemarcated mobile mass, inc size and tenderness during preg); 2) CYSTOSARCOMA PHYLLODES (leaf-like projections); 3) INTRADUCTAL PAPILLOMA (serous/bloody nipple discharge)
what causes fluctuation in TBG (thyroxine binding globulin)
dec TBG in liver failure, inc TBG in pregnancy (estrogen --> inc TBG)
neurofibromatosis increases risk of which cancers
pheochromocytoma, meningioma
Subacute thyroiditis (de Quervain's)
self-limited hypothyroidism following flu-like illness; elevated ESR, **jaw pain**, early inflammation, very tender thyroid gland; can be hypERthyroid at beginning (kinda like jarish-herxheimer rxn)
complications of DKA
MUCORMYCOSIS (Mucor or Rhizospus infection, also seen in leukemic patients, tx mucor with capsofungin); CEREBRAL EDEMA, cardiac ARRYTHMIAS, HEART FAILURE
marfinoid habitus
tall, slender, disporoportionately long arms -- a/w MEN III (MEN IIb)
acid-base compensation for metabolic acidosis
Winter's formula: PCO2 = 1.5 * HCO3 + 8 +/- 2
acid-base compensation for metabolic alkalosis
for every +1 HCO3 --> +0.7 PCO2
acid-base compensation for respiratory acidosis, acute and chronic
a: +10 PCO2 --> +1 HCO3; c: +10 PCO2 --> +3.5 HCO3
acid-base compensation for respiratory alkalosis, acute and chronic
a: -10 PCO2 --> -2 HCO3; c: -10 PCO2 --> -5 HCO3
tumors a/w tuberous sclerosis
cortical tubers, subependymal hamartomas in brain (--> seizures, MR), cardiac rhabdomyomas, facial angiofibromas, ash-leavf patchess
relation of pulm artery to bronchus at each lung
RALS (Right Anterior; Left Superior)
peripheral bronchogenic carcinomas
1) ADENOCARCINOMA (most common); 2) BRONCHIOALVEOLAR (no smoking link); 3) LARGE CELL (undifferentiated)
complications from lung cancer
SPHERE (SVC compression/invasion, Pancoast tumor, causes Horner syndrome (cervical sympathetic plexus dysfunction), Endocrine (paraneoplastic), Recurrent laryngeal symptoms (hoarseness), Effusions (pleural or pericardial)
cytoplasmic inclusions in oligodendrocytes
PML (progressive multifocal leukoencephalopathy)
most common location of ependymomas
infratentorial, roof of 4th ventricle in kids; spinal in adults
what NT initiates sleep, and from where?
5-HT from raphe nucleus
transient attack of extreme gernalized weakness, often precipitated by emotion state; often seen in narcolepsy
opiod contaminant in street drugs -- causes destruction of dopaminegic cells in s.nigra --> parkinsons
sx of parkinson's dz
"TRAPped in your own body:" Tremor (resting), Rigidity (cogwheel), Akinesia, Postural instability
alpha-synuclein in damaged cells
Lewy bodies, found in Parkinson's disease
friedreich's ataxia
AR dz w/ trinucleotide expansion on 9q; causes ataxia, dysarthria, scoliosis, muscle paralysis (lower extremities); a/w hypertrophic cardiomyopathy
werdnig-hoffman disease
degeneration of ANTERIOR HORNS; AR, "floppy baby" -- tongue fasciulations, death < 1y;
viral infection of oligodendrocytes --> demyelination
progressive multifocal leukoencephalopathy (PML), caused by JC virus (a polyoma virus of the Papova family)
MCC severe viral encephalitis
cerebellar tumors in kids
MEDULLOBLASTOMA (v. malignant, rosettes/pseudorosettes, can cause hydrocephalus, primitive neuroectoderm tumors [PNET]); HEMANGIOBLASTOMA (foamy cells w/ high vascularity, a/w VHL, produces EPO); PILOCYTIC ASTROCYTOMA (rosenthal fibers, low-grade tumors, better prog than medulloblastoma)
spinal cord deficit in Friedreich's ataxia
same as vit b12: dorsal columns, lateral corticospinals, spinocerebellars
presentation of CN V motor lesion
jaw deviates TOWARD side of lesion
causes of bell's palsy
ALexander bell with an STD (AIDS, Lyme disease, Sarcoid, Tumor, Diabetes)
complications of uncal herniation
1) CN III (ipsilateral mydriasis from parasympathetic interruption, eventual "down and out"); 2) PCA (contralateral visual field loss); 3) vessel stretch --> DURET hemorrhages (advanced stages); 4) contralateral CRUS CEREBRI (descending corticospinal fibers --> ipsilateral paresis)
pcp intox
VIOLENCE, horizontal nystagmus, homicidality, delrium, HYPERACUSIS
immunodeficiency w/ delayed separation of umbilicus
leukocyte adhesion deficiency (LAD) -- impaired migration of neutrophils b/c of defect in beta-2 integrin --> bacterial infections ('neutrophils needed to "eat up" umbilical stump')
four dimorphic fungi and distinguishing features
SPOROTHRIX (thorn prick --> subq nodules along lymphatics; round cigar-shaped budding yeast); COCCIDIOIDES (SW soil --> TB-like resp infec; 25'C: hyphae w/ doubly reflective wall, 37'C: *spherules* w/ endospores); HISTOPLASMA (miss r., caves--batshit; TB-like infec; 25'C: branching hyphae, 37'C: oval yeast *within macrophages*); BLASTOMYCOSES (miss r., TB-like infec; 25'c: branching hyphae, 37'C: large round yeasts with single broad-based bud)
candida infections (4)
THRUSH in I/C (AIDS, neonates, oral steroids, diabetes); ENDOCARDITIS (ivdu); VAGINITIS (post abx); DIAPER RASH
mechanism of amantadine
binds/inhibits M2 ion channel protein of Influenza A viruses --> blocks viral uncoating after endocytosis
presentation of somatostatinoma
CCK inhibition: gallstones, abd pain, steatorrhea; GI MOTILITY inhibition: constipation
AChEi used in atropine overdose
Physostigmine (crosses BBB --> CNS ==> also used for glaucoma, along w/ echothiophate)
presentation of crohn's vs uc
UC: bloody diarrhea, some abdominal discomfort; crohn's: abdominal PAIN (due to transmural inflammation), non-bloody diarrhea
side efffects of methotrexate
hepatitis, pulm fibrosis, bone marrow suppression
triad of sx in chediak-higashi syndrome
AR: immunodeficiency (defect in neutrophil phagolysosome fusion --> giant lysosomal inclusions); albinism (abnormal melanin storage in melanocytes); neurologic defects (nystagmus, peripheral and cranial neuropathies)
tetrahydrobiopterin (Bh4)
cofactor in synthesis of tyrosine, dopa, serotonin, and nitric oxide
which Ig against Giardia? Which immunodeficiencies?
IgA; X-linked agammaglobulinemia / CVID ==> predipsoed to giardiasis
Porphyria: enzyme defects early vs late in the pathway
EARLY (eg AIP): neuro abnormalities w/o photosensitivity; LATE (eg porphyria cutanea tarda): photosensitivity (light --> porphyrin --> free radical skin damage)
types of benign breast tumors
FIBROADENOMA (MCC <25yo, small, mobile, firm, well demarcated, fluctuates with preg); PHYLLODES (leaf-like projections); INTRADUCTAL PAPILLOMA (serous/bloody nipple discharge)
paget's dz of breast
eczemtaous patch on nipple; paget cells: large cells w/ c lear halo
sx of leptospirosis
Weil disease: hepatic dysfunction --> conjugated hyperbilirubinemia; renal dysfunction; thrombocytopenia
sx of Buerger's disease
thromboangiitis obliterans -- causes vasoocclusion --> claudication, raynaud's, GANGRENE
causes of acute pancreatitis
GET SMASHeD: Gallstones, EtOH, Trauma, Steroids, Mumps, Autoimmune, Scorpion sting, HyperCa/Hyperlipid, Drugs (sulfas)
which cholesterol reducing agents cause hypertriglyceridemia? And what are their other side effects?
bile acid-binding resins (eg cholestyramine): decreased bile acid recycling --> 10x increase bile acid production, concomitant inc in TG and VLDL as well --> elev TG levels; primarily USED WITH STATINS; (can also cause cholesterol stones b/c of inc chol content)
which proteins not bound in PNH?
defect in Pig-A protein which normally binds CD55 and CD59 ==> deficiency allows complement-mediated hemolysis; also causes pancytopenia
ticlodipine: mech, use, tox
MECH: inhibits plt aggregation (blocks ADP receptors irreversibly); USE: acute coronary syndrome, stents, thrombotic stroke; TOX: NEUTROPENIA (not a s/e of clopidegrel, which has same mech)
which CTX require bioactivation?
cyclophosphamide and nitrosoureas (both ALKYLATORS)
phenytoin tox
EYES (nystagmus, diplopia); FOLATE/B12 (megaloblastic anemia, teratogenesis); GROWTH (gingival hyperplasia, hirsutism); SLE-like syndrome, P450 induction
drug used n/v following chemotx; + mech
ondansetron (5-HT3 antagonist)
Caused by which drugs? Gynecomastia (6)
Spironolatone, Digitalis, Cimetidine, chronic Alcohol use, Estrogens, Ketoconazole (Some Drugs Create AwesomeE Knockers)
nitroprusside use, s/e
vasodilator, used for HTN; can cause cyanide toxicity (releases CN)
causes of polyhydramnios
decreased fetal swallowing (duodenal/esophageal/intestinal atresia, or anencephaly) or increased fetal urination (anemia --> high cardiac output, twin-twin transfusion syndrome)
embryonic origin of CNS/PNS support cells
all ectoderm (CNS : neuroectoderm, PNS: neural crest), except microglia (phagocytose, like macrophages --> mesoderm)
McCune Albright syndrome
polyostotic fibrous displasia in little girls: café au lait spots, short stature, precocious puberty
3 features of NF1
1) multiple neural tumors; 2) café-au-lait spots; 3) iris hamartomas (Lisch nodules)
measles vs rubella
both present with rashes that start at head/neck and spread downward; RUBELLA also has generalized lymphadenopathy, esp postauricular and occiptal, with sequelae including polyarthritis and polyarthralgia
complete vs partial mole
complete is diploid, results from androgenesis (sperm fertilizing empty egg), no fetal parts, and 2% progress to choriocarcinoma; PARTIAL: triploid, egg + 2 sperm, fetal parts, rarely progresses to choriocarcinoma
carcinoid tumor, rule of thirds
1/3 metastasize, 1/3 present with 2nd malignancy, 1/3 multiple
tx for carcinoid syndrome
octreotide (somatostatin analog, neutralizes 5-HT)
causes of anion gap metabolic acidosis
MUDPILES (Methanol, Uremia, DKA, Paraldehyde/Phenformin, Iron supplements/INH, Lactic acidosis, Ethylene glycol, Salycilates
causes of non-anion gap metabolic acidosis
diarrhea, glue sniffing, hyperchloremia, renal tubular acidosis (types I, II, and IV)
causes of respiratory acidosis
retention of CO2 b/c of hypoventilation: COPD, acute pulm infection, obstruction, medullary depression (opiods, narcotics), respiratory muscle weakness (guillain-barre, MS, ALS, Polio)
causes of respiratory alkalosis
hyperventilation, aspirin ingestion (early), psychogenic
what do RBC casts in urine suggest? (3)
glomerular inflammation (NEPHRITIC SYNDROMES), ischemia, or malignant HTN
what do WBC casts in urine suggest? (3)
tubulointerstitial disease, acute PYELONEPHRITIS, glomerular disorders
what do granular casts in urine suggest?
acute tubular necrosis (breakdown of necrotic cells); can also see epithelial cell casts in ATN (if not broken down into granular casts)
what do waxy casts in urine suggest?
advanced renal disease / CRF (end product of cast evolution --> must be from low urine flow / stasis); also tend to be larger (b/c of stasis --> dilated ducts)
PFTs in asthma vs emphysema
both COPD so both have dec FEV1/FVC, inc TLC; however, EMPHYSEMA causes destruction of alveoli and adjoining capillary beds --> DECREASED DLCO, while ASTHMA INCREASE DLCO due to increased pulmonary blood volumes
NT changes in Alzheimer's and Tx
dec ACh (from nucleus basalis of Meynert); Tx with AChEi
Gq mechanism
Gq --> PIP2 --> IP3 and DAG; IP3 --> inc Ca++; DAG -->PKC ("I Peed 3 Calciums…. DAG, did you relaly Pee (k) C???")
role of 3-5' exonuclease
proofreading of DNA polymerase III
what does HBV genome look like?
partially double-stranded circular DNA molecule; replication via reverse transcriptase
three clinical presentations of glucagonoma
1) DM; 2) necrolytic erythema (erythematous blisters across abdomnen/groin); 3) anemia
hyaline vs hyperplastic arteriosclerosis
HYALINE is caused by lower levels of essential hypertension, has homogenous deposition of hyaline material in intima/media of small vessels; HYPERPLASTIC: occurs in MALIGNANT hypertension; onion-like concentric thickening of arteriole wall, causes RAS --> more hypertension
Ataxia telangiectasia mechanism
AR, mutation of ATM gene (Ataxia Telangictasia Mutated) -- responsible for DNA break repair ==> hypersensitive to X-ray radiation (caues multiple chromosomal breaks)
immune deficiency in Ataxia-telangiectasia + clinical presentation
IgA deficiency --> upper/lower airway infection
production of 2,3-BPG
happens in RBCs to enable O2 delivery in low blood oxygen conditions; reaction is part ofglycolysis, consumes energy that would have otherwise been generated
insulin signaling pathway
insulin --> tyrosine kinase receptor --> phsphrylatin of "insulin receptor substrate" --> activation of protein PHOSPHATASE --> dephosphorylates glycogen synthase --> activation --> glycogen synthesis
what enzyme responsible for galactose --> galactitol?
aldose reductase
b.anthracis virulence factors (2)
1) EDEMA FACTOR: adenylate cyclase --> inc cAMP; 2) LETHAL FACTOR: stims macrophages to release TNFa
receptors for hypothalamic hormones
all Gq except CRH = Gs (C-RH :: C-AMP)
receptors for pituitary hormones
Gs, except oxytocin and V1 of ADH: Gq
actinic vs seborrheic keratoses
SEBORRHEIC: "stuck-on" appearance, velvety/greasy surface; ACTINIC: erythematous papules with central scaling due to hyperkeratosis --> SANDPAPER-like;
presentation of fibromyalgia vs polymyalgia rheumatica
POLYMYALGIA rheumatica: >50yo; morning stiffness of neck/shoulder/pelvic girdle; a/w wt loss, fever, inc ESR, and temporal arteritis; FIBROMYALGIA: 20-50yo; widespread MSK pain a/w stiffness, paresthesias, poor sleep, and emotional disturbances, exacerbated by exercise; multiple, symmetric, TENDER SPOTS over muscles/joints/tendons
role of alpha and beta adrenergic receptos in insulin control
alpha receptors --> INHIBIT insulin release; beta --> STIMULATE insulin secretion
systemic side effects of general anesthesia
shuts things down (myocardial depression --> hypotension; respiratory depression --> hypercapnia; dec mucociliary clearance --> postop atelectasis; dec cerebral vascular resistance -> INC CEREBRAL BLOOD FLOW --> inc ICP; kidney: dec GFR and RPF; liver: dec hepatic blood flow
what is No mechanism of endothelial relaxtiaion?
NO --> guanylate cyclase --> inc cGMP -- Ca pump --> Ca efflux --> dec MLCK --> myosin dephosphorylation
examples of zero-order drugs
EtOH, phenytoin, aspirin (at high conc)
which beta blockers are partial agonists
pindolol. Labetalol -- useful in hypertension with bradycardia (prevents complete cardiac depression)
venous anticoag in pregnancy
heparin/couamdin (doesn’t cross placenta -- warfarin does)
MTX tox
HEPATITIS, pulm fibrosis, bone marrow suppression, stomatitis
what's tox of c-ara
used to tx AML (c-ARAMEL) ==> "must stop RBC synth" ==> MEGALOBLASTIC ANEMIA
which DNA alkylators can cross BBB; what does that suggest about their use/tox
NITROSOUREAS (eg. -mustine + streptozocin); USE: brain tumors, eg GLIOBLASTOMA MULTIFORME; TOX: CNS (ataxia, dizziness); ["NITROgen goes straight to your BRAIN"]
most common antibiotic used to prevent endocarditis in patients w/ valvular disease
amoxicillin (all but MVP)
drugs that discolor skin
QUINACRINE (antimalarial): yellow; CHLORPROMAZINE/ARSENIC: blue-grey
thioridazine: class, tox
typical antipsychotic; can cause arrhythmias and RETINITIS PIGMENTOSA
which h2 blocker has s/e, and what are they?
cimetidine, p-450 inhibitor, antiandrogen effects, dec creatinine excretion
recombinant IL-2, used for RCC and metastatic melanoma
how to tx bladder urgency in cystitis?
ATROPINE, METHSCOPOLAMINE, oxybutin, glycopyrrolate
theophylline use
PDE inhibitor ==> prevents breakdown of cAMP ==> bronchodilation (asthma); use limited by NARROW TI: cardiotox (arrhythmias) and neurotox (seizures) ["hyperactivity" tox, just like salmeterol]
rod-shaped basal ciliary bodies near nucleus, found in EPENDYMOMAS