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141 Cards in this Set
- Front
- Back
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name of nerve that innervates muscles that abduct and adducts fingers
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ulnar
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peaked T waves on EKG
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hyperkalemia
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part of nervous system damaged in ALS
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motor neurons
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damage to these fibers causes "pie in the sky"
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meyers loop
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likely dx if amniocentesis shows increased hCG
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down's syndrome
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likely dx if amiocentesis shows increased alpha fetoprotein
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neural tube defect
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S. aureus Toxic shock syndrome toxins and mechanism
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TSST-1 and enterotoxin B (incite host immune factors: TNF, IL1)
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genetics of cystic fibrosis
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autosomal recessive (deletion of phenylalanine residue) defective cAMP regulated chloride channel
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genetics of fragile X syndrome
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X linked recessive expansion on CGG trinucleotide repeat
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genetics of sickle cell anemia
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autosomal recessive missence mutation of hemoglobin B subunit (valine for glutamic acid)
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genetics of down syndrome
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meiotic nondisjunction of chromosome 21 pair
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homocysteine increases in what deficiency
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folate deficiency (as well as B12, B6 deficiency)
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ligamentous attachment of distal clavicle torn in dislocation
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acromioclavicular ligament
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some DOCs for tourette's
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pimozide (neuroleptic); clonidine; guanfacine
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cosyntropin stimulation test checks what
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cortisol response to cosyntropin (synthetic ACTH)
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parasite causing African "river blindness"
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O. volvulus (onchocerciasis)
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dog parasite causing blindness
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T. canis (toxocariasis)
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parasite causing cerebral hypoxia due to sticky RBCs
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P. falciparum
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parasite causing keratits in contact lens wearers
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acanthamoeba
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mechanism of cyanide toxicity
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binds Fe+3 and cobalt, inactivating cytochrom oxidase, inhibiting oxidative phosphorylation
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drug approved for tx of cyanide intoxication
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hydroxocobalamin
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mechanism of action for hydroxocobalamin
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binds cyanide to form cyanocobalamin which undergoes renal excretion
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coagulation factors decreased by heparin use
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inactivates thrombin and factors IXa and Xa (primarily neutralizing Xa)
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drug used for prophylaxis of TB in immunocompromised pt
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isoniazid
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drug used for prophylaxis in people who have had contact w/ pts w/ TB
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isoniazid; rifampin
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midshaft humerus crushed from behind, what artery most likely injured
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profunda brachi artery (artery in radial groove)
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what drug used to tx giardia causes a disulfuram-like rxn w/ alcohol
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metronidazole
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auer rod is a clue to what diagnosis
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acute promyelocytic leukemia (AML
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most likely cause of lymphadenitis from bug bite on lower extremity
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wuchereris bancrofti infection (filariasis)
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urea positive breath test most likely due to
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H. pylori infection
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fibrosis of the appendix is most likely due to
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chronic inflammation
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portacaval anastomosis shunting through the paraumbilical veins seen in alcoholics
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caput medusa
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why does pt w/ emphysema purse lips when breathing
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decreased air trapping by creating positive pressure in lungs during exhalation
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pt w/ diabetes insipidus does not respond to desmopressin. this indicates
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nephrogenic diabetes insipidus
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drug for pt who is afraid of public speaking and being in public
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alprazolam
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pt is obsessive about details and a perfectionist but not compulsive w/ rituals or anxious. Dx?
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obsessive compulsive personality disorder
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facial nerve exits the skull via
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stylomastoid foramen
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T4, T3, and TSH levels in graves disease
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elevated T4 and T3 and depressed TSH
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muscle overlying thyroid cut in surgical approach
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platysma
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type of stroke causing vertigo, nausea, tinnitis and syncope
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vertebrobasilar
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causes of abruptio placentae (premature separation)
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trauma, maternal hypertension, clotting abnormalities, cocaine use
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cause of placenta accreta (placenta is retained after birth)
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placental villi penetrate deep into uterine wall
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cause of spontaneous painless bleeding in placenta previa
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low implantation of placenta in uterus; mild contractions cause partial separation of placenta overlying os
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teratogenic effect of warfarin (vit K antagonist)
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nasal cartilage hypoplasia from abnormal osteocalcin due to failed carboxylation of carboxyglutamic acid
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when during pregnancy is folic acid most important and how much
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1st month when neural tube forms (closes day 22); 400 micrograms per day
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most common cause of mental deficiency
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maternal alcohol abuse
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teratogenic effect of smoking and mechanism
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IUGR (intrauterine growth restriction); nicotine constricts uterine blood vessels
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teratogenic effect of exogenous progestin exposure during pregnancy
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hypospadias
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teratogenic effect of mothers exposed to DES diethylstilbestrol
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female babies develop adenocarcinoma of the vagina
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teratogenic effect of tetracycline
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yellow teeth
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teratogenic effect of streptomycin
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deafness
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teratogenic effect of valproic acid
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neural tube defects, facial, heart and limb abnormalities
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teratogenic effect of maternal rubella (german measles)
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deafness, cataracts, cardiac defects
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teratogenic effect of maternal toxoplasmosis infection
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intracranial calcifications and chorioretinitis
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baby has wide spaced, peg-shaped upper central incisors, and abnormal face shape. what was mother infected w/
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syphilis (hutchinson teeth)
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vitamin deficient in pt whose anemia improves w/ FOLATE supplementation but still has peripheral neuropathy
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B12
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dermatome of upper lateral region of arm
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C5 dermatome
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dermatome of palmar pad of thumb
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C6 dermatome
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dermatome of pad of middle finger
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C7 dermatome
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dermatome of pad of little finger
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C8 dermatome
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dermatome of skin on medial aspect of elbow
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T1 dermatome
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neoplasms associated w/ EBV
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lymphomas and nasopharyngeal carcinoma
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characteristic pain in small bowel obstruction
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crampy abdominal pain w/ crescendo-decrescendo pattern
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characteristic pain in mesenteric infarct
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pain that is out of proportion to physical findings
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what causes hematemesis to appear like "coffee grounds"
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conversion of hemoglobin to hematin by hydrochloric acid
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cause of hematemesis in a bulimic patient
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mallory-weiss tear (esophageal)
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cause of massive hematemesis in an alcoholic
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ruptured esophageal varices
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most common causes of hematemesis in pregnancy
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GERD, gastritis, and ulcers
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MOA of amphotericin B (and nystatin)
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binds ergosterol in membrane causing loss of intracellular contents from fungal cell
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MOA of flucytosine
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inhibits thymidylate synthase (conversion of dUMP to dTMP) step of fungal DNA synthesis
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MOA of ketoconazole (and other azoles)
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inhibits fungal p450 enzyme (14 alpha demethylase) blocking demethylation of lanosterol to ergossterol
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MOA of caspofungin
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inhibits fungal cell wall 1,3 D glucan synthesis
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MOA of terbinafine
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inhibits fungal squalene epoxidase decreasing ergosterol synthesis
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MOA of griseofulvin
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disrupts fungal mitotic spindle inhibits mitoses (fungistatic)
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infection causing skin ulceration 2-3 weeks after exposure to contaminated "fish tank" or "swimming pool"
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mycobacterium marinum
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infection causing skin ulceration w/ lymphagenic spreading pattern after "gardening" wound
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sporothrix schenchkii
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most frequent cause of human fungal infection. Characteristic blastoconida and budding yeast (psuedohyphae)
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candidia albicans
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thick gelatinous, encapsulated 5-10 micometers yeast (india ink halo) causing meningioencephalitis and its route of infection
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cryptococcus neoformans; inhalation (common in AIDS)
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septae hyphae w/ acute angle branching forming brown fungal balls in pulmonary cavities
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aspergillus fumigatus
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nonseptae, irregularly wide (6-50 micrometers) fungal hyphae w/ frequent right angle branching in sinuses and lungs
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zygomycosis (mucormycosis)
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infection causing fever and hemolytic anemia from tick bite, forms characteristic "maltese cross" tetrads in RBCs
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babesia microti
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sandfly protozoa causing chronic inflammatory cutaneous, visceral, or mucous membrane infection by infecting macrophages
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leishmania species (donovani)
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slender bloodstream parasites causing large, red, rubbery chancre to form at site of african tsetse fly bite followed by "sleeping sickness"
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trypanosoma brucei
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protozoa causing acute myocarditis following triatomine (reduviid) bug bite dug to amastigote pseudocyst formation
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trypanosoma cruzi (chagas disease)
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worm that penetrates skin, travels to lungs then up the trachea, then is swallowed where it infects the duodenal crypts causing diarrhea. endemic to southeast USA
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strongyloids stercoralis
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seizure illness from ingested eggs or rare pork, w/ characteristic "scolex hooklets". think of what?
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taenia solium (neurocysticercosis)
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nematode from rare pork that forms cysts in skeletal muscle
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trichinella spiralis (trichinosis)
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necrotizing vasculitis that affects the lungs and kidneys; PR3-cANCA positive
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wegner's granulomatosis
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immunological non-infectious necrotizing vasculitis of small to medium muscular arteries sparing the pulmonary circulation, associated w/ hep B
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polyarteritis nodosa (PAN)
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difference btwn wegeners granulomatosis and polyarteritis nodosum (PAN)
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wegeners affects lungs, PAN does not
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most important piece of information determining type of tx of lung cancer
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are mediastinal nodes involved? if no, then surgical resection; if yes the radiation and chemo
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major predisposing risk factor for hepatocellular carcinoma
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cirrhosis
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viral risk factor for hepatocellular carcinoma
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Hep B, Hep C
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deficiency associated w/ hepatocellular carcinoma
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a1-antitrypsin deficiency
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mineral disorder associated w/ hepatocellular carcinoma
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hereditary hemaochromatosis
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fungal toxin associated w/ hepatocellular carconoma
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aspergillus aflatoxin B1 (causes p53 mutation)
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chemical associated w/ hepatic angiosarcoma
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vinyl chloride
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receives lymph from the gluteal region, lower abdominal wall, perineum, and superficial regions of the lower limb ands superficial tissues of penis and clitoris
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superficial inguinal nodes
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receives lymph glans penis or glans clitoris, labia minora and inferior vagina
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deep inguinal nodes
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lymph from testes drains to
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preaortic and lateral aortic
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hostility, defiance, and disobedience toward authority figures that lasts beyond 6 months
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oppositional defiant disorder
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classic triad of impaired attention, impulsivity and excessive motor activity
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ADHD
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small gram negative bacteria that multiply in host endothelial cell cytoplasm, manifesting vasculitis
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rickettsia
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infection causing high fever, myalgias, nausea, headache and rash appearing first on wrists and ankles, 1-2 weeks after tick bit in america. Dx? tx?
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rocky mountain spotted fever (rickettsia rickettsii); doxycycline
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infection causing high fever, myalgias, nausea, headache and rash, 1-2 weeks after flea bites in rat infested area
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typhus (rickettsia typhi)
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tx of acute asthma in the emergency department
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oxygen and albuterol
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FEV1sec/FVC in COPD
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decreased
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FEV1sec/FVC in restrictive lung disease
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normal to increased
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while viral conjunctivitis can be caused by coxsackievirus, enterovirus, EBV, HSV and HZV, most cases of "pink eye" are caused by
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adenovirus
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common agents of chronic ear infections
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pseudomonas aeruginosa, S. pneumoniae, H. influenze, S. aureus, M. catarrhalis
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hyaline mold associated w/ chronic sinusitis
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aspergillus
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infection causing stridor, drooling, and pharyngitis in a child w/ questionable immunization
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haemophilus influenzae type b (epiglottitis)
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parental and fetal serotypes in erythroblastosis fetalis
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mother is Rh negative, father is Rh positive, baby inherits Rh positive from father
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mechanism of erythroblastosis fetalis
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mother makes anti Rh agglutinins that diffuse through placenta and cause hemolysis in baby (type II)
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signs of erythroblastosis fetalis
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jaundiced and anemic at birth (NOT parvovirus B19. this causes hydropsfetalis)
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tx of neonate w/ erythroblastosis fetalis
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repeated transfusions w/ Rh negative blood
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tx of mother to prevent erythroblastosis fetalis
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Rh immunoglobulin globin, and anti-D antibody that prevents B cell antibody production; give at 28-30 weeks gestation
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failure to maintain self-tolerance resulting in anti bodies to self constituents w/ facial rash exacerbated by UV light
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SLE (systemic lupus erythematous)
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cytokine mediators of fever
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TNF, IL1 and PGE2
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indirect mediator of bronchospasm in allergic pts via activation of sensory nerves
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bradykinin
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stimulates the leydig (interstitial) cells of the testes to produce testosterone by inducing formation of sterol carrier proteins that shuttle cholesterol to the outer mitochondrial membrane
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LH
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this hormone stimulates the sertoli cells to synthesize androgen binding protein, aromatase, growth factors and inhibins
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FSH
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function of progestin in oral contraceptives
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causes negative feedback on the pulsing of GnRH by hypothalamus
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Hemophilia A is lacking
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factor VIII
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hemophilia B is lacking
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factor 9
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lab value abnormality in both hemophilia A and B
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prolonged PTT (intrinsic pathway)
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mechanism of DIC in mother when fetus dies
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tissue factor released from dead fetus enters maternal circulation
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HPV types associated most w/ cervical cancer
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16 and 18
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mechanism by which HPV causes cervical cancer
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E6 protein inactivates p53 suppressor gene and E7 protein binds Rb suppressor gene
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vertebral elvel of splenic flexure
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T12 vertebral body
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persistent PDA manifests as what in adults
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pulmonary hypertension resulting in right heart failure (eisenmenger's syndrome)
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enzyme deficiency causing gout (as well as lesch-nyhan syndrome)
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hypoxanthine guanine phosphoribosyl transferase (HGPRT)
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large aggregations of urate crystals surrounded by an intense inflammatory reaction of macrophages, lymphocytes, and large foreign body giant cells
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gouty tophi
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microscopic appearance of gout crystals
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long needle shaped negatively birefringent
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tx of acute gout
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indomethacin, colchicine, glucocorticoids
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most common primary infection site of cryptococcus and coccidioides
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lungs
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cranial nerve signaling accommodation and pupillary constriction
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CN 3 from edinger-westphal nucleus
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schwannoma occuring at the cerebellopontine angle, attached to the vestibular branch of CN8, presenting w/ tinnitus and hearing loss
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acoustic neuroma
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cell that produces primary structure affected by multiple sclerosis
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oligodendrocytes (myelin)
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DOC for adult w/ campylobacter infection
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tetracyclines
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deficiency resulting in lack of inhibition of leukocyte elastase causing emphysema
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a1 antitrypsin
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