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80 Cards in this Set

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Potter's syndrome
Babies with Potter’s can’t “Pee” in utero. *necessary for lung development

Bilateral renal agenesis →
oligohydramnios →
limb deformities, facial deformities, pulmonary hypoplasia.

Caused by malformation of ureteric bud.
Paget's disease
bone pain with increased osteoclastic bone resorption

increased alk phosphatase levels (↑ ALP)

Abnormal bone architecture caused by ↑ in both osteoblastic and osteoclastic activity.

Serum calcium, phosphorus, and PTH levels are normal.

Mosaic bone pattern; long bone chalk-stick fractures

Can lead to osteogenic sarcoma.
Hemophilia B
X-linked recessive

Factor IX deficiency
Patau's syndrome
Microphthalmia,
microcephaly, cleft
lip/palate

NEEDS FA
A1AT deficiency
Misfolded gene product protein accumulates in hepatocellular ER.

↓ elastic tissue in lungs → emphysema.

PAS-positive globules in liver.

Autosomal recessive.
NK cells
destroy cells w/decreased MHC I particles (virally infected cells do this)
Trazodone
highly sedating anti-depressant

used to treat insomnia or as an adjunct to an SSRI (fluoxetine) when there is depression associated insomnia- b/c SSRIs cause reduced libido, anorgasmia, and delayed ejaculation (SSRI good for pre-ejac)

S/E: priapism, contraindicated in boys
MCC of elevated AFP?
dating error due to underestimation of gestational age

neural tube defects, anterior abdominal wall defects (omphalocele, gastroschisis), multiple gestation
decreased AFP?
Down's syndrome
increased hCG?
Hydatidiform mole or choriocarcinoma
what do the mesonephric ducts turn into
Males->Wolffian ducts -> ductus deferens, epidydimis

Females ->Gartner's ducts
what does the ureteric bud turn into?
collecting system of kidney (collecting ducts, minor and major calyces, renal pelvis, ureters)
What does the metanephric mesoderm turn into?
filtration system of kidney
(glomerulus, bowmans space, proximal tubule, loop of henle, distal tubule, collecting tubule)
characteristics of males w/Fragile X
moderate mental retardation
large ears, long face, prominent jaw
macroorchidism

trinucleotide repeat disorder
characteristics of Klinefelter
47 XXY

MILD mental retardation/normal intelligence
tall male w/ gynecomastia, small testis, and infertility
characteristics of Turners
45 XO

Primary amennorhea
mild mental retardation
webbed neck
shielded chest
ovarian dysgenesis
characteristics of 47 XYY

47 XXX
47 XYY- tall, acne, criminal behavior due to lower IQ

47 XXX- clinically silent
characteristics of Marfans
tall stature
arachnodactyly (long and thin fingers)
ectopia lentis (lens displacement)
dilatation of proximal aorta (dissecting aortic aneurysms)
characteristics of acute dystonia
twisting, involuntary movts
abnormal posture

muscle pains and stiffness
characteristics of tardive dyskinesia
"Tongue"
involuntary perioral movts
(biting, chewing, grimacing, tongue protusions)
characteristics of Akathisia
inability to sit still or remain standing in one place
characteristics of neuroleptic malignant syndrome
delirium, fever, muscle rigidity and autonomic instability

rare, FATAL syndrome

caused by adverse reaction to antipsychotic drugs
characteristics of Acute mania
grandiose delusions (chosen by holy spirit for magnificent purpose)

flight of ideas
characteristics of delirium
confusion or clouding of sensorium

dazed and unclear abt their surroundings

not oriented to time and place

often very difficult to get their attn
MCC of palpitations
anxiety

usu due to any change in heart rate or rhythm
What does an irregularly irregular tachyarrythmia indicate?

What will the EKG show?
Atrial fibrillation

EKG will show absent p waves (b/c coordinated atrial contractions don't occur) and irregularly irregular series of QRS complexes
MCC of Atrial fibrillation?
Binge drinking
Increased cardiac sympathetic tone
Pericarditis
What will EKG show in Afib?
irregularly irregular series of QRS complexes and absent P-waves

P-waves always absent in AF bc coordinated atrial contractions don't occur
pt has Prolonged QT interval?
Torsades, unique form of Vtach

QT interval defines period of ventricular depolarization + repolarization on EKG
pt has High QRS voltage?
ventricular hypertrophy (usu due to untreated chronic HTN)
pt has Prolonged QRS complex?
Bundle branch block

sign of ventricular dyssynchrony or slowed intraventricular impulse conduction
pt has ST elevation?
transmural MI
findings on biopsy of hyperacute renal allograft rejection
vascular fibrinoid necrosis
neutrophil inflammation
infarction of graft
findings on biopsy of chronic renal allograft rejection
occurs months to years after

recipient Abs against graft endothelium

obliterative intimal smooth muscle hypertrophy
fibrosis of cortical arteries
What is the most likely cause of UTIs characterized by dysuria and hematuria, in daycare center outbreaks
Adenovirus causing acute hemorrhagic cystitis (diffuse inflammation of the bladder)
Splitting of S2 that does NOT change w/ respiration?
ASD
Systolic ejection murmur

that is accentuated by standing?
aortic stenosis

hypertrophic obstructive cardiomyopathy
Early diastolic decrescendo murmur that decreases with amyl nitrate
aortic regurgitation
late diastolic murmur eliminated by atrial fibrillation
mitral (and/or tricuspid) stenosis
low pitched holosystolic murmur that increases with maneuvers that increase afterload
VSD
continuous flow murmur
PDA
Ulnar nerve lesions can produce:
• Clawing of the 4th and 5th digits
• Wasting of the hypothenar eminence and dorsal interosseous muscles
• Loss of sensation to the back of the 5th digit and half of the 4th digit
Chagas disease:
• Caused by T cruzi

• Can cause cardiac failure. megaesophagus and megacolon
The highest drop in the pressor is across the
arterioles because they are the segment with the highest resistance (not capillaries!)
What gives the symptoms of Flaccid muscle paralysis, Tachycardia, mydriasis, and elevated body temperature
The botulinum toxin binds to motor neurons and prevents the release of acetylcholine. causing:
• Flaccid muscle paralysis due to deceased Ach stimulation of nicotinic receptors in the neuromuscular junction
• Tachycardia. mydriasis(excessive dilation of pupil). and elevated body temperature due to decreased Ach activity at the muscarinic receptors
Psoriatic arthritis
is similar to rheumatoid arthritis although the process is less destructive

• Psoriatic arthritis is rheumatoid factor-negative and is associated with the HLA-B27 haplotype
Infection by the herpes simplex virus is recognized by
nuclear homogenization (“ground-glass” nuclei). intranuclear inclusions (Cowdry type A bodies). and the formation of multinucleated cells.

When a person is infected, the disease will manifest itself with the appearance of vesicles that ulcerate and cause burning. itching, and pain

Although there are two medications used to treat HSV infections (acyclovir and ganciclovir). only Acyclovir can be used without causing bone marrow suppression
common congenital anomaly that may contain heterotopic gastric mucosa
• Meckers diverticulum
• in the distal ileum about 12 inches from the ileocecal valve
• Heterotopic gastric mucosa can cause abdominal pain
What can cause lower than expected levels of drug even when pt is reporting taking them?
• Chronic alcohol use and cigarette smoking can induce cytochrome P450. which is located in the smooth endoplasmic reticulum of the liver
• This can enhance the metabolism of other drugs. leading to lower than expected plasma levels
What are chemoattractants causing the accumulation of white blood cells?
• C5a attracts to the site of complement activation
• Other chemotactic factors for neutrophils include IL-8. fibrinopeptides, leukotrienes, and forrnyl methionyl peptides from bacteria
Mech of action of Organophosphate insecticides, such as parathion.

Symptoms?
acetylcholinesterase inhibitors

• These agents increase acetylcholine levels at all cholinergic synapses

• Symptoms include bradycardia, increased gastrointestinal motility, increased secretions, miosis, and blurred vision
• Pseudomyxoma peritonei
is produced when a malignant or benign mucus-producing tumor (mucinous cystadenoma or mucinous cystadenocarcinoma) produces gel-like mucus that fills the peritoneal cavity
• The ovaries and appendix are the usual sites for these tumors
the EKG will show intermittent. nonconducted atrial beats not preceded by lengthening AV conduction

What is this?
What is it caused by?
• Mobitz type II AV block

• Metoprolol is a selective beta-1 blocker, but every beta-blocker can cause different degrees of AV blockade
Patient with an ovarian mass (usually a benign fibroma) with hydrothorax and ascites
Meigs syndrome
Low back pain and a stretching or pulling sensation are characteristic of
ascites in some patients (ascites can also be asymptomatic)
Trigeminal nerve
• principal motor nerve supplying the muscles of mastication

• three major branches: ophthalmic. maxillary, and mandibular The ophthalmic and maxillary nerves are purely sensory. The mandibular nerve has both sensory and motor functions

• The motor nucleus of cranial nerve V is located in the mid-pons
Pt presents with the cluster of diarrhea, flushing, and abdominal pain.

how to diagnose?
Carcinoid syndrome

Diagnosis can be confirmed by demonstrating the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in urine.
Direction of tranport for Dynein and Kinesin?
"DR. KA"

• Kinesin: toward the (+) end of microtubule (anterograde)

• Dynein: toward the (-) end of the microtubule (retrograde)
retroperitoneal organs
most of the duodenum, most of the pancreas (except the tail), ascending and descending colon, rectum, anal canal, kidney, adrenal glands, ureters, aorta, and inferior vena cava
What are Anticholinergics such as trihexyphenidyl helpful in alleviating

Side effects
tremors and rigidity associated with Parkinson disease

Antimuscarinic agents block cholinergic tone and can lead to various side effects. including dry mouth, constipation. mydriasis. urinary retention. and decreased sweating
mYdriasis vs. mIosis
mYdriasis vs. mIosis

Y is your pupil so big!!! (pupil is dilated)

I don't notice (pupil is constricted)
Features of Kartagener syndrome include:
• Triad of situs inversus. chronic sinusitis and bronchiectasis.

• Dynein arms of microtubules are missing or defective.

• Ciliary function (mucous sweeping or ciliary elevator functioning. sperm motility. embryonic cell movement) is adversely affected.
Pt comes in with bilateral papilledema. nausea/vomiting. nuchal rigidity, and mental status changes
A tumor (medulloblastoma) blocking the 4th ventricle can block CSF circulation, leading to an increase in the intracranial pressure
What are the symptoms of a pt who has been abusing stimulants such as amphetamines, cocaine, and methamphetamines?

What can be given to tx them?
Stimulant usage can cause agitation, mydriasis. arrhythmias, seizures, psychosis, and hyperthermia

• Acute treatment measures generally involve the use an antipsychotic +1- a benzodiazepine

• Because stimulants are basic substances. acidification of the urine with AMMONIUM CHLORIDE will hasten their elimination
What drug absorbs residual compounds in the stomach after oral ingestion of drugs or poisons
Activated charcoal
What drug chelates iron and increases its clearance from the body
Deferoxamine
What drug induces vomiting and is useful for orally ingested drugs
Ipecac
What drug is an opiate (morphine, codeine, heroin) antagonist
Naloxone
cause of heterophile-positive infectious mononucleosis
EBV
responsible for heterophile-negative mononucleosis
CMV
Downey cells
atypical reactive lymphocytes (CD8+ lymphocytes) that may comprise up to 70% of the white cells in a CBC

associated with EBV or CMV
Cold agglutinins
antibodies that agglutinate red blood cells at 4°C

observed in Mycoplasma pneumonia and autoimmune hemolytic anemia
Koilocyte
found in cells infected with HPV (human papillomavirus)

characterized by perinuclear vacuolization and an enlarged nucleus
Negri bodies
found in neurons infected with the rabies virus and represent sites of virus assembly
Owl’s-eye inclusions
found in cells infected with CMV

CMV is responsible for heterophile-negative mononucleosis.
Side effect of cyclosporine
cyclosporine-induced nephrotoxicity rises with increasing doses and duration of the cyclosporine therapy
the most common cause of nephrotic syndrome in children
Minimal change disease (lipoid nephrosis)

Glomeruli appear normal by light microscopy, but fusion of podocyte foot processes is seen by EM
Associate the following findings with diseases:
• Increased Reid index:

• Apical cavitary lesions:

• Curschmann spirals:

• Elevated sweat salt levels:

• Enlarged hilar glands:
• Increased Reid index: chronic bronchitis

• Apical cavitary lesions: tuberculosis

• Curschmann spirals: asthma

• Elevated sweat salt levels: cystic fibrosis

• Enlarged hilar glands: granulomatous diseases, lymphoma, or tumor
Acute theophylline overdose
can present with early symptoms of sinus tachycardia, tremors, and severe neurologic symptoms such as seizures

Theophylline acts by INHIBITING phosphodiesterase and by ANTAGONIZING ADENOSINE receptors
Tx for Patients with diabetes and hypertension

Mech of action?

S/E?
ACE inhibitors for the management of hypertension since these agents also protect against diabetic nephropathy

• ACE inhibitors block the formation of AT-II which is a potent vasoconstrictor and increase bradykinin levels.

• The ACE inhibitors are associated with the development of angioedema, dry “hacking” cough (due to bradykinin) and hyperkalemia

CONTRAINDICATED w/ bilateral renal artery stenosis