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78 Cards in this Set
- Front
- Back
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True or False
A disease that has LESS glutamate to the cortex = hyperkinetic disorder? |
False
Causes HYPOkinetic disorder (Parkinsons) |
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What is the cause of Parkinson's disease?
What is the pathologic hallmark? |
Neurodegeneration of SUBSTANTIA NIGRA (pars compacta)
Presence of cytoplasmic inclusions in the substantia nigra called LEWY bodies |
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What are the 4 main symptoms of Parkinsons?
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T - Resting Tremor
R - Rigidity A - Akinesia (disabling) P - Postural instability |
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What is the primary neurotransmitter in the striatum?
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Acetycholine
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What blood test detects human anti-red cell antibodies on patients RBC's?
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Direct Coombs Test
The indirect Coombs Test, detects human anti-red cell antibodies in pt. plasma/serum |
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True or False
An Rh - mother with an Rh + baby will have a positive direct Coombs test & a negative indirect Coombs test? |
False
Will have negative direct Coombs And positive indirect Coombs |
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True or False
In thalassemia you have defective RBC's because of a mutation in an amino acid of one of the side chains |
False
Mutation causes decreased synthesis, but chain itself is normal! |
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In a ventricular pressure volume loop, will increasing after-load give you a taller or smaller box?
Will it have a larger or smaller SV? |
Taller box
Narrower box b/c SV is reduced |
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What are the four features of Multiple Sclerosis?
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Multiple Myelinoclastic lesions in CNS
Does NOT involve myelin of PNS Protracted clinical course Periods of relapses & remissions |
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True or False
Axons are damaged in early plaques of MS patients? |
False, they are NOT damaged
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What is the most common cause of progressive multifocal leucoencephalopathy?
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JCV polyoma virus
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What kind of fibers are spared in leykodystrophies?
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U-fibers
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What disease is characterized by having metachromatic macrophages?
What lysosome deficiency do they have? |
Metachromatic leukodystrophy
Aryl Sulfatase A Deficiency |
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What demylinating disease is characterized by having large, globoid macrophages in white matter?
What lysosme deficiency do they have? |
Globoid leukodystrophy (Krebbe's dz)
Galactocerebrosidase beta galactosidase deficiency |
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Oligobands in the CSF is indicative of what disease?
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Multiple Sclerosis
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Where is B12 absorbed?
Where is folate absorbed? Where is Iron absorbed? |
Ileum
Jejunum Deuodenum |
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What 2 drugs may cause folate deficiency?
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DPH (diphenylhydantoin) - Dilantin
Phenytoin |
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In what 3 conditions does one have an increased need for folate?
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Pregnancy
Hemolytic anemia Neoplasia |
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What is the most serious potential side effect of spironolactone?
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Hyperkalemia
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What drug used in the treatment of CHF will cause a cough?
What class is it in? How does it produce a cough? |
Enatapril
RAAS Inhibitors Cough is due to accumulation of bradykinin |
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What class of CHF drugs have been shown to be renoprotective?
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Angiotensin Receptor Inhibitors
Valsartan |
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What are the 4 classes of drugs shown to improve survival in patients with heart failure?
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Beta receptor antagonists
ACE inhibitors Spironolactone Hydralazine |
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What is a major event that dramatically impedes LV filling in mitral stenosis?
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Atrial Fibrillation
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What is the first and most common symptom of mitral stenosis?
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Dyspnea on exertion
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How does hemoptysis occur in mitral stenosis?
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When pulmonary capillaries rupture from high hydrostatic pressure
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Does A2-OS interval widen or shorten upon standing?
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Widens
A split S2 narrows upon standing |
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What are the two most common causes of chronic mitral regurg in the US?
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Mitral Valve Prolapse
Coronary Artery Disease |
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True or False
In chronic mitral regurg, the isovolemic phase of systole is prolonged |
False
The isovolemic phase is abbreviated, and the ejection phase is prolonged |
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What organ makes hepcidin?
How does it work? |
Liver
Binds to ferroportin channels in duodenum thus prevents absorption of Fe |
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What are the two most common causes of Iron loss in adult male & postmenopausal females?
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GI ulcers or cancer
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If lab studies show excess free erythrocytic protoporphrin and microcytic anemia what is the cause?
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Iron Defficiency Anemia
Thalessemia also causes microcytic anemia but NO excess of FEP |
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True or False
In Thalessemia you have increased hepcidin? |
False
Does not increases b/c the anemia & hypoxia overrides effect of iron overload |
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What is the only microcytic anemia with elevated reticulocyte count?
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Thalassemia
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Basophilic stippling of red cells is indicative of what?
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Lead Poisoning
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True or False
Marrow folate reserves are frequently low in chronic hemolytic anemia? |
True
b/c of marked erythropoiesis |
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What are the 5 major causes of extrenisic hemolytic anemia?
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C - Chemical Agents (toxins)
A - Antibodies (autoimmune) P - Physical agents (burns) I - Infections (malaria, borrelia) T - Trauma (schistocytes - DIC) |
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In a RBC disease that have decreased CD55 & CD59, would you expect the leukocyte alkaline phosphatase to be increased or decreased?
What disease is this? |
Decreased
Paroxysmal Nocturnal Hemoglobinuria |
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What drug is the most effective for treatment of tremor in a patient with Parkinson's?
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Trihexyphenydyl
Benztropine Both are muscarinic antagonists |
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What drug would you use to treat prolactinomas?
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Bromocriptine
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What two drugs have a unique side effect of sudden attacks of sleep?
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Pramipexole
Ropinirole |
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With what PD drug would you have more dyskinesia side effect?
Is confusion also more prominent with this drug? |
Levodopa
No, confusions are seen more in dopamine agonists |
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What Parkinson drug is indicated when there is a "wearing off" effect from other drugs?
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Entacapone
Tolcapone |
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In what three conditions would you find pseudobulbar palsy?
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ALS
Multiple Sclerosis Progressive Supranuclear Palsy |
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If an MRI shows midbrain atrophy w/o pontine atrophy ("hummingbird sign") what would you suspect?
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Progressive Supranuclear Palsy
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What are the 3 compensatory mechanisms to maintain forward cardiac output in chronic mitral regurgitation?
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Decreased LV afterload - b/c is LA pressure
Increased LV preload - b/c volume from LA comes back to LV Eccentric LV hypertrophy-b/c increased preload |
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What is the best tolerated valvular disease?
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Chronic mitral regurg
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What is the first sign that develops in chronic mitral regurg?
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Fatigue with exercise - b/c of decreased forward CO
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Is the apical impulse in chronic mitral regurg, sustained or hyperdynamic?
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Hyperdynamic and displaced laterally b/c of increased SV (b/c of dilatation)
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True or False
The absence of a 3rd heart sound excludes significant regurg? |
True
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What are the two most common complaints of a patient with MVP?
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Palpitations
Sharp precordial chest pain |
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True or False
A patient with intravascular hemolysis will be more jaundiced? |
False
You have more jaundice in extravascular hemolysis |
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What extravascular disease will have a decrease in luekocyte alkaline phosphatase?
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Paroxysmal Nocturnal Hemoglobinuria (PNH)
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What are the drugs of choice to treat chronic mitral regurg?
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Arterial Dilators
Hydralazine |
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True or False
You do NOT have to have both obsessions and compulsions to have OCD |
True
Obsession - Repetitive Thoughts Compulsion - Repetitive Behaviors |
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What is the difference b/w a person with obsessive compulsive personality disorder and one who has obsessive compulsive disorder?
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OCPD - Perfectionist, inflexible, lack emotion
OCD - Obsessions, Compulsions |
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In what anxiety disorder, are biological/neural factors believed to play a key role?
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Obsessive Compulsive Disorder
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Agoraphobia is commonly associated with what personality disorder?
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Panic Disorder
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What neurotransmitter has a negative effect on locus cereulius, thus lowering anxiety?
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Serotonin
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True or False
In a person with syphillis the serum VDRL test will always be positive if the pt. has the infection? |
False
Negative during the chancre stage!!! |
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What is the largest of the spirochetes?
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Borrelia
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What is the host of tick borne relapsing fever?
What organism? |
Ornithodoros species
Borrelia hermsii |
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If a patient presents with sudden fever with chills that goes away and come back a week later what organism would you suspect is causing the infection?
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Borrelia hermsii
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If a patient presents with a erythema migrans and sudden arthritis intense joint inflammation, what genus is the host for the organism causing this disease?
What is the organism causing the disease? |
Ixodes scapularis (in east), Ixodes pacificia (in west)
Borrelia burgdorferi |
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What unique adaptation does the organism causing lymes disease have, which suppresses T cell activation?
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OspA & OspC
Acquired from tick protein |
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What is the only spirochete to have an outer envelope with LPS?
When should you check their urine? |
Leptospira
After first week of infection |
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What are the 3 most common causes of metastatic tumors to the brain?
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Lung carcinoma
Breast carcinoma GI carcinoma |
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True or False
A decrease in afterload prolongs the murmur of MVP but decreases its intensity because the amount of regutant flow decreases |
True
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What are the two common complications of MVP?
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Increased embolic events
Infective endocarditis |
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What is the most common cause of infective endocarditis?
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MVP
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What is the initial compensatory mechanism that maintains forward cardiac output in aortic stenosis?
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Concentric LV Hypertrophy
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What two physical manifestations develop in advanced cases of aortic stenosis?
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Myocardial ischemia
Angina Pectoris |
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What is the "triad" of findings in aortic stenosis?
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Angina
Dyspnea on exertion Syncope during exertion |
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What maneuver will decrease the intensity of an early systolic murmur?
What maneuver will increase the intensity of an early systolic murmur? What maneuver makes this murmur louder? |
Valsalva - b/c decreases preload
Amyl nitrate - b/c decreaes afterload Squatting b/c increases preload & afterload This is in aortic stenosis |
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What are the two most common causes of chronic aortic regurg?
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Essential Hypertension
Bicuspid Aortic Valve |
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In what valvular disease is the diastolic pressure less than normal?
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Aortic Regurg
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What is the initial compensatory mechanism that sustains forward cardiac output in aortic regurg?
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Increase in end-diastolic volume
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In what valvular disease does exercise actually help improve cardiac output?
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Aortic Regurg - bc tachycardia gives less time for regurg to occur
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What is the drug of choice for a patient with chronic aortic regurg?
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Hydralazine - Arterial Dilator
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