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69 Cards in this Set
- Front
- Back
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Major controller of respiration at the medullary center in normal patients...
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PCO2
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Major controller of respiration at the medullary center in long-standing COPD...
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PO2; long-standing hypercapnia blunts medullary response to PCO2 leaving hypoxia as the main controller
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O2 administration with long-standing COPD can be dangerous. Why?
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In these patients, hypoxia has become the major controller of respiration. Sudden administration of O2 may remove hypoxia and thereby remove the only drive to respiration in these patients
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Changes in enzymes following subtotal pancreatectomy...
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All digestive enzymes in excreted in the duodenum are permanently decreased; serum enzymes will return to normal after several months
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D-xylose test...
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Intestinal absorption; used following subtotal pancratectomy. These patients have limited ability to digest polysaccharides, but can absorb monosaccharide normally. If D-xylose is not fully absorbed, the patient has malabsorption
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Pt presents with macrosomia, large jaw, protruding ears, long thin face, MR...
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Fragile X syndrome; 2nd most common cause of cognitive MR (1st is downs); may have autism features
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Genetics of fragile x syndrome...
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Inherited in an X-linked fashion; defect is a increased triplet repeat defect in FMR-1 gene on X chromosome causing a discontinuity of staining on the chromosome ("fragile" appearance)
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Antibody marker of drug-induced lupus erythematosus...
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Anti-histone Ab; may also be ANA positive; remove drug only with clinical symptoms
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Drugs most commonly associated with drug-induced lupus erythematosus...
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hydralazine, isoniazid, phenytoin, procainamide
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Pharmacodynamic alteration associated with drug-induced lupus erythematosus...
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Hepatic Acetylation, particularly slow acetylators
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Side effect of risperidone...
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Hyperprolactinemia (due to its D2 blocking activity), which can lead to ammenorrhea
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Fasting blood sugar at 10 hours is maintained by...
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Glycogen stores; depleted by 12-18 hours
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Fasting blood sugar at 24 hours is maintained by...
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Gluconeogenesis
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Three irreversible enzymes in glycolysis that must be bypassed in gluconeogenesis...
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1. Pyruvate kinase - bypassed by converting pyruvate to oxaloacetate to phohphoenolpyruvate
2. Phosphofructokinase - bypassed by fructose-1,6-bisphosphatase 3. Hexokinase - bypassed by glucose-6-phosphatase |
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Psamomma bodies in CNS tumor...
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Meningioma
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CNS tumor that arises from arachnoid villia; most common presentation is new-onset seizures
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Meningioma
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Connects lateral ventricles to third ventricles...
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Foramen of Monro
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Connects third ventricle to fourth ventricle...
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Cerebral Aqueduct
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Connects the fourth ventricle to the subarachnoid space..
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Lateral foramen of Luschke (2) and medial foramen of Magendie
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Patient presents presents with eczematous rash, MR, and a mousy body odor...
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Phenylketonuria (AR)
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10 y.o. presents 2 weeks after pharyngitis with abdominal pain, arthralgia, renal involvement (hematuria, proteinuria) and palpable purpura...
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Henoch-Shonlein purpura
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Henoch-Shonlein purpura pathophysiology...
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Antigen exposure leads to IgA production and immune complex deposition in blood vessel wall and within the renal mesangium
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Testosterone production has a negative feedback on...
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LH
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Inhibin B production has a negative feed back effect on...
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FSH
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Mechanism of cell death in C. Diphtheria...
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AB-toxin mediated EF-2 ribosylation leads to destruction of epithelial cells (forming pseudomembrane)
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MOA of etoposide...
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Topoisomerase II inhibitor
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15 y.o. presents with portal HTN, Kaisser-Fleishcher rings will have increased serum levels of...
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Ceruloplasmin - Wilson's disease
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Neuropsychiatric effects of Wilson's disease...
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Parkinsonism, rigidity or catatonia, ataxia, slurred speech, personality changes, depression/paranoia
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Definitive diagnosis of Wilson's disease...
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Liver biopsy confirming elevated hepatic copper
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Drug used to treat Trichomona vaginalis or BV with a disulfiram-like effect...
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Metronidazole
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Newborn has hydrocephalus, intracranial calcifications and chorioretinitis...
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Congenital Toxoplasmosis; may also have hepatosplenomegaly, rash, neurologic Sx
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Hypophosphorylated Rb gene is...
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Active, and will stop cell cycle at G1/S checkpoint; hyperphorphorylated is inactive and allows cell cycle to proceed
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Barrett's Esophagus is a precursor to...
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Esophageal adenocarcinoma
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Desmopressin (DDAVP) has efficacy in stopping bleeding in vWF disease by...
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Increasing vWF release from endothelial cells; not beneficial in patients with severe vWF due to a complete absence of vWF
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Advanced atherosclerosis or MI in a very young patient...
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Homocysteinuria; also associated with ectopia lentis, osteoporosis and MR
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Defect in homocysteinuria...
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Most often due to a defect in cystathionine-beta-synthase
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Calcified intracranial mass with cholesterol-rich fluid filling cysts with keratin pearls...
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Craniopharyngioma; due to location, often confused with pituitary adenoma; may cause bitemporal hemianopsia
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Craniopharyngioma is a derivative of...
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Oral ectoderm, Rathke's pouch; shares
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Most common supratentorial tumor of childhood...
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Craniopharyngioma
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Effects of PCP vs. LSD...
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Both are hallucinogens; LSD usually associated with affective lability, delusions and visual hallucinations; PCP tends to produce more belligerence and psychomotor agitation including myoclonic jerks
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2-3 month old presents with fulminant cardiac symptoms - cardiomegaly, tachycardia, cyanosis, dyspnea, vomiting. This is due to a deficiency of...
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Thiamine, vitamin B1; Infantile Beriberi
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Adult presents with symmetrical peripheal neuropathy with sensory and motor impairment. Due to a deficiency of...
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Thiamine, vitamin B1; Dry beriberi
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Adult presents with symmetrical peripheral neuropathy with sensory and motor impairment and cardiac involvement. Due to a deficiency of...
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Thiamine, vitamin B1; Wet beriberi
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Pt presents with night blindness and xerophthalmia and nonspecific dermatologic symptoms...
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Vitamin A deficiency
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Vitamin A is used to shorten the duration of...
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Measels; also improves recovery time from pneumonia and diarrhea
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Renal biopsy shows glomerular capillary wall thickening with no increase in cellularity. EM: irregular dense deposits that appear as spikes on silver stain...
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Membranous glomerulonephropathy; "spikes" are deposits of IgG and C3
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Causes of membranous glomerulonephropathy...
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85% idiopathic; SLE, solid tumors (lung, colon), T2DM, gold, penicillamine, NSAIDs, Hep B, Hep C, malaria, syphilis
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Drug that alters bleeding times as follows: increased PT, increased aPT, N/C in TT...
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Rivaroxaban, Xa inhibitors
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Drug that alters bleeding times as follows: increased PT, N/C in aPTT or TT
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VIIa inhibitors (in development)
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Drug that alters bleeding times as follows: Increase in TT, N/C in PT or aPTT
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Dabigatran, Direct thrombin inhibitors
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Drug that alters bleeding times as follows: Increased aPTT, Increased TT, N/C in PT
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Heparin
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Anticoagulant that alters bleeding times as follows: N/C in PT, aPTT or TT
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Aspirin (COX inhibitors) because they inhibit platelet function
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Artery damaged by fracture at the junction of the frontal, parietal, temporal and sphenoid bones...
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Middle meningeal artery; pterion fracture
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Vascular origin of the middle meningeal artery...
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External carotid - maxillary artery - middle meningeal artery
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"Clasp-knife" spasticity due to lesion at...
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UMN lesion. May be lesion at: corticospinal tract, medulla, pons, midbrain, internal capsule or precentral gyrus
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Best auscultory indicator of severity of mitral stenosis...
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S2 to opening snap time interval
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Mechanism of gynecomastia in cirrhosis, associated symptoms...
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Hyperestronism due to inability of liver to break down circulating estrogen. Also the mechanism of formaiton of spider angiomata, testicular atrophy and decreased body hair in males
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Pt presents on prolonged fast with hypoglycemia and few ketone bodies. Defect...
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Deficiency of Acetyl-CoA Dehydrogenase prevents production of ketone bodies in prolonged fasting, resulting in over-utilization of glucose.
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Lung biopsy in suspected TB patient shows giant multinucleate cells with nuclei in a horseshoe shape. Formed by...
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Macrophages activated by CD4+ T-cells; Langhans giant cells
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Measurement of Renal Plasma Flow...
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PAH
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PAH in the kidneys is...
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Freely filtered by glomerular filtration and excreted by renal tubules; renal tubular secretion is a saturable process
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Pt presents with enlarged hilar lymph nodes; culture shows Gm+ rods in a medusa head configuration.
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Bacillus anthracis; associated with hemorrhagic mediastinitits, bloody pleural effusions, progressing to sepsis and death
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Bacteria with D-Glutamate capsule...
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B. Anthracis; required for pathogenicity
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Treatment of C. Diphtheria...
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In this order: Diphtheria Antitoxin (passive immunization), penicillin or erythromycin, DPT vaccine
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Pt presents with restlessness, agitation and dysphagia progressing to coma 30-50 days after going cave exploring...
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Rabies Encephalitis
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Rabies vaccine is...
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Killed-virus vaccine, recommended only for high-risk individuals
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Follicular lymphoma is composed of...
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Non-hodgkin's lymphoma of cleaved and non-cleaved B-lymphocytes in the follicular center
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t(14;18) is associated with what disease? What genetic change?
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Follicular lymphoma; moves bcl-2 gene near Ig enhancer gene resulting in anti-apoptotic activity (proto-oncogene)
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Culture shows Gm+, non-motile, non-encapsulated rods with cytoplasmic metachromatic granules
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C. Diphtheria
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