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69 Cards in this Set

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