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124 Cards in this Set

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cardiac intercalated discks made of?
fascia adherens and desmosomes (macula adherens)
action potential pattern for cardiac pacemaker?
ph 0--slow upstroke, calcium channel opening; ph3--gradual repolarization from closed Ca channels, open K+ channels; ph4--slow leak of Na until enough of depolarization--> ph0
first choice antiHTN drug for preggers?
methyldopa (decreases sympathetic outflow)
alternatives to aspirin for stroke prophylaxis
ADP inhibitors: ticlopidine, clopidogrel
when does developing fetus start making its blood in bone marrow?
~wk 28 (wk3--yolk sac; wks 7~30 liver; wks9-28 spleen)
cardiovascular structures and blood derived from?
mesoderm
how close PDA medically?
indomethacin (PG E can keep it open--would want in transposition of great vessels)
pheochromocytoma treatment?
alpha antags (phenoxybenzamine)
most common cardiac malformation in Downs
septum primum (ASD defect due to endocardial cushion abnl)
single umbilical artery assoc'd with?
(should be 2); congenital and chromosoma abnl
when should pregnant woman's BP be lowest?
~wk 24. slowly rises after that but should never exceeed pre-preggers level
highest PO2 in fetus is where?
umbilical vein (brings oxygenated blood from mom)
female infant with swelling at nape of neck at birth--?
think Turner's (and coarctation of aorta)
S3 in adults >40y/o?
usually indicative of congestive heart failure
4 classic signs of heart failure in kids, infants?
tachypnea, tachycardia, hepatomegaly, cardiomegaly (NOT peripheral edema--would see in adults)
when do PDAs usually close?
4-8 wks after birth
Job's syndrome characterized by?
increased IgE, repeated staph abscesses, eczema
which leukemia assoc'd with decreased AP?
CML
t(11;18)
marginal zone lymphoma
t(14;21)
robertsonian translocation in Downs
which coagulative factor changes the most in preggers?
fibrinogen
hemolytic uremic syndrome--a)classic triad; b) lab values
a) renal failure, anemia, thrombocytopenia; b) dec'd platelets, schistocytes, nl coagulation (PT, PTT)
which form of AML assoc'd with DIC?
M3 (APL)
which form of AML assoc'd with myelofibrosis?
M1-CML
which form of AML assoc'd with chronic myelomonocytic leukemia?
M4
M5 AML-?
chronic monocytic leukemia
yellowish tinge to skin + PMNs indicative of what kind of anemia?
megaloblastic
warm Ab autoimmune hemolytic anemia often secondary to what dzs?
SLE, Hodgkin lymphoma, non Hodgkin lymphoma
orotic acidemia caused by
AR, mut in pyrimidine synthesis; def: orotidylic pyrophosphorylase orotidylic decarboxylase
infant with severe megaloblastic anemia not reversible by vit B12, folate?
orotic acidemia; will have crystals of orotic acid
aspirated material goes where if a) standing b) supine
a) RLL, lower portion; b) RLL, upper portion
most common cause of fever or pneumonia in <1y/o?
RSV
which IL activates eosinophils?
IL-5
major complication of silicosis?
TB
what happens in PDA?
(L->R shunt) blood from aorta goes to pulmonary trunk (to lungs), exposing low P low R pulmonary circulation to increased P/vol. No hypoxemia. increased pulmonary blood flow and pulm arterial P, PO2
lab findings in sarcoidosis
hypercalcemia/calciuria, hypergammaglobulinemia, inc'd ACE activity
stages of lung development
1. glandular (wks5-17); 2. canalicular (wks13-25); 3. terminal sac (wks24-birth); 4. alveolar (birth-8yr)
in what week of gestation do type II pneumocytes start to secrete surfactant?
wk 35
TB cultured best on?
Lowenstein-Jenson agar
H. influenzae cultured on?
chocolate agar with factors V (NAD) and X (hematin)
None
fungi cultured on?
Sabouraud's agar
Berylliosis--presentation and assoc'ns
hilar adenopathy on CXR; exposure to nuclear weapons, ceramincs, fluorescent lights
Name the organism: catalase(-), alpha hemolysis, resistant to optochin
strep mutans (Viridans strep. strep pneumo also cat(-) and alpha hemolyis but optochin sensitive)
None
Hirschsprung's also assoc'd with what congenital dz?
Down syndrome; 10% of hirschsprungs have Down syndrome
HLA-DQw2 assoc'd with?
celiac sprue
HLA-DR2 assoc'd with
hay fever, MS
HLA-DR4 assoc'd with?
RA
HLA-DR3 assoc'd with?
DM
diarrhea, polyarthralgias, PAS+ macrophages--?
Whipple dz
Plummer-Vinson syndrome
1. cervical esophageal web; 2. mucosal lesions of mouth and pharynx; 3. Fe deficiency anemia
sequelae of Plummer-Vinson syndrome
carcinoma of oropharynx and upper esophagus (e.g. poscricoid carcinoma)
S. American with progressive dysphagia--think?
Chagas dz. paraste can infect neurons--> megacolon, megaesophagus
syndromes assoc'd with pyloric stenosis
Turner's (also coarctation of aorta); Edwards (trisomy 18)
Name the bug: polar flagella, rice water poo
Virio cholerae (>20L/day! grows on TCBS agar)
Name the bug: polar flagella, raw oysters or boating accident
Vibrio vulnificus
Peutz-Jeghers mutation?
(hamartomatous polyps in intestine and buccal pigmentation) SKT-100, a serine threonine kinase
incomplete fusion of lateral body folds-->
protrusion of abdominal viscera in neonate
failure of peritoneal fusion-->
omphalocele
failure of yolk sac degeneration--> ?
Meckel's diverticulum
which hep virus has high mortality in preggers?
Hep E
Name the bug: microabscesses in distal ileum & colon, postinfectious autoimmune arthritis & erythema nodosum
Yersinia enterocolitica
None
Name the dz: 70y/o man w/acute LLQ pain and passage of bright red blood after pain begins (w/in hours?)
acute colonic ischemia (pain not relieved by passage of blood)
None
nephroptosis assoc'd with?
truck drivers, motorcyclists, horseback riders. caused by loss of supporting fat (due to all the jarring/vibration?) around kidney
horizontally riding testicle--think?
testicular torsion (medical emergency!)
management of testicular torsion
doppler scan to check blood flow. then must detorsion
prostate--female counterpart and embryonic origin?
gls of skene; from embryonic genital cords
bartholin glands--male counterpart and embryonic origin?
Cowper's gls; from embryonic genital cords
Muller's tubercle gives rise to?
male: veromontanum; female: hymen
which nerve runs atop spermatic cord?
ilioinguinal (easily injured in inguinal hernia repair)
fibrillary pattern within mesangium and subendothelium--characteristic of what renal path?
amyloidosis
injury to what part of CNS leads to loss of urge to void & overflow incontinence
lateral spinothalamic tract (contains ascending fibers from pudendal, pelvic, and hypograstric nerves)
Sipple's syndrome
MEN IIA--pheochromocytoma, medullary thyroid carcinoma, hyperparathyroidism
phimosis
acquired or congenital; can't pull foreskin back behind glans penis
cremasteric mm of spermatic cord extension of what layer of ab wall?
internal oblique fascia (gives rise to middle spermatic fascia, conjoint tendon, cremasteric mm)
boundaries of Hesselbach triangle
inguinal ligament, inferior epigastric artery, lateral border of rectus abdominus
what calcium channel blocker may cause gingival hyperplasia?
nifedipine
what diuretic might precipitate gouty attack?
furosemide (in addition to inhibiting Na-K-Cl in ascending limb, also increases uric acid reabsorp. in PCT)
what other features assoc'd with exstrophy of bladder
epispadias, widened pubic symphysis
lymph drainage of vagina--a)lower 25% b)upper 75%
a)superficial inguinal nodes; b) internal iliac nodes
embryologic origin of vagina?
dual! upper portion (including fornix)--paramesonephric ducts; lower portion--sinovaginal bulbs
ovarian vessels run though what ligament?
suspensory ligament of ovary
uterine vessels run through what ligament?
transverse cervical ligament; also broad ligament
broad ligament contains what important structures?
uterine vessels, uterine tubules, round ligaments of uterus and ovaries
what important anatomic structures contained w/i round ligament of uterus?
none. but lymphatics run with it (uterus to subQ tissue of labia majora)
umbilical arteries in what ligaments?
median umbilical ligaments
multiple reddish-brown papules on penis of sexually active not old adult?
Bowenoid papulosis
most common presenting complaint of endometriosis?
cyclic abdominal pain
what increases risk of Peyronie's dz?
(=dorsal subQ fibrosis of penis); men with ED who continue to have intercouse at half mast
how would a carcinoma of uterus spread directly to labia majora?
via lymphatics that follow round ligament of uterus
treatment for metastasized prostate cancer?
pharmacologic orchiectomy
how soon do syphilitic chancres usually heal?
2-6 weeks
gestational choriocarcinoma
aggressive malignant neoplasm with inc'd hcG, early hematogenous spread to lungs. (50% preceded by hydatidiform mole)
tubular ducts lined by 1-2layers of nonciliated columnar cells with flattened layer of myoepithelial cells beneath epithelium
papillary hidroadenoma (sharply circumscribed, on/around labia majora, may ulcerate)
anencephaly--what lab findings?
increased alphaFP (NTD); polyhydramnios (b/c fetus can't swallow and reduce amount of uterine fluid)
cerebellum and pons derived from?
metencephalon
metencephalon-->
pons and cerebellum
mesencephalon-->
midbrain
myelencephalon-->
medulla
which toxin acts on Renshaw cells in spinal cord?
tetanus toxin
MOA of black widow venom?
acts on presynaptic side at NMJ to cause massive release of NTs, esp ACh
what toxin binds irreversibly to nicotinic R?
strychnine
hypopigmented "ash leaf spots" on skin--
tuberous sclerosis (also: facial lesions--adenoma sebaceum, cortical and retinal hamartomas, seizures mental 'tardation, etc)
test for fxn of flexor digitorum superficialis
fix other digits and have pt flex middle finger at MCP joint
what nerve root controls a)heel walking b)toe walking c) knee flexion
a)L5; b)S1 c) S2
None
inability to squat suggests what neuro deficit?
L4
Koplik spots
measles! (rubeola)
coryza, conjunctivitis, cough, Koplik spots--
measles (rubeola)
most common route of spread to CNS?
hematogenous
which comes first--wernicke or korsakoff?
Wernicke (ophthalmoplegia, ataxia, confusion); if untreated--Korsakoff (irreversible confabulation)
new onset HA, "graying out of vision", papilledema in overweight 20-50 y/o woman--think?
pseudotumor cerebri--benign intracranial neoplasm; (inc'd ICP, HA, papilledema w/o demonstrable lesion)
Binswanger dz
vascular dementia (due to strokes); usually no "cognitive features" (anomia, apraxia, etc)
methylsergide
serotonin antag--can be used for treatment of carcinoid symptoms
why might a hydatidiform mole cause hyperthyroidism?
lots of hcG and at high enough levels, hcG can stimulate TSH R
major side effect of metformin
lactic acidosis (also: GI side effects and should not be given to renal pts)
what Abs seen often in type 1 diabetes?
glutamic decarboxylase (GAD), pancreatic beta cells
increase in what can cause dry cough in pts on ACE inhibitors?
bradykinin
what test to confirm Addison's?
cosyntropin stim test
Duchenne muscular dystrophy also assoc'd with what congenital syndrome?
congential adrenal hyPOplasia (DAX1 gene); both on X chromosome
"hungry bones" syndrome
transient hypocalcemia after removal of parathyroid adenoma--due to rapid movement of Ca and phosphate back into bones b/c of sudden decrease in PTH
Somogyi effect
phenom of reactive hyperglycemia following period of relative hypoglycemia--get release of hyperglycemia elements (Ne, EPI, etc); (ex: when diabetic given too much insulin in evening)
dawn phenomenon
early morning hyperglycemia due to increased cortisol
why might choriocarcinoma cause gynecomastia?
high hcG can activate aromatase gene--> inc'd conversion of androgen to estrogen (Leydig cell tumor could also cuase gynecomastia but there wouldn't be high hcG)
umbilical hernia + macroglossia + enlarged fontanelles + coarse facial features in neonate--think?
congenital hyPOthyroidism (cretin!) T4 is best test
which anterior pituitary hormones are polypeptide dimers?
TSH, FSH/LH