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97 Cards in this Set

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how calculate water deficit for 75kg woman with [Na]= 160mEq/L ?
1. find nl body water-- 60% x 75kg= 45L; 2. determine nl [Na] in this woman--45L x 140mEq/L (nl [Na]) = 6300mEq; 3. current TBW= nl body [Na]/current [Na]--6300meQ/160mEg/L = 39L; 4. subtract
what is Nelson's syndrome?
excessive secretion of ACTH from a pituitary adenoma after b/l adrenalectomy to treat Cushing's--> extreme hyperpigmentation (adenoma no longer restrained by cortisol suppression)
edema plus frothy urine suggests?
nephrotic syndrome (urine with high protein is more able to form stable bubbles)
what test reflects basic and higher level cognitive and neuro-sensory functioning of entire brain--good for post CNS trauma evals
Halstead-Reitan battery
significance of riluzole
used in ALS, maybe extends survival/time til tracheostomy; MOA unknown
glioblastoma multiforme characterized by? (stage-esque)
brisk mitotic rate, multifocal necrosis, extreme nuclear pleomorphism (most common and most malignant of primary CNS neoplasms; astrocytoma)
retropharyngeal space between what fascias?
buccopharyngeal fascia and prevertebral fascia
why HTN in adult polycystic kidney dz?
cysts impair perfusion of glomeruli--> JGs release renin
inheritance of NF1?
AD with high penetrance but variable expressivity
maximal ventricular Na+ channel conductance corresponds to what phase of AP and what phase of ECG?
phase 0, QRS interval
lancet-shaped gram positive cocci?
strep pneumo
boundaries of popliteal fossa
biceps femoris (superiorlat); semimembranosus, semitendinosus (superomed); 2 heads of gastroc (inferolat/med)
stage III of HL defined by?
involvement of lymph nodes or extralymphatic organs on both side of diaphragm)
A vs B in staging of HL?
if constitutional sxs--> B; if not--> A
Stave IV of HL defined by?
multiple or disseminated dz foci in extralymphatic organs or tissues
inability to "look down", distinctive axial rigidity, poverty of movement, dysarthric speech but better memory and intellect than initially apparent--> ?
progressive supranuclear palsy (due to widespread neuronal loss and gliosis in subcortical sites)
amyloid assoc'd with chronic hemodialysis?
beta 2 microglobulin (related to high plasma levels)
amyloid assoc'd with neuropathic hereditry syndromes
what is Ames test used for?
to evaluate the mutagenicity of a compound; (bacteria w/mutations that prevent synthesis of his exposed to compound and then plated on his-free medium. How much reversion?)
most common primary site of oral squamous cell carcinoma?
floor of mouth
most common site for development of embryonal rhabdomyosarcoma?
head and neck
clawing of toes with flexion of IP jnts and extension of MTP jnts due to atrophy of what muscles?
lumbricals and interossei
what is mellitin?
found in bee venom, can cause direct degranulation of mast cells--> severe reaction to bee sting
significance of amoxipine?
TCA assoc'd with development of NMS
conditions that can cause enamel hypoplasia (6)
excess fluoride, inadequate calcium, inadequeate phosphorous, vit def (A, C, D); hypothyroidism; hypoparathyroidism
what are aphthous ulcers?
very common and exquisitely painful lesions of oral mucosa; etiology unclear; small necrotic shallow ulcers with erythematous border
"negative" birefringence means
appears yellow when parallel to polarizer, blue when perpendicular
"locked in" syndrome often due to stroke to what artery?
basilar (lg lesions in brainstem, at base of pons)
analgesic indicated for short term management of moderate pain. Similar to morphone but fewer GI and CNS effects; contraindicated for minor or chronic pain; serious ADR: hematologic toxicity
therapy with what can significantly lower ammonia levels?
lactulose--colonic metabolism generates short chain FA which lower the pH and ammonia protonated and trapped in GI
what is daclizumab?
monoclonal Ab with high affinity for IL-2 R on activated T cells
MOA of sirolimus
inhibits T cell proliferation by binding serine-threonine kinase (mTOR) which is necessary for cell cycle progression
small patches of fibrosis and vacuolization of damaged myocytes (usually subendocardial) assoc'd with what heart condition?
repeated episodes of stable angina
most sensitive indicator of recent alcohol abuse?
serum gamma-glutamyltranspeptidase
pec major action?
adduct and internally rotate humerus
what nerve lies in tonsillar fossa?
basophilic rhomboid crystals assoc'd with?
pseduogout, deposition of calcium pyrophosphate crystals
Potter syndrome usually caused by?
failure of ureteric buds to develop.
what percentage of Down syndrome pts have congenital CV dz?
20 percent
treatment of choice for HACEK endocarditis?
ab distension and tendernes + septicish findings in low birth wt baby just started on formula suggests?
necrotizing enterocolitis; would find gangrene of terminal ileum and ascending colon
painless enlargment of testis + elevated LDH suggests?
pathophys of malignant hyperthermia
AD, mutation in ryanodine R-gated calcium channel in SR of sk mm--> increased sensitivty to halothane and depolarizing agents
classic PAN vs microscopic polyangiitis
for one thing, classic is p-ANCA negative but microscopic is p-ANCA positive
delta waves?
low frequency high amplitude waveforms that herald arrival of stage 4 sleep (deepest type of nonREM)
sleep spindles and K complexes characteristic of what stage of sleep?
stage 2
what is Leigh disease?
subacute necrotizing encephalomyelophaty; v rare dz of mitochondrial DNA defect; often cytochrome oxidase def.; muscle and brain particularly affected
what is CagA?
pathogenicity island in dz-causing strains of H. pylori, contains cytotoxin assoc'd gene A and type II secretory system that injects CagA protein into host cells
MOA of mycophenolate mofetil
inhibits purine synthesis; convereted to active metabolite mycophenolic acid which inhibits de novo synthesis of guanine
what thyroid dz --> increased risk of developing thyroid lymphoma?
how does re-epithelialization occur when large areas of epidermis has been lost but dermis intact?
ingroth of epidermal cells from underlying skin appendages (b/c have epi stem cells)
most common side effect for treatment of person with antibodies to Delta agent?
delta agt--assoc'd with active chronic Hep B. treatment is IFN. Side effect--depression
what type of breast cancer has best prognosis?
tubular carcinoma (well-formed tubules often mistaken for benign)
Menkes dz due to?
deficienct cross-linking of collagen fibers secondary to copper deficiency
Menkes dz characterized by?
depigmented lusterless hair, facial deformities (sagging cheeks, ears), depressed nasal bridge, high arched palate, seizure-like activity
multiple localized whorls of CT plus precocious puberty
McCune-Albright syndrome; polyostotic fibrous dysplasi, aslo café au lait (coast of Maine) skin macules
anastomoses b/t foregut arterial supply and midgut arterial supply?
superior pancreaticoduodenal artery (celiac trunk's common hepatic)) and inferior pancreaticoduodenal artery (SMA)
hypnagogic vs hypnopompic hallucinations
hypnagogic--on going to sleep; hypnapompic--on waking
branchial sinus due to?
incomplete obliteration of 2nd pharyngeal cleft
which salivary gland is a)mostly mucinous? B) mostly serous?
a) sublingual glad-mucinous; b) parotid gl-serous (submandibular--mixed)
aprepitant-MOA and use?
NK1 antagonist approved for chemotherapy induced N/V
what is dronabinol?
orally active cannabinoid used for chemotherapy induced N/V
retinal angiomas seen in?
von Hippel-Lindau dz
embolization from infective endocarditis typcially causes?
multiple, small parietal lob abscesses--> defect in spatial recog (depending on dominance)
what is calreticulin?
quality control chaperone in rER that binds misfolded membrane proteins; binds to oligosaccharides containing terminal glucose residues
monoclonal Ab that binds human IgE and prevents release of mast cell mediators, etc. indicated for pts 12ys old+, mod-severe persistent asthma, sxs not controlled with 'roids
name the muscle: arises from medial and lateral processes of calcaneus, inserts into lateral side of 5th toe prox phalanx
abductor digiti minimi (lateral plantar n; helps act as "spring" during walking)
secondary follicle defined by?
formation of antrum (follicular cavity) with several layers of follicular cells
what is confined placental mosaicism
consequence of genetic aberration occurring in trophoblast or in extraembryonic progenitor cellsin inner cell mass-->abnl placental development and intrauterine growth retardation;
uterus smooth muscle has what receptors?
alpha 1 and beta 2
what is a Warthin-Finkeldey giant cell?
a giant cell with eosinophilic cytoplasmic and nuclear inclusion bodies, created by fusion of lymphocytes; pathognoonic for measles/live attenuated measles vaccine
lamellar bodies within macrophages in DIP composed of?
what nerve supplies anterior half of external ear canal?
auriculotemporal nerve (CN V3 branch)
what nerve supplies posterior half of external ear canal?
auricular branch of vagus
what nerve supplies cranial surface of upper part of auricle?
lesser occipital nerve (ventral ramus of C2)
what nerve supplies the lower part of the auricle
greater auricular nerve (C2,C3)
adult polycystic kidney dz--what csome? What gene? What gene product?
csome 16, PKD1 mutation for polycystin 1 (a transmembrane protein involved in cell-matric interactions)
truncal ataxia with headache and h/o smoking suggests?
intracranial lung met to cerebellar vermis
of the -cyclovirs, which has not been indicated for use in immunocompromised?
valacylcovir--b/c assoc'd with TTP and HUS
anti-RNP suggests?
mixed connective tissue dz
general organization of vental horn (lamina IX) wrt prox/distal and ext/flex?
alpha motor neurons to trunk/prox--medial; to distal--lateral; to extensors--anterior; to flexors--posterior
2 principal causes of rapidly progressive glomerulonephritis?
anti-glomerular basement membrane (goodpasture's and isolate anti-GBM) ; and primary systemic vasculitis (Wegener's, microscopic polyarterirts, etc)
mean is greater than median in what kind of distribution?
positively skewed
classic signs of congenital syphilis
cleft palate, rhinitis, desquamating rash
monoclonal abs against what have been shown to ameliorate effects of endotoxin shock?
anti TNFalpha
what is a worry when treating congenital syphilis (or any serious gram negative infection)
Jarisch-Herxheimer reaction--LPS released from bugs--> endotoxin shock (give anti-TNFalpha)
most common site of oral cancer?
lower lip. If in mouth cavity--floor of mouth
initial drug of choice in status epilepticus?
monoclonal antibody against the fusion protein of RSV
tx for RSV in babies?
ribavarin or palivizumab (ab against fusion protein of RSV)
examples of permanent cells in adult human
cardiac myocytes and neurons (have left cell cycle and can no longer undergo mitotic division)
arteriolar rarefaction
dissolution and loss of arterioles believed to result from longterm over-perfusion of tissues; seen in malignant HTN
delayed separation of umbilical cord and omphalitis (infection of cord) are common manifestations of?
leukocyte adhesion deficiency. LAD1--recurrent funaly/bacterial infections ,mutation in gene for C18 beta-2-leukocyte integrin subunit
corneal reflex--afferent? Efferent?
afferent--V1; efferent--facial
decreased ESR seen in?
polycythemia. ESR measures how fast RBC settle out. Also seen in sickle cell and CHF
borderline personality disorder characterized by?
short term psychotic episodes, self mutilation, "splitting", markely unstable interpersonal relationships
serious cardiovascular complications of FXS?
MVP and aortic root dilation