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100 Cards in this Set
- Front
- Back
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What are the three determining factors of Stroke volume?
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Preload, Contractiity and Afterload
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What factor of stroke volume is affected by a stenotic aortic valve?
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Afterload
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What is the mechanism for compensatory tachycardia and vasoconstriction following standing?
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The baroreceptor reflex
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The activated renin-angiotensin-aldosterone system affects which factor of Stroke volume?
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Preload
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What test is used to diagnose asthma?
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Methacholine challenge
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Respiratory drive in pts w/ COPD is primarily driven by _________
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Hypoxemia --> don't give O2!
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What syndrome is diagnosed by presence of sudden-onset respiratory failure, bilateral diffuse pulmonary infiltrates, severe hypoxemia and coexistence of a disease known to cause it?
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Acute Respiratory Distress Syndrome
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Which type of lung cancer is susceptible to radiation therapy?
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SCC (non-small cell treated with surgery)
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What are the three causes of renal failure?
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hypoperfusion (prerenal), intrinsic (renal), obstruction (postrenal)
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What are the two most common causes of end-stage renal dz?
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Diabetes and HTN?
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What renal problem is characterized by "muddy brown" casts in urine?
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ATN
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What is the level of proteinuria seen in nephrotic syndromes?
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> 3 g qd
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GFR is inversely proportional to and can be measured by _________
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Serum creatinine
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Ang II preferentially vaso______ the __________ arteriole
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Vasonconstricts the efferent arteriole
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Normally, effective circulating volume is regulated by adjusting ________ excretion, whereas osmolality is regulated by adjusting ________ excretion.
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Sodium; Water
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All diuretics lower extracellular fluid volume by inhibiting tubular reasorption of ________
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Sodium
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How long does compensation for respiratory alkalosis take?
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Several days for kidneys to compensate
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What are the 4 most common causes of metabolic alkalosis?
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Vomiting, diuretics, volume depletion, and mineralocorticoid excess
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How is anion gap calculated?
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Na - (Cl + HCO3)
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What is the mnemonic for wide anion gap metabolic acidosis?
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MUDPILES
Methanol, Uremia, DKA, Paraldehyde, INH/Iron, Lactic acidosis, Ethylene glycol, Salicylates |
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What is the characteristic pathogenesis and finding of achalasia?
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Destruction of the myenteric plexus --> bird's beak on barium swallow
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What are the two most common causes of PUD?
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NSAIDs --> gastric ulcer
H. pylori --> duodenal ulcer |
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What are the two major complications of ulcerative colitis?
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Colon cancer and toxic megacolon
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Is sclerosing cholangitis more commonly associated with Crohn's or UC?
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Ulcerative colitis
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Which two elevated enzyme levels would point you in the direction of cholestatic dz?
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ALP and GGT (ALT and AST --> think hepatic)
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Which hepatitis viruses are transmitted via the sexy time?
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B and C (D accompanies B)
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What is the toxic metabolite of Tylenol?
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N-acetyl-p-benzoquinoneimine
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What is the most common pituitary tumor?
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Prolactinoma
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What are the two presentations of growth-hormone secreting tumors (pre and post closure of the epiphyseal plates)?
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pre-closure --> gigantism
post-closure --> acromegaly |
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What are the two mechanism by which cortisol --> hypeglycemia?
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Protein catabolism in muscle to free up AAs (precursors to gluconeogenesis) and lipolysis to free up fatty acids (used for energy source)
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What is the cause of Grave's dz?
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Anti-bodies stimulate TSH receptor
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What is the mechanism by which oral contraceptives prevent a small human from taking up residence in a woman's uterus?
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Estrogen in the OCP's provides constant negative feedback to the Anterior pituitary --> stabilizing FSH and LH secretion --> preventing surges that would lead to ovulation
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What are the 4 thromboembolic phenomena a/w oral contraceptive use and what behavior increases these risks?
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Stroke, MI, PE, DVT increased by smoking
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Why does amenorrhea occur with anovulation?
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No corpus luteum --> no progesterone spike/decline --> absence of menses (remember estrogen grows the grass, and progesterone mows the lawn)
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What is the MOA by which leuprolide places a pt in a state of artificial menopause?
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Constant agonist at GnRH receptors --> inhibition of FSH/LH secretion --> no ovulation/endometrial proliferation
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Why does sickle cell cause deformation of RBCs?
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Insertion of valine for glutamate on 6th codon of beta-globin gene --> less soluble deoxyhemoglobin --> conditions that increase deoxyhemoglobin concentration --> precipitation of hemoglobin in RBCs --> deformation
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In _________ anemias, cell proliferation outpaces hemoglobin synthesis
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Microcytic
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What disease is caused by a defect in the erythrocyte cytoskeleton --> spherically shaped RBCs?
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Hereditary spherocytosis
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What is the compensatory response to hemolysis?
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Reticulocytosis
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What events occur in primary and secondary hemostasis?
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Primary --> platelet plug
Secondary --> coagulation cascade and formation of fibrin plug |
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What are the deficient coagulation factors in Hemophilia A and B?
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A --> def VIII
B --> def IX |
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What is the function of the factor deficient in the most common hereditary bleeding disorder?
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von Willebrand factor --> anchors platelets to subendothelial collagen following vascular injury
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Which drug irreversibly inhibits COX?
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Aspirin
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What disease should you think of when a pt presents with focal back pain without a history of trauma and constitutional symptoms of malaise, unintentional weight loss, and recurrent infections?
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Multiple myeloma
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What is the most common childhood cancer and its presentation?
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Acute lymphoblastic leukemia/lymphoma --> presents with fatigue, night sweats, weight loss and bone pain
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Which disease is associated with 9;22 translocation?
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Chronic Myelogenous Leukemia
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Which disease biopsy reveals the presence of large binucleated cells among other lymphocytes, histiocytes and granulocytes?
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Hodgkin's lymphoma
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What is used to classify the type of a neoplasm?
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The hypothesized cell of origin
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What three factors determine the stage of most solid cancers?
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Size, number of involved lymph nodes, presence of mets
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What causes jaundice?
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buildup of bilirubin in the blood
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What is required for loss of function mutation?
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Two hits of a tumor supressor gene
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Secretion of peptides or antibodies by a neoplasm causes what condition?
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Paraneoplastic syndromes
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Which Ig is a/w immature B cells?
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IgD
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What cells are activated by T helper cells?
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Th1 --> activation of cytotoxic T cells
Th2 --> activate B cells to plasma cells |
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Which surface proteins on T helper cells do class II MHC molecules?
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T-cell receptor and CD4
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What is the mechanism of the 4 types of hypersensitivity?
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Type 1 --> IgE mediated degranulation of mast cells
Type 2 --> cell-bound antigens allow antibody-mediated cytotoxicity Type 3 --> immune complexes lead to complement mediated damage Type 4 --> Th1 cell-mediated damage |
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Which type of anti-psychotics have a high incidence of anticholinergic effects, sedation, and orthostatic hypotension?
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Low potency typicals
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What is the mood stabilizer of choice for bipolar disorder?
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Valproate
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What are the side effects and OD tox of TCAs?
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S/E --> anticholinergic, orthostatic hypotension, and sedation
OD tox --> cardiac arythmias, convulsions, coma and death |
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What receptor is acted upon by alcohol, benzodiazepine, and barbiturates?
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GABA receptor
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What is the typical inheritance pattern for defects in structural proteins?
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AD
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What are the 4 routinely screened newborn diseases which manifeststions can be prevented by early treatment?
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Phenylketonuria, conginetal hypothyroidism, congenital adrenal hyperplasia, and galactosemia
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What is the most common inherited form of mental retardation?
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Fragile X syndrome
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Information from the __________ retina travels to the ipsilateral brain
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Temporal
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What do fragile X and Huntington's have in common?
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Trinucleotide repeat disorders
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What is a "pie in the sky" lesion?
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Contralateral temporal lobe --> temporal visual field radiations
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Which type of glaucoma is an acute, painful, vision-threatening condition?
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Closed-angle
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What eye position is a/w third nerve palsy?
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Down and out
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Are upper or lower motor neuron symptoms exhibited in amyotrophic lateral sclerosis?
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Both
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What is the pathogenesis of Parkinson's disease?
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Destruction of dopamenergic neurons in the substantia nigra --> eliminating projections to basal ganglia
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What is the pathogenesis of Myasthenia gravis?
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Autoimmune destruction of nicotinic receptor on skeletal smooth muscle --> weakness
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In __________, a fluid-filled cavity within the central spinal cord can compress the fibers of the spinothalmic tract
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Syringomyelia
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What are the three most important anastomoses with the esophageal veins/superior rectal veins/paraumbilical veins?
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esophageal veins <--> azygos system
superior rectal veins <--> inferior and middle rectal veins paraumbilical veins <--> superficial epigastric veins |
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Which type of hernia begins lateral to the epigastric vessels?
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Indirect
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The _________ recurrent laryngeal nerve originates from the vagus nerve just inferior to the right subclavian artery. The _________ recurrent nerve originates just inferior to the aorta.
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Right; Left
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What provides lymphatic drainage and arterial supply to the gonads?
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Lymphatics - pre-aortic and para-aortic
Blood - gonadal arteries branched directly from the aorta |
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What are the two types of systemic sclerosis and the difference between the two?
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Scleroderma --> limited amounts of skin and internal organ involvement
Diffuse cutaneous scleroderma --> large areas of skin and extensive internal organ involvement |
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What is the typical manifestation of SLE in the skin and heart?
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Skin --> malar rash
Heart --> pericarditis and Libman-Sacks endocarditis |
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What autoantibody is shared among many of the autoimmune diseases?
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ANA
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Which cells are defective in osteopetrosis, how does this disease affect blood?
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Defective osteoclasts --> thick bone --> crowding out marrow --> anemia
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____ are defined by the presence of leukocytes in the vessel walls and typically present with vague constitutional symptoms, such as fever, fatigue, malaise, myalgias, or arthralgias
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Vasculitides
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What are the two most widely used indicators of the acute-phase protein response?
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ESR and C-reactive protein
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What type of symptoms are typical of vasculitides?
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Vague constitutional symptoms
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What epidemiologic factors typically help distinguish vasculitides?
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Age and Race
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What is important to determine when developing a treatment plan for pneumonia?
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Nosocomial or CAP (different causative organisms)
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Bacterial endocarditis that occurs soon after prosthetic valvular surgery is commonly due to what organism?
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Staph. epidermidis
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What disease should you think of in a patient who recently traveled to New England complaining of flulike symptoms and large erythematous rash with central clearing?
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Lyme Disease (Borrelia burgdorferi)
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What is the gold standard for TB diagnosis?
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Sputum culture growing acid-fast bacilli
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All DNA viruses except __________ contain double-stranded DNA, and all are enveloped except _________, __________ and ________
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Parvoviridae; Parvoviridae, Adenoviridae, and Papovaviridae
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What 3 major organisms are responsible for MOST infections in both children and adults?
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Pneumococcus, Neisseria meningitides, and enteroviruses
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What are the two broad categories of parasites?
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Protozoa (single-celled eukaryotes) and Metazoa (worms)
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How is the mechanism of Amp B and nystatin different from Azoles?
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Azoles --> inhibit ergosterol synthesis
Amp B/nystatin --> bind ergosterol and create pores |
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What affect do prostaglandins have on uterine, vascular and bronchial tone?
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Increase uterine tone, decrease bronchial and vascular tone
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Opioids bind mu receptors and ____polarize the cell
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Hyperpolarize
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What drugs reverse OD on acetaminophen, benzodiazepines, and opioids?
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Acetaminophen --> acetylcysteine
Benzos --> flumazenil Opioids --> naloxone |
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What is the MOA of cardiac glycosides?
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Increase intracellular calcium levels --> increased cardiac contractility
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The __________ of a diagnostic test is a measure of how effectively it can detect a disease in a pt who has a disease; whereas the ________ of a diagnostic test is a measure of how effectively it can detect the absence of disease
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Sensitivity; Specificity
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What is the equation for positive predictive value? Negative predictive value?
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PPV = TP / TP + FP
NPV = TN / TN + FN |
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The _________ reflects the probability that the difference observed between groups could occur by chance alone
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P-value
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In a ________ study, a group of individuals is classified according to exposure and then followed to determine the effect of exposure on disease outcome. In a ________ study, individuals are classified according to the presence or absence of disease, and correlations are made between past exposures and the presence of disease
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Cohort; Case-control
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